http://med-sci.cn/cgzcx/en/contents_list.asp?issue=202604 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.1674-8034.2026.04.001 ObjectiveTo investigate the structural-functional coupling (SC-FC) characteristics of brain networks in patients with fibromyalgia syndrome (FMS) using multimodal neuroimaging and graph theory analysis, and to validate its predictive value for the efficacy of repetitive transcranial magnetic stimulation (rTMS), thereby promoting prospective and effective treatment screening for this disorder. Materials and MethodsForty-two female FMS patients and 42 healthy controls underwent multimodal MRI. GRETNA analyzed network properties; SC-FC coupling was evaluated at multiple levels, and its correlation with Visual Analog Scale (VAS) scores was examined. Patients received 10 rTMS sessions; receiver operating characteristic (ROC) curves evaluated pre-treatment SC-FC^,s predictive value. ResultsCompared to the HC group, FMS patients showed significantly reduced local efficiency (t = -2.569, P = 0.009) and average clustering coefficient (t = -3.098, P = 0.003) in the structural network. The brain regions with significant alterations in local topology for both structural and functional networks were primarily concentrated in areas related to pain and emotion. SC-FC coupling analysis revealed a significantly decreased global SC-FC coupling level in FMS patients (t = -5.541, P < 0.001). At the nodal level, multiple brain regions exhibited bidirectional abnormal coupling values (P < 0.05, FDR corrected), while at the subnetwork level, the SC-FC coupling values of the limbic network (LN) (t = 3.727, P = 0.002) and frontoparietal network (FPN) (t = 2.708, P = 0.032) were significantly increased. Correlation analysis indicated that baseline VAS scores in FMS patients were weakly positively correlated with LN coupling values (r = 0.370, P = 0.016) and weakly negatively correlated with FPN coupling values (r = -0.388, P = 0.011). The baseline SC-FC coupling value of the FPN demonstrated significant predictive value for the short-term efficacy of rTMS (AUC = 0.751, P = 0.006). ConclusionsFMS has impaired structural integration and compensatory SC-FC, which are associated with pain symptoms. The pre-treatment FPN SC-FC is a potential biomarker for rTMS efficacy, which could provide a reference for optimizing FMS treatment. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.002 ObjectiveTo investigate the characteristics of brain structure magnetic resonance imaging (sMRI) in patients with atrial fibrillation-associated mild cognitive impairment (AF-MCI) and to analyze their correlation with cognitive function. Materials and MethodsA case-control design was employed, enrolling 34 patients with atrial fibrillation and normal cognitive function (AF-N), 32 patients with AF-MCI, and 30 healthy controls (HC). T1-weighted structural MRI images were acquired from all participants, and data were processed using an MRI brain structure segmentation and analysis system. Statistical analysis was performed using SPSS 27.0. For data following a normal distribution, one-way ANOVA followed by the least significant difference (LSD) post-hoc test was used. For non-normally distributed data, the Kruskal-Wallis H test was used, followed by the Mann-Whitney U test for post-hoc comparisons (with Bonferroni correction). Further correlation analyses were conducted to explore the relationships between brain structural indices and cognitive scores. Results(1) Compared with the HC group, the AF-N group showed lower frontal pole asymmetry index (t = 3.184, P = 0.002), left frontal pole volume (Z = 2.235, P = 0.021), and middle corpus callosum volume (Z = 2.991, P = 0.008), while the right lateral orbitofrontal cortical thickness was increased (t = -3.417, P < 0.001). (2) Compared with the AF-N group, the AF-MCI group exhibited significant decreases in the anterior cingulate asymmetry index (t = 2.413, P = 0.018), right middle cingulate cortical thickness (Z = 2.707, P = 0.020), right medial orbitofrontal cortical thickness (t = 3.000, P = 0.004), right superior parietal cortical surface area (t = 2.571, P = 0.012), left hippocampal subfield CA3 volume (t = 2.541, P = 0.013), and right hippocampal subfield CA3 volume (t = 2.180, P = 0.032). (3) Comparison between the AF-MCI and HC groups revealed lower volumes in the left hippocampal CA3 (t = 2.855, P = 0.005), right hippocampal CA3 (t = 2.163, P = 0.033), left hippocampal molecular layer (Z = 2.548, P = 0.033), left hippocampal CA4 (Z = 2.620, P = 0.026), left hippocampal dentate gyrus (Z = 3.040, P = 0.007), and right hippocampal dentate gyrus (Z = 2.420, P = 0.047). Additionally, the asymmetry indices of the cuneus (Z = -2.639, P = 0.025) and precuneus (Z = -2.803, P = 0.015) were increased in the AF-MCI group compared to the HC group. (4) Furthermore, the right lingual gyrus cortical thickness was increased in the AF-MCI group compared to the HC group (t = -3.094, P = 0.002). The left calcarine sulcus cortical thickness was increased in the AF-MCI group compared to both the AF-N group (t = -2.432, P = 0.016) and the HC group (t = -3.184, P = 0.002). ConclusionsBrain structural damage in AF-MCI exhibits a two-stage progressive characteristic: early involvement predominantly affects the prefrontal executive network, which later extends to the medial temporal lobe-default mode network. Furthermore, the early damage demonstrates selectivity for frontal-subcortical circuits and left-lateralized hippocampal involvement, suggesting that vascular mechanisms and the specific vulnerability of the verbal memory network play important roles in the pathogenesis of AF-MCI. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.003 ObjectiveTo investigate the relationship between spatial navigation impairment, medial temporal lobe structural (e.g., the hippocampus and entorhinal cortex) volumes, and plasma phosphorylated tau 217 levels in individuals with early Alzheimer^,s disease (AD) using a virtual spatial navigation task, and to evaluate the classification performance of combined indicators for identifying early AD high-risk populations. Materials and MethodsWe enrolled 111 participants (70 normal controls, 41 mild cognitive impairment). All underwent virtual spatial navigation testing; 88 also completed structural MRI and plasma p-tau217 assessment. Hippocampal subfield and entorhinal cortex volumes were extracted using FreeSurfer. Group differences and intercorrelations among measures were examined, and ROC curves evaluated classification performance. ResultsCompared to the NC group, the MCI group demonstrated significant atrophy in the entorhinal cortex and several hippocampal subfields (dentate gyrus, CA3, CA4, subiculum), impaired spatial navigation performance, and elevated plasma p-tau217 levels. Both drop error (r = 0.259, P = 0.015) and rotation error (r = 0.292, P = 0.007) in the navigation task were positively correlated with plasma p-tau217 levels. Drop error was negatively correlated with volumes of the left dentate gyrus (r = -0.277, P = 0.011), CA4 (r = -0.290, P = 0.007), and subiculum (r = -0.264, P = 0.015). Plasma p-tau217 levels were also negatively correlated with volumes of the left dentate gyrus (r = -0.228, P = 0.037), CA4 (r = -0.251, P = 0.021), and subiculum (r = -0.254, P = 0.020). The area under the ROC curve (AUC) for spatial navigation alone in classifying MCI versus NC was 0.724. This increased to 0.822 when spatial navigation was combined with structural MRI and plasma biomarker data. ConclusionsSpatial navigation impairment in MCI is associated with elevated plasma p-tau217 and atrophy of specific hippocampal subregions. Virtual spatial navigation may serve as a useful behavioral indicator for early AD detection. A multimodal approach combining navigation performance with brain structural and plasma biomarkers enhances classification performance, providing a more comprehensive basis for early identification and monitoring of AD. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.004 ObjectiveTo systematically integrate the brain activity changes of patients with migraine after treatment of sham acupuncture, identify the consistent activated/inactivated brain regions, and reveals the central mechanism of sham acupuncture. Materials and MethodsThis study has been registered on the PROSPERO international prospective register of systematic reviews, with the registration number: CRD420251129628. PubMed, Web of Science, The Cochrane Library, EMbase, CBM, CNKI, WanFang Data and VIP databases were searched to collect randomized controlled studies on the changes of brain activity before and after sham acupuncture in migraine patients from inception to 6th February 2026. Two researchers independently screened, extracted and evaluated the risk of bias and reporting quality of the included literature using RoB 2.0 and SHARE pseudoacupuncture reporting guidelines. AlE-meta-analysis was performed with GingerALE 3.0.2. The robustness of the results was examined through Jackknife sensitivity analysis. ResultsA total of 11 studies involving 187 patients with migraine were included. Meta-analysis showed that, compared with pre-treatment, after sham acupuncture in the cumulative effects, the FWE-corrected (P < 0.05) robust deactivated brain regions were located in the left middle temporal gyrus (ALE value = 9.23e^-3) and left superior temporal gyrus (ALE value = 7.44e^-3); uncorrected exploratory findings (P < 0.001, for reference only) revealed an activated brain region in the left lentiform nucleus (ALE value = 9.24e^-3). In the immediate effects, uncorrected exploratory findings (P < 0.001, for reference only) showed deactivated brain regions located in the right middle occipital gyrus (ALE value = 8.14e^-3), right middle frontal gyrus (ALE value = 8.41e^-3), right caudate nucleus (ALE value = 7.77e^-3), right cuneus (ALE value = 8.14e^-3), left inferior occipital gyrus (ALE value = 7.53e^-3), and bilateral thalamus (ALE value = 7.53e^-3) after sham acupuncture. ConclusionsSham acupuncture may modulate multiple brain regions related to attention, pain transmission, sensory integration, and emotion in migraine patients. However, due to the limited number of included studies and some uncorrected results, the aforementioned conclusion requires further verification. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.005 ObjectiveTo investigate cognitive impairments and abnormalities in brain function associated with chemotherapy in breast cancer patients based on functional connectivity of the anterior cingulate cortex (ACC). Materials and MethodsA patient group consisting of 26 individuals with breast cancer who had undergone surgery, had pathologically confirmed infiltrative ductal carcinoma, and received standard chemotherapy was included. Neuropsychological assessment scales and magnetic resonance imaging of the brain were performed for all patients at the time of surgery, before chemotherapy (T0), and after chemotherapy (T1). 26 patients with breast cancer who were pathologically confirmed as invasive ductal carcinoma and received standardized chemotherapy were included into the patient group. All patients were evaluated with neuropsychological scale and brain MRI after surgery, before chemotherapy (T0 point) and after chemotherapy (T1 point). At T0, 26 healthy volunteers matched in age and education level were included to form a control group. Compare the cognitive function and differences in functional connectivity based on the ACC between the patient group and the control group at T0, as well as the longitudinal changes in cognitive function and functional connectivity based on the ACC between breast cancer patients at T0 and T1, and perform correlation analysis to explore the relationship between abnormal functional connectivity of the ACC and cognitive function. The differences of cognitive function and ACC based functional connectivity between the patient group and the control group at T0 were compared, and the longitudinal changes of cognitive function and ACC based functional connectivity between T0 and T1 in breast cancer patients were compared, and the correlation analysis was conducted to explore the relationship between abnormal ACC functional connectivity and cognitive function. ResultsAt T0, there was no statistically significant difference in neuropsychological scale scores and ACC functional connectivity between the patient group and the control group (P > 0.05); Compared with T0, the scores of short-term delayed recall, long-term delayed recall and word learning of breast cancer patients at T1 decreased (P < 0.05); The results of the functional connectivity analysis based on ACC as a seed point indicate that after chemotherapy, breast cancer patients exhibited reduced functional connectivity between ACC and the left middle cingulate gyrus, the left inferior frontal gyrus, and the left middle frontal gyrus (P < 0.001); Pearson correlation analysis revealed a positive correlation (r = 0.514, P < 0.05; r = 0.441, P < 0.05) between the degree of decline in ACC function connectivity with the left medial dorsal anterior cingulate cortex following chemotherapy and changes in scores for word learning and short-term delayed memory. ConclusionsChemotherapy may have impaired the functional coordination between the ACC and related brain regions in breast cancer patients, manifesting as a general decrease in connectivity strength, and can also lead to cognitive dysfunction in many aspects, such as reduced memory and learning ability. The functional connectivity between ACC and the left middle cingulate gyrus may participate in the regulation of related functions. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.006 ObjectiveTo investigate alterations in dynamic functional connectivity network (dFNC) and its temporal properties among welders with occupational manganese (Mn) exposure. Materials and MethodsWe conducted a study on 25 Mn-exposed welders and 29 healthy control group matched with welders. Both groups underwent resting-state functional magnetic resonance imaging (rs-fMRI) scan on a 3.0 T MRI scanner. Following standard preprocessing, group independent component analysis (ICA) was performed to identify resting-state networks. dFNC was computed using a sliding window correlation approach, and the resulting connectivity matrices were clustered into recurring brain states via the K-means algorithm. Group differences in state-specific dFNC patterns and temporal metrics were then evaluated. Furthermore, correlations between aberrant dFNC features and clinical indicators were examined in the welder group. ResultsCompared with HCs, Mn-exposed welders showed significantly reduced dynamic functional connectivity between the salience network (SN) - executive control network (ECN), the default mode network (DMN) - language network (LAN), and the SN-DMN (t = -3.18、-3.31、-3.11, false discovery rate correction, P < 0.05). However, no significant between-group differences were found in other dFNC features (P > 0.05). ConclusionsThe dFNC between the SN, ECN and DMN of Mn-exposed welders were significantly reduced, which provided evidence value for understanding the neuropathological mechanisms related to Mn overexposure and early prevention of Mn poisoning. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.007 ObjectiveTo jointly apply voxel-based morphometry (VBM) and causal structural covariance network (CaSCN) methods to identify characteristic brain atrophy regions in Alzheimer^,s disease (AD) and systematically reveal the underlying causal associations of gray matter structural changes and potential pathological propagation pathways. Materials and MethodsData were obtained from the Alzheimer^,s Disease Neuroimaging Initiative (ADNI) database, including 32 patients with mild-to-moderate AD and 29 demographically matched healthy controls (HC). First, VBM was used to compare whole-brain gray matter volume differences between the AD and HC groups. To explore the association between structural changes and clinical symptoms, the correlation between gray matter volumes in these group-difference brain regions and the Mini-Mental State Examination (MMSE) score, which represents disease severity, was further analyzed. Subsequently, based on the VBM results, the brain region with the most significant atrophy was selected as the seed point. The CaSCN method was applied to conduct whole-brain bidirectional causal analysis, including assessing the seed-to-map (outward causal effects from the seed to the whole brain) and map-to-seed (inward causal effects from the whole brain to the seed) effects. This analysis aimed to reveal how the causal interaction patterns between brain regions evolve with increasing disease severity, characterized by the continuous change in MMSE scores. Finally, brain regions with significant causal connections from the above analyses were defined as regions of interest (ROIs) to construct an ROI-to-ROI causal network. The weighted out-degree and in-degree of nodes were calculated to quantify the causal driving and receiving capacity of each brain region within the network. ResultsVBM analysis revealed significant gray matter atrophy in the AD group in the left hippocampus, right superior temporal pole, and right middle temporal gyrus [voxel-wise family-wise error (FWE) correction, corrected P < 0.001], and the volumes of these brain regions were positively correlated with MMSE scores (P < 0.05). Among these, the left hippocampus exhibited the most pronounced atrophy (t = 11.72). Seed-based CaSCN analysis of the left hippocampus demonstrated that, in the map-to-seed direction, the bilateral parahippocampal gyri and left amygdala exerted positive causal effects on the left hippocampus [voxel-wise false discovery rate (FDR) correction, P < 0.05], corresponding to Granger causality (GC) values > 0.61 and Z-values > 3.85. In contrast, in the seed-to-map direction, no significant causal effects from the left hippocampus to the whole brain were observed (GC < 0.61, Z < 3.85). These findings suggest that the left hippocampus primarily serves as a hub for information convergence within the structural covariance network. Further ROI-based network analysis (based on brain regions showing significant map-to-seed connections under FDR correction) revealed that the left hippocampus emitted significant GC connections to the bilateral parahippocampal gyri, right anterior entorhinal cortex, and right hippocampus (FDR correction, P < 0.05, GC > 0.61), with the strongest output effect directed to the right parahippocampal gyrus (weighted out-degree value = 1.03). However, no significant output from the left hippocampus to the ipsilateral amygdala was detected. ConclusionsIn the mild-to-moderate stage of AD, the left hippocampus acts as a dynamic hub within the gray matter atrophy network. It not only receives pathological input from structures such as the bilateral parahippocampal gyri, right anterior olfactory cortex, and right hippocampus but also drives further pathological output to these regions, forming a local closed-loop network with positive feedback regulation. The unidirectional causal dissociation between the hippocampus and amygdala suggests a difference in their pathological timelines. The strong cross-hemispheric output from the left hippocampus to the right parahippocampal gyrus further supports the notion of AD as a whole-brain network disorder. This study deepens the understanding of AD atrophy mechanisms from a causal network perspective and provides a new basis for explaining its clinical heterogeneity and disease progression. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.008 ObjectiveTo investigate the value of combined diffusion kurtosis imaging (DKI), free water diffusion tensor imaging (FW-DTI), and mean apparent propagator magnetic resonance imaging (MAP-MRI) in predicting 1p/19q co-deletion in adult diffuse gliomas. Materials and MethodsClinical, pathological, and imaging features from 72 glioma patients with surgically confirmed pathology were retrospectively analyzed. Patients were categorized into the co-deletion group (n=32) and non-co-deletion group (n=40) based on 1p/19q co-deletion status. Preoperative conventional MRI and q-space diffusion spectrum imaging (DSI) were performed, with post-processing generating DKI, FW-DTI, and MAP-MRI parameter maps. Clinical characteristics, conventional MRI features, and differences in diffusion model parameters were compared between groups. Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive value of each parameter for 1p/19q co-deletion in gliomas, with area under curve (AUC) values calculated. ResultsAmong MRI features, tumor margin indistinctness differed significantly between groups, while other clinical characteristics and MRI features showed no statistically differences. The 1p/19q-deleted group exhibited higher mean kurtosis (MK), extracellular free water fraction (FWF), extracellular water molecule return-to-origin probability (RTOP), and non-Gaussian index (NG) values compared to the non-deleted group (t-values were 4.913, 4.376, 3.761, and 6.916, respectively, with P < 0.05.). Conversely, the free water-corrected anisotropy fraction (FW-FA) and q-space inverse variance (QIV) values were lower in the deleted group (t-values were 2.945 and 3.761, with P < 0.05). No statistically significant differences were observed in other parameters (P > 0.05). The combined AUC value for predicting 1p/19q co-deletion using MK, FWF, and NG was 0.935, with a sensitivity of 85.00% and specificity of 93.75%. ConclusionsThe combination of DKI, FW-DTI, and MAP-MRI can predict the status of 1p/19q co-deletion in gliomas preoperatively, facilitating the development of individualized treatment plans. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.009 ObjectiveInvestigating the prognostic significance of epicardial adipose tissue (EAT) surrounding the heart, as assessed through cardiac magnetic resonance (CMR), in relation to left ventricular fibrosis among individuals with obesity. Materials and MethodsWe prospectively enrolled obese patients who underwent CMR examination at the First Affiliated Hospital of Wannan Medical College (Wannan Medical College Yijishan Hospital) from June 2023 to June 2025. Patients were divided into LGE (late gadolinium enhancement) positive and negative groups based on the presence or absence of myocardial fibrosis detected by CMR, and 65 healthy controls with normal body mass index (BMI) are matched. All subjects underwent CMR non-contrast and contrast-enhanced scans to measure the epicardial adipose tissue volume (EATV), EAT thickness, and left ventricular/left atrial function parameters (including conventional cardiac function parameters and myocardial strain parameters). Spearman correlation analysis was conducted to investigate the associations between EAT and myocardial strain parameters of the left ventricle and left atrium. Univariate and multivariate logistic regression analyses were performed to examine the relationship between EAT and left ventricular fibrosis. Additionally, receiver operating characteristic (ROC) curves were utilized to assess the diagnostic performance of EAT in identifying fibrosis. ResultsThe overall left ventricular strain in the obesity group was lower than that in the control group in all three directions (P < 0.05). The LGE(+) group showed significantly greater EAT thickness at the left atrioventricular groove (LAVG), right atrioventricular groove (RAVG), and inferior interventricular groove (IIVG), as well as significantly higher EATV, compared to the LGE(-) group and the control group (all P < 0.05). LAVG was negatively correlated with left atrial reservoir strain (Es) (ρ= -0.28, 95% CI: -0.48 to -0.05, P < 0.05), left atrial conduit strain (Ee) (ρ = -0.30, 95% CI: -0.50 to -0.07, P < 0.05), and overall radial strain of the left ventricle (peak radial strain, PRS) (ρ = -0.26, 95% CI: -0.46 to -0.03, P < 0.05). Conversely, LAVG showed a positive correlation with the overall longitudinal strain of the left ventricle (peak longitudinal strain, PLS) (ρ = 0.25, 95% CI: 0.06 to 0.49, P < 0.05). EATV is negatively correlated with Es (ρ = -0.28, 95% CI: -0.49 to -0.05, P < 0.05), Ee (ρ = -0.34, 95% CI: -0.53 to -0.12, P < 0.01), and PRS (ρ = -0.26, 95% CI: -0.46 to -0.03, P < 0.05), and positively correlated with the PLS (ρ = 0.30, 95% CI: 0.02 to 0.46, P < 0.05). IIVG was positively correlated with the PLS (ρ = 0.26, 95% CI: 0.03 to 0.47, P < 0.05).Univariate logistic regression analysis showed that the p-values for RVAG, LAVG, IIVG, and EATV were all < 0.05; after adjusting for confounding factors, multivariate logistic regression analysis indicated that LAVG and EATV were independent predictors of left ventricular fibrosis in obese patients (P < 0.05). ROC analysis showed that the area under the curve for LAVG and EATV predicting left ventricular fibrosis was 0.841 and 0.901, respectively. ConclusionsThe application of CMR technology enables precise quantification of EAT in obese patients. Both LAVG and EATV are independent predictors of left ventricular myocardial fibrosis, which holds significant clinical importance for the early detection of fibrosis. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.010 ObjectiveTo develop and validate a multi-lesion habitat radiomics (ML-HR) model based on late arterial phase MRI and evaluate its value in non-invasively predicting the gastrointestinal (GI) versus non-GI origin of hypervascular liver metastases (HLM). Materials and MethodsThe clinical and contrast-enhanced MRI Data of 111 HLM patients from two centers were retrospectively included and randomly divided into the training set and the validation set in a 7∶3 ratio. The volume of interest (VOI) of all lesions was delineated on the late-stage arterial images. Local radiomics features were extracted and subregions were divided. Fourteen machine learning algorithms were adopted to respectively construct the traditional single-lesion radiomics (SLR) model, the traditional multi-lesion radiomics (MLR) model and the multi-lesion habitat radiomics (ML-HR) model. To identify whether HLM originates from the GI. The optimal algorithm is screened and the best model is determined through the receiver operating characteristic curve. ResultsA total of 111 patients (241 lesions) were included, among which the training set (n = 77) and the validation set (n = 34) were included. Decision tree (DT), radial basis function support vector machine (rbf_SVM), and eXtreme Gradient Boosting (XGBoost) were identified as the optimal algorithms for SLR, MLR, and ML-HR models, respectively. The ML-HR model has the best performance. The AUC of the training set is 0.952 (95% confidence interval: 0.904 to 0.988), and that of the validation set is 0.901 (95% confidence interval: 0.765 to 0.997), which is significantly better than the traditional model (P < 0.05). ConclusionsThe ML-HR model can effectively and non-invasively predict the GI versus non-GI origin of HLM, providing a reliable imaging basis for clinical personalized medicine. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.011 ObjectiveTo calculate an intratumoral heterogeneity (ITH) score using a magnetic resonance imaging (MRI)-based radiomics approach, to construct a preoperative malignancy risk assessment model for ovarian neoplasms by integrating clinical variables and conventional MRI features, and to evaluate its adjunctive value for risk stratification of Ovarian-Adnexal Reporting and Data System (O-RADS) MRI category 4 lesions and for diagnosis by junior physicians. Materials and MethodsThis retrospective study included 120 patients with pathologically confirmed ovarian neoplasms, including 52 benign and 68 malignant tumors, the latter including borderline tumors. The patients were randomly assigned to a training set (n = 84) and a test set (n = 36) in a 7∶3 ratio. After preprocessing T2-weighted images with spectral attenuated inversion recovery fat suppression, intratumoral and 3-mm peritumoral regions of interest were delineated. Radiomics features were extracted using a sliding-window approach, and K-means clustering was used to calculate the ITH score and the combined ITH score. Clinical features, conventional MRI features, and ITH scores were integrated. After screening by univariable analysis and least absolute shrinkage and selection operator regression, independent predictors were identified by multivariable logistic regression to construct a clinical model, an intratumoral model, and a combined model, respectively. All lesions were scored according to O-RADS MRI, and O-RADS MRI category 4 lesions were further analyzed for risk stratification; the adjunctive value of the model for diagnosis by junior physicians was also evaluated. ResultsThe ITH score showed good intra- and interobserver agreement, with intra-class correlation coefficients of 0.86 and 0.84, respectively. Among the three models, the combined model based on the risk of ovarian malignancy algorithm (ROMA) index, tumor composition, and the combined ITH score achieved the highest diagnostic performance. In the test set, the areas under the receiver operating characteristic curve were 0.805 [95% confidence interval (CI): 0.662 to 0.948], 0.867 (95% CI: 0.750 to 0.984), and 0.923 (95% CI: 0.827 to 0.994) for the clinical, intratumoral, and combined models, respectively. The overall diagnostic performance of the O-RADS MRI score was comparable to that of the combined model. In the subgroup analysis of category 4 lesions, the combined model showed potential for further risk stratification, with relatively high diagnostic accuracy and specificity. ConclusionThe combined model based on the ROMA index, tumor composition, and the combined ITH score showed the highest diagnostic performance for preoperative malignancy risk assessment of ovarian neoplasms. It also has the potential to stratify O-RADS MRI category 4 lesions and may assist clinicians in diagnosis. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.012 ObjectiveTo compare the acquisition time and image quality of three diffusion-weighted imaging (DWI) sequences, including single-shot diffusion-weighted imaging (SS-DWI), readout segmentation of long variable echo-trains diffusion-weighted imaging (Resolve-DWI), and Resolve-DWI with simultaneous multi-slice (SMS-Resolve-DWI), in MRI examinations of acute cerebral infarction, with the aimof providing evidence for optimizing clinical scanning protocols. Materials and MethodsEighty-four patients with acute cerebral infarction treated at our hospital from July 2023 to December 2024 were retrospectively enrolled. Each patient underwent sequential scanning with conventional SS-DWI, Resolve-DWI, and SMS-Resolve-DWI. Two senior radiologists independently and blindly evaluated the image quality using a 5-point Likert scale. Objective metrics included signal intensity (SI), apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR), contrast ratio (CR), contrast-to-noise ratio (CNR), and SNR efficiency. Statistical analysis was performed using SPSS 26.0. The normality of continuous variables was assessed by the Shapiro-Wilk test. Data with normal distributions were expressed as mean ± standard deviation, and those without were represented as median (interquartile range). One-way analysis of variance (ANOVA) or the Kruskal-Wallis H test was used for group comparisons. Interobserver agreement was assessed with weighted Kappa statistics. ResultsThe scan times were 1 min 57 s for SS-DWI, 5 min 21 s for Resolve-DWI, and 3 min 16 s for SMS-Resolve-DWI. Subjective scoring demonstrated good to excellent inter-rater agreement (Kappa values 0.630 to 0.982). In terms of image quality scores, both SMS-Resolve-DWI and Resolve-DWI showed significantly higher scores than SS-DWI (P < 0.05), with no significant difference between the two advanced sequences (median Likert score of both was 4). Regarding objective metrics, there were no significant differences in ADC values among the three sequences (P > 0.05). Compared to SS-DWI, both Resolve-DWI and SMS-Resolve-DWI showed higher SI (in both lesion and contralateral brain tissue), SNR, and CNR (P < 0.001), with no significant difference between the two advanced sequences (P > 0.05). The CR of SS-DWI was higher than that of SMS-Resolve-DWI (P = 0.013). The SNR efficiency of SS-DWI and SMS-Resolve-DWI was superior to that of Resolve-DWI (P < 0.001), with no significant difference between SS-DWI and SMS-Resolve-DWI (P > 0.05). ConclusionsSMS-Resolve-DWI combines the scanning efficiency of SS-DWI with the image quality of Resolve-DWI, while maintaining the accuracy of ADC quantification. It can be recommended as the preferred MRI protocol for acute cerebral infarction examination. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.013 ObjectiveTo compare the impact of respiratory triggering under BioMatrix (RT-BM) versus navigator triggering (NT) on image quality and scan efficiency of upper-abdominal T2-weighted fat-suppressed (T2WI FS) magnetic resonance imaging (MRI) under the BioMatrix platform, and to provide evidence for protocol optimization. Materials and MethodsOne hundred consecutive patients (52 males, 48 females) scheduled for upper-abdominal MRI between June and November 2025 were prospectively enrolled. All examinations were performed on a Siemens 3.0 T Magnetom VIDA system; T2WI FS was acquired first with NT and then repeated with RT-BM. Scan duration, standard deviation (SD), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were recorded. Two senior radiologists independently graded image quality using a 5-point Likert scale evaluating hepatic edge sharpness, intrahepatic vessel depiction, gallbladder and extrahepatic bile duct definition, pancreatic duct visibility, motion artifacts and overall image quality. Detection for lesions ≤ 1 cm were documented. Statistical analysis of SD, SNR and CNR was performed using the Mann-Whitney U test. Subjective scoring consistency was assessed using intra-class correlation coefficient (ICC) consistency tests, scanning time and score differences between the two sequences were analyzed using paired t-tests, the detection and classification of minor lesions were performed using Bowker^,s matched chi-square test, and interlayer dislocation control comparison using McNemar test. ResultsRT-BM shortened scan time by 31.32% compared with NT (average shortened 94.3 s, P < 0.001). No significant differences were observed between groups for SD, SNR or CNR (P > 0.05). NT achieved higher subjective scores than RT-BM for hepatic edge sharpness, vessel depiction, motion-artifact control and overall image quality (P < 0.05), whereas gallbladder, extrahepatic bile duct and pancreatic duct visualisation were equivalent (P > 0.05). Both techniques fulfilled diagnostic requirements in every dimension. The detection rate of microlesions (NT 99.5% vs. RT-BM 96.4%) and the consistency rate of signal intensity four-category classification (undetectable/low/slightly high/high signal) (95.9%) showed no statistically significant differences between the two groups (Bowker test, χ² = 5.333, P = 0.502). Inter-slice misregistration was comparable between groups (χ² = 0.000, P > 0.999). ConclusionsRT-BM can significantly reduce scanning time while maintaining comparable objective image quality and diagnostic efficacy to NT. Although the subjective score is slightly lower than NT, it still fully meets diagnostic requirements. For patients with poor breath-holding cooperation or those requiring shortened examination time, RT-BM can serve as an alternative solution while ensuring objective image quality and diagnostic efficacy. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.014 ObjectiveThis study compares the diagnostic efficacy of T1-mapping and readout segmentation of long variable echo-train diffusion-weighted imaging (RESOLVE DWI) techniques in quantitatively assessing sacroiliac joint inflammation activity levels in axial spondyloarthropathy (axSpA), aiming to provide clinicians with more valuable quantitative indicators. Materials and MethodsThe retrospective cohort study included 74 patients diagnosed with axial spondyloarthropathy (axSpA) at the Department of Rheumatology, Provincial Hospital Affiliated to Fuzhou University between June 2017 and June 2024, forming the case group. A control group comprised 19 individuals who underwent sacroiliac joint MRI examinations for mechanical low back pain. Within the case group, participants were further categorised into an active group (n = 40) and an inactive group (n = 34) based on the Ankylosing Spondylitis Disease Activity Score (ASDAS). All research subjects underwent conventional MRI, T1-mapping, and RESOLVE DWI quantitative technical inspection. T1-mapping values and apparent diffusion coefficient (b = 50, 500, 700 s/mm², denoted as ADC_{50, 500, 700}) of the subchondral bone marrow in the sacroiliac joints were measured simultaneously across both groups. Comparisons were made between the control group, case group, and its subgroups (inactive and active groups) regarding differences in T1-mapping values and ADC_{50, 500, 700} values. The diagnostic efficacy of T1-mapping and ADC_{50, 500, 700} across groups was analysed using receiver operating characteristic (ROC) curves, and the area under the curve (AUC) was calculated. The DeLong test was used to compare the differences in AUC values between the two groups. ResultsThe T1-mapping values and ADC_{50, 500, 700} values of the subchondral bone marrow in the sacroiliac joint were higher in the case group, inactive group, and active group than in the control group (P < 0.001 for all comparisons). The T1-mapping values and ADC_{50, 500, 700} values of the subchondral bone marrow in the sacroiliac joint of the active group were higher than those in the inactive group (P < 0.05). In distinguishing the control group from the case group, the AUC values for T1-mapping and ADC_{50, 500, 700} were 0.889 and 0.877 respectively; when differentiating the control group from the inactive group, the AUC values were 0.811 and 0.828 respectively. In distinguishing the control group from the active group, the AUC values were 0.955 and 0.918 respectively, both demonstrating good diagnostic performance. The Delong test indicated no statistically significant difference between them (all P > 0.05). When distinguishing between inactive and active groups, the AUC for T1-mapping was 0.808, whereas the AUC for ADC_{50, 500, 700} was 0.693, with a statistically significant difference (P = 0.042). ConclusionsBoth T1-mapping and RESOLVE DWI techniques effectively assess the level of sacroiliac joint inflammation activity in axial spondyloarthritis (axSpA). However, T1-mapping demonstrates superior efficacy in distinguishing between inactive and active groups among axSpA patients. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.015 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.016 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.017 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.018 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.019 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.020 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.021 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.022 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.023 ^,s microstructure and physiological function, have brought the mechanisms underlying BSCB disruption in various CNS disorders into sharp focus. Elucidating these mechanisms is essential for a comprehensive understanding of disease pathophysiology. However, a systematic and comprehensive multimodal MRI framework for assessing BSCB integrity remains lacking.Therefore, this review aims to systematically summarize the structural and functional basis of the BSCB and the molecular mechanisms of its disruption. A primary focus is placed on elucidating the principles and applications of multimodal MRI techniques for the non-invasive, quantitative detection of relevant pathological biomarkers, while also addressing current methodological limitations. Building upon this foundation, the review explores future research directions. The goal is to provide a theoretical basis for developing novel strategies for early disease diagnosis, pathological subtyping, individualized treatment monitoring, and outcome prediction based on imaging biomarkers. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.024 18F-fluorodeoxyglucose positron emission tomography (¹⁸F-FDG PET), hydrogen proton magnetic resonance spectroscopy (¹H-MRS), amide proton transfer (APT) imaging, multi-nuclear magnetic resonance imaging and metabolic tracer techniques. However, there is still a lack of systematic integrated analysis of the mechanisms of metabolic reprogramming in nasopharyngeal carcinoma, as well as the application value and limitations of the metabolic imaging techniques. This article will systematically review the above metabolic imaging techniques and their application value from the perspective of metabolic reprogramming, analyze the limitations of current research, and propose future research directions, aiming to provide theoretical basis and technical prospects for enhancing the level of precision diagnosis and treatment of nasopharyngeal carcinoma. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.025 ^, understanding of mitral valve apparatus abnormalities and provide imaging evidence for early intervention and individualized treatment of the disease, this review systematically summarizes recent advances in CMR for assessing mitral valve abnormalities in HCM, analyzes the current research issues, and proposes future research directions, aiming to enhance clinicians^, understanding of these anomalies and provide imaging evidence for early intervention and individualized medicine. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.026 ^, quality of survival. Multi-parameter magnetic resonance imaging (mpMRI) integrates information from multiple imaging sequences to characterize lesions in a multi-dimensional manner and enable quantitative assessment. Radiomics extracts quantitative imaging features through high-throughput computing and further mines the heterogeneous characteristics of tumors in depth. However, several challenges remain to be overcome for mpMRI and radiomics in differentiating low HER‑2 expression from zero HER‑2 expression, including inconsistent MRI scanning parameters and non‑uniform standards for radiomic feature extraction, insufficient model generalization, unclear associations between imaging phenotypes and molecular mechanisms, and lagged clinical translation. Therefore, this review summarizes and compares the latest research progress on the application of mpMRI and radiomics in distinguishing between HER-2-low expressing and HER-2-zero expressing breast cancer, aiming to provide insights for future research and facilitate precise clinical diagnosis and treatment. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.027 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.028 ^, quality of life. Its clinical diagnosis has long relied on the Rome criteria, which suffer from limitations such as high subjectivity. As a highly heterogeneous disease, FC involves complex underlying pathophysiological mechanisms. Traditional empirical treatments often yield poor efficacy due to a lack of understanding of these mechanisms. Multimodal magnetic resonance imaging, as a radiation-free, high-resolution integrated imaging technology, holds irreplaceable value in elucidating the pathophysiological mechanisms, classification, and diagnosis/treatment of FC. This review summarizes the imaging manifestations of different FC mechanisms from the perspectives of dynamic magnetic resonance imaging and functional magnetic resonance imaging. It integrates imaging assessment results to establish a quantitative framework, analyzes current research limitations and potential future directions, aiming to provide references for clinical practice, precise evaluation, and personalized diagnosis and treatment. ]]> Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.029 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.030 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.031 Mon,20 Apr 2026 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2026.04.032 Mon,20 Apr 2026 00:00:00 GMT