orbital

轨道
  • 文章类型: Journal Article
    目的:评价眼眶MRI与颅内视路弥散峰度成像(DKI)联合应用对甲状腺功能异常视神经病变(DON)的诊断价值。
    方法:我们回顾性纳入61例甲状腺相关眼病(TAO)患者,包括25个有DON(40只眼)和36个没有DON(72只眼)。基于轨道MRI的根尖肌指数(MI),视神经直径指数(DI)(ON),ON的面积指数(AI),ON的表观扩散系数(ADC)和信号强度比(SIR),基于DKI的峰度分数各向异性(KFA)和视神经束(OT)的平均峰度(MK),光学辐射(OR),测量和比较Brodmann面积(BA)17、18和19。使用接收器工作特性曲线分析评估模型的诊断性能,并使用DeLong检验进行比较。
    结果:TAO合并DON患者的心尖MI明显增高,根尖AI,和ON的SIR,但ON组的ADC值显著低于无DON组(p<0.05)。同时,DON组在整个OT中表现出显著较低的KFA,OR,BA17、BA18和BA19在OT和OR的MK低于非DON组(p<0.05)。整合眼眶MRI和颅内视觉通路DKI参数的模型对DON的诊断效果最好(AUC=0.926),具有最佳诊断灵敏度(80%)和特异性(94.4%),然后是眼眶MRI组合(AUC=0.890),然后颅内视觉通路结合DKI(AUC=0.832)。
    结论:眼眶MRI和颅内视觉通路DKI均可辅助诊断DON。结合眼眶和颅内成像参数可以进一步优化诊断效率。
    结论:这项新发现可以为甲状腺功能失调性视神经病变的精确诊断和治疗带来新的见解,因此,有助于改善患者的预后和未来的生活质量。
    结论:•眼眶MRI和颅内视觉通路扩散峰度成像均可辅助诊断甲状腺功能失调性视神经病变。•结合眼眶MRI和颅内视觉通路扩散峰度成像优化甲状腺功能异常视神经病变的诊断效率。
    OBJECTIVE: To evaluate the combined performance of orbital MRI and intracranial visual pathway diffusion kurtosis imaging (DKI) in diagnosing dysthyroid optic neuropathy (DON).
    METHODS: We retrospectively enrolled 61 thyroid-associated ophthalmopathy (TAO) patients, including 25 with DON (40 eyes) and 36 without DON (72 eyes). Orbital MRI-based apical muscle index (MI), diameter index (DI) of the optic nerve (ON), area index (AI) of the ON, apparent diffusion coefficient (ADC) and signal intensity ratio (SIR) of the ON, DKI-based kurtosis fractional anisotropy (KFA) and mean kurtosis (MK) of the optic tract (OT), optic radiation (OR), and Brodmann areas (BAs) 17, 18, and 19 were measured and compared between groups. The diagnostic performances of models were evaluated using receiver operating characteristic curve analyses and compared using the DeLong test.
    RESULTS: TAO patients with DON had significantly higher apical MI, apical AI, and SIR of the ON, but significantly lower ADC of the ON than those without DON (p < 0.05). Meanwhile, the DON group exhibited significantly lower KFA across the OT, OR, BA17, BA18, and BA19 and lower MK at the OT and OR than the non-DON group (p < 0.05). The model integrating orbital MRI and intracranial visual pathway DKI parameters performed the best in diagnosing DON (AUC = 0.926), with optimal diagnostic sensitivity (80%) and specificity (94.4%), followed by orbital MRI combination (AUC = 0.890), and then intracranial visual pathway DKI combination (AUC = 0.832).
    CONCLUSIONS: Orbital MRI and intracranial visual pathway DKI can both assist in diagnosing DON. Combining orbital and intracranial imaging parameters could further optimize diagnostic efficiency.
    CONCLUSIONS: The novel finding could bring novel insights into the precise diagnosis and treatment of dysthyroid optic neuropathy, accordingly, contributing to the improvement of the patients\' prognosis and quality of life in the future.
    CONCLUSIONS: • Orbital MRI and intracranial visual pathway diffusion kurtosis imaging can both assist in diagnosing dysthyroid optic neuropathy. • Combining orbital MRI and intracranial visual pathway diffusion kurtosis imaging optimized the diagnostic efficiency of dysthyroid optic neuropathy.
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  • 文章类型: Randomized Controlled Trial
    自FDA批准针对背外侧前额叶皮质(DLPFC)的重复经颅磁刺激(rTMS)用于临床抑郁症治疗以来,已有15年。然而,rTMS诱导抑郁缓解的潜在机制尚未完全阐明.这项研究分析了rTMS治疗前后64名健康对照(HC)受试者和53名重度抑郁症(MDD)患者的TMS脑电图(EEG)数据。治疗前,MDD患者在DLPFC中的活性较低,海马体(HPC),眶额皮质(OFC),和DLPFC-OFC连接与HC的比较。活性rTMS治疗后,MDD患者的DLPFC显着增加,HPC,OFC。值得注意的是,HPC活性的增加与抑郁症状的改善特别相关,但与焦虑或睡眠质量无关.眶额-海马通路在介导rTMS治疗后的抑郁缓解中起着至关重要的作用。这些发现表明了针对抑郁症的大脑刺激治疗的潜在替代目标(chictr.org。cn:ChiCTR2100052007)。
    It has been 15 years since repetitive transcranial magnetic stimulation (rTMS) targeting the dorsolateral prefrontal cortex (DLPFC) was approved by the FDA for clinical depression treatment. Yet, the underlying mechanisms for rTMS-induced depression relief are not fully elucidated. This study analyzes TMS-electroencephalogram (EEG) data from 64 healthy control (HC) subjects and 53 patients with major depressive disorder (MDD) before and after rTMS treatment. Prior to treatment, patients with MDD have lower activity in the DLPFC, the hippocampus (HPC), the orbitofrontal cortex (OFC), and DLPFC-OFC connectivity compared with HCs. Following active rTMS treatment, patients with MDD show a significant increase in the DLPFC, HPC, and OFC. Notably, the increase in HPC activity is specifically associated with amelioration of depressive symptoms but not anxiety or sleep quality. The orbitofrontal-hippocampal pathway plays a crucial role in mediating depression relief following rTMS treatment. These findings suggest potential alternative targets for brain stimulation therapy against depression (chictr.org.cn: ChiCTR2100052007).
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  • 文章类型: Journal Article
    目的:分析原发性眼眶淋巴瘤(POL)的5年无病生存期(DFS)的临床特征和影像学特征。
    方法:共72例患者,43名男性和29名女性,经组织学证实的POL,在2012年1月至2017年5月期间进行回顾性招募.关于临床特征的信息,成像特征,并获得5年DFS。使用单变量和多变量正向逻辑回归分析来确定与5年DFS显着相关的变量。应用Kaplan-Meier进行生存分析。
    结果:单变量分析显示,单或双侧轨道受累,单个或多个病变,治疗方法,5年DFS的图像和对比度增强模式显着(P分别为0.022,0.042,<0.001和0.028),而在多变量逻辑回归分析中,只有单轨道或双边轨道参与,治疗方法和图像对比增强模式差异有统计学意义(r=0.453、0.897和0.556,P=0.038,<0.001和0.022)。获得DFS的存活曲线。
    结论:大多数POL是B细胞淋巴瘤。单侧轨道介入,图像上的均匀对比度增强,适当的治疗方案是POL预后良好的重要因素。
    OBJECTIVE: To analyze the 5-year disease-free survival (DFS) of primary orbital lymphoma (POL) by clinical characteristics and imaging features.
    METHODS: A total of 72 patients, 43 males and 29 females, with histologically confirmed POL, were retrospectively recruited between January 2012 and May 2017. The information on clinical characteristics, imaging features, and 5-year DFS was obtained. Univariate and multivariate forward logistic regression analyses were used to identify the variables significantly associated with 5-year DFS. Kaplan-Meier was applied for survival analysis.
    RESULTS: Univariate analysis revealed that uni- or bilateral orbital involvement, single or multiple lesions, treatment methods, and contrast enhancement pattern on images were significant for 5-year DFS (P=0.022, 0.042, <0.001, and 0.028, respectively), while in multivariate logistic regression analysis, only uni- or bilateral orbital involvement, treatment methods and contrast enhancement pattern on images were significant (r=0.453, 0.897, and 0.556, P=0.038, <0.001 and 0.022, respectively). The survival curves for DFS were obtained.
    CONCLUSIONS: The majority of POL are B-cell lymphomas. Unilateral orbital involvement, homogeneous contrast enhancement on images, and the appropriate treatment schemes result to be significant factors for a good prognosis for POL.
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  • 文章类型: Journal Article
    已知由等离子体金属纳米颗粒的局部表面等离子体共振(LSPR)激发产生的热载流子增强电催化反应。然而,等离子体产生的载体在界面电化学反应中的参与通常受到这些载体的快速弛豫的限制。在这里,我们通过调整等离子体电催化剂的电子结构来解决这一挑战。具体来说,我们设计了一种用于碱性析氢反应(HER)的电催化剂,该催化剂由三元Cu-Pt-Ni三元合金的纳米颗粒组成。CuPt合金具有等离子体属性和电催化HER活性。Ni掺杂有助于缺电子的3d带和完全填充的4s带,这促进了水的吸附并延长了等离子体激发产生的激发载流子的寿命。作为一个结果,Cu-Pt-Ni纳米颗粒在LSPR激发下表现出增强的电化学水解离和HER活性。
    Hot carriers generated by localized surface plasmon resonance (LSPR) excitation of plasmonic metal nanoparticles are known to enhance electrocatalytic reactions. However, the participation of plasmonically generated carriers in interfacial electrochemical reactions is often limited by fast relaxation of these carriers. Herein, we address this challenge by tuning the electronic structure of a plasmonic electrocatalyst. Specifically, we design an electrocatalyst for alkaline hydrogen evolution reaction (HER) that consists of nanoparticles of a ternary Cu-Pt-Ni ternary alloy. The CuPt alloy has both plasmonic attributes and electrocatalytic HER activity. Ni doping contributes an electron-deficient 3d band and fully filled 4s band, which promotes water adsorption and prolongs the lifetimes of excited carriers generated by plasmonic excitation. As an outcome, the Cu-Pt-Ni nanoparticles exhibit boosted activity for electrochemical water dissociation and HER under LSPR excitation.
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  • 文章类型: Case Reports
    嗜酸细胞癌是一种以上皮细胞增殖为特征的恶性肿瘤,具有丰富的嗜酸性粒细胞胞浆。在这篇文章中,我们报道了第一例61岁男性患者,表现为累及颅眶区的嗜酸细胞癌。患者的嗜酸细胞癌,他的右眼视力突然下降,是通过额眶开颅手术切除的.患者的术后发展迅速,在眼科筛查后,他被送入神经外科进行联合手术。病理分析显示肿瘤细胞很大,圆形或多边形,细胞质细颗粒状,似乎比嗜酸性腺瘤多形性。颅眶区的嗜酸细胞癌极为罕见。最有效的治疗方法是早期切除,由眼科和神经外科联合进行,长期随访和辅助放化疗是有益的。
    Oncocytic carcinoma is a malignant tumor characterized by a proliferation of epithelial cells with abundant eosinophilic granular cytoplasm. In this article, we report on the first case of a 61-year-old male patient presenting with oncocytic carcinoma involving the cranio-orbital area. An oncocytic carcinoma in the patient, who reported a sudden decrease in vision in his right eye, was removed through a frontal orbital approach craniotomy. The patient\'s postoperative development was rapid, and he was admitted to the neurosurgery department for a combined operation after ophthalmological screening. Pathological analysis revealed the tumour cells were large, round or polygonal, and the cytoplasm was finely granular and appeared to be more pleomorphic than the eosinophilic adenoma. Oncocytic carcinoma in the cranio-orbital area is extremely rare. The most effective treatment is early resection to be performed jointly by ophthalmology and neurosurgery, and long-term follow-up and adjuvant chemoradiotherapy are beneficial.
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  • 文章类型: Journal Article
    BACKGROUND: This study analyzed the clinical features, imaging manifestations, histopathology, immunohistochemistry, and surgical approaches of the orbital solitary fibrous tumor (OSFT), as well as the factors for postoperative recurrence of such disease.
    METHODS: The clinical data of 16 patients with OSFT treated in our center from 2003 to 2020 were analyzed retrospectively, and the clinical symptoms, treatment methods, and follow-up results were recorded.
    RESULTS: Of the 16 patients, 8 were females (50.0 %) and 8 were males (50.0 %); the average age of treatment was 37 ± 7 years and the median follow-up time was 74 (8, 228) months. Sixteen patients with OSFT underwent a total of 29 operations, of which 12 were transorbital approach operations and 17 were transfronto-orbital approach operations. Ten patients (10/16, 62.5 %) had recurrence. The recurrence rate of transorbital approach operations was 83.3 % (10/12), and the recurrence rate of transfronto-orbital approach operations was 17.6 % (3/17). No patients had treatment-related complications.
    CONCLUSIONS: The main pathological feature of OSFT is a benign tumor. OSFT has a tendency to grow toward the cranio-orbital junction. The postoperative recurrence rate of OSFT is relatively high, so complete tumor resection is very important for prognosis. Inappropriate surgical approaches can lead to incomplete removal of the tumor and cause recurrence. Choosing the correct operation approach according to the position of the OSFT in the orbit and complete removal of the dura mater and bone affected by the tumor is crucial for the prognosis. Nevertheless, regular long-term follow-up after complete resection is necessary.
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  • 文章类型: Case Reports
    BACKGROUND: Silicone oil insertion is a common modality in vitreoretinal surgeries. The purpose of this study is to conduct a systematic review to summarize the uncommon complication of extraocular silicone oil migration.
    METHODS: Following the PRISMA guidelines, a systematic review of the literature was performed on January 11, 2020, using PubMed and EMBASE with the following terms: \"silicone oil,\" \"eye,\" and \"migrat*.\"
    RESULTS: A total of 69 patients-68 patients from 59 articles and one case from our institution-were included in the final analysis. The median age was 54 years (range, 9-92) and 40 patients (57.9%) were men. Orbital migration was reported in 34 patients, and retrolaminar migration (including optic nerve, optic chiasm, suprasellar, subarachnoid space, intraventricular spaces) was reported in 35 patients. Orbital migration group had more aphakics (p = 0.007), implanted glaucoma drainage device (p = 0.005), scleral buckle (p = 0.000), history of trauma-related indications for pars plana vitrectomy (p = 0.000), shorter silicone oil endotamponade time (p = 0.008), more symptomatic (p = 0.000), and requiring surgical intervention (p = 0.000). Retrolaminar migration group had older patients (p = 0.016) and more diabetics (p = 0.041).
    CONCLUSIONS: Systematic review sheds light on plausible risk factors on site of silicone oil migration. Majority of orbital cases are symptomatic and require intervention while retrolaminar cases are incidental and can be managed conservatively. Awareness of this complication can help guide clinicians predict which patients would likely need surgical intervention. Graphical abstract.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:评估彩色多普勒成像(CDI)作为诊断小儿眼眶毛细血管瘤的主要成像方式。
    方法:这是一项2006年1月至2011年7月连续36例眼眶毛细血管瘤的回顾性研究。人口统计细节数据,临床发现,灰阶超声,CDI特性,治疗,并对随访期进行了回顾。
    结果:平均发病年龄为7周。29例(81%)病变表现为眼睑肿块,而7例(19%)表现为眼球突出。19例(53%)肿瘤位于上眼睑,下眼睑上有七个(19%),六个(17%)在内侧can中,上下眼睑都有一个.超声检查描绘了一种异质性,定义明确,具有低或中等回声的不规则肿瘤。所有病变在CDI上呈现丰富的彩色血流。病灶内血流的平均峰值收缩压速度为37.5±24.5厘米/秒,平均电阻指数为0.69±0.16,表示脉冲多普勒向高速度和高电阻的偏移。单次肿瘤内注射倍他米松后,18例(50%)解决。此外,15例(42%)和4例(11%)在两次注射和三次注射后得以解决,分别。在随访期内三次注射后,只有三次(8%)肿块持续存在。
    结论:CDI的血流特征在区分眼眶毛细血管血管瘤和其他眼眶病变中起着至关重要的作用。CDI的可用性和不良反应的缺乏使其能够用于小儿眼眶毛细血管瘤的早期临床诊断。
    BACKGROUND: To evaluate color Doppler imaging (CDI) as the primary imaging modality in the diagnosis of pediatric orbital capillary hemangioma.
    METHODS: This is a retrospective study of 36 consecutive cases of orbital capillary hemangiomas between January 2006 and July 2011. Data on demographic details, clinical findings, gray-scale ultrasonography, CDI characteristics, treatment, and follow-up period were reviewed.
    RESULTS: The mean age of onset was 7 weeks. Twenty-nine (81%) lesions presented as eyelid masses, whereas seven (19%) presented as exophthalmos. Nineteen (53%) tumors were located on the upper eyelid, seven (19%) on the lower eyelid, six (17%) in the medial canthus, and one on both upper and lower eyelids. Ultrasonography depicted a heterogeneous, well-defined, irregular tumor with a low or moderate echogenicity. All lesions presented with abundant color blood flow on CDI. The intralesional blood flow had a mean peak systolic velocity of 37.5 ± 24.5 cm/second, and a mean resistance index of 0.69 ± 0.16, representing a shift in the pulse Doppler toward high velocity and high resistance. After a single intratumoral injection of betamethasone, 18 cases (50%) resolved. Additionally, 15 (42%) and four (11%) cases resolved after two injections and three injections, respectively. Only three (8%) masses persisted after three injections within the follow-up period.
    CONCLUSIONS: The blood flow characteristics of CDI play a vital role in the differentiation of orbital capillary hemangiomas from other orbital lesions. The availability and lack of adverse effects of CDI enable its utilization in the early clinical diagnosis of pediatric orbital capillary hemangioma.
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  • 文章类型: Journal Article
    目的:动态对比增强MR成像(DCE-MRI)可以对微循环的生理学进行成像。这项研究的目的是确定时间强度曲线(TIC)和DCE参数用于表征轨道质量的诊断功效。
    方法:59例未经治疗的眼眶病变患者在手术前行DCE-MRI检查。对于每个病变,峰高(PH),最大增强比(ERmax),绘制并计算峰值增强时间(Tpeak)和最大上升斜率(Slopemax)。进行接收器操作特征(ROC)分析以评估适当的截止值。
    结果:显示持续性(I型)TIC的所有26个病变均为良性。大多数具有冲洗模式(III型)TIC的肿块是恶性的(10/14),包括淋巴瘤(n=6)和黑色素瘤(n=4)。良性病变的Slopemax在统计学上低于恶性病变,而良性病变的ERmax和Tpeak值则明显较高。PH差异无统计学意义(P=0.121)。ERmax的AUC,区分良性眼眶病变和恶性眼眶病变的Tpeak和Slopemax分别为0.683、0.837和0.738。在三个DCE参数中,Slopemax截断值1.10提供了93.8%的最高灵敏度;然而,相应的特异性较低(58.1%).ERmax截止值1.37和Tpeak截止值35.14分别提供了最佳的诊断性能。
    结论:DCE-MRI,特别是Slopemax的定性TIC模式和定量值,ERmax和Tpeak,可能是区分恶性眼眶肿瘤和良性眼眶肿瘤的补充研究。
    OBJECTIVE: Dynamic contrast enhanced MR imaging (DCE-MRI) allows imaging of the physiology of the microcirculation. The purpose of this study was to determine the diagnostic efficacy of time intensity curve (TIC) and DCE parameters for characterization of orbital masses.
    METHODS: Fifty-nine patients with untreated orbital lesions underwent DCE-MRI before surgery. For each lesion, peak height (PH), maximum enhancement ratio (ERmax), time of peak enhancement (Tpeak) and maximum rise slope (Slopemax) were plotted and calculated. Receiver operator characteristics (ROC) analysis was conducted to assess the appropriate cut-off value.
    RESULTS: All 26 lesions that demonstrated persistent pattern (type-I) TICs were benign. Most of the masses with the washout pattern (type-III) TIC were malignant (10/14), including lymphoma (n=6) and melanoma (n=4). The Slopemax of benign lesions was statistically lower than malignant ones, while the ERmax and Tpeak values of benign lesions were significantly higher. No statistical difference was found in PH (P=0.121). The AUC for ERmax, Tpeak and Slopemax in differentiating benign orbital lesions from malignant ones were 0.683, 0.837 and 0.738, respectively. In the three DCE parameters, Slopemax cut-off value of 1.10 provided the highest sensitivity of 93.8%; however, the corresponding specificity was low (58.1%). The ERmax cut-off value of 1.37 and Tpeak cut-off value of 35.14 respectively offered the best diagnostic performances.
    CONCLUSIONS: DCE-MRI, especially the qualitative TIC pattern and quantitative value of Slopemax, ERmax and Tpeak, could be a complementary investigation in distinguishing malignant orbital tumor from benign ones.
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