ClinicalValueofMRQuantitativeFatAnalysisinOrbitsofPatientswithGraves Ophthalmopath / 中山大学学报(医学科学版)

@#【Objective】To measure the orbital fat fraction（FF）of Graves ophthalmopathy（GO）patients and normal individuals with MR Water- fat separation（Dixon） technology ，and to explore the value of orbit MR quantitative fat analysis in diagnosis and treatment for GO patients.【Methods】Forty GO patients and 20 normal individuals who underwent orbital MR imaging were analyzed prospectively from February 2017 to February 2019 in the First Affiliated Hospital of Sun Yat- sen University. All participants received bilateral orbital MR examination with oblique coronary FSE T2- weighted imaging combined with two-point Dixon technique，and then the signal intensity values of ipsilateral extraocular muscles and lacrimal glands on water and fat phase images were measured to calculate FF. The differences of mean FF between the two groups were evaluated，and the correlation between FF of GO and TRAb，CAS score，and the course of GO were conducted by Spearman rank correlation analysis. 【Results】 The median FF of extraocular muscles in GO patients was higher than that of normal individuals，and the result showed a statistically significant difference（P < 0.05）， while the FF of lacrimal glands in the two groups showed no statistical difference. The FF of extraocular muscles in the GO group were correlated with TRAb，CAS score and the course of GO（P < 0.05），especially the course was more correlative.【Conclusions】The fat content of extraocular muscles in GO patients were higher than that of normal individuals ，and there was a positive correlation in the fat content among TRAb，CAS score and the course of GO，suggesting that MR fat quantitative analysis may provide a new reference indexes for the evaluation of clinical staging ，curative effect assessment in GO patients.

PreoperativePredictionoftheExpressionofCK19inHepatocellularCarcinomaby Gd-EOB-DTPAEnhancedMRI / 中山大学学报(医学科学版)

@#【Objective】 To investigate the predictive value of preoperative Gd- EOB- DTPA enhanced MRI in the expression of cytokeratin 19（CK19）in hepatocellular carcinoma（HCC）.【Methods】A total of 102 patients，including 94 male and 8 female，with single HCC confirmed by pathology after operation who underwent preoperative enhanced MRI were retrospectively analyzed. A total of 25 were CK19-positive HCC and 77 were CK19-negative HCC. Two radiologists evaluated MR features including tumor size，tumor margin，intratumoral vessels，signal intensity（SI）on arterial phase （AP） ，enhancement pattern ，arterial rim enhancement ，peritumoral enhancement ，internal cystic or necrotic portion，hemorrhage，intratumoral fat，tumor capsule，vascular invasion，lymph node metastasis，intratumoral septum， target sign on diffusion weighted imaging（DWI）or hepatobiliary phase（HBP），peritumor hypointensity，SI on ADC，SI on HBP ，T1 relaxation times and T1 reduction rate between pre- and post- contrast enhancement. The associations between these imaging features and CK19 expression were investigated. 【Results】SI on AP（P = 0.013），arterial rim enhancement（P = 0.018），target sign on DWI（P = 0.001）and target sign on HBP（P = 0.005）were significantly associated with CK19 expression. Delayed enhanced intratumoral septum（P = 0.042）was associated with CK19 expression between HCCs less than 5 cm. Target sign on DWI（P = 0.001，OR = 4.875，95%CI：1.838~12.927）were independent significant factors of CK19- positive HCC.【Conclusion】Preoperative enhanced MRI with Gd- EOB- DTPA is helpful to predict CK19 expression of HCC.

TheexperimentalstudyofGdGEOBGDTPAenhancedT1pimaging inquantitativeevaluationofnonalcoholicsteatohepatitis / 实用放射学杂志

Objective ToassessthevalueofGdGEOBGDTPAenhancedT1ρimaginginevaluatingtheseverityandinflammation gradeinnonalcoholicsteatohepatitis(NASH)rabbitsmodel.Methods NASH modelswereestablishedin26adultrabbitsbyfeeding withthehighGfat,highGcholesteroldietinavarieddurations (0,4,8,12 weeks).T1ρ,T1ρinthehepatobiliaryphase (HBP)and changeofT1ρ(Δ%)werecomparedamongthedifferentgroupswhichweredeterminedbydifferentnonGalcoholicfattyliverdisease activityscore(NAS)andinflammationgrades.SpearmancorrelationanalysiswasusedtoassessthecorrelationsofT1ρ,T1ρ(HBP) withNASscoresandinflammationgrades.ROCcurvewasperformedtoevaluatethediagnosticvalueofT1ρ,T1ρ(HBP)inpredicting NASHandadvancedinflammation.Results T1ρandT1ρ(HBP)werepositivelyassociatedwithNASandinflammationscores.The differencesofT1ρ(HBP)amongNASH,nonalcoholicfattyliver(NAFL)andnormalliverwerestatisticallysignificant(P＜0.05). T1ρ(HBP)wassignificantlydifferentintherabbitswithgrade3inflammationfromintherabbitswithgrade0,grade1andgrade2 inflammation (P＜0.05).AUCsofT1ρandT1ρ(HBP)fordifferentiatingNASH were0.849and0.949,respectively.AUCofT1ρand T1ρGHBPfordiagnosinggrade2andgrade3inflammationwere0.925and0.922,respectively.Fibrosisandinflammationwerethe mainindependentfactorsaffectingT1(HBP).Conclusion GdGEOBGDTPAenhancedT1ρimagingcanreflecttheseverityofNASH anddegreeofinflammation.T1ρ(HBP)mightbeamoresuperiornoninvasiveimagingbiomarkerthannonGenhancedT1ρforassessmentof NASHactivityandinflammationgrading.

RelationshipbetweenhighbilirubinrelatedencephalopathyandT1WIsignalintensityratio ofglobuspallidustoputamenintermneonates / 实用放射学杂志

Objective TodeterminethevalueofT1WIsignalratioofbilateralglobuspallidustoputamenindiagnosisofhighbilirubin relatedencephalopathyoftermneonates.Methods ThecranialMRIsignalcharacteristicsandclinicaldataof105newbornswereanalyzed retrospectively.Accordingtothetotalserumbilirubin (TSB)andclinicalsymptoms,86caseswithoutriskfactorsofterm neonates weredividedinto4groups(Ⅰ~Ⅳand3groups(A~C).TheT1WIsignalintensityofbilateralglobuspallidusandputamenwere m easured and the ratio of G/P w as calculated.T he data of each group w ere co m pared and analyzed by t test and ANOVA.R O C curve ofG/Pratiowasperformedtopredicttheprogressofdisease.Results TherewasstatisticallysignificantdifferencebetweengroupⅠandgroupⅡ,groupⅠandgroupⅢ,groupⅠandgroupⅣ,groupⅡandgroupⅢ,groupⅡandgroupⅣ(P＜0.05),whereasno differencewasfoundbetweengroupⅢandgroupⅣ (P＞0.05).Comparingthethreegroupsdividedbyclinicalsymptoms,statistically significantdifferenceswereobserved(P＜0.05).TheROCcurverevealedthatforserum TSB,thepredictiveriskofhyperbilirubinemia with1.51and1.62,thepredictiveperformanceforhighbilirubinrelatedencephalopathywith1.70and1.69.Conclusion TheT1WI signalintensityratioofG/Ppotentiallyassistsinthediagnosisofhighbilirubinrelatedencephalopathy.Combinedwithclinicalmanifestations, itcanbecomprehensivelyanalyzeddialectically,therebyincreasingtheobjectiveaccuracyofdiagnosis.

Thevalueof3DGSPACEsequencetodisplayposterolateralcomplexinthekneejoint / 实用放射学杂志

Objective Toinvestigatethediagnosticvalueof3DGSPACEsequencewith3Dreconstructiontechniqueinevaluationof posterolateralcomplexofthekneejoint.Methods 30kneejointsofhealthyvolunteersweresubjectedtoMRIconventionalsequences andSPACEsequencewith3Dreconstructiontechnique.AdoubleblindmethodwasusedtocompareMRIroutineand3DGSPACEsequence imagesontheposteriorlateralcomplexofthekneejoint.Theeffectoftwoscanningmethodsonthelateralcollateralligament,popliteal tendonandpoplitealligamentwasanalyzedbyrankandtest.Results Ithadstatisticaldifferencebetweentwogroupsindisplayof posterolateralcomplex(P＜0.01).Thedisplayeffecton3DGSPACEsequenceforthelateralcollateralligament,poplitealtendonand poplitealligamentwasbetterthanthatontheconventionalMRIsequence.Conclusion 3DGSPACEsequencewith3Dreconstruction techniquecancompletelydisplaytheconfigurationanddirectionofposterolateralcomplex,whichcanimprovetherateofshowingligament obviously.

MRIdiagnosisanddifferentialdiagnosisofpigmentedvillonodularsynovitisandgiantcelltumoroftendonsheath / 实用放射学杂志

Objective Toanalysisandcomparison MRImanifestationsofthepigmentedvillonodularsynovitis(PVNS)andgiant celltumoroftendonsheath(GCTTS),andfurthertoimprovethediagnosticaccuracyofthem.Methods 10patientswithPVNSand 20patientswithGCTTSconfirmedbyoperationandpathologywereanalyzedretrospectively.Allpatientswereexaminedwith MRI. Results Among10casesofPVNS,8caseswerelocatedinkneejoint,2infoot.5casesshoweddiffuseform,othersshowedfocal form.Comparedwiththesignalofskeletalmuscle,theproliferativesynovialappearedasisointensityonT1WI,mainlyisointensityor slighthyperintensityonT2WI.NodularhypointensityofT1andT2signalwereseenwithinthesynovialmembrane.Among20casesof GCTTS,18werelocalizedlesions,2werediffuselesions.Therewere3casesinkneejoint,8casesinhandsandfeetrespectively,1case inshoulderjoint.Among20casesofGCTTS,11caseswerenodularlesions,9caseswereirregularGshaped.Thelumpsappearedas isointensityorhypointensityonT1WI,andmostofthem wereslighthypointensityonT2WI.Conclusion The MRIsignalofPVNS andGCTTShaveoverlappinganddifference.Thelocation,morphologyoflesionscombinedwith MRIfindingscanimprovethediagnostic accuracyofthem.

Imagingfeaturesofextramedullarydiseaseinmultiplemyeloma / 实用放射学杂志

Objective Toexploretheimagingfeaturesofextramedullarydisease(EMD)in multiplemyeloma(MM).Methods Theclinicalandimagingdataof17patientswithpathologicallydiagnosedMMcombinedwithEMDwereanalyzedretrospectively.Results EMDhadcertainpredilectionsites,Centralnervoussysteminvasion (6):meningealinvasion (3:1 multiple,2focal),spinalcanal invasion (1focal),thelefttemporalpoleinvasion(1focal),theleftsideforeheadinvasion(1focal);Headandneckinvasion(3:allfocal);Thoraxinvasion(8):pleuralinvasion(6:5 multiple,1focal),intrapulmonaryinvasion(1focal),anteriormediastinalinvasion(1focal);Subcutaneoussofttissueinvasion(5:allmultiple);Muscleinvasion(2focal);Lymphnodeinvasion (1 multiple).BothCTand MRI showedsofttissuenodulesormasses.ThevaluesofCTwereabout30~70HU,especiallyin30~45HU,whileMRIpresentedequal orslightlylowsignalonT1WI,equalorslightlyhighsignalonT2WI,andhighsignalinthesequenceofDWIcombinedwithmoderate toobviousenhancement,Generally,theboundaryofEMDwereclearandtheshapeoftheselesionswereregular,However,theinvasion tomuscleinsomelesionsshowedthepatternofinvasivegrowth.Conclusion EMDofmultiplemyelomamayhappenanywhere,and thepleural,meningesandsubcutaneoussofttissuesarethemostcommonlocation.CTandMRIcanshowtheEMDverywell.Thelocation, size,shapeandrelationshipwithsurroundingtissuesoftheselesionshavecertainreferencevaluesforthediagnosisanddifferential diagnosisofEMD.

Thediagnosticvalueof1.5T multiparametricMRIscoringsystemfordetecting earlyprostatecancerinthecentralglandarea / 实用放射学杂志

Objective Toevaluatethediagnosticvalueof1.5T multiparametricmagneticresonanceimaging (mpMRI)scoring systeminearlycentralprostatecancer(PCa).Methods DataofpatientswhoreceivedprostatempMRIfromJune2014toJune2016 wereanalyzedretrospectively.AccordingtoProstateImagingReportingandDataSystem Version2 (PIGRADS V2),a5Gscorescale wasadoptedandthetwoassociateradiologists,whowereblindedtoanyclinicaldetails,interpretedMRimages.Withthepathological resultsasthediagnosticgoldstandard,theROCcurvewasplottedandtheAUCwascalculated.Thediagnosticsensitivity,specificity, positivepredictivevalueandnegativepredictivevalue,accuracyofPCawerecalculatedunderdifferentdiagnosticthresholds(score3 or4).Results Atotalof41patientswereincludedinthestudyoutofwhich15caseswerethosewithPCaand26caseswithbenign prostatichyperplasia(BPH).TheAUCwas0.733(P＝0.014).Onthediagnosticthresholdscoreof3and4,thesensitivity,specificity, positivepredictivevalue,negativepredictivevalueandaccuracywere73.33%vs40%,61.54%vs92.31%,52.38%vs75%,80%vs 72.73%and65.85%vs73.17%respectively.Conclusion The1.5T mpMRIscoringsystemisrelativelyareliabletechniquefordetecting earlyPCainthecentralglandarea.PatientscanbefollowedGupwithprostatespecificantigen(PSA)whenthescoreislessthan3,and ascoreof4ormoreishighlysuggestiveofPCa.

MRIfeaturesofthepseudoaneurysmandarteriovenousmalformationinuterus / 实用放射学杂志

Objective ToexploretheMRIfeaturesofthepseudoaneurysmsandarteriovenousmalformationsinuterus,andtoimprove ourunderstandingonthemforhigherdiagnosticaccuracy.Methods TheMRIfeaturesofthe4casesofuterinepseudoaneurysmsand the7casesofuterinearteriovenousmalformationswhichdiagnosedandcuredbyourhospitalwereanalyzedretrospetively.Results TheMRIofuterinepseudoaneurysms(n＝4)shownodular(n＝3)oroval(n＝1)abnormalsignalinthemyometriumsofuterus,low signalintensityonT1WI,highsignalintensityonT2WI.Thelesionenhancementissimilartotheuterinearterycommunicatingwiththe lesion.TheMRIofuterinearteriovenousmalformations(n＝7)showuterinepatchyabnormalsignal,andtheirboundaryarenotclear. Thereareanumberoftortuousbloodvessels.Thelesionsareobviouslyheterogenouslyenhanced,andthethickeneddrainagevessels couldalsobeseenoncontrastGenhancedimages.Thelesionsofuterinepseudoaneurysmsandarteriovenousmalformationsdon’tshow highsignalintensityonDWI,suggsetingnolimiteddiffusion.Conclusion The MRIcharacteristicsoftheuterinepseudoaneurysms showthattheuterinelesionenhancementissimilartotheuterinearterycommunicatingwiththelesion.The MRIcharacteristicsof theuterinearteriovenous malformationsarethatthereareanumberoftortuousbloodvesselsanddrainagevesselsintheuterus. Therearen’tlimiteddiffusioninthesetwodiseasesonDWI.

Apreliminarystudyofuseofintravoxelincoherentmotion MRItoassessplacentalperfusionin patientswithplacentaladhesiondisorderintheirthirdtrimester / 实用放射学杂志

Objective Toinvestigate MRIIVIM quantitativeassessmentoftheplacentalperfusioncanbeusedtodifferentiate womenwithandwithoutplacentaaccretaintheirthirdtrimester.Methods Thestudypopulationincluded17patientswithplacenta accreta,29patientswithplacentaincretaand16patientswithoutplacentaaccreta.Allwomenunderwentan MRIexaminationincluding anIVIMsequence.Theperfusionfraction(f),pseudodiffusioncoefficient(D?)andstandarddiffusioncoefficient(D)werecalculated. Results Womenwithplacentaaccretaandincretahadasmallerplacentalperfusionfraction (P＜0.05)thanpatientswithoutplacenta accreta,theplacentalperfusionfractiondidn’tdifferedbetweenplacentaaccretaandincreta(P＞0.05).DifferencesofDandD?between thethreegroupswerenotsignificant(P＞0.05).Conclusion Placentaaccretaandincretadifferinplacentalperfusionfractionfrom womenwithoutthedisease.Theperfusionfractioncanbeusedasafeasibleindextoevaluateplacentaperfusion.

Hysterosalpingographyand MRIfeaturesofintrauterineadhesion / 实用放射学杂志

Objective Toevaluatehysterosalpingography(HSG)and MRImanifestationsofintrauterineadhesion(IUA).Methods 40patientswithIUAconfirmedbyhysteroscopyunderwentHSGand MRIexamination.Wefoundoutthefeaturesofthoseimages, andworkedoutthedetectablerateofeachexamination.Results Inall40patients,19patientsweremildIUAprovedbyhysteroscopy,in which10patientswerediscoveredbyHSG,10patientsby MRIT2WI,16patientsby MRICUBE.16patientsweremiddleIUA,in which9patientswerediscoveredbyHSG,10patientsbyMRIT2WI,16patientsbyMRICUBE.5patientsweresevereIUA,allpatients werediscoveredbyHSG,MRIT2WIand MRICUBE.Andinallcases,therewere12casesofmembraneadhesions,inwhich5cases wereshowninHSG,8casesinMRIT2WIand10casesinMRICUBE.23caseswerefibrousadhesions,inwhich12caseswereshown in HSG,17casesinMRIT2WIand22casesinMRICUBE.5patientsweremuscularadhesions,allpatientswerediscoveredbyHSG, MRIT2WIandMRICUBE.Conclusion ComparingtoHSG,MRIexaminationshowshigherdetectablerateofIUA.MRICUBEsequences playsanimportantpartinthediagnosisofIUA.

Theimagingmanifestationsoffocalnodularhyperplasiaofliverwithoutcentralscar / 实用放射学杂志

Objective ToinvestigatetheMSCTand MRIcharacteristicsoffocalnodularhyperplasia(FNH)oftheliverwithout centralscar.Methods Aretrospectiveanalysisofimagingdatawascarriedoutin10patientswithFNH withoutcentralscar,confirmed bypathologyandfollowGupreview.PlainscanandenhancedCT wereperformedin10patients,5ofwhomunderwenttheplainscan andenhancedMRI.Results Lesionswerehomogeneousandslightlylowdensityin10casesonplainMSCT,andhypoGorisoGintensity onT1WIandhyperGorisoGintensityonT2WIin5cases.Nocentralscarwasfoundinalltheselesions.Thecorrelationcoefficientsof thechangeofCTvaluewere0.772onportalvenousphaseand0.827ondelayedphaseinnormalhepaticgroupandlesiongroup(P＜0.05).Theenhancedvolumeof8lesionswasslightlylargerontheportalvenousanddelayedphasethanthatonarterialphase.Conclusion MSCTand MRIcanclearlydisplaytheimagefeaturesofFNH withoutcentralscar.Thereisastrongcorrelationoftheenhancement curvebetweenthelesionsandnormalliverparenchymaonportalvenousanddelayedphase,whichishelpfulformoreaccuratediagnosis.

Thevalueofdynamicenhanced MRIimaginginthedifferentialdiagnosis betweenbenignIPandIP malignanttransformation / 实用放射学杂志

Objective ToinvestigatethevalueofDCEGMRIimagingindifferentiatingmalignanttransformationinvertedpapilloma (IP)frombenignIP.Methods 24casesofIPconfirmedbyoperationandpathologywerecollectedfromJanuary2012toJanuary 2018,including14caseswithbenignIPand10patientswithIP malignanttransformation.Thedynamicenhancementparametersof thetwogroups,theproductoftransferconstant(Ktrans),therefluxrateconstant(Kep),theextravascularextracellularspacevolume fraction (Ve)andthedifferenceoftheareaundertheinitialcurve(iAUC)wereanalyzed.Thesensitivityandspecificityofdifferent parametersintheidentificationofbenignIPandIP malignancytransformationwereevaluated.Results Thereweredifferencesno significantdifferenceinageandsexbetweenbenignIPgroupandIPmalignanttransformationgroup.Therewasasignificantdifference abouttheconvolutedcerebriformpatternbetweenthetwogroups(P＝0.004).Therewasnosignificantdifferenceofstagingbetween thetwogroups(P＝0.136).TheKtransvaluesofbenignIPgroupandIPmalignanttransformationgroupwere0.21±0.53 (min－1), 0.36±0.93 (min－1),andtherewasasignificantdifferencebetweenthetwogroups(P＝0.000).TheiAUCvaluesofbenignIPgroupand IP malignanttransformationgroupwere29.05±5.45,41.14±9.47,respectively,andthedifferenceofiAUCbetweentwogroupswas statisticallysignificant(P＝0.001).TherewasnosignificantdifferenceinKepandVebetweenbenignIPfromIPmalignanttransformation (P＞0.05).Conclusion BenignIPhasatypicalconvolutedcerebriG formpatternandtheabsenceofitindicatesmalignanttransformation. Thestagingoflesioncan’tdifferentiatethebenignIPfromIP malignanttransformation.DCEGMRIexaminationisworthyinthe evaluationbenignIPandIP malignanttransformation,especiallyKtransandiAUCvalues.

MRIfeaturesofgemistocyticastrocytoma / 实用放射学杂志

Objective ToexploretheMRIfeaturesanddifferentialdiagnosisofgemistocyticastrocytoma(GemA).Methods The MRIfeaturesof10casesofGemAprovedbysurgeryandpathologywereinvestigatedretrospectively(thelocationoftumor,tumor shape,boundary,signalandenhancement)andtheliteraturewasreviewed.Results All10casesofGemA weresupratentorialand solitary.Ofthese10cases,7caseswerelocatedinthefrontallobe,5casesinthetemporallobe,6casesinmultiplelobesandinvaded theoppositebraintissuesthroughcorpuscallosum.8casesweresolidGcystic,8casespresentedwithunclearboundary,only2cases hadclearboundary.Therewasnoedemaormildedemain7casesandobviousedemain3cases.Thesolidpartoftumorswereisointense orslighthypointenseonT1WI,only1caseshowedhighintensityonT1WI,isointenseorslighthyperintenseonT2WI.CTsuggested calcificationin2cases.6casesweremildlyenhanced,4casesweremarkedlyenhanced.MRSshowed(n＝4)thatCHopeakwasmildly ormoderatelyincreased,NAApeakwassignificantlyreduced,theaverageratioofCho/NAA was2.91.DWIshowedhyperintenseor slighthyperintense(n＝3),theADCaveragevalueoftumorROIwasabout(1.150±0.081)×10－3 mm2/s.1caseofSWIsequence showedthickeningandcircuitousvascularshadow.Conclusion AsMRIofGemAischaracterizedbyhighandlowgradegliomas,the preoperativediagnosisisdifficult.Combiningenhancementwithfunctionalexamination,itisexpectedtoimprovetheaccuracyofpreoperative diagnosisofGemA.

PredictionofthetextureofpituitaryadenomasbyMRIsignalintensity / 实用放射学杂志

Objective ToevaluatethepredictivevalueofpreoperativeMRIsignalintensityindifferenttexturesofpituitaryadenoma (PA).Methods Accordingtotheinclusioncriteria,47casesofPA werecollected,including37softcasesand10firmcases.Different texturesofPAonMRIsignalintensityanddynamicenhancementcharacteristicswereanalyzed.Results T2WIintensitybetweentwo texturegroups(T2PA/T2WM、T2PA/T2GM、T2PA/T2CSFandSER)hadsignificantstatisticaldifferences(P＜0.05).T1WIintensity betweentwotexturegroups(T1WIPA/T1WIPN )hadnosignificantstatisticaldifference(P＞0.05).TheT2signalintensity(T2PA/T2WM、T2PA/T2GM、T2PA/T2CSF)andSERinsoftgroupwashigherthanthatinthefirmgroup.Predictivevalueofthetextureof PAbyusingtheROCcurveofT2PA/T2WM,T2PA/T2GM,T2PA/T2CSF,T1PA/T1PNandSER wereobtained,andtheareasunder theROCcurvewere0.857,0.835,0.856,0.630and0.781respectively.ThelargestareaundertheROCcurvewasT2PA/T2WM (P＜0.05).Conclusion MRIT2signalintensityisrelatedtothetextureofPAandthoseindexescanbeusedtojudgethetextureofPA.

Cerebralbloodflowinpatientswithstenoticmiddlecerebralarteryorstroke / 实用放射学杂志

Objective Tomeasurecerebralbloodflow (CBF)inpatientswith middlecerebralartery (MCA)stenosisoracute stroke.Methods SeventyGonepatientswithstenoticMCAoracutestrokewererecruitedandclassifiedintofourgroups:mild MCA stenosis,severeMCAstenosis,occluded MCAandacutestroke.TheacquisitionprotocolsincludedASLsequence.CBFwereobtained from ASLsequence.CBFwasmeasuredandaveragedintheregionssuppliedby MCA.Theratiosoflesion/contralateralhemispheric CBFvaluesweredefinedastherelativeCBF (rCBF).Alldatawereperformedstatisticalanalyze.Results Thehemisphereswithstenotic MCAoracutestrokeshowedasignificantlylowerCBFthanthecontralateralhemispheres.TherewerenointerGgroupdifferencesin thecontralateralhemisphereCBFamongfourgroups.Additionally,significantdifferencesinlesionCBFandrCBF werefoundinthe foursubgroups.Patientswithoccluded MCAshowedthesamerCBFasthatwithacutestroke.Conclusion WiththedegreeofMCA stenosisaggravating,CBFdecreasesintheterritorysuppliedby MCA.Moreover,thepatientswhoseCBFislowerthan33.33 mL??min－1??100g－1orrCBFislowerthan0.69shouldperformactivetreatment.

Studyon MRInoiseanditseffectstohearingfunction / 实用放射学杂志

Objective ToexplorethenoiselevelsfromdifferentMRIsequencesandtheeffectsofMRInoiseonhearingfunction ofthesubjectswithtraditionalhearingprotection measures.Methods Intheprocessofscanningvolunteerswith MRI,soundlevel metersandelectretcapacitancemicrophoneswereusedsimultaneouslytodetectthenoiselevelsofdifferentMRIsequencesanddifferentpositionsof magnets,analyzingthe MRInoiserangeanddistributioncharacteristics.Dynamicauditorybrainstem response(ABR)wasusedto measurethehearingthresholdsof100healthyadultvolunteerswithtraditionalhearingprotection measures,respectivelywithin24 hoursbeforeMRIexamination (test1),within20minutesafterMRIexamination(test2),and25daysafterMRIexamination(test 3),estimatingthehearinglossandrecoveryofthesubjects.Results ThenoisevaluesofdifferentMRIsequencesweredifferent,the peakofsoundpressurelevel[Lpeak]rangedfrom119.7to124.5dB(A),theequivalentweightedsoundpressurelevel[Leq]ranged from103.5to115.3dB(A).DynamicABRresultsshowedthehearingthresholdsoftest2onbothleftandrightearsweresignificantlyhigher thanthoseoftest1(L:P=0.012;R:P=0.001);while,havingcomparedthehearingthresholdsofleftandrightearsintest3with thoseintest1,therewerenosignificantdifferences(L:P=0.138;R:P=0.451).Conclusion Thenoiseof3.0T MRIcancausethe hearingthresholdsofhealthyadultswithtraditionalhearingprotectionmeasuresincreasetemporarily,whenscanningwithMRI,more effectivemeasuresshouldbetakentoreducethehearingnoiseandprotectthehearingfunctionofthesubjects.

FeasibilitystudyofMRIDEAL-IQsequenceinevaluatingliverfunctionofpatientswithlivercirrhosis / 实用放射学杂志

Objective ToinvestigatethefeasibilityofassessingliverfunctiongradingbyIDEAL-IQsequenceon1.5T MR.Methods The patientswhowereclinicallydiagnosedaslivecirrhosisandunderwent1.5T MRIDEAL-IQsequenceinourhospitalfrom February 2016toDecember2017wereanalyzedretrospectively.TheyweredividedintoA,BandCgradesaccordingtotheChild-Pughgrading standardofliverfunction.Finally,therewere30patientsinChild-PughA,25patientsinChild-PughBand16patientsinChild-Pugh C.ThefatratiomapsandR2?relaxationratemapswereusedtomeasuretheliverfatcontentandironcontentbythetwoobservers onAW4.6workstation,respectively.ThemeanvaluesofthefatfractionsandtheR2?valuesweremeasuredandcomparedbyusing K ruskal-W allis H testamongthethreegroups.Then,thegroupAandBwerecombinedtoestablishthepredictivemodelindiagnosingthegroup Cbyusingthe L o g istic regressionanalysis,whichcombinedthefatfractionandR2?value.TheROCcurvewasdrawntoobtainedtheAUC,and calculatedthesensitivityandthespecificitywiththeoptimalthreshold.Results Thereweregoodconsistencyofmeasurementdata betweenthetwoobserves(ICC>0.8).ThefatfractionandR2?valueincreasedwiththedecreaseoftheliverfunction.Thefatfractionsofthe Child-PughA,BandCgroupwere(3.58±0.91)%,(3.64±1.20)%,(6.87±3.91)%,respectively.TheR2?valuesoftheChild-Pugh A,BandCgroupswere(33.31±11.80)Hz,(38.00±13.31)Hz,(58.98±44.54)Hz,respectively.TheAUCofwhichcombinedfat fractionandR2?valuediagnosingChild-PughCwas0.843.Thesensitivityandthespecificitywere81.8% and81.3%,respectively. Conclusion The1.5T MRIDEAL-IQsequencecanbeusedtoevaluatetheliverreserveunctionoflivercirrhosispatientsaccording ffatfractionandR2?value,especiallyfortheChild-PughCcirrhosis patientswithhighsensitivityandspecificity.

Theclinicaland MRIfeaturesofEV71childrenwithhand-foot-mouthdiseaseandnervoussystemdisease / 实用放射学杂志

Objective ToexploretheclinicalmanifestationsandMRIfeaturesofnervoussystemdiseasecomplicationsinpediatric EV71relatedhand-foot-mouthdisease(HFMD).Methods Theclinicaldataof17EV71relatedHFMDpatientswithnervoussystemdisease wereanalyzedretrospectively.Results 4patientswerediagnosedwith meningitisandthebrain MRIshowedasymmetricunilateral ventricularenlargement.9patientswerediagnosedwithbrainstemencephalitis,amongwhich8patientsshowedthecraniocerebral MRIfeaturesthatthelesionswerelocatedonthedorsalsideofthepontomedullaryjunction,andtheT2imageshowedahighsignal withasymmetrycharacteristic.1caseofbrain MRIdisplayedthatthelesionwaslocatedinthemidbrain,andT2imagewasahigh signalwithsymmetricalfeatures.4patientswerediagnosed withacuteflaccidparalysis.1casehadbrainstem encephalitis,andthe brain MRIshowedthatthelesion waslocatedonthedorsalsideofthepontomedullaryjunction,andthe MRIofthespinalcord showedthelesionintheC1-C7segment.1caseofspinalcordMRIshowedthatthelesionwaslocatedatT2-L1segment,1caseof spinalMRIshowedthelesionlocatedinT8-T12segment;1caseofspinalcord MRIshowedthatthelesionwaslocatedatT9-L1 segment,andsagittalT2 wasahighsignal,andthelesionconcentratedintheanteriorhornofthespinalcordand (or)theanterior rootofthespinalnerve.Byfollow-up,patientswithmeningitishadagoodprognosisandwithoutneurologicalsequelae.Thelesionsof brainstemencephalitiswerebasicallyabsorbedanddisappeared,theprognosiswasgood.Fortheacuteparalysis,theaffectedlimbs recoveredtovaryingdegrees,andthelesionswereabsorbedpartially.Conclusion HFMDpatientsclinicalmanifestationsand MRI characteristicsofconcurrentnervoussystemdiseasewerediversity.Whenthenervoussystemsymptomshappened,weshouldactively performtheMRIexaminationtoidentifytheinflammatoryinvasionarea.Onceinvolvingthebrainstemandspinalcord,highalert, earlyrecognitionandtimelyinterventionarekeytoreducethemorbidityandmortalityofacuteHFMD,toenableHFMDtobeoptimizedand comprehensivelytreated.

TherelationshipbetweentheSchizasgradingofthenerverootandtheareaoftheduralsacofthelumbarspine / 实用放射学杂志

Objective ToexploretherelationshipbetweenSchizasgradeofthenerverootwithintheduralsacandtheduralsac cross-sectionalarea(DSCA)ofthelumbarspineaswellastheclinicalsignificance.Methods 3.0T MRIexaminationofthelumbar spineof89patientswithlunbarspinestenosis(LSS)from May2016toSeptember2017intheaffiliatedhospitalofNantongUniversitywere collected.Twoexperienceddoctorsindependently measuredthekyphosisdegreeofthethoracolumbarspine,theDSCAofthe2-5 lumbarlevels,vDSCA,dDSCA,andevaluatedSchizasgradeofthenerverootforfourdegradsofA,B(gradeB1:DCSA≥100 mm2, gradeB2 :DCSA<100 mm2 ),CandDaccordingtozygopophysisconnectingline,andfinallyconductedthetestof Kappa consistency.DSCA wasdividedintothreegroupsof≤75 mm2,76-99 mm2and≥100 mm2,andχ2 wasadoptedtoexaminetherateineachSchizas grade.Schizasgradewithd/vvalue(dDSCA/vDSCA)andthekyphosisdegreeofthethoracolumbarspinewerecomparatedbyttest. Forthecorrelationcoefficient,S pear m an analysis wasadopted.Results In89cases with173lumbarlevels,schizasgradeofthenerve rootwere52,51,32and38levelsforgradeA-DrespectivelyI.nDSCA≤75mm2group,SchizasCandDwere18.5%and21.9%respectively, whichweresignificantlyhigherthanthoseforgradeAandB(0% and3.5%,P<0.01);InDSCA=76-99mm2group,Schizasgrade AandBwere8.7% and17.9%,whichweresignificantlyhigherthanthoseofgradeCandD (0% and0%,P<0.05and0.01);In DSCA≥100mm2group,therewere0% and0%forSchizasgradeCandD,whichweresignificantlylowerthanthoseforgradeAand B(21.4% and8.1%,P<0.0SchizasgradesofA-Dgroups,d/vaveragevalueswere0.64±0.29,0.48±0.22,0.42±0.20and0.34±0.11 respectively,in whichgradeCand D weresignificantlylower thanthoseofgradeAandB(P<0.01).Thecorrelationcoefficientof SchizasgradewiththeDSCAandd/vvalueswere0.83and0.87 respectively(P<0.01).Thekyphosisdegreeofthethoracolumbar spinewas(158.7±15.9)°inSchizasgradeB1,and (167.8±11.2)°inothergrades(t=4.37,P<0.05).Conclusion Theclassification ofnerverootSchizasgradeishighlyrelatedtoDCSA,andbothofthemaretheindicatorsforjudgingwhetherthelumbarspinalis stenosisornormal.TheSchizasgradeismoreconvenientandquicker;InordertoavoidconflictwithDCSA,SchizasBshouldbedividedintoB1 andB2 Whenitisusedtodeterminewhetherhavestenosis.