Objective To evaluate the value of measurement of medial temporal structure by MR imaging volumetry in the differential diagnosis for patients with Alzheimer′s disease (AD) and subcotical ischemic vascular dementia (SIVD) Methods Thirty three probable patients of AD, 33 normal controls, and 17 patients suspected with SIVD had been scanned by MRI, and volumetric measurements of amygdala (AMY), hippocampal formations (HF), entorhinal cortices (EC), parahippocampal gyri (PHG), and temporal horn of lateral ventricle (TH) were done on a serial reconstructed MR images Results Both atrophy of HF and dilatation of TH were significant ( P

Objective To compare the discriminative ability of MRI linear measurements and volumetric measurements between patients with Alzheimer disease (AD) and control subjects, and to evaluate their clinical value. Methods The study group consisted of 32 patients with probable Alzheimer disease and 32 healthy control subjects. Linear measurements and volumetric measurements of the bilateral hippocampal formations, temporal horns of lateral ventricle, parahippocampal gyri, and entorhinal cortices were performed on the serial reconstructed MR images. Discriminant analysis was used to identify measurements independently contributing to discriminating between AD and control subjects. Results With a stepwise method, the right height of temporal horn and right thickness of entorhinal cortex of linear measurements entered the function. The specificity, sensitivity, and accuracy of this function were 96.9%, 84.4%, and 90.6%, respectively. The left entorhinal cortex and left hippocampus of volumetric measurements entered the other discriminant function. The specificity, sensitivity, and accuracy of the second function were 100.0%, 90.6%, and 95.3%, respectively. All the linear and volumetric measurements of cerebral regions were significantly different between AD group and control subjects(t= -6.80～12.53,P

Objective To preliminarily evaluate the diagnostic value of co registration and fusion of positron emission tomography and MR images in Alzheimer disease (AD). Methods Twelve patients with AD (53-83 years) and six normal volunteer (45-71 years) were scanned by positron emission tomography (PET) and MR imaging. The interval between two examination was 1-32 days (average:18 2?11 6 days). The disc and magnetic tape were used to transfer the imaging data to image work station (SGI O 2), then the special software for co registration and fusion: Statistical Parametric Map was used to do automatic co registration between PET and MR images of brain in 3D. Results The findings of PET was completely accorded with the changes of AD in 9 patients (9/12), and accorded with AD, but should be differentiate from other diseases in 3 cases (3/12). According to the measurement of special cerebral structures, MR images could make the diagnosis of AD in 11 patients (11/12), and had no abnormal finding in 1 case. The medial temporal atrophy could be seen on the MR images co registrated with PET in AD patients, on the other hand, PET demonstrated the pink color region of metabolic rate of glucose decreased in temporoparietal lobes of cerebral hemisphere. The similar findings depicted on fusion images as red color region of metabolic rate of glucose decreased in temporoparietal lobes. Conclusion The co registrated images can accurately observe the abnormal findings of PET and MR images, and fix the location of foci depicted by PET, in addition, fusion images increase the contrast of the foci. Analyzing the images of co registration and fusion of PET and MRI can lead to the diagnosis of AD in all the patients.

By taking Vrije University Medical Center as an example, this paper introduced the cur-rent Neuroradiologist education training system which had the characteristics of training in a comprehen-sive and focused way, multi-disciplinary integration and paying attention to the combination of academic and clinical research. Through the comparison of the status quo of China's sub specialist training, Neuro-radiologist education training system in the Netherlands provided an important reference for China's sub specialty training.

0.05). The average FA of the corticospinal tracts (0.472?0.037) of RRMS group was significantly lower than that of normal control group (0.497?0.028) (P0.05). The average FA of the corticospinal tracts correlated with EDSS (r=-0.193, P0.05). Conclusion The average FA of the corticospinal tracts of RRMS patients is significantly abnormal and this index may be suitable in evaluating the functional status of the cerebral type of RRMS patients.

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

Neuromyelitis optica (NMO) is an inflammatory-demyelinating disease of central nervous system that is characterized by severe attacks of optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM).Conventional MRI is the most sensitive method in detection of NMO lesions in brain,spinal cord and optic nerve,which can objectively show the site,number,size and distribution of lesions.The MRI features of NMO lesion in brain,spinal cord and optic nerve lesions were reviewed in this article.

Objective To investigate the changes of amplitude of low frequency fluctuation (ALFF) of the resting state fMRI in cognitively impaired Parkinson' s disease patients and discuss its underling neurophysiological mechanism.Methods Blood oxygen level-dependent low-frequency amplitude (ALFF) in resting-state functional magnetic resonance imaging were calculated in 16 healthy controls(HC) and 29 idiopathic Parkinson's disease patients (16 of which were patients with cognitive normal,PDCN and 13 with cognitive impairment,PDCI).The brain regions showing increased and decreased ALFF in patients were demonstrated by comparing normal subjects with 2-sample t-test with threshold of P＜ 0.05 and the analysis of the relationship between the different regions of the brain activity and cognitive function tests scores were also analyzed.Results Compared with PDCN,the PDCI patients showed decreased activity in the caudate nucleus (-3,9,12),occipital lobe (0,-78,-15) and medial temporal lobe (42,9,-27) and increased activity in the superior frontal gyrus (9,63,24).PDCI patients showed increased activity mainly in the precuneus and inferior parietal lobules compared with controls.Additionally,the regions with ALFF changes had significant correlations with the cognitive performance of patients as measured by Montreal cognitive test(Beijing Version) and neuropsychological tests (including memory,attention,visuospatial functions and executive function).Conclusion The results demonstrate that there is a specific pattern of intrinsic activity in PDCI providing insights into neurophysiological mechanisms of the Parkinson's disease dementia.

Objective To evaluate the effects of an optimized resuscitation bundle on prognosis of emergency patients with septic shock.Methods 65 patients with septic shock,admitted into emergency intensive care unit (ICU),were randomly divided into the treatment group(treated by an optimized resuscitation bundle)and the control group(treated by surviving sepsis campaign classics methods)by using random number table.The scores of sepsis-related organ failure assessment(SOFA) scores,the vasoactive agent application times,the mechanical ventilation times,the stay days of ICU,and 28-day mortality of the two groups were observed and compared.Results 3,7 day after erollment the SOFA score of the treatment group was (9.1 ± 2.5) points,(8.2 ± 2.8) points,respectively,which was lower than that of the control group[(10.1 ± 3.3) points,(9.5 ± 3.1) points] at the same time(t =4.52,3.99,all P ＜ 0.05) ; 8-day mortality rate of the treatment group was 28.1％,which was lower than that of the control group (48.5％) (x2 =12.84,P ＜ 0.05).Conclusion Application of an early optimized resuscitation bundle can significantly improve the prognosis of emergency patients with septic shock.

Objective To explore the gray matter loss of Alzheimer's disease (AD) patients by processing the magnetic resonance imaging (MRI) with computer. Method A voxel-based morphometry (VBM) method was applied in this study. Result Bilateral loss of gray matter in AD patients was found in the entorhinal/ hippocampal/parahippocampal cortex areas, amygdala, the head of the caudate nucleus, middle temporal gyrus, cingulate gyrus, inferior parietal lobule, insula and dorsolateral prefrontal cortex. Furthermore, area of right pulvinar, cortex of superior temporal gyrus and superior parietal lobule reduced significantly. On the other hand, somatosensory/motor cortex, cerebellum and occipital lobe were relatively intact. Conclusion VBM overcomes the shortcomings of region of interesting(ROI), such as time-consuming, dependence on observer, and poorly reproducible, and can analyze the gray matter loss objectively and automatically and have a good perspective for clinical applications.