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Aim To explore the relationship between positron-emission tomography (PET) and intravoxel incoherent motion (IVIM) histogram parameters and their correlations with the clinicopathological features of cervical squamous cell cancer (CSCC). Materials and methods Forty-four patients with CSCC underwent pelvic combined PET/magnetic resonance imaging (MRI) including IVIM sequences. The maximum/mean standardized uptake value (SUVmax/SUVmean), metabolic tumour volume (MTV), and total lesion glycolysis (TLG) of PET, histogram parameters of apparent diffusion coefficient (ADC), IVIM biomarkers of tissue diffusivity (D), and perfusion fraction (F) were calculated. Correlations between SUV and IVIM (including ADC) histogram parameters, imaging parameters and clinicopathological features were evaluated. Results SUV showed weak or no correlations with most histogram parameters of ADC, D, and F, except for a moderate correlation between SUVmax or SUVmean and ADCmin (r=–0.69, p Conclusion No universal correlations between SUV and IVIM parameters were found in this study, and further investigation of PET and IVIM parameters as independent potential biomarkers should be investigated for evaluating the clinicopathological characteristics of cervical cancer.

The influence of alternating current (AC) electric field and KCl on the structure and gel properties of Konjac Glucomannan (KGM) were studied in this work by high-performance gel permeation chromatography (HPGPC), acid-base titration, solid-state nuclear magnetic resonance (NMR), X-ray diffraction (XRD), simultaneous differential scanning calorimetry/thermo gravimetric analyzer (DSC/TGA) and a rheometer. HPGPC showed KGM was degraded by AC electric field and Acid-base titration showed that under the action of AC electric field and KCl KGM removed part of acetyl groups, which were consistent with the analysis of NMR. XRD and temperature sweep measurements respectively showed that the electrotreatment time and KCl concentration had important effects on the gel formation and its three-dimensional network. Simultaneous DSC/TGA and temperature sweep measurements both demonstrated the gel had good thermal stability.

PURPOSE: To describe the relationship between conventional magnetic resonance (MR) imaging parameters and MR elastography of the pancreas in association with pancreatic histologic features and occurrence of postoperative pancreatic fistula (POPF). MATERIALS AND METHODS: Patients who underwent preoperative MR imaging (MR elastography and diffusion-, T1-, and T2-weighted imaging) followed by pancreatectomy with pancreaticoenteric anastomosis were included. The relationships between preoperative MR imaging parameters, demographic data, and intraoperative factors with POPF risk were analyzed with logistic regression analyses. The correlation of MR imaging parameters with histologic characteristics was evaluated with multivariate regression analysis. RESULTS: A total of 112 patients (64 men, 48 women; median age, 58 years) were evaluated. Forty-two patients (37.5%) developed POPF and 20 (17.9%) developed high-grade POPF (grades B and C). Lower pancreatic stiffness (≤1.43 kPa; odds ratio [OR], 9.196; 95% confidence interval [CI]: 1.92, 43.98), nondilated main pancreatic duct (MPD) diameter (

AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for staging liver fibrosis in chronic hepatitis B/C (CHB/C). METHODS We prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions (HeF) and relaxation time reduction rate (RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve (AUC) was used to compare the diagnostic performance in predicting liver fibrosis between HeF and RE. RESULTS A total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23 (31.5%); F1, n = 19 (26.0%); F2, n = 13 (17.8%); F3, n = 6 (8.2%), and F4, n = 12 (16.4%). HeF by EOB enhancement imaging was significantly correlated with fibrosis stage (r = -0.808, P < 0.05). AUC values for diagnosis of any (≥ F1), significant (≥ F2) or advanced (≥ F3) fibrosis, and cirrhosis (F4) using HeF were 0.837 (0.733-0.913), 0.890 (0.795-0.951), 0.957 (0.881-0.990), and 0.957 (0.882-0.991), respectively. HeF measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of HeF is a superior noninvasive liver fibrosis staging method. CONCLUSION A T1 mapping-based HeF method is an efficient diagnostic tool for the staging of liver fibrosis.

PURPOSE To evaluate the accuracy of magnetic resonance elastography (MRE) in comparison to contrast-enhanced computed tomography (CE-CT) for early diagnosis and prediction of severity in acute pancreatitis (AP). MATERIALS AND METHODS This cross-sectional prospective study included 76 patients with suspected AP who underwent both CE-CT and 3.0T MRE within 24 hours of hospital admission. Pancreatic stiffness, CT severity index (CTSI), Acute Physiology and Chronic Health Evaluation (APACHE)-II, and Bedside Index for Severity in AP (BISAP) scores were comparatively evaluated using data from the first 24 hours of admission, and diagnosis and severity of AP were confirmed according to the revised Atlanta Classification (2012). The accuracy of MRE for predicting disease severity was compared with that of CE-CT and the clinical scoring systems using area under the receiver-operating curve (AUC) analysis. RESULTS AP was confirmed in 56/76 patients (73.7%). Pancreatic stiffness values of >1.47 kPa showed significantly better diagnostic performance than CE-CT (AUC: 0.993 vs. 0.818, P 2.47 kPa was comparable to that of the CTSI, APACHE-II and BISAP scores for predicting severe AP (accuracy = 85.5%, 75.0%, 88.2%, and 78.9%, respectively). The pairwise comparisons were not significant after Bonferroni correction (P < 0.008 [0.05/6]), with P values of 0.008 (MRE vs. CTSI), 0.823 (MRE vs. APACHE-II) and 0.414 (MRE vs. BISAP). CONCLUSION Early MRE is a useful, noninvasive method for both diagnosis and early severity assessment of AP. We recommend MRE at hospital admission for initial evaluation of AP. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1311-1319.

The early diagnosis of liver fibrosis is crucial for the prevention of liver cirrhosis and liver cancer. As gold standard for staging liver fibrosis, liver biopsy is an invasive procedure that carries the risk of serious complications. The aim of this study was to evaluate the performance of the residual neural network (ResNet), a non-invasive methods, for staging liver fibrosis using plain CT images. This retrospective study involved 347 patients subjected to liver CT scanning and liver biopsy. For each patient, we selected three axial images adjacent to the puncture location in the eighth or ninth inter-space on the right side. After processing and enhancement (rotation, translation, and amplification), these images were used as input data for the ResNet model. The model used a fivefold cross-validation method. In each fold, the images of approximately 80% of the total sample size (278 patients) were used for training the ResNet model, the other 20% (69 patients) were used for testing the trained network, with the liver biopsy pathology results as gold standard. The proportion of patients in each fibrosis stage was equal for training and test groups. The final result was the mean of the fivefold cross-validation in the test group. The performance of the ResNet model was evaluated for the test group by receiver operating characteristic (ROC) analysis. For the ResNet model, the area under the ROC curve (AUC) for assessing cirrhosis (F4), advanced fibrosis (F3 or higher), significant fibrosis (F2 or higher), and mild fibrosis (F1 or higher) was 0.97, 0.94, 0.90, and 0.91, respectively. The ResNet model analysis of plain CT images exhibited high diagnostic efficiency for liver fibrosis staging. As a convenient, fast, and economical non-invasive diagnostic method, the ResNet model can be used to assist radiologists and clinicians in liver fibrosis evaluations.

To determine the diagnostic performance of MR elastography (MRE) and compare it with serum CA19-9 in differentiating malignant from benign pancreatic masses, with emphasis on differentiating between pancreatic ductal adenocarcinoma (PDAC) and mass-forming pancreatitis (MFP). We performed a prospective, consecutive, 24-month study in 85 patients with solid pancreatic masses confirmed by histopathologic examinations. The mass stiffness and stiffness ratio (calculated as the ratio of mass stiffness to the parenchymal stiffness) were assessed. The diagnostic accuracy was analysed by calculating the area under the ROC curve (AUROC). The final diagnosis included 54 malignant tumours (43 patients with PDAC) and 31 benign masses (24 patients with MFP). The stiffness ratio showed better diagnostic performance than the mass stiffness and serum CA19-9 for the differentiation between malignant and benign masses (AUC: 0.912 vs. 0.845 vs. 0.702; P = 0.026, P < 0.001) and, specifically, between PDAC and MFP (AUC: 0.955 vs. 0.882 vs. 0.745; P = 0.026, P = 0.003). The sensitivity, specificity, and accuracy of stiffness ratio for the differentiation of PDAC and MFP were all higher than 0.9. MRE presents an effective and quantitative strategy for non-invasive differentiation between PDAC and MFP based on their mechanical properties. • 3D MRE is useful for calculating stiffness of solid pancreatic tumours. • Stiffness ratio outperformed stiffness and CA19-9 for differentiating PDAC from MFP. • Incorporation of 3D MRE into a standard MRI protocol is recommended.

Orbital subperiosteal abscess (OSPA) secondary to paranasal sinus mucocele (PSM) is rare, and it may be misdiagnosed as PSM with orbital invasion or even as a malignant neoplasm. The present study explored the computed tomography (CT) and magnetic resonance imaging (MRI) features of OSPA. The cases of 13 patients with OSPA secondary to PSM were retrospectively reviewed. CT had been performed in 12, MRI in 7, and postcontrast MRI in 4. OSPA was revealed as a well-demarcated, spindle-shaped mass that was broad-based and located beneath the superior orbital wall (orbital roof) in 11 and at the medial wall in 2. PSM appeared as an expansile cystic lesion in the ethmofrontal sinus in 7, frontal sinus in 5, and ethmoidal sinus in 1. Because the OSPA was connected to the PSM, it looked like a single lesion involving both the orbit and the sinus. All 12 OSPAs examined on CT were low-density; 9 of the 12 PSMs were low-density and 3 were iso-density. Densities of the OSPAs and PSMs were equal in 4 and slightly different in 8. Five of the 10 OSPAs occurring beneath the orbital roof had unclear boundaries with the PSMs on CT. On MRI, although both OSPAs and PSMs mainly demonstrated hypointensity on T1-weighted images and hyperintensity on T2-weighted images, the signal intensities were slightly different, and linear-shaped hypointensity could be found between them. Postcontrast MRI revealed arch- and ring-shaped enhancement, respectively, at the edge of the OSPA and the PSM. Septal enhancement separated them more clearly. PSM is an important cause of OSPA in adults. CT and MRI can accurately display these entities' characteristic findings and their anatomic relationship, as well as playing an important role in the differential diagnosis.

The computer how to identify the language? How the brain controls the brain computer interface (BCI) equipment? Reading in a second language (L2) is a complex task that entails an interaction between L2 and the native language (L1). Previous studies have suggested that bilingual subjects recruit the neural system of their logographic L1 (Chinese) reading and apply it to alphabetic L2 (English) reading. In this study, we used functional magnetic resonance imaging (fMRI) to visualize Japanese-Chinese bilinguals’ brain activity in phonological processing of Japanese Kanji (L1) and Chinese characters (L2) and application to BCI, two written languages with highly similar orthography. In the experiment, the subjects were asked to judge whether two Japanese Kanji (or Chinese characters) presented at the left and right side of the fixation point rhymed with each other. A font size decision task was used as a control task, where the subjects judged whether the two Japanese Kanji (or Chinese characters) had an identical physical size. Subjects indicated a positive response by pressing the key corresponding to the index finger and a negative response by pressing the key corresponding to the middle finger of their right hand. The result showed that our bilingual Japanese subjects have large overlaps in the neural substrates for phonological processing of both native and second language. Our results are application to brain computer interface.

In this paper, we proposed a method for analyzing and optimizing the prism based single-lens stereovision system so that the pictures captured by this system are adequate for the application of stereovision. We first analyzed this system from the standpoint of system setup and parameters selection. Then we introduced a method to calculate the FOV of the prism based single-lens stereovision system. By adding some restricted condition, we redefined the area of FOV and gave a detailed connection between FOV and captured picture to obtain the appropriate image pair for stereovision.

To evaluate the accuracy of magnetic resonance elastography (MRE) in comparison to contrast-enhanced computed tomography (CE-CT) for early diagnosis and prediction of severity in acute pancreatitis (AP).This cross-sectional prospective study included 76 patients with suspected AP who underwent both CE-CT and 3.0T MRE within 24 hours of hospital admission. Pancreatic stiffness, CT severity index (CTSI), Acute Physiology and Chronic Health Evaluation (APACHE)-II, and Bedside Index for Severity in AP (BISAP) scores were comparatively evaluated using data from the first 24 hours of admission, and diagnosis and severity of AP were confirmed according to the revised Atlanta Classification (2012). The accuracy of MRE for predicting disease severity was compared with that of CE-CT and the clinical scoring systems using area under the receiver-operating curve (AUC) analysis.AP was confirmed in 56/76 patients (73.7%). Pancreatic stiffness values of1.47 kPa showed significantly better diagnostic performance than CE-CT (AUC: 0.993 vs. 0.818, P0.001) along with greater sensitivity (96.4% vs. 78.6%, P = 0.006) and accuracy (96.1% vs. 81.6%, P = 0.007). Ten patients (10/76; 13.2%) had clinically severe AP. The accuracy of pancreatic stiffness2.47 kPa was comparable to that of the CTSI, APACHE-II and BISAP scores for predicting severe AP (accuracy = 85.5%, 75.0%, 88.2%, and 78.9%, respectively). The pairwise comparisons were not significant after Bonferroni correction (P0.008 [0.05/6]), with P values of 0.008 (MRE vs. CTSI), 0.823 (MRE vs. APACHE-II) and 0.414 (MRE vs. BISAP).Early MRE is a useful, noninvasive method for both diagnosis and early severity assessment of AP. We recommend MRE at hospital admission for initial evaluation of AP.1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2017;46:1311-1319.

Excitatory amino acids (EAAs) and excitotoxicity medicated by receptors of these amino acids play an important role in hypoxic-ischemic brain injury (HIBI), but most studies were ex vivo experiments, the mechanism in vivo is not well understood. We sought to study the expression of N -methyl- d -aspartate receptor 1 (NR1) and phosphorylated N -methyl- d -aspartate receptor 1 (P-NR1) in basal ganglia in a piglet model of HIBI and to investigate the correlation between Glx(Glu/Gln) value measured by magnetic resonance spectroscopy (MRS) and NR1/P-NR1 expression. Multi-voxel 1 H MRS was applied to detect change in Glx in basal ganglia of the newborn piglets in vivo. Automatic amino acid analyzer was applied to accurately quantify the Glu concentration. Immunohistochemical method was used to examine the expression of NR1 and P-NR1. The NR1 receptors in basal ganglia of the newborn piglets were significantly activated after HIBI. P-NR1 expression in the basal ganglia was consistent with the change in brain Glu content, so the activation status of NMDA receptor in the brain could be indirectly reflected by β-, γ-Glx/NAA measured by 1 H MRS.

The aim of this study was to investigate the effect of perfusion computed tomography (PCT) with acetazolamide (ACZ) challenge and compare it to 10% carbon dioxide (CO(2)) challenge in rat C6 glioma.PCT was performed on 32 rats, including 20 with orthotopically implanted C6 gliomas and 12 serving as controls. Ten rats with gliomas and six normal rats underwent PCT with ACZ challenge. The other 10 rats with gliomas and six normal rats underwent PCT with 10% CO(2) challenge. The raw data were processed using Philips computed tomographic brain perfusion software. Perfusion parameters before and after the challenge were recorded. Percentage changes due to ACZ administration and 10% CO(2) challenge were calculated. Pearson's correlation coefficients were used to investigate relationships between percentage changes in perfusion parameters and vascular endothelial growth factor and microvessel density.In C6 gliomas, percentage change in cerebral blood flow was significantly different between ACZ (72.73%) and 10% CO(2) (28.47%) challenge (P.01). Percentage change in cerebral blood volume was 37.85% with ACZ and 24.69% with 10% CO(2) challenge (P = .02). In controls, percentage change in cerebral blood flow was significantly different between ACZ (117.42%) and 10% CO(2) (65.86%) challenge (P.01). For percentage change in cerebral blood volume, there was no significant difference between ACZ (107.51%) and 10% CO(2) (92.95%) challenge. Significant correlations were observed among percentage changes in vascular endothelial growth factor, microvessel density, and cerebral blood volume (P.01). Percentage change in cerebral blood flow correlated well with vascular endothelial growth factor.The results of this study indicate that PCT with ACZ challenge is a more reliable technique compared to 10% CO(2) challenge for the quantitative evaluation of microcirculation in gliomas.

Aim: To assess the working memory and explore the differential activations of brain areas in children with primary nocturnal enuresis (PNE) by performing functional magnetic resonance imaging (fMRI) scans using the categorical N-Back task. Methods: Thirteen right-handed PNE children (M/F = 7:6, average age 11.4 ± 0.8 years) and 15 age-matched, right-handed, healthy controls (M/F = 9:6, 11.3 ± 1.0 years) were recruited for the study. First, intelligence tests were performed using Chinese Wechsler Young Children Scales of Intelligence in PNE children and controls. The full intelligence quotient (FIQ), verbal IQ (VIQ), performance IQ (PIQ) and memory/caution (M/C) factor were measured. After intelligence tests, event-related fMRI scans were performed using the categorical N-Back working memory task on a 3.0T MR scanner. The percent of correct responses (PCR) and the mean reaction time to correct response (mRT) were recorded and compared; fMRI data were analysed using SPM2, the differences in activation were compared with the single subject and between-group levels. Results: The FIQ, VIQ and PIQ in the PNE group were within the normal range and did not significantly differ from the control group (P > 0.05). The M/C factor was statistically significantly lower in the PNE group (P

To investigate 64 computed tomography (CT) perfusion imaging features of patients with pancreatic cancer and mass-forming chronic pancreatitis.Between January 2003 and April 2010, 234 patients with pancreatic mass underwent 64-CT perfusion imaging. Among them, the histopathological results of 64 patients were proven to be pancreatic adenocarcinoma and 15 patients were proven to be mass-forming chronic pancreatitis. Additionally, CT perfusion imaging was performed in 33 healthy volunteers served as controls. The slice data were processed using CT perfusion software. Perfusion parameters including time density curve, blood flow, blood volume, permeability, peak enhancement, and time to peak were recorded.Blood flow was 77% lower in patients with pancreatic adenocarcinoma than in controls, 48% lower in patients with mass-forming chronic pancreatitis than in controls, and 56% lower in patients with pancreatic adenocarcinoma than with mass-forming chronic pancreatitis (P.016). Blood volume was 65% lower in pancreatic adenocarcinoma than in controls, 27% lower in mass-forming chronic pancreatitis than in controls, and 53% lower in cancer than mass-forming chronic pancreatitis (P.016). Permeability was 559% higher in pancreatic adenocarcinoma than in controls, 821% higher in mass-forming chronic pancreatitis than in controls, and 28% lower in cancer than mass-forming chronic pancreatitis (P.016). Peak enhancement was 27% lower and time to peak 23% longer in pancreatic adenocarcinoma than mass-forming chronic pancreatitis (P.016). Time-density curve showed the peak of mass-forming chronic pancreatitis is earlier and higher than that of pancreatic adenocarcinoma, and the peak of mass-forming chronic pancreatitis is later and lower than that of controls.CT perfusion imaging can provide additional quantitative hemodynamic information of pancreatic adenocarcinoma and mass-forming chronic pancreatitis.

Aim To determine the diagnostic performance of instantaneous wave-free ratio (iFR) derived from non-invasive coronary computed tomography angiography (CTA; iFRCT) for ischaemia-causing coronary stenosis, and to compare the diagnostic efficacy of iFRCT, CTA, and CTA plus iFRCT. Methods and materials Thirty-nine patients (55 vessels) with known or suspected coronary artery disease were included. All patients underwent invasive coronary angiography and fractional flow reserve (FFR) according to CTA findings and clinical indicators. The same raw data used for CTA were used to build patient-specific computed flow dynamic models and to calculate iFRCT. Results On a vessel-based level, the correlation between iFRCT and FFR was moderate (r=0.65, p Conclusion iFRCT showed better diagnostic performance than CTA. iFRCT may be a promising method for detection of ischaemia-causing coronary stenosis, even in vessels with intermediate stenosis.

PURPOSE To assess the imaging features and the management of hemobilia after laparoscopic cholecystectomy (LC). MATERIALS AND METHODS A total of 12 patients who were treated for hemobilia after LC were included in the study. Selective arteriography was performed to find the bleeding artery. Coils or microcoils were deployed superselectively to occlude the bleeding branch. The clinical course, imaging findings, the embolic effect, complications, and follow-up were evaluated. RESULTS Risk factors for hemobilia included a variant ductal anatomy, a variant cystic artery, and intraoperative adhesion. Abdominal computed tomography (CT) could provide the diagnostic signs as follows: a hematocele in the abdominal cavity, the gallbladder fossa, and the bile duct, biliary dilation, pseudoaneurysm of the right hepatic artery, and contrast extravasations on contrast-enhanced CT. No rebleeding occurred after the transcatheter arterial embolization in all patients without immediate procedural complications. CONCLUSIONS Gallbladder triangle anatomic variation and intraoperative adhesion were the risk factors for hemobilia after LC. Abdominal CT is a useful examination for the diagnosis. Transcatheter arterial embolization is the therapeutic option of choice.

Magnetic resonance elastography (MRE) with three-dimensional spin-echo echo planar imaging (3D-SE-EPI) is a newly emerging noninvasive method for assessing liver fibrosis. We hypothesized that 3D-SE-EPI might have better diagnostic accuracy than conventional two-dimensional gradient-recalled echo (2D-GRE).We prospectively included 179 consecutive patients with chronic hepatitis B (CHB) or C (CHC) who underwent both MRE and liver biopsy. Liver stiffness was measured by both 3D-SE-EPI and 2D-GRE for staging biopsy-proven liver fibrosis (using METAVIR scores). A receiver-operating characteristic analysis using the area under the receiver-operating characteristic curve (AUC) was used to compare the diagnostic performance in predicting liver fibrosis between these two techniques, and compared them to serum markers of fibrosis.The technical failure rate of 3D-SE-EPI (2.2%, n=4/179) was lower compared with 2D-GRE (8.3%, n=15/179). The stiffness measured by 3D-SE-EPI was slightly lower compared with 2D-GRE, with the mean difference of 0.57 kPa (Bland and Altman plot, 95% limits of agreement: -0.32 and 1.45 kPa). AUCs for the characterization of ≥F1, ≥F2, ≥F3, and F4 were 0.957 (95% confidence interval (CI): 0.913-0.983), 0.971 (0.932-0.991), 0.991 (0.961-0.999), and 0.979 (0.942-0.995) for 3D-SE-EPI, which was slightly higher compared with the AUCs for 2D-GRE at each fibrosis stage (0.948 (0.901-0.977), 0.959 (0.915-0.981), 0.979 (0.943-0.995), and 0.976 (0.938-0.994), respectively), although none reached statistical significance (P=0.160-0.585). In an "intention-to-diagnose" analysis, the diagnostic accuracy (the proportion of well-classified patients) by EPI (86.7-91.3%, n=169) was higher compared with GRE (80.9-82.1%, n=158) after applying optimal cutoffs. Both 3D-SE-EPI and 2D-GRE performed better than serum fibrosis markers.With respect to 2D-GRE, 3D-SE-EPI has the advantage of lower failure rate with equivalent high diagnostic performance for staging liver fibrosis in CHB/CHC patients, and thus more helpful for those challenging cases in 2D-GRE.

Rationale and objectives Diffusion/perfusion-weighted MRI (DWI/PWI) can provide additional useful information in the diagnosis of patients with brain gliomas in a noninvasive fashion. However, the exact role of these new techniques is still undergoing evaluation. Our hypothesis was that DWI and PWI could be useful for assessment of growth and vascularity of implanted C6 rat gliomas. Materials and methods Thirty-six rats were implanted with C6 glioma cells intracerebrally. Between 1 and 4 weeks after implantation, 8–10 rats were imaged on a clinical, 1.5-T whole-body magnetic resonance system with T1-weighted imaging (T1WI), T2-weighted imaging, DWI, PWI, and postcontrast T1WI at each weekly time point. All tumors were examined histologically; tumor cellularity and microvascular density were counted. Results On DWIs, statistical differences of apparent diffusion coefficient values for both the tumoral core and peritumoral region were present comparing tumors of 3–4 weeks’ growth with tumors of 1–2 weeks’ growth. Apparent diffusion coefficient value of tumoral core was negatively correlated with tumor cellularity (r = −0.682, P Conclusion DWI and PWI has potential to characterize C6 gliomas in rats, which is a promising model similar to human gliomas.

Introduction: To evaluate 1H Magnetic Resonance Spectroscopy (1HMRS) in the diagnosis of hypoxia-ischemic encephalopathy (HIE) of full-term neonates correlated with Magnetic Resonance Imaging (MRI). Materials and methods: Thirty-eight cases of full-term neonates diagnosed as HIE clinically were selected to perform MRI and 1HMRS examination. The ages ranged from 7 to 17 days, with median age of 8.2 days. In which, 26 cases were followed up and/or MRI reexamined at 6 months of age or later. Eight healthy neonates, with no evidence of birth asphyxia, also underwent 1HMRS for comparison. SE sequences were used for routine MR examination; point resolved spectroscopy sequence was required for 1HMRS. The metabolites in the spectra includes: N-acetylaspartate (NAA), choline compounds (CHO), creatine compounds (CR), myo-inositol (MI), lactate (LAC), glutamate and glutamine (Glu–Gln). Results: The peaks of NAA were fall in two cases; the peaks of LAC, which were elevated, appeared as typical double-peaks appearance in 26 cases; the peaks of Glu–Gln, which were also elevated, appeared as zigzag appearance in nine cases. The peaks of CR were decreased in 11 cases, while those of MI were increased in seven cases. Mild type of lesions was present on MRI in 12 cases whose LAC/CR ratio lower than 0.5; mild and moderate types of lesions were present in 15 cases whose LAC/CR ratio between 0.5 and 1.5. Whereas, nine cases of severe lesions and two cases of moderate lesions were present on MRI in 11 cases whose LAC/CR ratio greater than 1.5. Twenty-six of 38 cases were followed up and/or MRI reexamined after 6 months, in which, sequelae were present in 12 cases. Among them, eight cases of sequelae in nine cases whose LAC/CR ratio greater than 1.5 were present (account for 88.89%). Conclusion: 1HMRS plays an important role to diagnose and predict outcome of HIE.

To determine the diagnostic performance of magnetic resonance (MR) elastography for the staging of hepatic fibrosis and to evaluate the influence of necroinflammation on hepatic stiffness in patients with chronic hepatitis B virus (HBV) infection by using histopathologic findings as the reference standard.One hundred thirteen consecutive patients with chronic HBV infection were recruited prospectively in this institutional review board-approved study after providing written informed consent between March 2012 and October 2013. The stiffness measurements were obtained by using two-dimensional gradient-echo MR elastography with a 3.0-T MR system. The METAVIR scoring system was used for the assessment of fibrosis ("F" stage) and necroinflammation ("A" grade). The predictive ability of MR elastography was evaluated by using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC). Multiple linear regression analyses were conducted to determine the relationship between hepatic stiffness and the variables that showed a significant association in the univariate analysis or those that were of interest for comparison with earlier work (histologic scores, sex, age, aspartate aminotransferase level, and aspartate aminotransferase/alanine aminotransferase ratio).MR elastography showed excellent performance for characterization of ≥ F1, ≥ F2, ≥ F3, and F4 findings, with AUC values of 0.961, 0.986, 1.000, and 0.998, respectively. It showed a moderate capability for evaluation of necroinflammatory activity of ≥ A1, ≥ A2, and A3 (AUC = 0.806, 0.834, and 0.906, respectively). Multiple linear regression analysis showed that fibrosis, necroinflammation, and sex were independently associated with hepatic stiffness (β = 0.799, 0.277, and 0.070, respectively; P.05). For pairwise comparisons, log-transformed hepatic stiffness showed no difference between (a) groups F0/A2-3 and F1/A0-1 and (b) groups F1/A2-3 and F2/A0-1 (P.99 and P = .486, respectively).MR elastography demonstrated excellent performance for distinguishing the stages of hepatic fibrosis in patients with chronic HBV infection. For hepatic tissue with ≤ F2 fibrosis, necroinflammation can account for a substantial fraction of the increase in hepatic stiffness.

There is a continuing debate on whether transcatheter arterial chemoembolization (TACE) plus radiofrequency ablation (RFA) is more effective than RFA alone in the treatment of patients with hepatocellular carcinoma (HCC). We carried out this meta-analysis of randomized-controlled trials to provide greater clarity on whether RFA plus TACE was more effective than RFA alone for HCC.A literature search was carried out for all possible randomized-controlled trials. The outcomes were overall survival rates and major complications. Data were abstracted using standardized forms, and an overall rating of the quality of evidence was assigned using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) criteria. We estimated summary odds ratio (OR) with its 95% confidence interval (95% CI) to assess the effects.Seven randomized-controlled trials were included. Meta-analysis showed that RFA plus TACE significantly improved the survival rates of patients with HCC at 1 and 3 years (for the one-survival rate, fixed-effects OR=2.71, 95% CI 1.65-4.43, P0.0001; for the three-survival rate, fixed-effects OR=2.27, 95% CI 1.57-3.27, P0.0001) compared with RFA alone. There was no difference in terms of major complications (fixed-effects OR=1.26, 95% CI 0.33-4.77, P=0.73). Subgroup analyses by tumor size showed that RFA plus TACE significantly improved the survival rates at 1, 3, and 5 years compared with RFA alone in patients with HCC larger than 3 cm; however, there was no advantage of TACE plus RFA over RFA alone for patients with HCC smaller than 3 cm. The quality of evidence was high for the 1-year survival rate, the 3-year survival rate, and major complications. No evidence of publication bias was observed.High-quality evidence suggests that TACE plus RFA improve the survival rates compared with RFA alone for patients with HCC larger than 3 cm.

Alterations of dopamine in striatal presynaptic terminals play an important role in the hypoxic-ischemic (HI) brain injury. Quantification of DAT levels in the presynaptic site using (11)C-N-2-carbomethoxy-3-(4-fluorophenyl)-tropane ((11)C-CFT) with positron emission tomography (PET) was applied in studies for Parkinson's disease. The current study investigated the changes in striatal DAT following HI brain injury in newborn piglets using (11)C-CFT PET.Newborn piglets were subjected to occlusion of bilateral common carotid arteries for 30 min and simultaneous peripheral hypoxia. Brain DAT imaging was performed using PET/CT with (11)C-CFT as the probe in each group (including the control group and HI insult groups). Brain tissues were collected for DAT immunohistochemical (IHC) analysis at each time point post the PET/CT procedure. Sham controls had some operation without HI procedure.A few minutes after intravenous injection of (11)C-CFT, radioactive signals for DAT clearly appeared in the cortical area, striatum and cerebellum of newborn piglets of sham control group and HI insult groups. HI brain insult markedly increased striatal DAT at an early period (P.05 vs. sham controls) when neuronal pathological changes were mild. Changes in striatal DAT were absent at later period post-HI insult when neuronal injury became more severe. (11)C-CFT PET imaging data and IHC DAT staining data were highly correlated (r=0.844, P.05).HI brain injury resulted in a transient increase in striatal DAT. (11)C-CFT PET/CT imaging data reflected the dynamic changes of DAT in the striatum in vivo.

Morphologic imaging after radiofrequency ablation (RFA) of liver metastases is hampered by an inflammatory response in the ablation margin, making the identification of local tumor progression (LTP) difficult. The aim of this study was to evaluate the efficacy of early (18)F-FDG PET/CT scanning to monitor the effectiveness of RFA in colorectal liver metastases.Twelve patients with 20 metastases were treated with RFA for colorectal liver metastases. They underwent PET/CT within 2 weeks before RFA and within 24 hours after RFA (so termed "early PET/CT"). PET/CT was repeated at 1, 3, and 6 months, and then every 6 months after ablation. The standard of reference was based on available clinical and radiological follow-up data.Early PET/CT revealed total photopenia in 16 RFA-treated metastases, which were found to be without residual tumor on the final PET/CT scan. Three RFA-treated metastases with focal uptake were identified as local tumor progression, which necessitated further treatment. One RFA-treated metastasis with rim-shaped uptake was regarded as inflammation. The results of the early PET/CT scanning were consistent with the findings of the final follow-up.PET/CT performed within 24 hours after RFA can effectively detect whether residual tumor exists for colorectal cancer liver metastases. The results can guide further treatment, and may improve the efficacy of RFA.

Basal ganglia injury (BGI) is a type of perinatal hypoxic-ischemic (H-I) brain injury. Both malfunctions of glutamatergic and dopaminergic pathways in striatum were suggested to contribute to BGI. In current study, we investigated the imaging profile of glutamate (Glx) levels by proton magnetic resonance spectroscopy ( 1 H-MRS), and the expression of dopamine D2 receptors (D2R) and dopamine transporter (DAT) by immunohistochemical staining in a newborn piglet model of H-I brain injury. We found that the number of striatal D2R positive neurons decreased following H-I brain injury, and the decrease in positive neuron number was consistent with the degree of striatum. Following H-I brain insult, the number of striatal DAT positive neurons and glutamate level were simultaneously increased initially, followed by a gradual decline toward control level. There was a positive correlation between the changes in striatal DAT positive neurons and glutamate level following H-I brain insults in newborn piglets. Our findings suggest that following H-I brain insult, striatal D2R positive neurons decreased due to neuron death; straital DAT initially increased to compensate for dopamine uptake; and glutamatergic and dopaminergic systems in striatum may act in an interdependent way in the striatum of newborn piglets.

To discuss the proliferous rule of bile duct endothelium after the placement of metallic biliary stent.The metallic biliary stent was placed at the inferior segment of common bile duct of canine after a percutaneous transhepatic puncture at cholecyst. All the stented dogs were assigned randomly to 4 group including A, B, C and D, each group had been under research for 1 month, 3 months, 12 months and 24 months. The expression of PCNA and Ki-67 in bile duct endothelium covered by the stent were calculated on the immunohistochemistry staining images and compared with those uncovered in each group, then the expression of PCNA and Ki-67 in bile duct endothelium covered by the stent were compared between every two adjacent groups. The thickness of bile duct wall covered by the stent were measured on the HE staining images and compared between every two adjacent groups. The t-test was performed for the statistics.The animal model were successfully set in 18 canines. The expression of PCNA and Ki-67 in bile duct endothelium covered by the stent were significantly higher than those uncovered in every group (P0.05), which got much high within 1 month after stenting (P0.05) and gradually raised up again from 3 months to 1 year (P0.05) after a period of relatively low proliferation. The thickness of the bile duct covered by the stent changed following the same rule as well.The metallic biliary stent indeed induced the proliferation of bile duct endothelium. This phenomenon enhanced gradually from 3 months to 1 year after stenting, and continued persistently after that.

Seizures may be the first or sometimes the only manifestation of patients with glioma in clinics. The aim of operation is to eliminate epilepsy far beyond mere resection of tumor mass. The underlying mechanisms of glioma-associated epileptogenesis are poorly understood. Recently the theory of amino-acid like neurotransmitters in chemical synapse is gradually accepted. However, the molecular mechanisms remain to be further investigated on how glutamate release is regulated and how synaptic homeostasis in peripheral neurons is kept or disturbed. So detailed studies are needed to clarify specific molecular target and provide proper evidence for optimal antiepileptic drugs in glioma-associated epileptogenesis.

Sinonasal angiomatous polyp (SAP) is a rare benign nontumorous lesion and previously considered lack of characteristic computed tomography (CT) findings. This study aimed to evaluate 2-phase helical CT for characterization of SAP. Twelve patients with pathologically confirmed SAP underwent 2-phase helical CT preoperatively. After injection of 80 mL contrast material at a rate of 3 mL/s, early and delayed phases were obtained with delays of 30 and 120 s, respectively. The degree and pattern of enhancement were visually analyzed. The attenuation changes were also analyzed quantitatively by measuring CT values and compared with those of the internal maxillary artery (IMA). All 12 cases showed vessel-like marked heterogeneous enhancement at both early and delayed phases. An irregular linear, nodular, and patchy enhancement pattern was found at the early phase, and enlarged and fused together, that is, progressive enhancement pattern was found at the delayed phase. There was no significant difference between the CT values of SAP and those of the IMA at the plain, arterial phase, and delayed phase (53 ± 6 Hounsfield units [HU] vs 56 ± 7 HU, 187 ± 56 HU vs 209 ± 71 HU, and 143 ± 22 HU vs 139 ± 19 HU, respectively, P = 0.361, 0.429, and 0.613, respectively). Vessel-like marked heterogeneous enhancement was a characteristic CT feature of SAP, and progressive enhancement on 2-phase helical CT could further convince the diagnosis.

To obtain the coronary artery and coronary sinus (CS) and its tributaries imaging with multislice computed tomography (MSCT), measure the distance between coronary artery and CS and its tributaries and analyze their spatial relationships.The MSCT scans of 117 patients (67 men, 50 women, age 56 +/- 10 years) were obtained, 3D image reconstructed and the vessels courses evaluated. The concomitant distances and spatial relationships of the vessels were determined.Right coronary artery domination was found in 107 cases (91.4%), left coronary artery domination in 7 cases (6.0%), and co-domination in 3 cases (2.6%). Left circumflex artery (LCX) was concomitant with CS or the great cardiac vein (GCV) in 81 cases (69.2%), intersected with left posterior vein in 62 cases (53.0%) and with middle cardiac vein (MCV) in 5 cases (4.3%), respectively. The dominant coronary artery branched out into the posterior descending artery (PDA) and the left posterior artery (LPA) in 112 cases (95.7%). PDA was concomitant with MCV in 93 cases (79.5%) and intersected with MCV in 44 cases (37.6%). LPA was intersected with MCV in 106 cases (90.6%), and concomitant with CS in 50 cases (42.7%).MSCT is a reliable tool to visualize the relationship between coronary artery and CS and its tributaries. Owing to the multiple possibilities inherent to this technique, MSCT has broad potential for more clinical use.

AIM: To determine whether single-voxel proton magnetic resonance spectroscopy (1HMRS) could be used to differentiate gliomas from metastases on the basis of differences in metabolite levels in the different involved regions. MATERIALS AND METHODS: Twenty-two patients (age range from 32 to 62 years, with a median age of 46.7 years) with a solitary brain tumour (14 gliomas, eight metastases) underwent conventional, gadolinium-DTPA enhanced T1-weighted images, and 1HMRS before surgical resection. Spectra from the enhancing tumour, the peritumoural region, and normal brain were obtained from 1HMRS. A point resolved spectroscopy sequence was required for 1HMRS. The metabolites in the spectra include: N-acetylaspartate (NAA), choline (CHO), creatine compounds (CR), myo-inositol (MI), lactate (LAC), glutamate and glutamine (Glu-n). Relative concentrations of metabolites were related to the peak area, and expressed with reference to CR. Student's t-test was used to determine whether there was a statistically significant difference in relative metabolic ratios between high-grade gliomas and metastases. Meanwhile, 16 of all 22 patients were re-examined using magnetic resonance imaging (MRI) within 6 months of surgical resection. Recurrence was present in three patients (two gliomas, one metastasis). RESULTS: Of the 14 patients with gliomas, the peaks of NAA were reduced in three cases; the peaks of LAC, which were elevated, appeared as typical double-peaks in the peritumoural region in nine cases; the peaks of Glu-n, which were also elevated, had a zigzag appearance in seven cases. The peaks of MI were increased in the tumoural region in eight cases, and CHO levels were elevated in all 14 cases. Of the eight patients with metastases, Glu-n peaks in the tumoural region in three cases and CHO peaks in the tumoural region in four cases were elevated, respectively, while the peaks of CR were reduced in three cases, and the peaks of NAA were markedly reduced in four cases within the enhancing tumoural region. Elevated CHO levels (CHO-to-CR ratio was 4.98:1.46, 2.65:0.32) in both the tumoural and peritumoural regions of gliomas but not in the metastases (CHO-to-CR ratio was 1.37:0.92, 1.22:0.38), and elevated MI levels were present (MI-to-CR ratio was 1.67:0.35) within the enhancing foci of gliomas but not in the metastases (MI-to-CR ratio was 0.89:0.31). The difference was statistically significant (p

Objective We wanted to investigate the usefulness of event-related (ER) functional MRI (fMRI) for the assessment of cortical visual impairment in infants with periventricular leukomalacia (PVL). Materials and Methods FMRI data were collected from 24 infants who suffered from PVL and from 12 age-matched normal controls. Slow ER fMRI was performed using a 3.0T MR scanner while visual stimuli were being presented. Data analysis was performed using Statistical Parametric Mapping software (SPM2), the SPM toolbox MarsBar was used to analyze the region of interest data, and the time to peak (TTP) of hemodynamic response functions (HRFs) was estimated for the surviving voxels. The number of activated voxels and the TTP values of HRFs were compared. Pearson correlation analysis was performed to compare visual impairment evaluated by using Teller Acuity Cards (TAC) with the number of activated voxels in the occipital lobes in all patients. Results In all 12 control infants, the blood oxygenation level-dependent (BOLD) signal was negative and the maximum response was located in the anterior and superior part of the calcarine fissure, and this might correspond to the anterior region of the primary visual cortex (PVC). In contrast, for the 24 cases of PVL, there were no activated pixels in the PVC in four subjects, small and weak activations in six subjects, deviated activations in seven subjects and both small and deviated activations in three subjects. The number of active voxels in the occipital lobe was significantly correlated with the TAC-evaluated visual impairment (p < 0.001). The mean TTP of the HRFs was significantly delayed in the cases of PVL as compared with that of the normal controls. Conclusion Determining the characteristics of both the BOLD response and the ER fMRI activation may play an important role in the cortical visual assessment of infants with PVL.

To investigate magnetic resonance (MR) diffusion tensor imaging (DTI) and fibre tractography in the assessment of altered major white matter (WM) fibre tracts in periventricular leukomalacia (PVL).Twelve children (male:female = 7:5, age range 3-10 years; mean age = 6.5 years) who had suffered PVL were included in this study. Meanwhile, Twelve age-matched normal controls (male:female = 6:6, age range 4-12 years; mean age = 7.3 years) with normal MRI findings and no neurological abnormalities were recruited for comparison. DTI was performed with 15 different diffusion gradient directions and DTI colour maps were created from fractional anisotropy (FA) values and the three vector elements. To identify alteration of WM fibre tracts in patient of PVL quantitatively, FA values on diffusion tensor colour maps were compared between the patients and controls. Quantitative analysis was performed using the regions of interest (ROI) method settled on the central part of all identifiable WM fibres, including the corticospinal tract (CST) in the brainstem, middle cerebellar peduncle (MCP), medial lemniscus (ML), anterior/posterior limb of internal capsule (ICAL/ICPL), arcuate fasciculus (AF), posterior thalamic radiation (PTR), genu of corpus callosum (GCC), splenium of corpus callosum (SCC), corona radiata (CR), cingulum (CG), and superior longitudinal fasciculus (SLF). The averaged FA value of each WM fibre was measured and summarized as the mean +/- standard deviation (SD). All data were analysed by paired Student's t-test. A p-value of less than 0.05 was considered to indicate statistical significance.Visual investigation of WM fibre tracts showed that the ICAL, brainstem CST, ML, MCP, and external capsule (EC) was similar in controls and subjects. However, the ICPL, AF, PTR, CR, CG, SLF and corpus callosum, were all attenuated in size. All 12 cases of PVL showed a significant mean FA reduction in the ICPL, AF, PTR, CR, CG, SLF, SCC, and GCC in comparison with the ipsilateral regions of healthy controls (p0.05). However, there were no statistically significant differences of the ICAL, ML, MCP, and brainstem CST when analysed using a two-tailed Student's t-test for paired data (p0.01).DTI can provide more information for understanding the pathophysiology of motor disability and associated sensory handicap in PVL.