Objective To assess value and limitations of non-invasive methods in assessing liver fibrosis．Methods By summarized current situation and advancement of serum fibrotic markers, ultrasound, CT and MRI in assessing liver fibrosis, we investigated their value and limitations. Results In addition to diagnosis, non-invasive methods of assessing liver fibrosis assess severity of liver fibrosis. For liver fibrosis, however, non-invasive methods can not monitor effectively reaction to therapy and progression. Conclusion Non-invasive methods play important roles in diagnosis and assessing severity of liver fibrosis, and reduce the need of liver biopsy.
Objective To investigate the effects on myocardial perfusion of simultaneous antegrade/retrograde cardiopiegia （SARC） through a single coronary artery and coronary sinus （CS）. Methods SARC was conducted in isolated pig hearts through CS in conjunction with the left anterior descending （LAD）, the left circumflex （LCX）, or the right coronary artery （RCA） respectively. After injecting magnetic resonance （MR） contrast agent （gadolinium diethyienetriamine pentaacetic acid, Gd-DTPA） into arterial or venous route, the distribution of Gd-DTPA with magnetic resonance imaging（MRI） was monitored and the effluent from the venting coronary arteries to assess the efficacy of SARC for myocardial perfusion was measured. Results Injection of Gd-DTPA into a perfusing artery during SARC resulted in increased signal intensity not only in the territory of the perfusing artery but also in the areas normally served by the other two venting coronary arteries （including the right ventrieuiar free wall）. With Gd DTPA given into the CS during SARC, the myocardium in the territories of the two venting coronary arteries was lightened. Signal intensity of the myocardium in the perfusing artery territory and right ventricuiar free wall remained unchanged. Moreover, a significant amount of effluent was collected from the venting coronary arteries during SARC： the LAD 10.5-17.7 ml/min; LCX 9.7-15.2 ml/min, and RCA 4.7-7.8 ml/min. Conclusion SARC through a single coronary artery and CS can provide homogeneous perfusion to the entire heart and is sufficient to prevent ischemic injury in the myocardium normally supported by the venting coronary arteries.
Objective To evaluate the sensitivity， specificity, and accuracy of magnetic resonance imaging （MRI） in characterizing adnexal masses. Methods The databases such as the Cochrane Library, PubMed， EMbase， CNKI， and WanFang Data were searched on computer from 1991 to 2011. The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data， and assessed the methodology quality. Meta-analysis were performed using the Metadisc 1.40 software. The acquired pooled sensitivity, specificity， and summary receiver operating characteristic curve （SROC） were used to describe the diagnostic value. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Results Ten case-control studies involving 649 women who were suspected to have pelvic masses were included and 729 masses were confirmed by the postoperative histopathology. The pooled statistical results of meta-analysis showed that：the sensitivity and specificity of MRI were 〔89%（84%-92%）， P=0.046 6〕 and 〔87% （83%-90%）， P=0.000 2〕 respectively, the positive and negative likelihood ratios of MRI were 6.25（P=0.008 5） and 0.14（P=0.029 1） respectively, and the area under the SROC curve （AUC） was 0.941. The sensitivity and specificity of ultrasound were 〔87%（82%-91%）， P=0.000 0〕 and 〔73%（69%-77%）, P=0.000 0〕 respectively, the positive and negative likelihood ratios of MRI were 3.07（P=0.000 0） and 0.18（P=0.000 1） respectively， and the AUC was 0.897. The speci?city and accuracy of MRI in characterizing female pelvic masses were higher than ultrasound obviously. Conclusion According these evidences， the MRI should be recommended to the women who are suspected to have pelvic masses as a preferred.
ObjectiveTo observe the correlation between posterior myopic retinoschisis(MRS) and posterior scleral staphyma (PS) in pathological myopia (PM), and to preliminarily explore the influencing factors of MRS.MethodsA retrospective case series study. From November 2016 to November 2019, 38 patients with PM with MRS diagnosed in Henan Eye Hospital & Henan Eye Institute from were included in the study. There were 10 males and 28 females; 13 patients were binocular and 25 patients were monocular. The average age was (49±13) years old. BCVA, retinoscopy optometry, frequency domain OCT, three-dimensional magnetic resonance imaging (3D-MRI) examination and axial length (AL) measurement were performed. According to the frequency domain OCT inspection results, MRS was divided into inner splitting, outer splitting and mixed splitting; based on the 3D-MRI scan results, PS was divided into broad macula, narrow macula,discoid, nasal, subdisc and other types. The correlation between MRS and PS was tested by χ2 test or Fisher exact test.ResultsAmong 60 eyes, 58 eyes (96.77%) of MRS combined with PS. Among them, the wide macula, narrow macula, discoid, nasal, subdisc, and other types were 30 (51.72%), 19 (32.75%), 1 (1.72%), 2 (3.48%), 2 (3.48%) and 4 (6.85%) eyes; inner split, outer split, and mixed split were 10 (17.24%), 24 (41.38%), 24 (41.38%) eyes. Of the 19 eyes with narrow macular PS, MRS involved the fovea in 16 eyes; of the 39 eyes with PS of other forms, MRS involved the fovea in 22 eyes. There was a statistically significant difference between the narrow macular type and other types involving foveal eyes (P=0.044). The correlation between MRS involving the fovea and narrow macular PS was moderate (Cramer's V=0.275). The ages of patients with inner split, outer split, and mixed split were 44±12, 56±10, and 44±13 years, respectively. Patients with inner splitting were younger than those with outer splitting, and those with outer splitting were older than those with inner splitting and mixed splitting. The differences were statistically significant (P=0.010, 0.010, 0.060).ConclusionPM with MRS mostly occur in PS-affected eyes, and mainly macular PS (wide macula, narrow macula).
ObjectiveTo investigate the imaging findings of carcinoma of body and tail of the pancreas. MethodsTotally twentythree patients with carcinoma of body and tail of the pancreas were studied. The diagnosis was proven by surgery and pathological findings. The imaging features of twentythree cases were reviewed including the location, size, shape, texture, and enhancement patterns of the tumor masses. Five cases underwent enhanced MRI examination, 18 cases underwent enhanced spiral CT examination. ResultsThe tumors located in the pancreatic body in 5 cases, located in the tail in 7 cases, and located in the body and tail of pancreas in 11 cases. The tumor masses were irregular in shape and heterogeneously hypointense from CT scan. From MR, the masses were slightly hypointense on T1WI, and slightly or mixed hyperintense on T2WI. Nineteen cases showed heterogeneous slight enhancement and four cases had no enhancement. The tumors were well demarcated in five cases, while those were poorly defined in the other 18 cases. Metastatic lymphadenopathy was shown in 16 cases, vascular invasion in 8 cases, and metastatic lesions of other organs in 3 cases. ConclusionThe carcinoma of body and tail of the pancreas shows certain characteristic imaging. CT and MRI examination can reflect the morphologic features, the hemodynamic alterations, and the involvement of adjacent structures and organs.
ObjectiveTo investigate the value of MRI in the diagnosis of central nervous system lymphoma (CNSL). MethodsWe retrospectively analyzed the clinical data of 20 cases of primary CNSL (PCNSL) and 13 cases of secondary CNSL (SCNSL) from the Second People's Hospital of Chengdu and Chengdu 363 Hospital from January to December 2013, and analyzed their clinical data and MRI image data. We observed the tumor location, tumor size and signal, and carried out the statistical analysis. ResultsTwenty patients had PCNSL in the brain, including single lesion in 9 (45.0%), and multiple in 11 (55.0%). Among the 48 lesions, there were 23 (47.9%) nodular lesions, 21 (43.8%) crumb lesions, and 4 (8.3%) dot patch lesions; MRI showed slightly low T1 signal and slightly high T2 signal in most lesions, and showed significant even enhancing, and mild to moderate edema around the tumor. SCNSL lesions were mainly meningeal disseminated with 3 cases (23.1%) of single lesions and 10 cases (76.9%) of multiple ones, and there were a total of 30 lesions. MRI manifested that T1 and T2 mainly showed equal signals, and showed an obviously even enhancing status, and mild to moderate edema around the tumor. ConclusionThe central nervous system lymphoma has a certain characteristic MRI image, and MRI images of the primary and secondary central nervous system lymphoma were similar.
Objective To investigate the neuropathogenesis of Adieprime;s pupil. Methods The neuroelectrophysiological and neuroimaging data of 42 patients with Adie's pupil (lightnear dissociation and segmental palsy of iris sphincter) were retrospectively analyzed. There were 37 patients with unilateral pupil dilation and 5 patients with bilateral pupil dilation. Cranial magnetic resonance imaging (MRI, 23 patients), Cranial CT scanning (1 patient), nerve conduction velocity (NCV, 14 patients), limb electromyogram (EMG, 5 patients), both lower extremities EMG (9 patients), visual evoked potential (VEP, 18 patients), somatosensory evoked potential (SEP, 11 patients) and electroencephalograms (EEG,5 patients) were performed on some of those patients. Results Central nervous system midline anatomic variations or minor lesions were found in 13/23 cases of MRI/CT imaging. Slowed sensory NCV and multiple sensorymotor peripheral nerve damages were evident in 6/14 cases of the NCV/EMG assay. 5/18 patients showed prolonged latency of VEP P100. 2/11 cases showed peripheral nerve damage in SEP recording, and 1/5 cases showed abnormal EEG. Conclusion Peripheral nerve damage may be an important pathogenesis of Adie's pupil, while the central nervous system damage is also involved in its pathogenesis.
Objectives To observe the clinical characteristics of patients with posterior scleritis. Methods Ten patients with 16 eyes diagnosed as posterior scleritis were enrolled in this study. Ten patients consisted of seven males and three females. Their age ranged from 18 to 75 years old, with a mean age of 42.0plusmn;14.7 years old. Except for two patients aged 18 and 75 years old, the other eight patients aged 33 to 55 years old. Routine eye examination was performed including visual acuity, slit lamp microscope, ophthalmoscope, B scan ultrasound, color fundus photography, fundus fluorescein angiography (FFA), orbit MRI and chest Xray. According to the B scan ultrasonic examination, these ten posterior scleritis cases were divided into diffused and nodular types. Among them, the diffused type had 8 cases (14 eyes), the nodular type had 2 cases (2 eyes). The visual acuities of ten patients were from light perception to 0.4. The blood laboratory tests were negative in all cases. The diffused posterior scleritis patients received systemic and (or) local glucocorticoid therapy. The nodular posterior scleritis patients could not be ruled out choroidal melanoma in the initial evaluation, and they underwent enucleation operation in other hospitals. Results In the 14 eyes of diffused posterior scleritis, conjunctival congestion and edema were observed in 8 eyes, eyelid edema in 2 eyes, normal eye surface in 4 eyes. In the two eyes of nodular posterior scleritis, there was no conjunctival congestion and edema or eyelids swelling. All 16 eyes performed FFA, 11 eyes had fundus posterior pole early dot-like hyperfluorescence followed by leakage of fluorescence in the late stage, two eyes had hyperfluorescence mixed with hypofluorescence in the nearby retina of the lesion, and the rest three eyes had no abnormality in FFA. In 14 eyes of diffused type posterior scleritis, B scan ultrasound showed diffused scleral thickening more than 2 mm in 10 eyes with a typical quot;Tquot; shape sign. The other 4 eyes did not show typical sign in ultrasound. In 2 eyes of nodular type, ultrasound showed nodular enhanced echo in choroid with medium internal reflection and abundant blood flow. Eleven eyes underwent orbit MRI scan, 9 eyes displayed diffused posterior sclera thickening, 2 eyes showed nodular lesions in choroid. All lesions showed low signal on T1WI, high signal on T2WI. After treatment, six diffused posterior scleritis patients recovered to normal scleral thickness. Two nodular posterior scleritis patients underwent enucleation showed granulomatous posterior scleritis and necrotic posterior scleritis in pathology. Overall, 16 eyes of 10 patients were misdiagnosed as chronic angleclosure glaucoma in 2 eyes, acute iridocyclitis in 1 eye, central serous chorioretinopathy in 2 eyes, retrobulbar neuritis in 2 eyes, and choroidal melanoma in 2 eyes. Conclusions Posterior scleritis occurs mostly in young patients. The diffused posterior scleritis patients usually has anterior segment signs including conjunctival congestion and edema or eyelids swelling, while the nodular posterior scleritis patients has normal anterior segment signs. B scan ultrasonic and MRI examination showed typical image features. Systemic and (or) local glucocorticoid therapy can effectively release the symptoms of these patients.
Cerebral microinfarcts are presumed to be a manifestation of ischemic cerebral small vessel disease. It is presumed to have close relationship with dementia and cerebrovascular disease. With the advancement of imaging technology, high-resolution MRI has been found to detect microinfarctions in vivo. Current studies have shown that cerebral microinfarctions are not only commonly in individuals with dementia and elderly with normal aging, but also in patients with ischemic stroke. Based on the recently published MRI studies of microinfarcts in ischemic stroke patients, this paper summarizes the detection rate, risk factors, etiology and prognosis of cerebral microinfarcts, and aims to provide new ideas for the formulation of prevention and treatment strategies of cerebral microinfarcts related brain damage in ischemic stroke patients.
Objective To study the MRI features of intracranial solitary fibrous tumor (ISFT). Methods MRI features of 8 patients with ISFT treated between December 2010 and December 2015 were retrospectively analyzed and relavent literatures about its neuroimaging were reviewed. Results All the 8 cases were single solitary fibrous tumor (SFT), among which 4 arose from and beneath the tentorium, 2 in the left cerebellopontine angle, 1 in jugular foramen region and 1 in saddle area. All tumors had clear boundary, 3 were oval or round, 2 were irregular-shaped, 2 were lobulated and 1 was dumb-bell shaped. Tumor size ranged from 35 to 65 mm. On pre-contrast MRI, 5 cases were mixed with hypo to hyperintense signals on (T1 weighted image) T1WI and heterogeneous on (T2 weighted image) T2WI. The rest 3 cases were featured by solid and cystic components; the solid component was hypo to isotense on T1WI and hypointense on T2WI while the cystic areas, which were not enhanced in the postcontrast images, were hypo and hyperintense on T1WI and T2WI, respectively. All the areas with low T2 signal intensity were strongly enhanced after gadolinium administration. Flow-empty actions, peritumoral edema and “dural tail” sign was found in 6, 3 and 0 cases, respectively. All the 3 cystic cases were confirmed as malignant ISFT while the rest 5 were benign. Conclusions MRI manifestation of ISFT has some characteristics. There may exist some correlations between the intratumoral cyst and malignant potential. However, the diagnosis of ISFT remains dependent on histopathology.