Reference values for cerebral ventricular size in neonates with gestational age of 33 +0-41 +6 weeks / 中华围产医学杂志

Objective:To establish the reference values and neurological intervention cutoffs for cerebral ventricular size in neonates born at 33 +0-41 +6 weeks of gestation and to investigate the influential factors and reliability of the related indices. Methods:This study prospectively recruited 1 370 1-to 7-day neonates born or hospitalized at the Hunan Provincial Maternal and Child Health Care Hospital from February to August 2021. All the neonates, who were born between 33 +0 and 41 +6 weeks of gestation, were subjected to ultrasound scanning to obtain the indices, including ventricular index (VI), anterior horn width (AHW), thalamo-occipital distance (TOD), and ventricular height (VH). The reference value and neurological intervention cutoff for each index were set. Quantile regression was used to estimate the correlation between each index and continuous covariates [gestational age at birth (GA) and birth weight (BW)]. Mann-Whitney U test was used to analyze the differences in the medians of indices in different categorical covariates groups (males/females, left/right lateral ventricles, vaginal delivery/cesarean section, and singleton/multiple births). Intraclass correlation coefficient (ICC) calculated by a two-way mixed effect model and absolute agreement was used to access intra-rater reliability; ICC via a two-way random effect model and absolute agreement was utilized to rate inter-rater reliability (pool reliability: ICC below 0.50; moderate reliability: ICC between 0.50 and 0.75; good reliability: ICC between 0.75 and 0.90; excellent reliability: ICC exceeding 0.90). Results:The upper limits of reference values for AHW, TOD, VI, and VH in 555 (40.5%) preterm neonates were 2.7-3.5 mm, 20.9-22.5 mm, 12.6-13.7 mm, and 3.8-4.9 mm, and in 815 (59.5%) term newborns were 3.4-4.3 mm, 18.6-21.3 mm, 14.2-14.7 mm, and 3.4-3.8 mm, respectively. The cutoff of neurosurgical intervention for each index was the upper limit of reference value plus 4 mm. AHW median was positively correlated with GA [partial regression coefficient (PRC): 0.12, P<0.05], while TOD and VH medians were negatively correlated with GA (PRC:－0.31 and－0.06, both P<0.05). VI, AHW, and TOD medians were positively associated with BW (PRC: 0.46, 0.23, and 0.97, all P<0.05). The medians of VH, AHW, and TOD in the left cerebral ventricular exceeded those in the right cerebral ventricular, respectively (VH: 2.0 vs 1.8 mm, U=836 071.50; AHW: 1.8 vs 1.7 mm, U=874 141.50; TOD: 13.6 vs 12.5 mm, U=738 409.00, all P<0.05). The medians of AHW and VI in male neonates were greater than those in female newborns, respectively (AHW: 1.8 vs 1.7 mm, U=834 124.00; VI: 11.1 vs 10.8 mm, U=884 156.50, both P<0.05). The neonates delivered vaginally had greater AHW median, but smaller TOD median than those delivered by cesarean section (AHW: 2.0 vs 1.6 mm, U=685 546.00, P<0.001; TOD: 13.1 vs 12.9 mm, U=850 797.00, P=0.010). The AHW median in singleton newborns exceeded that in multiple births (1.9 vs 1.4 mm, U=356 999.00, P<0.001). The lower limits of 95% confidence intervals for intra-rater and inter-rater ICCs exceeded 0.75 and 0.50, respectively. Conclusion:Reference values and surgical intervention thresholds for VI, AHW, TOD, VH of newborns with a gestational age of 33 +0-41 +6 weeks were preliminarily established, and the reliability of these indicators were verified.

MORPHOMETRIC STUDY OF THE FRONTAL HORN OF LATERAL VENTRICLES OF BRAIN BY IMAGING USING COMPUTERIZED TOMOGRAPHY

Introduction The cerebral ventricular system consists of a series of interconnecting spaces and channels which originate from the central lumen of the embryonic neural tube. The ventricular system ?lled with cerebrospinal ?uid, is an essential part of the brain. Understanding the normal anatomy and the variations of the ventricular system of brain is helpful for clinicians, neurosurgeons and radiologists in day-to-day clinical practice1. Aims And Objectives To determine the average dimensions and variations of the frontal horn of the normal lateral ventricles of brain by CT scan. Materials And Methods The study was conducted in individuals who attended the Department of Radiodiagnosis in Government Medical College, Thiruvananthapuram. Those patients whose brain CT scans were read as normal by the radiologist were taken up for the study. A total of 200 CT brain of individuals above 10 years of age were taken during the period from January 2017 to June 2018.100 males and 100 females were included in the study group. The length of the frontal Results horn of lateral ventricle of brain was found to be more on the left side and in male gender. It was also observed to be increasing with age. The present study outlines the normal values of the length of frontal horn of the lateral ventricles of brain Conclusion using Computerized tomography which would aid in the diagnosis and management of neurological disorders.

Rare Case of Young Patient with Intraventricular Angiomatous Meningioma

Pediatricmeningiomas are rare and account for only 2.2% of the central nervous system (CNS) tumors. In this age group, they aremore frequently located in atypical sites, such as, mainly, the ventricular system, with a frequency of 8.8 to 13.6%. Adding this to the fact that the angiomatous subtype constitutes only 2.1% of allmeningiomas, the rarity of the case reported here is corroborated. We report a 17-year-old female patient diagnosed with intraventricular angiomatous meningioma; she underwent surgical resection of the tumor in the body and frontal horn of the right lateral ventricle, and there were no neurological sequelae. With a follow-up of 26 months, there was no recurrence and the patient had clinical stability. Intraventricular tumors usually have slow growth and reach a considerable size until they cause symptoms and then are diagnosed. In addition, the deep location of the tumor and its proximity to eloquent areas make these tumors a neurosurgical challenge. The angiomatous subtype, due to the presence of hypervascularization (consisting of > 50% of vascular components), may, in some cases, hinder surgical resection as well as be erroneously diagnosed. However, surgical treatment aimed at total resection of the lesion remains the conduct of choice in the case reported here, especially in patients in the first two decades of life, in which the use of radiation is avoided. Specifically when it comes to the surgery, we chose a transcalosal approach that allows a good transoperative visualization of the lesion when located in the body and frontal horn of the lateral ventricle.

Quiste aracnoideo intraventricular asintomático: reporte de un caso / Asymptomatic intraventricular arachnoid cyst: a case report

Introducción: Los Quistes Aracnoideos son colecciones benignas de líquido cefalorraquídeo que representan el 1% de lesiones ocupantes de espacios intracraneales. Se detecta frecuentemente antes de los 20 años, entre 60 a 90% de los casos. La prevalencia estimada es de 1,4% en adultos, siendo la menos frecuente la ubicación intraventricular. Caso Clínico: Mujer de 60 años de edad, consultó por cefalea holocraneana de larga data y ocasionales mareos. Sin alteraciones al examen físico neurológico. Se le realizó tomografía axial computarizada donde llamó la atención una leve alteración de la densidad intraventricular por lo que se procedió a realizar resonancia magnética nuclear que demostró imágenes quísticas en atrio de ventrículos laterales, bilateral. No se requirió de una intervención quirúrgica debido a que la paciente no presentaba sintomatología significativa. Discusión: El tratamiento quirúrgico es recomendado en pacientes sintomáticos, en quistes de gran extensión y en los que cursan con complicaciones. Para los pacientes que cursen sólo con dolor de cabeza, sin hidrocefalia secundaria o un aumento evidente de la presión intracraneal se recomienda la observación con o sin repetición de las imágenes.

Introduction: Arachnoid cysts are benign collections of cerebrospinal fluid that represents 1% of lesions occupying intracranial spaces. It is frequently detected before the age of 20, between 60 to 90% of cases. The estimated prevalence is 1.4% in adults, the least frequent being intraventricular location. Clinical Case: A 60-year-old woman attended for a long-standing holocranial headache and occasional dizziness. No alteration in the neurological physical examination. A computerized axial tomography was performed, where a slight alteration in the intraventricular density drew attention, for which a nuclear magnetic resonance was carried out, which showed cystic images in the atrium of bilateral lateral ventricles. No surgical intervention was required because the patient did not present a significant symptomatology. Discussion: Surgical treatment is recommended in symptomatic patients, in cysts of great extension and in those with complications. For patients with only headache, without secondary hydrocephalus or an obvious increase in intracranial pressure, observation with or without repetition of the images is recommended.

Analysis of pregnancy outcome of prenatal ultrasonic diagnosed solitary lateral ventricular asymmetry / 中国医学影像技术

Objective: To analyze the pregnancy outcome of prenatal ultrasonic diagnosed fetal solitary lateral ventricular asymmetry. Methods: Imaging data and pregnancy outcome of 191 fetuses with prenatal ultrasonic diagnosed solitary lateral ventricle asymmetry were retrospectively analyzed. The infants were followed up for 6-12 months after birth, and infant neurodevelopmental assessment was used to assess whether there were abnormal reactions and behaviors. Results: Among 191 fetuses, 98 were found with asymmetric (98/191, 51.31%), while 93 were found with unilateral ventricular broadening (93/191, 48.69%). With the development of pregnancy, the width of lateral ventricle became normal in 130 fetuses (130/191, 68.06%), remained as former in 58 fetuses (58/191, 30.37%) but further expanded in 3 fetuses (3/191, 1.57%). In addition, 2 cases underwent umbilical cord blood puncture chromosome karyotype examination, 1 was trisomy 18, the karyotype was 47, XN, +18, and the other was normal. Normal delivery achieved in 189 fetuses, while 2 received labor induction, 1 with chromosomal karyotype abnormality and the other was considered as unilateral lateral ventricular progressive broadening combined with prenatal MRI suspected bilateral cerebral hemisphere dysplasia. Conclusion: Fetal solitary unilateral unilateral ventricular asymmetry has no obvious impact on fetal growth and development fetuses. The pregnancy outcome and prognosis mainly depends on the intrauterine progress of lateral ventricular width, which need to be closely monitored and followed-up.

Diagnosis and prognosis of fetal periventricular pseudocysts / 中华围产医学杂志

Objective@#To investigate the diagnosis, clinical outcomes and factors influencing the prognosis of fetal periventricular pseudocysts (PVPC).@*Methods@#A retrospective analysis was performed on the results of fetal neurosonography (NSG), cranial magnetic resonance imaging (MRI), chromosome karyotype and neonatal cranial ultrasound of 76 PVPC cases detected by prenatal ultrasound in Peking University First Hospital from May 2014 to October 2018. The accuracy of NSG and cranial MRI in PVPC diagnosis was assessed. Prognosis of PVPC and the influencing factors were evaluated. Statistical analysis was performed using Chi-square test or Fisher's exact test.@*Results@#(1) This study involved 51 cases (67.1%) of isolated PVPC and 25 cases (32.9%) of non-isolated PVPC. Among the 25 non-isolated PVPC cases, 15 were complicated by one abnormality and 10 by multiple abnormalities. There were 20 cases with intracranial abnormalities, two with extracranial abnormalities, and three with both intracranial and extracranial abnormalities. (2) Eight out of the 76 pregnancies (10.5%) were terminated and among them, two were isolated PVPC cases, five complicated by determined abnormalities (one case of PVPC complicated with pachygyria and bilateral mild fetal ventriculomegaly, one case of PVPC complicated with pachygyria or agyria and agenesis of corpus callosum, one case of PVPC complicated with arachnoid cyst and vermis dysplasia, one case of PVPC complicated with cortical dysplasia, one case of PVPC complicated with intestinal dilatation) and one by abnormalities of undertermined prognosis (PVPC combined with mild fetal ventriculomegaly and polyhydramnios). A total of 61 neonates (80.3%, 61/76) were born alive and followed up. Seven cases (9.2%, 7/76) were lost to follow-up. (3) As of February 2019, among the 61 followed-up infants, 44 with isolated PVPC and 15 with unclear abnormalities developed well. The other two with determined intracranial abnormalities were diagnosed as having cystic lesions in the brain parenchyma. One of them died of respiratory failure two days after birth and the other suffered from chromosomal disease (13.23 Mb deletion in region q24.3q31.2 of chromosome 2) with mental retardation and delayed growth and development. (4) A total of 44 (57.9%, 44/76) neonates received cranial ultrasound after birth and confirmed the diagnosis of PVPC, among which 11 (25.0%, 11/44) were missed or misdiagnosed in prenatal MRI.@*Conclusions@#PVPC may have many comorbidities, particularly intracranial abnormalities, which are closely related to the prognosis. A thorough prenatal ultrasound examination is necessary for fetal PVPC, especially NSG. Isolated PVPC usually has a good outcome. However, PVPC complicated by cystic lesions in the brain parenchyma may be associated with chromosomal abnormalities, hence fetal chromosome examination is required.

Study on the best concentration of miRNA-22 agomir in the treatment of temporal lobe epilepsy by single injection of lateral ventricle / 中国医师杂志

Objective To investigate the optimal initial concentration of microRNA22 agomir in epilepsy model induced by lithium chloride-pilocarpine after single injection of lateral ventricle.Methods 36 rats with acute temporal lobe epilepsy were randomly divided into 6 groups:the control group and the other five groups were the experimental group.All epilepsy rats were selected for right lateral ventricle injection.The control group was given negative control reagent,while the experimental group were given 0.1 mmol/L,2.5 mmol/L,5 mmol/L,10 mmol/L,20 mmol/L different concentrations of miRNA22agomir reagent.6 rats in each group were randomly selected for acute phase experiment after 3 days of administration.The expression of P2X7 in hippocampus of epilepsy rats was determined by Western blot and quantitative real-time polymerase chain reaction (qRT-PCR).Results Compared with control group,the protein and mRNA expression of P2X7 reduced in all of the model group.The protein and mRNA expression level of P2X7 protein in hippocampus of rats injected with 2.5 mmol/L,5 mmol/L and 10 mmol/L in each experimental group were significantly lower than that in the other two groups (P ＜ 0.05).Moreover,the protein and mRNA expression level of P2X7 were the lowest at 2.5 mmol/L injection and 10 mmol/L,and there was no significant difference between the two groups (P ＞ 0.05).Conclusions The optimal onset concentration for unilateral lateral ventricle injection miRNA22 agomir treatment of temporal lobe epilepsy is 2.5 mmol/L.

Diagnosis and prognosis of fetal periventricular pseudocysts / 中华围产医学杂志

Objective To investigate the diagnosis, clinical outcomes and factors influencing the prognosis of fetal periventricular pseudocysts (PVPC). Methods A retrospective analysis was performed on the results of fetal neurosonography (NSG), cranial magnetic resonance imaging (MRI), chromosome karyotype and neonatal cranial ultrasound of 76 PVPC cases detected by prenatal ultrasound in Peking University First Hospital from May 2014 to October 2018. The accuracy of NSG and cranial MRI in PVPC diagnosis was assessed. Prognosis of PVPC and the influencing factors were evaluated. Statistical analysis was performed using Chi-square test or Fisher's exact test. Results (1) This study involved 51 cases (67.1%) of isolated PVPC and 25 cases (32.9%) of non-isolated PVPC. Among the 25 non-isolated PVPC cases, 15 were complicated by one abnormality and 10 by multiple abnormalities. There were 20 cases with intracranial abnormalities, two with extracranial abnormalities, and three with both intracranial and extracranial abnormalities. (2) Eight the 76 pregnancies (10.5%) were terminated and among them, two were isolated PVPC cases, five complicated by determined abnormalities (one case of PVPC complicated with pachygyria and bilateral mild fetal ventriculomegaly, one case of PVPC complicated with pachygyria or agyria and agenesis of corpus callosum, one case of PVPC complicated with arachnoid cyst and vermis dysplasia, one case of PVPC complicated with cortical dysplasia, one case of PVPC complicated with intestinal dilatation) and one by abnormalities of undertermined prognosis (PVPC combined with mild fetal ventriculomegaly and polyhydramnios). A total of 61 neonates (80.3%, 61/76) were born alive and followed up. Seven cases (9.2%, 7/76) were lost to follow-up. (3) As of February 2019, among the 61 followed-up infants, 44 with isolated PVPC and 15 with unclear abnormalities developed well. The other two with determined intracranial abnormalities were diagnosed as having cystic lesions in the brain parenchyma. One of them died of respiratory failure two days after birth and the other suffered from chromosomal disease (13.23 Mb deletion in region q24.3q31.2 of chromosome 2) with mental retardation and delayed growth and development. (4) A total of 44 (57.9%, 44/76) neonates received cranial ultrasound after birth and confirmed the diagnosis of PVPC, among which 11 (25.0%, 11/44) were missed or misdiagnosed in prenatal MRI. Conclusions PVPC may have many comorbidities, particularly intracranial abnormalities, which are closely related to the prognosis. A thorough prenatal ultrasound examination is necessary for fetal PVPC, especially NSG. Isolated PVPC usually has a good outcome. However, PVPC complicated by cystic lesions in the brain parenchyma may be associated with chromosomal abnormalities, hence fetal chromosome examination is required.

Influence of external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage on inflammatory mediators of patients with intracranial infection / 中国基层医药

Objective@#To observe and study the influence of external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage for the serum and cerebrospinal fluid on inflammatory mediators of patients with intracranial infection, in order to understand the clinical application value of the treatment methods.@*Methods@#From June 2016 to May 2018, 56 patients with intracranial infection in the People's Hospital of Lianshui County were selected in the study and randomly divided into two groups according to the random allocation principle, with 28 cases in each group.The control group was treated with repeated lumbar intrathecal drug therapy, the observation group was treated with external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage.The serum and cerebrospinal fluid inflammatory mediators of two groups before treatment and at the first and second week after treatment were compared.@*Results@#The serum and cerebrospinal fluid inflammatory mediators of the two groups before treatment had no statistically significant differences(all P>0.05). The serum levels of IL-1β, IL-6 and IL-8 of the observation group at the first and second week after treatment were (2.27±0.28)μg/L, (9.25±0.89)μg/L, (11.15±1.35)μg/L and (1.65±0.20)μg/L, (7.04±0.81)μg/L, (8.42±0.79)μg/L, respectively, which were significantly lower than those of the control group [(4.63±0.38)μg/L, (11.92±1.35)μg/L, (14.28±1.75)μg/L and (3.20±0.29)μg/L, (9.41±1.02)μg/L, (11.32±1.47)μg/L] (t=26.456, 8.737, 7.493, 23.282, 9.628, 9.195, all P<0.01). Two weeks after treatment, the levels of IL-1, IL-6 and IL-8 in CSF of the observation group were (1.51±0.15)μg/L, (5.14±0.45)μg/L and (5.96±0.59)μg/L, respectively, which were significantly lower than those of the control group(t=12.876, 12.810, 14.272, all P<0.01). The levels of leukotriene B4(LTB4), substance P(SP) and nitric oxide(NO) in serum and cerebrospinal fluid of the two groups continued to decrease after treatment for one week and two weeks, and those in the observation group were lower than the control group(all P<0.05).@*Conclusion@#External drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage can significantly decrease the serum and cerebrospinal fluid inflammatory mediators of patients with intracranial infection, so the treatment method has high clinical application significance.

Influence of external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage on inflammatory mediators of patients with intracranial infection / 中国基层医药

Objective To observe and study the influence of external drainage of lateral ventricle for contin-uous ventricular infusion and lumbar cistern drainage for the serum and cerebrospinal fluid on inflammatory mediators of patients with intracranial infection ,in order to understand the clinical application value of the treatment methods. Methods From June 2016 to May 2018,56 patients with intracranial infection in the People's Hospital of Lianshui County were selected in the study and randomly divided into two groups according to the random allocation principle , with 28 cases in each group.The control group was treated with repeated lumbar intrathecal drug therapy ,the observa-tion group was treated with external drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage.The serum and cerebrospinal fluid inflammatory mediators of two groups before treatment and at the first and second week after treatment were compared.Results The serum and cerebrospinal fluid inflammatory mediators of the two groups before treatment had no statistically significant differences (all P＞0.05).The serum levels of IL-1β, IL-6 and IL-8 of the observation group at the first and second week after treatment were (2.27 ±0.28) μg／L, (9.25 ±0.89)μg／L,(11.15 ±1.35)μg／L and (1.65 ±0.20)μg／L,(7.04 ±0.81) μg／L,(8.42 ±0.79) μg／L, respectively,which were significantly lower than those of the control group [( 4.63 ±0.38 ) μg／L, ( 11.92 ± 1.35)μg／L,(14.28 ±1.75)μg／L and (3.20 ±0.29) μg／L,(9.41 ±1.02) μg／L,(11.32 ±1.47) μg／L] ( t＝26.456,8.737,7.493,23.282,9.628,9.195,all P＜0.01).Two weeks after treatment ,the levels of IL-1,IL-6 and IL-8 in CSF of the observation group were (1.51 ±0.15) μg／L, ( 5.14 ±0.45 ) μg／L and (5.96 ± 0.59)μg／L,respectively,which were significantly lower than those of the control group (t＝12.876,12.810,14.272, all P＜0.01).The levels of leukotriene B4(LTB4),substance P(SP) and nitric oxide(NO) in serum and cerebrospi-nal fluid of the two groups continued to decrease after treatment for one week and two weeks ,and those in the observa-tion group were lower than the control group ( all P＜0.05).Conclusion External drainage of lateral ventricle for continuous ventricular infusion and lumbar cistern drainage can significantly decrease the serum and cerebrospinal fluid inflammatory mediators of patients with intracranial infection ,so the treatment method has high clinical applica-tion significance.

Effect of intracerebroventricular injection of leptin on proopiomelanocortin and neuropeptide Agouti related protein in type Ⅱ diabetic rats / 重庆医学

Objective To study the effect of intracerebroventricular injection of leptin on proopiomelanocortin(POMC) and neuropeptide Agouti related protein (AGRP) and fasting blood glucose (FBG) in rats with type 2 diabetes mellitus (T2DM).Methods Eighty male 8-week-age SD rats with T2DM were selected and divided into two groups:intracerebroventricular injection of leptin group(n=40)and intracerebroventricular injection of vehicle control group(n =40).Intracerebroventricular injection of 5 μL/kg(fasting leptin level 15 ng/mL) leptin was performed in the leptin injection group,and the control group was injected with same amount of vehicle instead.After 48 h,the FBG level was determined,and the levels of POMC and AGRP were detected by the titer method.Results The level of FBG in the leptin injection group was significantly lower than that in the control group(P＜ 0.05),the expression of serum POMC in the leptin injection group was significantly higher than that in control group(P＜0.05),The expression of AGRP in the leptin injection group was significantly decreased than control group(P＜0.05).Conclusion intracerebroventricular injection of leptin can significantly reduce the FBG level in rats with T2DM,increases POMC expression and decreases AGRP associated protein expression.

Relationship between white matter lesion and cognitive impairment in the elderly according to their arterial spin labeling / 中华老年心脑血管病杂志

Objective To study the relationship between regional cerebral blood flow (rCBF) in matter lesion (WML) and cognitive impairment by arterial spin labeling (ASL).Methods Fourteen WML patients served as a WML group and 9 WML-free subjects served as a control group.Their neuropsychology was assessed and their rCBF was measured by ASL.Results The MoCA score,positive rate of symbol digit modalities test (SDMT),verbal fluency test (VFT) and digital span test forward and backward (DST F and B) were significantly lower while the trail making test-A (TMT-A) score and positive rate of Stroop B test and psychomotion speed test were significantly higher in WML group than in control group (P＜0.05,P＜0.01).The rCBF in regional WML was significantly slower in right and left semioval center,anterior and posterior horn of right and left lateral ventricle than that in normal white matter region (P＜0.01).The rCBF in WML was positively related with DST F and B (P＜0.05).The rCBF in NAWM was positively related with VFT (P＜0.01).Conclusion ASL can show the relationship between rCBF and cognitive impairment,especially executive function,attention and memory in elderly WML patients and decreased rCBF can thus increase their risk of cognitive impairment and dementia.

In Vivo Spinal Distribution of Cy5.5 Fluorescent Dye after Injection via the Lateral Ventricle and Cisterna Magna in Rat Model

OBJECTIVE: The purpose of this study was to find an optimal delivery route for clinical trials of intrathecal cell therapy for spinal cord injury in preclinical stage.METHODS: We compared in vivo distribution of Cy5.5 fluorescent dye in the spinal cord region at various time points utilizing in vivo optical imaging techniques, which was injected into the lateral ventricle (LV) or cisterna magna (CM) of rats.RESULTS: Although CM locates nearer to the spinal cord than the LV, significantly higher signal of Cy5.5 was detected in the thoracic and lumbar spinal cord region at all time points tested when Cy5.5 was injected into the LV. In the LV injection Cy5.5 signal in the thoracic and lumbar spinal cord was observed within 12 hours after injection, which was maintained until 72 hours after injection. In contrast, Cy5.5 signal was concentrated at the injection site in the CM injection at all time points.CONCLUSION: These data suggested that the LV might be suitable for preclinical injection route of therapeutics targeting the spinal cord to test their treatment efficacy and biosafety for spinal cord diseases in small animal models.

In Vivo Spinal Distribution of Cy5.5 Fluorescent Dye after Injection via the Lateral Ventricle and Cisterna Magna in Rat Model

OBJECTIVE: The purpose of this study was to find an optimal delivery route for clinical trials of intrathecal cell therapy for spinal cord injury in preclinical stage. METHODS: We compared in vivo distribution of Cy5.5 fluorescent dye in the spinal cord region at various time points utilizing in vivo optical imaging techniques, which was injected into the lateral ventricle (LV) or cisterna magna (CM) of rats. RESULTS: Although CM locates nearer to the spinal cord than the LV, significantly higher signal of Cy5.5 was detected in the thoracic and lumbar spinal cord region at all time points tested when Cy5.5 was injected into the LV. In the LV injection Cy5.5 signal in the thoracic and lumbar spinal cord was observed within 12 hours after injection, which was maintained until 72 hours after injection. In contrast, Cy5.5 signal was concentrated at the injection site in the CM injection at all time points. CONCLUSION: These data suggested that the LV might be suitable for preclinical injection route of therapeutics targeting the spinal cord to test their treatment efficacy and biosafety for spinal cord diseases in small animal models.

Magnetic resonance imaging characteristics of ischemic brain infarction over time in a canine stroke model

This study describes magnetic resonance imaging (MRI) results and changes in lateral ventricular size over time in a canine ischemic stroke model. T1- and T2-weighted (T1W, T2W) imaging and fluid-attenuated inversion recovery (FLAIR) sequence MRI were performed at 3 h and 3, 8, and 35 days after brain infarct induction. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping were performed at 8 and 35 days. A total of 29 brain lesions were induced successfully in 12 of 14 beagle dogs. At 3 h, T2W and FLAIR detected hyperintense lesions in three randomly selected dogs. On T1W, all lesions appeared hypointense to isointense at 3 h, isointense (18/29) or hypointense (11/29) at 3 days, hypointense to isointense with peripheral hyperintensity (24/26) at 8 days, and hypointense (18/26) at 35 days. Infarcts on DWI/ADC were hypointense to isointense centrally, with the periphery hyperintense/hyperintense (17/26) at 8 days and hypointense/hyperintense (19/26) at 35 days. A marked increase in lateral ventricular size was observed in dogs with cerebral infarcts. In conclusion, T2W and FLAIR were useful for detecting early stage (3 h to 3 days) brain infarction. T1W and DWI were useful for detecting neuronal necrosis and providing supplemental information for phase evaluation.

Clinical significance and prognosis of asymmetric ventricles in fetuses / 中华围产医学杂志

Objective@#To investigate the clinical significance and prognosis of ultrasound-identified asymmetric ventricles in fetuses, and to provide evidences for clinical consultation and management. @*Methods@#From January 2014 to May 2017, 142 singleton fetuses were enrolled who were diagnosed with asymmetric ventricles through prenatal ultrasound in Peking University First Hospital and successfully followed up after birth. Asymmetric ventricles included simple lateral ventricular asymmetry [lateral ventricular widths were normal (<10 mm) but with a difference of ≥2 mm between the two lateral ventricles and unilateral ventricular widening (only one lateral ventricle was ≥10 mm in width and the other was <10 mm). All 142 fetuses were divided into two groups according to whether they had other abnormalities (including abnormal ultrasound soft markers and structural abnormalities) or not. Clinical and imaging data of them were analyzed retrospectively. They were followed up for at least six months after birth. Neurological development regarding language, behavior and motor was evaluated using Denver Developmental Screening Test. @*Results@#There were 109 cases without other abnormalities and among them, 38 (35%) spontaneously recovered in utero, two (2%) became worse, and 69 (63%) remained unchanged. Thirty-one of the 109 cases received fetal cranial MRI and abnormal brain development was found in only one case. No abnormal findings were reported in karyotyping in 38 cases and viral detection in 31 cases. One hundred and five fetuses were successfully delivered and four were induced including two cases for wider in unilateral lateral ventricle, one of continued widening, and one with abnormal brain development suggested by fetal cranial MRI. Among the 33 cases with other abnormalities, two were spontaneously recovered in utero, one became worse , 15 unchanged and 15 were induced. Of the 20 cases underwent chromosomal examination, one unbalanced chromosome translocation was identified. Twelve fetuses underwent cranial MRI among which two were found abnormal (periventricular cyst and brain asymmetry). Sixteen cases were aborted including 15 with major abnormalities (major deformity or absence of extremities) and one with mild abnormality (abnormal ultrasound soft markers with progression in lateral ventricular width ≥15 mm in in-utero follow-up). Seventeen cases were born including 16 with mild abnormalities and one with severe abnormality (unilateral renal cystic disease without chromosome abnormality). No significant developmental abnormality in language, behavior and motor was reported during follow-up. @*Conclusions@#Asymmetric ventricles have no significant impact on fetal growth and postnatal development. The prognosis of asymmetric ventricles mainly depends on the width of lateral ventricles in utero and concomitant abnormalities. Therefore, close attention should be paid on monitoring and follow-up.

Clinical significance and prognosis of asymmetric ventricles in fetuses / 中华围产医学杂志

Objective To investigate the clinical significance and prognosis of ultrasound-identified asymmetric ventricles in fetuses,and to provide evidences for clinical consultation and management.Methods From January 2014 to May 2017,142 singleton fetuses were enrolled who were diagnosed with asymmetric ventricles through prenatal ultrasound in Peking University First Hospital and successfully followed up after birth.Asymmetric ventricles included simple lateral ventricular asymmetry [lateral ventricular widths were normal (＜10 mm) but with a difference of ≥ 2 mm between the two lateral ventricles and unilateral ventricular widening (only one lateral ventricle was ≥ 10 mm in width and the other was ＜10 mm).All 142 fetuses were divided into two groups according to whether they had other abnormalities (including abnormal ultrasound soft markers and structural abnormalities) or not.Clinical and imaging data of them were analyzed retrospectively.They were followed up for at least six months after birth.Neurological development regarding language,behavior and motor was evaluated using Denver Developmental Screening Test.Results There were 109 cases without other abnormalities and among them,38 (35％) spontaneously recovered in utero,two (2％) became worse,and 69 (63％) remained unchanged.Thirty-one of the 109 cases received fetal cranial MRI and abnormal brain development was found in only one case.No abnormal findings were reported in karyotyping in 38 cases and viral detection in 31 cases.One hundred and five fetuses were successfully delivered and four were induced including two cases for wider in unilateral lateral ventricle,one of continued widening,and one with abnormal brain development suggested by fetal cranial MRI.Among the 33 cases with other abnormalities,two were spontaneously recovered in utero,one became worse,15 unchanged and 15 were induced.Of the 20 cases underwent chromosomal examination,one unbalanced chromosome translocation was identified.Twelve fetuses underwent cranial MRI among which two were found abnormal (periventricular cyst and brain asymmetry).Sixteen cases were aborted including 15 with major abnormalities (major deformity or absence of extremities) and one with mild abnormality (abnormal ultrasound soft markers with progression in lateral ventricular width ≥15 mm in in utero follow-up).Seventeen cases were born including 16 with mild abnormalities and one with severe abnormality (unilateral renal cystic disease without chromosome abnormality).No significant developmental abnormality in language,behavior and motor was reported during follow-up.Conclusions Asymmetric ventricles have no significant impact on fetal growth and postnatal development.The prognosis of asymmetric ventricles mainly depends on the width of lateral ventricles in utero and concomitant abnormalities.Therefore,close attention should be paid on monitoring and follow-up.

A preliminary study on the postnatal neurodevelopment of fetus with ventriculomegaly / 中国新生儿科杂志

Objective To study the neurological prognosis of neonates with ventriculomegaly and its influencing factors.Method A retrospective study was conducted among neonates with ventriculomegaly in Peking University First Hospital from January 2013 to December 2015.A series of cranial ultrasonography were performed after birth and the Gesell development scale was conpleted after six months.x2 test and two-independent-sample t test were used for statistical analysis.Result Among 103 cases of ventriculomegaly,95 cases (92.2％) had mildly enlarged lateral ventricles and 8 cases (7.8％) significantly enlarged.83 cases received serial cranial ultrasound examinations after birth.The lateral ventricles of 9 patients (10.8％) bacame wider and 74 (89.2％) not.The Gesell development scales were completed in 65 cases 6 months after birth.Among them,8 patients with widening lateral ventricles got poor prognosis (100％).Among 57 patients without progressively widening lateral ventricles,6 (10.5％) had poor prognosis.The difference was statistically significant (P ＜ 0.001).No correlation was found between the severity of the lateral ventricle widening and the neurological outcome (P =1.000).There were 2 cases with other abnormalities,and 1 case got poor prognosis on follow-up.Conclusion Most neonatal ventriculomegaly patients have mild and isolated lateral ventricle enlargement.Most of them remain stable or gradually return to normal.The patients with progressively widening lateral ventricles are likely to have adverse neurological prognosis.

Fetal Lateral Ventricular Dilatation Complicated with Malformation Diagnosed by Ultrasound and Its Relationship with Chromosome Abnormalities / 中国医学影像学杂志

Purpose To investigate the relationship between fetal lateral ventricle dilatation complicated with malformation and chromosome abnormalities,so as to provide reference for clinical consultation.Materials and Methods The ultrasound images,karyotype analysis and high resolution microarray comparative genomic hybridization (aCGH) results of 150 fetuses with lateral ventricular dilatation diagnosed by ultrasound were analyzed retrospectively.Results Among 150 lateral ventricular dilatation fetuses,81 cases were isolated lateral ventricle dilatation,30 cases were found complicated with fetal ultrasound soft index,22 cases with other CNS malformations and 17 cases with other malformations.Karyotype analysis of the above 4 groups showed 13 cases of abnormal karyotypes and 15 cases ofaCGH abnormalities.There was statistical significant difference (P＜0.05) in each group of abnormal chromosome and aCGH detection rate,in which the softer marker's group had a significantly higher rate than the isolated ventriculomegaly's group in abnormal chromosome and aCGH (P＜0.05).There was no statistical significant difference in any other groups (P＞0.05).Conclusion Fetal systems should be carefully examined when prenatal ultrasound reveals lateral ventricular dilatation.The probability of abnormal chromosome increases significantly when complicated with fetal ultrasound soft index or other structural abnormalities.Chromosomal abnormalities need to be excluded and regular ultrasound follow-up is necessary in fetuses with isolated lateral ventricles.