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Papillary thyroid carcinoma metastasizing to the kidney are extremely rare events, which may easily be misdiagnosed as renal cell carcinoma. The diagnosis needs to be based on immunohistochemical examination. We described a case of renal tumor to be proved renal metastatic carcinoma from thyroid origin by pathological examination. Computed tomography (CT) scan shows metastasis nodules in lungs. Following total thyroidectomy, he underwent iodine-131 ( 131Ⅰ), thyroid hormone and sorafenib to treat thyroid remnant tumor and metastases. Partial nephrectomy was conducted to remove the left renal metastatic carcinoma for preserving normal renal function. Follow-up revealed that partial pulmonary nodule gradually shrunk, and no new metastasis appeared.
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Objective To investigate the alteration and possible compensation mechanism of the default mode network (DMN) in patients with subacute pontine infarction.Methods Rs-fMRI data were collected from 23 patients with subacute pontine infarction and 23 normal controls.The data was analyzed with the functional connectivity (FC) method and compared between subacute pontine infarction patients and controls.All imaging was performed on a Philips Achieva 3.0T MRI scanner.Posterior cingulated cortox (PCC) was used as seed points to analyze the FC changes in the brain regions between the pontine infarction group and the controls.The discrepancies of experiment data between two groups were compared by using two-sample t-test analysis.Results The FC of the DMN showed a significant increase in the right postcentral gyrus, left medial prefrontal cortex and left precuneus compared with normal controls and a significant decrease in bilateral insula,posterior lobe of the left cerebellum,right parahippocampal gyrus and left inferior occipital gyrus.Conclusion The DMN altered in patients with subacute pontine infarction and the changes of the FC suggested the plasticity of cortical or compensation in the relevant brain areas.
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Purpose To explore the significance of MR diffusion tensor imaging (DTI) in diagnosing and predicting the motor function of patients with acute ischemic stroke in the brainstem. Materials and Methods Twenty patients with acute ischemic stroke in the brainstem and 20 normal controls were enrolled in the study. DTI was performed on all 40 subjects. Fractional anisotropy (FA) in specific regions were measured including infarction lesions, cerebral peduncle, the posterior limb of the internal capsule in the affected side and corresponding unaffected regions. The number and the length of the corticospinal tracts (CST) of both affected and unaffected sides were also measured. The correlation of FA, the number and the length of the CST, the NIH stroke scale (NIHSS) at the admission, 3 months and 6 months was analyzed. Results The FA values of infarction, cerebral peduncle, and the posterior limb of the internal capsule, and the number of CST in the affected side were significantly less than that of the corresponding unaffected regions (P<0.05). The rFA (<7 d) in the affected cerebral peduncle was negatively correlated with NIHSS and the score of the upper and lower extremity muscle strength at the admission, after 3 months and after 6 months (P<0.05). However, the rFA of the infarction and the posterior limb of the internal capsule, the ratio of the number and the length of CST of affected/unaffected sides had no correlation with NIHSS score and the score of the muscle strength. Conclusion The rFA in the cerebral peduncle is helpful for early evaluation and predicting recovery of the motor function in the patients with acute ischemic stroke in the brainstem.
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Objective To investigate the characteristics of resting-state functional magnetic resonance imaging (fMRI)in patients post-stroke depression (PSD).Methods Resting-state fMRI scans were performed in 13 patients with and without post-stroke depression.A regional homogeneity (ReHo) approach was used as an indicator.The brain function was analyzed in patients with post-stroke depression.Results Compared to a control group,the ReHo values decreased significantly in a PSD group in the left middle frontal gyrus,right superior frontal gyrus,right middle frontal gyrus,right anterior cingulate gyrus,right posterior cingutate gyrus,left insular lobe,left caudate nucleus,and left hippocampus.Conclusions The patients with PSD had restingstate neural circuit dysfunction,suggesting that the need to focus on the emotional state of stroke patients in the clinical treatment process.
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ObjectiveTo investigate the brain function in the patients with transient ischemic attack (TIA) using index of regional homogeneity ( ReHo ).MethodsSixteen TIA patients ( TIA group ) and 16 age-matched normal controls(control group) underwent standard resting state functional MRI (fMRI)scan.The changes of the brain ReHo were studied by DPARSF analysis.ResultsCompared with that of control group,TIA group showed significantly decreased ReHo in the left cingulate gyrus (z =-3.72),left frontal gyrus (z =-3.02),right frontal gyrus (z =-3.23),right superior frontal gyrus (z =-3.75),right precuneus (z =-3.80),right inferior parietal lobule (z =-3.98 ),left inferior parietal lobule (z =-3.82),precentral gyrus ( z =- 3.85 ),right midfrontal gyrus ( z =-4.15 ),right midtemporal gyrus (z =- 3.43 ),and increased ReHo in the right hippocampus (z =3.37) and right cerebellum (z =3.55).Conclusion The rest-state brain function is abnormal in TIA interictal phase,and the increased ReHo in the hippocampus and cerebellum may reflect stress-induced brain protection of TIA and partial comoensatory response.
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Objective To investigate any changes in motor functional connectivity in the brains of acute ischemic stroke patients after low frequency electrical stimulation.Methods Twenty-five ischemic stroke patients were given low frequency electrical stimulation in addition to their conventional rehabilitation treatment.Another 20 patients received only conventional treatment as a control group.Resting-state functional magnetic resonance imaging (rs-fMRl)was employed to assess motor function connectivity in the brains of all 45 subjects before and after treatment.Any differences in functional impairment,extremity motor function or ability in the activities of daily living were also recorded before and after treatment.Results In both groups,average scores on the Canadian neurological scale (CNS)and the National Institutes of Health stroke scale (NIHSS) had been reduced significantly after treatment and FuglMeyer assessment (FMA) and modified Barthel index (MBI) scores had significantly increased.The average improvements in terms of FMA and MBI scores were significantly greater in the observation group.Compared with before treatment,the coefficient of functional connectivity of the bilateral motor cortex had decreased significantly after treatment in both groups.In the observation group the changes were significantly correlated with the improvements in FMA scores.Conclusion Neural functional impairment after ischemic stroke can be reduced significantly and extremity motor function and ability in the activities of daily living can be significantly improved by low frequency electrical stimulation.
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Objective To discuss the spiral CT features of the bowel obstruction induced incarcerated abdominal external hernia and its value in clinical application.Methods The spiral CT feature of the bowel obstmction induced incarcerated abdominal external hernia which were confirmed by surgery in 14 cases were retrospectively analyzed and were compared with surgical results.Results The hernia sac of incarcerated abdominal external hernia in all cases of bowel obstruction were displayed by CT,in which the positions and varieties of the hernia were determined in 12 CaSes.the intestinal images within the hernia SaC were displayed in 10 cases,the epiploon image within the hernia sac was displayed in 1 case.homogeneus soft tissue density shadows were displayed in 3 cases,the intestinal wall thickening within the hernia sac was displayed in 4 cases.in which in 2 cases were involved in delamination of the intestinal wall.The intestinal wall thickening in abdominal cavity was displayed in 2 cases,the nuidify in abdominal cavity was displayed in 3 cases.the volvulus was displayed in 2 cases.Conclusion The spiral CT has an important value in determing the positions of bowel obstruction,varieties of the contents of hernia sac,th blood supply of the bowel within the hernia sac and proximate obstmction and other complieations.
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Objective To evaluate the CT appearances and diagnostic value of calcific metastases originated from the alimentary system mucous carcinoma.Methods CT appearances of calcific metastases originated from the alimentary system mucous carcinoma confirmed by surgery and pathology were retrospectively analysed.Results Calcification inside the metastatic tumors could be seen in all 9 patients.The calcification was multiple in 6,single in 3;4 lesions were in the brain and 5 in the liver.The calcific rate of tumors was 100%.Conclusion The metastases originated from malignant tumors of alimentary system are easy appearing calcification,CT scanning plays an important role in diagnosing the calcific metastases.