Objective To study the value of MR diffusion tensor imaging (MR-DTI)using a 3.0 T scanner in anterior ischemic optic neuropathy(AION).Methods A total of 26 patients suffering from unilateral subacute AION were examined using DTI and pattern visual evoked potential(P-VEP).The parameters values of optic nerves including fractional anisotropy (FA),ADC,vertical diffusivity (λ⊥),paralleldiffusion (λ//),P100 value and amplitude were obtained.Paired t-tests were used for comparing the FA,ADC,λ⊥,and λ// values of the two groups.Correlations of DTI parameters and P-VEP parameters were analysed by using the Pearson rank correlation analysis.Results The values of FA,ADC,λ//,and λ_ in the affected nerve were 0.28±0.07,(1.43±0.20) ×103 mm2/s,(1.79±0.16) ×10-3 mm2/s,and (1.25±0.17) ×10-3 mm2/s respectively,and the corresponding values of unaffected nerve were 0.57±0.05,(1.04±0.17) ×10-3 mm2/s,(1.71 ±0.19) × 10-3 mm2/s,and (0.75±0.08) × 10-3 mm2/s respectively.Compared to unaffected contralateral nerves,the mean FA was reduced,the mean ADC,λ⊥ were increased in the affected nerves(t=-19.269,10.537,15.301,P＜0.01).However,there were no significant difference of the λ//(t=l.632,P＞0.05).There was significant negative correlation between ADC and P-VEP amplitude in affected optic nerves (r=-0.722,P＜0.01).There was moderate negative correlation between λ⊥ and P-VEP amplitude in affected optic nerves (r=-0.634,P＜0.01).There was moderate correlation between FA and P-VEP amplitude (r=0.539,P＜0.01).There was no correlation between λ// and P-VEP amplitude.There was moderate negative correlation between FA and P-VEP P100 latency(r =-0.619,P＜0.01).Conclusions DTI can sensitively detect diffusional abnormality of anterior ischemic optic neuropathy.DTI could be used as a supplemental way in the assessment of AION.

Purpose To analyze the hemodynamic characteristics of brain stem in patients with basilar artery hypoplasia (BAH) by magnetic resonance perfusion-weighted imaging (PWI).Materials and Methods According to the inclusion and exclusion criteria,51 patients with BAH were selected as the BAH group,and 79 patients without BAH were selected as the non BAH group.All patients were examined by MRI,3D-TOF and PWI,and magnetic resonance angiography was acquired after the three examinations.The regional cerebral blood flow (rCBF),regional cerebral blood volume (rCBV),regional mean transit time (rMTT) and time to peak (TTP) values of pontine area were measured.Results The rCBF value of the BAH group [(17.10±6.52) ml/(100 g · min)] was significantly lower than that of the non BAH group [(29.06± 13.32) ml/(100 g · min)] (P＜0.05);the rCBV value of the BAH group [(1.41 ±0.26) ml] was significantly lower than that of the non BAH group [(2.62± 0.82) ml] (P＜0.05);the TTP value of the BAH group [(6.14± 1.31) s] was significantly higher than that of the non BAH group [(5.39 ± 1.08) s] (P＜0.05);the rMTT value of the BAH group [(20.78±3.48) s] was significantly higher than that of the non BAH group [(19.01 ±2.39) s] (P＜0.05).TTP was the most sensitive index of cerebral perfusion injury,and the incidence of TTP extension was 41.18％ in the BAH group.Conclusion PWI can detect the abnormal cerebral hemodynamics in patients with BAH,which provides the basis for the timely treatment and prevention of irreversible injury in the ischemic area of the brain.

Objective To study the value of magnetic resonance imaging (MRI)in diagnosis of cubital tunnel syndrome (CuTS). Methods We studied the findings of electrophysiological examination and MRI in 30 elbows of 23 patients with CuTS and 15 elbows of 1 5 controls.We observed the motor conduction velocity (MCV),cross sectional area (CSA)and relative signal intensity (RSI)of the ulnar nerve acrossing the elbow at the point of largest size proximal to the entrapment point (CSA1 ,RSI1 )and the entrapment point (CSA2 ,RSI2 ).Then we calculated the ratio of CSA (CSAR=CSA1/CSA2 ),and the ratio of RSI (RSIR=RSI1/RSI2 ).Results The value of CSA1 and RSI1 was significantly greater than CSA2 ,RSI2 in the patient group (P<0.05).The value of CSA1 ,RSI1 , CSAR and RSIR in patients were significantly larger than that in controls (P<0.05).MCV was negatively correlated with CSA1 and CSAR in the patient group (r=-0.62,r=-0.53).There were no correlation between MCV and RSI1 ,RSIR in the patient group. The area under ROC curve of CSAR was the largest 0.94 (95% CI,0.83-1).The optimum cutoff point of CSAR was 1.83.The CSAR had sensitivity of 93.3% and specificity of 80% in diagnosis of CuTS.Conclusion MRI combined with the electrophysiologi-cal examination shows a high accuracy of locating the entrapment point of ulnar never lesion at the elbow.The CSAR of the ulnar nerve is the best MRI parameters in diagnosis of CuTS.

Objective To study the relationship between the changes of diffusion tensor imaging(DTI)and diffusion tensor tractography(DTT)of optic radiation and the defect of visual field.Methods DTI and DTT were performed in 37 patients with invasion of the optic radiation by intracranial lesions and in 20 normal control group at 3.0T MR scanner,the visual fields of all cases were examined.The relativity between FA values,ADC values and mean sensitivity(MS)values,mean defect(MD)values of visual field and the relativity between the morphological change of optic radiation and the defect of visual field were analysed.Results In comparison with control group,FA values decreased and ADC values increased in subject group,there were statistically significant differences(P＜0.001)between them.In disordered group,FA values were positive correlation with MS values(r=0.718)and negative correlation with MD values(r=-0.694);ADC values were negative correlation with MS values(r=-0.625)and positive correlation with MD values(r=0.538).DTT showed that the ventral tracts of optic radiation were damaged which oppeared as the defect of ditto quadrant of bilateral field vision in 9 cases,the dorsal tracts and the lateral tracts of optic radiation were damaged which appeared as the defect of inferior quadrant of bilateral field vision in 7 cases,the optic radiations were damaged extensively that caused symmetric or asymmetric congruous hemianopia of bilateral field vision in 21 cases.Conclusion DTI and DTT of optic radiation are intimately correlated with the examined results of visual field,it will be a objective index to extimate the function and the morphological changes of optic radiation.

Purpose Central nervous system (CNS) hemangiopericytoma (HPC) is rare in clinic and prone to misdiagnosis. This paper aims to improve the diagnostic accuracy of CNS HPC by analyzing the MRI and CT features. Materials and Methods CT and MRI appearances and pathologic features of 14 cases with surgery and pathology proved CNS HPC were analyzed retrospectively. Results There were intracranial and intraspinal lesions in 12 and 2 cases respectively. 5 cases were lobular, 4 cases irregular, and 5 cases were round or oval in shapes. On CT scan, 2 intracranial lesions showed slight hyperdensity and were avidly enhanced following contrast injection. On T1WI, 11 cases showed isointensity compared with brain white matter;on T2WI, 10 cases showed isointensity compared with brain gray matter. Marked heterogeneous enhancement was shown in 7 cases. Necrosis and cystic changes were seen in 6 cases. Flow-void sign was seen in 9 cases;9 cases were attached to meninges through narrow base. Dural tail sign was observed in 4 cases. Bone erosion was seen in 4 cases. In 5 cases with DWI scan, isointensity was shown in 4 cases and slight hyperintensity in 1 case. The density and signals in 2 cervical spine lesions were uniform with homogenous enhancement;expansive bone swelling in 1 case. Conclusion CNS HPC shows hyperdensity on CT. They present equal signal compared with white matter on T1WI and equal signal compared with grey matter on T2WI, with some void signal of vessel, and isointense on diffusion weighted images. Tumor invades adjacent skull with rare dural tail sign.

Objective To investigate the CT imaging characteristics of primary malignant fibrous histiocytoma (MFH) of the liver.Methods The CT, clinical and histopathologic data of 6 patients with MFH were analyzed retrospectively.All the cases were confirmed by surgery and histopathological examinations.Results The tumors were located in the right liver in 4 patients and the left liver in 2 patients.The maximum diameter of the tumors ranged from 5 to 20 cm.All the tumors were unevenly hypodense on plain CT scan.Four tumors had relatively well-defined margins, while 2 tumors had ill-defined margins.After contrast enhancement, the peripheral and internal divisions of the three storiform-pleomorptic MFH showed progressive enhancement.The peripheral and internal divisions of the two inflammatory MFH were obviously enhanced in the arterial phase, and the enhancement decreased in the portal and delayed phases.The hypodense areas of the one myxiod MFH were not enhanced, but the internal floc and divisions were progressive enhanced.On gross pathology, the tumors were round or irregular in shape, most had a complete capsule with multiple surrounding vessels.These findings correlated well with the CT findings.Conclusions CT findings of primary Hepatic MFH have some characteristics.The enhancement pattern is manifested in a fast wash-in and slow wash-out pattern.However, the final diagnosis still relies on histopathological examination.

Objective To study the characteristic findings of computer tomography (CT) and magnetic resonance imaging (MRI) in hepatobiliary cystadenocarcinoma.Methods CT,MRI and clinical data were analysed retrospectively.Plain,dynamic CT and MRI were performed in all patients.Results There were 8 patients,7 female,1 male,aged 48-74 years,with a median age of 58.Five lesions were in the left liver,and 3 lesions were in the right liver.One lesion was multilocular cysts with septations.Seven lesions were solitary.The lesions showed low or mixed density on plain CT.Two cysts showed evidence of hemorrhage,while 3 cysts showed fluid levels.There were different signal intensities in the cystic wall nodules which could appear as slightly low intensity on T1WI or slightly high intensities on T2WI.The cyst wall and septations appeared as slightly low intensity on T1WI and T2WI.The cystic fluid signal intensity changed with liquid ingredients.The nodularities showed obviously high signal intensity on DWI,and the fluid showed slightly high signal,while the cystic wall and separations showed slightly low signal intensity.On CT and MRI dynamic enhancement scanning,the nodularities showed obvious enhancement on the arterial phase,while the cystic wall and separations showed no enhancement.The nodularities showed persistent enhancement on the portal venous and delayed phases while the cystic wall and separation showed slight enhancement.Conclusions Hepatobiliary cystadenocarcinoma showed characteristic features on MSCT and MRI.MSCT combined with MR is an important method in the diagnosis and differential diagnosis of hepatobiliary cystadenocarcinoma.

Objective To investigate CT appearances of abdominal primary malignant fibrous histiocytoma(MFH).Methods The CT characteristics,clinical features and pathological data of 1 7 patients with MFH proved pathologically were analyzed retrospectively. Results The lesions located in retroperitoneum were 6,in liver were 5,in kidney were 2,in superior mesentery was 1,in greater omentum was 1,in stomach was 1,in ileum was 1.The lesions are oval shape,lobulated,nodule shape,and the size of these lesions were large. 2 cases of MFH located in gastrointestinal tract were slightly low density,and the remaining were uneven high density due to necro-sis.In CT contrast enhanced scan,the solid portion and internal divisions showed progressive or continuous enhancement,and the nec-rosis were not enhanced in MFH located in the retroperitoneum,the greater omentum,the superior mesentery and the liver.MFH in kidney was poorly circumscribed and showed mild progressive enhancement lower than normal renal parenchyma.The stomach and ileum lesions showed uniform and continuous enhancement with normal gastrointestinal mucosa in corresponding parts.Conclusion Imaging features of retroperitoneal MFH were the same as those of interstitial tumors,and most tumors showed features of progres-sive and persistent enhancement,but have different imaging appearances with the malignant lesions in corresponding parts.

Objective To explore the bone marrow pathology ,diagnosis and differential diagnosis of Waldenstrom macroglobulinemia(WM). Methods 19 WM patients was examined by bone marrow aspiration (BMA) and bone marrow biopsy (BMB) for morphology. Flow cytometry (FCM) and immunohistochemistry (IHC) for immunophenotyping. Results Plasmacytoid lymphocytes were identified in 11 BMA. All of 19 BMB were involved by lymphoma cells. 17 cases showed a predominance of small lymphocytes and 2 of plasmacytoid lymphocytes. Typically plasmacytoid lymphocytes were not seen in 4 cases. Patterns of bone marrow involvement were as follow: diffuse (12 cases), nodular (4 cases), interstitial (3 cases). Immunophenotypically, FCM showed all cases were CD_(19)~+, CD_(20)~+, CD_(22)~+, CD_5~- and CD_(10)~-. IHC revealed small lymphocytes and plasmacytoid lymphocytes were Pax5~+ CD_(20)~+ and plasma cells were CD_(38) CD_(138)~+ CD_(20)~- Pax5~-. Conclusion Small lymphocytes proliferation with plasmacytic differentiation is the typical bone marrow pathologic features of WM. IHC is benefit for identifying lymphocytes and plasma cells components. The Combination of morphology, FCM and IHC is contributive to the diagnosis and differentiation of WM.

OBJECTIVETo compare enhanced spiral computed tomography (SCT), and plain CT with pathological findings in the diagnosis of peritoneal metastasis.

METHODSThirty-eight patients with peritoneal metastasis were examined by whole abdominal plain CT and enhanced SCT within one week before operation. The CT findings were compared with the pathological findings of specimens obtained during operation.

RESULTSIn the early phase of contrast SCT, various degrees of enhancement were observed in the majority of peritoneal metastases. Primary cancers and the metastatic lesions were enhanced to same degree. For lesions with rich blood supply, a 2 mm metastatic lesion was usually detected by contrast SCT. The sensitivity of plain CT and enhanced SCT for the detection of peritoneal metastasis in all involvements were 46.7% and 76.6% (chi(2) = 29.07, P < 0.005). For contrast SCT, the detection rates of peritoneal carcinomatosis were higher then 83% in the fallopian tubes, ovary, subphrenic spaces, mesentery of small intestine, transverse colon and omentum.

CONCLUSIONEnhanced spiral CT, being superior to plain CT, is effective in detecting and diagnosing peritoneal metastasis.

Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; diagnostic imaging ; Peritoneal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Tomography, X-Ray Computed ; methods