Objective To explore the characteristic appearance of MR imaging of atypical craniopharyngioma and improve the diagnostic accuracy.Methods 8 atypical craniopharyngioma were analyzed retrospectively by MR imaging,which had been confirmed by pathology.Results 3 atypical craniopharyngiomas were cystic lesions, 2 were solid lesions, and rest 3 were solid-cystic lesions.The cystic lesion presented variable intensities on T1-weighted imaging (T1WI);and the wall was remarkably enhanced and uniform in thickness.The solid lesions presented hypointense on diffusion weighted imaging (DWI), and reticular enhancement.Solid-cystic tumors presented heterogeneous enhancement.In these lesions,4 lesions in sellar and suprasellar regions were misdiagnosed as pituitary macroadenoma,because of the unclear boundary between the lesions and pituitary gland.2 lesions in superasellar region were misdiagnosed as germinoma, for the remarkable enhancement.And 2 cases in superasellar region were misdiagnosed as pilocytic astrocytoma,for indistinct boundary between lesions and pituitary stalk and optic chiasma.Conclusion The MR imaging characteristics can help distinguish atypical craniopharyngioma from pituitary macroadenoma,sellar germinoma and pilocytic astrocytoma.

Objective To investigate the application value of multi-slice CT enterography (MSCTE)in diagnosing intestinal tuberculosis (ITB)and Crohn’s disease (CD).Methods MSCTE findings were retrospectively analyzed in 25 patients with ITB and in other 25 patients with CD diagnosed through endoscopy,pathologic examination and clinical follow-up.Statistical analysis was performed to find out the difference in CT findings between the ITB and CD.Results 25 patients with CD included the involved ileum in 23,involved duode-num and jejunum in 8,multiple segmental lesions in 20,asymmetrically thickened intestinal wall in 20,hierarchical reinforcement in 1 9,mesenteric vascular hyperplasia in 20,fibrofatty hyperplasia in 18,peritoneal abscess or fistula in 8,anal fistula in 1,and pseu-do-diverticulum formation in the intestinal wall on the opposite side of the mesentery in 2.Meanwhile,the other 25 patients with ITB included the involved terminal ileum in 25,symmetrically thickened intestinal wall in 23,annular enhancement of lymph nodes in 11,thickened peritoneum and omentum together with distinct enhancement,or intestinal adhesion,or ascites appeared in 15.The CD was more likely to represent multiple segmental lesions,asymmetrically thickened intestinal wall,hierarchical reinforcement,mesenteric vascular hyperplasia,fibrofatty hyperplasia,and peritoneal abscess or fistula formation (P <0.05).Meanwhile,the ITB was more likely to represent the lesion only in ileum,symmetrically thickened intestinal wall,and annular enhancement of lymph nodes (P <0.05).Conclusion MSCTE shows promising clinical application in diagnosis and differential diagnosis of CD and ITB.

Objective To investigate the functional and structural changes of connectivity of default mode network (DMN) in relapsing-remitting multiple sclerosis (RRMS) by functional MRI (fMRI) and diffusion tensor imaging (DTI) and to study the relationship between them.Methods Twenty-seven RRMS patients(clinically diagnosed as RRMS)and 27 healthy volunteers (matched to the patients in age and gender) were selected to participate in this study.All the subjects underwent 3.0 T MR scanning.Softwares such as DPARSF,MICA,TrackVis were used for data post-processing.Medial prefrontal cortex (mPFC) and posterior cingulate cortex(PCC) of DMN were chosen as ROIs,and functional and structural changes of DMN and the relationship between them were analyzed.Values of r reflecting the functional connectivity and fractional anisotropy(FA) of two groups were obtained.Then statistical analysis was performed by using student t test and Pearson correlation analysis.Results The DMN space pattern of the RRMS patients was mostly identical to that of controls,but with specific difference in the connectivity strength with respect to that of controls.Particularly,the patient group showed increased DMN connectivity in the mPFC,but decreased connectivity in the inferior parietal lobule (IPL) and PCC.Compared with controls,the r value (0.695 ±0.151 vs.0.796±0.085),FA value(0.261 ±0.012 vs.0.285 ±0.017) between mPFC and PCC in RRMS patients were decreased (t =-3.020,-6.206,P ＜ 0.05).In addition,functional connectivity (r value) was found to correlate with structural connectivity(FA value) between the PCC and mPFC (r =0.704,0.735,P ＜ 0.01).The number of MS lesion,had no correlation with r value or FA value (P ＞ 0.05).Conclusions The functional connectivity and structural connectivity of DMN change in RRMS patients.The functional connectivity and structural connectivity between mPFC and PCC are both decreased in RRMS patients compared with the controls.The injury of structural connectivity may be the structural basis of the decrease of functional connectivity.

Objective:To comparatively study the chemical constituents in n-butanol part from Magnoliae Officinalis cortex before and after ginger mix-frying by HPLC-MS. Methods:A 4000 Q TRAP MS system was used with a C18 chromatographic column. Metha-nol-water with gradient elution was employed as the mobile phase. The data were collected by an electrospray ion source under the mode of positive and negative ions. The chemical constituents were analyzed by contrasting with the reference substances, analyzing the mass spectrometry data and retrieving literatures. Results:The negative ion mode had better separation for n-butanol part, and fourteen components with known peaks and the other unknown compositions were detected. The positive ion mode could detect fewer peaks, and the detected [ M+H] + peaks malnly were hydrogenation peaksmalnly for phenolic constituents. Conclusion:Through the analysis and comparison, it is suggested that n-butanol part from Magnoliae Officinalis cortex has qualitative and quantitative changes after ginger mix-frying.

This article analyzes mainly the X-ray imaging acquisition parameters in AXIOM Artis X-ray equipment, the relationship between the parameters, and how to select acquisition parameters in cardioangiography. We have sought a set of X-ray imaging acquisition parameters for producing optimal image in cardioangiography.
Angiography ; instrumentation ; Humans ; Photofluorography ; instrumentation ; Radiographic Image Enhancement ; instrumentation ; methods ; Radiographic Image Interpretation, Computer-Assisted ; instrumentation

Objective To examine brain regions with a functional connection to posterior cingulate cortex (PCC) in a relapsing-remitting multiple sclerosis (RRMS) group compared with matched control subjects,and to employ resting-state functional MRI (rs-fMRI) to PCC connectivity gathered by investigating synchronic low frequency fMRI signal fluctuations of default mode network with seed-based correlation analysis (SCA).Methods Twenty-seven patients with RRMS (RRMS group) and 27 age-,and sexmatched healthy controls (HC group) were examined by resting-state fMRI,DTI and 3D-T1 on Siemens Trio Tim 3.0T.The fMRI data preprocessing and processing was performed using Data Processing Assistant for Resting-State fMRI Advanced Edition (DPARSFA) based on Matlab 2012a,and PCC (-5,-49,40)was selected as seed.An SCA approach was used to analyze the rs-fMRI data.We examined the differences in SCA-derived connectivity metrics in patients with RRMS and healthy controls,and analyzed correlations between connectivity correlation coefficient of the differences regions and MRI-derived metrics (brain parenchymal fraction,T2 lesion load),as well as clinical metrics (expanded disability status scale,paced auditory serial addition test,and disease duration) of the disease.Results The SCA via functional connectivity of PCC showed that the temporal correlation between the blood-oxygen-level-dependent signals of the default mode network was reliable spatial patterns of activation in patients with RRMS.The lower connectivity in right superior frontal gyrus within default mode network,and higher connectivity in right posterior lobe of cerebellum,right crus of cerebellum,right medial frontal gyrus,right medial occipital gyrus,left precuneus/cingulate gyrus,right angular gyrus and right cingulate gyrus were found in our study.Significant negative-related was observed between the paced auditory serial addition test and functional connectivity in right middle temporal gyrus (0.387 ± 0.216) of RRMS patients (r =-0.59,P =0.001).Significant negative correlation also was observed between the course of disease and functional connectivity in right superior frontal gyrus (0.039 ± 0.293) in patients (r =-0.39,P =0.041).There was no significant correlations between other regions with different functional connectivity and expanded disability status scale,disease duration,or brain atrophy.The connectivity in right superior frontal gyrus,left medial occipital gyrus,left precentral gyrus was decreased; and connectivity in right cerebellum anterior lobe (dentate),right frontal lobe white matter was significantly increased.Significant positive correlation was observed between the course of disease and functional connectivity in left precentral gyrus (-0.924 ± 0.253),right cerebellum anterior lobe (dentate ;0.217 ± 0.208) of RRMS patients (r =0.650,P =0.000;r =0.436,P =0.023),respectively.Conclusion These findings reveal the compensatory mechanism of the brain in response to structural damage,by means of increased activation or synchronization of default mode network,which seems to be finite.

Objective To investigate CT features of primary ileocecum lymphoma (PIL),to improve the ability of CT diagnosis for the disease.Methods CT data of 12 patients with PIL confirmed by surgery and pathology were analyzed retrospectively.All of the patients underwent plain CT, and 8 cases of them also underwent enhanced CT.Results Among the 12 cases of PIL, there were mass type in 2 and diffused thickness type in 10.The length of the intestinal lesions ranged from 7.8 to 18.5 cm (mean 10.2 cm).Lumen was irregular or aneurysmal dilation in 9, and obvious stenosis in 3.Intestinal wall was soft in 10,and rigid in 2.Plain CT showed that the thickened intestinal wall was soft tissue density.Among the 8 cases performed enhanced CT,6 were approximately homogeneous enhancement, and 2 had small necrosis area without enhancement.Maximum intensity projection(MIP) displayed the lesion had blood supply from the branches of the superior mesenteric artery.Enlarged lymph nodes were detected around the lesions, in root of the mesentery, and in the retroperitoneum in 9.1 case was accompanied with intestinal obstruction,1 case was accompanied with intestinal perforation.Conclusion If CT examination found a homogeneous soft tissue mass in ileocecum with long extent, lumen dilation, soft intestinal wall,mild-to-moderate delayed homogeneous enhancement, PIL should be considered.

OBJECTIVETo evaluate the outcomes of arthroscopy-assisted treatment of severe comminuted distal radial fracture with external fixators and kirschner wire fixation.

METHODSTwenty-seven cases of severe comminuted distal radial fracture treated between March, 2010 and January, 2012 were reviewed. During the operation, the carpal joint space was expanded with the external fixator, and the fracture was fixed by Kirschner wire after open reduction. The carpal joint was observed intraoperatively with arthroscopy to ensure full reduction, and the distal posterior interosseous nerve was then severed. The results of postoperative X-ray and wrist functional status of the carpal joints were recorded. Another 27 cases of severe comminuted distal radial fracture treated by conventional surgical approach served as the control group.

RESULTSThe patients were followed up for a mean of 13.2 (5-27) months. Compared with the conventional surgical approach, arthroscopy-assisted treatment resulted in a significantly shorter operative time with better appearance of the articular surface and also better wrist function assessed using the Krimmer system (P<0.05).

CONCLUSIONArthroscopy-assisted external fixator treatment is effective for management of severe comminuted distal radial fracture and avoids the stair-like appearance of the articular surface to achieve the maximal functional recovery of the carpal joints and reduce traumatic arthritis.

Adult ; Arthroscopy ; External Fixators ; Female ; Fracture Fixation ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged ; Radius Fractures ; surgery ; Treatment Outcome

Objective: To review the clinical data of patients who underwent maxillary and mandibular reconstruction with vascularized fibula osteomycutaneous flap, using virtual surgery planning. Methods: From January 2012 to December 2016, 23 patients with mandibular defect and 2 patients with maxillary defect were treated in our department. In virtual surgery planning, the optimal osteotomy line and angle were designed. Segmental maxillectomy and mandibulectomy, as well as mandibular reconstruction were performed using guided templates to practice the virtual planning.Actual reconstruction results were compared with those of virtual surgery. Results: Among the 25 patients, 2 patients were repaired with the ipsilateral fibula myocutaneous flap, 22 patients were lateral fibula myocutaneous flap. One case of maxillary type Ⅱd defect was repaired with left fibular muscle flap. All patients were followed up for 12 to 48 months. Satisfied bony unions and occlusion were observed in 25 patients.All patients reported excellent or good facial appearance. One of them received dental implants at 1 year postoperatively. Conclusions An ideal contour of maxilla and mandible can be obtained using vascularized fibula osteomycutaneous flap in virtual surgery.

Objective:To explore the application and effect of anterolateral thigh free flap (ALTFF) and modified pectoralis major myocutaneous flap (PMMF) in the reconstruction of defects after radical resection of head and neck tumor.Methods:From November 2011 to November 2016, 394 cases with head and neck tumor, including 286 males and 108 females, aged 25-79 years, underwent radical resection. The defect was reconstructed with anterolateral thigh free flap (306 cases) or modified pectoralis major myocutaneous flap (88 cases). The result and the quality of life of patients are investigated, the advantages and disadvantages of the two flaps are summarized.Results:Survival rate of anterolateral thigh free flap and modified pectoralis major myocutaneous flap were 97.1% (297/306) and 97.7% (86/88) in 394 cases. The ALTFF group (3-4 h) and the PMMF group (1.5-2.5 h) have similar operative duration. Comparison of the UW-QOL scores of the ALTFF group and PMMF group 1 year post operation shows that the ALTFF group has significant advantages in appearance, speech and shoulder mobility, the difference was statistically significant ( P<0.01). Conclusions:Both of ALTFF group and PMMF group have high success rate in the reconstruction of defects after radical resection of head and neck tumor. Anterolateral thigh free flap is appropriate for the reconstruction of complex defects and modified pectoralis major myocutaneous flap is safer in patients with poor vascular conditions and systemic conditions.