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OBJECTIVE@#To evaluate the correlation of magnetic resonance (MR) T2-weighted image (T2WI) signal characteristics of adenomyosis and the efficacy of high-intensity focused ultrasound (HIFU) ablation.@*METHODS@#Based on the presence or absence of patchy hyperintense foci on preoperative MR T2WI, the patients with adenomyosis undergoing HIFU treatment were divided into homogeneous signal group and heterogeneous signal group, and the heterogeneous group was further divided into heterogeneous hypointense group and heterogeneous isointense group according to signal intensity of the lesions. The patients in heterogeneous signal group were matched with the patients in the homogeneous group at a 1:1 ratio using the propensity score matching, and similarly, the patients in the heterogeneous hypointense group were matched with those in the heterogeneous isointense group at a 1:1 ratio. The non-perfused volume ratio (NPVR) and relief of dysmenorrhea were used to assess the therapeutic efficacy in the 4 groups.@*RESULTS@#A total of 299 patients were enrolled, who had a median preoperative dysmenorrhea score of 7.0 (6.0, 8.0) and a median NPVR of 53.5% (35.4, 70.1)%. After propensity score matching, the NPVR in homogeneous signal group was significantly higher than that in heterogeneous signal group [(60.3 ± 21.8)% vs (44.6±21.6)%, P < 0.05]. At 3, 6 and 12 months after HIFU, dysmenorrhea relief rates were higher in homogeneous signal group than in heterogeneous signal group, and the difference was statistically significant at 12 months (91.1% vs 76.8%, P < 0.05). The NPVR of heterogeneous hypointense group was higher than that of heterogeneous isointense group [(54.0±22.0) % vs (47.3± 22.9) %, P < 0.05]. At 6 months after HIFU, dysmenorrhea relief rate was significantly higher in heterogeneous hypointense group than in heterogeneous isointense group (91.5% vs 80.9%, P < 0.05).@*CONCLUSION@#The signal characteristics of adenomyosis on T2WI are closely related with the outcome of HIFU ablation, and its efficacy is better for homogeneous than for heterogeneous adenomyosis, and better for heterogeneous hypointense adenomyosis than for heterogeneous isointense adenomyosis.
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Female , Humans , Adenomyosis/pathology , Dysmenorrhea , Cohort Studies , Propensity Score , High-Intensity Focused Ultrasound Ablation/methods , Treatment OutcomeABSTRACT
Objective To explore the value of prenatal MRI signs in diagnosis of placenta accreta.Methods MRI data of 163 pregnant women with suspected placenta accreta were retrospectively reviewed.According to the results of cesarean section,they were divided into placenta accreta group (n =136) or without placenta accreta group (n =27).The differencesof MRI signs between the two groups were compared.Taking cesarean section results as the gold standard,the sensitivity,specificity,positive and negative predictive value of MRI signs were calculated,respectively.Results Uterine bulging,abnormal vessels and hypointense T2WI bands at junction of placental and myometrium,as well as uterine recess had statistical differences between the two groups (all P＜0.05).No statistical difference of placental heterogeneity,focal interruptions in myometrial wall,uterine penetration and parametrium implantation nor protrusion of placenta into cervix was found between the two groups (all P＞0.05).The MRI signs of uterine penetration and parametrium implantation,uterine recess,protrusion of placenta into cervix yielded a specificity and positive predictive value of 100％,respectively.Conclusion Prenatal MRI has high efficacy in the diagnosis of placenta accrete.Placenta accrete should be highly suspected especially in the presence of uterine penetration and parametrium implantation,uterine recess and protrusion of placenta into the cervix.
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Objective To investigate the effect of signal characteristics of MR T2WI for predicting HIFU treatment outcome for adenomyosis.Methods According to signal characteristics of MR T2WI before HIFU treatment,502 adenomyosis patients were divided into group Ⅰ (lesions with most hypointense and/or little isointense) and group Ⅱ (lesions with most isointense and/or little hypointense).Then patients in each group were further subdivided into subgroup A (without slightly and extremely hyperintense foci in the lesions),subgroup B (with slightly hyperintense foci in the lesions) or subgroup C (with extremely and/or slightly hyperintense foci in the lesions).The correlation of signal characteristics of MR T2WI for adenomyosis on HIFU ablation results and parameters were analyzed.Results There was no statistical difference of non-perfused volume ratio (NPVR) between group Ⅰ and group Ⅱ (t=-0.504,P=0.612).In both group Ⅰ and group Ⅱ,NPVR of subgroup A was higher than that of subgroup B and subgroup C,respectively (group Ⅰ:LSD-t=2.608,3.677,P=0.009,＜0.001;group Ⅱ:LSD-t=3.255,3.778,P=0.001,＜0.001).There was no statistical difference of NPVR between subgroup B and subgroup C (group Ⅰ:LSD-t=-0.852,P=0.395;group Ⅱ:LSD-t=0.278,P=0.781).There was no statistical difference of sonication time,total ablation energy and energyefficiency factor (EEF) between group Ⅰ and group Ⅱ,respectively (sonication time:t=-1.716,P=0.087;total ablation energy:t=-1.676,P=0.094;EEF:Z=0.044,P=0.965).In both group Ⅰ and group Ⅱ,sonicationtime,total ablation energy and EEF of subgroup A were lower than those of subgroup B and subgroup C (all P＜0.05),while no statistical difference was found between subgroup B and subgroup C (all P＞0.05).Conclusion Signal characteristics of adenomyosis on MR T2WI can be used as predictors of HIFU treatment outcome for adenomyosis.
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Objective To evaluate the therapeutic efficacy and safety of HIFU ablation for uterine fibroids in patients with abdominal surgical scars in acoustic pathway causing acoustic attenuation width ＜10 mm.Methods Totally 861 patients with uterine fibroids were referred for HIFU treatment and underwent contrast-enhanced MR scans before and after HIFU ablation.Among all patients,202 had abdominal surgical scars causing width ＜10 mm acoustic attenuation (abdominal scars group) and 659 had no abdominal surgical scars (without abdominal scars group).The outcomes,intra-operative adverse reactions and post-operative complications between the two groups were compared.Results HIFU ablation was successfully performed in all patients.The volume ablation rate was (80.31 ± 18.16)％ in abdominal scars group and (79.60±17.57)％ in without abdominal scars group (P＝0.620).The rate of ‘hot'skin sensation during HIFU procedure in abdominal scars group (52.97％ [107/202]) was higher than that in without abdominal scars group (41.58％ [274/ 659];P＝0.004).Anterior abdominal wall edema was found in 40 cases (40/202,19.80％) in abdominal scars group and 98 cases (98/659,14.87％) in without abdominal scars group on post-operation MRI (P＝ 0.095).Conclusion Prior abdominal surgical scars in acoustic pathway causing width ＜10 mm acoustic attenuation has not significantly influence on the efficacy and safety of HIFU treatment for uterine fibroid.
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Objective@#Doubled blepharoplasty, which has a various types, is one of the commonest plastic surgery procedures. Incision method has a long-standing result but linear scars can be seen when eyes are closed. So it is necessary to improve this surgerical procedure. The aim of this report is to propose a novel palpebral margin incision technique which avoids scars in the upper eyelid.@*Methods@#15 patients undertook blepharoplasty with palpebral margin incision technique. All the patients in this study were healthy with no other serious diseases. The double-eyelid crease was formed after the operation.The aesthetic results were evaluated based on their satisfaction.@*Results@#All of the patients were satisfied with aesthetic results, and no significant complications occurred. And No obvious regression of the double fold took place.@*Conclusions@#This new method provides an effective way to achieve eyelid reconstruction without obvious scar in the upper eyelid which is of very important clinical significance and makes cosmetic surgery process take a step forward.
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Objective To compare the diagnostic value of MR examination with fast imaging employing steady state acquisition (FIESTA) and single shot fast spin echo (SSFSE) sequences for normal fetal thymuses.Methods Totally 366 normal fetuses were examined using MRI with FIESTA and SSFSE sequences,and the anatomy and MR manifestations of thymuses were observed.Kappa analysis and x2 test were performed.The transverse area (TA) and transverse diameter (TD) were measured on the "three vessel" level,while the superoinferior diameter (SID) was measured on the sagittal level.The mean value of these parameters at different gestational were calculated,and the regression equations of each parameter and gestational age were fitted.Results Two doctors had good agreements with the images of FIESTA and SSFSE sequences (Kappa=0.745,0.802,both P＜0.01).The clear rate of FIESTA and SSFSE sequences was 86.34％ (632/732) and 37.70％ (276/732) respectively,and the differences were significant (x2 =367.520,P＜0.001).The thymic size increased with the gestational age,and the regression equations and correlation coefficients were:TA =-5.80 + 0.35 ×gestational (r=0.820,P＜0.01),TD=-14.59+1.63×gestational (r=0.817,P＜0.01),and SID=-9.63+1.44×gestational (r=0.778,P＜0.01).Conclusion The subtle structure and contour of fetal thymus showed with FIESTA sequence are clearer than those of SSFSE sequence.MRI can clearly show fetal thymus after 22 weeks of pregnancy.
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Objective To compare the diagnostic value of MR examination with fast imaging employing steady state acquisition (FIESTA) and single shot fast spin echo (SSFSE) sequences for normal fetal thymuses.Methods Totally 366 normal fetuses were examined using MRI with FIESTA and SSFSE sequences,and the anatomy and MR manifestations of thymuses were observed.Kappa analysis and x2 test were performed.The transverse area (TA) and transverse diameter (TD) were measured on the "three vessel" level,while the superoinferior diameter (SID) was measured on the sagittal level.The mean value of these parameters at different gestational were calculated,and the regression equations of each parameter and gestational age were fitted.Results Two doctors had good agreements with the images of FIESTA and SSFSE sequences (Kappa=0.745,0.802,both P＜0.01).The clear rate of FIESTA and SSFSE sequences was 86.34％ (632/732) and 37.70％ (276/732) respectively,and the differences were significant (x2 =367.520,P＜0.001).The thymic size increased with the gestational age,and the regression equations and correlation coefficients were:TA =-5.80 + 0.35 ×gestational (r=0.820,P＜0.01),TD=-14.59+1.63×gestational (r=0.817,P＜0.01),and SID=-9.63+1.44×gestational (r=0.778,P＜0.01).Conclusion The subtle structure and contour of fetal thymus showed with FIESTA sequence are clearer than those of SSFSE sequence.MRI can clearly show fetal thymus after 22 weeks of pregnancy.
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At present,the graduate teaching of medical imaging and nuclear medicine is still facing many problems,such as paying more attention to the academic research while ignoring ideological and moral reconstruction,teaching arrangement being unreasonable,poor students' clinical practice ability,lack of scientific training system,and no mature evaluation system and so on.Therefore,in clinical teaching ideological and political education is needed as the guide,to enable students to understand the present medical environment,enhance their doctor-patient communication ability.Besides,in the clinical and scientific research ability cultivation,graduate students' learning enthusiasm should be fully mobilized to promote them to actively explore scientific problems.Furthermore the perfect clinical evaluation method and index system should be combined to assess the quality of training.
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Purpose Ovarian dysgerminoma has no specific symptoms or physical signs, which is thus prone to misdiagnosis before treatment. This paper aims to investigate CT and MRI clinical features of ovarian dysgerminoma, so as to provide an accurate basis for its clinical treatment and also improve patients'' life, quality.Materials and MethodsThe CT and MRI data of 13 patients with ovarian dysgerminoma proved by pathology were retrospectively analyzed. Three patients underwent plain and enhanced CT scan, 6 took plain and enhanced MRI scan on T1WI and T2WI with different angles of views, and 4 other patients were performed both CT and MRI scan.Results①Twelve patients had single lesions, and 1 was bilateral multiple ones. The diameter of the lesions ranged from 5.5 cm to 16.5 cm, with mean of (9.5±3.8) cm; in terms of pathological type, 11 belonged to single type and 2 were mixed.②The CT results showed that 6 were solid mass and 1 was cystic. On enhanced CT scan, 6 cases showed heterogeneous light-to-moderate enhancement, 4 had tumors with significantly enhanced blood vessels, and 1 showed heterogeneous significant enhancement at arterial phase; all cases presented continuous enhancement at venous phase.③The MRI manifestations demonstrated 8 were with solid mass, which displayed iso- or slightly hypointense signal on T1WI, and iso- or slightly hyperintense signal on T2WI. The enhanced scan showed that 5 cases had heterogeneous mild enhancement, 3 had moderate enhancement, and 4 were seen with tortuous tumor vessels at arterial phase; all displayed continuous enhancement at venous phase. In the one case of cystic mass, solid component had moderate enhancement at arterial phase and continuous enhancement at venous phase. In another case of multilocular cystic mass, the tumor separate and cyst were significantly enhanced at arterial phase, and were continuous enhanced with hyperintense at venous phase.Conclusion Ovarian dysgerminoma tumors present features such as large lesions with clear boundaries. Tumors of single type are likely to be solid mass with central necrosis; the plain CT scan shows isodensity; the plain MRI scan mainly shows isodensity on T1WI, and iso- or slight hyperintensity on T2WI; the enhanced scan presents slight to moderate enhancement. Tumors of mixed type demonstrate cystic mass; the solid and separate parts are significantly enhanced. The comprehensive analysis of imaging features of ovarian neoplasms could help to make a correct diagnosis before surgery.
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Objective To summarize the magnetic resonance imaging/ 1 H-magnetic resonance spectroscopy (MRI/1 H-MRS) features of tumor-like inflammatory demyelinating diseases (TIDD),and investigate the clinical value of MRI/1 H-MRS.Methods MRI features of 10 cases of TIDD in brain confirmed by pathology were retrospectively analyzed and compared with pathology.Results The lesions mainly located in the white matter with mild mass effect.MRI scan all showed low T1 high T2 signal,and 7 cases showed high signal,3 cases showed slightly high or mixed signals on DWI.Enhanced MRI showed 5 cases with significant enhancement withopen loop sign,4 cases with significant patchy or nodular enhancement,1 case with mild flakes or linear enhancement.Three cases showed expanded blood vessels and plumbed to the lateral wall inside the edge of the lesions.1H-MRS performance showed 4 cases all with significantly increased Lac and Lip; 3 cases with rised glutamate and glutamine complex β,γ-Glx peaks,reduced N-acetylaspartate acid (NAA),increased Cho to varying degrees.All pathological changes were demyelination,perivascular inflammatory infiltration and reactive gliosis,hypertrophy and abnormal mitotic figure.Seven cases could be seen obesity glial cells.Conclusions TIDD had its salient MRI features:lesion had obvious edema and mild mass effect,MRI enhancement showed open loop sign and small veins expansed,on perfusion-weighted imaging it showed low perfusion.1H-MRS showed β,γ-Glx peaks,Lac and Lip peaks significantly increased,NAA slightly reduced,Cho mildly elevated.Comprehensively analyzing the MRI and 1H-MRS features,combined with clinical manifestations,contribute to the diagnosis of the disease.
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Case based study emphasizes on the training of students' practical clinical ability. With the development of computer technology, picture archiving and communication system was widely applied, providing bases for case based study. According to the characteristics of radiology, appli-cation of case based study in medical imaging practice teaching was believed to stimulate students' learning interest, improve their analytical ability and thinking capacity, make them combine theory with practice better and develop their clinical thinking ability.
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Objective To discuss the ability of 64 slices CT to display the image of peripancreatic vessels. Methods 105 patients underwent abdomen enhancement scans. The scan data of aterial phase and venous phase were reconstructed respectively, the peripancreatic vessels were displayed by means of volume rendering (VR) and multiplanar volume reconstructions (MPVR). The percentage of successful display of the peripancreatic vessels were calculated. Results ①The display frequency of the peripancreatic big arteries and veins, including celiac trunk artery(CTA), common hepatic artery (CHA), 1eft gastric artery(LGA), splenic artery (SA), gastroduodenal artery (GDA), right gastloepiploic artery(RGEA), superior mesenteric artery (SMA), portal vein(PV), superiormesenteric vein(SMV), spleenic vein (SV)was 100%. ②The display frequency of small arteries including superior pancreaticoduodenal artery (PSPDA), inferior pancreaticoduodenal artery (PIPDA), dorsal pancreatic artery (PDA), transverse pancreatic artery (PTA), pancreaticomegana artery (PMA) and caudal pancreatic artery (PCA) ranged from 43.3% to 97.20%,while of the posteriorsuperior pancreaticoduodenal vein (PSPDV) and posterior-inferior pancreaticoduodenal vein (PIPDV) was 71.4% and 30.5% respectively. ③The display frequency of the peripancreatic small vessels by the multiplanar volume reconstruction (MPVR) was higher than that of the volume rendering (VR)(P＜0.05). Conclusions Multislice CT can display the peripancreatic peripancreatic vessels. Furthermore, there is a significant difference in the display frequency of the peripancreatic small vessels between the MPVR and VR reconstruction methods.
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Objective To evaluated the role of wt-P53 protein in telomerase regulation in keloid fibroblasts(KFBs). Methods The fibroblasts were derived from human keloid tissue which was proved by pathological diagnosis. KFBs were divided into 2 groups, the transfection group and the untransfection group. wt-p53 gene was transfected into the fibroblasts by adenovirus vectors in the transfection group. The KFBs untransfected with wt-p53 gene served as control (untransfection group). After 48 hours of transfection, the expression of wt-P53 protein was analyzed by both Western blotting and immunofluorescence method, respectively. The telomerase activity was evaluated by TRAP-ELISA after 1-7 days of transfection.Results All the KFBs from 2 groups expressed wt-P53 protein. But the expression level of wt-P53 protein in the transfection group was significantly higher than that in the untransfection group. At the same time of high expression of wt-P53 protein, the telomerase activity of KFBs in transfection group was significantly lower than that in the untransfection group( P＜0.05). Conclusion High level expression of wt-P53 protein can transiently inhibit the telomerase activity of KFBs.
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To improve the quality of practice teaching in medical imaging,we explored the teaching methods on the basis of quality-oriented education,combining the special nature of the medical imaging and the clinical medicine program.
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National level excellent courses' construction is an important part of the quality and reform in education .We explored the teaching methods of medical imaging under the construction of the excellent course to improve the quality education.
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Comparative imaging can be used to analyse and compare diseases in different respects,which can not only conduce to students’transversal contrast of knowledge they have learned, but also improve the teaching effect of medical imaging and the students’clinical skills,and at the same time,lay a solid foundation of the research for future.
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Objective:Tostudy the MRI with X-ray in the ability of bony generation by the way of the experiment of repairing bone defects with n-HA/PA66. Methods:30 New Zealand rabbits were avalued whose condyle of tibia in one side was performed boring which was 3mm diameter and 5mm depth with n-HA/PA66 composite implanting. The specimens were taken respectively in different times:2nd 4th 6th 8th 12th week after surgery,and were examined by the methods of plain roentgenography、histology and magnetic resonance imaging. Results:(1)MRI and X-ray:From the 4th week,n-HA/PA66 composite had the poor defined border and the signal inter-material had become more variform,more obvious enhancement,at the same time in the X-ray,there were more and more bony generation(.2)The histology showed that a layer of interface membrane forming. From the 4th week,The interface membrane had been widest and the number of cells was increasing. Till the 12th week,there were some bone trabecula formed and the HA were separated into small islands,more osteoclasts appeared. Conclusion:The experimental results showthat the perfect radiology technique is useful to predict the bone transplantation. Furthermore it is easy to operate in clinical setting,and the n-HA/PA66 Composite has the attribute of good biocompatility and osteoconductibity,which can be manifested by plain roentgenography and magnetic resonance imaging.
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Objective To study wt-p53 gene's influence on the proliferation of keloid fibroblasts in vitro. Methods wt-p53 gene was transfected into keloid fibroblasts by adenovirus vector. wt-p53 mRNA was analyzed by RT-PCR; wt-p53 protein was evaluated by indirectiy immunofluorescence; The ability of proliferation of keloid fibroblasts was analyzed by cell growing curves; The cell cycle of KFB was checked by FCAS. Results The expression of wt-p53 mRNA and protein was obviously higher in the fibroblasts of the experimental group than those of control group; the rate of G_0~G_1 in cell cycle was higher in the fibroblasts of the experimental group than those of control group; at the same time, the rate of G_2~M was lower in fibroblasts of the experimental group than those of control group (P
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Objective: To discuss the radiological evaluation after the experiment implanted artificial vertebral lamina made from n-HA/PA66 into the defect of vertebral lamina,in order to evaluate its value in preventing the complication of postlaminectomy.Methods:22 male dogs aged one year were classified randomly into three groups: the experimental group(13 dogs)and the control group(9 dogs).The specimens were examined by the methods of plain roentgenography,MRI and histology.Results:The X-ray: in the experimental group,it was becoming cloudy around the operative area in the 8th week;till 24th week,the density of the operative area was the same with the density of bone.The histology: in the experimental group,from the 8th week,there were many cartilage cells and lamellar bone observed.While in the control group,it was just fibrous layer forming.MRI:the reconstructed segment after the laminoplasty was detected clearly by MRI,which coincided with the histology.Compared with the control segment,the numbers of the area of vertebral canal and the sagital axis were significantly different(P