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Objective:To investigate magnetic resonance imaging (MRI) findings of primary ovarian leiomyoma (POL) and improve the understanding of the disease.Methods:The clinical data of four cases of POL confirmed by surgical pathology who received treatment in Huadu District People's Hospital between September 2006 and August 2018 were retrospectively analyzed. MRI manifestations and pathological features of POL were analyzed.Results:In four cases, POL occurred in unilateral ovarium and appeared to be a single quasi round mass with complete capsule and clear boundary. A solid mass was observed in three cases and a cystic solid mass in one case. Subcapsular effusion was observed in three cases with a relatively large tumor body. Typical MRI findings were iso-intensity or slight hypo-intensity signal on T 1WI, hypo-intensity signal on T 2WI and diffusion-weighted images. The solid part on enhanced scan was enhanced synchronously with the uterus. Atypical T 2WI findings included cystic changes as shown by varying degrees of hyper-intensity signal, and the cystic change area was not enhanced. The internal signal and pathological features of POL were similar to those of uterine leiomyoma. Conclusion:The research results are highly innovative and scientific. MRI is of great significance in the diagnosis and differential diagnosis of POL.
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Objective To determine imaging features that may help predict the presence of placenta accreta , placenta increta or placenta percreta on prenatal MRI scanning in order to identify the most diagnostic findings . Methods The prenatal MRI scan data of placenta accreta,placenta increta or placenta percreta (placenta implantation group,n＝15) and normal placenta (placenta normal group,n＝15) diagnosed and treated by surgical pathology from January 2010 to December 2017 in the Peopleˊs Hospital of Huadu District were retrospectively analyzed.Two expert MRI doctors were blinded to the patientsˊtrue diagnosis and were asked to score a total of 10 MRI features of the placenta and adjacent structures.The interrater reliability was assessed using kappa statistics.The features with a moderate kappa statistic or better ( kappa ＞0.40 ) were then compared with the true diagnosis for each observer. Results Eight of the scored features had an interobserver reliability of kappa ＞0.40:placenta previa (κ＝0.89);abnormal uterine bulging(κ＝0.57);intraplacental hemorrhage (κ＝0.45);the presence of dark intraplacental bands on T2 W imaging( κ＝0.76); flow －empty blood vessels in placenta ( κ＝0.67); border on placenta and uterus blurring(κ＝0.63);heterogeneity of signal intensity on T 2 －weighted( T2 W) imaging(κ＝0.53);and continuity of myometrium was interrupted ( κ＝0.64).Using Fisherˊs two －sided exact test, there were statistically significant differences between the proportion of patients with placental invasion and those without placental invasion for three of the features:abnormal uterine bulging ( P＝0.015,P＝0.011);heterogeneity of T2 W imaging signal intensity ( P＝0.006,P＝0.013);and presence of dark intraplacental bands on T 2 W imaging(P＝0.032,P＝0.010).Conclusion MRI can be a useful adjunct to ultrasound in diagnosing placenta accreta prenatally.Three features that are seen on MRI in patients with placental invasion appear to be useful for diagnosis : uterine bulging; heterogeneous signal intensity within the placenta;and the presence of dark intraplacental bands on T 2 W imaging.
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Objective@#To determine imaging features that may help predict the presence of placenta accreta, placenta increta or placenta percreta on prenatal MRI scanning in order to identify the most diagnostic findings.@*Methods@#The prenatal MRI scan data of placenta accreta, placenta increta or placenta percreta (placenta implantation group, n=15) and normal placenta(placenta normal group, n=15) diagnosed and treated by surgical pathology from January 2010 to December 2017 in the People's Hospital of Huadu District were retrospectively analyzed.Two expert MRI doctors were blinded to the patients' true diagnosis and were asked to score a total of 10 MRI features of the placenta and adjacent structures.The interrater reliability was assessed using kappa statistics.The features with a moderate kappa statistic or better(kappa>0.40 ) were then compared with the true diagnosis for each observer.@*Results@#Eight of the scored features had an interobserver reliability of kappa>0.40: placenta previa(κ=0.89); abnormal uterine bulging(κ=0.57); intraplacental hemorrhage(κ=0.45); the presence of dark intraplacental bands on T2W imaging(κ=0.76); flow-empty blood vessels in placenta(κ=0.67); border on placenta and uterus blurring(κ=0.63); heterogeneity of signal intensity on T2-weighted(T2W) imaging(κ=0.53); and continuity of myometrium was interrupted(κ=0.64). Using Fisher's two-sided exact test, there were statistically significant differences between the proportion of patients with placental invasion and those without placental invasion for three of the features: abnormal uterine bulging(P=0.015, P=0.011); heterogeneity of T2W imaging signal intensity(P=0.006, P=0.013); and presence of dark intraplacental bands on T2W imaging(P=0.032, P=0.010).@*Conclusion@#MRI can be a useful adjunct to ultrasound in diagnosing placenta accreta prenatally.Three features that are seen on MRI in patients with placental invasion appear to be useful for diagnosis: uterine bulging; heterogeneous signal intensity within the placenta; and the presence of dark intraplacental bands on T2W imaging.
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Objective To evaluate the response of neoadjuvant chemotherapy on osteosarcoma by semi-quantitative parameters of dynamic contrast-enhancement magnetic resonance imaging (DCE-MRI).Methods Retrospectively analysis 25 cases of osteosarcoma confirmed by pathology.All cases received DCE-MRI scan before and after 4 cycles of neoadjuvant chemotherapy.The following semi-quantitative parameters were calculated by post-processing software:early dynamic enhancement wash-in slope (Slope),maximum signal intensity (SImax),time to peak (TTP),signal enhanced extent (SEE),peak percent enhancement (PPE),wash out rate (WOR),enhancement rate (R).All cases were divided into good response group (tumor necrosis rate ≥90％,n =12) and non-response group (tumor necrosis rate ＜90％,n =13) according to the Huvos grading method.Semi-quantitative parameters of DCE-MRI before and after neoadjuvant chemotherapy between good response group and non-response group were compared by Mannwhitney U test.Receiver operating characteristic curve (ROC) analysis was performed to evaluate the efficacy of different good response group and non-response group after neoadjuvant chemotherapy (NAC).Results Slope,SImax,TTP,SEE,PPE,WOR,R,TTP,WOR before and after NAC in good response group were significant different (P ＜ 0.05),but only SImax,SEE in non-response group.TTP,R were significant different between the above two groups before NAC,and Slope,Simax,TTP,SEE,WOR,R were significant different after NAC (P ＜ 0.05).ROC was used to predict the diagnostic efficiency of various parameters for tumor necrosis rate after osteosarcoma NAC.It was found that the sensitivity and specificity of Slope,TTP and R parameters for predicting the response of osteosarcoma after chemotherapy were 83.3％ and92.3％,91.7％ and 69.2％,84.6％ and 75.0％ respectively.The area under the curve (AUC)were 0.872 (95％ CI:0.716 to 1.027),0.846 (95％ CI:0.685 to 1.007),0.833 (95％ CI:0.662 to 1.004),the cut-off value were 0.032,175 s,5.441,Youden index were 0.756,0.609,0.596,respectively.Conclusions Slope,TTP,R were the most valuable semi-quantitative parameter of DCE-MRI to predict the response of NAC in osteosarcoma.
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Objective@#To evaluate the response of neoadjuvant chemotherapy on osteosarcoma by semi-quantitative parameters of dynamic contrast-enhancement magnetic resonance imaging (DCE-MRI).@*Methods@#Retrospectively analysis 25 cases of osteosarcoma confirmed by pathology.All cases received DCE-MRI scan before and after 4 cycles of neoadjuvant chemotherapy.The following semi-quantitative parameters were calculated by post-processing software: early dynamic enhancement wash-in slope (Slope), maximum signal intensity (SImax), time to peak (TTP), signal enhanced extent (SEE), peak percent enhancement (PPE), wash out rate (WOR), enhancement rate (R). All cases were divided into good response group (tumor necrosis rate ≥90%, n=12) and non-response group (tumor necrosis rate <90%, n=13) according to the Huvos grading method. Semi-quantitative parameters of DCE-MRI before and after neoadjuvant chemotherapy between good response group and non-response group were compared by Mann-whitney U test. Receiver operating characteristic curve (ROC) analysis was performed to evaluate the efficacy of different good response group and non-response group after neoadjuvant chemotherapy (NAC).@*Results@#Slope, SImax, TTP, SEE, PPE, WOR, R, TTP, WOR before and after NAC in good response group were significant different (P<0. 05), but only SImax, SEE in non-response group. TTP, R were significant different between the above two groups before NAC, and Slope, SImax, TTP, SEE, WOR, R were significant different after NAC (P<0.05). ROC was used to predict the diagnostic efficiency of various parameters for tumor necrosis rate after osteosarcoma NAC. It was found that the sensitivity and specificity of Slope, TTP and R parameters for predicting the response of osteosarcoma after chemotherapy were 83.3% and 92.3%, 91.7% and 69.2%, 84.6% and 75.0% respectively. The area under the curve (AUC) were 0.872 (95% CI: 0.716 to 1.027), 0.846 (95% CI: 0.685 to 1.007), 0.833 (95% CI: 0.662 to 1.004), the cut-off value were 0.032, 175 s, 5.441, Youden index were 0.756, 0.609, 0.596, respectively.@*Conclusions@#Slope, TTP, R were the most valuable semi-quantitative parameter of DCE-MRI to predict the response of NAC in osteosarcoma.
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To investigate the influential factors for depression and anxiety in patients with chronic wounds, and the relationship between depression and anxiety and social support or quality of life. Methods: We used convenience sampling method to enroll 150 patients with chronic wounds. Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), Short Form 36 Health Survey (SF-36) and Social Support Rating Scale (SSRS) were used to assess the level of depression and anxiety, quality of life, and social support in patients with chronic wounds. Results: The detection rate of depression and anxiety in patients with chronic wounds was 45.3% and 14% respectively. In patients with chronic wounds, age was positively correlated with SDS and SAS scores (P<0.05), while education, eight factors of SF-36, objective support, subjective support, and social support scores of SSRS were negatively correlated with SDS and SAS scores (P<0.05). Further multiple regression analysis showed that the duration of wounds, physical functional score, role physical score and role emotional score of SF-36, objective support score, subjective support score, support utilization score, and social support score of SSRS were the independent influential factors for SDS score (P<0.05). Education, general health score, social functional score, and mental health score of SSRS were the independent factors for SAS score (P<0.05). Conclusion: The lower quality of life and social support of patients with chronic wounds could increase their depression and anxiety. While treating patients with chronic wounds, medical staff should also pay attention to the mutual influence between anxiety and depression, or quality of life and social support.