Objective To explore the MRI characteristics of saddle transverse carpal ligament (TCL)of patients with idiopathic carpal tunnel syndrome (CTS). Methods The clinical diagnosis of 21 cases of idiopathic CTS patients (22 wrists) were retrospectively analyzed and as the idiopathic CTS group. Thirty two patients without CTS symptoms or TCL and volar soft tissue lesions (33 wrist joints) were selected as the control group. Patients in two groups were both conducted with sagittal and axial MRI scan of wrist joint to observe the form of the TCL, determine whether the TCL saddle and calculate the TCL palmar concave curvature and the median nerve compression rate. The differences of the morphology of the TCL of patients in two groups were compared by Chi?square criterion, and the difference of the TCL palmar concave curvature were compared by non parametric test. The relativity of TCL palmar correlation concave curvature and compression ratio of the median nerve of patients with idiopathic CTS was evaluated by the Pearson correlation analysis.Results The sagittal plane of patients with idiopathic CTS was upper, saddle shaped TCL was dented to the palmar and the concave point most frequently located in the hamate hook. Thirty one patients were with saddle shaped TCL (20 patients with idiopathic CTS and 11 patients in the control group) and 24 patients were with non saddle shaped TCL (2 patients with idiopathic CTS and 22 patients in the control group) as the standard of saddle shaped TCL concave 0.25 mm and the difference of the morphology of the TCL of patients in two groups had statistical significance (χ2= 17.791, P<0.01). The median of TCL palmar concave curvature of patients with idiopathic CTS and patients in the control group was 8.49%and 0.00%, respectively, the difference of which was statistically significant (Z=-4.79, P<0.01). The level of the median nerve, the TCL palmar concave curvature [(7.88+4.28)%] and the median nerve compression rate [(39.36 + 19.43)% ] of patients with idiopathic CTS were positively correlated (r=0.714, P<0.01). Conclusions Saddle shaped TCL is the characteristic manifestation of patients with idiopathic CTS. The TCL sagittal concave palm and median nerve compression percentage rate are both helpful to the accurate diagnosis.

Integrins are a family of cell adhesion receptors that mediate cell-cell and cell-extracellular matrix adhesion, and interact with cytokines through a bidirectional signal transduction,thus regulating the biological behavior of pancreatic cancer cells,such as proliferation,apoptosis,invasion,and migration etc. Molecular and animal studies indicated that integrins targeted methods might benefit the early diagnosis and drug therapy of pancreatic cancer,which offered a new approach for the study of diagnosis and treatment of pancreatic cancer.

Objective To seek an approach to differentiate between tumors from parotid space and from parapharyngeal space on axial CT or MR imaging. Methods Forty-five patients with tumors originated at the parotid or parapharyngeal space were reviewed retrospectively. The diagnosis was confirmed pathologically in all of the cases. The correlation among neoplasms and the posterior belly of digastric muscle and its shifting situation were evaluated on axial CT or MRI scans by two senior radiologists. All of the estimations were compared with the results of operation. Results Twenty-seven tumors from parotid space were located in the superficial side to the posterior belly of digastric muscle and pushed it medially. On the contrary, 18 neoplasms from parapharyngeal space were situated at the profound side to the posterior belly and shifted it laterally. Conclusion Tumors superficial to the posterior belly of digastric muscle and pushing it medially indicate that they come from parotid space. While neoplasms profound to the posterior belly of digastric muscle and shifting it laterally mean that they come from parapharyngeal space.

Discoidin domain receptor 1(DDR1)is a kind of receptor tyrosine kinases(RTKs),which is expressed abnormally in many tumors. It is involved in the development,invasion and metastasis process of tumors and may become a potential target of tumor therapy. This article reviewed the expression and significance of DDR1 in tumors of digestive system.

Objective To study MRI features of fibroma of tendon sheath(FTS)and giant cell tumor of tendon sheath(GCTTS), so as to improve the diagnosis and differential diagnosis of two lesions. Methods Seventeen patients with FTS and 27 patients with GCTTS confirmed by operation and pathology were retrospectively analyzed. All patients were examined with MRI. The location, size, shape and the relationship with the surrounding tissue, the signal feature and enhancing pattern of the two groups were compared. Imaging features in the two groups were assessed and analyzed by using independent samples t test and Chi-square test. Results FTS were nodular or mass-like lesions(n=11). Few lesions appeared adjacent bone absorption(n=2). On T2WI, the lesions showed peripheral low signal ring(n=6)or internal mixed low-signal intensity of was striped or filamentous configurations(n=10). The volume of low-signal intensity accounted for more than 2/3 of the total lesion's volume(n=6). Enhanced T1WI, tumors revealed ring enhancement(n=6). GCTTS appeared mostly lobulated(n=16), common with adjacent bone compressive absorption(n=9). On T2WI, most of lesion had a peripheral low signal ring(n=22). Tumors revealed mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass(n=17), the area of low signal accounts for less than 1/3 of total neoplastic volume(n=18). On contrast T1WI, GCTTS appeared heterogenous enhancement. Statistical analysis showed that the shape of the lesion, the presence or absence of compressive bone absorption, the presence of a low signal ring around the lesion, the shape of the Low-signal in T2WI and the proportion, and the presence of circumferential enhancement(P<0.01), there were statistically significant differences between the two. And there was no statistically significant difference in the age, gender and location of disease(P>0.05). Conclusion FTS and GCTTS has a different characteristic of MRI features. FTS were nodular or mass-like, T2WI signal was mixed low, the shape of the low-signal was striped or filamentous, accounting for more than 1/3 of total lesion's volume, enhanced T1WI, tumor shows ring enhancement;GCTTS appears mostly lobulated.Most of lesion has low signal ring, common with adjacent bone compress compressive absorption. T2WI, tumor reveals mixed high signals intensity with granular or patchy irregular low signal intensity scattered in the mass. The area of low signal accounts for less than 1/3 of total neoplastic volume.

Objective To explore the imaging appearances of periprosthetic osteolysis after total hip arthroplasty(THA).Methods Imaging appearances of periprosthetic osteoleysis after THA in 24 cases confirmed by surgery and pathological examination were retrospectively analyzed.Twenty-four patients underwent X-ray examinations,and 17 of them underwent CT scanning additionally.Results (1) Location and type:Of the 24 cases with periprosthetic osteoleysis,23 femurs were involved (95.8％,expansile type in 15 cases and liner type in 8 cases).Lesions were located in Gruen 1-2 and 6-7 region (34.8％) in 8 cases,in Gruen 1 and 7 region in 8 cases (34.8％),in Gruen 1-7 region in 6 cases (26.0％),in Gruen 2-3 and 6 region in one case (4.3％).A total of 21 actabulums were involved (87.5％,expansile type in 14 cases and liner type in 7 cases included),with lesions located in Delee Ⅰ-Ⅲ in 14 cases (66.7％),in Delee Ⅰ and Ⅲ in 4 cases (19.0％),in Delee Ⅱ-Ⅲ in 2 cases (9.5％) and in Delee Ⅰ-Ⅱ in 1 case (4.8％).(2) Features of lesions:Adjacent cortex of the lucency lesion appeared irregular thin in 24 cases (100％),focally discontinuous in 18 cases (75.0％),disrupted in 16 cases (66.7％),and accompanied by a few tiny bony fragments in 10 cases (41.7％).Cortical thickening were seen near the lucency lesion in 3 cases(12.5％).Twenty-one cases (87.5％) presented with sclerotic margins,18 cases (75.0％) with crateriform interface.Of the 17 cases which underwent the CT scanning,16 cases (94.1％)had soft tissue mass.(3) Change of the prosthesis:Twenty-one cases (87.5％) presented with linear wear,11 cases (45.8％) with bony defect near the screw.The screw penetration was seen in 3 cases (12.5％),fractured screws were seen in 2 cases (8.3％),and screw invagination was seen in 1 case (4.2％),metal debris was seen in 12 cases (50.0％).(4) Complications:Nineteen cases (79.2％) presented with femur periprosthetic loosening,16 cases (66.7％) with actabulum periprosthetic loosening.Eleven cases (45.8％) presented with femur periprosthetic fractures,5 cases (20.8％) with actabulum periprosthetic fractures.Two cases (8.3％) had periprosthetic dislocation.Conclusions Linear or expansile lucent lesion of the bones around the prosthesis after THA,together with soft tissue mass and the imaging of linear wear can be diagnosed as the periprosthetic osteolysis.

Background:Pancreatic cancer is obscure in onset and progresses rapidly with very poor prognosis. Photodynamic therapy( PDT)has been developed as a novel anti-tumor treatment modality since 1980s. At present,there are only limited researches on pancreatic cancer treated with PDT in vivo. Aims:To investigate the efficacy of quantum dots-RGD ( QDs-RGD)based PDT combined with gemcitabine for treatment of pancreatic cancer xenograft in nude mice. Methods:QDs-RGD probe was synthesized and nude mice bearing pancreatic cancer xenograft was established. Nude mice were imaged at 1,5,10 and 24 hours after injection of QDs-RGD and QDs by in vivo imaging system. Forty model nude mice were randomly divided into five groups:control group( without any treatment),simple illumination group( laser 630 nm, 120 J/cm2,20 min),PDT group(QDs-RGD 0. 5 nmol+laser irradiation),gemcitabine group(gemcitabine 50 mg/kg)and combination group(QDs-RGD 0. 5 nmol+laser irradiation+gemcitabine 50 mg/kg). All the nude mice were sacrificed 18 days later. Tumor weight and volume were measured and tumor inhibition rate was calculated. Results:Fluorescence of tumor was shown 1 hour after injection and became clearest at the 5th hour,then showing a decrescendo trend. Density of QDs surrounding tumor was significantly less than that of QDs-RGD and faded away at the 10th hour. Tumor weight and volume in PDT group,gemcitabine group and combination group were all significantly lower than those in control group and simple illumination group(P<0. 01),and those in combination group were significantly lower than those in PDT group and gemcitabine group(P <0. 05). No significant differences in tumor weight and volume were found between control group and simple illumination group(P >0. 05),as well as between PDT group and gemcitabine group(P >0. 05). Tumor inhibition rate in combination group,gemcitabine group and PDT group was 70. 5%,43. 5% and 37. 1%, respectively. Conclusions:QDs-RGD based PDT combined with gemcitabine can inhibit the growth of pancreatic cancer xenograft in nude mice,which introduces a new idea to the treatment of pancreatic cancer.

Objective To evaluate the clinical effects of open reduction plate screw nail internal fixed and minimally invasive elastic intramedullary nail internal fixation combined with neck strap suspension for treating adult humeral shaft fracture . Methods A retrospective analysis was made on the clinical data of 65 patients with humeral shaft fracture in our hospital from March 2012 to March 2014 ,including 38 cases of open reduction plate screw internal fixation (plate screw nail fixation group) and 27 cases of limited open or closed reduction elastic intramedullary nail internal fixation combined with neck strap suspension (elastic intramedullary nail group) .The operation time ,intraoperative blood loss amount ,iatrogenic radial nerve injury ,occurrence rate of incision infection ,postoperative fracture reduction degree ,fracture recovery time and elbow joint function score were compared be‐tween the two groups .Results The operation time and intraoperative bleeding volume in the elastic intramedullary nail group were less than those in the plate screw nail fixation group ,the differences were statistically significant (P<0 .05);the postoperative frac‐ture healing rate had no statistically significant difference between the two groups (P>0 .05) ,the postoperative shoulder and elbow joint function scores in the plate screw nail group were significantly higher than those in the elastic intramedullary nail group ,the difference was statistically significant (P<0 .05) .No serious nerve damage ,incision infection and other postoperative complications occurred in the two groups .Conclusion Both the open reduction plate screw nail internal fixation and elastic intramedullary nail in‐ternal fixation are effective method for treating adult humeral shaft fracture ,the latter has shorter operation time ,less intraoperative bleeding ,but shoulder elbow pain and limitation of motion are more serious than the former .

Objective To evaluate the value of MR threedimensional arterial spin labeling (3D-ASL) perfusion imaging and intravoxel incoherent motion(IVIM) DWI in differential diagnosis and quantitative analysis of musculoskeletal tumors.Methods Forty-four patients with musculoskeletal tumors were included.According to pathologic results,there were 12 cases of benign tumors,10cases of intermediate tumors and 22 cases of malignant tumors.3D-ASL and IVIM DWI were both performed on forty-four patients to gain tumor blood flow (TBF),standard ADC (ADCstandard),slow ADC (ADCslow)and fast ADC (ADCfast).Immunohistochemical staining of specimens was performed by using CD34 monoclonal antibody to calculate microvessel density (MVD) counts.MVD,TBF,ADCfast and ADCslow of different groups were compared by one-way ANOVA analysis.ADCstandard was compared by Kruskal-Wallis test.ROC curve was used to analyze ASL and IVIM DWI,in order to determine the threshold and diagnostic reliability.Results The MVD of benign tumors was 10±4,the MVD of intermediate tumors was 15±6,and malignant tumors was 33 ± 1 1.There was significant difference among three groups of MVD(F=28.33,P＜0.05).There was better intra-observer agreement for ADCstandard,ADCfast,ADCslow and TBF(ICC=0.970,0.885,0.778,0.891,respectively,P＜0.05).The TBF of benign tumors was(30±10)ml· min-1· 100 g-1,intermediate tumors was(30± 12) ml·min 1· 100 g-1,and malignant tumors was(84±29)ml·min 1· 100 g-1.There was significant difference among three groups of TBF(F=32.34,P＜0.05).According to the ROC analysis,when the cut-offvalue of TBF was 45.5 ml·min-1· 100 g-1,the area under ROC curve was 0.95 1,and the sensitivity and specificity of TBF in diagnosing malignant tumors were 90.9％ and 95.5％ respectively.There was no significant difference among three groups of ADCstandard,ADCfastand ADCslow of benign tumors were(9.9±5.1)× 10-3,(1.9±0.5) × 10-3mm2/s respectively.ADCfast and ADCalow of intermediate tumors were(8.2 ± 3.6) × 10-3,(1.5 ± 0.6) × 10-3mm2/s respectively.ADCfast and ADCalow of malignant tumors were (16.9 ± 5.8) × 10 3,(1.4 ± 0.6) × 10-3mm2/s respectively.There were significant difference of ADCfast and ADCslow among three groups (F=12.75,5.60,P＜ 0.05).According to the ROC analysis,when the cut-off value of ADCfast was 9.4× 10-3mm2/s,the area under ROC curve was 0.861,the sensitivity and specificity of them in diagnosing malignant tumors were 95.5％ and 68.2％ respectively.Conclusion 3D-ASL and IVIM DWI are valuable in the differential diagnosis of musculoskeletal tumors.

Objective To explore the relationship between the tumor angiogenesis index (microvessel density,MVD)and biological behavior of the tumor.To analyze the correlations between TBF,standard ADC,fast ADC,slow ADC and MVD counts.Methods From March 2013 to June 2013,a total of 40 patients were involved in the study.3D-ASL and IVIM DWI were both performed on patients with musculoskeletal tumors.TBF,standard ADC,slow ADC,fast ADC were measured by regions of interest.Immunohistochemical staining of specimens were performed by using CD34 monoclonal antibody to calculate MVD counts.Group differences in MVD were assessed by using one-way ANOVA.The correlations between TBF,standard ADC,fast ADC,slow ADC and MVD counts were evaluated using Pearson correlative analysis.Results The MVD of benign tumors was (10.38±4.58)/0.26 mm2,the MVD of intermediate tumors was (14.64±6.69)/0.26 mm2,and the MVD of malignant tumors was (32.97±11.61)/0.26 mm2.The differences of MVD among three groups were statistically significant (F=28.83,P＜0.05).The differences of MVD between benign and malignant group were statistically significant (P＜0.05),as well as intermediate and malignant group (p=0.000).There was a significant positive correlation between TBF and MVD (r=0.784,P=0.000),as well as the correlation between TBF and fast ADC(r=0.727,P=0.000).There was a moderate positive correlation between fast ADC and MVD (r=0.516,P=0.000).There were no significant correlation between slow ADC and MVD,or between standard ADC and MVD.Conclusion The MVD represents the angiogenesis of musculoskeletal tumors,reflecting biological behavior of the tumor.ASL and IVIM DWI can be applied to evaluate the angiogenesis of musculoskeletal tumors by reflecting MVD of musculoskeletal tumors in vivo as a completely noninvasive technique.