Primary pulmonary angiosarcoma was misdiagnosed as IgG4-related disease by needle biopsy: A challenging case report.

ABSTRACT: Angiosarcoma is a rare soft tissue sarcoma. Primary angiosarcoma of the lung is even rarer. This case presents a patient with hemoptysis for 3 months. A chest computed tomography (CT) showed multiple patches of nodules with peripheral exudates distributed along the vascular bundles in both lungs, and the biopsy suggested IgG4 disease. However, the hemoptysis worsened for 3 days, and the patient underwent partial resection of the left upper lung, revealing eight masses of 0.5-2 cm in diameter. The tumor was composed of spindle, round, or polygonal cells arranged in bundles or sheets, and tumor cells were positive for vascular tumor markers. The patient was treated with six cycles of paclitaxel combined with gemcitabine chemotherapy, reducing the volume of the masses and improving hemoptysis.

Clinicopathological analysis of sclerosing angiomatoid nodular transformation in the spleen.

Background: Splenic sclerosing angiomatoid nodular transformation (SANT) is a rare benign nodular lesion in the red medulla of the spleen. In the past, SANT has not been consistently recognized as the name for this condition and was often misdiagnosed for other conditions. In recent years, SANT has been acknowledged by most scholars as multiple reports have been published. Aim: To assess the clinicopathological features of SANT to identify the histological characteristics of SANT to improve diagnosis and clinical treatment. Materials and Methods: We assessed 25 cases of SANT diagnosed at Zhongshan Hospital affiliated with Fudan University from September 2014 to October 2021, including 14 men and 11 women, aged 24-62 years old. Results: Fourteen cases were complicated with benign tumors of the liver, pancreas, kidney, uterus, and prostate. One case was complicated with renal clear cell carcinoma, and one was complicated with hepatocellular carcinoma. The gross neoplasm is multinodular and well defined. Histologically, angiomatoid nodules are composed of fattened, round, or irregular blood vessels, with or without red blood cells in the lumen, with unequal red blood cell extravasation, and fibrocytes around the nodules. The hemangiomatous nodules were positive for CD31 and CD34, while the vascular wall smooth muscle cells and fibrocytes around the nodules were positive for SMA. Conclusion: The diagnosis of SANT requires a combination of immunohistochemical and histological features, and early splenectomy is crucial for treatment.

Heat-Assisted Magnetization Switching in Flexible Spin-Orbit Torque Devices.

Heat-assisted magnetic anisotropy engineering has been successfully used in selective magnetic writing and microwave amplification due to a large interfacial thermal resistance between the MgO barrier and the adjacent ferromagnetic layers. However, in spin-orbit torque devices, the writing current does not flow through the tunnel barrier, resulting in a negligible heating effect due to efficient heat dissipation. Here, we report a dramatically reduced switching current density of ∼2.59 MA/cm2 in flexible spin-orbit torque heterostructures, indicating a 98% decrease in writing energy consumption compared with that on a silicon substrate. The reduced driving current density is enabled by the dramatically decreased magnetic anisotropy due to Joule dissipation and the lower thermal conductivity of the flexible substrate. The large magnetic anisotropy could be fully recovered after the impulse, indicating retained high stability. These results pave the way for flexible spintronics with the otherwise incompatible advantages of low power consumption and high stability.

Extranodal nasal-type NK/T-cell lymphoma with CD20 positive: A case report and review of literature.

ABSTRACT: Extranodal nasal-type natural killer (NK)/T-cell lymphoma is a type of non-Hodgkin lymphoma. Neoplastic lymphocytes are positive for CD4, CD56, and CD20, a specific B-cell marker. CD20 positive NK/T-cell lymphoma is rare, with only nine reported cases. This paper reports a case of nasal-type NK/T-cell lymphoma with CD20 positivity in a 47-year-old woman. The patient presented with bilateral nasal congestion and bloody nasal cavity secretions for 2 months. Computed tomography revealed thickening of the nasal mucosa and posterior wall of the nasopharyngeal crest, and the left and right cervical lymph nodes were enlarged. On histopathology, the lesion was composed of medium-sized atypical lymphoid cells and vascular infringement. Immunohistochemical staining showed that the tumor cells were positive for CD20, CD3, CD56, and Epstein-Barr virus (EBV)-encoded RNA in situ hybridization. The patient was treated with radiotherapy for 2 months and is currently well.

Comparison of diffusion tensor imaging (DTI) tissue characterization parameters in white matter tracts of patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD).

OBJECTIVE: To investigate the microstructural properties of T2 lesion and normal-appearing white matter (NAWM) in 20 white matter tracts between multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD) and correlations between the tissue damage and clinical variables. METHODS: The white matter (WM) compartment of the brain was segmented for 56 healthy controls (HC), 48 patients with MS, and 38 patients with NMOSD, and for the patients further subdivided into T2 lesion and NAWM. Subsequently, the diffusion tensor imaging (DTI) tissue characterization parameters of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were compared for 20 principal white matter tracts. The correlation between tissue damage and clinical variables was also investigated. RESULTS: The higher T2 lesion volumes of 14 fibers were shown in MS compared to NMOSD. MS showed more microstructure damage in 13 fibers of T2 lesion, but similar microstructure in seven fibers compared to NMOSD. MS and NMOSD had microstructure damage of NAWM in 20 fibers compared to WM in HC, with more damage in 20 fibers in MS compared to NMOSD. MS patients showed higher correlation between the microstructure of T2 lesion areas and NAWM. The T2 lesion microstructure damage was correlated with duration and impaired cognition in MS. CONCLUSIONS: Patients with MS and NMOSD show different patterns of microstructural damage in T2 lesion and NAWM areas. The prolonged disease course of MS may aggravate the microstructural damage, and the degree of microstructural damage is further related to cognitive impairment. CLINICAL RELEVANCE STATEMENT: Microstructure differences between T2 lesion areas and normal-appearing white matter help distinguish multiple sclerosis and neuromyelitis optica spectrum disorder. In multiple sclerosis, lesions rather than normal-appearing white matter should be a concern, because the degree of lesion severity correlated both with normal-appearing white matter damage and cognitive impairment. KEY POINTS: • Multiple sclerosis and neuromyelitis optica spectrum disorder have different damage patterns in T2 lesion and normal-appearing white matter areas. • The microstructure damage of normal-appearing white matter is correlated with the microstructure of T2 lesion in multiple sclerosis and neuromyelitis optica spectrum disorder. • The microstructure damage of T2 lesion in multiple sclerosis is correlated with duration and cognitive impairment.

U-fiber diffusion kurtosis and susceptibility characteristics in relapsing-remitting multiple sclerosis may be related to cognitive deficits and neurodegeneration.

OBJECTIVES: To evaluate the diffusion kurtosis and susceptibility change in the U-fiber region of patients with relapsing-remitting multiple sclerosis (pwRRMS) and their correlations with cognitive status and degeneration. MATERIALS AND METHODS: Mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), kurtosis fractional anisotropy (KFA), and the mean relative quantitative susceptibility mapping (mrQSM) values in the U-fiber region were compared between 49 pwRRMS and 48 healthy controls (HCs). The U-fiber were divided into upper and deeper groups based on the location. The whole brain volume, gray and white matter volume, and cortical thickness were obtained. The correlations between the mrQSM values, DKI-derived metrics in the U-fiber region and clinical scale scores, brain morphologic parameters were further investigated. RESULTS: The decreased MK, AK, RK, KFA, and increased mrQSM values in U-fiber lesions (p < 0.001, FDR corrected), decreased RK, KFA, and increased mrQSM values in U-fiber non-lesions (p = 0.034, p < 0.001, p < 0.001, FDR corrected) were found in pwRRMS. There were differences in DKI-derived metrics and susceptibility values between the upper U-fiber region and the deeper one for U-fiber non-lesion areas of pwRRMS and HCs (p < 0.05), but not for U-fiber lesions in DKI-derived metrics. The DKI-derived metrics and susceptibility values were widely related with cognitive tests and brain atrophy. CONCLUSION: RRMS patients show abnormal diffusion kurtosis and susceptibility characteristics in the U-fiber region, and these underlying tissue abnormalities are correlated with cognitive deficits and degeneration. CLINICAL RELEVANCE STATEMENT: The macroscopic and microscopic tissue damages of U-fiber help to identify cognitive impairment and brain atrophy in multiple sclerosis and provide underlying pathophysiological mechanism. KEY POINTS: • Diffusion kurtosis and susceptibility changes are present in the U-fiber region of multiple sclerosis. • There are gradients in diffusion kurtosis and susceptibility characteristics in the U-fiber region. • Tissue damages in the U-fiber region are correlated with cognitive impairment and brain atrophy.

Heavy metal content and health risk assessment of atmospheric particles in China: A meta-analysis.

In recent decades, China has devoted significant attention to the heavy metals pollution in particulate matter. However, the majority of studies have only focused on the field monitoring in relatively remote areas, which may not be representative of air quality across the country. This study reevaluated the characteristics, temporal and spatial changes, and health concerns associated with heavy metal pollution in atmospheric particulates on a national scale by coupling Meta-analysis and Monte Carlo simulation analysis. In terms of spatial distribution, the heavy metals pollution levels in the northern coast and northeastern regions are relatively high, whereas it is low along the middle Yellow River, middle Yangtze River, as well as Southwest. With the exception of Cu, the distribution of all elements in PM2.5 steadily decreased over time Moreover, PM10 and PM2.5 performed similar where Cd and Ni both first increased followed by a decline while, Cr displayed a decrease before it showed an increment. And since the implementation of prevention and control policies about the atmospheric release, the focus of industrial emission has gradually shifted from energy production and processing to living products manufacturing. Moreover, the carcinogenic risk was shown to be Cr > As, Pb > Ni, Cd, while the non-carcinogenic risk was as follows: As, Ni > Cr, Cd. Among all contaminants, Cd, As, and Cr in PM2.5 and PM10 exceeded the WHO standard in the cities with worst air quality. It was observed that As posed the largest non-carcinogenic risk to adults while, Cr caused the most carcinogenic risk to adults and children, where the carcinogenic risk of children remains higher than that of adults. Therefore, the findings of this study may offer data support to the China's heavy metal pollution standards in airborne particles and offer theoretical data support for pollution management.

Enlarged choroid plexus related to cortical atrophy in multiple sclerosis.

OBJECTIVES: To investigate the correlation between choroid plexus volume and whole brain morphology in patients with multiple sclerosis (MS) and neuromyelitis optica spectrum disorder (NMOSD). METHODS: Fifty-one patients with MS, 42 patients with NMOSD, and 56 healthy controls (HC) were recruited. The morphological changes in choroid plexus and whole brain tissue were compared between three groups and the correlations between choroid plexus volume and brain atrophy were further investigated. The longitudinal alterations of brain morphology in 25 MS and 20 NMOSD patients were compared. RESULTS: Compared to the HC group, the choroid plexus volumes were increased in the MS group (p < 0.001) but not in the NMOSD group (p > 0.05). Compared to the HC group, the MS group showed reduced cortex thickness, deep gray matter volume, and increased ventricle system volume, and the NMOSD group showed increased third ventricle volume (all p < 0.05, false discovery rate corrected). In the MS group, there were widespread correlations between enlarged choroid plexus volume and reduced cerebral cortex thickness (p < 0.05, r = -0.292~-0.538, false discovery rate corrected). The interval time was not significantly different between the MS (median: 1.37 years) and NMOSD group (median: 1.25 years) (p > 0.05). In MS, compared with the baseline, the right hippocampus and nucleus accumbens volumes were decreased in long follow-up, and bilateral lateral ventricle volumes were increased both in short and long follow-up (all p < 0.05, false discovery rate corrected). CONCLUSIONS: The enlarged choroid plexus related to reduced cortical thickness and progressive local brain atrophy are shown in MS patients, but not obvious in NMOSD patients. KEY POINTS: • MS and NMOSD have different altered patterns in choroid plexus volume and brain atrophy. • The enlarged choroid plexus related to brain atrophy is shown in MS patients, but not obvious in NMOSD patients. • Progressive local brain atrophy is shown in MS patients, but not obvious in NMOSD patients.

Primary liposarcoma of the uterus with MDM2 negative.

ABSTRACT: Liposarcoma is one of the most common soft-tissue sarcomas that originates from adipose tissue. Primary uterine liposarcoma is extremely rare. With the MDM2, negative is even rarer. We report a 37-year-old woman presented with lower abdominal discomfort and increase in vaginal secretions for more than 2 months. The ultrasonography revealed a hypoechoic mass sized 81 × 73 × 67 mm in the right adnexal area. Histopathologically, the neoplasm was mainly composed of mature adipose tissue, a small number of scattered lipoblasts, and the spindle cell which with mild atypia. Immunohistochemistry showed that the tumor cells were positive for CDK4 but negative for MDM2, and FISH analysis showed no MDM2 amplification. The patient only underwent tumor excision and is currently doing well.

Study the effect of drying on the oxidation thermogravimetric and functional group composition characteristics of immersed lignite.

The drying process of immersed lignite has a significant influence on the characteristics and progress of spontaneous combustion. To reveal the influence mechanism of the drying process of immersed coal on the spontaneous combustion characteristics and the change rule of the spontaneous combustion process, in this research, we measured the mass change during coal oxidation with thermogravimetry, and the change of the functional groups with Fourier transform infrared spectroscopy. The influence of the drying process on the coal was analyzed by comparing activation energy, functional group of immersed coal with different drying degrees and raw coal. The results showed that, compared with raw coal, the content of Ar-C-O- and antisymmetric stretching vibration of the carboxylate group (-COO-) as well as the stretching vibration in the quinone group (C=O) and the -OH group increased. For the content of [Formula: see text],[Formula: see text][Formula: see text], the value of Asym.CH2/Asym.CH3 decreased. The content of various functional groups changed to be favorable for oxidation and heat release. At different reaction stages, the activation energy was differently affected by the degree of drying. Average values of activation energies at different reaction stages are shown raw coal had the lowest activation energy. After soaking in water and drying, the activation energy of coal is increased to varying degrees, the reactivity is reduced, and the risk of spontaneous combustion is reduced. After soaking in water and drying, the activation energy of coal is increased to varying degrees, the reactivity is reduced, and the risk of spontaneous combustion is reduced. The activation energy of the coal samples dried for 24 h after soaking in water is the lowest among the coal samples dried for different times after soaking in water, and the moisture content is 10.5%.

Calcium peroxide alleviates the waterlogging stress of rapeseed by improving root growth status in a rice-rape rotation field.

Waterlogging stress has a negative influence on agricultural production, particularly for rapeseed yield in a rice-rape rotation field. To alleviate the profound impacts of waterlogging stress on rapeseed production, a new fertilization with calcium peroxide (CaO2) was proposed. In this field experiment, with the conventional rape (Brassica napus L.) variety fengyou958 (FY958) and early maturing rape variety xiangyou420 (XY420) as materials, waterlogging was imposed from the bud to flowering stage, and three supplies of CaO2 (0, C1 for the 594 kg hm-2 and C2 for the 864 kg hm-2) were added as basal fertilizer. The results showed that CaO2 significantly reduced the accumulation of fermentation products in roots and alleviated the peroxidation of leaves. The reduced waterlogging stress promoted the root vigor and agronomic characters, such as branches, plant height and stem diameter, accelerated dry matter and nutrients accumulation, and resulting in 22.7% (C1) to 232.8% (C2) higher grain yields in XY420, and 112.4% (C1) to 291.8% (C2) higher grain yields in FY958, respectively. In conclusion, 594 kg hm-2 to 864 kg hm-2 CaO2 application restored the growth of waterlogged rapeseed leaves, and reduced the anaerobic intensity of root, which enhanced the resistance of plants to waterlogging, and improved crop productivity. In a certain range, the higher CaO2 application, the more the yield. This study provides a valid method to prevent damage from flooding in crop fields.

The different damage patterns of short-, middle- and long-range connections between patients with relapse-remitting multiple sclerosis and neuromyelitis optica spectrum disorder.

Objective: To investigate the differences in short-, middle- and long-range connections between patients with relapse-remitting multiple sclerosis (RRMS) and neuromyelitis optica spectrum disorder (NMOSD), and their correlation with brain tissue volume, structural and functional network parameters. Methods: A total of 51 RRMS, 42 NMOSD and 56 health controls (HC) were recruited. Of these 25 RRMS (median: 1.37 years) and 20 NMOSD (median: 1.25 years) patients were also studied at follow-up. The whole-brain fiber connection was divided into three groups according to the trisected lengths of the tract in HC group, including short-, middle- and long-range connections. The brain tissue features (including total brain tissue and deep grey matter volumes) and parameters of DTI and functional networks (including the shortest path, clustering coefficient, local efficiency and global efficiency) were calculated. The differences in fiber number (FN) and average fractional anisotropy (FA) were compared between RRMS and NMOSD by the One-way ANOVA and post hoc tests. The correlation between the FN or FA and the brain tissue volume, DTI and functional network parameters were further analyzed by Pearson analysis. Results: Compared to HC and NMOSD, the total number of fibers in RRMS was decreased, including the reduced FN of middle- and long-range connections, but increased FN of short-range connections. Compared to HC, the FA of three fibers in RRMS and NMOSD were reduced significantly, and the decrease of FA in RRMS was greater than in NMOSD. There were correlations between the FN of short-, and long-range connections and the atrophy of whole brain tissue in two diseases and structural network topological parameters in RRMS. Additionally, there was no significant difference of FN and FA in short-, middle- and long-range connections between the baseline and follow-up in two diseases. Conclusions: RRMS and NMOSD patients have different patterns of fiber connection damage. The FN of different lengths in RRMS and NMOSD patients may be associated with brain atrophy. The FN and FA of different lengths may explain the decreased efficiency of the structural network in RRMS patients. In the short-term follow-up, neither has worsened damage of different fibers in two diseases.

Alterations in White Matter Fiber Tracts Characterized by Automated Fiber-Tract Quantification and Their Correlations With Cognitive Impairment in Neuromyelitis Optica Spectrum Disorder Patients.

Objectives: To investigate whether patients with neuromyelitis optica spectrum disorder (NMOSD) have tract-specific alterations in the white matter (WM) and the correlations between the alterations and cognitive impairment. Materials and Methods: In total, 40 patients with NMOSD and 20 healthy controls (HCs) who underwent diffusion tensor imaging (DTI) scan and neuropsychological scale assessments were enrolled. Automated fiber-tract quantification (AFQ) was applied to identify and quantify 100 equally spaced nodes of 18 specific WM fiber tracts for each participant. Then the group comparisons in DTI metrics and correlations between different DTI metrics and neuropsychological scales were performed. Results: Regardless of the entire or pointwise level in WM fiber tracts, patients with NMOSD exhibited a decreased fractional anisotropy (FA) in the left inferior fronto-occipital fasciculus (L_IFOF) and widespread increased mean diffusion (MD), axial diffusivity (AD), and radial diffusivity (RD), especially for the thalamic radiation (TR), corticospinal tract (CST), IFOF, inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus (SLF) [p < 0.05, false discovery rate (FDR) correction], and the pointwise analyses performed more sensitive. Furthermore, the negative correlations among MD, AD, RD, and symbol digit modalities test (SDMT) scores in the left TR (L_TR) were found in NMOSD. Conclusion: Patients with NMOSD exhibited the specific nodes of WM fiber tract damage, which can enhance our understanding of WM microstructural abnormalities in NMOSD. In addition, the altered DTI metrics were correlated with cognitive impairment, which can be used as imaging markers for the early identification of NMOSD cognitive impairment.

Clinical Variables, Deep Learning and Radiomics Features Help Predict the Prognosis of Adult Anti-N-methyl-D-aspartate Receptor Encephalitis Early: A Two-Center Study in Southwest China.

Objective: To develop a fusion model combining clinical variables, deep learning (DL), and radiomics features to predict the functional outcomes early in patients with adult anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis in Southwest China. Methods: From January 2012, a two-center study of anti-NMDAR encephalitis was initiated to collect clinical and MRI data from acute patients in Southwest China. Two experienced neurologists independently assessed the patients' prognosis at 24 moths based on the modified Rankin Scale (mRS) (good outcome defined as mRS 0-2; bad outcome defined as mRS 3-6). Risk factors influencing the prognosis of patients with acute anti-NMDAR encephalitis were investigated using clinical data. Five DL and radiomics models trained with four single or combined four MRI sequences (T1-weighted imaging, T2-weighted imaging, fluid-attenuated inversion recovery imaging and diffusion weighted imaging) and a clinical model were developed to predict the prognosis of anti-NMDAR encephalitis. A fusion model combing a clinical model and two machine learning-based models was built. The performances of the fusion model, clinical model, DL-based models and radiomics-based models were compared using the area under the receiver operating characteristic curve (AUC) and accuracy and then assessed by paired t-tests (P < 0.05 was considered significant). Results: The fusion model achieved the significantly greatest predictive performance in the internal test dataset with an AUC of 0.963 [95% CI: (0.874-0.999)], and also significantly exhibited an equally good performance in the external validation dataset, with an AUC of 0.927 [95% CI: (0.688-0.975)]. The radiomics_combined model (AUC: 0.889; accuracy: 0.857) provided significantly superior predictive performance than the DL_combined (AUC: 0.845; accuracy: 0.857) and clinical models (AUC: 0.840; accuracy: 0.905), whereas the clinical model showed significantly higher accuracy. Compared with all single-sequence models, the DL_combined model and the radiomics_combined model had significantly greater AUCs and accuracies. Conclusions: The fusion model combining clinical variables and machine learning-based models may have early predictive value for poor outcomes associated with anti-NMDAR encephalitis.

Foliar uptake, accumulation, and distribution of cadmium in rice (Oryza sativa L.) at different stages in wet deposition conditions.

Atmospheric deposition of cadmium (Cd) in rice (Oryza sativa L.) has become a major global concern. Foliar uptake allows vegetables to accumulate heavy metals from the atmosphere, but this has rarely been studied in rice. Therefore, this study investigated the Cd accumulation in rice growing at different exposure periods (the tillering, booting, heading, and maturity stages) under a wet deposition of CdCl2·2.5H2O solution through pot experiments. The Cd concentrations in leaves, roots, husk, brown rice, and leaf structures were analyzed to explore foliar uptake, accumulation, and distribution of Cd in rice tissues at different growth stages. The results showed that wet deposited Cd can be absorbed on the rice leaf surface and remains on the leaves for a long time. The sequence of Cd accumulation in rice tissues was: leaves > brown rice > husk > roots, with leaves accounting for greater than 71.78% of the total accumulation. The accumulation of wet deposited Cd in leaves, husk, and brown rice had large temporal variations between the four typical stages. There was no significant variations in Cd content in roots between different growth stages. Correspondingly, the foliar uptake of Cd was rarely transported from the leaves via the phloem to roots. Conversely, the foliar uptake of Cd was transported upwards to grains. The accumulation of Cd fluctuated with each growth stage, initially increasing and then decreasing at the heading stage and finally reaching a peak at the maturity stage. The highest total accumulation of Cd in both the high and low wet deposition conditions occurred at maturity, resulting in 15.53 and 11.23 µg plant-1, respectively. These results provide theoretical support for further research into identifying efficient foliar control measures to reduce Cd accumulation and maintain food safety.

Deciphering the diversity and functions of plastisphere bacterial communities in plastic-mulching croplands of subtropical China.

Considering the inhomogeneity of plastisphere and surrounding soil, it is plausible that the microbial community colonizing it also varies, affecting soil services and sustainability. Herein, we analyzed the soil and film residue from fifty-five plastic-mulching croplands in the subtropical areas of China. Based on the outcomes of this analysis, we explored the diversity and functions of the associated bacterial communities. Alpha-diversity and phylogenetic diversity of the plastisphere bacterial community was significantly lower than the surrounding soil. The average net relatedness and net nearest taxa indices of samples were less than zero. Four phyla and twenty genera were enriched in the plastisphere compared to the surrounding soil. Ecological networks of the plastisphere community showed multiple nodes, but fewer interactions, and the members of Bradyrhizobium, Rhodospirillaceae, and Bacillus were indicated as the hub species. Predicted pathways related to human disease, as well as the metabolisms of cofactors, vitamins, amino acids, and xenobiotic biodegradation, were reinforced in the plastisphere, and meanwhile, accompanied by an increase in abundance of genes related to carbon, nitrogen, and phosphorus cycles. These results demonstrated the diversity and functions of the plastisphere microbiome and highlighted the necessity for exploring the ecological and health risks of plastic residue in croplands.

Deep Learning-Enabled Identification of Autoimmune Encephalitis on 3D Multi-Sequence MRI.

BACKGROUND: Autoimmune encephalitis (AE) is a noninfectious emergency with severe clinical attacks. It is difficult for the earlier diagnosis of acute AE due to the lack of antibody detection resources. PURPOSE: To construct a deep learning (DL) algorithm using multi-sequence magnetic resonance imaging (MRI) for the identification of acute AE. STUDY TYPE: Retrospective. POPULATION: One hundred and sixty AE patients (90 women; median age 36), 177 herpes simplex virus encephalitis (HSVE) (89 women; median age 39), and 184 healthy controls (HC) (95 women; median age 39) were included. Fifty-two patients from another site were enrolled for external validation. FIELD STRENGTH/SEQUENCE: 3.0 T; fast spin-echo (T1 WI, T2 WI, fluid attenuated inversion recovery imaging) and spin-echo echo-planar diffusion weighted imaging. ASSESSMENT: Five DL models based on individual or combined four MRI sequences to classify the datasets as AE, HSVE, or HC. Reader experiment was further carried out by radiologists. STATISTICAL TESTS: The discriminative performance of different models was assessed using the area under the receiver operating characteristic curve (AUC). The optimal threshold cut-off was identified when sensitivity and specificity were maximized (sensitivity + specificity - 1) in the validation set. Classification performance using confusion matrices was reported to evaluate the diagnostic value of the models and the radiologists' assessments before being assessed by the paired t-test (P < 0.05 was considered significant). RESULTS: In the internal test set, the fusion model achieved the significantly greatest diagnostic performance than single-sequence DL models with AUCs of 0.828, 0.884, and 0.899 for AE, HSVE, and HC, respectively. The model demonstrated a consistently high performance in the external validation set with AUCs of 0.831 (AE), 0.882 (HSVE), and 0.892 (HC). The fusion model also demonstrated significantly higher performance than all radiologists in identifying AE (accuracy between the fuse model vs. average radiologist: 83% vs. 72%). DATA CONCLUSION: The proposed DL algorithm derived from multi-sequence MRI provided desirable identification and classification of acute AE. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 2.

Progressive brain microstructural damage in patients with multiple sclerosis but not in patients with neuromyelitis optica spectrum disorder: A cross-sectional and follow-up tract-based spatial statistics study.

BACKGROUND: Neuromyelitis optica spectrum disorder (NMOSD) may sometimes be misdiagnosed as multiple sclerosis (MS) because both disorders have similar clinical presentations and commonly show white matter damage in the brain. Diffusion tensor imaging (DTI) is an advanced MRI technique to assess the microstructural organization of white matter and provides greater pathological specificity than conventional MRI. In the present combined cross-sectional and longitudinal study, the novel DTI technique of Track-Based Spatial Statistics (TBSS) was used to investigate the difference of DTI parameter abnormalities between NMOSD and MS. METHODS: A total of 42 patients with NMOSD, 51 patients with MS and 56 health controls (HC) were recruited and of these 14 patients with NMOSD and 13 patients with MS were also studied at follow-up after an average interval of approximately one year. Measurements of fractional anisotropy (FA), mean diffusion (MD), axial diffusivity (AD) and radial diffusivity (RD) were compared at baseline and follow-up in patients with NMOSD and MS. RESULTS: Significant reduction in FA, increase in MD, AD and RD were observed in patients with MS (p < 0.05) and reduced FA was shown in NMOSD (p < 0.05) compared to HC, with all the effects, together with lesion load on T1WI and T2WI, being greater in patients with MS than in patients with NMOSD (p < 0.05). There was no significant difference in the time interval to follow-up in patients with MS (1.37 years) and NMOSD (1.25 years) (p > 0.05), during which there were significant changes in EDSS score between baseline and follow-up in NMOSD and MS patients (p < 0.05). There was a significantly reduced FA, and increased MD and RD in patients with MS (p < 0.05), but no significant changes in patients with NMOSD (p > 0.05). CONCLUSIONS: Both MS and NMOSD have microstructure damage in white matter, while the progressive change in brain microstructural properties is observed in patients with MS but may not in patients with NMOSD in a short-term follow-up.

Demyelination and remyelination detected in an alternative cuprizone mouse model of multiple sclerosis with 7.0 T multiparameter magnetic resonance imaging.

The aim of this study was to investigate the mechanisms underlying demyelination and remyelination with 7.0 T multiparameter magnetic resonance imaging (MRI) in an alternative cuprizone (CPZ) mouse model of multiple sclerosis (MS). Sixty mice were divided into six groups (n = 10, each), and these groups were imaged with 7.0 T multiparameter MRI and treated with an alternative CPZ administration schedule. T2-weighted imaging (T2WI), susceptibility-weighted imaging (SWI), and diffusion tensor imaging (DTI) were used to compare the splenium of the corpus callosum (sCC) among the groups. Prussian blue and Luxol fast blue staining were performed to assess pathology. The correlations of the mean grayscale value (mGSV) of the pathology results and the MRI metrics were analyzed to evaluate the multiparameter MRI results. One-way ANOVA and post hoc comparison showed that the normalized T2WI (T2-nor), fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) values were significantly different among the six groups, while the mean phase (Φ) value of SWI was not significantly different among the groups. Correlation analysis showed that the correlation between the T2-nor and mGSV was higher than that among the other values. The correlations among the FA, RD, MD, and mGSV remained instructive. In conclusion, ultrahigh-field multiparameter MRI can reflect the pathological changes associated with and the underlying mechanisms of demyelination and remyelination in MS after the successful establishment of an acute CPZ-induced model.

The effects of the depth of fertilization on losses of nitrogen and phosphorus and soil fertility in the red paddy soil of China.

Nitrogen (N) and phosphorus (P) losses from agroecosystems are dominant nonpoint pollution. To minimize the losses of N and P, the optimal depth of fertilization was explored using a soil column study with the red paddy soil as the research objects. The losses of N and P were measured under five depths of fertilization (0, 5, 7.5, 10, and 12.5 cm) as well as no fertilization. The results showed that ammonia volatilization was significantly decreased with increasing fertilization depth within 010 cm, and there was no significant difference among the 10 cm, 12.5 cm, and no-fertilization treatments. Comparing with surface fertilization (0 cm), N and P losses by runoff could be reduced by 30.767.1% and 96.998.7% respectively by fertilization at 512.5 cm. In addition, deep fertilization (512.5 cm) did not increase N and P losses by leaching at the depth of 40 cm. Total N and P contents in the tillage layer of soil were increased by 5.1 to 22.8% and by 1.0 to 7.5%, respectively. Fertilization at 10cm depth has the potential to minimal environmental impact in the red paddy soil of south China, at this depth, NH3 volatilization was reduced by 95.1%, and N and P losses by runoff were reduced by 62.0% and 98.4%, respectively, compared with surface fertilization.