Objective:To evaluate any effect of transcranial direct current stimulation (tDCS) on cognitive impairment after an ischemic stroke (IS) using tract-based spatial statistics (TBSS).Methods:Fifty-one patients with mild or more serious cognitive impairment after an IS were divided into an electrical stimulation group (26 cases) and a control group (25 cases) using a random number table. In addition to conventional rehabilitation treatment, the electrical stimulation group was given tDCS, while the control group was given sham tDCS for 15 days. Before and after the treatment, both groups were evaluated using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Diffusion tensor imaging (DTI) was also performed. TBSS were computed for the differences in fractional anisotropy (FA) between the two groups before and after the treatment, and Pearson correlation analysis was applied to the pre-treatment and post-treatment FA differences within each group and the improvements in MMSE and MoCA scores.Results:After the treatment, the average MMSE and MoCA scores of both groups had improved significantly, but the improvement was significantly greater in the electrical stimulation group. After the treatment, the FA values among the electrical stimulation group had increased significantly in the bilateral genu of the corpus callosum, the bilateral inferior fronto-occipital fasciculus, the bilateral anterior thalamic radiation and the left superior longitudinal fasciculus. In the control group significant increases were recorded only in the left superior longitudinal fasciculus and the left anterior thalamic radiation. The FA change in the left superior longitudinal fasciculus of the electrical stimulation group was then positively correlated with the improvement in MMSE scores ( r=0.42), and that in the left anterior thalamic radiation was positively correlated with the improvement in MoCA scores ( r=0.45). Conclusions:tDCS can significantly improve the cognition of stroke survivors with cognitive impairment and promote the recovery of white matter fiber tracts. The FA values of the anterior thalamic radiation and the superior longitudinal fasciculus may be useful predictors and indicators of the recovery of cognitive function among such patients.

Objective:To evaluate any effect of transcranial direct current stimulation (tDCS) on cognitive impairment after an ischemic stroke (IS) using tract-based spatial statistics (TBSS).Methods:Fifty-one patients with mild or more serious cognitive impairment after an IS were divided into an electrical stimulation group (26 cases) and a control group (25 cases) using a random number table. In addition to conventional rehabilitation treatment, the electrical stimulation group was given tDCS, while the control group was given sham tDCS for 15 days. Before and after the treatment, both groups were evaluated using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Diffusion tensor imaging (DTI) was also performed. TBSS were computed for the differences in fractional anisotropy (FA) between the two groups before and after the treatment, and Pearson correlation analysis was applied to the pre-treatment and post-treatment FA differences within each group and the improvements in MMSE and MoCA scores.Results:After the treatment, the average MMSE and MoCA scores of both groups had improved significantly, but the improvement was significantly greater in the electrical stimulation group. After the treatment, the FA values among the electrical stimulation group had increased significantly in the bilateral genu of the corpus callosum, the bilateral inferior fronto-occipital fasciculus, the bilateral anterior thalamic radiation and the left superior longitudinal fasciculus. In the control group significant increases were recorded only in the left superior longitudinal fasciculus and the left anterior thalamic radiation. The FA change in the left superior longitudinal fasciculus of the electrical stimulation group was then positively correlated with the improvement in MMSE scores ( r=0.42), and that in the left anterior thalamic radiation was positively correlated with the improvement in MoCA scores ( r=0.45). Conclusions:tDCS can significantly improve the cognition of stroke survivors with cognitive impairment and promote the recovery of white matter fiber tracts. The FA values of the anterior thalamic radiation and the superior longitudinal fasciculus may be useful predictors and indicators of the recovery of cognitive function among such patients.

Objective To investigate the correlation between quantitative parameters derived from iodine overlay images and the monochromatic images of dual‐energy CT and the differentiation degree of laryngeal and hypopharyngeal squamous cell carcinoma(LHSCC). Methods Retrospective analysis of clinical and imaging data of eighty patients with different differentiation degree of LHSCC who underwent dual‐energy CT enhanced scan in the arterial and venous phase from March 2016 to January 2017 (20, 42 and 18 patients with well, moderately and poorly differentiation, respectively) was performed.Among them, twenty‐eight cases were stage T1, twenty‐four cases were stage T2, twenty cases were stage T3 and eight cases were stage T4. All patients were not treated with radiotherapy and chemotherapy before operation. Iodine overlay images and the monochromatic images of arterial and venous phases were acquired from Syngo MultiModality Workplace dual‐energy post‐processing software of Siemens, respectively. The mean iodine concentration (IC), standardized iodine concentration (SIC), and the slope of spectral curve(λ) of different differentiation degrees of LHSCC were calculated and compared. The correlation between quantitative parameters of LHSCC and its differentiation degree was performed by Spearman rank sum test. One‐way analysis of variance was used to compare the quantitative parameters of different differentiation degree of LHSCC. Receiver operating characteristic (ROC) curve was used for analyzing diagnostic efficiency. Results The IC, SIC, and λ in the arterial phase, and IC in the venous phase correlated positively with differentiation degree in LHSCC (r=0.258, 0.350, 0.262 and 0.275, respectively; P<0.05) in this group. The IC, SIC, and λ of poorly differentiated LHSCC in the arterial phase [(3.13 ± 0.54) mg/ml, (0.38±0.10), (5.40±0.92)] were higher than those of well differentiated LHSCC [(2.38±1.02) mg/ml, (0.25± 0.09) and (4.19 ± 1.18); t=2.73, 3.36 and 2.75 respectively; P<0.05] and moderately differentiated LHSCC [(2.56±0.85) mg/ml, (0.28±0.16) and (4.56±1.41); t=2.38, 3.06 and 2.21, P<0.05]. IC of poorly differentiated LHSCC in the venous phase [(2.59 ± 0.62) mg/ml] was significantly higher than that of well differentiated LHSCC [(1.96±0.56) mg/ml,t=2.45,P<0.05] and moderately differentiated [(2.02±0.93) mg/ml,t=2.56,P<0.05] LHSCC. There was no significant difference in the SIC and λ between different differentiation degrees of LHSCC (P>0.05) in the venous phase. The standardized iodine concentration in the arterial phase was the best in distinguishing poorly and moderately differentiated LHSCC, and poorly and well differentiated LHSCC with the area under the receiver operating curve 0.77 and 0.81, respectively, the sensitivity 88.2% and 70.0%, respectively, and the specificity 69.0% and 70.0%, respectively. Conclusions Quantitative parameters derived from dual‐energy CT might be useful in the evaluation of different differentiated degrees of LHSCC. In addition, the standardized iodine concentration of LHSCC in the arterial phase was the best in the estimation of different differentiated degrees of LHSCC.

Objective To stuy the clinical value of combined DWI and PWI in diagnosis of cerebral infarction (CI) at different stages.Methods One hundred and sixty-eight elderly CI patients were divided into hyperacute phase group (n =32),acute phase group (n =64),subacute phase group (n=45) and chronic phase group (n=27).Their DWI and PWI parameters and abnormal brain regions were compared.Results The ADC on DWI for injured lateral brain tissue was significantly lower than that on DWI for unjured lateral brain tissue in hyperacute phase group and acute phase group (0.39±0.08 vs 0.83±0.03;0.32±0.07 vs 0.91±0.05,P＜0.01).However,the ADC on DWI for the injured lateral brain tissue was significantly higher than that on DWI for the uninjured lateral brain tissue in subacute phase group and chronic phase group (1.54±0.34 vs 0.85±0.07,2.01±1.29 vs 0.90±0.05,P＜0.01).The PWI showed that the CBV was smaller and the CBF was slower while the MTT and TTP were longer in CI patients at different stages.DWI＜PWI,DWI＞PWI,and DWI=PWI in abnormal signal region were more frequently detected in hyperacute phase,acute phase subacute phase and chronic phase respectively.Conclusion PWI can show ischemic penumbra while DWI can highlight infarct foci in CI patients.Combined PWI and DWI can display the CBF in CI patients at different stages,and can thus provide reference for the clinical treatment of CI.

Objective To investigate the correlation between micro?bleeds and hemorrhagic transformation( HT ) after ischemic stroke. Methods One hundred and forty?five cases patients with acute ischemic stroke who were admitted to Luhe Hospital of Beijing Affiliated to Capital Medical University from 2009 to 2014 were retrospective analyzed. The MBs T2??weighted gradient?echo MRI was performed within 48 hours after admission to examine if there was a micro?bleeds,and the incidence of HT was assessed using follow?up brain MRI or CT in 2 weeks after admission. There were 125 patients with stroke were in without HT group and 20 patients were in HT group. Results There were no significant differences in terms of MBs ( P=0. 170 ) , gender( P=0. 671 ) , age ( P=0. 528 ) , hypertension ( P=0. 597 ) , diabetes ( P=0. 571 ) , hyperlipidaemia ( P=0. 772),smoking(P=0. 672),history of stroke(P=0. 469),coagulation function(P=0. 527),antiplatelet(P=0. 642),anticoagulation(P=0. 611) in HT group and without HT group. Atrial fibrillation((45%(9/20) vs. 22%( 28/125 ) , P = 0. 034 ) , NIHSS score ( 10. 9 ± 0. 5 ) points vs. ( 7. 8 ± 1. 2 ) points, P<0. 001 ) , thrombolysis(20% (4/20) vs.5% (6/125),P = 0.015) have significant differences in two groups.In multivariate logistic regression analysis,atrial fibrillation( OR=2. 421,95%CI 1. 823-3. 256,P=0. 012) ,NIHSS score( OR=9. 303, 95%CI 3. 094-27. 970, P<0. 001 ) were independent predictors for HT after ischemic stroke. Conclusion There is no relationship between MBs and HT after ischemic stroke. Atrial fibrillation,the severe of stroke are independent predictors for HT after ischemic stroke.

Objective To study and analyze the MRI manifestation of miliary tuberculosis of the brain.Methods Twenty-two cases with cerebral miliary tuberculosis of the brain were retrospectively studied with MRI including plain scan and enhanced study with GD-DTPA MRI features regarding the size,shape and distribution of the lesions were summarized and analyzed.Results Miliary tuberculosis of the brain was found most frequently at the junctional area of white and gray matter.The diameter of the lesion was less than 3 mm,therefore,plain scan often failed to display the lesions,however,markedly enhanced tubercles could be demonstrated on enhanced scan.Conclusion Enhanced MRI scan proved to be very helpful in the early detection of miliary tuberculosis of the brain.