Quantitative evaluation of passive muscle stiffness by shear wave elastography in healthy individuals of different ages.

OBJECTIVES: To investigate age-related changes on passive muscle stiffness in healthy individuals and measure the shear modulus in different age groups. METHODS: Shear wave elastography (SWE) movies of gastrocnemius medialis (GM) were collected during passive stretching induced by ankle rotation from plantarflexion (PF) to dorsiflexion (DF). A series of SWE images at ankle angles of PF 40°, PF 30°, PF 20°, PF 10°, 0°, DF 10°, DF 20°, and DF 30° were collected and shear moduli measured accordingly for analyses. RESULTS: Eighty-six healthy volunteers (27 children, 31 middle-aged adults, and 28 older people) were recruited. No significant difference was observed in the shear modulus between the three groups at ankle angles of PF 40°, PF 30°, PF 20°, PF 10°, and 0° (p > 0.05). The difference in the shear modulus among the three groups became significant as DF increased. At ankle angles of DF 10°, DF 20°, and DF 30°, the shear modulus was the greatest in the older group, followed by the middle-aged group and then the children group (p = 0.007, 0.000, and 0.000, respectively). CONCLUSIONS: Passive muscle stiffness increases with age, and the difference between age groups was pronounced only after reaching a certain degree of stretching. KEY POINTS: • The influence of age on passive muscle stiffness becomes pronounced only after reaching a certain degree of stretching. • Age should be considered when evaluating passive muscle stiffness in muscular disorders.

[Imaging Analysis in Cases with Clonorchiasis-Associated Cholangiocarcinoma].

Objective: To investigate the magnetic resonance imaging （MRI） and computed tomography (CT) features of clonorchiasis-associated cholangiocarcinoma, and provide reference for its clinical diagnosis. Methods: The CT and MRI （including magnetic resonance cholangiopancreatography, MRCP） data of 60 patients diagnosed to have cholangiocarcinoma（26 cases with clonorchiasis-associated cholangiocarcinoma, group A; 34 cases with simple cholangiocarcinomas, group B） by surgery or biopsy in two hospitals in Guangdong Province during July 2005 and June 2015 were collected. The tumor location, pathological types, imaging features, mode of enhancement, and the bile duct expansion were analyzed. Results: Imaging results showed that the tumor tended to occur in the right liver in group A（46.2%, 12/26） and in the left hepatic duct and the liver explorer in group B （61.8%, 21/34）（P<0.05）. The pathological types of tumor in both groups included the nodule/mass type (group A, 73.1%, 19/26; group B, 52.9%, 18/34), the infiltration type （15.4%, 4/26; 23.5%, 8/34）, and the cavity growth type（11.5%, 3/26; 23.5%, 8/34）（P>0.05）. Plain and enhanced CT and MRI results revealed no significant difference in tumor density, signal characteristics or the mode of enhancement between the two groups. MRCP results showed that the intrahepatic distal bile duct cystic dilatation, the intrahepatic bile duct cane soft tubular ectasia, the bile duct dilatation in the tumor, and the bile duct dilatation surrounding the tumor accounted for 61.5%（16/26）, 19.2% （5/26）, 50% （13/26） and 7.7%（2/26） in group A, and 8.8% （3/34）, 64.8% （22/34）, 20.6% （7/34） and 38.2% （13/34） in group B （P<0.05 for each of the four）， respectively. Conclusion: The clonorchiasis-associated cholangiocarcinoma has certain imaging characteristics. It is different from the simple cholangiocarcinomas in tumor location and intrahepatic bile duct dilatation.

Atropine Premedication Facilitates Ultrasound-Guided Reduction by Saline Enema in Children With Intussusception.

Background and Objective: Intussusception is the most frequent pediatric abdominal emergency. Intestinal spasm, ischemia, necrosis and even death may occur without prompt diagnosis and treatment. The ultrasound-guided reduction by saline enema is a preferred non-surgical procedure for intussusception. Muscular relaxants can relieve the intestinal spasm and edema by relaxing the intestinal smooth muscle, which may facilitate the treatment of intussusception. However, controversy persists on whether muscular relaxants are effective in the procedure. Therefore, the purpose of our study was to assess the efficacy of atropine known as a muscular relaxant in ultrasound-guided reduction by saline enema in children with intussusception. Methods: All patients with intussusception diagnosed and treated in our department from July 2016 to February 2018 were included. Four hundred and thirty-seven children were enrolled and randomly divided into two groups: an atropine group and a control group. Intramuscular atropine at a dose of 0.02 mg per kilogram of body weight was administrated 15 min before ultrasound-guided reduction by saline enema in the atropine group. In the control group, the ultrasound-guided reduction was performed without using any muscular relaxants. The success rate, duration of the reduction, volume of saline, maximum intra-rectal pressure and complications were recorded and compared between the two groups. Results: The success rate was 95.9% (212 out of 221) and 94.9% (205 out of 216) in the atropine group and the control group, respectively. No significant difference was observed in the success rate between the two groups (P > 0.05). The duration of reduction was significantly lower in the atropine group than in the control group (P < 0.01). The volume of saline was also significantly lower in the atropine group than in the control group (P < 0.05). The maximum intra-rectal pressure showed no difference between the two groups (P > 0.05). Conclusion: Atropine premedication can facilitate ultrasound-guided reduction by saline enema in children with intussusception, by reducing the duration of reduction and the volume of saline in the procedure.

Corrigendum: Atropine Premedication Facilitates Ultrasound-Guided Reduction by Saline Enema in Children With Intussusception.

[This corrects the article DOI: 10.3389/fphar.2019.00043.].

Risk factors analysis of mirror aneurysms: A multi-center retrospective study based on clinical and demographic profile of patients.

As a special subgroup of multiple intracranial aneurysms, mirror aneurysms are located bilaterally on the corresponding intracranial arteries. The current study sought to compare the clinical and demographic features of patients harboring mirror aneurysm, and to elucidate the corresponding risk factors. We performed a retrospective cohort study of 2641 intracranial aneurysms patients, who were admitted to our hospitals between January 2005 and June 2014. Patients were subdivided into three groups based on the inclusion criteria: (i) single (n=2250); (ii) non-mirror multiple (n=285); and (iii) mirror aneurysms (n=106). Clinical and demographic files of the three groups were collected and compared, and medical histories including stroke, hyperlipemia, hypertension, hyperglycemia, valvular heart disease were considered as potential risk factors. Potential morphological reasons for mirror cerebral aneurysms rupture, including aneurysms size, irregular walls and cerebral hemispheric dominance, were also compared. Our data showed that the male to female ratio of mirror aneurysms patients was 1:3.61, which was significantly different from that of single aneurysm (1:1.27) and multiple aneurysms (1:2.00). The prevalence of mirror aneurysms in women is higher than that in men (P<0.001). Older patients (especially 60-69 years old) also appear to be more vulnerable to mirror aneurysm than single aneurysm (P<0.001). In 84 mirror aneurysm patients the aneurysms were located on the internal carotid arteries (79.2%), most typically at the PComA or in the Cavernous ICA. Patients with medical history of hyperlipemia appear to have an increased risk of harboring mirror aneurysms. Larger aneurysm size and presence of an irregular aneurysm wall appear to be the morphological factors that predispose for mirror aneurysms rupture.

[Quantitative study of diffusion weighted imaging on magnetic resonance imaging in focal hepatic lesions less than 3 cm].

OBJECTIVE: To evaluate the characteristics of MR imaging of hepatic lesions using measurement of apparent diffusion coefficient (ADC) value of hepatic lesions on diffusion weighted imaging. METHODS: MR diffusion weighted images were obtained in patients with 97 hepatic lesions (22 hepatocellular carcinomas, 21 metastatic tumors, 28 hemangiomas, 26 cysts). ADC values were evaluated with different sequences. The ADC ratio of lesion/liver was estimated. RESULTS: Average ADC values of hepatic lesions were as follows: carcinomas (0.91 +/- 0.07) x 10(-3) mm(2)/s, metastatic tumors (1.13 +/- 0.27) x 10(-3) mm(2)/s, cavernous hemangiomas (1.94 +/- 0.37) x 10(-3) mm(2)/s, cysts (3.26 +/- 0.30) x 10(-3) mm(2)/s. The ADC ratio of lesion/liver was significantly different between primary carcinomas and metastatic tumors (P < 0.05). CONCLUSION: Quantitative study in hepatic lesions using ADC values and the ADC ratio of lesion/liver, would improve the accuracy in diagnosing hepatic lesions.

[Dynamic evaluation of rabbit VX2 hepatic carcinoma with CT and MRI].

OBJECTIVE: To dynamically monitor the growth of rabbit VX2 hepatoma by CT and MRI, and to understand the CT and MRI features during different periods of tumor growth. METHODS: The plain and dual-phase enhanced CT as well as the plain and enhanced MRI were performed in all the 10 rabbit VX2 hepatoma models (with 20 foci) at 1, 2 and 3 weeks after tumor implantation. RESULTS: The detection rate of the VX2 tumors by CT and MRI was low at 1 week after implantation, but was raised to 100% after another week. The tumors were shown to be homogeneously hypointense by unenhanced CT. In arterial phase CT images, peripheral rim enhancement of all the tumors were observed, while the main bodies of the tumors remained hypointense. The nutrient arteries for the tumors stretching straight to the margins of the tumors were detected in 14 (70%) foci and arterial vessels in the tumors visualized in 9 (45%) lesions. On portal venous phase CT the tumors were also shown to be hypointense. The tumors were shown to be homogeneously hypointense in T1-weighted MR images and lightly hyperintense in T2-weighted images, with peripheral rim enhancement of the tumors after injection of the contrast agent. The intensity of most tumors became hetergenerous on plain CT and MRI at week 3 after implantation. CONCLUSION: Rabbit VX2 hepatomas are hypovascular tumors the growth of which can be monitored by CT and MRI effectively.

[Clinical analysis of the relationship between injury of the marginal division and cognitive impairment].

OBJECTIVE: To investigate the relationship between injury in the marginal division (MrD) of the striatum and the cognitive impairment. METHODS: Twenty patients with injury in the MrD of the striatum were examined routinely by magnetic resonance imaging (MRI). Cognitive tests of each patient were performed and the results evaluated against their MRI findings. A comparative study of the MRI features and the degree of cognitive impairment was also performed between these patients and 10 patients with Alzheimer's disease (AD). RESULTS: Ischemic injury was the main cause of MrD injuries, manifested by abnormal signals (long T1 and T2 signals) in the MrD. The findings in the 10 AD patients were characterized by atrophy of the temporal lobe, hippocampus and the cortex. The average mini-mental-status examination (MMSE) score of the 20 patients was 19.7, with impaired memory and computation abilities as the main manifestations of cognitive impairments. The average MMSE score in the AD group was 11, and the cognitive impairments included all aspects of the cognitive function. No significant difference of the cognitive impairment was noted between the patients with only injury in the MrD and those with also the injury in other areas of the striatum. CONCLUSION: The MrD is probably a new area related to the memory function of the brain, and the injury of MrD may cause cognitive impairment.

[A simple method for evaluation of the stability of magnetic resonance scanner during brain function imaging].

OBJECTIVE: To develop a simple method for evaluating the stability of magnetic resonance (MR) scanner during brain function imaging. METHOD: A symmetrical water phantom was scanned using the same sequence and parameters as for brain function imaging. The stability of MR scanner was evaluated in view of the signal levels of phantom images. RESULT: The quality control chart of the mean value, standard deviation and the range of the signal level in the region of interest (ROI) within the same region on 128 phantom images were obtained, demonstrating the state of stability of the MR scanner. CONCLUSION: The quality control chart of ROI can be used to evaluate the stability of the MR scanner.

[Hemorrhage in the medial areas of bilateral putamens causing deficiency of memory and calculation: report of one case].

Bilateral cerebral hemorrhages in the medial areas of bilateral putamens that impair the memory and calculation abilities are rare clinical entities. In the case presently reported, the patient suffered initial cerebral hemorrhage 3 years ago in the medial area of putamen on the right side with light left paralysis but the learning and memory functions were intact. A recent cerebral hemorrhage on the left side leaving mild paralysis of the right upper limb, however, had caused considerable loss of his recent memory and calculation ability. As the 2 cerebral hemorrhages were found to cause damage to the marginal devision, the symptoms developed in this special case had provided clinical evidence for the postulation that the marginal division is associated with memory and calculation function.

[Role of the marginal division of human neostriatum in working memory capacity for numbers received through hearing: a functional magnetic resonance imaging study].

OBJECTIVE: With the help with functional magnetic resonance imaging (fMRI) technique, we aim to clarify whether the marginal division of the striatum (MrD) is involved in the working memory function of human brain for remembering numbers received through hearing. METHODS: Thirteen healthy volunteers were instructed to undertake both a working memory task, in which the subjects were asked to remember as many numbers read to them as possible, and a non-working memory control task, in which the subjects were not asked to remember the numbers. FMRI of the brain was performed in the 2 groups while the tests were being carried out separately, and the activity of the brain regions was compared between these 2 tasks. RESULTS: Eleven volunteers passed the working memory task for digit remembering. Highly active areas were observed in the prefrontal cortex and the MrD with predominance by the left side during performance of the working memory task, while other regions of the neostriatum were not excited. The prefrontal cortex and the MrD were not obviously activated during the performance in the control test. CONCLUSION: The results suggest that the MrD, along with the prefrontal cortex in the human brain, is involved in working memory function in remembering numbers assigned through hearing. The MrD is probably a subcortical memory center, which is linked to other memory-related brain areas.