1.Application of semi-automated measurement of liver volume in living donor liver transplantation
Biyan GONG ; Qian JI ; Miaomiao LONG ; Wen SHEN ; Ji QI
Chinese Journal of Organ Transplantation 2011;32(2):108-111
Objective To evaluate the accuracy of multi-detector spiral CT (MSCT) semiautomated volumetric measurement of right lobes and its value in living donor liver transplantation (LDLT). Methods Fifty-six donors underwent four phases MSCT. Pre-operative liver volumes of two measurements [IQQA(R)-liver semi-automated (Vs) and manual volume (Vm) measurements] in portal vein phase were compared with intra-operative measurement (Vio) by means of water displacement. Results Correlation analysis and Bland-Altman tests were used for statistical analysis.Results Pre-operative measurements of grafts resulted in a mean Vs, Vm, Vio of (818. 60 ± 161.43)cm3 , (880. 16 ± 169. 92) cm3 and (669. 84 ± 141.37) cm3 respectively. All corresponding pre-and intra-operative data were correlated significantly with each other. There was a good correlation between Vs and Vio(r= 0. 778, P<0. 05), so did Vm and Vio(r= 0. 746, P<0. 05). The equations of linear regression were Vio = Vs × 0. 681 + 112. 26, and Vio = Vm × 0. 620 + 123. 81 respectively. Exact 95 % CIs and the extent of concordance were 121.57-175. 95 cm3, -354. 135-56. 62 cm3 for semiautomated measurements, and 180. 09-240. 56 cm3 , - 438. 66-18. 01 cm3 for manual measurements,respectively. Conclusion Semi-automated method for the volumetric measurements of the right liver lobes in LDLT is more accurate than the manual method.
2.Gastrointestinal stromal tumors:imaging features with intraoperative and clinicopathological correlation
Long-Jiang ZHANG ; Ya-Ying YANG ; Ji QI ; Wen SHEN ;
Chinese Journal of Radiology 1994;0(06):-
Objective To analyze imaging of gastrointestinal stromal tumors(GIST),and to compare their imaging features with operational and pathological findings.Methods Clinical,imaging,and pathological data of 20 patients with GIST were collected.Results Imaging findings were endophytic or exophytic tumors with heterogeneous density or signal intensity,corresponding to hemorrhage,necrosis,and cystic changes.Imaging was correct for the location of the lesion in 11 of 16 primary GIST and 4 cases of relapsed tumors.Preoperational CT did not detect mesenteric,peritoneal,and omental metastasis in 5 cases. Hepatic metastases detected at CT (3 cases )were identified by operational findings.Conclusions GIST has some imaging features.CT is a useful tool in detecting and characterizating of lesions rather than detecting mesenteric,peritoneal,and omental metastasis.
4.Resting-state functional MR changes in Alzheimer's disease patients visualized by amplitude of low-frequency fluctuation and fraction of amplitude of low-frequency fluctuation
Miaomiao LONG ; Hongyan NI ; Jie FENG ; Hongtao ZHANG ; Tie LIU ; Wen SHEN ; Ji QI
Chinese Journal of Radiology 2013;(1):44-48
Objective To investigate the difference of amplitude of low-frequency fluctuation (ALFF) and fraction of amplitude of low-frequency fluctuation(fALFF) between Alzheimer's disease (AD)patients and normal aging (NA) controls by voxel-based analysis.Methods Thirty-one AD patients and 44 NA controls were enrolled in the study.Blood oxygen level dependent functional (BOLD) EPI data were obtained during resting-state by using 32-channel head coil.Data were realigned,normalized and then smoothed with 8 mm FWHM kernel.Resting-state fMRI toolkit(version 1.6) was used to generate ALFF and fALFF images.Independent two sample t-test was performed with SPM5 to compare ALFF and fALFF of AD and NA controls.Pearson correlation analysis was performed to examine the relationship between MMSE score and ALFF,fALFF parameters.The significance level was set to be uncorrected O.001 on the voxel level and 0.05 on the cluster level.Results AD patients showed increased ALFF in left temporal lobe (0.492 ±0.119) and right cingulated cortex (0.434 ± 0.093) of AD patients,which were 0.443 ± 0.068 and 0.380 ±0.081 in NA controls (t =2.658,2.227,P < 0.05).Decreased fALFF was found in bilateral posterior cingulate cortices (1.167 ± 0.203) and increased fALFF was found in bilateral temporal lobes (left 1.226 ±0.127,right 1.146 ±0.214) with left side dominance,which were 1.453 ±0.269,1.134 ±0.088,1.014 ± O.132 in NA controls (t =5.001,3.695,3.285,P < 0.05).Bilateral temporal ALFF and fALFF correlated with MMSE positively (r =0.768—0.909,P < 0.05) with left dominance.Conclusion AD patients showed increased resting-state functional MRI changes correlated with MMSE score in the temporal lobes with left dominance,which indicated left temporal lobe may be the best location for the observation of disease progression in AD patients.
5.Magnetic resonance cholangiopancreatography classification of the bile duct anatomy of liver transplantation living donor: a meta-analysis
Miaomiao LONG ; Lihua LIU ; Tie LIU ; Jianlan YUE ; Wenjun FAN ; Wen SHEN ; Ji QI
Chinese Journal of Organ Transplantation 2012;33(7):407-411
Objective To systematically evaluate the diagnostic value of magnetic resonance cholangiopancreatography (MRCP) in the investigation of bile duct anatomy of liver transplantation living donors.Methods A search in Cochrane library,MEDLINE,EMBASE,CBMdisc (China Biology Medicine disc) was performed to identify relevant English and Chinese-language abstracts,supplemented by Springer,OVID,Sciencedirect full text database,etc.Criteria for inclusion were based on validity criteria for diagnostic research published by the Cochrane collaboration.With Meta analysis package for Stata10.1,heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity,positive likelihood ratio,negative likelihood ratio. Summary receiver operating characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally,sensitivity analysis was performed.Results Seventeen articles with 34 studies were included.Heterogeneity analysis revealed heterogeneity between studies and the source was MRCP imaging methods spotted by meta-regression analysis. Subgroup analysis according to MRCP imaging methods showed homogeneity within subgroups.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odd ratio of breath-holding thick slice MRCP,3D MRCP,the combination of the prior two methods,contrast enhance MRCP were 0.89,0.78,4.1,0.14,29; 0.92,0.80,4.5,0.10,45;0.95,0.82,5.2,0.06,85; and 1.00,0.76,4.1,0,1228,respectively with fixed effect model analysis.The area under the SROC curve was 0.83,0.92,0.96 and 0.99 respectively.Conclusion The combination of thick slice and 3D MRCP is a practical and effective method with good sensitivity and specificity to investigate bile duct anatomy of living liver transplantation donors,which fully meets the requirements of the preoperative assessment of bile duct structure.
6.Differentiation of benign and malignant lymph nodes with ADC value on diffusion MR: a Metaanalysis
Miaomiao LONG ; Lihua LIU ; Guangfeng GAO ; Lihua CHEN ; Wen SHEN ; Ji QI
Chinese Journal of Radiology 2012;46(2):152-157
Objective To summarize the diagnostic efficacy of ADC value for differentiation of benign and malignant lymph nodes on diffusion MRI with Meta-analysis. Methods Published papers on differentiation of benign and malignant lymph nodes with ADC value were searched and reviewed.Quality evaluation was performed for the eligible papers before data extraction.Test for heterogeneity was performed first,then appropriate model was selected to calculate the weighted mean difference,sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,pretest and posttest probability.The potential of ADC value for differentiation of benign and malignant lymph nodes was assessed qualitatively and quantitatively.Results Fifteen papers including 735 cases and 1963 lymph nodes were selected.According to Meta-regression analysis,subgroup analysis and robust analysis,two studies with benign lymph nodes in patients with benign lesion and one study using chemical shift saturation technique were excluded because of their impact on the robustness of the pooled results. The weighted mean difference (WMD) between malignant and benign lymph nodes was -0.355 × 10-3mm2/s[95% confidence interval (CI):-0.423 ×10-3- -0.288 × 10-3 mm2/s].Although the cutoff of ADC value for differentiation in each study was different,the diagnostic efficacy was stable,the pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio and area under summarized receiver operator's curve were 0.87 (95% CI:0.79-0.92),0.87 (95% CI:0.82-0.90),6.5 (95% CI:4.7-9.2),0.15 (95% CI:0.09-0.25 ),43 ( 95% CI:21-87 ),0.93 ( 95 % CI:0.90-0.95 ).The posttest malignancy probability of benign lymph node indicated by ADC was 6%,while that of malignant lymph node was 72%.Conclusion The ADC value can be used to differentiate benign and malignant lymph nodes with good sensitivity and specificity noninvasively.
7.A voxel-based correlation analysis between mini-mental state examination scores and brain apparent diffusion coefficients or fractional anisotropy image
Miaomiao LONG ; Hongyan NI ; Jinyao REN ; Biyan GONG ; Wen SHEN ; Ji QI
Chinese Journal of Geriatrics 2012;31(5):359-362
Objective To investigate the voxel-based correlation of mini-mental state examination(MMSE) score with apparent diffusion coefficients(ADC) and fractional anisotropy (FA) derived from diffusion tensor imaging(DTI) in the patients with Alzheimer disease. Methods 12 patients aged (70.0± 10.5) years and 16 normal control aged (66.5±6.7) years were enrolled in this study.DTI was performed based on sequence and 32-channel head coils.ADC and FA images were calculated and normalized to the same space and smoothed with 8 mm Gaussian Kernel. With statistical parameter mapping software SPM5 package,the independent two sample t-test with general linear model were performed to detect ADC and FA differences between AD patients and normal control.Correlation analysis was performed between MMSE score and FA or ADC. Results AD patients showed elevated ADC value and decreased FA value in bilateral temporal lobe and anterior cingulate,which was more pronounced in the left than in the right.There was elevation of ADC value but no FA decrease in bilateral posterior cingulate.The abnormal ADC area was larger than that of FA.There was negative correlation between MMSE score and ADC of the right hippocampus(r=-0.9474,P=0.0232) and a tendency towards positive correlation between MMSE score and FA of the right hippocampus(r=0.5414,P=0.5853). Conclusions ADC value may be more sensitive than FA value in DTI. Right temporal lobe microstructure involvement is less severe,but has a stronger relationship with neuropsyehological abnormality.
8.Effects of HBV infection on hepatic fibrosis and level of Th1/Th2 cytokines in the patients with Schistosomiasis japonica
Zhong-Wei JIA ; De-Yong CHU ; Wei WANG ; Qing-Li LUO ; Ji-Long SHEN ;
Chinese Journal of Laboratory Medicine 2003;0(10):-
Objective The levels of Thl cytokines(IL-10 and IL-13)and Th2 cytokines(INF-? and TNF-?)were determined in the sera of patients with Schistosomiasis japonica in order to find the relationship between cytokines and severe hepatic fibrosis(HF)in schistosomiasis.Methods A total of 358 patients with advanced Schistosomiasis japonica were examined by ultrasound.68 HBsAg negative patients were chosen randomly as experimental control.Among them,39 patients were found to have mild HF and 29 were severe HF.The sera levels of Thl and Th2 cytokines were determined with ELISA.Results Among these 358 patients,83(23.2%)were HBsAg positive.Neither earlier nor severer hepatic fibrosis was noted in the patients who had been simultaneously infected with HBV than those only infected with schistosomiasis. There was a significant difference between mild[ 1.60(1.30-12.14)ng/L]and severe[ 4.20(1.43- 52.07)ng/L]HF patients in the level of IL-10(Z=-3.907,P0.05)was found in level of IFN-?,between severe[3.12(1.38-66.14)ng/L]and mild[5.87(1.33-216.33)ng/ L]HF subjects.Our observation did not reveal any obvious difference of TNF-? between severe[ 2.48(0.79 -19.86)ng/L]and mild[ 2.28(0.67-15.72)ng/L]HF groups.Conclusions Patients infected with advanced shistosomiasis may become more susceptible to HBV.The results of the present investigation showed that a high level production of IL-13 was associated with severe HF.
10.Applications of magnetic resonance cholangiopancreatography after fat meal in the preoperative evaluation of the biliary system of the donors for living liver transplantation
Peng LI ; Wen SHEN ; Hongyan NI ; Jianzhong YIN ; Miaomiao LONG ; Shuang XIA ; Qian JI ; Minghui CUI ; Tie LIU ; Ji QI
Chinese Journal of Organ Transplantation 2011;32(1):43-46
Objective To evaluate the applications of magnetic resonance cholangiopancreatography (MRCP) after fat meal in the preoperative evaluation of biliary anatomy of living liver donors.Methods Fifty cases of the preoperative donors for living liver transplantation were included and all had the corresponding intraoperative cholangiography (IOC) information. The MRCP of the donors for living liver transplantation was performed before and after fat meal (two fried eggs). The visualization and diameter of the secondary bile duct were analyzed before and after the fat meal. The results of the biliary branching pattern by MRCP after fat meal were compared with the corresponding IOC results. The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of MRCP after the fat meal in distinguishing normal and any type of variant biliary anatomy were calculated. Results In all cases,82% of the 50 cases in MRCP before the fat meal could meet the diagnosis needs of the preoperative evaluation,and 100% of the 50 cases in MRCP after the fat meal could meet the diagnosis needs. There was significant difference in the demonstration quality and diameter of the secondary bile duct in MRCP before and after the fat meal (P<0. 05). MRCP showed accurate anatomy of the biliary system, using IOC as the reference standard, in 49(98%) subjects. The sensitivity, specificity, positive predictive value and negative predictive value of MRC in distinguishing normal and any type of variant biliary anatomy were 98%,94. 7%, 100%, 10% and 96. 9%,respectively. Conclusion The MRCP after fat meal can clearly demonstrate the secondary bile duct and perfectly meet the needs of the preoperative evaluation of the living liver transplantation. The MRCP after fat meal and routine MRCP should be considered complementary to one another in order to avoid complications in living liver transplantation donors.