OBJECTIVE:To study the utility of intratumoral and peritumoral radiomic models in distinguishing between benign and malignant thyroid micronodules. METHODS:CT-enhanced images of 607 patients with thyroid micronodules were obtained, and an additional 100 patients with micronodules were collected as an independent test group on the basis of the sequence of their examination times. The peritumoral region of interest (ROI) was delineated by expanding outward by 1 and 2 mm. Radiomics features were extracted from the 3-dimensional volume of interest (VOI), which included intratumoral, peritumoral 1 mm, peritumoral 2 mm, intratumoral+peritumoral 1 mm and 2 mm in the arterial phase, venous phase, and combined arteriovenous phase. All of the data were randomly divided into training and validation groups at an 8:2 ratio. The minimum redundancy maximum relevance (mRMR) and the least absolute shrinkage and selection operator (LASSO) method was utilized for regression dimension reduction. Radscore, clinical, and combined models were constructed. A nomogram was used to assess the performance of the fusion model, and an external test group was utilized to test the model's performance. RESULTS:The intratumoral+peritumoral 1 mm radiomic model based on arterial-venous phase fusion had the best prediction performance (AUC training group 0.838; 95% CI: 0.802-0.873; validation group 0.827; 95% CI: 0.755-0.899; external test group 0.770; 95% CI: 0675-0.864). The combined model constructed with the radscore and clinical model was the optimal model (AUC training group 0.859; 95% CI: 0.826-0.892; validation group 0.876; 95% CI: 0817-0.935; external test group 0.810; 95% CI: 0.723-0.897). CONCLUSION:Both the intratumoral and peritumoral radiomic models had good diagnostic efficacy in differentiating benign and malignant thyroid micronodules.

To evaluate the feasibility of using synthetic extracellular volume (sECV) fraction—calculated from synthetic hematocrit (sHCT) derived via blood CT attenuation—as an alternative for conventional ECV in differentiation heart failure (HF). This study prospectively included 120 patients undergoing calcium scoring (CS), coronary CT angiography (CCTA), and late enhancement (LE) imaging (5 min after CCTA), with HCT measured within 24 h. Conventional ECV (cECV) was calculated using serum HCT. An additional retrospective cohort of 207 patients with CS and HCT was analyzed. Linear regression was used to derive sHCT from blood CT attenuation in the left ventricle (LV), right ventricle (RV), and ascending aorta (AO), enabling calculation of sHCT fractions (sECVLV, sECVRV, sECVAO). Among 64 HF and 56 nonHF patients, cECV was significantly higher in HF cases (36.83 ± 5.75 vs. 30.34 ± 4.88, P < 0.001; AUC = 0.82). The sECVLV, sECVRV and sECVAO showed strong correlations with cECV (R²=0.96, 0.97, and 0.93). HF patients had higher sECVLV (36.79 ± 6.11

BACKGROUND:Gallbladder cancer is a rare but aggressive malignancy that is often diagnosed at an advanced stage and is associated with poor outcomes. PURPOSE:To develop a radiomics model to discriminate between benign and malignant gallbladder lesions using enhanced computed tomography (CT) imaging. MATERIAL AND METHODS:All patients had a preoperative contrast-enhanced CT scan, which was independently analyzed by two radiologists. Regions of interest were manually delineated on portal venous phase images, and radiomics features were extracted. Feature selection was performed using mRMR and LASSO methods. The patients were randomly divided into training and test groups at a ratio of 7:3. Clinical and radiomics parameters were identified in the training group, three models were constructed, and the models' prediction accuracy and ability were evaluated using AUC and calibration curves. RESULTS:In the training group, the AUCs of the clinical model and radiomics model were 0.914 and 0.968, and that of the nomogram model was 0.980, respectively. There were statistically significant differences in diagnostic accuracy between nomograms and radiomics features (P <0.05). There was no significant difference in diagnostic accuracy between the nomograms and clinical features (P >0.05) or between the clinical features and radiomics features (P >0.05). In the testing group, the AUC of the clinical model and radiomics model were 0.904 and 0.941, and that of the nomogram model was 0.948, respectively. There was no significant difference in diagnostic accuracy between the three groups (P >0.05). CONCLUSION:It was suggested that radiomics analysis using enhanced CT imaging can effectively discriminate between benign and malignant gallbladder lesions.

Abstract Introduction Amenorrhea induced decrease of hormones is associated with cognitive impairment. This study aimed to evaluate hippocampal functional connectivity patterns in chemotherapy‐induced amenorrhea (CIA) breast cancer (BC) patients, to evaluate the relationship between the functional connectivity features and hormone levels. Method Neuropsychological test, functional magnetic resonance imaging, and assessment of hormone levels were conducted in 21 premenopausal BC patients before chemotherapy (t0) and 1 week after completing chemotherapy (t1). Twenty matched healthy controls (HC) were also included and underwent the same assessments at similar time intervals. Mixed effect analysis and paired t‐test were used to compare differences in brain functional connectivity. Results Voxel‐based paired t‐tests revealed increased functional connectivity of the right and left hippocampus with the left fusiform gyrus, inferior and middle temporal gyrus, inferior occipital gyrus, left lingual gyrus, and parahippocampal gyrus after chemotherapy (p < .001) in CIA patients. Repeated measures analysis revealed significant group‐by‐time interactions in the left hippocampus with the bilateral fusiform gyrus, right parahippocampal gyrus, left inferior temporal gyrus, and left inferior occipital gyrus (p < .001). Premenopausal BC patients had no significant differences in cognitive function compared with HC at baseline. However, the CIA patients had high levels of self‐rating depression scale, self‐rating anxiety scale, total cholesterol, and triglycerides. Further, the CIA patients showed significant differences in hormone and fasting plasma glucose levels and cognitive performances between t0 and t1 (p < .05). Functional connectivity changes between the left hippocampus and the left inferior occipital gyrus was negatively correlated with E2 and luteinizing hormone changes (p < .05). Conclusion The CIA patients had cognitive dysfunction mainly in memory and visual mobility. Chemotherapy may affect hippocampal‐posterior cortical circuit which mediates visual processing in CIA patients. Moreover, E2 may be involved in this process.

Purpose The purpose of this study is to investigate the anatomical characteristics of persistent trigeminal artery (PTA) detected by computed tomography angiography (CTA) and magnetic resonance angiography (MRA), propose a modified classification and a novel grading system for basilar artery (BA). Methods Patients who underwent head CTA or MRA in our hospital between August 2014 and August 2022 were reviewed retrospectively. The prevalence, sex, and course of PTA were evaluated. PTA types were modified based on Weon’s classification. Type I to IV were similar to those in Weon’s classification except the presence of intermed fetal-type posterior cerebral artery (IF-PCA). Type V was the same as that in Weon’s classification. Type VI included subtypes of VIa (concomitant IF-PCA based on type I to IV) and VIb (other variants). BA was assessed based on a scale of 0 to 5 compared with PTA’s caliber (0, BA aplasia; 1 and 2, BA non-dominant; 3, equilibrium; 4 and 5, BA dominant). Results A total of 57 patients (0.06%) with PTA, including 36 females and 21 males, were detected in 94,487 patients. Six patients (10.5%) were medial type and 51 patients (89.5%) were lateral type. Thirty-seven patients (64.9%) were type I, 1 (1.8%) as type II, 13 (22.8%) as type III, 3 (5.3%) as type IV, 1 (1.8%) as type V, and 2 (3.5%) as type VI. For BA grading, 4 (7.0%), 21 (36.8%), 17 (29.8%), 6 (10.5%), 6 (10.5%), and 3 (5.3%) of the patients were grade 0, 1, 2, 3, 4, and 5, respectively. Fifteen patients (26.3%) had intracranial aneurysms. One cases (1.8%) had a fenestration of the PTA. Conclusion The prevalence of PTA in our study was lower than that in most previous reports. The modified PTA classification and BA grading system can be used to better understand the vascular structure of PTA patients.

目的 探讨分析冠状动脉周围脂肪(PCAT)CT值与斑块性质及所在分支的相关性.方法 通过冠状动脉CTA检查,入组管腔轻-中度狭窄的患者178例(疾病组),管腔无狭窄的106例(对照组),测量疾病组中不同冠状动脉分支中、不同性质斑块与同支正常区域的PCAT的CT值,并测量所有病例的心外膜脂肪(EAT)及左胸壁皮下脂肪CT值.结果 疾病组较对照组平均年龄大,平均心率快,高血压的发生率高,EAT及左胸壁皮下脂肪CT值较高(P＜0.05).对比各性质斑块、各冠状动脉分支斑块与同支正常区域PCAT的CT值,发现部分钙化、非钙化斑块PCAT的CT值对比正常差异有统计学意义(P＜0.05).右冠状动脉(RCA)斑块、左主干-左前降支(LM-LAD)斑块PCAT的CT值对比正常差异有统计学意义(P＜0.05).分析斑块性质及冠状动脉分支部位对斑块PCAT的CT值的影响,发现钙化斑块PCAT的CT值较部分钙化及非钙化斑块PCAT的CT值低,且差异有统计学意义(P＜0.05),而冠状动脉分支部位对斑块PCAT的CT值无明显影响(F = 0.603,P = 0.548).结论 PCAT、EAT及左胸壁皮下脂肪CT值与冠状动脉粥样硬化的斑块性质存在相关性,一定程度上对心血管病的诊断及预后有潜在的预测价值.

Colorectal cancer (CRC) is the second leading cause of cancer-related deaths worldwide. Our study aimed to identify novel circulating miRNAs as early diagnostic biomarkers of CRC. The Gene Expression Omnibus (GEO) datasets were analyzed by using the online tool GEO2R. Isolated exosomes were verified by using the transmission electron microscope (TEM), Nanosight, and western blot. qRT-PCR was implemented to examine miRNA expression. The diagnostic value of circulating exosomal miRNAs was identified by using the receiver operating characteristic curve (ROC). In this study, we found that serum exosomal miRNAs are more suitable for diagnosing CRC when compared to serum miRNAs. Furthermore, we identified four exosomal miRNAs (miR-126, miR-1290, miR-23a, and miR-940) in the serum of CRC patients as novel potential biomarkers for the early diagnosis of CRC because they showed high diagnostic values to differentiate CRC patients at TNM stage I from healthy controls (HCs). In addition, our data suggested that CRC cells may secrete miRNAs into the extracellular environment through exosomes regardless of intracellular miRNA expression. In conclusion, we identified serum exosomal miR-126, miR-1290, miR-23a, and miR-940 as novel potential biomarkers for the early diagnosis of CRC.

Purpose: Hepatocellular carcinoma (HCC) ranks as the fourth leading cause of cancer-related deaths worldwide. N6-methyladenosine (m6A) RNA methylation is the most common modification of messenger RNAs (mRNAs). The prognosis of HCC patients with metastasis remains poor. Our study aimed to elucidate the regulatory role of m6A on HCC metastasis. Patients and Methods: All HCC patients were enrolled from The Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University. The expression levels of gene were tested by quantitative polymerase chain reaction (qPCR), Western blot, or immunohistochemistry (IHC) analysis. Wound healing assay, Transwell invasion assay, and lung metastasis model were implemented to investigate the migration and invasion ability of HCC cells. Candidate targets were selected by a comprehensive analysis of RNA-sequencing and m6A-sequencing of HepG2 cells. Results: In this study, we demonstrated that METTL14 was significantly downregulated in HCC and significantly associated with the prognosis of HCC patients. METTL14 knockdown promoted the migration, invasion, and epithelial-mesenchymal transition (EMT) of HCC cells in vitro and in vivo. In addition, overlapping RNA-sequencing and m6A-sequencing data, we identified EGFR as a direct target of METTL14 in HCC. Mechanistically, METTL14 was found to inhibit HCC cell migration, invasion, and EMT through modulating EGFR/PI3K/AKT signaling pathway in an m6A-dependent manner. Conclusion: Targeting METTL14/EGFR/PI3K/AKT signaling pathway may facilitate the development of a new treatment strategy against the metastasis of HCC.

OBJECTIVE:Although noncoding RNAs, especially the microRNAs, have been found to play key roles in CRC development in intestinal tissue, the specific mechanism of these microRNAs has not been fully understood.METHODS:GEO and TCGA database were used to explore the microRNA expression profiles of normal mucosa, adenoma, and carcinoma. And the differential expression genes were selected. Computationally, we built the SVM model and multivariable Cox regression model to evaluate the performance of tumorigenic microRNAs in discriminating the adenomas from normal tissues and risk prediction.RESULTS:In this study, we identified 20 miRNA biomarkers dysregulated in the colon adenomas. The functional enrichment analysis showed that MAPK activity and MAPK cascade were highly enriched by these tumorigenic microRNAs. We also investigated the target genes of the tumorigenic microRNAs. Eleven genes, including PIGF, TPI1, KLF4, RARS, PCBP2, EIF5A, HK2, RAVER2, HMGN1, MAPK6, and NDUFA2, were identified to be frequently targeted by the tumorigenic microRNAs. The high AUC value and distinct overall survival rates between the two risk groups suggested that these tumorigenic microRNAs had the potential of diagnostic and prognostic value in CRC.CONCLUSIONS:The present study revealed possible mechanisms and pathways that may contribute to tumorigenesis of CRC, which could not only be used as CRC early detection biomarkers, but also be useful for tumorigenesis mechanism studies.

This study focused on the application of functional magnetic resonance imaging and neuropsychology in diagnosis of vascular mild cognitive impairment (MCI) and the exploration of its relevant factors. The study enrolled 28 patients with vascular MCI in an observation group and 30 healthy individuals in a control group. All patients underwent magnetic resonance imaging. An automatic segmentation algorithm based on graph theory was adopted to process the images. Age, sex, disease course, Montreal Cognitive Assessment score, regional homogeneity, and amplitude of low-frequency fluctuation levels were recorded. There were no significant differences in age, gender, and course of disease between the observation group and the control group (P > 0.05). The level of regional homogeneity in the left posterior cerebellum in the observation group was significantly higher than that in the control group (P < 0.05).The regional homogeneity level of bilateral cingulate cortex was negatively correlated with Montreal Cognitive Assessment score (P < 0.05). The amplitude of low-frequency fluctuation of bilateral inferior parietal lobe, parietal lobe, and prefrontal lobe in the observation group was significantly lower than that in the control group, and the amplitude of low-frequency fluctuation of bilateral anterior cingulate gyrus, superior medial frontal gyrus, orbital frontal gyrus, right middle frontal gyrus, and right auxiliary motor area was higher than that in the control group (P < 0.05). Heart disease, such as myocardial infarction and atrial fibrillation, is a high risk factor for vascular MCI. Functional magnetic resonance imaging combined with an automatic segmentation algorithm can noninvasively observe the changes of a patient's brain tissue, which can be used in the recognition of vascular MCI. The global network attributes of patients with depression tend to be more randomized and have stronger resilience under targeted attacks.

Intestinal lipomas are rare nonepithelial tumors that are typically small in size and detected incidentally. Colonic intussusception is an uncommon complication of colonic lipoma. A 56 y old woman visited our emergency room with sudden onset of intermittent abdominal cramps. A CT scan showed a 5.0 cm, nodular, homogenous, hypodense structure in the hepatic flexure of the colon as the lead point of an intussusception. The hypodense structure was suggestive of a colonic lipoma, and the tumor was suspected to be the cause of the intestinal intussusception. Laparoscopic exploration was performed, and the pathology demonstrated a mature submucosal colonic lipoma. In addition to the case report, we discuss the role of imaging modalities in diagnosing neoplasms and for assessing the clinical behavior of lipomas when symptomatic.

Background Atypical choroid plexus papilloma (APP) is a rare, newly introduced entity with intermediate characteristics. To date, few reports have revealed the magnetic resonance (MR) findings. Purpose To analyze the clinicopathological and MR features of APP. Material and Methods The clinicopathological data and preoperative MR images of six patients with pathologically proven APP were retrospectively reviewed. The MR features including tumor location, contour, signal intensity, degree of enhancement, intratumoral cysts, and necrosis; and flow voids, borders, peritumoral edema, and associated hydrocephalus were analyzed. Results The APP were located in the ventricle (n = 4) and cerebellopontine angle (CPA, n = 2). Tumor dissemination along the spinal subarachnoid space was found in one patient. The tumors appeared as milt-lobulated (n = 5) or round mass (n = 1), with slightly heterogeneous signals (n = 5) or mixed signals (n = 1) on T1-weighted and T2-weighted images. Heterogeneous and strong enhancement were found in five cases on contrast-enhanced images. Three of four intraventricular tumors had a partly blurred border with ventricle wall. Four tumors had mild to moderate extent of surrounding edema signals. A slight hydrocephalus was seen in four patients. Incomplete capsule was seen in four tumors at surgery. Histopathologically, mild nuclear atypia was seen in all tumors with a mitotic rate of 2-5 per 10 high-power fields. Conclusion APP should be included in the differential diagnosis when an intraventricular or CPA tumor appearing as a multi-lobulated solid mass with slight heterogeneity, heterogeneous strong enhancement, partly blurred borders, mild to moderate peritumoral edema, or slight hydrocephalus are present.

Objective To explore the imaging characteristics of the ovarian thecoma-fibroma.Methods The clinical imaging characteristics of 25 patients with thecoma-fibroma were retrospectively analyzed. Results A total of 27 lesions were seen in 25 patients, and the maximum diameter of the tumors was 1.2 - 15.0 cm, with an average diameter of 6.9 cm. The tumors whose maximum diameter larger than 6 cm were mainly as cysticsolid. Twenty-six lesions were well-defined margin, and 14 lesions were round and oval masses, 9 lesions were lobulated masses, 3 lesions were irregular masses, and 1 lesion presented with unclear boundary. A total of 10 lesions in 9 cases were performed with CT scan, and the density was similar to uterine muscle density. In MRI scan of a total of 17 lesions of 16 cases, all lesions showed hypointensity on T1WI. On T2WI, 8 lesions showed slightly hyperintensity, 7 lesions appeared slight hypointensity, and 2 lesions appeared significantly hypointense. Eight lesions showed slit hyperintensity. Enhancement scanning was performed in seven cases. Five cases showed mild to moderate enhancement, 1 case was enhanced obviously, and 1 case was not strengthened. Conclusions The imaging findings of the ovarian thecoma-fibroma have somewhat features and can indirectly reflect pathology of tumor. Combined with the clinical data, imaging characteristics are is helpful to the diagnosis and differential diagnosis of the disease.