Objective To investigate the effect of imaging parameters and postprocessing methods on the quality of MR imaging of short T2 components with 3D ultrashort TE (UTE) double echo pulse sequence. Methods 3D UTE double echo pulse sequence was performed on dry human femoral specimen and the tibial diaphyses, knee joints, and tendons of ankles of a group of healthy volunteers. To investigate the effect of different trajectory delays of the imaging system(-6, -3, -2, - 1,0, 1,2, 3 s), different flip angles(4°, 8°, 12°, 16°, 20°, 24°), different TEs (0. 08, 0. 16, 0. 24, 0. 35 ms)and different postprocessing methods(difference imaging of subtracted volume and non-volume UTE)on the 3D UTE MR imaging quality, the SNR and CNR were calculated and compared, and the artifacts of the images were analysed. Results The cortical bone, periosteum, tendon and meniscus showed high signal intensity on the images of UTE pulse sequence. The best SNR was acquired with 2 s trajectory delay. The best flip angle was 8° to 12° for the human UTE imaging in vivo. The highest CNR was obtained from the TE of 0. 08 ms. The longer the TE was, the more artifacts appeared. The SNR of difference imagewas improved when image subtraction was performed afer multiplanar reconstruction (MPR) of the primary double echo images.Conclusions The short T2 components show high signal intensity on the MRI of 3D UTE double echo pulse sequence. The imaging quality can be improved by shortening TE, using appropriate flip angle and performing subtraction for difference image after MPR of the primary double echo images.

Objective:To observe the changes of left ventricular energy loss(EL) and apical wall shear stress(WSS) in patients with ventricular aneurysm by using vector flow mapping (VFM).Methods:Twenty-seven patients with ventricular aneurysm were selected as the case group, and they were divided into the ventricular aneurysm group(16 cases) and ventricular aneurysm thrombus group(11 cases) according to whether the apex of the heart was accompanied by thrombosis. Twenty healthy people were collected as the control group. Ventricular structure and cardiac function parameters were measured and the VFM offline analysis was performed. Systolic and diastolic phases were determined based on time-flow curve(T-F curve) and the open-close of valves, the corresponding left ventricular energy loss and the parameters of the WSS of the apex segment of the heart were obtainedand then compared between groups.Results:①In diastolic and systolic phases, EL values of left ventricular apical segment in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than that in control group (all P<0.05). ②In diastolic phase, the peak WSS values of septal apical, lateral apical and anterior apical segments in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group (all P<0.05), and the mean WSS of anterior apical segment in aneurysm group was lower than that in control group ( P<0.05). ③In systolic phase, the peak WSS values of anterior wall in ventricular aneurysm group and ventricular aneurysm thrombus group were lower than those in control group, and the mean WSS of anterior wall in ventricular aneurysm group was lower than that in control group (all P<0.05). The mean WSS of anterior wall in ventricular aneurysm thrombus group was higher than that in ventricular aneurysm group( P<0.05). Conclusions:VFM technology can quantitatively evaluate the EL and WSS of patients with left ventricular aneurysm, and provide a new perspective for further understanding of intracardiac hemodynamics in patients with left ventricular aneurysm with or without thrombus.

Objective To investigate the application of 3D ultrashort TE double echo pulse sequence in the bone and joint MR imaging. Methods Eight volunteers and a porcine fibula in vitro with intact muscle were involved in this study. Among the volunteers, one was suspected with meniscus tear, the others were asypmtomatic. MR imaging of 3D ultrashort TE double echo pulse sequence were performed on the tibial diaphysis, knee joint, ankle and wrist of each volunteer and the porcine fibula in vitro. Using the first echo images subtract with the second echo images, we observed the subtracted images from the primary double echo images and MPR images respectively. We then compared the difference of SNR. Four different echo times of the first echo (TE1) in the images were set as 0. 08 ms, 0. 16 ms, 0. 24 ms, 0. 35 ms. The quality of the subtracted images from the primary double echo images of the four different TE1 was compared.The MIP images from the primary double echo images with TE1 of 0. 08ms were performed to display the 3D structure of the ankle tendons. The data were analysed with One-Way ANOVA and Paired-Samples t test statistically. Results The 3D images of the tendons were displayed through MIP of the subtracted images from the primary double echo images. The cortical bones, periosteums, tendons and menisci of the 8 volunteers appeared as high signal intensity in UTE pulse sequence. The SNR of the subtracted images from MPR images (SNR, 3.76 ± 0. 88) was significantly higher than those from the primary double echo images(SNR,2. 82±0. 75) (t = - 4. 851, P < 0. 01). There were significant differences among the subtracted images from each of the four different TE1. The highest quality were obtained from the TE1 of 0.08ms. The CNR were as follows: CNR<,0.08ms>1.74±0. 54, CNR<,0.16ms> 1.35 + 0. 60, CNR0.24ms>1.20±0. 48,CNR<0.35ms> 0.89±0. 24 (F = 3. 681, P < 0. 05). The artifacts appeared markedly with prolonging of the TE1.Conclusion The MRI of ultrashort TE double pulse sequence may display the short T2 components that appeared as low signal with conventional clinical MR imaging, which made it pessible to quantify the tissues containing a majority of short T2 components.

Objective To demonstrate the feasibility of DTI in human calf with body phased-array coil and surface coil of spine as receiving coil on 3 T system, and to optimize the parameters of sequence, including slice thickness and b-value. Methods Fifteen healthy volunteers were recruited in this study and randomly divided into three groups. The DTI sequence for head was performed on calf in the first group (5 cases), and the sequence parameters were optimized based on the deficits of the raw and the post-processed DTI images. Then, different slice thickness were applied in the senond group (5 eases) to optimize the slice thickness, and this optimized parameter with the highest score based on quality of the post-processed DTI images was applied in the next step. Finally, different b values were applied in the last group to optimize this parameters. The b value with the highest score based on the quality of the pest-processed was the proper one. Results Three problems existed in the raw and the pest-processed images, when the DTI sequence for brain was used for the calf. First, the SNR of raw images is extremely low. Second, the muscle were unclear on the image with parts of signal lose, especially in the anterior tibialis muscle. Finally, the artifacts due to chemical shift and ghost are quite serious. The scores for muscle display quality with slice thickness of 4 mm , 5 mm and 6 mm were (7.0±0. 0), (8.6±0. 9) and (9.0±0. 0) score respectively, the signal less scores were (5.0±0. 0) and ( 12. 8±2. 6) and ( 13. 8±2. 2) score respectively, and the general score were (22. 0±0. 0) and (30. 1±3.8) and (31.0±4. 1 ) score respectively. The differences of above scores were significant among different slice thickness (F-value were 21. 000 and 30. 544 and 12. 390 respectively, P <0. 05 ). The muscle displaying quality, signal loss and general scores were lowest in group with 4 mm slice thickness (q-value were 4. 896.6. 120,6. 327,7. 138,3. 863 and 4. 043, P < 0. 05 ) o The scores of muscle display quality, signal loss and general for b =400 s/mm2 were (9. 0±0. 0), ( 14. 0± 2. 2 ) and ( 33.0±2. 2 ) score respectively, which were lower than those with b = 800 s/ram2 [(7.0±0.0), (6.2±2.2), (21.8±3.4) score] and b=1000 s/mm2[(7.0±0.0), (5.0±0.0), (20.6±2.2) score] (q-value were 3.873,3.873,6.650,7.672,7. 101 and 5.917, P <0.05)o The scores of muscle displaying quality, signal loss and general for b =600 s/mm2 were (8.2±1.1 ), ( 13.0± 2. 3) and ( 30. 8±3. 8 ) score respectively, which were higher than those with b = 800 s/mm2 and b= 1000 s/nun2 (q-value were 3.873, 3.873, 5.797, 6.820, 5.326 and 5.917, P <0.05).There is no significant difference between b = 600 s/ram2 and 400 s/ram2 ( q-value were 2. 582 and 0. 852 and 1. 775, P > 0. 05 ). Conclusion Our preliminary findings indicate that it is feasible to perform DTI on human calf with 3 T MR. With body phased-array coil and surface coil of spine as receiving coil, the DTI sequence were optimized to acquire enough SNB with slice thickness of 5 mm and b-value of 400 s/mm2.

Objective To evaluate the value of DTI in mild articular cartilage injury in patellofemoral joint.Methods The DTI and arthroscopy data of 82 patients wih routine MRI diagnosed as mild articular cartilage injury were analyzed retrospectively.According to the results of arthroscopy,40 cases of mild articular cartilage injury with Outerbridge classification Ⅰ or Ⅱ were divided into experimental group,and 33 cases with normal patellofemoral articular cartilage were divided into control group.There were 8 articular cartilage injury patients with Outerbridge classification Ⅲ or Ⅳ in patello-femoral join were excluded.The DTI data were analyzed compared with arthroscopy.Results Arthroscopy detected 62 lesions of cartilage injury in experimental group.Totally 49 lesions (49/62,79.03 ％) were detected by ADC pseudocolor image and 51 lesions (51/62,82.25 ％) were detected by FA pseudocolor image.The DTI pseudocolor images of articular cartilage injury showed uneven levels.The red or pink levels can been observed.Compared with the control group,ADC value increased and FA value decreased significantly in experimental group (both P＜0.05).Conclusion DTI can clearly display and detect mild articular cartilage injury in patellofemoral joint,which provide valuable information for early cartilaginous injury.

Objective To assess the effects of two different managements of typeⅢsupracondyla humeral fractures in children: open reduction vs closed reduction and pinning. Methods Relevant articles were identified by using several database (Pubmed Medline, EMbase, cochranelibrary, CBM, CNKI, wanfang data). Control studies comparing closed reduction with percutaneous pinning and open reduction with pinning were analyzed.Results There was no significant difference in the carrying angle according to criteria of Flynn(OR=0.92,P=0.760).There was no significant difference in the functional results according to criteria of Flynn(OR=1.77, P=0.557).There was no significant difference in the ulnar nerve injury(OR=1.10,P=0.332).However, there was a obvious tendency to excellent and good results in the closed reduction group. Conclusions We recommend that closed reduction with percutaneous pinning should be performed first unless some special circumstances are present, for example:complex fractures and failed closed reduction.

OBJECTIVETo investigate the value of water enema (18)F-fluorodexyglucose positron emission tomography and computed tomography((18)F-FDG PET-CT) in incidental finding of hypermetabolism focus in the colon and rectum for differential diagnosis of benign or malignant lesions.

METHODSFrom June 2010 to December 2012 in our hospital, 77 patients were found incidentally with uncertain hypermetabolism focuses in the colon and rectum during PET-CT examination. Water enema (18)F-FDG PET-CT was performed to classify the lesions. According to the pathological examination and clinical follow-up, these cases were divided into malignant disease (including advanced colorectal adenoma), benign adenoma, inflammation and physiological uptake. Radioactive uptake level (SUVmax) and change of water enema imaging (retention index, RI) of hypermetabolism focus were compared between groups.

RESULTOf these 77 cases, 23 were malignant diseases, 16 benign adenoma, 7 inflammation and 31 physiological uptake. The difference of average SUVmax was not statistically significant between benign and malignant lesions as well as physiological uptake(P>0.05). But the difference of RI was statistically significant between neoplastic lesions and inflammation(P<0.05). The accuracy of water enema (18)F-FDG PET-CT in diagnosing non-neoplastic uptake was 100%, and the sensitivity, specificity and accuracy in differentiation of malignancy form benign lesions were 95.6%, 96.3%, and 96.1% respectively.

CONCLUSIONSThe incidental focal colorectal (18)F-FDG uptake in PET-CT may indicate potential colorectal malignant lesions and adenoma. Water enema can effectively differentiate the physiological uptake and predict benign lesions or malignancy in the colon and rectum colorectum with good accuracy.

Adenoma ; Colorectal Neoplasms ; diagnostic imaging ; Diagnosis, Differential ; Enema ; Fluorodeoxyglucose F18 ; Humans ; Incidental Findings ; Positron-Emission Tomography ; Radiopharmaceuticals ; Tomography, X-Ray Computed ; Water

Objective To investigate the value of a clinical-CT radiomics model in predicting cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods A total of 262 cases with PTC confirmed by pathology after surgery were selected.On CT arterial phase images,the PTC was outlined layer by layer via software 3D-slicer to extract CT radiomics features.The least absolute shrinkage and selection operator(LASSO)algorithm was used for dimensionality reduction and feature screening in relation to CLNM.The Mann-Whitney U test or Chi square test was performed to identify clinical parameters significantly associated with CLNM.The statistically significant CT radiomics features and clinical parameters were all selected for the multivariate logistic regression analysis to construct the clinical-CT radiomics model.The predictive efficiency of model was evaluated via the receiver operating characteristic(ROC)curve.Results The clinical-CT radiomics model demonstrated favorable predictive performance in both the training group[area under the curve(AUC)0.804,sensitivity 68.7％,specificity 82.4％]and the validation group(AUC 0.782,sensitivity 84.4％,specificity 61.8％).Conclusion The clinical-CT radiomics model demonstrates significant value in predicting CLNM of PTC,thereby,aiding in the development of personalized clinical plans for cervical lymph node(CLN)dissection.

Objective:To investigate the pathogenesis, selection of endovascular treatment (EVT) strategies, and efficacies of acute vertebrobasilar artery occlusion (AVBAO) of different lesion sites.Methods:One hundred and five patients with AVBAO, admitted to and accepted EVT in our hospital from February 2017 to September 2019, were chosen in our study. The data of disease onset, imaging findings, EVT status, perioperative complications, and prognoses of these patients were collected. According to DSA results, the involved lesions were divided into 4 sites: the upper segment of basilar artery (BA), the middle segment of BA, the lower segment of BA, and the intracranial segment of vertebral artery (V4 segment), and patients with tandem lesions would be recorded as distal lesions. The risk factors, EVT strategies, and prognoses 90 d after follow-up (modified Rankin scale [mRS] scores≤3: good prognosis) were compared in patients with 4 different lesion sites.Results:There were significant differences in etiological classifications and percentage of patients combined with atrial fibrillation among patients with 4 different lesion sites ( P<0.05). There was significant difference in proportion of patients accepted emergency stent implantation among patients with 4 different lesion sites ( P<0.05): those with lesions at the V4 segment had the highest proportion of patients accepted emergency stent implantation (79.55%), followed by those with lesions at the lower segment of BA (50.00%). There was significant difference in EVT time (the time from arterial puncture to successful recanalization of occluded vessels) among patients with 4 different lesion sites ( P<0.05): the EVT time in patients with lesions at the middle segment of BA was the shortest (87.5 [58.5, 130.8] min), and the EVT time in patients with lesions at the lower segment of BA was the longest (115.0 [81.0, 163.0] min). There was no statistical difference among patients with different lesion sites in good prognosis rate 90 d after follow-up ( P>0.05). Conclusion:The pathogenesis of patients with different AVBAO lesion sites is different, so different EVT strategies should be adopted.

Objective:To investigate the efficacy and safety of endovascular recanalization treatment for acute vertebral basilar artery occlusion (AVBAO) underlying intracranial atherosclerotic disease (ICAD) using a balloon-mounted stent.Methods:A total of 16 cases of consecutive AVBAO patients who underwent endovascular treatment with the balloon-mounted stent within 24 h after onset were retrospectively enrolled in Henan Provincial People′s Hospital from February 2017 to August 2019. And the recanalization rate, operation-related complications, symptomatic intracranial hemorrhage, the improvement of 1 week National Institutes of Health Stroke Scale (NIHSS) score and 3 months modified Rankin Scale (mRS) after treatment were recorded.Results:In all of the 16 patients, 4 patients underwent direct stenting angioplasty, 12 patients received salvage stenting. Stent placement was successful in all 16 patients. Balloon-mounted stent were implanted in basilar artery of 4 cases, in intracranial segment of vertebral artery of 8 cases, and in origination segment of vertebral artery of 4 cases. Recanalization was successful (thrombolysis in cerebral infarction grade 2b and 3) in 15 patients. The time between arterial puncture and recanalization was 79.0 (72.3, 109.3) min. One patient experienced distal thrombosis during surgery. Two patients suffered symptomatic intracranial hemorrhage within 48 h after surgery. The scores of the NIHSS were improved more than 4 points at 1 week after operation in 8 patients. At 3 months follow-up, 9 patients had a good outcome (mRS 0-3 points) and 4 patients died.Conclusion:Selective stenting angioplasty treatment with a balloon-mounted stent seems to be feasible and safe for AVBAO patients underlying ICAD.