1.Abnormal changes of white matter structure in temporal lobe epilepsy patients with sleep disorders based on diffusion kurtosis imaging
Min GUO ; Yanjing LI ; Boxing SHEN ; Hong LUO ; Ruohan YUAN ; Jie HU ; Xing TANG
Journal of Practical Radiology 2024;40(1):1-5
Objective To investigate the microstructural changes of temporal lobe epilepsy(TLE)in patients with sleep disorders based on diffusion kurtosis imaging(DKI).Methods This research prospectively included 38 TLE patients(case group)and 20 healthy controls(HC)(HC group).Participants used sleep questionnaires to evaluate their sleep status.All TLE patients were divided into groups with and without sleep disorders according to the diagnostic criteria and scale scores of sleep disorders.The mean kurtosis(MK),mean diffusivity(MD),and fractional anisotropy(FA)of the relevant region of interest(ROI)were measured by DKI sequence.The differences of sleep quality scores and DKI parameters between groups were further compared via independent samples t-test and one-way analysis of variance.Results The Epworth sleepiness scale(ESS),Athens insomnia scale(AIS),and Pittsburgh sleep qual-ity index(PSQI)scores of TLE patients with sleep disorders were significantly higher than those of HC group(P<0.05).The FA and MK values in TLE patients were significantly lower than those in HC group,while the MD value of TLE patients were substan-tially higher than that of HC group(P<0.05).The values of MK and FA in left TLE patients with sleep disorders were significantly lower than those of without sleep disorders(P<0.05),while there was no significant difference in MD value between the two groups(P>0.05).MK value of right TLE patients with sleep disor-ders was significantly lower than that of without sleep disorders(P<0.05),however,there were no significant differences in MD and FA values between the two groups(P>0.05).Conclusion Quantitative DKI analysis revealed differences in DKI parameters in TLE patients combined with sleep disorders,inferring a specific white matter fiber damage in this group and providing imaging data to support the personalized treatment and prognostic assessment of these patients.
2.Diagnostic value of cervical spine non-shared incentive diffusion weighted imaging technique in cervical spondylotic myelopathy
Jia LI ; Li ZHANG ; Yujin ZHANG ; Di ZHANG ; Xiaonan TIAN
Journal of Practical Radiology 2024;40(1):6-10
Objective To investigate the clinical application value of the non-shared incentive diffusion weighted imaging(ZOOM-DWI)technique at cervical level in diagnosis of cervical spondylotic myelopathy(CSM).Methods A total of 49 CSM patients(patient group),and 50 healthy volunteers(control group)were recruited.All subjects underwent conventional MRI and ZOOM-DWI of the cervical spine and neurologic modified Japanese Orthopaedic Association(mJOA)scores in patients with CSM.The apparent diffusion coefficient(ADC)value in the spinal cord at the narrowest area(C5-C6)of the compression site of patients,the ADC value at the disc level in each upper and lower level,and the spinal ADC value at the cervical level C2-C3 were measured.The ADC values of control group C2-C3,C3-C4,C4-C5,C5-C6,C6-C7 were measured.Within-group comparisons of the spinal cord ADC values for each segment between patient and control groups were performed using analysis of variance and post hoc comparisons(SNK-q).The ADC values at the narrowest point of the patient group and control group were tested by independent sample t-test.The Pearson correlation analysis was performed between patients'C5-C6 ADC values and mJOA scores.Results The mean ADC values showed no significantly different levels in the control group.Among the ADC values at each measurement level in the patient group,except for C4-C5 and C6-C7 where the difference was not statistically significant,the remaining pair-wise comparisons all showed statisti-cally significant differences(F=24.368,P<0.001),with the highest ADC value at C5-C6.The C5-C6 ADC value in the patient group was significantly higher compared to the control group(t=9.414,P<0.001),with statistical significance.The ADC values at the patient stenosis showed a significant negative correlation with the mJOA score(r=-0.493,P<0.001).Conclusion Cervical ZOOM-DWI technique can be applied to diagnose CSM,and spinal ADC values can be used as reliable imaging data for diagnosing CSM.
3.Study of resting-state functional MRI on immediate effect regulated by acupuncture on acupoints in patients with migraine without aura
Ya'nan ZHANG ; Ni LIU ; Mengmeng REN ; Yueying HONG ; Jianrui ZHANG ; Lei ZHANG ; Xuanzhi LUO ; Huilin LIU ; Jianwei HUO ; Fang HAN
Journal of Practical Radiology 2024;40(1):11-14
Objective To explore the mechanism of immediate effect regulated by acupuncture on acupoints in patients with migraine without aura(MwoA)during the interictal period.Methods A total of 28 MwoA patients were enrolled and resting-state functional magnetic resonance imaging(rs-fMRI)were performed at baseline and after acupuncture for 30 minutes.Paired t test was used to compare the differences of regional homogeneity(ReHo)and voxel-mirrored homotopic connectivity(VMHC)between two groups.Additionally,the correlation between the changes of rs-fMRI indexes and clinical scores was analyzed.Results In MwoA patients after acupuncture for 30 minutes,the mean regional homogeneity(mReHo)was decreased in the right lingual gyrus and right cere-bellum and was increased in the right middle frontal gyrus,while the z transformation voxel-mirrored homotopic connectivity(zVMHC)was significantly decreased in the bilateral cuneus compared with baseline.There was no significant correlation between imaging data and clinical scales.Conclusion Patients with MwoA after acupuncture for 30 minutes show abnormal ReHo and VMHC in multiple brain regions,which suggest that the mechanism of immediate effect may act through regulating pain-related brain regions.
4.Morphological study on gray matter volume changes of short-term withdrawal therapy in patients with alcohol use disorder
Journal of Practical Radiology 2024;40(1):15-18,26
Objective To explore the changes in brain structure after short-term withdrawal therapy in patients with alcohol use disorder(AUD).Methods A total of 28 male patients with AUD were included,and brain MRI scans were performed at the time of enrollment and 2-3 weeks after standardized treatment.The total volume of brain tissue,gray matter,white matter and cerebrospi-nal fluid volume before and after treatment were measured by voxel-based morphometry(VBM)technology,and the gray matter volume of each brain region of the whole brain was measured and statistically analyzed according to the automated anatomical labeling(AAL)template.Results Compared with the baseline data,after 2-3 weeks of standardized treatment,the volume of gray matter in brain tissue increased significantly,and the volume of cerebrospinal fluid decreased significantly.Compared with before treatment,the brain regions with increased gray matter volume in the left hemisphere were distributed in the medial and paracingulate gyrus,central sulcus cover,anterior wedge lobe and insula,and the brain regions with increased gray matter volume in the right hemisphere were distributed in the anterior cingulate gyrus,paracingulate gyrus,central sulcus cover,amygdala,superior temporal gyrus,middle temporal gyrus,transverse temporal gyrus,anterior cuneiformus,posterior central gyrus,superior marginal gyrus,peritaloid cortex and insula.Conclusion Patients with AUD experience some increases in gray matter volume,especially in the prefrontal lobe,after short-term withdrawal therapy.
5.Imaging features of acute and subacute toxic encephalopathy induced by organic solvents
Journal of Practical Radiology 2024;40(1):19-21
Objective To analyze the imaging features of acute and subacute toxic encephalopathy induced by organic solvents.Methods A total of 8 cases with acute and subacute toxic encephalopathy induced by organic solvents were retrospectively enrolled,and all imaging data were further analyzed.Of 8 patients,all patients underwent the plain CT scan,there were 3 patients with plain and enhanced cranial MR scan,and 2 patients with plain cranial MR scan.Results White matter density on CT imaging was signifi-cantly and symmetrically decreased in all cases,but the involvement of gray matter nuclei was unclear.White matter involvement on MRI was diffuse and symmetrical on both hemispheres.There were differences in white matter among affected areas.The gray mat-ter nuclei in the cerebellar dentate nucleus,globus pallidus,and thalamus were most involved,but there was no evidence of involve-ment in the white matter of the lateral ventricle,corpus callosum,and temporal pole.All lesions were with high signal on the diffu-sion weighted imaging(DWI)and high and low signals on apparent diffusion coefficient(ADC)map and without enhancement.Con-clusion The lateral ventricle white matter,corpus callosum,and temporal pole white matter are not easily affected in cerebral white matter in patients with organic solvents toxic encephalopathy,contributing to differentiate from other toxic encephalopathies.
6.Application value of diffusion weighted imaging and T2*mapping of parotid gland function in patients with head and neck tumors at different radiotherapy periods
Xiaoqi PU ; Jirui GAN ; Quan YUAN
Journal of Practical Radiology 2024;40(1):22-26
Objective To explore the application value of MR diffusion weighted imaging(DWI)and T2*mapping of parotid gland function in patients with head and neck tumors at different radiotherapy periods.Methods A total of 82 patients with head and neck tumors treated were selected.The data of parotid gland volume,salivary volume and parotid gland function were collected.MR DWI and T2*mapping were used to measure the apparent diffusion coefficient(ADC)value and T2*value of parotid gland tissue,and the correlation between parotid gland function and imaging values were analyzed.Results There were all significant differences in parotid gland volume,salivary volume and secretion index among different radiotherapy periods,and parotid gland volume,salivary volume and secretion index during and after radiotherapy were significantly lower than those before radiotherapy.There were signifi-cant differences in T2*values among different radiotherapy periods,and T2*value during and after radiotherapy was significantly lower than that before radiotherapy.There were significant differences in ADC values among different radiotherapy periods,and the ADC value during and after radiotherapy was significantly higher than that before radiotherapy.ADC value was negatively correlated with parotid gland volume,salivary volume and secretion index(r=-0.436,-0.730,-0.718,respectively,P<0.001),while the T2*value was positively correlated with parotid gland volume,salivary volume and secretion index(r=0.430,0.720,0.707,respec-tively,P<0.001).Conclusion Parotid gland volume,secretion index and salivary volume show abnormal levels at different radio-therapy periods.MR DWI is negatively correlated with parotid gland function,while T2*mapping is positively correlated with parotid gland function.
7.Diagnostic value of energy spectrum CT quantitative parameters combined with serum TSHR-mRNA for papillary thyroid microcarcinoma
Weiguo ZHANG ; Jiaping LIU ; Xiangnan LI ; Jiyang ZHANG
Journal of Practical Radiology 2024;40(1):27-31
Objective To explore the diagnostic value of energy spectrum CT quantitative parameters combined with serum thy-roid stimulating hormone receptor-messenger ribonucleic acid(TSHR-mRNA)for papillary thyroid microcarcinoma(PTMC).Methods A total of 105 patients with thyroid micronodules confirmed by surgery and pathology were collected,61 of whom were PTMC(PTMC group),and 44 patients with micronodular goiter(MNG)(MNG group).Energy spectrum CT quantitative parameters and serum TSHR-mRNA expression were compared between the two groups.The diagnostic value of energy spectrum CT quantitative parame-ters alone and combined with serum TSHR-mRNA for PTMC was analyzed by receiver operating characteristic(ROC)curve.Results The iodine concentration and slope of energy spectrum CT quantitative parameters between PTMC group and MNG group were signifi-cantly different in plain scan,arterial and venous phases(P<0.05).The mean serum TSHR-mRNA expression in the PTMC group was higher than that in MNG group(P<0.05).The area under the curve(AUC)for diagnosing PTMC using quantitative parame-ters of energy spectrum CT combined with serum TSHR-mRNA was 0.913,and the accuracy,sensitivity,and negative predictive value of diagnosing PTMC were significantly higher than those of quantitative parameters of energy spectrum CT or serum TSHR-mRNA(P<0.05).Conclusion Both energy spectrum CT quantitative parameters and serum TSHR-mRNA can be used to diagnose PTMC alone,and the combination of both is more accurately.
8.Application of CT imaging texture analysis in predicting simplified pathological types of thymic epithelial tumors
Yongkang XIN ; Yang YANG ; Xiulong FENG ; Yuchuan HU ; Xuebin LEI
Journal of Practical Radiology 2024;40(1):32-36
Objective To investigate the value of CT imaging texture analysis in predicting simplified pathological types of thymic epithelial tumors(TETs).Methods The CT data from 114 patients with TETs confirmed by surgical or pathology were analyzed retrospectivel,and the types of TETs were divided into three groups,including low-risk thymoma(LRT)group,high-risk thymoma(HRT)group,and thymic carcinoma(TC)group.First,the texture parameters of CT images were extracted,and then the weighted Rad-score values were obtained,and the predictive performance of the texture features was evaluated by using the receiver operating characteristic(ROC)curve.Results There were 114 TETs patients,including 45 patients with LRT,44 patients with HRT,and 25 patients with TC.Based on CT imaging texture analysis,the area under the curve(AUC)in differentiating LRT and HRT or TC via CT plain scan,arterial phase,and venous phase were 0.776,0.885,and 0.761,respectively.In differentiating HRT from TC,the AUC of CT plain scan,arterial phase,and venous phase were 0.828,0.808,and 0.804,respectively.In differentiating thymoma from TC,the AUC of CT plain scan,arterial phase,and venous phase were 0.808,0.769,and 0.774,respectively.Conclusion CT imaging texture analysis can serve as an effective auxiliary tool for predicting the simplified pathological types of TETs,helping to develop personal-ized treatment plans for TETs patients.CT enhanced scanning of arterial phase texture parameters has the highest differential diag-nostic efficiency.
9.Multi slice spiral CT features of bronchiolar adenoma
Chao CHEN ; Xing LÜ ; Min XIE ; Yang YIN ; Zhiyuan YANG
Journal of Practical Radiology 2024;40(1):37-40
Objective To summarize the multi slice spiral computed tomography(MSCT)features of bronchiolar adenoma(BA).Methods The imaging data of 9 cases of BA confirmed by surgery and pathology were analyzed retrospectively,and relevant literature was also reviewed.Results Among the 9 cases of BA,there were 8 cases with peripheral BA(away from the pleura≤5 mm)inclu-ding 4 cases close to the pleura and 1 case in central area.BA were located in the superior lobe of the right lung in 3 cases,the middle lobe of the right lung in 2,the inferior lobe of the right lung in 2,and the inferior lobe of the left lung in 2.Five cases were solid nod-ules,2 were ground-glass nodules and other 2 were cystic cavity nodules.In 2 cases of the solid nodules,the boundary on the non-venous side was blurred.In the 1 case of the ground-glass nodule,linear and reticular shadows were observed in the lesion,accompanied by a blurred boundary.2 nodules had mild pleura indentation,and other 7 nodules were found blood vessels entering into or adhering to the lesion,3 of which were accompanied by vascular thickening.In 8 cases with 2-48 month followed up,1 cystic cavity nodule was accompa-nied by obstructive pneumonia and then inflammatory absorption,1 solid nodule enlarged accompanied by the appearance of vacuoles,and the rest 6 had no changes.One central type nodule was operated after the CT examination.Conclusion BA are mainly manifes-ted as peripheral nodules of the lung,mostly close to the pleura and away from the pleura≤5 mm.Most BA are solid nodules,and sometimes are ground-glass or cystic cavity nodules.Some nodules show blurred boundaries or inflammation on the non-venous side,and few nodules increase during follow-up,with or without small vacuoles.
10.The correlation between peri-coronary fat attenuation index and different grades of hypertension based on coronary CT angiography
Xia LI ; Dan HAN ; Xiaoying LIU ; Jie JIANG ; Zitong WANG ; Xiaojie XIE ; Hui DUAN
Journal of Practical Radiology 2024;40(1):41-45
Objective lo analyze the difference of peri-coronary tat attenuation index(pr Al)on different grades of hypertension(HT),and to explore the value of pFAI in evaluating the risk of HT patients.Methods Retrospective data on hospitalized patients who underwent coronary computed tomography angiography(CCTA)examination for chest pain were collected.A total of 415 clini-cally confirmed HT patients were selected as observation group(including 132 patients in grade 1 HT group,137 patients in grade 2 HT group,146 patients in grade 3 HT group),and 187 non-hypertension patients during the same period as control group.The differ-ence of fat attenuation index(FAI)in three main coronary arteries[left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)]was compared,and the correlation between pF AI and HT patients was analyzed.Results RCA-FAI(-78.86 HU±7.66 HU)and LAD-FAI(-80.62 HU±7.50 HU)were higher in HT group than those in control group(-84.46 HU± 8.00 HU,-83.43 HU±7.51 HU,P<0.05).pFAI value was higher in grade 3 HT group than that in grade 1 HT group and grade 2 HT group(P<0.05),while there were no differences between grade 1 HT group and grade 2 HT group(P>0.05).After adjusting the influence of traditional risk factors and coronaryartery disease,RCA-FAI had relatively closer relationship with HT grades(r=0.47,P<0.001).Conclusion LAD-FAI,RCA-FAI in the HT group are higher than those in control group and RCA-FAI has relatively closer relationship with HT grades,suggesting that RCA-FAI may be an imaging indicator to evaluate the pro-gression of HT and predict the risk of HT.

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