Nan Lin Zeng

The Celiac Ganglia: Anatomic Study Using MRI in Cadavers

OBJECTIVE Our objective was to facilitate the in vivo identification of the celiac ganglia on MRI by using MRI to identify the celiac ganglia in cadavers. CONCLUSION MRI can show the celiac ganglia accurately in cadavers when the ganglia are large and labeled with gadolinium. The findings in cadavers can be a reference for identifying the celiac ganglia in vivo.

Abdominal MRI at 3.0 T: LAVA-Flex compared with conventional fat suppression T1-weighted images.

To study liver imaging with volume acceleration‐flexible (LAVA‐Flex) for abdominal magnetic resonance imaging (MRI) at 3.0 T and compare the image quality of abdominal organs between LAVA‐Flex and fast spoiled gradient‐recalled (FSPGR) T1‐weighted imaging.

Magnetic resonance imaging versus Acute Physiology And Chronic Healthy Evaluation II score in predicting the severity of acute pancreatitis.

OBJECTIVE To study the correlation between established magnetic resonance (MR) imaging criteria of disease severity in acute pancreatitis and the Acute Physiology And Chronic Healthy Evaluation II (APACHE II) score, and to assess the utility of each prognostic indicators in acute pancreatitis. MATERIALS AND METHODS In this study there were 94 patients with acute pancreatitis (AP), all had abdominal MR imaging. MR findings were categorized into edematous and necrotizing AP and graded according to the MR severity index (MRSI). The APACHE II score was calculated within 24h of admission, and local complications, death, duration of hospitalization and ICU were recorded. Statistical analysis was performed to determine their correlation. RESULTS In patients with pancreatitis, no significant correlation can be found between the APACHE II score and the MRSI score (P=0.196). The MRSI score correlated well with morbidity (P=0.006) but not with mortality (P=0.137). The APACHE II score correlated well with mortality (P=0.002) but not with the morbidity (P=0.112). The MRSI score was superior to the APACHE II score as a predictor of the length of hospitalization (r=0.52 vs. r=0.35). A high MRSI and APACHE II score correlated with the need for being in the intensive care unit (ICU) (P=0.000 and P=0.000, respectively). CONCLUSION In patients with pancreatitis, MRSI is superior to APACHE II in assessing local complications from pancreatitis but has a limited role in determining systemic complications in which the APACHE II score excels.

Liver dynamic contrast-enhanced MRI for staging liver fibrosis in a piglet model.

To determine whether dynamic contrast‐enhanced magnetic resonance imaging (DCE‐MRI) could monitor progression of liver fibrosis in a piglet model, and which DCE‐MRI parameter is most accurate for staging this disease.

MR imaging for blunt pancreatic injury

OBJECTIVE To study the MR imaging features of blunt pancreatic injury. MATERIALS AND METHODS Nine patients with pancreatic injury related to blunt abdominal trauma confirmed by surgery performed MR imaging. Two abdominal radiologists conducted a review of the MR images to assess pancreatic parenchymal and pancreatic duct injury, and associated complications. RESULT Diagnostic quality MR images were obtained in each of the nine patients. In the nine patients, pancreatic fracture, laceration and contusion were depicted on MR imaging in five, one and three patients, respectively. There were six patients with pancreatic duct disruption, eight patients with peripancreatic fluid collections, and four patients with peripancreatic pseudocyst or hematoma, respectively. All of the MR imaging findings was corresponded to surgical findings. CONCLUSION MR imaging is an effective method to detect blunt pancreatic injury and may provide information to guide management decisions.

Hepatic caudate vein in Budd-Chiari syndrome: Depiction by using magnetic resonance imaging

OBJECTIVE To study the visibility of the caudate vein and its diameter on MR imaging in healthy people and in patients with Budd-Chiari syndrome. MATERIALS AND METHODS In this study there were 14 patients with Budd-Chiari syndrome and 54 healthy subjects without hepatic lesion or liver disease, all of whom had upper abdominal enhanced MRI. The visibility of the caudate vein and its diameter on MR images was compared between Budd-Chiari patients and healthy subjects, and among Budd-Chiari patients, the correlation between the visibility of caudate vein and extrahepatic collaterals were compared. RESULTS Caudate vein was noted in 64% of patients with Budd-Chiari syndrome and in 7% of healthy subjects (P=0.000). The diameter of the caudate vein visualized on MR imaging in Budd-Chiari syndrome was significantly larger than that in healthy group (7.3±3.9 mm vs 2.6±0.6 mm, P=0.037). Among Budd-Chiari patients, both caudate vein and extrahepatic collateral veins were noted in 9 patients, only extrahepatic collateral veins were noted in 4 patients and neither caudate vein nor extrahepatic collateral veins were noted in 1 patient. No correlation was found between the visibility of caudate vein and that of extrahepatic collateral vein in patients with Budd-Chiari (P=0.375). CONCLUSION Gadolinium enhanced dynamic MR imaging can visualize hepatic caudate vein frequently. The visibility and dilation of hepatic caudate veins on MR imaging in Budd-Chiari syndrome were more frequent than in control subjects. MR depiction of a caudate vein may help differentiate Budd-Chiari from cirrhosis.

The Blood Oxygenation T2* Values of Resectable Esophageal Squamous Cell Carcinomas as Measured by 3T Magnetic Resonance Imaging: Association with Tumor Stage

Objective To explore the association between the blood oxygenation T2* values of resectable esophageal squamous cell carcinomas (ESCCs) and tumor stages. Materials and Methods This study included 48 ESCC patients and 20 healthy participants who had undergone esophageal T2*-weighted imaging to obtain T2* values of the tumors and normal esophagi. ESCC patients underwent surgical resections less than one week after imaging. Statistical analyses were performed to identify the association between T2* values of ESCCs and tumor stages. Results One-way ANOVA and Student-Newman-Keuls tests revealed that the T2* value could differentiate stage T1 ESCCs (17.7 ± 3.3 ms) from stage T2 and T3 tumors (24.6 ± 2.7 ms and 27.8 ± 5.6 ms, respectively; all ps < 0.001). Receiver operating curve (ROC) analysis showed the suitable cutoff T2* value of 21.3 ms for either differentiation. The former statistical tests demonstrated that the T2* value could not differentiate between stages T2 and T3 (24.6 ± 2.7 ms vs. 27.8 ± 5.6 ms, respectively, p > 0.05) or between N stages (N1 vs. N2 vs. N3: 24.7 ± 6.9 ms vs. 25.4 ± 4.5 ms vs. 26.8 ± 3.9 ms, respectively; all ps > 0.05). The former tests illustrated that the T2* value could differentiate anatomic stages I and II (18.8 ± 4.8 ms and 26.9 ± 5.9 ms, respectively) or stages I and III (27.3 ± 3.6 ms). ROC analysis depicted the same cutoff T2* value of 21.3 ms for either differentiation. In addition, the Students t test revealed that the T2* value could determine grouped T stages (T0 vs. T1–3: 17.0 ± 2.9 ms vs. 25.2 ± 6.2 ms; T0–1 vs. T2–3: 17.3 ± 3.0 ms vs. 27.1 ± 5.3 ms; and T0–2 vs. T3: 18.8 ± 4.2 ms vs. 27.8 ± 5.6 ms, all ps < 0.001). ROC analysis indicated that the T2* value could detect ESCCs (cutoff, 20 ms), and discriminate between stages T0–1 and T2–3 (cutoff, 21.3 ms) and between T0–2 and T3 (cutoff, 20.4 ms). Conclusion The T2* value can be an additional quantitative indicator for detecting ESCC except for stage T1 cancer, and can preoperatively discriminate between some T stages and between anatomic stages of this tumor.

Platelet count combined with right liver volume and spleen volume measured by magnetic resonance imaging for identifying cirrhosis and esophageal varices.

AIM To determine whether the combination of platelet count (PLT) with spleen volume parameters and right liver volume (RV) measured by magnetic resonance imaging (MRI) could predict the Child-Pugh class of liver cirrhosis and esophageal varices (EV). METHODS Two hundred and five cirrhotic patients with hepatitis B and 40 healthy volunteers underwent abdominal triphasic-enhancement MRI and laboratory examination of PLT in 10(9)/L. Cirrhotic patients underwent endoscopy for detecting EV. Spleen maximal width (W), thickness (T) and length (L) in mm together with spleen volume (SV) and RV in mm(3) were measured by MRI, and spleen volume index (SI) in mm(3) was obtained by W × T × L. SV/PLT, SI/PLT and RV × PLT/SV (RVPS) were calculated and statistically analyzed to assess cirrhosis and EV. RESULTS SV/PLT (r = 0.676) and SI/PLT (r = 0.707) increased, and PLT (r = -0.626) and RVPS (r = -0.802) decreased with the progress of Child-Pugh class (P < 0.001 for all). All parameters could determine the presence of cirrhosis, distinguish between each class of Child-Pugh class, and identify the presence of EV [the areas under the curve (AUCs) = 0.661-0.973]. Among parameters, RVPS could best determine presence and each class of cirrhosis with AUCs of 0.973 and 0.740-0.853, respectively; and SV/PLT could best identify EV with an AUC of 0.782. CONCLUSION The combination of PLT with SV and RV could predict Child-Pugh class of liver cirrhosis and identify the presence of esophageal varices.

Use of conventional MR imaging and diffusion-weighted imaging for evaluating the risk grade of gastrointestinal stromal tumors.

To study the risk grade of gastrointestinal stromal tumors (GISTs) with conventional MR imaging and diffusion‐weighted imaging (DWI).

Diameters of left gastric vein and its originating vein on magnetic resonance imaging in liver cirrhosis patients with hepatitis B: Association with endoscopic grades of esophageal varices

To determine whether diameters of the left gastric vein (LGV) and its originating vein are associated with endoscopic grades of esophageal varices.