Subcortical Volume Changes in Schizophrenia and Bipolar Disorder: A Quantitative MRI Study

SUMMARY: Volume abnormalities in subcortical structures, including the hippocampus, amygdala, thalamus, caudate, putamen, and globus pallidus have been observed in schizophrenia (SZ) and bipolar disorder (BD), not all individuals with these disorders exhibit such changes. In addition, the specific patterns and severity of volume changes may vary between individuals and at different stages of the disease. The study aims to compare the volumes of these subcortical structures between healthy subjects and individuals diagnosed with SZ or BD. Volumetric measurements of lateral ventricle, globus palllidus, caudate, putamen, hippocampus, and amygdale were made by MRI in 52 healthy subjects (HS), 33 patients with SZ, and 46 patients with BD. Automatic segmentation methods were used to analyze the MR images with VolBrain and MRICloud. Hippocampus, amygdala and lateral ventricle increased in schizophrenia and bipolar disorder patients in comparison with control subjects using MRIcloud. Globus pallidus and caudate volume increased in patients with schizophrenia and bipolar disorder compared control subjects using Volbrain. We suggested that our results will contribute in schizophrenia and bipolar disorder patients that assessment of the sub-cortical progression, pathology, and anomalies of subcortical brain compositions. In patients with psychiatric disorders, VolBrain and MRICloud can detect subtle structural differences in the brain.

Se han observado anomalías de volumen en las estructuras subcorticales, incluidos el hipocampo, la amígdala, el tálamo, el núcleo caudado, el putamen y el globo pálido, en la esquizofrenia (SZ) y el trastorno bipolar (BD); no todos los individuos con estos trastornos presentan tales cambios. Además, los patrones específicos y la gravedad de los cambios de volumen pueden variar entre individuos y en diferentes etapas de la enfermedad. El estudio tuvo como objetivo comparar los volúmenes de estas estructuras subcorticales entre sujetos sanos e individuos diagnosticados con SZ o BD. Se realizaron mediciones volumétricas del ventrículo lateral, globo pálido, núcleo caudado, putamen, hipocampo y amígdala mediante resonancia magnética en 52 sujetos sanos (HS), 33 pacientes con SZ y 46 pacientes con BD. Se utilizaron métodos de segmentación automática para analizar las imágenes de resonancia magnética con VolBrain y MRICloud. El hipocampo, la amígdala y el ventrículo lateral aumentaron en pacientes con esquizofrenia y trastorno bipolar en comparación con sujetos de control que utilizaron MRIcloud. El globo pálido y el núcleo caudado aumentaron en pacientes con esquizofrenia y trastorno bipolar en comparación con los sujetos control que utilizaron Volbrain. Sugerimos que en pacientes con esquizofrenia y trastorno bipolar, nuestros resultados contribuirán a la evaluación de la progresión subcortical, la patología y las anomalías de las composiciones cerebrales subcorticales. En pacientes con trastornos psiquiátricos, VolBrain y MRICloud pueden detectar diferencias estructurales sutiles en el cerebro.

Utilidad del complejo posterior para el diagnóstico prenatal de sintelencefalia

Introducción y objetivo: Demostrar el valor del plano axial del complejo posterior, como apoyo a la detección antenatal de sintelencefalia, variante de holoprosencefalia. Método: Se incluyeron todas las pacientes con diagnóstico de sintelencefalia evaluadas desde el año 2008. En todos los casos se consignaron los datos clínicos, de neurosonografía (NSG), de resonancia magnética (RM) y genética. Resultados: Cuatro casos fueron diagnosticados en el segundo trimestre y en todos se realizó estudio genético y RM. Tres tuvieron en su evolución anomalías extra-SNC y dos de ellos alteraciones cromosómicas, una de ellas incompatible con la vida extrauterina. Lo hallazgos descritos en neuroimagen para esta afección fueron detectados en la NSG, con una excelente correlación con RM, ya fuera esta última realizada en periodo fetal o posnatal. Conclusión: El diagnóstico prenatal de variantes de holoprosencefalia es difícil, considerando la existencia de una fusión medial más acotada que en las formas clásicas. El presente estudio demuestra la utilidad del plano del complejo posterior para la sospecha diagnóstica de sintelencefalia.

Introduction and objective: To demonstrate the value of the axial plane of the posterior complex, as a clue for the antenatal detection of synthelencephaly, a variant of holoprosencephaly. Method: All patients diagnosed with syntelencephaly evaluated since 2008 were included. In all cases, clinical, neurosonography (NSG), magnetic resonance imaging (MRI) and genetic data were recorded. Results: Four cases were diagnosed in the second trimester and in all of them a genetic study and MRI were performed. Three had extra-CNS anomalies in their evolution and two of them chromosomal anomalies, one of them incompatible with extrauterine life. Neuroimaging findings described for this condition were detected by NSG, with an excellent correlation with MRI, whether the latter was performed in the fetal or postnatal period. Conclusion: The prenatal diagnosis of holoprosencephaly variants is difficult, considering the existence of a more limited medial fusion than in the classical forms. The present study demonstrates the usefulness of the posterior complex plane for the diagnostic suspicion of synthelencephaly.

Aspects cliniques et IRM de l'endométriose pelvienne à Abidja: à propos de 68 cas / Clinical and MRI findings of pelvic endometriosis in Abidjan: A study of 68 patients

Introduction.L'endométriose est une pathologie mal connue et sous explorée en Afrique en particulier en Côte d'Ivoire. L'objectif de notre étude était d'étudierles caractéristiques épidémio-cliniques et à l'imagerie par résonnance magnétique(IRM)de l'endométriose pelvienne à Abidjan.Méthodologie. Il s'agissait d'une étude prospective et descriptive qui s'est déroulée à Abidjan sur une durée 15 mois. Les examens ont été réalisés sur une IRM 1,5 T avec les séquences conventionnelles. Les patientes retenues ont réalisé une IRM du pelvis pour suspicion d'endométriose pendant la période. N'ont pas été retenues les patientes qui ont réalisés l'examen pour d'autres affections gynécologiques. L'ensemble des données ont été recueillies à partir des comptes rendus d'IRM des patientes. Les paramètres épidémio-cliniques; les paramètres IRM des lésions endométriosiques ont été étudiés. Nous avons utilisé le test de khi carré pour vérifier le lien entre certains facteurs.Résultats.Nous avons enregistré 68 patientes dont l'âge moyen était de 38,61 ans. L'adénomyose représentait la localisation la plus fréquente (67,65%) suivi de l'atteinte ovarienne (35,29%). Dans l'adénomyose, la zone jonctionnelle était inférieure à 20 mm dans 44,19%. L'endométriose ovarienne a été objectivée chez 24 patientes, soit 35,29% des cas. Une endométriose sous péritonéale a été objectivée dans 19,12% des cas. L'atteinte tubaire était de 10,29%. L'association endométriose et fibrome a été observé chez 44,12% des patientes. Le risque d'adénomyose était élevé après 40 ans p < 0,005.Conclusion.L'IRM apparait comme l'examen d'imagerie de référence dans le diagnostic et le bilan d'extension de l'endométriose pelvienne. A Abidjan, le diagnostic d'endométriose se fait à un âge avancé.

Introduction.Endometriosis is a poorly understood and under-explored condition in Africa, particularly in Ivory Coast. The aim of our study was to investigate the epidemiological and clinical characteristics, as well as magnetic resonance imaging (MRI) features of pelvic endometriosis in Abidjan. Methodology.This was a prospective and descriptive study conducted in Abidjan over a period of 15 months. The examinations were performed on a 1.5 T MRI machine using conventional sequences. Patients who underwent pelvic MRI for suspected endometriosis during the study period were included, while those who underwent the examination for other gynecological conditions were excluded. All data were collected from the MRI reports of the patients. Epidemiological and clinical parameters, as well as MRI parameters of endometriotic lesions, were analyzed. The chi-square test was used to verify the association between certain factors. Results.We included 68 patients with a mean age of 38.61 years. Adenomyosis was the most common localization (67.65%), followed by ovarian involvement (35.29%). In adenomyosis, the junctional zone was less than 20 mm in 44.19% of cases. Ovarian endometriosis was documented in 24 patients, accounting for 35.29% of cases. Subperitoneal endometriosis was observed in 19.12% of cases. Tubal involvement was seen in 10.29% of cases. The co-occurrence of endometriosis and fibroids was observed in 44.12% of patients. The risk of adenomyosis was higher after the age of 40 (p < 0.005). Conclusion.MRI appears to be the imaging modality of choice for diagnosing and assessing the extent of pelvic endometriosis. In Abidjan, endometriosis is diagnosed at an older age.

Apport de l'IRM multimodale dans la prise en charge des tumeurs encéphaliques chez l'adulte à Abidjan / Contribution of multimodal MRI in the management of brain tumors in adults in Abidjan

Dans le monde, le nombre de nouveaux cas de tumeurs encéphaliques était de 14 millions en 2014 avec environ 8 millions de personnes décédées. Objectif: déterminer l'efficacité diagnostique de l'IRM multimodale dans la prise en charge des tumeurs encéphaliques dans notre contexte. Matériels et Méthodes: Etude rétrospective à visée descriptive, multicentrique sur une période de 2 ans allant de février 2017 à mars 2019, dans 2 services de radiologie et 2 services de Neurochirurgie, à Abidjan. Nous nous sommes intéressés àtous les patients ayant réalisé une IRM multimodale pour suspicion d'un processus tumoral encéphalique, et qui ont eu une exérèse chirurgicale suivie d'un examen anatomopathologique de la pièce opératoire. Les examens d'IRM multimodale encéphaliques ont été réalisés selon un protocole standard sur des appareils de 1,5 Tesla, et lus par des radiologues séniors. Nous avons confronté les résultats anatomopathologiques aux diagnostics posés à l'imagerie IRM multimodale.Résultats: Ont été retenu 18 dossiers. On notait une prédominance masculine avec un sex-ratio de 1,57. L'âge moyen était de 42,8 ans avec des extrêmes de 20ans et 61ans et un écart type de 10,75.La corrélation diagnostique entre l'examen anatomopathologique et l'IRM a été de6 sur 7 cas, 4 sur 5 cas, 2 sur 2 cas, 2 sur 2 cas et 1 sur 1 cas respectivement pour le méningiome, le gliome, les métastases, l'adénome hypophysaire, le lymphome cérébral primitif.Conclusion:Les tumeurs encéphaliques dans notre étude, étaient variéeset concernaient la population jeune. Les motifs d'erreur diagnostique étaient essentiellement en rapport avec la variété de présentations des tumeurs à l'IRM et l'expérience récente de nos radiologues sur l'utilisation efficace des séquences avancées.

Worldwide, the number of new cases of brain tumors was 14 million in 2014 with approximately 8 million people dying.Objective: determine the diagnostic effectiveness of multimodal MRI in the management of brain tumors in our context.Methods: Retrospective study with a descriptive aim, multicenter over a period of 2 years from February 2017 to March 2019, in 2 radiology departments and 2 neurosurgery departments, in Abidjan. We were interested in all patients who had a multimodal MRI for suspicion of a brain tumor process, and who had a surgical excision followed by an pathological examination of the surgical specimen. The multimodal brain MRI examinations were carried out according to a standard protocol on 1.5 Tesla devices, and read by seniorradiologists. We compared the pathological results with the diagnoses made on multimodal MRI imaging.Results:18 files were retained. There was a male predominance with a sex ratio of 1.57. The average age was 42.8 years with extremes of 20 and 61 years and a standard deviation of 10.75. The diagnostic correlation between the pathological examination and MRI was 6 out of 7 cases, 4 out of 5 cases, 2 out of 2 cases, 2 out of 2 cases and 1 out of 1 case respectively for meningioma, glioma, metastases, pituitary adenoma, primary cerebral lymphoma.Conclusion: The brain tumors in our study were varied and concerned the young population. The reasons for diagnostic error were mainly related to the variety of tumor presentations on MRI and the recent experience of our radiologists on the effective use of advanced sequences.

IRM corps entier 1, 5 T avec séquence de diffusion dans l'évaluation du cancer à propos de 124 cas / 1. 5 T Whole Body MRI with diffusion sequence in cancer assessment about 124 cases

L'IRM corps entier de diffusion 1,5T est une technique d'imagerie qui fournit des renseignements aussi bien morphologique que fonctionnel avec de nombreuses indications notamment dans les pathologies cancéreuses. Objectif: Faire le bilan d'activité de l'IRM corps entier en insistant sur son apport dans la pathologie cancéreuse. Méthodologie:Etude transversale descriptive avec collecte rétrospective des donnéesincluant les patients ayantréalisé une IRM corps entier pourtumeur maligne sur une période de quatre ans. La saisie et l'analyse des données ont été réalisées grâce aux logiciels Epi Info.Résultats:31,19% des patients avaient un âge compris entre 61 et 70 ans. Le cancer de la prostate était le plus représenté avec 34,68% suivi du cancer du sein 31,45%. L'IRM corps entier était réalisée pour le bilan d'extension dans 39,52% et dans 37,10% pour un bilan d'évolutivité. Les localisations métastatiques étaient observées dans 49% des cas avec une atteinte prépondérantede l'étage abdomino-pelvien 72,13%. Les localisations métastatiques osseuses étaient de 73,77%,hépatiques 26,23% et pulmonaire 14,75%. Les atteintes ganglionnaires de 57,14%. Une progression tumorale a été observée chez 53,33% des patients lors du suivi.Conclusion: L'IRM corps entier permet une fine analyse dans l'évaluation de la pathologie cancéreuse pour l'extension tumorale, la réponse thérapeutique et la recherche de cancer primiti

1.5T whole-body diffusion MRI is imaging that provides both morphological and functional information.It presents several indicationsparticularly in oncology. Objective: Assess the activity of whole-body MRI, emphasizing its contribution to oncologyMethodology:Descriptive retrospective study of patients who had undergone whole-body MRIfor malignancy over a four-year period. Data entry and analysis were performed using Epi Info software.Results:31.19% of patients were between 61 and 70 years old. Prostate cancer was the most represented with 34.68% followed by breast cancer 31.45%.Whole-body MRI was requested for an extension assessment in 39.52% and 37.10% for progress assessment. It revealed metastatic abnormalities in 49%. Abdomino-pelvic region was the most affected area with 72.13%. Metastatic organ involvement was predominantly in the bone 73.77%, followed by the liver 26.23% and the lung14.75%. Lymph node involvement was 57.14%.Tumor progression was observed in 53.33% of patients during follow-up.Conclusion:Whole body MRI allows a fine analysis in the evaluation of the cancerous pathology for the tumor extension, the therapeutic response and the search for primary cancer

Scintigraphie osseuse trois temps dans la caractérisation de l'ostéonécrose aseptique de la tête fémorale / Three-stage bone scintigraphy in the characterization of aseptic osteonecrosis of the femoral head

Objectifs. Déterminerla place de la scintigraphie osseuse 3 temps dans le diagnostic del'ostéonécrose avasculaire de la tête fémorale (OATF).Matérielset Méthode. Nousavons colligérétrospectivement62 scintigraphies osseuses (SO+)mettant en évidence uneOATF. Ces SO+ ont été réalisées au Service de Médecine Nucléaire du CHU YOde Ouagadougou,de 2017à 2022. Un formulaire de recueil de données a permis de collecter les données générales et les résultats de la scintigraphie osseuse. L'étude descriptive consistait à calculer les fréquences pour les variables qualitatives et les moyennes pour les variables quantitatives.La SO en trois temps a été faite chez tous les patients après injection de 296 à 925 MBq d'un dérivé diphosphonate : l'hydroxyméthyléne diphosphonate(HMDP) marqué au technétium 99 m (Tc99m). Résultats. 62patients ont présenté une SO+ à la recherche scintigraphique de l'OATF de 2016 à 2021. Leur âge moyen est de 35 ± 14,18 ans avec une nette prédominance féminine (75,8%). La principale étiologie retrouvée etaitla drépanocytose. La douleur coxale avec ou sans boiterie a indiquéla réalisation de la SO dans 41,66 % des cas. Lesvingt-cinqpatients (40,3%) qui avaient bénéficié d'une TDM de la hanche concernée ont été adressés pour confirmation du diagnostic (n=4), bilan pré opératoire (n=9), recherche d'autres foyers(n=12). Pour lesonzepatients atteints de pathologie cancéreuse,le diagnostic d'OATF était fortuit au décours d'une SO réalisée dans le cadre de leur bilan d'extension. Sur les images scintigraphiques tardives, les atteintes de type II de GOLLSHALK étaient majoritaires,suivies des atteintes de type III puis de type I. Il n'y avait pas d'atteinte de type IV. Conclusion. La SO est efficace dans la caractérisation de l'OATF avant l'apparition de la symptomatologie clinique et de la traduction radiologique. Lorsque l'IRM est disponible et n'est pas contre indiquée, la SO est la modalité diagnostique à utiliser en deuxième intention.

Objective: Determine the role of three-step bone scintigraphy (BS) in the diagnosis of aseptic osteonecrosis of the femoral head (AOFH).Materials and Method: Retrospectively we collected 62 positive bone scans (BS+) at aseptic osteonecrosis of the femoral (AOFH). These BS+ were carried out at the Nuclear Medicine Department of CHU YO, from 2017 to 2022. A data collection form has been prepared. It made it possible to collect general data and the results of the bone scintigraphy. The descriptive study consisted of calculating the frequencies for the qualitative and the the means for the quantitative variables. The three-step BS was performed in all patients after injection of 296 to 925 MBq of a diphosphonate derivative: hydroxy methylene diphosphonate (HMDP) labeled with technetium 99 m (Tc99m).Results: 62 patients were positive (BS +) in the aseptic avascular osteonecrosis of the femoral head scintigraphic research from 2016 to2021. Their average age is 35 ± 14.18 years with a clear female predominance (75.8%). The main etiology fremains sickle cell anemia. Hip pain with or without lameness indicated the realization of SO in 41.66% of cases. The twenty-five patients (40.3%) who had undergone CT of the affected hip were referred for confirmation of the diagnosis (n=4), preoperative workup (n=9), search for other foci (n=12). For the eleven patients with cancerous pathology, the diagnosis of AOFH was fortuitous after an BS performes as part of their extension workup. On the late scintigraphic images, type II involvement of GOLLSHALK was predominant, followed by by type then type I. There was no type IV involvement. Conclusion: BS is sensitive in the detection of aseptic avascular osteonecrosis of the femoral head before the onset of clinical symptoms and radiological translation. When MRI is available and not contraindicated, BS is the second-line modality

Grey-scale Reversed T1-weighted MRI for Detecting Structural Lesions of the Sacroiliac Joint in Patients with Axial Spondyloarthritis / 中山大学学报(医学科学版)

ObjectiveTo analyze the value of grey-scale reversed T1-weighted （rT1） MRI in the detection of structural lesions of the sacroiliac joint （SIJ） in patients with axial spondyloarthritis （ax-SpA）. MethodsFifty-two ax-SpA patients who underwent both MRI and CT in our hospital within a week from February 2020 to December 2022 were retrospectively included. Both sacral and iliac side of each SIJ on oblique coronal images were divided into anterior， middle and posterior portion. Two radiologists reviewed independently three groups of MRI including T1-weighted imaging （T1WI）， rT1 and T1WI + rT1 images to evaluate the structural lesions like erosions， sclerosis and joint space changes in each of the 6 regions of the SIJ. One of the radiologist did the evaluation again one month later. CT images were scored for lesions by a third radiologist and served as the reference standard. Intra-class correlation coefficients （ICC） were calculated to test the inter- and intra-reader agreement for the assessment of SIJ lesions. A Friedman test was performed to compare the lesion results of MRI and CT image findings. We examined the diagnostic performance ［accuracy， sensitivity （SE） and specificity］ of different groups of MRI in the detection of lesions by using diagnostic test. A McNemar test was used to compare the differences of three groups of MRI findings. ResultsCT showed erosions in 71 joints， sclerosis in 65 and joint space changes in 53. Good inter-and intra-reader agreements were found in three groups of MRI images for the assessment of lesions， with the best agreement in T1WI + rT1. There were no difference between T1WI + rT1 and CT for the assessment of all lesions， nor between rT1 and CT for the assessment of erosions and joint space changes （P>0.05）. T1WI + rT1 yielded better accuracy and SE than T1WI in detection of all lesions （Accuracy erosions： 90.3% vs 76. 9%； SE erosions： 91.6% vs 76.1%； Accuracy sclerosis： 89.4% vs 80.8%； SE sclerosis： 84.6% vs 73.9%； Accuracy joint space changes： 86.5% vs 73.1%； SE joint space changes： 84.9% vs 60.4%； P<0.05）. rT1 yielded better accuracy and SE than T1WI in detection of erosions and joint space changes （Accuracy erosions： 87.5% vs 76.9%； SE erosions： 88.7% vs 76.1%； Accuracy joint space changes： 85.6% vs 73.1%； SE joint space changes： 83.0% vs 60.4%； P<0.05）. ConclusionsIn the detection of SIJ structural lesions in ax-SpA， rT1 improves the diagnostic performance and T1WI + rT1 is more superior to others.

A comparative study of the diagnostic performance of gadoxetic acid-enhanced hepatic MRI and multislice CT in the evaluation of colorectal liver metastases / 西安交通大学学报(医学版)

【Objective】 To compare the diagnostic performance of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB) enhanced magnetic resonance imaging (MRI) and multi-detector computed tomography (MDCT) in detecting liver metastases from metastatic colorectal cancer (mCRC). 【Methods】 We made a retrospective collection of 128 patients diagnosed with mCRC from May 2019 to June 2022 at Haikou Hospital, Xiangya School of Medicine, Central South University and Xijing Hospital, Air Force Military Medical University. All patients underwent Gd-EOB MRI and MDCT imaging. Three radiologists judged the accuracy, sensitivity, specificity, positive predictive value and negative predictive value of the two modalities for colorectal liver metastases, respectively. 【Results】 Of the 128 patients diagnosed with mCRC, a total of 462 lesions were obtained, with 424 positive and 38 negative metastases confirmed by pathology. In the interpretation of physician A, Gd-EOB MRI judged 404 positive and 38 negative liver metastases, with accuracy of 95.67%, sensitivity of 95.28%, specificity of 100.00%, a positive predictive value of 100%, and a negative predictive value of 65.52%. MDCT judged 337 positive and 37 negative liver metastases, with accuracy of 80.95%, sensitivity of 79.48% and specificity of 97.37%, a positive predictive value of 99.70%, and a negative predictive value of 29.84%. In the interpretation of physician B, Gd-EOB MRI judged 403 positive and 36 negative liver metastases, with accuracy of 95.02%, sensitivity of 95.05%, specificity of 94.74%, a positive predictive value of 99.51%, and a negative predictive value of 64.91%. MDCT judged 335 positive and 35 negative liver metastases, with accuracy of 80.09%, sensitivity of 79.01%, specificity of 92.11%, a positive predictive value of 99.11%, and a negative predictive value of 28.23%. In the interpretation of physician C, Gd-EOB MRI judged 406 positive and 38 negative liver metastases, with accuracy of 96.10%, sensitivity of 95.75%, specificity of 100.00%, a positive predictive value of 100.00%, and a negative predictive value of 67.86%. MDCT judged 352 positive and 34 negative liver metastases, with accuracy of 83.55%, sensitivity of 83.02%, specificity of 89.47%, a positive predictive value of 98.88%, and a negative predictive value of 32.08%. Gd-EOB MRI judged the nature of liver metastases with higher accuracy, sensitivity and negative predictive value than MDCT, and had better agreement with pathological examination results in the judgment of physician A and physician C (Kappa=0.770, 0.788). In physician B’s judgment, the agreement with pathological findings was fair (Kappa=0.731), while the agreement between the results of MDCT examination and pathological findings was poor (Kappa=0.379, 0.378 and 0.400). 【Conclusion】 Gd-EOB MRI has higher accuracy, sensitivity and positive predictive rate than MDCT in diagnosing colorectal liver metastasis, and has higher diagnostic performance. Therefore, it can provide more valuable reference information for clinical differential diagnosis. Subcapsular lesions, peribiliary metastases and hepatic steatosis can reduce the diagnostic performance of MDCT, while Gd-EOB MRI detection can provide more accurate results than MDCT.

The latest progress of prostate targeted biopsy / 现代泌尿外科杂志

Image-guided targeted biopsy is currently the mainstream method of prostate cancer puncture biopsy, while risk stratification based on imaging and biochemical markers may become the new standard. This paper comprehensively reviews the latest advancements in various imaging techniques and strategies of targeted prostate biopsy. Ultrasound-assisted prostate biopsy mainly includes transrectal ultrasound (TRUS), transrectal-contrast enhanced ultrasound (TR-CEUS), and transrectal real-time elastography (TRTE), which can significantly increase the diagnosis rate of prostate cancer when combined with biopsy. Three-dimensional transrectal ultrasound (3D-TRUS) technology may be used in patients with a negative previous biopsy. At present, micro-ultrasound (Micro-US), the latest ultrasound method, is not inferior to mp-MRI in targeted biopsy of the prostate. Targeted biopsy by mp-MRI has improved the detection rate of clinically significant prostate cancer (csPCa), and the common NMR targeted technologies are magnetic resonance imaging-visual-targeted biopsy (MRI-visual-TB), magnetic resonance imaging-fusion-targeted biopsy (MRI-fusion-TB), and in-bore magnetic resonance imaging-target biopsy (MRI-TB). The fusion of MRI and Micro-US imaging for targeted biopsy has also become a new targeted biopsy method, and MR robot-assisted biopsy is gradually being applied. PET/CT improves localization of tumors and may be valuable for initial staging, re-staging after biochemical recurrence, even in patients with MRI-negative prostate cancer. PET/CT targeted biopsy using tracer has been shown to yield good diagnostic efficacy. PET/MRI technology has the potential to be the imaging test for needle-free biopsies in the future. The development of technology has led to the adaptation and optimization of biopsy strategies in clinical practice.

Cancer detection rate of MRI fusion-targeted and systematic prostate biopsy based on urologist-performed MRI reading and contouring in a Government Tertiary Hospital

Introduction@#Prostate cancer is a significant health problem worldwide. Transrectal ultrasound guided biopsy has limitations in the detection of clinically significant disease, hence, new imaging including multiparametric MRI and MRI targeted biopsy is developed. In most centers, reading and contouring of the prostate and identification of significant lesions on MRI are performed by radiologists. In this institution, these steps are performed by a urologist.@*Objective@#To determine the clinically significant cancer detection rate in patients undergoing MRI fusion-targeted and random systematic prostate biopsy where MRI PIRADS scoring, identification of lesions and contouring are performed by a trained urologist in a Philippine tertiary hospital.@*Methods@#This is a cross-sectional study of patients who underwent MRI fusion prostate biopsy in the Philippine General Hospital (PGH) from June 2021 to June 2023. Clinically significant cancer (csCancer) detection rates were calculated for MRI fusion prostate biopsy, random systematic prostate biopsy, and PIRADS scoring. Concordance was also determined between PIRADS scores and histopathological results.@*Results@#Forty six (46) patients who underwent MRI fusion biopsy in PGH were included in the study, representing a total of 90 lesions identified by urologists using mpMRA with PIRADS scores of at least 3. Of the patients, 13 (14.4%) were diagnosed with csCancer, while a large proportion was diagnosed with benign prostatic tissue. The csCancer detection rate of MRI fusion biopsy was 28.3% (13/46) and 8.7% (4/46) for random biopsy. The csCancer detection rate was 11.1%, 14.6%, and 36.4% for PIRADS 3, 4, and 5, respectively.@*Conclusion@#The detection rate of clinically significant prostate cancer using MRI fusion-targeted prostate biopsy based on urologist-performed MRI reading and contouring was superior to random systematic approach. The positive predictive value of PIRADS scores when interpreted by urologists was lower compared to reported values in the literature and did not show concordance. This may reflect lowered thresholds for labeling prostate lesions as suspicious in urologists.

Value of multiparameter MRI in predicting acute cerebral infarction secondary to transient ischemic attack / 中华神经医学杂志

Objective:To investigate the value of multiparameter MRI in predicting secondary acute cerebral infarction in patients with transient ischemic attack (TIA).Methods:A total of 358 patients with TIA admitted to Department of Neurology, Affiliated Hospital of Chengde Medical College from April 2020 to May 2022 were selected. They were divided into cerebral infarction group ( n=114) and non-cerebral infarction group ( n=244) according to whether they had secondary acute cerebral infarction within 3 months of follow up. Differences in multiparameter MRI (number of unstable plaques, reference vessel area/plaque area, internal carotid artery stenosis rate, intracranial arterial stenosis rate, ratio of unstable plaques, lumen area of the most stenotic responsible vessel, and wall area of the most stenotic responsible vessel) at the consultation time were collected and compared between the 2 groups; correlations of multiparameter MRI with secondary acute cerebral infarction was evaluated by partial regression analysis; value of multiparameter MRI in predicting secondary acute cerebral infarction in TIA patients was evaluated by receiver operating characteristic (ROC) curve. Results:Reference vessel area/plaque area, intracranial arterial stenosis rate, ratio of unstable plaques and wall area of the most stenotic responsible vessel in the infarction group were significantly higher/larger than those in the non-cerebral infarction group, and lumen area of the most stenotic responsible vessel in the infarction group was significantly smaller than that in the non-cerebral infarction group ( P<0.05). After adjusting for age and gender, reference vessel area/plaque area, intracranial arterial stenosis rate, ratio of unstable plaques and wall area of the most stenotic responsible vessel were positively correlated with secondary acute cerebral infarction, while lumen area of the most stenotic responsible vessel was negatively correlated with secondary acute cerebral infarction ( P<0.05); AUC of the combination of above parameters was 0.900, which was significantly greater than that of reference vessel area/plaque area (0.724), intracranial arterial stenosis rate (0.751), unstable plaque occurrence rate (0.812), lumen area of the most stenotic vessel (0.771), and wall area of the most stenotic vessel (0.763), respectively ( P<0.05). Conclusion:Multiparameter MRI analyzing reference vessel area/plaque area, intracranial arterial stenosis rate, ratio of unstable plaques, lumen area of the most stenotic responsible vessel, and wall area of the most stenotic responsible vessel can effectively predict secondary acute cerebral infarction in TIA patients.

Contrast of the therapeutic effect of CT/MRI image fusion technology and CT guided radiofrequency thermocoagulation of trigeminal semilunar ganglion / 安徽医科大学学报

Objective @#To evaluate the therapeutic effect of CT/MRI image fusion and usual CT guided percutaneous radiofrequency thermocoagulation of trigeminal semilunar ganglion . @*Methods @#The medical information of 88 patients diagnosed with primary trigeminal neuralgia were assembled . In accordance with different imaging guidance means , they were equally divided into the control group ( trigeminal semilunar ganglion radiofrequency thermo coagulation with CT guidance ) and the fusion group ( trigeminal semilunar ganglion radiofrequency thermocoagula tion with assistance of CT/MRI image fusion technology) at random. The puncture time , intraoperative discomfort rate , preoperative , intraoperative and postoperative visual analogue scale (VAS) score , Barrow neurological insti tute (BNI) pain score and postoperative complication rate were contrasted . @*Results @#The puncture operation time of the fusion group was shorter than that of the control group (P < 0 05) ; the intraoperative and postoperative VAS and BNI scores , occurrence rate of intraoperative discomfort and postoperative complications in the fusion group were lower than those in the control group (P < 0.05) .@*Conclusion @#In respect of improving therapeutic effect and diminishing intraoperative discomfort and postoperative complications , CT/MRI image fusion technique is superior to CT guidance .

Experience of Rehabilitation Treatment for Osmotic Demyelination Syndrome with Locked-in Syndrome / The Japanese Journal of Rehabilitation Medicine

Osmotic demyelination syndrome is a pathological condition that leads to electrolyte imbalances and rapid correction, resulting in pseudobulbar palsy, quadriplegia, and altered consciousness. Approximately 33-55％ of affected patients experience residual functional impairment. Herein, we describe a case of a patient with osmotic demyelination syndrome who developed locked-in syndrome during the disease course, underwent rehabilitation treatment, and achieved complete remission without sequelae.The patient was a 47-year-old man who was admitted to hospital A owing to weakness in the lower extremities and dysarthria. He had severe hyponatremia and received sodium correction. However, on hospital day 9, dysarthria redeveloped and involuntary finger movements were noted. Osmotic demyelination syndrome was suspected based on the findings of magnetic resonance imaging of the head and clinical course, leading to his transfer to hospital B. Steroid pulse and rehabilitation therapies were initiated at hospital B. By the 19th day of symptom onset, his limb and facial muscle paralysis progressed, leading to locked-in syndrome. Thereafter, the patient was transferred to hospital C, where he received physiotherapy, occupational therapy, and eating training, markedly improving his physical functions. He was discharged from hospital C, 4 months after the symptom onset, with limited range of motion of the fingers and weakness of the extremities and continued to receive outpatient rehabilitation treatment. His symptoms improved further, and 1 year after the onset of symptoms, he returned to work without any sequelae.

PDZK1 is correlated with DCE-MRI perfusion parameters in high-grade glioma

Abstract Objective This study investigated the relationship between PDZK1 expression and Dynamic Contrast-Enhanced MRI (DCE-MRI) perfusion parameters in High-Grade Glioma (HGG). Methods Preoperative DCE-MRI scanning was performed on 80 patients with HGG to obtain DCE perfusion transfer coefficient (Ktrans), vascular plasma volume fraction (vp), extracellular volume fraction (ve), and reverse transfer constant (kep). PDZK1 in HGG patients was detected, and its correlation with DCE-MRI perfusion parameters was assessed by the Pearson method. An analysis of Cox regression was performed to determine the risk factors affecting survival, while Kaplan-Meier and log-rank tests to evaluate PDZK1′s prognostic significance, and ROC curve analysis to assess its diagnostic value. Results PDZK1 was upregulated in HGG patients and predicted poor overall survival and progression-free survival. Moreover, PDZK1 expression distinguished grade III from grade IV HGG. PDZK1 expression was positively correlated with Ktrans 90, and ve_90, and negatively correlated with kep_max, and kep_90. Conclusion PDZK1 is upregulated in HGG, predicts poor survival, and differentiates tumor grading in HGG patients. PDZK1 expression is correlated with DCE-MRI perfusion parameters.

Effect of Diffuse Glioma with Precentral Gyrus Invasion on Interhemispheric Brain Activation： A Task-based FMRI Study / 中山大学学报(医学科学版)

ObjectivesTo explore the effect of diffuse glioma with precentral-gyrus invasion on fMRI activation maps by grasping T-fMRI. MethodsA total of 56 diffuse glioma patients were divided into precentral-gyrus invasion （PGI： n=21） and precentral-gyrus non-invasion （PGNI： n=35） groups. Three statistical thresholds （P value： 10-4， P1； 10-6， P2； 10-8， P3） were set to obtain the activation maps accordingly （V1， V2 and V3）. The interhemispheric and bilateral precentral gyrus activation volumes ratios （IAVR and PAVR） were calculated， respectively. The activation volumes ［△V1=V1-V2； △V2=V2-V3； △Vn （ipsilateral）/△Vn’ （contralateral）， n=1， 2］ within two statistical thresholds and the corresponding interhemispheric ratio was further compared. In addition， the associations of tumor characteristics with IAVR and PAVR were analyzed. ResultsCompared with PGNI， PGI showed significantly decreased IAVR at p1， and the same trends of PAVR in PGI at P1 and P2 （P＜0.05）. However， neither IAVR nor PAVR showed significant differences at P3. PGI showed significantly lower ratios of △V1/△V1’ than PGNI （P=0.02）， except for △V2/△V2’. Additionally， within PGI， PAVR was negatively correlated with tumor volume （P=0.043）， and the distance from the tumor to the hand-knob was positively correlated with the IAVR and PAVR （P＜0.05）. ConclusionDiffuse glioma invading eloquent areas tended to affect interhemispheric asymmetry of activation at relatively lower statistical thresholds than diffuse glioma without invasion， rather than stricter statistical thresholds. Multiple ranges of statistical thresholds were recommended to analyze T-fMRI.

Synthetic MRI to Assess Neurological Injury in Recovered COVID-19 Patients / 中山大学学报(医学科学版)

ObjectiveTo assess the microstructural involvement of gray matter in recovered COVID-19 patients using Synthetic MRI. MethodsThis study was conducted in 29 recovered COVID-19 patients， including severe group （SG， n=11） and ordinary group （OG， n=18）. Healthy volunteers matched by age， sex， BMI and years of education were selected as a healthy control group （HC=23 cases）. Each subject underwent synthetic MRI to generate quantitative T1 and T2 maps， and the T1 and T2 maps were segmented into 90 regions of interest （ROIs） using automatic anatomical labeling （AAL） mapping. T1 and T2 values for each ROI were obtained by averaging all voxels within the ROIs. The T1 and T2 values of the 90 brain regions between the three groups were compared. ResultsRelative to HC， the SG had significantly higher T2 values in bilateral orbital superior frontal gyrus， bilateral parahippocampal gyrus， bilateral putamen， bilateral middle temporal gyrus， bilateral Inferior temporal gyrus， left orbital superior frontal gyrus， left orbital inferior frontal gyrus， left gyrus rectus， left anterior cingulate and paracingulate gyri， right median cingulate and paracingulate gyri， left posterior cingulate gyrus， and left supramarginal gyrus （P＜0.05）； Relative to OG， SG showed significantly increased T2 values in the left rectus gyrus， left parahippocampal gyrus， bilateral middle temporal gyrus， and bilateral inferior temporal gyrus （P＜0.05）. Relative to HC， the T1 values of SG were significantly increased in bilateral orbital superior frontal gyrus， left rectus gyrus， left anterior cingulate and paracingulate gyri， right posterior cingulate gyrus， left parahippocampal gyrus， left lingual gyrus， left putamen， left thalamus（P＜0.05）； Relative to OG， the T1 values of SG were significantly higher in the right posterior cingulate gyrus， right calcarine fissure and surrounding cortex， and left putamen （P＜0.05）. ConclusionsEven after recovering from COVID-19， patients may still have persistent or delayed damage to their brain gray matter structure， which is correlated with the severity of the condition. SyMRI can serve as a sensitive tool to assess the extent of microstructural damage to the central nervous system， aiding in early diagnosis of the disease.

Clinical evolution and atypical spinal cord MRI features of myelitis post severe acute respiratory syndrome coronavirus 2 infection / 临床神经病学杂志

Objective To analyze the clinical evolution and atypical spinal cord MRI features of myelitis post severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Four patients with myelitis post the SARS-CoV-2 infection were retrospectively analyzed regarding the clinical manifestations,the dynamic changes of the spinal cord MRI and the treatment outcomes.Results The time latencies from SARS-CoV-2 infection to the onset of myelitis of the 4 patients were 5 d,15 d,80 d,and 30 d,respectively.The onset symptoms were numbness and weakness of lower limbs in 3 patients,and back pain with weakness of lower limbs in 1 patient.The peak symptoms included paraplegia,sphincter dysfunction,sensory plane and spastic gait.The expanded disability status score(EDSS)of the 4 patients were 7.5,9.0,9.0 and 7.5,respectively.Initial spinal cord MRI showed normal in 1 case,linear meningeal enhancement in 1 case,and punctate T2 signal changes in 2 cases.Spinal cord MRI at the peak of the symptoms showed patchy,linear and cloudy-like high signals on sagittal T2,which mainly distributed in lateral and posterior cords on axial T2.The prominent features of the MRI findings were the linear meningeal enhancement that appeared in all 4 cases during the disease and their mismatch with the severity of clinical symptoms.Two of the four patients received pulse methylprednisolone combined with plasma exchange therapy and did not show significant improvement,and all 4 patients were left with significant disability.Conclusions Myelitis post SARS-CoV-2 infection usually presents typical symptoms of myelitis,while the spinal cord MRI presents patchy,linear and cloudy-like high signals,with linear meningeal enhancement.The delayed and atypical spinal cord MRI findings need additional attention.

Prenatal diagnostic value of MRI in fetal Chiari malformation / 复旦学报（医学版）

Objective To evaluate the value of magnetic resonance imaging(MRI)in prenatal diagnosis of fetal Chiari malformation.Methods The prenatal MRI findings of 27 cases of Chiari malformation confirmed by follow-up in Obstetrics and Gynecology Hospital,Fudan University from Feb 2010 to Feb 2022 were retrospectively analyzed and compared with ultrasound findings.Results Twenty-seven pregnant women,aged from 16-36 years(average 28.0 years)and 27 fetuses with gestation from 15.3-38.4 weeks(average 24.3 weeks)were studied.There were 18 cases of Chiari Ⅱ(Chiari malformation type Ⅱ,CMⅡ),3 cases of Chiari Ⅲ(CMⅢ),6 cases of Chiari Ⅳ(CMⅣ).CMⅡ and CMⅢ images showed brain herniation,descending pons,narrowing or disappearance of the posterior fossa cistern and the fourth ventricle,the subarachnoid space disappears.There were 17 cases of hydrocephalus,2 cases of cerebrospinal fluid loss,17 cases of"lemon head"and"banana cerebellar"signs,4 cases of encephalocele,15 cases of spinal bifida,3 cases of lower spinal cord and 2 cases of spinal cavity,4 cases of spinal angular deformity and 6 cases of other malformations.In CMⅣ,there were 2 cases of undeveloped cerebellum and 4 cases of cerebellum and brainstem dysplasia,hydrocephalus in 5 cases,posterior fossa cistern widening in 4 cases,and other malformations in 4 cases.MRI showed the posterior fossa structure and spinal cord more clearly than ultrasound,and could find lesions not detected by ultrasound.Conclusion Prenatal MRI can be used as a complementary examination of ultrasound,which can improve the accuracy of diagnosis of Chiari malformation,reduce the rate of missed diagnosis,and clarify the classification of Chiari malformation.

Advances in MRI studies of brain structure and cerebral blood perfusion in patients with bipolar disorder / 实用医学杂志

Bipolar disorder(BD)is a class of common psychiatric disorders,and its high morbidity,disability,and mortality have attracted widespread attention.However,in clinical practice,the initial accurate diagnosis rate of BD is low and easily misdiagnosed as monophasic depression.Many neuroimaging studies have shown that cortical thickness,gray matter,white matter,and functional activities are altered in some brain regions of BD patients.However,their specific neuroimaging indexes have not been clarified,and the specific pathophysi-ological mechanisms for the onset of BD have not been fully elucidated.Therefore,in this paper,we combed through the recent years of BD patients to study the cortical structure and perfusion of the brain to review the methods in anticipation of more in-depth research at a later stage.

Digital characteristics of brainstem morphology and age-related development in young children / 中国组织工程研究

BACKGROUND:Previous brain studies have mostly focused on adults and fetuses,and the developmental characteristics of young children's brainstems have rarely been studied. OBJECTIVE:To observe the brainstem development characteristics of healthy young children and to explore the age-related differences and their correlation with sex. METHODS:From January 2019 to April 2022,a retrospective study of 3.0T MRI images of 174 children aged 2 to 6 years in the Affiliated Hospital of Inner Mongolia Medical University was conducted,and the median sagittal diameter,area and angle of the brainstem(including midbrain,pons and medulla oblongata)were measured. RESULTS AND CONCLUSION:There is an age-related increase in the anterior and posterior diameters of the midbrain,pons and medulla oblongata in the 2-5 years old group as well as in the longitudinal diameter and area of the midbrain,pons and medulla oblongata in the 2-6 years old group.Except for the longitudinal diameter of the medulla oblongata,all others show a positive correlation with age(r>0,P<0.05).In the 2-3 years old group and 4-5 years old group,the children are in the rapid growth and development stage,and these two age groups can be used as the key observation indicators for the development of young children.The anterior-posterior diameter,longitudinal diameter,area of the pons and total brainstem area are strongly correlated with age,which can be used as the key observation indicators for the brainstem development in young children.