Pub Date : 2020-03-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.03.011
Zhiyao Tian, Hongming Zhu, J. Shao
Objective To analyze the imaging features of acute necrotizing encephalopathy of childhood (ANEC), and try to investigate its potential clinical value. Methods The clinical and imaging findings of 22 children from Wuhan Children′s Hospital diagnosed with ANEC were retrospective analyzed, from January 2013 to October 2018. All children were presented with hyperpyrexia and rapidly developed into rapid neurological deterioration after prodromic infection. In the initial imaging examination, all patients underwent head MRI, and 6 cases underwent additional head CT. During MRI follow-up, 4 cases were lost, 6 cases were followed up only once ( 14 days).The presence of hemorrhage and encephalomalacia in thalamus, brainstem, white matter and basal ganglia was carefully investigated throughout the follow-up. Results For the imaging manifestations of ANEC, bilateral thalamus were involved in all children. Other symmetrical lesions included white matter (14 cases), basal ganglia (15 cases), brainstem (16 cases), cerebellum (9 cases), corpus callosum (2 cases) and hippocampus (1 case). There were 3 children with asymmetric lesions, which were found in white matter (2 cases) and cerebellum (1 case).In the acute phase, the most typical head MRI showed "tricolor pattern"(high signal intensity in the center with surrounding low-signal, and hyperintense signals in the periphery of thalamus) or "bicolor pattern"(low signal in the central thalamus with surrounding hyperintense signals) of the thalamus on the apparent diffusion coefficient (ADC) imaging. Hemorrhage and encephalomalacia on MRI may suggest poor clinical outcome. Conclusions ANEC is a rapid progressive encephalopathy with typical imaging features. Hemorrhage and encephalomalacia on MRI may be associated with poor prognosis. Key words: Brain diseases; Child; Magnetic resonance imaging; Thalamus
{"title":"Imaging diagnosis of acute necrotizing encephalopathy of childhood","authors":"Zhiyao Tian, Hongming Zhu, J. Shao","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.011","url":null,"abstract":"Objective \u0000To analyze the imaging features of acute necrotizing encephalopathy of childhood (ANEC), and try to investigate its potential clinical value. \u0000 \u0000 \u0000Methods \u0000The clinical and imaging findings of 22 children from Wuhan Children′s Hospital diagnosed with ANEC were retrospective analyzed, from January 2013 to October 2018. All children were presented with hyperpyrexia and rapidly developed into rapid neurological deterioration after prodromic infection. In the initial imaging examination, all patients underwent head MRI, and 6 cases underwent additional head CT. During MRI follow-up, 4 cases were lost, 6 cases were followed up only once ( 14 days).The presence of hemorrhage and encephalomalacia in thalamus, brainstem, white matter and basal ganglia was carefully investigated throughout the follow-up. \u0000 \u0000 \u0000Results \u0000For the imaging manifestations of ANEC, bilateral thalamus were involved in all children. Other symmetrical lesions included white matter (14 cases), basal ganglia (15 cases), brainstem (16 cases), cerebellum (9 cases), corpus callosum (2 cases) and hippocampus (1 case). There were 3 children with asymmetric lesions, which were found in white matter (2 cases) and cerebellum (1 case).In the acute phase, the most typical head MRI showed \"tricolor pattern\"(high signal intensity in the center with surrounding low-signal, and hyperintense signals in the periphery of thalamus) or \"bicolor pattern\"(low signal in the central thalamus with surrounding hyperintense signals) of the thalamus on the apparent diffusion coefficient (ADC) imaging. Hemorrhage and encephalomalacia on MRI may suggest poor clinical outcome. \u0000 \u0000 \u0000Conclusions \u0000ANEC is a rapid progressive encephalopathy with typical imaging features. Hemorrhage and encephalomalacia on MRI may be associated with poor prognosis. \u0000 \u0000 \u0000Key words: \u0000Brain diseases; Child; Magnetic resonance imaging; Thalamus","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42255957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.03.010
Qiuji Shao, Qiang Li, Tianxiao Li, Li Li, Kaitao Chang, Qiaowei Wu, Meiyun Wang
Objective To explore the application value of three dimensional T1 weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions (3D T1-SPACE) combined with three dimensional time of flight MR angiography (3D-TOF MRA) in the follow-up of stent-assisted coil embolization for intracranial aneurysm. Methods From December 2017 to October 2018, 25 patients with intracranial aneurysm who underwent stent-assisted coil embolization in Henan Provincial People′s Hospital were enrolled. All of them had wide neck intracranial aneurysms and were followed up for 6 to 10 months after endovascular treatment using 3D-TOF MRA, 3D T1-SPACE sequence and DSA. The DSA and 3D-TOF MRA were performed to evaluate aneurysm remnants using Raymond grade scale. Meanwhile, 3D-TOF MRA and 3D T1-SPACE sequence were performed to evaluate in-stent lumen visibility using the 4-point scale. The paired sample Wilcoxon test was used to evaluate the aneurysm remnants and the parent artery patency. DSA was used as the gold standard to calculate the specificity and accuracy of the aneurysm remnants evaluated by 3D-TOF MRA. Results Six to ten months′ follow up after the procedure, for aneurysm occlusion, the Raymond grade scale of the 25 patients evaluated by DSA indicated grade 1 in 23 patients, 2 in 1 and 3 in 1. For patients evaluated by 3D-TOF MRA, the results demonstrated grade 1 in 21 patients, 2 in 3 and 3 in 1. There was no difference between the 2 methods (Z=-0.557, P=0.577). The in-stent lumens of parent vessel evaluated by 3D-TOF MRA showed that there were 14 patients with grade 3, 8 patients with grade 2 and 3 patients with grade 1. However, 3D T1-SPACE demonstrated that all 25 patients were grade 4. The 3D T1-SPACE was superior to evaluate the in-stent lumens than 3D-TOF MRA (Z=-4.484, P<0.001). Taking DSA as standard, the specificity and accuracy of the aneurysm remnants evaluated by 3D-TOF MRA were 86.9% (20/23) and 84.0% (21/25), respectively. Conclusion 3.0 T 3D T1-SPACE MR sequence can be used to assess parent artery patency, with in-stent lumen being clearly visible. 3D-TOF MRA can evaluate intracranial aneurysm remnants. The combination of these two MRI imaging techniques can be used as an optional follow-up evaluation after the endovascular treatment of intracranial aneurysms. Key words: Intracranial aneurysm; Magnetic resonance imaging; Embolization, therapeutic; Follow-up studies
{"title":"Application of 3D-SPACE sequence combined with 3D-TOF MR angiography in follow-up for intracranial aneurysm after stent-assisted coil embolization","authors":"Qiuji Shao, Qiang Li, Tianxiao Li, Li Li, Kaitao Chang, Qiaowei Wu, Meiyun Wang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.010","url":null,"abstract":"Objective \u0000To explore the application value of three dimensional T1 weighted sampling perfection with application-optimized contrasts by using different flip angle evolutions (3D T1-SPACE) combined with three dimensional time of flight MR angiography (3D-TOF MRA) in the follow-up of stent-assisted coil embolization for intracranial aneurysm. \u0000 \u0000 \u0000Methods \u0000From December 2017 to October 2018, 25 patients with intracranial aneurysm who underwent stent-assisted coil embolization in Henan Provincial People′s Hospital were enrolled. All of them had wide neck intracranial aneurysms and were followed up for 6 to 10 months after endovascular treatment using 3D-TOF MRA, 3D T1-SPACE sequence and DSA. The DSA and 3D-TOF MRA were performed to evaluate aneurysm remnants using Raymond grade scale. Meanwhile, 3D-TOF MRA and 3D T1-SPACE sequence were performed to evaluate in-stent lumen visibility using the 4-point scale. The paired sample Wilcoxon test was used to evaluate the aneurysm remnants and the parent artery patency. DSA was used as the gold standard to calculate the specificity and accuracy of the aneurysm remnants evaluated by 3D-TOF MRA. \u0000 \u0000 \u0000Results \u0000Six to ten months′ follow up after the procedure, for aneurysm occlusion, the Raymond grade scale of the 25 patients evaluated by DSA indicated grade 1 in 23 patients, 2 in 1 and 3 in 1. For patients evaluated by 3D-TOF MRA, the results demonstrated grade 1 in 21 patients, 2 in 3 and 3 in 1. There was no difference between the 2 methods (Z=-0.557, P=0.577). The in-stent lumens of parent vessel evaluated by 3D-TOF MRA showed that there were 14 patients with grade 3, 8 patients with grade 2 and 3 patients with grade 1. However, 3D T1-SPACE demonstrated that all 25 patients were grade 4. The 3D T1-SPACE was superior to evaluate the in-stent lumens than 3D-TOF MRA (Z=-4.484, P<0.001). Taking DSA as standard, the specificity and accuracy of the aneurysm remnants evaluated by 3D-TOF MRA were 86.9% (20/23) and 84.0% (21/25), respectively. \u0000 \u0000 \u0000Conclusion \u00003.0 T 3D T1-SPACE MR sequence can be used to assess parent artery patency, with in-stent lumen being clearly visible. 3D-TOF MRA can evaluate intracranial aneurysm remnants. The combination of these two MRI imaging techniques can be used as an optional follow-up evaluation after the endovascular treatment of intracranial aneurysms. \u0000 \u0000 \u0000Key words: \u0000Intracranial aneurysm; Magnetic resonance imaging; Embolization, therapeutic; Follow-up studies","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44000191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
As a new interdisciplinary research field, imageomics integrates digital image information, statistics, artificial intelligence, machine learning and deep learning, breaking the traditional visual image evaluation model and opening up a new direction for atherosclerosis research. Imaging omics has shown great potential value in the diagnosis, treatment plan selection, efficacy evaluation, and prognosis judgment of major arterial vascular diseases such as carotid and coronary arteries. This article reviews the basic content and clinical application of atherosclerosis icomics.
{"title":"Research progress of radiomics in atherosclerosis","authors":"L. Peng","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.017","url":null,"abstract":"影像组学作为新兴多学科交叉研究领域，融合数字影像信息、统计学、人工智能、机器学习和深度学习等方法，打破了传统视觉影像评价模式，为动脉粥样硬化研究开辟了新的方向。影像组学在颈动脉、冠状动脉等大动脉血管疾病的诊断，治疗方案的选择，疗效评估及预后判断等方面显示出巨大潜在价值。笔者就动脉粥样硬化影像组学的基本内容及其临床应用进展进行综述。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49636229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Artificial intelligence (AI) has great potential for application in multi sequence cardiac MRI image data. AI can assist radiologists and researchers in quickly and accurately interpreting complex cardiac MRI images, providing quantitative indicators for clinical diagnosis and scientific research. The author reviews the development process of AI analysis of cardiac MRI from a technical perspective, including the characteristics of three types of algorithms: image based, model based, and data based, and briefly elaborates on the issues that need to be addressed in current AI research on MRI images.
{"title":"Application of artificial intelligence in cardiac MRI analysis","authors":"Q. Tao, Yuanyuan Wang, L. Xia","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.001","url":null,"abstract":"人工智能（AI）在心脏MRI多序列的图像数据上有巨大的应用潜力。AI可辅助放射科医师和科研工作者对复杂心脏MRI图像进行快速精准的解读，为临床诊断和科学研究提供量化指标。笔者从技术角度回顾AI分析心脏MRI的发展历程，包括基于图像、基于模型和基于数据的3类算法的特点，并简要阐述现阶段MRI图像的AI研究所需要关注的问题。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49039013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the value of mammography and MRI combined with clinical features in predicting upgrade to malignancy in high-risk breast lesions. Methods Data from 230 patients who were diagnosed with high-risk breast lesions and underwent both mammography and MRI examinations before biopsy were analyzed retrospectively from Jan 2017 to Mar 2018 in Fudan University Shanghai Cancer Hospital. The imaging features of both mammography and MRI were analyzed, and the association between mammography, MRI and clinical features were evaluated using pathology as the gold standard. Independent t test and χ2 test were used to compare the difference of clinical and imaging features between upgrade and non-upgrade groups, using receiver operating characteristic (ROC) curve to test the diagnostic value between mammography and MRI. Binary logistic regression was used to evaluate the correlation between upgrade and clinical, imaging findings. Results Two hundred and thirty patients had 230 lesions, and 47 cases had atypia upgrade to malignancy during second surgery (upgrade rate was 20.4%). There were statistically significant differences in age, maximum diameter of lesion, and menopausal status between the upgraded and non-upgraded groups (P 0.05), while there was statistically significant difference in breast MRI features and background parenchymal enhancement (P<0.05). For the diagnostic value in predicting upgrade of high-risk lesions, MRI was better than mammography (the areas under ROC curve were 0.913 and 0.606, Z=6.919, P<0.01). Single factor analysis showed that age, lesion size, menopausal status, MRI negative and background parenchymal enhancement on MRI were significantly different for upgrade to malignancy (P<0.05). Multiple factors analysis showed age and background parenchymal enhancement on MRI were independent factors for predicting upgrade (P<0.01). Conclusion For the upgrade to malignancy in high-risk lesions, the diagnostic value of MRI is better than mammography. The elder age and moderate or marked background parenchymal enhancement on MRI may serve as useful predictors of upgrade. Key words: Breast neoplasms; High-risk lesion; Mammography; Magnetic resonance imaging
{"title":"The diagnostic value of both mammography and MRI in combination with clinical features in high-risk breast lesions","authors":"Chao You, Weijun Peng, Yajia Gu, Sheng Chen, Xiaohan Liu, Tingting Jiang, Wentao Yang","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.006","url":null,"abstract":"Objective \u0000To evaluate the value of mammography and MRI combined with clinical features in predicting upgrade to malignancy in high-risk breast lesions. \u0000 \u0000 \u0000Methods \u0000Data from 230 patients who were diagnosed with high-risk breast lesions and underwent both mammography and MRI examinations before biopsy were analyzed retrospectively from Jan 2017 to Mar 2018 in Fudan University Shanghai Cancer Hospital. The imaging features of both mammography and MRI were analyzed, and the association between mammography, MRI and clinical features were evaluated using pathology as the gold standard. Independent t test and χ2 test were used to compare the difference of clinical and imaging features between upgrade and non-upgrade groups, using receiver operating characteristic (ROC) curve to test the diagnostic value between mammography and MRI. Binary logistic regression was used to evaluate the correlation between upgrade and clinical, imaging findings. \u0000 \u0000 \u0000Results \u0000Two hundred and thirty patients had 230 lesions, and 47 cases had atypia upgrade to malignancy during second surgery (upgrade rate was 20.4%). There were statistically significant differences in age, maximum diameter of lesion, and menopausal status between the upgraded and non-upgraded groups (P 0.05), while there was statistically significant difference in breast MRI features and background parenchymal enhancement (P<0.05). For the diagnostic value in predicting upgrade of high-risk lesions, MRI was better than mammography (the areas under ROC curve were 0.913 and 0.606, Z=6.919, P<0.01). Single factor analysis showed that age, lesion size, menopausal status, MRI negative and background parenchymal enhancement on MRI were significantly different for upgrade to malignancy (P<0.05). Multiple factors analysis showed age and background parenchymal enhancement on MRI were independent factors for predicting upgrade (P<0.01). \u0000 \u0000 \u0000Conclusion \u0000For the upgrade to malignancy in high-risk lesions, the diagnostic value of MRI is better than mammography. The elder age and moderate or marked background parenchymal enhancement on MRI may serve as useful predictors of upgrade. \u0000 \u0000 \u0000Key words: \u0000Breast neoplasms; High-risk lesion; Mammography; Magnetic resonance imaging","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45804770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.03.008
Ximing Wang, J. Bao, Chunhong Hu, Zhongshuai Zhang, Qi-lin Xi, Jianquan Hou, Han Li, Zhuxin Wei
Objective To evaluate the application of multiparametric MRI (mpMRI)-transrectal ultrasound (TRUS) fusion guided biopsy in the diagnosis of clinical significant prostate cancer (PCa). Methods A prospective analysis was performed in 168 patients with suspected PCa from September 2015 to June 2017 in the First Affiliated Hospital of Soochow University. Suspicious areas on mpMRl were defined and graded using prostate imaging reporting and data system version 2 (PI-RADS V2) score. All the patients had the TRUS-guided systematic biopsy, 108 patients with PI-RAD V2 scores ≥ 3 had additional MRI-TRUS targeted biopsies. Taking pathologic results as golden standard, the detection rates were compared between the 2 methods using χ2 test. Results Initially, all of the 168 patients underwent TRUS biopsy. PCa was detected in 86 (101 niduses) of 168 patients (51.19%, 86/168), 82 (91 niduses) (48.81%, 82/168) were not prostate cancer. Seventy eight (46.43%, 78/168) cases of PCa were detected by TRUS biopsy, and 63 (58.33%, 63/168) cases of PCa were detected by MRI-TRUS fusion guided biopsy, the difference was statistically significant between TRUS biopsy and MRI-TRUS fusion guided biopsy (χ2=3.73, P=0.035). The 168 patients were biopsied with a total of 2 300 cores, including TRUS biopsy 2 016 cores and MRI-TRUS fusion targeted biopsy 284 cores. Additionally, the detection rate for per cores for MRI-TRUS fusion targeted biopsy (51.76%, 147/284) was significantly higher than that for TRUS biopsy cores (19.64%, 396/2 016) (χ2=142.38,P<0.05). Among patients with a positive biopsy for PCa, the biopsy cores for conventional TRUS biopsy was 1 032 comparing to 214 cores for MRI-TRUS biopsy. The suspicious MRI-TRUS fusion targeted biopsy (68.69%, 147/214) detected more PCa compared with TRUS biopsy (38.37%, 396/1 032) (χ2=66.27, P<0.05). Among patients with a positive biopsy for PCa, MRI-TRUS fusion targeted biopsy [69.74% (106/152)] detected more significant cancer cores than TRUS biopsy [54.50% (351/644) ] (χ2=11.67, P<0.05). Conclusion MRI-TRUS fusion biopsy combined with PI-RADS V2 increases positive rate markedly and improves the detection rate of clinical significant PCa. Key words: Prostate neoplasms; Magnetic resonance imaging; Transrectal ultrasound
{"title":"The value of multiparametric MRI and transrectal ultrasound fusion guided biopsy in the detection of clinical significant prostate cancer","authors":"Ximing Wang, J. Bao, Chunhong Hu, Zhongshuai Zhang, Qi-lin Xi, Jianquan Hou, Han Li, Zhuxin Wei","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.008","url":null,"abstract":"Objective \u0000To evaluate the application of multiparametric MRI (mpMRI)-transrectal ultrasound (TRUS) fusion guided biopsy in the diagnosis of clinical significant prostate cancer (PCa). \u0000 \u0000 \u0000Methods \u0000A prospective analysis was performed in 168 patients with suspected PCa from September 2015 to June 2017 in the First Affiliated Hospital of Soochow University. Suspicious areas on mpMRl were defined and graded using prostate imaging reporting and data system version 2 (PI-RADS V2) score. All the patients had the TRUS-guided systematic biopsy, 108 patients with PI-RAD V2 scores ≥ 3 had additional MRI-TRUS targeted biopsies. Taking pathologic results as golden standard, the detection rates were compared between the 2 methods using χ2 test. \u0000 \u0000 \u0000Results \u0000Initially, all of the 168 patients underwent TRUS biopsy. PCa was detected in 86 (101 niduses) of 168 patients (51.19%, 86/168), 82 (91 niduses) (48.81%, 82/168) were not prostate cancer. Seventy eight (46.43%, 78/168) cases of PCa were detected by TRUS biopsy, and 63 (58.33%, 63/168) cases of PCa were detected by MRI-TRUS fusion guided biopsy, the difference was statistically significant between TRUS biopsy and MRI-TRUS fusion guided biopsy (χ2=3.73, P=0.035). The 168 patients were biopsied with a total of 2 300 cores, including TRUS biopsy 2 016 cores and MRI-TRUS fusion targeted biopsy 284 cores. Additionally, the detection rate for per cores for MRI-TRUS fusion targeted biopsy (51.76%, 147/284) was significantly higher than that for TRUS biopsy cores (19.64%, 396/2 016) (χ2=142.38,P<0.05). Among patients with a positive biopsy for PCa, the biopsy cores for conventional TRUS biopsy was 1 032 comparing to 214 cores for MRI-TRUS biopsy. The suspicious MRI-TRUS fusion targeted biopsy (68.69%, 147/214) detected more PCa compared with TRUS biopsy (38.37%, 396/1 032) (χ2=66.27, P<0.05). Among patients with a positive biopsy for PCa, MRI-TRUS fusion targeted biopsy [69.74% (106/152)] detected more significant cancer cores than TRUS biopsy [54.50% (351/644) ] (χ2=11.67, P<0.05). \u0000 \u0000 \u0000Conclusion \u0000MRI-TRUS fusion biopsy combined with PI-RADS V2 increases positive rate markedly and improves the detection rate of clinical significant PCa. \u0000 \u0000 \u0000Key words: \u0000Prostate neoplasms; Magnetic resonance imaging; Transrectal ultrasound","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48724733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.03.007
W. Niu, Yahong Luo, Tao Yu, Yan Guo, Yi Zhang, Tengfei Peng, Xiaowen Ma, Puchen Li
Objective To investigate the value of tumor hemodynamics and morphological features from conventional dynamic contrast-enhanced MRI (DCE-MRI) scan before surgery in predicting postoperative recurrence time in breast cancer patients. Methods A retrospective analysis of 58 patients with breast cancer who had recurred after operation from November 2012 to December 2014 in Liaoning Cancer Hospital was performed. According to the recurrence time, the patients were divided into early recurrence group (≤2 years after surgery, 33 cases) and late recurrence group (>2 years after surgery, 25 cases). All patients underwent routine DCE-MRI scans before surgery, and hemodynamic features of the three-dimensional volume of the tumor and the morphological and textural features of the tumor in each phase were extracted by computer. The counts and measurement data of patients in early recurrence group and late recurrence group were compared by Fisher′s exact probability method and Mann-Whitney U test, and receiver operating characteristic (ROC) curves were drawn. The multivariate logistic regression was used to calculate the combined efficacy in predicting early recurrence and late recurrence. Kaplan-Meier method was used to analyze the survival prognosis, and Log-Rank test was used to compare the differences in survival curves between groups. Results There was no significant difference in background parenchymal enhancement, lesion margin, lesion internal enhancement characteristics, lesion morphology, time-signal intensity curve type and the degree of whole-breast vascularity increase between early recurrence and late recurrence groups (P>0.05).There were significant differences in the maximum concentration of contrast (Max Conc), the area under the time signal curve (AUC) and the maximum slope value of the time signal curve (Max Slope) (P<0.05). Comparative analysis of the radiomics parameters of 8 phases DCE-MRI found that the sphericity of morphological characteristic parameters in the phase 3 was statistically different between the early recurrence and late recurrence groups (P=0.03). Area under the ROC curve of AUC, Max Conc, Max Slope and parameter sphericity of phase 3 morphological characteristics for predicting early and late recurrence were 0.664, 0.659, 0.684 and 0.670, respectively. The area under the ROC combined with the above four parameters for prediction was 0.765, with a specificity of 63.6% and a sensitivity of 84.0%; the predictive efficacy was higher than that of univariate. Fifty-eight patients were followed up for 17 to 64 months with a median follow-up of 47 months. The disease-free survival and overall survival in the early recurrence group were significantly lower than those in the late recurrence group, and the difference was statistically significant (P<0.05). Conclusion It is of certain value to predict the postoperative recurrence time of breast cancer based on the tumor hemodynamic characteristics combined with mo
{"title":"The value of tumor hemodynamics and morphological features in predicting the postoperative recurrence time of breast cancer based on dynamic contrast-enhanced MRI","authors":"W. Niu, Yahong Luo, Tao Yu, Yan Guo, Yi Zhang, Tengfei Peng, Xiaowen Ma, Puchen Li","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.007","url":null,"abstract":"Objective \u0000To investigate the value of tumor hemodynamics and morphological features from conventional dynamic contrast-enhanced MRI (DCE-MRI) scan before surgery in predicting postoperative recurrence time in breast cancer patients. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis of 58 patients with breast cancer who had recurred after operation from November 2012 to December 2014 in Liaoning Cancer Hospital was performed. According to the recurrence time, the patients were divided into early recurrence group (≤2 years after surgery, 33 cases) and late recurrence group (>2 years after surgery, 25 cases). All patients underwent routine DCE-MRI scans before surgery, and hemodynamic features of the three-dimensional volume of the tumor and the morphological and textural features of the tumor in each phase were extracted by computer. The counts and measurement data of patients in early recurrence group and late recurrence group were compared by Fisher′s exact probability method and Mann-Whitney U test, and receiver operating characteristic (ROC) curves were drawn. The multivariate logistic regression was used to calculate the combined efficacy in predicting early recurrence and late recurrence. Kaplan-Meier method was used to analyze the survival prognosis, and Log-Rank test was used to compare the differences in survival curves between groups. \u0000 \u0000 \u0000Results \u0000There was no significant difference in background parenchymal enhancement, lesion margin, lesion internal enhancement characteristics, lesion morphology, time-signal intensity curve type and the degree of whole-breast vascularity increase between early recurrence and late recurrence groups (P>0.05).There were significant differences in the maximum concentration of contrast (Max Conc), the area under the time signal curve (AUC) and the maximum slope value of the time signal curve (Max Slope) (P<0.05). Comparative analysis of the radiomics parameters of 8 phases DCE-MRI found that the sphericity of morphological characteristic parameters in the phase 3 was statistically different between the early recurrence and late recurrence groups (P=0.03). Area under the ROC curve of AUC, Max Conc, Max Slope and parameter sphericity of phase 3 morphological characteristics for predicting early and late recurrence were 0.664, 0.659, 0.684 and 0.670, respectively. The area under the ROC combined with the above four parameters for prediction was 0.765, with a specificity of 63.6% and a sensitivity of 84.0%; the predictive efficacy was higher than that of univariate. Fifty-eight patients were followed up for 17 to 64 months with a median follow-up of 47 months. The disease-free survival and overall survival in the early recurrence group were significantly lower than those in the late recurrence group, and the difference was statistically significant (P<0.05). \u0000 \u0000 \u0000Conclusion \u0000It is of certain value to predict the postoperative recurrence time of breast cancer based on the tumor hemodynamic characteristics combined with mo","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49167153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nonpsammomatous melanotic schwannoma of the lumbar spine: a case report","authors":"Yuge Chen, Yueqin Chen, Xiang Guo, Zhanguo Sun, Zhitao Shi","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.016","url":null,"abstract":"本文报道1例53岁女性腰椎无沙粒体型色素性神经鞘瘤患者的临床资料，患者主要临床表现为腰背部持续性钝痛。CT显示腰3、4椎体水平椎管及左侧椎间孔区不均质实性病灶，呈哑铃状，左侧椎间孔扩大；MRI显示病灶T1WI呈混杂稍高信号，T2WI呈混杂略低信号，DWI呈团块状扩散受限，增强扫描呈轻度不均匀强化信号。经病理诊断为腰椎非沙粒体型色素性神经鞘瘤。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43288844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-10DOI: 10.3760/CMA.J.ISSN.1005-1201.2020.03.003
D. Kong, Jian-dong Zhang, W. Shan, S. Duan, Lili Guo
Objective To investigate the value of CT radiomics mode in differential diagnosis of benign and malignant thyroid nodules. Methods The clinical and imaging data of 179 patients with thyroid nodules confirmed by pathology from May 2017 to August 2018 were retrospectively analyzed in the Affiliated Huaian First People′s Hospital of Nanjing Medical University. Among the patients, 89 cases were benign nodules and 90 cases were malignant nodules. All patients underwent unenhanced and enhanced CT scan before operation. The stratified random sampling method was used to divide patients into a training group (143 cases) and a testing group (36 cases) according to a ratio of 8∶2. The A.K software was used to extract 378 imaging omics features based on preoperative CT images, and then Spearman correlation analysis and least absolute shrinkage and selection operator regression analysis were used for feature selection and model construction. The receiver operating characteristic (ROC) curve was used to verify the model in the training group and the testing group, and the efficacy of imaging omics features to predict benign and malignant thyroid nodules was evaluated. Results After feature screening, 16 radiomics features were used to construct an identification model between benign and malignant thyroid nodules. In the training group, the area under the ROC curve (AUC) was 0.92 [95% confidence interval (CI): 0.88-0.97], the sensitivity and specificity were 88.7%, 82.0%, and the diagnostic accuracy of the model was 91.1%. In the testing group, AUC was 0.90 (95%CI: 0.81-0.98), sensitivity and specificity were 88.5%, 84.6%, and the diagnostic accuracy of the model was 88.2%. Conclusion The CT radiomics mode has a good diagnostic performance in the identification of benign and malignant thyroid nodules. Key words: Tomography, X-Ray computed; Thyroid nodule; Diagnosis, differential; Radiomics
{"title":"CT radiomics model for differentiating malignant and benign thyroid nodules","authors":"D. Kong, Jian-dong Zhang, W. Shan, S. Duan, Lili Guo","doi":"10.3760/CMA.J.ISSN.1005-1201.2020.03.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1005-1201.2020.03.003","url":null,"abstract":"Objective \u0000To investigate the value of CT radiomics mode in differential diagnosis of benign and malignant thyroid nodules. \u0000 \u0000 \u0000Methods \u0000The clinical and imaging data of 179 patients with thyroid nodules confirmed by pathology from May 2017 to August 2018 were retrospectively analyzed in the Affiliated Huaian First People′s Hospital of Nanjing Medical University. Among the patients, 89 cases were benign nodules and 90 cases were malignant nodules. All patients underwent unenhanced and enhanced CT scan before operation. The stratified random sampling method was used to divide patients into a training group (143 cases) and a testing group (36 cases) according to a ratio of 8∶2. The A.K software was used to extract 378 imaging omics features based on preoperative CT images, and then Spearman correlation analysis and least absolute shrinkage and selection operator regression analysis were used for feature selection and model construction. The receiver operating characteristic (ROC) curve was used to verify the model in the training group and the testing group, and the efficacy of imaging omics features to predict benign and malignant thyroid nodules was evaluated. \u0000 \u0000 \u0000Results \u0000After feature screening, 16 radiomics features were used to construct an identification model between benign and malignant thyroid nodules. In the training group, the area under the ROC curve (AUC) was 0.92 [95% confidence interval (CI): 0.88-0.97], the sensitivity and specificity were 88.7%, 82.0%, and the diagnostic accuracy of the model was 91.1%. In the testing group, AUC was 0.90 (95%CI: 0.81-0.98), sensitivity and specificity were 88.5%, 84.6%, and the diagnostic accuracy of the model was 88.2%. \u0000 \u0000 \u0000Conclusion \u0000The CT radiomics mode has a good diagnostic performance in the identification of benign and malignant thyroid nodules. \u0000 \u0000 \u0000Key words: \u0000Tomography, X-Ray computed; Thyroid nodule; Diagnosis, differential; Radiomics","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46835671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-05DOI: 10.3760/CMA.J.CN112149-20200220-00205
Rui Hu, Nan Huang, C. Wen, Qiang He, Liang Zhao, Junhua Qiu, Dehong Wu, Can Guo, Lin Xu
Objective To explore the value of chest CT features and clinical indexes in the differential diagnosis between suspected COVID-19 with two or more negative nucleic acid tests and confirmed COVID-19. Methods The clinical data and chest CT images of 105 cases withconfirmedCOVID-19 (55 males and 50 females, aged from 2 month to 88 years) and 97 cases with suspected COVID-19(59 males and 38 females, aged from 1 month to 93 years) were analyzed retrospectively in Shiyan Taihe Hospital from January 21 to February 10, 2020. χ2test and two independent sample t test were used to analyze the clinical data and CT signs of the two cases, with P<0.05 for the difference statistically significant. Results Compared with the suspected patients, the average age of diagnosis of covid-19 was higher (t = 2.460, P = 0.01). The main pathological changes were pure ground glass (68 cases) and mixed ground glass density (53 cases) (χ2 = 50.016, P< 0.01). Interstitial thickening (83 cases) (χ2 = 55.395, P< 0.01), vascular thickening (73 cases) (χ2 = 57.527, P< 0.01), air bronchoscopic sign or bronchiectasis Zhang (67 cases) (χ2 = 17.899, P< 0.01), cord focus (54 cases) (χ2 = 5.500, P = 0.02), easily distributed under the pleura and the long axis of the lesion was parallel to the pleura (89 cases) (χ2 = 23.597, P< 0.01), most of them had no pleural effusion (χ2 = 7.017, P< 0.01); both lesions were mainly distributed in patches (89 cases were confirmed, 87 suspected) (χ2 = 19.573, P< 0.01). In addition, the lesions of patients with confirmed covid-19 showed progress in short term (72 / 87, 82.76%), and those with suspected covid-19 showed remission in short term (63 / 89, 70.78%). The difference was statistically significant (χ2 = 51.114, P< 0.01). There was no significant difference in gender and distribution of pulmonary lobes (χ2 = 1.462, P= 0.23; χ2 = 7.381, P= 0.19). The number of white blood cells (χ2 = 17.891, P< 0.01) and the percentage of lymphocytes (χ2 = 11.151,P< 0.01) of covid-19 were mostly normal or decreased, creatine kinase (χ2 = 9.589, P< 0.01) were mostly normal, and erythrocyte sedimentation rate was mostly normal or increased (χ2 = 4.240, P= 0.04). Conclusions The imaging features and biochemical indexes of diagnosed COVID-19 are different from those of suspected COVID-19. The comparative analysis of imaging features, clinical indexes and reexamination are helpful for the differential diagnosis of COVID-19 and suspected COVID-19. Key words: COVID-19; Tomography, X-ray computed
{"title":"Comparison of chest CT images between confirmed and suspected cases of COVID-19/ 中华放射学杂志","authors":"Rui Hu, Nan Huang, C. Wen, Qiang He, Liang Zhao, Junhua Qiu, Dehong Wu, Can Guo, Lin Xu","doi":"10.3760/CMA.J.CN112149-20200220-00205","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200220-00205","url":null,"abstract":"Objective \u0000To explore the value of chest CT features and clinical indexes in the differential diagnosis between suspected COVID-19 with two or more negative nucleic acid tests and confirmed COVID-19. \u0000 \u0000 \u0000Methods \u0000The clinical data and chest CT images of 105 cases withconfirmedCOVID-19 (55 males and 50 females, aged from 2 month to 88 years) and 97 cases with suspected COVID-19(59 males and 38 females, aged from 1 month to 93 years) were analyzed retrospectively in Shiyan Taihe Hospital from January 21 to February 10, 2020. χ2test and two independent sample t test were used to analyze the clinical data and CT signs of the two cases, with P<0.05 for the difference statistically significant. \u0000 \u0000 \u0000Results \u0000Compared with the suspected patients, the average age of diagnosis of covid-19 was higher (t = 2.460, P = 0.01). The main pathological changes were pure ground glass (68 cases) and mixed ground glass density (53 cases) (χ2 = 50.016, P< 0.01). Interstitial thickening (83 cases) (χ2 = 55.395, P< 0.01), vascular thickening (73 cases) (χ2 = 57.527, P< 0.01), air bronchoscopic sign or bronchiectasis Zhang (67 cases) (χ2 = 17.899, P< 0.01), cord focus (54 cases) (χ2 = 5.500, P = 0.02), easily distributed under the pleura and the long axis of the lesion was parallel to the pleura (89 cases) (χ2 = 23.597, P< 0.01), most of them had no pleural effusion (χ2 = 7.017, P< 0.01); both lesions were mainly distributed in patches (89 cases were confirmed, 87 suspected) (χ2 = 19.573, P< 0.01). In addition, the lesions of patients with confirmed covid-19 showed progress in short term (72 / 87, 82.76%), and those with suspected covid-19 showed remission in short term (63 / 89, 70.78%). The difference was statistically significant (χ2 = 51.114, P< 0.01). There was no significant difference in gender and distribution of pulmonary lobes (χ2 = 1.462, P= 0.23; χ2 = 7.381, P= 0.19). The number of white blood cells (χ2 = 17.891, P< 0.01) and the percentage of lymphocytes (χ2 = 11.151,P< 0.01) of covid-19 were mostly normal or decreased, creatine kinase (χ2 = 9.589, P< 0.01) were mostly normal, and erythrocyte sedimentation rate was mostly normal or increased (χ2 = 4.240, P= 0.04). \u0000 \u0000 \u0000Conclusions \u0000The imaging features and biochemical indexes of diagnosed COVID-19 are different from those of suspected COVID-19. The comparative analysis of imaging features, clinical indexes and reexamination are helpful for the differential diagnosis of COVID-19 and suspected COVID-19. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Tomography, X-ray computed","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44901721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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