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Objective:To evaluate the value of color Doppler ultrasound combined with ultrasonic elastography for curative effect of neoadjuvant chemotherapy (NAC) for breast cancer.Methods: 100 patients with breast cancer who has received NAC were divided intoobservation group (50 cases, underwent examination of color Doppler ultrasound scanner combined with ultrasonic elastography) and control group (50 cases, only underwent examination of color Doppler ultrasound scanner) according to the different examination methods. The accuracy, sensitivity and specificity of differential diagnosis methods for curative effect of NAC between the two groups were compared as above data.Results: The accuracy, sensitivity and specificity of differential diagnosis for curative effect of NAC in observation group were 88.00％, 90.00％ and 86.00％, respectively. While them of control group were 78.00％, 80.00％ and 76.00％, respectively. And the differences of these indicators between the two groups were statistically significant (x2=2.01,x2=3.24,x2=3.45, P<0.05).Conclusions: Color Doppler ultrasound combined with ultrasound elastography can diagnose the curative effect of NAC for patients with breast cancer from two aspects which includes tissue hardness and blood supply, and it can achieve more diagnostic accuracy compared with only using simple color Doppler ultrasound.
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Objective In this retrospective study, we analyzed the magnetic resonance imaging (MRI)and computed tomography(CT)scans of patients with prostate cancer to investigate the relationship between the apex of prostate and the anatomic structures visible in CT, and to provide evidence for localizing the prostatic apex in radiation treatment planning. Methods MRI and CT scans from 108 patients with prostate cancer were analyzed to measure the distance between the prostatic apex and the bottom of ischial tuberosities,the bottom of obturator foramen, the bottom of pubic symphysis and the bulb of the penis. The volume of prostate was calculated and the relationship between the size of the prostate and the localization of the prostatic apex was analyzed. Results The prostatic apex is located 13. 1 mm ±3. 3 mm superior to the bulb of the penis, 11.0 mm ± 5.4 mm superior to the bottom of obturator foramen, 31.3 mm ± 5.5 mm superior to the bottom of ischial tuberosities, and 7. 1 mm ± 4. 7 mm superior to the bottom of obturator foramen. There was no correlation between the size of prostate and the localization of the prostatic apex(R =0. 07、-0. 33, all P ＞ 0. 05). Conclusions Ninety-five percent of patients had a prostatic apex that is above the bulb of the penis 6 mm, and 100% of patients had a prostatic apex that is above the bottom of obturator foramen.
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Objective To explore convenient and practical semi-quantitative MRS indicators in diagnosis of prostate cancer.Methods One hundred patients with completer MRS data and clinical data were enrolled in the study.The following parameters were assessed to evaluate their efficacy in diagnosis of prostate cancer, (Cho + Cr)/Cit of single voxel, mean (Cho + Cr)/Cit of the whole area and (Cho + Cr)/ Cit positive voxel ratio at the sextant level.Similarly, all the parameters mentioned above and mean (Cho +Cr)/Cit positive voxel ratios of the whole gland were assessed at the whole gland level.Pearson test and Kappa test were used in the research.Results Two thousand nine hundred and forty-five voxels were assessed including 1203 in cancer positive region and 1742 in cancer negative regioa The range of the (Cho + Cr) /Cit ratio in cancer positive region was from 0.22 to 8.00 (median, 1.87), and that in cancer negative region was from 0.11 to 8.00 (median, 0.53).The (Cho + Cr)/Cit ratio in cancer positive region was higher than that in cancer negative region (Z =28.48, P<0.01) with partial overlap.On the level of sextant, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (Cho + Cr)/Cit ratio> 0.911 to diagnose prostate cancer were 81.4% (179/220),64.2% (194/302), 62.4% (179/287) 、82.6% (194/235) 、71.5% (373/522) respectively; those of mean (Cho + Cr)/Cit ratio>0.911 were 77.3% (170/220),77.2% (233/302),71.1% (170/239),82.3% (233/283),77.2% (403/522) respectively; those of positive voxel ratio>0.519 were 73.2% (161/220),80.8% (244/302)、 73.5% (161/219),80.8% (244/302), 77.6% (405/522) respectively; the consistency between mean (Cho + Cr) /Cit ratio and positive voxel ratio was high (Kappa=0.907).On the level of the whole prostate, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of (Cho + Cr)/ Cit ratio>0.911 to diagnose prostate cancer were 94.3% (50/53),40.4% (19/47),64.1% (50/78), 86.4% (19/22),69.0% (69/100) respectively; those of mean (Cho + Cr)/Cit ratio>0.911 were73.6% (39/53),83.0% (39/47), 83.0% (39/47), 73.6% (39/53), 78.0% (78/100) respectively; those of maximum positive voxel ratio> 0.519 were 88.7% (47/53),61.7% (29/47),72.3% (47/65),82.9% (29/35),76.0% (76/100) respectively; those of mean positive voxel ratio>0.519 were 62.3% (33/53), 85.1% (40/47), 82.5% (33/40), 66.7% (40/60), 73.0% (73/100) respectively; the consistency between mean (Cho + Cr)/Cit ratio and mean positive voxel ratio was fairly high (Kappa =0.818).Conclusion Single voxel criteria were suggested to diagnose clinically suspected prostate cancer.Maximum positive voxel ratio criteria were suggested to guide localization in biopsy.
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Juvenile hemochromatosis is an autosomal recessive disease characterized by progressive tissue iron overload which leads to irreversible organ damage and even death.This disease is mainly caused by mutations in two genes:hemojuvelin gene and hepcidin gene.Different mutations have different phenotype.The two genes may act as modifying genes in HFE hemochromatosis.Hepcidin secreted by liver plays a central role in the regulation of iron homeostasis.HJV can act as a bone morphogenetic protein(BMP)co-receptor which is required for HJV to regulate hepcidin expression and iron homeostasis.Recent researches suggest that the bone morphogenetic protein(BMP)signaling pathway mediated by HJV is a significant mechanism for HJV to regulate hepcidin expression and iron homeostasis.HJV mutant impaires BMP signaling which results in hepcidin expression decrease and abnormal iron metabolism.
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Objective To quantitatively analyze and testify the diagnostic value of combined MRS and DWI for prostate cancer based on sextant localization.Methods Patients who underwent prostate MR examinations in our hospital had MRS and DWI scanning in addition to conventional MRI.The(choline+creatine)/citrate(CC/C)value in each measurable voxel and the minimal ADC value(ADC_(mini))in each sextant were measured.Taking CC/C of no less than 0.911 as the cutoff value for prostate cancer,the ratios of positive voxel(PVR)in sextants were calculated.The selected patients were divided into 2 groups according to the date of examination,for the quantitative analysis and the verification respectively.Group 1 was from Feb,2006 to Dec,2006,and group 2 from Jan,2007 to Jul,2007.The diagnostic efficacy of PVR,ADC_(mini) and their combination was tested by ROC analysis.Results There were 40 patients in group 1 and group 2 respectively for the linear discrimination of the cluster analysis,including 20 patients with prostate cancer and 20 patients without prostate cancer.The linear discrimination equation calculated from group 1 was 'D=3.264×ADC_(mini)-0.205×PVR-4.407'.The areas under curve(Az)of ROC for PVR,ADC_(mini) and D were 0.769,0.910 and 0.909,respectively.In group 2,the Az of ROC for PVR,ADC_(mini) and D were 0.838,0.912 and 0.915,respectively.There were no statistical difference between ADC_(mini)-alone and D in both groups(X~2=0.32 and 1.50,P＞0.05).Conclusions Quantitative prostate DWI had higher diagnostic value than MRS.The combined use of MRS and DWI was not superior to the DWI-alone in the diagnostic efficacy of prostate cancer.
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Objective To evaluate and testify the diagnostic efficacy of the ADC value of the diffusion-weighted imaging (DWI) in prostatic peripheral zone cancer. Methods There were 40 patients with prostatic diseases proved by ultrasound guided systemic biopsy. DWI scans were performed with 1.5T MR scanner using TOSORPA coil and b value of 800 s/mm2. The peripheral zones of prostate were divided in six areas and were attributed to noncancerous and cancerous areas according to the results of biopsy. The minimal ADC values of each peripheral zone were recorded and analyzed. Results There were 240 areas, in which 89 areas were cancerous and the others were noncancerous. The mean ADC value of cancerous areas was (0.98±0.30)×10-3 mm2/s, while the noncancerous areas was (1.59±0.29)×10-3 mm2/s. The diagnostic sensitivity, specificity and accuracy were 80.58%, 92.42% and 86.73% respectively with cutoff point ≤1.24×10-3 mm2/s, whereas 66.56%, 96.95% and 86.26% respectively with cutoff point ≤1.04×10-3 mm2/s. The diagnostic sensitivity was 98.63%, the specificity was 37.07%, the accuracy was 58.82% with cutoff point <1.69×10-3 mm2/s. Conclusion The ADC value ≤1.24×10-3 mm2/s should be regarded as the diagnostic standard of prostate cancer. When ADC value is between (1.04-1.24)×10-3 mm2/s, some cancer might be missed.
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Objective To evaluate the therapeutic effect of endocrine for prostate cancer with bone metastases with MR diffusion-weighted imaging (DWI). Methods Forty patients with bone metastases from prostate cancer were examined with DWI. Seventeen patients underwent endocrine therapy were recruited as the test group, the other 23 were regarded as the control group. There was no relapse of the metastases according to clinical diagnosis in the test group. DWI sequences were based on steady-state free precession with b value (800 s/mm~2). After identifying the metastasis according to the T1WI and T2WI, ROIs were marked at the metastases, normal muscle, normal bone and bladder on DWI, and the ADC values of the ROIs were calculated respectively. Non-parameter two independent samples test was applicated to compare the ADC values of the metastases between the two groups.Results ADC values of the bone metastases were (1.10±0.50)×10~(-3)mm~2/s in the test group and (1.12±0.30) ×10~-3mm~2/s in the control group (P>0.05).Conclusion MR DWI shows no help in evaluating the therapeutic effect of endocrine for prostate cancer with bone metastases.
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@# Objective To observe the effects of control training of scapula on upper limbs function and the pain of shoulder in patients with hemiplegia. Methods 60 patients with hemiplegia were divided into treatment group (30 cases) and control group (30 cases). The patients in control group received routine rehabilitation, while the treatment group received scapula control training in addition. They were assessed with Fugl-Meyer Assessment of the upper limbs and the severity of shoulder pain before and after the treatment. Results The scores of Fugl-Meyer Assessment of the upper limbs improved significantly (P<0.01) after treatment in both groups, and the score in the treatment group were higher than in the control group (P<0.05). The pain of shoulder decreased significantly (P<0.01) after treatment in both groups, and decreased more in the treatment group than in the control (P<0.05). Conclusion Scapula control training was effective on the function of upper limbs and the pain of shoulder in patients with hemiplegia.
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Objective To evaluate the diagnostic efficacy of MRS in prostate cancer based on sextant localization. Methods There were 110 patients, 54 patients with pathologically confirmed prostate cancer and 56 patients confirmed non-prostate cancer proved by ultrasound guided systemic biopsy. The (choline + creatine)/citrate (CC/C) value in each voxel and ratio of positive voxel (PVR) in sextant localization were measured. The ROC analysis was used to evaluate the diagnostic efficacy of CC/C in single voxel and PVR in sextant localization. Results There are 1673 and 2426 voxel in prostate cancer and non-prostate cancer respectively. The median of CC/C in cancer sextants was 2. 137; the median of CC/C in noncancer sextants was 0. 600. The difference of these two groups was statistically significant (Z = -41.7, P < 0. 01 ). The diagnostic sensitivity was 81.4% ( 1362/1673 ), the specificity was 83.1% (2018/2426), and the accuracy was 82.4% [ (1362+2018)/4099] for prostatic cancer with the cutoff point 0. 911 of the CC/C value. The median of PVR in cancer sextants and noncancer sextants were 1 and 0 respectively, the difference of PVR was statistically significant (Z = -11.7,P < 0.01 ). The diagnostic sensitivity was 77. 5% (148/191), the specificity was 76. 9% (247/321), and the accuracy was 77. 1% [ ( 148 + 247 )/ 512] for prostatic cancer with the cutoff point 0. 519 of the PVR. Conclusion Detecting the cutoff point of the CC/C value in single voxel and the PVR in sextant localization may be valuable in the diagnosis of prostate cancer.
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Objective To study the changes of the apparent diffusion coefficient (ADC) values and the association with serum prostate specific antigen (PSA) in prostate cancer patients. Methods Diffusion-weighted echo-planar imaging (EPI) sequences were performed in 47 patients with biopsy proved locally confined prostate cancer,age ranged from 56 to 86 years.t-PSA range,f-PSA range and F/T range in serum of all patients were 1.41-603.16 ng/ml,0.10-12.29 ng/ml and 0.01-0.36,respectively.The patients'clinical staging were 2 cases of stage A,18 cases of stage B and 27 cases of stage C,among which 1 cases were well differentiated (Gleason 2-4), 23 were moderately differentiated (Gleason 5-7) and 23 were poorly differentiated(Gleason 8-10),respectively.Images were obtained with a diffusion factor of 800 s/mm2.According to the pathological results obtained by ultrasound guided systemic biopsy,the locations of the prostate cancerous region were marked as one or more of the sextants.The ADC values of every region and whole gland were measured and analyzed with ROC curve.Correlations between the ADC and t-PSA,f-PSA,F/T ratios were analyzed.Results Acceptable images for ADC measurement were obtained in all cases.The mean ADC values of cancerous and noncancerous regions in 47 prostate patients were(1.29±0.28)×10-3mm2/s and (1.78+0.32)×10-3mm2/s and significant difference was noted in ADC values between cancerous and noncancerous regions(t=13.58,P＜0.01).Negative correlation was found between the ADC values and t-PSA,f-PSA,(γ=-0.353,P＜0.01;γ=-O.401.P＜0.01).There were no significant associations between the ADC values and F/T(γ=-0.123,P＞0.05). Conclusions The ADC values in cancerous regions were negatively correlated with t-PSA,f-PSA. Measurement of ADCs,combined with serum PSA,might be useful to accurate location and preoperative assessment of tumor.
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Objective To compare the diagnostic value of MRS acquired by body coil(BODY)and endorectal Coil(ERC)in the detection of prostate cancer.Methods MRI and 3D MRS were performed in 12 patients with prostate disease,in which 6 of them were proved to have prostate cancer and the other 6 noncancerous disease.Both BODY and ERC MRS were performed in 7 patients,and only BODY MRS was performed in the other 5 patients.All MRS data were quantitatively assessed with a per-sextant method.The metabolic ratio of(Choline+Creatine)/Citrate[(Cho+Cre)/Cit]was measured in each ROI.ROC analysis was carried out to assess and to compare the diagnostic value of BODY and ERC MRS in patients with prostate cancer with Wilcoxon test.Results (1)The ratios of(Cho+Cre)/Cit in the prostate cancer group(median 1.744,0.295 to 7.998)was statistically higher than that in the non-prostate cancer group (median 0.412,0.112 to 2.113)acquired by using BODY MRS(Z=-9.159,P＜0.01).(2)The ratios of(Cho+Cre)/Cit in the prostate cancer group(median 1.975,0.479 to 7.998)was statistically higher than that in the lion-prostate cancer group(median 0.400,0.104 to 2.232)acquired by using ERC MRS(Z=-9.200,P＜0.01).(3)The mean ratios of(Cho+Cre)/Cit in the prostate cancer group and in the non-prostate cancer group acquired by using both coils were not of statistically significant difference(P＞0.05).(4)ROC analysis for diagnosing prostate cancer showed no significant difference(P=0.851)between the areas under the curve of BODY and that of ERC MRS(Az=0.93 1 and 0.935 respectively).Conclusion The BODY MRS could provide comparable diagnostic efficacy to ERC MRS in patients with prostate cancer.
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<p><b>OBJECTIVE</b>To identify the mutation of coagulation factor VII (F VII) gene in two pedigrees with hereditary F VII deficiency.</p><p><b>METHODS</b>F VII gene mutations were analysed in two propositi and their family members by direct DNA sequencing. Allele specific PCR and PCR combined with restricted enzyme digestion were used to confirm the detected mutations.</p><p><b>RESULTS</b>Two gene mutations were detected in the propositus of pedigree A: G to C transition at position 6390 resulting in Trp40Cys and G to A at 11496 resulting in Arg353Gln, both are heterozygotes. The heterozygosity for polymorphism Arg353Gln was confirmed with the restriction enzyme Msp I digestion in his mother. In the propositus of pedigree B, there was a T to G transition at position 11482 resulting in His348Gln, heterozygosity of which was confirmed with Nsp I digestion in the propositus and his daughter. G to T transition at position 11514 resulting in Thr359Met was also found in the propositus of pedigree B, and the heterozygosity for Thr359Met was confirmed with allele specific PCR in the propositus and his son.</p><p><b>CONCLUSION</b>Three missense mutations were found in two pedigrees with hereditary F VII deficiency. A novel Trp40Cys mutation was reported for the first time.</p>
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Feminino , Humanos , Masculino , Fator VII , Genética , Deficiência do Fator VII , Genética , Heterozigoto , Mutação de Sentido Incorreto , Linhagem , Mutação Puntual , Reação em Cadeia da Polimerase , MétodosRESUMO
Objective To assess the difference in detection of simulated chest nodules in different lung fields with dual-energy digital subtraction chest radiography by receive operating characteristic curve (ROC) analysis.Methods Dual-energy digital subtraction chest radiography was performed on 20 volunteers with simulated chest nodules. ROC analysis was made in the evaluation results on regular DR images and soft tissue images in different lung fields respectively.Results Az was greater on the soft tissue images than on the regular DR images in the superior lung fields and outer zone of middle lung fields. There were significant differences in the superior lung fields and outer zone of middle lung fields.Conclusion Dual-energy digital subtraction chest radiography is superior to regular DR image on detecting more chest nodule lesions, especially in the superior lung fields and outer zone of middle lung fields. So the two techniques should be united to diagnose.
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Objective To compare pediatric patients with periventricular leukomalacia (PVL) with normal children by using diffusion tensor MR imaging. Methods Diffusion tensor images were obtained in 15 pediatric patients with PVL and 15 age-matched normal children. Regions of interest were drawn to measure the fractional anisotropy (FA) in bilateral posterior limb of internal capsule, bilateral optic radiation, genu of corpus callosum, and splenium of corpus callosum. The values of PVL patients and normal children were compared using non-dependent samples T-test. Results The FA values of regions of interest prescribed were significantly lower in PVL patients than in normal children(P
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Objective To study the normal changes in brain during childhood by analyzing the diffusion characters of different regions and different age phases with diffusion tensor imaging (DTI). Methods DTI was performed in 63 children (age range, 2 days to 9 years) without brain abnormalities and the data measured in ADC maps were analyzed statistically. Results (1) There were significant differences in ADC values among some different regions of brain tissue; (2) In babyhood, the ADC values in gray matters decreased faster than in white matters; (3) The ADC values decreased with the increasing of age , and show negatively exponentially correlation with age. Conclusion DTI shows the changes of brain tissue composition in vivo, with which normal changes in brain during childhood can be evaluated.
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Objective To study the normal changes in brain white matter during childhood by analyzing the anisotropy of different regions and different age groups with diffusion tensor imaging (DTI). Methods DTI was performed in 89 children (age range from 2 days to 18 years) without brain abnormalities, and the data measured in fractional anisotropy(FA) maps were analyzed statistically. Children less than 6 months were ranged to group 1, 6-12 months to group 2, 1-3 years to group 3, 3-5 years to group 4, 5-8 years to group 5, 8-12 years to group 6, 12-18 years to group 7. Results (1) There were significant differences in anisotropy (FA values) among different regions of white matter in brain In group 7, the FA value of corpus callosum was 0.826?0.039, middle cerebellar peduncle 0.678?0.043, frontal white matter 0.489?0.033. (2) The anisotropy among different age group was statistically different, P
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Objective To study findings of the white matter of nomal children on color tensor map and evaluate the diffusion tensor imaging in the assessing development of the brain. Methods DTI was obtained in 89 normal children aging from 2 days to 18 years.Their color tensor maps were generated and analyzed.Results Their color tensor maps revealed different findings due to aging;with the increase of the age,the fiber tracts showed were more and well defined.Conclusion The color tensor map is superior to the routine MR in assessing the development of the white matter.
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Objective To investigate the optimal beam tube potential for amorphous silicon/cesium iodide flat panel digital chest radiography(indirect DR). Methods(1)60 healthy adults were undergone digital posteroanterior(PA) chest radiography at 80,100,150 kV respectively.The images quality of these three were compared by 5 independent observers.Several normal anatomy parts of the chest and the overall impression of the images were evaluated;(2)PA chest exposures of the anthropomorphic chest phantom to produce a constant ESDs(entrance skin doses) and exit dose were made using tube potential at 80,100,120,150 kV.The simulated chest nodules were scored. Results The quality of the adult chest radiography and the manifestation of the simulated chest nodules were superior at the lower tube voltages.The contrast of the images were best at 80 kV,while the appearance of the images look like that of the low potential radiography. Conclusion The optimal tube potential for chest DR is considered to be 80~100 kVp,while the high KV technique is no longer suitable for digital equipment.
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Objective To analyze MRI characteristic features of TSC.Methods 13 clinically proven patients with TSC,each one had head MR scanning.Results There were mainly four findings on MRI:①Subependymal nodules,which were detected in all cases.Of them 71 lesions on T 1WI,39 lesions on T 2WI and 56 lesions on PDWI were detected;②Cortical tubers in 11 cases,114 lesions on T 2WI and PDWI,72 lesions on T 1WI were detected;③The abnormal findings of white matter,which were detected in 5 cases,10 lesions on T 2WI and PDWI,none on T 1WI were detected;④Subependymal giant cell astrocytoma,only 1 case detected.Conclusion MRI is sensitive to the changes in central neural system in TSC and is the first choice among the diagnostic imaging modalities.T 1WI is sensitive to the subependymal nodules,while T 2WI and PDWI were sensitive to the cortical tubers and abnormal findings of white matter.