游离血管化髂骨瓣：26例回顾分析

该文对应用游离髂骨瓣修复颌骨缺损的病例进行回顾研究，并分析手术并发症。作者共用26块髂骨肌瓣、1块髂骨肌皮瓣修复18例下颌骨和8例上颌骨缺损。1例因微血管再灌注问题而导致手术失败：3例术后行组织瓣抢救，其中2例吻合口血栓形成，重新吻合血管后抢救成功；10例术后出现股外侧皮神经支配区皮肤麻木，3例并发切口疝，1例供区创口裂开，2例并发口鼻瘘，1例颈部创口感染，     

Different patterns of cerebellar abnormality and hypomyelination between POLR3A and POLR3B mutations

Background

Mutations of POLR3A and POLR3B have been reported to cause several allelic hypomyelinating disorders, including hypomyelination with hypogonadotropic hypogonadism and hypodontia (4H syndrome). Patients and methods: To clarify the difference in MRI between the two genotypes, we reviewed MRI in three patients with POLR3B mutations, and three with POLR3A mutations. Results: Though small cerebellar hemispheres and vermis are common MRI findings with both types of mutations, MRI in patients with POLR3B mutations revealed smaller cerebellar structures, especially vermis, than those in POLR3A mutations. MRI also showed milder hypomyelination in patients with POLR3B mutations than those with POLR3A mutations, which might explain milder clinical manifestations. Conclusions: MRI findings are distinct between patients with POLR3A and 3B mutations, and can provide important clues for the diagnosis, as these patients sometimes have no clinical symptoms suggesting 4H syndrome.     

Metabolic changes in early childhood using LCModel with corrected water scaling method

Purpose:

To examine metabolic changes of the brain in early infancy measured by the LCModel with the water scaling method (LCModel‐WS), and to determine whether the unsuppressed water signal (UWS) on the MR console and the area of the unsuppressed water peak (AUW) in the LCModel can be used to correct metabolite concentrations.

Materials and Methods:

MR spectroscopy was performed on a 1.5 Tesla MR scanner. To determine whether UWS and AUW increases linearly with PD and exp(‐TE/T2), these values were measured using three phantoms with different PD and T2 values. UWS and AUW were also measured (PRESS, TR = 5000 ms, TE = 30 ms, VOI = 4.5 mL) in 57 pediatric controls (aged 2 weeks to 15 years).

Results:

Phantom studies revealed UWS and AUW increases linearly with PD and exp(‐TE/T2). UWS and AUW were high in controls younger than 2 years of age, but gradually decreased to become almost constant after 4 years (UWS = 504 × 10³, AUW = 2.05 × 10⁷). AUW was linearly proportional to UWS in controls. These indicated that metabolite concentrations should be multiplied by the ratio of UWS/504 × 10³ or AUW/2.05 × 10⁷. Age dependent metabolite concentrations corrected by the ratio were obtained.

Conclusion:

Both UWS and AUW can be used to correct metabolite concentrations; these corrections can significantly improve quantification of metabolites' concentration in early childhood. J. Magn. Reson. Imaging 2012;35:174‐180. © 2011 Wiley Periodicals, Inc.