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Difficulties in Diagnosis and Operation Associated With Lumbar Intradural Disc Herniation: A Case Report 腰椎间盘突出症的诊断和手术难题:病例报告
Pub Date : 2023-11-23 DOI: 10.34172/icnj.2023.13
Hieu T. Le, Hoai Thi Phuong Dinh, Quynh H.T. Pham, Hoang D. Tran, Minh T. Nguyen
Intradural disk herniation (IDH) represents an uncommon instance of disk degeneration. The surgical treatment of IDH, preoperative, and intraoperative diagnosis are difficult. The present case report highlights difficult parts of diagnosis and surgery. A 44-year-old man presented with lower back pain radiating to his right leg. A disk protruding into the ventral dural sac and exhibiting the hawk-beak sign was discovered by MRI. The dorsal side was exposed and incised during L3/4 laminectomy, a puncture on the ventral side was detected, and subsequently, three fragments extending into the dura sac were discovered. The defect was corrected and completed internal fixing was done. Pathology identified it as nucleus pulposus tissue. At one-month follow-up, he was able to walk normally. An incredibly uncommon form of disc degeneration is lumbar IDH. MRI can assist in the diagnosis, however, surgical investigation and pathology are necessary for an accurate diagnosis.
硬膜内椎间盘突出症(IDH)是一种不常见的椎间盘变性。IDH 的手术治疗、术前和术中诊断都很困难。本病例报告强调了诊断和手术的难点。一名 44 岁的男子因下腰痛向右腿放射而就诊。核磁共振检查发现一个突出于腹侧硬膜囊的椎间盘,呈鹰嘴征。在进行 L3/4 椎板切除术时暴露并切开了背侧,发现腹侧有穿孔,随后发现有三块碎片伸入硬膜囊。对缺损进行了矫正,并完成了内固定。病理鉴定为髓核组织。在一个月的随访中,他可以正常行走。腰椎间盘 IDH 是一种非常不常见的椎间盘退变。核磁共振成像可以帮助诊断,但要做出准确诊断,还需要进行手术检查和病理检查。
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引用次数: 0
EEG-Based Effective Connectivity Analysis for Attention Deficit Hyperactivity Disorder Detection Using Color-Coded Granger-Causality Images and Custom Convolutional Neural Network 利用彩色编码格兰杰因果关系图像和自定义卷积神经网络进行基于脑电图的有效连接性分析以检测注意力缺陷多动障碍
Pub Date : 2023-11-13 DOI: 10.34172/icnj.2023.12
Farhad Abedinzadeh Torghabeh, Yegane Modaresnia, Seyyed Abed Hosseini
Background: Attention deficit hyperactivity disorder (ADHD) is prevalent worldwide, affecting approximately 8-12% of children. Early detection and effective treatment of ADHD are crucial for improving academic, social, and emotional outcomes. Despite numerous studies on ADHD detection, existing models still lack accuracy distinguishing between ADHD and healthy control (HC) children. Methods: This study introduces an innovative methodology that utilizes granger causality (GC), a well-established brain connectivity analysis technique, to reduce the required EEG electrodes. We computed GC indexes (GCI) for the entire brain and specific brain regions, known as regional GCI, across different frequency bands. Subsequently, these GCIs were transformed into color-coded images and fed into a custom-developed 11-layer convolutional neural network. Results: The proposed model is evaluated through a five-fold cross-validation, achieving the highest accuracy of 99.80% in the gamma frequency band for the entire brain and an accuracy of 98.50% in distinguishing the theta frequency band of the right hemisphere of ADHD and HC children by only using eight electrodes. Conclusion: The proposed framework provides a powerful automated tool for accurately classifying ADHD and HC children. The study’s outcome demonstrates that the innovative proposed methodology utilizing GCI and a custom-developed convolutional neural network can significantly improve ADHD detection accuracy, improving affected children’s overall quality of life.
背景:注意力缺陷多动障碍(ADHD)在全球非常普遍,约有 8-12% 的儿童受到影响。早期发现并有效治疗注意力缺陷多动障碍对改善学业、社交和情感状况至关重要。尽管对多动症检测进行了大量研究,但现有模型仍无法准确区分多动症儿童和健康对照组(HC)儿童。方法:本研究引入了一种创新方法,利用格兰杰因果关系(GC)这一成熟的大脑连接分析技术来减少所需的脑电图电极。我们计算了整个大脑和特定大脑区域(称为区域 GCI)在不同频段的 GC 指数(GCI)。随后,这些 GCI 被转换成彩色编码图像,并输入一个定制开发的 11 层卷积神经网络。结果:通过五倍交叉验证对所提出的模型进行了评估,结果表明,该模型在整个大脑的伽马频段上达到了 99.80% 的最高准确率,在区分 ADHD 儿童和 HC 儿童右半球的 Theta 频段上,仅使用 8 个电极就达到了 98.50% 的准确率。结论所提出的框架为准确分类 ADHD 和 HC 儿童提供了强大的自动化工具。研究结果表明,利用 GCI 和定制开发的卷积神经网络提出的创新方法可以显著提高多动症检测的准确性,从而改善受影响儿童的整体生活质量。
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引用次数: 0
The Relationship Between Arachnoid Cysts and the Subarachnoid Space by Hounsfield Unit Value in Computed Tomography Scans: Identification of Isolated and Communicating Arachnoid Cysts in a Cohort Study 计算机断层扫描中 Hounsfield 单位值显示的蛛网膜囊肿与蛛网膜下腔的关系:在一项队列研究中识别孤立性和沟通性蛛网膜囊肿
Pub Date : 2023-10-28 DOI: 10.34172/icnj.2023.11
Ziya Asan
Background: Arachnoid cysts are formations containing cerebrospinal fluid (CSF). They may be associated with the subarachnoid space. This feature is a factor that can affect the change in the size of arachnoid cysts over time. Hounsfield Unit (HU) value measurements provide rational numeric representation of imaging of tissues in computed tomography (CT) examinations. In this study, we aimed to define isolated or communicated arachnoid cysts, and whether arachnoid cysts communicate with the subarachnoid distance, with the HU values obtained in CT examinations. Methods: Patients with radiological diagnosis of arachnoid cyst were identified retrospectively by examining the CT database. HU value measurements were recorded over the Picture Archiving and Communication System (PACS) in the area where the arachnoid cyst was detected. HU value measurements are a method that rationally shows the amount of radiograph absorption of tissues in CT examinations. HU value measurements were performed in cerebrospinal fluid (CSF) and arachnoid cysts, and whether arachnoid cysts had equal HU values with CSF. They were defined as homogeneous or heterogeneous by measuring HU values in different regions of arachnoid cysts. Results: Data on 478 cases were obtained. An average of 2.82 CT scans were detected per case. A change in arachnoid cyst size was detected in 47 (9.8%) cases. In cases of arachnoid cysts of varying size, the mean HU value of arachnoid cysts was 9.32±1.93 (6.43±1.67 in the lateral ventricle and 7.04±1.71 in the fourth ventricle). HU value of arachnoid cysts with a change in size significantly differed from CSF. Conclusion: Arachnoid cysts with HU values equal to CSF are not real arachnoid cysts, and significant volume changes are not expected. Arachnoid cysts, which have a different HU value than CSF, may secrete a different fluid from CSF. This type of arachnoid cyst is a real cyst that can be detected in various sizes on CT examinations at different times since they are not in communication with the subarachnoid space.
背景:蛛网膜囊肿是一种含有脑脊液(CSF)的病变。它们可能与蛛网膜下腔有关。这一特征是影响蛛网膜囊肿大小随时间变化的一个因素。Hounsfield 单位(HU)值测量为计算机断层扫描(CT)检查中的组织成像提供了合理的数字表示。在这项研究中,我们旨在通过 CT 检查中获得的 HU 值来定义孤立或沟通的蛛网膜囊肿,以及蛛网膜囊肿是否与蛛网膜下腔距离沟通。方法通过检查 CT 数据库,对经放射学诊断为蛛网膜囊肿的患者进行回顾性鉴定。通过图像存档和通信系统(PACS)记录发现蛛网膜囊肿区域的 HU 值测量结果。HU 值测量是一种合理显示 CT 检查中组织对射线吸收量的方法。HU值测量在脑脊液(CSF)和蛛网膜囊肿中进行,以及蛛网膜囊肿是否与CSF具有相同的HU值。通过测量蛛网膜囊肿不同区域的 HU 值,将其定义为均质或异质。结果:共获得 478 个病例的数据。每个病例平均检测到 2.82 次 CT 扫描。发现蛛网膜囊肿大小发生变化的有 47 例(9.8%)。在不同大小的蛛网膜囊肿病例中,蛛网膜囊肿的平均 HU 值为 9.32±1.93(侧脑室为 6.43±1.67,第四脑室为 7.04±1.71)。蛛网膜囊肿大小变化的 HU 值与 CSF 显著不同。结论HU 值与 CSF 相同的蛛网膜囊肿并非真正的蛛网膜囊肿,预计其体积不会发生显著变化。蛛网膜囊肿的 HU 值与 CSF 不同,可能分泌与 CSF 不同的液体。这类蛛网膜囊肿是真正的囊肿,由于与蛛网膜下腔不相通,因此在不同时间的 CT 检查中可以发现不同大小的囊肿。
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引用次数: 0
The Positive Effect of Atropa belladonna on Inflammatory Cytokines in the Animal Model of Multiple Sclerosis 颠茄对多发性硬化症动物模型炎性细胞因子的积极作用
Pub Date : 2023-10-23 DOI: 10.34172/icnj.2023.10
Hassanali Abedi, Mehdi Karimi, Najmeh Sadeghi, Hossein Kargar Jahromi, Maryam Jalali Jahromi, Afsaneh Ranjbar, Aref Bagherzadeh, Sepideh Dialameh
Background: Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation and demyelination of the central nervous system. Given the role of inflammation in the pathogenesis of MS and the anti-inflammatory effect of Atropa belladonna (AB), the aim of this study was to determine the effect of AB on inflammatory and anti-inflammatory factors in MOG35-55 induced experimental autoimmune encephalomyelitis (EAE). Methods: Thirty-two purebred C57BL/6 mice, weighing (20±2g) were randomly assigned to the 4 groups: control, and three experimental groups: EAE, EAE+AB100, and EAE+AB300 that after EAE induction received 0, 100, and 300 mg/kg AB daily. AB was dissolved in PBS (phosphate-buffered saline) and the volume of gavage in all groups was 100 µL. After 30 days, the mice were weighed, anesthetized with ether and blood was collected directly from the heart. Specific animal ELISA kits measured the inflammatory cytokines (IL-10, IL-17, IL-4, and TNF-α). One-way ANOVA with Duncan post hoc test was used for comparison between groups. Results: EAE increased serum concentrations of TNF-α, IL-17, and decreased IL-10 and IL-4 compared to the control group. AB significantly decreased the mean level of TNF-α, IL-17 and increased IL-10 and IL-4 compared with EAE group. The effect of 300 mg/ kg was clearly better than 100 mg/kg. There was also a significant difference between the control group and the 300 mg/kg group. Conclusion: In the present study, AB plant extract increased serum levels of anti-inflammatory cytokines and decreased proinflammatory cytokines in the MS animal model.
背景:多发性硬化症(MS)是一种以中枢神经系统炎症和脱髓鞘为特征的慢性自身免疫性疾病。考虑到炎症在MS发病中的作用以及颠茄(Atropa belladonna, AB)的抗炎作用,本研究旨在探讨AB对MOG35-55诱导的实验性自身免疫性脑脊髓炎(EAE)中炎症和抗炎因子的影响。方法:将32只体重为(20±2g)的C57BL/6纯种小鼠随机分为对照组和EAE、EAE+AB100、EAE+AB300 3个实验组,分别在EAE诱导后每天分别给予0、100、300 mg/kg的AB。将AB溶解于PBS(磷酸盐缓冲盐水)中,各组灌胃量均为100µL。30天后,给小鼠称重,用乙醚麻醉,并直接从心脏采血。特异性动物ELISA试剂盒检测炎症因子(IL-10、IL-17、IL-4和TNF-α)。组间比较采用Duncan事后检验的单因素方差分析。结果:与对照组相比,EAE组血清TNF-α、IL-17浓度升高,IL-10、IL-4浓度降低。与EAE组相比,AB显著降低了TNF-α、IL-17的平均水平,升高了IL-10、IL-4的水平。300 mg/kg的效果明显优于100 mg/kg。对照组与300 mg/kg组之间也存在显著差异。结论:在本研究中,AB植物提取物可提高MS动物模型血清抗炎因子水平,降低促炎因子水平。
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引用次数: 0
Unexpected Outcomes for Headache Under Evaluation; A Case Series of Four Cases 评估头痛的意外结果;四个案例的案例系列
Pub Date : 2023-09-13 DOI: 10.34172/icnj.2023.09
Uddalok Das, Debasish Dey
Headache is a common cause of hospital visits and admissions throughout the world. Headaches may be primary or secondary; the primary one being far more common. Although the primary cases by far outnumber the secondary cases the role of the physician is to separate the benign causes from the more sinister ones. Using clinical examination and history alone this can often be a mountain-moving task. However, radiology can help as a problem-solving tool in equivocal cases. This case series highlights the role of radiological imaging in four cases of chronic headaches that were being treated empirically as primary headaches for a long time before neuroimaging revealed a secondary cause.
头痛是世界各地就诊和住院的常见原因。头痛可能是原发性的,也可能是继发性的;第一种要常见得多。虽然原发病例远远超过继发病例,但医生的作用是将良性病因与恶性病因区分开来。仅凭临床检查和病史,这往往是一项艰巨的任务。然而,在模棱两可的情况下,放射学可以作为解决问题的工具。本病例系列强调放射成像在四个慢性头痛病例中的作用,这些病例在神经影像学显示继发原因之前很长一段时间被经验治疗为原发性头痛。
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引用次数: 0
Is Brain Fog a Temporary or Life-long Condition? 脑雾是暂时的还是终身的?
Pub Date : 2023-05-15 DOI: 10.34172/icnj.2023.08
Afshan Niknafs
In the 1880s, German physician Georg Greiner coined the concept of “brain fog” to describe the cognitive deficits associated with delirium. The term “brain fog” has been used intermittently since then to describe sluggish cognition. It gained popularity again in the 1990s as a way to describe chronic fatigue syndrome and some autoimmune diseases. However, there are no diagnostic criteria for brain fog and it is not a medical condition.1The term “brain fog” describes cognitive difficulties that are increasingly used colloquially. Long-term COVID-19 is characterized by persistent symptoms following a COVID-19 diagnosis that cannot be explained by any other illness. Persistent symptoms following COVID-19 are often described as “brain fog.” Brain fog syndrome, which is associated with excessive academic strain, was revived in the 1960s and was included in the DSM-IV.2As a result of post-COVID-19 infection, residual cognitive impairment (“brain fog”) often interferes with work and daily activities.3 Recent investigations have shown that fungal co-infections significantly affect the morbidity and mortality of patients with COVID-19.
19世纪80年代,德国医生格奥尔格·格雷纳(Georg Greiner)创造了“脑雾”的概念,用来描述与谵妄相关的认知缺陷。从那时起,“脑雾”一词就断断续续地被用来描述迟钝的认知。在20世纪90年代,它作为一种描述慢性疲劳综合征和一些自身免疫性疾病的方式再次流行起来。然而,脑雾没有诊断标准,也不是一种医学疾病。“脑雾”一词描述的是认知困难,越来越多地被口语使用。长期COVID-19的特征是在COVID-19诊断后持续出现无法用任何其他疾病解释的症状。COVID-19后的持续症状通常被描述为“脑雾”。脑雾综合症是一种与过度学习压力有关的症状,在20世纪60年代重新出现,并被纳入DSM-IV。由于covid -19感染后,残留的认知障碍(“脑雾”)经常干扰工作和日常活动最近的调查显示,真菌合并感染对COVID-19患者的发病率和死亡率有显著影响。
{"title":"Is Brain Fog a Temporary or Life-long Condition?","authors":"Afshan Niknafs","doi":"10.34172/icnj.2023.08","DOIUrl":"https://doi.org/10.34172/icnj.2023.08","url":null,"abstract":"In the 1880s, German physician Georg Greiner coined the concept of “brain fog” to describe the cognitive deficits associated with delirium. The term “brain fog” has been used intermittently since then to describe sluggish cognition. It gained popularity again in the 1990s as a way to describe chronic fatigue syndrome and some autoimmune diseases. However, there are no diagnostic criteria for brain fog and it is not a medical condition.1The term “brain fog” describes cognitive difficulties that are increasingly used colloquially. Long-term COVID-19 is characterized by persistent symptoms following a COVID-19 diagnosis that cannot be explained by any other illness. Persistent symptoms following COVID-19 are often described as “brain fog.” Brain fog syndrome, which is associated with excessive academic strain, was revived in the 1960s and was included in the DSM-IV.2As a result of post-COVID-19 infection, residual cognitive impairment (“brain fog”) often interferes with work and daily activities.3 Recent investigations have shown that fungal co-infections significantly affect the morbidity and mortality of patients with COVID-19.","PeriodicalId":33222,"journal":{"name":"International Clinical Neuroscience Journal","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135187694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coexistence of Cerebellopontine Angle Tumor and Frontal Convexity Meningioma at Distinct Location – A Rare Case Report and Review of Literature 脑桥小脑角肿瘤与额部凸脑膜瘤在不同部位共存1例罕见病例报告及文献复习
Pub Date : 2023-04-30 DOI: 10.34172/icnj.2023.07
Shalendra Singh, Aarthy Kumaraguru, Ankit Kumar, Munish Sood
The perioperative management of brain tumors can be significantly impacted by the presence of another intracranial tumor at a distinct location. We report a rare case of an adult who developed two primary brain tumors, a frontal convexity meningioma and a cerebellopontine angle (CPA) tumor at anatomically disparate locations. In our patient, it was unambiguously decided to address the CPA tumor first as it had led to multiple cranial nerve palsies and obstructive hydrocephalus. The relevant literature helped us better extrapolate the patient presentation and management of this disastrous presentation swiftly.
脑肿瘤的围手术期处理可能会受到另一个颅内肿瘤在不同位置的存在的显著影响。我们报告一例罕见的成人谁发展了两个原发性脑肿瘤,额凸脑膜瘤和小脑桥脑角(CPA)肿瘤在解剖不同的位置。在我们的患者中,明确决定首先处理CPA肿瘤,因为它导致多发性脑神经麻痹和阻塞性脑积水。相关文献帮助我们更好地推断患者的表现和管理的灾难性表现迅速。
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引用次数: 0
Innovative Measures of Verhulst Diagram for Emotion Recognition using Eye-Blinking Variability 基于眨眼变异性的Verhulst图情感识别创新测度
Pub Date : 2023-04-20 DOI: 10.34172/icnj.2023.06
Atefeh Goshvarpour, Ateke Goshvarpour
Background: The human body continuously reveals the status of several organs through biomedical signals. Over time, biomedical signal acquisition, monitoring, and analysis have captured the attention of many scientists for further prediction, diagnosis, decision-making, and recognition. Recently, building an intelligent emotion recognition system has become a challenging issue using the application of signal processing. Frequently, human emotion classification was proposed utilizing the internal body status in dealing with affective provocations. However, external states, such as eye movements, have been claimed to convey practical information about the participant’s emotions. In this study, we proposed an automatic emotion recognition scheme through the analysis of a single-modal eye-blinking variability. Methods: Initially, the signal was transformed into a 2D space using the Verhulst diagram, a simple analysis based on the signal’s dynamics. Next, some innovative features were introduced to characterize the maps. Then, the extracted measures were inputted to the support vector machine (SVM) and k-nearest neighbor (kNN). The former classifier was evaluated with three kernel functions, including RBF, linear, and polynomial. The latter performances were examined with different values for k. Moreover, the classification results were assessed in two feature-set partitioning modes: a 5-fold and 10-fold cross-validation. Results: The results showed a statistically significant difference between neutral/fear and neutral/sadness for all Verhulst indices. Also, the average values of these characteristics were higher for fear and sadness than those of other emotions. Our results indicated a maximum rate of 100% for the fear/neutral classification. Therefore, the suggested Verhulst-based approach was supremely talented in emotion classification and analysis using eye-blinking signals. Conclusion: The novel biomarkers set the scene for designing a simple accurate emotion recognition system. Additionally, this experiment could fortify the territory of ocular affective computing, and open a new horizon for diagnosing or treating various emotion deficiency disorders.
背景:人体通过生物医学信号不断地揭示几个器官的状态。随着时间的推移,生物医学信号的采集、监测和分析已经引起了许多科学家的注意,用于进一步的预测、诊断、决策和识别。近年来,应用信号处理技术构建智能情绪识别系统已成为一个具有挑战性的课题。通常,人类情感分类是利用身体内部状态来处理情感挑衅的。然而,外界状态,如眼球运动,被认为传达了参与者情绪的实际信息。在这项研究中,我们提出了一种通过分析单模态眨眼变异性的自动情绪识别方案。方法:首先,使用基于信号动力学的简单分析方法Verhulst图将信号转换为二维空间。接下来,引入了一些创新的特征来描述地图。然后,将提取的度量输入到支持向量机(SVM)和k近邻(kNN)中。前一种分类器用RBF、线性和多项式三种核函数进行评价。后一种性能用不同的k值进行检验。此外,分类结果在两种特征集划分模式下进行评估:5倍和10倍交叉验证。结果:中性/恐惧和中性/悲伤在所有Verhulst指标上的差异均有统计学意义。此外,恐惧和悲伤的这些特征的平均值高于其他情绪。我们的结果表明,恐惧/中性分类的最高准确率为100%。因此,建议的基于verhulst的方法在使用眨眼信号进行情绪分类和分析方面非常有天赋。结论:新的生物标记物为设计简单、准确的情绪识别系统奠定了基础。此外,本实验还可以巩固眼部情感计算的研究领域,为各种情感缺乏性障碍的诊断和治疗开辟新的视野。
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引用次数: 0
Serum Matrix Metalloproteinase-9 Level and Previous Disease Activity in Relapsing-Remitting Multiple Sclerosis 复发缓解型多发性硬化症患者血清基质金属蛋白酶-9水平与既往疾病活动性
Pub Date : 2023-03-05 DOI: 10.34172/icnj.2023.05
Eman Hamdy, Ismail Ramdan, Jaidaa Mekky, Aya Abdel Gleel, Dina Gaber
Background: Matrix metalloproteinase-9 (MMP-9) is a marker of blood-brain barrier destruction, that is elevated during clinical relapses in multiple sclerosis (MS). In between relapses, MMP-9 levels decline but remain higher than the normal population. This study aimed to investigate the relation between serum MMP-9 level and disease activity in MS during relapse-free periods. Methods: This was a retrospective study conducted on adult patients with relapsing-remitting MS (RRMS) whose last relapse was≥1 month ago. Serum MMP-9 was withdrawn at the time of recruitment and correlated with parameters of disease activity. Results: Of the 40 patients recruited, 75% were women. The mean age was 36.2±8.4 years, and the mean disease duration was 7 years. Patients’ median Expanded Disability Status Scale (EDSS) was 3.5 (IQR: 2.5-5.25), the median duration since the last relapse was 3 months, and the median duration since last corticosteroid administration was 6 months. On multivariate regression analysis, there was a significant association between serum MMP-9 levels and duration since the last relapse (B: -0.004, 95% CI: -0.007- -0.002, P=0.001) as well as duration since the last corticosteroid intake (B: -0.003, 95% CI: -0.006- -0.001, P=0.005). Conclusion: Serum MMP-9 levels correlated with the duration since last relapse and duration since last corticosteroids administration during relapse-free periods.
背景:基质金属蛋白酶-9 (MMP-9)是血脑屏障破坏的标志,在多发性硬化症(MS)的临床复发期间升高。在两次复发之间,MMP-9水平下降,但仍高于正常人群。本研究旨在探讨无复发期MS患者血清MMP-9水平与疾病活动度的关系。方法:对最后一次复发≥1个月的成年复发-缓解型MS (RRMS)患者进行回顾性研究。在招募时提取血清MMP-9,并与疾病活动性参数相关。结果:在招募的40名患者中,75%是女性。平均年龄36.2±8.4岁,平均病程7年。患者扩展残疾状态量表(EDSS)中位数为3.5 (IQR: 2.5-5.25),距最后一次复发的中位数持续时间为3个月,距最后一次使用皮质类固醇的中位数持续时间为6个月。在多变量回归分析中,血清MMP-9水平与上一次复发后的持续时间(B: -0.004, 95% CI: -0.007- -0.002, P=0.001)以及上次摄入皮质类固醇后的持续时间(B: -0.003, 95% CI: -0.006- -0.001, P=0.005)之间存在显著关联。结论:血清MMP-9水平与无复发期最后一次复发时间和最后一次皮质激素治疗时间相关。
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引用次数: 0
Apparent Diffusion Coefficient Values and Intra-tumoral Susceptibility Signals in Meningiomas and Schwannomas: Useful Tools for Challenging Cases 脑膜瘤和神经鞘瘤的表观扩散系数值和肿瘤内易感信号:对挑战性病例的有用工具
Pub Date : 2023-02-26 DOI: 10.34172/icnj.2023.04
Sweta Swaika, Akshara Gupta, Sourabh Agarwal
Background: We aimed to estimate the diagnostic accuracy of apparent diffusion coefficient values (ADC) and intra-tumoral susceptibility signals (ITSS) in differentiating meningiomas and schwannomas. Methods: This retrospective study included 41 patients with 23 histopathologically proven meningiomas (20 patients with benign meningioma and 3 patients with high-grade meningioma) and 18 schwannomas. We calculated the mean ADC values and ADC ratio from ADC maps and intratumoral susceptibility signals (ITSS) in susceptibility-weighted imaging (SWI) for all patients. The quantitative variables were compared between the tumor groups using t test and the qualitative variables were compared between them using Chi-square test. Results: In this study, the mean ADC value of meningiomas (0.86±0.11×10-3 mm2 /s, range 0.67-1.04) was lower than schwannomas (1.32±0.16×10-3 mm2 /s, range 1.10-1.65) with no overlap in the range of ADC values. The mean ADC ratio of schwannomas (2.0±0.29, range 1.45- 2.58) was higher than meningiomas (1.24±0.17, range 0.83-1.64) with some overlap. We found significant difference in mean ADC value and ADC ratio between meningiomas and schwannomas. The presence of intratumoral microhemorrhages (ITSS-H) in SWI was more suggestive of schwannomas and the presence of calcification was in favor of benign meningiomas. We did not find any significant difference in mean ADC value and ADC ratio between benign and high-grade meningiomas with considerable overlap in their range. Conclusion: Additional magnetic resonance imaging findings such as ADC values and ITSS in SWI can help better pre-operative diagnosis of meningiomas and schwannomas, particularly in challenging patients.
背景:我们旨在评估表观扩散系数值(ADC)和肿瘤内易感信号(ITSS)在脑膜瘤和神经鞘瘤鉴别中的诊断准确性。方法:回顾性研究41例经组织病理学证实的23例脑膜瘤(20例为良性脑膜瘤,3例为高级别脑膜瘤)和18例神经鞘瘤。我们根据ADC图和敏感性加权成像(SWI)中的肿瘤内易感信号(ITSS)计算所有患者的平均ADC值和ADC比率。肿瘤组间定量变量比较采用t检验,定性变量比较采用卡方检验。结果:本研究中脑膜瘤的平均ADC值(0.86±0.11×10-3 mm2 /s,范围0.67 ~ 1.04)低于神经鞘瘤(1.32±0.16×10-3 mm2 /s,范围1.10 ~ 1.65),ADC值范围无重叠。神经鞘瘤的平均ADC比(2.0±0.29,范围1.45 ~ 2.58)高于脑膜瘤(1.24±0.17,范围0.83 ~ 1.64),两者有一定的重叠。我们发现脑膜瘤和神经鞘瘤的平均ADC值和ADC比值有显著差异。SWI的瘤内微出血(tss - h)更提示神经鞘瘤,钙化的存在有利于良性脑膜瘤。我们没有发现良性和高级别脑膜瘤的ADC值和ADC比值有显著差异,但其范围有相当大的重叠。结论:额外的磁共振成像结果,如ADC值和ITSS在SWI中可以帮助更好地术前诊断脑膜瘤和神经鞘瘤,特别是在挑战性患者中。
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引用次数: 0
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International Clinical Neuroscience Journal
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