1.Correlation of diagnostic imaging and autopsy findings of eight patients with acquired immune deficiency syndrome
Hongjun LI ; Yuzhong ZHANG ; Jingliang CHENG
Chinese Journal of Radiology 2009;43(11):1196-1200
Objective To investigate the imaging findings with pathologic correlation in patients with acquired immune deficiency syndrome(AIDS).Methods Imaging findings,autopsy and pathological data were retrospectively analyzed in eight patients with AIDS.Routine CT scanning of different body parts was performed during their hospitalization.CT scanning was performed from the skull to the pelvis immediately following their death.After routine formalin fixing,7 cardevers were cross sectioned for autopsy in freezing state and 1 for gross autopsy.Tissues were obtained from each sections and organs for pathological examinations.Results The autopsy data showed parasitic infections(5 cases),bacterial infections (3 cases),fungal infections(2 cases),virus infections(2 cases),lymphoma(1 case)and cerebrovascular diseases(1 case)in eight patients with AIDS.The CT scanning demonstrated symmetrical ground glass liked shadows with pulmonary hilus as the center in 5 cases of pulmonary PCP infection; pulmonary patchy shadows,scattering distribution of nodular shadows,extensive military nodular shadows with even distribution and tuberculous pleurisy; cloudy shadows for 2 cases of fungi infection with multiple foci of chronic inflammation;pulmonary net-like parenchymal changes for 2 cases of pulmonary CMV infection;thickened intestinal wall and narrowed intestinal lumen for 1 case of intestinal tumor; low density shadows of brain tissue for 1 case of CMV encephalitis and MRI findings of high T_1 and high T_2 signals as well as MRA findings of broken vascular channels in liquefied areas of brain tissues; patchy low density areas inside a cyst of brain for one case of brain toxoplasmosis infection:multiple small patchy low density areas in cerebral basal ganglia for one case of brain cryptococcus infection.Conclusions In AIDS patients,infection and tumor may occur in various organs resulting in complex symptoms,which makes it more complicated and difficult to make accurate diagnosis.A correlative study of imaging findings and pathological manifestation of AIDS patients at autopsy could be helpful for clinical diagnosis.
2.Clinical Applied Value of the Early Slope Value of MR Contrast-Enhancement in Differentitating Benign Musculoskeletal Neoplasms from Malignant Ones
Huili GUO ; Min ZHANG ; Jingliang CHENG
Journal of Practical Radiology 2000;0(02):-
Objective To investigate the clinical applied value of the early slope value of MR contrast-enhancement in differentitating benign from malignant musculoskeletal neoplasms.Methods 48 patients with benign or malignant musculoskeletal masses(26 benign,22 malignant) confirmed by pathology underwent dynamic contrast-enhanced scanning.The largest slope of dynamic enhancement in early stage and SI-Time curve type were gained and the difference of them in benign and malignant musculoskeletal tumours were analysed.Spearman rank correlation analysis was used to determine the relation between slope and microvessel density of tumor tissues.Results There were 3 SI-Time curve types in all cases with typeⅠ(precipitous rise) in 22 cases,type Ⅱ(slow rise) in 21 cases and type Ⅲ(slight rise) in 5 cases.The average early slope value of enhancement was(4.23?2.68)% per second(range 0.96%~10.53%)in malignant tumors,and(1.44?0.99)% per second(range 0.36%~3.76%)in benign tumors.There was an apparent statistical significance between benign and malignant tumors(P
3.Correlation between middle cerebral artery atherosclerotic plaques and single subcortical infarction
Keyan WANG ; Jingliang CHENG ; Yong ZHANG
International Journal of Cerebrovascular Diseases 2015;23(7):506-511
Objective To investigate the correlation between middle cerebral artery (MCA) atherosclerotic plaques and single subcortical infarction (SSI) using high-resolution magnetic resonance imaging (HR-MRI).Methods The patients with SSI received HR-MRI examinations at the ipsilateral MCA horizontal segment stenosis from January 2012 to November 2014 were analyzed prospectively.They were divided into proximal SSI (pSSI) and distal SSI (dSSI).The longitudinal and transverse diameters and volume of different types of infarction pattern as well as the degree of luminal stenosis of MCA deep perforating parent artery,plaque distribution,plaque enhancement or not,white matter lesions,and general information of both groups were documented respectively.Results A total of 78 patients with SSI were enrolled,including 40 (51%) in the pSSI group and 38 (49%) in the dSSI group.The proportions of Fazekas scale grade 3 white matter lesions (63.5%vs.40.0%;x2 =4.183,P=0.041) and deep white matter lesions (50.0% vs.15.0%;x2 =10.961,P =0.001) in the dSSI group were significantly higher than those in the pSSI group.The proportions of MCA plaque in the opening (35.0% vs.13.2%;x2=3.930,P=0.047),plaque enhancement (87.5% vs.30.0%;x2 =25.447,P < 0.001) and posterosuperior wall plaques (42.5% vs.21.4%;x2 =9.491,P < 0.001) and the degree of luminal stenosis (60.38% ± 10.20% vs.45.00% ±6.44%;t =3.625,P =0.031) in the pSSI group were all significantly higher than those in the dSSI group.In addition,the longitudinal and transverse diameters and volume of the infarcts in the pSSI group were significantly larger than those in the dSSI group (all P < 0.001).Multivariate logistic regression analysis showed that MCA enhanced plaques on the lesionipsilateral sides (odds ratio[OR] 11.764,95% confidence interval[CI] 2.081-66.511;P =0.005) and posterosuperior wall plaques (OR 6.131,95% CI 1.012-23.339;P =0.037) were independently associated with pSSI,while deep white matter lesions (OR 0.280,95% CI 0.203-0.648;P=0.012) was independently associated with dSSI.Conclusions The atherosclerotic plaques of MCA deep perforating parent artery are common in both the pSSI group and the dSSI group.pSSI is mainly associated with the location of atherosclerotic plaques of deep perforating parent artery and enhanced plaques,while dSSI is mainly associated with deep perforating artery vasculopathy.
4.MRI Diagnosis and Clinical Analysis of Achilles Tendon Injury
Huili GUO ; Min ZHANG ; Jingliang CHENG
Journal of Practical Radiology 1992;0(11):-
Objective To study the diagnostic value of achilles tendon injury(ATJ) and the diagnostic standards for different severities of the injury by MRI.Methods Twenty-six cases of traumatic ATJ proved both clinically and surgically and had complete MRI materials were selected.The characteristic MRI appearances were summed up and retrospectively compared with that of 10 normal achilles tendons.Results The results were as follows :(1) MRI appearances of 10 normal achilles tendons : regular course,smooth margin,homogenous hypointensity on T_1WI and T_2WI;(2) MRI appearances of 17 partial ATJs:tendon thickening,decreased ratio of wide/vertical diameter,localized hyperintensity in tendon on T_1WI and T_2WI,crude and irregular fibrous bundles but at least keeping one continuous layer on sagital view;(3) MRI appearances of 9 total ATJs: tendon thickened and irregular appearance,totally discontinuous fibrous bundles,"brush" or "pestle" change and mixed hyperintensity on T_1WI and T_2WI;(4) 7 cases with bone contrusion and soft tissue injury,2 cases with ligament injury,2 cases with bone and cartilage injury and 11 cases with fluid collected around tendon.Conclusion MRI can accurately judge thenature,range,degree and complications of ATJ and is of great value for preoperative plan of the treatment program and the postoperativeanalysis of the therapeutic effect.
5.Paraspinal muscle approach plus dorsomedian laminectomy approach for thoracolumbar fractures with spinal cord injury
Zaijiong ZHANG ; Jingliang ZHANG ; Lei ZHANG ; Zhendui WEI
Chinese Journal of Orthopaedic Trauma 2017;19(3):261-264
Objective To observe the clinical efficacy of screwing via the paraspinal muscle approach plus single-segment laminectomy decompression via the dorsomedian approach for thoracolumbar fractures complicated with spinal cord injury.Methods From February 2013 to September 2015,21 patients with thoracolumbar fracture plus spinal cord injury were treated at our department.They were 15 men and 6 women,aged from 20 to 54 years (average,33.2 years).The injury was located at T1 1 in 2 cases,at T12 in 6,at T12 and L1 in one,at L1 in 7 and at L2 in 5;the injury was rated as grade A in one case,grade B in 3 cases,grade C in 8 and grade D in 9 according to the American Spinal Injury Association (ASIA) grading system.A1 the patients were treated by screwing via the paraspinal muscle approach followed by single-segment laminectomy decompression via the dorsomedian approach.Results The operation time averaged 116.1 + 24.5 minutes and the amount of bleeding 580.7 + 80.8 mL.At 3 days after surgery and the final follow-up,their visual analogue scale (VAS) score,anterior vertebral height and cobb angle were significantly improved in comparison with the preoperative values (P < 0.05).At the final follow-up,their Japanese Orthopaedic Association (JOA) the score were also significantly better than the preoperative one (P < 0.05),giving 12 excellent cases,6 good ones and 3 fair ones.Their ASIA grading at the final follow-up showed one case of grade B,2 cases of grade C,6 cases of grade D and 12 cases of grade E.Conclusion Treatment of thoracolumbar fractures complicated with spinal cord injury by crewing via the paraspinal muscle approach plus single-segment laminectomy decompression via the dorsomedian approach is a good way due to limited invasion,less bleeding,simple operation,excellent reduction,reliable fixation and rapid recovery.
6.Value of DCE-MRI quantification study with exchange model in evaluation of liver cirrhosis
Lan ZHANG ; Yan ZHENG ; Wei XING ; Jingliang CHENG
Chinese Journal of Medical Imaging Technology 2017;33(7):1019-1023
Objective To investigate the value of dynamic contrast-enhanced MRI (DCE-MRI) quantitation study with exchange model in evaluation of liver cirrhosis.Methods A total of 30 patients with liver cirrhosis confirmed to included and excluded criteria were divided into compensatory cirrhosis group (n=15) and decompensatory cirrhosis group (n=15).And 15 healthy volunteers were scrvcd as a control group.All subjects were performed liver DCE-MRI and quantitative pa rameters of three groups were obtained by exchange model,including volume transfer constant of the contrast agent (Ktrans),reverse reflux rate constant (Kep),volume fraction of EES (Ve),volume fraction of plasma (Vp),arterial perfusion index (HPI),blood volume (BV),blood flow(BF) and mean transit time (MTT).The parameters of three groups were compared by ANOVA analysis and LSD test for every two groups.The diagnostic efficacy of Ktrans,Ve,HPI,MTT for liver cirrhosis were analyzed by ROC.Results Ktrans,Ve,HPI,MTT and BF values in the control group,compensatory cirrhosis group and decompensatory cirrhosis group were (0.85 ± 0.34) min-1,(0.67 ± 0.36) min-1,(0.39±0.18)min-1;0.47±0.42,0.34±0.13,0.16±0.06;0.35±0.09,0.57±0.17,0.76±0.20;(17.38±15.38)s,(34.26111.37)s,(57.33±16.73)s;(97.22±36.29)ml/(min· 100 g),(69.30±35.22)ml/(min· 100 g),(24.64± 28.24) ml/(min · 100 g),respectively,and showing significant differences among three groups,and significant with HPI and MTT for every two groups (P<0.05).There were no significant differences for Kep,Vp and BV among three groups (P>0.05).According to ROC of Ktrans and Ve for decompensatory liver cirrhosis,AUC were 0.86,0.92,the sensitivity were 90%,90% and the specificity were 80%,80%.According to ROC of HPI and MTT for compensatory liver cirrho sis,AUC were 0.79,0.76,the sensitivity were 85%,85% and the specificity were 75%,75%.According to ROC of HPI and MTT for decompensatory liver cirrhosis,AUC were 0.91,0.88,the sensitivity were 95%,90% and the specificity were 80%,80%.Conclusion DCE-MRI quantitative study with exchange model can obtain multiple parameters,refleet hemodynamic changes and vascular microenvironment and evaluate severity of liver cirrhosis.
7.Strategies and methods for collection of medical information
Yongxuan DUAN ; Wenhua CHANG ; Jingliang GU ; Rui ZHANG ; Yuan YUE
Chinese Journal of Medical Library and Information Science 2016;25(9):18-21,42
Described in this paper are the significance of medical information collection, selection principles for medical information resources and common strategies for medical information collection, methods of collecting elec-tronic medical information resources, practical techniques of collecting common medical knowledge, and the whole collection process of medical information.
8.Analysis to radiological features of synovial sarcoma in spine
Weijian WANG ; Jingliang CHENG ; Yong ZHANG ; Chunxiao BU
Journal of Practical Radiology 2017;33(9):1404-1406,1426
Objective To improve the recognition to synovial sarcoma in spine by discussing the imaging features of the disease.Methods The clinical and imaging data of 4 cases (2 cases of male,2 cases of female) with synovial sarcoma in spine were analyzed retrospectively, which were confirmed by surgery and pathology,the imaging features and surgical pathology were mainly analyzed.Results All the 4 patients underwent conventional CT and MRI examination,3 of which underwent CT and MRI contrast enhancement examination.On CT plain scan,2 cases showed equal density,2 showed slightly high density.After enhancement,3 cases showed inhomogeneous enhancement.On T1WI,2 cases showed low signal intensity,2 showed iso-signal intensity.On T2WI,1 case showed high signal intensity,1 showed slightly high signal intensity,and 2 showed mixed high signal intensity.On Fat suppression sequence image,2 cases showed hyperintensity,1 had mixed hyperintensity,and 1 had slightly hyperintensity.On DWI,4 cases showed obviously hyperintensity.On T1WI enhancement,1 case had significant enhancement,2 showed inhomogeneous enhancement.Conclusion The CT and MRI manifestation of synovial sarcoma in spine has certain characteristics.Combined with clinical manifestations, CT and MRI are significantly helpful to improve the cognition and diagnosis of synovial sarcoma in spine.
9.Long-term dynamic observation of erythromycin eye ointment entered into the orbit of guinea pigs by using magnetic resonance imaging
Lu YANG ; Jingliang CHENG ; Yong ZHANG ; Jingjing WAN ; Yu ZHU
Journal of Practical Radiology 2014;(6):1030-1034
Objective To evaluate the MRI features of erythromycin eye ointment entered into the orbital soft tissue of guinea pigs.Methods MRI was performed dynamically to observe the signal changes 1 day,1 week,2 weeks ,3 weeks and 4 weeks after erythromycin eye ointment was successfully injected into orbital soft tissue of guinea pigs ,as well as HE stainings to monitor retrob-ulbar soft tissue specimens at each time point were obtained.Results After the injection of erythromycin eye ointment 1 day,1 week,2 weeks,3 weeks and 4 weeks later,the signal intensity of erythromycin eye ointment was resemble to the surrounding soft tissue and indistinguishable on T2 WI.On T1 WI,the signal intensity of erythromycin eye ointment was higher than that of contralat-eral adipose body of orbit at 1day and 1 week,and slightly higher than the contralateral adipose body of orbit at 2 weeks and 3 weeks,but resemblance at 4 weeks.HE staining showed that inflammatory cell infiltration and tissue necrosis at 1 day,the presence of foreign body macrophages and fibroblasts at 2 weeks,and the inflammatory cells surrounding the optic nerve gradually subsided at 3 weeks and 4 weeks.Conclusion Fat-suppressed T1 WI is the best sequence to observe erythromycin eye ointment.Abnormal signal changes on T1 WI can reflect the histopathological changes after erythromycin eye ointment into the tissue.
10.The value of DWI based on biexponential model in differential diagnosis of benign and malignant breast lesions
Jie HE ; Yan ZHANG ; Jingliang CHENG ; Ying HU ; Anfei WANG
Journal of Practical Radiology 2014;(7):1137-1140
Objective To investigate the application value of DWI based on biexponential signal decay model with extended b-fac-tor range in differential diagnosis of benign and malignant breast lesions.Methods A total of 57 patients with breast tumor under-went DWI based on the biexponential model with 12 b-factors (0,10,20,50,100,200,400,600,800,1000,1 200 and 1 500 s/mm2 ), including benign lesions in 1 9 patients (24 breast tumors,defined as benign group)and malignant ones in 38 (47 tumors,defined as malignant group ).The values of slow apparent diffusion coefficient,fast apparent diffusion coefficient and fraction of fast ADC of le-sions were measured at a workstation (Advantage Windows 4.5).Differences in these parameters between the benign and malignant groups were compared.Results The ADCslow,ADCfast and ffast were(1.434±0.291)×10 -3 mm2/s,(2.744±0.050)×10 -3 mm2/s and (0.677±0.130)% in benign group,and (0.614±0.196)×10 -3 mm2/s,(2.692±0.068)×10 -3 mm2/s and (0.446±0.112)% in malig-nant one,respectively.The statistical differences in ADCslow and ffast were found between two groups (P <0.05),whereas no difference in ADCfast was found.Conclusion Biexponential signal decay model of DWI with extended b-factor range can provide helpful tissue characterization parameters for the differential diagnosis of benign and malignant breast lesions.