Background:Medical imaging advancements are constrained by fundamental trade-offs between acquisition speed,radiation dose,and image quality,forcing clinicians to work with noisy,incomplete data.Existing reconstructio...Background:Medical imaging advancements are constrained by fundamental trade-offs between acquisition speed,radiation dose,and image quality,forcing clinicians to work with noisy,incomplete data.Existing reconstruction methods either compromise on accuracy with iterative algorithms or suffer from limited generalizability with task-specific deep learning approaches.Methods:We present LDM-PIR,a lightweight physics-conditioned diffusion multi-model for medical image reconstruction that addresses key challenges in magnetic resonance imaging(MRI),CT,and low-photon imaging.Unlike traditional iterative methods,which are computationally expensive,or task-specific deep learning approaches lacking generalizability,integrates three innovations.A physics-conditioned diffusion framework that embeds acquisition operators(Fourier/Radon transforms)and noise models directly into the reconstruction process.A multi-model architecture that unifies denoising,inpainting,and super-resolution via shared weight conditioning.A lightweight design(2.1M parameters)enabling rapid inference(0.8s/image on GPU).Through self-supervised fine-tuning with measurement consistency losses adapts to new imaging modalities using fewer annotated samples.Results:Achieves state-of-the-art performance on fastMRI(peak signal-to-noise ratio(PSNR):34.04 for single-coil/31.50 for multi-coil)and Lung Image Database Consortium and Image Database Resource Initiative(28.83 PSNR under Poisson noise).Clinical evaluations demonstrate superior preservation of anatomical structures,with SSIM improvements of 8.8%for single-coil and 4.36%for multi-coil MRI over uDPIR.Conclusion:It offers a flexible,efficient,and scalable solution for medical image reconstruction,addressing the challenges of noise,undersampling,and modality generalization.The model’s lightweight design allows for rapid inference,while its self-supervised fine-tuning capability minimizes reliance on large annotated datasets,making it suitable for real-world clinical applications.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
BACKGROUND Rectal cancer is a common malignant tumor of the digestive system,with older patients representing the predominantly affected population.Magnetic resonance imaging(MRI)has been widely applied in preoperativ...BACKGROUND Rectal cancer is a common malignant tumor of the digestive system,with older patients representing the predominantly affected population.Magnetic resonance imaging(MRI)has been widely applied in preoperative tumor assessment;however,the value of high-resolution MRI(HR-MRI)combined with dynamic contrast-enhanced(DCE)scanning in the preoperative diagnosis of rectal cancer in older patients remains unclear.AIM To evaluate the value of HR-MRI combined with DCE scanning in the preoperative diagnosis of rectal cancer in older patients.METHODS This retrospective study included 148 consecutive older female patients with rectal cancer who were treated at our hospital between December 2020 and December 2024.Clinical data and HR-MRI and DCE scan findings were collected.Histopathological examination after surgical resection served as the gold standard.The diagnostic accuracy of MRI for preoperative T and N staging was calculated.Consistency,sensitivity,and specificity between HR-MRI combined with DCE scanning and pathological staging were analyzed using the k test.Among the 148 patients,the overall accuracy of T staging was 84.5%.Sensitivity for T1,T2,T3,and T4 staging was 75.00%,62.50%,89.47%,and 90.48%,respectively,whereas specificity was 100.00%,94.35%,79.25%,and 96.06%,respectively.T staging based on HR-MRI combined with DCE scanning showed good agreement with pathological staging(k=0.8176,P<0.001).For N staging,sensitivity and specificity were 54.88%and 84.85%for N0,36.96%and 72.55%for N1,and 70.00%and 73.44%for N2,respectively;agreement with pathological N staging was poor(k=0.259,P<0.001).CONCLUSION HR-MRI combined with DCE scanning demonstrates high diagnostic accuracy for T staging of rectal cancer in older patients and can provide a theoretical basis for treatment planning.However,its diagnostic accuracy for N staging requires improvement.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
A medical image encryption is proposed based on the Fisher-Yates scrambling,filter diffusion and S-box substitution.First,chaotic sequence associated with the plaintext is generated by logistic-sine-cosine system,whic...A medical image encryption is proposed based on the Fisher-Yates scrambling,filter diffusion and S-box substitution.First,chaotic sequence associated with the plaintext is generated by logistic-sine-cosine system,which is used for the scrambling,substitution and diffusion processes.The three-dimensional Fisher-Yates scrambling,S-box substitution and diffusion are employed for the first round of encryption.The chaotic sequence is adopted for secondary encryption to scramble the ciphertext obtained in the first round.Then,three-dimensional filter is applied to diffusion for further useful information hiding.The key to the algorithm is generated by the combination of hash value of plaintext image and the input parameters.It improves resisting ability of plaintext attacks.The security analysis shows that the algorithm is effective and efficient.It can resist common attacks.In addition,the good diffusion effect shows that the scheme can solve the differential attacks encountered in the transmission of medical images and has positive implications for future research.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
The location of an acute ischemic stroke is associated with its prognosis. The widely used Gaussian model-based parameter, apparent diffusion coefficient(ADC), cannot reveal microstructural changes in different locati...The location of an acute ischemic stroke is associated with its prognosis. The widely used Gaussian model-based parameter, apparent diffusion coefficient(ADC), cannot reveal microstructural changes in different locations or the degree of infarction. This prospective observational study was reviewed and approved by the Institutional Review Board of Xiamen Second Hospital, China(approval No. 2014002).Diffusion kurtosis imaging(DKI) was used to detect 199 lesions in 156 patients with acute ischemic stroke(61 males and 95 females), mean age 63.15 ± 12.34 years. A total of 199 lesions were located in the periventricular white matter(n = 52), corpus callosum(n = 14), cerebellum(n = 29), basal ganglia and thalamus(n = 21), brainstem(n = 21) and gray-white matter junctions(n = 62). Percentage changes of apparent diffusion coefficient(ΔADC) and DKI-derived indices(fractional anisotropy [ΔFA], mean diffusivity [ΔMD], axial diffusivity [ΔD_a], radial diffusivity ΔDr, mean kurtosis [ΔMK], axial kurtosis [ΔK_a], and radial kurtosis [ΔK_r]) of each lesion were computed relative to the normal contralateral region. The results showed that(1) there was no significant difference in ΔADC, ΔMD, ΔD_a or ΔD_r among almost all locations.(2) There was significant difference in ΔMK among almost all locations(except basal ganglia and thalamus vs. brain stem; basal ganglia and thalamus vs. gray-white matter junctions; and brainstem vs. gray-white matter junctions.(3) The degree of change in diffusional kurtosis in descending order was as follows: corpus callosum > periventricular white matter > brainstem > gray-white matter junctions > basal ganglia and thalamus > cerebellum. In conclusion, DKI could reveal the differences in microstructure changes among various locations affected by acute ischemic stroke, and performed better than diffusivity among all groups.展开更多
Diffusion weighted imaging(DWI) is a method of signal contrast generation based on the differences in Brownian motion. DWI is a method to evaluate the molecular function and micro-architecture of the human body. DWI s...Diffusion weighted imaging(DWI) is a method of signal contrast generation based on the differences in Brownian motion. DWI is a method to evaluate the molecular function and micro-architecture of the human body. DWI signal contrast can be quantified by apparent diffusion coefficient maps and it acts as a tool for treatment respon-se evaluation and assessment of disease progression. Ability to detect and quantify the anisotropy of diffusion leads to a new paradigm called diffusion tensor imaging(DTI). DTI is a tool for assessment of the organs with highly organised fibre structure. DWI forms an integral part of modern state-of-art magnetic resonance imaging and is indispensable in neuroimaging and oncology. DWI is a field that has been undergoing rapid technical evolution and its applications are increasing every day. This review article provides insights in to the evolution of DWI as a new imaging paradigm and provides a summary of current role of DWI in various disease processes.展开更多
AIM:To investigate the use of multi-b-value diffusionweighted imaging in diagnosing pancreatic cancer.METHODS:We retrospectively analyzed 33 cases of pancreatic cancer and 12 cases of benign pancreatic tumors at the S...AIM:To investigate the use of multi-b-value diffusionweighted imaging in diagnosing pancreatic cancer.METHODS:We retrospectively analyzed 33 cases of pancreatic cancer and 12 cases of benign pancreatic tumors at the Second Affiliated Hospital of Kunming Medical University from December 2008 to January2011.The demographic characteristics,clinical presentation,routine magnetic resonance imaging and diffusion weighted imaging(DWI)features with different b values were reviewed.Continuous data were expressed as mean±SD.Comparisons between pancreatic cancer and benign pancreatic tumors were performed using the Student’s t test.A probability of P<0.05 was considered statistically significant.RESULTS:Thirty-three patients with pancreatic cancer were identified.The mean age at diagnosis was 60±5.6 years.The male:female ratio was 21:12.Twenty cases were confirmed by surgical resection and 13 by biopsy of metastases.T1 weighted images demonstrated a pancreatic head mass in 16 patients,a pancreatic body mass in 10 cases,and a pancreatic tail mass with pancreatic atrophy in 7 cases.Eight patients had hepatic metastases,13 had invasion or envelopment of mesenteric vessels,4 had bone metastases,and 8had lymph node metastases.DWI demonstrated an irregular intense mass with unclear margins.Necrotic tissue demonstrated an uneven low signal.A b of 1100s/mm2was associated with a high intensity signal with poor anatomical delineation.A b of 700 s/mm2was associated with apparent diffusion coefficients(ADCs)that were useful in distinguishing benign and malignant pancreatic tumors(P<0.05).b values of 50,350,400,450 and 1100 s/mm2were associated with ADCs that did not differentiate the two tumors.CONCLUSION:Low b value images demonstrated superior anatomical details when compared to high b value images.Tumor tissue definition was high and contrast with the surrounding tissues was good.DWI was useful in diagnosing pancreatic cancer.展开更多
Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors s...Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.展开更多
Diffusion kurtosis imaging can be used to assess pathophysiological changes in tissue structure and to diagnose central nervous system diseases. However, its sensitivity in assessing hippocampal differences between pa...Diffusion kurtosis imaging can be used to assess pathophysiological changes in tissue structure and to diagnose central nervous system diseases. However, its sensitivity in assessing hippocampal differences between patients with Alzheimer’s disease and those with amnestic mild cognitive impairment has not been characterized. Here, we examined 20 individuals with Alzheimer’s disease (11 men and 9 women, mean 73.2 ± 4.49 years), 20 with amnestic mild cognitive impairment (10 men and 10 women, mean 71.55 ± 4.77 years), and 20 normal controls (11 men and 9 women, mean 70.45 ± 5.04 years). We conducted diffusion kurtosis imaging, using a 3.0 T magnetic resonance scanner, to compare hippocampal differences among the three groups. The results demonstrated that the right hippocampal volume and bilateral mean kurtosis were remarkably smaller in individuals with Alzheimer’s disease compared with those with amnestic mild cognitive impairment and normal controls. Further, the mean kurtosis was lower in the amnestic mild cognitive impairment group compared with the normal control group. The mean diffusion in the left hippocampus was lower in the Alzheimer’s disease group than in the amnestic mild cognitive impairment and normal control groups, while the mean diffusion in the right hippocampus was lower in the Alzheimer’s disease group than in the normal control group. Fractional anisotropy was similar among the three groups. These results verify that bilateral mean kurtosis and mean diffusion are sensitive to the diagnosis of Alzheimer’s disease and amnestic mild cognitive impairment. This study was approved by the Ethics Review Board of Affiliated Sixth People’s Hospital of Shanghai Jiao Tong University, China on May 4, 2010 (approval No. 2010(C)-6).展开更多
Pancreatic cancer is one of the most common malignanttumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods ...Pancreatic cancer is one of the most common malignanttumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods are conducive to detecting small lesions. Compared to the other techniques, magnetic resonance imaging(MRI) has irreplaceable advantages and can provide valuable information unattainable with other noninvasive or minimally invasive imaging techniques. Advances in MR hardware and pulse sequence design have particularly improved the quality and robustness of MRI of the pancreas. Diffusion MR imaging serves as one of the common functional MRI techniques and is the only technique that can be used to reflect the diffusion movement of water molecules in vivo. It is generally known that diffusion properties depend on the characterization of intrinsic features of tissue microdynamics and microstructure. With the improvement of the diffusion models, diffusion MR imaging techniques are increasingly varied, from the simplest and most commonly used technique to the more complex. In this review, the various diffusion MRI techniques for pancreatic cancer are discussed, including conventional diffusion weighted imaging(DWI), multi-b DWI based on intra-voxel incoherent motion theory, diffusion tensor imaging and diffusion kurtosis imaging. The principles, main parameters, advantages and limitations of these techniques, as well as future directions for pancreatic diffusion imaging are also discussed.展开更多
With improvements in care of at-risk neonates, more and more children survive. This makes it increasingly important to assess, soon after birth, the prognosis of children with hypoxic-ischemic encephalopathy. Computed...With improvements in care of at-risk neonates, more and more children survive. This makes it increasingly important to assess, soon after birth, the prognosis of children with hypoxic-ischemic encephalopathy. Computed tomography, ultrasound, and conventional magnetic resonance imaging are helpful to diagnose brain injury, but cannot quantify white matter damage. In this study, ten full-term infants without brain injury and twenty-two full-term neonates with hypoxic-ischemic encephalopathy （14 moderate cases and 8 severe cases） underwent diffusion tensor imaging to assess its feasibility in evaluating white matter damage in this condition. Results demonstrated that fractional anisotropy, voxel volume, and number of fiber bundles were different in some brain areas between infants with brain injury and those without brain injury. The correlation between fractional anisotropy values and neonatal behavioral neurological assessment scores was closest in the posterior limbs of the internal capsule. We conclude that diffusion tensor imaging can quantify white matter injury in neonates with hypoxic-ischemic encephalopathy.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
AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Six...AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ±11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Ana- tomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE.展开更多
Identifying data-driven biotypes of major depressive disorder(MDD) has promise for the clarification of diagnostic heterogeneity. However, few studies have focused on white-matter abnormalities for MDD subtyping. This...Identifying data-driven biotypes of major depressive disorder(MDD) has promise for the clarification of diagnostic heterogeneity. However, few studies have focused on white-matter abnormalities for MDD subtyping. This study included 116 patients with MDD and118 demographically-matched healthy controls assessed by diffusion tensor imaging and neurocognitive evaluation.Hierarchical clustering was applied to the major fiber tracts, in conjunction with tract-based spatial statistics, to reveal white-matter alterations associated with MDD.Clinical and neurocognitive differences were compared between identified subgroups and healthy controls. With fractional anisotropy extracted from 20 fiber tracts, cluster analysis revealed 3 subgroups based on the patterns of abnormalities. Patients in each subgroup versus healthy controls showed a stepwise pattern of white-matter alterations as follows: subgroup 1(25.9% of patient sample),widespread white-matter disruption;subgroup 2(43.1% of patient sample), intermediate and more localized abnormalities in aspects of the corpus callosum and left cingulate;and subgroup 3(31.0% of patient sample),possible mild alterations, but no statistically significant tract disruption after controlling for family-wise error. The neurocognitive impairment in each subgroup accompanied the white-matter alterations: subgroup 1, deficits in sustained attention and delayed memory;subgroup 2, dysfunction in delayed memory;and subgroup 3, no significant deficits. Three subtypes of white-matter abnormality exist in individuals with major depression, those having widespread abnormalities suffering more neurocognitive impairments, which may provide evidence for parsing the heterogeneity of the disorder and help optimize typespecific treatment approaches.展开更多
AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our i...AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our institutional review board,and informed consent was obtained from each patient.Fifteen patients(median age 56 years)with locally advanced rectal cancer were treated in our hospital from June 2006 to December 2007.All patients were stageⅢB-C according to the results of MRI and endorectal ultrasound examinations.All patients underwent pelvic irradiation with 45 Gy/25 fx per 35 days.The concurrent chemotherapy regimen consisted of capecitabine 625mg/m2,bid(Monday-Friday),and oxaliplatin 50 mg/m2,weekly.The patients underwent surgery 5-8 wk after the completion of neoadjuvant therapy.T downstaging was defined as the downstaging of the tumor from cT3to ypT0-2 or from cT4 to ypT0-3.Good regression was defined as TRG 3-4,and poor regression was defined as TRG 0-2.Diffusion-weighted magnetic resonance images were obtained prior to and weekly during the course of neoadjuvant chemoradiation,and the apparent diffusion coefficient(ADC)values were calculated from the acquired tumor images.RESULTS:Comparison with the mean pretreatment tumor ADC revealed an increase in the mean tumor ADC during the course of neoadjuvant chemoradiation,especially at the 2ndweek(P=0.004).We found a strong negative correlation between the mean pretreatment tumor ADC and tumor regression after neoadjuvant chemoradiation(P=0.021).In the T downstage and tumor regression groups,we found a significant increase in the mean ADC at the 2ndweek of neoadjuvant therapy(P=0.011;0.004).CONCLUSION:DW-MRI might be a valuable clinical tool to help predict or assess the response of rectal cancer to neoadjuvant chemoradiation at an early timepoint.展开更多
文摘Background:Medical imaging advancements are constrained by fundamental trade-offs between acquisition speed,radiation dose,and image quality,forcing clinicians to work with noisy,incomplete data.Existing reconstruction methods either compromise on accuracy with iterative algorithms or suffer from limited generalizability with task-specific deep learning approaches.Methods:We present LDM-PIR,a lightweight physics-conditioned diffusion multi-model for medical image reconstruction that addresses key challenges in magnetic resonance imaging(MRI),CT,and low-photon imaging.Unlike traditional iterative methods,which are computationally expensive,or task-specific deep learning approaches lacking generalizability,integrates three innovations.A physics-conditioned diffusion framework that embeds acquisition operators(Fourier/Radon transforms)and noise models directly into the reconstruction process.A multi-model architecture that unifies denoising,inpainting,and super-resolution via shared weight conditioning.A lightweight design(2.1M parameters)enabling rapid inference(0.8s/image on GPU).Through self-supervised fine-tuning with measurement consistency losses adapts to new imaging modalities using fewer annotated samples.Results:Achieves state-of-the-art performance on fastMRI(peak signal-to-noise ratio(PSNR):34.04 for single-coil/31.50 for multi-coil)and Lung Image Database Consortium and Image Database Resource Initiative(28.83 PSNR under Poisson noise).Clinical evaluations demonstrate superior preservation of anatomical structures,with SSIM improvements of 8.8%for single-coil and 4.36%for multi-coil MRI over uDPIR.Conclusion:It offers a flexible,efficient,and scalable solution for medical image reconstruction,addressing the challenges of noise,undersampling,and modality generalization.The model’s lightweight design allows for rapid inference,while its self-supervised fine-tuning capability minimizes reliance on large annotated datasets,making it suitable for real-world clinical applications.
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 Tianjin Key Medical Discipline(Specialty)Construction Project,No.TJYXZDXK-3-012B.
文摘BACKGROUND Rectal cancer is a common malignant tumor of the digestive system,with older patients representing the predominantly affected population.Magnetic resonance imaging(MRI)has been widely applied in preoperative tumor assessment;however,the value of high-resolution MRI(HR-MRI)combined with dynamic contrast-enhanced(DCE)scanning in the preoperative diagnosis of rectal cancer in older patients remains unclear.AIM To evaluate the value of HR-MRI combined with DCE scanning in the preoperative diagnosis of rectal cancer in older patients.METHODS This retrospective study included 148 consecutive older female patients with rectal cancer who were treated at our hospital between December 2020 and December 2024.Clinical data and HR-MRI and DCE scan findings were collected.Histopathological examination after surgical resection served as the gold standard.The diagnostic accuracy of MRI for preoperative T and N staging was calculated.Consistency,sensitivity,and specificity between HR-MRI combined with DCE scanning and pathological staging were analyzed using the k test.Among the 148 patients,the overall accuracy of T staging was 84.5%.Sensitivity for T1,T2,T3,and T4 staging was 75.00%,62.50%,89.47%,and 90.48%,respectively,whereas specificity was 100.00%,94.35%,79.25%,and 96.06%,respectively.T staging based on HR-MRI combined with DCE scanning showed good agreement with pathological staging(k=0.8176,P<0.001).For N staging,sensitivity and specificity were 54.88%and 84.85%for N0,36.96%and 72.55%for N1,and 70.00%and 73.44%for N2,respectively;agreement with pathological N staging was poor(k=0.259,P<0.001).CONCLUSION HR-MRI combined with DCE scanning demonstrates high diagnostic accuracy for T staging of rectal cancer in older patients and can provide a theoretical basis for treatment planning.However,its diagnostic accuracy for N staging requires improvement.
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.
文摘A medical image encryption is proposed based on the Fisher-Yates scrambling,filter diffusion and S-box substitution.First,chaotic sequence associated with the plaintext is generated by logistic-sine-cosine system,which is used for the scrambling,substitution and diffusion processes.The three-dimensional Fisher-Yates scrambling,S-box substitution and diffusion are employed for the first round of encryption.The chaotic sequence is adopted for secondary encryption to scramble the ciphertext obtained in the first round.Then,three-dimensional filter is applied to diffusion for further useful information hiding.The key to the algorithm is generated by the combination of hash value of plaintext image and the input parameters.It improves resisting ability of plaintext attacks.The security analysis shows that the algorithm is effective and efficient.It can resist common attacks.In addition,the good diffusion effect shows that the scheme can solve the differential attacks encountered in the transmission of medical images and has positive implications for future research.
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 Science and Technology Planned Project from Xiamen Science and Technology Bureau,China,No.3502Z20154065(to LHZ)the Joint Project for Xiamen Key Diseases from Xiamen Science and Technology Bureau,China,No.3502Z20149032(to GG)
文摘The location of an acute ischemic stroke is associated with its prognosis. The widely used Gaussian model-based parameter, apparent diffusion coefficient(ADC), cannot reveal microstructural changes in different locations or the degree of infarction. This prospective observational study was reviewed and approved by the Institutional Review Board of Xiamen Second Hospital, China(approval No. 2014002).Diffusion kurtosis imaging(DKI) was used to detect 199 lesions in 156 patients with acute ischemic stroke(61 males and 95 females), mean age 63.15 ± 12.34 years. A total of 199 lesions were located in the periventricular white matter(n = 52), corpus callosum(n = 14), cerebellum(n = 29), basal ganglia and thalamus(n = 21), brainstem(n = 21) and gray-white matter junctions(n = 62). Percentage changes of apparent diffusion coefficient(ΔADC) and DKI-derived indices(fractional anisotropy [ΔFA], mean diffusivity [ΔMD], axial diffusivity [ΔD_a], radial diffusivity ΔDr, mean kurtosis [ΔMK], axial kurtosis [ΔK_a], and radial kurtosis [ΔK_r]) of each lesion were computed relative to the normal contralateral region. The results showed that(1) there was no significant difference in ΔADC, ΔMD, ΔD_a or ΔD_r among almost all locations.(2) There was significant difference in ΔMK among almost all locations(except basal ganglia and thalamus vs. brain stem; basal ganglia and thalamus vs. gray-white matter junctions; and brainstem vs. gray-white matter junctions.(3) The degree of change in diffusional kurtosis in descending order was as follows: corpus callosum > periventricular white matter > brainstem > gray-white matter junctions > basal ganglia and thalamus > cerebellum. In conclusion, DKI could reveal the differences in microstructure changes among various locations affected by acute ischemic stroke, and performed better than diffusivity among all groups.
文摘Diffusion weighted imaging(DWI) is a method of signal contrast generation based on the differences in Brownian motion. DWI is a method to evaluate the molecular function and micro-architecture of the human body. DWI signal contrast can be quantified by apparent diffusion coefficient maps and it acts as a tool for treatment respon-se evaluation and assessment of disease progression. Ability to detect and quantify the anisotropy of diffusion leads to a new paradigm called diffusion tensor imaging(DTI). DTI is a tool for assessment of the organs with highly organised fibre structure. DWI forms an integral part of modern state-of-art magnetic resonance imaging and is indispensable in neuroimaging and oncology. DWI is a field that has been undergoing rapid technical evolution and its applications are increasing every day. This review article provides insights in to the evolution of DWI as a new imaging paradigm and provides a summary of current role of DWI in various disease processes.
文摘AIM:To investigate the use of multi-b-value diffusionweighted imaging in diagnosing pancreatic cancer.METHODS:We retrospectively analyzed 33 cases of pancreatic cancer and 12 cases of benign pancreatic tumors at the Second Affiliated Hospital of Kunming Medical University from December 2008 to January2011.The demographic characteristics,clinical presentation,routine magnetic resonance imaging and diffusion weighted imaging(DWI)features with different b values were reviewed.Continuous data were expressed as mean±SD.Comparisons between pancreatic cancer and benign pancreatic tumors were performed using the Student’s t test.A probability of P<0.05 was considered statistically significant.RESULTS:Thirty-three patients with pancreatic cancer were identified.The mean age at diagnosis was 60±5.6 years.The male:female ratio was 21:12.Twenty cases were confirmed by surgical resection and 13 by biopsy of metastases.T1 weighted images demonstrated a pancreatic head mass in 16 patients,a pancreatic body mass in 10 cases,and a pancreatic tail mass with pancreatic atrophy in 7 cases.Eight patients had hepatic metastases,13 had invasion or envelopment of mesenteric vessels,4 had bone metastases,and 8had lymph node metastases.DWI demonstrated an irregular intense mass with unclear margins.Necrotic tissue demonstrated an uneven low signal.A b of 1100s/mm2was associated with a high intensity signal with poor anatomical delineation.A b of 700 s/mm2was associated with apparent diffusion coefficients(ADCs)that were useful in distinguishing benign and malignant pancreatic tumors(P<0.05).b values of 50,350,400,450 and 1100 s/mm2were associated with ADCs that did not differentiate the two tumors.CONCLUSION:Low b value images demonstrated superior anatomical details when compared to high b value images.Tumor tissue definition was high and contrast with the surrounding tissues was good.DWI was useful in diagnosing pancreatic cancer.
文摘Diffusion-weighted imaging(DWI), a functional imaging technique exploiting the Brownian motion of water molecules, is increasingly shown to have value in various oncological and non-oncological applications. Factors such as the ease of acquisition and ability to obtain functional information in the absence of intravenous contrast, especially in patients with abnormal renal function, have contributed to the growing interest in exploring clinical applications of DWI. In the liver, DWI demonstrates a gamut of clinical applications ranging from detecting focal liver lesions to monitoring response in patients undergoing serial follow-up after loco-regional and systemic therapies. DWI is also being applied in the evaluation of diffuse liver diseases such as non-alcoholic fatty liver disease, hepatic fibrosis and cirrhosis. In this review, we intend to review the basic principles, technique, current clinical applications and future trends of DW-MRI in the liver.
基金supported by the Shanghai Municipal Education Commission-Gaofeng Clinical Medicine in China,No.2016427(to YHL)the Clinical Science and Technology Innovation Project of Shanghai Shen Kang Hospital Development Center in China,No.SHDC22015038(to YHL)the Shanghai Municipal Science and Technology Commission Medical Guide Project in China,No.16411968900(to YHL)
文摘Diffusion kurtosis imaging can be used to assess pathophysiological changes in tissue structure and to diagnose central nervous system diseases. However, its sensitivity in assessing hippocampal differences between patients with Alzheimer’s disease and those with amnestic mild cognitive impairment has not been characterized. Here, we examined 20 individuals with Alzheimer’s disease (11 men and 9 women, mean 73.2 ± 4.49 years), 20 with amnestic mild cognitive impairment (10 men and 10 women, mean 71.55 ± 4.77 years), and 20 normal controls (11 men and 9 women, mean 70.45 ± 5.04 years). We conducted diffusion kurtosis imaging, using a 3.0 T magnetic resonance scanner, to compare hippocampal differences among the three groups. The results demonstrated that the right hippocampal volume and bilateral mean kurtosis were remarkably smaller in individuals with Alzheimer’s disease compared with those with amnestic mild cognitive impairment and normal controls. Further, the mean kurtosis was lower in the amnestic mild cognitive impairment group compared with the normal control group. The mean diffusion in the left hippocampus was lower in the Alzheimer’s disease group than in the amnestic mild cognitive impairment and normal control groups, while the mean diffusion in the right hippocampus was lower in the Alzheimer’s disease group than in the normal control group. Fractional anisotropy was similar among the three groups. These results verify that bilateral mean kurtosis and mean diffusion are sensitive to the diagnosis of Alzheimer’s disease and amnestic mild cognitive impairment. This study was approved by the Ethics Review Board of Affiliated Sixth People’s Hospital of Shanghai Jiao Tong University, China on May 4, 2010 (approval No. 2010(C)-6).
基金Supported by National Nature Science Foundation of ChinaNo.81271643
文摘Pancreatic cancer is one of the most common malignanttumors and remains a treatment-refractory cancer with a poor prognosis. Currently, the diagnosis of pancreatic neoplasm depends mainly on imaging and which methods are conducive to detecting small lesions. Compared to the other techniques, magnetic resonance imaging(MRI) has irreplaceable advantages and can provide valuable information unattainable with other noninvasive or minimally invasive imaging techniques. Advances in MR hardware and pulse sequence design have particularly improved the quality and robustness of MRI of the pancreas. Diffusion MR imaging serves as one of the common functional MRI techniques and is the only technique that can be used to reflect the diffusion movement of water molecules in vivo. It is generally known that diffusion properties depend on the characterization of intrinsic features of tissue microdynamics and microstructure. With the improvement of the diffusion models, diffusion MR imaging techniques are increasingly varied, from the simplest and most commonly used technique to the more complex. In this review, the various diffusion MRI techniques for pancreatic cancer are discussed, including conventional diffusion weighted imaging(DWI), multi-b DWI based on intra-voxel incoherent motion theory, diffusion tensor imaging and diffusion kurtosis imaging. The principles, main parameters, advantages and limitations of these techniques, as well as future directions for pancreatic diffusion imaging are also discussed.
基金supported by a grant from the Clinical Medicine Science and Technology Projects in Jiangsu Province of China,No.BL2014037a grant from the Changzhou City Science and Technology Support Plan in China,No.CE20165027+1 种基金a grant from the Changzhou Health Development Planning Commission Major Projects in China,No.ZD201515the Changzhou High-Level Health Personnel Training Project Funding
文摘With improvements in care of at-risk neonates, more and more children survive. This makes it increasingly important to assess, soon after birth, the prognosis of children with hypoxic-ischemic encephalopathy. Computed tomography, ultrasound, and conventional magnetic resonance imaging are helpful to diagnose brain injury, but cannot quantify white matter damage. In this study, ten full-term infants without brain injury and twenty-two full-term neonates with hypoxic-ischemic encephalopathy （14 moderate cases and 8 severe cases） underwent diffusion tensor imaging to assess its feasibility in evaluating white matter damage in this condition. Results demonstrated that fractional anisotropy, voxel volume, and number of fiber bundles were different in some brain areas between infants with brain injury and those without brain injury. The correlation between fractional anisotropy values and neonatal behavioral neurological assessment scores was closest in the posterior limbs of the internal capsule. We conclude that diffusion tensor imaging can quantify white matter injury in neonates with hypoxic-ischemic encephalopathy.
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.
基金Supported by National Institutes of Health R01 CA126809
文摘AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ±11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Ana- tomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P < 0.014). CONCLUSION: Intra-procedural ADC changes of > 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE.
基金supported by the National Natural Science Foundation of China (81630030, 81130024, 81801326, and 81571320)the National Natural Science Foundation of China/ Research Grants Council of Hong Kong Joint Research Scheme (81461168029)+3 种基金the National Basic Research Development Program of China (2016YFC0904300)the 1.3.5 Project for Disciplines of Excellence, West China Hospital of Sichuan Universitythe National High-Technology Research and Development Project (863 Project) of China (2015AA020513)a Scientific Project of Sichuan Science and Technology Department, China (2015JY0173)
文摘Identifying data-driven biotypes of major depressive disorder(MDD) has promise for the clarification of diagnostic heterogeneity. However, few studies have focused on white-matter abnormalities for MDD subtyping. This study included 116 patients with MDD and118 demographically-matched healthy controls assessed by diffusion tensor imaging and neurocognitive evaluation.Hierarchical clustering was applied to the major fiber tracts, in conjunction with tract-based spatial statistics, to reveal white-matter alterations associated with MDD.Clinical and neurocognitive differences were compared between identified subgroups and healthy controls. With fractional anisotropy extracted from 20 fiber tracts, cluster analysis revealed 3 subgroups based on the patterns of abnormalities. Patients in each subgroup versus healthy controls showed a stepwise pattern of white-matter alterations as follows: subgroup 1(25.9% of patient sample),widespread white-matter disruption;subgroup 2(43.1% of patient sample), intermediate and more localized abnormalities in aspects of the corpus callosum and left cingulate;and subgroup 3(31.0% of patient sample),possible mild alterations, but no statistically significant tract disruption after controlling for family-wise error. The neurocognitive impairment in each subgroup accompanied the white-matter alterations: subgroup 1, deficits in sustained attention and delayed memory;subgroup 2, dysfunction in delayed memory;and subgroup 3, no significant deficits. Three subtypes of white-matter abnormality exist in individuals with major depression, those having widespread abnormalities suffering more neurocognitive impairments, which may provide evidence for parsing the heterogeneity of the disorder and help optimize typespecific treatment approaches.
文摘AIM:To evaluate the clinical value of diffusion-weighted magnetic resonance imaging(DW-MRI)in predicting the response of rectal cancer to neoadjuvant chemoradiation.METHODS:This prospective study was approved by our institutional review board,and informed consent was obtained from each patient.Fifteen patients(median age 56 years)with locally advanced rectal cancer were treated in our hospital from June 2006 to December 2007.All patients were stageⅢB-C according to the results of MRI and endorectal ultrasound examinations.All patients underwent pelvic irradiation with 45 Gy/25 fx per 35 days.The concurrent chemotherapy regimen consisted of capecitabine 625mg/m2,bid(Monday-Friday),and oxaliplatin 50 mg/m2,weekly.The patients underwent surgery 5-8 wk after the completion of neoadjuvant therapy.T downstaging was defined as the downstaging of the tumor from cT3to ypT0-2 or from cT4 to ypT0-3.Good regression was defined as TRG 3-4,and poor regression was defined as TRG 0-2.Diffusion-weighted magnetic resonance images were obtained prior to and weekly during the course of neoadjuvant chemoradiation,and the apparent diffusion coefficient(ADC)values were calculated from the acquired tumor images.RESULTS:Comparison with the mean pretreatment tumor ADC revealed an increase in the mean tumor ADC during the course of neoadjuvant chemoradiation,especially at the 2ndweek(P=0.004).We found a strong negative correlation between the mean pretreatment tumor ADC and tumor regression after neoadjuvant chemoradiation(P=0.021).In the T downstage and tumor regression groups,we found a significant increase in the mean ADC at the 2ndweek of neoadjuvant therapy(P=0.011;0.004).CONCLUSION:DW-MRI might be a valuable clinical tool to help predict or assess the response of rectal cancer to neoadjuvant chemoradiation at an early timepoint.
