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1.
BMC Neurol ; 20(1): 114, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228519

RESUMO

BACKGROUND: Progressive supranuclear palsy (PSP) is a rare movement disorder with poor prognosis. This retrospective study aimed to characterize the natural history of PSP and to find predictors of shorter survival and faster decline of activity of daily living. METHOD: All patients recruited fulfilled the movement disorder society (MDS) clinical diagnostic criteria for PSP (MDS-PSP criteria) for probable and possible PSP with median 12 years. Data were obtained including age, sex, date of onset, age at onset (AAO), symptoms reported at first visit and follow-up, date of death and date of institutionalization. Magnetic resonance imaging was collected at the first visit. Endpoints were death and institutionalization. Kaplan-Meier method and Cox proportional hazard model were used to explore factors associated with early death and institutionalization. RESULTS: Fifty-nine patients fulfilling MDS-PSP criteria were enrolled in our study. Nineteen patients (32.2%) had died and 31 patients (52.5%) were institutionalized by the end of the follow-up. Predictors associated with poorer survival were late-onset PSP and decreased M/P area ratio. Predictors associated with earlier institutionalization were older AAO and decreased M/P area ratio. CONCLUSION: Older AAO and decreased M/P area ratio were predictors for earlier dearth and institutionalization in PSP. The neuroimaging biomarker M/P area ratio was a predictor for prognosis in PSP.

2.
Biomed Res Int ; 2020: 7056056, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32149125

RESUMO

Purpose: The aim of the present study was to evaluate the relationship of fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) with haemodynamic abnormality and severity of arterial stenosis in patients with transient ischemic attack (TIA) of the carotid artery system. Patients and Methods. Consecutive inpatients (N = 38) diagnosed with TIAs of the carotid system in a 4-year period (2014-2017) were retrospectively analysed in our study and divided into FVH-negative and FVH-positive groups based on the presence of FVH sign. Each inpatient had undergone magnetic resonance imaging (MRI) followed by computed tomography (CT) perfusion imaging studies. We investigated the degree of arterial stenosis, number of stenosis, watershed regions, and related CT perfusion indexes, including hypoperfusion regions, mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV). Spearman rank correlation was performed between FVHs score, the degree of arterial stenosis, and CT perfusion indexes with significant difference. Results: Thirty-one patients (81.6%) observed with FVH sign were assigned to the FVH-positive group. The hypoperfusion regions, MTT, and CBF values were significantly different between the FVH-negative group and FVH-positive groups. Spearman correlation analysis showed significant positive correlations between hypoperfusion regions, MTT, and FVHs scores (r = 0.755 and 0.674, respectively, p < 0.01); a moderate negative correlation was found between CBF and FVHs scores (r = 0.755 and 0.674, respectively, p < 0.01); a moderate negative correlation was found between CBF and FVHs scores (r = 0.755 and 0.674, respectively, p < 0.01); a moderate negative correlation was found between CBF and FVHs scores (. Conclusion: Hyperintense vessels on FLAIR were closely associated with hypoperfused regions, MTT, and CBF values, which indicated that the presence of FVHs could be an important and convenient imaging marker of haemodynamic impairment in patients with TIA.

3.
Neuroimage Clin ; 22: 101691, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30708349

RESUMO

BACKGROUND: Computerized multi-model training has been widely studied for its effect on delaying cognitive decline. In this study, we designed the first Chinese-version computer-based multi-model cognitive training for mild cognitive impairment (MCI) patients. Neuropsychological effects and neural activity changes assessed by functional MRI were both evaluated. METHOD: MCI patients in the training group were asked to take training 3-4 times per week for 6 months. Neuropsychological and resting-state fMRI assessment were performed at baseline and at 6 months. Patients in both groups were continuously followed up for another 12 months and assessed by neuropsychological tests again. RESULTS: 78 patients in the training group and 63 patients in the control group accomplished 6-month follow-up. Training group improved 0.23 standard deviation (SD) of mini-mental state examination, while control group had 0.5 SD decline. Addenbrooke's cognitive examination-revised scores in attention (p = 0.002) and memory (p = 0.006), as well as stroop color-word test interference index (p = 0.038) and complex figure test-copy score (p = 0.035) were also in favor of the training effect. Difference between the changes of two groups after training was not statistically significant. The fMRI showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus. However, difference between the changes of two groups after another 12 months was not statistically significant. CONCLUSIONS: Multi-model cognitive training help MCI patients to gained cognition benefit, especially in memory, attention and executive function. Functional neuroimaging provided consistent neural activation evidence. Nevertheless, after one-year follow up after last training, training effects were not significant. The study provided new evidence of beneficial effect of multi-model cognitive training.


Assuntos
Córtex Cerebral/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/reabilitação , Remediação Cognitiva/métodos , Terapia Assistida por Computador/métodos , Idoso , Córtex Cerebral/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Resultado do Tratamento
4.
Acad Radiol ; 25(7): 904-914, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29373210

RESUMO

RATIONALE AND OBJECTIVES: This study aimed to measure apparent diffusion coefficient (ADC) in Chinese patients with newly diagnosed multiple myeloma by whole-body diffusion-weighted magnetic resonance imaging (WB-DWI MRI) and assess the diagnostic accuracy of ADC in the discrimination of deep response to induction chemotherapy. MATERIALS AND METHODS: Seventeen patients underwent WB-DWI MRI before and after induction chemotherapy (week 20). DWI images and ADC maps were produced and 89 regions of interest were chosen. ADC percent changes were compared between deep (complete response or very good partial response) and non-deep responders (partial response, minimal response, stable disease, or progressive disease) as International Myeloma Working Group criteria. Diagnostic accuracy of ADC was calculated using specific cut offs. Predictive positive value of ADC was calculated to predict deep response to consolidation therapy. RESULTS: Lesions reduced in size and number and signal intensity decreased in follow-up DWI, which did not differ between deep and non-deep responders. ADC percent changes were significantly higher in deep responders (36.79%) than in non-deep responders (11.50%) after induction therapy (P = .02) in per lesion analysis. ADC percent increases by 46.96%, 78.0% yielded specificity at 81.4%, 90.7% in discriminating deep response to induction therapy. Predictive positive value predicting deep response to consolidation therapy was 60.5% by using ADC cutoff >1.00 × 10-3 mm2/s at week 20. CONCLUSIONS: ADC from WB-DWI MRI increased remarkably in patients who achieved deep response at the end of induction chemotherapy, which represented a confirmatory diagnostic tool to discriminate deep response to induction therapy for patients with multiple myeloma. ADC may have a potential to predict deep response to consolidation therapy.


Assuntos
Imagem de Difusão por Ressonância Magnética , Mieloma Múltiplo/diagnóstico por imagem , Mieloma Múltiplo/tratamento farmacológico , Imagem Corporal Total/métodos , Idoso , Feminino , Humanos , Quimioterapia de Indução , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Dados Preliminares , Estudos Prospectivos , Indução de Remissão
5.
Chin Med J (Engl) ; 128(20): 2764-71, 2015 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-26481743

RESUMO

BACKGROUND: This study was to investigate the relationship among aortic artery calcification (AAC), cardiac valve calcification (CVC), and mortality in maintenance hemodialysis (MHD) patients. METHODS: All MHD patients in Shanghai Ruijin Hospital in July 2011 were included. To follow up for 42 months, clinical data, predialysis blood tests, echocardiography, and lateral lumbar X-ray plain radiography results were collected. Plasma FGF23 level was measured using a C-terminal assay. RESULTS: Totally, 110 MHD patients were involved in this study. Of which, 64 (58.2%) patients were male, the mean age was 55.2 ± 1.4 years old, and the median dialysis duration was 29.85 (3.0-225.5) months. About 25.5% of the 110 MHD patients had CVC from echocardiography while 61.8% of the patients had visible calcification of aorta from lateral lumbar X-ray plain radiography. After 42 months follow-up, 25 (22.7%) patients died. Kaplan-Meier analysis showed that patients with AAC or CVC had a significant greater number of all-cause and cardiovascular deaths than those without. In multivariate analyses, the presence of AAC was a significant factor associated with all-cause mortality (hazard ratio [HR]: 3.149, P = 0.025) in addition to lower albumin level and lower 25-hydroxy Vitamin D (25(OH)D) level. The presence of CVC was a significant factor associated with cardiovascular mortality (HR: 3.800, P = 0.029) in addition to lower albumin level and lower 25(OH)D level. CONCLUSION: Lateral lumbar X-ray plain radiography and echocardiography are simple methods to detect AAC and CVC in dialysis patients. The presence of AAC and CVC was independently associated with mortality in MHD patients. Regular follow-up by X-ray and echocardiography could be a useful method to stratify mortality risk in MHD patients.


Assuntos
Doenças da Aorta/complicações , Calcinose/complicações , Doenças das Valvas Cardíacas/complicações , Valvas Cardíacas/patologia , Diálise Renal/mortalidade , Doenças da Aorta/sangue , Calcinose/sangue , China , Feminino , Fatores de Crescimento de Fibroblastos/sangue , Seguimentos , Doenças das Valvas Cardíacas/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais
6.
Clin Interv Aging ; 9: 493-500, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24707173

RESUMO

PURPOSE: A three-dimensional (3D) continuous pulse arterial spin labeling (ASL) technique was used to investigate cerebral blood flow (CBF) changes in patients with Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), and age- and sex-matched healthy controls. MATERIALS AND METHODS: Three groups were recruited for comparison, 24 AD patients, 17 MCI patients, and 21 age- and sex-matched control subjects. Three-dimensional ASL scans covering the entire brain were acquired with a 3.0 T magnetic resonance scanner. Spatial processing was performed with statistical parametric mapping 8. A second-level one-way analysis of variance analysis (threshold at P<0.05) was performed on the preprocessed ASL data. An average whole-brain CBF for each subject was also included as group-level covariates for the perfusion data, to control for individual CBF variations. RESULTS: Significantly increased CBF was detected in bilateral frontal lobes and right temporal subgyral regions in aMCI compared with controls. When comparing AD with aMCI, the major hyperperfusion regions were the right limbic lobe and basal ganglia regions, including the putamen, caudate, lentiform nucleus, and thalamus, and hypoperfusion was found in the left medial frontal lobe, parietal cortex, the right middle temporo-occipital lobe, and particularly, the left anterior cingulate gyrus. We also found decreased CBF in the bilateral temporo-parieto-occipital cortices and left limbic lobe in AD patients, relative to the control group. aMCI subjects showed decreased blood flow in the left occipital lobe, bilateral inferior temporal cortex, and right middle temporal cortex. CONCLUSION: Our results indicated that ASL provided useful perfusion information in AD disease and may be used as an appealing alternative for further pathologic and neuropsychological studies, especially of compensatory mechanisms for cerebral hypoperfusion.


Assuntos
Doença de Alzheimer/fisiopatologia , Circulação Cerebrovascular , Disfunção Cognitiva/fisiopatologia , Imagem por Ressonância Magnética/métodos , Idoso , Estudos de Casos e Controles , Circulação Cerebrovascular/fisiologia , Feminino , Lobo Frontal/irrigação sanguínea , Humanos , Masculino , Neuroimagem/métodos , Marcadores de Spin , Lobo Temporal/irrigação sanguínea
7.
Hypertension ; 63(1): 61-7, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24144646

RESUMO

It is unclear at what time-window of the day blood pressure (BP) is most closely associated with cerebrovascular damage. In this cross-sectional study, we examined the strength of association between intracranial arterial stenosis (ICAS) and systolic BP (SBP) across different time-windows using 24-hour ambulatory BP monitoring in 757 consecutively recruited patients with hypertension. ICAS was diagnosed with computerized tomographic angiography in 127 (16.8%) patients, of whom 64 (50.4%) had stenosis ≥50% and 82 (64.6%) had ICAS in ≥2 vessels. Patients with ICAS (142 mm Hg), especially of multiple vessels (145 mm Hg), compared with patients without ICAS (126 mm Hg), had significantly (P<0.001) higher early morning (05:00-07:59 am) SBP. The differences remained significant (P≤0.015) after adjustment for cardiovascular risk factors and SBPs at other time-windows of the day. Multivariate regression analysis showed that consecutive 3-hourly mean SBPs during the day were significantly associated with ICAS (odds ratio for each 10-mm Hg increase, 1.28-1.38; P≤0.001). However, only mean SBP obtained between 05:00 am and 07:59 am remained significant for ICAS (odds ratio, 1.30; P=0.019) when all consecutive 3-hourly mean SBPs were forced into a single multivariate model. In conclusion, the present study showed a significant association between early morning SBP and asymptomatic ICAS in patients with hypertension after accounting for conventional cardiovascular risk factors. Our findings highlight the importance of morning SBP as a cardiovascular risk factor and should be validated in prospective studies.


Assuntos
Ritmo Circadiano , Hipertensão/fisiopatologia , Doenças Arteriais Intracranianas/fisiopatologia , Idoso , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Encéfalo/irrigação sanguínea , Angiografia Cerebral , Circulação Cerebrovascular , Constrição Patológica , Estudos Transversais , Feminino , Humanos , Doenças Arteriais Intracranianas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Sístole , Tomografia Computadorizada por Raios X
8.
J Alzheimers Dis ; 39(4): 883-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24321893

RESUMO

The number of elderly in the world is increasing rapidly, especially in China. The prevalence of dementia among elderly was investigated in a community of Sheshan town, located in the Southwest suburb of Shanghai, China. Face-to-face interviews were conducted to collect relevant information with prepared questionnaires. The Chinese version of the Mini-Mental Status Examination was used to screen subjects with cognitive impairment (CI). Physical examinations and neuropsychological assessments were carried out. Dementia and its major subtypes, Alzheimer's disease (AD) and vascular dementia (VaD), were diagnosed by senior neurologists according to relevant diagnostic criteria. In addition, magnetic resonance imaging and EEG (with P300) were performed for a number of cases with AD or VaD. There were 1,472 participants (666 males and 806 females) aged 60 years and over in the study. A total of 167 subjects with CI were screened. Among them, dementia was recognized in 79 cases with a prevalence of 5.37% (95% confidence intervals: 4.22%-6.52%). The diagnosis of AD was made for 53 cases (16 males and 37 females) with a prevalence of 3.60% (95% confidence intervals: 2.65%-4.55%), and VaD for 21 cases (5 males and 16 females) with a prevalence of 1.43% (95% confidence intervals: 0.82%-2.03%); while the ratio of AD to VaD was 2.52. The prevalence rates of dementia among elderly from our study are higher than that previously reported from China, but in line with that reported from most world regions. A nationwide survey and surveillance system on the prevalence of dementia is recommended.


Assuntos
Coleta de Dados/métodos , Demência/diagnóstico , Demência/epidemiologia , População Rural , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Demência/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
9.
Dement Geriatr Cogn Disord ; 31(4): 300-8, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21502761

RESUMO

BACKGROUND/AIMS: To investigate if and where abnormal iron accumulation in white matter fibers occurs in patients with Alzheimer's disease (AD) by phase imaging and to relate these findings to white matter tract degeneration assessed by diffusion tensor imaging. METHODS: Twenty-five patients with AD and 20 normal controls underwent phase imaging and diffusion tensor imaging with a 3.0-tesla system. White matter fibers including fornix (Fx), genu of corpus callosum (GCC), splenium of corpus callosum (SCC), bilateral posterior cingulum (PC), superior longitudinal fasciculus (SLF), inferior longitudinal fasciculus (ILF) and frontal occipital fasciculus (IOF) were measured on a fractional anisotropy (FA) map, mean diffusivity (MD) map and phase map. RESULTS: Significantly decreased phase values and FA values in the Fx and PC regions were found in the AD group. The phase value in Fx had a moderately positive correlation with the FA value (r = 0.666, p = 0.000) in the AD group. Meanwhile, phase values in PC showed positive correlation with FA values (right side: r = 0.436, p = 0.033; left side: r = 0.458, p = 0.022, respectively). CONCLUSION: Iron accumulation of Fx and PC regions was significantly positively correlated with FA value, indicating that abnormal iron deposition may be one of the causes of white matter disruption in AD.


Assuntos
Doença de Alzheimer/etiologia , Doença de Alzheimer/patologia , Sobrecarga de Ferro/complicações , Sobrecarga de Ferro/patologia , Leucoencefalopatias/etiologia , Leucoencefalopatias/patologia , Idoso , Doença de Alzheimer/metabolismo , Imagem de Tensor de Difusão , Feminino , Humanos , Ferro/metabolismo , Sobrecarga de Ferro/metabolismo , Masculino , Pessoa de Meia-Idade , Degeneração Neural/etiologia , Degeneração Neural/metabolismo , Degeneração Neural/patologia , Fibras Nervosas Mielinizadas/metabolismo , Fibras Nervosas Mielinizadas/patologia
10.
J Dig Dis ; 11(4): 215-23, 2010 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-20649734

RESUMO

OBJECTIVE: To study the correlation of liver and spleen volume with the degree of liver fibrosis and cirrhosis induced by hepatitis B virus infection. METHODS: 128 participants who had undergone liver and spleen volumetry were enrolled. The control group consisted of 41 participants who were potential living liver donors. The liver fibrosis group consisted of 63 histologically proved liver fibrosis patients who were further divided into two subgroups: 44 patients with slight liver fibrosis, and 19 patients with advanced liver fibrosis. The liver cirrhosis group consisted of 24 patients. The following parameters were determined by multi-detector spiral computed tomography (MSCT) examination: total liver volume (TLV), right liver lobe volume (RV), left lateral liver segment volume (LLV), left medial liver segment volume (LMV), caudate lobe volume (CV), and spleen volume (SV). The ratios of CV to TLV (C/T), RV to TLV (R/T), LLV to TLV (LL/T), LMV to TLV (LM/T), and SV to TLV (S/T) were calculated. RESULTS: TLV, RV, LMV tended to decrease and SV, C/T, S/T tended to increase gradually with the increased degree of fibrosis. C/T >or= 3.34% and S/T >or= 47.36% were identified as the cut-off values of fibrosis >or=F3 (advanced liver fibrosis) and cirrhosis, respectively. Their sensitivities were 68.4% and 87.5% and their specificities were 59.1% and 89.5%, respectively. CONCLUSION: Variations in liver and spleen volume correlated with the degree of liver fibrosis and cirrhosis and could be used in the non-invasive follow-up of the development of liver fibrosis.


Assuntos
Hepatite B Crônica/diagnóstico , Cirrose Hepática/diagnóstico , Fígado/diagnóstico por imagem , Fígado/patologia , Baço/diagnóstico por imagem , Baço/patologia , Adolescente , Adulto , Idoso , Feminino , Hepatite B Crônica/complicações , Hepatomegalia/diagnóstico por imagem , Hepatomegalia/patologia , Humanos , Cirrose Hepática/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Esplenomegalia/diagnóstico por imagem , Esplenomegalia/patologia , Tomografia Computadorizada Espiral/métodos , Adulto Jovem
11.
Zhonghua Yi Xue Za Zhi ; 89(1): 37-40, 2009 Jan 06.
Artigo em Chinês | MEDLINE | ID: mdl-19489242

RESUMO

OBJECTIVE: To investigate the characteristics of hydrogen proton magnetic resonance spectroscopy (H-MRS) in posterior portion cingulate gyrus and the correlations thereof with the results of mini-mental state examination (MMSE), Alzheimer disease assessment scale-cognitive (ADAS-cog) in patients with mild-moderate Alzheimer's disease (AD). METHODS: H-MRS in posterior portion cingulate gyrus was conducted in gender, age, and educational background-matched 24 patients with AD, 8 patients with vascular dementia (VD), and 11 normal controls (NC group) to measure the values of NAA (N-acetyl aspartate)myo-inositol (mI), and creatine and phosphocreatine (Cr). All the 4 subjects underwent MMSE and assessment with ADAS-cog as well. The correlations among these results were assessed. RESULTS: The NAA/Cr ratios in posterior portion cingulate gyrus of the AD and VD groups were (1.24 +/- 0.12) and (1.25 +/- 0.15) respectively, both significantly lower than that of the NC group [(1.46 +/- 0.19), P = 0.003, P = 0.017] without significant difference between the AD and VD groups (P = 0.800). The mI/Cr value of the AD group was (0.74 +/- 0.15), not significantly different from that of the VD group [(0.65 +/- 0.15), P = 0.153], and significantly higher than that of the NC group [(0.62 +/- 0.09), P = 0.007], however, the mI/Cr value of the VD group was not significantly different from that of the NC group (P = 0.662). If the NAA/Cr ratio < 1.31 was used as criteria of AD, the positive predictive value of AD was 73% and negative predictive value was 71%. The NAA/Cr ratio was positively correlated with the MMSE score (r = 0.731, P = 0.000), and negatively correlated with the ADAS-cog score (r = -0.541, P = 0.011). CONCLUSIONS: The NAA/Cr ratio decreases in the posterior portion cingulate gyrus of AD patients, and has statistical significant correlations with the score of MMSE and ADAS-cog. The H-MRS characteristics of posterior portion cingulate gyrus cannot effectively differentiate the early AD from early VD.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/fisiopatologia , Giro do Cíngulo/fisiopatologia , Espectroscopia de Ressonância Magnética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/psicologia , Estudos de Casos e Controles , Cognição , Demência Vascular/diagnóstico , Demência Vascular/fisiopatologia , Demência Vascular/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
12.
J Magn Reson Imaging ; 29(4): 793-8, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19306401

RESUMO

PURPOSE: To investigate the brain iron deposits in patients with Alzheimer's disease (AD) and healthy age-matched controls using phase imaging. MATERIALS AND METHODS: Twenty-six AD patients and 24 healthy controls were recruited. A three-dimensional high-resolution, gradient-echo sequence was used to acquire phase data in the coronal plane. A high-pass filter was used to remove the phase variation caused by field inhomogeneity. The regions evaluated included the bilateral putamen, globus pallidus, and the head and body of the hippocampus. RESULTS: Significantly lower phase values in both the basal ganglion and hippocampus were revealed in the AD group compared to the normal controls (P < 0.05). The phase value in the right side of the head of the hippocampus had a moderate positive correlation with the MMSE score (r= 0.603, P = 0.000) and a negative correlation with the duration of the disease (r = -0.677, P = 0.013). Using -0.0972 radians as an optimal cutoff value, the sensitivity and specificity for differentiation between AD and normal controls reached 95.8 and 80.8%, respectively. CONCLUSION: Phase imaging proved to be a useful method for the differentiation between normal controls and AD patients. An investigation of the excessive accumulation of iron in the hippocampus may help us better understand the pathologic process and neuropsychological dysfunction of AD disease.


Assuntos
Doença de Alzheimer/metabolismo , Hipocampo/metabolismo , Ferro/metabolismo , Idoso , Estudos de Casos e Controles , Feminino , Globo Pálido/metabolismo , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Estudos Prospectivos , Putamen/metabolismo , Curva ROC , Estatísticas não Paramétricas
13.
Chin Med Sci J ; 23(3): 178-82, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18853854

RESUMO

OBJECTIVE: To investigate the feasibility of whole body diffusion weighted imaging (WB-DWI) in screening metastasis. METHODS: WB-DWI was performed in 24 patients diagnosed with various types of primary tumors. The three-dimensional maximum intensity projection reconstruction and black-and-white flip technique were used to observe metastatic lesions, and the results were compared with those of bone scintigraphy. RESULTS: By WB-DWI scanning sequence at b = 800 s/mm2, all the bone lesions found by bone scintigraphy in the cohort were well identified, and other lesions of soft tissue and organs were also well demonstrated. Its screening capability was equivalent with bone scintigraphy in screening metastases in bones (P = 0.062). CONCLUSION: WB-DWI was practicable with the parameter settings attempted in metastases screening.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Metástase Neoplásica , Neoplasias , Imagem Corporal Total/métodos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica/diagnóstico , Metástase Neoplásica/patologia , Neoplasias/diagnóstico , Neoplasias/patologia , Cintilografia , Adulto Jovem
14.
Zhonghua Yi Xue Za Zhi ; 88(15): 1027-31, 2008 Apr 15.
Artigo em Chinês | MEDLINE | ID: mdl-18754434

RESUMO

OBJECTIVE: To study the brain volume changes of patients with Alzheimer's disease (AD). METHODS: 23 patients with (AD and 23 sex, age, and educational background-matched normal controls (NC group) underwent three-dimensional MRI to measure the hippocampus, amygdala, entorhinal cortex (EC), perirhinal cortex (PC), cornu temporale, and uncus distance in the baseline survey. Two years later 10 AD patients and 11 normal controls underwent 3-D MRI once again in the follow-up survey. RESULTS: The baseline survey showed that the levels of uncus distance and total temporal horn volume of the ADS patients were 11 +/- 4 and 1.21 +/- 1.00 respectively, both significantly higher than those of the NC group (7 +/- 3 and 0.59 +/- 0.54 respectively, P < 0.01, P < 0.05), and the levels of total entorhinal cortex volume, total perirhinal cortex volume, and total hippocampus volume were 2.52 +/- 0.86, 2.19 +/- 0.62, and 3.23 +/- 0.75 respectively, all significantly lower than those of the BC group (3.67 +/- 0.54, 3.39 +/- 0.51, and 3.98 0.38, all P < 0.01). The levels of uncus distance and total temporal horn volume of the AD patients during the follow-up survey were 11 +/- 4 and 1.21 +/- 1.00 respectively, both significantly higher than those of the NC group (7 +/- 3 and 0.59 +/- 0.54 respectively, both P < 0.05); and the total entorhinal cortex volume, total perirhinal cortex volume, and total hippocampus volume of the AD patients during the followup survey were. 1.79 +/- 0.56, 1.77 +/- 0.59, and 2.80 +/- 0.80 respectively, all significantly lower than those of the NC group (2.76 +/- 0.50, 2.76 +/- 0.41, and 3.59 +/- 0.38 respectively, all P < 0.01). CONCLUSION: The AD patients have more remarkable atrophy of entorhinal cortex, perirhinal cortex, and have obvious extension of cornu temporale and uncus distance in comparison with the normal controls. The shrinkage rate of hippocampus can be used as a marker for the diagnosis and progress of AD.


Assuntos
Doença de Alzheimer/patologia , Encéfalo/patologia , Idoso , Idoso de 80 Anos ou mais , Tonsila do Cerebelo/patologia , Estudos de Casos e Controles , Córtex Cerebral/patologia , Córtex Entorrinal/patologia , Feminino , Seguimentos , Hipocampo/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
15.
Dement Geriatr Cogn Disord ; 25(3): 218-25, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18219201

RESUMO

BACKGROUND/AIMS: To compare proton magnetic resonance spectroscopy ((1)H-MRS) and diffusion tensor imaging (DTI) findings in the posterior cingulate regions in patients with Alzheimer's disease (AD). METHODS: 17 patients with mild AD, 20 with moderate to severe AD and 20 cognitively normal aging subjects (CN) underwent single-voxel MRS and DTI examinations. A region of interest was positioned in the posterior cingulate regions. Ratios of N-acetylaspartate (NAA), myo-inositol (mI), and choline to creatine (Cr) were measured. Mean spectroscopy data and DTI values (fractional anisotropy, FA, and mean diffusivity, MD) were analyzed with nonparametric testing. RESULTS: The group with mild AD showed a significantly lower FA value in the left posterior cingulum compared to CN. The group with moderate to severe AD revealed significantly decreased FA values and increased MD values in both the left and right cingulum compared to the group with mild AD. Partial correlation analysis revealed a positive correlation between mI/Cr and left-side FA values in the group with mild AD and a negative correlation between NAA/Cr and right-side MD values in the group with moderate to severe AD. CONCLUSION: There are different regional and temporal patterns in AD, resulting from gliosis or axonal loss. Combining MRS with DTI could provide valuable information to better understand the AD process.


Assuntos
Doença de Alzheimer/diagnóstico , Doença de Alzheimer/metabolismo , Imagem de Difusão por Ressonância Magnética/métodos , Giro do Cíngulo/metabolismo , Giro do Cíngulo/patologia , Espectroscopia de Ressonância Magnética/métodos , Prótons , Idoso , Transtornos Cognitivos/diagnóstico , Feminino , Humanos , Masculino , Modelos Biológicos , Fibras Nervosas/metabolismo , Fibras Nervosas/patologia , Testes Neuropsicológicos , Índice de Gravidade de Doença
16.
Neuroradiology ; 48(10): 773-81, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16937146

RESUMO

INTRODUCTION: Regional cerebral blood volume (rCBV) and permeability surfaces (rPS) permit in vivo assessment of glioma microvasculature, which provides quite important pathophysiological information in grading gliomas. The aim of our study was to simultaneously examine rCBV and rPS in glioma patients to determine their correlation with histological grade using CT perfusion imaging. METHODS: A total of 22 patients with gliomas underwent multislice CT perfusion imaging preoperatively. Low-grade and high-grade groups were categorized corresponding to WHO grade II gliomas and WHO grade III or IV gliomas, respectively, as determined by histopathological examination. rCBVs and rPSs were obtained from regions of maximal abnormality in tumor parenchyma on CBV and PS color perfusion maps. Perfusion parameters were compared using the Kruskal-Wallis test in order to evaluate the differences in relation to tumor grade. The Pearson coefficients of rCBV and rPS for each tumor grade were assessed using SPSS 13.0 software. RESULTS: rCBV and rPS provided significant P-value in differentiating glioma grade (low-grade gliomas 3.28+/-2.01 vs 2.12+/-3.19 ml/100 g/min, high-grade gliomas 8.87+/-4.63 vs 12.11+/-3.18 ml/100 g/min, P<0.05). Receiver operating characteristic (ROC) curves revealed better specificity and sensitivity in PS than in CBV for glioma grade. A significant correlation between rCBV and rPS was observed in high-grade gliomas (r=0.684). rCBVs in oligodendrogliomas were higher than in other low-grade gliomas, whereas their rPS values did not show a parallel difference. CONCLUSION: Perfusion CT provides useful information for glioma grading and might have the potential to significantly impact clinical management and follow-up of cerebral gliomas.


Assuntos
Volume Sanguíneo/fisiologia , Neoplasias Encefálicas/patologia , Permeabilidade Capilar/fisiologia , Glioma/patologia , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/fisiopatologia , Circulação Cerebrovascular/fisiologia , Feminino , Glioma/metabolismo , Glioma/fisiopatologia , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
17.
Zhonghua Yi Xue Za Zhi ; 83(9): 753-5, 2003 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-12899751

RESUMO

OBJECTIVE: To evaluate the clinical value of three-dimensional computed tomographic angiography (3D-CTA) in embolization of ruptured intracranial aneurysms with Guglielmi detachable coil (GDC). METHODS: From December 1998 to February 2002, 175 consecutive patients with acute subarachnoid hemorrhage (SAH) underwent 3D-CTA on the day of admission. All the patients with intracranial aneurysms diagnosed by 3D-CTA received emergency intraaneurysmal GDC embolization in case the ruptured aneurysm was suitable to endovascular therapy. RESULTS: Eighty patients with intracranial aneurysms received successfully emergency GDC embolization according to the results of 3D-CTA, all verified by digital subtraction angiography (DSA). 3D-CTA was superior to DSA in depiction of the 3D anatomy of aneurysms and parent arteries and provided valuable information for embolization of intracranial aneurysms prior to catheter angiography, especially for anterior communicating artery aneurysms. CONCLUSION: 3D-CTA discloses the existence of intracranial aneurysms early, establishes the indications of embolization prior to the catheter angiography, determines the side of insertion of guiding catheters, helps choose the appropriate coil size, and may become a routine diagnostic modality.


Assuntos
Aneurisma Roto/terapia , Angiografia Cerebral , Embolização Terapêutica/métodos , Imageamento Tridimensional , Aneurisma Intracraniano/terapia , Adulto , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Angiografia Digital/métodos , Angiografia Cerebral/métodos , Feminino , Humanos , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Ruptura Espontânea/complicações , Ruptura Espontânea/diagnóstico por imagem , Ruptura Espontânea/terapia , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/etiologia , Hemorragia Subaracnóidea/terapia , Tomografia Computadorizada por Raios X
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