MRI Reference Ranges for Fetal Cardiothoracic Ratio of Diameter, Area, and Circumference from 21 to 38 Weeks Gestational Age.

BACKGROUND: Whether fetal cardiothoracic ratio (CTR) is constant or increasing with gestational age (GA) is controversial. The majority of the fetal CTR data has been obtained through ultrasound. PURPOSE: To retrospectively analyze CTR of diameter, area, and circumference on prenatal MR images in a low-risk population of singleton pregnancies, and to clarify its diagnostic value. STUDY TYPE: Retrospective. SUBJECTS: 1024 low-risk singleton pregnancies undergoing MRI. FIELD STRENGTH: Balanced steady state free precession sequence and single shot-fast spin echo sequence at 1.5 Tesla. ASSESSMENT: Pregnancy clinical data were recorded and diameter, area, and circumference of the fetal heart and thorax were measured by two researchers with 6 and 7 years of radiology experience, respectively, and their variation with GA was investigated. The relationship between CTRs with GA was also investigated. Finally, the value of CTR in the diagnosis of fetuses with abnormal development was explored by using receiver operating characteristic (ROC) curves. STATISTICAL TESTS: Linear regression and ROC curves. A P value <0.05 was considered significant. RESULTS: There were significant positive linear correlations (R2 > 0.7, P < 0.0001) between the diameter, area, and circumference of the heart and thorax with GA. The CTRs remain constant values and do not change with GA. The 5th, 50th, and 95th percentiles of the CTR in 21-38 weeks GA were 0.32, 0.39, and 0.48 respectively. The corresponding percentiles for the area ratio were 0.15, 0.21 and 0.27, respectively, and for the circumference ratio were 0.40, 0.46, and 0.52, respectively. Based on ROC curves of CTR with three methods, the area under curves (AUCs) were up to 0.95, the sensitivity and the specificity were more than 88%. DATA CONCLUSION: Reference ranges of fetal CTR were established using MRI, which remain constant. These may be helpful in making a definitive diagnosis in fetuses with abnormal development. TECHNICAL EFFICACY: Stage 2.

Correlation between asymmetrical vein sign of SWI and long-term clinical outcomes in patients with middle cerebral artery ischemic stroke.

OBJECTIVE: To evaluate the association of asymmetrical cortical vein sign (ACVS) and asymmetrical medullary vein sign (AMVS) on susceptibility-weighted imaging (SWI) with 90-day poor outcomes in patients with unilateral middle cerebral artery acute ischemic stroke (AIS) after conservative drug treatment. METHODS: Clinical data for the participants included age, sex, smoking, alcohol, hypertension, diabetes, hyperlipidemia, coronary heart disease, NHISS-admission, and NHISS-discharge scores. Participants underwent magnetic resonance imaging (MRI) within 12 h of hospital admission, including conventional scan sequences and a SWI sequence. Poor prognosis was defined as a modified Rankin scale (mRS) ≥ 3 at 90 days. RESULTS: A total of 108 patients were included from January 2021 to March 2022. Twenty-seven (25%) patients had a poor outcome at 90 days. Univariate analysis indicated that diabetes, NHISS-admission, NHISS-discharge, DWI-ASPECTS, SWI-ASPECTS, FLAIR-ASPECTS, and AMVS + were associated with 90-day poor outcome. Multivariate regression analysis showed that AMVS + was associated with 90-day poor outcome from the three models (OR = 3.57, P = 0.006; OR = 3.74, P = 0.005; OR = 5.14, P = 0.0057). However, no significant association was found between ACVS + and 90-day poor outcome. CONCLUSIONS: AMVS might be a helpful neuroimaging predictor for poor outcome at 90 days compared to ACVS in drug-conserving treatment of patients with unilateral middle cerebral artery ischemic stroke.

Assessment of central nervous system vasculitis in children based on high-resolution vascular wall imaging.

Objectives: Central nervous system vasculitis (CNSV) is a rare disease. High-resolution vessel wall imaging (HR-VWI) enables the identification of inflammatory changes within the vessel wall. Few studies have applied HR-VWI to assess CNSV in children. This study delves into the utility of HR-VWI for diagnosing and treating CNSV in children, with the aim of enhancing clinical diagnosis and efficacy evaluation. Methods: Imaging data were acquired from children who underwent HR-VWI examinations. The study meticulously analysed clinical data and laboratory tests to discern the characteristics and distribution patterns of diverse vasculitis forms. Results: In children, CNSV mainly involves medium vessels with grade 1 and 2 stenosis (grade 4 stenosis is rare), and the imaging features generally show centripetal and moderate enhancement, suggesting that this feature is specific for the diagnosis of CNSV. High-grade stenosis, concentric enhancement and strong enhancement of the vasculature indicate more severe disease activity. Remarkably, HR-VWI proved to be significantly more sensitive than magnetic resonance angiography in detecting CNSV. Among the 13 cases subjected to imaging review, 8 demonstrated a reduction or resolution of vessel wall inflammation. In contrast, five patients exhibited worsening inflammation in the vessel wall. HR-VWI demonstrated that changes in vessel wall inflammation were closely correlated with changes in brain parenchymal lesions and symptoms. Conclusion: This study underscores the diagnostic value of HR-VWI in CNSV assessment and treatment monitoring, offering a quantitative evaluation of CNSV in children.

Differential Alterations in Topology Property of Resting State Networks Associated With Mental Health and Childhood Trauma.

Context: Childhood trauma can lead to greater vulnerability to psychopathology and can affect person's mental health throughout his or her life cycle. Research on the associations between childhood trauma and developmental outcomes is critical to creating effective interventions. Objective: The study intended to identify brain networks that are susceptible to childhood trauma by comparing differences in the networks of individuals with and without trauma, to investigate how changes in networks can mediate the effects childhood adversity on mental health. Design: The research team performed a prospective cross-sectional survey. Setting: The study took place at the Second Hospital of Hebei Medical University in Shijiazhuang, China. Participants: Participants were 80 individuals aged 18-30 years, with and without childhood trauma. Outcome Measures: Participants underwent resting-state functional magnetic resonance imaging (rs-fMRI). The research team: (1) assessed participants' depressive symptoms using the Beck Depression Inventory (BDI); anxiety levels using the State-Trait Anxiety Inventory (STAI); personality traits using the Three-Dimensional Personality Questionnaire (TPQ), and childhood traumatic experiences using the Childhood Trauma Questionnaire (CTQ); (2) analyzed the data using independent component analysis (ICA) and graph theory based on resting-state functional networks to assess the functional connectivity (FC) and global efficiency of participants' brains; (3) performed a correlation analysis between changes in the topological properties of participants' brains and neglect and abuse, (4) explored the mediating effects between childhood trauma and mental health, and (5) explored gender as a moderator of the relationship between neglect and changes in the global efficiency of within-network connectivity. Results: Childhood trauma was associated with altered global efficiency of the salience network (SAN) and the default mode network (DMN). Compared with the healthy control group, the childhood trauma group's global efficiency of the SAN for the left (P = .022) and right (P = .013) bilateral anterior insula were significantly higher and the global efficiency of the DMN for the right lateral precuneus was significantly lower (P = .022). Compared with males, neglect was significantly more likely to affect the global efficiency of the SAN for females (R2 = 0.473, t = -2.33, F(3,76) = 24.66, B = -0.005, and P = .022). The childhood trauma group's mean score for novelty seeking on the TPQ was significantly higher than that of the healthy control group (P = .029), showing that the global efficiency of the SAN and DMN had a significant role as a mediator between neglect and novelty seeking. Conclusions: These findings indicate that childhood trauma can alter resting-state functional networks in healthy youth. This abnormality in brain circuitry is especially relevant to the DMN and SAN networks.

MRI measurement assessment on ischiofemoral impingement syndrome.

BACKGROUND: To explore the value of MRI upon diagnosis of ischiofemoral impingement syndrome (IFI) and to recognise deformation or oedema of the quadratus femoris muscle. MRI applied to measure the ischial femoral space (IFS), the average width of quadratus femoral space (QFS), and the ischial intertuberal diameter. METHODS: A retrospective analysis was carried out of 213 hip joints MRI images of 58 cases diagnosed with IFI and 61 cases of normal subjects. IFS, QFS and ischial intertuberal diameter were measured by axial T1WI sequence. The morphological and signal changes of the quadratus femoris muscle were observed through proton density weighted image fat suppression sequence (PDWI-FS). RESULTS: The widths of IFS and QFS in the normal group were larger than those in the case group, while the ischial intertuberal diameter was significantly smaller (p < 0.05). Pearson correlation analysis revealed that there was a positive correlation (r = 0.824) between IFS and QFS in all hip joints and a negative correlation between the ischial intertuberal diameter and the widths of IFS and QFS (r = -0.213, -0.222, p < 0.05) respectively. As the grade of oedema in quadratus femoris muscle increased, the corresponding IFS gradually decreased. The corresponding IFS width of grade 0 oedema of the quadratus femoris muscle oedema was significantly higher than that of grade 1, grade 2 and grade 3. The receiver operating characteristic curve (ROC) of the subjects was applied to determine the diagnostic boundary value of the IFS and QFS in IFI patients, which was 1.98 cm and 1.05 cm respectively. The area under the curve (AUC) was 0.948 and 0.953 respectively. CONCLUSIONS: MRI examination could provide a reliable basis for the diagnosis of ischiofemoral impingement syndrome. The narrowing of IFS and QFS with deformation and oedema in the quadratus femoris muscle may be the features of manifestation of IFI.

Correlation between characteristics of intracranial atherosclerotic plaques and ischemic stroke in high-resolution vascular wall MRI.

BACKGROUND: Intracranial atherosclerotic stenosis is a major cause of ischemic stroke, accounting for 30% of ischemic strokes in Asian populations. PURPOSE: To investigate the relationship between the degree of arterial stenosis and enhancement grade of intracranial atherosclerotic disease (ICAD), the plaque characteristics in different remodeling patterns, and its potential impact. MATERIAL AND METHODS: A total of 210 patients diagnosed with ICAD were enrolled in this retrospective study. Patients were divided into the middle cerebral artery (MCA) group (101 cases), posterior cerebral artery (PCA) group (14 cases), basilar artery (BA) group (71 cases), and intracranial segment of vertebral artery (VA) group (90 cases) according to the difference of diseased vessels. Data on presence or absence of ischemic infarction, intracranial vascular position of lesions, plaque characteristics, ICAD enhancement grade, remodeling index, and degree of arterial stenosis were collected for analysis. RESULTS: The incidence of ischemic infarction in enhancement grade 2 was significantly higher than that in enhancement grade 1 in MCA group (P = 0.019). Enhancement grade 2 of ICAD was an independent risk factor for the development of ischemic infarction (odds ratio = 4.60; 95% confidence interval: 1.91-11.03; P = 0.001). There was no significant statistical difference in infarct rate between different remodeling modalities (P>0.05). CONCLUSION: Enhancement grade of ICAD is significantly associated with the degree of stenosis and the occurrence of ischemic stroke, which varies in different intracranial vessels. The pattern of vascular remodeling varies among different intracranial vessels, and the pattern of vascular remodeling has a significant impact on plaque characteristics.

HR-MRI findings of intracranial artery stenosis and distribution of atherosclerotic plaques caused by different etiologies.

OBJECTIVE: To investigate the etiology of intracranial artery stenosis and the distribution characteristics of intracranial artery atherosclerotic stenosis using high-resolution magnetic resonance imaging (HR-MRI). METHODS: A total of 262 patients with intracranial artery stenosis that underwent HR-MRI from November 2019 to December 2020 were retrospectively enrolled. The etiology of intracranial anterior and posterior circulation artery stenosis was analyzed, and the relationship between the location of plaques and the distribution characteristics of plaques and the occurrence of ischemic stroke was summarized. RESULTS: A total of 276 plaques were identified with HR-MRI. There were 101 cases (36.59%) in the middle cerebral artery (MCA), 14 cases (5.07%) in the posterior cerebral artery (PCA), 90 cases (32.62%) in vertebral artery (VA), and 71 cases (25.72%) in the basilar artery (BA). The infarct rate of ventral and superior wall MCA plaques was higher than that of dorsal and inferior wall (63.33% vs 31.25% P = 0.021) (100.00% vs 50% P = 0.022). MCA with plaques throughout the course had the greatest degree of stenosis (P < 0.001). Sphenoid segment (M1) of MCA was most susceptible (85 cases, 84.16%), MCA plaques were most common in the proximal M1 segment (35 cases, 34.65%), and most BA plaques were found in the distal segment (28 cases, 39.44%). PCA plaques were most frequently involved in traffic anterior segment (P1) (7 cases, 50.00%). CONCLUSION: HR-MRI could provide accurate imaging reference for clinical evaluation of intracranial arterial stenosis and formulation of treatment plans. The intracranial arterial plates mostly appeared in the middle cerebral artery and vertebral artery. Middle cerebral arteries with atherosclerotic plaques are more likely to narrow.

Development and Validation of a Radiomics Nomogram for Prognosis Prediction of Patients with Acute Paraquat Poisoning: A Retrospective Cohort Study.

OBJECTIVE: To evaluate the efficiency of a radiomics model in predicting the prognosis of patients with acute paraquat poisoning (APP). MATERIALS AND METHODS: Chest computed tomography images and clinical data of 80 patients with APP were obtained from November 2014 to October 2017, which were randomly assigned to a primary group and a validation group by a ratio of 7 : 3, and then the radiomics features were extracted from the whole lung. Principal component analysis (PCA) and least absolute shrinkage and selection operator (LASSO) regression were used to select the features and establish the radiomics signature (Rad-score). Multivariate logistic regression analysis was used to establish a radiomics prediction model incorporating the Rad-score and clinical risk factors; the model was represented by nomogram. The performance of the nomogram was confirmed by its discrimination and calibration. RESULT: The area under the ROC curve of operation was 0.942 and 0.865, respectively, in the primary and validation datasets. The sensitivity and specificity were 0.864 and 0.914 and 0.778 and 0.929, and the prediction accuracy rates were 89.5% and 87%, respectively. Predictors included in the individualized predictive nomograms include the Rad-score, blood paraquat concentration, creatine kinase, and serum creatinine. The AUC of the nomogram was 0.973 and 0.944 in the primary and validation datasets, and the sensitivity and specificity were 0.943 and 0.955, respectively, in the primary dataset and 0.889 and 0.929 in the validation dataset, and the prediction accuracy was 94.7% and 91.3%, respectively. CONCLUSION: The radiomics nomogram incorporates the radiomics signature and hematological laboratory data, which can be conveniently used to facilitate the individualized prediction of the prognosis of APP patients.

The value of high-resolution MRI in the diagnosis, efficacy of treatment, and prognosis of central nervous system vasculitis.

AIM OF THE STUDY: To explore the high-resolution magnetic resonance imaging (HR-MRI) characteristics of central nervous system (CNS) vasculitis and to explore the value of HR-MRI in the treatment effect and prognosis evaluation of CNS vasculitis. MATERIAL AND METHODS: During the follow-up of 24 patients diagnosed as CNS vasculitis by the Second Hospital of Hebei Medical University, 3.0T HR-MRI was used for imaging examination and HR-MRI characteristics were analysed. RESULTS: The affected vessel wall of 24 patients showed diffuse uniform centripetal thickening. The HR-MRI examination showed varying degrees of lumen stenosis, including 5 cases (20.8%) involving a single arterial segment, and 19 cases (79.2%) involving multiple arterial segments. And most cases (92.9%) showed grade 2 enhancement of the involved vessel wall. Except for one case involving the basilar artery at the same time, the remaining 23 cases involved only the anterior circulation vessels. We analysed and compared the affected vessels between the relapsed group and the non-relapsed group, and found that the average number of involved vascular segments was 6.5 ±3.4 (3-11) in the relapsed group and 3.5 ±2.1 (1-8) in the non-relapsed group, with a significant difference between the two groups (p = 0.039). CONCLUSIONS: The CNS vasculitis was more likely to involve the anterior circulation vessels. The number of affected vascular segments in the relapsed group of CNS vasculitis was higher than in the non-relapsed group, suggesting that the more vascular segments involved, the more prone to recurrence.

Diagnostic value of HR-MRI and DCE-MRI in unilateral middle cerebral artery inflammatory stenosis.

PURPOSE: High-resolution magnetic resonance imaging (HR-MRI) has high spatial resolution and can simultaneously perform wall and lumen imaging. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can evaluate the integrity of the blood-brain barrier. In this paper, the result of 3.0T HR-MRI and 3.0T DCE-MRI has been evaluated to explore the application value of unilateral middle cerebral artery inflammatory stenosis and changes in vascular permeability parameters of stroke events. METHODS: Thirty-six cases of neurological suspicion of central nervous system vasculitis of our hospital were selected from 20 January 2018 to 1 January 2019, who were diagnosed as unilateral middle cerebral artery M1 stenosis/occlusion by 3D TOF MRA. 3.0T HR-MRI and 3.0T DCE-MRI has been applied. RESULTS: Among the 36 patients who met the inclusion criteria, 23 patients with central nervous system vasculitis were diagnosed. The 23 patients with HR-MRI showed diffuse thickening and enhanced stenosis. The Ktrans value of 10/23 patients with acute-subacute cerebral infarction and 3/23 patients in chronic phase were significantly higher than that of the mirror side, and the Ktrans value of these patients remeasured in the same region of interest is lower than before after 6 months treatment. The Ktrans value in the target area of 10 patients without cerebrovascular events was not statistically significant compared with the mirror side. The Ktrans value of patients with acute-subacute cerebral infarction was significantly higher than that without cerebrovascular events (0.098 ± 0.038 vs. 0.007 ± 0.001, p = .000), and there was no significant difference between Ktrans in the chronic infarction group and the other two groups (0.098 ± 0.038 vs. 0.044 ± 0.012, p = .058; 0.044 ± 0.012 vs. 0.007 ± 0.001, p = .057). CONCLUSION: HR-MRI is an accurate direct imaging method and has a high value for the etiological diagnosis of central nervous system vasculitis. DCE-MRI could be an effective way to evaluate and monitor blood-brain barrier to prevent clinical ischemic stroke.

Diffusion Tensor Imaging and Fiber Tractography Reveal Significant Microstructural Changes of Cervical Nerve Roots in Patients with Cervical Spondylotic Radiculopathy.

OBJECTIVE: To delineate the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of patients with cervical spondylotic radiculopathy by diffusion tensor imaging and fiber bundle tracing. METHODS: Thirty patients with cervical spondylotic radiculopathy and 24 healthy volunteers were assessed using the International Standards for Neurological Classification of Spinal Cord Injury scale. All subjects underwent conventional sagittal T1- and T2-weighted imaging and horizontal 3-dimensional T2 driven equilibrium radiofrequency reset pulse and diffusion tensor imaging scan. The ADC and FA values were measured in the cervical nerve at most stenotic segment and heterolateral nonstenotic segment of patients. RESULTS: Fiber tractography revealed thinned and sparse nerve roots and disruption of the fiber bundles in patients with cervical spondylotic radiculopathy. The FA values of C5-C8 in healthy volunteers or heterolateral nonstenotic nerve of patients with cervical spondylotic radiculopathy were significantly greater than those of the stenotic cervical segments of patients with cervical spondylotic radiculopathy (both P < 0.01). Furthermore, the ADC values of C5-C8 in healthy volunteers or heterolateral nonstenotic nerve of patients with cervical spondylotic radiculopathy were significantly lower than those of the stenotic cervical segments of cervical spondylotic radiculopathy patients (both P < 0.01). CONCLUSIONS: Fiber tractography is capable of delineating microstructural changes of cervical nerve roots and cervical spondylotic radiculopathy exhibits significant changes in FA and ADC values.