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ABSTRACT: AIM: This study aimed to investigate the anatomy and mechanism of pseudolesions around falciform ligament, which appeared on dynamic contrast magnetic resonance (MR) imaging. METHODS: A total of 30 cases were included in the normal control group (group 1), and 30 cases were enrolled into the liver cirrhosis group (group 2). All cases underwent MR examination including in-phase and out-phase T1-weighted image, T2-weighted fat-suppressed image, and dynamic MR imaging enhancement scanning. The MR images were analyzed to detect pseudolesions, and results from the 2 groups were compared. An ultrasound examination was also performed in all cases to assess the abdominal umbilical vein blood flow. RESULTS: In group 1, MR images detected pseudolesions in 13 cases, and signal reduction did not appear in out-phase MR images compared with in-phase MR images. In 5 of these cases, the umbilical vein was observed to be connected with the hepatic IV segment, and direction flow was toward hepatic during Doppler ultrasound examination. In the 30 patients with liver cirrhosis, pseudolesions were not detected in any of the cases, dilation of the vena epigastricas was observed in 12 cases, and flow direction was from liver. The difference in the incidence of falciform ligament pseudolesions between group 1 and group 2 was statistically significant (P > 0.01). CONCLUSIONS: Pseudolesions around the falciform ligament are associated with the Sappey vein, and there is no significant relationship with fatty infiltration.
Journal of computer assisted tomography 03/2013; 37(2):149-153. · 1.38 Impact Factor
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ABSTRACT: To enhance diagnosis of gastrointestinal neuroendocrine carcinomas using CT and contrast-enhanced CT images.
A total of 44 patients with gastrointestinal neuroendocrine carcinomas, as confirmed by clinical pathology and immunohistochemistry in the Sixth Affiliated People's Hospital of Shanghai Jiao Tong University Shanghai China, were included in the study. CT and enhanced CT scanning were performed, and the resulting images were reviewed and analyzed.
Twenty-seven males and 17 females were enrolled. Gastrointestinal involvement included the following: 5 cases located in the middle or inferior segment of the esophagus; 5 in the gastric cardia, 15 in the body of stomach, 6 located in the gastric antrum; 5 located in the Vater papilla of the duodenum; and 8 located in the colon. Among the 44 cases 80%-90% of the lesions had homogeneous density. Totally 81.8% (36/44) cases demonstrated homogeneous enhancement in arterial phases, most of the cases (n = 33) moderately or obviously enhanced. Only 17.2% (8/44) cases appeared as heterogeneous enhancement. And 86.4% cases (n = 38) were further enhanced in the venous phase. The CT images also revealed some of the metastases. Some liver metastasis cases have obvious homogeneous enhancement.
CT and enhanced CT provide useful information regarding gastrointestinal neuroendocrine carcinomas' location, density, enhancement pattern, and some metastasis. These features are helpful to increase the diagnostic accuracy.
Abdominal Imaging 02/2012; 37(5):738-45. · 1.73 Impact Factor
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ABSTRACT: We report a primary hemangiopericytoma in the right tentorium with multiple metastases within 5 years after tumor subtotal resection. The patient was treated with conventional radiotherapy and interventional radiology techniques. The patient is still alive until now. It is obvious that the subtotal resection of the tumor accelerated the speed of the extracranial metastasis in this case.
Neurosurgery Quarterly 01/2012; 22(1):16–18. · 0.10 Impact Factor
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ABSTRACT: To quantify age-dependent iron deposition changes in healthy subjects using Susceptibility Weighted Imaging (SWI).
In total, 143 healthy volunteers were enrolled. All underwent conventional MR and SWI sequences. Subjects were divided into eight groups according to age. Using phase images to quantify iron deposition in the head of the caudate nucleus and the lenticular nucleus, the angle radian value was calculated and compared between groups. ANOVA/Pearson correlation coefficient linear regression analysis and polynomial fitting were performed to analyze the relationship between iron deposition in the head of the caudate nucleus and lenticular nucleus with age.
Iron deposition in the lenticular nucleus increased in individuals aged up to 40 years, but did not change in those aged over 40 years once a peak had been reached. In the head of the caudate nucleus, iron deposition peaked at 60 years (p<0.05). The correlation coefficients for iron deposition in the L-head of the caudate nucleus, R-head of the caudate nucleus, L-lenticular nucleus and R-lenticular nucleus with age were 0.67691, 0.48585, 0.5228 and 0.5228 (p<0.001, respectively). Linear regression analyses showed a significant correlation between iron deposition levels in with age groups.
Iron deposition in the lenticular nucleus was found to increase with age, reaching a plateau at 40 years. Iron deposition in the head of the caudate nucleus also increased with age, reaching a plateau at 60 years.
PLoS ONE 01/2012; 7(11):e50706. · 4.09 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and its quantitative coefficient (K(trans)) in the assessment of the extent of traumatic brain injury (TBI) in a rabbit model.
A weight-drop device (height, 20 cm) was used with varying impact force, 30-, 60-, or 90-g weight, to induce mild, moderate, or severe TBI, respectively. DCE-MRI and T2-weighted MRI was used to examine the injured groups and a sham group 1 day after TBI. We analyzed the relationship between K(trans) and the lesion volume on the basis of T2-weighted images in each group.
The lesion volumes in both the severe and the moderate injury groups were greater than those observed in the mild injury group (p < 0.01). Furthermore, the lesion volumes in the severe injury group tended to be greater than those seen in the moderate injury group (p = 0.053). The K(trans) values in all injury groups were greater than those observed in the sham group (p < 0.01). In addition, the K(trans) values in the severe and moderate injury groups were greater than those of the mild injury group (p < 0.01), and the values seen in the severe injury group tended to be greater than those of the moderate injury group (p = 0.08). Moreover, we observed a correlation between the K(trans) value and lesion volume in all injury groups (mild injury group: r = 0.766, p = 0.01; moderate injury group: r = 0.731, p = 0.04; and severe injury group: r = 0.886, p = 0.019).
DCE-MRI and its quantitative coefficient, K(trans), have the potential to accurately assess the blood-brain barrier and the extent of injury in an in vivo model of TBI.
The Journal of trauma 12/2011; 71(6):1645-50; discussion 1650-1. · 2.48 Impact Factor
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ABSTRACT: We use multiple MRI modalities to measure cerebral edema and intracerebral hemorrhage quantitatively after TBI in rabbits and to acquire the early prognostic MRI information. Multiple MRI modalities (DCE-MRI, DWI and SWI) were used to assess cerebral edema and intracerebral hemorrhage quantitatively at different time points within a month after TBI in 15 rabbits. The functional outcomes were evaluated at 1 and 30 days after TBI. The relationships between the quantitative MRI information at different time points and functional outcome at 30 days were analyzed. The volume transfer coefficient (K (trans)) in the focal lesion area and the perifocal lesion area at the acute phase correlated with the functional outcome at 30 days (p < 0.05). The apparent diffusion coefficient (ADC) value at 7 days in the focal lesion area correlated with the functional outcome at 30 days (p < 0.01) and had a trend to correlate at 3 days (p = 0.08). In the perifocal lesion area, the ADC values at both acute and subacute phase correlated with the functional outcome at 30 days (p < 0.05). The volume of hemorrhage correlated with functional outcome at 30 days (p < 0.05). The cerebral edema assessed by DCE-MRI (K (trans)) and DWI (ADC) and intracerebral hemorrhage assessed by SWI may have predictive values.
Neurological Sciences 09/2011; 33(4):731-40. · 1.32 Impact Factor
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ABSTRACT: To improve the diagnosis of heterotopic pancreas by the use of contrast-enhanced computed tomography (CT) imaging and CT virtual endoscopy (CTVE).
A total of six patients with heterotopic pancreas, as confirmed by clinical pathology and immunohistochemistry in the Sixth Affiliated People's Hospital of Shanghai Jiao Tong University, Shanghai, China, were included. Non-enhanced CT and enhanced CT scanning were performed, and the resulting images were reviewed and analyzed using three-dimensional post-processing software, including CTVE.
Four males and two females were enrolled. Several heterotopic pancreas sites were involved; three occurred in the stomach, including the gastric antrum (n = 2) and lesser curvature (n = 1), and two were in the duodenal bulb. Only one case of heterotopic pancreas lesion occurred in the mesentery. Four cases had a solid yet soft tissue density that had a homogeneous pattern when viewed by enhanced CT. Additionally, their CT values were similar to that of the pancreas. The ducts of the heterotopic pancreas tissue, one of the characteristic CT features of heterotopic pancreas tissue, were detected in the CT images of two patients. CTVE images showed normal mucosa around the tissue, which is also an important indicator of a heterotopic pancreas. However, none of the CTVE images showed the typical signs of central dimpling or umbilication.
CT, enhanced CT and CTVE techniques provide useful information about the location, growth pattern, vascularity, and condition of the gastrointestinal wall around heterotopic pancreatic tissue.
World Journal of Gastroenterology 09/2011; 17(33):3850-5. · 2.47 Impact Factor
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ABSTRACT: Abstract To understand the dynamics of brain edema in different areas after traumatic brain injury (TBI) in rabbit, we used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) to monitor blood-brain barrier (BBB) permeability and cytotoxic brain edema after weight drop-induced TBI in rabbit. The dynamics of BBB permeability and brain edema were quantified using K(trans) and apparent diffusion coefficient (ADC) in the focal and perifocal lesion areas, as well as the area contralateral to the lesion. In the focal lesion area, K(trans) began to increase at 3 h post-TBI, peaked at 3 days, and decreased gradually while remaining higher than sham injury animals at 7 and 30 days. ADC was more variable, increased slightly at 3 h, decreased to its lowest value at 7 days, then increased to a peak at 30 days. In the perifocal lesion area, K(trans) began to increase at 1 day, peaked at 3-7 days, and returned to control level by 30 days. ADC showed a trend to increase at 1 day, followed by a continuous increase thereafter. In the contralateral area, no changes in K(trans) and ADC were observed at any time-point. These data demonstrate that different types of brain edema predominate in the focal and perifocal lesion areas. Specifically cytotoxic edema was predominant in the focal lesion area while vasogenic edema predominated in the perifocal area in acute phase. Furthermore, secondary opening of the BBB after TBI may appear if secondary injury is not controlled. BBB damage may be a driving force for cytotoxic brain edema and could be a new target for TBI intervention.
Journal of neurotrauma 06/2011; 29(14):2413-20. · 4.25 Impact Factor
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Y-D Li,
M-H Li,
B-L Gao,
C Fang,
Y-S Cheng,
W Wang, W-B Li,
J-G Zhao,
P-L Zhang,
J Wang,
M Li
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ABSTRACT: To report our experiences in the treatment of recurrent intracranial aneurysms with re-coiling or covered stents.
A total of 291 patients with 305 intracranial aneurysms were treated with detachable coils, and 41 (28.9%) of 142 patients with aneurysms in the internal carotid artery had a recurrent aneurysm during the follow-up period. For this study, 31 recurrent aneurysms in 31 patients who had angiograms within 6 months following retreatment with detachable coils (group A, n = 20) or covered stents (group B, n = 11) were analysed. Aneurysms were categorised as complete or incomplete occlusion via angiographic assessment and graded as full recovery, improvement, no change or deterioration via clinical assessment. Data regarding technical success, initial and final angiographic results, mortality, morbidity and final clinical outcome were collected and analysed postoperatively.
Coil embolisation and covered stent placement were technically successful in all recurrent aneurysms. The initial angiographic results showed complete occlusion in 11 patients (55%) in group A and in eight (72.7%) in group B (p = 0.452), and the final angiographic results exhibited complete occlusion in 10 patients (50%) in group A and in 11 (100%) in group B (p = 0.005). There were no significant differences in technique success, mortality, culminate morbidity or final clinical outcome between the two groups.
Recurrent aneurysms after coiling can be successfully treated and occluded with re-coiling or covered stent placement. However, covered stents seem to be more effective than re-coiling with regard to complete occlusion of recurrent aneurysms.
Journal of neurology, neurosurgery, and psychiatry 09/2009; 81(1):74-9. · 4.87 Impact Factor
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Headache The Journal of Head and Face Pain 08/2009; 49(8):1229-31. · 2.52 Impact Factor
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ABSTRACT: The present study evaluated the clinical results of covered tracheobronchial metallic stent placement in the management of gastrotracheal fistulas (GTFs) and gastrobronchial fistulas (GBFs).
Sixteen patients with GTFs or GBFs after esophagogastrectomy were treated with one of two types of covered tracheobronchial metallic stents: a hinged stent or a straight stent. These included 12 GTFs and four GBFs. Thirteen hinged stents and three straight stents were placed during the initial procedure. Data regarding the technical success of stent placement, initial clinical success and failure, fistula reopening, and complications were obtained.
Stent placement was technically successful in all patients. The stent completely sealed off the fistula in 12 of 16 patients (75% initial clinical success rate), whereas the remaining four patients (25%) had persistent aspiration symptoms as a result of incomplete GTF or GBF closure (ie, initial clinical failure). During follow-up, the fistula reopened in three of the 12 patients in whom initial clinical success was achieved (25%). Two reopened fistulas were sealed off with stent placement, and one was treated with a nasoenteric feeding tube and a nasogastric decompression tube. All patients died during the 1-year follow-up period; mean survival time was 17 +/- 3.02 weeks (range, 1-42 weeks) after stent placement. Mean survival in patients in whom initial clinical success was achieved was significantly longer than in patients with initial clinical failure (P = .003; log-rank test).
Use of covered metallic stents appears to be a safe and moderately effective procedure to occlude GTFs and GBFs.
Journal of Vascular and Interventional Radiology 11/2006; 17(10):1649-56. · 2.08 Impact Factor
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ABSTRACT: ObjectiveTo evaluate if the combination of both prone position on a belly board and intensity-modulated radiotherapy (IMRT) further
reduces the radiation dose to small bowel in pelvic RT for gynecologic malignancies.
MethodsConformal pelvic RT plans were computed in 13 patients with gynecologic malignancies who had pre-existing planning computed
tomography (CT) scans in both the supine position and prone position on a belly board. There were 10 cervical cancer and 3
endometrial cancer patients. A limited arc technique (180° arc length) and an extended arc technique (340° arc length) were
used in IMRT plans. Normal tissue regions of interest (ROI) included small bowel, large bowel and bladder. Dose and volume
for normal tissue structures were traced and compared between supine and prone plans using the paired t-test.
ResultsFor the limited arc technique, prone position using a belly board device improved small bowel sparing. Analysis of the results
showed a 12∼26 Gy reduction of volume of small bowel irradiation compared to the supine position. With the extended arc technique,
there was no obvious radiation reduction in the prone position. Large bowel and bladder dose showed no significant differences
between prone and supine position with either technique.
ConclusionProne positioning on a belly board decreases the small bowel dose in gynecologic pelvic IMRT, and the magnitude of improvement
depended on the limited arc IMRT technique used.
Chinese Journal of Cancer Research 02/2006; 18(1):51-56. · 0.18 Impact Factor
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ABSTRACT: Objective: To study the clinical significance of the morphological and volume changes in cervical cancer during an ongoing
course of radiation therapy (RT) using MR imaging. Methods: Serial MR imaging examinations were performed in 60 advanced cervical
cancer patients. MR imaging was obtained at the start of RT, at 20–25 Gy (2–2.5 weeks of RT), at 45–50 Gy (4–5 weeks of RT),
and 1–2 month post-RT. Tumor morphology was classified qualitatively as well-defined (round/oval with a well-demarcated smooth
margin) vs. lobulated vs. irregular and tumor volume was assessed in each serial MR examination independently by ROI volumetry
and diameter volumetry. ROI volumetry was traced on the computer workstation with a trackball in each sagittal T2-weighted
image and calculated by the summation of all tumor areas in each slice and multiplication by the slice profile. Diameter volumetry
was to measure the largest three orthogonal tumor diameters in each orthogonal measurement plane and calculate as an ellipsoid
formula (V=d1×d2×d3×π/6). Serial tumor volume was compared between the two measurement methods. Results: The proportion of lobulated and irregular
tumors increased early during RT and declined lately post-RT (68% pre-RT, 80% at 2–2.5 weeks of RT, 72% at 4–5 weeks of RT,
33% post-RT). Accordingly, ROI volumetry and diameter volumetry correlated well pre-RT (r1=0.89) and post-RT (r4=0.80), but poorly during RT (r2=0.17 at 2–2.5 weeks of RT, r3=0.69 at 4–5 weeks of RT). Conclusions: Cervical cancers regress in a non-uniform fashion during RT and undergo increasingly
irregular shrinkage. Measurement with ROI volumetry techniques, which can optimally measure irregular volumes, provides better
assessment of radiation response during treatment than diameter volumetry.
Chinese Journal of Cancer Research 05/2004; 16(2):137-141. · 0.18 Impact Factor
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ABSTRACT: A 12-week-old baby with a vein of Galen aneurysmal malformation (VGAM) was successfully treated with performing transarterial microcatheter-directed embolization with Berenstein Liquid Coils and n-butyl cyanoacrylate in the feeding arteries. Post-procedure angiography showed a marked decrease of the blood flow into the dilated vein of Galen. Three months later, follow-up angiography showed that the vein of Galen aneurysmal malformation had totally disappeared, and the baby recovered very well without any sequelae. We report here on this interesting case along with a review of the relevant literature, and we aim to enhance physicians' awareness of the treatment for VGAMs.
Korean Journal of Radiology 8(2):164-8. · 1.54 Impact Factor
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ABSTRACT: To compare diffusion tensor image (DTI) study in association fiber tracts among normal control (NC), amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) subjects. To assess diagnostic value of DTI in aMCI and differential diagnosis of DTI study between aMCI and AD.
DTI was used to assess changes in cerebral association fiber tracts in NC, aMCI, and AD subjects (n = 20/group). Regions of interest included the inferior fronto-occipital fascicles (IFOF), superior longitudinal fascicles and cingulum tract, genu of corpus callosum (Gcc) was set right, splenium of corpus callosum was set left. Bilateral fractional anisotropy (FA) and apparent diffusion coefficient values were compared in three groups.
Relative to NC, aMCI subjects had significantly different FA values for the IFOF and cingulum tract, while AD subjects had significantly different FA values of IFOF, Gcc, and cingulum tract. Relative to aMCI, AD subjects had significantly different FA values of cingulum tract.
Based on the results, DTI could be used as a diagnostic method for aMCI with abnormal changes in IFOF and cingulum tract. DTI could also be used for differential diagnosis of aMCI and AD by comparing FA values of the cingulum tract. Abnormal FA values of IFOF, Gcc, and cingulum tract in AD patients may help to elucidate the pathological processes in this disease.
Neurology India 59(2):168-73. · 0.96 Impact Factor
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ABSTRACT: Aim: To quantify iron deposition in Alzheimer's disease (AD), amnestic mild cognitive impairment (aMCI), and control individuals using susceptibility weighted imaging (SWI). Materials and Methods: Sixty participants (22 aMCI, 20 AD, 18 normal controls) underwent conventional magnetic resonance imaging (MRI) and SWI using axial/oblique coronal sequences. Phase images were used to calculate bilateral iron deposition in 18 regions of interest (ROI). The radian angle value was calculated and compared between the three participant groups. Results: The difference in radian angle value was significant between the aMCI and control groups in the left (L)-hippocampus, L-head of the caudate nucleus, R-lenticular nucleus, L-lenticular nucleus (P =0.02239, <0. 001, 0.03571, 0.00943, respectively). The difference in radian angle value was significant between the AD and aMCI groups in the R-cerebellar hemisphere, L-cerebellar hemisphere, R-hippocampus, L-hippocampus, R-red nucleus, R-thalamus, L-thalamus, and splenium of corpus callosum (P =0.02754, 0.01839, 0.00934, 0.04316, 0.02472, 0.00152, <0.001, 0.01448, respectively). Pearson correlation coefficients of the Mini-Mental State Examination score were all significant for the bilateral cerebellar hemisphere, hippocampus, red nucleus, lenticular nucleus, thalamus, R-head of the caudate nucleus, and splenium of corpus callosum. Conclusion: Iron deposition in the hippocampus, head of the caudate nucleuslenticular nucleus, and thalamus are significantly different between individuals with aMCI, AD, and controls. The thalamus is a particularly sensitive area. Using SWI to quantify the iron deposition is a useful tool in detecting aMCI and AD.
Neurology India 61(1):26-34. · 0.96 Impact Factor
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ABSTRACT: To analyze the value of readout-segmented echo-planar imaging (rs-EPI) with parallel imaging and a two-dimensional (2D) navigator-based reacquisition technique in the detection of brain lesions at the skull base.
A total of 54 patients (male 37, female 17) with suspected skull-base intracranial lesions underwent magnetic resonance imaging (MRI), including pre-T1 weighted imaging, T2-weighted imaging, Fluid Attenuated Inversion Recovery (FLAIR), standard single shot echo-planar imaging diffusion weighted imaging (ss-EPI DWI) and rs-EPI DWI, post-contrast T1-weighted. The total number of lesions and the number of lesions at different sites on all MRI sequences were used as reference measures. Then differences in detecting lesions and image quality between standard ss-EPI DWI and rs-EPI DWI were analyzed.
There was a significant difference in the total number of lesions detected by rs-EPI DWI and standard ss-EPI DWI (P = 0.01). But this difference was mainly due to an improved ability of rs-EPI DWI to detect lesions located in the anterior cranial fossa, compared to ss-EPI DWI (P=0.02); the ability of ss-EPI and rs-EPI DWI to detect lesions in the middle cranial fossa and posterior cranial fossa was not significantly different (P = 0.471, P = 0.486, respectively). For image quality, rs-EPI images were significantly better than standard ss-EPI DWI images (P<0.001).
The rs-EPI DWI technique is a useful tool for the detection and evaluation of lesions located at the skull base.
Neurology India 59(6):839-43. · 0.96 Impact Factor
