ObjectiveThe purpose of this study was to better delineate the clinical spectrum of periventricular nodular heterotopia (PNH) in a large patient population to better understand social support in people with PNH and epilepsy in west China. Specifically, this study aimed to relate PNH subtypes to clinical or epileptic outcomes and epileptic discharges by analyzing anatomical features. MethodsThe study included 70 patients with radiologically confirmed nodular heterotopias and epilepsy. We also recruited healthy controls from nearby urban and rural areas. People with PNH and epilepsy and healthy controls were gender-and age-matched. Two-sided Chi-square test and Fisher's exact t-test were used to assess associations between the distribution of PNHs and specific clinical features. ResultsBased on imaging data, patients were subdivided into three groups: (a) classical (bilateral frontal and body, n=25), (b) bilateral asymmetrical or posterior (n=9) and (c) unilateral heterotopia (n=36). Most patients with classical heterotopia were females, but were mostly seizure-free. Patients with unilateral heterotopia were prone to develop refractory epilepsy. ConclusionsEach group's distinctive genetic mutations, epileptic discharge patterns and overall clinical outcomes confirm that the proposed classification system is reliable. These findings could not only be an indicator of a more severe morphological and clinical phenotype, but could also have clinical implications with respect to the epilepsy management and optimization of therapeutic options.
Objective To evaluate the clinical value of cardiac MRI for the diagnosis of viral myocarditis (VMC). Methods Such databases as PubMed (1950 to 2009), EMbase (1974 to 2009), and The Cochrane Library (December 2009) were searched to include clinical research reports of diagnosing viral myocarditis with MRI. QUADAS items were used to evaluate the quality of the included studies. The Meta-disc software was used to conduct merger analyses on sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. The Heterogeneity test was performed and summary receiver operating characteristic curve (SROC) was completed. Results Five trials were included. The value of merger sensitivity, specificity, and diagnostic odds ratio (DOR) were 0.94, 0.69, 2.76, and 28.11, respectively. The area under of SROC curve (AUC) was 0.871 9. Conclusion The current evidence shows that cardiac MRI has high sensitivity (94%) and moderate specificity (69%) in the diagnosis of viral myocarditis. The positive rate in the viral myocarditis group is 28.11 times as high as that in the non-viral myocarditis group, so Cardiac MRI has good diagnostic values for viral myocarditis.
When applying deep learning algorithms to magnetic resonance (MR) image segmentation, a large number of annotated images are required as data support. However, the specificity of MR images makes it difficult and costly to acquire large amounts of annotated image data. To reduce the dependence of MR image segmentation on a large amount of annotated data, this paper proposes a meta-learning U-shaped network (Meta-UNet) for few-shot MR image segmentation. Meta-UNet can use a small amount of annotated image data to complete the task of MR image segmentation and obtain good segmentation results. Meta-UNet improves U-Net by introducing dilated convolution, which can increase the receptive field of the model to improve the sensitivity to targets of different scales. We introduce the attention mechanism to improve the adaptability of the model to different scales. We introduce the meta-learning mechanism, and employ a composite loss function for well-supervised and effective bootstrapping of model training. We use the proposed Meta-UNet model to train on different segmentation tasks, and then use the trained model to evaluate on a new segmentation task, where the Meta-UNet model achieves high-precision segmentation of target images. Meta-UNet has a certain improvement in mean Dice similarity coefficient (DSC) compared with voxel morph network (VoxelMorph), data augmentation using learned transformations (DataAug) and label transfer network (LT-Net). Experiments show that the proposed method can effectively perform MR image segmentation using a small number of samples. It provides a reliable aid for clinical diagnosis and treatment.
ObjectiveTo analyse the seizure semeiology of MRI negative insular epilepsy.MethodsA case of patient with insular epilepsy who presented in Epileptic Center, Guangdong 999 Brain Hospital was collected. Related literatures were thoroughly reviewed.ResultsThe patient was diagnosised as insular epilepsy by SEEG and postoperative pathology reported focal cortical dysplasia Ib.ConclusionsThe insula lobe is a part of the limbic system, and the seizure semeiology in insular epilepsy is varied. Seizure semeiology analysis is particularly important in the evaluation of presurgical especially in a MRI negative case. In this paper, we summarized the semeiology characteristics of various parts of insula lobe, and provided some references for the diagnosis and treatment of insular epilepsy.
Objective The method of metabonomics based on nuclear magnetic resonance (NMR) imaging was used to explore the difference in metabolites of serum and bile, and to analyze the metabolic variation related to the pathogenesis of gallbladder stones between normal people/liver transplantation donors and patients with gallbladder stones. Methods Prospectively collected the serum samples (17 cases) and bile samples (19 cases) in 19 patients with gallbladder stones who underwent surgery in West China Hospital form March 2016 to December 2016, as well as the serum samples of 10 healthy persons and the bile samples of 15 liver transplantation donors at the same time period. The differences of metabolites in the blood and bile in these 3 groups were compared by using 1H-NMR metabonomics technology and chemometric methods. Results The concentrations of valine, alanine, lysine, glutamine, glutamate, pyruvate, creatinine, choline, alpha-glucose, beta-glucose, tyrosine, histidine, and hypoxanthine in serum of patients with gallbladder stones decreased significantly, comparing with those of healthy people without gallbladder stones (P<0.05), while 1, 2-propanediol, acetoacetate, and lactate increased significantly in the serum of patients with gallbladder stones (P<0.05). The concentrations of taurine conjugated bile acids, glycine conjugated bile acids, choline, and phosphatidylcholine decreased significantly in the bile of patients with gallbladder stones when compared with those of liver transplantation donors (P<0.05), while cholesterol increased significantly in the bile of patients with gallbladder stones (P<0.05). Conclusions There are significant differences of the serum and bile metabolites between patients with gallbladder stones and healthy men without gallbladder stones/liver transplantation donors. 1H-NMR metabonomics is helpful to investigate the pathogenesis of gallbladder stones.
摘要:目的: 分析肝脏局灶性结节增生(FNH)的MRI表现和病理特点,探讨两者的相关性,提高FNH诊断的准确率。 方法 :回顾性分析23例(共28个病灶)经手术切除病理证实为FNH的MRI平扫及增强表现,与其病理特点进行对照。 结果 :25个病灶在平扫T1WI上呈等或稍低信号,T2WI上呈等或稍高信号,3个病灶在平扫T1WI及T2WI上均呈稍高信号,增强后所有28病灶动脉期可见明显强化,门脉期及延迟期呈稍高、等或稍低信号,其中12个病灶可见中心纤维瘢痕延迟强化。FNH组织病理上表现为富血供的实质性肿块,肿物内部组织较均匀,没有异型细胞,中心可见纤维瘢痕。 结论 :肝脏MRI平扫及增强检查能很好的反映FNH的组织病理及血供特点,能为FNH的诊断及鉴别诊断提供可靠证据。Abstract: Objective: To analyze the MRI manifestations and pathology characteristic of hepatic focal nodular hyperplasia(FNH),and to investigate their correlation. Methods : A retrospective analysis was made on the unenhanced and dynamic enhanced MR images of 23 patients (totally 28 lesions) with surgical and pathological proved FNH. Results :25 FNH lesions demonstrated isointensity or slightly hypointense on unenhanced T1WI,and isointensity or slightly hyperintense on unenhanced T2WI,3 FNH demonstrated hyperintense on both unenhanced T1WI and T2WI. 28 FNHs were markediyhyperintense in the arterial phase of dynamic contrast enhanced MRI, and isointense or slightly hyperintense in the portal and delayed phase．The seals were shown in 12 lesions, and enhanced in delayed phase．FNH is solid mass with vast blood supply,its inside structure is homogemeous. Typical seal can be found by microscopic examination．〖WTHZ〗Conclusion : MRI could disclose the pathologic features of FNH and its blood supply and improve the accuracy 0f its diagnosis．
ObjectiveTo explore the correlation between cognitive function and diffusion tensor imaging (DTI) in children with self-limited epilepsy with centrotemporal spikes (SelECTS). Methods A total of 28 children with SelECTS who visited our hospital from June 2020 to December 2022 were selected as the SelECTS group. An additional 28 healthy children of similar age and gender were selected as the control group. Cognitive function was assessed using the Wechsler Intelligence Scale for Children (WISC). The SelECTS group also underwent cranial DTI. The results of the WISC were then combined with DTI values for correlation analysis. Results Children in the SelECTS group exhibited varying degrees of cognitive deficits. Their full-scale IQ and verbal IQ were significantly lower than those of the control group (P<0.05). Specific cognitive domains, including classification, verbal comprehension, block design, knowledge, and comprehension, also showed significantly lower scores compared to the control group (P<0.05). DTI revealed significant microstructural changes in multiple regions of interest in the SelECTS group (P<0.05), and these changes were correlated with the results of several cognitive function tests. Conclusion Children with SelECTS have certain cognitive deficits. There is evidence of occult damage in brain white matter, and cognitive function is correlated with damage in specific brain regions.