The aim of this study was to investigate the temporal evolution of perihematomal blood-brain barrier (BBB) compromise and edema growth and to determine the role of BBB compromise in edema growth. Spontaneous intracerebral hemorrhage patients who underwent computed tomography perfusion (CTP) were divided into five groups according to the time interval from symptom onset to CTP examination. Permeability-surface area product (PS) maps were generated using CTP source images. Ipsilateral and contralateral mean PS values were computed in the perihematomal and contralateral mirror regions. The relative PS (rPS) value was calculated as a ratio of ipsilateral to contralateral PS value. Hematoma and perihematomal edema volume were determined on non-contrast CT images. In the total of 101 intracerebral hemorrhage patients, the ipsilateral mean PS value was significantly higher than that in contralateral region (z = −8.284, p < 0.001). The perihematomal BBB permeability showed a course of dynamic changes including an increase in the hyperacute and acute phases, a decrease in the early subacute phase and a second increase in the late subacute phase and chronic phase. Perihematomal edema increased gradually until the late subacute phase and then slightly increased. There was a relationship between rPS value and edema volume (β = 0.254, p = 0.006). The perihematomal BBB permeability is dynamic changes, and edema growth is gradually increased in patients following intracerebral hemorrhage. BBB compromise plays an essential role in edema growth. The quantitative assessment of BBB compromise may provide valuable information in therapeutic interventions of intracerebral hemorrhage patients.

Objective:To investigate the diagnostic value of high resolution CT (HRCT) scan combined with various serum tumor markers in different pathological types of early lung cancer.Methods:The clinical data of 164 patients with early lung cancer (lung cancer group) admitted to Beijing Tiantan Hospital, Capital Medical University from August 2019 to October 2021 were analyzed retrospectively, and 78 healthy people who participated in physical examination at the same time were selected as the control group. There were 94 males and 70 females in the lung cancer group, aged (52.4±3.6) years. Among them, 90 cases were adenocarcinoma, 62 cases were squamous cell carcinoma, and 12 cases were small cell carcinoma. All the patients were confirmed by histopathological examination. The serum levels of neuron-specific enolase (NSE), carcinoembryonic antigen (CEA), cyto-keratin 19 fragment antigen 21-1, squamous cell carcinoma antigen and carbohydrate antigen 125 (CA125) were compared between the two groups and different pathological types of patients. The sensitivity, specificity and accuracy of HRCT scan, five tumor markers and HRCT scan + five tumor markers in the diagnosis of lung cancer were calculated based on the results of histopathological examination as the gold standard. The measurement data were compared by two independent samples t-test, and the counting data were compared by Chi-square test. Results:The levels of serum tumor markers in lung cancer group were higher than those in control group ( t=8.107-30.460; all P<0.001). The serum CEA and CA125 levels in patients with adenocarcinoma were higher than those in squamous cell carcinoma and small cell carcinoma ( t=12.712-4.326; all P<0.001). No significant difference was found in serum CEA and CA125 levels between patients with squamous cell carcinoma and those with small cell carcinoma ( t=1.342, 1.256; both P>0.05). The NSE level in patients with adenocarcinoma and squamous cell carcinoma was lower than that in patients with small cell carcinoma ( t=10.342-11.534; all P<0.001). The sensitivity, specificity and accuracy of HRCT scann + five tumor markers in the diagnosis of lung cancer were 95.62%, 96.43% and 98.65% respectively, which were higher than any single diagnosis ( χ2=55.823, 48.652, 62.718; all P<0.001). Conclusion:HRCT scan combined with detection of various serum tumor markers can improve the sensitivity, specificity and accuracy of early lung cancer diagnosis, and this method has high clinical value in the diagnosis of lung cancer.

Objectives Hematoma expansion (HE) is an important factor of unfavorable outcome in patients with intracerebral hemorrhage (ICH). Imaging markers on noncontrast computed tomography (NCCT) provide increasing value in the prediction of HE due to fast and easy-to-use advantages; however, the accuracy of NCCT-based prediction of intracerebral HE remains unclear. We aimed to investigate the predictive accuracy of NCCT markers for the evaluation of HE using a well-characterized ICH cohort. Methods We retrospectively analyzed 414 patients with spontaneous ICH, who underwent baseline CT within 6 h after symptom onset and follow-up CT within 24 h after ICH. Hematoma volumes were measured on baseline and follow-up CT images, and imaging features that predicted HE were analyzed. The test characteristics for the NCCT predictors were calculated. Results Of the 414 patients investigated, 63 presented blend sign, 45 showed black hole sign, 36 had island sign and 34 had swirl sign. In the 414 patients, 88 presented HE, the incidence was 21.26%. Of the 88 patients with HE, 22 presented blend sign, 11 showed black hole sign, 8 had swirl sign and 7 had island sign. The blend sign showed highest sensitivity (25.00%) and swirl sign showed the highest specificity (92.02%) among the four predictors. We noted excellent interobserver agreement for the identification of HE. Conclusion The four NCCT markers can predict HE with limited sensitivity, high specificity and good accuracy. This may be useful for prompt identification of patients at high risk of active bleeding, and prevention of over-treatment associated with HE.

Introduction: Spontaneous intracerebral hemorrhage (ICH) is associated with increased blood-brain barrier (BBB) permeability, potentially contributing to hematoma expansion, edema development and exacerbation of brain injury. Though we know BBB permeability with time after the onset of ICH, little is about the temporal evolution of BBB permeability in humans after ICH. A more detailed understanding the timeline of BBB permeability change after ICH would be important for guiding future ICH treatments. Hypothesis: We want to test the hypothesis there is two increase in BBB permeability in ICH patients. Methods: Patients with ICH were divided into five groups based on the period between ICH onset and computed tomography perfusion (CTP) assessed, which are hyperacute (<24 hours), acute (1~3 days), early subacute (3~7 days), late subacute (7~14 days) and chronic (>14 days) groups. Maps of BBB permeability-surface area product (PS), a measure of extravascular contrast leakage rate, were calculated from CTP source images. Mean PS was measured in regions of interest defining the hematoma, a 1cm radial peri-hematoma region,in both ICH and contralateral non-ICH hemispheres. Results: PS maps were generated in 61 patients (17 female, mean age 53 years old). The median (interquartile range) PS in ICH hemisphere of 31 patients underwent CTP in hyperacute phase is 1.4 (5.3), 8 patients in acute phase is 1.6 (3.2), 11 patients in early subacute phase is 1.2 (0.8), 8 patients in late subacute phase is 0.7 (1.2), and 3 patients in chronic phase is 0.9. The BBB permeability has an early increase in hyperacute phase, is followed by a decrease period in acute and subacute phases, and a delayed second increase in chronic phase. The permeability pattern is similar in non-ICH hemisphere; however, the second increase in permeability was from late subacute phase. Discussions: In conclusion, acute ICH patients have a generalized increase in BBB permeability, which affects the entire brain diffusely. The BBB permeability is not continually elevated but follows a triphasic course in ICH patients.

目的 探讨儿童毛细胞黏液样星形细胞瘤(PMA)的影像特征及其与病理学改变的关系.方法 回顾性分析2010年10月至2018年6月首都医科大学附属北京天坛医院收治的20例儿童颅内PMA患者的临床资料、CT和磁共振成像(MRI)影像表现以及病理和免疫组织化学结果.结果 20例儿童PMA患者中,男15例,女5例;肿瘤位于幕下小脑半球10例,幕上大脑半球5例,视交叉-下丘脑4例,三脑室内1例.在CT图像上,PMA表现为低密度10例;在MRI图像上,肿瘤呈混杂信号11例,T1WI低信号7例,T2WI高信号7例,DWI未见弥散受限12例,MRI增强扫描表现为不均匀强化17例;肿瘤边界清楚18例,发生囊变16例,瘤周水肿11例.组织病理学检查可见双极性梭形细胞,以血管为中心生长,间质内含有大量黏液,缺乏Rosenthal纤维.结论 儿童PMA具有较为特征性的影像表现和低度恶性的肿瘤特征,肿瘤不均质性、边界清楚、边缘囊变和不均匀强化是PMA的特征性表现,CT和MRI可为儿童PMA的术前诊断、临床治疗和预后评估提供参考.

Cerebellar liponeurocytoma is a rare central nervous system tumor, we investigate its biological behaviors and clinical prognosis to improve the understanding of this tumor. We retrospectively analyzed the clinical, radiological and histopathological findings as well as follow-up data of two patients with intraventricular liponeurocytomas in Beijing Tiantan Hospital between July 2000 and July 2016. The main clinical manifestations of the two patients were headache. The supratentorial intraventricular liponeurocytoma appeared as isodense to slight hyperdense on CT scan and heterogeneous intensity on T1-weighted imaging (T1WI) and T2-weighted imaging (T2WI). The plaque-like hypodense on CT images and hyperintensity on T1WI resembling fat could be seen inside the tumor. The liponeurocytoma located in the fourth ventricle showed isointensity on T1 and T2WI as well as slight enhancement on contrast. Two patients accepted gross total resection of tumors. Two intraventricular tumors demonstrated similarly histopathological features, such as isomorphic small tumor cells with clear cytoplasm, sheets of monomorphic round cells and focal lipomatous differentiation. In addition, expression of synaptophysin, neuron specific enolase, microtubule-associated protein 2 and S-100 were found. No radiological or clinical evidence of recurrence of the tumors was observed in their follow-up surveys. In conclusion, intraventricular liponeurocytoma has a favorable clinical course, radiological features may be useful in the diagnosis of this rare tumor before surgery.

OBJECTIVETo explore the value of computed tomography (CT) imaging in clinical diagnosis and prognostic evaluation of pleural mesothelioma.METHODSThe clinical data and CT features were analyzed retrospectively in 12 pathologically confirmed cases of pleural mesothelioma. And 15 relevant papers were reviewed.RESULTSThe major clinical symptoms included chest pain, stuffiness and cough. The chest CT demonstrated diffusive pleural thickening (n = 9), local pleural thickening (n = 3), pleural thickening over 1 cm (n = 10) and concurrent pleural effusion (n = 11).CONCLUSIONChest CT may help to determine the location, shape, extent of pleural lesion and its relation to surrounding tissues. And it provides objective rationales for the clinical diagnosis and prognostic assessment in patients with pleural mesothelioma.

Objective To investigate the imaging and pathological features of atypical teratoid/rhab doid tumor (AT/RT)occur-ring in the central nervous system (CNS).Methods The CT and MRI findings of 1 6 patients with CNS AT/RT were retrospectively analyzed,and their pathological and immunohistochemical results were studied.Results There were 12 males and 4 females. Tumors located is at supratentorial in 10 and infratentorial in 6.Cystic changes in tumors were noted in 12 cases.The solid portion of tumors was isointense on T2-weighted images relative to normal brain grey matter in 9 patients.Extensive peritumoral edema was observed in 1 1 lesions.The tumors showed bandlike rim of significant enhancement in 10 cases.The incidence of hemorrhage and calcification in tumors were 43.8% and 41.7% respectively.Histopathologically,AT/RT was characterized by the presence of rhab-doid cells associated with variable components of epithelial,primitive neuroectodermal and mesenchymal differentiation.Conclusion Atypical teratoid/rhabdoid tumor is several imaging findings which are relatively specific on CT and MR images.CT and MRI may provide valuable information for pre-operation diagnosis and prognostic evaluation in patients with CNS AT/RT.