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Objective To assess the value of magnetic resonance imaging compilation(MAGiC)sequence in predicting lympho-vascular space invasion(LVSI)in early cervical cancer.Methods The data of 48 patients with cervical cancer confirmed by pathology were collected retrospectively,and classified into LVSI-positive group(n=29)and LVSI-negative group(n=19)according to postop-erative pathological results.MAGiC sequence images of patients were obtained before injecting contrast agents,then the region of interest(ROI)was delineated along the largest dimension edge of the lesion,and T1,T2 and proton density(PD)values were automatically generated by the software.Predictors were screened by univariate analysis and receiver operating characteristic(ROC)curves were drawn to assess their diagnostic efficacy for predicting LVSI in cervical cancer.Results Significant differences were found in T1 and PD values between LVSI-positive and LVSI-negative groups(P=0.003,P=0.017).There were no significant differences in T2 values between the two groups(P=0.414).The area under the curve(AUC)for T1 and PD values to predict LVSI status were 0.73 and 0.721,respectively.Conclusion LVSI-positive group of cervical cancer has lower T1 and PD values than LVSI-negative group based on MAGiC sequence.The MAGiC sequence has a certain application value for predicting LVSI status in early cervical cancer.
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Objective To observe the value of combined synthetic MRI and multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)for differentiating benign and malignant endometrial lesions.Methods Data of 112 patients with benign or malignant endometrial lesion confirmed by pathology were retrospectively analyzed.According to pathologic diagnosis,the patients were divided into malignant group(n=72)and benign group(n=40).Synthetic MRI and MUSE-DWI quantitative parameters,including T1,T2,proton density(PD)and apparent diffusion coefficient(ADC)of all lesions were acquired.The clinical data as well as ADC,T1,T2 and PD values of lesions were compared between groups,and those being significantly different between groups were included in univariate and multivariate logistic regression.Then the univariate and combined models were established for differentiating benign and malignant endometrial lesions.The receiver operating characteristic curves were drawn,and areas under the curves(AUC)were calculated to evaluated the diagnostic efficacy of the models,which were compared with DeLong test.Results Patients'age in malignant group were higher than that in benign group(P<0.05).The length of the maximum diameter was larger,ADC,T2 and PD values were lower in malignant lesions than those in benign ones(all P<0.05),while no significant difference of T1 value was found between groups(P=0.074).The AUC of ADC univariate model was 0.966,and there was no significant difference in AUC(0.970)between the combined ADC+T2+PD model(adjusted P>0.05),but both higher than AUC of T2 univariate model(0.618),PD univariate model(0.664)and the combined T2+PD model(0.668)(all adjusted P<0.05).Conclusion ADC univariate model and combined model with other parameters of combined synthetic MRI and MUSE-DWI could be used to effectively differentiate benign and malignant endometrial lesions.
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Objective To investigate the clinical value of MRI in the diagnosis of oblique vaginal septum syndrome(OVSS),and to improve the diagnostic level for this disease.Methods Clinical and imaging data of 8 patients (7 adolescent females and 1 female in fertility period)with vaginal septum syndrome were analyzed retrospectively.All participants were evaluated by ultrasound examination before MRI scanning,and 1 of them underwent enhanced MRI scan.Results Among the 8 patients with OVSS,the main findings of MRI includes uterine deformity (4 double uterus,3 mediastinal uterus,1 double angle uterus with uterine septum),oblique vaginal septum (7 right oblique septum and 1 left oblique septum).All subjects presented with ipsilateral renal agenesis,and 4 patients with endometriosis,1 patient with ureteral distortion and ectopic opening and 1 patient with double inferior vena cava.6 patients suffered with hemorrhage in the posterior chamber of oblique septum and 2 patients with empyema.Hemorrhage in the contralateral vagina were observed in 3 cases,while no significant abnormality was found in other 5 cases.Conclusion MRI scan has an important clinical value on the diagnosis of OVSS and can provide crucial information for the optimal individual treatment.
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Objective To improve the diagnostic level of the holoprosencephaly (HPE) disease in children by imaging analysis. Methods From May 2007 to August 2015, 14 cases of HPE in children were collected (7 males and 7 females, aged 2 days to 8 years, mean 14 months). Two cases were showed as sucking difficulty and convulsions frequently after birth. Mental and motor development defects were showed in 12 cases, in which 4 cases were associated with cleft lip and palate deformities and 1 case with microcephaly. Of the 14 cases, CT scan was performed in 7 cases and MRI scan in 7 cases. Results All 14 cases were consistent with the diagnostic criteria of HPE according to the imaging findings of literatures reviewed. Four cases were showed as semilobar HPE, 8 cases were lober HPE, and 2 cases were middle interhemispheric fusion variant. There were thirteen cases were associated with corpus callosum agenesis, including 2 cases were with heterotopic gray matter. Putamen and caudate partia fusion were showed in 6 cases, and thalamus partia fusion in 3 cases. One case was associated with schizencephaly, 4 cases were palate malformation, one case was microcephaly, and one case was cerebellar hypoplasia. Conclusion CT and MRI scan could contribute to diagnosis and classification of holoprosencephaly, and determine whether HPE was associated with other neurological abnormalities. MRI scan should be the first choice for HPE diagnosis.
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Objective To evaluate the imaging features and causes of cerebral cortical laminar necrosis(CLN) in children,to improve understanding this sign.Methods The imaging and clinical data of 33 children diagnosed with CLN were analyzed retrospectively.The imaging features of CT and MRI were summarized and compared according to their etiologies.Results Children cerebral CLN involved multiple lobes of bilateral hemicerebrum, including the cortical region, subcortical region and basal ganglia region, and linear or gyral shape,patchy shape and punctate shape abnormal density or signal were demonstrated.The typical imaging features were high-signal intensity over the lateral cortical surfaces or along the gyri on T1WI and FLAIR.Diffusion weighted imaging(DWI) showed high signal with restricted diffusion on acute-stage, and Gd-DTPA enhancement demonstrated linear or gyrate enhanced appearance on early-stage.The extent of CLN of cerebral infarction was relatively limited.Acute anoxic encephalopathy showed an early imaging change and extensive involvement.While chronic anoxic encephalopathy and inflammatory encephalopathy showed a late imaging change and a longer existence.Conclusion Children cerebral CLN may have various causes and imaging features,and show characteristic chronological signal changes on imaging studies.The different causes result in the different patterns for CLN in distribution and time distribution.
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Objective Through the analysis of cases,to improve the cognition of clinicians on extracranial vas-cular embolism diseases(VED)in children.Methods The clinical information included incidence trend,thrombophi-lia,clinical features,treatment and prognosis of 29 children with VED,who were admitted from January 201 1 to Decem-ber 201 5 in Nanjing Children′s Hospital Affiliated to Nanjing Medical University,and retrospectively analyzed.Results The annual rate of VED increased from 0 to 1 .49 per 1 0 000 hospital admissions from January 201 1 to December 201 5.In 29 cases,there were 20 male and 9 female,with an average age of 6.03 years old (2 h -1 3.83 years old).In-fants accounted for >20%(6 /29 cases).The average age of the female,non infected group,rheumatic disease group and venous thrombosis group was higher than that of the male,the infection group,the non rheumatic disease group and the arterial embolization group,but there was no significant difference(all P >0.05).Thrombophilia were as follows:in-fection disease,heart disease,kidney disease syndrome,rheumatoid disease,tumor,and twins embolization syndrome. Risk factors included central venous line,immobility,dehydration,glucocorticoids use,etc.Heart disease was the leading cause of non thrombotic embolism,while other thrombophilic diseases resulted in thrombotic embolism.Pulmonary em-bolism was mainly seen in patients with severe pneumonia,especially mycoplasma pneumoniae pneumonia (MPP ).The older the age,the more typical clinical manifestations,and significantly elevated D dimer,fibrin/fibrinogen degradation products tips VED.Treatment depends on the degree of risk.Thirty -seven point five percent(3 /8 cases)of children with arterial embolism were less than 1 year old,and the mortality 25.00% (2 /8 cases)was significantly higher than that of venous thrombosis 1 7.65%(3 /1 7 cases)and 1 1 .76% (2 /1 7 cases).Conclusion Heart disease mainly cause arterial embolism and infection,while nephritic syndrome and rheumatic disease mainly cause venous embolism.Pulmona-ry embolism is mainly seen in children with severe pneumonia,especially MPP.The risk of arterial embolization is higher than that of venous embolism.
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Objective To study the imaging features of MRI in children glioblastoma and improve the understanding of this disease.Methods The clinical data and MR features of 5 cases in children with glioblastoma confirmed by surgery and pathology were analyzed retrospectively. Imaging features including location,shape,growth pattern,peritumoral edema and contrast enhancement were assessed.Results 4 cases occurred in the cerebral hemisphere and 1 in cerebellar hemisphere,all of which manifested obvious mass effect with 2 cases across midline.3 cases were round-like,while another 2 cases were irregular in shape.In spite of 1 case without peritumoral edema, 4 cases performed mild to moderate peritumoral edema.Among all patients,one showed cystic mass,2 caese showed cystic-solid mass,and the other 2 cases showed solid mass.Cystic portion presented long T1 and long T2 signal,as well as low signal on FLAIR. Solid part of lesion showed iso-intense on T1 WI and T2 WI,as well as high signal on FLAIR and DWI.After contrast enhancement,cyst wall showed annular enhancement.Ring-shaped or nodular enhancement was seen in solid components of cystic-solid mass.And solid mass showed irregular and lump-like enhancement.Conclusion Glioblastoma in children has certain characteristic MRI appearances. The surgical and pathological results are still required to establish the final diagnosis.
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Objective To investigate MRI findings and its relationship with clinical grading and prognosis of infant muggy syn-drome (IMS).Methods Twenty five cases of IMS diagnosed newly and nine cases of IMS with follow-up were collected.MRI find-ings were retrospectively analyzed and compared with their clinical data.Results Seven early abnormal signs could be shown on cer-ebral MRI examination.There was no correlation between the clinical grading and three abnormal signs,which were subdural effu-sion,supratentorial cerebral edema and subarachnoid hemorrhage (P >0.05).In contrast,the other four abnormal signs (abnormal signal of subcortex and cortex,diffuse cerebral hemorrhage,basal ganglia and corpus callosum edema or infarction,large area cere-bral infarction)were closely related to the severity of clinical symptom (P <0.05).MRI findings had certain correlation with clinical classification.Conclusion MRI can objectively reflect the serious change of brain damage in IMS,and provide important information for clinical therapy and prognosis.
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Objective To study the value of MRI and proton magnetic resonance spectroscopy(H 1-MRS)for neonatal hypoxic-is-chemic encephalopathy(HIE).Methods Magnetic resonance imaging (MRI)and proton magnetic resonance spectroscopy (H 1-MRS)were performed in 30 cases of full-term neonates with HIE,and 10 infant control group without evidence of birth asphyxia. Cerebral MRI and H 1-MRS were performed within 1 5 days after birth.The results of H 1-MRS such as subwave crest values of me-tabolites in lesion areas were recorded.The data were analyzed statistically.Results (1)MRI showed abnormal fetures of HIE such as diffuse cerebral edema,loss of hyperintensity in the posterior limb of the internal capsule on T1 WI,gyrus sign,diffuse parenchy-mal hemorrhage,which could predict the severity of brain damage.(2)On H 1-MRS,the ratio of Lac/Cr in HIE group was much higer than that in control group,which was statistically significant (P <0.05).The ratio of Lac/Cr showed a rising trend with clini-cal grading of HIE.The ratio of NAA/Cr and NAA/Cho were lower in HIE group than that in control group (P <0.05),which showed a trend of gradually reduce with clinical grading of HIE.The difference between ratio of Glx-α/Cr in HIE group and control group was also significantly,the moderate-severe group was much higher than the mild group and control group.There was no sig-nificant difference in the ratio of Cho/Cr between the 4 groups.Conclusion The combination of MRI and H 1-MRS can objectively re-flect brain morphology and metabolic changes of HIE,and evaluate the severity of the brain injury,and provide an effective evidence for clinical diagnosis and treatment.
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Objective To study the multi-slice helical CT (MSCT) features of horseshoe lung and to improve its diagnostic ability. Methods The clinical and imaging data were retrospectively reviewed in 5 patients. All of them underwent plain MSCT scan, and 4 patients also had enhanced MSCT scan and threedimensional reconstruction. Results In horseshoe lung, the basal segments of the right and left lungs were fused together by a isthmus of pulmonary parenchyma, across the midline behind the pericardium and before the esophagus, descending aorta and spine. All patients were companied with bronchopulmonary dysplasia,anomalous origin of the central bronchi, anomalous arterial supply. Anomalous pulmonary venous return to inferior vena cava and congenital cardiovascular malformations were also found in 4 cases. Conclusion MSCT and three-dimensional reconstruction are valuable for identification of horseshoe lung.