Computer-assisted analysis of human upper arm flexion by 4D-visualization based on MRI

Purpose  

4D-visualization of the human upper arm based on sequential or dynamic MRI may be useful in functional orthopedic disorders and surgical planning. A cascade of 4D-visualization approaches have been applied including deformation of the soft tissue surfaces and muscular contraction. Skeletal structures and the epifascial tissue comprising vascular structures are included in the 4D-visualization.     

Lumbar disc sequestration mimicking a tumor: Report of four cases and a literature review

BACKGROUNDDisc herniation refers to the displacement of disc material beyond its anatomical space. Disc sequestration is defined as migration of the herniated disc fragment into the epidural space, completely separating it from the parent disc. The fragment can move in upward, inferior, and lateral directions, which often causes low back pain and discomfort, abnormal sensation, and movement of lower limbs. The free disc fragments detached from the parent disc often mimic spinal tumors. Tumor like lumbar disc herniation can cause clinical symptoms similar to spinal tumors, such as lumbar soreness, pain, numbness and weakness of lower limbs, radiation pain of lower limbs, etc. It is usually necessary to diagnose the disease according to the doctor''s clinical experience, and make preliminary diagnosis and differential diagnosis with the help of magnetic resonance imaging (MRI) and contrast-enhanced MRI. However, pathological examination is the gold standard that distinguishes tumoral from non-tumoral status. We report four cases of disc herniation mimicking a tumor, and all the pathological results were intervertebral disc tissue.CASE SUMMARYThe first case was a 71-year-old man with low back pain accompanied by left lower extremity radiating pain for 1 year, with exacerbation over the last 2 wk. After admission, MRI revealed a circular T2-hypointense lesion in the spinal canal of the L4 vertebral segment, with enhancement on contrast-enhanced MRI suggesting neurilemmoma. The second case was a 74-year-old man with pain in both knees associated with movement limitation for 3 years, with exacerbation over the last 3 mo. MRI revealed an oval T2-hyperintense lesion in the spinal canal at the L4–5 level, with obvious peripheral enhancement on contrast-enhanced MRI. Thus, neurilemmoma was suspected. The third case was a 53-year-old man who presented with numbness and weakness of the lumbar spine and right lower extremity for 2 wk. MRI revealed a round T2-hyperintense lesion in the spinal canal at the L4–5 level, with obvious rim enhancement on contrast-enhanced MRI. Thus, a spinal tumor was suspected. The fourth case was a 75-year-old man with right lower extremity pain for 2 wk, with exacerbation over the last week. MRI revealed a round T1-isointense lesion in the spinal canal of the L3 vertebral segment and a T2-hyperintense signal from the lesion. There was no obvious enhancement on contrast-enhanced MRI, so a spinal tumor was suspected. All four patients underwent surgery and recovered to ASIA grade E on postoperative days 5, 8, 8, and 6, respectively. All patients had an uneventful postoperative course and fully recovered within 3 mo.CONCLUSIONDisc herniation mimicking a tumor is a relatively rare clinical entity and can be easily misdiagnosed as a spinal tumor. Examinations and tests should be improved preoperatively. Patients should undergo comprehensive preoperative evaluations, and the lesions should be removed surgically and confirmed by pathological diagnosis.     

兔腰椎间盘退行性病变模型的建立及影像学改变

背景:建立最佳的椎间盘退行性病变动物模型对了解椎间盘退行性病变的发生机制、预防与治疗均具有重要意义.目的:以针刺损伤制备兔椎间盘退行性病变模型,通过X射线及MRI分析针刺损伤对椎间盘高度及退行性病变的影响.设计:随机对照观察.单位:解放军第二军医大学长海医院骨科.材料:实验于2005-06/2006-04在解放军第二军医大学长海医院动物中心完成,选用6只健康新西兰大白兔,雌雄不拘,平均6月龄,体质量平均为2.5 kg,均来自解放军第二军医大学长海医院动物中心,许可证号码为SCXK (hu) 2002-0006.实验过程中对动物的处置符合动物伦理学标准.方法:①采用腹膜后入路对实验兔腰椎进行手术,以L3～4椎间盘为正常对照, 不做处置;L4～5椎间盘作为假手术,只进行暴露;L5～6椎间盘暴露后用24 G针头从椎间盘的前外侧针刺3次.②分别于术前及术后4周采用Simens公司CR机拍摄腰椎正侧位X射线片,测量L3～4,L4～5及L5～6椎间隙高度,计算与术前椎间隙高度比值;采用Simens Avanto 1.5 T 医用超导型磁共振扫描仪检测各节段腰椎间盘T2加权信号,根据信号强度记分,4分为正常椎间盘,髓核内信号均匀、明亮;3分为轻微退行性病变椎间盘,T2加权信号部分降低;2分为中度椎间盘退行性病变,T2加权信号明显降低;1分为重度椎间盘退行性病变,其T2加权信号明显降低,而且伴有椎间隙狭窄.主要观察指标:①腰椎X射线侧位片椎间盘高度变化.②椎间盘退行性病变程度.结果:纳入实验兔6只,均进入结果分析,无脱落.①椎间盘高度变化:L3～4及L4～5术后与术前椎间盘高度比分别为0.982 5±0.017 08,0.972 5±0.017 08,均高于L5～6椎间盘高度比(0.550 0±0.025 82),差异有统计学意义(P ＜ 0.01).②腰椎MRI的T2加权像上观察椎间盘退行性病变程度:L3～4及L4～5椎间盘T2加权像信号得分分别为(4.00±0.0),(3.75±0.5)分,均高于L5～6椎间盘,差异有统计学意义(P ＜ 0.01).结论:针刺损伤实验兔椎间盘4周后可造成椎间盘高度降低,并使椎间盘出现明显退行性病变.     

兔腰椎间盘退行性病变模型的建立及影像学改变

背景：建立最佳的椎间盘退行性病变动物模型对了解椎间盘退行性病变的发生机制、预防与治疗均具有重要意义。 目的：以针刺损伤制备兔椎间盘退行性病变模型，通过X射线及MRI分析针刺损伤对椎间盘高度及退行性病变的影响。 设计：随机对照观察。 单位：解放军第二军医大学长海医院骨科。 材料：实验于2005—06／2006—04在解放军第二军医大学长海医院动物中心完成，选用6只健康新西兰大白兔，雌雄不拘，平均6月龄，体质量平均为2．5kg，均来自解放军第二军医大学长海医院动物中心，许可证号码为SCXK（hu）2002-0006。实验过程中对动物的处置符合动物伦理学标准。 方法：①采用腹膜后入路对实验兔腰椎进行手术，以L3-4椎间盘为正常对照，不做处置；L4-5椎间盘作为假手术，只进行暴露；L5-6椎间盘暴露后用24G针头从椎间盘的前外侧针刺3次。②分别于术前及术后4周采用Simens公司CR机拍摄腰椎正侧位X射线片，测量L3-4，L4-5及L5-6椎间隙高度，计算与术前椎间隙高度比值；采用Simens Avanto 1．5T医用超导型磁共振扫描仪检测各节段腰椎间盘T2加权信号，根据信号强度记分，4分为正常椎间盘，髓核内信号均匀、明亮：3分为轻微退行性病变椎间盘，T2加权信号部分降低：2分为中度椎间盘退行性病变，T2加权信号明显降低；1分为重度椎间盘退行性病变，其T2加权信号明显降低，而且伴有椎间隙狭窄。 主要观察指标：①腰椎X射线侧位片椎间盘高度变化。②椎间盘退行性病变程度。结果：纳入实验兔6只，均进入结果分析，无脱落。①椎间盘高度变化：L3-4及L4-5术后与术前椎间盘高度比分别为0．9825±0.01708，0．9725±0．01708，均高于L5-6椎间盘高度比（0．5500±0．02582），差异有统计学意义（P〈0．01）。②腰椎MRI的T2加权像上观察椎间盘退行性     

颞下颌关节紊乱病患者临床特征及MRI影像表现

  目的  探讨182例颞下颌关节紊乱病患者的临床特征及MRI影像表现。  方法  回顾性选取2018年9月~2021年6月于我院就诊的182例颞下颌关节紊乱病患者364只颞颌关节为研究对象,收集并分析其临床病例资料,包括一般资料、临床特征及MRI影像表现等。  结果  182例颞下颌关节紊乱病患者364只关节,关节盘可复性前移162只关节,不可复性前移114只关节,侧方移位27只关节,关节盘损伤变性60只,关节盘穿孔32只,髁状突变形、破坏47例,关节囊、韧带损伤31例。患者临床特征复杂多变,但多数患者普遍表现为关节疼痛、弹响、张口受限、下颌偏斜等症状。MRI图像可见清晰的关节盘位置、形态、厚度变化和关节积液。  结论  颞下颌关节紊乱病患者临床特征多样,可通过MRI精确反映颞下颌关节紊乱病进展中关节盘位置、形态及厚度变化情况,提高临床诊断准确性。      

经直肠超声与体部线圈磁共振检查对直肠癌T分期的比较研究

目的比较经直肠超声(ERUS)和体部线圈MRI对直肠癌T分期诊断准确性。方法回顾性分析31例术前未接受新辅助放化疗的直肠癌患者,对所有患者均于术前1周行ERUS和MR检查、后行一期手术切除。以术后病理结果作为金标准,比较ERUS和MRI对直肠癌T分期的诊断效能。结果 31例患者中,术后病理诊断T1期7例,T2期6例,T3期18例。ERUS显示病变累及肠管长度约(28.18±13.30)mm,MRI显示约为(35.58±18.24)mm,二者差异有统计学意义(t=3.497,P=0.002),但两种检查所测得病变下缘距肛门距离、病灶厚度的差异均无统计学意义(P均>0.05)。ERUS诊断直肠癌T1、T2、T3、T4期的准确率分别为93.55%,93.55%,87.10%和100%,总准确率为93.55%;MRI诊断直肠癌T1、T2、T3、T4期的准确率分别为87.10%,70.97%,64.52%和93.55%,总准确率为79.03%;ERUS、MRI诊断的直肠癌各期以及总准确率的差异均无统计学意义(P均>0.05)。结论 ERUS和MRI均为直肠癌术前分期诊断的可靠检查方法,ERUS对于T分期的准确性稍高于MRI。     

三维二值掩模零化法结合体素绘制法切割及渲染CT与MRI体积数据

目的 观察三维二值掩模零化法联合体素绘制法对于切割及渲染CT与MRI体积数据的作用。方法 利用Matlab软件将DICOM形式头颈部CT、腹部平扫CT、正常头部MR T1WI及脑胶质瘤T1WI转化为体积数据，以半自动或手动方法获得相应掩模图像；基于原始掩模以零化法在x、y、z轴方向对体积数据进行正向与反向切割，结合三维体素绘制法对切割后的模型进行渲染。结果 所获目标结构原始掩模可在体素绘制后突出显示CT及MRI数据中的相应解剖结构。基于体素绘制法实现了以三维二值掩模零化法与原体数据点积后切割模型，结合手动输入不同阈值进行切割可显示脑胶质瘤及其毗邻结构。结论 三维二值掩模零化法联合体素绘制法可结合不同层面CT与MRI体积数据显示其内部结构。     

3.0TMRI弥散加权成像评价腰椎间盘退变原因的价值

背景：MR 弥散加权成像对水分子的扩散运动敏感,能早期了解椎间盘纤维环和髓核的含水量改变,从而明确其退变程度。 目的：通过对109例腰椎间盘的弥散加权成像进行前瞻性研究,旨在提高应用MRI中弥散加权成像序列对椎间盘退变程度和早期变性诊断的认识。 方法：采用Siemens Verio 3.0T 超导磁共振仪。常规平扫包括矢状位T1WI序列及T2WI抑脂序列;弥散加权成像采用SE-EPI序列行矢状位扫描,取b值为800s/mm2,层厚、间距和显示野同T2WI抑脂序列扫描。根据Pfirrmann等的椎间盘退变分级标准,采用盲法在矢状位T2WI上对符合纳入标准的109例545个腰椎间盘进行分级。将弥散加权成像数据传至工作站,并对表观扩散系数图像进行测量,得到表观扩散系数值。分别画出L1/2-L5/S1椎间盘的感兴趣区,记录数据。 结果与结论：年龄与椎间盘退变分级存在明显相关性,年龄越大高级别数量越多。椎间盘表观扩散系数值影响因素分析：男性与女性各椎间盘表观扩散系数值之间差异无显著性意义（P〉0.05）。L1-S1各椎间盘年龄与表观扩散系数值之间存在负相关（P 〈0.05）;椎间盘评级与表观扩散系数值之间存在负相关（P 〈0.05）。提示通过对表观扩散系数值的研究,弥散加权成像将会成为椎间盘退行性变诊断、特别是椎间盘早期退变、无创评价治疗效果及预后判断的重要技术手段。     

MRI对鼻咽癌T、N分期的影响

目的探讨MRI对鼻咽癌(NPC)的UICC/AJCC(2002,6th)分期和我国1992年福州分期的影响.方法分析经病理证实的39例NPC患者的影像学资料,治疗前1周内均有CT和MRI资料.结果 CT不能显示咽颅底筋膜,MRI显示清楚;MRI显示茎突后间隙肿块和鼻窦肿块性质较CT明确;MRI显示颅底骨质肿瘤侵犯较CT敏感.根据UICC/AJCC分期标准,28.2%(11/39)的病例发生分期改变,根据1992年福州分期标准,35.9%(14/39)发生改变.结论 MRI对于鼻咽癌的侵犯途径和范围,特别早期诊断有重要意义.建议NPC临床分期应考虑以MRI为标准.     

Combining atlas-based parcellation of regional brain data acquired across scanners at 1.5 T and 3.0 T field strengths

Longitudinal brain morphometric studies designed for data acquisition at a single MRI field strength can be seriously limited by system replacements from lower to higher field strength. Merging data across field strengths has not been endorsed for a variety of reasons, yet the ability to combine such data would broaden longitudinal investigations. To determine whether structural T1-weighted MRI data acquired across MR field strengths could be merged, parcellations of archival SPGR data acquired in 114 individuals at 1.5 T and at 3.0 T within 3 weeks of each other were compared. The first set of analyses examined 1) the correspondence between regional tissue volumes derived from data collected at 1.5 T and 3.0 T and 2) whether there were systematic differences for which a correction factor could be determined and applied to improve measurement agreement. Comparability of regional volume determination at 1.5 T and 3.0 T was assessed with intraclass correlation (ICC) computed on volumes derived from the automated and unsupervised SRI24 atlas registration and parcellation method. A second set of analyses measured the reliability of the registration and quantification using the same approach on longitudinal data acquired in 69 healthy adults at a single field strength, 1.5 T, at an interval < 2 years. The mainstay of the analyses was based on the SRI24 method; to examine the potential of merging data across field strengths and across image analysis packages, a secondary set of analyses used FreeSurfer instead of the SRI24 method. For both methods, a regression-based linear correction function significantly improved correspondence. The results indicated high correspondence between most selected cortical, subcortical, and CSF-filled spaces; correspondence was lowest in the globus pallidus, a region rich in iron, which in turn has a considerable field-dependent effect on signal intensity. Thus, the application of a regression-based correction function that improved the correspondence in regional volume estimations argues well for the proposition that selected T1-weighted regional anatomical brain data can be reliably combined across 1.5 T and 3.0 T field strengths with the application of an appropriate correction procedure.     

3.0T磁共振T2* mapping成像诊断腰椎间盘退变

目的 评价T2^* mapping成像技术在诊断腰椎间盘退变中的临床应用价值。方法 对12例下腰痛患者(症状组)及12名无症状志愿者 (对照组)行腰椎间盘MR扫描,在L₁-S₁共120个椎间盘放置ROI,测量相应的T2^*值,并按Pfirrmann标准对常规 T2WI显示的椎间盘进行分级,分析并比较症状组和对照组腰椎间盘内T2^*值的差异,对T2^*值与椎间盘分级间的相关性采用Spearman相关分析。结果 症状组椎间盘Pfirrmann分级平均得分高于对照组(t=5.04,P<0.05)。症状组腰椎间盘平均T2^*值为(76.90±33.10)ms,低于对照组[(116.00±71.60)ms,P<0.05]。症状组和对照组T2^*值均与Pfirrmann分级呈负相关(r=-0.84、-0.76,P均<0.05)。结论 T2^* mapping成像技术能为影像学量化诊断腰椎间盘退变提供依据。     

定量磁共振T2映射成像在椎间盘退变中的研究进展

椎间盘退变是引起下腰背痛的主要原因之一,影像学的检查是诊断椎间盘退变的重要手段。传统MRI技术虽可显示椎间盘的信号强度和形态学改变,但很难客观量化椎间盘退变的程度。T2 mapping技术能够检测椎间盘内水含量、蛋白多糖含量及胶原纤维排列顺序等多种生化成分,为椎间盘退变早期临床评估提供新的方法。本文从T2 mapping与其他定量磁共振技术对比,及其与椎间盘退变分级、日本骨科学会评分、视觉模拟评分及年龄、性别等联系论述定量磁共振T2映射成像在椎间盘退变中的研究进展。      

单侧椎弓根螺钉置入并椎间融合对邻近椎间盘节段退变的影响

背景:坚强内固定和良好融合存在严重缺陷和不足。目前还未见临床应用单侧椎弓根螺钉固定结合椎间cage植骨融合治疗腰椎退变性疾病对邻近节段退变影响的相关报道。目的:回顾分析单侧椎弓根螺钉固定结合椎间cage植骨融合治疗部分腰椎退变性疾病后对固定融合邻近上下节段退变的影响。方法:2006-03/2009-12对收治的部分腰椎管狭窄症、腰椎失稳及腰椎间盘脱出症患者22例,进行了单侧椎弓根螺钉固定加椎间cage植骨融合,术中不显露对侧。在固定融合后3,6,12,20个月及取出内固定钉棒后3,6个月,随访X射线片及MRI。针对X射线片运用角平分线法测量固定融合邻近上位椎间隙高度变化,MRI测量椎间盘髓核退变情况。结果与结论:所有病例获得随访,患者椎管狭窄症状及神经根性症状消失,并且在随访期间内没有新的临床症状出现。固定融合前、固定融合后3,6,12,20个月邻近节段上位椎间隙高度分别为(7.420±0.0354),(7.4266±0.0369),(7.4533±0.0369),(7.5166±0.0369),(7.4308±0.0369)mm,结果表明,腰椎单侧固定融合后邻近节段椎间隙高度无明显变化(P>0.05)。MRI测量结果显示,固定融合邻近上位椎间盘髓核信号在T2加权像无明显退变。提示单侧椎弓根螺钉固定结合椎间融合治疗部分腰椎退变性疾病能有效预防固定融合邻近上下节段退变。     

3D U-Net深度学习模型基于盆腔T2WI自动分割盆腔软组织结构

目的 评估3D U-Net深度学习(DL)模型基于盆腔T2WI自动分割盆腔软组织结构的可行性.方法 回顾性分析147例经病理证实或盆腔MRI随访观察确诊的前列腺癌或良性前列腺增生患者,其中28例接受2次、121例接受1次盆腔MR扫描,共175组T2WI;手动标注T2WI所示软组织结构,包括前列腺、膀胱、直肠、双侧精囊腺...     

3D MRI诊断胎儿体表畸形的研究

目的 研究3D MRI显示胎儿体表正常结构和畸形的临床应用价值.方法 对34例孕妇行US检查和MRI检查.胎儿尸检及出生后随访证实体表畸形36例,共42处.MR扫描均采集单次激发快速自旋回波序列(SSFSE),厚层重T2WI,三维稳态进动快速成像(3D FIESTA)序列,然后对3D FIESTA序列原始数据行多平面重...     

不同种类超顺磁性氧化铁标记猪骨髓间充质干细胞的体外MR成像

背景:干细胞磁性标记是新近开展的一项干细胞体外标记技术,结合MR成像设备可以活体监控移植入体内的干细胞.目的:明确超顺磁性氧化铁粒子体外标记猪骨髓间充质干细胞的方法、不同种类超顺磁性氧化铁标记细胞经MR成像的特征及可成像的最低标记细胞量.设计、时间及地点:对比观察,于2006-09/2007-03在苏州大学医学部心血管外科实验室及苏州大学附属第一医院影像中心完成.材料:猪髂骨骨髓由太湖梅山猪新鲜采集:超顺磁性氧化铁纳米颗粒为德国Schering公司产品;超微型超顺磁性氧化铁纳米颗粒由苏州大学化学与化工学院提供:铁颗粒晶核表面包被葡聚糖,3种超微型超顺磁性氧化铁包被葡聚糖后根据颗粒大小(12,15,20 nm)分别依次简称为1#,2#,3#.方法:分离、纯化、培养猪骨髓间充质干细胞,体外进行不同种类超顺磁性氧化铁标记,染色及荧光显微镜观察;测量并绘制未标记细胞和标记细胞的MTT生长曲线;选取不同的细胞量组(Feridex标记细胞分别选取1×106、5×105及1×105L-1量组,未标记细胞选取5×105L-1量组,1#、2#及3#超微型超顺磁性氧化铁标记细胞均选取5×105L-1量组)进行标记后MR成像,测量不同扫描序列标记细胞管的信号强度改变,并进行统计学分析.主要观察指标:超顺磁性氧化铁标记干细胞的普鲁士蓝染色检测标记率:标记干细胞的MTT生长曲线;双染色法检测细胞凋亡;不同Ependoff管内细胞团T1WI、T2WI和FFE图像的信号强度.结果:应用多聚赖氨酸介导干细胞磁标记方法标记骨髓间充质干细胞有效率为100%,普鲁士蓝染色见细胞浆内有多少不等的蓝染铁颗粒;超顺磁性氧化铁标记的间充质干细胞在T2WI尤其是FFE(T2WI)序列信号明显降低;在25 mg/L Fe培养液标记浓度下,MR成像的最低细胞量为1×105;在不同种类超顺磁性氧化铁标记下,2#、3#USPIO与Feridex在T2WI及T2*WI上有显著性差异(P<0.01);而1#USPIO与Feridex在T2WI及T2WI上差异无显著性意义(P>0.05):Feridex标记间充质干细胞在T2WI及T2WI上与T1WI相比,差异均有显著性意义(P<0.01).结论:超顺磁性氧化铁可以简便标记间充质干细胞并且在适当浓度下对间充质干细胞的生物学活性没有影响,MR T2WI和T2*WI序列可敏感显像磁性标记的干细胞.     

髁突骨折急性期颞下颌关节MRI表现

目的 探讨MRI在髁突骨折后颞下颌关节软组织损伤中的诊断价值.方法 选取我院急性单侧或双侧髁突骨折17例行MRI检查,根据受伤的严重程度及损伤的类型进行分类、分级,分析髁突损伤程度与颞下颌关节软组织损伤的相关性.结果 17例共23个髁突骨折,其中14个为髁突Ⅱ级损伤,9个为Ⅲ级损伤.Ⅱ级、Ⅲ级损伤中出现关节盘移位分别为8个（57.1％）、9个（100.0％）,关节内出血为5个（35.7％）、9个（100.0％）,组间比较差异有统计学意义（P＜0.05）;关节囊撕裂分别为1个（7.1％）、2个（22.2％）,组间比较差异无统计学意义（P＞0.05）.髁突骨折损伤程度与关节盘移位、关节内出血呈明显正相关性（r =0.691、0.643）,与关节囊撕裂无明显相关性（r=0.219）.结论 MRI可明确诊断髁突骨折患者颞下颌关节软组织损伤,且髁突损伤程度越重,关节盘移位、关节内出血概率越高.     

Nucleus pulposus deformation following application of mechanical diagnosis and therapy: a single case report with magnetic resonance imaging

Background

The McKenzie management strategy of mechanical diagnosis and therapy (MDT) is commonly used for the assessment and management of spinal problems. Within this system, ‘derangement syndrome’ is the most common classification, for which the conceptual model is an intra-discal displacement. However, the reduction of an intra-discal displacement by MDT has never been documented. The purpose of this study was to compare, using magnetic resonance imaging (MRI), the nucleus pulposus (NP) profiles before and after the use of this approach.

Patient characteristics

The patient was a 34-year-old female with a long history of right sided low back and buttock pain classified with ‘derangement syndrome’.

Examination

T2-weighted images of the L4–5 disc at initial assessment were compared with that at final assessment 1 month later. Initially, the MRI showed a portion of the NP displaced right and posteriorly towards the side of pain, and an overall NP position in the coronal plane shifted to the left.

Intervention

The patient was managed with a 1-month course of the McKenzie management strategy treatment.

Outcomes

One month later, the displaced portion of the NP was no longer present and the left-shifted NP was centrally located.

Discussion

These intervertebral disc changes coincided with centralization and abolition of symptoms. This case may support the conceptual model of MDT.     

High resolution MR anatomy of the subthalamic nucleus: imaging at 9.4 T with histological validation

Using conventional MRI the subthalamic nucleus (STN) is not clearly defined. Our objective was to define the anatomy of the STN using 9.4 T MRI of post mortem tissue with histological validation. Spin-echo (SE) and 3D gradient-echo (GE) images were obtained at 9.4 T in 8 post mortem tissue blocks and compared directly with corresponding histological slides prepared with Luxol Fast Blue/Cresyl Violet (LFB/CV) in 4 cases and Perl stain in 3. The variability of the STN anatomy was studied using internal reference points. The anatomy of the STN and surrounding structures was demonstrated in all three anatomical planes using 9.4 T MR images in concordance with LFB/CV stained histological sections. Signal hypointensity was seen in 6/8 cases in the anterior and medial STN that corresponded with regions of more intense Perl staining. There was significant variability in the volume, shape and location of the borders of the STN. Using 9.4 T MRI, the internal signal characteristics and borders of the STN are clearly defined and significant anatomical variability is apparent. Direct visualisation of the STN is possible using high field MRI and this is particularly relevant, given its anatomical variability, for planning deep brain stimulation.     

2006 Bethesda International Consensus recommendations on the immunophenotypic analysis of hematolymphoid neoplasia by flow cytometry: optimal reagents and reporting for the flow cytometric diagnosis of hematopoietic neoplasia

Immunophenotyping by flow cytometry has become standard practice in the evaluation and monitoring of patients with hematopoietic neoplasia. However, despite its widespread use, considerable variability continues to exist in the reagents used for evaluation and the format in which results are reported. As part of the 2006 Bethesda Consensus conference, a committee was formed to attempt to define a consensus set of reagents suitable for general use in the diagnosis and monitoring of hematopoietic neoplasms. The committee included laboratory professionals from private, public, and university hospitals as well as large reference laboratories that routinely operate clinical flow cytometry laboratories with an emphasis on lymphoma and leukemia immunophenotyping. A survey of participants successfully identified the cell lineage(s) to be evaluated for each of a variety of specific medical indications and defined a set of consensus reagents suitable for the initial evaluation of each cell lineage. Elements to be included in the reporting of clinical flow cytometric results for leukemia and lymphoma evaluation were also refined and are comprehensively listed. The 2006 Bethesda Consensus conference represents the first successful attempt to define a set of consensus reagents suitable for the initial evaluation of hematopoietic neoplasia.