Evaluation of renal function in chronic kidney disease using histogram analysis based on multiple diffusion models.

OBJECTIVES: To compare the diagnostic value of histogram features of multiple diffusion metrics in predicting early renal impairment in chronic kidney disease (CKD). METHODS: A total of 77 patients with CKD (mild group, estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2) and 30 healthy controls (HCs) were enrolled. Diffusion-weighted imaging was performed by using single-shot echo planar sequence with 13 b values (0, 20, 50, 80, 100, 150, 200, 500, 800, 1000, 1500, 2000, and 2500 s/mm2). Diffusion models including mono-exponential (Mono), intravoxel incoherent motion (IVIM), stretched-exponential (SEM), and kurtosis (DKI) were calculated, and their histogram features were analysed. All diffusion models for predicting early renal impairment in CKD were established using logistic regression analysis, and diagnostic efficiency was compared among the models. RESULTS: All diffusion models had high differential diagnosis efficiency between the mild group and HCs. The areas under the curve (AUCs) of Mono, IVIM, SEM, DKI, and the combined diffusion model for predicting early renal impairment in CKD were 0.829, 0.809, 0.760, 0.825, and 0.861, respectively. There were no significant differences in AUCs except SEM and combined model, SEM, and DKI model. There were significant correlations between eGFR/serum creatinine and some of histogram features. CONCLUSIONS: Histogram analysis based on multiple diffusion metrics was practicable for the non-invasive assessment of early renal impairment in CKD. ADVANCES IN KNOWLEDGE: Advanced diffusion models provided microstructural information. Histogram analysis further reflected histological characteristics and heterogeneity. Histogram analysis based on multiple diffusion models could provide an accurate and non-invasive method to evaluate the early renal damage of CKD.

Is surgery a risk factor for contralateral recurrence pneumothorax in adolescent with primary spontaneous pneumothorax?

OBJECTIVES: Controversy exists regarding the justification of primary surgery in primary spontaneous pneumothorax, and surgery is not free from recurrence. We hypothesized that surgery is a risk factor for contralateral recurrence pneumothorax in adolescent. METHODS: We performed a retrospective cohort study of 163 adolescent with pneumothorax who were treated conservatively with chest tube (n = 100) or chest tube followed by video-assisted thoracoscopic surgery (n = 63) from January 2009 through December 2017. RESULTS: Ipsilateral recurrence was significantly more common following conservative treatment than surgical treatment (25.0 vs. 3.2%, P < 0.001), while contralateral recurrence was more common in the surgical group than in the conservative group (15.9 vs. 6.0%, P = 0.039). The rates of second episode pneumothorax did not significantly differ between the two treatment groups (P = 0.092). Univariate analysis identified that patients who were treated conservatively had greater risk of ipsilateral recurrence (P = 0.002), while those who proceeded to surgery had greater risk of contralateral recurrence (P = 0.046). No predictors for second episode pneumothorax were found. CONCLUSION: To avoid over treatment, we recommend that conservative treatment should be the superior option and CT scan should not be a routine examination in adolescent with their first episode of PSP.

Diagnostic value of using multiplanar reformation images: Case report for rare endotracheal hamartomas.

RATIONALE: Pulmonary hamartomas are the most common benign tumor of the lung. Two types of pathologically similar hamartomas exist based on their location. These tumors have a low incidence, are rarely reported and frequently misdiagnosed because of lack of familiarity and/or understanding concerning their imaging features. PATIENT CONCERNS: Seventeen patients received treatment between June 2007 and May 2013 and had complete medical records. All of them had different degrees of cough and expectoration. Other symptoms include fever (5 cases), hemoptysis (4 cases), chest pain (3 cases), shortness of breath (2 cases), and dyspnea (1 case). DIAGNOSES: These patients all have pathologically confirmed, and informed the diagnosis of endobronchial hamartoma. INTERVENTIONS: Unenhanced and enhanced CT scans were performed using Toshiba Aquilion 64-slice and GE Lightspeed 64-slice CT scanners. The scan was performed from the superior thoracic aperture to the lateral costophrenic angle. The transaxial CT data was inserted into a Volume Wizard workstation to reconstruct images using MPR technique. OUTCOMES: The relationship between the location of the tumor and bronchi was clearly displayed on the axial images in only 2 patients. In all 17 patients, reconstructed MPR images were able to display the tumor parallel to the long axis of bronchi, thus facilitating in tumor identification and positioning along the bronchial tree. LESSONS: MPR images are valuable tools in the diagnosis of endobronchial hamartomas. Chiefly, these reconstructions aid in the detection of intratumoral fat/calcification and clearly demonstrate the tumors relationship and effect with the adjacent bronchi.

The correlation of contrast-enhanced ultrasound and MRI perfusion quantitative analysis in rabbit VX2 liver cancer.

Our objective is to explore the value of liver cancer contrast-enhanced ultrasound (CEUS) and MRI perfusion quantitative analysis in liver cancer and the correlation between these two analysis methods. Rabbit VX2 liver cancer model was established in this study. CEUS was applied. Sono Vue was applied in rabbits by ear vein to dynamically observe and record the blood perfusion and changes in the process of VX2 liver cancer and surrounding tissue. MRI perfusion quantitative analysis was used to analyze the mean enhancement time and change law of maximal slope increasing, which were further compared with the pathological examination results. Quantitative indicators of liver cancer CEUS and MRI perfusion quantitative analysis were compared, and the correlation between them was analyzed by correlation analysis. Rabbit VX2 liver cancer model was successfully established. CEUS showed that time-intensity curve of rabbit VX2 liver cancer showed "fast in, fast out" model while MRI perfusion quantitative analysis showed that quantitative parameter MTE of tumor tissue increased and MSI decreased: the difference was statistically significant (P < 0.01). The diagnostic results of CEUS and MRI perfusion quantitative analysis were not significantly different (P > 0.05). However, the quantitative parameter of them were significantly positively correlated (P < 0.05). CEUS and MRI perfusion quantitative analysis can both dynamically monitor the liver cancer lesion and surrounding liver parenchyma, and the quantitative parameters of them are correlated. The combined application of both is of importance in early diagnosis of liver cancer.