Background: Several otologic conditions can present with fluctuating sensorineural hearing loss, including Ménière’s disease, autoimmune inner ear disease, and enlarged vestibular aqueduct. Although these 3 etiologies vary greatly, distinguishing between these conditions at initial presentation can be challenging. Furthermore, initial treatment of these conditions is often similar. In this review, we discuss historical and current perspectives on diagnosis and treatment of these conditions. Summary: A literature search was performed regarding fluctuating hearing loss, and current treatment of these etiologies of fluctuating hearing loss was summarized. Immediate measures at the onset of acute hearing loss include corticosteroid therapy, while preventative and chronic therapies, which can limit disease severity and frequency, vary based on the specific condition treated. Key Messages: Fluctuating hearing loss can represent a range of pathologies, but the precise etiology may not be clear at initial presentation. Timely treatment and long-term follow-up, along with appropriate diagnostics, are necessary to optimize long-term hearing.
Background
Intravoxel incoherent motion diffusion‐weighted imaging (IVIM‐DWI) and dynamic contrast‐enhanced MRI (DCE‐MRI) are sensitive imaging modalities for detecting liver lesions, but their value in evaluating cirrhosis‐related nodules remains unclear.
Purpose
To investigate whether IVIM‐DWI and DCE‐MRI can differentiate different types of cirrhosis‐related nodules, and whether these modalities can monitor changes in cell density and angiogenesis during the malignant transformation of cirrhosis‐related nodules in a rat model
Study Type
Prospective.
Animal Model
Thirty‐five male Sprague–Dawley rats with 106 cirrhosis‐related nodules (19 regenerative nodules [RNs], 47 dysplastic nodules [DNs], and 40 hepatocellular carcinomas [HCCs]).
Field Strength/Sequence
IVIM‐DWI and DCE sequence at 3.0T MRI.
Assessment
IVIM‐DWI parameters (D, D*, f, and apparent diffusion coefficient [ADC]) and DCE‐MRI parameters (Ktrans, Kep, and Ve) were calculated by two radiologists using postprocessing software. The “cell density” and “unpaired arterial ratio” were analyzed with a microscope by two pathologists.
Statistical Tests
MRI parameters were compared among the different types of nodules by one‐way analysis of variance or the Kruskal–Wallis test. The Pearson correlation test was used to analyze the correlation of MRI parameters with the pathological types of nodules, cell density, and unpaired arterial ratio.
Results
The Ktrans, Kep, and Ve values of HCCs were significantly higher than those of DNs and RNs. D and ADC values were significantly lower in HCCs than in DNs and RNs. There were moderate positive correlations of Ktrans with the pathological types of nodules and the unpaired arterial ratio. Moderate negative correlations were observed among D, ADC, and the pathological types of nodules, between D and cell density, and between ADC and cell density.
Data Conclusion
IVIM‐DWI and DCE‐MRI are valuable in differentiating different types of cirrhotic‐related nodules. D and ADC are correlated with changes in cell density during the malignant transformation of cirrhosis‐related nodules, while Ktrans is correlated with increased angiogenesis.
Level of Evidence: 1
Technical Efficacy: Stage 1
J. Magn. Reson. Imaging 2020;51:812–823.
Voltage source converter-based high-voltage direct current (VSC-HVDC) has the advantage of fast and independent controllability on active and reactive power. This paper focuses on effects of commonly proposed reactive power control modes, constant reactive power control and AC voltage margin control. Based on the mathematical model of single machine infinity equivalent system with embedded VSC-HVDC, the influence of VSC-HVDC with different reactive power control strategies on transient stability and dynamic stability of the AC system is studied. Then case studies were conducted with a realistic model of grid. The dynamic responses of AC/DC systems for different VSC-HVDC reactive power control modes were compared in detail. It is shown that compared to constant reactive power control, AC voltage margin control can provide voltage support to enhance the transient angle stability of an AC system. However, the fluctuant reactive power injected into a weak AC system may adversely affect power system oscillation damping for VSC-HVDC with AC voltage margin control, if the parameters of the controller have not been optimized to suppress the low-frequency oscillation. The results of this paper can provide certain reference for the decision of an appropriate VSC-HVDC reactive power control mode in practice.
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