目的探索合成MRI(synthetic MRI,syMRI)对卵巢-附件影像报告和数据系统(Ovarian-Adnexal Reporting and Data System,O-RADS)MRI 3~5分的卵巢附件占位良恶性鉴别的效能。材料与方法回顾性分析在2021年8月至2023年6月期间于我院就诊的10...目的探索合成MRI(synthetic MRI,syMRI)对卵巢-附件影像报告和数据系统(Ovarian-Adnexal Reporting and Data System,O-RADS)MRI 3~5分的卵巢附件占位良恶性鉴别的效能。材料与方法回顾性分析在2021年8月至2023年6月期间于我院就诊的100例盆腔占位患者病例及影像资料,共计附件肿块126例,所有占位的O-RADS MRI评分均为3~5分。以手术病理或至少1年的随访结果为诊断标准。所有患者均在3.0 T MRI扫描仪上进行盆腔MRI扫描,包括syMRI及扩散加权成像(diffusion-weighted imaging,DWI)序列。在附件区病灶的实性成分的最大层面勾画感兴趣区,以获得syMRI定量参数[T1、质子密度(proton density,PD)、T2^(*)、R2^(*)]及表观扩散系数(apparent diffusion coefficient,ADC)值。采用独立样本t检验或Mann-Whitney U检验比较各参数的差异,通过logistic回归分析建立syMRI及syMRI+ADC诊断模型,采用受试者工作特征(receiver operating characteristic,ROC)曲线比较各参数及模型的诊断效能,DeLong检验比较各模型ROC曲线下面积(area under the curve,AUC)的差异。结果入组100例患者共126个病灶,其中良性55例,恶性71例。T1、T2^(*)、R2^(*)及ADC值在两组间差异有统计学意义(P<0.05),其鉴别卵巢附件良恶性病变的AUC分别为0.739[95%置信区间(confidence interval,CI):0.652~0.826]、0.780(95%CI:0.698~0.862)、0.783(95%CI:0.699~0.866)及0.674(95%CI:0.576~0.772)。syMRI及syMRI+ADC模型的AUC分别为0.860(95%CI:0.791~0.929)及0.879(95%CI:0.818~0.940),二者之间差异无统计学意义,均高于ADC值(P<0.05)。结论syMRI在鉴别O-RADS MRI 3~5分卵巢附件病变的良恶性中具有很好的效能。展开更多
AIM: To assess the functional status and etiology of liver cirrhosis by quantitative 31p magnetic resonance spectroscopy (MRS).METHODS: A total of 80 patients with liver cirrhosis of different etiology and functional ...AIM: To assess the functional status and etiology of liver cirrhosis by quantitative 31p magnetic resonance spectroscopy (MRS).METHODS: A total of 80 patients with liver cirrhosis of different etiology and functional status described by Child-Pugh score were examined and compared to 11 healthy volunteers. MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.Absolute concentrations of phosphomonoesters (PME),phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured.RESULTS: MRS changes reflected the degree of liver dysfunction in all the patients as well as in individual etiological groups. The most important change was a decrease of PDE. It was possible to distinguish alcoholic,viral and cholestatic etiologies based on MR spectra.Alcoholic and viral etiology differed in PDE (alcoholic,viral, controls: 6.5±2.3, 6.5±3.1, 10.8±2.7 mmol/L,P＜0.001) and ATP (alcoholic, viral, controls: 2.9±0.8, 2.8±0.9, 3.7±1.0 mmol/L, P＜0.01) from the control group.Unlike viral etiology, patients with alcoholic etiology also differed in Pi (alcoholic, controls: 1.2±0.4, 1.6±0.6mmol/L, P＜0.05) from controls. No significant changes were found in patients with cholestatic disease and controls; nevertheless, this group differed from both alcoholic and viral groups (cholestatic, alcoholic, viral: 9.4±2.7, 6.5±2.3, 6.5±3.1 mmol/L, P＜0.005) in PDE.CONCLUSION: 31p MRS can significantly help in noninvasive separation of different etiological groups leading to liver cirrhosis. In addition, MRS changes reflect functional liver injury.展开更多
AIM： To assess the effectiveness of the current UK clinical practice in reducing hepatic fat （IHCL）.METHODS： Whole body MRI and IH MRS were obtained, before and after 6 mo nutritional counselling, from liver, sole...AIM： To assess the effectiveness of the current UK clinical practice in reducing hepatic fat （IHCL）.METHODS： Whole body MRI and IH MRS were obtained, before and after 6 mo nutritional counselling, from liver, soleus and tibialis muscles in 10 subjects with non-alcoholic fatty liver disease （NAFLD）.RESULTS： A 500 Kcal-restricted diet resulted in an average weight loss of 4% （-3.4 kg,） accompanied by significant reductions in most adipose tissue （AT） depots, including subcutaneous （-9.9%）, abdominal subcutaneous （-10.2%） and intra-abdominal- AT （-11.4%）. Intramyocellular lipids （IMCL） were significantly reduced in the tibialis muscle （-28.2%）. Decreases in both IHCL （-39.9%） and soleus IMCL （-12.2%） content were also observed, although these were not significant. Several individuals showed dramatic decreases in IHCL, while others paradoxically showed increases in IHCL content. Changes in body composition were accompanied by improvements in certain liver function tests： serum aspartate aminotransferase （AST） and alanine aminotransferase （ALT）. Significant correlations were found between decreases in IHCL and reductions in both intra-abdominal and abdominal subcutaneous AT. Improvements in liver function tests were associated with reductions in intra-abdominal AT, but not with changes in IHCL. CONCLUSION： This study shows that even a very modest reduction in body weight achieved through lifestyle modification can result in changes in body fat depots and improvements in LETs.展开更多
BACKGROUND Bowel ultrasound and magnetic resonance enterography(MRE)are decisive medical imaging modalities for diagnosing and locating bowel lesions with its extramural extent and complications.They assess the degree...BACKGROUND Bowel ultrasound and magnetic resonance enterography(MRE)are decisive medical imaging modalities for diagnosing and locating bowel lesions with its extramural extent and complications.They assess the degree of activity,help clinicians to identify patients in need of surgery,and can be used for patient follow-up.AIM To compare the role of MRE and bowel ultrasound in diagnosis and follow-up of inflammatory bowel disease(IBD)patients in Egypt.METHODS The study was conducted on 40 patients with IBD.All patients were subjected to clinical assessment,laboratory investigations,bowel ultrasound,MRE,and colonoscopy up to the terminal ileum with biopsies for histopathological examination.RESULTS This study was conducted on 14 patients(35%)with ulcerative colitis and 26 patients(65%)with Crohn's disease;34(85%)of these patients had active disease.Bowel ultrasound detected different bowel lesions with the following accuracies:ileum(85%),large bowel(70%),fistula(95%),stricture and proximal dilatation(95%)and abscesses(100%).Also,it showed that statistically significance of bowel ultrasound in differentiation between remission and activity of IBD in comparison to MRE and colonoscopy.CONCLUSION In comparison to MRE,bowel ultrasound is a useful,non-invasive,and feasible bedside imaging tool for the detection of inflammation,detection of complications,and follow-up of IBD patients when performed by the attending physician.展开更多
文摘目的探索合成MRI(synthetic MRI,syMRI)对卵巢-附件影像报告和数据系统(Ovarian-Adnexal Reporting and Data System,O-RADS)MRI 3~5分的卵巢附件占位良恶性鉴别的效能。材料与方法回顾性分析在2021年8月至2023年6月期间于我院就诊的100例盆腔占位患者病例及影像资料,共计附件肿块126例,所有占位的O-RADS MRI评分均为3~5分。以手术病理或至少1年的随访结果为诊断标准。所有患者均在3.0 T MRI扫描仪上进行盆腔MRI扫描,包括syMRI及扩散加权成像(diffusion-weighted imaging,DWI)序列。在附件区病灶的实性成分的最大层面勾画感兴趣区,以获得syMRI定量参数[T1、质子密度(proton density,PD)、T2^(*)、R2^(*)]及表观扩散系数(apparent diffusion coefficient,ADC)值。采用独立样本t检验或Mann-Whitney U检验比较各参数的差异,通过logistic回归分析建立syMRI及syMRI+ADC诊断模型,采用受试者工作特征(receiver operating characteristic,ROC)曲线比较各参数及模型的诊断效能,DeLong检验比较各模型ROC曲线下面积(area under the curve,AUC)的差异。结果入组100例患者共126个病灶,其中良性55例,恶性71例。T1、T2^(*)、R2^(*)及ADC值在两组间差异有统计学意义(P<0.05),其鉴别卵巢附件良恶性病变的AUC分别为0.739[95%置信区间(confidence interval,CI):0.652~0.826]、0.780(95%CI:0.698~0.862)、0.783(95%CI:0.699~0.866)及0.674(95%CI:0.576~0.772)。syMRI及syMRI+ADC模型的AUC分别为0.860(95%CI:0.791~0.929)及0.879(95%CI:0.818~0.940),二者之间差异无统计学意义,均高于ADC值(P<0.05)。结论syMRI在鉴别O-RADS MRI 3~5分卵巢附件病变的良恶性中具有很好的效能。
文摘目的:探讨磁共振弹性成像(magnetic resonance elastography,MRE)在区分肝脏局灶性良恶性病变中的应用价值,并分析其在预测恶性肿瘤患者预后方面的潜力。方法:回顾并分析2021年12月—2024年10月于上海中医药大学附属曙光医院进行肝脏常规磁共振成像(magnetic resonance imaging,MRI)和MRE扫描的肝脏局灶性病变患者,包括肝血管瘤、肝细胞癌、肝转移瘤和胆管细胞癌。在3.0 T MRI扫描仪上进行2D MRE扫描,获取弹性图并测量病变的弹性值。采用单因素方差分析比较不同病变MRE弹性值差异,通过受试者工作特征(receiver operating characteristic,ROC)曲线确定MRE弹性值鉴别良恶性病变的最佳截断值,并计算曲线下面积(area under the curve,AUC)等诊断效能指标。采用配对样本t检验比较恶性肿瘤全身治疗前后弹性值差异。结果:本研究纳入肝脏局限性病变患者172例,其中肝血管瘤50例,肝细胞癌59例,肝转移瘤51例,胆管细胞癌12例。肝细胞癌、肝转移瘤和胆管细胞癌的弹性值分别为(8.97±5.33)kPa、(7.52±4.64)kPa和(8.74±4.82)kPa;肝血管瘤弹性值为(3.10±1.30)kPa;恶性肿瘤组和血管瘤组病变弹性值差异有统计学意义(F=66.080,P<0.001)。MRE弹性值在鉴别良恶性病变的AUC为0.870,灵敏度、特异度、阳性预测值和阴性预测值分别为75.4%、84.0%、92.0%和58.3%,最佳截断值为4.15 kPa。通过对30例恶性肿瘤患者不同疗效组进行分析后发现,疾病进展组治疗前后弹性值分别为(5.98±2.48)kPa和(10.74±3.83)kPa,两者差异有统计学意义(t=-5.134,P<0.001);部分缓解组治疗前后弹性值分别为(4.31±1.88)kPa和(3.06±1.43)kPa,差异有统计学意义(t=4.411,P=0.003)。疾病稳定组弹性值分别为(10.64±7.71)kPa和(10.67±7.64)kPa,治疗前后弹性值差异无统计学意义(t=1.209,P=0.258)。结论:MRE作为一种无创技术,能够有效地区分肝脏良恶性病变,并在恶性肿瘤预后评估中具有潜在应用价值,可为临床提供重要的诊断和治疗依据。
基金Supported by grant from Ministry of Health IGA 7853-3, and MZO 00023001, Czech Republic
文摘AIM: To assess the functional status and etiology of liver cirrhosis by quantitative 31p magnetic resonance spectroscopy (MRS).METHODS: A total of 80 patients with liver cirrhosis of different etiology and functional status described by Child-Pugh score were examined and compared to 11 healthy volunteers. MR examination was performed on a 1.5 T imager using a 1H/31P surface coil by the 2D chemical shift imaging technique.Absolute concentrations of phosphomonoesters (PME),phosphodiesters (PDE), inorganic phosphate (Pi) and adenosine triphosphate (ATP) were measured.RESULTS: MRS changes reflected the degree of liver dysfunction in all the patients as well as in individual etiological groups. The most important change was a decrease of PDE. It was possible to distinguish alcoholic,viral and cholestatic etiologies based on MR spectra.Alcoholic and viral etiology differed in PDE (alcoholic,viral, controls: 6.5±2.3, 6.5±3.1, 10.8±2.7 mmol/L,P＜0.001) and ATP (alcoholic, viral, controls: 2.9±0.8, 2.8±0.9, 3.7±1.0 mmol/L, P＜0.01) from the control group.Unlike viral etiology, patients with alcoholic etiology also differed in Pi (alcoholic, controls: 1.2±0.4, 1.6±0.6mmol/L, P＜0.05) from controls. No significant changes were found in patients with cholestatic disease and controls; nevertheless, this group differed from both alcoholic and viral groups (cholestatic, alcoholic, viral: 9.4±2.7, 6.5±2.3, 6.5±3.1 mmol/L, P＜0.005) in PDE.CONCLUSION: 31p MRS can significantly help in noninvasive separation of different etiological groups leading to liver cirrhosis. In addition, MRS changes reflect functional liver injury.
基金Supported by the British Medical Research Council, United Kingdom, No. MRC CEG G99000178
文摘AIM： To assess the effectiveness of the current UK clinical practice in reducing hepatic fat （IHCL）.METHODS： Whole body MRI and IH MRS were obtained, before and after 6 mo nutritional counselling, from liver, soleus and tibialis muscles in 10 subjects with non-alcoholic fatty liver disease （NAFLD）.RESULTS： A 500 Kcal-restricted diet resulted in an average weight loss of 4% （-3.4 kg,） accompanied by significant reductions in most adipose tissue （AT） depots, including subcutaneous （-9.9%）, abdominal subcutaneous （-10.2%） and intra-abdominal- AT （-11.4%）. Intramyocellular lipids （IMCL） were significantly reduced in the tibialis muscle （-28.2%）. Decreases in both IHCL （-39.9%） and soleus IMCL （-12.2%） content were also observed, although these were not significant. Several individuals showed dramatic decreases in IHCL, while others paradoxically showed increases in IHCL content. Changes in body composition were accompanied by improvements in certain liver function tests： serum aspartate aminotransferase （AST） and alanine aminotransferase （ALT）. Significant correlations were found between decreases in IHCL and reductions in both intra-abdominal and abdominal subcutaneous AT. Improvements in liver function tests were associated with reductions in intra-abdominal AT, but not with changes in IHCL. CONCLUSION： This study shows that even a very modest reduction in body weight achieved through lifestyle modification can result in changes in body fat depots and improvements in LETs.
文摘BACKGROUND Bowel ultrasound and magnetic resonance enterography(MRE)are decisive medical imaging modalities for diagnosing and locating bowel lesions with its extramural extent and complications.They assess the degree of activity,help clinicians to identify patients in need of surgery,and can be used for patient follow-up.AIM To compare the role of MRE and bowel ultrasound in diagnosis and follow-up of inflammatory bowel disease(IBD)patients in Egypt.METHODS The study was conducted on 40 patients with IBD.All patients were subjected to clinical assessment,laboratory investigations,bowel ultrasound,MRE,and colonoscopy up to the terminal ileum with biopsies for histopathological examination.RESULTS This study was conducted on 14 patients(35%)with ulcerative colitis and 26 patients(65%)with Crohn's disease;34(85%)of these patients had active disease.Bowel ultrasound detected different bowel lesions with the following accuracies:ileum(85%),large bowel(70%),fistula(95%),stricture and proximal dilatation(95%)and abscesses(100%).Also,it showed that statistically significance of bowel ultrasound in differentiation between remission and activity of IBD in comparison to MRE and colonoscopy.CONCLUSION In comparison to MRE,bowel ultrasound is a useful,non-invasive,and feasible bedside imaging tool for the detection of inflammation,detection of complications,and follow-up of IBD patients when performed by the attending physician.
