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{L-End}Objective To analyze the changes of seven potential biomarkers in plasma of patients with occupational silicosis (hereinafter referred to as "silicosis"), and explore their clinical value in determining the stage of silicosis. {L-End}Methods A total of 100 male silicosis patients were selected as the silicosis group (63 cases in stage Ⅰ and 37 cases in stage Ⅱ subgroups), and 100 male healthy individuals were selected as the control group using the 1∶1 matched case-control study. Enzyme-linked immunosorbent assay was used to analyze the level of interleukin-17 (IL-17), monocyte chemoattractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), Krebs von den Lungen-6 (KL-6), connective tissue growth factor (CTGF), platelet-derived growth factor (PDGF), and histone H4 in plasma. Their clinical value for diagnosing silicosis was evaluated using receiver operating characteristic (ROC) curve, discriminant analysis stepwise method, and Fisher discriminant function analysis. {L-End}Results The levels of IL-17, MCP-1, MMP-9, KL-6, CTGF, PDGF, and histone H4 in the plasma of the silicosis group, silicosis stage Ⅰ subgroups, and stage Ⅱ subgroups were higher than those in the control group (all P<0.05). The levels of IL-17, MCP-1, and MMP-9 in the plasma of the stage Ⅱ subgroup decreased (all P<0.05), while the levels of KL-6, CTGF and histone H4 increased (all P<0.05) compared with the stage Ⅰ subgroup. The area under the ROC curve for diagnosing silicosis using these seven potential biomarkers ranged from 0.761 to 1.000 (all P<0.01), with the sensitivity of 0.640-1.000, the specificity of 0.840-0.990, and the Youden index of 0.540-0.990. The Fisher discriminant function was formed by stepwise discriminant analysis, and the results showed that the coincidence rate was 99.5%, and the misdiagnosis rate was 0.5% for diagnosing and staging silicosis with these seven potential biomarkers. The coincidence rate of diagnosing control group, silicosis stageⅠsubgroup and the silicosis stage Ⅱ subgroup was 100.0%, 98.4% and 100.0%, respectively. {L-End}Conclusion IL-17, MCP-1, MMP-9, KL-6, CTGF, PDGF and histone H4 in plasma can be used as biomarkers for the diagnosis of silicosis, and the Fisher discriminant function based on the combination of these seven biomarkers can assist in staging silicosis.
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Objective@#To investigate the imaging features of cerebral small vessel disease(SVD) in systemic lupus erythematosus(SLE) patients with impaired renal function and their related risk factors.@*Methods@#Seventy-six SLE patients and forty age- and sex-matched healthy controls were recruited, and SLE patients were divided into the impaired renal function group [estimated glomerular filtration rate (eGFR) <90 ml/(min·1.73 m2)] (n=38) and the normal renal function group [eGFR≥90 ml/(min·1.73 m2)] (n=38) according to their eGFR. All subjects underwent brain MRI, cognitive and psychiatric testing. The SVD scores were measured, total white matter hyperintensity (WMH) and SVD scores were calculated, and the risk factors of SVD scores were analyzed by using ordinal logistic regression.@*Results@#SLE patients in the impaired renal function group showed higher basal ganglia PVS, centrum semiovale perivascular space (PVS), periventricular WMH, deep WMH and total SVD scores compared with normal controls or patients with normal renal function (H=44.568, 31.380, 31.172, 43.419, 24.317, P<0.001) . The ordinal logistic regression analysis showed that C-reactive protein was a risk factor for SVD in patients with SLE(OR=1.323, P<0.01).@*Conclusion@#SLE patients with impaired renal function had a higher SVD burden on MR imaging, particularly PVS in the basal ganglia and deep WMH, which was affected by the C-reactive protein level.
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Objective With the improvement of technology and strategy , reduced field-of-view diffusion weighted imaging ( rFOV DWI) has provided more robust imaging .This article was intended to compare the clinical utility between rFOV DWI and con-ventional DWI in the diagnosis of prostate cancer . Methods Retrospective analysis was made on 58 prostate cancer patients under-going verification of biopsy or surgery after 3.0 T MRI rFOV DWI and regular DWI examinations in Nanjing General Hospital of Nan-jing Military Command from August 2014 to September 2015 , among whom prostate cancer and benign prostatic hyperplasia were 31 cases and 27 cases respectively .Independent grading was made by 2 radiol-ogists who were unaware of any clinical data and sequences in the as-pects of distortion on DW images , lesion conspicuity on DWI ( b=1000 ) and ADC images according to a 4-point Likert scale .rFOV and conventional DWI sequences were acquired using b =400,1000,0s/mm2.The IVIM double exponential model software was applied to generate ACD value, slow dispersive coefficient(D value) and parameterized image of volume fraction of fast dispersion (f value).Se-quence analysis was made in suspected peripheral tumor regions of prostate cancer patients and and healthy peripheral zones of patients with benign prostatic hyperplasia respectively to get ACD , D and f values .The ratio values rADC , rD and rf were attained compared with obturator internus .ROC analysis was made on the efficacy of different parameters of two sequences in prostate cancer . Results Image qualities of rFOV DWI were rated superior to conventional DWI (P<0.001,Wilcoxon Signed-Rank Test).Compared with con-ventional DWI, ADC value (0.728 ±0.094 vs 0.789 ±0.116, P<0.05)and D value(0.622 ±0.077 vs 0.651 ±0.099, P<0.05)of peripheral tumor regions in rFOV DWI were lower and the difference was statistically significant , whereas no significant difference was found in f value(P=0.932).No difference was found in area under ROC curve of f value between rFOV DWI and traditional DWI (0.853 vs 0.767, P=0.283). Conclusion The rFOV DWI sequence yielded can efficiently improve image quality , which is of important value to the clinical diagnosis of prostate cancer .
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Objective Neuropsychiatric systemic lupus erythematosus ( SLE) is a common complication of SLE, whose path-ogenesis is not yet clear but associated with the alteration of cerebral blood flow ( CBF) in some studies.This study was to investigate the CBF alteration in SLE patients without overt neuropsychiatric symptoms by arterial spin labeling ( ASL) MRI. Methods Twenty-eight SLE patients without overt neuropsychiatric symptoms and 30 age-and sex-matched healthy controls underwent conventional MRI and ASL examinations, and all received such neuropsychologic tests as number connecting test-A ( NCT-A ) , digit symbol test ( DST ) , self-rating anxiety scale ( SAS ) , and self-rating depression scale ( SDS) .Independent sample-t test was used to detect the mean CBF in the whole brain, gray matter, and white matter of the SLE patients and healthy controls.The voxel-wise CBF maps of the two groups of subjects were further analyzed with the SPM8 software to compare the regional CBF between the two groups, followed by evaluation of the correlation between the regional CBF values and clinical markers. Results In comparison with the healthy controls, the SLE pa-tients showed significantly reduced CBF in the gray matter (40.5 ±3.7 vs 37.3 ±6.5, P=0.028) and the whole brain (38.0 ±3.5 vs 35.1 ±6.1, P=0.032), especially in the supplementary motor area and the adjacent middle cingulate, anterior cingulate, left medial frontal gyrus, left inferior frontal gyrus, and left insula (P<0.05, FWE corrected).The NCT-A score was negatively correlated with the CBF values of the left medial frontal gyrus (r=-0.402, P=0.032) and left inferior frontal gyrus (r=-0.382, P=0.045) of the SLE patients. Conclusion ASL and MRI showed significantly reduced cerebral blood flow in the SLE patient without overt neu-ropsychiatric manifestations, which was correlated with the change of the patient's cognitive function.
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Objective Analysis of MRI image of lateral ventricular subependymomas to improve our recognition of radiology manifestation of the disease. Methods Clinical data and MRI findings of 6 patients with subependymomas proved by surgical pathology, observed from January 2007 to June 2013, were analyzed retrospectively. Results Six patients (4 males and 2 females) presented with headache and dizziness. Among these 6 patients, tumor developed in right lateral ventri-cle in three patients, in left lateral ventricle in 2 patients and in frontal of dual lateral ventricle in one patient. In MRI image, tumors showed iso-intense to hypointense to normal white matter on T1-weighted and DWI images, hyperintense on T2-weighted and FLAIR. Mild or no enhancement was noted in most cases. MRS showed findings consistent with low-grade tu-mor, with a normal choline peak and depressed N-acetyl-aspartate peak. Conclusion Lateral ventricular subependymo-mas have characteristic MRI features and multi-direction images are helpful for diagnosis.
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Objective To investigate the relationship between the carotid calcification and the prognosis in patients with ischemic stroke. Methods A total of 522 patients with non-cardiac ischemic stroke registered in the Nanjing Stroke Registry Program (NSRP )from December 2009 to October 2012 were enrolled. All patients underwent head and neck CT angiography (CTA). The original data of CT scan were transmitted into the Siemens workstation. Calcium score measurement was performed using the same reconstruction conditions and Agatston calcium score to measure calcification score. The patients were divided into no (0),mild (0
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Objective To investigate the alteration of the default-mode network (DMN) in the patients with minimal hepatic encephalopathy (MHE) using resting functional MRI, and to explore its underlying clinical significance. Methods Fourteen MHE patients and 14 age-matched normal controls underwent standard resting state functional MRI scan. The components representing DMN were picked out after separation of independent component analysis. One and two sample t-tests were used to observe the changes of DMN in the patients in contrast to the controls. Results Typically spatial distributions of the DMN were found in both MHE patients and controls. Comparison results revealed that there was significantly reduced functional connectivity in the left posterior cingulate cortex, bilateral anterior cingulate cortex, bilateral medial prefrontal cortex, left parahippocampal cortex in MHE patients, while functional connectivity increased in the right precuneus. Conclusion Resting state functional MRI can be used to observe DMN changes in MHE patients. In MHE patients, there is reduced DMN activation in the widespread regions, while the activation of right precuneus increases.
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Objective To study the radiographic features of the chordoid glioma and its differential diagnosis,and increase neuroradiologists'awareness of this newly described tumor,facilitating prospective diagnosis.Methods Three patients with chordoid glioma were reviewed retrospectively to determine whether any characteristic radiographic findings and clinical-pathologic findings would emerge,and the relevant literatures were reviewed.Routine CT(2 cases)and MR(3 cases),contrast-enhanced MR(3 cases)were performed.Results The masses were well circumscribed and located in the region of the hypothalamus/third ventricle-suprasellar region(2 cases)and intrasuprasellar region(1 case).Tumors were isointense to gray matter on CT scans and were isointense or hypointense on T_1WI and hyperintense on T_2WI.In two patients,vasogenic edema extended into the optic tracts and cystic or necrotic area was seen.All cases were remarkably enhanced following contrast administration.Conclusions Radiologic findings of the chordoid glioma has some unique features.Tumor,in the region of the hypothalamus-third ventricle-suprasellar region,if it is well circumscribed and remarkably enhancing following contrast administration,should be included in the differential diagnosis.
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Extracranial carotid athcrosclcrosis is the major cause of ischcmic stroke.The intumescence of carotid atherosclerotic plaque in meries results in lumen stenosis or detachment of plaque organisms.causing the distal vascular embolization,and thus resulting in a reduced cerebral blood supply and cerebral ischemic event.The volume data acquisition of multislice spiral CT angiography can provide high-quality two-dimensional and three-dimensional images,its imaging technique has become a very effective detection tool for carotid atherosclerosis.This article reviews the diagnosis application of multislice spiral CT angiograohy of carotid atherosclerosis and its pitfalls.
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Different from conventional MRI, Diffusion-weighted(DW) magnetic resonance(MR)imaging is dependent on the molecular motion of water, and provides information on the physiologic state of the brain. In the diagnosis of acute cerebral infarction,the sensitivity is 94% and specificity is 100%. On MRDW imaging, the epidermoid tumors and cerebrospinal fluid or arachnoid cysts, subdura effusions and subdural empyemas,abscess cavities or empyemas and necrotic tumors could be differentiated accurately. MRDW imaging also provides adjunctive information for the diagnosis and evaluation of other cerebral diseases including neoplasms, intracranial infections, traumatic brain injury, and demyelinating processes. As a valuable technique, diffusion-weighted MR imaging should be considered an essential sequence on the diagnosis of brain stroke, and its use in most brain MR studies is recommended.
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Objective Different grades of glioma lead to different clinical course,treatments and prognosis,thus it is important to predict histological grades of glioma preoperatively.18F-FDG PET/CT imaging and MR perfusion imaging is considered a promising method to evaluate glioma,and the present study was to evaluated the contribution of 18F-FDG PET/CT imaging and MR perfusion imaging in grading intracranial glioma.Methods Eighteen consecutive patients with suspected primary brain glioma underwent 18F-FDG PET/CT scanning and MR perfusion scanning in our hospital.To evaluate the relative sensitivity among standardized uptake value (SUV),L/W,and rCBV,the PET/CT imaging were analyzed,and the SUV and Lesion-to-white matter ratio (L/W) were calculated.The rCBV ratios of lesions were calculated relative to the region of interest (ROI) values in contra lateral normal white matter.Results Eighteen brain gliomas were confirmed by pathologic diagnosis,including 7 WHOⅡ tumors,6 WHOⅢ tumors,and 5 WHOⅣ tumors.SUV and rCBV could not differentiate between WHOⅡ tumor and WHOⅢ tumor,however significant difference could be found among the three using L/W.Conclusion 18F-FDG PET/CT imaging and MR perfusion imaging could offer more diagnostic information than conventional MRI.All of the three semiquantitative data offer some contribution in grading intracranial gliomas,and L/W might be the best one.
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Objective: To evaluate the application value and potential faults of Dual-source CT in carotid arterial angiography.Methods: We retrospectively analyzed the images of 477 patients with symptomatic carotid atherosclerosis detected by dual-source CT angiography(CTA) from February 2007 to January 2008,and evaluated the quality of the images,which were classified into 3 quality grades: excellent(with clear display of the lesion and no noticeable motion artifacts,good(with a few motion artifacts but still diagnostically applicable),and poor(with heavy motion artifacts,unclear display and no diagnostic value).Results: Of the 477 images,420(88.1%) were of excellent quality,44(9.2%) of good quality and 13(2.7%) of poor quality.Among the total number of cases,134(28.1%) were shown to be normal and 34(7.1%) abnormal in anatomic structure.Atheromatous plaques were detected in 295 cases(61.8%),carotid artery stenting in 11(2.3%),internal carotid artery occlusion in 1,common carotid artery occlusion in 1,and cervical tumor in 3.Conclusion: Dual-source CT,faster,effective and minimally invasive,is particularly valuable in the diagnosis of carotid arterial lesion and stenosis.
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Objective To discuss the construction and principal of dual-source CT,as well as its superiorities in imaging of heart coronary artery and the clinical application of dual energy technique.Methods The structure of Siemens 64-slice CT was analyzed.The superiorities of dual-source CT in imaging of heart coronary artery were compared with conventional multi-slice CT,and the clinical value of dual energy technique was discussed.Results The dual-source computed tomography had high temporal resolution superiority,and high quality coronary artery CT angiography could be acquired without heart rate control.Dual energy technique could be applied to differentiate tissue component,display given tissue,evaluate the content of iodine in tissue.Conclusion Dual-source CT can not only enhance the diagnosis veracity of pathological changes of heart coronary artery but improve the ability of CT in tissue differentiation.
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The dual source computed tomography is equipped with two X-ray tubes and two corresponding detectors.With its 83 ms-temporal resolution of single segment reconstruction,high quality coronary artery CT angiography can be acquired without heart rate control.Dual energy output by two x-ray tubes improves the differentiation of body tissues,clinical application and lesion diagnostic accuracy of CT.
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Atypical teratoid/rhabdoid tumor of the central nervous system has aggressive growth with high potential CSF dissemination and frequently affects very young children.The tumor contains rhabdoid cells and primitive neuroectodermal,malignant mesenchymal and epithelial elements.Immunohistochemistry is helpful in differentiating atypical teratoid/rhabdoid tumor from primitive neuroectodermal tumor/medulloblastoma.Atypical teratoid/rhabdoid tumor is cytogenetically characterized by monosomy 22 or deletion of chromosome band 22q11.2.Intensified therapy combined with surgical resection has been suggested for its treatment.Due to the secondary cystic/necrotic changes and hemorrhage,the imaging features of the tumor are variable.
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Objective To discuss the application of DWI and DTI in diagnosis and evaluation of brain tumor. Methods Combining with literatures, the application of DWI and DTI in brain tumor diagnosis, differential diagnosis, tumors classi- fication, preoperative evaluation, operation plan establishment, follow-up role of treatment were reviewed and evaluated. Results The DWI and DTI were available to brain tumor diagnosis, differential diagnosis and tumor grade. The DTI could be clearly shown the influence of tumor with white matter quality, it was important in operation plan establishment. The combination of intra-operative MRI, functional MRI and DTI was valuable for brain tumor resection. In the meantime, the treatment response of tumor and the changes of treatment-induced white matter were accurately assessed by DTI. Conclu- sion With the MRI hardware and software technology development, the DWI and DTI imaging information can be provided important value in brain tumor pathological changes diagnosis, evaluation, therapeutic planning and post treatment assess- ment.
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External hard disk with USB interface is used to storage CT raw data so as to solve the question that CT raw data cannot be storage for long time. This method benefits CT clinical work and scientific research. Compression and storage of CT raw data will play an important role in CT data storage.