Differences in CT imaging signs between patients with tuberculosis and those with tuberculosis and concurrent lung cancer.

OBJECTIVE: The purpose of this study was to compare the differences in imaging features between patients with pulmonary tuberculosis (TB) alone and patients with TB complicated with lung cancer (LCA) as well as to investigate the diagnostic value of CT in these two groups. METHODS: In this retrospective study, 110 patients with confirmed TB admitted to the Second Affiliated Hospital of Hainan Medical University from March 2020 to April 2021 were collected and divided into TB+LCA group (50 cases, diagnosed with TB complicated with lung cancer) and TB group (60 cases, diagnosed with TB alone) according to actual diagnosis. The CT results of both groups were analyzed by the same group of physicians in a double-blind manner. The diagnostic value of CT for TB alone and TB complicated with lung cancer was calculated. The differences in CT imaging characteristics between the two groups were investigated. The differences in the structural characteristics of para-cancerous tissue between the two groups were analyzed. RESULTS: The diagnostic accuracy of CT was 91.67% in TB patients (55/60) and 92.00% in TB+LCA patients (46/50) without significant difference (X2 =0.004, P=0.949). The detection rate of spiculation, lobulation and cavitation in TB+LCA group was significantly higher than that in TB group (P<0.05), and the distribution, size and wall thickness of cavitation varied significantly between the two groups (P<0.05). Patients in TB group had higher percentage of mediastinal lymph node calcification, peripheral satellite lesion, and mediastinal lymph node enlargement around the TB lesions compared with those in TB+LCA group (P<0.05). CONCLUSION: CT has certain application value in differentiating TB alone from TB complicated with lung cancer, and there are many similarities in the imaging features of the two conditions. CT can be considered as a preliminary means of differential diagnosis of TB complicated with lung cancer, which is helpful to the primary screening diagnosis of lung cancer.

Pelargonidin ameliorates MCAO-induced cerebral ischemia/reperfusion injury in rats by the action on the Nrf2/HO-1 pathway.

BACKGROUND: Morbidity and mortality remain high for ischemic stroke victims, and at present these patients lack effective neuroprotective agents, which improve the cure rate. In recent years, studies have shown that pelargonidin has many biological actions. However, few studies are available regarding the pelargonidin treatment of cerebral ischemia. METHODS: The rat middle cerebral artery occlusion (MCAO) model was established to investigate the neuroprotective effect of pelargonidin on cerebral ischemia/reperfusion injury. Reperfusion was performed 2 h after ischemia; magnetic resonance imaging (MRI) and 2, 3, 5-triphenyltetrazolium chloride (TTC) staining were used to measure the volume of cerebral ischemia. Both modified neurological severity scores (mNSSs) and Morris water maze test were used to assess the neurological functions. ELISA was applied to determine the levels of TNF-α, TGF-ß, IL-6, IL-10, MDA, and SOD. The expression of Nuclear factor-E2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) protein in brain tissue was measured by immunofluorescence and Western blot assays. RESULTS: The results showed that pelargonidin could effectively reduce the volume of cerebral ischemia and improve the neurological function in MCAO rats, thereby improving memory and learning ability. With the corresponding decreases in the expression of TNF-α, TGF-ß, IL-6, and MDA, the level of IL-10 and SOD increased and also promoted the nuclear metastasis of Nrf2 and the expression of HO-1 in ischemic brain tissues. CONCLUSIONS: Our data demonstrated that pelargonidin ameliorated neurological function deficits in MCAO rats, and its potential mechanism of action was associated with overexpression of the Nrf2/HO-1-signaling pathway. This study will provide a new approach to treat cerebral ischemia/reperfusion injury.

Computed Tomography Image Analysis of Neuromuscular Electrical Stimulation in the Treatment of Knee Osteoarthritis with Different Radiologic Characteristics Based on Iterative Reconstruction Algorithm.

OBJECTIVE: To use computed tomography image analysis of iterative reconstruction algorithm to understand effect of neuromuscular electrical stimulation of quadriceps on motor function rehabilitation after total knee arthroplasty. METHODS: After total knee arthroplasty, 104 patients were randomly divided into 2 groups. The treatment group comprised 52 patients. The quadriceps femoris was stimulated by neuromuscular electrical stimulation, and patients were required to actively extend the knee along with the current stimulation. In the second group, which received cutaneous nerve electrical stimulation, 2 sets of electrodes were placed on knee pain points. All patients participated in conventional rehabilitation and were discharged from the hospital a mean 14.89 ± 3.65 days after treatment. Visual analog scale, range of motion of knee joint, and Knee Injury and Osteoarthritis Score were evaluated before discharge. The mean interval between follow-up evaluations after discharge was 9.5 months. Knee Society Score and Knee Injury and Osteoarthritis Score were assessed during follow-up. RESULTS: Visual analog scale scores of treatment and control groups at discharge were 18.11 ± 9.66 and 16.13 ± 4.25, and active range of motion of the knee joint was 103.21° ± 15.44° and (99.21° ± 15.19°, respectively. Limitation of active knee extension in the treatment group was 1.93° ± 3.47°, which was significantly smaller than in the control group (6.26° ± 4.28°). CONCLUSIONS: Neuromuscular electrical stimulation of the quadriceps muscle early after total knee arthroplasty helps to improve the function of the knee extension device and accelerate functional rehabilitation. Computed tomography has found that changes in tibial subchondral bone plate and subchondral cancellous bone in patients with knee osteoarthritis are mainly due to destruction of ultrastructural homeostasis. This change may be the cause of knee osteoarthritis.

Presence of Intratumoral Calcifications and Vasculature Is Associated With Poor Overall Survival in Clear Cell Renal Cell Carcinoma.

PURPOSE: The objective of this study was to explore the prognostic significance of the preoperative computed tomography (CT) features in clear cell renal cell carcinoma. PATIENTS AND METHODS: The clinical data and CT data from 210 patients (1 grade 1, 84 grade 2, 92 grade 3, and 32 grade 4) generated with The Cancer Imaging Archive were reviewed. Overall survival was assessed using Kaplan-Meyer analysis. The relationship between CT features and survivals were evaluated using univariate and multivariable Cox regression analysis. RESULTS: The follow-up occurred between 13 and 3989 days (median, 1405 days; mean, 1434 days).On univariate Cox regressions, 4 preoperative CT features (intratumoral calcifications: yes vs no hazard ratio [HR], 2.054; 95% confidence interval [CI], 1.231-3.428; renal vein invasion: yes vs no HR, 2.013; 95% CI, 1.218-3.328; collecting system invasion: yes vs no HR, 2.139; 95% CI, 1.286-3.558; gross appearance of intratumoral vasculature: yes vs no HR, 2.385; 95% CI, 1.454-3.915) were significantly associated with overall survival (all P < 0.05). On multivariable Cox regression analysis, predictors of mortality in clear cell renal cell carcinoma were the presence of intratumoral calcifications (HR, 1.718; 95% CI, 1.014-2.911; P = 0.044) and gross appearance of intratumoral vasculature (HR, 2.137; 95% CI, 1.284-3.557; P = 0.003). CONCLUSIONS: Presence of intratumoral calcifications and vasculature can be potential prognostic features to screen patients for unfavorable prognosis.

Diffusion-weighted multiparametric MRI for monitoring longitudinal changes of parameters in rabbit VX2 liver tumors.

PURPOSE: To investigate the value of different quantitative models of diffusion-weighted multiparametric imaging (DW-MPI) including traditional as well as several advanced models for monitoring the longitudinal parameter changes in rabbit liver VX2 carcinoma and for correlating the perfusion-related imaging parameters to vascularity of tumor tissue. MATERIALS AND METHODS: Rabbit liver VX2 carcinoma was imaged by DW-MPI at the 2nd, 3rd, and 4th weeks after tumor implantation at 1.5T using two sets of b values ranging from 0 to 2000 s/mm(2) . Serial parameter changes of each model at three timepoints were compared. Univariate and multivariate regression analyses were carried out to analyze the ability of perfusion-related parameters, including apparent diffusion coefficient (ADC), perfusion fraction (f), and pseudodiffusion coefficient (D*), to predict mean microvessel density (MVD) as determined by quantitative histopathology. RESULTS: For the period from Week 2 to Week 4, the measurements of ADC, f, and KDKI illustrated a statistical difference (P = 0.000, P = 0.000, and P = 0.002, respectively), whereas the comparison of D, D*, DDKI , DSEM , and αSEM demonstrated no statistical significance. ADC and f showed highest correlation with MVD at Week 4 (r(2) = 0.307, P = 0.017, and r(2) = 0.402, P < 0.01, respectively). Multivariate analyses confirmed highest correlation of f and ADC with MVD at Week 4 (P = 0.001 and P = 0.002). CONCLUSION: ADC, f, and KDKI were identified as the most promising parameters for monitoring changes in rabbit liver VX2 carcinoma and f and ADC showed highest correlation with MVD. J. Magn. Reson. Imaging 2016;44:707-714.