Objective To study the quantitative fiber tractography variations and 3D simulation patterns in patients with multiple sclerosis (MS),and assess the correlation between quantitative fiber tractography and scores of expanded disability status scale (EDSS).Methods MR diffusion tensor imaging was applied in 28 MS patients and 28 age-matched healthy volunteers.Then,quantitative tractography was generated in all subjects; and mean numbers of tracked lines and fiber density were measured.Paired-samples t tests were used to compare tracked lines and fiber density in MS patients with those in controls.Analysis of variance of ADC value and FA value was applied to MS patients having demyelinating plaque and normal appearing white matter,and controls.Linear regression model was used to determine the relationship between quantitative fiber tractography and scores of EDSS in MS patients.Results Tractography's tracked lines (2220±100) and fiber density (0.75±0.04) in MS patients were less than those in controls (2750±70) and (0.93±0.02,P＜0.05).In MS patients having plaque and normal appearing white matter,and controls,the ADC values of ROI were (1.23±0.13)× 10-3 mm2/s,(0.76±0.09)×10-3 mm2/s and (0.63±0.10)×10-3 mm2/s,respectively,with a gradual declined trend; and the FA values were 0.24±0.04,0.42±0.07 and 0.48±0.06,respectively,with a gradual increased trend; significant differences were noted between each 2 groups (P＜0.05).Both tracked lines and fiber density were found negative correlations with scores of EDSS in MS patients (P＜0.05).Conclusion Damages of white matter tracts in MS patients can be detected by diffusion tensor fiber tractography,and it provide more space information than conventional MRI.

OBJECTIVETo investigate the manifestation and diagnostic value of multislice spiral CT (MSCT) and MRI imaging in detection of tumor recurrence after liver transplantation for hepatocellular carcinoma (HCC).

METHODSThe clinical data of 161 consecutive HCC patients who underwent orthotopic liver transplantation were retrospectively reviewed. Twenty-nine HCC patients were classified by pTNM according to the "Pittsburgh criteria". MSCT and MRI findings of tumor recurrence after liver transplantation were evaluated retrospectively in 29 stage II-IVb HCC patients. The recurrence site and relapse interval between liver transplantation and recurrence were analyzed.

RESULTSLung tumor recurrence were found in 21 cases, presented as cotton-like lesions in a diameter of 2 - 3 cm, with a clear margin and homogeneous density. Pleural tumor recurrence was detected in 4 cases. Liver tumor recurrence were found in 9 cases, which can be divided into four subtypes: multinodular in 4 cases, diffuse lesion in 2 cases, huge mass in 2 cases, and uninodular in 1 case. Two cases showed tumor thrombus in the inferior vena cava and portal vein. Lymph node tumor recurrence was found in 9 cases, presented as multiple nodules at hepatic hilum, lesser peritoneal sac, posterior mediastinum, retroperitoneum, or around pancreatic head, and accompanied with merging and necrosis in one case. Bone tumor recurrence were found as osteolytic destruction in 4 cases, and accompanied with adjacent soft-tissue mass in 2 cases. The recurrence sites of the 29 cases were as following: lung (21 cases, 72.4%), liver (9 cases, 31.0%), lymph nodes (9 cases, 31.0%), bone (4 cases, 13.8%) and other sites (3 cases, 10.3%). Lung tumor recurrence was found in all the 10 stage IVb patients with tumor recurrence after liver transplantation, significantly more frequent than that in stage IVa patients (P = 0.023). After liver transplantation, all 25 patients with stage III approximately IVb HCC developed recurrence within one year, but in the 4 cases with stage II HCC at one year later (P = 0.009).

CONCLUSIONThe results of our study show that in hepatocellular carcinoma patients after liver transplantation, the lung and pleura are the most frequent site of recurrence, followed by liver, lymph node and bone as the second and third sites. The Stage IVb hepatocellular carcinoma should be regarded as a contradiction for liver transplantation due to rapid recurrence. Tumor recurrence occurs later in stage II HCC than in stage III approximately IVb patients. MSCT and MRI are of significant importance in diagnosis and formulating operation plan in HCC patients with recurrence after liver transplantation.

Adult ; Carcinoma, Hepatocellular ; diagnosis ; diagnostic imaging ; secondary ; surgery ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; surgery ; Liver Transplantation ; Lung Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; diagnosis ; diagnostic imaging ; Neoplastic Cells, Circulating ; Pleural Neoplasms ; diagnosis ; diagnostic imaging ; secondary ; Retrospective Studies ; Tomography, Spiral Computed ; methods

OBJECTIVETo evaluate the clinical significance of 320-slice CT hepatic artery images in patients with liver transplantation.

METHODSA total of 58 patients underwent CT scanning by 320-slice scanner after liver transplantation. They were divided into 2 groups according to the concentration of contrast media as follows: Group A (27 cases, 350 mgI/ml iopromide), Group B (31 cases, 370 mgI/ml iopromide). Contrast medium was infused at 6 ml/s, with a total dose of 50 ml. Images were generated by dynamic volume scanning and were processed by 4D digital subtraction angiography (DSA) imaging software. The time-density curve (TDC) of the hepatic artery was delineated. The time to peak, peak contrast enhancement were recorded. The physiological parameters such as body weight and height were analyzed.

RESULTS(1) There were no differences in clinical parameters such as age, sex, height, weight, or BMI between groups. The time to peak of hepatic artery of group A and B was (19.71+/-3.11) s and (20.06+/-3.67) s, and had no significant difference. The maximum peak enhancement of hepatic artery in groups B was higher than that group A (P < 0.05). (2) 4D DSA revealed hepatic artery pseudo-aneurysm (n = 2), and hepatic artery mild stenosis (n = 13), moderate stenosis (n = 5), severe stenosis (n = 9) and occlusion (n = 1), segmental moderate and severe stenosis (n = 4), and compensatory circulation with hepatic artery severe stenosis and occlusion (n = 6). hepatoportal arteriovenous fistulas (HPAVF, n = 12), donor-recipient hepatic artery mismatch (n = 3). Hepatic arterial branch are decreased and opened in 15 cases and 8 cases.

CONCLUSION320-slice CT hepatic artery images is safe, noninvasive, and accurate technique to evaluate hepatic arterial complications after liver transplantation.

Adolescent ; Adult ; Aged ; Female ; Hepatic Artery ; diagnostic imaging ; Humans ; Liver Diseases ; diagnostic imaging ; etiology ; Liver Transplantation ; adverse effects ; Male ; Middle Aged ; Tomography, X-Ray Computed ; methods ; Young Adult