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Objective To compare the diagnostic value of Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI and contrast-enhanced ultrasound (CEUS) in detection of small hepatocellular carcinoma (sHCC).Methods A total of 22 patients with 29 lesions who underwent Gd-EOB-DTPA enhanced MRI and CEUS scan,and confirmed as sHCCs by pathology were included in this study.Gd EOB DTPA enhanced MRI pattern for the conclusive diagnosis of sHCC were lesions showed iso or low signal on T1 WI,showed slightly high signal or high signal on T2 WI,showed high signal on DWI and obviously enhanced in the arterial phase and/or clearance in the hepatobiliary phase;CEUS pattern for the conclusive diagnosis of sHCC were rapidly increasing in the arterial phase and showing low echo in the delay phase.Results The diagnostic sensitivity of detecting sHCC by Gd EOB-DTPA enhanced MRI and CEUS were 82.76％ and 65.52％ respectively,and there was no statistical difference (x2 =2.248,P=0.134),the diagnosis specificity were both 100 ％.Conclusion Both of the diagnostic sensitivity and specificity for detecting sHCC by Gd EOB DTPA enhanced MRI and CEUS showed no difference,the value of diagnostic sensitivity of the former is higher.
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DREAM (downstream regulatory element antagonist modulator), Calsenilin and KChIP3 (potassium channel interacting protein 3) belong to the neuronal calcium sensor (NCS) superfamily, which transduces the intracellular calcium signaling into a variety of activities. They are encoded by the same gene locus, but have distinct subcellular locations. DREAM was first found to interact with DRE (downstream regulatory element) site in the vicinity of the promoter of prodynorphin gene to suppress gene transcription. Calcium can disassemble this interaction by binding reversibly to DREAM protein on its four EF-hand motifs. Apart from having calcium dependent DRE site binding, DREAM can also interact with other transcription factors, such as cAMP responsive element binding protein (CREB), CREB-binding protein (CBP) and cAMP responsive element modulator (CREM), by this concerted actions, DREAM extends the gene pool under its control. DREAM is predominantly expressed in central nervous system with its highest level in cerebellum, and accumulating evidence demonstrated that DREAM might play important roles in pain sensitivity. Novel findings have shown that DREAM is also involved in learning and memory processes, Alzheimer's disease and stroke. This mini-review provides a brief introduction of its discovery history and protein structure properties, focusing on the mechanism of DREAM nuclear translocation and gene transcription regulation functions.
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Objective To investigate the prompt value of abnormal vaginal morphology on diagnosing pelvic organ prolapse . Methods Forty eight pelvic organ prolapse female patients diagnosed by pelvic organ prolapse quantification were enrolled in the pelvic organ prolapse group and 51 normal female volunteers were enrolled in the control group in this study. Pelvic MRI T2WI were performed in all cases. The vaginal shape were evaluated according to Delancey Ⅱ level on the transverse images, which were divided into two categories:normal morphology (H-shaped) and abnormal morphology(non H-shaped). The vaginal shape distribution of different prolapse degree(0,Ⅰ,Ⅱ,Ⅲ,Ⅳstage) and types(anterior,middle, posterior pelvic prolapse) were recorded. Chi-square test was used to analyse distribution difference of vaginal shape between the two groups. The ROC curve was used to analyse the diagnostic efficiency of abnormal vaginal morphology for diagnosing pelvic organ prolapse. Results In the control group, there were 40 cases with normal vaginal morphology and 11 cases with abnormal morphology mainly including W-shaped and U-shaped abnormal morphology. In the prolapse group, there were 5 cases with normal vaginal morphology and 43 cases with abnormal morphologymainly including U-shaped (13 cases), W-shaped (26 cases) and O-shaped(4 cases) abnormal morphology. There was significant difference between the two groups(c2=46.137,P<0.01). The area under the curve (AUC) was 0.800. The sensitivity and specificity of abnormal vaginal shape for diagnosing pelvic organ prolapse were 89.6% and 78.4%respectively.The distribution of vaginal morphology in different degrees and types of prolapse were different:vaginal morphology of 0 stage prolapse showed H-typed mainly (40/51, 78.4%), Ⅰ stage prolapse showed W-shaped (16/28 57.1%), Ⅱ,Ⅲ stage prolapse all showed non H-shaped (20/20, 100%), Ⅱstage mainly showed W-shaped (9/14), Ⅲ stage mainly showed O-shaped (3/6). Anterior pelvic organ prolapse were manifested mainly with W-shaped vaginal morphology (4/9) and middle pelvic organ prolapse mainly showed O-shaped vaginal morphology (4/7). Conclusions The abnormal vaginal morphology has the prompt value on diagnosing pelvic organ prolapse.Moreover, the different shape probably indicates the different degrees and types of pelvic organ prolapse.
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Purpose To investigate the value of arterial spin labeling (ASL) in evaluating renal function in patients with renal cell carcinoma (RCC) after laparoscopic partial nephrectomy.Materials and Methods Fifteen patients with RCC undergoing laparoscopic partial nephrectomy were studied prospectively.The patients were performed ASL scan one week before and three months after operation.The correlation between renal blood flow (RBF) value measured by ASL and the glomerular filtration rate (GFR) measured by radionuclide method in the renal cortex of healthy side was analyzed.The RBF values in the kidney of affected side or healthy side were measured,the difference of which between before operation and three months after operation was compared.Results The RBF value and GFR data in the renal cortex of healthy side had positive correlation (r=0.638,P＜0.05).In the affected side of kidney,the RBF value of remaining renal tissue [(291.5 ± 37.3) ml/(100g·min)] compared with that of preoperative renal tissue [(237.8 ± 46.2) ml/(100g·min)]increased about 53.7 ml/(100g · min) (P＜0.05).In the healthy side of kidney,the RBF value of renal tissue [(241.1 ± 50.3) ml/(100 g · min)] compared with that of preoperative renal tissue [(290.4 ± 51.8) ml/(100 g·min)] decreased about 49.3 ml/(100 g·min) (P＜0.05).Conclusion ASL can be used to evaluate renal function,and it is valuable to evaluate renal perfusion function after laparoscopic partial nephrectomy of RCC.
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of left and right side cerebral cortical veins was 159.16(154.88-164.13)ppb(× 10-9), 164.61(156.23-168.04) ppb, respectively. The median susceptibility (extent) of left and right side thalamostriate veins was 160.51 (152.14-170.06) ppb, 162.48(153.47-173.66)ppb, respectively. Left were less than the right, and the difference was statistically significant (Z=-3.14,-2.02, P<0.05). And the difference of two side of other cerebral venous susceptibility had no statistical significance. The median susceptibility (extent) of right cerebral cortical veins, left thalamostriate veins and right septal veins of 22 male was 166.22(159.21-169.99) ppb, 168.65(159.19-174.45)ppb and 153.42(148.10-161.78)ppb, respectively. The coresponding positions of median susceptibility (extent) of 38 female was 161.10(155.06-167.15)ppb, 157.70(151.53-164.41)ppb and 147.52(142.94- 154.16)ppb, respectively. The susceptibility of right cerebral cortical vein, left thalamostriate vein, right septal vein of male was significantly different from the females (Z=-2.03,-2.20,-2.33, P<0.05). Futhermore, we also found that there had positive correlation between age and right thalamostriate vein(r=0.28,P<0.05). Conclusion The magnetic sensitive of the right thalamostriate vein tends to increase along with the age, and some of peoples had difference with bilateral and age.
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Objective To detect the volume changes of cerebral gray and white matter in patients with maintaining hemodialysis using voxel-based morphometry(VBM) and to correlate these changes with cognitive function. Methods Forty-two patients with maintaining hemodialysis and 41 age and sex matched normal subjects were recruited in this study. MMSE was obtained to evaluate their neuropsychiatric conditions. Whole brain high-resolution T1WI was performed on 3.0 T MR scanner in both patients and normal controls. The data were analyzed by VBM based on SPM8, using analysis of functional neuroimages (AFNI) software package with the Monte Carlo simulation method(AlphaSim method) for multiple cluster level comparisons correction. Independent sample t test analysis was used to compare the volume of gray and white matter between the patients and normal controls. In addition, Stepwise multiple linear regression analysis was performed to explore the correlation between the voxel value of cerebral volume changes area and dialysis duration and clinical laboratory examination, and Spearman correlation analysis was used for the correlation between the left insula voxel values and neuropsychological test scores. Results Compared with normal controls, patients showed significantly decreased volume in the grey matter of the right putamen, the left putamen, the left insula (numbers of voxel in clusters were 455, 561, 162, t=-9.5681,-5.9516,-5.7185,P<0.001, AlphaSim-corrected). There was negative correlation between decreased grey matter volume of the right putamen[(0.53 ± 0.12)mm3]and the left putamen[(0.48 ± 0.12)mm3] and dialysis duration [19.0(1.5-114.0)months] (r=-0.330,-0.307,P<0.05). MMSE score of patients[29(21-30)score] was significantly lower than normal controls[30(28-30)score] (Z=-30.58,P<0.01). Decreased grey matter volume of the left insula [(0.39 ± 0.12) mm3] was positively correlated with MMSE(r=0.320, P<0.05). Conclusions The patients with maintaining hemodialysis show grey matter atrophy which is associated with neurocognitive dysfunction. Dialysis duration may be an important risk factor for decreased gray matter in patients with maintaining hemodialysis.
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The imaging findings of pelvic lipomatosis as confirmed by operation and pathology were examined in 1 case and two follow-up asymptomatic cases retrospectively analyzed.The imaging findings included a compressed and deformed bladder with a superior displacement.Its shape was like an inverted tear and pear in coronal view and a banana in sagittal view.Bilateral ureters were both compressed with a medial deviation.And bilateral ureters were dilated with hydronephrosis in 1 case.Rectum and sigmoid were both compressed and became narrowed.The clinical manifestations included frequent urination , urgent urination , urination pain, dysuria, constipation, nausea, vomit and fever in 1 case while another 2 cases stayed asymptomatic.
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Objective To evaluate the distribution and age-related changes of brain iron content in healthy people using MR quantitative susceptibility mapping (QSM).Methods Sixty three healthy right-handed volunteers underwent the routine MRI and SWI scan to get SWI-unfiltered phase images and magnitude images.QSM were reconstructed from the SWI-unfiltered phase images and magnitude images using SMART software.The regions of interest at the bilateral frontal white matter and nuclei (caudate nuclews,globus pallidus,putamen,substantia nigra,dorsal thalamus,red nucleus and dental nucleus) were drawn manually,and the susceptibility was measured.The linear correlation between the susceptibility and iron concentration cited from Hallgren and Sourander's post-mortem brain study was calculated.Wilcoxon test were applied to calculate the difference between the bilateral frontal white matter and bilateral nuclei.The correlation of age with susceptibility of bilateral frontal white matter and bilateral nuclei were analyzed by Spearman correlation analysis.Results The median susceptibility (extent) of frontal white matter,caudate nucleus,globus pallidus,putamen,dorsal thalamus,substantia nigra,red nucleus and dentate nucleus of 63 healthy people were-12.81 (-31.56,8.72),39.27 (22.35,75.13),93.99 (19.19,158.75),29.16 (4.11,81.53),2.91 (-27.80,27.95),83.14 (38.57,185.79),63.49 (13.83,142.09),63.30 (36.78,128.53) ppb (× 10-9),respectively.There was high consistency with Hallgren and Sourander's study (r=0.91,P＜0.05).The susceptibility of globus pallidus was the highest,followed by substantia nigra.The least susceptibility was seen in the frontal white matter.The susceptibility of right caudate nucleus,substantia nigra,red nucleus and dental nucleus was higher than that of left side (Z value was-3.18,-4.44,-3.70 and-2.64,respectively,P＜0.05).The susceptibility of bilateral globus pallidus of the male was significantly different from that of the female (Z value was-2.27 and-2.42,respectively,P＜0.05).There was positive correlation between age and the susceptibility of bilateral caudate nucleus,putamen,red nucleus and dental nucleus (r value was 0.30 to 0.49,P＜0.05).Conclusions QSM based on the SWI-unfiltered phase and magnitude images can clearly display the cerebral nuclei and evaluate the brain iron content accurately,which is consistent with the histopathological results.Iron content of bilateral caudate nucleus,putamen,red nucleus and dental nucleus increase with aging.