Objective To study the CT features and its correlation of normal neonates and neonatal hypoxic-ischemic encephalopathy(HIE).Methods 128 cases of normal neonate brains were scanned, the CT value arrangement was got by measuring CT value of bilateral cerebral parenchyma of related slices. On this basis, a quantitative classification criteria was made for 332 cases of neonatal HIE.Results The CT value of normal neonates were ranging from 27 to 39 Hu for cerebral cortex and from 20 to 28 HU for cerebral medulla. Neonates with HIE could be classified into three degrees according to CT value (17~19.9 HU for gentle degree, 14~16.9 HU for moderate degree and below 14 HU for severe degree).Conclusion The measuring CT value of cerebral cortex and medulla for normal neonates and neonatal HIE can play a significant role in clinical diagnosis of HIE.

Objective To investigate clinical efficacy of the CT guided mixture Danshen injection into the periganglionic space in the treatment of lumbocrural pain.Methods Mixture Danshen infiltrations were performed in 63 patients with lumbocrural pain under CT guidance.Scores of VAS were compared at 3 and 6 months after the therapeutic procedure with evaluation of the efficacy.Results Significant pain reduction was observed in 51 patients (51/63,80.95%),with the score of VAS 7.60± 2.00 (before therapy) dropping to 3.85 ± 1.60 (after 1 month) and 4.05± 1.70 (after 6 month).Differences of VAS scores before and after the therapy were statistically significant.Differences between one-month and three-month follow-up were not statistically significant.Conclusion Mixture Danshen injection around the spinal nerve roots under CT guidance is safe and useful in the treatment of lumbocrural pain.

MR appearance of brain metastases from 33 cases of lung carcinoma was reported. The lesions were mainly localized in the cerebrum associated with edema in varying degrees. Squamous cell carcinoma had a tendency to cystic degeneration and adenocarcinoma to bleeding. The low signal rings around the bleeding locus were irregular in T2WI imaging. Enhanced MR could find the lesions that noncontrast-enhanced MR could not. From the above, it was concluded that MRI had an important value in the imaging diagnosis of brain metastases from lung carcinoma.

Objective To investigate the diagnostic value of adrenal tumors by MRI.Methods The MRI features of adrenal tumors proved pathologically in 26 patients were reviewed,and were comparatively studied with the results of operation and pathology.All patients received pre-and post-contrast MRI scans,the morphology,size,margin,signal intensity and enhancement pattern of the lesion were observed.Results Of 26 adrenal tumors,8 were pheochromocytoma which were encapsulated mass with long T 1 heterogeneous T 2 signal and heterogeneous enhancement,the characteristic manifestations were prominent high signal on T 2WI,heterogeneous signals were showed in haemorrhagia,necrosis,cystic formation.5 cases were metastatic tumors from pulmonary cancers,the shape and signal of tumons were regular or irregular.6 cases were adenomas which were showed as round mass with distinct margin and iso-signal without necrosis and cystic formation.Adenocarcinoma was seen in 4 cases and was manifested as irregular long T 1 heterogeneous T 2 signal and heterogeneous enhancement, the surrounding tissues and blood vessel were involved. Myelolipoma was found in 3 cases and presented as short T 1 and short T 2 signal intensity.Conclusion MRI is valuable in diagnosis and differentiated diagnosis of adrenal tumors, and is important in the delineation of tumor extent and surgical planning.

In order to evaluate the value of magnetic resonance cholangiography (MRC) and dynamic examination of duodenal fluid in the differential diagnosis between extrahepatic biliary atresia (EHBA) and infantile hepatitis syndrome (IHS), 52 patients with infantile cholestatic jaundice were examined by MRC and duodenal fluid examination. Original interpretations were compared with clinical outcome. Calculated sensitivity of duodenal fluid examination in diagnosis of EHBA was 100%, and specificity was 91.1%. Sensitivity of MRC in the diagnosis of EHBA was 94.4% and specificity 88.24%. The sensitivity of MRC and examination of duodenal fluid combined in diagnosis of EHBA was 94.4% and specificity 97.06%. We are led to conclude that MRC and dynamic examination of duodenal fluid are useful in the differential diagnosis between IHS and EHBA and the combined use of the two techniques yield better results.

Objective To compare the efficiency of enhanced T2* weighted angiography (ESWAN) sequence with that of a conventional T2*-weighted gradient-recalled-echo (GRE T2*WI) sequence for the detection of hemorrhagic shearing lesions in patients with diffuse axonal injury (DAI). And combined with MRI parameters, to further discuss the principles and virtues of ESWAN sequence. Methods Seventeen patients with DAI were enrolled in this study. The raw data acquired from ESWAN scan were postprocessed by using the mean square root of multi-echoes. Then, the postprocessed images were compared with the conventional GRE T2* weighted images. The global and regional (superficial, deep and posterior fossa) lesion numbers determined by both sequences were compared by using Wilcoxon signed ranks test (two-tailed). Differences were considered to be significant at P≤0.05. Results Hemorrhagic lesions were more obvious on ESWAN images than those on conventional GRE T2* weighted images. The median and range value of the detected lesion numbers on ESWAN images were 27 and (1-239) in whole brain, 13 and (1-89) in cerebral superficial region, 5 and (0-111) in cerebral deep region and 1 and (0-39) in posterior fossa region, respectively; whereas, on GRE T2* weighted images, they were 7 and (1-34) in whole brain, 5 and (1-27) in cerebral superficial region, 2 and (0-25) in cerebral deep region and 0 and (0-4) in posterior fossa region, respectively. There were significant statistical differences between the two sequences in revealing the lesions in all the four regions (Z=-3.519,-3.182,-3.185,-2.677,P＜0.05). Conclusion In ESWAN sequence, multi-echo acquisition ensured sufficient magnetic susceptibility for detecting small hemorrhagic lesions. So, ESWAN is more sensitive to small hemorrhage, which revealed more hemorrhagic lesions than conventional GRE T2*WI and presented more valuable information for the diagnosis of DAI.

Objective To evaluate the diagnostic value of in vivo 1H-MRS in the hyper acute reaction stage of radiation-induced brain injury after nasopharyngeal carcinoma radiotherapy. Methods Eighteen patients with nasopharyngeal carcinoma accepted radiotherapy for the first time. Bilateral temporal lobes in all cases were examined by conventional MRI and 1H-MRS before and after radiotherapy with radiation dose of 20 Gy, 40 Gy, and 60 Gy, respectively. MR image was performed with T_1-weighted gradient- and spin-echo, T_2-weighted spin-echo, fluid-attenuated inversion-recovery, and point resolution spectroscopy. The change of the spectroscopic morphology and the ratios of the metabolites were observed. Results There were no changes of signal in the temporal lobes with conventional MRI, but the peak height of NAA and Cho decreased obviously in the anterior half of the temporal lobes with 1H-MRS after radiotherapy. The post-radiotherapy changes of different metabolic peak in the anterior temporal lobes presented as two types: one type was that Cho and NAA peak were of the same height simultaneously. There were 20 locations (56%) of the 36 reaching the peak when accepting 20 Gy, 22 (61%) when accepting 40 Gy, and 13 (36%) when accepting 60 Gy, respectively. The other type was that Cho peak became the highest, whereas NAA peak was obviously lower and decreased to be the second highest. There were 4 locations(11%) of the 36 reaching the peak when accepting 20 Gy, 10 (28%) when accepting 40 Gy, and 23 (64%) when accepting 60 Gy, respectively. The ratio of Cho/Cr, NAA/Cr, and NAA/Cho decreased in the same position too. In addition, there was positive correlation between the ratios of the metabolites and the dose of radiotherapy.Conclusion 1H-MRS can be used to diagnose the radiation-induced injury of the brain in early acute reaction stage after nasopharyngeal carcinoma radiotherapy through reflecting histiocytic metabolism, and provide objective basis for pathology development and cellular metabolism study, also it can provide feasible projects for the clinic.

The value of combined application of both ECG-gated cine MRA and 3D-CEMRA in the detection of large intracranial aneurysms was evaluated and the findings were compared with those of conventional MRA and DSA. Twenty-four patients with 26 large intracranial aneurysms underwent MRI and DSA. All these aneurysms, diameter from 15 to 39 mm, were located at internal cerebral artery (n=12), vertebral artery (n=3), basilar artery (n=4), anterior cerebral artery (n=2), middle cerebral artery (n=2), anterior communicate artery (n=2) and posterior communicate artery (n=1). Thirteen cases of hematoma or cavernoma were studied as control group. All patients were examined on GE 1.5T MR system. ECG-gated cine MRA was performed with 2D multi-phase fast gradient-recalled echo sequence in a single section. All the images were analyzed with signal intensity VS time curve for differentiating intraaneurysmal blood flow from static tissue. The results were analyzed by statistic "t" test. 3D-CEMRA was performed with spoiled gradient-recalled echo and one dose of Gd-DTPA. All data was processed with multi-plannar reformat (MPR) and tomography for the demonstration of aneurysms in detail. All 26 aneurysms were demonstrated successfully by combined application of both cine MRA and 3D-CEMRA. Compared to DSA and conventional 3D-MOTSA, its sensitivity and specificity figures were both 100%. Cine MRA could differentiate the blood flow from the static tissue. The intensity VS time curves of intraaneurysmal blood flow offered fluctuating form and average signal change between systole and diastole period was about 89.8 +/- 37.4; However, under the control group, intraaneurysmal thrombus or cerebral hemorrhage or cavernomas had no significant signal change and the curves offered steady form with the average signal change being about 8.2 +/- 6.3. There was statistically significant difference between the intraaneurysmal blood flow and static tissue (P=0.025, <0.05). 3D-CEMRA was very useful in demonstrating the aneurysmal size, intraaneurysmal thrombus formation, neck and the detailed relationship of the aneurysm to the surrounding structures. It was concluded that the combined application of both cine MRA and 3D-CEMRA might be a valuable clinical tool for the detection of large intracranial aneurysms.
Angiography, Digital Subtraction ; Contrast Media ; Evaluation Studies ; Image Enhancement ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional/methods ; Intracranial Aneurysm/*diagnosis ; Magnetic Resonance Angiography/*methods ; *Magnetic Resonance Imaging, Cine

Objective:To evaluate the value of cardiac MR feature tracking (CMR-FT) on the early assessment of left ventricular subclinical myocardial dysfunction in patients of hypertensive heart disease (HHD).Methods:From October 2018 to November 2019, 16 HHD patients with left ventricular hypertrophy (HHD-LVH), 24 HHD patients without left ventricular hypertrophy (HHD-nonLVH) and 24 age-and gender-matched normotensive controls who underwent 3.0 T CMR examination were retrospectively enrolled. Imaging protocol included cine sequence and late gadolinium enhancement. Left ventricular function variables were measured using Argus software, mainly including left ventricular end-diastolic volume index (LVEDVI), left ventricular mass index (LVMI), left ventricular maximal wall thickness (LVMWT), the ratio of left ventricular mass to left ventricular end-diastolic volume (M/V). CMR-FT was performed using commercial software CVI 42, with parameters including global radial, circumferential, longitudinal strains (GRS, GCS, GLS), peak systolic radial, circumferential, longitudinal strain rate (SRSR peak, SCSR peak, SLSR peak) and peak diastolic radial, circumferential, longitudinal strain rate (DRSR peak, DCSR peak, DLSR peak) derived. One-way analysis of variance with scheffe correction or Kruskal-Wallis test was performed for multiple comparisons. Pearson or Spearman analysis was used for linear or monotonic nonlinear correlations. Results:HHD-LVH group had higher LVEDVI, LVMI, LVMWT and M/V than HHD-nonLVH group and control group ( P<0.05). Compared with control group, GRS, GCS and GLS were statistically impaired in HHD-LVH group, and DRSR peak, DCSR peak and DLSR peak were statistically reduced in HHD-LVH group and HHD-nonLVH group(all P<0.05). Correlation analysis showed that LVMI correlated linearly with GRS ( r=-0.384, P=0.002), GCS ( r=0.392, P=0.001) and GLS ( r=0.491, P<0.0001),LVMWT correlated nonlinearly with GRS ( r=-0.362, P=0.003), GCS ( r=0.384, P=0.002) and GLS ( r=0.422, P=0.001), LVEDVI correlated nonlinearly with GRS ( r=-0.295, P=0.018) and GCS ( r=0.264, P=0.035). Conclusion:CMR-FT derived left ventricular strain parameters could be served as early indicators for the assessment of subclinical myocardial dysfunction in HHD patients, which have great potential in guiding appropriate intervention therapy and improving cardiac remodeling.

Objective To study the value of magnetic resonance diffusion tensor imaging(MR-DTI) in evaluating the severity of liver cirrhosis.Methods Seventeen patients with Child A liver fibrosis (age=35.0+11.8 years,14 males and 3 females),12 with Child B(age=44.7+14.0 years,5 males and 7 females) and 8 with Child C(age=48.7+7.6 years,3 males and 5 females) were recruited.All patients had clinical data and serum makers in full.Fifty normal controls (age=35.2+14.2,28 males and 22 females) were also recruited.Diffusion tensor imaging(DTI) was performed in all subjects using a GE Propeller HD 1.5T MR scanner by employing a spin echo single-shot EPI(echo planar imaging) sequence.Average diffusion coefficient(DCave) and fractional anisotropy(FA) maps were generated from each P articipants DTI scan using AW 4.2 functool software.All the statistic analysis was performed in SPSS 13.0 , and P value of less than 0.05 was deemed to be significant . Results DCave values were 1.54±0.25 ,1.33±0.18 ,1.02±0.12 ,0.66±0.27 in control group and Child A , B , C respectively , the FA values were 0.46±0.10, 0.42±0.08, 0.56±0.05,0.71±0.41 in control group and Child A, B, C respectively. Significantly low DCave and changed FA in liver fibrosis group were found(P< 0. 05). Among the four groups, significant differences were found in DCave values and FA values(P<0.05) except control group VS Child A group in FA values(P=0.54).Conclusion MR-DTI is relevant to the severity of liver cirrhosis, and may be a useful tool for evaluating the severity of liver cirrhosis.