1.Application of MRI in common non-traumatic brachial plexopathies
Qiufeng ZHAO ; Song WANG ; Daoying GENG
Chinese Journal of Radiology 2013;(7):643-647
Objective To evaluate the MRI application in the common non-traumatic brachial plexopathies.Methods Twenty-seven patients with non-traumatic brachial plexopathies were retrospectively analyzed,which consisted of 10 males and 17 females with age range from 22 to 70 years old.Among the patients,2 were neurofibromatosis,8 were schwannoma,3 were metastases,2 were radiation plexopathy,1 was multifocal motor neuropathy (MMN),and 11 were typical thoracic outlet syndrome (TOS).Before treatment,all patients underwent MRI of brachial plexus,in which 8 patients underwent Gd-DTPA enhanced MRI.Results In 2 cases of neurofibromatosis,the tumors appeared as fusiform,bead-like masses,growing along the course of brachial plexus with involvement of rootlets in vertebral canal,and iso-to little hypointensity on T1WI,inhomogeneous hyperintensity on T2WI and inhomogeneously enhanced.Schwannoma of 8 cases displayed as fusiform mass,eccentric to the original nerve with sharply defined edge,and hypointensity or inhomogeneous hyperintensity on T1WI,inhomogeneous hyperintensity on T2WI with cystic necrosis in 3 cases which was inhomogeneously enhanced.Two of the 3 cases of metastases manifested as multiple masses besides brachial plexus,the other one appeared as widespread lesion infiltrating brachial plexus and surrounding structures.Two cases of radiation plexopathy displayed as diffused thickened nerves,with increased signal intensity on short time inversion recovery (STIR),clear structure and no mass surrounding the plexus.One case of MMN showed thickened nerves with increased signal intensity on STIR.Eleven cases of typical TOS manifested as arched elevation of C8,T1 and inferior trunk,with thickened nerves and increased signal intensity on STIR.Elevated subclavian artery could be seen in 8 cases.And in one case of TOS,a mass in the end of cervical rib compressed the local brachial plexus.Conclusions MRI can clearly show the location,involved scope and the relationship with adjacent structures.So MRI can provide reliable information for clinical diagnosis and treatment.
2.MRI diagnosis of brachial plexus preganglionic injury
Qiufeng ZHAO ; Daoying GENG ; Wenbo YANG
Chinese Journal of Radiology 2009;43(1):60-64
Objective To evaluate MRI in diagnosing brachial plexus preganglionic injury.Methods Twenty cases with brachial plexus preganglionic injury underwent M R scanning before operation.MR imaging was obtained by GE Signa EXCITE 1.5 T scanner.The scanning sequences included SE T1 WI,FSE T2 WI,T2 WI STIR and 3D Fast imaging employing steady state with phase cycled(3D-FIESTA-c).All the patients had exploration of the supraclavicular plexus and electrophysiology examination. And the accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus iniury were calculated with the standards of surgical and EMG results.Results Among the 73 pairs of i,jured roots.MR imaging detected the abnormalities in 63 pairs.The accuracy, sensitivity and specificity of MRI in diagnosing preganglionic brachial plexus injury were 86.5/(83/96),86.3/(63/73).87.0/(20/23),respectively.The direct signs of brachial plexus preganglionic injury included (1) lack or mutilation of netwe root in 54 pairs (85.7/),(2)coarsening,bending,stiff course and unable to be traced to the intervertebral foramen continuously in 9 pairs (14.3/).The indirect signs included (1)cystic cerebrospinal fluid gathering in the vertebral canal,posttraumatic spinal meningocele in 46 pairs (73.0/),(2)abnormal shape of nerve sleeve in 13 pairs(20.6/),(3)displacement and deformity of spinal cord in 50 pairs(79.4/),(4)abnormal signal of paravertebral muscles in 1 9 patients.Conclusion MRI can distinctly show the nerve rootlets within the vertebral canal,so it is helpful in making a correct diagnosis of brachial plexus preganglionic injuries.
3.1HMR spectrosocopy and diffusion tensor technology in heroin-induced brain damage
Min LI ; Shuyong LIU ; Daoying GENG
Chinese Journal of Radiology 2008;42(6):601-604
Objective To study the values of HMRS and DTI technology for detecting brain damage in heroin-dependent patients.Methods The routine MRI,HMRS and DTI were performed in 7 heroin abuser8 and 8 healthy volunteers without the history of drug abuse.The regions of interest(ROI) were selected in the gray matter and white matter of prefrontal lobe in HMRS exam,and the ratio of NAA/ Cr、Cho/Cr and Cho/NAA were measured respectively.For the DTI,six ROIs were selected,and the values of fractional anisotropy(FA)and ADC were calculated respectively.The independent samples t test was used for the statistics.Results No abnormality was found in the routine MRI.The ratio of NAA/Cr decreased in the prefrontal lobe.the values were 1.40±0.16 in gray matter and 1.72±0.41 in white matter 0f the drug group.1.57±0.09 and 2.08±0.21 in the control group on HMRS examiation.The differenee between the two groups had statistical significance(t=2.183,2.190,P<0.05)On DTI examination,the values of FA decreased in GCC,SCC and AIC,each was 0.70±0.04,0.76±0.41,0.55±0.03 in drug group,and 0.76±0.03,0.82±0.03,0.64±0.03 in controlgroup.The difference betweenthetwo groups had statistical significance(t=3.830,3.713,5.555,P<0.05).The value8 of ADC increased in SCC,PIC and EC in drug group,each Was(8.18±0.48)×10-4,(7.54±0.22)×10-4,(7.72±0.30)× 10-4and(7.50±0.26)×10-4,(7.154-0.20)×10-4,(7.19±0.39)×10-4mm2/s in control group respectively.The difference between tlle two groups had statistical significance(t=3.477,3.507,2.895, P<0.05).Conclusion The early abnormalities of the brain in heroin-induced patients can be found combining HMRS and DRI.
4.Utility of computer -aided detection in the diagnosis of breast carcinoma with mammography
Xiaohong WANG ; Jiuhua WANG ; Daoying GENG
China Oncology 1998;0(04):-
Purpose: To determine breast carcinoma detection rate of a new mammographic computer-aided system (CAD) in order to assess its clinical usefulness. Methods: 467 cases of breast carcinoma proved by surgery and pathology were retrospectively analyzed. All the mammograms of the cases were reviewed by two radiologists working as a team and then analyzed by the CAD-system. The sensitivity for breast carcinoma detection (masses or calcification) was calculated respectively, and the results compared. Results: The sensitivity for breast carcinoma detection by the same radiologists without and with the CAD-system were 80. 94% , 88. 01% , respectively (P
5.Study of white matter hyperintensities of Parkinson's disease by MRI
Zhen ZHU ; Daoying GENG ; Liwei SHEN ; Xiaoyan WU
Chinese Journal of Rehabilitation Theory and Practice 2005;11(10):834-837
ObjectiveTo explore the correlation between white matter hyperintensities(WMH) and the clinical features of Parkinson's disease(PD) when examined by magnetic resonance imaging(MRI).MethodsThe correlation between WMH,periventricular hyperintensities(PVH),deep white matter hyperintense signals(DWMH) in MRI and age,disease duration,distribution in 64 patients with PD and 45 age-matched healthy controls was studied.ResultsThe frequency of WMH was higher in patients with PD,but no significant difference compared with controls(P>0.05).The patients with WMH were significantly older(P<0.01) and more severity(P<0.01) than those without WMH,but disease duration was no significant difference(P>0.05).The frequency of DWMH was higher in patients with PD,but no significant difference compared with controls(P>0.05).The patients with DWMH were significantly older(P<0.01) than those without DWMH,but disease duration and severity were no significant difference(P>0.05).The frequency of PVH was higher in patients with PD and having a significant difference compared with controls(P<0.05).The patients with PVH were significantly older(P<0.01) and more severity than those without PVH,but disease duration was no significant difference(P>0.05).The distribution of DWMH was not significantly different between patients with PD and controls (P>0.05),but distribution of PVH was significantly different between patients with PD and controls(P<(0.05)).ConclusionPVH may influence some clinical features of PD characterized by a greater disease severity.
6.Analysis of factors related to the development of interstitial lung disease in 206 patients with dermatomyositis
Hao WU ; Jinhua XU ; Kefei KANG ; Daoying GENG
Chinese Journal of Dermatology 2012;45(3):161-164
Objective To assess the clinical features and associated factors of interstitial lung disease (ILD) in patients with dermatomyositis (DM).Methods Clinical data were retrospectively analyzed on 206 patients with DM collected at the Department of Dermatology,Huashan Hospital,Fudan University in the past 6 years.Chi-square test and t test were performed for statistical analysis.Results The prevalence of ILD was 49.03% in the 206 patients with DM.Heliotrope rash on the upper eyelids,Gottron's sign (papules),arthralgia,and cough were correlated with the incidence of ILD in DM patients (all P < 0.05),and of these factors,the prevalence of artharalgia and cough were positively correlated with the incidence of ILD,while the presence of Gottron's papules was negatively correlated.The patients with DM and ILD showed a higher prevalence of abnormal serum levels of lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH) and anti-Jo-1 antibodies,as well as with a poorer pulmonary function,compared with those suffering from DM only (all P <0.05).Characteristic imaging findings on computed tomography (CT) scan in patients with DM and ILD included linear opacity (57.4%),high-density patchy opacity (31.7%),reticular opacity (16.8%) and even ground glass-like opacity (13.8%),usually at the bottom or apex of the lungs.Conclusions In patients with DM,the prevalence of artharalgia and cough is positively correlated,whereas the presence of Gottron's papules is negatively correlated,with the incidence of ILD.Characteristic imaging findings on CT scan in patients with DM and ILD are linear opacity,high-density patchy opacity,reticular opacity and ground glass-like opacity at the bottom and apex of lungs.
7.Clinical and radiologic study in intracranial epithelioid haemangioendothelioma and a literature review
Jun ZHANG ; Zonghui LIANG ; Daoying GENG ; Li ZHU ; Ke LI
China Oncology 2009;19(7):532-535
Background and purpose: Primary intracranial epithelioid haemangioendothelioma (EH) was rare. This study was to discuss the clinical pathological features, radiographic findings, treatment and prognosis of primary intracranial EH combined with literature review. Methods: We reviewed a case of EH reported from our hospital, and comprehensively analyzed the related literature. Results: Based on our report and review of the literature, EH is rare and with borderline or uncertain behavior. The original tumors demonstrated specific image features. The tumor usually appeared as a small nest or cords composed of eosinophilic epithlioid or spindled cells.Immunohistochemical assay were positive for endothelial markers CD31, CD34 and FⅧ. EH may be treated with complete surgical resection whenever possible and is sensitive to radiation. The EH has a favorable prognosis. Conclusion: EH has variable malignant potential, and should be differentiated from meningioma. Total resection and close follow-up is recommended. Additional radiotherapy is advised for residual tumors.
8.Magnetic resonance imaging and diffusion tensor imaging of gray matter damage in multiple sclerosis
Yuxin LI ; Shuguang CHU ; Zhenxin LI ; Ping WU ; Daoying GENG
Chinese Journal of Radiology 2008;42(7):709-713
Objective To study MRI characteristics of the gray matter lesions in multiple sclerosis (MS) patients, and to investigate the occult damage in normal appearing gray matter (NAGM) by quantitative analysis using diffusion tensor imaging (DTI). Methods Conventional brain MRI and DTI were performed in 34 clinically defined MS patients and 25 non-MS healthy volunteers. Main signs of the GMlesions detected by conventional MRI were analyzed, including the distribution, numbers, shape, size,signal intensity and enhanced pattern. The apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values derived by DTI were measured in normal appearing deep gray matter for all participants and the differences between the two groups were compared. Results MRI examination revealed 83 lesions in cerebral gray matter, 18. 7% of the total 443 lesions. The GM lesions distributed over all brain lobes especially in frontal lobe, temporal lobe, and thalamus. Thirty-four, 60, 78, and 36 plaques were detected on T1WI, T,2WI, FLAIR, and reconstructed DWI images, respectively. Nine small lesions were identified on DWI more easily than on T2WI and FALIR. The ADC values of the head of caudatum (8. 0±0. 7) ×10-4mm2/s, t=-3.079, P<0.05), putamen (7.4±0.5)× 10-4mm2/s, t= -2.564, P<0.05),and thalamus (7.7± 0. 4) × 10-4mm<'2>/s, t = -2. 722, P < 0. 05) in MS group were significantly higher than those in healthy controls [ the ADC values of head of candatum (7.4 ± 0. 6) × 10-4 mm2/s, putamen(7.0±0.5) ×10-4 mm2/s,and thalamus(7.2±0.7)×10-4mm2/s]. Conclusions This study confirms the presence of GM damage in MS. It shows MRI characteristics of the macro-lesions, and combination of FLAIR and DWI can improve the detection of GM lesions. Occult micro-change in NAGM can be evaluated by using DTI quantitative analysis.
9.The Analysis on CT Misdiagnosis of Gallbladder Carcinoma
Xufeng LAI ; Zonghui LIANG ; Xiaoyuan FENG ; Daoying GENG
Journal of Practical Radiology 2001;0(07):-
Objective To analyses the CT misdiagnostic causes of gallbladder carcinoma, in order to improve the diagnostic rate.Methods Fourty-three patients with the gallbladder carcinoma proved histologically were examined by computed tomography (CT), twenty-three of them were misdiagnosed.The misdiagnostic causes were analysed and compared CT images with operation.Results In the cases of misdiagnosis they were diagnosed as acute or chronic cholecystitis in 5; polyp in 1; bile duct carcinoma in porta hepatis in 2; cholangiocarcinoma in 1; neoplasm of distal part of common bile duct or ampulla in 3; carcinoma of head of pancreas in 5;cholangitis in 1; jaundice of obstruction in 2;tumefaction of gallbladder in 2;carcinoma of colon in 1. Conclusion To be aware of CT characters of gallbladder carcinoma and the way of metastasis is useful to avoid misdiagnosis of the gallbladder carcinoma and to improve the diagnostic rate.
10.Ventricular Meningioma: Imaging Diagnosis
Zonghui LIANG ; Zhen ZHU ; Xiaoyuan FENG ; Daoying GENG ; Xingrong CHEN
Journal of Practical Radiology 1991;0(03):-
Objective To study the imaging features of the ventricular meningioma, in order to improve the understanding knowledge. Methods Compared with operative and pathological findings,the CT and MRI features of ventricular meningioma were analyzed in 22 patients (8 males and 14 females,range from 17~72 years old with average age 45 years).21 cases were examined by MRI(17 with enhanced scan),11 cases by CT(4 with enhanced scan).Results The ventricular meningioma were mostly fibrous type. Mostly, the locations were in the trigone of the lateral ventricle with regular shape. On imaging, the most were parenchymatous with markedly enhancement. Calcification may be found, but cystic changes and hemorrhage were very rare.Conclusion The ventricular meningiomas have characteristic imaging features. CT and MRI are valuable in diagnosis, especially MRI.