http://med-sci.cn/cgzcx/en/contents_list.asp?issue=202405 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.1674-8034.2024.05.001 ObjectiveTo analyze the functional hierarchy of Alzheimer^,s disease (AD) cerebral cortex along the brain-cerebellar connectivity gradient and its altered interaction with the cerebellum and the association with cognitive dysfunction using a gradient-based approach. Materials and MethodsA total of 33 AD patients and 46 age, sex matched healthy controls (HC) were included based on the publicly available database ANDI. The cerebral-cerebellar functional connectivity gradient of each subject was obtained by nonlinearly decomposing the cerebral-cerebellar resting-state functional connectivity matrix of all subjects, using gradient computation method. Two-sample t-tests were performed to analyze differences of cerebral-cerebellar gradient scores between groups, as well as group^,s comparisons of functional connectivity between abnormal regions of gradients and cerebellar , and correlation analyses were used to assess the correlation of abnormal gradient scores and connectivity values with scores on clinical scales. ResultsCompared with healthy controls, AD patients had locally altered gradient scores in the right inferior temporal gyrus (RITG) (t=4.71, P<0.001) which involved in higher cognitive functions, and further functional connectivity analyses based on the gradient-abnormal cerebral region as a seed point showed functional connectivity of RITG to the bilateral Crus Ⅱ region and extending to the Ⅶ B region of the cerebellum (right: t=-4.89, P<0.001; left: t=-4.98, P<0.001) was reduced. Clinical scale correlation analyses showed that connectivity gradient scores in gradient-abnormal brain regions were strongly correlated with Functional Activity Questionnaire (FAQ) scores (r=0.40, P=0.025) in AD patients. ConclusionsThe abnormal changes in the functional hierarchy of locoregional areas involved in higher cognitive function in AD patients and their reduced functional connectivity with bilateral cerebellar CrusⅡ and Ⅶ B regions may be one of the potential factors for cognitive impairment. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.002 ObjectiveTo explore the abnormal spontaneous neural activity in type 2 diabetes mellitus (T2DM) without cognitive impairment by combining multiple indices of resting-state functional magnetic resonance imaging (rs-fMRI). Materials and MethodsThirty-four T2DM patients without cognitive impairment and 34 age, sex and education matched control subjects were included in this study. Both groups received rs-fMRI scans in a 3.0 T MRI scanner. Amplitude of low frequency fluctuation(ALFF), regional homogeneity (ReHo) and voxel-mirrored homotopic connectivity (VMHC) were calculated after image preprocessing. Two sample t-test was performed to explore the abnormal alterations of brain function and the relationship among rs-fMRI indices and clinical characteristics was also investigated. ResultsT2DM patients showed decreased spontaneous neural activity in the left prefrontal cortex, right angular gyrus, while increased neural activity in the left caudate nucleus and supplementary motor area (GRF corrected, voxel P<0.001, cluster P<0.05). We also observed a decreased correlation between ALFF and ReHo in the prefrontal cortex and angular gyrus of T2DM (r=0.592-0.767, corrected P<0.05). ConclusionsThe application of multiple rs-fMRI indices detected abnormal neural activities in different brain regions of T2DM patients, and the decreased coupling trend between ALFF and could help to understand the early changes before cognitive impairment appeared. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.003 ObjectiveTo explore the alterations of cortical thickness (CT) in Parkinson^,s disease (PD) patients with pain using high-resolution structural MRI and their correlations with pain scores, revealing the neuroanatomical basis of pain in PD patients. Materials and MethodsFrom September 2020 to March 2022, 82 PD patients diagnosed by the Neurology Department of the Second Affiliated Hospital of Soochow University and 29 pain-free normal controls (NC) from local communities were recruited. Demographic and clinical data as well as structural and MRI images of all subjects were collected. The non-motor symptoms questionnaire and the visual analog scale (VAS) were applied to pain screening and pain severity assessment. The PD patients were divided into 41 PD patients with pain (PDP) and 41 PD patients without pain (nPDP) according to the VAS scores. CT analysis steps are as follows: Frist, the structural MRI data were pre-processed by the computational anatomy toolbox 12 (CAT12) software package to get the CT maps of all subjects. Then, one-way ANOVA and post hoc analysis were used to compare the three groups. The statistical results were corrected for multiple comparisons using the threshold-free cluster enhancement (TFCE) and false discovery rate (FDR), and the threshold was set at P<0.05. Finally, the CT values of significant regions in PDP groups were extracted and partial correlated with VAS scores. ResultsThe CT values of the right superior frontal gyrus, right middle frontal gyrus, and right pars triangularis showed significant differences among the three groups. Post hoc analysis showed that the CT values of the right middle frontal gyrus and right pars triangularis were significantly reduced in the PDP group relative to the nPDP group (P=0.033, 0.007). Compared with the NC group, the PDP group showed decreased CT in the right superior frontal gyrus, right middle frontal gyrus, and pars triangularis. There was no significant correlation between CT values of significant regions and VAS scores in PDP group (P=0.088). ConclusionsThe decreased CT of the prefrontal region (middle frontal gyrus and inferior frontal gyrus) may be the underlying structural basis of pain in PD patients, which might be involved in the pain through the mechanisms of pain perception and regulation, emotional processing, and cognitive processing. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.004 ObjectiveTo investigate the alterations in the centrality of whole brain network nodes of tension-type headache (TTH) patients in the slow-4 (0.027-0.073 Hz) band and slow-5 (0.010-0.027 Hz) band and the correlation with clinical features using resting state functional magnetic resonance imaging (rs-fMRI) with degree centrality (DC). Materials and MethodsThirty-three patients with TTH who went to the Department of Neurology of Affiliated Hospital of Weifang Medical University from May 2018 to July 2019 and 38 matched healthy controls were collected for resting state functional magnetic resonance scanning. The method of degree centrality was used to analyze the difference of DC values in different frequency bands between TTH group and healthy control group. The correlation between the abnormal DC value and Visual Analog Scale (VAS) score, disease duration and headache attack frequency of TTH patients was analyzed. ResultsCompared with the healthy control group, in the slow-5 (0.010-0.027 Hz) frequency band, the DC values of the right middle frontal gyrus and the right dorsolateral superior frontal gyrus of TTH patients were significantly increased; however, in the slow 4 (0.027-0.073 Hz) frequency band, there was no significant difference in DC value between TTH group and healthy control group (GRF correction, voxel level P<0.001, cluster level P<0.05). In addition, the results of correlation analysis showed that there was no significant correlation between abnormal DC brain regions and VAS scores, disease duration and headache attack frequency. ConclusionsThe middle frontal gyrus and superior frontal gyrus were involved in the integration and processing of pain signals, so they might be the key hub of TTH; the slow-5 frequency band was more sensitive in detecting the DC value of TTH than the slow-4 frequency band. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.005 ObjectivePrenatal MRI was used to study the changes of the hippocampal infolding angle (HIA) of fetuses in the second and third trimester of pregnancy. Materials and MethodsThe imaging data of normal fetuses in the second and third trimester of pregnancy undergoing prenatal MRI in the Second Hospital of Hebei Medical University from January 2018 to December 2021 were collected and were retrospectively analyzed. HIA in the coronal section of fetal brain MRI using the fast imaging employing steady state acquisition (FIESTA) sequence was measured, the normal range of HIA in fetuses in the second and third trimester of pregnancy was analyzed, to explore its correlation with gestational age changes and clinical application value. ResultsA total of 139 cases of fetuses in the second and third trimester of pregnancy were included in the study, with a gestational age ranging from 20 to 38 weeks (mean 29.17±3.90 weeks), and a male-to-female ratio of 105∶34. The data was divided into 6 groups based on gestational age, and the confidence interval of fetal HIA was analyzed. With increasing gestational age, the HIA on both sides increased linearly (R²=0.803, 0.836, both P<0.001), and the HIA on the right side was greater than that on the left side. However, no gender differences were found in the left and right sides (P=0.898). ConclusionsPrenatal MRI revealed that the changes of the HIA in fetuses in the second and third trimester of pregnancy follows a certain pattern, which can provide imaging diagnostic evidence for diseases related to hippocampal structural abnormalities either in utero or after birth. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.006 ObjectiveTo explore the impact of prognostic factors of acute anterior circulation ischemic stroke (AACIS) after conservative drug treatment based on territorial arterial spin labeling (TASL) technology. Materials and MethodsRetrospectively, a total of 136 patients with confirmed AACIS were consecutively collected and divided into two groups:good prognosis (70 cases) and poor prognosis (66 cases) according to their prognosis after 90 d treatment. The degree of stenosis of the responsible vessel, territorial cerebral blood flow (TCBF) before treatment, TCBF_{10 d} after treatment, relative CBF (rTCBF) and the lesion volume were recorded. Simultaneously, baseline national institute of health stroke scale (NIHSS), age, gender, stroke classification, body mass index and other risk factor information from patients were collected. Incorporate the above indicators into the statistical model. The measurement data between the two groups were analyzed using Mann Whitney U test, and the counting data were analyzed using χ²test for univariate differences. Multivariate joint logistic regression analysis was performed on statistically significant indicators, and receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of the results. ResultsIn univariate analysis, there were significant differences in age (Z=16.022), baseline NIHSS score (Z=148.400), stroke classification (Z=49.640), responsible vessel stenosis (Z=27.193), baseline TCBF_{pre-treatment} (Z=693.000), rTCBF (Z=18.874) and lesion volume (Z=-10.140) between the two groups (P<0.05). In multivariate joint analysis, age (OR=0.108), baseline NIHSS score (OR=0.615), perforating artery disease of stroke classification (OR=90.154), TCBF_{pre-treatment} (OR=4.611) and lesion volume (OR=0.138) had significant impact on prognosis (P<0.05). The combination of the four methods for predicting prognosis was effective (P<0.05), and the area under the ROC curve was 0.962, which has high value. The changes in responsible vascular perfusion have no significant impact on prognosis (P>0.05). ConclusionsWith drug conservative treatment, the 90 d prognosis of patients was more likely to be affected by age, baseline NIHSS, stroke classification, TCBF_{pre-treatment} and lesion volume, but not related to the improvement of responsible vascular perfusion. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.007 ObjectiveTo investigate the prediction of Ki-67 expression in glioma by multi-modal magnetic resonance imaging and quantitative and qualitative parameters. Materials and MethodsThree hundred and thirty patients with glioma were selected, including 201 patients with isocitrate dehydrogenase (IDH) wild type and 129 patients with IDH mutant type. Conventional MRI features, apparent diffusion coefficient (ADC), qualitative and quantitative parameters of dynamic contrast-enhanced (DCE) MRI such as time-intensity curves (TIC), volume transfer constant (K^trans), the rate constant (K_ep), fractional volume of the extravascular-extracellular (V_e), plasma fraction (V_p) and magnetic resonance spectroscopy (MRS) metabolites were obtained. Logistic regression was performed for all gliomas to identify factors associated with Ki-67 expression. The area under receiver operating characteristic curve (AUC) was used to evaluate the performance of the prediction model. ResultsIn glioma patients^,analyses, K^trans (OR=1.012, P<0.001), ADC (OR=0.998, P<0.05), enhancement degree (OR=3.317, P<0.05) were independent predictors of Ki-67 expression level, and AUC value is 0.893, respectively. ConclusionsK^trans, ADC and enhancement may be effective parameters for predicting Ki-67 expression level in glioma. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.008 ObjectiveTo establish and validate a radiomics model to predict 1p/19q molecular feature of adult intracranial lower-grade gliomas (LGG) based on preoperative magnetic resonance apparent diffusion coefficient (ADC) map. Materials and MethodsA total of 146 adult intracranial LGG (WHO grade 2-3) patients confirmed by postoperative pathology in our hospital from January 2017 to December 2021 with complete magnetic resonance data were retrospectively analyzed, including 68 cases with 1p/19q co-deleted (1p/19q-Codel) and 78 cases with 1p/19q non-codeleted (1p/19q-Noncodel). A completely random method was used to divide the training and validation sets in a 7:3 ratio. Image segmentation was performed independently by a radiologist using ITK-SNAP software, and 30 patient images were then segmented between radiologists to evaluate the stability of the extracted features. The volume of interest (VOI) was defined as the abnormal area in FLAIR, excluding obvious cystic and necrosis. The VOI extracted from the FLAIR image was copied to the registered ADC map, and then the radiomics features were extracted using Python software, and the features with good stability were retained for Z-score standardization. Pearson or Spearman correlation analysis and least absolute shrinkage and selection operator (LASSO) analysis were used for feature selection. The radiomics score (Rad-score) model was built using the selected radiomics features. The performance of the Rad-score model was evaluated using receiver operating characteristic (ROC) curves and validated within validation sets. ResultsOne hundred and forty six LGG patients were randomly divided into the training set (n=102) and the validation set (n=44) in a 7∶3 ratio. There was no statistical difference in clinical features between the two sets (P>0.05). Fifteen non-zero coefficient features were selected by intra-rater and inter-rater correlation coefficients, Pearson or Spearman correlation analysis and LASSO analysis, and the Rad-score model was constructed. There were significant differences in Rad-score between the 1p/19q-Codel and the 1p/19q-Noncodel in both the training and validation sets (P<0.001). At the same time, the Rad-score model showed good predictive performance in both the training and validation sets, with an area under the curve (AUC) value of 0.896 in the training set, the accuracy was 85.29%, the sensitivity was 87.72% and the specificity was 82.22%. The AUC value of the validation set was 0.778, the accuracy was 77.27%, the sensitivity was 71.43% and the specificity was 82.61%. ConclusionsThe radiomics model based on the preoperative ADC map can noninvasively predict the 1p/19q molecular features in adult intracranial LGG. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.009 ObjectiveTo evaluate the value of multi-sequence MRI features combined with routine signs in differentiating meningioma from other other intracranial meningeal tumors. Materials and MethodsClinical and preoperative MRI data of 360 patients confirmed by pathology in two centers were retrospectively analyzed. A total of 256 patients (145 meningiomas and 111 non-meningiomas) in center 1 were randomly divided into the training group (n=179) and the test group (n=77) at a ratio of 7∶3. A total of 104 patients in Center 2 served as the external validation group (53 meningiomas and 51 non-meningiomas). The tumor growth site, growth pattern, number and other 18 general clinical data and MRI routine signs were evaluated. Univariate and multivariate binary logistic regression analysis was used to screen the indicators related to differential diagnosis. After image standardization, 3D Slicer software was used to outline region of interest (ROI) and extract features on T2WI, diffusion-weighted imaging (DWI) and enhanced T1WI images. The feature screening was performed by using the method of 5-fold cross-validation and least absolute shrinkage and selection operator (LASSO). The training group and the test group were modeled by five classifiers: logistic regression (LR), support vector machine (SVM), K-nearest neighbor (KNN), light gradient boosting machine (LightGBM) and adaptive boosting (AdaBoost). MRI conventional model, radiomics intratumoral model, radiomics peritumoral model, radiomics fusion model, and full fusion model were established, and the models with the best performance were selected for external verification. The receiver operating characteristic (ROC) curve was plotted to evaluate the differential diagnostic performance of the model. The area under the curve (AUC) of the model was compared by DeLong test. Decision curve analysis (DCA) was used to assess the clinical value of the model. ResultsThe effectiveness of the same model constructed by different classifiers was different. The overall efficiency of the SVM models was higher, and the AUC of the radiomics intratumoral SVM model in the test group was 0.889. In addition, the AUC of all SVM models in the training group and the test group was greater than 0.900. The efficacy of the radiomics intratumoral model and the radiomics peritumoral model were similar, both of which were higher than the MRI conventional model, while the efficacy of the radiomics fusion model was higher than that of the three, but the efficacy of the full fusion model was the best, and it also performed well in the external validation group, with an AUC of 0.925 and an accuracy of 88.5%. DCA showed that this model could bring clinical net benefits to patients within a wide range of thresholds. ConclusionsMulti-sequence MRI-based radiomics model can be used to distinguish meningioma from other intracranial meningeal tumors before surgery, and combined with conventional signs can improve the effectiveness of the model. Different classifiers have influence on model efficiency, SVM model has high efficiency, robustness and good generalization ability. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.010 ObjectiveTo explore the changes of individual-based morphological brain network topological properties in patients with mild traumatic brain injury (mTBI). Materials and MethodsA sample of 43 mTBI patients and 37 healthy controls (HC) were included. After T1WI data of all subjects were collected, using the Freesurfer to do data preprocessing and geting severals morphological indices (cortical thickness, gray matter volume, brain surface area, sulcus depth, mean curvature), which construct the individual-based morphological brain network, and then Graph Theoretical Network Analysis (GRETNA) was utilized to calculate the network topological properties. The last, differences between the two groups were compared based on two-samples t-test, with false discovery rate (FDR) corrections for multiple comparisons. ResultsCompared with the HC group, the mTBI group showed approximately differences in nodal degree centrality (DC), the brain regions of left frontal pole transverse gyrus (t=-2.186, P=0.032), central sulcus (t=-2.617, P=0.011), horizontal anterior segment of lateral fissure (t=-2.456, P=0.016) and right pole occipital (t=-2.013, P=0.048) were increased, and nodal efficiency (N_e) of left frontal pole transverse gyrus (t=-2.182, P=0.032;), central sulcus (t=-2.226, P=0.029), horizontal anterior segment of lateral fissure (t=-2.440, P=0.017) and right precuneus (t=-2.207, P=0.030) were increased, which were related to cognitive and executive functions; in addition, the memory and emotional regulation cortexs suffered biggest drop, the DC of the nodes in the left cuneus (t=2.173, P=0.033), angular return (t=2.498, P=0.015) and parahippocampal gyrus (t=4.009, P<0.001) were dropped, and N_e in the left planum polare of the superior temporal gyrus (t=2.394, P=0.019), angular return (t=2.668, P=0.009), parahippocampal gyrus (t=4.671, P<0.001), callosal sulcus (t=2.189, P=0.032) were dropped. The global topological properties differences were not statistically significant (P>0.05). ConclusionsThe individual morphological brain network of mTBI in the acute phase still retains the small-world attribute. The abnormally elevated nodes DC and N_e of mTBI are mainly concentrated in brain regions related to cognitive and executive functions, reflecting the brain^,s stress compensation for cognitive functions. The abnormally reduced nodes DC and N_e, mainly concentrated in brain regions related to memory and emotion regulation, revealed cognitive and emotional changes in the acute phase. This provides a new perspective for the study of mTBI in the acute phase and provides further clues for the exploration of the mechanism of brain network alteration. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.011 ObjectiveTo evaluate the correlation between lacrimal gland parameters and clinical activity score (CAS) in patients with Graves ophthalmopathy (GO) by 3 T MRI. Materials and MethodsA total of 40 patients with 80 eyes of diagnosed with GO from Fuyang Hospital Affiliated to Anhui Medical University and the First Affiliated Hospital of Anhui Medical University from February 2020 to June 2023 were prospectively selected as the GO group, and 40 healthy people with 80 eyes matching the gender and age of the GO group were selected as the control group. According to CAS score, GO patients were divided into active GO group and inactive GO group. The conventional MRI images and readout segmentation of long variable echo-trains diffusion weighted images (RESOLVE DWI) were used to collect images of the three groups respectively, T2-weighted imaging (T2WI) was used to obtain exophthalmos and lacrimal gland exophthalmos. The long diameter, short diameter, and area of the lacrimal gland at the maximum cross section were measured on T2-weighted imaging, and the apparent dispersion coefficient (ADC) of transverse lacrimal gland was recorded. SPSS 24.0 software was used for statistical analysis, and P<0.05 was considered statistically significant. The t test of two independent samples was used to compare the quantitative data between groups. The Chi-square test was used for the differences between groups in gender, smoking history, drinking history and CAS score. Receiver operating characteristic (ROC) curve and its area under the curve (AUC) were used to evaluate the diagnostic efficiency of GO activity. Spearman^,s correlation analysis was used to analyze the correlation between lacrimal gland quantitative parameters and CAS score. Results(1) The parameters of ocular exophthalmia and transverse lacrimal gland, including lacrimal gland exophthalmia, long diameter, short diameter, area and ADC mean value, were increased in active phase GO group compared the inactive phase GO group and control group, while those in inactive GO group were higher compared with control group (all P<0.05). (2) ROC curve results: ocular exophthalmia and transverse lacrimal gland area had the highest diagnostic efficacy in GO patients (AUC=0.906 and 0.905), and lacrimal gland exophthalmia and the mean value of ADC in transverse lacrimal gland also had certain diagnostic values in GO patients (0.793 and 0.702). The optimal cut-off point of the optimal cut-off point of RESOLVE DWI ADC value for predicting GO activity was 1.181×10^-3 mm²/s, with a sensitivity of 95.00% and a specificity of 76.30%. (3) The exophthalmis (r=0.734, P<0.05), lacrimal gland prominence (r=0.719, P<0.05), mean ADC of lacrimal gland (r=0.742, P<0.05) were strongly correlated with CAS. ConclusionsThe prominence of transverse lacrimal gland and the mean value of DWI ADC value can be used as important reference indexes for diagnosis and staging of ophthalmopathy of GO patients. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.012 ObjectiveTo investigate the apparent diffusion coefficient (ADC) and morphology of lymph nodes in the drainage area of salivary glands among patients with primary Sjögren^,s syndrome (pSS) before and after treatment and healthy volunteer, and its potential in reflecting the degree of inflammatory activity of the disease in patients with pSS. Materials and MethodsA total of 23 patients with pSS were collected to undergo routine head and neck MRI and diffusion weighted imaging (DWI) before and after 12 weeks of regular treatment, respectively. ADC images were obtained after post-processing. Then 15 healthy volunteers were collected as controls during the same period. Using t-test to compare the morphology and ADC values of the lymph nodes in each level among the pSS patients before and after treatment, and healthy volunteers. ResultsThe short diameters of lymph nodes in level Ⅰb, Ⅱa, and Ⅱb in patients with pSS before treatment were larger than those of healthy volunteers [Ⅰb (t=2.293, P=0.028), Ⅱa (t=2.397, P=0.022), Ⅱb (t=1.409, P=0.030)] , and the short diameters of lymph nodes in all salivary gland drainage levels were smaller after 12 weeks of treatment [Ⅰa (t=4.391, P<0.001), Ⅰb (t=3.439, P=0.002), Ⅱa (t=3.458, P=0.002), Ⅱb (t=4.667, P=0.001)]. ADC values of lymph nodes in level Ⅰb and Ⅱa in pSS patients before treatment were smaller than those of healthy volunteers [Ⅰb (t=3.337, P=0.002), Ⅱa (t=2.207, P=0.038)] , and they became larger than those of lymph nodes in level Ⅰa, Ⅰb, and Ⅱa after 12 weeks of treatment [Ⅰa (t=3.674, P=0.001), Ⅰb (t=2.198, P=0.039), Ⅱa (t=2.484, P=0.004)]. ConclusionsThe short diameters of lymph nodes in level Ⅰb, Ⅱa and Ⅱb may be of great value in identifying patients with pSS and healthy volunteers, and the short diameters of lymph nodes in all levels may be of great value in identifying patients with pSS before and after treatment; the ADC values of lymph nodes in level Ⅰb and Ⅱa may be of great value in identifying patients with pSS and healthy volunteers, and the ADC values of lymph nodes in level Ia, Ⅰb and Ⅱa may be of great value in identifying patients with pSS before and after treatment. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.013 ObjectiveTo investigate MRI features and diagnostic efficacy of the lower lip salivary glands in Sjogren^,s syndrome (SS). Materials and MethodsThe clinical and lower lip salivary glands MRI data of 232 patients with clinically suspected SS were retrospectively analyzed and divided into the SS group (155 patients) and the non-Sjögren^,s syndrome (NS) group (77 patients) according to the classification criteria for SS jointly developed by the American College of Rheumatology/European League Against Rheumatism in 2016. The lower lip salivary glands^, T1WI and T2WI-iterative decomposition of water and fat with echo asymmetric and least-squares estimation (IDEAL) water-phase imaging features (glands volume, fat content, signal characteristics) were observed. Based on the T2WI-IDEAL water-phase sequence, ITK-SNAP software was used to measure and calculate the volume of the lower lip salivary glands, the mean and standard deviation of signal intensity, and univariate and multivariate analyses were performed, and the multi-factor joint prediction model was established by binary logistic regression. The diagnostic efficacy of independent influencing factors and combined prediction model on SS was evaluated by the receiver operating characteristic (ROC) curve. ResultsMRI of the lower lip salivary glands in 48 and 12 patients in the SS and NS groups, respectively, showed glandular atrophy with increased inter-glandular fatty tissue, and the T2WI-IDEAL water-phase signal was unevenly reduced, with a statistically significant difference between the groups (χ²=5.316, P=0.023). The lower lip salivary glands volume and signal intensity standard deviation had statistically significant intergroup differences (Z=-3.260, -2.803; P=0.001, 0.005), were independent influences on SS (OR=0.999, 1.014; P=0.001, 0.003), and the areas under the curve (AUCs) of predicted SS were 0.629 [95% confidence internal (CI): 0.553-0.704] and 0.613 (95% CI: 0.534-0.692), respectively, the AUC value of the combined prediction model of the two features was 0.682 (95% CI: 0.608-0.756). ConclusionsThe MRI features of the lower lip salivary glands in SS are glandular atrophy and signal inhomogeneity, and the prediction of SS based on the volume of the labial glands and the standard deviation of signal intensity has a certain diagnostic value. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.014 ObjectiveTo explore the value of dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) quantitative parameters combined with reduced field-of-view diffusion-weighted magnetic resonance imaging in the differentiation between benign and malignant thyroid nodules. Materials and MethodsFrom January 2022 to October 2023, a total of 38 thyroid nodule patients (52 nodules) were collected, which were diagnosed by surgery and pathology in the Affiliated Hospital of Binzhou Medical College. They were divided into benign nodule group and malignant nodule group. Before operation, all patients underwent 3.0 T MRI scanning, including conventional MRI, reduced field-of-view diffusion-weighted magnetic resonance imaging (b value was 0, 800 s/mm²) and DCE-MRI examination, and their apparent diffusion coefficient (ADC) value and quantitative parameters of DCE-MRI were measured, including contrast blood plasma and extravascular extracellular space (K^trans), rate constant between extravascular extracellular space and blood plasma (K_ep) and Volume of extravascular extracellular space per unit volume of tissue (V_e). The ADC, K_ep, V_e and K^trans of thyroid benign and malignant nodules were analyzed by independent sample t test, and the difference was statistically significant (P<0.05). Then, stepwise logistic regression model was used to analyze the independent predictors of benign and malignant nodules. And draw receiver operating characteristic (ROC) curve to analyze the diagnostic efficiency of ADC, K_ep and K^trans independent diagnosis model and joint ADC and K^trans diagnosis model. ResultsThe average ADC value, K^trans value,K_ep value in benign nodules group were (1.659±0.370)×10^-3 mm²/s, (0.427±0.214) min^-1, (0.966±0.225) min^-1, respectively. While the average ADC value, K^trans value, K_ep value in malignant nodules group were (1.182±0.195)×10^-3 mm²/s, ( 0.178±0.073) min^-1, (0.600±0.248) min^-1, respectively. The value of ADC, K_ep and K^trans in benign nodules group were higher than those in malignant nodule group, and the differences were statistically significant (P<0.001). The independent sample t test and stepwise logistic regression analysis showed that there had a difference between ADC value and K^trans value (P<0.05). And they were independent predictors for differentiating benign from malignant thyroid nodules. The area under the curve (AUC) of ADC alone was 0.915, and the AUC of K^trans alone was 0.827. The AUC of the combined model of ADC value and K^trans was 0.973, which was significantly higher than that of the single application of ADC value and K^trans, and the diagnostic efficiency of the combined diagnosis model was the highest. According to the DeLong test, there was statistical difference between the combined diagnosis model and K^trans diagnosis alone (P<0.05). The combined diagnostic model of ADC value and K^trans had a sensitivity of 97.3%, which was higher than ADC and K^trans, and a specificity of 84.6%, which was higher than ADC value. ConclusionsADC value and K^trans are important parameters for differentiating benign and malignant nodules. The combined model of ADC value and K^trans can assist clinical practice and provide an important basis for preoperative diagnosis. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.015 ObjectiveTo investigate the value of cardiac magnetic resonance feature tracking (CMR-FT) in evaluating early subclinical changes in cardiac function during chemotherapy in breast cancer patient. Materials and MethodsThis was a prospective study, in which 73 breast cancer patients were enrolled. All subjects underwent a once-time 1.5 T cardiac magnetic resonance examination with a scan sequence heart cinema. According to different chemotherapy cycles, breast cancer patients were divided into three groups, i.e., baseline group (no chemotherapy yet; n=20), early chemotherapy group (3-4 cycles; n=27), and late chemotherapy group (7-8 cycles; n=26). Conventional cardiac function parameters and myocardial strain parameter including left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume index (LVEDVI), global radial strain (GRS), global longitudinal strain (GLS), and global circumferential strain (GCS) were obtained using CVI42 post-processing software. Normality tests were performed, moreover, a one-way analysis of variance was to compare intergroup differences. Pearson correlation coefficient was utilized to analyze the relationship between cardiac function and myocardial strain data, with statistical significance set at P<0.05. ResultsWhen compared to the baseline group, a pronounced decrease was detected in the cardiac function indexes of LVEF, right ventricular ejection fraction (RVEF), and stroke volume index (SVI) in the late chemotherapy group (all P<0.05), while the main myocardial strain indexes GRS, GCS, and GLS in the early chemotherapy group (all P<0.05). Correlation analysis revealed a linear positive correlation between LVEF, RVEF, SVI and GRS, GCS, GLS respectively (r=0.26-0.45, all P<0.05). LVMI, LVEDVI, LVESVI, and cardiac index (CI) showed no significant correlation with myocardial strain data (all P>0.05). Repeatability analysis indicated good inter- and intra-observer agreement for GRS, GCS, and GLS measurements. ConclusionsCompared to conventional cardiac function indexes, the cardiac strain index measured by CMR-FT technology is more sensitive in detecting subclinical cardiac function injury in breast cancer patients, providing an opportunity for early prevention and treatment of severe cardiac damage. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.016 ObjectiveTo ascertain whether dynamic contrast-enhancement MRI (DCE-MRI) is a useful diagnostic tool for intratumoral and peritumoral vascular features in breast imaging reporting and data system (BI-RADS) 4 of tumors. Materials and MethodsA retrospective collection of 102 female cases with BI-RADS4 breast MRI examination and clear pathological results from August 2018 to March 2023 at the First Affiliated Hospital of Dalian Medical University, 43 cases were benign group and 59 cases were breast malignant group. Record the patient^,s age, maximum lesion diameter (dmax), and basic imaging features of breast DCE-MRI, as well as peritumor vascular characteristics and intratumor hemodynamic parameters. Differences in several parameters between the two groups were analyzed by univariate and multivariate Logit models. The diagnostic efficacy of combining various peritumor vascular characteristic indexes and intratumor parameter values to differentiate between benign and malignant BI-RADS4 lesions in the breast was analysed using the receiver operating characteristic, (ROC) curves and the area under the curve (AUC). Evaluate AUC with the DeLong test. ResultsThere were statistically significant differences in number of adjacent vascular signs (AVS), maximum diameter (dmax) of peritumoral blood vessels, the difference in diameter of blood vessels around the tumor between the affected and healthy sides (∆d), peritumoral vascular appearance phase, volume transfer constant (K^trans), flux rate constant (K_ep), maximum slope of enhancement (MSI), type of time signal intensity curve (TIC), background parenchymal enhancement (BPE) and fibrous glandular tissue (FGT) between the two groups of benign and malignant breast cases (P<0.05), while there was no statistically significant difference between signal enhancement ratio (SER) and volume fraction of extracellular space (V_e) (P>0.05). ∆d, dmax, MSI and K^trans were independent factors that affected how the two groups differentiated from one another, according to multiple logistic regression analysis, with MSI values having the largest predominance ratio (AUC of 0.923). Comparing peritumor vascular characteristic indexes (∆d) with dmax, MSI, and K^trans, the combined model of ∆d and MSI showed the highest diagnostic performance (AUC value of 0.933, sensitivity and specificity of 93.2% and 83.7%, respectively), and the difference between ∆d combined with MSI and ∆d combined with K^trans was statistically significant (P=0.001); When comparing additional joint indicators pairwise, there was no statistically significant difference (P>0.05). The joint model performed better diagnostically than the individual MSI model. ConclusionsThe combination of peritumoral vascular characteristic indexes (∆d) and intratumoral semi quantitative parameters (MSI) has high application value in identifying benign and malignant breast lesions in BI-RADS4. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.017 ObjectiveTo explore the value of clinical-pathological, mammographic (MG), and MRI features in predicting ductal carcinoma in situ with microinvasion (DCISM). Materials and MethodsA retrospective study was conducted on female patients diagnosed with pure ductal carcinoma in situ (DCIS) and DCISM confirmed by final surgical pathology from June 2019 to June 2022 at General Hospital of Ningxia Medical University. Clinical-pathological, MG, and MRI features of the patients were evaluated. The univariate and multivariate logistic regression analysis was used to identify independent risk factors for DCISM and develop a combined model. The diagnostic performance of the model was assessed using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration plot. The clinical utility of the combined model was evaluated using decision curve analysis (DCA). A prospective validation was performed on patients who meet the eligibility criteria for inclusion and exclusion from July 2022 to July 2023. Shapley Additive exPlanation (SHAP) analysis was applied to assess the value of the combined model in predicting DCISM based on the longest diameter of the lesion, nuclear grade, necrosis, Ki-67 index, P63 status, calcification status, and minimum ADC value. A total of 535 patients with 550 lesions (15 cases were synchronous bilateral breast cancer) were collected. The patients^, ages ranged from 23 to 81 years, with a median age of 50 years. Among the training group (n=382), 102 lesions (27%) were diagnosed as DCISM, while in the validation group (n=168), 52 lesions (31%) were diagnosed as DCISM. ResultsThe multivariable logistic regression analysis showed the independent risk factors of DCISM included longest diameter of the lesion, nuclear grade, necrosis, Ki-67 index, P63 status, calcification status, and the minimum value of apparent diffusion coefficient (ADCmin). A predictive model combining the above parameters with preoperative clinical-pathological, mammography, and MRI features was constructed, demonstrating high predictive performance in both the training and validation groups (AUC: 0.937, 0.899). According to SHAP analysis, the longest diameter of the lesion, Ki-67 index, and ADCmin make the primary contributions in the combined model for predicting DCISM, while the calcification status, nuclear grade, P63 status, and necrosis are supplementary factors. ConclusionsA combined predictive model using clinical-pathological, preoperative MG and MRI features can effectively differentiate DCISM from pure DCIS, thereby improving the accuracy of clinical decision-making and treatment planning. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.018 ObjectiveTo develop a nomogram based on preoperative magnetic resonance imaging (MRI) features and apparent diffusion coefficient (ADC) to predict lymphovascular invasion (LVI) in invasive breast cancer. Materials and MethodsA retrospective analysis was conducted on data from 141 patients with invasive breast cancer. Among them, 66 patients from March 2019 to July 2021 were assigned to the training group, and 75 patients from July 2021 to December 2022 were assigned to the validation group. The evaluation included assessment of lesion MRI features (such as mass shape, margins, internal enhancement patterns, and peritumoral edema) and measurement of ADC. The differences in imaging features and mean, maximum, and minimum ADC values within the tumor and peritumoral regions between the LVI-positive and LVI-negative groups were analyzed using chi-square tests, independent sample t-tests, and Mann-Whitney U tests. Multivariate logistic regression analysis was employed to identify independent risk factors associated with LVI and to establish a nomogram model for predicting LVI. ResultsLVI was significantly associated with tumor size, Ki-67 expression, and lymph node metastasis rate. Multivariable logistic regression analysis showed that tumor shape [P=0.014, odds ratio (OR): 0.142 (0.030-0.679)], internal enhancement patterns [P=0.046, OR: 0.157 (0.025-0.965)], maximum tumor diameter [P=0.037, OR:4.372 (1.093-17.488)], DWI rim [P=0.024, OR: 0.193 (0.047-0.803)], and ADCration [P=0.010, OR: 1.056 (1.013-1.101) were independent predictors of LVI. Areas under the receiver operating characteristic curve of the comprehensive prediction model based on MRI features and peritumoral intratumoral ADC ratio in the training and validation groups were 0.867 and 0.872, the specificity were 88.6% and 84.6%, and the precision were 74.2% and 69.7%, respectively. Calibration curves demonstrated good agreement between predicted and actual values in the training and validation groups. ConclusionsLVI is correlated with various clinical and pathological prognostic factors and MRI imaging features. The comprehensive model based on preoperative MRI features and apparent diffusion coefficient demonstrates good predictive efficiency for LVI, that contribute to clinical decision-making in guiding surgery, developing individualized treatment plans, and assessing prognosis. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.019 ObjectiveFour-dimensional flow (4D Flow) cardiac magnetic resonance (CMR) technology was used to evaluate the presence of left ventricular diastolic dysfunction in patients with hypertrophic cardiomyopathy (HCM), and the effect of myocardial fibrosis on left ventricular diastolic function in HCM patients was explored. Materials and MethodsA total of 44 HCM patients were prospectively enrolled, and they were divided into HCM late gadolinium enhancement (LGE) (+) group (25 cases) and HCM LGE (-) group (19 cases) according to whether the patients had LGE, and 31 healthy controls were included in the same period. All three groups underwent 3.0 T magnetic resonance imaging, including steady-state free precession sequences and 4D Flow CMR scans. Analysis using CVI42 post-processing software included cardiac functional parameters and mitral valve blood flow velocity parameters. Clinical and imaging parameters were compared among the three groups using one-way analysis of variance or Mann-Whitney U test. Correlation analysis was performed between early diastolic mean blood flow velocity (E) and cardiac functional parameters. ResultsThe left ventricular mass (LVmass) and global peak wall thickness (GPWT) of HCM patients were greater than those of healthy controls, and the GPWT of HCM patients with myocardial fibrosis increased more significantly than that of HCM patients without myocardial fibrosis [HCM LGE (+) group vs. HCM LGE (-) group vs. healthy control group]; [LVmass: 157.34 (122.24, 194.38) g vs. 148.29 (131.79, 189.83) g vs. 85.73 (73.00, 94.02) g; GPWT: 20.04 (16.76, 24.99) mm vs. 17.46 (16.19, 19.99) mm vs. 9.47 (8.35, 10.92) mm] (P<0.001); The peak early diastolic mean blood flow velocity (peak E) of HCM patients with myocardial fibrosis was lower than that of HCM patients without myocardial fibrosis, and was lower than that of healthy control group [HCM LGE (+) group vs. HCM LGE (-) group vs. healthy control group: (30.03±11.33) cm/s vs. (38.05±12.03) cm/s vs. (47.44±10.82) cm/s] (P<0.001), while there was no significant difference in the peak value of mean blood flow velocity (peak A) in late diastolic period between the three groups, and the E/A value of HCM patients with myocardial fibrosis was significantly lower than that of the healthy control group (1.10±0.61 vs. 1.74±0.85) (P<0.05). The mean blood flow velocity at the mitral valve level in early diastolic was negatively correlated with GPWT and LVmass (r=-0.593/r=-0.371, P<0.001/P=0.001). ConclusionsBased on 4D Flow CMR, it can not only accurately measure the blood flow velocity from a three-dimensional perspective, but also quantitatively evaluate the effects of left ventricular diastolic dysfunction and myocardial fibrosis on the left ventricular diastolic function of HCM patients from the hemodynamic aspect. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.020 ObjectiveTo explore the value of multi-parameter cardiac magnetic resonance (CMR) in the diagnosis and short-term follow-up of acute myocarditis in young children. Materials and MethodsA total of 60 children with acute myocarditis under eight years old and 30 children in the control group who attended our hospital from January 2022 to February 2024 were prospectively analyzed. Clinical information and CMR data [including native T1 value, extracellular volume fraction (ECV), T2 value, T2 signal ratio, and late gadolinium enhancement (LGE) of the left ventricle myocardium] of all subjects were collected. The diagnostic efficacy of single and combined parameters was evaluated using the receiver operating characteristic (ROC) curve, and the area under the curve (AUC), sensitivity, specificity, and accuracy were calculated. The paired test was used to compare the CMR data of young children with acute myocarditis at initial diagnosis and follow-up. ResultsThe native T1 value, ECV value, T2 value, T2 signal ratio, and LGE-positive cases were significantly higher in the acute myocarditis group than in the control group (all P<0.001). The optimal cut-off values of the native T1 value, ECV value, T2 value, and T2 signal ratio were 1 232.50 ms, 30.50%, 53.50 ms, and 1.75, respectively. The AUCs of the native T1 value, T2 value, and T2 signal ratio (0.917, 0.889 and 0.839, respectively) were higher than those of other single parameters, but there was no significant difference between the three parameters (all P>0.05), with the native T1 value having the highest sensitivity and accuracy of 81.7% and 83.3%, respectively. The AUCs of the 2018 Lake Louise Criteria (LLC), the 2018LLC excluding ECV, and the native T1 value combined with the T2 value (0.933, 0.917 and 0.892, respectively) were higher than other combined parameters, but there was no significant difference between the three parameters (all P>0.05), with 2018LLC having the highest sensitivity and accuracy of 90.0% and 92.2%, respectively. Compared with the initial diagnosis, the native T1 value, ECV value, T2 value, T2 signal ratio, the number of myocardial segments involved in LGE, and the number of cases consistent with 2018LLC were overall lower at short-term follow-up (all P<0.05). ConclusionsMulti-parameter CMR can be used as an effective method to diagnose acute myocarditis in young children and monitor the changes in children^,s condition after treatment during the short-term follow-up. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.021 ObjectiveTo explore the impact of rectal susceptibility artifacts on the subjective evaluation and deep learning-based computer aided diagnosis (DL-CAD) in MRI-based prostate cancer diagnosis. Materials and MethodsA retrospective analysis was conducted on 685 patients who underwent biparametric magnetic resonance imaging (bpMRI). All patients have confirmed pathological results via either biopsy or surgical resection. Three groups of radiologists (Reader 1-6) with varying years of experience independently reviewed suspicious lesions on prostate MRI according to the Prostate Imaging Reporting and Data System (PI-RADS) version 2.1. The other two readers scored whether there were rectal artifacts on MRI and the degree of artifacts. A DL-CAD model based on prostate MRI was constructed to evaluate the impact of rectal artifacts on the deep learning-based diagnostic model. The weighted Kappa coefficient was used for the consistency test of rectal artifact assessment. Differences in PI-RADS scores and rectal artifact scores among radiologists with different years of experience were compared using the chi-square test. The diagnostic differences among readers were compared using the multi-reader multi-case receiver operating characteristic curve (MRMC-ROC). The area under the curve (AUC) was used to evaluate the diagnostic performance of DL-CAD. The DeLong test was used to compare the differences in AUC values. A significance level of P<0.05 was considered statistically significant. ResultsThis study included a total of 685 patients, comprising 199 cases of prostate cancer and 486 cases of benign lesions. In subjective evaluation, the AUC for junior Reader 1 was 0.772 without artifacts and 0.644 with artifacts, a statistically significant difference (P=0.023), while the AUC for junior Reader 2 was 0.809 without artifacts and 0.682 with artifacts, a statistically significant difference (P=0.007). The difference was not statistically significant (P>0.05) between the diagnostic performance of the middle and senior readers. Regarding the assessment of different degrees of rectal artifacts, there were no statistically significant differences in the diagnostic performance AUC among all readers (0.071≤P<0.973). Based on subjective scoring criteria, the other two readers rated the rectal artifact with a consistency of 0.851. In rectal artifact subgroup analysis, the AUC in the area without artifacts was higher than that in the area with artifacts in peripheral zone (Reader 1: 0.754 vs. 0.532; Reader 2: 0.771 vs. 0.580), and these differences were statistically significant (P<0.05). However, no statistically significant differences were observed in the remaining subgroups (P>0.05). In deep learning, the AUC without artifacts was 0.794 and the AUC with artifacts 0.538 for DL-CAD, and the difference was statistically significant(P<0.05). The AUC with mild artifacts were 0.546, the AUC with moderate artifacts were 0.590, and the AUC with severe artifacts were 0.481, and there was no significant difference in the diagnostic performance of DL-CAD (P>0.05). ConclusionsRectal susceptibility artifacts have significant negative effects on subjective visual assessment and DL-CAD assessment. There are differences in the impact of rectal artifacts on subjective visual assessment and DL-CAD assessment. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.022 ObjectiveTo investigate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in predicting pelvic lymph node metastasis (PLNM) of early cervical cancer. Materials and MethodsImaging and clinical data from 124 patients with FIGO ⅠB-ⅡA cervical cancer confirmed by pathology were retrospectively analyzed. The quantitative parameters obtained from DCE-MRI and IVIM-DWI of the primary tumor between the PLNM group and non-PLNM group were compared. Multivariate logistic analysis was used to determine the independent risk factors, and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic performance of all parameters. ResultsThe volume transfer constant (K^trans; t=6.203, P<0.001), perfusion fraction (f; t=3.944, P<0.001), apparent diffusion coefficient (ADC; Z=4.393, P<0.001) and extravascular extracellular volume fraction (V_e; Z=2.312, P=0.021) in the PLNM group were significantly lower than those in the non-PLNM group. Multivariate analysis showed that K^trans (P<0.001), f (P=0.003) and ADC (P=0.031) were the independent risk factors of PLNM in cervical cancer. The ROC curves showed that the area under curve (AUC) of K^trans, f, and ADC for predicting PLNM were 0.808, 0.707 and 0.745, respectively. Compared with individual parameter, the combination of the three parameters achieved the highest diagnostic efficacy to predict PLNM with an AUC of 0.893, the sensitivity and specificity were 82.4% and 86.8%, respectively. ConclusionsK^trans, V_e from DCE-MRI, f and ADC from IVIM-DWI of primary tumor are helpful in evaluating PLNM of early cervical cancer. The three independent risk factors of K^trans, f, ADC have high predicting value, and their combination can further improve diagnostic efficiency. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.023 ObjectiveTo investigate the diagnostic efficacy of synthetic MRI (syMRI) in differentiation of benign and malignant ovarian adnexal lesions with Ovarian-Adnexal Reporting and Data System (O-RADS) MRI score 3-5. Materials and MethodsTotally 100 patients with 126 ovarian adnexal lesions scored 3-5 according to O-RADS MRI in our hospital from August 2021 to June 2023 were retrospectively enrolled. The diagnosis was confirmed via pathological examination or one-year follow-up. All patients underwent pelvic syMRI and diffusion-weighted imaging (DWI) on a 3.0 T MR scanner. Regions of interest (ROIs) were placed on the largest slice of the solid part of adnexal lesion and avoid the cystic or necrotic areas. Quantitative parameters of syMRI [T1, proton density (PD), T2^*, R2^*] and apparent diffusion coefficient (ADC) values were calculated. Independent samples t test and Mann-Whitney U test were utilized to compare the differences of quantitative parameters between benign and malignant lesions. Two models, the syMRI model and the syMRI+ADC model, were constructed using logistic regression analysis. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of the individual quantitative parameters and diagnostic models. DeLong test was employed to compare the difference of area under the curve (AUC). ResultsAmong 126 ovarian adnexal lesions, 55 lesions were benign, and 71 lesions were malignant. T1, T2^*, R2^*, and ADC showed significant difference between groups (all P<0.05) and the AUCs of these parameters in differentiating benign and malignant adnexal lesions were 0.739 [95% confidence interval (CI): 0.652-0.826], 0.780 (95% CI: 0.698-0.862), 0.783 (95% CI: 0.699-0.866), and 0.674 (95% CI: 0.576-0.772), respectively. The AUCs of syMRI and syMRI+ADC models were 0.860 (95% CI: 0.791-0.929) and 0.879 (95% CI: 0.818-0.940), respectively. The AUCs of the two models showed no statistical difference, and both of them were higher than that of ADC (all P<0.05). ConclusionsThe syMRI proved to be valuable in differential diagnosis of benign and malignant ovarian adnexal lesions with O-RADS MRI score 3-5. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.024 ObjectiveTo investigate the clinical significance of deep learning (DL) model based on self-attention mechanisms in predicting the progression of new bone formation on coronal T1-weighted MR images of sacroiliac joints (SIJ) in patients with axial spondylarthritis (axSpA). Materials and MethodsWe conducted a retrospective analysis of MRI data (with one-year, two-year or three-year follow-up duration) for 351 axSpA patients who were diagnosed at the Third Affiliated Hospital of Southern Medical University from January 2010 to December 2022. The patients were randomly allocated into training, validation, and test sets in a 8∶1∶1 ratio. The Bifpn-YOLOv8 model based on self-attention mechanisms was developed. And another three baseline models (YOLOv8, YOLOv7, Faster-RCNN) were constructed to compare model performance with Bifpn-YOLOv8. We evaluated the predictive performance of each model using metrics such as mean average precision (mAP), F1 score, accuracy, recall, and Common Objects in Context (COCO) evaluation metrics. Among them, mAP₅₀ and mAP_50:95 indicates the mean average precision at different intersection over union thresholds, respectively. The average precision (AP) of COCO metrics, such as AP, AP₅₀, AP₇₅, follows the same principle. ResultsThe Bifpn-YOLOv8 model exhibited good predictive performance on both validation and test sets. In comparison to the baseline models, Bifpn-YOLOv8 achieved the highest mAP₅₀ and mAP_50:95 on the test set, with values of 83.8% and 50.4%, respectively. The results were statistically significant (all P<0.05) compared to each baseline model. Similarly, the Bifpn-YOLOv8 model outperformed the baseline models on the test set with superior COCO evaluation metrics (AP: 50.5%, AP₅₀: 82.3%, AP₇₅: 58.6%). ConclusionsThe self-attention-based Bifpn-YOLOv8 model could effectively predicting the progression of new bone formation in the SIJ on MR images of axSpA patients. This model is poised to become a valuable clinical tool for evaluating the progression of new bone formation, providing assistance to physicians in clinical decision-making and management of axSpA patients. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.027 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.028 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.029 ^,s disease (AD) is the most common neurodegenerative disease. The main symptoms are progressive memory decline and cognitive dysfunction. The incidence rate is on the rise, and there is a lack of effective treatment. Therefore, early diagnosis, prevention and delay of AD are essential. In recent years, MRI has been widely used in the study of AD and other cognitive impairment fields. Three-dimensional T1 weighted imaging (3D-T1WI), diffusion MRI can objectively and indirectly reflect abnormal brain structural changes, providing imaging evidence for explaining their mechanisms. This article provides a review of the application of 3D-T1WI, diffusion MRI in AD, exploring the changes in brain structure and pathophysiological mechanisms of AD patient from multiple perspectives, and providing assistance for the early diagnosis of AD. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.030 ^,s disease (AD) is a degenerative disease of the central nervous system, and dysregulation of iron homeostasis in the brain is one of the important pathological features of AD. Quantitative susceptibility mapping (QSM), a noninvasive magnetic resonance technique, is sensitive to the presence of iron and can quantify local tissue magnetization with high spatial resolution. In recent years, the QSM technique has been investigated on the magnetization rate of different brain regions and the relationship with other pathological biomarkers. The aim of this paper is to analyze the effect of iron homeostasis dysregulation on the pathology of AD as well as the potential value of the QSM technique in the early diagnosis of AD and tracking of the disease course, to provide objective neuroimaging basis for the early diagnosis and treatment of AD. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.031 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.032 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.033 ^, disease, so as to formulate the best treatment strategy for patients. It is expected to improve the prognosis of patients and provide a reference direction for future research. ]]> Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.034 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.035 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.036 Mon,20 May 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.05.037 Mon,20 May 2024 00:00:00 GMT