Investigating the relationship between intracranial atherosclerotic plaque remodelling and diabetes using high-resolution vessel wall imaging.

BACKGROUND: Intracranial atherosclerosis, a leading cause of stroke, involves arterial plaque formation. This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging (HR-VWI). AIM: To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI. METHODS: Ninety-four patients diagnosed with middle cerebral artery or basilar artery atherosclerosis were enrolled. Their basic clinical data were collected, and HR-VWI was performed. The vascular area at the plaque (VAMLN) and normal reference vessel (VAreference) were delineated and measured using image postprocessing software, and the Remodelling index (RI) was calculated. According to the value of the RI, the patients were divided into a positive remodelling (PR) group, intermediate remodelling (IR) group, negative remodelling (NR) group, PR group and non-PR (N-PR) group. RESULTS: The PR group exhibited a higher prevalence of diabetes and serum cholesterol levels than the IR and NR groups [45.2%, 4.54 (4.16, 5.93) vs 25%, 4.80 ± 1.22 and 16.4%, 4.14 (3.53, 4.75), respectively, P < 0.05]. The diabetes incidence was also significantly greater in the PR group than in the N-PR group (45.2% vs 17.5%, P < 0.05). Furthermore, the PR group displayed elevated serum triglyceride and cholesterol levels compared to the N-PR group [1.64 (1.23, 2.33) and 4.54 (4.16, 5.93) vs 4.54 (4.16, 5.93) and 4.24 (3.53, 4.89), P < 0.05]. Logistic regression analysis revealed diabetes mellitus as an independent influencing factor in plaque-PR [odds ratio (95% confidence interval): 3.718 (1.207-11.454), P < 0.05]. CONCLUSION: HR-VWI can clearly show the morphology and signal characteristics of intracranial vascular walls and plaques. Intracranial atherosclerotic plaques in diabetic patients are more likely to show PR, suggesting poor plaque stability and a greater risk of stroke.

Application of dual-layer spectral detector computed tomography to evaluate the expression of Ki-67 in colorectal cancer.

BACKGROUND: Compared with traditional computed tomography (CT), dual-layer spectral detector CT (SDCT) shows significant improvement in imaging soft tissues of the digestive tract. This work aimed to explore the application of SDCT to evaluate the expression of the molecular marker Ki-67 in colorectal cancer. METHODS: We retrospectively analyzed the imaging data of the SDCT (IQon Spectral CT; Philips Healthcare) of 45 patients with colorectal cancer in our centre. We used Spearman's test for the imaging parameters (reconstruction of 40, 70, and 100 keV virtual monoenergetic images [VMIs] and the slope of the Hounsfield unit attenuation plot [VMI Slope] based on venous phase CT images, the arterial phase iodine concentration [AP-IC] and venous phase iodine concentration [VP-IC], and the effective atomic number [Z effect]) and correlation analysis for the Ki-67 index. Multivariate logistic regression was used to eliminate confounding factors. We evaluated the expression level of Ki-67 and drew the receiver operating characteristic curve. RESULTS: The 40-keV VMI, VMI Slope, and AP-IC were found to better reflect the Ki-67 index in patients with colorectal cancer with statistical significance. The 40-keV VMI (r = -0.612, p < 0.001) and VMI Slope (r = -0.523, p < 0.001) were negatively correlated with the Ki-67 index, and AP-IC (r = 0.378, p = 0.010) was positively correlated with the Ki-67 index. The other indexes (p > 0.05) were not statistically significant. The SDCT parameters demonstrated good performance, with area under curves of 0.785 for 40-keV VMI and 0.752 for AP-IC. CONCLUSION: The SDCT parameters 40-keV VMI and AP-IC can be used for preliminary evaluation of the Ki-67 index in colorectal cancer.

MR imaging features of Lhermitte-Duclos disease: Case reports and literature review.

RATIONALE: Lhermitte-Duclos disease (LDD) is a rare tumor of the nervous system with a typical "tiger striped'" sign, but its features on functional magnetic resonance imaging (fMRI) are still inconclusive. PATIENT CONCERNS: To explore the characteristics of LDDs using fMRI. DIAGNOSES: We report 3 cases of pathologically confirmed LDDs. INTERVENTIONS: Three patients underwent brain tumor surgery. OUTCOMES: All the patients had a good prognosis. LESSONS: Magnetic resonance spectroscopy and susceptibility-weighted imaging combined with conventional MRI can be used to better diagnose LDDs. Perfusion-weighted imaging is not specific for distinguishing cerebellar tumors. The combined application of fMRI and conventional MRI can improve the accuracy of LDD diagnoses.

Quantitative visual pathway abnormalities predict visual field defects in patients with pituitary adenomas: a diffusion spectrum imaging study.

OBJECTIVES: This study was to investigate clinical applicability of diffusion spectrum imaging (DSI) for quantitative detection of visual pathway abnormalities to predict the degree of visual field defects (VFD) in patients with pituitary adenomas. METHODS: Sixty-five patients with pituitary adenomas and 33 healthy controls underwent conventional MRI and DSI scanning that allowed high-angular-resolution fiber tracking. Optic chiasmal compression and VFD were confirmed in all patients via radiological and neuro-ophthalmological examinations. Quantitative assessments of chiasmal lift, VFD, and DSI parameters from the optic nerve, optic tract, and optic radiation were performed. Group comparisons and correlation analyses were conducted in patients and controls. Using the 5-fold cross-validation method, the support vector machine classifiers were constructed to predict the degree of visual defects. RESULTS: The mean values of quantitative anisotropy and generalized fractional anisotropy in optic nerve and optic tract showed significant differences between patients and controls (p < 0.05). These parameters were also significantly correlated with the chiasmal lift distance and degree of visual defects (p < 0.05). All patients were divided into mild (n = 42) and severe (n = 23) VFD groups, using the mean deviation value of -8 dB as the threshold. The classifiers achieved an accuracy of 0.83, sensitivity of 0.78, and specificity of 0.86 to discriminate patients with mild and severe visual defects. CONCLUSIONS: Using high-angular-resolution fiber tracking, DSI may provide quantitative information to detect visual pathway abnormalities and be a potential diagnostic tool for determining the degree of visual field defects in pituitary adenomas. KEY POINTS: • Abnormal QA and GFA values of optic nerve and optic tract in adenoma patients • Close relationship between DSI parameters and VFD degree in adenoma patients • The classifiers achieved an accuracy of 0.83, sensitivity of 0.78, and specificity of 0.86 to discriminate patients with mild and severe VFD.

Preoperative Axillary Ultrasound Helps in the Identification of a Limited Nodal Burden in Breast Cancer Patients.

Since the Z0011 trial, the clinical evaluation of axillary status has been redirected to predicting nodal tumor burden rather than nodal metastases. Our study aimed to evaluate the value of clinicopathological factors and axillary ultrasound (US) for the prediction of a high nodal burden (≥3 metastatic lymph nodes) in breast cancer patients. A total of 532 consecutive patients who underwent preoperative axillary US and subsequent surgery for clinical T1-2 breast cancer with a final pathologic analysis were included. Clinical and pathologic variables were retrospectively evaluated. Univariate and multivariate statistical analyses were performed to identify the variables that were associated with a high nodal burden. Among the 532 patients, 110 (20.7%) had a high axillary nodal burden and 422 (79.3%) had a limited nodal burden. The multivariate analysis showed that suspicious axillary US findings (P < 0.001), clinical T2 stage (P = 0.011), the presence of lymphovascular invasion (P < 0.001), and estrogen receptor positivity (P < 0.001) were significantly associated with a high nodal burden. Patients with negative axillary US findings seldom had a high nodal burden, with a negative predictive value of 93.0% (294/316). Patients with suspicious axillary US findings, clinical T2 stage, lymphovascular invasion, and estrogen receptor positivity are more likely to have a high nodal burden, which may provide additional information for the treatment plan of breast cancer patients. Preoperative axillary US helps identify a limited nodal burden in breast cancer patients and has implications for axillary lymph node dissection and adjuvant treatment.

Corona Virus International Public Health Emergencies: Implications for Radiology Management.

The outbreak of 2019 novel coronavirus (2019-nCoV) pneumonia was reported in Wuhan, Hubei Province, China in December 2019 and has spread internationally. This article discusses how radiology departments can most effectively respond to this public health emergency.

Comparison of extracranial artery stenosis and cerebral blood flow, assessed by quantitative magnetic resonance, using digital subtraction angiography as the reference standard.

Extracranial arteriosclerosis usually indicates a high risk of ischemic stroke. In the past, a clinical decision following diagnosis was dependent on the percentage of vessel stenosis determined by an invasive technique. We aimed to develop a quantitative magnetic resonance (QMR) technique to evaluate artery structure and cerebral hemodynamics noninvasively.QMR and digital subtraction angiography (DSA) were performed in 67 patients with suspected cerebral vascular disease at our hospital. Accuracy, sensitivity, positive predictive values (PPVs), negative predictive values (NPVs), and Pearson correlation coefficient of QMR were calculated and compared for the detection and measurement of vascular stenoses using DSA as a gold standard. For patients with unilateral artery stenosis, quantitative cerebral blood flow (CBF) was measured by QMR in ipsilateral and contralateral hemispheres.Among 67 subjects (male 54, female 12), 201 stenoses were detected by QMR and DSA. QMR measuring the degree of stenosis and lesion length was in good correlation with the results obtained by DSA (r = 0.845, 0.721, respectively). As for artery stenosis, PPV and NPV of QMR were 89.55% and 95.71%, respectively. As for severe stenosis, sensitivity and specificity of QMR were 82.3% and 86.0% with DSA as a reference. For subjects with unilateral carotid stenosis, CBF in basal ganglia decreased significantly (P < 0.001) compared with the contralateral one in symptomatic and asymptomatic groups. For subjects with moderate stenosis (50-79%), CBF of temporal and basal ganglia was decreased compared with the contralateral ganglia. However, CBF in subjects with severe stenosis or occlusion in the basal ganglia was mildly elevated compared with the contralateral ganglia (P < 0.001).In our study, a good correlation was found between QMR and DSA when measuring artery stenosis and CBF. QMR may become an important method for measuring artery stenosis and cerebral hemodynamics in the future.