Magnetic resonance hyperintense vessel sign: clinical significance and related factors / 中华神经科杂志

Objective:To investigate clinical significance and related factors of magnetic resonance hyperintense vessel sign (HVS).Methods:The clinical data and related imaging parameters of 109 patients with acute anterior circulation occlusion cerebral infarction, who admitted to Northern Theater Command General Hospital of People′s Liberation Army from April 2017 to August 2019, were analyzed retrospectively. Brain magnetic resonance imaging (MRI) examinations including fluid attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI) and three dimensional time of flight magnetic resonance angiography (3D TOF MRA) sequences within 24 hours of onset were performed. According to the distribution range of HVS in FLAIR sequence, the patients were divided into four grades (0, 1, 2 and 3), grades 0 and 1 belonging to HVS low grade group, and grades 2 and 3 HVS high grade group. Univariate and multivariate analyses were made to explore related factors of HVS. Fifty-two patients who completed baseline CT within six hours of onset before MRI examination were performed CT-Alberta Stroke Program Early CT Score (CT-ASPECTS) and DWI-Alberta Stroke Program Early CT Score (DWI-ASPECTS).The difference between CT-ASPECTS and DWI-ASPECTS was calculated. When the difference of ASPECTS ≤1, they were categorized as ASPECTS unchanged group (AN group); when the difference of ASPECTS>1, they were categorized as ASPECTS changed group (AY group). These two groups were compared to explore whether there was any difference in HVS grade, and Spearman correlation analysis was performed to investigate the relationship between HVS grade and the difference of ASPECTS.Results:The difference of hyperlipidemia, TOAST classification (large artery atherosclerosis (LAA), other etiology (SOE) or undetermined etiology (SUE)) and Willis circle classification (types Ⅰ, Ⅱ, Ⅲ and Ⅳ) between HVS groups were remarkable (58.6% (34/58) vs 37.3% (19/51), χ2=4.959, P=0.026; 23/5/23 vs 43/1/14, P=0.004; 3/14/12/22 vs 7/29/14/8, χ2=13.124, P=0.004). Other clinical factors and the locations of vessel occlusion did not show significant difference ( P>0.05). Multivariate Logistic regression analysis indicated that LAA in TOAST classification (LAA vs SOE or SUE, OR=3.054, 95% CI1.257-7.422, P=0.014), Willis circle type Ⅰ (type Ⅰ vs type Ⅳ, OR=5.494, 95% CI1.074-28.091, P=0.041), and type Ⅱ (type Ⅱ vs type Ⅳ, OR=5.571, 95% CI1.895-16.372, P=0.002) were independent related factors to stimulate wide distribution of HVS. The grades of HVS were significantly different between the AN group and the AY group (1/15 vs18/18, χ2=9.114, P=0.002). Spearman correlation analysis showed that HVS grade was negatively correlated with the difference of ASPECTS ( r=-0.573, P<0.001). Conclusions:Both TOAST and Willis circle classifications are crucial factors affecting HVS distribution. HVS distribution range reflects the status of collateral compensatory. Recognizing HVS may help to evaluate the progress of early cerebral infarction volume.

Construction of standardized training course system for new nurses in radiology department based on post competency / 中国实用护理杂志

Objective:To construct a standardized training course system for new nurses in radiology department based on their post competency.Methods:The first draft of standardized training course for new nurses in radiology department was drawn up by referring to domestic and foreign literature, expert interview and group discussion. 20 experts in radiology department from 12 third grade hospitals were consulted for two rounds by Delphi method, and the index weight at all levels was determined by AHP.Results:The standardized training course system of new nurses in radiology department based on post competency includes four first level indicators (knowledge, skills, situational decision-making, humanistic quality), 10 second level indicators and 55 third level indicators. In the second round of expert consultation, the positive coefficient of experts was 85%, 100% and the authoritative coefficient was 0.75 and 0.80 respectively; In the second round expert consultation, the harmony coefficient of the first, second and third level indexes was 0.401 and 0.493 respectively, P < 0.01. Conclusion:the standardized training course system of new nurses in radiology department based on post competency is scientific and reasonable, which can provide reference for standardized training of new nurses in radiology department.

Lexiscan can open the blood-brain barrier temporarily and reversibly / 中华核医学与分子影像杂志

Objective To evaluate the opening level and optimal time window of the blood-brain barrier induced by adenosine A2 receptor agonist ( Lexiscan) via dynamic enhanced MRI. Methods Twen-ty New Zealand white rabbits were divided into experiment group ( group A, n=10) and control group ( group B, n=10) . Rabbits in group A were injected with Lexiscan and rabbits in group B were injected with physiological salt via ear vein, then the coronary scanning was performed. Contrast enhanced MRI was performed at different time points ( 5, 10, 15, 20 min, and then every 10 min, until 2 h) following the in-fusion of Gd-diethylene triamine pentaacetic acid (DTPA). The signal intensity (SI) of region of interest ( ROI) was measured and the percent enhancement of SI was calculated. Evens blue staining results in brain tissues were observed. Pair t test was used to analyze the data. Results The percent enhancement of SI in group A significantly increased to (40. 93±3.70)％ at 5 min, reached the maximum of (43.03±3.62)％ at 30 min, slowly decreased until 50 min, and got to a stable level at almost 80 min. At each time point, the per-cent enhancement of SI in group A was significantly higher than that in group B ( t values:6.88-20.28, all P<0. 05) . The staining was evident in group A. Conclusions Lexiscan can open blood-brain barrier tem-porarily and reversibly, and the optimal opening time window is 10-50 min post-injection.

Diagnosis value of late gadolinium enhancement derived from magnetic resonance imaging in patients with acute myocardial infarction / 中华心血管病杂志

Objective@#To explore the diagnosis value of late gadolinium enhancement(LGE) detected by magnetic resonance imaging(MRI) in acute myocardial infarction(AMI) patients.@*Methods@#The clinical and MRI data of 52 AMI patients hospitalized from January 2016 to July 2017 in our hospital were retrospectively analyzed. All patients received medication and revascularization therapies after admission and cardiac magnetic resonance examination was performed within 1 week after admission. According to whether there was LGE, AMI patients were divided into LGE(+) group(33 cases) and LGE(-) group(19 cases). According to the existence of microvascular obstruction(MVO) and/or intramyocardial hemorrhage(IMH),LGE(+) patients were divided into MVO/IMH(+) group(18 cases) and MVO/IMH(-) group(15 cases).@*Results@#(1)There were no statistical significance between the LGE(+)group and LGE(-)group in the age, gender,smoking history, hypertension, diabetes mellitus, dyslipidemia, ventricular arrhythmia, culprit vessel, left ventricular end-diastolic volume(LVEDV), and left ventricular end-systolic volume(LVESV) (all P>0.05). The left ventricular ejection fraction was significantly lower in LGE(+) group than in LGE(-) group( (38.7±17.6) % vs. (51.2±7.9)%, P=0.001). (2)The infarct size was positively correlated with LVEDV and LVESV(r=0.436,P=0.011;r=0.479,P=0.005,respectively), and negatively correlated with left ventricular ejection fraction (r=-0.641, P<0.001) in LGE(+) group. (3) The infarct size, LVEDV, and LVESV were significantly higher in MVO/IMH(+) group thanin MVO/IMH(-) group ((26.5±7.3)%vs. (16.2±8.3)%, P=0.001; (145.7±40.9)ml vs. (112.2±23.8)ml,P=0.009; (90.0±30.8)ml vs. (61.4±19.0)ml,P=0.004, respectively), and the left ventricular ejection fraction was significantly lower in MVO/IMH(+) group than in MVO/IMH(-) group ((29.8±15.0)% vs. (49.3±14.5)%, P=0.001).@*Conclusions@#LGE detected bycardiac magnetic resonance can provide useful information on the myocardial necrosis extent of AMI patients. Presence of MVO/IMH in LGE(+) patients is linked with larger infarct size and worse cardiac dysfunction in AMI patients.

MSCT in diagnosis of pulmonary atresia with ventricular septal defect / 中国医学影像技术

Objective To explore the value of MSCT in diagnosis of pulmonary atresia complicated with ventricular septal defect (PA/VSD).Methods Clinical and imaging data of 81 patients with PA/VSD were retrospectively analyzed.All patients underwent transthoracic echocardiography (TTE) and MSCT before surgical operation,and the imaging data were compared with surgical findings.Results There were 23 patients of type A1,17 of type A2,34 of type B and 7 of type C PA/VSD.The accuracy rate of MSCT classification of PA/VSD (93.82％ [76/81]) was higher than that of TTE (59.26％ [48/81];x2=26.95,P＜0.01).The accuracy rate of MSCT diagnosis of origin of major aortopulmonary collateral arteries (MAPCAs,100％ [93/93]) was higher than that of TTE (51.84％ [51/93];x2 =54.25,P＜0.01).Fifty cardiac malformations (50/53,94.34％) were detected with MSCT,53 with TTE ([53/53,100％];x2 =1.37,P=0.24),while 66 heart-vessel conjunction abnormalities (66/66,100％) were detected with MSCT,and 65 with TTE ([65/66,98.48％],P＞0.05).Meanwhile,106 extracardiac great vessel abnormalities (106/106,100％) were detected with MSCT and 87 with TTE ([87/106,82.08％],x2 =20.87,P＜0.05).McGoon index,pulmonary artery index and total neo-pulmonary arterial indexes (TNPAI) measured with MSCT were not statistical different with findings of surgical operation (all P＞ 0.05).Conclusion MSCT can accurately diagnose type of PA/VSD and display pulmonary artery developmental state,therefore providing guidance for clinical treatment of PA/VSD.

Role of bright vessel sign on raw three dimensional arterial spin labeling image in evaluating occlusion of intracranial artery / 中华神经科杂志

Objective To explore the role of bright vessel sign (BVS) on raw three dimensional arterial spin labeling (3D ASL) image in evaluating occlusion of intracranial artery. Methods One hundred and twenty-two patients who were highly suspected of acute cerebral infarction were enrolled and analyzed. All patients were performed magnetic resonance scan with diffusion weighted image (DWI), 3D ASL and magnetic resonance angiography (MRA) sequences within 24 hours after admission. The presence or absence of restricted lesion on DWI, BVS and occlusion of intracrainal artery on MRA was reviewed. The sensitivity, specificity, positive predictive value, negative predictive value of BVS and consistency of BVS and MRA in assessing occlusion of intracranial artery were assessed. Results The sensitivity, specificity, positive predictive value and negative predictive value of BVS in assessing occlusion of intracranial artery were 83%, 99%, 95% and 96%, respectively.And the presence or absence of BVS on ASL was highly consistent with MRA in assessing occlusion of intracranial artery (κ=0.86, P<0.01). Conclusion BVS has a good sensitivity and high specificity in identifying occlusion of intracranial artery, and it is highly consistent with MRA.

Correlation of 3D ASL perfusion index with the expression of VEGF and MVD in glioma / 中国肿瘤临床

Objective:To investigate the correlation of the relative cerebral blood flow (rCBF) of three dimensional arterial spin labeling (3D ASL) with vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in glioma. Methods:Fifty-three glio-ma patients confirmed by pathology were subjected to conventional, enhanced MR and 3D ASL imaging before operation to deter-mine VEGF expression and MVD levels in each patient. The correlations of rCBF with VEGF expression and MVD in glioma were evaluat-ed, respectively. Results:rCBF was noted to be positively correlated to VEGF expression and MVD in glioma. The rs were 0.728 (VEGF) and 0.620 (MVD), respectively (P<0.05). Conclusion:The positive correlation of rCBF with VEGF expression and MVD in glioma implied that 3D ASL is beneficial for evaluating microvessel angiogenesis in glioma prior to surgery. This finding is significant for developing clin-ical treatment plans and for assessing patient prognoses.

Correlation of Ki-67 expression with MRS metabolism in low-and high-grade cerebral gliomas / 中国肿瘤临床

objective:To investigate the relationship between magnetic resonance spectroscopy (MRS) metabolism and Ki-67 expres-sion in high-(HGG) and low-grade gliomas (LGG) by analyzing Ki-67 expression and HGG and LGG metabolites. Methods:We consid-ered 56 pathologically confirmed glioma cases in our hospital. The Ki-67 expression and the MRS metabolism parameters in the tu-mors were analyzed simultaneously. Results:The tumor solid value of Cho was positively correlated with the Ki-67 expression level (rs=0.714, P<0.05). By contrast, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA (rs=?0.708, P<0.05) in 35 cases of the LGG group. The tumor solid value of Cho was also positively correlated with the Ki-67 expression level (rs=0.624, P<0.05). By comparison, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA in the HGG group (rs=?0.769, P<0.05). Conclusion:The MRS metabolism was correlated with the Ki-67 expression in high-and low-grade gliomas.

PC Interface and Control Technology of Foot Switch / 医疗卫生装备

Objective To realize foot switch long-distance control of PC for medical image acquisition. Methods The foot switch was connected with PC through RS232 DB9 port, and the software was programmed by Microsoft Visual C++6.0 on Windows 2000 operating system. Results Foot switch control of PC was successfully achieved in acquiring medical images. Conclusion The foot switch has the advantages of long-distance and foot control of PC. It not only saves manpower but ensures the accuracy and real time of images acquired. This method can be applied to image acquisition workstations for medical equipments such as CT apparatus, X-ray apparatus, Ultrasound apparatus, Endoscope apparatus and so on.

Design and realization of image acquisition system for Philip Tomoscan AV CT / 医疗卫生装备

Objective The images of CT Equipment without DICOM interface are stored by means of film all along,and they can't be digitally stored,shared,retrieved,integrated to diagnostic reports.This paper introduces a method to capture images,mainly focus on the image capture and crop technology.Methods The hardware is composed of Philip Tomoscan AV CT,PC,OK_RGB20B image capture card,foot switch.The software is programmed by Microsoft Visual C++6.0,OK_RGB20B SDK and GDI+ Class Library on Windows 2000 operating system.Results The system can capture the CT image successfully,and make the images stored and shared permanently.Conclusion This method is a valuable clew for capturing images from other types of non-DICOM-based medical equipment such as ECT,X-ray,Ultrasound,Endoscope and so on.

CT,MRI features and pathology of supratentorial gliomas and ependymoma-contrast study of ultrastructure and immunohistochemistry / 中国实用内科杂志

Objective To study the correlation of supratentorial gliomas and ependymoma between the features of pathology and the characteristic of CT,MRI and provide relevant data for diagnosis and treatment.Methods We analysised 60 patients with gliomas and 40 with ependymoma,contrasted their characteristic of CT,MRI with the features of pathology.Results The feature of irregular appearance,lobulation,tumor wall,tumor tubercle,necrotic cystiform zone,hemorrhage and tumor blood vessels were showed in CT and MRI,which was accord with the alteration of ultrastructure and the expression of tumous label.Conclusion Studying the morphology of supratentorial gliomas and ependymoma may be helpful to raise the veracity of pathologic grading,provide evidence to select treatment,operation and anti-vasoformation of the tumor etc.

Correlation studies of rCBV with VEGF protein expression and MVD in gliomas / 中华放射学杂志

Objective To investigate the correlation of rCBV with vascular endothelial growth factor (VEGF) protein expression and microvessel density (MVD) in gliomas Methods MR examinations were performed preoperatively in 46 patients with suspected supratentorial gliomas All the 46 cases were proved by operation and pathology Immunohistochemical stain methods were used to demonstrate the situation of VEGF protein expression and quantitatively measure the MVD in gliomas The procedures of MR examinations included plain MR scan, PWI and routine contrast enhanced MR scan The pulse sequence of PWI was single shot GRE EPI T  2WI The CBV maps were calculated from the original data of perfusion images and the maximum rCBV of gliomas was acquired from CBV maps through measurement on the region of interest (ROI) According to the situation of VEGF protein expression, all the 46 cases were divided into two groupsincluding positive VEGF protein expression group and negative VEGF protein expression group Mann Whitney U test was used for comparing the difference between the two groups Spearman′s rho correlation analysis was used for observing the correlation between maximum rCBV and MVD in gliomas Results Of the 46 cases; 12 cases were astrocytomas, 3 were oligodendrogliomas, 1 was mixed glioma, 14 were anaplastic astrocytomas, and 16 were glioblastomas multiforme The maximum rCBV value in VEGF(-) group ( n =14) and VEGF(+) group ( n =32) ranged from 0 33～6 63 and 1 03～10 68, with median of 3 08 and 5 95, respectively The difference in maximum rCBV between the two groups was statistically significant ( Mann Whitney U test | z| =2 638, P

Research of 2D Medical Image Magnification / 医疗卫生装备

Objective To find a programming method of magnifying two-dimentional medical image for clearer view and more precise diagnosis. Methods The software was programmed by using Microsoft Visual C++6.0 and GDI+ Class Library on Windows 2000 operating system. Results The software could magnify the medical images with high quality and definition. Conclusion This method is valuable for medical image digital post-processing.