Objective To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential(VEP)in diagnosing optic neuritis.Methods One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis,papillitis,multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using x2 test,wilcoxon test and Kappa test.Results Out of the 154 sick eyes.56 eyes presented thickened optic nerves.76 eyes had normal diameter of the optic nerve,and 22 eyes had thin optic nerves.A total of 132 optic nerves showed abnormally high signal in STIR sequences.including involvement of intraocular segment in 7,intraorbitsl segment in 135,intracanalicular segment in 109,intracranial segment in 97,optic chiasm in 56,and optic tract in 23.A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement.Among the 196 eyes of 98 patients,132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve.and 26 eyes had both normal vision and normal MR signal of optic nerve.The consistency of MRI findings and vision status was 80.61%(Kappa=0.453,P＜0.01).Among the 175 eyes with VEP results.129 eyes had visual loss with simultaneous VEP abnormalities,and 30 eyes had both normal vision and normal VEP results.The consistency of VEP and vision status was 90.86%(Kappa=0.731,P＜0.01).Among the 175 eyes with VEP results,117 eyes had abnormal MR signal of the optic nerve and simultaneous abnormal VEP,and 24 eyes had both normal MR signal of the optic nerve and normal VEP.The consistency of MRI findings and VEP was 80.57%(Kappa=0.460,P＜0.01).Conclusion STIR sequence and gadolinium-enhanced T1-weighted MR sequence combined with fatsuppression are helpful in diagnosis of optic neuritis.VEP is helpful in diagnosing optic neuritis and in finding subclinical visual problem.The MRI combined with VEP could improve the diagnostic accuracy of optic neuritis.

Objective:To evaluate the value of CT in the diagnosis of skeletal metastases from hepatoma.Methods:27 patients proved by clinical or pathological materials were analysed retrospectively.Results:All the lesion were osteolytic on CT scans.The most frequently involved areas were spine(26%),ribs(22%),pelvis(19%)and femur(11%).Conclusion:CT scan is superior to X-ray plain flims in showing the lesions.Most foci can be diagnosed accurately.

Objective To study high resolution CT (HRCT) and MRI findings of temporal bone anomaly in patients with tinnitus and identify the optimal examination method in the detection of the anomaly. Methods The HRCT and MRI data were analyzed retrospectively in 1015 patients including 145 patients with pulsatile tinnitus (PT) and 870 patients with nonpulsatile tinnitus (NPT). The positive rates of HRCT and MRI in the identification of temporal bone anomaly were analyzed and the efficiency of various examination methods was compared in revealing the anomaly. Data were tested by Chi-square test analysis. Results Among 1015 patients, anomaly was seen in 767 cases (75.57%). High jugular bulb was found in 414 patients, accounting for 40. 79%. Sigmoid sinus anomaly was detected in 387 patients (38. 13%), while otitis media was found in 148 cases (14. 58%), and low middle cranial fossa in 70 cases (6. 90%). The positive rate of HRCT in the detection of high jugular bulb was 54. 89% (365/665), which was significantly higher than those of other methods (P ＜ 0. 05). The positive rate of enhanced HRCT in showing sigmoid sinus anomaly was 73.68% (56/76), which was significantly higher than those of other methods(P ＜0. 05). Sigmoid sinus anomaly was the most frequent finding in patients with PT, accounting for 66. 21% (96/145). The incidence of sigmoid sinus anomaly was higher in PT than in NPT (291/870,33.45% ;χ2 =56. 537 ,P ＜0. 01). The fast imaging employing steady-state acquisition (FIESTA) sequence was the best examination method in displaying the vessel within the internal auditory canal (42/42,100%).Conclusions High jugular bulb and sigmoid sinus anomaly were the most frequent abnormal findings of temporal bone in patients with tinnitus. Enhanced HRCT was the choice of modality in patients with PT.Plain HRCT was recommended for NPT. FIESTA sequence was the best in the evaluation of the vessel within the internal auditory canal.

Objective To evaluate the value of MRI diagnosis in Stewart-Treves syndrome(STS).Methods The 48 STS nodules proved by pathology were retrospectively studied,which compared the MRI findings and pathological results.Results All nodules were solid and more than 4 mm in diameter.According to the expression of D2-40 and CD31,all nodules were divided into two types.The 47 nodules were divided into STS type I(hemangiosarcoma).The MRI findings showed slightly low signal on T1 WI and slightly high signal on T2 WI,while were higher than the muscular signal.Additionally,all nodules of STS type I were remarkably enhanced.The 1 mass-like-shape cases wsa divided into STS type Ⅱb (mixed lymphangiosarcoma).The MRI findings showed heterogeneous signal on both T1 WI and T2 WI,in which the high signal was leading.And the enhancement showed the low-level inhomogeneous signal.Conclusion MRI could be a valuable tool for the diagnosis in STS because of the characteristic signal on MRI.And if combined with the history of chronic upper limb lymphedema,the diagnostic accuracy could be improved before surgery.

OBJECTIVE To analyze the incidence of anatomic variations of the temporal bone to provide valuable reference for clinical otology. METHODS Sev-enty six healthy adults (152 ears) and 66 patients(96 ears) with chronic suppurative otitis media confirmed by clinical examination underwent axial and coronal High-resolution Computed Tomography(HRCT) scan. The incidence of high jugular bulb, dehiscent jugu-lar bulb, anterior location of sigmoid sinus, low-lying middle cranial fossa, dehiscent tegmen tympani, mas-toid antrum dysplasia, aberrant internal carotid artery, and large sinus tympani were recorded. RESULTS In normal, abnormal, well and poorly pneumatized groups, the incidence of highly positioned jugular bulb on the right was higher than that on the left. The total inci-dence of high jugular bulb on the left and right was 26.2 % and 46.0 % respectively. The incidence of ante-rior location of sigmoid sinus in the abnormal group (32.3 %) was higher than that in normal group(15.8 %), which was higher in poorly pneumatized group(43.5 %) than that in well pneumatized group(11.3 %). The inci-dence of dehiscent tegmen tympani in well pneuma-tized group(18.0 %) was higher than that in poor pneu-matized group(8.7 %). There was no significant differ-ence in dehiscent jugular bulb, low-lying middle cranial fossa, mastoid antrum dysplasia, aberrant internal ca-rotid artery, and large sinus tympani between the left and right within and among groups. The incidence of these varia-tions was 2.0 %,21.8 %,1.2 %,0.4 %,0.8 %respectively. CONCLUSION HRCT can show ana-tomic variances of temporal bone clearly before opera-tion and has great clinical value for reducing the inci-dence of complications caused by middle ear operation.

Objective To evaluate the efficacy and safety of traditional Chinese medicine in the treatment of skin rash caused by epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI).Methods The clinical randomized controlled trials of traditional Chinese medicine in the treatment of EGFR-TKI-induced skin rash which published in domestic journals were selected.The quality assessment of included literature was made by Jadad score,RevMan 5.2 software was used to make Meta-analysis.Results A total of 6 studies met the inclusion criteria,the 6 studies included 248 patients,133 cases in the treatment group,115 cases in the control group.All patients were 30 to 75 years old.Compared with the control group,the combined OR value of the clinical efficacy of traditional Chinese medicine in the treatment of EGFR-TKIinduced rash was 7.51,with 95 ％ confidence interval 4.46-12.65.Conclusions Meta-analysis shows that the clinical efficacy of traditional Chinese medicine in the treatment of EGFR-TKI-induced skin rash is better than Western medicine,and no adverse reactions.It can be widely used in clinical practice.

The phosphoinositide-3 kinase (PI3K)/protein kinase B (PKB/AKT)/mammalian target of rapamycin (mTOR) pathway is asso-ciated with cell growth, proliferation, differentiation, apoptosis and metabolism. The abnormalities of this signal pathway are found in various malignant tumors. This pathway has also been investigated as an anti-tumor target. Recently, novel inhibitors have been stud-ied in clinical trials of lymphoma. This review summarizes the activation status of the PI3K/AKT/mTOR pathway and its use for targeted therapy of lymphoma.

Objective To investigate the characteristics of the morphological changes of the lens and related structures of human eyes before and after accommodation by magnetic resonance imaging(MRI). Design Prospective case series. Participants Healthy volunteers. Methods Eleven eyes of 8 healthy volunteers were measured by MRI before and after accommodation. Main Outcome Measures Thickness and sectional area of lens,anterior chamber depth,axial length. Results The thickness and section area of lens,anterior chamber depth,axial length was 3.51?0.20 mm,22.89?1.82 mm2,3.54?0.27 mm,23.91?0.90 mm before accommodation,and 3.73? 0.34 mm,23.17?1.66 mm2,3.29?0.32 mm,23.82?1.07 mm after accommodation. The thickness of lens and anterior chamber depth were significantly higher difference after accommodation(t=3.563,P=0.007; t=4.804,P=0.001). Conclusion As a useful tool of biometric measurement,MRI showed the morphological characteristics of the lens and related structures of human eyes,in an accomodated enviroment,and thus might play an important role in related researches.

Objective To study the CT and MRI findings of schwannoma in tIle sinonasal region and evaluate their clinical application.Methods All 12 cases of schwannoma locating in the sinonasal region were verified by pathology.r111e CT images in all 12 cases and MRI findings in 10 cases were analyzed retrospectively.Results Of the 12 cases of schwannoma in the sinonasal cavity.11 were benign and l was malignant.The tumors located in the nasoethmoid region in 4 cases.in the maxillary sinus in 3 cases and in the maxillary.ethmoid and sphenoid sinuses in 2 cases.The lesion of the remaining 3 cases involved maxillary sinus and hasal cavity,sphenoid sinus and choana respectively.The lesions with well-defined margin showed elliptic shape in 4 cases,irregular shape in 8 cases.On CT,the lesion resulted in dilatation of the affected sinonasal cavity with remodeling,thinning and displacement of the bony wall.In addition.local bony absorption was detected in 8 cases and bony destruction was found in 1 case.The lesions revealed homogeneous density in 10 cases and inhomogeneous in 2 on precontrast CT.Two cases showed heterogeneous enhancement on postcontrast CT. On MR T1WI,schwannoma in the sinonasal region demonstrated isointense signal compared to brain in 10 cases with patchy and nodular low signal intensity in 3 cases and patchy hish signal intensity in 2 cases.On T2 WI.the lesion showed heterogeneous isointense singal in 7 cases and slightly hyperintense signal in 3 cases.Stippled and patchy hyperintense signal was seen in 9 cases and well-defined and regular nedular high intense signal in 6 cases.Patchy low signal intensity was found in 2 cases corresponding to the high signal intensity on MR Tl WI.In addition,liquid-iquid level was identified in one case.The lesion displayed rooderate to marked inhomogeneous enhancement on contrast-enhanced MR images in 9 cases and marked homogeneous enhancement in one case.The time.intensity curve of dynamic contrast enhancement of MRI showed plateau type in 2 cases.In this group,the lesions were complicated with obstructive parasinusitis in 6 cases.which showed hypointense signal on MR T1 WI,hyperintense signal on T,WI and peripheral enhancement on postcontrast MRI.MRI showed the extent and other associated changes of the lesions more clearly compared to CT Conclusions Bone remodeling.thinning and absorption on CT and Patchy and noduhr high signal intensity on MR T2WI without postcontrast enhancement were typical manifestations of schwannoma in the sinonasal region.Combined findings of CT and MRI call provide more comprehensive information for the diagnosis and therapy.

ObjectiveTo observe the cells of frontal recess region with multi-detector CT muhiplanar reconstruction(MPR).MethodsOne hundred patients without the disease of frontal sinus and frontal recess region underwent axial multi-detector CT scan with axial,coronal and sagittal multiplanar reconstruction.ResultsIn 100 cases(200 sides),the agger nasi cell is present in 186 sides(93.0%),the frontal cells were identified in 88 sides(44.0%),the prevalence of type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ cells were 51 sides(58.0%),23 sides(26.1%),14 sides(15.9%)and 0 sides,respectively. The suprabullar cells,the frontal bullar cells and the supraorbital ethmoid cells were identified in 130 sides (65.0%),23 sides(11.5%)and 11 sides(5.5%),respectively.The interfrontal septal cells were identified in 36 sides(18.0%).There was no significant difference between males and females,as well as between left and right side(P＞0.05).Conclusion With MPR imaging,doctors could better understand the frontal recess region,which is helpful to the endoscopic frontal sinus surgery.