Application of 3.0 T non-contrast coronary MR angiography in children with Kawasaki disease / 中华放射学杂志

Objective:To explore the diagnostic accuracy and application value of 3.0 T non-contrast coronary magnetic resonance angiography (CMRA) in evaluating coronary artery in children with Kawasaki disease (KD).Methods:From May 2019 to January 2022, 75 children diagnosed with KD in our hospital were enrolled. All the patients underwent CMRA and transthoracic echocardiography (TTE) in one week, twenty-six of whom underwent coronary CT angiography (CCTA) or invasive coronary angiography (ICA) within two weeks. The diagnostic performance of CMRA and TTE was evaluated with CCTA/ICA as reference standard by per-patient basis, per-vessel basis, per-segment basis. Sensitivity and specificity of CMRA and TTE was compared by paired chi square test.The distribution of coronary artery aneurysm (CAA), thrombosis and other pathological changes of coronary artery were recorded and compared between two methods. The patients′ height and weight were collected to calculate the Z value. Z value>2.5 was defined as CAA.Results:All patients successfully completed CMRA examinations. Among the 26 patients, the sensitivity of CMRA was significantly higher than that of TTE by per coronary artery[97.7%(43/44)vs.84.1%(37/44), χ2=4.17, P<0.05]. CMRA showed a higher sensitivity than that of TTE both by proximal segments and middle/distal segments [97.7%(43/44)vs. 84.1%(37/44), 100%(21/21) vs. 52.4%(11/21), χ2=10.08, 7.11, both P<0.05). A total of 115 CAAs was found by CMRA, while only 87 (75.7%) CAAs were observed by TTE. Of the 28 (24.3%) CAAs missed by TTE, 16 (57.1%) were located in right coronary artery (RCA), 2(7.1%) in left main coronary artery, 7(25.0%) in left anterior ascending coronary artery (LAD) and 3(10.7%) in left circumflex coronary artery (LCX). Eleven (39.3%) missed CAAs by TTE were located in the proximal segment of RCA, LMCA, LAD and LCX, and 17 (60.7%) missed CAAs were located in the middle and distal segments. TTE missed coronary thrombosis in 5 patients compared with CMRA. Conclusions:3.0 T non-contrast CMRA is non-invasive and non-radiation, and the image quality can meet the needs of diagnosis, especially for detection of CAAs in RCA or in middle and distal segments of coronary artery in KD patients.

Evaluatingthecorrelationbetweenvolumeoftheperipherallungadenocarcinoma andlymphnodemetastasison MSCT / 实用放射学杂志

Objective Todeterminetherelationshipbetweenthetumorvolumeoftheperipherallungadenocarcinomawith maximum diameter≤3cmandlymphnodemetastasis(LNM).Methods TheMSCTmanifestationsof235subjectswhowerediagnosedasperipheral lungadenocarcinomawithmaximumdiameter≤3cm wereretrospectivelyanalyzed.Thesepatientsweregroupedaccordingtodifferent parametersincludingsmokinghistory,differentiation,tumorconsistencyandavailabilityoftumornecrosis.Tumorvolumeandratesof LNMamongthesegroupswerecompared.ROCanalysiswasusedtocalculatethecut-offvalueanddiagnosticaccuracy.Results (1) ThetumorvolumeofLNMgroupwaslargerthanthatofnoLNMgroup,cut-offvaluewas5.5cm3,andAUCwas0.76;(2)Therates ofLNMofthewell,moderate-well,moderate,moderate-poorandpoordifferentiationgroupswere0%,8.7%,17.7%,45.6%and46.7%respectively.Theratesofpuregroundglassopacity(p-GGO),mixedandsolidtumorwere0%,8.3%and29.3%respectively.The ratesofthetumorpresentandabsentofnecrosiswere47.8%,22.0%respectively(P＜0.05).Conclusion Usingthevolumeoftumor on MSCTtopredictLNMisanewnon-invasivewayofassessingLNM,withhighsensitivityandspecificity,whichcouldsupplymore imaginginformationforsurgeonstochoosethewayoflymphnodedissection.

Assessment of left ventricular systolic function with magnetic resonance imaging: comparison with that of echocardiography / 生物医学工程学杂志

This study is designed to test the agreement in measuring left ventricular systolic function between transthoracic two-dimensional echocardiography (2DTTE) and "gold standard" of non-invasive cardiac imaging, magnetic resonance imaging (CMRI) and their impacts on the classification of patients according to the left ventricular ejection fraction (EF). 32 patients who were suspected with heart disease were evaluated by CMRI and 2DTTE examinations. End diastolic volume (EDV), end systolic volume (ESV), EF and left ventricular function category were then calculated and compared. There was no significant difference (P=0.504) for EDV, while ESV of CMRI was significantly higher than that of 2DTTE (P=0.049), and EF of CMRI was significantly lower than that of 2DTTE (P= 0.018). There was no significant difference (P=0.077) in left ventricular functional category. Bland-Altman analysis of LV volumetric data and EF measurements showed a good agreement between two methods. The 2DTTE over-estimated I (n=5) or II (n=1) degrees of functional classification when compared with the CMRI. Both CMRI and 2DTTE are of great clinical value in evaluating left ventricular systolic function, while CMR may be more beneficial to patients with abnormal LV functions.

MDCT features and anatomic-pathological basis of thyroid diseases involving the upper mediastinum / 生物医学工程学杂志

To determine the multidetector computed tomography (MDCT) features as well as the anatomic-pathological basis in thyroid diseases involving the upper mediastinum, we performed a retrospective analysis of 49 patients who had thyroid diseases involving the upper mediastinum. In the study, 22 cases were nodular goiter, 13 cases were thyroid adenoma, and 14 cases were thyroid cancer. The relevance between MDCT appearances and their diffusing route of common thyroid diseases as well as the anatomic-pathological features in this region were evaluated. It was found that the lesions located in the upper anterior mediastinum, the upper posterior mediastinum, and both sides were 67.3% (33/49), 14.3% (7/49), 18.4% (9/49), respectively. Different diseases had their distinct MDCT features nodular goiter mainly showed localized and multiple nodules or tumor bulk (77.3%), thyroid adenoma mainly showed solitary tumor bulk (92.3%), and thyroid cancer mainly demonstrated solitary tumor bulk (57.1%), respectively. Among the 49 cases, 9 cases had cervical and/or mediastinal metastases in lymph nodes. The thyroid diseases involving the upper mediastinum most commonly occurred in the upper anterior mediastinum. The MDCT features and distribution of diffusing thyroid lesions in cervico-thoracic junctional region closely correlated with the anatomic-pathological characteristics in this region.

MDCT features and anatomic-pathological basis of lymphoid neoplasm in cervico-thoracic junctional region / 生物医学工程学杂志

To determine the relevance between MDCT features and anatomic-pathological basis of lymphoid neoplasm in cervico-thoracic junctional region, we performed a retrospective analysis of 69 patients with lymphoid neoplasm (lymphoma: 41 patients; metastatic tumor: 28 patients) involving the cervico-thoracic junctional region for MDCT features and distribution of lesions. The relevance between MDCT features and the anatomic-pathological basis in this region were evaluated. Among all the 41 patients with lymphoma, 29 with NHL (70.7%), 12 with HD (29.3%). The lymphomatous lymphadenopathy mainly located in superficial lateral cervix (51.2%, 21/41) ,deep jugular chain (65.9%, 27/41), supraclavicular fossa (75.6%, 31/41), paratrachea space in anterior mediastinum (46.3%, 19/41), around aortic arch (56.1%, 23/41), aortopulmonary window (53.7%, 22/41), upper anterior mediastinum (41.5%, 17/41), subcarinal space (26.8%, 11/41) and paraesophageal space (17.1%, 7/41). 28 patients had metastatic lymphoid tumor. The primary tumor were nasopharynx tumor (5 patients), thyroid cancer (7 patients), lung cancer (10 patients), and esophageal cancer (6 patients). Most metastasis took stage by stage in the way of lymphatic return, but a minority of cases migrated jumpily. The main metastatic sites were: beside jugular chain (82.1%), supraclavicular fossa (75%), paratracheal in anterior mediastinum (60.7%), upper anterior mediastinum (64.3%), beside aortic arch (35.7%), aortopulmonary window (39.2%), and paraesophageal space (28.6%). So lymphoid neoplasms in cervico-thoracic junctional region were involving both lower cervix and upper thorax simultaneously. The MDCT features and main distribution of lesions correlated with the anatomic-pathological characteristics in this region.