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Objective@#To compare the characteristics of MRI signals in different therapeutic effect of desmoid-type fibromatosis (DF).@*Methods@#One hundred and twenty-four DF patients with pathologically proven postoperative recurrent lesions from Peking University Cancer Hospital from 2008 to 2015 were enrolled in the study. All patients had baseline MRI scans, followed by once MRI scan at least every six months, and the follow-up period was three years. All patients had MRI images at the end of the third year. The therapeutic effect was evaluated by response evaluation criteria in solid tumors (RECIST) criteria, and the patients were divided into three groups: progressive disease (PD), stable disease (SD) and partial response (PR). Differences in features in the PD, SD, and PR groups were compared using one-way analysis of variance, Kruskal-Wallis, or Chi-square test. Multiple comparisons were performed using Bonferroni to correct P values. The spearman correlation coefficient was used to test the correlation between signal score and tumor maximum diameter.@*Results@#Among the 124 patients, 17 experienced PD, 37 exhibited SD and 70 exhibited PR. There were no significant differences in age, gender distribution and the location of lesion among three groups (P>0.05). The difference of treatment strategies was statistically significant (P<0.05). The difference of tumor maximum diameter of baseline and the last follow-up MRI scan was also statistically significant between three groups (P<0.05). There was no significant differences in T2 scores and enhancement scores of baseline MRI scan among the PD, SD, and PR groups (P>0.05). At the last follow-up MRI scan, the T2 signal scores, the changes of T2 signal, the scores of enhancement and the changes of enhancement of the PD, SD, and PR groups were significantly different among three groups (P<0.05). At the last follow-up MRI scan, the tumor maximum diameter was positively correlated with the score of T2 signal (r=0.434, P<0.01), and the tumor maximum diameter was positively correlated with the score of enhancement (r=0.743, P<0.01).@*Conclusion@#MRI has great value in evaluating the therapeutic effect of DF.
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Objective: To investigate the accuracy of MRI measurement of early cervical carcinoma invasion depth of stroma. Methods: Preoperative MRI data, including T2WI, DCE-MRI and DWI of 66 early cervical cancer patients were retrospectively analyzed. The maximum depth of cervical interstitial invasion was measured on MRI. The tumors were divided into infiltrating type (including deep infiltrating and two-way infiltrating)and intraluminal growth type. The consistency of MRI measurements and pathological results were analyzed, and the difference values of the maximum depth of cervical interstitial invasion measured by 3 kinds of MRI and pathological results were compared. Results: Among 66 patients, deep infiltrating was observed in 31 cases, two-way infiltrating in 17 and intraluminal growth type carcinoma in 18 cases. The maximum depth of cervical stromal infiltration measured on T2WI, DCE-MRI and DWI were all moderately consistent with pathological results (ICC=0.66, 0.57 and 0.60, all P0.05). MRI measurement of invasive tumors, especially for those with deep infiltrating had superior consistent with pathological results than that of intraluminal growth tumors. Conclusion: MRI has good accuracy in measuring the depth of interstitial invasion of early cervical cancer, for tumors with deep infiltrating is better than for intraluminal growth type tumors.
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Objective: To explore the value of preoperative MRI in evaluating prognosis of resectable soft tissue sarcomas (STS) after surgery. Methods: Data of 70 STS patients confirmed pathologically who underwent radical surgery and preoperative MRI were retrospectively analyzed. The tumor sizes were measured, signal intensity heterogeneity at T2WI, tumor enhancement, peritumoral edema, peritumoral enhancement, vascular/nerve or bone invasion and other signs on MRI were evaluated. The progression free survival (PFS) were evaluated, and the impact factors of PFS after radical surgery of STS were analyzed by using univariate and multivariate analyses. Results: Among 70 patients, local relapses and metastatic relapses occurred in 14 (14/70, 20.00%) and 22 cases (22/70, 31.43%) during follow-up. The median progression time was 22 months, and 1-, 2- and 3- year PFS was 62.86% (44/70), 51.43% (36/70) and 51.43% (36/70), respectively. Age, histological grade, preoperative therapy, the longest diameter of tumor, signal intensity heterogeneity at T2WI, peritumoral edema, peritumoral enhancement, vascular/nerve or bone invasion, tail sign and intercompartmental extension were the impact factors for PFS of STS after radical surgery (all P<0.05). The longest diameter of tumor, peritumoral enhancement and vascular/nerve or bone invasion were independent predictors for PFS of STS patients after radical surgery (all P<0.05). Conclusion: MRI had important predictive value for prognosis of resectable STS. The longest diameter of tumor, peritumoral enhancement and vascular/nerve or bone invasion were independent predictors for PFS of STS patients after radical surgery.
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Objective:To compare the characteristics of MRI signals in different therapeutic effect of desmoid-type fibromatosis (DF).Methods:One hundred and twenty-four DF patients with pathologically proven postoperative recurrent lesions from Peking University Cancer Hospital from 2008 to 2015 were enrolled in the study. All patients had baseline MRI scans, followed by once MRI scan at least every six months, and the follow-up period was three years. All patients had MRI images at the end of the third year. The therapeutic effect was evaluated by response evaluation criteria in solid tumors (RECIST) criteria, and the patients were divided into three groups: progressive disease (PD), stable disease (SD) and partial response (PR). Differences in features in the PD, SD, and PR groups were compared using one-way analysis of variance, Kruskal-Wallis, or Chi-square test. Multiple comparisons were performed using Bonferroni to correct P values. The spearman correlation coefficient was used to test the correlation between signal score and tumor maximum diameter. Results:Among the 124 patients, 17 experienced PD, 37 exhibited SD and 70 exhibited PR. There were no significant differences in age, gender distribution and the location of lesion among three groups ( P>0.05). The difference of treatment strategies was statistically significant ( P<0.05). The difference of tumor maximum diameter of baseline and the last follow-up MRI scan was also statistically significant between three groups ( P<0.05). There was no significant differences in T 2 scores and enhancement scores of baseline MRI scan among the PD, SD, and PR groups ( P>0.05). At the last follow-up MRI scan, the T 2 signal scores, the changes of T 2 signal, the scores of enhancement and the changes of enhancement of the PD, SD, and PR groups were significantly different among three groups ( P<0.05). At the last follow-up MRI scan, the tumor maximum diameter was positively correlated with the score of T 2 signal ( r=0.434, P<0.01), and the tumor maximum diameter was positively correlated with the score of enhancement ( r=0.743, P<0.01). Conclusion:MRI has great value in evaluating the therapeutic effect of DF.
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Purpose To evaluate parameter changes of pelvic floor muscles in patients with female pelvic organ prolapse (POP) through diffusion tensor imaging (DTI).Materials and Methods Fifty female patients with POP at Ⅲ or ⅣV degree (research group) and fifty healthy women volunteers (control group) were collected to make prospective research.The axial DTI sequence was performed in subjects,with b=500 s/mm2,at 15 directions.DTI original images were imported into the post-processing software,and the corresponding DTI mappings were formed.In the original images,pelvic floor muscles were sketched out layer by layer,and various DTI parameters,including fractional anisotrophy (FA),mean diffusivity (MD),λl,λ2,λ3,linear anisotropy (CL),planar anisotropy (CP) and spherical anisotropy (CS),were calculated.Six kinds of pelvic floor muscles,including anal sphincter,superficial transverse perineal muscle,pubic visceral muscle,puborectal muscle and iliococcygeal muscle were measured,and five of them were measured on both sides.The difference of DTI parameters between right and left side of each muscle,and the difference of DTI parameters between research and control group were compared.Results Between the right and left side of five kinds of pelvic floor muscles in control group,significant difference was only found in FA,λ3,CP,CS value of internal obturator muscle (P＜0.01,P＜0.001).There were significant differences in FA,λ3,CL,CP and CS values of the left and right muscles in the study group (P＜0.05,P＜0.001).Compared with control group,FA value and CS value of superficial transverse perineal muscle,CL value of left pubic visceral muscle,FA,λ3,CL,CS and CP value of right pubic visceral muscle,λ1 and λ3 value of left iliococcygeal muscle of research group were significantly different (P＜0.01,P＜0.05).Conclusion DTI for observation of female pelvic floor muscle is technically feasible,and it can detect the injury of pelvic floor muscle in POP patients,and may be helpful to reveal the pathogenesis of POP.
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Objective To develop and validate one optimal MR radiomics model for lymph node (LN) re-evaluation of locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotheray (NCRT). Methods Four hundred and seven patients with clinicopathologically confirmed LARC in Beijing Cancer Hospital were included in this study from July 2010 to June 2015. All patients received NCRT before surgery,and underwent T2WI and DWI before and after NCRT.These patients were chronologically divided in the primary cohort(300 patients)and independent validation cohort(107 patients).The predicting model was trained and validated using postoperative pathological findings as truth values. By using radiomics method, we extracted the features of the tumor and the largest LN before and after neoadjuvant therapy, combined different features of the tumor and/or the largest LN before and/or after neoadjuvant therapy,and constructed 4 different prediction models,compared the performance of four predicting models.The optimal model with the highest accuracy was validated in the independent cohort. Decision curve analysis was conducted to determine the clinical usefulness of the radiomics nomograms by quantifying the net benefits at different threshold probabilities in the validation dataset. Results In the primary cohort, the radiomics signatures from 4 models provided an AUC of 0.637, 0.709, 0.753, 0.835, respectively in LN re-evaluation after chemoradiotheray. The diagnostic efficacy of model 4 was much better than that of 1, 2 and 3 model. In the validation cohort, the radiomics signatures provided an AUC of 0.795 for LN re-evaluation after chemoradiotheray. The sensitivity, specificity, positive predictive value, negative predictive value were 0.813, 0.693, 0.531, 0.897, respectively (95% CI: 0.694 to 0.896, 0.647 to 0.911, 0.582 to 0.786, 0.361 to 0.621, 0.792 to 0.952). While the probability of predicting N+ ranges from 17% to 80%, using the proposed radiomics model to predict N+ shows a greater advantage than either the scheme in which all patients were assumed to N+ or the scheme in which all patients are N-. Decision curve analysis demonstrated that the radiomics nomograms were clinically useful. Conclusion With a systematic analysis and comparison of both pre-and post-NCRT MRI data, we constructed an optimal individualized LN re-evaluation model based on MR radiomics, combing primary tumor and the largest LN features, compared with other models (only with pre/post tumor or pre/post largest LN features).
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Objective To investigate the diagnostic value of dynamic MRI with coupling agent filled vaginal and rectumin the display of vaginal vault prolapse and rectocele. Methods Thirty three female patients, who were diagnosed with pelvic organ prolapse with Ⅲ degrees and above by gynecologic outpatient clinic and prepared to be treated with surgery were prospectively collected. All of them underwent two types of dynamic MRI, one was routine dynamic MRI (Group A) and the other was dynamic MRI with vaginal and rectum filled with coupling agent (Group B). Two radiologists evaluated and scored the display of vaginal vault and rectocele on these two groups of dynamic MRI images. According to the joint result of two radiologists, two gynecologists made surgical planning. Kappa test was used to compare the consistency of scores performedby two radiologists, and Fisher exact test was used to compare the differentiation fromboth groups, as well as the differentiation of probability of high uterosacral ligament suspension.Results The Kappa value of both groups was 0.65 and 1.00 respectively, where the consistency of Group B was superior than Group A. There were significant differences between the two groups(P<0.01), where Group B was better than Group A. Based on the imaging results of Group A, 7 patients (21.2%, 7/33) were decided to make high uterosacral ligament suspension. Based on the imaging results of Group B, 20 patients (60.6%, 20/33) were decided to make high uterosacral ligament suspension, and differences were statistical significance between the two groups(P<0.05). Conclusions Fo purpose of the displaying vaginal vault and rectocele, the dynamic MR imaging with vaginal and rectum filled with coupling agent was better than routine method. The proposed method can provide important information and reference for the establishment of surgical planning.
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Assessment of salivary gland function plays an important role in the diagnosis and treatment of salivary gland disease.Currently,there are several ways to evaluate the salivary gland function including sialography,salivary gland flowmetry,radionuclide imaging,ultrasonography Doppler and MRI.The pros and cons of these different methods were reviewed and analysed.Nowadays,sialography and salivary gland flowmetry are less commonly used clinically.Doppler can be used for screening of salivary gland diseases.Radionuclide imaging is the clinically preferred method,and MRI is one of the most rapidly developing methods for the evaluation of salivary gland function.Proper selection of these methods can provide valuable information for the diagnosis and treatment of salivary gland diseases.