Muscle strength evaluation in older adults: based on hierarchical analysis-fuzzy comprehensive analysis method / 中国组织工程研究

BACKGROUND: Focusing on the challenge of population aging, the Chinese government attaches great importance to the development of pension services, and actively explores ways to solve the problem. The muscle strength of the older adults is closely related to their daily life, and how to scientifically and effectively assess and attend the elderly is critical. OBJECTIVE: To evaluate the muscle strength of the older adults using a new combination of subjective and objective quantitative evaluation model. METHODS: Six joints of shoulder, elbow, wrist, hip, knee and ankle with high correlation with daily muscle activity were selected. The analytic hierarchy process was used to build muscle strength index system, the weight values of each index were determined. The muscle strength was classified by fuzzy comprehensive evaluation method, and a new combination of subjective and objective quantitative evaluation model was established. Fifty older individuals from a rehabilitation center of Beijing were selected to evaluate the feasibility and accuracy of the new model. RESULTS AND CONCLUSION: Compared with the professional doctors, the new model for muscle strength grading exhibited the significantly similar results, and the accuracy rate of four classifications was above 80%, which met the measurement requirements. The new combination of subjective and objective quantitative evaluation model overcomes the problems due to subjective factors in questionnaire, and provides a more objective, quantified and improved method for assessing the muscle strength in the older adults.

Changes of perimysial junctional plates induced by excessive eccentric training and the effects of acupuncture intervention / 生理学报

This study aimed to investigate the effects of acupuncture intervention on excessive eccentric training-induced changes of perimysial junctional plates (PJPs) domain. Thirty healthy male Wistar rats were randomly assigned to 5 groups: control group, four-week training group, four-week training + 1-week recovery group and four-week training + 1-week acupuncture group. Rats were subjected to continuous excessive eccentric training for 4 weeks (incline -16°, speed 16-20 m/min, 60-90 min/d, 5 day per week), and then were subjected to one-week spontaneous recovery or one-week recovery with acupuncture intervention (a piece of filiform needle for 4 min every day). The PJPs domain changes were observed under transmission electron microscopy, and the perimysial collagen network structural changes were examined by scanning electron microscopy with or without a digestion technique (NaOH). The following results were obtained: (1) Compared with control group, PJPs domain of four-week training group showed excessive shortening of sarcomere (P < 0.001), serious damage of sarcomere structure, and altered mitochondria morphology in intermyofibria and subsarcolemma; 54% degradation of sarcolemma, and increased number of caveolae (P < 0.01); reduced number of PJPs (P < 0.001). (2) In comparison with four-week training group, PJPs domain was slightly changed in four-week training + 1-week recovery group, i.e., partial recovery of sarcomere length and structure (accounting for 85.23% of control group), and recovery of intermyofibrial and subsarcolemmal mitochondria morphology; decreased sarcolemmal degradation (P < 0.001), and increased number of caveolae (P < 0.05); increased PJPs number (P < 0.001). (3) PJPs domain changed in four-week training + 1-week acupuncture group compared with four-week training + 1-week recovery group, which were substantial recovery of sarcomere length (accounting for 94.51% of control group), increased subsarcolemmal mitochondrial fusion (P < 0.001), decreased caveolae number (P < 0.001), and decreased PJPs number (P < 0.001). The results indicated that excessive eccentric training resulted in excessively reduced number of PJPs with altered PJPs domain homeostasis, thus impeding the adaptability to eccentric training. After 1 week of natural recovery, the number of PJPs was excessively increased, hindering muscle damage repair. Acupuncture intervention helped to recover PJPs number and PJPs domain homeostasis, thus significantly relieving overuse injuries.

Clinical application of T2*GRE multiple echo sequence on articular cartilage disease in the knee / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the correlation between T2* relaxation time and the pathological changes in the knee joint of patients with osteoarthritis (OA) and analyze the changes of T2* relaxation time in early cartilage injury.</p><p><b>METHODS</b>Sixty-two patients with OA in different phases underwent magnetic resonance imaging (MRI) of the knee and the articular cartilage T2* relaxation time was recorded, with 20 young healthy volunteers as the control group.</p><p><b>RESULTS</b>Patients with mild OA showed significantly different T2* relaxation time for most of the articular cartilage from that of the healthy volunteers (P<0.05), but no such difference was found between serious OA group and the healthy volunteers. The change of T2* relaxation time of the cartilage was also associated with age, weight and body height, and the potential effects of other factors could not be excluded.</p><p><b>CONCLUSION</b>The articular cartilage shows no obvious morphological changes in early OA of the knee, a stage characterized mostly by alterations of the tissue structure and compositions. Cartilage pathologies can be the most obvious on the weight-bearing surface of the medial condyle of the femur or in the patella. T2* relaxation time measurement can be helpful in the detection of early cartilage pathologies.</p>

Application of dynamic contrast-enhanced magnetic resonance imaging in evaluating liver fibrosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the value of time-signal intensity curve (TIC) in dynamic contrast-enhanced magnetic resonance imaging (DEC-MRI) in the evaluation of liver fibrosis.</p><p><b>METHODS</b>Thirty-six consecutive patients and healthy volunteers were divided into 4 groups according to the stages of fibrosis, namely the normal group (n=9), mild fibrosis group (n=5), moderate to severe fibrosis group (n=7), and liver cirrhosis group (n=15). All the subjects underwent conventional and DEC-MRI, and the TIC was generated automatically to evaluate the peak height, TTP, MSI and MSD. The correlations between the TIC parameters and the stage of fibrosis were assessed. Receiver operating characteristic (ROC) curve analyses were conducted to evaluate the value of the TIC parameters in the evaluation of fibrosis stage.</p><p><b>RESULTS</b>Moderate but significant inverse correlations of the peak height, MSI, and to fibrosis stage were noted in these patients (P<0.05); the peak time was positively correlated to the fibrosis stage (P<0.05). In patients with a fibrosis stage ≥1, the AUC of the measured TIC parameters ranged from 0.747 to 0.783, with the MSD of the spleen had the highest AUC (0.783). For a fibrosis stage ≥3, the AUC of the indices ranged between 0.728 and 0.877, highest for liver MSI of the arterial phase, followed by the portal vein MSI, liver MSI of portal venous phase, liver MSD, splenic MSI of arterial phase and splenic MSD. In the diagnosis of liver cirrhosis, the AUC (range 0.742-0.821) decreased in the order of liver MSI of the portal venous phase, liver MSD, liver MSI of the arterial phase, the portal vein MSI, splenic MSI of the arterial phase and splenic MSD.</p><p><b>CONCLUSION</b>TIC of DEC-MRI can be used to evaluate hemodynamic changes in the liver, and may serve as a practical non-invasive functional imaging modality for assessing the severity of liver fibrosis.</p>

Correlation of ABO groups to hypertensive intracerebral hemorrhage / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the relationship between ABO blood groups and hypertensive intracerebral hemorrhage (HICH).</p><p><b>METHODS</b>The clinical data of 425 patients with HICH admitted to Nanfang Hospital were collected to analyze the relationship between the ABO blood groups and the occurrence of HICH, with normal Han Chinese subjects serving as the controls.</p><p><b>RESULTS</b>Compared to the officially documented distribution of ABO groups in Chinese population (O 34.11%, B 28.98%, A 28.29%, AB 8.69%) and in Guangzhou residents (O 46.00%, B 25.00%, A 23.00%, AB 6.00%), a significant difference was noted in the blood group distribution in this cohort (O 45.10%, A 26.00%, B 24.00%, AB 4.90%). O blood type individuals with HICH showed a higher morbidity than others. Th ABO blood type distribution in this cohort showed no significant difference from that in the control group (P>0.05), but differed significantly from the Chinese norm (P<0.05).</p><p><b>CONCLUSION</b>The ABO blood group is a factor contributing to the occurrence of HICH. O blood type is related to cerebral hemorrhage, and may serve as a risk factor for HICH.</p>

PKC isoform selectivity and radiation-induced apoptosis of HepG2 cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the expressions of protein kinase C (PKC) isoforms in X-ray-exposed HepG2 cells and identify the PKC isoforms that induce radioresistance in HepG2 cells.</p><p><b>METHODS</b>Cultured HepG2 cells were divided into control group and 6 Gy radiation group for corresponding treatments. The fluorescence intensity (FI) and the percentage of positive cells were determined using flow cytometry.</p><p><b>RESULTS</b>The FI of PKCalpha and PKCdelta were 2.28 and 5.05 in the radiation group, respectively, significantly higher than those in the control group (P<0.05). The percentages of PKCalpha- and PKCdelta -positive cells were significantly higher in the radiation group than in the control group (P<0.05). The FI and the percentages of PKC zeta, gamma, epsilon, zeta positive cells were rather low and showed no significant differences between the two groups (P>0.05); PKCbeta expression was not detected in the two groups of cells. The apoptosis rates of the control and radiation groups were 1.73% and 20.90%, respectively.</p><p><b>CONCLUSION</b>PKCalpha and PKCdelta may be involved in protecting HepG2 cells from radiation-induced apoptosis.</p>

Diagnosis of liver pathologies based on apparent diffusion coefficient of magnetic resonance diffusion-weighted imaging in a rabbit model of liver fibrosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of apparent diffusion coefficient (ADC) of magnetic resonance diffusion-weighted imaging (MR-DWI) for diagnosis of the liver pathologies in rabbit model of liver fibrosis.</p><p><b>METHOD</b>MR-DWI with four different b values (200, 500, 300 and 600 s/mm(2)) was performed in 4 normal New Zealand white rabbits and 13 rabbits with experimental liver fibrosis. For each rabbit, 4 ADC values were obtained in the left and right lobes of the liver. According to the ISHAK criteria of liver histopathological scoring and fibrosis staging system, all the liver specimens were histopathologically graded (scores 1-6 for grade I, 7-12 for grade II, and 13-18 for grade III) and assessed for fibrosis staging (stages I to VI). The variation of ADC values were analyzed based on the results of histopathological grading and fibrosis staging.</p><p><b>RESULTS</b>The 4 ADC values were obviously lower in rabbits with liver fibrosis than in the normal control rabbits. Statistical analysis showed significant differences in the ADC values between the normal control and liver fibrosis groups, and between the rabbits with different histopathological grades and fibrosis stages (P=0.000).</p><p><b>CONCLUSIONS</b>Liver fibrosis results in significantly lowered ADC values of the liver depending on the histopathological grades and fibrosis stages. The pathological basis for these changes lies in reduced water content and restricted Brownian motion of water in the liver due to hepatocyte degeneration and swelling, inflammatory cell infiltration, and collagen fiber deposition in the interstitial space.</p>

Heterogeneity of angioarchitecture and their hemodynamic changes in benign and malignant breast tumors / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore the differences between the angioarchitecture, hemodynamics, ultrastructure of neovasculr endothelial cells, and vascular distribution in different perfusion regions in benign and malignant breast tumors.</p><p><b>METHODS</b>30 cases of breast carcinoma (33 lesions) and 30 cases of breast fibroadenoma (34 lesions) were examined by contrast enhanced microvascular imaging (MVI), and perfusion indexes were collected both inside and at the margin of each focus according to time-intensity quantitative analysis, including peak intensity (PI), area under the curve (AUC), time to peak (TTP) and wash-out time (WOT). The ultrastructure of neovascular endothelial cells was examined by transmission electron microscopy. The expression of CD34, VEGF, Flk-1/KDR in both two groups were detected by immuhistochemistry.</p><p><b>RESULTS</b>Significant differences were found between the two groups characterized with filling defect, vascular distortion, dilatation and uneven enhancement. Most of the curves of malignant group (87.9%, 29/33) ascended rapidly and dropped slowly while those of the benign group (79.4%, 27/34) ascended slowly and dropped rapidly. The AUC and WOT of malignant tumor group were significantly higher than those of benign group, while the PI and TTP had statistically no significant difference. In the malignant tumor group, PI, AUC and WOT collected from the margin of foci were significantly different from those collected inside the foci, however, there was no significant difference in the benign group. The margin of foci was characterized with dilated and distorted vessels, and the center of the foci was occupied by narrow or occluded blood vessels, sometimes with contracted endothelial cells and pericytes. Abundant microvascular areas located at the margin of foci. The ultrastructure of endothelial cells in the newly formed blood vessels of malignant group showed strong ability to divide, which was different from normal endothelium cells.</p><p><b>CONCLUSION</b>The perfusion pattern, mode of time-intensity curve, mean perfusion parameter and variation of regional perfusion parameters provide a valuable diagnostic basis in distinguishing benign and malignant breast tumors. The density, morphology, distribution, structure and function of newly formed microvessels in tumor foci are also crucial factors when tumors are assessed by imaging examination.</p>

Evaluation of angiogenesis in the tumorigenesis and progression of breast cancer / 中华外科杂志

<p><b>OBJECTIVES</b>To investigate the expression of CD34, vascular endothelial growth factor (VEGF) and its receptor Flk-1/KDR in precancerous lesion, atypical hyperplasia (AH) and infiltrating carcinoma of breast cancer and to explore the correlation between angiogenesis abnormality and the tumor progression.</p><p><b>METHODS</b>One hundred and sixty cases of resected tissues from breast cancer patients were enrolled in the study and were divided into 5 groups: 30 cases as normal controls, 30 cases with simple hyperplasia, 30 cases with AH, 20 cases with intraductal carcinoma in situ and 50 cases with infiltrating ductal carcinoma. The expression of CD34, VEGF and its receptor, Flk-1/KDR in those tissues were determined with immunohistochemical techniques. The micro vascular density (MVD) in those tissues was determined with the expression of CD34.</p><p><b>RESULTS</b>The expression level of CD34, VEGF and Flk-1/KDR were different among the groups, with the highest expression in the infiltrating ductal carcinoma group. With the progression of breast cancer, the major indexes showed no significant changes in the early stage of progression, but the expression of VEGF and Flk-1/KDR increased significantly from AH stage. Meanwhile, the MVD increased in the same way. There was significant difference between AH and intraductal carcinoma group in the expression of VEGF and Flk-1/KDR (P<0.05), but not in the MVD (P>0.05).</p><p><b>CONCLUSIONS</b>Abnormality in angiogenesis may be an early event in the tumorigenesis of breast cancer. Abnormal expression of VEGF and Flk-1/KDR may be the initiating factor of angiogenesis in the process of breast hyperplasia-AH-breast cancer, it could be the molecular target of early diagnosis and treatment.</p>

Dynamic enhanced scanning of the pulmonary nodules with 16-slice spiral CT / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of dynamic enhanced CT scanning in diagnosis of pulmonary nodules.</p><p><b>METHODS</b>Sixty-nine patients with pulmonary nodules underwent examination with dynamic enhanced CT scanning. Of these patients, 53 with definite diagnoses confirmed by histological or clinical data were divided into three groups according to the nature of the nodules, namely the malignant group (n=34), benign group (n=13) and active inflammatory group (n=6). The time-density curve (T-DC) and the corresponding parameters of these patients were compared.</p><p><b>RESULTS</b>Significant differences in the net enhancement and S/A ratio were found among the 3 groups (P<0.001). The active inflammatory nodules showed the highest enhancement, followed by malignant nodules and then by benign nodules, with significant differences between any of the two groups (P<0.05). At the diagnostic threshold of net enhancement by 25 Hu or S/A ratio by 10% for malignant nodules, a higher negative predictive value and accuracy were obtained. The difference in the wash-out value among the 3 groups was statistically significant (P<0.05). When diagnostic criteria for malignancy was defined by a wash-in value of 25 Hu or higher and wash-out value of 0-35 Hu, the false-positive rate was decreased from 57.89% to 47.37%.</p><p><b>CONCLUSION</b>The application of 16-slice spiral CT and its CT perfusion software allows convenient dynamic enhancement study of pulmonary nodules and can be helpful in their differential diagnosis.</p>

Characteristic imaging features of primary central nervous system lymphoma in comparison with pathological findings / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the imaging features of primary central nervous system lymphoma (PCNSL).</p><p><b>METHOD</b>The imaging and pathological findings in 13 patients with pathologically confirmed PCNSL were analyzed retrospectively. Of these patients, 5 underwent CT scan, 6 had magnetic resonance imaging (MRI) examination, 1 patient underwent both CT and MRI examinations, and another had both MRI and PET/CT examinations.</p><p><b>RESULTS</b>Among the 13 patients with PCNSL, 11 were identified to have solitary tumor foci and the other 2 had multiple lesions. Supratentorial tumors were found in 9 patients, infratentorial tumors in 3 patients, and both supratentorial and infratentorial tumors in 1 patient. In 6 cases, the tumor presented isodensity or slight hypodensity on plain CT images, with mild or moderate enhancement after contrast agent injection. The lesions showed isointense or hypointense signals on T1WI and isointense or slightly hypointense signals on T2WI in 7 cases, with obvious homogenous enhancement in 5 cases and microcystic foci in 2 cases after gadolinium injection. Five patients showed the "angular sign" and 4 the "hilar depression sign". All the patients presented with mild or moderate peritumoral edema and space-occupying mass except for 1 patient with diffuse lesions, who showed hypointense signals on T1WI and hyperintense signals on T2WI with obvious nodular enhancement after gadolinium injection and high 18F-FDG uptake on PET/CT. Pathologically, the tumors appeared pinkish or grey-white, soft, with rich blood supply and without capsules. The tumor cells were found to cluster around the blood vessels under microscope.</p><p><b>CONCLUSIONS</b>PCNSL may present with typical imaging features which can be suggestive of the diagnosis. Stereotactic biopsy can be performed when necessary to obtain a definite diagnosis.</p>

Hemodynamic study of primary hepatocellular carcinoma evolved from viral-induced cirrhosis using CT perfusion imaging / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the hemodynamic changes of primary hepatocellular carcinoma (HCC) evolved from hepatic cirrhosis using CT perfusion imaging.</p><p><b>METHODS</b>Thirty-two patients with primary hepatocellular carcinoma evolved from virus-induced fibrosis or cirrhosis underwent dynamic CT scanning of the target slices for 60 min. The perfusion parameters of the hepatic parenchyma and HCC including the blood flow (BF), blood volume (BV), mean transit time (MTT), permeability-surface area product (PS), hepatic arterial fraction (HAF), IRF time of arrival (IRF TO) were obtained. Paired-sample t test was used to determine the differences in the perfusion parameters between the hepatic parenchyma and the primary HCC mass.</p><p><b>RESULTS</b>Compared with hepatic BF (117.13-/+31.05 ml/100 mg/min), BV (14.73-/+3.91 ml/100 mg), PS (31.93-/+5.91 ml/100 mg/min), HAF (25.02-/+8.19%), MTT (12.79-/+3.31 s), IRF TO (3.14-/+1.09 s), the primary HCC mass showed significant increments in the BF (239.69-/+96.07 ml/100 mg/min), BV (20.26-/+6.73 ml/100 mg), PS (37.50-/+9.50 ml/100 mg/min), HAF (68.97-/+15.22%) with decreased MTT (7.17-/+1.38 s) and IRF TO (2.42-/+0.94 s). Significant differences were found in all the perfusion parameters between the hepatic parenchyma and HCC (P<0.05).</p><p><b>CONCLUSION</b>Liver perfusion parameters can represent the hemodynamic changes in the HCC derived from hepatic cirrhosis.</p>

Value of computed tomography and magnetic resonance imaging in diagnosis and differential diagnosis of small hepatocellular carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) findings of small hepatocellular carcinoma to improve the accuracy in the diagnosis.</p><p><b>METHODS</b>This retrospective analysis involved 41 patients with small hepatocellular carcinoma cases confirmed by pathological examination of the biopsy samples or follow-up. These patients were assessed for CT and MRI findings including lesion size, density or signal intensity, enhancement patterns, and presence of tumor capsules.</p><p><b>RESULTS</b>On unenhanced CT images, small hepatocellular carcinomas were displayed mainly as low-density masses, and the majority of tumors presented with low signal intensity on T1-weighted unenhanced MR images with increased signal intensity on T2-weighted images in comparison with the surrounding liver parenchyma. Most of tumors showed intense enhancement during the arterial phase (CT in 15 cases and MRI in 13 cases), but some appeared isointense to the liver parenchyma (CT in 4 cases and MRI in 4 cases). In portal and delayed phases, the tumors typically had lower signal intensity than that of the surrounding liver tissues (CT in 25 cases and MRI in 12 cases) with enhancement of the tumor capsules (13 cases).</p><p><b>CONCLUSION</b>Dynamic enhanced scanning can be more informative of the pathology and blood supply of small hepatocellular carcinoma. Early and late arterial phase imaging may help in detecting the small lesions and in making differential diagnosis.</p>

Optic radiation in normal adults: a study using magnetic resonance diffusion tensor imaging and diffusion tensor tractography / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the fractional anisotropy (FA) and the architecture of the optic radiation fiber tracts of normal adults with magnetic resonance (MR) diffusion tensor imaging (DTI).</p><p><b>METHODS</b>Diffusion tensor images were obtained from 30 healthy volunteers without any cerebral abnormalities on conventional MRI. FA and the mean diffusivity (MD) of the optic radiation were measured in the directional encoded color (DEC) maps. The architecture of the optic radiation fiber tracts were displayed with the software of diffusion tensor fiber tracking.</p><p><b>RESULTS</b>In all subjects, the optic radiation could be readily identified in the DEC maps. The FA value was 0.509-/+0.029 in the left and 0.502-/+0.026 in the right, with the MD value of (0.763-/+0.050) x10(-3) and 0.748-/+0.052)x10(-3) mm2/s, respectively. No significant differences were found in the FA or MD value of the bilateral optic radiation (P>0.05). Diffusion tensor tractography (DTT) demonstrated that the 3 bundles of the optic radiation fibers were located in the lateral sagittal stratum, passing from the lateral geniculate body of the thalamus to the primary visual cortex. The dorsal and lateral bundles passed posteriorly to the superior bank of the calcarine cortex, while the ventral bundle passed anteriorly before making a sharp turn, known as the Meyer loop, and subsequently coursed posteriorly to terminate in the inferior margin of the calcarine cortex, which was consistent with the results of classic anatomical studies.</p><p><b>CONCLUSION</b>As a novel method to study the relationship between visual function and optic pathway, DTI and DTT can show the FA and architecture of the optic radiation.</p>

MRI diagnosis of multiple cerebral sclerosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the magnetic resonance imaging (MRI) feature of multiple cerebral sclerosis (MS) for better understanding and diagnosis of this disease.</p><p><b>METHODS</b>The MRI data of 32 patients with MS were reviewed. Conventional scanning with T1WI, T2WI, Flair sequence was performed, and 26 patients underwent Gd-DTPA enhanced scanning. The MS plaques were analyzed for their locations, sizes, shapes, MR signals and enhanced features, space-occupying signs, and the related corpus callosum changes and brain atrophy. Descriptive statistical method was used for all the data.</p><p><b>RESULTS</b>MRI identified MS lesions in the brain in 30 cases, with the sensitivity of 93.75%. All the MS patients had multiple lesions with predilection sites of the cortical/juxtacortical and periventricle areas, the centrum semiovale, and the corpus callosum. Most of the MS plaques were round or oval of different sizes. Bilateral lesions were almost symmetrical in distribution. Twenty patients had "rectangular demyelination" and 12 had "dirty white matter" signs, and 11 had both manifestations. The lesions were isointense, slightly hypointense or hypointense on T1WI, and hyperintense on T2WI and Flair sequences. Most of the MS plaques presented no enhancement, with occasional nodular or circular enhancement. No or slight space-occupying effect was found in the plaques. Of the 28 MS patients undergoing sagittal scanning of the corpus callosum, 17 presented with abnormal signals, with the sensitivity of 60.71% (17/28). Five patients had corpus callosum atrophy, and 10 had brain atrophy of different degrees.</p><p><b>CONCLUSION</b>These results suggest that the corpus callosum is often compromised by the MS lesions to present diffusive, nodular, radiating signal abnormalities and irregular ependymal thickening, which can be most obvious with sagittal FLAIR imaging.</p>

Magnetic resonance imaging findings in comparison with histopathology of heroin-associated encephalopathy / 南方医科大学学报

<p><b>OBJECTIVE</b>To review the magnetic resonance imaging (MRI) features and explore the histopathological basis of heroin-associated encephalopathy (HE).</p><p><b>METHODS</b>The data were collected from 34 established HE cases diagnosed with epidemiological evidence, clinical manifestations, MRI findings and laboratory examination. Histopathological sections were obtained in 10 cases. All patients were examined with T1WI, T2WI and FLAIR using 1.5T MRI scanner. Four patients died and autopsy was performed in 2 of them. Eight patients underwent stereotactic cerebral biopsy and the results of pathological examination were compared with the MRI findings.</p><p><b>RESULTS</b>All the 34 cases had low signals in T1WI but high signals in T2WI. Extensive involvement of the hemispheres beyond the cerebellar tentorium, brain stem and cerebellum was identified in 85.3% of the cases, and less than 10% had lesions involving only one of these three structures. Most of the lesions involved mainly the white matter, and 91.2% of the cases showed involvement of the bilateral hemispheres. Specific MRI features were found to help in HE diagnosis: lesions compromising the hemispheres beyond the cerebellar tentorium presented with the pattern resembling the Chinese character "eight", a hollow pattern was found in brain stem involvement, and "butterfly wing" pattern in cerebellar involvement. The abnormal signals were caused mainly by demyelination and vacuole formation in the white matter, and these vacuoles resulted in the sponge-like appearance of the white matter containing fluid.</p><p><b>CONCLUSION</b>MRI can provide strong evidence for HE diagnosis and can be informative of the involvement, position and aggravation of the lesions with some characteristic MRI features. In most of the cases, a MRI-based diagnosis can be consistent with histopathological diagnosis.</p>

Imaging features of primary bone lymphoma and its histopathology / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the imaging features of primary bone of the lymphoma PLB on X-ray, CT and magnetic resonance imaging (MRI).</p><p><b>METHODS</b>The data of 8 patients (6 males and 3 females, aged 9-60 years with a median age of 26.5 years) with pathologically confirmed PLB were retrospectively reviewed. Plain radiographs were obtained in all the 8 cases, CT scans performed in 5 and MRI examinations in 7. Four patients underwent X-ray, CT and MRI, two underwent CT and MRI, and one underwent X-ray and MRI. Surgical resection was performed in 7 cases and biopsy done in 2, and routine histopathological examination and immunohistochemistry were performed for all patients.</p><p><b>RESULTS</b>The site of PLB focus was found in the pelvic bone in 4 cases, right frontal bone in 1 case, proximal femoral bone in 1 case, occipital clivus in 2 cases, and vertebral column in 1 case. Plain X-ray revealed in 4 cases roughly normal shape of the involved bone with stippled interior bone structure destruction; the other 4 cases presented with slight or moderate bone expansion with obvious signs of osteolysis. CT scans displayed areas of different sizes of osteolytic cortical and marrow cavity destruction with large soft tissue masses around the lesion. MRI found heterogeneous iso- to hyperintense signals in the lesions in the bone and soft-tissue masses on T2-weighted images but homogeneous isointense signals on T2-weighted images. The tumors were obviously enhanced after contrast-enhanced scans on CT and MRI. Histological examination identified B-cell lymphoma in 5 cases and T-cell lymphoma in 4 cases.</p><p><b>CONCLUSION</b>PBL is characterized in imaging examinations by basically normal shape of the involved bones with possible bone expansion, obvious stippled osteolytic destruction, large soft-tissue mass around the lesion and obvious enhancement after contrast-enhanced scans.</p>

Proton magnetic resonance spectroscopy for radiation encephalopathy induced by radiotherapy for nasopharyngeal carcinoma / 南方医科大学学报

<p><b>OBJECTIVE</b>To understand the metabolic patterns of NAA, Cr and Cho in radiation encephalopathy (RE) induced by radiotherapy for nasopharyngeal carcinoma detected by proton magnetic resonance spectroscopy (1H-MRS), and provide useful evidence for early diagnosis of this disease.</p><p><b>METHODS</b>Chemical shift imaging 1H-MRS was performed for 10 healthy volunteers (control group) and 21 patients with pathologically confirmed nasopharyngeal carcinomas, who developed RE after radical radiotherapy as diagnosed on the basis of clinical symptoms and imaging findings. The contents of NAA, Cr and Cho in the pixels were observed, the metabolic maps generated, and NAA/Cr and NAA/Cho ratios calculated for all the subjects.</p><p><b>RESULTS</b>The concentrations of NAA, Cr and Cho were rarely observed in the necrosis and liquefaction foci in the patients, nor were any signals displayed on their metabolic maps. In the visible lesions, with the exception of the necrosis and liquefaction foci, the content of NAA increased slightly, whereas that of Cr or Cho decreased obviously or even became absent. An area around the lesion was identified where NAA content decreased but Cr or Cho increased. The signal in the metabolic maps appeared indistinguishable. The NAA/Cr and NAA/Cho ratios were less than 1. Farther away from the visible lesions, the NAA, Cr and Cho contents remained normal with NAA/Cr and NAA/Cho ratios of less than 1.</p><p><b>CONCLUSION</b>1H-MRS is capable of displaying the patterns of metabolite changes in RE induced by radiotherapy, and identifying larger area of abnormal metabolism in RE than the visible lesion in MRI, which suggests the possibility of earlier detection of RE with 1H-MRS.</p>

Diagnosis of aortic intramural hematoma by electron beam CT / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the value of electron beam CT (EBCT) in the diagnosis of aortic intramural hematoma (AIH).</p><p><b>METHODS</b>Twenty-five patients who complained of acute chest and back pain were scanned with an EBCT scanner (Imatron C-150) using contrast-enhanced continuous volume scanning (CVS) for establish the diagnosis of AIH.</p><p><b>RESULTS</b>Seven patients were diagnosed as having Stanford type A, and the others as type B AIH. The direct features of AIH in EBCT included crescent or circular thickening (>5 mm) of the aortic wall without signs of lumen formation resulting from intimal rupture. The indirect features included calcification ingression (7 cases), penetrating ulcer (12 cases), atherosclerosis (18 cases) and leakages (5 cases). The complicating features included pericardial effusion (5 cases), pleural effusion (14 cases), involvement of the large branches (5 cases), aortic dissection (3 cases) and aneurysms (4 cases).</p><p><b>CONCLUSION</b>EBCT can provide important information for the diagnosis and treatment of AIH, and can be useful for follow-up observation of the patients.</p>

The prognostic value of angiogenic activity evaluation with contrast enhanced power doppler imaging in axillary-node-negative breast carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To determine the value of contrast ultrasound on evaluating tumor angiogenic activity and its prognostic value in axillary-node-negative breast carcinoma (ANNBC).</p><p><b>METHODS</b>Power doppler imaging (PDI) was used to observe intratumoral vascularization before and post contrast agents injection. Intratumoral blood flow signals were measured and intratumoral vessel positive total areas (VPTA) were analyzed with computer-assisted quantitative assessment. Sections of malignant tumors were analyzed for the intratumoral microvessel density (MVD) by immunohistochemistry using monoclonal antibody to factor VIII-related antigen. The relationships within VPTA, MVD and prognosis were the main outcome measures.</p><p><b>RESULTS</b>There was no significant correlation between VPTA and MVD before contrast agents used while there was a positive correlation between them after that. However, VPTA and MVD had significant correlation with histology grade and tumor recurrence and metastasis while had no correlation with the general clinic pathologic factors. VPTA and MVD were significantly higher in postoperative cases with recurrence or metastasis than those in cases with tumor-free. Total survival rate and tumor-free survival rate of high-VPTA or high-MVD group were significantly lower than those of low-VPTA or low-MVD group.</p><p><b>CONCLUSIONS</b>The value of VPTA by contrast enhanced PDI was a beneficial prognostic indicator. High VPTA in ANNBC patients may has worse prognosis and antiangiogenic therapy is strongly suggested on them.</p>