The lumbar intervertebral disc is a disc-shaped fibrocartilaginous structure located between the vertebral bodies and acts as an important anatomical structure in the spine for stability. The spinal stability system consists of three subsystems: passive subsystem, active subsystem, and neural control subsystem. Lumbar intervertebral disc degeneration (IVDD), the leading cause of low back pain, induces pathological changes in other tissues of the three subsystems and interacts to degrade spinal stability. IVDD is commonly accompanied by degeneration of facet joint and ligament, Modic change, decreased vertebral blood flow, increased paraspinal muscle fat infiltration, reduced axial tension injury of the nerve, et al. Magnetic resonance imaging (MRI) is the preferred imaging modality for assessing spinal stability. Conventional MRI could completely demonstrate the morphological changes of the three subsystems in IVDD patients, and functional MRI could quantitatively evaluate the degree of pathophysiological change. We summarized the morphological and functional changes of MRI in lumbar intervertebral disc, facet joint, ligament, vertebral body, paraspinal muscle, and nerve of patients with IVDD, and then analysed the changes in spinal stability caused by IVDD, aiming to provide more imaging information for improving diagnosis accuracy and developing appropriate management of patients with low back pain.

Objective:To compare the quality and diagnostic utility of the three sequences including fast spin echo (FSE), multi-acquisition variable resonance image combination selective (MAVRIC-SL), and isotropic MAVRIC-SL (iso MAVRIC-SL), in evaluating the intervertebral foramen and spinal canal in patients after lateral lumbar interbody fusion (LLIF).Methods:Totally 30 patients after LLIF were enrolled prospectively from May to June 2020 in the Second Hospital of Shanxi Medical University. The patients underwent MRI of the lumbar spine including sagittal MAVRIC-SL and iso MAVRIC-SL sequence three-dimensional volume imaging, and the axial spinal canal level images were reconstructed. FSE sequence sagittal T 1WI and axial T 2WI images were acquired simultaneously. The sagittal and axial images were subjectively graded for visualization of the intervertebral foramen and spinal canal. The artifact area and SNR were measured. The Friedman M test was used to compare the differences in image quality scores, artifact area and SNR among the three sequences. Results:Nonparametric test results showed significant differences in sagittal and axial image quality scores among the three sequences (both P<0.001). Sagittal image quality scores of MAVRIC-SL [4 (4, 4) points] and iso MAVRIC-SL [4 (4, 4) points] were higher than those of FSE T 1WI sequence [3 (3, 3) points, both P<0.001]. The quality scores of MAVRIC-SL and iso MAVRIC-SL showed no significant differences ( P=1.000). The axial image quality score of iso MAVRIC-SL[5 (5, 5) points] were higher than those of MAVRIC-SL [4 (4, 4) points] and FSE T 2WI [3 (3, 3) points, both P<0.05]. The iso MAVRIC-SL images enabled a significantly improved reduction in the artifact area and SNR compared to the MAVRIC-SL and FSE sequence (all P<0.05). Conclusion:The iso MAVRIC-SL acquisitions enhance visualization of the intervertebral foramen and spinal canal and decrease metal artifacts compared with MAVRIC-SL and FSE acquisitions.

Objective: To investigate the magnetic resonance imaging (MRI) findings and clinicopathological features of primary lesions in patients with occult breast cancer (OBC). Methods: The imaging reports from the Breast Imaging Reporting and Data System in 2013 were retrospectively analyzed to investigate the morphology and the time signal intensity curve (TIC) of breast lesions in patients with OBC. The clinical and pathological characteristics of these patients were also included. Results: A total of 34 patients were enrolled. Among these patients, 24 patients underwent modified radical mastectomy and 18 of them had primary breast carcinoma in pathological sections. MRI detected 17 cases of primary lesions, including six masse lesions with a diameter of 0.6-1.2 cm (average 0.9 cm), and 11 non-mass lesions with four linear distributions, three segmental distributions, three focal distributions, and one regions distribution. Five patients had TIC typeⅠprimary lesions, ten had TIC type Ⅱ primary lesions, and two had TIC type Ⅲ primary lesions. Among all 34 cases, 23 of them had complete results of immunohistochemistry: 11 estrogen receptor (ER) positive lesions (47.8%), tenprogesterone receptor (PR) positive lesions (43.5%), seven human epidermal growth factor receptor 2 (HER-2) positive lesions (30.4%), and 20high expression(>14%) of Ki-67 (87.0%). The proportion of type luminal A was 4.3%, type luminal B was 43.5%, triple negative breast cancer (TNBC) was 30.4%, and HER-2 over expression accounted for 21.7%. Conclusions The primary lesions of OBC usually manifested as small mass lesions, or focal, linear or segmental distribution of non-mass lesions. The positive rate of ER and PR was low, but the positive rate of HER-2 and the proliferation index of Ki-67 was high. Type luminal B is the most common molecular subtype.

Multiple myeloma (MM) is a hematological malignancy characterized by proliferation of monoclonal plasma cells in bone marrow,mostly resulting in bone marrow infiltration and bone destruction.X-ray plain film is a primary imaging modality for MM,and it is also used for Durie-Salmon staging and risk stratification of MM.Currently,advanced imaging techniques,such as CT,MRI,PET/CT and PET/MRI have been widely used in the diagnosis and treatment of MM,providing important references for staging accurately,prognostic evaluation and therapeutic monitoring in patients with MM.The imaging progresses in MM were reviewed in this article.

Objective To investigate the magnetic resonance imaging ( MRI ) findings and clinicopathological features of primary lesions in patients with occult breast cancer ( OBC) . Methods The imaging reports from the Breast Imaging Reporting and Data System in 2013 were retrospectively analyzed to investigate the morphology and the time signal intensity curve ( TIC) of breast lesions in patients with OBC. The clinical and pathological characteristics of these patients were also included. Results A total of 34 patients were enrolled. Among these patients, 24 patients underwent modified radical mastectomy and 18 of them had primary breast carcinoma in pathological sections. MRI detected 17 cases of primary lesions, including six masse lesions with a diameter of 0.6?1.2 cm ( average 0.9 cm) , and 11 non?mass lesions with four linear distributions, three segmental distributions, three focal distributions, and one regions distribution. Five patients had TIC typeⅠprimary lesions, ten had TIC typeⅡprimary lesions, and two had TIC typeⅢprimary lesions. Among all 34 cases, 23 of them had complete results of immunohistochemistry:11 estrogen receptor (ER) positive lesions (47.8％), tenprogesterone receptor (PR) positive lesions (43.5％), seven human epidermal growth factor receptor 2 (HER?2) positive lesions (30.4％), and 20high expression(>14％) of Ki?67 (87.0％). The proportion of type luminal A was 4.3％, type luminal B was 43.5％, triple negative breast cancer ( TNBC) was 30.4％, and HER?2 over expression accounted for 21.7％. Conclusions The primary lesions of OBC usually manifested as small mass lesions, or focal, linear or segmental distribution of non?mass lesions. The positive rate of ER and PR was low, but the positive rate of HER?2 and the proliferation index of Ki?67 was high. Type luminal B is the most common molecular subtype.

Objective To investigate the magnetic resonance imaging ( MRI ) findings and clinicopathological features of primary lesions in patients with occult breast cancer ( OBC) . Methods The imaging reports from the Breast Imaging Reporting and Data System in 2013 were retrospectively analyzed to investigate the morphology and the time signal intensity curve ( TIC) of breast lesions in patients with OBC. The clinical and pathological characteristics of these patients were also included. Results A total of 34 patients were enrolled. Among these patients, 24 patients underwent modified radical mastectomy and 18 of them had primary breast carcinoma in pathological sections. MRI detected 17 cases of primary lesions, including six masse lesions with a diameter of 0.6?1.2 cm ( average 0.9 cm) , and 11 non?mass lesions with four linear distributions, three segmental distributions, three focal distributions, and one regions distribution. Five patients had TIC typeⅠprimary lesions, ten had TIC typeⅡprimary lesions, and two had TIC typeⅢprimary lesions. Among all 34 cases, 23 of them had complete results of immunohistochemistry:11 estrogen receptor (ER) positive lesions (47.8％), tenprogesterone receptor (PR) positive lesions (43.5％), seven human epidermal growth factor receptor 2 (HER?2) positive lesions (30.4％), and 20high expression(>14％) of Ki?67 (87.0％). The proportion of type luminal A was 4.3％, type luminal B was 43.5％, triple negative breast cancer ( TNBC) was 30.4％, and HER?2 over expression accounted for 21.7％. Conclusions The primary lesions of OBC usually manifested as small mass lesions, or focal, linear or segmental distribution of non?mass lesions. The positive rate of ER and PR was low, but the positive rate of HER?2 and the proliferation index of Ki?67 was high. Type luminal B is the most common molecular subtype.

BACKGROUND:To establish a tumor-bearing animal model of the head and neck is of clinical significance for further studying pathogenesis and transfer mechanisms and for actively finding an effective diagnosis and therapeutic regimen. OBJECTIVE:To compare the growth, lymphatic metastasis and distant metastasis characteristics of head and neck tumors in animals. METHODS:VX2 tumor cel lines were resuscitated and passaged to establish tumor-bearing rabbit models. Under anesthesia, the tumor was stripped from the tumor-bearing site to make tumor cel suspension. Then, thecel suspension was injected into the thigh muscle of rabbits and then passaged 2 weeks later. Tumor samples were harvested from the thigh of passage rabbits to make VX2 tumor cel suspension that was injected into the ear, tongue and nasopharynx of rabbits to make a VX2 tumor model of the head and neck in the rabbit. RESULTS AND CONCLUSION: The three groups of rabbits had significant differences in spirit, diet, activity and so on. Rabbits with tumor xenograft of the ear were significantly better than those with tumor xenograft of the tongue and nasopharynx. At 2 weeks after injection of VX2 tumor cel suspension, the VX2 tumor models of the head and neck were made successfuly in rabbits, and the tumor formation rate was 100% (15/15) at the ear, 93% (14/15) at the tongue and nasopharynx. VX2 tumors at different sites experienced rapid growth period, central necrosis period, surface ulceration period, and the life cycle was about 4-6 weeks. Lymph node metastasis in head and neck and pulmonary metastasis were found in the al three groups. Hematoxylin-eosin staining showed that VX2 tumor tissues and metastatic lymph nodes were confirmed as moderately to poorly differentiated squamous cel carcinoma. These findings indicate that tumor-bearing rabbit models of the head and neck established by VX2 cel suspension are characterized by short modeling cycle, good stability, easy to repeat, high tumor formation rate and simple operation. VX2 tumors in the different sites of the head and neck of rabbits have different characteristics, so we can choose the different implanting sites according to the different research purposes.

BACKGROUND:The patients with porcelain-fused-to-metal crowns who do examination of magnetic resonance imaging (MRI) can cause artifacts. In recent years, researching for MRI artifacts of different porcelain-fused-to-metal materials has been some progress, but there are less quantitatively reports on the MRI artifacts of different porcelain-fused-to-metal materials.
OBJECTIVE:To evaluate the artifact sizes shown on fast spin-echo T 2-weighted sequence caused by different kinds of porcelain-fused-to-metal crowns.
METHODS:Forty-eight lower right first molar crown patients who had MRI examination in MRI room were enrol ed. The patients were divided into nickel-chromium al oy group, cobalt-chromium al oy group and titanium crown group. Al patients were examined with fast spin-echo T 2-weighted sequences by means of 1.5 T MRI apparatus. MRI artifacts areas of same sequence on the MRI images of different porcelain-fused-to-metal materials were analyzed with variance test.
RESULTS AND CONCLUSION:Forty-five cases appearing to have high signal samples with clearly curved boundary zone that can be measured were selected, 15 cases for each material. Different artifact sizes were produced on the same sequence of different porcelain-fused-to-metal materials, which were (321.67±33.29) mm in the nickel-chromium al oy group, (263.53±34.95) mm2 in the cobalt-chromium al oy group, and (143.67±31.13) mm2 in the titanium crown group. There were significant differences between groups (P<0.05). The artifact size is smal est for the titanium crown and largest for the nickel-chromium al oy crown.

Objective To analyze effects of thoracoscopy in the diagnosis and treatment of suspected diaphragmatic injury after thoracoabdominal stab wound.Methods Sixty-eight patients who received thoracoscopic diagnosis and management of diaphragmatic injuries due to thoracoabdominal stab wounds from April 2000 to October 2011 were retrospectively analyzed.Results Occult diaphragmatic injuries were found in 11 patients.Seven patients underwent thoracoscopic suture,of which five had synchronous laparotomy for inspected abdominal organ injuries.Pulmonary parenchymal lacerations occurred in 15 patients who received thoracoscopic repair or resection.Coagulated hemothorax in 13 patients were removed.Postoperative complications included pleural effusion in one patient,pneumonia in two and pulmonary atelectasis in one.Hospital stay was(7.9±13.5)days,without ICU stay.The length of drainage,operation time and intraoperative blood loss were(3.3±1.5)days,(45.6±78.1)minutes and(57.8±24.3)ml respectively.There was no conversion to thoracotomy.Thoracic CT scan was performed six months postoperatively,without hernias.The accuracy of thoracoscopy in diagnosing diaphragmatic injury was 100％.Conclusion Thoracoscopy should be performed for the thoracoabdominal stab wounds with stable hemodynamics,with definite significance especially for the diagnosis and treatment of wounds at the 7-9th intercostal spaces.

Objective Using single direction dispersion breathless DWI, to analyze the value of DWI for vertebral bone marrow infiltration in patients with acute leukemia (AL). MethodsForty-two patients with AL and 15 healthy volunteers received vertebral sagittal DWI with single shot spin-echo echoplan imaging (SS-SE-EPI) sequence( b value ＝ 0,650 s/mm2) at a GE Signa Excite 1. 5 T scanner with 8 channels body coil. DWI for all patients were performed from three directions, including from superior to inferior (S/I), from anterior to posterior (A/P) and from right to left (R/L). The apparent diffusion coefficient (ADC) value was measured on ADC map from each direction using GE-Function tool DWI software. Forty two patients consisted of 13 onset with untreated patients and 29 treated patients (7 nonremission,8 complete remission and 14 consolidation therapy). The ADC values among the three diffusion directions were compared. Analysis of variance and t test were used to compare the ADC values in different AL stages, Pearson correlation analysis was used to analyze the correlation between ADC values and the percentage of bone marrow progenitor cells. Results The ADC values from S/I, A/P and R/L of 362 vertebras in the 57 subjects are (0. 758 ±0. 009) × 10-3 mm2/s, (0. 732 ±0. 009) × 10 -3 mm2/s and (0. 758 ±0. 009) × 10 -3 mm2/s, respectively. There is no statistical significance( F ＝ 2. 958, P ＞ 0. 05 ).The ADC values from S/I of 94 vertebras in 15 healthy volunteers is (0. 697 ± 0. 122) × 10 -3 mm2/s, of 85 vertebras in 13 untreated AL patients is (0. 592 ±0. 071 ) × 10-3mm2/s. There is statistical significance between them ( t ＝ 2. 568, P ＜ 0. 05 ) ; The ADC value of 183 vertebras in 29 treated AL patients [ ( 0. 796 ±0. 225 ) × 10-3mm2/s]is higher than that in untreated patients with statistical significance (t ＝ -1. 332,P ＜0. 05). One hundred and forty vertebras in patients with complete remission and consolidation therapy were [ (0. 786 ±0. 184) × 10-3 mm2/s],and 43 vertebras in patients with non-remission(NR) [ (0. 804 ±0. 327 ) × 10 - 3 mm2/s], there was not statistical significance between them ( t ＝ - 0. 160, P ＞ 0. 05 ). The ADC values from S/I direction of untreated patients showed significant negative correlation with the proportion of the blast cell in the bone marrow ( median value 26. 4％. Min 7.9％, Max 48. 2％ ) ( r ＝- 0. 524, P ＜ 0. 05 ). ConclusionsDWI of vertebral bone marrow is isotropy. ADC value is a non-invasive and quantitative index for evaluating the pathogenetic condition of AL.