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Objective To investigate MRI manifestations of lumbar and proximal femoral bone marrow changes before and after recombinant human granulocyte colony stimulating factor (rhG-CSF) was subcutaneous injected for healthy adults.Methods Twenty healthy blood stem cell donors without hematologic disease were enrolled in this study. All of them underwent lumbar sagittal and proximal femur coronal MRI examination with spin echo T1 WI and fat-suppressed T2WI.The first examination were performed before subcutaneous injection of rhG-CSF for comparison. In 4-7 days and 30-60 days after injection, the other two examinations were performed. The signal changes of lumbar and proximal femoral bone marrow were investigated by reading pictures and calculating the contrasted noise ratio (CNR).ResultsBefore rhG-CSF injection, all patients presented normal signal intensity of hone marrow. In 4-7 days after injection, all the 20 cases presented homogeneous signal decrease in lumbar vertebral bodys on T1 WI, accompanied by reduced fatty signal. In proximal femur, patchy or stripped hypointensity areas were found in intertrochanteric and subtrochanteric areas on T1 WI. On fat-suppressed T2 WI images, the signal of lumbar and proximal femoral bone marrow changed to equal or slightly-high signal intensity. In all cases,abnormal signal areas presented in lumbar and proximal femoral bone marrow occurred simultaneously in the same case.In the 10 cases received the third MRI during 30-60 days after rhG-CSF injection, signal intensity of lumbar bone marrow turned to normal in all sequence, but abnormal signal intensity areas were still existed and extended to distal part in femoral bone marrow, which appeared as symmetric stripped or patchy equal or slightly-low signal intensity on T1 WI and equal or slightly-high signal intensity on T2 WI. The CNR of lumbar bone marrow to subcutaneous fat before rhG-CSF injection, in 4-7 days and 30-60 days after rhG-CSF injection were 114. 11 ± 15. 11,71.04 ± 12. 25 and 91.64 ± 1 I. 68, respectively. Significant difference was found between before rhG-CSF injection and 4-7 days after injection ( P ＜ 0. 05 ) , but no significant difference between the others( P ＞ 0. 05 ). Conclusion After injection of rhG-CSF, the short-term changes of hematopoietic cells and fat content in bone marrow can be displayed on MRI, which provided non-invasive information for bone marrow transplantation.
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Objective To evaluate X-ray and MRI features of limbs in childhood acute leukemia.Methods Thirteen children with acute leukemia in our pediatric hematology ward were recruited.Allpatients were pathologically diagnosed by bone marrow aspiration and complained of bone or joint pain in the first visit.ConventionaI X-ray and MRI examinations of algesic sites were performed before clinical treatment and after complete remission.MR images were obtained with SE-T1WI,SE-T2WI and T2WI-fat suppressed sequences and symmetria bilateralis was requested while scanning.X-ray and MRI manifestations were evaluated and compared.Resuits All 13 patients had received X-ray examinations.Among them,6 had normal X-ray findings,whereas the other 7(14 sites)showed various abnormalities including radiolucent metaphyseal bands(5 sites),periosteal reaction(3 sites),osteapenia(2 sites),mixed lesions(lysissclerosis,1 site),and permeative pattern(3 sites).The number of patients for MRI examinations was 8(11 sites).Among them,6(9 sites)showed bone marrow infiluration and bone marrow necrosis accompanied by normal X-ray findings,another 2(2 sites)showed bone marrow infiltration associated with radiographic abnormalities of periosteal reaction and radiolucent metaphyseal bands.Four cases were followed up within 1 week when reached complete remission by chemotherapy.MR images features included reduced sizes of bone marrow infiltration lesions associated with increased signal intensity on T1WI,and disappearance of double-line sign on bone marrow necrosis accompanied by signal homogenization.However,the radiograph before and after treatment in the same cases did not differ significantly.Conclusions MRI was earlier and more comprehensive in showing limbs bone marrow abnormality than radiogram in acute leukemia children with chief complaint of osteoarticular pains.MRI might be one of indicators in following up therapeutic effect for AL children with osteoarticular disorder.
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Objective To investigate the value of MRI and~1H-MRS in diagnosis of early stage of diabetic encephalopathy by detecting regional metabolite in cynomolgus diabetes models. Methods Five pathogen-free male adolescent cynomolgus were made type 1 diabetes mellitus models (T1DM) by intravenous injection of streptozotocin (STZ) (100 mg/kg), and the reliability and stability of the modes were assessed with long term follow-up of blood glucose and intravenous glucose tolerance tests. MRI and ~1H-MRS were performed to evaluate the volume, signal intensity and metabolic ratios of NAA/Cr, mI/Cr and Cho/Cr at hippocampus, lateral temporal lobe and occipital lobe 3 years after model establishment. Cortisol in serum was detected with immunoradiometric assay. In addition, 5 normal adult cynomolgus monkeys were selected in the control group and accepted the same examination above. Results ①Intravenous administration of STZ could made stable T1DM monkey model. ②Only mI/Cr ratio increased at hippocampus of diabetic monkeys compared to the control group (P<0.05). ③There was no statistical difference of cortisol in serum between the diabetic group and the control group (P＞0.05). Conclusion ~1H-MRS may detect the metabolic changes of the hippocampus in STZ-induced diabetic adolescent cynomolgus monkeys and may contributes to the early diagnosis of diabetic encephalopathy.
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Objective:To improve diagnostic ability by the evaluation of imaging appearances of solitary plasmacytoma.Meth-ods:Seventeen patients with solitary plasmacytoma confirmed by biopsy or operation were included in our study,whose clinical features and diagnostic imaging appearances were included.Results:Single lesion was found in all cases;Lesions of vertebra in 5 cases,flat bone in 5 cases,pipe bone in 2 cases and outside the bone in 5 cases.The Lesions in bone showed expansive osteolytic with clear border,soft tissue mass nearby,and thin and broken cortical.Vertebra lesions showed lytic destruction and compressed fracture.MRI showed slightly hypointense in T1WI and hyperintense in T2WI with markedly homogeneous enhancement.Lesions outside the bone appeared soft tissue mass with similar density to muscle in CT and X ray,and isointen-sity in T1WI and T2WI with markedly homogeneous enhancement.Lesions in ECT showed medium-to-high nuclide concentration,and in PET/CT showed the increase of glucose metabolize,with SUV 6.3～8.6.About one month after effective chemical therapy,soft tissue mass shrank obviously and new bone appeared,with the decrease of glucose metabolize,and SUV under 2.0.Conclusion:Solitary plasmacytoma often occurs in male,and in younger age and lacks symptoms in the whole body compared with multiple myeloma.Lesions in different regions show different manifestations,but all borders are well defined.CT and MRI can depict the extent of solitary plasmacytoma of bone clearly,but MRI was better in showing bone marrow infiltration range,and showing compression of spinal cord.PET/CT are more suitable in follow-up therapy.
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Objective To study MR imaging features of bone marrow after priming.Methods 11 cases with lymphoma or myeloma alleviated after treatment were administration of recombinant human granulocyte colony-stimulating factor(rhG-CSF)injection.Two regions of bone marrow in L3 and iliac were followed up with T1WI,and STIR fat saturation before treatment(0 week),and 1 week,2 weeks and 4 weeks after treatment respectively.MRI features were observed by three experienced doctors independently and the average results acted as the final result.In the meantime,CNR of marrow and fat were calculated and paired sample test.Statistical process was performed in SPSS 10.0 for Windows.Results In comparison with 0 week,the signal intensity of bone marrow was no changed in all cases one week after intensive chemotherapy,slight high in 5 cases 2 weeks later and obvious low signal intensity in all cases three weeks after priming with rhG-CSF.In comparison with 0 week,CNR was no any different significance at 1 week,2 weeks and 4 weeks.Bone marrow changes in lumber and iliac were parallel except one case at 2 weeks and one case at 4 weeks.Conclusion Obvious low signal intensity of bone marrow is found three weeks after priming with rhG-CSF.
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Objective To evaluate MRI findings and X ray appearance in primary myelofibrosis (PMF) in marrow of lumber vertebra and pelvis. Methods Eleven cases of PMF with integrated clinical and pathology data were collected. All cases were examined with X ray and MRI simultaneously. The imaging findings of PMF were studied and compared with that of normal group. The MRI findings and X ray appearance of cases with PMF were evaluated and compared with each other to find their good quality, the shortcoming, and the relationships. Results X ray appearance in the plain film in cases with PMF: There were no abnormal findings in lumbar vertebra, iliac bone, and superior segment of femur in 5 of 11 cases. Blurred bone trabecula and ground glass changes in bone marrow were found in 3 of 11 cases. In another 3 cases, the bone trabeculas were obscured, tightly closed or mixed together, and the density of bone marrow were widespreadly high, and the difference in it couldn′t be distinguished. MRI findings in cases with PMF: MRI findings in different parts of lumbar vertebrae, iliac bone, and femur superior segments in all 11 cases were consistent. Compared with the control group, both images on T 1 and T 2 weighted spin echo displayed diffusely and well distributed lower signal intensity in 6 of 11 cases, but displayed scattered spot and patchy lowersignals in 5 of 11 cases in all parts of bone marrow including lumbar vertebra, iliac bone, and superior segment of femur. The extents of lower marrow signal intensity varied in different cases. The high signal in femoral head and greater trochanters remained unchanged as that of subcutaneous fat in 4 of 11 cases. The positive rate was 54.6%(6/11)in X ray findings, but 100%(11/11)in MRI appearances. Conclusion MRI has greater value than X ray in the early diagnosis of PMF. The early diagnostic value of X ray plain film for PMF is limited.
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Objective To find the X-ray characteristic and diadynamic method in congenital defect of muscular layer in stomach wall. Methods Six cases confirmed by operation and pathology were collected,underwent eight standing abdomen plain films,underwent 5 decubitus abdomen plain films in 6 cases. Results The appearances in standing plain film of freeing gas under diaphragm, eventration of diaphragm, passing through the whole abdomen of gas and liquid plane, vanished gastriole were found in 6 cases. Superior border of liver was found in 4 cases.The appearances in decubitus abdomen plain films of abdominal distension, increasing gas gathered in umbilical region, vanshed fat line in abdominal wall were found in 4 cases. Conclusion Large part of typical cases could be diagnosis by x-ray and clinical appearance.
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Objective To evaluate the diagnostic value of MRI and X ray and to analyze MRI and X ray characteristics in Med anemia Methods MRI was performed in thoracic spine,lumbar spine, sacral spine,pelvis,and superior femurs in 15 patients with pathologically proved Med anemia with T 1WI and T 2WI Seven of them were examined on X ray Twenty volunteers were examined on MR as control group The authors analyzed the manifestations of MRI in the Med anemia, including abnormality of signal intensity of bone marrow,T 1 value,vertebral alteration of size and shaped, spinal cord compression due to epidural extramedullary haematopoiesis, and compared with the findings of bone on X ray Results In the control group, bone marrow showed an inhomogeneous iso signal intensity with band shaped, triangular or motley high signal intensity in the middle or back part of the vertebra, neck of the femur on T 1WI and a homogeneous iso signal intensity on T 2WI in the vertebra, pelvis, and superior femur All cases with Med anemia had low homogenous signal intensity in the bone marrow of the vertebra, pelvis and superior femur on T 1WI but had no alterations on T 2WI The spinal cord was constricted resulting from protruding crushed vertebra with bullet like shape in 4 cases The soft tissue masses, confirmed as extramedullary haematopoiesis by operation, were demonstrated in 4 cases Among 7 cases with X ray examinations, 2 cases showed normal on X ray but abnormal bone marrow on MRI, another 5 cases demonstrated bone alteration including osteoporosis, widening of striations, enlargement of ribs and vertebras T 1 value showed (897 4?75 43)ms in the Med anemia group and (401 5?28 1)ms in the control group with significant statistical difference ( P
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Objective To evaluate the MRI in the diagnosis of aplastic anemia (AA) and MRI changes after therapy. Methods MR imaging of lumber spine in 16 patients with AA proved pathologically were performed on 0.5 T superconductive MR unit with T 1WI, T 2WI, and STIR, slice thick 5 mm, slice gap 1 mm, matrix 180?256. Thirty cases of normal volunteers were examined as control group. Lumber spines of the two groups were studied by observation of MRI findings, measurement of the T 1 relaxation value. In AA group, the percentage of the hypointense signal areas in the centrum was calculated. Results Three patterns were classified by MR appearance in lumber spine of our cases. MR findings of pattern 1 (2 cases) were hyperintense on T 1WI, isointense on T 2WI, and hypointense on STIR, and all two cases were acute aplastic anemia (AAA). In pattern 2 (7 cases), a few irregular hypointense signals appeared in the background of hyperintense signal on all 3 sequences, and 5 of them were AAA. Pattern 3 (7 cases) demonstrated mixed irregular shape of hyperintense and hypointense signals, all 7 cases were chronic aplastic anemia (CAA). The percentage of the area of hypointense signal in AAA was significantly smaller than that in CAA (t=30 00, P
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0.05). Homogenous or inhomogenous high signal in aplastic anemia were detected with decreased T 1 value. Homogenous iso-intensity was revealed in acute pure red cell aplasia with normal T 1 value. Aplastic anemia and acute pure red cell aplasia had a homogenous signal on T 2WI, their T 1 value showed significant difference (P
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0.05), but insulin sensitivity was actually improved (P