Progressive gray matter hypertrophy with severity stages of insomnia disorder and its relevance for mood symptoms.

OBJECTIVE: To investigate the gray matter (GM) alterations in patients with insomnia disorder (ID) at different severity stages and the relationship between GM alterations and sleep, mood, and cognitive measures. METHODS: One hundred one ID patients and 63 healthy controls (HC) were included. Each patient underwent structural MRI and completed sleep-, mood-, and cognitive-related questionnaires. The ID patients were further grouped into subthreshold insomnia (SI) group and clinical insomnia (CI) group. We investigated changes in GM volumes in ID patients via diffeomorphic anatomical registration through exponentiated lie algebra voxel-based morphometry (DARTEL-VBM). We first compared voxel-wise differences in GM volumes between the HC group and the ID group. Analysis of variance was performed on individual GM maps in the SI, CI, and HC groups to further investigate the effects of different stages of ID severity on GM volumes. Multiple regression was used to model the relationship between altered GM volumes in SI and CI groups and clinical measures. RESULTS: GM hypertrophies in the left anterior and middle cingulate gyrus, right middle and inferior temporal gyrus, and right cerebellum Crus II were detected in ID. Increased GM volume in the right middle temporal gyrus was detected in the SI group, whereas all three regions in the CI group. Regression analysis showed that mood- and cognitive-related measures had a positive correlation with GM volumes, while sleep-related measures had a negative correlation with GM volumes in the CI group. CONCLUSIONS: Our findings of the progressively increased GM volumes in ID suggest that a hypertrophic cortical morphological mechanism may underlie the altered neuroanatomy induced by insomnia. KEY POINTS: • Insomnia-induced GM hypertrophies in the cingulate gyrus, temporal gyrus, and cerebellum Crus II. • The middle temporal gyrus was early detectable in the SI group. • The increased GM volumes in the CI group were correlated with clinical measures.

Altered resting state connectivity in right side frontoparietal network in primary insomnia patients.

OBJECTIVE: This study investigated alterations of resting-state networks (RSNs) in primary insomnia patients as well as relationships between these changes and clinical features. METHODS: Fifty-nine primary insomnia patients and 53 healthy control subjects underwent a resting-state fMRI scan (rs-fMRI). Ten RSNs were identified using independent component analysis of rs-fMRI data. To assess significant differences between the two groups, voxel-wise analysis of ten RSNs was conducted using dual regression with FSL randomised non-parametric permutation testing and a threshold-free cluster enhanced technique to control for multiple comparisons. Relationships between abnormal functional connectivity and clinical variables were then investigated with Pearson's correlation analysis. RESULTS: Primary insomnia patients showed decreased connectivity in regions of the right frontoparietal network (FPN), including the superior parietal lobule and superior frontal gyrus. Moreover, decreased connectivity in the right middle temporal gyrus and right lateral occipital cortex with the FPN showed significant positive correlations with disease duration and self-rated anxiety, respectively. CONCLUSIONS: Our study suggests that primary insomnia patients are characterised by abnormal organisation of the right FPN, and dysfunction of the FPN is correlated with disease duration and anxiety. The results enhance our understanding of neural substrates underlying symptoms of primary insomnia from the viewpoint of resting-state networks. KEY POINTS: • Primary insomnia patients showed altered functional connectivity in the right FPN. • Middle temporal gyrus FC with FPN was significantly correlated with disease duration. • Lateral occipital cortex FC with FPN was significantly correlated with SAS scores.

Increased insular connectivity with emotional regions in primary insomnia patients: a resting-state fMRI study.

OBJECTIVE: To explore the abnormal connectivity patterns between the insular and the voxels of the brain in primary insomnia (PI) with insular-based functional connectivity (FC). METHODS: With the resting-state fMRI data acquired from 57 PI patients and 46 healthy controls, a two-sample t test was performed on individual FC correlation maps from two groups. The person correlation analysis was used to evaluate the relationship between the abnormal FC and clinical features. RESULTS: PI patients show enhanced connectivity between the left insula with the right anterior cingulate cortex (p < 0.05 and p < 0.001, AlphaSim-corrected), right frontal sup orb, bilateral thalamus and left precuneus,as well as decreased connectivity with the left middle temporal gyrus and right fusiform (p < 0.05, AlphaSim-corrected). Correlation analysis indicated the enhanced connectivities in the PI patients have significant negative correlations with Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS)scores. In addition, the decreased functional connectivities showed positive correlations with SDS and SAS scores. CONCLUSION: Our study showed the increased connectivity regions with insula were mainly in the emotional circle and decreased connectivity was in cognitive-related regions. These provide additional evidence from functional integration view to understand the possible underlying neural- mechanisms of PI. KEY POINTS: • The aberrant insular-based connectivity pattern of PI patients was detected. • Regions showing increased connectivity with left insular were mainly in emotional circle. • Significant correlations between changed FC and SDS and SAS score were found.

Regional homogeneity changes in patients with primary insomnia.

PURPOSE: The study aimed to explore the regional spontaneous activity changes in primary insomnia (PI) patients. MATERIALS AND METHODS: Based on the resting-state fMRI datasets acquired from 59 PI patients and 47 healthy controls, a two-sample t-test was performed on individual normalized regional homogeneity (ReHo) maps. Relationships between abnormal ReHo values and the Pittsburgh Sleep Quality Index (PSQI), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) were investigated with Pearson correlation analysis. RESULTS: In PI patients, we found increased ReHo in the left insula, right anterior cingulate gyrus, bilateral precentral gyrus and left cuneus, as well as decreased ReHo in the right middle cingulate cortex and left fusiform (p < 0.05, AlphaSim-corrected). We also found a significant positive correlation between increased ReHo in the left insula and SAS scores, decreased ReHo in the right middle cingulated cortex and SDS, SAS scores as well as a negative correlation between increased ReHo in the right precentral gyrus and SDS scores (p < 0.05). CONCLUSIONS: Our study found abnormal spontaneous activities in multiple brain regions, especially in emotion-related areas in PI patients. Alterative activities in these regions might contribute to an understanding the intrinsic functional architecture of insomnia and its clinical features. KEY POINTS: • Regional spontaneous activity changes were detected in PI patients. • Decreased or increased ReHo of some regions was identified in PI patients. • Significant correlations between mean ReHo and SDS scores were found.

Computer tomography imaging findings of adrenal cavernous hemangiomas: a report of 10 cases.

BACKGROUND: Cavernous hemangiomas (CHs) of the adrenal gland are extremely rare. To date, only a few studies of adrenal CH imaging have been reported. PURPOSE: To analyze the computed tomography (CT) imaging findings of adrenal CHs. MATERIAL AND METHODS: Ten cases of adrenal CHs confirmed by a histopathological examination were retrospectively analyzed. All of the patients had undergone unenhanced and enhanced CT examinations, and eight had also undergone multiphase CT enhancement examinations. CT characteristics, including shape, size, margin, attenuation, and enhancement patterns, were analyzed. RESULTS: The study included six women and four men with a mean age of 49.2 years (age range, 25-62 years) and no signs of abnormal endocrine activity. The unenhanced CTs showed well-defined, heterogeneous (n = 8) or homogeneous (n = 2) density masses with scattered (n = 8) or spread calcifications (n = 2) in six tumors. In the contrast-enhanced CTs, seven tumors appeared to be marked with heterogeneous enhancement, whereas three cases exhibited no obvious enhancement. The evaluation of the pattern of dynamic enhancement in eight patients revealed that the tumors showed early peripheral enhancement (n = 4), early central enhancement (n = 1), and mixed enhancement (n = 1) with progressive partial filling-in, and no obvious enhancement in any phases (n = 2). CONCLUSION: Adrenal CHs should be included in the differential diagnosis when an adrenal neoplasm is incidentally found and appears as a well-defined, heterogeneous mass with calcifications and various enhancement patterns, including heterogeneous enhancement with characteristic progressive partial filling-in, as well as lack of enhancement in any phase.

Abnormal regional homogeneity of resting-state brain activity in patients with HBV-related cirrhosis without overt hepatic encephalopathy.

BACKGROUND: Many studies have reported that cognitive deficits exist in cirrhotic patients without overt hepatic encephalopathy (OHE). However, the neurobiological mechanisms underlying these deficits are still not fully understood. AIM: To investigate regional activity abnormalities in patients with hepatitis B virus-related cirrhosis (HBV-RC) without OHE using resting-state functional MRI (Rs-fMRI), and to examine the relationship between regional activity abnormalities and impaired cognition. METHODS: A newly reported regional homogeneity (ReHo) approach was used to compare the local synchronization of Rs-fMRI signals in 32 patients with HBV-RC without OHE and 32 well-matched healthy controls. Cognition was measured in all patients using psychometric hepatic encephalopathy score (PHES) tests, and the relationship between ReHo variation and PHES was analysed. RESULTS: Relative to healthy controls, the cirrhosis group showed high ReHo in the prefrontal cortex, and widespread low ReHo in visual association areas (left lingual gyrus, middle temporal gyrus and right middle occipital gyrus), motor association areas (bilateral precentral gyrus and paracentral lobule) and the bilateral precuneus. Correlation analysis of the mean ReHo values in different brain areas and PHES in cirrhotic patients revealed a significantly positive correlation in the left lingual gyrus (r = 0.352; P = 0.048), right middle occipital gyrus (r = 0.453; P = 0.009) and bilateral precentral gyrus (left: r = 0.436, P = 0.013; right: r = 0.582, P < 0.001), paracentral lobule (r = 0.485; P = 0.005) and precuneus (r = 0.468; P = 0.007). CONCLUSIONS: Our results provide information on the pathophysiological mechanisms underlying cognitive alterations in cirrhotic patients and demonstrate the feasibility of using Rs-fMRI with ReHo analysis as a noninvasive modality with which to detect the progression of cognitive changes in cirrhotic patients.

Aberrant brain entropy in posttraumatic stress disorder comorbid with major depressive disorder during the coronavirus disease 2019 pandemic.

Aim: Previously, neuroimaging studies on comorbid Posttraumatic-Major depression disorder (PTSD-MDD) comorbidity found abnormalities in multiple brain regions among patients. Recent neuroimaging studies have revealed dynamic nature on human brain activity during resting state, and entropy as an indicator of dynamic regularity may provide a new perspective for studying abnormalities of brain function among PTSD-MDD patients. During the COVID-19 pandemic, there has been a significant increase in the number of patients with PTSD-MDD. We have decided to conduct research on resting-state brain functional activity of patients who developed PTSD-MDD during this period using entropy. Methods: Thirty three patients with PTSD-MDD and 36 matched TCs were recruited. PTSD and depression symptoms were assessed using multiple clinical scales. All subjects underwent functional magnetic resonance imaging (fMRI) scans. And the brain entropy (BEN) maps were calculated using the BEN mapping toolbox. A two-sample t-test was used to compare the differences in the brain entropy between the PTSD-MDD comorbidity group and TC group. Furthermore, correlation analysis was conducted between the BEN changes in patients with PTSD-MDD and clinical scales. Results: Compared to the TCs, PTSD-MDD patients had a reduced BEN in the right middle frontal orbital gyrus (R_MFOG), left putamen, and right inferior frontal gyrus, opercular part (R_IFOG). Furthermore, a higher BEN in the R_MFOG was related to higher CAPS and HAMD-24 scores in the patients with PTSD-MDD. Conclusion: The results showed that the R_MFOG is a potential marker for showing the symptom severity of PTSD-MDD comorbidity. Consequently, PTSD-MDD may have reduced BEN in frontal and basal ganglia regions which are related to emotional dysregulation and cognitive deficits.

Amplitude low-frequency oscillation abnormalities in the heroin users: a resting state fMRI study.

Functional neuroimaging studies have revealed abnormal functional organization of the heroin users' brain, including reward circuit, cognitive control circuit, memory circuit, motivation and salience evaluation circuits and so on. In the current study, we aimed to explore the functional changes in the regional brain of heroin users using the amplitude of low-frequency oscillations in the Blood Oxygenation Level Dependent (BOLD) signals. With fMRI data acquired during resting state from 24 chronic heroin users (all subjects were being treated with methadone) and 24 non-addicted controls, we investigated addiction related altered in the amplitude low-frequency fluctuate (ALFF) between the two groups. Compared with controls, we found that heroin addicts had decreased ALFF in the bilateral dorsal anterior cingulate cortex (dACC), bilateral medial orbit frontal cortex (mOFC), left dorsal lateral prefrontal cortex (dlPFC), left middle temporal gyrus, left inferior temporal gyrus, posterior cingulate cortex and left cuneus as well as increased ALFF in the bilateral angular gyrus, bilateral precuneus, bilateral supramarginal gyrus, left post cingulate cortex and left middle frontal gyrus. Moreover, we also found that the increased ALFF in the bilateral parietal lobe had a significantly positive correlation with the methadone does, thus we inferred that the reduced ALFF may due to heroin consumption, nevertheless, the increased ALFF in the bilateral parietal lobe may have resulted from the methadone treatment. This resting-state fMRI study suggests that the changed spontaneous neuronal activity of these regions may be implicated in the underlying pathophysiology of heroin addicts.

Regional homogeneity changes in heroin-dependent individuals: resting-state functional MR imaging study.

PURPOSE: To identify heroin-related modulations of neural activity in the resting state in heroin-dependent individuals (HDIs) by using resting-state functional magnetic resonance (MR) imaging and a regional homogeneity method and to investigate whether these changes of neural activity can be related to duration of heroin use and to decision-making deficits in HDIs. MATERIALS AND METHODS: This prospective study was approved by the appropriate ethics committee, and written informed consent was obtained from each participant. Thirty-one HDIs receiving methadone-maintained treatment and 24 control subjects participated. Resting-state functional MR imaging was performed by using a gradient-echo echo-planar imaging sequence. Regional homogeneity was calculated by using software. Voxel-based analysis of the regional homogeneity maps between control and HDI groups was performed with two-sample t tests by using software. Statistical maps were set at P less than .05 and were corrected for multiple comparisons. The Iowa gambling task (IGT) was used to assess participant decision making during uncertainty. Abnormal clusters revealed by group comparison were extracted and correlated with behavioral performance at the IGT and with duration of heroin use. RESULTS: Regional homogeneity was diminished in the bilateral medial orbitofrontal cortex (OFC), bilateral dorsal medial thalamus, bilateral cuneus, and lingual gyrus in HDIs compared with control subjects. There were negative correlations between mean regional homogeneity in the medial OFC, bilateral cuneus, and lingual gyrus and duration of heroin use. There was a positive correlation between mean regional homogeneity in the medial OFC and performance level at the IGT. CONCLUSION: The present study reveals resting-state abnormalities in HDIs that may lead to further improvement of the understanding of the neural substrates of cognitive impairment in HDIs.

Building an Integrated Radiotherapy Information System to Improve Patient Safety.

In our hospital, the medical records of patients receiving tumor radiotherapy were paper-base. The purpose of this study was to develop an integrated radiotherapy information system to improve the quality and efficiency of treatment for patients with cancer. What's more, it's expected that the system can reduce time and errors caused by manual record.

Cortical thickness, gyrification and sulcal depth in trigeminal neuralgia.

Neuroimaging studies have documented brain structural alterations induced by chronic pain, particularly in gray matter volume. However, the effects of trigeminal neuralgia (TN), a severe paroxysmal pain disorder, on cortical morphology are not yet known. In this study, we recruited 30 TN patients and 30 age-, and gender-matched healthy controls (HCs). Using Computational Anatomy Toolbox (CAT12), we calculated and compared group differences in cortical thickness, gyrification, and sulcal depth with two-sample t tests (p < 0.05, multiple comparison corrected). Relationships between altered cortical characteristics and pain intensity were investigated with correlation analysis. Compared to HCs, TN patients exhibited significantly decreased cortical thickness in the left inferior frontal, and left medial orbitofrontal cortex; decreased gyrification in the left superior frontal cortex; and decreased sulcal depth in the bilateral superior frontal (extending to anterior cingulate) cortex. In addition, we found significantly negative correlations between the mean cortical thickness in left medial orbitofrontal cortex and pain intensity, and between the mean gyrification in left superior frontal cortex and pain intensity. Chronic pain may be associated with abnormal cortical thickness, gyrification and sulcal depth in trigeminal neuralgia. These morphological changes might contribute to understand the underlying neurobiological mechanism of trigeminal neuralgia.

Functional connectome-based biomarkers predict chronic codeine-containing cough syrup dependent.

PURPOSE: Codeine-containing cough syrup (CCS) is considered among the most popular drugs of abuse in adolescents worldwide. Accurate prediction and identification of CCS dependent (CCSD) users are crucial. This study aimed to identify a brain-connectome-based predictor of CCSD using a machine learning model based on a ten-fold cross-validation logistic regression (LR) classifier. METHODS: 40 CCSD users and 40 healthy control (HC) subjects underwent functional magnetic resonance imaging to construct weight functional networks. Partial correlation analysis was used to analyze relations between abnormal network metrics and clinical characteristics (BIS total scores, CCS abuse duration, and mean CCS dose) in CCSD. A ten-fold cross-validation LR classifier was used to classify CCSD users and HC subjects. RESULTS: The CCSD group showed significantly abnormal nodes and connections in the right posterior cingulate, right middle insula, bilateral prefrontal cortex, parietal lobe, temporal lobe, occipital lobe, and cerebellum. Furthermore, higher characteristic path length and lower clustering coefficient (Cp), global efficiency, and local efficiency (Eloc) were observed in the global topologies in CCSD. The abnormal global properties (Cp and Eloc) and node properties of the prefrontal cortex were significantly correlated with clinical characteristics (BIS-11 scores, CCS abuse duration) in CCSD. The LR classifier models demonstrated accuracy, sensitivity, specificity, precision, and AUC of 82.5%, 82.5%, 82.5%, 76.8%, and 82.5%. CONCLUSIONS: These data demonstrate that abnormal functional connectome may be closely linked to clinical characteristics in CCSD. Functional connectome-based biomarkers can be a powerful tool for personalized diagnosis of CCSD in the future.

Clinical and MRI response to dose reduction of an etanercept-biosimilar for hip arthritis in patients with ankylosing spondylitis: an observational, retrospective cohort study.

OBJECTIVES: Hip arthritis plays a critical role in the prognosis of ankylosing spondylitis (AS). Dose reduction of tumor necrosis factor inhibitors preserves general improvement of AS, so this study attempted to examine the equivalence between Yisaipu® tapering and conventional therapy for hip arthritis in AS patients, using clinical parameters and magnetic resonance image (MRI). METHODS: AS patients received this etanercept-biosimilar injections (50 mg/week) in the first 12 weeks. Participants in the tapering group were treated with this reagent 50 mg every other week from week 13 to week 24, while the control group kept undergoing full-dose therapy. Clinical and laboratory parameters were assessed at baseline, week 12 and week 24. MRI examination of hip was performed at baseline and week 24. RESULTS: One hundred and thirty-six patients were enrolled, and 80 of them were in the tapering group. Linear mixed model revealed that main effects of tapering group with control group as reference in disease activity parameters were insignificant (p > 0.05). Main effects of baseline with week 24 as reference were significant (p < 0.05), but main effects of week 12 with week 24 as reference were not (p > 0.05). Prevalence of acute inflammatory change in MRI significantly decreased in the tapering group (76.88% vs 20.00%, p < 0.05) and control group (76.79% vs 19.64%, p < 0.05). Influence of both treatments on acute inflammatory change was equivalent (p > 0.05). CONCLUSION: Efficacy of Yisaipu® tapering treatment is comparable to the full-dose therapy for hip arthritis in AS patients. Both treatments maintain remission of hip arthritis after patients achieved low disease activity.

Abnormal Topology of the Structural Connectome in the Limbic Cortico-Basal-Ganglia Circuit and Default-Mode Network Among Primary Insomnia Patients.

Purpose: Primary insomnia (PI) is the second most common mental disorder. However, the topologic alterations in structural brain connectome in patients with PI remain largely unknown. Methods: A total of 44 PI patients and 46 age-, gender-, and education level matched healthy control (HC) participants were recruited in this study. Diffusion tensor imaging (DTI) and resting state MRI were used to construct structural connectome for each participant, and the network parameters were employed by non-parametric permutations to evaluate the significant differences between the two groups. Relationships between abnormal network metrics and clinical characteristics, including the disease duration, the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS), were investigated with Spearman's correlation analysis in PI patients. Results: PI patients demonstrated small-world architecture with lower global (P = 0.005) and local (P = 0.035) efficiencies compared with the HC group. The unique hub nodal properties in PI patients were mainly in the right limbic cortico-basal-ganglia circuit. Five disrupted subnetworks in PI patients were observed in the limbic cortico-basal-ganglia circuit and left default-mode networks (DMN) (P < 0.05, NBS corrected). Moreover, most unique hub nodal properties in the right limbic cortico-basal-ganglia circuit were significantly correlated with disease duration, and clinical characteristics (SAS, SDS, ISI scores) in PI processing. Conclusion: These findings suggested the abnormal anatomical network architecture may be closely linked to clinical characteristics in PI. The study provided novel insights into the neural substrates underlying symptoms and neurophysiologic mechanisms of PI.

Abnormal degree centrality in neurologically asymptomatic patients with end-stage renal disease: A resting-state fMRI study.

OBJECTIVE: End-stage renal disease (ESRD), characterized by multi-organ dysfunction, has been shown to co-occur with abnormal brain function. Previous resting-state fMRI studies suggested that regional brain spontaneous activity and functional connectivity within the default mode network are abnormal in ESRD patients. The current study aimed to depict intrinsic dysconnectivity pattern of whole-brain functional networks in voxel level in neurologically asymptomatic patients with ESRD. METHODS: fMRI datasets were acquired from 22 ESRD patients (without clinical neurological disease) and 29 healthy control (HC) subjects. We investigated the degree centrality for a given element in a network to reveal the changes of functional connectivity throughout the huge human functional network. In the brain regions showing a difference between the HC and ESRD groups, we further conducted receptive operation characteristic (ROC) analyses to confirm the accuracy, sensitivity and specificity of our results. RESULTS: ESRD patients showed decreased functional connectivity in the left inferior parietal and left precuneus within the brain network; both regions are important components of the default-mode network (DMN). In contrast, patients showed increased connectivity in depression-related regions including bilateral inferior frontal gyrus and right superior temporal gyrus. These regions showed an acceptable accuracy (0.68-0.75), sensitivity (0.64-0.70) and high specificity (0.82-0.96) in distinguishing between the two groups. CONCLUSIONS: Our findings reveal abnormal intrinsic dysconnectivity pattern of whole-brain functional networks in ESRD patients. SIGNIFICANCE: Our results could lead to a better understanding of the intrinsic dysconnectivity patterns of default-mode network-related regions in ESRD patients from the whole brain network perspective.

[Atypical magnetic resonance imaging vs pathological findings of leiomyoma in the female reproductive system].

OBJECTIVE: To investigate magnetic resonance imaging (MRI) findings of the atypical leiomyoma in the female reproductive system in comparison with the pathological features of the neoplasms. METHODS: A retrospective analysis of the MRI findings and the pathological features was conducted in 24 cases of atypical leiomyoma involving the female reproductive system. RESULTS: Atypical leiomyomas were displayed by MRI as solid tumor mass surrounded by cystic degeneration, pseudotumors, or solid mass with homogeneous signal intensity. Intrauterine lesions were found in 19 cases, involving the subserosal layer (n=11), intramural region (n=4), broad ligament (n=3), cervix (n=2), submucous layer (n=2), vagina (n=1), and the ovary (n=1). Except for two cases with submucous lesions shown as solid mass, all the cases had lesions appearing as solid cystic mass, whose solid part showed hypo or isointense signals on T1WI and moderate hyperintense signals on T2WI, with heterogeneous enhancement after contrast agent injection. Tumor cell and interstitial cell swelling, vascular hyalinosis, hyalinosis, myxoedema, cystic degeneration, and hemorrhage were found in the lesions. CONCLUSION: Leiomyoma can occur at almost any site in the female reproductive system, and atypical leiomyoma usually are shown as solid cystic mixed mass in the pelvic cavity. Evaluation of the relationship between the solid mass and cystic portion and observation for the presence of low signal on T2WI may help in the diagnosis of atypical leiomyoma.

[Correlation analysis between multi-slice CT perfusion imaging and microvessel density in ovarian tumors].

OBJECTIVE: To analyze the correlation between the perfusion data and microvessel density (MVD) in ovarian tumors, and investigate the hemodynamic features of the tumors in terms of anatomy and functional CT imaging. METHODS: Six patients with surgically confirmed benign ovarian tumors and 6 with malignant ovarian tumors underwent multi-slice CT perfusion imaging to acquire the perfusion parameters including perfusion, PEI, TTP, BV peak enhancement image(PEI), time to peak(TTP) and blood volume(BV). The tumors were stained and counted by Immunohistochemical staining of the microvessels in the tumor was performed to detect the MVD. RESULTS: s The time-density curves of the benign ovarian tumors increased slowly, reaching the peak at 40 s; the curves of the malignant tumors rose rapidly and continuously and reached the peak at 25 s. The differences in the perfusion data (PEI, TTP, BV) were statistically significant between the benign and malignant tumors (P<0.05). The MVD of the malignant tumors was significantly greater than that of the benign tumors (P<0.05). The mean BV of the malignant ovarian tumor was positively correlated to MVD (r=0.786, P<0.05). CONCLUSION: Multi-slice spiral CT perfusion imaging can provide accurate enhancement data of the ovarian tumors and helps in the diagnosis and differential diagnosis of the ovarian tumors by presenting the changes of the hemodynamic features in the tumors.

[Anatomic study of the facial artery using multislice spiral CT angiography].

OBJECTIVE: To study the anatomy of the facial artery using 16-slice spiral CT angiography (CTA). METHODS: Forty-five patients without vascular pathologies or other anomalies underwent 16-slice spiral CT angiography after injection of 350 mg I/ml Omnipaque through the ulnar vein. MIP and volume rendering of the images were performed to analyze the left and right facial artery. RESULTS: The left facial artery arose from the external carotid artery with the distances from the carotid artery bifurcation of 4.5-47.90 mm (mean 18.77-/+8.98 mm), and in 1 case (2.2%), the artery arose from the common carotid artery. The right facial artery arose from the external carotid artery in all the 45 cases (100%) with distances from the carotid artery bifurcation of 6.8-39.70 mm (mean 19.23-/+8.25 mm). The bilateral facial arteries more commonly arose from the external carotid artery independently, and the lingual artery and facial artery sharing the same trunk arising from the external carotid artery was less common. In 1 case, the left facial artery and the submental artery shared the same trunk, and in another case, the left facial artery, thyroid artery and lingual artery shared the same trunk. The diameter of the left facial artery ranged from 1.40 to 4.70 mm (mean 2.83-/+0.77 mm), and that of the right facial artery was 1.60-4.30 mm (mean 2.81-/+0.79 mm). The left facial artery ended below the angle of the mouth in 12 cases (26.67%), between the angle of the mouth and the nasal wing in 7 cases (15.56%), and above the nasal wing in 26 cases (57.77%). The right facial artery ended below the angle of the mouth in 7 cases (15.56%), between the angle of the mouth and the nasal wing in 12 cases (26.67%), and above the nasal wing in 26 cases (57.77%). The bilateral facial arteries frequently passed through the submandibular gland parenchyma (23 cases on the left and 24 cases on the right), and the facial arteries were found occasionally to run below the submandibular gland (11 cases on the left and 9 on the right). CONCLUSION: 16-slice spiral CT angiography can help in preoperative facial artery evaluation noninvasively. This modality can clearly display the bilateral facial arteries, including their origin, course, distribution and ending to provide detailed information for flap designing before plastic surgery and for preoperative evaluation for microvascular surgery.