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Objective To explore the value of combination of diffusion weighted imaging(DWI)and dynamic contrast-enhanced MRI(DCE-MRI)for predicting recurrence of hepatocellular carcinoma(HCC)after TACE combined with radiofrequency ablation.Methods Date of 80 HCC patients who underwent TACE combined with radiofrequency ablation were retrospectively analyzed.Abdominal DWI and DCE-MRI were performed 10 days before as well as 20,60 and 90 days after treatment.The sensitivity,specificity and accuracy of combination of DWI and DCE-MRI for predicting recurrence of HCC 20 days after TACE combined with radiofrequency ablation were calculated,and receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of apparent diffusion coefficient(ADC)value for predicting recurrence of HCC 20 days after treatment.Results Patients with HCC were divided into stable group(n=47)and progressive group(n=33)according to modified response evaluation criteria in solid tumors.Twenty days after TACE combined with radiofrequency ablation,most HCC lesions in stable group presented as uneven DWI signals and high ADC signals without enhancement,while those in progressive group mainly presented as high DWI signals and low ADC signals with mild enhancement.The sensitivity,specificity and accuracy of combination of DWI and DCE-MRI for predicting recurrence of HCC 20 days after TACE combined with radiofrequency ablation was 97.75％(87/89),92.31％(24/26)and 96.52％(111/115),respectively,and the AUC of ADC value was 0.82.Taken 1.42X10-3 mm2/s as the cutoff value of ADC,the sensitivity and specificity of ADC value for predicting recurrence of HCC 20 days after TACE combined with radiofrequency ablation was 72.13％and 82.25％,respectively.Conclusion Combination of DWI and DCE-MRI had certain value for predicting recurrence of HCC after TACE combined with radiofrequency ablation,and ADC could be used as an effective predicting index.
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Objective:To explore the effect of joint segmentation model of myocardial-fibrotic region based on deep learning in quantitative analysis of myocardial fibrosis in patients with dilated cardiomyopathy(DCM).Methods:The data of 200 patients with confirmed DCM and myocardial fibrosis in the left ventricle detected by cardiac MR-late gadolinium enhancement (CMR-LGE) in Xuzhou Central Hospital from January 2015 to April 2022 were retrospectively analyzed. Using a complete randomized design, the patients were divided into training set ( n=120), validation set ( n=30) and test set ( n=50). The left ventricle myocardium was outlined and the normal myocardial region was selected by radiologists. Fibrotic myocardium was extracted through calculating the threshold with standard deviation (SD) as a reference standard for left ventricle segmentation and fibrosis quantification. The left ventricular myocardium was segmented by convex prior U-Net network. Then the normal myocardial image block was recognized by VGG image classification network, and the fibrosis myocardium was extracted by SD threshold. The myocardial segmentation effect was evaluated using precision, recall, intersection over union (IOU) and Dice coefficient. The consistency of myocardial fibrosis ratio in left ventricle obtained by joint segmentation model and manual extraction was evaluated with intra-class correlation coefficient (ICC). According to the median of fibrosis rate, the samples were divided into mild and severe fibrosis, and the quantitative effect of fibrosis was compared by Mann-Whitney U test. Results:In the test set, the precision of myocardial segmentation was 0.827 (0.799, 0.854), the recall was 0.849 (0.822, 0.876), the IOU was 0.788 (0.760, 0.816), and the Dice coefficient was 0.832 (0.807, 0.857). The consistency of fibrosis ratio between joint segmentation model and manual extraction was high (ICC=0.991, P<0.001). No statistically significant difference was found in the ratio error between mild and severe fibrosis ( P>0.05). Conclusions:The joint segmentation model realizes the automatic calculation of myocardial fibrosis ratio in left ventricle, which is highly consistent with the results of manual extraction. Therefore, it can accurately realize the automatic quantitative analysis of myocardial fibrosis in patients with dilated cardiomyopathy.
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This article elucidated the meaning of moving cupping method based on heaven-human-earth theory. The heaven-human-earth moving-cupping method has innovated the idea, operation, and application protocol of moving-cupping method. It also diversifies the moving routine and function, standardizes protocol, expands the area, and quantifies the operation. It endows the cupping therapy with a new method and idea. However, the action mechanism still expects further study.