Validation of the Capacity for the Psychotherapy Process Scale for Use in Adolescent Patients.

Although pre-treatment assessments of the capacity for the psychotherapy process can aid in identifying patients experiencing great difficulties in therapy and in tailoring therapies for individual patients, limited information exists for adolescents. To address this gap, this study followed the World Health Organization's age standards for adolescents (younger adolescents aged 10-14 years; older adolescents aged 15-19 years), examined the psychometric properties of the Capacity for Psychotherapy Process Scale (CFPPS; mainly used for adult patients) in these two groups of adolescents, and compared their capacities for the psychotherapy process. The participants were 434 younger adolescent (mean age = 13.00 ± 1.08 years; 70.0% female) and 883 older adolescent outpatients (mean age = 16.68 ± 1.29 years; 62.3% female) at the department of psychiatry of the hospital in Guangzhou, China. The results of exploratory and confirmatory factor analyses validated the 5-factor model (motivation, belief, self-revelation, persistence, and insight) in both groups. The scale also demonstrated good internal consistency. Furthermore, the CFPPS exhibited small or no associations with pre-treatment sleep problems, depression symptoms, or anxiety symptoms but was a significant predictor of working alliance and psychological benefit in therapy. The capacity for the psychotherapy process among younger adolescents was lower than that among older adolescents. The CFPPS appears to be a reliable and validated instrument for measuring the capacity for the psychotherapy process among adolescent outpatients in China. Therapists should provide therapy tailored to the Chinese adolescents' capacity. Future studies are needed to examine the predictive utility of the CFPPS for the whole sessions of the psychotherapy.

Comparison of the EPDS and PHQ-9 in the assessment of depression among pregnant women: Similarities and differences.

BACKGROUND: Perinatal depression has attracted increasing attention. However, a detailed investigation of the network structure of depression is still lacking. We aim to examine the similarities and differences between the Edinburgh Postnatal Depression Scale (EPDS) and Patient Health Questionnaire (PHQ-9) from a network perspective. METHODS: A cross-sectional study was conducted from August 2020 to March 2022. We followed the STROBE checklist to report our research. Pregnant women (n = 2484) were recruited. All participants completed the EPDS and PHQ-9. We mainly used network analyses for statistical analysis and constructed two network models: the EPDS and PHQ-9 models. RESULTS: The detection rates of prenatal depression measured by the EPDS and PHQ-9 were 30.2 % and 28.2 %, respectively. In the EPDS network, the EPDS8 'sad or miserable' node (strength = 1.2161) was the most central node, and the EPDS10 'self-harming' node (strength = 0.4360) was the least central node. In the PHQ-9 network, the PHQ4 'fatigue' node (strength = 0.9815) was the most central node, and PHQ9 'suicide' was the least central symptom (strength = 0.5667). For both models, 'sad' acted as an important central symptom. CONCLUSIONS: Psychological symptoms may be more important in assessing depression using the EPDS, while physical symptoms may be more influential in assessing depression using the PHQ-9. For both the EPDS and PHQ-9, "sad" was an important central symptom, suggesting that it may be the most important target for further maternal depression interventions in the future.

Inhibition of the long non-coding RNA UNC5B-AS1/miR-4455/RSPO4 axis reduces cervical cancer growth in vitro and in vivo.

BACKGROUND: Long non-coding RNAs (lncRNAs) are significant regulatory factors for the initiation and development of numerous malignant tumors, including cervical cancer (CC). The expression of lncRNA unc-5 netrin receptor B antisense RNA 1 (UNC5B-AS1, also known as UASR1) is up-regulated in tissues of cervical squamous cell carcinoma and endocervical adenocarcinoma compared to in normal tissues based on the GEPIA database. In the present study, we explored the functions of UNC5B-AS1 and its underlying mechanism with respect to CC development. METHODS: A real-time quantitative polymerase chain reaction was applied for the detection of UNC5B-AS1 expression in CC cells. Cell counting kit-8, colony formation and transwell assays, as well as western blot and flow cytometry analyses, were employed to detect the biological effects of UNC5B-AS1 knockdown on malignant phenotypes of CC cells in vitro. In addition, the combination between microRNA-4455 (miR-4455) and UNC5B-AS1 or R-spondin 4 (RSPO4) was explored by RNA immunoprecipitation, luciferase reporter and RNA pulldown assays. A tumor xenograft nude mice model was established to explore the effect of UNC5B-AS1 depletion or miR-4455 overexpression on tumor growth. RESULTS: UNC5B-AS1 is up-regulated in CC tissues and cells. The knockdown of UNC5B-AS1 inhibits CC cell proliferation, migration and invasion and promotes CC cell apoptosis. Mechanistically, UNC5B-AS1 binds with miR-4455 to up-regulate RSPO4 expression. RSPO4 is targeted by miR-4455 and its expression is negatively regulated by miR-4455 expression. In vivo assays revealed that UNC5B-AS1 depletion or miR-4455 overexpression inhibits tumor growth by regulating RSPO4 expression. CONCLUSIONS: Inhibition of UNC5B-AS1/miR-4455/RSPO4 reduces CC growth both in vitro and in vivo, furnishing new insights into molecular studies on UNC5B-AS1 with respect to CC development.

Clinical and psychobehavioral features of outpatients with somatic symptom disorder in otorhinolaryngology clinics.

OBJECTIVE: In the Otorhinolaryngology Department, patients exhibiting somatic symptoms without a medical cause are frequently neglected and left untreated. The aim of this study was to characterize the psychosomatic features of outpatients with somatic symptom disorder (SSD) to better identify patients needing treatment. METHODS: This cross-sectional study enrolled 883 consecutive patients with medically unexplained symptoms. A semistructured clinical interview was employed to confirm the diagnosis of SSD. Data, including sociodemographic and clinical measures, were collected. The Patient Health Questionnaire-15 (PHQ-15) and Somatic Symptom Scale-China (SSS-CN) were used to assess the severity of somatic symptoms; the Patient Health Questionnaire-9 (PHQ-9) was used to assess depression; the General Anxiety Disorder-7 (GAD-7) was used to assess anxiety; and the 12-item Short-form Health Survey (SF-12) was used to assess quality of life (QoL). RESULTS: Based on the DSM-5 criteria, 641 patients were placed in the SSD group, and 212 were placed in the normal group. Compared with the normal group, the SSD group had significantly more doctor visits, longer symptom durations, higher GAD-7 and PHQ-9 scores, and lower physical composite scores (PCSs) and mental composite scores (MCSs). Spearman's correlation analysis and multiple linear regression analyses showed that the SSS-CN score, PHQ-15 score and the patient's subjective feeling that his or her daily life was affected by the disorder were significant risk factors for low PCSs; the SSS-CN, PHQ-15, PHQ-9, and GAD-7 scores were independent risk factors for low MCSs. CONCLUSION: Our findings demonstrated that SSD patients are not rare in otorhinolaryngology clinics in China and that their QoL is significantly affected by SSD. Otolaryngologists should thoroughly evaluate these patients from the perspective of psychosomatic medicine.

The clinical effect of psychosomatic interventions on empty nose syndrome secondary to turbinate-sparing techniques: a prospective self-controlled study.

BACKGROUND: Individuals affected by empty nose syndrome secondary to turbinate-sparing techniques (ENS-type) experience decreased productivity and lifestyle disruption owing to considerable nasal-associated discomfort. This study aimed to evaluate the effect of psychosomatic intervention on ENS-type. METHODS: A prospective self-controlled study was conducted, and 28 patients suffering from ENS-type who met the diagnostic criteria for somatic symptom disorder (SSD) according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) received cognitive and behavioral therapy (CBT) plus antidepressants. Nasal symptom burden was evaluated using the 25-item Sino-Nasal Outcome Test (SNOT-25). Somatic symptom burden, anxiety severity, and depression severity were assessed by the 25-item Patient Health Questionnaire (PHQ-15), the 9-item PHQ (PHQ-9), and the 7-item Generalized Anxiety Disorder (GAD-7) scale, respectively. Patient assessments were completed prior to treatment and 3 and 12 months after the intervention. RESULTS: The total scores of the SNOT-25 declined posttreatment, showing a significant difference at the 3-month and 12-month follow-ups compared with the baseline scores (p < 0.001). The severity of the 5 most common subjective symptoms, including "nose is too open," "waking up at night," "lack of a good night's sleep," "difficulty falling asleep," and "reduced concentration," declined significantly at 3 and 12 months posttreatment compared to baseline levels. Statistically significant changes in the PHQ-15, PHQ-9, and GAD-7 scores were observed at 3 and 12 months posttreatment compared to baseline scores (p < 0.001). CONCLUSION: This study showed that some patients with ENS-type meeting the diagnostic criteria for SSD might benefit from psychiatric treatment.

REPEAT CHEST CT SCANS IN MODERATE-TO-SEVERE PATIENTS' MANAGEMENT DURING THE COVID-19 PANDEMIC: OBSERVATIONS FROM A SINGLE CENTRE IN WUHAN, CHINA.

OBJECTIVE: To observe the rates of repeated computed tomographic scans (CTs) in a cohort of patients with coronavirus disease-2019 (COVID-19) and to assess the validity of repeat CTs. METHODS: Each CT was recorded, and the validity of the repeated CTs was assessed. RESULTS: The 394 patients underwent a total of 1493 CTs. Of the 394 patients, 260 received at least one non-value-added CT. Both the total number of CTs (median, 4; interquartile range (IQR), 3-5) and non-value-added CTs (median, 1; IQR, 0-1) per patient were strongly related to the disease duration (R2 = 0.566 for total CTs, R2 = 0.432 for non-value-added CTs, p < 0.001). The proportion of non-value-added CTs was potentially higher after 3 weeks from symptom onset (>35%). CONCLUSIONS: There was a high rate of repeat CTs for the COVID-19 patients, and the proportion of non-value-added CTs increased with disease duration. Follow-up CT should be avoided without clinical decline. ADVANCES IN KNOWLEDGE: As COVID-19 is impacting healthcare systems across the globe, we believe in our findings that serial chest CT imaging has limited clinical utility in basically stable COVID-19 patients, will help relieve some of this burden.

Radiology department strategies to protect radiologic technologists against COVID19: Experience from Wuhan.

The outbreak of Coronavirus Disease 2019 (COVID-19) is a huge threat to global public health security. In the absence of specific antiviral medicines to prevent or treat COVID-19, it is essential to detect the infected patients at an early stage and immediately isolate them from the healthy population. In view of the advantages of sensitivity and high spatial resolution, CT imaging has played an important role in screening and diagnosing of COVID-19 in China. The radiologic technologists performing CT scans for the infected patients become high-risk medical care personnel. It is critical for the radiology department to ensure the personal safety of radiologic technologists and avoid cross-infection. In this review article, we describe the systematic strategies to combat COVID-19 from the radiology department in Tongji hospital in Wuhan, P.R. China, including personnel arrangements, environmental modification, protection levels and configurations, radiological imaging (CT and radiography), and disinfection methods. It can provide guidance to other radiology departments faced with COVID-19 to reduce infection risk for radiologic technologists.

PMA treated THP-1-derived-IL-6 promotes EMT of SW48 through STAT3/ERK-dependent activation of Wnt/ß-catenin signaling pathway.

Colon cancer is one of the most common digestive malignant tumors that leads to high mortality worldwide, and metastasis is the primary cause of cancer-related death. It is well accepted that the epithelial-mesenchymal transition (EMT) plays a key role in the process of metastasis. As a cytokine that macrophage secretes, IL-6 is involved in the progression of tumors, including the invasion and metastasis via kinds of signaling pathways. However, the mechanism of interactions between IL-6, macrophage, EMT and colon cancer is not fully understood. Increased CD68+ macrophages and IL-6 level were found in colon tumor as compared to normal colon tissue. Metastatic lymph node showed even more CD68+ macrophages and higher IL-6 level than the primary tumor. These results suggested that macrophages and IL-6 play an important role in EMT of colon cancer. In order to investigate the effect of macrophage and IL-6 on EMT of colon cancer, we cultured human colon carcinoma cell line SW48 with conditioned medium (CM) from PMA-stimulated monocyte THP-1 cells and tested for IL-6 dependent EMT pathways. Wound healing assay and Transwell assay were used to analyze cell migration and invasion. Results showed that CM-treated SW48 cells increased IL-6 production and displayed elevated capacity of migration and invasion compared to untreated cells. Increased expressions of EMT markers (N-cadherin, Vimentin and ß-catenin) and decreased expression of EMT marker(E-cadherin) were found in CM-treated SW48 cells by Western Blot. The addition of an anti-IL-6 antibody significantly inhibited the increase of EMT markers (Vimentin and ß-catenin) as well as cell migration and invasion, suggesting that IL-6 played a critical role in promoting EMT of CM-treated SW48 cells. In addition, we found that the levels of p-STAT3 and p-ERK increased in CM-treated SW48 compared to untreated cells, which can be reversed by AG490, an inhibitor of JAK. In the meantime, the suppression of JAK-associated signaling pathways caused a decrease of ß-catenin. In summary, our study suggested that macrophage-induced IL-6 promotes migration and invasion of colon cancer cell via Wnt/ß-catenin pathway in STAT3/ERK-dependent way.

The influence of tracheostomy timing on outcomes in trauma patients: A meta-analysis.

OBJECTIVE: This study aims to assess the influence of tracheostomy timing on outcomes among trauma patients, including mortality, medical resource utility and incidence of pneumonia. METHOD: A systematic review of the literature was conducted by internet search. Data were extracted from selected studies and analyzed using Stata to compare outcomes in trauma patients with early tracheostomy (ET) or late tracheostomy (LT)/prolonged intubation (PI). RESULT: 20 studies met our inclusion criteria with 3305 patients in ET group and 4446 patients in LT/PI group. Pooled data revealed that mortality was not lower in trauma patients with ET compared to those with LT/IP. However, ET was found to be associated with a significantly reduced length of ICU and hospital stay, shorter MV duration and lower risk of pneumonia. CONCLUSION: Evidence of this meta-analysis supports the dimorphism in some clinical outcomes of trauma patients with different tracheostomy timing. Additional well-designed randomized controlled trials (RCTs) are needed to confirm it in future.

Use of magnetic resonance imaging to assess ovarian maturation in live Rhinogobio ventralis (Sauvage & Dabry de Thiersant, 1874).

The aim of this study is to evaluate the application of magnetic resonance imaging (MRI) to assess ovarian maturation in live female Rhinogobio ventralis (Sauvage & Dabry de Thiersant, 1874). The fish were randomly collected from the Jiangjin area of the Yangtze River between January and April 2014. Magnetic resonance imaging was performed using a 3.0 T clinical MRI scanner with a brain coil and two pulse sequences (IDEAL and 3D CUBE) were employed. Magnetic resonance and histologic images at different stages of ovarian maturation (I-IV) were acquired. An empirical equation (y = -0.1 + 1.56 × x) was derived by traditional method to describe the relationship between the gonadosomatic index (y) and the percentage volume of the ovary (x). A significant correlation (R(2) = 0.977, P < 0.01, N = 53) was found between measurements of the percentage volume of the ovary by MRI and traditional methods. The research findings suggested that MRI was a reliable, rapid, and noninvasive method to assess stages of ovarian maturity in female R. ventralis.

Application of (18)F-FDG PET/CT imaging in diagnosing bladder tumor metastasis lesions.

Bladder tumor is the most common malignant tumor in urinary system and always companied with lymph node metastasis. The accurate staging plays a significant role in treatment for bladder tumor and prognostic evaluation, and the distant metastasis predicts worse prognosis. The objective of this study was to assess the clinical significance of (18)F-FDG PET/CT imaging in diagnosing bladder tumor metastasis lesions. A retrospective analysis of 60 patients with bladder tumor from October 2008 to May 2010 was done. The patients were stratified based on the imaging technique. Among all 60 cases, besides the primary lesion, 81 suspected lesions were spotted and 73 confirmed as metastasis, including 50 lymph node metastases, 22 distant metastases, and 1 bone metastasis. For PET/CT imaging, its sensitivity was 94.5%, specificity 87.5%, positive predictive value 98.6%, negative predictive value 63.6% and accuracy 93.8% respectively. For CT, its sensitivity was 82.2%, specificity 50%, positive predictive value 93.8%, negative predictive value 23.5% and accuracy 79% respectively. PET/CT imaging was superior to CT in sensitivity, specificity and accuracy. In conclusion, (18)F-FDG PET/CT imaging is more significant in diagnosing bladder tumor metastasis lesions.

Dynamic gadoteridol-enhanced MR imaging in the end of growing long bone of piglets.

BACKGROUND: It is of value to identify the non-invasive means that can accurately reflect the blood supply of epiphysis and is more sensitive in detection of early ischemia of epiphysis than the conventional gadoteridol (Gd)-enhanced SE T1WI. The aim of this study was to evaluate the blood supply of various anatomic regions at the end of normal growing long bone using dynamic Gd-enhanced MR imaging and compare the sensitivities between dynamic Gd-enhanced MR imaging and conventional Gd-enhanced SE T1WI in the detection of decreased blood perfusion of early epiphyseal ischemia. METHODS: Twenty-seven two-week-old piglets were used in this study. For the study of the end of normal growing long bone, unilateral MR imaging of the distal femur and proximal tibia was performed on eleven piglets. The comparison was made among various anatomic regions (physeal and epiphyseal cartilage, metaphyseal spongiosa, the secondary ossification center and metaphysis) using MRI in terms of the enhancement ratio and speed. Their relationships with the histological findings, including RBC/mm(2) and vessel distribution, were evaluated. To examine ischemic femoral head, 16 piglets were divided into two groups, with the control group having 8 piglets (involving 16 normal hips) and an ischemic group having 8 piglets (involving 16 hips with hyperabduction). In the ischemic group, MR imaging was performed on the hips in the hyperabduction immobilized persistently for 30 minutes. After MRI, the piglets were allowed to ambulate freely for 1 day and the same MR scanning was then repeated in a neutral position. The difference in enhancement ratio and speed of the femoral head between the control and ischemic group were evaluated. RESULTS: With regard to the end of normal growing long bone, the enhancement ratio of the metaphyseal spongiosa was greatest among all the anatomic regions (P < 0.001). The enhancement ratio of physeal cartilage was greater than that of epiphyseal cartilage (P < 0. 001), which was the lowest in all tissues (P < 0.001). The enhancement speed of the spongiosa was greater than that of physis but the difference was not significant (P > 0.05). The enhancement speed of physis was greater than that of epiphyseal cartilage (P < 0.05), which was the lowest among all the tissues (P < 0.05). The enhancement ratio and speed were found to be related to the histological findings, including RBC/mm(2) (R > 0.75) and distribution of vessels in the tissues. With ischemic femoral head, the enhancement ratios of physis, anterior part and posterior part of capital femoral epiphysis were significantly lower (P < 0.05) and enhanced more slowly (P < 0.05) than those of normal femoral head on dynamic Gd-enhanced MR imaging. On conventional Gd-enhanced SE T1WI, however, no apparent decrease in enhancement ratio and speed in ischemic hips was found (P < 0.05), when they were compared with those in the normal hips. CONCLUSIONS: Dynamic gadoteridol-enhanced MR imaging can reveal the blood supply in various anatomic regions of the end of normal growing long bone. It is more sensitive than conventional Gd-enhanced SE T1WI in the detection of early epiphyseal ischemia.

Magnetic resonance susceptibility weighted imaging in detecting intracranial calcification and hemorrhage.

BACKGROUND: Computed tomography (CT) is better than routine magnetic resonance imaging (MRI) in detecting intracranial calcification. This study aimed to assess the value of MR susceptibility weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage. METHODS: Enrolled in this study were 35 patients including 13 cases of calcification demonstrated by CT and 22 cases of intracerebral hemorrhage. MR sequences used in all the subjects included axial T1WI, T2WI and SWI. The phase shift (PS) of calcification and hemorrhage on SWI was calculated and their signal features on corrected phase images were compared. The sensitivity of T1WI, T2WI and SWI in detecting intracranial calcification and hemorrhage was analyzed statistically. RESULTS: The detection rate of SWI for cranial calcification was 98.2%, significantly higher than that of T1WI and T2WI. It was not significantly different from that of CT (P > 0.05). There were 49 hemorrhagic lesions at different stages detected on SWI, 30 on T2WI and 18 on T1WI. The average PS of calcification and hemorrhage was +0.734 +/- 0.073 and -0.112 +/- 0.032 respectively (P < 0.05). The PS of calcification was positive and presented as a high signal or the mixed signal dominated by a high signal on the corrected phase images, whereas the PS of hemorrhage was negative and presented as a low signal or the mixed signal dominated by a low signal. CONCLUSIONS: SWI can accurately demonstrate intracranial calcification, not dependant on CT. Being more sensitive than routine MRI in detecting micro-hemorrhage, SWI may play an important role in differentiating cerebral diseases associated with calcification or hemorrhage.

Diffusion MRI in ischemic epiphysis of the femoral head: an experimental study.

PURPOSE: To evaluate whether line-scan diffusion-weighted imaging (LSDWI) can provide temporal information of epiphyseal ischemia. MATERIALS AND METHODS: Ischemia was induced by ligation of arteries of the unilateral femoral head in piglets (N = 25). LSDWI was performed at several time points after ligation. A comparison of apparent diffusion coefficients (ADCs) was made between ischemic and control sides. The difference in percentage change of ADC in the ischemic hips between two neighboring time points was evaluated. A histological study was made after MR scanning. RESULTS: Three hours after ligation, ADCs were significantly lower in the ischemic hips than in the contralateral (control) hips. At 72 hours after surgery, ADCs in the ischemic hips were significantly higher than in the control hips and continued to rise up until the sixth week after operation. Histological study revealed necrosis of chondrocytes and osteocytes and abnormal thickening of the epiphyseal cartilage in the ischemic femoral head. CONCLUSION: The ADCs may be used as a marker of ischemia and necrosis in the femoral head; changes in the ADCs after the acute ischemia may reflect the evolution of ischemia and subsequent necrosis. LSDWI can be used for the evaluation of the duration and extent of ischemic injury in the epiphysis.

Early reversible ischemia of femoral head epiphysis in piglets on gadolinium-enhanced MRI: an experimental study.

The purpose of this study is to demonstrate if Gadolinium-enhanced MRI can detect early reversible ischemia of the femoral head epiphysis caused by hip hyper-abduction in piglets. Between 3 and 6 h consistent hyper-abduction, gadolinium-enhanced MRI was performed in 20 femoral heads of 10 piglets. After completion of MRI scan, the piglets were allowed to ambulate freely for 1 or 7 days and re-imaged. The enhanced-MRI results of epiphyseal and physeal cartilage and the secondary center of ossification were observed. MRI appearances and histological findings were compared. On Gadolinium-enhanced MRI, decreased or absent enhancement was seen in 14 cartilaginous epiphyses of all 20 femoral heads. Reperfusion was completed in 10 of 14 femoral heads after one day of ambulation and in the rest 4 after 7 days of ambulation. Gadolinium-enhanced MRI can identify early ischemia and its reversal of the capital femoral epiphysis induced by hip hyper-abduction.

Epiphyseal and physeal cartilage: normal gadolinium-enhanced MR imaging.

To evaluate the normal appearance of epiphyseal and physeal cartilage on Gadolinium (Gd)-enhanced MR imaging. The appearance and enhancement ratios of 20 proximal and distal femoral epiphyses in 10 normal piglets were analyzed on Gd-enhanced MR images. The correlation of the MR imaging appearance with corresponding histological findings of immature epiphyses was examined. Our results showed that Gd-enhanced MRI could differentiate the differences in enhancement between physeal and epiphyseal cartilage and show vascular canals within the epiphyseal cartilage. Enhanced ratios in the physeal were greater than those in the epiphyseal cartilage (P < 0.005). It is concluded that Gd-enhanced MR imaging reveals epiphyseal vascular canals and shows difference in enhancement of physeal and epiphyseal cartilage.

MRI characteristics and transverse relaxation time measurements in normal growing cartilage.

To determine the characteristics of magnetic resonance (MR) signals of normal growing cartilage and identify the difference in transverse relaxation times between physeal and epiphyseal cartilage in vivo. 24 distal femora of 12 two-week-old piglets were imaged on a 1.5 Tesla GE MR scanner. Comparison was made between signal intensity on MR images and the structure shown in corresponding histologic sections. T2 values were measured in eight piglets by means of multiecho spin-echo sequences. Our results showed that MR imaging delineated five regions between the secondary ossification center and the metaphysis, which histologically correspond to the zone of provisional calcification of the secondary ossification center, physis of the secondary ossification center, epiphyseal cartilage, physis and zone of provisional calcification. The T2 value in the physeal cartilage was much larger than that in the epiphyseal cartilage (P<0.05). It is concluded that MRI findings could differentiate the different regions of growing cartilage. T2 is longer in physeal than in epiphyseal cartilage, perhaps reflecting differences in water binding by proteoglycans.

MRI and magnetic resonance angiography in evaluating simultaneous pancreas-kidney transplantation.

OBJECTIVE: To evaluate the value of magnetic resonance imaging (MRI) and three dimensional (3D) contrast magnetic resonance angiography (MRA) in the diagnosis of complications of simultaneous pancreas-kidney transplantation (SPKT), as confirmed by biopsy and digital subtraction angiography (DSA). METHODS: Five MR examinations of five patients were performed within 28 days to 2 years after surgery on GE 1.5T MR system. Imaging techniques included axial and sagittal chemical fat-suppressed T1-weighted image (T1WI) and T2-weighted image (T2WI), additional contrast axial or saggital chemical fat-suppressed T1WI were obtained after 3D contrast MRA for calculating the mean percentage of the parenchymal enhancement (MPPE) of the pancreas and kidney. 3D contrast MRA was performed with Smartprep technique. MRA data were analyzed with maximum intensity projection (MIP) and multi-planner reformat (MPR). RESULTS: In five cases of transplant pancreases, MRI found two normal pancreas grafts, one case of acute rejection, one case of chronic rejection with 70% fibrosis and one case of late pancreatitis. In five transplant kidneys, MRI detected four normal kidney grafts and one case of acute rejection with infarction. MPPE could distinguish infarction from other complications. 3D contrast MRA could display vascular complications of SPKT, such as stenosis or occlusion, aneurysm formation of transplanted vessels and narrowing at the site of anastomosis, as confirmed by DSA. CONCLUSION: With combined application of MRI and 3D contrast MRA, complications of SPKT can be clearly identified.