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Objective:To compare the diagnostic efficacies of Sonazoid contrast-enhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance imaging (CE-MRI) in the diagnosis of focal liver lesions (FLLs), and to evaluate the clinical value of Sonazoid.Methods:A total of 58 FLLs in 50 patients who underwent Sonazoid-CEUS and CE-MRI examinations from July 2019 to January 2021 in the First Affiliated Hospital of Zhejiang University School of Medicine were enrolled in this study according to the inclusion criteria. The final diagnostic reference standard was decided by surgical pathology or ultrasound-guided biopsy pathology. Sonazoid-CEUS and CE-MRI features of benign and malignant FLLs were analyzed, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of the two tests were calculated respectively.Results:There was a statistically significant difference between benign and malignant FLLs in the imaging pattern of homogeneous or heterogeneous intratumoral enhancement in the artery-dominant phase and washout images in the late phase( P<0.001).9.8%(4/41) of the malignant lesions did not decrease until the late phase but decreased in the post-vascular phase. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic coincidence rate of the two tests were 97.6%, 52.9%, 83.3%, 90.0%, 84.5%(Sonazoid-CEUS) and 85.4%, 64.7%, 85.4%, 64.7%, 79.3%(CE-MRI), the differences of sensitivity and specificity were not statistically significant ( P=0.125, P=0.687). Conclusions:The vascular phase in Sonazoid-CEUS is still an important diagnostic sign of FLLs, and the unique Kupffer phase can provide additional information for the diagnosis. Sonazoid-CEUS has the same important value as CE-MRI in the diagnosis of FLLs.
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Magnetic resonance imaging (MRI) is a very important imaging method for diagnosis and treatment of prostate cancer (PCa) in clinical practice. As functional MRI is growing and maturing, its quantitative parameters are expected to enhance the clinical value of MRI furtherly. Intravoxel incoherent motion diffusion imaging, diffusion tensor imaging, and diffusion kurtosis imaging, which were derived from diffusion weighted imaging, have provided richer and more accurate parameters. The newly-developed magnetic resonance elastography can complement the mechanical characteristics of PCa.
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Humans , Male , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Motion , Prostatic Neoplasms/diagnostic imagingABSTRACT
BACKGROUND: As a non-invasive detection method, dynamic contrast-enhanced magnetic resonance imaging is widely used in the field of tumor. It can be used for the differentiation of benign and malignant tumors, the grading of tumor grade and the prediction and evaluation of prognosis. In recent years, the application research in the field of bone and joint has gradually become a hot spot, which can be used in the determination of bone marrow blood perfusion, the evaluation of bone tissue activity, the early detection of bone perfusion abnormality and the evaluation of blood circulation of joint inflammatory lesions. OBJECTIVE: To summarize the technical situation of dynamic contrast-enhanced magnetic resonance imaging and its application research in bone and joint. METHODS: The keywords were “(bone OR joint) AND (dynamic contrast-enhanced MRI) OR dynamic contrast-enhanced magnetic resonance imaging) OR DCE-MRI” in English and Chinese, respectively. The first author searched PubMed, Springerlink and China National Knowledge Infrastructure databases for the articles published between 1984 and 2019. The relevant literature was reviewed on the application of dynamic contrast-enhanced magnetic resonance imaging in bone and joint in recent years. Finally, 55 articles were summarized and analyzed. RESULTS AND CONCLUSION: (1) At present, dynamic contrast-enhanced magnetic resonance imaging technology and data processing have not been standardized. T1WI imaging is mainly used in bone and joint. Qualitative, semi-quantitative and full quantitative analysis of its data is feasible. (2) Qualitative analysis and semi-quantitative analysis are simple and easy to operate. Quantitative indicators are clear, can objectively describe the shape of the curve, but cannot reflect the concentration of contrast agent between tissues and blood vessels, and are easily affected by the sequence of scanning parameters, so cannot detect the pharmacokinetic information of tissue. Quantitative analysis can obtain the concentration changes and generation parameters of contrast media between substructures in tissues, and evaluate the microangiogenesis and function of tissues. (3) Dynamic contrast-enhanced magnetic resonance imaging can noninvasively evaluate the microcirculation perfusion of bone and joint. It has certain reference value for the discussion of the pathogenesis, diagnosis and differential diagnosis, prediction of prognosis, evaluation of curative effect and choice of treatment of many bone and joint diseases.
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Objective: To evaluate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the efficacy of foam sclerotherapy and selecting sclerosants for endovascular sclerosis of venous malformations. Methods: A retrospective analysis was conducted for 56 patients with venous malformations who underwent intravascular sclerotherapy and DCE-MRI examination from January 2018 to June 2019 in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. All the patients were firstly treated with foam sclerotherapy. During the surgery, the surgeons determined whether to subsequently use ethanol, depending on the immediate therapeutic effect of foam sclerotherapy. Among them the 40 cases were treated with foam sclerotherapy only (foam sclerotherapy group) and the other 16 cases (ethanol group) with subsequent ethanol. The basic characteristics and DCE-MRI parameters of the two groups were compared. Logistic regression was used to analyze the risk factors of selecting different sclerosing agents, and the receiver operator characteristic curve was applied to assess the efficacy of these risk factors. Results: There were no significant differences in the gender, age, lesion location, pre-treatment volume and presence or absence of phleboliths between foam sclerotherapy group and ethanol group. The lesion classification, maximum intensity time ratio (MITR) and peak enhancement percentage showed significant differences between the two groups. Multivariate Logistic regression analysis showed that the lesion classification and MITR were two independent factors for the selection of sclerosing agents. The area under curve (AUC) of MITR was 0.947, while the AUC of lesion classification was 0.844. After the combination of these two parameters, the AUC was 0.969 with the sensitivity of 93.8% and the specificity of 90.0%. Conclusion: DCE-MRI can be helpful for clinical selection of appropriate sclerosing agents to improve the effectiveness of venous malformations treatment.
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Objective To investigate the difference of blood supply in different areas of the normal femoral head in adults.Methods A retrospective study analyzed the DCE-MRI parameters data of 2 5 normal adults (25 right hips)in our hospital.The femoral head was assumed to be a sphere.On T1 WI of DCE-MRI,the right femoral head was divided into three parts equally in coronal,sagittal, and transverse plane respectively.Time to peak(TTP),maximum of enhancement at first past(fEmax),maximum of enhancement (Emax)were measured in three parts and compared in coronal,sagittal and transverse plane respectively.Results (1 )In coronal plane,there were no significant differences between the three parts in TTP,fEmax and Emax.(2 )In transverse plane,fEmax and Emax were lower in the transverse superior zone than that in the transverse central zone significantly (P＝0.024 and P＝0.001)and the transverse inferior zone(P＝0.005 and P＝0.018).TTP was higher in the transverse superior zone than that in the transverse central zone and the transverse inferior zone(P＝0.005 and P＝0.018).(3)In sagittal plane,fEmax and Emax were lower in the sagittal lateral zone than that in the sagittal centralzone (P＝0.019 and P＝0.041)and sagittal medial zone (P＝0.047 and P＝0.01 1).TTP was higher in the sagittal lateral zone than that in the sagittal central zone and the sagittal medial zone(P＝0.014 and P＝0.010).There were no significant differences between other paired zones of the any values.Conclusion DCE-MRI can show the microcirculation in the normal adult femoral head in a non-invasive way.According to DCE-MRI parameters,there are poor perfusions on the transversesuperior and sagittallateral zones of the normal femoral head in adults.
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Objective To explore the application of DCE-MRI and DWI in the preoperative diagnosis of breast cancer.Methods
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Objective To investigate the relationship between histogram analysis of DCE-MRI quantitative parameters and clinical stage of nasopharyngeal carcinoma (NPC).Methods 70 patients with NPC confirmed by pathology underwent MRI examination and staging.NPC tumors were measured by full-volume ROI setting method,and the obtained DCE-MRI quantitative parameters were analyzed by histogram.Spearman correlation coefficients were obtained to evaluate the potential correlation between the DCE-MRI histogram quantitative parameters and NPC clinical stages.Results The histogram-based Ktrans (mean,10 th,75 th,90 th),Kep (mean,10 th,kurtosis),and Ve (mean,90 th,skewness)had correlation with T stage (P＜0.05,respectively).The histogram-based Ktrans (mean)and Ve (mean,90 th) showed correlation with N stage (P＜0.05,respectively).The histogram-based Kep (kurtosis)and Ve (mean)had correlation with M stage (P＜0.05,respectively).The histogram-based Kep had no correlation with N stage,and Ktrans had no correlation with M stage. The histogram-based Ktrans (mean,10 th,75 th,90 th),Kep (10 th,75 th,kurtosis)and Ve (mean,75 th,90 th)had correlation with overall stage (P＜0.05,respectively).Conclusion The histogram analysis of DCE-MRI quantitative parameters showed that the multiple parameters associated with NPC overall stages.DCE-MRI quantitative parameters non-invasively reflect the aggressiveness and progression of NPC.The histogram analysis of DCE-MRI quantitative parameters may play a role in clinical stage of NPC.
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Objective To assess the contribution of contrast-enhanced spectral mammography (CESM) in detecting breast carcinoma of dense breasts. Methods To retrospectively analyze the imaging and clinical data of 52 female patients with breast carcinoma which were confirmed by pathology in Tai'an Central Hospital of Shandong Province from April 2017 to April 2018.All cases classified as dense or uneven dense breasts by DM examination underwent Ultrasound (US), digital mammography (DM), CESM, dynamic contrast enhanced MRI (DCE-MRI).The breast imaging report and data system (BI-RADS) and breast density classification were both evaluated using the 5th edition of BI-RADS. The efficacy of US, DM, DM+CESM, DCE-MRI in detecting breast carcinoma (BI-RADS 5) was evaluated by χ2 test. Results Histopathology confirmed that 87 lesions were malignant and 35 lesions were benign. The sensitivity of US, DM, DM +CESM, DCE-MRI were 66.67％(58/87), 64.37％(56/87), 100.00％(87/87), 100.00％(87/87) and the specificity were 94.28％(33/35), 74.28％(26/35), 85.71％(30/35), 51.43％(18/35), respectively. There was statistically significant difference in specificity (χ2=9.545, P=0.002) and BI-RADS 5 category, detection 39.08％(34/87), 22.99％(20/87), respectively (χ2=5.263, P=0.022) between the DM + CESM group and DCE-MRI group. Conclusion In dense breasts, CESM has a high application value in breast carcinoma diagnosis.
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Objective To analyze the imaging characteristics of contrast-enhanced ultrasound(CEUS) and dynamic contrast enhanced magnetic resonance imaging ( CEMRI) for diagnosis of hepatic epithelioid hemangioendothelioma ,and to increase the accuracy of diagnostic imaging . Methods The imaging characteristics of CEUS and dynamic CEMRI in 11 patients with hepatic epithelioid hemangioendothelioma confirmed by surgical pathology or fine needle aspiration biopsy were retrospectively analyzed . Results On conventional ultrasound ,14 lesions in 11 patients showed hypoechoic . The peripheral blood flow was detected in most patients by color Doppler flow imaging and the average resistant index was 0 .62 ± 0 .05 . During the arterial phase ,6 lesions showed diffuse enhancement ,6 lesions showed annular enhancement and 2 lesions showed branch enhancement .As to time of peak enhancement ,compared to the normal hepatic parenchyma ,hypoenhancement ,isoenhancement and hyperenhancement were observed in 1 lesion ,7 lesions and 6 lesions respectively . Synchronous enhancement was observed in 8 lesions on contrast-enhanced ultrasound ,rapid enhancement was observed in 5 lesions and slow enhancement was observed in 1 lesion and all lesions decreased quickly in portal phase and delayed phase . On CEMRI ,all lesions showed low signal on TIWI ,high signal on T2WI and DWI . There were 5 lesions showed obvious annular constant enhancement and 1 lesion showed obvious annular progressive enhancement . Progressive peripheral enhancement and fully filling in delayed phase were found in 4 lesions .While progressive peripheral enhancement and incompletely filling in delayed phase were found in 3 lesions . One lesion displayed constant enhancement and incompletely filling in delayed phase . Halo sign" , lollipopsign" , capsular retraction sign" and vessel sign" were appeared in 6 ,7 ,8 and 8 patients respectively . Conclusions Both contrast-enhanced ultrasound and CEMRI have characteristic manifestations for the diagnosis of hepatic epithelioid hemangioendothelioma and cominbing them would be great significance to improve the preoperative diagnostic accuracy .
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Objective To investigate the magnetic resonance multimodal function imaging characteristics of small hepa-tocellular carcinoma and evaluate its diagnostic value in small liver cancer. Methods Thirty-nine patients with small hepato-cellular carcinoma were selected in the First Affiliated Hospital of Xinxiang Medical University from January 2016 to January 2018. The magnetic resonance plain scan data,dynamic enhance data and diffusion imaging data of all patients were analyzed. Results Forty-five lesions were found by plain scan,and 48 lesions(37 lesions were rapid rise and rapid descent type,6 le-sions were flatbed type,3 lesions were slow ascent and rapid descent type,2 lesions were not obvious strengthening type)were found by dynamic enhancement. The lesions were hyperintense or slightly hyperintense on the diffusion weighted imaging (DWI)image. The lesions were hyperintense or slightly hyperintense on the DWI. The main shape of lesions was round,irregu-lar ring and nodositas. The apparent diffusion coefficient(ADC)value of cancer tissue and normal liver tissue gradually de-creased with the increase of b value. Under the same b value,the ADC values of small hepatocellular carcinoma was significant-ly lower than that in the normal liver tissue(P < 0. 05). Conclusion Magnetic resonance multimodality functional imaging (magnetic resonance imaging dynamic enhanced combine with multi-b value DWI)can effectively improve the diagnostic effi-cacy of small hepatocellular carcinoma.
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Objective To explore the value of dynamic contrast-enhanced MRI (DCE-MRI)with Exchange model in the quantitative evaluation of liver fibrosis.Methods Liver DCE-MRI was performed on 85 patients with chronic hepatitis confirmed by liver aspiration biopsy.Quantitative parameters,including volume transfer constant of the contrast agent (Ktrans),reverse reflux rate constant (Kep),volume fraction of EES (Ve),volume fraction of plasma (Vp),full perfusion (FP),portal venous perfusion (PVP),hepatic arterial perfusion (HAP),hepatic arterial perfusion index (HPI),mean transit time (MTT),time to peak (TTP) and blood volume (BV)were obtained by Exchange model.The parameters of each stage were compared by A N OVA analysis and LSD test was used for comparison between groups.Spearman rank correlation analysis was used to analyze the relationship between quantitative parameters and liver fibrosis stages.The diagnostic efficacy of Ktrans,Ve,HPI and MTT were analyzed by receiver operating curve (ROC).Results Ktransdecreased in all stages of liver fibrosis and Ve decreased in the late stages (S3 and S4)(P＜0.05).FP and PVP decreased in all stages and HAP increased in the late stage (P＜0.05);HPI,MTT and TTP increased in all stages,there were statistic differences between every two stages (P＜0.05).Ktrans and Ve were negatively correlated with live fibrosis staging (r=-0.837,-0.726, P＜0.05);PVP and FP were negatively correlated with live fibrosis staging (r=-0.927,-0.864,P＜0.05);HAP,HPI,MTT and TTP were positively correlated with live fibrosis staging (r=0.622,0.873,0.906,0.852,P＜0.05).Ktrans showed high sensitivity and specificity in diagnosis of ≥S2,≥S3 and S4 liver fibrosis;HPI and MTT showed high sensitivity,specificity and efficiency in diagnosis of every stage of liver fibrosis.Conclusion The quantitative study of DCE-MRI with Exchange model can be used for diagnosis and staging of liver fibrosis.
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Objective To investigate prospectively the changes of quantitative parameters in dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer patients before and after neoadjuvant chemotherapy (NACT).Methods Thirty-eight patients with locally advanced cervical cancer (in stage Ⅰ B2,Ⅱ A2,Ⅱ B) underwent DCE-MRI one week before and 1 month after NACT.The patients were classified into two groups:significant reaction(sCR) group and non-sCR group.The DCE-MRI pharmacokinetics parameters (mean Ktrans,mean Kep,mean Ve and mean Vp) were measured and compared between the sCR and non-sCR groups.Receiver operating characteristic (ROC) curves were constructed to describe the diagnostic accuracy of the significant parameters and their decision thresholds.Results There were 22 and 16 patients in sCR and non-sCR groups,respectively.Before NACT,the mean Ktrans was higher (P＜0.05) but the mean Ve (P＜0.05) was lower in sCR group than those in non-sCR group,and these differences were statistically significant,respectively.After NACT,the mean Ktrans (P＜0.05) and the changed value of Ktrans (P＜0.05) were significantly lower in the sCR group compared with those in the non-sCR group.The remained parameters such as Vp and Kep had no statistically difference between the two groups.When combined the parameters values before and after treatment by using ROC curves,the area under curve (AUC) of pre-mean Ktrans and /Ktrans were 0.801 (P＜0.05),0.955 (P＜0.001).The optimal cut off value for distinguishing sCR from non-sCR were the pretreatment Ktrans (0.702 0) and/Ktrans (0.043 7),and their sensitivity and specificity were 77.3％,81.2 ％,95.5％ and 81.2％,respectively.Conclusion Quantitative parameters of DCE-MRI provided a new noninvasive way to reflect the changes of hemodynamics in cervical cancer patients with NACT.The quantitative parameters,such as pre-mean Ktrans and /Ktrans could predict the treatment efficacy more precisely.
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Objective To analyze the diagnostic value of parameters derived from intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and dynamic contrast-enhanced MRI (DCE-MRI) in cervical cancer and to explore the correlation of parameters between DCE-MRI and IVIM-DWI.Methods MRI data of 30 patients with cervical cancer confirmed by surgical pathology and 26 patients with normal cervix confirmed by clinical or MRI examination were analyzed retrospectively.All patients underwent IVIM-DWI and DCE-MRI.The IVIM-DWI was performed to calculate the values of ADC,D,D* and f.The values of Ktrans,Kep and Ve were measured on DCE-MRI.All parameters between cervical cancer and normal cervix were compared by two independent sample t-test.Diagnostic efficacy of these parameters in cervical cancer group was evaluated by using area under curve(AUC).The correlation of these parameters between IVIM-DWI and DCE-MRI was analyzed by Pearson correlation.Results The D*,f,Ktrans,Kep and Ve in cervical cancer were significantly higher than those in normal cervix.The ADC and D in cervical cancer were significantly lower than those in normal cervix.The differences of these parameters between the two groups were statistically significant (P ＜0.05).The AUC of Ktrans was the maximum (0.958),with diagnostic sensitivity of 86.7％ and specificity of 100％.F and K were positively correlated (r=0.446,P＜0.05).F and Kep were positively correlated (r=0.400,P＜0.05).Conclusion IVIM-DWI and DCE-MRI can improve the diagnostic value of cervical cancer.DCE-MRI has better diagnostic performance than IVIM-DWI.Significantly positive correlations were found between perfusion paramenters from IVIM-DWI and quantitative perfusion paramenters from DCE-MRI.
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Objective To evaluate the value of 3.0T dynamic contrast-enhanced MRI (DCE-MRI)quantitative parameters for the diagnosis,pathological classification,clinical staging and lymph node status of cervical cancer.Methods The DCE-MRI data of 41 cases with cervical cancer and 1 5 cases with normal cervix were analyzed retrospectively.The quantitative parameters including Ktrans,Kepand Ve were obtained by Siemens Tissue 4D software.Statistical analysis was performed by SPSS 22.0.Results The Ktransand Kepvalues of cervical cancer group were significantly higher than normal cervix group(P<0.001),and there was no statistical difference in Vevalue between the two groups(P>0.05).The Ktransvalue of squamous carcinoma was significantly higher than adenocarcinoma(P<0.05),while Kep and Vevalues showed no statistical differences(P>0.05).The Ktransvalue of International Federation of Gynecology and Obstetrics (FIGO)for early cervical cancer was significantly lower than that for advanced cervical cancer(P<0.05),while Kepand Vevalues showed no statistical differences (P>0.05).There were no statistically significant differences in Ktrans,Kepand Vevalues between cervical cancer with or without lymph node metastasis(P>0.05).Conclusion The quantitative parameters of 3.0T DCE-MRI can be used for the diagnosis, pathological classification and clinical staging of cervical cancer,and it is also of great significance for the rational formulation of the clinical treatment plan.
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Objective To explore the significance of ADC value combined with MRI signs on identifying benign and malignant breast lump lesions with the type of TICⅡ.Methods 187 patients with breast lump lesions of TICⅡ,which were confirmed by surgical pathology,proceeded MRI.The ADC value,early-phase enhancement rate,length of lesions,lobulated appearance and spiculation, inverted nipple,thickening of the skin and the length of ipsilateral axillary lymph nodes were analyzed and recorded.T-tests was used to analyzed the measurement data,χ2test was used to analysis the attribute data.The ROC curves were used to evaluate the diagnostic efficiency of ADC value and MRI signs.Results The ADC value was (1.418±0.299)×10-3mm2/s and(0.860±0.142)× 10-3mm2/s (P<0.01)for breast benign and malignant lesions respectively,while the early-phase enhancement rate were (170.387± 74.580)% and (160.778±39.786)%(P=0.258)respectively.When ADC values were used for differential diagnosis of breast benign and malignant lesions with a threshold of 1.017×10-3mm2/s,the area under the sensitivity and specificity were 89.0% and 98.0% The sensitivity and specificity of lobulated appearance,spiculation,inverted nipple and thickening of the skin were 92.6% and 33.3%, 88.2% and 88.2%,20.5% and 94.1%,35.3% and 88.2%,respectively.When the 1.0 cm was used as the threshold of the length of ipsilateral axillary lymph,its sensitivity and specificity were 47.8% and 80.4%.The ROC curve of early-phase enhancement rate showed no diagnostic capability(P>0.05).Conclusion ADC value combined with MRI features are helpful to improve the sensitivity and specificity in breast lesions with the type of TICⅡ.
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Objective To explore the application value of different dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) models in pathological grading of breast invasive ductal carcinoma.Methods Forty-five cases of breast invasive ductal carcinoma confirmed by clinical pathology from June 2016 to October 2017 in Shanxi Provincial People's Hospital were enrolled in this study.Grade 1 and 2 invasive ductal carcinomas were classified into the low-grade group,grade 3 invasive ductal carcinomas was classified as the high-grade group.The whole patients underwent DCE-MRI scans.Volume transport constant (Ktrans) was obtained by using the Extended Tofts Linear model with population arterial input function (AIF).Then,the Reference Region model was used to obtain the reference region model volume transport constant(RRKtrans).The performances of histogram analysis of these two quantitative parameters in pathological grading of breast invasive ductal carcinoma were compared.Results The mean,25 ％,50 ％,75 ％,90 ％ percentiles,kurtosis and skewness of RRKtrans in high grade group were (0.793±0.258)/min,(0.484±0.209)/min,(0.773±0.277)/min,(1.066±0.351)/min,(1.322±0.406)/min,2.647 (1.426,3.679),0.398 (0.297,0.514) respectively,and the corresponding parameters in low grade group were (0.506±0.203)/min,(0.301 ±0.142)/min,(0.487 ±0.211)/min,(0.692±0.281)/min,(0.861±0.323)/min,1.725 (0.779,2.316),0.258 (0.133,0.302) respectively.There were significant differences between the two groups (all P ＜ 0.05).The mean,50 ％,75 ％,90 ％percentiles of Ktrans in high grade groups were (0.099±0.034)/min,(0.110±0.033)/min,(0.132±0.045)/min,(0.140±0.047)/min respectively,and the corresponding parameters in low grade group were (0.067±0.030)/min,(0.082 ±0.067)/min,(0.096 ±0.059)/min,(0.113 ±0.074)/min respectively.There were significant differences between the two groups (all P ＜ 0.05).RRKtrans was superior to Ktrans in distinguishing area under the curve (AUC) of receiver operating characteristic curve (ROC) of high and low grading of breast invasive ductal carcinoma.Conclusion RRKtrans obtained by Reference Region model and Ktrans obtained by Population AIF DCE-MRI have some values in pathological grading of breast invasive ductal carcinoma,but the performance of RRKtrans is superior to Kftrans.
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OBJECTIVE: To evaluate the incidence, characteristics, and variations of the falcine sinus with contrast-enhanced three-dimentional (3D) thin-section magnetic resonance (MR) images. MATERIALS AND METHODS: retrospective review identified 1531 patients (745 males and 786 females, 2 months to 85 years) who underwent cranial MR imaging including T1-weighted imaging, T2-weighted imaging, T2-weighted fluid-attenuated inversion recovery, contrast-enhanced 3D thin-section sagittal scans, and MR venography, from June 2014 to January 2016. The incidence, characteristics of the falcine sinus, and coexisted intracranial lesions were confirmed by two neuroradiologists. RESULTS: Falcine sinuses were identified in 81 (38 males and 43 females) cases (5.3%, 81/1531, 5 months to 76 years of age) with calibers ranging from 2.3 mm to 17.0 mm. Three major forms of falcine sinuses were defined: arch-like (n = 47), stick-like (n = 22), and bifurcated (n = 12). Persistent falcine sinuses were found in 57 cases, among which 3 cases showed complicated cerebral anomalies, and 2 cases showed smaller straight sinuses. Recanalization of falcine sinuses were found in 24 cases, including 17 cases with tumor compression, 6 cases with cerebral venous sinus thrombosis, and one case with hypertrophic meningitis. CONCLUSION: Falcine sinus is not as rare as has been reported previously. Most falcine sinuses are not associated with congenital cerebral abnormalities. Diseases that cause increased pressure in the venous sinus may lead to recanalization of falcine sinus. Illustrating the characteristics of falcine sinus may prompt a more comprehensive understanding and diagnosis of associated diseases, and avoid potential surgical damage in the future.
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Female , Humans , Male , Diagnosis , Incidence , Magnetic Resonance Imaging , Meningitis , Phlebography , Retrospective Studies , Sinus Thrombosis, IntracranialABSTRACT
Objective To study the application of dynamic contrast-enhanced MRI (DCE-MRI)in preoperative TN staging of rectal cancer. Methods Seventy-two patients with rectal cancer confirmed by surgery and pathology underwent preoperative conventional MRI and DCE-MRI.The consistencies between conventional MRI and pathology,conventional MRI combined with DCE-MRI and pathology in diagnosing the TN staging were analyzed retrospectively.The quantitative parameters of DCE-MRI including Ktrans,Veand Kepwere measured to analyze the correlation with T staging and lymph nodes metastasis.Results The accuracy of conventional MRI and conventional MRI combined with DCE-MRI in diagnosing the T staging were 72.2% and 84.7%,respectively,in diagnosing the N staging were 65.3% and 77.8%, respectively.The DCE-MRI quantitative parameters (Ktransvalue,Vevalue and Kepvalue)were positively related to the T staging and lymph nodes metastasis(P<0.05).Conclusion DCE-MRI can improve the accuracy of the preoperative TN staging of rectal cancer. DCE-MRI quantitative parameters of Ktrans,Ve,Kepvalues can help to determine T staging and lymph node properties of rectal cancer.
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Objective To probe into the clinical application value of dynamic contrast-enhanced MR imaging (DCE-MRI) and diffusion weighted imaging (DWI) in identifying benign and malignant breast lesions.Methods 60 patients with clinically suspected breast lesions underwent MR examination.Morphologic features,early enhancement rate,time-signal intensity curve (TIC),apparent diffusion coefficient (ADC) value,as well as the differences between ADC values of the surrounding normal tissues and these of the lesions were compared and analyzed.Results The areas under the receiver operating characteristic curves (AUC) of the early enhancement rate,TIC,ADC value,ADC difference value were 0.741,0.808,0.882 and 0.959,respectively;the best diagnostic thresholds for the early enhancement rate,ADC value,and ADC difference value were 163％,1.30× 10-3 mm2/s and 0.47× 10-3 mm-2/s,respectively.The sensitivity of morphologic features,early enhancement rate,type Ⅲ curve,type Ⅱ and type Ⅲ curve,ADC value and ADC difference value in differentiating benign and malignant breast lesions was 53.1％,59.4％,43.8％,90.6％,93.8％ and 96.9％,respectively;the specificity was 85.7％,82.1％,89.3％,57.1％,75.0％ and 82.1％,respectively;the positive predictive values were 81.0％,79.2％,82.4％,70.7％,81.1％ and 86.1％,respectively;the negative predictive values were 61.5％,63.9％,58.1％,84.2％,91.3％ and 95.8％,respectively;and the accuracy was 68.3％,70.0％,65.0％,75.0％,85.0％,90.0％,respectively.Conclusion DCDMRI and DWI play important roles in differential diagnosis of benign and malignant breast lesions,among which ADC difference value is associated with the highest diagnostic capability.Combination of multiple imaging diagnostic methods is necessary to improve the diagnostic accuracy of breast lesions.
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Objective To explore the application value of multiphase dynamic contrast-enhanced MRI (MDCE-MRI) in the early chemoradiation efficacy in cervical cancer.Methods Twenty-one patients with cervical cancer received chemoradiation.Routine MR scan and MDCE-MRI scan were examined at different stages, including pre-treatment, 15 days,1 month and 2 months after treatment.According to volume change of the tumor after treatment, the cases were mainly divided into complete remission(CR), partial remission (PR).The correlation between volume change of cancer after treatment and the time-signal intensity curve (TIC),mean time to enhancement(MTE),time to peak(TTP),maximum slope of increase(MSI),maximum slope of decrease(MSD), negative enhancement integral (NEI) were analysed.Results After system chemoradiation for 2 months,4 of enrolled patients got complete remission and 17 partial remission.The reduction rate of the tumor diameter was negatively correlated to MSI values(r=-0.877,P<0.05) and positively related with NEI (r=0.819,P<0.05) before the treatment.15 days after the treatment, the diminished rate of the tumor diameter had active relation with change of TTP(r=0.765,P<0.05) and NEI(r=0.775,P<0.05).It indicated that MSI and NEI values before cervical cancer chemoradiation and the variation of TTP and NEI after treatment for 15 days could help predict the variation tendency of cancer diameter.Chemoradiation and therapy 1 month later,for all the parameters'' AUC values,the change rate of NEI were the largest one.When the critical value was not less than 96.46%, the sensitivity was 82.4%, specificity was 75%.TIC curve of type Ⅰ increased, type Ⅲ decreased to disappear gradually.Conclusion MDCE-MRI can be used to predict the efficacy of chemoradiation in cervical cancer patients, of which the MSI, TTP and NEI are more sensitive.