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OBJECTIVES@#With the increasing detection rate of lung nodules, the qualitative problem of lung nodules has become one of the key clinical issues. This study aims to evaluate the value of combining dynamic contrast-enhanced (DCE) MRI based on time-resolved imaging with interleaved stochastic trajectories-volume interpolated breath hold examination (TWIST-VIBE) with T1 weighted free-breathing star-volumetric interpolated breath hold examination (T1WI star-VIBE) in identifying benign and malignant lung nodules.@*METHODS@#We retrospectively analyzed 79 adults with undetermined lung nodules before the operation. All nodules of patients included were classified into malignant nodules (n=58) and benign nodules (n=26) based on final diagnosis. The unenhanced T1WI-VIBE, the contrast-enhanced T1WI star-VIBE, and the DCE curve based on TWIST-VIBE were performed. The corresponding qualitative [wash-in time, wash-out time, time to peak (TTP), arrival time (AT), positive enhancement integral (PEI)] and quantitative parameters [volume transfer constant (Ktrans), interstitium-to-plasma rate constant (Kep), and fractional extracellular space volume (Ve)] were evaluated. Besides, the diagnostic efficacy (sensitivity and specificity) of enhanced CT and MRI were compared.@*RESULTS@#There were significant differences in unenhanced T1WI-VIBE hypo-intensity, and type of A, B, C DCE curve type between benign and malignant lung nodules (all P<0.001). Pulmonary malignant nodules had a shorter wash-out time than benign nodules (P=0.001), and the differences of the remaining parameters were not statistically significant (all P>0.05). After T1WI star-VIBE contrast-enhanced MRI, the image quality was further improved. Compared with enhanced CT scan, the sensitivity (82.76% vs 80.50%) and the specificity (69.23% vs 57.10%) based on MRI were higher than that of CT (both P<0.001).@*CONCLUSIONS@#T1WI star-VIBE and dynamic contrast-enhanced MRI based on TWIST-VIBE were helpful to improve the image resolution and provide more information for clinical differentiation between benign and malignant lung nodules.
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Adult , Humans , Retrospective Studies , Magnetic Resonance Imaging , Plasma , Tomography, X-Ray Computed , LungABSTRACT
:To explore the value of quantitative perfusion histogram parameters of dynamic contrast-enhanced magnetic resonance imaging （DCE-MRI） in pathological classification of uterine leiomyoma and its correlation with Ki-67 protein expression. Thirty five patients with uterine leiomyoma confirmed by operation and pathology at Shaoxing People's Hospital from October 2015 to September 2017 were analyzed retrospectively，including 15 cases of ordinary type，8 cases of cellular type and 12 cases of degenerative type. All patients were examined by pelvic DCE-MRI before operation，and the histogram parameters （median，mean，skewness，kurtosis，energy，entropy） of various quantitative perfusion parameters，including volume transport constant （K），rate constant （K），extravascular extracellular space distribute volume per unit tissue volume （V），blood plasma volume per unit volume of tissue （V） were calculated，and the efficacy of different parameters in pathological classification of uterine leiomyoma was evaluated by ROC curve. The expression of Ki-67 protein in uterine leiomyoma was detected by immunohistochemical method，and the correlation between histogram parameters and Ki-67 protein expression was analyzed by Pearson and Spearman correlation analysis. The median and mean values of K，K，V and V in the cellular group were higher than those in the degenerative group and the ordinary group（<0.05 or <0.01），while the skewness of V，the skewness and kurtosis of K in the cellular group were lower than those in the ordinary group （all <0.05）. The entropy of K in the cellular group was higher than that in the degenerative group and the ordinary group （all < 0.05）. The entropy of V in the cellular group was higher than that in the ordinary group （<0.01）. The median，mean，skewness of K，median and mean of K，median and mean of V，median，mean，energy and entropy of V were correlated with Ki-67 expression（all <0.05）. The results of ROC curve analysis showed that the median threshold of K was 0.994/min，the sensitivity and specificity for the diagnosis of cellular uterine leiomyoma were 100.0% and 77.8% respectively，and the area under the ROC curve was 0.949. When the mean threshold of K was 1.170/min，the sensitivity and specificity for diagnosing cellular uterine leiomyoma were 100.0% and 77.8% respectively，and the area under the ROC curve was 0.958. The area under the ROC curve of K （entropy），K （median，mean），V （median，mean，entropy） in the diagnosis of cellular uterine leiomyoma were 0.755-0.907. :DCE-MRI quantitative perfusion histogram parameters have high diagnostic value in differentiating pathological types of uterine leiomyoma，especially for cellular uterine leiomyoma.
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Humans , Contrast Media , Leiomyoma/diagnostic imaging , Magnetic Resonance Imaging , Perfusion , Retrospective StudiesABSTRACT
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 explore the value of dynamic contrast-enhanced MR imaging (DCE-MRI) of original plaque to predict carotid artery in-stent restenosis (ISR). Methods: Forty cases of the patients with carotid atherosclerosis who were to undergo the carotid artery stenting (CAS) were included in this study. All participants underwent vessel wall MR imaging (VW-MRI) and DCE-MRI within one week before CAS. Carotid digital subtraction angiography (DSA) were performed at the sixth month to reassess the stenosis of stent. The correlation between DCE-MRI and ISR was evaluated. Results: The level of Ktran in ISR group was significantly higher than that in non-ISR group (P=0.000), and so was the vP (P=0.037). Ktrans could independently predict ISR (OR=1.43, 95%CI 1.17-1.56, P=0.012), and the cut-off value of Ktrans was 0.09 min-1 (sensitivity=100%, specificity=87.5%). Conclusion: Intraplaque inflammation may lead to excessive intimal hyperplasia after ISR. Ktrans could be a risk predictor of ISR with high sensitivity and specificity. DCE-MRI could be an effective tool to predict ISR.
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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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PURPOSE: To evaluate the usefulness of wash-in color map in detecting early enhancement of prostate focal lesion compared to whole dynamic contrast-enhanced MRI (DEC MRI) images. MATERIALS AND METHODS: This study engaged 50 prostate cancer patients who underwent multiparametric MRI and radical prostatectomy as subjects. An expert [R1] and a trainee [R2] independently evaluated early enhancement and recorded the time needed to review 1) a wash-in color map and 2) whole DCE MRI images. RESULTS: The review of whole DCE images by R1 showed fair agreement with color map by R1, whole images by R2, and color map by R2 (weighted kappa values = 0.59, 0.44, and 0.58, respectively). Both readers took a significantly shorter time to review the color maps as compared to whole images (P < 0.001). CONCLUSION: A trainee could achieve better agreement with an expert when using wash-in color maps than when using whole DCE MRI images. Also, color maps took a significantly shorter evaluation time than whole images.
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Humans , Magnetic Resonance Imaging , Prostate , Prostatectomy , Prostatic NeoplasmsABSTRACT
Magnetic resonance (MR) perfusion weighted imaging (PWI) is a functional MR imaging technique that reflects the distribution of tissue microvessels and blood perfusion. In recent years,with the development of MR technology, PWI has been widely used in the clinical diagnosis and treatment of cerebral infarction. Dynamic susceptibility contrast-enhanced imaging can delineate the ischemic penumbra and evaluate the compensation of collateral circulation. Dynamic contrast-enhanced imaging can reflect the integrity of blood-brain barrier, evaluate risk of the hemorrhagic transformation and the compensation of collateral circulation. The technique of arterial spin labeling can also be used to delineate ischemic penumbra, confirm the perfusion around the infarct core,and to evaluate the collateral circulation. The relevant studise on MR PWI in acute cerebral infarction will be reviewed.
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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 evaluate the value of MR DWI combined with dynamic contras-t enhanced (DCE)scanning in the differential diagnosis of orbital lymphoma and inflammatory pseudotumor.Methods The clinical and imaging data of 1 5 cases with orbital lymphoma and 10 cases with inflammatory pseudotumor confirmed by surgery and pathology were analyzed retrospectively.25 patients were performed with conventional MR scanning,DWI scanning and DCE scanning.ADW4.7 software was used for DWI images and DCE images pos-t processing for analyzing the two groups of lesions in the TIC subtyping.Independent sample t test statistical analysis was used for comparing two groups of ADC values and Tmax values.The ROC curve was used for determining the statistically significant differences in measurement data of the threshold.With pathologic and immunohistochemical results as the gold standard,the accuracy,sensitivity and specificity of DWI combined with DCE in the diagnosis of orbital lymphoma and inflammatory pseudotumor were further detected.Results Among the 1 5 patients with orbital lymphoma,8 cases (8/15)occurred in the lacrimal gland area,5 cases (5/1 5)occurred in the outer cone space and 2 cases (2/15)occurred in the eyelid.Among the 10 patients with inflammatory pseudotumor,6 cases (6/10)occurred in the lacrimal gland and 4 cases (4/10)in the bulb.Among the 25 patients,9 of them had the TIC curve of outflow,6 of them had the TIC curve of platform and 10 of them had the TIC curve of inflow.The ADC value of orbital lymphoma was (0.573 ±0.1 1 6)×10－3 mm2/s,and the Tmax value was (248.2±1 59.4)ms.The ADC value of inflammatory pseudotumor was (1.186±0.244)×10－3 mm2/s,and the Tmax value was (5 5 7.6 ±98.7)ms.With the ADC＝0.885×10－3 mm2/s for the threshold,the AUC was 0.9 3 6 ,with diagnostic accuracy of 9 1.3%, the sensitivity of 90.1% and specificity of 80%.With the Tmax＝481.2 ms as the threshold,the AUC was 0.927,with the diagnosis accuracy rate of 88%,the sensitivity of 80%,and the specificity of 86.7%. Finally,DWI combined with DCE could reach the AUC 0.945, diagnostic accuracy of 89.5%,sensitivity of 93.3%,and specificity of 82.6%.Conclusion Conventional MRI scan combining DWI with DCE could show the histological components of the lesion of orbital tumor,which is of certain significance for the qualitative diagnosis of orbital lymphoma and inflammatory pseudotumor.
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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 TostudythevalueofquantitativeparametersofDCE-MRIandthreedimensionalarterialspinlabeling(3D-ASL) inpreoperativegliomagrading.Methods 70patientsdiagnosedpathologicallywithinitialgliomawereassessedretrospectively,including 32caseswithlow-gradeglioma(LGG)and38caseswithhigh-gradeglioma(HGG).Allpatientsunderwentconventional,enhanced, DCEand3D-ASL MRIat3.0Tbeforesurgery.TheparametricvaluesofDCEsuchasvolumetransferconstant(Ktrans),extravascular extracellularspacevolumefraction(Ve),therateconstant(Kep),fractionalplasmavolume(Vp),cerebralbloodflow (CBF)andcerebral bloodvolume(CBV)wereobtainedbycorrespondingpost-processingsoftware.ThecerebralbloodflowofASL (ASL-CBF)wasalso obtained.Ttestoftwoindependentsampleswasusedtoanalyzewhetherthemaximumandaveragevaluesofeachparameterwere statisticallydifferentbetweenLGGand HGG.Thediagnosticaccuracyofdifferenttechniqueforgliomagradingwasdeterminedby ROCcurveanalysis.Results ThemaximumvaluesofDCE-Ktrans,Ve,rCBVandmaximumvalueofASL-rCBFwerestatisticallydifferent betweentheHGGandLGG (P＜0.05).AlltheparametricaveragevalueswerestatisticallydifferentbetweentheHGGandLGG (P＜0.05).ThemaximumandaveragevaluesofKtranshadarelativelyhighestdiagnosticefficiencyinallparameters,withtheAUCwere0.986 and0.971,theoptimumthresholdwere0.264and0.068,thesensitivitywere93.3%and94.1%,andthespecificitywere100%and 100%,respectively.ThemaximumvaluesofVe,rCBV,ASL-rCBFandtheaveragevaluesofallparametershadarelativelyhigher diagnosticefficiency.Conclusion ThemaximumvaluesofKtrans,VeandrCBFofDCE,themaximumvalueofASL-rCBFandtheaverage valueofeachparameterwereusefultodistinguishbetweenLGGand HGG.ThemaximumandaveragevaluesofKtransarethebest parametersforidentifyingHGGandLGG.
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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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Background and purpose: The technique of dynamic contrast-enhanced MRI (DCE-MRI) is widely applied in differential diagnosis between benign and malignant tumor and therapeutic estimation of neoadjuvant chemotherapy in clinic. However, there is no standard quantitative measurement method. This study aimed to assess the variability of different region of interest (ROI) selections for tumor bed of breast cancer using DCE-MRI, and to ascertain the optimal ROI delineation. Methods: We retrospectively analyzed DCE-MRI of 30 patients diagnosed with breast cancer by pathology. The ROIs were delineated by 2 different observers using iCAD software with 4 methods, including whole tumor (Whole), the slice containing the most enhancing voxels (SliceMax), 3 slices centered in SliceMax (Partial) and the 5％ most enhancing contiguous voxels within SliceMax (5Max), to generate the volume transfer constant (Ktrans), the extracellular volume fraction (Ve) and rate constant (Kep). And the reproducibilities of the measurements were assessed using the Bland-Altman method. Results: In the analysis of ROIs delineation, the Ktrans, Ve and Kep reported by different observers were 1.26±0.54 vs 1.25±0.53, 0.75±0.23 vs 0.73±0.22 and 1.93±1.46 vs 1.95±1.51 (P＞0.05) using the method of Whole, and 1.28±0.43 vs 1.26±0.43, 0.74±0.21 vs 0.80±0.27, 1.95±1.53 vs 1.93±1.43 (P＞0.05) using the method of Partial, and 1.30±0.33 vs 1.32±0.33, 0.77±0.20 vs 0.73±0.24, 1.82±1.53 vs 1.87±1.45 (P＞0.05) using the method of SliceMax, and 1.31±0.35 vs 1.35±0.33, 0.77±0.20 vs 0.98±0.25, 1.97±1.36 vs 1.73±1.55 using the method of 5Max (P＜0.05). Using the methods of ROI delineation except 5Max, there was no significant difference between Ktrans, Ve and Kep reported by different observers. The bias vs limits of agreement were 0.002 vs-0.013 to 0.012,-0.003 vs-0.023 to 0.017, 0.006 vs-0.018 to 0.029,-0.035 vs-0.054 to 0.018 measured with Whole method, SliceMax, Partial and 5Max respectively using the Bland-Altman method. Conclusion: It may be reliable to measure functional parameters of primary tumors in breast cancer using DCE-MRI according to the methods of Whole, Partial and SliceMax.
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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 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 value of quantitative analysis of dynamic contrast-enhanced MRI (DCE-MRI) and diffusion weighted imaging (DWI) for differentiating malignant from benign orbital lymphoproliferative disorder(OLPD). Methods Forty-three patients with OLPDs(20 patients with benign OLPDs and 23 patients with orbital lymphoma) confirmed by histopathology or clinical follow-up were enrolled in this retrospective study.Quantitative parameters of DCE-MRI including volume transfer constant (Ktrans), flux rate constant (Kep), and extravascular extracellular volume fraction (Ve) and mean apparent diffusion coefficient(ADC)values were obtained. χ2test and t test were used to compare the differences of qualitative and quantitative parameters between two groups. Receiver operating characteristic (ROC) curve analyses were used to evaluate the diagnostic ability of each parameter and its combination. Results Malignant group showed significantly lower mean ADC values and higher Kepvalues than benign group [ADC:(0.674±0.126)×10-3mm2/s vs(1.030±0.304)×10-3mm2/s,P<0.001;Kep:(1.299±0.566)/min vs(0.787± 0.311)/min, P= 0.001], while no significant differences was found on Ktrans(P= 0.637) and Ve(P= 0.023). ROC analyses results indicated that,a sensitivity of 95.7%,specificity of 80.0% and area under curve(AUC) of 0.896 could be obtained,when using ADC=0.809×10-3mm2/s as the cut-off value.Setting the Kepvalue of 0.863/min as the cut-off value, a sensitivity of 91.3%, specificity of 75.0% and AUC of 0.848 could be obtained. When combination of mean ADC and Kepwas used, optimal diagnostic performance could be obtained (AUC, 0.926;sensitivity, 91.3%;specificity, 90.0%). Conclusion Mean ADC values and Kepare significant variables in predicting malignant OLPDs. Combination of DWI and DCE-MRI can further improve the diagnostic capability in differentiating malignant from benign OLPDs.