http://med-sci.cn/cgzcx/en/contents_list.asp?issue=202406 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.1674-8034.2024.06.002 ObjectiveDiffusion kurtosis imaging (DKI) was employed to evaluate microstructural changes in the white matter fiber tracts of the brain in children with global developmental delay (GDD). Materials and MethodsThis prospective study included 37 children with GDD in the experimental group and 32 age- and gender-matched healthy children in the control group. All participants underwent DKI sequence scanning, and diffusion tensor and kurtosis tensor parameters were obtained following post-processing. The parameters were compared between the two groups using tract-based spatial statistics (TBSS). Spearman correlation analysis was conducted between the parameter values within the fiber bundles showing significant intergroup differences and the neurodevelopmental scores of children with GDD. ResultsCompared to the control group, the mean diffusivity (MD) of the right corticospinal tract and right anterior thalamic radiation were significantly increased in the GDD group (all P<0.05); the radial diffusivity (RD) of the bilateral anterior thalamic radiation, bilateral corticospinal tract, and right superior longitudinal fasciculus were also significantly increased (all P<0.05). Additionally, the radial kurtosis (RK) in the GDD group was significantly decreased (all P<0.05), including the bilateral anterior thalamic radiations, bilateral corticospinal tracts, bilateral inferior fronto-occipital fasciculi, bilateral superior longitudinal fasciculi, bilateral inferior longitudinal fasciculi, forceps minor, left uncinate fasciculus, and right cingulum. Correlation analysis revealed that the average RK values of the left inferior longitudinal fasciculus and left uncinate fasciculus were positively correlated with adaptive behavior scores (r=0.349, 0.486, respectively; all P<0.05); the average RK value of the left uncinate fasciculus was positively correlated with fine motor and personal-social behavior scores (r=0.365, 0.590, respectively; all P<0.05). ConclusionsThe DKI technique can detect abnormalities in the microstructure of the white matter fiber bundles in children with GDD, providing useful insights into the potential pathophysiological mechanisms of GDD. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.003 ObjectiveTo study the topology of brain functional networks in epilepsy comorbidity depression using resting-state functional magnetic resonance imaging (rs-fMRI) combined with graph theory analysis. Materials and MethodsFifty-five included epilepsy patients underwent rs-fMRI examination and 17 item version of Hamilton Depression Rating Scale (HAMD) assessment, and were divided into depression and non-depression groups based on HAMD scores, with 30 cases in the depression group (ED group) and 25 cases in the non-depression group (E group) finally included. Based on the brain network analysis method of rs-fMRI combined with graph theory, the brain functional connectivity network was constructed, the global and node indexes of the brain network topology were calculated, and analyze whether there are abnormalities in the topological properties of the brain networks in the ED and E groups, and whether there is a correlation between abnormal indicators and HAMD scores. ResultsThe clustering coefficient (Cp) and standardized characteristic path length (lambda, λ) decreased in patients in ED group, and the difference was statistically significant (P<0.05). At the nodal level, the brain regions with decreased centrality included the left cuneus and left supraoccipital gyrus; the brain regions with increased centrality were located in the orbital part of the right middle frontal gyrus, and the differences were all statistically significant (P<0.05, FDR corrected). Global attribute clustering coefficients (r=-0.349, P=0.012), node clustering coefficients (NCp) of the left superior occipital gyrus (r=-0.382, P=0.006), NCp of the left cuneus (r=-0.477, P<0.001), and nodal local efficiency (NLe) of the left superior occipital gyrus nodes (r=-0.351, P=0.011) were negatively correlated with HAMD scores, and NLe of the orbital node of the right middle frontal gyrus (r=0.409, P=0.003) was positively correlated with HAMD scores. ConclusionsIn this study, we found that patients with epilepsy with/without depression have small-world network properties, the abnormal changes in some global and nodal indicators of its brain functional network provide imaging evidence for a better understanding of the occurrence and development of comorbidities and depression in epilepsy. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.004 ObjectiveTo investigate the alterations in brain structure and function among patients with Crohn^,s disease (CD) and their correlation with clinical indicators. Materials and MethodsBrain structural and resting-state functional magnetic resonance imaging data, along with clinical indicator data, were collected from 20 CD patients and 21 healthy controls. Based on the Schaefer atlas, the left and right hemispheres were divided into 100 brain regions, and the differences in cortical thickness between the two groups were examined. Functional connectivity (FC) was calculated among the brain regions showing significant structural group difference, and the differences in FC between the two groups were compared. The associations between clinical indicators [Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, CD activity index and disease duration] and abnormal cortical thickness & FC were measured using Pearson correlation coefficient in CD group. ResultsCompared to the healthy control group, CD patients exhibited a decrease in cortical thickness in the left insula (P=0.002, FDR correction) and right posterior parietal cortex (P=0.031, FDR correction). The FC between the left insula and right posterior parietal cortex was significantly reduced in CD group (P=0.025). Furthermore, there was a significant negative correlation between cortical thickness of left insula and SDS score among CD patients (r=-0.61, P=0.007). ConclusionsThe left insular and right posterior parietal cortex structure and FC are damaged in CD patients compared with normal controls. The thickness of left insular cortex is associated with the increase of depression score, which provides new clues for understanding the neural mechanism of CD. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.005 ObjectiveThe central mechanisms of pain in patients with primary dysmenorrhea (PDM) were investigated using the amplitude of low frequency fluctuations (ALFF), fractional amplitude of low frequency fluctuations (fALFF), and functional connectivity (FC) methods. Materials and MethodsThirty-one patients with PDM were included, and all subjects underwent dual-phase resting-state functional magnetic resonance imaging during menstruation and periovulatory. ALFF and fALFF values were calculated, and brain regions with differences in both ALFF and fALFF values were extracted as regions of interest (ROI), and FC values of ROI versus whole-brain voxels were calculated. The paired-sample t-test was used to compare the ALFF, fALFF, and FC values of PDM patients in pain and pain-free states, and Pearson^,s correlation analysis was used to explore the relationship between the ALFF and fALFF values and the clinical indicators of PDM patients. ResultsCompared with the non-painful phase, PDM patients showed significantly higher ALFF values in the left medial superior frontal gyrus and right cerebellar area Ⅱ and significantly lower ALFF values in the left insula during the painful phase (two-tailed test P<0.05, Alphasim-corrected, cluster level>176); fALFF values in the left dorsolateral superior frontal gyrus, left inferior frontal gyrus delta, and right pedunculopontine nucleus during the painful phase of PDM patients were significantly higher than in the non-painful phase, and the fALFF values in the left precuneus were significantly lower than in the non-painful phase (two-tailed test P<0.05, Alphasim corrected, cluster level>154). Subsequently, seed-point-based FC analysis showed that the left superior frontal gyrus was the brain region that differed in both ALFF and fALFF values, and its connectivity with the left cerebellar area Ⅷ was reduced in the painful phase compared to the non-painful phase (two-tailed test P<0.05, Alphasim corrected, cluster level>181); Pearson correlation analysis showed that the left insula in the painful phase of PDM patients ALFF values were negatively correlated with CMSS-t (r=-0.400, P=0.026). ConclusionsThe present study reveals abnormal alterations of ALFF and fALFF in PDM and involves multiple brain networks, providing new insights to help understand the central mechanisms of PDM. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.006 ObjectiveTo investigate the changes of immediate sensory motor network (SMN) and default mode network (DMN) in patients with acute ischemic stroke (AIS) using resting-state functional magnetic resonance imaging (rs-fMRI) and independent component analysis (ICA). Materials and MethodsTwenty-seven patients with AIS and 27 healthy controls (HCs) were included in the study. Each subject was assessed on relevant clinical scales and baseline data were collected, followed by immediate electroacupuncture stimulation for AIS, and relevant rs-fMRI data were collected. Then, the SMN and DMN network components were extracted using the ICA method. The functional connectivity values of patients and healthy controls were compared, as well as the changes in functional connectivity before and after acupuncture; bias correlation analysis was performed between the change values and the corresponding changes in clinical scale scores; and then the differential brain regions were used as seed points to calculate their functional connectivity (FC) with the whole brain. ResultsBefore acupuncture, functional connectivity increased in the left prefrontal lobe of the AIS group comparable to the healthy control group (P<0.001), and decreased in the left subparietal lobule (Z=4.38, P<0.001) and the right posterior cingulate gyrus (Z=4.87, P<0.001); the FC values of the left subparietal lobule (P<0.001), the left posterior cingulate gyrus (P<0.001), and the left frontal lobe (P<0.001) increased, increased FC values in some cerebellar regions (P<0.001). After acupuncture, the functional connectivity of the right prefrontal lobe in the AIS group significantly increased (P<0.001) and strongly and positively correlated with the difference of (Fugl-Meyer Assessment, FMA) score (r=0.842, P<0.001); the FC values of the right thalamus (Z=4.38, P<0.001) and the left frontal lobe in the AIS group significantly increased (P<0.001), and the FC values of some cerebellar regions increased. ConclusionsAIS patients have abnormal brain activity in the limbic system (posterior cingulate gyrus, hippocampus)-thalamus-cortex (subparietal lobule-frontal lobe) neural circuit; electroacupuncture can immediately modulate the brain spontaneous activity of AIS patients, which involves the brain areas related to motor completion, and it may be a potential target brain area for electroacupuncture treatment of AIS. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.007 ObjectiveTo explore the clinical application value of structural MRI in conjunction with computerized cognitive assessment based on VR eye-tracking technology in early diagnosis of Alzheimer^,s disease (AD). Materials and MethodsSeventy-seven patients with early AD and fifty-eight cognitively unimpaired (CU) participants underwent the traditional neuropsychological scale assessment [including Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)], a 5-minute VR eye-tracking technology-based cognitive assessment, and 3D T1-weighted MRI. The hippocampal volume (HV) was quantified using an automatic structural analysis tool. Receiver operating characteristic (ROC) curves were constructed to analyze the diagnostic effectiveness of the single index (HV) and the combined index (HV along with the total score from the VR eye-tracking technology-based cognitive assessment) for AD. Results(1) The area under ROC curve (AUC) of early AD diagnosed by HV was 0.629 (95% CI:0.542-0.711). When combining HV with the VR eye-tracking cognitive assessment, the AUC increased to 0.825 (95% CI: 0.751-0.885). The DeLong test results indicated a significant difference between the two methods (P<0.001). (2) The HV in the early AD group was significantly lower than that in the CU group (Z=-2.565, P=0.010). (3) The total score of VR eye-tracking cognitive assessment was positively correlated with MMSE score and MoCA score (r=0.531, 0.627, P<0.001). ConclusionsCombining computerized cognitive assessment using VR eye-tracking technology significantly enhances the diagnostic value of hippocampal volume in the early detection of AD. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.008 ObjectiveTo explore the effects of ultra-high altitude environment on the network degree centrality in migrant populations. Materials and MethodsHealthy individuals were recruited in ultra-high altitude (Lhasa) and high altitude (Lanzhou). Physiological indicators (arterial oxygen saturation, heart rate and breath-holding time after inhalation) and imaging dates (resting functional magnetic resonance imaging and 3D T1WI) were collected. The degree centrality (DC) of resting-state functional magnetic resonance imaging data were performed. Two-sample t-test was used to compare physiologic and DC values between groups. Controlling for factors that differed in demographic significance between groups. The partial correlation was analyzed between DC values of differential brain regions and physiological factors. ResultsCompared with high altitude group, the migrants in ultra-high altitude group had a decrease in their breath holding time and oxygen saturation, and an increase in heart rate (P<0.001). The DC value of visually related brain regions, such as bilateral Calcarine gyrus, middle occipital gyrus and cuneus, and the right central posterior gyrus increased (FDR correction, P<0.05) in ultra-high altitude group, which were negatively correlated with arterial oxygen saturation (r=-0.360, P=0.006; r=-0.481, P<0.001). The DC value of bilateral insula and putamen, right middle cingulate and supplementary motor area and left cerebellum decreased (FDR correction, P<0.05) in ultra-high altitude group. The DC value of right insula and putamen, left insula and putamen and left cerebellum were positively correlated with arterial oxygen saturation (r=0.518, P<0.001; r=0.416, P=0.001; r=0.414, P=0.001). ConclusionsThe high-altitude environment may alters post inspiratory breath-holding time and heart rate, enhances functional compensatory in visual areas, and weakens the centrality of the nucleus accumbens, insula, and cerebellum in the functional brain network. These features may serve as potential imaging biomarkers of the degree centrality on functional brain networks in immigrant populations in ultra-high altitude environments. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.009 ObjectiveTo explore the MRI characteristics of brain structure in patients with coronary heart disease and depression (CHDD) and analyze their correlation with emotion and cognitive ability. Materials and MethodsA case-control design was adopted, including 22 CHDD patients, 44 coronary heart disease without depression (CHD-nD) patients, and 30 healthy controls (HC). T1-weighted images of all subjects were processed using a MR brain structure segmentation auxiliary analysis system, and statistical analysis was performed using SPSS 26.0 software. Firstly, all data were tested for normality. For data conforming to a normal distribution, one-way ANOVA was used to compare the three groups, followed by post-hoc comparisons using the least significant difference (LSD) test. For non-normally distributed data, the Kruskal Wallis H nonparametric test was applied, with post-hoc comparisons performed using the Mann-Whitney U test and Bonferroni correction to control for errors in multiple comparisons. Additionally, correlation analysis was conducted to explore the relationship between brain structural changes and emotional and cognitive scores. Results(1) Compared to the HC group, the CHDD group showed significantly reduced cortical curvature in the right anterior middle frontal gyrus, inferior temporal gyrus, and lateral occipital cortex (P<0.05), and a significant increase in cortical surface area in the left superior temporal gyrus (P<0.05). (2) Compared to the HC group, CHD-nD patients exhibited a significant increase in the volume of the posterior corpus callosum and significant decreases in the proportion of whole brain volume in the left posterior cingulate gyrus, left operculum, right paracentral lobule, left hippocampal subiculum, left hippocampal fissure, and cortical curvature of the left entorhinal cortex (all P<0.05). (3) Compared to the HC group, the CHDD and CHD-nD groups showed significantly reduced proportions of whole brain volume in the bilateral medial orbitofrontal cortex. They left cuneus and reduced cortical curvature in the right precentral gyrus. Additionally, volume significantly increased in the right hippocampal fissure (all P<0.05). (4) Correlation analysis revealed that the Hamilton Depression Scale (HAMD) score was negatively correlated with the proportion of whole brain volume in the left medial orbitofrontal cortex (r=-0.228, P=0.025), right precentral gyrus (r=-0.239, P=0.019), and cortical curvature of the right lateral occipital cortex (r=-0.256, P=0.012), and positively correlated with the cortical surface area of the left superior temporal gyrus (r=0.254, P=0.013). The Montreal Cognitive Assessment (MoCA) score was positively correlated with the proportion of whole brain volume in the left medial orbitofrontal cortex (r=0.342, P=0.007). ConclusionsStructural abnormalities in the frontal lobe (precentral gyrus anterior and precentral gyrus), temporal lobe (inferior temporal gyrus and superior temporal gyrus slope), occipital lobe (lateral occipital gyrus and cuneus), and hippocampal fissure of CHDD patients may be the neuroanatomical basis of CHDD. These brain regions are related to patients^, emotional, and cognitive impairments. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.010 ObjectiveTo investigate the predictive value of CSVD burden score for recurrent cerebrovascular events (RCVEs) in patients with transient ischemic attack (TIA). Materials and MethodsA total of 182 patients with TIA who were treated in the Second People^,s Hospital of Anhui Province from October 2019 to December 2022 were selected as the research objects. The overall burden score of CSVD was calculated according to MRI examination. According to the presence or absence of RCVEs within 1 month of follow-up, they were divided into RCVEs group (n=46) and non-RCVEs group (n=136). The clinical data and CSVD total burden score were compared between the two groups. Multivariate logistic regression analysis model was used to analyze the independent risk factors of RCVEs. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of CSVD image feature score and total burden score for RCVEs in TIA patients. ResultsThere were significant differences in the number of TIA attacks, duration of symptoms, history of hypertension, total burden score and classification of CSVD between the RCVEs group and the non-RCVEs group (P<0.05). Multivariate Logistic regression analysis showed that the number of TIA attacks, the duration of symptoms, and the total burden score of CSVD were independent risk factors for RCVEs in TIA patients (P<0.05). The results of ROC curve analysis showed that the areas under curve (AUC) of CSVD imaging marker score and total burden score in predicting RCVEs in TIA patients were 0.771 (95% CI: 0.673-0.869, P<0.001), 0.745 (95% CI: 0.655-0.835, P<0.001), 0.664 (95% CI: 0.549-0.780, P=0.009), 0.845 (95% CI: 0.766-0.924, P<0.001), 0.945 (95% CI: 0.896-0.994, P<0.001), respectively. The AUC predicted by CVSD total burden score was the highest. When the optimal cutoff value was 2 points, the sensitivity was 86.05% and the specificity was 83.02%. ConclusionsThe CSVD total burden score has a good predictive value for RCVEs in TIA patients, which is helpful for clinical evaluation of short-term prognosis in TIA patients. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.011 ObjectiveTo quantitatively evaluate the myocardial strain by cardiac magnetic resonance feature tracking (CMR-FT) and investigate the value of cardiac magnetic resonance (CMR) parameters of patients with pulmonary hypertension due to left heart failure (PH-LHF). Materials and MethodsThe clinical and CMR data of 215 patients with left heart failure (LHF) hospitalized between September 2018 and September 2020 were retrospectively analyzed, and they were divided into two groups, 129 patients with LHF and 86 patients with PH-LHF according to systolic pulmonary artery pressure (sPAP) measured by echocardiography. The baseline data and CMR parameters, including biventricular related volumetric and functional parameters, structural parameters and myocardial strain parameters were statistically analyzed. Univariate and multivariate logistic regression analysis were used to analyze the independent predictors of PH-LHF, and receiver operating characteristics (ROC) curves were plotted to evaluate the diagnostic value of CMR parameters. ResultsIn patients with PH-LHF, left ventricular (LV) and right ventricular (RV) end diastolic volume index (EDVI), end systolic volume index (ESVI), right ventricular myocardial mass index (RVMMI), ventricular septal angle as well as left atrial structural parameters, including maximum of left atrial diameter (LAD_max) and maximum of left atrial area (LA-a_max) were higher than those in patients with LHF, while LV and RV ejection fraction (EF), right ventricular stroke volume index (RVSVI), right ventricular cardiac index (RVCI) were lower than those in patiets with LHF. LV global longitudinal strain (GLS), global circumferential strain (GCS) and the corresponding rate, RV GCS, left atrial active strain (εa), left atrial passive strain (εe), left atrial total strain (εs) were all decreased in patients with PH-LHF. Multivariate logistic regression analysis showed that RVEF, LV GCS, εa and LAD_max were independent predictors of PH-LHF. ROC analysis showed that the AUC values of the clinical model, CMR model and combined model were 0.773, 0.777 and 0.828, respectively. The DeLong test showed that the diagnostic performance of the clinical model was improved after the addition of CMR parameters (0.773 vs. 0.828, P<0.05). ConclusionsCMR-FT can quantitatively evaluate biventricular and left atrial strain, and reflect myocardial function in patients with PH-LHF. CMR has a certain clinical value in the assessment of patients with PH-LHF. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.012 ObjectiveTo predict the sensitivity of breast cancer to neoadjuvant therapy (NAT) based on multiparametric magnetic resonance imaging (mpMRI) combined with clinical variables. Materials and MethodsA total of 248 patients with pathologically confirmed breast cancer were enrolled in this study and randomly divided into a training group (173 cases) and a validation group (75 cases) in a 7∶3 ratio. All patients underwent mpMRI examination before NAT. The Miller-Payne (MP) grading system was used to assess the effectiveness of NAT, with MP grades 1-2 considered as insensitive to NAT response, and MP grades 3-5 as sensitive. Based on dynamic contrast-enhanced MRI (DCE-MRI), T2WI, and diffusion weighted imaging (DWI) sequence images to delineate tumor regions, to extract and filter imaging radiomics features. A radiomics score (Rad-score) was derived using the least absolute shrinkage and selection operator algorithm. Univariate logistic regression was ultilized to analyze clinical and pathological variables, including age, menstrual status, molecular subtype, chemotherapy regimen, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), and tumor proliferative index Ki-67. Significant clinical and pathological variables, along with the Rad-score, were included in the multivariate logistic regression analysis to establish an radiomics-clinical combined model and nomogram. The predictive performance of model was assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). ResultsUnivariate logistic regression analysis showed that Rad-score (P<0.001), ER expression status (P=0.001), and chemotherapy regimen (P=0.031) were significantly associated with the sensitivity of NAT in breast cancer. The AUC of the radiomics-clinical combined model constructed by Rad-score with ER expression status and chemotherapy regimen was 0.845 (95% CI: 0.780-0.910) in the training cohort, and 0.820 (95% CI: 0.718-0.923) in the validation cohort. The nomogram in prediction of breast cancer susceptibility to NAT had a higher degree of differentiation (C index: training queue is 0.842, validation queue is 0.822), the calibration curve shows good consistency. The clinical decision curve showed that the nomogram had a high overall net benefit. ConclusionsThe integration of radiomics and clinical variables and nomogram show promise in predicting sensitivity of breast cancer to neoadjuvant therapy. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.013 ObjectiveTo evaluate the diagnostic performance of Kaiser score and apparent diffusion coefficient (ADC) in the differential diagnosis of benign and malignant breast lesions during lactation. Materials and MethodsThis retrospective study enrolled 65 patients who underwent breast MRI in the Third Affiliated Hospital of Zhengzhou University from October 2016 to October 2023. The clinical, pathological and imaging data of 65 patients were collected. According to the pathological results, the cases were divided into malignant group (31 cases) and benign group (34 cases). One primary lesion was selected from each patient for Kaiser score and ADC value measurement. Lesions with Kaiser scores greater than 4 were reevaluated based on their ADC values, and new predictive indicator Kaiser+ were obtained. Using pathological results as the gold standard, and receiver operating characteristic (ROC) curve was used to compare the diagnostic accuracy of ADC value. Calculated the area under the curve (AUC), sensitivity, specificity, and accuracy, and compared the AUC of the three using DeLong test. ResultsThe AUC of ADC value was 0.818 [95% confidence interval (CI): 0.709-0.927]. The AUC of Kaiser score was 0.881 (95% CI: 0.791-0.971). The AUC of Kaiser+ score was 0.910 (95% CI: 0.931-0.990). The AUC between Kaiser+ score and ADC value was statistically significant (0.910 vs. 0.818, P=0.011). There was no significant difference in AUC between Kaiser score and ADC value (0.881 vs. 0.818, P=0.141), and there was no significant difference in AUC between Kaiser+ score and Kaiser score (0.910 vs. 0.881, P=0.151). ConclusionsKaiser+ score has higher diagnostic efficiency than ADC value, which can accurately identify benign and malignant breast lesions during lactation and provide reference for clinical development of personalized treatment plans. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.014 ObjectiveTo explore the association between MRI features of different pathological subtypes of uterine sarcoma and patients^, menopausal status. Materials and MethodsRetrospective analysis of clinical and imaging data of 68 patients with surgically and pathologically confirmed uterine sarcoma, including 17 cases of uterine leiomyosarcoma, 18 cases of endometrial stromal sarcoma, 9 cases of undifferentiated uterine sarcoma, and 24 cases of adenosarcoma; the menopausal status of the patients was summarized, including 41 (60.3%) postmenopausal and 27 (39.7%) premenopausal patients; their common MRI features were analyzed, including necrosis, hemorrhage, irregular or nodular tumor borders, and pelvic lymph node enlargement or peritoneal metastasis. By applying the χ²/Fisher test, an analysis is conducted on the distribution differences of MRI features across various menopausal statuses and different pathological subtypes, for multiple subgroup data with statistical significance, Bonferroni correction was applied for multiple comparisons. ResultsThe differences in pelvic lymph node enlargement or peritoneal metastasis among patients with uterine sarcoma in different menopausal statuses are statistically significant (P<0.05). However, necrosis, hemorrhage, and irregular or nodular tumor margins among patients with uterine sarcoma in different menopausal statuses do not show statistically significant differences (P>0.05). Regardless of menopausal status, irregular or nodular tumor margins have statistical significance in differentiating various pathological types (P<0.05), including comparisons between endometrial stromal sarcoma and adenosarcoma, and undifferentiated sarcoma and adenosarcoma in the menopausal state (P<0.008 3, Bonferroni correction), and between endometrial stromal sarcoma and adenosarcoma in the premenopausal state (P<0.008 3, Bonferroni correction). Necrosis, hemorrhage, pelvic lymph node enlargement, or peritoneal metastasis do not have statistical significance in differentiating among the pathological types (P>0.05). In the menopausal group, the proportion of adenosarcoma patients experiencing pelvic lymph node enlargement or peritoneal metastasis is significantly higher than in the non-menopausal group, which is statistically significant (P<0.05). ConclusionsAmong MRI features, changes in tumor border morphology have a certain diagnostic value for differentiating various subtypes of uterine sarcoma. Uterine adenosarcomas often present with regular, clear margins, whereas endometrial stromal sarcomas, undifferentiated sarcomas, and some leiomyosarcomas exhibit irregular or nodular tumor margins. Patients with adenosarcoma who have not yet reached menopause are more likely to exhibit lymph node or peritoneal metastasis compared to postmenopausal patients. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.015 ObjectiveTo investigate the accuracy and value of peritumoral and intratumoral radiomics models based on T2-weighted MRI in predicting the International Federation of Gynecology and Obstetrics (FIGO) stage of epithelial ovarian cancer (EOC). Materials and MethodsA total of 189 EOC patients from Suzhou Municipal Hospital (Center I) and the First Affiliated Hospital of Soochow University (Center Ⅱ) were retrospectively collected, including 87 patients with FIGO stage I/Ⅱ and 102 patients with FIGO stage Ⅲ/Ⅳ. The data from Center I were used for model training, while the data from Center Ⅱ were used as an external validation set. The region of interest (ROI) was drawn based on the tumor boundary and extended outwardly by 2 mm, 4 mm, 6 mm, 8 mm, and 10 mm to obtain multiple peritumoral information. A total of 1223 radiomics features were extracted from both intra- and peritumoral regions. Univariate analysis, correlation analysis, minimum redundancy maximum relevance, and least absolute shrinkage and selection operator (LASSO) algorithm were employed for feature selection. The performance of peritumoral radiomics models with different peritumoral extension ranges was compared in the training set to determine the optimal extension for constructing the peritumoral model. Subsequently, both intratumoral and clinical models were developed. The combined model was constructed based on intratumoral, peritumoral, and clinical features using a nomogram. Each individual model was subsequently applied to the external validation set, and their diagnostic performance was assessed through receiver operating characteristic (ROC) analysis. The DeLong test was employed to compare the differences in diagnostic efficacy between these models. ResultsThe peritumoral radiomics model demonstrated superior performance within an extended range of 2 mm, exhibiting an area under the ROC curve (AUC) of 0.840 in the training set. In the external validation set, the combined model exhibited optimal diagnostic performance, showcasing exceptional accuracy (74.2%), specificity (80.8%), and AUC (0.837). According to the DeLong test, the combined model significantly outperformed the peritumoral model (P=0.047). ConclusionsThe T2-weighted MRI-based peritumoral and intratumoral radiomics method demonstrated promising potential in effectively predicting the FIGO stage of EOC. Notably, the model combining peritumoral, intratumoral radiomics, and clinical information exhibits superior performance. This advanced model is anticipated to assist clinicians in accurately assessing patient conditions and devising personalized treatment plans. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.016 ObjectiveTo evaluate the therapeutic effect of electroacupuncture and stem cell transplantation on acute peripheral nerve injury by magnetic resonance diffusion tensor imaging (DTI). Materials and MethodsA total of 48 adult SD rats with successful modeling were randomly divided into an electroacupuncture (EA) group, a stem cell group and a control group, 16 rats in each group. The rats in the EA group were treated with EA at Huantiao (GB 30) and Zusanli (ST 36). Rats in the stem cell group were microinjected with 3μL saline suspension containing about 5×10⁵ bone marrow mesenchymal stem cells under the epineurium at the injury site. The control group was microinjected with the same volume of saline. Multi-parametric magnetic resonance imaging [DTI and T2-weighted fat saturation (T2WI-FS)], histological evaluation and immunohistochemical analysis were used to monitor the changes of nerve structure (including nerve diameter, myelin sheath thickness and morphological changes, axonal continuity recovery). Somatic functional index (SFI) and gait trajectory analysis were used to evaluate the motor function of sciatic nerve. The differences of T2 value, DTI parameters [fractional anisotropy (FA), radial diffusivity (RD)] and SFI values among different experimental groups were analyzed by repeated measures one-way ANOVA. Bonferroni test was used to correct the threshold results of multiple testing at different time points. ResultsAt the first week after acute peripheral nerve injury, the FA value of all groups decreased significantly, and then gradually increased, and returned to the normal level at the fourth week. The mean value of RD increased significantly within 1 week after surgery, then gradually decreased, and returned to the normal level at the 4th week. The recovery of rats in the EA group and the stem cell group was better than that in the control group at different time points (2-4 weeks) after operation, and the recovery in the EA group was the most significant (P<0.001). T2WI-FS showed that at 1, 2, and 4 weeks after operation, the EA group and the stem cell group had significant differences in the speed of nerve edema regression compared with the control group (P<0.001). The nerve diameter and T2 value increased significantly in the first week after operation, then gradually decreased, and returned to the normal level in the fourth week. Toluidine blue staining and SPRR1A axonal staining indicated that the nerve fiber continuity in the EA group recovered most rapidly, followed by the stem cell group. ConclusionsThe therapeutic effect of electroacupuncture on acute peripheral nerve injury is similar to that of stem cell transplantation, and it has great advantages in reducing edema and inflammatory response. DTI parameters FA and RD values are imaging markers of myelin integrity. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.017 ObjectiveTo investigate the effect of image quality of ultra-high b-values diffusion weighted imaging (DWI) with b=2000 s/mm² (DWI_b2000) and routine DWI with b=1000 s/mm² (DWI_b1000) by different bowel preparation (drinking folium sennae soup or dietary restrictions) in patients with rectal cancer (RC). Materials and MethodsThe DWI (DWI_b1000 and DWI_b2000) image quality and related factors were analyzed in 203 patients with RC between the bowel preparation group with folium sennae soup and the dietary restrictions groups. The bowel preparation metrics (rectal dilatation, rectal contents, amount of gas in rectum and amount of gas around the tumor) and magnetic susceptibility artifacts (overall artifacts and artifacts of the tumor area) were independently assessed in the DWI_b1000 and DWI_b2000 by two radiologists. Between-group comparisons of bowel preparation metrics and DWI artifacts were calculated using Mann-Whitney U test or t-test. Subsequently, DWI_b2000 artifact scores of less than or equal to 3 score in the tumor area was defined as clinical relevant artifacts. Univariate and multivariable logistic regression was used to assess related factors (bowel preparation methods, age, gender, tumor location, tumor circumferential percentage and thickness of posterior rectal mesentery) for DWI_b2000 clinical relevant artifacts. ResultsInter-reader agreement was good [intra-class correlation coefficient (ICC) >0.70]. The rectal contents, amount of gas in rectum and amount of gas around the tumor in the bowel preparation group with folium sennae soup were higher than those of the dietary restriction groups (P<0.05), respectively. The degree of overall artifacts and artifacts of the tumor area (DWI_b1000 and DWI_b2000) in the bowel preparation group with drinking folium sennae soup were significantly higher than those of the dietary restriction groups (P<0.05), respectively. In the same bowel preparation group, the degree of overall artifacts and artifacts of tumor area in DWI_b2000 were significantly higher than those of DWI_b1000 (P<0.01), respectively. Multivariable logistic regression analysis demonstrated that the bowel preparation method was an independent related factor for DWI_b2000 clinical relevant artifacts in tumor area (OR=3.463, 95% CI: 1.738-6.901, P<0.001). ConclusionsCompared with the dietary restriction group, patients with bowel preparation by drinking folium sennae soup can obtain good bowel preparation quality, reduce the DWI artifacts and improve the image quality of DWI_b1000 and DWI_b2000. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.018 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.020 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.021 ^,s disease (AD), characterized by decreased learning and memory abilities, with no impact on daily life. Acupuncture at Siguan point has a definite therapeutic effect on MCI and is widely used in clinical practice; acupuncture can improve cognitive function, but the principle of action is complex. Multimodal MRI provides visual support for the study of brain effects and efficacy assessment of acupuncture at the Siguan point in the treatment of MCI due to its advantages of precise localization and real-time observation of abnormal brain regions.In this article, structural MRI (sMRI), diffusion tensor imaging (DTI), blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI), magnetic resonance spectroscopy (MRS), and arterial spin labeling (ASL) were introduced to review the literature on cerebral structure, function, metabolism and blood perfusion of MCI treated by acupuncture at Siguan point. The intracerebral changes of MCI were discussed from multiple perspectives and the mechanism of acupuncture treatment was analyzed, it provides new ideas for the follow-up research of MCI. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.022 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.023 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.024 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.025 ^,s disease (AD), a leading cause of dementia, emphasizes the critical importance of early diagnosis for timely intervention and disease progression mitigation. In 2018, the National Institute of Aging and Alzheimer^,s Association (NIA-AA) introduced the ATN (amyloid/tau/neurodegeneration) diagnostic criteria for AD, which has garnered extensive clinical acceptance and utilization. This article offers a comprehensive review of the applications of positron emission tomography (PET), magnetic resonance imaging (MRI), and integrated positron emission tomography-magnetic resonance imaging (PET/MR) in the ATN diagnostic framework, and explores the profound advantages of multi-probe, multi-modal PET/MR in diagnosis. The objective is to provide researchers with novel perspectives and references for further investigation, drive the clinical application of PET/MR for AD patients, and furnish clinicians with crucial imaging evidence to support their practice ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.026 ^,s disease, and dementia. This article reviews the current research status of applying DTI-ALPS technology to evaluate GS function in patients with central nervous system diseases, aiming to provide new directions for neuroimaging research. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.027 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.028 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.029 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.030 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.031 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.032 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.033 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.034 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.035 Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.036 ^, understanding of UHF-MR, broaden researchers^, perspectives, further promote the development of novel contrast agents, the application of multimodal imaging techniques, and the integration of artificial intelligence-assisted diagnosis, thereby facilitating the clinical translation and application of UHF-MR in musculoskeletal system diseases. ]]> Thu,20 Jun 2024 00:00:00 GMT http://med-sci.cn/cgzcx/en/en_articlexml.asp?doi=10.12015/issn.1674-8034.2024.06.037 ^,s disease, multiple sclerosis, and brain gliomas. This article will review the principles of T1ρ imaging, factors influencing T1ρ values, and the current research status of clinical applications of T1ρ imaging, aiming to promote the continuous maturity of T1ρ technology and assist in guiding clinical diagnosis and treatment. ]]> Thu,20 Jun 2024 00:00:00 GMT