The Value of the Cardiac Magnetic Resonance Intravoxel Incoherent Motion Technique in Evaluating Microcirculatory Dysfunction in Hypertrophic Cardiomyopathy.

Objective: To evaluate the value of the cardiac magnetic resonance intravoxel incoherent motion (IVIM) technique in microcirculatory dysfunction in patients with hypertrophic cardiomyopathy (HCM). Methods: The medical records of 19 patients with HCM in our hospital from January 2020 to May 2021 were collected retrospectively, and 23 healthy people with a similar age and gender distribution to the patients with HCM were included as controls. All the included subjects underwent clinical assessment and cardiac magnetic resonance imaging. The original IVIM images were analysed, and the imaging parameters of each segment were measured. The HCM group was divided into non-hypertrophic myocardium and hypertrophic myocardium groups. The differences in imaging parameters between the normal and HCM groups were compared. A Spearman correlation analysis was used to explore the correlation between end-diastolic thickness (EDTH) and each IVIM parameter. Results: The D∗ and f values in the HCM group were lower than those in the normal group (p < 0.0001 and p = 0.004, respectively). The f, D, D∗, and EDTH values of the hypertrophic segment, non-hypertrophic segment, and normal groups were statistically significant (p < 0.05). The difference in D∗ values among the mild, moderate, severe, and very severe HCM groups was statistically significant (p < 0.05). There was a statistically significant difference in EDTH among the mild, moderate, severe, and very severe groups (p < 0.001). There were significant differences in the values of D, D∗, and f between the non-delayed enhancement group and the delayed enhancement group (p < 0.05). The EDTH values of 304 segments in the HCM group were negatively correlated with f (r = -0.219, p = 0.028) and D∗ values (r = -0.310, p < 0.001). Conclusion: The use of IVIM technology can achieve a non-invasive early quantitative assessment of microvascular disease in HCM without the injection of a contrast agent and provide a reference for the early diagnosis of and intervention in myocardial ischemia in patients with HCM.

Sheehan's syndrome in Xinjiang: Clinical characteristics and laboratory evaluation of 97 patients.

OBJECTIVE: To evaluate the clinical and hormonal characteristics of patients with Sheehan's syndrome in Xinjiang, China. METHODS: 97 cases diagnosed as Sheehan's syndrome in our hospital from 1999 to 2013 were retrospectively reviewed. The medical history, physical examination findings and hormonal profiles were documented and analyzed. RESULTS: The mean age at diagnosis was 43.7±12.4 years, with a mean diagnostic delay of 9.1±9.5 years (range, 1 month-35 years). 10 of our patients (10.3%) had a home birth. 96 of our patients (99.0%) had a history of obstetric hemorrhage. The most common clinical presentation included amenorrhea (80/97, 82.5%), agalactia (2/97, 74.2%) and loss of axillary or pubic hair (83/97, 85.6%). Seventy two of our patients (74.2%) failed to lactate and 80 of our patients (82.5%) failed to resume menstruation. Hypothalamic dysfunction included the hypothalamic-pituitary-gonadal axis (HPG) (LH deficiency: 77/83 patients, 92.8%; FSH deficiency: 73/83 patients, 88%; E2 deficiency: 62 of 82 patients,75.6%), the hypothalamic-pituitary-thyroid (HPT) axis (TSH deficiency: 77/93 patients, 82.8%, TT3 deficiency: 70/ 87 patients, 80.5%, TT4 deficiency: 72/87 patients, 82.8%) and the hypothalamus-pituitary-adrenal (HPA) axis (ACTH deficiency: 19/37 patients, 51.4%, cortisol deficiency: 49/64, 76.6%). CONCLUSIONS: Sheehan's syndrome is still common in Xinjiang, especially in rural areas. Long diagnosis delay in most of the patients indicates that women might be lacking correct diagnosis and treatment. Physicians need to be aware of the most important clues for diagnosis such as lack of lactation in the postpartum period and failure to resume menstruation.

MRI findings and diagnosis of brain echinococcus / 中华放射学杂志

Objective To study the characteristic findings of brain echinococcosis on MRI. Methods The MRI findings of 18 patients with pathologically confirmed brain echinococcosis were retrospectively reviewed.Results Among the patients.there were 9 cases of cystic echinococcosis and 9 cases of alveolar echinococcosis.In cystic echinococeosis,MRI revealed homogeneously hypointensity on T1WI and hyperintensity on T2WI,while it showed low signal intensity inside the cysts on FLAJR and DWI. In 6 cases of cystic echinococcosis, no edema was detected surrounding the lesions,while edema resulting from cyst rupture was found in 3 cases.The cystic walls were visible in 6 csses, obscure in 3 cases.The ruptured hydatid cysts in 3 cases showed slight ring enhancement.Alveolar echinococcosis appeared as multiple lesions with isointensity on T1WI and hypointensity on T2WI,surrounded by vasogenic edema.The "charcoal-like"hypointensity and innumerous hyperintense bubbles of 1-10 mm in diameter inside the lesions on T2-weighted MR images were characteristic for lesions of alveolar echinococcosis.The lesions revealed hypointensity on DWI and showed irregular ring enhancement after injection of Gd-DTPA. Perfusion-weighted MR imaging revealed low relative cerebral blood volume.Conclusion MRI can demonstrate lesions of brain echinococcosis accurately due to its advantages of multiorientation and multiparameter.It is clinically valuable.

MRI features of hydatid disease of the spine / 中华放射学杂志

on on PWI. Conclusions MRI can demonstrate hydatid cysts in vertebra, spinal canal, paravertebral and neighboring soft tissue. MRI is a valuable tool in the diagnosis and treatment planning of hydatid disease of the spine.