1.Whole Body Diffusion-weighted MR Imaging Study of Bone Marrow in Healthy Adults
Xian XU ; Lin MA ; Ningyu AN ; Youquan CAI ; Xinqiu LIU
Chinese Journal of Medical Imaging 2013;(6):401-405,410
Purpose To explore the correlation between whole body magnetic resonance diffusion-weighted imaging (WB-DWI) quantitative parameters of healthy adults' bone marrow with gender, age, height, weight, body mass index, and sex hormone levels. Materials and Methods 108 healthy adult subjects in different age groups underwent WB-DWI scan using GE 1.5T MR scanner, among them estradiol and progesterone levels were measured in 60 subjects within 48 hours before or after the scan. Apparent diffusion coefficient (ADC) values of bone marrow and the signal to noise ratio (SNR) were compared among different gender and age groups. Partial correlation analysis was used to evaluate the correlation of skeletal system ADC values and SNR with sex, age, height, weight, body mass index, estradiol and progesterone levels in 60 subjects. Results ADC values and SNR of the female subjects were significantly higher than males (P<0.01);there were significantly differences for skeletal system ADC values and SNR in different age groups (P<0.01). Skeletal system ADC values was significantly negatively correlated (r=-0.642, P<0.01) with age, and were mildly positively correlated (r=0.278, 0.271, P<0.05) with estradiol and progesterone levels;SNR was significantly negatively correlated (r=-0.709, P<0.01) with age, and was mildly positively correlated (r=0.293, P<0.05) with estradiol levels;ADC values and SNR had no significant correlation with height, weight and body mass index. Conclusion Skeletal system ADC values are effected by gender, age and sex hormone levels, the skeletal system WB-DWI manifestations are different in different gender and age groups.
2.Comparison of whole body MR diffusion weighted imaging and skeletal scintigraphy In detecting bone metastasis
Xian XU ; Lin MA ; Jinshan ZHANG ; Youquan CAI ; Baixuan XU ; Liuquan CHENG ; Gao GUO
Chinese Journal of Radiology 2008;42(6):636-640
0bjective To evaluate the application of whole body MR diffusion weighted imaging (DWI)in the detection of bone metastasis using skeletal scintigraphy as the referenee.Methods Fonv.two healthy volunteers and 38 patients with malignant tumors were enrolled in our studv.A11 the patients received MR examination and skeletal scintigraphy within one week.MR examination was performed on GE signa 3.0T MR scanner using a build.in body coil.The skeletal system Was divided into eight regons and the images of the whole body MR DWI and skeletal seintigraphy were reviewed to compare the two modalities patient by patient and region by region.The images were reviewed separately by two radiologists and two nuclear medicine physicians,who were blinded to the results of another imaging modality.Results A total of 169 metastatic lesions in 69 regions of 30 patients were detected by whole body MR DWI while 156 lesions in 68 regions of 29 patients were identified by skeletal seintigraphy.There were two cases negative in scintigraphy but positive in whole body MR DWI and one case positive in scintigraphy only.There were eight lesions negative in scintigraphy but positive in whole body MR DWI,mainly located in the spine.pelvis and femur.Seven 1esions were only detected by scintigraphy,mainly located in the skull.sternum.clavicle and scapula.Conclusion The whole body MR DWI reveals excellent consistency with skeletal scintigraphy regarding bone metastasis.and the two modalities are complementary for each Other.
3.The curative effect of inner stents on the treatment of malignant esophageal stenosis
Yiming LI ; Youquan XU ; Zhen YANG ; Guodong WANG ; Jinshui XU ; Lihua TONG
Chinese Journal of Primary Medicine and Pharmacy 2010;17(8):1047-1048
Objective To observe the effect and safety of home-made metallic stent implantation in the treatment of malignant esophageal stricture. Methods Among 47 cases with malignant esophageal stricture, there were 8 cases in superior esophagus, 12 cases in middle esophagus,27 cases in inferior esophagus, and 12 cases with gastric cardia carcinoma. Those cases were not suitable or willing to accept surgical operation. Before stenting, radiotherapies were not done in all cases. Different shape home-made metallic stents were used to place the segment of structure via mouth according to the positions and diameters of esophageal stricture. The follow-up periods was 5 ~ 16 months. Results 48 stents were implanted successfully in 47 patients. After operation,swallow was improved in all patients. No major complications occurred in these groups. Restenosis occurred in the third month post-operation in 1 case owing to tumor relapsed and grew at proximal stent, and another stent was implanted successfully. Conclusions Stents implantation for malignant stricture can effectively and safely relieve the dysphasia.
4.Clinical study on microcirculation resistance index for predicting major adverse cardiac events after PCI operation in patients with ST segment elevation myocardial infarction
Shixiang WANG ; Wei XU ; Youquan CHEN ; Zhifeng LU ; Ximing CHEN ; Cibin CHEN
Chongqing Medicine 2017;46(13):1779-1781,1785
Objective To investigate the clinical value of the index of microcirculation resistance(IMR) in the prediction of major adverse cardiac events after PCI in the patients with ST segment elevation myocardial infarction.Methods Forty-eight inpa tients with acute ST segment elevation myocardial infarction(STEMI) in the cardiology department CCU of our hospital from December 2013 to June 2015 were selected,including 38 males and 10 females,and divided into 3 groups according to the measured IMR value after PCI operation:the group A,IMR≤25(n=18);group B,IMR 25 ~ 32 (n =16);group C,IMR≥32 (n =14).Serum NT-ProBNP was collected,and the data in cardiac color ultrasound after PCI and at postoperative 1 year:left ventricular ejection fraction(LVEF) and left ventricular end diastolic diameter(LVEDD),and major adverse cardiac events within 1 years after PCI were also collected.Results The serum of concentrations NT-ProBNP were compared among the three groups[(2 734.83 ± 1 009.40) vs.(4 929.68±611.52) vs.(7 480.64±2 082.78)],and the difference among 3 groups was statistically significant (F=35.449,P=0.000).The difference of LVEF among the three groups had statistal significance[(54.00-±-5.99) vs.(52.31 ± 4.35)vs.(49.29 ±4.68),F=3.376,P=0.043)],and there was no statistical difference among the three groups in LVEDD(P>0.05).The difference of LVEF at postoperative 1 year among 3 groups had statistical significance[(57.28 ± 5.21)vs.(54.43 ±3.69)vs.(46.43±5.33),F=16.744,P=0.000],and the difference of LVEDD (48.94±1.95)vs.(50.63±2.68)vs.(52.14±2.69) among 3 groups was statistically significant(F=6.875,P=0.002).The differences in the major adverse cardiac events,cases of cardiac death and cases of heart failure after postoperative 1 year among 3 groups were statistically significant(x2 value=6.707,P=0.035;x2 value=6.084,P=0.048);the occurrence of again ACS,again PCI and malignant arrhythmia had no statistical difference among 3 groups(P>0.05).Conclusion Measurement of IMR after PCI in the patients with STEMI can effectively predict the heart function and the risk of major adverse cardiac events within 1 year.
5.H-magnetic resonance spectrum of putaman of Tourette' s syndrome
Bo YANG ; Guiping LI ; Jinshan ZHANG ; Xiangquan KONG ; Haibo XU ; Lin MA ; Huiyi YE ; Youquan CAI ; Yuangui GAO
Chinese Journal of Neurology 2012;45(6):392-395
Objective To study the changes of the putamen metabolites with magnetic resonance spectrum(MRS),and to explore possible underlying unrecongnised aetiological factor and pathophysiology mechanism in the central nervous system of the patients with Tourette' s syndrome.Methods Twenty-two cases of Tourette' s syndrome,and twenty-two gender and age-matched subjects ( the control subjects ) were performed on a clinical 3.0 T MRI system.Proton prob-voxel spectroscopy imaging (1H-MRS) was obtained from two sides of the putamen.The metabolites included N-acetylaspartate (NAA),creatine and phosphocreatine ( Cr),choline-containing compounds (Cho),and myoinositol ( MI ).The value of the NAA,Cr,Cho,and MI were calculated by integration of their peaks.The ratios of NAA/Cr,Cho/Cr,ML/Cr were calculated respectively.Repeated measures analysis of variance ( ANOVA ) was used to test both the value of NAA/Cr,Cho/Cr,MI/Cr of the putamen for group difference,with group as between-subjects factor and side as within-subjects factor.Results The NAA/Cr ratio in patients ( left:1.29 ± 0.13 ; right:1.34 + 0.15 ) was significantly lower than that in the control subjects ( left:1.50 ± 0.08,T =1.962,P <0.05 ; right:1.52 ± 0.11,T =1.865,P < 0.05 ).There was no significant difference in the Cho/Cr and MI/Cr ratio between both groups.Conclusion The abnormalities of the structure and(or) function in the putamens of patients may be the one of the underlying anaetiological factors and pathophysiology mechanisms of the Tourette' s syndrome.
6.A finger-taping switch task functional magnetic resonances imaging study in the patients with Tourette's syndrome
Bo YANG ; Guiping LI ; Jinshan ZHANG ; Xiangquan KONG ; Haibo XU ; Lin MA ; Huiyi YE ; Youquan CAI ; Yuangui GAO ; Denghua LIU
Chinese Journal of Neurology 2012;45(8):600-604
ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P < 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P <0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.
7.Scan time reduction with a small field-of-view quadruple inversion-recovery high-resolution contrast-enhanced MRI for carotid atherosclerosis.
Qingjun WANG ; Yong WANG ; Jianming CAI ; Youquan CAI ; Danqing LIU ; Xu HAN
Journal of Southern Medical University 2013;33(1):1-7
OBJECTIVETo reduce the acquisition time of carotid high-resolution contrast-enhanced magnetic resonance imaging (CEMRI), we designed a small field-of-view (FOV) quadruple-inversion-recovery (SF-QIR) T1WI and evaluated the image quality.
METHODSTwenty-four subjects with carotid plaque were enrolled in our study. All the subjects were imaged using the same 3.0T MRI by SF-QIR and standard rectangular FOV QIR (SrF-QIR) with identical parameters except for the phase-encoding step numbers and the RF excitation methods. Three independent readers qualitatively evaluated the differences between the two sequences in regard of the carotid outer wall border delineation, fibrous cap and lipid-rich necrotic core (LR-NC) border delineation, and diagnostic confidence. The quantitative measurements included maximal stenosis, wall area, LR-NC area, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The inter-reader variability was assessed.
RESULTSThe application of SF-QIR combined with orthogonal radio frequency excitation resulted in nearly half of the scan time with the SrF-QIR. Both qualitative and quantitative assessment by the readers revealed no significant differences between the two sequences except for SNR and CNR (Pgt;0.05). Since the mean loss of SNR with SF-QIR was 37.7%, SrF-QIR demonstrated a superior performance in SNR (P<0.001).
CONCLUSIONThe small FOV QIR sequence is effective in high-resolution CEMRI for evaluating carotid plaques and can effectively reduce the scan time and eliminate motion artifacts.
Adult ; Aged ; Aged, 80 and over ; Carotid Artery Diseases ; diagnosis ; pathology ; Female ; Humans ; Image Enhancement ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged
8.Quantitative measurement of carotid atherosclerotic plaque by high-resolution three- dimensional black-blood magnetic resonance imaging.
Danqing LIU ; Qingjun WANG ; Jianming CAI ; Youquan CAI ; Yong WANG ; Xu HAN
Journal of Southern Medical University 2013;33(3):365-369
OBJECTIVETo assess the value of high-resolution three-dimensional black-blood magnetic resonance imaging (3D-BB-MRI) in quantitative measurement of carotid atherosclerotic plaque by comparison with two-dimensional black-blood magnetic resonance imaging (2D-BB-MRI).
METHODSForty patients were scanned with routine 2D and oblique-sagittal 3D-BB-MRI. The original oblique-sagittal 3D images were reformatted to an axial 2D-like dataset. Two experienced radiologists identified the interested slice in consensus for every patient (unilateral carotid artery) in 2D-BB-MRI images and matched the axial reformatted 3D images with 2D black-blood images. Plaque thickness (PT), lumen area (LA) and total vessel area (TVA) were measured, and lumen stenosis (LS) and normalized wall index (NWI) were calculated.
RESULTSThere was no measurement difference between 2D-BB-MRI and reformatted 3D-BB-MRI (P>0.05), and these two methods had a good correlation (r<0.9). The Bland-Altman chart showed that 2D-BB-MRI and 3D-BB-MRI were in good agreement in the measurement of PT, LA and TVA.
CONCLUSION3D-BB-MRI and 2D-BB-MRI have no obvious difference in quantitative measurement of the carotid plaques. 3D-BB-MRI can demonstrate the vessels and plaques by multiplanar reconstruction and thus have better performance in evaluating carotid atherosclerosis compared with 2D-BB-MRI.
Adult ; Aged ; Aged, 80 and over ; Carotid Artery Diseases ; pathology ; Female ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged
9.Effect of edaravone on oxidative stress and myocardial fibrosis induced by isoproterenol in rats.
Shixiang WANG ; Zhifeng LU ; Wei XU ; Youquan CHEN ; Ximing CHEN
Journal of Southern Medical University 2015;35(11):1591-1596
OBJECTIVETo investigate the effect of edaravone on oxidative stress and myocardial fibrosis induced by isoproterenol in rats.
METHODSFifty male SD rats were randomly divided into 5 groups, including a control group, a myocardial fibrosis model (established by injections of isopropyl adrenaline for 10 days) group, and 3 edaravone groups with edaravone treatment at low, medium, or high doses for 14 days. After the treatments, the rats were examined for the degree of myocardial fibrosis, left ventricular mass index (LVMI), collagen volume fraction (CVF), and myocardial contents of collagen I (Col I), collage III (Col III), hydroxyproline (Hyp), superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO); The expression of transforming growth factor-β1 (TGF-β1) in the myocardial tissues was examined by immunofluorescence assay and Western blotting.
RESULTSCompared with the control rats, the rat models of myocardial fibrosis showed significantly increased CVF and LVMI (P=0.000), which were lowered by edaravone treatments in a dose-dependent manner (P<0.05). The myocardial contents of Col I, Col III and Hyp also increased in the model group (P=0.000) and were lowered dose-dependently by edaravone; the contents of MDA was higher (P=0.000) and SOD and NO were lower in the model group (P=0.000), and edaravone treatments obviously increased SOD and NO contents (P<0.05). The model rats showed significantly increased myocardial expression of TGF-β1 (P=0.000), which was markedly lowered by edaravone treatments (P=0.000). The myocardial content of MDA was positively correlated while SOD and NO were negatively with LVMI, CVF, Col I, Col III and Hyp; TGF-β1 was positively correlated with LVMI, CVF, Col I, Col III, Hyp and MDA but negatively with SOD and NO.
CONCLUSIONEdaravone can relieve oxidative stress and inhibit TGF-β1 activation to ameliorate myocardial fibrosis in rats.
Animals ; Antipyrine ; analogs & derivatives ; pharmacology ; Cardiomyopathies ; chemically induced ; drug therapy ; Collagen ; metabolism ; Disease Models, Animal ; Drugs, Chinese Herbal ; Heart ; drug effects ; Hydroxyproline ; metabolism ; Isoproterenol ; Male ; Malondialdehyde ; metabolism ; Myocardium ; pathology ; Oxidative Stress ; Rats ; Rats, Sprague-Dawley ; Superoxide Dismutase ; metabolism ; Transforming Growth Factor beta1 ; metabolism
10.Discusion on Improvement of Standardized Teaching Based on the Teaching Mode of PBL Teaching Method Combined with the Situational Teaching of the Internal Medicine
Yunhong XU ; Xiaoqing HE ; Youquan CHEN
Journal of Zhejiang Chinese Medical University 2017;41(3):252-256
[Objective] Based on the combination of teaching in the scientific scenario of PBL teaching mode improving the status of implementation of standardized teaching.[Methods]Firstly,domestic science teaching methods summary review and classification details of the traditional teaching methods,problem-centered teaching methods,teaching scenarios and situational approach combining four kinds of PBL teaching content as well as the first three inadequate teaching methods.And analysis showed that this method can promote standardization within science teaching implemented.[Results] The combination of PBL teaching scenarios for students can play an active role,while teachers also have some pedagogical implications.[Conclusion]The combination of PBL teaching scenario of higher professional level of teachers,innovation and professionalism requirements,etc.,in the teaching process,also requires teachers to have a certain ability to manage the classroom and modern teaching philosophy to fully mobilize students active learning.