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Objective:To investigate the correlation between lumbar bone mineral density (BMD), musculoskeletal perfusion andmuscle mass.Methods:From May 2019 to August 2020, totally 91 patients who applied for CT perfusion (CTP) examination of abdomen (the scan range included the vertebral body of L1－L3) in Shanghai Tenth People′s Hospital of Tongji University were retrospectively analyzed. The mean BMD of L1－L3 vertebral body was measured by quantitative CT (QCT) at the same time of CT plain scan. According to BMD, the subjects were divided into normal BMD group ( n=33), osteopenia group ( n=41) and osteoporosis (OP) group ( n=17). The L3 level perivertebral muscle mass index and fat fraction were calculated based on QCT examination. The lumbar vertebral and perivertebral muscle perfusion parameters were measured based on CTP images. The parameters of QCT and CTP among three groups were analyzed by Kruskal-Wallis H test or one-way ANOVA. The correlation analysis was conducted between these parameters using Pearson or Spearman analysis. Results:The differences of the perivertebral muscle mass index and fat fraction among three groups were statistically significant ( P<0.05). The differences of the lumbar vertebral perfusion parameters including blood flow (BF), blood volume (BV) and flow extraction product (FE) among three groups were statistically significant ( P<0.05), and BF, BV and FE were positively correlated with BMD ( r=0.444, 0.312 and 0.266 respectively, all P<0.05; adjusted for age and gender r=0.437, 0.340 and 0.337 respectively, all P<0.05). There was no statistically significant difference in perivertebral muscle perfusion parameters among three groups ( P>0.05). Perivertebral muscle mass index was negatively correlated with fat fraction ( r=-0.599, P<0.001; adjusted for age and gender r=-0.404, P<0.001), and there was no correlation between perivertebral muscle mass index and muscle perfusion parameters, as well as perivertebral muscle fat fraction and muscle perfusion parameters. Conclusions:With the changes of BMD, bone mass and perivertebral muscle mass at L3 level are synchronous. Decreased vertebral bone mass is accompanied with reduced perivertebral muscle mass, increased muscle fat and decreased bone perfusion. The changes of vertebral perfusion and perivertebral muscle perfusion at L3 level are asynchronous, which implies that reduced perfusion in OP patients may be confined to the bone.
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Objective To investigate the diagnostic value of texture analysis derived from conventional MR imaging in differentiating benign and malignant breast lesions. Methods Thirty-six patients with malignant breast lesion and 33 patients with benign breast lesion were retrospectively analyzed in our study. All patients underwent conventional MR imaging including axial T1WI, T2WI, and contrast-enhanced T1WI before surgery. Texture features were calculated from manually drawn ROIs by using MaZda software. The feature selection methods included mutual information (MI), Fishers coefficient, classification error probability combined with average correlation coefficients (POE + ACC) and the combination of the above three methods(FPM). These methods were used to identify the most significant texture features in discriminating benign breast lesion from malignant breast lesion. The statistical methods including raw data analysis (RDA), principal component analysis (PCA), linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were used to distinguish malignant breast lesion from benign breast lesion. The results were shown by misclassification rate. Results In the three kinds of sequences, the texture features for differentiating malignant breast lesion and benign breast lesion were mainly from T2WI which had the lowest misclassification rate 4.35%(3/69). The misclassification rates of the feature selection methods were similar in MI, Fisher coefficient and POE+ACC (15.94%to 56.52%for MI;17.39%to 56.52%for Fisher coefficient and 17.39%to 56.52%for POE+ACC). However, the misclassification rate of the combination of the three methods (4.35%to 53.62%for FPM) was lower than that of any other kind of method. In the statistical methods, NDA (4.35% to 27.54%) had lower misclassification rate than RDA (33.33% to 56.52%), PCA (33.33% to 53.62%) and LDA (15.94% to 44.93%). Conclusion Texture analysis of conventional MR imaging can provide reliably objective basis for differentiating benign from malignant breast lesions.
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Objective To investigate the MRI features and Ki-67 expression and correlation with prognosis in undifferentiated pleomorphic sarcoma (UPS).Methods MRI and clinicopathological data of 34 cases with UPS proved by operation and pathology were analyzed retrospectively(with an average follow-up of 3 years).According to the presence of local recurrence,the data were divided into two groups:no recurrence group (15 cases)and recurrence group(19 cases).Two groups were analyzed according to age,tumor size,location,MRI features (lesions margin,hemorrhage,necrosis,pseudocapsule and perilesional characteristics)and expression of Ki-67.Results The results showed that two groups tumor’s size(P =0.002),location(P =0.025),pseudocapsule(P =0.025 ),peritumoral tissue inva-sion(P =0.008)and expression of Ki-67 (P =0.000)were of statistical correlation with tumor local recurrence.Conclusion Preoper-ative MRI can observe the characteristics of undifferentiated pleomorphic sarcoma,the relationship with the adjacent tissue and local invasive scope,which will be helpful for clinical diagnosis and decision of surgical plan.
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ObjectiveTo dynamically assess the regular pattern of both bone quantity and bone quality by means of MR spectroscopey and Micro-CT scanning in an osteoporosis rabbit model induced by ovariectomy and glucocorticoid, so as to explore the advantage of combining MRS with Micro-CT. MethodsSixty 8-month-old,mature female New Zealand white rabbits were allocated into three groups. Group B ( n =20 ) underwent bilateral ovariectomy (OVX)and Group C (n =20 )underwent OVX combining with daily i. m.injections of methylprednisolone sodium succinate (MPS). Group A ( n =20 ) were used as sham controls. Bone marrow fat fraction (FF) and bone microstructure parameters were detected by MR spectroscopy and Micro-CT scanning at 2,4,8, and 10 weeks ( 5 rabbits at each time point every group) after operation in three groups. ResultsLumber spine bone marrow FF in Group C was significantly increased over the time course of osteoporosis development with significant difference between Group C and Group A at 4,8,and 10 weeks after operation( all P＜0. 01 ). Bone mineral density(BMD) in Group C at 8 and 10 weeks after OVX was significantly decreased compared with Group A ( P＜0. 0l ). A moderately significant negative correlation between marrow fat content and bone microstructure parameters such as BMD, bone volume fraction, trabecular thickness, connectivity density, and trabecular plate number was found, while FF was positively correlated with structure model index and trabecular spacing( all P＜0. 01 ). ConclusionsMRS and MicroCT scanning noninvasively evaluate the bone marrow changes of osteoporosis in the field of pathophysiology and microstructure. Combination of both modalities seems to be valuable in the early, comprehensive assessment of bone quality and bone mass in osteoporosis.
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OBJECTIVE@#To study dynamic change and pathophysiology of airway obstruction of the soft palate in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) during wakefulness and natural sleep.@*METHOD@#Sixteen patients who were diagnosed as OSAHS by sleep questionnaires, medical examination and polysomnography were enrolled in this study in Shanghai Tenth People' Hospital from May to December during 2007. All patients were requested to keep awake prior to examination. Sequential midline sagittal images of the upper airway were obtained during awake and asleep state with Cine-MRI and been transmitted to portable computer. Morphologic change of the soft palate, the anterior-posterior pendulum angle of the soft palate, the anteroposterior diameter and the length of soft palate were measured. Statistical analysis was performed with paired t-test.@*RESULT@#During wakefulness: soft palate caused obstruction by floating backwards and widening anteroposterior diameter(distance between hard palate and uvula P > 0.05, included angle of hard palate and segmental vente of uvula P 0.05, included angle of hard palate and segmental dorsum of uvula P > 0.05, difference of included angle P < 0.01). Main obstruction site was on retroglottal region.@*CONCLUSION@#Morphologic change of soft palate in patients with OSAHS is multiple, and level of obstruction is deeper during natural sleep than during wakefulness. Main reason of airway obstruction is distinct during different state. The obstruction of upper airway of patients with OSAHS during wakefulness can't replace that during natural sleep.
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Adult , Humans , Male , Middle Aged , Airway Obstruction , Magnetic Resonance Imaging, Cine , Palate, Soft , Pathology , Polysomnography , Sleep Apnea, Obstructive , PathologyABSTRACT
Objective To study the changing of vertebral body marrow fat fraction(FF) in different age and sex and the relation-ship between FF and bone mineral densities (BMD). Methods Eighty-five healthy volunteers aged from 21 to 70 years old and twenty patients with osteoporosis based on T score after dual X-ray absorptionmetry examination underwent proton magnetic reso-nance spectroscopy (MRS) in L_3 vertebral bodies. The volunteers were divided into five groups according to the age(10 years and 16～18 cases in each group). Results The FF values in 21～30 years group,31～40 years group,41～50 years group,51～60 years group , >60 years group and the osteoporotic group were 30.7%±4.4%, 35.5%±6.8% , 41.9%±6.6%, 46.8%±5.5%, 51.7%±5.2% and 59.2%±7.4%, respectively. The FF values in L_3 vertebral bone marrow in men were high than that in women in the same age group (P<0.05) except >60 years group. There was negative correlation between marrow fat content and T score in osteoporotic group(γ=-0.6, P<0.01). Conclusion The vertebral marrow fat content in healthy adults was significantly in-creased with the aging. MRS may be used as a new way to evaluate the physiological and pathological process of bone marrow.
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Objective To study the cause of newborn convulsion and first aid processing method,and to reduce harm and sequels occurrence.Methods Uses the review analysis.The clinical characteristic45 patients newborn convulsions,the laboratory inspection result,the treatment and the transformation were detected.Discusses its common cause of disease and treatment.Results Cure 36 examples,improvement and leaves the hospital 9 examples.The first cause of the newborn to convulsion is:the newborn suffocates the result oxygen deficit anemic brain illness or and the skull internal hemorrhage.After lives the hypoglycemia is the second cause of disease,next is the infection.The treatment key point is stop spasm;the first choice medicine is Phenobarbital.Conclusion The newborn suffocates the result oxygen deficit anemic brain illness or and the skull internal hemorrhage;Causes the main cause of disease which the newborn convulsion are:The newborn hypoglycemia,the newborn infects the septicemia and hypocalcaemia and so on,and the anti-convulsion first choice medicine is Phenobarbital.
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Objective To determine how endoscopic retrograde cholangiopancreatography (ERCP) compared with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of pancreaticobiliary diseases. Methods A total of 40 patients with suspected pancreaticobiliary diseases underwent both MRCP and ERCP. Images obtained from ERCP and MRCP were compared. Results Pictures of both the examinations in the 40 patients had come out satisfactorily revealing the pancreatic duct and the biliary tree. The sensitivity, specificity and accuracy were 87% (34/39), 100% (1/1) and 88% (35/40) in MRCP and 100% (39/39), 100% (1/1) and 100% (40/40) in ERCP, respectively, without significant differences between the two examinations. Conclusions Although MRCP offers a diagnostic means equivalent to ERCP, it cannot take the place of the latter as regards identification of biliary obstruction.