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 In order to evaluate the efficacy of endovascular therapy (EVT) for Leriche syndrome. Methods Retrospectively analyzed clinical and 2-year follow-up data of 37 patients with Leriche syndrome underwent EVT. In all cases the trans-brachial access was attempted for antegrade recanalization. Once the guidewire and catheter crossed the segment of occlusion,the small-diameter balloons as pre-dilatation plain angioplasty was routinely conducted. After pre-dilatation,the catheter-directed thrombolysis (CDT) therapy was used. According to the results of angiography,the balloon angioplasty and stent implantation were performed. Results The success of vascular recanalization was achieved in all patients without perioperative death. There were 9 patients without stent,17 patients 1 stent,7 patients 2 stents,3 patients 3 stents,1 patient 4 stents. All 44 stents included 41 bare stents and 3 covered stents. During therapy,there were “blue toe syndrome” in 3 cases,subcutaneous hematoma at the inguinal puncture point in 1 case. Perioperative complications were observed in 10.8%,which were not serious. All of them could be successfully managed via endovascular method. The ankle-brachial indexes of post-operation and during follow up significantly increased than pre-operation. The primary and secondary patency rates were 89.2% and 94.6% respectively,at 2-year follow-up. Conclusion EVT for Leriche syndrome was effective. CDT could reveal underlying lesions and decrease the need for stents.

Objective To evaluate the effect of a whole-heart motion-correction algorithm (second generation snapshot freeze,SSF2) on the image quality of coronary computed tomography angiography images in patients with myocardial bridge (MB) and mural coronary artery (MCA) compared to standard images without snapshot freeze (SSF0) and images with first generation snapshot freeze (SSF1). Methods 66 CCTA examinations with MB-MCA in left anterior descending artery were retrospectively analyzed. Images were reconstructed using standard algorithm without motion-correction algorithm,with first-generation motion-correction algorithm,and with second-generation motion-correction algorithm,respectively. The image quality of MB-MCA was assessed and compared (0:nondiagnostic,1:adequate and 2:excellent). Results The image quality scores in SSF2 group(systole:1.9±0.3;diastole:1.9±0.3) were significantly higher than those in SSF1 group(systole:1.4±0.8;diastole:1.6±0.6),and scores in SSF1 group were significantly higher than SSF0(systole:0.8±0.8;diastole:1.1±0.8),all P＜0.001.There were more non-diagnostic images in SSF0 group (systole:26,diastole:15)than SSF1(systole:12,diastole:4).No nondiagnostic image was found in SSF2 group,all P＜0.001. Conclusion Whole-heart motion-correction algorithm can further reduce motion artifact and improve CT image quality in patients with MB-MCA,compared to standard images and images with first-generation motion-correction algorithm.

Objective To explore the value of three-dimensional T₂-weighted fast field echo(3D-T₂-FFE) sequence with curved planar reconstruction (CPR)in demonstrating sacral plexus. Methods 26 healthy volunteers which were recruited were scanned with Philips ingenia 1.5 T XD MR,including T₁WI axial scan and 3D-T₂-FFE sequence coronal scan. The scanning data were reconstructed by curved surface reconstruction (CPR) in the workstation by two doctors independently. Two doctors read the post-processing images and gave each sacral nerve grade and scores independently. Each sacral nerve was divided into internal sacral canal segment and external sacral canal segment and scored respectively. The score of two segments of each sacral nerve was tested by T-test. Results The sacral nerve showed high signal while muscles and bones showed low signal in 3D-T₂-FFE sequence,the contrast between sacral nerve and surrounding tissue was clear,complete displaying rate of sacral 1- sacral 3 nerves were 100%,100%,92% respectively. Grade I displaying rate of internal sacral canal segment of each sacral nerve was 100%.Grade I displaying rate of external sacral canal segment of sacral 1- sacral 4 nerves were 100%,91%,50% and 17% respectively; Grade II displaying rate of external sacral canal segment of sacral 2- -sacral 4 nerves were 9%,42% and 23% respectively. T-test between the internal and external sacral canal segment of the sacral 2-4 nerves showed that,there’s no statistical significance (P> 0.05) between the two groups of the sacral 2 nerve while there were statistical significance (P< 0.01) between the two groups of the sacral 3 and 4 nerves. Conclusion 3D-T2-FFE sequence with curved planar reconstruction (CPR) can clearly display the morphology and surrounding adjacent relationship of the internal sacral canal segment of each sacral plexus nerve and the external sacral segment of sacral 1 and 2 nerve; and partially display the morphology of the external sacral canal segment of sacral 3 and 4 nerve. It’s provide an intuitive and objective image basis for clinical and imaging diagnosis.

Objective To explore the feasibility of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and three-dimensional arterial spin labeling (3D-ASL) perfusion imaging technique dynamically evaluating the regulation of METTL14 on the cell proliferation and angiogenesis of subcutaneous xenograft in nude mice of human colorectal cancer. Methods Immunohistochemistry (IHC) was used to detect METTL14 expression in CRC and adjacent tissues of 52 clinical specimens. Twenty 5-week-old nude mice were randomly divided into two groups.HCT116 cells with stable interference of METTL14 gene and control HCT116 cells with empty plasmid (no interference of METTL14 gene) were subcutaneously injected to the two group of nude mice,respectively,to establish subcutaneous transplanted tumor models of METTL14 knockdown group and control group. After that these mice carrying subcutaneous tumor preoperatively underwent plain MRI for IVIM-DWI and 3D-ASL examinations. IVIM-DWI quantitative parameters (ADC,D,D^*,f) and 3D-ASL parameters(blood flow,BF)value were measured and optimal maps were reconstructed. Correlation analysis was conducted between all parameters and subcutaneous tumor volume,mass,Ki-67 and CD34 staining indices. Results IHC staining results showed that the expression of METTL14 protein was higher in adjacent tissues but lower in tumor tissues. Compared with control group,the volume and mass of subcutaneous xenograft in the Mettl14 knockdown group were much greater,with statistically significant differences (t value was 5.312,5.535,P<0.05).Besides,the values of ADC and D in the Mettl14 knockdown group were lower than those in the control group,while D^*,F and BF values were higher than the counterpart,and the differences were statistically significant (t values were -2.802,-4.311,4.992,4.141 and 6.498,respectively,all P<0.05).Ki-67 and CD34 immunohistochemical results showed that the proliferation index and the microvessel density(MVD) count of xenograft in the Mettl14 knockdown group was significantly higher than that in the control group,and the difference was statistically significant (t value 9.387,7.3,P<0.05).Pearson correlation analysis showed that D^* and BF values of the experimental group were positively correlated with MVD count,xenograft volume and weight (P<0.05),while ADC values and D values were negatively correlated with Ki-67 proliferation index,xenograft tumor volume and weight (P<0.05). Conclusion The microcirculation and molecular diffusion movement of water of xenografts in nude mice can be monitored quantitatively via IVIM-DWI and 3D-ASL technology,noninvasively reflecting the microvascular formation and cell density of tumor tissues. It can be used to evaluate the regulation of METTL14 on the growth of CRC subcutaneous transplanted tumor,and provide quantitative imaging basis for the efficacy evaluation of CRC gene therapy.

Objective To explore the influence of the deep learning reconstruction algorithm (DL) on CT radiomics features at different radiation dose levels. Methods PH-75 body phantom were scanned at high (150 mAs),medium (90 mAs) and low (30 mAs) dose levels at 120 kVp tube voltage by using uCT760.Soft tissue rod (liver equivalent material) and iodine rod (12 mgI/ml) were inserted into the phantom respectively to simulate non-enhanced scan of abdomen and enhance image. After scanning,filtering back projection (FBP) and DL (level 1-4) algorithms were used for image reconstruction based on the original scanning data. The ROI was manually sketched with ITK-SNAP software. AK software was used to extract the radiomics features of each ROI (107 in 7 categories),including shape,first order,gray level correlation matrix,gray level run matrix,gray level co-occurrence matrix,gray level region matrix and neighborhood gray level difference matrix. The coefficient of variation (CV) of each feature was calculated to evaluate the effects of different grades of the DL algorithm on CT radiomics characteristics at different dose levels. Results For non-enhanced scan (liver equivalent material) at high and medium doses,the DL algorithm resulted in stabilization of radiomics features compared to the FBP algorithm,and with an increase in the number of stabilizing the radiomics features as the DL level increased. At low doses,the trend was not significant,and some features still had a high degree of variability even with DL4 level reconstruction. And by the same ranking algorithm,the number of stable radiomics features increases with the increase of radiation dose. For enhanced CT imaging (iodine bar,12 mgI/ml) at different dose levels,compared with the FBP algorithm,the DL algorithm makes the radiomics features tend to be stable. With the increase of DL level,the number of moderately stable features decreases,while the number of stable and very stable features increases,while the number of unstable features is the least in DL1 level reconstruction. Conclusion The use of the DL reconstruction algorithm can improve the stability of image radiomics features at different dose levels. The high-grade DL algorithm is more favorable for radiomics feature extraction,especially for soft tissue in non-enhanced CT images.

Objective To investigate the correlation between the severity of abdominal aortic calcification and abdominal visceral fat. Methods A total of 166 subjects who had complete clinical history and underwent CT scan of whole abdomen and pelvis were analyzed retrospectively. According to the abdominal aortic calcification score(AAC),the subjects were divided into three groups (non-calcification group,mild-calcification group and severe-calcification group).Intraclass correlation coefficient (ICC) and Kappa test were used to evaluate the consistency of abdominal fat measurement and abdominal aortic calcification grade by two radiologists. Independent sample t-test and multivariate Logistic regression were used to analyze the relationship between abdominal fat and abdominal aortic calcification score. Results Two radiologists had high consistency in the measurement of abdominal fat (ICC > 0.833) and abdominal aortic calcification grade (k= 0.86). The visceral fat area (VFA) in the middle layer of L3-4 vertebral body was representative to the total visceral fat volume (VFV) of abdominal cavity (r = 0.838,P < 0.001).The percentage of VFA (VFA%) in severe-calcification group was significantly higher than that in none-calcification group (P< 0.01).Multivariate Logistic regression analysis showed that age (OR=3.803 P< 0 01),VFA% (OR=1.728 P< 0 05) and dyslipidemia (OR=3.08 P< 0 05) were independent risk factors for abdominal aortic calcification. Conclusion The severity of abdominal aortic calcification was significantly correlated with the abdominal visceral fat.

Objective To show the changes of sacral nerve after HIFU ablation of uterine fibroids by DTI and MATRIX imaging,and to analyze the factors causing the changes. Methods Forty-two patients who underwent HIFU ablation of uterine fibroids in our hospital were recruited and underwent S1-S3 nerve DTI and MATRIX scanning within one week before surgery and one day after surgery.The signal changes of the sacral nerve before and after HIFU ablation of fibroids were compared and analyzed using the sacral nerve at the foraminal outlet as the region of interest.At the same time,multiplanar reconstruction of the sacral nerve was performed before and after HIFU ablation to observe the changes in nerve signal and morphology.The relationship between sacral nerve signal changes and patients' general data and treatment parameters were also analyzed. Results (1) There were significant differences in FA and ADC values of S1-S3 nerve between the left same segment before and after operation (P﹤ 0.05).The FA and ADC values of S1-S3 nerve in the right same segment before and after surgery were significantly different (P﹤ 0.05).(2) Postoperative FA and ADC values of the left and right sides of the S1 -S3 nerve were compared,respectively,and there were no significant differences (P﹥0.05).(3) The morphology of all sacral nerves did not change significantly after surgery,but some nerves showed varying degrees of signal enhancement,including 22 cases with nerve signal enhancement and 20 cases without nerve signal enhancement.(4) The distance between the dorsal surface of the fibroid and the sacrum,the total ablation time and the total energy and sacral nerve signal enhancement were statistically significant in univariate analysis (P﹤0.05).In logistic regression analysis the distance between the dorsal surface of the fibroid and the sacrum was negatively correlated with nerve injury,and the total energy of ablation was positively correlated with nerve injury. Conclusion DTI and MATRIX techniques can assess sacral plexus injury during ultrasound-guided HIFU ablation of uterine fibroids.The distance between the dorsal surface of the fibroid and the sacrum and the total energy of ablation are two independent risk factors for increased sacral nerve signal.

Objective To extract the imaging characteristics of medulloblastoma (MB) and ependymoma (EP),and to explore the ability of the radiomics to distinguish the two,so provide reference for early diagnosis. Methods Retrospective analysis was performed on the data of patients diagnosed with MB and EP in the posterior fossa from January 2014 to December 2021 in the First Affiliated Hospital of Xinjiang Medical University.There were 60 patients with MB and EP,and the regions of interest were drawn on the T₁WI and T₂WI sequences of the patients.A total of 2072 features were extracted by 3D Slicer.Mean was used for standardized data processing,PCC was used for preliminary dimensionality reduction,Recursive Feature Elimination (RFE) was used for feature screening,and Support Vector Machine (SVM) was used for modeling.The training set was cross-validated for 5 times,and the effectiveness of the classifier was evaluated by using accuracy,sensitivity,specificity,Positive Predictive Value (PPV) and Negative Predictive Value (NPV). Results The model based on 24 image features can obtain the highest AUC,with the AUC values of training set and test set reaching 0.9983 and 0.9537,respectively,and the accuracy is 98.81% and 88.89%,respectively. Conclusion Radiomics has high value in distinguishing medulloblastoma from ependymoma and can be used as an auxiliary method for clinical diagnosis.

Objective To explore the value and semi-quantitative analysis of ¹⁸F-FDG PET/MR in staging of nasopharyngeal carcinoma. Methods A TNM staging was done by retrospective analysis of histologically confirmed nasopharyngeal carcinoma including 78 untreated treatment,for each of patients whole body imaging was conducted on the integrated TOF PET/MR (GE SIGNA).The results of TNM staging and re-staging according to the 8th edition of AJCC with PET/MR images were compared with the clinical diagnosis and staging.Independent-sample t test or Mann-Whitney U test were used for data analysis.Evaluation of the diagnostic consistency between PET/MR imaging staging and clinical staging using Kappa consistency test.Receiver operating characteristic(ROC) curve analysis was used to calculate the diagnostic performance of each parameter for T staging. Results The accuracy of PET/MR in T stage,N stage,M stage and overall stage were 98.72%,93.59%,100% and 94.87%.PET/MR staging is highly correlated with clinical staging diagnosis (Kappa value = 0.926).SUV_max、SUV_mean、SUV_max/ADC_min are well correlated with T stage(P=0.003,0.005,0.004,P＜0.01).SUV_max are well correlated with N staging of lymph nodes(P=0.000,P＜0.01).ROC curve analysis showed that SUV_max/ADC_min had the highest diagnostic performance,the area under the curve (AUC) was 0.876. Conclusion ¹⁸F-FDG PET/MR whole-body imaging can accurately stage and re-stage nasopharyngeal carcinoma.Compared with independent parameter of PET/MR,multiparametric model(SUV_max/ADC_min)can further improve the diagnostic performance of T staging of nasopharyngeal carcinoma.

Objective To explore the classification performance of nomogram constructed from CT signs combined with radiomics for thyroid papillary carcinoma (PTC) and nodular goiter (NG). Methods The clinical data and CT images of patients with thyroid nodules confirmed by pathology in our hospital from January 2019 to April 2022 were analyzed retrospectively.CT plain scan and enhanced scan were performed within 2 weeks before operation; PTC 113 cases,NG 119 cases; The patients were divided into training cohort (162 cases) and test cohort (70 cases) at a ratio of 7∶3 using random stratified sampling.Relevant signs and iconography features of thyroid nodules were extracted from CT plain scan and two-phase enhanced images.Through screening of clinical image signs and iconography features,four independent models were constructed in the training set and the test set,and calculating the radiomics score.The combined model was constructed based on the radiomics score and the clinical model,and to draw the nomogram based on the combined model.The performance of models in the differential diagnosis of PTC and NG was evaluated by multiple indicators,such as receiver operating characteristic curve (ROC),area under the curve (AUC),net reclassification improvement(NRI),integrated discrimination improvement(IDI),and so on.Calibration plots were formulated to evaluate the reliability and accuracy of the nomograms,and the clinical value of nomograms were evaluated by using decision curves. Results 6,4 and 3 features were retained to construct plain‐scanned model,arterial-phase and venous-phase models respectively.In single phase,The plain-scanned model has the best differential diagnosis performance.Six independent predictors were used to construct the clinical models.Nomograms based on combined models had the highest differential diagnostic efficacy for PTC and NG (training set:AUC was 0.980; test set:AUC was 0.928).Except for the clinical models in the test set,the differences of AUC values between the nomograms and other independent models were significant statistically(P<0.05).The nomogram of training set and test set has positive improvement compared with plain scan model and clinical model(NRI>0,IDI>0).The calibration curves showed that the predicted results of nomograms were in good agreement with the pathological results,and the decision curves showed that nomograms had the higher clinical value. Conclusion The nomogram of CT signs combined with radiomics might be a potential method for distinguishing PTC and NG with good performance.

Objective To evaluate the prognosis of swallowing disorders in stroke patients via a quantitative analysis of VFSS and to compare the assessment power of these parameters. Methods Data of stroke patients with swallowing disorders who underwent VFSS were retrospectively analyzed.A total of 69 patients were divided into group A(acupuncture at Achou group,n=22),group B (balloon dilation group,n=22),and group C(acupuncture at Achou combined with balloon dilatation group,n=25)according to different treatment.Differences in 8 VFSS parameters among groups were investigated.Then the random forest models were also established using the selected features based on the intergroup comparisons.SVM-RFE and RF were used to build the model.The optimal feature number and corresponding features ranking set were screened,and the features with high frequency selected from different models of the two algorithms were used as prognostic evaluation indicators. Results Through the SVM-RFE algorithm in the total model group and each subgroup model screening of the optimal index are:4,5,2,8.RF algorithm combined with SVM-RFE algorithm cross-longitudinal bidirectional common high frequency,evaluation efficiency optimal quantitative index are:hyoid displacement distance,pharyngeal delivery time,hyoid movement time,throat closing time,swallowing start time,among which the hyoid displacement distance is the most valuable evaluation. Conclusion The VFSS quantitative analysis exhibited significantly higher power in predicting the prognosis of stroke with swallowing disorders,which will contribute to clinical practice with a valuable reference.

Objective To explore the feasibility of double-layer detector spectral CT Virtual Monoenergetic Images (VMI) in improving the image quality of papillary thyroid carcinoma (PTC). Methods The imaging data of 60 patients with pathologically proved PTC who underwent spectral CT thyroid plain scan and enhanced thyroid scan in our hospital from January 2022 to March 2022 were analyzed retrospectively.The images were reconstructed retrospectively,and the images of 40,50,60,70,80,90 keV virtual single-level plain scan and conventional plain scan and arterial phase images were obtained respectively.The noise value (SD),focus CT value and normal thyroid tissue CT value of each group were measured,and the contrast-to-noise ratio (CNR) was calculated,which was used as the objective evaluation index of image quality.Two senior imaging diagnostic doctors read the films independently by double-blind method,diagnosed and recorded the number of lesions in each group,and scored the images of each group as a subjective evaluation index of image quality.the size of lesions was measured at 40,50 keV and routine arterial phase images,and the results were compared with pathological results. Results A total of 76 lesions were detected by pathology,and 76 lesions were detected by 40,50 keV and arterial phase images.The SD of VMI images was the highest at 40 keV,then decreased gradually,and remained basically unchanged after 70 keV.There was no significant difference in SD between 50 keV images and conventional plain scan images and arterial phase images.The CNR of 40 and 50 keV images were higher than that of conventional images.the subjective score of 50 and 60 keV were higher than that of conventional images,but there was no significant difference between the size of lesions measured by 40 and 50 keV images and pathological results. Conclusion Spectral CT VMI can significantly improve the image quality and detection rate of PTC plain scan at low energy levels,and 50keV images are recommended for the diagnosis of PTC.

Objective To quantitatively analyze the enhancement characteristics of breast lesions on contrast-enhanced spectral mammography (CESM) subtraction images,and to explore the correlation between benign and malignant breast lesions and the degree and patterns of enhancement. Methods The data of 282 patients who underwent bilateral breast CESM examination due to suspected breast lesions in clinical or ultrasonography from August 2017 to December 2021 in West China Hospital of Sichuan University were retrospectively collected.The signal values of the lesions shown on CESM images and the breast background at CC and MLO positions were measured respectively,and the contrast-to-noise ratio (CNR) and relative signal difference (RSD) of the lesions were calculated,and the differences in the enhancement degree and enhancement patterns of benign and malignant lesions were analyzed. Results The enhancement degree of the malignant group was higher than that of the benign group (P<0.05),and the main difference was between the invasive cancer group and the benign lesions group.the benign lesions were mostly non-enhanced (52.2%),and the enhancement pattern of the enhanced benign lesions is mostly ascending pattern.Most of the malignant lesions showed enhancement (90.5%),and most of the enhancement patterns were descending pattern,and the difference was statistically significant (P<0.05). Conclusion The quantitative analysis of enhancement degree and enhancement patterns of breast lesions can provide the basis for the differential diagnosis of benign and malignant breast lesions,especially the differentiation of invasive carcinoma and benign lesions.

Objective To investigate the application value of intratumoral and peritumoral radiomics based on DBT for HER2 status in breast cancer. Methods The imaging and clinicopathological data of 178 patients with breast cancer confirmed by pathology were retrospectively analyzed.The tumor region of interest (ROI) was delineated on the DBT images of the CC and MLO positions,and the intratumoral ROI was automatically expanded by 3 mm to obtain the peritumoral region,and the intratumoral and peritumoral three-dimensional volumetric region of interest (VOI) was generated.Extract and screen the radiomics features,and then establish three radiomics models of intratumoral,peritumoral and intratumoral addition based on the optimal features.Statistical analysis of clinicopathological data was performed to build clinical models.Then,a comprehensive model based on clinical-radiomics was established and a nomogram was drawn.ROC curve and area under curve were used to evaluate the performance of the model,and the calibration and decision curves were drawn. Results AUC of intratumoral,peritumoral and intratumoral radiomics models were 0.800,0.726 and 0.844,respectively.AUC of clinical model and combined clinical-imaging model were 0.585 and 0.850,respectively. Conclusion DBT-based radiomics features can be used to assess HER2 status of breast cancer,and combined with peritumoral radiomics features can improve model performance.And the comprehensive model and nomogram combined with clinical and radiomics features have good predictive value.

Objective To investigate the correlation between radiomics features and molecular classification of mass breast cancer based on dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI) sequences. Methods From January 2019 to April 2022,120 patients with breast cancer confirmed by pathology in the First Affiliated Hospital of Bengbu Medical College were retrospectively analyzed.All patients underwent dynamic contrast enhancement-magnetic resonance imaging (DCE-MRI) examination before treatment.Upload all patient images from image storage and transmission system to Huiying big data scientific research platform in the form of digital Imaging and Communications in Medicine (DICOM).In the third phase of dynamic enhancement,the region of interest (ROI) was delineated layer by layer around the lesion using the double-blind method,and then all ROIs delineated by the lesion were fused into Three dimensional volume region of interest (ROI).A total of 1409 texture features were extracted by omics analysis.Variance Threshold,univariate feature selection method and minimum absolute contraction operator (LASSO) were used for feature screening and dimensionality reduction of lesions.Finally,the most valuable radiomics features are obtained,the effective prediction model is constructed,the receiver operating characteristic curve (ROC) is drawn,and the area under the ROC curve is obtained.AUC,specificity,sensitivity and accuracy were used to evaluate the efficiency of the model.Rank sum test and chi-square test were used to analyze the lesion size,age,menstruation and lymph node metastasis of patients with different molecular subtypes. Results According to the pathological results,the patients were divided into 4 types:luminal A type,luminal B type,HER-2 overexpression type and triple negative type.The AUC values of the four types of prediction models were 0.80,0.77,0.79 and 0.79,respectively.There were significant differences in age,menstruation and lesion size among different molecular subtypes of breast cancer (P<0.05),there was no significant difference in lymph node metastasis (P>0.05). Conclusion There is a good correlation between the radiomics features of 3D-MRI and the molecular classification of mass breast cancer.

Objective To evaluate the correlation between metabolic parameters calculated by different SUV thresholds on ¹⁸F-FDG PET/CT with TNM staging for non-small cell lung cancer. Methods The data of 84 pathologically proven non-small cell lung cancer(NSCLC)patients who underwent ¹⁸F-FDG PET/CT examination were retrospectively analyzed.Maximum standardized uptake value (SUV_max)was measured,and metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were calculated by three methods :the absolute SUV threshold method (MTVp and TLGp, p= 2.5,3,4); the fixed% SUV_max threshold method (MTVq% and TLGq%,q = 40,50),and the adaptive iterative algorithm method(ALA) (MTV_ALA and TLG_ALA).The differences of parameters between TNM stage and the correlation between parameters and TNM stage were analyzed.The ROC curves evaluated the value of each parameter in predicting lymph node metastasis. Results All metabolic parameters were significantly different among T、N stage groups(P＜0.05 for all).MTV_ALA,TLG_ALA,MTV_2.5,TLG_2.5,MTV₃,MTV_40%,TLG_40%,MTV_50% were significantly different between M stage groups(P＜0.05 for all),but SUV_max、TLG₃、MTV₄、TLG₄、TLG_50% were not(P＞0.05 for all).The correlation between SUV_max and T stage was positively moderate(r=0.529,P＜0.001).The correlation between all metabolic parameters calculated by different SUV thresholds,and T stage was positively good(r=0.701-0.772,P＜0.001 for all),and TLG2.5 showed the most remarkable relationship(r=0.772,P＜0.05).The correlation between All metabolic parameters and N stage was positively fair(r=0.320-0.398,P＜0.05 for all).MTV_ALA,TLG_ALA,MTV_2.5,TLG_2.5,MTV₃,MTV_40%,TLG_40%,MTV_50% were fairly positively correlated with M stage(r=0.219-0.262,P＜0.05 for all),but SUV_max、TLG₃、MTV₄、TLG₄、TLG_50% were not(P＞0.05 for all).All metabolic parameters had important value for the evaluation of lymph node metastasis.The best diagnostic efficiency was TLG_2.5(AUC=0.749,95%CI:0.629-0.869),but the difference was not significant(Z=0.023-0.934,P＞0.05 for all).The sensitivity,specificity and accuracy of TLG_2.5 were 85.7%,55.9% and 69.4%,respectively. Conclusion All metabolic parameters calculated by different SUV thresholds are closely correlated with clinical stage,which are more relevant than SUV_max.In addition,TLG_2.5 shows the most remarkable relationship,suggesting great value for clinical setting.

Objective To evaluate the outcome of intracranial internal carotid artery occlusion (IICAO) after EVMT along with primary collateral circulation of acute intracranial internal carotid artery occlusion based on Willis circle variation.Methods In all,162 patients with IICAO treated by EVMT were evaluated.Baseline data were collected including demographic characteristics,vascular risk factors,ASPECTS,and initial NIHSS score.The number of hemorrhagic transformation cases were counted. The variation of Willis' circle was categorized into four degrees. Combined with the location of the IICAO and Willis' circle variation,the retrograde flow direction was divided into four groups.Postoperative clinical outcomes were measured by mRS (Modified Rankin Scale) at 90 days to determine the association between multiple factors and good clinical outcomes.Results Among the 162 patients with IICAO,38.3%(62cases) showed improved clinical efficacy after thrombectomy(mRS 0-2),29.0%(47 cases) did not recover(mRS 3-5),and 32.7%(53 cases) died(mRS 6).There were statistically significant differences in age,admission NIHSS score and atrial fibrillation among the three groups (P<0.05).There was no statistical difference in the proportion of Willis development variation among the three groups with different clinical outcomes (P>0.05),and there was statistical difference between the presence and absence of primary collateral circulation (P<0.05).The mortality rate of patients without primary collateral blood flow was 57.1%.Multivariate Logistic regression analysis showed that primary collateral circulation and atrial fibrillation were predictors of favorable outcomes.Conclusion Primary collateral circulation based on Willis variation may be potential predictors of favorable outcomes for patients with IICAO after EVMT.

Objective The aim of this study was to evaluate the associations between pericarotid fat density (PFD) and the event of acute cerebral infarction (ACI).Methods 71 consecutive patients with unilateral carotid plaque subjected to both carotid artery CT angiography (CTA) and brain MRI examination were retrospectively analyzed.Perivascular fat density (PFD) was measured on the carotid plaque side and the contralateral side based on CTA images by two radiologists.And the most severe stenosis slice of plaque was used for analysis.Then the PFD of plaque,the PFD of non-plaque and the Δ PFD (difference of perivascular fat density)was calculated respectively. Patients were divided into ACI and non-ACI group,mild/moderate stenosis group and severe stenosis group. The differences of clinical,laboratory variables and PFD between groups were compared.The t-test,Mann-Whitney U test,and Chi-square test were used to compare the differences between different risk groups.P< 0.05 was considered statistically significant.Results Compared with the non-ACI group,ACI group showed higher Δ PFD (P= 0.039).In patients with ACI,the ipsilateral PFD was higher than the contralateral PFD (P< 0.001).The ΔPFD of patients in severe stenosis group was higher than the patients with mild/moderate stenosis group (P= 0.013).Conclusion Carotid PFD was associated with ACI.PFD may be associated with plaque vulnerability and may use as an alternative imaging marker of perivascular inflammation.

Objective To evaluate the diagnostic value of dual source CT dual energy imaging in differential diagnosing benign and malignant thyroid nodules.Methods 85 patients with thyroid nodules confirmed by surgical and pathology were enrolled in this study for retrospective analysis,which included 34 of malignant nodules and 51 of benign nodules.All patients underwent DSCT dual energy enhancement scan before surgery.CT image including size,number,shape,margin,degree of enhancement,calcification,cystic change and peripheral tissue invasion were assessed on the enhanced fusion image.Quantitative DSCT dual energy parameters including standardized iodine concentration (NIC) and slope of energy spectrum curve (λ_HU) were calculated.ROC curve analysis was used CT image features,quantitative DSCT dual energy parameters and their combination and to evaluate the diagnostic efficiency.Results Significant differences were found in CT image features including number,shape,margin,cystic change and peripheral tissue invasion(P<0.05). DSCT dual energy parameters in malignant thyroid nodules group were lower than those in benign nodules group in both arterial and venous phase(P<0.001).The area under curve (AUC),sensitivity,specificity of CT image features and DSCT dual energy parameters and combination of logistic model based on both CT image features and quantitative DSCT dual energy parameters were 0.798、0.907、0.934,79.4%、88.2%、91.2% and 66.7%、92.2%、90.2% for diagnosing benign and malignant thyroid nodules.The differentiating performance of the two latter were higher than the former (P<0.001).The differentiating performance of combination of logistic model based on both CT image features and quantitative DSCT dual energy parameters was the highest.Conclusion DSCT dual energy imaging has promising diagnostic value in differentiating benign and malignant thyroid nodules,Integrating CT image features can further improve the diagnostic efficiency.

Objective Longitudinal observation of the relationship between MR enhancement features and prognosis of facial nerve in patients with Bell's palsy.Methods This study was a longitudinal observational study.26 patients with clinical diagnosis of unilateral Bell's facial palsy who were hospitalized in our hospital's neurology department were prospectively and consecutively enrolled as the research object.Three MR enhanced scans were performed within 3 days,one month and three months after onset.According to the recovery of Bell's palsy after three months,the patients were divided into complete recovery group and incomplete recovery group.Contrast-enhanced three-dimensional magnetization prepared rapid acquisition gradient echo sequence (T₁-3D-MP RAGE)were performed on patients every time.The facial nerve was divided into five anatomical segments for the evaluation of the enhancement patterns,and the signal intensities of the enhanced facial nerves were graded from 1 to 3.Results The patients were categorized into a complete recovery group (n=21) and an incomplete recovery group (n=5).The enhancement degree of fundal canalicular,labyrinthine,geniculate ganglion and tympanic segment in the incomplete recovery group were higher than those in the complete recovery group after 3 months of onset (P<0.05).There was no significant difference of mastoid segment in the incomplete recovery group and complete recovery group after 3 months of onset (P>0.05).However,within 3 days and 1 month after the onset of the disease,there was no significant difference in the enhancement degree of five anatomical segments between the incomplete recovery group and the complete recovery group(P>0.05).Conclusion There is no direct correlation between the degree of abnormal enhancement of the paralyzed facial nerve at early onset and the patient's final prognosis.However,there were still some segments had abnormal enhancement after 3 months of onset indicating a poor prognosis for patients three months later or even longer.

Objective To analyze the clinical and CT features of Minimally invasive adenocarcinoma (MIA) and Invasive adenocarcinoma cancer (IAC) cases in ground glass nodule (GGN),establish a diagnostic model of IAC and evaluate its diagnostic value.Methods The imaging and clinical data of MIA and IAC cases in pulmonary GGN in our hospital from July 2017 to July 2021 were retrospectively analyzed. The patients were randomly divided into training group and validation group according to the ratio of 7∶3.IAC was used as the experimental group and MIA was used as the control group in the training group.The clinical and imaging characteristics of the two groups were compared.The risk factors of IAC were analyzed by multivariate Logistic regression and the IAC diagnostic model was established. The diagnostic efficacy of the model was analyzed by ROC curve.The risk factors were quantified by nomogram.Results 479 GGN lesions were included in the study,including 335 in the training group and 144 in the validation group.Lesion mass (P=0.001),deep lobulation sign (P=0.029),and vacuole sign (P=0.014) were independent risk factors for IAC.The AUC value of the ROC curve in the training group was 0.852,the validation group was 0.762,and the cutoff value of the predictive probability of the IAC nomogram diagnostic model was 0.634.Conclusion The diagnostic model of IAC nomogram based on clinical and imaging features has a good diagnostic value for IAC.

Objective To investigate the correlation study between parameters such as coronary CTA-derived plaque characteristics,noninvasive CT fractional flow reserve (FFR_CT) and pericoronary fat attenuation index (FAI) and PCI revascularization in patients with coronary artery disease.Methods A retrospective collection of 104 patients (118 diseased vessels) with stable coronary artery disease,underwent coronary CTA and coronary arteriography (CAG) within 1 month.The plaque characteristics,lumen area at the narrowest point (MLA),plaque load (PB),remodeling index (RI),low-attenuation plaque,positive remodeling,napkin ring sign and speckle calcification of the diseased coronary arteries were assessed;calculation of coronary CTA-derived parameters,FFR_CT,measurement of peri-coronary FAI of the diseased coronary artery.The patients were divided into PCI revascularization group and non-reconstruction group according to the Chinese percutaneous coronary intervention (PCI) treatment guidelines.Comparative analysis of the relationship between coronary CTA-derived lesion anatomical features,hemodynamic and peri-lesion inflammatory parameters between the two groups.Logistic regression analysis was performed to analyze the relationship between PCI revascularization and plaque characteristics,FFR_CT,and pericoronary FAI.ROC curves were used to evaluate the efficacy of each parameter in predicting PCI revascularization.Results PB,pericoronary FAI,and low-attenuation plaques were significantly higher and FFR_CT and MLA were significantly lower in the PCI revascularization group compared with the non-reconstruction group.Univariate and multifactorial logistic regression suggested that pericoronary FAI,FFR_CT and MLA were significant predictors of PCI revascularization.The efficacy of FAI and FFR_CT in predicting PCI revascularization was similar,with no statistically significant difference (AUC 0.853 and 0.857,respectively;P=0.932).MLA had a higher AUC compared with other parameters (0.955,all P< 0.05).FAI combined with MLA increased the AUC to 0.985,both higher than the AUC of other single parameters (P< 0.05),and the difference was statistically significant.Conclusion Pericoronary FAI was significantly higher in the PCI revascularization group than in the non-reconstruction group,and FFR_CT and MLA were significantly lower than in the non-reconstruction group.Coronary CTA-derived pericoronary FAI combined with MLA could improve the accuracy of predicting PCI revascularization.

Objective To explore and compare the accuracy of absolute apparent diffusion coefficient (aADC) and relative apparent diffusion coefficient (rADC) in differentiating intrapancreatic accessory spleen (IPAS) and pancreatic neuroendocrine tumour (PNET).Methods The information of 13 patients with IPAS confirmed by imaging and 16 patients with PNET confirmed by pathology were analyzed retrospectively.The ADC values of the lesion and spleen were measured independently by the two attending physicians of the imaging department,and inter-reader reliability for the two methods was assessed.The accuracy of aADC and rADC in differentiating IPAS and PNET was evaluated by the receiver operating curve (ROC),and the diagnostic efficacy of the two methods was compared by Delong test.Results Both methods demonstrated excellent inter-reader reliability with intra-class correlation coefficients(ICCs)for aADC and rADC 0.968 and 0.976,respectively,and the bias between two readers was not significant.The aADC values of IPAS and PNET were (0.931±0.773)×10^-3mm/s² and (1.254±0.219)×10^-3mm/s²,and the rADC values of IPAS and PNET were 1.154±0.167 and 1.591±0.364,respectively.Significant differences were observed in aADC and rADC values between the two groups (P values < 0.001 for both).The cut-off value of aADC was 1.046×10^-3mm/s² with 81.25% sensitive and 100% specific in differentiation,and the cut-off value of rADC was 1.342 with 81.25% sensitive and 92.31% specific of differentiation.The area under the curve (AUC) of the two methods were 0.9399 and 0.9315,respectively,and the diagnostic efficacy was comparable (P value = 0.6668).Conclusion aADC and rADC have high accuracy in differentiating IPAS and PNET,which is helpful to guide clinical selection.

Objective To investigate the correlation between serum trypsin (serum amylase and lipase) and pancreatic microcirculation in acute pancreatitis based on CT perfusion imaging.Methods 163 patients with acute pancreatitis were retrospectively collected and divided into three groups according to the high and low value of serum trypsin:47 patients in the group with normal serum amylase and lipase (group A),50 patients in the group with elevated serum amylase and lipase at least one but not three times the normal value (group B),at least one of serum amylase and lipase increased to three times the normal value in 66 cases (Group C).Pancreatic CT perfusion imaging was performed in all cases,and the perfusion data were transmitted to the post-processing workstation.The perfusion data were processed by perfusion software package,and the perfusion parameters [blood flow (BF),blood volume (BV),mean transit time (MTT) and flow extraction parameters (FE)]were recorded and statistically analyzed.Spearman correlation analysis was used to analyze the correlation between serum ptrypsin and pancreatic perfusion parameters.One-way ANOVA was used to compare the statistical differences of perfusion parameters among the three groups.Results Spearman correlation analysis showed that CT perfusion parameters BF and BV were positively correlated with serum pancreatic amylase,lipase,γ= 0.247 and 0.189 respectively. One-way ANOVA showed that there were significant differences in BF,BV,MTT among the three groups (P＜0.05),but there was no significant difference in FE among the three groups (P> 0.05).SNK-q test showed that there was significant difference in perfusion parameters BF,BV,MTT between group A and group C (P＜0.05),BF,MTT and BV between group B and group C(P＜0.05),and there was no significant difference in perfusion parameters BF,BV and MTT between group A and group B (P> 0.05).Conclusion There is a positive correlation between serum trypsin and pancreatic blood perfusion in acute pancreatitis,pancreatic perfusion would increase with the increase of serum trypsin.

Objective To investigate the value of Gd-EOB-DTPA enhanced MRI in the differential diagnosis of intrahepatic mass-forming cholangiocarcinoma (IMCC) and atypical hepatocellular carcinoma (aHCC) with hepatitis B cirrhosis.Methods The clinical and MRI data of 31 IMCC and 71 aHCC patients with hepatitis B cirrhosis confirmed by pathology were retrospectively analyzed from February 2019 to March 2022.All patients underwent MRI plain scan,DWI and Gd-EOB-DTPA enhanced MRI.The clinical indicators and imaging features in the two groups were analyzed,and the variables with statistical significance in the univariate Logistic regression analysis were included in the multivariate Logistic regression to screen out the independent predictors for differentiating IMCC from aHCC.Receiver operating characteristic (ROC) curve was used to analyze the efficacy of each independent indicator and its combination in the diagnosis of IMCC.Results Univariate Logistic regression analysis showed that the increased CA19-9 (25/31),increased CEA (10/31),T₂WI central high signal area (8/31),T₂WI central low signal area (11/31) and targetoid sign (DWI and/or HBP targetoid sign) (30/31) indicated IMCC.Increased AFP (44/71),multifocal hyperintensity on T₂WI (21/71),capsular sign (25/71) suggested aHCC (all P＜0.1).Multivariate Logistic regression analysis showed that targetoid sign (DWI and/or HBP targetoid sign) (OR:88.978,95%CI:8.328-950.702) and increased CA19-9 (OR:35.494,95%CI:6.582-191.413) were the independent predictive indicators to distinguish the two groups (all P＜0.05).The area under the curves (AUC) of targetoid sign,increased CA19-9 and their combination in the diagnosis of IMCC were 0.86,0.85 and 0.96,and diagnostic accuracy were 82.4%,87.3% and 91.2%.Conclusion Gd-EOB-DTPA enhanced MRI is of great importance in the differential diagnosis between IMCC and aHCC with hepatitis B cirrhosis. Targetoid sign (DWI and/or HBP targetoid sign) and CA19-9 were independent predictive indicators of IMCC,and their combination can improve the diagnostic performance.

Objective To construct a MR based omics model combined with clinical features to achieve preoperative non-invasive diagnosis of prostate cancer with PSA of 4-10 ng/ ml and PI-RADS v2.1 score ≥3.Methods Retrospective analysis was performed on 82 cases of prostate cancer and 150 cases of benign prostatic hyperplasia with pathologically confirmed PSA levels between 4-10 ng/ ml and PI-RADS score ≥3 in two hospitals.ITK-SNAP was used to manually delineate the areas of interest in T₂WI,ADC and DCE,respectively.Features were extracted using Python platform,and data preprocessing,feature selection and model construction were completed by FAE software.The clinical model was established by univariate and multivariate Logistic regression analysis to determine clinical independent predictors.The AUC value was used to evaluate the model performance,and the best omics model was combined with clinical model to construct the comprehensive model.The generalization ability of the model is verified by external validation.R software was used to draw the comprehensive model rosette,and the fitting degree and clinical application value of the rosette were evaluated by calibration curve and decision curve.Results The AUC of comprehensive model,omics model and clinical model in training set were 0.933(95%CI:0.874-0.970),0.915(95%CI:0.852-0.957),0.802(95%CI:0.722-0.867),In the test set,AUC were 0.887(95%CI:0.792-0.982),0.872(95%CI:0.755-0.947),0.677(95%CI:0.521-0.833),Inthe external validation set,the AUC was 0.866 (95%CI:0.740-0.946),0.812 (95%CI:0.676-0.908) and 0.709 (95%CI:0.564-0.829),respectively,and the diagnostic efficiency of the comprehensive model was the best.The calibration curve of the line map was in good agreement with the pathological results.The decision curve shows good clinical application value.Conclusion The comprehensive model based on MR omics model and clinical model can be used to predict prostate cancer noninvasively with “grey area” PSA and PI-RADS V2.1 score of 3 or above,thus reducing unnecessary biopsy rate.