Our study aimed to assess the image quality of lower kiloelectron volt (keV) level abdominal virtual monoenergetic imaging (VMI) with lower radiation dose on photon-counting detector computed tomography (PCD-CT), in comparison to energy-integrating detector computed tomography (EID-CT). We prospectively included three matched groups, each with 59 participants, to undergo contrast-enhanced abdominal CT scans using EID-CT with full-dose (EID_FD), PCD-CT with full-dose (PCD_FD), and PCD-CT with low-dose (PCD_LD) protocols, respectively. The data of portal-venous phase were reconstructed into VMI at 40, 50, 60, and 70 keV, respectively. The standard deviation of CT values in liver parenchyma was measured as image noise. The signal-to-noise ratio (SNR) of liver parenchyma and contrast-to-noise ratio (CNR) of liver-portal vein were calculated. Three radiologists assessed the image noise, vessel sharpness, and overall quality, and rated the hepatic lesion conspicuity if possible. Our study found that the PCD_LD significantly reduced the radiation dose than EID_FD or PCD_FD (p < 0.001). The noise was significantly decreased by PCD_FD and PCD_LD compared to EID_FD, but SNR values were significantly increased (p ≤ 0.006). The CNR values were significantly increased by PCD_FD and PCD_LD compared to EID_FD in VMI at 40 keV and 50 keV (p ≤ 0.010). The ratings of image noise, vessel sharpness, overall quality, and lesion conspicuity were significantly greater in PCD_FD and PCD_LD compared to EID_FD (p ≤ 0.001). There was no significant difference detected in rating of lesion conspicuity between PCD_FD and PCD_LD (p ≥ 0.259). In conclusion, PCD-CT allows abdominal VMI with lower keV and lower noise using lower radiation dose, to provide better visualization of the hepatic lesions.

This study aimed to investigate the potential benefit of ultra-high-resolution (UHR) photon-counting detector CT (PCD-CT) angiography in visualization of abdominal arteries in comparison to standard-reconstruction (SR) images of virtual monoenergetic images (VMI) at low kiloelectron volt (keV). We prospectively included 47 and 47 participants to undergo contrast-enhanced abdominal CT scans within UHR mode on a PCD-CT system using full-dose (FD) and low-dose (LD) protocols, respectively. The data were reconstructed into six series of images: FD_UHR_Br48, FD_UHR_Bv56, FD_UHR_Bv60, FD_SR_Bv40, LD_UHR_Bv48, and LD_SR_Bv40. The UHR reconstructions were performed with three kernels (Bv48, Bv56, and Bv60) within 0.2 mm. The SR were virtual monoenergetic imaging reconstruction with Bv40 kernel at 40-keV within 1 mm. Each series of axial images were reconstructed into coronal and volume-rendered images. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of seven arteries were measured. Three radiologists assessed the image quality, and visibility of nine arteries on all the images. SNR and CNR values of SR images were significantly higher than those of UHR images (P < 0.001). The SR images have higher ratings in image noise (P < 0.001), but the FD_UHR_Bv56 and FD_UHR_Bv60 images has higher rating in vessel sharpness (P < 0.001). The overall quality was not significantly different among FD_VMI_40keV, LD_VMI_40keV, FD_UHR_Bv48, and LD_UHR_Bv48 images (P > 0.05) but higher than those of FD_UHR_Bv56 and FD_UHR_Bv60 images (P < 0.001). There is no significant difference of nine abdominal arteries among six series of images of axial, coronal and volume-rendered images (P > 0.05). To conclude, 1-mm SR image of VMI at 40-keV is superior to 0.2-mm UHR regardless of which kernel is used to visualize abdominal arteries, while 0.2-mm UHR image using a relatively smooth kernel may allow similar image quality and artery visibility when thinner slice image is warranted.

Background: Deep learning has developed rapidly, and deep learning reconstruction (DLR) methods in magnetic resonance imaging (MRI) are gaining attention for their potential to improve efficacy in clinical work. The preoperative MRI assessment of rectal cancer is crucial for patient management, but the imaging quality is currently limited by a number of factors. DLR could be applied to the preoperative MRI assessment of primary rectal cancer, but research about its specific reliability is limited. Thus, this study aimed to evaluate the reliability of DLR in the preoperative MRI examination of primary rectal cancer. Methods: This cross-sectional study was conducted at Ruijin Hospital, Shanghai Jiaotong University School of Medicine from March 2022 to October 2022. Patients with primary rectal cancer underwent routine MRI scans on a 3.0T magnetic resonance scanner (SIGNA Architect, GE Healthcare, USA) with 32-channels flexible coil with conventional reconstruction (ConR) and DLR. The DLR method had three noise reduction levels: DLR-H: 75% noise reduction reconstruction; DLR-M: 50% noise reduction reconstruction; and DLR-L: 25% noise reduction reconstruction. Three components were evaluated: objective image quality; subjective image quality; and diagnostic performance. The objective image quality assessment included the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). The subjective image quality assessment involved evaluating five subjective image quality parameters based on a 4-point Likert scale. The diagnostic performance assessment included tumour (T) staging, node (N) staging, as well as the circumferential resection margin and extramural vascular invasion evaluation. The images were evaluated in a blinded manner by two radiologists with different levels of experience. The paired sample Wilcoxon signed-rank test, Kappa test, interclass correlation coefficient, Chi-square test, Friedman test, and weighted kappa coefficients were used for the statistical analysis. Results: In total, 61 patients (mean age: 65 +/- 12 years; 38 men) were enrolled in the study. The DLR method improved the SNR and CNR values of the images relative to the ConR method, while the DLR-H produced the greatest improvement (P<0.040). The subjective image quality of the DLR-H images was superior to that of the ConR images (P<0.001), but there was no significant difference between the DLR-H and DLR-M images (P >= 0.075). The evaluators showed good agreement in subjective scoring, and in the DLR image scoring, the evaluators have the best consistency in the DLR-H images scoring (kappa =0.921, P<0.001). The diagnostic efficacy of the DLR images was comparable to that of the ConR images in terms of T staging [Reader 1 (R1): P=0.603; Reader 2 (R2): P=0.206] and N staging (R1: P=0.990; R2: P=0.884). Conclusions: The DLR method improved the quality of the images, and had comparable diagnostic efficacy without additional scanning time to that of the ConR method, and thus could be a feasible option for replacing the ConR method in the preoperative MRI examination of primary rectal cancer.

Rationale and Objectives: To validate the image quality of low-dose ultra-high-resolution (UHR) scanning mode of photon-counting detector CT (PCD-CT) for visceral artery computed tomography angiography (CTA). Material and Methods: We prospectively enrolled 57 patients each in the full dose (FD) and low-dose (LD) protocols, respectively, to undergo abdominal CT scans using the UHR mode on a PCD-CT system (NAEOTOM Alpha), between April 2023 and September 2023. Both the FD data and LD data were then reconstructed into two series of images: (a) 0.2 mm slice thickness, reconstruction kernel Bv48, quantum iterative reconstruction (QIR) 4; (b)1 mm slice thickness, Bv40, QIR 3. The signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) of seven arteries were objectively measured. The image noise, vessel sharpness, overall quality, and visibility of nine arteries were subjectively assessed by three radiologists. Results: The SNRs and CNRs of 0.2 mm reconstruction set was inferior to that of 1 mm reconstruction set (p < 0.001 for all the arteries and noise), however, the image quality of 0.2 mm reconstruction set was higher than that of 1 mm reconstruction set in qualitative evaluation especially for tiny arteries in Volume-rendered (VR) image (p < 0.001). The SNRs and CNRs were not significantly higher for FD group than LD group on the same slice thickness except for SNRs of common hepatic artery, splenic artery and bilateral renal arteries in 0.2 mm reconstruction set. In the comparison on image quality between normal weight and overweight patients within the same reconstruction set, the results showed that low-dose scan did not significantly impact the image quality in overweight patients. The ratings of visibility of nine visceral arteries were not significantly different among FD and LD at the same thickness reconstruction set except for superior mesenteric artery (p = 0.002 and 0.007 for 0.2 mm and 1 mm reconstruction set in axial image; p = 0.002 and 0.007 for 0.2 mm and 1 mm reconstruction set in coronal image, respectively) and left gastric artery (p = 0.002 and p < 0.001 for 0.2 mm and 1 mm reconstruction set in VR image, respectively). Conclusion: The low-dose UHR scanning mode of PCD-CT has proven to be adequate for the clinical evaluation of visceral arteries. Utilizing a reconstruction with a slice thickness of 0.2 mm could enhance arterial depiction, particularly for small vessels.

Deep learning reconstruction (DLR) has exhibited potential in saving scan time. There is limited research on the evaluation of accelerated acquisition with DLR in staging rectal cancers. Our first objective was to explore the best DLR level in saving time through phantom experiments. Resolution and number of excitations (NEX) adjusted for different scan time, image quality of conventionally reconstructed T2W images were measured and compared with images reconstructed with different DLR level. The second objective was to explore the feasibility of accelerated T2W imaging with DLR in image quality and diagnostic performance for rectal cancer patients. 52 patients were prospectively enrolled to undergo accelerated acquisition reconstructed with highly-denoised DLR (DLR_H40sec) and conventional reconstruction (ConR2min). The image quality and diagnostic performance were evaluated by observers with varying experience and compared between protocols using κ statistics and area under the receiver operating characteristic curve (AUC). The phantom experiments demonstrated that DLR_H could achieve superior signal-to-noise ratio (SNR), detail conspicuity, sharpness, and less distortion within the least scan time. The DLR_H40sec images exhibited higher sharpness and SNR than ConR2min. The agreements with pathological TN-stages were improved using DLR_H40sec images compared to ConR2min (T: 0.846vs. 0.771, 0.825vs. 0.700, and 0.697vs. 0.512; N: 0.527vs. 0.521, 0.421vs. 0.348 and 0.517vs. 0.363 for junior, intermediate, and senior observes, respectively). Comparable AUCs to identify T3-4 and N1-2 tumors were achieved using DLR_H40sec and ConR2min images (P > 0.05). Consequently, with 2/3-time reduction, DLR_H40sec images showed improved image quality and comparable TN-staging performance to conventional T2W imaging for rectal cancer patients.

Cronkhite-Canada综合征(CCS)是一组以胃肠道弥漫性息肉和外胚层变化为特征的综合征,其临床表现主要为慢性腹泻和吸收不良,由于发病率罕见,早期发现和诊断对医生来说是一个挑战.本文报告1例CCS病例,58岁男性,临床表现为慢性水样腹泻、便血、体重减轻和皮肤变化,包括指甲营养不良和色素沉着;实验室检查结果提示贫血和低蛋白血症;CT小肠造影检查发现全消化道黏膜息肉样增生,高度怀疑CCS,随后行内镜检查证实了该诊断.患者经治疗后,症状明显好转,在近1年的随访中,CT小肠造影和内镜检查均提示明显缓解.本文对该疾病进行文献综述,旨在总结其CT小肠造影表现,以提高临床医生对本病的认识,为CCS的早期诊断提供一定的思路.

Purpose. /e aim of the present study was to evaluate the relationship of fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) with haemodynamic abnormality and severity of arterial stenosis in patients with transient ischemic attack (TIA) of the carotid artery system. Patients and Methods. Consecutive inpatients (N� 38) diagnosed with TIAs of the carotid system in a 4-year period (2014–2017) were retrospectively analysed in our study and divided into FVH-negative and FVHpositive groups based on the presence of FVH sign. Each inpatient had undergonemagnetic resonance imaging (MRI) followed by computed tomography (CT) perfusion imaging studies. We investigated the degree of arterial stenosis, number of stenosis, watershed regions, and related CTperfusion indexes, including hypoperfusion regions, mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV). Spearman rank correlation was performed between FVHs score, the degree of arterial stenosis, and CTperfusion indexes with significant difference. Results./irty-one patients (81.6%) observed with FVH sign were assigned to the FVH-positive group. /e hypoperfusion regions, MTT, and CBF values were significantly different between the FVH-negative group and FVH-positive groups. Spearman correlation analysis showed significant positive correlations between hypoperfusion regions, MTT, and FVHs scores (r� 0.755 and 0.674, respectively, p< 0.01); a moderate negative correlation was found between CBF and FVHs scores (r� − 0.525, p< 0.01), whereas the degree of artery stenosis revealed no significant correlation with FVH scores (r� 0.253, p> 0.05). Conclusion. Hyperintense vessels on FLAIR were closely associated with hypoperfused regions, MTT, and CBF values, which indicated that the presence of FVHs could be an important and convenient imaging marker of haemodynamic impairment in patients with TIA.

Purpose. The aim of the present study was to evaluate the relationship of fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH) with haemodynamic abnormality and severity of arterial stenosis in patients with transient ischemic attack (TIA) of the carotid artery system. Patients and Methods. Consecutive inpatients (N = 38) diagnosed with TIAs of the carotid system in a 4-year period (2014–2017) were retrospectively analysed in our study and divided into FVH-negative and FVH-positive groups based on the presence of FVH sign. Each inpatient had undergone magnetic resonance imaging (MRI) followed by computed tomography (CT) perfusion imaging studies. We investigated the degree of arterial stenosis, number of stenosis, watershed regions, and related CT perfusion indexes, including hypoperfusion regions, mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV). Spearman rank correlation was performed between FVHs score, the degree of arterial stenosis, and CT perfusion indexes with significant difference. Results. Thirty-one patients (81.6%) observed with FVH sign were assigned to the FVH-positive group. The hypoperfusion regions, MTT, and CBF values were significantly different between the FVH-negative group and FVH-positive groups. Spearman correlation analysis showed significant positive correlations between hypoperfusion regions, MTT, and FVHs scores (r = 0.755 and 0.674, respectively, p<0.01); a moderate negative correlation was found between CBF and FVHs scores (r = −0.525, p<0.01), whereas the degree of artery stenosis revealed no significant correlation with FVH scores (r = 0.253, p>0.05). Conclusion. Hyperintense vessels on FLAIR were closely associated with hypoperfused regions, MTT, and CBF values, which indicated that the presence of FVHs could be an important and convenient imaging marker of haemodynamic impairment in patients with TIA.

目的 探讨遗传性弥漫性脑白质病变合并球状轴索(HDLS)的磁共振特点,以加深对该病的理解和认识.方法 报道2例确诊为集落刺激因子1受体基因突变的HDLS患者的临床诊疗经过,结合文献对其磁共振不同序列的影像学特征进行讨论及分析.结果 2例均为青年,慢性起病,亚急性进展,临床表现为体重减轻,口齿不清,反应迟钝,近记忆力减退及肢体运动功能障碍.头颅MRI表现为双侧侧脑室旁、半卵圆中心对称性白质病变、DWI显示弥散受限,MRS提示病变区域NAA峰减低,Cho峰增高,2例均有不同程度脑萎缩,以顶叶及胼胝体体部较明显.结论 HDLS为罕见疾病,临床表现多样,容易误诊,双侧侧脑室体旁、半卵圆中心区多发持续性DWI高信号伴有Cho峰增高为本病较特异性的影像学表现,有助于HDLS的早期诊断.

目的:前瞻性评估双能量CT(dual-energy computed tomography,DECT)中的总碘摄取(total iodine uptake,TIU)在预测胃癌病人新辅助化疗疗效和无进展生存期(progression-free survival,PFS)的应用价值.方法:收集我院44例化疗前、后均行DECT扫描的局部进展期胃癌病人.计算肿瘤面积(％△S),直径(％△D)和密度(％△HU)的变化率来评估WHO、RESCIST和Choi标准.同时计算肿瘤体积(％△V)和门静脉期TIU的变化率(％△TIU-p)来评估ROC曲线下的界值.统计学分析不同标准与组织病理退缩分级(Becker)或PFS间的关系.结果:分别根据△V(43.34％,P=0.002)和△TIU-p(63.87％,P=0.002)的界值将病人分为反应组和非反应组.％△TIU-p标准与Becker间显示较强的相关性(r=0.602,P＜0.001),％△V显示中等相关(r=0.416,P=0.005),而WHO (r=0.075,P=0.627),RECIST(r=0.270,P=0.077)和Choi标准(r=0.238,P=0.120)与Becker间无相关性.％△TIU-p (P=0.001)和Choi标准(P=0.013)的反应组和非反应组PFS间差异具有统计学意义.结论:TIU-p可预测进展期胃癌病人新辅助化疗后病理退缩.％△TIU-p分析新辅助化疗后的PFS有一定意义.

Objective: To investigate the after-sales demand of medical magnetic resonance imaging (MRI) from MRI practitioners in different grades of medical institutions, so as to provide reference for the optimization of after-sales service quality evaluation system and guidance for MRI equipment manufacturers to improve after-sales service quality. Materials and Methods:The after-sales service demand questionnaire was proposed by the joint of radiologists, medical engineers and statisticians using Delphi method. The survey of after-sales service demand was carried out among MRI practitioners from 70 different hospitals in 24 provinces. Results: A total of 246 valid feedbacks from 21 provinces were collected from September to November, 2018.After comprehensive analysis, 18 first-level demand indicators related to maintenance of MRI equipment were extracted. Among all these indicators, troubleshooting efficiency was mostly demanded. In addition, MRI users preferred on-site service rather than remote guidance. During the warranty period, the manufacturers should carry out 2-3 times of technical training for engineers, technicians and radiologists. The results showed the on-site training is more demanded than distance training. In terms of scientific research collaboration, the demand for scientific research project cooperation, protocal setting, and post-processing training in tertiary hospitals is higher than secondary hospitals. Conclusions: MRI equipment manufacturers should continuously improve after-sales service quality based on the specific demands of MRI users. The demand indicators from perspectives of maintenance services, technical training, and scientific research collaboration should be considered when establishing the after-sales service quality evaluation system.

目的 探讨颈动脉系统短暂性脑缺血发作(TIA)患者出现液体衰减反转恢复(FLAIR)序列高信号血管征(FVH)的血流动力学因素.方法 搜集2011年6月至2017年4月本院神经外科30例TIA患者,所有病例均证实存在颈动脉系统动脉狭窄,并行常规头颅MR检查及CT灌注成像(CTP)检查.评价患者的动脉狭窄程度、FVH评分、低灌注区域及相关参数,包括平均通过时间(MTT)、脑血流量(CBF)及脑血容量(CBV).结果 低灌注区域、MTT及CBF值在FVH阴性组与阳性组间存在明显统计学差异.FVH评分与各参数间的Spearman秩相关分析显示低灌注区域及MTT与FVH评分存在明显正相关(r=0.755,0.674,P＜0.01),与CBF呈中等程度负相关(r=-0.525,P＜0.01),而与动脉的狭窄程度无明显相关性(r=0.253,P＞0.05).结论 FVH的出现及分布范围与CTP所显示的低灌注区域及其相应的MTT、CBF值密切相关,由此推测FVH可作为反映TIA患者脑组织灌注不足的一种重要且便捷的影像学表现.

Introduction: White matter hyperintensities (WMHs) were commonly seen in brain magnetic resonance imaging (MRI) of the elderly. Many studies found that WMHs were associated with cognitive decline and dementia. However, the association between WMHs in different brain regions and cognitive decline remains debated. Methods: We explored the association of the severity of WMHs and cognitive decline in 115 non-demented elderly (>= 50 years old) sampled from the Wuliqiao Community located in urban area of Shanghai. MRI scans were done during 2009-2011 at the beginning of the study. Severity of WMHs in different brain regions was scored by Improved Scheltens Scale and Cholinergic Pathways Hyperintensities Scale (CHIPS). Cognitive function was evaluated by Mini-Mental State Examination (MMSE) every 2 to 4 years during 2009-2018. Results: After adjusting for confounding factors including age, gender, education level, smoking status, alcohol consumption, depression, hypertension, diabetes, hyperlipidemia, brain infarcts, brain atrophy, apoE4 status, and baseline MMSE score, periventricular and subcortical WMH lesions as well as WMHs in cholinergic pathways were significantly associated with annual MMSE decline ( p < 0.05), in which the severity of periventricular WMHs predicted a faster MMSE decline (-0.187 points/year, 95% confidence interval: -0.349, -0.026, p = 0.024). Conclusions: The severity of WMHs at baseline was associated with cognitive decline in the non-demented elderly over time. Interventions on WMH lesions may offer some benefits for cognitive deterioration.

Objective: To investigate the clinical demand of medical magnetic resonance imaging (MRI) from radiologists of different grades of medical institutions in China, so as to provide reference and theoretical foundation for the development of domestic MRI equipment. Materials and Methods: The clinical MRI demand questionnaire was optimized by the panel of experts comprised of radiologists, medical engineers and statisticians using Delphi method. The survey of clinical demand was carried out online (https://www.sojump.com/) with MRI users working in different grades of hospitals in China. Results: A total of 246 valid feedbacks from 21 provinces were collected from September to November, 2018.The survey of magnetic field strength requirements showed that 1.5 T and 3.0 T MRI were mostly demanded, with the percentage of 74.2％ and 77.9％ respectively. Less than 5％ of the participants had the demand for MRI equipment with magnetic field strength under 1.5 T25 first-level demand indicators and 29 second-level demand indicators were extracted from perspectives of clinical diagnosis, scientific research and prospective equipment. Conclusions:The medium and high-end MRI equipment are highly demanded among MRI users. Domestic MRI equipment manufacturers should conduct product positioning and technical research and development based on the specific demands of MRI users.

Pathologic response to neoadjuvant chemotherapy is a prognostic factor in many cancer types. However, the existing evaluative criteria are deficient. We sought to prospectively evaluate the total iodine uptake derived from dual-energy computed tomography (DECT) in predicting treatment efficacy and progression-free survival (PFS) time in gastric cancer after neoadjuvant chemotherapy.

We explored the role of secreted frizzled-related protein 1 (sFRP1) overexpression in gastric cancer and its relationship with radiological findings from dual-energy spectral CT(DEsCT) and positron emission tomography/computed tomography (PET/CT). We established mouse metastatic models using the SGC-7901/sFRP1 gastric cancer cell line. A control group was established using the SGC-7901/vector cell line. The models were then scanned with dual-energy spectral CT and PET-CT. Subsequent analysis, including immunohistochemistry and Transferase-mediated deoxyuridine triphosphate-biotin nick end labelling (TUNEL), was performed to confirm the role of sFRP1. Transwell chamber and angiogenesis assays were conducted to verify the effect of sFRP1 in vitro . We found that the control group showed negative radiological performance with successful implantation. Concurrently, the treated group showed visible lesions, a higher FDG uptake and increasing enhancement. The immunological and histological analysis confirmed the positive radiological performance with larger size, increasing proliferation, more microvessels and less apoptosis. The angiogenic up-regulation of sFRP1 overexpression were further verified with in vitro cell models. This preliminary study demonstrates that sFRP1 overexpression in gastric cancer cells leads to increased cell proliferation and angiogenesis, which may, in turn, contribute to positive PET/CT and CT performances.

Objective:To investigate the imaging characteristics and diagnostic value of magnetic resonance imaging (MRI) for postpartum placenta implantation.Methods:Fifty-two patients with suspicious postpartum placenta implantation receiving MRI examination were enrolled.The imaging findings on MRI were analyzed in correlation with the clinical and pathological data,and diagnostic performance was calculated.Results:Of the 53 cases,35 cases were diagnosed as placenta implantation by surgery or pathologic examination,and of them 31 were diagnosed by MRI,with a sensitivity of 88.57％,and specificity of 88.24％.The main MRI feature was placenta-myometrium interface disappearance with a diagnostic sensitivity of 91.43％.And secondly,myometrium was thinned and placenta signal was uneven (sensitivity 74.29％ and 68.57％).The sensitivity and specificity of enhanced MRI examination for diagnosing postpartum placenta implantation were 54.29％ and 100％ respectively.Four cases of retained placenta diagnosed by preoperative MRI were confirmed to be placenta implantation by pathological examination after surgery,While 2 cases of retained placenta were misdiagnosed as placenta implantation by preoperative MRI.Conclusions:MRI is valuable for diagnosing postpartum placenta implantation.For patients with postpartum recovery time less than 4 weeks,enhanced MRI scan is recommended.

Objective:A preliminary study of 3D arterial spin labeling (3D-ASL)technique in observing the quantita-tive whole-brain perfusion in patients with mild amnestic cognitive impairment (MACI)was performed.The relationship of MMSE scores for MACI and the change of brain perfusion was investigated in order to provide the imaging evidence for ear-ly diagnosis.Methods:Seventeen MACI patients and twenty-one age and gender matched normal senior subjects were recrui-ted in this study.Perfusion scans were performed using 3D-ASL technique.Voxel based analyses (VBA)was used for the a-nalysis of perfusion imaging.SPM8 was used for multiple comparison correction.A second-level regression analysis against MMSE scores was performed to identify disease relevant perfusion abnormalities.AlphaSim program was used for multiple comparison correction,in order to control the false positive rate (corrected P <0.05).Results:MACI patients showed nega-tive correlation in bilateral caudate nucleus,right putamen,right hippocampus and amygdala,left thalamus,left frontal orbit-al lobe,right precentral gyrus,positive correlation in left middle frontal gyrus.In the control group,positive correlation was showed in left cuneus,superior temporal gyrus and bilateral middle temporal gyrus.Conclusion:The perfusion regions which are responsible for cognitive declining in MACI patients and normal seniors were obviously different.3D-ASL technique might provide helpful information in early detection of the disease.

Parkinson's disease (PD) is a heterogeneous neurodegenerative disorder with variable clinicopathologic phenotypes and underlying neuropathologic mechanisms. Each clinical phenotype has a unique set of motor symptoms. Tremor is the most frequent initial motor symptom of PD and is the most difficult symptom to treat. The dentate nucleus (DN) is a deep iron‐rich nucleus in the cerebellum and may be involved in PD tremor. In this study, we test the hypothesis that DN iron may be elevated in tremor‐dominant PD patients using quantitative susceptibility mapping. Forty‐three patients with PD [19 tremor dominant (TD)/24 akinetic rigidity (AR) dominant] and 48 healthy gender‐ and age‐matched controls were recruited. Multi‐echo gradient echo data were collected for each subject on a 3.0‐T MR system. Inter‐group susceptibility differences in the bilateral DN were investigated and correlations of clinical features with susceptibility were also examined. In contrast with the AR‐dominant group, the TD group was found to have increased susceptibility in the bilateral DN when compared with healthy controls. In addition, susceptibility was positively correlated with tremor score in drug‐naive PD patients. These findings indicate that iron load within the DN may make an important contribution to motor phenotypes in PD. Moreover, our results suggest that TD and AR‐dominant phenotypes of PD can be differentiated on the basis of the susceptibility of the DN, at least at the group level. Copyright © 2016 John Wiley & Sons, Ltd.

BACKGROUND:This study was to investigate the relationship among aortic artery calcification (AAC), cardiac valve calcification (CVC), and mortality in maintenance hemodialysis (MHD) patients.METHODS:All MHD patients in Shanghai Ruijin Hospital in July 2011 were included. To follow up for 42 months, clinical data, predialysis blood tests, echocardiography, and lateral lumbar X-ray plain radiography results were collected. Plasma FGF23 level was measured using a C-terminal assay.RESULTS:Totally, 110 MHD patients were involved in this study. Of which, 64 (58.2%) patients were male, the mean age was 55.2 ± 1.4 years old, and the median dialysis duration was 29.85 (3.0-225.5) months. About 25.5% of the 110 MHD patients had CVC from echocardiography while 61.8% of the patients had visible calcification of aorta from lateral lumbar X-ray plain radiography. After 42 months follow-up, 25 (22.7%) patients died. Kaplan-Meier analysis showed that patients with AAC or CVC had a significant greater number of all-cause and cardiovascular deaths than those without. In multivariate analyses, the presence of AAC was a significant factor associated with all-cause mortality (hazard ratio [HR]: 3.149, P = 0.025) in addition to lower albumin level and lower 25-hydroxy Vitamin D (25(OH)D) level. The presence of CVC was a significant factor associated with cardiovascular mortality (HR: 3.800, P = 0.029) in addition to lower albumin level and lower 25(OH)D level.CONCLUSION:Lateral lumbar X-ray plain radiography and echocardiography are simple methods to detect AAC and CVC in dialysis patients. The presence of AAC and CVC was independently associated with mortality in MHD patients. Regular follow-up by X-ray and echocardiography could be a useful method to stratify mortality risk in MHD patients.