Diffusion-weighted images(DWI) without ADC values in assessment of small focal nodules in cirrhotic liver

Objective： To assess if diffusion-weighted magnetic resonance （MR） imaging without apparent diffusion coefficient （ADC） values provides added diagnostic value in combination with conventional MR imaging in the detection and characterization of small nodules in cirrhotic liver. Methods： Two observers retrospectively and independently analyzed 86 nodules （_〈3 em） certified pathologically in 33 patients with liver cirrhosis, including 48 hepatocellular carcinoma （HCC） nodules, 13 high-grade dysplastic nodules （HDN）, 10 low-grade dysplastic nodules （LDNs） and 15 other benign nodules. All these focal nodules were evaluated with conventional MR images （Tl-weighted, T2-weighted and dynamic gadolinium-enhanced images） and breath-hold diffusion-weighted images （DWI） （b=500 s/mm2）. The nodules were classified by using a scale of 1-3 （1, not seen; 3, well seen） on DWI for qualitative assessment. These small nodules were characterized by two radiologists. ADC values weren＇t measured. The diagnostic performance of the combined DWI-conventional images and the conventional images alone was evaluated using receiver operating characteristic （ROC） curves. The area under the curves （Az）, sensitivity and specificity values for characterizing different small nodules were also calculated. Results： Among 48 HCC nodules, 33 （68.8%） were graded as 3 （well seen）, 6 （12.5%） were graded as 2 （partially obscured）, and 9 weren＇t seen on DWI. Among 13 HDNs, there were 3 （23.1%） and 4 （30.8%） graded as 3 and 2 respectively. Five （50%） of 10 benign nodules were partially obscured and slightly hyperintense. For 86 nodules, the average diagnostic accuracy of combined DWI-conventional images was 82.56%, which was increased significantly compared with conventional MR images with 76.17%. For HCC and HDN, the diagnostic accuracy of combined DWI-conventional images increased from 78.69% to 86.07 %. Conclusions： Diffusion-weighted MR imaging does provide added diagnostic value in the detection and characterization of HDN and HCC, and it may not be helpful for LDN and regenerative nodule （RN） in cirrhotic liver.

Differences in brain pathological changes between rotenone and 6-hydroxydopamine Parkinson＇s disease models

Rotenone and 6-hydroxydopamine are two drugs commonly used to generate Parkinson＇s disease animal models.They not only achieve degenerative changes of dopaminergic neurons in the substantia nigra,but also satisfy the requirements for iron deposition.However,few studies have compared the characteristics of these two models by magnetic resonance imaging.In this study,rat models of Parkinson＇s disease were generated by injection of 3 μg rotenone or 10 μg 6-hydroxydopamine into the right substantia nigra.At 1,2,4,and 6 weeks after injection,coronal whole-brain T2-weighted imaging,transverse whole-brain T2-weighted imaging,and coronal diffusion tensor weighted imaging were conducted to measure fractional anisotropy and T2＊ values at the injury site.The fractional anisotropy value on the right side of the substantia nigra was remarkably lower at 6 weeks than at other time points in the rotenone group.In the 6-hydroxydopamine group,the fractional anisotropy value was decreased,but T2＊ values were increased on the right side of the substantia nigra at 1 week.Our findings confirm that the 6-hydroxydopamine-induced model is suitable for studying dopaminergic neurons over short periods,while the rotenone-induced model may be appropriate for studying the pathological and physiological processes of Parkinson＇s disease over long periods.

Detecting dopaminergic neuronal degeneration using diffusion tensor imaging in a rotenone-induced rat model of Parkinson's disease: fractional anisotropy and mean diffusivity values

Dopamine content in the basal ganglia is strongly associated with the degree of dopaminergic neuron loss in the substantia nigra pars com- pacta. Symptoms of Parkinson＇s disease might not arise until more than 50% of the substantia nigra pars compacta is lost and the dopamine content in the basal ganglia is reduced by more than 80%. Greater diagnostic sensitivity and specificity would allow earlier detection of Parkinson＇s disease. Diffusion tensor imaging is a recently developed magnetic resonance imaging technique that measures mean diffusiv- ity and fractional anisotropy, and responds to changes in brain microstructure. When the microscopic barrier （including cell membranes, microtubules and other structures that interfere with the free diffusion of water） is destroyed and extracellular fluid volume accumulates, the mean diffusivity value increases; when the integrity of the microstructure （such as myelin） is destroyed, fractional anisotropy value decreases. However, there is no consensus as to whether these changes can reflect the early pathological alterations in Parkinson＇s disease. Here, we established a rat model of Parkinson＇s disease by injecting rotenone （or sunflower oil in controls） into the right suhstantia nigra. Diffusion tensor imaging results revealed that in the stages of disease, at 1, 2, 4, and 6 weeks after rotenone injection, fiactional anisotropy value decreased, but mean diffusivity values increased in the right substantia nigra in the experimental group. Fractional anisotropy values were lower at 4 weeks than at 6 weeks in the right substantia nigra of rats from the experimental group. Mean diffusivity values were mark- edly greater at 1 week than at 6 weeks in the right corpus striatum of rats from the experimental group. These findings suggest that mean diffusivity and fractional anisotropy values in the brain of rat models of Parkinson＇s disease 4 weeks after model establishment can reflect early degeneration of dopaminergic neurons. ＇The change in fractional anisotropy values after destruction of myelin integrity is likely to be of greater early diagnostic significance than the change in mean diffusivity values.