Objective To analyze the MR imaging classification of parenchymal tuberculosis,to explore the value of DCE-MRI quantitative parameters in differentiating parenchymal tuberculosis from brain metastases.Methods The conventional MRI and DCE-MRI were performed in 59 cases (28 cases with parenchymal tuberculosis,and 31 cases with brain metastases),the MRI findings and enhancement characteristics were retrospectively summarized.DCE-MRI quantitative parameters were measured from solid enhanced nodules,the rim of ring-like enhanced lesions,including Ktrans、Kep、Ve and iAUC.Data was statistically analyzed by using t test or u test.Results Parenchymal tuberculosis had 337 lesions.102 lesions were evenly enhanced nodules,69.6％ of the lesions were less than 3.0 mm,25.5％ of the lesions were between 3.0 mm to 1.0 cm.235 lesions showed ring-like contrast enhancement,and the rim had uniform thickness,32.4％ of the lesions were between 3.5mm to 5.0 mm,45.5％ of the lesions were between 5.0 mm to 1.0 cm,22.1％ of the lesions were more than 1.0 cm.Brain metastases have 285 lesions.102 lesions were heterogeneously enhanced nodules,27.0％ of the lesions were less than 3.0 mm,73.0％ of the lesions were more than 3.0mm.211 lesions showed uneven ring-like enhancement,84.8％ of the lesions were more than 5.0 mm.The Kep of the solid nodules and ring wall of parenchymal tuberculosis were (0.158 ± 0.064)min-1 and (0.156 ± 0.066) min-1,they were lower than the brain metastases (t =-2.518、-2.407,P ＜ 0.05).The Ve of the solid nodules and ring wall of parenchymal tuberculosis were 0.465 ± 0.170 and 0.527 ± 0.174,they were higher than the brain metastases (Z =2.399、4.666,P ＜ 0.05).When Kep and Ve of the enhancing ring wall were 0.166 min-1 and 0.431,the sensitivity of differentiating these two diseases was 70.7％ and 70.6％,the specificity was 57.4.％ and 68.0％ respectively.Conclusion According to the lesion size and MRI enhanced features of parenchymal tuberculosis,lesions can be classified into three types:miliary,nodules and tuberculoma.It conforms to the pathological features of tuberculous nodules.Measuring the Kep and Ve values is helpful in differential diagnosis of parenchymal tuberculosis and brain metastases.

Purpose:To study the MRI findings of brain parenchymal tuberculosis,and to explore the valve of multi-b-value diffusion weighted imaging (multi-b-DWI) in differentiating parenchymal tuberculosis from brain metastases.Methods:The conventional MRI and multi-b-DWI were performed in 59 cases (28 cases with parenchymal tuberculosis,and 31 cases with brain metastases),their MRI findings were retrospectively summarized.Apparent diffusion coefficient (ADC) values,including ADC10b,ADChigh and ADCperf,were measured in the solid enhanced nodules,the rim and central of ring-like enhanced lesions.All the data were analyzed by t test.Results:There were 337 brain parenchymal tuberculosis lesions.Of them,102 lesions were evenly enhanced nodules,69.6％ of the lesions were less than 3.0mm,25.5％ of the lesions were between 3.0mm to 1.0cm;235 lesions showed ring-like contrast enhancement,32.4％ of the lesions were between 3.5mm to 5.0mm,45.5％ of the lesions were between 5.0mm to 1.0cm,22.1％ of the lesions were more than 1.0cm.There were 285 brain metastases lesions.Of them,102 lesions were heterogeneously enhanced nodules,27.0％ of the lesions were less than 3.0mm,73.0％ of the lesions were more than 3.0mm;211 lesions showed unevenly ringlike enhancement,84.8％ of the lesions were more than 5.0mm.The ADChigh of the solid nodules and ring wall of parenchymal tuberculosis were (0.24±0.038)× 103mm2/s,(0.249±0.039)× 103mm2/s,they were higher than that of the brain metastases.The ADChigh of caseous solid center of ring enhancing lesions in parenchymal tuberculosis was (0.251±0.056)× 10-3mm2/s,it was lower than that of the necrosis center of brain metastases.When ADC10b and ADChigh of the enhancing ring wall were set as 0.088× 10-3mm2/s and 0.241× 10-3mm2/s,the sensitivity in differentiating these two diseases were 83.9％ and 58.9％,the specificity were 72.5％ and 100％ respectively.Conclusion:Combination of the lesion size,MRI enhanced features and ADC values are helpful in differential diagnosis of brain parenchymal tuberculosis and brain metastases.

Objective To evaluate DWI in the assessment of viability of hepatic alveolar echinococcosis (HAE) by comparing DWI with PET-CT results. Methods 18-fluorodeoxy glucose(18F-FDG) PET-CT and DWI(b values=0, 800 s/mm2) were retrospectively analyzed in 8 patients with clinically verified HAE. The metabolic activity of HAE lesions in both techniques were determined by two independent radiologists respectively. Kappa test was assessed between the results of two observers. Results Sixteen lesions (composed of 14 HAE and 2 cystic echinococcosis, CE) were detected. (1)Eight lesions (≥2 cm) showed perilesional hyper-signal intensity on DWI, mainly around the lesion bounding by normal liver parenchyma. One patient (≥2 cm) had oral drug therapy for three years, and the lesion showed discontinuous perilesional hyper-signal intensity on DWI after the therapy. Five lesions (<2 cm) were depicted as nodular high signal on DWI.(2)Eight lesions (≥2 cm) showed perilesional increased FDG uptake on PET-CT, while 5 lesions (<2 cm) displayed as“hot pot”. One patient (leison≥2 cm) who had oral drug therapy for three years showed hepatic defect without any FDG uptake in post-treatment PET-CT. Two CE lesions showed negative results on both DWI and PET-CT. The Kappa value of 0.880 indicated a good coincidence between DWI and PET-CT in depicting the metabolic activity of HAE (P=0.006). Conclusions This preliminary study showed the value of DWI in assessing HAE viability. DWI should be routinely used as one of the techniques in the evaluation of HAE.

Objective To establish the model of alveolar hydatid encephalopathy in New Zealand white rab-bits.Methods The skull puncture was 2.5cm under the front behind the fontanel,0.5cm right to the sag-ittal suture,inclined lateral forward,with the needle injection to the depth of 1cm and 0.3~0.5 cm contai-ning (5~10)×103 per milliliter the mixed suspension of the head section of vesicular spines ball larva.An-imal Model A and Model B were established with respective MRI and pathology examination.Results The two methods in different brain inoculations under direct vision of the skull puncture were successful,with 26.32% of vaccination rates in Group A,and 5.56% in Group B.Experimented animals in successful Mod-eling by MRI were characterized of nodular and annular lesions.The lesions were single by pathologic chec-king and confirmed as alveolar hydatid encephalopathy by HE dyeing.Conclusion The inoculation method under direct vision of the skull puncture to the brain was more successful.

鼻咽癌三维适形放疗是头颈部肿瘤尤其是鼻咽癌的重要治疗手段,放射线在杀伤肿瘤细胞的同时,对肿瘤周围的正常组织造成损伤,造成张口吞咽困难、口腔粘膜反应、鼻咽症状及放疗区域皮肤的刺激,采取有效的护理干预措施,对控制和减轻患者口腔黏膜等放疗急性反应及并发症的发生,保证营养的摄入,提高患者的生存质量具有重要意义.