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Objective:To explore the value of BLADE sequence in determining the target range of esophageal cancer radiotherapy through the correlation and consistency between measured esophageal cancer length on the MRI-BLADE sequence and the surgical pathological specimens.Methods:Clinical data of 36 patients who were pathologically diagnosed with esophageal carcinoma and received preoperative esophageal MRI in the Affiliated Cancer Hospital of Zhengzhou University between January 2016 to June 2019 were collected. The CT, DWI and BLADE sequence images of all participants were collected and imported into the Monaco system, by which the correlation and consistency between the tumor length measured based on these three imaging methods were statistically compared. Furthermore, the differences in gross tumor volume (GTV) delineated by different physicians in different images were compared.Results:The correlation coefficients of the tumor length measured by CT, DWI and BLADE and pathological specimen length were 0.467, 0.723 and 0.896, respectively. The consistency analysis indicated that all the differences between the BLADE sequence and pathological specimen length were within the 95% consistency limit. The consistency and correlation between the BLADE sequence and actual tumor length were significantly better than those between the DWI sequence and CT images (both P<0.05). The volume of DWI and BLADE images obtained by four physicians was significantly smaller than that of CT images (both P<0.05). The differences in GTV delineated by different physicians by these three imaging methods were insignificant (all P>0.05), but the GTV delineated by the four physicians on the BLADE sequence were more similar (all P>0.05). Conclusions:BLADE sequence can help physicians to determine the upper and lower boundaries of esophageal tumors more accurately and reduce the differences in GTV delineation among different physicians. And it can effectively improve the unity of individual′s understanding of the scope of target area delineation, and improve the objectivity of clinicians′ judgment of GTV. BLADE sequence can be used as an important imaging tool for accurate target delineation in radiotherapy.
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Objective@#To evaluate the value of MRI-T2WI texture analysis in the differentiation of atypical medulloblastoma and ependymoma of the fourth ventricle.@*Methods@#Preoperative MRI data of 36 cases of fourth ventricle tumor (19 cases of medulloblastoma and 17 cases of ependymoma) confirmed by the Central Theater General Hospital of the Chinese People′s Liberation Army were retrospectively analyzed. Manually sketch areas of interest (ROI) were made using texture analysis software to get histogram parameters, including mean, median, standard deviation, skewness, kurtosis, maximum, minimum, heterogeneity, entropy, the 5th percentile (T2WI5th), the 10th percentile (T2WI10th), the 25th percentile (T2WI25th), the 50th percentile (T2WI50th), the 75th percentile(T2WI75th), the 95th percentile(T2WI95th). Independent sample t test or mann-whitney U test was used for statistical analysis of each parameter value between the two groups. Logistic regression analysis was used to perform multiparameter joint analysis on meaningful parameters. The area under the curve (AUC) was obtained by using the subject operating characteristic (ROC) curve to determine the threshold and diagnostic efficacy for distinguishing the two group.@*Results@#The mean, median, T2WI5th, T2WI10th, T2WI25th, T2WI50th, T2WI75th values of the medulloblastoma group were smaller than those of the ependymoma group, and difference was statistically significant (P<0.05). The T2WI5th had the best diagnostic performance. When the critical value was 1 343, the diagnostic specificity was 75.0% and the sensitivity was 92.9%. Logistic regression was used to predict the joint analysis of probability parameters. T2WI5th+T2WI10th had the best performance, and AUC was 0.928. When the critical value was 0.75, the diagnostic specificity was 75.0% and the sensitivity was 100.0%.@*Conclusions@#MRI-T2WI texture analysis can provide quantitative information for preoperative diagnosis of atypical medulloblastoma and ependymoma and improve the accuracy of preoperative diagnosis, which has obvious clinical value.
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Objective To evaluate the value of MRI-T2WI texture analysis in the differentiation of atypical medulloblastoma and ependymoma of the fourth ventricle.Methods Preoperative MRI data of 36 cases of fourth ventricle tumor (19 cases of medulloblastoma and 17 cases of ependymoma) confirmed by the Central Theater General Hospital of the Chinese People's Liberation Army were retrospectively analyzed.Manually sketch areas of interest (ROI) were made using texture analysis software to get histogram parameters,including mean,median,standard deviation,skewness,kurtosis,maximum,minimum,heterogeneity,entropy,the 5th percentile (T2WI5th),the 10th percentile (T2WI10th),the 25th percentile (T2WI25th),the 50th percentile (T2WI50th),the 75th percentile(T2WI75th),the 95th percentile (T2WI95th).Independent sample t test or mann-whitney U test was used for statistical analysis of each parameter value between the two groups.Logistic regression analysis was used to perform multiparameter joint analysis on meaningful parameters.The area under the curve (AUC) was obtained by using the subject operating characteristic (ROC) curve to determine the threshold and diagnostic efficacy for distinguishing the two group.Results The mean,median,T2WI5th,T2W10th,T2WI25th,T2WI50th,T2WI75th values of the medulloblastoma group were smaller than those of the ependymoma group,and difference was statistically significant (P ＜ 0.05).The T2WI5th had the best diagnostic performance.When the critical value was 1 343,the diagnostic specificity was 75.0％ and the sensitivity was 92.9％.Logistic regression was used to predict the joint analysis of probability parameters.T2WI15th+T2WI10th had the best performance,and AUC was 0.928.When the critical value was 0.75,the diagnostic specificity was 75.0％ and the sensitivity was 100.0％.Conclusions MRI-T2WI texture analysis can provide quantitative information for preoperative diagnosis of atypical medulloblastoma and ependymoma and improve the accuracy of preoperative diagnosis,which has obvious clinical value.
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Objective@#To evaluate the value of T2WI signal intensity related parameters that can be obtained by magnetic resonance imaging (MRI) for predicting pathological complete response (pCR) after neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanved rectal cancer (LARC).@*Methods@#Signal Intensity of Tumor (SIT) and Signal Intensity of Tumor/Muscle (SIT/M) of MR T2WI before and after neoadjuvant chemoradiotherapy of 101 patients with locally advanced rectal cancer were evaluated by two experienced readers independently. Signal Intensity of Tumor Reduction Rate (SITRR) and Signal Intensity of Tumor/Muscle Reduction Rate (SIT/MRR) were calculated. The difference of related parameters of T2WI tumor signal intensity between the pCR and the non-pCR group were analyzed. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic performance for predicting pCR.@*Results@#Of the 101 patients, 18 were in pCR group and 83 were in non-pCR group. In all patients, the SITpre, SITpost, SITRR, SIT/Mpre, SIT/Mpost and SIT/MRR measured by reader 1 were 197.0 (133.0), 144.2 (69.7), 0.4% (0.5%), 2.6 (0.6), 3.0 (2.3) and 0.4 (0.2)% in pCR group, and 227.0 (99.0), 205 (95.4), 0.1% (0.6%), 2.6 (0.6), 2.6 (1) in non-pCR group, respectively. SITpre, SITpost, SITRR, SIT/Mpre, SIT/Mpost and SIT/MRR measured by reader 2 were 193.0 (135.0), 143.0 (69.8), 0.4% (0.2%), 2.6 (0.6), 1.5 (0.5) and 0.39% (0.2%) in pCR group, and 234.0(108.0), 203(96.5), 0.1% (0.3%), 2.6 (0.6%), 1.7 (0.7) and 0.25% (0.2%) in non-pCR group, respectively. Between the pCR and non-pCR group, there were significant differences in SITpost, SIT/Mpost and SIT/MRR measured by both readers (all P<0.01), but there was no significant differences in SITpre and SIT/Mpre (P>0.05). The difference of SITRR measured by reader 1 was not statistically significant (P=0.415), while the difference of SITRR measured by reader 2 was statistically significant (P=0.001). In patients with rectal non-mucinous adenocarcinoma, SITpost, SIT/Mpost, SITRR and SIT/MRR measured by two physicians were still statistically significant between the pCR and non-pCR group (all P<0.01), but SITpre and SIT/Mpre had no significant difference (P>0.05). ROC curve analysis showed that in all patients, the area under curve (AUC) of SITpost, SIT/Mpost and SIT/MRR for predicting pCR to neoadjuvant chemoradiotherapy in locally advanced rectal cancer was 0.694-0.762, the sensitivity was 68.2%-77.3%, and the specificity was 63.6%-77.3%. In rectal non-mucinous adenocarcinoma patients, the AUC, sensitivity and specificity was 0.704-0.764, 62.7%-78.9% and 66.2%-84.2%, respectively.@*Conclusions@#T2WI signal intensity related parameters are potential predictors for pCR in locally advanced rectal cancer after neoadjuvant chemoradiptherapy. The predictive value is higher in non-mucinous adenocarcinoma.
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Objective To investigate the value of MR 3D CUBE T2WI sequence in displaying anatomical structure of knee joint.Methods Sixty cases of knee joints (30 cases in lesion group and 30 cases in control group) were scanned with conventional 2D and 3D CUBE T2WI sequence by HDXt 3.0T superconducting magnetic resonance of GE Signa imaging system and hased-array coil.The meniscus,articular cartilage,anterior and posterior cruciate ligaments demonstrated by two sequences were evaluated as excellent,good and poor grade,the results were comparatively analyzed by statistics.Results 3D CUBE T2WI was superior to conventional 2D sequence in displaying of articular cartilage,anterior and posterior cruciate ligaments,and inferior to conventional 2D sequence in displaying of meniscus(all P =0.000).When we put excellent and good levels of image quality as according with diagnostic requirement.The satisfaction rate demonstrating anterior and posterior cruciate ligaments by 3D CUBE T2WI sequence in lesion and control group were 100％,articular cartilage was 93.33％ in control group and 90.00％ in lesion group,while the meniscus was 30.00％ in control group and 33.33％ in lesion group.Conclusion MR 3D CUBE T2WI sequence is a sensitive technique in demonstrating ligaments and articular cartilage of knee joint,but it was inferior to conventional 2D sequence in displaying of meniscus.We should adopt it according to clinical diagnosis.
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PURPOSE: To compare the frequency of posterior globe flattening between two-dimensional T2-weighted imaging (2D T2WI) and three-dimensional (3D T2WI). MATERIALS AND METHODS: Sixty-nine patients (31 female; mean age, 44.4 years) who had undergone both 5-mm axial T2WI and sagittal 3D 1-mm isovoxel T2WI of the whole brain for evaluation of various diseases (headache [n = 30], large hemorrhage [n = 19], large tumor or leptomeningeal tumor spread [n = 15], large infarct [n = 3], and bacterial meningitis [n = 2]) were used in this study. Two radiologists independently reviewed both sets of images at separate sessions. Axial T2WI and multi-planar imaging of 3D T2WI were visually assessed for the presence of globe flattening. The optic nerve sheath diameter (ONSD) was measured at a location 4 mm posterior to each globe on oblique coronal imaging reformatted from 3D T2WI. RESULTS: There were significantly more globes showing posterior flattening on 3D T2WI (105/138 [76.1%]) than on 2D T2WI (27/138 [19.6%], P = 0.001). Inter-observer agreement was excellent for both 2D T2WI and 3D T2WI (Cohen's kappa = 0.928 and 0.962, respectively). Intra-class correlation coefficient for the ONSD was almost perfect (Cohen's kappa = 0.839). The globes with posterior flattening had significantly larger ONSD than those without on both 2D and 3D T2WI (P < 0.001; 6.14 mm +/- 0.44 vs. 5.74 mm +/- 0.44 on 2D T2WI; 5.90 mm +/- 0.47 vs. 5.56 mm +/- 0.34 on 3D T2WI). Optic nerve protrusion was significantly more frequent on reformatted 1-mm 3D T2WI than on 5-mm 2D T2WI (8 out of 138 globes on 3D T2WI versus one on 2D T2WI; P = 0.018). CONCLUSION: Posterior globe flattening is more frequently observed on 3D T2WI than on 2D T2WI in patients suspected of having increased intracranial pressure. The globes with posterior flattening have significantly larger ONSD than those without.
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Female , Humans , Brain , Hemorrhage , Intracranial Pressure , Meningitis, Bacterial , Optic NerveABSTRACT
OBJECTIVE: The aims of this article are to differentiate soft tissue masses showing low signal intensity on T2-weighted images (T2WIs) according to the histopathologic findings. CONCLUSION: To know relatively small numbered soft tissue masses with low signal intensities on T2WIs adding characteristic location, morphology, signal intensities on other sequences might be helpful for differential diagnosis of mostly nonspecific soft tissue tumors on MRI.
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Diagnosis, Differential , Magnetic Resonance Imaging , Soft Tissue NeoplasmsABSTRACT
Primary intracranial melanoma is uncommon. These tumors most commonly occur at the temporal lobe, cerebellum and cerebellopontine angle. We report a case of intracranial malignant melanoma of the occipital lobe in a 60-year-old man who presented with headache and visual disturbance. The mass showed hyperintensity on T1-weighted images and hypointensity on T2-weighted magnetic resonance images. He underwent gross total removal of tumor and received radiotherapy. Followup imaging studies showed neither recurrence nor any signs of residual disease for 4 months.
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Humans , Middle Aged , Cerebellopontine Angle , Cerebellum , Follow-Up Studies , Headache , Melanoma , Occipital Lobe , Radiotherapy , Recurrence , Temporal LobeABSTRACT
Extracerebral cavernous hemangiomas are rare vascular tumors that are very difficult to remove because of severe intraoperative bleeding. We report a case of 57-year-old male with extracerebral cavernous hemangioma with review of 126 cases in the literature. Patient presented with blurred vision, diplopia, numbness on the left side of his face. Magnetic resonance imaging revealed a well defined mass of 3 x 4 x 3 cm size with heterogenous iso-or hypointensity on T1-weighted image showing strong homogenous contrast enhancement and marked hyperintensity on T2-weighted image. Digital subtraction angiography(DSA) revealed a faint tumor blush by feeders from the left internal carotid artery(ICA) and left external carotid artery(ECA) in the delayed phase. Even with profuse intratumoral bleeding, near total removal was achieved. In addition to preoperative neurologic deficits such as ophthalmoplegia, facial numbness in the V1-2 dermatomes, ptosis appeared postoperatively.