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Objective To explore the value of quantitative parameters of gemstone spectral CT in the diagnosis of pulmonary embolism (PE). Methods 29 patients with PE were examined by gemstone spectral CT under GSI scanning mode.The pulmonary embolus on CTPA image were detected and the location and number of embolus were recorded.A variety of quantitative parameters of the embolic and normal areas were measured by the GSI Viewer.Paired t test was used to compare and analyze the quantitative parameters,and ROC curve was used to evaluate the diagnostic efficacy of quantitative parameters.Results 76 clots were diagnosed by CTPA in 29 patients.The iodine content,slope of energy spectrum curve and corresponding CT of 40 keV in the embolic area were significantly lower than those in the normal area (P＜0.001),there were no significant differences in water content and effective atomic number between the embolic and normal area;The ROC curve analysis showed that iodine content had the largest area under the diagnosis curve of pulmonary embolism (0.84)with the specificity of 88% and the sensitivity of 65%.The AUC could be up to 0.89 when three quantitative parameters were combined to get the ROC curve,with the sensitivity of 82% and the specificity of 90%.Conclusion Some quantitative parameters of the pulmonary embolic area are lower than those in the normal area,which indirectly reflect the abnormal blood perfusion of the embolism and provide more basis for the early diagnosis,condition assessment and evaluation of therapeutic effect of PE.
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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 assess the activity of Crohn’s disease (CD)by using the quantitative parameter of dynamic contrast-enhanced MRI (DCE-MRI).Methods 50 CD patients with ileocecal solitary lesion were recruited in this study.All of patients underwent con-ventional and DCE-MRI.The quantitative parameter of volume transfer constant (Ktrans )and the clinical data including Harvey-Brad-show index (HBI)and C-reactive protein (CRP)were recorded.(1)the reliability and repeatability of Ktrans measurement were analyzed. (2)the correlation between Ktrans value and clinical data was analyzed by using Pearson analysis.(3)according to HBI,all of the CD patients were divided into severe group,mild-moderate group,and static group.The differences of Ktrans values among the three groups were compared by using Mann-Whitney U test.Results (1)the reliability of Ktrans measurement was high (Cronbach’s Alpha=0.993).(2)there was positive correlation between HBI and Ktrans(r=0.635,P<0.001),and between CRP and Ktrans(r= 0.764,P<0.001).(3)there was significant difference of Ktrans value between the static group and the mild-moderate group (P<0.001),be-tween the static group and the severe group (P<0.001),and.between the mild-moderate group and the severe group (P<0.001). Conclusion Quantitative parameter of DCE-MRI (Ktrans )had a high reliability and can be used to assess the inflammation activity of CD.
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BACKGROUND/AIMS: To evaluate the geographic and demographic variabilities of the quantitative parameters of computed tomography perfusion (CTP) of the left ventricular (LV) myocardium in patients with normal coronary artery on computed tomography angiography (CTA). METHODS: From a multicenter CTP registry of stress and static computed tomography, we retrospectively recruited 113 patients (mean age, 60 years; 57 men) without perfusion defect on visual assessment and minimal (< 20% of diameter stenosis) or no coronary artery disease on CTA. Using semiautomatic analysis software, quantitative parameters of the LV myocardium, including the myocardial attenuation in stress and rest phases, transmural perfusion ratio (TPR), and myocardial perfusion reserve index (MPRI), were evaluated in 16 myocardial segments. RESULTS: In the lateral wall of the LV myocardium, all quantitative parameters except for MPRI were significantly higher compared with those in the other walls. The MPRI showed consistent values in all myocardial walls (anterior to lateral wall: range, 25% to 27%; p = 0.401). At the basal level of the myocardium, all quantitative parameters were significantly lower than those at the mid- and apical levels. Compared with men, women had significantly higher values of myocardial attenuation and TPR. Age, body mass index, and Framingham risk score were significantly associated with the difference in myocardial attenuation. CONCLUSIONS: Geographic and demographic variabilities of quantitative parameters in stress myocardial CTP exist in healthy subjects without significant coronary artery disease. This information may be helpful when assessing myocardial perfusion defects in CTP.
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Female , Humans , Male , Angiography , Body Mass Index , Coronary Artery Disease , Coronary Vessels , Cytidine Triphosphate , Healthy Volunteers , Myocardium , Perfusion , Retrospective StudiesABSTRACT
Objective To evaluate the value of dynamic contrast-enhanced MRI (DCE-MRI)in the assessment of cervical cancer with different features.Methods A cohort study of 1 56 cervical cancer patients underwent routine MRI and DCE-MRI scanning on 3.0T MR unit.The semi-quantitative parameters from time-signal curve of DCE-MRI were divided into the following groups:1 ) squamous carcinoma and adenocarcinoma.2)different pathologic grades of cervical cancer (G1,G2,G3).3)early stage (FIGOⅠb/Ⅱa)tumor and advanced tumor (FIGOⅡb,Ⅲ and Ⅳ).4)cervical cancer with different lymph node status (no/yes).5)cervical cancer with dif-ferent tumor size (greatest diameter 4 cm).6)cervical cancer with different age range.Statistical analysis was performed with the data analysis program SPSS and R3.1.1.Results There was a statistically significant difference between the squamous carcinoma and adenocarcinoma in the SI30s% and Slope,as well as between the tumor FIGO early and advanced stage in TTP and Slope.There was no significant difference among other groups.Conclusion The semi-quantitative parameters from time-signal curve of DCE-MRI can be used to differentiate histologic type and FIGO early/advanced stage of cervical cancer.The diagnostic accuracy may be high for Slope for histologic type differentiation,and the diagnostic accuracy is equal for TTP and Slope in differenti-ation of FIGO early and advanced stage of cervical cancer.
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Objective The widely use of ultrasound elastography has increased the detection rate of breast cancer.It has great advantage of differential diagnosis of breast tumor.Our study is to evaluate and compare the value of the quantitative ultrasound elastography parameters of AR ( area ratio) , ESR ( entire strain ratio) , LSR ( locolized strain ratio) , EFLR( entire fat to lesion ratio) and LFLR( locolized fat to lesion ratio) in the differential diagnosis of breast tumor. Methods 110 patients with 113 breast tumors were collected from Nanjing General Hospital of Nanjing Military Region between January 2015 and January 2016 who underwent breast exami-nation.The tumors were divided into two groups according to patholo-gy which acts as gold standard:benign group with 59 lesions and ma-lignant group with 54 lesions.Participants underwent quantitative ul-trasound elastography parameters examination.AR、ESR、LSR、EFLR、LFLR were compared between benign group and malignant group and ROC curve was drawn.Conventional ultrasound and ultrasound elastography parameter are combined to differentiate the benign or malignant lesion.Calculate the various parameters on the accuracy、susceptibility、specificity、positive likelihood ratio、negative likeli-hood ratio of the diagnosis of benign and malignant lesions, and determine the quantitative parameter with the highest accuracy. Results The mean value of AR、ESR、LSR、EFLR and LFLR of malignant lesions were all significantly greater than that of benign le-sions (P=0.000).Compared with the conventional ultrasound, AR、ESR、LSR、EFLR and LFLR have higher AUC in the differentia-tion of benign and malignant breast lesions;AUC of AR and ESR are higher than conventional ultrasound、LSR、EFLR and LFLR( P<0.000).Compared with conventional ultrasound(1.523) alone, conventional ultrasound combined separately with AR、ESR、EFLR and LFLR have higher positive likelihood ratio(11.581、8.272、3.482、2.458、2.100) in the differentiation of benign and malignant breast lesions, so as accuracy、susceptibility、specificity(P<0.000).The AUC of conventional ultrasound combined separately with AR and ESR[0.940(0.890~0.990)、0.941(0.891~0.990)] were higher than conventional ultrasound and conventional ultrasound com-bined separately with LSR、EFLR、LFLR[0.669(0.669~0.768)、0.837(0.759~0.915)、0.763(0.673~0.852)、0.787(0.701~0.874)],so as accuracy、susceptibility、specificity and positive likelihood ratio(P<0.000). Conclusion Quantitative ultrasound elastography may be helpful in differentiation of benign and malignant breast lesions, especially combining conventional ultrasound with AR and ESR, which were superior to combining with the other parameters and provide a more objective and credible basis to differenti-ate benign and malignant breast tumors with conventional ultrasound.
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PURPOSE: To determine the quantitative parameters of breast MRI that predict tumor invasion in biopsy-proven DCIS. MATERIALS AND METHODS: From January 2009 to March 2010, 42 MRI examinations of 41 patients with biopsy-proven DCIS were included. The quantitative parameters, which include the initial percentage enhancement (E1), peak percentage enhancement (E(peak)), time to peak enhancement (TTP), signal enhancement ratio (SER), arterial enhancement fraction (AEF), apparent diffusion coefficient (ADC) value, long diameter and the volume of the lesion, were calculated as parameters that might predict invasion. Univariate and multivariate analyses were used to identify the parameters associated with invasion. RESULTS: Out of 42 lesions, 23 lesions were confirmed to be invasive ductal carcinoma (IDC) and 19 lesions were confirmed to be pure DCIS. Tumor size (p = 0.003; 6.5 +/- 3.2 cm vs. 3.6 +/- 2.6 cm, respectively) and SER (p = 0.036; 1.1 +/- 0.3 vs. 0.9 +/- 0.3, respectively) showed statistically significant high in IDC. In contrast, E1, Epeak, TTP, ADC, AEF and volume of the lesion were not statistically significant. Tumor size and SER had statistically significant associations with invasion, with an odds ratio of 1.04 and 22.93, respectively. CONCLUSION: Of quantitative parameters analyzed, SER and the long diameter of the lesion could be specific parameter for predicting invasion in the biopsy-proven DCIS.
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Humans , Breast , Carcinoma in Situ , Carcinoma, Ductal , Carcinoma, Intraductal, Noninfiltrating , Diffusion , Lymphokines , Magnetic Resonance Imaging , Multivariate Analysis , Odds Ratio , Thymine NucleotidesABSTRACT
Objective To explore the relationship between the stromal angiogenesis and growth of the large intestinal carcinoma. Methods The vascular quantitative parameters(, , Sv, TA/BA) of the distal and proximal ends of the carcinoma, the center of the carcinoma, and the intestinal mucosa of distal and proximal ends of carcinoma were analyzed with computerized image. Differentiation degree of tumor cell was observed microscopically. Results Of the 48 cases studied, significant differences( P