【Abstract】Objective To compare radiologists’ performance on combined unenhanced and feridexs-enhanced MR imaging （MRI） with their performance on helical CT enhanced, unenhanced MRI, and feridexs-enhanced MR alone imaging for the characteristics of local hepatic lesions. Methods MR images and CT scans obtained in 26 patients with 57 local hepatic lesions were analyzed with reviewer operator characteristic (ROC) curve analysis. The imaging of patient were divided into 4 groups including combined unenhanced and feridexs-enhanced MRI group, helical CT enhanced group, unenhanced MRI group, and feridexsenhanced MR alone group. Results The combined approach resulted in larger area under the ROC curve (Az=0.926 0) and accuracy (86.8%),P＜0.05，as compared with the others methods. There were no significant differences among the other three methods. Conclusion Feridexs-enhanced MRI was more accurate than enhanced helical CT scan in characterization of local hepatic lesion. The combined analysis of unenhanced and feridexs-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of feridexs-enhanced images alone.
Objective
To investigate the application of Magnetoencephalograph (MEG), Wada test combined with neuronavigation in the surgical treatment of frontal and temporal epilepsy caused by focal cortical dysplasia (FCD ).
Methods
The epileptogenic focus and IQ, memory and language examination were performed in 34 patients with frontal and temporal epilepsy caused by FCD. MEG and Wada test were conducted to determine the language and memory advantage hemisphere, and to clarify the scope and memory function of language function areas. Operation was guided by the Medtronic stealhealth 7 surgical navigation system (USA) to remove the FCD and protect nerve function. IQ, memory and language examination were measured 1 year after operation, and the difference was observed before and after operation. The postoperative follow-up was 23 ~ 46 months, curative effect of epilepsy was determined according to the international anti-epilepsy union Engel’s standard.
Results
Thirty-four patients with epilepsy (21 temporal lobe epilepsy and 13 frontal lobe epilepsy) were included in this study. The examination process of MEG and Wada test was smooth. MEG can accurately locate the position of language function area. Twenty-eight patients’ dominant hemisphere of language was on the left and 6 was on the right side. Wada test can evaluate the patient’s memory function. Twenty-three patients’ dominant hemisphere of memory was located on the left, 8 on the right and 3 on the bilateral hemisphere. Compared with the dominant hemisphere and nondominant hemisphere, the memory score was significantly different (P<0.05). Statistics showed that the verbal IQ and total IQ increased (P<0.05)1 year after operation, but there was no significant change in memory IQ and Performance IQ (P>0.05). FCD patients recovered well without language, memory and limb impairment. The curative effect of epilepsy: 15 cases of Engel’sⅠgrade, 14 cases of Engel’sⅡgrade and 5 cases of Engel’s Ⅲ grade.
Conclusion
MEG, Wada test combined with neuronavigation was of important value in locating and guiding the surgical resection of FCD in patients with refractory frontal and temporal epilepsy, protecting cortical function, avoiding severe postoperative complications, and improving the therapeutic effect of epilepsy.
ObjectiveTo explore the clinical features and sum up the laws of the hepatic focal nodular hyperplasia (FNH) in its diagnosis and treatment. MethodsFNH was an uncommon benign hepatic tumor that often posed diagnostic dilemmas. We analyzed retrospectively the clinical, imaging of ultrasound, imaging of computed tomography (CT) and magnetic resonance images (MRI), and pathological materials of 21 patients with FNH proven by the pathological diagnosis during 5 years from April 1996 through April 2001 in two hospitals. ResultsThe diagnosis of FNH remained a challenge for clinicians and surgeons. Rate of correct diagnosis of FNH was low preoperatively (19.0%). The lesions of FNH were seen in males and females (m/f: 14/7). Only three female patients (3/7) had the history of taking oral contraceptive. Patients with FNH were largely young and middle age persons (81.0% under 50 years), discovered by accident (57.1%), without infection of the hepatitis B virus (95.2%) and with normal liver functions (100%) and serum AFP levels (100%). Color Doppler ultrasound showed blood vessels passing through the lesion (80.0%) and there was abundant in blood (66.7%). CT scan showed that the lesion had transient immediate enhancement in 60.0% of patients and had homogeneous signal in 60.0% after bolus injection. MR imaging demonstrated early vigorous enhancement (64.3%), homogenous signal (57.1%) and having central scar (35.7%) in the lesion. The demonstration of a central scar in the lesion was very helpful for the diagnosis of FNH. MRI was more helpful for the diagnosis of FNH using liver specific contrast agents: superparamagnetic iron oxide（SPIO）. All patients underwent focus resection (18 cases) or segmentectomy (2 cases), except one having no treatment. ConclusionFNH shows some typical clinical and imaging features. We could increase the rate of correct diagnosis by comprehensively analyzing the clinical and imaging materials. It is very important and necessary to determine a definite diagnosis of FNH, hepatic adenoma (HA) and primary liver cancer (PLC) preoperatively, because the HA and PLC must be surgically resected, FNH can only be followed up.
ObjectiveTo explore the microscopic character and clinical pathological feature of focal cortical dysplasia (FCD).Methods51 cases were collected from January 2015 to September 2018 in the 988th Hospital of the Joint Logistics Support Force of the People’s Libereation Army. Pathology with FCD of their diseased brain tissue was classified according to the classification standard by the International Anti-Epilepsy Union (ILAE) in 2011. Epileptic seizure characteristics were analysed in different types.ResultsFCD I was 23 cases (45.1%). FCD II was 11 (21.6%). FCD III was 17 (33.3%). Ia was the most common type (23.5%, 12/51). Neurons were arranged into microcolumnar structures in Ia. NF expression in immunohistochemistry was characteristic. It was close to the neuron like line or waterfall. The second type was Ⅲa (15.7%, 8/51). Hippocampal sclerosis was given priority to CA4 area pyramidal cells to reduce or disappear. Three types all happened in bilateral cerebral hemisphere. There was no statistical difference. Temporal lobe was significantly more than frontal lobe. More than 50% of the cases occurredepilepsy before the age of 18. The main manifestation was partial onset seizures and secondary body stiffness clonus. The onset age and history of epilepsy in patients with FCD Ⅲ were earlier than those in the other two types. On image the positive rate of I type was 78.3% and that of Ⅱ and Ⅲ was both 100%.ConclusionFCD is a common pathological feature of epilepsy patients. Carefully pathologic examination is the premise of accurate classification of each subtype. Ⅲ type is different from Ⅰ and Ⅱ type in epileptic seizures.
Objective To evaluate the sensitivity and accuracy of SPIO-enhanced MR Imaging in the detection of focal hepatic lesions. Methods We searched MEDLINE (1966 to 2004), EMBSAE (1984 to 2004), The Cochrane Library (Issue 1, 2004), CBMdisc (Jan.1978 to Jul. 2004), CMCC (1994 to 2004), “Radiology”, “AJR” and “European Radiology” database. Data from pharmaceutical companies and our research were also added. Related journals published from 1985 to 2003 were handsearched. Participants were clinically suspected of focal hepatic lesions. The quality of studies was assessed, and descriptive systematic review was applied to evaluate the detection sensitivity and accuracy of the imaging modality. Results Ten studies (418 patients with 1 037 focal hepatic lesions) were included. Because the data of sensitivity and specificity could not be extracted from any of the 10 included studies, it was impossible to do the meta-analysis using SROC curve. The sensitivity of SPIO-enhanced MRI ranged from 66% to 100%; accuracy ranged from 76% to 97%. Conclusions At present, there is no evidence to ascertain that SPIO-enhanced MRI has a considerably high accuracy in the detection of focal hepatic lesions. More studies with good methodology are needed.
ObjectiveTo compare the clinical and imaging characteristics of eyes with idiopathic focal choroidal excavation (FCE) and acquired FCE, and to preliminarily analyze the association of FCE with different fundus diseases. MethodsA retrospective clinical study. A total of 90 patients (93 eyes) diagnosed with FCE at the Ophthalmology Department of The First Affiliated Hospital of Zhengzhou University from March 2021 to May 2024 were included in the study. All affected eyes underwent best-corrected visual acuity (BCVA) testing, intraocular pressure (IOP) measurement, ophthalmoscope, fundus color photography, and swept-source optical coherence tomography (SS-OCT). SS-OCT was used to measure subfoveal choroidal thickness (SFCT), choroidal thickness at the temporal, nasal, and inferior margins of the FCE, as well as the maximum width and depth of the FCE. Based on the presence of concomitant fundus diseases, FCE cases were divided into an idiopathic FCE group (51 eyes) and an acquired FCE group (42 eyes). Clinical characteristics at the initial and final visits were compared between the two groups. Clinical features were also analyzed for acquired FCE eyes with different associated fundus diseases. A logistic regression model was used to identify potential risk factors for FCE coexisting with other fundus diseases. ResultsCompared to the idiopathic FCE group, the acquired FCE group had significantly decreased BCVA (Z=?8.290), significantly increased FCE width (Z=?2.762), and significantly higher incidence rates of saucer-shaped FCE (χ2=8.352) and ellipsoid zone disruption (χ2=7.999). These differences were all statistically significant (P＜0.05). No significant differences were found between the two groups in age, gender distribution, IOP, foveal involvement, proportion of conforming FCE, retinal pigment epithelium-Bruch’s membrane rupture, presence of hyperreflective material under the excavation, presence of surrounding thick vessels, FCE depth, SFCT, or choroidal thickness at the inferior, temporal, and nasal margins of the FCE (P＞0.05). Logistic regression analysis revealed that FCE width (odds ratio=1.002, 95% confidence interval: 1.001-1.004, P=0.005) was the sole risk factor for FCE coexisting with other fundus complications. In both the idiopathic and acquired FCE groups, FCE depth and width remained relatively stable during follow-up. BCVA improved in the acquired FCE group after treatment. ConclusionsFCE can coexist with various fundus diseases. FCE width is the only risk factor for the development of other fundus complications in FCE-affected eyes. Treating retinal or choroidal diseases associated with acquired FCE can provide visual benefits to patients.
Objective To investigate the diagnostic value of a double action MR contrast agent——gadobenate dimeglumine （Gd-BOPTA） for focal liver lesion and biliary system disease. Methods Articles about Gd-BOPTA in CNKI and PubMed for the past few years were searched and the value of Gd-BOPTA in the diagnosis of focal liver lesion and biliary system disease was summarized. Results For focal liver lesion, Gd-BOPTA not only can reveal blood supply of the lesion, but also reveal the hepatocellular functional status in the lesion. For biliary system, biliary excretion of Gd-BOPTA can be used to evaluate the anatomic structure of bile duct， function of gallbladder and biliary system disease. Conclusions Gd-BOPTA has an important value in the diagnosis of focal liver lesion and biliary system disease. Gd-BOPTA may have wider applications in the future.
ObjectiveTo summarize the application of dual-energy CT scanning technology in the liver.
MethodsTo search the relevant literatures at home and abroad, then the application of dual-energy CT scanning technology in focal liver lesions, diffuse liver lesions were analyzed and summarized.
ResultsDual-energy CT scanning technology can improve detection rate of the focal liver lesions, liver cancer recurrence lesions after local treatment and help to differentiate focal liver lesions, to stage the malignant lesions, and it also can be more accurate quantification of liver iron, fat content, indirect measurement of hepatic blood flow dynamics change situation.
ConclusionDual-energy CT scanning technology can improve the diagnostic value of CT scanning technology in liver disease.
Objective To approach the enhancing patterns of hepatic focal nodular hyperplasia (FNH) under contrast-enhanced ultrasound, and improve the recognition on diagnosis for FNH by contrast-enhanced ultrasound. Methods The clinical data of 12 patients with histologically proved FNHs having accepted contrast-enhanced ultrasound examination from May 2007 to February 2009 in West China Hospital of Sichuan University were retroptectively analyzed, and related literatures were reviewed. Results All FNHs were rapidly enhanced in arterial phase and spoke-wheel-like sign was detected in 9/12 lesions. Slightly hyper-enhancement or iso-enhancement were showed in 11/12 lesions, while 1/12 lesions showed hypo-enhancement in late phase. Conclusion Contrast-enhanced ultrasound can display the dynamic blood perfusion of FNH, especially spoke-wheel-like arterial flow in early arterial phase, which is of great value for the diagnosis of FNH.
ObjectiveTo make the model of Wistar suckling rats Focal cortical dysplasia (FCD) by liquid nitrogen freezing brain cortex and verify it. Analysed the electroencephalogram (EEG) and magnetic resonance imaging (MRI) features of the FCD model, in order to provide theoretical and experimental basis for human FCD diagnosis and treatment.
MethodsTake the first day of Wistar suckling rats as experimental object, liquid nitrogen freezing Wistar suckling rats brain cortex.Make examination of EEG and MRI for Wistar suckling rats. The Brain tissue slice of Wistar suckling rats model dyed by HE and check with light microscope examination.
ResultsIn experiment group, the sample epileptic discharge rate of EEG was about 41.6% on average, and showed visible spike wave, spine slow wave frequency distribution. Experimental Wistar suckling rats MRI showed positive performance for long T1 and long T2 signal, brain tissue slices HE staining showed brain cortex layer structure and columnar structure disorder, exist abnormal neurons and the balloon sample cells.
ConclusionThe method of liquid nitrogen freezing Wistar suckling rats cortex can established FCDⅢd animal models successfully, and showed specific EEG and MRI, which has important value for diagnosis and treatment of human FCD.
