OBJECTIVES:Digital subtraction angiography (DSA) is the current gold standard for diagnosing spinal dural arteriovenous fistulas (SDAVF). However, DSA is invasive and associated with risks such as ionizing radiation and iodine contrast allergy. Contrast-enhanced magnetic resonance angiography (CE-MRA) with high temporal/high spatial resolution allows dynamic multiphase contrast-enhanced imaging with excellent detail. This study aims to evaluate the diagnostic value of spinal CE-MRA with high temporal/high spatial resolution for SDAVF. METHODS:Clinical data were retrospectively collected from patients who underwent both conventional spinal MRI and high temporal/high spatial resolution CE-MRA at Xiangya Hospital between January 1, 2021, and January 1, 2024, and who subsequently underwent DSA or surgery within 90 days. Two experienced radiologists independently reviewed all conventional MRI and CE-MRA images. The sensitivity and specificity of conventional MRI and CE-MRA for diagnosing SDAVF were calculated against the gold standard DSA findings. Kappa statistics were used to evaluate the consistency of MRI and CE-MRA compared to DSA. The diagnostic value was further assessed by calculating the area under curve (AUC) of the receiver operating characteristic (ROC). RESULTS:A total of 60 patients were included, of whom 47 were diagnosed with SDAVF and 13 were not. Conventional MRI had 3 false negatives and 1 false positive; CE-MRA had 2 false positives and 0 false negative. The sensitivity and specificity of conventional MRI were 93.62% and 92.31%, respectively. CE-MRA demonstrated 100% sensitivity and 84.62% specificity. The main cause of false positives was the misidentification of posterior spinal arteries as feeding arteries. CE-MRA clearly displayed most feeding arteries, and the accuracy of fistula localization was 74.47% (35/47). Kappa values for conventional MRI and CE-MRA were 0.814 and 0.896, respectively (both P<0.001), indicating good agreement, with CE-MRA outperforming conventional MRI. The AUCs for diagnosing SDAVF were 0.930 for conventional MRI and 0.923 for CE-MRA (both P<0.05). CONCLUSIONS:Spinal CE-MRA with high temporal/high spatial resolution is a reliable, non-invasive imaging technique with high sensitivity for diagnosing SDAVF. It can clearly visualize feeding arteries and provides valuable preoperative diagnostic and localization information to support DSA or surgical planning.

Glioma is a fatal primary brain tumor. Improved glioma treatment effectiveness depends on a better understanding of its underlying mechanisms. Glioblastoma (GBM), was classified as high-grade glioma with the most lethality and therapeutic resistance. Herein, we reported LINC00978 overexpressed in high-grade gliomas. Down-regulation of LINC00978 in glioblastoma cells inhibited cell proliferation, invasion, migration, and induced apoptosis. In vivo experiments confirmed that the CamK-A siRNA of LINC00978 could effectively inhibit the proliferation of glioblastoma cells. The main pathway and genes regulated by LINC00978 were detected using RNA sequencing to elucidate the molecular mechanism. The results suggest that LINC00978 regulates the expression of genes related to metabolic pathways, including aldo-keto reductase family 1 member B (AKR1B1), which mediates the cytotoxicity of 2-deoxyglucose. LINC00978 positively regulated AKR1B1 expression, and 2-deoxyglucose induced AKR1B1 expression via a LINC00978-dependent mechanism. This research has revealed that LINC00978 promotes the sensitivity of glioblastoma cells to 2DG. LINC00978 is highly expressed in most high-grade glioma patients. Thus, understanding the anticancer mechanism identified in this study may contribute to treating the majority of glioma patients. This study clarified the function and molecular mechanism of LINC00978 in glioblastoma and provided a study basis for LINC00978 to guide the clinical treatment of glioblastoma.

We compared the clinical utility of single-shot echo-planar imaging (SS-EPI) using different breathing schemes, readout-segmented EPI and zoomit EPI in the repeatability of apparent diffusion coefficient (ADC) measurements, cortico-medullary contrast to noise ratio (c-mCNR) and image quality. In this institutional review board-approved prospective study, some common clinically applicable diffusion-weighted imaging (b = 50, 400, 800 s/mm 2 ) of kidney on 3.0 T MRI were performed on 22 volunteers using SS-EPI with breath-hold diffusion-weighted imaging (BH-DWI), free-breathing (FB-DWI), navigator-triggered (NT-DWI) and respiratory-triggered (RT-DWI), readout-segmented DWI (RS-DWI), and Zoomit DWI (Z-DWI). ADC and c-mCNR were measured in 12 anatomic locations (the upper, middle, and lower pole of the renal cortex and medulla), and image quality was assessed on these DWI sequences. A DWI with the optimal clinical utility was decided by systematically assessing the ADC repeatability, c-mCNR and image quality among the DWIs. For ADC measurements, Z-DWI had an excellent intra-observer agreement (intra-class correlation coefficients (ICCs): 0.876–0.944) and good inter-observer agreement (inter-class ICCs: 0.798–0.856) in six DWI sequences. Z-DWI had the highest ADC repeatability in most of the 12 anatomic locations of the kidneys (mean ADC absolute difference: 0.070–0.111 × 10 −3 mm 2 /s, limit of agreement: 0.031–0.056 × 10 −3 mm 2 /s). In all DWIs, Z-DWI yielded a slightly higher c-mCNR than other DWIs in most representative locations ( P > 0.05), which was significantly higher than BH-DWI and FB-DWI in the middle pole of both kidneys and the upper pole of the left kidney ( P < 0.05). In addition, Z-DWI yielded image quality that was similar to RT-DWI and NT-DWI ( P > 0.05) and superior to BH-DWI, FB-DWI and RS-DWI ( P < 0.05). Our results suggest that Z-DWI provides the highest ADC reproducibility, better c-mCNR and good image quality on 3.0 T MRI, making it the recommended sequence for clinical DWI of the kidney.

In order to study the value of high order singular value decomposition (SVD)-based denoising algorithm (DA) in magnetic resonance imaging (MRI) of cerebral blood flow (CBF) in patients with cerebral infarction (CI), in this study, 68 patients with acute CI admitted to our hospital from October 30, 2017 to March 30, 2019 were taken as the experimental group (EG), and 40 healthy volunteers were selected as the control group (CG). 3D-MRI was performed on all subjects. Firstly, the DA based on high order SVD was used to reconstruct the 3-D image. Then, the oxygen extraction fraction (OEF), CBF, and Cerebral metabolic rate of oxygen utilization (CMRO2) in the ischemic penumbra of the EG and the CG were measured. The results showed that the MSE of the reconstructed image (RI) was greatly lower than that of the non-RI (P > 0.05); the SNR and CNR of the RI were greatly higher than that of the non-RI (P > 0.05); the RI was clearer, the artifact and noise were reduced, the image SNR was improved, the boundary of lesion area was clearer, and the overall quality was improved obviously. The CBF values of the frontal lobe, temporal lobe, parietal lobe, thalamus, and cerebellum in the EG were greatly lower than those in the healthy CG (P > 0.05); OEF and CMRO, values in the frontal lobe, temporal lobe, parietal lobe, and cerebellum in the EG were greatly higher than those in the healthy CG (P > 0.05), which indicated that the 3D-MRI image DA based on high order SVD had excellent denoising performance and can improve the image quality. There was ischemic penumbra in CI patients, and the decrease of blood flow and increase of oxygen uptake fraction (OUF) can provide the basis for clinical diagnosis.

Purpose Early recurrence of glioblastoma after standard treatment makes patient care challenging. This study aimed to assess preoperative magnetic resonance imaging (MRI) radiomics for predicting early recurrence of glioblastoma. Patients and Methods A total of 122 patients (training cohort: n = 86; validation cohort: n = 36) with pathologically confirmed glioblastoma were included in this retrospective study. Preoperative brain MRI images were analyzed for both radiomics and the Visually Accessible Rembrandt Image (VASARI) features of glioblastoma. Models incorporating MRI radiomics, the VASARI parameters, and clinical variables were developed and presented in a nomogram. Performance was assessed based on calibration, discrimination, and clinical usefulness. Results The nomogram consisting of the radiomic signatures, the VASARI parameters, and blood urea nitrogen (BUN) values showed good discrimination between the patients with early recurrence and those with later recurrence, with an area under the curve of 0.85 (95% CI, 0.77-0.94) in the training cohort and 0.84 [95% CI, 0.71-0.97] in the validation cohort. Decision curve analysis demonstrated favorable clinical application of the nomogram. Conclusion This study showed the potential usefulness of preoperative brain MRI radiomics in predicting the early recurrence of glioblastoma, which should be helpful in personalized management of glioblastoma.

目的 探讨CT增强检查中合理提高对比剂注入前预注射生理盐水的流速在减少肿瘤非首疗程化疗患者对比剂外渗发生率中的应用价值.方法 选取2019年7月至2020年10月在中南大学湘雅医院肿瘤化疗科接受非首疗程化疗行常规CT增强检查的1266例患者分为A组、B组、C组、D组、E组及F组,A组采用与对比剂相同速率(2.0 mL/s)进行生理盐水预注射,B组、C组、D组、E组及F组采用较对比剂注射流速依次递增0.1 mL/s速率进行生理盐水预注射.比较6组预注射外渗率及当各组预注射均未发生外渗时出现的对比剂外渗率情况.结果 A组与B组、C组及D组预注射外渗率比较,差异无统计学意义(P＞0.05).A组预注射外渗率低于E组和F组,差异有统计学意义(P＜0.05).A组与B组对比剂外渗率比较,差异无统计学意义(P＞0.05).A组对比剂外渗率高于C组、D组、E组和F组,差异有统计学意义(P＜0.05).结论 合理提高生理盐水预注射速率,能够有效降低肿瘤非首疗程化疗患者CT增强检查时对比剂的外渗风险.

Previous studies have suggested that resting-state functional connectivity plays a central role in the physiopathology of major depressive disorder (MDD). However, the individualized diagnosis of MDD based on resting-state functional connectivity is still unclear, especially in first episode drug-naive patients with MDD. Resting state functional magnetic resonance imaging was enrolled from 30 first episode drug-naive patients with MDD and age- and gender-matched 31 healthy controls. Whole brain functional connectivity was computed and viewed as classification features. Multivariate pattern analysis (MVPA) was performed to discriminate patients with MDD from controls. The experimental results exhibited a correct classification rate of 82.25% (p < 0.001) with sensitivity of 83.87% and specificity of 80.64%. Almost all of the consensus connections (125/128) were cross-network interaction among default mode network (DMN), salience network (SN), central executive network (CEN), visual cortex network (VN), Cerebellum and Other. Moreover, the supramarginal gyrus exhibited high discriminative power in classification. Our findings suggested cross-network interaction can be used as an effective biomarker for MDD clinical diagnosis, which may reveal the potential pathological mechanism for major depression. The current study further confirmed reliable application of MVPA in discriminating MDD patients from healthy controls.

OBJECTIVES To evaluate the image quality of magnetic resonance 3D-sampling perfection with application-optimized contrasts by using different filp angle evolutions (3D-SPACE) sequence combined with different fusion methods in image fusion technology and the application value of fusion technology in preoperative evaluation of pituitary macroadenoma. METHODS We collected MRI data of 43 patients with pituitary macroadenoma confirmed by Xiangya Hospital of Central South University, including collecting conventional MRI scan+enhancement, 3D-SPACE T2WI, and 3D-SPACE T1WI+C image data. 3D-SPACE sequence fusion was used in 6 combinations of 3D-SPACE T2WI/3D-SPACE T1WI+C, which were normal phase+normal phase, reverse phase+normal phase, normal phase+reverse phase, reverse phase+reverse phase, and normal phase pseudo color+normal phase, normal phase+normal phase pseudo color. Two senior radiologists used semi-quantitative methods to evaluate and compare the image quality of different combinations to obtain the best fusion mode. According to the degree of tumor invasion of the optic chiasma, oculomotor nerve, and cavernous sinus vessels, the MRI enhancement, 3D-SPACE T2WI, 3D-SPACE T1WI+C, and 2 3D-SPACE sequence fusion images were performed according to a three-level score system. Taking the intraoperative observation as the gold standard, Fisher probability exact method was used to compare different sequences to show the difference between the degree of invasion of the pituitary macroadenoma to the surrounding tissue and the intraoperative results. RESULTS The Kruskal-Wallis H rank sum test showed that among the 6 image fusion modes, 3D-SPACE T1WI+C normal phase pseudo-color and 3D-SPACE T2WI normal phase fusion images had the best quality (P<0.05). No significance was observed among the 4 groups in the evaluation of consistency between the intraoperative findings and the graphically displayed extent of tumor invasion into oculomotor nerve (both level I, II, and III, P>0.05). The 3D-SPACE T2WI/3D-SPACE T1WI+C fusion images and the 3D-SPACE T2WI images showed better performance in the evaluation of consistency between the intraoperative findings and the graphically displayed extent of tumor invasion into optic chiasma (level II and III) than that in other two kinds of imaging data of the MRI enhancement group and 3D-SPACE T1WI+C group (P<0.01, P<0.05, respectively), with no significance being observed in level I. The 3D-SPACE T2WI/3D-SPACE T1WI+C fusion images and the 3D-SPACE T1WI+C images showed better performance in the evaluation of consistency between the intraoperative findings and the graphically displayed extent of tumor invasion into cavernous sinus vessels (level II) than that in other two kinds of imaging data of the MRI enhancement group and 3D-SPACE T2WI group (P<0.01, P<0.05, respectively), with no significance being observed in level I and III. CONCLUSIONS Magnetic resonance 3D-SPACE sequence combined with image fusion technology is better than conventional magnetic resonance sequence for showing pituitary macroadenoma invasion of skull base vascular nerves. The invasion is better than the 3D-SPACE sequence alone, showing that the relationship between tumor and cavernous sinus vascular grade II better than the 3D-SPACE sequence alone. It has good application prospects for preoperative risk assessment and surgical plan.

Objective To evaluate the capability of magnetic resonance imaging 3D-sampling perfection with application optimize contrasts using different flip angle evolution (MRI 3D-SPACE) full-volume scanning sequence to detect lower extremity deep vein thrombosis (LEDVT),and to explore the characteristics of the images of LEDVT and surrounding soft tissue at different stages.Methods MRI 3D-SPACE full volume T1WI and T2WI scanning of lower limb were performed on 45 patients diagnosed of LEDVT via digital subtraction angiography (DSA) by Siemens Prisma 3T MRI scanner.43 cases completed scanning.The location and quantity of vascular segment lesions were recorded,of which the diagnostic sensitivity,specificity and accuracy were calculated comparing to the gold standard of DSA results.The characteristics of magnetic resonance imaging signals of thrombus and thrombus surrounding soft tissue at different times were summarized.Results According to the location of thrombosis,there were 15 cases of central type,17 cases of peripheral type and 11 cases of mixed type.In all imaging levels,272 segments of embolic vessels were found in 3D-space T1WI and 261 segments in 3D-space T2WI.Compared with the DSA results,the sensitivity,specificity,and accuracy of the two groups in the diagnosis of deep venous thrombosis were:T1 WI:Common iliac vein 97.10％,97.90％,98.20％;External iliac vein 96.80％,97.60％,97.10％;Internal iliac vein 96.40％,97.20％,97.20％;Femoral vein 98.10％,98.20％,98.50％;Popliteal vein 94.40％,93.50％,93.70％;The anterior tibial vein is 94.30％,88.50％ and 90.40％.The posterior tibial vein is 93.40％,85.20％,85.30％.T2WI:Common iliac vein 97.10％,97.90％,97.10％;External iliac vein 96.50％,96.20％,96.00％;Internal iliac vein 96.20％,96.60％,96.20％;Femoral vein 98.10％,98.20％,98.50％;Popliteal vein 93.40％,92.50％,92.70％;The anterior tibial vein is 90.30％,86.50％ and 85.40％;Posterior tibial vein 89.40％,84.20％,83.30％.According to the onset time,17 cases in the acute phase,the thrombus was equal or slightly higher and uneven signal in the two groups of sequences,the perivascular and muscle tissue gap signal increased;21 cases in the subacute phase,the thrombus was high in both groups signal;5 cases in the chronic phase,the thrombus showed equal or slightly lower signal in the two groups of sequences,the blood vessel wall was irregular,and the surrounding soft tissue was mild or no obvious edema.Conclusions MRI 3D-space sequence full volume scanning technology has high sensitivity,high specificity and high accuracy for the diagnosis of lower extremity deep vein thrombosis,and can reflect the characteristics of thrombus and soft tissue signal around thrombus in different periods.It has high application value for the early detection of thrombosis and the stage diagnosis of the course of disease.

目的 制备装载壳聚糖修饰氧化铁的聚酰胺-胺(PAMAM)纳米粒(磁性PAMAM纳米粒),并对其理化性质进行表征,观察其体外MR显像效果.方法 以壳聚糖修饰氧化铁和PAMAM-COOH为原料,采用单乳化法制备磁性PAMAM纳米粒.以激光共聚焦扫描显微镜及透射电镜观察其表面及内部结构;Malvern激光分析仪测量其粒径大小、分布及表面电位;X射线粉末衍射仪分析其内部物象结构;原子吸收光谱法测量样品中Fe的浓度;热重分析法分析其内装载的Fe3O4的量.将稀释到不同浓度的磁性PAMAM纳米粒分别置于Eppendof管中,行MR扫描.结果 所得样品为棕褐色混悬液,大小均匀,粒径为(183.26±41.39)nm,多分散指数为0.012,粒径分布较窄;Zeta电位为(-46.24±4.36)mV;透射电镜和射线粉末衍射法证实其内包裹大量Fe3O4颗粒;原子吸收光谱法计算得Fe3O4的包封率为41.2％,Fe3O4的负载量为1.048％.体外MR显像显示,所得样品能使T2*信号强度降低,且样本中Fe浓度越大,其信号强度越低.结论 制备所得磁性PAMAM纳米粒粒径小、分布窄,能有效降低T2*信号强度,为构建潜在多功能MRI分子探针奠定了基础.

目的：对比320层CT血管造影（CTA）与数字减影血管造影（DSA）在老年下肢动脉闭塞性病变诊断中的应用效果。方法选取2011年5月至2013年5月在该院行下肢动脉CTA及DSA检查的28例老年下肢动脉闭塞性病变患者，将肾动脉水平以下的单侧下肢动脉和腹主动脉分为15个节段，共840个节段，对比320层CTA与DSA的诊断准确率、特异性、敏感性及显示的节段数。结果在全部的840个节段中，320层CTA诊断的准确率、特异性、敏感性分别为99％、98％、99％，DSA诊断的准确率、特异性、敏感性分别为99％、99％、99％。评估腘动脉以下区的动脉节段时320层CTA和DSA诊断的准确率、特异性、敏感性均98％、99％、100％；评估股动脉-腘动脉区节段时320层CTA诊断的准确率、特异性、敏感性分别为98％、98％、99％，DSA诊断分别为99％、98％、98％；评估主动脉-髂动脉区节段时320层 CTA诊断的准确率、特异性、敏感性分别为97％、98％、98％，DSA诊断分别为98％、98％、97％。另有1例腘动脉以下节段在320层CTA显影不清晰，50个节段在 DSA检查中显示不清晰，无法进行评估。结论320层CTA对老年下肢动脉闭塞性病变的诊断具有较高的准确率、特异性、敏感性，与 DSA 基本一致，且较 DSA能够显示出更多的节段。可作为老年下肢动脉闭塞性病变患者制定介入治疗方案的参考依据。

目的 探讨眶内视路病变患者的病因及MRI扫描序列的成像特点,制定合理的扫描方案.方法 对628例疑似眶内视路病变患者使用西门子SONATA 1.5T磁共振扫描仪扫描,扫描序列均采用T2 WI,T1WI,短时反转恢复序列STIR,液体信号衰减反转恢复序列Darkfluid,增强T1WIFS序列,薄层小视野三维扫描.结果 628例疑似眶内视路病变患者行SONA-TA 1.5T磁共振扫描检查,共检出病变总阳性率为76.9％ (483/628),其中球内病变78例,占16.1％,眼眶病变及视路外压性病变272例,占56.3％,视神经炎133例,占27.5％.Darkfluid序列对于显示球内病变阳性率[88.5％ (69/78)]显著高于传统T1WI,T2WI[20.5％ (16/78)、34.6％(27/78),x2=47.78,72.61,P＜0.01]；T1WIFS对于眼眶病变及视路外压性病变显示优于常规T1WI,T2WI[89.3％ (243/272) vs 32.7％ (89/272)、60.7％ (165/272),x2=183.30,59.65,P＜0.01]；STIR序列显示视神经炎检出率[73.7％(98/133)]均高于T1WI、T2 WI及T1WIFS[27.8％(37/133)、44.4％(59/133)、59.4％(79/133),x2=55.97,23.64,6.10,P＜0.01].结论 根据引起眶内视路病变的病因采用不同的MRI序列能很好的发现引起视力下降的各种眶内视路病变.Darkfluid(水抑制)能更好显示眼球内占位性病变；增强T1WIFS序列对于眼眶病变及视路外压性病变显示优于传统T2WI,T1WI序列；冠状面STIR序列显示视神经炎最佳。

【Objectives】To recognize the MRI findings of Hirayama disease, and to evaluate its clinical value. 【Methods】Eight patients with Hirayama disease confirmed clinically underwent pre and post contrast neutral and flexion position cervical MRI. The MR images were reviewed and analyzed retrospectively. 【Results】The neutralposition cervical MRI manifestations were as follows: straight cervical curvature in 5 cases, kyphotic cervical curvature in one case, localized lower cervical cord atrophy and flattening in 5 cases, and loss of attachment between the posterior dural sac and subjacent lamina in 4 cases. The anterior shifting of cervical dural sac and posterior epidural crescent-shaped component with flow voids were noted in all eight cases at flexion position. The posterior epidural component enhanced significiantly after intravenous contrast examination and disappeared when the patient returned to a neutral position.【Conclusion】Hirayama disease has some characteristic features on cervical MRI. The pre and post contrast neutral and flexion position cervical MRI can be used as a routine aided method for the diagnosis of Hirayama disease.

Objective To study the value and safety of perfusion-weighted MR imaging with large dose of Gd-DTPA in the diagnosis of intracranial tumors.Methods MR PWI with FID-EPI sequence was performed in 36 patients with intracranial tumors,including 15 cases of low-grade(grade Ⅰ-Ⅱ) glioma,12 cases with highgrade(grade Ⅲ-Ⅳ) glioma,7 cases with meningioma,one case with cholesteatoma and one case with choroid plexus papilloma.The tumors' rCBV were measured on the pseudo-color images of CBV,which were undertook t test.The safty of PWI with large dose of Gd-DTPA was evaluated by writing down the appearances of patients and adverse reactions of Gd-DTPA.Results The difference of rCBV between low-grade gliomas and high-grade gliomas,meningiomas were statistically significant(P0.05).However,the rCBV between high-grade glimoas and meningiomas showed no statistic difference(P0.05).One choroid plexus papilloma and one cholesteatoma showed hypertransfusion(9.15) and hypoperfusion(0.09) respectively.No allergic reactions of drug occurred in 36 patients.Conclusion PWI with large dose of Gd-DTPA is helpful in grading gliomas and differential diagnosis of intracranial tumors,which is safe in clinic application.

Objective To explore the application value of magnetic resonance cholangiopancreatography (MRCP) before and after oral ferric ammonium citrate (FAC) solution administration (MRCP pre+post). Methods A total of 86 patients suspected of biliary tract and pancreatic diseases underwent MRCP and conventional MRI before and after oral FAC solution administration. Not only the image quality of MRCP before and after the administration but also the diagnostic accuracy of MRCP before the administration (MRCPpre) and MRCPpre+post were studied self comparatively by two experienced radiologists. Results The high signal from the stomach and duodenum fluid was suppressed completely, the image quality of single-slice and multi-slice MRCP was improved markedly (P0.001). When combined with conventional MRI, the locative and qualitative diagnostic accuracy of MRCPpre+post were higher than those of MRCPpre (P0.05). Conclusion Oral ferric ammonium citrate solution administration can significantly improve the image quality of MRCP. MRCPpre+post is of important clinical value in diagnosing biliary tract and pancreatic diseases.