Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and t...Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.展开更多
In recent decades,maternal–fetal medicine has undergone substantial advancements in the management of high-risk pregnancies.These include enhanced prenatal screening and diagnosis facilitated by innovations in ultras...In recent decades,maternal–fetal medicine has undergone substantial advancements in the management of high-risk pregnancies.These include enhanced prenatal screening and diagnosis facilitated by innovations in ultrasound imaging,as well as the advances in fetal medical and interventional therapies informed by the deeper understanding of pathophysiological mechanisms underlying fetal and maternal disease processes.展开更多
Background:Magnetic resonance spectroscopy(MRS)represents a significant advancement in the noninvasive assessment of brain metabolism.MRS can provide valuable metabolic information and facilitate more accurate diagnos...Background:Magnetic resonance spectroscopy(MRS)represents a significant advancement in the noninvasive assessment of brain metabolism.MRS can provide valuable metabolic information and facilitate more accurate diagnoses of intrauterine fetal brain development than was previously possible.To obtain information regarding normal intrauterine fetal brain metabolism and to establish gestational age-specific reference values for normal fetal brain metabolites for subsequent use in MRS,we conducted MRS scans of normal fetal brains during mid-to late-term pregnancies,along with related processing.Methods:In this prospective study,MRS scans were conducted on 109 fetuses,with a total of 54 normal fetal brains enrolled on the basis of specific inclusion and exclusion criteria.We analyzed metabolic ratios,including the sum of N-acetylaspartate(NAA)and total N-acetylaspartate(tNAA),total choline(tCho),inositol(Ins),and total creatine(tCr),in relation to gestational age.Results:Gestational age was significantly correlated with specific metabolic ratios(Ins/tCr:r=-0.75,p<0.0001;tCho/tCr:r=-0.50,p<0.0001),especially tNAA/tCho(tNAA/tCho:r=0.54,p<0.0001)and tNAA/Ins(r=0.56,p<0.0001),providing a baseline for fetal brain metabolic assessment.Linear regression analysis was used to calculate regression lines for fetal brain metabolite ratios.Slopes were tested at p of 0.05.Conclusions:The current findings confirmed a significant correlation between fetal brain metabolites and gestational age,supporting the feasibility of establishing standard values for these metabolites in fetal brain assessment.展开更多
Background:Platinum can cause chemotherapy-related cognitive impairment.Low-intensity focused ultrasound(LIFUS)is a promising noninvasive physical stimulation method with a unique advantage in neurological rehabilitat...Background:Platinum can cause chemotherapy-related cognitive impairment.Low-intensity focused ultrasound(LIFUS)is a promising noninvasive physical stimulation method with a unique advantage in neurological rehabilitation.We aimed to investigate whether LIFUS can alleviate cisplatin-induced cognitive impairment in rats and explore the related neuropatho-logical mechanisms.Methods:After confirming the target position for LIFUS treatment in 18 rats,64 rats were randomly divided into four groups:control,model,sham,and LIFUS groups.Before and after LIFUS treatment,detailed biological behavioral assessments and magnetic resonance imaging were performed.Finally,the rats were euthanized,and relevant histopathological and molecular biological experiments were conducted and analyzed.Results:In the Morris water maze,the model group showed fewer platform crossings(1.250.93 vs.5.691.58),a longer escape latency(41.6536.55 s vs.6.382.11 s),and a lower novel object recognition index(29.7711.83 vs.83.695.67)than the control group.LIFUS treatment improved these metrics,with more platform crossings(3.130.34),a higher recognition index(65.588.71),and a shorter escape latency(6.452.27 s).Longitudinal analysis of the LIFUS group further confirmed these improvements.Neuroimaging revealed significant differences in diffusion tensor imaging metrics of specific brain regions pre-and post-LIFUS.Moreover,neuropathology showed higher dendritic spine density,less myelin loss,fewer apoptotic cells,more synapses,and less mitochondrial autophagy after LIFUS treatment.The neuroimaging indicators were correlated with behavioral improvements,highlighting the potential of LIFUS for alleviating cognitive impairment(as demonstrated through imaging and analysis).Our investigation of the molecular biological mechanisms revealed distinct protein expression patterns in the hippocampus and its subregions.In the model group,glial fibrillary acidic protein(GFAP)and ionized calcium-binding adaptor molecule 1(IBA1)expression levels were elevated across the hippocampus,whereas neuronal nuclei(NeuN)expression was reduced.Subregional analysis revealed higher GFAP and IBA1 and lower NeuN,especially in the dentate gyrus subregion.Moreover,positive cell areas were larger in the cornu ammonis(CA)1,CA2,CA3,and dentate gyrus regions.In the CA2 and CA3,significant differences among the groups were observed in GFAP-positive cell counts and areas,and there were variations in NeuN expression.Conclusions:Our results suggest that LIFUS can reverse cisplatin-induced cognitive impairments.The neuroimaging findings were consistent with the behavioral and histological results and suggest a neuropathological basis that supports further research into the clinical applications of LIFUS.Furthermore,LIFUS appeared to enhance the plasticity of neuronal synapses in the rat hippocampus and reduce hippocampal inflammation.These findings highlight the clinical potential of LIFUS as an effective,noninvasive therapeutic strategy and monitoring tool for chemotherapy-induced cognitive deficits.展开更多
Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with t...Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.展开更多
Fetal intracranial tumors are rare,accounting for approximately 0.5%–1.9%of all pediatric tumors,though the true incidence may be underestimated.These tumors often present with distinct histopathological features,ima...Fetal intracranial tumors are rare,accounting for approximately 0.5%–1.9%of all pediatric tumors,though the true incidence may be underestimated.These tumors often present with distinct histopathological features,imaging characteristics,and clinical behavior compared to their postnatal counterparts.This review summarizes the current understanding of the prenatal diagnosis and characterization of fetal brain tumors,with a particular focus on the role of fetal magnetic resonance imaging(MRI).We discuss the advantages of advanced MR sequences in enhancing lesion detection and anatomical delineation following suspicious findings on obstetric ultrasound.Common tumor types encountered in utero—including teratomas,as-trocytomas,medulloblastomas,choroid plexus papillomas,and craniopharyngiomas—are reviewed in terms of imaging fea-tures,differential diagnosis,and clinical implications.Furthermore,the review addresses the diagnostic challenges,prognostic considerations,and the potential role of fetal MRI in guiding perinatal management and parental counseling.展开更多
Background:Congenital heart disease(CHD)results from abnormal heart development during fetal development,leading to life-threatening complications.This study aimed to evaluate the feasibility of applying myocardial pa...Background:Congenital heart disease(CHD)results from abnormal heart development during fetal development,leading to life-threatening complications.This study aimed to evaluate the feasibility of applying myocardial parametric mapping in post-mortem magnetic resonance imaging and to examine differences in the left ventricular myocardium between fetuses with CHD and controls.Methods:This prospective case–control study was conducted on 14 deceased fetuses with CHD(CHD group)and 24 fetuses without CHD(control group).Fetuses with CHD were further stratified into the cyanotic(n=9)and non-cyanotic(n=5)CHD groups.T1,T2,and proton density relaxation times of the left ventricular myocardium were calculated and compared using multiple-dynamic multiple-echo post-mortem magnetic resonance imaging technology.Results:The myocardial T2 relaxation time was significantly different between the groups(p=0.033),with no difference in T1 or proton density relaxation times between the groups.A one-way analysis of variance with Tukey's test showed that the mean cyanotic CHD group showed a longer myocardial T2 relaxation time than the control group(98.00013.143 vs.83.5429.491 ms,p=0.003).Additionally,the correlation coefficient in the CHD group was significantly different between the myocardial T2 relaxation time and peak systolic velocity of pulmonary artery on a fetal echocardiogram(r2=0.681,p=0.010).Conclusions:These results suggest that using myocardial alterations in the T2 relaxation time may provide a accurate early warning for myocardial injury and enable noninvasive recognition of cardiac involvement in fetuses with CHD.展开更多
Alzheimer's disease(AD)is a neurodegenerative disease characterized by a progressive decline in cognitive functions.Given that AD undermines the quality of life for millions and has an extended asymptomatic period...Alzheimer's disease(AD)is a neurodegenerative disease characterized by a progressive decline in cognitive functions.Given that AD undermines the quality of life for millions and has an extended asymptomatic period,exploring the full AD pathogenesis and seeking the optimal therapeutic solution have become critical and imperative.This allows researchers to intervene,delay,and potentially prevent AD progression.Several clinical imaging methods are utilized routinely to diagnose and monitor AD,such as magnetic resonance imaging(MRI),functional magnetic resonance imaging(fMRI),positron emission tomography(PET),and single photon emission computed tomography(SPECT).Nevertheless,due to their intrinsic drawbacks and restrictions,such as radiation concerns,high cost,long acquisition time,and low spatial resolution,their applications in AD research are limited,especially at the cellular and molecular levels.In contrast,optical microscopic imaging methods overcome these limitations,offering researchers a variety of approaches with distinct advantages to explore AD pathology on diverse models.In this review,we provide a comprehensive overview of commonly utilized optical microscopic imaging techniques in AD research and introduce their contributions to image amyloid beta(Aβ)species.These techniques include fluorescence microscopy(FM),confocal microscopy(CM),two-photon fluorescence microscopy(TPFM),super-resolution microscopy(SRM),expansion microscopy(ExM),and light-sheet fluorescence microscopy(LSFM).In addition,we introduce some related topics,such as the development of near-infrared(NIR)Aβprobes,the Aβplaque hypothesis,and Aβoligomer hypothesis,and the roles of microglia and astrocytes in AD progression.We believe optical microscopic imaging methods continue to play an indispensable role in deciphering the full pathogenesis of AD and advancing therapeutic strategies.展开更多
Advances in fetal surgery techniques have enabled the treatment of certain congenital defects before birth.A critical area of focus is the role of perinatal imaging in optimizing prenatal interventions within the prec...Advances in fetal surgery techniques have enabled the treatment of certain congenital defects before birth.A critical area of focus is the role of perinatal imaging in optimizing prenatal interventions within the precision medicine framework.Magnetic resonance imaging(MRI)is emerging as an indispensable tool for guiding these intricate procedures with the potential to significantly enhance the standard of care and outcomes for affected fetuses.This review begins with an overview of the classification and indications for fetal surgical interventions.It then explores the detailed applications of prenatal MRI scanning and diagnostic techniques across various categories of fetal surgery.A key focus is how fetal MRI provides critical insights into specific lesion characteristics and tissue involvement,thereby aiding healthcare professionals in selecting the optimal surgical strategies for prenatal and postnatal interventions.Fetal MRI offers detailed visualizations that complement traditional ultra-sound findings,enhancing the precision of radiological planning for fetal surgery.Finally,the review highlights how integration of fetal MRI into the decision-making process enables healthcare providers to make well-informed choices,ultimately improving the prognosis and outcomes for both the mother and fetus.展开更多
Background:Congenital hepatic hemangioma(CHH)is a rare benign vascular tumor that occurs prenatally.However,only a few cases have been summarized and evaluated for the prenatal and postnatal imaging features of CHH,an...Background:Congenital hepatic hemangioma(CHH)is a rare benign vascular tumor that occurs prenatally.However,only a few cases have been summarized and evaluated for the prenatal and postnatal imaging features of CHH,and no studies have conducted long-term follow-up on it.This study aimed to explore the ultrasound and magnetic resonance features,growth patterns,and clinical outcomes of CHH.Methods:Thirty-six pregnancies with a prenatal fetal diagnosis and postnatal diagnosis of CHH were studied.CHHs were grouped into those with a diameter≥4 cm and those with a diameter<4 cm according to the largest diameter.Fisher's exact test was used to compare the imaging characteristics between the groups.The volume of CHHs was measured at each follow-up visit to plot the growth pattern of the tumors,and the volume of CHHs was compared before and after birth using a rank sum test analysis.Results:Thirty-three cases of CHHs were confirmed by postnatal imaging,and three were confirmed by a biopsy.Mixed echoes were more common in the diameter≥4 cm group than in the diameter<4 cm group(p=0.026).Complications were more likely to occur in the large-diameter group.Eighteen(54.5%)cases were classified as rapidly involuting congenital hemangioma,nine(27.3%)as partially involuting congenital hemangioma,and two(6.1%)as noninvoluting congenital hemangioma.A new type of CHH was identified in which four(12.1%)cases continued to proliferate after birth and spontaneously subsided in subsequent months.The CHH volume decreased with age and was significantly decreased at 9 months postnatal compared to birth(p=0.001).Conclusion:This study showed the imaging features of CHH were associated with the lesion size.Based on postnatal follow-up,a new type of CHH was identified.If there are no complications at birth in CHH cases,a good prognosis is indicated.展开更多
A 28-year-old pregnant woman with no prior obstetric complications had a normal prenatal workup before 24 weeks'gestation.At 24 weeks,ultrasound revealed gastrointestinal malformations,a persistent left superior v...A 28-year-old pregnant woman with no prior obstetric complications had a normal prenatal workup before 24 weeks'gestation.At 24 weeks,ultrasound revealed gastrointestinal malformations,a persistent left superior vena cava,and polyhydramnios.展开更多
A 35-year-old woman with a history of regular menstruation presented with a positive urine pregnancy test and elevated blood human chorionic gonadotropin concentrations.Color Doppler ultrasound showed multiple slightl...A 35-year-old woman with a history of regular menstruation presented with a positive urine pregnancy test and elevated blood human chorionic gonadotropin concentrations.Color Doppler ultrasound showed multiple slightly hyperechoic areas within the uterine cavity.She was admitted to the hospital with a preliminary outpatient diagnosis of“suspected molar pregnancy,pending further evaluation.”展开更多
A pregnant woman underwent fetal brain magnetic resonance imaging(MRI)following ultrasound detection of a posterior fossa cyst at 29 weeks'gestation.She presented with no relevant medical history and underwent a r...A pregnant woman underwent fetal brain magnetic resonance imaging(MRI)following ultrasound detection of a posterior fossa cyst at 29 weeks'gestation.She presented with no relevant medical history and underwent a routine obstetric examination during pregnancy.The fetal head position,fetal cranial development,and limb development remained normal until 29 weeks.展开更多
Positron emission tomography/magnetic resonance imaging(PET/MRI)combines the advantages of both imaging modalities.PET/MRI demonstrates superior performance in the evaluation of the therapeutic impact,staging,diagnosi...Positron emission tomography/magnetic resonance imaging(PET/MRI)combines the advantages of both imaging modalities.PET/MRI demonstrates superior performance in the evaluation of the therapeutic impact,staging,diagnosis,and treatment planning of malignancies because of its lower radiation dose,higher contrast for soft tissues,and multiparametric functional imaging.^(18)F-fluorodeoxyglucose PET/MRI has demonstrated considerable potential in the assessment of pelvic malignancies.This review briefly describes the evolution of PET/MRI imaging technology and compares the application of PET/MRI in five common pelvic tumors,including endometrial cancer,cervical cancer,ovarian cancer,prostate cancer,and bladder cancer,with that of PET/computed tomography.Additionally,radiotracers other than^(18)F-fluorodeoxyglucose have been introduced for use in pelvic tumors.The development and application of these new tracers further enhance the clinical application of PET/MRI in precision medicine for pelvic malignant cancers.Overall,this review revealed the unique contribution of PET/MRI as a promising diagnostic instrument in the management of pelvic tumors,demonstrating its important position in future clinical practice.展开更多
Background:Convolutional neural networks(CNN)have achieved remarkable success in medical image analysis.However,unlike some general-domain tasks where model accuracy is paramount,medical applications demand both accur...Background:Convolutional neural networks(CNN)have achieved remarkable success in medical image analysis.However,unlike some general-domain tasks where model accuracy is paramount,medical applications demand both accuracy and explainability due to the high stakes affecting patients'lives.Based on model explanations,clinicians can evaluate the diagnostic decisions suggested by CNN.Nevertheless,prior explainable artificial intelligence methods treat medical image tasks akin to general vision tasks,following end-to-end paradigms to generate explanations and frequently overlooking crucial clinical domain knowledge.Methods:We propose a plug-and-play module that explicitly integrates anatomic boundary information into the explanation process for CNN-based thoracopathy classifiers.To generate the anatomic boundary of the lung parenchyma,we utilize a lung segmentation model developed on external public datasets and deploy it on the unseen target dataset to constrain model ex-planations within the lung parenchyma for the clinical task of thoracopathy classification.Results:Assessed by the intersection over union and dice similarity coefficient between model-extracted explanations and expert-annotated lesion areas,our method consistently outperformed the baseline devoid of clinical domain knowledge in 71 out of 72 scenarios,encompassing 3 CNN architectures(VGG-11,ResNet-18,and AlexNet),2 classification settings(binary and multi-label),3 explanation methods(Saliency Map,Grad-CAM,and Integrated Gradients),and 4 co-occurred thoracic diseases(Atelectasis,Fracture,Mass,and Pneumothorax).Conclusions:We underscore the effectiveness of leveraging radiology knowledge in improving model explanations for CNN and envisage that it could inspire future efforts to integrate clinical domain knowledge into medical image analysis.展开更多
Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis trea...Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis treated with stereotactic radio-surgery(SRS)and quantifies their radiomic quality score(RQS).A systematic search on Scopus,Web of Science,and PubMed was conducted to identify original studies on radiomics for predicting treatment response,adhering to predefined patient,intervention,comparator,and outcome(PICO)criteria.No restrictions were placed on language or publication date.Two in-dependent reviewers assessed eligible studies,and the RQS was calculated based on Lambin’s guidelines.The Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guidelines were followed.Seventeen studies involving 2744 patients met the inclusion criteria out of 200 identified.All studies were retrospective and utilizing various MRI scanners models with different field strength.The average RQS across studies was low(39.2%),with a maximum score of 19 points(52.7%).Radiomic-based models demonstrated superior predictive accuracy compared to clinical or visual assessment,with AUC values ranging from 0.74 to 0.92.Integration of clinical features such as Karnofsky performance status,dose,and isodose line further improved model performance.Deep learning models achieved the highest predictive accuracy,with AUC of 0.92.Radiomics demonstrate significant potential in predicting treatment outcomes with high accuracy,offering opportunities to advance personalized management for BM.To facilitate clinical adoption,future studies must prioritize adherence to standardized guidelines and robust model validation to ensure reproducibility.展开更多
A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally ...A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.展开更多
As a doctor,being away from patients is like being a fish out of water.As long as I have breath,I will do something for my patients.-Life motto of Dr.Zijiang Liu As a pioneer and founder of interventional radiology in...As a doctor,being away from patients is like being a fish out of water.As long as I have breath,I will do something for my patients.-Life motto of Dr.Zijiang Liu As a pioneer and founder of interventional radiology in China,Professor Zijiang Liu(1925-2003)paved new pathways for disciplinary construction and clinical practice in this field.Professor Liu brought hope to countless patients with his exceptional wisdom and outstanding dedication.Born in Shaoxing,Zhejiang Province,on 4 October 1925,Professor Liu was inspired to pursue a career in medicine after suffering from tuberculosis in his youth.展开更多
Ultrasmall superparamagnetic iron oxide nanoparticles(usSPIONs)are promising alternatives to gadolinium‐based contrast agents for positive contrast enhancement in magnetic resonance imaging(MRI).Unlike larger SPIONs ...Ultrasmall superparamagnetic iron oxide nanoparticles(usSPIONs)are promising alternatives to gadolinium‐based contrast agents for positive contrast enhancement in magnetic resonance imaging(MRI).Unlike larger SPIONs that primarily function as T2/T2*negative contrast agents,usSPIONs with core diameters below 5 nm can effectively shorten T1 relaxation times,producing bright signals in T1‐weighted images.This distinct behavior stems from their unique magnetic properties,including single‐domain configurations,surface spin canting,and rapid Néel relaxation dynamics,which are particularly enhanced at low magnetic field strengths.The biocompatibility of iron oxide,efficient renal clearance pathways,and versatility for surface functionalization offer potential advantages over gadolinium‐based agents,especially regarding safety concerns related to nephrogenic systemic fibrosis and gadolinium deposition.These nanoparticles show particular promise for applications in lowfield MRI,vascular imaging,targeted molecular imaging,and theranostic platforms.Although challenges remain in optimizing synthesis methods for consistent production of monodisperse usSPIONs with tailored surface chemistry,ongoing research continues to advance their potential for clinical translation.This review explores the mechanisms,synthesis approaches,applications,and future perspectives of usSPIONs as positive contrast agents in MRI.展开更多
A 21-year-old woman presented with a left-hand deformity that had been present since birth.She had no clear family or genetic history.Physical examination revealed absence of the left metacarpal phalanges and four sof...A 21-year-old woman presented with a left-hand deformity that had been present since birth.She had no clear family or genetic history.Physical examination revealed absence of the left metacarpal phalanges and four soft tissue bulges at the distal end of the wrist(Figure 1a).Digital radiography showed fusion of the lunate and triangular bones of the left wrist,fusion of the scaphoid with the distal row of carpal bones,and an irregular bone with an uneven distal margin.展开更多
文摘Background:We aimed to study physician attitudes toward ultrasound-guided procedures and possible improvements.We hypothesized that the usage of ultrasound in procedures may be limited by a high barrier of entry and that most physicians would choose to adopt software that provides real-time image guidance if accessible.Methods:A voluntary,cross-sectional survey of physicians at a single site was conducted using a five-point Likert scale.Data analysis included both descriptive and inferential statistical analyses and stratified by categorical descriptors,including variables of formal training,years of experience,and specialty of practice.Results:One hundred sixteen physicians responded to the survey.The majority disagreed that there was a steep learning curve(57.5%)and that they need more time to identify structures under ultrasound(85.0%).Overall attitudes were mixed about the use of additional software to improve ease of use,but most(55.4%)had positive opinions toward the addition of real-time 3D reconstruction.Respondents without formal training were significantly more likely to agree that additional software would improve ease of ultrasound-guided procedures(p=0.0389).Radiologists were significantly more likely to perceive a steeper learning curve and less likely to advocate for supplemental software compared to emergency medicine physicians,surgeons,or anesthesiologists.Conclusions:Surveyed physicians demonstrated comfort with ultrasound-guided procedures and a mixed stance toward the use of additional software to assist with procedures.Those without formal training had significantly more positive attitudes toward the use of additional technology to augment ultrasound-guided procedures,suggesting a knowledge gap that may benefit from such technology.
文摘In recent decades,maternal–fetal medicine has undergone substantial advancements in the management of high-risk pregnancies.These include enhanced prenatal screening and diagnosis facilitated by innovations in ultrasound imaging,as well as the advances in fetal medical and interventional therapies informed by the deeper understanding of pathophysiological mechanisms underlying fetal and maternal disease processes.
基金supported by China Society for Maternal and Child Health Research(Gant/Award Number:2023CAMCHS003A17).
文摘Background:Magnetic resonance spectroscopy(MRS)represents a significant advancement in the noninvasive assessment of brain metabolism.MRS can provide valuable metabolic information and facilitate more accurate diagnoses of intrauterine fetal brain development than was previously possible.To obtain information regarding normal intrauterine fetal brain metabolism and to establish gestational age-specific reference values for normal fetal brain metabolites for subsequent use in MRS,we conducted MRS scans of normal fetal brains during mid-to late-term pregnancies,along with related processing.Methods:In this prospective study,MRS scans were conducted on 109 fetuses,with a total of 54 normal fetal brains enrolled on the basis of specific inclusion and exclusion criteria.We analyzed metabolic ratios,including the sum of N-acetylaspartate(NAA)and total N-acetylaspartate(tNAA),total choline(tCho),inositol(Ins),and total creatine(tCr),in relation to gestational age.Results:Gestational age was significantly correlated with specific metabolic ratios(Ins/tCr:r=-0.75,p<0.0001;tCho/tCr:r=-0.50,p<0.0001),especially tNAA/tCho(tNAA/tCho:r=0.54,p<0.0001)and tNAA/Ins(r=0.56,p<0.0001),providing a baseline for fetal brain metabolic assessment.Linear regression analysis was used to calculate regression lines for fetal brain metabolite ratios.Slopes were tested at p of 0.05.Conclusions:The current findings confirmed a significant correlation between fetal brain metabolites and gestational age,supporting the feasibility of establishing standard values for these metabolites in fetal brain assessment.
基金supported by the National Natural Science Foundation of China(82171908 and 82102015)the General Project of the Nanjing Medical Science and Technology Development Program(YKK21075)the Guangdong Basic and Applied Basic Research Foundation(No.2023A1515140030).
文摘Background:Platinum can cause chemotherapy-related cognitive impairment.Low-intensity focused ultrasound(LIFUS)is a promising noninvasive physical stimulation method with a unique advantage in neurological rehabilitation.We aimed to investigate whether LIFUS can alleviate cisplatin-induced cognitive impairment in rats and explore the related neuropatho-logical mechanisms.Methods:After confirming the target position for LIFUS treatment in 18 rats,64 rats were randomly divided into four groups:control,model,sham,and LIFUS groups.Before and after LIFUS treatment,detailed biological behavioral assessments and magnetic resonance imaging were performed.Finally,the rats were euthanized,and relevant histopathological and molecular biological experiments were conducted and analyzed.Results:In the Morris water maze,the model group showed fewer platform crossings(1.250.93 vs.5.691.58),a longer escape latency(41.6536.55 s vs.6.382.11 s),and a lower novel object recognition index(29.7711.83 vs.83.695.67)than the control group.LIFUS treatment improved these metrics,with more platform crossings(3.130.34),a higher recognition index(65.588.71),and a shorter escape latency(6.452.27 s).Longitudinal analysis of the LIFUS group further confirmed these improvements.Neuroimaging revealed significant differences in diffusion tensor imaging metrics of specific brain regions pre-and post-LIFUS.Moreover,neuropathology showed higher dendritic spine density,less myelin loss,fewer apoptotic cells,more synapses,and less mitochondrial autophagy after LIFUS treatment.The neuroimaging indicators were correlated with behavioral improvements,highlighting the potential of LIFUS for alleviating cognitive impairment(as demonstrated through imaging and analysis).Our investigation of the molecular biological mechanisms revealed distinct protein expression patterns in the hippocampus and its subregions.In the model group,glial fibrillary acidic protein(GFAP)and ionized calcium-binding adaptor molecule 1(IBA1)expression levels were elevated across the hippocampus,whereas neuronal nuclei(NeuN)expression was reduced.Subregional analysis revealed higher GFAP and IBA1 and lower NeuN,especially in the dentate gyrus subregion.Moreover,positive cell areas were larger in the cornu ammonis(CA)1,CA2,CA3,and dentate gyrus regions.In the CA2 and CA3,significant differences among the groups were observed in GFAP-positive cell counts and areas,and there were variations in NeuN expression.Conclusions:Our results suggest that LIFUS can reverse cisplatin-induced cognitive impairments.The neuroimaging findings were consistent with the behavioral and histological results and suggest a neuropathological basis that supports further research into the clinical applications of LIFUS.Furthermore,LIFUS appeared to enhance the plasticity of neuronal synapses in the rat hippocampus and reduce hippocampal inflammation.These findings highlight the clinical potential of LIFUS as an effective,noninvasive therapeutic strategy and monitoring tool for chemotherapy-induced cognitive deficits.
文摘Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.
基金supported by the Medical Innovation Research Special Project of Science and Technology Commission of Shanghai Municipality(Grant/Award Number:23Y11907800)Fundamental Research Funds for the Central Universities(Grant/Award Number:YG2023ZD22)Shanghai Key Laboratory of Child Brain and Development(Grant/Award Number:24dz2260100).
文摘Fetal intracranial tumors are rare,accounting for approximately 0.5%–1.9%of all pediatric tumors,though the true incidence may be underestimated.These tumors often present with distinct histopathological features,imaging characteristics,and clinical behavior compared to their postnatal counterparts.This review summarizes the current understanding of the prenatal diagnosis and characterization of fetal brain tumors,with a particular focus on the role of fetal magnetic resonance imaging(MRI).We discuss the advantages of advanced MR sequences in enhancing lesion detection and anatomical delineation following suspicious findings on obstetric ultrasound.Common tumor types encountered in utero—including teratomas,as-trocytomas,medulloblastomas,choroid plexus papillomas,and craniopharyngiomas—are reviewed in terms of imaging fea-tures,differential diagnosis,and clinical implications.Furthermore,the review addresses the diagnostic challenges,prognostic considerations,and the potential role of fetal MRI in guiding perinatal management and parental counseling.
基金supported by Zhejiang Provincial Natural Science Foundation of China(Grant/Award number:ZCLTGY24H0401)Education Department of Zhejiang Province(Grant/Award number:Y202352970).
文摘Background:Congenital heart disease(CHD)results from abnormal heart development during fetal development,leading to life-threatening complications.This study aimed to evaluate the feasibility of applying myocardial parametric mapping in post-mortem magnetic resonance imaging and to examine differences in the left ventricular myocardium between fetuses with CHD and controls.Methods:This prospective case–control study was conducted on 14 deceased fetuses with CHD(CHD group)and 24 fetuses without CHD(control group).Fetuses with CHD were further stratified into the cyanotic(n=9)and non-cyanotic(n=5)CHD groups.T1,T2,and proton density relaxation times of the left ventricular myocardium were calculated and compared using multiple-dynamic multiple-echo post-mortem magnetic resonance imaging technology.Results:The myocardial T2 relaxation time was significantly different between the groups(p=0.033),with no difference in T1 or proton density relaxation times between the groups.A one-way analysis of variance with Tukey's test showed that the mean cyanotic CHD group showed a longer myocardial T2 relaxation time than the control group(98.00013.143 vs.83.5429.491 ms,p=0.003).Additionally,the correlation coefficient in the CHD group was significantly different between the myocardial T2 relaxation time and peak systolic velocity of pulmonary artery on a fetal echocardiogram(r2=0.681,p=0.010).Conclusions:These results suggest that using myocardial alterations in the T2 relaxation time may provide a accurate early warning for myocardial injury and enable noninvasive recognition of cardiac involvement in fetuses with CHD.
基金supported by NIH(R01AG055413),(R01AG085562),(R21AG059134),(R21AG078749),and(S10OD028609)awards(C.R.).NIH Office of the Director,National Institute on Aging.
文摘Alzheimer's disease(AD)is a neurodegenerative disease characterized by a progressive decline in cognitive functions.Given that AD undermines the quality of life for millions and has an extended asymptomatic period,exploring the full AD pathogenesis and seeking the optimal therapeutic solution have become critical and imperative.This allows researchers to intervene,delay,and potentially prevent AD progression.Several clinical imaging methods are utilized routinely to diagnose and monitor AD,such as magnetic resonance imaging(MRI),functional magnetic resonance imaging(fMRI),positron emission tomography(PET),and single photon emission computed tomography(SPECT).Nevertheless,due to their intrinsic drawbacks and restrictions,such as radiation concerns,high cost,long acquisition time,and low spatial resolution,their applications in AD research are limited,especially at the cellular and molecular levels.In contrast,optical microscopic imaging methods overcome these limitations,offering researchers a variety of approaches with distinct advantages to explore AD pathology on diverse models.In this review,we provide a comprehensive overview of commonly utilized optical microscopic imaging techniques in AD research and introduce their contributions to image amyloid beta(Aβ)species.These techniques include fluorescence microscopy(FM),confocal microscopy(CM),two-photon fluorescence microscopy(TPFM),super-resolution microscopy(SRM),expansion microscopy(ExM),and light-sheet fluorescence microscopy(LSFM).In addition,we introduce some related topics,such as the development of near-infrared(NIR)Aβprobes,the Aβplaque hypothesis,and Aβoligomer hypothesis,and the roles of microglia and astrocytes in AD progression.We believe optical microscopic imaging methods continue to play an indispensable role in deciphering the full pathogenesis of AD and advancing therapeutic strategies.
基金supported by Zhejiang Provincial Natural Science Foundation of China(Grant No.ZCLTGY24H0401)Technology Program of Jiaxing(Grant No.2024AD30125).
文摘Advances in fetal surgery techniques have enabled the treatment of certain congenital defects before birth.A critical area of focus is the role of perinatal imaging in optimizing prenatal interventions within the precision medicine framework.Magnetic resonance imaging(MRI)is emerging as an indispensable tool for guiding these intricate procedures with the potential to significantly enhance the standard of care and outcomes for affected fetuses.This review begins with an overview of the classification and indications for fetal surgical interventions.It then explores the detailed applications of prenatal MRI scanning and diagnostic techniques across various categories of fetal surgery.A key focus is how fetal MRI provides critical insights into specific lesion characteristics and tissue involvement,thereby aiding healthcare professionals in selecting the optimal surgical strategies for prenatal and postnatal interventions.Fetal MRI offers detailed visualizations that complement traditional ultra-sound findings,enhancing the precision of radiological planning for fetal surgery.Finally,the review highlights how integration of fetal MRI into the decision-making process enables healthcare providers to make well-informed choices,ultimately improving the prognosis and outcomes for both the mother and fetus.
文摘Background:Congenital hepatic hemangioma(CHH)is a rare benign vascular tumor that occurs prenatally.However,only a few cases have been summarized and evaluated for the prenatal and postnatal imaging features of CHH,and no studies have conducted long-term follow-up on it.This study aimed to explore the ultrasound and magnetic resonance features,growth patterns,and clinical outcomes of CHH.Methods:Thirty-six pregnancies with a prenatal fetal diagnosis and postnatal diagnosis of CHH were studied.CHHs were grouped into those with a diameter≥4 cm and those with a diameter<4 cm according to the largest diameter.Fisher's exact test was used to compare the imaging characteristics between the groups.The volume of CHHs was measured at each follow-up visit to plot the growth pattern of the tumors,and the volume of CHHs was compared before and after birth using a rank sum test analysis.Results:Thirty-three cases of CHHs were confirmed by postnatal imaging,and three were confirmed by a biopsy.Mixed echoes were more common in the diameter≥4 cm group than in the diameter<4 cm group(p=0.026).Complications were more likely to occur in the large-diameter group.Eighteen(54.5%)cases were classified as rapidly involuting congenital hemangioma,nine(27.3%)as partially involuting congenital hemangioma,and two(6.1%)as noninvoluting congenital hemangioma.A new type of CHH was identified in which four(12.1%)cases continued to proliferate after birth and spontaneously subsided in subsequent months.The CHH volume decreased with age and was significantly decreased at 9 months postnatal compared to birth(p=0.001).Conclusion:This study showed the imaging features of CHH were associated with the lesion size.Based on postnatal follow-up,a new type of CHH was identified.If there are no complications at birth in CHH cases,a good prognosis is indicated.
基金supported by the Natural Science Foundation of Zhejiang Province(Grant number:LGF22H040003).
文摘A 28-year-old pregnant woman with no prior obstetric complications had a normal prenatal workup before 24 weeks'gestation.At 24 weeks,ultrasound revealed gastrointestinal malformations,a persistent left superior vena cava,and polyhydramnios.
文摘A 35-year-old woman with a history of regular menstruation presented with a positive urine pregnancy test and elevated blood human chorionic gonadotropin concentrations.Color Doppler ultrasound showed multiple slightly hyperechoic areas within the uterine cavity.She was admitted to the hospital with a preliminary outpatient diagnosis of“suspected molar pregnancy,pending further evaluation.”
基金supported by China Society for Maternal and Child Health Research(Grant/Award Number:2023CAMCHS003A17).
文摘A pregnant woman underwent fetal brain magnetic resonance imaging(MRI)following ultrasound detection of a posterior fossa cyst at 29 weeks'gestation.She presented with no relevant medical history and underwent a routine obstetric examination during pregnancy.The fetal head position,fetal cranial development,and limb development remained normal until 29 weeks.
基金supported by the National Natural Science Foundation of China(Grant/Award Numbers:82272043,U24A20758,82171987,82402333)the Basic Science Project of the Educational Department of Liaoning Province(Grant/Award Number:LJ232410159018).
文摘Positron emission tomography/magnetic resonance imaging(PET/MRI)combines the advantages of both imaging modalities.PET/MRI demonstrates superior performance in the evaluation of the therapeutic impact,staging,diagnosis,and treatment planning of malignancies because of its lower radiation dose,higher contrast for soft tissues,and multiparametric functional imaging.^(18)F-fluorodeoxyglucose PET/MRI has demonstrated considerable potential in the assessment of pelvic malignancies.This review briefly describes the evolution of PET/MRI imaging technology and compares the application of PET/MRI in five common pelvic tumors,including endometrial cancer,cervical cancer,ovarian cancer,prostate cancer,and bladder cancer,with that of PET/computed tomography.Additionally,radiotracers other than^(18)F-fluorodeoxyglucose have been introduced for use in pelvic tumors.The development and application of these new tracers further enhance the clinical application of PET/MRI in precision medicine for pelvic malignant cancers.Overall,this review revealed the unique contribution of PET/MRI as a promising diagnostic instrument in the management of pelvic tumors,demonstrating its important position in future clinical practice.
文摘Background:Convolutional neural networks(CNN)have achieved remarkable success in medical image analysis.However,unlike some general-domain tasks where model accuracy is paramount,medical applications demand both accuracy and explainability due to the high stakes affecting patients'lives.Based on model explanations,clinicians can evaluate the diagnostic decisions suggested by CNN.Nevertheless,prior explainable artificial intelligence methods treat medical image tasks akin to general vision tasks,following end-to-end paradigms to generate explanations and frequently overlooking crucial clinical domain knowledge.Methods:We propose a plug-and-play module that explicitly integrates anatomic boundary information into the explanation process for CNN-based thoracopathy classifiers.To generate the anatomic boundary of the lung parenchyma,we utilize a lung segmentation model developed on external public datasets and deploy it on the unseen target dataset to constrain model ex-planations within the lung parenchyma for the clinical task of thoracopathy classification.Results:Assessed by the intersection over union and dice similarity coefficient between model-extracted explanations and expert-annotated lesion areas,our method consistently outperformed the baseline devoid of clinical domain knowledge in 71 out of 72 scenarios,encompassing 3 CNN architectures(VGG-11,ResNet-18,and AlexNet),2 classification settings(binary and multi-label),3 explanation methods(Saliency Map,Grad-CAM,and Integrated Gradients),and 4 co-occurred thoracic diseases(Atelectasis,Fracture,Mass,and Pneumothorax).Conclusions:We underscore the effectiveness of leveraging radiology knowledge in improving model explanations for CNN and envisage that it could inspire future efforts to integrate clinical domain knowledge into medical image analysis.
文摘Radiomics and machine learning(ML)are increasingly utilized to predict treatment response by uncovering latent information in medical images.This study systematically reviews radiomics studies on brain metastasis treated with stereotactic radio-surgery(SRS)and quantifies their radiomic quality score(RQS).A systematic search on Scopus,Web of Science,and PubMed was conducted to identify original studies on radiomics for predicting treatment response,adhering to predefined patient,intervention,comparator,and outcome(PICO)criteria.No restrictions were placed on language or publication date.Two in-dependent reviewers assessed eligible studies,and the RQS was calculated based on Lambin’s guidelines.The Preferred Reporting Items for Systematic Review and Meta-Analysis(PRISMA)2020 guidelines were followed.Seventeen studies involving 2744 patients met the inclusion criteria out of 200 identified.All studies were retrospective and utilizing various MRI scanners models with different field strength.The average RQS across studies was low(39.2%),with a maximum score of 19 points(52.7%).Radiomic-based models demonstrated superior predictive accuracy compared to clinical or visual assessment,with AUC values ranging from 0.74 to 0.92.Integration of clinical features such as Karnofsky performance status,dose,and isodose line further improved model performance.Deep learning models achieved the highest predictive accuracy,with AUC of 0.92.Radiomics demonstrate significant potential in predicting treatment outcomes with high accuracy,offering opportunities to advance personalized management for BM.To facilitate clinical adoption,future studies must prioritize adherence to standardized guidelines and robust model validation to ensure reproducibility.
文摘A 31-year-old woman with untreated hypertension presented with a progressively worsening occipital headache for 3 months.In the last 4 days,she developed a pulsating holocranial headache that awakened her nocturnally and worsened with Valsalva maneuver.Neurological examination revealed no focal deficits.The patient reported decreased visual acuity,and fundoscopic examination demonstrated grade III hypertensive retinopathy,but no optic disc edema.Blood pressure was 230/160 mmHg and laboratory analysis showed elevated serum creatinine(3.42 mg/dL).Autoimmune and infectious markers were negative.
文摘As a doctor,being away from patients is like being a fish out of water.As long as I have breath,I will do something for my patients.-Life motto of Dr.Zijiang Liu As a pioneer and founder of interventional radiology in China,Professor Zijiang Liu(1925-2003)paved new pathways for disciplinary construction and clinical practice in this field.Professor Liu brought hope to countless patients with his exceptional wisdom and outstanding dedication.Born in Shaoxing,Zhejiang Province,on 4 October 1925,Professor Liu was inspired to pursue a career in medicine after suffering from tuberculosis in his youth.
文摘Ultrasmall superparamagnetic iron oxide nanoparticles(usSPIONs)are promising alternatives to gadolinium‐based contrast agents for positive contrast enhancement in magnetic resonance imaging(MRI).Unlike larger SPIONs that primarily function as T2/T2*negative contrast agents,usSPIONs with core diameters below 5 nm can effectively shorten T1 relaxation times,producing bright signals in T1‐weighted images.This distinct behavior stems from their unique magnetic properties,including single‐domain configurations,surface spin canting,and rapid Néel relaxation dynamics,which are particularly enhanced at low magnetic field strengths.The biocompatibility of iron oxide,efficient renal clearance pathways,and versatility for surface functionalization offer potential advantages over gadolinium‐based agents,especially regarding safety concerns related to nephrogenic systemic fibrosis and gadolinium deposition.These nanoparticles show particular promise for applications in lowfield MRI,vascular imaging,targeted molecular imaging,and theranostic platforms.Although challenges remain in optimizing synthesis methods for consistent production of monodisperse usSPIONs with tailored surface chemistry,ongoing research continues to advance their potential for clinical translation.This review explores the mechanisms,synthesis approaches,applications,and future perspectives of usSPIONs as positive contrast agents in MRI.
文摘A 21-year-old woman presented with a left-hand deformity that had been present since birth.She had no clear family or genetic history.Physical examination revealed absence of the left metacarpal phalanges and four soft tissue bulges at the distal end of the wrist(Figure 1a).Digital radiography showed fusion of the lunate and triangular bones of the left wrist,fusion of the scaphoid with the distal row of carpal bones,and an irregular bone with an uneven distal margin.
