RESUMO
Objective: The present study aimed to explore the application value of magnetic resonance imaging (MRI) histograms with multiple sequences in the preoperative differential diagnosis of endometrial stromal sarcoma (ESS) and degenerative hysteromyoma (DH). Methods: The clinical and preoperative MRI data of 20 patients with pathologically confirmed ESS and 24 patients with pathologically confirmed DH were retrospectively analyzed, forming the two study groups. Mazda software was used to select the MRI layer with the largest tumor diameter in T2WI, the apparent diffusion coefficient (ADC), and enhanced T1WI (T1CE) images. The region of interest (ROI) was outlined for gray-scale histogram analysis. Nine parameters-the mean, variance, kurtosis, skewness, 1st percentile, 10th percentile, 50th percentile, 90th percentile, and 99th percentile-were obtained for intergroup analysis, and the receiver operating curves (ROCs) were plotted to analyze the differential diagnostic efficacy for each parameter. Results: In the T2WI histogram, the differences between the two groups in seven of the parameters (mean, skewness, 1st percentile, 10th percentile, 50th percentile, 90th percentile, and 99th percentile) were statistically significant (P < 0.05). In the ADC histogram, the differences between the two groups in three of the parameters (skewness, 10th percentile, and 50th percentile) were statistically significant (P < 0.05). In the T1CE histogram, no significant differences were found between the two groups in any of the parameters (all P > 0.05). Of the nine parameters, the 50th percentile was found to have the best diagnostic efficacy. In the T2WI histogram, ROC curve analysis of the 50th percentile yielded the best area under the ROC curve (AUC; 0.742), sensitivity of 70%, and specificity of 83.3%. In the ADC histogram, ROC curve analysis of the 50th percentile yielded the best area under the ROC curve (AUC; 0.783), sensitivity of 81%, and specificity of 76.9%. Conclusion: The parameters of the mean, 10th percentile and 50th percentile in the T2WI histogram have good diagnostic efficacy, providing new methods and ideas for clinical diagnosis.
RESUMO
We reviewed recent studies on ischemic penumbra, including the evolution of the definitions of ischemic penumbra and observations on the characteristics of blood flow and the molecular evolutionary mechanism of ischemic tissues; at the same time, a brief summary of current clinical treatment methods were included. From the perspective of neuroimaging and clinical treatment, the characteristics of cerebral blood flow, oxygen consumption, cell water content, and metabolites were analyzed, to evaluate the diagnosis and evolution of ischemic penumbra. The analysis of the evolutionary characteristics of multiple gene molecules and metabolites may provide ideas for clinical imaging diagnosis and clinical treatment, also allow the combination of multiparameter imaging indexes to be more accurate and effective for the assessment of ischemic penumbra. The research hotspot of imaging on the ischemic penumbra region in the future may be more focused on reflecting the evolutionary characteristics of local metabolites in the ischemic area. Using multimodality imaging to evaluate IP zones and guide the formulation of clinical treatment protocols.
