Semantic image synthesis aims to generate highquality images given semantic conditions,i.e.,segmentation masks and style reference images.Existing methods widely adopt generative adversarial networks(GANs).GANs take a...Semantic image synthesis aims to generate highquality images given semantic conditions,i.e.,segmentation masks and style reference images.Existing methods widely adopt generative adversarial networks(GANs).GANs take all conditional inputs and directly synthesize images in a single forward step.In this paper,semantic image synthesis is treated as an image denoising task and is handled with a novel image-to-image diffusion model(IIDM).展开更多
Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle...Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle to accurately capture microstructural changes.Various diffusion models have been used to study white matter in systemic lupus erythematosus;however,comparative analyses of their sensitivity and specificity for detecting microstructural changes remain insufficient.To address this,our team designed a diagnostic trial that used multimodal diffusion imaging techniques to observe white matter microstructural changes in patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with an aim to identify key diagnostic biomarkers for these patients.Patients with active lupus who received treatment at the Department of Rheumatology and Immunology,The First Affiliated Hospital of China Medical University,from September 2023 to March 2024 were recruited.According to the standards of the American College of Rheumatology,patients with systemic lupus erythematosus who had neuropsychiatric symptoms were assigned to the systemic lupus erythematosus group,whereas those without neuropsychiatric symptoms were assigned to the non-systemic lupus erythematosus group.Additionally,healthy volunteers matched by region,sex,and age were recruited as controls.All three groups underwent the same diffusion magnetic resonance imaging examination protocol to compare differences in diffusion parameters.Advanced diffusion imaging models were able to sensitively detect microstructural changes in the white matter fibers of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with specific diffusion parameters showing significant abnormalities in key brain regions.In the left superior longitudinal fasciculus subregion and the right thalamic radiations of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,we also identified abnormal diffusion characteristics that were clearly correlated with disease activity,suggesting that microstructural changes in these areas may reflect the dynamic process of neuroinflammatory damage.The present study addresses critical challenges in the diagnosis of systemic lupus erythematosus by identifying specific white matter imaging biomarkers and elucidating the association between microstructural damage and clinical manifestations.The main contributions of our study include:1)establishing axial regression probability parameters from mean apparent propagator magnetic resonance imaging as sensitive biomarkers for systemic lupus erythematosus,particularly in the third subregion of the left superior longitudinal fasciculus;2)demonstrating that multimodal diffusion imaging may be superior to conventional diffusion tensor imaging for detecting white matter microstructural abnormalities in patients with systemic lupus erythematosus;and 3)integrating tract-based spatial statistics with clinically relevant analyses to link imaging findings to pathological mechanisms.展开更多
Three high dimensional spatial standardization algorithms are used for diffusion tensor image(DTI)registration,and seven kinds of methods are used to evaluate their performances.Firstly,the template used in this paper...Three high dimensional spatial standardization algorithms are used for diffusion tensor image(DTI)registration,and seven kinds of methods are used to evaluate their performances.Firstly,the template used in this paper was obtained by spatial transformation of 16 subjects by means of tensor-based standardization.Then,high dimensional standardization algorithms for diffusion tensor images,including fractional anisotropy(FA)based diffeomorphic registration algorithm,FA based elastic registration algorithm and tensor-based registration algorithm,were performed.Finally,7 kinds of evaluation methods,including normalized standard deviation,dyadic coherence,diffusion cross-correlation,overlap of eigenvalue-eigenvector pairs,Euclidean distance of diffusion tensor,and Euclidean distance of the deviatoric tensor and deviatoric of tensors,were used to qualitatively compare and summarize the above standardization algorithms.Experimental results revealed that the high-dimensional tensor-based standardization algorithms perform well and can maintain the consistency of anatomical structures.展开更多
Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 3...Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient(ADC) and exponential ADC(eADC) of regions of interest(ROIs) were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans(P>0.05).Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.展开更多
To denoise the diffusion weighted images （DWls） featured as multi-boundary, which was very important for the calculation of accurate DTIs （diffusion tensor magnetic resonance imaging）, a modified Wiener filter was...To denoise the diffusion weighted images （DWls） featured as multi-boundary, which was very important for the calculation of accurate DTIs （diffusion tensor magnetic resonance imaging）, a modified Wiener filter was proposed. Through analyzing the widely accepted adaptive Wiener filter in image denoising fields, which suffered from annoying noise around the edges of DWIs and in turn greatly affected the denoising effect of DWIs, a local-shift method capable of overcoming the defect of the adaptive Wiener filter was proposed to help better denoising DWIs and the modified Wiener filter was constructed accordingly. To verify the denoising effect of the proposed method, the modified Wiener filter and adaptive Wiener filter were performed on the noisy DWI data, respectively, and the results of different methods were analyzed in detail and put into comparison. The experimental data show that, with the modified Wiener method, more satisfactory results such as lower non-positive tensor percentage and lower mean square errors of the fractional anisotropy map and trace map are obtained than those with the adaptive Wiener method, which in turn helps to produce more accurate DTIs.展开更多
The existence of a global minimizer for a variational problem arising in registration of diffusion tensor images is proved, which ensures that there is a regular spatial transformation for the registration of diffusio...The existence of a global minimizer for a variational problem arising in registration of diffusion tensor images is proved, which ensures that there is a regular spatial transformation for the registration of diffusion tensor images.展开更多
BACKGROUND： Limbic encephalitis is a rare syndrome that specifically affects the limbic system. Magnetic resonance imaging （MRI） has been typically used to detect brain changes in this disease. However, the mechani...BACKGROUND： Limbic encephalitis is a rare syndrome that specifically affects the limbic system. Magnetic resonance imaging （MRI） has been typically used to detect brain changes in this disease. However, the mechanisms of limbic encephalitis-related white matter damage remain poorly understood. OBJECTIVE： To characterize white matter connectivity changes secondary to injuries of the limbic system in limbic encephalitis through combined application of diffusion tensor imaging （DTI） and voxel-based morphometry. DESIGN, TIME AND SETTING： A non-randomized, controlled, clinical, neuroimaging, DTI study was performed at the Department of Radiology, West China Hospital in December 2008. PARTICIPANTS： A male, 46-year-old, limbic encephalitis patient, as well as 11 age- and gender-matched healthy volunteers, were enrolled in the present study. METHODS： MRI was performed on the limbic encephalitis patient using a 3.0T MR scanner. Three-dimensional SPGR Tl-weighted images and DTI were acquired in the patient and controls. Data were analyzed using Matlab 7.0 and SPM2 software. MAIN OUTCOME MEASURES： Results from routine MRI scan with contrast enhancement of patient, as well as fractional anisotropy and mean diffusivity value map differences between patient and controls. RESULTS： Significant symmetric MRI signal intensity abnormalities were observed with routine MRI Affected bilateral hippocampi and amygdala exhibited hypointense signals in TIWI and hyperintense signals in T2 images. The DTI study revealed decreased fractional anisotropy values in the bilateral alveus and fimbria of the hippocampus, bilateral internal and external capsules, white matter of the right prefrontal area, and left corona radiate in the patient compared with normal controls （P 〈 0.001） Significantly increased fractional anisotropy, mean diffusivity, or decreased mean diffusivity were not observed in the patient, compared with controls. CONCLUSION： Secondary white matter damage to the hippocampal afveus and fimbria was apparent in the limbic encephalitis patient. In addition, other white matter fiber injuries surrounded the limbic structures, which were not attributed to secondary limbic system injuries.展开更多
The human brain is known to contain a maximum of eight cholinergic nuclei： the basal forebrain region： the medial septal nucleus （Ch 1）, the vertical nucleus of the diagonal band （Ch 2）, the horizontal limb of t...The human brain is known to contain a maximum of eight cholinergic nuclei： the basal forebrain region： the medial septal nucleus （Ch 1）, the vertical nucleus of the diagonal band （Ch 2）, the horizontal limb of the diago- nal band （Ch 3）, and the nucleus basalis of Meynert （Ch 4）; the brainstem： the pedunculopontine nucleus （Ch 5）, the laterodorsal tegmental nucleus （Ch 6）, and the para- bigeminal nucleus （Ch 8）; and the thalamus： the medial habenular nucleus （Ch 7） （Nieuwenhuys et al., 2008; Naidich and Duvernoy, 2009）. The cingulum is the neu- ral tract extending from the orbitofrontal cortex to the medial temporal lobe （Mufson and Pandya, 1984）. The cingulum plays an important role in memory because it is a passage of the medial cholinergic pathway, which pro- vides cholinergic innervations to the cerebral cortex after originating from Ch 1 and Ch 2 as well as Ch 4 （mainly） （Selden et al., 1998; Nieuwenhuys et al., 2008; Hong and lang, 2010）.展开更多
The Rician noise introduced into the diffusion tensor images （DTIs） can bring serious impacts on tensor calculation and fiber tracking. To decrease the effects of the Rician noise, we propose to consider the wavelet...The Rician noise introduced into the diffusion tensor images （DTIs） can bring serious impacts on tensor calculation and fiber tracking. To decrease the effects of the Rician noise, we propose to consider the wavelet-based diffusion method to denoise multiehannel typed diffusion weighted （DW） images. The presented smoothing strategy, which utilizes anisotropic nonlinear diffusion in wavelet domain, successfully removes noise while preserving both texture and edges. To evaluate quantitatively the efficiency of the presented method in accounting for the Rician noise introduced into the DW images, the peak-to-peak signal-to-noise ratio （PSNR） and signal-to-mean squared error ratio （SMSE） metrics are adopted. Based on the synthetic and real data, we calculated the ap- parent diffusion coefficient （ADC） and tracked the fibers. We made comparisons between the presented model, the wave shrinkage and regularized nonlinear diffusion smoothing method. All the experiment results prove quantitatively and visually the better performance of the presented filter.展开更多
BACKGROUND Spinal cord injury can lead to long-term disability,but current imaging methods are limited in predicting outcomes.Rapid diffusion tensor imaging(DTI)has shown promise,yet its clinical utility remains under...BACKGROUND Spinal cord injury can lead to long-term disability,but current imaging methods are limited in predicting outcomes.Rapid diffusion tensor imaging(DTI)has shown promise,yet its clinical utility remains underexplored.AIM To evaluate the potential applications of a short DTI sequence,incorporated into a cervical spine magnetic resonance imaging(MRI)protocol,for characterizing a range of symptomatic spinal cord pathologies.We propose that cervical spine tractography can provide essential diagnostic information beyond what is currently available from conventional MRI.METHODS We utilized a quick DTI sequence to create tractography models of the cervical spinal cord in four patients with distinct pathologies of various etiologies:Cord contusion,metastasis,myelopathy,and multiple sclerosis.We used DSI Studio software for post-processing of tractography cases.Fiber tract findings for each pathology case were compared to five control cases from the same scanner by looking for individual differences in white matter tract integrity based on the fractional anisotropy(FA)and mean diffusivity(MD)of the regions of interest from controls.These correlated with clinical presentations and conventional MRI findings.RESULTS Control cases showed consistent and intact tract patterns with stable FA and MD values.In pathological cases,abnormalities in fiber orientation and tract continuity correlated with clinical symptoms and lesion locations.CONCLUSION The tractography models can provide additional information on white matter disruption that was not discernible on standard MRI sequences.However,its clinical use remains limited due to the need for specialized imaging protocols and complex post-processing,restricting its use to mostly academic settings.展开更多
BACKGROUND The differential diagnosis between hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)is crucial.The individual differences of patients increase the complexity of diagnosis.Currently,imagi...BACKGROUND The differential diagnosis between hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)is crucial.The individual differences of patients increase the complexity of diagnosis.Currently,imaging diagnosis mainly relies on conventional computed tomography and magnetic resonance imaging(MRI),but few studies have investigated MRI functional imaging.This study combined MRI functional imaging including intravoxel incoherent motion(IVIM)and diffusion kurtosis imaging(DKI),facilitating differential diagnosis.AIM To explore the differential diagnostic value of IVIM imaging and DKI in differentiating between HCC and ICC.METHODS A total of 58 patients who underwent multi-b-value diffusion weighted imaging(DWI)on a 3.0 T magnetic MRI scanner were enrolled in this study.Standard apparent diffusion coefficient(SADC),IVIM quantitative parameters,including pure diffusion coefficient(D),pseudo diffusion coefficient(Dstar),and perfusion fraction(f),as well as the DKI quantitative parameters mean diffusion coefficient(MD)and mean kurtosis coefficient(MK)were computed by multi-b DWI images.Theχ2 test was used for classified data,and a one-way analysis of variance was performed for counted data.P<0.05 indicated statistical significance.The diagnostic value of parameters in HCC and ICC was analyzed using the receiver operating characteristic(ROC)curve.RESULTS The SADC,D,and MD values were significantly lower in the HCC group compared to the ICC group,whereas MK was significantly higher in the HCC group than in the ICC group(P<0.05).No significant difference in Dstar and f was observed between the HCC group and the ICC group(P>0.05).The optimal cutoff levels of the total values of SADC,D,MK,MD and all associated parameters were 1.25×10^(-3)mm^(2)/second,1.32×10^(-3)mm^(2)/second,650.2×10^(-3)mm^(2)/second,1.41×10^(-3)mm^(2)/second and 0.46×10^(-3)mm^(2)/second,respectively.The sensitivity of diagnosis was 95%,80%,90%,100%,and 70%,respectively,the specificity of diagnosis was 67.39%,69.57%,67.39%,43.48%,and 93.48%,respectively,and the area under the ROC curve was 0.874,0.793,0.733,0.757,and 0.895,respectively.CONCLUSION SADC,D,MK,and MD could be used to distinguish HCC from ICC,with the diagnostic value reaching a maximum after establishing a joint model.展开更多
Background:Cardiac magnetic resonance imaging(MRI)plays a key role in assessing acute myocardial infarction(AMI)and detecting myocardial edema.Diffusion-weighted imaging(DWI)has recently been applied to cardiac explor...Background:Cardiac magnetic resonance imaging(MRI)plays a key role in assessing acute myocardial infarction(AMI)and detecting myocardial edema.Diffusion-weighted imaging(DWI)has recently been applied to cardiac exploration and is perceived as a promising method for evaluating cardiomyopathies.This study aims to evaluate the role of DWI in the assessment of AMI by analyzing the accuracy of both low b-value diffusion-weighted(DW)spin-echo(SE)echo-planar imaging(EPI)sequence and apparent diffusion coefficient(ADC)mapping in detecting ischemia-induced myocardial edema.Methods:This study included 13 patients with recent reperfused AMI who underwent cardiac MRI.A cardiac protocol was applied,including black blood T2-weighted imaging(BB-T2W),two low b-value DW SE EPI(b=20 s/mm^(2)),one for low b-value DW SE EPI in free-breathing(DWF)and the other for low b-value DW SE EPI in breath-holding(DWH),T2 mapping,and ADC mapping.BB-T2W,DWH,and DWF images were analyzed quantitatively and qualitatively.The T2 and ADC values were measured within the infarct and remote myocardium.Statistical analysis was performed using a nonparametric Wilcoxon test.Results:ADC values in the infarct area were significantly higher than the remote myocardium([2.36±0.34]×10^(-3)mm^(2)/s and[1.20±0.14]×10^(-3)mm^(2)/s,respectively;p=0.001).Besides,low b-value DW SE EPI(DWH and DWF)allowed the detection of ischemia-induced myocardial edema in a way surpassing the BB-T2W sequence with a higher sensitivity to edema(96.7%,96.7%,and 87.9%,respectively).No statistically significant difference was noted between DWH and DWF sequences.Conclusion:DWI may be a promising technique for the exploration of AMI,with the advantage of being feasible for dyspneic patients.展开更多
To evaluate the effect of the positive-indefinite matrix on the diffusion tensor-derived parameters, a modified algorithm is proposed for calculating these parameters. Magnetic resonance （MR） diffusion tensor images...To evaluate the effect of the positive-indefinite matrix on the diffusion tensor-derived parameters, a modified algorithm is proposed for calculating these parameters. Magnetic resonance （MR） diffusion tensor images of five healthy volunteers are collected. The diffusion sensitive gradient magnetic fields are applied along 25 directions and the diffusion weighting value is 1 000 s/mm^2. Many positive-indefinite diffusion tensors can be found in the white matter area, such as the genu and the splenium of corpus callosum. Due to the positive-indefinite matrix, the mean diffusivity （MD） and the fractional anisotropy （FA） are under-estimated and over-estimated by using the conventional algorithm. Thus, the conventional algorithm is modified by using the absolute values of all eigenvalues. Results show that both the robustness and the reliability for deriving these parameters are improved by the modified algorithm.展开更多
Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological me...Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological mechanisms,preventing and treating cerebral small vessel vasculopathy is challenging.Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis.Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease.This review begins with a comprehensive introduction to the structure,function,and driving factors of the glymphatic system,highlighting its essential role in brain waste clearance.Afterwards,cerebral small vessel disease was reviewed from the perspective of the glymphatic system,after which the mechanisms underlying their correlation were summarized.Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain,thereby exacerbating the pathological processes associated with cerebral small vessel disease.The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease:arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease.Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system.However,the effectiveness of its parameters needs to be enhanced.Among various nervous system diseases,including cerebral small vessel disease,glymphatic failure may be a common final pathway toward dementia.Overall,this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.展开更多
Mesenchymal stromal cell transplantation is an effective and promising approach for treating various systemic and diffuse diseases.However,the biological characteristics of transplanted mesenchymal stromal cells in hu...Mesenchymal stromal cell transplantation is an effective and promising approach for treating various systemic and diffuse diseases.However,the biological characteristics of transplanted mesenchymal stromal cells in humans remain unclear,including cell viability,distribution,migration,and fate.Conventional cell tracing methods cannot be used in the clinic.The use of superparamagnetic iron oxide nanoparticles as contrast agents allows for the observation of transplanted cells using magnetic resonance imaging.In 2016,the National Medical Products Administration of China approved a new superparamagnetic iron oxide nanoparticle,Ruicun,for use as a contrast agent in clinical trials.In the present study,an acute hemi-transection spinal cord injury model was established in beagle dogs.The injury was then treated by transplantation of Ruicun-labeled mesenchymal stromal cells.The results indicated that Ruicunlabeled mesenchymal stromal cells repaired damaged spinal cord fibers and partially restored neurological function in animals with acute spinal cord injury.T2*-weighted imaging revealed low signal areas on both sides of the injured spinal cord.The results of quantitative susceptibility mapping with ultrashort echo time sequences indicated that Ruicun-labeled mesenchymal stromal cells persisted stably within the injured spinal cord for over 4 weeks.These findings suggest that magnetic resonance imaging has the potential to effectively track the migration of Ruicun-labeled mesenchymal stromal cells and assess their ability to repair spinal cord injury.展开更多
Diffusion weighted magnetic resonance imaging (DWI) is an imaging technique which provides tissue contrast by the measurement of diffusion properties of water molecules within tissues. Diffusion is expressed in an app...Diffusion weighted magnetic resonance imaging (DWI) is an imaging technique which provides tissue contrast by the measurement of diffusion properties of water molecules within tissues. Diffusion is expressed in an apparent diffusion coefficient (ADC), which reflects the diffusion properties unique to each type of tissue. DWI has been originally used in neuroradiology. More recently, DWI has increasingly been used in addition to conventional unenhanced and enhanced magnetic resonance imaging (MRI) in other parts of the body. The reason for this delay was a number of technical problems inherent to the technique, making DWI very sensitive to artifacts, which had to be overcome. With assessment of ADC values, DWI proved to be helpful in characterization of focal liver lesions. However, DWI should always be used in conjunction to conventional MRI since there is considerable overlap between ADC values of benign and malignant lesions. DWI is useful in the detection of hepatocellular carcinoma in the cirrhotic liver and detection of liver metastases in oncological patients. In addition, DWI is a promising tool in the prediction of tumor responsiveness to chemotherapy and the follow-up of oncological patients after treatment, as DWI may be capable of detecting recurrent disease earlier than conventional imaging.This review focuses on the most common applications of DWI in the liver.展开更多
To investigate the feasibility and time window of early detection of Wallerian degeneration in the corticospinal tract after middle cerebral artery infarction, 23 patients were assessed using magnetic resonance diffus...To investigate the feasibility and time window of early detection of Wallerian degeneration in the corticospinal tract after middle cerebral artery infarction, 23 patients were assessed using magnetic resonance diffusion tensor imaging at 3.0T within 14 days after the infarction. The fractional anisotropy values of the affected corticospinal tract began to decrease at 3 days after onset and decreased in all cases at 7 days. The diffusion coefficient remained unchanged. Experimental findings indicate that diffusion tensor imaging can detect the changes associated with Wallerian degeneration of the corticospinal tract as early as 3 days after cerebral infarction.展开更多
Objective To evaluate the value of whole-body diffusion weighted imaging （WB-DWI） on detection of malignant metastasis. Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 20...Objective To evaluate the value of whole-body diffusion weighted imaging （WB-DWI） on detection of malignant metastasis. Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging （MRI） or computed tomography （CT）. WB-DWI was performed using short TI inversion recovery echo-planar imaging （STIR-EPI） sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations. Results WB-DWI demonstrated 143 focuses, 14 routine imaging. The number of bone metastases depicted of which were diagnosed to be benign lesions in on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain （ X^2=30, P〈0.001）. Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mecliastinal lymph node, brain, and lung metastases.展开更多
Objective To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. Methods Twenty-four patients (mean age 37.9 years old) with proved cer...Objective To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. Methods Twenty-four patients (mean age 37.9 years old) with proved cervical cancer by cervical biopsy and 24 female patients with other suspected pelvic abnormalities received preoperative body DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient (ADC) values of normal cervix and different pathological types of cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic ones. Student's t test was used for statistical analysis. Results There were 5 adenocarcinomas and 19 epitheliomas showed with biopsy results, and DWI showed 21 cervical lesions out of them (87.5%). ADC values of the normal cervix (n = 24), epithelioma (n = 19), and adenocar- cinoma (n = 5) were (1.73 ± 0.31) ×10-3, (0.88 ± 0.22) ×10-3, and (1.08 ± 0.12) ×10-3 mm2/s, respectively. Statistical analysis showed significant difference in ADC value between normal cervical tissue and either tumor tissues (both P < 0.01). In patients had lymphadenectomy (n = 24), totally 67 lymph nodes including 16 metastatic lymph nodes were pathologically analyzed, and DWI showed 66 (98.5%) out of them. ADC values of normal/inflammatory and metastatic lymph nodes were (1.07 ± 0.16) ×10-3 and (0.77 ± 0.13) ×10-3 mm2/s (P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of metastatic lymph node showed that area under curve was 0.961. Conclusions ADC value in cervical carcinoma is lower than that in normal cervix, and ADC may have predictive value in subtype discrimination. ADC value may improve the preoperative characterization of lymph node metastasis. And at least abdominal and pelvic DWI scan is suggested for N staging evaluation in such patients.展开更多
Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction, but whether naajor ozonated autohelnotherapy affects remote in）ury remains po...Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction, but whether naajor ozonated autohelnotherapy affects remote in）ury remains poorly understood. Here, we assumed that major ozonated autohemotherapy contributes to recovery of clinical function, possibly by reducing remote injury after acute cerebral infarction. Sixty acute cerebral infarction patients aged 30-80 years were equally and randomly allocated to ozone treatment and control groups. Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy （47 mg/L, 100 mL ozone） for 10 ± 2 days. Patients in the control group received medical treatment only. National Institutes of Health Stroke Scale score, modified Rankin scale score, and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased, brain function improved, clinical efficiency significantly increased, and no obvious adverse reactions detected in the ozone treatment group compared with the control group. These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing re,note injury, and additionally, exhibits high safety.展开更多
基金supported by the National Natural Science Foundation for Young Scientists of China Award(No.62106289).
文摘Semantic image synthesis aims to generate highquality images given semantic conditions,i.e.,segmentation masks and style reference images.Existing methods widely adopt generative adversarial networks(GANs).GANs take all conditional inputs and directly synthesize images in a single forward step.In this paper,semantic image synthesis is treated as an image denoising task and is handled with a novel image-to-image diffusion model(IIDM).
基金supported by the National Natural Science Foundation Joint Fund,No.U22A20309(to PY)the Natural Science Foundation of LiaoningProvince,No.2023-MS-07(to HuL)the Unveiling Key Scientific and Technological Projects of Liaoning Province,No.2021JH1/10400051(to HuL).
文摘Some patients with systemic lupus erythematosus experience neuropsychiatric symptoms.Although magnetic resonance imaging can detect abnormal signals in the white matter of the brain,conventional methods often struggle to accurately capture microstructural changes.Various diffusion models have been used to study white matter in systemic lupus erythematosus;however,comparative analyses of their sensitivity and specificity for detecting microstructural changes remain insufficient.To address this,our team designed a diagnostic trial that used multimodal diffusion imaging techniques to observe white matter microstructural changes in patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with an aim to identify key diagnostic biomarkers for these patients.Patients with active lupus who received treatment at the Department of Rheumatology and Immunology,The First Affiliated Hospital of China Medical University,from September 2023 to March 2024 were recruited.According to the standards of the American College of Rheumatology,patients with systemic lupus erythematosus who had neuropsychiatric symptoms were assigned to the systemic lupus erythematosus group,whereas those without neuropsychiatric symptoms were assigned to the non-systemic lupus erythematosus group.Additionally,healthy volunteers matched by region,sex,and age were recruited as controls.All three groups underwent the same diffusion magnetic resonance imaging examination protocol to compare differences in diffusion parameters.Advanced diffusion imaging models were able to sensitively detect microstructural changes in the white matter fibers of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,with specific diffusion parameters showing significant abnormalities in key brain regions.In the left superior longitudinal fasciculus subregion and the right thalamic radiations of patients with systemic lupus erythematosus who had neuropsychiatric symptoms,we also identified abnormal diffusion characteristics that were clearly correlated with disease activity,suggesting that microstructural changes in these areas may reflect the dynamic process of neuroinflammatory damage.The present study addresses critical challenges in the diagnosis of systemic lupus erythematosus by identifying specific white matter imaging biomarkers and elucidating the association between microstructural damage and clinical manifestations.The main contributions of our study include:1)establishing axial regression probability parameters from mean apparent propagator magnetic resonance imaging as sensitive biomarkers for systemic lupus erythematosus,particularly in the third subregion of the left superior longitudinal fasciculus;2)demonstrating that multimodal diffusion imaging may be superior to conventional diffusion tensor imaging for detecting white matter microstructural abnormalities in patients with systemic lupus erythematosus;and 3)integrating tract-based spatial statistics with clinically relevant analyses to link imaging findings to pathological mechanisms.
基金Supported by the National Key Research and Development Program of China(2016YFC0100300)the National Natural Science Foundation of China(61402371,61771369)+1 种基金the Natural Science Basic Research Plan in Shaanxi Province of China(2017JM6008)the Fundamental Research Funds for the Central Universities of China(3102017zy032,3102018zy020)
文摘Three high dimensional spatial standardization algorithms are used for diffusion tensor image(DTI)registration,and seven kinds of methods are used to evaluate their performances.Firstly,the template used in this paper was obtained by spatial transformation of 16 subjects by means of tensor-based standardization.Then,high dimensional standardization algorithms for diffusion tensor images,including fractional anisotropy(FA)based diffeomorphic registration algorithm,FA based elastic registration algorithm and tensor-based registration algorithm,were performed.Finally,7 kinds of evaluation methods,including normalized standard deviation,dyadic coherence,diffusion cross-correlation,overlap of eigenvalue-eigenvector pairs,Euclidean distance of diffusion tensor,and Euclidean distance of the deviatoric tensor and deviatoric of tensors,were used to qualitatively compare and summarize the above standardization algorithms.Experimental results revealed that the high-dimensional tensor-based standardization algorithms perform well and can maintain the consistency of anatomical structures.
文摘Objective To assess the reproducibility of whole-body diffusion weighted imaging(WB-DWI) technique in healthy volunteers under normal breathing with background body signal suppression.Methods WB-DWI was performed on 32 healthy volunteers twice within two-week period using short TI inversion-recovery diffusion-weighted echo-planar imaging sequence and built-in body coil.The volunteers were scanned across six stations continuously covering the entire body from the head to the feet under normal breathing.The bone apparent diffusion coefficient(ADC) and exponential ADC(eADC) of regions of interest(ROIs) were measured.We analyzed correlation of the results using paired-t-test to assess the reproducibility of the WB-DWI technique.Results We were successful in collecting and analyzing data of 64 WB-DWI images.There was no significant difference in bone ADC and eADC of 824 ROIs between the paired observers and paired scans(P>0.05).Most of the images from all stations were of diagnostic quality.Conclusion The measurements of bone ADC and eADC have good reproducibility.WB-DWI technique under normal breathing with background body signal suppression is adequate.
基金Project(2009AA04Z214) supported by the National High Technology Research and Development Program of ChinaProject(07JJ6133) supported by the Natural Science Foundation of Hunan Province, China
文摘To denoise the diffusion weighted images （DWls） featured as multi-boundary, which was very important for the calculation of accurate DTIs （diffusion tensor magnetic resonance imaging）, a modified Wiener filter was proposed. Through analyzing the widely accepted adaptive Wiener filter in image denoising fields, which suffered from annoying noise around the edges of DWIs and in turn greatly affected the denoising effect of DWIs, a local-shift method capable of overcoming the defect of the adaptive Wiener filter was proposed to help better denoising DWIs and the modified Wiener filter was constructed accordingly. To verify the denoising effect of the proposed method, the modified Wiener filter and adaptive Wiener filter were performed on the noisy DWI data, respectively, and the results of different methods were analyzed in detail and put into comparison. The experimental data show that, with the modified Wiener method, more satisfactory results such as lower non-positive tensor percentage and lower mean square errors of the fractional anisotropy map and trace map are obtained than those with the adaptive Wiener method, which in turn helps to produce more accurate DTIs.
基金supported by NSFC under grant No.11471331partially supported by National Center for Mathematics and Interdisciplinary Sciences
文摘The existence of a global minimizer for a variational problem arising in registration of diffusion tensor images is proved, which ensures that there is a regular spatial transformation for the registration of diffusion tensor images.
基金the National Natural Science Foundation of China,No.30800263
文摘BACKGROUND： Limbic encephalitis is a rare syndrome that specifically affects the limbic system. Magnetic resonance imaging （MRI） has been typically used to detect brain changes in this disease. However, the mechanisms of limbic encephalitis-related white matter damage remain poorly understood. OBJECTIVE： To characterize white matter connectivity changes secondary to injuries of the limbic system in limbic encephalitis through combined application of diffusion tensor imaging （DTI） and voxel-based morphometry. DESIGN, TIME AND SETTING： A non-randomized, controlled, clinical, neuroimaging, DTI study was performed at the Department of Radiology, West China Hospital in December 2008. PARTICIPANTS： A male, 46-year-old, limbic encephalitis patient, as well as 11 age- and gender-matched healthy volunteers, were enrolled in the present study. METHODS： MRI was performed on the limbic encephalitis patient using a 3.0T MR scanner. Three-dimensional SPGR Tl-weighted images and DTI were acquired in the patient and controls. Data were analyzed using Matlab 7.0 and SPM2 software. MAIN OUTCOME MEASURES： Results from routine MRI scan with contrast enhancement of patient, as well as fractional anisotropy and mean diffusivity value map differences between patient and controls. RESULTS： Significant symmetric MRI signal intensity abnormalities were observed with routine MRI Affected bilateral hippocampi and amygdala exhibited hypointense signals in TIWI and hyperintense signals in T2 images. The DTI study revealed decreased fractional anisotropy values in the bilateral alveus and fimbria of the hippocampus, bilateral internal and external capsules, white matter of the right prefrontal area, and left corona radiate in the patient compared with normal controls （P 〈 0.001） Significantly increased fractional anisotropy, mean diffusivity, or decreased mean diffusivity were not observed in the patient, compared with controls. CONCLUSION： Secondary white matter damage to the hippocampal afveus and fimbria was apparent in the limbic encephalitis patient. In addition, other white matter fiber injuries surrounded the limbic structures, which were not attributed to secondary limbic system injuries.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Education,Science and Technology,No.2012R1A1A4A01001873
文摘The human brain is known to contain a maximum of eight cholinergic nuclei： the basal forebrain region： the medial septal nucleus （Ch 1）, the vertical nucleus of the diagonal band （Ch 2）, the horizontal limb of the diago- nal band （Ch 3）, and the nucleus basalis of Meynert （Ch 4）; the brainstem： the pedunculopontine nucleus （Ch 5）, the laterodorsal tegmental nucleus （Ch 6）, and the para- bigeminal nucleus （Ch 8）; and the thalamus： the medial habenular nucleus （Ch 7） （Nieuwenhuys et al., 2008; Naidich and Duvernoy, 2009）. The cingulum is the neu- ral tract extending from the orbitofrontal cortex to the medial temporal lobe （Mufson and Pandya, 1984）. The cingulum plays an important role in memory because it is a passage of the medial cholinergic pathway, which pro- vides cholinergic innervations to the cerebral cortex after originating from Ch 1 and Ch 2 as well as Ch 4 （mainly） （Selden et al., 1998; Nieuwenhuys et al., 2008; Hong and lang, 2010）.
基金National‘973’ProjectGrant number:2003 CB716103+1 种基金Shanghai Normal University ProjectGrant number:SK200734
文摘The Rician noise introduced into the diffusion tensor images （DTIs） can bring serious impacts on tensor calculation and fiber tracking. To decrease the effects of the Rician noise, we propose to consider the wavelet-based diffusion method to denoise multiehannel typed diffusion weighted （DW） images. The presented smoothing strategy, which utilizes anisotropic nonlinear diffusion in wavelet domain, successfully removes noise while preserving both texture and edges. To evaluate quantitatively the efficiency of the presented method in accounting for the Rician noise introduced into the DW images, the peak-to-peak signal-to-noise ratio （PSNR） and signal-to-mean squared error ratio （SMSE） metrics are adopted. Based on the synthetic and real data, we calculated the ap- parent diffusion coefficient （ADC） and tracked the fibers. We made comparisons between the presented model, the wave shrinkage and regularized nonlinear diffusion smoothing method. All the experiment results prove quantitatively and visually the better performance of the presented filter.
文摘BACKGROUND Spinal cord injury can lead to long-term disability,but current imaging methods are limited in predicting outcomes.Rapid diffusion tensor imaging(DTI)has shown promise,yet its clinical utility remains underexplored.AIM To evaluate the potential applications of a short DTI sequence,incorporated into a cervical spine magnetic resonance imaging(MRI)protocol,for characterizing a range of symptomatic spinal cord pathologies.We propose that cervical spine tractography can provide essential diagnostic information beyond what is currently available from conventional MRI.METHODS We utilized a quick DTI sequence to create tractography models of the cervical spinal cord in four patients with distinct pathologies of various etiologies:Cord contusion,metastasis,myelopathy,and multiple sclerosis.We used DSI Studio software for post-processing of tractography cases.Fiber tract findings for each pathology case were compared to five control cases from the same scanner by looking for individual differences in white matter tract integrity based on the fractional anisotropy(FA)and mean diffusivity(MD)of the regions of interest from controls.These correlated with clinical presentations and conventional MRI findings.RESULTS Control cases showed consistent and intact tract patterns with stable FA and MD values.In pathological cases,abnormalities in fiber orientation and tract continuity correlated with clinical symptoms and lesion locations.CONCLUSION The tractography models can provide additional information on white matter disruption that was not discernible on standard MRI sequences.However,its clinical use remains limited due to the need for specialized imaging protocols and complex post-processing,restricting its use to mostly academic settings.
基金Supported by Chutian Talents of Hubei,No.CTYC001Talent Project of Hubei Cancer Hospital,No.2025HBCHLHRC001Clinical Medical Science and Technology of Jinan,No.202134053.
文摘BACKGROUND The differential diagnosis between hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC)is crucial.The individual differences of patients increase the complexity of diagnosis.Currently,imaging diagnosis mainly relies on conventional computed tomography and magnetic resonance imaging(MRI),but few studies have investigated MRI functional imaging.This study combined MRI functional imaging including intravoxel incoherent motion(IVIM)and diffusion kurtosis imaging(DKI),facilitating differential diagnosis.AIM To explore the differential diagnostic value of IVIM imaging and DKI in differentiating between HCC and ICC.METHODS A total of 58 patients who underwent multi-b-value diffusion weighted imaging(DWI)on a 3.0 T magnetic MRI scanner were enrolled in this study.Standard apparent diffusion coefficient(SADC),IVIM quantitative parameters,including pure diffusion coefficient(D),pseudo diffusion coefficient(Dstar),and perfusion fraction(f),as well as the DKI quantitative parameters mean diffusion coefficient(MD)and mean kurtosis coefficient(MK)were computed by multi-b DWI images.Theχ2 test was used for classified data,and a one-way analysis of variance was performed for counted data.P<0.05 indicated statistical significance.The diagnostic value of parameters in HCC and ICC was analyzed using the receiver operating characteristic(ROC)curve.RESULTS The SADC,D,and MD values were significantly lower in the HCC group compared to the ICC group,whereas MK was significantly higher in the HCC group than in the ICC group(P<0.05).No significant difference in Dstar and f was observed between the HCC group and the ICC group(P>0.05).The optimal cutoff levels of the total values of SADC,D,MK,MD and all associated parameters were 1.25×10^(-3)mm^(2)/second,1.32×10^(-3)mm^(2)/second,650.2×10^(-3)mm^(2)/second,1.41×10^(-3)mm^(2)/second and 0.46×10^(-3)mm^(2)/second,respectively.The sensitivity of diagnosis was 95%,80%,90%,100%,and 70%,respectively,the specificity of diagnosis was 67.39%,69.57%,67.39%,43.48%,and 93.48%,respectively,and the area under the ROC curve was 0.874,0.793,0.733,0.757,and 0.895,respectively.CONCLUSION SADC,D,MK,and MD could be used to distinguish HCC from ICC,with the diagnostic value reaching a maximum after establishing a joint model.
文摘Background:Cardiac magnetic resonance imaging(MRI)plays a key role in assessing acute myocardial infarction(AMI)and detecting myocardial edema.Diffusion-weighted imaging(DWI)has recently been applied to cardiac exploration and is perceived as a promising method for evaluating cardiomyopathies.This study aims to evaluate the role of DWI in the assessment of AMI by analyzing the accuracy of both low b-value diffusion-weighted(DW)spin-echo(SE)echo-planar imaging(EPI)sequence and apparent diffusion coefficient(ADC)mapping in detecting ischemia-induced myocardial edema.Methods:This study included 13 patients with recent reperfused AMI who underwent cardiac MRI.A cardiac protocol was applied,including black blood T2-weighted imaging(BB-T2W),two low b-value DW SE EPI(b=20 s/mm^(2)),one for low b-value DW SE EPI in free-breathing(DWF)and the other for low b-value DW SE EPI in breath-holding(DWH),T2 mapping,and ADC mapping.BB-T2W,DWH,and DWF images were analyzed quantitatively and qualitatively.The T2 and ADC values were measured within the infarct and remote myocardium.Statistical analysis was performed using a nonparametric Wilcoxon test.Results:ADC values in the infarct area were significantly higher than the remote myocardium([2.36±0.34]×10^(-3)mm^(2)/s and[1.20±0.14]×10^(-3)mm^(2)/s,respectively;p=0.001).Besides,low b-value DW SE EPI(DWH and DWF)allowed the detection of ischemia-induced myocardial edema in a way surpassing the BB-T2W sequence with a higher sensitivity to edema(96.7%,96.7%,and 87.9%,respectively).No statistically significant difference was noted between DWH and DWF sequences.Conclusion:DWI may be a promising technique for the exploration of AMI,with the advantage of being feasible for dyspneic patients.
基金Supported by the Research Project of Dongguan Higher Education (200910815252)the Beijing Natural Science Foundation(7102102)the Scientific Research Key Program of Beijing Municipal Commission of Ed-ucation(KZ200810025011)~~
文摘To evaluate the effect of the positive-indefinite matrix on the diffusion tensor-derived parameters, a modified algorithm is proposed for calculating these parameters. Magnetic resonance （MR） diffusion tensor images of five healthy volunteers are collected. The diffusion sensitive gradient magnetic fields are applied along 25 directions and the diffusion weighting value is 1 000 s/mm^2. Many positive-indefinite diffusion tensors can be found in the white matter area, such as the genu and the splenium of corpus callosum. Due to the positive-indefinite matrix, the mean diffusivity （MD） and the fractional anisotropy （FA） are under-estimated and over-estimated by using the conventional algorithm. Thus, the conventional algorithm is modified by using the absolute values of all eigenvalues. Results show that both the robustness and the reliability for deriving these parameters are improved by the modified algorithm.
基金supported by the National Natural Science Foundation of China,No.82274304(to YH)the Major Clinical Study Projects of Shanghai Shenkang Hospital Development Center,No.SHDC2020CR2046B(to YH)Shanghai Municipal Health Commission Talent Plan,No.2022LJ010(to YH).
文摘Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological mechanisms,preventing and treating cerebral small vessel vasculopathy is challenging.Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis.Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease.This review begins with a comprehensive introduction to the structure,function,and driving factors of the glymphatic system,highlighting its essential role in brain waste clearance.Afterwards,cerebral small vessel disease was reviewed from the perspective of the glymphatic system,after which the mechanisms underlying their correlation were summarized.Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain,thereby exacerbating the pathological processes associated with cerebral small vessel disease.The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease:arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease.Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system.However,the effectiveness of its parameters needs to be enhanced.Among various nervous system diseases,including cerebral small vessel disease,glymphatic failure may be a common final pathway toward dementia.Overall,this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.
基金supported by the National Key R&D Program of China,Nos.2017YFA0104302(to NG and XM)and 2017YFA0104304(to BW and ZZ)
文摘Mesenchymal stromal cell transplantation is an effective and promising approach for treating various systemic and diffuse diseases.However,the biological characteristics of transplanted mesenchymal stromal cells in humans remain unclear,including cell viability,distribution,migration,and fate.Conventional cell tracing methods cannot be used in the clinic.The use of superparamagnetic iron oxide nanoparticles as contrast agents allows for the observation of transplanted cells using magnetic resonance imaging.In 2016,the National Medical Products Administration of China approved a new superparamagnetic iron oxide nanoparticle,Ruicun,for use as a contrast agent in clinical trials.In the present study,an acute hemi-transection spinal cord injury model was established in beagle dogs.The injury was then treated by transplantation of Ruicun-labeled mesenchymal stromal cells.The results indicated that Ruicunlabeled mesenchymal stromal cells repaired damaged spinal cord fibers and partially restored neurological function in animals with acute spinal cord injury.T2*-weighted imaging revealed low signal areas on both sides of the injured spinal cord.The results of quantitative susceptibility mapping with ultrashort echo time sequences indicated that Ruicun-labeled mesenchymal stromal cells persisted stably within the injured spinal cord for over 4 weeks.These findings suggest that magnetic resonance imaging has the potential to effectively track the migration of Ruicun-labeled mesenchymal stromal cells and assess their ability to repair spinal cord injury.
文摘Diffusion weighted magnetic resonance imaging (DWI) is an imaging technique which provides tissue contrast by the measurement of diffusion properties of water molecules within tissues. Diffusion is expressed in an apparent diffusion coefficient (ADC), which reflects the diffusion properties unique to each type of tissue. DWI has been originally used in neuroradiology. More recently, DWI has increasingly been used in addition to conventional unenhanced and enhanced magnetic resonance imaging (MRI) in other parts of the body. The reason for this delay was a number of technical problems inherent to the technique, making DWI very sensitive to artifacts, which had to be overcome. With assessment of ADC values, DWI proved to be helpful in characterization of focal liver lesions. However, DWI should always be used in conjunction to conventional MRI since there is considerable overlap between ADC values of benign and malignant lesions. DWI is useful in the detection of hepatocellular carcinoma in the cirrhotic liver and detection of liver metastases in oncological patients. In addition, DWI is a promising tool in the prediction of tumor responsiveness to chemotherapy and the follow-up of oncological patients after treatment, as DWI may be capable of detecting recurrent disease earlier than conventional imaging.This review focuses on the most common applications of DWI in the liver.
基金supported by the National Stroke Rehabilitation Research Foundation of the Ministry of Health, China,No.01BA703B18bthe Young and Middle-Aged Clinical Scientists Research Foundation of Shanghai Government,No.01YZK
文摘To investigate the feasibility and time window of early detection of Wallerian degeneration in the corticospinal tract after middle cerebral artery infarction, 23 patients were assessed using magnetic resonance diffusion tensor imaging at 3.0T within 14 days after the infarction. The fractional anisotropy values of the affected corticospinal tract began to decrease at 3 days after onset and decreased in all cases at 7 days. The diffusion coefficient remained unchanged. Experimental findings indicate that diffusion tensor imaging can detect the changes associated with Wallerian degeneration of the corticospinal tract as early as 3 days after cerebral infarction.
文摘Objective To evaluate the value of whole-body diffusion weighted imaging （WB-DWI） on detection of malignant metastasis. Methods Forty-six patients with malignant tumors underwent WB-DWI examinations between April 2007 and August 2007 in our hospital. Before WB-DWI examination, the primary cancers of all the patients were confirmed by pathology, and the TNM-stage was assessed with conventional magnetic resonance imaging （MRI） or computed tomography （CT）. WB-DWI was performed using short TI inversion recovery echo-planar imaging （STIR-EPI） sequence. Abnormal high signal intensities on WB-DWI were considered as metastases. The results of WB-DWI were compared with other imaging modalities. For the assessment of the diagnostic capability of WB-DWI, WB-DWI were compared with CT for demonstrating mediastinal lymph node metastases and lung metastases, and with conventional MRI for demonstrating metastases in other locations. Results WB-DWI demonstrated 143 focuses, 14 routine imaging. The number of bone metastases depicted of which were diagnosed to be benign lesions in on WB-DWI and routine imaging was 85 and 86; lymph node metastases was 17 and 18; liver metastases was 14 and 14; lung metastases was 4 and 8; and brain metastases was 6 and 8, respectively. WB-DWI failed to detect 12 metastatic lesions including 3 osteoplastic bone metastases, 4 lung metastases, 3 mediastinal lymph node metastases, and 2 brain metastases Four metastatic lesions including 2 deltopectoral lymph nodes and 2 rib metastases were detected with WB-DWI alone, all of which evolved greatly during clinical follow-up for more than 6 months. WB-DWI had higher detection rates for metastatic lesions in liver, bone, and lymph nodes than those in lung and brain （ X^2=30, P〈0.001）. Conclusions WB-DWI could detect most of metastatic lesions that were diagnosed with conventional MRI and CT. The limitations of WB-DWI might be had high false-positive rate and low efficiency in detecting mecliastinal lymph node, brain, and lung metastases.
文摘Objective To evaluate the clinical impact of body diffusion weighted imaging (DWI) on the diagnosis and preoperative N staging of cervical cancer. Methods Twenty-four patients (mean age 37.9 years old) with proved cervical cancer by cervical biopsy and 24 female patients with other suspected pelvic abnormalities received preoperative body DWI scan. Results of body DWI were compared with pathological findings. The apparent diffusion coefficient (ADC) values of normal cervix and different pathological types of cervical cancer were compared. ADC value of normal or inflammatory lymph nodes was also compared with that of metastatic ones. Student's t test was used for statistical analysis. Results There were 5 adenocarcinomas and 19 epitheliomas showed with biopsy results, and DWI showed 21 cervical lesions out of them (87.5%). ADC values of the normal cervix (n = 24), epithelioma (n = 19), and adenocar- cinoma (n = 5) were (1.73 ± 0.31) ×10-3, (0.88 ± 0.22) ×10-3, and (1.08 ± 0.12) ×10-3 mm2/s, respectively. Statistical analysis showed significant difference in ADC value between normal cervical tissue and either tumor tissues (both P < 0.01). In patients had lymphadenectomy (n = 24), totally 67 lymph nodes including 16 metastatic lymph nodes were pathologically analyzed, and DWI showed 66 (98.5%) out of them. ADC values of normal/inflammatory and metastatic lymph nodes were (1.07 ± 0.16) ×10-3 and (0.77 ± 0.13) ×10-3 mm2/s (P < 0.01). Receiver operating characteristic (ROC) curve of ADC value of metastatic lymph node showed that area under curve was 0.961. Conclusions ADC value in cervical carcinoma is lower than that in normal cervix, and ADC may have predictive value in subtype discrimination. ADC value may improve the preoperative characterization of lymph node metastasis. And at least abdominal and pelvic DWI scan is suggested for N staging evaluation in such patients.
基金supported by the Science and Technology Project of Guangdong Province of China,No.2013B021800164the Scientific Research Project in Medicine of Guangdong Province of China,No.B200258
文摘Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction, but whether naajor ozonated autohelnotherapy affects remote in）ury remains poorly understood. Here, we assumed that major ozonated autohemotherapy contributes to recovery of clinical function, possibly by reducing remote injury after acute cerebral infarction. Sixty acute cerebral infarction patients aged 30-80 years were equally and randomly allocated to ozone treatment and control groups. Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy （47 mg/L, 100 mL ozone） for 10 ± 2 days. Patients in the control group received medical treatment only. National Institutes of Health Stroke Scale score, modified Rankin scale score, and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased, brain function improved, clinical efficiency significantly increased, and no obvious adverse reactions detected in the ozone treatment group compared with the control group. These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing re,note injury, and additionally, exhibits high safety.
