Diagnostic value of diffusion tensor imaging in spinal neurotype brucellosis spondylitis / 中华地方病学杂志

Objective To investigate the diagnostic effect of diffusion tensor imaging (DTI) on spinal neurotype brucellosis spondylitis (BS).The characteristics of apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value of spinal neurotype BS in different disease stages were quantitatively analyzed to evaluate the different forms of spinal neurofibrillary tract injury.Methods A prospective design was used to collect data of BS patients with spinal neurological symptoms from June 2015 to July 2017 in the First Affiliated Hospital of Hebei North University as the brucellosis group (n =39),including 23 males and 16 females,aged (20.8 ± 15.3) years old.Healthy subjects were selected as the control group (n =30),including 20 males and 10 females,aged (25.2 ± 4.0) years old.The brucellosis group was divided into acute stage (＜ 3 months),subacute stage (3-6 months) and chronic stage (＞ 6 months),with 12,10 and 17 cases,respectively.Routine spinal scans and DTI scans were performed using a 3.0T superconducting magnetic resonance imaging (MRI) scanner,DTI used Fiber Trak package to measure ADC value and FA value and perform quantitative analysis [receiver operating characteristic (ROC) curve],and reconstructed the changed form of the spinal neurotype BS nerve fiber bundle.Results A total of 39 patients' data were collected in the brucellosis group.Among them,5 patients showed segmental thickening of spinal nerves on conventional MRI,high signal on T2 weighted imaging (T2WI) and short time inversion recovery (STIR),and color code changes on DTI scan FA imaging.Routine MRI of 34 patients showed spinal cord compression,spinal cord morphological changes or cauda equina nerve aggregation and displacement,while DTI scan FA imaging showed spinal cord or cauda equina nerve morphological changes,but no color code changes.The ADC values of patients in the acute and subacute stages were higher than that of the control group [(1.41 ± 0.05),(1.31 ± 0.05),(1.23 ± 0.05) × 10-3 mm2/s,P ＜ 0.05],and the FA values were lower than that of the control group (0.40 ± 0.04,0.68 ± 0.08,0.76 ± 0.05,P ＜ 0.05).There were no statistically significant differences in ADC and FA values between patients with chronic spinal neurotype BS [(1.25 ± 0.04) × 10-3 mm2/s,0.72 ± 0.04] and the control group (P ＞ 0.05).ROC curve analysis showed that the area under curve (AUC),specificity,sensitivity and accuracy of ADC were 0.912,0.942,0.930 and 0.924,respectively.The AUC,specificity,sensitivity and accuracy of FA were 0.901,0.937,0.928 and 0.943,respectively.The change forms of spinal neurotype BS were:① color code change;② loss/fracture;③ displacement and pressure;④ rarity.Conclusion DTI plays a diagnostic role in spinal neurotype BS,and can quantitatively analyze the characteristics of changes in ADC value and FA value in different periods,and can clearly display the forms of changes in spinal neurofiber,providing a reliable basis for the diagnosis of spinal neurotype BS.

ADCMin ,ADCDR and DCE-MRI in the differential diagnosis of breast ductal carcinoma in situ and breast ductal carcinoma in situ with microinvasion / 实用放射学杂志

Objective To explore the differential diagnosis of breast ductal carcinoma in situ (DCIS)and breast ductal carcinoma in situ with microinvasion (DCIS-Mi)by ADCMin ,ADCDR and DCE-MRI,and to analyze the correlation between DCIS-Mi and biological factors. Methods Preoperative breast MRI examinations were performed in 41 patients with DCIS-Mi and 3 7 patients with DCIS.DCIS-Mi and DCIS patients were compared in terms of ADCMin ,ADCMax ,ADCDR ,early enhancement rate (EER)and the morphological characteristics of DCE-MRI.The optimal diagnostic variables were determined by binary Logistic regression,the threshold value of the optimal diagnostic variables was ensured by ROC,and the correlation between DCIS-Mi and biological factors was analyzed by Spearman.Results ADCMin of DCIS-Mi patients was lower than that of DCIS (t＝6.294,P＝0.033),and ADCDR was higher than that of DCIS (t＝9.246,P＝0.020).70.7 3% DCIS-Mi showed non-tumor-like enhancement,inclined to segmental distribution,and internal heterogeneous or cluster ring enhancement;29.27% manifested tumor-like enhancement,internal heterogeneous or ring enhancement,and unclear margin.64.86% DCIS showed non-tumor-like enhancement,inclined to linear distribution,internal homogeneous/heterogeneous enhancement;35.14% expressed tumor-like enhancement,internal homogeneous enhancement,and clear margin.The accuracy,sensitivity and specificity of ADCMin , ADCDR ,tumor or non-tumor internal enhancement features in the diagnosis of DCIS-Mi were higher (84.0%,9 5.3%,9 2.4%;89.3%, 9 5.3%,9 2.4%;85.1%,9 2.5%,9 3.8%;87.4%,9 6.8%,84.7%, respectively).ADCMin and ADCDR threshold value were 1.1 1× 10－3 mm2/s and 0.35×10－3 mm2/s,respectively.ADCMin of patients with DCIS-Mi was positive correlation with ER(－)and PR(－), and negative correlation with HER-2(+)(P＜0.05).ADCDR ,non-tumor distribution,and non-tumor internal enhancement characteristics,the tumor edge and internal enhancement characteristics were negative correlation with ER(－)and PR(－),and positive correlation with HER-2 (+)(P＜0.05).Conclusion ADCMin ,ADCDR and DCE-MRI can be used for the differential diagnosis of DCIS-Mi and DCIS, and provided evidence for clinical treatment plan.

Feasibility of double low techniques in cerebral perfusion using 640-slice volume CT / 实用放射学杂志

Objective To evaluate the feasibility of low tube voltage (80 kV)with low concentration contrast medium iodixanol (270 mg I/mL)in cerebral perfusion using 640-slice volume CT.Methods Patients who underwent CT cerebral perfusion were randomly divided into two groups.Group A:100 kV,320 mg I/mL contrast medium;group B:80 kV,270 mg I/mL contrast medium.The effective dose(ED)was record,the frontal cortex,temporal cortex and occipital cortex were selected as regions of interest(ROI),and the cerebral perfusion parameters (rCBV,rCBF,MTT,TTP)were measured separately.The CT value of the M1 segment of cerebral middle artery, the C7 segment of internal carotid artery,the basilar artery and the surrounding brain tissue were measured.The signal-to-noise radio (SNR)and the contrast-to-noise ratio(CNR)of two groups were compared and analyzed.All data will be statistically analyzed,and the consistency of two physicians for image quality evaluation was analyzed by Kappa analysis.Results The ED of group B was 4.56 mSv, which was reduced by 35.2% compared to group A(7.04 mSv).The perfusion parameters,the CT value of ROI and the SNR,CNR for two groups were of no statistical difference(P>0.05).Conclusion The feasibility of low tube voltage combined with low concentration contrast media is better,which not only meets the requirements of clinical diagnosis,but also reduces the radiation dose and the probability of contrast induced nephropathy.

Effect of hydrogen sulfide on inducible nitric oxide synthase in kidneys of Type Ⅰ diabetic rats / 中南大学学报(医学版)

Objective:To investigate effects of hydrogen sulfide (H2S) on inducible nitric oxide synthase (iNOS) in kidneys of Type 1 diabetic rats.Methods:Thirty-two male SD rats were randomly divided into four groups:A normal control (NC) group,a diabetes mellitus (DM) group,a NaHS (NaHS+DM) group,and a NaHS control (NaHS) group (n=8 per group).Type 1 diabetes was induced by a single intraperitoneal injection of streptozotocin (55 mg/kg).After successful establishment of models,the rats in NaHS+DM and NaHS groups were injected with NaHS solution (56 μmol/kg) intraperitoneally.Eight weeks later,the activities of total nitric oxide synthase (T-NOS) and iNOS,as well as the level of nitric oxide (NO) were detected in serum and renal tissues,respectively,The activity of glutathione peroxidase (GSH-Px) was determined in renal tissues,The ultrastructures of renal tissues were observed by transmission electron microscope,The protein expression ofiNOS in renal tissues was detected by Western blot.Results:Compared with the NC group,there was no significant difference in the various indexes in the NaHS group (P＞0.05).However,in the DM group,the activities of T-NOS and iNOS,and the level of NO were all increased significantly in serum and renal tissues,while the activity of GSH-Px was decreased in renal tissues.Under the electronic microscope,the thickening of the glomerular capillary basement membrane,the proliferation of mesangial matrix,and the foot fusion were observed.The protein expression ofiNOS was increased obviously in renal tissues in the DM group (P＜0.01).Compared with the DM group,the activities of T-NOS and iNOS and the level of NO were all decreased in serum and renal tissues,while the activity of GSH-Px was increased in renal tissues in the NaHS+DM group (P＜0.01).The renal ultrastructural damages were ameliorated obviously.The protein expression ofiNOS was decreased significantly (P＜0.01).Conclusion:H2S exerts a protective effect on kidney injury in type 1 diabetic rats.The mechanism might be related to inhibition of iNOS activity and protein expression,in turn leading to reduction of NO content in renal tissues.

Quantitative Analysis of Small Airway Wall Thickness in Acute Exacerbations of Chronic Obstructive Pulmonary Disease Using CT / 中国医学影像学杂志

PurposeTo measure the areas and diameter lines of bronchi at acute exacerbation and at remission period in patients with chronic obstructive pulmonary disease (COPD) using CT, and to explore the correlation between the two periods and evaluate the comprehensive assessment in diagnosing COPD exacerbation.Materials and Methods Fifty-two COPD patients were scanned with 64-row spiral CT on chest and PFT at acute exacerbation and at remission period. The areas and diameter lines of apical segmental and the sub-segmental bronchi of the right upper lobe in the patients were measured at the two periods, including indicators such as wall thickness (WT), thickness-diameter ratio (TDR), wall area (WA), percentage of wall area (WA%). The differences of those indicators at the two periods were compared with such factors of COPD comprehensive assessment as forced expiratory volume at the first second% (FEV1%), percentage of forced expiratory volume in first second to forced vital capacity (FEV1/FVC), COPD assessment test (CAT), modified medical research council questionnaire (mMRC) for assessing the severity of breathlessness, 6-minute walking distance (6MWD). Results The patients had significant differences between acute exacerbation period and remission period in the indicators of COPD comprehensive assessment like FEV1%, FEV1/FVC, CAT, mMRC and 6MWD (t=-4.119,-2.583, 4.012, 3.321 and-3.892,P<0.05). Compared with those at remission period, the WT, TDR, WA and WA% of sub-segmental bronchi were all higher at acute exacerbation period (t=3.025, 2.341, 2.204 and 2.124, P<0.05); only TDR of segmental bronchi showed significant difference between the two periods (t=2.990,P<0.05). The correlation of sub-segmental bronchi with FEV1%, FEV1/FVC, CAT, mMRC and 6MWD was more significant than that of segmental bronchi with those indicators at the two periods.Conclusion The COPD comprehensive assessment can help diagnose COPD at acute exacerbation period; MSCT shows the remodeling of segmental and sub-segmental bronchi and the changes on the airway wall, and the quantitative measurement of sub-segmental bronchi has correlation with the differences of indicators in the comprehensive assessment; COPD comprehensive assessment seems to be more valuable than PFT in the estimation of COPD at acute exacerbation.