Objective To investigate the value of 4D-CTA combined with SDF-1a/CXCR4 signaling pathway in evaluating the risk of intracranial aneurysm rupture.Methods Fifty patients with unruptured intracranial posterior communicating aneurysms and 50 patients with ruptured intracranial posterior communicating aneurysms were divided into unruptured group 1 and ruptured group 1.All patients underwent 4D-CTA examination and serumSDF-1alevel was detected.Non-ruptured group 1 was followed up for 12 months(After conservative treatment),on this basis,patients with ruptured posterior communicating aneurysms were included in ruptured group 2,and patients with unruptured posterior communicating aneurysms were included in non-ruptured group 2.Results The AUC values of Wn,AR,L,SR,SDF-1a and their combinations in diagnosing ruptured intracranial posterior communicating aneurysms were all greater than 0.70.The AUC values of Wn,AR,L,SR,SDF-1a and their combinations in predicting ruptured intracranial posterior communicating aneurysms in ruptured group 2 were all greater than 0.70.Conclusion 4D-CTA combined with SDF-1acan effectively distinguish ruptured intracranial posterior communicating aneurysms and predict the risk of rupture.

Objective ToinvestigatetheCTfindingsofovarianneuroendocrinecarcinomaandthecorrelationswithclinicaland pathologicfeatures.Methods CTfindingsof8patientswithovarianneuroendocrinecarcinomawereretrospectivelyanalyzed.Allcaseswere confirmedbypathologyinourhospital.Thecorrelationofpatients’imagingfindingswiththepathologicalandclinicalcharacteristics wasevaluated.Results Thetumorsinthesepatientsweremorecommonlyseeninunilateralovary(7/8).CTshowedmultiplecystic-solidmixed lesions,mostlyoval-shaped,withanaveragediameterof11.45cm.Thelesions’enhancementpatternswererelatedwithpatient’sageand clinicalstaging.Thepatientsontheirlateclinicalstage(7/8)usuallyhadseveresymptomswithadjacentorgansinvasion,abdominal pelvicperitoneum,omentum,mesentericthickeningandretroperitoneallymphnodeenlargement(7/8).Conclusion Theearlyclinicalfeaturesof ovarianneuroendocrinecarcinomaareconcealed,andmostpatients’clinicalstagesareusuallylate.TheCTfindingsofovarianneuroendocrine carcinomaarerelativelycharacteristic.Lesionsshowapoint-like,andlinearvascular-likeenhancement.Althoughthediagnosisofovarianneuroendocrine carcinomaisstilldependentonthepathology,CTimagesareusefulinpreoperativeevaluationandtreatmentplanning.

OBJECTIVE:To observe the clinical efficacy and safety of flupirtine maleate combined with amitriptyline in the treatment of thalamic pain after stroke. METHODS:A total of 70 patients with thalamic pain after stroke in our hospital during Jan. 2016-Aug. 2017 were divided into control group(34 cases)and observation group(36 cases)according to random number table. Both groups received secondary prevention therapy of stroke. Based on it,control group was given Amitriptyline hydrochloride tablet 25 mg/time orally,tid. Observation group was additionally given Flupirtine maleate capsule 0.1 g/time orally,tid,on the basis of control group. Treatment course of 2 groups lasted for 4 weeks. VAS,HAMD17 and HAMA14 scores of 2 groups evaluated before treatment,after 1,2,3,4 weeks of treatment Clinical efficacies and the occurrence of ADR were observed in 2 groups. RESULTS:Before treatment,there was no statistical significance in the scores of VAS,HAMD17 or HAMA14 between 2 groups(P>0.05). VAS score and HAMD17 score of observation group after 1,2,3,4 weeks of treatment,those of control group after 2,3 and 4 weeks of treatment were significantly lower than before treatment;the observation group was significantly lower than the control group at different time periods(P<0.05 or P<0.01). HAMA14 score of 2 groups after 2,3,4 weeks of treatment were significantly lower than before treatment;the observation group was significantly lower than the control group at different time periods(P<0.05 or P<0.01). Total efficiency rate(91.67%)of observation group were significantly higher than that(67.65%)of control group(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (11.76% vs. 11.11%)(P>0.05). CONCLUSIONS:Flupirtine maleate combined with amitriptyline can effectively relieve thalamic pain after stroke,and improve post-stroke,anxiety depression,which are better than control group,and the incidence of ADR is familar to control group.

Objective To investigate the imaging features of perivascular epithelioid cell tumor of liver (PEComa),and to improve the diagnostic level of the disease. Methods A retrospective analysis of imaging manifestations was performed on 11 cases of hepatic hemangioma confirmed by surgery and pathology. All patients underwent CT and MRI examination before PET/CT examination ,then received operation. Results Eleven cases were solitary hepatic lesions ,10 of which were located in the right lobe of the liver ,and 1 in the left. The lesions were round or quasi-circular and the diameter ranged from about 13.5cm to about 1.8 cm,with an average of 5.7 cm. CT plain scanning showed that the liver was slightly lower density ,with clear boundary. The smaller lesions were homogeneous density,while the larger ones were not,and the lower density area was visible. Enhancement of peripheral lesions in the arterial phase was enhanced. The lesions in the portal vein were not uniformly enhanced , and visible separation was found in large lesions. In the delay phase ,the lesions were significantly decreased or slightly lower. MRI plain scan showed the lesion T1WI showed moderate signal or slightly low signal ,and large lesion signal was not uniform,and T2WI lesions showed slightly high signal while DWI lesions high signal and the enhanced features were similar to those of CT. PET/CT examination showed that visible radioactive uptake of abnormal concentration or uneven concentration were found in lesions with diameter larger than 3.0 cm,and the maximum SUV value ranged from 12.2 to 3.6,with an average value of 5.7. Lesions with diameter less than 3.0 cm showed a slight concentration of radioactive uptake and the highest SUV value was 4.7,with an average value of 2.9. The only 11.8 cm lesion showed no significant radioactivity ,which was as the same as that of normal liver tissue. Delayed PET/CT imaging(1 hour)showed that SUV values of all lesions were decreased in varying degrees. Conclusion PET/CT imaging of perivascular epithelioid cell tumor of liver has its characteristics. The combina-tion of PET/CT imaging and routine imaging examination will benefit the improvement of diagnosis level obviously.

Objective To explore the value of manganese-enhanced MRI in locating the rat visual nuclei.Methods The visual nuclei of thirty-six rats were located by 3 different ways including individual MEMRI locating (group A,n= 1 6),anatomical atlas locating (group B,n=1 6)and direct puncture by using the data obtained in MEMRI (group C,n=4).After unilateral intra-vitreal injection of MnCL2 (30 mmol/L×3 μL)in group A,the brain MRI was performed 24 h later.The location coordinate of lateral geniculate nucleus (LGN) and superior colliculus (SC)were recorded individually.The nuclei injections (3% fluorogold solution,1 μL)were performed by using different location coordinate in groups A and B.The rat’s retinas were examined under fluorescence microscope 5 days later,and the results were compared between the two groups.After brain nucleus puncture injection (30 mmol/L MnCL2 solution,0.5 μL),MRI was performed 1 h later in group C.Results The success rate was 93.8% (1 5/1 6)in group A,and 65.5% (10/1 6)in group B.The difference between groups was statistically significant (P<0.05).All the injection locations of C group were agreed with atlas.Conclusion MEMRI in the visual nucleus stereotactic can improve the accuracy of location.

Objective To investigate the optimal concentration of manganese-enhanced MRI (MEMRI)in the visual pathway of experimental rats.Methods Sprague-Dawley rats were intravitreally injected with 3 μL of 10 - 100 mmol/L MnCl2 ,respectively. The contrast-to-noise ratio (CNR)of MEMRI for optic nerve(ON)and midbrain superior colliculus (SC)enhancement were measured at differ-ent concentrations of MnCl2 .Results The ON and SC were all clearly detected by MEMRI 24 h after unilateral intravitreal injected 10-100 mmol/L MnCl2 ,respectively.The CNR increased with the increasing concentration of MnCl2 from 10 to 50 mmol/L;But the CNR decreased from 50 to 100 mmol/L.The enhancement of superior colliculus were higher than optic nerve.Conclusion The optimal concentration of MnCl2 is 30 mmol/L(3 μL)through intravitreal injection for the rat visual pathway on 1.5T MEMRI.

Objective To discuss the CT manifestations of multi-parasite infection in liver to improve the diagnostic accuracy. Methods A total of 11 patients with ELISA-proved multi-parasite infection in liver were enrolled in this study.The plain and dynamic enhanced CT scans were performed.The imaging findings including the number,distribution,size,shape,density,enhancement and degree intratumaral features,cholangiectasis and abdominal lymphadenopathy were retrospectively analyzed.Results A single lesion of multi-parasite infection in liver was detected in 6 patients and multiple lesions were in other 5.The lesions in 8 patients were located in a single lobe of the liver,and involved in several hepatic lobes in other 3.The maximum diameter of the lesion ranged from 1.7 cm to 6.3 cm with an average diameter of 4.4 cm.Irregular lesions were found in 7 patients and round ones in shape were in other 4.Plain CT showed the lesions with low-intensity.All lesions were mild to moderate inhomogeneous enhancement on portal vein phase,presented honeycomb-like or separated enhancement with cholangiectasis (n=2)and abdominal lymphadenopathy (n=2).Conclusion The CT manifestations on portal vein phase in combination with clinical data are useful for the diagnosis of multi-parasite infection in liver.

Objective To investigate the diagnostic values of CT and MRI by analysing the CT and MRI features of presacral tumor.Methods The CT and MRI imaging features of 37 cases of primary presacral tumor with surgical pathology were analyzed retrospectively,and the imaging findings were compared with the pathologic findings.All data were analyzed by Fishersχ2 test.Re-sults 9 cases of presacral tumors were cystic type,18 cases were solid type and 10 cases were cystic-solid type.90.3% (28/31)of benign tumors had round or oval shapes,83.3% (5/6)of malignant tumors were irregular form(χ2=16.093,P=0.001).The den-sity of lesions whether uniform or not,and the presence of enhancement showed no obvious statistical differences between benign and malignant lesions.In all 37 cases,28 cases of benign and 1 case of malignant tumor were found compressed the surrounding tissues and organs;4 cases of benign and 5 cases of malignant tumor invaded adjacent tissues and organs(χ2=13.547,P=0.002).Conclu-sion CT and MRI can differentiate benign and malignant tumor,and can make clear diagnosis in some cases.

Objective To explore the value of Gadofluorine M,a novel M RI enhancement agent,in the diagnosis the early radiation brain injury.Methods Seventy-two Wistar rats were randomly divided into 5 equal groups.To establish the radiation injury model,the rat's posterior brain was irradiated with 0(blank controls),25,35,45,55,and 65 Gy,respectively.After irradiation MR plain scanning and Gadofluorine M enhancement scanning (after the T1WI and T2WI scanning Gf at the dosage of 0.1 mmol/kg was injected intravenously and scanning was performed again 12 h later) were performed once a week for 8 weeks.Another 12 rats were randomly divided into 2 equal groups to exposure to 55 and 65Gy,respectively,and MR scanning was performed once a week for 8 weeks since the third week after MR.After T1WI and T2WI scanning Gd-DTPA was injected intravenously,MR was conducted again 30 min later,and Gf was injected intravenously (Gd-DTPAenhancement and Gf enhancement contrast).The MR image and the pixel count were compared.Since the third week 2 rats from the Gf enhancement scanning group and 1 rat from the Gd-DTPA enhancement and Gf enhancement contrast were killed after MR with their brains taken out to undergo pathological examination.Results No abnormal signal changes were found in MRI in 25 and 35 Gy groups within 2 months after irradiation.A high signal in the Gf enhancement T1 WI image was found in 45,55,and 65 Gy groups within the period of 4-6 weeks after radiation.The signal intensity was significantly higher than that of the control,25,and 35 Gy groups(F =2.15,P <0.05).The emerge time of this signal was negatively correlated with the dose of radiation(r =-0.62,P < 0.05).When there was no obvious change was found by Gd-DTPA enhancement,a high signal representing change of injury could be found in Gf enhancement in the same rat.The signal intensity was significantly enhanced in Gf enhancement compared to the Gd-DTPA enhancement (F = 2.74,P <0.01).Histopathology examination of the 65 Gy group showed frosted degeneration in part of the region,however,no obvious necrotic damage was found in other groups.Conclusions The Gf enhancement change appears before histopathological changes,it helps discover early radiation injury in brain.Compared to the regular MRI and Gd-DTPA enhancement,Gadofluorine M enhancement has obvious advantage and is worth further research and application.

Objective To analyse CT appearances of fibroma and fibrosarcoma and to provide evidences for clinical diagnosis and treatment.Methods 8 cases with surgically-and pathologically-proved hard fibroma(nasal cavity,maxillary sinus and soft palate each and all 2 cases)and fibrosarcoma(nasal cavity and maxillary sinus each and all 1 case)were studied with retrospectively analysis.The scanning parameters were 5 mm thickness and interval for axial scanning.Results CT appearances of fibroma were single circular,semicircular or elliptical soft tissue masses which usually had homogeneous density,clear margin,thin and full envelope,wide base or a pedicel and slight or middle enhancement after contrast.The tumors grew distensibly,bones near the mass were constricted and thinned or absorbed but never destroried and the structures nearby were deviated but not involved.Fibrosarcoma showed such common CT manifestations as other malignant tumors in the same locations.Conclusion CT appearances of fibroma has some features,they are different from more common benign lesions.Fibrosarcoma can not be differeciated from other maglinant tumors,thier diagnosis must depend on pathology.