Objective To investigate the predictive value of ADC value in grading of neuroepithelial tumors. Methods The clinical data and images of 70 patients with neuroepithelial tumors pathologically proven were collected and analyzed restrospectively. All the patients were classified into low(WHOⅠ or Ⅱ)and high(WHO Ⅲ or Ⅳ)grade groups which included 40 and 30 cases respectively accroding to the 2007 WHO classification of tumours of the central nervous system. All the patients underwent plain and contrast-enhanced MR scan and DWI before surgery. The minimum ADC(MinADC)value was measured postoperatively on ADC maps. The Ki-67 labeling index(Ki-67 LI)of tumor tissue was determined by immunohistochemistry.MinADC values for two groups were analyzed using student t test, while the age and Ki-67 LI for the two groups was analyzed using Mann-Whitney test(P＜0.05 considered to be significant＝.Also the MinADC valHe and Ki-67 LI were analyzed with Pearson correlation. The receiver operating characteristic analysis was used for evaluation for grading neuroepithelial tumors of the patients using MinADC. Results The mean MinADC value[(1.08±0.31)×10~(-3) mm~2/s]of the low grade group was significantly higher than that[(0.74±0.18)×10~(-3) mm~2/s]of the high grade group(t=5.42,P＜0.05＝,and the Ki-67 LI of the low grade group[0-50%,median 4%]was significantly lower than that[0-75%,median 25%]of the high grade group(U=325.50,P＜0.05＝.There was a negative correlation between MinADC value and Ki-67 LI(r=-0.30,P＜0.05＝.The area under the ROC curve was 0.85,and the cutoff MinADC value of 0.86×10~(-3) mm~2/s for the differentiation between high and low grade neuroepithelial tumors provided the best combination of sensitivity(90.0%)and specificity(77.5%)(receiver operatingcharacteristic analysis).Conclusion MinADC value is helpful for prediction of neuroepithelial tumor grade.

ObjectiveTo evaluate morphometric changes of brain in patients with alcohol addiction by voxel-based morphometry. MethodsFifteen patients with alcohol addiction and 15 health controls were recruited and underwent fluid attenuated inversion recovery (FLAIR) and 3D fast spoiled gradient echo (FSPGR) T1 -weighted sequences on a 3.0 T MRI system. 3D FSPGR T1 structure images were normalized,segmented and smoothed, and then underwent voxel-based morphometry. An ANCOVA was applied with age,body mass index ( BMI ), and education years as covariates because of exact sex match.A statistical threshold of P ＜ 0. 01 (uncorrected) and more than continuous 50 voxels were determined as significant.ResultsRegional results showed there was a significant reduction of gray matter volume in left middle frontal gyrus, superior frontal gyrus, precuneus, gyrus rectus, right medial superior frontal gyrus and orbital gyrus in patients with alcohol addiction compared with health controls, and the regional reduction of white matter volume in patients with alcohol addiction mainly located in the white matter of bilateral superior frontal gyrus. Global brain volume analysis showed there was a significant smaller volume in white matter [ (675. 14 ± 70. 62) ml]and brain parenchyma [ ( 1578. 81 ± 199. 05 ) ml]for patient group than that in white matter [ ( 841.33 :± 177. 35 ) ml]and brain parenchyma [ ( 1722. 13 ± 117.62) ml]for control group (t ＝ 11.37,5. 764, respectively, P ＜0. 05 ), but there was no difference in the gray matter volume between patient group [(903.67 ±1±9.87) ml]and control group [(880.79 ±1±7.10) ml](t ＝0.177, P＞0. 05 ). ConclusionsRegional gray and white matter atrophy can be the initial changes in patients with alcohol addiction and the frontal region is a relative specific damaged brain region.VBM has a potential value for the detection of subtle brain atrophy in patients with alcohol addiction.

Objective To investigate the changes of brain volumes in neuromyelitis optica (NMO)patients using voxel-based morphometry (VBM) method, and preliminarily explore the pattern of cerebral anatomical impairment. Methods Twenty-three clinically defined NMO patients and 15 gender and age matched healthy volunteers underwent 3-dimensional (3D) fast spoiled gradient echo (FSPGR) sequence scanning on 3.0 Tesla MR systen. Raw data was processed and analyzed using statistical parametric mapping (SPM) 5. Whole brain volumes included grey matter volume (GMV), white matter volume (WMV), total intracranial volume (TIV), grey matter fraction (GMF), white matter fraction (WMF),brain tissue fraction (BTF) and regional brain volumes between the two groups were compared by independent samples t-test and an Pearson were performed to compare the regional brain volumes and the ages. Results GMV of NMO group[(610. 2 ± 55.0) ml] was significantly decreased comparing to healthy control group[(657. 2 ± 36. 3) ml] (t = - 2. 915, P ＜ 0. 05). The age of NMO patients [(40 ± 9) years old] showed negative correlation with GMF [(42. 5 ± 2. 6) %] (r = - 0. 673, P ＜ 0. 05). Regional brain volume analysis showed decreased GMV in left insula and bilateral posterior cingutates in NMO patients,while decreased WMV was found in left frontal and left parietal white matter. Conclusion VBM could detect brain volume changes sensitively. Total grey matter volume in NMO patients was decreased comparing to HC group. Regional grey matter atrophy in NMO patients occurred in left insular and bilateral posterior cingutates, regional white matter atrophy occurred in left frontal and left parietal lobe.

Objective To evaluate early occult brain damage by diffusion tensor imaging in patients with type Ⅱ diabetes mellitus.Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images and diffusion tensor imaging were obtained from 16 patients with type Ⅱ diabetes mellitus (T2DM) and 16 normal controls (NC).Average apparent diffusion coefficient (ADC) map and fractional anisotropy (FA) map were calculated and analyzed with voxel-based analysis.Analysis of covariance was performed to compare ADC and FA between T2DM and NC.Results Increased ADC values of gray matter were demonstrated in right superior temporal gyrus,middle frontal gyrus,anterior cingulate gyrus,middle cingulate gyrus,inferior occipital gyrus,and left lingual gyrus,operculum orbitale,fusiform gyrus and parahippocampal gyrus in T2DM (voxel numbers in clusters were 176-3125,P ＜ 0.01).And increased ADC values of white matter were demonstrated in the regions of right middle temporal lobe,linual lobe,middle frontal lobe,calcarine gyrus,superior parietal lobe,and left operculum orbitale in T2DM patients compared with NC (voxel numbers in clusters were 200-781,P ＜ 0.01).Decreased FA values of gray natter were mainly located in left thalamus,bilateral caudate nuclei and right cuneus in T2DM(voxel numbers in clusters were 210-1402,P ＜0.01).Decreased FA values of white matter were demonstrated in the regions of right cuneus and the body of corpus callosum in T2DM (voxel numbers in clusters were 206,253,P ＜ 0.01).Conclusions The occult brain damage is demonstrated as increased ADC values and decreased FA values in regional brain parenchyma in type Ⅱ diabetes mellitus.Voxel-based analysis of diffusion tensor indices may be a simple and effective tool for the evaluation of occult brain damage in type]][diabetes mellitus.

Objective To evaluate gray matter volume,white matter volume and FA value changes in amyatrophic lateral sclerosis(ALS)patients by voxel-based morphometry(VBM)and voxel-based diffusion tensor analysis(VBDTA).Methods Thirty-nine definite or probable ALS patients diagnosed by El Escorial standard and 39 healthy controls were recruited and underwent conventional MR scans and the neuropsychological evaluation.The 3D FSPGR T_1WI and DTI data were collected on GE Medical 3.0 T MRI system.The 3D T_1 structural images were normalized,segmented and smoothed,and then VBM analysis was performed.DTI data were acquired from 76 healthy controls,and FA map template was made.FA maps generated from the DTI data of ALS patients and healthy controls were normalized to the FA map template for voxel-based analysis.ANCOVA was applied,controlling with age and total intracranial volume for VBM and age for VBDTA.A statistical threshold of P＜0.01(uncorrected)and cluster level of more than continuous 20 voxels determined significance.Results Statistical results showed no significant difference in the global volumes of gray matter and white matter,total intracranial volumes and gray matter fraction between ALS patients and healthy controls,but the white matter fraction of ALS patients(0.29±0.02)was significantly less than that of healthy controls(0.30±0.02)statistically(P=0.003).There was significant reduction of gray matter volumes in bilateral superior frontal gyri and precentral gyri,right middle frontal gyrus,right middle and inferior temporal gyrus,left superior occipital gyms and cuneus and left insula in ALS patients when compared with healthy controls;and the regional reduction of white matter volumes in ALS patients mainly located in genu of corpus callosum,bilateral medial frontal gyri,paracentral lobule and insula,right superior and middle frontal gyrus and left postcentral gyrus.VBDTA showed decrease in FA values in bilateral parahipocampal gyri and cingulate gyri in ALS patients compared with healthy controls.Conclusions VBM and VBDTA analysis results suggest that ALS is not simply a motor neuron disease but a multisystem disorder;and VBDTA has a potential value for the detection of FA value changes of cingulate and parahippocampal gyral white matter in suspected cognitive impairment of ALS patients.

Purpose At present,morphological observation and CT value measurement were mainly used to evaluate ground-glass nodule (GGN),and there was no effective image feature-quantization evaluation method.Therefore,in this study,a follow-up quantization analysis was conducted on GGN within 2 years using texture feature analysis method to confirm reasonable GGN follow-up time.Materials and Methods Baseline and highresolution CT images of 100 GGN follow-up patients were retrospectively analyzed.They were assigned into three groups,3 months follow-up (group A),6 to 12 months follow-up (group B) and 2 years follow-up (group C).For each group,using firstly founded GGN image as baseline,GGN texture features (including energy,contrast,autocorrelation,inverse difference moment and entropy) were analyzed.Results There were 1 case of narrowed nodules in group A,1 case of increased nodules and 1 case of narrowed nodules in group B,and 4 cases of increased nodules in group C,2 of which showed density differences.There was no significant change in shape,density and size of the remaining nodules.There were no significant differences in texture features (energy,contrast,autocorrelation,deficit,entropy) among group A,group B and group C (P＞0.05).Conclusion Texture feature analysis can quantitatively evaluate the change of GGN attribute characteristics,and as a GGN follow-up quantitative tool,it can guide patients to choose reasonable follow-up mode.

Objective To compare the effect of high volume continuous blood purification (CBP) with routine CBP on multiple organ dysfunction syndrome(MODS).Methods 38 patients with MODS were randomly divided into high volume CBP group( treatment group,18 cases) and routine CBP group (control group,20 cases).And they were respectively detected on mean arterial pressure(MAP),dosage of Dopamine,PaO2/FiO2,APACHE [ score,lactic acid,length of stay and mortality in ICU post-treatment 24h and 48h.Results Compared with control group,MAP and PaO2/FiO2 on treatment group were more higher( P ＜ 0.05 ),while dosage of Dopamine,APACHE Ⅱ score,lactic acid were significantly shorter than these of treatment group( P ＜ 0.05 ),and length of stay and mortality in ICU were significantly lower than those of treatmen group [ ( 8.54 ± 4.15 ) d vs ( 11.82 ± 5.76) d,P ＜ 0.05:22.2％ vs 35.0％,P ＜0.05 ].Conclusion High volume CBP could reduce the mortality in ICU compared with control group routine CBP.

Objective To explore the diagnostic value of optic diffusion tensor imaging (DTI) in detecting the impairment of optic nerve in neuromyelitis optica (NMO) patients.Methods Conventional MRI and optic DTI were performed in 28 NMO patients and 38 normal controls (NC).Fractional anisotropy (FA) values were measured in the anterior part,middle part and posterior part of intraorbital segment of optic nerve.The patients were classified into 3 groups based on the impairment of vision and visual evoked potential (VEP): monocular impairment (MI) group,10 eyes; biocular impairment (BI) group,36 eyes;and normal-appearing (NA) group,10 eyes.All patients were performed with the evaluation of expanded disability status scale (EDSS).One-way analysis of variance (ANOVA),receiver operating characteristic (ROC) curve,and Spearman correlation analysis were performed among the subgroups of NMO and normal controls.Results There was significantly statistical difference between the four groups (F =43.54,P ＜0.01).Decreased FA values were demonstrated in the MI group (0.29 ±0.08),BI group (0.27 ±0.08),and NA group (0.35 ±0.13) compared with NC (0.45 ±0.07) (P ＜0.01).FA value in BI group was significantly lower than that of NA group(P ＜0.01).Area under curve by ROC analysis in NC vs MI,NC vs BI,NC vs NA,and NC vs NMO was 0.92,0.95,0.74,and 0.91,respectively.The diagnostic sensitivity of ROC was 80％,86％,50％,and 79％,respectively.The diagnostic specificity of ROC was 95％ for the each compared groups.FA value showed no correlation with EDSS for each NMO groups,and showed negative correlation with disease duration for BI group (r =-0.371,P ＜ 0.05).Conclusions Various degrees of optic nerve injuries,indicated by decreased FA value,are present in NMO patients,and optic DTI may be a simple and effective tool for the quantitative evaluation of optic nerve in NMO patients.

Objective To investigate the effect of integrated traditional Chinese ( TCM ) and western medicine fast-track surgery ( FTS) in the perioperative management of laparoscopic cholecystectomy ( LC) .Methods One hundred and fifty patients with acute cholecysititis undergoing LC from June 2012 to January 2015, were recruited and divided randomly into 3 groups.Patients in group A (n=30) were treated with routine method in perioperative period, patients in group B ( n=60) were treated with western medicine FTS, and patients in group C (n=60) were treated with integrated TCM and western medicine FTS.The first exhaust time after operation, length of stay, times of clinic visit, symptoms, levels of IL-6, CRP and ALB, postoperative complications, readmission rate, reoperation rate, and patient satisfaction were evaluated in three groups.Results The first exhaust time after operation of group B and group C was earlier than that of group A [(25.16 ±8.36)h and (21.61 ±6.52)h vs.(36.06 ±10.88)h, P<0.05], and the first exhaust time of group C was earlier than that of group B (P<0.05).The length of stay of group B and group C were shorter than that of group A [(4.30 ±1.07)d and (3.98 ±1.16)d vs.(6.11 ±1.26)d, P<0.05].The nausea and vomiting, and abdominal distension of group C were lighter than those of group B [(0.27 ±0.08) vs.( 0.31 ±0.09); (0.35 ±0.09 ) vs.(0.40 ±0.13), respectively].There were no difference of the level of IL-6, CRP and ALB between group B and group C [(57.12 ±16.29) ng/L vs. (53.91 ±17.15) ng/L, (53.93 ±17.18) mg/L vs.(51.16 ±16.67) mg/L,(40.50 ±4.65) g/L vs. (41.01 ±4.60)g/L, respectively, all P<0.05].There was no difference among the three groups in the complication rate, readmission rate and reoperation rate(all P>0.05).Conclusion Integrated traditional Chinese and western medicine FTS in the perioperative period of LC can promote recovery, reduce symptoms and operation stress and maintain albumin level.

PurposeTo optimize the imaging parameters of clinical MRI scanner in rat pancreas imaging to improve the image quality and to provide better MRI image quality and more economical research method for imaging study of rat pancreas. Materials and Methods Twenty-four healthy male Wistar rats were randomly divided into the conventional sequence (CS) group, the adjustment sequence (AS) group and the optimization sequence (OS) group, with 8 rats in each group. The rats in the CS group were scanned with conventional parameters using a clinical MRI scanner. The principle of parameter adjustment was: parameters associated with T1WI or T2WI imaging quality (TR, TE, slice thickness, NEX, FOV and matrix) was set with four changes, and only one of the six parameters was changed in each scan, image quality was evaluated by two senior radiologists, the parameter corresponded the best image quality evaluated consistently by two radiologists were selected as the optimal imaging parameter, all the optimized parameters were set up step by step in this way which formed the imaging parameters in OS group. The pancreatic signal intensity and signal to noise ratio was compared between CS group and OS group after imaging.Results The optimized sequence parameters in clinical MRI scanner were listed below: T1WI sequence (M3D/FSPGR/15): TR 6 ms, TE 2.5 ms, slice thickness 2.0 mm, NEX 8, FOV 7 cm×7 cm, Matrix 120×120; T2WI sequence (FSE-XL/90): TR 4000 ms, TE 71 ms, slice thickness 2.0 mm, NEX 1, FOV 8 cm×8 cm, Matrix 192×160. The pancreatic SI in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.16 and 3.80,P<0.01), while the pancreatic SNR in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.65 and 3.26,P<0.01).Conclusion The optimized parameters can improve the imaging quality of rat pancreas MRI significantly, thus provide a reference for the related experimental study.