Objective To build a deep learning method based on CT for hematoma segmentation and hematoma expansion (HE) prediction of patients with hypertensive intracerebral hemorrhage (ICH). Methods This study retrospectively analyzed 500 cases of hypertensive intraparenchymal hematoma.Baseline non-contrast-enhanced CT scans (NECTs) were collected at admission and compared with subsequent CTs to determine the presence of HE.A deep learning method based on CT was proposed to automatically segment the hematoma region.In order to build the model for hematoma segmentation and HE prediction,patients were randomly divided into the training set and the test set according to the ratio of 7:3.The training set contains 350 patients for training the model,while the test set contains 150 patients for model validation.The segmentation module adopts the attention U-net to automatically segment and detect the hematoma,while the prediction module uses the resnet-34 to predict the HE.Mean intersection over Union (Miou) and Dice coefficient were used to evaluate the segmentation task.The accuracy evaluation of the prediction model was evaluated using the area under curve (AUC) of the receiver operating characteristic (ROC) curve.The continuous variables were compared by independent sample t-test or Mann Whitney U test.P<0.05 was considered statistically significant. Results There was no significant difference in age (P=0.211) and gender (P=0.213) between the HE and the non-HE groups.Hematoma volume (16.7 ml vs.26.7 ml,P< 0.001) and hematoma diameter (41.7mm vs.48.9mm,P< 0.001) in the non-HE group were significantly lower.The Miou and Dice coefficient of the segmentation model was 0.89 and 0.90 respectively.The AUC value of the prediction model was 0.909 (95%CI:0.85 -0.949),and the sensitivity and specificity were 81.58% (95%CI:65.7%-92.3%) and 96.43% (95%CI:91.1%-99.0%) respectively. Conclusion The deep learning system based on brain CT can accurately segment hematoma and predict the expansion of hematoma.

Objective To investigate the radiation performance of new domestic DSA equipment by comparing the radiation dose of two digital subtraction angiography devices during percutaneous vertebraplasty. Methods Patients undergo-ing elective percutaneous vertebraplasty were randomly assigned to the trial group [United Imaging uAngio(UIuA)] and the control group [Siemens Axiom Zee Biplane(SAZB)] after being matched by a 5% range of difference in their body mass index (BMI).Comparison and analysis of image quality evaluation,Fluoroscopy Time (T),Dose-Areas Product rate(DAP rate),Air Kerma rate (K rate),and Entrance Surface Dose (ESD) magnitude on the left and right sides of the patient's torso at the surgical site for the two devices. Results There was no significant difference between the fluoroscopic and spot image evaluations of the UIuA and the SAZB; The DAP rate of the UIuA (31.88; 24.01-44.15)μGy·mm²/min was significantly lower than that of the SAZB (63.73; 51.62-80.26μGy·mm²/min),P= 0.022.K rate was not significantly different between the UIuA (4.74; 3.17-5.97 mGy/min) and the SAZB (5.76; 4.58-8.73 mGy/min),P=0.074.The ESD was significantly lower in the right and left sides of patients with the UIuA than with the SAZB,both the P-values < 0.05. Conclusion On the premise of equal image quality evaluations,the domestic DSA device UIuA outperforms the SAZB in terms of radiation dose. UIuA is important for reducing radiation exposure and thus radioactive damage,as well as for improving the radiation safety environment for interventional medicine in China.

Objective To investigate the changes in topological properties of resting-state functional brain networks in alcohol-dependent patients and their relationship with cognitive function and clinical performance. Methods Resting-state functional magnetic resonance imaging scans were performed on 53 alcohol-dependent patients (AD group) and 68 age and education-matched healthy controls (HC group).The functional brain network model was constructed using graph theory to compare the small-world network characteristics and nodal properties of brain regions in the two groups,and to analyses the correlation between brain network changes and the Penn Alcohol Craving Scale (PACS),the Beck Anxiety Inventory (BAI),the Mini-Mental State Examination (MMSE),and the Digital Span Test (DST). Results The brain networks of both groups had small-world network characteristics (γ＞1,λ ≈ 1,σ＞1).The differences in γ and σ between the two groups were not statistically significant (P＞0.05).In the sparsity range of 0.20 to 0.40,λ was reduced in the alcohol-dependent group compared with the healthy control group,and the differences were statistically significant (P＜0.05).The alcohol-dependent group had higher degree centrality in the left insula and left amygdala,higher betweenness centrality in the left temporal transverse gyrus,and lower betweenness centrality in the left putamen compared with the healthy control group (all P＜0.05).The left insula was positively correlated with DST scores (r=0.273,P=0.048),and the left amygdala was positively correlated with PACS (r=0.322,P=0.019) and BAI (r=0.293,P=0.033) scores. Conclusion The information transmission capacity of functional brain networks in alcohol-dependent patients is impaired,and graph theory analysis of brain network can be used as an imaging indicator of the abnormal brain function in patients with alcohol dependence.

Objective To analyze the correlation between quantitative parameters of abdominal adipose tissue on CT and composition of carotid atherosclerotic plaque in patients divided by age. Methods The clinical and imaging data of 160 patients were retrospectively evaluated. All patients underwent abdominal CT and head-neck computed tomography angiography (CTA) examination,and the time interval of two examinations was less than one month. All raw data of original abdominal CT were uploaded to postprocessing workstation (GE AW4.7).Visceral fat area (VFA) and subcutaneous fat area (SFA) were measured at umbilical level on workstation by one radiologist. Then,the ratio of visceral to subcutaneous fat area (VFA/SFA) was calculated according to the results of VFA and SFA. Carotid plaques were evaluated according CTA by one senior radiologist. According to the American Heart Association (AHA) guidelines,soft plaques and mixed plaques mainly composed of fat were classified as vulnerable carotid plaques while calcified plaques were classified as stable plaques. Patients were divided into age < 70 years subgroup and age ≥ 70 years subgroup. The differences of clinical characteristics and quantitative parameters of abdominal adipose tissue were separately compared between stable plaque group and vulnerable plaque group. Multivariate Logistic regression analysis was used to analyze the risk factors of vulnerable carotid plaque. ROC curve analysis was used for indicating the predictive performance of different variables for vulnerable carotid plaque. P value less than 0.05 was considered statistically significant difference. Results In the subgroup of patients aged < 70 years subgroup,the proportion of patients with VFA > 151.65 cm2 in the vulnerable plaque group was higher than that in the stable plaque group (P= 0.019).Nevertheless,there was no significant difference in VFA and SFA between the two groups (P= 0.523,0.288).In the subgroup of patients aged ≥ 70 years subgroup,gender and SFA showed significant difference between vulnerable plaque group and stable plaque group (P= 0.005,0.003).Then,gender,SFA and VFA/SFA were included in multivariate analysis (P< 0.1).Multivariate analysis showed that compared with patients with SFA ≤ 156.27 cm²,the OR value of patients with SFA > 156.27 cm² was 0.264 (95% CI = 0.079-0.887,P= 0.031),with statistical significance. Male (OR = 3.676,95% CI:1.164-11.609,P= 0.026) was an independent risk factor for patients with vulnerable carotid plaque in aged ≥ 70 years subgroup. The AUC under SFA > 156.27 cm² for predicting vulnerable carotid plaque were 0.684,respectively. Conclusion VFA was associated with composition of carotid atherosclerotic plaque in patients aged < 70 years. Male or patients with lower SFA had a higher risk of vulnerable carotid plaque in patients aged ≥ 70 years.

Objective To develop a CESM model for predicting malignant probability of breast masses,and to evaluate its predictive. Methods The clinical and imaging data of 328 patients were analyzed retrospectively,which were randomly divided into training set (235 cases) and verification set (93 cases).To pathology results for the gold standard,the predictors were screened by univariate and multivariate Logistic regression analysis. Then a predictive model was constructed based on the results with a nomogram drawn. Performances of predictive models were evaluated with area under the curve (AUC) of ROC,calibration curve,and decision curve analysis (DCA). Results A total of 328 women with breast neoplasia including 179 malignant and 149 benign was collected. Six predictive factors were harvested to construct the predictive model,which included age,lobulation,spiculation,early-phase (CC) enhancement degree,late-phase (MLO) enhancement heterogeneity or enhancement curve. The predictive model had good performance in both training set and verification set,with the AUC values of 0.975 and 0.963,respectively. The calibration and DCA curve showed that the predictive result was much closer to actual result and this model had good clinical application values. Conclusion The CESM predictive model can predict malignancy probability of breast masses,which can be used as a referable method for radiologist and to provide guidance for clinical practice.

Objective To evaluate the value of multi-slice spiral CT in the differential diagnosis of calcification of the ligamentum arteriosum (CLA) and aortic arch calcified plaque in the presenile population. Methods 200 patients aged 50-59 years with clinically suspected chest lesions were retrospectively analyzed,scanned with multi-slice spiral CT,calculated the incidence,observed the location and the shape,measured the density of CLA and aortic calcified plaque in the thin-layer mediastinal window image. Results CLA occurred between the aortic arch and the left pulmonary trunk,most of which were strip and spotted,with an incidence of 27.00%,the CT value was (247.63±92.23) HU. Aortic calcified plaque occurred in all positions of the aortic arch,patchy and spotted,some were multiple,with an incidence of 45.00%,and the CT value was (448.44±222.41)HU. Conclusion CLA occurs in the area of arterial ligament,mostly in strip and spotted shape,which is significantly different from aortic calcified plaque in incidence,location,shape and density,et al.

Objective To investigate the value of Gd-EOB-DTPA MRI T1 mapping in the evaluation of liver function. Methods This study prospectively collected the clinical and imaging data of 42 patients who met the inclusion and exclusion criteria,and divided them into three groups according to Child-Pugh classification:23 cases in the Child-Pugh grade A (LCA group),13 cases in the Child-Pugh grade B (LCB group),and Child-Pugh grade C ( LCC group) 6 cases. The T1 relaxation time (T1_pre) and signal intensity (SI) of the liver before enhancement were measured,the liver T1 relaxation time (T1_HBP) and SI of hepatobiliary phase were measured; the SI ratio of liver/erector spinae (SIpre,SIHBP) before enhancement and hepatobiliary phase were calculated,respectively; the reduction rate of liver T1 relaxation time (△T1%) and relative liver enhancement rate (RLE) were calculated. The difference between SI and T1 quantitative parameters between different groups were compared,and the performance of different parameters in evaluating Child-Pugh B+C grade were analyzed. Pearman correlation coefficient was used to analyze the correlation between each parameter and indocyanine green retention rate at 15 min (ICG R15). Results The area under the curve of ROC of T1_pre,T1_HBP,Δ T1%,SIpre,SI_HBP,and RLE diagnosing Child-Pugh B+C grade were 0.714,0.884,0.914,0.643,0.832,0.834,respectively.T1_HBP was significantly positively correlated with ICG R15 and Child-Pugh scores (r= 0.677,r= 0.662,P<0.05). Conclusion T1_HBP is not only significantly positively correlated with ICG R15 and Child-Pugh scores,but the diagnostic performance is better than ΔT1% and the correlation parameter of SI,which has an important value for liver function assessment.

Objective To investigate the value of tumor blood flow imaging (TBF) with three-dimensional arterial spin labeling (3D-ASL) perfusion imaging for the assessment of non-enhancing cranial astrocytoma grading.Methods Twenty-five patients with non-enhancing cranial astrocytomas who presented to our hospital between March 2020 and March 2022 and were pathologically confirmed were retrospectively collected as study subjects and divided into high-grade group (n=15) and low-grade group (n=10) according to tumor grading.The absolute maximum TBF (TBF_max),absolute mean TBF (TBF_mean) and the corresponding normalized values of cerebral blood flow (TBF_max rate and TBF_mean rate) of the tumor were calculated after the enrolled subjects were scanned by MRI conventional sequences and ASL.The differences in TBF_max,TBF_mean,TBF_max rate,and TBF_mean rate between the two groups of subjects were compared using independent samples t-test,and the subject operating characteristic curve (ROC) was applied to predict the accuracy of each index for tumor grading assessment.Results ROC curve analysis showed that TBF_max rate had the highest accuracy in predicting non-enhancing high-grade cranial astrocytoma (AUC=0.960,best cut-off value of 1.35,Youden of 0.800,sensitivity 80.00%,and specificity 100.00%),TBF_mean rate (AUC=0.887,best cut-off value of 1.36,Youden index of 0.600,sensitivity 80.00%,specificity 80.00%) and TBF_max (AUC=0.853,best cut-off value 76.01 ml/100 g/min,Youden index 0.633,sensitivity 73.33%,specificity 90.00%) were next,and TBF_mean (AUC= 0.773,best cutoff value of 30.09 ml/100 g/min,Youden of 0.533,sensitivity 93.33%,specificity 60.00%) was the lowest.Conclusion The 3D-ASL perfusion imaging parameters,especially the TBF_max rate,can more accurately distinguish between high-grade and low-grade non-enhancing cranial astrocytomas,which can provide a sufficient theoretical basis for individualized clinical treatment plans.

Objective The aim of this study was to assess sex- and age-specific normal values of left atrium (LA) myocardial strain (MS) and strain rate (SR) in healthy adults in China by cardiac magnetic resonance (CMR). Methods 110 healthy adults (45.65±12.77,76 males) were retrospectively included,all of whom underwent 3.0T CMR and were stratified according to gender and age.LA global longitudinal strain (GLS),GLS SR,and global circumferential strain (GCS) were assessed using CMR.The GLS is divided into three stages:Reservoir,Conduit and Booster. Results LA GLS Reservoir,GLS Conduit,GCS and SR Reservoir were significantly greater in females compared to males(P<0.05).Differences in LA GLS Reservoir,SR Reservoir and GLS Conduit and SR Conduit between age groups were statistically significant (all P<0.05) and gradually decreased with increasing age.Among females,age was significantly negatively correlated with LA GLS Conduit,SR Conduit (P<0.001),significantly positively correlated with GLS Booster (P=0.034) and not significantly correlated with GLS Reservoir (P=0.070).In the male population,a significant negative correlation (P≤0.001) could be found between age and both LA GLS (Reservoir,Conduit) and SR (Reservoir,Conduit). Conclusion CMR is feasible and reproducible for quantifying LA MS and SR and determining left atrial phase function.The presence of age- and sex-related differences in LA MS and SR suggests the need to establish specific normal values for individual groups.

Objective To explore the clinical value of dynamic volume perfusion CT (dVPCT) for multidimensional evaluation of T-staging and pathological grading of pancreatic carcinoma (PC). Methods 56 cases of pathologically confirmed PC who underwent preoperative epigastric dVPCT in Deyang People's Hospital were retrospectively collected from July 2017 to March 2022.Based on multiple reconstructive morphological images,the PC was observed and preoperatively T-staged.The Cohen’s weighted Kappa (Kw) concordance analysis was used to compare dVPCT T-staging with postoperative pathological T-staging and the accuracy of dVPCT for preoperative T-staging of PC was assessed.Blood flow (BF),blood volume (BV),permeability surface(PS) and mean transit time (MTT) in each case were measured.Patients were divided into T1-2,T3,and T4 groups,and 31 of them were classified into highly,moderately,and poorly differentiated groups based on pathologic stage.The Kruskal-Wallis H test was used to compare the perfusion parameters of PC with different T stage and different pathologic stage. Results The detection rate of PC lesion was 100%.dVPCT staging was remarkably consistent with pathological T staging (Kw 0.83 ± 0.07,95% CI 0.70-0.96).The T staging accuracy was 87.5%,with T1,T2,T3 and T4 staging accuracy were 96.4%,89.3%,92.9% and 96.4%,respectively.BF,BV,PS and MTT were significantly lower in T4 than in T1-2 (P＜0.05).BV,PS and MTT were significantly lower in T3 than in T1~2 (P＜0.05).The BF,BV and PS values in the poorly differentiated group were significantly lower than those in the highly differentiated group (P＜0.05).The BF and BV values in the poorly differentiated group were significantly lower than those in the moderately differentiated group (P＜0.05). Conclusion dVPCT can acquire both high quality images and functional parameters,which is more clinically useful for PC display,T-staging and pathological grading.

Objective To observe the value of radiomics based on different regions of interest on multiparametric MRI for the assessment of prostate cancer aggressiveness. Methods In this retrospective study,patients with pathologically confirmed prostate cancer from two different centers were included,with center 1 including 123 cases as a training cohort and 53 cases as an internal validation cohort.Center 2 included 69 patients as an external validation cohort.Two different segmentation methods were used on multiparametric MRI:segmentation of prostate region and lesion,and after feature extraction and reduction,radiological feature sets were obtained.Using logistic regression algorithms,three radiomic models were established based on three radiomic feature sets:model 1 (based on prostate region),model 2 (based on lesion region),and model 3 (based on prostate + lesion).Clinical features associated with prostate cancer aggressiveness were analyzed to create an integrated model combining radiomic features with clinical features (model 4).Receiver operating characteristic (ROC) curve analysis was used to compare the performance of each model in assessing prostate cancer aggressiveness. Results The region of interest based on the prostate region retained the 57 best features,the region of interest based on the lesion region retained the 27 best features and the region of interest based on the prostate region + lesion retained the 64 best features.The model with both prostate and lesion region segmented (AUC 0.92) performed better in assessing prostate cancer aggressiveness compared to the model with only prostate region segmented (AUC 0.89) and the model with only lesion region segmented (AUC 0.87),and was comparable to the performance of the integrated model combining radiomic and clinical features (AUC 0.92). Conclusion A radiomics model combining the prostate region and the lesion region may perform better in assessing prostate cancer aggressiveness than a radiomics model segmenting only the lesion region or segmenting only the prostate region.

Objective To develop a novel nomogram based on multi-parameter magnetic resonance imaging radiomics combined with PI-RADS v2.1 and clinical indicators,and evaluate its application value in predicting clinically significant prostate cancer (csPCa). Methods The data of 204 patients in our hospital from January 2018 to December 2019 were retrospectively analyzed.The PI-RADS v2.1 score was used to evaluate images and PI-RADS v2.1 score and radiomics analysis were performed.Applying receiver operating characteristic (ROC) curve and clinical decision curve to evaluate the diagnostic efficacy and clinical benefit of clinical model,PI-RADS model,radiomics model,and each combined model to detect csPCa,and a nomogram was developed and validated based on the optimal model. Results The diagnostic performance of radiomics model was significantly better than the clinical model and PI-RADS model,and the difference is statistically significant (P<0.05).By adding the radiomics features to the clinical model or PI-RADS model,the combined model significantly improved the diagnostic efficiency of csPCa (P<0.05). Conclusion The nomogram based on the combined model of multiparametric MRI radiomics combined with PI-RADS v2.1 and clinical indicators provides a noninvasive new method for preoperative prediction of csPCa.

Objective To investigate the imaging features and clinical value of gynecologic carcinosarcoma (CS). Methods The imaging data of 42 cases with female primary genital carcinosarcoma confirmed by pathology were retrospectively analyzed,and the characteristics were summarized and compared with the pathology. Results The OCS lesions in 15 cases were large cystic-solid,and most of them were round or oval.The maximum diameter of OCS was 5.3-24.2 cm.The imaging of 27 UCS patients were mostly round,oval and triangular in shape.The maximum diameter of type I was 3.5-11.8 cm,and the endometrial thickness of type II was 1.3-2.8 cm.In gynecological CS,the density or signal was mixed,and the boundary was uncleared.Solid components were slightly to obviously enhanced,and tortuous thickened vascular shadow,the signs of invasion,pelvic and abdominal lymph node metastasis,and ascites could be found. Conclusion Gynecological CS has certain characteristics in imaging manifestations.Imaging examinations can evaluate the location,size,number,edge,relationship with adjacent structures and the presence of metastasis,which provides an important basis for clinical diagnosis and treatment.

Objective To investigate the value of DCE-MRI or high-b-value diffusion weighted imaging (DWI,b-1200) for differentiating borderline and malignant (StageⅠ) epithelial ovarian tumors. Methods This study included 19 cases of BEOTs and 21 cases of stage I MEOTs confirmed by pathology.Complete the sequence examination of DCE-MR and DWI.Measure the quantitative parameter values of tumor solid part (K^trans,K_ep,V_e) and ADC (b-1200),detected HE4 and CA125,use the formula to calculate the ROMA value.The data of the two groups were statistically analyzed according to the pathological results.Through the ROC curve,the area under the curve (AUC) was analyzed to obtain the Youden index,threshold,sensitivity and specificity of each parameter. Results There were significant differences in K^trans,K_ep,ADC(b-1200)and ROMA value between BEOTs and MEOTs groups (P< 0.05).K^trans= 0.1245 min^-1 provide an optimal diagnostic efficiency ( AUC = 0.831), K_ep=0.2805min^-1(AUC=0.793),ADC(b-1200)=1114.7 mm²/s(AUC=0.865),ROMA=13.45%(AUC=0.796).When K^trans、ADC were combined with ROMA,the AUC was 0.932. Conclusion DCE-MRI,DWI (b-1200) and ROMA have certain diagnostic value for BEOTs and MEOTs.The combined application can significantly improve the diagnostic efficiency.

Objective To investigate the imaging method and clinical application of magnetic resonance DCE-MRA imaging in female pelvic vein angiography. Methods The imaging data of 20 patients with suspected female pelvic lesions in our hospital who underwent pelvic plain scan and enhanced examination were collected.Routine MRI scan was performed first,followed by enhanced scan.Before enhanced scan,coronal mask scan was performed,and vascular imaging was performed during enhanced scan.Using MRI-flash-3D-DCE-MRA-cor sequence,according to the situation of arterial imaging,the group was divided into 1-3 groups.After interspersed or venous vessel scanning,T₁-fl3D-fs-tra,T₁-fl3D-fs-cor and T₁-fl3D-fs-sag sequences were used for organ enhancement scanning,and subtraction technology was used to select images with better venous display for reconstruction.The display of pelvic vein images was observed and scored,and the imaging manifestations of pelvic vein lesions were performed. Results The overall score of pelvic vein imaging in 20 patients was 4.54±0.64,and the image quality was good,which satisfy the needs of diagnostic requirements.Female pelvic venous lesions showed:4 cases of pelvic venous vascular variation,6 cases of venous lumen stenosis or distal venous congestion caused by uterine fibroids,5 cases of the left common iliac vein is compressed by the right common iliac artery,4 cases of cervical cancer pelvic venous blood vessels lumen tortuous and thickened and increased.1 case of pelvic venous congestion syndrome. Conclusion MRI-flash-3D-DCE-MRA-cor sequence shows the feasibility of female pelvic veins,which provides a new technical means for further research on the morphology of female pelvic vessels in vivo imaging.Understanding the images,branches and shapes of female pelvic veins will help us to further understand pelvic venous diseases and provide imaging support for clinical diagnosis and treatment.

Objective To evaluate the diagnostic value of MRI in fetal bowel dilatation. Methods The imaging data of 45 cases of fetal bowel dilatation diagnosed by MRI were retrospectively analyzed.The maximum diameter of the dilated bowel was measured.The signals of the dilated bowel were recorded,and the postoperative or pathological results were followed up.Spearman correlation coefficient was used to investigate the relationship between the diameter and signal of the dilated bowel and follow-up results. Results There were 6 cases of duodenal obstruction,11 cases of jejunum obstruction,17 cases of ileal obstruction,6 cases of colon obstruction and 5 cases of postpartum normal.T₁WI signals of fetal dilated bowel were positively correlated with the level of bowel obstruction (P< 0.001),while T₂WI signals of fetal dilated bowel were negatively correlated with the level of bowel obstruction (P< 0.001).The dilated bowel diameter was positively correlated with the level of ileus (P< 0.001). Conclusion MRI can assist in diagnosing the degree and level of bowel obstructions,and provide more valuable information for prenatal diagnosis and prognosis evaluation.

Objective Explore the value of diffusion tensor imaging(DTI) and routine magnetic resonance imaging (MRI) in evaluating the severity of mature neonatal hypoxic-ischemic encephalopathy(HIE). Methods 40 full-term newborns with HIE(mild 13 cases, moderate 15 cases and severe 12 cases) were included. The conventional MRI characteristics and DTI parameters of all cases were analyzed. Results Routine MRI showed that the severity of HIE was related to the sites and range of lesions involved. The sensitivity, specificity, false positive rate, false negative rate and accuracy of distinguishing mild from moderate-severe HIE were 76.9%, 81.5%, 18.5%, 23.1% and 80.0% respectively. DTI parameters demonstrated that there were statistical differences in FA values of inner capsule hind limb among different degrees of HIE. When FA value of inner capsule hind limb was set to optimal cutoff point 0.41, the diagnostic efficiency of differentiating mild from moderate-severe HIE was the best (sensitivity 100%, specificity 85.2%, false positive rate 14.8%, false negative rate 0, accuracy 90.0%). The two methods showed good consistency in distinguishing mild from moderate-severe HIE (Kappa =0.792, P＜0.001), and DTI was of better diagnostic efficiency. Conclusion Compared with routine MRI, DTI can be used as a more accurate quantitative index to evaluate the severity of mature neonatal HIE, thus playing an important role for clinicians in accurately predicting prognosis and implementing earlier targeted intervention.

Objective To investigate the differences in brain MRI features of children with cerebral palsy and mental retardation. Methods Based on the diagnosis,1076 patients with cerebral palsy and 796 patients with mental retardation who met the criteria were retrospectively included.To analyze the abnormal rate of brain MRI between cerebral palsy and mental retardation,and the relationship with GMFCS classification and intelligence scale respectively. Results There was a statistically significant difference in the abnormal rate of brain MRI between children with cerebral palsy and mental retardation (χ²=543.692,P<0.001).The abnormal rate of brain MRI in children with cerebral palsy had a trend relationship with the GMFCS grade (χ²=181.88,P<0.0001).The abnormal rate of head MRI increased with the increase of GMFCS grade.There was no statistical difference between grade IV and grade V (χ²=0.414,P=0.52>0.05),which may be related to the pathogenesis of cerebral palsy.The abnormal rate of brain MRI in children with mental retardation was not related to the degree of mental retardation (χ²=1.536,P=0.214>0.05).The most common abnormality in brain MRI of cerebral palsy was periventricular softening,with 468 cases,accounting for 52.71%.Followed by multiple malacia and atrophy,with 178 cases,accounting for 21.76%.Among the abnormal brain MRI manifestations of mental retardation,white matter myelination was the most common,with 67 cases,accounting for 41.88%.Followed by widening of the extracerebral space and ventriculomegaly,with 38 cases,accounting for 23.75%. Conclusion Brain MRI examination is of great value in speculating the pathological mechanism and predicting the prognosis of children with cerebral palsy,which is more important than that in children with mental retardation.

Objective To investigate Non-invasive fibrosis indexes in predicting the risk of acute liver function deterioration (ALFD) and survival after drug-eluting beads transarterial chemoembolization (DEB-TACE). Methods The clinical data of 288 HCC patients treated with DEB-TACE were analyzed retrospectively.According to the text's criteria,the patients were divided into the ALFD group and control group,and the baseline data and preoperative liver function indices of the two groups were compared.Then receiver operating characteristic (ROC) of Child-Pugh score,Kaplan-Meier log-rank test and Cox risk regression model were used for univariate analysis of survival rate,and the independent prognosis factors were screened out by multivariate analysis. Results Except for ALT,all other liver function indexes showed statistically significant differences in the two groups (P＜0.05).The AUCs of Child-Pugh score,APRI,and FIB-4 were 0.763,0.735,and 0.740 respectively,which the difference had no significance in statistics,also APRI,FIB-4 optimal cut-off point values of 1.42,and 4.47 respectively.Stratified analysis suggested that APRI > 1.42 or FIB-4 > 4.47 were risk factors for ALFD after DEB-TACE.Survival analysis showed that the median survival was 32.5 months and 19 months for APR≤1.42 versus APRI>1.42 respectively (P=0.005); and 32.5 months and 20.5 months for FIB-4≤4.47 versus FIB-4>4.47,respectively (P=0.097).Multi-factor Cox risk regression model analysis yielded maximum tumor diameter and portal vein invasion as independent prognostic factors. Conclusion The non-invasive fibrosis indexes based on APRI and FIB-4 has certain clinical application to assess the risk of ALFD and prognostic survival after DEB-TACE for hepatocellular carcinoma.

Objective Exploring the impact of different acceleration factors (AF) of compressed SENSE (CS) combined with different MultiVane (MV) acquisition percentages (AQP) on the image quality of T₂ weighted imaging (T₂WI). Methods A total of 21 subjects (9 males,mean age:38.95±19.56) were scanned using a 3.0 T MR scanner.Each subject underwent a series of T₂WI scans with varying CS acceleration factors (CS = 2,3,and 4) combined with different MV AQPs (160%,210%,and 260%).Two observers delineated the ROI on the original image to measure the signal intensity (SI) and standard deviation (SD),and then to calculate the signal to noise ratio (SNR) and contrast to noise ratio (CNR).Subjective scoring of image quality was evaluated by a 4-point scale.The intraclass correlation coefficient (ICC) and Kappa test were adopted to evaluate the consistency of the objective measurement and subjective scores by the two radiologists,respectively.The Friedman test was used to assess differences of SNR,CNR and scores among images by different CS factor and MV AQP,and the LSD test was employed to make a pairwise comparison. Results The measurement data and the score of the two observers were in good agreement (ICC:0.971-0.996;Kappa:0.769-1.000).The SNR and CNR measured in different brain regions by MV scans with different scan settings were mostly higher than those of the conventional Cartesian turbo spin echo scan (P<0.001).For MV-T₂WI with the same CS acceleration factor,SNR and CNR increase with the increase of AQP.For MV-T₂WI with the same MV AQP,SNR and CNR decrease with the increase of AF.The differences in corpus callosum SNR,CNR,and cerebellar CNR were statistically significant (P<0.05).For MV-T₂WI with a similar scan time,AF=CS3 (210%) of callosum,cerebellar SNR and pons CNR were higher than AF=CS2 (160%) and AF=CS4 (260%) (P<0.05). Conclusion The combination of AF = CS3 with AQP = 210% can reduce the scan time by 25% (72s VS.96s) while ensure the image quality.Therefore,it is recommended for routine clinical brain T₂WI scan.

Objective To investigate CT and MRI manifestation and pathological features of extraskeletal Ewing's sarcoma/primitive neuroectodermal tumor(EES/PNET),in order to improve the understanding level of the disease. Methods 10 cases of EES/PNET confirmed by pathology were diagnosed retrospectively . Results The lesions were located as follows: submaxillary,cerebrum,pleura,chest wall,gastric,retroperitoneum and spinal canal were respectively in one case,and three cases were in renal.All lesions were characterized as large invasive soft tissue masses,with low density on CT and isodense or slight low signal on T₁WI and mixed signal on T₂WI and various level of asymptotic enhancement.Five cases showed restricted diffusion on high b-value DWI.Eight cases were with cystic necrosis.One case located on chest wall was with calcification and adjacent bone destruction.The lesions in the third ventricle,gastric antrum and spinal canal were large but the obstruction was not obvious.The diameter were more than 10cm occurred in kidney and retroperitoneum,and while the tumor occurred in the kidney,tumor thrombus in the ipsilateral renal vein and inferior vena cava can be observed.Tumor immunohistochemical staining showed diffuse and positive expression of CD99 in all cases. Conclusion EES/PNET were usually large and aggressive soft tissue mass,which were often accompanied with cystic necrosis and lack of calcification.EES/PNET of the kidney was very easy to be accompanied by tumor thrombus of renal vein and inferior vein.

Objective To investigate the alteration of white matter structure in patients with systemic lupus erythematosus (SLE) and its correlation with neuropsychiatric scale by diffuse peak imaging (DKI).Methods A total of 41 female patients with SLE (SLE group) and 45 healthy volunteers (HCs) matching their age,sex and education level were selected for DKI examination,and the differences between fractionalanisotropy (FA),mean diffusion (MD) and mean kurtosis (MK) of the statistically different brain regions were measured,and the relationship between the FA,MD and MK values of the different brain regions and the neuropsychiatric scale was investigated by spearman correlation analysis.Results Compared with the HC group,the FA values of the corpus callosum (knee,body,pressure),bilateral anterior,superior radiation crown,retrothalamus radiation,external capsule,superior longitudinal tract and right posterior radiation crown were significantly reduced in the SLE group (P average < 0.05).The MD values of the callosum (knee,body,pressure),the medial capsule knee branch,the bilateral anterior,superior,and posterior radiation crown,the retrothalamus radiation,the superior longitudinal tract,and the left external capsule were significantly increased (P average <0.05),and in the callosum (knee,body,pressure),posterior limbs of the medial capsule,bilateral anterior,superior radiation crown,bilateral retrothalamus radiation,external capsule,superior longitudinal tract,and right posterior radiation crown were significantly reduced (P average<0.05).Correlation analysis showed that the MMSE scale score was positively correlated with the FA and MK values of the callosum body part (r=0.5487,P<0.05;r=0.4269,P<0.05),and was negatively correlated with the MD value of the callosum body part (r=-0.5487,P<0.05).Conclusion DKI technology can detectchanges in white matter structure in patients with SLE,and the changes in white matter structure in different brain regions have a certain correlation with the neuropsychiatric scale.

Objective The present study aimed to evaluate the role of multi-voxel proton magnetic resonance spectroscopy (MRS) in the lateralization of temporal lobe epilepsy (TLE) by investigating the N-acetylaspartate (NAA)/choline (Cho)+creatine (Cr) [NAA/(Cho+Cr)]ratios in hippocampal subregions.Methods Magnetic resonance imaging (MRI) followed by proton MRS (¹H-MRS) was performed in 60 patients with a clinical diagnosis of TLE.MRI and ¹H-MRS were also performed in 60 healthy control subjects of comparable age.NAA/(Cho + Cr) ratios in hippocampal subregions were measured.A threshold value for the NAA/(Cho + Cr) ratio and bilateral differences in NAA/(Cho + Cr) ratios were used as lateralization criteria.Results Two radiologists with more than 10 years-experience had good interobserver reproducibility of blind measurement (ICC=0.822-0.869).There was no significant difference in NAA/(Cho + Cr) in each subregion of hippocampus in the healthy control group(P>0.05).The △NAA/(Cho + Cr) ratios in each subregions of hippocampus in the TLE group were higher than those in the control group,and the difference was statistically significant (P<0.05).Among the subregions of TLE,the NAA/(Cho + Cr) in the head of hippocampus in TLE group was the lowest,and the difference of NAA/(Cho + Cr) ratio was the largest,and the NAA/(Cho + Cr) value was significantly lower and NAA/(Cho + Cr) ratio was significantly higher than that in the control group (P<0.05),while the difference of NAA/(Cho + Cr) and NAA/(Cho + Cr) ratio in the body and tail of hippocampus in TLE group was not statistically significant (P>0.05).A NAA/(Cho + Cr) ratio of <0.65 and a △NAA/(Cho + Cr) ratio of >0.03 in the hippocampal head were used as standards to lateralize TLE.The corresponding area under the curve,sensitivity,and specificity were 0.812,76.7%,and 85.5%,respectively.Conclusion Metabolic impairments in the hippocampi of patients with TLE were not equal between subregions.Specifically,the hippocampal head was more susceptible to metabolic impairment compared with the hippocampal body and tail.Taking the head of hippocampus as the region of interest of ¹H-MRS lateralization of epileptic foci is helpful to improve the accuracy of lateralization.

Objective To assess the values of diffusion kurtosis imaging (DKI) in the differentiation of vestibular schwannomas (VS) from meningiomas with atypical manifestation in cerebellopontine angle.Methods Fifty-two VS and meningioma with atypical manifestation in the cerebellopontine angle were prospectively enrolled.All patients underwent DKI exam before surgery.Mean kurtosis (MK),radial kurtosis (RK),axial kurtosis (AK),fractional anisotropy (FA) and mean diffusivity (MD) were semi-automatically obtained in the solid components of tumors.The two-sample t-test was used to compare the values of DKI parameters between the two groups,and analysis of variance (ANOVA) was used to compare the DKI parameters between VS and meningioma subtypes.The receiver operating curve (ROC) analysis was used to evaluate the value of DKI parameters in differential diagnosis between the two groups.Results MK,RK,AK,and FA were significantly lower in VS than in meningiomas,MD were significantly higher in VS than in meningiomas (all P< 0.05).The kurtosis values of VS and meningioma subtypes were significantly different (P ≤ 0.001).The area under the ROC curve of MK,AK and RK values were 0.971,0.969 and 0.972,and the accuracy was 90.39%,90.39% and 92.31%,respectively.The diagnostic efficacy of MK,RK and AK values was significantly better than that of FA and MD values (P< 0.05).Conclusion DKI is helpful to distinguish VS and meningiomas with atypical manifestation in cerebellopontine angle.Kurtosis values may serve as optimal parameters for discriminating them.

Objective To investigate the diagnostic value of nomogram based on CT imaging features in differentiating benign and malignant thyroid nodules.Methods The clinical and imaging data of 262 patients with thyroid nodules confirmed by surgery and pathology were retrospectively analyzed,including 114 cases of benign group and 148 cases of malignant group.The general data and CT imaging features of the two groups were compared,including the number,location, shape,boundary,calcification,composition,capsule,enhancement mode,plain scan,arterial phase and venous phase CT value,aspect ratio (transverse and coronal) of benign and malignant nodules.The independent influencing factors for differential diagnosis of benign and malignant thyroid nodules were screened by multi-factor logistic regression analysis,and according nomogram model was constructed.The performance of the model was verified by receiver working characteristic curve (ROC) and calibration curve.Results Both benign and malignant thyroid nodules were more common in women,and the proportion of benign nodules was slightly higher than that of malignant nodules,and there was no statistically significant difference(P>0.05).But the average age in benign nodule group was higher than that in malignant nodule group,and the difference was statistically significant (P<0.05).The benign nodule groupwasmostly located in the gland,the shape was regular,the boundary was clear,the capsulewas intact;The malignant nodule groupwasmostly located under the capsule,the shape was irregular,the boundary was fuzzy,the capsule was incomplete.There were significant differences between the two groups in location,shape,boundary,composition,calcification,capsule integrity,axial aspect ratio and arterial phase CT value and venous phase CT value (P<0.05),but there were no significant differences in the number of nodules,enhancement mode,coronal aspect ratio and plain CT value between the two groups(P>0.05).The CT signs with statistically significant differences were included in multivariate logistic regression analysis,and the nodule position,boundary and transverse aspect ratio [OR value(95%CI):11.266(5.679-22.350),4.414(2.361-8.252),5.348(1.762-16.228)] were selected as independent predictors for the differential diagnosis of benign and malignant thyroid nodules.The nomogram model was established accordingly.The area under the ROC curve (AUC) was 0.851(95% CI:0.805-0.889),the sensitivity was 77.5%,the specificity was 86.7%,and the predicted probability fitted well with the actual probability.Conclusion The nomogram based on CT image features can be used to differentiate benignthyroid nodules from malignant thyroid nodules.When the boundary of thyroid nodule was blurred,it was located under the capsule,and the aspect ratio of transverse axis of thyroid nodule was greater than 1.06,malignant nodule tended to be considered,on the contrary,it tended to benign nodule.

Objective To analyze the anatomy of normal incudostapedial joint (ISJ) using ultra-high-resolution CT (U-HRCT).Methods A total of 258 patients from Otorhinolaryngology Department who underwent U-HRCT from September 2020 to August 2021 were retrospectively analyzed,with a total of 304 normal sides.After setting the standard observation plane for ISJ on U-HRCT images,its anatomical characteristics were described,and the differences of ISJ anatomical morphology between age groups or sexes were compared.Results There were 88.2% (268/304) of ISJ being clearly visible,and 11.8% (36/304) were vaguely visible.While 47.7% (145/304) of ISJ showed low attenuation,40.8% (124/304) presented partial bony density,and 11.5% (35/304) had bony density.There was no significant difference in the anatomical features of ISJ between those≤30 years old and >30 years old (all P>0.05).The distance between stapes head to lateral border of the lenticular processand the length of the lenticular process were higher in males than in females [0.93 mm (0.81 mm ,1.02 mm )] vs.[0.87 mm (0.74 mm ,0.96 mm )] ,Z=-2.870,P=0.004,[0.66 mm (0.55 mm ,0.77 mm )] vs.[0.59 mm (0.51 mm ,0.69 mm )] ,Z=-2.825,P=0.005,respectively.No significant difference was found in the width of ISJ space (that is,the difference between the former two metrics).The angle between the incus lenticular process and the stapes head was significantly greater in males [137.9°(126.3°,155.6°) ]than in female[129.8°(119.8°,148.9°) ] ,Z=-2.942,P=0.003].Conclusion U-HRCT can clearly display normal ISJ,which provides the basis for imaging diagnosis and preoperative evaluation of ISJ lesions.

Objective To investigate the correlations of clinicopathological and lesion MRI features with axillary lymph node (ALN) metastasis and the added diagnostic value of ALN metastasis in breast cancer.Methods The clinicopathological and breast MRI features of 842 breast cancer patients confirmed by pathology were analyzed retrospectively.According to the results of pathological evaluation,the patients were divided into ALN metastasis group and non-metastasis group;the differences of clinicopathological and breast MRI features between the two groups were analyzed,and the independent influencing factors of breast cancer ALN metastasis were analyzed by Logistic regression,then ROC curve was drawn to evaluate its diagnostic efficiency.Results Among 842 breast cancer patients,307 patients had ALN metastasis and 535 patients without ALN metastasis;and there were statistically significant differences in the aspects of pathological grade,PR,HER-2,Ki-67 and vascular tumor embolism between this two groups (all P<0.05).On MRI features,the lesion size,number,enhancement type and BI-RADS classification were significantly different between the groups of ALN metastasis and ALN non-metastasis(all P＜0.05).According to the morphological criteria of MRI for ALN metastasis,a total of 390 (46.3%) patients with suspected metastatic ALNs and 452 (53.7%) patients without metastatic ALNs,and the sensitivity,specificity and accuracy were 82.1%,74.2% and 77.1% respectively.Logistic regression analysis showed that low expression of PR,positive HER-2,vascular tumor invasion,lesion >20 mm,non-mass enhancement and BI-RADS 5 category were independent risk factors for ALN metastasis in breast cancer,and the AUC values for diagnosing ALN metastasis based on MRI morphological criteria,clinicopathological and lesion MRI features,and the combination were 0.781,0.739 and 0.848 respectively.Conclusion The clinicopathological and MRI features of lesions have some correlations with ALN status in breast cancer,especially when combining with MRI morphological criteria,the diagnostic efficiency of ALN metastasis would be improved.

Objective To explore the diagnostic value of multimodal magnetic resonance imaging (DWI + IVIM + DKI + DCE-MRI model) for benign and malignant breast lesions.Methods A total of 177 cases of patients with breast lesion confirmed by pathology were collected,including 29 cases in the benign group and 148 cases in the malignant group.DWI,IVIM,DKI and DCE-MRI scanning were performed in all patients.The clinicopathological characteristics,time signal intensity curve and true diffusion coefficient (D),perfusion-related diffusion coefficient (D^*),perfusion fraction (f),mean diffusion rate (MD),mean kurtosis value (MK),volume transfer constant (K^trans),extravascular extracellular space distribute volume per unit tissue volume (V_e) and rate constant (K_ep) were analyzed.The ROC was plotted to compare the diagnostic efficiency.Results In the malignant group,the boundary of breast cancer was mostly unclear,and the TIC curve was mostly plateau or washout type,which is significantly different from those of the benign group.The values of ADC,D and MD in benign group were lower than those in benign group,while the values of D^*,MK,K^trans,K_ep,V_e were higher than that in malignant group (P< 0.05).The MD value of DKI had the largest AUC of 0.826.The AUCs of the DWI,IVIM,DKI,DCE-MRI models were 0.768,0.821,0.871,0.791.The differences in AUCs between the four quantitative models were not statistically significant (Z= 0.045 to 1.618,P> 0.05).The sensitivity,specificity,and accuracy of the DKI models were higher than the DWI and IVIM models,but with a slightly lower accuracy than the DCE-MRI.Combining DKI and DCE-MRI model,the AUC was 0.946,and the diagnostic efficacy was higher than single model (Z=2.197-3.600,P<0.05).Conclusion DWI,IVIM,DKI,and DCE-MRI can all be used to discriminate benign and malignant breast lesions,and the combination of DKI and DCE-MRI model is more conducive to the precise preoperative treatment of patients.

Objective To investigate the value of ¹⁸F-FDG PET/CT relative uptake value and metabolic parameters of the primary tumor for predicting mediastinal lymph node metastasis in non-small cell lung cancer.Methods The data of 80 pathologically proven non-small cell lung cancer(NSCLC)patients who underwent surgery and systemic lymph node dissection were retrospectively analyzed.According to the pathological results,patients were divided into lymph node metastasis group and non-metastasis group.The maximum diameter,maximum standardized uptake value (SUV_max),average standardized uptake value(SUV_mean)of the primary tumor were measured.Tumor SUV_max to blood SUV_mean and tumor SUV_max to liver SUV_mean were calculated.Metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated by the fixed% SUV_max threshold method (MTVq% and TLGq%,q=40).The risk factors of mediastinal lymph node metastasis were determined through univariate and multivariate Logistic regression analysis.The ROC curves evaluated the value of each parameter in predicting mediastinal lymph node metastasis.Results A total of 80 patients were included in the study.28 of them(35.0%) had mediastinal lymph node metastasis and 52 of them(65.0%)did not have.Significantly higher values of the maximum diameter,SUV_max,SUV_mean,SUR_blood,SUR_liver,MTV,TLG of the primary tumor were found in patients with mediastinal lymph node metastasis(Z=-2.845--3.752,P＜0.01 for all).The proportion of patients who had central primary lesion with lymph node metastasis was significantly higher than those without lymph node metastasis(60.7% vs.21.2%)(χ²=12.520,P＜0.001).The multivariate analysis showed that SUR_blood(odds ratio,21.278,95%CI:1.041-1.568,P=0.019) was the independent risk factor for mediastinal lymph node metastasis in NSCLC.Receiver operating characteristic (ROC) analysis showed that all parameters had important value for the evaluation of lymph node metastasis.The best diagnostic efficiency was SUR_blood with the optimal cut-off value of 3.42(AUC=0.755,95%CI:0.648-0.863).The sensitivity and specificity of SUR_blood were 96.4% and 44.2%.Conclusion ¹⁸F-FDG PET/CT relative uptake value and metabolic parameters of the primary tumor have important value for the evaluation of mediastinal lymph node metastasis.In addition,SUR_blood is the independent risk factor for mediastinal lymph node metastasis in NSCLC and it showes the most powerful predictive performance for predicting mediastinal lymph node metastasis in NSCLC,suggesting great value for clinical setting.

Objective To establish a preoperative radiomics model based on CT to predict the early recurrence after resection of China Liver Cancer staging (CNLC) Ⅰ-Ⅱ hepatocellular carcinoma (HCC).Methods This study retrospectively analyzed 153 CNLC Ⅰ-Ⅱ HCC patients who underwent radical resection.The regions of interest were delineated with 3D slicer.The radiomics features were calculated using the pyradiomics package.The least absolute shrinkage and selection operator (LASSO) analysis were performed for Rad-score establishment.Univariate logistic regression and multivariate logistic regression stepwise method were sequentially performed to establish a radiomics model and a clinical model.The area under the receiver operating characteristic curve (AUC) was used to compare the differentiation of the models,the calibration curve was used to evaluate the calibration of the models,and the decision curve analysis (DCA) was used to evaluate the clinical application value of the models.Results The independent predictors were Rad-score,albumin-bilirubin (ALBI) grade,intratumoral arteries and sex.The radiomics model achieved an AUC of 0.900/0.853 in the training/validation set,which was higher than the clinical model (0.832/0.741 in the training/validation set).The calibration curves show the radiomics model with good calibration.The DCA analysis showed that when the threshold probability was around 0.1 to 1.0,the net benefit of radiomics model was higher than that of the clinical model.Conclusion The preoperative radiomics nomogram is helpful in assessing early recurrence after resection of HCC and may be beneficial for improving clinical decision making.

Objective To evaluate the value of residual liver volume in predicting liver dysfunction and prognosis in patients with hepatocellular carcinoma (HCC) post-transcatheter arterial chemoembolization (TACE).Methods Retrospective analysis of 160 patients with China liver cancer staging Ⅰb-Ⅱb HCC,who were treated with TACE from March 2014 to April 2018.The residual liver volume(RLV)pre-TACE were assessed using CT volumetry and normalized to body surface area(BSA)to yield RLV_BSA.The cutoff value of Receiver operating characteristic (ROC) curve was used for RLV_BSA stratification.Logistic regression analysis was performed to determine the risk factors of liver dysfunction.Survival prognosis were calculated using Kaplan-Meier curve.Results The cutoff value of RLV_BSA for predicting liver dysfunction post-TACE was 559 cm³.Univariate and multivariate analyses showed that RLV_BSA was an independent risk factor for predicting liver dysfunction.The median overall survival of patients with a RLV_BSA > 559 cm³ was 31 (95% CI:29,33) months,while that of patients with a RLV_BSA ≤ 559cm3 was 17 (95% CI:11,23)months (P＜0.002).At a median overall survival of 28 (95% CI:26,30) months,52 patients were diagnosed with hepatic dysfunction post-TACE.Conclusion A smaller RLVBSA is positively associated with chronic liver dysfunction and reduced overall survival.

Objective To investigate the effect of HGDN categories on diagnostic performance of LI-RADS v2018 criteria based on Gd-EOB-DTPA-enhanced MRI with high-risk patients for HCC.Methods From January 2015 to December 2021 in the Department of Radiology,Affiliated Hospital of Guilin Medical University,169 patients with high-risk for HCC underwent Gd-EOB-DTPA-enhanced MRI,total of 192 nodules diagnosed by pathological.Two radiologists evaluated the imaging features and classified according to LI-RADS v2018 criteria independently,calculate the diagnostic performance of LR-4/5,LR-5 based on consensus data.LR-DN was added for HGDNs,while other nodules remained unchanged,and the diagnostic performance of LR-4/5,LR-5 was recalculated.Results The sensitivity,specificity,accuracy of LR-4/5,LR-5 using the version of 2018 LI-RADS criteria were 92.81%,56.41%,85.42% and 82.35%,79.49%,81.77%,respectively.After the addition of the LR-DN,the sensitivity of LR-4/5,LR-5 unchanged,with accuracies of 91.67%,84.38%,specificities of 87.18%,92.31%,respectively.Conclusion Gd-EOB-DTPA-enhanced MRI combined with LI-RADS v2018 criteria may improve the sensitivity of LR-4/5,LR-5 for sHCC.The addition of the LR-DN classification may improve the sensitivity and specificity of LR-4/5,LR-5 and may help to strengthen the clinical classification management.

Objective To investigate the application value of different quantitative parameters of dual energy CT in patients with rectal cancer.Methods 118 patients with rectal cancer were enrolled retrospectively.All patients were performed dual energy CT.According to pathological results,the patients were divided into lymph node metastasis negative and positive groups,tumor depositnegative and positive groups,lymphovascular or perineurium invasionnegative and positive groups.Dual energy parameters including dual-phase CT value,iodine concentration (IC),normalized iodine concentration (nIC),the electron density (Rho),effective atomic number (Z),dual energy index (DEI) and K were analyzed in different groups.The receiver operating characteristic (ROC) curve was analyzed,and the area under the ROC curve (AUC) was calculated to evaluate the diagnostic performance.Results Interobserver agreement were 0.803-0.928 for parameters. The mean values of nIC in venous phase in lymph node metastasis negative group were smaller than that in lymph node metastasis positive group (P<0.001,AUC=0.771).The mean values of Rho in venous phase intumor deposit negative group was higher than that in tumor deposit positive group (P=0.037,AUC=0.635).The mean values of Rho in arterial phase in lymphovascular or perineurium invasion negative group was higher than that in lymphovascular or perineurium invasion positive group (P=0.025,AUC=0.648).Conclusion Different quantitative parameters of dual energy CT can be used to evaluate lymph nodes metastasis,tumor deposit and lymphovascularor perineurium invasionin rectal cancer and provide effective basis for precision therapy of patients with rectal cancer.

Objective To investigate the feasibility of using Revolution energy spectral CT VNC in the diagnosis of adrenal tumor by comparing the image quality and CT features of virtual non-contrast scan (VNC) and true non-contrast scan (TNC) of adrenal tumors.Methods Sixty-seven patients with suspected adrenal space occupation in Ningxia Medical University General Hospital from October 2021 to April 2022 were prospectively collected,and underwent energy spectrum CT non-contrast scan and dual-phase enhanced scan.Virtual non-contrast scan images of arterial and venous phases were reconstructed after the scanning and recorded as VNCA and VNCV,respectively.The CT values,background noise and signal-to-noise ratio (SNR)of bilateral normal adrenal gland,adrenal tumor,liver,spleen,abdominal aorta and erector spinal muscle in three group images (VNC_A,VNC_V and TNC) were measured and calculated.The TNC and VNC image quality were scored subjectively by 2 observers and the CT features of adrenal tumors (such as the detection rate of adrenal tumors,anatomical details of lesions,and the relationship between tumors and surrounding tissues)on TNC and VNC image were analyzed by 2 observers.Objective indicators of the three groups of images were compared by one-way ANOVA,the CT features of adrenal tumors were compared by Chi-square test of Fisher's exact probability,and observer consistency was analyzed by Kappa test.Results There were no significant differences in CT values of normal adrenal gland,adrenal tumor,liver,spleen,abdominal aortaanderector spinal muscle in three group images (VNC_A,VNC_V and TNC) (P>0.05),except for the SNR of erector spinae,there were significant differences in SD and SNR (P<0.05).SD values of VNC_A and VNC_V images were lower than TNC images,SNR values of VNC_A and VNC_V images were higher than TNC images.There was no significant difference in tumor CT features among VNC_A,VNC_V and TNC groups (P>0.05).The subjective scores of TNC,VNC_A and VNC_V images were all higher than 3 points,which could meet the needs of clinical diagnosis.The DLP of true non-contrast scan,arterial scan and venous scan were (273.56±91.75) mGy·cm,(267.57±90.23) mGy·cm and (267.53±90.20) mGy·cm,respectively.The total DLP of scanning dose was (808.67±268.16) mGy·cm.The true non-contrast scan accounted for 33.88% of the total DLP.The effective dose was (4.10±1.37) mSv.Conclusion Revolution energy spectrum CT virtual non-contrast scan technology can provide VNC images with similar image quality and diagnostic information as TNC for adrenal tumor patients,and significantly reduce radiation dose.