Meta-analysis of the diagnostic value of 3.0t mr dynamic enhancement in prostate cancer among fitness andathletic patients

Objective: To systematically evaluate the diagnostic value of 3.0T MR Dynamic enhancement in prostate cancer among fitness and athletic patients, aiming to offer insights for the selection of early diagnostic techniques in this specific population. Methods: This study conducted a comprehensive search in Cochrane Library, Web of Science, PubMed, Proquest, and Chinese biomedical literature databases including Wanfang, Wipu, and CNKI, focusing on literature published until September 2022. The search was tailored to assess the value of 3.0T MR dynamic enhancement in diagnosing prostate cancer in fitness and athletic individuals. A meta-analysis was performed on the selected studies to calculate combined sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio. Sensitivity-specific forest plots, SROC curves, and funnel plots were employed to evaluate publication bias. Results: The metaanalysis included seven studies, comprising a total of 516 subjects who were actively involved in fitness or athletic activities. Among these, 216 were true positive cases, 204 true negative, 43 false positive, and 53 false negative. The analysis revealed that the combined sensitivity of 3.0T MR Dynamic enhancement for prostate cancer diagnosis in this population was 0.82 (95% CI: 0.73, 0.90), and the combined specificity was 0.83 (95% CI: 0.77, 0.88). The combined positive likelihood ratio was 4.91 (95% CI: 3.25, 7.16), and the negative likelihood ratio was 0.21 (95% CI: 0.12, 0.26). The diagnostic odds ratio was 35.28 (95% CI: 16.57, 40.32), with an AUC of 0.86 (95% CI: 0.81, 0.92). No significant heterogeneity due to non-threshold effects (p>0.01) was observed, and a fixed effect model was applied. No publication bias was detected (P>0.05) (AU)

Application of Dynamic Enhanced Magnetic Resonance Imaging Texture Analysis Combined with ADCs in Predicting Pelvic Lymph Metastasis of Prostate Cancer.

OBJECTIVE: The application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) texture analysis combined with apparent diffusion coefficient (ADC) in predicting pelvic lymph node metastasis of prostate cancer was explored. METHODS: The clinical and imaging data of 151 patients with prostate cancer admitted to The Affiliated Tumor Hospital of Guizhou Medical University from November 2019 to November 2021 were retrospectively analysed. According to the final pathological diagnosis results, they were divided into two groups: Metastasis group (n = 63, pelvic lymph node metastasis) and non-metastasis group (n = 88, no pelvic lymph node metastasis). The DCE-MRI texture parameters and ADCs of the two groups were compared using Omni-Kinetics software and MADC software packages. The receiver operating characteristic (ROC) curve was used in evaluating the predictive value of each method and their combination, and Spearman rank correlation analysis was used in evaluating their correlation. RESULTS: The volume transfer (Ktrans) and interstitium-to-plasmarate rate constant (Kep) in the metastatic group were significantly higher than those in the non-metastatic group (p < 0.001). However, no significant difference in extravascular extracellular space volume fraction (Ve) was found between the groups (p > 0.05). The ADC of the metastatic group was lower (p < 0.001). The Ktrans and Kep values were positively correlated with pelvic lymph node metastasis of prostate cancer (r = 0.580, 0.684; p < 0.001), and the ADC was negatively correlated with pelvic lymph node metastasis of prostate cancer (r = -0.478; p < 0.001). The ROC curve showed that the area under the curve (AUC) of DCE-MRI texture analysis parameters Ktrans and Kep combined with ADC was large, and the prediction efficiency increased. The AUC, sensitivity and specificity were 0.974, 95.20% and 93.20% (p < 0.001), respectively. CONCLUSIONS: DCE-MRI texture analysis combined with ADC value can accurately predict pelvic lymphatic metastasis of prostate cancer, which is helpful for the selection and formulation of clinical treatment plans and has certain guiding value for the implementation of pelvic lymph node clearing in patients.

Application of Dynamic Enhanced Magnetic Resonance Imaging Texture Analysis Combined with ADCs in Predicting Pelvic Lymph Metastasis of Prostate Cancer

Objective: The application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) texture analysis combined with apparent diffusion coefficient (ADC) in predicting pelvic lymph node metastasis of prostate cancer was explored. Methods: The clinical and imaging data of 151 patients with prostate cancer admitted to The Affiliated Tumor Hospital of Guizhou Medical University from November 2019 to November 2021 were retrospectively analysed. According to the final pathological diagnosis results, they were divided into two groups: Metastasis group (n = 63, pelvic lymph node metastasis) and non-metastasis group (n = 88, no pelvic lymph node metastasis). The DCE-MRI texture parameters and ADCs of the two groups were compared using Omni-Kinetics software and MADC software packages. The receiver operating characteristic (ROC) curve was used in evaluating the predictive value of each method and their combination, and Spearman rank correlation analysis was used in evaluating their correlation. Results: The volume transfer (Ktrans) and interstitium-to-plasmarate rate constant (Kep) in the metastatic group were significantly higher than those in the non-metastatic group (p < 0.001). However, no significant difference in extravascular extracellular space volume fraction (Ve) was found between the groups (p > 0.05). The ADC of the metastatic group was lower (p < 0.001). The Ktrans and Kep values were positively correlated with pelvic lymph node metastasis of prostate cancer (r = 0.580, 0.684; p < 0.001), and the ADC was negatively correlated with pelvic lymph node metastasis of prostate cancer (r = −0.478; p < 0.001) (AU)

The value of dynamic contrast-enhanced magnetic resonance imaging combined with apparent diffusion coefficient in the differentiation of benign and malignant diseases of the breast.

BACKGROUND: The value of combined dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and apparent diffusion coefficient (ADC) histogram analysis for the diagnosis of breast cancer has not been evaluated in previous studies. PURPOSE: To investigate the diagnostic value of DCE-MRI combined with ADC in benign and malignant breast lesions. MATERIAL AND METHODS: The clinicopathological imaging data included 168 patients (177 lesions) with breast lesions who underwent convention breast MRI, DCE-MRI, and diffusion-weighted imaging (DWI); they were divided into the benign lesion group (n = 39) and malignant lesion group (n = 129) based on pathology. RESULTS: Using the type III outflow curve as a diagnostic criterion for malignant breast lesions, the diagnostic sensitivity was 76.9%, the specificity was 80%, the correct rate was 72.2%, and its area under the curve (AUC) was 0.823. Using an enhancement ratio > 100% as a diagnostic criterion for malignant breast lesions, the sensitivity was 61.5%, specificity was 80%, and AUC was 0.723. Using > 3 ipsilateral vessels as a diagnostic criterion for malignant lesions in the breast resulted in a diagnostic sensitivity of 81.6%, a specificity of 80.8%, and an AUC of 0.805. CONCLUSION: The type of time intensity curve DCE-MRI, the early enhancement rate in the first phase, the number of ipsilateral vessels, and the ADC full volume histogram of the blood supply score and DWI are valuable in the diagnosis of benign and malignant breast lesions.

Value of MRI in diagnosis of benign and malignant breast lesions with cluster ring enhancement / 国际肿瘤学杂志

Objective:To investigate the diagnostic value of MRI in benign and malignant breast lesions with cluster ring enhancement.Methods:The imaging signs of 68 patients with clustered ring enhancement who underwent MRI examination due to clinical palpation, ultrasound or X-ray examination for suspected malignant lesions in Tangdu Hospital of Air Force Military Medical University from October 2017 to July 2019 were retrospectively analyzed. The differences between benign and malignant lesions in the distribution pattern, T2 lipid suppression signal intensity, time-signal intensity curve (TIC), ductal dilatation, peripheral gland edema, pectoralis major edema were compared using χ2 test or Mann-Whitney U test, and the risk factors of MRI imaging signs of malignant breast lesions were analyzed using binomial logistic regression model. Results:There were 68 cluster ring enhancement lesions in 68 patients, all of which were single lesions, among which 18 cases (26.5%) were benign, and the common lesions were plasma cell mastitis (9 cases). Fifty cases (73.5%) were malignant, and the most common type was invasive breast cancer (40 cases). Imaging features of plasma cell mastitis showed cluster ring enhancement, regional distribution, slightly high signal on fat suppression T2 image, type Ⅲ TIC, with ductal dilatation, edema of peripheral glands and pectoralis major. Imaging features of invasive breast cancer showed cluster ring enhancement, regional distribution, iso-signal on fat suppression T2 image, type Ⅲ TIC, no ductal dilatation, and edema of peripheral gland and pectoralis major. There were statistically significant differences in the intensity of fat-suppression T2 signal ( Z=3.003, P=0.003) and duct dilatation ( χ2=7.174, P=0.007) between benign and malignant lesions. There were no significant differences in distribution ( χ2=5.510, P=0.313), TIC type ( χ2=3.538, P=0.133), peripheral gland edema ( χ2=0.164, P=0.686) and pectoralis major edema ( χ2<0.001, P>0.999). The analysis of binomial logistic regression model showed that fat-suppression T2 iso-signal ( OR=0.182, 95% CI: 0.036-0.914, P=0.039) and no ductal dilatation ( OR=0.198, 95% CI: 0.047-0.846, P=0.029) were the risk factors for breast malignant lesions. Conclusion:Breast cancer MRI findings of cluster ring enhancement, fat-suppression T2 iso-signal and no ductal dilatation are related risk factors for malignant breast lesions. MRI is helpful for early detection and diagnosis of breast lesions.

Multiphase convolutional dense network for the classification of focal liver lesions on dynamic contrast-enhanced computed tomography.

BACKGROUND: The accurate classification of focal liver lesions (FLLs) is essential to properly guide treatment options and predict prognosis. Dynamic contrast-enhanced computed tomography (DCE-CT) is still the cornerstone in the exact classification of FLLs due to its noninvasive nature, high scanning speed, and high-density resolution. Since their recent development, convolutional neural network-based deep learning techniques has been recognized to have high potential for image recognition tasks. AIM: To develop and evaluate an automated multiphase convolutional dense network (MP-CDN) to classify FLLs on multiphase CT. METHODS: A total of 517 FLLs scanned on a 320-detector CT scanner using a four-phase DCE-CT imaging protocol (including precontrast phase, arterial phase, portal venous phase, and delayed phase) from 2012 to 2017 were retrospectively enrolled. FLLs were classified into four categories: Category A, hepatocellular carcinoma (HCC); category B, liver metastases; category C, benign non-inflammatory FLLs including hemangiomas, focal nodular hyperplasias and adenomas; and category D, hepatic abscesses. Each category was split into a training set and test set in an approximate 8:2 ratio. An MP-CDN classifier with a sequential input of the four-phase CT images was developed to automatically classify FLLs. The classification performance of the model was evaluated on the test set; the accuracy and specificity were calculated from the confusion matrix, and the area under the receiver operating characteristic curve (AUC) was calculated from the SoftMax probability outputted from the last layer of the MP-CDN. RESULTS: A total of 410 FLLs were used for training and 107 FLLs were used for testing. The mean classification accuracy of the test set was 81.3% (87/107). The accuracy/specificity of distinguishing each category from the others were 0.916/0.964, 0.925/0.905, 0.860/0.918, and 0.925/0.963 for HCC, metastases, benign non-inflammatory FLLs, and abscesses on the test set, respectively. The AUC (95% confidence interval) for differentiating each category from the others was 0.92 (0.837-0.992), 0.99 (0.967-1.00), 0.88 (0.795-0.955) and 0.96 (0.914-0.996) for HCC, metastases, benign non-inflammatory FLLs, and abscesses on the test set, respectively. CONCLUSION: MP-CDN accurately classified FLLs detected on four-phase CT as HCC, metastases, benign non-inflammatory FLLs and hepatic abscesses and may assist radiologists in identifying the different types of FLLs.

Diagnosis and Monitoring Value of Diffusion-Weighted Magnetic Resonance Imaging Using Neuroendocrine Analysis During Radiotherapy for Laryngeal Cancer.

We used 1.5T magnetic resonance imaging (MRI) to investigate the role of semiquantitative parameters related to dynamic contrast-enhanced (DCE)-MRI and the apparent diffusion coefficient (ADC) of diffusion-weighted imaging (DWI) in predicting and monitoring the efficacy of concurrent radiotherapy and chemotherapy for laryngeal cancer. The data from 58 patients with newly diagnosed laryngeal cancer who had been treated at our hospital from August 2016 to March 2018 were collected. The 58 patients included 56 men and 2 women, with a median age of 57 years. The pathologic examination of the biopsy specimens revealed squamous cell carcinoma. The time signal curve (TIC) of the tumor and related semiquantitative parameters was measured before, during (radiation dose, 50 Gy), and at the end of treatment (monitoring value after treatment). The results revealed that the TIC types and DCE-MRI-related semiquantitative parameters can predict the efficacy of concurrent chemoradiotherapy for laryngeal and hypopharyngeal cancer. Of the semiquantitative parameters, the signal enhancement ratio at 56 seconds had the greatest predictive value. Patients with TIC type I before treatment had a better prognosis than those with TIC type III. The pre-ADC value was not enough to predict the efficacy. The ADC value, DCE-MRI-related semiquantitative parameters, and their change before treatment had a certain effect in monitoring the changes in water molecule diffusion movement and hemodynamic changes after tumor treatment. However, these were not enough to predict the efficacy.

Application value of dynamic contrast-enhanced magnetic resonance imaging and conventional magnetic resonance imaging in evaluation of hepatocellular carcinoma before and after TACE treatment / 中国基层医药

Objective@#To compare the application of dynamic contrast-enhanced magnetic resonance imaging (MRI) and conventional MRI in the detection of hepatocellular carcinoma (HCC) lesions before and after transcatheter arterial chemoembolization (TACE) treatment and evaluation of the effect of TACE treatment, thus to judge its application value, and to provide guidance for early clinical diagnosis.@*Methods@#Seventy-six patients with HCC who underwent TACE in Pingyang Hospital Affiliated to Wenzhou Medical University from January 2018 to December 2018 were selected in the research.According to the random number table method, 76 patients were randomly divided into control group and study group, with 38 cases in each group.The control group was examined by conventional MRI, while the study group was examined by dynamic enhancement of MRI.The lesions were observed before and after treatment, and Ktrans, Kep and ve of the two groups were recorded before and after treatment.The accuracy, sensitivity and specificity of the two groups were compared.@*Results@#Before and after treatment, the total detection rates of the study group (92.05%, 100.00%) were significantly higher than those of the control group (80.85%, 71.43%) (χ2=16.489, 15.246, all P<0.05). Before treatment, the Ktrans, Kep, ve equivalents between the two groups had no statistically significant differences (t=0.915, 0.448, 0.354, all P>0.05). After treatment, the Ktrans and Kep values of the two groups were significantly decreased, and the Ktrans[(0.419±0.101)min] and Kep[(1.073±0.237)min] values of the study group were significantly lower than those of the control group [(0.647±0.128)min, (1.158±0.221)min], the differences were statistically significant (t=9.485, 5.642, all P>0.05). There was no statistically significant difference in ve value between the two groups (t=1.025, P>0.05). The accuracy and sensitivity of detection in the study group (92.11%, 97.37%) were significantly higher than those in the control group (81.58%, 84.21%), and the specificity (94.74%) of the study group was significantly lower than that of the control group (97.37%) (χ2=17.186, 14.453, 6.489, all P<0.05).@*Conclusion@#Dynamic contrast-enhanced MRI is more effective in the detection of HCC patients before and after TACE treatment.It is convenient to provide guidance for treatment and has higher clinical application value.It is worthy of popularizing.

Differential diagnostic value of 64-slice spiral computed tomography in solitary pulmonary nodule.

The present study aimed to evaluate the diagnostic value of 64-slice spiral multivariate computed tomography (CT) combined with dynamic contrast-enhanced scanning for benign and malignant solitary pulmonary nodules (SPNs). A total of 93 patients with SPN as diagnosed by CT were included. All these patients were subjected to routine and dynamic enhancement CT scanning. After reconstruction, the morphological characteristics following dynamic enhancement were analyzed, and compared for the benign and malignant SPN cases. The incidences of lobulation, spicular sign, pleural indentation and vacuole sign in the malignant SPN group were significantly higher compared with the benign SPN group. During the dynamic enhancement scanning, the CT values at all the time points for the inflammatory and malignant SPN groups were significantly higher than the benign SPN group. No significant differences were observed in the dynamic enhancement CT values at 30, 60, 90 and 120 sec between the inflammatory, and malignant SPN groups. However, in the inflammatory SPN group, the dynamic enhancement CT values at 300 and 540 sec were significantly lower than the malignant SPN group. Notably, the diagnostic accordance rate for the morphological signs combined with dynamic enhancement diagnosis was significantly higher than the morphological signs alone. The 64-slice spiral CT morphological signs combined with dynamic enhancement detection can be more effective for the differential diagnosis of benign and malignant SPN, which may provide potent evidence for the early clinical treatment.

Radiomic analysis of DCE-MRI for prediction of response to neoadjuvant chemotherapy in breast cancer patients.

OBJECTIVES: To enhance the accurate prediction of the response to neoadjuvant chemotherapy (NAC) in breast cancer patients by using a quantitative analysis of dynamic enhancement magnetic resonance imaging (DCE-MRI). MATERIALS AND METHODS: A dataset of 57 cancer patients with breast DCE-MR images acquired before NAC was used. Among them, 47 patients were Responders, and 10 patients were non-Responders based on the RECIST criteria. The breast regions were segmented on the MR images, and a total of 158 radiomic features were computed to represent the morphologic, dynamic, and the texture of the tumors as well as the background parenchymal features. The optimal subset of features was selected using evolutionary based Wrapper Subset Evaluator. The classifier was trained and tested using a leave-one-out cross-validation (LOOCV) method to classify Responder and non-Responder cases. The area under a receiver operating characteristic curve (AUC) was computed to assess the classifier performance. An additional independent dataset with 46 patients was also included to validate the results. RESULTS: The evolutionary algorithm (EA)-based method identified optimal subsets comprising 12 image features that were fit for classification for the main cohort. Following the same feature selection procedure, the independent validation dataset produced 11 image features, 7 of which were identical to those from the main cohort. The classifier based on the features yield a LOOCV AUC of 0.910 and 0.874 for the main and the reproducibility study cohort, respectively. If the optimal features in the main cohort were utilized to test performance on the reproducibility cohort, the classifier generated an AUC of 0.713. While the features developed in the reproducibility cohort were applied to test the main cohort, the classifier achieved an AUC of 0.683. The AUC of the averaged receiver operating characteristic (ROC) curve for the two data cohort was 0.703. CONCLUSIONS: This study demonstrated that quantitative analyses of radiomic features from pretreatment breast DCE-MRI data could be used as valuable image markers that are associated with tumor response to NAC.

Time dependence of the enhancement effect of chemical enhancers: Molecular mechanisms of enhancing kinetics.

Chemical enhancers are widely used for facilitating drug penetration in transdermal drug delivery system (TDDS). However, there is a lack of knowledge about how the enhancement effect changes over time. In this study, on the basis of kinetic parameters of enhancement effect, molecular details of the dynamic enhancement process was described and a new hypothesis of the recovery mechanism of the skin barrier function was proposed. Using pretreated skin and flurbiprofen patch, the effects of Azone (AZ) and menthyl decanoate (MT-10) were evaluated with in vitro permeation experiment and further confirmed by confocal laser scanning microscopy (CLSM) and TEWL. The results showed that the enhancement ratio (ER) increased firstly, then reached a plateau and finally decreased. The enhancement effect of MT-10 was slower (Tonset, MT-10>Tonset, AZ), weaker (ERmax, MT-10

Clinical application value of MRI combined with DWI sequence in the diagnosis and follow-up of patients with meningioma / 重庆医学

Objective To explore the performance of meningiomas in MRI dynamic enhancement and DWI sequence,and to improve the accuracy of differential diagnosis of benign and malignant meningiomas.Methods Meningioma MRI data,which were pathology proved by the Guilin medical college affiliated hospital at different levels(Ⅰ,Ⅱ and Ⅲ),were retrospectively analyzed.The enhancement of meningiomas at all levels and the extent of edema were summarized,at the meantime the dynamic enhancement perfusion parameters and ADC values of meningioma MRI meningioma were contrastively analyzed.Results There were 30 cases of meningioma located in the brain falcus,27 cases of meningioma located in the sagittal sinus,10 cases of meningioma located in the cerebellopontine angle and 6 cases of meningioma located in other parts.The difference of ADC value between grade Ⅰ meningiomas and grade Ⅲ meningiomas was statistically significant different[(1.253±0.123)×10-3 mm2/s vs.(0.891±0.103)×10-3 mm2/s,P<0.05].The relative blood flow(rCBF)and relative blood volume(rCBV)of grade Ⅰ meningiomas were significantly lower than those of grade Ⅲ meningiomas(P<0.05).Conclusion MRI dynamic enhancement combined with DWI can accurately identify grade Ⅰ meningiomas and grade Ⅲ meningiomas,and it is necessary that the assessment of its classification should be appropriately considered to the higher level for patients who do not have a characteristic manifestation of meningioma in the preoperative.

ROI for outlining an entire tumor is a reliable approach for quantification of lung cancer tumor vascular parameters using CT perfusion.

OBJECTIVE: To investigate the effect of position and size of tumor region of interest (ROI) on the estimation of lung cancer vascular parameters using 256-slice computed tomography (CT) perfusion. METHODS: After institutional review board approval and written informed consent, 16 men and 11 women with lung cancer were enrolled in this CT perfusion study. Perfusion, blood volume, and peak enhancement were determined for 60 or 120 mm(2) circular ROIs placed at the edge, center, and around (outlining) the visible tumor. Average values were obtained by performing ROI analysis twice by the same observers without any procedural changes. RESULTS: Perfusion, blood volume, and peak enhancement measurements were substantially higher at the edge than at the center for both 60 and 120 mm(2) ROIs (all P<0.05). Measurements varied substantially depending on the ROI size. Perfusion, blood volume, and peak enhancement for the ROIs outlining tumor were intermediate between those at the tumor edge and center. There were significant correlations between median values and interquartile ranges as follows; perfusion (12.51 [7.91-28.10] mL⋅min(-1)⋅100 mL(-1)), blood volume (29.31 [21.82-37.65] mL⋅100 g(-1)), peak enhancement (12.93 [2.42-22.50]) for the ROIs outlining the tumor, and microvascular density ([19.43±8.78] vessels/0.74 mm(2)), respectively (r values were 0.732, 0.590, and 0.544 respectively, all P<0.05). CONCLUSION: Spatial and size selection of ROI significantly affects CT perfusion analysis. ROI outlining of entire tumor provides efficient and reliable measurements for clinical assessment of lung cancer using CT perfusion.

Clinical value of magnetic resonance diffusion weighted imaging and dynamic enhanced imaging in endome-trial carcinoma staging / 中国基层医药

Objective To study the value of magnetic resonance diffusion weighted imaging (DWI)and dynamic enhanced imaging (DCE)in endometrial carcinoma staging.Methods 200 cases with endometrial carcinoma were selected,DWI and DCE were given before operation.The diagnostic value of two kinds of examination methods for the diagnosis of endometrial carcinoma in general and basic level was compared.Results The overall accuracy of muscle invasion of magnetic resonance DWI was 91.5%(183 /200),which was significantly higher than 77.5%(155 /200)of magnetic resonance DCE,the difference was statistically significant (χ2 =11.231,P <0.05 ).The accuracy,sensitivity and positive predictive value of the magnetic resonance DWI superficial and deep muscular layer were significantly higher than those of the magnetic resonance DCE (χ2 =9.283,8.231,9.021,8.927,8.142, 9.405,all P <0.05).Compared with pathological results,Kappa value of magnetic resonance DWI was 0.807,Kappa value of magnetic resonance DCE was 0.587.Conclusion Magnetic resonance DWI compared with magnetic reso-nance DCE,the accuracy and sensitivity of the infiltration of endometrial carcinoma was higher.

Dynamic enhancement pattern of HCC smaller than 3 cm in diameter on gadoxetic acid-enhanced MRI: comparison with multiphasic MDCT.

BACKGROUND & AIMS: The dynamic enhancement pattern of HCCs smaller than 3 cm in diameter on gadoxetic acid-enhanced magnetic resonance imaging (MRI) have not been extensively investigated. We aimed to evaluate the dynamic enhancement patterns of small HCCs (≤3 cm) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and compare enhancement patterns with multiphasic multidetector computed tomography (MDCT) based on tumour cellular differentiation and size. METHODS: We retrospectively included 55 patients with 67 surgically confirmed small HCCs (≤3 cm) who underwent multiphasic MDCT and gadoxetic acid-enhanced MRI. Dynamic enhancement patterns were analysed according to tumour cellular differentiation and size. Hepatobiliary phase images were also analysed to assess their additional value. RESULTS: The proportion of small HCCs demonstrating the typical enhancement pattern differed depending on tumour cellular differentiation on both MRI (P = 0.001) and MDCT (P = 0.001), but differed depending on tumour size only on CT (P = 0.008). Gadoxetic acid-enhanced MRI more sensitively depicted the typical enhancement pattern than CT for all tumours (P = 0.001), for moderately or poorly differentiated HCCs (P = 0.021) and for HCCs ≤2 cm (P = 0.001). 80% of tumours with atypical enhancement could be diagnosed as HCC based on tumour size and hepatobiliary phase images. CONCLUSIONS: On both gadoxetic acid-enhanced MRI and multiphasic CT, the dynamic enhancement patterns of small HCCs (≤3 cm) differed according to tumour cellular differentiation. Gadoxetic acid-enhanced MRI more frequently demonstrated the typical HCC enhancement pattern than CT in small HCCs.

An imaging protocol for dynamic contrast-enhanced breast MRI with 3.0T: using sagittal sequence interleaved between axial sequences.

BACKGROUND: B1 transmission-field inhomogeneity has been reported at 3.0 Tesla (T) breast imaging. Enhancement measurements of breast cancers at 3.0T may be insufficient for some patients and improvements in imaging protocols are needed. PURPOSE: To quantify B1 inhomogeneities in normal tissue and malignant masses at 3.0T breast MR imaging and to evaluate effect of an imaging protocol using an interleaved sagittal sequence in dynamic contrast-enhanced MRI (DCE-MRI). MATERIAL AND METHODS: A total of 76 patients were included who underwent DCE-MRI of the breast at 3.0T with an imaging protocol consisting of 1st, 2nd, and 4-6th bilateral axial sequences, and 3rd and 7th unilateral sagittal sequences. Signal intensity (SI) of normal breast tissue was measured at nipple level in four bilateral locations (anterior, posterior, medial, and lateral). Mean whole breast and location specific SI were calculated and compared between right and left breast using a paired t-test. All malignant masses were classified into three groups according to tumor size on MRI (≤2 cm, 2-4 cm, >4 cm). SI of malignant masses was measured independently on axial and sagittal sequences. The axial-sagittal SI gap in each mass was calculated and difference between right and left breast was compared using the t test. Size of each malignant mass was compared with pathologic findings to assess performance of the imaging protocol. RESULTS: SI of normal breast tissue were lower for the right breast (R-L difference, -91.9; P < 0.0001) and in all four locations (anterior, P < 0.01; posterior, P < 0.01; medial, P < 0.0001; lateral, P < 0.0001). SI of malignant masses were lower for the right breast among same size of the lesions (P < 0.0001), particularly < 4 cm (P < 0.0001). Decreased right to left difference in SI was produced with an interleaved sagittal sequence, as axial-sagittal gap of malignant masses was significant when tumor locates on the right side (P < 0.001). The concordance rate in predicting size of mass in this imaging protocol was 92.2%. CONCLUSION: The interleaved sagittal sequence is helpful to adjust reduced SI of malignant masses on right breast at 3.0T. This imaging protocol is clinically applicable by adding a single sequence during DCE-MRI of the breast.

Features of magnetic resonance imaging of pancreatic endocrine tumors / 中华消化外科杂志

Pancreatic endocrine tumors (PETs) are very rare and are divided into functional and nonfunctional tumors.Their clinical manifestations vary,and imaging diagnosis easily led to missing diagnosis and misdiagnosis for PETs.With the development of MRI technology,especially application of fat suppression techniques,diffusion weighted imaging (DWI) and dynamic enhanced magnetic resonance imaging (DEMRI) are of great value on imaging diagnosis and differential diagnosis for PETs.The clinical data of 13 patients with PETs who were admitted to the Central Hospital of Enshi Autonomous Prefecture from June 2007 to December 2011 were retrospectively analyzed,and their MRI imaging features were studied.The diagnostic values of MRI,especially DWI and DEMRI for PETs were investigated.

The Application of MR 3D-FLASH Dynamic Enhancement in the Breast / 实用放射学杂志

Objective To investigate the application of MR 3D-FLASH dynamic enhanced scanning in the breast diseases. Methods 108 women (35～76 years old,mean,47 years) with breast diseases confirmed by pathology were examined by using Siemens 1.0T superconducting MRI and double breast circles.Plain MR imaging performed first,then contrast-enhanced MR scans were followed with 3D FLASH sequence,and the images were subtracted.Results Among 108 cases,62 cases were benign and 46 cases were breast cancer,the diagnosing accurate rate of MR imaging was 81.5% compared with pathology pre-operation.Conclusion 3D-FLASH enhanced MR scan is the most valuable sequence in diagnosing breast lesions.

Diagnostic Value of Hypotonic-MRCP Combined with LAVA Dynamic Contrast-Enhanced Scan in Duodenal Tumor / 实用放射学杂志

Objective To discuss the value of hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan in diagnosis of duodenal tumor.Methods Five patients with duodenal adenocarcinomas confirmed by pathology were involved in this study.All cases underwent plain MRI and hypotonic-MRCP and LAVA dynamic contrast-enhanced scans.Results 4 of 5 cases were correctly diagnosed with MR imaging.Imaging signs included:the cavum of descending duodenum appeared as asymmetrical stenosis,masses with soft tissue signal intensity connecting the intestinal wall with wide base,the intestinal wall stiff,the intestinal mucosa destruction.The lesions would be slightly-moderately enhanced at LAVA dynamic enhancement scanning.Conclusion Hypotonic-MRCP combined with LAVA dynamic contrast-enhanced scan can display the direct and indirect sign of duodenal tumors,which was effective in identifying the circumscription of the tumor and its extension.

MR Diffusion-Weighted Imaging and ADC Value Measurement in the Diagnosis of Breast Axillary Lymph Node Cancer / 医疗卫生装备

Objective To value diffusion-weighted imaging and ADC value measurement of benign and malignant axillary lymph node identification value. Methods From 2006-06 to 2008--02, by collecting in the hospital for breast dynamic con-trast-enhanced scans and diffusion-weighted imaging, 217 lesions in 56 cases with a clear outcome of the surgery and pathology and/or needle biopsy results were retrospectively analyzed.Results The DWI could accurately show the lymph node of the armpit abnormality, 163 cases of 47 breast cancer cases with lymph node metastasis showed high signal in DWI image that did not decrease with increasing b value, similar to the 54 cases of 9 benign enlarged responsive prolifer-ative lymph nodes. But the former showed higher signal than the later. The ADC values were(1.017±0.114)×10-3mm2/s and (1.905±0.136)×10-3mm2/s respectively, and showed significant difference between two groups (P<0.05). Conclusion The dynamic contrast-enhanced subtraction MR technology benign and malignant breast lesions has high diagnosis and differ-ential diagnosis importance. DWI and ADC value measurement is a safe, non-invasive, accurate and rapid diagnosis of metastasis axillary lymph nodes and benign proliferative response of the lymph nodes means.