The application of silent MR angiography in the imaging of brain arteriovenous malformation in children / 中华放射学杂志

Objective:To explore the application value of silent MR angiography (MRA) in imaging of brain arteriovenous malformation (BAVM) in children.Methods:A total of 20 children with BAVM confirmed by digital subtraction angiography (DSA) were retrospectively collected. All children were imaged by silent MRA and time-of-flight MRA (TOF MRA) in the same examination. The image quality of feeding artery, nidus and drainage vein of BAVM was evaluated using the four-point method. Wilcoxon rank-sum test was utilized to compare the image quality scores between silent MRA and TOF MRA. Weighted Kappa statistics used to evaluate the inter-modality agreement of silent MRA and TOF MRA with DSA in displaying of angioarchitecture characteristics and determination of Spetzler-Martin grading.Results:Among the 20 BAVMs, significant differences in image quality scores of the nidus (2.75±0.55 versus 2.20±0.70) and drainage vein (2.60±0.68 versus 2.20±0.77) were observed between silent MRA and TOF MRA ( Z=-3.05, P=0.002; Z=-2.13, P=0.033, respectively). The agreement between silent MRA and DSA was excellent in nidus size grading, deep venous drainage, associated aneurysm and SM grading (Kappa 0.91, 1.00, 0.83 and 0.93, respectively); The agreement between TOF MRA and DSA was fair to moderate (Kappa 0.46, 0.59, 0.35 and 0.47, respectively). Conclusions:Silent MRA showes better image quality compared to TOF MRA and improves the evaluation of angioarchitecture characteristics and Spetzler-Martin grading of BAVMs in children.

Imaging of giant cell tumors of the skull:a report of 16 cases and literature review / 实用放射学杂志

Objective To investigate the imaging features of giant cell tumors (GCTs) of the skull and review of the literatures.Methods CT and MR features of 16 histologically proven GCTs of the skull were analyzed retrospectively.The imaging features of GCTs of the skull were summarized based on literature.Results 16 patients (male=9,female=7) with GCTs of the skull were enrolled in the study.Most of the lesions were originated from sphenoid and temporal bone.On CT scan,the lesions showed slightly hyperdense with cystic formation.Those of the sphenoid bone in sellar region usually showed osteolytic bone destruction;those of the temporal bone usually showed expansive bone destruction,foci calcification in the lesion and discontinuous "bony shell" sign could be seen at the edge.On MR images,the lesion showed isointense on T1 WI and iso-or hypointense on T2 WI with cystic formation.After contrast medium injection,the lesions demonstrated heterogeneous and apparent enhancement,and the enhancement of the adjacent meninges could be detected in some cases.Conclusion GCTs of the skull mainly originate from sphenoid and temporal bone,and the bone changes are different between the two sites on CT scan.The imaging features of GCTs are various on MR images and mainly show isointense or hypointense on T2 WI.

Comparison of T2 FLAIR and GRE-T2* WI in detection of traumatic extra-axial hemorrhage / 实用放射学杂志

Objective To explore the value of fluid-attenuated inversion recovery (FLAIR)sequence and gradient echo T2 ?weighted image (GRE-T2 ? WI)in diagnosis of acute traumatic extra-axial hemorrhage.Methods 50 patients who were diagnosed as acute traumatic extra-axial hemorrhage by plain CT underwent FLAIR and GRE-T2 ? WI in acute stage.The diagnosis consistency (Kappa ),detection rate of subarachnoid hemorrhage(SAH),epidural hemorrhage(EDH)and subdural hemorrhage(SDH)were compared.The detection rates of SAH in 8 locations among FLAIR,GRE-T2 ? WI and combination of two sequences were analyzed by Chi-square test.Results 48 patients were enrolled in the study.The diagnosis consistency of SAH between FLAIR and GRE-T2 ? WI was high (k =1.0).The detection rate of SAH was 100% for both FLAIR and GRE-T2 ? WI.Comparing with GRE-T2 ? WI and combi-nation of two sequences,FLAIR tended to misdiagnose SAH in perimesencephalic cistern (P <0.05).The diagnosis consistency of EDH between FLAIR and GRE-T2 ? WI was high (k =1.0).3 patients with EDH were all detected by FLAIR and GRE-T2 ? WI. The diagnosis consistency of SDH between FLAIR and GRE-T2 ? WI was high (k =0.943).The detection rate of 12 patients with SDH was 100% in FLAIR,and 1 patient with SDH was missed by GRE-T2 ? WI.Conclusion The detection rate of acute traumatic extra-axial hemorrhage is high for both FLAIR and GRE-T2 ? WI.Combination of two sequences can improve the accuracy of acute traumatic extra-axial hemorrhage in clinic.

Effect of spvB/spvC gene on Salmonella virulence and the host immune function / 南方医科大学学报

<p><b>OBJEVTIVE</b>To study the effect of spvB/spvC gene on Salmonella virulence and the Host immune.</p><p><b>METHODS</b>STM.211, STM.211-Delta;spvB, STM.211-Delta;spvC, STM.211-Delta;spvB.spvC and PBS were infected with 0.2 mL 10(5) CFU corresponding strain respectively by intraperitoneal. We observed the mental status, movement, diarrhea, weight, pelage changed hair of the infected mouse. Then the level of IL-10, IL-12, IFN-γ were detected by ELISA. Finally, we observe the pathological changes of liver and spleen with the general view and the microscope.</p><p><b>RESULTS</b>Infection symptoms of STM.211, STM.211-Delta;spvB and STM.211-Delta;spvC were significantly worse than PBS group, but there was no significant difference between STM.211-spvB.spvC group and PBS group. The secretion of IFN-γ and IL-12 of STM.211, STM.211-Delta;spvB, STM.211-Delta;spvC group were significantly lower than those in the STM.211-Delta;spvB.spvC group (P<0.05), but IL-10 secretion was significantly higher than STM.211-Delta;spvB.spvC group (P<0.05). There were no statistical significance among the STM.211, STM.211-Delta;SpvB, STM.211-Delta;spvC groups (P>0.05).</p><p><b>CONCLUSIONS</b>Salmonella virulence can be affected obviously by spvB combined with spvC gene, but not by spvB or spvC. spvB/spvC gene can inhibit the TH1 cytokines (IFN-γ and IL-12) secretion but promote the TH2 cytokines (IL-10) expression, leading immune response trend to TH2 shift. It shows that spvB/spvC gene can help the bacteria evade the host immune defenses, leading to aggravation of infection.</p>

Assessment of breast cancer response to neoadjuvant chemotherapy with time-intensity curve parameters in MRI / 中华放射学杂志

Objective To investigate the clinical value of the type and the steepest slope of tumor's time-intensity curve (TIC) in assessing the pathologic response of locally advanced breast cancer treated with neoadjuvant chemotherapy (NAC). Methods Thirty-six patients with pathologically confirmed locally advanced breast cancer who finished four courses of neoadjuvant chemotherapy underwent preoperative breast MRI three times during the NAC. Pathologic response was assessed according Miller-Payne grading system, grade 4 and 5 were defined as major histological response ( MHR, n = 16) group, and grade 1 to 3 as nonmajor histological response( NMHR,n = 20)group. The type and the steepest slope of tumor's TIC were compared between two groups before NAC, after the second cycle and after the fourth cycle of NAC. ROC analysis was carried out to assess the clinical value of the TIC parameters. Results After the second cycle of NAC, the steepest slope of TIC and its first change rate were different between the MHR group [ ( 1.93 ±0.88) %/s, median 35.6%] and NMHR group [(2.73 ± 1.22) %/s, median - 11.4%] (P =0.045 and 0. 01,t=1. 09,Z= -3.64). After the fourth cycle, the proportion of type Ⅰ in MHR group (62.5% ,10/16) was significantly higher than that in NMHR group (10.0%, 2/20, P = 0.01, Z=-2. 02), and the proportion of type Ⅲ in MHR group (6. 2% ,1/16)was significantly lower than that in NMHR group (60. 0% ,12/20,P =0. 01 ,Z = -1.48). The steepest slope and its second change rate were different between the MHR group [ ( 1.33 ± 0. 52) %/s, median 56. 8% ] and NMHR group [ (2. 33 ±0. 94) %/s, median 15. 8% ] ( P ＜ 0. 01, t = 1.82, Z = - 3. 58 ). After the second cycle, the area under curve of the steepest slope of TIC and its first change rate were 0. 70 ( P = 0. 04 ), 0. 80 ( P = 0. 01 ),respectively. After the fourth cycle, the area under curve of the type Ⅰ, the type Ⅰ + Ⅱ, the steepest slope and its second change were 0. 78 ( P = 0. 03 ), 0. 69 ( P = 0. 06), 0. 82 ( P = 0. 01 ), 0. 92 ( P = 0. 01 ),respectively. Conclusion The steepest slope of TIC and its first change rate could assess the NAC response after the second cycle, and the type Ⅰ, the steepest slope and its second change could assess the NAC response after the fourth cycle.

Breast tumor diameter on MRI and histological grading system for predicting response to neoadjuvant chemotherapy / 中华放射学杂志

Objective To assess the value of initial MRI measurements of breast tumor diameter and pathological responses for predicting response to neoadjuvant chemotherapy (NAC). Methods Fortynine patients who underwent neoadjuvant chemotherapy were included in this study. The longest diameter of each tumor was measured on MRI before and after two cycles of NAC and just before operation. Pathological responses were evaluated by Miller and Payne grading system criteria by comparing post-operation breast tissue with large core biopsy tissue. Changes of diameter after two cycles of NAC and before operation were compared and pathological responses were evaluated. ROC and spearman correlation analysis was used.Results The sensitivity and specificity of initial diameter for predicting response to NAC were 96. 7% (29/30) and 84.2% (16/19). There was a moderate correlation between pathological responses and diameter measured pre-operation ( r = 0. 613, P = 0. 000 ). Conclusion The initial diameter changes of breast tumor could predict response to neoadjuvant chemotherapy, pathological response have moderate correlation with changes of tumor diameter.

Assessment of Breast Cancer Response to Neoadjuvant Chemotherapy with Tumor's Size at MR Imaging / 实用放射学杂志

Objective To investigate the clinical value of tumor's longest diameter and volume in assessing pathologic response in locally advanced breast cancer treated with neoadjuvant chemotherapy(NAC).Methods A prospective study was undertaken in women undergoing NAC for locally advanced breast cancer in order to determine the ability of quantitative MRI to assess the final pathologic response. 36 cases with pathologically confirmed locally advanced breast cancer who had been undergone four courses of NAC underwent preoperative breast MRI three times during the NAC. Pathologic response was assessed according Miller & Payne grading system, of which grade 4 and 5 defined as major histological response (MHR), and grade 1 to 3 as non-major histological response (NMHR). The tumor's longest diameters and volumes in MHR were compared with those in NMHR by Mann-Whitney U test before, after the second and fourth cycle of NAC. Concordance correlation coefficient (CCC) were assessed to evaluate the agreement between the two method. Receiver operating characteristic curve (ROC) analysis was carried out to assess the clinical value of tumor size and the change rate.Results Before,after the second and the fourth cycle of NAC, the difference of tumor's longest diameters and their first change rate between MHR [(2.75±1.16) cm,(2.19±1.07) cm ,(1.58±0.75) cm and (21.70±15.09)%]respectively,and NMHR [(2.71±1.10) cm,(2.33±0.90) cm,(2.01±0.94) cm and (11.68±10.27)%] respectively were not significant(P>0.05). The second change rate of tumor's longest diameter in MHR [(39.00±15.38)% ] was significantly higher than that in NMHR[ (25.83±21.77)% ](P=0.04). Before, after the second and the fourth cycly of NAC, the differences of tumor volumes and their first change rate between MHR [ median 14.00 cm~3 ( range 2.96～83.41 cm~3 ) , median 7.31 cm~3 (range 0.05～55.35 cm~3), median 2.69 cm~3 (range 0～33.40 cm~3 ) , median 48.65% (range 33.64%～98.48%) ] and NMHR [median 4.25 cm~3 (range 4.78～106.55 cm~3), median 10.53 cm~3 (range 1.72～42.85 cm~3), median 7.56 cm~3 (range 0.68～156.58 cm~3), median 52.04% (range-35.79%～78.31%) ] were not significant. The second changing rate of tumor's volume in MHR [median 85.37% (ranged 27.52%～100%)] was significantly higher than that in NMHR [median 68.80% (ranged -289.60%～94.24%)](P=0.01). CCC was computed before and (0.82), after the second cycle (0.67) and after the fourth cycle (0.55), in all examinations pooled together (0.78).The second change rates of tumor's longest diameter and volume were equal to predict the final pathologic response, and the area under curve were 0.75 and 0.80, respectively (P=0.61). Conclusion The agreement between the tumor's longest diameters and tumor's volumes is good in all in breast carcinoma. The assessment efficacy of the change rate of tumor's longest diameter and that of volume were low.

The effect of intravenous administration of gadolinium contrast medium on diffusion-weighted MR of breast / 中华放射学杂志

Objective To evaluate the effect of intravenous Gd-DTPA on DWI of breast. Methods DWI was performed before and after Gd-DTPA injection on 25 patients with breast cancer confirmed by core or fine-needle aspiration biopsy. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and ADC values were measured on DWI when b = 0 and 1000 s/mm2 were selected. A paired t-test and non-parametric test were used to compare the differences between SNR, CNR and ADC values before and after enhancement in breast cancer and normal breast. Results There were no significant differences between the SNR(34. 56 ± 11.34 and 33.60 ± 14. 34 for cancer, 9. 88 ± 3.16 and 10. 42 ± 4. 18 for normal breast)and CNR( 24. 16 ± 9. 05 and 22. 26 ± 10. 05 ) before and after administration of contrast medium in breast cancer and normal breast, and no significant differences between the ADC values before and after administration of contrast medium in breast cancer [(0.96±0. 13) × 10-3 vs (0.95±0. 14) × 10-3 mm2/s] and normal breast[(1.90±0.47) × 10-3 vs (1.91±0.61) × 10-3 mm2/s], either (P =0.20 and 0.97). Conclusion It is possible to repeat DWI acquisition after administration of contrast medium in breast MRI.