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Objective:To evaluate the value of 18F-FDG PET/CT for preoperative localization of epileptogenic foci in refractory epilepsy patients with negative MRI. Methods:Clinical data (550 lobes) of 55 epilepsy patients (38 males, 17 females, age (20.0±8.1) years) with negative MRI who underwent preoperative 18F-FDG PET/CT-MRI between January 2014 and June 2020 at the First Affiliated Hospital of Jinan University were retrospectively analyzed. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of 18F-FDG PET/CT, video electroencephalogram (VEEG), PET/CT+ VEEG and PET/CT-VEEG for localizing epileptogenic foci were calculated using stereoelectroencephalography (SEEG) and the outcomes of at least 1 year of postoperative follow-up as reference standards. χ2 test was used to compare the efficiencies of different examination modalities for unilobar, multilobar and all patients. Results:The correct lateralization rate of epileptogenic foci was 92.6%(25/27) using PET/CT. The sensitivity, specificity, accuracy, PPV and NPV of PET/CT for localization of epileptogenic foci were 65.1%(54/83), 77.9%(364/467), 76.0%(418/550), 34.4%(54/157) and 92.6%(364/393), respectively. The sensitivities of PET/CT-VEEG for localization of epileptogenic foci in all patients and patients with multilobar epilepsy were higher than those of VEEG alone (75.9%(63/83) vs 45.8%(38/83), 68.6%(35/51) vs 31.4%(16/51); χ2 values: 15.80, 14.16, both P<0.001). The specificities of PET/CT+ VEEG for localization of epileptogenic foci in all patients and patients with unilobar epilepsy were higher than those of VEEG alone (97.6%(456/467) vs 94.6%(442/467), 97.9%(282/288) vs 94.1%(271/288); χ2 values: 5.66, 5.48; P values: 0.017, 0.019). The sensitivity of PET/CT-VEEG (PET/CT and VEEG concordance) for localization of epileptogenic foci was higher than that of PET/CT+ VEEG (PET/CT and VEEG discordance) (8/9 vs 28.4%(21/74); χ2=10.40, P=0.001), and its specificity and accuracy were higher than those of PET/CT-VEEG (PET/CT and VEEG discordance) (93.4%(57/61) vs 71.7%(291/406), 92.9%(65/70) vs 72.1%(346/480); χ2 values: 13.23, 13.96; both P<0.001). Conclusions:18F-FDG PET/CT can localize and lateralize epileptogenic foci in patients with negative MRI. The combination of 18F-FDG PET/CT and VEEG improves the sensitivity, specificity, and accuracy for epileptogenic foci detection. 18F-FDG PET/CT is more accurate in detecting epileptogenic foci when it is concordant with VEEG.
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Objective:To predict the short-term postoperative recurrence status of patients with refractory temporal lobe epilepsy (TLE) by analyzing preoperative 18F-FDG PET images and patients′ clinical characteristics based on deep residual neural network (ResNet). Methods:Retrospective analysis was conducted on preoperative 18F-FDG PET images and clinical data of 220 patients with refractory TLE (132 males and 88 females, age 23.0(20.0, 30.2) years)) in the First Affiliated Hospital of Jinan University between January 2014 and June 2020. ResNet was used to perform high-throughput feature extraction on preprocessed PET images and clinical features, and to perform a postoperative recurrence prediction task for differentiating patients with TLE. The predictive performance of ResNet model was evaluated by ROC curve analysis, and the AUC was compared with that of classical Cox proportional risk model using Delong test. Results:Based on PET images combined with clinical feature training, AUCs of the ResNet in predicting 12-, 24-, and 36-month postoperative recurrence were 0.895±0.073, 0.861±0.058 and 0.754±0.111, respectively, which were 0.717±0.093, 0.697±0.081 and 0.645±0.087 for Cox proportional hazards model respectively ( z values: -3.00, -2.98, -1.09, P values: 0.011, 0.018, 0.310). The ResNet showed best predictive effect for recurrence events within 12 months after surgery. Conclusion:The ResNet model is expected to be used in clinical practice for postoperative follow-up of patients with TLE, helping for risk stratification and individualized management of postoperative patients.
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Objective To observe18F-FDG PET/MRI manifestations of gray matter heterotopia(GMH)related epilepsy.Methods Data of 27 patients with GMH and epilepsy diagnosed with MRI were retrospectively analyzed.Brain 18 F-FDG PET/MRI manifestations and complicated brain malformations were observed,and the classification of GMH were performed.Results Among 27 cases,periventricular GMH,focal subcortical GMH,subcortical lamellar(band)GMH and mixed GMH were detected each in 15,2,2 and 8 cases,respectively.Compared with cerebral white matter around the lesion or in the contralateral mirror area of the lesion,glucose hypermetabolism and glucose hypometabolism were found in 22 and 3 cases,respectively,while glucose metabolism was normal in 2 cases.Compared with gray matter in precentral gyrus,glucose hypermetabolism and glucose hypometabolism were observed in 8 and 16 cases,respectively,while glucose metabolism was normal in 3 cases.Six cases complicated with cerebral fissure deformity,6 cases with bilateral cerebellar hemispheric volume reduction,1 case with absence of pellucid septum and lower fornix,1 case with dysplasia of corpus callosum and 1 case with polymicrogyria.Conclusion 18 F-FDG PET/MRI manifestations of GMH related epilepsy had certain characteristics,which were helpful for clinical diagnosis.
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Objective To compare the composition of γδ T cells in the peripheral blood of gestational diabetes mellitus(GDM) patients with those of normal pregnant women,so as to explore the association of γδ T cells with the onset and progression of GDM.Methods The peripheral blood mononuclear cells(PBMC) of GDM patients(case group) and normal pregnant women(con-trol group) were separated by Ficoll-Hypaque density gradient centrifugation.γδ T cells were labeled with FITC conjugated anti TCRγδ monoclonal antibody(McAb) and PE conjugated anti-CD3 McAb and analyzed by flow cytometry.Results γδ T cells in GDM patients' peripheral blood were about(6.89 ± 3.22) ％,which was higher than normal control group(4.26 ± 1.64) ％.The percentage of γδ T cells in non-treated GDM group was significantly increased to(8.79 ± 2.33)％,while in treated GDM group,the percentage of γδ T cells was drop to normal(3.76±1.62)％.Conclusion γδ T cells in GDM patients' peripheral blood and CD3+ T Cells were slightly increased.The alteration may be related to the onset of GDM.
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Objective To compare the composition of γδ T cells in the peripheral blood of gestational diabetes mellitus(GDM) patients with those of normal pregnant women,so as to explore the association of γδ T cells with the onset and progression of GDM.Methods The peripheral blood mononuclear cells(PBMC) of GDM patients(case group) and normal pregnant women(con-trol group) were separated by Ficoll-Hypaque density gradient centrifugation.γδ T cells were labeled with FITC conjugated anti TCRγδ monoclonal antibody(McAb) and PE conjugated anti-CD3 McAb and analyzed by flow cytometry.Results γδ T cells in GDM patients' peripheral blood were about(6.89 ± 3.22) ％,which was higher than normal control group(4.26 ± 1.64) ％.The percentage of γδ T cells in non-treated GDM group was significantly increased to(8.79 ± 2.33)％,while in treated GDM group,the percentage of γδ T cells was drop to normal(3.76±1.62)％.Conclusion γδ T cells in GDM patients' peripheral blood and CD3+ T Cells were slightly increased.The alteration may be related to the onset of GDM.
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Objective To investigate PET/CT and PET/MR characteristics of head and neck squamous cell carcinoma (HNSCC).Methods Totally 40 patients with HNSCC underwent whole body 18F-FDG PET/CT and MR scans of head and neck before anti-tumor treatment.PET positive lesions of HNSCC,including primary lesions and lymph nodes were evaluated by 2 radiologists independently.Then the imaging quality,fusion quality,lesion conspicuity and lesion characteristics were assessed based on PET/CT,PET/MR T1WI and PET/MR T2WI.Results Ninety PET positive lesions in all 40patients were evaluated,including 40 primary lesions and 50 lymph nodes.Similar imaging quality and fusion quality of PET/CT,PET/MR T1WI and PET/MR T2WI were obtained without statistical difference (both P＞0.05).For the lesion conspicuity,PET/MR T1WI and PET/MR T2WI demonstrated significantly better than PET/CT in positive primary lesions and lymph nodes (all P＜0.05).For the characteristics of positive primary lesions,PET/MR T2WI provided more information than PET/CT in 29 lesions,equal to PET/CT in 4 lesions,and less than PET/CT in 7 lesions.Conclusion The application of PET/MR in HNSCC is feasible,being superior to PET/CT in indication of lesions in head and neck area.
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Objective The purpose of this study was to establish and evaluate a mouse model of sepsis for studying the mechanism of sepsis and development of anti-inflammatory drugs.Methods The sepsis in mice was induced by cecal ligation and puncture ( CLP) .The survival rates, microbial load, liver and kidney damages, cytokines and pathological changes were detected to evaluate the mouse models.Results The death of mice was closely related with the ligated sites. The mice with 50%cecal ligation displayed about 40% of 12-day survival rate, however, all the mice with 75% cecum ligation died within 4 days (P<0.01).Compared with the sham surgery group, the mice with 50% cecal ligation had a high microbial load in the blood and abdominal cavity.Leukopenia was also emerged (P<0.001).CLP mice demonstra-ted elevated levels of serum ALT, AST and BUN (P<0.01).The levels of IL1α, IL6, IL10, MIP1α, MIP1β, and TNFαwere increased a lot.The liver and lung showed obvious pathological injury at 48 h post CLP.Conclusions The established mouse model of CLP shows typical characteristics of sepsis and is an ideal tool for further study of anti-inflam-matory drugs.
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Objective To identify the possible alterations of brain function in prefrontal lobes and hippocampus in the first-episode patients with positive symptoms of schizophrenia using magnetic resonance spectroscopy. Methods 20 patients were selected to perform MRI and HMRS examination. Proton multi-voxel spectroscopy imaging(1 H-MRSI)was obtained from two sides of the hippocampus and frontal lobes regions. The metabolites included N-acetylaspartate (NAA), and choline-containing compounds (Cho), creatine and phosphocreatine (Cr).The ratios of NAA/Cr, Cho/Cr and NAA/Cho were determined. Results (1)The Cho/Cr ratio was significantly reduced in left frontal white matter of patients compared to right(1. 178 ± 0.210 vs 1.437 ± 0. 337). (2) There was no statistically significant difference in metabolite levels in between left anterior cingulate gray matter and right (N AA. Cr: 1. 339 ± 0.452 vs 1. 748 ± 0. 147;Cho/Cr: 1. 406 ± 0. 394 vs 1. 761 ± 0.362) (P ＜ 0.05). (3) The NAA/Cr, Cho/Cr were significantly reduced in left hippocampus of patients compared to right. Conclusion The results implicate that the metabolic abnormalities might exist in the left hippocampus and frontal lobe of schizophrenic patients with positive symptoms.
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The manifestation of clinical symptoms of cerebral small-vessel disease (SVD) is cognitive disorders. Its pathological changes are manifested as leukoaraiosis and/or lacunar infarction. However, it is not clear whether cognitive disorders caused by SVD is correlated with the severity of white matter damage. Magnetic resonance spectroscopy analysis can noninvasively detect metabolite concentrations of brain tissue in vivo and directly reflect cerebral metabolism; Diffusion-tensor imaging is a novel noninvasive technique for specific observation of white matter through different parameters such as mean diffusivity and anisotropy for quantitative evaluation of the abnormalities of fine structure of white matter. The combination of magnetic resonance spectroscopy analysis and diffusion-tensor imaging may more sensitively reveal the severity of white matter damage, and provide a research tool for cognitive disorders caused by SVD.resonance imaging
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0.05). Conclusions DTI is valuable in assessing the directionality and density of white matter and can reflect the age-related physiological changes of white matter in vivo non- invasively.
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Objective To study the value of MR perfusion-weighted imaging(PWI)after administration of acetazolamide(ACZ)in evaluating the cerebrovascular capacity.Methods MR perfusion-weighted imaging were performed before and after ACZ administeredorally in 7 cases with cerebral infarction.The values of rCBV and rMTT were analysed and the cerebrovascular capacity were evaluated.Results The prolonged rMTT was found in rMTT map before and after ACZ in all cases.Only 5 subjects were abnormal at rCBV map visually.rMTT was increased at the abnormal region on rMTT map.The abnormal regions at rCBV maps included both rCBV increased or decreased.The abnormal region was larger at rMTT map than that at rCBV map.Conclusion MR perfusion-weighted imaging with ACZ test has significant value in assessing the cerebrovascular capacity.