The aim of this preliminary study was to retrospectively evaluate the usefulness of high b-value diffusion-weighted MR imaging (DWI) in the detection of gallbladder carcinoma. Fifteen patients with gallbladder carcinoma and 14 other patients were included in this study. All patients and subjects underwent DWI, and images were evaluated by two radiologists. The area under the receiver operating characteristic curve (AUC), apparent diffusion coefficient (ADC) measurement, sensitivity and specificity were calculated. An AUC yielded 0.980 (95% CI, 0.850-0.999) and 0.941 (95% CI, 0.791-0.990) for the two radiologists. The mean sensitivity and specificity were 83.3% and 100%, respectively. The mean ADC value of gallbladder carcinoma was (1.28 +/- 0.41)x10(-3) mm(2)/s and that of control gallbladder lesions was (1.92 +/- 0.21)x10(-3) mm(2)/s (P < 0.01). According to the results of our preliminary study, high b-value DWI might be a useful tool for detecting gallbladder carcinoma by measuring the ADC value and direct visual assessment.
We applied transcranial magnetic stimulation (TMS) as a therapeutic approach for patients with spinocerebellar degeneration (SCD). The subjects were four familial SCD patients (three men and one woman) aged from 27 to 76 years old. They were genetically analysed as two spinocerebellar ataxia type 6 (SCA 6), one SCA 1, and one SCA 7. The durations of their illness ranged from 1 to 7 years. Ten consecutive magnetic pulses were delivered over the scalp corresponding to the right cerebellar hemisphere, the middle of the cerebellum and the left cerebellar hemisphere, respectively, every day for 21 days. In all patients, the time and the number of steps required for a 10 m walk examination were significantly decreased after TMS trial compared with those before TMS. The number of feasible steps in tandem gait test increased. The total length of tracing body balance for 30 seconds measured by gravinometer was significantly decreased. However, nystagmus, dysarthria or incoordination of the upper limbs did not change after TMS trial. It is of interest that the blood flow of the cerebellar hemisphere, putamen and pons were significantly increased during the TMS trial. Although we do not know the exact mechanism by which TMS improved the ataxic gait, we speculate the increase of blood flow in the cerebellum, putamen and pons takes part in the improvement. These findings suggest that TMS over the cerebellum may be an effective therapy for patients with SCD.
Avulsive cortical irregularity, a benign condition occurring only among children and adolescents, has been known to simulate malignancy not only radiologically but also microscopically. Therefore, in addition to plain radiographs, further studies including by magnetic resonance (MR) imaging may occasionally be required. MR images of seven cases of avulsive cortical irregularity of the femur were reviewed. In all cases, the lesion appeared hypointense on T1-weighted images and hyperintense on T2-weighted images, with a dark rim on both sequences at or near the sites of the bony attachment of the medial head of the gastrocnemius muscle. In all cases, bilateral involvement was demonstrated by plain radiography, computed tomography, and/or MR imaging. The authors suggest that avulsive cortical irregularity involves both femora much more frequently than has been reported previously.
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