Objective To quantitatively study the features of cerebromspinal fluid(CSF)flow dynamies in normal sella region in MRI with phase-contrast method.Methods Seventeen healthy volunteers were studied.The CSF flow image in sella region was positioned at the middle sagittal T1WI or T2WI image.This pulse sequence used a encoding velocity of 20 cm/s.The waveforms were analyzed for the maximum flow velocity,flow volume rate and the change of the figures.From the velocity and area measurements on the cine images,mean CSF flow was calculated in millimeters per second and milliliters per cardiac cycle.Results The normal CSF flow of the sella region had two directions which was downward(caudal)flow during thesystolic period and upward(cranial)flow during the diastolic period of the cardiac cycle.The downward and upward peak flow velocity,mean downward and upward flow velocity and mean flow velocity was(1.44±0.99)cm/s,(302.71±248.15)ms,(1.16±0.64)cm/s,(331.00±225.38)ms,(0.49±0.39)cm/s.(0.67±0.44)cm/s,(0.54±O.30)cm/s,respectively.The downward and upward peak flow volume rate.mean downward and upward flow volume rate and mean flow volume rate was (0.014±0.009)ml/s.(0.012±0.006)ml/s,(0.047±0.041)ml/s,(0.053±0.003)ml/s,(0.005±0.003)ml/s,(0.034±0.031)ml/s,respectively.The mean cycle was(775.25±173.06)ms.Conclusion Phase-contrast method in MRI cine is a noninvasive method to study the CSF flow in physiological and pathological conditions for determining the pattern,direction,speed and quantity of the CSF flow.Therefore it is better than other invasive research modalities and has an important value in clinical application.

Objective To explore the diagnostic value of MRI in invasively pernicious placenta previa.Methods MRI and color doppler ultrasound were performed in 1 50 patients with pernicious placenta previa.According to the operation or pathology findings, the diagnostic value of placental invasion was compared among MRI,color doppler ultrasound and both of them.Analyzed and com-pared the MRI findings of 64 patients which were confirmed as invasive placenta including adherent placenta in 20 patients,implanted one in 38 and penetrated one in 6.Results Significant difference was not found among MRI,color doppler ultrasound and both in the diagnostic value of invasive placenta (P >0.05).There was a significant difference among adherent placenta,implanted one and pen-etrated one in the diagnostic value of MRI (P <0.05),and the highest and lowest values were penetrated placenta and adherent pla-centa respectively.Conclusion MRI is an important diagnostic method in invasively pernicious placenta previa,which was useful for its classification but with a limitation for the diagnosis of adherent placenta.

Objective To analyze the correlation between MRI features and pathological characterization of ovarian thecoma-fibro-ma.Methods MRI manifestations of 21 patients with ovarian thecoma-fibroma proved by pathological diagnosis were analyzed retro-spectively and compared with pathologic findings.Results The 21 cases involved 22 lesions (one patient had bilateral masses of the-cofibroma),including 13 fibrothecoma,4 thecofibroma and 5 fibroma.All lesions presented with well-defined margin,and cystic changes were found in 1 5 cases,7 lesions were solid masses ,1 9 lesions were round or oval masses ,2 lesions were lobulated mas-ses,and 1 lesion was irregular mass.The diameters of tumor ranged from 3.4 to 18.5 cm with mean diameter of 8.9 cm.On MR images,all lesions showed isointense or slight hypointense on T1 WI.On T2 WI,most tumors showed isointense or slight hypoin-tense,along with hyperintense cystic areas in 1 5 lesions,patchy slight hyperintense edema areas in 4 lesions,and homogeneous isointense or slight hypointense in 3 lesions.After contrast enhancement,all lesions demonstrated mild-to-moderate enhancement and delayed progressive enhancement slightly.13 cases associated with varied degrees of pelvic effusion,1 case with thickening of endometrium,and 1 case with endometrial carcinoma.Two patients had a higher level of CA125.Postoperative pathology demon-strated that all lesion were benign.Conclusion The MRI findings of the ovarian thecoma-fibroma are considerably characteristic and indirectly reflect pathology of tumor,thus beneficial to the correct diagnosis of tumor with relevant clinical information.

Objective To investigate temperature changes in prefrontal cortex and hippocampus of heroin addicts with magnetic resonance spectroscopy (MRS).Methods 18 heroin addicts in the withdrawal state and 18 healthy volunteers (control group) were performed with MRS scan.First, resting-state MRS scan was performed on all subjects, and then did MRS scan again under visual stimulation while subjects were asked to carefully watch the heroin-related cue images.Measurements of NAA of the identified regions (the prefrontal cortex, bilateral hippocampus) were obtained from all subjects.Brain temperatures were calculated by the modified brain temperature-chemical shift equation.Results In resting state, the temperature of prefrontal cortex in heroin addicts group was higher than the control group, the difference was statistically significant (P<0.05),and the brain temperature was positively correlated with total dose of heroin (P<0.05).The prefrontal cortex/hippocampus temperature of heroin addicts group did not showed statistical significance between resting state and visual stimulation state (P>0.05).Conclusion MRS can be used to measure brain temperature noninvasively.Temperature change of brain may be helpful for exploring the mechanism of drug addiction and craving.

Background and purpose:Esophageal cancer is one of the common malignant tumors in our country. Anastomotic stenosis is a common complication after resection of esophageal cancer, seriously affecting the quality of life of patients after operation. By changing anastomosis, this study explored the methods for prevention of anastomotic stenosis after esophageal cancer surgery.Methods:Patients were randomly divided into groups. Patients admitted on odd dates were placed in the control group whereas patients admitted on even dates were placed in the experimental group. Patients in the control group were treated with gastroesophageal anastomosis using anastomat for gastroesophageal anastomosis. Anastomotic stomach was contracted by purse string suture at first, and then treated with stapler gastroesophageal anastomosis, before the gastroesophageal anastomosis was carried out on patients in the experimental group. After 6 months’ follow-up, the incidences of anastomotic stenosis between the two groups were compared.Results:The postoperative anastomotic stenosis rate in the control group was 19.2%, while that in the exper-imental group was 0%. There were statistically signiifcant differences between them (χ2=22.8,P<0.005). The incidence of anastomotic stenosis in the control group was signiifcantly higher than that in the experimental group.Conclusion:Anastomotic stomach contracted by purse string suture before stapler gastroesophageal anastomosis can effectively reduce the occurrence of anastomotic stenosis after esophageal cancer surgery.

Objective To analyze the adverse drug reactions (ADR) during the standardized treatment of multidrug-resistant pulmonary tuberculosis (MDR-PTB), and to evaluate its impact on treatment outcomes.Methods A retrospective study was carried out on 305 MDR-PTB patients.Medical records of clinical treatment and laboratory examinations were collected, and the ADR data were analyzed.Chi-square test or Fisher exact test was used for discontinuous variables, and t test or non-parametric test was used for continuous variables.Results Among 305 MDR-PTB patients , 282 (92.5%) had at least one ADR.The major ADR were gastrointestinal reaction (46.9%), thyroid dysfunction (41.3%), hypokalemia (34.1%), renal injury (29.8%), hematological system impairment (21.6%), hepatotoxicity (19.0%), arthralgia or courbature (11.1%), and ototoxicity and vestibular dysfunction (8.5%).Sex, age, native place, the history of using second-line TB drugs or the history of diabetes mellitus had no significant effect on the incidence of ADR (all P>0.05).As per the Naranjo causality assessment of ADR, 34 patients had definite, 236 had probable, 12 had possible and 0 had doubtful causal relations.Among the 282 cases with ADR, 175 (62.1%) patients continued the original treatment regimen, 89 (31.6%) patients changed or stopped ADR-related drugs, only 18 (6.4%) cases stopped MDR-PTB treatment.The episodes of ADR had no significant effect on the treatment outcomes (P>0.05).Conclusions Although ADR are common in MDR-PTB patients during the treatment course, most of the ADR can be managed.Through timely monitoring and appropriate treatment of ADR, most of the patients could continue MDR-PTB treatment.

Objective To investigate the clinical value of the thickness of pharyngeal wall of nasopharynx in adenoids hypertrophy examined with CT. Methods CT manifestations in 117 patients suspected with adenoids hypertrophy were analysed. The thickness of adenoid and pharyngeal wall were observed. The width of adenoid/pharynx(A/N) ratio were measured and the correlation of pharyn-geal wails with A/N ratio were analysed. Results A/N ratio was ≥0.70 in 50 cases (group Ⅰ), between 0.60 ～ 0.70 in 35 cases (group Ⅱ) ,≤0.60 in 32 cases (group Ⅲ) ,the thickness of pharyngeal wall were (1.26±0.33) cm, (0.99±0.41) cm and (0.86± 0.19) cm respectively. There were significant differences between group Ⅰ and Ⅱ, Ⅲ in the thickness of pharyngeal wails(P<0.01). The relationship of linear regression of A/N ratio with pharyngeal wall was found and the equation of the thickness of pharyngeal wall was 1.69×A/N ratio-0.08. Conclusion There is correlation between A/N ratio and thickness of pharyngeal wall, which is helpful for clinical diagnosis of adenoid hypertrophy.

Objective To evaluate the value of dynamic susceptibility contrast-enhanced MR imaging (DSC)in evaluation of brain tumor after operation.Methods 41 cases with brain tumors verified histologically,including 8 cases of high-grade gliomas,16 of low-grade gliomas,7 of metastases and 10 of meningiomas underwent DSC examination.All the cases at 3.0T MR unit.All primitive data were sent to ADW4.3 workstation for post-processing.The mean maximal rCBV and rCBF ratios of tumors,1 cm and 2 cm regions of peri-tumor were obtained respectively.The relativity of MR perfusion parameters(rCBV and rCBF)between diferent tumors were statistically evaluated by using Pearson correlative analysis.Results In the　solid region of tumors,rCBV and rCBF were statistically significant differences (P<0.05)between low-grade gliomas and the other three groups of tumors; in 1 cm region of peri-tumor between high-grade gliomas and the other three groups,and between low-grade gliomas and metastases,between the solid region and both regions of 1 cm and 2 cm peri-tumors at the same tumor were all of statistically significant differences(P<0.05),between 1 cm and 2 cm region of peri-tumors at high-grade gliomas and metastases,the rCBV and rCBF were also of statistically significant differences.Pearson correlative analysis showed that there were significant positive correlations between the mean maximal rCBV and rCBF　ratios at the same region in the same tumor's group.Conclusion DSC is very valuable in evaluation of the histopathological grade and the differentiation of brain tumor.

In February, 2019, a patient with a defect of open dorsal cartilage and bone in the first metatarsal head, including the defects of soft tissue, tendon and joint capsule, was treated in our department. After multiple debridement, the vascularised medial femoral condyle osteochondral chimeric tissue flap was transferred to repair the composite tissue defect in the metatarsal head at the second stage. After 18 months of follow-up, the patient felt no pain in the foot and walking, and there was no sign of lameness and discomfort at donor sites. The postoperative functional recovery was satisfactory.

Objective To evaluate the clinical efficacy of interventional techniques in the diagnosis and therapy of Dieulafoy disease. Methods A retrospective study was performed, including 17 patients with massive upper gastrointestinal hemorrhage (patients without peptic ulcer and portal hypertension or diagnosed with Dieulafoy disease by endoscopic examination). All patients had both DSA and interventional embolization treatment, and were followed for 12 months to appraise the clinical effectiveness. Results Sixteen patients were diagnosed as Dieulafoy disease by using DSA. Fifteen of the 16 patients were treated with embolization successfully withoutserious complications. One patient received subtotal gastrectomy because of upper gastrointestinal hemorrhage recurrence. Nine patients with irregular upper abdominal pain and burning sensation had complete remission after symptomatic management. Fifteen patients who had embolization showed no serious complications during the follow-up period of 12 months, there was no hematemesis and melena for the 15 cases with successful embolization. Conclusion The angiography and embolization are safe and efficacious in the diagnosis and therapy of Dieulafoy disease.