2014 Vol. 38, No. 4
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2014, 38(4): 211-215.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.001
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Abstract:
Objective To elucidate the generation mechanism of cerebellum in language by resting state functional magnetic resonance imaging(fMRI). Methods Siemens verio 3.0T MR Scanner was used to obtain all of the subjects of fMRI data. The fMRI data were processed with the software of Data Processing Assistant for Resting-State fMRI Analysis Toolkit. Firstly, 12 patients with poststroke aphasia and 20 normal controls were analyzed by amplitude of low frequency fluctuation(ALFF) and performed with two sample t-test by REST software; Secondly, decreased ALFF of certain brain regions of the cerebellum were selected as the regions of seed point and ROI, and then calculated the single sample t-test in normal controls to obtain function connectivity map. Results As compared with those in normal subjects, the regions showing decreased ALFF in aphasia patients were distributed in left middle temporal gyrus, left medial prefrontal gyrus, right cerebellum. Positive functional connectivity with certain brain regions of the cerebellum ROI was seen in cerebellum tonsil, left middle temporal gyrus, left medial superior frontal gyrus and supplementary motor area. Conclusion Right cerebellum itself and through its impact on the presence of functional connections and structural connections of the brains participate in language production.
2014, 38(4): 216-218.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.002
Abstract:
Objective To observe the effects of G-CSF combined with SB203580(SB) on the immune system of mice received 4 Gy total body irradiation(TBI). Methods Thirty male C57BL/6 mice were randomly divided into control group, irradiated group, combined group. The mice in irradiated and combined group received 4 Gy TBI. In combined group, G-CSF(1 μg/each) was intraperitoneally(ip) injected twice one day for 5 days, SB(15 mg/kg) was ip injected every other day after 4 Gy TBI for 5 times. After 4 Gy TBI 10 days, the peripheral bloods were counted, the CD4, CD8, B220 cells in WBC and CD4, CD8 in thymocytes were analyzed by flowcytometry. The reactive oxygen species levels(ROS) of bone marrow cells were detected by microplate reader. Results Compared to the control group, the proportion of CD8, B220 and WBC in the irradiated mice significantly decreased, CD4+CD8+ thymocytes and ROS levels of bone marrow cells increased significantly. Compared to irradiation group, red blood, platelet, CD4 and CD8 cells in peripheral blood, CD4+CD8+ thymocytes decreased in the combined group. Conclusion G-CSF combined with SB has protective effects on the radiation-induced injury in immune system.
2014, 38(4): 219-222.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.003
Abstract:
Objective To investigate the diagnosis value of the joint inspection of radionuclide dynamic images of salivary gland and antinuclear antibody examination in Sjögren′s syndrome(SS) patients. Methods Radionuclide dynamic images and antinuclear antibody examination were applied in 30 patients who were confirmed as SS clinically. The diagnostic value of these 2 methods in SS was studied retrospectively. The positive rates were calculated according to the classical definitions. Results Out of the 30 SS cases, antinuclear antibody examination detected 19 cases(63.3% of the cohort). The other 11 cases turned out to be false negative. Compared with antinuclear antibody examination, dynamic salivary gland scintigraphy identified 24 SS cases, and the positive rate was 80%. The positive rate of the joint examination were calculated as 100%, significantly higher than that of radionuclide dynamic images of salivary gland(P < 0.05), or antinuclear antibody test(P < 0.01). Conclusion Joint inspection of dynamic salivary gland images and antinuclear antibody tests has very important clinical value in SS screening, diagnosing and evaluating of salivary gland dysfunction.
2014, 38(4): 223-226, 246.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.004
Abstract:
Objective To study the early evaluation value of 18F-FDG PET/CT imaging in nasopharyngeal carcinoma on the 7-day after different models of radiotherapy, including conformal radiotherapy(CRT) and intensity-modulated radiotherapy(IMRT). Methods PET/CT imaging was performed in 21 cases of CRT group and 19 cases of IMRT group on the 7-day after radiotherapy. The visual examination was performed and the maximum standardized uptake value(SUVmax) was measured, and the results were compared with the two years clinical follow-up and the result of pathological biopsy. Results Two years clinical follow-up of the CRT group confirmed there was no residual tumor. There was no residual tumor in 17 cases and 2 cases were positive of the IMRT group confirmed by biopsy. The SUVmax of the CRT group and the IMRT group were 9.57±4.33 and 9.40±3.32 respectively before radiotherapy without significant difference(t=-0.43, P=0.132). SUVmax of the CRT group and the negative patients confirmed by biopsy of the IMRT group were 2.38±0.34 and 3.1±0.55 respectively after radiotherapy with significant difference (t=-3.4, P=0.002). The accuracy rate and the false positive rate of visual examination of the CRT group were 76.2% and 23.8% respectively. The accuracy rate and the false positive rate of visual examination of the IMRT group were 63.2% and 36.8% respectively. Conclusion s One week after nasopharyngeal carcinoma CRT is the feasible time-point for 18F-FDG PET/CT assessment. SUVmax of the IMRT group on 7-day after radiotherapy was higher than that in CRT group, so this time-point is not the best evaluation time-point of the PET/CT.
2014, 38(4): 227-231.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.005
Abstract:
Objective To explore the clinical features and 131I whole body scans(WBS) characteristics of physiological thymic uptake of 131I in post-operative patients with differentiated thyroid cancer(DTC). Methods One thousand eight hundred and eighty-two WBS were performed on the 3-5 day after 131I therapy in post-operative patients with DTC between 2007 and 2013. On the basis of thyroglobulin and thyroglobulin antibody measurement, other imaging and clinical follow-up, the mediastinal activity was attributed to physiological thymic uptake of 131I. For such patients, their data were reviewed retrospectively. Results Physiological thymic uptake of 131I were confirmed in 16 patients. All of them were under the age of 45. Fifteen patients received at least two therapeutic doses of 131I, and there was only one patient to be found physiological thymic uptake of 131I on the first treatment. The pattern of physiological thymic uptake of 131I was classified as "diffuse" or "dumbbell". Thymic uptake of 131I became more prominent with repeated treatments. Conclusions For the next appropriate treatment, it is essential to acknowledge that physiological thymic uptake of 131I in patients with DTC under the age of 45 is an important cause of false-positive WBS.
2014, 38(4): 232-234, 265.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.006
Abstract:
Objective To measure the levels of blood lipid and plasma N-terminal pro-brain natriuretic peptide(NT-proBNP), cardiac troponin I(CTnI) and high sensitive C-reaction protein(hs-CRP) in patients with chronic heart failure(CHF), and carry out clinical analysis. Methods The blood lipid and plasma NT-proBNP, CTnI and hs-CRP levels in 165 patients with CHF and 60 controls were analyzed by chemistry, fluorescent immunoassay and radioimmunoassay, and then the results were analyzed and compared. Results The serum TC, TG, LDL-C and HDL-C levels in 165 patients with CHF were significantly lower than those of 60 controls(TC:tⅡ=2.214, P < 0.05; tⅢ=2.873, P < 0.01; tⅣ=3.146; P < 0.01; TG:tⅡ=2.167, P < 0.05; tⅢ=2.863, P < 0.01; tⅣ=3.063, P < 0.01; LDL-C:tⅡ=2.147, P < 0.05; tⅢ=2.056, P < 0.05; tⅣ=2.184, P < 0.05; HDL-C:tⅡ=2.137, P < 0.05; tⅢ=2.256, P < 0.05; tⅣ=3.148, P < 0.01). In biomarkers determining, the plasma NT-proBNP, CTnI and hs-CRP levels in 165 patients with CHF were significantly higher than those of 60 controls(NT-proBNP:tⅡ=2.096, P > 0.05; tⅢ=2.813, P < 0.01; tⅣ=4.135, P < 0.001; CTnI:tⅡ=2.736, P < 0.01; tⅢ=2.962, P < 0.01; tⅣ=3.816, P < 0.01 and hs-CRP:tⅡ=2.103, P < 0.05; tⅢ=2.956, P < 0.01; tⅣ=4.452, P < 0.001), and the plasma three biomarker levels were increased with decreasing left ventricular ejection function(LVEF). Conclusion The blood lipid(TC, TG, LDL-C and HDL-C) levels were decreased with decreasing LVEF and showing abnormal metabolism, but the plasma biomarkers levels were increased with decreasing LVEF.
2014, 38(4): 235-238.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.007
Abstract:
Objective To explore the value of plasma myocardial cell damage markers in detecting myocardial injury patients with acute myocardial infraction(AMI). Methods The plasma cardiac troponin I(CTnI), TNF-α, high sensitive C-reaction protein(hs-CRP) and β2-microglobulin(β2-MG) levels in 184 patients with AMI and 60 controls were determined by radioimmunoassay, and then the comparative analysis were carried on. The positive and negative predictive value, the specificity, the effective rate and the sensitivity of these myocardial cell damage markers at 3 h, 6 h, 9 h after admission to the hospital were determined. Results The plasma CTnI, TNF-α, hs-CRP and β2-MG levels in 184 patients with AMI were significantly higher than those in 60 controls(tCTnI=6.384, P < 0.001; tTNF-α=2.136, P < 0.05; ths-CRP=5.109, P < 0.001; tβ2-MG=3.185, P < 0.01). The plasma CTnI and hs-CRP levels increased significantly. The specificity of plasma CTnI, TNF-α, hs-CRP and β2-MG were 96.67%, 51.67%, 65.00% and 48.33% respectively in the diagnosis of AMI patients. The sensitivity of these myocardial cell damage markers in the diagnosis of AMI patients at 3 h, 6 h and 9 h after admission were showed as follows:the plasma CTnI were 21.74%, 92.93% and 98.37% respectively; the plasma TNF-α were 17.93%, 65.76% and 69.02% respectively; the plasma hs-CRP were 16.30%, 78.26% and 79.89% respectively, and the plasma β2-MG were 21.20%, 69.57% and 74.46% respectively, and the sensitivity of plasma CTnI was the highest. The positive, negative predict value and effective rate of plasma CTnI were the highest also, and they were 89.67%, 88.33%, 89.24% respectively. Conclusion The plasma CTnI levels of myocardial cell damage markers was a valuable index in the early diagnosis of AMI, and had clinical value in treatment following.
2014, 38(4): 239-241, 270.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.008
Abstract:
Objective To investigate the features and clinical diagnosis values of CT and MRI in schizencephaly. Methods The imaging features of CT and MRI were restrospectively analyzed in 17 cases of schizencephaly patients. Results CT and MRI showed the fractures from the cortex to the lateral ventricle which stretch across the brain hemisphere, and there were inflexed grey matter on both sides. In the inner end of fracture, there were some curtain like protuberance of the ventricle walls, the lateral end of closed type fracture presented a trumpet or deep sulci like shape, and the open type fracture presented a dumbbell shape. A total of 24 fractures were found in 17 cases of schizencephaly patients, 12 cases were unilateral, 5 cases were bilateral; 12 cases were closed type, 5 cases were open type; 10 cases complicated with transparent septum defect, 8 cases were heterotopic gray matter, 2 cases were unilateral thalamus and partial basal ganglia defect, 4 cases were polymicrogyria, 1 case was pachygyria, 2 cases were less white matter at the trigone of the lateral ventricles, 5 cases were arachnoid cyst. Conclusion Schizencephaly has distinctive imaging features, CT and MRI examination can clearly display the pathological morphology of schizencephaly.
2014, 38(4): 242-246.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.09
Abstract:
Objective To evaluate the application value of 64-multi detector spiral CT (64-MSCT)in the diagnosis of small bladder tumor. Methods Forty-eight patients with small bladder tumor(≤1.5 cm) were re-checked by bladder axial scans of 64-MSCT, arterial phase, venous phase, delayed phase enhancement scanning and multi planar reconstruction(MPR) reprocessing. CT imaging data were analyzed retrospectively. Results Among the 48 cases of small bladder tumor, 45 cases were detected through bladder axial scans of 64-MSCT, with the positive rate of 93.75%, and 3 cases were not detected, with the miss rate of 6.25%. While 48 cases were detected through bladder axial scans of 64-MSCT, arterial phase, venous phase and delayed enhancement scanning, the positive rate was 100%. The application of MPR reprocessing is favorable to the location of small bladder tumor. Among the 48 cases of small bladder tumor, 44 cases occurred on walls of urinary bladders, and 4 cases in vesical diverticulum. All the cases were confirmed by surgery and pathology. Among the 48 cases of small bladder tumour, 2 cases were demonstrated as carcinoma in situ, 6 cases as adenocarcinoma, 38 cases as transitional cell carcinoma, and 2 cases as papillary epithelioma. The signal intensities of small nodular soft tissues with the papillary or cauliflower-like structures were shown by axial scans of 64-MSCT, and uniform and constant reinforcement were appeared in delayed enhancement scanning. Six cases of narrow base pedunculated lesions were diagnosed as papillary epithelioma by 64-MSCT, while 2 cases were confirmed as papillary epithelioma, and 4 cases as transitional cell carcinoma by pathology. Four cases were misdiagnosed by 64-MSCT, with the misdiagnosis rate of 66.67%. There is some difficulty in differential diagnosis of 64-MSCT on narrow base pedunculated lesions. The accuracy rate of diagnosis of small bladder tumor by 64-MSCT was 89.59%, and the rate of misdiagnosis was 10.41%. Conclusion 64-MSCT can meet the needs of detection and diagnosis of small bladder tumor, and may be an ideal method for the non-invasive diagnosis of small bladder tumor.
2014, 38(4): 247-251.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.010
Abstract:
Prostate cancer is one of the most common malignant tumor for aged males in our country, radiation therapy is considered to be one of the best treatment. There is an increasing use of IMRT in the radiotherapeutic management of prostate cancer, which do target location by using imaging method. CT can not distinguish between prostate and its adjacent soft tissue structures very well, whereas, CT/MRI image fusion has an advantage of providing the internal structure of the prostate and estimating the tumor scale, with or without membrane damage and seminal vesicle invasion. So CT/MRI image fusion-based treatment planning allows more accurate target volume and risk organ, optimizes radiation therapy planning, protects adjacement organ and reduces radiation damage.
Prostate cancer is one of the most common malignant tumor for aged males in our country, radiation therapy is considered to be one of the best treatment. There is an increasing use of IMRT in the radiotherapeutic management of prostate cancer, which do target location by using imaging method. CT can not distinguish between prostate and its adjacent soft tissue structures very well, whereas, CT/MRI image fusion has an advantage of providing the internal structure of the prostate and estimating the tumor scale, with or without membrane damage and seminal vesicle invasion. So CT/MRI image fusion-based treatment planning allows more accurate target volume and risk organ, optimizes radiation therapy planning, protects adjacement organ and reduces radiation damage.
2014, 38(4): 252-256.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.011
Abstract:
Breast cancer is one of the most common forms of cancer in women. The combination of surgery and radio-chemotherapy is the best treatment for breast cancer nowadays. However, due to heterogeneity of breast cancers, some subtypes of breast cancer, especially the triple negative breast cancer(TNBC), do not respond well to traditional therapy and has relatively poor prognosis. Recent studies indicate that the Wnt/β-catenin signaling pathway, which is particularly over-activated in breast cancer, especially in TNBC, is associated with the occurrence, development, invasion, metastasis and poor prognosis of breast cancer. Inhibition of Wnt/β-catenin signaling can effectively inhibits the growth of breast cancer cells and multidrug resistance in chemotherapy. Furthermore, Wnt/β-catenin signaling is also closely related to radiation resistance. Therefore, with a better understanding of Wnt/β-catenin signaling, it may be a new radio-chemotherapeutic target of breast cancer, especially for TNBC.
Breast cancer is one of the most common forms of cancer in women. The combination of surgery and radio-chemotherapy is the best treatment for breast cancer nowadays. However, due to heterogeneity of breast cancers, some subtypes of breast cancer, especially the triple negative breast cancer(TNBC), do not respond well to traditional therapy and has relatively poor prognosis. Recent studies indicate that the Wnt/β-catenin signaling pathway, which is particularly over-activated in breast cancer, especially in TNBC, is associated with the occurrence, development, invasion, metastasis and poor prognosis of breast cancer. Inhibition of Wnt/β-catenin signaling can effectively inhibits the growth of breast cancer cells and multidrug resistance in chemotherapy. Furthermore, Wnt/β-catenin signaling is also closely related to radiation resistance. Therefore, with a better understanding of Wnt/β-catenin signaling, it may be a new radio-chemotherapeutic target of breast cancer, especially for TNBC.
2014, 38(4): 261-265.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.013
Abstract:
Magnetic resonance elastography(MRE) is a noninvasive technique for quantitatively evaluating tissue mechanical properties and it can provide useful diagnostic information. Recently, MRE has been gradually applied into clinical practice, the purpose of this review is to summarize the value and prospect of MRE application in liver examination.
Magnetic resonance elastography(MRE) is a noninvasive technique for quantitatively evaluating tissue mechanical properties and it can provide useful diagnostic information. Recently, MRE has been gradually applied into clinical practice, the purpose of this review is to summarize the value and prospect of MRE application in liver examination.
2014, 38(4): 266-270.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.014
Abstract:
Tumor-like disorders are diseases which are similar to bone tumor in clinical feature, imaging and pathology. Radionuclide bone imaging can display the morphology, blood supply and metabolism of the whole body bone clearly. It can detect abnormal bone metabolism at early stage, and is more sensitive than other imaging examination methods. Imaging data of bone tumor-like disorders are commonly seen in X-ray, CT and MRI at present. This article reviews the diagnostic value in tumor-like disorders by radionuclide bone imaging, which may help clinicians know systematically and improve the diagnosis level.
Tumor-like disorders are diseases which are similar to bone tumor in clinical feature, imaging and pathology. Radionuclide bone imaging can display the morphology, blood supply and metabolism of the whole body bone clearly. It can detect abnormal bone metabolism at early stage, and is more sensitive than other imaging examination methods. Imaging data of bone tumor-like disorders are commonly seen in X-ray, CT and MRI at present. This article reviews the diagnostic value in tumor-like disorders by radionuclide bone imaging, which may help clinicians know systematically and improve the diagnosis level.
2014, 38(4): 271-274.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.015
Abstract:
Differentiated thyroid carcinoma is the most common malignant tumor of the endocrine system, with an increasing incidence rate in recent years. Patients with papillary thyroid carcinoma might have a high incidence of cervical lymph node metastasis. Ultrasound and ultrasound guided fine-needle aspiration cytology is a highly sensitive and specific process for detecting the cervical lymph node metastasis. And the accurate determination of the characteristics of cervical lymph nodes is critical to make the choice of reoperation, 131I radiotherapy and follow-up after 131I therapy as well.
Differentiated thyroid carcinoma is the most common malignant tumor of the endocrine system, with an increasing incidence rate in recent years. Patients with papillary thyroid carcinoma might have a high incidence of cervical lymph node metastasis. Ultrasound and ultrasound guided fine-needle aspiration cytology is a highly sensitive and specific process for detecting the cervical lymph node metastasis. And the accurate determination of the characteristics of cervical lymph nodes is critical to make the choice of reoperation, 131I radiotherapy and follow-up after 131I therapy as well.
2014, 38(4): 275-277.
doi: 10.3760/cma.j.issn.1673-4114.2014.04.016
Abstract:
Bone is one of the most favorite sites of malignant tumor metastasis, and bone metastasis usually correlates with the prognosis of disease, which leads to the important place of bone scintigraphy in the diagnosis of bone metastasis. Bone scan is widely used in clinical work for its high sensitivity as well as its low cost, revealing bone metabolism and blood flow, and no limitation of metal implantation. Compared with plain bone scan, SPECT/CT bone tomography shows better orientation of lesion, and has higher detection rates and specificity. This article reviews the diagnostic value of malignant tumor bone metastasis.
Bone is one of the most favorite sites of malignant tumor metastasis, and bone metastasis usually correlates with the prognosis of disease, which leads to the important place of bone scintigraphy in the diagnosis of bone metastasis. Bone scan is widely used in clinical work for its high sensitivity as well as its low cost, revealing bone metabolism and blood flow, and no limitation of metal implantation. Compared with plain bone scan, SPECT/CT bone tomography shows better orientation of lesion, and has higher detection rates and specificity. This article reviews the diagnostic value of malignant tumor bone metastasis.
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