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Objective To explore the value of curvature value of liver surface nodularity(LSN)based on MRI in evaluating liver function in patients with liver cirrhosis.Methods A retrospective analysis was made on the patients who underwent upper abdomen MR examination at 3.0T.The normal liver function patients and cirrhosis patients were enrolled in the study and then the Child-Pugh score of the patients were calculated.The patients were divided into three groups:normal liver group,compensated cirrhosis group and decompensated cirrhosis group.The water phase imaging of 3D modified Dixon fast field echo(mDixon-FFE)sequence was copied in DICOM format.ITK software was used to manually draw the full-thickness liver edge by two observers.The curvature value of LSN was obtained by using matlab self compiled code for follow up analysis.Kruskal-Wallis H test was used to compare the curvature value between the groups.The receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was obtained.Spearman test was used for the correlation analysis.Results The curvature values of LSN among the normal liver,compensated cirrhosis and decompensated cirrhosis groups gradually increased(P<0.05).Comparing normal liver with compensated cirrhosis,the AUC of diagnosing compensated cirrhosis was 0.84,with the sensitivity of 72.7%and the specificity of 89.3%.Comparing compensated cirrhosis with decompensated cirrhosis,the AUC of diagnosing decompensated cirrhosis was 0.91,with the sensitivity of 80%and the specificity of 90.9%.There was a moderate positive correlation between the curvature value of LSN and liver function score in patients with cirrhosis(r=0.63,P=0.002).Conclusion The curvature value of LSN based on MRI can be used for preliminary evaluation of liver function of liver cirrhosis,with the AUC more than 0.80 and higher sensitivity and specificity.
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Objective To observe the influence of different acceleration factors(AF)on compressed sensing susceptibility weighted imaging(CS-SWI)for cerebral medullary veins of healthy people,and to screen the best AF.Methods Forty healthy volunteers were prospectively enrolled.Axial brain SWI images were obtained with CS technique under different AF(AF0,CS2,CS4,CS6,CS8 and CS10),and the phase value(PV)and standard deviation(SD)of bilateral septal vein(SV),internal cerebral vein(ICV),thalamus vein(TV),basal vein(BV)and dentate nucleus vein(DNV)were measured.Taken PV and SD of parietal white matter as controls,the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of venous images were calculated.Then the original images were reconstructed with minimum intensity projection,and the subjective quality scoring of reconstructed images were performed using a 5-point scale.SNR,CNR,PV and quality score were compared among images under different AF,and the best AF,i.e.with the best performances for displaying and quantitatively analyzing cerebral medullary veins in healthy people was obtained.Results Compared with those acquired with AF0,SNR and CNR of all cerebral medullary veins acquired with CS6,CS8 and CS10 were significantly different(all adjusted P＜0.05).Meanwhile,significant differences of PV in bilateral SV and right TV were found among CS6,CS8 and CS10,also in bilateral ICV,left TV and bilateral BV between CS8 and CS10(all adjusted P＜0.05).Conclusion Excessive AF might decrease image quality of CS-SWI for cerebral medullary veins.CS4 was the best AF for displaying and quantitatively analyzing cerebral medullary veins in healthy people.
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Objective:To explore the consistency of MRI fast field echo resembling a CT using restricted echo-spacing (FRACTURE) and CT in the evaluation of knee and ankle bone changes.Methods:From November 2020 to November 2021, seventeen patients who underwent CT and MRI FRACTURE examinations of knee joint or ankle joint in the First Affiliated Hospital of Dalian Medical University were retrospectively collected, including 14 patients with knee joint examinations and 3 patients with ankle joint examinations. According to the number of joint components, 80 components were included, including 14 for femur and patella, 17 for tibia and fibula, and 3 for talus, scaphoid, medial cuneiform, medial cuneiform, lateral cuneiform and calcaneus, respectively. The fracture, hyperosteogeny, and bone destruction of the joint bones were evaluated by two observers using CT and FRACTURE images, respectively. Kappa test was used to analyze the consistency of CT and FRACTURE images between observers in the evaluation of joint bone lesions.Results:The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by CT and FRACTURE images were 0.925 (0.823-1.027), 0.905 (0.799-1.011) and 0.895(0.752-1.038) respectively for observer 1, and were 0.963 (0.892-1.034), 0.933 (0.843-1.023) and 0.886 (0.731-1.041) respectively for observer 2. The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by observers 1 and 2 via CT images were 1.000 (1.000-1.000), 0.937(0.851-1.023) and 0.945 (0.839-1.051) respectively, and that by FRACTURE images were 0.962 (0.888-1.036), 0.966 (0.899-1.033) and 0.836 (0.656-1.016) respectively.Conclusion:For the evaluation of fracture, hyperosteogeny, and bone destruction of knee joint and ankle joint, MRI FRACTURE sequence is highly consistent with CT.
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Objective:To explore the value of echo-planar imaging correction (EPIC) for improving image quality of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) of cervical cord.Methods:A total of 33 subjects (20 males, 13 females) were scanned on a 3.0 T MR scanner from January to March 2022, and the sequences included T 1WI, DWI and DTI (with and without corrections). Two observers delineated the regions of interest (ROIs) on the fused images of DWI and DTI with T 1WI before and after correction, and measured the average diffusion coefficient (ADC), fractional anisotropy (FA), and offset distance of ROIs between images with and without corrections. The subjective scores of image quality were also evaluated. The ICC or Kappa was used to test the consistency of the quantitative measurement and subjective scores by the two observers. The average values by the two observers would be used for subsequent analysis. The independent pair t-test and Wilcoxon test were used for comparison of objective measurements and Mann-Whitney U test was used for subjective image assessments between images with and without corrections. Results:The measurement data and the subjective scores of the two observers were in good agreement (ICC 0.912-0.999, Kappa 0.778-0.816). The independent sample t-test showed the subjective scores were significantly different for the DWI and DTI images between before and after geometry and/or ADC corrections. The ADC values of C6, the offset distances measured by DWI before and after correction of C4, C5, and C6 and subjective scores were significantly different ( P<0.05); The FA values of C1 and C3, ADC values of C1 and C3, offset distance of C4, C5 and C6 measured by DTI before and after correction and subjective scores were statistically significant ( P<0.001). Conclusion:EPI geometry correction and ADC value correction can significantly reduce geometric distortion, increase image quality, and thus improve the diagnosis accuracy of essential diseases.
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Objective:To assess the value of amide proton transfer weighted (APTw) imaging in the evaluation of pH changes in infarct core (IC) and ischemic penumbra (IP) in subacute cerebral infarction.Methods:The data of twenty-three subacute cerebral infarction patients with unilateral steno-occlusive disease of the middle cerebral artery (subacute infarction group) from April to November 2019 in the First Affiliated Hospital of Dalian Medical University were prospectively analyzed. Fifteen healthy volunteers were enrolled in this study as the control group. All subjects underwent conventional MRI, DWI, 3D-pseudo continuous arterial spin labeling (3D-pCASL) and APTw sequences. Based on DWI images, relative cerebral blood flow (rCBF) and APTw images to determine the region of IC, blood flow penumbra [cerebral blood flow(CBF)-DWI mismatch area, IP CBF] and metabolic penumbra (APTw-DWI mismatched area, IP APT). 3D ROIs were used to semi-automatically measure the APTw signals and the volume of IC and IP CBF of the patients in subacute infarction group. The comparison of APTw signals between the infarct side and the contralateral side in the subacute infarction group, the comparison of bilateral APTw signals in the control group, and the comparison of APTw signals in the IC and IP CBF regions were performed by paired-sample t test or Wilcoxon signed-rank test. The paired-sample t test or Mann-Whitney U test was used to compare the APTw signals between the two groups. The Friedman test was applied to compare the difference of volumes among IP CBF1.5, IP CBF2.5 and IP APT . Results:There was no significant difference of the APTw signals among the IC, the contralateral side in the subacute infarction group and the control group ( P>0.05). The APTw signals of IP CBF and IC of the infarction group were statistically different ( P<0.05). Compared with the contralateral side of IP CBF1.5 (3.7±1.7, -1.84±1.48, 5.57±2.75), the APTwmax (3.07±1.41, t=-3.012, P=0.006), APTw min [-1.30 (-1.74, -0.57), Z=-2.099, P=0.036], and APTwmax-min(4.51±2.58, t=-3.273, P=0.003) signals in the IP CBF1.5 were decreased ( P<0.05). Compared with the contralateral side of IP CBF2.5 [-1.53 (-2.80, -0.91), 5.31±2.61], the APTw min [-1.08 (-1.60, -0.49), Z=-2.616, P=0.009] and APTwmax-min (4.41±2.72, t=-3.228, P=0.004) signals in the IP CBF2.5 were decreased. The volumes of IP CBF1.5 [107.51(50.08, 138.61)mm 3], IP APT [99.00 (53.27, 121.335) mm 3] and IP CBF2.5 [89.91 (51.53, 139.87) mm 3] were successively reduced (χ2=7.913, P=0.019), and the volume of IP CBF2.5 was significantly smaller than that of IP CBF1.5 ( P=0.037). Conclusion:The acid-base metabolism in the IC of subacute cerebral infarction is not obvious, but the blood flow penumbra has local acid-base metabolism imbalance, and the range of metabolic penumbra coincides with the blood flow penumbra.
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Objective To investigate the value of diffusion kurtosis imaging (DKI)quantitative parameters in evaluating patholog-ical grade of cervical squamous cell carcinoma (CSCC).Methods The DKI images of 45 patients with CSCC were analyzed retrospec-tively.According to the results of pathology,22 cases were divided into poorly differentiated group and 23 cases well-moderately dif-ferentiated group.The DKI parameters of two groups were measured by two observers,which included mean kurtosis (MK),axial kurtosis (Ka),radial kurtosis (Kr),fractional anisotropy of kurtosis (FAk),mean diffusivity (MD),axial diffusivity (Da),radial diffusivity (Dr)and fractional anisotropy (FA).The intra-class correlation coefficients (ICC)was used to test the consistency of the parameters measured results on two observers.The two independent samples t test was used to compare the parameters of two groups,and the ROC curve was used to evaluate the effectiveness of each parameter in order to evaluate the poorly differentiated CSCC and find the boundary values.Results The data consistency of two observers were good (ICC>0.75).The MK,Ka and Kr values on poorly differentiated CSCC were greater than that on well-moderately differentiated (P0.05).Thearea un-der curve (AUC)of MK,Ka,Kr,MD,Da and Dr values to diagnose poorly differentiated CSCC were 0.914,0.831,0.865,0.850, 0.778 and 0.865,respectively.The boundary values of diagnosing poorly differentiated CSCC were MK≥0.973,Ka≥1.075,Kr≥0.823, MD≤0.974μm2/ms,Da≤1.185μm2/ms and Dr≤0.762μm2/ms,respectively.Conclusion DKI can effectively predict the patho-logical grading of CSCC,which has a good clinical application prospects.
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Objective To explore the value of cardiovascular magnetic resonance feature tracking (CMR-FT) in quantita tive evaluation of myocardium deformation in patients with hypertrophic cardiomyopathy (HCM).Methods Sixteen HCM patients (HCM group) and 18 healthy volunteers (control group) were enrolled and measured with CMR-FT.The differences of left ventricular (LV) end diastolic volume (LVEDV),LV end systolic volume (LVESV),LV ejection fraction (LVEF),left ventricular mass (LVMASS) and LV global radial strain (RS),LV global circumferential strain (CS) were compared between the two groups.The correlations between segmental wall thickness and segmental RS and CS were studied.And the correlation among global RS,CS and LVEDV,LVESV,LVEF,LVMASS were analyzed.Results LVMASS in HCM group was higher than that in control group ([133.74±79.13]g vs [76.87±14.15]g,P=0.01).No sig nificant differences of LVEDV,LVESV,LVEF were found between HCM group and control group (all P＞0.05).Global RS and CS were significantly lower in HCM group than those in control group (RS:[27.05 ± 13.35]％ vs [40.62 ± 4.92] ％,P＜0.01;CS:[-8.68± 5.56] ％ vs [-20.73 ± 1.56] ％,P＜0.01).No significant correlations was observed between segmental wall thickness and segmental RS (r=-0.41,P＜0.01),CS (r=0.28,P＜0.01),respectively.In HCM group,no significant correlations was observed between global RS (r=-0.36,-0.41,0.22,-0.36),CS (r=0.34,0.10,0.22,0.42) and LVEDV,LVESV,LVEF,LVMASS,respectively (all P＞0.05).Conclusion CMR-FT is conducive to quantitative evaluate myocardial deformation in HCM patients.
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Objective To evaluate the value of ADC and FA of diffusion tensor imaging (DTI) in differentiating clear cell renal cell carcinoma (ccRCC) and transitional cell carcinoma (TCC) of kidney pelvis.Methods Thirty-eight histopathology proven ccRCC and TCC patients (29 cases of ccRCC and 9 cases of TCC) were retrospectively enrolled.All the patients were performed abdominal MR fat saturation T1WI,fat saturation T2WI,LAVA and DTI (b=0,600 s/mm2).MR images were reviewed and analyzed by two radiologists in a double-blind manner with the value of ADC and FA measured using the Functool on AW 4.4 workstation.The data of two observers were analyzed with intra-class correlation coefficients (ICC) to assess inter-observer consistency.The differences of ADC values and FA values between ccRCC and TCC were compared by independent t-test.The ROC curves were used to analyze and compare the diagnostic value of DTI in differentiating ccRCC and TCC.Results The inter-observer agreements were good (ICC＞0.75).The ADC value of ccRCC was statistically higher than that of TCC ([2.03 ± 0.49] × 10-3 mm2/s vs [1.57 ± 0.43] × 10-3 mm2/s,P =0.015).But the FA value of ccRCC was statistically lower than that of TCC ([0.24±0.10] vs [0.42±0.22],P=0.002).The area under the ROC curve of ADC was 0.761 (P＜0.05),and the sensitivity and specificity were 79.3％ and 77.8％.The ADC threshold for differentiating ccRCC from TCC was 1.59× 10-3 mm2/s.The area under the ROC of FA was 0.762 (P＜ 0.05),and the sensitivity and specificity were 66.7 ％ and 93.1％.The FA threshold for differentiating ccRCC from TCC was 0.326.Conclusion MR DTI can effectively discriminate ccRCC and TCC.FA values has good diagnostic specificity in differentiating between ccRCC and TCC.
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Objective To explore the value of diffusion tensor imaging (DTI) in differential diagnosis of intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC).Methods Fifty-two patients including 20 patients with ICC (ICC group) and 32 patients with HCC (HCC group) confirmed by histopathological examination were recruited in the study.All the patients were performed MR exams on a 1.5T scanner in a protocol containing the routine T1WI,T2WI,DWI and DTI.The values of ADC,fractional anisotropy (FA),diffusion coefficient (D) were blindly reviewed and analyzed by two experienced observers,and were compared between two groups.The ROC curve was used to evaluate the di agnostic efficiency.Results The border clear percentage of ICC group (9/20,45.00％) had no significant difference compared with that of HCC group (15/32,46.88％;x2 =0.02,P=0.90),the detection rate of bile duct expansion in ICC group (11/20,55.00％) was higher than that in HCC group (4/32,12.50％;x2=10.83,P=0.001).Theintraclasscor relation coefficient value of ADC,D and FA in the ICC group and HCC group were all more than 0.90.The mean FA of ICCgroup (0.45±0.16) were significantly higher than that of HCC group (0.30±0.13;P=0.001),while the mean ADC and D values in ICC and HCC groups had no significant difference (both P＞0.05).The area under the ROC curve of FA was 0.76.And when FA=0.31,there was a higher sensitivity (85.0％) in identifying ICC and HCC.Conclusion The FA of DTI shows a stronger capability than the ADC and D values in differentiating the ICC from HCC.
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Objective To evaluate MRI characteristics of solid papillary carcinomas (SPCs) in situ of the breast.Methods A retrospective study included 5 patients with pathologically confirmed SPC in situ was performed.MRI data before operation including conventional MRI,dynamic contrast enhanced MRI (DCE-MRI) and DWI were analyzed.Results All the lesions showed iso/hypointensity on T1 FSPGR sequence,iso/hyperintensity on FSE T2WI sequence and STIR sequence.Mass enhancements were observed for all lesions with oval or irregular shapes on DCE-MRI.The margin of lesions were circumscribed,and internal enhancements were homogeneous or heterogeneous.Time intensity curve appeared a rapid increase in initial contrast phases and platform or outflow types in delayed phases.All the lesions on DWI showed slightly hyperintensity with the ADC value range from 1.34 × 10-3 mm2/s to 1.96)× 10-3 mm2/s.Conclusion MRI manifestations of SPC are characteristics,which may provide valuable information to distinguish SPC in situ from other invasive breast carcinomas.
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Objective To evaluate the feasibility of multi-parameter MRI in diagnosing ovarian endometrial cysts. Methods Pelvic MRI of 68 patients with confirmed pathological diagnosis were retrospectively reviewed. The patients were divided into ovarian endometriosis (35 patients with 42 lesions, group A) and other cystic lesions (33 patients with 38 lesions , group B).The signal intensity value of T1WI, T2WI of cyst fluid and iliopsoas, ADC value, phase values and R2*values were obtained, cyst fluid/iliopsoas ratios (T1R and T2R) were calculated. The non-parametric Mann-Whitney U test was employed to compare parameter values between the two groups. The values of diagnostic performance were analyzed by using receiver operating characteristic curve (ROC). Use the Logistics regression parameters of diagnostic efficacy to select the highest Youden index for the best parameter association after combining the parameters step by step. Results The median of T1R, T2R, ADC, phase, T1R and R2*values for group A were 3.39, 5.28, 1.20×10-3 mm2/s,2.19×10-2, 15.08 Hz respectively, and that of group B were 0.91, 10.85, 2.64×10-3mm2/s,2.67×10-2, 3.01 Hz, respectively. There were statistically significant difference between the two groups (P0.05). When combining T1R, ADC value, R2*value together, the Youden index (0.849 7) was highest. Conclusion Combining T1R, ADC and R2* values can provide an effective way to discriminate endometrial ovarian cyst from other ovary cystic lesions.
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Objective To study the microscopic changes of white matter and the relationship between white matter changes and cognitive impairment in Alzheimer's disease (AD) using voxel-based analysis of DTI. Methods Thirty-sev?en patients with probable AD,and 32 normal controls(NC) were all examined by MMSE scores, and underwent a diffusion tensor imaging. The value of FA changes and the correlations between FA and MMSE scores were investigated. Results FA reduction was detected in the right frontal, temporal and parietal lobes as well as the thalamus, the bilateral cingu?lum, corpus callosum, precuneus, inferior parietal lobule, inferior patieto gyrus, supramaginal gyrus and hippocampus in AD. FA values in the right cingulum, left corpus callosum, left inferior temporal gyrus and the bilateral inferior parietal lobule, inferior patieto gyrus and precuneus were significantly decreased in AD than in the health control groups (P<0.05, FWE corrected). There was a positive correlation between the values of FA and MMSE scores(P<0.001,uncorrect?ed). Conclusion AD patients have significant reduction of FA values in the specific regions. There is a positive correla?tion between white matter changes and impairments of cognitive function.
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Oleanolic acid (OA) has a wide variety of bioactivities such as hepatoprotective, anti-inflammatory and anti-cancer activity and is used for medicinal purposes in many Asian countries. In the present study, the effect of OA on induction of autophagy in human hepatocellular carcinoma HepG2 and SMC7721 cells and the related mechanisms were investigated. MTT assay showed that OA significantly inhibited HepG2 and SMC7721 cells growth. OA treatment enhanced formation of autophagic vacuoles as revealed by monodansylcadaverine (MDC) staining. At the same time, increasing punctuate distribution of microtubule-associated protein 1 light chain 3 (LC3) and an increasing ratio of LC3-II to LC3-I were also triggered by OA incubation. In addition, OA-induced cell death was signifi cantly inhibited by autophagy inhibitors 3-methyladenine (3-MA) and chloroquine (CQ) pretreatment. And we found out that OA can suppress the PI3K/Akt1/mTOR signaling pathway. Furthermore, our data suggested that OA-triggered autophagy was ROS-dependent as demonstrated by elevated cellular ROS levels by OA treatment. When ROS was cleared by N-acetylcysteine (NAC), OA-induced LC3-II convertsion and cell death were all reversed. Taken together, our results suggest that OA exerts anticancer eff ect via autophagic cell death in hepatocellular carcinoma.
الموضوعات
Humans , Acetylcysteine , Asian People , Autophagy , Carcinoma, Hepatocellular , Cell Death , Chloroquine , Microtubule-Associated Proteins , Oleanolic Acid , Vacuolesالملخص
Objective To investigate the feasibility of MR angiography of the dorsalis pedis artery (DPA),the first dorsal metatarsal artery (FDMA) and the branches at the first toe web by threedimensional time-resolved imaging of contrast kinetics (TRICKS) sequence.Methods Forty three patients with suspected or known soft tissue diseases of the ankle and foot were examined retrospectively by MR TRICKS sequence.Two experienced radiologists independently evaluated the visualization performance of DPA,FDMA and its branches with maximum intensity projection.Kappa analysis was performed for the image evaluation of the two radiologists.Consensus scores were obtained if the two radiologists had different scores.Clinical classification of FDMA was carried out for patients with scores equal to,or more than 2 points after imaging evaluation.FDMA was categorized according to its location (superficial,intramuscular,infra-muscular,absent),diameter (large,medium and small) and branching pattern at the toe web (ramifying type,main trunk type and fine small branch).Results The scoring results of the two radiologists indicated a high agreement (Kappa value =0.895,P ＜ 0.05).TRICKS images can clearly show the arterial filling of DPA,FDMA and its branches.The final consensus scores were as follows:8 patients had 4 grade and 22 patients 3 grade,8 patients 2 grade and 5 patients 1 grade.Clinical classification of FDMA for 38 patients(arterial scales ≥2 point):(1) Location:superficial (8 patients),intramuscular (23 patients),intramuscular (7 patients) ; (2) Diameter at the midpoint of FDMA:large (2 patients),medium (25 patients),and small (11 patients); (3)Branching pattern at the toe web:ramifying type (11 patients),main trunk type (5 patients),fine branch (14 patients).Conclusion MR TRICKS sequences are valuable in the evaluation of the DPA and FDMA and its branches,which can provide useful anatomical information for classification of FDMA.
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Objective To explore the relationship between the characteristics of dynamic contrastenhanced MRI (DCE-MRI) and the stages of endometrial cancer.Methods A retrospective analysis of DCE-MRI manifestation in 55 patients with scratch-pathologically confirmed endometrial cancer was performed.All patients were divided into different groups according to differentiation,muscle layer infiltration,cervix involvement and metastasis.The enhanced rate,including the arterial phase relative signal increase ratio (ARSI％),the maximal relative signal increase ratio (MRSI％) and the signal enhancement ratio (SER％),was calculated at different time (i.e.16 s,32 s,48 s,64 s and 300 s),respectively.Time-intensity curves (TIC) of lesions were also obtained and divided into 4 subtypes.Two sample t test was performed to compare the MRSI％ among groups,and the Mann-Whitney U test was performed in ARSI％ and SER％ as well.Results The early phase enhanced rate of normal tissue was 894 ± 355,higher than that of tumor 716 ± 215 (t =-2.911,P ＜ 0.01).The delayed phase enhanced rate of normal tissue was 1111 ± 289,higher than that of tumor 803-± 289 (t =-4.926,P ＜ 0.01).ARSI％ of low differentiation group (n =16,M =1.07％) was higher than that of middle to high differentiation group (n =39,M=0.36％).ARSI％ of deep muscle layer infiltration group (n =19,M =0.76％) was higher than that of no muscle layer infiltration group (n =36,M =0.32％).ARSI％ of cervix involvement group (n =27,M =0.84％) was higher than that of no cervix involvement group (n =28,M =0.25％).SER％ of cervix involvement group (n =27,M =2.90％) was higher than that of no involvement group (n =28,M =1.40％) and SER％ of parauterine involvement and metastasis group (n =7,M =2.03％) was higher than that of uterine involvement group (n =48,M =1.60％).The differences between these groups were statistically significant (Z =-2.038,-2.260,-2.172,-2.695 and-2.621 respectively,P ＜ 0.05).Based on the TIC types,type Ⅰ occurred in 13 tumors (23.6％),type Ⅱ in 22 tumors (40％),type Ⅲ in 9 tumors (16.4％),and type Ⅳ in 11 tumors (20％).Conclusions Based on TIC curves,most of endometrial cancers showed significant enhancement which reflected of their rich blood supply.The parameters of DCE-MRI is helpful in staging of uterus tumors.
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Objective To investigate the value of kinetic features measured by computer-aided diagnosis (CAD)for breast MRI.Methods One hundred and sixty four lesions diagnosed pathologically by operation or biopsy comprised the analysis set.Automated lesion kinetic information from CADStream programs for breast MRI was identified.Three CAD variables were compared for benign and malignant lesions: initial phase peak enhancement (greatest percentage of signal intensity increase on first contrast enhanced sequence),delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement (washout,plateau,or persistent),and delayed phase enhancement categorized by single most suspicious type of kinetics (any washout ＞ any plateau ＞ any persistent).Morphological characteristics of breast lesions were described according to breast imaging and reporting data system (BI-RADS).Initial phase peak enhancement mean values between benign and malignant breast lesions were compared by using Wilcoxon rank-sum test,delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement or by single most suspicious type of kinetics between benign and malignant breast lesions were compared by using Chi-square test.Results There were 72 benign and 92 malignant breast lesions.A total of 123 (75.0％) mass lesions were identified,and the other 41 (25.0％) lesions showed no mass.Thirty lesions were BI-RADS-MRI 2,68 lesions were BI-RADS-MRI 3,43 lesions were BI-RADS-MRI 4,23 lesions were BI-RADS-MRI 5.Initial phase peak enhancement mean values of benign and malignant lesions were 237％ (69％ to 629％)and 336％ (86％ to 793％),respectively.There was no significant difference between benign and malignant lesions in initial peak enhancement mean value (Z =-1.626,P =0.104).Delayed phase enhancement categorized by single most suspicious type of kinetics (any washout ＞ any plateau ＞ any persistent) for benign and malignant lesions were 15,10,47 and 2,3,87 respectively.There was a significant difference between benign and malignant lesions (x2 =23.562,P =0.000).Initial peak enhancement value ＜ 100％ or ≥100％ were 5 and 67 for benign lesions,3 and 89 for malignant lesions,respectively.There was no significant difference between benign and malignant lesions at 100％ threshold (x2 =1.181,P =0.277).Delayed phase enhancement categorized by a single type of kinetics comprising the largest percentage of enhancement (washout,plateau,or persistent) for benign and malignant lesions were 48,6,18 and 47,15,30 respectively.There was no significant difference between benign and malignant lesions (x2 =4.496,P =0.106).Conclusions Of CAD kinetics analyzed,only delayed enhancement categorized by most suspicious type is helpful for the differentiation between benign and malignant lesions.However,there is significant overlap between initial peak enhancement at 100％ threshold or delayed kinetics categorized by largest percentage enhancement types of benign and malignant lesions,so lesion morphologic features should be considered.
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Objective To evaluate the feasibility of renal artery angiography with interpolated finite impulse response (IRFR) sequence on 1.5T MR. Methods A total of 122 subjects underwent MR scan with IFIR sequence. On axial image of IFIR, bilateral signal-to-noise ratio (SNR) and breath artifact of renal artery were measured and 3D maximum intensity projection (MIP) images were reconstructed on workstation ADW 4.3, and each branch was scored according to its displaying quality. Influence of SNR, age and breath artifact on the displaying of renal artery were compared and analyzed. Results Renal segmental artery could be seen in 112 subjects (91.80%). Among them, segmental artery was showed clearly in 78 subjects (63.93%), post-segmental artery was showed in 54 subjects (44.26%) and branches of post-segmental artery was showed in 22 subjects (18.03%). There was statistical difference of renal artery scores mean rank between ≥60 years group and ＜60 years group (49.25 vs 67.48, P=0.006), as well as between the group without and with breath artifact (66.66 vs 43.35, P=0.002). No statistical difference of SNR was found among renal artery scores from 1-5 (P=0.177). Conclusion IFIR sequence is simple and safe for renal artery angiography on 1.5T MR, and different grades of renal artery branch can be showed clearly.
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Objective To evaluate MR diffusion-weighted imaging (DWI)and MR perfusion-weighted imaging(PWI) in differentiating benign from malignant soft tissue tumors by comparing the related parameters. Methods Fifty patients with soft tissue tumors verified by pathology( benign 24, malignant 26) underwent DWI and dynamic contrast-enhanced T2 * -weighted PWI. DWI and PWI data of benign and malignant soft tissue tumors were acquired at the workstation and their difference was analyzed with t-test. The diagnostic accordance rate was verified with x2-test. Subjective overall performance of two techniques were evaluated with receiver operating characteristic (ROC) analysis. Results ADC values of benign and malignant tumors were (2. 03±0. 36) × 10-3 mm2/s, ( 1.52±0. 39) × 10-3 mm2/s,respectively. The signal intensity decrease of them during the first-pass perfusion (SIdecrease ) were ( 13.54 ± 3.37 )%, (47. 57 ± 5. 21 ) % ,respectively. The maximum linearity slope rate of TIC ( SSmax ) of them were ( 5.51 ± 2. 54 ) %, (7.94 ± 3. 33) %, respectively. There were significant differences between benign and malignant tumors of ADC value and SIdecrease ( t = 2. 515,2. 938 ;P < 0. 05 ), while there was no significant difference in SSmax (t = 1. 272,P >0. 05). When the threshold of ADC value was 1. 866 × mm2/s, sensitivity and specificity for determining malignant tumors were 84. 6% (22/26)and 83.3% (20/24). When the threshold of SIdecrease was 40. 33% ,sensitivity and specificity for determining malignant tumors were 88. 5% (23/26)and 75.0% (18/24). In type Ⅰa of TIC,the proportion of benign soft tissue tumor was 3/24 and malignant tumor was 20/26. In type Ⅰb , benign tumor was 14/24 and malignant tumor was 3/26. In type Ⅰc, malignant tumor was 3/26. In type Ⅱ ,benign tumor was 7/24. The diagnostic accordance rate of DWI and PWI were 84. 0% (42/50) and 82. 0% (41/50), respectively. There was no significant difference between them ( x2 = 0. 8, P >0. 05). The accuracies of them were 81.7% , 83. 6% respectively by the area under the ROC curve (AUC). The sensitivity of PWI in diagnosing malignant soft tissue tumors was higher. Conclusions ADC value and SIdecrease are Valllable diagnostic parameters in differentiating benign and malignant soft tissue tumors. The threshold of these parameters for diagnosing malignant soft tissue tumors are 1. 866 × 10-3 mm2/s and 40. 33%, respectively. The type of TIC can help to distinguish malignant tumors from benign tumors, while the SSmax can not. The accuracies of DWI and PWI in the diagnosis of malignant soft tissue tumors are moderate. Compared with DWI, PWI should be selected firstly because of its higher sensitivity in diagnosing malignant tumors.
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ul in some degree in prognostic assessment and staging of the uterine cervical cancer.
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Objective To evaluate multiple magnetic resonance (MR) imaging techniques in the differentiation of benign and malignant soft tissue tumors by comparing different information from MR perfusion-weighted Imaging (MR-PWI) and 1 HMR spectroscopy (1 H-MRS).Methods Forty patients with soft tissue tumors underwent conventional MR imaging,dynamic contrast-enhanced T2*-weighted MR-PWI and 1 H proton MR spectroscopy.The differences of perfusion and 1 H-MRS parameters of benign and malignant tumors were analyzed with t test.Results There was significant difference between benign and malignant tumoral tissues of BF value and Cho/Cr ratio(t=2.531,2.927,P < 0.05),while BV,MTT,Cho,Cr or Lip peak value were not.TIC was different between benign group (Ib) and malignant group (Ia).When the threshold value of BF was 4.35 ml ·100 mg-1·min-1,sensitivity and specificity for determining malignant tumors were 81.8%(18/22),72.2%(13/18),respectively.When the threshold value of Cho/Cr ratio was 3.22,Sensitivity and specificity for determining malignant tumors were 86.4% (19/22),88.9% (16/18),respectively.The abnormal wave crest is detected at 2.0-2.1ppm in 5 malignant tumors (2 malignant schwannoma and 3 malignant fibrous histiocytoma),while the other 35 cases were not.Conclusion The BF value and Cho/Cr ratio were both valuable diagnostic parameters in differentiating benign and malignant soft tissue tumors.TIC was helpful to distinguish malignant tumors from benign tumors,while the sensitivity and specificity of 1 H-MRS in diagnosing malignant soft tissue tumors were both higher.