Background: Early-stage high-grade lung invasive adenocarcinoma (IAC) has poor prognosis and is hard to identify using conventional radiological assessment. Current reliance on postoperative histology to identify high-grade subtypes delays risk-adapted surgical planning. Three-dimensional (3D) vision transformers (ViTs) may improve prediction by modeling long-range dependencies in computed tomography (CT) scans. We aimed to develop and validate 3D-ViT and Swin Transformer (SwinT) for preoperative CT-based prediction of early-stage high-grade IAC subtypes (micropapillary/solid), benchmarking against ResNet. Methods: A multicenter cohort of 1028 patients with surgically confirmed early-stage lung adenocarcinoma was divided into training (n = 806), validation (n = 100), and external test (n = 122) sets. 3D-ViT, SwinT, and ResNet models were trained on CT to classify nodules harboring high-grade histologic patterns. A novel decision-aid tool for IAC surgery was provided. Performance was evaluated using area under the curve (AUC), accuracy, sensitivity, specificity, and precision. Attention mapping was performed to interpret 3D-ViT decision-making. Results: The 3D-ViT model achieved AUC values of 0.856 (95% CI: 0.845–0.877) (validation) and 0.806 (95% CI: 0.790–0.816) (testing), compared to 0.854 (95% CI: 0.841–0.872) (validation) and 0.760 (95% CI: 0.743–0.776) (testing) for the ResNet baseline. 3D-ViT showed balanced accuracy, sensitivity, specificity, and precision in the validation set. In external testing, 3D-ViT significantly outperformed ResNet in all metrics with P < 0.01. The SwinT-based AlignSen model from decision-aid tool prioritized sensitivity for high-grade IAC (88.0% validation, 93.4% testing), while maintaining specificity (76.0% validation, 54.1% testing) which significantly outperformed ViT and ResNet-based AlignSen models’ specificity (60.0% and 54% validation, 52.5% and 24.6% testing, respectively). Attention maps highlighted 3D nodule heterogeneity and peripheral irregularities. Conclusion: The 3D-ViT model demonstrated robust accuracy and generalizability in predicting high-grade IAC subtypes using CT images. Integration of preoperative SwinT into clinical workflows may offer a viable alternative to intraoperative pathology subtyping, potentially reducing reliance on frozen sections while optimizing surgical planning.

Background:The relationship between the peridiscal attachments and temporomandibular joint (TMJ) internal derangement (ID) remains poorly understood. This study aimed to investigate the association between graded imaging features of the peridiscal attachments and disc displacement using wireless detector-based magnetic resonance imaging (WD-MRI). Methods:This retrospective study included 61 patients (122 TMJs) diagnosed with TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). All patients underwent oblique sagittal proton density-weighted imaging in both closed- and open-mouth positions using WD-MRI. Two radiologists independently assessed disc position [normal, disc displacement with reduction (DDWR), or disc displacement without reduction (DDWOR)] and performed ordinal grading (1-3 points: clearly, indistinctly, or non-visualized) of four peridiscal attachments: the anterior attachment superior (AAS), anterior attachment inferior (AAI), posterior attachment superior (PAS), and posterior attachment inferior (PAI). Inter-observer reliability between the two radiologists was evaluated using the weighted kappa coefficient. Group differences and correlations between attachment scores and disc position were analyzed using the Kruskal-Wallis H test, Mann-Whitney U test, and Spearman correlation analysis. Results:A total of 122 TMJs (12 normal, 37 DDWR, and 73 DDWOR) were evaluated using WD-MRI. Peridiscal attachment scores differed significantly among the three groups (all P<0.05). The inter-observer reliability for AAS, AAI, PAS, and PAI demonstrated substantial to almost perfect agreement, with weighted kappa values of 0.838 [95% confidence interval (CI): 0.746-0.930], 0.896 (0.825-0.967), 0.852 (0.774-0.930), and 0.799 (0.705-0.893), respectively. Mann-Whitney U tests revealed that peridiscal attachment grades in the DDWOR group were significantly higher than those in both the normal and DDWR groups across all four attachments (Z=2.571-6.572, r=0.279-0.738, all P<0.05). However, when comparing the DDWR and normal groups, a significant difference was observed only for PAI (Z=2.653, P<0.05), with no significant differences for AAS, AAI, or PAS (P>0.05). The grading of the peridiscal attachments showed significant positive correlations with disc reducibility. Specifically, the positive correlations were strong for PAS (r=0.720) and PAI (r=0.630), and moderate for AAS (r=0.467) and AAI (r=0.356). Conclusions:This study demonstrated that structural alterations in the peridiscal attachments, particularly the posterior attachment, are significantly correlated with TMJ ID severity on WD-MRI, suggesting their potential value in TMD assessment.

Cardiovascular disease (CVD) is a leading cause of mortality in systemic sclerosis (SSc). Early risk identification is crucial for improving prognosis. The aim of this study was to develop a clinical prediction model for assessing cardiovascular disease risk in SSc patients via integrating clinical and imaging data. We retrospectively analyzed the occurrence of CVD among 245 SSc patients and 245 controls. SSc patients were stratified by CVD event. Independent predictors of CVD risk were identified using Cox regression analysis in SSc patients. Receiver operator characteristic (ROC) curves assessed the model's predictive performance. Kaplan–Meier (KM) curves evaluated the association of these factors with event-free survival. SSc patients exhibited significantly higher CVD events than controls. Significant differences were observed between SSc patients with and without events regarding age, sex, disease duration, modified Rodnan skin score (mRSS), erythrocyte sedimentation rate (ESR), anti-Scl-70 antibody (ATA), anti-U3 RNP, pulmonary arterial hypertension (PAH), interstitial lung disease (ILD), coronary artery calcium score (CACS) and epicardial adipose tissue (EFV). Cox regression identified CACS, mRSS, EFV, and ATA as independent predictors of increased CVD risk. The combined model (CACS, EFV, mRSS, ATA) achieved an area under the curve (AUC) of 0.910, showing high accuracy for predicting CVD events in SSc. KM analysis confirmed significantly reduced event-free survival in patients with high CACS, high mRSS, ATA positivity, or high EFV (all P < 0.05). CACS, mRSS, EFV, and ATA are independent risk factors for CVD events in SSc patients. A model combining these factors effectively predicts CVD incidence in this population.

Background:Systemic sclerosis (SSc) patients face greater odds of developing cardiovascular disease. In this study, patient clinical characteristics, coronary artery calcium score (CACS) values, and epicardial fat volume (EFV) were analyzed to identify predictors of major adverse cardiovascular events (MACE) among SSc patients without pulmonary arterial hypertension (PAH). Methods:This study enrolled 202 SSc patients and 202 controls from the First Affiliated Hospital of Ningbo University. SSc patients were separated into two groups based on their MACE status. The relationship between EFV and MACE incidence was assessed with Kaplan-Meier curves and Cox proportional hazards regression models, calculating hazard ratios (HRs) and 95% confidence intervals (CIs). Discrimination efficiency was evaluated based on global chi-square, concordance index (C-index), net reclassification index (NRI), and integrated discrimination improvement (IDI) index results. The incremental value of EFV as a predictor of MACE incidence was analyzed among these SSc patients. Results:SSc patients presented with higher CACS values relative to controls {33.5 [interquartile range (IQR), 0-128.5] vs. 0 (IQR, 0-88.25), P=0.006}, and EFV was similarly elevated among SSc patients [120 (IQR, 93.5-148.5) vs. 110 (IQR, 89.5-142.5), P=0.037]. These patients underwent follow-up for a median of 48 (IQR, 36-60) months, during which 25.2% (51/202) of these patients experienced MACEs. The mean CACS value among MACE patients was significantly higher than that for non-MACE patients [88 (IQR, 19-144) vs. 0 (IQR, 0-123), P=0.003], as was the mean EFV [160 (IQR, 138-192) vs. 110 (IQR, 84-130), P<0.001]. Multivariable Cox regression revealed that EFV was independently associated with the risk of MACE incidence (HR: 1.027, 95% CI: 1.015-1.041, P=0.001). Time-dependent Youden index analyses revealed that the optimal EFV cut-off for the prediction of MACE incidence was 126 cm3, and this value was therefore used to separate participants into groups with low and high EFV levels. Kaplan-Meier analyses demonstrated that relative to low-EFV patients, high-EFV patients exhibited significantly lower MACE-free survival (P<0.01). EFV values were found to aid in the prediction of MACE incidence more effectively when combined with traditional risk factors, increasing the C-index from 0.77 to 0.84 (P<0.01), with a corresponding increase in the global c2 from 45.2 to 52.2 (P<0.01), and corresponding significant increases in IDI and NRI values (0.12 and 0.46, respectively, both P<0.01). Conclusions:High EFV levels are independently associated with MACE risk among SSc patients, with poorer prognostic outcomes being evident among patients with SSc even if they were unaffected by PAH. The introduction of EFV offers incremental utility over traditional risk factors alone for the prediction of MACE incidence.

Antibiotic resistance is a tricky threat that demands worldwide attention, and there is an urgent need to develop novel therapies for various infections. Photothermal therapy (PTT) relies on photothermal agents (PTAs) and irradiation to induce hyperthermia, which aids in disinfection and the subsequent wound healing, thereby reducing the likelihood of bacterial resistance. In this study, we employed Ni(II)-PyNc2, a photostable antiaromatic complex, as a PTA to treat Staphylococcus aureus (S. aureus) infections. Ni(II)-PyNc2 exhibited intense near-infrared (NIR) absorption in the range of 650 to 1200 nm and demonstrated a high photothermal conversion efficiency (PCE) of 73 %. Utilizing the photothermal effect of Ni(II)-PyNc2, we observed an effective suppression of S. aureus growth in vitro. Furthermore, in vivo studies using a mouse abscess model demonstrated its potential for wound healing. Therefore, Ni(II)-PyNc2 is considered a promising candidate for clinical PTT applications.

Manganese(II) is considered a valuable alternative to gadolinium(III) in developing contrast agents (CAs) for magnetic resonance imaging (MRI). However, due to the labile nature of common Mn(II) complexes, designing ligands that enable stable and inert complexation is essential before clinical application. Mn(1,4-Et4DO2A) bearing four ethyl groups, is found to have a log KMnL as high as 17.86, together with a pMn of 7.52 at pH 7.4. Kinetically, Mn(1,4-Et4DO2A) is approximately 20 times more inert than Mn(1,4-DO2A) in the presence of a 25-fold excess of Zn(II) at pH 6.0 and 37 °C, with the incorporation of a benzoic group to one pendant arm extending the half-life time (t1/2) to around 22 hours. Its r1 is measured as 2.34 and 2.20 mM−1 s−1 at 310 K and 1.5 and 3.0 T, respectively, representing an approximate 50

Magnetic resonance imaging (MRI) is a critical tool in medical diagnostics, yet conventional MRI contrast agents (CAs) are often limited by their small-molecule nature, resulting in rapid clearance and low relaxivity. This study presents a chiral strategy for developing high-performance polymeric gadolinium-based CAs, PAA-EOB-GdA and PAA-EOB-GdB, tailored for enhanced vascular and tumor imaging. Notably, PAA-EOB-GdA, a chiral Gd-DOTA derivative integrated with sodium poly-(acrylic acid) (PAA), benefits from the optimized water exchange rate of chiral Gd-(III) complex and the polymer effect of PAA, exhibiting exceptionally high relaxivity (r 1 = 37.87 mM-1 s-1, 11.9-fold of clinical Gd-DOTA) and showed remarkable imaging efficacy in magnetic resonance angiography (MRA) with low-dose administration (0.05 mmol kg-1) and an extended imaging duration. Its performance in tumor imaging was also impressive, maintaining superior enhancement values compared to Gd-DOTA. These characteristics feature PAA-EOB-GdA as a promising candidate for clinical diagnosis in both vascular and tumor imaging applications.

BackgroundPatients with myeloproliferative neoplasms (MPN) are exposed to a higher risk of cardiovascular disease, especially cardiovascular calcification. The present research aimed to analyze the clinical features and coronary artery calcium score (CACS) in MPN patients, and construct an effective model to predict acute coronary syndrome (ACS) in MPN patients.Materials and methodsA total of 175 MPN patients and 175 controls were recruited from the First Affiliated Hospital of Ningbo University. Based on cardiovascular events, the MPN patients were divided into the ACS group and the non-ACS group. Multivariate Cox analysis was completed to explore ACS-related factors. Furthermore, ROC curves were plotted to assess the predictive effect of CACS combined with white blood cells (WBC) and platelet for ACS in MPN patients.ResultsThe MPN group exhibited a higher CACS than the control group (133 vs. 55, P < 0.001). A total of 16 patients developed ACS in 175 MPN patients. Compared with non-ACS groups, significant differences in age, diabetes, smoking history, WBC, percentage of neutrophil, percentage of lymphocyte, neutrophil count, hemoglobin, hematocrit, platelet, lactate dehydrogenase, β2-microglobulin, and JAK2V617F mutation were observed in the ACS groups. In addition, the CACS in the ACS group was also significantly higher than that in the non-ACS group (374.5 vs. 121, P < 0.001). The multivariable Cox regression analysis identified WBC, platelet, and CACS as independent risk factors for ACS in MPN patients. Finally, ROC curves indicated that WBC, platelet, and CACS have a high predictive value for ACS in MPN patients (AUC = 0.890).ConclusionCACS combined with WBC and platelet might be a promising model for predicting ACS occurrence in MPN patients.

Personalized radiotherapy strategies enabled by the construction of hypoxia-guided biological target volumes (BTVs) can overcome hypoxia-induced radioresistance by delivering high-dose radiotherapy to targeted hypoxic areas of the tumor. However, the construction of hypoxia-guided BTVs is difficult owing to lack of precise visualization of hypoxic areas. This study synthesizes a hypoxia-responsive T1, T2, T2 mapping tri-modal MRI molecular nanoprobe (SPION@ND) and provides precise imaging of hypoxic tumor areas by utilizing the advantageous features of tri-modal magnetic resonance imaging (MRI). SPION@ND exhibits hypoxia-triggered dispersion-aggregation structural transformation. Dispersed SPION@ND can be used for routine clinical BTV construction using T1-contrast MRI. Conversely, aggregated SPION@ND can be used for tumor hypoxia imaging assessment using T2-contrast MRI. Moreover, by introducing T2 mapping, this work designs a novel method (adjustable threshold-based hypoxia assessment) for the precise assessment of tumor hypoxia confidence area and hypoxia level. Eventually this work successfully obtains hypoxia tumor target and accurates hypoxia tumor target, and achieves a one-stop hypoxia-guided BTV construction. Compared to the positron emission tomography-based hypoxia assessment, SPION@ND provides a new method that allows safe and convenient imaging of hypoxic tumor areas in clinical settings. This article introduces a T1, T2, T2 mapping tri-modal magnetic resonance imaging (MRI) molecular nanoprobe (SPION@ND) with hypoxia and acidic pH responsiveness, and demonstrates its capability in T1 contrast MRI, hypoxia T2 contrast MRI, and hypoxia T2 mapping imaging. The integration of molecular nanoprobe and tri-modal MRI techniques explores a novel quantitative evaluation approach for tumor hypoxia. image

Hepatobiliary-specific magnetic resonance imaging contrast agents (MRI CAs) play a crucial role in the early diagnosis of hepatocellular carcinoma (HCC). However, only two acyclic CAs, Gd-BOPTA and Gd-EOB-DTPA, exhibit unfavorable kinetic inertness. Our study focused on the development of superior stable innovative macrocyclic CAs. By introducing a lipophilic benzyloxy group (OBn) into the H4DOTA ring (Gd-L 1 ), we achieved significant enhancement in kinetic inertness. In vivo experiments in mice demonstrated that 40% of the dosage was distributed to the liver at 5 min, providing sustained hepatic enhancement for over 35 min. We also developed an MPO-responsive MRI CA (Gd-L 3 ), which can participate in the “peroxidase cycle” as the substrate, generating oligomers with a 3.8-fold increase in relaxivity, and selectively enhance the lesion in an acute gout mouse model. Overall, our work represents a significant advancement in the field of hepatic and inflammatory MRI, offering promising avenues for early diagnosis and improved imaging outcomes.

Objective: Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients. Methods: All enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group. Results: There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, respectively. Conclusions: GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.

BACKGROUND:COVID-19 is a global pandemic. Currently, the predominant strain is SARS-CoV-2 Omicron subvariant BA.2 in many countries. Understanding its infection characteristics can facilitate clinical management.OBJECTIVES:This study aimed to characterize the clinical, laboratory, and high-resolution computed tomography (HRCT) findings in patients with mild or moderate infection from SARS-CoV-2 Omicron subvariant BA.2.METHODS:We performed a retrospective study on patients infected with SARS-CoV-2 Omicron subvariant BA.2 between April 4th and April 17th, 2022. The clinical characteristics, laboratory features, and HRCT images were reviewed.RESULTS:A total of 805 patients were included (411 males and 394 females, median age 33 years old). The infection was mild, moderate, severe, and asymptomatic in 490 (60.9%), 37 (4.6%), 0 (0.0%), and 278 (34.5%) patients, respectively. Notably, 186 (23.1%), 96 (11.9%), 265 (32.9%), 11 (3.4%), 7 (0.9%), and 398 (49.4%) patients had fever, cough, throat discomfort, stuffy or runny nose, fatigue, and no complaint, respectively. Furthermore, 162 (20.1%), 332 (41.2%), and 289 (35.9%) patients had decreased white blood cell counts, reduced lymphocytes, and elevated C-reactive protein levels, respectively. HRCT revealed pneumonia in 53 (6.6%) patients. The majority of the lung involvements were ground-glass opacity (50, 94.3%) mostly in the subpleural area. The grade of lung injury was mainly mild (90.6%). Short-term follow-ups showed that most patients with pneumonia recovered.CONCLUSION:Most patients with mild or moderate infection from SARS-CoV-2 Omicron subvariant BA.2 were adults, with fever and upper respiratory symptoms as the main clinical presentations. Lower respiratory infection was mild, with ground-glass opacity in the subpleural area as the main finding.

Abstract Background Nonalcoholic fatty liver disease (NAFLD) has a multidirectional relationship with metabolic syndrome (MetS) and used to be considered a hepatic manifestation of MetS. Perirenal fat, as a part of visceral adipose tissue (VAT), was reported to be correlated with MetS components, but data for intraorgan fat are lacking. This study was undertaken to assess the value of peripheral and intraorgan fat to predict MetS in adults with overweight and obesity with suspected NAFLD. Methods We studied 134 sequential adults (mean age, 31.5 years; 47% female) with overweight and obesity with suspected NAFLD. All participants underwent abdominal magnetic resonance imaging (MRI) examination. Anthropometric and metabolic parameters and perirenal fat thickness (PRFT), subcutaneous adipose tissue thickness (SATT), liver fat fraction (LFF), pancreas fat fraction (PFF), and lumbar spine fat fraction (LSFF) were collected. MetS was defined according to the International Diabetes Federation (IDF) criteria. Statistical analyses included basic statistics, linear correlation and logistic regression analysis. Results A total of 63 adults with MetS and 71 adults with advanced liver steatosis (grades 2 and 3) were included in our study. Patients with MetS had greater PRFT (p = 0.026) and LFF (p < 0.001), as well as greater homeostasis model assessment of insulin resistance (HOMA-IR), alanine transaminase (ALT), aspartate transaminase (AST), and decreased SATT. MetS patients had a higher proportion of advanced steatosis than those without MetS (P < 0.001). The MetS score was associated with PRFT and LFF. Logistic regression analysis showed that the PRFT and LFF were independent predictors of MetS after adjusting for age and sex. A cutoff of 9.15 mm for PRFT and 14.68% for LFF could be predictive of MetS. Conclusions This study shows that the absolute cutoff level of 9.15 mm for PRFT and 14.68% for LFF may be clinically important markers for identifying patients who are at high risk of MetS among adults with overweight and obesity with suspected NAFLD, irrespective of sex and age. Moreover, ectopic fat levels in pancreas and lumbar spine are positively associated with PRFT. Trial registration Not applicable.

Objective: The end plate plays an important role in maintaining the structural integrity, balancing biomechanical and supplying nutrition, how dose it changes with the reduced bone mineral density (BMD) remains unknown. The objective of this study is to investigate the relationship between lumbar end plate degeneration and normal BMD, osteopenia and osteoporosis. Methods: A retrospective analysis of 362 patients equal or over 55 years old who underwent both lumbar MRI and dual-energy x-ray absorptiometry(DXA) examinations due to lumbar discomfort or a healthy physical examination. Two Radiologists reported the Modic changes, Schmorl node, and end plate irregularities of 11 end plates from L1 to S1. Data were separated by sex, and then the summed results were grouped in age matching. Results: In women, with the decrease of hip BMD, the positive rate and severity of Modic changes and the severity of end plate irregularities showed an increasing trend; Among men, the number of Modic changes and end plate irregularities increased in osteoporosis subjects and osteopenia subjects compared with normal BMD subjects. While the positive rate of Schmorl nodes incremental trend was not obvious in female and male subjects. Conclusions: Osteoporosis in the elderly will aggravate the degeneration of the lumbar end plate Modic changes and end plate irregularities.

Purpose: To assess the clinical potential of multi-cycle temozolomide (TMZ) chemotherapy in patients with glioblastoma who underwent surgery and successive radiotherapy. Methods: The clinical data of 68 glioblastoma patients who underwent surgery from January 2015 to December 2019 were collected. A total of 33 patients were treated with multi-cycle (& GE;9 cycles) TMZ chemotherapy (study group), while 35 patients were treated with standard-cycle (6 cycles) TMZ chemotherapy (control group). Differences in progression-free survival (PFS) and overall survival (OS) between the two groups were analyzed to evaluate the effects of multi-cycle and standard-cycle TMZ chemotherapies. The survival rates of the patients in both groups were analyzed using Kaplan-Meier survival curve. Results: The median PFS times were 10.5 months and 7.7 months in the study and control groups, respectively (P = 0.010), while the median OS times were 27.2 and 19.8 months, respectively (P = 0.036). The 1-, 2 -, and 3-year survival rates in the control group were 77.1 %, 42.9 %, and 25.7 % while those in the study group were 87.8 % (P = 0.344), 63.6 % (P = 0.097), and 39.4 % (P = 0.302), respectively. Conclusions: The multi-cycle TMZ chemotherapy could prolong the OS and PFS time of patients with glioblastoma undergoing surgery and successive radiotherapy. However, it could not significantly elevate the 1 -, 2 -, and 3year survival rates of these patients.

Rationale and Objectives: Determine the effect of a multiphase fusion deep-learning model with automatic phase selection in detection of intracranial aneurysm (IA) from computed tomography angiography (CTA) images.Materials and Methods: CTA images of intracranial arteries from patients at Ningbo First Hospital were retrospectively analyzed. Images were randomly classified as training data, internal validation data, or test data. CTA images from cases examined by digital subtraction angiography (DSA) were examined for independent validation. A deep-learning model was constructed by automatic phase selection of multiphase fusion, and compared to the single-phase algorithm to evaluate algorithm sensitivity.Results: We analyzed 1110 patients (1493 aneurysms) as training data, 139 patients (174 aneurysms) as internal validation data, and 134 patients (175 aneurysms) as test data. The sensitivity of the multiphase analysis of the internal validation data, test data, and independent validation data were greater than from the single-phase analysis. The recall of the multiphase selection was greater or equal to that of single-phase selection in the aneurysm position, shape, size, and rupture status. Use of the test data to determine the presence and absence of aneurysm rupture led to a recall from multiphase selection of 94.8% and 87.6% respectively; both of these values were greater than those from single-phase selection (89.6% and 79.4%).Conclusion: A multiphase fusion deep learning model with automatic phase selection provided automated detection of IAs with high sensitivity.

目的 比较Grasp-vibe序列和CDT-vibe、Dixon-vibe组合序列在肝脏MRI增强中的图像质量,分析Grasp-vibe序列的应用价值.方法 选取因体检发现肝脏占位、CA199增高等原因来我院检查的患者共70例.行Grasp-vibe序列和CDT-vibe、Dixon-vibe组合序列扫描方式的患者各35例.采用5分制法,评价两种模式下的动脉晚期、门静脉期、延迟期图像的主观评分以及所有序列的运动伪影得分.测量肝脏信号SI、噪声SD并计算肝脏信噪比SNR、对比噪声比CNR.采用独立样本t检验分析或者非参数秩和检验.结果 主观评价:两种模式下所有期相图像运动伪影得分分别为(3.7±0.7)、(3.9±0.8),差异有统计学意义(P＜0.05);两种模式之间的动脉晚期、门静脉期、延迟期图像的所有主观评分比较均无统计学意义(P＞0.05).Grasp-vibe序列组的动脉晚期分别和门静脉期、延迟期比较显示:对肝脏锐利度的评价差异无统计学意义(P＞0.05),其余评分差异有统计学意义(P＜0.05).客观评价:两种模式下门静脉期的SD值分别为7.6(6.7,8.7)、6.1(4.3,7.2),差异有统计学意义(P＜0.05),CDT-vibe序列的SD值高;其余客观评价均差异无统计学意义(P＞0.05).结论 基于压缩感知的Grasp-vibe序列在肝脏MR增强后的图像质量初步满足诊断要求,其自由呼吸的意义可以使绝大部分患者得到较满意的检查.

OBJECTIVES:The artifacts produced by calcification on coronary computed tomographic angiography (CCTA) have a great influence on the diagnosis of coronary stenosis. The purpose of this study is to investigate the value of corrected coronary opacification (CCO) difference in the diagnosis of stenosis in diffusely calcified coronary arteries (DCCAs).METHODS:A total of 84 patients were enrolled. The CCO difference across the diffuse calcification was measured through CCTA. Coronary arteries were grouped according to the extent of stenosis obtained by invasive coronary angiography (ICA). The Kruskal-Wallis H test was used to compare the CCO differences between different groups and a receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of the CCO difference.RESULTS:Among the 84 patients, 58 patients had one DCCA, 14 patients had 2 DCCAs, and 12 patients had 3 DCCAs. A total of 122 coronary arteries were examined, 16 showed no significant stenosis, 42 had <70% stenosis, and 64 had 70-99% stenosis. The median CCO differences among the 3 groups were 0.064, 0.117, and 0.176, respectively. There were significant differences between the group without stenosis and the group with 70-99% stenosis (H = -3.581, P = 0.001), and between the group with <70% stenosis and the group with 70-99% stenosis (H = -2.430, P = 0.045). The area under the ROC curve was 0.681 and the optimal cut-off point was 0.292. Taking the ICA results as the gold standard, the sensitivity and specificity for the diagnosis of ≥70% coronary stenosis with a cut-off point of 0.292 were 84.4% and 44.8%, respectively.CONCLUSION:CCO difference could be useful in the diagnosis of ≥70% severe coronary stenosis in DCCA. Through this non-invasive examination, the CCO difference could be a reference for clinical treatment.

目的 比较读出方向分段采集(RESOLVE)、逐层匀场(Slice-Adjust)和单次激发回波平面成像(SS-EPI)在乳腺扩散加权成像(DWI)检查中的图像质量.方法 前瞻性选取怀疑乳腺疾病的女性患者45例,分别采用RESOLVE、Slice_Adjust和SS-EPI技术进行DWI.由2名具有5年以上诊断经验的医师采用Likert 5分法单独评价图像的主观评分,测量并计算病变信噪比(SNR)、对比噪声比(CNR)、对比度、最长径、表观扩散系数(ADC)平均值.采用多个相关样本非参数秩和检验和单因素方差进行分析.结果 45例患者中,最终评价23个病灶.3种DWI序列的病灶清晰度、乳腺变形度、乳腺磁敏感伪影、乳腺整体图像质量比较均有明显差异;RESOLVE得分高于SS-EPI和Slice_Adjust(P＜0.001);SS-EPI和Slice_Adjust之间无明显差异(P＞0.05).3种DWI序列病变的对比度、最长径无明显差异(P＞0.05);在病变SNR方面,RESOLVE得分明显高于SS-EPI和Slice_Adjust(P＜0.001、P=0.006);SS-EPI 和 Slice-Adjust 之间无明显差异(P=0.554);在病变 CNR 方面,RESOLVE 得分明显高于 SS-EPI(P=0.010);余无明显差异.3种DWI序列病变ADC平均值无明显差异(P=0.738).结论 在乳腺DWI方面,RESOLVE图像质量明显优于Slice Adjust和SS-EPI;Slice Adjust和SS-EPI相仿;3种技术获得的病灶ADC平均值相仿.

目的 利用泪道造影及多层螺旋CT测量慢性泪囊炎者泪囊的体积,并探讨其与性别、年龄的关系.方法 收集溢泪、溢脓患者109例(共126眼),先行X线透视下泪道造影,随后立即行CT扫描.结果 泪囊的轴位长度和宽度分别为(7.48±1.87)mm和(5.11±1.35)mm,冠状位长度和宽度分别为(11.32±2.60)mm和(5.10±1.31)mm,体积为(289.10±182.39)mm3.男女五个参数差异均无统计学意义(均P＞0.05).不同年龄泪囊的轴位宽度差异有统计学意义(P＜0.05).结论 影像学方法能准确测量慢性泪囊炎患者泪囊的大小体积及变化情况,不同患者泪囊变异较大,术前个体化扫描对于临床医生了解泪囊及确定手术方式很有必要.