BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in...BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.展开更多
BACKGROUND Posterior lumbar interbody fusion has good clinical results,but adjacent segment disease(ASD)affects its long-term efficacy.In patients with L4-5 fusion who were followed up for more than 10 years,the ASD i...BACKGROUND Posterior lumbar interbody fusion has good clinical results,but adjacent segment disease(ASD)affects its long-term efficacy.In patients with L4-5 fusion who were followed up for more than 10 years,the ASD incidence was 33.3%.Magnetic resonance imaging(MRI)is key for ASD diagnosis,but metal artifacts from internal fixation limit its use;therefore,removing the artifacts is crucial for ASD diagnosis and treatment.AIM To evaluate the value of WARP MRI for patients with lumbar ASD.METHODS In our hospital,the lumbar spines of patients with ASD were assessed via lumbar MRI,including conventional sequences and sequences for artifacts.A PACS workstation was used for image measurement,analysis,and assessment,which mainly included measurement of the internal fixation implant artifact area,evaluation of the visibility of the anatomical structures surrounding the implant,and diagnostic assessment of ASD in the section.Conventional MRI data sequences and artifacts to sequence the contrast analysis of the MRI data.RESULTS A total of 30 patients with ASD after lumbar fusion and internal fixation were included in the study;the patients included 13 male and 17 female patients and were aged 66.03±5.83 years.The metal artifact area of the WARP T2-tirm sequence was significantly smaller than that of the conventional STIR sequence[(20.85±6.27)cm²vs(50.56±8.55)cm²,P<0.01].The WARP T2-tirm sequence was observed around the implants,pedicles,intervertebral foramen,and vertebral bodies,and the conventional STIR sequence clearly displayed nerve roots within the intervertebral foramen.In all 30 patients,all adjacent segments of the WARP T2-tirm sequence could be clearly observed(above Grade 4),whereas it was difficult to observe these segments in the conventional STIR sequence due to the presence of more severe metal artifacts.CONCLUSION WARP sequences can significantly reduce the artifact area in the sagittal and cross-sectional images of titanium alloy spinal fixation,providing a good imaging reference for the diagnosis of ASD.展开更多
BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of d...BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.展开更多
OBJECTIVE:To examine the variations in brain regions among individuals with decreasing ovarian reserve(DOR) compared to healthy controls using resting-state functional magnetic resonance imaging(rs-fMRI),and to assess...OBJECTIVE:To examine the variations in brain regions among individuals with decreasing ovarian reserve(DOR) compared to healthy controls using resting-state functional magnetic resonance imaging(rs-fMRI),and to assess the immediate effects of acupuncture stimulation on these brain regions in DOR patients.METHODS:Twenty patients diagnosed with DOR(DOR group) and twenty healthy controls(HC group) who underwent rs-fMRI scans were included.The DOR group received acupuncture and underwent a subsequent rsfMRI scan.Amplitude of low-frequency fluctuations(ALFF) analysis was utilized to identify disparities in brain regions between DOR and HC groups,and to evaluate the immediate effects of acupuncture on DOR patients' brain regions.Common brain regions were identified as seed points for functional connectivity(FC) analysis.RESULTS:In this study,a total of 20 HCs and 20 patients with DOR were initially enrolled.However,due to incomplete personal information,three participants were removed from the HC group.Additionally,two DOR patients experienced symptoms such as physical discomfort and shortness of breath during the MRI scan,leading to their exclusion due to excessive head movement parameters.Consequently,17 HCs and 16 DOR patients completed the entire study protocol.Comparative analysis revealed that DOR patients exhibited increased ALFF values in the left inferior temporal gyrus(ITG) and middle temporal gyrus(MTG),while ALFF values in the bilateral superior frontal gyrus(SFG),middle frontal gyrus(MFG),and left inferior frontal gyrus(IFG) were decreased compared to HCs.Following acupuncture intervention,ALFF values in the left SFG,MFG,and supplementary motor area(SMA) of DOR patients increased.Furthermore,functional connectivity(FC) analysis demonstrated increased connectivity of the left SFG with the bilateral calcarine sulcus and lingual gyrus post-acupuncture.CONCLUSION:This study highlights abnormal neural activity in the SFG,MFG,IFG,and ACC in DOR patients compared to HCs.Acupuncture was found to regulate the activity of the SFG,bringing it closer to normal levels,and enhancing its functional connectivity with the bilateral calcarine sulcus and lingual gyrus.展开更多
Introduction.Osteogenesis imperfecta(OI),also known as brittle bone disease,is a phenotypically diverse disorder due to deficiencies in the synthesis of type I collagen.OI is a disease characterized by brittle bones a...Introduction.Osteogenesis imperfecta(OI),also known as brittle bone disease,is a phenotypically diverse disorder due to deficiencies in the synthesis of type I collagen.OI is a disease characterized by brittle bones and frequent fractures with minimal trauma leading to skeletal deformities[1].Its incidence is estimated at 1 per 20,000 births.Though rare,it is the most common inherited disorder of connective tissue.Principally,it affects bone,but it also impacts other tissues rich in type I collagen,such as joints,eyes,ears,skin,and teeth.展开更多
To conduct a computational investigation to explore the influence of clinical reference uncertainty on magnetic resonance imaging(MRI)radiomics feature selection,modelling,and performance.This study used two sets of p...To conduct a computational investigation to explore the influence of clinical reference uncertainty on magnetic resonance imaging(MRI)radiomics feature selection,modelling,and performance.This study used two sets of publicly available prostate cancer MRI=radiomics data(Dataset 1:n=260;Dataset 2:n=100)with Gleason score clinical references.Each dataset was divided into training and holdout testing datasets at a ratio of 7:3 and analysed independently.The clinical references of the training set were permuted at different levels(increments of 5%)and repeated 20 times.Four feature selection algorithms and two classifiers were used to construct the models.Cross-validation was employed for training,while a separate hold-out testing set was used for evaluation.The Jaccard similarity coefficient was used to evaluate feature selection,while the area under the curve(AUC)and accuracy were used to assess model performance.An analysis of variance test with Bonferroni correction was conducted to compare the metrics of each model.The consistency of the feature selection performance decreased substantially with the clinical reference permutation.AUCs of the trained models with permutation particularly after 20%were significantly lower(Dataset 1(with≥20%permutation):0.67,and Dataset 2(≥20%permutation):0.74),compared to the AUC of models without permutation(Dataset 1:0.94,Dataset 2:0.97).The performances of the models were also associated with larger uncertainties and an increasing number of permuted clinical references.Clinical reference uncertainty can substantially influence MRI radiomic feature selection and modelling.The high accuracy of clinical references should be helpful in building reliable and robust radiomic models.Careful interpretation of the model performance is necessary,particularly for high-dimensional data.展开更多
Introduction Aortic arch anomalies are congenital malformations of the position or branching of the aortic arch,or both.Double aortic arch(DAA)is a very rare malformation,affecting approximately 0.005%~0.007% of fetus...Introduction Aortic arch anomalies are congenital malformations of the position or branching of the aortic arch,or both.Double aortic arch(DAA)is a very rare malformation,affecting approximately 0.005%~0.007% of fetuses[1],and there has been no relevant literature mentioning the prenatal finding DAA in Macao till now.展开更多
BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-we...BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in colorectal cancer.METHODS We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging.Surgical pathology was used as the gold standard for comparison.Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.RESULTS The combined method achieved 94.74%sensitivity,95.45%specificity,95.00%accuracy,94.74%positive predictive value,and 95.45%negative predictive value in qualitative diagnosis.It showed 94.44%sensitivity,95.00%specificity,94.74%accuracy,94.44%positive predictive value,and 95.00%negative predictive value in clinical staging.Finally,it showed 94.74%sensitivity,94.59%specificity,94.74%accuracy,94.74%positive predictive value,and 94.59%negative predictive value in diagnosing lymph node metastasis.These results were highly consistent with that of the gold standard.CONCLUSION This study combined T2WI and DWI for accurate diagnosis of colorectal cancer,aiding clinical staging and lymph node metastasis assessment.This approach is promising for clinical application.展开更多
BACKGROUND Gastric cancer(GC)remains a significant global health challenge,with high incidence and mortality rates.Neoadjuvant chemotherapy is increasingly used to improve surgical outcomes and long-term survival in a...BACKGROUND Gastric cancer(GC)remains a significant global health challenge,with high incidence and mortality rates.Neoadjuvant chemotherapy is increasingly used to improve surgical outcomes and long-term survival in advanced cases.However,individual responses to treatment vary widely,and current imaging methods often fall short in accurately predicting efficacy.Advanced imaging techniques,such as computed tomography(CT)3D reconstruction and texture analysis,offer potential for more precise assessment of therapeutic response.AIM To explore the application value of CT 3D reconstruction volume change rate,texture feature analysis,and visual features in assessing the efficacy of neoadjuvant chemotherapy for advanced GC.METHODS A retrospective analysis was conducted on the clinical and imaging data of 97 patients with advanced GC who received S-1 plus Oxaliplatin combined chemotherapy regimen neoadjuvant chemotherapy from January 2022 to March 2024.CT texture feature analysis was performed using MaZda software,and ITK-snap software was used to measure the tumor volume change rate before and after chemotherapy.CT visual features were also evaluated.Using postoperative pathological tumor regression grade(TRG)as the gold standard,the correlation between various indicators and chemotherapy efficacy was analyzed,and a predictive model was constructed and internally validated.RESULTS The minimum misclassification rate of texture features in venous phase CT images(7.85%)was lower than in the arterial phase(13.92%).The volume change rate in the effective chemotherapy group(75.20%)was significantly higher than in the ineffective group(41.75%).There was a strong correlation between volume change rate and TRG grade(r=-0.886,P<0.001).Multivariate analysis showed that gastric wall peristalsis(OR=0.286)and thickness change rate≥40%(OR=0.265)were independent predictive factors.Receiver operating characteristic curve analysis indicated that the volume change rate[area under the curve(AUC)=0.885]was superior to the CT visual feature model(AUC=0.795).When the cutoff value was 82.56%,the sensitivity and specificity were 85.62%and 96.45%,respectively.CONCLUSION The CT 3D reconstruction volume change rate can serve as a preferred quantitative indicator for evaluating the efficacy of neoadjuvant chemotherapy in GC.Combining it with a CT visual feature predictive model can further improve the accuracy of efficacy evaluation.展开更多
BACKGROUND Mac-2 binding protein glycosylation isomer(M2BPGi)serves as a marker of activated hepatic stellate cells and as such holds potential as a biomarker for liver fibrosis.In Viet Nam,metabolic dysfunction-assoc...BACKGROUND Mac-2 binding protein glycosylation isomer(M2BPGi)serves as a marker of activated hepatic stellate cells and as such holds potential as a biomarker for liver fibrosis.In Viet Nam,metabolic dysfunction-associated steatotic liver disease(MASLD)is rising in prevalence and there is an urgent need for better clinical management,particularly in early detection methods that will improve overall prognosis.AIM To examine M2BPGi cut-off values for staging liver fibrosis in patients with MASLD and risk factors associated with disease progression.METHODS A total of 301 individuals with ultrasound-confirmed or FibroScan-confirmed diagnosis of fatty liver were enrolled in the study.The participants were stratified according to fibrosis stage,measured via magnetic resonance elastography.M2-BPGi,Fibrosis-4(FIB-4)Index score,and routine parameters of liver function were assessed to statistically investigate the correlation of M2BPGi levels in various fibrosis stages and to identify risk factors associated with fibrosis severity.RESULTS M2BPGi levels positively correlated with fibrosis stages,with cut-off indexes of 0.57 for F0-1,0.68 for F2-3,and 0.78 for F4.M2BPGi levels in the F0-1 group were significantly different from those in both the F2-3 group(P=0.038)and the F4 group(P=0.0051);the F2-3 and F4 groups did not show a significant difference(P=0.39).Females exhibited significantly higher M2BPGi levels than males for all fibrosis stages,particularly in the F2-3 group(P=0.01)and F4 group(P=0.0006).In the F4(cirrhosis)group,individuals with diabetes had significantly higher M2BPGi levels than those without.M2BPGi,hemoglobin A1c,and FIB-4 score were identified as independent risk factors for greater fibrosis and cirrhosis.CONCLUSION M2BPGi levels varied significantly throughout fibrosis progression,from early MASLD to cirrhosis,with sex correlation.M2BPGi holds promise as an early biomarker for fibrosis characterization in MASLD adult patient populations.展开更多
BACKGROUND The Mac-2 binding protein glycosylated isomer(M2BPGi)is a serum marker for fibrosis that correlates with the fibrosis stages in various liver diseases.AIM To examine the M2BPGi’s threshold for staging fibr...BACKGROUND The Mac-2 binding protein glycosylated isomer(M2BPGi)is a serum marker for fibrosis that correlates with the fibrosis stages in various liver diseases.AIM To examine the M2BPGi’s threshold for staging fibrosis in patients with chronic hepatitis B(CHB),and its changes during treatment.METHODS This was a prospective,longitudinal study.A total of 348 eligible patients were recruited from the Hepatology Department,Medic Medical Center between March 2020 and December 2023.Liver enzyme tests,platelet counts,M2BPGi levels,and FibroScan were conducted at baseline and at 3-month intervals until six months post-treatment.Correlation plots of M2BPGi,FibroScan,and the other parameters were generated.Receiver operating characteristic curves were constructed for M2BPGi and the other parameters to evaluate their performance.RESULTS M2BPGi levels correlated well with FibroScan results and increased as the fibrosis stage advanced.The median M2BPGi levels at the different stages of fibrosis showed statistically significant differences.The cut-off values of M2BPGi for diagnosing significant fibrosis(F≥2),advanced fibrosis(F3),and cirrhosis(F4)were determined to be 1.08,1.4,and 1.52,respectively.In the context of fibrosis regression in CHB patients during the first 6-month of treatment,M2BPGi levels appeared to decrease before this pattern occurred in the FibroScan results.CONCLUSION M2BPGi levels were strongly correlated with FibroScan.M2BPGi can be used to assess liver fibrosis,and to serve as a tool for monitoring fibrosis regression in CHB patients undergoing treatment.展开更多
Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD)has emerged as a predominant cause of chronic liver disease globally,with its prevalence rising steadily each year.If left untreated,MASLD may progress to...Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD)has emerged as a predominant cause of chronic liver disease globally,with its prevalence rising steadily each year.If left untreated,MASLD may progress to metabolic dysfunction in associated steatohepatitis(MASH),a more severe condition that can irreversibly advance to liver fibrosis,cirrhosis,and even hepatocyte carcinoma(HCC).Recent studies have illuminated a pivotal link between dysregulated cholesterol metabolism and the pathogenesis and severity of MASLD.This underscores the critical need for a comprehensive exploration of the regulatory mechanisms underlying hepatic cholesterol metabolism in MASLD,as such insights could unveil new therapeutic targets and pave the way for early diagnosis and effective prevention strategies.Cyclocarya paliurus(Batal.)Iljinskaja,a plant known for both medicinal and dietary applications,has demonstrated diverse pharmacological properties,including hypoglycemic,lipid-regulating,and hepatoprotective effects.This study aimed to investigate the hypolipidemic and hepatoprotective activities of Cyclocarya paliurus extract(CCE)in a murine model of MASLD induced by a methionine-choline-deficient(MCD)diet.Simvastatin was employed as a positive control drug,while various doses of CCE were administered to assess its therapeutic potential.Meanwhile,the control and model groups received 0.5%sodium carboxymethyl cellulose(CMC-Na)once daily for 6 weeks.At the end of the treatment period,blood and liver samples were collected for biochemical analysis,histopathological assessment,and gene expression profiling.The findings revealed that CCE significantly reduced serum levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)while enhancing the activities of cholinesterase(CHE)and high-density lipoprotein cholesterol(HDL-C).In liver tissues,CCE markedly decreased the levels of total cholesterol(TC)and triglycerides(TG),while simultaneously increasing hepatic HDL-C content.Histological analyses showed notable alleviation of pathological liver damage in CCE-treated mice.Molecular studies further demonstrated that CCE downregulated the expression of key genes and proteins involved in cholesterol synthesis,including SREBP2,LDLR,and HMGCR.Concurrently,it upregulated the expression of genes and proteins related to cholesterol transport,such as ABCG5 and ABCG8.Additionally,CCE mitigated inflammation by improving the expression levels of pro-inflammatory cytokines,including TNF-α and IL-6,and modulated oxidative stress markers,such as NRF2,KEAP1,and NQO1.Protein expression analyses revealed reduced levels of IL-6 and IL-1β,further corroborating its anti-inflammatory effects.In summary,C.paliurus exhibited potent hepatoprotective effects in MCD-induced MASLD mice.These protective mechanisms were closely linked to the upregulation of cholesterol transporters ABCG5/8 and the modulation of sterol regulatory element-binding protein 2(SREBP2).This study highlighted the therapeutic potential of C.paliurus as a promising intervention for MASLD and underscored its role in regulating cholesterol metabolism and mitigating inflammation and oxidative stress.展开更多
AIM: To compare breath-hold cartesian volumetric interpolated breath-hold examination(cVIBE) and freebreathing radial VIBE(rVIBE) and determine whether rVIBE could replace cVIBE in routine liver magnetic resonance ima...AIM: To compare breath-hold cartesian volumetric interpolated breath-hold examination(cVIBE) and freebreathing radial VIBE(rVIBE) and determine whether rVIBE could replace cVIBE in routine liver magnetic resonance imaging(MRI).METHODS: In this prospective study, 15 consecutive patients scheduled for routine MRI of the abdomen underwent pre- and post-contrast breath-hold cVIBE imaging(19 s acquisition time) and free-breathing rVIBE imaging(111 s acquisition time) on a 1.5T Siemens scanner. Three radiologists with 2, 4, and 8 years post-fellowship experience in abdominal imaging evaluated all images. The radiologists were blinded to the sequence types, which were presented in a random order for each patient. For each sequence, the radiologists scored the cVIBE and rVIBE images for liver edge sharpness, hepatic vessel clarity, presence of artifacts, lesion conspicuity, fat saturation, and overall image quality using a five-point scale. RESULTS: Compared to rVIBE, cVIBE yielded significantly(P < 0.001) higher scores for liver edge sharpness(mean score, 3.87 vs 3.37), hepatic-vessel clarity(3.71 vs 3.18), artifacts(3.74 vs 3.06), lesion conspicuity(3.81 vs 3.2), and overall image quality(3.91 vs 3.24). cVIBE and rVIBE did not significantly differ in quality of fat saturation(4.12 vs 4.03, P = 0.17). The inter-observer variability with respect to differences between rVIBE and cVIBE scores was close to zero compared to random error and inter-patient variation. Quality of rVIBE images was rated as acceptable for all parameters. CONCLUSION: rVIBE cannot replace cVIBE in routine liver MRI. At 1.5T, free-breathing rVIBE yields acceptable, although slightly inferior image quality compared to breath-hold cVIBE.展开更多
Five types of superparamagnetic iron oxide （SPIO）,i.e. Ferumoxides （Feridex？ Ⅳ, Berlex Laboratories）,Fe r u c a r b o t ra n （ Re s ov i s t？, B aye r H e a l t h c a re ） ,Ferumoxtran-10 （AMI-227 or Code-72...Five types of superparamagnetic iron oxide （SPIO）,i.e. Ferumoxides （Feridex？ Ⅳ, Berlex Laboratories）,Fe r u c a r b o t ra n （ Re s ov i s t？, B aye r H e a l t h c a re ） ,Ferumoxtran-10 （AMI-227 or Code-7227, Combidex？, AMAG Pharma; Sinerem？, Guerbet）, NC100150（Clariscan？, Nycomed,） and （VSOP C184, Ferropharm）have been designed and clinically tested as magneticresonance contrast agents. However, until nowResovist？ is current available in only a few countries.The other four agents have been stopped for furtherdevelopment or withdrawn from the market. AnotherSPIO agent Ferumoxytol （Feraheme） is approved forthe treatment of iron deficiency in adult chronic kidneydisease patients. Ferumoxytol is comprised of ironoxide particles surrounded by a carbohydrate coat, andit is being explored as a potential imaging approach forevaluating lymph nodes and certain liver tumors.展开更多
AIM: To compare apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) of hepatic fibrosis patients with those of healthy controls and to identify their correlations with serum indices of live...AIM: To compare apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) of hepatic fibrosis patients with those of healthy controls and to identify their correlations with serum indices of liver fibrosis.展开更多
Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available i...Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.展开更多
The main goal of this study was to introduce a novel three-dimensional procedure to objectively quantify both inner and outer condylar remodelling on preoperative multi-slice computed tomography （MSCT） and postopera...The main goal of this study was to introduce a novel three-dimensional procedure to objectively quantify both inner and outer condylar remodelling on preoperative multi-slice computed tomography （MSCT） and postoperative cone-beam computed tomography （CBCT） images. Second, the reliability and accuracy of this condylar volume quantification method was assessed. The mandibles of 20 patients （11 female and 9 male） who underwent bimaxillary surgery were semi-automatically extracted from MSCT/CBCT scans and rendered in 3D. The resulting condyles were spatially matched by using an anatomical landmark-based registration procedure. A standardized sphere was created around each condyle, and the condylar bone volume within this selected region of interest was automatically calculated. To investigate the reproducibility of the method, inter- and intra-observer reliability was calculated for assessments made by two experienced radiologists twice five months apart in a set of ten randomly selected patients. To test the accuracy of the bone segmentation, the inner and outer bone structures of one dry mandible, scanned according to the clinical set-up, were compared with the gold standard, micro-CT. Thirty-eight condyles showed a significant （P〈O.05） mean bone volume decrease of 26.4%_ 11.4% （502.9 mm3＋ 268.1 mm3）. No significant effects of side, sex or age were found. Good to excellent （ICC〉 0.6） intra- and inter-observer reliability was observed for both MSCT and CBCT. Moreover, the bone segmentation accuracy was less than one voxel （0.4 mm） for MSCT （0.3 mm __. 0.2 mm） and CBCT （0.4 mm _ 0.3 mm）, thus indicating the clinical potential of this method for objective follow-up in pathological condylar resorption.展开更多
The anterior cruciate ligament(ACL)is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament.However,the oblique course of the ACL within the intercond...The anterior cruciate ligament(ACL)is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament.However,the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the ligament.This pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL,particularly magnetic resonance imaging.展开更多
BACKGROUND Diffusion-weighted imaging(DWI)has become a useful tool in the detection,characterization,and evaluation of response to treatment of many cancers,including malignant liver lesions.DWI offers higher image co...BACKGROUND Diffusion-weighted imaging(DWI)has become a useful tool in the detection,characterization,and evaluation of response to treatment of many cancers,including malignant liver lesions.DWI offers higher image contrast between lesions and normal liver tissue than other sequences.DWI images acquired at two or more b-values can be used to derive an apparent diffusion coefficient(ADC).DWI in the body has several technical challenges.This include ghosting artifacts,mis-registration and susceptibility artifacts.New DWI sequences have been developed to overcome some of these challenges.Our goal is to evaluate 3 new DWI sequences for liver imaging.AIM To qualitatively and quantitatively compare 3 DWI sequences for liver imaging:free-breathing(FB),simultaneous multislice(SMS),and prospective acquisition correction(PACE).METHODS Magnetic resonance imaging(MRI)was performed in 20 patients in this prospective study.The MR study included 3 separate DWI sequences:FB-DWI,SMS-DWI,and PACE-DWI.The image quality,mean ADC,standard deviations(SD)of ADC,and ADC histogram were compared.Wilcoxon signed-rank tests were used to compare qualitative image quality.A linear mixed model was used to compare the mean ADC and the SDs of the ADC values.All tests were 2-sided and P values of<0.05 were considered statistically significant.RESULTS There were 56 lesions(50 malignant)evaluated in this study.The mean qualitative image quality score of PACE-DWI was 4.48.This was significantly better than that of SMS-DWI(4.22)and FB-DWI(3.15)(P<0.05).Quantitatively,the mean ADC values from the 3 different sequences did not significantly differ for each liver lesion.FB-DWI had a markedly higher variation in the SD of the ADC values than did SMS-DWI and PACE-DWI.We found statistically significant differences in the SDs of the ADC values for FB-DWI vs PACE-DWI(P<0.0001)and for FB-DWI vs SMS-DWI(P=0.03).The SD of the ADC values was not statistically significant for PACE-DWI and SMS-DWI(P=0.18).The quality of the PACE-DWI ADC histograms were considered better than the SMS-DWI and FB-DWI.CONCLUSION Compared to FB-DWI,both PACE-DWI and SMS-DWI provide better image quality and decreased quantitative variability in the measurement of ADC values of liver lesions.展开更多
Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for...Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound(US)is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs(e.g.,lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.展开更多
文摘BACKGROUND Colorectal cancer(CRC)is a malignant tumor with high morbidity and mortality rates worldwide.With the development of medical imaging technology,imaging features are playing an increasingly important role in the prognostic evaluation of CRC.Laparoscopic radical resection is a common surgical approach for treating CRC.However,research on the link between preoperative imaging and short-term prognosis in this context is limited.We hypothesized that specific preope-rative imaging features can predict the short-term prognosis in patients under-going laparoscopic CRC resection.AIM To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.METHODS This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who under-went laparoscopic radical resection between January 2021 and February 2024.All patients underwent magnetic resonance imaging(MRI)and were diagnosed with CRC through pathological examination.MRI data and prognostic indicators were collected 30 days post-surgery.Logistic regression analysis identified imaging fea-tures linked to short-term prognosis,and a receiver operating characteristic(ROC)curve was used to evaluate the predictive value.RESULTS Among 122 patients,22 had irregular,low-intensity tumors with adjacent high signals.In 55,tumors were surrounded by alternating signals in the muscle layer.In 32,tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue.Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps.Logistic regression revealed differences in longitudinal tumor length,axial tumor length,volume transfer constant,plasma volume fraction,and apparent diffusion coefficient among patients with varying prognostic results.ROC analysis indicated that the areas under the curve for these parameters were 0.648,0.927,0.821,0.809,and 0.831,respectively.Sensitivity values were 0.643,0.893,0.607,0.714,and 0.714,and specificity 0.702,0.904,0.883,0.968,and 0.894(P<0.05).CONCLUSION The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection.These findings provide valuable insights for clinical decision-making.
基金Supported by Shanghai Tongren Hospital Scientific Research Funds,No.TRKYRC-xx202203Shanghai Municipal Health Commission,No.2022YQ006Science and Technology Commission of Shanghai Municipality,No.22ZR1457200.
文摘BACKGROUND Posterior lumbar interbody fusion has good clinical results,but adjacent segment disease(ASD)affects its long-term efficacy.In patients with L4-5 fusion who were followed up for more than 10 years,the ASD incidence was 33.3%.Magnetic resonance imaging(MRI)is key for ASD diagnosis,but metal artifacts from internal fixation limit its use;therefore,removing the artifacts is crucial for ASD diagnosis and treatment.AIM To evaluate the value of WARP MRI for patients with lumbar ASD.METHODS In our hospital,the lumbar spines of patients with ASD were assessed via lumbar MRI,including conventional sequences and sequences for artifacts.A PACS workstation was used for image measurement,analysis,and assessment,which mainly included measurement of the internal fixation implant artifact area,evaluation of the visibility of the anatomical structures surrounding the implant,and diagnostic assessment of ASD in the section.Conventional MRI data sequences and artifacts to sequence the contrast analysis of the MRI data.RESULTS A total of 30 patients with ASD after lumbar fusion and internal fixation were included in the study;the patients included 13 male and 17 female patients and were aged 66.03±5.83 years.The metal artifact area of the WARP T2-tirm sequence was significantly smaller than that of the conventional STIR sequence[(20.85±6.27)cm²vs(50.56±8.55)cm²,P<0.01].The WARP T2-tirm sequence was observed around the implants,pedicles,intervertebral foramen,and vertebral bodies,and the conventional STIR sequence clearly displayed nerve roots within the intervertebral foramen.In all 30 patients,all adjacent segments of the WARP T2-tirm sequence could be clearly observed(above Grade 4),whereas it was difficult to observe these segments in the conventional STIR sequence due to the presence of more severe metal artifacts.CONCLUSION WARP sequences can significantly reduce the artifact area in the sagittal and cross-sectional images of titanium alloy spinal fixation,providing a good imaging reference for the diagnosis of ASD.
基金Supported by the Czech Ministry of Health,General University Hospital in Prague,No.VFN00064165。
文摘BACKGROUND Whole-body magnetic resonance imaging(wbMRI)allows general assessment of systemic cancers including lymphomas without radiation burden.AIM To evaluate the diagnostic performance of wbMRI in the staging of diffuse large B-cell lymphoma(DLBCL),determine the value of individual MRI sequences,and assess patients’concerns with wbMRI.METHODS In this single-center prospective study,adult patients newly diagnosed with systemic DLBCL underwent wbMRI on a 3T scanner[diffusion weighted images with background suppression(DWIBS),T2,short tau inversion recovery(STIR),contrast-enhanced T1]and fluorodeoxyglucose(18F-FDG)positron emission tomo-graphy/computed tomography(PET/CT)(reference standard).The involvement of 12 nodal regions and extranodal sites was evaluated on wbMRI and PET/CT.The utility of wbMRI sequences was rated on a five-point scale(0=not useful,4=very useful).Patients received a questionnaire regarding wbMRI.RESULTS Of 60 eligible patients,14(23%)were enrolled and completed the study.The sensitivity of wbMRI in the nodal involvement(182 nodal sites)was 0.84,with 0.99 specificity,positive predictive value of 0.96,negative predictive value of 0.97,and 0.97 accuracy.PET/CT and wbMRI were concordant both in extranodal involvement(13 instances)and staging(κ=1.0).The mean scores of the utility of MRI sequences were 3.71±0.73 for DWIBS,2.64±0.84 for T1,2.14±0.77 for STIR,and 1.29±0.73 for T2(P<0.0001).Patients were mostly concerned about the enclosed environment and duration of the MRI examination(27%of patients).CONCLUSION The wbMRI exhibited excellent sensitivity and specificity in staging DLBCL.DWIBS and contrast-enhanced T1 were rated as the most useful sequences.Patients were less willing to undergo wbMRI as a second examination parallel to PET/CT,especially owing to the long duration and the enclosed environment.
基金Innovation and Development Joint Fund of Natural Science Foundation of Shandong Province:based on the Nuclear Factor-erythroid 2 Related Factor 2/AU-rich Element Antioxidant Pathway,the Effect and Mechanism of Menstrual Stimulation Acupuncture on in vitro Fertilization and Embryo Transfer Pregnancy Outcomes in Poor Ovarian Response Patients were Studied (ZR2022LZY008)Shandong Provincial Traditional Chinese Medicine High-level Personnel Training Program Supported by Special Funds (No.6 [2021])+3 种基金Qilu Health and Health Leading Talents Training Project (No.3 [2020])Clinical Science and Technology Innovation Program of Jinan Science and Technology Bureau:Study on the Regulatory Mechanism of Menstrual Regulation and Pregnancy Promotion Acupuncture Method based on rs-functional Magnetic Resonance Imaging Technology on the Brain Function Network of Decreasing Ovarian Reserve Patients (202225059)Shandong Traditional Chinese Medicine Science and Technology Development Plan Project:a Multimodal Neuroimaging Study of Menstrual Stimulation Acupuncture in Patients with Polycystic Ovary Syndrome (No.Q-2022099)Shandong Traditional Chinese Medicine Science and Technology Development Plan Project:based on the Immunoregulation of Treg Cells,the Mechanism of Menstruation and Pregnancy Promotion Injection in the Treatment of Early-onset Ovarian Insufficiency was Explored (No.B-2022002)。
文摘OBJECTIVE:To examine the variations in brain regions among individuals with decreasing ovarian reserve(DOR) compared to healthy controls using resting-state functional magnetic resonance imaging(rs-fMRI),and to assess the immediate effects of acupuncture stimulation on these brain regions in DOR patients.METHODS:Twenty patients diagnosed with DOR(DOR group) and twenty healthy controls(HC group) who underwent rs-fMRI scans were included.The DOR group received acupuncture and underwent a subsequent rsfMRI scan.Amplitude of low-frequency fluctuations(ALFF) analysis was utilized to identify disparities in brain regions between DOR and HC groups,and to evaluate the immediate effects of acupuncture on DOR patients' brain regions.Common brain regions were identified as seed points for functional connectivity(FC) analysis.RESULTS:In this study,a total of 20 HCs and 20 patients with DOR were initially enrolled.However,due to incomplete personal information,three participants were removed from the HC group.Additionally,two DOR patients experienced symptoms such as physical discomfort and shortness of breath during the MRI scan,leading to their exclusion due to excessive head movement parameters.Consequently,17 HCs and 16 DOR patients completed the entire study protocol.Comparative analysis revealed that DOR patients exhibited increased ALFF values in the left inferior temporal gyrus(ITG) and middle temporal gyrus(MTG),while ALFF values in the bilateral superior frontal gyrus(SFG),middle frontal gyrus(MFG),and left inferior frontal gyrus(IFG) were decreased compared to HCs.Following acupuncture intervention,ALFF values in the left SFG,MFG,and supplementary motor area(SMA) of DOR patients increased.Furthermore,functional connectivity(FC) analysis demonstrated increased connectivity of the left SFG with the bilateral calcarine sulcus and lingual gyrus post-acupuncture.CONCLUSION:This study highlights abnormal neural activity in the SFG,MFG,IFG,and ACC in DOR patients compared to HCs.Acupuncture was found to regulate the activity of the SFG,bringing it closer to normal levels,and enhancing its functional connectivity with the bilateral calcarine sulcus and lingual gyrus.
文摘Introduction.Osteogenesis imperfecta(OI),also known as brittle bone disease,is a phenotypically diverse disorder due to deficiencies in the synthesis of type I collagen.OI is a disease characterized by brittle bones and frequent fractures with minimal trauma leading to skeletal deformities[1].Its incidence is estimated at 1 per 20,000 births.Though rare,it is the most common inherited disorder of connective tissue.Principally,it affects bone,but it also impacts other tissues rich in type I collagen,such as joints,eyes,ears,skin,and teeth.
基金supported by hospital research project RC-2022-12.
文摘To conduct a computational investigation to explore the influence of clinical reference uncertainty on magnetic resonance imaging(MRI)radiomics feature selection,modelling,and performance.This study used two sets of publicly available prostate cancer MRI=radiomics data(Dataset 1:n=260;Dataset 2:n=100)with Gleason score clinical references.Each dataset was divided into training and holdout testing datasets at a ratio of 7:3 and analysed independently.The clinical references of the training set were permuted at different levels(increments of 5%)and repeated 20 times.Four feature selection algorithms and two classifiers were used to construct the models.Cross-validation was employed for training,while a separate hold-out testing set was used for evaluation.The Jaccard similarity coefficient was used to evaluate feature selection,while the area under the curve(AUC)and accuracy were used to assess model performance.An analysis of variance test with Bonferroni correction was conducted to compare the metrics of each model.The consistency of the feature selection performance decreased substantially with the clinical reference permutation.AUCs of the trained models with permutation particularly after 20%were significantly lower(Dataset 1(with≥20%permutation):0.67,and Dataset 2(≥20%permutation):0.74),compared to the AUC of models without permutation(Dataset 1:0.94,Dataset 2:0.97).The performances of the models were also associated with larger uncertainties and an increasing number of permuted clinical references.Clinical reference uncertainty can substantially influence MRI radiomic feature selection and modelling.The high accuracy of clinical references should be helpful in building reliable and robust radiomic models.Careful interpretation of the model performance is necessary,particularly for high-dimensional data.
文摘Introduction Aortic arch anomalies are congenital malformations of the position or branching of the aortic arch,or both.Double aortic arch(DAA)is a very rare malformation,affecting approximately 0.005%~0.007% of fetuses[1],and there has been no relevant literature mentioning the prenatal finding DAA in Macao till now.
文摘BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in colorectal cancer.METHODS We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging.Surgical pathology was used as the gold standard for comparison.Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.RESULTS The combined method achieved 94.74%sensitivity,95.45%specificity,95.00%accuracy,94.74%positive predictive value,and 95.45%negative predictive value in qualitative diagnosis.It showed 94.44%sensitivity,95.00%specificity,94.74%accuracy,94.44%positive predictive value,and 95.00%negative predictive value in clinical staging.Finally,it showed 94.74%sensitivity,94.59%specificity,94.74%accuracy,94.74%positive predictive value,and 94.59%negative predictive value in diagnosing lymph node metastasis.These results were highly consistent with that of the gold standard.CONCLUSION This study combined T2WI and DWI for accurate diagnosis of colorectal cancer,aiding clinical staging and lymph node metastasis assessment.This approach is promising for clinical application.
文摘BACKGROUND Gastric cancer(GC)remains a significant global health challenge,with high incidence and mortality rates.Neoadjuvant chemotherapy is increasingly used to improve surgical outcomes and long-term survival in advanced cases.However,individual responses to treatment vary widely,and current imaging methods often fall short in accurately predicting efficacy.Advanced imaging techniques,such as computed tomography(CT)3D reconstruction and texture analysis,offer potential for more precise assessment of therapeutic response.AIM To explore the application value of CT 3D reconstruction volume change rate,texture feature analysis,and visual features in assessing the efficacy of neoadjuvant chemotherapy for advanced GC.METHODS A retrospective analysis was conducted on the clinical and imaging data of 97 patients with advanced GC who received S-1 plus Oxaliplatin combined chemotherapy regimen neoadjuvant chemotherapy from January 2022 to March 2024.CT texture feature analysis was performed using MaZda software,and ITK-snap software was used to measure the tumor volume change rate before and after chemotherapy.CT visual features were also evaluated.Using postoperative pathological tumor regression grade(TRG)as the gold standard,the correlation between various indicators and chemotherapy efficacy was analyzed,and a predictive model was constructed and internally validated.RESULTS The minimum misclassification rate of texture features in venous phase CT images(7.85%)was lower than in the arterial phase(13.92%).The volume change rate in the effective chemotherapy group(75.20%)was significantly higher than in the ineffective group(41.75%).There was a strong correlation between volume change rate and TRG grade(r=-0.886,P<0.001).Multivariate analysis showed that gastric wall peristalsis(OR=0.286)and thickness change rate≥40%(OR=0.265)were independent predictive factors.Receiver operating characteristic curve analysis indicated that the volume change rate[area under the curve(AUC)=0.885]was superior to the CT visual feature model(AUC=0.795).When the cutoff value was 82.56%,the sensitivity and specificity were 85.62%and 96.45%,respectively.CONCLUSION The CT 3D reconstruction volume change rate can serve as a preferred quantitative indicator for evaluating the efficacy of neoadjuvant chemotherapy in GC.Combining it with a CT visual feature predictive model can further improve the accuracy of efficacy evaluation.
文摘BACKGROUND Mac-2 binding protein glycosylation isomer(M2BPGi)serves as a marker of activated hepatic stellate cells and as such holds potential as a biomarker for liver fibrosis.In Viet Nam,metabolic dysfunction-associated steatotic liver disease(MASLD)is rising in prevalence and there is an urgent need for better clinical management,particularly in early detection methods that will improve overall prognosis.AIM To examine M2BPGi cut-off values for staging liver fibrosis in patients with MASLD and risk factors associated with disease progression.METHODS A total of 301 individuals with ultrasound-confirmed or FibroScan-confirmed diagnosis of fatty liver were enrolled in the study.The participants were stratified according to fibrosis stage,measured via magnetic resonance elastography.M2-BPGi,Fibrosis-4(FIB-4)Index score,and routine parameters of liver function were assessed to statistically investigate the correlation of M2BPGi levels in various fibrosis stages and to identify risk factors associated with fibrosis severity.RESULTS M2BPGi levels positively correlated with fibrosis stages,with cut-off indexes of 0.57 for F0-1,0.68 for F2-3,and 0.78 for F4.M2BPGi levels in the F0-1 group were significantly different from those in both the F2-3 group(P=0.038)and the F4 group(P=0.0051);the F2-3 and F4 groups did not show a significant difference(P=0.39).Females exhibited significantly higher M2BPGi levels than males for all fibrosis stages,particularly in the F2-3 group(P=0.01)and F4 group(P=0.0006).In the F4(cirrhosis)group,individuals with diabetes had significantly higher M2BPGi levels than those without.M2BPGi,hemoglobin A1c,and FIB-4 score were identified as independent risk factors for greater fibrosis and cirrhosis.CONCLUSION M2BPGi levels varied significantly throughout fibrosis progression,from early MASLD to cirrhosis,with sex correlation.M2BPGi holds promise as an early biomarker for fibrosis characterization in MASLD adult patient populations.
文摘BACKGROUND The Mac-2 binding protein glycosylated isomer(M2BPGi)is a serum marker for fibrosis that correlates with the fibrosis stages in various liver diseases.AIM To examine the M2BPGi’s threshold for staging fibrosis in patients with chronic hepatitis B(CHB),and its changes during treatment.METHODS This was a prospective,longitudinal study.A total of 348 eligible patients were recruited from the Hepatology Department,Medic Medical Center between March 2020 and December 2023.Liver enzyme tests,platelet counts,M2BPGi levels,and FibroScan were conducted at baseline and at 3-month intervals until six months post-treatment.Correlation plots of M2BPGi,FibroScan,and the other parameters were generated.Receiver operating characteristic curves were constructed for M2BPGi and the other parameters to evaluate their performance.RESULTS M2BPGi levels correlated well with FibroScan results and increased as the fibrosis stage advanced.The median M2BPGi levels at the different stages of fibrosis showed statistically significant differences.The cut-off values of M2BPGi for diagnosing significant fibrosis(F≥2),advanced fibrosis(F3),and cirrhosis(F4)were determined to be 1.08,1.4,and 1.52,respectively.In the context of fibrosis regression in CHB patients during the first 6-month of treatment,M2BPGi levels appeared to decrease before this pattern occurred in the FibroScan results.CONCLUSION M2BPGi levels were strongly correlated with FibroScan.M2BPGi can be used to assess liver fibrosis,and to serve as a tool for monitoring fibrosis regression in CHB patients undergoing treatment.
基金National Key Research and Development Program of China(Grant No.2022YFC3501700)the Beijing Municipal Natural Science Foundation(Grant No.7144219).
文摘Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD)has emerged as a predominant cause of chronic liver disease globally,with its prevalence rising steadily each year.If left untreated,MASLD may progress to metabolic dysfunction in associated steatohepatitis(MASH),a more severe condition that can irreversibly advance to liver fibrosis,cirrhosis,and even hepatocyte carcinoma(HCC).Recent studies have illuminated a pivotal link between dysregulated cholesterol metabolism and the pathogenesis and severity of MASLD.This underscores the critical need for a comprehensive exploration of the regulatory mechanisms underlying hepatic cholesterol metabolism in MASLD,as such insights could unveil new therapeutic targets and pave the way for early diagnosis and effective prevention strategies.Cyclocarya paliurus(Batal.)Iljinskaja,a plant known for both medicinal and dietary applications,has demonstrated diverse pharmacological properties,including hypoglycemic,lipid-regulating,and hepatoprotective effects.This study aimed to investigate the hypolipidemic and hepatoprotective activities of Cyclocarya paliurus extract(CCE)in a murine model of MASLD induced by a methionine-choline-deficient(MCD)diet.Simvastatin was employed as a positive control drug,while various doses of CCE were administered to assess its therapeutic potential.Meanwhile,the control and model groups received 0.5%sodium carboxymethyl cellulose(CMC-Na)once daily for 6 weeks.At the end of the treatment period,blood and liver samples were collected for biochemical analysis,histopathological assessment,and gene expression profiling.The findings revealed that CCE significantly reduced serum levels of aspartate aminotransferase(AST)and alanine aminotransferase(ALT)while enhancing the activities of cholinesterase(CHE)and high-density lipoprotein cholesterol(HDL-C).In liver tissues,CCE markedly decreased the levels of total cholesterol(TC)and triglycerides(TG),while simultaneously increasing hepatic HDL-C content.Histological analyses showed notable alleviation of pathological liver damage in CCE-treated mice.Molecular studies further demonstrated that CCE downregulated the expression of key genes and proteins involved in cholesterol synthesis,including SREBP2,LDLR,and HMGCR.Concurrently,it upregulated the expression of genes and proteins related to cholesterol transport,such as ABCG5 and ABCG8.Additionally,CCE mitigated inflammation by improving the expression levels of pro-inflammatory cytokines,including TNF-α and IL-6,and modulated oxidative stress markers,such as NRF2,KEAP1,and NQO1.Protein expression analyses revealed reduced levels of IL-6 and IL-1β,further corroborating its anti-inflammatory effects.In summary,C.paliurus exhibited potent hepatoprotective effects in MCD-induced MASLD mice.These protective mechanisms were closely linked to the upregulation of cholesterol transporters ABCG5/8 and the modulation of sterol regulatory element-binding protein 2(SREBP2).This study highlighted the therapeutic potential of C.paliurus as a promising intervention for MASLD and underscored its role in regulating cholesterol metabolism and mitigating inflammation and oxidative stress.
文摘AIM: To compare breath-hold cartesian volumetric interpolated breath-hold examination(cVIBE) and freebreathing radial VIBE(rVIBE) and determine whether rVIBE could replace cVIBE in routine liver magnetic resonance imaging(MRI).METHODS: In this prospective study, 15 consecutive patients scheduled for routine MRI of the abdomen underwent pre- and post-contrast breath-hold cVIBE imaging(19 s acquisition time) and free-breathing rVIBE imaging(111 s acquisition time) on a 1.5T Siemens scanner. Three radiologists with 2, 4, and 8 years post-fellowship experience in abdominal imaging evaluated all images. The radiologists were blinded to the sequence types, which were presented in a random order for each patient. For each sequence, the radiologists scored the cVIBE and rVIBE images for liver edge sharpness, hepatic vessel clarity, presence of artifacts, lesion conspicuity, fat saturation, and overall image quality using a five-point scale. RESULTS: Compared to rVIBE, cVIBE yielded significantly(P < 0.001) higher scores for liver edge sharpness(mean score, 3.87 vs 3.37), hepatic-vessel clarity(3.71 vs 3.18), artifacts(3.74 vs 3.06), lesion conspicuity(3.81 vs 3.2), and overall image quality(3.91 vs 3.24). cVIBE and rVIBE did not significantly differ in quality of fat saturation(4.12 vs 4.03, P = 0.17). The inter-observer variability with respect to differences between rVIBE and cVIBE scores was close to zero compared to random error and inter-patient variation. Quality of rVIBE images was rated as acceptable for all parameters. CONCLUSION: rVIBE cannot replace cVIBE in routine liver MRI. At 1.5T, free-breathing rVIBE yields acceptable, although slightly inferior image quality compared to breath-hold cVIBE.
文摘Five types of superparamagnetic iron oxide （SPIO）,i.e. Ferumoxides （Feridex？ Ⅳ, Berlex Laboratories）,Fe r u c a r b o t ra n （ Re s ov i s t？, B aye r H e a l t h c a re ） ,Ferumoxtran-10 （AMI-227 or Code-7227, Combidex？, AMAG Pharma; Sinerem？, Guerbet）, NC100150（Clariscan？, Nycomed,） and （VSOP C184, Ferropharm）have been designed and clinically tested as magneticresonance contrast agents. However, until nowResovist？ is current available in only a few countries.The other four agents have been stopped for furtherdevelopment or withdrawn from the market. AnotherSPIO agent Ferumoxytol （Feraheme） is approved forthe treatment of iron deficiency in adult chronic kidneydisease patients. Ferumoxytol is comprised of ironoxide particles surrounded by a carbohydrate coat, andit is being explored as a potential imaging approach forevaluating lymph nodes and certain liver tumors.
文摘AIM: To compare apparent diffusion coefficient (ADC) values on diffusion-weighted imaging (DWI) of hepatic fibrosis patients with those of healthy controls and to identify their correlations with serum indices of liver fibrosis.
基金Supported by SAK is supported by a grant from the Higher Education Funding Council for England (HEFCE)SDTR is funded by grants from the British Medical Research Council (MRC), London, UK+3 种基金the British Engineering, Physics and Science Research Council (EPSRC), Swindon, UKthe Alan Morement Memorial Fund AMMF, Essex, UKBroad Foundation, Los Angeles, USAPfizer Global Research and Development Inc, Sandwich, UK and GlaxoSmithKline, Ware, UK
文摘Improvements in imaging technology allow exploitation of the dual blood supply of the liver to aid in the identif ication and characterisation of both malignant and benign liver lesions. Imaging techniques available include contrast enhanced ultrasound, computed tomography and magnetic resonance imaging. This review discusses the application of several imaging techniques in the diagnosis and staging of both hepatocellular carcinoma and cholangiocarcinoma and outlines certain characteristics of benign liver lesions. The advantages of each imaging technique are highlighted, while underscoring the potential pitfalls and limitations of each imaging modality.
基金the Coordination for the Improvement of Higher Education Personnel(CAPES)programmeScience without borders from Brazilian governmentthe Research Foundation Flanders(FWO)from Flemish government for the fellowship support
文摘The main goal of this study was to introduce a novel three-dimensional procedure to objectively quantify both inner and outer condylar remodelling on preoperative multi-slice computed tomography （MSCT） and postoperative cone-beam computed tomography （CBCT） images. Second, the reliability and accuracy of this condylar volume quantification method was assessed. The mandibles of 20 patients （11 female and 9 male） who underwent bimaxillary surgery were semi-automatically extracted from MSCT/CBCT scans and rendered in 3D. The resulting condyles were spatially matched by using an anatomical landmark-based registration procedure. A standardized sphere was created around each condyle, and the condylar bone volume within this selected region of interest was automatically calculated. To investigate the reproducibility of the method, inter- and intra-observer reliability was calculated for assessments made by two experienced radiologists twice five months apart in a set of ten randomly selected patients. To test the accuracy of the bone segmentation, the inner and outer bone structures of one dry mandible, scanned according to the clinical set-up, were compared with the gold standard, micro-CT. Thirty-eight condyles showed a significant （P〈O.05） mean bone volume decrease of 26.4%_ 11.4% （502.9 mm3＋ 268.1 mm3）. No significant effects of side, sex or age were found. Good to excellent （ICC〉 0.6） intra- and inter-observer reliability was observed for both MSCT and CBCT. Moreover, the bone segmentation accuracy was less than one voxel （0.4 mm） for MSCT （0.3 mm __. 0.2 mm） and CBCT （0.4 mm _ 0.3 mm）, thus indicating the clinical potential of this method for objective follow-up in pathological condylar resorption.
文摘The anterior cruciate ligament(ACL)is an important structure in maintaining the normal biomechanics of the knee and is the most commonly injured knee ligament.However,the oblique course of the ACL within the intercondylar fossa limits the visualization and assessment of the pathology of the ligament.This pictorial essay provides a comprehensive and illustrative review of the anatomy and biomechanics as well as updated information on different modalities of radiological investigation of ACL,particularly magnetic resonance imaging.
文摘BACKGROUND Diffusion-weighted imaging(DWI)has become a useful tool in the detection,characterization,and evaluation of response to treatment of many cancers,including malignant liver lesions.DWI offers higher image contrast between lesions and normal liver tissue than other sequences.DWI images acquired at two or more b-values can be used to derive an apparent diffusion coefficient(ADC).DWI in the body has several technical challenges.This include ghosting artifacts,mis-registration and susceptibility artifacts.New DWI sequences have been developed to overcome some of these challenges.Our goal is to evaluate 3 new DWI sequences for liver imaging.AIM To qualitatively and quantitatively compare 3 DWI sequences for liver imaging:free-breathing(FB),simultaneous multislice(SMS),and prospective acquisition correction(PACE).METHODS Magnetic resonance imaging(MRI)was performed in 20 patients in this prospective study.The MR study included 3 separate DWI sequences:FB-DWI,SMS-DWI,and PACE-DWI.The image quality,mean ADC,standard deviations(SD)of ADC,and ADC histogram were compared.Wilcoxon signed-rank tests were used to compare qualitative image quality.A linear mixed model was used to compare the mean ADC and the SDs of the ADC values.All tests were 2-sided and P values of<0.05 were considered statistically significant.RESULTS There were 56 lesions(50 malignant)evaluated in this study.The mean qualitative image quality score of PACE-DWI was 4.48.This was significantly better than that of SMS-DWI(4.22)and FB-DWI(3.15)(P<0.05).Quantitatively,the mean ADC values from the 3 different sequences did not significantly differ for each liver lesion.FB-DWI had a markedly higher variation in the SD of the ADC values than did SMS-DWI and PACE-DWI.We found statistically significant differences in the SDs of the ADC values for FB-DWI vs PACE-DWI(P<0.0001)and for FB-DWI vs SMS-DWI(P=0.03).The SD of the ADC values was not statistically significant for PACE-DWI and SMS-DWI(P=0.18).The quality of the PACE-DWI ADC histograms were considered better than the SMS-DWI and FB-DWI.CONCLUSION Compared to FB-DWI,both PACE-DWI and SMS-DWI provide better image quality and decreased quantitative variability in the measurement of ADC values of liver lesions.
文摘Since it has been recognized that sarcoidosis(SA) is not an exclusive disorder of the lungs but can also affect other organs such as the liver and spleen, efforts have been made to define specific imaging criteria for the diagnosis of the single organ involvement, and the concept has been reinforced that the exclusion of alternative causes is important to achieve the correct diagnosis. Ultrasound(US)is a useful tool to evaluate patients with suspected abdominal SA, such as of the liver, spleen, kidney, pancreas and other organs, showing findings such as organomegaly, focal lesions and lymphadenopathy. While the diagnosis of abdominal SA is more predictable in the case of involvement of other organs(e.g.,lungs), the problem is more complex in the case of isolated abdominal SA. The recent use of contrast-enhanced ultrasound and endoscopic ultrasound elastography has provided additional information about the enhancement patterns and tissue rigidity in abdominal SA. Here we critically review the role of US in abdominal SA, reporting typical findings and limitations of current evidence and by discussing future perspectives of study.
