Objective To clarify relationship between signal heterogeneity on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI and prognosis of hepatocellular carcinoma (HCC). Methods From January 2014 to January 2017 in the First Affiliated Hospital of Chongqing Medical University, a total of 77 patients with the pathologically proved HCC underwent Gd-EOB-DTPA-enhanced MRI prior to surgery were included in this study. On the basis of the signal heterogeneity in the hepatobiliary phase, the included patients were designed to homogeneous hypointensity group and heterogeneous hyperintensity group. The disease-free survival time were compared between the 2 groups and it’s influencing factors were analyzed. Results Seventy-seven patients with HCC were included, including 45 cases of homogeneous hypointensity and 32 cases of heterogeneous hyperintensity. There were no significant differences in the age, gender, etiology, liver function, alpha-fetoprotein, differentiated degree, Child-Pugh grade, lesion diameter, lesion border, and number of lesions between the 2 groups (P>0.05). However, the HCC patients with heterogeneous hyperintensity had a later BCLC staging (P=0.001). The disease-free survival time of the patients with homogeneous hypointensity and heterogeneous hyperintensity was (17.0±9.8) months and (12.4±10.4)months, respectively. The Kaplan-Meier survival curve showed that the disease-free survival time in the patients with homogeneous hypointensity was significantly better than that in the patients with heterogeneous hyperintensity (P=0.020). The results of univariate analysis showed that the other confounding factors had no effect on the disease-free survival time of patients with hepatocellular carcinoma (P>0.05) except for the signal of hepatobiliary phase (P<0.05). Furthermore, the hepatobiliary phase signal, BCLC stage, and degree of differentiation, which might be clinically considered as potentially influencing for the prognosis of patients with HCC, were included in the Cox multivariate proportional hazard regression model and found that the heterogeneous hyperintensity was still the risk factor of the disease-free survival rate in patients with HCC (P=0.047). Conclusion Signal heterogeneity on hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI is related to prognosis of patients with HCC, heterogeneous hyperintensity may indicate a lower disease-free survival rate.
Migraine is the most common primary headache clinically, with high disability rate and heavy burden. Functional MRI (fMRI) plays a significant role in the study of migraine. This article reviews the main advances of migraine without aura (MwoA) based on resting-state fMRI in recent years, including the exploration of the mechanism of fMRI in the occurrence and development of MwoA in terms of regional functional activities and functional network connections, as well as the research progress of the potential clinical application of fMRI in aiding diagnosis and assessing treatment effect for MwoA. At last, this article summarizes the current distresses and prospects of fMRI research on MwoA.
Objective To summarize the CT, MRI, and positron emission computed tomography (PET) imaging findings of hematologic malignancies of the pancreas, so as to improve the capacity of its diagnosis. Methods After searching articles concerning radiological research about hematologic malignancies of the pancreas, summarizing its imaging characteristics. Results Hematologic malignancies of the pancreas include pancreatic lymphoma, pancreatic multiple myeloma, myeloid sarcoma, posttransplantation lymphoproliferative disorder, and giant lymph node hyperplasia. ① Pancreatic lymphoma: imaging features of pancreatic lymphoma are segmental or diffuse homogeneous enlargement of the pancreas, diameter of mass >5 cm, adenopathy below the level of renal veins, and lack of pancreatic duct dilation. Blurred margins of pancreas by lymphadenopathy is highly suggestive of lymphoma. ② Pancreatic multiple myeloma: pancreatic multiple myeloma are hyperintense on both T1- and T2-weighted images. ③ Pancreatic granulocytic sarcoma: pancreatic granulocytic sarcoma present as homogeneous hypoenhancing mass on CT, usually without pancreatic duct dilation. On MRI, the lesions are isointense and mildly hyperintense on T1- and T2-weighted images respectively. ④ Posttransplantation lymphoproliferative disorder: diameter of leison of posttransplantation lymphoproliferative disorder usually is >5 cm with poor enhancement. Lesions are mildly hyperintense on T2-weighted images and extremely hypermetabolic on PET images. ⑤ Giant lymph node hyperplasia: it mainly appear as solitary noninvasive masses. Punctate calcification and surrounding supply vessels are observed in hyaline vascular type. Plasma cell type demonstrate unapparent enhancement and less calcification. Conclusions Hematologic malignancies of the pancreas manifest different imaging features on CT, MRI, and PET. Familiarity with such characteristics helps to early recognize diseases and determine next-step measures.
Objective To identify and screen sensitive predictors associated with subscapularis (SSC) tendon tear and develop a web-based dynamic nomogram to assist clinicians in early identification and intervention of SSC tendon tear. Methods Between July 2016 and December 2021, 528 consecutive cases of patients who underwent shoulder arthroscopic surgery with completely MRI and clinical data were retrospectively analyzed. Patients admitted between July 2016 and July 2019 were included in the training cohort, and patients admitted between August 2019 and December 2021 were included in the validation cohort. According to the diagnosis of arthroscopy, the patients were divided into SSC tear group and non-SSC tear group. Univariate analysis, least absolute shrinkage and selection operator (LASSO) method, and 10-fold cross-validation method were used to screen for reliable predictors highly associated with SSC tendon tear in a training set cohort, and R language was used to build a nomogram model for internal and external validation. The prediction performance of the nomogram was evaluated by concordance index (C-index) and calibration curve with 1 000 Bootstrap. Receiver operating curves were drawn to evaluate the diagnostic performance (sensitivity, specificity, predictive value, likelihood ratio) of the predictive model and MRI (based on direct signs), respectively. Decision curve analysis (DCA) was used to evaluate the clinical implications of predictive models and MRI. Results The nomogram model showed good discrimination in predicting the risk of SSC tendon tear in patients [C-index=0.878; 95%CI (0.839, 0.918)], and the calibration curve showed that the predicted results were basically consistent with the actual results. The research identified 6 predictors highly associated with SSC tendon tears, including coracohumeral distance (oblique sagittal) reduction, effusion sign (Y-plane), subcoracoid effusion sign, biceps long head tendon displacement (dislocation/subluxation), multiple posterosuperior rotator cuff tears (≥2, supra/infraspinatus), and MRI suspected SSC tear (based on direct sign). Compared with MRI diagnosis based on direct signs of SSC tendon tear, the predictive model had superior sensitivity (80.2% vs. 57.0%), positive predictive value (53.9% vs. 53.3%), negative predictive value (92.7% vs. 86.3%), positive likelihood ratio (3.75 vs. 3.66), and negative likelihood ratio (0.25 vs. 0.51). DCA suggested that the predictive model could produce higher clinical benefit when the risk threshold probability was between 3% and 93%. ConclusionThe nomogram model can reliably predict the risk of SSC tendon tear and can be used as an important tool for auxiliary diagnosis.
Objective To review the current status of magnetic resonance imaging (MRI) techniques in the evaluation of hepatic fibrosis. Methods The application and recent advances of various kinds of MRI techniques in evaluating hepatic fibrosis were summarized by literature review. Results The state-of-the-art of MRI evaluating of hepatic fibrosis included common contrast-enhanced MRI, double contrast-enhanced MRI, and various functional MRI techniques. Common contrast-enhanced MRI could detect morphological changes of the liver, but little value in phasing. Double contrast-enhanced MRI markedly increased the contrast to noise ratio. Except diagnosis liver fibrosis, functional MRI also could phase it by its serverity. Conclusion MRI techniques, especially those functional MRI techniques, are advancing very fast and have very great potentiality in both the diagnosis and severity assessment of hepatic fibrosis.
ObjectiveTo investigate the value of proton magnetic resonance spectroscopy (1H-MRS), gradient dual-echo, and triple-echo sequences in the quantitative evaluation of treatment effect of fatty liver at 3.0T MR.MethodsThirty patients with fatty liver diagnosed by CT or ultrasound who admitted in Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital between August 2017 and May 2018, were enrolled and undergone gradient dual-echo, triple-echo, and 1H-MRS examination before and 3 months after treatment. The fat index (FI) and relative lipid content (RLC) were measured. Fatty liver index (FLI) was calculated from blood biochemical indicators, waist circumference, and BMI at the same time. With the reference standard of FLI, the results before and after treatment measured from MRI were analyzed.ResultsThere were significantly differences of FLI, FIdual, FItriple, and RLC before and after treatment (t=5.281, P<0.001; Z=–3.651, P<0.001; Z=–3.630, P<0.001; Z=–4.762, P<0.001), all indexes decreased after treatment. FIdual and FItriple were positively correlated with FLI before (rs=0.413, P=0.023; rs=0.396, P=0.030) and after treatment (rs=0.395, P=0.031; rs=0.519, P=0.003), the highest correlation factor was FItriple to FLI after treatment. There were no significant correlation between RLC and FLI before and after treatment (P>0.05).ConclusionsIt is feasible to quantitatively evaluate the treatment effect of fatty liver by using 1H-MRS, gradient dual-echo, and triple-echo sequences. Gradient triple-echo sequences has better accuracy, which is technically easy to implement and more suitable for clinical development.
In order to accurately implant the brain electrodes of carp robot for positioning and navigation, the three-dimensional model of brain structure and brain electrodes is to be proposed in the study. In this study, the tungsten electrodes were implanted into the cerebellum of a carp with the aid of brain stereotaxic instrument. The brain motor areas were found and their three-dimensional coordinate values were obtained by the aquatic electricity stimulation experiments and the underwater control experiments. The carp brain and the brain electrodes were imaged by 3.0 T magnetic resonance imaging instrument, and the three-dimensional reconstruction of carp brain and brain electrodes was carried out by the 3D-DOCTOR software and the Mimics software. The results showed that the brain motor areas and their coordinate values were accurate. The relative spatial position relationships between brain electrodes and brain tissue, brain tissue and skull surface could be observed by the three-dimensional reconstruction map of brain tissue and brain electrodes which reconstructed the three-dimensional structure of brain. The anatomical position of the three-dimensional reconstructed brain tissue in magnetic resonance image and the relationship between brain tissue and skull surface could be observed through the three-dimensional reconstruction comprehensive display map of brain tissue. The three-dimensional reconstruction model in this study can provide a navigation tool for brain electrodes implantation.
ObjectiveTo observe the accuracy of magnetic resonance imaging (MRI) for predicting pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer, and to analyze the cause of the prediction error.MethodsData from 157 breast cancer patients who underwent NAC before surgery in Mianyang Central Hospital from January 2017 to January 2019 were analyzed. MRI parameters before and after NAC and pCR conditions were collected to analyze the parameters that produced false positives and false negatives.ResultsOf the 157 patients, 37 (23.6%) achieved pCR after NAC, and 33 (21.0%) achieved radiation complete remission (rCR) after NAC. The accuracy of MRI prediction was 70.7% (111/157), the sensitivity was 82.5% (99/120), and the specificity was 32.4% (12/37). A total of 25 cases did not achieve rCR, but postoperative evaluation achieved pCR (false positive), 21 cases achieved rCR, but postoperative evaluation did not achieve pCR (false negative). Diameter of tumor, peritumoral oedema, and background parenchymal enhancement were associated with MRI false positive prediction (P<0.05); gland density and tumor rim enhancement were associated with MRI false negative prediction (P<0.05).ConclusionMRI can be used as an important method to predict pCR after NAC in breast cancer patients, and its accuracy may be related to diameter of tumor, peritumoral oedema, background parenchymal enhancement, gland density, and tumor rim enhancement.
To solve the problem of precise positioning of carp brain tissue coordinates, it is proposed in this paper for a method for transforming the coordinates of magnetic resonance imaging of carp brain tissue into the coordinates of electrode implantation using a brain stereotaxic apparatus. In this study, the 3.0T magnetic resonance imaging instrument was used to scan the carp brain. We independently established the three-dimensional positioning coordinate system of the brain, the three-dimensional coordinate assistance system of skull surface and the three-dimensional coordinate assistance system in brain tissue. After two coordinate transformations, the magnetic resonance image coordinates of the brain electrodes implantation sites were converted into the three-dimensional stereotactic coordinate system to guide the electrodes implantation. The experimental groups were divided into two groups, A and B. Group A was the group of magnetic resonance imaging apparatus combining with the brain stereotaxic apparatus, and group B was the group of brain atlas combining with the brain stereotaxic apparatus. Each group had 20 tails of carps (n = 20). This two methods were used to implant the electrodes into the cerebellar motor area. The underwater experiments of the carp robots were carried out to test the two methods. The results showed that the accuracy of the implanted electrodes were 90% in group A and 60% in group B. The success rate of group A was significantly higher than that of group B (P < 0.05). Therefore, the new method in this paper can accurately determine the coordinates of carp brain tissue.
The patients with rectal cancer account for 50% or more of patients with colorectal cancer. The rectal magnetic resonance imaging (MRI) plays a pivotal role in clinical practice for evaluating the treatment baseline of tumors. The structured report of MRI serves as the foundation so as to promote homogenized, standardized, and normalized diagnosis and treatment of rectal cancer. We presented the MRI-based baseline evaluation structured reporting system for rectal cancer developed by West China Hospital of Sichuan University, aiming to advance the standardization and normalization of imaging reports for treatment baseline assessment in rectal cancer.