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Objective To explore the value of CT spinal angiography with 256 MSCT and fast dynamic contrast-enhanced 3D MR angiography (CE-MRA) at 3.0 T in the diagnosis of spinal vascular malformations by comparing with results of DSA and operation.MethodsSeventeen patients suspected of spinal vascular diseases by initial MR and clinical manifestations all underwent CT spinal angiography.Of them,10 patients underwent MRA,15 patients underwent DSA within 3-5 days,and 8 patients finally underwent surgical treatment.ResultsCTA examination clearly showed the abnormal vascular lesions in 16 of 17 cases,including 7 cases with the diagnosis of spinal dural arteriovenous fistula,7 cases of perimedullary arteriovenous fistula,and 2 cases of spinal arteriovenous malformations. The results were consistent with the diagnosis of DSA or surgery.One case was poorly diagnosed.The feeding vessels were correctly determined in 12 cases,and the level of fistulas were correctly displayed in 12 cases.The level of fistulas and feeding vessels were accurately showed in 7 of 10 cases with MRA,while the other 3 cases exhibited normal with DSA.ConclusionsSpinal angiography with 256 MSCT and CE-MRA at 3.0 T can clearly show the extent of spinal vascular malformations,feeding arteries and fistula location.They are safe,noninvasive,convinient and can shorten the time of DSA diagnosis and treatment.They play an important role in diagnosis and treatment of spinal vascular malformations and postoperative follow-up.
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Objective To evaluate the correlation between diffusion tensor imaging(DTI)measurements,fiber tracking(FT)and the clinical symptoms in patients with cervical spondylotic myelopathy.Methods According to the Japanese orthopaedics association score(JOA),104 patients with cervical spondylopathy were divided into 4 groups:mild in 31 patients with 13-16 scores,moderate in 27 with 9-12 scores,severe in 25 with 5-8 scores,and serious in 21 with 0-4 scores.According to the lesion signal characters,all patients were divided into 3 groups:Group A with normal signal in both T1 WI and T2WI in 33 patients,Group B with normal signal in T1WI but high signal in T2WI in 30 patients,and Group C with low signal in T1 WI and high signal in T2WI in 41 patients.Apparent diffusion coefficient (ADC),fractional anisotropy(FA),λ1,λ2,λ3 were measured in the spinal cord at the serious pressed section,and fiber tractography was performed.The Spearman correlation analyses was used to correlate each of the DTI measurement with JOA score.Group difference was tested with one-way ANOVA method.Results High quality of DTI was acquired in all patients.The FA values in the mild,moderate,severe,and serious groups were respectively 0.69 ±0.13,0.58 ±0.03,0.46 ±0.08,and 0.37 ±0.11 and significant difference was found in different groups(F =100.59,P ＜ 0.05)and positively correlated with JOA scores (r =0.883,P ＜ 0.05).There was no statistical significance between JOA scores and ADC,λ1,λ2,λ3(r=0.232,0.217,0.113,0.127,P ＞0.05).The FA values in group A,B,and C were respectively 0.67 ±0.33,0.51 ±0.21,0.38 ±0.03,and significant difference was found among different groups(F =50.05,P ＜ 0.05).Decrease of JOA score and high signal in T2 companied with decrease of FA value.Decrease of FA values was found associated with increase of fiber bundle damage.The ADC,λ2,λ3 but not λ1 were significantly different among the JOA groups and the group A,B,and C.Conclusions The FA values are positively correlated with clinical symptoms.Decrease of FA values is found associated with increase of fiber bundle damage.DTI can show the severity and extent of damage of spinal cord in patients with cervical spondylotic myelopathy.
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Objective To investigate the morphological change of intratumoral microvessels after administration of thalidomide in the murine hepatic metastases. Methods Among 20 mice with hepatic metastases created by injection of colon-26 tumor cells into the spleen, 10 were treated with thalidomide (200 mg/kg) by intraperitoneal injection daily, the other 10 were treated with saline only by intraperitoneal injection daily. Fifteen days after inoculation of tumor cell, the intratumoral mierovessel of hepatic metastases with similar size in both groups were studied with in vivo microscopy (26 and 27 neoplasms in experimental group and control group respectively ) and immunohistochemistry for CD34 (52 and 55 neoplasms in experimental group and control group respectively). Two-tailed student t test was used to determine differences in intratumoral microvessel density (MVD), intratumoral branch density (BD) and CD34 positive intratumoral microvessel density (MVD-CD34) between the small ( < 400 μm in diameter) and large metastases in both groups, and that between thalidomide treated group and control group. Results For the control group, although the MVD and MVD-CD34 of larger metastases was more than that of small metastases respectively [(18.1±3.5)% vs (13.0±3.2) %, t =2.840,P<0.01;(22.9±2.8)vs ( 12. 8±2. 5) vessels per field, t = 9. 860, P < 0. 01 ], the BD was similar to that of small metastases [(110.0±20.5)vs(99.7±17.3) branches/rnm2, t = 1.040,P >0.05]. For the thalidomide treated group, despite the MVD-CD34 of larger metastases was more than that of small metastases [ ( 17.4±2. 3)vs (11.5±2. 5 ) vessels per field, t = 8. 770, P < 0. 01], the MVD and BD was similar to that of small metastases respectively [(14.7±3.5)% vs(13.2±3.3) %, t =0.826,P >0.05; (95.3±18.3)vs (97. 1±21. 0)branches/mm2,t=0. 347,P>0. 05]. The MVD, BD and MVD-CD34 of small metastases were similar to each other between two groups ( t = 0. 098, 0. 392,1. 190; P > 0. 05 ), however, that of large metastases were significantly lower in thalidomide treated group than in control group ( t = 3. 140,2. 870, 9. 850;P < 0. 01 ). Conclusions Thalidomide exerts antiangiogenic effect on the hepatic metastases with angiogenesis only, and the different vascular components in the tumor vasculature demonstrate variousresponses to antiangiogenic therapy.
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Objective To investigate the relationship between the expression of tumor apoptosis inhibitory protein(survivin) and the apoptosis induced by arsenic trioxide(As2O3) in transcatheter arterial chemoembolization therapy.Methods Sixteen Japanese big-ear white rabbits with implanted hepatic VX2 tumor at both right and left hepatic lobes were randomly and equally divided into two groups.Three weeks after the tumor was inoculated,1 ml lipiodol(UFLP) and 2 mg As2O3 were injected via hepatic arterial cannulation into the rabbits of study group,while only 1 ml UFLP was used for the rabbits in control group.Three weeks later,all the rabbits were sacrificed,and the tumor tissue,the tumor-neighboring tissue and the normal liver were separately collected and sent for TUNEL staining and examinations,which included the observation of apoptosis of tumor cells and the assessment of the expression of survivin protein.Results In study group,a large number of yellow apoptosis cells was seen in the tumor tissue but no apoptosis cell was found in the tumor-neighboring tissue or in the normal liver tissue.In the control group,no yellow apoptosis cell was observed in the tumor tissue,tumor-neighboring tissue or normal liver tissue.The survivin protein expression rate of the tumor tissue was 100%(16 / 16) in the control group,including strongly-positive in 12 and weakly-positive in 4 rabbits.In contrast,the survivin protein expression rate of both the tumor-neighboring tissue and the normal tissue was 0%.In study group,the survivin protein expression rate of the tumor tissue was 37.5%(6 / 16),including strongly-positive in 2 and weakly-positive in 4 cases,and the survivin protein expression rate of both the tumor-neighboring tissue and the normal tissue was 0%.Significant difference in survivin protein expression rate of the tumor tissue existed between two groups(P