Objective To explore the role of proton MR spectroscopic imaging(1H-MRSI)and diffusion tensor imaging(DTI)in the diagnosis of adrenoleukodystrophy and to demonstrate the involvement of fibers by using the technique of DTT.Methods 1H-MRSI,DTI and routine imaging examinations were performed in 6 patients with ALD.The values of NAA,Cho,Cr,ADC,and FA were evaluated in different regions of lesion.The involved fibers were demonstrated by using the technique of DTT.Results The ratios of NAA/Cr(0.55±0.19)and NAA/Cho(0.22±0.11)were lower(F=7.693,7.751),and Cho/Cr(2.54±0.37)was higher(F=6.348)in the initial lesions,where higher ADC values(1.49±0.36,F=5.226)and the lowest FA values(0.21±0.08,F=5.139)were also observed(P＜0.05).The decreases of NAA/Cr(1.16±0.03)and NAA/Cho(0.45±0.17)in adjacent regions were more distinct than those of remote regions(t=1.769,1.842,P＜0.05).In the developing regions,the ADC values(0.89±0.03)were lower and the FA values(0.45±0.07)were the highest.There was negative correlation between NAA/Cho and ADC values(r=-0.71,P＜0.05),and there was positive correlation between NAA/Cho and FA values(r=0.31,P＜0.05).Discontinuations and fragments of fibres were observed in corpus callosum and pyramidal tract.Conclusions Combination of 1H-MRSI and DTI can offer a sensitive method for the early diagnosis and monitor the progress of white matter.DTT can be used to directly observe the involvement of fibers.

Objective:The hemodynamic parameters of elderly patients with septic shock were measured simultaneously with pulse index continuous cardiac output(PiCCO)and thoracic electrical bioimpedance(TEB)to evaluate the accuracy of TEB and to provide empirical evidence for its clinical use.Methods:A total of 24 elderly patients with septic shock admitted to the intensive care unit of our hospital between July 2021 and December 2021 were retrospectively recruited.TEB and PiCCO hemodynamic monitoring were performed continuously in all patients, and hemodynamic data were collected for statistical analysis.Results:Cardiac output, cardiac index, stroke volume, stroke index and systemic vascular resistance measured by the two methods had no significant difference( P>0.05). The 95% confidence intervals in the Bland-Altman plots for cardiac output, CI, stroke volume, stroke index, and systemic vascular resistance were(-1.18, 1.25), (-0.65, 0.71), (-24.23, 37.00), (-12.93, 19.26)and(397.11, 425.83). In the Bland-Altman plots for cardiac output, cardiac index, stroke volume and systemic vascular resistance, 4.17% of the points(1/24)fell outside of the 95% confidence interval, and in the Bland-Altman plots for stroke index, 8.33% of the points(2/24)fell outside of the 95% confidence interval. Conclusions:TEB and PiCCO have good consistency in evaluating the hemodynamics of elderly patients with septic shock.Therefore, TEB can be recommended for community hospitals and used in elderly patients.