Diffusion MRI With High to Ultrahigh b-Values: How It Will Benefit the Discovery of Brain Microstructure and Pathological Changes

Diffusion MRI (dMRI) has been widely utilized to probe the random motion of water molecules in tissues. In a dMRI acquisition protocol, diffusion weighting or b-value is one of the most important parameters to consider. In recent years, high and ultrahigh b-values have become popular partly due to advances in hardware. In this mini-review, we will discuss impacts of high/ultrahigh b-values in three different areas: brain microstructure, tractography, and clinical applications. We will emphasize advantages of high b-value in probing diffusion within highly restricted regions or fine structures with enhanced diffusion contrast. A short summary is included at the end of each section to illustrate both advantages and disadvantages of using a high/ultrahigh b-value for each purpose.

Acupuncture's Role in Solving the Opioid Epidemic: Evidence, Cost-Effectiveness, and Care Availability for Acupuncture as a Primary, Non-Pharmacologic Method for Pain Relief and Management-White Paper 2017 / 中西医结合学报

The United States (U.S.) is facing a national opioid epidemic, and medical systems are in need of non-pharmacologic strategies that can be employed to decrease the public's opioid dependence. Acupuncture has emerged as a powerful, evidence-based, safe, cost-effective, and available treatment modality suitable to meeting this need. Acupuncture has been shown to be effective for the management of numerous types of pain conditions, and mechanisms of action for acupuncture have been described and are understandable from biomedical, physiologic perspectives. Further, acupuncture's cost-effectiveness can dramatically decrease health care expenditures, both from the standpoint of treating acute pain and through avoiding addiction to opioids that requires costly care, destroys quality of life, and can lead to fatal overdose. Numerous federal regulatory agencies have advised or mandated that healthcare systems and providers offer non-pharmacologic treatment options for pain. Acupuncture stands out as the most evidence-based, immediately available choice to fulfil these calls. Acupuncture can safely, easily, and cost-effectively be incorporated into hospital settings as diverse as the emergency department, labor and delivery suites, and neonatal intensive care units to treat a variety of commonly seen pain conditions. Acupuncture is already being successfully and meaningfully utilized by the Veterans Administration and various branches of the U.S. Military, in some studies demonstrably decreasing the volume of opioids prescribed when included in care.

Altered Activity and Functional Connectivity of Superior Temporal Gyri in Anxiety Disorders: A Functional Magnetic Resonance Imaging Study

OBJECTIVE: The prior functional MRI studies have demonstrated significantly abnormal activity in the bilateral superior temporal gyrus (STG) of anxiety patients. The purpose of the current investigation was to determine whether the abnormal activity in these regions was related to a loss of functional connectivity between these regions. MATERIALS AND METHODS: Ten healthy controls and 10 anxiety patients underwent noninvasive fMRI while actively listening to emotionally neutral words alternated by silence (Task 1) or threat-related words (Task 2). The participants were instructed to silently make a judgment of each word's valence (i.e., unpleasant, pleasant, or neutral). A coherence analysis was applied to the functional MRI data to examine the functional connectivity between the left and the right STG, which was selected as the primary region of interest on the basis of our prior results. RESULTS: The data demonstrated that the anxiety patients exhibited significantly increased activation in the bilateral STG than the normal controls. The functional connectivity analysis indicated that the patient group showed significantly decreased degree of connectivity between the bilateral STG during processing Task 2 compared to Task 1 (t = 2.588, p = 0.029). In addition, a significantly decreased connectivity was also observed in the patient group compared to the control group during processing Task 2 (t = 2.810, p = 0.012). CONCLUSION: Anxiety patients may exhibit increased activity of the STG but decreased functional connectivity between the left and right STG, which may reflect the underlying neural abnormality of anxiety disorder, and this will provide new insights into this disease.

Angiographic manifestations of hepatocarcinoma after radiofrequency ablation treatment / 中国癌症杂志

Background and purpose:Radiofrequency ablation (RFA) was one of the best combined treatments for hepatocarcinoma. CT was commonly used to evaluate treatment response and recurrent disease. However it was diffi cult to evaluate treatment effectiveness of RFA and to detect recurrent nodule especially the size below 1cm. Digital subtraction arteriography(DSA) may provide fi nal diagnosis of recurrent nodule after RFA for hepatocarcinoma. Our purpose was to analyze the signs of DSA after RFA for hepatocarcinoma in order to provide possible reference for treatment effectiveness and the imaging follow-up methods. Methods:17 patients with primary liver cancer (n=15) or hepatic metastasis(n=2) were enrolled in this study. Common hepatic arteriography or super-selective angiography of suspicious tumor area were performed on all patients. Results:On DSA, most ablated regions presented as round or ovoid low density areas with no stain. At the peripheral zone of the lesion, fi ve signs after RFA could be found: Stain of localized granulation tissue, arterio-portal fi stula, hemorrhage, recurrence and no abnormal fi ndings. Local or intrahepatic recurrence occurred in 9 cases. Conclusion:Hepatic DSA has great value in detecting local recurrence of hepatic tumor after RFA treatment. DSA is superior to CT in detecting marginal or intrahepatic recurrent nodule below 1 cm.