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1.
Chinese Journal of Digestive Surgery ; (12): 543-550, 2022.
Article in Chinese | WPRIM | ID: wpr-930967

ABSTRACT

Objective:To investigate the application value of contrast-enhanced ultra-sound, enhanced computed tomography (CT) and enhanced magnetic resonance imaging (MRI) in the diagnosis of small hepatocellular carcinoma.Methods:The clinical diagnositic trial was con-ducted. The clinicopathological data of 145 patients with small hepatocellular carcinoma who were admitted to the First Affiliated Hospital of Amy Medical University from January 2019 to June 2021 were collected. There were 121 males and 24 females, aged from 26 to 78 years, with a median age of 54 years. All patients were examined with contrast-enhanced ultrasound, enhanced CT and enhanced MRI, and underwent surgical resection of liver lesions within one month. Observation indicators: (1) postoperative histopathological examinations of patients with small hepatocellular carcinoma; (2) examination of small hepatocellular carcinoma by contrast-enhanced ultrasound, enhanced CT and enhanced MRI; (3) imaging features of small hepatocellular carcinoma in the contrast-enhanced ultrasound, enhanced CT and enhanced MRI; (4) enhancement mode distribution of small hepatocellular carcinoma in the arterial, portal and delayed phases of contrast-enhanced ultrasound, enhanced CT and enhanced MRI; (5) the efficacy of contrast-enhanced ultrasound, enhanced CT and enhanced MRI in the diagnosis of small hepatocellular carcinoma. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the Cochran′s Q test or the chi-square test. The sensitivity, specificity and accuracy were used to analyze the efficacy of contrast-enhanced ultrasound, enhanced CT and enhanced MRI in the diagnosis of small hepatocellular carcinoma. Results:(1) Postoperative histopathological examinations of patients with small hepatocellular carcinoma. There were 154 lesions detected in the postoperative histopathological examinations for the 145 small hepatocellular carcinoma patients, with the tumor diameter as (2.2±0.6)cm. (2) Examination of small hepatocellular carcinoma by contrast-enhanced ultrasound, enhanced CT and enhanced MRI. There were 153, 154 and 154 lesions detected in contrast-enhanced ultrasound, enhanced CT and enhanced MRI for the 145 patients with small hepatocellular carcinoma, respectively, with the detection rate as 99.35%(153/154), 100.00%(154/154) and 100.00%(154/154), showing no significant difference among the 3 imaging examination methods ( Q=2.00, P>0.05). (3) Imaging features of small hepatocellular carcinoma in the contrast-enhanced ultrasound, enhanced CT and enhanced MRI. Of the 153 lesions reported in contrast-enhanced ultrasound for patients with small hepatocellular carcinoma, 140 lesions showed "fast-in and fast-out" enhancement, 12 lesions showed "fast-in and slow-out" enhancement and 1 lesion showed isoenhancement in arterial phases and hypoenhancement in portal and delayed phase. Of the 154 lesions reported in enhanced CT for patients with small hepatocellular carcinoma, 112 lesions showed "fast-in and fast-out" enhancement, 13 lesions showed "fast-in and slow-out" enhancement, 14 lesions showed isoenhancement in arterial phase and hypoenhancement in portal and delayed phases, 5 lesions showed rim-like hyperenhancement in arterial phase and hypoenhancement in portal and delayed phases, 5 lesions showed hypoenhancement in the three phases, 3 lesions showed hyperenhancement in the three phases, 1 lesion showed isoenhancement in the three phases and 1 lesion showed isoenhancement in arterial and portal phases and hypoenhancement in delayed phase. Of the 154 lesions reported in enhanced MRI for patients with small hepatocellular carcinoma, 134 lesions showed "fast-in and fast-out" enhancement, 1 lesion showed "fast-in and slow-out" enhancement, 8 lesions showed isoenhancement in arterial phase and hypoenhance-ment in portal and delayed phases, 5 lesions showed rim-like hyperenhancement in arterial phase and hypoenhancement in portal and delay phases, 2 lesions showed rim-like hyperenhancement in the three phases, 1 lesion showed hyperenhancement in the three phases, 1 lesion showed hypoenhancement in the three phases, 1 lesion showed isoenhancement in arterial and portal phases and hypoenhancement in delayed late phase, 1 lesion showed edge delay enhancement in the three phases. (4) Enhancement mode distribution of small hepatocellular carcinoma in the arterial, portal and delayed phases of contrast-enhanced ultrasound, enhanced CT and enhanced MRI. Of the 153 lesions reported in contrast-enhanced ultrasound for patients with small hepatocellular carcinoma, there were 152 lesions with hyperenhancement and 1 lesion with iso or hypoenhance-ment in the arterial phase, there were 55 lesions with hyper or isoenhancement and 98 lesions with hypoenhancement in the portal venous phase, there were 12 lesions with hyper or isoenhancement and 141 lesions with hypoenhancement in the delayed phase. Of the 154 lesions reported in enhanced CT for patients with small hepatocellular carcinoma, there were 133 lesions with hyperen-hancement signal and 21 lesions with iso or hypoenhancement in the arterial phase, there were 53 lesions with hyper or isoenhancement and 101 lesions with hypoenhancement in the portal phase, there were 17 lesions with hyper or isoenhancement and 137 lesions with hypoenhancement in the delayed phase. Of the 154 lesions reported in enhanced MRI for patients with small hepatocellular carcinoma, there were 143 lesions with hyperenhancement and 11 lesions with iso or hypoenhance-ment in the arterial phase, there were 29 lesions with hyper or isoenhancement and 125 lesions with hypoenhancement in the portal phase, there were 5 lesions with hyper or isoenhancement and 149 lesions with hypoenhancement in the delayed phase. There were significant differences in the enhancement mode distribution of lesions in the arterial, portal and delayed phases among contrast-enhanced ultrasound, enhanced CT and enhanced MRI ( χ2=19.47, 13.21, 6.92, P<0.05). (5) The efficacy of contrast-enhanced ultrasound, enhanced CT and enhanced MRI in the diagnosis of small hepatocellular carcinoma. Of the 153 lesions reported in contrast-enhanced ultrasound for patients with small hepatocellular carcinoma, there were 3 lesions misdiagnosed according to the postoperative histopathological examinations. Of the 154 lesions reported in enhanced CT and enhanced MRI for patients with small hepatocellular carcinoma, there were 7 lesions and 2 lesions misdiagnosed according to the postoperative histopathological examinations, respectively. Lesions misdiagnosed in one imaging examination method were correctly diagnosed in the other two imaging examination methods. The sensitivity, specificity, accuracy were 97.4%, 63.0%, 92.3% for contrast-enhanced ultrasound in the diagnosis of small hepatocellular carcinoma. The above indica-tors were 95.5%, 63.0%, 90.6% for enhanced CT and 98.7%, 63.0%, 93.4% for enhanced MRI in the diagnosis of small hepatocellular carcinoma. There was no significant difference in the sensitivity and accuracy among the 3 imaging examination methods ( Q=2.92, 0.00, 1.81, P>0.05). Conclusion:Contrast-enhanced ultrasound, enhanced CT and enhanced MRI all have good diagnostic value in diagnosis of small hepatocellular carcinoma, and they complement each other.

2.
Acta Academiae Medicinae Sinicae ; (6): 755-760, 2021.
Article in Chinese | WPRIM | ID: wpr-921535

ABSTRACT

Objective To evaluate the application of two-dimensional magnetization-prepared true fast imaging with steady-state precession(2D-MP-TrueFISP)sequence in brain tumor enhancement.Methods In this study,60 cases of brain tumor patients who underwent enhanced magnetic resonance imaging of brain were scanned with 2D-MP-TrueFISP/two-dimensional spoiled gradient-recalled echo(2D-SPGR)before and after enhancement.The scores of lesions on the images of 2D-MP-TrueFISP/2D-SPGR were compared.At the same level of 2D-SPGE and 2D-MP-TrueFISP,the signal intensities(SIs)of lesions,white matter,and cerebrospinal fluid were measured before and after enhancement,and the contrast ratios(CRs)of lesions were calculated.The CRs before and after 2D-SPGR/2D-MP-TrueFISP enhancement and those between 2D-SPGR and 2D-MP-TrueFISP after enhancement were compared.Results The scores of lesions after 2D-MP-TrueFISP/2D-SPGR T1WI enhancement were 9.0(9.0,9.0)and 7.0(6.0,7.0),respectively,with significant difference(


Subject(s)
Humans , Brain , Brain Neoplasms/diagnostic imaging , Image Enhancement , Imaging, Three-Dimensional , Magnetic Resonance Imaging
3.
Journal of Central South University(Medical Sciences) ; (12): 414-420, 2021.
Article in English | WPRIM | ID: wpr-880675

ABSTRACT

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.


Subject(s)
Humans , Male , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Motion , Prostatic Neoplasms/diagnostic imaging
4.
Chinese Journal of Ultrasonography ; (12): 494-499, 2021.
Article in Chinese | WPRIM | ID: wpr-910084

ABSTRACT

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.

5.
Journal of Shanghai Jiaotong University(Medical Science) ; (12): 873-878, 2020.
Article in Chinese | WPRIM | ID: wpr-843140

ABSTRACT

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.

6.
Chinese Journal of Tissue Engineering Research ; (53): 2418-2424, 2020.
Article in Chinese | WPRIM | ID: wpr-847659

ABSTRACT

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.

7.
Chinese Journal of Radiology ; (12): 98-102, 2019.
Article in Chinese | WPRIM | ID: wpr-745215

ABSTRACT

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.

8.
Chinese Journal of Ultrasonography ; (12): 964-970, 2019.
Article in Chinese | WPRIM | ID: wpr-801397

ABSTRACT

Objective@#To compare the diagnostic efficacies of contrast-enhanced ultrasonography (CEUS) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) in the diagnosis of liver nodules ≤2.0 cm in patients with cirrhosis, and to explore the clinical values of combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI in the diagnosis of early hepatocellular carcinoma (HCC).@*Methods@#One hundred and thirteen nodules with diameters lower than 2.0 cm in 98 patients from February to December 2016 in Tianjin Third Central Hospital were included in this retrospective study. The enhancement patterns of nodules in CEUS and EOB-MRI were analyzed. The reference standard was pathological diagnosis or substantial lesion growth at a follow-up of at least 6 months. The efficiencies of CEUS and EOB-MRI in the diagnosis of liver lesions with a diameter lower than 2.0 cm were compared. A new diagnostic strategy, which combines the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was presented to diagnose the early HCC in this study.@*Results@#The area under the ROC curve of CEUS and EOB-MRI were 0.858 and 0.814(P>0.05), the sensitivity were 79.1%, 81.4%, specificity were 92.6%, 81.5% and diagnostic accuracy were 82.3% and 81.4%, respectively. By combination of CEUS and EOB-MRI, the area under the ROC curve was 0.831, without difference from CEUS, EOB-MRI (0.831 vs 0.858, 0.814; all P>0.05); its sensitivity was 66.3%, specificity was 100% and diagnostic accuracy was 74.3%. The area under the ROC curve of the new diagnostic strategy, combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was 0.934, which was larger than that of CEUS, EOB-MRI and the combination of CEUS and EOB-MRI(0.934 vs 0.858, 0.814, 0.831; all P<0.05). The sensitivity, specificity and diagnostic accuracy of new strategy were 94.2%, 92.6% and 93.8%, respectively.@*Conclusions@#The new diagnostic strategy based on the arterial phase of CEUS and hepatobiliary phase of EOB-MRI improves the sensitivity and accuracy in detecting small lesions, which can be used as a complementary diagnostic enhancement pattern for lesions with an atypical enhancement pattern in CEUS or EOB-MRI.

9.
Journal of Practical Radiology ; (12): 1805-1808,1816, 2019.
Article in Chinese | WPRIM | ID: wpr-789950

ABSTRACT

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.

10.
Journal of Practical Radiology ; (12): 1768-1773, 2019.
Article in Chinese | WPRIM | ID: wpr-789941

ABSTRACT

Objective To explore the differential diagnosis of breast ductal carcinoma in situ (DCIS)and breast ductal carcinoma in situ with microinvasion (DCIS-Mi)by ADCMin ,ADCDR and DCE-MRI,and to analyze the correlation between DCIS-Mi and biological factors. Methods Preoperative breast MRI examinations were performed in 41 patients with DCIS-Mi and 3 7 patients with DCIS.DCIS-Mi and DCIS patients were compared in terms of ADCMin ,ADCMax ,ADCDR ,early enhancement rate (EER)and the morphological characteristics of DCE-MRI.The optimal diagnostic variables were determined by binary Logistic regression,the threshold value of the optimal diagnostic variables was ensured by ROC,and the correlation between DCIS-Mi and biological factors was analyzed by Spearman.Results ADCMin of DCIS-Mi patients was lower than that of DCIS (t=6.294,P=0.033),and ADCDR was higher than that of DCIS (t=9.246,P=0.020).70.7 3% DCIS-Mi showed non-tumor-like enhancement,inclined to segmental distribution,and internal heterogeneous or cluster ring enhancement;29.27% manifested tumor-like enhancement,internal heterogeneous or ring enhancement,and unclear margin.64.86% DCIS showed non-tumor-like enhancement,inclined to linear distribution,internal homogeneous/heterogeneous enhancement;35.14% expressed tumor-like enhancement,internal homogeneous enhancement,and clear margin.The accuracy,sensitivity and specificity of ADCMin , ADCDR ,tumor or non-tumor internal enhancement features in the diagnosis of DCIS-Mi were higher (84.0%,9 5.3%,9 2.4%;89.3%, 9 5.3%,9 2.4%;85.1%,9 2.5%,9 3.8%;87.4%,9 6.8%,84.7%, respectively).ADCMin and ADCDR threshold value were 1.1 1× 10-3 mm2/s and 0.35×10-3 mm2/s,respectively.ADCMin of patients with DCIS-Mi was positive correlation with ER(-)and PR(-), and negative correlation with HER-2(+)(P<0.05).ADCDR ,non-tumor distribution,and non-tumor internal enhancement characteristics,the tumor edge and internal enhancement characteristics were negative correlation with ER(-)and PR(-),and positive correlation with HER-2 (+)(P<0.05).Conclusion ADCMin ,ADCDR and DCE-MRI can be used for the differential diagnosis of DCIS-Mi and DCIS, and provided evidence for clinical treatment plan.

11.
Journal of Practical Radiology ; (12): 1599-1602, 2019.
Article in Chinese | WPRIM | ID: wpr-789907

ABSTRACT

Objective To explore the application of DCE-MRI and DWI in the preoperative diagnosis of breast cancer.Methods

12.
Journal of Practical Radiology ; (12): 1590-1594, 2019.
Article in Chinese | WPRIM | ID: wpr-789905

ABSTRACT

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.

13.
Chinese Journal of Ultrasonography ; (12): 964-970, 2019.
Article in Chinese | WPRIM | ID: wpr-824439

ABSTRACT

Objective To compare the diagnostic efficacies of contrast-enhanced ultrasonography (CEUS) and gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) in the diagnosis of liver nodules ≤2.0 cm in patients with cirrhosis,and to explore the clinical values of combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI in the diagnosis of early hepatocellular carcinoma (HCC).Methods One hundred and thirteen nodules with diameters lower than 2.0 cm in 98 patients from February to December 2016 in Tianjin Third Central Hospital were included in this retrospective study.The enhancement patterns of nodules in CEUS and EOB-MRI were analyzed.The reference standard was pathological diagnosis or substantial lesion growth at a follow-up of at least 6 months.The efficiencies of CEUS and EOB-MRI in the diagnosis of liver lesions with a diameter lower than 2.0 cm were compared.A new diagnostic strategy,which combines the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was presented to diagnose the early HCC in this study.Results The area under the ROC curve of CEUS and EOB-MRI were 0.858 and 0.814 (P > 0.05),the sensitivity were 79.1%,81.4%,specificity were 92.6 %,81.5 % and diagnostic accuracy were 82.3 % and 81.4 %,respectively.By combination of CEUS and EOB-MRI,the area under the ROC curve was 0.831,without difference from CEUS,EOB-MRI (0.831 vs 0.858,0.814;all P >0.05);its sensitivity was 66.3 %,specificity was 100% and diagnostic accuracy was 74.3%.The area under the ROC curve of the new diagnostic strategy,combining the arterial phase of CEUS and hepatobiliary phase of EOB-MRI was 0.934,which was larger than that of CEUS,EOB-MRI and the combination of CEUS and EOB-MRI(0.934 vs 0.858,0.814,0.831;all P <0.05).The sensitivity,specificity and diagnostic accuracy of new strategy were 94.2%,92.6% and 93.8%,respectively.Conclusions The new diagnostic strategy based on the arterial phase of CEUS and hepatobiliary phase of EOB-MRI improves the sensitivity and accuracy in detecting small lesions,which can be used as a complementary diagnostic enhancement pattern for lesions with an atypical enhancement pattern in CEUS or EOB-MRI.

14.
Korean Journal of Radiology ; : 463-469, 2018.
Article in English | WPRIM | ID: wpr-715445

ABSTRACT

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.


Subject(s)
Female , Humans , Male , Diagnosis , Incidence , Magnetic Resonance Imaging , Meningitis , Phlebography , Retrospective Studies , Sinus Thrombosis, Intracranial
15.
Chinese Journal of Ultrasonography ; (12): 692-697, 2018.
Article in Chinese | WPRIM | ID: wpr-707708

ABSTRACT

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 .

16.
Journal of Xinxiang Medical College ; (12): 521-524, 2018.
Article in Chinese | WPRIM | ID: wpr-699529

ABSTRACT

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.

17.
Journal of Practical Radiology ; (12): 892-896, 2018.
Article in Chinese | WPRIM | ID: wpr-696931

ABSTRACT

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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Journal of Practical Radiology ; (12): 725-729, 2018.
Article in Chinese | WPRIM | ID: wpr-696895

ABSTRACT

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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Journal of Practical Radiology ; (12): 717-720, 2018.
Article in Chinese | WPRIM | ID: wpr-696893

ABSTRACT

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.

20.
Journal of Practical Radiology ; (12): 609-612, 2018.
Article in Chinese | WPRIM | ID: wpr-696874

ABSTRACT

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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