http://med-sci.cn/cgzcx/en/contents_list.asp?issue=202310 zh-cn An RSS feed for Chinese Journal of Magnetic Resonance Imaging http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.001 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.002 ObjectiveTo observe bilateral hippocampal static state and dynamic functional connectivity (dFC) features and association with clinical symptoms in first episode depression (FDE). Materials and MethodsTwenty-six FDE patients (FDE group) and 20 healthy controls (HCs group) were retrospectively included. rs-fMRI scans were performed on the two groups of subjects, and after using the bilateral hippocampus as the seed point, the resting state functional connectivity (sFC) and dynamic functional connectivity (dFC) differences between the two groups were observed. The differences of sFC and dFC between the two groups were observed, and the clinical depression scale of FDE patients was completed to analyze the correlation between the different brain regions and clinical symptoms. ResultsCompared with the HCs group, the sFC of the left hippocampus with the right orbitofrontal middle gyrus was decreased in the FDE group, and the sFC of the right hippocampus with the right precentral gyrus was decreased. Compared with the HCs group, the dFC of the left hippocampus with the right supplementary motor area and the right precentral gyrus was decreased in the FDE group, and the dFC of the right hippocampus with the left precentral gyrus was decreased and increased with the dFC of the right inferior occipital gyrus. Correlation analysis revealed a positive correlation between dFC values in the right hippocampus with the right suboccipital gyrus and 24-item Hamilton Rating Scale for Depression, scores in the FDE group (r=0.474, P=0.015). ConclusionsThe presence of abnormal alterations in the sFC of the hippocampus and reward network and sensorimotor network bilaterally with abnormal alterations in the dFC of the sensorimotor network and visual processing cortex in FDE patients provides some implications for understanding the neuropathological mechanisms and targeted therapies in FDE patients. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.003 ObjectiveThis study investigated the spatial and temporal coupling alterations in the brain of Parkinson^,s patients with severe hyposmia (PD-SH) to understand the dynamic alterations of intrinsic brain activity in the PD-SH group. Materials and MethodsThe resting-state functional magnetic resonance imaging data acquired from 15 PD-SH, 15 Parkinson^,s disease patients with no/mild hyposmia (PD-N/MH), and 15 healthy controls (HC) were enrolled in this study. The volume-wise and voxel-wise concordance among four dynamic metrics was calculated. One-way analyses of variance and covariance analysis were used to compare the volume-wise and voxel-wise concordance among the PD-SH, PD-N/MH, and HC groups. The associations between concordance values and clinical/neuropsychological assessments were investigated as well. ResultsCompared with the PD-N/MH and HC, the PD-SH had lower dynamic volume concordance in the whole brain (P＜0.05). PD-SH showed increased voxel-wise concordance than PD-N/MH in left superior temporal gyrus, left cuneus, left postcentral gyrus and right precuneus (Gaussian random field correction, voxel level P＜0.005, cluster level P＜0.05). Compared with HC group, we found the decreased voxel-wise concordance in left inferior temporal gyrus, middle temporal gyrus, superior temporal gyrus and middle cingulum of PD-SH. Moreover, the decreased concordance in right middle cingulum was positively associated with the score of Odor Stick Identification Test for the Japanese in PD-SH (r=0.5251, P=0.0444). ConclusionsThere were some differences in the spatial and temporal concordance of intrinsic brain activity among the three groups. The analysis of concordance provided results and new insights into the neurophysiological mechanism of hyposmia in PD patients. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.004 ObjectiveTo explore the changes of brain volume and relaxation value in the early stage of early stage of Parkinson^,s disease (ESP) based on synthetic MRI (sMRI) technology and voxel-based morphometry (VBM) whole brain partitioning method, and provide imaging basis for the early diagnosis of this disease. Materials and MethodsIn this study, 22 patients with ESP were prospectively included in the ESP group, and 25 sex-and age-matched healthy control (HC) in the HC group. All subjects were scanned using GE 3.0 T MR to acquire conventional sequence, 3D T1WI and quantitative magnetic resonance imaging (MAGiC) scans, and performed Minimum Mental State Examination (MMSE) scoring. The MATLAB software SPM 12 data processing package was used to VBM whole brain partition of all data, and the gray matter volume (GMV), white matter volume (WMV) and brain region relaxation value of the whole brain and each brain region in different cortical and subcortical regions were obtained. The volume characteristics and brain region relaxation values between ESP group and HC group were compared, and the volume of brain regions, T1, T2 and proton density (PrD) values and MMSE scores were analyzed in the case group. The ROC curve was made for the brain region with the most obvious difference in correlation analysis results, and the relaxation values of each sequence were jointly diagnosed in this brain region. ResultsThere were more cases in which the volume of brain regions correlated with clinical scales (P＜0.05). There were differences in the relaxation values of some brain regions between the HC group and ESP, but the difference in the relaxation values of the right thalamus and the correlation with the MMSE score existed in all sequences, so the relaxation values of each sequence of the right thalamus were used for ROC diagnosis, and the relaxation values of the right thalamus in T1 and T2 sequences were used for joint diagnosis, and the AUC was 0.822 (0.697-0.911). ConclusionsThe results of this study showed that ESP patients had changes in right thalamic volume and brain region relaxation values. In this study, it is believed that the relaxation values of the right thalamus in the various sequences of sMRI can make an early diagnosis of PD. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.005 ObjectiveTo explore the value of the substantia nigra radiomics on susceptibility-weighted imaging (SWI) and machine learning in diagnosing the Parkinson^,s disease (PD). Materials and MethodsSWI images of 80 early PD patients and 80 healthy controls were collected. The ITK-SNAP software was used to delineate the regions of interest in substantia nigra on SWI, and extract and screen radiomics. Five machine learning methods (support vector machine, logistic regression analysis, random forest, Bayesian, K-nearest neighbor) were used to build the diagnosis model for Parkinson^,s disease, and the model with best diagnosis efficiency and most stable was selected for verification, and compared with the diagnosis efficiency of visual analysis of swallow tail sign. ResultsA total of 7 radiomic features closely related to Parkinson^,s disease were screened. In the training set, the diagnostic performance of the logistic regression analysis model is the best (AUC=0.975) and the most stable (relative standard deviations of AUC: 4%). In the test set, the AUC of logistic regression analysis model for diagnosing PD was 0.938, the sensitivity was 83.3%, and the specificity was 95.8%, which was significantly better than that of visual analysis (Z=2.241, P=0.025). ConclusionsA logistic regression analysis model based on substantia nigra radiomics on SWI can accurately diagnose PD and provide image guidance for early intervention treatment in clinical. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.006 ObjectiveTo explore he intervention mechanism of limb linkage training on patients with Parkinson^,s disease (PD) by using functional MRI (fMRI). Materials and MethodsFifty patients with Parkinson^,s disease who visited the First People^,s Hospital of Kashi area from April 2021 to February 2023 were collected as the case group, and 30 healthy volunteers matched with the baseline data were selected as the control group. The whole brain fMRI scanning of the two groups of subjects during limb linkage was performed. ResultsIn the healthy control group, the brain activation areas mainly include right primary sensory motor cortex (SM1) (t=14.4829, P＜0.05), left primary sensory motor cortex (t=8.7640, P＜0.05), left auxiliary motor area (SMA) (t=8.4628, P＜0.05), right thalamus (t=9.3230, P＜0.05), right insular lobe (t=8.8615, P＜0.05), left superior temporal gyrus (t=9.0467, P＜0.05) and left inferior parietal lobule (t=10.8249, P＜0.05). In patients with Parkinson^,s disease, the brain activation areas mainly include right SM1 (t=10.0234, P＜0.05), left SMA (t=7.8221, P＜0.05), right insular lobe (t=6.3241, P＜0.05), left superior temporal gyrus (t=7.6571, P＜0.05) and left inferior parietal lobule (t=4.9862, P＜0.05). Compared with the healthy control group, the left SMA (t=6.011, P＜0.05), the right insular lobe (t=5.610, P＜0.05) and the left superior temporal gyrus (t=6.781, P＜0.05) were less activated in PD patients while the right SM1 (t=3.652, P＜0.05) was more activated. ConclusionsLimb linkage training enhances the compensatory function of the primary motor function area in PD patients, which has theoretical guiding significance for the rehabilitation treatment of PD patients. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.007 ObjectiveTo evaluate the short-term prognosis of acute ischemic stroke (AIS) patients with arterial transit artifact (ATA) and the intra-arterial high-intensity signal (IAS) in three dimensional arterial spin labeling (3D-ASL) imaging. Materials and MethodsA total of 36 patients with AIS due to severe stenosis or occlusion of intracranial segment of unilateral internal carotid artery or middle cerebral artery admitted to the Department of Neurology of Shanxi Provincial People^,s Hospital from July 2018 to October 2022 were collected for study. They were divided into ATA (+) group and ATA (-) group according to whether ATA appeared. According to whether IAS appeared, ATA (+) group was divided into ATA (+) IAS (+) group and ATA (+) IAS (-) group. National Institute of Health Stroke Scale (NIHSS) scores difference (ΔNIHSS) were recorded for patient discharge and admission. ATA Alberta Stroke Program Early CT Score (ASPECTS) were developed and documented based on Alberta stroke program early CT score. Cerebral blood flow (CBF) in the ATA distribution area was measured , and relative cerebral blood flow (rCBF) was calculated. Compare whether there are differences in ΔNIHSS between the groups. The relationship between groups ATA ASPECTS, rCBF and ΔNIHSS. ResultsThe post labeling delay (PLD) were 1525 ms and 2525 ms, the difference of ΔNIHSS in ATA (+) group and ATA (-) group was statistically significant (P＜0.05), and ΔNIHSS of the former fell more than the latter. The difference of ΔNIHSS between ATA (+) IAS (-) group and ATA (+) IAS (+) group was not statistically significant (P＞0.05), but ΔNIHSS of the former fell more than the latter. Spearman correlation analysis shows that PLD were 1525 ms and 2525 ms, there is negative correlation between ATA ASPECTS, rCBF and ΔNIHSS, and there was a positive correlation between rCBF and ATA ASPECTS. The results were statistically significant (P＜0.05). ConclusionsDepending on the presence of ATA and IAS, the range of ATA distribution and the measured CBF in the distribution area are helpful for evaluating the open status of collateral circulation in patients with AIS, moreover, the accuracy of PLD used 2525 ms is higher. All these will provide an effective basis for extending the time window of endovascular therapy, evaluating patient^,s short-term prognosis and guiding clinical formulation of treatment plans. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.008 ObjectiveTo investigate the influencing factors of susceptibility vessel sign (SVS) in acute anterior circulation occlusive stroke. Materials and MethodsWe retrospectively analyzed the data of 161 patients with acute stroke who underwent middle cerebral artery occlusion and MRI examination from July 16 2020 to June 24 2022, and all contained readable susceptibility-weighted imaging (SWI) information. The characteristics of the patients were compared according to the presence or absence of SVS. Univariate statistical analysis was performed, and then meaningful variables from the univariate statistical analysis were included in the multivariate statistical analysis. ResultsSVS+ was significantly correlated with age, cardiogenic stroke subtype and the combination of atrial fibrillation/flutter (P＜0.05). Multivariate analysis showed that combined atrial fibrillation/flutter was an independent risk factor for SVS+ (OR=4.296; 95% CI: 1.248-14.791, P=0.021). The difference between SVS+ and symptom onset -MRI time was not statistically significant. ConclusionsSVS is still supported as a clinical marker for the diagnosis of the cause of acute ischemic stroke, even when symptom onset -MRI time is considered. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.009 ObjectiveTo evaluate the number and location distribution of cerebral microbleeds (CMBs) based on susceptibility weighted imaging (SWI), and analyze the correlation with the severity of cerebral small vessel disease (CSVD). Materials and MethodsThree hundred and ninety four patients who diagnosed with CSVD by clinical and imaging features were enrolled in this study. Evaluating the imaging markers of CSVD, including lacunar lacunae (LI), white matter hyperintensities (WMH), CMBs, recent small subcortical infarct (RSSI), perivascular spaces (PVS) and cerebral atrophy. The total CSVD score was calculated to evaluate the severity of CSVD. The Microhemorrhage Anatomical Rating Scale (MARS) were used to evaluate the distribution and severity of CMBs. The correlation between the severity and location distribution of CMBs and the imaging characteristics of CSVD was analyzed. ResultsThere were statistical differences in the severity of CMBs in terms of age, WMH, brain atrophy and the total CSVD score (P=0.005; P＜0.001; P=0.005; P＜0.001). After adjusting for age, the severity of CMBs was correlated with the total CSVD score and WMH (r=0.441, P＜0.001; r=0.380, P＜0.001). The location distribution of CMBs was correlated with WMH. The modified Fazekas scores of mixed CMBs group was significantly higher than that of simple lobar type, simple deep type and simple subtentorial type (P=0.011; P=0.034; P=0.023). ConclusionsThe severity and distribution of CMBs are related to WMH and the severity of CMBs is related to the total CSVD score. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.010 ObjectiveTo explore the value of multi-parametric MRI-based radiomics models in differentiating primary central nervous system lymphoma (PCNSL) from high-grade glioma. Materials and MethodsAll preoperative routine MRI images of 99 patients with high-grade gliomas and primary PCNSLs who confirmed by pathology were collected, and all patients were randomly divided into training (n=69) and testing (n=30) sets at 7:3 ratios. ROI1 included the of core the tumor, ROI2 included the core of tumor and peritumoral edema. Delineated the ROI on the axial contrast enhancement (CE)-T1WI and T2 fluid-attenuated inversion-recovery (FLAIR) images. The independent sample t-test or the Mann-Whitney U test, the Pearson correlation analysis and the least absolute shrinkage and selection operator (LASSO) were used to screen out the features, the radiomics score of each patients were also calculated. We used the logistic regression (LR) algorithm to construct models for CE-T1WI, T2 FLAIR and a combined model as well. The receiver operating characteristic (ROC) was used to evaluate classifier performance, calculating the area under curve (AUC), accuracy, sensitivity, specificity to the corresponding radiomics model. ResultsAmong single-sequence radiomics models, the CE-T1WI model had the best prediction performance, its AUC values in the training and testing groups were 0.952 and 0.949, respectively. The T2 FLAIR model established by the core features of the tumor is superior to the model based on the whole tumor, its AUC values in the training and testing groups were 0.915 and 0.898, respectively. The AUC values of the combined model in the training and the testing groups were 0.978 and 0.983, respectively. ConclusionsMulti-parametric MRI-based radiomics models had good diagnostic performance in differentiating PCNSL from high-grade glioma, among single-sequence radiomics models, the CE-T1WI model had the best prediction performance, the combined model increased the accuracy of the model, the features of tumor core area are more related to tumor classification. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.011 ObjectiveTo investigate the value of conventional MRI combined with arterial spin labeling (ASL) imaging and diffusion tensor imaging (DTI) in assessing the phenotype of isocitrate dehydrogenase 1 (IDH1) value in glioma. Materials and MethodsSixty-one cases of patients with pathologically confirmed glioma from September 2019 to December 2021 were collected retrospectively and divided into IDH1 mutant (IDH1_mut) and IDH1 wild (IDH1_wt) groups according to IDH1 phenotype by genetic or immunohistochemical detection. Routine cranial MRI examination, ASL and DTI examination were performed before surgery. Evaluate the conventional MRI features of IDH1_mut and IDH1_wt gliomas (size, location, margin, necrotic cystic changes, hemorrhage, edema, and enhancement), measure the anisotropy fraction (FA), apparent diffusion coefficient (ADC), maximum cerebral blood flow (CBF_max) and mean (CBF_mean) of the solid tumor area and peritumor area, and the relative CBF_max (rCBF_max), relative cerebral CBF_mean (rCBF_mean) were computed. Statistical analysis was performed using SPSS 25.0. All inter-sample analyses were performed using independent samples t-tests or non-parametric tests. Multi-factor logistic regression models were developed and receiver operating characteristic (ROC) curves were plotted to predict diagnostic efficacy. ResultsA total of 61 cases of gliomas were included in this study: 19 cases of IDH1_mut and 42 cases of IDH1_wt. There were significant differences in the location, enhancement, edema, CBF in the solid tumor area, and ADC in the peritumor area between IDH1_mut and IDH1_wt gliomas (P＜0.05). CBF_max, CBF_mean, rCBF_max, and rCBF_mean in the solid tumor area of IDH1_wt were higher than those of IDH1_mut (P＜0.05), and the area under the curve (AUC) was 0.879, 0.832, 0.806, 0.875, respectively. The peritumoral ADC value of IDH1_wt was higher than that of IDH1_mut (P＜0.05). The CBF_mean in solid tumor area combined with ADC value in peritumor area had the highest diagnostic efficacy (AUC=0.892). Multi-factor logistic regression showed that CBF in the solid tumor area was an independent risk factor for predicting the IDH1 phenotype of glioma. ConclusionsMulti-parametric MRI has important value in evaluating the IDH1 phenotype of gliomas. The combination of tumor parenchymal CBF and peritumoral ADC can further improve the diagnostic efficacy of the IDH1 phenotype of gliomas. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.012 ObjectiveTo investigate the application value of MAGIC relaxation time quantitative technique in the evaluation of acute bilirubin encephalopathy (ABE). Materials and MethodsThirty-two children with confirmed ABE (ABE group) admitted to the PICU of Ningxia Medical University for jaundice from October 2020 to June 2022, 71 children with hyperbilirubinemia (hyperbilirubinemia group), and 44 normal-term children (control group) as the study subjects. All the included subjects completed cranial MAGIC examination in our hospital within 10 days after birth, and measured the relaxation value T1, T2 andproton density (PD) values in 6 areas of interest (ROI), including bilateral glous pallidus, putamen, ventrolateral thalamic nucleus, posterior limb of internal capsule, anterior limb of internal capsule, pedunculus cerebri. The values of T1, T2 and PD among all groups were compared by one-way variance analysis; the area under the curve (AUC), optimal critical value, sensitivity, specificity and Yoden index of ABE were analyzed by receiver operating characteristic (ROC) curve; Pearson correlation was used to analyze the correlation between T1, T2, PD and total serum bilirubin (TSB) in each area of interest. ResultsThe values of T1 and T2 in the globus pallidus were statistically significant among the three groups (P＜0.05), which were the lowest in ABE, followed by the high bile group, and the highest in the control group. The T1 and T2 values of the posterior limb of the internal capsule and the T1 values of the pedunculus cerebral were statistically different among the three groups (P＜0.05), with the highest value in the ABE group, followed by the high bile group, and the lowest in the control group. In T1, the pallidum AUC (0.977) had the highest sensitivity (95.3%), specificity (92.0%), the posterior limb and the cerebral foot; in T2, the pallidum AUC (0.880), the posterior capsule AUC (0.857), the slightly higher pallidum specificity (82.1%), and the internal capsule (79.1%). T1 values of the globus pallidus were negatively correlated with TSB (r=-0.541, P＜0.05), and T1 values of the posterior limb of the internal capsule and the peduncle were positively correlated with TSB (r=0.503, 0.384, all P＜0.05). ConclusionsRelaxation time quantitative technique of MAGIC has high clinical value in the diagnosis of neonatal ABE. The measurement of T1 and T2 values of the globus pallidus, posterior limb of the internal capsule and the T1 values of the cerebral pedicle can provide objective and quantitative imaging reference basis for the early clinical diagnosis of neonatal ABE. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.013 ObjectiveTo construct a nomogram based on MRI and clinicopathological indicators of breast cancer for early prediction of pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients. Materials and MethodsA total of 82 breast cancer patients who underwent NAC and subsequent surgery at the First Hospital of Lanzhou University from January 2021 to October 2022 were retrospectively analyzed. Imaging and clinicopathological data of patients prior to NAC were collected. All patients underwent MRI scanning program before surgery. First, a univariate logistic regression analysis was performed to screen out the predictors associated with pCR. Multivariate logistic regression analysis was then performed to finally screen out the independent predictors of pCR. The independent predictors were used to construct a nomogram model for predicting pCR after NAC for breast cancer. Bootstrap was used for internal validation and calibration of models. The ROC curve was drawn to evaluate the diagnostic efficacy of the model, and the clinical application value of the model was evaluated by the decision curve analysis (DCA). ResultsThis study showed that progesterone receptor (PR) state (P=0.04), human epidermal growth factor receptor 2 (HER-2) state (P＜0.01), and maximum apparent diffusion coefficient (ADC_max) (P=0.03) were independent predictors of pCR. The area under the ROC curve of the nomogram was 0.86. The calibration plot showed a high degree of agreement between the nomogram prediction probability and the actual pCR probability. Decision curve analysis showed that the nomogram model had good clinical application value. The corrected concordance index (C-index) for internal verification by the Bootstrap method was 0.84. ConclusionsThe nomogram model is helpful in predicting the pCR after NAC for breast cancer, which was constructed based on HER-2 status, PR status and ADC_max value, so as to realize personalized diagnosis and treatment of patients and improve their prognosis. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.014 ObjectiveTo explore the application value of synthetic MRI (syMRI) in the differential diagnosis of benign and malignant breast lesions with peripheral rim enhancement. Materials and MethodsA total of 52 patients (54 breast lesions with peripheral rim enhancement) which underwent MRI examination were included in the study. All subjects underwent plain scan and enhanced scan of syMRI, diffusion weighted imaging scan and dynamic contrast-enhanced imaging MRI (DCE-MRI) scan, and then all of them received pathology results by surgery or biopsy within one week after MRI examination. The T1, T2, PD values of breast lesions pre-contrast and post-contrast injection (T1pre, T2pre, and PDpre; T1post, T2post, and PDpost) were estimated from syMRI data by using syMRI post-processing software. The relative change rate was calculated (ΔT1%, ΔT2%, ΔPD%). The apparent diffusion coefficient (ADC) values of the ring wall and inside the ring were measured. According to the result of pathology, all lesions were divided into benign and malignant groups. Independent sample t-test and Wilcoxon rank-sum test were used to analyze whether the data were significantly different (P＜0.05). The χ² test or Fisher exact test were used to analyze the image features of DCE-MRI [morphology, edge and time-signal intensity curve (TIC)]. Logistic regression was used to establish single-factor and multi-factor prediction models for statistically significant parameters, and the ROC curve of the subjects was drawn and the diagnosis efficiency of the prediction model was evaluated by DeLong test. ResultsIn 54 lesions, malignant 42 cases, 12 cases were benign. The T2pre of benign groups [101.17 (28.42)] higher than malignant group [88.67 (21.75)], the PDpost of benign groups (101.90±14.60) higher than malignant group (84.90±20.00). There were significant differences in TIC (P＜0.001) and the ADC values of the ring wall (P＜0.001) between benign and malignant groups (P＜0.05). The area under the curve (AUC) of PDpost was 0.763 and higher than T2pre (AUC=0.758), lower than TIC (AUC=0.883) and the ADC values of the ring wall (AUC=0.901). The diagnosis efficiency of the ADC values of the ring wall was highest when applied separately. When the parameters were used together, the multi-factor model combined by the four joint parameters diagnosis efficiency highest (AUC=0.998). As a single parameter, the diagnosis efficiency of TIC type, T2pre and PDpost was statistically different from that of the multi-factor model combined by the four joint parameters (P＜0.05), but the diagnosis efficiency of the ADC values of the ring wall was not statistically different from that of the multi-factor model combined by the four joint parameters (P＞0.05). ConclusionsT2pre and PDpost obtained using syMRI can be used as an auxiliary means for diagnosis of benign and malignant breast lesions with peripheral rim enhancement, the diagnosis efficiency is lower than TIC and the ADC values of the ring wall when applied separately, and the diagnosis efficiency of combined application with TIC and the ADC values of the ring is highest. The diagnosis efficiency of the ADC values of the ring wall is not statistically different from that of the multi-factor model combined by the four joint parameters. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.015 ObjectiveTo construct a nomogram model for differential diagnosis of prostate cancer (PCa) with PSA (4-20 ng/mL) based on biparametric MRI (bp-MRI) of Prostate Imaging Report and Data System version 2.1 (PI-RADS v2.1) and other clinical indicators such as prostate specific antigen (PSA). Materials and MethodsRetrospectively analyzed the data of 206 patients undergoing bp-MRI examination with pathological results between October 2017 and February 2022 in the General Hospital of Ningxia Medical University. The patients were divided into PCa group (n=66) and benign prostatic hyperplasia and / or inflammation group (n=140) according to the pathological results. The independent risk factors of PCa patients with PSA (4-20 ng/mL) were screened by univariate and multivariate logistic regression analysis, then the nomogram model was constructed by R software, and the clinical net benefit was analyzed by decision curve (DCA). Diagnostic performance was evaluated by using the area under the curve (AUC) of receiver operating characteristic (ROC) curve, sensitivity and specificity, and the differences between AUC values were compared by the DeLong test. ResultsAge, total prostate specific antigen (tPSA), prostate volume (PV), and PI-RADS v2.1 are independent risk factors for predicting PSA (4-20 ng/mL) PCa. The nomogram model based on the above four independent indexes shows the best performance (AUC=0.945), which is significantly higher than that of PI-RADS v2.1 (AUC=0.816), PV (AUC=0.772), tPSA (AUC=0.737) and age (AUC=0.680). ConclusionsThe diagnostic performance of the nomogram model based on PI-RADS v2.1 score of bp-MRI combined with clinical related indicators is significantly better than that of the single index to predict the PSA (4–20 ng/mL) PCa, and can be used as a non-invasive accurate prediction tool.It will predict the risk probability of PCa more comprehensively and accurately, and provide effective diagnosis and treatment guidance for clinicians. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.016 ObjectiveThe aim of this study was to assess diagnostic efficacy of biparametric magnetic resonance imaging (BP-MRI) and BP-MRI combined with clinical predictors vs. multiparametric MRI (MP-MRI) for prostate cancer (PCa) based on the Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1). Materials and MethodsThis study retrospectively analyzed 171 patients with clinically suspected PCa who underwent MP-MRI examination before systematic biopsy in our hospital from January 2020 to May 2022. The prostate MR images of all lesions were scored by the two schemes of MP-MRI and BP-MRI based on PI-RADS v2.1. Combined with the results of pathology, the lesions were divided into three groups: all lesions group, lesions located in peripheral zone (PZ) group and lesions located in transition zone (TZ) group. BP-MRI, MP-MRI and clinical predictors were analyzed by univariate and multivariate analysis, and the independent predictors were established. The diagnostic performance of the two schemes and BP-MRI combined with independent predictors was analyzed by the receiver operating characteristic (ROC) curve. ResultsFor all of the lesions (PZ+TZ), the BP-MRI, MP-MRI, age, PSAD, and f/tPSA were the independent predictors of PCa, there was no statistical difference in the diagnostic efficacy between BP-MRI and MP-MRI [area under the curve (AUC): 0.888, 0.886; P＞0.05]. Combined model and the combination of BP-MRI and f/tPSA or PSAD (AUC=0.937, 0.924, 0.915) had higher diagnostic efficience than MP-MRI (AUC=0.886). The difference between the AUC value of these combined models and MP-MRI was statistically significant (P＜0.05); PSAD had a larger AUC than the other predictors alone (AUC=0.837), the AUC for the combination of BP-MRI and independent predictors is significantly superior to using BP-MRI score and independent predictors alone (P＜0.05), and compared with the age or f/tPSA index, combining BP-MRI and PSAD had a higher clinical diagnostic efficacy. For lesions in the PZ or TZ, the two schemes of MP-MRI and BP-MRI were the independent predictors, there was no statistical difference in the diagnostic efficacy between BP-MRI (AUC=0.821, 0.908; P＞0.05) and MP-MRI (AUC=0.817, 0.908; P＞0.05). ConclusionsBP-MRI has equivalent diagnostic efficacy for PCa to MP-MRI, combining BP-MRI with f/tPSA or PSAD can improve diagnostic efficacy and avoid clinically unnecessary biopsies. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.017 ObjectiveTo explore the value of the nomogram based on clinical, pathological, and diffusion weighted imaging (DWI) quantitative parameters for predicting programmed death-ligand 1 (PD-L1) positive expression in cervical cancer. Materials and MethodsA total of 683 patients with pathologically confirmed cervical cancer between January 2018 to June 2020 were retrospectively enrolled as the training cohort. They underwent pelvic MRI scans and PD-L1 immunohistochemical staining. The solid component of tumors on DWI images was identified using T2WI and enhanced images. The region of interest (ROI) was manually drawn around the tumor borders, and apparent diffusion coefficient (ADC) values were obtained from corresponding ADC pseudo-color images. The mean ADC value (ADC_mean) was calculated by averaging ADC values from selected slices. Additionally, the maximum solid component slice on DWI was chosen, and the ADC value for this slice was recorded as single section ADC (ADC_ss). For each slice containing solid tumor components, multiple circular or circular-like ROIs (30-50 mm²) were placed to extract minimum ADC (ADC_min) values. Differences in clinical, pathological, and imaging parameters including age at diagnosis, FIGO staging, pathological grade, parametrial invasion, lymph node status, and ADC values from different ROIs were compared between PD-L1 positive and negative groups. Univariable and multivariable logistic regression analyses were conducted to identify independent parameters related to PD-L1 positive expression. Clinical-pathological and combined clinical-pathological-imaging models were developed. Diagnostic effectiveness of different ADC values and models was assessed using area under the curve (AUC) of receiver operating characteristic (ROC) and DeLong test. The combined model^,s nomogram, calibration slope, and decision curve were evaluated. A validation cohort of 332 cervical cancer patients from July 2020 to December 2022 was enrolled to validate the nomogram. ResultsFIGO staging, pathological grade, parametrial invasion, lymph node status, ADC_mean, ADC_ss, ADC_min were independently correlated with PD-L1 expression (all P＜0.05). Among three ADC values, ADC_min demonstrated the highest diagnostic efficacy with an AUC of 0.882 (95% CI: 0.855-0.905). The combined nomogram, incorporating ADC_min, clinical, and pathological factors, performed well in both the training and validation cohorts, yielding AUC of 0.906 (95% CI: 0.882-0.927) and 0.903 (95% CI: 0.866-0.933) respectively. Calibration curves indicated good fit of the nomogram. Decision curve analysis showed the nomogram^,s higher net benefit compared to the clinicopathological model. ConclusionsThe nomogram, utilizing clinical, pathological, and ADC_min data, effectively predicted PD-L1 expression in cervical cancer. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.018 ObjectiveTo prepare the magnetic resonance T2 contrast Fe₃O₄@Cys modified with cysteine (Cys) surface and tested by New Zealand rabbits using a 3.0 T magnetic resonance imaging system. Materials and MethodsUsing the solvent thermal method, different Fe₃O₄ nanoparticles were prepared by changing the reaction time and substrate concentration. The samples were characterized by X-ray diffractometer and their crystallinity were analyzed. The morphology and particle size of the samples were measured by scanning electron microscope. The samples with high crystallinity and uniform particle size were selected for surface modification with Cys. The surface potentials of Fe₃O₄, Fe₃O₄@Cys were measured by ZETA Potential Nanoparticle analyzer. The magnetic properties of Fe₃O₄ and Fe₃O₄@Cys were tested by vibration sample magnetometer. The cytotoxicity of the samples before and after modification was tested by MTT cell proliferation inhibition assay. The imaging performance was tested by observing signal changes in the renal cortex, medulla and small intestine at different time points before and after injection. ResultsWhen the amount of ferric chloride hexahydrate was 0.325 g, the Fe₃O₄ nanoparticles prepared for reaction at 200℃ temperature had high crystallization and uniform particle size. The average particle size was about 57.2 nm, the surface potential was -20 mV and-22 mV respectively. The particle size and morphology were not significantly changed, and the cell survival rate of Fe₃O₄@Cys was higher than 80%, which was higher than that of Fe₃O₄ group. The modified Fe₃O₄ nanoparticles exhibit superparamagnetism and have obvious negative contrast enhancement effect in magnetic resonance imaging in vivo. ConclusionsAs the reaction time increases, Fe₃O₄ crystallization increases; substrate concentration increases and Fe₃O₄ particle size decreases. Cys modification increases stability with biocompatibility and can be used as a T2 contrast agent for a variety of experimental and basic studies. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.019 ObjectiveTo explore the clinical value of fast intelligent quick magnetic resonance (IQMR) in cervical MRI. Materials and MethodsIn this study, 50 patients with suspected cervical spondylosis were collected retrospectively and included in T2-weighted (T2WI) conventional, IQMR original, and IQMR reconstructed images. ANOVA test was used to compare the differences among the objective scores of the three groups of images signal strength (SI), average background standard deviation (SD), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). Multiple rank sum (Kruskal-Wallis H) test was used to evaluate the subjective scores. The focus detection and scanning time differences among the three groups were compared. ResultsThe average scanning time of IQMR sagittal T2WI sequence was about 1 min 17 s, about 57% shorter than conventional scanning. Compared with the original image, the SD_background of the image reconstructed by IQMR decreased by 21%, and CNR increased by 28%. Compared with the conventional image, the SD of the image reconstructed by IQMR decreased by 43%, and the CNR increased by 68%. There was no statistical difference in SI_{spinal cord} among the three groups of images. There were significant differences in cerebrospinal fluid signals among the three groups. The cerebrospinal fluid signals of conventional images were lower than those of IQMR original images and IQMR reconstruction images. ConclusionsIQMR technology can reduce noise, and improve SNR and CNR in cervical MRI, thus improving image quality. In the case of ensuring image quality, it has the potential to reduce scanning time and improve the efficiency of clinical MR cervical spine scanning. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.020 ObjectiveTo investigate the impact of compressed sensing (CS) technology on breast enhanced-T1 high resolution isotropic volume excitation imaging quality and scan time, and to optimize isotropic e-THRIVE sequence. Materials and MethodsA total of 43 patients isotropic DCE-MRI examination in our hospital were prospectively included, which type of time signal intensity curve of tumor was platform type. On the basis of T1 high resolution isotropic volume excitation (e-THRIVE), different acceleration factors (AF) [sensitivity encoding (SENSE) AF=4, CS AF=4, CS AF=5, CS AF=6, CS AF=7] were used with 3.0 T MRI equipment. The sequence optimization was carried out on the delayed e-THRIVE sequence. Subjective evaluation and objective measurements of the images were performed by two observers. The image signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and relative contrast (RC) were calculated. Friedman test were used to analyze the SNR, CNR, RC and subjective scores of images between different groups. P＜0.05 was that the difference was statistically significant, if the difference was statistically significant, follow-up multiple comparison. ResultsThe objective and subjective scores were consistent between the two observers, and there were significant differences in SNR_{fibroglandular}, CNR_{fibroglandular}, SNR_lesion, CNR_lesion and subjective scores among different AF (P＜0.05). There were no significant differences in RC_{fibroglandulars-to-lesion}, RC_{lesion-to-muscle} and RC_{fibroglandulars-to-muscle} among different AF (P＞0.05). The results of pairwise comparison showed that SNR_{fibroglandulars}, CNR_{fibroglandulars}, SNR_lesion, CNR_lesion and subjective scores of sense AF=4, CS AF=4 and CS AF=5 images were higher than those of CS AF=6 and CS AF=7 images (P＜0.05). ConclusionsDuring clinical practice, in consideration scanning time and image quality, the CS AF=5 is recommended for breast e-THRIVE sequence, which saves 26.7% of scanning time compared with conventional parallel acquisition. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.022 ^,s disease (PD) is a common, progressive degenerative neurological disease for which there is no cure. The non-invasive neuromodulation (NINM) possesses the advantage of significant efficacy, less adverse effects, convenience and readily accepted by patients, they have great potential in treating different motor and non-motor symptoms of Parkinson^,s disease. MRI can reveal the information of brain structure and function, and has been widely used in the efficacy evaluation of various neuromodulation therapies and the exploration of neuromodulation mechanisms. This paper reviews the recent MRI studies of four types of NINM in the treatment of the neuromodulation mechanism of PD, including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (TES), transcranial ultrasound stimulation (TUS) and noninvasive vagal nerve stimulation (nVNS). ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.023 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.024 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.025 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.026 ^,s disease and Parkinson^,s disease, emphasizing its potential in assessing the relationship between brain iron content and cognitive decline. Additionally, we highlighted the potential applications of QSM in conditions like post-stroke cognitive impairment, diabetes, anemia, and others. Through an in-depth exploration of QSM technology, this review aims to provide new avenues for early diagnosis, treatment, and understanding of neurodegenerative diseases and cognitive impairment. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.027 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.028 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.029 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.030 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.031 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.032 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.033 Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.034 ^,s life and health. Determining the histological subtype and stage grade of cervical cancer is of great significance for formulating a reasonable treatment plan. In recent years, diffusion kurtosis imaging (DKI) has attracted widespread attention as a non-invasive imaging technique. DKI can reflect more realistic microdynamics and microstructure of water molecules. DKI has played an important role in the staging, grading and treatment evaluation of cervical cancer. This article will review the basic principles of DKI, the research status of DKI in cervical cancer, and the application of DKI image-based radiomics in cervical cancer, in order to provide important references for the clinical diagnosis, individualized treatment plan formulation and treatment evaluation of cervical cancer. ]]> Fri,20 Oct 2023 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2023.10.035 ^,s foundational theories into clinical research and providing robust support for the realization of precision medicine. ]]> Fri,20 Oct 2023 00:00:00 GMT