Objective To investigate the application value of intravoxel incoherent motion (IVIM) MRI for evaluating the sensitivity of chemoradiotherapy on nasopharyngeal carcinoma (NPC). Methods Sixty eight consecutive patients newly diagnosed with NPC in the stage of T3 (30 patients) or T4 (38 patients) were retrospectively enrolled. They were divided into effective group (45 patients) and poor?effective group (23 patients) clinically after a standard chemoradiotherapy according to the RECIST criteria. IVIM with 13 b?values (range,0 to 800 s/mm2) and general MRI were performed at 3.0 T MR scanner before and after chemoradiotherapy. Two radiologists major in MRI diagnose analyzed all images independently and placed regions of interest (ROIs). Intraclass correlation coefficient (ICC) was used to evaluate intra?observer and inter?observer agreement. And Mann?Whitney test was used to assess the differences between the two groups. Results The reproducibility between intra?observer and inter?observer was relatively good. Statistically,D [(0.69±0.06)×10?3 mm2/s vs. (0.52±0.10)×10?3 mm2/s; U=51.5,P<0.01)] and D* [(161.33 ± 11.50)×10-3 mm2/s vs. (126.96 ± 10.27)×10-3 mm2/s; U=18.0, P<0.01] were significantly higher in effective group than those in poor?effective group, whereas the difference of f (16.68 ± 1.94% vs. 16.40±1.11%, U=434.5, P=0.282) and ADC (1.23±0.11)×10?3 mm2/s vs. (1.25±0.10)×10?3 mm2/s,U=427.0,P=0.240) could not reach statistical significance between the 2 groups (P>0.05). Conclusions IVIM may be potentially useful in assessing the chemoradiotherapy on NPC. The higher D value combined with higher D*value might indicate the chemoradiotherapy on NPC is more sensitive,and the higher D*value might reflect increased blood vessel generation and parenchymal perfusion in NPC.

OBJECTIVE: To develop a model based on the clinical variables for evaluating the risk of distant metastasis in patients with advanced nasopharyngeal carcinoma (NPC). METHODS: From September,2007 to June,2015,a total of 238 consecutive patients with biopsy-proven NPC in stage Ⅲ-Ⅳ(M0) based on the AJCC TNM staging manual were enrolled in this study,including 106 male and 34 female patients with a median age of 45 years (range 18-68 years).In this cohort,126 patients received concurrent chemoradiotherapy,and 24 received chemotherapy and radiotherapy,and 40 had induction chemotherapy.We used the least absolute shrinkage and selection operator (LASSO) method to select the most significant features for establishing the model for assessing the risks of distant metastasis. RESULTS: Among the 18 clinical variables tested,5 were significantly associated with distant metastasis in advanced NPC,including plasma Epstein-Barr virus (EBV) DNA,neutrophil/lymphocytes (NLR),VCA-IgA,concurrent chemoradiotherapy,and induction chemotherapy.Based on these 5 clinical variables,we established the following model:risk score=1.73×EBV DNA+0.54×NLR+0.38×VCA-IgA-0.95×concurrent chemoradiotherapy-2.37×induction chemotherapy+0.51.The cutoff point of this model was-0.62,which classified the patients into high-risk and low-risk groups for distant metastasis.This model showed a good performance in predicting distant metastasis in patients with advanced NPC (<0.01). CONCLUSIONS The model we established herein can be used for evaluating the risks of distant metastasis in patients with advanced NPC and provides assistance in the clinical decision-making on individualized treatment strategy.
Adult ; Aged ; Chemoradiotherapy ; Female ; Herpesvirus 4, Human ; genetics ; Humans ; Induction Chemotherapy ; Male ; Middle Aged ; Models, Statistical ; Multivariate Analysis ; Nasopharyngeal Carcinoma ; secondary ; therapy ; virology ; Nasopharyngeal Neoplasms ; pathology ; therapy ; virology ; Neoplasm Staging ; Prognosis ; Young Adult

Objective To establish a preprocedure nomogram for predicting contrast-induced acute kidney injury (CI-AKI) after coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods Clinical data of 245 patients underwent CAG or PCI were collected.CI-AKI prediction nomogram integrated preprocedural predictors was established with clinical characteristics associated with CI-AKI which were selected with the LASSO regression model,and CI-AKI risk scores were calculated.The ROC curve was constructed to calculate the risk score cutoff.Results The occurrency of CI-AKI was 13.88％ (34/245).Sex,diabetes mellitus,lactate dehydrogenase level,high-sensitivity C-reactive protein,drinking years,chronic kidney disease (CKD),stage of CKD,stroke,acute myocardial infarction as well as systolic blood pressure were significant risk factors.The efficiency of CI-AKI nomogram was good,and the cutoff value of risk score was-1.953.Conclusion The novel nomogram can be used to preprocedurally predict the risk of CI-AKI after CAG or PCI treatment.

Objective To study and analyze the CT and MRI findings of hepatic eosinophilic infiltration. Methods Twenty nine patients of hepatic eosinophilic infiltration who were confirmed by biopsy or clinical diagnosis were retrospectively analyzed. All the patients underwent CT and/or MRI scan. Twenty seven cases underwent upper abdominal CT plain scan and three phase enhanced scan, and 5 cases underwent upper abdominal MR plain scan and three phase enhanced scan, of which 3 cases underwent CT and MRI scan. Evaluations were made regarding to the numbers of lesion, distribution, size, shape, margin, density or signal characteristic, enhancement parttern and other special features. Pearson correlation analysis was used to analyze the correlation between the number of hepatic lesions and the number of eosinophils in peripheral blood. Results A total of 108 lesions of eosinophilic hepatic infiltration were observed in 29 cases, including 2 cases with single lesion and 27 cases with multiple lesions. Ninety five of the lesions were located in subcapsular parenchyma or surrounding the portal vein. Most subcapsular lesions were wedge-shaped(n=28). Lesions surrounding portal vein were round-shaped(n=32), while the hepatic parenchymal lesions were irregular or round-shaped(n=13). The mean size of lesion was 34 mm, ranging from 3 to 61 mm. The margin of all the lesions were obscure. The lesions showed slightly low density or isodensity on CT pre-contrast images. On MR pre-contrast images, lesions showed slightly low signal or isointense on T1WI, and hyperintense on T2WI. Branches of portal vein were found infilrated by all lesions. Tueleve cases showed“stripe sign”along the portal vein branches, 16 cases showed“halo ring sign”around the portal vein. Pearson analysis indicated a significant correlation between the number of eosinophilic hepatic infiltrated lesions and the increase of eosinophils in peripheral blood (r=0.783, P<0.05). Conclusion The imaging features of EHI had certain characteristics, especially in the three phase dynamic enhanced scanning, from which we can mainly find“progressive enhancement”,“portal vein sign”,“stripe sign”and“halo ring sign”.

Objective: To investigate the feasibility and significance of modified Killian(MK) method in the clinical diagnosis of congenital pyriform sinus fistula(CPSF) by electronic laryngoscopy. Methods: The following examinations were performed for 30 suspected cases of CPSF, including the traditional electronic laryngoscopy, MK examination(modified Killian position+ head rotation+ the Valsalva maneuver), barium swallow X-ray(BSX) and CT , and a prospective comparison among them were done. Patients were divided into two groups according to their age: young age group(≤14 years old) and older age group (>14 years old). The results of MK examination from the patients were analyzed and the positive diagnostic rates (PDR) between groups were compared by using χ² tests. Results: Sinuses in 20 of 30 patients were depicted from pyriform sinus in BSX, and the PDR was 66.7%(20/30). The PRD of CT was 83.3%(25/30). The presence of air bubbles around the upper lobe of the thyroid gland or at the inferomedial edge of cricothyroid joints, morphological changes of thyroid grand as well as pseudo-fistula formation on lower neck were detected clearly on CT. Comparing to the traditional electronic laryngoscopy, the effect of exposing piriform fossa fistula by MK examination is significant(χ²=17.05, P<0.05), with the PDR of 13.3%(4/30) and 76.7%(23/30) respectively. Nevertheless, comparing to BSX and CT, there were no statistically significant differences in the effect to diagnose CPSF (χ²=0.31, χ²=0.10 respectively, P>0.05). The PDR of MK in older group is significantly higher than younger group(χ²=6.68, P<0.05). Conclusions MK examination can clearly reveal the hypopharyngeal anatomical structure and detect the sinus of CPSF .It could be a safe, feasible, convenient and economical method as an application in preoperative diagnosis and follow-up examination of clinical suspected CPSF.

Endoscopy ; Humans ; Myosarcoma ; diagnosis ; surgery ; Nasal Cavity ; Nose Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; Skull Base ; Skull Base Neoplasms ; diagnosis ; surgery

OBJECTIVE: To assess the long-term clinical efficacy of endoscopic surgery of primary sinonasal malignant neoplasms and find out the potential postoperative prognostic factors. METHOD: Forty-three clinical cases of primary sinonasal malignant neoplasms treated under endoscopy were analyzed retrospectively. RESULT: Fifteen patients died. The 1-year, 2-year, 3-year and 5-year survival rates were 83. 7% (36/43), 74. 4% (32/43), 69. 8% (30/43) and 65. 1% (28/43), respectively. Kaplan-Meier single-variable analysis showed that gender, T grade, TNM stage and pathological types of olfactory neuroblastoma were statistically significant prognostic factors (P< 0. 05). COX Pro-Portional hazard models showed that TNM stage was an independent prognostic factors. CONCLUSION Endoscopic surgery for primary sinonasal malignant neoplasms is a safe and effective minimally invasive surgical treatment, and it is an important supplement to the traditional surgery. Gender, T grade, TNM stage and pathological types of olfactory neuroblastoma might be significant prognostic factors.
Endoscopy ; Esthesioneuroblastoma, Olfactory ; surgery ; Humans ; Nasal Cavity ; pathology ; surgery ; Nose Neoplasms ; surgery ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective To investigate the treatment of diabetes mellitus complicated acute necrotizing sinusitis .Methods By way of reviewing the clinical procedures of 2 patients with diabetes mellitus complicated acute necrotizing sinusitis .Results In perioper-ative period ,by means of glycemic control ,anti-infection ,and emergency surgery to remove the necrotic tissue in nasal sinuses and open the sinuses ,one of the patients discharged from hospital after 8 days .He has been followed up for more than 4 years without recurrence ,and is still in follow-up .Due to complicating renal failure and ascites ,the another patient gave up treatment and dis-charged on the third postoperative day ,and died on the same day .Conclusion Glycemic control ,homeostasis ,surgical removal of necrotic tissue and anti-infection treatment in perioperative period as soon as possible ,is the key to a successful treatment .

OBJECTIVETo investigate the changes in brain regional homogeneity in first-onset major depressive disorders (MDDs) using resting-state functional magnetic resonance imaging (fMRI).

METHODSEighteen patients with first-onset MDDs and twenty gender- and age-matched healthy controls underwent resting-state fMRI scans to compare the regional homogeneities of the brain regions.

RESULTSCompared with the normal controls, the patients with MDDs showed significantly decreased regional homogeneity in the left posterior cingulated gyrus, bilateral inferior temporal gyrus, bilateral superior temporal gyrus, left inferior frontal gyrus, left hippocampa gyrus, left posterior central gyrus, left angular gyrus, right amygdala, right orbital frontal gyrus, right supplementary motor area, and right cerebellar lobe.

CONCLUSIONPatients with first-onset MDDs have dysfunctions in the brain regions closed related with cognition and emotional control.

Amygdala ; Brain ; physiopathology ; Case-Control Studies ; Cerebellum ; Cognition ; Depressive Disorder, Major ; diagnosis ; Emotions ; Frontal Lobe ; Humans ; Magnetic Resonance Imaging ; Temporal Lobe

Objective To evaluate the clinical application value of susceptibility weighted imaging (SWI) in neonatal hy-poxic ischemic encephalopathy (HIE). Methods Thirty-six neonates with HIE were collected and scanned by GE 3.0 T supercon-ducting MR scanner. Routine axial T1WI, T2WI, FLAIR scan and axial SWI scan were conducted. SWI sequence was compared with conventional head MRI sequences in detection rate of distribution and quantity of intracranial hemorrhage. Meanwhile, the display condition of the dilated cerebral deep veins and cortical veins was observed on SWI image and the performance of HIE in different clinical classification on SWI was compared. Results A total of 97 intracranial hemorrhages were detected by SWI in 27 cases. Only 41, 27 and 51 hemorrhages were found by TIWI, T2WI and FLAIR sequences, respectively. SWI were significantly superior to T1WI, T2WI and FLAIR in displaying the size, scope and boundary definition of hemorrhage. A total of 50 dilated ce-rebral deep veins and cortical veins were detected by SWI in 22 cases which were not found by conventional head sequences. The detection rates of intracranial hemorrhage and intracranial hemorrhage in addition of dilated cerebral veins on SWI sequence were the lowest in mild HIE group, and highest in severe group. There was significant difference among the mild, medium and severe groups (P<0.05). Conclusions SWI sequence has higher sensitivity than conventional MRI sequence in detecting intracranial hemorrhage and dilated vein in HIE, and is useful for early diagnosis of HIE.