Assessment of pharmacokinetics for microvessel proliferation by DCE-MRI for early detection of physeal bone bridge formation in an animal model

Self-inflicted partial epiphyseolysis of the distal femur-a case report

Introduction

Injuries to the epiphyseal plate are of great concern as they can affect bone growth. Although epiphyseal fractures are common in adolescents, fractures of the distal femoral epiphyseal plate are rare.

Case presentation

We present a case of a Salter-Harris type 1 fracture of the distal epiphysis of the femur that was self-inflicted by a patient with paraplegia due to spina bifida. The patient was brought to the pediatrician's attention during a routine checkup with an apparent swelling of the right thigh. Upon presentation, we performed a radiograph and an additional MRI, which revealed a partial ventero-medial epiphyseolysis, consistent with a Salter-Harris type 1 fracture. Due to the dislocation, we indicated closed reduction with K-wires. Repositioning was performed using a modified Kapandji maneuver and was completed with additional K-wires.

Conclusion

Distal epiphyseolysis is a relatively rare injury that can lead to serious complications. Therefore, although rare, epiphyseal fractures should be considered in pediatric patients presenting with uncertain limb swelling.

Enlightenment of Growth Plate Regeneration Based on Cartilage Repair Theory: A Review

The growth plate (GP) is a cartilaginous region situated between the epiphysis and metaphysis at the end of the immature long bone, which is susceptible to mechanical damage because of its vulnerable structure. Due to the limited regeneration ability of the GP, current clinical treatment strategies (e.g., bone bridge resection and fat engraftment) always result in bone bridge formation, which will cause length discrepancy and angular deformity, thus making satisfactory outcomes difficult to achieve. The introduction of cartilage repair theory and cartilage tissue engineering technology may encourage novel therapeutic approaches for GP repair using tissue engineered GPs, including biocompatible scaffolds incorporated with appropriate seed cells and growth factors. In this review, we summarize the physiological structure of GPs, the pathological process, and repair phases of GP injuries, placing greater emphasis on advanced tissue engineering strategies for GP repair. Furthermore, we also propose that three-dimensional printing technology will play a significant role in this field in the future given its advantage of bionic replication of complex structures. We predict that tissue engineering strategies will offer a significant alternative to the management of GP injuries.

Quantitative Multiparametric MRI May Augment the Response to Radiotherapy in Mid-Treatment Assessment of Patients with Esophageal Carcinoma

OBJECTIVE

The purpose of this study was to assess the mid-treatment response to radiotherapy (RT) using dynamic contrast-enhanced MRI (DCE-MRI) and diffusion-weighted imaging (DWI) in patients with esophageal cancer (EC).

METHODS

42 patients with squamous EC were prepared for DCE-MRI and DWI scans both before treatment (NRT) and after the fifth radiotherapy (5th RT). The patients were classified into two groups (complete response [CR] and partial response [PR]) according to tumor regression after treatment. The quantitative parameters of DCE-MRI (Ktrans, Kep, Ve, and ADC) were measured. A receiver operating characteristic curve (ROC) was used to detect the efficiency of the above parameters.

RESULTS

After 1 month of RT, 29 patients were classified as CR and 11 patients were classified as PR. In the NRT group, the p values of Ktrans, Kep, Ve, and ADC were 0.004, 0.078, 0.0008, and <0.0001, respectively. After the 5th RT, the p values of the above parameters were <0.001, 0.005, 0.108, and 0.365, respectively. In the NRT group, the areas under the ROC curves of Ktrans, Ve, and ADC were 0.790, 0.617, and 0.737; the sensitivity values were 89.3, 92.5, and 90.0%; the specificity values were 69.4, 27.5, and 50.0%. In the 5th RT group, the areas under the ROC curves of Ktrans and Kep were 0.816 and 0.804; the sensitivity values were 71.2 and 95.0%; the specificity values were 81.6 and 50.0%.

CONCLUSION

DCE-MRI combined with DWI is effective in the early prediction of radiotherapeutic response of EC after the 5th RT other than after the traditional final treatment.