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Objective:To investigate age-related morphological changes of the pancreas in healthy people using magnetic resonance imaging(MRI).Methods:From January 2017 to October 2019, people who took physical examinations at our hospital were enrolled and were divided into 7 groups according to age: 20-29 years old, 30-39 years old, 40-49 years old, 50-59 years old, 60-69 years old, 70-79 years old and ≥80 years.Also, the former four groups were classified as young and middle-aged(<60 years old)and the latter three as the elderly(≥60 years old). Morphological characteristics of the pancreas in each group were examined via MRI.Differences in parameters such as anteroposterior diameters of the head, body and tail and the pancreatic volume between the groups and the relationship between these parameters and age were analyzed.Results:A total of 191 cases who met the inclusion criteria were enrolled, including 96(50.3%)males and 95(49.7%)females, with 28 aged 20-29 years, 28 aged 30-39 years, 27 aged 40-49 years, 26 aged 50-59 years, 30 aged 60-69 years, 28 aged 70-79 years and 26 aged ≥80 years.There were 109 cases in the young and middle-aged category and 82 cases in the elderly category.MRI findings included pancreatic atrophy, which was most obvious in the tail; uneven and serrated edges of the pancreas and pancreatic lobulation; uneven signal intensity in the T 1-and T 2-weighted sequences; the "crispening effect" of pancreatic steatosis in the opposed-phase T 1-weighted sequences, and a trend of widening of the main pancreatic duct.The anteroposterior diameters of the pancreatic head, body and tail and the pancreatic volume reached the peak at(28.21±4.55)mm, (24.00±4.45)mm, (24.91±5.08)mm and(100.91±27.44)cm 3 between 30-39 years of age, and then gradually decreased to(18.87±3.82)mm, (15.63±3.96)mm, (13.70±3.70)mm and(43.88±10.47)cm 3 in those aged ≥80 years, with a decrease of 33.10%, 34.88%, 45.00% and 56.51%, respectively.The anteroposterior diameters of the pancreatic head, body, tail and the pancreatic volume in the elderly were(21.59±4.35)mm, (18.10±4.29)mm, (17.00±4.56)mm and(59.85±22.73)cm 3, which were smaller than those in the young and middle-aged category[(26.18±4.57)mm, (22.10±4.64)mm, (22.42±4.71)mm and(90.09±25.06)cm 3], and the differences were statistically significant( t=7.12, 6.19, 8.10 and 8.71, respectively, all P<0.001). The anteroposterior diameters of the head, body and tail and the pancreatic volume were negatively correlated with age( r=-0.52, -0.45, -0.56 and -0.57, respectively, P<0.001). Conclusions:The anteroposterior diameters of the head, body and tail and the pancreatic volume reach the peak between 30-39 years of age, and then gradually start to decline with the increase of age.After age 60, the decline become more evident, showing morphological signs of degeneration and dilatation of the main pancreatic duct.
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Objective@#To explore the feasibility of high-throughput texture analysis in the distinction of single brain metastases (SBM) from high-grade gliomas (HGG) and validate the established model.@*Methods@#A total of 86 patients who were histologically diagnosed with SBM or HGG were retrospectively collected, including 43 patients with SBM and 43 with HGG. All of patients were performed preoperative conventional head magnetic resonance imaging (MRI) scans. A total of 236 fluid-attenuated inversion recovery (FLALR) images containing the information of tumors were selected from the MRI images and each image was considered as an object. The training set had 200 images, including 106 from SBM group and 94 from HGG group, whereas the validation set had 36 images, including 19 from SBM group and 17 from HGG. After images preprocessing, images segmentation, features extraction, and features selection, a radiomic diagnostic model was finally established using the training set. The diagnostic performance of the diagnostic model was evaluated using a receiver operating characteristic (ROC) curve. Hierarchical clustering analysis was used to evaluate the quality of the extracted feature data and the classification effect of the model. The model was further validated using the independent validation set.@*Results@#A total of 629 features were extracted and quantified from each sample, and 41 features were selected to establish feature subsets and the diagnostic model. The classification decision function of the model is f(x)=sign and the kernel function of the model is K(x, xi)=exp. In the training set, the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value were 0.845, 0.849, 0.840, 0.857 and 0.832, respectively. The area under the ROC curve reached to 0.939. Similar results were obtained in the validation set.@*Conclusion@#The high-throughput texture analysis shows high accuracy in differentiating SBM from HGG.
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Objective To study the relationship between regional cerebral blood flow (rCBF) in matter lesion (WML) and cognitive impairment by arterial spin labeling (ASL).Methods Fourteen WML patients served as a WML group and 9 WML-free subjects served as a control group.Their neuropsychology was assessed and their rCBF was measured by ASL.Results The MoCA score,positive rate of symbol digit modalities test (SDMT),verbal fluency test (VFT) and digital span test forward and backward (DST F and B) were significantly lower while the trail making test-A (TMT-A) score and positive rate of Stroop B test and psychomotion speed test were significantly higher in WML group than in control group (P＜0.05,P＜0.01).The rCBF in regional WML was significantly slower in right and left semioval center,anterior and posterior horn of right and left lateral ventricle than that in normal white matter region (P＜0.01).The rCBF in WML was positively related with DST F and B (P＜0.05).The rCBF in NAWM was positively related with VFT (P＜0.01).Conclusion ASL can show the relationship between rCBF and cognitive impairment,especially executive function,attention and memory in elderly WML patients and decreased rCBF can thus increase their risk of cognitive impairment and dementia.
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Objective To compare the appearances between chronic mastitis and breast cancer on MRI and investigate the differ-ential diagnostic value.Methods MRI data of 20 patients with chronic mastitis pathologically proved by biopsy or operation were ret-rospectively analyzed.30 cases of breast cancer were contemporaneously chosen as the control group.Morphological feature and dy-namic contrast-enhanced(DCE)manifestation of the lesions were evaluated and statistical difference was compared between mastitis and breast cancer.Morphological feature included configuration,spiculated sign,ring-like enhancement,peri-focal edema,skin thick-ening,nipple involvement and axillary lymph nodes enlargement.DCE manifestation contained calculating early enhancement ratio and drawing time-intensity curve (TIC).Results There were significant statistical differences among configuration,ring-like en-hancement and peri-focal edema between mastitis and breast cancer,respectively.No statistical differences could be found among spiculated sign,skin thickening,nipple involvement and axillary lymph nodes enlargement.Early enhancement ratio in the group of mastitis was 1.1 56±0.635 while 1.253±0.499 in the group of breast cancer and there was no statistical difference between them. There were 1 1 cases with type Ⅰ TIC,6 with type Ⅱ,3 with type Ⅲ in the lesions of mastitis,while 4 with type Ⅰ,1 1 with typeⅡ,1 5 with type Ⅲ in the lesions of breast cancer and significant statistical differences could be found between two groups.Conclu-sion Mastitis usually manifests as non-mass-like lesions on MRI.Ring-like enhancement,peri-focal edema and benign type TIC can be applied to discriminate mastitis from breast cancer.
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<p><b>OBJECTIVE</b>The purpose of this study was to compare MRI findings of solitary hypovascular hepatic nodules, benign and malignant, to identify their MRI characteristics.</p><p><b>METHODS</b>We retrospectively assessed solitary hypovascular hepatic nodules ≤ 3 cm in 135 patients, among them there were 55 malignant nodules [29 peripheral nodules of cholangiocarcinoma, PCC, and 26 hepatic metastases, HM] and 80 benign nodules [48 inflammatory myofibroblastic tumors, IMT, and 32 hepatic hemangioma, HG], proved by surgery, biopsy or follow-up imaging. Unenhanced and dynamic enhanced MRI findings of the 135 patients were analyzed retrospectively. Statistical analysis included Chi-square test or Fisher's exact test, and receiver operating characteristic (ROC) curve.</p><p><b>RESULTS</b>There was significant difference (P < 0.05) between the malignant group and benign group in terms of location, margin, T2WI signal intensity, heterogeneity or homogeneity of the nodule, and type and degree of peritumoral and intratumoral enhancement. Area under the curve at the first film reading by three radiologists was 0.678 ± 0.047, 0.920 ± 0.022 at the second time, and there was a significant difference (Z = 5.22, P < 0.05) between them.</p><p><b>CONCLUSIONS</b>Our data indicated that solitary hypovascular hepatic nodules show unenhanced and dynamic enhanced MRI features. Therefore, MR imaging combined with clinical and biochemical data does provide reliable information for a proper diagnosis of such hepatic lesions and differentiation of malignant from benign nodules.</p>
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Humans , Cholangiocarcinoma , Pathology , Diagnosis, Differential , Hemangioma , Pathology , Liver , Pathology , Liver Neoplasms , Pathology , Magnetic Resonance Imaging , ROC Curve , Retrospective StudiesABSTRACT
Objective To explore the value of high-field-strength MRCP in diagnosing of intraductal papillary mucinous neoplasms (IPMNs)of pancreas.Methods Fifteen cases with IPMNs confirmed surgically and pathologically were recruited.The magnetic res-onance imaging (MRI)and MRCP findings were retrospectively analyzed.Results All cases were benign,including main pancreatic duct type (MPD)in 1,branch pancreatic duct type(BPD)in 8,and the combined type in 6.The MPD type showed diffuse dilation of main pancreatic duct which is about 14.5 mm with no enhancement.The BPD type displayed unilocular or multilocular cystic le-sions which showed communication with main pancreatic duct .The combined type demonstrated dilation of main pancreatic duct and branch pancreatic duct.The septa and mural nodule in the BPD type and the combined type were moderately enhanced.Conclusion MRCP is superior with regard to the diagnosis and classification of IPMN type and is helpful to differentiate malignant tumors from benign ones combined with routine contrast-enhanced.
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Objective To study the MR imaging appearances in a series of patients with stages T1N0M0 and T2N0M0 peripheral cholangiocarcinoma of the liver and to differentiate these tumors from hepatic metastases and from other solitary necrotic nodules.Methods A retrospective analysis was carried out on MR examinations of 26 patients with histologically confirmed choangiocarcinoma.The imaging findings were compared with those of 2 non-choangiocarcinoma groups including 23 patients with metastasis and 29 patients with solitary necrotic nodules confirmed with surgery,biopsy or follow-up imagings.Statistical analysis included Chi-square test or Fisher's exact test and the use of receiver operating characteristic (ROC) curves.Results Peripheral choangiocarcinomas in stages T1N0M0 and T2N0M0 were less than or equal to 3 cm in diameter (10 patients,≤2 cm and 16 patients,2 cm).Common findings for cholangiocarcinoma were defined margins (n =22,85％),slightly high signal on T2W1 (n =23,88％),patchy enhancement (n =20,77％),“fill-in” enhancement from periphery toward the center (n =21,81％) and diffuse hypointensity at the periphery and center of tumor (n =9,35％).There were significant differences (P ＜ 0.05) between the choangiocarcinoma group and the non-cholangiocarcinoma group in the above imaging findings.The area under the curve (Az) for differentiating peripheral cholangiocarcinoma was 0.896 ± 0.037,sensitivity was 84.6％,and specificity was 86.5％.Conclusions Our data indicated that MRI features of peripheral cholangiocarcinoma in stages T1N0M0 and T2N0M0 could be determined.MR imaging,when combined with clinical and biochemical data,provided reliable information to diagnose peripheral cholangiocarcinoma.
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Objective To discuss the imaging manifestations of chordoma.Methods The imaging manifestations of chordoma in 42 cases proved by surgery and pathology were retrospectively analysed.Results The lesions located at the region of skull base in 23 cases(54.8%),at the sacrococcygeal region in 18 cases(42.9%) and one case(2.3%) outside the axial skeleton as an extra-axial chordoma or parachordoma.Bone destruction in the areas near skull base and sacrococcygeal region could be found on radiography.On CT,chordoma typically appeared as a expansile soft-tissue mass that arises from the clivus and sacrococcygeal region with associated extensive lytic bone destruction.MR imaging was considerably superior to CT in the delineation of lesion extent.Conclusion Chordoma has typically distribution and characteristic imaging manifestations,especially MRI.