Hemodynamic evaluation and diagnostic value of SWI combined with ASL in acute ischemic stroke / 中国医学物理学杂志

Objective To analyze the diagnostic utility of combining susceptibility-weighted imaging(SWI)with arterial spin labeling(ASL)in patients with acute ischemic stroke(AIS).Methods Fifty AIS patients who admitted to Yongchuan Hospital,Chongqing Medical University from July 2020 to July 2021 were selected.Scans were performed using a 3.0T MRI scanner,including sequences such as FLAIR,DWI,3D-TOF-MRA,3D-ASL,and SWI.The perfusion status of the infarction core,the grading of draining veins around the infarction core,compensation by collateral circulation,the occurrence of hemorrhagic transformation,and prognosis were assessed.Results The grading of draining veins around the infarction core was significantly correlated with NIHSS scores(r=0.869,P＜0.05)and prognosis(r=0.825,P＜0.05).In addition,significant correlations were found between the perfusion status of the infarction core and the occurrence of hemorrhagic transformation(r=0.873,P＜0.05),compensation by collateral circulation and prognosis(r=0.883,P＜0.05).Conclusion The combination of SWI and ASL provides accurate indications of the hemodynamic conditions around the infarction core in AIS patients,and it can accurately assess the prognosis of AIS patients,contributing valuable information for clinical diagnosis and the selection of treatment strategies.

Application of fast susceptibility weighted imaging based on deep learning in assessment of acute ischemic stroke / 中华放射学杂志

Objective:To explore the value of fast susceptibility weighted imaging (SWI) generated by a deep learning model in assessment of acute ischemic stroke (AIS).Methods:From January 2019 to January 2021, 118 AIS patients [75 males and 43 females, aged 23-100 (66±14) years] who underwent MR examination and SWI sequence scanning within 24 h of symptom onset in the First Medical Center of PLA General Hospital were retrospectively analyzed. MATLAB ′s randperm function was used to divide 118 patients into a training set of 96 cases and a test set of 22 cases at a ratio of 8∶2. Fourty-seven AIS patients [38 males and 9 females, aged 16-75 (58±12) years] from one center of a multicenter study were selected to build the external validation set. SWI image and filtered phase image were combined into complex value image as full sampling reference image. Undersampled SWI images were obtained by retrospective undersampling of reference fully sampled images, and the undersampling multiple was five times which could save 80% of the scanning time, then the complex-valued convolutional neural network (ComplexNet) was used to develop reconstruct fast SWI. Interclass correlation coefficient (ICC) or Kappa tests were used to compare the consistency of image quality and the diagnostic consistency for the presence of susceptibility vessel sign (SVS), cerebral microbleeds and asymmetry of cerebral deep medullary veins (DMVs) in AIS patient on fully sampled SWI and fast SWI based on ComplexNet.Results:In test set, score of image quality was 4.5±0.6 for fully sampled SWI image and 4.6±0.7 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.86, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.79, P<0.05), microbleeds (Kappa=0.86, P<0.05), and DMVs asymmetry (Kappa=0.82, P<0.05) in AIS patients. In the external validation set, score of image quality was 4.1±1.0 for fully sampled SWI image and 4.0±0.9 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.97, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.74, P<0.05), microbleeds (Kappa=0.83, P<0.05), and DMVs asymmetry (Kappa=0.74, P<0.05) in AIS patients. Conclusions:Deep learning techniques can significantly accelerate the speed of SWI, and the consistency of image quality and detected AIS signs between fast SWI based on ComplexNet and fully sampled SWI is good. The fast SWI based on ComplexNet can be applied to the radiographic assessment of clinical AIS patients

MRI susceptibility weighted imaging for monitoring vertebral development trajectory in second-third trimester fetuses / 中华放射学杂志

Objective:To measure the morphological parameters of the fetal vertebral centrum ossification centers (COC) in the second-third trimester using MRI susceptibility weighted imaging (SWI), and to explore the growth and development trajectory of the vertebrae.Methods:Fetus in the second-third trimester with normal vertebrae development were prospectively and continuously included in Shandong Provincial Hospital Affiliated to Shandong First Medical University from December 2015 to December 2021, and the SWI scanning of fetal spine was performed. The following morphometric parameters of the C4, T6, L3, S1 vertebrae COC were measured, including sagittal diameter, transverse diameter, height, cross-sectional area and volume. The linear and nonlinear regression analysis was used to derive the best-fit curve for each parameters and gestational age.Results:A total of 112 fetuses were recruited with gestatonal age 21-39 (29.4±3.9) weeks, including 30 cases of C4, 58 cases of T6, 92 cases of L3, 62 cases of S1. Fetal spine in utero with global curvature was kyphosis, presenting two primary curves (thoracic and sacral kyphosis). The morphological parameters sagittal diameter, transverse diameter, height, cross-sectional area and volume of C4 followed the quadratic polynomial rule during 25 to 38 weeks (R 2=0.938, 0.943, 0.952, 0.957, 0.982). During 21 to 38 weeks, the sagittal diameter, transverse diameter and height of the T6 followed the exponential growth pattern (R 2=0.915, 0.923, 0.849) and the growth of the area and volume followed the quadratic polynomial growth pattern (R 2=0.943, 0.961). The L3 followed the quadratic polynomial rule during 21 to 39 weeks (R 2=0.910, 0.916, 0.914, 0.942, 0.948) The sagittal diameter, transverse diameter and height of the S1 followed the linear growth pattern (R 2=0.905, 0.911, 0.922) and the area and volume followed the quadratic polynomial growth pattern (R 2=0.930, 0.964) during 23 to 39 weeks. Conclusions:The growth and development of C4, T6, L3 and S1 COC of fetus in the second-third trimester has a good correlation with gestational age. The growth of fetal vertebral COC in the early stage is slow, but with the growth of gestational age, the growth rate of vertebral bodies accelerates.

Susceptibility weighted imaging of superficial cerebellar veins / 解剖学报

[Abstract] ObjectVisualizing the superficial cerebellar vein and its tributaries on suscepxibility weighted imaging (SWI), and to construct superficial cerebellar vein network. Methods According to the inclusion criteria, 80 healthy volunteers (40 males and 40 females) were selected for 3. 0 T MRI scans to obtain conventional sequence cross-section, sagittal tomographic images, and SWI image data. Post-processing was performed on the Extended MR workspace 2. 6. 3. 4 image workstation to reconstruct minimum intensity projection(mIP) images. SPSS 21. 0 statistical software was used to analyze and process each data, and the diameter measurement result were expressed as mean ± standard deviation. Results Both SWI and mIP could image the structures of the cerebellum and its veins. The cerebellar veins were divided into deep and superficial parts. The superficial cerebellar veins were divided into two groups: the vermis and the cerebellar hemispheres. The superficial vein of the cerebellar vermis consisted of superior vermis vein [diameter: (1. 21±0. 24)mm, occurrence rate: 92. 16%], summit vein [ diameter: (0. 66 ± 0. 05) mm, occurrence rate: 95%], mountain vein [diameter: (0. 76±0. 03)mm, occurrence rate: 100%], inferior vermis vein [diameter: (1. 40±0. 27)mm, occurrence rate: 99. 02%]. The superficial cerebellar hemisphere vein consists of anterior superior cerebellar vein [diameter: (1. 09± 0. 12)mm, occurrence rate: 100%], posterior superior cerebellar vein [diameter: (0. 88±0. 13) mm, occurrence rate: 70%], anterior inferior cerebellar vein [ diameter: (1. 34 ± 0. 15) mm, occurrence rate: 100%], posterior inferior cerebellar vein [ diameter: (1. 11 ± 0. 09) mm, occurrence rate: 92. 5%]. The deep veins were divided into cerebellomesencephalic fissure group, cerebellopontine fissure group, and cerebellomedullary fissure group. Conclusion SWI can display the microstructure and venules of the cerebellum, and can construct a network of superficial cerebellar veins.

Stage division of Wilson's disease based on imaging indexes / 中华神经医学杂志

Objective:To explore the feasibility of staging Wilson's disease (WD) based on imaging indexes, and evaluate the clinical characteristic differences of WD patients at different stages.Methods:Sixty WD patients (40 with cerebral type and 20 with hepatic type) hospitalized in Department of Neurology, First Affiliated Hospital of Sun Yat-sen University from July 2015 to June 2022 and 20 age- and gender-matched normal controls were selected. All subjects accepted susceptibility-weighted imaging (SWI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS); 7 regions of interest were selected: globus pallidus, caudate nucleus, putamen, thalamus, cerebellum, midbrain and pons; their fractional anisotropy (FA), corrected phase (CP), N-acetylaspartate/creatine (NAA/Cr) values were measured. According to DTI, SWI and MRS results, WD patients were divided into group of metal deposition stage (decreased CP, normal FA and NAA/Cr), group of fiber damage stage (abnormal FA, normal NAA/Cr), and group of neuron necrosis stage (decreased NAA/Cr); the clinical data (modified Young scale scores, Child-Pugh grading of liver function, serum copper content, and urinary copper content) and imaging indexes (FA, CP, and NAA/Cr) among the 3 groups and control group were compared. Results:Among the 60 patients, 19 patients were at metal deposition stage (including 18 with liver type and 1 with brain type), 28 patients at fiber injury stage (including 2 with liver type and 26 with brain type), and 13 patients at neuron necrosis stage (all brain type). (1) Compared with group of metal deposition stage and fiber damage stage, group of neuron necrosis stage had significantly decreased urinary copper content ( P<0.05). The modified Young scale scores in groups of metal deposition stage, fiber injury stage and neuronal necrosis stage increased successively; Child-Pugh grading in group of metal deposition stage was higher than that in groups of fiber injury stage and neuronal necrosis stage. (2) Compared with groups of metal deposition stage and neuron necrosis stage, CP values in the globus pallidus and substantia nigra in group of fiber injury stage group were significantly decreased ( P<0.05). Compared with groups of metal deposition stage and fiber injury stage, the FA value in the putamen and NAA/Cr value in the pallidum, thalamus and caudate nucleus in group of neuron necrosis stage were significantly decreased ( P<0.05). Conclusion:Disease stages of WD patients can be divided by imaging methods; neurological symptoms gradually worsen following progressed WD.

Reliability in detection and differentiation between calcification and hemorrhage by 3 d GRE/ SWI technique compared to CT

This study was conducted to evaluate the sensitivity of Magnetic Resonance (MR) Susceptibility- Weighted Imaging (SWI) and also to compare the sensitivity of Magnetic Resonance (MR) susceptibility-Weighted Imaging (SWI) and Computed Tomography (CT), such that SWI can replace the use of CT as a standard protocol in the detection and differentiation between calcification and hemorrhage. A series of 70 patients included in this study with clinical suspicion or known history of intracranial hemorrhage/ calcifications for follow up, were scanned using both Philips Multiva 1.5T (MRI/SWI) and Philips Ingenuity 128 slice (CT). Results showed that SWI had 100% relative sensitivity, as it was able to detect both hemorrhage and calcifications in all the cases identified in CT. In addition, SWI detected hemorrhage in 2 additional cases that were nonspecific in CT. Furthermore, SWI detected signal from micro bleeds, which was missed on CT in three cases, and also detected calcification in two cases, which were not positively identified in CT. In conclusion, Susceptibility- Weighted Imaging (SWI) is highly sensitive for the detection and differentiation of hemorrhage and calcifications using Phase reconstructed images compared to conventional MRI methods and Computed Tomography

Research Development in Patients with Multiple Sclerosis by Focus on MRI / 罕见病研究

Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disease of the central nervous system whose clinical manifestations and diagnostic criteria are non-specific and absence of golden criteria when diagnosing. Magnetic resonance imaging (MRI) can not only observe the focal lesions of demyelination, but also evaluate microstructural damages and iron deposition in the white/gray matter in MS patients by applying various developing sequences. MRIs play an irreplaceable role in revealing pathological evolution, prognosis and monitoring after treatment of MS patients. This paper reviewed the clinical value and application of MRIs for the MS patients in recent years.

The relationship between cerebral microbleeds and cerebral artery stenosis in patients with large atherosclerotic cerebral infarction / 中风与神经疾病杂志

@#Objective　To investigate the relationship between cerebral microbleeds and cerebral artery stenosis in patients with large atherosclerotic cerebral infarction.Methods　We retrospectively enrolled 512 patients with large atherosclerotic cerebral infarction who were the first time admitted to the Department of Neurology of our hospital from October 2018 to June 2021.According to the results from the craniocerebral magnetic sensitive weighted imaging,patients were divided into non-CMBs group and CMBs group.The purpose of this study was to investigate the risk factors and incidence rate of CMBs，the relationship between cerebral microbleeds and cerebral artery stenosis in patients with large atherosclerotic cerebral infarction.Results　The incidence rate of CMBs was 39.3% in this study.Factors including age,hypertension,hyperhomocysteinemia,history of antiplatelet drug use,WMH,intracranial and extracranial artery stenosis coexisted independently with CMBs.The degree of CMBs is positively correlated with cerebral artery stenosis.Conclusion　Age,hypertension,high-profile cysteinemia,anti-platelet drug application history,WMH and intracranial artery or both of extracranial vessels stenosis are independent risk factors of CMBs.The degree of CMBs is positively correlated with cerebral artery stenosis.Triacylglycerol may be a protective factor for CMBs.

Superficial veins located in dorsolateral aspect of hemispheres on susceptibility-weighted imaging / 解剖学报

Objective To investigate whether physiological asymmetry of normal bilateral superficial veins located in dorsolateral aspects of hemispheres is existed on susceptibility-weighted imaging (SWI). Methods There were 45 healthy young volunteers in this study. After exclusion of intracranial lesions by using common brain magnetic resonance imaging examination, they underwent SWI examination. We observed the number, diameter and signal intensity of superficial veins located in dorsolateral aspects of hemispheres according to the images of SWI on transverse sections through the centrum semiovale, trunk of corpus callosum, splenium of corpus callosum, and superior colliculus. Results The frequencies of asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres on transverse sections through the centrum semiovale, trunk of corpus callosum, splenium of corpus callosum, and superior colliculus were 20.0%, 37.8%, 35.6% and 26.7%, respectively. The frequencies of mild asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres on above transverse sections were 17.8%, 31.1%, 31.1% and 24.4% respectively, and the frequencies of prominent asymmetry were 2.2%, 6.7%, 4.4% and 2.2%, respectively. According to chi square test, there was no gender difference in asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres. Conclusion SWI technique was used to show the physiological asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres on different transverse sections. Most of them are mild. Therefore, when cerebrovascular disease occurs, if transverse sections of images by SWI show asymmetry of the bilateral superficial veins located in dorsolateral aspects of hemispheres, the possibility of physiological phenomenon is needed to take into consideration.

Association between visibility of deep medullary vein and pathogenesis of recent small subcortical infarct / 中华神经医学杂志

Objective:To evaluate the visibility of intracranial deep medullary vein (DMV) by sensitivity weighted imaging (SWI), and explore its correlation with recent small subcortical infarct (RSSI).Methods:From March 2021 to May 2022, 277 patients with cerebral small vascular disease (CSVD) confirmed by cranial MRI in Department of Neurology, Third Hospital of Hebei Medical University, were consecutively enrolled. These patients were divided into RSSI group ( n=128) and non-RSSI group ( n=149) according to RSSI presence or not within one week of onset. According to the DMV scores, these patients were divided into mild-moderate DMV group (0-12 scores, n=199) and severe DMV group (13-18 scores, n=78). The clinical and imaging data of these groups were analyzed retrospectively and compared. Multivariate Logistic regression analysis was used to determine the correlation between DMV and RSSI, as well as the independent influencing factors for DMV grading. Results:The cerebral microbleed (CMB), periventricular white matter hyperintensity (WMH) scores, deep WMH scores, total WMH scores, total CSVD burden scores, and DMV scores in patients of the RSSI group were significantly higher than those in the non-RSSI group ( P<0.05); and patients in the RSSI group had significantly younger age and significantly lower high density lipoprotein cholesterol (HDL-C) level than those in the non-RSSI group ( P<0.05). Multivariate Logistic regression analysis showed that DMV score ( OR=1.142, 95%CI: 1.026-1.271, P=0.016) was an independent influencing factor for RSSI after adjusting for HDL-C and deep WMH scores. The severe DMV group had significantly older age, statistically higher percentages of patients having history of hypertension, CMB, lacuna and moderate to severe EPVS in basal ganglia, and significantly higher periventricular WMH scores, deep WMH scores, total WMH scores, and total CSVD burden scores as compared with the mild-moderate DMV group ( P<0.05). Multivariate Logistic regression analysis showed that age ( OR=1.101, 95%CI: 1.060-1.143, P<0.001) and total CSVD burden scores ( OR=3.589, 95%CI: 2.506-5.141, P<0.001) were independent influencing factors for DMV scores. Conclusion:DMV is involved in the mechanism of RSSI, and DMV visibility can be used as an indicator to diagnose RSSI and evaluate RSSI progression.

The clinical value of CT and SWI in evaluating the occurrence of CMBs in diabetic patients with hypertension / 中国辐射卫生

Objective With the help of computerized tomography (CT) and susceptibility-weighted imaging (SWI) examinations, to analyze and compare the incidence and the prevalent sites of microbleeds (CMBs) in control group, diabetes group, hypertension group and diabetic hypertension group with intracerebral CMBs. The risk factors for the onset of CMBs also will be explored, in order to provide a basis for the selection of clinical diagnosis and treatment options for CMBs. Methods A collection of 174 non-acute patients in the Department of Neurology of Shandong Electric Power Central Hospital from May 2019 to October 2020, including 101 males and 73 females, aged 45-89 years, with an average age of 72 ± 5 years. Divided into four groups according to disease types: Hypertension with type 2 diabetes group, Hypertension group, Type 2 diabetes group, Control group (no hypertension and type 2 diabetes). All patients underwent CT and MRI SWI sequence scans. The 4 groups of patients were matched in terms of gender and age, excluding the influence of gender and age. The incidence, number and distribution of CMBs in the four groups were counted, and the CT and SWI imaging manifestations of CMBs in the four groups were analyzed and compared. Results CT did not find the incidence of CMBs in the brain of patients. SWI imaging showed that CMBs were detected in 58 of 174 patients (incidence rate 33.3%), and CMBs occurred in 24 cases of diabetes and hypertension group (incidence rate 57.1%). CMBs occurred in 21 cases in the hypertension group (incidence rate 46.7%), 8 cases in the diabetes group (incidence rate 22.2%), and CMBs occurred in 5 cases in the control group (incidence rate 9.8%). The incidence of CMBs in the hypertension group and the diabetes combined with hypertension group was significantly higher than that in the control group (P < 0.05). There was no significant difference in the incidence of CMBs in patients with simple diabetes compared with the control group. Also, there was no significant difference in the incidence of CMBs between the diabetes combined with hypertension group and the simple hypertension group. Conclusion CT did not find the incidence of CMBs in the brains of patients in the non-acute phase. SWI could clearly show the CMBs of the enrolled patients. Diabetes is less likely to cause an increase in CMBs. Hypertension is significantly related to the occurrence of CMBs. CMBs associated with hypertension or/and diabetes are common in the basal ganglia and thalamus, which is different from cerebral amyloid angiopathy, which provides a basis for the choice of clinical treatment options.

Susceptibility vessel sign in subacute stroke patients with large vessel occlusion / 北京大学学报(医学版)

OBJECTIVE@#To investigate the presentation of susceptibility vessel sign (SVS) in subacute stroke patients with large vessel occlusion.@*METHODS@#We collected consecutive stroke patients who were admitted to Peking University First Hospital from December 2017 to August 2019 retrospectively. Those who had intracranial large vessel occlusion and received sensitivity weighted imaging (SWI) within 3 to 14 days after stroke onset were included in our analysis. The diagnosis of large vessel occlusion was based on magnetic resonance angiography (MRA), CT angiography (CTA) or digital subtraction angiography (DSA). The demographic information, clinical characteristics and imaging results were obtained from medical record. The occurrence rates of SVS sign were compared between stroke patients with cardioembolism (CE) and large artery atherosclerosis (LAA). In the sensitivity analysis, we performed a subgroup analysis in those patients who received SWI within 7 to 14 days after stroke onset. We also compared the occurrence rate of SVS sign between the patients with and without atrial fibrillation.@*RESULTS@#A total of 51 patients, 19 females and 32 males, with an average age of (63.04±11.23) years were analyzed in this study. Compared with LAA group, the patients in CE group were older and more likely to have an atrial fibrillation (P < 0.05). There were no significant differences between the CE group and LAA group in gender, hypertension, diabetes, coronary heart disease, hyperlipidemia, smoking, or National Institute of Health stroke scale(NIHSS) score at admission. SVS sign was found in 30 patients. Of whom, 3 were in CE group and 27 in LAA group. The occurrence rate of SVS sign was higher in the LAA group than in the CE group significantly (65.9% vs. 30.0%, P=0.039). The subgroup analysis showed that, in the patients who received SWI examination within 7 to 14 days after stroke onset, the differences between the two groups were still statistically significant (0 vs. 72.7%, P=0.006). Another sensitivity analysis showed that, the rate of SVS in the patients with atrial fibrillation was significantly lower than those patients without atrial fibrillation (25% vs. 65.1%, P=0.043).@*CONCLUSION@#In subacute stroke patients, the occurrence rate of SVS sign in CE group was lower than that of LAA group. The significance of SVS sign in the differentiation of stroke subtype needs further validation.

Susceptibility weighted imaging of the veins around foramen of monro / 解剖学报

Objective To image the veins around the foramen of monro (FM), to build the 3D model of them, to construct venous network in this area and to explore the spatial positional correlation between FM and veins around it. Methods Totally 60 healthy subjects were selected to get the original images on 3. 0 T MR and procesed the original images by minimum intensity projections (mIP) and Materialise’ s interactive medical image control system (Mimics), built the 3D model of the veins around FM, observed and analyzed the morphology of FM and the veins around it on original and processed images. Results The displaying rate of FM was 65% (78 sides), the displaying rate of internal cerebellar veins (ICV) was 100% (120 sides), the diameter was (2. 13±0. 30) mm. The displaying rate of anterior septal vein (ASV) was 100% (120 sides), the diameter was(0. 69±0. 19)mm. The displaying rate of superior thalamostriate vein (STV) was 98. 3% (118 sides), the diameter was (1. 47± 0. 38) mm. The displaying rate of superior choroidal vein (SCV) was 82. 5% (99 sides), the diameter was(0. 40±0. 18)mm. According to the relationship between the converging point of the tributaries of ICV and the location of FM, FMs were classified into 5 types:ⅠA, 24. 2% (29 sides), ASV converged into ICV at the venous angle and closed to the posterior edge of FM; ⅠB, 13. 3% (16 sides), ASV converged into ICV away from the venous angle and the posterior edge of FM; ⅡA, 45% (54 sides), ASV converged into ICV at the false venous angle and closed to the posterior edge of FM; ⅡB, 15. 8% (19 sides), ASV converged into ICV away form the false venous angle and the posterior edge of FM. Ⅲ, 1. 7% (2 sides), STV was absent. Conclusion FM and the veins around it are visible on the susceptibility weighted imaging(SWI). It can be constructed by Mimics that the 3D model of ICV, its tributaries, FM and the converging points of the major veins. The classification of FMs is meaningful to the option of surgical approaches through FM.

The value of TCS、SWI and MRI in identifying progressive supranuclear palsy and Parkinson’s disease / 中风与神经疾病杂志

@#Objective　To explore the value of the three auxiliary examinations of transcranial ultrasound imaging,magnetic sensitivity weighted imaging,and magnetic resonance imaging in the identification of progressive supranuclear palsy and Parkinson’s disease.Methods　Twenty-two clinically diagnosed patients with PSP,33 patients with PD were selected,and 30 cases in the control group underwent TCS,SWI,and MRI examinations and medical records were comprehensive.ROC curve was used to compare and analyze the results of TCS,SWI and MRI.The value of three auxiliary examinations in the identification of progressive supranuclear palsy and Parkinson’s disease was discussed.Results　Compared with the PD group and the control group,the ratio of hyperechoic lenticular nucleus,the ratio of the minimum diameter of the third ventricle more than 10mm,the midbrain area/pontine area,the ratio of midbrain/pontine diameter,magnetic resonance Parkinson’s index,low signal strength of the putamen,and low signal strength of the red nucleus in the PSP group were higher (P<0.01).Compared with the PSP group and the control group,the substantia nigra hyperechoic area,the ratio of total substantia nigra hyperechoic area to total midbrain area in the PD group were higher (P<0.01).According to the ROC curve,it can be observed that the sensitivity of substantia nigra hyperechoic area in TCS was high while the specificity of low signal intensity of putamen in SWI was high as well;When TCS and SWI jointly identified the PD group and PSP group,the sensitivity was 93.9%,the specificity was 81.8%,the area under the curve (AUC) was 0.938,and the value of identification diagnosis was high.The sensitivity and specificity of the MRPI and P/M values in the identification of the PSP group and PD group reached 100%.Conclusion　The value of TCS,SWI,and MRI in the identification of PSP and PD is different.TCS combined with SWI is of higher diagnosis value in the identification of PD group and PSP group,which provides a new method for the identification diagnosis of PSP.The overall value of differential diagnosis of MRI is better than TCS and SWI.

Clinical prognosis of patients with acute ischemic stroke and its application value were evaluated using 3D CUBE T1 high resolution imaging and magnetic sensitivity techniques / 中风与神经疾病杂志

@#Objective　Clinical prognosis and clinical application value of patients with acute ischemic stroke were evaluated using magnetic resonance 3D CUBE T1 high resolution vascular wall imaging and magnetic sensitive vascular signs （SVS）. Methods　Demographic data and imaging characteristics of patients with acute ischemic stroke with in 24 hours were collected to evaluate the NIH Stroke Scale （NIHSS） and the modified Rankin Scale. The risk factors of 3D CUBE T1 high signal and SVS （dual-symptom group） were found by binary logistic regression analysis，and whether there a difference between NIHSS score at admission and discharge time and the score of modified Rankin scale 3 months later. Results　No risk factors associated with MRA occlusion or dual-sign group were found by binary logistic regression analysis. When the NIHSS score was compared at 7 days’ discharge，it was found that the patients in the MRA group （P=0.007） and the double-sign group （P=0.010） had higher NIHSS score and heavier clinical manifestations. By comparing the modified Rankin scores of the patients 3 months after discharge，it was found that the patients in the MRA group （P=0.019） and the dual-sign group （P=0.026） had worse prognosis at 3 months. At the same time，the data showed that there was a good consistency between dual-sign and MRA in assessing the severity of symptoms and prognosis of patients （P=0.996 for comparison of NIHSS score and P=0.912 for the modified Rankin Scale score）. Conclusion　In patients with acute ischemic stroke，the combination of 3D CUBE T1 sequence high signal and magnetic sensitive vascular signs of thrombosis can better determine and predict the prognosis of patients. Meanwhile，patients with 3D CUBE T1 high signal and magnetic sensitive vascular signs （SVS） have higher NIHSS score at discharge and worse prognosis after 3 months. Compared with the MRA group，the combination of 3D CUBE T1 sequence high signal and magnetic sensitive vascular signs of thrombosis has a better consistency in the assessment of patients’ clinical manifestations and prognosis，which is worthy of clinical technology promotion and application.

Cerebellar dentate nucleus and its veins on susceptibility weighted imaging / 解剖学报

Objective Make use of image dentate nucleus and the veins around it on susceptibility weighted images (SWI), explore the correlation between the location of hilum of dentate nucleus and the venous variation of dentate nucleus. Methods Selecting 51 healthy adults (24 men, 27 women) at the age between 18 and 30 years old to get the original images on 3. 0T MR. Process the original images by minimum intensity projections (mIP) observed and analyzed the morphology of dentate nucleus and veins around it on original and processed images. Results The length of dentate nucleus was (16. 64±0. 20)mm, and the width was (8. 36±0. 14)mm. There was no significant difference between bilateral dentate nucleus. The median angle of the long axis of the dentate nucleus was 26. 80° (interquartile distance was 34. 58°). The venous network of dentate nucleus was formed in 2 groups of veins: the lateral group, drained by the vein of the horizontal fissure and nuclear vein; the medial group, drained by vermian vein and central vein of dentate nucleus. These two groups had been further typing as follows: the lateral anterior group drained by the nuclear vein, finally opening to superior petrosal sinus; the lateral median group had plenty of small veins of lateral dentate nucleus converge into the vein of the horizontal fissure; the lateral posterior group drained by a lot of very small veins converging to vermian veins or medullary veins; the medial anterior group that the central vein of dentate nucleus and the paravermian vein were jointed at hilum of dentate nucleus, opening into straight sinus; the medial posterior group usually converged into tributaries of vermian vein, or converged with paravermian vein into tributaries of vermian vein. Totally 75. 49% of hilums of dentate nucleus were located at upper inner quadrant, the other 24. 51% of them were located at lower inner quadrant. Conclusion Dentate nucleus and its veins are clearly visible on the susceptibility weighted images, and the location of the hilum of dentate nucleus may be related to the abouchement of paravermian vein.

Experimental study on early diagnosis of liver fibrosis using multi?parametric MRI / 中华放射学杂志

Objective To assess diagnostic performance of multi?parametric MRI including MR elastography (MRE), susceptibility?weighted imaging (SWI) and T1ρ imaging in detecting the early stage of liver fibrosis (LF). Methods Eighty healthy rabbits were randomly divided into LF group (n=60) and control group (n=20). The LF group (n=12) and control group (n=5) were randomly selected at the end of the 4th, 5th, 6th, 15th week after injection of 50% CCl4 oil solution, respectively. All rabbits underwent 3.0 T MRI scans and histopathological Scheuer staging. Differences between groups were examined using one?way analysis of variance with Dunnett's T3 test. Spearman correlation was used to analyze the correlation between liver stiffness (LS), liver?to?muscle SI ratio (SIR), T1ρ value in different LF stages. ROC curve analysis was used to assess the diagnostic performance. Results Fifty?five rabbits were included in our study, which covered F0 (n=14), F1 (n=11), F2 (n=10), F3 (n=9) and F4 (n=11). Significant differences of all characteristic values were found among different LF stages (P<0.05).There were significant differences in LS values between F0 and F2, F3, F4, respectively; F1 and F3, F4, respectively; F2 and F4; F3 and F4 (P<0.05). There were significant differences in SIR between F0 and F2, F3, F4, respectively; F1 and F2, F3, F4, respectively; F2 and F4 (P<0.05). T1ρ value showed significant differences between F0, F1, F2, F3 and F4, respectively (P<0.05). LS, SIR, and T1ρ values were correlated with LF stage (r=0.910, -0.808, 0.512, respectively, P<0.01). The area under curve (AUC) for LS value were greater than those for the other two methods (0.953 for≥F1, 0.949 for≥F2, 0.986 for≥F3, 0.979 for F4). The AUCs of the combination of MRE and SWI for detecting≥F1 was 0.965, for≥F2 was 0.983, for≥F3 was 0.991, and for F4 was 0.950. Combining all three MR methods showed the highest diagnostic performance for staging LF with AUCs of 0.969, 0.985, 0.996 and 1.000.Conclusion MRE is the most prominent MRI method, and combination of MRE and SWI show higher diagnostic performance than the others for staging LF; however, combining all three MR methods exhibits the most excellent diagnostic efficacy.

Susceptibility-Weighted MR Imaging for the Detection of Isolated Cortical Vein Thrombosis in a Patient with Spontaneous Intracranial Hypotension

Spontaneous intracranial hypotension (SIH) can be a rare risk factor of cerebral venous thrombosis. We describe a case of isolated cortical vein thrombosis (CVT) secondary to SIH and discuss the value of susceptibility-weighted imaging for the detection of isolated CVT.

Clinical characteristics of patients with delayed hepatolenticular degeneration / 中华内科杂志

Objective To evaluate the clinical manifestations, metal metabolism, imaging characteristics and treatment response in patients with delayed Wilson disease (WD). Methods Patients with untreated WD (40 with delayed onset and 40 with non?delayed onset) were enrolled. Twenty healthy people were included as normal controls. All patients were evaluated with modified Young scale neural symptom scores, grade of Child liver function and mental symptoms rating scale, magnetic resonance imaging (MRI) scan, magnetic sensitive imaging (susceptibility weighted imaging, SWI), metal metabolism. Corrected phase (CP) was measured at SWI. After 2 week treatment, neurologic symptoms, liver function, and metal metabolism were reviewed. Results The total score of neurological symptoms in WD patients with delayed onset was lower than that of non?delayed onset (13.00 ± 6.87 vs. 21.13 ± 5.53, P=0.033). The scores of SCL?90 and HAMA depression scales in patients with delayed onset were lower than those of non?delayed onset. On T2 weighted imaging, areas including substantia nigra and thalamus, the caudate nucleus, globus pallidus, putamen presented high signal rate in patients with delated onset than those with non?delayed (P=0.022, 0.037, 0.022, 0.037, 0.029 respectively). The SWI CP values of cangbai sphere and shell nucleus in patients with delayed onset were lower than those with non?delayed onset. Patients with delayed onset had higher urinary copper than those with non?delayed onset before and after treatment (P=0.040, 0.036). After treatment, the score of abnormal tremor and gait in patients with delayed onset was decreased (P=0.037, 0.044), while as the occurrence of neurological symptoms was increased by 10%, and the liver function level in patients with delayed WD was decreased in 3 cases. Conclusions The brain of WD patients with delayed onset is mainly composed of metal deposits, however the cell damage is not apparent. Clinical symptoms are characterized by significant liver injury, but relatively mild neurological and psychiatric symptoms. Patients with delayed WD have higher urinary copper excretion than those with non?delayed WD. Chelating agents improves the neurological symptoms in patients with delayed onset.

Arterial Spin Labelling Perfusion, Proton MR Spectroscopy and Susceptibility-Weighted MR Findings of Acute Necrotizing Encephalopathy: a Case Report

In this study, we report arterial spin labelling perfusion, proton MR spectroscopy and susceptibility-weighted MR findings of acute necrotizing encephalopathy in a child with rotavirus infection.