Structural white matter abnormalities in patients with idiopathic dystonia

We investigated whether structural white matter abnormalities, in the form of disruption of axonal coherence and integrity as measured with diffusion tensor imaging (DTI), constitute an underlying pathological mechanism of idiopathic dystonia (ID), independent of genotype status. We studied seven subjects with ID: all had cervical dystonia as their main symptom (one patient also had spasmodic dysphonia and two patients had concurrent generalized dystonia, both DYT1‐negative). We compared DTI MR images of patients with 10 controls, evaluating differences in mean diffusivity (MD) and fractional anisotropy (FA). ID was associated with increased FA values in the thalamus and adjacent white matter, and in the white matter underlying the middle frontal gyrus. ID was also associated with increase in MD in adjacent white matter to the pallidum and putamen bilaterally, left caudate, and in subcortical hemispheric regions, including the postcentral gyrus. Abnormal FA and MD in patients with ID indicate that abnormal axonal coherence and integrity contribute to the pathophysiology of dystonia. These findings suggest that ID is not only a functional disorder, but also associated with structural brain changes. Impaired connectivity and disrupted flow of information may contribute to the impairment of motor planning and regulation in dystonia. © 2006 Movement Disorder Society     

Mapping brain size and cortical gray matter changes in elderly depression.

BACKGROUND: In elderly depression, volumetric brain imaging findings suggest abnormalities of the frontal lobe, particularly the orbitofrontal cortex, and the hippocampus. No studies to date have mapped cortical abnormalities over the entire brain surface in major depression. Here, we conducted detailed spatial analyses of brain size and gray matter within the cortical mantle in elderly patients with major depression. METHODS: High-resolution, three-dimensional, structural magnetic resonance imaging data and cortical pattern matching methods were used in 24 depressed elderly patients and 19 group-matched controls to measure local brain size and proportions of gray matter at thousands of homologous cortical surface locations. RESULTS: Prominent brain size reductions were observed in the depressed subjects in the orbitofrontal cortex bilaterally. Cortical gray matter measurements revealed significant gray matter increases in the orbitofrontal cortex, adjacent to focal trend level significant decreases of gray matter in the same region. Depressed patients also exhibited significant gray matter increases in parietal cortices, as well as the left temporal cortex. CONCLUSIONS: Complex cortical changes may contribute to the brain size reduction of the orbitofrontal cortex and to the gray matter abnormalities detected in orbitofrontal cortex and temporoparietal cortices, thereby providing a potentially new window into the pathophysiology of elderly depression.     

原位杂交与免疫组化技术在HPV检测中的应用

目的：对两种HPV检测技术DNA原位杂交和免疫组化染色方法进行对比观察。方法：选取本院外阴尖锐湿疣病例95例，组织经固定、脱水、石蜡包埋、切片，分别采用原位杂交和免疫组化技术进行检测。结果：HPV—DNA阳性率为94．7％(90／95)，阳性反应由鳞状上皮表层的空泡细胞核内延伸至棘层中下部近基底层的细胞核内；HPV—Ag阳性率为63．1％(60／95)，阳性反应主要位于鳞状上皮表层的空泡细胞核内及角质层内。个别阳性细胞可在棘层出现。结论：原位杂交技术在敏感度、阳性率及阳性强度、背景染色等方面均优于免疫组化方法，为尖锐湿疣的确诊及临床治疗提供更准确、可靠的依据。     

动力髋螺钉治疗股骨转子间骨折

目的 评价动力髋螺钉(DHS)治疗股骨转子间骨折的临床效果。方法 1996年3月～2002年3月用DHS共治疗患者29例．骨折按Evans分型，本组Evans ⅠA2例，Evans ⅠB 10例，Evans ⅡA 3例，Evanslib12例，Evans Ⅲ2例．结果 29例患者均获随访，随访12～48个月，平均26个月，根据Harris髋关节评分：优16例，良9例，中3例，差1例。结论 如能及时手术良好复位，DHS是治疗股骨转子间骨折的较好选择。     

咽旁间隙在头颈部肿瘤MRI诊断中的价值

目的探讨咽旁间隙移位方向及肿瘤MRI信号特点对病变定位、定性的价值。方法回顾性分析经病理确诊的累及咽旁间隙肿瘤76例,其中恶性肿瘤51例,良性肿瘤25例。结果扁桃体肿瘤和鼻咽癌使茎突前间隙外移,腮腺肿瘤使茎突前间隙向前内移位,或(和)颈动脉鞘区后移。颈动脉鞘区交感神经鞘瘤使颈内动、静脉向前外侧移位,迷走神经鞘瘤使颈内动、静脉明显分离,颈动脉体瘤使颈内、外动脉分叉角增大,颈静脉球瘤使血管向前外侧移位,转移淋巴结使颈内动、静脉向前内侧移位。25例良性肿瘤边界清楚,其中9例信号均匀;51例恶性肿瘤中,19例边界模糊,15例信号欠均匀。茎突前间隙脂肪消失或不连续6例均为恶性肿瘤,肿瘤边界较清但颈部淋巴结肿大符合淋巴结转移诊断标准2例及颈内动、静脉被肿瘤包绕3例,病理证实亦为恶性肿瘤。结论咽旁间隙移位方向及肿瘤MRI信号特点对头颈部肿瘤的定位、定性具有重要的价值。     

老年性骨质疏松脊柱良性骨折与转移瘤性骨折的MRI鉴别

目的探讨脊椎骨质疏松性压缩骨折的MRI表现及其与转移性压缩骨折的鉴别诊断.资料与方法回顾性分析53例老年性骨质疏松伴压缩性骨折和20例转移性椎体压缩骨折患者的MRI资料.全部病例均行常规MRI检查(矢状位、横轴位).分析两者引起的压缩骨折MRI征象,包括椎体和椎弓根的形态及信号改变、椎间盘增厚、椎体内真空现象和椎旁软组织形态.探讨两者之间的差别.结果两者在椎体和椎弓根形态及信号、椎体内真空现象、椎旁软组织形态上存在非常显著性差异(P＜0.01).结论 MRI能准确显示骨质疏松性压缩骨折的形态及信号,与转移瘤之间有显著差异,大多能对二者做出鉴别诊断.     

MR灌注成像在评估脑胶质瘤放疗效果中的应用

目的探讨MR灌注成像在评估脑胶质瘤放疗疗效中的应用价值。方法对25例脑胶质瘤术后患者于放疗前及放疗后3、6个月行MR灌注成像及常规MRI检查。由灌注数据获取脑血容量（CBV）图和脑血流量（CBF）图。计算出病灶的最大相对局部脑血容量（rCBV）值和最大相对局部脑血流量（rCBF）值。结果25例脑胶质瘤术后放疗前肿瘤区的rCBV值和rCBF值分别为6．32±2．14和5．49±1．98，与正常脑组织的2．58±1．21和2．17±1．19相比，显著升高（P〈0．01）。其中11例放疗后rCBV值和rCBF值与放疗前相比，显著下降（P〈0．01），其中5例证实为放射性脑坏死；另14例放疗后rCBV值和rCBF值与放疗前相比，有不同程度升高，但无统计学意义（P〉9．05）。其中7例证实为肿瘤伴部分放射性坏死组织，2例死亡，5例再次行放射治疗取得较好疗效。结论MR灌注成像可作为评估脑胶质瘤放疗疗效的一项重要指标。并有助于下一步治疗方案的制定。     

瘤蒂征在MRI诊断小脑桥脑角听神经瘤中的价值

听神经瘤是小脑桥脑角的常见、多发肿瘤,但有时易与其他肿瘤混淆.本研究分析了19例经手术病理证实的小脑桥脑角听神经瘤MRI表现,探讨"瘤蒂征"对小脑桥脑角听神经瘤的诊断价值.     

Smaller hippocampal volume in patients with recent-onset posttraumatic stress disorder.

BACKGROUND: Previous structural magnetic resonance (MR) research in patients with posttraumatic stress disorder (PTSD) has found smaller hippocampal volumes in patients compared with control subjects. These studies have mostly involved subjects who have had PTSD for a number of years, such as war veterans or adult survivors of childhood abuse. Patients with recent-onset PTSD have rarely been investigated. To our knowledge only one other study has investigated such a group. The aim of this study was to compare hippocampal volumes of patients with recent onset PTSD and nontrauma-exposed control subjects. METHODS: Fifteen patients with PTSD, recruited from an accident and emergency department, were compared with 11, non-trauma-exposed, healthy control subjects. Patients underwent a structural MR scan soon after trauma (mean time = 158 +/- 41 days). Entire brain volumes, voxel size 1 x 1 x 1 mm, were acquired for each subject. Point counting and stereology were used to measure the hippocampal and amygdala volume of each subject. RESULTS: Right-sided hippocampal volume was significantly smaller in PTSD patients than control subjects after controlling for effects of whole brain volume and age. Neither left nor total hippocampal volume were significantly smaller in the PTSD group after correction. Whole brain volume was also found to be significantly smaller in patients. There were no differences in amygdala or white matter volumes between patients and control subjects. CONCLUSIONS: This result replicates previous findings of smaller hippocampal volumes in PTSD patients, but in an underinvestigated population, suggesting that either smaller hippocampal volume is a predisposing factor in the development of PTSD or that damage occurs within months of trauma, rather than a number of years. Either of these two hypotheses have significant implications for the treatment of PTSD. For instance, if it could be shown that screening for hippocampal volume may, in some cases, predict those likely to develop clinical PTSD.     

深部脑白质缺血影像表现与MTHFR基因多态性关系的探讨

目的：探讨MTHFR的纯合突变TT型基因是否为诱发皮层下深部脑白质缺血的危险因子，并证实皮层下深部脑白质缺血影像表现与MTHFR基因C／T多态性的关系。资料与方法：选择影像表现符合皮层下深部脑白质缺血诊断标准者30例，对照组30例为影像表现正常者，运用多聚酶链反应－限制性内切酶片段长度多态性技术（PCR－RFLP）检测两组MTHFR基因多态性。结果：采用χ^2检验，得出MTHFR基因纯合突变TT型在病变组与对照组比较差异有显著性（χ^2=5.0794,P＜0．05），病变组TT型较对照组显著升高，说明MTHFR的纯合突变TT型可能是诱发深部脑白质缺血的危险因素。运用成组设计两样本比较的秩和检验，得出TT型和非TT型患者在影像表现的分级程度上有差别，携带TT型基因者影像表现分级重。结论：MTHFR纯合突变TT型基因是深部脑白质缺血发病的危险因子，且TT型基因与深部脑白质缺血的易感性和影像表现呈明显正相关。