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Objective:To explore the risk factors of microvascular invasion (MVI) in hepatocellular carcinoma (HCC), and to predict MVI preoperatively, non-invasively and accurately.Methods:A total of 150 HCC patients (183 HCC lesions) were retrospectively collected in the First Affiliated Hospital of Xi′an Jiaotong University from January 2016 to June 2022.The clinical data and hematological data, gray-scale ultrasonography (US), contrast-enhanced ultrasonography (CEUS), enhanced magnetic resonance imaging with gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (EOB-MRI) and pathological data of these patients were recorded. According to the pathological diagnosis of MVI, the lesions were divided into MVI (+ ) group and MVI (-) group. The indicators between the two groups were compared. All 183 lesions were put into the training set, and the prediction model with nomogram was constructed according to the risk factors of MVI selected by multivariate Logistic regression. The internal verification was carried out by ten-fold cross-validation method.Results:There were significant statistical differences in the following parameters between MVI (+ ) group ( n=109) and MVI (-) group ( n=74) (all P<0.05). These were cirrhosis, serological parameters (alpha-fetoprotein, albumin, total bilirubin), qualitative indexes of US (size, boundary, internal echo), qualitative indexes of CEUS (hyper/iso/hypovascularity of lesions in arterial phase, portal phase, and delayed phase compared with hepatic parenchyma), and quantitative indexes of EOB-MRI [post enhancement rate (post ratio) and gadolinium disodium rate (EOB ratio)] calculated mainly in terms of lesions and surrounding liver parenchyma in hepatobiliary phase and unenhanced T1 images). Finally, cirrhosis of patients, the size, boundary, internal echo of lesions in US; arterial phase (AP), portal phase (PP), post-vascular phase (PVP) features in CEUS; the EOB rate and post rate of EOB-MRI entered the prediction model of MVI. The training set exhibited good calibration and net gain rate. The areas under the ROC curve for the training set and the validation set were 0.981 and 0.961, respectively, while the diagnostic accuracy were 92.9% and 85.8%, respectively. Conclusions:The model constructed mainly by multimodality imaging methods can achieve favorable predictive performance for MVI, which provides valuable ideas for noninvasively predicting the incidence of MVI and optimizing the MVI-related treatment of MVI in HCC patients.
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Objective To investigate the value of whole-tumor histogram analysis of quantitative perfusion in the prediction of ablation response in MR-guided high-intensity focused ultrasound (MR-HIFU)treatment for uterine fibroids.Methods A total of 31 fibroids in 28 eligible patients were treated with MR-HIFU.Four histogram parameters of the quantitative perfusion parameter (Ktrans )were obtained prior to MR-HIFU treatment:mean,median,skewness and kurtosis.T1 contrast-enhanced MRI immediately after MR-HIFU was performed to determine the non-perfused volume (NPV)and acquire non-perfused volume ratio (NPVR).The relationship between NPVR and all fibroid characteristics was determined by Spearman correlation analysis.Results The 3 1 fibroids were divided into high-response group and low-response group according to whether NPVR was higher than 60%.Four histogram metrics of Ktrans showed statistical difference between the two groups.The mean and median of Ktrans ,fibroid maximum diameter and T2 signal intensity type were correlated with NPVR.The Spearman correlation coefficient were －0.60,－0.66,－0.45 and －0.39,respectively (P＜0.05).Conclusion Uterine fibroids with lower whole-tumor Ktrans can achieve higher immediate ablation efficiency in MR-HIFU.Together with its histogram metrics,it might be a valuable indicator for patient selecting.
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Objective To assess the non-invasive and quantitative value of diffusion tensor imaging (DTI)in the diagnosis,differ-ential diagnosis and classification of renal occupying lesions.Methods 30 healthy volunteers and 126 suspected cases with renal space-occupying lesions underwent conventional magnetic resonance imaging (MRI)and DTI scans.A total of 144 lesions were found in 126 patients.DTI was performed in 6 directions with b values of 0 and 500 s/mm2 .Fractional anisotropy (FA)and appar-ent diffusion coefficient(ADC)values were measured.Results With b values at 500 s/mm2 ,FA and ADC values between the nor-mal renal cortex and medulla in renal carcinoma,renal angiomyolipomas,renal cysts were pairwisely compared and there were all statistical difference (P <0.05).Difference of FA and ADC values between clear renal cell carcinoma and non-clear cell carcinoma was also significant (P <0.05).Conclusion FA and ADC values could distinguish benign from malignant renal tumour which may be helpful in the speculation of renal carcinoma pathological types.
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Objective To study the CT manifestations and diagnostic value of stromal tumor.Methods CT documentation of 25 stromal tumor cases confirmed by surgery and pathology were analyzed retrospectively,all cases underwent 64 row or 256 row spiral CT plain scan and enhanced scan.Results Within 25 cases,1 7 cases were gastrointestinal,of which,10 cases were found in stom-ach,1 case in duodenum,3 cases in jejunum and 3 cases in ileum;and 8 cases were extra-gastrointestinal,of which,6 cases were found in enterocoelia,1 cases in inguinal region,1 case in abdominal wall;the ratio was 2.1 ︰ 1.In 25 cases,highly malignant dan-ger level were 1 1 cases,7 cases of moderate and 7 cases of low malignant danger;Transfer occurred in 7 cases and 3 cases of postop-erative recurrence.Conclusion The volume CT has great advantages in displaying information in lesion,and has high value in loca-ting the lesion and qualitative diagnosis of disease.
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Objective To explore the characteristics and applied value of diffusion-weighted MR imaging of kidney in healthy people.Methods Using Philips Gyroscan Intera 1.5T MR System,DWI of kidney was performed in 40 healthy adult volunteers,the ADCs of renal cortex and medulla were measured.Results The cortex and medulla of the normal kidney could be clearly showed by DWI.The ADCs of the cortex medulla and average were 3.08?0.52,2.74?0.68 and 2.91?0.58;2.79?0.51,2.53?0.65 and 2.63?0.62;2.64?0.43,2.32?0.47 and 2.48?0.44 when the b values were 300,500 and 800 s/mm2,respectively.The ADC was higher in the cortex than that in the medulla.Conclusion DWI can be used in kidney,it may be helpful for the diagnosis of renal diseases.
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Objective To study the applied value of MR diffusion-weighted imaging(DWI)and apparent diffusion coefficient(ADC)value in chronic kidney disease(CKD).Methods 10 healthy volunteers and 45 patients with different period of CKD underwent routine MRI and DWI.The DWI features were observed.The ADC values were acquired by using Philips soft package on the ADC images.Results Under different b value(300 s/mm2,500 s/mm2 and 800 s/mm2),the ADC value of CKD were 2.29?0.27,2.07?0.21 and 1.91?0.22,respectively,which were significantly lower than that in normal kidneys,and there was statistical difference between different group of CKD.Conclusion DWI may be a noninvasive method to evaluate the renal function.