Long-term Brain Tissue Monitoring after Semi-brain Irradiation in Rats Using Proton Magnetic Resonance Spectroscopy: A Preliminary Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In head and neck neoplasm survivors treated with brain irradiation, metabolic alterations would occur in the radiation-induced injury area. The mechanism of these metabolic alterations has not been fully understood, while the alternations could be sensitively detected by proton (1H) nuclear magnetic resonance spectroscopy (MRS). In this study, we investigated the metabolic characteristics of radiation-induced brain injury through a long-term follow-up after radiation treatment using MRS in vivo.</p><p><b>METHODS</b>A total of 12 adult Sprague-Dawley rats received a single dose of 30 Gy radiation treatment to semi-brain (field size: 1.0 cm × 2.0 cm; anterior limit: binocular posterior inner canthus connection; posterior limit: external acoustic meatus connection; internal limit: sagittal suture). Conventional magnetic resonance imaging and single-voxel 1H-MRS were performed at different time points (in month 0 before irradiation as well as in the 1st, 3rd, 5th, 7th, and 9th months after irradiation) to investigate the alternations in irradiation field. N-acetylaspartate/choline (NAA/Cho), NAA/creatinine (Cr), and Cho/Cr ratios were measured in the bilateral hippocampus and quantitatively analyzed with a repeated-measures mixed-effects model and multiple comparison test.</p><p><b>RESULTS</b>Significant changes in the ratios of NAA/Cho (F = 57.37, P<sub>g < 0.001), NAA/Cr (F = 54.49, P<sub>g < 0.001), and Cho/Cr (F = 9.78, P<sub>g = 0.005) between the hippocampus region of the irradiated semi-brain and the contralateral semi-brain were observed. There were significant differences in NAA/Cho (F = 9.17, P<sub>t < 0.001) and NAA/Cr (F = 13.04, P<sub>t < 0.001) ratios over time. The tendency of NAA/Cr to change with time showed no significant difference between the irradiated and contralateral sides. Nevertheless, there were significant differences in the Cho/Cr ratio between these two sides.</p><p><b>CONCLUSIONS</b>MRS can sensitively detect metabolic alternations. Significant changes of metabolites ratio in the first few months after radiation treatment reflect the metabolic disturbance in the acute and early-delayed stages of radiation-induced brain injuries.</p>

Neuroendocrine carcinoma of the breast: mammographic features correlated with sonography and histopathological findings / 中华肿瘤杂志

<p><b>OBJECTIVE</b>The purpose of this study was to describe the X-ray features of the neuroendocrine carcinoma (NEC) of breast to raise the awareness for the disease.</p><p><b>METHODS</b>The mammography, sonography and clinicopathologic features in a total of 16 cases of pathologically proven breast neuroendocrine carcinoma in Fudan University Cancer Hospital were analyzed retrospectively.</p><p><b>RESULTS</b>All the 16 patients were women with a mean age of 67.3 years old (ranged from 45 to 75 years old). Twelve patients had palpable masses and the other four patients had outflow from the nipple. Pathological diagnosis included endocrine ductal carcinoma in situ (E-DCIS) in 4 cases, E-DCIS with microinvasion in 5, and invasive solid neuroendocrine carcinoma in 7. On mammography, 9 of 16 cases exhibited round or slightly lobulated masses. Five of the 16 cases exhibited irregular or asymmetric opacities. Two of the 16 cases had negative findings. The borders of the 14 masses detected on mammography were vague in 7, partly unclear in 3 and clear-cut in 4 cases. Malignant microcalcification was not found in all cases. The accuracy rates of preoperative qualitative diagnosis for NEC with mammography and sonography were 68.8% (11/16) and 81.3% (13/16), respectively. Given the application of combined mammography and sonography, the accuracy rates could be improved to 87.5% (14/16).</p><p><b>CONCLUSIONS</b>A round mass and irregular or asymmetric opacities without malignant calcification are the most frequent appearances of mammography in neuroendocrine carcinoma of the breast. Combination of mammography and sonography may be useful to improve the accuracy of diagnosis and early detection of neuroendocrine carcinoma of the breast.</p>

Common complications due to CT-guided transthoracic aspiration biopsy and the comprehension of puncture / 介入放射学杂志

Objective To analyze the complications due to CT-guided transthoracic aspiration biopsy for pulmonary lesions and discuss the role of puncture skill for reducing the complications.Methods CT- guided transthoracic aspiration biopsy was performed in 116 patients with intrapulmonary parenchymal occupied lesions from June 2006 to June 2007 in our hospital.The complications and the whole process of puncture were analyzed to obtain the experience for reducing the occurrence of complications.Results CT-guided transthoracic aspiration biopsy was succeeded in all 116 cases.The major complications included pneumothorax (15.51%),puncture tract hemorrhage(10.34%),hemoptysis(4.31%)and others(1.72%).Only 1 case of pneumothorax was treated by closed thoracic drainage and no specific treatment for others.Conclusion CT- guided transthoracic aspiration biopsy for pulmonary lesions is an efficient and safe diagnostic modality.The criteria for reducing the complications are associated with accurate localization,the correct breath training and evaluation of lesion before the operation.(J Intervent Radiol,2007,16:847-849)

Diagnostic value of contrast-enhanced fluid-attenuated inversion-recovery MRI for intracranial tumors in comparison with post-contrast T1W spin-echo MRI / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Contrast-enhanced fluid-attenuated inversion-recovery (FLAIR) magnetic resonance imaging (MRI) has been reported to have higher sensitivity for detecting leptomeningeal disease compared with contrast-enhanced T1-weighted MRI (CE T1WI). However, currently there are no studies showing the potential value of clinical applications of contrast-enhanced FLAIR (CE FLAIR) sequence in diagnosing intracranial tumors in a larger group of patients. The purpose of this study was to evaluate the diagnostic value of CE FLAIR in comparison with CE T1WI for intracranial tumors and to provide more information for clinical diagnosis and therapy.</p><p><b>METHODS</b>One hundred and four consecutive cases of intracranial tumors referred for CE brain MRI were analyzed with regard to FLAIR and T1WI pre- and post-administration of Gd-DTPA. The CE FLAIR and CE T1WI were evaluated independently by two radiologists for the number of examinations with one or more enhanced lesions, the number and location of enhanced lesions per examination, signal-to-noise ratio (SNR) and contrast-enhancement ratio (CER) of lesions, as well as the size and extent of the enhanced lesions.</p><p><b>RESULTS</b>In 98 of 104 cases, enhanced lesions were seen both on the FLAIR and T1W images. More lesions were seen on CE T1WI (n = 120) than those on CE FLAIR sequence (n = 117), but no differences of statistical significance were found between the two sequences (P > 0.05). Four lesions were revealed only on the CE FLAIR images whereas 7 lesions were only found on CE T1WI. Enhanced lesions located in the cerebral hemisphere or the forth ventricle were revealed much more on CE T1WI than on CE FLAIR images. However, CE FLAIR images may be useful in showing superficial abnormalities and those located in the sulcus or lateral ventricle. The CER and contrast-to-noise ratio (CNR) on CE T1WI was significantly higher (t = 7.10, P = 0.00; t = 9.67, P = 0.00, respectively), but grey matter/white matter contrast was lower (t = 2.46, P = 0.02) than those on CE FLAIR images. The SNR did not show any statistically significant difference between the two sequences (t = 1.1, P = 0.27). The size and extent of lesions on the CE FLAIR images were significantly larger than those on CE T1WI (t = 4.13, P = 0.00).</p><p><b>CONCLUSIONS</b>CE FLAIR and CE T1WI may complement each other in showing intracranial tumors and the CE FLAIR sequence should be selected as a routine MRI sequence.</p>

Evaluation of MRI in nasopharyngeal carcinoma with cavernous sinus infiltration / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the incidence, MRI characteristics and invasion route of nasopharyngeal carcinoma (NPC) infiltrating the cavernous sinus.</p><p><b>METHODS</b>The data of 141 patients with histologically proven NPC collected from May 2003 to June 2004 were reviewed. All patients were examined by 1.5-tesla superconducting MR unit to evaluate the tumor extent. MR FSE technique was used for T1 WI and T2WI images in the axial plane, followed by FSPGR fat-suppressed gadolinium-enhancement for T1WI images in the axial and coronal sections. All MR images were interpreted and evaluated by two diagnostic radiologists, paying particular attention to the nasopharynx and cavernous sinus infiltration.</p><p><b>RESULTS</b>MR imaging showed infiltration of 49 cavernous sinuses in 39 patients (27.7%). The most common MRI features were enlargement of cavernous sinus with unconventional enhancement (22/49, 44.9%), even with formation of mass inside the sinus (9/49, 18.4%). The other MRI image features were local or diffuse dura mater thickening of cavernous sinus and presence of obscure structure as intra-sinus blurs and hazies inside. The most common infiltration route is through the foramen ovale (18/49, 36.7%), or through both the foramen ovale and foramen lacerum (6/49, 12.2%).</p><p><b>CONCLUSION</b>In NPC patients, MRI invasion is characteristically and clearly shown as changes in the cavernous sinus. Possession of this information is crucial for giving correct treatment. The main infiltrtion route is through foramen ovale.</p>

NEW TYPE EXTERNAL IMMOBILIZATION MATERIAL—THE THRMOPLASTIC SPILINT / 医疗卫生装备

The plastic splint PCL,which is introduced in this article,is a new type of medical exter- nal immobilization material.During the course of its development,the burden has been optimality seeked with regressive orthogonality after screening of the material.Its function has attained the international levels during the eighties.This splint may be used not only in the treatment of burns and various orthopedic conditions,but also in the immobilization of fracture and rehabilation treatment of orthopedic patients etc.