Assessment of Changes in the Cesarean Scar and Uterus Between One and Two Years after Cesarean Section Using 3D T2w SPACE MRI

Objective Io evaluate changes in morphology of the cesarean scar and uterus between one and two years after cesarean section using high-resolution,three dimensional T2-weighted sampling perfection with application optimized contrast using diflerent flip angle evolutions Magnetic Resonance Imaging(3DT2w SPACE MRI).Methods This prospective study was performed to investigate morphological changes in the cesarean scars and uterus from one to two years after cesarean section using high-resolution,3D T2w SPACE MRI.The healthy volunteers having no childbearing history were recruited as the controls.All data were measured by two experienced radiologists.All data with normal distribution between the one-year and two-year groups were compared using a paired-sample t test or independent t test.Results Finally,46 women took a pelvic MR examination one year after cesarean section,and a subset of 15 completed the same examination again after two years of cesarean section.Both the uterine length and the anterior wall thickness after two years of cesarean section(5.75±0.46 and 1.45±0.35 cm)were significantly greater than those measured at one year(5.33±0.59 and 1.25±0.27 cm)(t=-2.363 and-2.175,P=0.033 and 0.048).No significant difference was shown in myometrial thickness two years after cesarean section(1.45±0.35 cm)with respect to the control group(1.58±0.21 cm,P=0.170).Nine women who underwent MRI twice were considered to have scar diverticula one year after cesarean section,and still had diverticula two years after cesarean section.The thickness,height,and width of the uterine scar showed no significant change from one to two years(all P>0.05).Conclusions 3D T2w SPACE MRI provides overall morphologic details and shows dynamic changes in the scar and the uterus between one and two years after cesarean section.Scar morphology after cesarean section reached relatively stable one year after cesarean section,and uterine morphology was closer to normal two years after cesarean section.

Assessing Liver Function by T1 Maps on Gd-EOB-DTPA- Enhanced MRI for up to 50 Min in Rat Models of Liver Fibrosis: A Longer Hepatobiliary Time Period may Help

Objectives To investigate whether a longer time period of gadolinium ethoxybenzyl diethylenetriaminepen-taacetic add(Gd-EOB-DTPA)-enhanced T1 mapping scanning,as well as dynamic contrast-enhanced(DCE)and multiple hepatobiliary phase magnetic resonance imaging(MRI)have the potential to provide information about liver function in rats with liver fibrosis.Methods Forty rats were divided into the carbon tetrachloride-induced hepatic injury groups[carbon tetrachloride for four(n=14),eight(n=8),or twelve(n=8)weeks]and the control group(n=10).Gd-EOB-DTPA-enhanced MRI was performed including T1-mapping(delayed to 50 min),DCE,and multiple hepatobiliary phases.Indocyanine green retention rate at 15 min(ICG-R15)was determined.Parameters such as T1 reduction rate(△T1),elimination half-life of △T1(T_(△T1 1/2)),relative enhancement(RE),time to maximum RE(T_(max)),and perfusion parameters were calculated.Pearson correlation analysis was used for correlation analysis between ICG-R15 and each MRI indices.Results △T1 at 30,40,and 50 min showed significant positive correlations with ICG-R15(r=0.784,0.653,0.757,P=0.007,0.041,0.030).T_(△T1 1/2) showed a significant positive correlation with ICG-R15(r=0.685,P=0.029).showed a significant positive correlation with ICG-R15(r=0.532,P=0.019).Conclusions △T1 in the late hepatobiliary phase and T_(△T1 1/2) exhibited moderate correlations with liver function.The longer time period of Gd-EOB-DTPA-enhanced Tl mapping scanning,as well as DCE and multiple hepatobiliary phases,may be of some value for estimating liver function in rats with liver fibrosis.

Imaging Diagnosis of TypeⅢCholedochal Cyst:A Case Report

Choledochocele is a congenital abnormality of the biliary system,which characterized by a cystic dilatation of intramural segment of the distal common bile duct.Choledochocele manifests as cystic lesions in the duodenal lumen and resembles duodenal duplication cysts in imaging.We reported a patient with choledochocele.Magnetic resonance cholangiopancreatography showed a thin-walled sac in the duodenal cavity and a fine tubular structure connecting with the end of the common bile duct.Magnetic resonance cholangiopancreatography is a noninvasive and convenient technique in the diagnosis of choledochocele.

医学影像世界的人工智能:挑战与机遇

Medical imaging is involved in all processes of clinical practice.Approximately 70%of diagnostic information originates from radiologic images,which also account for 90%of the digital data volume of a hospital.However,the number of physicians has increased only modestly compared to the rapid growth in the number of medical images.In China,data from medical imaging increases by 30%every year,whereas the number of radiologists increases by only 4%annually.Artificial intelligence(AI),which is representative technology of the fourth industrial revolution,may alleviate the increasing pressure and job burnout,and further improve the diagnostic efficiency of radiology services[1].Despite the urgent and realistic demand for AI technology,many challenges remain in the development and translation of AI products.The rate of the scientific translation of AI research into clinical applications is extremely low.Furthermore,AI models that are applied in clinical settings exhibit unreliable performance and are often impractical[2].Therefore,radiologists may not have access to suitable medical imaging AI models to solve specific clinical problems.This paper analyzes and discusses this problem according to two aspects:the data sources and the AI algorithm(Fig.1).

Chinese expert consensus on multidisciplinary diagnosis and treatment of pancreatic neuroendocrine liver metastases

Many management strategies are available for pancreatic neuroendocrine neoplasms with liver metastases.However,a lack of biological,molecular,and genomic information and an absence of data from rigorous trials limit the validity of these strategies.This review presents the viewpoints from an international conference consisting of several expert working groups.The working groups reviewed a series of questions of particular interest to clinicians taking care of patients with pancreatic neuroendocrine neoplasms with liver metastases by reviewing the existing management strategies and literature,evaluating the evidence on which management decisions were based,developing internationally acceptable recommendations for clinical practice,and making recommendations for clinical and research endeavors.The review for each question will be followed by recommendations from the panel.

Pancreatic cancer with ovarian metastasis: cases report and literature review

Background: Pancreatic cancer with ovarian metastases is rare and easily misdiagnosed. Patients with ovarian metastases are first diagnosed with ovarian cancer and may miss the opportunity to receive surgical operation. We report 7 rare cases of ovarian metastases secondary to pancreatic adenocarcinoma and review the literature to analyze clinical characteristics, diagnostic methods, and potential therapeutic strategies for the rare malignancy.Cases Summary: We retrospectively analyzed the clinical data of 7 female patients with ovarian metastases of primary pancreatic cancer who were admitted to our hospital from January 01, 1985, to April 1, 2020. These 7 patients were diagnosed with ovarian metastasis at an average age of 52.28 (38-69) years. The reason for the patient’s visit was generally a mass in the lower abdomen and/or abdominal pain. Six of them had significantly higher serum Carbohydrate antigen19-9 (CA19-9) levels, 6 patients had pancreatic tumors located in the body or tail, and 1 patient had one in the head of the pancreas. All patients underwent excision of ovarian tumors and resection or biopsy of pancreatic tumors. Five patients had pancreatic ductal adenocarcinoma (PDAC), and 2 had pancreatic cystadenocarcinoma (PCC), all of which were revealed by the pathological results. Ovarian tumors were assessed by pathology and were consistent with pancreatic metastasis. Currently, all 7 patients have died (follow-up to January 2, 2021). The median survival time for all patients was 13.7 months (2.9-27 months).Conclusions: For this rare tumor, elevated serum CA19-9 may indicate that the primary lesion is in the pancreas. Enhanced pancreatic Computed Tomography (CT) can facilitate diagnostic localization. In addition, if the pancreatic tumor cannot be removed, the ovarian tumor should still be resected to reduce the tumor load and improve the quality of life.

新型冠状病毒肺炎疫情对放射科住院医师规范化培训的影响及思考

我国放射科住院医师规范化培训发展迅速,在新型冠状病毒肺炎疫情防控期间,大量教学内容转化为线上教育,面临线上教学条件和资源不足,在线课程互动不足等挑战,为此,我们需要加强线上课程资源建设,增加线上课程的互动交流,优化医学影像学人才的培养体系。

The Chinese guidelines for the diagnosis and treatment of pancreatic neuroendocrine neoplasms(2020)

Pancreatic neuroendocrine neoplasms(pNENs)are highly heterogeneous,and the management of pNENs patients can be intractable.To address this challenge,an expert committee was established on behalf of the Chinese Pancreatic Surgery Association,which consisted of surgical oncologists,gastroenterologists,medical oncologists,endocrinologists,radiologists,pathologists,and nuclear medicine specialists.By reviewing the important issues regarding the diagnosis and treatment of pNENs,the committee concluded evidence-based statements and recommendations in this article,in order to further improve the management of pNENs patients in China.

Radiomics in pancreatic ductal adenocarcinoma:a state of art review

Radiomics analysis extracts a large number of features from conventional radiological cross-sectional images that were traditionally undetectable by the naked human eye.It identifies tumor heterogeneity in a comprehensive and noninvasive way,reflecting the biological behaviour of lesions,and thus assists in clinical diagnosis and treatment evaluation.This review describes the radiomics approach and its uses in the evaluation of pancreatic ductal adenocarcinoma(PDAC).This discipline holds the potential to characterize lesions more accurately,assesses the primary tumour and predicts the response to therapy and prognosis in PDAC.Existing studies have provided significant insights into the application of radiomics in managing the PDAC.However,a variety of challenges,including data quality and quantity,imaging segmentation,and the standardization of the radiomics process need to be solved before its widespread clinical implementation.