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The value of diffusion kurtosis imaging combined with diffusion weighted imaging in evaluating the microstructure of cerebral gray and white matter in chronic mountain sickness

Yanqiu SUN ; Wenyou DENG ; Yijing WANG ; Dengfeng TIAN

Journal of Practical Radiology.2018;34(12):1827-1830,1838. doi:10.3969/j.issn.1002-1671.2018.12.001

Objective To explore the gray and white matter microstructures in the brain of patients with different degrees of chronic mountain sickness(CMS).Methods 30 cases of CMS (10 cases in each group divided into mild,moderate and severe groups according to the severity)were collected as experimental group,and 10 normal adults in high altitude area were collected as the normal control group.All cases underwent MRI conventional head sequences,diffusion weighted imaging (DWI)and diffusion kurtosis imaging (DKI)sequences.The values of mean kurtosis(MK),radial kurtosis(RK),kurtosis anisotropy(KA)and apparent diffusion coefficient(ADC) graphs were reconstructed by post-processing software respectively.Selected the region of interest(ROI)symmetrically and fixedly, then measured and analyzed the parameter values of ROI in the same area.Results Compared the CMS groups with normal control group,the diffusion parameters and ADC values in certain parts of deep gray matter nucleus and white matter fibers were statistically significant,and the difference was significant with the progression of the disease.Conclusion DKI combined with DWI has certain value in evaluating the gray and white matter microstructure of human brain,there are some difference in the brain microstructure between CMS patients and high altitude normal subjects,additionally,the difference in different degrees of CMS is diverse.

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Study on gray matter volume changes of long-term night shift physicians of the emergency department based on MRI data

Ning LI ; Rongrong ZHU ; Jianwei DONG ; Ruoshui HA

Journal of Practical Radiology.2018;34(12):1831-1834. doi:10.3969/j.issn.1002-1671.2018.12.002

Objective To investigate the abnormal region of gray matter and distribution in long-term night shift physicians of the emergency department,and explore the brain structural changes closely related to long-term chronic sleep loss.Methods The study was carried out among two groups of medical staff,with the chronic sleep deprived(CSD)group(n=15)performing a fixed night work and the regular sleep controls (RSC)group (n=15)working regularly during the day at our hospital.Both groups were age-and gender-matched.The data of two groups were analyzed using voxel-based morphometry (VBM)based on SPM8 to generate gray maps.Results Compared to the RSC group without night shifts,increased gray matter volume in the CSD group was observed in the middle temporal gyrus,inferior frontal fyrus,insula,thalamus,posterior cingulate,medial frontal gyrus,inferior parietal lobule and postcentral gyrus (P<0.05).Conclusion These findings suggest that long-term,chronic sleep loss is associated with the change of the gray matter volume in the network,and may have a neuroanatomical basis.The brain structural changes are related with the domains of emotion and language,this contributes to further explore on the neural mechanism of the effects of the long-term night shift on brain function.

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Diagnostic value of multimodal MRI in patients with temporal lobe epilepsy caused by dual pathology

Lina CHENG ; Wensheng WANG ; Shengwen GUO ; Chunren LAI ; Di ZHAO ; Jun SHEN

Journal of Practical Radiology.2018;34(12):1835-1838. doi:10.3969/j.issn.1002-1671.2018.12.003

Objective To investigate the diagnostic value of multimodal MRI for dual pathology (DP)in temporal lobe epilepsy (TLE).Methods The methods of voxel based morphometry (VBM)and voxel based analysis (VBA)had been employed to study the difference between 36 patients (20 cases left group and 16 cases right group)with TLE caused by DP and 36 healthy subjects on the grey matter (GM)volume,exponential apparent diffusion coefficient (eADC)and cerebral blood flow (CBF)value.The corresponding statistical study had also been conducted.Results There were significant statistical differences (FDR correction,P=0.001)between healthy subj ects and patients on the GM volume,eADC and CBF value.Those values decreased with diseased laterality and wider range in functional imaging.These overlaying abnormal brain regions were located in the temporal pole (superior temporal gyrus), temporal pole (middle temporal gyrus),middle temporal gyrus,inferior temporal gyrus,fusiform gyrus,hippocampus and parahippocampal gyrus which represented in all examination results.Conclusion The combined findings of multimodal MRI can improve the localization ability of seizure focus in TLE,which caused by DP,before surgery.

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Application of diffusion tensor imaging in crossed cerebellar diaschisis of cerebral gliomas

Mei LI ; Xinlan XIAO ; Jianglong HUANG ; Binyan QIAN

Journal of Practical Radiology.2018;34(12):1839-1841. doi:10.3969/j.issn.1002-1671.2018.12.004

Objective To explore the application of diffusion tensor imaging (DTI)in crossed cerebellar diaschisis (CCD)of cerebral gliomas. Methods MR images of 17 patients with high grade gliomas and 20 patients with low grade gliomas confirmed by postoperative pathology and 18 normal controls were analyzed retrospectively.The fractional anisotropy (FA)of cerebellar hemisphere was quantitatively measured with DTI technique.The asymmetry index (AI)of cerebellar hemispheric was calculated and compared in patients.The correlation between CCD phenomenon and histological grade of cerebral gliomas was also analyzed.Results Compared with ipsilateral cerebellar hemisphere of cerebral high grade gliomas,the FA value of contralateral cerebellar hemisphere significantly reduced (t=3.42,P<0.05).But there were no significant differences of FA values between contralateral cerebellar hemisphere and ipsilateral cerebellar hemisphere in cerebral low grade gliomas patients (t=0.80,P>0.05).The AI values of cerebellar hemisphere in high grade gliomas increased compared with low grade gliomas and normal controls (t=4.15,P<0.05;t=4.68,P<0.05),but there were no significant differences in the AI values of cerebellar hemisphere between low grade gliomas patients and normal controls (t=0.79,P>0.05).Conclusion CCD phenomenon is associated with the histological grade of cerebral gliomas.High grade gliomas can cause CCD phenomenon,but there is no evident CCD phenomenon in low grade gliomas.DTI technique is able to quantitatively assess CCD noninvasively by FA parameter.

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Application of combination 3D arterial spin labeling and diffusion kurtosis imaging in the grading of gliomas

Lisui ZHOU ; Yuan QU ; Tao PENG ; Xiangke NIU ; Liang SUN ; Guangnan QUAN ; Wei XIONG

Journal of Practical Radiology.2018;34(12):1842-1845,1892. doi:10.3969/j.issn.1002-1671.2018.12.005

Objective To evaluate the diagnostic value of combining 3D arterial spin labeling (3D ASL)and DKI in grading cerebral gliomas. Methods Thirty-four patients with pathologically confirmed gliomas were enrolled in this study.3D ASL and DKI (3 b-values were used:1,1 000,2 000 s/mm2and 15 diffusion directions)were acquired and tumor blood flow (TBF),mean kurtosis(MK),mean diffusivity (MD) and fractional anisotropy of kurtosis (FAk)were measured in the solid part of the tumor.The contralateral normal appearing white matter was used to normalize these parameters.The parameters of 3D ASL and DKI before and after normalization of high-grade and low-grade gliomas were compared.Receiver operating characteristic (ROC)curve analyses were also conducted for all parameters to determine the sensitivity and specificity for grading.Results TBF and MK values were significantly higher in the high-grade gliomas than the low-grade gliomas (All P<0.001),but there were no differences of MD and FAkbetween the two groups.The area under curve (AUC)of combination TBF and MK for glioma grading was 0.951.After normalization,the AUC of combination TBF and MK was 0.986 with a sensitivity of 94.7% and specificity of 94.3%.Conclusion The multi-parameter combined analysis of 3D ASL and DKI further improves the sensitivity and specificity of preoperative glioma grading.

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Comparative study of arterial spin labeling and dynamic susceptibility contrast of solitary brain metastasis at 3.0T MR

Cunzhong MENG ; Fan ZHAO ; Yulei WANG ; Yanchao WANG ; Changxiu ZHAO ; Huinian ZHI

Journal of Practical Radiology.2018;34(12):1846-1848. doi:10.3969/j.issn.1002-1671.2018.12.006

Objective To evaluate the perfusion findings of solitary brain metastasis using MR arterial spin labeling (ASL)imaging,and make a comparison with dynamic susceptibility contrast (DSC)imaging.Methods Twenty-three patients with pathologically proven solitary brain metastasis from lung cancer underwent ASL and DSC imaging.The ASL cerebral blood flow (CBF),DSC regional CBF (rCBF)and DSC regional cerebral blood volume (rCBV)were measured and compared between the tumor and the contralateral brain parenchyma.Pearson correlation test was performed to assess the relations between ASL and DSC measurements.Results Brain metastasis showed ring-like hyper-perfusion on ASL and DSC mappings.ASL CBF values of the tumor and the contralateral brain parenchyma were(54.872±21.131)mL·min-1·100 g-1and (21.109±4.788)mL·min-1·100 g-1,respectively (P<0.01).DSC rCBF values of the tumor and the contralateral brain parenchyma were (1.094 8±0.309 3)mL·min-1·100 g-1and (0.495 7±0.154 1)mL· min-1·100 g-1,respectively (P<0.01).DSC rCBV values of the tumor and the contralateral brain parenchyma were (1.753 1±0.545 5)mL/100 g and (0.729 9±0.215 8)mL/100 g,respectively (P<0.01).There was a strong correlation between ASL CBF and DSC rCBF (r=0.898,P<0.01),and there was no correlation between ASL CBF and DSC rCBV.Conclusion ASL can evaluate the CBF of brain metastasis as DSC dose. It requires no contrast agent administration and can be used in daily clinical practice.

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The application of quantitative analysis of eADC values in differentiating benign from malignant thyroid nodules

Yerong CHEN ; Yu LU ; Xiuhong SHAN ; Yueyuan ZHOU ; Shudong HU

Journal of Practical Radiology.2018;34(12):1849-1852. doi:10.3969/j.issn.1002-1671.2018.12.007

Objective To evaluate the application of exponential apparent diffusion coefficient (eADC)value in differentiating benign from malignant thyroid nodules.Methods Routine MR sequences and axial diffusion weighted imaging (DWI)sequences with different b-values(0, 300,500,800 s/mm2)were performed in 46 patients with 51 histopathologically confirmed thyroid nodules,including 35 malignant nodules and 1 6 benign nodules.The eADC values of each thyroid nodules’solid component with different b-values were measured and assessed by independent samples t test.Receiver operating characteristic (ROC)curves were drawn and used to determine the diagnostic threshold and assess the screen test.Results The eADC values of the malignant nodules were higher than that of benign nodules (P<0.05)in all of the three different b-values.The eADC values of the malignant nodules and the benign nodules were 0.618±0.080 and 0.492±0.071 (b=300 s/mm2),0.520±0.104 and 0.371±0.077 (b=500 s/mm2)and 0.407±0.114 and 0.286±0.097 (b=800 s/mm2)respectively. According to the ROC curve,the area under the curve(AUC)was 0.883,0.890 and 0.824 when the b-value was set as 300,500 and 800 s/mm2respectively.When the b-value was set as 500 s/mm2and the diagnostic threshold was 0.454,the sensitivity,specificity, positive predictive value,negative predictive value and Youden index were 74.3%,93.8%,96.3%,60.9% and 0.68,respectively.Conclusion The eADC value is helpful in differentiating benign from malignant thyroid nodules,and the best result can be obtained by using DWI with b-value of 500 s/mm2.

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Predictive value of heart function in acute pulmonary embolism patients based on embolic morphology and quantity

Leitao WEN ; Cong SHEN ; Nan YIN ; Jun WANG ; Sheng ZHOU ; Fuwen DONG ; Nan YU ; Youmin GUO

Journal of Practical Radiology.2018;34(12):1853-1856. doi:10.3969/j.issn.1002-1671.2018.12.008

Objective To explore the value of the morphological quantitative indexes and the number of emboli in predicting heart function in patients with acute pulmonary embolism (APE)based on computer-aided diagnosis (CAD)technique.Methods One-hundred and forty-eight APE patients confirmed by CT pulmonary angiography (CTPA)in our hospital.Total number of emboli (N)and three morphological quantitative indexes,including total volume of emboli (V),total length (L)and total maximum cross-section embolism proportion (P)were obtained by CAD.The maximal short axis and area of left and right ventricular (LVd,RVd,LVS,RVS)were measured by hand on axial image to calculate the ratio of maximal short axis of right and left ventricular (RVd/LVd)and ratio of maximal area of right and left ventricular (RVS/LVS).The correlation of the above indexes was analyzed by the Pearson correlation of SPSS 22.0.Results The ranking of the correlation between CAD indexes and the heart function was in the order of V,L,P and N.The correlation between CAD indexes and the right heart function was greater than that of the left heart.The V had the strongest correlation with RVd (r=0.544,P=0.000),RVS (r=0.515,P=0.000),RVd/LVd (r=0.595,P=0.000)and RVS/LVS (r=0.579,P=0.000),respectively.While other the CAD indexes had lower correlation with the heart function (|r|:0.167-0.476,P<0.05),and there was no correlation between the N and the left heart function.Conclusion In embolic morphology and quantitative indexes,the V is the best quantitative index to reflect the change of right heart function in APE,which can reflect dys-function of right heart and severity of pulmonary embolism dis-ease in the APE embolism patient.

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Compared analysis of CT features and pathology of pulmonary solitary fibrous tumor

Xuemei ZHANG ; Bangguo LI ; Lingwen ZENG ; Meng WANG ; Shuo WU ; Nianlan CHENG ; Xianli LUO

Journal of Practical Radiology.2018;34(12):1857-1859. doi:10.3969/j.issn.1002-1671.2018.12.009

Objective To compare the CT features and pathology of pulmonary solitary fibrous tumor (SFT),to improve the diagnosis and differential diagnosis.Methods CT images and corresponding pathological results of 14 cases with pulmonary SFT were analyzed retrospectively. Results Among the 14 cases,6 were in the right lung and other 8 were in the left.The maximum diameters of tumors were ranged from 2.5 cm to 20.0 cm,and 6 cases were over 10.0 cm.All 14 cases represented as irregular solid nodule or mass,4 as unclear boundary and 1 as lobulation.Most of the cases showed heterogeneous and progressive enhancement.The light microscopy showed that tumor tissues were mainly composed of collagen fibers and spindle cells with different proliferation degrees,and 3 cases showed atypia cells.There were abundant blood vessels in the intercellular substance.Immunohistochemistry were done in 13 cases,presenting Bcl-2,CD99 and Vimentin positive expressions in all cases and CD34 expression in 9.Conclusion The CT features of pulmonary SFT are related to pathological features.CT scan is important in the localization and qualitative diagnosis of pulmonary SFT,and obvious inhomogeneous map-like and progressive enhancement should be considered for the diagnosis of SFT.

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Contrast observation of MSCT findings of pulmonary lymphoma with pathological features

Yanjing WEI ; Dong DENG ; Xiaomei TAN

Journal of Practical Radiology.2018;34(12):1860-1862,1873. doi:10.3969/j.issn.1002-1671.2018.12.010

Objective To study the MSCT findings of pulmonary lymphoma,and improve its imaging diagnostic accuracy.Methods The MSCT findings of 14 patients with pathologically proven pulmonary lymphoma were reviewed retrospectively.Evaluated imaging findings included distribution position,number,shape,density and accompanying signs of the lesion.Results In 14 cases of pulmonary lymphoma,except for miliary shadow,there were 108 lesions,including small nodules,nodules,masses,consolidation,ground-glass density and meshlike shadow.Solitary lesions were founded in 2 and multiple lesions were founded in 12 of 14 cases,which the multiple lesions found in single lung in 3 cases,and multiple lesions found in both lungs in 9 cases.There were 24 lesions in 7 cases of pulmonary consolidation, including air bronchogram in 6 cases and bronchiectasis in 3 cases.There were 7 cases with masses,5 cases with nodules,5 cases with small nodules,2 cases with ground-glass density,2 cases with pulmonary interstitial changes,2 cases with CT angiogram sign,4 cases with pleural effusion and 3 cases with mediastinal or pulmonary hilar lymphadenopathy.Conclusion The mainly MSCT findings of pulmonary lymphoma was pulmonary consolidation with air bronchogram,or masses,or nodules,or multiple signs exist at the same time.The diagnosis is mainly based on histopathology.

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