Objective:To investigate the changes in brain functional network and structural-functional network coupling in children with drug-resistant epilepsy (DRE), and to analyze their correlation with cognitive function, disease duration, and age of onset.Methods:This study was a cross-sectional study. Clinical and imaging data of 19 children with DRE who received consultation and treatment at the Affiliated Hospital of Zunyi Medical University from August 2021 to August 2023 (DRE group) were prospectively included. Another 27 age-and sex-matched healthy children were collected as the healthy control group. All subjects had 3D-T 1WI, T 2 fluid-attenuated inversion recovery, diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI) scans and Wechsler Intelligence Scale assessments. Independent sample t-test and Mann-Whitney U test were used to analyze the global and local topological attributes, as well as the structural-functional coupling (SFC) values at the whole brain and modular levels in two groups. Correlations between abnormal resting state brain functional network indicators and the Wechsler Intelligence Scale score [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ)], disease duration and age of onset was evaluated using a Spearman or Pearson correlation analysis. Results:Compared to the healthy control group, DRE group exhibited decreased VCI, PRI, WMI, PSI, FSIQ and the differences were all statistically significant (all P<0.05). Both brain functional networks had small world attributes. There was a statistically significant difference in the area under the curve of sparsity of degree centrality (DC) in the left pallidum between the DRE group and healthy control group (2.998±0.942, 4.992±1.945, t=-4.07, FDR corrected P<0.05). Compared with the control group, the DRE group had decreased SFC within the limbic network (LN) ( P<0.05), increased SFC within the sensorimotor (SMN) ( P<0.05), decreased SFC between the default mode network-LN ( P<0.05), and increased SFC between the SMN-attentional network (AN) ( P<0.05). There was no statistically significant difference in SFC at the whole brain level between the two groups. Correlation analysis indicated that DC in left pallidum in DRE group negatively correlated with the PSI ( r=-0.537, P=0.018), and SFC between the SMN and AN demonstrated a negative correlation with age of onset ( r=-0.537, P=0.018). Conclusion:The altered DC in left pallidum may be related to cognitive impairment in children with DRE, providing biomarker information for the study of neural mechanisms in children with DRE.

Purpose To analyze CT and MRI manifestations of rare primary malignant liver tumors in adults to improve the diagnostic accuracy.Materials and Methods This retrospective study analyzed imaging,clinical and pathological data from 28 patients with pathologically confirmed rare primary malignant liver tumors at the Affiliated Hospital of Zunyi Medical University(April 2011 to July 2024).Clinical presentations,laboratory findings,and CT/MRI characteristics of different tumor types were evaluated.Results The cohort included eight cases of hepatic sarcomatoid carcinoma,eight of primary hepatic lymphoma,six of primary hepatic gastrointestinal stromal tumor,three of intrahepatic biliary cystadenocarcinoma,and three of hepatic adenosquamous carcinoma.Distinct imaging features were observed:all eight sarcomatoid carcinomas presented as solitary,large cystic-solid masses;three showed progressive or persistent enhancement of solid components/septae,with four demonstrating portal vein tumor thrombus.Seven cases of primary hepatic lymphomas appeared as homogeneous,round/oval lesions,with one case restricted diffusion on diffusion weighted imaging,and seven cases exhibited mild homogeneous enhancement;two exhibited the vessel penetration sign;all six primary hepatic gastrointestinal stromal tumors manifested as cystic-solid masses with extensive central necrosis;two showed peripheral pseudocapsules while four had tortuous feeding vessels,with mild-to-moderate persistent enhancement of solid components;all three intrahepatic biliary cystadenocarcinomas occurred in the left lobe,presenting as multilocular cystic lesions with papillary mural nodules showing variable enhancement of walls,septations and nodules;two adenosquamous carcinomas demonstrated irregular morphology with distal biliary dilation and predominant delayed enhancement.Conclusion Imaging diagnosis of rare primary malignant liver tumors remains challenging.While some lesions demonstrate characteristic features,pathological confirmation remains essential for definitive diagnosis.

Resting-state functional MRI(rs-fMRI)is an important tool for non-invasive research of brain function having been widely used in gray matter network function but not in changes of white matter brain function in neurological and psychiatric disorders.Recent studies on white matter function in neuropsychiatric disorders had provided new insights into the mechanisms underlying brain network organization and pathogenesis of brain disorders.The progresses of rs-fMRI research on brain white matter networks in neuropsychiatric diseases were reviewed in this article.

Purpose To analyze CT and MRI manifestations of rare primary malignant liver tumors in adults to improve the diagnostic accuracy.Materials and Methods This retrospective study analyzed imaging,clinical and pathological data from 28 patients with pathologically confirmed rare primary malignant liver tumors at the Affiliated Hospital of Zunyi Medical University(April 2011 to July 2024).Clinical presentations,laboratory findings,and CT/MRI characteristics of different tumor types were evaluated.Results The cohort included eight cases of hepatic sarcomatoid carcinoma,eight of primary hepatic lymphoma,six of primary hepatic gastrointestinal stromal tumor,three of intrahepatic biliary cystadenocarcinoma,and three of hepatic adenosquamous carcinoma.Distinct imaging features were observed:all eight sarcomatoid carcinomas presented as solitary,large cystic-solid masses;three showed progressive or persistent enhancement of solid components/septae,with four demonstrating portal vein tumor thrombus.Seven cases of primary hepatic lymphomas appeared as homogeneous,round/oval lesions,with one case restricted diffusion on diffusion weighted imaging,and seven cases exhibited mild homogeneous enhancement;two exhibited the vessel penetration sign;all six primary hepatic gastrointestinal stromal tumors manifested as cystic-solid masses with extensive central necrosis;two showed peripheral pseudocapsules while four had tortuous feeding vessels,with mild-to-moderate persistent enhancement of solid components;all three intrahepatic biliary cystadenocarcinomas occurred in the left lobe,presenting as multilocular cystic lesions with papillary mural nodules showing variable enhancement of walls,septations and nodules;two adenosquamous carcinomas demonstrated irregular morphology with distal biliary dilation and predominant delayed enhancement.Conclusion Imaging diagnosis of rare primary malignant liver tumors remains challenging.While some lesions demonstrate characteristic features,pathological confirmation remains essential for definitive diagnosis.

Resting-state functional MRI(rs-fMRI)is an important tool for non-invasive research of brain function having been widely used in gray matter network function but not in changes of white matter brain function in neurological and psychiatric disorders.Recent studies on white matter function in neuropsychiatric disorders had provided new insights into the mechanisms underlying brain network organization and pathogenesis of brain disorders.The progresses of rs-fMRI research on brain white matter networks in neuropsychiatric diseases were reviewed in this article.

Objective:To investigate the changes in brain functional network and structural-functional network coupling in children with drug-resistant epilepsy (DRE), and to analyze their correlation with cognitive function, disease duration, and age of onset.Methods:This study was a cross-sectional study. Clinical and imaging data of 19 children with DRE who received consultation and treatment at the Affiliated Hospital of Zunyi Medical University from August 2021 to August 2023 (DRE group) were prospectively included. Another 27 age-and sex-matched healthy children were collected as the healthy control group. All subjects had 3D-T 1WI, T 2 fluid-attenuated inversion recovery, diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI) scans and Wechsler Intelligence Scale assessments. Independent sample t-test and Mann-Whitney U test were used to analyze the global and local topological attributes, as well as the structural-functional coupling (SFC) values at the whole brain and modular levels in two groups. Correlations between abnormal resting state brain functional network indicators and the Wechsler Intelligence Scale score [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ)], disease duration and age of onset was evaluated using a Spearman or Pearson correlation analysis. Results:Compared to the healthy control group, DRE group exhibited decreased VCI, PRI, WMI, PSI, FSIQ and the differences were all statistically significant (all P<0.05). Both brain functional networks had small world attributes. There was a statistically significant difference in the area under the curve of sparsity of degree centrality (DC) in the left pallidum between the DRE group and healthy control group (2.998±0.942, 4.992±1.945, t=-4.07, FDR corrected P<0.05). Compared with the control group, the DRE group had decreased SFC within the limbic network (LN) ( P<0.05), increased SFC within the sensorimotor (SMN) ( P<0.05), decreased SFC between the default mode network-LN ( P<0.05), and increased SFC between the SMN-attentional network (AN) ( P<0.05). There was no statistically significant difference in SFC at the whole brain level between the two groups. Correlation analysis indicated that DC in left pallidum in DRE group negatively correlated with the PSI ( r=-0.537, P=0.018), and SFC between the SMN and AN demonstrated a negative correlation with age of onset ( r=-0.537, P=0.018). Conclusion:The altered DC in left pallidum may be related to cognitive impairment in children with DRE, providing biomarker information for the study of neural mechanisms in children with DRE.

Objective To investigate the changes in brain dynamic functional connectivity(dFC)in children and adolescents with idiopathic generalized epilepsy(IGE)who have negative findings for conventional magnetic resonance imaging(MRI)and to explore the correlation between dFC indicators and clinical variables.Methods A total of 40 children and adolescents with IGE who have negative findings for routine brain MRI and 37 healthy controls were enrolled.T2-fluid attenuated inversion recovery(T2-FLAIR)was performed for all subjects.They also uinderwent 3-dimensional T,weighted imaging(3D-T1WI)and resting-state functional MRI(rs-fMRI).Using independent component analysis(ICA),sliding time windows,and k-means clustering,we identified 6 functional connectivity states and derived dFC indicators,including fraction of time,mean dwell time,and the number of transitions.Then,SPSS18.0 and GIFT software Stats module were used to analyze the intergroup differences in dFC and its correlation with clinical variables.The reliability and stability of the dFC results were validated by changing the size of the sliding window.Results There were no significant differences in the general clinical data between the IGE group and the control group(P＞0.05).Compared with the control group,the IGE group showed in state 5 increased dFC within the default mode network(DMN),increased dFC between DMN and the frontoparietal network(FPN),and decreased dFC between DMN and the visual network(VN)(P＜0.001).In state 6,the IGE group showed increased dFC between DMN and VN,increased dFC between the basal ganglia network(BGN)and the sensorimotor network(SMN),decreased dFC between the DMN and the attention network(ATTN),and decreased dFC within the VN(P＜0.001).There were statistically significant differences between the two groups in the fraction of time(Z=-2.192,P=0.028)and the mean dwell time(Z=-2.144,P=0.032)in state 1,in the fraction of time(Z=-2.444,P=0.015)and the mean dwell time(Z=-2.368,P=0.018)in state 4,and in the fraction of time(Z=-2.047,P=0.041)in state 6.There was a negative correlation between the duration of the disease and the fraction of time of state 1 in the IGE group(r=-0.421,P=0.007,Bonferroni correction).In the validation analysis,significant differences in dFC indicators between the IGE group and the control group persisted when the size of the sliding window and the number of clusters were changed.Conclusion Children and adolescents with IGE and negative findings for conventional MRI exhibit abnormal dynamic properties of whole-brain functional connectivity,and the fraction of time of state 1 in IGE patients is correlated with clinical variables,providing new imaging evidence for research in the neural mechanisms of children and adolescents with IGE.

Objective To study the CT and MRI findings and corresponding pathological basis of non-epithelial ovarian cancer (NEOC).Methods The CT,MRI and clinical data of 74 patients with NEOC proved by surgical pathology were reviewed retrospectively.CT plain scan was performed in 57 cases,and CT enhancement scan was performed in 52 cases;MRI plain scan was performed in 17 cases,and MRI enhancement scan was performed in 11 cases;CT and MRI scans were performed together in 3 cases.Results Among the 74 patients,there were 23 mature teratomas (25 lesions),2 immature teratomas,8 strumas,10 yolk sac tumors,6 dysgerminomas,7 granulosa cell tumors,11 thecomas,5 fibromas and 2 sertoli-leydig cell tumors.97.3% (72/74)of the lesions were unilateral.There were 88.0% (22/25)and 92.0% (23/25)detection rate of calcification and fat in teratomas,respectively.On contrast enhancement,the immature teratoma showed significant enhancement,whereas the mature teratoma showed mild enhancement.On plain CT,strumas presented as multilocular cystic-solid masses,with calcification in 5 cases.After contrast agent administration,the solid portions showed marked enhancement.Tortuous vessels were seen in 7 yolk sac tumors.The linear hypointensity in dysgerminoma on T2WI showed marked enhancement.The granulosa cell tumors were cystic-solid masses,and 4 cases with increased estradiol.Solid mass with mild enhancement were present in thecomas and fibromas,and there were 8 cases with ascites.CT findings of 2 sertoli-leydig cell tumors were cystic-solid masses with significant enhancement of the cystic wall on contrast CT.Conclusion NEOC have some certain CT and MRI characteristics.Teratomas often contain calcification and fat.Strumas:multilocular cystic-solid masses.Yolk sac tumor:tortuous vessels.Dysgerminoma:marked linear enhancement.

Objective To study the MRI findings of superficial siderosis of the central nervous system(SSCNS)and to improve the understanding of SSCNS imaging features.Methods MRI images of 21 cases were retrospectively reviewed.MRI plain scan (T1WI,T2WI)and diffusion weighted imaging(DWI)were performed in all patients;T2* weighted angiography(SWAN)scan was performed in 8 patients.Results On T1WI of 21 cases,only 4 cases showed infratentorial superficial siderosis which appeared as linear hypointense signal in sulci cerebelli and around brainstem.On T2WI of 21 cases,18 cases presented with linear hypointense signal on cerebral surface.On DWI of 21 cases,20 cases showed linear hypointense signal on cerebral surface,and the other one case showing negative signal on DWI presented hypointense signal on SWAN.On SWAN of 8 cases,more lesions were found in more regions.Conclusion SSCNS has characteristic findings on MRI.SWAN is sensitive to superficial siderosis.MRI is a reliable method for the assessment of SSCNS.

Objective To study the CT findings of ovarian sertoli-leydig cell tumor (SLCT),to improve the understanding of SLCT imaging features.Methods CT images of 6 cases were reviewed retrospectively.CT plain scan was performed in 6 patients;CT enhancement scan was performed in 4 patients.Results All tumors were unilateral.On non-enhanced CT,5 cases showed cystic-solid masses with clear margin,and 1 case showed solid mass.After contrast administration,the cystic walls,septum and solid portions showed progressively obvious enhancement.Of these 6 cases, 3 cases showed increased testosterone levels,2 cases had high prolactin level,and 1 case was with raised AFP in plasma.Positive expressions of immunohistochemical markers were as following:Inhibin-α (6 cases),Vimentin (4 cases),Calretinin (2 cases), CD99 (1 case), Ki-67 (1 case), CK20 (1 case).Conclusion CT findings of SLCT have some certain characteristics, especially a unilateral, cystic-solid and well-defined mass, and marked solid part enhancement on contrast CT.Combined with clinical findings, especially increased plasma testosterone levels, SLCT should be included in the differential diagnosis of regional tumors.