SUMMARY: 3D diffusion-weighted steady-state free precession imaging (3D DW-SSFP) with isotropic resolution was performed to delineate structures of the human lumbosacral plexus (LSP). 3D DW-SSFP clearly revealed detailed anatomy of the LSP and its branches. Our data suggest that the sequence based on 3D DW-SSFP can be used for high-resolution MR imaging of the peripheral nervous system. MR imaging evaluation of the normal peripheral nerve anatomy and diseases is mainly dependent on 2D MR imaging techniques, including T1-weighted spin-echo, T2-weighted fast spin-echo, and inversion-recovery sequences with fat saturation.1-7 Although these techniques can produce excellent-quality images, they have limitations in describing deliberate orientations of the targeted nerves, in that section gaps in these techniques lead to lower anatomic coverage and less quantitative information. Furthermore, T2-weighted spin-echo techniques cannot image smaller nerves in the periphery because the nerves cannot be distinguished from blood vessels on T2-weighted spin-echo images.8 A combination of diffusion-weighted imaging (DWI) with fat-suppressed T2-weighted sequences has been proposed to overcome these technical limitations. Additionally, DWI based on spin-echo with an echo-planar readout has been used to evaluate the anatomy of the peripheral nervous system. 9-10 However, these conventional techniques have limited spatial resolution or low signal-to-noise ratio and often produce severe image distortion. 8,11 It is difficult to reveal the detailed anatomy of the lumbosacral plexus (LSP) by using conventional MR imaging in that many important branches of the LSP are small, and contrast of the various anatomic structures is not sufficient to exhibit their discrete identification. The purpose of this study is to describe a high-spatial-resolution 3D diffusion-weighted steady-state free precession (3D DW-SSFP) sequence and prospectively evaluate its feasibility in human LSP imaging at 3T. Materials and MethodsTwenty-four healthy subjects (10 men, 14 women; mean age, 42.2 years; range, 24 -69 years) underwent high-spatial-resolution T2-weighted 3D DW-SSFP imaging with a generalized autocalibrating partially parallel acquisition (GRAPPA) technique on a clinical 3T MR imager (Trio; Siemens Medical Solutions, Erlangen, Germany) with 2-element circularly polarized (CP) phased-array body coils combined with CP phased-array spinal coils.After optimization of the sequence in 3 healthy subjects (1 woman and 2 men, 30 -36 years of age), we used the following parameters: TR/TE, 14.16/4.61 ms; flip angle, 30°; FOV, 360 mm; matrix, 512 ϫ 512; bandwidth, 184 Hz per pixel; fat suppression, water excitation technique; diffusion moments, 90 mT/m (*)msec; 3D slab thickness, 256 mm; voxel dimension, 0.8 ϫ 0.8 ϫ 0.8 mm (320 partitions); number of acquisitions, 1; acquisition time, 10 minutes 49 seconds. The diagram of the 3D DW-SSFP sequence used in this study is shown in Fig 1. The postprocessing techniques, including maximum intensity projection and mul...

Interleukin-6 (IL-6) has been found to be a predictor of heart attack. We aimed to investigate the relationship of risk factor IL-6 with extent and severity of the coronary artery disease (CAD) evaluated using coronary computed tomography angiography (CCTA). A total of 303 participants without history of CAD undergoing CCTA were enrolled. Using the model of risk-adjusted Cox proportional-hazards, the association of IL-6 level with major adverse cardiac events (MACE) was detected. The participants were assigned into three study groups based on serum IL-6 level. Compared with those in the lowest tertile, patients with highest IL-6 level displayed higher atherosclerotic burden such as plaque extent defined as prevalence of obstructive CAD and segments with any plaque. After a median 3.0 year follow-up period, we also found that patients with highest IL-6 level experienced higher MACE risk and all-cause death compared with those from the lowest tertile. Among participants without CAD history who underwent CCTA, patients with high level of IL-6 had increased burden of atherosclerosis and higher MACE risk compared to participants of low level of IL-6.

Melamine overdose can cause an increased risk of developing kidney stones in children. B-ultrasound is the first choice for the diagnosis of urolithiasis related to melamine. For most patients, the conservative treatment is effective; however, the patients with kidney stones >10 mm, surgery may be needed.

Increased B-type natriuretic peptide (BNP) level has been suggested to improve clinical predictions of coronary events and all-cause mortality. We aimed to analyze the relationship between BNP levels and coronary plaque subtypes as detected by coronary computed tomography angiography (CCTA). 402 subjects undergoing CCTA were enrolled. The relationship between increased levels of BNP and plaque subtypes was tested using multivariable linear and logistic regression analysis. Plaques were categorized into subtypes of calcified, mixed and non-calcified. Coronary plaque was observed in 93 of 402 individuals. The participants were divided into three groups according to their serum BNP levels. Compared to those with low BNP level, subgroup with high BNP level had increased prevalence of all plaque types and mixed calcified arterial plaque (MCAP). Multivariable logistic regression analysis suggested increased BNP level predicted the MCAP. Multivariable logistic regression analysis between the presence of ≥2 plaques and BNP indicated that, subgroup with high BNP level was more likely to have MCAP than low BNP level. Our study suggests that increased BNP level is associated with MCAP detected by CCTA. Increased BNP level provides additional information about coronary artery disease in patients with stable chest pain detected by CCTA.

No abstract