Improved ability of demonstrating ocular masses on 3.0 T MR scanner combined with an 8-channel eye surface phased array coil: a multi-center study / 中华放射学杂志

Objective:To investigate the value of the 8-channel eye surface phased array coil in improving image quality and demonstrating ocular masses on 3.0 T MR scanner.Methods:From July 2018 to January 2020, the data of orbital MRI in 692 patients with ocular masses on 6 medical centers were prospectively collected. The patients were simple randomly assigned into 8-channel eye surface phased array coil group (413 patients) or 8-channel head phased array coil group (279 patients), with the same MRI sequences. The signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated in orbital anatomy structures and masses (eyelid mass, intraocular mass, lacrimal mass and orbital mass). The image quality scores including motion artifact, mass margin, the relationship between the mass and adjacent structures, and overall image quality were recorded. The differences of image quality between the two groups were compared by two independent sample t-test or Wilcoxon rank test. Results:The SNR and CNR were higher in eye surface coil group than those in head coil group ( P<0.05). The scores of ocular movement artifacts were higher in head coil group than those in surface coil group ( P<0.05). The scores of intraocular mass margin, the relationship between the mass and adjacent structures, and overall image quality were higher in surface coil group than those in head coil group ( P<0.001). There were no significant differences in mass margin, the relationship between the mass and adjacent structures, and overall image quality scores of eyelid, lacrimal gland, and orbital mass between the two groups ( P>0.05). Conclusion:3.0 T MR scanner combined with the 8-channel eye surface phased array coil can improve the SNR and CNR of orbital MR images, the demonstration of the intraocular mass margin and the relationship between the mass and adjacent structures.

Assessment of depth of invasion in early tongue squamous cell carcinoma based on dynamic contrast-enhanced MRI / 中华放射学杂志

Objective:To investigate the feasibility of dynamic contrast-enhanced (DCE)-MRI in assessing the depth of invasion (DOI) of early tongue squamous cell carcinoma.Methods:From January 2016 to December 2020, a total of 100 patients with early tongue squamous cell carcinoma confirmed by postoperative pathology were retrospectively analyzed in the Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. The study included 48 cases of T1 stage and 52 cases of T2 stage. All patients underwent routine MRI, DCE-MRI and contrast-enhanced T 1WI (CE-T 1WI) before surgery. The DOI was measured on images at different phases of axial DCE-MRI (30, 60 and 120 s after contrast injection) and CE-T 1WI (MRI-DOI) by 2 doctors independently. The intraclass correlation coefficient (ICC) was applied to evaluate the consistency of the measurements. MRI-DOI measured on DCE-MRI 30, 60, 120 s, CE-T 1WI and pathological DOI measured on biopsies were statistically analyzed with analysis of variance for repeated measurement and least significant difference t test. Pearson correlation coefficient was used to compare the correlation between MRI-DOI and pathological DOI. Receiver operation characteristic (ROC) curve analysis was used to explore the performance of MRI-DOI for clinical T1 and T2 staging. Results:There was a good consistency in MRI-DOI measured on DCE-MRI 30, 60, 120 s, and CE-T 1WI images with ICC of 0.752, 0.875, 0.883, and 0.841, respectively. The values of MRI-DOI were (8.35±3.52), (6.88±2.41), (7.52±2.65) and (8.60±3.39) mm, respectively, and pathological DOI was (5.75±2.01) mm. There was statistically significant difference in the overall comparison among different phases of MRI-DOI and pathological DOI ( F=69.25, P<0.001). MRI-DOI were significantly higher than pathological DOI ( P<0.05). All MRI-DOI measured on DCE-MRI 30, 60, 120 s and CE-T 1WI correlated positively with pathological DOI ( r=0.574, 0.851, 0.731, 0.663, all P<0.001). MRI-DOI derived from DCE-MRI 60 s showed the highest diagnostic efficiency for T1 and T2 staging (area under the ROC curve was 0.931, 95%CI 0.881-0.982). When the optimal cutoff value was 6.0 mm, the accuracy, sensitivity and specificity were 88.0%, 96.2% and 79.2%, respectively. Conclusions:DCE-MRI can be applied to assess DOI in early tongue squamous cell carcinoma. MRI-DOI based on DCE-MRI 60 s has the best correlation with pathological DOI and has a potential to predict clinical T staging in early tongue squamous cell carcinoma.

Improved ability of demonstrating ocular masses on 3.0 T MR scanner using PROPELLER: a multi-center study / 中华放射学杂志

Objective:To investigate the value of periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) in improving ability of demonstrating ocular masses on 3.0 T MR scanner.Methods:This study was a multi-center prospective study involving 6 centers. From July 2018 to January 2020, totally 413 patients with ocular masses from 6 centers were prospectively enrolled, and all of them underwent T 1WI and T 2WI, PROPELLER T 1 FLAIR and T 2WI, and contrast-enhanced scans. The signal intensity of eyelid, vitreous body, lacrimal gland, intraorbital segment of optic nerve, and orbital masses of eyelid, intraocular, lacrimal gland and retrobulbar were measured by two radiologists, and the signal to noise ratio (SNR) and contrast noise ratio (CNR) were calculated. The 5-point scoring method was used to evaluate the motion artefacts, tumor edges and the relationship between the tumor and adjacent structures, and the overall score of image quality was calculated. Paired t-test or Wilcoxon signed rank test was used to compare the image quality between PROPELLER and non-PROPELLER images. Results:The SNR and CNR of PROPELLER T 2WI were higher than those of non-PROPELLER T 2WI (all P<0.001). The SNR and CNR of PROPELLER T 1 FLAIR were lower than those of non-PROPELLER T 1WI (all P<0.05). The scores of artefacts and overall image quality in PROPELLER images were higher than those in non-PROPELLER images (all P<0.001). The tumor edge and the relationship between the tumor and adjacent structures scores of eyelid, intraocular, and lacrimal gland masses in PROPELLER images were higher than those in non-PROPELLER images (all P<0.001),while compared to non-PROPELLER images, retro-global masses in PROPELLER images showed no significant differences (all P>0.05). Conclusion:PROPELLER can reduce ocular motion artefacts, effectively improve image quality and ability of demonstrating anterior (eyelid, intraocular, and lacrimal gland) masses.

Imaging characteristics analysis of high resolution CT and MRI of facial nerve venous malformation / 中华放射学杂志

Objective:To analyze imaging features on high resolution CT (HRCT) and MRI of facial nerve venous malformation (FNVM).Methods:A total of 23 patients with pathologically confirmed FNVM were retrospectively included from January 2016 to December 2020 in the Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine. All patients underwent preoperative temporal bone HRCT, non-contrast MRI, diffusion weighted imaging (DWI) and dynamic contrast enhanced MRI (DCE-MRI). The location, morphology, and signal intensity of the lesions, as well as the enhancement pattern on DCE-MRI were reviewed. The time-intensity curve (TIC) was analyzed and the apparent diffusion coefficient (ADC) was measured.Results:The locations of FNVM lesions were geniculate ganglion ( n=19), mastoid segment ( n=1) and internal auditory canal ( n=3). Among 19 cases in geniculate ganglion, HRCT showed honeycomb-like bone change ( n=13) or expansive bone destruction with sharp border ( n=6). The case located in mastoid segment also presented as honeycomb-like changes. The other 3 cases in internal auditory canal presented with patchy hyperdensity bone change ( n=2) or resorptive bone destruction ( n=1). All 23 lesions demonstrated as irregular nodules with obviously heterogeneous enhancement on MRI. The lesions showed isointensity ( n=14), hypointensity ( n=8) or hyperintensity ( n=1) on T 1WI, and hyperintensity ( n=15) or isointensity ( n=8) on fat-suppression T 2WI. The ADC values of the lesions were (1.18±0.20)×10 -3 mm 2/s. A characteristic "point-to-plane" progressive enhancement pattern displayed on DCE-MRI, with type Ⅰ TIC (persistent pattern) presented. Conclusion:The imaging characteristics of FNVM are honeycomb-like bone changes on HRCT and"point-to-plane"progressive enhancement pattern on DCE-MRI.

Value of MRI radiomics for predicting occult cervical lymph nodes metastases in early-stage oral tongue squamous cell carcinoma / 中华放射学杂志

Objective:To explore the value of conventional MRI radiomics for predicting occult cervical lymph nodes (LNs) metastases in early-stage oral tongue squamous cell carcinoma (OTSCC).Methods:The preoperative MRI data of 77 cases of early-stage OTSCCs (cT1-2N0M0) in Shanghai Ninth People′s Hospital from January 2015 to December 2019 were retrospectively analyzed. All patients underwent primary lesion resection with selective neck dissection and the pathologic reports of LNs couldal be obtained. In total, 168 LNs (51 positive and 117 negative metastases) were enrolled and allocated into training set ( n=112) and validation set ( n=56) with a ratio of 2∶1 using random number table. The volumes of interest of LNs on T 2WI and contrast enhanced T 1WI (ceT 1WI) were delineated by two doctors using ITK-SNAP software. The 1 046 radiomics features of each sequence were extracted using 3D Slicer software. Data dimension reduction was done by inter-observer agreement analysis and univariate analysis. The least absolute shrinkage and selection operator regression analysis were used for selecting optimal feature subsets and constructing radiomics signature for each sequence. Mann-Whitney U test was used to compare the differences of node size and radiomics scores between the LNs with positive and negative metastases. The receiver operating characteristic (ROC) curve was used to explore the performance of LNs size, T 2WI radiomics signature and ceT 1WI radiomics signature in predicting occult LNs metastases. Stepwise logistic regression was used to determine the independent predictors. Results:Fifteen and 10 optimal features were selected to construct radiomics signature for T 2WI and ceT 1WI respectively. The short diameter, T 2WI radiomics signature and ceT 1WI radiomics signature showed significant differences between LNs with positive and negative metastases in the both training and validation sets (all P<0.05), with the areas under the ROC curve of 0.67, 0.83 and 0.82 in the training set, and 0.69, 0.78 and 0.70 in the validation set, respectively. In the stepwise logistic regression analysis, T 2WI radiomics signature was identified as the independent predictor in the both sets (training set: OR=5.92, P<0.001; validation set: OR=2.53, P=0.012). Conclusion:Conventional MRI radiomics can provide a good potential to predict occult LNs metastases in early-stage OTSCC.

CT and MRI features of lymphoepithelial carcinoma of salivary gland / 中华放射学杂志

Objective:To analyze imaging features of lymphoepithelial carcinoma (LEC) of salivary gland through conventional CT, MRI and functional MRI.Methods:From March 2010 to March 2020, a total of 75 patients with salivary gland LEC who were initially diagnosed and confirmed by postoperative pathology were retrospectively collected in the Ninth People′s Hospital Affiliated to Shanghai Jiaotong University Medical College. The preoperative CT and MRI findings were analyzed. Information including location, size, shape, boundary, density/signal intensity and enhancement degree of lesions were evaluated by conventional CT and MRI. The ADC value and time-intensity curve (TIC) pattern of lesions were measured from DWI and dynamic contrast enhanced (DCE)-MRI.Results:Among 75 cases of LEC in salivary gland, 56 cases had solitary lesions, 38 cases were round/oval or irregular, 34 cases were irregular morphology. Only 1 case exhibited calcification and 5 cases had necrotic regions. In 68 cases with CT images, 28 cases showed moderate enhancement and 30 cases showed intense enhancement. In 12 cases with MRI, 11 cases showed iso-intensity on T 1WI and 12 cases showed slightly hyperintensity on T 2WI. After contrast injection, 11 cases showed homogeneous enhancement and all of the 12 cases showed intense enhancement. The ADC value of LEC in salivary gland was (0.68±0.05)×10?3 mm 2/s and the TIC type of all the 12 cases was type Ⅱ (fast rising platform type). Conclusion:The LEC of salivary gland is single, has homogeneous texture, moderate enhancement and low ADC value. DCE-MRI shows type Ⅱ TIC curve. Morphological features combined with functional MRI features are helpful for accurate preoperative imaging diagnosis and differential diagnosis.

Role of CT in predicting capsular invasion and cervical lymph node metastasis in papillary thyroid carcinoma / 中华放射学杂志

Objective:To investigate the value of CT tumor-thyroid marginal contact range (MCR) for predicting capsular invasion and cervical lymph node metastasis in papillary thyroid carcinoma (PTC) with a diameter>1.0 cm and papillary thyroid microcarcinomas (PTMC) with a diameter ≤ 1.0 cm, and to evaluate the diagnostic efficacy of direct CT signs for lymph node metastasis.Methods:The CT data of 148 patients with PTC (>1.0 cm) and 193 patients with PTMC confirmed by surgery and pathology were retrospectively analyzed from January 2017 to April 2020 at Hangzhou First People′s Hospital. MCR was evaluated based on CT images and classified as<1/4 tumor circumference or ≥1/4 tumor circumference. Direct CT signs of cervical lymph nodes were observed, including cystic change, microcalcification, hyperenhancement, short/long diameter≥0.5, clustered lymph nodes or central area turbidity. The difference in the distribution of MCR between PTC (>1.0 cm) and PTMC was compared using the χ 2 test, and the efficiency of MCR and direct CT signs for diagnosing capsular invasion and lymph node metastasis was calculated using the pathological results as the gold standard. Results:In 148 PTC (>1.0 cm) and 193 PTMC patients, the pathological results showed capsular invasion in 88.5% (131/148) and 57.0% (110/193), and lymph node metastasis in 71.6% (106/148) and 44.0% (85/193), respectively. In PTC (>1.0 cm) patients, MCR≥1/4 tumor circumference was more common in patients with capsular invasion (χ2=22.211, P<0.001) and lymph node metastasis (χ2=4.746, P=0.029), and the corresponding sensitivity and specificity for predicting capsular invasion and lymph node metastasis were 84.7% (111/131) and 64.7% (11/17), 83.0% (88/106) and 33.3% (14/42), respectively. In PTMC patients, MCR≥1/4 tumor circumference was more common in patients with capsular invasion (χ2=66.066, P<0.001) and lymph node metastasis (χ2=5.343, P=0.021), and its sensitivity and specificity for predicting capsular invasion and lymph node metastasis were 87.3% (96/110) and 69.9% (58/83), 71.8% (61/85) and 44.4% (48/108), respectively. The sensitivity and specificity of direct CT signs for diagnosing lymph node metastasis in PTC (>1.0 cm) and PTMC were 89.6% and 73.8%, 69.4% and 76.9%, respectively. Conclusions:Both direct CT signs and MCR ≥ 1/4 tumor circumference can predict cervical lymph node metastasis in PTC patients, and the former had higher sensitivity and specificity. MCR≥1/4 tumor circumference has high efficiency for predicting capsular invasion in PTC patients.

Dynamic CT Myocardial Perfusion Imaging in Patients without Obstructive Coronary Artery Disease: Quantification of Myocardial Blood Flow according to Varied Heart Rate Increments after Stress

Objective@#The present study aimed to investigate the association between myocardial blood flow (MBF) quantified by dynamic CT myocardial perfusion imaging (CT-MPI) and the increments in heart rate (HR) after stress in patients without obstructive coronary artery disease. @*Materials and Methods@#We retrospectively included 204 subjects who underwent both dynamic CT-MPI and coronary CT angiography (CCTA). Patients with more than minimal coronary stenosis (diameter ≥ 25%), history of myocardial infarction/ revascularization, cardiomyopathy, and microvascular dysfunction were excluded. Global MBF at stress was measured using hybrid deconvolution and maximum slope model. Furthermore, the HR increments after stress were recorded. @*Results@#The median radiation dose of dynamic CT-MPI plus CCTA was 5.5 (4.5–6.8) mSv. The median global MBF of all subjects was 156.4 (139.8–180.4) mL/100 mL/min. In subjects with HR increment between 10 to 19 beats per minute (bpm), the global MBF was significantly lower than that of subjects with increment between 20 to 29 bpm (153.3 mL/100 mL/min vs. 171.3 mL/100 mL/min, p = 0.027). This difference became insignificant when the HR increment further increased to ≥ 30 bpm. @*Conclusion@#The global MBF value was associated with the extent of increase in HR after stress. Significantly higher global MBF was seen in subjects with HR increment of ≥ 20 bpm.

Comparing the effect of different concentrations of contrast media in CT enterography / 中华放射学杂志

Objective:To explore the enhancement effect of different concentrations of contrast media on blood vessels and hollow organs in CT enterography.Methods:Sixty patients with CT enterography were enrolled from January to August 2019 at Shanghai Ninth People's Hospital, and were prospectively randomly divided into three groups (group A: 90 ml 400 mg/ml contrast media, group B: 90 ml 350 mg/ml contrast media, and group C: 79 ml 400 mg/ml contrast media). Evaluation parameters included CT value, signal noise ratio (SNR) and contrast noise ratio (CNR) of main abdominal vessels (abdominal aorta, superior and inferior mesenteric atery, jejunal artery, ileum artery, superior and inferior mesenteric vein), jejunum, ileum and inflammatory bowel disease. The overall image quality and direct jejunum ileum artery quality scores were evaluated. One-way ANOVA was used to compare the parameters among the three groups.Results:There was no statistical difference in CT value, SNR and CNR of each measurement index among the three groups in plain scan ( P>0.05). The CT value, SNR and CNR of abdominal aorta, superior mesenteric artery, inferior mesenteric artery, jejunal artery and ileal artery in group A and C were higher than those in group B in arterial phase ( P<0.05), but there was no significant difference between group A and group C ( P>0.05). The CT value, SNR and CNR of superior mesenteric vein, inferior mesenteric vein, normal jejunum, ileum and inflammatory lesions in group A were higher than those in group B and C in venous phase ( P<0.05), but there was no significant difference between group B and group C ( P>0.05). The overall image quality scores of group A, B and C were (3.8±0.7), (3.4±0.6), (3.4±0.6), respectively, with no significant difference ( F=3.075, P=0.054). The direct jejunum ileum artery scores of the three groups were (3.5±0.5), (3.1±0.5), (3.4±0.5), respectively, the difference was statistically significant ( F=3.684, P=0.031). Conclusion:At the same injection rate and scanning parameters, contrast media at 400 mg/ml can provide better vessel and hollow organ enhancement.

Value of texture analysis on apparent diffusion coefficient maps in the preoperative prediction of histological grade of tongue and mouth floor squamous cell carcinoma / 中华放射学杂志

Objective To explore the value of texture analysis on ADC maps in the preoperative prediction of histological grade of tongue and mouth floor squamous cell carcinoma (SCC). Methods Forty?nine pathologically confirmed tongue and mouth floor SCC with definite grading from May 2015 to June 2018 were retrospectively analyzed, including 21 cases of gradeⅠ, 21 cases of gradeⅡand 7 cases of gradeⅢ. All subjects underwent preoperative MRI examination with DWI included. Two doctors delineated whole tumor region of interest and extracted texture parameters by the 3D Slicer software, including 8 histogram parameters, 11 grey?level co?occurrence matrix (GLCM) parameters and 7 gray?level run?length matrix (GLRLM) parameters. Intraclass correlation coefficient (ICC) was used to evaluate the inter?observer delineation agreement, and the texture parameters with excellent reproducibility (ICC>0.8) were used for analysis only. Mann?Whitney U test was used to compare the differences of ADC texture parameters between grade Ⅰ and grade Ⅱ?Ⅲ SCCs. Stepwise logistic regression was used to determine the independent predictors and to build combined model. ROC analysis was used to explore the performance of texture parameter and model in predicting histological grade of tongue and mouth floor SCCs. Pearson correlation coefficient was used to evaluate the correlation between texture parameters with statistical significance. Results (1) Excellent inter?observer delineation agreement (ICC: 0.81-0.98) was observed in 69.23% (18/26) texture parameters, including 6 histogram parameters, 7 GLCM parameters and 5 GLRLM parameters. (2) Among histogram parameters, significantly higher 10 percentile ADC value (ADC10) and significantly lower energy and entropy were shown in gradeⅠcompared with gradeⅡandⅢSCCs (all P<0.05). Among GLCM parameters, significantly lower joint entropy, difference entropy, sum entropy, difference variance, difference average and contrast were shown in grade Ⅰ SCCs (all P<0.05). Among GLRLM parameters, significantly lower gray?level nonuniformity and run?length nonuniformity were shown in gradeⅠSCCs (all P<0.05). ADC10 and entropy were identified as independent predictors. The ADC10 and entropy were 960(913, 1 178)×10?6mm2/s and 4.32(4.06, 4.76) in gradeⅠSCCs, and 888(816, 987)×10?6mm2/s and 4.88(4.57, 5.29) in gradeⅡ?ⅢSCCs respectively. The area under ROC curve (AUC) of ADC10, entropy and combined model were 0.72, 0.75, 0.81. (3) Significant correlation (|r|≥0.5) was observed among 52.73% (29/55)texture parameters with statistical significance. Conclusion Texture analysis on ADC maps can provide more quantitative information, which can be more accurately in discriminating grade Ⅰfrom gradeⅡ?Ⅲtongue and mouth floor SCCs.

CT features of jaw venous malformations and differential diagnosis from osteosarcoma of the j aw / 实用放射学杂志

Objective To analyze the CT imaging features of jaw venous malformation (VM),and to evaluate the effect and diagnostic significance of CT in differentiating VM from osteosarcoma of the j aw.Methods 22 cases with pathological diagnosis of j aw VM and 13 cases of jaw osteosarcoma were reviewed on their CT images’morphologic characters and CT values.SPSS statistics 25.0 software package was used for statistical analysis.Results 50% of jaw VM cases showed fanGshaped bone trabecula structure,and 31.8% showed lumbricoid vessels.No invasive periosteal reaction was found in jaw VM cases.53.5% of jaw osteosarcoma cases showed invasive periosteal reactions.Neither fanGshaped bone trabecula structure nor lumbricoid vessels was found in jaw osteosarcoma cases.Significantly statistical differences existed in these morphologic characters between these two groups (P＜0.01).Minimum enhanced CT value and maximum nonGenhanced CT value were statistically different between the two groups (P＜0.05 ,U＞ 0).The AUC of minimum enhanced CT value,maximum plain CT value,and the combined predict parameter of these two values were 0.735,0.864,and 0.956,respectively.Conclusion FanGshaped bone trabecula structure and lumbricoid vessels are key features in diagnosing jaw VM on CT.Jaw VM has a lower maximum nonGenhanced CT value and a higher minimum enhanced CT value than jaw osteosarcoma has.The combined predict parameter of these two values has good diagnostic efficacy.

Superficial circumflex iliac artery perforator flap for reconstruction of buccal and plate soft tissue defects / 中华整形外科杂志

Objective@#To investigate the therapeutic effect of free superficial circumflex iliac artery perforator (SCIP)flap for reconstruction of soft tissue defects secondary to resection of retromolar and lateral buccal squamous cell carcinoma.@*Methods@#From January 2014 to January 2017, eight patients with retromolar and lateral buccal squamous cell carcinoma received radical resection and reconstructed with SCIP flap immediately. CTA and color Doppler sonography were routinely performed before the surgery. According to the size of the defect in the recipient area, the flap vascularized by the perforator vessel was carefully prepared and transferred to the buccal-pharynx-palate composite defect. The recipient area and donor area were sutured tightly after arteriovenous anastomosis under microscope. The survival and functional recovery of the flap were observed after operation.@*Results@#The flap sizes ranged from 5 cm× 6 cm to 7 cm×9 cm.The mean diameter of the superficial circumflex iliac arteries was 0.65 mm. And the mean diameter of the veins was 1.2 mm. The mean arterial pedicle length was 7.0 cm, and the venous pedicle length was 8.0 cm. Eight flaps were all survived. The shape of the buccal-parapharyngeal-palate was good and the mouth opening was normal after operation.@*Conclusions@#Superficial circumflex iliac artery perforator flap was a good choice for repairing the defect of parapharyngeal squamous cell carcinoma in the posterior molar region.

Application of MR fingerprinting technology in medical imaging / 中国介入影像与治疗学

MR fingerprinting (MRF) is a technology which can be used to quickly get quantitative images and post processing.The program of signal acquisitions,post-processing and virtualization of MRF are innovatively designed,being able to obtain a highly repeatable and multi-parametric quantification map in one scanning.MRF has shown various advantages,such as short scanning time,high fault tolerance and easy recognition of image data with computer,therefore having broad prospect in clinical application.The research progresses of MRF were reviewed in this article.

Expression and significance of HMGA2 and E-Cadherin in prostate cancer / 实用医学杂志

Objective To investigate the role of high mobility group protein2(HMGA2)and E-Cadherin in the development of prostate cancer(PCa). Methods A total of 60 paraffln-embedded specimens of PCa were collected from patients who underwent operation in Dalian Central Hospital from 2008 to 2016.The expression lev-els of HMGA2 and E-Cadherin in the specimens were examined by immunohistochemical staining.The correlations between the expression of HMGA2 and E-Cadherin and clinical features such as age,Gleason score,invasion,me-tastasis and TNM stage were studied. Results The expression levels of HMGA2 in PCas were significantly higher than that in controls(χ2=51.818,P<0.01),but the positive expression levels of E-Cadherin in PCas were lower than that in controls(χ2=53.494,P<0.01).The positive expression of HMGA2 and the loss of E-Cadherin were confirmed in PCa accompanied by metastasis,seminal invasion,Gleason score>7 and stageⅢ~Ⅳ(P<0.05). Overexpression of HMGA2 was associated with down-regulation of E-cadherin(Spearman′s r=-0.569,P<0.01). Conclusions Up-regulation of HMGA2 and down-regulation of E-Cadherin are cooperatively correlated with the invasion and metastasis in PCa.

Value of conventional and functional MRI in the diagnosis of orbit solitary fibrous tumor / 实用放射学杂志

Objective To evaluate the value of conventional and functional MRI in the diagnosis of orbital solitary fibrous tumor (SFT).Methods MR images of 8 patients with pathologically confirmed orbital SFT were analyzed retrospectively.The lesion shape, size,location and signal features on conventional MRI were evaluated.Apparent diffusion coefficient(ADC)values and DCE-MRI parameters(time-signal intensity curve pattern,maximum ratio of enhancement and washout ratio)were calculated.Results The majority of tumors(6/8)showed regular shape with maximum diameters varying from 2.5 cm to 3.7 cm.Of 8 cases,there was 1 case in intraconal space,2 cases involved with intra and extraconal space,5 cases in extraconal space.On T1WI,all lesions demonstrated isointense to gray matter.On T2WI,5 lesions showed isointensity and 3 lesions showed slight hypointensity,of which 6 cases showed heterogeneous signal.After contrast enhancement,8 lesions showed marked enhancement.Plateau pattern of time-signal intensity curve was observed in 6 cases with maximum ratio of enhancement of 1.37 ± 0.54 and washout ratio of 6.58% ± 3.66%.Mean ADC value was(1.28 ± 0.25)×10-3mm2/s.Conclusion Combination of conventional MRI,DWI and DCE-MRI can assist the diagnosis of orbital SFT.

MRI texture analysis in differential diagnosis of orbital lymphoma and inflammatory pseudotumor / 中国医学影像技术

Objective To discuss the application value of texture analysis of conventional MRI in differential diagnosis of orbital lymphoma from inflammatory pseudotumor.Methods The conventional MRI data of 15 patients with lymphoma and 17 patients with inflammatory pseudotumor proven by pathology or clinical follow-up were retrospectively reviewed.The texture features of lesions based on axial T1WI,fat-saturated T2WI and contrast enhanced fat-saturated T1WI were extracted by manually drawn ROIs with software MaZda.The subsets of optimized texture parameters were chosen by four different methods:Fisher coefficient,probability of classification error and average correlation coefficient (POE+ ACC),mutual information measure (MI) and the combination of the above three methods (FPM),respectively.Linear discriminant analysis (LDA) and nonlinear discriminant analysis (NDA) were performed for texture classification.The texture features from the sequence with the best classification result of orbital lymphoma and inflammatory pseudotumor were compared.Results The optimal texture parameters were mainly derived from co occurrence matrix and run-length matrix on T1WI and T2WI.The optimal texture parameters were mainly derived from co-occurrence matrix and histogram on contrast enhanced T1WI.The best classification of MRI texture was obtained within T2WI with lowest classification error of 1.56％ achieved by FPM in combination with NDA.Comparing the texture parameters of orbital lymphoma and inflammatory pseudotumor on T2WI,the angular second moment and long length emphasis were significantly higher in orbital lymphoma (both P＜0.005),while the entropy and short length emphasis were significantly lower in orbital lymphoma (both P＜0.005).Conclusion It is feasible to use texture analysis on conventional MRI for the differentiation of orbital lymphoma and inflammatory pseudotumor.

Application of 3D printing models in undergraduate medical imaging teaching / 中华医学教育探索杂志

Objective To evaluate the effect of 3D printing models applied to Medical Imaging Di-agnosis Undergraduate Teaching. Methods Students in the year 2012/2013 of Shanghai Jiao Tong Univer-sity School of Medicine stomatology specialty were chosen for this study, including 38 students in the exper-imental group (2013) and 40 students in the control group (2012). All of them were taught by the same group of teachers, including 28 core curriculum hours and 5 practice class hours. 3D printing technology with PPT was applied to the experimental group in the medical imaging diagnostic teaching, and conventional teaching including PPT and usual models in the control group. Medical students were given a test about cardiovascular system and tasked with completion of drawing hand and foot bones. Students in experimental group were also asked to complete a questionnaire about their experience. Results The questionnaire showed that 3D printing teaching molds with PPT was of great significance to improve the students interest in learning imaging anatomy, to meet the vast majority of students' learning requirements, and to achieve satis-factory results. The average scores of the circulatory system test in the experimental group were higher than that of the control group [(8.32 ±2.352) vs. (6.15 ±1.284), P<0.05)]. Students in experimental group per-formed better than students in the control group on the Locomotor system test [(6.81 ±1.347] vs. (3.84 ± 0.985), P<0.01]. Conclusions 3D printing mold combined with PPT teaching method can promote the med-ical imaging anatomy structure, learning effect and teaching quality, and has practical value in the under-graduate teaching of medical imaging diagnosis.

Imaging features of the arteriovenous malformation in maxilla / 实用放射学杂志

Objective To summarize the radiography ,CT and MRI findings of maxillary arteriovenous malformation (AVM ) . Methods Seventeen patients with maxillary AVM underwent panoramic radiography (3 patients) and enhanced MRI examination (6 patients) ,all the patient underwent enhanced CT examination .The clinical manifestation and imaging findings of maxillary AVM ,in‐cluding the location ,shape ,margin ,inner texture ,involvement of adjacent structures ,the density and signal intensity of the lesions , were analyzed .Results The lesions mainly located in molar areas (15/17) .The major clinical manifestation were repeated bleeding and acute bleeding .Other symptoms included swelling of the face ,pulsatile soft mass and anesthesia .The panoramic radiography only showed increased density .According to the change of the maxilla on enhanced CT images ,the lesions could be devided into two types :type Ⅰ ,showed intraosseous osteolytic destruction and cortical expansion (n=12);type Ⅱ ,showed“ground glass”appearance (n=5) .Bone destruction and soft tissue involvement ,widened feeding artery and draining veins ,elevated maxillary sinus were shown in all patients .External jugular vein enlargement and early enhancement (n=14) and root resorption (n= 6) were also detected . Flowing void on T1 and T2 weighted images (type Ⅰ) and hypo‐or isointense on T1WI ,hyperintense on T2WI and obvious enhance‐ment after injecting contrast material (type Ⅱ ) could observed .Conclusion Enhanced CT examination could be primarily recom‐mended and observe the extent of lesions and situation of vessels invaded of maxillary AVM .

Review of ear and nose and throat involvement in IgG4-RD / 临床耳鼻咽喉头颈外科杂志

IgG4-related disease (IgG4-RD) is a newly recognized disease entity. IgG4-RD is characterized by a single or multiple masses in one or more organs; a lymphoplasmacytic infiltrate with a high percentage of plasma cells within the lesion staining for IgG4; a peculiar pattern of fibrosis known as "storiform" fibrosis; and elevated serum IgG4 concentrations. IgG4-RD can occur in various organs, including pancreas, kidneys, lungs, retroperitoneum, and prostate gland. The head and neck involvements of IgG4-RD have been chiefly described in Mikulicz disease (MD), Küttner's tumor, orbital? inflammatory pseudotumor, and idiopathic hypertrophic pachymeningitis (IHP) previously. Recent studies reported that IgG4-RD could also involve ear, nose and throat. Here we reviewed the literatures about ear, nose and throat involvement by IgG4-RD, in order to provide some theoretical bases for the diagnosis and treatment of IgG4-RD.

Diagnostic value diffusion weighted imaging with different b values in the differentiation of malignant from benign orbital masses / 实用放射学杂志

Objective To investigate the changes on apparent diffusion coefficient(ADC)of diffusion weighted imaging with dif-ferent b values and to assess the diagnostic value of ADC for discriminating malignant from benign orbital masses.Methods 81 pa-tients (55 benign orbital masses and 26 malignant orbital masses)were enrolled.These patients underwent serial MR and echo-pla-nar DW imaging examinations of the orbits with b values=0 and/or 400,700,1 000 s/mm2 .The differences of ADC values under different b values between benign and malignant orbital masses were observed and compared,and diagnosis of ADC values was as-sessed by the receiver operating characteristic (ROC)curve.Results In three groups,the ADC values of benign orbital masses [(1.56±0.35)×10 -3 mm2/s,(1.40±0.34)×10 -3 mm2/s and (1.30±0.32)×10 -3 mm2/s,respectively]were significantly differ-ent (P <0.01),while the ADC values of malignant orbital masses were not statistically different (P =0.093)[(1.12 ±0.47)× 10 -3 mm2/s,(0.92±0.42)×10 -3 mm2/s and (0.87±0.40)× 10 -3 mm2/s,respectively].The areas under the ROC curve of ADC values were 0.799,0.866 and 0.867,respectively.The threshold values were 1.05 × 10 -3 mm2/s,0.94 × 10 -3 mm2/s and 0.93 × 10 -3 mm2/s (while sensitivity were 65%,81% and 81%;specificity were 94.5%,91% and 85%;positive predictive values were 85%,80%,72%,negative predictive values were 85%,91%,90%,and accuracy were 85%,87% and 84%,respectively).Conclusion The b value of 700 s/mm2 offered better diagnostic performance.ADC values of diffusion weighted imaging can reflect diffusion characteristics of the orbital masses,as a complementary tool in the differentiation of malignant from benign orbital masses.