Objective To compare the Chinese 2008, 1992 and 2002 UICC (International Union Against Cancer) staging System for nasopharyngeal carcinoma and find out the reasons for the changes in the new Chinese 2008 staging system. Methods From Apr. 2007 to Dec. 2008, 285 naive patients with pathologically proved NPC, but without metastasis, received standard enhanced MRI scans of the nasopharynx and neck. Based on MRI imaging data and clinical information, clinical stage was classified according to the Chinese 2008, Chinese 1992 staging system and 2002 6th UICC staging system,respectively. Comparisons were made between Chinese 2008 and 1992 staging system, and between Chinese 2008 and 2002 UICC staging system by χ2 test. Results As a result of deleting some details of the old staging system, Chinese 2008 staging system is easier to grasp. With Chinese 2008 staging system, the number of cases in stage T1 to T4 are 66, 84, 72,63, respectively; those in stage N0 to N3 are 12,48,169,56; the number of cases in clinical stage Ⅰ -Ⅳ are 5,30,141 and 109. With 2002 6th UICC staging system, the number of cases in stage T1 to T4 are 66, 83, 55,81; those in stage N0 to N3 are 26,50,201,8;the number of cases in clinical stage Ⅰ -Ⅳ are 6,40,153 and 86. With Chinese 1992 staging system, the number of cases in stage T1 to T4 are 62,91,71,61; those in stage No to N3 are 26,189,61,9; the number of cases in clinical stage Ⅰ -Ⅳ are 6, 110, 98 and 71. Comparing with the staging results of Chinese 1992 staging system, many cases showed different stage based on Chinese 2008 system including 12 cases (4.21%) inT stage (3 up-staging and 9 down-staging), 217 cases (76.14%) in N stage (216 up-staging, most rise I stage, and 1 down-staging), 123 cases (43. 16% ) in clinical stage ( 121 up-staging and 2 down-staging). Comparing with the staging results of 2002 UICC staging system, 35 cases ( 12. 28% )changes in T stage (8 up-staging and 27 down-staging), 77 cases (27. 02% ) changes in N stage (all upstaging, most rise 1 stage), 74 cases (25. 95% ) changes in clinical stage (54 up-staging and 20 downstaging) based on Chinese 2008. Comparing the constituent ratio of T, N and clinical staging results separately, statistical differences were found between Chinese 2008 and Chinese 1992 staging system in N0,N1, N2, N3, clinical stage Ⅱ , Ⅲ, Ⅳ. Statistical difference was also found in N0, N2, N3, clinical stage Ⅳ between Chinese 2008 and 2002 UICC staging system. χ2 test results show that there is N0 significant difference of T stage constituent ratio among the 3 staging system ( χ2 = 6. 916, P = 0. 329 ), but the difference of N stage and clinical stage constituent ratio are significant( χ2 = 275. 169 and 84. 515, P ＜0. 0125). Conclusion Chinese 2008 Staging System for nasopharyngeal carcinoma is based on MRI, with clear definition to some anatomical location, after deleting some details in the old stage system, it's easier to use. The most obvious change for Chinese 2008 Staging System is the up-staging in N staging,which leads to the changes in clinical stage and constituent ratio of stage result.

Objective To evaluate the correlation between MRI and X-Ray discography findings and pain response at provocative discography in patients with discogenic back pain. Methods Two hundred and fifty-six lumbar intervertebral discs in 93 patients who underwent MRI and X-Ray discography were included in this study. MR images were retrospectively evaluated regarding disc degeneration, endplate abnormalities and high intensity zone. Disc degeneration was graded according to the modified criteria of Pearce, et el. Evaluation of disc morphology was performed with X-Ray discography by using the classification of Adams, et al. Endplates and adjacent bone marrow abnormalities were classified according to Modic,et al. During discography concordant pain was regarded as positive, whereas discordant pain and no pain were regarded as negative. The data were analyzed using the Chi-squnre test. Results There were 116 discs with concordant pain and 140 discs with discordant pain or no pain. Of 256 discs on discography, 17 discs were type Ⅰ17(6.6%),type Ⅱ were 25(9.8%),type Ⅲ were 91(35.5%), type Ⅳ were 77(30.1%) and type Ⅴ were 46(18.0% ). On MR images, discs of grade Ⅰ were 23 (9.0%) ,grade Ⅱ were 34(13.3%), grade Ⅲ were 84(32.8%), grade Ⅳ were 85 (33.2%) and grade Ⅴ were 30(11.7%). There was positive correlation between Pearce graded of MRI and classification of Adams of discography (r=0.62, X2 =160.87,P <0.01).In 123 discs of type Ⅳ to type Ⅴ on discography, 104 discs were with concordant pain. There was positive correlation between type Ⅳ-Ⅴ and concordant pain( r=0.60, X2 = 144.08, P < 0.01). In 115 discs of Ⅳ-Ⅴ grade degeneration, 99 discs presented with concordant pain. There was positive correlation between Ⅳ-Ⅴ grade disc degeneration and concordant作者单位:510120 广州,中山大学附属第二医院放射科 pain(r = 0.59, X2 = 137.11, P <0.01 ). In 60 discs with high intensity zone(HIZ), 52 discs presented with concordant pain. There was positive correlation between HIZ and concordant pain ( r=0.41, X2= 51.93, P <0.01 ). In 58 discs with endplate degeneration, 51 presented with concordant pain. There was positive correlation between Modic degeneration and concordant pain ( r = 0.41, X2= 52.76, P < 0.01 ). Conclusion In patients with chronic low back pain, MR imaging may present moderate to severe disc degeneration, high intensity zone, endplates and adjacent bone marrow abnormalities. MR findings with concordant pain can raise the diagnostic possibility of discogenic lumbar pain. Typical discography findings, fissured or ruptured disc, with concordant pain are important diagnostic evidence for discogenic lumbar pain.

Objective To prospectively evaluate the value of diffusion-weighted imaging with background signal suppression (DWIBS) in the detection and diagnoses of metastatic cervical lymph nodes. Methods Twenty patients with head and neck squamous cell carcinomas underwent conventional MRI and DWIBS. The ADC values were measured and compared between metastatic and benign lymph nodes. The abilities of DWIBS and conventional MRI in the evaluation of metastatic cervical lymph nodes were compared. Results Conventional MRI demonstrated 101 lymph nodes, in which 58 were diagnosed as metastatic nodes. When MRI criteria were used for discrimination between metastatic and benign nodes, the obtained sensitivity, specificity, accuracy, positive and negative predictive value were 78% (47/60), 81%(44/54), 80% (91/114), 82% (47/57) and 77% (44/57), respectively. The mean ADC values of metastatic nodes (n =60) and benign nodes (n =54) were (0.945 ±0.122) × 10-3 mm2/s and (1. 210 ±0. 151 ) × 10-3 mm2/s ( t = - 10. 354 ,P ＜0. 01 ). When an ADC value of 1. 090 × 10 -3 mm2/s was used as the threshold for discrimination between metastatic and benign nodes, the obtained sensitivity, specificity,accuracy, positive and negative predictive value were 88% (53/60), 80% (43/54), 84% (96/114), 83%(53/64) and 86% (43/50), respectively. Conclusion DWIBS is helpful in diagnosing metastatic cervical lymph nodes of head and neck squamous cell carcinoma, and is superior to conventional MRI in their detection.

Objective To compare the success rate, time of tumor formation and number of tumors in three methods of tumor transplantation, in order to seek an ideal animal model for molecular imaging study. Methods Forty-eight BALB/C-nu/nu nude mice were randomly divided into three groups (each n=16). Tumor tissue mass of 2 mm3 was injected into subcutaneous of nude mice in experiment group. Tumor tissue mass of 1 mm3 was applied in control group 1. Tumor cells suspension liquid was injected into subcutaneous of nude mice in control group 2. The tumor formation rate, the time of tumor formation and the number of tumors were observed. MRI scanning were performed 3-6 weeks after implantation. Results The rate of tumor formation of three groups was 93.75%, 75.00% and 43.75%, respectively. The time of tumor formation was (21.7±2.4), (29.8±2.9) and (34.6±3.9) days, respectively. The rate of solitary nodule implanted tumor was 93.33% in experiment group, higher than that in control group 1 (75.00%) and control group 2 (14.29%). The tumors were hypointense on T1WI and hyperintense on T2WI. Conclusion Transplantation 2 mm3 tumor tissue mass is effective to set up the subcutaneous implanted tumor models with a high success rate of tumor formation, a short time of tumor formation and high rate of solitary tumors, being suitable for the study of molecular imaging. The models can undertake conventional T1WI, T2WI and T2-mapping imaging, and the imaging qualities are good.

Objective To evaluate the diagnostic values of diffusion tensor imaging(DTI)in early radiation-induced brain injury of the temporal lobes.Methods Conventional and MR diffusion tensor imaging examinations were performed in 23 patients following radiotherapy for nasopharyngeal carcinoma(NPC)and in 28 age-matched healthy controls.Isotropic apparent diffusion coefficient(ADCiso)and anisotropic index were measured in the white matter on both of the temporal lobes.Results The value of ADCiso,fractional anisotropy(FA),relative anisotropy(RA)and 1 minus volume ratio(1-VR)were(644.08?56.80)?10-6 mm2/s,0.394?0.074,0.344?0.075 and 0.182?0.072 respectively.In comparison with control group,these values were significant decreased(P

Objective To investigate the level and relationships of posttraumatic growth (PTG) and psychological distress among patients with prostate cancer. Method Totally 116 patients with prostate cancer involved in the investigation by a self-designed demographic questionnaire, posttraumatic growth inventory (PTGI) and distress thermometer (DT). Results The total score of PTGI was (53.12 ± 13.51), at a low level, and the score of DT was (4.32 ± 2.59), at a medium level. The score of DT was negatively correlated to the scores of PTG and its dimensions (all P<0.05). Conclusions Patients with prostate cancer show a low level of PTG and a medium level of psychological distress and they are negatively related . Therefore , nurses should take measures to reduce the patients psychological distress and then improve their PTG level.

Objective To evaluate spleen autotransplantation with lower esophagus transection for the treatment of portal hypertension by three-dimensional dynamic contrast-enhanced magnetic resonance angiography (3D-DCE MRA). Methods Twenty-eight patients were randomly divided into study group undergoing splenic autotransplantation and cardia-esophageal devascularization plus lower esophagus transection and control group without splenic transplantation. The cross section area, blood velocity and blood flow of main portal vein (MPV) were measured by 3D-DCE MRA, and the blood flow, collateral circulation of transplanted spleen were assessed. Results The cross section areas (cm ) of MPV of the two groups decreased postoperatively ( study group 1. 80 ? 0. 69 vs. 1. 20 ? 0. 73 , t = 13.96, P = 0. 00; control group 1. 78 ? 0. 43 vs. 1. 29 ? 0. 57, t = 11. 38, P = 0. 00). The mean blood velocity ( cm/s) of MPV decreased postoperatively (study group 9. 85 ? 0. 09 vs. 7. 06 ? 1. 98, t = 18. 98 , P = 0. 00; control group 10. 01 ?0. 43 vs. 8. 19 ?2. 44, t =22. 32, P =0. 00) in the two groups, and the mean blood velocity ' of MPV in study group was lower postoperatively than that in control group ( t = - 8. 02, P = 0. 00 ) . The mean blood flow (ml/s) of MPV decreased postoperatively (study group 15. 05 ? 2. 43 vs. 10. 52 ? 2. 55, 1 = 16.93, P=0. 00; control group 14. 81 ?2. 29 vs. 11.58 ?2. 96, t = 15. 90, P=0. 00) , and the mean blood flow of MPV in study group was lower postoperatively than that in control group (t = - 2. 73, P = 0. 02). Extensive collateral circulation developed around the transplanted spleen. Conclusions 3D-DCE MRA clearly shows the autotransplantated spleen and portal hemodynamics. It is an important non-invasive way to evaluate the result of the procedures.

Objective The purpose of our study was to investigate three dimensional dynamic contrast enhanced MR angiography(3D DCE M RA) in the detection of portosystemic collateral circulation in the falciform ligament in patients with portal hypertension. Methods From April 2003 to July 2008, 53 portal hypertension patients with varices in the falciform ligament were evaluated with 3D DCE MRA.Two radiologists independently assessed the number, diameter, location and drainages of the portosystemic collateral circulation in the falciform ligament according to the information on the 3D DCE MRA.Results The veins in the falciform ligament were classified into the superior and inferior groups, and both groups arise from the left trunk of the portal vein.In our study, the number of varices detected on 3D DCE MRA images varied from 1 to 3, and the diameters of these vessels varied from 0.4 to 2.6 cm.The inferior group consisted of paraumbilical/umbilical veins (47 cases), which flowed toward umbilicus and then drained upwards (n = 16) including deep superior epigastric veins (n = 7), superficial superior epigastric veins (n = 9), downwards (n = 40) including deep inferior epigastric veins (n = 7), superficial inferior epigastric veins (n = 33), or upwards and downwards at the same time (n = 9).The superior group of vessels in the falciform ligament were directly anastomosed with the internal thoracic vessels (n = 6).Conclusion In patients with portal hypertension, 3D DCE MRA can optimally demonstrate the portosystemic collateral circulation in the falciform ligament, which includes the superior and inferior drainage groups.

Objective To detect the distribution of mesenchymal stem cells(MSCs) after total-body irradiation in rats. Methods MSCs were cultured and labeled with green fluorescent protein(GFP). Rats were exposed to total-body irradiation(TB1) or TBI plus total brain irradiation, and then MSCs were injected through the tail vein. The Fluorescent MSCs were observed by fluorescence microscope. The MSCs numbers in different organs were determined by quantitative RT-PCR method. Results GFP-labeled MSCs were ob-tained. After MSCs were infused to the rats,few of them were observed in the organs of nonirradiated group except for a very low number in the lungs,bone marrow(BM) and spleen. TBI of 6 Gy increased the engraft-ment of MSCs in almost all the organs, especially in early response tissues such as the small intestine and BM. TBI of 7 Gy further increased the number of MSCs. The MSCs numbers in the brain and other organs were significantly increased after 20 Gy total brain irradiation in addition to 6 Gy TBI. Conclusions Radi-ation injury can induce the aggregation of MSCs. With the increase of radiation dose and severity of radiation injury,a significant increase of MSCs in different organs were observed. Local irradiation can increase the MSCs distribution in the radiation field as well as other organs.

Objective To evaluate the apparent diffusion coefficient (ADC) of parenehyma and necrosis in distinguishing among metastatic lymph nodes, lymphoma and tuberculous lymph nodes. Methods Thirty-six patients with cervical lymph nodes metastasis from the head and neck squamous cell carcinomas,19 patients with lymphoma and 23 patients with lymph nodes tuberculosis underwent diffusion-weighted imaging. The ADC values were measured and compared in parenchyma and necrosis of 177 lymph nodes confirmed by histopathology (n = 114) and clinical follow-up (n = 63). The means between two groups were compared by t-test, and one-way analysis of variance (one-way ANOVA) was used to analyze the data among three or more groups. Results The mean ADC values of parenchyma in metastatic nodes, lymphoma and tuberculous nodes were (0.93±0.16) × 10-3mm2/s, (0.64±0.13) × 10-3mm2/s and (1.01±0.11) ×10 -3 mm2/s respectively (F = 82.928, P < 0.01) ; the ADC values of necrosis in metastatic and tuberculous nodes were (2.02 ± 0. 36) × 10-3 mm2/s and (1.25 ± 0.15) × 10-3 mm2/s respectively (t = 12.045, P <0.01). An ADC value of parenchyma lower than or equal to 0.77 × 10 -3mm2/s was used as the threshold for lymphoma, with a sensitivity 83% and specificity of 89%. An ADC value of necrotic area greater than or equal to 1.60 × 103mm2/s was used as the threshold for metastatic nodes, with a sensitivity of 88% and specificity of 100%. Conclusion The ADC value of lymph nodes, especially for their internal necrotic areas, can help judge the nature of the cervical lymph nodes.