BACKGROUND:Left atrial (LA) strain and left atrioventricular coupling index (LACI) independently predict prognosis in multiple cardiovascular diseases, but their prognostic value in chronic myocarditis remains unclear. This study aimed to evaluate the prognostic value of CMR-derived LA strain and LACI in patients with chronic myocarditis. METHODS:This single-center retrospective study included patients suspected of chronic myocarditis who underwent CMR from June 2019 to October 2024. CMR-derived LA functional parameters, LACI, as well as clinical characteristics and outcomes were collected. Composite endpoints included major adverse cardiovascular events and arrhythmia (including ventricular premature beats and intraventricular conduction block). Multivariable Cox regression identified predictive parameters. RESULTS:A total of 113 patients (mean age 50 ± 12 years; 62 males) were enrolled. After a median follow-up of 24 months, 17 (15.0%) patients experienced composite events. Multivariable Cox regression showed that LA reservoir strain (adjusted HR = 0.770, 95%CI: 0.631-0.894, P = 0.003) and LA conduit strain (adjusted HR = 0.770, 95%CI: 0.615-0.911, P = 0.007) were independent predictors of composite events. LA reservoir strain and LA conduit strain had high negative predictive values (98.6% and 97.5%, respectively) and sensitivities (94.1% and 88.2%, respectively) for ruling out composite events, with statistical significance. The integrated model incorporating traditional CMR parameters, LARS, and LACS exhibited the best predictive performance (AUC=0.906, 95% CI: 0.788-0.973). CONCLUSION:CMR-derived LA reservoir and conduit strains are independent predictors of adverse clinical outcomes in patients with chronic myocarditis, serving as reliable "rule-out" tools for composite events. Additionally, the combined model of these two strains exhibits excellent predictive performance for composite events.

Background Identifying prognostic factors for severe COVID-19 pneumonia during the Omicron wave remains crucial for early risk stratification and improving patient outcomes. This study aimed to identify and analyze key clinical and CT imaging features associated with survival in patients with severe pneumonia caused by the SARS-CoV-2 Omicron variant.Methods This retrospective study included patients presenting to the emergency department of Shandong Provincial Hospital (December 2022-January 2023) with confirmed SARS-CoV-2 Omicron infection and severe pneumonia. Clinical/laboratory data and CT imaging features were systematically collected and evaluated. Patients were randomly divided into training (70%) and validation (30%) cohorts. Univariate and multivariate analyses were rigorously applied to identify significant baseline clinical and CT imaging features associated with survival. A predictive nomogram was constructed based on the selected feature combination.Results Among 1,739 COVID-19 patients, 151 (8.68%) had severe pneumonia (median age 75, 70.1% male). Multivariate logistic regression analysis identified a critical combination of features independently associated with survival: CT findings of pleural effusion (p = 0.008) and cardiac enlargement (p = 0.008), along with clinical/laboratory factors including reduced baseline pulse oxygen saturation (p = 0.034), elevated SAA (p = 0.020), elevated GLU (p = 0.022), and reduced Ca concentration (p = 0.029). The nomogram integrating these combined features demonstrated good predictive performance for in-hospital mortality (AUC: training cohort 0.914, validation cohort 0.802).Conclusion This study identifies a distinct combination of clinical and CT imaging features (pleural effusion, cardiac enlargement, low SpO2, elevated SAA, elevated GLU, low Ca) as key independent prognostic factors for survival in severe Omicron pneumonia. The predictive tool based on this feature combination shows significant clinical utility. These preliminary findings provide critical insights for early risk assessment and targeted management, facilitating improved patient prognosis.

Cerebral blood volume (CBV) maps play an important role in the differential diagnosis between glioblastoma recurrence and treatment response. However, it needs high injective velocity. This study aimed to synthesize CBV maps from arterial spin labeling (ASL) and standard MRI sequences using a deep learning method and to validate its discriminating value. A total of 744 MRI scans from 364 patients were included in this retrospective, single-institution study. A three-dimensional (3D) incrementable encoder–decoder network (IEDN) designed for an asymmetrical sample size was trained to synthesize the CBV maps from ASL and the standard MRIs. The synthetic performance was evaluated quantitatively using the structural similarity index (SSIM) and the peak signal-to-noise ratio (PSNR) and qualitatively using a four-point Likert scale (from 0 to 3). In 96 patients suspected of glioblastoma recurrence vs. treatment response as the external test set from a hospital-based cohort, the difference in the additive value between synthetic CBV maps and ASL to standard MRIs was examined using the Z test. The best algorithm appeared to be achieved by the 3D IEDN with ASL + T1-weighted imaging (T1WI) + T2-weighted imaging (T2WI) + apparent diffusion coefficient (ADC) maps + post-contrast T1WI (SSIM = 88.69 ± 3.97%, PSNR = 32.76 ± 3.39 dB). For the image quality scores, the mean image quality score for all synthetic CBV maps was 2.90. Standard MRI plus synthetic CBV maps had better performance than standard MRI and ASL scans in the differential diagnosis between tumor recurrence and treatment response (p = 0.019). Therefore, 3D IEDN produced qualified synthetic CBV maps without the need for high injective velocity from ASL and standard MRIs. The synthetic CBV maps achieved better performance in the differential diagnosis between glioblastoma recurrence and treatment response.

OBJECTIVE:The objective of this study is to examine the evolving cardiac characteristics of patients with cardiac amyloidosis (CA) and hypertrophic cardiomyopathy (HCM) by integrating multimodal imaging techniques, including conventional echocardiography, strain echocardiography, and cardiac magnetic resonance imaging. METHODS:A retrospective study was conducted, comprising 38 patients with CA, 20 patients with HCM, and 16 healthy individuals in the control group. Statistical analyses were conducted to assess conventional and strain echocardiography parameters across these groups. Furthermore, cardiac magnetic resonance imaging data from 15 patients with CA and 15 patients with HCM were analyzed and compared, focusing on correlations between imaging parameters and myocardial amyloid load. RESULTS:Analysis of conventional and strain echocardiography revealed that left ventricular ejection fraction, E/e', relative apical longitudinal sparing, and the ejection fraction-to-longitudinal strain ratio were strongly associated with the diagnosis of CA and served as key differentiators between the CA and HCM groups. The combination of these four parameters yielded optimal diagnostic efficiency, with an area under the curve of 0.916. CONCLUSION:The integration of conventional and strain multiparametric echocardiography demonstrated superior diagnostic efficacy in differentiating CA from HCM. Furthermore, the analysis of cardiac magnetic resonance parameters indicated that an increase in cardiac amyloid load is associated with changes in cardiac indices, with parameters such as E/e', basal longitudinal strain, global longitudinal strain, and ejection fraction-to-strain ratio effectively reflecting the extent of amyloid infiltration in the myocardium.

Our study aimed to explore the calcification patterns of culprit lesions associated with artery-to-artery embolism (AAE) infarction in patients with vertebrobasilar artery atherosclerosis, using vessel wall magnetic resonance imaging (VW-MRI) and computed tomography (CT). We retrospectively analyzed data from patients undergoing VW-MRI and CT scans at two institutions. Patients with ≥ 50% vertebrobasilar atherosclerotic stenosis were categorized based on their stroke mechanisms as AAE (+) and AAE (-). Calcification profiles of the culprit lesion, including the morphology, location, quantity, and VW-MRI characteristics were compared among stroke patients. Multivariate logistic regression model was used to evaluate the relationship between vertebrobasilar artery calcification characteristics and the presence of AAE (+). Among the 151 stroke patients included, 56 (37.09%) were classified as AAE (+), while 95 (62.91%) as AAE (-). Multivariate regression analysis revealed the odds ratio of AAE (+) was 2.69 and 2.15 for the presence and count of spotty calcification, 3.33 for intimal-predominant calcification, and 3.65 for multiple calcifications. Calcification characteristics observed at the culprit lesion were associated with posterior circulation infarction in patients exhibiting AAE infarction. Understanding the relationship between intracranial artery calcification and stroke mechanisms may help clinicians improve stroke prevention and treatment.

ObjectivesThe aim of this study was to extract radiomic features from vertebrobasilar artery calcification (VBAC) on head computed tomography (CT) images and investigate its diagnostic performance to identify culprit lesions responsible for acute cerebral infarctions.MethodsPatients with intracranial atherosclerotic disease who underwent vessel wall MRI (VW-MRI) and head CT examinations from a single center were retrospectively assessed for VBAC visual and textural analyses. Each calcified plaque was classified by the likelihood of having caused an acute cerebral infarction identified on VW-MRI as culprit or non-culprit. A predefined set of texture features extracted from VBAC segmentation was assessed using the minimum redundancy and maximum relevance method. Five key features were selected to integrate as a radiomic model using logistic regression by the Aikaike Information Criteria. The diagnostic value of the radiomic model was calculated for discriminating culprit lesions over VBAC visual assessments.ResultsA total of 1,218 radiomic features were extracted from 39 culprit and 50 non-culprit plaques, respectively. In the VBAC visual assessment, culprit plaques demonstrated more observed presence of multiple calcifications, spotty calcification, and intimal predominant calcification than non-culprit lesions (all p < 0.05). In the VBAC texture analysis, 55 (4.5%) of all extracted features were significantly different between culprit and non-culprit plaques (all p < 0.05). The radiomic model incorporating 5 selected features outperformed multiple calcifications [AUC = 0.81 with 95% confidence interval (CI) of 0.72, 0.90 vs. AUC = 0.61 with 95% CI of 0.49, 0.73; p = 0.001], intimal predominant calcification (AUC = 0.67 with 95% CI of 0.58, 0.76; p = 0.04) and spotty calcification (AUC = 0.62 with 95% CI of 0.52, 0.72; p = 0.005) in the identification of culprit lesions.ConclusionCulprit plaques in the vertebrobasilar artery exhibit distinct calcification radiomic features compared to non-culprit plaques. CT texture analysis of VBAC has potential value in identifying lesions responsible for acute cerebral infarctions, which may be helpful for stroke risk stratification in clinical practice.

ObjectiveThe meta-analysis aimed to explore the cardiac adaptation in hypothyroidism patients by cardiac magnetic resonance.Research methods and proceduresDatabases including PubMed, Cochrane Library, Embase, CNKI, and Sinomed for clinical studies of hypothyroidism on cardiac function changes. Databases were searched from the earliest data to 15 June 2023. Two authors retrieved studies and evaluated their quality. Review Manager 5.4.1 and Stata18 were used to analyze the data. This study is registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY), 202440114.ResultsSix studies were selected for further analysis. Five of them reported differences in cardiac function measures between patients with hypothyroidism and healthy controls, and three studies reported cardiac function parameters after treatment in patients with hypothyroidism. The fixed-effect model combined WMD values for left ventricular ejection fraction (LVEF) had a pooled effect size of -1.98 (95% CI -3.50 to -0.44], P=0.01), implying that LVEF was lower in patients with hypothyroidism than in healthy people. Analysis of heterogeneity found moderate heterogeneity (P = 0.08, I² = 50%). WMD values for stroke volume (SV), cardiac index (CI), left ventricular end-diastolic volume index(LVEDVI), left ventricular end-systolic volume (LESVI), and left ventricular mass index(LVMI) were also analyzed, and pooled effect sizes showed the CI and LVEDVI of patients with hypothyroidism ware significantly decrease (WMD=-0.47, 95% CI [-0.93 to -0.00], P=0.05, WMD=-7.99, 95%CI [-14.01 to -1.96], P=0.009, respectively). Patients with hypothyroidism tended to recover cardiac function after treatment [LVEF (WMD = 6.37, 95%CI [2.05, 10.69], P=0.004), SV (WMD = 7.67, 95%CI [1.61, 13.74], P=0.01), CI (WMD = 0.40, 95%CI [0.01, 0.79], P=0.05)], and there was no difference from the healthy controls.ConclusionHypothyroidism could affect cardiac function, although this does not cause significant heart failure. It may be an adaptation of the heart to the hypothyroid state. There was a risk that this adaptation may turn into myocardial damage. Cardiac function could be restored after treatment in patients with hypothyroidism. Aggressive levothyroxine replacement therapy should be used to reverse cardiac function.Systematic review registrationhttps://inplasy.com, identifier (INPLASY202440114).

Abstract Background We investigated the value of three-dimensional amide proton transfer-weighted imaging (3D-APTWI) in the diagnosis of early-stage breast cancer (BC) and its correlation with the immunohistochemical characteristics of malignant lesions. Methods Seventy-eight women underwent APTWI and dynamic contrast-enhanced (DCE)-MRI. Pathological results were categorized as either benign (n = 43) or malignant (n = 37) lesions. The parameters of APTWI and DCE-MRI were compared between the benign and malignant groups. The diagnostic value of 3D-APTWI was evaluated using the area under the receiver operating characteristic curve (ROC-AUC) to establish a diagnostic threshold. Pearson’s correlation was used to analyze the correlation between the magnetization transfer asymmetry (MTRasym) and immunohistochemical characteristics. Results The MTRasym and time-to-peak of malignancies were significantly lower than those of benign lesions (all p < 0.010). The volume transfer constant, rate constant, and wash-in and wash-out rates of malignancies were all significantly greater than those of benign lesions (all p < 0.010). ROC-AUCs of 3D-APTWI, DCE-MRI, and 3D-APTWI+DCE to differential diagnosis between early-stage BC and benign lesions were 0.816, 0.745, and 0.858, respectively. Only the difference between AUCAPT+DCE and AUCDCE was significant (p < 0.010). When a threshold of MTRasym for malignancy for 2.42%, the sensitivity and specificity of 3D-APTWI for BC diagnosis were 86.5% and 67.6%, respectively; MTRasym was modestly positively correlated with pathological grade (r = 0.476, p = 0.003) and Ki-67 (r = 0.419, p = 0.020). Conclusions 3D-APTWI may be used as a supplementary method for patients with contraindications of DCE-MRI. MTRasym can imply the proliferation activities of early-stage BC. Relevance statement 3D-APTWI can be an alternative diagnostic method for patients with early-stage BC who are not suitable for contrast injection. Key points • 3D-APTWI reflects the changes in the microenvironment of early-stage breast cancer. • Combined 3D-APTWI is superior to DCE-MRI alone for early-stage breast cancer diagnosis. • 3D-APTWI improves the diagnostic accuracy of early-stage breast cancer. Graphical Abstract

Background: Myocardial microcirculation dysfunction is the most potent predictor of adverse cardiovascular events in hypertension. The current study aimed to apply intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) to assess hypertension-related microcirculation dysfunction. Methods: In this prospective study, 102 participants were recruited from our hospital and underwent cardiac magnetic resonance (CMR) examination on a 3T scanning system. Hypertensive patients were divided into 3 subgroups based on blood pressure (BP) types. Two experienced CMR radiologists independently analyzed all images, and Bland-Altman analysis was applied to assess intra- and inter-observer reproducibility. Cardiac function indexes and IVIM-DWI parameters were compared between the hypertension and healthy control groups, as well as among the three hypertension subgroups. Results: Totally 62 participants with hypertension and 27 healthy controls were included. 13 participants were excluded for poor quality of IVIM-DWI images. Significantly higher maximal left ventricular wall thickness (10.3 +/- 2.0 vs. 8.6 +/- 1.4 mm, P<0.001) and left ventricular mass index (49.0 +/- 9.1 vs. 42.1 +/- 7.5 g/m(2), P<0.05) were observed inhypertension group compared with healthy control group. There were significant statistical differences in pseudo diffusion (D*) between them (81.3 +/- 16.3 vs. 111.8 +/- 18.9 mm(2)/s, P<0.001), as well as among the three hypertension subgroups (99.4 +/- 13.9 vs. 79.7 +/- 10.6 vs. 67.1 +/- 6.6 mm(2)/s, P<0.001). Participants with poor quality of IVIM-DWI images had higher heart rates (72.2 +/- 10.0 vs. 62.0 +/- 8.1 bpm, P<0.001). Conclusions: IVIM-DWI is feasible for quantitatively evaluating myocardial microcirculation dysfunction in hypertension. The D* parameter has a potential value for assessing the severity of microcirculation dysfunction in different BP categories.

Doxorubicin (DOX) is one of the most frequently used chemotherapeutic drugs belonging to the class of anthracyclines. However, the cardiotoxic effects of anthracyclines limit their clinical use. Recent studies have suggested that ferroptosis is the main underlying pathogenetic mechanism of DOX-induced cardiomyopathy (DIC). BTB-and-CNC homology 1 (Bach1) acts as a key role in the regulation of ferroptosis. However, the mechanistic role of Bach1 in DIC remains unclear. Therefore, this study aimed to investigate the underlying mechanistic role of Bach1 in DOX-induced cardiotoxicity using the DIC mice in vivo (DOX at cumulative dose of 20 mg/kg) and the DOX-treated H9c2 cardiomyocytes in vitro (1 μM). Our results show a marked upregulation in the expression of Bach1 in the cardiac tissues of the DOX-treated mice and the DOX-treated cardiomyocytes. However, Bach1−/− mice exhibited reduced lipid peroxidation and less severe cardiomyopathy after DOX treatment. Bach1 knockdown protected against DOX-induced ferroptosis in both in vivo and in vitro models. Ferrostatin-1 (Fer-1), a potent inhibitor of ferroptosis, significantly alleviated DOX-induced cardiac damage. However, the cardioprotective effects of Bach1 knockdown were reversed by pre-treatment with Zinc Protoporphyrin (ZnPP), a selective inhibitor of heme oxygenase-1(HO-1). Taken together, these findings demonstrated that Bach1 promoted oxidative stress and ferroptosis through suppressing the expression of HO-1. Therefore, Bach1 may present as a promising new therapeutic target for the prevention and early intervention of DOX-induced cardiotoxicity.

of hypothyroidism patients, (3) clinical study.And exclusion criteria was poor methodological quality.Information sources PubMed, Cochrane Library, Embase, CNKI, and Sinomed. Main outcome(s)Compared with healthy people, the decline of cardiac function indexes in patients with hypothyroidism, such as LVEF, LV Volume, SV, CI, LV Mass. Quality assessment / Risk of bias analysisThe quality of RCT and Case-control studies was assessed using NOS scales.Other types of studies used JBI scores.the studies. Country(ies) involvedChina.

Approximately 15-20% of the patients with breast cancer overexpress human epidermal growth factor receptor 2 ( HER2 ). HER2 -positive breast cancer is highly aggressive and has a high relapse rate, suggesting that it is prone to and progresses rapidly after drug resistance. Pyrotinib resistance and changes in patients' conditions after drug resistance are challenging clinical issues and require medical attention. Recently, there are few clinical reports on changes in patients' conditions after pyrotinib resistance. We report a case of a 46-year-old patient with HER2 -positive breast cancer who developed resistance to pyrotinib and rapidly progressed to uncontrolled liver failure in less than a week. To elucidate the cause of the rapid progression, we collected samples of the patient's ascites and performed next-generation sequencing (NGS). On the basis of the NGS results, we speculated that the rapid progression after pyrotinib resistance might be due to RET gene fusion and TP53 gene mutations. Therefore, this case report aims to alert oncologists that patients with HER2 -positive breast cancer, who are resistant to pyrotinib or other targeted drugs, could experience rapid or even flare-up progression and that RET gene fusion and TP53 gene mutations might be potential causes.

Triple-negative breast cancers (TNBC) represent a pathological subtype of breast cancer, which are characterized by strong invasiveness, high metastasis rate, low survival rate, and poor prognosis, especially in patients who have developed resistance to multiline treatments. Here, we present a female patient with advanced TNBC who progressed despite multiple lines of treatments; next-generation sequencing (NGS) was used to find drug mutation targets, which revealed a coiled-coil domain-containing protein 6 (CCDC6)-rearranged during transfection (RET) gene fusion mutation. The patient was then given pralsetinib, and after one treatment cycle, a CT scan revealed partial remission and adequate tolerance to therapy. Pralsetinib (BLU-667) is a RET-selective protein tyrosine kinase inhibitor that can inhibit the phosphorylation of RET and downstream molecules as well as the proliferation of cells expressing RET gene mutations. This is the first case in the literature of metastatic TNBC with CCDC6-RET fusion treated with pralsetinib, an RET-specific antagonist. This case demonstrates the potential efficacy of pralsetinib in cases of TNBC with RET fusion mutations and suggests that NGS may reveal new opportunities and bring new therapeutic interventions to patients with refractory TNBC.

Background and aims: It remains unknown about the relationship between vertebrobasilar artery (VBA) calcifi-cation and plaque instability. We aimed to investigate the characteristics of VBA calcification using vessel wall magnetic resonance imaging (MRI) and computed tomography (CT) and its association with acute cerebral infarction (ACI).Methods: Nine hundred and thirty patients with VBA stenosis who underwent vessel wall MRI and CT exami-nations were evaluated retrospectively. Calcification morphology was classified as either intimal or non-intimal predominant using a CT-pathology-validated grading method. Qualitative and quantitative plaque MRI variables and calcification characteristics were compared between culprit and non-culprit lesions. The association between VBA calcification and the occurrence of culprit lesions was investigated using multivariate logistic regression.Results: A total of 150 patients with ACI and 142 patients without ACI were eligible for subsequent analyses, respectively. In the qualitative analysis, T1 hyperintensity (p < 0.001) and intimal predominant calcification (p = 0.021) were more frequently observed in the culprit than non-culprit lesions. In the quantitative analyses, culprit lesions had a larger stenosis degree, plaque length, normal wall index, contrast enhancement ratio, lower calcification density and smaller calcification volume than non-culprit lesions (p all < 0.05). Intimal predominant calcification (odds ratio [OR], 2.51; 95 % confident interval [CI], 1.31-4.82, p = 0.006) and calcification density (OR, 0.53; 95 % CI, 0.35-0.78, p = 0.001) were independently associated with the presence of ACI after adjusting for clinical risk factors and plaque variables.Conclusions: Intimal predominant calcification in vertebrobasilar atherosclerosis is associated with the likelihood of having caused acute cerebral infarction. The morphology and density of VBA calcification may provide insight into stroke risk stratification in the posterior circulation.

新辅助治疗(NAT)是乳腺癌综合治疗的重要组成部分.目前,NAT疗效评估的金标准是组织病理学,但其需要术后标本,存在明显滞后性.准确评估和预测NAT疗效对及时改进治疗方案、确定精准的手术计划具有重要价值.已有多种影像学检查方法被用于乳腺癌NAT疗效评估与预测,其中磁共振(MR)检查因其优越的软组织分辨力和多方位、多参数成像特点,成为准确性最高的影像学手段.传统MR成像可从肿瘤长径、体积和退缩模式等形态学改变来评估与预测NAT疗效.近年来随着MR功能成像技术不断更新迭代,动态对比增强磁共振成像、扩散加权成像及体素内不相干运动扩散加权成像、酰胺质子转移成像、磁共振波谱成像等MR功能成像从不同维度实现了对乳腺癌NAT疗效的早期预测,进一步提高了MR成像对NAT疗效的早期预测能力.

PurposeTo confirm the ability of native T1 and T2 values in detecting and monitoring early myocardial injuries of chest radiotherapy in neoplasm patients.Materials and methodsFifteen participants received non-anthracycline chemotherapy and chest radiotherapy, and 30 age/gender-matched controls were enrolled in this prospective study. Cardiac magnetic resonance scans were performed within 2 days, 3 months, and 6 months after chest radiotherapy. Myocardial native T1 and T2 values were measured in irradiated and nonirradiated areas. Meanwhile, the parameters of left ventricular function and left ventricular myocardial strain were obtained.ResultsThere were no significant differences in left ventricular function, native T1, T2, and strain between patients and controls before chest radiotherapy. In 15 participants who were followed up for 6 months, there was a significant change only in left ventricular ejection fraction (LVEF) among baseline and the first follow-up (P = 0.021), while the adjusted P-value was higher than 0.05 after Bonferroni correction, as well as other parameters. Native T1 values were elevated at 3 and 6 months in irradiated areas compared with baseline (1,288.72 ± 66.59 ms vs. 1,212.51 ± 45.41 ms; 1,348.01 ± 54.16 ms vs. 1,212.51 ± 45.41 ms; P < 0.001 for both). However, T2 values only changed at 3 months in irradiated areas compared with baseline (44.21 ± 3.35 ms vs. 39.14 ± 1.44 ms; P = 0.006). Neither the native T1 nor T2 values changed in nonirradiated areas during the follow-up period (all P > 0.05). There were no significant differences in strain changes during the follow-up period (all P > 0.05).ConclusionNative T1 and T2 values elevated at 3 months after chest radiotherapy, whereas LVEF showed no significant change during the 6-month follow-up.

乳腺癌是一类具有高度异质性的恶性肿瘤,严重威胁着女性的生命安全与健康.近年来乳腺癌的发病率不断上升,现已成为全球女性最多发的癌症.早期检出和确诊对乳腺癌对患者的治疗与预后具有重要价值.乳腺癌的检出主要依靠影像检查,其中磁共振成像技术占据了越来越重要的位置.酰胺质子转移(APT)技术是一种新的可无创测定人体内微量蛋白质的MR定量技术,可以反映组织的微观信息,首先被应用于神经系统的鉴别诊断中,近年来,其在乳腺疾病的诊断方面也有了许多新的突破与发现.本文总结了国内外相关研究,较全面地阐述了APT技术的相关基础及其目前在乳腺疾病临床应用中的研究进展.

蒽环类药物(anthracycline,ATC)是常见的化疗药物,具有突出的心脏毒性.蒽环类药物所致心脏毒性(anthracycline-induced cardiotoxicity,AIC)是影响癌症患者生存质量的重要因素.准确检测及正确评估AIC能够为临床诊疗提供重要信息,降低癌症患者出现心血管并发症的风险.心脏磁共振(cardiac magnetic resonance,CMR)具有无创、可重复性好、空间分辨率高、多序列成像等优势,在AIC的基线评估及跟踪随访中起到了重要作用.近年来,包括特征追踪(feature-tracking,FT)技术及mapping技术在内的一系列CMR新技术的发展更是在AIC的早期检测方面发挥了重要的作用.本文将对CMR在检测和评估AIC中的应用及研究进展作一综述.

Background: Coronavirus disease-2019 (COVID-19) epidemic is spreading globally. Sex differences in the severity and mortality of COVID-19 emerged. This study aims to describe the impact of sex on outcomes in COVOD-19 with a special focus on the effect of estrogen. Methods: We performed a retrospective cohort study which included 413 patients (230 males and 183 females) with COVID-19 from three designated hospitals in China with a follow up time from January 31, 2020, to April 17, 2020. Women over 55 were considered as postmenopausal patients according to the previous epidemiological data from China. The interaction between age and sex on in-hospital mortality was determined through Cox regression analysis. In addition, multivariate Cox regression models were performed to explore risk factors associated with in-hospital mortality of COVID-19. Results: Age and sex had significant interaction for the in-hospital mortality ( P < 0.001). Multivariate Cox regression showed that age (HR 1.041, 95% CI 1.009–1.073, P = 0.012), male sex (HR 2.033, 95% CI 1.007–2.098, P = 0.010), the interaction between age and sex (HR 1.118, 95% CI 1.003–1.232, P = 0.018), and comorbidities (HR 9.845, 95% CI 2.280–42.520, P = 0.002) were independently associated with in-hospital mortality of COVID-19 patients. In this multicentre study, female experienced a lower fatality for COVID-19 than male (4.4 vs. 10.0%, P = 0.031). Interestingly, stratification by age group revealed no difference in-hospital mortality was noted in women under 55 compared with women over 55 (3.8 vs. 5.2%, P = 0.144), as well as in women under 55 compared with the same age men (3.8 vs. 4.0%, P = 0.918). However, there was significantly difference in women over 55 with men of the same age group (5.2 vs. 21.0%, P = 0.007). Compared with male patients, female patients had higher lymphocyte ( P < 0.001) and high-density lipoprotein ( P < 0.001), lower high sensitive c reaction protein level ( P < 0.001), and lower incidence rate of acute cardiac injury (6.6 vs. 13.5%, P = 0.022). Conclusion: Male sex is an independent risk factor for COVID-19 in-hospital mortality. Although female mortality in COVID-19 is lower than male, it might not be directly related to the effect of estrogen. Further study is warranted to identify the sex difference in COVID-19 and mechanisms involved.