Objective To explore the role of bright vessel sign (BVS) on raw three dimensional arterial spin labeling (3D ASL) image in evaluating occlusion of intracranial artery. Methods One hundred and twenty-two patients who were highly suspected of acute cerebral infarction were enrolled and analyzed. All patients were performed magnetic resonance scan with diffusion weighted image (DWI), 3D ASL and magnetic resonance angiography (MRA) sequences within 24 hours after admission. The presence or absence of restricted lesion on DWI, BVS and occlusion of intracrainal artery on MRA was reviewed. The sensitivity, specificity, positive predictive value, negative predictive value of BVS and consistency of BVS and MRA in assessing occlusion of intracranial artery were assessed. Results The sensitivity, specificity, positive predictive value and negative predictive value of BVS in assessing occlusion of intracranial artery were 83%, 99%, 95% and 96%, respectively.And the presence or absence of BVS on ASL was highly consistent with MRA in assessing occlusion of intracranial artery (κ=0.86, P<0.01). Conclusion BVS has a good sensitivity and high specificity in identifying occlusion of intracranial artery, and it is highly consistent with MRA.

Objective To study the correlation of supratentorial gliomas and ependymoma between the features of pathology and the characteristic of CT,MRI and provide relevant data for diagnosis and treatment.Methods We analysised 60 patients with gliomas and 40 with ependymoma,contrasted their characteristic of CT,MRI with the features of pathology.Results The feature of irregular appearance,lobulation,tumor wall,tumor tubercle,necrotic cystiform zone,hemorrhage and tumor blood vessels were showed in CT and MRI,which was accord with the alteration of ultrastructure and the expression of tumous label.Conclusion Studying the morphology of supratentorial gliomas and ependymoma may be helpful to raise the veracity of pathologic grading,provide evidence to select treatment,operation and anti-vasoformation of the tumor etc.

Objective The images of CT Equipment without DICOM interface are stored by means of film all along,and they can't be digitally stored,shared,retrieved,integrated to diagnostic reports.This paper introduces a method to capture images,mainly focus on the image capture and crop technology.Methods The hardware is composed of Philip Tomoscan AV CT,PC,OK_RGB20B image capture card,foot switch.The software is programmed by Microsoft Visual C++6.0,OK_RGB20B SDK and GDI+ Class Library on Windows 2000 operating system.Results The system can capture the CT image successfully,and make the images stored and shared permanently.Conclusion This method is a valuable clew for capturing images from other types of non-DICOM-based medical equipment such as ECT,X-ray,Ultrasound,Endoscope and so on.

Objective To find a programming method of magnifying two-dimentional medical image for clearer view and more precise diagnosis. Methods The software was programmed by using Microsoft Visual C++6.0 and GDI+ Class Library on Windows 2000 operating system. Results The software could magnify the medical images with high quality and definition. Conclusion This method is valuable for medical image digital post-processing.

Objective To realize foot switch long-distance control of PC for medical image acquisition. Methods The foot switch was connected with PC through RS232 DB9 port, and the software was programmed by Microsoft Visual C++6.0 on Windows 2000 operating system. Results Foot switch control of PC was successfully achieved in acquiring medical images. Conclusion The foot switch has the advantages of long-distance and foot control of PC. It not only saves manpower but ensures the accuracy and real time of images acquired. This method can be applied to image acquisition workstations for medical equipments such as CT apparatus, X-ray apparatus, Ultrasound apparatus, Endoscope apparatus and so on.

Objective To investigate the correlation of rCBV with vascular endothelial growth factor (VEGF) protein expression and microvessel density (MVD) in gliomas Methods MR examinations were performed preoperatively in 46 patients with suspected supratentorial gliomas All the 46 cases were proved by operation and pathology Immunohistochemical stain methods were used to demonstrate the situation of VEGF protein expression and quantitatively measure the MVD in gliomas The procedures of MR examinations included plain MR scan, PWI and routine contrast enhanced MR scan The pulse sequence of PWI was single shot GRE EPI T  2WI The CBV maps were calculated from the original data of perfusion images and the maximum rCBV of gliomas was acquired from CBV maps through measurement on the region of interest (ROI) According to the situation of VEGF protein expression, all the 46 cases were divided into two groupsincluding positive VEGF protein expression group and negative VEGF protein expression group Mann Whitney U test was used for comparing the difference between the two groups Spearman′s rho correlation analysis was used for observing the correlation between maximum rCBV and MVD in gliomas Results Of the 46 cases; 12 cases were astrocytomas, 3 were oligodendrogliomas, 1 was mixed glioma, 14 were anaplastic astrocytomas, and 16 were glioblastomas multiforme The maximum rCBV value in VEGF(-) group ( n =14) and VEGF(+) group ( n =32) ranged from 0 33～6 63 and 1 03～10 68, with median of 3 08 and 5 95, respectively The difference in maximum rCBV between the two groups was statistically significant ( Mann Whitney U test | z| =2 638, P

Objective:To investigate the correlation of the relative cerebral blood flow (rCBF) of three dimensional arterial spin labeling (3D ASL) with vascular endothelial growth factor (VEGF) expression and microvessel density (MVD) in glioma. Methods:Fifty-three glio-ma patients confirmed by pathology were subjected to conventional, enhanced MR and 3D ASL imaging before operation to deter-mine VEGF expression and MVD levels in each patient. The correlations of rCBF with VEGF expression and MVD in glioma were evaluat-ed, respectively. Results:rCBF was noted to be positively correlated to VEGF expression and MVD in glioma. The rs were 0.728 (VEGF) and 0.620 (MVD), respectively (P<0.05). Conclusion:The positive correlation of rCBF with VEGF expression and MVD in glioma implied that 3D ASL is beneficial for evaluating microvessel angiogenesis in glioma prior to surgery. This finding is significant for developing clin-ical treatment plans and for assessing patient prognoses.

objective:To investigate the relationship between magnetic resonance spectroscopy (MRS) metabolism and Ki-67 expres-sion in high-(HGG) and low-grade gliomas (LGG) by analyzing Ki-67 expression and HGG and LGG metabolites. Methods:We consid-ered 56 pathologically confirmed glioma cases in our hospital. The Ki-67 expression and the MRS metabolism parameters in the tu-mors were analyzed simultaneously. Results:The tumor solid value of Cho was positively correlated with the Ki-67 expression level (rs=0.714, P<0.05). By contrast, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA (rs=?0.708, P<0.05) in 35 cases of the LGG group. The tumor solid value of Cho was also positively correlated with the Ki-67 expression level (rs=0.624, P<0.05). By comparison, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA in the HGG group (rs=?0.769, P<0.05). Conclusion:The MRS metabolism was correlated with the Ki-67 expression in high-and low-grade gliomas.

Objective To evaluate the opening level and optimal time window of the blood-brain barrier induced by adenosine A2 receptor agonist ( Lexiscan) via dynamic enhanced MRI. Methods Twen-ty New Zealand white rabbits were divided into experiment group ( group A, n=10) and control group ( group B, n=10) . Rabbits in group A were injected with Lexiscan and rabbits in group B were injected with physiological salt via ear vein, then the coronary scanning was performed. Contrast enhanced MRI was performed at different time points ( 5, 10, 15, 20 min, and then every 10 min, until 2 h) following the in-fusion of Gd-diethylene triamine pentaacetic acid (DTPA). The signal intensity (SI) of region of interest ( ROI) was measured and the percent enhancement of SI was calculated. Evens blue staining results in brain tissues were observed. Pair t test was used to analyze the data. Results The percent enhancement of SI in group A significantly increased to (40. 93±3.70)％ at 5 min, reached the maximum of (43.03±3.62)％ at 30 min, slowly decreased until 50 min, and got to a stable level at almost 80 min. At each time point, the per-cent enhancement of SI in group A was significantly higher than that in group B ( t values:6.88-20.28, all P<0. 05) . The staining was evident in group A. Conclusions Lexiscan can open blood-brain barrier tem-porarily and reversibly, and the optimal opening time window is 10-50 min post-injection.

Objective To analyze the effects of quality supervision and continuous improvement system on optimizing in-hospital diagnosis and treatment process in patients with acute ischemic stroke (AIS).Methods From September 2013 to May 2016,424 consecutive patients with AIS treated with intravenous thrombolysis and/or endovascular therapy in Changhai Hospital,the Second Military Medical University were enrolled retrospectively.They were analyzed according to the annual running process (the first year[from September 2013 to August 2014],the second year[from September 2014 to August 2015],and the third year[from September 2015 to May 2016]).The spend time and delay (DTN>60 min,DTP>90 min) rate of each treatment process in the first,second,and third year (time from door-to-imaging[DTI],door-to-needle[DTN],imaging-to-needle (ITN),door-to-groin puncture (DTP) and imaging-to-groin puncture (ITP) were compared.Taking the time periods (>median) of having significant differences of the spend time of the treatment processes as the dependent variables in the first,second,and third year,the influence of the years and treatment modalities on delay was observed.The difference of constituent ratio of the reasons for delay in intravenous thrombolysis and endovascular therapy (objective reasons/other reasons) in different years were analyzed.Results (1) DTIs were 23.0 (11.0,42.0) min,22.0 (10.1,39.0) min,and 13.0 (6.0,27.0) min,respectively,and DTNs were 50.0 (30.0,77.1) min,45.0 (30.0,70.2) min,and 36.0 (24.0,57.0) min,respectively in the first,second,and third year.The spending time was shortened year by year.There were significant differences among the different years (all P<0.01).The spending time of DTP had a tendency to be shortened,but there were significant differences among different years (P=0.06).There were no significant differences between the spending time of ITN and ITP (all P>0.05).(2) The DTN delay rates were 33.3% (40/120),20.7% (29/140),and 8.1% (9/111),respectively in the first,second,and third year.There were significant differences among the 3 years (x2=22.111,P<0.01).There were no significant differences among the DTP delay rates (P=0.08).(3) Multivariate Logistic regression analysis showed that taking the first years as a reference,the risk of DTI delay was reduced in the third year (OR,0.174,95%CI 0.101-0.298,P<0.01),the risks of DTN delay were reduced in the second and third year (OR,0.564,95%CI 0.338-0.941;OR,0.180,95%CI 0.101-0.320,all P<0.05).For simple intravenous thrombolysis,bridging therapy was a protective factor for the improvement of treatment efficiency in the DTI process (OR,0.530,95%CI 0.297-0.943,P=0.031).Compared with the bridging therapy,the direct endovascular therapy was a protective factor for DTP treatment (OR,0.427,95%CI 0.202-0.901,P=0.025).The remaining independent variables were not associated with the occurrence of DTN and DTP delay (all P>0.05).(4) During the three years,the delay of intravenous thrombolysis was mainly due to objective reasons.The constituent ratio of other reasons caused delay of intravenous thrombolysis was decreased year by year.There was no other reasons for delay in the third year).There was no significant difference in the constituent ratio of the delay reasons in endovascular treatment (x2=3.622,P=0.164).Conclusion Under the existing process and resource allocation,setting the DTN target time and implementing continuous quality improvement are conducive to the effective implementation of brain CT scan and continuous optimization of intravenous thrombolysis in the processes in AIS patients with the first diagnosis.