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Objective@#To explore the value of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA) enhanced MRI T1 mapping in diagnosing and distinguishing dysplastic nodule (DN) and hepatocellular carcinoma (HCC) with different degrees of differentiation.@*Methods@#A retrospective study in the first affiliated Hospital of Guangxi Medical University from September 2015 to December 2017 was conducted. Seventy-one patients with HCC or DN (a total of 79 lesions) that confirmed by biopsy or surgical pathology findings. Seventy-nine lesions were divided into DN (n=10), well differentiated HCC (n=15), moderately differentiated HCC (n=36) and poorly differentiated HCC (n=18) according to histopathology. All the patients underwent plain MRI scan and Gd-EOB-DTPA-MRI T1 mapping before surgery or needle biopsy. The T1 values of each lesion and non-tumorous liver parenchyma were measured on 20 min hepatobiliary phase (HBP) T1 mapping after Gd-EOB-DTPA administration, respectively. The increment rate of T1 value in lesions relative to non-tumorous liver parenchyma were calculated. One-way ANOVA was used to compare the differences of T1 value and the increment rate of T1 value of DN and 3 groups of HCC with different degrees of differentiation. Spearman correlation was used to evaluate the correlation between T1 mapping parameters and the malignancy degree of DN and HCC. Area under the receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T1 mapping parameters in the differential diagnosis of DN and HCC with different degree of differentiation.@*Results@#Significant differences were found in T1 value and increase rate of T1 value of DN and HCC with different degrees of differentiation (P< 0.05). The T1 value and increase rate of T1 value showed an increasing trend from DN to poorly differentiated HCC after enhancement. The T1 value and increase rate of T1 value were positively correlated with the malignancy of DN and HCC (r=0.418 and 0.634, P<0.01). There were significant differences in the increase rate of T1 value between well-differentiated HCC and moderately-differentiated, well-differentiated HCC and poorly-differentiated HCC, respectively (P<0.05). The area under ROC curve of T1 value and the increase rate of T1 value for differentiating DN from well-differentiated, moderately differentiated and poorly differentiated HCC was 0.933, 0.928, 0.939 and 0.867, 0.961, 0.961, respectively. The area under ROC curve of the increase rate of T1 value for differentiating well-differentiated HCC from moderately-differentiated, well-differentiated HCC from poorly-differentiated HCC was 0.770 and 0.844, respectively.@*Conclusions@#Gd-EOB-DTPA enhanced MRI combined with T1 mapping can provide valuable diagnostic information for identifying DN and HCC with different degrees of differentiation.
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Objective To investigate the diagnostic value of some measured values of CT for nutcracker syndrome(NCS).Methods 28 patients with NCS confirmed by clinical diagnosis and other 81 normal controls were enrolled in the study.The angle between the superior mesenteric artery and the abdominal aorta,and the diameter and the area of left renal vein before/within this angle were measured on enhanced CT and MPR reconstruction images.The ratios of the diameter and the area before the angle to those within the angle were calculated.ROC curve was established to calculate the cut-off value and to evaluate the sensitivity,specificity,positive predictive value and negative predictive value of these parameters.Results In patient group,the mean aortomesenteric angle was 22.4°± 7.16°,mean diameter ratio was 5.10 ± 1.76 and the mean area ratio was 4.07 ± 2.10.In control group,the mean aortomesenteric angle was 61.32°± 22.82°,mean diameter ratio was 1.38 ± 0.40 and mean area ratio was 1.29 ± 0.49.The area under the ROC of the aortomesenteric angle,and the diameter ratio and area ratio were 0.979,1.000 and 0.989 respectively with corresponding cut-off values of 32.5°,2.63 and 2.06,sensitivity of 92.8%,100% and 96.4%,specificity of 95.1%,100% and 92.6%,positive predictive value of 86.7%, 100% and 81.8%,and negative predictive value of 97.5%,100% and 98.7%,respectively.Conclusion The aortomesenteric angle, the diameter and area ratios of left renal vein before/within the aortomesenteric angle have significant diagnostic value in the patients with NCS,and the value of diameter ratio is the highest.
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Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver, and in the process of HCC development, early identification and timely treatment can significantly improve patient survival rate. Imaging techniques play an important role in the monitoring of chronic liver diseases, evolution of cirrhotic nodules, and early diagnosis of HCC. Multi-phase or dynamic contrast-enhanced computed tomography and magnetic resonance imaging (MRI) reflect the changes in blood supply during the evolution of liver cirrhotic nodules. Functional MRI can reflect the structure and function of living organisms at the molecular level. The application of liver-specific contrast agents can improve the detection rate and identification of early-stage HCC. With the development of MRI techniques and the accumulation of clinical experience in functional imaging will further improve the diagnostic rate of early-stage HCC.
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Objective To explore the feasibility,reproducibility and reliability of the T 2* MRI technique in quantifying different concentrations of MnCl2water phantoms at 3.0T.Methods The water phantoms with different concentrations of MnCl2underwent T2* imaging at both 1.5T and 3.0T MRI,and repeated imaging at 3.0T MRI after 1 month.A Spearman correlation was used to determine the relationship of T2* values and Mn concentrations,and established the linear regression equations by using the simple linear regression.W ilcoxon signed-rank sum test and Bland-Altman method were used to evaluate the reproducibility of twice T 2* measurements at 3.0T,and the interclass correlation coefficient(ICC)was calculated.Results T2* values of the phantoms were negatively correlated to Mn concentrations(r= -1.000,P<0.001),and R2* values of the phantoms were positively correlated to Mn concentrations(r=1.000,P<0.001). T2* values of the phantoms measured at 3.0T were positively correlated to that measured at 1.5T(r=1.000,P<0.001).The linear regression equation was T2* 3.0T =0.651T2* 1.5T +0.041.There was no statistical difference of T2* values between the two measurements at 3.0T (Z= -1.732,P=0.083),and ICC was 1.000.Conclusion 3.0T MRI is feasible to quantify cardiac iron deposition.
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Objective To investigate the value of high-resolution 3.0T MR in the assessment of local infiltration of preoperative rectal cancer.Methods A total of 168 patients pathologically proved rectal cancer underwent both conventional pelvic and rectal high-resolution before operation, and the imaging findings were reviewed retrospectively.The accuracy of preoperative high-resolution 3.0T MR in prediction of pathological staging was assessed,and the characteristic imaging features of local infiltration in preoperative rectal cancer were discussed.Results The relationship between circumference invasion of colorectal cancer and the pathological T staging was moderately positive (rs=0.530,P=0.003).Compared the staging of colorectal cancer on MRI with pathologic T staging,the overall diagnostic accuracy was 84.52%,and there was a stronger correlation between MRI findings and pathological staging (rs=0.837,P=0.001).The best single parameters for diagnosing T3 stage rectal cancer on MRI were nodular convex of the tumor and muscular signal interruption,with 91.1% specificity and 89.7% sensitively respectively.And the best combination of parameters was the cord appearence of intestinal wall and muscular signal interruption,with 89.3% specificity and 78.0% sensitively respectively.Conclusion High-resolution 3.0T MR can be preferable to evaluating local infiltration of rectal cancer, showing a higher clinical value to asseee T staging of preoperative rectal cancer.
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Objective Study the apply of diffusional kurtosis imaging(DKI) value to assess liver cancer and tumoral cell invasion of peritumoral liver zone. Methods This research belonging to prospective study which included 24 patients with liver cancer and confirmed by clinical history and imaging features(liver cancer group), 10 healthy volunteers as control group. The liver cancer group underwent MRI plain and contrast enhanced scan, and DKI examination, while control group underwent MRI plain scan and DKI scan. The signal features of liver parenchyma and liver cancer lesion could be observed from the routine MRI and DKI. Fractional anisotropy (FA), mean diffusion (MD), axial diffusivity (Da), radial diffusivity (Dr), fractional anisotropy kurtosis (Fak), mean kurtosis (MK), kurtosis anisotropy (Ka) and radial kurtosis (Kr) value of four groups, the distant liver parenchyma(far away from the tumor>2 cm), peritumoral liver parenchyma(the distance≤2 cm around the tumor) and liver cancer were recorded. The differences of DKI parameters were evaluated using one-way analysis of variance (ANOVA). Results The signal of liver cancer in MR plain scan showed mild long T1 and mild long T2 signal, fast in and fast out enhanced feature of the neoplasms could be observed from the enhanced MRI and signal of liver cancer would not lower in DKI with b value up to top. The difference of DKI parameters including FA, MD, Da, Dr and Ka value had statistical significance in these four groups excepted for MK and Kr value. MD, Da and Dr value of normal parenchyma were higher than that of peritumoral parenchyma and liver cancer,while the Ka value was reverse. The differences of MD, Da, Dr and Ka value only had no statistical significance between the distant liver parenchyma and peritumoral liver parenchyma(P>0.05),and the differences of them had statistical significance among the rest group(P<0.05). Conclusion The DKI quantitative parameters can reflect the differences of different tissue, meaning that they can provide molecular imaging information for evaluating liver cancer and peritumoral zone.
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Objective To explore the value of MRI T2*quantification of visceral iron deposition in patients with β-thalassemia major. Methods A total of one hundred and two patients with β-thalassemia major were retrospectively analyzed. They underwent genetic testing and the cardiac and (or) abdominal MRI scanning. Among them, 47 patients underwent splenectomy operation, 95 patients underwent cardiac MRI scanning, 102 underwent abdominal MRI scanning for their livers, pancreases and kidneys, and 55 underwent splenic MRI scanning. The T2* values of the hearts, livers, pancreases and kidneys were measured, meanwhile the liver iron concentrations (LIC) were measured. The levels of serum ferritin (SF) patients were measured in 81 patients. The Spearman rank correlation was employed to analyze the relationship between SF, LIC, age and each organs T2* values. Independent sample t test (normal distribution) or the Mann- Whitney U test (non-normal distribution) were used to compare the hepatic, cardiac, renal and splenic T2* values differences between patients with splenectomy and those without. Results Serum ferritin were highly positively correlated with LIC, moderately correlatied with age, moderately negatively correlated with hepatic and pancreatic T2* values, with r values of 0.833, 0.537,-0.623 and -0.403, respectively (P0.05). The hepatic and pancreatic T2*values were reduced (P0.05). Conclusions The patients with β-thalassemia major have prone to suffer from excessive iron deposition in the heart and abdominal organs. The technology of MRI quantification of T2*values could reflect the body iron overload.
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Objective To analyze the computed tomography (CT)characteristics of splenic lymphangioma and the association be-tween CT findings and pathological results.Methods The CT characteristics and pathological findings of 9 patients with splenic lym-phangioma were retrospectively analyzed.Results There were 8 cavernous lymphangioma and 1 cystic lymphangioma.Of the 9 ca-ses,it revealed that the percentage of blood vessel elements ranging from 5% to 50% via microscope.CT found 2 cases were with single lymphangioma,3 with multiple lesions,exhibiting as round or round-like mass;4 cases were found with diffuse lymphangio-ma and different size of cystic masses distributed across spleen.Five of the 9 cases who were with single or multiple lymphangioma showed circular and thin line-like cyst wall,while the remaining 4 cases showed latticed cyst wall in CT characteristics.The content in the cysts were with uneven density in all the 9 cases with CT value ranging from 10 to 40 HU,3 of which combined with sand-like calcification.Enhancement scanning found two characteristics:(a)cyst wall and separation were mildly enhanced,especially in the delayed phase;(b)the content in the cyst presents anomalous small patchy and mild enhancement.The enhancement of the content in the cyst did not change as the increasing of blood vessel composition.Conclusion CT examination will help the diagnosis of splenic lymphangioma and is of significance in informing clinical treatment.
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Objective To observe the growth characteristics and multi-time dynamic contrast-enhanced MR(DCE-MR)findings of rabbit VX2 liver tumor on MR imaging, and to provide a reliable basis for the values of MR in assessment of non-surgical treatment effect of rabbit VX2 liver tumor.Methods 10 rabbit VX2 liver tumor models were established by liver tissue embedding through laparotomy under direct vision and DCE-MRI scaning was performed at the 2nd,3rd,4th and 5th week after establishment.The tumor volume (V)and tumor growth rate (TGR)were calculated at different time points and the signal characteristics were analyzed on MR imaging;then all the rabbits were excuted and HE staining were performed to observe the cancer cells in different places with microscope.Results The TGR at the 3rd week after establishment (404.16%±114.64%)was significantly higher than that at the 4th week (223.49%±65.90%)(t=3.417,P<0.05).The tumors with well-boundary were rim-like enhanced significantly and the central parts were not enhanced on DCE-MR imaging,and the parts between the edge and centre of tumors were heterogeneously mild enhanced. The HE staining results showed that 6 cases of tumor were squamous cell carcinoma and the cells were distributed densely in the edge,the cancer cells and necrosis were distributed equally in the parts between the edge and centre of tumors and the centre of tumors were necrosis parts.Conclusion The rabbit VX2 liver tumor grows rapidly at the 3rd week after establishment, and its histological features can be better reflected by DCE-MRI.
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Objective To explore the value of MRI-R2 * and to compare clinical effect of two iron chelators(deferasirox and deferoxamine) in iron-overloaded patients.Methods By completely randomized balanced design,24 iron-overloaded patients were randomly divided into 2 groups,which consisted of 12 patients treated with deferasirox and 12 patients treated with deferoxamine.The planned deferasirox dose was 40 mg· kg-1 · d-1,and the deferoxamine dose was no less than 50 mg · kg-1 · d-1 All patients underwent quantitative MRI at the time points of the primary screening,6 months and 12 months.Pair Wilcoxon rank sum test was used to compare the differences of liver R2 * values of the 2 groups at various time points respectively.Wilcoxon rank sum test was used to compare the differences of change rate of liver R2 * values between the two groups at the time point of 6 months,12 months,respectively.Results Deferasirox group's liver R2 * values of primary screening,6 months and 12 months were 1081,889 and 712 Hz,while deferoxamine group's liver R2 * values were 1042,838 and 488 Hz.There was no statistically significant difference between liver R2 * values of two groups at primary screening (Z =-0.029,P ＞ 0.05).The change rate of liver R2 * of deferasirox group at 12 month was-32％,while it was-58％ for the deferoxamine group,and there was statistically significant difference between the two groups (Z =-3.060,P ＜0.01).The change rate of serum ferritin of deferasirox group at 12 month was-15％,while it was -55％ for the deferoxamine group,and there was statistically significant difference between the two groups (Z =-2.945,P ＜ 0.01).Conclusion By using MRI-R2*,it suggest that both deferasirox and deferoxamine can effectively remove liver iron and deferoxamine is superior to deferasirox.
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ObjectiveTo investigate the value of the MSCT liver perfusion imaging parameters inthe evaluation of the chronic hepatic fibrosis and cirrhosis. Methods Liver CT perfusion ( CTP ) was performed in 107 participants,including 31 patients with mild hepatic fibrosis( S1,S2),34 patients with severe hepatic fibrosis ( S3,S4 ) and early stage of hepatic cirrhosis which conformed by liver pathologic biopsy,42 patients with hepatic cirrhosis who had typical clinical and image signs,and 30 healthy subjects as control group.The data of CTP ( HAP,PVP,LTP,HPI and TTP) at different stages were obtained with Body perfect CT-syngo CT2007A and control study with histopathologic stage.Compared the study index by the one-way ANOVA analysis. Used Spearman rank correlation to analysis the relationship between liver perfusion imaging parameters and the degrees of the chronic hepatic fibrosis. Used Logistic regression to analysis the maximum.regression coefficient among the liver perfusion imaging paraneters,which affected the histopathologic stage mostly.ResultsIn the subgroups of the chronic hepatic fibrosis S1,S2,S3,S4 to the hepatic cirrhosis,HAP values was (28.9 ±8.6),(24.6 ±2.4),(29.2 ±2.3) and (38.9 ± 7.0) ml · 100 ml -1 · min-1,respectively.HAP decreased firstly,then increased.Statistic analysis showed the difference of HAP between later-stage cirrhosis and other groups( F =40.26,P ＜ 0.01 ).PVP values of above subgroups was (111.3 ± 18.1),(92.9 ±5.3),(73.0 ±9.0) and (54.1 ± 13.8) ml · 100 ml-1 ·min -1,respectively.TLP values of above subgroups was ( 140.2 ± 25.9 ),( 117.1 ± 4.5 ),( 102.3 ± 8.7 )and (93.0 ± 11.8) ml · 100 ml-1.min-1,respectively.The difference of PVP,TL.P among each subgroup was significant ( F =136.79,67.40,respectively,P ＜ 0.01 ).HPI values of above subgroups was (20.4 ± 2.6)％,(21.0 ±2.1)％,(28.5 ±3.1)％ and (42.6± 11.1)％,respectively.TTP values of above subgroups was (123.7±22.2),(137.1 ±27.1),(145.0 ±28.6) and (166.5 ±25.1)s,respectively.The difference of HPI,TTP among each subgroup was significant( F =93.05,17.37,respectively; P ＜0.01 ).PVP,TLP was significant negative correlation with the degree of the hepatic fibrosis( r =-0.920,-0.846,respectively; P ＜0.01 ).HAP,HPI and TTP was significant positive correlation with the degree of the hepatic fibrosis( r =0.611,0.882 and 0.545,respectively; P ＜ 0.01 ).Logistic regression analysis showed the regression coefficient of PVP( - 8.798) was maximum.With an area under the receiver operating characteristic curve of PVP =84.76 ml · 100 ml- 1 · min- 1 as a diagnose critical point.The sensitivity was 0.890,the specificity was 0.950,and the accuracy was 0.931 in the prediction of the chronic hepatic fibrosis.Conclusions MSCT liver perfusion imaging parameters can reflect the hemodynamic changes of chronic hepatic fibrosis and cirrhosis.CTP may be helpful for differentiation the severe hepatic fibrosis and early stage of hepatic cirrhosis and later-stage cirrhosis.
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Objective To study the correlation of multi-slice CT portography (MSCTP) and digestive endoscopy in the diagnosis and evaluation of esophageal and gastric varices (EGV) caused by cirrhosis.Methods A total of 92 patients with cirrhosis were enrolled in the prospective study.All the patients were examined by endoscopy and 64-slice spiral CT scan in 4 weeks.The types,grading of EGV were observed by endoscopy and MSCTP,and Kappa conformance test was applied with the endoscopic findings as gold standard.The sensitivity,specificity,consistency,and Youden index were evaluated for the diagnosis of sophageal and gastric varices by MSCTP.Results Sixty-five patients were diagnosed to have EGV by endoscopy and 27 were negative.The positive patients included 45 patients of GOV1,19 of GOV2 and 1 patient of IGV1.MSCTP diagnosed 67 cases of EGV and 25 patients of negative results.The positive patients included 46 of GOV1,18 of GOV2 and 3 of IGV1.Two patients of IGV1 varicose veins without positive findings on endoscopy were diagnosed by using MDCTP,which revealed isolated varicose veins under the gastric mucosa.There was high consistency between MSCTP and EGV in the diagnosis of EGV (Kappa =0.732,P ＜ 0.01).The sensitivity of MSCTP was 93.8％,specificity was 77.8％,consistency was 89.1％,and Youden index 71.6％.There was high consistency between MSCTP and EGV in the classification of EGV (Kappa values were 0.743 and 0.763,P ＜ 0.01).Conclusions There is high consistency between MSCTP and digestive endoscopic in the diagnosis and classification of EGV in cirrhosis.MSCTP is superior to endoscopy in the detection of gastric varices.
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Objective Using MRI-T2 * method to quantify the cardiac iron overload in patients with β-thalassemia major and to evaluate the correlation between cardiac T2 * values and serum ferritin (SF),liver iron concentration(LIC).Methods Fifty-eight over 10 years old transfusion-dependent patients with β-thalassemia major were underwent MRI heart measurement to obtain T2 * values.Spearman rank correlation was used to analyze the relationship between cardiac T2*,SF,and LIC.Patients were divided into two groups based on standard setting (SF ＞2500 μg/L or LIC ＞ 15 mg/g of dry tissue).Differences of cardiac T2 * values between two groups were evaluated by Wilcoxon rank sum test with cardiac T2 * ＜ 20 ms as diagnosis standard.The sensibilities and specificities of prediction for cardiac iron deposition with the index of SF ＞ 2500 μg/L or LIC ＞ 15 mg/g dry tissue were calculated,and receiver operating characteristic (ROC) curve analysis was performed.Results The range (median) of cardiac T2 * values,SF and LIC in 58 patients were 4.7-51.1 ms (14.0 ms),1345-23 640 μg/L (5741 μg/L),9.0-＞43.0 mg/g dry tissue (41.4 mg/g),respectively.There was no linear correlation between cardiac T2 * values and SF (r =-0.240,P =0.070).Cardiac T2 * values and LIC was weakly correlated (r =-0.420,P =0.002).The range (median) of cardiac T2 * values was 6.1-47.6 ms (23.7 ms) in 7 patients of SF ≤ 2500 μg/L group.The range (median) of cardiac T2 * values was 4.7-51.1 ms(13.5 ms) in 51 patients of SF ＞2500 μg/L group.There was no statistically significant difference between two groups (Z =-0.489,P =0.625).The range (median) of cardiac T2 * values was 24.4-51.1 ms (44.8 ms) in 5 patients of the LIC ≤15 mg/g dry tissue group.The range (median) of cardiac T2 * values was 4.7-45.5 ms (13.2 ms) in 53 patients of HIC ＞ 15 mg/g dry tissue group.There was significant difference between T2 * values of the two groups(Z =-2.895,P =0.004).To predict cardiac iron deposition,the sensibilities and specificities were 90.9％ (30/33) and 16.0％ (4/25) for the index of SF ＞2500 μg/L,100.0％ (33/33) and 20.0％(5/25) for LIC ＞ 15 mg/g dry tissue respectively.The areas under the ROC curve were 0.652 with the index of SF and 0.775 with the index of LIC.Conclusions MRI-T2 * method can directly quantify the cardiac iron overload in patients with β-thalassemia major.There is no linear correlation between cardiac T2 * values and SF.Cardiac T2 * values and LIC is weakly correlated.Using SF or LIC as an indirect index to predict cardiac iron deposition is not reliable in clinical.
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Objective To quantify the heart and liver iron overload in thalassemia patients and discuss the relationship of iron deposition between them,and to evaluate the accuracy of using hepatic iron concentration ＞ 15 mg/g dry tissue as an index to predict heart iron deposition as used in clinical practice.Methods One hundred and three transfusion-dependent patients with thalassemia,who were older than 5 years,underwent MRI heart and liver measurement to obtain T2 * values.The Spearman rank correlation was employed to analyze the relationship between cardiac T2 * and liver T2 * values.By using liver T2 * =0.96 ms as standard setting,patients were divided into two groups,and the differences of cardiac T2 * values between the two groups were compared by Wilcoxon rank sum test.Then by using cardiac T2 * =10,20 ms as standard setting,patients were divided into 3 groups,and the differences of liver T2 * values among the 3 groups were compared by Wilcoxon rank sum test.The ROC curves were drawn to predict the possibility of using hepatic iron concentration ＞ 15 mg/g dry tissue as an index of cardiac iron deposition.Results The cardiac and liver T2 * values of the 103 thalassemia patients showed low correlation(r =0.453,P =0.000).With the liver T2 * value reduced,the cardiac T2* value did not decline proportionally.The cardiac T2 * value range and median of 25 patients' group whose liver T2 * ＜ 0.96 ms were 4.70 to 41.70 ms and 12.10 ms,respectively.The cardiac T2 * value range and the median of 78 patients' group whose liver T2 * ＞ 0.96 ms were 4.80 to 51.10 ms and 26.10 ms,respectively.There was statistically significant difference between those of the two groups(Z =-3.566,P =0.000).The liver T2 * value range and the median of 20 patients'group whose cardiac T2 * ＜ 10 ms was 0.68 to 3.83 ms and 1.06 ms,respectively.The liver T2 * value range and the median of 58 patients' group whose cardiac T2 * ≥20 ms were 0.74 to 14.80 ms and 1.76 ms,respectively.There was statistical difference between those of the two groups(Z =-3.553,P =0.000).The liver T2 * value range and the median of 25 patients' group with cardiac 10 ms≤T2 * ＜20 ms were 0.69 to 13.59 ms and 0.99 ms,respectively.The values were significantly different from that of T2* ≥20 ms group(Z =-3.951,P =0.000).The liver T2 * values of cardiac T2* ＜ 10 ms group was not statistically different from that of 10 ms≤T2* ＜20 ms group(Z =-0.046,P =0.964).To predict cardiac iron deposition with the index of hepatic iron concentration ＞ 15 mg/g dry tissue,the area under the ROC curve was 0.771.The sensibility was 42.2％,the specificity was 89.7％.Conclusions There is low correlation between heart and liver iron level in thalassemia patients with long-term transfusions.Patients with hepatic iron concentration ＞ 15 mg/g dry tissue have a higher incidence of heart iron deposition,but the accuracy of using hepatic iron concentration as an index to predict myocardial iron deposition is low to moderate.
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Objective To evaluate X-ray and MRI features of limbs in childhood acute leukemia.Methods Thirteen children with acute leukemia in our pediatric hematology ward were recruited.Allpatients were pathologically diagnosed by bone marrow aspiration and complained of bone or joint pain in the first visit.ConventionaI X-ray and MRI examinations of algesic sites were performed before clinical treatment and after complete remission.MR images were obtained with SE-T1WI,SE-T2WI and T2WI-fat suppressed sequences and symmetria bilateralis was requested while scanning.X-ray and MRI manifestations were evaluated and compared.Resuits All 13 patients had received X-ray examinations.Among them,6 had normal X-ray findings,whereas the other 7(14 sites)showed various abnormalities including radiolucent metaphyseal bands(5 sites),periosteal reaction(3 sites),osteapenia(2 sites),mixed lesions(lysissclerosis,1 site),and permeative pattern(3 sites).The number of patients for MRI examinations was 8(11 sites).Among them,6(9 sites)showed bone marrow infiluration and bone marrow necrosis accompanied by normal X-ray findings,another 2(2 sites)showed bone marrow infiltration associated with radiographic abnormalities of periosteal reaction and radiolucent metaphyseal bands.Four cases were followed up within 1 week when reached complete remission by chemotherapy.MR images features included reduced sizes of bone marrow infiltration lesions associated with increased signal intensity on T1WI,and disappearance of double-line sign on bone marrow necrosis accompanied by signal homogenization.However,the radiograph before and after treatment in the same cases did not differ significantly.Conclusions MRI was earlier and more comprehensive in showing limbs bone marrow abnormality than radiogram in acute leukemia children with chief complaint of osteoarticular pains.MRI might be one of indicators in following up therapeutic effect for AL children with osteoarticular disorder.
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Objective To investigate MRI manifestations of lumbar and proximal femoral bone marrow changes before and after recombinant human granulocyte colony stimulating factor (rhG-CSF) was subcutaneous injected for healthy adults.Methods Twenty healthy blood stem cell donors without hematologic disease were enrolled in this study. All of them underwent lumbar sagittal and proximal femur coronal MRI examination with spin echo T1 WI and fat-suppressed T2WI.The first examination were performed before subcutaneous injection of rhG-CSF for comparison. In 4-7 days and 30-60 days after injection, the other two examinations were performed. The signal changes of lumbar and proximal femoral bone marrow were investigated by reading pictures and calculating the contrasted noise ratio (CNR).ResultsBefore rhG-CSF injection, all patients presented normal signal intensity of hone marrow. In 4-7 days after injection, all the 20 cases presented homogeneous signal decrease in lumbar vertebral bodys on T1 WI, accompanied by reduced fatty signal. In proximal femur, patchy or stripped hypointensity areas were found in intertrochanteric and subtrochanteric areas on T1 WI. On fat-suppressed T2 WI images, the signal of lumbar and proximal femoral bone marrow changed to equal or slightly-high signal intensity. In all cases,abnormal signal areas presented in lumbar and proximal femoral bone marrow occurred simultaneously in the same case.In the 10 cases received the third MRI during 30-60 days after rhG-CSF injection, signal intensity of lumbar bone marrow turned to normal in all sequence, but abnormal signal intensity areas were still existed and extended to distal part in femoral bone marrow, which appeared as symmetric stripped or patchy equal or slightly-low signal intensity on T1 WI and equal or slightly-high signal intensity on T2 WI. The CNR of lumbar bone marrow to subcutaneous fat before rhG-CSF injection, in 4-7 days and 30-60 days after rhG-CSF injection were 114. 11 ± 15. 11,71.04 ± 12. 25 and 91.64 ± 1 I. 68, respectively. Significant difference was found between before rhG-CSF injection and 4-7 days after injection ( P ＜ 0. 05 ) , but no significant difference between the others( P ＞ 0. 05 ). Conclusion After injection of rhG-CSF, the short-term changes of hematopoietic cells and fat content in bone marrow can be displayed on MRI, which provided non-invasive information for bone marrow transplantation.
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Objective To evaluate the clinical value of CT perfusion (CTP) imaging for providing quantitative information about angiogenesis in patients with lung carcinoma and investigate the correlation of CTP enhancement parameters and histological microvessel density (MVD) with lymphatic involvement in peripheral lung carcinoma. MethodsFifty-three patients with pathology-proved peripheral lung carcinoma underwent CT perfusion scan before operation. The enhancement parameters of CTP were calculated based on the time-density curves (TDC) of fist pass phase. All cases were classified into two groups according to pathologic results: tumor with and without lymph node involvement. Two-sample t test was used for the statistics. The ROC curve was used to assess the efficiency of the enhancement parameters of CT perfusion and MVD for predicting lymphatic involvement.Results Tumors with lymph node involvement had significantly higher value of MVD than those without lymph node involvement (64.69±16.34 and 42.67± 16.78, respectively,t=4.84,P<0.01). Tumors with lymph node involvement had significantly higher value of CTP enhancement parameters (PH, M/A, PV) than those without lymph node involvement [PH= (41.79±15.50) and (29.99±10.91) HU,M/A =0.24±0.09 and 0.15±0.06, PV=(2.14±1.09) and (1.27±0.53) ml·min~(-1)·ml~(-1), t=3.21,3.95, 3.66, P<0.01, respectively]. The CTP enhancement parameters (PH, M/A, PV) of lung cancer correlated positively with the MVD, the highest correlation coefficient was between the PV and MVD (r=0.716, P<0.01). MVD and PV had higher values for predicting lymph node involvement in ROC curve analysis.The sensitivity, specificity and accuracy for predicting lymph node involvement were 80.8%, 81.5% and 81.1% or 84.6% ,85.2% and 84.9% respectively if MVD>52/0.74 mm~2 or PV>1.52 ml·min~(-1)·ml~(-1). ConclusionThe CT perfusion PV and histological MVD have good correlation with lymph node involvement in peripheral lung carcinoma and are important predicting parameters before operation.
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Objective To evaluate clinical application value of DWI and reservation of liver function in patients with chronic liver disease. Methods Thirty cases of healthy control group, and 60 case group with chronic liver disease,including both 30 chronic hepatitis B and 30 cirrhosis. liver function in case group was analysed by venous blood samples. Case groups were divided into three groups according to MELD score: ＜30 group in 27 cases, 30 to 36 group in 17 cases, ＞36 group in 16 cases. All cases underwent liver magnetic resonance DWI. Among the case group, 15 cases were followed-up twice of pre- and aftertreatment. DWI images were read, ADC values of liver parenchyma were measured and standardized with the cephalospinal fluid (CSF) at the same slice. Used SPSS 13.0 for windows to treat the data, group comparison of ADC values were treated by one-factor analysis of variance, interclass comparison each other by SNK method, comparison between pretherapy and post-treatment by paired-samples t test. Results Healthy liver parenchyma of the control group is homogeneous signal on DWI. ADC pseudo-color pictures showed green on the homogeneous areas. Slightly restricted area of chronic hepatitis B showed irregular scattered patchy in DWI images, 25 cases in right and left lobes, 5 cases only in right lobe of the liver. ADC pseudo-color pictures reaveled blue region in proliferation-constrained areas. Restricted areas of the liver parenchymal become more evident, also showed an irregular liver edge in 30 cases of cirrhosis. The standarized ADC average values were: the healthy group (0. 47 ±0. 02) × 10-3 mm2/s, chronic hepatitis B group (0. 37 ±0. 03) × 10-3 mm2/s, cirrhosis group (0. 36 ±0. 04) × 10-3 mm2/s( F =97.05,P ＜0. 05).The difference between healthy group and patients group was statistically significant (P ＜ 0. 05 ). No statistically significant difference between groups of chronic hepatitis B and liver cirrhosis ( P ＞ 0. 05 ).Average ADC values of MELD score among groups of ＜ 30, 30 to 36, ＞ 36 were ( 0. 38 ± 0. 02 ) ×10-3 mm2/s,(0.35 ±0.02) × 10-3 mm2/s, (0.32 ± 0.03) × 10-3 mm2/s respectively. There is a significant difference among the three groups (P ＜0. 05). After treatment, DWI of 15 patients with chronic liver disease showed reduction in restricted areas, and the average ADC value from pre-treatment (0. 33 ±0. 03) × 10-3 mm2/s increased to(0. 38 ±0. 03) × 10-3 mm2/s, MELD score from pre-treatment 36. 01 ±6. 00 reduced to 27. 83 ± 4. 86. Conclusion DWI of chronic liver disease showed patchy diffuse restricted areas; more severe of the liver cell damage was, more worse the liver function was and lower ADC values was. ADC values increased after effective treatment, liver function recoved and diffuse restricted areas of liver parenchyma reduced.
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Objective To study the correlation of the bone mineral density (BMD) and the body composition components of body mass index (BMI), FAT and LEAN in Chinese obesity. Methods There were 150 cases in obesity group diagnosed by BMI, including 75 males[ median age 46 years, mean weight (89. 64±8. 33) kg] and 75 females[ median age 45 years, mean weight (77.23±6. 85) kg]. There were 150 persons with normal BMI in the control group, including 75 males [ ( median age 47 years, mean weight (62. 34±5.72) kg] and 75 females [ median age 45 years, mean weight (50. 16±5.06) kg]. The body height and weight of 300 persons in two groups were measured respectively and, simultaneously calculated the BMI. These data and the body composition parameters measured by the dual energy X-ray absorptiometry (DEXA) in these two groups were compared and analyzed. The data obtained used two-sample t-test analysis, bi-variable correlation used Pearson linear correlation analysis and multi-variable correlation used multiple linear regression analysis. Results FAT of arms, legs, trunk and total body of male cases in obesity group was (2.90±0.57), (7.48±1.46), ( 15.67±3.05 ), ( 30.92±5.94 ) kg respectively, FAT% was ( 30.9±5.1 ) %, ( 30.6±5.8 ) %, ( 37. 3±4.7 ) %, ( 35.1±4.4 ) % respectively, it was significantly higher than that in control group [ FAT was ( 1.12±0. 64 ), (3.27±1.22), (6. 71±3. 29 ), ( 11.61± 5. 16) kg respectively,FAT% was( 15.4±4. 8)%, ( 16. 5±5.0)%, (21.8±5.8)%, ( 18.6±5. 3)% respectively] ,P <0. 01 ;LEAN of trunk and total body of male cases in obesity group was (27.65±4. 08), (57. 09±7.08 ) kg respectively ; BMD was ( 0. 99±0. 09 ), ( 1.22±0. 09 ) g/cm2 respectively, it was significantly higher than that in control group [ LEAN was ( 22. 89±1.68 ), (48.89 s 3.72 ) kg respectively, BMD was( 0. 89±0. 07 ), ( 1.15±0. 06 ) g/em2 respectively ], P < 0. 01 ; LEAN of arms and legs of male cases in obesity group was(6.22±0.92), (17.31±2.65) kg respectively; BMD was(0.92±0. 04), (1.31±0. 09)g/cm2 respectively,and there were no statistical significance compared with those in control group [ LEAN was ( 5.99±0. 72 ), ( 16. 83±1.67 ) kg respectively, BMD was ( 0. 90±0. 08 ), ( 1.29± 0.09) g/cm2 respectively]. FAT of arms, legs, trunk and total body of females in obesity group was (3.78±1.53), ( 12. 61±3.72), ( 17. 56±2. 59), (33.71±6. 96) kg respectively, FAT% was (33.8± 4.0)%,(40. 1±6.9)%,(43.9±4.9)%, (43.5±4.2)% respectively, LEAN was(7.28±0.94), ( 14. 40 ±2. 05 ), ( 20. 71±3.08 ), ( 43.43±5.69 ) kg respectively, BMD was ( 0. 86±0. 08 ), ( 1.27± 0. 12),(0.95±0. 14), (1.19±0.09)g/cm2 respectively, they were significantly higher than those in control group [ FAT was(2. 04±0. 79), (3.79±0. 94), (6. 89±2. 56), ( 14. 68±3.57) kg respectively, FAT% was (27. 2±4. 5 ) %, ( 29. 6±3.9 ) %, ( 31.0±3.8 ) %, ( 25.9±4. 9 ) % respectively, LEAN was (5. 25±0. 63), ( 10. 65±1.44), ( 16. 65±1.50), (33. 10±3.22) kg respectively, BMD was (0. 78± 0. 04), ( 1.11±0. 09), ( 0. 82±0. 07 ), ( 1.05±0. 07 ) g/cm2 respectively ], P < 0. 01. Conclusion The significantly increasing of fat tissue in all parts of body is a major cause of change of body composition components in obesity. FAT in the trunk increases more obviously than that in other parts of the body in both males and females. The change of distribution of FAT and LEAN can obviously influence BMD.
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Objective To investigate the value of MRI and~1H-MRS in diagnosis of early stage of diabetic encephalopathy by detecting regional metabolite in cynomolgus diabetes models. Methods Five pathogen-free male adolescent cynomolgus were made type 1 diabetes mellitus models (T1DM) by intravenous injection of streptozotocin (STZ) (100 mg/kg), and the reliability and stability of the modes were assessed with long term follow-up of blood glucose and intravenous glucose tolerance tests. MRI and ~1H-MRS were performed to evaluate the volume, signal intensity and metabolic ratios of NAA/Cr, mI/Cr and Cho/Cr at hippocampus, lateral temporal lobe and occipital lobe 3 years after model establishment. Cortisol in serum was detected with immunoradiometric assay. In addition, 5 normal adult cynomolgus monkeys were selected in the control group and accepted the same examination above. Results ①Intravenous administration of STZ could made stable T1DM monkey model. ②Only mI/Cr ratio increased at hippocampus of diabetic monkeys compared to the control group (P<0.05). ③There was no statistical difference of cortisol in serum between the diabetic group and the control group (P＞0.05). Conclusion ~1H-MRS may detect the metabolic changes of the hippocampus in STZ-induced diabetic adolescent cynomolgus monkeys and may contributes to the early diagnosis of diabetic encephalopathy.