Objective To evaluate the value of apparent diffusion coefficients (ADCs) in the diagnosis of malignant bone neoplasms.Methods Eighteen cases with consecutive primary malignant bone neoplasms of the knee were prospectively enrolled in the study. Each patient had a controlled preoperative MRI including a SSEPI-DWI sequence. With the help of a pathologist, spatially localized histological sampling study of the postoperative specimens was performed. ADCs of viable tumor (intra- and extraosseous part), peritumoral edema (including soft tissue edema and intramedullary edema), and tumor necrosis of the neoplasms confirmed by spatially localized histological sampling or following up were calculated and compared.Results Mean ADCs of viable tumor, peritumoral muscle edema, peritumoral marrow edema, tumor nerosis, normal muscle, and normal marrow were (1.181?0.236)?10 -3mm2/s (intraosseous part)/(1.158?0.259)?10 -3mm2/s (extraosseous part), (2.347?0.233)?10 -3mm2/s, (1.997?0.119)?10 -3mm2/s, (2.230?0.208)?10 -3mm2/s, (0.486?0.313)?10 -3mm2/s, and (0.483?0.288)?10 -3mm2/s, respectively. Statistical differences were significant among all these tissues (F=153.131, P=0.000). The ADCs of viable tumor were higher than that of normal tissues (P

Objective To study the correlation between bone marrow edema (BME), the amount of joint fluid and clinical symptoms in order to strengthen further understandings about clinical significance of BME in osteonecrosis of the femoral head (ONFH). Methods Fifty-seven patients (91 hips) with ONFH proved by clinical follow-up or pathology were examined by conventional radiography, 1.5 T MRI, and radionuclide imaging. BME, necrotic area, and joint fluid were analyzed respectively in ONFH with pre- or post-collapse of the femoral head and different MR signal intensities within necrotic area.Results ①The characteristic “line-like sign” appeared on MRI in 88 of 91 affected hips, and BME was seen in the distal zone away from line(s) in 61 hips, extending to the femoral neck and intertrochanteric region. ②The ratio of the occurance of BME in the collapse was greater than that in noncollapse, and in mixed signals within necrotic area without collapse greater than pure fat-like signal (P0.05), and both were greater than noncollapse without BME (P

0.05). Conclusion There is no significant correlation between MVD and perfusion. Neovascularizaton and perfusion are highly presented in early colorectal carcinoma. SCT may be more suitable for assessing tumorigenesis than histological MVD technique.

Objective To evaluate the value of MRI categorization of cholesteatoma of the skull base (CSB) and its MRI diagnostic characteristic Methods The CT, MRI and pathological data of 15 patients with CSB were reviewed The CSBs were categorized into type I and type II based on the difference of signal intensity on T 1 weighted image, and the differences between the two types of CSB were compared in the aspects of CT and MRI findings and osseous encroachment of the skull base Results Extremely high signal intensity on T 2 weighted image being similar to that of cerebrospinal fluid, and unenhanced tumor parenchyma on enhanced T 1 weighted image were noted in the 15 cases of CSB Of the 15 CSBs, 6 were categorized as type I and the other 9 as type II on the basis of the difference of the signal intensity on T 1 weighted image The 6 CSBs of type I, located in the prepontine and cerebellopontine angle cisterns, appeared as homogeneous hypoattenuating on CT scan and homogeneously decreased signal intensity on T 1 weighted image coupled with unenhanced tumoral capsule and relatively normal skull base The tumor parenchyma of this type was consisted of homogeneous cholesterol crystal The 9 CSBs of type II, located in unilateral floor of middle or posterior cranial fossa, were demonstrated as mixed density on CT scan and mixed signal intensity on T 1 weighted image, of which 4 presented as decreased signal intensity scattered with increased signal intensity, 5 largely as increased signal intensity The 9 cases were noted with enhanced tumoral capsule and marked osseous encroachment of the skull base, and the parenchyma of which was mainly comprised of keratinized epithelia and proteins Conclusion The categorization of CSB into type I and type II is sensible, which reflects the distinction in both histopathology and biological behaviour between the two types of CSB and plays an important role in guiding MRI diagnosis of CSB The MRI diagnostic characteristic of CSB includes the versatile signal intensity on T 1 weighted image, marked increased signal intensity on T 2 weighted image, unenhanced tumor parenchyma and type related osseous encroachment of the skull base

Objective To probe the feasibility of single dose contrast enhanced magnetic resonance aortography(CEMRA) and evaluate its value in clinical application. Methods Transit time(TT) test and duration of peak enhancement of aorta(DPE) test in 28 healthy adults were performed. With 2 different injection rate of Gd DTPA at 2 ml/s and 3 ml/s, the TT,peak signal intensity of aorta(SPE),DPE and the interval between DPE and the time of injection(?T) were measured and compared. Two groups of healthy volunteers(each 10) underwent three diamentional fast imaging in static procession sequence (3D FISP) CEMRA with standard dosage of Gd DTPA with the injection rate at 2 ml/s and 3 ml/s respectively. The signal/noise ratio(SNR) of the source images and the image quality of CEMRA of both groups were compared. Fifteen patients with aortic disease did the same study as the voluteers with the injection rate only at 3 ml/s. Results With the injection rate of 2 ml/s and 3 ml/s,the TT,SPE,DPE,?T and the SNR of CEMRA in two groups were significantly different( P

Objectiye To measure longitudinal (T1) and transverse (T2 ) relaxation time of metabolites in m. soleus (SOL) and m. tibialis anterior TA of healthy volunteers at 3.0 T through 1H-MRS and optimize measurement protocols. Methods Altogether 24 healthy volunteers were recruited in the study. All subjects signed a letter of informed consent. After divided into 2 groups randomly by the table of random number, 1H-MRS measurements with stimulated echo acquisition mode (STEAM) sequence were undertaken in SOL and TA separately. Progressive saturation method was used for T1 measurement. Spectra with 8 different TRs (770,900,1000, 1100,1200,1500,2000 and 3000ms ) were acquired with TE=20 ms.T2 time was measured by changing TE. Altogether 8 TEs (20,30,45,60,90,135,200 and 270 ms) were used with TR = 3000 ms. Metabolites' concentration was calculated through T1 and T2 correction using water as internal reference. The t test was used for statisties. Results Altogether 22 groups of data were gained ( 12 for SOL, 10 for TA ) . T1 value of water, Creatine-CH3 ( Cr3 ), Trimethyl amonium ( TMA ),extramyocellular lipid (EMCL) and intramyocellular lipid (IMCL) in SOL were ( 1384. 0 ± 36. 9 ),( 1064. 0 ± 167.0), (964. 2 ± 144. 0 ), ( 373.0 ± 46. 8 ), ( 374. 7 ± 20. 6) ms respectively and T2 value were (26.5 ±1.2), (100.2±19.3), (149. 1 ±32.7), (81.4±5.2), (84.7±4.2) ms. InTA T1 value of water, Cr3, TMA, EMCL, and IMCL were ( 1307. 0 ± 24.4), (945.7 ± 132. 0), (968.3 ± 127. 0),(372. 7 ± 39. 2), (412. 8 ±80. 2) ms respectively and T2 value were (27. 1 ± 0. 9), (135.3 ± 18. 2 ),(62.1 ± 6. 0), ( 84. 3 ± 4. 0 ), ( 90. 7 ± 3.2 ) ms. After corrected by the calculated relaxation times, the concentrations of Cr3 in SOL and TA were (33. 1 ± 3.7) and (31.7 ± 3. 1 ) mmol/kg respectively, TMA (35.2±3.2) and (32.9 ±5.2) mmol/kg, EMCL (12.2 ±5.0) and (8.9 ±4.9) mmol/kg, IMCL (9. 0 ± 2. 4) and (3.0 ± 0. 8 ) mmoL/kg. IMCL in TA was much lower than SOL with statistical significant ( t = 8. 044, P < 0. 01 ), the difference between other metabolites were not statistically significant( t = 0. 926,1. 264, 1. 542, P > 0. 05 ) . Conclusions Accurate relaxation time was measured at 3.0 T of the metabolites in skeletal muscles of healthy adult human. After corrected by the relaxation times, the absolute concentrations calculated were consistent with the reported results. Quantitative knowledge of muscle NMR relaxation time was a prerequisite for absolute quantification of metabolites using the 1H-MRS and also was useful for optimizing measurement protocols.

Objective To study the clinical, radiologic and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma for further improving the diagnostic ability.Methods The data of 10 patients with histologically proved telangiectatic osteosarcomas were retrospectively reviewed, and the clinical, radiologic and pathologic characteristics were further analysed in combination with the literature.All 10 patients were examined with X-ray and MRI, and 2 patients with CT.Results Telangiectatie osteosarcomas originated from inferior femur in 5 patients, femur neck in 1 patients, superior humerus in 2 patients and superior segment of tibia in 2 patients.The lesions showed osteolytic bone destruction on X-ray films (n = 10) and CT images ( n = 2), with mild bone expansion in 4 patients.The majority of the edge of the destroyed bone areas was unclear but without sclerotic rim.There were Codman's triangle and soft tissue mass in each patient but no obvious neoplastic bone forming.On MRI, all the lesions were mostly or completely constituted by the multiple cysts with periostnal reaction, and several scatteredly smaller liquid-liquid levels were found within cystic cavity in 7 patients.In all 10 cases, there were pathologic hemocoele similar to aneurysmal bone cysts (ABC), but malignant tumor cells and some neoplastic bones were found in cystic walls or septations.Only a small number of neoplastic bone tissue were seen by microscopy in 6 patients.Conclusions The radio-pathologic characteristics of telangiectatic osteosarcoma include the similar imaging findings of ABC, the common growth patterns of malignant tumors,and the pathologic hemocoele, malignant tumor cells within cystic wails or septations.The comprehensive analysis of clinical, radiologic and pathological data may help clinicans to make a correct diagnosis for telangiectatic nsteosareoma.

Objective To determine the optimal sequences and scan parameters of Brachial Plexus MRI.Methods Eighteen volunteers were underwent conventional MRI and echo planar imaging scanning. The images acquired were compared with the standard anatomical pictures. Results Ventral rami, ganglion, trunks, cords and some peripheral nerves of brachial plexus were demonstrated very well by echo planar imaging with the post-processing techniques such as MIP, thin slice MIP and MPR.In 18/18 cases the postganglions on both sides and 17/18 cases the preganglions of brachial plexus on both sides could be visualized in EPI pre-processed and post-processed images.Conclusion Echo planar imaging is an effective technique of accurately displaying brachial plexus and adjacent structures. It has potential value in the diagnosis and treatment of brachial plexus diseases. It is also a potential technique to demonstrate other peripheral nerves accurately.

Objective To analyze the MRI characters of Charcot joint, and to evaluate the diagnostic value of X-ray, CT, and MRI on Charcot joint. Methods Eight patients with 8 Charcot joints underwent X-ray, CT, and MR examinations. 6 of them had syringomyelia, 1 patient had injury of the spinal cord, and 1 case had diabetes. All 8 patients had sensory reduction or deficit in the sick extremities. Results There were two types of Charcot joint, hypertrophic and atrophic. Radiographic and CT features of hypertrophic joint (n=3) showed hyperostotic osteosclerosis and mammoth osteophytes in the sick bones, periarticular ossification,and articular disorganization. Radiographic and CT features of atrophic joint (n=5) showed extensive bone resorption (destruction), periarticular debris, and articular disorganization. Main MRI features of Charcot joint included hydrarthrosis within joint capsule, thickened, loose, and elongated joint capsule with para-joint, peri-diaphysis, and inter-muscular extension in a pseudopodia pattern. The irregular joint capsule wall was presented as mild hypointensity on T 1WI, slight hyper-intensity on T 2WI, and was markedly enhanced after Gd-DTPA was administrated, which was considered as a characteristic manifestation of the lesion. Soft tissue mass containing hypo-intense stripes on both T 1WI and T 2WI was commonly noted adjacent to the involved joint. Conclusion X-rays plain film is the first choice for the diagnosis of Charcot joint, and MRI is pretty useful in the diagnosis of Charcot joint.

Objective To analyze the X -ray, CT, and MR imaging findings in osteoid osteoma. Methods Forty-eight cases of osteoid osteoma proved by surgical pathology were collected, including 33 males and 15 females. Among the 48 cases, all patients had plane films, 32 were imaged with CT scanning, 10 with MR imaging, and 8 with all three techniques. The imaging findings of osteoid osteoma and the ability of X-ray, CT, and MRI in demonstrating the nidus and the surrounding reaction were analyzed. Results The imaging manifestations of osteoid osteoma revealed a circular or oval nidus with different bone sclerosis around the nidus. The diameters ranged from 0.4 cm to 1.7 cm, with the average of 9.7 cm. There were also soft tissue and bone morrow edema around the nidus or distinct effusion of joint on MR imaging in all 10 cases. Among 48 cases, only 37 cases showed nidus on plane film. All 32 cases with CT scanning showed nidus. The display ratios of nidus were 77% for X-ray and 100% for CT, respectively. 10 cases with MR imaging could be diagnosed correctly. But the nidus could be affirmed in only 8 cases, and the nidus was affirmed by comparing with plane film or CT in the other 2 cases. Conclusion Nidus is the key in diagnosing the osteoid osteoma correctly. Plane film is still an important checking method for osteoid osteoma. CT scan is the best method to demonstrate the nidus. MRI can demonstrate the soft tissue and bone morrow edema around the nidus sensitively, but probably lead to an incorrect diagnosis. Combining with X-ray or CT, MRI can make an accurate diagnosis.