Atrophy in subcortical gray matter in adult patients with moyamoya disease.

BACKGROUND: Acute cerebrovascular accidents, long-term hypoperfusion, and/or remote neuronal degeneration may lead to structural alterations in patients with moyamoya disease (MMD). This study sought to comprehensively investigate the distribution characteristics of subcortical gray matter volume and their correlations with angiographic changes in the intracranial artery in patients with MMD. METHOD: One hundred forty-two patients with MMD and 142 age- and sex-matched healthy controls underwent 3-dimensional high-resolution structural magnetic resonance imaging. Volumes of subcortical gray matter and subregions of the hippocampus and amygdala were calculated, and the degree of stenosis/occlusion of intracranial arteries in patients with MMD was evaluated on MR angiography. RESULTS: Volume reductions in the thalamus, caudate, putamen, hippocampus, amygdala, pallidum, and nucleus accumbens were found in patients with MMD. Hippocampal subfields and amygdala subnuclei in patients with MMD showed distinct vulnerability, and morphological alterations in specific subregions were more obvious than in the whole hippocampus/amygdala. Volume loss in several subcortical areas was related to disease duration and intracranial arterial changes. CONCLUSIONS: Our findings revealed structural alteration patterns of subcortical gray matter in MMD. The specific atrophy in subregions of the hippocampus and the amygdala suggested potential cognitive and affective impairments in MMD, which warrants further investigation. Chronic cerebral hemodynamic alterations in MMD may play a pivotal role in morphological changes in subcortical areas.

The clinical application of 320-detector row CT in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma.

PURPOSE: To evaluate the clinical value of 320-detector row CT in transcatheter arterial chemoembolization (TACE) treatment for hepatocellular carcinoma (HCC). MATERIALS AND METHODS: Sixty-four patients with HCC underwent CT perfusion scanning with a 320-detector row CT before and after TACE. With the help of built-in dual-source CT perfusion software, color perfusion images of hepatic arterial perfusion (HAP), portal vein perfusion (PVP) and hepatic arterial perfusion index (HAPI) of all HCC lesions were obtained, and the above perfusion parameters were measured on the color images. The parameters obtained after TACE were compared with those obtained before TACE, and the differences were statistically analyzed. RESULTS: There were significant differences in HAP, PVP and HAPI between cancer tissues and non-cancerous tissues before TACE (P < 0.05). HCC necrotic tissues had no blood perfusion after TACE. Lower HAP and HAPI and higher PVP were observed in active cancer tissues after operation as compared with those before operation. CONCLUSIONS: The 320-row CT upper abdominal one-stop examination can display the whole liver perfusion well, especially the abnormal perfusion of HCC tissues and postoperative active tissues. Angiography can display the hepatic and nutrient arteries of tumors from three dimensions, and has important guiding significance in preoperative evaluation and postoperative follow up of TACE.

Comparison of lower extremity atherosclerosis in diabetic and non-diabetic patients using multidetector computed tomography.

BACKGROUND: Lower extremity atherosclerosis (LEA) is among the most serious diabetic complications and leads to non-traumatic amputations. The recently developed dual-source CT (DSCT) and 320- multidetector computed tomography (MDCT) may help to detect plaques more precisely. The aim of our study was to evaluate the differences in LEA between diabetic and non-diabetic patients using MDCT angiography. METHODS: DSCT and 320-MDCT angiographies of the lower extremities were performed in 161 patients (60 diabetic and 101 non-diabetic). The plaque type, distribution, shape and obstructive natures were compared. RESULTS: Compared with non-diabetic patients, diabetic patients had higher peripheral neuropathy, history of cerebrovascular infarction and hypertension rates. A total of 2898 vascular segments were included in the analysis. Plaque and stenosis were detected in 681 segments in 60 diabetic patients (63.1%) and 854 segments in 101 non-diabetic patients (46.9%; p <0.05). Regarding these plaques, diabetic patients had a higher incidence of mixed plaques (34.2% vs. 27.1% for non-diabetic patients). An increased moderate stenosis rate and decreased occlusion rate were observed in diabetic patients relative to non-diabetic patients (35.8% vs. 28.3%; and 6.6% vs. 11.4%; respectively). In diabetic patients, 362 (53.2%) plaques were detected in the distal lower leg segments, whereas in non-diabetic patients, 551 (64.5%) plaques were found in the proximal upper leg segments. The type IV plaque shape, in which the full lumen was involved, was detected more frequently in diabetic patients than in non-diabetic patients (13.1% vs. 8.2%). CONCLUSION: Diabetes is associated with a higher incidence of plaque, increased incidence of mixed plaques, moderate stenosis and localisation primarily in the distal lower leg segments. The advanced and non-invasive MDCT could be used for routine preoperative evaluations of LEA.

Short-term changes in chest CT images among individuals at low altitude after entering high-altitude environments.

Objective: To investigate the short-term changes in chest CT images of low-altitude populations after entering a high-altitude environment. Methods: Chest CT images of 3,587 people from low-altitude areas were obtained within one month of entering a high-altitude environment. Abnormal CT features and clinical symptoms were analyzed. Results: Besides acute high-altitude pulmonary edema, the incidence of soft tissue space pneumatosis was significantly higher than that in low-altitude areas. Pneumatosis was observed in the mediastinum, cervical muscle space, abdominal cavity, and spinal cord epidural space, especially the mediastinum. Conclusion: In addition to acute high-altitude pulmonary edema, spontaneous mediastinal emphysema often occurs when individuals in low-altitude areas adapt to the high-altitude environment of cold, low-pressure, and hypoxia. When the gas escapes to the abdominal cavity, it is easy to be misdiagnosed as gastrointestinal perforation. It is also not uncommon for gas accumulation to escape into the epidural space of the spinal cord. The phenomenon of gas diffusion into distant tissue space and the mechanism of gas escape needs to be further studied.

Bi-Parametric Magnetic Resonance Imaging Analysis of Biochemical Recurrence of Prostate Cancer after Radical Surgery and Its Predictive Value: A Retrospective Study.

OBJECTIVE: This study aimed to analyse the characteristics of biochemical recurrence after radical prostatectomy via bi-parametric magnetic resonance imaging. METHODS: A total of 200 patients with radical prostatectomy admitted to our hospital from January 2016 to January 2021 were retrospectively enrolled as observation objects. According to whether there was biochemical recurrence after surgery, the patients were divided into the abnormal group (n = 62) and normal group (n = 138). Clinical data, encapsulation infiltration, seminal vesicle infiltration and prostate imaging report and data system (PI-RADS) were collected and compared between the two groups. Propensity score matching (PSM) was used to balance the baseline data of the two groups. Student's t-test and Chi-square test were used to analyse the data. RESULTS: PSM was performed in a 1:1 ratio, and a total of 72 patients were included in the abnormal and normal groups. The baseline data of the patients in each group were not statistically significant. The incidence of extraperitoneal invasion and seminal vesicle invasion was higher in the abnormal group than in the normal group, and we observed a significant difference in PI-RADS scores between the two groups (p < 0.05). Extracapsular invasion, seminal vesicle invasion, PI-RADS score and biochemical recurrence were significantly correlated (p < 0.05). The PI-RADS score has a high value for predicting biochemical recurrence, with an area under the curve value of 0.824, sensitivity of 0.667, specificity of 0.861 and Youden index of 0.528. CONCLUSIONS: Bi-parametric magnetic resonance imaging has a high predictive value in biochemical recurrence after radical prostatectomy, which can provide reference for early intervention measures.

Predictive Value of Magnetic Resonance Imaging Radiomics Combined with Serum PSA for the Extracapsular Extension of Prostate Cancer Prediction.

OBJECTIVE: We aimed to investigate the value of magnetic resonance imaging (MRI) radiomics combined with serum prostate-specific antigen (PSA) in predicting the extracapsular extension (ECE) of prostate cancer. METHODS: In total, 213 patients with prostate cancer admitted to our hospital from May 2021 to April 2023 were retrospectively enrolled as observation subjects. Based on the presence or absence of extracapsular extension, the patients were divided into occurrence (n = 70) and non-occurrence (n = 143) groups. The clinical data, PSA levels, Prostate Imaging Reporting and Data System (PI-RADS®), and MRI-ECE scores of the two groups were compared. RESULTS: In total, 80 patients were included in the occurrence (n = 40) and non-occurrence groups (n = 40), and no statistical significance was observed in the baseline data of the two groups. Preoperative PSA levels were significantly higher in the occurrence group than in the non-occurrence group, and the PI-RADS and MRI-ECE scores of each group differed significantly (p < 0.05). The area under the curve (AUC) for the combined determination of PSA levels and PI-RADS and MRI-ECE scores was 0.900, which was significantly higher than the AUC for the individual determination of the mentioned indicators (p < 0.05). CONCLUSIONS: The combination of MRI radiomics and PSA can accurately predict the extracapsular extension of prostate cancer; Thus, it is a favorable reference for subsequent precise diagnosis and treatment.

Predicting acute pancreatitis severity with enhanced computed tomography scans using convolutional neural networks.

This study aimed to evaluate acute pancreatitis (AP) severity using convolutional neural network (CNN) models with enhanced computed tomography (CT) scans. Three-dimensional DenseNet CNN models were developed and trained using the enhanced CT scans labeled with two severity assessment methods: the computed tomography severity index (CTSI) and Atlanta classification. Each labeling method was used independently for model training and validation. Model performance was evaluated using confusion matrices, areas under the receiver operating characteristic curve (AUC-ROC), accuracy, precision, recall, F1 score, and respective macro-average metrics. A total of 1,798 enhanced CT scans met the inclusion criteria were included in this study. The dataset was randomly divided into a training dataset (n = 1618) and a test dataset (n = 180) with a ratio of 9:1. The DenseNet model demonstrated promising predictions for both CTSI and Atlanta classification-labeled CT scans, with accuracy greater than 0.7 and AUC-ROC greater than 0.8. Specifically, when trained with CT scans labeled using CTSI, the DenseNet model achieved good performance, with a macro-average F1 score of 0.835 and a macro-average AUC-ROC of 0.980. The findings of this study affirm the feasibility of employing CNN models to predict the severity of AP using enhanced CT scans.

High-flow priapism due to bilateral cavernous artery fistulas treated by unilateral embolization: A case report.

BACKGROUND: High flow priapism (HFP) is a rare type of priapism. Perineal trauma is the most common cause of HFP. Trauma-induced penile artery injury may lead to an arterial-cavernosal fistula, whereas persistent irregular arterial blood flow entering the corpora cavernosum can cause a persistent penile erection. The routine treatment of HFP focuses on addressing the abnormal penile erectile status and avoiding post-treatment erectile dysfunction. Interventional embolization is an important therapeutic modality for HFP, and bilateral embolization therapy is currently the most commonly used technique for patients with bilateral cavernous artery fistulas; however, unilateral embolization therapy has yet to be reported. CASE SUMMARY: Herein, we report of the case of a 26-year-old Chinese male who presented with a persistent abnormal erection for 12 h after perineal impact injury. Medical history, cavernous arterial blood gas analysis and radiological examinations led to a diagnosis of HFP caused by bilateral cavernous artery fistulas. We performed routine conservative treatment (compression therapy and ice application) for the patient after admission; however, 10 d later, his symptoms had not been relieved. After completion of the preoperative workup, right (severe side) selective perineal artery embolization was performed; the left cavernous artery fistula was left untreated. After postoperative continuation of conservative treatment for 72 h, the patient experienced complete penile thinning. The patient had no symptoms of erectile dysfunction over a follow-up period of 12 mo. CONCLUSION: Compared with bilateral cavernous artery fistula embolization, we believe that unilateral cavernous artery fistula embolization can achieve positive clinical efficacy and reduce the risk of postoperative erectile dysfunction secondary to penile ischemia.

Computed tomography-guided interstitial implantation of I (125) radioactive seeds in the treatment of hilar airway stenosis caused by non-small cell lung cancer.

BACKGROUND: Airway stenosis secondary to non-small cell lung cancer (NSCLC) is one of the severe complications that can lead to life-threatening outcomes. OBJECTIVE: To investigate the clinical utility of computed tomography (CT)-guided interstitial implantation of radioactive I-125 seeds in the treatment of hilar airway stenosis caused by NSCLC. METHODS: The cases of hilar airway stenosis caused by NSCLC in our hospital from 2017 to 2022 were collected and divided into observation and control groups. Both groups underwent conventional lung cancer treatment, and the observation group was treated with CT-guided interstitial implantation of radioactive I-125 seeds. The mean tumor diameter, hilar airway stenosis, and obstructive pneumonia scores at 3 months after treatment were compared between the two groups. RESULTS: After 3 months of treatment, the mean tumor diameter (28.8 ±â€…9.3 mm vs 49.33 ±â€…16.75 mm, P  < 0.001), hilar airway stenosis (20.55 ±â€…30.36% vs 84.85 ±â€…26.19%, P  < 0.001), and obstructive pneumonia score (2.19 ±â€…1.41 vs 3.48 ±â€…1.12, P  < 0.001) of the observation group were significantly lower than those of the control group. CONCLUSION: CT-guided interstitial implantation of I (125) radioactive seeds in the treatment of hilar airway stenosis caused by NSCLC can effectively reduce the tumor volume, relieve airway stenosis, and alleviate the associated obstructive pneumonia and has a certain value of application in the clinic.

Application of Magnetic Resonance DTI Technique in Evaluating the Effect of Postoperative Exercise Rehabilitation.

Magnetic resonance diffusion tensor imaging (DTI) is a new kind of magnetic resonance imaging technology. Its imaging principle is to distinguish different pathological tissues according to the movement of water molecules, which is higher than regular magnetic resonance diffusion-weighted imaging. Magnetic resonance diffusion tensor imaging has exact utility price in medical analysis and sickness evaluation. However, there are few researches on the utility of diffusion tensor imaging in the rehabilitation comparison of patients. This paper explores the utility of magnetic resonance DTI science in evaluating the impact of postoperative patients' exercising rehabilitation. Taking stroke patients as an example, through giving patients rehabilitation training method, using magnetic resonance DTI technology, the motor function rehabilitation of patients was evaluated, and FA changes of the affected side and healthy side and Fugl-Meyer score of two groups of patients before and after rehabilitation were observed. The software outcomes exhibit that, in the contrast of rehabilitation therapy impact of motor feature in sufferers with cerebral infarction, the use of magnetic resonance DTI technological know-how gives a foundation for clinicians to deeply apprehend the CST involvement of patients, which helps to scientifically evaluate the effect and quality of limb motor rehabilitation training of patients and provides a basis for disease treatment.

Computed tomography and clinical parameters predict intracerebral hemorrhage expansion.

ABSTRACT: This study aimed to evaluate the association of imaging signs, and to establish a predictive model through selecting highly relevant imaging signs in combination with clinical parameters for hematoma expansion.Intracerebral Hemorrhage (ICH) patients who received 2 consecutive noncontrast computed tomography scans were examined and recruited through January 2014 to December 2020. Demographic information and clinical characteristics were collected. Two experienced radiologists reviewed baseline noncontrast computed tomography images to assess the imaging characteristics. Correlation analysis was analyzed with Pearson and Spearman correlation tests. The association between clinical and imaging predictors with hematoma expansion was evaluated in multivariate models. Receiver operating characteristic (ROC) curve analysis was adopted to evaluate predictive performance.A total of 232 ICH patients, with mean age of 59.73 years, and 31% of female were included, among which, 32 patients occurred with hematoma expansion. For sex, ICH density, low density in hematoma, the midline shift, and Glasgow Coma Scale score, liquid level, H-tra, edema Cor, H Volume, time from onset to examination, there were significant differences between the 2 groups. As for imaging signs, only blend sign showed a significant difference, that patients with blend sign had a higher incidence of ICH expansion. The logistic analysis found that radiation attenuation, liquid level, the midline shift, Glasgow Coma Scale score, history of ischemic stroke, and smoking could predict the occurrence of ICH expansion.In summary, the model combined radiological characteristics with clinical indicators showed considerable predictive performance. Further validation is needed to verify the findings and help transfer to clinical practice.

Chemotherapy, transarterial chemoembolization, and nephrectomy combined treated one giant renal cell carcinoma (T3aN1M1) associated with Xp11.2/TFE3: A case report.

BACKGROUND: Renal cell carcinoma (RCC) with Xp11.2 translocation/TFE3 gene fusion is a rare and distinct subtype of RCC that is classified under tumors with translocation of the microphthalmia-associated transcriptional factor. CASE SUMMARY: We report an adult case of Xp11.2 translocation advanced RCC with metastasis (T3aN1M1), after targeted treatment, alcohol ablation, and transarterial chemoembolization, who eventually underwent successful surgical excision. No recurrence or transfer was seen within one year, and the survival period was more than 3 years. A review of the relevant literature was conducted to improve our understanding of the pathogenesis, epidemiology, clinical manifestations, diagnosis, differential diagnosis, treatment, and other aspects of the disease. CONCLUSION: Transarterial chemoembolization and ablation did not achieve the desired tumor reduction in this patient, but had a significant effect on reducing intraoperative bleeding and inhibiting tumor activity.

Functional magnetic resonance imaging based on Chinese tasks to protect language function in epileptics.

OBJECTIVE: To evaluate the efficacy of functional magnetic resonance imaging (fMRI) based on Chinese tasks to protect the language function in epileptics. MATERIALS AND METHODS: A total of 34 native Chinese patients with epilepsy were enrolled and examined with BOLD-fMRI scan based on six Chinese tasks. The epileptics were randomly divided into the control group (n = 15) and the experimental group (n = 19). The control group underwent the hollowing and multiple subpial transection operation only based on intraoperative EEG, while the experimental group was under notification of task-state fMRI results in addition. Whereafter, the language ability of patients was evaluated by ABC assessment. RESULTS: The brain regions related to Chinese function activated by different tasks were remarkably distinct and mainly concentrated in the temporal lobe and frontal lobe. In ontoanalysis, the activation signals of the fusiform gyrus, parahippocampal gyrus, hippocampus, and precentral gyrus were generally low or even could not be detected. Unlike ontoanalysis, group analysis showed that the main effect regions of AN and PN task were in right superior temporal gyrus. The main effect regions of FF and VFC task were in right middle temporal gyrus. The main effect region of SF task was in left superior temporal gyrus. The main effect region of VFL task was in right middle frontal gyrus. The ABC assessment score of the control group 6 months after surgery was significantly lower than that 1 week before surgery (p < .05), while there was no significant difference in the experimental group, and the score of the experimental group was higher than that of the control group. CONCLUSION: In the surgical treatment of epilepsy, a personalized surgical plan, based on task-state fMRI and intraoperative EEG, can be developed according to the difference of activation areas to protect the language function and improve the quality of life in postoperative patients.

320-slice CT angiography of an interrupted aortic arch patient relying on collaterals: An addition to classification criteria.

A 13-year-old female patient presented with chest pain had no history of heart disease or trauma. She was finally diagnosed with the interrupted aortic arch by 320-slice CT angiography, without intracardial malformations or patent ductus arteriosus. Her descending aortic blood was supplied by plentiful collateral circulation on the chest. According to literature reports, patients with complete interruption of the aortic arch rarely live 10 years without surgical intervention. More particularly, this case does not fit the current classification systems.

Application of Dual-Source CT Coronary Angiography in Type 2 Diabetic Patients with Symptomatic Coronary Heart Disease.

OBJECTIVE: To evaluate the epidemiological and morphological characteristics of coronary plaque in diabetic patients with symptomatic coronary heart disease (CHD) by dual-source computed tomography (DSCT). MATERIALS AND METHODS: From June 2013 to December 2014, 267 consecutive patients with type 2 diabetes mellitus were examined by DSCT. Plaque type, distribution, as well as extent and obstructive characteristics were determined for each segment. RESULTS: A total of 225 patients were included in the final study. Among the 225 cases, patients with calcium score >10 accounted for 76.9%. With the increase in calcium score, the number of obstructive stenoses increased from 17 (22.7%) to 150 (66.4%) segments, and non-obstructive stenosis decreased from 58 (77.3%) to 76 (33.6%) segments. A total of 862 (3.8±3.0 per patient) plaques were detected, of which 448 (52%) were calcified plaque, 272 (32%) mixed plaques and 142 (16%) soft plaques. Regarding the stenosis type, there were significantly more mild (54%), followed by moderate (26%) and severe stenosis (20%); 152 (67.6%) patients had .2 vascular lesions, while 73 (32.4%) patients with single diseased vessel. 190 (84.40%) patients with atherosclerotic plaque were located in left anterior descending (LAD) coronary artery, 146 (64.9%) patients in right coronary artery (RCA), 114 (50.7%) patients in left circumflex (LCX) coronary artery. The most common site of all detected plaques was the proximal segment of the LAD (18.7%). CONCLUSION: DSCT showed that coronary arteries of diabetic patients with symptomatic CHD were more prone to calcification. There was more non-obstructive than obstructive lumen narrowing; obstructive stenosis and calcification score was positively correlated; coronary plaques were widely distributed, and mainly located in multiple diseased vessels.

Injuries sustained by earthquake relief workers: a retrospective analysis of 207 relief workers during Nepal earthquake.

BACKGROUND: This study aimed to analyse the injuries sustained by rescue workers in earthquake relief efforts in high altitude areas for improving the ways of how to effectively prevent the injuries. METHODS: The clinical data of 207 relief workers from four military hospitals in Tibet, who were injured in the Tibetan disaster areas of China during '4.25' Nepal earthquake rescue period, was retrospectively analyzed. The demographic features, sites of injury and causes of injury were investigated. RESULTS: The most frequently injured sites were the ankle-foot and hand-wrist (n = 61, 26.5 %), followed by injuries in leg-knee-calf (n = 22, 9.6 %), head-neck (4.87 %), thoracic and abdominal region (2.6 %) and lower back (3.9 %). The specific high-altitude environment increased the challenges associated with earthquake relief. DISCUSSION: The specific plateau environment and climate increased the burden and challenge in earthquake relief. The injury distribution data shown in this study demonstrated that effective organization and personnel protection can reduce the injury occurrences. CONCLUSION: Relief workers were prone to suffering various injuries and diseases under specific high-altitude environment.

The accuracy of spot sign in predicting hematoma expansion after intracerebral hemorrhage: a systematic review and meta-analysis.

PURPOSE: The role of spot sign on computed tomography angiography (CTA) for predicting hematoma expansion (HE) after primary intracerebral hemorrhage (ICH) has been the focus of many studies. Our study sought to evaluate the predictive accuracy of spot signs for HE in a meta-analytic approach. MATERIALS AND METHODS: The database of Pubmed, Embase, and the Cochrane Library were searched for eligible studies. Researches were included if they reported data on HE in primary ICH patients, assessed by spot sign on first-pass CTA. Studies with additional data of second-pass CTA, post-contrast CT (PCCT) and CT perfusion (CTP) were also included. RESULTS: 18 studies were pooled into the meta-analysis, including 14 studies of first-pass CTA, and 7 studies of combined CT modalities. In evaluating the accuracy of spot sign for predicting HE, studies of first-pass CTA showed that the sensitivity was 53% (95% CI, 49%-57%) with a specificity of 88% (95% CI, 86%-89%). The pooled positive likelihood ratio (PLR) was 4.70 (95% CI, 3.28-6.74) and the negative likelihood ratio (NLR) was 0.44 (95% CI, 0.34-0.58). For studies of combined CT modalities, the sensitivity was 73% (95% CI, 67%-79%) with a specificity of 88% (95% CI, 86%-90%). The aggregated PLR was 6.76 (95% CI, 3.70-12.34) and the overall NLR was 0.17 (95% CI 0.06-0.48). CONCLUSIONS: Spot signs appeared to be a reliable imaging biomarker for HE. The additional detection of delayed spot sign was helpful in improving the predictive accuracy of early spot signs. Awareness of our results may impact the primary ICH care by providing supportive evidence for the use of combined CT modalities in detecting spot signs.

The value of diffusion tensor imaging in differentiating high-grade gliomas from brain metastases: a systematic review and meta-analysis.

PURPOSE: Differentiation of high-grade gliomas and solitary brain metastases is an important clinical issue because the treatment strategies differ greatly. Our study aimed to investigate the potential value of diffusion tensor imaging (DTI) in differentiating high-grade gliomas from brain metastases using a meta-analytic approach. MATERIALS AND METHODS: We searched Pubmed, Embase and the Cochrane Library for relevant articles published in English. Studies that both investigated high-grade gliomas and brain metastases using DTI were included. Random effect model was used to compare fractional anisotropy (FA) and mean diffusivity (MD) values in the two tumor entities. RESULTS: Nine studies were included into the meta-analysis. In the peritumoral region, compared with brain metastases, high-grade gliomas had a significant increase of FA (SMD  = 0.47; 95% CI, 0.22-0.71; P<0.01) and a significant decrease of MD (SMD  = -1.49; 95% CI, -1.91 to -1.06; P<0.01). However, in the intratumoral area, no significant change in FA (SMD  = 0.16; 95% CI, -0.49 to 0.82; P = 0.73) or MD (SMD  = 0.34; 95% CI, -0.91 to 1.60; P = 0.59) was detected between gliomas and metastases. CONCLUSIONS: High-grade gliomas may be distinguished from brain metastases by comparing the peritumoral FA and MD values. DTI appears to be a promising tool in diagnosing solitary intracranial lesions.