Post-stroke cognitive impairment (PSCI) seriously affects neurological recovery and quality of life of patients. Its mechanism, clinical evaluation, intervention have become research hotspot at home and abroad. Many studies have confirmed that secondary neurodegeneration in remote cognitive-related brain not affected by ischemia after stroke is one of the mechanisms of PSCI. It has been found in rodents that β-amyloid deposition and neuron loss in distant cognitive-related brain regions are involved in the occurrence of cognitive dysfunction and reducing these secondary damages can improve cognitive function. Experiments involving non-human primates have found neuronal loss but no β-amyloid deposition in distant brain regions after stroke. Clinical studies have found associations between secondary neurodegeneration in remote regions and cognitive function by using neuroimaging techniques, but the relationship between PSCI and β-amyloid deposition is not clear now. Due to its late occurrence time and wider therapeutic time window, its intervention treatment is expected to alleviate cognitive impairment, which has great clinical significance.

Objective To study the changes of the putamen metabolites with magnetic resonance spectrum(MRS),and to explore possible underlying unrecongnised aetiological factor and pathophysiology mechanism in the central nervous system of the patients with Tourette' s syndrome.Methods Twenty-two cases of Tourette' s syndrome,and twenty-two gender and age-matched subjects ( the control subjects ) were performed on a clinical 3.0 T MRI system.Proton prob-voxel spectroscopy imaging (1H-MRS) was obtained from two sides of the putamen.The metabolites included N-acetylaspartate (NAA),creatine and phosphocreatine ( Cr),choline-containing compounds (Cho),and myoinositol ( MI ).The value of the NAA,Cr,Cho,and MI were calculated by integration of their peaks.The ratios of NAA/Cr,Cho/Cr,ML/Cr were calculated respectively.Repeated measures analysis of variance ( ANOVA ) was used to test both the value of NAA/Cr,Cho/Cr,MI/Cr of the putamen for group difference,with group as between-subjects factor and side as within-subjects factor.Results The NAA/Cr ratio in patients ( left:1.29 ± 0.13 ; right:1.34 + 0.15 ) was significantly lower than that in the control subjects ( left:1.50 ± 0.08,T =1.962,P ＜0.05 ; right:1.52 ± 0.11,T =1.865,P ＜ 0.05 ).There was no significant difference in the Cho/Cr and MI/Cr ratio between both groups.Conclusion The abnormalities of the structure and(or) function in the putamens of patients may be the one of the underlying anaetiological factors and pathophysiology mechanisms of the Tourette' s syndrome.

ObjectiveTo investigate the central nervous system mechanisms of active of movement switch in the patients with Tourette' s syndrome( TS),and to explore the possible underlying distinct neural networks for tic trigger and generation. Methods Participants were 14 patients with TS and 14 age- and gender-matched healthy volunteers with no history of physical,psychiatric or neurological disease: All patients were assessed with functional magnetic resonances imaging (fMRI)of the brain during the intermittent performance of finger-tapping switch tasks,Blood-oxygen-level dependent-fMRI was performed using a 3.0 Tesla MR.The area over which the activation was distributed was calculated,and the activation volumes were also compared between the patients with TS and the control subjects.ResultsThe regions activated in the patients with TS and in the volunteers were similar in several brain regions,including contralateral precentral and postcentral gyrus,contralateral mesia pre-front gyrus,contralateral cingulate gyrus,contralateral insula and ipsilataral cerebellum. There were also many different activation areas between the patients and the control subjects. The patients with TS demonstrated more significant and extended activation in the contralateral pre- and postcentral gyrus than the healthy volunteers.The volume of the left pre- and postcentral gyrus of the TS patients was (8.024 ±0.071 ) cm3,while the volume of the left pre-and postcentral gyrus of the control subjects was ( 6.480 ± 0.026) cm3 ( t =3.026,P ＜ 0.01 ) ; The volume of the right pre- and postcentral gyrus was (6.192 ± 0.019) cm3 in the TS cases,while there was (5.608 ±0.037) cm3 in the control subjects (t =2.752,P ＜0.05).There were significant differences in the volumes of bilateral pre- and postcetral gyrus between the TS and control subjects. The activations of conralateral thalamus without contralateral insula were found in the patients with TS. Conversely, the contralateral insula activation without thalamus activation could be found in the healthy volunteers.ConclusionThe thalamus might play an important role in the aetiological and physiopathologic mechanisms of the TS. The thalamus along with the parietal cortex,cingulate cortex and insular cortex appear to constitute a distinct neural network for tic trigger and generation.

Objective To evaluate the effect of quick injection combining with slow infusion of Gd-DTPA on T1 relaxation of the blood. Methods Fifteen volunteers were recruited for coronary MRA study using a navigator-gated 3D-FIESTA sequence. Coronary MRA were acquired on the same segments two times at 5 minutes and 15 minutes after Gd-DTPA administration. Contrast agent was injected biphasically with 10 ml at a flow rate of 1.5 ml/s and 20 ml at 0. 05 ml/s to prolong the T1 relaxation effect. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated pre- and post-contrast MRA. Image quality was compared using t-test. Results The SNR and CNR at 5 minutes after contrast injection (35.37 ±6. 84 and 21.57 ± 6. 08 ) were significantly higher than that of pre-contrast MRA ( 27.38 ± 6. 24 and 13.19 ±6. 50). The SNR at 15 minutes after contrast injection (33. 81 ±9. 43) was higher than that of precontrast MRA, but there was no statistically difference(t = 1. 885 ,P =0. 074). The CNR at 15 minutes after contrast injection (21.20 ± 7.65) was significantly higher than that of pre-contrast MRA. The SNR and CNR at 15 minutes after contrast injection were no significant different compared with those at 5 minutes after contrast injection. Conclusion T1-shorting effect in the blood can be prolonged by quick injection combining with slow infusion of Gd-DTPA ,which meet with the need of multiple scans of coronary MRA.

Objective To get a MR imaging protocol for coronary arterial wall in vitro. Methods MR examinations were performed in 10 fresh porcine hearts. Three dimensional fast imaging employing steady state acquisition (3D FIESTA) was used to delineate left anterior descending artery (LAD), while 2D spin-echo T1W was performed with 8-channel head surface coil, temporomandibular surface coil and knee coil with the same parameters. T1WI was obtained with 384×256 and 512×512 in matrix using temporomandibular surface coil, and then T1WI, PDW and T2WI with fat saturation were obtained with different NEX using temporomandibular surface coil after injecting Resovist in LAD. Signal of the LAD wall, lumen, fat tissue adjacent to LAD, myocardium of anterior part of interventricular septum and noise were respectively measured. Signal-to-noise ratio (SNR) of image, contrast to noise ratio (CNR) between the wall and lumen (CNR1), CNR between the wall and surrounding fatty tissue (CNR2) were calculated. Results The SNR and CNR1, CNR2 of SE T1WI with temporomandibular coil were higher than those with 8-channel head surface coil and knee coil. SNR and CNR1, CNR2 of SE T1WI with 384×256 matrix were higher than those with 512×512 matrix. SNR and CNR1, CNR2 using 3 NEX were the highest. Conclusion Good SNR and CNR of porcine coronary wall can be achieved using temporomandibular surface coil, 384×256 in matrix and NEX of 3.

Objective To compare 16-slice multi-detector spiral computed tomography (MDCT) and breathhold 3D magnetic resonance (MR) coronary angiography in the visualization of coronary arteries and the accuracy of detecting significant (＞ 50%) coronary stenoses in patients with suspected coronary artery disease. Methods Forty patients were examined by 16-slice CT (GE, Lightspeedl6)and MR (GE,Twinspeed) within 3 days; 31 of them underwent conventional coronary angiography (CAG) within 2 weeks after CT and MR scan. CT was performed with 16× 1.25 mm detector collimation, 0.5 s rotation time and images were reconstructed at 60%-75% of the cardiac cycle. MR was performed with breath hold 3D FIESTA (TR4.0 ms, TE1.7 ms, flip angle 65, slice thickness 3 mm, FOV 280 mm, matrix 256× 192). Mean heart rate was 63 ± 5.8 bpm and β-blocker was used in 24 patients. MR and CT image quality was evaluated in 9 coronary segments (RCA1, RCA2, RCA3, LM, LAD1, LAD2, LAD3, LCX1, LCX2) using a four-point grading scale.Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for detection of significant stenosis using CAG as the gold standard. Results 16-slice CT showed higher image quality in most coronary segments except RCA2.Forty-three segments were diagnosed as significant stenosis by CAG, 36 and 27 of these were correctly detected by CT and MR respectively. Sensitivity, specificity, positive predictive value, and negative predictive value of 16-slice CT and MR for detecting significant stenosis were 83 %, 84 %, 49 %, 97 % and 63 %, 90 %, 55 %, 93 %, respectively. Conclusion Sixteen-slice CT showed higher image quality in most coronary segments excepted for middle RCA. 16-slice CT had higher sensitivity than MR for detection of coronary significant stenosis, whereas MR had higher specificity than CT. Both CT and MR showed high negative predictive value,which is useful for excluding coronary stenosis in symptomatic patients.

Objective To describe the MR manifestations of demyelinating pseudotumor of the central nervous system (CNS), and to discuss the pathologic features and MR diagnostic value and limit in this disease entity. Methods Seven pathologically proved and one clinically proved cases of demyelinating pseudotumor of CNS were studied with MR imaging, and the MR imaging features were retrospectively analyzed. Results MR imaging demonstrated localized mass without adjacent multiple accompanying lesions in all 8 cases. On T 1WI, the lesions showed homogenous low signal in 5 cases, inhomogenous low signal in 2 cases, and mixed high and low signal in 1 case. On T 2WI, the lesions presented as homogenous high signal in 5 cases and inhomogenous high signal in 3 cases. Of the 7 cases with Gd DTPA administration, marked enhancement was seen in each case. The enhancement pattern of vertical distribution to the lateral ventricle was demonstrated in left frontoparietal lobe in one case, and predominant dorsal white matter enhancement of the cervical spinal cord was revealed in another case. Follow up MR imaging showed no lesion recurrence, and gradual shrinkage of the lesion after steroid therapy was demonstrated in one case. Conclusion It is a difficult task to make the correct diagnosis of CNS demyelinating pseudotumor based on the clinical information and imaging findings, and this disease entity is often misdiagnosed as tumor by MR imaging. Thorough analysis of the clinical history and careful observation of MR manifestations (especially contrast enhanced MR findings) would be helpful in diagnosing the demyelinating pseudotumor and, in such circumstances, providing test steroid therapy, thus avoiding the devastating injury caused by surgery or radiation therapy.

Objective To evaluate the efficiency of coronary magnetic resonance angiography (CMRA) for stenoses detection by using breath-hold three-dimensional fast imaging employing steady state acquisition (FIESTA) sequence with the reference of conventional coronary catheter angiography. Methods~Consecutive 33 patients accepted CMRA examination within 3 weeks after the catheter angiography. Coronary stenoses was graded in 5 levels as 0%, 0%-25%, 25%-50%, 50%-75%, and 75%-100%, respectively, and CMRA and catheter angiogram were compared segment by segment. Results For the differentiation of the stenoses 50%, the accuracy, sensitivity, and specificity of CMRA was 84.3%, 84.8%, and 84.1%, respectively, and the negative prediction value was 92.3%. The accuracy, sensitivity, and specificity for the differentiation of stenoses between 50%-75% and 75%-100% were all 61.5%. Conclusion The breath-holding three-dimensional FIESTA sequence for CMRA was practical to exclude hemodynamic significant coronary stenoses but limited in detail grading.

Objective To compare the accuracy of CE MRA and Gated 2D TOF MRA in evaluation of internal carotid artery stenosis. Methods 34 patients (male 27, female 7, age range 45-78 years) were evaluated with contrast enhanced three dimensional magnetic resonance angiography (CE MRA) and unenhanced ECG gated two dimensional time of flight MRA (Gated 2D TOF MRA). Digital subtraction angiography (DSA) was used as the “gold standard”. The MRA images were reprojected with maximum intensity projection (MIP) algorithm. Sensitivity, specificity, diagnositic accuracy,overestimation and underestimation were assessed. Results (1) DSA provided 68 diagnostic judgments: 23 were negatives and 45 were positives (mild stenosis 10, moderate stenosis 14, severe stenosis 17, occlusion 4). CE MRA was in agreement with angiography in 66 (97%), but overestimation resulted in 2 cases. Gated 2D TOF MRA was in agreement with angiography in 56 (82%), with 9 overestimation and 3 underestimation. (2) Taking negative and positive cases as judgement, CE MRA showed higher sensitivity, specificity, and diagnostic accuracy than Gated 2D TOF MRA (100% versus 95 6%, 100% versus 78.3%, 100% versus 89.4%, respectively). (3) Taking 70% stenosis as judgement, CE MRA also showed higher sensitivity, specificity, and diagnostic accuracy than Gated 2D TOF MRA (100% versus 95 2%, 97.8% versus 93.6%, 98.5% versus 94.1%, respectively). Gated 2D TOF MRA vs DSA, CE MRA vs DSA and Gated 2D TOF MRA vs CE MRA all had no significant difference (? 2=3.000 with P =0.083, ? 2=2.000 with P =0.157, and ? 2=1.600 with P =0.206 respectively) Conclusion Compared with Gated 2D TOF MRA,CE MRA is more accurate in evaluation of carotid artery stenosis.

Objective To develop a localization strategy for magnetic resonance coronary angiography (MRCA). Methods In 89 subjects, the standard 4-chamber view and long-axis view of left and right ventricle were acquired using Fast-Imaging-Employing-Steady-State-Acquisition (FIESTA) sequence in CINE mode, and the trigger-delay time for mid-diastolic phase was determined. Coronary vessels including right coronary artery (RCA), left main (LM), left anterior descending (LAD), and left circumflex (LCX) were localized and imaged using 3-dimensional fat-suppressed FIESTA sequence during end-expiration. The reproducibility of the localization strategy was evaluated by taking the standard of coronary segmentation system recommended by American Heart Association. Results Eighty-six subjects completed the examination with full respiratory co-operation and the indication ratio was 96.63%. Nine planes were optimized as the standard to target the main branches of coronary arteries, and a comprehensive reproducibility reached 100% in demonstrating the proximal and middle segment of RCA (AHA-18, 19), LM (AHA-1, 2), proximal and middle segment of LAD (AHA-3, 5, 7), and proximal LCX (AHA-10). The reproducibility for the demonstration of distal segments of LAD, LCX, and RCA (AHA-9, 14, 21) was 94.19%, 72.09%, and 96.51%, respectively. Conclusion This is a simple and practical localization strategy for MRCA. It could image the proximal and middle segments of the coronary arteries with good reproducibility, which indicates the potential for clinical application.