目的采用静息态脑功能成像探索2型糖尿病患者早期脑部功能损伤。方法对18名2型糖尿病患者及18名健康志愿者进行脑部静息态功能成像及脑部结构像扫描,计算全脑局部一致性(regional homogeneity,ReHo)、低频振幅(amplitude of low frequency fluctuation,ALFF)及双侧海马、后扣带回的功能连接。统计学方法采用成组t检验。结果 2型糖尿病患者较正常对照ReHo减低脑区主要位于右侧丘脑、海马、嗅皮质及左侧壳核,ALFF减低脑区主要位于左侧额中回及右侧缘上回、枕中回。2型糖尿病患者较正常对照海马功能连接主要表现双侧海马之间功能连接的减低,但与其他脑区之间无显著功能连接减低区域;双侧后扣带回与其他脑区之间未见显著功能连接减低区域。结论 2型糖尿病患者早期脑部静息态脑功能主要表现为局部脑区ReHo及ALFF的减低,双侧海马之间功能连接的减低,双侧后扣带回功能连接无显著改变。
目的探讨光谱CT定量增强参数对结直肠癌的诊断价值。方法对46例行腹盆部光谱CT三期增强的结直肠癌患者的能谱基数据进行处理,生成无水碘图、动脉增强分数(AEF)图及细胞外容积(ECV)图,分别测量肿瘤及正常肠壁的碘浓度(IC)、AEF及ECV值。采用独立样本t检验及Mann-Whitney U检验进行组间比较,并采用ROC曲线评价其诊断效能。结果结直肠癌病变的AEF及IC值大于正常肠壁AEF值及IC值(0.338±0.122 vs 0.225±0.072,1.007±0.402 mg/mL vs 0.599±0.229 mg/mL,P<0.0001),ECV在结直肠癌病变与正常肠壁间的差异无统计学意义(P>0.999)。AEF、IC、ECV及三者联合诊断结直肠癌的ROC曲线下面积分别为0.806、0.797、0.671及0.842,其约登指数分别为0.565、0.565、0.326及0.609。三者联合诊断结直肠癌的截断值为0.660,敏感度为63.04%,特异性为97.83%,其逻辑回归方程为Y=13.75×AEF+16.30×ECV-6.70。结论光谱CT定量增强参数AEF、ECV及IC联合诊断对结直肠癌的诊断具有一定价值。
目的通过MRI评估颞下颌关节紊乱病患者髁突位置及形态的变化,为临床提供参考。方法对2011年11月至2019年4月解放军总医院放射科及解放军总医院海南医院放射科门诊就诊的137例临床诊断为颞下颌关节紊乱病的患者[年龄(37.5±16.1)岁,男性39例,女性98例]进行颞下颌关节MRI扫描,根据关节盘移位情况分为关节盘位置正常组(disc without displacement,DWoD)(185侧关节),关节盘可复性前移位组(anterior disc displacement with reduction,DDWR)(17侧关节)及关节盘不可复性前移位组(disc displacement without reduction,DDWoR)(72侧关节),观察颞下颌关节髁突位置(前位、中立位及后位)和形态(卵圆形、扁平形及鸟嘴形),并在横轴位T2WI图像上测量髁突长轴和短轴长度。根据双侧关节盘移位情况分为正常组(74例)、单侧移位组(40例)及双侧移位组(23例),并在横断面T2WI上测量并比较3组髁间角。结果DWoD组、DDWR组和DDWoR组髁突位置差异无统计学意义(χ^2=7.435,P=0.115)。DWoD组扁平形髁突发生率[83.9%(115/137)]显著高于DDWoR组[50.7%(34/67)](P<0.05),DWoD组鸟嘴形髁突发生率[16.1%(22/137)]显著低于DDWoR组[49.3%(33/67)](P<0.05)。DWoD组髁突长轴长度[(17.2±2.4)mm]显著大于DDWR组[(15.4±2.0)mm]和DDWoR组[(14.7±2.7)mm](P<0.05)。DWoD组髁突短轴长度[(7.3±1.2)mm]显著大于DDWR组[(6.5±1.3)mm]和DDWoR组[(6.1±1.4)mm](P<0.05)。正常组、单侧移位组髁间角(分别为136°±13°和132°±14°)均显著大于双侧移位组(124°±17°)(P<0.05)。结论颞下颌关节紊乱病患者群中颞下颌关节盘移位患者可见髁突形态显著改变。
Objective To investigate cerebral structural signatures of the bulbar-and spinal-onset amyotrophic lateral sclerosis(ALS) using voxel-based morphometry on magnetic resonance imaging.Methods The MR structural images of the brain were obtained from 65 ALS patients(15 bulbar-onset, 50 spinalonset) and 65 normal controls(NC) on a 3.0 T MRI system. Gray matter(GM) volume changes were investigated by voxel-based morphometry, and the distribution of the brain regions with volume changes was compared between ALS and normal controls, as well as between bulbar-onset and spinal-onset ALS based on Neuromorphometrics atlas.Results On voxel-level the decreased volume of brain regions in ALS patients was located in the right precentral gyrus(r Prc Gy) and right middle frontal gyrus compared with that in NC. The bulbar-onset ALS presented extramotor cortex atrophy(fronto-temporal pattern), including left medial orbital gyrus, left inferior temporal gyrus and right middle temporal gyrus; the spinal-onset ALS suffered from motor cortex atrophy(r Prc Gy dominance) and extra-motor cortex atrophy(fronto-temporal and extra-fronto-temporal pattern) compared with NC. The spinal-onset ALS featured by GM volume loss of left postcentral gyrus and bulbar-onset ALS featured by GM volume loss of left middle temporal gyrus compared with each other. Conclusions The asymmetric GM atrophy of the motor cortex and extra-motor cortex represents the common MRI structural signatures of spinal-onset ALS, and sole extra-motor cortex atrophy represents the structural signatures of bulbar-onset ALS. The present study also demonstrated that the pattern of GM damage is likely to distribute wider in spinal-onset ALS than in bulbar-onset ALS.
Objective To evaluate the reliability of three dimensional spiral fast spin echo pseudo-continuous arterial spin labeling(3 D pc-ASL) in measuring cerebral blood flow(CBF) with different post-labeling delay time(PLD) in the resting state and the right finger taping state.Methods 3 D pc-ASL and three dimensional T1-weighted fast spoiled gradient recalled echo(3 D T1-FSPGR) sequence were applied to eight healthy subjects twice at the same time each day for one week interval. ASL data acquisition was performed with post-labeling delay time(PLD) 1.5 seconds and 2.0 seconds in the resting state and the right finger taping state respectively. CBF mapping was calculated and CBF value of both the gray matter(GM) and white matter(WM) was automatically extracted. The reliability was evaluated using the intraclass correlation coefficient(ICC) and Bland and Altman plot.Results ICC of the GM(0.84) and WM(0.92) was lower at PLD 1.5 seconds than that(GM, 0.88; WM, 0.94) at PLD 2.0 seconds in the resting state, and ICC of GM(0.88) was higher in the right finger taping state than that in the resting state at PLD 1.5 seconds. ICC of the GM and WM was 0.71 and 0.78 for PLD 1.5 seconds and PLD 2.0 seconds in the resting state at the first scan, and ICC of the GM and WM was 0.83 and 0.79 at the second scan, respectively.Conclusion This work demonstrated that 3 D pc-ASL might be a reliable imaging technique to measure CBF over the whole brain at different PLD in the resting state or controlled state.
