Application of diffusion tensor imaging in crossed cerebellar diaschisis of cerebral gliomas / 实用放射学杂志

Objective To explore the application of diffusion tensor imaging (DTI)in crossed cerebellar diaschisis (CCD)of cerebral gliomas. Methods MR images of 17 patients with high grade gliomas and 20 patients with low grade gliomas confirmed by postoperative pathology and 18 normal controls were analyzed retrospectively.The fractional anisotropy (FA)of cerebellar hemisphere was quantitatively measured with DTI technique.The asymmetry index (AI)of cerebellar hemispheric was calculated and compared in patients.The correlation between CCD phenomenon and histological grade of cerebral gliomas was also analyzed.Results Compared with ipsilateral cerebellar hemisphere of cerebral high grade gliomas,the FA value of contralateral cerebellar hemisphere significantly reduced (t=3.42,P<0.05).But there were no significant differences of FA values between contralateral cerebellar hemisphere and ipsilateral cerebellar hemisphere in cerebral low grade gliomas patients (t=0.80,P>0.05).The AI values of cerebellar hemisphere in high grade gliomas increased compared with low grade gliomas and normal controls (t=4.15,P<0.05;t=4.68,P<0.05),but there were no significant differences in the AI values of cerebellar hemisphere between low grade gliomas patients and normal controls (t=0.79,P>0.05).Conclusion CCD phenomenon is associated with the histological grade of cerebral gliomas.High grade gliomas can cause CCD phenomenon,but there is no evident CCD phenomenon in low grade gliomas.DTI technique is able to quantitatively assess CCD noninvasively by FA parameter.

Quantitative estimation of regional brain gray nuclei iron content in idiopathic restless legs syndrome patients by phase values / 中华放射学杂志

Objective To investigate the applicative value of enhanced 3D multi-echo GRE T2*-weighted angiography(ESWAN) sequence phase values in evaluating brain gray nuclei iron content in idiopathic restless legs syndrome(RLS) patients, providing imaging basis in diagnosis and treatment of idiopathic RLS. Methods In our institute from June 2012 to September 2016,forty-five RLS patients were selected as the RLS group, and 45 healthy volunteers as the control group. ESWAN sequence was performed and serum ferritin values were obtained in all patients and volunteers. The raw data of ESWAN was postprocessed , where the phase maps were obtained. Phase analysis was performed on localized brain gray nuclei regions of interest (substantia nigra, red nucleus, dentate nucleus, thalamus, pallidum, putamen and caudate nucleus ) selected on phase maps. Differences between the 2 subject groups were evaluated using ANCOVA including age as a covariate. Results The phase values of the substantia nigra, thalamus, pallidum and putamen in the RLS group were (-0.087 ± 0.021), (-0.053 ± 0.012), (-0.161 ± 0.008), (-0.125 ± 0.019) radians , respectively. The phase values of the substantia nigra, thalamus, pallidum and putamen in the control group were (-0.127 ± 0.007), (-0.066 ± 0.007), (-0.166 ± 0.007), (-0.150 ± 0.010) radians, respectively. There were significant differences between the two groups (F=142.492, 37.988, 10.558, 60.725;P0.05). Conclusions Phase values can make a quantitative assessment of brain gray nuclei iron content in RLS patients, our results supported the hypothesis of reduced brain iron content in RLS patents , which may have an important role in the pathogenesis of the disorder. However, iron content change in some brain regions was not correlated with serum ferritin concentration changes.

Relationship of the serum levels of high sensitivity C-reactive protein and homocysteine with middle cerebral artery intraplaque hemorrhage / 中华老年医学杂志

Objective To investigate the relationship of the serum levels of high sensitivity C-reactive protein(hs-CRP) and homocysteine with middle cerebral artery(MCA) intraplaque hemorrhage.Methods A total of 63 patients who met the inclusion criteria showed high-grade(≥ 70％)MCA stenosis.The levels of serum hs-CRP and Hcy were detected.All patients were divided into symptomatic group and asymptomatic group,intraplaque hemorrhage group and non-intraplaque hemorrhage group.All patients performed conventional MRI and high-resolution MRI(HR-MRI).The correlation of the serum levels of hs-CRP and homocysteine with middle cerebral artery intraplaque hemorrhage was analyzed.Results Totally 37 symptomatic and 26 asymptomatic MCA stenoses were analyzed.The occurrence rate of intraplaque hemorrhage was significantly higher in symptomatic MCA stenosis group than in asymptomatic MCA stenosis group (40.5 ％ vs.11.5 ％,x2 =6.29,P＜ 0.05).Symptomatic group displayed a higher hs-CRP and Hey levels (8.97 ± 3.36 mg/L and 20.00 ± 3.16 μmol/L,respectively) than did asymptomatic group [(5.26 ± 3.12) mg/L and (12.22 ± 1.88) μmol/L,t =4.43 and 11.23,respectively,each P ＜ 0.001].The hs-CRP and Hcy levels were higher in intraplaque hemorrhage group [(10.53 ± 3.59) mg/L and (21.70 ± 2.40) μmol/L,respectively] than in non-intraplaque hemorrhage group[(6.20 ± 3.02) mg/L and(11.77±1.69) μmol/L,t=4.87 and 18.58,respectively,each P＜0.001].The hs-CRP and Hcy levels were positively correlated with the risk for middle cerebral artery intraplaque hemorrhage(r=0.461 and 0.519,each P＜0.001).Conclusions The serum levels of hs-CRP and Hcy are closely associated with middle cerebral artery intraplaque hemorrhage,which can be used to evaluate the stability of plaque.The MCA intraplaque hemorrhage is associated with ipsilateral stroke.

A study of 3D-PCASL in brain gliomas at 3.0T MR / 实用放射学杂志

Objective To evaluate the value of 3D-PCASL in the pre-operation brain gliomas-grading.Methods 3D-PCASL images of 41 cases of gliomas comfirmed by pathology,including 20 cases of low-grade and 21 cases of high-grade were retrospectively analyzed. The cerebral blood flows of the solid region of tumor (TBF),1cm and 1 cm-2 cm brain tissue around the tumor,and contralateral normal brain CBF were obtained based on the region of interest (ROI),respectively.Results According to independent sample t-test,all had statisti-cally significant differences (P <0.001)between high and low-grade gliomas except the 1-2 cm region around the tumor.One-way ANO-VA displayed that all of them had its statistically significant between differences region (P <0.001)in high-grade gliomas,which had statisti-cally significant differences (P <0.001)except 1 cm and 1 -2 cm of peri-tumor in low-grade gliomas.ROC curve analysis of TBF/contralateral gray matter showed that the area under the curve was 0.96.When 2 was chosen as threshold of rCBF,there was the highest sensitivity (85.7%)and specificity (100%).The accurate rate of conventional MRI for gliomas dianosis was 76% and the ac-curate rate of conventional MRI with ASL was 93%,which was statistically significant difference (χ2 =6.61,P =0.01)between two methodson the chi-square test.Conclusion 3D-PCASL can improve the accuracy of diagnosis of different grade brain gliomas.Com-pared with others parameters,rCBF have a higher sensitivity and specificity.

Genetic analysis of a congenital nephrogenic diabetes insipidus pedigree / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>As an X-linked recessive way, arginine vasopressin receptor 2 (AVPR2) gene mutation resulted in a hereditary disease - congenital nephrogenic diabetes insipidus (CNDI). We found a suspect clinical CNDI pedigree. In order to identify the genetic etiology, we performed the genetic analysis.</p><p><b>METHODS</b>The clinical features of the proband and his family members were recorded. The laboratory tests and imaging inspections were analyzed. The water deprivation and pituitrin loading test were performed in the proband and his brother. The genomic DNA of all the members of the pedigree was extracted and then PCR amplification on AVPR2 gene was carried out. Sequencing in both directions was performed to identify mutation on AVPR2 gene.</p><p><b>RESULTS</b>Both the proband and his brother were diagnosed as CNDI, meanwhile the other members of this pedigree were normal. No severe biochemical abnormality was found in the two CNDI patients. Both the patients had moderate urinary retention, severe megaloureter and hydronephrosis, and mild renal insufficiency. Two mutations of AVPR2 gene were discovered in the 3rd exon in the patients, a silent mutation L309L and a nonsense mutation R337X. The AVPR2 gene R337X mutation was co-segregated with CNDI. R337X mutation was not a reported mutation in the mainland of China.</p><p><b>CONCLUSION</b>The AVPR2 gene R337X mutation was also a genetic etiology of CNDI patients in the mainland of China.</p>

Magnetic resonance diffusion tensor imaging for optic nerves and optic radiation in blind patients / 中华眼底病杂志

Objective To observe the characteristics of magnetic resonance diffusion tensor imaging (MR-DTI)for optic nerves and optic radiation in blind patients. Methods The optic nerves and optic radiation of 20 blind patients (blind group) and 20 controls (control group) were scanned by MR-DTI.Fractional anisotropy (FA) and directional encoded color (DEC) maps were acquired through postprocessing with the aid of volume-one 1. 72 software. The signal intensity of optic nerves and optic radiation were then observed. The FA, mean diffusivity (MD), λ∥ and λ⊥ value of bilateral optic nerves and optic radiation in two groups were measured in the DEC maps. Results While the high signal intensity was found in bilateral optic nerves in FA and DEC maps in control group, the signal decreased markedly in the blind group. The FA and λ∥ value of optic nerves in the blind group were declined obviously compared to that in the control group. The difference was statistically significant (t= 16. 294, 14. 660;P=0. 000). The MD and λ⊥ value of optic nerves in the blind group were increased obviously compared to that in the control group, the difference was also statistically significant (t=8. 096, 8. 538;P = 0. 000). The high signal intensity was found in bilateral optic radiation in FA and DEC maps in both the blind and control groups. There were no statistic differences in FA and MD value in bilateral optic radiation between the blind and control groups (Left:t=1.456,1.811;P = 0. 152,0.076. Right:t = 0. 779,0. 073;P = 0. 440,0. 942). Conclusion A low signal intensity of bilateral optic nerves and a high signal intensity of bilateral optic radiation were found in blind patients.

The preliminary study of searching primary tumors in patients with metastases using MR whole body diffusion weighted imaging / 中华放射学杂志

Objective To evaluate the availability and sensitivity of MR whole body diffusion weighted imaging (DWI) in searching primary tumors in patients with metastases.Methods Thirty-four patients with symptoms of metastases and unknown primary leasions were scanned by whole body DWI.All the metastases cases were diagnosed by CT,single photon emission computed tomography(SPECT) or MRL For the cases of suspected primary tumors,apparent diffusion coefficient (ADC) values of the primary and metastatic lesions were measured respectively.For the cases with primary lung cancers and metastases proved by pathology of biopsy or surgical specimens,statistics analysis of ADC values of primary and metastatic lesions was performed with paired samples t-test.The detection rate and sensitivity of this technique for screening primary tumors were evaluated.Results By whole body DWI,24 cases were found with suspected primary lesions,in which 23 cases were proved primary tumors,and 1 case was proved benign lesion.Ten cases were not identified with primary lesions on whole body DWI,but in which 2 cases were proved primary malignant tumor by biopsy later,and the other 8 cases remained unknown within follow-up of half a year to one year.For the 14 definite cases of lung cancers,the average ADC values of primary and metastatic lesions was (1.24±0.18)×10-3 and(1.16±0.27)×10-3mm2/s,respectively (t=1.28,P>0.05).The detection rate and sensitivity of whole body DWI for searching primary tumors was 67.6% (23/34) and 92.0% (23/25),respectively.Conclusion The sensitivity of whole body DWI for searching primary tumors is relatively high,and it can be used to search primary tumors in patients with metastases.

Diagnostic value of MRI in pituitary stalk interruption syndrome / 中华放射学杂志

Objective To study characteristic findings and the diagnostic value of MRI in pituitary stalk interruption syndrome (PSIS). Methods Twenty-one patients with PSIS were included. Small field of view (FOV) MR1 scanning and clinic hormone detection were performed in all patients. Moreover, fluid attenuated inversion recovery (FLAIR)T,1 WI with fat-suppression sequence was performed in 8 cases. The appearance on FLAIR T1 WI and T2 WI were recorded. The shape of pituitary stalk and antehypophysis, and the signal intensity of posthypophysis were analyzed simultaneously. Results Growth hormone deficiency (GHD) was confirmed by clinic hormone detection in all 21 cases. The level of basal GH varied from 0. 03 μg,/L to 1.50 μg/L. The peak value under GH provocation was from 0. 13 μg/L to 4. 14 μg/L, and the GH was absolute default in all patients. Seventeen cases of them were combined pituitary hormone deficiency (CPHD), and 4 cases were isolated growth hormone deficiency (IGHD). The height of antepituitary was in the range from 1 mm to 3 mm, and the average value was (1.9±1.2) mm. Pituitary stalk was absent in 18 cases and showed as linear and discontinuous stalk in the other 3 cases. The high signal intensity was invisible in normal position in all cases, the high signal intensity spot in the region of infundibular recess of the third ventricle was shown in 19 cases, while it could not be found anywhere in 2 patients with diabetes insipidus. Conclusion PSIS often shows characteristic appearance on MRI, and a definite diagnosis can be made by using MRI combined with clinic hormone detection.

MR Diffusion Tensor Imaging in Optic Atrophy / 实用放射学杂志

Objective To study the MR diffusion tensor imaging(MR-DTI) feature of optic atrophy.Methods Diffusion tensor imaging data of optic nerve were acquired in twenty patients with optic atrophy and 20 healthy subjects.Results ①Atrophic optic nerves were thin obviously on MRI,and the signal of atrophic optic nerves decreased markedly on fractional anisotropy(FA) map and directionally encoded color(DEC) map.②The FA value(0.277?0.078) and ?∥ value(1.808?0.307) of atrophic optic nerves were declined obviously,and mean diffusivity(MD) value(1.442?0.264) and ?⊥ value(1.231?0.225) increased obviously in comparison to the normal optic nerves,there were statistically significant differences between the patients and the volunteers(P

MR-DTI Study on Wallerian Degeneration of the Optic Radiation after Occipital Lobe Chronic Infarction / 实用放射学杂志

Objective To evaluate the possibility of diffusion tensor imaging(DTI)in detecting and quantifying the Wallerian degeneration of optic radiation in occipital lobe chronic infarction.Methods 20 patients with unilateral occipital chronic infarction were undergone DTI.Quantitative fractional anisotropy(FA)and mean diffusivity(MD)were obtained from the ipsilateral optic radiation of the occipital lobe infarction and compared with that of contralateral region using the independent samples t-test.Results On the three dimensional color-coding tensor fractional anisotropic map,the regions of occipital lobe chronic infarction were markedly low signal intensity,the FA value and MD value were 0.274?0.062 and(1.226?0.372)?10-3mm2/s,while in the contralateral region of optic radiation,FA and MD values were 0.495?0.035 and(0.775?0.070)?10-3mm2/s respectively,there was significant difference in FA and MD values in comparing both side(P〈0.01).Conclusion DTI can detect and quantify the Wallerian degeneration in optic radiation after occipital lobe chronic infarction.