1.Magnetic resonance imaging features of Cryptococcus infection in central nervous system in patients with AIDS
Chuanjun XU ; 南京市第二医院放射科 ; Zhiliang HU ; Hongxia WEI ; Yongfeng YANG ; Chao DU ; Jianping GU
Journal of Central South University(Medical Sciences) 2017;42(10):1184-1190
Objective:To investigate the magnetic resonance imaging (MRI) features of Cryptococcus infection in central nervous system patients with acquired immune deficiency syndrome (AIDS).Methods:The retrospective study on magnetic resonance imaging (MRI) and clinical data of cryptococcal meningitis (CM) was carried out between July 2011 and March 2017.These patients had not received anti-retroviral treatment.Patients with other specific or suspicious diseases in the central nervous system were not included in the analysis.Results:A total of 39 patients were included in the analysis,with CD4 cell counts of 13.0×106/L [(0-205)×106/L],and 94.9% (37/39) of patients with CD4 cell count <100×106/L.Of the 39 patients,26 patients showed abnormal MRI signals in the brain,which were most frequently involved in the basal ganglia (20/26,76.9%).The basal ganglia lesions showed dilated VirchowRobin space (VRS)/gelatinous spseudocysts (18/20,90%).Postcontrast T 1-weighted MRI revealed no significant enhancement (3/5,60%) and mild enhancement (2/5,40%).The incidence of cerebral cryptococcal granuloma were 35% (7/20).Nineteen of 26 patients with lesions outside the basal ganglia,of which 13 patients also complicated with basal ganglia lesions.Postcontrast T1-weighted MRI revealed no significant enhancement.The incidence of cryptococcal granuloma and meningeal thickening were 15.7% (3/19) and 26.3% (5/19),respectively.Postcontrast T1-weighted MRI meningeal thickening revealed enhancement (5/5,100%).Conclusion:The incidence of brain MRI abnormality in AIDS complicated with central nervous system Cryptococcus infection may not be low,and the lesions are mostly located in the basal ganglia.It most frequently displays the dilated VRS/gelatinous spseudocysts.It can also be showed cryptococcal granuloma.Postcontrast T1-weighted MRI often reveals no enhancement or mild enhancement.
2.Imaging diagnosis and management of inferior vena cava filter related complications
Chinese Journal of Interventional Imaging and Therapy 2018;15(3):179-183
Although inferior vena cava (IVC) filter (IVCF) has been widely used in clinic,the retrieval rate was low,and many of them were left as permanent devices.IVCF can induce many complications,including filter deformation,incomplete opening,tilting,migration and fracture,as well as IVC perforation,stenosis and IVC occlusion.Some of the complications caused by IVCF may cause serious consequence,even death,such as IVCF migration to heart can cause arrhythmia and cardiac arrest.IVCF related complications have many imaging manifestations,whereas there are still some characteristics of each complication.Timely diagnosis based on qualified imaging information and effective treatment is the key to avoid serious complications.The imaging features and management strategies of IVCF related complications were reviewed in this article.
3.Resting-state functional magnetic resonance imaging study in type 2 diabetic retinopathy using regional homogeneity analysis
Xiaomin GE ; Yi LU ; Ling ZOU ; Wei LIU ; Changjie PAN ; Hanqi CHEN ; Hao ZHANG ; Zhongling WANG
Journal of Practical Radiology 2018;34(6):831-834
Objective To investigate the altered spontaneous cerebral activity in patients with type 2 diabetic retinopathy (T2DR). Methods Twenty-one patients with T2DR and sixteen healthy control subject underwent rs-fMRI scans,and the data were analyzed statistically using regional homogeneity(ReHo)method to observe the change of ReHo value.Results Compared to the control group,the T2DR group showed significantly increased ReHo value in the right occipital gyrus,occipital gyrus,inferior occipital gyrus and lingual gyrus regions (t=5.30,P<0.05,voxel>30,AlphaSim corrected),and significantly decreased ReHo value in the left posterior cingulate,margin lobe,right inferior parietal lobule,superior temporal gyrus and hippocampus (t=-4.01,-4.86,P<0.05,voxel>30, AlphaSim corrected).Conclusion The patients with T2DR showed significantly increased ReHo values in the brain visual cortex and visual pathway that were associated with the injury of brain function regions.It is of important value to evaluate brain dysfunction in patients with T2DR using ReHo method of rs-fMRI.
4.Application of low-dose multi-slice spiral CT multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma
Huihua KAI ; Xiang WANG ; Yuejun XUE ; Ping ZOU ; Chunhong ZHANG ; Jian CAO ; Changjie PAN
Journal of Clinical Medicine in Practice 2017;21(5):106-109
Objective To explore the value of low-dose multi-slice spiral computed tomography (MSCT) multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma.Methods A total of 40 patients with gastric carcinoma were selected.All the patients were conducted with low-dose MSCT scan,dynamic contrast scanning and three-dimensional reconstruction scan,and then were processed by multi-planar reconstruction,volume reconstruction and CT virtual endoscopy.Primary lesions in gastric cancer,peripheral infiltration and distant metastasis were observed.Results All the patients were satisfied with the low dose MSCT images,and all of them found primary gastric lesions and had satisfactory diagnosis rates of gastric peripheral infiltration,lymph node metastasis and distant metastasis.Conclusion Low-dose MSCT multi-stage scan and three-dimensional reconstruction can reduce the radiation dose and reveal the primary gastric lesions,gastric peripheral infiltration and distant metastasis.
5.Application of low-dose multi-slice spiral CT multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma
Huihua KAI ; Xiang WANG ; Yuejun XUE ; Ping ZOU ; Chunhong ZHANG ; Jian CAO ; Changjie PAN
Journal of Clinical Medicine in Practice 2017;21(5):106-109
Objective To explore the value of low-dose multi-slice spiral computed tomography (MSCT) multi-stage scan and three-dimensional reconstruction in diagnosis of patients with gastric carcinoma.Methods A total of 40 patients with gastric carcinoma were selected.All the patients were conducted with low-dose MSCT scan,dynamic contrast scanning and three-dimensional reconstruction scan,and then were processed by multi-planar reconstruction,volume reconstruction and CT virtual endoscopy.Primary lesions in gastric cancer,peripheral infiltration and distant metastasis were observed.Results All the patients were satisfied with the low dose MSCT images,and all of them found primary gastric lesions and had satisfactory diagnosis rates of gastric peripheral infiltration,lymph node metastasis and distant metastasis.Conclusion Low-dose MSCT multi-stage scan and three-dimensional reconstruction can reduce the radiation dose and reveal the primary gastric lesions,gastric peripheral infiltration and distant metastasis.
6.Clinical diagnostic value of altered functional connectivity in the central executive network on mild cognitive impairment in patients with end-stage renal disease
Wenqing LI ; Di WANG ; Tongqiang LIU ; Wanchao ZHANG ; Haifeng SHI
Chinese Journal of Behavioral Medicine and Brain Science 2024;33(11):993-1000
Objective:To evaluate the clinical diagnostic significance of altered functional connectivity (FC) within the central executive network (CEN) in patients with mild cognitive impairment (MCI) related to end-stage renal disease (ESRD).Methods:A total of 155 patients with ESRD receiving hemodialysis treatment at the department of nephrology, Changzhou Second People's Hospital, from June 2020 to December 2023, were recruited. According to wether the patient had MCI symptoms, 85 patients were classified in the ESRD with MCI group, while 70 patients were in the ESRD without MCI group. Additionally, 76 healthy volunteers matched for age, sex, and years of education were enrolled in the study. All participants underwent resting-state functional magnetic resonance imaging and were evaluated using the Montreal cognitive assessment. With the dorsolateral prefrontal cortex serving the core of CEN, functional attributes of the CEN were calculated using seed-based FC analysis. Based on these imaging features and clinical data, a LASSO + Logistic regression model was constructed to predict MCI in patients with ESRD, and SPSS 20.0 software was used for analysis.Results:There were significant differences in FC in 10 brain regions, including the inferior temporal gyrus, temporal pole, corpus callosum, ventromedial prefrontal cortex, ventral posterior cingulate cortex, inferior parietal lobule, precuneus, dorsomedial prefrontal cortex, dorsal anterior cingulate cortex, and supplementary motor area, among the three groups (all P<0.001). Post hoc analysis revealed that the zFC values of the ventromedial prefrontal cortex and dorsomedial prefrontal cortex in ESRD with MCI group(0.385±0.219, 0.215±0.247) were significantly higher than those in the ESRD without MCI group (0.278±0.184, 0.121±0.221) and the healthy controls (0.206±0.217, 0.078±0.212) (all P<0.05). In addition to the ventromedial prefrontal cortex and dorsomedial prefrontal cortex, zFC values in all brain regions exhibiting significant differences were markedly reduced in both the ESRD with MCI group (temporal pole (0.157±0.221 vs 0.327±0.191), corpus callosum (0.100±0.184 vs 0.327±0.191), ventral posterior cingulate cortex (0.027±0.199 vs 0.128±0.154), inferior parietal lobule (0.218±0.195 vs 0.387±0.213), precuneus (0.193±0.184 vs 0.358±0.142), supplementary motor area (0.182±0.163 vs 0.231±0.163)) and the ESRD without MCI group (inferior temporal gyrus (0.055±0.125 vs 0.250±0.146), temporal pole (0.048±0.223 vs 0.335±0.195), corpus callosum (0.192±0.161 vs 0.327±0.191), inferior parietal lobule (0.234±0.197 vs 0.387±0.213), dorsal anterior cingulate cortex (0.383±0.242 vs 0.585±0.195), supplementary motor area (0.076±0.162 vs 0.231±0.163)), compared to healthy controls ( P<0.01). The zFC values of 4 brain regions in ESRD with MCI group were significantly higher than those in the ESRD without MCI group (inferior temporal gyrus (0.226±0.205 vs 0.055±0.125), temporal pole (0.157±0.221 vs 0.048±0.223), dorsal anterior cingulate cortex (0.498±0.254 vs 0.383±0.242), supplementary motor area (0.182±0.163 vs 0.076±0.162)) ( P<0.05). The diagnostic model developed from these results demonstrated excellent discrimination(the area under the curve=0.94, the sensitivity=0.89, the specificity=0.86, and the accuracy=0.88). Additionally, it exhibited strong calibration ( R2=0.908) and clinical applicability(patients benefited when the predicted probability exceeded 0.12). Conclusion:The enhancement of FC in CEN and its attenuation with other networks provide relevant evidence for the neuropathological mechanisms underlying MCI in patients with ESRD.The diagnostic model based on FC changes in the CEN, as presented in this study, is valuable for detecting early cognitive impairment in patients with ESRD.