Imaging features of severe unilateral transverse sinus and sigmoid sinus thromboses and efficacy and safety of intravascular interventional therapy in them / 中华神经医学杂志

Objective:To summarize the imaging features of severe unilateral transverse sinus and sigmoid sinus thromboses, and evaluate the efficacy and safety of intravascular interventional therapy in them.Methods:Thirty-seven patients with severe unilateral transverse sinus and sigmoid sinus thromboses clinically mainly manifested as intracranial hypertension and accepted endovascular intervention in Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University from June 2012 to September 2022 were chosen; their clinical data were retrospectively analyzed and imaging features were summarized. Short-term efficacy was evaluated according to blood flow restoration degrees and pressure gradient reduction in the occlusive sinus and modified neurological symptoms before and after endovascular intervention. Hospitalized complications were observed; safety and long-term efficacy were evaluated according to postoperative clinical follow-up and imaging results 6-12 months after endovascular intervention.Results:(1) Preoperative brain MRI and (or) CT showed different degrees of swelling of the brain tissues, with the affected side as the target; mixed signals/density shadow could be seen in the blocked transverse sinus and sigmoid sinus; venous cerebral infarction or post-infarction cerebral hemorrhage could be combined in some patients. MRV, CTV and DSA showed poor or completely occluded transverse sinus and sigmoid sinus while normal in the contralateral side; obvious thrombus filling-defect was observed in the occluded venous sinus after mechanical thrombolysis. (2) Occlusive sinus blood flow was restored in all patients after endovascular intervention, and pressure gradient of the occlusive segment decreased from (16.6±3.3) mmHg before to (2.8±0.8) mmHg after endovascular intervention. Before discharge, clinical symptoms of all patients were significantly improved (modified Rankin scale [mRS] scores of 0 in 30 patients, 1 in 5 patients, 2 in 1 patient and 3 in 1 patient), and 2 patients had unilateral limb movement disorder (muscle strength grading III and IV, respectively). All patients received clinical follow-up for (9.6±3.0) months. At the last follow-up, neurological function obviously improved compared with that before endovascular intervention, without new neurosystem-related symptoms (mRS scores of 0 in 30 patients, 1 in 6, and 2 in 1 patient). In 34 patients received MRV or DSA follow-up, 28 had complete recanalization of occlusive sinus and 6 had partial recanalization, without obvious stenosis or recurrent occlusion.Conclusions:Severe unilateral transverse sinus and sigmoid sinus thrombosis can cause local intracranial venous blood stasis, and then cause "increased regional venous sinus pressure", which is manifested as unilateral brain tissue swelling and even venous cerebral infarction or post-infarction cerebral hemorrhage. Early diagnosis and endovascular intervention can obviously improve the prognosis of these patients, enjoying good safety.

Clinical Analysis of Pulmonary Lymphoma / 中国实验血液学杂志

OBJECTIVE@#To study the clinical, imaging, and pathological features of pulmonary lymphoma.@*METHODS@#Patients with pulmonary lymphoma diagnosed by lung biopsy in Zhongda Hospital Affiliated to Southeast University from November 2013 to December 2020 were collected and divided into secondary pulmonary lymphoma (SPL) group and primary pulmonary lymphoma (PPL) group according to the primary site of lymphoma. The clinical characteristics, stages, imaging features, diagnostic methods and pathological types of the two groups were analyzed.@*RESULTS@#A total of 22 patients were included, 10 cases were PPL and 12 cases were SPL. The main symptoms of the two groups were cough, dyspnea and chest pain. The proportion of stage III/IV patients and international prognostic index (IPI) in SPL group were significantly higher than those in PPL group (P<0.05). Chest high-resolution computed tomography (HRCT) mainly showed masses, nodules and consolidation in both groups. The proportions of single mass and air bronchial sign in PPL group were significantly higher than those in SPL group, while the proportions of multiple nodules, mediastinal/hilar lymphadenopathy and pleural effusion were significantly lower (P<0.05). The max standardized uptake value (SUVmax), peak standardized uptake value (SUVpeak), total lesion glycolysis (TLG) and metabolic tumor volume (MTV) of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in PPL group were lower than those in SPL group, but the differences were not statistically significant (P>0.05). In PPL group, 8 cases were diagnosed by transbronchial lung biopsy (TBLB) and 2 cases by percutaneous lung puncture. In SPL group, 4 cases were diagnosed by TBLB, 7 cases by percutaneous lung puncture, and 1 case by surgery. 95.5% patients were diagnosed by non-surgical methods. The main pathological type of PPL was mucosa-associated lymphoid tissue (MALT) lymphoma, while that of SPL was diffuse large B-cell lymphoma (P<0.05).@*CONCLUSION@#The clinical symptoms of pulmonary lymphoma are nonspecific, but the chest HRCT has characteristic manifestations, which can also help to distinguish between SPL and PPL. 18F-FDG PET/CT is also a potential method to distinguish between SPL and PPL. TBLB and percutaneous lung puncture biopsy are reliable methods for the diagnosis of lung lymphoma. The main pathological type of PPL is MALT lymphoma, while that of SPL is diffuse large B-cell lymphoma.

Clinical characteristics and prognosis of posterior reversible encephalopathy syndrome with spinal cord involvement / 中华神经科杂志

Objective:To investigate the clinical manifestations, imaging features and prognosis of posterior reversible encephalopathy syndrome with spinal cord involvement (PRES-SCI).Methods:The clinical data of 1 patient with PRES-SCI admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University in November 2021 were analyzed, and the data of 38 patients with PRES-SCI reported in domestic and foreign databases and this patient were collected for pooled analysis.Results:The main clinical manifestations of 39 PRES-SCI patients (including this patient) included headache (79.5%, 31/39), visual disturbance (79.5%, 31/39), vomiting (46.2%, 18/39), disturbance of consciousness (38.5%, 15/39), limb weakness (28.2%, 11/39) and seizure (23.1%, 9/39). There were up to 97.4% (38/39) of patients who had significantly elevated blood pressure. The imaging feature was long-segment spinal cord lesion involving central gray matter. Approximately 89.7% (35/39) of the spinal cord lesions originated from the junction of the medulla oblongata and the cervical spinal cord. The median number of abnormal spinal cord segments corresponding to the vertebral body was 9 (the shortest was 4 and the longest was the entire spinal cord). Thirty-eight patients had brain lesions, and the most frequently involved sites were medulla oblongata (82.1%, 32/39), occipital lobe (46.2%, 18/39), pons (43.6%, 17/39), parietal lobe (41.0%, 16/39), and cerebellum (38.5%, 15/39). Among 38 patients completing the follow-up, 31 patients (81.6%) were clinically recovered.Conclusions:Posterior reversible encephalopathy syndrome could involve the spinal cord. For patients with long-segment spinal cord lesions and significantly increased blood pressure or other risk factors, PRES-SCI should be considered. Timely identification and treatment could make most patients recovery.

Clinical analysis of 26 cases of Chlamydia psittaci pneumonia confirmed using metagenomic next-generation sequencing / 中华传染病杂志

Objective:To explore the clinical characteristics and treatment strategies for Chlamydia psittaci pneumonia confirmed using metagenomic next-generation sequencing (mNGS). Methods:A total of 26 patients with Chlamydia psittaci pneumonia admitted to the Huizhou Municipal Central People′s Hospital and Huizhou First People′s Hospital from January 2020 to December 2021 were enrolled. The clinical data were collected, including basic information, clinical manifestations, laboratory examinations, chest computed tomography (CT) findings, mNGS results, treatment outcomes and prognosis. Results:Twenty (76.9%) of the 26 cases with Chlamydia psittaci pneumonia had a definite bird or poultry contact history. The onset season was mostly in winter (57.7%, 15/26). All 26 cases had symptoms of high fever, chill, fatigue, anorexia and cough, 21 cases (80.8%) had dyspnea, 19 cases (73.1%) had relative infrequent pulse, 12 cases (46.2%) had headache, myalgia, and seven cases (26.9%) had disturbance of consciousness. Among the 26 cases, the white blood cell count was normal in 17 cases (65.4%), and the lymphocyte count was decreased in 21 cases (80.8%). All 26 cases had increased hypersensitive C-reactive protein and procalcitonin. D-dimer was elevated in 24 cases (92.3%), aspartate aminotransferase was elevated in 18 cases (69.2%), and alanine aminotransferase was elevated in 15 cases (57.7%). Chest CT mainly showed lung consolidation, and 20 cases (76.9%) had multiple lobes of the lungs involved, 18 cases (69.2%) had the lower lobe of the lung as the main lesion. Among the results of mNGS of 26 cases, nine cases (34.6%) had only Chlamydia psittaci detected, and 17 cases (65.4%) had other pathogenic microorganisms detected. After targeted anti-infection treatment, two cases died of multiple organ failure and the remaining 24 patients recovered. Conclusions:The common manifestations of Chlamydia psittaci pneumonia are high fever, dyspnea, relative bradycardia, normal white blood cell count, and lung consolidation. mNGS is helpful for early diagnosis of disease, and appropriate treatment can improve the prognosis.

The image characteristics of spectral-domain optical coherence tomography on retinal tuft / 中华眼底病杂志

Objective:To describe the spectral-domain optical coherence tomography (SD-OCT) features of retinal tuft.Methods:A retrospective clinical study. From May 2019 to April 2020, 22 patients (22 eyes) diagnosed as retinal tuft by clinical fundus examination in Eye Hospital of Wenzhou Medical University at Hangzhou were included in the study. There were 9 eyes in 9 males and 13 eyes in 13 females. All patients underwent ultra-widefield laser scanning fundus photography and SD-OCT examination. SD-OCT was performed with a 55° wide-angle lens to observe the morphology, color, size and location of the lesions.Results:Twenty-six retinal tuft lesions were found in 22 eyes, all of which were solitary, gray, thylakoid and protrusion. SD-OCT images showed that all the lesions of retinal tuft showed a local protuberant appearance with moderate and hyperreflectivity, which was higher than the surrounding retina plane. In 22 lesions (84.62%, 22/26), there were one or more irregular hyporeflective cavities between the retinal neuroepithelial layers, and the other 4 lesions (15.38%,4/26) contained no hyporeflective cavities. In addition, 23 cases (88.46%, 23/26) with hyperreflective condensed cortical vitreous attached to the retina at the top of lesions, 8 cases (30.77%, 8/26) with retinal tear, and 6 cases (23.08%, 6/26) with shallow retinal detachment.Conclusions:In SD-OCT, the retinal tufts show moderate and strong local protrusion, which are higher than the surrounding retinal plane. In most of the lesions, there are multiple or single irregular weak reflex cavities, and there are hyperreflective condensed cortical vitreous attached to the retina at the top of lesions. Local retinal tears or shallow retinal detachment are present in some lesions.

Application of PET/CT radiomics in the treatment of non-small-cell lung cancer / 中华放射医学与防护杂志

Primary lung cancer is the first malignant tumor in our country and in the world with an increasing mortality trend, which seriously endangers the human health. By digging the deep relationship between high-dimensional imaging features and pathophysiological features, radiomics can establish a predictive model to distinguish pathological types, tumor stages, distant metastases and survival, guide individualized diagnosis and treatment strategies, and improve prognosis. PET/CT has higher diagnostic accuracy and specificity by reflecting tumor tissue metabolism. This article reviews the application of PET/CT radiomics in the treatment of non-small-cell lung cancer (NSCLC).

Diagnoses and treatments of pleomorphic xanthoastrocytoma: a clinical analysis of 25 cases / 中华神经医学杂志

Objective:To analyze the clinical, imaging and pathological characteristics of pleomorphic xanthoastrocytoma (PXA), and to explore the effective treatment of PXA.Methods:A total of 25 patients with PXA admitted to our hospital from July 1, 2012 to December 1, 2019 were chosen in our study. Their clinical manifestations, imageology features, pathology features, treatments, and prognoses were retrospectively analyzed.Results:Headache ( n=12) and epilepsy ( n=8) were the most common first symptoms in 25 patients. The tumors in 8 patients were located in the parietal lobe, 6 were in the temporal lobe, and 6 were in the frontal lobe. Among the pathological results, the average positive rate of cell proliferation antigen Ki-67 and P53 in patients with WHO grading II was 6.4% and 21.2%, respectively; the average positive rate of Ki-67 and P53 in patients with WHO grading III was 22.2% and 48.3%, respectively. Synaptophysin protein was confirmed in 12 of the 15 patients. Twenty patients were followed up for 31 months after surgery; 19 survived; 9 had no tumor recurrence or residue, including 8 with WHO grading II and one with WHO grading III. Conclusion:Pathological result play an important role in PXA diagnosis; the prognosis of patients with WHO grading II is obviously better than that of patients with WHO grading III.

Clinical characteristics of several patients with coronavirusdisease 2019 in Lanzhou City / 西安交通大学学报(医学版)

【Objective】 To investigate and summarize the clinical and imaging features of a few patients with coronavirus disease 2019 (COVID-19) in Lanzhou City. 【Methods】 We carried out a retrospective analysis of the epidemiological data, laboratory results and clinical imaging features of eight hospitalized patients with confirmed COVID-19 in The First Hospital of Lanzhou University from January 23 to February 23, 2020. 【Results】 The sex ratio (men to women) of the 8 patients was 5∶3 while their age ranged from 24 to 57 years old. The incubation period was 1-10 days. Of the 8 patients, 7(87.5%) had COVID-19 brought in from other places in China and 1(12.5%) was a secondary infection case. The main clinical manifestations included cough in 6 cases (75%), fever in 4 cases (50%), expectoration in 3 cases (37.5%), and fatigue in 2 cases (25%). All the 8 cases indicated abnormal manifestations in blood routine examinations, 4 cases (50%) decreased in WBC, 7 cases (87.5%) decreased in Lym count, 5 cases (62.5%) increased in LDH, 1 case (12.5%) increased in CK, 1 case(12.5%) increased in CK-MB, 4 cases (50%) increased in CRP, 2 cases (25%) increased in PCT, and 1 case (12.5%) increased in D-dimer. Of the 2 patients examined by chest digital radiography (DR), one DR finding was not typical and the other one suggested increased bilateral lung markings. Six patients were examined by HRCT, of whom four (50%) showed multiple ground glass opacities on both lobes and two (25%) showed multiple ground glass opacities only on the right lobe; none of the 6 imaging findings suggested pleural effusion. Six patients were discharged from hospital after being cured and 1 patient still underwent treatment. 【Conclusion】 Most of these 8 patients had COVID-19 imported from outside the city, and the patients were relatively young with few underlying diseases. Their major symptoms were fever, cough, and expectoration. All of them exhibited abnormal findings in blood routine examinations; half of them suggested increased CRP while a few ones showed abnormal CK and Ddimer values. The imaging manifestations of most patients were multiple ground glass opacities near the peripheral pleura.

Recent advance in diagnosis and treatment of fourth ventricle meningiomas / 中华神经医学杂志

The primary fourth ventricle meningiomas (FVMs) are rare fourth intraventricular tumors. Meningiomas account for approximately 13%-20% of all intracranial tumors; 0.5%-3% of meningiomas locate in the ventricle, whereas only 5% of meningiomas locate in the ventricle occur in the fourth ventricle. To date, the report about the FVMs is less than 80 cases all over the world, and most of the literatures about this disease are case reports. The clinical manifestations, imaging features, intraoperative findings and prognoses are lack of comprehensive understanding. In this paper, based on the FVMs case reports and research progress in recent years, we aim to summarize the clinical characteristics and treatment of FVMs to provide a beneficial reference for the diagnoses and treatments of FVMs.

Clinical and imaging features of thirty cases of paragonimiasis westermani / 中国血吸虫病防治杂志

Objective To analyze the clinical manifestations and imaging characteristics of pulmonary and extra pulmonary paragonimiasis westermani. Methods A retrospective analysis was performed of 30 patients diagnosed by clinical features, laboratory serological tests and surgical pathology. Results The symptoms of the lung included mainly chest distress, fever, chest pain, cough and expectoration, and dyspnea. The extra pulmonary symptoms included abdominal pain, vomiting, diarrhea, poor appetite, emaciation, both lower extremities asthenia, headache, dizziness, epileptic seizures, and subcutaneous migratory masses. The laboratory examination showed that the eosinophil numbers of serum and pleural effusion of all the thirty patients were increased, and the eggs of Paragonimus westermani were found by the stool tests in four cases. The chest CT tests found abnormal nodules, ground glass changes, insect damages, pleural effusion, "tunnel" signs, and "halo" signs. Cranial CT and MRI showed intracranial hemorrhage foci, and extensive "finger-like" edema. Abdominal CT showed serpentine deformation and “tunnel” signs in the hepatic and spleen capsules. Conclusions Paragonimiasis westermani is a multiple organ system involved infection, and it has complex and varied clinical manifestations. The "tunnel" sign and serpentine deformations in the intracranial part, lung, liver and spleen are important imaging manifestations of the disease.

Clinical and imaging features of thirty cases of paragonimiasis westermani / 中国血吸虫病防治杂志

Objective To analyze the clinical manifestations and imaging characteristics of pulmonary and extra pulmonary paragonimiasis westermani. Methods A retrospective analysis was performed of 30 patients diagnosed by clinical features, laboratory serological tests and surgical pathology. Results The symptoms of the lung included mainly chest distress, fever, chest pain, cough and expectoration, and dyspnea. The extra pulmonary symptoms included abdominal pain, vomiting, diarrhea, poor appetite, emaciation, both lower extremities asthenia, headache, dizziness, epileptic seizures, and subcutaneous migratory masses. The laboratory examination showed that the eosinophil numbers of serum and pleural effusion of all the thirty patients were increased, and the eggs of Paragonimus westermani were found by the stool tests in four cases. The chest CT tests found abnormal nodules, ground glass changes, insect damages, pleural effusion, "tunnel" signs, and "halo" signs. Cranial CT and MRI showed intracranial hemorrhage foci, and extensive "finger-like" edema. Abdominal CT showed serpentine deformation and “tunnel” signs in the hepatic and spleen capsules. Conclusions Paragonimiasis westermani is a multiple organ system involved infection, and it has complex and varied clinical manifestations. The "tunnel" sign and serpentine deformations in the intracranial part, lung, liver and spleen are important imaging manifestations of the disease.

CT imaging features and its correlation with histopathology of thyroid nodules in children / 中华实用儿科临床杂志

Objective To investigate the CT features of benign and malignant thyroid nodules in children and their correlation with histopathology of thyroid nodules.Methods The clinical data of 28 children with thyroid nodules confirmed by pathological diagnosis in Shanghai Children's Hospital from June 2014 to October 2017 were retrospectively analyzed.The CT imaging features and pathological results were compared and analyzed.Results The thyroid nodules of benign,malignant and uncertain malignant potential nodules in this group respectively were 35 nodules (11 cases),15 nodules (10 cases) and 8 nodules (7 cases) respectively,with a total of 58 nodules.Benign and uncertain malignant potential nodules were all(100.0％) enveloped,4 nodules(11.4％,4/35 nodules) were benign nodules and 1 nodule (12.5％,1/8 nodules) was uncertain malignant potential nodules and its capsule was incomplete.There were 11 nodules (73.3％,11/35 nodules) malignant nodules without capsule and 4 nodules(26.7％,4/15 nodules) were malignant nodules with incomplete capsule.In the benign nodules,9 nodules(25.7％,9/35 nodules) of them were cystic,and the others were solid or solid cystic (74.3 ％,26/35 nodules).All of the malignant nodules and uncertain malignant potential nodules were solid or solid cystic nodules.Benign nodules and uncertain malignant potential nodules were mostly had clear edges,but the edges of malignant nodules were not clear.There were 2 cases (18.2％,2/ll cases) of the benign nodules which had calcification,8 cases(80.0％,8/10 cases) of the malignant nodules had calcification,and 3 cases (42.9％,3/7 cases)of the uncertain malignant potential nodules had calcification.There was no lymph node metastasis in the patients with benign and uncertain malignant potential nodules.In the malignant nodules,there were 7 cases with lymph node metastasis,accounting for 70.0％ (7/10 cases).It had certain reference value for the differentiation of benign and malignant nodules to know whether the boundary of the mass was clear or not,whether the capsule was intact or not,and whether there was calcification or not.The surrounding lymph node enlargement had certain reference value for the differential diagnosis of benign and malignant nodules.The diagnostic results of CT and the coincidence rate of pathological histological diagnosis after operation,the benign nodules and malignant nodules,and also the uncertain malignant potential were respectively 61.1％ (11/18 cases),90.0％ (9/10 cases) and 14.3％ (1/7 cases).The thyroid nodules of uncertain malignant potential CT imaging were lack of specificity,and definite diagnosis should be based on pathology.Conclusions There is a certain relationship between CT imaging features and pathology of thyroid nodules,which is of great value for the diagnosis and differential diagnosis of thyroid nodules in children.

Research progress on radiomics reproducibility / 中华放射肿瘤学杂志

Radiomics has played an irreplaceable role along with the development of precision medicine. In the field of radiomics researches,the stability of imaging features is of vital significance,which is directly linked to the modeling analysis. In this review,we summarized the recent research progress on the reproducibility problems in four crucial steps of the standard workflow of radiomics including imaging acquisition and reconstruction, region of interest(ROI)segmentation, imaging feature extraction and modeling establishment. In addition,the commonly used software related to radiomics was briefly introduced.

Symptomatic splanchnic artery dissection：imaging diagnosis and interventional treatment / 介入放射学杂志

Objective To summarize the experience in the diagnosis and treatment of symptomatic splanchnic artery dissection. Methods A total of 21 patients with symptomatic splanchnic artery dissection, who were admitted to the Affiliated First Hospital of China Medical University during the period from June 2006 to March 2014, were included in this study. Combined with the literature, the clinical data, including the diagnosis and treatment, were analyzed. Results Contrast-enhanced abdominal CT and CT angiography revealed superior mesenteric artery dissection in 15 cases, celiac artery dissection in 5 cases and splenic artery dissection in one case. Conservative therapy was employed in 5 patients; among them one was complicated with hepatic artery thrombosis. Of the 16 patients who received endovascular stent placement, additional intestinal resection was performed in 2 and transcatheter thrombolysis treatment in other 2. No procedure-related severe complications occurred in perioperative period. All the patients were followed up for 2-74 months (mean of 19.1 months). In patients who received endovascular stent placement, the abdominal pain and the bloody stool were relieved or disappeared, and no abdominal pain recurred. CT angiography showed that in-stent blood flow was fluent, the stent was in good position, and neither stenosis nor thrombosis was observed. One patient with superior mesenteric artery dissection died of stroke three months after the treatment. Conclusion It is very important to make early diagnosis and to adopt early treatment for symptomatic splanchnic artery dissection. CT angiography can confirm the diagnosis in most cases, but attention should be paid to some atypical manifestations. For the treatment of splanchnic artery dissection, endovascular stent placement is mini-invasive, safe and reliable.

Imaging findings of spinal giant cell tumor / 实用放射学杂志

Objective To improve the accuracy of diagnosis and differential diagnosis by summarizing imaging characteristics of spinal giant cell tumor of bone (GCTB).Methods Total 28 cases of spinal GCT were confirmed by pathology,of which 2 localized in cervical vertebra,8 in thoracic vertebra,8 in lumbar vertebra,and the other 10 lesions in the sacrum.All patients underwent X-ray,CT,and MRI scanning.Results (1)The incidence of spinal GCTB in the sacrum is highest,up to 35.7%.Lesions can locate in single or more vertebral bodies.All of the 10 cases with primary lesion locating the sacrum were involved in more vertebral bodies. (2)X-ray and CT showed central or eccentric vertebral destruction with 22 cases involving in adnexal bones,21 cases with bone crest or bony septum and 26 cases with soft tissue mass.(3)Lesions examined with MRI showed inhomogeneous isointense or slight hy-pointense on T1 WI,inhomogeneous hyperintense or isointense on T2 WI and inhomogeneous hyperintense or slight hyperintense on STIR.(4)Expansive bone destruction and soft tissue mass occurred again in postoperative recurrent lesions.Conclusion X-ray,CT and MRI are of significant value in the diagnosis of the spinal GCT.The combination of the three is helpful to improve the accuracy of diagnosis and differential diagnosis.

Hemichorea associated with diabetic hyperglycemia: a clinical characteristic analysis of 2 cases / 中华神经医学杂志

Objective To investigate the clinical characteristics and the imaging features of patients with hemichorea associated with hyperglycemia in primary diabetes mellitus (DM). Methods We retrospectively analyzed the clinical manifestations and the neuroimaging features of 2 patients with hemichorea induced by hyperglycemia in primary DM, admitted to our hospital on 9 and 29 October 2010; the related literatures about this disease were reviewed. Results These 2 patiewnts were both old female diabetics with acute onset of symptomatic hemichorea. One had an outbreak during using insulin to control blood glucose and the other did without using insulin; at first,case 2 symptom of one side chorea was showed,and then both sides were noted.CT findings indicated T1-high-density shadow in the contralateral caudate nucleus, putamen and globus pallidus (CT values in 50 Hu or so); MR imaging indicated that T1WI showed high-signal in the contralateral caudate nucleus,putamen and globus pallidus,while T2WI showed low-signal; partial light atrophy but no strengthening phenomenon in lesion location were noted. These patients were treated effectively with haloperidol and clonazepam.Conclusion Hemichorea induced by hyperglycemia often involves diabetic patients with poor glucose control. Characteristic imaging changes in the contralateral basal ganglia; blood glucose control is the foundation of treatment; haloperidol and clonazepam are helpful in controling hemichorea.

Clinical and imaging features of reversible posterior leukoenphalopathy syndrome: a report of 6 cases / 中华神经医学杂志

Objective To explore the clinical and imaging features of reversible posterior leukoencephalopathy syndrome (RPLS). Methods The etiology, clinical manifestations, imaging features, treatment and prognosis of 6 patients with RPLS, admitted to our hospital from December 2007 to August 2010, were retrospectively analyzed. Results Among the 6 patients with RPLS, 1 was secondary to leukemia, 1 secondary to nephrotic syndrome, 1 secondary to renal transplantation, 1 secondary to pheochromocytoma, and 2 secondary to primary hypertention. The clinical manifestations of patients included seizure, dizziness, headache, nausea, vomit, conscious disturbance, behavioral and psychological abnormalities, and visual disorder. Cranial CT showed that 4 patients had low-density white matter lesions; cranial MRI mainly indicated posterior cerebral hemisphere white matter lesions,and the lesions showed low or iso-signal in T1WI, high signal in T2WI and FLAIR, low or iso-signal in diffusion-weighted magnetic imaging (DWI) and high signal in apparent diffusion coefficient (ADC)map. Five patients received the right treatment got rapid improvement of clinical symptoms with normal imaging examinations. One patient with renal transplantation who refused to disable cyclosporin A and mycophenolate mofetil eventually died. Conclusion The diagnosis of RPLS relys on history, clinical features and imaging characteristics. Most patients have a better prognosis, but a few patients have poor prognosis due to various reasons.

Clinical and etiology analysis of 54 patients with pulmonary mycosis / 中国感染与化疗杂志

Objective To investigate the clinical manifestations, imaging features, diagnosis and management of pulmonary mycosis.Methods Fifty-four patients were identified with pulmonary mycosis by pathological examination in our hospital from January 2002 to June 2008. Data of clinical manifestations, imaging features, diagnosis and management were retrospectively reviewed.Results Of the 54 cases, 30 (55.6%) were pulmonary aspergillosis, 15 (27.8%) were pulmonary cryptococcosis. Underlying disease was reported in 42 of 54 (77.8%) cases. The diagnosis of all the patients was confirmed by pathological exami-nation. Lung or bronchi tissue was obtained by operation in 30 (55.6%) cases, by bronchofibroscope in 12 (22.2%) cases, by CT-guided percutaneous needle biopsy in 9 (16.7%) cases, and by lymphoid node biopsy in 4 cases. Main symptoms included cough (41, 75.9%), expectoration (30, 55.6%), hemoptysis (20, 37.0%), fever (16, 29.6%), and asymptomatic (6, 11.1%). The X-ray and chest CT showed masses or nodule lesions (41, 75.9%), patchy lesions (8, 14.8%), cavity (12, 22.2%), diffuse milliary nodules (1 case). Bilateral lungs were involved in 7 cases (13.0%);right lung alone in 26 cases (48.1%);left lung alone in 21 cases (38.9%). Among the 54 cases, 41 (75.9%) were misdiagnosed before pathological examination. Thirty (55.6%) cases underwent surgical resection of pulmonary lesions. One patient suffered from cryptococcal meningitis after operation. Twenty (37.0%) patients received systemic anti-fugal therapy. Cure or significant improvement was found in 16 cases. Conclusions The most frequently isolated fungi were Aspergillus, followed by Cryptococcus. Final diagnosis is mainly dependent on pathological examination. Clinical manifestations, imaging features, diagnostic procedures and management are different due to the difference of pathogenic fungi. Satisfactory Results can be obtained by anti-fungal therapy combined with surgical management.