Objective To investigate the effective MRI sequences and describe the correlation between MRI and visual evoked potential(VEP)in diagnosing optic neuritis.Methods One hundred and fifty-four eyes with visual impairment of 98 patients with diagnoses of optic neuritis,papillitis,multiple sclerosis and Devic's disease underwent MRI and VEP examination. The MRI findings were analyzed and correlated with VEP results and clinical presentation by using x2 test,wilcoxon test and Kappa test.Results Out of the 154 sick eyes.56 eyes presented thickened optic nerves.76 eyes had normal diameter of the optic nerve,and 22 eyes had thin optic nerves.A total of 132 optic nerves showed abnormally high signal in STIR sequences.including involvement of intraocular segment in 7,intraorbitsl segment in 135,intracanalicular segment in 109,intracranial segment in 97,optic chiasm in 56,and optic tract in 23.A total of 54 patients underwent postcontrast MRI. Seventy-four optic nerves of 87 eyes showed enhancement.Among the 196 eyes of 98 patients,132 eyes presented visual impairment and simultaneous abnormal MR signal of the optic nerve.and 26 eyes had both normal vision and normal MR signal of optic nerve.The consistency of MRI findings and vision status was 80.61%(Kappa=0.453,P＜0.01).Among the 175 eyes with VEP results.129 eyes had visual loss with simultaneous VEP abnormalities,and 30 eyes had both normal vision and normal VEP results.The consistency of VEP and vision status was 90.86%(Kappa=0.731,P＜0.01).Among the 175 eyes with VEP results,117 eyes had abnormal MR signal of the optic nerve and simultaneous abnormal VEP,and 24 eyes had both normal MR signal of the optic nerve and normal VEP.The consistency of MRI findings and VEP was 80.57%(Kappa=0.460,P＜0.01).Conclusion STIR sequence and gadolinium-enhanced T1-weighted MR sequence combined with fatsuppression are helpful in diagnosis of optic neuritis.VEP is helpful in diagnosing optic neuritis and in finding subclinical visual problem.The MRI combined with VEP could improve the diagnostic accuracy of optic neuritis.

Objective To explore the MRI features of solitary fibrous tumor(SFT)in the orbit.Methods The MRI findings of 7 patients with SFT in the orbit confirmed by histopathology were analyzed retrospectively.Re sults Of the 7 lesions,5 occurred in the right orbit and 2 in the left orbit.Six lesions were located in the extraconal space near the lacrimal gland fossa,including 5 in the superomedial region and 1 in the inferolateral region.The other one was located in the retrobulbar intraconal space.The lesions with well-defined margin showed elliptic shape in 6 cases and lobulated configuration in 1.The maximum diameter of the lesions ranged from 18 to 40 mm(mean,31 mm).The lesions showed homogeneous isointense relative to gray matter on T1-weighted images in 6 patients.On T2-weighted images,the lesions showed heterogeneous hypointense in 5 patients,isointense and hyperintense in one patient respectively.SFT demonstrated markedly homogeneous enhancement in 6 patients and inhomogeneous enhancement in one patient The time-intensity curves(TIC)of 7 patients exhibited a rapidly enhancing and rapid washout pattern on dynamic contrast-enhanced(DCE)MRI.Conclusion Hypointense signal on T2WI,marked enhancement on contrast-enhanced T1 WI,and a rapidly enhancing and rapid washout pattern TIC on DCE MRI are the typical MRI features of orbital SFT.

Objective To investigate the characteristics and value of nasal area-distance curves.Methods Based on data from CT images, nasal cavity cross-sectional areas in 60 volunteers were reconstructed. The size of each nasal airway and the distance from nostril to the corresponding cross-sectional area were measured. Area-distance curves were then established according to data obtained. t test was used to analysis the data. Results Three types of curves were found and categorized according to their shapes.Type Ⅰ consisted of 56 sides (46.7%) ,type Ⅱ 40 sides(33.3%), and type Ⅲ 24 sides (20. 0% ). Forcurves of nasal valve area, smooth type was seen in 86 sides (71.7%), and concave type in 34 sides(28.3%). Curves in area of inferior turbinate head were seen with shallow notch(48 sides,40.0%) ,deep notch (54 sides,45.0%), and no notch( 18 sides,15.0% ). Curves in area of middle turbinate head wereseen with shallow notch (31 sides, 25.8%), deep notch (38 sides, 31.7%), and no notch ( 51 sides,42. 5% ). Nasal minimal cross-sectional area was located at nasal valve area in76 sides (63.3%), head of inferior turbinate in 26 sides ( 21.7% ), region anterior to nasal valve in 15 sides ( 12. 5% ), head ofmiddle turbinate in 1 side, and region anterior to choana in 2 sides. The cross-sectional area at nasal valve in men and women were (197.9 ±41.2) and (151.2 ±35.5) mm2, respectively. The cross-sectional area at choana in men and women were (361.8±97.9) and (296.3 ± 81.8) mm2, respectively. There wassignificant difference between men and women at both sites (t = 4.707 and 0. 007, P ＜ 0.01). The distance from nostril to nasal valve in men and women were (14. 0 ± 2.4) and ( 11.8 ± 2. 9) mm, which presented significant difference, too (t = 3. 232,P ＜ 0. 01). Conclusions CT nasal area-distance curve varied with individual, CT may provide information for evaluating nasal passage on individual basis

OBJECTIVE To analyze the incidence of anatomic variations of the temporal bone to provide valuable reference for clinical otology. METHODS Sev-enty six healthy adults (152 ears) and 66 patients(96 ears) with chronic suppurative otitis media confirmed by clinical examination underwent axial and coronal High-resolution Computed Tomography(HRCT) scan. The incidence of high jugular bulb, dehiscent jugu-lar bulb, anterior location of sigmoid sinus, low-lying middle cranial fossa, dehiscent tegmen tympani, mas-toid antrum dysplasia, aberrant internal carotid artery, and large sinus tympani were recorded. RESULTS In normal, abnormal, well and poorly pneumatized groups, the incidence of highly positioned jugular bulb on the right was higher than that on the left. The total inci-dence of high jugular bulb on the left and right was 26.2 % and 46.0 % respectively. The incidence of ante-rior location of sigmoid sinus in the abnormal group (32.3 %) was higher than that in normal group(15.8 %), which was higher in poorly pneumatized group(43.5 %) than that in well pneumatized group(11.3 %). The inci-dence of dehiscent tegmen tympani in well pneuma-tized group(18.0 %) was higher than that in poor pneu-matized group(8.7 %). There was no significant differ-ence in dehiscent jugular bulb, low-lying middle cranial fossa, mastoid antrum dysplasia, aberrant internal ca-rotid artery, and large sinus tympani between the left and right within and among groups. The incidence of these varia-tions was 2.0 %,21.8 %,1.2 %,0.4 %,0.8 %respectively. CONCLUSION HRCT can show ana-tomic variances of temporal bone clearly before opera-tion and has great clinical value for reducing the inci-dence of complications caused by middle ear operation.

The phosphoinositide-3 kinase (PI3K)/protein kinase B (PKB/AKT)/mammalian target of rapamycin (mTOR) pathway is asso-ciated with cell growth, proliferation, differentiation, apoptosis and metabolism. The abnormalities of this signal pathway are found in various malignant tumors. This pathway has also been investigated as an anti-tumor target. Recently, novel inhibitors have been stud-ied in clinical trials of lymphoma. This review summarizes the activation status of the PI3K/AKT/mTOR pathway and its use for targeted therapy of lymphoma.

Objective To evaluate the efficacy and safety of traditional Chinese medicine in the treatment of skin rash caused by epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI).Methods The clinical randomized controlled trials of traditional Chinese medicine in the treatment of EGFR-TKI-induced skin rash which published in domestic journals were selected.The quality assessment of included literature was made by Jadad score,RevMan 5.2 software was used to make Meta-analysis.Results A total of 6 studies met the inclusion criteria,the 6 studies included 248 patients,133 cases in the treatment group,115 cases in the control group.All patients were 30 to 75 years old.Compared with the control group,the combined OR value of the clinical efficacy of traditional Chinese medicine in the treatment of EGFR-TKIinduced rash was 7.51,with 95 ％ confidence interval 4.46-12.65.Conclusions Meta-analysis shows that the clinical efficacy of traditional Chinese medicine in the treatment of EGFR-TKI-induced skin rash is better than Western medicine,and no adverse reactions.It can be widely used in clinical practice.

ObjectiveTo observe the cells of frontal recess region with multi-detector CT muhiplanar reconstruction(MPR).MethodsOne hundred patients without the disease of frontal sinus and frontal recess region underwent axial multi-detector CT scan with axial,coronal and sagittal multiplanar reconstruction.ResultsIn 100 cases(200 sides),the agger nasi cell is present in 186 sides(93.0%),the frontal cells were identified in 88 sides(44.0%),the prevalence of type Ⅰ,type Ⅱ,type Ⅲ and type Ⅳ cells were 51 sides(58.0%),23 sides(26.1%),14 sides(15.9%)and 0 sides,respectively. The suprabullar cells,the frontal bullar cells and the supraorbital ethmoid cells were identified in 130 sides (65.0%),23 sides(11.5%)and 11 sides(5.5%),respectively.The interfrontal septal cells were identified in 36 sides(18.0%).There was no significant difference between males and females,as well as between left and right side(P＞0.05).Conclusion With MPR imaging,doctors could better understand the frontal recess region,which is helpful to the endoscopic frontal sinus surgery.

ObjectiveTo investigate the MRI appearance of malignant melanoma in the sinonasal tract and nasopharynx.MethodsMRI Findings and clinical data from 8 patients with biopsy or operation proved malignant melanoma were retrospectively reviewed.Gadolinium-enhanced imaging and dynamic contrast enhancement scanning were performed in all cases.ResultsThe majority of lesions were located in the nasopharynx (n =2),middle turbinate (n =1 ),or a combination of the nasal cavity,ethmoidal sinus,and maxillary sinus ( n =5 ).The aggressive nature of the tumors was demonstrated by bone destruction ( n =5 ) and invasion of adjacent structures,involving anterior fossa (n =2 ),orbits (n =4 ),infratemporal fossa ( n =2 ),pterygopalatine fossa ( n =3 ),and parapharyngeal space ( n =1 ).The MRI appearance included two patterns.In the first pattern,the tumors were round and small (smaller than 2 cm in maximum dimension in three patients).MR signal intensity of the lesions was hyperintense to gray matter on T1 WI and hypointense on T2.In the second pattern,the lesions were irregular and large ( larger than 3 cm in maximum dimension in five patients).They showed heterogeneous low-signal on T1 WI.On T2WI,one lesion showed isointensity or little hypo-intensity,and four lesions showed hyperintense.They demonstrated mild heterogeneous enhancement on gadolinium-enhanced images.Four patients demonstrated as plateau type time-signal intensity curve (TIC) pattern,and another four patients demonstrated as wash-out type TIC pattern.ConclusionsThe MR signal characteristic of the malignant melanoma in the sinonasal tract and nasopharynx were related with the tumor size.When the lesion was small,the MR signal intensity was more typical.When the lesion was large,they had mixed signal intensity as other malignant tumors,and specific mild heterogeneous enhancement.

Objective To investigate the clinical and image features of cerebral venous sinus thrombosis (CVST) presented as isolated intracranial hypertension.Methods The medical records of patients with diagnosis of CVST presented as isolated intracranial hypertension were reviewed.Clinical features and imaging data were retrospectively analyzed.Results Twenty cases of CVST were included,all these patients were clinically presented as isolated intracranial hypertension.The male to female ratio was 13:7,and the average age was (38.3 ± 11.7) years old.None of the patients was obesity.The visual acuity was lower than 0.1 in 42.5％ (17/40)of the eyes.Possible risk factors relevant to CVST were found in 11 cases (55％),including head trauma for 4 cases,autoimmune disease for 2 cases,and other causes of single case including spontaneous abortion,phlebitis,otitis media postoperative,trigeminal nerve microvascular decompression surgery and obstructive sleep apnea syndrome.Image analysis showed that lateral sinus thrombosis was involved in 85％ (17/20) of the patients,while superior sagittal sinus was involved in 35％ (7/20),and 65％ (13/20) of the patients were isolated lateral sinus thrombosis.Conclusions Young male predominance is found in CVST patients which presented as isolated intracranial hypertension but severe visual function loss.Risk factors such as head trauma are commonly found in these patients.Most of the patients are isolated lateral sinus thrombosis,with lateral sinus narrowing as the most common abnormal findings in magnetic resonance venogram.

Objective To evaluate the value of magnetic resonance thoracic ductography (MRTD)and magnetic resonance (MR) pelvic scanning in the chylous leakage of female reproductive system.Methods A retrospective evaluation of the imaging findings of MRTD and MR pelvic in 7 patients was performed,and compared with direct lymphangiography (DLG),lymphoscintigraphy and surgery.Results The rate of thoracic duct visualization in DLG was 71 .4% (5/7 ).The rate of venous angle visualization inlym-phoscintigraphy was 71.4% (5/7).The rate of thoracic duct visualization in MRTD was 100% (7/7).Except for 1 case withgeneral-ly normal findings,the remaining 6 cases showedobstruction of the thoracic duct in MRTD.Among those cases,bilateral drainage was found in 1 case,right thoracic ductwas seen in 1 case,multiple tortuous dilated lymphatic channelsaround the venous angle was detected in 4 cases,and multiple lymphangiomas was seen in 1 case.All of the 7 patients were conducted by surgery.6 cases were confirmed as obstruction of the thoracic duct.MRTD & MR pelvic found more multiple lymphangiomas lesions and detected 2 cases with bone abnormalities.Conclusion MRTD combined with MR pelvic could provide more comprehensive assessment of female re-productive system chylous leakage.It should be used as routine examination before operation.