[The Value of MRI in Early Cervical Cancer Staging with Vaginal Filling of Ultrasound Gel].

OBJECTIVE: To investigate the value of MRI after ultrasonic gel vagina filling in the staging of early-stage cervical cancer. METHODS: A total of 158 patients with cervical cancer who underwent MRI examination after their cervical cancer diagnosis was confirmed by cervical biopsy were prospectively enrolled. Routine MRI examination was performed first, followed by another MRI examination after vaginal filling with ultrasound gel. Two physicians used a double-blind method to determine the staging of cervical cancer based on the MRI images before and after vaginal filling of ultrasound gel. Results of the postoperative pathology analysis were used as the golden standard. The positive predictive value and negative predictive value for stage Ⅱa cases of the two examinations of the same patient were compared, and the sensitivity, specificity and accuracy in identifying stage Ⅱa cervical cancer were compared. RESULTS: Two physicians used the double blind method to determine the staging of cervical cancer based on conventional MRI images, achieving moderate consistency ( κ=0.680). However, for the staging of cervical cancer with MRI images after vaginal filling of ultrasound gel, the two physicians achieved highly consistent results ( κ=0.932). Regarding identifying stage Ⅱa cervical cancer, the positive predictive value of conventional MRI was 66.67%, the negative predictive value was 76.74%, and the sensitivity, specificity and accuracy were 70.59%, 73.33% and 72.15%, respectively. The positive predictive value of MRI after vaginal filling of ultrasound gel was 90.91%, the negative predictive value was 91.3%, and the sensitivity, specificity and accuracy were 88.24%, 93.33% and 91.14%, respectively. The sensitivity, specificity and accuracy of the two methods were compared and the difference was statistical significant ( P<0.05). CONCLUSION: MRI examination after ultrasound gel vaginal filling has better diagnostic value for identifying stage Ⅱa cervical cancer. The method is simple and easy to do, and can be used in routine MRI examination of cervical cancer.

[Tracking Early Reperfused Myocardial Infarction using Cardiac MR].

OBJECTIVE: To determine segmental myocardial changes in cardiovascular magnetic resonance feature-tracking (CMR-FT) in the early phase of reperfused myocardial infarction in patients and rats. METHODS: Ten patients receiving percutaneous coronary interventions (2-10 d) and 10 rats with 60 min induced myocardial ischemia followed by reperfusions (48 h and 7 d) were investigated by MRI. The steady state free precession cine and late gadolinium enhancement (LGE) sequences were measured to evaluate the standard short axis of the whole heart after an injection of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA, Magnevist, Bayer Health Care Pharmaceuticals) at a dose of 0.1 mmol/kg. The infarction sizes (all areas were expressed as a percentage of the whole myocardial tissues of left ventricle (LV), end-diastolic volume (EDV) and ejection fractions (EF) were calculated. The MRI cine images were analyzed using the myocardial feature tracking software CVI, estimating the peak value of radial strains (RS) and circumferential strains (CS) of the 16 AHA segments excluding apex cordis. The complete myocardial infarction (CMI) segments, partial myocardial infarction (PMI) segments and non-myocardial infarction (NMI) segments were identified and compared. RESULTS: Patients: The radial strain and circumferential strain of the CMI and PMI segments were smaller than the NMI segment (both P < 0.01). However, there was no significant difference between the CMI and the PMI segment (P>0.05). Rats: No significance differences were found in EF and EDV between the two time period 48 h and 7 d (both P>0.05). The radial strain and circumferential strain of the CMI and PMI segments were smaller than the NMI segment (all P < 0.01). But there was no significance difference between the CMI segment and the PMI segment (P>0.05). No significant changes in the global radial strain and the circumferential strain were found over time (both P>0.05). But the segmental radial strain and circumferential strain became larger over time (all P < 0.05). CONCLUSIONS: The systolic ability of myocardium decreases as a result of reperfusion injury in the early phase of reperfused myocardial infarction. But it can gradually recover over time with reperfusion.

[Effect of acupuncture stimulation of Zusanli (ST 36) on cerebral regional homogeneity in volunteer subjects with different constitutions: a resting-state fMRI study].

OBJECTIVE: To observe the synchronism difference of brain region activities in response to acupuncture stimulation of Zusanli (ST 36) in healthy volunteer subjects with different acupuncture analgesia sensitivity, so as to study the central factors influencing acupuncture intervention outcomes. METHODS: Forty-five healthy volunteer subjects with different constitutions (different sensitivities in response to needling stimulation) were divided into insensitive group, normal group and sensitive group (n = 15). The pressure pain threshold (PPT) of the Zusanli (ST 36) region before and after acupuncture stimulation of ST36 was assessed using visual analog scale (VAS). Two weeks later after acupuncture stimulation of ST 36, resting-state fMRI images were acquired by using a nuclear magnetic resonance imaging system and analyzed by using DPARSFV 2.1 software package, software SPM 8 and REST 1.7. The cerebral regional homogeneity (ReHo) of the subjects was then calculated by Resting-State fMRI Data Analysis Toolkit (REST). RESULTS: Compared with pre-acupuncture, PPT levels of the normal and sensitive groups were significantly increased after acupuncture of ST 36 (P < 0.05), and that of the insensitive group had no significant change (P > 0.05). Following acupuncture stimulation of ST 36, the insensitive group only showed a significant decreased ReHo in the left fusiform gyrus, left inferior temporal gyrus, bilateral postcentral gyrus, and left anterior central gyrus. In the normal group, a significantly increased ReHo was found in left brainstem, the right cerebellum posterior lobe, right parahippocampa gyrus, right fusiform gyrus, left angular gyrus, temporal lobe and the left frontal lobe; and a significantly decreased ReHo in the occipital lobes and the right superior temporal gyrus after acupuncture stimulation of ST 36. In the sensitive group, a markedly increased ReHo was found in the left brainstem, bilateral cerebellum posterior lobes, left inferior temporal gyrus, basal ganglia, the left insular lobe, anterior cingutate, frontal lobe, inferior parietal lobule, and the right supplementary motor area, and an obviously decreased ReHo found in the bilateral occipital lobes, fusiform gyrus, posterior central gyrus, the right posterior cingutate, the left temporal lobe and the left paracentral lobule, etc. after acupuncture of ST 36. CONCLUSION: Constitution-associated needling sensation may be an important influential factor for acupuncture analgesia in normal subjects. The change of ReHo in different cerebral areas is probably responsible for the difference of acupuncture analgesia in different constitution people.

[Clinical manifestations and imaging features of peripheral vestibular paroxysmia: a report of 7 cases].

OBJECTIVE: To investigate the clinical manifestations and imaging features of peripheral vestibular paroxysmal (PVP). METHODS: The clinical data, including magnetic resonance tomographic angiography (MRTA), of 7 PVP patients, 1 male and 2 females, aged 40-72, were retrospectively analyzed. RESULTS: (1) All 7 patients had non-specific cochleovestibular symptoms, e.g., recurrent vertigo and continuous dizziness. (2) The predominant symptom was transient vertigo or dizziness with the sudden change of head position. (3) MRTA showed cross of the cochleovestibular nerve (CNV) and blood vessel in all patients. (4) Carbamazepine and sibelium succeeded to relieve the symptoms. CONCLUSION: Compression of the cranial nerve VIII by crossing vessel thereon may be the mechanism of PVP which can be identified and diagnosed clinically.

[Effects of Ciwujia in inducing marrow stromal cell differentiation into neuron-like cells in vitro].

OBJECTIVE: To study the effect of the traditional Chinese herbal drug Ciwujia in inducing the differentiation of marrow stromal cells (MSCs) into neuron-like cells. METHODS: Rat MSCs isolated from the whole bone marrow were amplified by adherent culture in vitro and induced to differentiate into neuron-like cells using serum-free DMEM/F12 containing Ciwujia. The protein and mRNA expressions of nestin, beta-Tubulin III and glial fibrillary acidic protein (GFAP) in the differentiated cells were detected by indirect immunofluorescence method, Western blotting and RT-PCR. RESULTS: The third-passage MSCs showed positive expression rates for CD44 and CD54 beyond 90% with decreased CD14 expression rate to 2.37%. Induction by Ciwujia of the MSCs resulted in cell body shrinkage and protrusion of the cell processes resembling those of neurons. The differentiated cells were positive for nestin and beta-Tubulin III expression and negative for GFAP as shown by immunofluorescence assay, Western blotting and RT-PCR. CONCLUSION: Ciwujia can induce the differentiation of rat MSCs into neuron-like cells in vitro.

[Study on corresponding areas the liver and lung channels in brain with fMRI].

OBJECTIVE: To explore distribution of the Liver and Lung Channels in the brain so as to provide imaging basis for construction of channel theory in the brain. METHODS: Sixty healthy student volunteers were randomly divided into a Liver Channel group (I) and a Lung Channel group (II), and the each group was further divided into five subgroups with 6 volunteers in each subgroup, based on five-shu-point principles which, were Dadun (LR 1, I 1), Xingjian (LR 2, I 2), Taichong (LR 3, I 3), Zhongfeng (LR 4, I 4), Ququan (LR 8, I 5), Shaoshang (LU 11, II 1), Yuji (LU 10, II 2), Taiyuan (LU 9, II 3), Jingqu (LU 8, II 4), and Chize (LU 5, II 5), respectively. In order to observe the brain activating patterns during acupuncture at the different acupoints, functional magnetic resonance imaging (fMRI) technique was adopted. All image data were then analyzed with SPM 2 software. The statistical parameter gram was composed of the pixel P < 0.01, and anatomic location was made according to Talairach coordinate, attaining experimentally activated areas, and the commonly activated area of five-shu-point of each channel was considered as the brain distribution of the Liver and Lung Channels. RESULTS: The common areas activated by the five-shu-points of the Liver Channel were homolateral Brodmann area (BA) 34, BA 47, red nucleus, contralateral BA 19, BA 30, BA 39, the superior parietal lobule, cerebellum decline, and bilateral BA 3 and culmen. The common areas activated by the five-shu-points of the Lung Channels included homolateral BA 2, BA 18, BA 35, and contralateral BA 9 and substania nigra. CONCLUSION: There are relatively specific corresponding brain areas for the Liver and Lung Channels, indicating that there is possible relatively specific connection between channels and the brain.

[Functional magnetic resonance image study on the brain areas involved in reading Chinese, English, and Nepali in Nepalese].

OBJECTIVE: To explore the different brain areas activated by Chinese, English, and Nepali word tasks in Nepalese by using the functional magnetic resonance image (fMRI). METHODS: To determine the neuroanatomic functional brain areas responsible for Chinese, English and Nepali reading as well as sentence-formation, blood oxygenation level dependent (BOLD) block design by fMRI was performed in 6 healthy Nepalese volunteers. RESULTS: During Chinese reading, the activated areas included bilateral motor area, subfrontal gyri, superior temporal gyri, and superior parietal lobule; during English reading, the activated areas were left motor area, left subfrontal gyrus, left supra temporal gyrus, left insula and bilateral cerebellum; and the Nepali task demonstrated the activation of left anterior central gyrus, superior frontal gyrus, superior temporal gyrus. Aside from the bilateral occipital lobes, both English and Nepali activated areas were the left cerebral hemisphere dominant. CONCLUSION: The more familiar with the language, the fewer areas are activated. Superior temporal gyrus might be involved in sentence-formation.