Increased Extracellular Water in Normal-Appearing White Matter in Patients with Cerebral Small Vessel Disease.

BACKGROUND: Microcirculatory variations have been observed in the normal-appearing white matter (NAWM) of individuals affected by cerebral small vessel disease (CSVD). These variations collectively possess the potential to trigger neuroinflammation and edema, ultimately leading to an elevation in extracellular fluid (ECF). Nevertheless, the specific alterations in ECF within the NAWM of CSVD patients have remained inadequately understood. METHODS: We reviewed the clinical and imaging characteristics of a cohort comprising 129 patients diagnosed with CSVD to investigate alterations in the ECF within NAWM. The severity of CSVD was assessed by total CSVD magnetic resonance (MR) score according to the four imaging markers, namely perivascular space, lacunar infarction, white matter hyperintensities and cerebral microbleed. ECF was evaluated by the parameter free water (FW), ranging from 0 to 1 generated from diffusion tensor imaging. RESULTS: Significant differences in NAWM FW were observed in relation to the total CSVD MR score (p < 0.05). Patients with a total CSVD MR score of 0 exhibited significantly lower NAWM free water (FW) values compared to those with a score greater than 0 (p < 0.05). Similarly, patients with a total CSVD MR score of 1 also demonstrated notably lower NAWM FW values than those with a score greater than 1 (p < 0.05). After conducting multivariate regression analysis, age and total CSVD MR score was independently associated with FW in NAWM (p < 0.001). Further, the total CSVD MR score served as a partial mediator in the relationship between age and FW in the NAWM among patients with CSVD. CONCLUSIONS: ECF in NAWM is increased in CSVD patients, even during the early course of CSVD.

A meta-analysis of contrast-enhanced computer tomography in the diagnosis of colorectal cancer.

OBJECTIVE: To investigate the diagnostic value of contrast-enhanced computer tomography in diagnosis of colorectal cancer. METHODS: All the diagnostic studies about contrast-enhanced computer tomography in diagnosis of colorectal cancer were searched in the PubMed, Medline, EMBASE, CNKI, and Wanfang databases and included in this meta-analysis. The diagnostic sensitivity and specificity were pooled. The data were analyzed by statistic software Meta-DiSc1.4. RESULTS: After searching the databases, eight studies with 4764 cases were finally included in this meta-analysis. The combined results showed the pooled diagnostic sensitivity and specificity were 0.73 (95% confidence interval [CI] of 0.69-0.76) and 0.86 (95% CI of 0.85-0.87). Moreover, the area under the receiver operating characteristic was 0.896. CONCLUSION: Contrast-enhanced computer tomography was a good method for detection colorectal cancer.