Comparative imaging study of mediastinal lymph node from pre-surgery dual energy CT versus post-surgeron verifications in non-small cell lung cancer patients / 北京大学学报(医学版)

OBJECTIVE@#To validate the value of dual energy CT (DECT) in the differentiation of mediastinal metastatic lymph nodes from non-metastatic lymph nodes in non-small cell lung cancer (NSCLC).@*METHODS@#In the study, 57 surgically confirmed NSCLC patients who underwent enhanced DECT scan within 2 weeks before operation were enrolled. Two radiologists analyzed the CT images before operation. All mediastinal lymph nodes with short diameter≥5 mm on axial images were included in this study. The morphological parameters [long-axis diameter (L), short-axis diameter (S) and S/L of lymph nodes] and the DECT parameters [iodine concentration (IC), normalized iodine concentration (NIC), slope of spectral hounsfield unit curve (λHU) and effective atomic number (Zeff) in arterial and venous phase] were measured. The differences of morphological parameters and DECT parameters between metastatic and non-metastatic lymph nodes were compared. The parameters with significant difference were analyzed by the Logistic regression model, then a new predictive variable was established. Receiver operator characteristic (ROC) analyses were performed for S, NIC in venous phase and the new predictive variable.@*RESULTS@#In 57 patients, 49 metastatic lymph nodes and 938 non-metastatic lymph nodes were confirmed by surgical pathology. A total of 163 mediastinal lymph nodes (49 metastatic, 114 non-metastatic) with S≥5 mm were detected on axial CT images. The S, L and S/L of metastatic lymph nodes were significantly higher than those of non-metastatic lymph nodes (P < 0.05). The DECT parameters of metastatic lymph nodes were significantly lower than those of non-metastatic lymph nodes (P < 0.05). The best single morphological parameter for differentiation between metastatic and nonmetastatic lymph nodes was S (AUC, 0.752; threshold, 8.5 mm; sensitivity, 67.4%; specificity, 73.7%; accuracy, 71.8%). The best single DECT parameter for differentiation between metastatic and nonmetastatic lymph nodes was NIC in venous phase (AUC, 0.861; threshold, 0.53; sensitivity, 95.9%; specificity, 70.2%; accuracy, 77.9%). Multivariate analysis showed that S and NIC were independent predictors of lymph node metastasis. The AUC of combined S and NIC in the venous phase was 0.895(sensitivity, 79.6%; specificity, 87.7%; accuracy, 85.3%), which were significantly higher than that of S (P < 0.001) and NIC (P=0.037).@*CONCLUSIONS@#The ability of quantitative DECT parameters to distinguish mediastinal lymph node metastasis in NSCLC patients is better than that of morphological parameters. Combined S and NIC in venous phase can be used to improve preoperative diagnostic accuracy of metastatic lymph nodes.

Analysis of X-ray signs to confirm the successful puncture in shoulder MR arthrography with low dose of contrast agent / 中华放射学杂志

Objective:To explore the value of X-ray signs with applying low dose of contrast agent to confirm successful puncture in direct shoulder MR arthrography.Methods:In total 669 patients who underwent shoulder MR arthrography in Peking University Third Hospital from January 2016 to August 2018 were retrospectively analyzed. All patients received the anterior approach puncture in shoulder arthrography. X-ray films were taken after 1-2 ml contrast agent was injected. Six X-ray signs of contrast agent distribution were recorded. MR arthrography findings were used to confirm whether the puncture was success. Kappa analysis was used to verify the consistency between each 2 signs. The accuracy rate of each X-ray sign to confirm the successful puncture was calculated. X-ray signs were paired to define the best diagnostic index of successful puncture.Results:Successful puncture was performed in arthrographies for all 669 cases .The displaying rates of six signs were as follows. Contrast agent distribution at overlapping humeral head away from the needle was 66.8% (447/669), in axillary recess was 64.7% (433/669), in glenohumeral space was 93.9% (628/669), in subscapular bursa was 69.8% (467/669), in sheath of long head tendon of biceps brachii (LHBT) was 1.9% (13/669), between LHBT and supraspinatus tendon was 17.2% (115/669). Consistency of each 2 signs was poor (Kappa<0.2), in which the poorest consistency was found between contrast agent overlapping humeral head away from the needle and contrast agent in glenohumeral space (Kappa=-0.115). With combining the above 2 signs, the accuracy rate for defining successful puncture was 100% (669/669).Conclusion:In direct shoulder arthrography by anterior approach, X-ray signs with low dose of contrast agent can be regard as the method to confirm successful puncture. The accuracy rate of the signs of contrast agent distribution at overlapping humeral head away from the needle or in glenohumeral space to define a successful puncture is 100%.

Value of Diffusion-weighted Imaging in Evaluating the Activity of Sacroiliitis in Ankylosing Spondylitis / 中国医学科学院学报

Objective To investigate the clinical value of diffusion-weighted imaging (DWI) for evaluating the activity of sacroiliitis in ankylosing spondylitis (AS).Methods Totally 73 AS patients were prospectively enrolled and divided into active group (n=43) and chronic group (n=30) according to Bath ankylosing spondylitis disease activity index (BASDAI) scores and laboratory findings. Conventional magnetic resonance imaging (MRI) and DWI were performed in all subjects. Apparent diffusion coefficient (ADC) values of subchondral lesions in sacroiliac joint were independently measured by two radiologists,and the relative ADC (rADC) values were calculated. ADC and rADC values were compared between active and chronic groups. The efficiencies of ADC and rADC values for differentiating the activity of sacroiliitis were analyzed. In addition,the correlation coefficients of ADC values,rADC values,and BASDAI scores were calculated.Results The ADC and rADC values in the active group were (0.667±0.122)×10 mm /s and (1.715±0.343)×10 mm /s,respectively,which were significantly higher than those of the chronic group [(0.492±0.0651)×10 mm /s and (1.289±0.209)×10 mm /s,respectively)] (P0.81. The correlation coefficients of ADC value and rADC value with BASDAI scores were 0.82 and 0.80,respectively (P<0.0001). The optimal cutoff values of ADC value and rADC value for differentiating AS activity were 0.545×10 mm /s and 1.467×10 mm /s,respectively,The specificity was 81.8% for both indicators,and the sensitivity was 92.0% and 88.0%,respectively.Conclusion DWI is helpful in the quantitative assessment of the activity of sacroiliitis in AS patients.

Preoperative Evaluation of the Grade and Stability of Osteochondritis Dissecans of the Knee by Magnetic Resonance Imaging / 中国医学科学院学报

Objective To assess the diagnostic performance of magnetic resonance imaging (MRI) in the grading of osteochondritis dissecans (OCD) of the knee.Methods Totally 47 patients with OCD of the knee confirmed by arthroscopy were retrospectively enrolled in this study.The OCD lesions were classified into four stages according to classification system of the International Cartilage Repair Society.Two radiologists analyzed all MRI findings independently,and the results were compared with those of arthroscopy.Sensitivity,specificity,and accuracy were calculated.Kappa value were calculated to quantify inter-observer agreement of the diagnostic OCD grade between two doctors by MRI.Specificity,sensitivity,and accuracy of MRI criteria indicating instability for detection of OCD instability were calculated.Results Of these 47 patients with 48 OCD lesions,stages Ⅰ,Ⅱ,Ⅲ,and Ⅲ lesions were detected in 4,8,16,and 20 patients,respectively.The specificity,sensitivity,and accuracy for the diagnosis of OCD stability were 75.0% (83.3%),88.9% (86.1%),and 85.4% (85.4%) for observer l (2),and the agreement of OCD grade between these two readers was substantial with a Kappa value of 0.82.The specificity,sensitivity,and accuracy of MRI criteria for the detection of OCD instability including high T2 signal intensity at the interface between the OCD and the underlying bone,multiple cysts or a single cyst of>5 mm in diameter surrounding OCD lesions,high T2 signal intensity cartilage fracture line traversing the articular cartilage,and osteochondral defect were 83.3%,80.6%,and 81.3%;75.0%,72.2%,and 72.9%;66.7%,69.4%,and 68.8%;100%,86.1%,and 89.6%,respectively. Conclusions Osteochondral defect is the most specific MRI sign for diagnosing instable OCD of the knee,whereas osteochondral fracture line has the lowest accuracy.MRI is a useful method to evaluate the grade and stability of OCD of the knee.

Ligustrazine Promoted the Migration of Bone Marrow Mesenchymal Stem Cells by Up-regulating MMP-2 and MMP-9 Expressions / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of ligustrazine on the migration of bone marrow mesenchymal stem cells (BMSCs) and protein expressions of matrix metalloproteinase-2 and-9 (MMP-2 and MMP-9) in vitro.</p><p><b>METHODS</b>BMSCs were in vitro isolated and cultured using whole bone marrow adherent method, and phenotypes [surface positive antigens (CD29 and CD90) and negative antigens (CD34 and CD45)] identified using flow cytometry. BMSCs were divided into the blank control group, 25, 50, 100 µmol/L ligustrazine group, and the GM6001 group (100 µmol/L ligustrazine +MMPs inhibitor GM6001 ). The migration of BMSCs was tested by Transwell chamber test and wound healing assay after treated with ligustrazine for 24 h. The protein expressions of MMP-2 and MMP-9 were detected by Western blot.</p><p><b>RESULTS</b>The third passage BMSCs grew well in uniform morphology. The expression rate of CD29, CD90, CD34, and CD45 was 96.9%, 97.3%, 0.2%, and 3.0%, respectively. Compared with the blank control group, the number of migrated cells and relative distance of cell invasion increased, and the protein expressions of MMP-2 and MMP-9 were elevated in each ligustrazine group (P < 0.05, P < 0.01). Compared with 100 µmol/L ligustrazine group, the number of migrated cells and relative distance of cell invasion decreased in 25 and 50 µmol/L ligustrazine groups and the GM6001 group (P < 0.01). Protein expression of MMP-2 decreased in 25 and 50 µmol/L ligustrazine groups (P < 0.01).</p><p><b>CONCLUSION</b>Ligustrazine could promote the migration of BMSCs in vitro, and its mechanism might be related to up-regulating expression levels of MMP-2 and MMP-9 protein.</p>

Buyang Huanwu decoction promotes neuroblast migration from subventricular zone via inducing angiogenesis after ischemia / 中国中药杂志

<p><b>OBJECTIVE</b>To study the effect of Buyang Huanwu decoction (BYHWD) inducing angiogenesis on the neuroblast migration from the subventricular zone and its mechanisms after focal cerebral ischemia.</p><p><b>METHOD</b>The middle cerebral artery occlusion (MCAO) was performed to mice for 30 minutes to establish the model. The rats were divided into sham group, model group, BYHWD group and endostatin group. BYHWD (20 g x kg(-1), ig) and endostatin (10 μg, sc) were administered 24 h after ischemia once a day for consecutively 14 days. At 14 d after ischemia, the density of micro-vessel and the number of neuroblasts in the ischemia border zone were determined by immunofluorescence staining. The mRNA and protein expression of cell-derived factor-1 (SDF-1) and brain-derived neurotrophic (BDNF) were examined by real-time PCR and Western blot.</p><p><b>RESULT</b>Compared with the model group, BYHWD significantly increased the density of micro-vessel and the number of DCX positive cells in the ischemia border zone (P < 0.01), and significantly increased the SDF-1 and BDNF mRNA and protein expression (P < 0.01). Compared with BYHWD group, endostatin significantly reduced the density of micro-vessel and the number of DCX positive cells in the ischemia border zone (P < 0.01), as well as the SDF-1, BDNF mRNA and protein expression (P < 0.01).</p><p><b>CONCLUSION</b>BYHWD could promote the neuroblast migration from the subventricular zone via inducing angiogenesis after cerebral ischemia, the mechanism may be correlated with up-regulating the expression of SDF-1 and BDNF.</p>

Value of diffusion-weighted imaging in diagnosis of lymph node metastasis in patients with cervical cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the value of diffusion-weighted imaging (DWI) in the differentiation of metastatic lymph nodes from non-metastatic lymph nodes in cervical cancer.</p><p><b>METHODS</b>In 65 patients who underwent lymph node dissection for cervical cancer, conventional MRI and DWI examinations were performed before surgery. Of the 1590 total dissected pelvic lymph nodes, 392 enlarged nodes with a short-axis diameter (S )of 5 mm or greater were included for further analysis. Each of the size-based criteria [i.e., S, long-axis diameter (L), and S/L ratio] and apparent diffusion coefficient(ADC)-based criteria (i.e., ADCmin, ADCmean, rADCmin, rADCmean) were compared between metastatic lymph nodes and non-metastatic lymph nodes.</p><p><b>RESULTS</b>There were statistically significant differences between metastatic and non-metastatic lymph nodes in S, L, S/L ratio, ADCmin, ADCmean, rADCmin, and rADCmean (all P<0.0001). The Az of the ADCmin (0.956) was greater than that of the other ADC-based criteria and all size-based criteria. Using ADCmin=759.0×10(-6) mm(2)/s, the sensitivity and specificity for differentiating metastatic from non-metastatic lymph nodes were 95.2% and 92.1%, respectively.</p><p><b>CONCLUSION</b>DWI, particularly ADCmin, is feasible for differentiating metastatic from non-metastatic pelvic lymph nodes in patients with cervical cancer.</p>

Clinical application of magnetic resonance imaging in preoperative evaluation of endometrial cancer / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the value of magnetic resonance imaging (MRI) in the preoperative assessment of endometrial cancer.</p><p><b>METHODS</b>Ninety-four patients with histopathologically confirmed endometrial carcinoma were retrospectively enrolled in this study. MRI findings were compared with the pathologic findings in all cases. The depth of myometrial invasion and lymph node metastasis were evaluated by T2 weighted imaging (T2WI) combined with contrast enhancement or diffusion weighted imaging (DWI).</p><p><b>RESULTS</b>Among these 94 patients,62 had no or superficial myometrial involvement and 32 cases had deep myometrial involvement. Meanwhile, 24 groups of metastatic lymph nodes and 164 groups of non-metastatic lymph nodes were detected. The accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of T2WI combined with contrast enhancement in discriminating no/superficial myometrial involvement from deep myometrial involvement were 88.3%, 90.3%, 84.4%, 91.8%, and 81.8%, whereas those of T2WI combined with DWI were 81.9%, 87.1%, 71.9%, 85.7%, and 74.2%, respectively. The accuracy, specificity, sensitivity, negative predictive value, and positive predictive value of T2WI combined with contrast enhancement in identifying metastatic lymph nodes were 89.4%, 96.8%, 54.5%, 90.9%, and 78.3%, whereas those of T2WI combined with DWI were 91.5%, 95.5%, 72.7%, 94.3%, and 77.4%, respectively.</p><p><b>CONCLUSIONS</b>T2WI combined with contrast enhancement is superior to T2WI combined with DWI in evaluation of the depth of myometrial invasion. However, DWI is more sensitive in identifying lymph node metastasis than T2WI combined with contrast enhancement.</p>

Comparative Study on Spiral CT Features and Surgical-Pathologic Results of Renal Cell Carcinoma / 实用放射学杂志

Objective To study the value of spiral CT in diagnosing renal cell carcinoma(RCC) and to evaluate the correlation of CT findings with histopathologie features in RCC. Methods 279 cases with RCC proven by surgery and pathology underwent plain and contrast-enhanced CT examinations. The clinic characteristics and CT findings were analyzed statistically and compared with surgical results. Results 90.32% lesions showed medium or obvious enhancement on contrast-enhanced CT,with the exception of granule cells for enhanced uniform, the other cell type of RCC showed heterogeneous enhancement. 32.26% of tumors was of more or less short-burres (χ~2 = 38.2,P<0.01) ,and the there was significant relationship between pathological signs of short burr and the renal capsule involved by tumors. CT qualitative diagnostic rate was 91.40%. CT staging and pathologic staging were of the correla-tive coefficient of 0. 84, while there was not obviously correlation between CT classification of RCC and cancer cell types(P>0.05). Conclusion Spiral CT can better show characteristics of RCC, that can improve the diagnostic accuracy and staging aility for RCC.

Analysis of ant oil extracted with supercritical CO2 fluid from Polyrhachis vicina by GC-MS / 中国中药杂志

<p><b>OBJECTIVE</b>To study the optimum extraction parameters and components on ant oil from Polyrhachis vicina.</p><p><b>METHOD</b>The optimum condifious for supercritical CO2 fluid extraction (SFE-CO2), were investigated with orthogonal design, GC-MS was applied for analyzing. The components and their contents in the ant oil were analyzed by GC-MS, and the contents of lead, zinc and manganese in the oil were determined by ICP-AES.</p><p><b>RESULT</b>The optimum extraction parameters were achieved, temperature of 50 degrees C, pressure of 30 MPa and time of 2 hours. The extracting yield of the ant volatile oil was 11.4% - 14.3%. 51 Constituents were identified including 9-octadecenoic acid, ethyl oleate, cholesterol, n- Hexadecanoic acid, etc, and the content of various constituents was determined by orea normalization. The oil contained unsaturated fatty acid of 64.6%, lead of 0.80 microg x g(-1), zinc of 0.54 microg x g(-1) and manganese of 0.15 microg x g(-1).</p><p><b>CONCLUSION</b>The method showes advantages including faster and efficient of extraction, good quality and no solvent residues in the oil.</p>