Quantitative evaluation of ankle cartilage in asymptomatic adolescent football players after season by T2-mapping magnetic resonance imaging.

BACKGROUND: Ankle sprain affects the structure and function of ankle cartilage. However, it is not clear whether the daily training and competition affect the ankle cartilage without acute injury. Changes in ankle cartilage without injury may influence future strategies to protect ankle function in athletes. This study aimed to evaluate whether the composition of ankle cartilage significantly altered in asymptomatic adolescent football players after a whole season of training and competition using T2-mapping magnetic resonance imaging (MRI). MATERIALS AND METHODS: 12 local club's U17 asymptomatic adolescent football players without abnormalities in routine MRI were included. Routine and T2-mapping MRI were performed to measure the cartilage thickness of tibiotalar joint (TT) and posterior subtalar joint (pST) and T2 values in pre- and post-seasons. All of them took the right side as dominant foot. RESULTS: In the pre- and post-seasons, cartilage T2 values in TT (talus side) and pST (calcaneus side) were higher than that of TT (tibial side) and pST (talus side) (all p < 0.05), which was caused by magic angle effect and gravity load. No statistically significant differences in thickness after season in the other cartilages of ankle were found compared with that before the season (all p > 0.05). However, T2 values of TT (tibial side and talus side) cartilage in the dominant foot were significantly reduced after season (p = 0.008; p = 0.034). These results indicate that the microstructure of articular cartilage changes in the joints with greater mobility, although no trauma occurred and the gross morphology of cartilage did not change. CONCLUSION: Changes in the T2 values of tibiotalar joint cartilage in the dominant foot of healthy young athletes before and after the season suggest that the microstructure of cartilage had changed during sports even without injury. This finding suggests that the dominant ankle joint should be protected during football to delay degeneration of the articular cartilage.

Radiographic measurement for transforaminal percutaneous endoscopic approach (PELD).

OBJECTIVE: A radiographic study to analyze the working zone and relationship of the nerve root to their corresponding intervertebral disc for transforaminal percutaneous approaches. METHODS: 100 MRIs of transverse and sagittal views of 37 males, 63 females (average age 45 years), 50 MRIs of coronal views of 22 males, 28 females (average age 42 years), and 100 X-rays, 46 males, 54 females (average age of 44 years) were used for image analysis. All radiologic measurements were obtained independently by two experienced radiologists. On sagittal plane, foraminal height, foraminal diameter, nerve root-disc distance and nerve root-pedicle distance were measured. On transverse plane, foraminal width, nerve root-disc distance, nerve root-facet distance and target angle (J°) were analyzed at the superior (s) and inferior (i) margin of the disc. On coronal plane, nerve root-disc distance and nerve root-pedicle distance were measured at the medial, middle and lateral borders of the pedicle. RESULTS: Sagittal plane; foraminal height and diameter decreased caudally. Transverse plane; foraminal width was larger at the superior margin of the disc. Nerve root-disc distance decreased caudally. The nerve root lied dorsal to the disc at L2-L3 and L3-L4, whereas at L4-L5 and L5-S1 it lied ventrally. Nerve root-facet distance was shortest at the superior margin. Target angles (Js°, Ji°) at L2-L3 and L3-L4 were wider at their superior margin than at their inferior margin. Coronal plane; nerve root-disc distance increased from L2-L3 to L5-S1 whereas nerve root-pedicle distances decreased, thus coursing more vertically. CONCLUSIONS: At lower lumbar levels the exiting nerve root is at risks of injury. Hence, it is advised to enlarge the foramen for safe passage of endoscopic instruments and to minimize the possibility of nerve injury.

Perfusion and diffusion characteristics of endometrial malignancy based on intravoxel incoherent motion MRI at 3.0 T: comparison with normal endometrium.

BACKGROUND: There has been a growing need for a non-invasive imaging method for the accurate diagnosis and differentiation of endometrial malignancy (EM). PURPOSE: To study tissue characteristics of EM using an intravoxel incoherent motion (IVIM) model and to assess their diagnostic potential. MATERIAL AND METHODS: Sixty-eight EMs and 31 healthy participants were prospectively recruited for diffusion-weighted (13 b-values, b = 0-3,000 s/mm(2)) and standard magnetic resonance imaging (MRI). A bi-exponential analysis was performed to derive f (perfusion fraction), D* (pseudodiffusion coefficient), and D (true diffusion coefficient) in EM and normal endometrium (NE). Apparent diffusion coefficient (ADC) was calculated. Student's t test, the Mann-Whitney U test and a receiver operating characteristics (ROC) curve analysis were performed. RESULTS: EM had lower f (37.809 ± 12.158%) and was significantly different from NE (P < 0.001). However, the EMs had higher D (0.503 ± 0.155 × 10(-3) mm(2)/s) and D* (19.796 ± 20.029 × 10(-3) mm(2)/s) and were all significantly different from NE (P < 0.001). D was significantly lower than ADC in NE (P < 0.001) but not in EM (P > 0.05). f ≤ 48.5%, D > 0.432 × 10(-3) mm(2)/s, D* > 4.94 × 10(-3) mm(2)/s, and ADC ≤ 0.542 × 10(-3) mm(2)/s could diagnose EM (AUC 0.786-0.961). CONCLUSION: EM has distinctive IVIM perfusion and diffusion characteristics with promising potential for earlier non-invasive diagnosis.

A biocompatible NIR-II light-responsive nanoknife for permanent male sterilization.

Nanomaterial-mediated photothermal therapy (PTT) is a promising strategy for permanent male sterilization owing to its easy operation, rapid heating, minimal invasiveness, and high spatiotemporal controllability. However, the currently available PTT for male sterilization utilizes irradiation sources in the first near-infrared window (NIR-I), which may suffer from incomplete sterilization due to the insufficient penetration depth of NIR-I light. Herein, we developed a facile one-pot hydrothermal synthetic method of cysteine-coated copper sulfide (Cys-CuS) nanosheets for the second NIR window (NIR-II) PTT-mediated permanent male sterilization. In this method, Cys acted not only as a template but also as a sulfur resource in the formation of Cys-CuS nanosheets. The obtained Cys-CuS nanosheets possessed good photothermal properties and satisfied deep-tissue light response capacity under 1064 nm laser exposure. Given this, the permanent male sterilization in vivo was readily achieved by Cys-CuS nanosheets in a rapid manner (only 40 s). To the best of our knowledge, it is the first time that nanomaterial-mediated NIR-II PTT is applied for permanent male sterilization. We believe that the facilely prepared biocompatible Cys-CuS nanosheets can serve as a promising NIR-II light-responsive nanoknife to control the overpopulation of domestic pets and stray animals.

Quantitative evaluation of bone marrow characteristics in occult and subtle rib fractures by spectral CT.

PURPOSE: The present study aimed to determine whether the water content change in the medullary cavity of occult rib fractures by spectral computed tomography (CT). METHODS: The material decomposition (MD) images were reconstructed using the water-hydroxyapatite basis material pairs from spectral CT. The water contents of the medullary cavity in subtle or occult rib fractures and the symmetrical sites of the contralateral ribs were measured, and their difference was calculated. The absolute value of the water content difference was compared to patients without trauma. An independent samples t-test was adopted to compare the consistency of the water content in the medullary cavity of the normal ribs. Intergroup and pairwise comparisons were applied to the difference in water content among the subtle/occult fractures and normal ribs, followed by receiver operating characteristic curve calculations. p < 0.05 was considered to have a statistically significant difference. RESULTS: A total of 100 subtle fractures, 47 occult fractures, and 96 pairs of normal ribs were included in this study. The water content of the medullary cavity in the subtle and occult fractures was both higher than that in their symmetrical sites with the difference value of 31.06 ± 15.03 mg/cm3 and 27.83 ± 11.40 mg/cm3, respectively. These difference values between the subtle and occult fractures were not statistically significant (p = 0.497). For the normal ribs, the bilateral water contents were not statistically different (p > 0.05) with a difference value of 8.05 ± 6.13 mg/cm3. The increased water content of fractured ribs was higher than that of normal ribs (p < 0.001). According to the classification based on whether the ribs were fractured, the area under the curve was 0.94. CONCLUSIONS: The water content measured on MD images in spectral CT in the medullary cavity increased as a response to subtle/occult rib fractures.

Effectiveness of Platelet-Rich Plasma in Anterior Cruciate Ligament Reconstruction: A Systematic Review of Randomized Controlled Trials.

This study aimed to identify the effectiveness of platelet-rich plasma (PRP) for patients operated with anterior cruciate ligament reconstruction (ACLR). Databases of PubMed, Embase, and CENTRAL were independently retrieved by two authors, for identifying the eligible randomized controlled trials (RCTs) comparing the clinical and imaging outcomes of ACL reconstructed patients augmented with or without PRP. The Cochrane Collaboration tool was utilized to assess the risk of bias of the included trials. We qualitatively synthesized the outcomes include the image evaluations on the healing of bone tunnels, graft remodeling, donor site healing and tunnel widening, and clinical evaluations on knee stability and function, pain symptom by visual analogue scale (VAS), inflammatory parameters and so on. A total of 16 RCTs, including 1025 patients, were included for eligibility. Generally, the included studies were of low risk of bias, but the conducting of allocation concealment was not clearly described in many studies. Three imaging techniques, including MRI, CT and ultrasound, were selected in these trials. Significant improvement on graft remodeling, bone tunnel healing, harvest site healing and bone tunnel diameters were demonstrated in one of five (20.0%), three of five (60.0%), two of four (50.0%) and one of five (20.0%) studies respectively, for PRP group. Various clinical outcomes, such as IKDC score, Lysholm score, Tegner score, knee anteroposterior and rotational laxity, range of motion and VAS, could not be improved with PRP application. The PRP is associated with very limited role in improving knee outcomes following ACLR, and there is no indication for PRP procedures in ACLR at this stage.

Significant Association between the T2 Values of Vertebral Cartilage Endplates and Pfirrmann Grading.

OBJECTIVE: The T2 value of lumbar cartilage endplates was measured using the T2 mapping imaging technique, aiming to explore the correlation between the T2 value and Pfirrmann grading of intervertebral discs. METHODS: A total of 130 patients with lumbar spine MR examination due to persistent low back pain were enrolled, including 71 men and 59 women (age: 21-63 years). Lumbar Modic changes and Schmorl nodules were recognized by conventional T1WI and T2WI images in 49 patients, and these patients were excluded from the study. A total of 81 patients were enrolled in this study, including 45 men (45.16 ± 12.20 years) and 36 women (43.33 ± 11.27 years). Pfirrmann (Pm) grading of each lumbar disc was performed based on conventional T2WI median sagittal images and the position of cartilage endplates (CEP) was determined by IDEAL-SPGR images. Meanwhile, the T2 mapping technique was used to obtain T2 values of cartilage endplates. The T2 values of CEP corresponding to different Pm grade discs were compared, and the correlation between the T2 value and the Pm grade of intervertebral discs was analyzed. RESULTS: The T2 values of cephalic and caudal CEP of L1-2 in Pm grades I-II, Pm grades III, and Pm grades IV-V were 61.96 ± 5.89 ms, 54.45 ± 3.29 ms, 42.47 ± 3.69 ms and 64.35 ± 5.93 ms, 55.28 ± 3.97 ms, 44.75 ± 2.12 ms, respectively. For cephalic and caudal CEP of L2-3 , the T2 values in Pm grades I-II, Pm grades III, and Pm grades IV-V were 62.96 ± 6.93 ms, 55.19 ± 4.02 ms, 48.67 ± 4.56 ms and 65.51 ± 6.49 ms, 57.16 ± 5.55 ms, 52.05 ± 4.20 ms, respectively. The T2 values of cephalic and caudal CEP from L3-4 to L5 -S1 in Pm grades I-II, Pm grades III, and Pm grades IV-V were (63.72 ± 5.76 ms, 53.96 ± 6.52 ms, 48.05 ± 5.00 ms), (65.46 ± 6.37 ms, 55.70 ± 7.50 ms, 48.10 ± 3.27 ms); (66.34 ± 7.68 ms, 56.76 ± 9.48 ms, 47.80 ± 4.33 ms), (64.44 ± 4.65 ms, 59.30 ± 8.80 ms, 47.30 ± 5.78 ms), (65.32 ± 5.11 ms, 55.33 ± 6.65 ms, 48.18 ± 5.37 ms), and (63.47 ± 4.92 ms, 50.32 ± 8.86 ms, 44.77 ± 4.69 ms), respectively. There were significant differences in T2 values of cartilage endplates between the Pm grades I-II, III, and IV-V of intervertebral discs (P = 0.000). T2 values corresponding to Pm I-II grades were higher than those in Pm III grade, while T2 values in Pm grades IV-V were lowest. The T2 value of the L4-5 , L5 -S1 segment endplates was highly correlated with the Pm grades (r = -0.711, -0.721, -0.796, -0.745; P = 0.000) and that of L1-2 , L2-3 endplates were moderately correlated (r = -0.542, -0.562, -0.637, -0.612; P = 0.000). CONCLUSION: The T2 values of cartilage endplates revealed varying degrees of degeneration of intervertebral discs, and more severe degeneration corresponded to lower T2 values. Measurement of changes in the T2 value through cartilage endplates can be useful for the diagnosis of early intervertebral disc degeneration and the prevention of disc degeneration.

Analysis of pathological parameters of cervical spondylotic myelopathy using magnetic resonance imaging.

OBJECTIVES: Cervical spondylotic myelopathy is a cervical degenerative disease that seriously jeopardizes the physical and mental health of patients. The aim of this study was to use magnetic resonance imaging (MRI) to compare differences in pathological parameters among the healthy group, latent cervical spondylosis (LCS) group, and cervical spondylotic myelopathy (CSM) group. PATIENTS AND METHODS: Magnetic resonance imaging (MRI) describes cervical spine changes from the Pavlov ratio of the cervical spinal canal on sagittal T2-weighted images (T2WI), trace value and fractional anisotropy (FA) value of cervical spinal cord on Diffusion tensor images (DTI). In our study, above mentioned parameters were compared among Group A (healthy group), Group B (LCS group) and Group C (CSM group). RESULTS: In Pavlov ratio, there were statistical differences on 7 levels of 10 levels between Group A and B, on all levels between Group C and another two groups. On trace value, there was no statistical difference on all levels between Group A and B. There are statistical differences on 7 levels of 10 levels between Group C and another two groups. On FA value, there was also no statistical difference on all levels between Group A and B. There were statistical differences on 3 levels of 10 levels between Group A and C, on 5 levels of 10 levels between Group B and C. The Pearson correlation between trace value and FA value is -0.526 (p = 0). CONCLUSION: The MRI scan results showed that there was a significant difference among the three groups for the parameter Pavlovian ratio, but not for the parameter trace value and FA value.

Pathological changes of cervical spinal canal in cervical spondylotic myelopathy: A retrospective study on 39 cases.

OBJECTIVE: To evaluate and compare the cervical spinal canal (CSC) morphology among healthy people, cervical spondylosis myelopathy (CSM), and latent cervical spondylosis (LCS, people with cervical spine degeneration on medical imaging but without clinic symptoms). PATIENTS AND METHODS: We reviewed MRI data describing cervical spinal morphology in healthy persons, LSC patients and CSM patients. All cases underwent cervical MRI. In transverse image, anteroposterior diameter (A-P diameter), area of cervical spinal canal (CSC) and area of cervical spinal cord were measured. In sagittal image, A-P diameter was measured. Dural sac area = the area of CSC in the transverse position - the area of cervical spinal cord in transverse position. RESULTS: There're 8 cases in the healthy group, 18 cases in the group of LCS, and 13 cases in CSM group. Generally, the measured indicators at two ends of CSC (C2/3 and C7) are larger than those at C3-C6. A-P diameters on axial and sagittal position show a decrease trend from healthy group to LCS group and to CSM group. CSC area and dural sac area on axial position of CSM group are significantly lower than those in healthy group and LCS group. Almost all measured indicators of CSM group are significantly lower than healthy group and LCS group. Every two measured indicators in each group are significantly corelated. CONCLUSIONS: The results suggested that CSC size of CSM was smaller than that of LCS, and A-P diameter <11 mm, CSC area <170mm2 and dural sac area <90 mm2 were more advisable to indicate cervical spinal canal stenosis in Chinese people.

Single NIR Laser-Activated Multifunctional Nanoparticles for Cascaded Photothermal and Oxygen-Independent Photodynamic Therapy.

Inconvenient dual-laser irradiation and tumor hypoxic environment as well as limited judgment of treating region have impeded the development of combined photothermal and photodynamic therapies (PTT and PDT). Herein, Bi2Se3@AIPH nanoparticles (NPs) are facilely developed to overcome these problems. Through a one-step method, free radical generator (AIPH) and phase transition material (lauric acid, LA, 44-46 °C) are encapsulated in hollow bismuth selenide nanoparticles (Bi2Se3 NPs). Under a single 808-nm laser irradiation at the tumor area, hyperthermia produced by Bi2Se3 not only directly leads to cell death, but also promotes AIPH release by melting LA and triggers free radical generation, which could further eradicate tumor cells in hypoxic environments. Moreover, Bi2Se3 with high X-ray attenuation coefficient endows the NPs with high computed tomography (CT) imaging capability, which is important for treating area determination. The results exhibit that Bi2Se3@AIPH NPs possesses 31.2% photothermal conversion efficiency for enhanced PTT, ideal free radical generation for oxygen-independent PDT, and 37.77 HU mL mg-1 X-ray attenuation coefficient for CT imaging with high quality. Most importantly, the tumor growth inhibition rate by synergistic PTT, PDT, and following immunotherapy is 99.6%, and even one tumor disappears completely, which demonstrates excellent cascaded synergistic effect of Bi2Se3@AIPH NPs for the tumor therapy.

Is fetal-type posterior cerebral artery a risk factor for intracranial aneurysm as analyzed by multislice CT angiography?

Fetal-type posterior cerebral artery (FTP) is a common anatomic variation that is closely associated with intracranial aneurysm. In the present study, multislice computed tomography angiography (CTA) was performed to assess whether FTP is a risk factor for intracranial aneurysm. CTA data of 364 consecutive cases of patients who were suspected with cerebrovascular disease or intracranial aneurysm of intracranial artery from 2013 to 2016 were reviewed and the incidence rates of FTP, other variations of the circle of Willis, intracranial aneurysm and FTP with intracranial aneurysm were evaluated. The χ2 test was used to assess the influence of FTP and gender on the incidence rates of other variations of the circle of Willis, intracranial aneurysm and internal carotid artery-posterior communicating artery (ICA-PComA) aneurysm. Binary logistic regression analysis was performed to assess the associations of FTP and gender with intracranial aneurysm and ICA-PComA aneurysm. Compared with non-FTP patients, FTP cases exhibited significantly higher rates of other variations of the circle of Willis (χ2=80.173, P<0.001) and ICA-PComA aneurysm (χ2=4.437, P=0.035). Among patients with FTP and bilateral FTP, more female than male patients with intracranial aneurysm were identified. However, among all patients with intracranial aneurysm, no statistically significant differences in the prevalence of FTP (χ2=2.577, P=0.108) and bilateral FTP (χ2=2.199, P=0.159) between males and females were identified. Binary logistic regression analysis revealed that FTP and gender were risk factors for intracranial aneurysm and ICA-PComA aneurysm. A moderate association between FTP and ICA-PComA aneurysm (OR=2.762) were identified, although there was a weak association between FTP and intracranial aneurysm [odds ratio (OR)=1.365]. Furthermore, a strong association was identified between gender and intracranial aneurysm (OR=0.328), and a moderate association existed between gender and ICA-PComA aneurysm (OR=0.357). In conclusion, female gender is an independent risk factor for intracranial aneurysm, and FTP and female gender are independent risk factors for ICA-PComA aneurysm.

[Correlation between the stenosis degree of aorto-iliac artery and superior mesenteric artery in patients with lower extremity atherosclerotic occlusive disease by CT angiography].

OBJECTIVE: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: (1) according to the degree of SMA stenosis, the patients were divided into group I (stenosis degree ≤70%) and group II (stenosis degree > 70%); (2) LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis. RESULTS: The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group I (n = 64) and group II (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group I, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group II, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient. CONCLUSIONS: Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.

An intelligent re-shieldable targeting system for enhanced tumor accumulation.

Programmed ligand targeting strategy promotes the blood circulation stability of nanoparticles by shielding the ligand. However, the irreversible shielding causes the deshielded nanoparticles to be easily recognized and cleared by the reticuloendothelial system (RES), impeding their further retention in the tumor. Here, we for the first time prove the superiority of the intelligent re-shieldable targeting system that is based on the pH-responsive self-assembly/disassembly of gold nanoparticles. The system can enhance the stability of gold nanoparticles in the blood circulation (2.6-fold at 24h), reduce uptake by the RES (35% lower) and improve tumor accumulation (41% higher by analysis of gold content in tumor) effectively compared with the conventional irreversible system. Furthermore, preliminary study indicates that the system could be applied as computed tomography contrast agent in tumor imaging. The in vivo validity of the intelligent re-shieldable targeting system provides inspiration for the design of nanomaterials for cancer diagnosis and treatment.

Dua-energy virtual noncontrast imaging in diagnosis of cervical metastasis lymph nodes.

OBJECTIVE: The aim of this study was to evaluate the clinical value of dua-energy virtual noncontrast imaging (DVNCT) in the diagnosis of cervical metastasis lymph nodes. MATERIALS AND METHODS: From February 2014 to January 2015, 41 patients with 98 enlarged cervical lymph nodes were recruited in this study. All the enlarged lymph nodes were pathology confirmed. The patients received DVNCT and conventional noncontrast scan. The difference of average computed tomography (CT) value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and lesion detectability between virtual noncontrast imaging and conventional noncontrast scan were compared. The radiation dose of virtual noncontrast imaging and real noncontrast imaging of cervical lymph node were also compared. The diagnostic sensitivity and specificity for DVNCT was also evaluated. RESULTS: No statistical difference of average CT value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and radiation dosage between virtual noncontrast imaging and conventional noncontrast scan were found. However, the radiation dosage of DVNCT was significant lower than that of conventional noncontrast scan (P < 0.05). The diagnostic sensitivity and specificity for malignant metastasis lymph node were 88.6% and 70.3% by DVNCT. CONCLUSION: DVNCT combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dosage.

Kanglaite injection combined with hepatic arterial intervention for unresectable hepatocellular carcinoma: a meta-analysis.

OBJECTIVE: The purpose of this study was to evaluate the Kanglaite (KLT) injection combined with hepatic arterial intervention for treatment of unresectable hepatocellular carcinoma (HCC) by meta-analysis. MATERIALS AND METHODS: Computerized bibliographic searching were undertaken to identify all eligible published studies about the KLT injection combined with hepatic arterial intervention for unresectable hepatocellular carcinoma (HCC). PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases were all searched to included the suitable trails. The odds ratios (ORs) and its corresponding 95% confidence intervals (95% CIs) were calculated as effect size with fixed-effect or random-effect models according to the heterogeneity test across the studies. RESULTS: Nine trails were finally included in this meta-analysis. The objective response rate (ORR) was significant improved in the group of KLT injection combined with hepatic arterial intervention compared to hepatic arterial intervention alone (OR =1.80, 95% CI:1.18-2.75, P < 0.05); The combined treatment can significant improve the KSP score (OR = 3.22, 95% CI:1.36-7.60, P < 0.05) and relief the pain of patients compared to that in single treatment (OR = 2.57, 95% CI:1.65-3.99, P < 0.05). CONCLUSION: KLT injection combined with hepatic arterial intervention can improve the short-term clinical efficacy, quality of life, and decrease the pain of patients with unresectable HCC.

The anatomical study of left atrium diverticulum by multi-detector row CT.

The purpose of this study was to describe radiologic anatomy of the left atrium diverticulum. There were 20 patients with 27 left atrium diverticulums in 120 consecutive patients who underwent CT of coronary angiography. The presence probability of left atrium diverticulum was 16.7%, male of it was 13.0%, female was 17.6%. There was no difference on gender (P > 0.05). There were four patients accompanying with variation of pulmonary vein at one time. The diverticulum might be single or multiple, cystiform or tubiform. It could locate anterior wall or posterior wall or superior wall of left atrium. Left atrium diverticulums which was single, cystiform, and located in anterior wall were common. The cervix width of diverticulum was 4.9 +/- 3.2 mm, the body height of them was 5.4 +/- 2.0 mm. The ratio of body height to cervix width was from 0.47 to 4.08 (median 1.16). Ten patients of them undertook cardiac ultrasound examination at same time. There were five patients who left atrial diastolic function decreased, four patients who left ventricular systolic function decreased. Three of them both existed left atrial diastolic function decreasing and left ventricular systolic function decreasing, accompanied with mitral or aortic regurgitation. No patient was found that left atrium pressure or left ventricle diastolic pressure was increasing. The left atrium diverticulums of ten patients were probably congenital because their hemodynamical status cannot lead to diverticulum formation. It can be proved by reexamination after therapy or autopsy at last. In conclusion, multi-detector row computed tomography could provide anatomy details of left atrium diverticulum to help to finish heart and chest surgery successfully.