Objective To evaluate the changes of brain structure in preschool children with non-lesional epilepsy(NLE)by analyzing their 3D-T1WI brain structural images with surface-based morphometry(SBM).Methods Thirty-five preschool children with diagnosed NLE in the neurology department of some hospital from January 2021 to September 2022 were enrolled into a NLE group,and 35 healthy preschool children from the same period were included in a control group.The two groups were compared in terms of cortical thickness,sulcus depth,gyrus index,cerebrospinal fluid volume,gray matter volume and white matter volume.SPSS 25.0 software was used for statistical analysis.Results When compared with the control group,the NLE group had the thicknesses of temporal lobe cortex decreased at both left and right sides while the thickness of cingulate cortex increased on the right,and the differences were statistically significant(P＜0.05);the NLE group had the depths of sulcus in lingual gyrus and middle frontal gyrus of right cerebral hemisphere reduced,and the differences were statistically significant(P＜0.05);the NLE group had the gyrus index of left cerebral hemisphere talus cortex highered,and the differences were statistically significant(P＜0.05).There were no significant differences between the two groups in cerebrospinal fluid,gray matter and white matter(P＞0.05).Conclusion Cortical structural abnormalities in children with NLE may be a major factor in its pathogenesis.SBM can be used to evaluate localized brain structural abnormalities in NLE children by analyzing their 3D-T1WI brain structural images,and thus can be an effective tool for determining the potential pathogenesis of NLE in children.[Chinese Medical Equipment Journal,2024,45(2):62-66]

OBJECTIVETo study the distribution of cervical lymph nodes metastases in patients with differentiated thyroid carcinoma, explore the surgical modality of the neck of cN + cervical node metastasis and evaluate the role of preoperative ultrasonography in detecting of cervical metastases of differentiated thyroid carcinoma.

METHODSData were reviewed retrospectively from medical records between July 2003 and July 2005, in which 93 patients (113 sides) of differentiated thyroid carcinoma patients with cN + cervical lymph nodes metastasis. Patients were divided into 2 groups: group 1, 64 cervical sides with preoperative palpable cervical lymph nodes; group 2, 49 cervical sides with impalpable node but preoperative ultrasonic positive nodal metastasis. All the pathologic specimens were reviewed by pathologists counting the numbers of pathologic positive nodes and mapping localization of positive nodes in level II, III, IV, V and VI respectively.

RESULTSIn 93 patients 21.5% (20/93) of those metastasize bilaterally. In those 113 sides specimens 92 sides (81.4%) involved multi-sites in the neck. The distribution of metastasized nodes were; level II, 60.2% (68/113); level III, 70.8% (80/113); level IV,61.9% (70/113); level VI, 58.4% (66/113); level V, 22.5% (25/113). The numbers of positive nodes of group 1 were more than the number of group 2 (10.1 vs 6.9) and the involved levels of group 1 was also more than the levels of group 2 (3.18 level vs 2.61 level). Preoperative ultrasonography could detect 43.4% (49/113) of lymph nodes metastasis that were missed by palpation in the physical examination.

CONCLUSIONSThe distribution of the cervical nodes in patients with differentiated thyroid carcinoma were multi-levels in the neck and mainly localized in level II , level III, level IV and level VI. Preoperative ultrasonography is a mainstay in detecting of cervical lymph nodes metastasis in thyroid cancer. For patients with differentiated thyroid carcinoma of cN + cervical lymph nodes should be undergone modified neck dissection, includes level II, III, IV, V, VI.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Lymph Nodes ; diagnostic imaging ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Neck ; pathology ; Neck Dissection ; Neoplasm Staging ; Retrospective Studies ; Thyroid Neoplasms ; diagnostic imaging ; pathology ; Ultrasonography ; Young Adult