Objective To observe the course of motor related activation cortex after unilateral subcortical ischemic stroke. Methods6 healthy volunteers and 3 patients with solitary lacunar infarction in subcortical region underwent blood-oxygen level dependent functional MRI （BOLD-fMRI） as a block design of sequential finger tapping task. The data were analyzed with Statistical Parametric Mapping (SPM2). The activated voxels and the laterality index (LI) were calculated. The patients were assessed with the Fugl-Meyer Assessment of upper limb after scanning, and were scanned again 8 months after stroke. ResultsThe activated cortices in patients were more extensive than that of volunteers. In the early stage of stroke, the activation cortex involved the bilateral sensory motor cortex (SMC) in all the patients, but various in other regions. In the late stage, the ipsilateral activations decreased while the contralateral activation increased in SMC. The LI of hemisphere, SMC, and M1 is higher than the early stage. ConclusionThe motor related activation gradually localized to the contralateral SMC with motor function recovery.

Objective To assess the characterization and usefulness of contrast enhanced ultrasound (CEUS)to diagnose solid focal lesions of pancreas(s-FLPs)in comparison to contrast enhanced computed tomography(CECT).Methods Forty-nine s-FLPs with final diagnosis were studied with low mechanical index CEUS and CECT.The enhanced patterns and diagnostic capability of CEUS were analyzed,and these results were compared with those from CECT.Results ①In CEUS,the perfusion of capillary could be detected in vascular phase.②The concordance of dual-phases enhanced patterns between CEUS and CECT was 73.5%(36/49).The concordance of enhanced level between early parenchymatous perfusion phase in CEUS and pancreatic phase in CECT could achieve 87.8%(43/49).Hypo/hypo enhancement was the most common enhanced pattern of pancreatic carcinoma in CEUS and CECT.③There was no statistical significance between CEUS and CECT in the differential diagnostic.Conclusions The concordance of enhanted patterns between CEUS and CECT is satisfactory.CEUS is similar to CECT in the differential diagnosis of s-FLPs.CEUS would become an important non-invasive diagnostic method for s-FLPs.

Objective To evaluate the accuracy and utility of percutaneous ultrasonic cholangiography in Bismuth staging of hilar cholangiocarcinoma. Methods Thirty patients who underwent surgery and obtained pathologic diagnosis of hilar cholangiocarcincoma were perspectively ruled in this study. All patients with hilar obstruction underwent baseline ultrasound (BUS), percutaneous ultrasonic cholangiography (PUSC) and percutaneous transhepatic cholangiography(PTC) respectively. Taking operative findings as reference standard,the accuracy of the three imaging modalities in staging of hilar cholangiocarcinoma was compared. Results Among 30 patients, the accuracy of classification among BUS, PUSC and PTC was 23.3 % (7/30), 73.3 % ( 22/30 ), 73.3 % (22/30), respectively. There was statistically significant difference between BUS and PUSC, but the difference between PUSC and PTC was not statistically significant.Conclusions As a new technique for cholangiography, PUSC expands the application of ultrasound in evaluating hilar cholangiocarcinoma and is comparable to PTC in classifying hilar cholangiocarcinoma by Bismuth classification.

Objective To compare the enhancement characteristic of the gallbladder diseases and to evaluate the diagnostic efficacy in differential diagnosis of the gallbladder diseases between contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT).Methods Seventy-two patiens with gallbladder lesions were examined by CEUS and CECT before operation and all final diagnoses were confirmed by surgery and/or pathological diagnosis.Results 1)In early phase,84.6％ (33/39) and 79.5％ (31/39) of benign diseases showed hyper-enhancement on CEUS and CECT,and 97.0％ (32/33) and 87.9％ (29/33) of malignant diseases showed hyper-enhancement on CEUS and CECT respectively (P =0.250).In later phase,91.2％ (31/34) and 88.2％ (30/34) of benign diseases showing hypo-enhancement (P =1.000),and 100％ of the malignant diseases showing hypo-enhancement on CEUS and CECT respectively.2)The time of enhancement from hyper-to hypo in CEUS for benign and malignant diseases were (39.9 ± 15.7)s and (29.9 ± 5.6)s respectively (t =3.61,P =1.000).3)The inhomogeneous enhancement on CEUS and CECT were 41.0％ (16/39) and 53.8％ (21/39) in the benign diseases respectively (P =0.063),84.8 ％ (28/33) and 97.0 ％ (32/33) in the malignant diseases respectively(P =0.125).4)The destruction of the gallbladder wall on CEUS and CECT are 87.9％ (29/33) and 90.9％ (30/33) respectively(P =1.000).5)The accuracy,diagnostic sensitivity,specificity of CEUS and CECT were 91.7％(66/72) and 87.5％(63/72),97.0％(32/33) and 93.9％(31/33),87.2％(34/39) and 82.15％ (32/39) respectively (P =0.250,1.000,0.500).Conclusions The enhancement pattern of the gallbladder diseases on CEUS and CECT were much similar.CEUS has equal diagnostic efficacy in comparison with CECT,but CEUS can supply more diagnostic information than CECT.

Objective To evaluate the therapeutic efficacy and safety of radiofrequency ablation (RFA) combined with ethanol injection with a multipronged needle under ultrasound guidance for the treatment of hepatocellular carcinoma (HCC) larger than 3 cm in diameter.Methods 65 patients with 67HCC nodules ranging from 3.1 to 7.0 cm in diameter were treated percutaneously under ultrasound guidance.Tumor response and complications after treatment were observed.Results Complete ablation was achieved in 94.0％ (63/67) of HCC nodules.4 residual tumor nodules received complete ablation after additional treatment.Ablation-related major complications was occurred in 3 patients,including liver abscess in 1 case,abdominal bleeding in 1 case and massive ascites in 1 case,all were cured by conservative therapy.After a mean follow-up period of (20.0 ± 7.6) months (6.7-32.6 months),local-tumor progression was observed in 10 (14.9％) of 67 HCC nodules,and distant recurrence was observed in 32 (49.2％) of 65patients.The 1-year and 2-year survival rate were 93.1 ％ and 88.1％,respectively.Conclusions RFA combined with ethanol injetion with a multipronged needle is a safe and effective technique for the treatment of hepatocellular carcinoma larger than 3 cm,especially 3-5 cm in diameter.

OBJECTIVE To provide computed tomographic reference for the infralabyrinthine approach to the internal auditory canal.METHODS Temporal bone CT images of forty patients(80 sides) were randomly selected without ear lesions,and some relative structures were observed and measured.RESULTS The mean distance from the inferior edge of the posterior semicircular canal to the superior edge of the jugular bulb was (4.69±2.91)mm left and (3.10±3.01)mm right,the mean thickness of the bone inferior to the posterior semicircular canal was (0.92 ± 0.37)mm left and (0.69 ± 0.37)mm right,the mean distance from the vertical portion of the facial nerve to the anterior edge of the sigmoid sinus was (8.66±2.71)mm left and (7.74± 1.99)mm right,the mean distance from the superior edge of the jugular bulb to the internal auditory canal was (6.32 ± 2.88)mm left and (5.39 ± 2.61) mm right,the mean distance from the superior edge of the jugular bulb to the single foramen was (6.82 ± 3.02)mm left and (5.84 ± 2.82)mm right,the mean distance from the external aperture of vestibular aqueduct tothe posterior edge of internal acoustic porus was (14.38 ± 2.56)mm left and (14.12±2.76)mm right,the mean distance from the external aperture of vestibular aqueduct tothe midpoint of internal auditory canal was (12.02 ± 2.46)mm left and (11.91 ± 2.53)mm right.There were statistical differences in distances of different sides among the anterior three groups,no statistical differences were seen in distances of different sides among the posterior four groups.CONCLUSION The temporal bone CT images are helpful to the infralabyrinthine approach to the internal auditory canal.