http://med-sci.cn/cgzcx/en/contents_list.asp?issue=202403 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.1674-8034.2024.03.001 Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.002 ObjectiveVoxel-mirrored homotopic connectivity (VMHC) was used to study the difference of functional connection between parity points in the brain of postpartum women and nulliparous women to explore the changes of brain function of postpartum women. Materials and MethodsThe resting-state functional magnetic resonance imaging (rs-fMRI) data and structural image data of 39 postpartum women and 26 nulliparous women were collected for VMHC analysis, and the differences of VMHC between groups were analyzed by a two-sample t-test. Moreover, the demographic data and Interpersonal Reactivity Index-C (IRI-C) scores of the two groups were collected. ResultsThe analysis of the IRI-C scale found a significant difference in empathy between postpartum women and nulliparous women (P<0.001). Compared with the nulliparous women, the postpartum women showed significantly decreased VMHC in bilateral fusiform gyrus, parahippocampal gyrus, middle frontal gyrus, medial frontal gyrus, anterior central gyrus, putamen and lentiform nucleus and other brain regions (FDR corrected, voxel level P<0.001, cluster level P<0.05, two tailed), while they showed significantly increased VMHC in bilateral precuneus, parietal lobules and subparietal lobules (FDR corrected, voxel level P<0.01, cluster level P<0.05, two tailed). ConclusionsAfter giving birth for the first time, the functional connections between hemispheres in some brain regions of women have changed, which may be the adaptive changes of women^,s parenting behavior during the postpartum period. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.003 ObjectiveTo explore the altered static and dynamic functional connectivity of the brain in patients with left-sided basal ganglia stroke (L-BGS) versus right-sided basal ganglia stroke (R-BGS) and to further explore the mechanisms of stroke lateralisation. Materials and MethodsTwenty-three L-BGS patients, 18 R-BGS patients and 20 healthy controls (HCs) were analysed, and resting-state functional MRI (rs-fMRI) was performed on each of the three groups of subjects. Based on rs-fMRI and sliding window techniques, static functional connectivity analysis and dynamic functional connectivity analysis were performed on the two groups of patients and HCs, respectively. ResultsIn static brain network connectivity analysis, L-BGS patients had more extensive increased and decreased intra-network connectivity compared to HCs (P<0.001, cluster level FWE correction); R-BGS patients had more extensive impaired inter-network connectivity compared to HCs (P<0.016 7, FDR correction). In dynamic connectivity analyses, L-BGS showed more positive reorganisation of network connectivity compared to HCs (P<0.05, FDR corrected). ConclusionsThe present study confirms that within 1 month of basal ganglia stroke onset, L-BGS patients show more positive compensatory changes in static and dynamic brain network connectivity. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.004 ObjectiveTo investigate the value of multi-delayed arterial spin labeling (mASL) technique in evaluating cerebral perfusion changes in patients with severe unilateral internal carotid artery or middle cerebral artery stenosis or occlusion. Materials and MethodsPerfusion images obtained from single-delayed pseudo continuous arterial spin labeling (pCASL) and mASL of 34 patients with clinical diagnosis of unilateral internal carotid artery or middle cerebral artery stenosis and occlusion in the Department of Neurology of our hospital were prospectively collected for evaluation of abnormal perfusion area on the side of arterial stenosis. The consistency of two observers in judging the abnormal perfusion area on the stenosis side was evaluated by Kappa consistency test. The region of interest was manually delineated in the abnormal perfusion region and perfusion parameter values were obtained, including cerebral blood flow (CBF_2020ms) obtained from pCASL perfusion images and corrected cerebral blood flow (cCBF), arterial arrival time (ATT), arterial cerebral blood volume (aCBV) and relative arterial transit time (rATT) obtained from mASL. Paired sample t test was used to compare the differences of CBF_2020ms and cCBF, and independent sample t test was used to compare the differences of ATT on the stenosis side and rATT. ResultsAccording to the results of pCASL and mASL, in 34 patients, the perfusion images of 10 cases were consistent (8 cases were hypoperfusion, 2 cases were hypoperfusion with local high signal), and the perfusion images of 24 cases were not completely consistent (3 cases of pCASL showed normal perfusion, mASL showed low perfusion; pCASL showed hypoperfusion with local hyperintensity in 21 cases, and mASL showed hypoperfusion). There was a high degree of agreement between the two observers (Kappa coefficient=0.788, P<0.001). mASL showed that ATT on the stenotic side was higher than rATT (P<0.001). In patients with hypoperfusion on both pCASL and mASL, CBF_2020ms was lower than cCBF (P=0.173). In patients with both pCASL and mASL showing hypoperfusion with local hyperintensity, ATT is prolonged and aCBV is increased. CBF_2020ms was significantly higher than cCBF in patients with pCASL showing hypoperfusion with local high signal and mASL showing hypoperfusion (P<0.001). Patients with normal perfusion on pCASL and hypoperfusion on mASL were found to have prolonged ATT but preserved normal aCBV. ConclusionsMulti-parameter cCBF, ATT and aCBV obtained by multi-delay arterial spin labeling technique can evaluate the changes of brain perfusion in patients with severe unilateral internal carotid artery or middle cerebral artery stenosis or occlusion more sensibly and accurately, and provide guidance for clinical diagnosis and treatment. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.005 ObjectiveHigh resolution magnetic resonance vessel wall imaging (HR-VWI) was used to analyze the correlation between the composition of symptomatic carotid atherosclerotic plaque and the mRS score three months after secondary prevention of stroke in patients with first ischemic stroke, so as to provide a theoretical basis for the prognosis evaluation of such patients. Materials and MethodsFrom November 2022 to June 2023, patients with ischemic stroke symptoms and carotid atherosclerotic plaque on the symptomatic side were recruited in the First Affiliated Hospital of Shihezi University. Patients who meet the inclusion and exclusion criteria and have completed secondary stroke prevention for 3 months will be continuously enrolled in this study and will receive a modified Rankin Scale (mRS) score. Based on the mRS score, the enrolled patients will be divided into a poor prognosis group (mRS≥2) and a good prognosis group (mRS<2). Compare the clinical data, plaque composition on the first HR-VWI examination, and plaque composition three months after secondary stroke prevention between two groups of patients. Analyzing the correlation between different components in plaques and mRS scores. ResultsA total of 66 patients were included in the group (39 in the poor prognosis group and 27 in the good prognosis group), and there was no statistically significant difference in clinical data between the two groups (P>0.05). In the first examination, the proportion of plaque bleeding in the poor prognosis group was higher than that in the good prognosis group (P<0.05), and the proportion and volume of calcification in plaques in the good prognosis group were higher than those in the poor prognosis group (P<0.05); After 3 months of secondary prevention of stroke, there was no significant difference in the proportion of plaque bleeding between the poor prognosis group and the good prognosis group (P>0.05), while the good prognosis group had a larger proportion and volume of calcification in plaques (P<0.05). ConclusionsThe calcification and calcification volume in symptomatic carotid atherosclerotic plaques were correlated with the mRS score 3 months after secondary prevention of stroke in patients with first ischemic stroke; HR-VWI at the initial stage of symptoms can provide a theoretical basis for the prognosis evaluation of ischemic stroke patients due to carotid atherosclerotic plaque. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.006 ObjectiveTo develop a glioblastoma (GBM) overall survival (OS) prediction model using multi-sequence MRI radiomics method. Materials and MethodsThis study retrospectively collected data from 309 patients with GBM in the TCIA/TCGA (The Cancer Imaging Archive/The Cancer Genome Atlas) public database, and extracted 10 128 radiomics features from preoperative post-contrast enhanced T1-weighted (T1CE) and T2-weighted fluid attenuation inversion recovery (T2 FLAIR) sequences for three regions of interest: necrosis area, tumor area, and edema area. Correlation analysis, principal component analysis (PCA) for dimensionality reduction, and least absolute shrinkage and selection operator-cox proportional-hazards (LASSO-Cox) regression were used to screen radiomics features significantly related to OS and calculate a Risk-score as a radiomics signature. Kaplan-Meier (KM) survival analysis and Log-rank test were used to compare the survival differences between high-risk and low-risk groups. A clinical-radiomics combined model and nomogram were constructed using multivariate Cox proportional-hazards (Cox) regression and evaluated using concordance index (C-index), which was compared with the clinical model. ResultsBased on the 16 radiomics features selected from the training set, a Risk-score was calculated and patients were divided into high- and low-risk groups based on this Risk-score, using both the training and testing sets. Log-rank testing showed a significant difference in survival probability between the high- and low-risk groups. Univariate Cox regression identified Risk-score, age, and O⁶-methylguanine-DNA methyltransferase (MGMT) status as significant risk factors for OS in GBM. Multivariate Cox regression was used to build clinical model and a clinical-radiomics combined model, and it was found that the clinical-radiomics combined model (training set: C-index=0.768, testing set: C-index=0.724) outperformed the radiomics model (training set: C-index=0.744, testing set: C-index=0.710) and the clinical model (training set: C-index=0.659, testing set: C-index=0.653). ConclusionsRadiomics signature can serve as independent prognostic factor for OS of GBM, and the combined model constructed by combining clinical pathological information and radiomics signature can better assist in risk stratification and survival prediction of GBM, which holds significant clinical value. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.007 ObjectiveTo investigate the value of structural MRI features and enhanced T1-weighted images histogram analysis in the differential diagnosis of atypical meningioma (AtM) and angiomatous meningioma (AnM). Materials and MethodsThe clinical, imaging and pathological data of AtM (n=40) and AnM (n=30) were collected retrospectively. The tumor was delineated layer-by-layer on axial enhanced T1-weighted images by MaZda software and histogram parameters of tumor enhancement areas were obtained. Structural MRI characteristics were compared using the chi-square test or Fisher^,s exact test. Histogram parameters were compared between the two groups using independent samples t-tests or Mann-Whitney U-tests, and diagnostic efficacy between the two groups was assessed by receiver operating characteristic (ROC) curves. ResultsThe incidence of tumor necrosis was significantly higher in the AtM group (75.0%) than in the AnM group (36.7%) (P=0.001). The mean (P=0.003), 1st percentile (P<0.001), 10th percentile (P=0.001), and 50th percentile (P=0.009) of the AnM were greater than those of the AtM. ROC curve analysis showed that tumor necrosis + combined histogram parameters had the optimal differential diagnostic efficacy between the two, with area under the curve, sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 0.858 (0.753-0.930), 95.00%, 66.67%, 82.86%, 79.20%, and 90.90%. ConclusionsThe conventional MRI features and histogram analysis based on enhanced T1-weighted images is helpful in the preoperative non-invasive differentiation of AnM and AtM, of which the diagnostic efficacy is highest in the tumor necrosis + combined histogram parameters. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.008 ObjectiveResting-state functional magnetic resonance imaging (rs-fMRI) was used to measure the difference between patients with acute mTBI and healthy controls (HCs), voxel-based indicators were used to observe whether cognitive function changes in patients with mTBI and the correlation between cognitive function changes and Montreal Cognitive Assessment (MoCA) scale scores. Materials and MethodsThirty-one patients with acute mTBI within 11 days of unilateral craniocerebral injury were prospectively enrolled. Thirty-one HCs matched for age, gender, and education were recruited at the same time. All subjects underwent rs-fMRI scans, and the mTBI group was clinically scored. SPM 12 and DPABI software were used for image preprocessing and voxel-based two-sample t-test. Gaussian Random-Field (GRF) correction was used chi-square test was used to estimate the distribution of gender composition in the two groups, and the effect of age between the two groups was used two-sample t-test, and the effect of years of education between the two groups was used U test. In addition, the time of enrollment into the study and clinical scores after injury in the mTBI group were analyzed using a one-sample t-test. Spearman correlation coefficient was used to analyze the correlation between the voxel-based indicators and the MoCA scale scores in the mTBI group. ResultsThere was no significant difference in age (t=1.587, P>0.05), gender (χ²<0.001, P>0.05), and education years (U=448, P>0.05) between the mTBI group and HC group. Compared with HC, the amplitude of low-frequency fluctuations (ALFF) in the left insula, left postcentral gyrus, and left precentral gyrus were increased in patients with acute mTBI (voxel P<0.005, GRF corrected). The fractional amplitude of low-frequency fluctuation (fALFF) was increased in the right postcentral gyrus and right precentral gyrus (voxel P<0.005, GRF corrected). Increased regional homogeneity (ReHo) was observed in the right cuneus and left postcentral gyrus (voxel P-value<0.005, GRF corrected). Enhanced functional connectivity (FC) between the right postcentral gyrus and the right middle occipital gyrus and right cuneus (voxel P<0.005, GRF corrected); FC was enhanced between the right cuneus and the right precuneus (voxel P-value<0.005, GRF corrected), and decreased between the right cuneus and the right caudate nucleus (voxel P-value<0.005, GRF corrected). Correlation analysis showed a significant correlation between MoCA scale scores and seed-based FC. ConclusionsOur findings suggest that cognitive performance is associated with spontaneous brain activity at resting state, especially in the default mode network (DMN), salience network (SAN), and visual network, in the acute phase after brain injury. In addition, this study demonstrated a correlation between cognitive performance and MoCA scale scores. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.009 ObjectiveTo evaluate the clinical value of multi-parameter MRI in distinguishing parotid tumors by arterial spin labeling (ASL) and diffusion tensor imaging (DTI). Materials and MethodsA total of 66 patients with surgically and pathologically proven parotid gland tumors from Binzhou Medical University Hospital from June 2019 to November 2023 were retrospectively analyzed. 3D ASL imaging and DTI were perfomed before surgery, and the maximum tumor blood flow (TBFmax), minimum apparent diffusion coefficient (ADCmin) and fraction anisotropy (FA) were measured. The Mann-Whitney U test or Kruskal-Wallis test were used to compare the parameters of benign tumors (BT) and malignant tumors (MT). Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic efficacy of each parameter and the combination of different parameters for parotid tumors. ResultsThere were 66 patients with parotid gland tumors, including 55 BT [15 Warthin tumors (WT), 23 pleomorphic adenomas (PA), 17 others] and 11 MT. The FA value of BT was lower than that of MT (0.13±0.06 vs. 0.18±0.04, P=0.003). The TBFmax value of PA [(43.72±37.64) mL/(100 g·min^-1)] was lower than that of MT [(92.56±58.26) mL/(100 g·min^-1)] (P<0.001) and WT [(145.26±64.54) mL/(100 g·min^-1)] (P=0.016). The ADCmin value of PA [(1.55±0.51)×10^-3 mm²/s] was higher than that of MT [(1.11±0.28)×10^-3 mm²/s] (P=0.016) and WT [(1.03±0.53)×10^-3 mm²/s] (P<0.001). The FA value of MT (0.18±0.05) was higher than that of PA (0.11±0.04) (P<0.001) and WT (0.12±0.02) (P=0.015). The area under the curve (AUC) for distinguishing BT from MT by FA was 0.78, and the sensitivity and specificity were 81.82% and 70.18%, respectively. The AUC for distinguishing WT, PA from MT by FA were 0.85 and 0.87, the sensitivity were 72.73% and 100.00%, and the specificity were 94.12% and 65.22%, respectively. The AUC for distinguishing WT from PA by TBFmax and ADCmin were 0.90 and 0.85, the sensitivity were 94.12% and 95.65%, and the specificity were 91.30% and 82.35%, respectively. The AUC for distinguishing PA from MT by combining them could be increased to 0.98, the sensitivity was 100.00%, and the specificity was 86.96%. ConclusionsThe combination of ASL and DTI is helpful for the differential diagnosis of benign and malignant parotid tumors, and the comprehensive application of multiple parameters is helpful for the differentiation of WT, PA and MT. Combining the different parameters can significantly improve the diagnostic efficiency of distinguishing PA from MT. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.010 ObjectiveTo explore the feasibility of using four-dimensional flow (4D-Flow) magnetic resonance imaging (MRI) in left ventricle, and to evaluate the reproducibility and consistency of quantification of left ventricular outflow tract (LVOT) peak velocity by comparing with two-dimensional flow (2D-Flow) MRI and echocardiography. Materials and MethodsThis research was a prospective and cross-sectional study. Twenty-one patients with hypertrophic cardiomyopathy (HCM) underwent cardiac MRI 2D-Flow and 4D-Flow data acquisition on a 3.0 T MRI scanner August 2022 to January 2023. Echocardiography within one weeks before or after MRI examination were collected. The inter-class correlation coefficient (ICC), coefficient of variation (COV) and Bland-Altman analysis were used to evaluate the reproducibility and consistency of LVOT peak velocity derived from 2D-Flow and 4D-Flow, and the relationship between 2D/4D-Flow and echocardiography was analyzed by Pearson correlation analysis. ResultsThe ICC of 2D-Flow and 4D-Flow were 0.999/0.999 and 0.995/0.992, respectively, and the COV of 2D-Flow and 4D-Flow were 0.5%/0.5% and 2.4%/2.6%, respectively. 4D-Flow was moderately correlated with echocardiography (r=0.574, P=0.006), but the consistency between the two was poor (ICC=0.375, P=0.013). Besides, there were no significant consistency and correlation between 2D-Flow and 4D-Flow/echocardiography. Conclusions4D-Flow cardiac MRI can visualize the flow patterns within the heart. The peak velocity of LVOT derived from 4D-Flow is highly reproducible and is significantly correlated with echocardiography. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.011 ObjectiveTo explore the feasibility of free-breathing with motion correction artificial intelligence (FB-MOCO AI) cine sequence of cardiac magnetic resonance (CMR) in patients with heart failure by evaluating the image quality, biventricular volumetric and functional parameters. Materials and MethodsFrom August 2022 to May 2023, 29 patients with heart failure who underwent CMR in our hospital were prospectively consecutive enrolled. All patients underwent cardiac short-axis scans with conventional breath-hold (BH) cine and FB-MOCO AI cine sequences. The overall image quality of the two cine sequences was scored by two radiologists (5-point scale). The parameters of biventricular volume and function including end-diastolic volume (EDV), end-systolic volume (ESV), stroke volume (SV), ejection fraction (EF), and left ventricular end-diastolic mass (LVEDM) were measured. Paired t-test or Wilcoxon signed-rank test were used to assess differences in quantitative data and qualitative scoring data between the two sequences. The correlation analysis of the quantitative parameters between the two sequences was also assessed. Bland-Altman analysis was performed to assess the agreement of quantitative parameters obtained from different sequences. ResultsThe durations of FB-MOCO AI cine [(14.3±1.9) s] scans were significantly shorter than conventional BH cine [(79.2±11.4) s] (P˂0.001). Overall image quality of FB-MOCO AI cine (4.4±0.5) were comparable to conventional BH cine (4.3±0.7) (P=0.343). All measured biventricular volumetric and functional parameters and LVEDM of two cine sequences presented no statistical difference (P˃0.05 for all), and there was excellent correlations (r˃0.94, P˂0.001 for all). Bland-Altman analysis showed that all the quantitative parameters between the two cine sequences had excellent agreement with a mean difference close to zero and a small range of variation. ConclusionsCompared to conventional breath-hold cine, the FB-MOCO AI cine method in patients with heart failure achieved comparable image quality and biventricular volumetric and functional parameters with shortened scan times, suggesting it has the potential to replace conventional cine sequence in patients with heart failure for clinical application. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.012 ObjectiveTo evaluate the prognostic role of left ventricular (LV) entropy in patients with myocarditis. Materials and MethodsA total of 56 consecutive patients diagnosed with clinically suspected myocarditis between July 2015 and October 2023 were included in this retrospective study. Clinical indicators, conventional cardiac magnetic resonance (CMR) parameters and LV entropy were assessed. Patients were categorised into good prognosis (n=42) and poor prognosis groups (n=14) according to whether they experienced major adverse cardiovascular events (MACE). Prognostic efficacy of LV entropy was assessed by receiver operating characteristic (ROC) curves. Kaplan-meier (K-M) analysis was used for survival analysis, and Log-rank test was used for survival comparison. ResultsDuring follow-up 14 patients (25.00%) experienced MACE, and LV entropy was significantly higher in patients who experienced MACE (P<0.001). ROC curve analysis indicated that the area under ROC curve (AUC) of the LV entropy was 0.871, the sensitivity was 78.5% and the specificity was 83.2%. K-M analysis suggested that the overall survival rate was lower in patients with LV entropy≥7.805 than in patients with LV entropy<7.805 (P<0.001). ConclusionsLV entropy could help predict the occurrence of MACE in patients with myocarditis, and contribute to a better clinical evaluation of the prognosis of patients with myocarditis. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.013 ObjectiveTo evaluate left ventricular structure and function in patients with Parkinson^,s disease (PD) by cardiac magnetic resonance feature tracking (CMR-FT). The factors affecting its structure and function were also investigated. Materials and MethodsProspective inclusion of 39 PD patients (PD group) who visited West China Hospital of Sichuan University from March 2022 to August 2023, and 34 age- and gender-matched healthy controls (control group) recruited during the same period, all completed routine cardiac magnetic resonance (CMR) examinations. CVI42 software was used to obtain the conventional cardiac function and myocardial strain parameters of the left ventricle and left atrium. Left ventricular parameters included left ventricular end-systolic volume, end-diastolic volume, myocardial mass, ejection fraction, global circumferential strain, radial strain and longitudinal strain. Left atrium parameters included ejection fraction, volume, strain and strain rate during the left atrium reserve phase, catheter phase and pumping phase. Independent sample t test or Mann-Whitney U test was used to analyze the differences between groups in each parameter. Pearson or Spearman correlation coefficient model was used to analyze the correlation of conventional cardiac function and strain parameters with motor function and autonomic nerve function. ResultsLeft ventricular ejection fraction [(62.01±6.59) % vs. (64.84±4.70) %] and global longitudinal strain [(-17.25±1.57) % vs. (-18.28±1.99) %] in the PD group were lower than those in the control group, and the differences were statistically significant (all P<0.05). Left ventricular end-systolic volume (LVESV) [(51.17±16.56) mL vs. (42.56±9.06) mL], LVESV index (LVESVi) [(30.44±8.00) mL•m^-2 vs. (25.56±5.14) mL•m^-2]、, left ventricular end-diastolic volume index (LVEDVi) [(79.31±10.76) mL•m^-2 vs. (72.97±12.51) mL•m^-2] and left ventricular mass index (LV massi) [41.82 (33.11, 47.77) g•m^-2 vs. 33.71 (32.27, 38.78) g•m^-2] in the PD group were higher than those in the control group, and the difference was statistically significant (P<0.05). Left atrial ejection fraction, strain and strain rate during reserve, catheter and pump phases were significantly lower in the PD group than in the control group (all P<0.05). Correlation analysis showed that the left atrial reserve strain and strain rate were negatively correlated with the unified Parkinson^,s disease rating scale Ⅲ (UPDRS Ⅲ) score (r=-0.409, -0.355, P<0.05). Left atrial ejection fraction and strain during the catheter phase were negatively correlated with UPDRS Ⅲ score (r=-0.326, -0.482, P<0.05), and strain rate was positively correlated with UPDRS Ⅲ score (r=0.417, P=0.008). The left atrial reserve strain and strain rate were negatively correlated with the scores of the scales for outcomes in Parkinson^,s disease-autonomic (SCOPA-AUT) (r=-0.535, -0.319; All P<0.05). The left atrial catheterization strain was negatively correlated with SCOPA-AUT score (r=-0.319, P=0.048), and strain rate was positively correlated with SCOPA-AUT score (r=0.359, P=0.025). The left atrial strain during pumping was negatively correlated with SCOPA-AUT (r=-0.342, P=0.033). ConclusionsThe strain and strain rate parameters obtained from CMR-FT can early assess the degree of cardiac dysfunction in PD patients. Left ventricular systolic function and left atrial reserve, catheter and pump function are impaired in PD patients. Left atrial reserve function and catheter function are related to the severity of motor dysfunction and autonomic dysfunction. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.014 ObjectiveThe Meta-analysis was used to explore the diagnostic value of native T1 and extracellular volume fraction (ECV) for cardiac amyloidosis (CA). Materials and MethodsPubMed, Embase, Cochrane Library, Web of Science, Wanfang Database, CBM, VIP and CNKI were searched to explore the value of T1 and ECV of the diagnostic value in CA. The search time was from the establishment of the database to November 2022. Two researchers independently completed the literature screening, extracted the relevant data included in the literature and evaluated the quality. The bias risk was evaluated and statistically analyzed by Revman 5.3, Stata 16.0 and Meta-Disc 1.4. Heterogeneity and publication bias analysis were carried out. Sensitivity analysis was used to verify the stability and reliability of Meta-analysis results. ResultsA total of 12 articles (1 045 patients) were included. Meta-analysis showed that sensitivity (Sen), specificity (Spe), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve (AUC) and 95% confidence interval (CI) of T1 diagnostic CA were 86% (95% CI: 82%-89%), 86% (95% CI: 80%-91%), 6.2 (95% CI: 4.2-9.3), 0.16 (95% CI: 0.12-0.22), 38 (95% CI: 19-75), 0.92 (95% CI: 0.90-0.94). The Sen, Spe, PLR, NLR, DOR, and AUC of ECV diagnostic CA were 90% (95% CI: 83%-94%), 90% (95% CI: 83%-94%), 8.8 (95% CI: 5.3-14.6), 0.11 (95% CI: 0.07-0.19), 79 (95% CI: 38-162), and 0.95 (95% CI: 0.93-0.97). ConclusionsNative T1 value and ECV have high diagnostic value for CA and can provide imaging basis for the early diagnosis of CA. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.015 ObjectiveTo explore the value of a radiomics model based on T2-weighted imaging (T2WI) and contrast-enhanced T1-weighted imaging (CE-T1WI) magnetic resonance imaging (MRI) in non-invasive preoperative prediction of epidermal growth factor receptor (EGFR) mutation status in brain metastases of lung cancer patients. Materials and MethodsWe retrospectively collected clinical and MRI data of all lung cancer patients who underwent surgical resection of brain metastases and EGFR gene testing at Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Sun Yat-sen University Cancer Center and Anhui Provincial Hospital from December 2016 to October 2021. A total of 103 patients (118 brain metastases) were included, with 80 patients (89 brain metastases) in the training set (Sun Yat-sen University Cancer Center and Anhui Provincial Hospital) and 23 patients (29 brain metastases) in the test set (Sun Yat-sen Memorial Hospital, Sun Yat-sen University). The enhanced edges of brain metastases were delineated on the CE-T1WI images to obtain the volume of interest (VOI), which was then copied to the registered T2WI images to obtain the T2WI-VOI of brain metastases. Radiomics features of brain metastases were extracted from these VOI using the PyRadiomics software, and feature selection was performed using mRMR and LASSO-logistics methods. A predictive model for EGFR mutation status was constructed, and the performance of the radiomics model in predicting EGFR mutations status was evaluated using the area under the receiver operating characteristic curve (AUC). The calibration curve and Hosmer-Lemeshow (HL) test were used to evaluate the calibration of the model, and decision curve analysis (DCA) was used to assess the clinical net benefit of the radiomics model in predicting EGFR mutation status. ResultsIn the training set and test set, there were no statistically significant differences in age, sex, pathological type, number of brain metastases, and diameter of brain metastases between the EGFR mutation and wild-type groups in terms of clinical data and MRI features (P>0.05). A total of 3 190 radiomics features of brain metastases were extracted from the CE-T1WI and T2WI images. Finally, four radiomics features based on CE-T1WI and five radiomics features based on T2WI were selected, and a radiomics model for predicting EGFR mutation status was constructed using these features. The radiomics model showed good predictive performance with an AUC of 0.828, accuracy of 76.4%, sensitivity of 81.6%, and specificity of 70.0% in the training set and an AUC of 0.783, accuracy of 82.8%, sensitivity of 95.7%, and specificity of 33.3% in the test set. The calibration curves of the radiomics model in the training and test sets showed good consistency between the predicted probabilities and the actual probabilities of EGFR mutation status (HL>0.05). DCA demonstrated the clinical utility of the radiomics model within a threshold range of 13.8%-87.2%. ConclusionsThe radiomics model based on T2WI and CE-T1WI MRI can serve as an auxiliary tool for non-invasive preoperative prediction of EGFR mutation status in brain metastases of lung cancer patients. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.016 ObjectiveTo investigate the value of radiomics based on combined machine learning models in predicting the response to neoadjuvant chemotherapy (NAC) in mass enhancement breast cancer. Materials and MethodsThe clinical and imaging data of ninety-seven patients with mass enhancement breast cancer confirmed by histopathology and underwent NAC from January 2018 to October 2021 in the Fifth Medical Center of Chinese PLA General Hospital were retrospectively analyzed in our study. Based on the results of Response Evaluation Criteria in Solid Tumors (RECIST), the patients were classified into effective group and ineffective group. Based on the radiomics features extracted on the first dynamic contrast-enhanced MRI (DCE-MRI) subtraction images before treatment, a high-pass or low-pass wavelet filter and a Laplace-Gaussian filter with different parameters were also introduced to preprocess the original MR images. For feature screening, feature selection methods based on univariate analysis and multivariate analysis were used. The univariate analysis included F-test, chi-square test and mutual information. The multivariate analysis used the least absolute shrinkage and selection operator (LASSO). Support vector machine (SVM), random forest (RM), and logistic regression (LR) were used for modeling, and finally a total of twelve combinations of feature filters and classifiers were combined by crossover. Ten repetitions of five-fold cross-validation were used for training. Finally, area under the curve (AUC), sensitivity, specificity, accuracy, positive prediction value and negative prediction value were used to evaluate the prediction performance. ResultsAmong all cross-combined schemes, the feature screening method that achieved the best classification performance was the F-test method in univariate analysis, and the best classifier was the SVM. The combination screened a total of 191 imaging features with an overall mean AUC of 0.83 [95% confidence interval (CI): 0.80-0.86] in predicting NAC response, and the accuracy of the model was 77% (95% CI: 74%-80%). Specificity was 81% (95% CI: 78%-84%), sensitivity was 71% (95% CI: 65%-77%), positive predictive value was 67% (95% CI: 62%-72%), and negative predictive value was 85% (95% CI: 83%-87%). ConclusionsA combined machine learning model based on F-test and SVM validated good performance of radiomics in predicting the response to NAC for mass enhancement breast cancer patients. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.017 ObjectiveTo investigate the clinical value of MRI radiomics in predicting Luminal and non-Luminal subtypes of invasive breast carcinoma of no special type. Materials and MethodsA total of 149 cases with pathologically confirmed invasive breast carcinoma of no special type from April 2021 to December 2022 were retrospectively collected according to the inclusion and exclusion criteria, and all of them underwent non-contrast MRI scanning and contrast-enhanced scanning before treatment. Clinical and pathological data of all enrolled patients were collected. Patients were classified into Luminal subtype (n=90) and non-luminal subtype (n=59) based on the expression of estrogen receptor (ER) and progesterone receptor (PR). They were divided into training group (n=104) and test group (n=45) in a ratio of 7∶3,randomly. Screened the optimal features of radiomics from the extracted data, and three prediction models were established based on the random forest method, namely DWI model, DCE model, and DWI combining DCE model. The prediction performance of the models was evaluated by receiver operating characteristic (ROC) curve and the area under the curve (AUC). The DeLong test was used to compare the prediction performance of different models. ResultsThere were no significant differences in the clinicopathological features (age, ER status, PR status, menopausal status, lymph node metastasis) between Luminal and non-Luminal groups, training group and test group (P>0.05). The AUCs of DWI model, DCE model and joint model were 0.859, 0.839 and 0.903 in the training group. In the test group, the AUCs were 0.722, 0.798 and 0.821 respectively. The DeLong test showed that the prediction efficacy of the DCE model and the joint model in the training group were statistically significant (P=0.03), but there was no statistically significant difference in the prediction efficacy among the three models (P>0.05). ConclusionsThe model constructed based on MRI radiomics can better predict the luminal and non-luminal subtypes of invasive breast carcinoma of no special type, and can help the decision-making of clinical treatment options for invasive breast carcinoma of no special type. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.018 ObjectiveTo investigate the value of the Liver Imaging Reporting and Data System version 2018 (LI-RADS v2018) in preoperative predicting the expression of cytokeratin 19 (CK19) and assessing postoperative prognosis in hepatocellular carcinoma (HCC). Matirials and Methods: Two hundred and twenty patients with pathologically-confirmed HCC were retrospectively included who underwent preoperative MRI examination, including 59 cases with CK19-positive expression and 161 cases with CK19-negative expression. All patients were divided into training and validation sets in a 7∶3 ratio, and the clinical, pathological, and imaging data of the patients were analyzed. Independent predictors for CK19 expression in HCC were determined by univariate- and multivariate logistic regression analysis and a nomogram scoring model was constructed. The diagnostic performance of the model was assessed using receiver operating characteristic (ROC) curve analysis. Calibration curves and decision curves were plotted to evaluate the calibration performance and clinical applicability of the model. Nomogram scores for patients were calculated and used for high and low risk stratification. The Kaplan-Meier survival curve was employed to compare the overall, early, and late recurrence-free survival rates among different subgroups. ResultsCorona enhancement (OR=3.432, P=0.045), rim arterial phase hyperenhancement (OR=32.073, P=0.017), targetoid diffusion restriction (OR=12.941, P=0.006), irregular tumor margin (OR=4.590, P=0.014), and relative enhancement ratio (RER) in the hepatobiliary phase (OR=0.014, P=0.023) were independent predictors for CK19 expression in HCC. The AUC of the prediction model in the training set and validation set were 0.884 (95% CI: 0.823-0.930) and 0.748 (95% CI: 0.625-0.846), respectively. The calibration curve and decision curve showed that the calibration performance and clinical applicability of the model were good. Significant differences were observed in overall recurrence-free survival rates between the CK19-positive and CK19-negative groups, as well as in overall, early and late recurrence free survival rates between high and low-risk groups (P<0.05). ConclusionsCorona enhancement, rim arterial phase hyperenhancement, and targetoid diffusion restriction, combined with irregular tumor margin and enhancement quantitative parameter in hepatobiliary phase can achieve preoperative risk prediction of CK19 expression in HCC, which also aids in assessing HCC postoperative recurrence. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.019 ObjectiveA multi-parametric MRI radiomics model was constructed by combining the radiomics features of conventional MRI and apparent diffusion coefficient (ADC) map to predict lymph node metastasis (LNM) in pancreatic ductal adenocarcinoma (PDAC), and the prediction performance was compared with the established conventional MRI radiomics model and clinical model, to explore the added value of ADC map radiomics. Methods and Materials A total of 218 patients with PDAC were randomly divided into a training cohort and a validation cohort at a ratio of 7∶3. Clinical and conventional imaging features were used to construct the clinical imaging model. Then the radiomics features were extracted based on conventional MRI images (T1WI, T2WI, arterial phase images and portal venous phase images) and ADC maps. Least absolute shrinkage and selection operator was used to select the most relevant features of LNM in the training cohort for model construction. Radiomics models based on conventional MRI images (represented as radiomics model 1) and radiomics models combined with conventional MRI images and ADC maps (represented as radiomics model 2) were constructed. The area under the curve (AUC) of receiver operator characteristic was used to evaluate the prediction performance of the models. DeLong validation was used to compare the difference of AUC values between models. The calibration curve was used to evaluate the accuracy of the model. The clinical value of the model was evaluated by decision curve analysis. ResultsThe AUC values of clinical and radiographic model, radiomics model 1 and radiomics model 2 for preoperative prediction of LNM in the training and validation cohorts were 0.741 and 0.674, 0.818 and 0.702, 0.854 and 0.839, respectively. The AUC value of radiomics model 2 for preoperative prediction of LNM was significantly higher than that of the clinical and radiographic model (P=0.009 in the training cohort; P=0.023 in the validation cohort) and radiomics model 1 (P=0.044 in the training cohort; P=0.041 in the validation cohort). The prediction performance of radiomics model 1 was not significantly different from that of the clinical radiographic model (P=0.095 in the training cohort; P=0.759 in the validation cohort). The calibration curves of the three models showed good agreement between the predicted values and the actual values. Decision curve analysis curve showed that radiomics model 2 had a higher net benefit than radiomics model 1 and clinical imaging model. ConclusionsThe multi-parametric MRI radiomics model by combining conventional MRI and ADC map radiomics can improve the diagnostic efficiency of predicting LNM of PDAC, which is significantly better than the conventional MRI radiomics model and clinical-radiographic model. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.020 ObjectiveTo investigate multiparametric magnetic resonance imaging (MRI), magnetic resonance hysterosalpingography (MR-HSG) and clinical characteristics of uterine factor infertility (UFI) and to develop a model for predicting UFI. Materials and MethodsThe clinical characteristics, MRI and MR-HSG imaging data of 312 patients with UFI only were analyzed retrospectively. The pregnancy results were followed up after treatment and divided into the infertile group and the pregnant group. The differences were compared including clinical indexes (age, diet, menstrual cycle, etc), sex hormones, and uterine abnormalities (such as uterine fibroids, intrauterine adhesions, scarred uterus, adenomyosis, endometrial polyps, Nabothian cyst, etc) between the two groups. Risk factors for UFI were then identified through univariate and multivariate logistic regression analysis. The enter method was performed to construct the clinical parameter model, the combination of clinical and MRI and MR-HSG parameter prediction models. The performance of the model was evaluated by the area under the curve (AUC) of receiver operating characteristic (ROC), and the AUCs were compared using the DeLong test. ResultsThe differences in age, menstrual cycle irregularity, uterine fibroids, cesarean scar diverticulum, and intrauterine adhesions between the infertility group of 86 cases and pregnant group of 226 cases were statistically significant (all P<0.05). Multivariate logistic regression analysis confirmed that age (OR=0.822, P<0.001)、multiple uterine fibroids (OR=0.540, P=0.002) and intrauterine adhesion (OR=0.367, P=0.036) were independent risk factors for UFI. The AUC for the combined model (age + multiple uterine fibroids + intrauterine adhesion) was 0.809, which was significantly higher than the age model (P<0.05). The combined model did not show a statistically significant difference compared to the age + intrauterine adhesion model and the age + multiple fibroids model (all P>0.05). ConclusionsAge, multiple uterine fibroids, and intrauterine adhesion are identified as risk factors for UFI, and the combined model has clinical value in predicting pregnancy. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.021 ObjectiveTo explore the value of preoperative prediction of cervical cancer lymph-vascular space invasion (LVSI) by combining deep transfer learning features based on MR-T2WI, radiomic features, and clinical characteristics. Materials and MethodsData of 178 patients with cervical cancer by postoperative pathology, including 70 cases with LVSI (+) and 108 cases with LVSI (-) were retrospectively analyzed. The patients were divided into training set [n=142, including 54 LVSI (+) and 88 LVSI (-)] and test set [n=36, including 16 LVSI (+) and 20 LVSI (-)] at a ratio of 8∶2. Univariate logistic regression analysis was conducted on clinical factors to identify independent predictors for LVSI (+) cases. The deep transfer learning (DTL) method and traditional radiomics methods were used to extract the DTL features and radiomics features from the lesions in the sagittal T2WI images. This led to the construction of a deep transfer learning feature dataset, a radiomics feature dataset, and a dataset that merges the DTL features with the radiomics features. Each feature dataset in the training set underwent feature dimension reduction using t-tests, Pearson analysis, and least absolute shrinkage and selection operator (LASSO) regression. The best of these were used to construct radiomics models [radiomics (Rad) model, DTL model, Fusion model of Rad and DTL features (Rad+DTL) model], and the optimal radiomics model was selected. A joint model was constructed based on the best model^,s radiomics score and independent clinical factors, and a nomogram was drawn. The calibration of the model was evaluated using calibration curves, and the application value of the model was assessed using decision curve analysis. ResultsLymph node metastasis and the neutrophil-to-lymphocyte ratio were identified as independent predictors (P<0.05) with LVSI (+). The Rad+DTL model was determined as the optimal radiomics model. The combined model exhibited a higher AUC in the training set compared to the Rad+DTL model (0.984 vs. 0.966, P<0.05), and in the testing set (0.912 vs. 0.759, P=0.05). The combined model showed higher calibration accuracy and greater clinical net benefit. ConclusionsThe combination of DTL features from MR-T2WI, radiomics features, and clinical characteristics can effectively predict LVSI in cervical cancer. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.022 ObjectiveMultifrequency magnetic resonance elastography was used to investigate the relationships of different anatomical regions of the kidney (left and right kidneys, whole kidney, outer cortex, inner cortex, and medulla) and various physiological factors (age, sex, body mass index, and water intake) on renal stiffness. Materials and MethodsNinety-two healthy volunteers were recruited from Shenzhen Traditional Chinese Medicine Hospital during the period from March 2023 to December 2023. Multifrequency elastography was employed using a 3.0 T MR to assess the stiffness of renal different anatomical regions, including the whole kidney, outer cortex, inner cortex, and medulla. The aim was to conduct a bilateral comparison of differences between these regions, perform an analysis on the correlation among age, body mass index and kidney stiffness, as well as investigate gender and age disparities in kidney stiffness. Finally, the changes in kidney stiffness before and after drinking water were compared in 18 of the volunteers. ResultsThere was no difference in the stiffness of the whole kidney, outer cortex, inner cortex and medulla bilaterally (P≥0.05). However, the stiffness of different anatomical regions of the kidney exhibited statistically significant differences, with the inner cortex demonstrating the highest stiffness [(3.01±0.22) m/s], followed by the outer cortex [(2.69±0.20) m/s] and the entire kidney [(2.55±0.17) m/s], while the medulla displayed a slightly lower stiffness [(2.16±0.15) m/s]. The stiffness of the whole kidney (r=-0.301, P=0.004) and the inner cortex (r=-0.330, P=0.001) exhibited a slightly decrease with age, as well as differed among the three age groups (P<0.05). The stiffness of different anatomical regions within the kidney was higher in males than in females (P<0.05). The stiffness of different anatomical regions of kidney was higher after drinking water than before in males and females (P<0.05), with particularly notable increases observed in both the outer cortex and inner cortex. ConclusionsThe stiffness of the kidney exhibits regional variations and it is related to age, gender and water intake. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.023 ObjectiveTo evaluate bone marrow endothelial progenitor cells (BMEPCs) functions of proximal femur in diabetes mellitus (DM) combined with critical limb ischemia (CLI) rabbits via dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) microvascular permeabilities and fatty acid metabonomics. Materials and MethodsEighteen rabbits were randomly selected from 36 male New Zealand big ear white rabbits to build DM model rabbits by intravenous injection of alloxan. Among them, 12 DM rabbits were successfully modeled and 6 rabbits that failed to be modeled were euthanized. 12 DM rabbits and 12 non-DM rabbits underwent right femoral artery ligation as DM combined with CLI (DM+CLI) group and simple CLI group. In the two groups,10 rabbits in each group survived after surgery. Six non-DM rabbits underwent surgery to expose the right femoral artery without ligation as sham operation control (Control) group (n=6) and all survived. DCE-MRI examination of the right proximal femur was performed in each group at week 0 and 4 after operation. The number of peripheral blood endothelial progenitor cells and right proximal femur BMEPCs, migration and angiogenesis function of BMEPCs and bone marrow fatty acid liquid chromatography-mass spectrometry metabonomics were measured at week 4 after operation, as well as bone marrow microvessel density (MVD) calculated. ResultsCompared with CLI group and Control group, DM+CLI group presented higher K^trans, K_ep, V_e at week 4 after operation, while MVD of bone marrow decreased (P<0.05). In addition, the contents of palmitoleic acid, the ratio of monounsaturated fatty acid/polyunsaturated fatty acid and activity of stearoyl-CoA desaturase 1 index decreased (P<0.05) and elongase activity index increased (P<0.05). The abilities of mobilization, migration and angiogenesis of BMEPCs were impaired in DM+CLI group (P<0.05). At week 4 after operation, the K^trans, K_ep and V_e of right proximal femur bone marrow, the related indexes of bone marrow fatty acid anabolism were positively correlated with BMEPCs migration and angiogenesis functions (P<0.05). Correlation analysis of DM+CLI group and CLI group was performed, and the mobilization ability of BMEPCs was negatively correlated with K^trans, K_ep and V_e. ConclusionsIt is feasible to evaluate BMEPCs functions in DM+CLI rabbits combining DCE-MRI with fatty acid metabonomics, which can provide visual imaging evidence for the pathophysiological mechanism for lipid regulation therapy to improve functions of BMEPCs and prevent amputation. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.024 ObjectiveTo assess the value in endolymphatic hydrops (EH) diagnosis of positive perilymph image (PPI) and HYDROPS (HYbriD of reversed image of positive endolymph signal and native image of positive perilymph signal) of three-dimensional fluid attenuated inversion recovery with CUBE (3D CUBE FLAIR) based on inner ear magnetic resonance imaging with contrast enhancement following intravenous injection of gadolinium. Materials and MethodsThe data and MRI images of 22 patients with EH on the affected side and without EH on the contralateral side were retrospectively analyzed. The Image J software was used to delineate the regions of interest the images obtained to analyze the signal intensity ratios (SIR) of the cochlear basal turn to the same side cerebellar white matter on affected and unaffected sides in the same image and SIRs of perilymph to the same side endolymph of vestibule both in PPI and HYDROPS; Count the numbers of cochlear EH on the affected side and the scores of vestibular EH boundaries definition both in PPI and HYDROPS. Evaluate the visualization of permeability change of the blood-labyrinth barrier (BLB) on the affected side, the vestibular developing effect, the cochlear EH sensibility and the development in vestibular EH boundaries in the two kinds of images. ResultsThere was statistical difference in SIRs of the cochlear basal turn to the same side cerebellar white matter between affected and unaffected sides in PPI (P<0.001). There was statistical difference in SIRs of the cochlear basal turn to the same side cerebellar white matter between affected and unaffected sides in HYDROPS (P<0.001). There was statistical difference in SIRs of perilymph to the same side endolymph of vestibule between PPI and HYDROPS on the affected side (P<0.001). There was statistical difference in SIRs of perilymph to the same side endolymph of vestibule between PPI and HYDROPS on the unaffected side (P<0.001). There was statistical difference in the sensibility of the cochlear EH diagnosis between PPI and HYDROPS (P=0.030). There was statistical difference in the scores of vestibular EH boundaries definition between PPI and HYDROPS (P<0.001). ConclusionsCombining PPI with HYDROPS in 3D CUBE FLAIR of inner ear gadolinium enhancing magnetic resonance imaging contributes to assessing the permeability, locating the EH and displaying the boundaries. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.025 ObjectiveTo compare and analyze the image quality of breast MRI T2WI sequences between double-echo Fast water-fat separation (Dixon) technique and traditional two-point Dixon technique, and to explore the clinical application value of the two Dixon techniques. Materials and MethodsA retrospective study was conducted on 41 female patients who underwent Fast Dixon (Fast Dixon group) and two-point Dixon (two-point Dixon group) two fat-suppressed T2WI sequences for MRI breast examination in Guangxi Zhuang Autonomous Region People^,s Hospital from June 2022 to March 2023. The image quality of the two groups was comprehensively analyzed (including overall image quality, fat-suppressed quality, motion artifact size in axilla, chest wall, skin area, and clarity of fibroglandular tissue and solid lesions). The signal-to-noise ratio (SNR) of lesions, axilla, chest wall, normal parenchyma, and the contrast-to-noise ratio (CNR) of lesion parenchyma were calculated. Kendall^,s W coefficient was used to evaluate the consistency of subjective score data between observers, and the intra-class correlation coefficient (ICC) was used to evaluate the consistency of objective quantitative evaluation parameters of image quality between observers. Count data were compared by nonparametric test, and measurement data were compared by paired t test or Wilcoxon signed rank test. P<0.05 was considered statistically significant. ResultsSubjective evaluation: the subjective scores of the two physicians showed good or excellent consistency (Kendall^,s W=0.773-0.928, P<0.001). Both Dixon techniques can achieve uniform fat inhibition image quality (P>0.05). Fast Dixon group had smaller motion artifacts in axilla, chest wall and skin area, and the overall image quality was better than that of two-point Dixon group, with statistical significance (P<0.05). There was no statistical significance in the definition of fibroglandular tissue and lesions between the two groups (P>0.05). Objective evaluation: The SNR and CNR calculated by two observers showed very good consistency (ICC=0.897-0.936, P<0.001). The SNR of the Fast Dixon group was better than that of the two-point Dixon group in the lesions, normal parenchyma, pectoral muscle and axilla (P<0.05), and there was no significant difference in the CNR of the lesions between the two groups. ConclusionsCompared with two-point Dixon technique, Fast Dixon technique can achieve uniform and consistent fat-suppressed images and reduce motion artifacts in the image quality of the peri-mammary region, thereby significantly improving the overall image quality of the breast MRI T2WI sequence. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.026 ObjectiveTo investigate the feasibility of parameter optimized 3 dimensions amide proton transfer weighted (3D-APTw) imaging for image quality evaluation and clinical scanning in primary liver cancer. Materials and MethodsA total of 109 patients with suspected primary liver cancer were prospectively collected from October 2020 to February 2022. Philips 3.0 T MRI equipment was used for scanning, and T1WI, T2WI, diffusion-weighted imaging, amide proton transfer weighted (ATPw) and multi-phase enhanced images were collected. The machine automatically generates an 3D-APTw image of the liver corrected by B0. The scanning success rate and calculation success rate of 3D-APTw imaging were calculated. Kendall agreement consistency test was used to analyze the subjective score of inter-observer and intra-observer APTw image quality. SNR and CNR, APTw of tumor and liver were measured for cases with subjective scores above 3 and calculated and the coefficient of variation was calculated for each parameter value. Intra-group correlation coefficient was used to analyze the consistency of intra-observer and inter-observer repeatability measurements. ResultsAmong the 109 patients, 11 patients had signal loss in the lesion area in 3D-APTw images, and the scanning success rate was 89.91% (98/109). Among the remaining 98 patients, 78 patients had APTw image subjective score of more than 3 points, and the calculation success rate was 71.56% (78/109). The intraobserver and interobserver subjective scores of 3D-APTw image quality with a correlation coefficient of 0.771 and 0.692, P<0.01. ICC of intraobserver and interobserver agreement with APTw values in tumor tissue was 0.822 and 0.811, while ICC of intraobserver agreement with APTw, SNR and CNR in hepatic tissue was 0.675, 0.634, 0.666. ICC of interobserver agreement with APTw, SNR and CNR in hepatic tissue was 0.614, 0.290, 0.560. APTw value of tumor tissue was higher than that of liver tissue [(2.55±0.08) % vs. (1.45±0.07) %)], and the difference was statistically significant (P<0.001). The coefficients of variation of APTw values in tumor tissue and liver were 30.40% and 44.40%, respectively. SNR and CNR were 25.92±18.50 and 3.35±3.20. The coefficient of variation was 71.40% for SNR and 90.00% for CNR. ConclusionsParameter-optimized 3D-APTw imaging can be used for clinical scanning of primary liver cancer, but it is prone to signal loss or artifact due to the influence of respiratory movement, gallbladder or blood vessels, so there is still room for improvement in parameter setting and imaging technology to further optimize its image quality. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.027 ObjectiveTo evaluate the diagnostic value of the neck imaging reporting and data systems (NI-RADS) MRI in exclusive mucosal local recurrent nasopharyngeal carcinoma (EMLRNPC) and mucosal posttreatment changes (MPTC), and attempted to propose adding qualitative diffusion-weighted imaging (DWI) criteria for the focal mucosal abnormality in NI-RADS MRI lexicon. Materials and MethodsFrom February 2015 to February 2023, totally 21 cases of EMLRNPC and 29 cases of MPTC confirmed by pathology or imaging follow-up were retrospectively enrolled. Two radiologists independently evaluated the MRI findings and assigned a NI-RADS MRI category in the first step, then reevaluated with the adding qualitative DWI criteria and assigned a modified NI-RADS MRI category in the second step. All images were reevaluated by the senior radiologist in the same steps after three months. Inter- and intra-reader agreements were assessed with Cohen^,s Kappa test. Receiver operating characteristic curves were generated to assess the diagnostic values of the two NI-RADS categories between EMLRNPC and MPTC. Area under the curve (AUC) was compared by DeLong^,s test. ResultsInter- and intra-reader agreements were 0.69 and 0.88 for NI-RADS MRI categories, and 0.83 and 0.96 for modified NI-RADS MRI categories. In differential diagnosis of EMLRNPC and MPTC, the AUC, sensitivity, specificity of NI-RADS MRI were 0.845 [95% confidence interval (CI): 0.715-0.932], 100.0% (95% CI: 83.9%-100.0%), 69.0% (95% CI: 49.2%-84.7%), and of modified NI-RADS MRI were 0.966 (95% CI: 0.871-0.997), 100.0% (95% CI: 83.9%-100.0%), 93.1% (95% CI: 77.2%-99.2%), respectively. There was statistical difference between the AUCs of two categories (Z=2.985, P=0.003). ConclusionsFor both NI-RADS MRI and modified NI-RADS MRI which adding the qualitative DWI criteria, the differential diagnostic value of EMLRNPC and MPTC are great, while the consistency and diagnostic performance are stronger for the modified NI-RADS MRI. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.028 ObjectiveTo evaluate the differential diagnosis value of MR pharmacokinetic perfusion scan using compressed sense technique between idiopathic granulomatous mastitis (IGM) and invasive ductal carcinoma (IDC) appearing as non-mass enhancement with segmental distribution on MR. Material and Methods: A total of 42 non-mass enhanced breast lesions with segmental distribution on MR (IGM 27 cases, IDC 15 cases) were retrospectively analyzed. All cases were pathologically proved. Comparison of menstrual state, age, inner enhancement pattern, between two groups were made with Fisher^,s exact test, t test and Chi-square test. The t test and Mann Whitney U test were used to screen out the difference terms in the volume transfer constant (K^trans), rate constant (K_ep), extravascular space volume fraction and extracellular space volume fraction (V_e) between the two groups. Binary logistic linear regression was used to obtain the odds ratios (OR) of the parameter with significant difference and its receiver operating characteristic (ROC) curve was generated to evaluate the diagnostic value. ResultsThere were significant differences in age and menstrual state between two groups (P=0.001, 0.003), while the difference in inner enhancement pattern was of no significant difference (P=0.883). MR pharmacokinetic perfusion scan: K^trans_(IGM) was (0.274±0.163) min^-1, which was lower than K^trans_(IDC) (0.451±0.257) min^-1. While K_{ep (IGM)} (0.618±0.245) min^-1 was higher than K_{ep (IDC)} (0.856±0.420) min^-1. Both differences of K^trans and K_ep between two groups were significant (P=0.013, 0.012). The V_e for two groups were V_{e (IGM)} (0.531±0.320) min^-1 and V_{e (IDC)} (0.629±0.323) min^-1. There was no significant difference in V_e between them (P=0.182). The OR value for K^trans was 2.243 [95% confidence interval (CI): 0.652-6.294)] in logistic linear regression (P=0.021). The Jordan index (0.585), sensitivity (73.3%), specificity (85.2%) and area under the curve (AUC) (0.778, 95% CI: 0.623-0.891) were obtained from the ROC for K^trans (P=0.001). ConclusionsThe parameter K^trans derived from MR pharmacokinetic perfusion scan using compressed sense technique can be used to distinguish IGM from IDC, which appeare as non-mass enhancement with segmental distribution on MR. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.029 ObjectiveTo explore the risk factors contributing to femoroacetabular impaction (FAI) syndrome based on MRI factors and clinical factors and evaluate the correlation of each risk factor. Materials and MethodsPatients with FAI who underwent hip MRI examination between February 2022 and June 2023 in our hospital were retrospectively enrolled. Patients were divided into two groups: the FAI syndrome group and the asymptomatic FAI group, based on whether they presented with clinical symptoms or signs. After evaluating the demographic characteristics of clinical data and anatomical features of hip joints through MRI, univariate analysis was used to identify risk factors for FAI syndrome. Subsequently, multivariate regression analysis was employed to explore the correlation between each risk factor and symptomatic FAI, ultimately pinpointing independent risk factors. ResultsIn univariate analysis, significant differences were observed in age, FAI classification, peritrochanteric muscle edema, and femoral neck bone marrow edema (P<0.05). The multivariate statistical results showed that age (P=0.012), FAI classification (P=0.022) and peritrochanteric muscle edema (P<0.001) were identified as the independent risk factors associated with FAI syndrome. ConclusionsAge, FAI classification and peritrochanteric muscle edema are independent risk factors for FAI syndrome, which can provide help for clinical individualized treatment and influence clinicians^, decision-making regarding patients^, treatment plans. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.031 Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.032 Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.033 ^,s disease (PD), which is characterized by resting tremor, muscular tonus, bradykinesia, and postural balance abnormalities, is the second most prevalent neurodegenerative disease in middle-aged and older persons worldwide. Its incidence is expected to increase to double in the following three decades. As the negative effects of medicines become increasingly evident, deep brain stimulation (DBS) has gained popularity as a novel type of adjuvant therapy. Magnetic resonance imaging (MRI) can non-invasively provide information on the structure, function, and metabolism of brain tissues in vivo, which is of greater clinical significance for assessing the effects of DBS after treatment of PD and guiding therapy. Therefore, this article provides a review of the research progress of multimodal MRI, including structural magnetic resonance imaging (sMRI), diffusion tensor imaging (DTI), blood oxygenation level dependent-functional magnetic resonance imaging (BOLD-fMRI), susceptibility-weighted imaging (SWI), quantitative magnetic susceptibility mapping (QSM), and magnetic resonance spectroscopy (MRS) in the treatment of PD with DBS, with the aim of assisting the clinic in choosing efficient and safe treatment methods and correctly evaluating the therapeutic effects. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.034 ^, quality of life. Resting-state functional magnetic resonance imaging (rs-MRI) has become an effective method to investigate the changes of brain function in epilepsy. At present, the data analysis methods for epilepsy research based on rs-fMRI mainly include amplitude of low frequency fluctuation (ALFF), regional homogeneity (ReHo), function connection (FC) and graph theory analysis. This article provides a review of the application of various rs-fMRI analysis methods in epilepsy, aiming to provide imaging indicators for the pathophysiological mechanism, preoperative and precise clinical treatment of epilepsy. ]]> Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.035 Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.036 Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.037 Wed,20 Mar 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.03.038 Wed,20 Mar 2024 00:00:00 GMT