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Objective Early diagnosis of extra-nodal nasal type NK /T cell lymphoma (ENKTCL) is difficult and it is often misdiagnosed.This article was to analyze the CT and MRI findings of ENKTCL originating in the nasal cavity or sinus and investigate the values of CT and MRI in the diagnosis of the disease . Methods We retrospectively analyzed the clinical data and CT and MRI findings about 13 cases of ENKTCL originating in the nasal cavity or sinus examined in our hospital from January 2012 to December 2017. Results Non-contrast CT scanning displayed soft tissue density shadow in the nasal cavity or sinus , with homogeneous density in the tumor and soft tissue mass with bony destruction ( mostly infiltrative absorption) in the midline nasal cavity and sinal area , and the area of soft tissue lesion was obviously larger than that of bony de -struction.Ten cases of contrast-enhanced CT of the tumor manifested mild to moderate heterogeneous density ; 10 cases of plain MRI pres-ented isointensity of T1WI and slightly increased intensity of T 2WI, while enhanced MRI showed mild to moderate heterogeneous density . Low-intensity T1WI, high-intensity T2WI and edge-enhancement were observed in the 10 cases accompanied by obstructive sinusitis . Conclusion ENKTCL originating in the nasal cavity or sinus has its own specific CT or /and MRI manifestations.Conventional CT or /and MRI combined with clinical signs and symptoms can accurately determine the site of lesion and scope of invasion and is therefore of important clinical significance for the early diagnosis and prognosis of the disease.
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Objective To investigate the value of MR on diagnosis of intracranial primary lymphoma in immunocompetent patients.Methods The MR features of 28 cases with pathology proved intracranial primary lymphoma were analyzed retrospectively.Conventional MRI scans,enhanced MRI scan were observed.Immunohistochemical staining were done and the results were compared with the MR imaging signs. Results Twenty-eight cases were all B-cell type Non-Hodgkin's lymphoma,16 cases were single lesion (57%)and 12 cases were multiple lesions (43%).The tumors mainly located in the deep white matter,7 cases in callus corpus and grew crossing the midline supratentorial.The lesions presented mass or node (20/28),11 cases showed massive edema.On T1WI,lesions were mostly hypo-or iso-intense to gray matter.On T2WI,tumors showed iso-or hyper-intense.All lesions presented hyper-or iso-to hyper-intense on diffusion weighted imaging(DWI).Most lesions show marked mass-like or nodular-like contrast enhancement on MR imaging,8 cases presented"incision sign",5 cases showed"fist sign"and 7 cases showed"butterfly-like".Immunohistochemical staining showed that GFAP(-) was 78.6% (22/28),as well as CD20 (+)96.4% (27/28),CD79α(+)67.9% (19/28),CD10(+)10.7% (3/28),Bcl-6 (+)75% (21/28),Mum1 (+)89.3% (25/28).Ki-67 was greater than or equal to 50% (22/28).Among the 28 patients,25 cases (89.3%) showed an"activated non-germinal center B-cell(non-GCB)"in origin and 3 cases(10.7%)were considered as a"GCB"subset.Conclusion The imaging features of marked mass-kike or nodular-like on MRI enhancement scan and hyper-or iso-to hyper-intense on DWI are helpful in the diagnosis and the differential diagnosis of intracranial primary lymphoma.
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Objective To evaluate the correlation of CT enhancement parameters with Fuhrman grade in T1 (≤7 cm) clear cell renal carcinoma(ccRCC).Methods From September 2011 to November 2017,102 post-operation cases in our hospital proven to be T1 ccRCC were retrospectively analyzed.There were 71 males and 31 females,with a mean age of (59.1 ± 12.7)years (26 ～79 years),mean body mass index(BMI) of (24.0 ± 2.8)kg/m2 (14.3 ～ 31.6 kg/m2).Tumors of 55 patients were in left kidneys,47 in right kidneys.Fuhrman grade 1 and 2 were defined as low-grade group,meanwhile high-grade group included grade 3 and 4.There were 46 males and 21 females in low-grade group,with a mean age of (59.0 ± 13.2) years,mean BMI of (24.0 ± 2.9) kg/m2.In high-grade group,there were 25 males and 10 females,with a mean age of (58.8 ± 11.8) years,mean BMI of (24.2 ± 2.7) kg/m2.The maximum diameter and tumor enhancement value (TEVX),relative enhancement value (REVX) were measured and calculated.In arterial phase,X =1;in venous phase X =2.The total consumption amount of iodine was recorded.Comparisons of maximum diameter,TEV1,TEV2,REV1,REV2 and the total consumption of iodine between the two different groups were performed.The ROC curves of TEV1,TEV2,REV1,and REV2 were drawn to predict the grade of tumors..Results The TEV1 [(146.1 ± 29.1) HU vs.(100.2 ± 32.1) HU],TEV2 [(98.2 ± 22.9) HU vs.(75.6 ± 25.7) HU],REV1 (1.12 ± 0.24 vs.0.70 ± 0.16),REV2(0.67 ± 0.17 vs.0.54 ± 0.18) between low-grade group and high-grade group had statistical difference (P ＜ 0.05).There was no significant difference in the maximum diameter[(41.8 ± 15.4)mm vs.(45.3 ± 17.0)mm] and the total consumption of iodine [(33.3 ± 5.0)g vs.(34.2 ± 4.4)g] between the two groups (P ＞ 0.05).The area under ROC curve of TEV1,TEV2,REV1 and REV2 were 0.856,0.755,0.901 and 0.728,respectively.REV1 had the highest distinguish efficiency and the best critical value was 0.93.Conclusions The enhancement parameters of T1 ccRCC could contribute to predicting the Fuhrman grade.When the REV1 ≤0.93,the tumor tended to be high-grade tumor(Fuhrman grade 3-4).
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Objective To monitor the dynamic changes of radiation-induced parotid damage using T2 ? mapping.Methods Thirty-four patients with nasopharyngeal carcinoma (NPC)were enrolled.All patients underwent T1 WI,T2 WI and T2 ? mapping for bilateral parotid glands at pre-RT (2 weeks before radiotherapy),mid-RT (5 weeks after the beginning of radiotherapy)and post-RT (4 weeks after the completion of radiotherapy).Parotid MR parameters,mean radiation dose and xerostomia degrees of the patients at different time points were recorded.Furthermore,nine healthy volunteers were enrolled,who undergone T2 ? mapping twice with an interval of 4 weeks in order to analyze the reproducibility of T2 ? value.Results From pre-RT to mid-RT and post-RT,parotid volume decreased [atrophy rates,(25.34±11.33)％ and (25.74±9.93)％,respectively]and T2 ? values decreased [change rates,(-5.63±8.86)％ and (-4.81±10.67)％, respectively]significantly (all P < 0.01 ).Parotid normalized T1 signal intensity decreased significantly from pre-RT to post-RT [change rate,(-7.43±10.61)％,P =0.007],and the change rate was correlated inversely with mean radiation dose significantly (r =-0.646, P <0.001).Parotid volume and T2 ? value changed correspondingly with xerostomia degrees of the patients during radiotherapy.Parotid MR parameters showed excellent reproducibility (intraclass correlation coefficient,0.843 -0.993).Conclusion The dynamic changes of radiation-induced parotid damage in patients with NPC can be noninvasively evaluated by routine MRI and T2 ? mapping.
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Objective To monitor the dynamic changes of radiation-induced parotid damage using T2 ? mapping.Methods Thirty-four patients with nasopharyngeal carcinoma (NPC)were enrolled.All patients underwent T1 WI,T2 WI and T2 ? mapping for bilateral parotid glands at pre-RT (2 weeks before radiotherapy),mid-RT (5 weeks after the beginning of radiotherapy)and post-RT (4 weeks after the completion of radiotherapy).Parotid MR parameters,mean radiation dose and xerostomia degrees of the patients at different time points were recorded.Furthermore,nine healthy volunteers were enrolled,who undergone T2 ? mapping twice with an interval of 4 weeks in order to analyze the reproducibility of T2 ? value.Results From pre-RT to mid-RT and post-RT,parotid volume decreased [atrophy rates,(25.34±11.33)％ and (25.74±9.93)％,respectively]and T2 ? values decreased [change rates,(-5.63±8.86)％ and (-4.81±10.67)％, respectively]significantly (all P < 0.01 ).Parotid normalized T1 signal intensity decreased significantly from pre-RT to post-RT [change rate,(-7.43±10.61)％,P =0.007],and the change rate was correlated inversely with mean radiation dose significantly (r =-0.646, P <0.001).Parotid volume and T2 ? value changed correspondingly with xerostomia degrees of the patients during radiotherapy.Parotid MR parameters showed excellent reproducibility (intraclass correlation coefficient,0.843 -0.993).Conclusion The dynamic changes of radiation-induced parotid damage in patients with NPC can be noninvasively evaluated by routine MRI and T2 ? mapping.
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Objective To investigate the feasibility of low-dose CT perfusion imaging(CTPI)examination combined with iterative model reconstruction (IMR) in the brain.Methods 80 patients with clinical suspicion of acute cerebral infarction underwent the cerebral CTPI were enrolled in this study.30 normal hemispheres on group A [35 cases,80 kV,150 mAs, filtered back projection(FBP)] and group B(45 cases,80 kV,30 mAs, IMR) were selected to evaluate respectively.The pictures' subjective scores, effective radiation dose (ED),CT value,SD,signal to noise ratio(SNR), contrast to noise ratio(CNR) and the perfusion parameters of the grey matter (GM) and white matter(WM) in each hemisphere of the middle cerebral artery(MCA) territory were respectively compared at ASPECTS level 2 for the two groups.Results The ED were 2.52,0.50 mSv for group A,B.There were no statistical significances in the perfusion parameters,CT value, SD, CNR of the ROIs of the GM and WM,the SNR of the ROIs of the GM and the pictures' subjective scores between group A, B (P>0.05).There was statistical significance in the SNR of the ROIs of the WM between group A,B (P<0.05).Conclusion IMR combined with 30 mAs of the CTPI can reduce the radiation dose apparently while maintain the stability of the image quality and perfusion parameters.
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Medical imaging is an interdisciplinary subject closely related to clinical and pathological subject. Its clinical reading skills' training has become the focus of postgraduate teaching. In the process of clinical teaching, the interactive reading mode of problem-based learning (PBL) combined with multi-disci-plinary team (MDT) was introduced into clinical reading meeting. The tutors chose the reading cases proved by pathology; designed in-depth issues step by step for execution of PBL teaching; guided postgraduates to delineate imaging signs and propose the diagnostic results, evidences and differential diagnoses according to the step from localizing to qualitative and then to pathological diagnosis;then guided postgraduates to attend in-depth case analysis of MDT and analyze the correlation or inconsistency between the imaging diagnosis and clinical and pathological diagnosis; exercise document retrieval and verbalization, multimedia design, and writing level of the records of the reading cases and papers. The interactive reading mode of PBL com-bined with MDT has achieved significant effects, which is worthy of further exploration and promotion.
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Objective To investigate the feasibility of iterative model reconstruction (IMR) combined with low tube voltage and low iodine intaken of contrast media in head and neck CT angiography (CTA). Methods Eighty patients with clinical suspicion of head and neck vascular disease underwent head and neck CTA were enrolled in this prospective study. According to random number table, patients were randomly divided into two groups. Group A (n=40) was scanned according to the protocol of 120 kV, 50 ml iopromide (370 mg/ml) and filtered back projection (FBP) reconstruction, and group B (n=40) was scanned with 80 kV, 30 ml iohexol (300 mg/ml) and IMR, while the other parameters kept consistent. Mann-Whitney U test was used to compare the enhanced CT value of arteries, image noise, signal noise ratio (SNR), contrast noise ratio (CNR), the score of image quality, effective radiation dose (ED) and iodine intaken of contrast media between two groups. Results The CT value at the origin level of common carotid artery were (316.9 ± 53.0) and (433.4 ± 101.8)HU in group A and B, image noise were (28.1 ± 6.8)and (12.1 ± 2.6)HU ,SNR were (11.9 ± 3.2) and (37.7 ± 13.3) ,and CNR were (10.2 ± 2.9) and (32.6 ± 13.3), respectively. There were showed significant differences in CT value, image noise, SNR and CNR between two groups (Z=-5.490,-7.592,-7.698,-7.660, P<0.05). The CT value at the origin level of internal carotid artery were (359.5 ± 54.3) and (443.5 ± 120.1) HU in group A and B, image noise were (18.8±6.2) and (6.8±1.7) HU ,SNR were 21.5±8.7 and 69.7±27.4 ,and CNR were 18.0±7.3 and 62.7± 26.4, respectively. The significant differences were acquired in CT value, image noise, SNR and CNR between two groups (Z=-3.022,-7.376,-7.496,-7.515, P<0.05). The CT value at M1 segment level of middle cerebral artery were (321.1±47.3) and (401.6±104.0) HU in group A and B, image noise were (32.3± 17.2) and (11.2 ± 2.7) HU,SNR were 12.4 ± 5.6 and 39.3 ± 18.4,and CNR were 10.7 ± 4.7 and 36.4 ± 17.7, respectively. There also showed significant differences in CT value, image noise, SNR and CNR between two groups (Z=-3.527,-7.487,-7.482,-7.535, P<0.05). The score of image quality of group A and B were 3.9 ± 0.7 and 4.5±0.6, which also showed significant difference between two two groups (Z=-3.517, P<0.05). The ED were (2.78 ± 0.13) and (0.84 ± 0.04) mSv for group A and B, which also showed significant difference between the two groups (Z=-7.706, P<0.05). The iodine intaken of contrast media were 1.85 g and 0.90 g in group A and B. Conclusion IMR combined with low tube voltage and low iodine intaken of contrast media can not only decrease effective radiation dose and iodine intaken of contrast media significantly, but also improve the imaging quality in head and neck CTA examination.
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Objective To investigate the effect of moderate pain on attentional bias towards emotional pictures among healthy subjects.Methods Thirty-two healthy college students aged from 17 to 26 (21.8±2.2;16 males and 16 females) participated in this study.A tourniquet was tied to each subject's left upper arm 1 to 2cm above the cubits horizontal grain.Pain was inflicted by inflating the tourniquet,and the pressure was maintained at 26.66kPa.While tourniquet was inflated (with pain) or not (no pain),each subject was asked to finish a pictorial dot-probe task with three kinds of pictures-emotionally positive,negative and neutral.In experiment 1,subjects performed the dot-probe tasks with the contralateral hand while the tourniquet was tied on the left upper arm without inflation.In experiment 2 the tourniquet was inflated until the subject completed the dot-probe task (for about 10min).The reaction times (RTs) and the error rates (Ers) in the recognition task were recorded,and the intensity of the subject's pain and discomfort were measured using a verbal rating scale.Results The subjects reported moderate to severe pain with the tourniquet inflated.The RT and ER data were analyzed using two-way analysis of variance (ANOVA) which showed a significant difference between the average RTs of the males (482±73ms without pain and 466±82ms with pain) and those of the females (536±90ms without pain and 519±100 ms with pain).The average ER was significantly different between the pain (2.38±1.49)％ and no pain (1.09±0.82)％ conditions in both groups.Holn-Sidak multiple comparison testing showed significant differences in both groups' average ER between the negative picture (3.81±1.73)％ and the positive picture (1.66±0.97)％,and between the negative and neutral pictures (1.68±0.8) ％ in the pain condition.Mild attentional avoidance was observed with the positive [pain condition (-5.1±4.8) ms and no pain (-4.6±4)ms] and negative pictures [pain condition (-3.43±6) ms and no pain (-0.79±4.1)ms],but no significant difference was found between the pain and no pain conditions.Conclusion The error rate in a pictorial dot-probe task is influenced by pain,especially with negative pictures.
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In this paper, we reviewed the brain imaging studies of male sexual function in recent years from three aspects: the brain mechanism of normal sexual function, the brain mechanism of sexual dysfunction, and the mechanism of drug therapy for sexual dysfunction. Studies show that the development stages of male sexual activities, such as the excitement phase, plateau phase and orgasm phase, are controlled by different neural networks. The mesodiencephalic transition zone may play an important role in the start up of male ejaculation. There are significant differences between sexual dysfunction males and normal males in activation patterns of the brain in sexual arousal. The medial orbitofrontal cortex and inferior frontal gyrus in the abnormal activation pattern are correlated with sexual dysfunction males in sexual arousal. Serum testosterone and morphine are commonly used drugs for male sexual dysfunction, whose mechanisms are to alter the activating levels of the medial orbitofrontal cortex, insula, claustrum and inferior temporal gyrus.
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Humanos , Masculino , Encéfalo , Fisiologia , Mapeamento Encefálico , Córtex Cerebral , Imageamento por Ressonância Magnética , Ereção Peniana , Fisiologia , Comportamento SexualRESUMO
<p><b>OBJECTIVE</b>To explore the correlation between the dosage of corticosteroid, time of onset and incidence of osteonecrosis (ON) in patients with SARS.</p><p><b>METHODS</b>From July 2003 to January 2004, general survey carried out for ON in 551 patients with SARS. Five hundred and fifty-one patients except 12 were administrated by corticosteroid from 80 mg to 30 000 mg. The age of patients was (33 +/- 9) years old ranging from 19 to 59 years old. One hundred and thirty-one were male, and four hundred and twenty were female. MRI and X-ray film were taken in all patients including both hips, knees, shoulders, ankles and wrists. CT scan was taken in partial patients. Common classification system were used for staging of hip (ARCO), knee (Lotka) and shoulder (Cruess). Independent test, rank-sum test and multiple factor logistic regression analysis were used for statistical analysis.</p><p><b>RESULTS</b>No osteonecrosis was detected in 12 patients without corticosteroid. Osteonecrosis was detected in 176 patients (32.7 percent) among 539 patients. There were ON of femoral head in 130 cases (210 hips), ON of knee in 98 cases (130 knees), ON of humeral head in 21 cases (36 shoulders), ON of talus and calcaneus in 16 cases (26 ankles), ON of scaphoid and lunate in 11 cases (17 wrists), ON of patella in 3 cases (4 patella), ON of ilium in 1 case and bone infarction (femur, tibia) in 18 cases. One hundred and nineteen cases (195 hips) with ONFH were in stage I (IA 45 hips, IB 77 hips, IC 73 hips). Eleven cases (15 hips) were in stage II. All osteonecrosis of the knee and humoral head was stage I. Thirty-four patients with ON had one joint affected, 45 patients had 2 joints, 93 patients had more than 3 joints. The dosage of corticosteroid was (5842 +/- 4988) mg in ON group and (2719 +/- 2571) mg in non-ON group (P < 0.0001). The duration of steroid was (38 +/- 17) d in ON group and (27 +/- 15) d in non-ON group (P < 0.01). The dosage of pulse treatment was (340 +/- 207) mg/d in ON group and (211 +/- 160) mg/d in non-ON group (P < 0.01). The duration of pulse treatment was (28 +/- 13) d in ON group and (18 +/- 11) d in non-ON group (P < 0.01). All patients with ON were detected within 6 months from administration.</p><p><b>CONCLUSION</b>About one-third patients with SARS who were treated with a high dose of corticosteroid occurred osteonecrosis. ON is frequently multiple focuses. The actual time of onset of ON is early of steroid used. MRI is golden standard for early diagnosis of ON. The patients who were treated with a high dose of corticosteroid should be inspected initially by MRI.</p>
