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Objective To explore the feasibility of intravoxel incoherent motion DWI (IVIM-DWI) in differential diagnosis of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH).Methods A total of 407 patients with clinically-suspected HCC or FNH underwent conventional and dynamic enhanced MRI and IVIM-DWI,60 patients (40 cases of HCC,20 cases of FNH) were enrolled.Parameters of ADC,slow apparent diffusion coefficient (D),fast apparent diffusion coefficient (D*) and fraction of fast apparent diffusion coefficient (f) were obtained by monoexponential model and biexponential model respectively.Results The values of ADC,D,D* and f in FNH group were (1.60±-0.25) × 10-3mm2/s,(1.12±0.17)×10-3mm2/s,(44.89±18.23)× 10-3 mm2/s and (34.80 ± 9.68)％,and those in HCC group were (1.32 ± 0.21) × 10-3 mm2/s,(0.82±-0.21) × 10-3mm2/s,(49.82±20.11) × 10 3mm2/s and (28.72±13.84) ％,respectively.Significant inter-group differences were observed in ADC and D (both P＜0.001),however,there were no significant differences in D* and f (both P＞0.05).The areas under the ROC curve of D were 0.90,and taking D=0.96 × 10-3 mm2/s as cut-off value,the sensitivity and specificity of D in diagnosis of HCC were 84.44％ and 90.02％.Conclusion IVIM-DWI is useful to distinguish FNH from HCC,and the D value in biexponential model has the best diagnostic efficacy for differentiations.
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Objective To establish the Logistic regression model by reporting and data system version 2 (PI-RADS v2)and prostate specific antigen (PSA),and to evaluate the diagnostic efficiency in transition zone prostate cancer (PCa).Methods MRI and PSA data of 33 patients with PCa and 54 patients with non-PCa confirmed by pathology were analyzed retrospectively.The PI-RADS v2 was used to evaluate the risk of 2 groups (from low to high as 1 to 5 points).Total PSA (t-PSA),free to total PSA ratio (f-PSA/t-PSA),PSA density (PSAD) and PI-RADS v2 scores were compared between 2 groups.The Logistic regression models were established with parameters which were significantly different between 2 groups.The Logistic regression was divide into three protocols:PI-RADS v2-+ t-PSA (A),PI-RADS v2 + f-PSA/t-PSA (B),PI-RADS v2+PSAD (C).The ROC curves were constructed by the new parameters Logit (P) and PI-RADS v2 scores for assessing the diagnostic efficiency.Results The t-PSA,f-PSA/t-PSA,PSAD and PI-RADS v2 scores had significant differences between the 2 groups (all P＜0.01).Predictive multivariate model of A,B,C was established as Logit (P)=-8.682+1.507 PI-RADS v2+0.234 t-PSA (x2=65.993,P＜0.01),Logit(P)=-5.425+1.906 PI-RADS v2 13.921 f-PSA/t-PSA (x2 =65.993,P＜0.01),Logit(P)=-7.534+1.045 PI-RADS v2+13.318 PSAD (x2 =74.036,P＜0.01),their area underthe curve (0.945,0.919,0.960) were all higher than that of PI-RADS v2 score (0.861,all P ＜0.01).The protocol C had the best diagnostic efficiency,and the sensitivity and specificity were 87.88 ％ and 92.59 ％.The sensitivity and specificity of PI-RADS v2 score were 87.88％ and 77.78％.Conclusion The diagnostic efficiency of the Logistic regression model which includes the PI-RADS v2 score and PSA are superior to the PI-RADS v2 score alone for transition zone PCa,which can provide a reliable basis for patients whether need biopsy or not.
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Objective To compare the display effect of contrast enhanced MR angiography (CE-MRA) and CTA in evaluating blood supply of early stage cervical cancer.Methods CE-MRA and CTA before the operation of 30 patients with pathologically confirmed early stage cervical cancer were analyzed retrospectively.The origins and continuity of bilateral uterine arteries and the conspicuity of bilateral decending branch of uterine arteries between CE-MRA and CTA were evaluated.Results Fifty uterine arteries could classify as origins clearly visible and vessels clearly visible without discontinuity,5 uterine arteries as origins clearly visible but vessels unclearly visible on both CEMRA and CTA.Both CE-MRA and CTA were conformed well in evaluating the origin and continuity of uterine arteries (Kappa=0.80,P＜0.05).The conspicuity of decending branches for CE-MRA was 55.00％ (33/60),which was lower than that of CTA (73.33％ [44/60]),which had statistically significant difference between CE-MRA and CTA (x2 26.22,P＜0.01).Conclusion For early stage cervical cancer,CE-MRA and CTA can both provide a good performance in evaluating the origin and continuity of uterine arteries,CTA reveals advantage over CE MRA in detecting conspicuity of decending branch of uterine arteries.
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As a local medical college,taking the school running orientation and characteristic into consideration,our school paid attention to people-oriented policy,optimizing the course structure,strengthening practice teaching in the revised talent cultivation scheme and constructed talent cultivation system which was in line with international norms and had local distinguishing feature.