Objective,To evaluate the value of magnetic resonance imaging(MRI) in clinical diagnosis of tuberculous meningitis.Methods,Forty-six patients (29 men,17 women,age ranged 11-72,mean age 41.5) with tuberculous meningitis were examined with MRI.The MRI findings of tuberculous meningitis were analyzed retrospectively.Results,On pre-contrast T1WI and T2WI,meningeal lesions in the basal cistern region were detected in twenty cases.Abnormal meningeal thickening and enhancement were found in 38 patients.Meningeal and cerebral miliary tuberculous foci were demonstrated in 21 cases.Ependymal involvement was found in six patients and cranial nerves were affected in other two patients.No abnormal meningeal enhancement was detected in eight mild cases.On the follow-up images in nine patients,the abnormal findings alleviated in varied degree or,remained unchanged.Conclusion,The pathological changes in tuberculous meningitis could be demonstrated effectively by specific findings on MRI.MRI,especially the post-contrast MRI,proved a reliable modality in clinical diagnosis and assessment of tuberculous meningitis.

The fluorescence of Rhodamune B could be quenched by the manner of photo-unduced electron transfer wuth Cu2-x Se nanopartucles as the energy receptor and Rhodamune B as the energy donor. However, L-cysteune was capable of recoverung the fluorescence of Rhodamune B, and the fluorescence untensuty was proportuonal to the concentratuons of L-cysteune. Based on that, a novel method for detectung L-cysteune was establushed. After muxung L-cysteune and Rhodamune B pretreated by Cu2-x Se nanopartucles at pH 4. 6 and 30℃ for 2 mun, a lunear relatuonshup was obtauned between the fluorescence untensuty of Rhodamune B at 575 nm and the concentratuons of L-cysteune un the range of 2. 5 ×10-7-1. 1 ×10-6 mol/L. Thus method was used un the determunatuon of L-cysteune wuth a detectuon lumut (3σ/k) of 5. 5×10-8 mol/L. The common amuno acuds presented luttle unterference for the L-cysteune detectuon.

Objective To evaluate the role of several imaging technology in the diagnosis of patients with mitochondrial encephalomyopathy.Methods Clinical and image findings of 11 cases of mitochondrial encephalomyopathy were retrospectively analyzed.9 patients were studied with MR,2 patients with MRA and DSA,3 patients with CT plain scan,and 1 patient with positron emission tomography (PET).Results CT and MR imaging showed multiple or migrating infarct-like lesions in 9 cases,mainly involving the posterior temporal and occipital regions which crossed vascular boundaries.Lesions were distributed in the temporo- occipital and parietal lobes in 7 cases,bilateral thalamus in 1 case,the brainstem,cerebellum,and the deep cerebral white matter in 1 case.Other lesions demonstrated as cerebellum atrophy in 1 case,syringomyelia in thoracic spinal cord in 1 case.PET showed the metabolic rate of glucose was elevated early in the acute phase and reduced in the recovery phase.Conclusion The examination combined with several imaging methods will help to improve the imaging diagnosis.

3 T CE-CMRA allows for accurate detection of coronary artery stenosis of the main coronary artery branches with high sensitivity and specificity,but is still limited in small coronary branches.

Objective To evaluate the effects of an optimized resuscitation bundle on prognosis of emergency patients with septic shock.Methods 65 patients with septic shock,admitted into emergency intensive care unit (ICU),were randomly divided into the treatment group(treated by an optimized resuscitation bundle)and the control group(treated by surviving sepsis campaign classics methods)by using random number table.The scores of sepsis-related organ failure assessment(SOFA) scores,the vasoactive agent application times,the mechanical ventilation times,the stay days of ICU,and 28-day mortality of the two groups were observed and compared.Results 3,7 day after erollment the SOFA score of the treatment group was (9.1 ± 2.5) points,(8.2 ± 2.8) points,respectively,which was lower than that of the control group[(10.1 ± 3.3) points,(9.5 ± 3.1) points] at the same time(t =4.52,3.99,all P ＜ 0.05) ; 8-day mortality rate of the treatment group was 28.1％,which was lower than that of the control group (48.5％) (x2 =12.84,P ＜ 0.05).Conclusion Application of an early optimized resuscitation bundle can significantly improve the prognosis of emergency patients with septic shock.

Objective To explore the morphological characteristics of optic tracts in healthy Chinese Han adults on the high-resolution MRI and fill the database of Chinese standard brain with morphological data of optic tracts.Methods Cerebral MRI scans with T1 WI 3D MPRAGE sequence of 1000 healthy Chinese volunteers from 15 hospitals were divided into five stages, ranging in age from 18 to 70.With the technique of multi-baseline, structure and morphology of optic tracts were displayed optimally on the images with multiplanar reconstruction.Data were measured as following: transverse distance of the cisternal optic tract (TD1) and peri-crural optic tract (TD2), length from the cisternal optic tract to the peri-crural optic tract (L) ,angle between optic tract(AOT) and height of optic tract from its first segment to plane of anterior commissure (H) including H1, H2, H3, H4 and HS.The measurements of optic tracts between sexualities and among age groups were compared by anasis of covariance; those among five age groups were compared pairwisedly by least significant difference analysis (LSD); and the differences of measurements between left and right optic tracts were analyzed using paired t test.Results (1) Comparisons of optic tract structures between male and female: the mean optic tract length of male [(11.69±1.45),(11.56±1.44) mm] was significant longer than that of female [(10.58±1.29),(10.40±1.34) mm] (F=22.236, 29.703, P=0.000); the mean H1 of male [(2.56±0.28),(2.60±0.29) mm] and female [(2.57±0.31 ), (2.63±0.32) mm] were significantly different ( F =11.130,7.805, P = 0.000, 0.005).No significant differences of the other measurements were found between male and female ( P > 0.05 ).(2) Comparisons among age groups: among 5 age groups, TD1 of both sides [left TD1 :(4.64±0.51 ), (4.64±0.57), (4.55±0.58), (4.39±0.53), (4.36±0.58)mm;right TD1 :(4.84±0.53) ,(4.80±0.60), (4.77±0.65), (4.60±0.59), (4.57±0.59) mm] and the right TD2[(3.33±0.45),(3.34±0.41),(3.33±0.36),(3.23±0.38),(3.23±0.39) mm] had statistical differences ( F = 3.458, 2.735, 4.711, P = 0.008,0.028, 0.001 ).The LSD analysis found that the 50 years old group was the watershed with significant differences ( P < 0.05 ).The results also showed that the L of both sides had statistical differences among 5 age groups ( F = 14.510,14.532, P = 0.000).The LSD analysis found that the 60 years old group was the watershed with significant differences (P <0.05).Left TD2 and the H1-H5 of both sides had no significant differences among age groups ( P >0.05).(3) Comparisons of the measurements between left and right optic tracts: TD1 of bilateral optic tracts were (4.52±0.57)and(4.72±0.60) mm respectively; H1 of bilateral optic tracts were (2.56±0.30)and (2.61±0.30) mm respectively; H2 of bilateral optic tracts were (2.66±0.30)and (2.70±0.30) mm respectively; and L of bilateral optic tracts were ( 11.14±1.47 ) and ( 10.98±1.50 )mm respectively.There were significant differences in these measurements between left and right optic tracts( t =12.460, - 6.013,5.595,4.784, P = 0.000 ), while there were no significant differences in TD2, H3, H4 and H5( P > 0.05 ).Conclusions With high-resolution MR1 and 3D reconstruction, optic tract can be displayed clearly and measured accurately.There are definite differences in anterior segments of optic tracts between sexualities, sides and among ages in normal Chinese Han adults, while the posterior segments of optic tracts keep stable.Normal reference values of optic tracts in Chinese Han adults are provided to clinical practices and scientific researches, which are valuable for building of Chinese standard brain.

Objective To evaluate 64-slice CT angiography in diagnosing spinal vascular malformations. Methods Fifteen patients,who were suggestive of spinal vascular malformations bv clinical manifestation and MRI,underwent CT angiography with a 64-slice spiral CT(GE lightspeed VCT).DSA were performed later within 1 week in all the patients and four of them were treated with operation as well.We evaluated CTA images in displaying the lesions according to the following aspects:the type of malformation,lesion range,feeding artery,draining vein and possible fistula.and compared those details with DSA and operation findings.Results All 15 patients acquired their final diagnosis by DSA and operation,which were intramedullary axteriovenous malformation in 6 cases,perimedullary arteriovenous fistula in 2,spinal dural arteriovenous fistula in 3 and Cobb syndrome in 4 cases. CTA was consistent with DSA in the classification of lesions and in the determination of the involved regions and it reveaIed the main feeding arteries and draining veins in all patients.CTA showed four arteriovenous fistulae confinned bv DSA.but it failed in a complex arteriovcnous fistula.In Cobb syndrome patients,not only the intramedullary but also paravertebral and subcutenous vascular malformation could be clearly seen on CTA images.Conclusion 64-slice CT angiography can be a preliminary method in spinal vascular malformation because it can determine the classification and reveal almost all the main lesions quickly,atraumatically.

Objective To evaluate the diagnostic accuracy of 3.0 T contrast enhanced (CE) whole heart coronary MRA ( CE MRA ) using 32-channel coils with high acceleration factor. Methods Sixty patients with suspected coronary artery disease who were scheduled for coronary angiography (CAG)underwent CE CMRA at 3.0 T MRI scanner. A 32-channel receiver coil was used for data acquisition. For image acquisition, an ECG-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence was used with an acceleration factor of three in the phase-encoding direction using GRAPPA reconstruction. Gd-BOPTA (0.15 mmol/kg body weight) was intravenously administered at a rate of 0. 3 ml/s. The diagnostic accuracy in detecting significant stenoses ( ≥50% of vessel lumen) was evaluated using χ2 test with X-ray angiography as the reference. Results Whole-heart CE CMRA was successfully completed in 56 patients who were scheduled for CAG. The averaged imaging time was ( 6. 0 ± 1.3 ) min.3.0 T CE CMRA using 32 channel coils correctly identified significant CAD in 28 patients and correctly ruled out CAD in 23 patients. The sensitivity and specificity were 93. 3% and 88.5% respectively.Conclusion Combined with dedicated 32-channel coils, 3.0 T CE CMRA allows significant reduction in imaging speed and reduced dose of the contrast agent. These improvements resulted in substantially improved overall accuracy of CE CMRA in detecting coronary artery disease.

Objective To evaluate the value of contrast-enhanced whole-heart coronary magnetic resonance angiography ( CE CMRA ) at 3.0 T in the delineation of cardiac venous anatomy. Methods Contrast-enhanced whole-heart CMRA at 3.0T was performed in 43 consecutive subjects using ECG-triggered, navigator-gated, inversion-recovery prepared, segmented gradient-echo sequence with a 32-channel cardiac coil. The visibility of the coronary veins was graded visually using a 4-point scale.Continuous variable was expressed as (-x)±s. The paired student t test was used to evaluate the differences of the coronary sinus (CS) ostium diameter in anteroposterior and superoinferior directions. Results CMRA examination was successfully completed in 40 subjects with acquisition time of ( 6. 9 ± 1.8 ) min. The cardiac veins were finally evaluated in 38 of 40 (95.0%) subjects. The mean distance of the posterior vein of the left ventricle (PVLV) and the left marginal vein (LMV) to the CS ostium were (3.34 ± 0. 90) and (6. 12 ± 1.02) cm, respectively. The mean visibility scores of CS, posterior interventricular vein (PIV),PVLV, LMV, and anterior interventricular vein (AIV) were 4.0 ± 0.0, 3.4 ± 0. 5, 3.4 ± 0. 5, 3.0 ± 0. 8,and 3. 3 ± 0. 5, respectively. The diameter of the CS ostium in the superoinferior direction ( 1.13 ±0. 26) cm was larger than that in the anteroposterior direction (0. 82 ± 0. 19) cm (t = -4. 31 ,P <0. 05).Conclusion Contrast-enhanced whole-heart CMRA at 3.0 T can clearly depict the cardiac venous anatomy.

Objective To explore a new index for reflecting the topological information of brain functional networks in patients at high risk of Alzheimer disease using characteristics of resting-state functional connectivity strengths(FCS) in patients with amnestic mild cognitive impairment(aMCI). Methods Thirty-one aMCI patients and 42 age, gender and years of education matched normal controls were enrolled between September 2009 and April 2011 in this study. The resting-state functional MRI (rs-fMRI) data of all participants were acquired and preprocessed. Then the whole-brain functional connectivities were constructed for exploring the distribution characteristics of hub regions which had higher FCS values. Using two-sample t test to compare group differences in age, years of education and each neuropsychological assessment. In addition, using Chi-squared test to compare group differences in gender. Group differences in FCS values were analyzed by general linear model. Finally, correlation analyses were used to evaluate the relationships between the FCS values of the brain regions with group differences and behavioral scores in aMCI patients. Results The hub regions of the functional networks in the aMCI patients were mainly located in the association cortices such as the precuneuses, posterior cingulate cortices, medial prefrontal cortices, angular gyri, superior occipital gyri, fusiform gyri and lingual gyri. The distribution models in the aMCI patients were consistent with those in the normal controls. However, the FCS values of these brain regions were significantly lower in the aMCI patients than those in the normal controls. In comparison to the normal controls, the aMCI patients had significantly decreased FCS values in the bilateral fusiform gyri, lingual gyri, superior occipital gyri, left middle occipital gyrus and postcentral gyrus (the cluster was 389, 230, 187 and 107 voxels, respectively;P<0.05, respectively), and they had decreased trends of FCS values in the bilateral posterior cingulate cortices and right insulas. The correlation analysis with uncorrected conditions showed that the FCS values of the left postcentral gyri were correlatid with the clock drawing test (CDT) scores (r=0.436, P=0.026). Conclusions aMCI mainly attacks the hub regions of brain functional networks. The changes of functional connectivities in aMCI may reflect the early pathophysiologic alterations of AD.