Clinical and imaging features of idiopathic intracranial hypertension / 中南大学学报(医学版)

OBJECTIVES@#Idiopathic intracranial hypertension (IIH) is a syndrome that excludes secondary causes such as intracranial space-occupying lesion, hydrocephalus, cerebrovascular disease, and hypoxic ischemic encephalopathy. If not be treated promptly and effectively, IIH can cause severe, permanent vision disability and intractable, disabling headache. This study aims to explore the clinical and image features for IIH, to help clinicians to understand this disease, increase the diagnose rate, and improve the outcomes of patients.@*METHODS@#We retrospectively analyzed 15 cases of IIH that were admitted to Xiangya Hospital, Central South University, during January 2015 to September 2020. The diagnosis of IIH was based on the updated modified Dandy criteria. We analyzed clinical data of patients and did statistical analysis, including age, gender, height, weight, medical history, physical examination, auxiliary examination, treatment and outcome.@*RESULTS@#There were 10 females and 5 males. Female patients were 22 to 42 years old with median age of 39.5. Male patients were 27 to 52 years old with the median age of 44.0. The BMI was 24.14-34.17 (28.71±2.97) kg/m@*CONCLUSIONS@#IIH primarily affects women of childbearing age who are overweight. The major hazard of IIH is the severe and permanent visual loss. Typical image signs have high specificity in IIH diagnosis. Prompt diagnosis and effective treatment are significantly important to improve the outcomes of patients.

Value of 1H-MRS on SCA3/MJD diagnosis and clinical course / 中南大学学报(医学版)

Objective:To investigate the value of proton magnetic resonance spectroscopy (1H-MRS) on the diagnosis of SCA3/MJD,and to calculate the correlation between 1H-MRS ratio and the clinical score.Methods:Sixteen patients with SCA3/MJD and 19 healthy volunteers were scanned with 1H-MRS.The data of N-acetyl aspartate,creatine,choline-containing compounds,myoinositol,NAA/Cr,Cho/Cr,and mI/Cr ratio were collected,which were grouped for comparative study.The onset patients with SCA3/MJD were evaluated with the International Cooperative Ataxia Rating Scale and Scale for the Assessment and Rating of Ataxia,the correlation between NAA/Cr,Cho/Cr or mI/Cr ratio and the clinical score was calculated.Results:The NAA/Cr in the pons and cerebellar dentate nucleus from the onset patients with SCA3/MJD was significantly reduced compared to that in the normal control group.The NAA/Cr in the cerebellar dentate nucleus of onset patients with SCA3/MJD was obviously correlated with ICARS.Conclusion:SCA3/MJD lesions are mainly located in the cerebellum and brainstem,where gray and white mater are also involved.The cerebellar dentate nucleus may be the earliest involved area.There is a correlation between the ICARS and the cerebellar lesion degree.The ICARS reflects the severity of clinical manifestations.1H-MRS is useful in the diagnosis of SCA3/MJD.

Diffusion weighted imaging of SCA3/MJD and SPG4 / 中南大学学报(医学版)

OBJECTIVE@#To determine the value of diffusion weighted imaging (DWI) in the diagnosis of hereditary spinocerebellar ataxia 3 and the Machado Joseph disease (SCA3/MJD) and hereditary spastic paraplegia 4 (SPG4).@*METHODS@#We scanned 13 patients with SPG4, 30 patients with SCA3/MJD (21 onset patients and 9 with only genetic abnormalities), and 27 healthy volunteers with DWI. The processing data were apparent diffusion coefficient (ADC). The above data were grouped for comparative study.@*RESULTS@#In the precentral gyrus, posterior limb of the internal capsule, cerebral peduncle, pons, cerebellar cortex and cerebellar white matter, the ADC of onset SCA3/MJD patients increased compared with the control group. The ADC of non-onset SCA3/MJD patients increased only in the cerebellar dentate nucleus compared with the control group. In the cerebellar cortex, the ADC of onset SCA3/MJD patients was significantly higher than the non-onset SCA3/MJD. The ADC of onset SCA3/MJD patients was significantly higher in the posterior limb of the internal capsule, cerebellar cortex, cerebellar white matter and pons than that of SPG4 patients. In the precentral gyrus, the ADC of SPG4 was significantly higher than control.@*CONCLUSION@#DWI is useful in the diagnosis of SCA3/MJD and SPG4.

Imaging characteristics of insulinoma / 中华消化外科杂志

Insolinoma is a rare disease,but with an increased incidence in recent years.From March 2003 to October 2010,16 patients with insulinoma had been admitted to the Nanfang Hospital,and the results of imaging investigation were compared with histopathological examination after operation.All cases had typical Whipple's triad,low plasma glucose and high plasma insulin concentrations. Sixteen tumors were found in total.The detection rate of ultrasonography was 44％ (7/16),and the detection rate of enhanced computed tomography (CT)and magnetic resonance imaging (MRI) were 67％ (8/16) and 75％ (6/8) respectively.The detection rate reached 88％ by combination of CT and MRI.Two patients had no abnormal findings in ultrasonography,CT and MRI,while positive results were found in the arterial stimulation procedure with venous sampiing (ASVS) in both patients.CT or MRI is the preferred approach for localization diagnosis of insulinoma. The ASVS achieves a distinct advantage in localization of insulinoma.

Related factors of ICARS and SARA scores on spinocerebellar ataxia type 3/Machado-Joseph disease / 中南大学学报(医学版)

Objective To investigate the related factors of international cooperative ataxia rating scale (ICARS) and scale for the assessment and rating of ataxia scores (SARA) in patients with spinocerebellar ataxia type 3/Machado-Joseph disease. Methods A total of 126 SCA3/MJD patients were assessed by ICARS and SARA. The relation between ICARS or SARA scores and age of onset, disease duration and CAG repeat size was analyzed. Results Either the total ICARS or the total SARA score was positively related with the disease duration(r=0.586,P＜0.05；r=0.643,P＜0.05). Simple linear regression equations were: Y1(total ICARS score)=13.072+2.388 X2(disease duration)(F=68.874,P＜0.05); Y2(total SARA score)=4.403+ 0.961 X2(disease duration)(F=87.254, P＜0.05). Either age adjusted the total ICARS score or age adjusted the total SARA score was positively related with CAG repeat size(r=0.328, P＜0.05; r=0.335, P＜0.05). Both the ICARS subscores and the SARA subscores were positively related with the disease duration(r=0.257-0.589, P＜0.05; r=0.432-0.623, P＜0.05). Both age adjusted ICARS subscores and age adjusted SARA subscores were positively related with CAG repeat size(r=0.263-0.403, P＜0.05; r=0.189-0.366, P＜0.05). Analysis of variance showed that the total ICARS score and the total SARA score increased with the disease stage. Conclusion ICARS and SARA are both reliable and effective scales in assessing the severity of ataxia in patients with SCA3/MJD, and researchers can choose the most suitable scale according to specific requirement.

Expression and significance of CXCL5 and CXCL8 in hepatic fibrosis and cirrhosis tissues / 中华消化外科杂志

Objective To investigate the level of chemotactic factors(CXCL5 and CXCL8)in hepatic fibrosis and cirrhosis tissue.Methods Hepatic tissues were obtained from 9 patients with hepatic hemangioma (hepatic hemangioma group),10 patients with liver fibrosis(liver fibrosis group)and 11 patients with liver cirrhosis(1iver cirrhosis group)at Nanfang Hospital from May 2008 to May 2009.The contents of CXCL5 and CXCL8 in hepatic tissue were assayed by ELISA.All data were analyzed by one-way ANOVA,Pearson rank correlation or Spearman correlation.Results The contents of CXCL5 and CXCL8 were(0.8±0.7)ng/g and(6.2±3.7)ng/g in hepatic hemangioma group,(2.0±2.0)ng/g and(11.6±3.5)ng/g in liver fibrosis group and (17.1±4.8)ng/g and(12.3±3.9)ng/g in liver cirrhosis group,with significant difference among the 3 groups (F=60.050,7.690,P＜0.05).The expression of CXCL5 was correlated with the content of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and prothrombin time(PT)(r=0.502,0.468,0.523,P＜0.05):the expression of CXCL8 was correlated with the content of ALT,AST.total bilirubin and PT(r=0.477,0.504,0.537,0.431,P＜0.05).Conclusions With the aggravation of hepatic fibrosis,the contents of CXCL5 and CXCL8 are increased with different patterns.The changes of CXCL5 and CXCL8 are related with the injury of liver,but the changes of CXCL5 and CXCL8 do not correspond with the degree of the injury of liver.