MR弥散张量成像及弥散张量纤维束示踪成像在不同级别脑胶质瘤诊断中的应用

本文探讨不同级别脑胶质瘤诊断中应用MR弥散张量成像(DTI)及弥散张量纤维束示踪成像(DTT)的价值。选取脑胶质瘤患者84例,比较低级别和高级别脑胶质瘤DTI、DTT参数差异。实验结果显示:高级别瘤周白质纤维束破坏比例明显高于低级别(P0.05);高级别病灶实质区部分各向异性(FA)值明显高于低级别脑胶质瘤(P0.05),而表观扩散系数(ADC)值明显低于低级别(P0.05);高级别瘤周水肿区纤维密度指数(FDi)值明显低于低级别(P0.05);瘤周白质纤维束破坏,病灶实质区FA值和ADC值,瘤周水肿区FDi值鉴别诊断高级别脑胶质瘤的ROC曲线下面积分别为0.857、0.877、0.965和0.828(P0.05)。研究证实:同级别脑胶质瘤中,DTI及DTT参数有所差异,在鉴别诊断中有一定应用价值。     

256层螺旋CT灌注成像参数在脑胶质瘤诊断中的应用价值

本文探讨了256层螺旋CT灌注成像参数在脑胶质瘤诊断中的应用价值。选取91例脑胶质瘤患者纳入本研究,均给予256层螺旋CT灌注成像检查,同时采用免疫组化染色法检测病灶血管内皮生长因子(VEGF)表达。与对侧正常脑组织比较,病灶区CT灌注成像参数脑血流量(CBF)、脑血容量(CBV)和毛细血管表面通透性(PS)明显较高(P0.05);高级别病灶CT灌注成像参数CBF、CBV、PS及VEGF表达光密度值明显高于低级别病灶(P0.05);CBF、CBV与VEGF表达光密度呈正相关(P0.05);CBF、CBV和PS鉴别高级别病灶的AUC分别为0.885、0.877和0.792(P0.05)。256层螺旋CT灌注成像参数在低、高级别脑胶质瘤鉴别中有较好的应用价值,并且与VEGF表达存在相关性,可间接反映血管生成情况。     

先天性感音神经性耳聋患儿的HRCT耳蜗定量参数与听觉传导通路DTI参数的相关性

本研究探讨分析先天性感音神经性耳聋(CSNHL)患儿高分辨率CT(HRCT)定量参数与听觉传导通路磁共振弥散张量成像(DTI)参数的关系。选取CSNHL患儿62例作为观察组,同时选取听力正常患儿50例作为对照组,分析各组HRCT、DTI参数差异。实验结果显示:观察组蜗神经管长度和宽度、耳蜗高度明显低于对照组(P0.05);观察组颞横回、颞上回、内囊后肢、听辐射和上橄榄核各向异性分数(FA)值明显低于对照组(P0.05),表观弥散系数(ADC)值明显高于对照组(P0.05);观察组轻度患儿蜗神经管长度、蜗神经管宽度及耳蜗高度、听辐射FA值明显高于中重度、极重度患儿(P0.05),ADC值明显低于中重度、极重度患儿(P0.05);蜗神经管长度、蜗神经管宽度及耳蜗高度与听辐射FA值呈正相关(P0.05),与听辐射ADC值呈负相关(P0.05)。研究证实:不同严重程度CSNHL患儿HRCT参数蜗神经管长度、蜗神经管宽度及耳蜗高度与听辐射FA、ADC有一定相关性。     

MR-DWI成像预测乳腺癌腋窝淋巴转移的价值

本研究探讨磁共振弥散加权成像(MR-DWI)评估乳腺癌患者腋窝淋巴结转移的价值。回顾性选取乳腺癌患者68例(观察组),同时选取乳腺良性病变患者60例作为对照组,比较两组MR-DWI差异。观察组弥漫高信号、混杂高信号比例明显高于对照组(P<0.05);观察组病灶ADC值明显低于对照组(P<0.05);观察组Ⅲ期病灶ADC值明显低于Ⅰ~Ⅱ期(P<0.05);观察组腋窝淋巴结转移ADC值明显低于无淋巴结转移(P<0.05);弥漫高信号和其他信号组织ADC值比较差异无统计学意义(P>0.05);ADC值预测腋窝淋巴结转移的ROC曲线下面积为0.752,P<0.05。MR-DWI在乳腺癌腋窝淋巴结转移诊断应用价值较好,值得临床使用。     

磁共振T2WI、DWI对直肠癌新辅助治疗疗效的评估价值

本研究探讨磁共振成像T2WI、弥散加权成像(DWI)在直肠癌新辅助治疗疗效的评估价值。选取直肠癌患者92例,给予新辅助治疗,比较治疗前后T2WI、DWI参数变化。治疗无效患者治疗后肿瘤绝对信号值(SIT)明显高于治疗有效患者(P<0.05),而肿瘤绝对信号值减低率(SITRR)、治疗后肿瘤相对信号值(SIT/M)、肿瘤相对信号值减低率(SIT/MRR)明显低于治疗有效患者(P<0.05);治疗无效患者治疗后表观扩散系数(ADC)值、ADC变化值明显低于治疗有效患者(P<0.05);治疗后SIT、SITRR、SIT/MRR预测治疗有效的ROC曲线下面积分别为0.671、0.950和0.879(P<0.05);治疗后ADC值、ADC变化值预测治疗有效的ROC曲线下面积分别为0.717和0.977(P<0.05)。磁共振T2WI图像参数、ADC在预测直肠癌新辅助治疗疗效中有较高的应用价值。     

基于双源CT血管造影技术评估MMP-9、PAF及Lp-PLA2与冠状动脉斑块性质的关系

冠状动脉粥样硬化性心脏病是威胁健康的常见病之一,本研究选取我院2017年2月~2018年12月确诊的206例冠心病患者,其中急性冠脉综合征(acute coronary syndrome,ACS)患者114例(ACS组)、稳定型心绞痛(stable angina pectoris,SAP)患者92例(SAP组),用双源CT血管造影技术检测患者的斑块性质,并检测了血清明胶酶B(MMP-9)、血小板活化因子(PAF)及脂蛋白相关磷脂酶2(Lp-PLA2)浓度,分析MMP-9、PAF及Lp-PLA2与斑块性质间的关系。结果显示,ACS组患者斑块面积和偏心指数均大于SAP组(P<0.05);ACS组患者血清MMP-9、PAF及Lp-PLA2的水平均高于SAP组(P<0.05);ACS组患者易损斑块的比例明显高于SAP组(P<0.05)。所有易损斑块患者血清MMP-9、PAF及Lp-PLA2的水平均高于稳定斑块的患者,且差异具有统计学意义(P<0.05)。患者冠状动脉斑块偏心指数与血清MMP-9、PAF及Lp-PLA2浓度呈正相关关系(P<0.05)。因此,通过双源CT血管造影技术观察冠状动脉粥样硬化斑块性质,结合血清MMP-9、PAF及Lp-PLA2浓度,可以对患者的病情进行评估。血清MMP-9、PAF及Lp-PLA2浓度与斑块的性质及不稳定性有关,可为预测患者冠状动脉斑块性质提供参考。     

多参数MRI对子宫肉瘤与良性子宫肌瘤的鉴别诊断价值及与肿瘤细胞恶性程度的关系

本文选取子宫肉瘤(US)患者103例作为观察组,另选取同期良性子宫肌瘤患者103例作为对照组,探究多参数MRI对US与良性子宫肌瘤的鉴别诊断效果及与肿瘤细胞恶性程度的关系。结果发现,观察组达峰时间(TTP)、扩散系数(ADC)低于对照组;随临床分期增加,TTP、ADC呈下降趋势,TopoⅡα、AgNOR、PDGFα、Matriptase mRNA相对表达量呈升高趋势,TTP、ADC与TopoⅡα、AgNOR、PDGFα、Matriptase mRNA相对表达量呈负相关,且TTP、ADC联合鉴别诊断US和良性子宫肌瘤的AUC值最大,提示US与良性子宫肌瘤MRI参数存在显著差异,且TTP、ADC值与增殖分子、侵袭分子活性直接相关,可为临床鉴别诊断提供数据支持。     

MRI-DWI技术诊断复杂性肛瘘的效能及与治疗效果的关联性分析

选取83例复杂性肛瘘患者作为观察组,选取同期80例健康体检者作为对照组,均接受磁共振弥散加权成像(MRI-DWI)技术检查,统计两组表观扩散系数(ADC)值、肛周疾病活动指数(PDAI)。结果发现,病灶ADC值与肛周异常排泄物评分、并发肛周疾病类型评分、肛周硬结评分呈负相关(P<0.05);ROC曲线显示,ADC诊断复杂性肛瘘价值的曲线下面积(AUC)值为0.826,诊断敏感度及特异度分别为85.54%和66.25%。由此可见,ADC值与复杂性肛瘘患者肛周疾病活动性、疗效及肛周功能具有一定关联性,早期采用MRI-DWI技术检查,可为复杂性肛瘘诊治、病情程度与疗效判断、预后评估提供辅助影像学手段。     

体素内不相干运动扩散加权成像技术对肝细胞癌的诊断效能

本文分析了体素内不相干运动扩散加权成像(IVIM-DWI)技术对肝细胞癌(HCC)微循环功能的评估,及其对HCC的诊断效能。选取经病理证实的120例HCC患者作为研究组,其中,病理分级Ⅰ级58例、Ⅱ级36例、Ⅲ级26例。另选取同期健康体检者120例作为对照组。两组均行3.0T核磁共振常规序列、DWI序列及IVIM序列扫描检查,测量并比较两组灌注参数表观扩散系数(ADC)、灌注分数(f)、真实扩散系数(D)及灌注相关扩散系数(D~*)值,并通过绘制受试者工作特征曲线(ROC)分析上述各参数值对HCC的预测价值。研究组ADC、D值均低于对照组,f、D~*值均高于对照组,差异有统计学意义(P0.05);Ⅰ级患者的ADC、D值均高于Ⅱ级、Ⅲ级患者,f、D~*值均低于Ⅱ级、Ⅲ级患者,差异有统计学意义(P0.05);Ⅱ级患者的ADC、D值均高于Ⅲ级患者,f、D~*值均低于Ⅲ级患者,差异有统计学意义(P0.05);ADC、f、D、D~*值预测肝癌的曲线下面积分别为0.799、0.600、0.700、0.593,其中ADC、D值对肝癌的预测效果较好(P0.05),其最佳诊断阈值分别为2.011×10~(-3) mm~2/s、2.141×10~(-3) mm~2/s。结果表明,IVIM-DWI技术对肝癌微循环功能评估具有较高的应用价值,其灌注参数有助于肝癌的病理分级诊断,其ADC、D值对HCC具有较高的诊断效能。     

超声弹性成像参数联合血清MK和VEGF对分化型甲状腺癌的诊断价值及与肿瘤恶性程度关系研究

本研究选取了分化型甲状腺癌(DTC)患者106例为甲状腺癌组,同期106例甲状腺腺瘤患者为甲状腺腺瘤组,检测比较了两组患者的超声弹性成像参数(弹性比值、蓝色面积比值)、血清中期因子(midkine,MK)、血管内皮生长因子(VEGF)水平。研究结果发现,弹性比值、蓝色面积比值、血清MK和VEGF水平与DTC患者淋巴结转移、包膜侵犯、临床分期相关(P<0.05);弹性比值、蓝色面积比值、血清MK和VEGF水平联合诊断DTC的曲线下面积(AUC)为0.888;弹性比值、蓝色面积比值、血清MK及VEGF水平与DTC患者组织中趋化因子受体(CXCR)4、解聚素金属蛋白酶(ADAM)9、靶向Xklp2靶蛋白(TPX2)基因表达量呈正相关,与程序性细胞死亡因子(PDCD)4基因表达量呈负相关。这些结果提示超声弹性成像参数、血清MK及VEGF水平上调可能用来评估DTC患者病情程度及肿瘤恶性程度,三者联合对DTC具有可靠诊断价值,可为临床诊治提供参考。     

Combination of surgical resection and photodynamic therapy of 9L gliosarcoma in the nude rat

The objective of the present study was to investigate the treatment of 9L gliosarcoma brain tumor in the rat with the combination of surgical resection and photodynamic therapy (PDT). Nude rats with intracranial 7-day-old 9L gliomas were randomly subjected to no treatment, PDT alone (Photofrin: 2 mg kg(-1), optical: 80 J cm(-2)), surgical resection alone or resection combined with 2 mg kg(-1) Photofrin-mediated PDT at an optical dose of 80 J cm(-2). All animals were sacrificed 14 days after tumor implantation. Hematoxylin-and-eosin and immunohistochemical stainings were performed to assess the tumor volume and the expression of vascular endothelial growth factor (VEGF) in the brain adjacent to the tumor (BAT) as well as the tumor cell apoptosis and proliferation. Our data show that both surgical resection alone and PDT alone significantly decreased tumor volume, but furthermore, surgical resection combined with PDT significantly reduced the tumor volume and reduced local tumor infiltration compared to either surgical resection or PDT treatment alone. PDT treatment with or without resection increased tumor apoptosis, but resection alone did not alter the tumor cell apoptosis compared with a nontreatment control group. Both surgical resection alone and PDT alone induced a significant increase in VEGF expression in the BAT; however intraoperative PDT did not further increase VEGF expression, compared with surgery alone or PDT alone. No significant differences were found in tumor cell proliferation as indicated by Ki67 immunoreactivity among the four groups. Our results suggest that PDT enhances the efficacy of surgical resection in the management of malignant gliomas without increasing VEGF expression in the BAT.     

Analysis of human brain tissue, brain tumors and tumor cells by infrared spectroscopic mapping

This study uses infrared (IR) spectroscopic, point detection, mapping procedures to examine tissue samples from normal brain specimens and from astrocytic gliomas, the most frequent human brain tumors. Model systems were derived from cultured glioma cell lines. IR spectra of normal tissue sections distinguished white matter from gray matter by increased spectral contributions from lipids and cholesterol. Qualitatively the same differences were found in IR spectra of low and high grade glioma tissue sections pointing to a significant reduction of brain lipids with increasing malignancy. Whereas spectral contributions of proteins and lipids were similar in IR spectra of glioma cells and tissues, nucleic acid bands were more intense for cells suggesting higher proliferative activities. For statistical analyses of IR spectroscopic maps from 71 samples, a parameter for the lipid to protein ratio was introduced involving the CH(2) symmetric stretch band with lipids as main contributors and the amide I band of proteins. As this parameter correlated with the grade of gliomas obtained from standard histopathological examination, it was applied to classify brain tissue sections based on IR spectroscopic mapping.     

Differential effects of photofrin, 5-aminolevulinic acid and calphostin C on glioma cells

The invasive nature of malignant gliomas makes treatment by surgery alone extremely difficult. However, the preferential accumulation of photosensitisers in neoplastic tissues suggests photodynamic therapy (PDT) may be useful as an adjuvant therapy following tumour resection. In this study, the potential use of three different photosensitisers, namely Photofrin, 5-aminolevulinic acid (5-ALA) and calphostin C in the treatment of glioma was investigated. The uptake, cytotoxicity on U87 and GBM6840 glioma cell lines were determined by flow cytometry and MTT assay respectively. Their effect on glioma cell invasiveness was evaluated by (1) measuring the levels of matrix degradation enzymes matrix metalloproteinase (MMP)-2 and -9 using gelatin zymography, and (2) Matrigel invasion assay. The results showed that uptake of calphostin C reached saturation within 2 h, while Photofrin and 5-ALA induced protoporphyrin IX (PpIX) levels elevated steadily up to 24 h. Photocytotoxic effect on the two glioma cell lines was similar with LD50 at optimal uptake: 1 microg/mL Photofrin at 1.5 J/cm(2); 1 mM 5-ALA at 2 J/cm(2) and 100 nM calphostin C at 2 J/cm(2). The inhibition in cell proliferation after Photofrin treatment was similar for both cell lines, which correlated to more cells being arrested in the G0/G1 phase of the cell cycle (P<0.01). By contrast, U87 was more sensitive to calphostin C whereas GBM6840 was more susceptible to 5-ALA treatment. The ability of both cell lines to migrate through the Matrigel artificial basement membrane was significantly reduced after PDT (P<0.001). This might be due to a decreased production in MMP-2 and MMP-9, together with the reduction of adhesion molecule expression. Photofrin was most superior in inhibiting cell invasion and calphostin C was least effective in reducing adhesion molecule expression. Taken together, PDT could be useful in the treatment of gliomas but the choice of photosensitisers must be taken into consideration.     

An integrated experimental and analytical approach to the chemical state imaging of iron in brain gliomas using X-ray absorption near edge structure spectroscopy

X-ray absorption near-edge structure spectroscopy is used for human neoplastic tissues in order to investigate distributions and chemical states of iron. The specimens used in this study were obtained intraoperatively from brain gliomas of different types and various grades of malignancy and from a control subject. An integrated experimental and analytical approach toward topographic and quantitative analysis in thin freeze-dried cryo-sections is presented. The full XANES spectra at the Fe absorption K edge show the presence of both chemical forms of Fe in the analyzed points of the tissues. The main goal of the work is the chemical state imaging of Fe in tissue areas. Topographic analysis of Fe speciation in the tissues investigated with the use of the XANES technique indicates the presence of microstructures where Fe²⁺ is dominant as well as those with a high abundance of the oxidized form of Fe. The quantitative analysis shows that for all cases the content of the oxidized form of Fe is significantly higher in comparison with Fe²⁺. The highest level of Fe³⁺ is found in the control sample, and the lowest one for the glioma of the highest grade of malignancy. The content of either Fe²⁺ or Fe³⁺ is increased in low grade gliomas in comparison to high-grade malignant tumors.     

Characterization of lipid extracts from brain tissue and tumors using Raman spectroscopy and mass spectrometry

Brain tissue is characterized by high lipid content. The amount of lipids decreases, and its composition changes in the most frequent primary brain tumor, the glioma. Scope of the current paper was to extract quantitatively lipids from porcine and human brain tissue as well as from five human gliomas using a modified protocol according to Folch. The lipid extracts were studied by Raman spectroscopy with 785 nm excitation and by mass spectrometry with electron impact ionization. Porcine and human brain tissues have similar water and lipid content and show similar Raman and mass spectra. In contrast, gliomas are characterized by increased water content and decreased lipid content. Elevated phosphatidylcholine to cholesterol ratios in lipid extracts of gliomas were indicated by Raman bands of the choline group and cholesterol. Due to its higher sensitivity, mass spectrometry detected increased levels of cholesterol ester relative to cholesterol in lipid extracts of gliomas. For comparison, thin tissue sections were prepared from the glioma specimens before lipid extraction; infrared spectroscopic images were recorded and analyzed by a supervised classification model. This study demonstrates how to improve the analysis of brain tumors and to complement the diagnosis of brain pathologies using a multimodal approach.     

Matrix metalloproteinase-28 deletion amplifies inflammatory and extracellular matrix responses to cardiac aging

To determine if matrix metalloproteinase (MMP)-28 mediates cardiac aging, wild-type (WT) and MMP-28-/- young (7 ± 1 months, n = 9 each) and old (20 ± 2 months, n = 7 each) female mice were evaluated. MMP-28 expression in the left ventricle (LV) increased 42% in old WT mice compared to young controls (p < 0.05). By Doppler echocardiography, LV function declined at 20 ± 2 months of age for both groups. However, dobutamine stress responses were similar, indicating that cardiac reserve was maintained. Plasma proteomic profiling revealed that macrophage inflammatory protein (MIP)-1 α, MIP-1β and MMP-9 plasma levels did not change in WT old mice but were significantly elevated in MMP-28-/- old mice (all p < 0.05), suggestive of a higher inflammatory status when MMP-28 is deleted. RT2-PCR gene array and immunoblotting analyses demonstrated that MIP-1α and MMP-9 gene and protein levels in the LV were also higher in MMP-28-/- old mice (all p < 0.05). Macrophage numbers in the LV increased similarly in WT and MMP-28-/- old mice, compared to respective young controls (both p < 0.05). Collagen content was not different among the WT and MMP-28-/- young and old mice. In conclusion, LV inflammation increases with age, and MMP-28 deletion further elevates inflammation and extracellular matrix responses, without altering macrophage numbers or collagen content.