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Intervertebral disc degeneration (IDD) is the main cause of back pain, and its treatment is a serious socio-economic burden. The safety and treatment of fecal microbiota transplantation (FMT) has been established. However, the relationship between FMT and IDD still unclear. We aimed to explore whether FMT plays a role in IDD to provide a reference for the treatment of IDD.An experimental model of IDD was established using 2-month-old male Sprague-Dawley rats. FMT was performed by intragastric gavage of IDD rats with a fecal bacterial solution. Rat serum, feces, and vertebral disc tissue were collected after surgery for 2 months. The levels of TNF-α, IL-1β, IL-6, matrix metalloproteinase (MMP)-3, MMP-13, Collagen II, and aggrecan in the serum or vertebral disc tissue were measured by an enzyme-linked immunosorbent assay, immunohistochemistry, quantitative real-time polymerase chain reaction, or western blotting. We also examined the pathology of the vertebral disc tissue using hematoxylin and eosin (HE) and safranin O-fast green staining. Finally, we examined the gut microbiota in rat feces using 16 S rRNA gene sequencing.We found that the expression of TNF-α, IL-1β, IL-6, MMP-3, MMP-13, NLRP3 and Caspase-1 increased in the IDD group rats. In contrast, Collagen II and aggrecan levels were downregulated. Additionally, vertebral disc tissue was severely damaged in the IDD group, with disordered cell arrangement and uneven safranin coloration. FMT reversed the effects of IDD modeling on these factors and alleviated cartilage tissue damage. In addition, FMT increased the gut microbiota diversity and microbial abundance in rats treated with IDD.Our findings suggest that FMT has a positive effect in maintaining cellular stability in the vertebral disc and alleviating histopathological damage. It affects the diversity and abundance of gut microbiota in rats with IDD. Therefore, FMT may serve as a promising target for amelioration of IDD.

Background: Necrotizing fasciitis (NF) is a rare, rapidly progressing, and potentially fatal tissue infection involving subcutaneous tissue, superficial fascia, and the overlying skin. Breast NF is...

The purpose of this study was to evaluate the differences in carotid arterial morphology and plaque composition between patients with acute coronary syndrome (ACS) and patients with stable coronary artery disease (SCAD). Twenty-eight patients (12 ACS patients and 16 SCAD patients) underwent carotid high-resolution MRI examination using a 3.0-Tesla (3.0T) MRI scanner. The indicators of carotid arterial morphology included the maximum total vessel area (Max-TVA), mean TVA, minimum lumen area (Min-LA), mean LA, maximum wall area (Max-WA), mean WA, maximum wall thickness (Max-WT), mean WT, maximum normalized wall index (Max-NWI), mean NWI, and maximum stenosis (Max-stenosis). The indicators of plaque composition included the prevalence and mean area percentage (%) of lipid-rich necrotic core (LRNC), calcification (Ca), intraplaque hemorrhage (IPH), and fibrous cap rupture (FCR). None of the indicators of carotid arterial morphology had significant differences (all P > 0.05) between the ACS and SCAD patients. The prevalence and plaque composition area percentage of LRNC, Ca, and IPH did not exhibit significant differences between the two groups. However, carotid plaques in the ACS patients presented a higher prevalence of FCR than SCAD patients (P < 0.05). This study revealed a similar carotid arterial morphology between ACS and SCAD patients. However, FCR is more common in carotid plaques with ACS than in those with SCAD. Ruptured carotid plaques may be a forewarning factor for those patients who are at high risk of ACS.

To evaluate the differences of signal evolution of intraplaque hemorrhage (IPH) and associated stenosis between symptomatic and asymptomatic atherosclerotic carotid arteries. Thirty-three carotid arteries (15 symptomatic and 18 asymptomatic plaques) with recent carotid IPH underwent serial high-resolution MRI examinations on a 3.0-Tesla (3.0T) MRI scanner over a period of 18 months. MR sequences included three-dimensional time-of-flight (3D-TOF), quadruple-inversion-recovery T1-weighted imaging (QIR T1 WI), proton density-weighted imaging (PDWI), and T2-weighted imaging (T2WI). The contrast-to-noise ratios (CNRs) of subsequent IPH during the follow-up period between symptomatic and asymptomatic carotid IPH showed a significant difference on 3D-TOF (P = 0.029), T1 WI (P = 0.005), and PDWI (P = 0.028), except for that on T2WI (P = 0.362). Compared with no significant signal intensity change of symptomatic IPH, CNRs of asymptomatic IPH exhibited a gradually descending trend on all contrast weighted images (P

In this study, we have aimed to evaluate the relationship between the shape and location of superficial calcification and the presence of fibrous cap rupture and intraplaque hemorrhage in atherosclerotic carotid plaque. Sixty-three patients with carotid stenosis underwent contrast-enhanced high resolution MR examinations with a 3-T MR scanner and 226 slices with superficial calcification were evaluated in the study. The shape of superficial calcification was categorized as the irregular type (dotted/arcuated) and patchy type and the location of superficial calcification was categorized as the marginal type and central type. Intraplaque hemorrhage and fibrous cap rupture depicted on the same slice as superficial calcification were identified. The chi-squared test was used for statistical analysis. A total of 149 slices (65.9%) with intraplaque hemorrhage and 107 slices(47.3%)with fibrous cap rupture were detected. There were 191 slices with irregular type (dotted/arcuated) calcification and 166 slices with marginal type calcification. Irregular superficial calcification was found more frequently accompanied with intraplaque hemorrhage as compared to the patchy type (73.8 vs. 22.9%, P0.0001); there was a significant difference between the marginal type and the central type for the accompaniment of intraplaque hemorrhage (72.9 vs. 46.7%, P0.05). However, there was no significant difference between different shapes and locations of superficial calcification that accompanied with fibrous cap rupture (P0.05). This study showed that superficial calcification is an important factor for determination of instability of atherosclerotic carotid plaque. The shape and location of superficial calcification are important features associated with the occurrence of intraplaque hemorrhage.

Purpose To determine if contrast-enhanced (CE) MRI of intracranial lesions benefits from time-resolved MR angiography (MRA) during contrast agent injection. Materials and Methods For 126 patients with suspected intracranial lesions undergoing routine CE MRI at 3.0T (N = 88) or 1.5T (N = 38), time-resolved CE MRA (three-dimensional [3D] time-resolved imaging of contrast kinetics [TRICKS]) was performed during injection of the routine gadolinium (Gd) dose of 0.1 mmol/kg. Time to peak (TTP) enhancement of lesions as well as time to internal carotid artery (ICA), middle cerebral artery (MCA), superior sagittal sinus (SSS), and jugular vein enhancement were measured. Source and maximum intensity projection (MIP) images were reviewed to delineate the spatial relationship of lesions and the vasculature. Results In 61 patients (48%), additional important findings were detected on time-resolved MRA that were not seen on the routine CE protocol, including aneurysms (N = 6), arteriovenous malformations (N = 7), ICA stenoses (N = 2), vascular anomalies (N = 18), and relationships between lesions and vessels (N = 28). In addition, tumor TTP correlated with glioma grade (r = 0.87) and discriminated epithelial from nonepithelial meningiomas (P = 2.6 × 10–5). MRA added eight minutes to the total exam time. Conclusion Time-resolved MRA performed during contrast agent injection adds information to the routine brain CE MRI examination of intracranial lesions with only a small time penalty and no additional risk to the patient. J. Magn. Reson. Imaging 2008. © 2008 Wiley-Liss, Inc.

Background Creutzfeldt-Jakob disease (CJD), a rare disease, is uncharacterized by computed tomography (CT) and magnetic resonance imaging (MRI). This study was aimed to evaluate the diffusion-weighted MRI (DWI) manifestations of CJD and to discuss their diagnostic value. Methods The findings of T1-weighted MRI (T1 WI), T2-weighted MRI (T2WI), DWI and post-contrast MRI in 5 patients (3 patients with biopsy-proven CJD and 2 patients with clinically-proven CJD) were retrospectively analyzed in this study. Results Four out of the 5 patients had cerebral atrophy of various degrees. One patient showed symmetric high signal intensity at the bilateral globus pallidus and the head of the caudate nucleus, with very high signal in the cerebral cortex on the DWI. This patient only had symmetric slightly high signal at the bilateral globus pallidus and putamen on T2WI. One patient had high signal intensity at the basal ganglia and cerebral cortex on DWI, but abnormal T2 signal intensity at the bilateral paraventricular white matter on MRI. Two patients presented with widely gyri-like high signal intensity at the cortex on DWI, but routine MRI showed bilateral paraventricular long T2 signal intensity in 1 patient and no abnormal findings in another. No abnormalities were shown by both routine MRI and DWI in the last patient. Conclusions DWI is more sensitive than its conventional counterpart in the depiction of CJD. DWI is more sensitive to detect cortical abnormal signal intensity in CJD not detected by T2WI. Chin Med J 2006; 119(15):1242-1247

Motor neuron damage and cortical spinal tract (CST) degeneration are pathological features of amyotrophic lateral sclerosis (ALS). We combined whole-brain diffusion tensor imaging (DTI) and three-dimensional magnetic resonance spectroscopic imaging (MRSI) to study the CST at different locations. Eight ALS patients were compared with normal controls. Fractional anisotropy (FA) and mean diffusivity (MD), and the ratio of N-acetyl-aspartate (NAA) to creatine (Cr) were measured at various locations in the CST, including the subcortical white matter (SWM), centrum semiovale (CS), periventricular white matter (PV), posterior limb of the internal capsule (PIC) and cerebral peduncle (CP). Patients showed significantly lower FA than controls in the CST, including the SWM, CS, PV and PIC. Although there was a trend towards elevated MD in ALS patients, this did not reach statistical significance. NAA/Cr ratios were also decreased in ALS patients compared with normal controls, with significant differences in the SWM and PV but not in PIC. Combined whole-brain DTI and MRSI can detect axonal degeneration in ALS. Measurements of FA obtained in the SWM, CS, PV and PIC, and NAA/Cr ratios in the SWM and PV yield the most robust results.

To assess the value of high-resolution three-dimensional black-blood magnetic resonance imaging (3D-BB-MRI) in quantitative measurement of carotid atherosclerotic plaque by comparison with two-dimensional black-blood magnetic resonance imaging (2D-BB-MRI).Forty patients were scanned with routine 2D and oblique-sagittal 3D-BB-MRI. The original oblique-sagittal 3D images were reformatted to an axial 2D-like dataset. Two experienced radiologists identified the interested slice in consensus for every patient (unilateral carotid artery) in 2D-BB-MRI images and matched the axial reformatted 3D images with 2D black-blood images. Plaque thickness (PT), lumen area (LA) and total vessel area (TVA) were measured, and lumen stenosis (LS) and normalized wall index (NWI) were calculated.There was no measurement difference between 2D-BB-MRI and reformatted 3D-BB-MRI (P0.05), and these two methods had a good correlation (r0.9). The Bland-Altman chart showed that 2D-BB-MRI and 3D-BB-MRI were in good agreement in the measurement of PT, LA and TVA.3D-BB-MRI and 2D-BB-MRI have no obvious difference in quantitative measurement of the carotid plaques. 3D-BB-MRI can demonstrate the vessels and plaques by multiplanar reconstruction and thus have better performance in evaluating carotid atherosclerosis compared with 2D-BB-MRI.

To reduce the acquisition time of carotid high-resolution contrast-enhanced magnetic resonance imaging (CEMRI), we designed a small field-of-view (FOV) quadruple-inversion-recovery (SF-QIR) T1WI and evaluated the image quality.Twenty-four subjects with carotid plaque were enrolled in our study. All the subjects were imaged using the same 3.0T MRI by SF-QIR and standard rectangular FOV QIR (SrF-QIR) with identical parameters except for the phase-encoding step numbers and the RF excitation methods. Three independent readers qualitatively evaluated the differences between the two sequences in regard of the carotid outer wall border delineation, fibrous cap and lipid-rich necrotic core (LR-NC) border delineation, and diagnostic confidence. The quantitative measurements included maximal stenosis, wall area, LR-NC area, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The inter-reader variability was assessed.The application of SF-QIR combined with orthogonal radio frequency excitation resulted in nearly half of the scan time with the SrF-QIR. Both qualitative and quantitative assessment by the readers revealed no significant differences between the two sequences except for SNR and CNR (Pgt;0.05). Since the mean loss of SNR with SF-QIR was 37.7%, SrF-QIR demonstrated a superior performance in SNR (P0.001).The small FOV QIR sequence is effective in high-resolution CEMRI for evaluating carotid plaques and can effectively reduce the scan time and eliminate motion artifacts.

Not uncommonly, differentiating multiple sclerosis (MS) from ischemic cerebral vascular disease is difficult based on conventional magnetic resonance imaging (MRI). We aim to determine whether preferential occult injury in the normal-appearing corpus callosum (NACC) is more severe in patients with MS than symptomatic carotid occlusion by comparing fractional anisotropy (FA) from diffusion tensor imaging (DTI).Eighteen patients (eight men, ten women; mean age, 38.6 years) with MS and 32 patients (24 men, eight women; mean age, 64.0 years) with symptomatic unilateral internal carotid occlusion were included. DTI (1.5 T) were performed at corpus callosum which were normal-appearing on fluid-attenuated inversion recovery MRI. Mean FA was obtained from the genu, anterior body, posterior body, and splenium of NACC. Independent-sample t test statistical analysis was performed.The FA values in various regions of NACC were lower in the MS patients than symptomatic carotid occlusion patients, which was statistically different at the anterior body (0.67 +/- 0.12 vs 0.74 +/- 0.06, P = 0.009), but not at genu, posterior body, and splenium (0.63 +/- 0.09 vs 0.67 +/- 0.07, P = 0.13; 0.68 +/- 0.09 vs 0.73 +/- 0.05, P = 0.07; 0.72 +/- 0.09 vs 0.76 +/- 0.05, P = 0.13).MS patients have lower FA in the anterior body of NACC compared to patients with symptomatic carotid occlusion. It suggests that DTI has potential ability to differentiate these two conditions due to the more severe preferential occult injury at the anterior body of NACC in MS.

Objective To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in bone metastasis detection using bone scintigraphy as comparison. Methods Forty-five patients with malignancy history were enrolled in our study. All the patients received the whole body DWI and bone scintigraphy scan within 1 week. The magnetic resonance (MR) examination was performed on 3.0T MR scanner using embedded body coil. The images were reviewed separately by two radiologists and two nuclear medicine physicians, who were blinded to the results of the other imaging modality. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the two techniques for detecting bone metastasis were analyzed. Results A total of 181 metastatic lesions in 77 regions of 34 patients were detected by whole body DWI, and 167 metastatic lesions in 76 regions of 31 patients were identified by bone scintigraphy. The patient-based sensitivity and PPV of whole body DWI and bone scintigraphy were similar (89.5% vs. 81.6%, 97.1% vs. 91.2%), whereas, the patient-based specificity and NPV of whole body DWI were obviously higher than those of bone scintigraphy (85.7% vs. 57.1%, 60.0% vs. 36.4%). Ten regions negative in scintigraphy but positive in whole body DWI, mainly located in spine, pelvis, and femur; nine regions only detected by scintigraphy, mainly located in skull, sternum, clavicle, and scapula. The region-based sensitivity and specificity of whole body DWI were slightly higher than those of bone scintigraphy (89.5% vs. 88.4%, 95.6% vs. 87.6%). Conclusion Whole body DWI reveals excellent concordance with bone scintigraphy regarding detection of bone metastasis, and the two techniques are complementary for each other.

To investigate the magnetic resonance (MR) features of meningeal carcinomatosis, and to improve the ability in understanding and diagnosing meningeal carcinomatosis by MR findings.Eleven cases with proven meningeal carcinomatosis were studied by conventional and Gd-DTPA enhanced MR imaging. The enhancement patterns and features, as well as the types of meningeal involvement, were retrospectively analyzed.Conventional MR imaging showed no evident meningeal abnormalities. After the administration of Gd-DTPA, abnormal pia mater enhancement was detected in 9 cases, demonstrating as the continuous, thin, and lineal high signal intensity on the brain surface that could descend into the sulci. The abnormal pial enhancement occurred on the cortical surfaces of cerebellum, brainstem, and cerebrum. No abnormal enhancement in the subarachnoid space was found. Abnormal dura-arachnoid enhancement was seen in 3 cases, showing as the continuous, thick, and curvilineal high signal intensity over the convexities or in the tentorium without extension into the cortical sulci. Cerebral dura-arachnoid involvement was found in all 3 cases and one of them also showed abnormal enhancement in cerebellar dura-arachnoid and tentorium. Of the 11 cases, 9 with pial involvement had abnormal cerebrospinal fluid (CSF) results, 2 involving only the dura-arachnoid had normal CSF results.Meningeal carcinomatosis could be well demonstrated by Gd-DTPA enhanced MR imaging, and its type could be differentiated by the enhancement features. Combined with the clinical information, Gd-enhanced MR imaging may lead to the diagnosis and guide the therapy of meningeal carcinomatosis.

Cerebral blood flow (CBF) in the human primary visual cortex is correlated with the loss of visual function in neuro-ophthalmological diseases. Advanced three-dimensional pseudo-continuous arterial spin labeling (3D pCASL), as a non-invasive method to access the CBF, can be a novel measurement to detect the visual cortex. The objective of the study was to assess the intra- and inter-scanner reliability of 3D pCASL of the visual cortex in healthy adults and suggest the selection of different post-labeling delay times (PLDs). For this reason, 3D pCASL was conducted in two 3.0T MR three times with twelve healthy volunteers at an interval of 10-15 days. The 1st and 3rd tests were performed on scanner-1, and the 2nd test was performed on scanner-2. The value of the CBF was abstracted from the visual cortex with two PLDs. The intra- and inter-scanner reliability and reproducibility were evaluated with the intraclass correlation coefficient (ICC) and Bland-Altman plots. By estimating the mean value of the CBF in the visual cortex, the intra-scanner results demonstrated the higher reliability (ICC for PLD = 1.5 second presented at 0.743 compared with 0.829 for PLD = 2.5 seconds), and the Bland-Altman plots showed the reproducibility at a longer PLD. We conclude that the calibrated 3D pCASL approach provides a highly reproducible measurement of the CBF of the visual cortex that can serve as a useful quantitative probe for research conducted at multiple centers and for the long-term observation of the clinical effects of neuro-opthalmological diseases.