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The histopathological growth pattern (HGP) of colorectal cancer liver metastasis (CRLM) is correlated with the prognosis of patients. Patients with desmoplastic HGP have a better prognosis. The latest international scoring guidelines have modified the cut-off value of HGP, and divides it into two types: complete desmoplastic HGP and incomplete desmoplastic HGP. However, the relationship between the HGPs and the treatment response to systemic treatment is still unclear. It is necessary to develop non-invasive methods to evaluate changes in HGP during treatment in the future. This paper reviews the new scoring consensus and clinical applications of HGP in CRLM.
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Objective:To explore the value of metal artifact reduction in oblique sagittal multi-acquisition with variable resonance image combination slab selectivity (MAVRIC-SL) inversion recovery (IR) sequence compared with conventional fast spin-echo (FSE) fat saturation (FS)-T 2WI and proton density weighted imaging (PDWI) on the postoperative review of patients with metal-fixed anterior cruciate ligament reconstruction (ACLR) at 3.0 T MR. Methods:From June to November 2018, 27 patients with metal fixtures in ACLR were prospectively recruited in the First Hospital of China Medical University. The FSE sequences (FS-T 2WI and PDWI) and the MAVRIC-SL IR were performed at 3.0 T MRI system. The maximum artifact slice was selected and ROI was drawn, then the implant and artifact area and the number of artifact-influence slices were recorded. Image signal-to-noise ratio (SNR) was calculated. The degree of image artifacts (artifact degree of spiked ligament staple and its influence on the diagnosis of surrounding structures), measurability (measurability of distance between the upper edge of the staple and the lower edge of the graft entrance on tibia), and other degree of artifacts (whether there were metal artifacts other than implants that affect the observation of other structures within the scanning range) were scored. The Friedman M test and pairwise comparison were used to compare and analyze the quantitative and qualitative data. Results:The differences in artifact area, the number of artifact-influence slices and SNR among FS-T 2WI, PDWI and MAVRIC-SL IR images were statistically significant (all P<0.001). Pairwise comparison analysis suggested that the metal implant artifact area and the number of artifact-influence slices in the MAVRIC-SL IR image were smaller, and the SNR was higher than those of FS-T 2WI and PDWI (all P<0.05 after correction). The differences of the three scores among FS-T 2WI, PDWI and MAVRIC-SL IR were statistically significant (all P<0.001). Pairwise comparison analysis suggested that the degree of image artifacts score of MAVRIC-SL IR sequence was lower, and the measurability and other degree of artifacts scores were higher than FS-T 2WI and PDWI (all P<0.05 after correction). Conclusion:MAVRIC-SL can significantly reduce the metal artifacts and improve image quality in the postoperative MRI review of the patients with metal-fixed ACLR. Therefore, oblique sagittal MAVRIC-SL IR sequence can be used for assisting the diagnosis of conventional FS-T 2WI and PDWI.
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Objective: To explore the value of spectral CT in differentiating pure and impure cholesterol stones. Methods: Spectral CT was used to scan in vitro gallstones, and infrared spectroscopy spectrum was used to observe the composition and classification of gallstones. ROIs were outlined in the axial, coronal and sagittal maximum planes of gallstones. Spectral CT indexes, including spectral curves, CT value, CT slope, effective atomic number (Zeff) and calcium-water ratio (CWR)) of the stones were acquired. Mann-Whitney U test was used to analyze the differences of parameters among different gallstone groups and subgroups. ROC curve was used to determine the diagnostic threshold, sensitivity, specificity, positive predictive value and negative predictive value of pure and impure cholesterol stone group. Results: There were significant differences of CT parameters between pure and impure cholesterol stone groups (all P0.05). Conclusion: The parameters of pure and impure cholesterol stones have good diagnostic efficacies. There are differences of energy spectrum curves of gallstones with different compositions.