Objective To evaluate the value of apparent diffusion coefficients (ADCs) in the diagnosis of malignant bone neoplasms.Methods Eighteen cases with consecutive primary malignant bone neoplasms of the knee were prospectively enrolled in the study. Each patient had a controlled preoperative MRI including a SSEPI-DWI sequence. With the help of a pathologist, spatially localized histological sampling study of the postoperative specimens was performed. ADCs of viable tumor (intra- and extraosseous part), peritumoral edema (including soft tissue edema and intramedullary edema), and tumor necrosis of the neoplasms confirmed by spatially localized histological sampling or following up were calculated and compared.Results Mean ADCs of viable tumor, peritumoral muscle edema, peritumoral marrow edema, tumor nerosis, normal muscle, and normal marrow were (1.181?0.236)?10 -3mm2/s (intraosseous part)/(1.158?0.259)?10 -3mm2/s (extraosseous part), (2.347?0.233)?10 -3mm2/s, (1.997?0.119)?10 -3mm2/s, (2.230?0.208)?10 -3mm2/s, (0.486?0.313)?10 -3mm2/s, and (0.483?0.288)?10 -3mm2/s, respectively. Statistical differences were significant among all these tissues (F=153.131, P=0.000). The ADCs of viable tumor were higher than that of normal tissues (P

Objective To study the correlation between bone marrow edema (BME), the amount of joint fluid and clinical symptoms in order to strengthen further understandings about clinical significance of BME in osteonecrosis of the femoral head (ONFH). Methods Fifty-seven patients (91 hips) with ONFH proved by clinical follow-up or pathology were examined by conventional radiography, 1.5 T MRI, and radionuclide imaging. BME, necrotic area, and joint fluid were analyzed respectively in ONFH with pre- or post-collapse of the femoral head and different MR signal intensities within necrotic area.Results ①The characteristic “line-like sign” appeared on MRI in 88 of 91 affected hips, and BME was seen in the distal zone away from line(s) in 61 hips, extending to the femoral neck and intertrochanteric region. ②The ratio of the occurance of BME in the collapse was greater than that in noncollapse, and in mixed signals within necrotic area without collapse greater than pure fat-like signal (P0.05), and both were greater than noncollapse without BME (P

0.05). Conclusion There is no significant correlation between MVD and perfusion. Neovascularizaton and perfusion are highly presented in early colorectal carcinoma. SCT may be more suitable for assessing tumorigenesis than histological MVD technique.

Objective To probe the feasibility of single dose contrast enhanced magnetic resonance aortography(CEMRA) and evaluate its value in clinical application. Methods Transit time(TT) test and duration of peak enhancement of aorta(DPE) test in 28 healthy adults were performed. With 2 different injection rate of Gd DTPA at 2 ml/s and 3 ml/s, the TT,peak signal intensity of aorta(SPE),DPE and the interval between DPE and the time of injection(?T) were measured and compared. Two groups of healthy volunteers(each 10) underwent three diamentional fast imaging in static procession sequence (3D FISP) CEMRA with standard dosage of Gd DTPA with the injection rate at 2 ml/s and 3 ml/s respectively. The signal/noise ratio(SNR) of the source images and the image quality of CEMRA of both groups were compared. Fifteen patients with aortic disease did the same study as the voluteers with the injection rate only at 3 ml/s. Results With the injection rate of 2 ml/s and 3 ml/s,the TT,SPE,DPE,?T and the SNR of CEMRA in two groups were significantly different( P

Objective To evaluate the value of MRI categorization of cholesteatoma of the skull base (CSB) and its MRI diagnostic characteristic Methods The CT, MRI and pathological data of 15 patients with CSB were reviewed The CSBs were categorized into type I and type II based on the difference of signal intensity on T 1 weighted image, and the differences between the two types of CSB were compared in the aspects of CT and MRI findings and osseous encroachment of the skull base Results Extremely high signal intensity on T 2 weighted image being similar to that of cerebrospinal fluid, and unenhanced tumor parenchyma on enhanced T 1 weighted image were noted in the 15 cases of CSB Of the 15 CSBs, 6 were categorized as type I and the other 9 as type II on the basis of the difference of the signal intensity on T 1 weighted image The 6 CSBs of type I, located in the prepontine and cerebellopontine angle cisterns, appeared as homogeneous hypoattenuating on CT scan and homogeneously decreased signal intensity on T 1 weighted image coupled with unenhanced tumoral capsule and relatively normal skull base The tumor parenchyma of this type was consisted of homogeneous cholesterol crystal The 9 CSBs of type II, located in unilateral floor of middle or posterior cranial fossa, were demonstrated as mixed density on CT scan and mixed signal intensity on T 1 weighted image, of which 4 presented as decreased signal intensity scattered with increased signal intensity, 5 largely as increased signal intensity The 9 cases were noted with enhanced tumoral capsule and marked osseous encroachment of the skull base, and the parenchyma of which was mainly comprised of keratinized epithelia and proteins Conclusion The categorization of CSB into type I and type II is sensible, which reflects the distinction in both histopathology and biological behaviour between the two types of CSB and plays an important role in guiding MRI diagnosis of CSB The MRI diagnostic characteristic of CSB includes the versatile signal intensity on T 1 weighted image, marked increased signal intensity on T 2 weighted image, unenhanced tumor parenchyma and type related osseous encroachment of the skull base

Objective To summarize the types and imaging features of periosteal anomaly in osteosarcoma.Further to seek the feature of genesis and advancement of periosteal anomaly and its clinical significance.Methods One hundred and twenty-eight patients with osteosarcoma were enrolled in this study,which consisted of 76 males and 52 females aging from 5 to 66 years old with an average of 19 years.Both x-ray plain film and MR images were obtained in all patients.and DWI were done in 23 patients.CT scanning was conducted in 48 patients.which included post-contrast scanning done in 36.The pathological gross specimen,macrosection and point-to-point microsection were obtained in each of 14 cases to correlate the imaging findings of periosteal anomaly to the pathological outcome.Results The imaging and pathological finding:(1)Periosteodema,occurring in 96 patients.The sign was merely demonstratable on MR image and presented as loosened periosteal structure with no tumoral infiltration pathologically.(2)Periosteal lift and thickening,demonstratable on both CT and MR image,including 13 noted on CT and 42 on MR image.Pathologically,non-tumoral infiltration was noted in the thickened periosteum.(3)Periosteal destruction,occurring in 48 patients.Periosteal destruction was merely demonstratable on MR image and presented as localized or generalized tumoral infiltration of the periosteum.(4)Linear periosteal neo-bone formation,demonstrated in 42 cases on plain films,13 cases on CT and 22 on MR images,respectively.The linear periosteal neo-bone formation was pathologically regularly arranged periosteal neo-bone.(5)Laminar periosteal neo-bone fomarion,demonstrated in 21 cases on plain films,6 cases on CT and 21 on MR images,respectively.Pathologically,it appeared as multi-layer arrangement.(6)Radiated and spiculate periosteal neo-bone formation,demonstrated in 13 cases on plain films,7 cases on CT and 14 on MR images,respectively.On both plain film and CT,the closer to the center of the tumor,the longer and denser the spicule was.The interspiculate structure was tumoral tissue pathologically.(7)Periosteal neo-bone formation of mixed type,demonstrated in 7 cases on plain films,4 cases on CT and 8 on MR images,respectively.It was composed of 2 types or more of periosteal neo-bone.Conclusions (1)Multiform periosteal anomaly can be induced by osteosarcoma,and difierent periosteal anomaly possesses different imaging findings and different pathological basis.(2)The pathologically-based classification of periosteal anomaly generalizes the 3-modality imaging findings of various periosteal pathological alterations.(3)MR imaging enables to demonstrate periosteal anomaly more early,and periosteodema and periosteal destruction without neo-bone formation can only be demonstrated by MR imaging.MR imaging is more sensitive than CT in displaying periosteal thickening.

ObjectiveTo study MRI features and pathologic basis of various periosteal changes in rabbit VX2 bone tumor and to evaluate the role of MRI in the change of periosteum in bone tumor. MethodsBone tumor models were induced by injection of VX2 carcinoma cell suspension into the medullary cavitv of right tibias in 32 rabbits.Thirty-six positive contrast cases and 4 negative contrast cases were established.Serial plain films and MRI examinations were performed at an interval of 5 days foliowing the implantation.Every 4 rabbits were sacrificed immediately after imaging. The findings of periosteal changes were compared between imaging features and pathologic Results . ResultsFrom the 5th to 15th day after implantation of VX2 carcinoma,periosteal edema was demonstrated in 32 tibias. On the 20th day,periosteal thickening Was revealed in 19 tibias. On the 25th day,periosteal new bone with the thickened periosteum attaching to its outer Surface was found in 12 tibias. On the 30th day,periosteal new bone with the thickened Deriosteum were elevated by the tumor in 11 tibias.On the 35th to 40th day,destruction of periosteal bone and periosteum were revealed.ConclusionsThe progress of periosteal changes in rabbit VX2 bone tumor included periosteal edema,periosteal thickening,periosteal new bone,destruction of periosteal new bone and destruction of periosteum. Various periosteal changes could be demonstrated on MRI and MRI is useful in evaluating periosteal changes.

Objectiye To measure longitudinal (T1) and transverse (T2 ) relaxation time of metabolites in m. soleus (SOL) and m. tibialis anterior TA of healthy volunteers at 3.0 T through 1H-MRS and optimize measurement protocols. Methods Altogether 24 healthy volunteers were recruited in the study. All subjects signed a letter of informed consent. After divided into 2 groups randomly by the table of random number, 1H-MRS measurements with stimulated echo acquisition mode (STEAM) sequence were undertaken in SOL and TA separately. Progressive saturation method was used for T1 measurement. Spectra with 8 different TRs (770,900,1000, 1100,1200,1500,2000 and 3000ms ) were acquired with TE=20 ms.T2 time was measured by changing TE. Altogether 8 TEs (20,30,45,60,90,135,200 and 270 ms) were used with TR = 3000 ms. Metabolites' concentration was calculated through T1 and T2 correction using water as internal reference. The t test was used for statisties. Results Altogether 22 groups of data were gained ( 12 for SOL, 10 for TA ) . T1 value of water, Creatine-CH3 ( Cr3 ), Trimethyl amonium ( TMA ),extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) in SOL were ( 1384. 0 ± 36. 9 ),( 1064. 0 ± 167.0), (964. 2 ± 144. 0 ), ( 373.0 ± 46. 8 ), ( 374. 7 ± 20. 6) ms respectively and T2 value were (26.5 ±1.2), (100.2±19.3), (149. 1 ±32.7), (81.4±5.2), (84.7±4.2) ms. InTA T1 value of water, Cr3, TMA, EMCL, and IMCL were ( 1307. 0 ± 24.4), (945.7 ± 132. 0), (968.3 ± 127. 0),(372. 7 ± 39. 2), (412. 8 ±80. 2) ms respectively and T2 value were (27. 1 ± 0. 9), (135.3 ± 18. 2 ),(62.1 ± 6. 0), ( 84. 3 ± 4. 0 ), ( 90. 7 ± 3.2 ) ms. After corrected by the calculated relaxation times, the concentrations of Cr3 in SOL and TA were (33. 1 ± 3.7) and (31.7 ± 3. 1 ) mmol/kg respectively, TMA (35.2±3.2) and (32.9 ±5.2) mmol/kg, EMCL (12.2 ±5.0) and (8.9 ±4.9) mmol/kg, IMCL (9. 0 ± 2. 4) and (3.0 ± 0. 8 ) mmoL/kg. IMCL in TA was much lower than SOL with statistical significant ( t = 8. 044, P < 0. 01 ), the difference between other metabolites were not statistically significant( t = 0. 926,1. 264, 1. 542, P > 0. 05 ) . Conclusions Accurate relaxation time was measured at 3.0 T of the metabolites in skeletal muscles of healthy adult human. After corrected by the relaxation times, the absolute concentrations calculated were consistent with the reported results. Quantitative knowledge of muscle NMR relaxation time was a prerequisite for absolute quantification of metabolites using the 1H-MRS and also was useful for optimizing measurement protocols.

Objective To study the clinical, radiologic and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma for further improving the diagnostic ability.Methods The data of 10 patients with histologically proved telangiectatic osteosarcomas were retrospectively reviewed, and the clinical, radiologic and pathologic characteristics were further analysed in combination with the literature.All 10 patients were examined with X-ray and MRI, and 2 patients with CT.Results Telangiectatie osteosarcomas originated from inferior femur in 5 patients, femur neck in 1 patients, superior humerus in 2 patients and superior segment of tibia in 2 patients.The lesions showed osteolytic bone destruction on X-ray films (n = 10) and CT images ( n = 2), with mild bone expansion in 4 patients.The majority of the edge of the destroyed bone areas was unclear but without sclerotic rim.There were Codman's triangle and soft tissue mass in each patient but no obvious neoplastic bone forming.On MRI, all the lesions were mostly or completely constituted by the multiple cysts with periostnal reaction, and several scatteredly smaller liquid-liquid levels were found within cystic cavity in 7 patients.In all 10 cases, there were pathologic hemocoele similar to aneurysmal bone cysts (ABC), but malignant tumor cells and some neoplastic bones were found in cystic walls or septations.Only a small number of neoplastic bone tissue were seen by microscopy in 6 patients.Conclusions The radio-pathologic characteristics of telangiectatic osteosarcoma include the similar imaging findings of ABC, the common growth patterns of malignant tumors,and the pathologic hemocoele, malignant tumor cells within cystic wails or septations.The comprehensive analysis of clinical, radiologic and pathological data may help clinicans to make a correct diagnosis for telangiectatic nsteosareoma.

Objective To investigate the value of CT and endoscopic ultrasonography (EUS) in the diagnosis of gastrointestinal stromal tumors (GIST). Methods Eleven patients with surgically and pathologically proved GIST were collected and retrospectively analyzed.Plain CT scanning was performed in all 11 cases and enhancement in 10 cases, while additional EUS in 8 cases.Results Of the 11 lesions, 8 were located in stomach, 1 in esophagus, 1 in duodenum, and 1 in rectum, respectively.In benign GIST, the diameter of the tumor was less than 5 cm, with clear margin and homogeneous density.In malignant GIST, the characteristic appearances were as follows: (1) The diameter of the tumor was more than 7 cm; (2) The tumor was lobular in shape; (3) Lesions contained intratumoral small or large patchy necrosis; (4) The tumor had large and deep ulcers; (5) Around the tumor, small vessels arranged in clumps or in line; (6) The tumor contained scattered small calcifications; (7) Invasion of adjacent tissues and metastasis.The positive predictive value of CT for location of GIST was 54.5% (6/11), the positive predictive value of EUS was 87.5% (7/8).By pathology, benign GIST was identified in 3 cases, malignant in 7 cases, and active proliferation in 1 case.The positive predictive value of CT for differentiation of benign and malignant GIST was 72.7% (8/11), the positive predictive value of EUS was 62.5% (5/8).Conclusion CT combined with EUS are helpful in evaluating the gastrointestinal origin of GIST, and in differentiating between benign and malignant GIST, and in instructing clinical treatment and estimating prognosis.