Magnetic resonance imaging thicknesses and apparent diffusion coefficient values of the endometrium and junction zone in women of reproductive age.

BACKGROUND: The endometrium and uterine junction zone often change throughout the menstrual cycle. Some pathological conditions may appear normal in uterine imaging, which will lead to missed diagnosis and misdiagnosis. PURPOSE: To evaluate the changes in the thickness and apparent diffusion coefficient (ADC) values of the endometrium and uterine junction zone throughout the menstrual cycle in magnetic resonance imaging (MRI) of women of reproductive age. MATERIAL AND METHODS: Data were collected from 40 healthy women of reproductive age with regular menstrual cycles from January 2017 to April 2018. They underwent four total MRI sessions during the menstrual, proliferation, and early and late secretive phases. The main MRI sequences were T2-weighted (T2W) volume isotropic turbo spin echo acquisition (VISTA) spectral attenuated inversion recovery (SPAIR) and diffusion-weighted imaging (b = 0, 600, 800, 1000 s/mm2), which were used to measure the thicknesses and ADC values of endometrium and uterine junction zone. RESULTS: First, the endometrium was thinnest during the menstrual phase and thickest in the late secretive phase. Second, the uterine junction zone was thinnest in the late secretive phase and thickest in the menstrual phase. Third, the ADC values of the endometrium were lowest in the menstrual phase and peaked in the early secretive phase. Finally, the ADC values of the uterine junction zone were lowest in the menstrual phase and peaked in the late secretive phase. CONCLUSION: The endometrium and uterine junction zone showed cyclic changes. Radiologists should consider these changes in the thickness and ADC values when analyzing MRI images of the uterus.

Amide proton transfer weighted imaging evaluation on isocitrate dehydrogenase mutation status in patients with high-grade gliomas / 中国医学影像技术

Objective: To observe the value of amide proton transfer weighted (APTw) imaging in predicting isocitrate dehydrogenase (IDH) wild type and IDH mutant of high-grade gliomas. Methods: Twenty-five patients with pathologically confirmed high-grade gliomas were enrolled. All patients underwent preoperative MR scanning, including routine sequences, T1WI enhancement and APTw scanning. According to the pathology, the patients were divided into IDH wild type group and IDH mutant group. ROIs were placed on FLAIR images of all tumor layers to select the solid components of the tumor, and APT values of each layer were obtained to get the mean value. Differences of APT values were analyzed between groups using independent sample t test, and ROC curve analysis was performed to evaluate the diagnostic efficacy of APT values in assessing the gene status of IDH. Results: Among 25 patients of high-grade gliomas, 9 cases were IDH mutant and 16 cases were IDH wild type. APT value of IDH wild type group ([3.21±0.82]%) was significantly higher than that of IDH mutant group ([2.23±0.72]%; t=2.89, P<0.05), and the AUC was 0.84 (P<0.05). The sensitivity and specificity of IDH wild type diagnosis was 93.8% and 66.7%, respectively. Conclusion: APTw imaging can be used to predict gene status of IDH in high-grade gliomas.

The advantage by MRI of brain lesions after fetoscopic selective laser coagulation for twin-twin transfusion syndrome / 实用放射学杂志

Objective To demonstrate that MRI is more advantageous than ultrasound in the detection of ischemic cerebral lesions precisely in twin-twin transfusion syndrome(TTTS)fetus following fetoscopic selective laser coagulation(SLCPV).Methods The fetus with TTTS treated by SLCPV were collected.All fetuses underwent brain MRI within 1-5 days after the procedure and a follow-up MRI at 29-32 weeks'gestation.All fetuses also had frequent ultrasound evaluation until delivery.Results Twenty-five pregnancies with TTTS were included in the study.Six pregnancies resulted in survival of only one twin after the procedure(Group A),while the other 19 pregnancies resulted in the survival of both twins(Group B),as assessed at the time of initial MRI.Two fetus in Group A and three in Group B had evidence of bleeding in lateral ventricle.Two fetus in Group B had actue brain ischemia.One fetus in Group B had appeared brain atrophy and choosed to terminate pregnancy.Conclusion MRI can make a clearer diagnosis of cerebral damage of TTTS fetus in a short period after SLCPV.

The diagnostic value of CT in adnexal abscess / 实用放射学杂志

Objective To evaluate the value of CT in diagnosis of adnexal abscess retrospectively.Methods The characteristic CT findings in 26 patients with adnexal abscess proved by histopathology were reviewed retrospectively.Results Of 26 patients,the adnexal abscess was presented in unilateral lesions(n=6) and bilateral lesions(n=20).There were total 46 lesions,which were pyosalpingitis (n=33) and tubo-ovarian abscess (n=13),respectively.CT findings of pyosalpingitis included dilated, thick-walled, enhancing fallopian tubes containing complex fluid.CT findings in tubo-ovarian abscess were thick-walled and multiloculated cystic masses,which had thick mural enhancement with multilayered appearance (n=10).Reactive inflammation of adjacent structures(n=21) manifested as haziness and stranding of the pelvic fat,thickening of the uterosacral ligaments, and pelvic peritonitis.Small or large bowel ileus (n=5) and hydroureter (n=3) resulted from adjacent inflammation of tubo-ovarian abscess.Endometritis was seen in 19 patients and ascites in 18 patients.Conclusion Familiarity with the CT appearances is important for timely diagnosis and treatment of adnexal abscess and its complications.

Reflection on the Protection of Patients' Privacy in Imaging Medical Examination / 中国医学伦理学

With the continuous application of high-technology in the clinical practice,the privacy of patient is infringed or leaked during the process of imaging medical examination and teaching or because of improper management of hospital.The main reasons include that relative laws and regulations are inadequate,patients don't understand the scope of privacy rights and medical technicians lack knowledge of medical ethics.From the angle of medical ethics,this paper further discussed the protection of patients' privacy in imaging medical examination,so as to effectively reduce medical disputes in practical work and build a good doctor-patient relationship.

Diagnosis of Prenatal MRI in Placenta Implantation Abnormality / 中国医学影像学杂志

Purpose To discuss the value of MRI in the diagnosis of placenta implantation abnormality, and to explore preliminarily the relationship between MRI signs and types of placenta implantation abnormality. Materials and Methods The clinical preoperative data and postnatal pathological findings of 54 women at high risk of placenta accreta were collected. All the patients undertook the conventional pelvic MRI examination. The scanning sequences mainly included: sagittal, coronal and axial T2-weighted imaging-turbo spin echo, balance fast field echo. The MRI images were observed and the areas which showed low signal in all the three directions on T2WI were measured. Then the correlation between the areas of low signal on T2WI in placental and the types of placenta implantation abnormality was analyzed. Results The incidence of placenta implantation abnormality was 64.8% in our research (35/54). The main MRI signs were low signal on T2WI (68.5%, 37/54) and heterogeneous signal in placenta (57.4%, 31/54); the main sign of placenta percreta was tenting bladder (75.0%, 6/8). The types of placenta implantation abnormality were positively correlated with the areas of low signal on T2WI (r=0.454, P<0.05). Conclusion Pregnant women at risk of placenta accreta should be evaluated with imaging examinations, particularly with MRI scanning, to improve disease detection rate. The typical indirect signs of placenta implantation abnormality are low signal on T2WI and heterogeneous signal in placenta. The larger size of low signal area on T2WI in placenta, the deeper implantation of placenta.