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Objective To explore the value of prenatal MRI in the diagnosis of fetal simple expansion of lateral ventricle(ventriculomegaly), and follow up the nervous system development status after birth. Methods Simple expansion of the lateral ventricle fetus by prenatal MRI examination were collected in Huzhou Maternal and Child Care Hospital from May 2013 to June 2015, 126 cases of live births in expansion group, 50 normal cases were recruited in the same period as the control group. In expansion group, fetal subgroup analysis was done:(1) unilateral or bilateral lateral ventricle expasion:one group was 98 cases was lateral ventricle expansion (77.8%, 98/126), expansion of bilateral ventricle group was 28 cases (22.2%, 28/126). (2) Prenatal MRI in the diagnosis of the lateral ventricle of expansion: expansion of the lateral ventricle width was greater than 10.0 mm, if both sides were expanding, the expand width was the heavier one side, divided into 3 subgroups: ①Expansion in group A (lateral ventricle width 10.0-12.0 mm) were 88 cases (69.8%, 88/126).②Expansion in group B (lateral ventricle width 12.1-15.0 mm) were 29 cases (23.0%, 29/126). ③Expansion of group C (lateral ventricle width> 15.0 mm) were 9 cases (7.12%, 9/126). All 176 cases were followed up after birth at the 3rd, 6th, 12th, 18th month (corrected age was used for premature babies), and Gesell developmental schedules (GDS) were used to evaluate the neurobehavioral development. Results (1) The MRI results after birth:21 cases were followed up by MRI after birth. In group A, 11 cases had MRI and 9 were normal (the ventricular width0.05). (3) The GDS results among the subgroups:in each evaluation after birth, there were no statistically significant differences between group A and the control group (all P>0.05). The GDS results of group B at the 3rd and 6th month were lower than those of the control group (P0.05). And for group C, statistically significant differences were found compared to the control group at each follow-up time (all P0.05). But when the result at the 3rd month was compared to the results of the 12th or 18th month, the differences were statistically significant (P0.05). There was no statistically significant difference between the results at the 12th and 18th month (P>0.05). (5) The GDS results in unilateral and bilateral ventricle expansion:at the 18th month, among the 98 unilateral cases, 86 (87.8%, 86/98) had normal GDS results(>85 scores);8 (8.2%, 8/98) had borderline results (75-85 scores);4 (4.1%, 4/98) had delayed results (0.05). Conclusions Among the simple expansion of lateral ventricle, those whose ventricular width are≤12.0 mm may not need clinical treatment. If the width is between 12.1 to 15.0 mm, closely follow-up and targeted rehabilitation training after birth are recommended. When the width is more than 15.0 mm, the risk of the central nervous system function delay is significantly increased, and early intervention might improve the prognosis.
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Objective To study the diagnostic value of magnetic resonance for placenta previa,so as to provide clinical guidance.Methods 118 pregnant women who met the inclusion criteria were chosen in the study.Each pregnant woman's basic information, diagnostic results of magnetic resonance and cesarean section were collected.The diagnostic results of cesarean section were chose as the gold standard,and the sensitivity,specificity and Kappa value of magnetic resonance were calculated.Results Using magnetic resonance,49 pregnant women with placenta previa and 69 pregnant women without placenta previa were detected and diagnosed.Both of the sensitivity and specificity were 100.00%.In the further diagnosis of placenta previa type,the total placenta previa's diagnostic sensitivity and specificity of magnetic resonance were the highest,which were 88.89% and 97.18%,respectively.And for the marginal placenta previa,those were 85.71% and 95.83%,respectively.The last was the part of placenta previa,for which were the 77.78% and 95.83%,respectively.Compared with the diagnostic results of cesarean section,there existed correlation between the two methods of detection,and the Kappa value was 0.95,which was very good.Conclusion The magnetic resonance has very high diagnostic value for the placenta previa,thus it is worthy of clinical popularization and application.
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Objective To investigate intradermal injection and subcutaneous injection of Gadodiamide MR lymphangiography (MRL) in evaluation on the central conducting lymphatics in rabbits.Methods T1 weighted three-dimendional fast low angle shot (fl3d) sequence was used before and after administration of Gadodiamide to undertake MRL.Gadodiamide was administed intrademally in the left and right footpad in 8 rabbits,and then undertake MRL in 1.5T MRI system (intradermal injection group).Three days later,Gadodiamide was administered subcutaneously in the left and right footpad in 8 rabbits,and MRL were underdone with the same sequence (subcutaneous injection group).The degree of contrast enhancement within the lumbar lymphatic trunk and thoracic duct were evaluated using a 3-point scoring system.Results Intradermal injection group showed the popliteal lymph nodes,sacral lymph node and inferior aortic lymph node enhanced obviously in all 8 rabbits,and the enhancement duration time was about 30 90 mini the lumbar lymphatic trunk and cisterna chyli were detected in 6 rabbits,and part of the thoracic duct were detected in 5 rabbits.Subcutaneous injection group showed the popliteal lymph nodes enhanced obviously in all 8 rabbits,but the lumbar lymphatic trunk and the thoracic duct were not detected.The score of contrast enhancement within the lymphatic system of intradermal injection group and subcutaneous injection group had statistical difference (t=100.00,P=0.0002).Conclusion MRL with intradermal injection Gadodiamide are better than subcutaneous injection in evaluation of the lumbar lymphatic trunk.
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Objective To investigate the clinical value of prenatal MRI in the diagnosis and differential diagnosis of congenital bronchopulmonary sequestration (BPS). Methods From January 2009 to December 2014, 16 fetuses with BPS were diagnosed by fetal MRI in Huzhou Maternity and Child Care Hospital and Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine. The clinical data of these cases were analyzed retrospectively. All were singleton pregnancy, and MRI was carried out within 24-48 hours after routine prenatal ultrasound. All the neonates underwent postnatal enhanced CT scan or surgical biopsy after birth, and the results were compared to prenatal MRI diagnosis. Results (1)With prenatal MRI, 16 cases were diagnosed BPS. The lesions located in left lung in 10 cases, and right lung in 6 cases. As the scope of the lesion, 3 cases located in the whole left lung, 6 cases limited to the left lower lobe, and 1 case was subdiaphragmatic on the left side. 2 cases located in the whole right lung and 4 cases limited to the right lower lobe. One case complicated oligoamnios, and one had pleural effusion. Supplying vessels could be found in 14 cases.(2)When the postnatal results were compared with prenatal MRI, 15 cases were comfirmed as BPS (15/16), including 10 intralobar cases 5 extralobar cases. One that was diagnosed as BPS by prenatal MRI was confirmed to be congenital cystic adenomatoid malformation (CCAM) by pathology. The accuracy of prenatal MRI diagnosis of BPS was 15/16. Prenatal ultrasound missed one case and misdiagnosed two cases, as one was mistakened as CCAM and the other as cystic teratoma. Conclusion Prenatal MRI has good clinical value in the diagnosis and differential diagnosis of fetal BPS.
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Objective To investigate the reversal effect and the mechanism of sodium norcantharidate(SNCTD)on human lung adenocarcinoma cell line A549/DDP. Methods CKK assay was used to screen out non-toxic concentration (less than 10 percent of cell inhibition ratio) of SNCTD, and to measure the IC50 of cisplatin and IC50 of innoxious concentration SNCTD plus cisplatin in drug-resistant cell line. The accumulation effect of Rh123 was assayed by flow cytometry after treatment with non-toxic concentration of SNCTD. PT-PCR was used to detect the expression of mdr1, MRP1 gene for the drug-resistant cell line treated with non-toxic concentration of SNCTD for 48h. Results (1)The non-toxic concentration of SNCTD was 5μg/ml. SNCTD could decrease drug resistance to cisplatin. The reversal fold was 1.97. (2)The fluorescence intensity of Rh123 in the cells treated with 5μg/ml SNCTD was obviously increased (F=36.99, P＜0.05). (3)The expressions of mdr1, MRP1 gene decreased significantly in a concentration-dependent manner.Conclusions SNCTD could reverse the resistance to cisplatin in A549/DDP cell line. It possibly downregulates the expression of mdr1, MRP1 gene, and inhibits the function of efflux pump of membrance protein.