High T2 Research Articles

A longitudinal study of social, religious, and spiritual capital and physical and emotional functioning in a national sample of African-Americans.

The present study builds on prior research by examining the moderating relationships between different types of capital on physical functioning, emotional functioning, and depressive symptoms using a 2.5-year longitudinal design with a national sample of African-American adults. Results indicated a significant T1 social capital × T1 religious capital interaction such that among low T1 religious capital participants, those with high T1 social capital had lower T2 physical functioning than those with lower T1 social capital. There was also a marginally significant T1 social capital × T1 spiritual capital interaction suggesting that among low T1 spiritual capital participants, those with higher T1 social capital reported a decline in depressive symptoms compared to those with lower T1 social capital. Future research and implications for intervention and policy development are discussed.

Elucidating the Impact of Hydrophilic Segments on 19F MRI Sensitivity of Fluorinated Block Copolymers.

A major challenge in the preparation of polymeric 19F magnetic resonance imaging (MRI) contrast agents (CAs) is signal attenuation caused by reduced segmental mobility of partly fluorinated polymers possessing large numbers of fluorine atoms. Previous studies have thus mainly focused on the development of fluorinated segments for improved 19F MRI; however, detailed investigations of the role of hydrophilic segments on imaging performance remain scarce. In this study, three hydrophilic and biocompatible monomers, i.e., 2-(methylsulfinyl)ethyl acrylate (MSEA), oligo(ethylene glycol) methyl ether acrylate (OEGA), and oligo(2-methyl-2-oxazoline) acrylate (OMOXA), were used to prepare perfluoropolyether (PFPE)-containing amphiphilic block polymers through reversible addition-fragmentation chain-transfer (RAFT) polymerization. The effect of the different hydrophilic segments on 19F imaging performance was explored. The three polymers could be readily dissolved in aqueous solutions, forming assemblies with the hydrophobic PFPE as the core and the hydrophilic chains as the shell. Molecular dynamics simulations demonstrate that the POMOXA chains adopt a rigid, extended conformation, leading to a relatively short 19F NMR spin-spin relaxation time (T2), lower NMR detectable 19F spins (i.e., visibility), and the least intense 19F MRI signal. In contrast, although PMSEA-PFPE has a shorter 19F NMR T2 than POEGA-PFPE, the much higher 19F spin visibility enhances its MRI signal intensity. The result confirms the importance of maintaining both high fluorine visibility and long T2 relaxation time to prepare effective CAs and highlight the key role of the nonfluorinated hydrophilic segments in determining these parameters.

İntratekal Gadolinyumlu Manyetik Rezonans Myelografide THRIVE Sekansının Katkısı

İntratekal Gadolinyumlu Manyetik Rezonans Myelografi (İG-MRM) spontan intrakraniyal hipotansiyonun (SİH) etyolojisini araştırmak için yapılan bir inceleme yöntemidir. İncelemede genellikle yağ baskılı 2 boyutlu T1A turbo spin eko (2B-T1A TSE) sekansı tercih edilmektedir. “T1-weighted high-resolution isotropic volume examination” (THRIVE) sekansı; yüksek çözünürlüklü yağ baskılı T1 görüntüleme imkanı sunan, yeni nesil 3 boyutlu gradient eko (GRE) görüntüleme tekniğidir. Bu çalışmada; THRIVE sekansının intrakraniyal hipotansiyon ile ilişkili İG-MRM bulgularını saptamadaki tanısal başarısını 2B-T1A TSE ile karşılaştırarak değerlendirmeyi amaçladık. Mart 2018 – Kasım 2019 tarihleri arasında klinik ve radyolojik bulgularına göre SİH tanısı konan ve İG-MRM yapılan 16 hasta dahil edildi. 2B-T1A TSE ve THRIVE sekansları; servikal, torakal ve lomber düzeydeki beyin omurilik sıvısı (BOS) opasifikasyon düzeyleri, tekniklerin her birinde saptanan epidural BOS kolleksiyonu, dural defekt ve meningeal divertikül bulgularının sayısı açısından karşılaştırıldı. Servikal ve torakal düzeyde THRIVE sekansındaki BOS opasifikasyon düzeyi 2B-T1A TSE’ye göre anlamlı düzeyde daha düşüktü (p0,05). SİH olgularının İG-MRM’sinde THRIVE sekansının kullanımı ile küçük dural defektler ve meningeal divertiküller rutin sekanslara göre daha kolay saptanabilir. Ancak sekansın gradient eko tabanlı olması nedeni ile özellikle servikal ve torakal düzeyde BOS alanları yeterince opasifiye olmayabilir.

New-Fashioned Universal and Functional Host-Material from a Near-Ultraviolet Organic Emitter for High-Efficiency Organic Light-Emitting Diodes with Low Efficiency Roll-Offs.

In this work, a near-ultraviolet (NUV) emitter, 2MCz-CNMCz, with hot-exciton property is designed based on a "long-short axis" strategy, which exhibits good thermal stability, bipolar carrier transport ability, and high T1 energy level. Its nondoped NUV organic light-emitting diode (OLED) achieves a record maximum external quantum efficiency (ηext ) of 7.76%, with a peak at 404nm and CIE coordinates of (0.158, 0.039). The corresponding high exciton utilization efficiency (ηr ) in the electroluminescence process reveals its potential as a functional sensitizing host. As expected, the TBPe-based blue fluorescent OLED with 2MCz-CNMCz as the host material shows better efficiency and lower efficiency roll-off than that with traditional host material mCP. Meanwhile, the Ir complexes-based green/yellow/red phosphorescent OLEDs with 2MCz-CNMCz host are also fabricated, reaching high ηext values of 26.1%, 30.4%, and 20.4%, respectively, and displaying negligible efficiency roll-offs at 1000cdm-2 , which are among the best OLED performances based on the same emitters. To the authors' best knowledge, this is the first report on the design of high-quality universal and functional host material, and may bring new inspiration to the preparation of high-efficiency, low roll-off, full-color OLEDs.

Impact of C3 Involvement on Postoperative Kyphosis Following Cervical Laminoplasty: A Comparison Between High and Low T1 Slope

The goal of the present study was to investigate the impact of C3 involvement on the postoperative kyphosis following cervical laminoplasty in patients with high and low T1S. The data from ossification of the posterior longitudinal ligament patients who had undergone laminoplasty between January 2016 and December 2019 were retrospectively reviewed. Patients were divided into low-and high-T1S groups according to preoperative T1S, and the postoperative alignment change was compared between the groups. The relationships between postoperative cervical kyphosis and preoperative variables, including gender, C3 laminoplasty, T1S, cervical lordosis (CL), C2-7 Sagittal Vertical Axis, and T1S minus CL (T1S-CL) were investigated. Eighty-six patients were divided into 2 groups above and below median preoperative T1S (23.70). There were thirty-three patients (38.3%) in low-T1S group and fifty-three patients (61.7%) in high-T1S group. Twenty-three patients (26.7%) were performed with C3 involved laminoplasty. C3 laminoplasty (odds ratio [OR], 9.67; 2.82-33.16; P=0.000), high T1S (OR, 4.89; 1.54-15.49; P=0.007), and mismatched T1S-CL (OR, 5.96; 1.83-19.43; P=0.003) were significantly associated with postoperative kyphosis. In high-T1S group, the loss of CL was significant (P=0.017) when C3 laminoplasty was performed, whereas, in low-T1S group, the C3 laminoplasty did not show the statistically significant difference. (P=0.194). C3 laminoplasty, mismatched T1S-CL, and high T1S were found to increase the risk of postoperative kyphosis following cervical laminoplasty. Patients with high T1 slope tended to exhibit a greater loss of CL when the laminoplasty was performed extending to C3 segment.

The type 2 high intensity zone: Two cases of axial low back pain in the setting of high T1 and high T2 signal in the posterior annulus

The type 2 high intensity zone: Two cases of axial low back pain in the setting of high T1 and high T2 signal in the posterior annulus

Low CC16 mRNA Expression Levels in Bronchial Epithelial Cells Are Associated with Asthma Severity.

Rationale: CC16 is a protein mainly produced by nonciliated bronchial epithelial cells (BECs) that participates in host defense. Reduced CC16 protein concentrations in BAL and serum are associated with asthma susceptibility. Objectives: Few studies have investigated the relationship between CC16 and asthma progression, and none has focused on BECs. In this study, we sought to determine if CC16 mRNA expression levels in BECs are associated with asthma severity. Methods: Association analyses between CC16 mRNA expression levels in BECs (242 asthmatics and 69 control subjects) and asthma-related phenotypes in Severe Asthma Research Program were performed using a generalized linear model. Measurements and Main Results: Low CC16 mRNA expression levels in BECs were significantly associated with asthma susceptibility and asthma severity, high systemic corticosteroids use, high retrospective and prospective asthma exacerbations, and low pulmonary function. Low CC16 mRNA expression levels were significantly associated with high T2 inflammation biomarkers (fractional exhaled nitric oxide and sputum eosinophils). CC16 mRNA expression levels were negatively correlated with expression levels of Th2 genes (IL1RL1, POSTN, SERPINB2, CLCA1, NOS2, and MUC5AC) and positively correlated with expression levels of Th1 and inflammation genes (IL12A and MUC5B). A combination of two nontraditional T2 biomarkers (CC16 and IL-6) revealed four asthma endotypes with different characteristics of T2 inflammation, obesity, and asthma severity. Conclusions: Our findings indicate that low CC16 mRNA expression levels in BECs are associated with asthma susceptibility, severity, and exacerbations, partially through immunomodulation of T2 inflammation. CC16 is a potential nontraditional T2 biomarker for asthma development and progression.

Long term follow-up of uterine fibroids treated with microwave ablation: an up to 3-year observational study of volume, regrowth, and symptoms

Objective To study long-term effects in patients treated with microwave ablation (MWA) for symptomatic uterine fibroids and investigate fibroid characteristics predictive of successful treatment. Method Women who received MWA treatment for uterine fibroids in a previous study were included. A total of 16 patients underwent contrast enhanced MRI before treatment, postoperatively at 6 months and at long-term follow-up, to assess volumes of treated fibroids (n = 42). Long-term MRI was performed between 16 and 36 months after treatment [median 22 months, interquartile range (IQR) 18.5–27]. Validated questionnaires for evaluation of uterine fibroid symptoms and menstrual bleeding (UFS-QoL and PBAC) were used to assess long-term effects on symptoms. The degree of shrinkage was correlated to vascularization and T2 signal intensity (SI) at preoperative MRI and location of fibroids according to the FIGO classification, using the Mann–Whitney U test. Results Most patients (82%) reported improvement up to 3 years after treatment. Out of 42 treated fibroids, 35 (83%) continued to shrink over time with median relative volume reduction of 77% (IQR 39–95). For eight fibroids (19%) which showed low vascularization on the pretreatment MRI, there was less shrinkage compared to well-vascularized fibroids (p = 0.01). Most fibroids (79%) showed iso- to hyperintense T2 signal on preoperative MRI and showed a higher grade of shrinkage than hypointense fibroids (p = 0.02). Conclusion After microwave treatment improvement is maintained for most patients up to 36 months and most fibroids showed continuous shrinkage. Preoperative vascularization, high T2 SI and submucosal location predicted continuous volume reduction. However, to confirm this, larger studies are needed.

GLOMUS TUMOR OF THE WRIST PRESENTING AS CARPAL TUNNEL SYNDROME. A CASE REPORT OF RARE PRESENTATION

Glomus tumors are caused by hyperplasia of the glomus body. Extra-digital glomus tumors are occasionally challenging to identify. We report a case of a patient who was misdiagnosed with carpal tunnel syndrome and eventually after surgical excision it was found to be a Glomus tumor. Tumors must therefore be considered in the differential diagnosis of individuals with extra digital lesions that present at the wrist with stabbing pain, hypersensitivity, paroxysmal pain, and MRI findings of subcutaneous low T1 high T2 signal cystic lesion.

Cervical cord reperfusion injury: a rare complication of spine surgery

BackgroundAnterior cervical discectomy and fusion procedure has been considered the surgical procedure of choice for the management of degenerative cervical myelopathy. Postoperative paresis is one of the most serious and concerning complications. The occurrence of such complications without any clear anatomic explanation (e.g., epidural hematoma) is unusual.Case presentationA 62-year-old man underwent cervical spine decompression via the anterior approach for marked central canal stenosis and spinal cord compression due to degenerative changes. The operation was performed under neuromonitoring, and a complete discectomy for the levels C3/C4, C5/C6, and C6/C7 was performed. Fluoroscopy confirmed the correct placement of the inserted plates and screws. No motor or sensory deficits were evident after postoperative recovery. However, 1 day later, the patient experienced progressive weakness in his both upper and lower extremities. A whole spine MRI study was performed to exclude epidural hematoma as the possible etiology. Although no localized fluid collection or hematoma was observed, the study demonstrated abnormal signal intensity in the spinal cord on T2-weighted images at the levels C5 to C7. Such findings were consistent with changes in cord reperfusion syndrome. The patient was administered intravenous methylprednisolone therapy. Gradual improvement in the muscle power in his both extremities was noted, and the patient was discharged with a satisfactory outcome. One month later, the MRI study was repeated and showed regression of the previously seen high T2 signal intensity in the cervical spine.ConclusionCervical cord reperfusion injury is an extremely rare etiology of neurological deterioration following spinal cord decompressive surgeries. Clinicians need to maintain a high index of suspicion for this complication and should be familiar with its imaging appearance.

Fabrication and Pulse Sequences Evaluation of Iron Oxides Nanoparticles as MRI Contrast Agent

The objective of this in vivo study is to enhance the T2-weighted MRI contrast using superparamagnetic nanoparticles in liver and spleen of rabbits for biomedicine application. Superparamagnetic nanoparticles were synthesized using co-precipitation method. Superparamagnetic nanoparticles were characterized using SEM, EDX, VSM, magnetic resonance relaxation and magnetic resonance imaging (MRI). T1 and T2 relaxations were measured as function of concentration of contrast agents in liver and spleen. High relaxivity ratio r2/r1 showed the efficacy of prepared T2- weighted MRI contrast agent. Rabbits were anesthetized using xylazine and ketamine salts for medical procedure. Ketamine and xylazine were injected with the dose rate of ketamine 25-40 mg/kg and xylazine 2.5-5mg/kg intra-muscularly for veterinary anesthesia. MRI of albino rabbits was executed at 0.35 Tesla using magnetic nanoparticles. FDA approved, 0.2 ml/kg dose of contrast agents was injected in rabbits for MRI scanning. MRI axial and coronal, T1-W and T2-W images of liver and spleen were taken using Spin Echo (SE) at TE=92 and TR=551 and STIR at TE=24 and TR=5170. Spin software was used to estimate the intensity of signal in region of interest induced by magnetic contrast agent. In vivo, MRI study of magnetic contrast agents demonstrated the high T2 -weighted contrast on MRI images of liver and spleen of rabbits. This research also concludes that superparamagnetic nanoparticles may be used as MRI contrast agents for biomedicine application to see the pathology of living organs even at low tesla field.

Analysis of humus formation and factors for driving the humification process during composting of different agricultural wastes

Composting can convert organic materials into stable humus (HS), resulting in high-fertility organic fertilizers that were widely used in the treatment of agricultural wastes. Therefore, it would be beneficial to strengthen the degree of composting humification by exploring the formation law and the main influencing factors of composting humification for different agricultural wastes. In this study, straw, cabbage, chicken manure, and pig manure were used as research objects, and the industrial mixed-material strip-stack composting and the single-material laboratory reactor composting were carried out, respectively. The results showed that the industrial mixed-material composting mode was beneficial to the continuation of the high-temperature period for composting (the heat lasts for 20 days), and the high lignin treatment T2 (straw + chicken manure composting) helped to promote the degradation of lignin and formation of humic acid (HA). At the end of composting, the absolute degradation of lignin in T2 treatment increased by 13.18% and 120.02% (p < 0.01) compared with T1 (straw + cabbage + chicken manure) and T3 (straw + pig manure) treatments, respectively (p < 0.01), and the humic acid (HA) content increased by 11.78% and 26.59% (p < 0.05). In the single-material laboratory reactor composting system, the continuous high-temperature period (31 days) contributed to the degradation of the composting materials and the formation of HA in the straw (TS) composting treatment; at the end of composting, the absolute degradation amount of TS lignin increased by 137.98%, 170.99%, and 196.82% compared with TV (cabbage), TC (chicken manure), and TP (pig manure) treatments (p < 0.01), and the HA content increased by 281.76%, 377.57%, and 460.71% (p < 0.01), respectively. Redundancy analysis showed that temperature was the main environmental factor affecting the decomposition and humification process of composting organic materials; the increase of lignin absolute degradation was helpful to promote the formation of HA. This study found that temperature was the main environmental factor that drove lignin degradation and promoted the humification process of agricultural waste composting; the lignin content in the composting material was the basis for the formation of HA, and the absolute degradation amount of lignin was the main material factor that promoted the humification process.

Insight into complexation of Cd(II) and Cu(II) to fulvic acid based on feature recognition of PARAFAC combined with 2DCOS

Fulvic acid which could govern the environmental geochemistry behavior of heavy metals is considered as the eco-friendly substances for controlling heavy metal pollutants in environment. Knowledge on the individual fulvic acid ligand is crucial to characterize the effect of fulvic acid on the migration and toxicity of metal pollutants. Herein, fulvic acid substances were analyzed by fluorescence quenching associated with parallel factor analysis (PARAFAC). Three components were identified based on PARAFAC. Furthermore, two-dimensional correlation spectroscopy (2DCOS) associated with complexation model were used to elucidate the Cd(II)- and Cu(II)-binding characteristics of the individual fulvic acid ligand. The Cd(II)- and Cu(II)-binding capability and speed of different fulvic acid ligands were revealed and theoretical guidance and technical support were provided for the practical application. The Cd(II) contaminated soil could be amended with high fulvic acid ligands A1 and Y2 containing composting products and the Cu(II) contaminated soil could be amended with high fulvic acid ligands Y1, T1 and A1 containing composting products to control the pollution and improve the soil condition. Based on these excellent results, the different fulvic acid ligands-contaminants-binding properties was characterized for the theoretical supporting of environmental pollution control.

Pathways to adaptive functioning in autism from early childhood to adolescence.

Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. This study examines longitudinal and contemporaneous associations of adaptive functioning in autistic youth across a wide ability range. Parent-reported autism symptoms, co-occurring emotional, behavioral and attention deficit hyperactivity disorder (ADHD) symptoms, and IQ were assessed in early childhood (M age 7 years; T1) and 6 years later in adolescence (M age 13 years; T2) in 179 autistic youth. Adaptive functioning was assessed at T2. Structural equation modeling estimated pathways to adaptive functioning from autism, and psychiatric symptoms at T1 and T2, testing whether associations were driven by continuity of behaviors from T1 to T2 or their contemporaneous effect at T2, or both, controlling for T1 IQ. Lower adaptive functioning at T2 was associated with higher T1 and T2 ADHD symptoms (β=-0.14, and β=-0.21) but not behavioral nor emotional symptoms at either timepoint. Lower adaptive functioning at T2 was also associated with lower T1 IQ (β=0.43) and higher social communication symptoms (β=-0.37) at T2 but not T1, but the relationship with ADHD symptoms remained. Paths were not moderated by sex or IQ. Increased symptoms of ADHD, both in early childhood and contemporaneously, were associated with reduced adaptive functioning in adolescence. Co-occurring ADHD may be a modifiable risk factor for adaptive function impairments and should be routinely assessed and when present evidence-based treatments initiated which may benefit adaptive functioning outcomes. LAY SUMMARY: Adaptive functioning is lower in many autistic individuals to a greater extent than would be expected based on IQ. However, the clinical features associated with these difficulties are less well understood. In a community sample higher attention deficit/hyperactivity disorder (ADHD) symptoms, but not emotional or behavioral symptoms, in both early childhood and contemporaneously were associated with lower adaptive functioning in autistic adolescents. Co-occurring ADHD may be a modifiable risk factor for adaptive function difficulties in autism.

Series of Intravoxel Incoherent Motion and T2* Magnetic Resonance Imaging Mapping in Detection of Liver Perfusion Changes and Regeneration Among Partial Hepatectomy in Sprague-Dawley Rats

To evaluate liver perfusion changes and their effect on liver regeneration (LR) after partial hepatectomy (PH) using intravoxel incoherent motion (IVIM) and T2* mapping in a rat model. One hundred and two rats underwent 30%, 50%, or 70% PH. Within each group (n=34), rats in MR imaging subgroup (n=10) underwent liver IVIM and T2* mapping before and within 2 h, 1, 2, 3, 5, 7, 14, and 21 days post-PH to measure D*, perfusion fraction (PF), and T2* values. Three rats from histologic subgroup (n=24) sacrificed at each time point for hepatocyte Ki-67 indices and diameters measurement. Liver D* and PF values decreased immediately post-PH, then returned to original level as LR progressed in all groups. PF values in 70% PH group were significantly lower than in the other two groups (p < .05). D* and PF values correlated significantly with hepatocyte Ki-67 indices (r = -0.588 to -0.915; p < .05) and hepatocyte diameter (r = -0.555 to -0.792; p < .05). Liver T2* values decreased immediately within 2 h post-PH, then increased to a high level and followed with returning to original level gradually. The duration of the high T2* levels was consistent with Ki-67 indices. Liver perfusion decreased immediately followed with increasing gradually after PH. IVIM and T2* mapping are promising methods for monitoring changes of liver perfusion. IVIM-derived D* value is the best indicator in reflecting the process of LR noninvasively.

Molecular and Nano-Structural Optimization of Nanoparticulate Mn2+-Hexarhenium Cluster Complexes for Optimal Balance of High T1- and T2-Weighted Contrast Ability with Low Hemoagglutination and Cytotoxicity.

The present work introduces rational design of nanoparticulate Mn(II)-based contrast agents through both variation of the μ3 (inner) ligands within a series of hexarhenium cluster complexes [{Re6(μ3-Q)8}(CN)6]4− (Re6Q8, Q = S2−, Se2− or Te2−) and interfacial decoration of the nanoparticles (NPs) K4−2xMnxRe6Q8 (x = 1.3 − 1.8) by a series of pluronics (F-68, P-123, F-127). The results highlight an impact of the ligand and pluronic for the optimal colloid behavior of the NPs allowing high colloid stability in ambient conditions and efficient phase separation under the centrifugation. It has been revealed that the K4−2xMnxRe6Se8 NPs and those decorated by F-127 are optimal from the viewpoint of magnetic relaxivities r1 and r2 (8.9 and 10.9 mM−1s−1, respectively, at 0.47 T) and low hemoagglutination activity. The insignificant leaching of Mn2+ ions from the NPs correlates with their insignificant effect on the cell viability of both M-HeLa and Chang Liver cell lines. The T1- and T2-weighted contrast ability of F-127–K4−2xMnxRe6Q8 NPs was demonstrated through the measurements of phantoms at whole body 1.5 T scanner.

Skull Base Chordoma: The Thumb Sign

A 57 year old woman with no past medical history presented with headaches and progressive left vision loss. Subsequently, a contrast enhanced brain MRI was performed showing a large well defined skull base mass located laterally in the left petro clival fissure, exhibiting high T2 and FLAIR signal intensity (Figure A), with areas of low signal intensity on susceptibility weighted images consistent with calcifications and a heterogenous enhancement after injection. This tumor was responsible for mass effect on the orbital apex and optic nerve anteriorly and the mesio temporal lobe laterally. Most importantly, on the sagittal planes we can see the tumor projection indenting the pons which is displaced posteriorly. This finding is known as the thumb sign (Figure B and C) characteristic of chordomas. Given these MRI features and after a stereotactic biopsy the diagnosis of chordoma of the skull base was confirmed. Because of the major local extension, the patient underwent radiotherapy rather than surgical resection. Chordomas are rare skull base tumors arising from embryonal rest cells [1]. The major differential being chondrosarcomas with similar appearance but higher ADC values. The thumb sign is relatively specific of chordomas [2] although itcan be described in chondromas of the skull base and can also be seen in chondrosarcomas.

Adrenal pheochromocytoma: Keys to radiologic diagnosis

Pheochromocytomas are adrenal paragangliomas. Potentially malignant, these tumors have a low incidence but clear importance. They can appear in various hereditary syndromes, especially in von Hippel-Lindau syndrome, multiple endocrine neoplasia-2 (MEN2), and familial paraganglioma syndromes. In sporadic cases, underlying genetic alterations are often found, and these findings are changing our understanding of the disease.Although these tumors can manifest with a characteristic clinical presentation, in 13.1%–57.6% of cases, it is the radiologist who first suggests the diagnosis, indicating analyses for catecholamines or nuclear medicine examinations.Radiologists should suspect a pheochromocytoma on detection of a well-delimited adrenal mass with rapid, intense enhancement that typically shows cystic and hemorrhagic phenomena, high T2 signal intensity, and the absence of macroscopic or microscopic lipids. The behavior in diffusion-weighted imaging usually does not provide very useful information. Approximately one-third of lesions show late washout similar to that seen with adenomas on CT. Percutaneous puncture should be avoided to avoid the risk of unleashing a severe hypertensive crisis.

Engineering manganese ferrite shell on iron oxide nanoparticles for enhanced T1 magnetic resonance imaging

Doping Mn (II) ions into iron oxide (IO) as manganese ferrite (MnIO) has been proved to be an effective strategy to improve T1 relaxivity of IO nanoparticle in recent years; however, the high T2 relaxivity of MnIO nanoparticle hampers its T1 contrast efficiency and remains a hurdle when developing contrast agent for early and accurate diagnosis. Herein, we engineered the interfacial structure of IO nanoparticle coated with manganese ferrite shell (IO@MnIO) with tunable thicknesses. The Mn-doped shell significantly improve the T1 contrast of IO nanoparticle, especially with the thickness of ∼0.8 nm. Compared to pristine IO nanoparticle, IO@MnIO nanoparticle with thickness of ∼0.8 nm exhibits nearly 2 times higher T1 relaxivity of 9.1 mM−1s−1 at 3 T magnetic field. Moreover, exclusive engineering the interfacial structure significantly lower the T2 enhancing effect caused by doped Mn (II) ions, which further limits the impairing of increased T2 relaxivity to T1 contrast imaging. IO@MnIO nanoparticles with different shell thicknesses reveal comparable T1 relaxation rates but obvious lower T2 relaxivities and r2/r1 ratios to MnIO nanoparticles with similar sizes. The desirable T1 contrast endows IO@MnIO nanoparticle to provide sufficient signal difference between normal and tumor tissue in vivo. This work provides a detailed instance of interfacial engineering to improve IO-based T1 contrast and a new guidance for designing effective high-performance T1 contrast agent for early cancer diagnosis.

Cervical Alignment Analysis Comparing Two-Level Cervical Disc Arthroplasty with Anterior Cervical Discectomy and Fusion with Anterior Plate Fixation

This study assesses cervical alignments after 2-level cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) with anterior plate fixation. Eighty-two patients who underwent 2-level CDA or ACDF in 2014-2019 were identified. Cervical alignment parameters were compared between the 2 cohorts. Subgroup analyses were performed to determine factors that differentiate alignment outcomes between the 2 procedures. Although both cohorts achieved significant focal lordosis (FL) and overall cervical lordotic (CL) gains, CDA cohorts achieved significantly greater 12-month FL gain (P= 0.022). However, in a multivariate analysis controlling for preoperative variables, FL gain was no longer significant. Although the CDA cervical sagittal vertical axis (cSVA) significantly improved at 3 (P= 0.030) and 12 (P= 0.007) months, these improvements were not superior to the ACDF cSVA. Male patients undergoing CDA achieved greater 12-month CL gain. Patients undergoing CDA with body mass index >25 kg/m2 achieved greater 12-month FL gain. Patients undergoing CDA with symptom duration >12 months achieved greater FL gain at 3 and 12 months. Patients undergoing CDA with high baseline T1 slope or cSVA achieved greater 12-month cSVA reduction. Clinical outcomes were comparable between the 2 cohorts. Unlike the ACDF group, CL gain in the CDA group was significantly correlated with the cSVA reduction, which was associated with significant improvement in the Neck Disability Index, arm pain, and 12-Item Short-Form Mental Component Scores. Heterotopic ossification was not found to significantly affect patient outcome and cervical alignment in both cohorts. ACDF and CDA are viable options for 2-level degenerative disc disease in carefully selected patients. Both approaches produced equivalent postoperative alignment changes in a 2-level operation.