Background: Occult peritoneal metastasis (OPM) in advanced gastric cancer (AGC) patients remains a major diagnostic challenge. The aim of this study was to develop novel predictive models for identification of OPM in AGCs. Method: A total of 810 patients with primary AGCs from two hospitals were retrospectively selected and divided into training (n = 393), internal validation (n = 215) and external validation cohorts (n = 202). CT based machine learning models were built and tested to predict the OPM status in AGCs., which are 1) Radiomic signatures: using venous CT imaging features, 2) Clinical models: integrating tumor location, differentiation and extent of serosal exposure, and 3) Radiomics models: combining of radiomic signature, tumor location and tumor differentiation. Result: Total incidence of OPM was 8.27% (67/810). Clinical models yielded comparable classification accuracy with the corresponding radiomics models with similar AUCs (0.902-0.969 vs. 0.896-0.975) while the radiomic signatures showed relatively low AUCs of 0.863e0.976. In the case where the specificity is higher than 90%, the overall sensitivity of clinical model and radiomics model for OPM positive cases was 76.1% (51/67) and 82.1% (55/67). A nomogram based on the logistic clinical model was drawn to facilitate the usage and verification of the clinical model. Conclusion: Both the novel CT based clinical nomogram and radiomics model provide promising method to yield high accuracy in identification of OPM in AGC patients.

目的 评估采用80 kV管电压、50 mA管电流的扫描方式并结合自适应迭代重建(ASiR-V)的下肢动脉计算机断层成像血管造影(CTA)扫描方案的图像质量和辐射剂量.方法 收集2022年1月—2022年6月80例行下肢动脉C T A扫描患者的临床资料,随机分为标准化低剂量扫描组(标准化组,n=40)和超低剂量扫描组(超低剂量组,n=40),标准化组采用100 kV管电压和自动调节管电流,图像重建采用滤波反投影(FBP)算法;超低剂量组采用80 kV管电压及50 mA固定管电流,图像重建采用50％ 权重的ASiR-V(ASiR-V 50％)算法.测量目标血管的CT值、信噪比(SNR)、对比噪声比(CNR),记录容积CT剂量指数(CTDIvol)和剂量长度乘积(DLP),并对图像质量进行主观评分.结果 超低剂量组各血管评估区的CT值均高于标准化组(P<0.05),且具有更高的SNR(P<0.05)和CNR(P<0.05).超低剂量组的CTDIvol[(1.09±0.00)mGy vs(5.63±1.28)mGy,P<0.05]和DLP[(131.05±5.50)mGy·cm vs(714.94±189.23)mGy·cm,P<0.05]较标准化组明显降低,其中CTDIvol降低约81％.与标准化组比较,超低剂量组在腘下动脉节段具有更优的主观评分(P<0.05),其余节段差别无统计学意义(P>0.05).结论 采用80 kV低管电压、50 mA低管电流并结合ASiR-V 50％ 图像重建算法的超低剂量下肢CTA扫描方案,可有效降低辐射剂量,且保持较高的图像质量.

RATIONALE AND OBJECTIVES:The purpose of the present study was to evaluate the clinical feasibility of the modified 3D breath-hold magnetic resonance cholangiopancreatography with parallel imaging (3D-BH-PI-MRCP) using a spatially selective radiofrequency excitation pulse in patients with suspected pancreaticobiliary diseases. Moreover, we also compared its image quality with those of the original 3D-BH-PI-MRCP with a nonselective exciting pulse and the 3D breath hold compressed sensing magnetic resonance cholangiopancreatography (3D-BH-CS-MRCP).MATERIALS AND METHODS:Between January 2021 and July 2021, 106 patients prospectively underwent modified 3D-BH-PI-MRCP, original 3D-BH-PI-MRCP and 3D-BH-CS-MRCP at 3T in this study. The Friedman test was performed to compare the contrast, signal-to-noise-ratio (SNR), and contrast-noise-ratio, overall image quality, and duct visualization among the three protocols.RESULTS:The contrast ratio, SNR and contrast-to-noise ratio of the common bile duct differed significantly among the three sequences (p < 0.001). Compared to the 3D-BH-CS-MRCP protocol, the overall imaging quality of the two 3D-BH-PI-MRCP was higher but not significantly different. The scores for the anterior and posterior branches visualization were significantly higher in the original 3D-BH-PI-MRCP compared to the 3D-BH-CS-MRCP, but were no significant differences between the modified 3D-BH-PI-MRCP and the 3D-BH-CS-MRCP.CONCLUSION:The modified 3D-BH-PI-MRCP with a spatially selective radiofrequency excitation pulse could provide comparable image quality to the original 3D-BH-PI-MRCP and the 3D-BH-CS-MRCP during a single breath hold (22 seconds), and showed improved SNR and superior visualization of the pancreaticobiliary tree.

To compare the short-term outcomes of a new gastrointestinal decompression tube combined with conservative treatment in patients with esophagojejunal anastomotic leakage (EJAL) after total gastrectomy. We retrospectively analyzed the data of 81 patients with EJAL who had undergone total gastrectomy and Roux-en-Y reconstruction at Fujian Medical University Union Hospital between January 2014 and December 2021. The patients were divided into experimental (12 patients with new gastrointestinal decompression tube plus conservative treatment) and control (69 patients with conservative treatment) groups, according to the different treatment methods they received. Anatomic defect size linearly correlated with time to clinical success, hospital stay, and hospital cost in the control group. The two groups showed no significant differences in anastomotic defect size, time of defect after surgery, hospitalization cost, and time of antibiotic use. However, the time to clinical success was significantly shorter in the experimental group than in the control group (16.0 ± 8.3 vs. 23.6 ± 17.8, P = 0.04), as was the length of hospital stay (30.1 ± 6.3 vs. 36.8 ± 16.7, P = 0.017). Furthermore, when the defect size was ≥ 4 mm, the time to clinical success, hospital stay, and hospital cost in the experimental group were lower than those in the control group (P < 0.05). Placement of a new gastrointestinal decompression tube is a safe treatment. When the defect size is ≥ 4 mm, the time to clinical success, length of hospital stay, and hospital cost can be reduced.

目的:以多时相CTA为标准,联合区域性动脉自旋标记(t-ASL)与TOF-MRA评估急性缺血性卒中患者侧支循环的开放情况,并探讨侧支循环与临床预后的关系.方法:前瞻性收集急性缺血性卒中患者52例.以多时相CTA为标准,联合t-ASL与TOF-MRA评估卒中患者的侧支循环,并计算Cohen's Kappa系数值.记录卒中患者出院1月后的改良Rankin量表(mRS)评分,使用Logistic回归分析经t-ASL联合TOF-MRA评估的侧支循环开放情况与临床预后之间的关系.结果:在26例同时行MR和CTA扫描的患者中,联合t-ASL与TOF-MRA对侧支开放的评估与多时相CTA的一致性中等(Cohen's Kappa:0.667,95％CI:0.261～1.073,P＜0.05).在伴有大动脉急性狭窄或闭塞的19例卒中患者中,经校正干扰因素后,Logistic回归显示侧支循环不是患者出院1月预后良好的独立预测因素(OR:0.018;95％CI:0～1.295;P=0.063).结论:t-ASL联合TOF-MRA能较好地对卒中患者侧支循环进行评估,经t-ASL联合TOF-MRA评估的二级侧支循环不能独立预测患者的1月预后.

OBJECTIVES To evaluate the potential role of histogram analysis of stretched exponential model (SEM) through whole-tumor volume for preoperative prediction of microvascular invasion (MVI) in single hepatocellular carcinoma (HCC). METHODS This study included 43 patients with pathologically proven HCCs by surgery who underwent multiple b-values diffusion-weighted imaging (DWI) and contrast-enhanced MRI.The histogram metrics of distributed diffusion coefficient (DDC) and heterogeneity index (α) from SEM were compared between HCCs with and without MVI, by using the independent t-test. Morphologic features of conventional MRI and clinical data were evaluated with chi-squared or Fisher's exact tests. Receiver operating characteristic (ROC) and multivariable logistic regression analyses were performed to evaluate the diagnostic performance of different parameters for predicting MVI. RESULTS The tumor size and non-smooth tumor margin were significantly associated with MVI (all p < 0.05). The mean, fifth, 25th, 50th percentiles of DDC, and the fifth percentile of ADC between HCCs with and without MVI were statistically significant differences (all p < 0.05). The histogram parameters of α showed no statistically significant differences (all p > 0.05). At multivariate analysis,the fifth percentile of DDC was independent risk factor for MVI of HCC(p = 0.006). CONCLUSIONS Histogram parameters DDC and ADC, but not the α value, are useful predictors of MVI. The fifth percentile of DDC was the most useful value to predict MVI of HCC. ADVANCES IN KNOWLEDGE There is limited literature addressing the role of SEM for evaluating MVI of HCC. Our findings suggest that histogram analysis of SEM based on whole-tumor volume can be useful for MVI prediction.

Background Multiple neurovascular contacts in patients with vascular compressive trigeminal neuralgia often challenge the diagnosis of responsible contacts. Purpose To analyze the magnetic resonance imaging (MRI) features of responsible contacts and establish a predictive model to accurately pinpoint the responsible contacts. Material and Methods Sixty-seven patients with unilateral trigeminal neuralgia were enrolled. A total of 153 definite contacts (45 responsible, 108 non-responsible) were analyzed for their MRI characteristics, including neurovascular compression (NVC) grading, distance from pons to contact (Dpons-contact), vascular origin of compressing vessels, diameter of vessel (D-vessel) and trigeminal nerve (D-trigeminal nerve) at contact. The MRI characteristics of the responsible and non-responsible contacts were compared, and their diagnostic efficiencies were further evaluated using a receiver operating characteristic (ROC) curve. The significant MRI features were incorporated into the logistics regression analysis to build a predictive model for responsible contacts. Results Compared with non-responsible contacts, NVC grading and arterial compression ratio (84.44%) were significantly higher, Dpons-contact was significantly lower at responsible contacts (P < 0.001, 0.002, and 0.033, respectively). NVC grading had a highest diagnostic area under the ROC curve (AUC) of 0.742, with a sensitivity of 64.44% and specificity of 75.00%. The logistic regression model showed a higher diagnostic efficiency, with an AUC of 0.808, sensitivity of 88.89%, and specificity of 62.04%. Conclusion Contact degree and position are important MRI features in identifying the responsible contacts of the trigeminal neuralgia. The logistic predictive model based on Dpons-contact, NVC grading, and vascular origin can qualitatively improve the prediction of responsible contacts for radiologists.

目的 评估拉伸指数模型弥散加权成像(DWI)直方图分析术前预测单发肝细胞癌(HCC)微血管侵犯(MVI)的价值.方法 回顾性分析43例经病理确诊单发HCC患者的腹部MRI,根据病理结果分为MVI(+)组(n=22)和MVI(-)组(n=21).采用拉伸指数模型分析DWI,获得表观弥散系数(ADC)、分布弥散系数(DDC)和水分子各向异质性(α)直方图参数,比较组间临床资料及直方图参数差异;应用受试者工作特征(ROC)曲线分析差异有统计学意义的参数预测MVI的效能,并以多因素Logistic回归分析MVI的独立预测因素.结果 组间肿瘤直径、ADC第5百分位数(5th)、DDC第5、25、50百分位数(5th、25th、50th)及平均值差异均有统计学意义(P均<0.05),其余直方图参数差异均无统计学意义(P均>0.05).DDC 5th预测MVI的曲线下面积(AUC)最大,为0.86,高于DDC(25th、50th)及平均值、ADC 5th、肿瘤直径(Z=1.96～2.91,P均<0.05),其余参数两两比较差异均无统计学意义(Z=0.12～1.91,P均>0.05).DDC 5th是MVI的独立预测因素(P=0.005).结论 拉伸指数DWI模型直方图分析有助于术前预测单发HCC的MVI,以DDC 5th诊断效能最佳.

Purpose: To evaluate the image quality and image consistency between 3D Breath-hold (BH)-MRCP with parallel imaging (3D-BH-PI-MRCP) and 3D-BH compressed sensing (CS)-MRCP (3D-BH-CS-MRCP) in patients with suspected pancreaticobiliary diseases, compared with 3D navigator-triggered (NT)-MRCP. Materials and methods: The A total number of 109 patients who underwent 3D-NT-MRCP, 3D-BH-PI-MRCP and 3D-BH-CS-MRCP were prospectively enrolled in this study. The Friedman test was performed to compare quantitative values, image acquisition time, the presence of artifacts, overall image quality, and duct visualization among the three protocols. Additionally, we compared 3D-BH-PI-MRCP and 3D-BH-CS-MRCP with 3D-NTMRCP in morphological consistency of main pancreatic duct and common bile duct (CBD) based on overall image quality score of = 4. Results: Three MRCP methods were successfully performed in all the patients. The contrast ratio, SNR and CNR of the CBD were significantly higher for 3D-BH-CS-MRCP than those for 3D-NT-MRCP and 3D-BH-PI-MRCP images. Overall image quality did differ significantly across the three sequences. Visualization of the CBD, RHD, LHD, anterior branch, posterior branch and cystic duct was similar with the 3D-BH-CS-MRCP and 3D-BH-PI-MRCP sequences. In contrast, segment 2 or 3 branch and main pancreatic duct visualization were significantly better with 3D-BH-PI-MRCP than with 3D-BH-CS-MRCP and 3D-NT-MRCP (p < 0.001). Conclusions: Both the two breath-hold approaches were considering the time-saving advantages without deterioration of image quality. Compared with 3D-BH-CS-MRCP, 3D-BH-PI-MRCP yielded significantly better visualization of the segment 2 and 3 branch of the intrahepatic duct and performed better consistency in main pancreatic duct and common bile duct morphology.

Introduction: Preoperative diagnosis of No.10 lymph nodes (LNs) metastases in advanced proximal gastric cancer (APGC) patients remains a challenge. The aim of this study was to develop a CT-based radiomics nomogram for identification of No.10 LNs status in APGCs. Materials and methods: A total of 515 patients with primary APGCs were retrospectively selected and divided into a training cohort (n = 340) and a validation cohort (n = 175). Total incidence of No.10 LNM was 12.4% (64/515). CT based radiomics nomogram combining with radiomic signature calculated from venous CT imaging features and CT-defined No.10 LNs status evaluated by radiologists was built and tested to predict the No.10 LNs status in APGCs. Results: CT based radiomics nomogram yielded classification accuracy with areas under ROC curves, AUC = 0.896 and 0.814 in training and validation cohort, respectively, while radiomic signature and radiologist' diagnosis based on contrast-enhanced CT images yielded lower AUCs ranging in 0.742-0.866 and 0.619-0.685, respectively. In the specificity higher than 80%, the sensitivity of using radiomics nomogram, radiomic signature and radiologists' evaluation to detect No.10 LNs positive cases was 82.8% (53/64), 67.2% (43/64) and 39.1% (25/64), respectively. Conclusions: The CT-based radiomics nomogram provides a promising and more effective method to yield high accuracy in identification of No.10 LNs metastases in APGC patients. (c) 2020 Elsevier Ltd, BASO -The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Objective:To explore the technical advantages of MR cholangiopancreatography (MRCP) with single breath holding high parallel acquisition factor 3-D variable flip angle fast spin echo (3D-SPACE) sequence.Methods:From November 2018 to March 2019, 75 patients who underwent MRCP examination in our hospital were prospectively enrolled, with single breath holding high parallel acquisition factor 3D-SPACE sequence and free breathing navigation gated 3D-SPACE sequence. Three experienced radiologists scored the overall image quality, artifacts, CBD visibility, left and right hepatic ducts, right anterior and posterior branches, second and third branches, main pancreatic duct and gallbladder duct with four scales. Paired t test was used for statistical analysis. Results:The scanning time of single breath holding method (18 s) was significantly shorter than that of free breathing diaphragm navigation method［264（226，313）s］, and the difference between the two methods was statistically significant ( Z=-7.520， P<0.001). The SNR, CR and CNR (8.31±4.23, 0.92±0.30, 11.46±5.77) of single breath holding method were lower than those of free breathing diaphragm navigation method (11.23±5.70, 0.93±0.38, 15.06±7.37), and the differences between the two methods were also statistically significant ( t=4.378, 3.429, 4.063, P<0.05). The overall image quality, artifact, the CBD, left and right hepatic duct, right anterior and posterior branchs, the second and third branches, main pancreatic duct and cystic duct of single breath holding method were higher than those of free breathing diaphragm navigation method, and the differences between the two methods were statistically significant ( P<0.001). Conclusions:Compared with the free breathing diaphragm navigation gated 3D-SPACE MRCP imaging method, the single breath holding high parallel acquisition factor 3D-SPACE MRCP imaging method has less artifacts and examination time, but higher visibility to pancreaticobiliary tree and work efficiency, which is worthy of further promotion.

目的 观察原发性睾丸淋巴瘤(primary testicular lymphoma,PTL)的磁共振成像(magnetic resonance imaging,MRI)特点,探讨原发性睾丸淋巴瘤的磁共振成像影像诊断思路及鉴别诊断.方法 回顾性分析经手术病理证实的9例PTL的MRI表现,术前均行平扫及增强检查,分析影像特点,并与手术病理结果对照分析.结果 原发性睾丸淋巴瘤形态欠规则,T2WI上呈混杂等高信号,T1WI上呈等或稍低信号,可见小片状T1WI高信号出血灶,增强后可见不均匀中度-明显强化,呈渐进性,ADC呈低信号.结论 磁共振成像上原发性睾丸淋巴瘤具有一定的特异性,掌握MRI特点有助于疾病的诊断和鉴别诊断.

目的 采用颈动脉高分辨MRI评估早期颈动脉粥样硬化患者左右侧颈动脉分叉几何形态的差异.方法 对92例早期颈动脉粥样硬化患者采集颈动脉管壁高分辨MRI,观察双侧颈动脉管壁厚度及斑块分型,计算并比较左右侧颈动脉分叉几何参数的差异.结果 左侧颈动脉管壁厚度[1.24(1.09,1.46)mm]与右侧[1.29(1.10,1.57)mm]差异无统计学意义(Z=-1.12,P=0.26);左右侧斑块分型差异无统计学意义(P=0.22).左侧颈内动脉(ICA)平面角(Z=-2.69)、近端面积比(Z=-3.43)、颈总动脉(CCA)扩张面积比(Z=-2.87)、ICA5～CCA3弯曲度(Z=-3.17)及二维CCA弯曲度(Z＝-2.14)均大于右侧(P均＜0.05);左右侧颈动脉分叉角(Z=-1.23)、ICA角(Z=-8.89)差异无统计学意义(P均＞0.05).结论 早期颈动脉粥样硬化患者左右侧颈动脉分叉几何结构存在显著差异,可能导致左右侧颈动脉斑块发生率不同.

To assess the prevalence and missed reporting rate of potential clinically-significant incidental findings (IFs) in the neck CTA scans.All consecutive patients undergoing neck CTA imaging, from January 1, 2017 to December 31, 2018, were retrospectively evaluated by a radiologist for the presence of incidental findings in the upper chest, lower head and neck regions. These incidental findings were subsequently classified into 3 categories in terms of clinical significance: Type I, highly significant, Type II, moderately significant; and Type III, mildly or not significant. Type I and Type II IFs were determined as potential clinically significant ones and were retrospectively analyzed by another 2 radiologists in consensus. The undiagnosed findings were designated as those that were not reported by the initial radiologists. The differences in the rate of unreported potential clinically significant IFs were compared between the chest group and head or neck group.A total of 376 potential clinically significant IFs were detected in 1,698 (91.19%) patients, of which 175 IFs were classified as highly significant findings (Type I), and 201 (53.46%) as moderately significant findings (Type II). The most common potential clinically significant findings included thyroid nodules (n = 88, 23.40%), pulmonary nodules (n = 56, 14.89%), sinus disease (n = 39, 10.37%), intracranial or cervical artery aneurysms (n = 30, 7.98%), enlarged lymph nodes (n = 24, 6.38%), and pulmonary embolism (n = 19, 5.05%). In addition, 184 (48.94%) of them were not mentioned in the initial report. The highest incidence of missed potential clinical findings were pulmonary embolism and pathologic fractures and erosions (100% for both). The unreported rate of the chest group was significantly higher than that of the head or neck one, regardless of Type I, Type II or all potential clinically significant IFs (χ = 32.151, χ = 31.211, χ = 65.286, respectively; P < .001 for all).Important clinically significant incidental findings are commonly found in a proportion of patients undergoing neck CTA, in which nearly half of these patients have had potential clinically significant IFs not diagnosed in the initial report. Therefore, radiologists should beware of the importance of and the necessity to identify incidental findings in neck CTA scans.

目的:回顾性分析主动脉夹层(aortic dissection,AD)合并迷走锁骨下动脉(aberrant subclavian arteries,ASA)CT血管造影(CT angiography,CTA)表现,总结其图像表现并分析临床意义.方法:自2011年1月至2019年4月,我院经CTA诊断为主动脉夹层合并迷走锁骨下动脉共15例,其中男11例、女4例,分析CT表现及临床资料,观察ASA的起源与走行、与夹层破口的关系,总结其形态学特征.结果:AD合并ASA主要表现为AD患者CTA横断面ASA呈L或T型直接由主动脉弓发出,VR图像呈“象鼻样”,4例合并Kommerell憩室,9例夹层累及ASA.结论:CTA可以明确AD合并ASA的存在,提示其形态学改变及影像学表现,为AD术前明确诊断、选择合理的治疗方案、避免术后并发症提供强有力的影像学支持.

目的 分析胃肝样腺癌(HAS)的动态增强CT表现,并探讨其与普通腺癌(AC)的不同之处.方法 回顾性分析经病理证实的HAS(13例)和AC(52例)患者的临床资料和动态CT增强图像.CT影像表现包括病灶的部位、形态、边界、强化特征,有无溃疡、坏死及淋巴结转移,病灶的平扫CT值、动态增强各期CT值和各期间增加CT值.两组间计数资料比较采用x2检验,计量资料比较采用两样本t检验,运用受试者工作曲线(ROC)评估动态增强CT参数鉴别两种类型肿瘤的诊断价值.结果 HAS患者的术前血清甲胎蛋白(AFP)、术后AFP免疫组织化学阳性率和溃疡发生率较AC患者增高(P＜0.05).HAS患者病灶的平扫CT值、增强动脉期CT值显著高于AC患者,而静脉期增加CT值显著低于AC患者(P＜0.05).联合动态增强CT参数诊断HAS的AUC最大,灵敏度为100.00％,特异度为53.85％.结论 联合应用平扫CT值、增强动脉期CT值及静脉期增加CT值有助于鉴别胃HAS和AC,可以更好地诊断HAS.

目的 观察基于深度学习的计算机辅助诊断系统(DL-CAD)检出DR胸部正位片中骨折的效能及其对低年资放射科医师的辅助作用.方法 ①试验1:回顾性收集547例DR胸部正位片,其中361例存在胸部骨折(共983处骨折)、186例无胸部骨折,评估DL-CAD对骨折的预测性能.②试验2:随机选取试验1中的397例DR胸片,其中211例存在胸部骨折(共604处骨折)、186例无胸部骨折,记录并比较单独DL-CAD(1组)、单独低年资医师(2组)、DL-CAD辅助低年资医师(3组)、单独高年资医师(4组)的检出结果.结果 ①试验1:983处骨折中,DL-CAD识别出672处,正确识别641处,误诊31处,敏感度65.21％(641/983),F值为77.46％;361例骨折患者中,DL-CAD识别出320例,正确识别314例,误诊6例,敏感度86.98％(314/361),F值92.22％.②试验2:1、2、3、4组观察者检出骨折的敏感度分别为62.09％ (375/604)、61.59％(372/604)、86.75％(524/604)和83.44％(504/604),F值分别为75.38％、74.62％、90.74％及89.84％;3、4组检测效能均高于1、2组(P均＜0.001),而1组与2组间、3组与4组间差异均无统计学意义(P均＞0.05).结论 DL CAD对DR胸部正位片中骨折的检出效果较好,且可有效提高低年资放射科医师对胸部骨折的检出效能.

Background In recent years, substantial advances have been made in noninvasive cardiac imaging, including cardiac computed tomography (CT) and cardiovascular magnetic resonance (CMR). The purpose of this study was to prospectively compare the diagnostic performance of contrast-enhanced whole heart coronary CMR angiography (CCMRA) to dual-source coronary CT angiography (CCTA) for the diagnosis of significant coronary stenoses (≥50%) in patients with known or suspected coronary artery disease (CAD) referred for conventional x-ray coronary angiography. Methods Our objective was to directly compare the diagnostic accuracy of contrast-enhanced whole-heart CCMRA (CE-CCMRA) to dual-source CCTA (DS-CCTA) for the detection of CAD. We prospectively studied 57 symptomatic patients with suspected or known CAD who were scheduled for conventional x-ray coronary angiography. Significant CAD was defined as an x-ray defined diameter reduction of ≥50% in a coronary artery with a reference diameter of ≥1.5 mm. Results CE-CCMRA and DS-CCTA were completed in 51 (89%) of 57 patients without complications. The acquisition times of CE-CCMRA and DS-CCTA, respectively, were 9.5 ± 3.1 min and 8.3 ± 1.4 s. On patient-based analysis, the sensitivity, specificity, positive and negative predictive value of CE-CCMRA and DS-CCTA were 93.5% versus 93.5%( P > 0.05), 85% versus 90%(P > 0.05), 90.6% versus 93.5%(P > 0.05), and 89.4% versus 90%(P > 0.05), respectively. The area under the curve (AUC) was 0.89 (95% CI: 0.79 to 0.99) for CE-CCMRA and 0.92 (95% CI: 0.83 to 1.00) for DS-CCTA. Conclusions DS-CCTA was found to be superior to CE-CCMRA in the diagnosis of significant coronary stenoses (≥50%) in patients with suspected or known CAD scheduled for conventional x-ray coronary angiography, owing to shorter scanning times and higher spatial resolution. However, CE-CCMRA and DS-CCTA have similar diagnostic accuracies.

Background Presurgical grading is particularly important for selecting the best therapeutic strategy for meningioma patients. Purpose To investigate the value of histogram analysis of diffusion kurtosis imaging (DKI) maps in the differentiation of grades and histological subtypes of meningiomas. Material and Methods A total of 172 patients with histopathologically proven meningiomas underwent preoperative magnetic resonance imaging (MRI) and were classified into low-grade and high-grade groups. Mean kurtosis (MK), fractional anisotropy (FA), and mean diffusivity (MD) histograms were generated based on solid components of the whole tumor. The following parameters of each histogram were obtained: 10th, 25th, 75th, and 90th percentiles, mean, median, maximum, minimum, and kurtosis, skewness, and variance. Comparisons of different grades and subtypes were made by Mann-Whitney U test, Kruskal-Wallis test, ROC curves analysis, and multiple logistic regression. Pearson correlation was used to evaluate correlations between histogram parameters and the Ki-67 labeling index. Results Significantly higher maximum, skewness, and variance of MD, mean, median, maximum, variance, 10th, 25th, 75th, and 90th percentiles of MK were found in high-grade than low-grade meningiomas (all P < 0.05). DKI histogram parameters differentiated 7/10 pairs of subtype pairs. The 90th percentile of MK yielded the highest AUC of 0.870 and was the only independent indicator for grading meningiomas. Various DKI histogram parameters were correlated with the Ki-67 labeling index (P < 0.05). Conclusion The histogram analysis of DKI is useful for differentiating meningioma grades and subtypes. The 90th percentile of MK may serve as an optimal parameter for predicting the grade of meningiomas.

In this study, we investigated the hyperthermia efficiency of magnetic hyperthermia therapy (MHT), photo-thermal therapy (PTT), and the combination of both techniques by employing SPIO-based magneto-nanomicelles as the heating agents. Magneto-nanomicelles in aqueous suspension were exposed to 808-nm laser irradiation (PTT mode), alternating magnetic field (MHT mode), and both modalities (DUAL mode). All the three methods can offer effective temperature increases (above 20 °C). DUAL-mode resulted in an approximately 2-fold increase in heating efficiency (36 °C) compared with PTT or MHT alone. For in vivo experiments, a total of 24 Lewis carcinoma-bearing mice were randomly divided into four groups: the control group (no therapy), PTT, MHT, and DUAL group. In the three therapy groups, magneto-nanomicelles were injected into the tumor and the corresponding treatment measures were performed every other day for a total of three times each. MRI scans were used to calculate tumor volume after each treatment. One-way analysis of variance (ANOVA) was employed to compare the curative effect of different treatment groups. Compared with the control group, PTT, MHT, and DUAL groups all showed a significant inhibitory effect on tumor volume (P < 0.05). In the DUAL group, the mean tumor volume was smaller than that of the PTT or the MHT group. Our work demonstrated that hyperthermia using SPIO-based magnetonanomicelles has a remarkable suppressive effect in anticancer therapy. Moreover, the combined model of hyperthermia in vivo can achieve synthetic effects with shorter healing time by using the same magneto-nanomicelles.