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BACKGROUND Intravenous gadoteridol injection can be applied to visualize endolymphatic hydrops (EH). AIMS/OBJECTIVES To explore whether 3.5-h time interval was feasible for clinical practice. MATERIALS AND METHODS We collected 70 unilateral Meniere's disease (MD) patients who were divided into two groups randomly (group A: 3.5-h time interval; group B: 4-h time interval). Among the two groups, the signal intensity (SI) in perilymphatic area of the basal turn of cochlea, the results of visual evaluations in the vestibule, cochlea and semicircular canal and the detection results of EH were compared. RESULTS Regarding the SI, no difference was found between A-affected ears and B-affected ears (p=.499), and no difference was found between A-unaffected ears and B-unaffected ears (p=.111). However, a difference was found between A-affected ears and A-unaffected ears (p=.005), and a difference was found between B-affected ears and B-unaffected ears (p=.012). Besides, no difference was found between the visual evaluations in the vestibule, cochlea, and semicircular canal of the two groups. Regarding the detection results of EH, no difference was found between the two groups (all p>.05). CONCLUSIONS AND SIGNIFICANCE In the clinical application of gadoteridol for the inner ear, 3.5-h delayed MR imaging is feasible.

To evaluate the clinical characteristics of optic neuritis (ON) with different phenotypes. This prospective study recruited patients with new-onset ON between January 2015 and March 2017 who were followed-up for 3 years. They were divided into the myelin oligodendrocyte glycoprotein-seropositive (MOG-ON), aquaporin-4-seropositive (AQP4-ON), and double-seronegative (seronegative-ON) groups, and their clinical characteristics and imaging findings were evaluated and compared. Two-hundred-eighty patients (405 eyes) were included (MOG-ON: n = 57, 20.4%; AQP4-ON: n = 98, 35.0%; seronegative-ON: n = 125, 44.6%). The proportion of eyes with best-corrected visual acuity > 20/25 at the 3-year follow-up was similar between the MOG-ON and seronegative-ON groups; the proportion in both groups was higher than that in the AQP4-ON group (p p p = 0.476) but both were thinner than the seronegative-ON group (74.06 ± 11.14 μm, p

Intravenous gadolinium injection (IV-method) can be used to visualize endolymphatic hydrops.This study was designed to use a three-dimensional inversion-recovery sequence with real reconstruction (3 D-real IR) sequence 4 h after the IV-method, images of the perilymph space were scored for endolymphatic hydrops in cases of suspected Meniere's disease (MD) in children to investigate its diagnostic value of MD in children.We collected 28 suspected MD children aged ≤17 years old, all of whom underwent the IV-method. After 4 h, inner ear 3 D-real IR magnetic resonance imaging (MRI) was performed and results were analyzed.Gadolinium contrast agent was seen distributed in the perilymphatic space with perilymphatic enhancement on 3 D-real IR MRI, allowing differentiation between the perilymphatic and endolymphatic spaces. Based on perilymph MRI diagnostic scoring, 64.3% (18/28) of the patients were categorized as having endolymphatic hydrops, who were followed and eventually diagnosed with confirmed MDs.Suspected MD children should undergo gadolinium-enhanced examinations of the inner ear while taking dynamic audiology examinations for the confirmed diagnosis.

Background An isolated oculomotor nerve (CN III) palsy is a diagnostic concern because of the potential for serious morbidity or life-threatening causes. We present 5 unusual causes of oculomotor nerve palsy that escaped initial diagnosis in order to raise awareness of their associated features that will facilitate correct diagnosis. Methods This study consisted of a retrospective analysis of clinical features and imaging of 5 patients who were referred for neuro-ophthalmologic evaluation with presumed diagnosis of oculomotor nerve palsy of unknown reasons. Results A complete CN III palsy and an inferior division CN III palsy were diagnosed with a schwannoma in the cavernous sinus and orbital apex portion, respectively; a middle-aged woman with aberrant regeneration was found to have a small meningioma; an adult man with ptosis was diagnosed with cyclic oculomotor paresis with spasms; and a patient after radiation was diagnosed with neuromyotonia. Conclusions Localizing the lesion of oculomotor nerve palsy and careful examination of the imaging is crucial. Aberrant regeneration, cyclic pupil changes, and past medical history of amblyopia, strabismus, or radiation are also very helpful for diagnosis.

Purpose The purpose of this study was to explore the characteristic computed tomography (CT) and magnetic resonance (MR) features of small cell neuroendocrine carcinoma (SNEC) of paranasal sinuses. Materials and methods Computed tomography (n = 8) and MR (n = 14) images and clinical findings from 14 patients with SNEC of paranasal sinuses were retrospectively reviewed. Results Eight lesions were located in the ethmoidal sinus, 4 in the maxillary sinus, and 2 in the sphenoid sinus. Small cell neuroendocrine carcinoma of the sphenoid sinus showed bilateral asymmetry patterns. On CT images, bony changes were visible in all 8 cases. On MR, 4 cases contained hemorrhage, and 10 cases contained cystic or necrotic areas. All cases demonstrated marked heterogeneous enhancement, with half showing a "cribriform-like" or "geographic" appearance. The nasal cavity was the most common site invaded by SNEC of paranasal sinuses, followed by the orbits. A time-signal intensity curve examination showed a washout-type pattern in all but 1 case. The mean ± SD apparent diffusion coefficient value was 0.702 ± 0.112 (×10 mm/s). According to the Dulguerov staging system, 9 tumors were staged as N0 (1 T1, 1 T2, 5 T3, and 2 T4). The recurrence rate was 64.3%. Conclusions Some characteristics of radiological findings can provide important clues for preoperative diagnosis.

Introduction: Meniere's disease is associated with impaired hearing, tinnitus, vertigo, and aural fullness. Many anatomical studies have suggested idiopathic endolymphatic hydrops as the pathological basis of Meniere's disease, which now can be visualized by using gadolinium -enhanced magnetic resonance imaging of the inner ear. Objective: To investigate the development of endolymphatic hydrops in Meniere's disease by monitoring the vestibules and cochleae of affected patients. Methods: Inner ears of 178 patients with definite unilateral Meniere's disease diagnosis were visualized by 3-dimensional fluid-attenuated inversion recovery and three-dimensional real inversion recovery magnetic resonance imaging following bilateral gadolinium intratympanic injection. The scans were used to evaluate the presence and degree of endolymphatic hydrops in the vestibules and cochlear structures, including the cochlear apical turn, the cochlear middle turn, and the cochlear basal turn. The correlation of endolymphatic hydrops occurrence between the various parts of the inner ear was determined. Results: Symptomatic endolymphatic hydrops was detected on the affected side in all patients, whereas asymptomatic endolymphatic hydrops was detected on the unaffected contra-lateral side in 32 patients (18.0%). On the affected side, the cochlear apical turn and the cochlear middle turn demonstrated significantly higher rates of endolymphatic hydrops than the cochlear basal turn and the vestibule. The severity of endolymphatic hydrops gradually decreased from the cochlear apical turn to the cochlear basal turn. On the contra lateral side, the incidence and degree of the detected asymptomatic endolymphatic hydrops were significantly greater in the cochleae than in the vestibules (p

Pseudotumour cerebri syndrome (PTCS) remains to be fully investigated in Chinese patients and our study reported PTCS-related clinical differences between Chinese patients and Western patients. This study enrolled 55 consecutive patients (females: 44, median age: 37 y, age range: 14–62 y) with PTCS diagnosed from October 2015 to December 2017. Nine (16.4%, females) patients had primary PTCS, and 46 (83.6%) had secondary PTCS (P = 0.001). At presentation, 81.8% of patients had grade >3 papilloedema, with 23.6% having diffusely constricted fields. Mean subarachnoid space around the optic nerve measured by retrobulbar ultrasonography during lumbar puncture was 1.12 ± 0.17 mm and decreased to 0.86 ± 0.11 mm after treatment. Optical coherence tomography (OCT) showed that 92.9% of eyes with intact macular ganglion cell-inner plexiform layer (GCIPL) at baseline had good outcomes after treatment. Patients’ demographic and clinical characteristics showed that secondary PTCS was more common than primary idiopathic intracranial hypertension in Chinese patients. Polycystic ovarian syndrome was the main associated factor in females. Poor visual function was common at presentation. Noninvasive ocular ultrasonography and OCT are the prognostic indicators of PTCS treatment in intracranial pressure and visual function, respectively, after PTCS treatment.

Background: Intratympanic and intravenous gadolinium administration is used to visualise endolymphatic hydrops. Aims/objectives: The goal of this study was to compare the image quality between intratympanic (IT-method) and intravenous (IV-method) gadolinium administration using three-dimensional inversion recovery with real reconstruction (3D real IR) sequences. Materials and methods: A number of 152 patients with Meniere's disease were included. The 3D real IR sequence was performed 24 h after IT administration or 4 h after IV administration. The detection rate of endolymphatic hydrops, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the two methods were compared. Specifically, the average image scores of the two methods were evaluated by two radiologists. Results: The SNRROI and CNRs of the IT-method were higher than those of the IV-method, whereas no significant difference between the IT-method and IV-method with regard to the SNRB was found. The average image scores were 3.49 ± 0.12 and 3.30 ± 0.12 for the IT-method and IV-method, respectively (p = .229). No statistically significant difference was found between two methods in terms of the detection rate of endolymphatic hydrops. Conclusions and significance: IT-method images can display endolymphatic hydrops more precisely than IV-method images. The IV-method can be used as an alternative to the IT-method in clinical applications to some extent.

Background Based on its high resolution in soft tissue, MRI, especially diffusion-weighted imaging (DWI), is increasingly important in the evaluation of cholesteatoma. The purpose of this study was to evaluate the role of the 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with the BLADE trajectory technique in the diagnosis of cholesteatoma at 3 T and to qualitatively and quantitatively compare image quality between the TGSE BLADE and RESOLVE methods. Method A total of 42 patients (23 males, 19 females; age range, 7–65 years; mean, 40.1 years) with surgically confirmed cholesteatoma in the middle ear were enrolled in this study. All patients underwent DWI (both a prototype TGSE BLADE DWI sequence and the RESOLVE DWI sequence) using a 3-T scanner with a 64-channel brain coil. Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR]) were assessed for the two diffusion acquisition techniques by two independent radiologists. Result A comparison of qualitative scores indicated that TGSE BLADE DWI produced less geometric distortion, fewer ghosting artifacts (P P P P The ADC (P − 3 mm2/s) than RESOLVE DWI (0.928 × 10− 3 mm2/s). Conclusion Compared with RESOLVE DWI, TGSE BLADE DWI significantly improved the image quality of cholesteatoma by reducing magnetic sensitive artifacts, distortion, and blurring. TGSE BLADE DWI is more valuable than RESOLVE DWI for the diagnosis of small-sized (2 mm) cholesteatoma lesions. However, TGSE BLADE DWI also has some disadvantages: the whole image intensity is slightly low, so that the anatomical details of the air-bone interface are not shown well, and this shortcoming should be improved in the future.

PURPOSE The discrimination between neuromyelitis optica (NMO)- and multiple sclerosis (MS)-related acute optic neuritis (ON) after the first presentation is difficult in clinical practice. Through a comparison with diffusion-weighted imaging using readout-segmented echo-planar imaging (RESOLVE-DWI), our aim was to determine the feasibility of diffusional kurtosis imaging (DKI) for differential diagnosis. MATERIALS AND METHODS Orbital DKI and RESOLVE-DWI in a 3.0-T scanner were performed on 37 patients with acute ON (15 NMO-related and 22 MS-related). The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), mean diffusivity (MD), and apparent diffusion coefficient (ADC) were calculated for quantitative analyses, and receiver operating characteristic curve analyses were also performed to determine their abilities to differentiate the 2 conditions. RESULTS The intraclass correlation coefficients among observers were 0.842, 0.885, 0.828, 0.871, and 0.942 for MK, RK, AK, MD, and ADC, respectively, in the affected nerve group and 0.890, 0.840, 0.832, 0.934, and 0.941 in the unaffected nerve group. Regarding the comparisons of the DKI and RESOLVE-DWI parameters among the groups, the mean MK, RK, AK, MD, and ADC values were significantly lower in the affected groups (all, P < 0.001). Furthermore, the MK, RK, MD, and ADC values were significantly lower in the NMO-ON group than in the MS-ON group (P = 0.001, 0.002, 0.013, and

PURPOSE In clinical practice, acute optic neuritis (ON) associated with the development of neuromyelitis optica (NMO) after the first attack is often indistinguishable from that associated with multiple sclerosis (MS). We aimed to determine the optimal combination of features derived from conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging using readout-segmented echo-planar imaging (RESOLVE-DWI) for the differentiation of these conditions. MATERIALS AND METHODS Orbital conventional MRI and RESOLVE-DWI were performed using a 3.0-T scanner on 54 patients with acute ON (26 NMO-related and 28 MS-related). The features detected by conventional MRI (including laterality, the enhancement pattern, and the extent and position of involvement) and the apparent diffusion coefficient (ADC) measurements were retrospectively compared between the NMO-related and MS-related groups. A multivariate logistic regression analysis was used to identify the most significant variables, and receiver operating characteristic curve analyses were performed to determine the ability of a combined diagnostic model based on the qualitative and quantitative characteristics identified in this study to differentiate the 2 conditions. RESULTS The multivariate logistic regression analyses indicated that the presence of chiasm involvement and lower ADC values were significantly associated with NMO-related acute ON compared with MS-related acute ON (P = 0.037 and 0.008, respectively). The diagnostic criterion of chiasm involvement or "ADC < 791 × 10 mm/s and chiasm involvement" had the highest specificity (96.9%), and "ADC < 791 × 10 mm/s or chiasm involvement" showed the optimal sensitivity (77.8%) for differentiating NMO-related from MS-related acute ON. CONCLUSIONS Conventional MRI RESOLVE-DWI is helpful for differentiating NMO-related acute ON from MS-related acute ON. The combination of the ADC value chiasm involvement appears to be effective for discriminating these 2 types of acute ON.

Through a comparison with the axial orientation, we aimed to evaluate the role of coronal high-resolution diffusion-weighted imaging (DWI) in acute optic neuritis based on diagnostic accuracy and the reproducibility of apparent diffusion coefficient (ADC) measurements. Orbital DWI, using readout-segmented, parallel imaging, and 2D navigator-based reacquisition (RESOLVE-DWI), was performed on 49 patients with acute vision loss. The coronal (thickness = 3 mm) and axial (thickness = 2 mm) diffusion images were evaluated by two neuroradiologists retrospectively. The sensitivity, specificity, and accuracy were calculated through diagnostic test; the inter- and intra-observer reliabilities were assessed with a weighted Cohen’s kappa test. In addition, the agreement of ADC measurement among observers was evaluated by the intra-class correlation coefficient (ICC), coefficient of variation (CV), and Bland-Altman plots. Comparison of ADC values was also performed by unpaired t test. Among the 49 patients, 47 clinically positive optic nerves and 51 clinically negative optic nerves were found. The sensitivity, specificity, and accuracy were 85.1/87.2%, 90.2/94.12%, and 87.8/90.8%, respectively, for coronal RESOLVE-DWI and 83.0/85.1%, 66.7/76.5%, and 75.5/79.6%, respectively, for axial RESOLVE-DWI. The inter-observer kappa values were 0.710 and 0.806 for axial and coronal RESOLVE-DWI, respectively, and the intra-observer kappa values were 0.822 and 0.909, respectively (each P

Trichloroethylene (TCE) -induced hypersensitivity syndrome (TIHS) is a potentially life-threatening disease. Several genetic susceptibility biomarkers have been found to be associated with TIHS, and this systematic prospective study has been conducted to evaluate the utility of these genetic susceptibility biomarkers in preventing the disease.The newly hired TCE-exposed workers were recruited from March 2009 to October 2010.Among 1651 workers, 158 (9.57%) were found to carry theProspective

To characterize features of organized hematoma (OH) that may cause considerable diagnostic difficulties.Case series with chart review.Tertiary medical center.Eighty-four patients with pathologically confirmed OH over a 10-year period were retrospectively reviewed for clinical features, imaging findings, pathologic characteristics, and treatment modalities.This study included 39 males and 45 females who presented with frequent epistaxis and nasal obstruction. There were 62 (74%) patients40 years old (mean, 50; range, 9-81). OH mainly originated in the maxillary sinus (n = 82) or nasal cavity (n = 2) unilaterally, and most were expansile masses (n = 73) that extended into nasal cavity (n = 71) or choanae (n = 17). Several lesions were locally aggressive and simulated a malignant process that involved the ethmoid sinus (n = 22), orbit (n = 11), pterygopalatine fossa (n = 16), infratemporal fossa (n = 9), cheek (n = 3), and hard palate (n = 3). Internal architecture on computed tomography (CT) scans showed OH with expansile remodeling of the maxillary wall (82.1%) and smooth bony destruction (70.2%), whereas T2-weighted magnetic resonance (MR) images showed inhomogeneity with a notable hypointense peripheral rim in all lesions. CT and MR contrast-enhanced images revealed patchy heterogeneous enhancement that could be interpreted according to histopathologic findings of hemorrhage and neovascularization. OH was successfully removed with endoscopic surgery, although 5 cases recurred.OH can be successfully treated by endoscopic surgery. CT and MR examination provide characteristic findings for prediction and careful surgical planning.

Objective: To explore and quantify the surgically relevant anatomic relationships and three-dimensional (3D) morphology of the supralabyrinthine space, and enable a deeper, clearer understanding of its regional anatomy. Materials and Methods: 3D-DOCTOR software was used to create a 3D reconstruction of the axial CT images and multiplanar reformatting of 55 slices of temporal bone in 29 patients (17 males and 12 females), whose average age was 38.69 ± 17.81 years. The 3D relationships between the mutual complex structures were displayed graphically and measured. Results: The important structures within the temporal bone were displayed in detail. 3D relationships between the structures in the temporal bone, such as the ossicles, facial nerves, labyrinth, and skull base, were quantified. Conclusion: Quantification of surgically relevant anatomic relationships and the morphology of the supralabyrinthine space in three dimensions are very helpful in surgical dissection.

The aims of the present study are to investigate the variations in clinical features, including medical history, hearing function, vestibular function, and degree of endolymphatic hydrops (EH), in Meniere's disease (MD) patients with and without drop attacks (DAs), and to examine the efficacy of intratympanic gentamicin (ITG) treatment in alleviating DAs.In total, 177 unilateral definite MD patients, including 16 patients with DAs and 161 patients without DAs, were enrolled. The results of hearing test, vestibular-evoked myogenic potentials (VEMPs), and magnetic resonance imaging (MRI) were analyzed. Thirteen patients with DAs received a single ITG treatment and were followed up.The disease course of MD in the DA group was significantly longer than that in the control group (p = 0.007). MD patients with DAs had significantly greater hearing loss and worse EH than MD patients without DAs (p 0.05). However, there was no between-group difference in vestibular function. In the study, 92.31% of refractory definite MD patients with DAs achieved satisfactory control of DAs after ITG treatment.MD patients with DAs tend to suffer from severe hearing loss and a significant degree of EH in the inner ear. However, the vestibular function of MD patients with DAs may not be completely abolished, but be sensitive to stimulating signals. ITG treatment, which helps to decrease vestibular sensitivity, was an effective treatment to control DAs.

This study suggests that jugular bulb-vestibular aqueduct dehiscence (JBVAD) does not affect the hearing or balance functions of the inner ear.Since JBVAD may cause impairment of the inner ear and induce hearing loss, tinnitus, and vertigo, this study was to investigate the effect of JBVAD on hearing and balance.Patients undergoing temporal bone computed tomography (TBCT) scans from May 2013 to December 2013 at a tertiary referral hospital were reviewed. The topographic relationship between the jugular bulb (JB) and the vestibular aqueduct was assessed. The findings were classified as normal when there was always a bony structure between the two structures and as dehiscent when the bony coverage separating the two structures was absent. Clinical data were collected via electronic records and clinical follow-up.A total of 1313 out of 8325 patients were diagnosed with a HJB. Forty-six patients showed JBVAD. The prevalence of dehiscence was 0.6% in patients undergoing temporal bone CT scans and 3.5% in patients with HJB. Of the 46 patients with JBVAD, 23 (50%) had sensorineural hearing loss, three (6.5%) had tinnitus, and two (4.3%) had vertigo. The correlation between JBVAD and these clinical symptoms did not achieve statistical significance.

OBJECTIVES The aims of this article are: 1) to re-evaluate the accuracy of multiple planar reconstruction computed tomography (MPR-CT) imaging on stapes-prosthesis parameters, and 2) to clarify possible relationships between prosthesis intravestibular depth and postoperative hearing outcomes. PATIENTS Seventy patients (46 women and 24 men; 32 right and 38 left sides) with the mean age of 40 years (range, 19-62 yr) with clinical otosclerosis. INTERVENTION(S) All patients underwent stapedotomy and were implanted with the same type of titanium piston prosthesis by the same surgeon. MAIN OUTCOME MEASURE(S) Postoperative MPR-CTs were obtained at patients' follow-up visits. The length and intravestibular depth of the stapes prosthesis (including absolute and relative depth) were calculated from the MPR-CT imaging. Relationships between the intravestibular depth of the prosthesis and hearing outcomes (pre- and postoperative audiograms) were analyzed using Spearman correlation analyses. RESULTS The length of the prosthesis was overestimated by 1.8% (0.1 mm) by the MPR-CT imaging. Axial and coronal measurements were significantly correlated (p

Purpose To determine the feasibility of intravoxel incoherent motion (IVIM) for characterizing perfusion properties and its potential diagnostic utility for nonarteritic anterior ischemic optic neuropathy (NAION). IVIM diffusion-weighted imaging is a promising technique that can measure perfusion and diffusion characteristics simultaneously in a noninvasive manner. Materials and Methods Orbital IVIM in a 3.0T scanner was performed on 33 patients with NAION and 15 controls using readout-segmented echo-planar imaging, parallel imaging, and 2D navigator-based reacquisition (RESOLVE-IVIM). Both visual field (VF) and visual acuity (VA) examinations were performed in 19 of the patients. The vascular volume fraction (f), diffusion coefficient (D), and pseudodiffusion coefficient (D*) were calculated for quantitative analysis. Additionally, correlation analyses of IVIM parameters with visual function were also performed. Results Affected optic nerves showed significantly lower f values than both unaffected contralateral nerves of the patients and nerves of the controls (P < 0.0001), and no significant difference for f was found between unaffected contralateral nerves and nerves of the controls (P = 0.1602). In addition, D and D* values showed no significant differences among the three groups (P = 0.0979, 0.0600, 0.6136 for D and 0.1779, 0.6253, 0.4743 for D*). Correlation analysis only demonstrated significant correlations between f values and the mean deviation of the visual field (r = 0.576, P = 0.0051). Conclusion RESOLVE-IVIM measurement may reflect the perfusion abnormality and visual function impairment in NAION patients, demonstrating its potential application for the diagnosis and clinical evaluation of NAION. Level of Evidence: 1 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017.

OBJECTIVE We assessed whether the three-dimensional fluid-attenuated inversion-recovery (3-D FLAIR) and three-dimensional inversion-recovery with real reconstruction (3-D real IR) sequences can be used to detect cochlea endolymphatic hydrops (EHs) in guinea pigs using 3 Tesla magnetic resonance imaging (3T MRI). The results of 3-D real IR imaging were compared with histopathological outcomes. MATERIALS AND METHODS Fourteen healthy men and women albino guinea pigs were used in this study. Their right ears received procedures that promoted EHs, and their left ears were used as untreated controls. High-resolution 3T MRI, combined with the intratympanic injection of gadolinium (Gd) in both ears, was performed 8 to 12 weeks after surgery. Both sides of the cochlea midmodiolar sections were observed under a light microscope and saved as the histopathological images. The signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) between the T2-weighted 3-D FLAIR and T2-weighted 3-D real IR sequences were compared. The appearance of EHs in the basal, second, third, and apical turns of the cochlea was further evaluated using 3-D FLAIR, 3-D real IR, and the histopathological images. Moreover, the maximum scala media area ratios (SMRs) on the histopathological sections were compared with the grading of the EHs on the 3-D real IR sequence with regard to each turn of the cochlea. RESULTS Significant differences were found between the 3-D FLAIR and 3-D-real IR sequences with regard to the SNRs and CNRs (p

Aim To evaluate the effect of serious periventricular white matter injury (PWMI) on the voiding patterns of preterm infants. Methods Free voiding was continuously observed for eight hours in 19 preterm infants with serious PWMI and 16 infants without PWMI. The infants had a gestational age of 32–35 weeks and a postnatal age of 9–15 days. Voiding frequency, voided volume, postvoid residual volume, empty voiding, awake voiding and interrupted voiding were recorded and compared between the two groups of infants. Results The voiding frequency ((5.1 ± 1.0) vs. (7.0 ± 1.1)), awake voiding percentage ((23 ± 11)% vs. (42 ± 7)%) and empty voiding percentage (lower quartile = 16% vs. 28%, median = 20% vs. 33%, upper quartile = 28% vs. 40%) were significantly lower, while the voided volume ((19.9 ± 6.6) mL vs.(15.9 ± 5.3) mL)and postvoid residual volume (lower quartile = 1 mL. vs. 0 mL., median = 3 mL. vs. 2 mL., upper quartile = 3 mL. vs. 2 mL.) were significantly higher in the injured preterm infants, compared with the healthy infants (p

Background: The conventional venous access for cardiovascular implantable electronic device (CIED) is the subclavian vein, which is often accompanied by high complication rate. The aim of this study was to assess the efficacy and safety of optimized axillary vein technique. Methods: A total of 247 patients undergoing CIED implantation were included and assigned to the axillary vein group or the subclavian vein group randomly. Success rate of puncture and complications in the perioperative period and follow-ups were recorded. Results: The overall success rate (95.7% vs. 96.0%) and one-time success rate (68.4% vs. 66.1%) of punctures were similar between the two groups. In the subclavian vein group, pneumothorax occurred in three patients. The subclavian gaps of three patients were too tight to allow operation of the electrode lead. In contrast, there were no puncture-associated complications in the axillary vein group. In the patient follow-ups, two patients in the subclavian vein group had subclavian crush syndrome and both of them received lead replacement. The incidence of complications during the perioperative period and follow-ups of the axillary vein group and the subclavian vein group was 1.6% (2/125) and 8.2% (10/122), respectively ( χ 2 = 5.813, P = 0.016). Conclusion: Optimized axillary vein technique may be superior to the conventional subclavian vein technique for CIED lead placement. Trial Registration: www.clinicaltrials.gov , NCT02358551; https://clinicaltrials.gov/ct2/show/NCT02358551?term=NCT02358551& rank=1 .

The aim of this study was to examine and assess comparative values of HRCT-based multiplanar reformation (MPR), volume rendering (VR) and virtual endoscope built on three-dimensional (3D) shaded-surface display (SSD-based CTVE) for detections of ossicular chain's damage in patients with otitis media. 70 human ears from 70 patients suffering by chronic otitis media or cholesteatoma, who were examined with a preoperative multi-slice computer tomography (MSCT) examination and tympanoplasty in our hospital were collected. The patients ossicular chains were reconstructed with the aforementioned three protocols and assessed via a three-point scoring system by three radiologists. Then, all the patients ossicular chains were reviewed by a surgeon and a radiologist via the same three-point scoring system used during surgeries at same time. By calculation, the Youden's index and coincidence rate were acquired without a significant difference for display of malleus. With regard to the incus, the Youden's index and coincidence rate of VR and MPR did not show any difference, however, both were higher than CTVE. For representation of the stapes, the accuracy of these three modalities is very low; especially, for the CTVE. In conclusion, both MPR and VR are relative robust, and CTVE is not effective for evaluation of small ossicular structures, particularly the stapes. Furthermore, the VR images are real 3D ones. Therefore, it could be the more valuable protocols for detection of the damage of ossicular chain in the patients with otitis media, and should be further applied in the future work.

To evaluate the value of 3D images based on multi-detect computer tomography (MDCT) for the diagnosis and management of patients with suspected foreign bodies aspiration, and report our experience about diagnosis and management of the aforementioned patients using the 3D images, as well as detail our protocol for the management of those patients. Forty-four patients (37 children, 7 adults) with suspected foreign bodies aspiration who accepted pre-surgical examination and bronchoscopy in our hospital were included in this study. All the patients' pre-surgical 3D images based on MDCT were reconstructed and analyzed. After that all the results were compared with observations in the surgeries. Among the 37 pediatrics, 34 patients were detected with FB in their tracheobronchial system by the 3D images based on MDCT, and 3 cases were detected negative. The sensitivity of 3D images is 100 %, and the specificity is 75 %.In the adult group, all the 7 cases of FB in the tracheobronchial tree were detected by 3D images and proved by bronchoscopy. 3D images based on MDCT were proved to be a valuable method for the diagnosis of the patients with suspected FB aspiration. In the diagnosis and management of those patients, we considered that both the typical FB aspiration history and the intractable symptoms of cough should be taken as the criteria and the first step for selecting those suspected patients; then 3D images based on MDCT could be taken as the second step and as the selective criteria for those patients who should accept the rigid bronchoscopy.

Aquaporin 8 (AQP8) is expressed within the female reproductive system but its physiological function reminds to be elucidated. This study investigates the role of AQP8 during pregnancy using AQP8-knockout (AQP8-KO) mice. Homozygous AQP8-KO mice were mated, and the conception rate was recorded. AQP8-KO pregnant mice or their offspring were divided into 5 subgroups according to fetal gestational day (7, 13, 16, 18 GD) and newborn. Wild type C57 pregnant mice served as the control group. The number of pregnant mice, total embryos and atrophic embryos, as well as fetal weight, placental weight and placental area were recorded for each subgroup. The amount of amniotic fluid in each sac at 13, 16, and 18 GD was calculated. Statistical significance was determined by analysis of variance of factorial design and chi-square tests. Conception rates did not differ significantly between AQP8-KO and wild type mice. AQP8-KO pregnant mice had a significantly higher number of embryos compared to wild type controls. Fetal/neonatal weight was also significantly greater in the AQP8-KO group compared to age-matched wild type controls. The amount of amniotic fluid was greater in AQP8-KO pregnant mice than wild type controls, although the FM/AFA (fetal weight/amniotic fluid amount) did not differ. While AQP8-KO placental weight was significantly larger than wild type controls, there was no evidence of placental pathology in either group. The results suggest that AQP8 deficiency plays an important role in pregnancy outcome.

The aim of this study is to evaluate the usefulness of high-resolution computed tomography (HRCT) densitometry in the diagnosis of otosclerosis and to investigate the relationship between CT densitometry and audiometry.HRCT findings and audiometry were compared among 34 patients (34 ears, the otosclerosis group) with surgically confirmed otosclerosis between January 2007 and December 2007 and 33 patients (33 opposite normal ears, the control group) with facial paralysis diagnosed at the same period of time. Seven regions of interest (ROI) were set manually around the otic capsule on the axial slice of 0.75-mm-thick CT image. The mean CT values of these seven regions were measured. In each ROI, the mean CT value of the otosclerosis group and that of the control group were compared. Based on the CT findings, the ears with otosclerosis were classified into two groups: Group A showed no pathological CT findings; Group B showed low density around the cochlea. In the otosclerosis group, the relationship between the findings of CT and the results of audiometry was analyzed.The mean CT values in the area posterior to the oval window and anterior to the oval window were significantly lower for the otosclerosis group compared with the control group (the former t=-2.030, p=0.046; the latter Z=-4.979, p0.01). Group A consisted of 30 patients, 7 of which (23.33%) exhibited conductive hearing loss, and 23 of which (76.67%) exhibited mixed hearing loss; Group B had 4 patients, all with mixed hearing loss. For the otosclerosis group, the mean CT value in the area posterior to the oval window was positively correlated with the mean air conduction threshold (r=0.4273, p=0.0117) and with the mean air-bone gap (r=0.3995, p=0.0192).Quantitative evaluation of CT with slices less than 1mm in thickness may provide important information for the diagnosis and assessment of otosclerosis which are unattainable through other methods.

From 1940 to September 2008, 21 cases with TDCs extending into respiratory tract have been reported, often with misdiagnosis. There were only 10 cases by the end of 2006, but the number increased rapidly recently. To evaluate endoscopic carbon dioxide (CO(2)) laser procedure for thyroglossal duct cyst (TDC) extending into respiratory tract, we reported an unusual case and performed a retrospective correlate review. A 3-year-old female patient with a TDC extending into respiratory tract, without any neck lumps, was previously misdiagnosed as an epiglottic cyst. An asymptomatic follow-up visit had been for 10 months after she had received endoscopic CO(2) laser procedure. To our best knowledge, endoscopic CO(2) laser procedure was administered for the first time for TDCs, though it had been a valid management of other benign lesions in respiratory tract. The endoscopic CO(2) laser procedure might be for TDC extending into respiratory tract. In order to increase awareness of this situation, we recommend that the novel concept of endogenous type should be considered to unify these TDCs extending into respiratory tract without projecting neck masses.

Purpose To evaluate the accuracy of diffusion-weighted imaging (DWI) in comparison to contrast-enhanced, fat-suppressed T1-weighted imaging (CET1WI) in detecting acute optic neuritis (ON). Materials and Methods The clinical data and magnetic resonance imaging (MRI) findings of 42 patients who presented with decreased vision were retrospectively reviewed. Both 3.0T MRI DWI and CET1WI orbital imaging studies were performed. Two neuroradiologists independently evaluated the DWI and CET1WI. The sensitivity, specificity, and accuracy of the DWI and CET1WI were individually calculated using the clinical diagnosis as the reference standard. The interobserver and intraobserver reliability of DWI and CET1WI were assessed by using a weighted Cohen's kappa (κ) test; a value of P

Aquaporins (AQP) are water channel proteins, and some play an important role in maternal-fetal fluid exchange. The present study aimed to measure the osmotic water permeability in primary cultures of trophoblast cells from AQP1-deficient (AQP1(-/-) ) pregnant mice and to define the quantitative role of AQP1 in water transport across the trophoblast plasma membrane.Trophoblast cells were obtained from placental tissue cell culture of AQP1(-/-) pregnant mice and were characterized by cytokeratin 7 immunostaining. The expression of the AQP1 gene in trophoblast cells of wild-type (AQP1(+/+) ) mice was confirmed by immunofluorescence. The osmotic water permeability of trophoblast plasma membranes was measured by a calcein fluorescence quenching method in response to osmotic gradients.A primary cell culture system for trophoblasts was successfully established. Immunofluorescence showed the expression of AQP1 in the trophoblast cell membrane of AQP1(+/+) mice. The osmotic water permeability of AQP1(-/-) trophoblast cells was significantly lower than that in AQP1(+/+) trophoblast cells, in response to both hypotonic and hypertonic challenges.The results suggest an important role of AQP1-mediated plasma membrane water permeability in maternal-fetal fluid balance and also provide a potential direction for the identification of therapeutic targets for the treatment of abnormalities in amniotic fluid volume.

Occupational exposure to (benzene, toluene and xylene, BTX is common in the Chinese workplace. Chronic occupational exposure to benzene is associated with an increased risk of hematological malignancies such as acute myeloid leukemia (AML), but the underlying mechanisms are still unclear. This study investigates changes in poly(ADP-ribosyl)ation and DNA methylation in subjects occupationally exposed to a BTX. Blood DNA samples and exposure data were obtained from subjects with different levels of exposure, including 132 decorators, 129 painters, and 130 unexposed referents in a container-manufacturing factory in Shenzhen, China. Occupational exposure assessment included personal monitoring of airborne benzene, toluene and xylene. Hematological parameters were measured and the cytokinesis-block micronucleus (CBMN) assay was used to detect DNA damage in peripheral lymphocytes. Quantitative real-time PCR was used to detect the mRNA expression of poly(ADP-ribose) polymerase 1 (PARP1) and poly(ADP-ribose) glycohydrolase (PARG), DNA methyltransferases (DNMTs) including DNMT1, DNMT3a and DNMT3b, methyl-CpG-binding domain protein 2(MBD2). PARP1 assay was used to measure PARP activity. Airborne levels of benzene, toluene and xylene in the two exposed groups were significantly higher than those of controls (P

To analyze the CT and MRI features of glomus tympanicum tumors accompanied with tympanitis and evaluate the diagnostic value of CT and MRI in order to improve the cognition for the disease.The clinical materials and images of 8 patients with the symptoms of pulsatile tinnitus and hearing loss in whom glomus tympanicum tumors with tympanitis surgically and pathologically confirmed were retrospectively reviewed. The characteristics and diagnostic value of CT and MR imaging were summarized.By CT examination the lesions in middle ear and mastoid were preoperatively diagnosed as tympanitis in five cases and only in three cases the glomus tympanicum tumors were suspected. In six patients underwent MR examination the lesions were all preoperatively diagnosed as glomus tympanicum tumors accompanied with tympanitis. HRCT scanning of the temporal bone in all patients showed the soft tissue lesions in the tympanic cavity and mastoid, and the caritas tympanic were mostly (n = 3) or completely (n = 5) occupied by soft tissue lesions, but the auditory ossicles were all without destruction. Contrast-enhanced axial CT scanning performed in five cases showed less soft tissue mass on the cochlear promontory, and the size of mass was less than that observed in MR imaging. MR T(1)-weighted imaging showed the presence of isointense lesions in middle ear and isointense (n = 3) or hyperintense (n = 3) lesions in mastoid. On T(2)-weighted imaging the lesions with slight hyperintense were viewed in the middle ear and the lesions with hyperintense in mastoid. T(1)-weighted gadolinium-enhanced MRI showed the masses in tympanum were markedly increased enhancement, but the lesions in mastoid without enhancement. MRI and CT imaging revealed the masses in six cases of eight extending to the eustachian tube.When the glomus tympanicum tumor was accompanied with tympanitis the tumor could be misdiagnosed or missed only by CT examination. The patients with pulsatile tinnitus should be taken seriously. MRI with contrast-enhancement is superior to CT in the preoperative diagnosis and accurately evaluation for the glomus tympanicum tumors with tympanitis.

To improve the imaging diagnosis accuracy on masses of temporal bone associated with pulsatile tinnitus.The CT and MRI features of masses in temporal bone associated with pulsatile tinnitus in 32 cases, confirmed by pathology, were retrospectively analyzed.They were grouped into two according to the jugular bulb involved or not. In the group involving the jugular bulb, there were 5 cases with glomus jugular, 2 cases of them presented the feature of "salt-pepper". There were 5 cases with middle ear carcinoma, which presented the masses in the tympanic cavity and antrum, extended to the external auditory canal and eroded the eustachian tube and jugular bulb. There were 3 cases with endolymphatic sac tumors, which presented multiple bony spicules on CT images and high signal on T1-weighted images. There was 1 case with metastatic tumor, which extensively eroded temporal and occipital bone, involved the jugular bulb, presented intermediate signal on T1-weighted images and intermediate or high signal on T2-weighted images, moderately enhanced following contrast administration. In the group not involving the jugular bulb, there were 15 cases with tympanic glomus, without ossicles and tympanic erosion, 7 cases of them limited to the promontory, 7 cases of them filled the tympanic cavity and antrum and 5 cases extended deep into the external auditory canals, 1 case extended to the mastoid, 12 cases intensely enhanced with gadolinium. There were 2 cases with cholesterol granulomas of the middle ear, which presented the masses in the tympanic cavity and antrum and high T1-weighted and T2-weighted signal. There was 1 case with facial nerve hemangioma, which presented the enlargement and mass of the geniculate fossa involving the tympanic segment of facial nerve with the erosion and displacement of ossicles. On MR images, the mass was intensely enhanced after contrast administration.Among the masses of temporal bone associated with pulsatile tinnitus, the paragangliomas are the most common and easy to be diagnosed by their imaging features. While the other masses of temporal bone are uncommon, they could also be diagnosed accurately by clinical and imaging characteristics.

Objective:This study aimed to investigate the computed tomography and magnetic resonance imaging findings of primary middle-ear carcinoma.Methods:In this retrospective study of 13 patients with primary middle-ear carcinoma, we collected pre- and post-contrast magnetic resonance images for all 13 cases, high-resolution computed tomography scans for 11 cases, and conventional computed tomography scans with contrast for 2 cases.Results:Soft-tissue masses were mainly located in the tympanum, tympanic sinus and deep within the external auditory canal, and involved the jugular fossa (9 of 13 patients), middle cranial fossa (5/13), parotid gland (2/13) and temporomandibular joint fossa (1/13). An irregular, ‘moth-eaten’ bone destruction pattern was seen on high-resolution computed tomography images, most commonly in the eustachian tube (9/13), jugular foramen (9/13) and facial nerve canal (7/13). On non-contrast magnetic resonances images, masses were isointense or slightly hypointense on T1-weighted images, and isointense or slightly hyperintense on T2-weighted images. On post-contrast images, lesions were moderately and homogeneously enhanced in seven cases and inhomogeneously enhanced in six.Conclusion:High-resolution computed tomography precisely detects regions of bone destruction, whereas MRI can better assess soft-tissue tumour margins, intracranial extension and vessel patency. Eustachian tube erosion is an important characteristic of primary middle-ear carcinoma.

To evaluate the role of magnetic resonance (MR) diffusion-weighted imaging (DWI) in discriminating lacrimal masses, including neoplastic and nonneoplastic entities.Forty-four patients with lacrimal masses underwent conventional MRI and DWI. The apparent diffusion coefficient (ADC) values of each mass and the ipsilateral temporal lobe were measured and the ratios of the lesion to temporal lobe ADC were calculated.Pleomorphic adenomas had significantly higher ADC values (1.37 ± 0.22 × 10(-3) mm(2) /sec) and ADC ratios (1.85 ± 0.34) than malignant tumors (1.03 ± 0.19 × 10(-3) mm(2) /sec, 1.37 ± 0.27) (P0.001), inflammatory pseudotumors (0.9 ± 0.08 × 10(-3) mm(2) /sec, 1.19 ± 0.07) (P0.01), reactive lymphoid hyperplasias (RLHs) (0.6 ± 0.06 × 10(-3) mm(2) /sec, 0.79 ± 0.07) (P0.001), and lymphomas (0.55 ± 0.06 × 10(-3) mm(2) /sec, 0.74 ± 0.08) (P0.001). RLHs and lymphomas had significantly lower ADC values and ADC ratios than malignant tumors (P0.05) and inflammatory pseudotumors (P0.05). An ADC value of less than 1.14 × 10(-3) mm(2) /sec and an ADC ratio of less than 1.6 were optimal for differentiating malignant tumors from benign tumors (sensitivity: 80 and 90%, specificity: 100 and 88.9%, respectively). An ADC value of less than 0.76 × 10(-3) mm(2) /sec and an ADC ratio of less than 1.0 were optimal for distinguishing lymphoproliferative disorders from inflammatory pseudotumors (sensitivity: 100%, specificity: 100% for both).DWI can help differentiate lacrimal masses and provides a potential clinical tool for noninvasive tissue characterization.

Labyrinthine sequestrum, a rare form of labyrinthitis, is highly distinct from the more commonly encountered labyrinthitis ossificans based on its unique clinical, radiologic, and histologic characteristics. The study included 4 such patients who had undergone clinical and laboratory investigations, computed tomography (CT), and magnetic resonance imaging (MRI) assessments followed by surgical procedures and pathological evaluation. Their major symptoms were otorrhea, otalgia, tinnitus, and profound hearing loss. Imaging studies showed an osteolytic soft mass with calcified debris in the inner ear, and the bony labyrinth was eroded partly or completely by granulation mass, with loss of bony morphology. Further pathological examination was coincident with inflammatory granulation tissue with some calcification or osseous tissue. The disease process is attributed to chronic osteomyelitis due to the presence of osteonecrosis. Prompt CT and MRI examinations and optimal therapeutic management facilitate definitive diagnosis and protect against fatal complications.

Maternal-fetal fluid balance is critical during pregnancy, and amniotic fluid is essential for fetal growth and development. The placenta plays a key role in a successful pregnancy as the interface between the mother and her fetus. Aquaporins (AQPs) form specific water channels that allow the rapid transcellular movement of water in response to osmotic/hydrostatic pressure gradients. AQPs expression in the placenta and fetal membranes may play important roles in the maternal-fetal fluid balance.

To explore the radiologic characteristics of lingual thyroglossal duct cyst relevant to diagnosis. In addition, to probe the feasibility of modified Sistrunk surgery for patients who experience recurrence after cystectomy or marsupialization under endoscopy.Retrospective.Seven patients, three male and four female, who had been diagnosed with lingual thyroglossal duct cysts, had received cystectomy or marsupialization under endoscopy between one and eight times with cyst recurrence soon after every operation. All of these cases were evaluated by CT before proceeding with the latest modified Sistrunk surgery. During surgery, we routinely used methylene blue to trace the cysts, and then we used an enlarged Sistrunk procedure for such cases.The CT images demonstrated that there were cysts located posteriorly to the tongue that had a close relationship with the hyoid bone and the foramen cecum. In addition, the results of the pathological examinations were consistent with thyroglossal duct cysts. During the postoperative follow up of 18 to 31 months, the patients did not show any symptoms or signs of recurrence. The results of their most recent examinations, two by laryngoscopy and five by CT scan, did not reveal any abnormality in their pars laryngea pharyngis.CT could differentiate lingual thyroglossal duct cysts from the other cysts occurring at the lingual root. For those patients with lingual thyroglossal duct cysts that recur after cystectomy or marsupialization under endoscopy, the modified Sistrunk operation could be a suitable treatment option.

The aim of this study was to examine and assess the comparative values of HRCT-based multiplanar reformation (MPR), volume rendering (VR) and virtual endoscope built on three-dimensional shaded-surface display (SSD-based CTVE) for evaluations of the ossicular chain. The normal pure tone audiograms, type-A tympanogram, and normal HRCT characteristics of 32 human ears of 18 patients were reviewed, whose ossicular chains were reconstructed with the three aforementioned protocols and assessed via the 3-point scoring system. The HRCT-based protocols could demonstrate a 3D image of the ossicular chain, except that of the footplate on the SSD-based CTVE. On the qualitative assessment, the efficacy of the MPR and VR, which were both superior to the SSD-based CTVE (P0.05), presented no statistical significance among the major and/or hyperdense structures (P0.05). As regards the lateral process of the malleus, VR was found to be significantly superior to the MPR and SSD-based CTVE (P0.05), both of which, however, showed no significant comparative differences (P0.05). Moreover, the three protocols in terms of efficacy were comparatively different in their representations of the anterior crus and footplates of the stapes, respectively (P0.05). On the MPR images, not all the images of the lenticular process were ideal; 20 of 32 cases were detected, but not defined. VR could be the more valuable protocol for the 3D reconstruction of the ossicular chain and ought to be more employed in future, especially for the education.

Focal atrial tachycardia (AT) arising from non-coronary cusp (NCC) is very rare, and the experience in catheter ablation of this kind of tachycardia remains limited. This study describes the electrophysiologic characteristics and radiofrequency ablation of AT arising from NCC.The study population consisted of five consecutive patients (three females and two males; age 37-68 years) with AT arising from NCC. The morphology of P waves was described as positive, negative, isoelectric, or biphasic (positive-negative or negative-positive). The atrial mapping was performed during tachycardia to define the earliest atrial activation site. Mean tachycardia cycle length of AT in five patients was 363 +/- 44 ms. P-wave morphology was predominantly upright or biphasic in lead II, III, and aVF, inverted in aVR. Positive P-wave morphology was seen in lead aVL in all five patients. The precordial leads were negative-positive in V(1) and V(2), negative-positive or positive in lead V(3)-V(5), and positive in lead V(6). All the five patients underwent successful radiofrequency ablation within NCC. During a follow up of3 months, no patient presented with a recurrence.This study demonstrated that mapping and ablation of focal AT arising from NCC is safe and effective. When earliest activation was recorded in the proximal electrode of the His-bundle catheter, but radiofrequency ablation in this region cannot successfully eliminated the tachycardia, the AT should be considered to arise from NCC especially when P-wave morphology was initially negative with a late positive component in right precordial leads, upright or biphasic in inferior leads.

To evaluate the clinical application of multi-planar reformation (MPR) for the diagnosis of superior semicircular canal dehiscence syndrome.A retrospective study was conducted on 9 patients who were diagnosed with SSCD syndrome in the Otology and Skull Base Surgery group of Fudan University. Three radiologists analyzed all the patients' 0.75 mm-collimated axial and coronal images and 0.75 mm-collimated MPR images, and they came up with the same results.There were 18 superior semicircular canal in the 9 patients, of whom 9 were intact and 9 were defective. All the defective superior semicircular displayed a definite dehiscence in all the MPR images, which indicated the sensitivity was 100%; however, 7 of the 9 defective superior semicircular canal were diagnosed as dehiscence in axial images, while 8 of the 9 were diagnosed in coronal images, but the sensitivities were 77.8% and 88.9% respectively. The results of the other 9 with intact superior semicircular canal displayed in the MPR, axial, and coronal images were also different. In the MPR images, they all displayed definite intact roof over the superior semicircular canal. There were 2 dehiscence in all axial and coronal images, and the specificities were 77.8%.The MPR image is more useful in diagnosis of superior semicircular canal dehiscence syndrome than that of the routine axial and coronal images.

To better understand superior semicircular canal dehiscence (SSCD) syndrome.A retrospective study was conducted on 6 patients who were diagnosed with SSCD syndrome in the Otology and Skull Base Surgery group of Fudan University. The clinical presentations including symptoms, signs, auditory tests and high resolution temporal bone computed tomography were reviewed.Four patients presented with low frequency hearing loss while acoustic reflex responses were intact. Another patient was concomitance with chronic otitis media demonstrated profound sensorineural hearing loss. The sixth patient demonstrated normal hearing. Two patients also complained of autophony, but they were unable to tolerate their own voice. Five patients presented with vertigo while 2 patients were unable to tolerate the environmental noise. All patients showed slow component vertical torsional eye movement away from the effected eye which was induced by the presence of loud sound or pressure in the middle ear or valsalva maneuver. Four patients also demonstrated vertigo induced by the loud sound, 1 patient was induced head movement by 110 dB tone. All patients were revealed variable bone defect overlying on the SSC using high resolution temporal bone CT scan with SSC reformation.The diagnosis of SSCD syndrome was established on both the presence of bone defect overlying superior semicircular canal which was demonstrated using high resolution temporal bone CT scan, and the presence of associated vestibular and auditory symptoms and signs.

To explore a set of quantitative methods to determine the position of the facial nerve based on three-dimensional CT reconstruction of temporal bone structures on personal computer, which can provide a series of important parameters for ear and the lateral skull base surgery.The internal structures of temporal bone were reconstructed based on a set of axial CT images of adult patients, the complicated relationship and their morphologic characteristics were clearly presented by using Able Software 3D-DOCTOR. The precise measurement of some parameters between facial nerve and its adjacent structures could easily be processed with the software. Based on all obtained data, the relationship of facial nerve and its adjacent structures were effectively summarized and analyzed.Three-dimensional images, including the facial nerve, tympanic anulus, auditory ossicles, chochleariform process, pyramidal eminence, internal auditory, the cochlea, semicircular canal, jugular fossa and carotid artery in the temporal bone, were reconstructed. Some parameters obtained from measuring the distance or angle between the facial nerve and its adjacent structures in the three-dimensional models had some extent regularity, which were benefit to design surgical approach and determine the position of facial nerve during relevant operation.CT 3D reconstruction can accurately display the detailed internal structures anatomy of the temporal bone and their quantitative spatial relationships.

To study the clinical curative effect of the new Bian-stone therapy.According to clinical trail principle of multi-centers, randomized grouping, parallel control and single-blind, the observation group (n=120) were treated by the new Bian-stone therapy, with multi-functional Bian-stone respectively dredging qi and blood of channels on the neck and shoulder, the shoulder and back, the limbs, and the control group (n=120) by electroacupuncture with Jianyu (LI 15), Jianliao (SJ 14), Jianzhen (SI 9), and other points selected. Their therapeutic effects were compared.The two therapies had effects of analgesia, improving functional activity and transient analgesia. The total effective rate of the analgesic effect was 86.8% in the observation group and 72.5% in the control group with a significant difference between the two groups (P0.05), the observation group being better than the control group; the total effective rate of shoulder functional activity was 86.8% in the observation group and 79.8% in the control group with no significant difference between the two groups (P0.05).The new Bian-stone therapy has obvious therapeutic effect on scapulohumeral periarthritis, with effects of analgesia, improving functional activity, and transient analgesia, and good long-term therapeutic effect.

Objective To investigate an effective method of quantitative analysis of the facial nerve and its adjacent structures on the basis of three-dimensional (3D) CT image reconstruction of the temporal bone. Methods The inner structures of the temporal bone from CT images of 34 healthy adults were reconstructed. Precise measurement of the facial nerve and its adjacent structures were accomplished by using Able Software 3D-DOCTOR. Results 3D images of temporal bone structures, including facial nerve, tympanic annulus, cochleariform process, cochlea, semicircular canals, jugular fossa, and carotid artery, were reconstructed. Quantitative data of the facial nerve and its adjacent structures were analyzed, especially the detailed spatial relationships between the facial nerve and the surface of the mastoid process or tympanomastoid fissure. Conclusion 3D reconstruction of CT images clearly displayed the detailed structures of the temporal bone. Quantitative data of the facial nerve and its adjacent structures are very useful for temporal bone surgery.

The purpose of this study was to determine the quantitative relationships between the positions of the sigmoid sinus (SS) and jugular bulb (JB) and the influence of mastoid pneumatization upon these structures. The investigations were carried out on 116 healthy adult ears based on the axial images of computed tomography (CT). The reference system locating the displacements of the SS and JB was established and the shape and position of the SS and JB were measured. The volume of pneumatization was quantitatively measured based on the serial digital images of CT. The method of partial correlation analysis was used to find the real relationship of two variables from the complicated dependence relationships. There was a tendency for the SS in the males to be situated more laterally and more backwardly, and the JB in the males was situated more laterally with thicker lateral bone wall when compared to the females. When compared to the left side, the SS on the right side tended to protrude more deeply and was situated more laterally and with less thickness of the lateral bone wall. In male, the right SS was situated more anteriorly than the left SS. In female, the right JB was situated more posteriorly than the left JB. There was a tendency for the SS to be situated more medially, to have a thicker lateral bone wall, and to protrude more superficially in the well-pneumatized bones. When the pneumatization was well, the JB tended to be situated more backwards and have a thicker lateral bone wall. However, there was no significant difference of pneumatization between the high JB group and the low JB group. The SS position and JB position changed synchronously in forward-backward or medial-lateral directions. The results suggest that the factors that influence the shape and position of the SS and JB are multiple. The results suggest that the morphological and positional relationships between the SS and the JB are complicated but could be grasped. The development of the cranial base, the temporal bone pneumatization and non-synchronous dural venous development between the right and left sides are considered to contribute to the morphological and positional changes of the SS and JB.

To determine the consistence of the parameters related to type I thyroplasty measured by laryngeal specimens and CT scan.The related parameters of 50 laryngeal specimens (unilateral) obtained following total laryngectomy were measured postoperative immediately, and compared with those measured by spiral CT scan with multiple plain reconstructive (MPR) technique preoperatively. Comparative results were analyzed to evaluate the statistical significance between these two methods.There were no significant statistical differences among the 6 parameters between two methods (P0.05), and the results (x +/- s) measured by CT scan and laryngeal specimens showed that the length of the thyroid notch to the inferior thyroid border were (20.7 +/- 1.7) mm and (20.6 +/- 1.7) mm; the length of the vocal cord were (17.3 +/- 1.8) mm and (17.3 +/- 1.8) mm; the length of the oblique line were (28.6 +/- 3.2) mm and (29.1 +/- 2.7) mm; the length of the presumptive horizontal line were (26.2 +/- 2.0) mm and (26.2 +/- 2.0) mm; the endolaryngeal vertical length of the anterior of the vocal cord to the presumptive horizontal line were (4.5 +/- 0.6) mm and (4.5 +/- 0.7) mm; the endolaryngeal vertical length of the vocal process to the presumptive horizontal line were (10.8 +/- 1.1) mm and (10.9 +/- 1.1) mm, respectively. As a result, the endolaryngeal anterior and posterior width of the wedge inserted in the thyroid cartilage were 4 - 5 mm and 8 - 9 mm respectively.MPR technique of spiral CT scan is able to design the size of the window and the prosthesis of type I thyroplasty preoperatively, which was testified to be a precise and reliable method to measure the larynx.

To study the changes of orphanin (OFQ) and serotonin (5-HT) in the patients with postpartum depression (PPD).Twenty one patients with postpartum depression (PPD group) and 25 healthy lying-in women (control group) were studied. The concentrations of plasma OFQ were measured by radioimmunoassay. The levels of 5-HT were measured with high-pressure liquid chromatography with electrochemical detector.(1) The levels of plasma OFQ in PPD group were (28.5 +/- 5.8) ng/L, in control group, the levels of OFQ was (10.4 +/- 3.7) ng/L, the levels of OFQ in PPD group were significantly higher than that in the control group (P0.01). (2) The levels of plasma 5-HT in PPD group and control group were (1.0 +/- 0.3) micro mol/L and (1.4 +/- 0.4) micro mol/L respectively, the levels of 5-HT in PPD group decreased significantly (P0.05). (3) In the PPD group, there was a significant negative correlation between the OFQ and 5-HT level (P0.05).The PPD was associated with OFQ and 5-HT, the changes of OFQ levels may play an important role in the pathogenesis of the PPD.

To evaluate the role of orphanin in the perinatal ischemia-hypoxia.The concentration of hypothalamus and peripheral orphanin were measured by radioimmunoassay. Animal model of perinatal ischemia-hypoxia was set up by ligating uterine vessels. All the rats were delivered by cesarean section and scored according to respiration, heart beat, skin color, muscle tone and reflex after delivery.(1) The levels of orphanin in hypothalamus and peripheral blood in group B were (114 +/- 21) pg/g and (58 +/- 11) ng/L respectively. In group A, the were (71 +/- 14) pg/g and (31 +/- 7) ng/L respectively, the levels of orphanin in group B increased significantly when compared with the group A (P0.05). In control group, the levels of orphanin were (48 +/- 9) pg/g and (19 +/- 4) ng/L. The levels of orphanin in group A and B were significantly higher than those in the control group (P0.01, P0.05). (2) The Apgar scores in groups A and B were significantly decreased than that in control group (P0.01). The group A pups had significantly better scores than the group B (P0.05).The perinatal ischemia and hypoxia was associated with orphanin, the changes of orphanin levels may play an important role in the pathophysiological changes in perinatal ischemia and hypoxia.