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1.
Chinese Journal of Radiology ; (12): 1184-1190, 2021.
Article in Chinese | WPRIM | ID: wpr-910283

ABSTRACT

Objective:To explore the incremental value of subtraction technique in evaluating the major features of liver reporting and data system version 2018 (LI-RADS v2018) on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI.Methods:The Gd-EOB-DTPA enhanced MRI of 117 pathologically verified hepatocellualr carcinoma(HCC) from 87 high-risk patients in Henan Provincial People′s Hospital from January 2019 to July 2020 was analyzed retrospectively. The major features of LI-RADS in arterial phase, portal venous phase, subtraction and combined images were evaluated including nonrim arterial phase hyperenhancement (Nonrim APHE), nonperipheral washout and enhancing capsule. The lesions were graded according to LI-RADS v2018. According to the lesion size (<20 mm, ≥20 mm) and T 1WI signal intensity (hypointensity, isointensity or hyperintensity), the patients were divided into different subgroups. Cochran′s Q test was used for the comparison of the detection rate of the major features of LI-RADS and the accurate diagnosis rate based on LR-5 as the diagnostic standard among multiple groups. McNemar test was used for the comparison between two groups. Results:For all HCC, hypointensity HCC and HCC ≥20 mm, the detection rate of Nonrim APHE (χ2=12.190, 12.500, 10.083, all P<0.001) and the accurate diagnosis rate of HCC (χ2=14.450, 12.500, 10.083, all P<0.001) of subtraction images from arterial phase were significantly higher than that of arterial images. For HCC<20 mm, the detection rate of Nonrim APHE combined with arterial phase images was significantly higher than that in arterial phase images (χ2=5.143, P=0.016). For all HCC and isointensity or hyperintensity HCC, the detection rate of nonperipheral washout combined with portal venous phase images was higher than that in portal venous phase images (χ2=7.111, 6.125, P=0.004, 0.008). The detection rate of enhancing capsule of subtraction images from portal venous phase was higher than that of portal venous phase images in all groups (all P<0.017). The accurate diagnosis rate of subtraction images from portal venous phase in all HCC and HCC≥20 mm was higher than that in portal venous phase images (χ2=6.722, 6.750, P=0.008, 0.006). The accurate diagnosis rate of LR-5 in all groups using subtraction images from arterial phase and portal venous phase was higher than that of MRI images (all P<0.013). Conclusion:For Gd-EOB-DTPA dynamic enhanced MRI, subtraction images from arterial phase and portal venous phase are better than arterial phase and portal venous phase images in displaying Nonrim APHE, nonperipheral washout and enhancing capsule, which can improve the LI-RADS classification of HCC.

2.
Article in Chinese | WPRIM | ID: wpr-910491

ABSTRACT

Objective:To investigate the value of serum miR-143 level combined with MRI in predicting the early response to concurrent chemoradiotherapy (CCRT) in cervical cancer.Methods:A total of 85 patients with pathologically confirmed cervical cancer underwent conventional MRI, intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced MRI (DCE-MRI) before CCRT. The biopsy tissues and serum samples were collected. The differential expression of miRNA in the biopsy tissues was determined by microarray chip. The expression level of miR-143 in the serum samples was analyzed by qRT-PCR. All patients were divided into the non-residual and residual tumor groups according to post-treatment MRI. Pre-treatment clinical factors, MRI parameters and miR-143 between two groups were statistically analyzed by the univariate and multivariate analyses. The optimal thresholds and predictive performance for post-treatment incidence of residual tumors were estimated by drawing the ROC curve.Results:At one month after CCRT, there were 52 patients in the non-residual tumor group and 33 patients in the residual tumor group. In the residual tumor group, pre-treatment FIGO staging, apparent diffusion coefficient (ADC), D and V e were significantly higher (all P<0.05), whereas K trans value was significantly lower ( P<0.001) when compared to those in the non-residual tumor group. The miRNA array analysis showed that there were 16 miRNAs with differential expression levels between two groups (all P<0.05). Among them, the increase of miR-143 was the most significant in the residual tumor group. Compared with the residual tumor group, the expression level of serum miR-143 was significantly down-regulated in the non-residual tumor group ( P=0.002). Compared with the SiHa cells, the expression level of miR-143 in the SiHa-R cells was significantly up-regulated ( P<0.05). Multivariate analysis showed that only miR-143, D, K trans and V e were the independent prognostic factors. The combination of multi-parametric MRI and miR-143 exhibited the highest predictive performance (AUC=0.975), with a sensitivity of 84.8% and a specificity of 96.2%. Conclusion:The combination of multi-parametric MRI with miR-143 further improves the predictive performance for residual tumors after CCRT, which contributes to the personalized treatment of cervical cancer.

3.
Chinese Journal of Radiology ; (12): 1179-1184, 2020.
Article in Chinese | WPRIM | ID: wpr-868384

ABSTRACT

Objective:To explore the value of radiomics features extracted from multi-parameter MRI (mp-MRI) in preoperative prediction of triple negative breast cancer (TNBC) and non triple negative breast cancer (NTNBC).Methods:The clinical and preoperative-MRI data of 371 patients with breast cancer confirmed by surgical pathology from January 2017 to July 2019 in Henan Provincial People′s Hospital were retrospectively analyzed. Based on the results of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) from postoperative pathological specimens, the cancer was classified as TNBC and NTNBC. Patients were randomly assigned to a training set ( n=250) and a validation set ( n=121). Quantitative radiomics features were extracted from three-dimensional lesions based on dynamic contrast enhanced-T 1WI (DCE-T 1WI) and fat-suppressed T 2WI sequences, and 32 quantitative radiomics features were selected by Mann-Whitney U test, elastic network, and support vector machine recursive feature elimination. Three radiomics signatures were constructed by using the algorithm of support vector machine based on the quantitative radiomics features extracted from fat-suppressed T 2WI, DCE-T 1WI and the mp-MRI of their combination. The prediction performances were evaluated by receiver operating characteristic (ROC) curve and the area under the ROC curve, accuracy, sensitivity, and specificity were calculated. Results:There were 61 patients with TNBC and 310 patients with NTNBC. The clinicopathological characteristics between NTNBC and TNBC were statistically different in the pathological grade (χ2=24.544, P<0.001). Other clinicopathological characteristics (age, maximum diameter of mass, vascular tumor thrombus, axillary lymph nodes) were not statistically differences between NTNBC and TNBC ( P>0.05). The radiomics signature presenting the best performance for predictive TNBC and NTNBC were based on mp-MRI radiomics features. The area under the ROC curve, accuracy, sensitivity, and specificity were 0.91[95% confidence interval (CI) 0.881-0.932], 86.0%, 84.4% and 86.3% in training set, and 0.84 (95%CI 0.807-0.868), 75.2%, 68.7% and 76.1%, in validation set, respectively. Conclusion:Radiomics based on mp-MRI features can be a effectively potential tool for predictive TNBC and NTNBC breast cancer and provide scientific basis for clinicians to make treatment decisions.

4.
Chinese Journal of Radiology ; (12): 113-118, 2018.
Article in Chinese | WPRIM | ID: wpr-707904

ABSTRACT

Objective To explore the value of various diffusion parameters obtained from monoexponential, biexponential and stretched exponential diffusion-weighted imaging models in assessing hepatic fibrosis in chronic hepatitis B(CHB). Methods A total of 52 patients who were diagnosed hepatitis B by the markers of hepatitis and were confirmed by liver biopsy pathology were prospectively recruited between June 2014 and May 2016 in People's Hospital of Henan Province. Concomitantly, 30 healthy volunteers who had no history of hepatitis B and liver dysfunction were enrolled in the control group. All patients underwent multi-b values DWI on a 3.0 T MRI unit. ADC was calculated by using the monoexponential model. True diffusion coefficient(Dt),pseudo diffusion coefficient(Dp)and fraction of perfusion(f)were calculated by using the biexponential model.Distributed diffusion coefficient(DDC)and water molecular diffusion heterogeneity index(α)were calculated by using the stretched exponential model. Liver biopsy specimens were staged according to the degree of hepatic fibrosis (S0 to S4). The Kruskal-Wallis test was employed for the comparison of each parameter among the control group and the fibrosis stage groups. The Mann-Whitney U test was adopted to compare each parameter between fibrosis stage≤S1and≥S2,between≤S2 and≥S3.Spearman rank correlation coefficients were obtained to assess the correlation of the parameters with the fibrosis stages.ROC analysis was used to evaluate the performance of various parameters in predicting stage≥S2 and≥S3.Results The hepatic fibrosis stage distributions were as follows:1 cases with S0,9 cases with S1,22 cases with S2,11 cases with S3,9 cases with S4.ADC,Dt,f and DDC values all showed significant difference among the control group and groups S1,S2,S3,S4(all P<0.05), while Dp and α values showed no significant difference(P>0.05). Dt, DDC and ADC showed a moderate negative correlation with the fibrosis stage(r=-0.630,-0.603 and-0.464,respectively,all P<0.01),and f showed a mild negative correlation with the fibrosis stage(r=-0.379,P<0.05),while Dp and α values showed no correlation with the fibrosis stages(all P>0.05).The ADC, Dt, f and DDC values all showed significant difference between stage≥S2 and≤S1,between stage≥S3 and≤S2(all P<0.05),and the parameter values of the former were greater than those of the latter. While Dp and α values showed no significant difference among both groups(all P>0.05).The AUCs of ADC,Dt,f and DDC values for detecting fibrosis stage ≥S2 were 0.738,0.835,0.740 and 0.831, and the AUCs of ADC, Dt, f and DDC values for detecting fibrosis stage≥S3 were 0.716, 0.811, 0.672 and 0.798. Conclusion The Dt derived from biexponential and DDC derived from stretched exponential DWI could be useful for the staging of hepatic fibrosis in CHB.

5.
China Pharmacy ; (12): 4074-4077, 2016.
Article in Chinese | WPRIM | ID: wpr-502993

ABSTRACT

OBJECTIVE:To explore the correlation between ornidazole (ONZ) salivary concentration and plasma concentra-tions in healthy subjects,and to provide reference for clinical therapeutic drug monitoring. METHODS:24 healthy volunteers were selected. After oral administration of ONZ capsules 1.00 g,their venous blood and saliva were collected at 0.25,0.5,1.5,5.5, 10.5,24.5 and 43.5 h after medication. HPLC method was used to determine the plasma and salivary concentrations of ONZ. The correlation between the two was analyzed. RESULTS:The peak values of plasma and salivary ONZ concentrations appeared imme-diately at 1.5 h after administration and the peak values were(0.96±0.15)μg/ml and(0.93±0.15)μg/ml;salivary concentration of ONZ was lower than plasma concentration at each time points,but there was no statistical significance (P>0.05);the regres-sion equation of salivary ONZ concentration and plasma concentration was csaliva=1.176 5cplasma-0.199 4(r=0.990 1). The ratio of salivary concentration and plasma concentration of ONZ (S/P) was (0.91 ± 0.06),showing positive correlation (r=0.632-0.970, P<0.05). CONCLUSIONS:The salivary ONZ concentration is significantly correlated with plasma concentration in healthy peo-ple,so saliva can be used for therapeutic drug monitoring.

6.
Article in Chinese | WPRIM | ID: wpr-464369

ABSTRACT

Purpose To study the clinic-pathological features, differential diagnosis and prognosis of extragastrointestinal stromal tumor ( EGIST) arising in the vulva and the rectovaginal septum. Methods Clinical manifestations, pathological features, immunohisto-chemistry, gene mutations, treatment and prognosis were analyzed in 1 case of EGIST arising in the vulva and 2 cases of EGIST arising in the rectovaginal septum with review of related literature. Results Case 1 was a 59-years-old woman who was found to have a 4. 4 cm × 3 cm × 3 cm recurrent mass in the right vulva after 6 months of the first resection. Case 2 was a 58-years-old woman who presen-ted with a 7. 3 cm × 6. 1 cm × 4. 6 cm mass in the rectovaginal septum. Case 3 was a 41-year-old woman who presented with an 8. 6 cm × 7. 4 cm × 6. 7 cm mass in the rectovaginal septum. Histologically, the uniform spindle cells showed the interlacing fascicular, whirl-pool and palisade patterns with high cellular density. Mitotic figures were readily identified. Immunohistochemical evaluation revealed that the tumor cells exhibited strong and diffuse staining for CD117, CD34, NES, H-Caldesmon and DOG-1. Molecular analysis showed the gene mutation of c-Kit exon 11 in all 3 cases. Conclusion EGIST should be considered in the differential diagnosis of the mesenchymal tumors arising in the vulva and the rectovaginal septum. The immunohistochemical evaluation and molecular genetic tes-ting are crucial tools for the differential diagnosis and assessment of the prognosis and targeted therapy of EGIST.

7.
Chinese Medical Journal ; (24): 3082-3087, 2014.
Article in English | WPRIM | ID: wpr-240225

ABSTRACT

<p><b>BACKGROUND</b>The diagnosis of liver fibrosis is a difficult task at any time using conventional clinical imaging. Intravoxel incoherent motion (IVIM) can be used to investigate both diffusion and perfusion changes in tissues. This study was designed to determine the value of IVIM in the diagnosis and staging of liver fibrosis.</p><p><b>METHODS</b>IVIM examinations were performed on a GE 3.0T MR scanner in 25 patients with liver fibrosis and 25 healthy volunteers as the control group. Patients with liver fibrosis diagnosis were confirmed by pathology and staged on a scale of F0-4. The standard ADC values and the values of a biexponential model (slow ADC (Dslow), fast ADC (Dfast) and fraction of fast ADC (FF)) were measured in three liver regions per person. The mean standard ADC values, Dslow values, Dfast values and FF values from the study group were compared among the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Receiver Operating Characteristic (ROC) curves and independent-samples t-tests were used to calculate the mean standard ADC values, Dslow values, Dfast values and FF values from the study group and the control group. Spearman rho correlation analysis was used for the stage of liver fibrosis. The liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 were compared.</p><p><b>RESULTS</b>Among the liver fibrosis, there was no significant difference in the mean standard ADC values, Dslow values, Dfast values, and FF values obtained from the right posterior hepatic lobe, right anterior hepatic lobe and medial segment of the left lobe. Using ROC analysis, the Area Under the Curve (AUC) values of standard ADC, Dslow, Dfast, FF were all between 0.7 to 0.9. The mean standard ADC values, Dslow values, Dfast values and FF values of the liver in the study group were significantly lower than the values in the control group (P < 0.05). As the stage of the fibrosis increased, the values decreased by Spearman rho correlation analysis. The mean values (standard ADC, Dslow, Dfast, and FF) of liver fibrosis stages between the groups F0-1 and F2-4, the groups F0-2 and F3-4 showed significant differences (P < 0.05).</p><p><b>CONCLUSIONS</b>IVIM can reflect the conditions of perfusion and diffusion in liver fibrosis and thus distinguish between normal liver and liver fibrosis. The IVIM technique may serve as a valuable tool for detecting and characterizing liver fibrosis, and monitoring its progression in a noninvasive manner.</p>


Subject(s)
Adult , Aged , Diffusion Magnetic Resonance Imaging , Methods , Female , Humans , Liver , Pathology , Liver Cirrhosis , Diagnosis , Male , Middle Aged
8.
Article in Chinese | WPRIM | ID: wpr-252916

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the styryllactone components in Goniothalamus cheliensis Hu (Annonaceae).</p><p><b>METHOD</b>UPLC-Q-TOF-MS was used to identify the main styryllactone components in G. cheliensis. The chromatographic separation was performed on ACQU ITY UPLC BEH C18 column and eluted by actonitrile and 0.1% acetic acid in water gradiently. The mass spectrometer equipped with electrospray ionization souce was used as detector under the positive ion modes.</p><p><b>RESULT</b>Twelve styryllactons were identified based on their MS data and published literatures, and the MS fragmentation regularity of the styryllactones was also proposed.</p><p><b>CONCLUSION</b>It is an accurate and effective method to obtain the structural information of styryllactones.</p>


Subject(s)
Chromatography, High Pressure Liquid , Methods , Goniothalamus , Chemistry , Lactones , Chemistry , Mass Spectrometry , Methods , Plant Extracts , Chemistry
9.
Article in Chinese | WPRIM | ID: wpr-388390

ABSTRACT

Objective To investigate the effects of Blastocyst MHC gene transfection to coronary on the survival time of mouse heart grafts and the mechanism. Methods Inbred male Balb/c mice and C57BL/6 mice were selected as donors and recipients respectively, to construct mouse cervical heart transplantation models. In the control group, the donor hearts were perfused using the 0~4 ℃ St. ThomasⅡ solution; in the cyclosporine A (CsA) group, the donor hearts were perfused as same as the control's and received intraperitoneal injection of CsA (5 rng·g-1·d-1) after surgery; in the transfection group, the donor hearts were perfused using St. Thomas Ⅱ solution with Blastocyst MHC gene plasmid; in the combined treatment group, the donor hearts were perfused using St. Thomas Ⅱ solution with Blastocyst MHC gene plasmid and received intraperitoneal injection of CsA (5 mg·g-1·d-1) after surgery. The survival time of transplanted heart allografts were observed, and their histopathological changes and the degrees of coronary intimal hyperplasia were estimated.Blastocyst MHC gene mRNA expression levels were detected by real-time fluorescence quantitative RT-PCR. Flow cytometry was applied in assessment of the levels of CD4+ CD25+ regulatory T cells (Treg) and CD3+ CD8+ T cells. Results The survival time in the CsA group, transfection group and combined treatment group was significantly longer than in the control group (P<0.05) and that in the combined treatment group was the longest, up to (20. 50 ± 5. 61) days. On the postoperative day 1 and 3, Blastocyst MHC gene mRNA expression level in the transfection group was significantly higher than that in the control group (P<0.05). On the postoperative day 7, the degrees of rejection and coronary intimal hyperplasia in the combined treatment group were the lightest. On the postoperative day 7 the number of Tregs in the CsA group and the combined treatment group was significantly increased as compared with that in the control group (P<0.05), but that of CD3 + CD8+ T cells in the CsA group and the combined treatment group was less than that in the control group (P<0.05). Conclusion Blastocyst MHC gene transfection in mouse transplanted cardiac allograft can extend its survival time through upregulation of Treg and downregulation of CD3 + CD8 + T cells in the mice. The combination of Blastocyst MHC gene and CsA may exert the synergic effects.

10.
Article in Chinese | WPRIM | ID: wpr-383303

ABSTRACT

Objective Cervical heterotopic heart transplantation model was established in different inbred strains of mice with modified cuff technique. Inbred male Balb/c mice and C57BL/6 mice were selected as donors and recipients, respectively. Mice were randomly assigned into four groups: control group (the donor hearts were perfused through coronary artery with 200 μl, 0℃~4℃ St. Thomas Ⅱ solution during 2 to 3 min, then they were immersed in it for 15 min), CsA group ( the donor hearts were perfused with the same method as for the control's and intraperitoneal injection of CsA 5 mg· g-1 · d -1 was given after surgery ), H2-B1 transfection group (the donor hearts were perfused through coronary artery with 200 μl, 0℃ -4℃ St. Thomas Ⅱ solution contained with 30 μg H2-Bl plasmid vectors during 2 to 3 min, then they were immersed in it for 15 min ), and H2-B1 + CsA group ( the donor hearts were perfused with St. Thomas Ⅱ solution contained H2-Bl gene plasmid and intraperitoneal injection of CsA was given after surgery as mentioned above. ). At 1,3 and 7 days after transplantation, three allografts were harvested at each time points in all of the groups, respectively, for pathological examination and analysis of CD40 expression with immunohistochemistry assays. The expression of Th1/Th2 cytokines were also determined with flow cytometry. The survival time of rest allografts were observed. Results Histological features for rejection were observed more apparent in the grafts of control group than those in other groups, especially those in H2-Bl + CsA group. The expression of CD40 in H2-Bl + CsA group and CsA group was lower significantly than that of the control group ( P <0.01 ), so was the expression of CD40 in the H2-Bl group as compare with that of the control group (P <0.05). No significant difference between H2-Bl group and CsA group (P >0.05 ) at 7 days was observed. The expression of IL-2, TNF-α (Th1 cytokines) in control group was much higher than that in other groups, and the expression of IL-4 ( Th2 cytokine) in control group was much lower ( P <0.05 ). The level of IL-4 in CsA group increased significantly at 3 days ( P < 0.05 ), with a peak level at 7 days after transplantation (P<0.01). The survival time of grafts was significantly prolonged in CsA group (P<0.01), H2-Bl group (P<0.05) and H2-Bl+CsA group(P<0.01). Conclusion Treating the donor hearts with H2-Bl plasmid vectors at the time of transplantation may suppress rejection in the heart allografts and prolong the survival time through some presumed mechanisms such as preventing upregulation of CD40 expression, relucing the production of IL-2 and TNF-α, increasing the production of IL-4, and as a result, inducing immune tolerance, as well as improving the function of transplanted heart grafts.

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