Purpose: This study aimed to explore the diagnostic value of high-resolution magnetic resonance images and tumour markers in predicting lymph node metastasis of rectal cancer.
Material and methods: The clinical, imaging, and pathological data of patients with suspected rectal cancer were collected. The baseline data, and surgical and pathological characteristics were compared between the lymph node metastasis group and no metastasis group. Univariate and multivariate logistic regression were used to analyse the clinical and pathological factors, and preoperative magnetic resonance imaging (MRI) signs of extramural vascular invasion and rectal cancer lymph node metastasis. A nomogram model was established with statistically significant factors.
Results: 150 patients were included. Among them, 50 (33.3%) presented with vascular tumour thrombus, and 72 (48.0%) had lymph node metastasis. The detection of regional lymph nodes (DWI-LN) was an independent risk factor for lymph node metastasis. The area under curve of the nomogram model was 0.804.
Conclusion: Preoperative serum CA19.9, and the relationship between tumour and peritoneal reflection in preoperative MRI and DWI-LN have clinical value in predicting lymph node metastasis in patients with rectal cancer.
Purpose: This study investigates the relationship between diffusion-weighted imaging (DWI) and mean apparent diffusion coefficient (ADC) values in predicting the genetic and molecular features of gliomas. The goal is to enhance non-invasive diagnostic methods and support personalised treatment strategies by clarifying the association between imaging biomarkers and tumour genotypes.
Material and methods: A total of 91 glioma patients treated between August 2023 and March 2024 were included in the analysis. All patients underwent preoperative magnetic resonance imaging (MRI), including DWI, and had available histopathological and genetic test results. Clinical data, tumour characteristics, and genetic markers such as IDH1 mutation, MGMT promoter methylation, EGFR amplification, TERT pathogenic variant, and CDKN2A deletion were collected. Statistical analysis was performed to identify correlations between ADC values, MRI perfusion parameters, and genetic characteristics.
Results: Significant associations were found between lower ADC values and aggressive tumour features, including IDH1-wildtype, MGMT unmethylated status, TERT pathogenic variant, and EGFR amplification. Additionally, distinct ADC patterns were observed in gliomas with CDKN2A, TP53, and PTEN gene deletions. These findings were further supported by contrast enhancement and other MRI parameters, indicating their role in tumour characterisation.
Conclusions: DWI and ADC measurements demonstrate strong potential as non-invasive tools for predicting glioma genetics. These imaging biomarkers can aid in tumour characterisation and provide valuable insights for guiding personalised treatment strategies.
Purpose: This study aimed to determine whether the mediastinal lymph node/tumour ratio (NTR) of the standardised uptake value (SUV) predicts N2 involvement more accurately than node SUV in patients with non-small cell lung cancer (NSCLC).
Material and methods: We retrospectively analysed consecutive patients with lung cancer at clinical stages I-IVA. All patients underwent positron emission tomography-computed tomography (PET-CT), followed by mediastinal staging using endobronchial ultrasound and endoscopic ultrasound imaging, and curative-intent lung resection with systematic lymph node dissection. Pathological examination of the surgical specimen was performed for confirmation.
Results: The data from 774 patients were analysed. There was a significant correlation between the risk of false-negative PET results for N2 disease and both the SUV of the mediastinal nodes (p = 0.012) and NTR (p = 0.030). The NTR outperformed node SUV in predictive ability; the Akaike information criterion was 307.268 for NTR compared to 308.498 for node SUV. Three factors were significantly associated with the positive predictive value of PET: patient age (p = 0.021), female sex (p = 0.012), and adenocarcinoma histology (p = 0.036). There were no significant correlations between PET sensitivity, specificity, and negative predictive value (NPV), and age, sex, body mass index (BMI), tumour grade, lobar location, or histological type.
Conclusions: The NTR may be a useful tool for excluding N2 disease in NSCLC. PET sensitivity and NPV for detecting N2 disease are not influenced by age, sex, BMI, tumour grade, lobar location, or histological type.
Four cases of girls with metastases of soft tissue or bone sarcomas to the reproductive system or breasts are reported. Two patients had metastases to the breast from rhabdomyosarcoma (RMS) of the limbs, one had metastases to the ovary from RMS of the foot, and one had metastases to the uterine venous plexus from chondrosarcoma of the sacrum. In each case, the appearance of metastases was shown in various imaging methods: ultrasound, magnetic resonance imaging, and computed tomography. A thorough literature review confirmed that only a few cases of soft tissue and bone sarcoma metastasis to the locations of primary interest of this article in girls have been described, especially in the context of reproductive organs. Despite the rare occurrence of this type of metastases, the malignant tumours mentioned above should be considered when differentiating the source. These rare clinical situations are woven into a review of malignant neoplasms' metastases to the reproductive organs and breast.
Purpose: The purpose of this study was to evaluate the use of the transthoracic ultrasonography (US) for pleural adhesions and pleural thickening and to quantify pleural effusion by standardised sonographic techniques and its comparison with thoracoscopic findings. An assessment of the association between pleural thickness and pleural nodularity with histopathological examination findings was also attempted.
Material and methods: Thirty-one patients with suspected chest pathologies were initially assessed by transthoracic US followed by videothoracospy. Findings observed were noted and appropriately analysed statistically.
Results: Transthoracic US is 100% sensitive and specific for detecting pleural septations in the presence of pleural effusion with 100% accuracy. Gliding sign is a highly sensitive and specific sign to detect the pleural septations in absence of pleural effusion. There was no significant association of thickness of pleural septation with the pleural malignancy.
Conclusions: Transthoracic US plays an important role in the quantification of pleural effusion, assessment of the pleura and pleural space for pleural adhesion, pleural thickening, and guiding trocar insertion.
Purpose: Our aim was to evaluate the diagnostic efficacy of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters [D, D*, f, and apparent diffusion coefficient (ADC) values] in the detection and staging of liver fibrosis in patients with hepatitis B virus (HBV).
Material and methods: In this prospective study, a patient group of 64 consecutive patients (with a mean age of 43 years, 30 women and 34 men) with HBV, who scheduled liver biopsy, and a control group of 30 healthy individuals without liver disease underwent IVIM-DWI scan. A total of 94 IVIM-DWI examinations were analysed. IVIM-DWI parameters were measured in the right lobe of the liver. The IVIM-DWI parameters of the patient and control groups were compared by Mann-Whitney U test. The patient group was classified into subgroups according to fibrosis stage of histopathological results. Receiver operating characteristic (ROC) analysis was conducted to assess the sensitivity and specificity of each parameter for detection and staging fibrosis.
Results: D and ADC values were significantly lower in the patient group compared to the control group (p < 0.05), while D* values were significantly higher (p < 0.05). No significant difference was observed in f values between the 2 groups. D* had the highest diagnostic performance, with a sensitivity of 78.1% and specificity of 73.3%, with a cut-off value of 1.4 × 10-3 mm2/s in the differentiation of fibrosis stages.
Conclusions: IVIM-DWI, particularly the D, D*, and ADC parameters, is an adjunctive non-invasive alternative to biopsy in the staging of HBV-related liver fibrosis, especially for the prediction of advanced fibrosis.
Purpose: This single-centre study includes a comparative analysis of the diagnostic performance of contrast-enhanced mammography (CEM) and automatic breast ultrasound (ABUS). The study involved 81 patients with focal breast lesions, who underwent ABUS, full-field digital mammography (FFDM), and CEM.
Material and methods: A total of 169 focal lesions were found in 81 patients, of which 110 lesions were histopathologically verified, 92 were malignant, 5 were B3 lesions, and 13 were benign. On CEM 19 additional lesions not visible on other imaging examinations were found, and as many as 36 new lesions were detected on ABUS. The number of lesions detected in patients with multiple lesions were 106 from 169 on ABUS, 65 on FFDM, and 88 on CEM. The highest correlation between the lesion's margin and its histopathological character was found in FFDM (p < 0.00), then ABUS (p = 0.038), and the lowest in CEM (p = 0.043). Compliance in determining the lesions' size comparing to histopathology as a gold standard was the highest for ABUS (p = 0.258) and lower for CEM (p = 0.012).
Results: The sensitivity of ABUS, FFDM, and CEM was, respectively: 80.43, 90.22, and 93.48; specificity: 27.78, 11.11, and 11.11; positive predictive value (PPV): 85.06, 83.84, and 84.31; negative predictive value (NPV): 21.74, 18.18, and 25; and accuracy: 71.82, 77.27, and 80. The sensitivity and accuracy of the combination of FFDM and ABUS were, respectively, 100 (p = 0.02) and 84.55 (AUC = 0.947) and for the combination of FFDM + CEM 93.48 (p = 0.25) and 79.09 (AUC = 0.855).
Conclusions: The study confirms that both ABUS and CEM may serve as a valuable complementary method for FFDM.
The aim of this paper is to present the currently used classification of split cord malformation. Split cord malformation (SCM) is a developmental defect arising during neurulation, resulting in abnormal neural tube development, with the formation of a division within the spinal cord and dural sac. The terms diastematomyelia and diplomyelia are used in the literature to describe this defect. In 1992, Pang proposed the term SCM to describe all dysraphic spinal cord defects and classified them into type I and type II, depending on the nature of the sagittal septum within the spinal canal and the presence or absence of a divided dural sac. SCM type I includes cases with a bony septum and a divided dural sac, while SCM type II includes cases without a divided dural sac but with a fibrous septum present. Depending on the type of defect, and the location and extent of the split, the condition is accompanied by neurological symptoms of varying localisation and severity. As symptoms may worsen with the child's growth, surgical intervention to remove the septum is usually necessary. In this article, the authors present the defect based on literature data, describe the current terminology regarding the defect and associated anomalies, and present a set of features that should be assessed to classify lesions.
Purpose: Despite the low incidence of COVID myocarditis, its influence on outcomes is substantial. The pivotal role of cardiac magnetic resonance (CMR) in diagnosing myocarditis is considered to be associated with disease prognosis. The primary objective of this study was to conduct a comparative analysis of myocardial injury patterns, CMR pathologic features, outcomes, and their correlation with CMR findings in COVID- and non-COVID-related myocarditis.
Material and methods: This historical cohort study involved 124 patients diagnosed with myocarditis (COVID-19 or non-COVID-19), who underwent CMR between 2018 and 2021. The COVID group consisted of 70 individuals with a definite history of COVID-19 infection within 4 weeks, and the non-COVID group comprised 54 individuals who had no prior exposure to the SARS-CoV-2 virus. All patients were monitored for one year to assess the incidence of major adverse cardiovascular events (MACE). Additionally, baseline and follow-up echocardiography data were obtained with a minimum 3-month interval.
Results: In comparison between two groups regarding to indices of CMR, left ventricular (LV) ejection fraction (p < 0.001), right ventricular (RV) ejection fraction (p < 0.001) were significantly lower in non-COVID group, and significant LV and RV systolic dysfunction were meaningfully lower in the COVID group. Extension of late gadolinium enhancement (LGE) was significantly greater in COVID group. Finally, the incidence of MACE and mean event-free survival did not have significant difference between two groups.
Conclusions: Although CMR findings differed between the 2 groups, there was no significant difference in the risk of MACE or survival during one-year follow-up. Notably, LV and RV dysfunction were more prevalent in the non-COVID group, while extension of LGE was greater in the COVID group.
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：