Investigating the relationship between intracranial atherosclerotic plaque remodelling and diabetes using high-resolution vessel wall imaging

BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.

APT联合mDIXON-Quant成像对前列腺癌和前列腺增生的鉴别诊断价值

目的:探讨酰胺质子转移加权(APT)成像联合脂肪和R2*定量成像(mDIXON-Quant)对前列腺癌(PCa)与前列腺增生(BPH)的鉴别诊断价值。方法:回顾性分析72例经病理证实的前列腺癌(34例)及前列腺增生(38例)患者的病例资料,均于术前行3.0T MRI扫描,包括常规T1WI、T2WI抑脂、DWI、APT及mDIXON-Quant序列。由两位观察者分别在APT与DWI的融合图及mDIXON-Quant与DWI的融合图上勾画感兴趣区(ROI),测量得到相应的APT、FF、R2*和T2*值。通过组内相关系数(ICC)评估观察者间测量的一致性。采用受试者工作特征(ROC)曲线评价APT及mDIXON-Quant各参数的阈值及诊断效能,采用逻辑回归分析将两个序列参数进行联合并评估其诊断效能。采用Delong检验比较ROC曲线下面积(AUC)的差异,采用Spearman检验两个序列有统计学差异参数的相关性。结果:2位观察者测得两组参数的一致性良好(ICC均>0.75);PCa组的APT值、FF值、R2*值分别为3.033%(2.392,3.808)、2.633%(1.918,3.550)、19.158s-1(15.357,25.375),BPH组的APT值、FF值、R2*值分别为1.767%(1.258,2.208)、1.067%(0.800,1.500)、16.783s-1(15.300,18.175),PCa组明显高于BPH组,差异均有统计学意义(P值均<0.05);PCa组的T2*值为57.017 ms(44.933,67.018),BPH组为61.517 ms(58.483,68.354),PCa组明显低于BPH组,差异有统计学意义(P<0.01)。ROC曲线分析结果显示,APT、FF、R2*、T2*值鉴别诊断PCa与BPH的效能分别为0.805、0.870、0.656、0.655,FF值的鉴别诊断效能显著高于R2*值(P=0.002)和T2*值(P=0.002)。APT联合mDIXON-Quant序列鉴别诊断PCa与BPH的效能为0.913,显著高于APT(P=0.041)和mDIXON-Quant(P=0.032)。相关性分析结果显示APT值与FF值、FF值与R2*值之间存在低度正相关,FF值与T2*值之间存在低度负相关,R2*值与T2*值之间存在高度负相关。结论:APT及mDIXON-Quant两种序列均可有效鉴别PCa与BPH,其中FF值的诊断效能最高,两种技术联合能大幅提升鉴别诊断效能。

Quantitative parameters in novel spectral computed tomography:Assessment of Ki-67 expression in patients with gastric adenocarcinoma

BACKGROUND The level of Ki-67 expression has served as a prognostic factor in gastric cancer.The quantitative parameters based on the novel dual-layer spectral detector computed tomography(DLSDCT)in discriminating the Ki-67 expression status are unclear.AIM To investigate the diagnostic ability of DLSDCT-derived parameters for Ki-67 expression status in gastric carcinoma(GC).METHODS Dual-phase enhanced abdominal DLSDCT was performed preoperatively in 108 patients with gastric adenocarcinoma.Primary tumor monoenergetic CT attenuation value at 40-100 kilo electron volt(kev),the slope of the spectral curve(λ_(HU)),iodine concentration(IC),normalized IC(nIC),effective atomic number(Z^(eff))and normalized Z^(eff)(nZ^(eff))in the arterial phase(AP)and venous phase(VP)were retrospectively compared between patients with low and high Ki-67 expression in gastric adenocarcinoma.Spearman’s correlation coefficient was used to analyze the association between the above parameters and Ki-67 expression status.Receiver operating characteristic(ROC)curve analysis was performed to compare the diagnostic efficacy of the statistically significant parameters between two groups.RESULTS Thirty-seven and 71 patients were classified as having low and high Ki-67 expression,respectively.CT_(40 kev-VP),CT_(70 kev-VP),CT_(100 kev-VP),and Z^(eff)-related parameters were significantly higher,but IC-related parameters were lower in the group with low Ki-67 expression status than the group with high Ki-67 expression status,and other analyzed parameters showed no statistical difference between the two groups.Spearman’s correlation analysis showed that CT_(40 kev-VP),CT_(70 kev-VP),CT_(100 kev-VP),Z^(eff),and n Z^(eff) exhibited a negative correlation with Ki-67 status,whereas IC and nIC had positive correlation with Ki-67 status.The ROC analysis demonstrated that the multi-variable model of spectral parameters performed well in identifying the Ki-67 status[area under the curve(AUC)=0.967;sensitivity 95.77%;specificity 91.89%)].Nevertheless,the differentiating capabilities of singlevariable model were moderate(AUC value 0.630-0.835).In addition,the nZ_(VP)^(eff) and nIC_(VP)(AUC 0.835 and 0.805)showed better performance than CT_(40 kev-VP),CT_(70 kev-VP) and CT_(100 kev-VP)(AUC 0.630,0.631 and 0.662)in discriminating the Ki-67 status.CONCLUSION Quantitative spectral parameters are feasible to distinguish low and high Ki-67 expression in gastric adenocarcinoma.Z^(eff) and IC may be useful parameters for evaluating the Ki-67 expression.

Relationship of Microvascular Obstruction with Global and Regional Myocardial Function Determined by Cardiac Magnetic Resonance after ST-Segment Elevation Myocardial Infarction

Objective To investigate the impact of microvascular obstruction(MVO)on the global and regional myocardial function by cardiac magnetic resonance feature-tracking(CMR-FT)in ST-segment-elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention.Methods Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1-7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study.Based on the presence or absence of MVO on late gadolinium enhancement images,patients were divided into groups with MVO and without MVO.The infarct zone,adjacent zone,and remote zone were determined based on a myocardial 16-segment model.The radial strain(RS),circumferential strain(CS),and longitudinal strain(LS)of the global left ventricle(LV)and the infarct,adjacent,and remote zones were measured by CMRFT from cine images and compared between patients with and without MVO using independent-samples t-test.Logistic regression analysis was used to assess the association of MVO with the impaired LV function.Results A total of 157 STEMI patients(mean age 56.66±11.38 years)were enrolled.MVO was detected in 37.58%(59/157)of STEMI patients,and the mean size of MVO was 3.00±3.76 mL.Compared with patients without MVO(n=98),the MVO group had significantly reduced LV global RS(t=-4.30,P<0.001),global CS(t=4.99,P<0.001),and global LS(t=3.51,P=0.001).The RS and CS of the infarct zone in patients with MVO were significantly reduced(t=-3.38,P=0.001;t=2.64,P=0.01;respectively)and the infarct size was significantly larger(t=8.37,P<0.001)than that of patients without MVO.The presence of LV MVO[OR=4.10,95%CI:2.05-8.19,P<0.001]and its size[OR=1.38,95%CI:1.10-1.72,P=0.01],along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis,while only heart rate(OR=1.08,95%CI:1.03-1.13,P=0.001)and LV infarct size(OR=1.10,95%CI:1.03-1.16,P=0.003)were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.Conclusion The infarct size was larger in STEMI patients with MVO,and MVO deteriorates the global and regional LV myocardial function.

超高场磁共振人体成像应用研究和医学前景

20世纪90年代初,随着第一代超高场磁共振成像仪的投入使用,因其诸多的优点,如更高的检测信噪比、更好的对比度、更强的BOLD效应和更宽的波谱,超高场磁共振成像成为国际医学磁共振领域最热门的研究方向之一.该文以最新一代的7.0 T MRI成像仪为例,简述超高场磁共振人体成像仪的系统结构、研究进展,并展望其在神经科学、认知科学和医学的应用前景.

Diffusion-weighted magnetic resonance imaging without bowel preparation for detection of ulcerative colitis

AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A total of 20 patients who underwent 3T magnetic resonance imaging(MRI) without bowel preparation and colonoscopy within 24 h were recruited.Biochemical indexes,including C-reactive protein(CRP),erythrocyte sedimentation rate,hemoglobin,leucocytes,platelets,serum iron and albumin,were determined.Biochemical examinations were then performed within 24 h before or after MR colonography was conducted.DWI was performed at various b values(b = 0,400,600,800,and 1000 s/mm2).Two radiologists independently and blindly reviewed conventional- and contrast-enhanced MR images,DWI and ADC maps; these radiologists also determined ADC in each intestinal segment(rectum,sigmoid,left colon,transverse colon,and right colon).Receiver operating characteristic(ROC) analysis was performed to assess the diagnostic performance of DWI hyperintensity from various b factors,ADC values and different radiological signs to detect endoscopic inflammation in the corresponding bowel segment.Optimal ADC threshold was estimated by maximizing the combination of sensitivity and specificity.MRfindings were correlated with endoscopic results and clinical markers; these findings were then estimated by ROC analysis.RESULTS: A total of 100 segments(71 with endoscopic colonic inflammation; 29 normal) were included.The proposed total magnetic resonance score(MR-score-T) was correlated with the total modified Baron score(Baron-T; r = 0.875,P < 0.0001); the segmental MR score(MR-score-S) was correlated with the segmental modified Baron score(Baron-S; r = 0.761,P < 0.0001).MR-score-T was correlated with clinical and biological markers of disease activity(r = 0.445 to 0.831,P < 0.05).MR-score-S > 1 corresponded to endoscopic colonic inflammation with a sensitivity of 85.9%,a specificity of 82.8% and an area under the curve(AUC) of 0.929(P < 0.0001).The accuracy of DWI hyperintensity was significantly greater at b = 800 than at b = 400,600,or 1000 s/mm2(P < 0.05) when endoscopic colonic inflammation was detected.DWI hyperintensity at b = 800 s/mm2 indicated endoscopic colonic inflammation with a sensitivity of 93.0%,a specificity of 79.3% and an AUC of 0.867(P < 0.0001).Quantitative analysis results revealed that ADC values at b = 800 s/mm2 differed significantly between endoscopic inflamed segment and normal intestinal segment(1.56 ± 0.58 mm2/s vs 2.63 ± 0.46 mm2/s,P < 0.001).The AUC of ADC values was 0.932(95% confidence interval: 0.881-0.983) when endoscopic inflammation was detected.The threshold ADC value of 2.18 × 10-3 mm2/s indicated that endoscopic inflammation differed from normal intestinal segment with a sensitivity of 89.7% and a specificity of 80.3%.CONCLUSION: DWI combined with conventional MRI without bowel preparation provides a quantitative strategy to differentiate actively inflamed intestinal segments from the normal mucosa to detect UC.

Non invasive blood flow measurement in cerebellum detects minimal hepatic encephalopathy earlier than psychometric tests

AIM: To assess whether non invasive blood flow measurement by arterial spin labeling in several brain regions detects minimal hepatic encephalopathy.

Evaluation of Glycosaminoglycan in the Lumbar Disc Using Chemical Exchange Saturation Transfer MR at 3.0 Tesla:Reproducibility and Correlation with Disc Degeneration

Objective This study aims to explore the clinical applicability and relevance of giycosaminoglycan Chemical Exchange Saturation Transfer （gagCEST） for intervertebral disc. Methods 25 subjects ranging in age from 24 yrs to 74 yrs were enrolled, gagCEST was acquired using a single-slice TSE sequence on a 3T. Saturation used a continuous rectangular RF pulse with B1=0.8 I^T and a fixed duration time =1100 ms. Sagittal image was obtained firstly without saturation pulse, and then saturated images were acquired at 52 offsets ranging from ＋0.i25 to ＋_7 parts per million （ppm）. MR T2 relaxivity map was acquired at the identical location. Six subjects were scanned twice to assess scan-rescan reproducibility. Results GagCEST intraclass correlation coefficient （ICC） of six subjects was 0.759 for nucleus pulposus （NP） and 0.508 for annulus fibrosus （AF）. Bland-Altman plots showed NP had a mean difference of 0.10% （95% limits of agreement： -3.02% to 3.22%）; while that of AF was 0.34% （95% limits of agreement： -2.28% to 2.95%）. For the 25 subjects, gag CEST in NP decreased as disc degeneration increased, with a similar trend to T2 relaxivity. Gag CEST of AF showed a better correlation with disc degeneration than T2 relaxivity. Conclusion GagCEST in NP and AF decreased as disc degeneration increased, while gagCEST in AF showed a better correlation than T2 relaxivity.

Prognostic Value of Feature-Tracking Circumferential Strain in Dilated Cardiomyopathy Patients with Severely Reduced Ejection Fraction Incremental to Late Gadolinium Enhancement

Myocardial fiber deformation measurements have been reported to be associated with adverse outcomes in patients with acute heart failure and those with myocardial infarction.However,few studies have addressed the prognostic value of global circumferential strain(GCS)in dilated cardiomyopathy(DCM)patients with severely impaired systolic function.This study aimed to evaluate the prognostic value of cardiac magnetic resonance(CMR)-derived GCS in DCM patients with severely reduced ejection.Consecutive DCM patients with severely reduced ejection fraction(EF<35%)who underwent CMR were included.GCS was calculated from CMR cine images.The clinical endpoint was a composite of all-cause mortality,heart transplantation,implantable cardioverter defibrillator(ICD)implantation and aborted sudden cardiac death(SCD).A total of 129 patients with a mean EF of 15.33%(11.36%–22.27%)were included.During a median follow-up of 518 days,endpoint events occurred in 50 patients.Patients with GCS≥the median(−5.17%)had significantly reduced event-free survival as compared with those with GCS<the median(P<0.01).GCS was independently associated with adverse events after adjusting for clinical and imaging risk factors including extent of late gadolinium enhancement(LGE)(P<0.05).Adding GCS into the model including the extent of LGE resulted in significant improvements in the C-statistic(from 0.706 to 0.742;P<0.05)with a continuous net reclassification improvement(NRI)of 29.71%.It was concluded that GCS derived from CMR could be useful for risk stratification in DCM patients with severely reduced EF,which may increase common imaging risk factors including LGE.

Virtual nonenhanced abdominal dual-energy MDCT:Analysis of image characteristics

AIM: To evaluate abdominal and pelvic image characteristics and artifacts on virtual nonenhanced (VNE) images generated from contrast-enhanced dual-energy multidetector computed tomography (MDCT) studies. METHODS: Hadassah-Hebrew University Medical Institutional Review Board approval was obtained; 22 patients underwent clinically-indicated abdominal and pelvic single-source dual-energy MDCT (Philips Healthcare, Cleveland, OH, USA), pre- and post-IV administration of Omnipaque 300 contrast (100 cc). Various solid and vascular structures were evaluated. VNE images were generated from the portal contrast-enhanced phase using probabilistic separation. Contrast-enhanced-, regular nonenhanced (RNE)-, and VNE images were evaluated with a total of 1494 density measurements. The ratio of iodine contrast deletion was calculated. Visualization of calcifications, urinary tract stones, and image artifacts in VNE images were assessed. RESULTS: VNE images were successfully generated in all patients. Significant portal-phase iodine contrast deletion was seen in the kidney (61.7%), adrenal gland (55.3%), iliac artery (55.0%), aorta (51.6%), and spleen (34.5%). Contrast deletion was also significant in the right atrium (RA) (51.5%) and portal vein (39.3%), but insignificant in the iliac vein and inferior vena cava (IVC). Average post contrast-to-VNE HU differences were significant (P < 0.05) in the: RA -135.3 (SD 121.8), aorta -114.1 (SD 48.5), iliac artery -104.6 (SD 53.7), kidney -30.3 (SD 34.9), spleen -9.2 (SD 8.8), and portal vein -7.7 (SD 13.2). Average VNE-to-RNE HU differences were significant in all organs but the prostate and subcutaneous fat: aorta 38.0 (SD 9.3), RA 37.8 (SD 16.1), portal vein 21.8 (SD 12.0), IVC 12.2 (SD 11.6), muscle 3.3 (SD 4.9), liver 5.7 (SD 6.4), spleen 22.3 (SD 9.8), kidney 40.5 (SD 6.8), and adrenal 20.7 (SD 13.5). On VNE images, 196/213 calcifications (92%) and 5/6 renal stones (84%) were visualized. Lytic-like artifacts in the vertebral bodies were seen in all studies. CONCLUSION: Iodine deletion in VNE images is most significant in arteries, and less significant in solid organs and veins. Most vascular and intra-abdominal organ calcifications are preserved.

Healthy individuals vs patients with bipolar or unipolar depression in gray matter volume

BACKGROUND Previous studies using voxel-based morphometry(VBM)revealed changes in gray matter volume(GMV)of patients with depression,but the differences between patients with bipolar disorder(BD)and unipolar depression(UD)are less known.AIM To analyze the whole-brain GMV data of patients with untreated UD and BD compared with healthy controls.METHODS Fourteen patients with BD and 20 with UD were recruited from the Mental Health Center of Shantou University between August 2014 and July 2015,and 20 nondepressive controls were recruited.After routine three-plane positioning,axial T2WI scanning was performed.The connecting line between the anterior and posterior commissures was used as the scanning baseline.The scanning range extended from the cranial apex to the foramen magnum.Categorical data are presented as frequencies and were analyzed using the Fisher exact test.RESULTS There were no significant intergroup differences in gender,age,or years of education.Disease course,age at the first episode,and Hamilton depression rating scale scores were similar between patients with UD and those with BD.Compared with the non-depressive controls,patients with BD showed smaller GMVs in the right inferior temporal gyrus,left middle temporal gyrus,right middle occipital gyrus,and right superior parietal gyrus and larger GMVs in the midbrain,left superior frontal gyrus,and right cerebellum.In contrast,UD patients showed smaller GMVs than the controls in the right fusiform gyrus,left inferior occipital gyrus,left paracentral lobule,right superior and inferior temporal gyri,and the right posterior lobe of the cerebellum,and larger GMVs than the controls in the left posterior central gyrus and left middle frontal gyrus.There was no difference in GMV between patients with BD and UD.CONCLUSION Using VBM,the present study revealed that patients with UD and BD have different patterns of changes in GMV when compared with healthy controls.

Assessment of Mechanical Properties of Muscles from Multi-Parametric Magnetic Resonance Imaging

We hypothesized that a relationship existed between the mechanical properties and the magnetic resonance imaging (MRI) parameters of muscles, as already demonstrated in cartilaginous tissues. The aim was to develop an indirect evaluation tool of the mechanical properties of degenerated muscles. Leg and arm muscles of adult rabbits were dissected, and tested 12 hours post mortem, in a state of rigor mortis, or 72 hours post mortem, in a state of post-rigor mortis. The tests consisted of a multi-parametric MRI acquisition followed by a uniaxial tensile test until failure. The statistical analysis consisted of multiple linear regressions and principal component analysis. Significant differences existed between the rigor mortis and post-rigor mortis groups for E but not for the MRI parameters. 78%, 60% or 33% of the Young’s modulus could be explained by the MRI parameters in the post-rigor mortis group, rigor mortis group or both groups respectively. These relationships were confirmed by the principal component analysis. The proposed multi-parametric MRI protocol associated to principal component analysis is a promising tool for the indirect evaluation of muscle mechanical properties and should be useful to find biomarkers and predictive factors of the evolution of the pathologies.

Evaluation of fetoplacental oxygenation in a rat model of gestational diabetes mellitus using BOLD-MRI at 7.0-T

Objective:To compare the differences in blood oxygen level-dependent(BOLD)parameters following maternal hyperoxia between normal pregnancy and pregnancy in the rat model of gestational diabetes mellitus(GDM).Methods:GDM was induced by high-fat and sucrose diet(HFS)combined with an intraperitoneal injection of streptozotocin(STZ).On embryonic day 19(E19),the two groups of pregnant rats were imaged using a 7.0-T animal MRI scanner.TurboRARE was initially used to localize the fetoplacental units(FPUs).Next,multiple gradient echo BOLD was performed during the air and oxygen inhalation periods.T2^(*)map was then generated,and the baseline T2^(*)and absolute changes in T2^(*)value(ΔT2^(*),difference between T2^(*)oxy and T2^(*)air)were calculated.Following the MRI scan,the placentas and fetuses were aseptically stripped,weighed,and immunostained.Results:Nine rats were used in this study.After maternal oxygen inhalation,T2^(*)increased significantly in all subjects in both groups.TheΔT2^(*)for the placenta(5.97 vs.7.81 msec;P=0.007)and fetal brain(2.23 vs.3.97 msec;P=0.005)differed significantly between the GDM and control groups.Histochemical detection of placental glycogen content and inflammatory cytokines(IL-6 and TNF-α)showed significantly higher levels in the GDM than in the normal placenta.Conclusions:BOLD-MRI revealed abnormalities in the fetoplacental response to maternal hyperoxygenation in rats with GDM.We believe that this approach can potentially be used to evaluate placental dysfunction and assess the state of the fetus during pregnancy with GDM.

Pudendal nerve lesions in young men with erectile dysfunction:imaging with 3T magnetic resonance neurography

Dear Editor,Erectile dysfunction(ED)is a major health problem worldwide that reduces the quality of life of many families.ED is recognized as a consistent or recurrent inability to achieve and/or maintain a penile erection sufficient for sexual satisfaction.Epidemiological data have shown that ED is associated with increasing age.?Nevertheless,the prevalence of ED is increasing in younger men(<40 years of age),with previous estimates as high as 30%.More recent studies have also reported organic causes in 5%-72%of ED patients<40 years old,and suggested involvement of the pudendal nerve(PN)as primary cause.3.4 The aim of this study was to evaluate the clinical utility of magnetic resonance neurography(MRN)for visualizing and quantifying PN changes in young men with ED.

Detection of brown adipose tissue in rats with acute cold stimulation using quantitative susceptibility mapping

To the Editor:Adipose tissue occurs in at least two different entities in mammals and humans:brown adipose tissue(BAT)and white adipose tissue(WAT).BAT is characterized by a unique uncoupling protein 1(UCP1)in the mitochondria that enables the uncoupling of the respiratory chain from adenosine triphosphate synthesis.Thus,energy is dissipated as heat to reduce fat accumulation.BAT is also considered a highly heterogeneous tissue with abundant oxygen,blood supply,and iron-rich mitochondria.[1,2]Activation of BAT via exposure to a cold environment is considered to be a means of reducing triglycerides to fight obesity.[3]The alterations in cells and tissues of activated BAT include increased iron content and UCP1 expression in mitochondrial,blood perfusion,and lipid utilization.[4]Therefore,accurate identification and quantitative analysis of inactive and activated BAT are of great significance for the treatment of metabolic diseases that target BAT,such as obesity.

Protocol for Brain Magnetic Resonance Imaging and Extraction of Imaging‑Derived Phenotypes from the China Phenobank Project

Imaging-derived phenotypes(IDPs)have been increasingly used in population-based cohort studies in recent years.As widely reported,magnetic resonance imaging(MRI)is an important imaging modality for assessing the anatomical structure and function of the brain with high resolution and excellent soft-tissue contrast.The purpose of this article was to describe the imaging protocol of the brain MRI in the China Phenobank Project(CHPP).Each participant underwent a 30-min brain MRI scan as part of a 2-h whole-body imaging protocol in CHPP.The brain imaging sequences included T1-magnetization that prepared rapid gradient echo,T2 fuid-attenuated inversion-recovery,magnetic resonance angiography,difusion MRI,and resting-state functional MRI.The detailed descriptions of image acquisition,interpretation,and post-processing were provided in this article.The measured IDPs included volumes of brain subregions,cerebral vessel geometrical parameters,microstructural tracts,and function connectivity metrics.

3.0T磁共振扩散张量成像诊断前列腺外周带癌的初步研究

目的应用3.0 T磁共振成像系统探讨扩散张量成像(DTI)诊断前列腺外周带癌的价值。资料与方法搜集在3.0 T MR行前列腺检查并经穿刺活检证实的33例前列腺病变患者资料。扫描序列包括矢、冠、轴位TSET2WI序列及轴位单次激发平面回波成像(SS-EPI)DTI序列,b值采用0和700 s/mm2。扫描图像由两名放射学家进行评估,将前列腺外周带分为六个区域(每侧外周带分为尖部、中部和基底部三部分),根据穿刺结果将每个区域定为癌区或非癌区,测量前列腺外周带癌区和非癌区的表观扩散系数(ADC)值和各向异性分数(FA)值。采用t检验比较两者的ADC和FA值,并对DTI参数建立Logistic回归模型,对ADC、FA值和DTI参数行受试者工作特征(ROC)曲线分析以确定它们区分前列腺外周带癌区和非癌区的效能。结果前列腺外周带癌区及外周带非癌区的ADC值分别为(1.02±0.16)×10-3mm2/s和(1.22±0.14)×10-3mm2/s;FA值分别为0.38±0.09和0.31±0.06,两者差异均具有统计学意义(P<0.0001,P<0.0001)。ADC值、FA值及DTI区分前列腺外周带癌区和非癌区的ROC曲线下面积分别为0.84、0.76和0.86。DTI曲线下面积显著高于FA值(P=0.0009),但DTI和ADC曲线下面积无显著差异(P=0.1595)。结论 DTI有助于诊断前列腺外周带癌。

Amide Proton Transfer Magnetic Resonance Imaging of Alzheimer＇s Disease at 3.0 Tesla： A Preliminary Study

Background：Amide proton transfer （APT） imaging has recently emerged as an important contrast mechanism for magnetic resonance imaging （MRI） in the field of molecular and cellular imaging.The aim of this study was to evaluate the feasibility of APT imaging to detect cerebral abnormality in patients with Alzheimer＆#39;s disease （AD） at 3.0 Tesla.Methods：Twenty AD patients （9 men and 11 women; age range,67-83 years） and 20 age-matched normal controls （11 men and 9 women; age range,63-82 years） underwent APT and traditional MRI examination on a 3.0 Tesla MRI system.The magnetic resonance ratio asymmetry （MTRasym） values at 3.5 ppm of bilateral hippocampi （Hc）,temporal white matter regions,occipital white matter regions,and cerebral peduncles were measured on oblique axial APT images.MTRasym （3.5 ppm） values of the cerebral structures between AD patients and control subjects were compared with independent samples t-test.Controlling for age,partial correlation analysis was used to investigate the associations between mini-mental state examination （MMSE） and the various MRI measures among AD patients.Results：Compared with normal controls,MTRasym （3.5 ppm） values of bilateral Hc were significantly increased in AD patients （right 1.24% ± 0.21% vs.0.83% ± 0.19%,left 1.18% ± 0.18% vs.0.80%± 0.17%,t =3.039,3.328,P =0.004,0.002,respectively）.MTRasym （3.5 ppm） values of bilateral Hc were significantly negatively correlated with MMSE （right r =-0.559,P =0.013; left r=-0.461,P =0.047）.Conclusions：Increased MTRasym （3.5 ppm） values of bilateral Hc in AD patients and its strong correlations with MMSE suggest that APT imaging could potentially provide imaging biomarkers for the noninvasive molecular diagnosis of AD.

Altered small-world,functional brain networks in patients with lower back pain

In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks within the brain. Functional MRI(fMRI) was performed on 20 individuals with LBP and 17 age and gender-matched normal controls during the resting state. The severity of the pain in the individuals with LBP ranged from 5 to 8 on a 0–10 scale, with 0 indicating no pain. Network-based statistics were performed to investigate the differences between the brain networks of individuals with LBP and those of normal controls. Several small-world parameters of brain networks were calculated, including the clustering coefficient, characteristic path length, local efficiency, and global efficiency. These criteria reflect the overall network efficiency. The brain networks in the individuals with LBP due to herniation of a lumbar disc demonstrated a significantly longer characteristic path length as well as a lower clustering coefficient, global efficiency, and local efficiency compared to those in control subjects. We found that LBP patients tended to have unstable and inefficient brain networks when compared with healthy controls. In addition, LBP individuals showed significantly decreased functional connectivity in the anterior cingulate cortex, middle cingulate cortex, post cingulate cortex, inferior frontal gyrus, middle temporal gyrus, occipital gyrus, postcentral gyrus, precentral gyrus, supplementary motor area, thalamus, fusiform, caudate, and cerebellum. We believe that these regions may be involved in the pathophysiology of lower back pain.

Role of Diffusion-weighted and Contrast-enhanced Magnetic Resonance Imaging in Differentiating Activity of Ankylosing Spondylitis

Background： Previous studies showed that combining apparent diffusion coefficient （ADC） value with the Spondyloarthritis Research Consortium of Canada （SPARCC） index value might provide a reliable evaluation of the activity of ankylosing spondylitis （AS）, and that contrast-enhanced （CE） magnetic resonance imaging （MRI） is unnecessary. However, the results were based on confirming only a small random sample. This study aimed to assess the role of CE-MRI in differentiating the disease activity of AS by comparingADC value with a large sample. Methods： A total of l 15 patients with AS were enrolled in accordance with Bath AS Disease Activity Index and laboratory indices, and 115 patients were divided into two groups, including active group （n = 69） and inactive group （n 46）. SPARCC, ASI, and ADC values were obtained from the short tau inversion recovery （STIR）, diffusion-weighted imaging （DWI）, and CE-MRI, respectively. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. Results： The optimal cutoff values （with sensitivity, specificity, respective area under the curve, positive likelihood ratio, and negative likelihood ratio） for the differentiation between active and inactive groups are as follows： SPARCC = 6 （72.06%, 82.61%, 0.836, 4.14, 0.34）; ASI （%） 153 （80.6%, 84.78%, 0.819, 5.3, 0.23）; ADC value - 1.15 × 10 3 mm2/s （72.73% 81.82%, 0.786, 4, 0.33）. No statistical differences were found among the predictive values of SPARCC, △SI, and ADC. Multivariate analysis showed no significant difference between the combination of SPARCC and ADC values with and without ASI. Conclusions： Using large sample, we concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, and CE-MRI sequence is not routinely used in imaging of AS to avoid renal fibrosis and aggravation of kidney disease.