Prenatal imaging classification and potential diseases of fetal abnormal sylvian fissure / 中华超声影像学杂志

Objective:To assess the ultrasonographic features and potential diseases of fetal abnormal sylvian fissure(SF), and to explore the value of whole-genome sequencing (WGS) in prenatal detection.Methods:A total of 28 fetuses with a sonographic diagnosis of abnormal SF in Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University between October 2018 and October 2020 were prospectively included. The fetal brain was evaluated by neuroultrasound and intrauterine MRI in detail. Amniotic fluid/cord blood obtained by amniocentesis or tissue samples from umbilical cord after birth were collected for WGS. Pregnancy outcomes and postnatal MRI were recorded, and neurodevelopment of live-born infants was followed up for more than 24 months after delivery.Results:During the study period, 28 fetuses with abnormal SF were identified, with a gestational age of 21.3-30.0 (24.8±2.0) weeks. Abnormal SF presented in MCD ( n=15, 53.6%), chromosomal anomalies ( n=3, 10.7%) or single-gene genetic syndromes ( n=3, 10.7%) with the affected fetuses showing developmental delay, hydrocephalus or leukomalacia ( n=4, 14.2%), corpus callosal agenesis with large interhemispheric cysts ( n=1, 3.6%), benign subarachnoid space enlargement with arachnoid cysts ( n=1, 3.6%), and multiple malformations ( n=1, 3.6%). Among the 15 cases with MCD, the most common pathology was lissencephaly/pachygyria, followed by schizencephaly, severe microcephaly, hemimegalencephaly with paraventricular heterotopia, and polymicrogyria. Abnormal SF presented bilaterally in 23 fetuses and unilaterally in 5. All cases were categorized into six types depending on SF morphology in the transthalamic section: no plateau-like or a small insula, linear type, irregular corrugated SF, Z-shaped, and cyst occupying type. In addition to abnormal SF, associated anomalies or mild variations were identified in all fetuses. There were 17 cases underwent intrauterine MRI, and 13 cases underwent postnatal MRI examination.And 25 pregnancies were terminated; 3 were born alive, and 2 had typical syndromic changes with poor neurodevelopmental prognosis. A related pathogenic genetic variant was detected in 57.1% (16/28) fetus, and the incidence of single nucleotide variants(SNVs) was 42.9% (12/28), among which de novo SNVs accounted for 91.7% (11/12). Conclusions:Fetal abnormal SF could be classified based on the ultrasonographic features of transthalamic section. Fetal abnormal SF may indicate MCD, some chromosomal abnormalities or single-gene genetic syndromes that may lead to poor neurodevelopmental outcomes, and may be affected by extra-cortical factors. It is suggested to carry out targeted prenatal genetic diagnosis for fetuses with abnormal SF.

DKIandDWIinevaluatinghistologicalfeaturesofendometrialcarcinoma / 实用放射学杂志

Objective ToevaluatethevalueofMRDKIandDWIindiagnosingendometrialcarcinomaandevaluatingitspathologicalgrade. Methods TheDKIandDWIdataof48patientswithendometrialcarcinomaand27patientswithnormalendometrium wereanalyzed retrospectively.Thevaluesofmeankurtosis (MK),meandiffusion (MD)andADCinendometrialcarcinomaandnormalendometrium were measuredrespectively.Thesimilaritiesanddifferencesoftheparametersbetweentheendometrialnormalgroup(G0)andtheendometrialcarcinoma group (G1,G2,G3)werecomparedandanalyzed.TheROCcurvewasemployedtoevaluatethediagnosticefficacyandthresholdof eachparameter.P earson correlation wasappliedtoanalyzethecorrelationbetweeneachparametervalueandpathologicalgrade.Results The MK valuesincreasedgradually,meanwhiletheMDandADCvaluesdecreasedgraduallyinG0,G1,G2andG3groups.ExceptforMDand ADCvaluesbetweenG0andG1groups,othervalueswerestatisticallysignificantdifferent(P<0.05)betweendifferentgroups.In differentiatingoftheG0/(G1+G2+G3),G0/G1,G1/G2,G2/G3,theMKvalueshadthehighestdiagnosticefficacy(AUC=09.2,07.6,09.0,0.96, P<0 .05 ).M oreover ,in the correlation of pathological grading ,M K>M D>A D C (r=0 .850 ,0 .781 ,0 .709 ,P<0 .05 ).Conclusion Both DKIandDWIcandiagnoseandevaluatepathologicalgradeofendometrialcarcinoma.ComparedwithDWI,DKIembracesmoreperfectmathematical modelandmoresensitiveparameters,andcanbeusedasaneffectivemethodtoevaluatethepathophysiologicalfeaturesofendometrialcarcinoma.

PCV13 (13-valent pneumococcal conjugate vaccine) containing capsular polysaccharides of Streptococ-cus pneumoniae serotypes 6A and 6B confers cross-protection against newly discovered serotypes 6C and 6D / 中华微生物学和免疫学杂志

Objective To investigate whether capsular polysaccharides of Streptococcus pneumoniae serotypes 6A and 6B contained in 13-valent pneumococcal conjugate vaccine ( PCV13 ) could induce cross- protective antibodies against newly discovered serotypes 6C and 6D and the differences between them. Methods New Zealand rabbits were radomly divided into three groups and respectively muscularly administrated with three doses of PCV13, PCV6A and PCV6B on days 0, 14 and 28. PCV6A and PCV6B were conjugates of capsular polysaccharides of serotypes 6A and 6B chemically coupled with diphtheria toxin mutant CRM197. Serum samples were collected on days 0 and 35. Enzyme-linked immunosorbent assay (ELISA) recommended by World Health Organization (WHO) was used to quantitatively measure serotype-specific antibodies to capsular polysaccharides of serotypes 6A, 6B, 6C and 6D. Opsonophagocytosis assay ( OPA) of WHO pneumococcal serology reference laboratory was used to determine antibody functional activities targeting serotypes 6A, 6B, 6C and 6D. Results Immunization rabbits with PCV13 induced the secretion of antibodies to capsular polysaccharides of serotypes 6A and 6B. These antibodies were able to not only cross-react with capsular polysaccharides of serotypes 6C and 6D but also recognize and bind to target Streptococcus pneumoniae serotypes 6A, 6B, 6C and 6D, resulting in the activation of complements and further phagocytosis of target bacteria by differentiated HL60 cells. Bactericid-al titers were largely even among these serotypes except for serotype 6D which was slightly lower. PCV6A could induce antibody against capsular polysaccharide of serotype 6A, which was able to cross-react with capsular pol-ysaccharides of serotypes 6B, 6C and 6D and showed higher bactericidal titers to serotypes 6A, 6B and 6C over serotype 6D. PCV6B could induce antibody against capsular polysaccharide of serotype 6B, which was able to cross-react with capsular polysaccharides of serotypes 6A, 6C and 6D and showed higher bactericidal titers to se-rotypes 6A, 6B and 6C over serotype 6D. Antibody concentrations and bactericidal titers specific to serotypes 6A, 6B, 6C and 6D were significantly increased following immunization with PCV13, PCV6A or PCV6B (P<0. 01). Conclusion PCV13 containing pneumococcal serotypes 6A and 6B induced antibodies against capsular polysaccharides of serotypes 6A and 6B in New Zealand rabbits, which were able to cross-react with capsular polysaccharides of serotypes 6C and 6D and provide cross-protection to bacteria of serotypes 6C and 6D. Both serotypes of 6A and 6B contained in PCV13 contributed to the induction of cross-protective antibodies, especially to serotype 6C.

Multiple model parameters of intravoxel incoherent motion in differential diagnosis of cervical carcinoma and pre-judgement of pathological types / 中国医学影像技术

Objective To investigate the feasibility of multiple model parameters of intravoxel incoherent motion (IVIM) in differential diagnosis of cervical carcinoma and its pathological types.Methods IVIM images of 33 patients with cervical cancer (cervical cancer group) and 30 patients with normal cervix (normal group) were retrospectively analyzed.The monoexponential model parameters (ADC-stand),biexponential model parameters (ADC-slow,ADC-fast,f) and stretched-exponential model values (distributed diffusion coefficient [DDC],α) were measured,respectively.Then the parameters were compared among the two groups,as well as among different pathological types and different pathological grades of cervical cancer.The thresholds and diagnostic efficiency of the parameter values were evaluated with ROC curve.Results ADC-stand,ADC-slow,f,DDC and α values of cervical cancer group were lower than those of normal group (all P＜0.05).The area under the ROC curve of ADC-stand,ADC-slow,DDC,f and a values in diagnosis of cervical cancer was 0.93,0.94,0.96,0.94 and 0.93 (all P＜0.05),and the diagnostic thresholds were 1.03 × 10-3 mm2/s,0.99 × 10-3mm2/s,30.50％,1.21 × 10-3 mm2/s and 0.699,respectively.ADC-stand,ADC-slow and DDC values in cervical squamous cell carcinoma patients were lower than those of cervical adenocarcinoma patients (all P＜0.05).The area under the ROC curve of ADC-stand,ADC-slow and DDC values in differential diagnosis of cervical squamous cell carcinoma and cervical adenocarcinoma was 0.98,0.91 and 0.98 (all P＜0.05),the diagnostic thresholds were 1.11 × 10-3 mm2/s,0.81×10-3 mm2/s and 0.98 × 10-3 mm2/s,respectively.There was no significant difference of the parameters among high,moderate,low differentiation of cervical squamous cell carcinoma.Conclusion Multiple model parameters of IVIM can quantitatively reflect the histological features of cervical cancer.

Single Index, Double Exponential and Tensile Density Index Model Diffusion Weighted Imaging in Diagnosis of Endometrial Carcinoma / 中国医学影像学杂志

Purpose To explore the application of single index,double exponential and tensile density index model diffusion weighted imaging and other parameters on endometrial carcinoma diagnosis to offer new ideas for it.Materials and Methods Intravoxel incoherent motion imaging data of 28 endometrial carcinoma patients and 24 patients of normal endometrium were analyzed retrospectively.Single index,double exponential and DWI parameter of endometrial carcinoma tissue and normal endometrial tissue were measured respectively,including standard apparent diffusion coefficient (ADC-stand),slow apparent diffusion coefficient (ADC-slow),fast apparent diffusion coefficient (ADC-fast,perfusion fraction (f),distributed diffusion coefficient (DDC) and a.Receiver operator characteristic (ROC) curve was adopted to assess threshold value and diagnostic efficiency of each parameter,and analyzed difference among each parameter in two groups and relativity of each parameter in the same group.Results ADC-stand,ADC-slow,f,DDC and a in endometrial carcinoma group were all lower than those in normal endometrium group.The difference was statistically significant (P＜0.05).The difference of ADC-fast was not statistically significant (P＞0.05).Areas of ADC-stand and ADC-slow on ROC curve were 0.949 and 0.911 respectively,and threshold values were 1.245×10-3 mm2/s and 0.998× 10-3 mm2/s.ADC-stand in endometrial carcinoma group was positive correlated with ADC-slow and DDC value (r=0.787 and 0.880,P＜0.05).ADC-slow was significantly lower than ADC-stand (P＜0.05).Conclusion The differences in single index,double exponential and DWI can provide new ideas for endometrial carcinoma diagnosis.

CT and MRI diagnosis of elastofibroma dorsi / 实用放射学杂志

Objective To explore the CT and MRI manifestations and diagnosis of elastofibroma dorsi(EFD).Methods CT or MRI findings of 20 cases (36 lesions)of EFD confirmed by surgical pathology were analyzed retrospectively.12 patients underwent plain chest CT,4 patients plain chest MRI,4 patients plain unilateral shoulder MRI.Results ① All of cases were located in the infrascapular region,between the thorax wall and serratus anterior,mainly shaped flat mound-like or semi-circular.CT densities and MRI signal intensities of the masses were similar to those of muscle with some interlaced fat-like areas within the lesions.The masses had irregular edges, with no clear boundary between the thorax wall and serratus anterior,with disappeared fat gaps.② Statistical difference were found in patients’incidence between men and women,incidence between unilateral and bilateral and lesion volume between the left and right (P <0.05),and the incidence in female was significantly higher than that in male,the incidence in bilateral was significantly higher than that in unilateral,the lesion volume in the right was bigger than that in the left.Conclusion ① EFD has its characteristic location and imaging findings,so a definite diagnosis can be made with CT and MRI.② The mechanical friction between the scapula and chest wall may be related to tumor growth.

The value of 125iodine implantation combining transcatheter arterial chemoembolization to prevent digestive tract bleeding in patients with portal vein tumor thrombus in primary hepatocellular carcinoma / 中华放射学杂志

Objective This study was to investigate the value of CT guided 125iodine implantation combining transcatheter arterial chemoembolization(TACE) to prevent digestive tract bleeding in patients with portal vein tumor thrombus in primary hepatocellular carcinoma. Methods Forty patients with portal vein tumor thrombus which were diagnosed to have primary hepatocellular carcinomas by diagnostic criteria of Chinese Anti-Cancer Association were collected prospectively. They were divided into the treatment group and the control group, with 20 patients in each group. The treatment group was treated by TACE for hepatic tumor and 125iodine seed implantation for portal vein tumor thrombus, while the control group was treated by TACE for hepatic tumor and only given β-blockers medicines after treatment. Intraoperative and postoperative surgery-related complications were observed. Three months after surgery, enhanced abdominal CT scanning was performed to evaluate treatment effects which were divided into complete response (CR), partial response (PR), and progressive disease (PD) and stable of disease (SD), and the local tumor control rates were calculated. The bleeding rates and mortality after 3 months, 6 months, 12 months were recorded. Treatment effects of the two groups were compared with continuously correction Chi-square test, bleeding rates were compared with Fisher test, and survival rates were analyzed with Kaplan-Meier survival curve and compared with Log-rank test. Results Overall the 40 patients were treated successfully without serious surgery-related complications. In the treatment group, there were 8 patients with PR, 6 with SD and 6 with PD, and the local control rates were 40% (8/20). In the control group, there were 1 patient with PR, 6 patients with SD and 13 with PD. The difference of the local control rates was statistically significant (χ2=5.161, P=0.023).The bleeding rates at 3, 6 and 12 months were 2, 2 and 3 cases in the treatment group, for control group they were 2, 6 and 10 cases respectively. There was no statistical difference between the 3 months and 6 months bleeding rates (P values were 1.000 and 0.235), but for 12 months bleeding rates, the difference was statistically significant (P=0.041).The 1 year cumulative survival rates of the treatment group and control group were 70% (14/20) and 40% (8/20), and the difference was statistically significant (χ2=4.675, P=0.031). Conclusion The treatment of 125iodine implantation combining transcatheter arterial chemoembolization in patients with portal vein tumor thrombus in primary hepatocellular carcinoma can reduce variceal bleeding rate and improve survival rate.

Biodegradable covered magnesium alloys stent for a lateral aneurysm model in common carotid artery in rabbits / 中华放射学杂志

Objective To discuss the feasibility of biodegradable covered magnesium alloys stent for a rabbit model of lateral aneurysm in the common carotid artery (CCA). Methods The left CCA was ligated in 20 conventional New Zealand rabbits. MRA of the neck was performed 1 month after ligation. The rabbits with thickening of the right CCA and non-or slight thickening of the bilateral vertebral arteries were selected for lateral aneurysm model making. The venous pouch and the right CCA wall by discontinuous extroversion sutures, to form a lateral aneurysm model. The biodegradable covered magnesium alloys stents or Willis covered stents were inserted two weeks after model making. Angiography was performed prior to the procedure, 3, 6 and 12 months after stent implantation to evaluate the disappearance of the aneurysms and patency of the right CCA. The degradation behaviour is invastagated with molybdenum target 2 weeks, 1, 2, 4, 6,9 and 12 months after stent placement. Results The left CCAs were successful ligated in all rabbits. MRA 1 month after ligation showed thickening of the right CCA and non-thickening of the bilateral vertebral arteries in 17 of 20 rabbits. In these animals, the CCA lateral aneurysm model was deemed successful, and biodegradable covered magnesium alloys stents and Willis covered stents were implanted in 9 and 8 aneurysms, respectively. DSA after biodegradable covered magnesium alloys stent placement displayed disappearance of the aneurysms and patency of the CCA in all 9 rabbits during follow-ups. DSA 3 months after Willis stent placement displayed patency of the CCA in 7 rabbits and occlusion of the artery in one. No occlusion of the right CCA was observed on angiography at 6 and 12 months. The degradation of the biodegradable covered magnesium alloys stent was investigated with molybdenum target during follow-ups, and no changes was observed in Willis covered stent. Conclusion Biodegradable covered magnesium alloys stent is a feasible approach for the treatment of a lateral aneurysm in the right CCA.

MRI evaluation on the time and function prognosis of vertebral compression induced by spinal trauma or primary osteoporosis / 中国组织工程研究

BACKGROUND: The bone fragments from spinal vertebral fracture can enter into vertebral canal to cause neural functional injury. The restoration of neural function after injury is mainly determined by the character and extent of primary injury, and is related with the spinal injured range. Early imageological analysis can evaluate the degree and range of spinal injury to preliminarily evaluate the therapeutic method and prognosis of the patient.OBJECTIVE: To explore the merit of MRI in the evaluation of function prognosis in compressive fracture induced by spinal trauma or primary osteoporosis to provide a gist for early rehabilitative intervention.DESIGN: A case retrospective study by employing patients with benign vertebral compressive fracture as subjects.SETTING: Department of Imageology of Henan Provincial Hebi Mineral Bureau General Hospital, Department of Radiology of affiliated hospitals of two universities.PARTICIPANTS: Totally 107 cases(123 vertebras) of benign vertebral compressive fracture with complete clinical data including 65 cases of trauma (trauma group, 71 vertebras) and 42 cases of osteoporosis(osteoporosis group, 52 vertebras) were selected from 125 spinal MRI testees of the first affiliated hospital of Beijing Medical University and the first affiliated hospital of Xinxiang Medical College for retrospective analysis.INTERVENTIONS: MRI images of the compressive vertebras in 107 cases (123 vertebras) induced by acute trauma or primary osteoporosis were comparatively analyzed by two vice botanic physicians with blindness method.Vertebral compression was classified into "wedge-shaped" or "flat-shaped" based on the difference between anterior and posterior height of the deformed vertebras and the shapes to observe whether there was bone fragment or not and typical fracture line.RESULTS: MRI manifestation of osteoporosis compression: medullary signal was completely kept in the deformed vertebras with the mixture of high signals. The anterior superior angle of vertebra stuck into vertebral canal. Strip low signal was under the endplate of T1 vertebra. The anterior and posterior vertebral border had normal morphology or slightly sucked with smooth margin. Vertebral vein was clearly displayed. MRI manifestation of traumatic compression: vertebra had relatively even low signal and kept partial medullary signals. Vertebra was obviously deformed with para-vertebral hematoma. There was fracture line or usually accompanied with medullary edema, and cystic degeneration. Vertebral enhancement was an important manifestation of fracture rehabilitative stage, which was the indicator for the judgment of fresh or old fracture.CONCLUSION: MRI can differentiate spinal traumatic fracture and primary osteoporosis fracture, judge fracture time, and preliminarily evaluate the function and prognosis of the patient.

The Comparative Study of Different Magnetic Resonance Cholangiopancreatography (MRCP) in the Diagnosis of Obstructive Jaundice / 实用放射学杂志

0.05).Conclusion Breath-hold MRCP utilizing the SSFSE technique with high-quality images can accurately assess the level of obstruction and the causes of the obstruction in patients with obstructive jaundice, without the risks of endoscopic retrograde cholangiopancreatography(ERCP).This MRCP technique should be preferred a reliable and noninvasive imaging modality for the diagnosis of obstructive jaundice.