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Background: Unfortunately, the morphologic magnetic resonance imaging (MRI) is unable to determine perineural invasion (PNI) status. This study applied histogram analysis of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the assessment of PNI status of rectal cancer (RC). Methods: The retrospective analysis enrolled 175 patients with RC confirmed by postoperative pathology in The First Affiliated Hospital of Shandong First Medical University from January 2019 to December 2021. All patients underwent preoperative rectal MRI. Whole-tumor volume histogram features from IVIM-DWI were extracted using open-source software. Univariate analysis and multivariate logistic regression analysis were used to compare the differences in histogram parameters and clinical features between the PNI-positive group and PNI-negative group. Receiver operating characteristic curve analysis was used to evaluate the diagnostic performance, while the Delong test was used to compare the area under the curve of the models. Results: The interobserver agreement of the histogram features derived from DWI, including apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), water molecular diffusion heterogeneity index (α), and distributed diffusion coefficient (DDC) were good to excellent. A total of eight histogram features including DWI_maximum, DWI_skewness, D_kurtosis, D_minimum, D_skewness, D*_energy, D*_skewness, and f_minimum were significantly different between the PNI-positive and PNI-negative groups in the univariate analysis (P<0.05); among the clinicoradiologic factors, percentage of rectal wall circumference invasion (PCI) was significantly different between the two groups (P<0.05). Multivariate analysis demonstrated that the values of D*_energy, D*_skewness, and f_minimum differed significantly between the PNI-positive patients and PNI-negative patients (P<0.05), with the independent risk factors being D*_skewness [odds ratio (OR) =1.157; 95% confidence interval (CI): 1.050-1.276; P=0.003] and PCI (OR =11.108, 95% CI: 1.767-69.838; P=0.0002). The area under the curve of the model combining the three histogram features and PCI to assess PNI status in RC was 0.807 (95% CI: 0.741-0.863). The results of the Delong test showed that the combined model was significantly different from each single-parameter model (P<0.05). Conclusions: The combined model constructed on the basis of IVIM-DWI histogram features may help to assess the status of RC PNI.
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Background: The noninvasive prediction of sentinel lymph node (SLN) metastasis using quantitative magnetic resonance imaging (MRI), particularly with synthetic MRI (syMRI), is an emerging field. This study aimed to explore the potential added benefits of syMRI over conventional MRI and diffusion-weighted imaging (DWI) in predicting metastases in SLNs. Methods: This retrospective study consecutively enrolled 101 patients who were diagnosed with breast cancer (BC) and underwent SLN biopsy from December 2022 to October 2023 at the Affiliated Hospital of Jiangnan University. These patients underwent preoperative MRI including conventional MRI, DWI, and syMRI and were categorized into two groups according to the postoperative pathological results: those with and without metastatic SLNs. MRI morphological features, DWI, and syMRI-derived quantitative parameters of breast tumors were statistically compared between these two groups. Binary logistic regression was used to separately develop predictive models for determining the presence of SLN involvement, with variables that exhibited significant differences being incorporated. The performance of each model was evaluated through receiver operating characteristic (ROC) curve analysis, including the area under the curve (AUC), sensitivity, and specificity. Results: Compared to the group of 54 patients with BC but no metastatic SLNs, the group of 47 patients with BC and metastatic SLNs had a significantly larger maximum axis diameter [metastatic SLNs: median 2.40 cm, interquartile range (IQR) 1.50-3.00 cm; no metastatic SLNs: median 1.80 cm, IQR 1.37-2.50 cm; P=0.03], a higher proton density (PD) (78.44±11.92 vs. 69.20±10.63 pu; P<0.001), and a lower apparent diffusion coefficient (ADC) (metastatic SLNs: median 0.91×10-3 mm2/s, IQR 0.79-1.01 mm2/s; no metastatic SLNs: median 1.02×10-3 mm2/s, IQR 0.92-1.12 mm2/s; P=0.001). Moreover, the prediction model with maximum axis diameter and ADC yielded an AUC of 0.71 [95% confidence interval (CI): 0.618-0.802], with a sensitivity of 78.72% and a specificity of 51.85%; After addition of syMRI-derived PD to the prediction model, the AUC increased significantly to 0.86 (AUC: 0.86 vs. 0.71; 95% CI: 0.778-0.922; P=0.002), with a sensitivity of 80.85% and a specificity of 81.50%. Conclusions: Combined with conventional MRI and DWI, syMRI can offer additional value in enhancing the predictive performance of determining SLN status before surgery in patients with BC.
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OBJECTIVES: To investigate the feasibility of synthetic MRI (syMRI), diffusion-weighted imaging (DWI), and their combination with morphological features for differentiating nasopharyngeal lymphoma (NPL) from nasopharyngeal carcinoma (NPC). METHODS: Sixty-nine patients with nasopharyngeal tumours (NPL, n = 22; NPC, n = 47) who underwent syMRI and DWI were retrospectively enrolled between October 2020 and May 2022. syMRI and DWI quantitative parameters (T1, T2, PD, ADC) and morphological features were obtained. Diagnostic performance was assessed by independent sample t-test, chi-square test, logistic regression analysis, receiver operating characteristic curve (ROC), and DeLong test. RESULTS: NPL has significantly lower T2, PD, and ADC values compared to NPC (all P < .05), whereas no significant difference was found in T1 value between these two entities (P > .05). The morphological features of tumour type, skull-base involvement, Waldeyer ring involvement, and lymph nodes involvement region were significantly different between NPL and NPC (all P < .05). The syMRI (T2 + PD) model has better diagnostic efficacy, with AUC, sensitivity, specificity, and accuracy of 0.875, 77.27%, 89.36%, and 85.51%. Compared with syMRI model, syMRI + Morph (PD + Waldeyer ring involvement + lymph nodes involvement region), syMRI + DWI (T2 + PD + ADC), and syMRI + DWI + Morph (PD + ADC + skull-base involvement + Waldeyer ring involvement) models can further improve the diagnostic efficiency (all P < .05). Furthermore, syMRI + DWI + Morph model has excellent diagnostic performance, with AUC, sensitivity, specificity, and accuracy of 0.986, 95.47%, 97.87%, and 97.10%, respectively. CONCLUSION: syMRI and DWI quantitative parameters were helpful in discriminating NPL from NPC. syMRI + DWI + Morph model has the excellent diagnostic efficiency in differentiating these two entities. ADVANCES IN KNOWLEDGE: syMRI + DWI + morphological feature method can differentiate NPL from NPC with excellent diagnostic performance.
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Imagem de Difusão por Ressonância Magnética , Linfoma , Carcinoma Nasofaríngeo , Neoplasias Nasofaríngeas , Sensibilidade e Especificidade , Humanos , Imagem de Difusão por Ressonância Magnética/métodos , Masculino , Feminino , Carcinoma Nasofaríngeo/diagnóstico por imagem , Carcinoma Nasofaríngeo/patologia , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Pessoa de Meia-Idade , Diagnóstico Diferencial , Estudos Retrospectivos , Adulto , Linfoma/diagnóstico por imagem , Idoso , Estudos de Viabilidade , Imageamento por Ressonância Magnética/métodos , Adulto JovemRESUMO
PURPOSE: We evaluated the potential role of intravoxel incoherent motion (IVIM) in predicting the therapeutic response and peritumoral invasion in patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). MATERIALS AND METHODS: We enrolled 47 patients previously treated with TACE between January 2018 and December 2021. We evaluated the IVIM-derived metrics [apparent diffusion coefficient (ADC), D, D*, f] in the TACE-treated, peritumoral, and parenchymal areas of the liver. RESULTS: The ADCtace and Dtace values (1.13 ± 0.22 × 10-3 m2/s vs 0.95 ± 0.13 × 10-3 mm2/s, 1.28 ± 0.27 × 10-3 mm2/s vs 1.07 ± 0.3 × 10-3 mm2/s, P < 0.05) were higher in the non-progressing groups than in the progressing groups in the TACE-treated areas. Dpt represented the D values in the peritumoral area, which can distinguish between the progressive and non-progressive groups with an AUC of 0.73. The Dstd values, which represent the D values in the peritumoral area normalized by the D values in the liver parenchyma in the non-progressing groups (1.10 ± 0.14 × 10-3 mm2/s), were higher than those of the progressing groups (0.93 ± 0.17 × 10-3 mm2/s). CONCLUSION: The ADCtace, Dtace, Dpt, and Dstd values reflect the changes in the microstructure of the progressive and non-progressive groups after TACE treatment, showing robust diagnostic performances in predicting the therapeutic response and peritumoral invasion.
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Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Recidiva Local de Neoplasia , Humanos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/diagnóstico por imagem , Quimioembolização Terapêutica/métodos , Masculino , Feminino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Idoso , Invasividade Neoplásica , Prognóstico , Estudos Retrospectivos , Imageamento por Ressonância Magnética/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Adulto , Fígado/patologia , Fígado/diagnóstico por imagem , Curva ROCRESUMO
RATIONALE AND OBJECTIVES: To investigate if the combination of multishot diffusion imaging-based multiplexed sensitivity encoding intravoxel incoherent motion (MUSE-IVIM) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is feasible for staging Crohn's disease (CD) activity. MATERIALS AND METHODS: A total of 65 CD patients were enrolled and analyzed in this retrospective study. The simplified endoscopic score for Crohn's disease (SES-CD) and magnetic resonance index of activity (MaRIA) were used as the reference. The MUSE-IVIM and DCE-MRI data were acquired at 3.0-T MRI scanner and processed by two radiologists. Three MUSE-IVIM parameters: fast apparent diffusion coefficient (ADCfast), slow apparent diffusion coefficient (ADCslow), and the fractional perfusion (Fraction of ADCfast), as well as four DCE-MRI parameters: volume transfer constant (Ktrans), rate constant (Kep), extravascular extracellular volume fraction (Ve), and plasma volume fraction (Vp) were generated. Intraclass correlation coefficient (ICC), non-parametric test (Kruskal-Wallis H and Mann-Whitney U), logistic regression, receiver operating characteristic analysis, Delong test, and Spearman's correlation test were performed. RESULTS: According to SES-CD, 116 ileocolonic segments with CD lesions were identified as: inactive, mild, and moderate to severe. With multivariable logistic regression analysis, ADCfast (p < 0.001), Fraction of ADCfast (p = 0.005), Ktrans (p < 0.001) and Kep (p = 0.003) were identified as significant factors for differentiating among the three groups. Binary logistic analyses identified ADCfast (p = 0.001), Ktrans (p = 0.014), and Kep (p = 0.029) as independent predictors for the active status. The combination of ADCfast, Ktrans, and Kep performed better than MaRIA score (p = 0.028), for differentiating inactive and active status. MaRIA score was positively correlated with ADCfast (p < 0.001), Ktrans (p < 0.001), Kep (p < 0.001), and Ve (p = 0.001), however, negatively correlated with Fraction of ADCfast (p < 0.001). CONCLUSION: The combination of MUSE-IVIM and DCE-MRI has been demonstrated to accurately stage inflammatory activity in CD.
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Doença de Crohn , Imageamento por Ressonância Magnética Multiparamétrica , Humanos , Alprostadil , Doença de Crohn/diagnóstico por imagem , Estudos Retrospectivos , Meios de Contraste , Imageamento por Ressonância Magnética/métodos , Imagem de Difusão por Ressonância Magnética/métodosRESUMO
Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is commonly used in clinical practice to detect tumor blood supply, and it has recently been applied to assess skeletal vasculature. In this study, we retrospectively analyzed DCE-MRI data from 37 patients with osteonecrosis of the femoral head to evaluate alterations in microvascular circulation of the femoral head. Time-intensity curves (TICs) in the region of interest were classified into different lesion stages. In the greater trochanter area, extracellular space volume per unit volume of tissue was significantly higher in Association Research Circulation Osseous (ARCO) stage III than in ARCO stage II (P<.05 and power ≥ 0.8), while other parameters showed no statistical difference (P>.05 and/or power < 0.8). In the necrotic area, contrast enhancement ratio and maximum slope of increase were significantly lower in ARCO stage III than in ARCO stage II (P<.05 and power ≥ 0.8), while other parameters showed no statistical difference (P>.05 and/or power < 0.8). In the repair reaction area, all parameters were significantly higher in ARCO stage III than in ARCO stage II (P<.05 and power ≥ 0.8). TIC classification showed that the greater trochanter area mainly exhibited type C (plateau type), the necrotic area mainly exhibited type B (out-flow type), and the repair reaction area mainly exhibited type A (inflow type). We believe that the exchange capacity of the vessels has a much greater impact on femoral head necrosis than the number of vessels, while the generation of the repair area greatly affects the prognosis of femoral head necrosis. These findings suggest that DCE-MRI can provide a good assessment of osteonecrosis of the femoral head perfusion and can serve as a new reference for clinical treatment decisions. [Orthopedics. 2024;47(2):e73-e78.].
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Necrose da Cabeça do Fêmur , Humanos , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Microcirculação , Cabeça do Fêmur/diagnóstico por imagem , Cabeça do Fêmur/irrigação sanguínea , Estudos Retrospectivos , Transplante Ósseo , Imageamento por Ressonância MagnéticaRESUMO
It is difficult to distinguish other pathologies mimicking Ménière's disease (MD) clinically. This study aims to investigate the differences of imaging findings and features between MD and other menieriform diseases via intravenous gadolinium-enhanced magnetic resonance imaging (MRI). 426 patients with menieriform symptoms, including MD, vestibular migraine (VM), and vestibular schwannoma (VS), underwent 3D-FLAIR and 3D-T2WI MRI 6 h after the intravenous gadolinium injection. MR images were analyzed for inner ear morphology, perilymphatic enhancement (PE), EH and other abnormalities. EH was observed at a higher rate in MD patients (85.71%) than patients with other menieriform diseases (VM group = 14.75%, VS group = 37.50%). The prevalence of unilateral EH as well as both cochlear and vestibular EH showed significant differences between MD and VM groups. The prevalence of cochlear EH (I and II) and vestibular EH (II and III) was different between MD and VM groups. The prevalence of PE was higher in MD than VM group. The degrees of cochlear and vestibular hydrops were higher in the definite than probable MD group (P < 0.05). Using these imaging features, MRI can be used to help differentiate MD from other menieriform diseases.
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Hidropisia Endolinfática , Doença de Meniere , Transtornos de Enxaqueca , Neuroma Acústico , Vestíbulo do Labirinto , Humanos , Doença de Meniere/diagnóstico por imagem , Hidropisia Endolinfática/diagnóstico , Gadolínio , Vertigem , Imageamento por Ressonância Magnética/métodos , Transtornos de Enxaqueca/diagnósticoRESUMO
Background: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are neurodegenerative processing stages of Alzheimer's disease (AD). Cognitive decline is thought to manifest in intrinsic brain activity changes, but research results yielded conflicting and few studies have explored the roles of brain regions in cognitive decline, and sensitivity of the cognitive field to changes in the altered intrinsic brain activity. Methods: In this cross-sectional study, 158 elderly participants were recruited from the memory clinic of the First Affiliated Hospital of Nanjing Medical University from July 2019 to May 2021, and grouped into SCD (n=73), MCI (n=46), and normal controls (NC) (n=39). The amplitude of low-frequency fluctuation (ALFF) was calculated and evaluated among the groups. Then canonical correlation analysis (CCA) was conducted to investigate the associations between imaging outcomes and cognitive behaviors. Results: Neuropsychological tests in different cognitive dimensions and ALFF values of the prefrontal, parietal, and temporal gyrus, were significantly different (P<0.05) among the three groups, with no appreciable decline in daily activity. The changes in intrinsic activities were closely related to the decline in cognitive function (R=0.73, P=0.002). ALFF values in the left middle occipital gyrus, right middle frontal gyrus, left superior frontal gyrus, left angular gyrus, and superior temporal gyrus played significant roles in the analysis, while the Montreal Cognitive Assessment (MoCA) and Auditory-Verbal Learning Test scores were found to be more sensitive to changes in ALFF values. Conclusions: Spontaneous brain activity is a stable imaging biomarker of cognitive impairment. ALFF changes of the prefrontal, occipital, left angular, and temporal gyrus were sensitive to identifying cognitive decline, and the scores of the Auditory-Verbal Learning Test and MoCA could predict the abnormal intrinsic activities.
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PURPOSE: To investigate whether moyamoya disease (MMD) and atherosclerotic moyamoya syndrome (AS-MMS) differ in vascular morphology and perfusion characteristics using T1w-CUBE imaging and multiple post-labeling delay 3D pseudo-continuous arterial spin labeling imaging (MP 3D-PcASL), and to explore the potential of the combined techniques for accurate diagnosis of both diseases. METHOD: This prospective study enrolled 51 patients with moyamoya vasculopathy, including 26 with MMD and 25 with AS-MMS. All patients underwent digital subtraction angiography (DSA)/magnetic resonance angiography (MRA), T1w-CUBE imaging, and MP 3D-PCASL examinations. Morphological parameters, including the outer diameter, maximum wall thickness, luminal stenosis morphology, degree of wall enhancement, number of collateral vessels, and perfusion parameters, such as cerebral blood flow (CBF) and arterial transit time (ATT), were measured. After univariate analysis between the two groups, logistic regression models based on the derived parameters of T1w-CUBE imaging, MP 3D-PCASL, and combined imaging were implemented, and receiver operating characteristic (ROC) curves were generated to compare the discriminatory power of the different imaging methods for the diagnosis of MMD. RESULTS: With T1w-CUBE imaging, MMD showed a smaller outer diameter (2.76 ± 0.39 vs. 3.07 ± 0.49 mm) and maximum wall thickness (1.27 ± 0.19 vs. 1.49 ± 0.24 mm) than AS-MMS (both P < 0.05). Using MP 3D-pcASL, the resultant CBF (36.64 ± 14.28 vs. 28.77 ± 8.63 mL/100 g/min) was higher in MMD relative to AS-MMS, while an opposite pattern was shown for ATT (1.61 ± 0.09 vs. 1.72 ± 0.13 s; both P < 0.05). Robust diagnostic efficacies for disease differentiation, confirmed by high areas under the ROC curve (AUCs) (>0.808), were separately shown with T1w-CUBE and MP 3D-pcASL derived parameters. However, the combined multivariate logistic regression model showed optimaldiagnostic efficacy(AUC: 0.938; P < 0.05). CONCLUSIONS: Combined T1w-CUBE imaging and MP 3D-PCASL provides distinctive morphological and functional features to evaluate vessel walls and cerebral perfusion, and might help distinguish MMD from AS-MMS.
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Doença de Moyamoya , Humanos , Doença de Moyamoya/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Estudos Prospectivos , Artérias , Angiografia por Ressonância Magnética/métodos , Marcadores de Spin , Circulação Cerebrovascular/fisiologiaRESUMO
Determining the presence of extrathyroidal extension (ETE) is important for established of different surgical protocol and postoperative patient management in patients with papillary thyroid carcinoma (PTC). The correlation relationship between texture features from T2-weighted imaging (T2WI) and ETE has not been explored extensively. This study aimed to explore the value of T2-weighted magnetic resonance imaging - based whole tumor texture analysis in predict extrathyroidal extension with PTC. In this retrospectively study, 76 patients with pathologically proven PTC were recruited, who received surgical resection and underwent preoperative thyroid magnetic resonance imaging. Based on histo-pathologically findings, patients were classified into ETE and no ETE groups. ETE group was further divided into 2 subgroups (minimal ETE and extensive ETE). Whole-tumor texture analysis was independently performed by 2 radiologists on axial T2WI images. Nine histogram and gray-level co-occurrence matrix (GLCM) texture features were automatically extracted. Univariate and multivariate analysis were performed to determine risk factors associated with ETE. Predictive performance was evaluated by receiver operating characteristic (ROC) analysis. Interobserver agreement, confirmed by intraclass correlation coefficients (ICCs) ranging from 0.78 to 0.89, was excellent for texture analysis between 2 radiologists. T2WI image derived entropy, standard deviation, energy and correlation have significant difference between PTC with and without ETE (all P < .05). Among these, entropy showed the best diagnostic efficiency with the area under ROC curve of 0.837, diagnostic threshold of 5.86, diagnostic sensitivity and specificity of 81.5% and 75.6%, respectively. Additionally, the multivariate analysis revealed that high entropy was an independent risk factor of ETE (odds ratio, OR = 19.348; 95%CI, 4.578-81.760; P = .001). The findings indicate a significant association between texture features of the primary tumor based on T2WI and the presence of ETE in PTC. These results have the potential to help predict ETE preoperatively in patients with PTC, offering valuable insights for clinical decision-making.
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Carcinoma Papilar , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide/patologia , Estudos Retrospectivos , Carcinoma Papilar/patologia , Imageamento por Ressonância Magnética/métodosRESUMO
Purpose: To evaluate the value of quantitative parameters derived from diffusion kurtosis imaging (DKI) and intravoxel incoherent motion (IVIM) in differentiating histologic grades and clinical stages of clear cell renal cell carcinoma (ccRCC). Materials and methods: A total of 65 patients who were surgically and pathologically diagnosed as ccRCC were recruited in this study. In addition to routine renal magnetic resonance imaging examination, all patients underwent preoperative IVIM and DKI. The corresponding diffusion coefficient (D), pseudo-diffusion coefficient (D*), perfusion fraction (f), mean diffusivity (MD), kurtosis anisotropy (KA), and mean kurtosis (MK) values were obtained. Independent-samples t-test or Mann-Whitney U test was used for comparing the differences in IVIM and DKI parameters among different histologic grades and clinical stages. The diagnostic efficacy of IVIM and DKI parameters was evaluated using the receiver operating characteristic (ROC) curve. Spearman's correlation analysis was used to separately analyze the correlation of each parameter with histologic grades and stages of ccRCC. Results: The D and MD values were significantly higher in low-grade ccRCC than high-grade ccRCC (all p < 0.001) and in low-stage than high-stage ccRCC (all p < 0.05), and the f value of high-stage ccRCC was lower than that of low-stage ccRCC (p = 0.007). The KA and MK values were significantly higher in low-grade than high-grade ccRCC (p = 0.000 and 0.000, respectively) and in low-stage than high-stage ccRCC (p = 0.000 and 0.000, respectively). The area under the curve (AUC) values of D, D*, f, MD, KA, MK, DKI, and IVIM+DKI values were 0.825, 0.598, 0.626, 0.792, 0.750, 0.754, 0.803, and 0.857, respectively, in grading ccRCC and 0.837, 0.719, 0.710, 0.787, 0.796, 0.784, 0.864, 0.823, and 0.916, respectively, in staging ccRCC. The AUC of IVIM was 0.913 in staging ccRCC. The D, D*, and MD values were negatively correlated with the histologic grades and clinical stages (all p < 0.05), and the KA and MK values showed a positive correlation with histologic grades and clinical stages (all p < 0.05). The f value was also negatively correlated with the ccRCC clinical stage (p = 0.008). Conclusion: Both the IVIM and DKI values can be used preoperatively to predict the degree of histologic grades and stages in ccRCC, and the D and MD values have better diagnostic performance in the grading and staging. Also, further slightly enhanced diagnostic efficacy was observed in the model with combined IVIM and DKI parameters.
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Background: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are preclinical stages of Alzheimer's disease (AD). Individual biomarkers are essential for evaluating altered neurological outcomes at both SCD and MCI stages for early diagnosis and intervention of AD. In this study, we aimed to investigate the relationships between topological properties of the individual brain morphological network and clinical cognitive performances among healthy controls (HCs) and patients with SCD or MCI. Methods: The topological measurements of individual morphological networks were analyzed using graph theory, and inter-group differences of standard graph topology were correlated and regressed to scores of clinical cognitive functions. Results: Compared with HCs, the topology of the individual morphological networks in SCD and MCI patients was significantly altered. At the global level, altered topology was characterized by lower global efficiency, shorter characteristics path length, and normalized characteristics path length [all P<0.05, false discovery rate (FDR) corrected]. In addition, at the regional level, SCD and MCI patients exhibited abnormal degree centrality in the caudate nucleus and nodal efficiency in the caudate nucleus, right insula, lenticular nucleus, and putamen (all P<0.05, FDR corrected). Conclusions: The topological features of individual gray matter morphological networks may serve as biomarkers to improve disease prognosis and intervention in the early stages of AD, namely SCD and MCI. Moreover, these findings may further elucidate the relationships between brain morphological alterations and cognitive dysfunctions in SCD and MCI.
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Background: There were no effective noninvasive methods to diagnose renal ischemia-reperfusion injury (IRI), which is a major clinical problem. The objective of this study was to explore the feasibility of the quantitative susceptibility mapping (QSM) technique in evaluating the dynamic changes in the renal IRI process. Methods: A total of 36 New Zealand rabbits were randomly assigned to the IRI group (n=30) and the sham group (n=6). All rabbits underwent magnetic resonance imaging (MRI) examination, including T2-weighted imaging and QSM before the operation (pre-IRI) and 1, 12, 24, and 48 h after the operation (IRI-1h, IRI-12h, IRI-24h, and IRI-48h, respectively). Regions of interest were manually delineated in the outer medulla. All specimens were stained with hematoxylin and eosin (HE) and glutathione peroxidase 4 (GPX4). The pathological score of renal injury and the average optical density value of GPX4 were calculated. The repeated measurement analysis of variance (ANOVA) and Spearman correlation analysis were used to compare the differences between the susceptibility values and determine the correlation. Results: In the IRI group, the susceptibility values of the outer medulla at the pre-IRI, IRI-1h, IRI-12h, IRI-24h, and IRI-48h time points were (42.83±7.83)×10-3, (-5.33±6.28)×10-3, (6.50±3.94)×10-3, (12.00±3.74)×10-3, and (22.00±6.81)×10-3 ppm, respectively. The susceptibility values significantly differed among the different time points (P<0.001). The susceptibility values had a negative correlation with the scores of cell edema (ρ=-0.61; P=0.002) and the average optical density value of GPX4 (ρ=-0.70; P<0.001). The susceptibility values had a positive correlation with iron content (ρ=0.79; P<0.001), the scores of cell necrosis (ρ=0.71; P<0.001), interstitial inflammation (ρ=0.60; P=0.002), cast (ρ=0.75; P<0.001), and the total pathological score of renal injury (ρ=0.51; P=0.01). Conclusions: QSM can be used as a noninvasive method to assess the dynamic changes of the outer medulla in the early stage of renal IRI in rabbits.
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To explore the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the assessment of laryngeal cartilage lesions. In this study, 3 groups of cases were selected, including 16 cases benign lesions of the laryngopharynx as the benign group, 17 cases malignant lesions of laryngopharynx as the malignant group and 23 healthy adults as the control group. Conventional magnetic resonance imaging and DCE-MRI were performed with a 3.0 T MR scanner. cutoff, sensitivity, specificity and area under the curve values were calculated via receiver operating characteristic curve analysis based on the pathologic findings of surgically resected specimens. There were significant differences in the values of the volume transfer constant (Ktrans), the rate constant between the extravascular extracellular space and blood plasma (Kep) and The extravascular extracellular space fractional volume (Ve) between the control, benign and malignant groups (Pâ <â .005). Among the 3 groups, the malignant group had the highest Ktrans and Ve values (0.8681â ±â 0.3034 and 0.6186â ±â 0.2405, respectively), and the benign group had the highest Kep value (2.445â ±â 0.7346). The cutoff points of the Ktrans, Kep, and Ve values of the control, benign and malignant groups were 0.39, 1.261, and 0.195; 0.471, 0.964, and 0.235; and 0.706, 2.005, and 0.659, respectively. The Ktrans, Kep, and Ve values obtained via DCE-MRI may enable differentiating laryngeal cartilage lesions. DCE-MRI can be used to evaluate laryngeal cartilage lesions accurately and quantitatively.
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Meios de Contraste , Imageamento por Ressonância Magnética , Adulto , Humanos , Imageamento por Ressonância Magnética/métodos , Curva ROC , Diagnóstico DiferencialRESUMO
OBJECTIVE: This study aimed to assess the computed tomography (CT) and magnetic resonance imaging (MRI) features of pancreatic mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) and compare them with those of pancreatic ductal adenocarcinoma (PDAC) and neuroendocrine tumor (NET). METHODS: Twelve patients with pancreatic MiNEN, 24 patients with PDAC, and 24 patients with NET, who underwent both contrast-enhanced CT and MRI, were included. Clinical data and the key imaging features were retrospectively evaluated by two independent readers and compared between MiNEN and PDAC or NET. Univariate and multivariable logistic regression analyses were performed to obtain predictors for pancreatic MiNEN. RESULTS: Patients with pancreatic MiNEN more frequently presented with large size and heterogeneous and cystic components compared with PDAC (p < 0.031) and ill-defined irregular margins, progressive enhancement, and adjacent organ involvement compared with NET (p < 0.036). However, vascular invasion was less commonly seen in MiNEN than PDAC (p = 0.010). Moderate enhancement was observed more frequently in MiNEN than in PDAC or NET (p < 0.001). Multivariate logistic analyses demonstrated that moderate enhancement and ill-defined irregular margin were the most valuable features for the prediction of pancreatic MiNEN (p ≤ 0.044). The combination of the two features resulted in a specificity of 93.8%, sensitivity of 83.3%, and accuracy of 91.7%. CONCLUSIONS: We have mainly described the radiological findings of pancreatic MiNEN with ill-defined irregular margin and moderate enhancement compared with PDAC and NET. The combination of imaging features could improve diagnostic efficiency and help in the selection of the correct treatment method.
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Tillage systems may change the cadmium (Cd) threshold of farmland soil. However, there have been few studies on this topic. Therefore, this study aimed to explore the influence of tillage systems on Cd threshold. The study conducted 2-year field experiments under different tillage systems (early rice-fallow, early rice-late rice and early rice-vegetable) at three typical Cd-polluted sites in China. The species sensitivity distribution (SSD) method was used to construct the SSD curves for the calculation of the Cd threshold by analyzing the experimental data. The sensitivity analysis results based on the SSD curves revealed that the sensitivities to Cd in rice varieties under the same tillage system were substantially different but almost the same under different tillage systems. These results can help select rice varieties with low Cd sensitivity for crop safety. Different tillage systems at the same site varied in their influence on Cd threshold values. Cd threshold values under early rice-late rice (e.g., 0.27, 0.28 mg/kg in Xiangtan City) and early rice-vegetable (e.g., 0.26, 0.31 mg/kg in Xiangtan City) tillage systems were roughly lower than that under the early rice-fallow tillage system (e.g., 0.33, 0.35 mg/kg in Xiangtan City). Notably, the influence of tillage systems resulted in Cd threshold values being generally lower than the Cd risk screening values of the current Chinese soil environmental quality standard. Analysis of the influence of different tillage systems on the Cd threshold is beneficial for the optimization of farmland soil environmental quality standards.
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Oryza , Poluentes do Solo , Cádmio/análise , Solo , Fazendas , Poluentes do Solo/análise , China , VerdurasRESUMO
OBJECTIVES: This study aimed to evaluate the synthetic MRI (syMRI), its combination with diffusion-weighted imaging (DWI), and morphological features for discriminating benign from metastatic retropharyngeal lymph nodes (RLNs). METHODS: Fifty-eight patients with a total of 63 RLNs (21 benign and 42 metastatic) were enrolled. The mean and standard deviation of syMRI-derived relaxometry parameters (T1, T2, PD; T1SD, T2SD, PDSD) were obtained from two different regions of interest (namely, partial-lesion and full-lesion ROI). The parameters derived from benign and metastatic RLNs were compared using Student's t or chi-square tests. Logistic regression analysis was used to construct a multi-parameter model of syMRI, syMRI + DWI, and syMRI + DWI + morphological features. Areas under the curve (AUC) were compared using the DeLong test to determine the best diagnostic approach. RESULTS: Benign RLNs had significantly higher T1, T2, PD, and T1SD values compared with metastatic RLNs in both partial-lesion and full-lesion ROI (all p < 0.05). The T1SD obtained from full-lesion ROI showed the best diagnostic performance among all syMRI-derived single parameters. The AUC of combined syMRI multiple parameters (T1, T2, PD, T1SD) were higher than those of any single parameter from syMRI. The combination of synthetic MRI and DWI can improve the AUC regardless of ROI delineation. Furthermore, the combination of synthetic MRI, DWI-derived quantitative parameters, and morphological features can significantly improve the overall diagnostic performance. CONCLUSIONS: The value of syMRI has been validated in differential diagnosis of benign and metastatic RLNs, and syMRI + DWI + morphological features can further improve the diagnostic efficiency for discriminating these two entities. KEY POINTS: ⢠Synthetic MRI was useful in differential diagnosis of benign and metastatic RLNs. ⢠The combination of syMRI, DWI, and morphological features can significantly improve the diagnostic efficiency.
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Imagem de Difusão por Ressonância Magnética , Linfonodos , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Imagem de Difusão por Ressonância Magnética/métodos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Imageamento por Ressonância Magnética/métodos , Pescoço , Diagnóstico Diferencial , Sensibilidade e EspecificidadeRESUMO
Background: Hemodynamic changes after intracranial artery stenosis (ICAS) or occlusion are important causes of metabolic alterations in tissue. This study aimed to explore the feasibility of using amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI) to diagnose patients with symptomatic chronic ICAS based on pH variations caused by metabolite damage. Methods: Sixty-seven patients with clinically confirmed unilateral anterior circulation ICAS (≥70% arterial narrowing) and 20 healthy volunteers were recruited for the study. Each patient underwent an MRI examination including a T2 fluid-attenuated inversion recovery (T2-FLAIR) sequence, spin-echo echo-planar diffusion-weighted imaging (DWI), three-dimensional pseudo-continuous arterial spin labeling (pcASL), and an APTw sequence. Areas with abnormal perfusion and APTw effects were defined as perfusion/pH matched areas; areas with abnormal perfusion but normal APTw effects were defined as perfusion/pH unmatched areas; the contralateral mirror areas were defined as the normal areas. Regions of interest (ROIs) were selected within these three areas, and the corresponding apparent diffusion coefficient (ADC), cerebral blood flow (CBF), and magnetization transfer ratio asymmetry (MTRasym) were measured. Results: High intraclass correlation coefficient (ICC) values (0.78≤ ICCs ≤0.97; P<0.05) were observed between the two radiologists who independently performed the data analysis. Significant differences were found in CBF and MTRasym between the perfusion/pH matched, perfusion/pH unmatched, and normal areas [F(2,64)=288.5, 163.5; both P<0.05], but the ADC values were comparable between the three [F(2,64)=2.11; P>0.05]. Spearman correlation analysis revealed no significant correlation between changes in MTRasym and CBF (P>0.05). Finally, APTw showed a robust performance in diagnosing symptomatic chronic ICAS, with an area under the receiver operating characteristic curve (ROC) of 0.953 (sensitivity 97.01%; specificity 85.07%; cut-off value 1.005%). Conclusions: The present study has demonstrated that metabolic alterations are present in patients with symptomatic chronic ICAS. Our findings illustrate that APTw imaging could potentially serve as an effective method to provide a robust clinical diagnosis for patients with symptomatic chronic ICAS.
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BACKGROUND: Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality worldwide. Transcatheter arterial chemoembolization (TACE) has been performed as a palliative treatment for patients with HCC. However, HCC is easy to recur after TACE. Magnetic resonance imaging (MRI) has clinical potential in evaluating the TACE treatment effect for patients with liver cancer. However, traditional MRI has some limitations. AIM: To explore the clinical potential of diffusion kurtosis imaging (DKI) in predicting recurrence and cellular invasion of the peritumoral liver zone of HCC after TACE. METHODS: Seventy-six patients with 82 HCC nodules were recruited in this study and underwent DKI after TACE. According to pathological examinations or the overall modified response evaluation criteria in solid tumors (mRECIST) criterion, 48 and 34 nodules were divided into true progression and pseudo-progression groups, respectively. The TACE-treated area, peritumoral liver zone, and far-tumoral zone were evaluated on DKI-derived metric maps. Non-parametric U test and receiver operating characteristic curve (ROC) analysis were used to evaluate the prediction performance of each DKI metric between the two groups. The independent t-test was used to compare each DKI metric between the peritumoral and far-tumoral zones of the true progression group. RESULTS: DKI metrics, including mean diffusivity (MD), axial diffusivity (DA), radial diffusivity (DR), axial kurtosis (KA), and anisotropy fraction of kurtosis (Fak), showed statistically different values between the true progression and pseudo-progression groups (P < 0.05). Among these, MD, DA, and DR values were higher in pseudo-progression lesions than in true progression lesions, whereas KA and FAk values were higher in true progression lesions than in pseudo-progression lesions. Moreover, for the true progression group, the peritumoral zone showed significantly different DA, DR, KA, and FAk values from the far-tumoral zone. Furthermore, MD values of the liver parenchyma (peritumoral and far-tumoral zones) were significantly lower in the true progression group than in the pseudo-progression group (P < 0.05). CONCLUSION: DKI has been demonstrated with robust performance in predicting the therapeutic response of HCC to TACE. Moreover, DKI might reveal cellular invasion of the peritumoral zone by molecular diffusion-restricted change.