目的:探讨前列腺影像报告和数据系统第2.1版（PI-RADS v2.1）结合扩散峰度成像（DKI）、前列腺特异性抗原（PSA）及衍生物对前列腺癌（PCa）的诊断价值。方法:选取余姚市人民医院2019年1月至2022年6月收治的前列腺疾病患者163例，所有患者完成超声引导下的经直肠前列腺穿刺活检或前列腺外科手术。资料包括：患者年龄、总前列腺特异性抗原（tPSA）、游离前列腺特异性抗原（fPSA）、游离/总PSA比值（f/tPSA）、前列腺特异性抗原密度（PSAD）、PI-RADS v2.1和DKI后处理定量参数，包括平均扩散率（MD）、平均峰度（MK）和各向异性分数值（FA）。比较PCa和前列腺良性病变患者的各指标差异，并评估其诊断效能。结果:78例患者被证实为PCa，85例患者证实为前列腺良性病变。f/tPSA、PI-RADS v2.1、PSAD、MK、FA组间比较差异均有统计学意义（ t=3.74、-16.01、-4.47、-2.81、-6.40，均 P < 0.05），但MD组间比较差异无统计学意义（ t=1.86， P > 0.05）。PI-RADS v2.1结合DKI、f/tPSA和PSAD的联合模型诊断PCa的曲线下面积（AUC）为0.960，灵敏度和特异度分别为94.87%和85.88%。联合模型诊断PCa的AUC高于PI-RADS v2.1、DKI、f/tPSA和PSAD的单独诊断。 结论:基于PI-RADS v2.1联合DKI、PSA及衍生物对PCa具有较高的诊断价值，有助于前列腺恶性肿瘤的诊断和筛查。

目的 探讨基于磁共振弥散张量成像(DTI)引导下的软通道置管引流术在深部脑出血患者中的应用价值.方法 收集47例未发生脑疝的深部脑出血患者,按手术方式不同分为A组和B组,A组22例采用开颅显微镜下血肿清除术,B组25例采用软通道脑内血肿置管引流术.患者术前及术后2周检测DTI,术后随访6个月,术后2周及术后6个月按照NIHSS评分评估患者的预后.结果 两组术前rFA值、平均出血量、平均GCS评分差异均无统计学意义(均P＞ 0.05).术后2周,A组rFA值0.43±0.04,B组rFA值0.51±0.06,差异有统计学意义(P＜0.05).B组术后2周及6个月NIHSS评分均低于A组(均P＜0.05).结论 通过DTI可以客观评估深部脑出血后患者皮质脊髓束继发受损情况,软通道置管引流联合DTI能改善深部脑出血患者的神经功能障碍.

目的 分析高频彩色多普勒超声联合MRI在乳腺癌腋下转移性淋巴结中的诊断效能.方法 回顾性分析98例乳腺癌患者根治术前超声及MRI影像资料,以所有患者手术病理结果为"金标准",分析单独应用高频彩色多普勒超声、MRI及高频高彩色多普勒超声联合MRI对转移性淋巴结的诊断效能.结果 超声结果显示转移性淋巴结46例,非转移性淋巴结52例;MRI结果显示转移性淋巴结47例,非转移性淋巴结51例;超声联合MRI结果显示转移性淋巴结53例,非转移性淋巴结45例.转移性淋巴结患者L/S、皮质厚度、ADC值、边缘不规则、脂肪间隙不清晰、高DWI、强化不均及未见淋巴门与非转移性淋巴结患者差异均有统计学意义(均P＜0.05).转移性淋巴结的Adler血流分级及血流类型与非转移性淋巴结差异均有统计学意义(均P＜0.05).结论 高频彩色多普勒超声联合MRI用于转移、非转移性乳腺癌淋巴结患者的诊断效能较高.

Objective:To investigate the value of diffusion-weighted imaging (DWI) quantitative parameters with different b values in the diagnosis of prostate cancer and its correlation with prostate cancer diagnosis to determine the optimal b values.Methods:Forty-one patients with pathologically confirmed prostate cancer who were admitted by Yuyao People's Hospital from May 2019 to April 2021 were included in this study. Forty-seven foci were selected to undergo 1.5T MR high-resolution T 2-weighted imaging (T 2WI) and DWI. Four different b values (800, 1 000, 1 500, 2 000 s/mm 2) were applied to DWI. The apparent diffusion coefficient (ADC) values and areas of tumor region were measured on different b-value ADC maps. Tumor signal intensity and area were measured on DWI. The same area in the same layer was selected as the reference area to calculate and analyze the signal intensity. Results:The ADC values of tumor area were 0.93 ± 0.21, 0.87 ± 0.19, 0.76 ± 0.17 and 0.68 ± 0.14 when b values were 800, 1 000, 1 500 and 2 000 s/mm 2, respectively, which were significantly different from the ADC values of the reference area (1.59 ± 0.26, 1.50 ± 0.27, 1.28 ± 0.25, and 1.08 ± 1.84, t = 13.53, 13.08, 11.79, 7.30, all P < 0.01). However, there was no significant difference in the signal intensity ratio (-0.26, -0.27, -0.25, -0.22) on the ADC maps of tumor area under different b values ( P = 0.52). The DWI signal intensities of tumor region were 68.2 ± 19.1, 59.5 ± 18.8, 47.9 ± 17.7, and 50.1 ± 11.5, respectively when b values were 800, 1 000, 1 500, and 2 000 s/mm 2, respectively, which were significantly different from the DWI signal intensities of reference area (49.1 ± 17.7, 38.7 ± 11.3, 25.3 ± 6.9, 19.6 ± 4.5, t = 5.02, 6.50, 9.43, 16.93, all P < 0.01). DWI signal intensity ratio of tumor region at the b value of 800 s/mm 2 was significantly different from that at the b value of 1 000, 1 500 and 2 000 s/mm 2 (0.16 vs. 0.21, 0.30, 0.33, t = 10.84, 23.27, 22.85, all P < 0.01). DWI signal intensity ratio at the b value of 1 000 s/mm 2 was significantly different from that at the b value of 1 500 and 2 000 s/mm 2 ( t = 12.34, 14.10, both P < 0.01). Conclusion:High b-value DWI ( b ≥ 1 500 s/mm 2) has a remarkable advantage in the diagnosis of prostate cancer over low b-value DWI.

目的 探讨第2版前列腺影像报告与数据系统(PI-RADS v2.1)联合前列腺特异性抗原(PSA)及其衍生物对前列腺癌(PCa)的诊断价值.方法 回顾性分析因PSA异常(4～10ng/ml)怀疑PCa并行MRI检查的92例患者的临床和影像学资料,以超声引导下的直肠穿刺活检结果作为"金标准".收集患者年龄、总前列腺特异性抗原(tPSA)、游离前列腺特异性抗原(fPSA)、游离/总PSA比值(f/tPSA)、PI-RADS v2.1评分和前列腺特异性抗原密度(PSAD).比较PCa和前列腺良性病变患者各临床指标的差异,并评估诊断效能.结果 共纳入92例患者,其中39例经前列腺穿刺活检被证实为PCa,其余为前列腺良性病变.PCa组fPSA和f/tPSA水平均低于良性病变组,而PCa组PI-RADS v2.1和PSAD水平均高于良性病变组(均P＜0.05).多因素Logistic回归分析结果显示f/tPSA、PSAD和PI-RADS v2.1评分为PCa的独立预测因子(均P＜0.05).当诊断阈值分别设置为PI-RADS v2.1评分≥3、f/tPSA＜0.16和PSAD≥0.18,相应阈值下诊断PCa的AUC分别为0.787、0.848和0.822.f/tPSA、PSAD和PI-RADS v2.1评分联合诊断PCa的灵敏度、特异度和AUC分别为87.2％、88.7％和0.915,联合模型诊断PCa的准确性均高于f/tPSA、PSAD和PI-RADS v2.1的单独诊断(均P＜0.05).结论 PI-RADS v2.1评分联合f/tPSA及PSAD的模型对前列腺穿刺结果有较高的诊断价值,能够显著提高PCa的诊断效能.

OBJECTIVETo investigate the diagnostic value of quantitative parameters of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in prostate cancer.METHODSFrom January 2019 to June 2020, 96 patients with prostatic tumor admitted in the department of urological surgery of our hospital were selected as subjects. Magnetic resonance imaging data of 48 cases of benign prostatic hyperplasia and 48 cases of prostate cancer were retrospectively analyzed. The patients included in this study received conventional MRI and IVIM-DWI examinations. Quantitative parameters of IVIM-DWI including D value, D* value, apparent diffusion coefficient (ADC) value and f value in lesions of prostatic tumor were calculated through the double exponential model fitting algorithm. D value, D* value, ADC value and f value were compared between benign prostatic hyperplasia (BPH) group and prostate cancer group. Quantitative parameters of IVIM-DWI were also compared among patients from different Gleason scores groups. The correlation of quantitative parameters of IVIM-DWI with Gleason scores and PSA concentration was analyzed. Diagnostic efficiency of quantitative parameters of IVIM-DWI for prostate cancer was evaluated by ROC curve.RESULTSCompared with those in BPH group, D value, ADC value and f value in prostate cancer group were significantly lower, but D* value was obviously higher. With the Gleason score increased, D value, ADC value and f value gradually decreased, while D* value gradually increased. The diagnostic efficiency of parameters ADC and D was higher among other parameters. D value, ADC value and f value of prostate cancer were negatively correlated with Gleason score and PSA concentration, respectively (all P<0.05), while D* value was positively correlated with Gleason score and PSA concentration.CONCLUSIONSQuantitative parameters of IVIM-DWI could be used for the diagnosis and evaluation of prostate cancer, and quantitative parameters of IVIM-DWI were associated with Gleason score and PSA concentration.

Abstract This study aimed to evaluate the diagnostic performance of diffusion kurtosis imaging (DKI) and prostate-specific antigen (PSA) biomarkers in differentiating prostate cancer (PCa) and benign prostatic hyperplasia (BPH). A total of 43 cases of prostate diseases verified by pathology were enrolled in the present study. These cases were assigned to the BPH group (n = 20, 68.85±10.81 years old) and PCa group (n = 23, 74.13 ± 7.37 years old). All patients underwent routine prostate magnetic resonance imaging and DKI examinations, and the mean diffusivity (MD), mean kurtosis (MK), and fractional anisotropy (FA) values were calculated. Three serum indicators (PSA, free PSA [fPSA], and f/t PSA) were collected. We used univariate logistic regression to analyze the above quantitative parameters between the 2 groups, and the independent factors were further incorporated into the multivariate logistic regression model. The area under the receiver operating characteristic curve (AUC) was used to evaluate the diagnostic efficacy of the single indicator and combined model. The difference in PSA, f/t PSA, MK, and FA between PCa and BPH was statistically significant (P < .05). The AUC for the combined model (f/t PSA, MK, and FA) of 0.972 (95% confidence interval [CI]: 0.928, 1.000) was higher than the AUC of 0.902 (95% CI: 0.801, 1.000) for f/t PSA, 0.833 (95% CI: 0.707, 0.958) for MK, and 0.807 (95% CI: 0.679, 0.934) for FA. The MK and FA values for DKI and f/t PSA effectively identify PCa and BPH, compared to the PSA indicators. Combining DKI and PSA derivatives can further improve the diagnosis efficiency and might help in the clinical setting.

Objective:To compare the clinical value of magnetic resonance imaging (MRI) and enhanced CT in the diagnosis of liver cancer.Methods:From January 2017 to December 2017, 72 patients with liver neoplasms who received treatment in Yuyao People's Hospital were selected as the subjects of this study.Enhanced CT scan and liver MRI scan were used in all patients respectively to compare the examination conditions of the two scanning methods for the lesions, the positive rate and accuracy of the detection, as well as the sensitivity and specificity of the two methods.Results:There was no statistically significant difference in the detection of extrahepatic lesions between the two methods(41.67% vs.36.11%, P>0.05). The detective rate of intrahepatic lesions of MRI (94.44%) was higher than that of enhanced CT(77.78%), the difference was statistically significant(χ 2=8.361, P<0.05). The missed diagnosis rate[5.56%(4/72)], misdiagnosis rate[1.39%(1/72)] of MRI were lower than those of enhanced CT[22.22%(16/72), 11.11%( 8/72)], and the accuracy of MRI[93.06%(67/72)] was higher than that of enhanced CT[66.67%(48/72)], the differences were statistically significant(χ 2=8.361, 4.354, 15.587, all P<0.05). The sensitivity[92.86%(52/56)], specificity[93.75%(15/16)] of MRI were higher than those of enhanced CT[71.43%(40/56), 50.00%(8/16)](χ 2=8.675, 7.575, all P<0.05). Conclusion:In the clinical diagnosis of liver cancer, the diagnostic accuracy of liver MRI is relatively high, which is conducive to the establishment and implementation of patients' treatment plan, and is conducive to clinical application and promotion.

目的 分析肝脏局灶性结节增生的MRI征象特点,进一步提高对该病的认识.方法 回顾性分析经手术病理证实的11例肝脏局灶性结节增生患者的MRI图像,包括肿块的位置、大小、各序列信号强度及肿瘤血管等.结果 11例患者均无明显肝硬化背景,11个病灶有7个可见中央星形瘢痕区;增强后病灶动脉期明显强化,门脉期及延迟期除中央瘢痕外均呈均匀性等或稍高信号,6个病灶中央星形瘢痕区延迟强化;3例行钆塞酸二钠(EOB-Gd-DTPA)检查的患者,病灶在肝细胞期均呈高或稍高信号.结论 肝脏局灶性结节增生具有一定的MRI特点,无肝硬化背景的肝实质内出现边界清楚的肿块,有中央星形瘢痕区;增强后呈快进缓出式强化,中央瘢痕区延迟强化;行EOB-Gd-DTPA增强检查,肝细胞期呈高或稍高信号,则可以做出明确诊断.

Objective:To evaluate and analyze the clinical value of Gd-EOB-DTPA magnetic resonance imaging in the differential diagnosis of cirrhotic nodules and small hepatocellular carcinoma.Methods:A total of 40 patients with cirrhosis admitted to Yuyao People's Hospital from January 2017 to June 2018 were enrolled in this study.MRI scan, Gd-EOB-DTPA dynamic enhanced scan and hepatobiliary specific scan were performed in these patients, and their magnetic resonance images were analyzed.All patients underwent magnetic resonance examination and were given surgery or needle biopsy to detect their pathological results.According to the signal intensity of hepatobiliary specific lesions, the patients were divided into three groups: low signal, mixed signal and other signals, and the results were compared with pathological grades of postoperative specimens.Results:After 40 patients with cirrhosis received MRI and dynamic contrast-enhanced scans, 136 nodules were diagnosed as cirrhotic regenerative nodules or hyperplastic nodules.Thirty-four patients were diagnosed with small hepatocellular carcinoma, and 42 small liver cancers were found after combined with Gb-EOB-DTPA hepatobiliary specific scan, the difference was statistically significant (χ 2=8.962, P<0.05). There was statistically significant difference between the signal intensity and pathological grade of 42 cases with hepatocellular carcinoma.There were no statistically significant differences in tumor size and pathological grade. Conclusion:For patients with clinically suspected hepatocellular carcinoma, Gd-EOB-DTPA magnetic resonance imaging is helpful to early detection of cirrhotic nodules and small liver cancer with malignant tendency, and can improve the accuracy of clinical diagnosis of diseases.

Objective:To compare the clinical value of ultrasonography, multi-slice spiral computed tomography(MSCT) and magnetic resonance cholangiopancreatography(MRCP) in the early diagnosis of cholelithiasis.Methods:The clinical data of 140 patients with suspected cholelithiasis treated in Yuyao People's Hospital from January 2017 to March 2019 were reviewed.All the patients were examined by ultrasonography, MSCT and MRCP.Based on the results of operation, the diagnostic results of ultrasonography, MSCT and MRCP were compared, and the consistency between the diagnostic results was analyzed.Results:Of 140 patients with suspected cholelithiasis, 100 cases were confirmed to be cholelithiasis by operation.The sensitivity, specificity and accuracy of MRCP were 97.00%(97/100), 95.00%(38/40) and 96.43%(135/140), which were higher than those of ultrasonography[87.00% (87/100), 80.00%(32/40), 85.00%(119/140)] and MSCT[89.00%(89/100), 77.50%(31/40) and 85.71%(120/140)](χ 2=6.794, 4.114, 10.854, χ 2=4.916, 5.165, 9.882, all P<0.05). The consistency between MRCP and surgical diagnosis was good, but the consistency between ultrasound, MSCT and surgical diagnosis was moderate. Conclusion:The accuracy of MRCP is better than ultrasound and MSCT in the diagnosis of cholelithiasis, which has good diagnostic value and can reduce the missed diagnosis and misdiagnosis of cholelithiasis.

目的 研究综合性放射防护和管理在CT检查中对医护患健康的影响分析.方法:选取2018年放射影像科CT检查的共80例患者作为研究对象,根据不同护理措施分成观察组和对照组各40例,对照组患者采取常规放射防护和护理,观察组在对照组基础上采取综合性放射防护和护理管理对策.比较两组患者护理总满意度和患者对整体护理、防护措施、CT室管理、医院医疗水平的评分.结果:观察组患者的护理总满意度高于对照组(P＜0.05).观察组患者对医院医疗水平、整体护理、防护措施、CT室管理等方面的质量评分均高于对照组(P＜0.05).结论:采取综合性放射防护与护理管理对策,能够提高患者的护理总满意度,提高了患者对医院医疗水平、防护措施、CT室管理等方面的评分.

To evaluate the ability of MRI radiomics to categorize ovarian masses and to determine the association between MRI radiomics and survival among ovarian epithelial cancer (OEC) patients.

目的:对模块化管理在影像科技术管理中的应用效果,进行分析与探讨.方法:由影像科质量管理小组牵头,让各个专科小组根据患者的需求进行综合考虑后,设计出相对完善的各类检查配合管理模块,并将经常出现问题的模块图片在室内墙面处进行粘贴,同时对科室人员进行必要的培训,确保模块化管理在影像科技术管理中的应用效果.共选择医院落实模块化管理前后的35例各专科手术前检查的患者,对在检查配合管理模块中的检查安全核查执行准确率、相关器械药品准备工作的准确率、仪器准备布局操作的准确率与检察管理准备的时间进行考核与比较评价.结果:通过模块化管理的应用,在安全核查执行工作中的准确率达到了100.00％,同时检查的达标率与医生的满意度也有了显著提高.结论:模块化管理模式在影像科技术管理中的应用,有效提高了影像科的工作准确率.

目的 探讨基于钆塞酸二钠(Gd-EOB-DTPA)结合大偏转角技术的肝局灶性病变定性诊断.方法 选取肝局灶性病变患者62例,患者均进行Gd-EOB-DTPA增强MRI扫描,分别行5 min、10 min、20 min延迟扫描,采用常规的低偏转角(10°)及大偏转角(20°)法获得肝胆期图像,比较Gd-E0B-DTPA结合低偏转角及大偏转角对肝局灶性病变定性诊断的敏感度、特异度.结果 经Kappa检验,在低偏转角、大偏转角检测肝局灶性病变的k值中,5 min分别为0.95、0.95,10 min分别为0.93、0.82,20 min分别为0.96、1.00;大偏转角成像的敏感度均明显高于低偏转角成像,差异均有统计意义(χ2分别=9.89、10.67、20.08、14.73、5.03、9.48,P均<0.05);病灶大小≤10 mm中大偏转角成像的敏感度均明显高于低偏转角成像,差异均有统计意义(χ2分别=4.22、4.89、8.42、8.42、12.52、12.52,P均<0.05),各时间点检测恶性病灶大偏转角成像的敏感度均明显高于低偏转角成像,差异均有统计意义(χ2分别=5.86、5.86、15.24、11.16、7.60、5.64,P均<0.05);肝癌中大偏转角成像的敏感度均明显高于低偏转角成像,差异均有统计意义(χ2分别=7.63、6.23、8.16、4.94、6.34、6.34,P均<0.05);在转移灶检测中两者无明显差异(χ2分别=0.29、0.29、3.41、3.41、0.21、0.21,P均>0.05).结论 Gd-E0B-DTPA结合大偏转角技术可提高对肝局灶性病变定性诊断的敏感度,为临床制定治疗方案提供可靠资料.

目的 探讨彩色多普勒超声检查和乳腺X线摄影在早期乳腺癌诊断中的应用效果.方法 对98例乳腺肿块患者采用彩色多普勒超声和乳腺X线摄影进行检查,以病理确诊结果作为金标准,计算全数字化乳腺X线摄影对乳腺癌疾病诊断符合率,并与彩超检查的诊断符合率进行比较研究.结果 全数字化乳腺X线摄影对乳腺癌的诊断准确率(90.82%,89/98)明显高于彩色多普勒超声(83.67%,82/98),且差异具有统计学意义.彩色多普勒超声检查出钙化39例,钙化检出率为45.35%(39/86);全数字化乳腺X线摄影检查出钙化68例,钙化检出率为79.07%(68/86);经统计学分析发现全数字化乳腺X线摄影对病灶内钙化的检出率明显高于彩色多普勒超声,且差异具有统计学意义.结论 乳腺X线摄影诊断的操作简单安全,和彩色多普勒超声检查结合使用,效果更好.

目的:探究DR摄影技术在放射科的应用价值.方法:以2013年5月～2015年5月进行DR摄影检查及胸部X线检查的160例患者为研究对象,对这些患者的资料进行回顾性分析.比较分析两组患者采用常规X线检查及DR摄影检查效果.结果:采用DR检查所获得的检查结果清晰度及比较度,均明显优于常规X线检查(P＜0.05).在这些患者中有12例患者借助于DR摄影技术检测出了微小病变,对图像进行进一步处理后得到清晰图像.这12例患者初步确诊为早期肿瘤,而采用常规X线检查却未发现微小病变.结论:DR摄影技术在放射科应用价值显著,相对于传统X线检查图像质量更高,可以对图像进一步处理,得到更加精确的诊断结果.