Objective:To investigate the application value of fractional-order calculus(FROC)model diffusion weighted imaging(DWI)combined with simultaneous multi-slice(SMS)acquisition technology in the differentiation between benign and malignant breast lesions.Materials and Methods:A total of 124 patients(with 141 lesions)who underwent breast MRI scan at our hospital from January 2021 to December 2022 were retrospectively analyzed.All patients underwent DWI scanning with two sets of multiple b values(14 b values,the highest b value was 3 000 s/mm2)using a 3.0 T MRI system.One group underwent conventional single-shot echo planar imaging(SSEPI-DWI),while the other group underwent SMS-SSEPI-DWI.Independent sample t test or Mann-Whitney U test was used to compare the image quality scores,FROC model parameters(D,β,μ)and apparent diffusion coefficient(ADC)value between benign and malignant groups.The receiver operating characteristic curve was used to evaluate the diagnostic efficacy of each parameter.Bland-Altman plots were used to assess the agreement between the two DWI-derived parameters.Results:The ADC,D and β values of malignant breast lesions were significantly lower than those of benign breast lesions(P＜0.05),while the p value of malignant breast lesions was notably higher than that of benign breast lesions(P＜0.05).Among the SSEP-DWI and SMS-SSEP-DWI sequences,the D value had the largest area under the curve,the p value demonstrated the highest diagnostic sensitivity,and the D value displayed the highest specificity.Bland-Altman plot indicated unbiased and substantial agreement between the corresponding parameter values derived from the two DWI sequences were unbiased and had good agreement.Conclusions:The FROC model based on SMS-SSEPI DWI can provide high-quality images and lesion characteristic parameter values with shorten scan time.Compared with SSEPI-DWI.It has a comparable diagnostic performance in distinguishing between benign and malignant breast lesions.Particularly.The D and p value show better diagnostic performance.
Objective:To explore the application value of deep learning reconstruction(DLR)technology in enhancing the image quality and reducing the scan time of fast-spin echo proton density weighted imaging(FSE-PD)in MRI of the temporomandibular joint(TMJ).Materials and Methods:Recruit 40 healthy volunteers and undergo MRI scans of the TMJ.Each healthy volunteer underwent conventional FSE-PD MRI scans and accelerated FSE-PD scans using DLR,the original accelerated FSE-PD images without DLR were simultaneously preserved.Two radiologists qualitatively and quantitatively evaluated the image quality of the three FSE-PD image sets,individually.Qualitative assessments utilized a Likert scale(5-point)for subjective scoring of anatomical structure clarity and overall image quality.Quantitative assessments utilized signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)for objective evaluation of image quality.One-way ANOVA and Kruskal-Wallis test were used to compare the differences in subjective scores and objective indicators among the three groups.The intra-class correlation coefficient(ICC)was used to evaluate the consistency of the subjective scores of the two radiologists.Results:Compared to the conventional FSE-PD group,the DLR-accelerated FSE-PD group demonstrated a 67％reduction in scan time.The two radiologists exhibited good consistency in subjective scores for anatomical structure clarity and overall image quality(ICC of 0.80 and 0.78,respectively).There were significant differences in anatomical clarity and overall image quality scores among the conventional FSE-PD group,accelerated FSE-PD group,and DLR-accelerated FSE-PD group(P＜0.05).The differences in SNR and CNR among the three FSE-PD groups were statistically significant(P＜0.05).Qualitative and quantitative evaluation results for the DLR-accelerated FSE-PD group were both significantly superior to the conventional FSE-PD group.Conclusions:DLR technology could shorten the scanning time of conventional FSE-PD MRI of the TMJ,enhance image quality,and help patients complete the examination faster.
一、概述 根据中国国家癌症中心发布的数据,2022年全国原发性肝癌发病人数36.77万,位列各种癌症新发病人数第4位(肺、结直肠、甲状腺、肝),发病率位列第5位(肺、女性乳腺、甲状腺、结直肠、肝);2022年因原发性肝癌死亡人数31.65万,死亡人数和死亡率均位列第2位(肺、肝)[1-2].原发性肝癌主要包括肝细胞癌(hepatocellular carcinoma,HCC)、肝内胆管癌(intrahepatic cholangiocarcinoma,ICC)和混合型肝细胞癌-胆管癌(combined hepatocellular-cholangiocarcinoma,cHCC-CCA)3 种不同病理学类型,三者在发病机制、生物学行为、病理组织学、治疗方法以及预后等方面差异较大,其中HCC占75％～85％、ICC占10％～15％[3-4].本指南中的"肝癌"仅指HCC.
BackgroundThis study aims to develop and validate a pretreatment MRI-based radiomics model to predict lymph node metastasis (LNM) following neoadjuvant chemotherapy (NACT) in patients with locally advanced cervical cancer (LACC).MethodsPatients with LACC who underwent NACT from two centers between 2013 and 2022 were enrolled retrospectively. Based on the lymph node (LN) status determined in the pathology reports after radical hysterectomy, patients were categorized as LN positive or negative. The patients from center 1 were assigned as the training set while those from center 2 formed the validation set. Radiomics features were extracted from pretreatment sagittal T2-weighted imaging (Sag-T2WI), axial diffusion-weighted imaging (Ax-DWI), and the delayed phase of dynamic contrast-enhanced sagittal T1-weighted imaging (Sag-T1C) for each patient. The K-best and least absolute shrinkage and selection operator (LASSO) methods were employed to reduce dimensionality, and the radiomics features strongly associated with LNM were selected and used to construct three single-sequence models. Furthermore, clinical variables were incorporated through multivariate regression analysis and fused with the selected radiomics features to construct the clinical-radiomics combined model. The diagnostic performance of the models was assessed using receiver operating characteristic (ROC) curve analysis. The clinical utility of the models was evaluated by the area under the ROC curve (AUC) and decision curve analysis (DCA).ResultsA total of 282 patients were included, comprising 171 patients in the training set, and 111 patients in the validation set. Compared to the Sag-T2WI model (AUC, 95%CI, training set, 0.797, 0.722-0.782; validation set, 0.648, 0.521-0.776) and the Sag-T1C model (AUC, 95%CI, training set, 0.802, 0.723-0.882; validation set, 0.630, 0.505-0.756), the Ax-DWI model exhibited the highest diagnostic performance with AUCs of 0.855 (95%CI, 0.791-0.919) in training set, and 0.753 (95%CI, 0.638-0.867) in validation set, respectively. The combined model, integrating selected features from three sequences and FIGO stage, surpassed predictive ability compared to the single-sequence models, with AUC of 0.889 (95%CI, 0.833-0.945) and 0.859 (95%CI, 0.781-0.936) in the training and validation sets, respectively.ConclusionsThe pretreatment MRI-based radiomics model, integrating radiomics features from three sequences and clinical variables, exhibited superior performance in predicting LNM following NACT in patients with LACC.
Lumbar magnetic resonance imaging has a significant diagnostic value for spine lesions. Reducing scan time is critical to improve patient compliance and comfort. The purpose of this study aims to introduce a combination of compressed-sensing and parallel imaging for high acceleration and motion artifact reduction for the lumbar spine MRI, and to determine an optimal acceleration factor, meanwhile, provide high quality images .
Compressed sensing(CS)is a technique that significantly shortens image acquisition time by undersampling the k-space.Simultaneously,it employs advanced algorithms to reconstruct the original signal,ensuring the quality of the reconstructed image.Applying CS to MRI can accelerate imaging speed while maintaining image quality,effectively reducing artifacts,and promoting rapid disease diagnosis.This article starts with the application origin of CS technology,aiming to explore the current clinical applications of CS technology in whole-body magnetic resonance imaging examinations,including brain,heart,vascular,and musculoskeletal imaging.It emphasizes the potential value of CS in the field of medicine,providing crucial insights for future clinical practices.
Depression is one of the most common non-motor symptoms of Parkinson's disease(PD).It usually appears in the early stage of the disease,seriously affecting the quality of life and increasing the burden of the disease.Neuroimaging has found a wide range of structural and functional abnormalities in the limbic system,especially the orbitofrontal lobe,anterior cingulate gyrus,amygdala and hippocampus are closely related to the pathophysiology of PD with depression(DPD).Therefore,taking the limbic system as a starting point,this paper reviews the MRI studies related to the changes of brain structure and function in DPD patients,in order to provide new ideas for future research.
Bipolar disorder is a complex mental illness characterized by intricate clinical symptoms and treatment processes.With the rapid advancement of imaging techniques,bipolar disorder manifests distinct characteristics through various resting-state functional magnetic resonance imaging(rs-fMRI)analysis methods.Utilizing rs-fMRI research can offer deeper insights into the underlying pathogenesis of bipolar disorder and establish objective imaging biomarkers for clinical diagnosis,treatment response assessment,and prognosis prediction.This approach holds the potential to guide the development of novel mood stabilizing medications.This review article focused on recent rs-fMRI research in bipolar disorders,aiming to elucidate the current advancements in neural imaging related to bipolar disorder.Furthermore,it explored potential biomarkers and avenues for early treatment response prediction.The ultimate goal is to furnish clinicians with supplementary tools for diagnosing bipolar disorder and employing imaging indicators to forecast treatment efficacy.
Objective:To evaluate the feasibility of quantitative parameters based on T1 mapping sequence in predicting the pathological types of lung cancer.Materials and Methods:A total of 117 lung cancer patients,including 62 cases of adenocarcinoma,26 cases of squamous cell carcinoma,29 cases of small cell lung cancer(SCLC),were enrolled in this study.Prior routine sequence scans,then the B1 field corrected variable flip angle VIBE sequence was used to acquire T1 mapping images.Afterwards,Gd-DTPA was used for dynamic enhanced scanning.T1 mapping images were collected 5 minutes before and after enhancement.Measure tumor size,T1 value before enhancement(T1pre),T1 value after enhancement(T1post),and calculate ΔT1,ΔT1%.SPSS and MedCalc software were used for analysis the differential diagnostic value of each quantitative parameter in each group,logistic regression combined with area under the curve(AUC)was constructed to evaluate the diagnostic value of each quantitative parameter and multi-parameter combination.Results:There were statistically significant differences in ΔT1,ΔT1%and T1post among adenocarcinoma,squamous cell carcinoma and SCLC(P＜0.05),but no difference in T1pre(P=0.506).The AUCs of T1post,ΔT1,and ΔT1%values to differentiate SCLC and non-small cell lung cancer(NSCLC)were 0.856,0.805 and 0.864,combination of the three parameters can improve the diagnostic accuracy of differentiating SCLC and NSCLC(AUC=0.870,P＜0.05).The AUCs of ΔT1 and ΔT1%values to differentiate adenocarcinoma and squamous cell carcinoma were 0.755 and 0.767,combination of the two could slightly improve the diagnostic accuracy(AUC=0.771,P＞0.05).The AUCs of ΔT1%,T1post values to differentiate squamous cell carcinoma and SCLC were 0.788 and 0.818,combination of the two could improve the diagnostic accuracy(AUC=0.831,P＞0.05).The AUCs of ΔT1%,T1post values to differentiate adenocarcinoma and SCLC is 0.895 and 0.873,combination of the two could improve the diagnostic accuracy(AUC=0.898,P＞0.05).Conclusions:T1 mapping can non-invasively and quantitatively obtain the T1 value of adenocarcinoma,squamous cell carcinoma and small cell lung cancer,and can be used to distinguish SCLC from NSCLC,as well as squamous cell carcinoma and adenocarcinoma,provide more accurate histological correlations and prognostic value in lung cancer.
Objective:The integrity of Willis ring and the characteristics of Atherosclerosis plaque in the skull and neck of patients with ischemic stroke in the anterior circulation were analyzed by using magnetic resonance angiography(MRA)integrated with the skull and neck to explore the image characteristics independently related to recurrent stroke.Materials and Methods:Eighty-seven patients with anterior circulation ischemic stroke were collected retrospectively.all of them were examined by high-resolution magnetic resonance angiography within 14 days after the onset of symptoms,and were divided into initial stroke group and recurrent group according to clinical and imaging data.They were divided into the initial stroke group and the recurrent stroke group based on clinical and imaging data.Record the total number of plaques,the characteristics of carotid artery plaques(intracranial:plaque enhancement,intra plaque bleeding,degree of stenosis;extracranial:lipid core,intra plaque bleeding,degree of stenosis),and the integrity of the Willis ring.Compare the characteristics of carotid artery plaques between the initial and recurrent groups.Evaluation of independent risk factors associated with recurrence of ischemic stroke in the anterior circulation using multivariate logistic regression analysis.Results:A total of 87 patients were included.There are 54 cases in the initial group and 33 cases in the recurrence group.There was no statistically significant difference in gender(P=0.223)and age(P=0.779)between the two groups.Compared with the initial group,the recurrent group showed intracranial plaque enhancement(P=0.010),degree of intracranial artery stenosis(P=0.002),total number of plaques(P＜0.001),intracranial plaque enhancement combined with extracranial plaques(P=0.006),intracranial(or extracranial)artery stenosis＞50%combined with extracranial(or intracranial)plaques(P=0.001),and incomplete symptom side of Willis'posterior circulation(P＜0.001).Significant correlation with recurrent stroke.Compared with the Willis group with intact anterior circulation,the Willis group with incomplete anterior circulation showed more enhancement of intracranial plaques(P=0.012).Multivariate logistic regression analysis showed that the total number of plaques[odds ratio(OR)=2.14,95%confidence interval(CI):1.182-3.869,P=0.012]and the incomplete symptomatic side of Willis'posterior circulation(OR=4.58,95%CI:1.496-14.041,P=0.008)were independent predictors of anterior circulation ischemic stroke recurrence.The overall prediction performance of the logistic regression model is optimal[area under the curve(AUC)=0.811,95%CI:0.711-0.910].Conclusions:The total number of plaques and incomplete posterior circulation symptoms of Willis are independently associated with the recurrence of ischemic stroke in the anterior circulation.High resolution vascular wall magnetic resonance imaging with integrated craniocervical imaging can provide new indicators for the construction of predictive models for anterior circulation ischemic stroke recurrence.
Chemotherapy-related cognitive impairment(CRCI)is common among breast cancer patients after chemotherapy.More and more evidence shows that CRCI is mainly due to changes in the brain structure and function.MRI technology can reveal the reduction of gray matter volume/density,the decrease of cortical thickness,the destruction of white matter microstructure,and the abnormalities in brain function or network connectivity.This article aims to review the research on the CRCI of breast cancer using gray matter,white matter structural imaging and resting-state functional MRI(rs-fMRI).It mainly includes three dimensional T1-weighted imaging and diffusion tensor imaging(DTI)on study gray matter and white matter abnormalities,as well as the changes in brain amplitude of low frequency fluctuation(ALFF),regional homogeneity(ReHo),functional connectivity(FC)and brain networks observed in rs-fMRI.To evaluate the association between neuroimaging markers and cognitive function in the trajectory of breast cancer chemotherapy,explore the neurobiological mechanism of CRCI,and provide relatively objective neuroimaging markers for CRCI.
Objective:To explore the feasibility of using magnetic resonance image compilation(MAGiC)parameters to quantitatively evaluate changes of sacroiliac joint in ankylosing spondylitis(AS),in order to provide a quantitative index for the evaluation of sacroiliac joint inflammatory activity in AS.And to evaluate the correlations of T1,T2 and proton density(PD)values with Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and Spondyloarthritis Research Consortium of Canada(SPARCC)scores.Materials and Methods:A total of 78 AS patients with sacroiliitis and 35 healthy controls were enrolled.All patients were scanned using a GE SIGNATM Architect 3.0 T MRI scanner by T1WI,fat-saturated T2-weighted imaging(FS-T2WI)and MAGiC sequence of the sacroiliac joints.According to Ankylosing Spondylitis Disease Activity Score(ASDAS)scores and C-reactive protein(CRP),the 78 patients were divided into an active group(40 cases)and an inactive group(38 cases).The T1,T2 and PD values of the subchondral bone marrow were measured in the active group,the inactive group,and the healthy control group using the MAGiC sequence.The T1,T2 and PD values of the active,inactive,and healthy groups were compared using one-way analysis of variance(ANOVA).Receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of T1、T2 and PD values for sacroiliitis.The correlations of the T1,T2 and PD values with the BASDAI and SPARCC scores were analyzed using Spearman's rho.Results:The T1 values[(531.04±60.28)ms]in the active group were lower than those in the inactive group[(691.50±72.44)ms],and lower than those in the healthy control group[(933.23±100.98)ms],t=-11.517,P＜0.001.T2 and PD values in the active group[(119.00±9.56)ms,(86.03±14.79)pu]were both higher than those in the inactive group[(96.61±8.86)ms,(68.12±7.77)pu],and higher than those in the healthy control group[(78.94±6.20)ms,(53.71±6.69)pu],t=-15.332,15.972,all P＜0.001;the area under the ROC curve(AUC)of T1,T2 and PD values between the active and inactive groups were 0.965(95%CI:0.949-0.991),0.981(95%CI:0.970-0.998),0.840(95%CI:0.842-0.923),respectively.The T1,T2 and PD values of the AS patients were positively correlated with BASDAI scores,and the correlation coefficients(r)were-0.771,0.914 and 0.846(all P＜0.001),respectively.And positively correlated with BASDAI scores,and the correlation coefficients(r)were-0.924,0.915 and 0.938(all P＜0.001),respectively.Conclusions:MAGiC parameters can be used to quantitatively assess the activity of AS,especially,T2 value can serve as a biological marker for the activity of sacroiliac arthritis,providing imaging basis for clinical diagnosis.
Objective:The ratio of related metabolites in magnetic resonance spectroscopy(1H-MRS)and the relative apparent diffusion coefficient(rADC),and relative fractional anisotropy(rFA)in diffusion tensor imaging(DTI)were evaluated.And the application value in high-grade gliomas(HGG)and brain metastatic tumors(BMT).Materials and Methods:The MR Data of 43 patients with gliomas and brain metastases confirmed by histopathology and clinical follow-up were collected from October 2016 to February 2023,including 25 cases of high-grade glioma and 18 cases of brain metastases.All patients were examined by routine brain MRI,MRS,DTI and T1WI enhanced scan.Obtaining the choline(Cho)/N-acetyl aspartate(NAA),Cho/creatine(Cr),NAA/Cr ratio of the tumor parenchyma,peritumoral edema(＜3 cm),and the ADC and FA values of the tumor parenchyma,peritumoral edema(＜3 cm),and contralateral white matter in the workstation.Calculating the relative ADC(rADC)values and relative FA(rFA)values to eliminate the influence of individual differences.Comparing the ages,genders and permeability parameters(Cho/NAA,Cho/Cr,NAA/Cr,rADC,rFA)of patients.In addition,the diagnostic values of each parameter were evaluated by the receiver operating characteristic(ROC)curve analysis,and the optimal cut-off values of each parameter as well as the corresponding sensitivity and specificity were calculated.The difference was statistically significant when P＜0.05.Results:There were no statistically significant differences in gender and age between HGG and BMT(P＞0.05).In the area of the tumor parenchyma,the values of Cho/NAA,NAA/Cr,and rFA between the two groups were significantly different(P＜0.05).There were no significant differences in Cho/Cr and rADC(P＞0.05).In the area of peritumoral edema,there were significant differences in quantitative parameters of Cho/NAA and Cho/Cr(P＜0.05).There were no significant differences in NAA/Cr,rFA,and rADC(P＞0.05).ROC curve showed that the quantitative quantitative parameters(Cho/NAA,NAA/Cr,and rFA)of the tumor parenchyma and the quantitative parameters(Cho/NAA,Cho/Cr)of the peritumoral edema were the most effective in the differential diagnosis of HGG and BMT.rFA was more efficient than other quantitative parameters.The diagnostic efficiency of combined quantitative parameters was the most significant with the maximum AUC of 0.934,and the corresponding sensitivity and specificity were 81.3%and 95.0%,respectively.Conclusions:The quantitative parameters(Cho/NAA,NAA/Cr,Cho/Cr,and rFA)measured by 1H-MRS and DTI were all helpful in distinguishing high-grade brain gliomas from brain metastases,and rFA was more efficient than other parameters.The combination of the quantitative parameters can further improve the diagnostic efficiency between high-grade glioma and brain metastatic tumor.
Objective:To investigate the brain regions with abnormal neural activity in the patients with obstructive sleep apnea hypopnea syndrome(OSAHS),using regional homogeneity(ReHo)and fractional amplitude of low-frequency fluctuation(fALFF)of the rest-state functional magnetic resonance imaging(rs-fMRI)technique.Materials and Methods:A total of 30 male patients with OSAHS who were initially diagnosed and untreated by polysomnography(PSG)in the Department of Respiratory of Shiyan Renmin Hospital were collected,and 30 volunteers with normal sleep,similar age and education level monitored by PSG during the same period were selected as the normal control(NC)group.Rs-fMRI examination was performed to obtain blood oxygen level dependent(BOLD)signals.ReHo,fALFF are used to compare the OSAHS group with the NC group to find out the brain regions with significant differences.Results:Compared with the NC group,the OSAHS group has significant differences between ReHo and fALFF(P＜0.001).The brain regions with increased ReHo value included left pons(t=3.94,P＜0.001),left anterior cerebellar lobe(t=4.68,P＜0.001)and right anterior cerebellar lobe(t=4.94,P＜0.001).The brain region with decreased ReHo value is none.The brain regions with increased fALFF value are left posterior lobe of the cerebellum(t= 6.20,P＜0.001),left superior temporal gyrus(t=5.49,P＜0.001),and left fusiform gyrus(t=4.35,P＜0.001).The brain region with decreased fALFF value is left paracentral lobule(t=-4.12,P＜0.001).Conclusions:In patients with OSAHS,the ReHo value and the fALFF value in multiple brain regions were changed.The ReHo value of some brain regions in OSAHS patients increased,and the brain regions that fALFF value changed were mostly concentrated in the left cerebral hemisphere.
Primary liver cancer ranks third among the world's leading causes of cancer death,with hepatocellular carcinoma being the most common.In most cases,the cancer is advanced when hepatocellular carcinoma is diagnosed,so the prognosis for hepatocellular carcinoma is usually poor.MRI radiomics technology can combine imaging information and clinical risk factors to build a combination model for preoperative prediction and postoperative evaluation of hepatocellular carcinoma patients.This article reviews the application potential of MRI radiomics in microvascular invasion,prediction of recurrence,efficacy assessment and survival analysis in patients with hepatocellular carcinoma,and shows that MRI radiomics models have good predictive ability,guide patients and clinicians to choose the appropriate treatment plan to improve the survival rate of patients,and hope to provide more new ideas and new directions for future scientific research.
Cerebral small vessel disease(CSVD),a common cause of stroke and dementia,is a dynamic whole-brain dysfunction disease caused by the abnormity of the neurovascular unit.Chronic cerebral ischemia and hypoperfusion,endothelial dysfunction and blood-brain barrier(BBB)disruption are considered to be important pathogenic mechanisms.Magnetic resonance perfusion imaging technology can provide multi-parameter about perfusion information,observe the changes of BBB permeability and vascular reactivity,so that CSVD can be diagnosed earlier,the technology can also give opportunity to early reversal,and provide technical support for the verification of potential protective drug intervention.In this article,we reviewed the application and research progress of three different magnetic resonance perfusion imaging techniques in CSVD.
Objective:To explore the value of T2-weighted imaging(T2WI),diffusion weighted imaging(DWI)and mean apparent diffusion coefficient(mADC)combined with cancer antigen 125(CA125)in the differential diagnosis of uterine sarcoma and atypical leiomyoma.Materials and Methods:From January 2011 to February 2023,59 patients with uterine sarcoma and 118 patients with atypical leiomyomas confirmed by pathology in our hospital were retrospectively analyzed.The imaging features of T2WI and DWI(including signal intensity of T2WI and DWI,maximum tumor diameter,mADC value)and clinical relevant information(including age,clinical symptoms,menopausal status and serum CA125)were collected.Mann-Whitney U test and chi-square test were used for univariate analysis,and then logistic regression was used to construct models based on T2WI,DWI sequence and serum CA125 alone or in combination.The receiver operating characteristic(ROC)curve was used to evaluate the performance of the prediction model,and the area under the curve(AUC),sensitivity and specificity of the model were calculated.Results:The preoperative serum CA125 levels in the uterine sarcoma group were significantly higher than those in the atypical leiomyoma group(P=0.043).On T2WI and DWI sequences,the solid component of uterine sarcoma showed more hyperintensity than that of atypical leiomyoma,and the mADC value was significantly lower than that of atypical leiomyoma(all P＜0.001).The optimal preoperative cut-off value for serum CA125 used to identify the two was 23.41 U/mL,and the optimal cut-off value for mADC was 1.165×10-3 mm2/s.The combination of T2WI,DWI,mADC values and serum CA125 resulted in an AUC of 0.981,a sensitivity of 98.3%and a specificity of 92.4%(P＜0.001).Conclusions:T2WI and DWI sequences combined with serum CA125 can be used as an effective method to distinguish uterine sarcoma from atypical leiomyoma.
本回顾性研究遵守《赫尔辛基宣言》,并经兰州大学第二医院伦理委员会审核批准,免除受试者知情同意,批准文号:2023A-325. 患者女,48岁,自述于2022年7月无明显诱因出现间断性黑便,偶有恶心、呕吐,呕吐物为胃内容物,未予特殊处理.
Objective:To evaluate the MRI characteristics of breast edema in idiopathic granulomatous mastitis and the associated clinical and radiological factors.Materials and Methods:This retrospective study included 129 patients with idiopathic granulomatous mastitis(IGM)from January 2021 to December 2022 in our hospital.All patients were proved by biopsy or surgical pathology and underwent breast MRI before biopsy.The course of disease,serum prolactin(PRL)and vascular endothelial growth factor(VEGF)were collected.The presence or absence of retroareola involvement,the depth of breast involvement,the number of quadrants and the extent of involvement were analyzed from breast magnetic resonance images.Then the appearance of breast edema on T2WI images and breast edema score(BES)were evaluated.The differences in these clinical and radiological characteristics between with and without breast edema groups,and between no or slight breast edema and moderate to severe edema groups were compared with χ2 test and t test.The logistic regression was used for multivariable analysis of significant variables.Results:Among the 129 patients with IGM,124 cases involved unilateral breast and 5 cases involved bilateral breasts.And totally 139 breasts were analyzed.There were 127 breasts with breast edema(91.4%)and 12 breasts with no breast edema(8.6%).For BES estimation,there were 12 breasts with BES 1(8.6%),15 breasts with BES 2(10.8%),68 breasts with BES 3(48.9%)and 44 breasts with BES 4(31.7%).On multivariate analysis,the significant independent predictors for MRI breast edema features was extension of the lesion[P=0.003,odds ratio(OR)=1.091,95%confidence interval(CI):1.035-1.150],the significant independent predictors for the moderate to severe breast edema features were serum PRL,VEGF and extension of the lesion(P＜0.05),OR=22.807(95%CI:2.281-228.008),24.140(95%CI:2.937-198.409),1.102(95%CI:1.035-1.174),respectively.Conclusions:The incidence of breast edema on MRI is high in IGM,and the degree of breast edema is related to the levels of serum PRL and VEGF and the extent of the lesion.
Fabry disease is a rare X-linked genetic lysosomal storage disorder,which leads to reduction of α-galactosidase A and accumulation of metabolic substrates in heart and other organs.Cardiac magnetic resonance(CMR)with development of new techniques,such as mapping analysis,late gadolinium enhancement(LGE)assessment,strain imaging and perfusion imaging,plays an important role in distinguishing FD from other hypertrophic heart conditions.CMR offers a comprehensive evaluation of cardiac structure,function,and histological characteristics in a'one-stop shop'approach.Our study comprehensively reviewed the characteristic features of FD in various CMR techniques,including tissue changes in the early stages of the disease.Furthermore,we emphasized the significant role of CMR in early diagnosis,risk stratification,prognosis assessment,and treatment monitoring in FD.The aim is to achieve early and accurate diagnosis of FD in the clinical practice,differentiate FD from other hypertrophic cardiac diseases,thus enabling early intervention and treatment for FD patients,ultimately improving prognosis.
