Staging liver fibrosis with various diffusion-weighted magnetic resonance imaging models

BACKGROUND Diffusion-weighted imaging(DWI)has been developed to stage liver fibrosis.However,its diagnostic performance is inconsistent among studies.Therefore,it is worth studying the diagnostic value of various diffusion models for liver fibrosis in one cohort.AIM To evaluate the clinical potential of six diffusion-weighted models in liver fibrosis staging and compare their diagnostic performances.METHODS This prospective study enrolled 59 patients suspected of liver disease and scheduled for liver biopsy and 17 healthy participants.All participants underwent multi-b value DWI.The main DWI-derived parameters included Mono-apparent diffusion coefficient(ADC)from mono-exponential DWI,intravoxel incoherent motion model-derived true diffusion coefficient(IVIM-D),diffusion kurtosis imaging-derived apparent diffusivity(DKI-MD),stretched exponential model-derived distributed diffusion coefficient(SEM-DDC),fractional order calculus(FROC)model-derived diffusion coefficient(FROC-D)and FROC model-derived microstructural quantity(FROC-μ),and continuous-time random-walk(CTRW)model-derived anomalous diffusion coefficient(CTRW-D)and CTRW model-derived temporal diffusion heterogeneity index(CTRW-α).The correlations between DWI-derived parameters and fibrosis stages and the parameters’diagnostic efficacy in detecting significant fibrosis(SF)were assessed and compared.RESULTS CTRW-D(r=-0.356),CTRW-α(r=-0.297),DKI-MD(r=-0.297),FROC-D(r=-0.350),FROC-μ(r=-0.321),IVIM-D(r=-0.251),Mono-ADC(r=-0.362),and SEM-DDC(r=-0.263)were significantly correlated with fibrosis stages.The areas under the ROC curves(AUCs)of the combined index of the six models for distinguishing SF(0.697-0.747)were higher than each of the parameters alone(0.524-0.719).The DWI models’ability to detect SF was similar.The combined index of CTRW model parameters had the highest AUC(0.747).CONCLUSION The DWI models were similarly valuable in distinguishing SF in patients with liver disease.The combined index of CTRW parameters had the highest AUC.

Potential applications of 7 Tesla magnetic resonance imaging in paediatric neuroimaging:Feasibility and challenges

The integration of 7 Tesla magnetic resonance imaging(7 T MRI)in adult patients has marked a revolutionary stride in radiology.In this article we explore the feasibility of 7 T MRI in paediatric practice,emphasizing its feasibility,applications,challenges,and safety considerations.The heightened resolution and tissue contrast of 7 T MRI offer unprecedented diagnostic accuracy,particularly in neuroimaging.Applications range from neuro-oncology to neonatal brain imaging,showcasing its efficacy in detecting subtle structural abnormalities and providing enhanced insights into neurological conditions.Despite the promise,challenges such as high cost,discomfort,and safety concerns necessitate careful consideration.Research suggests that,with precautions,7 T MRI is feasible in paediatrics,yet ongoing studies and safety assessments are imperative.

Low-energy spin dynamics in a Kitaev material Na_(3)Ni_(2)BiO_(6) investigated by nuclear magnetic resonance

We perform ^(23)Na nuclear magnetic resonance(NMR) and magnetization measurements on an S=1,quasi-2D honeycomb lattice antiferromagnet Na_(3)Ni_(2)BiO_(6).A large positive Curie-Weiss constant of 22.9 K is observed.The NMR spectra at low fields are consistent with a zigzag magnetic order,indicating a large easy-axis anisotropy.With the field applied along the c*axis,the NMR spectra confirm the existence of a 1/3-magnetization plateau phase between 5.1 T and 7.1 T.The transition from the zigzag order to the 1/3-magnetization plateau phase is also found to be a first-order type.A monotonic decrease of the spin gap is revealed in the 1/3-magnetization plateau phase,which reaches zero at a quantum critical field H_(C)≈8.35 T before entering the fully polarized phase.These data suggest the existence of exchange frustration in the system along with strong ferromagnetic interactions,hosting the possibility for Kitaev physics.Besides,well below the ordered phase,the 1/T_(1) at high fields shows either a level off or an enhancement upon cooling below 3 K,which suggests the existence of low-energy fluctuations.

Nuclear magnetic resonance experiments on the time-varying law of oil viscosity and wettability in high-multiple waterflooding sandstone cores

A simulated oil viscosity prediction model is established according to the relationship between simulated oil viscosity and geometric mean value of T2spectrum,and the time-varying law of simulated oil viscosity in porous media is quantitatively characterized by nuclear magnetic resonance(NMR)experiments of high multiple waterflooding.A new NMR wettability index formula is derived based on NMR relaxation theory to quantitatively characterize the time-varying law of rock wettability during waterflooding combined with high-multiple waterflooding experiment in sandstone cores.The remaining oil viscosity in the core is positively correlated with the displacing water multiple.The remaining oil viscosity increases rapidly when the displacing water multiple is low,and increases slowly when the displacing water multiple is high.The variation of remaining oil viscosity is related to the reservoir heterogeneity.The stronger the reservoir homogeneity,the higher the content of heavy components in the remaining oil and the higher the viscosity.The reservoir wettability changes after water injection:the oil-wet reservoir changes into water-wet reservoir,while the water-wet reservoir becomes more hydrophilic;the degree of change enhances with the increase of displacing water multiple.There is a high correlation between the time-varying oil viscosity and the time-varying wettability,and the change of oil viscosity cannot be ignored.The NMR wettability index calculated by considering the change of oil viscosity is more consistent with the tested Amott(spontaneous imbibition)wettability index,which agrees more with the time-varying law of reservoir wettability.

Brain mechanism of acupuncture for children with anisometropic amblyopia: a resting functional magnetic resonance imaging study based on voxel-mirrored homotopic connectivity

AIM:To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxelmirror homotopic connectivity(VMHC)analysis method of resting functional magnetic resonance imaging(rs-fMRI)technology based on clinical effectiveness.METHODS:Eighty children with anisometropic monocular amblyopia were randomly divided into two groups:control(40 cases,1 case of shedding)and acupuncture(40 cases,1 case of shedding)groups.The control group was treated with glasses,red flash,grating,and visual stimulations,with each procedure conducted for 5min per time.Based on routine treatment,the acupuncture group underwent acupuncture of“regulating qi and unblocking meridians to bright eyes”,Jingming(BL1),Cuanzhu(BL2),Guangming(GB37),Fengchi(GB20)acupoints were taken on both sides,with the needle kept for 30min each time.Both groups were treated once every other day,three times per week,for a total of 4wk.After the treatment,the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted.At the same time,nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rsfMRI before and after treatment.The differences in the brain regions between the two groups were compared and analyzed with VMHC.RESULTS:Chi-square test showed a notable difference in the total efficiency rate between the acupuncture(94.87%)and control groups(79.49%).Regarding the P100 wave latency and amplitude,the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group.Moreover,the VMHC values of the bilateral temporal lobe,superior temporal gyrus,and middle temporal gyrus were notably increased in the acupuncture group after treatment.CONCLUSION:Acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia.Compared with the conventional treatment,the regulation of acupuncture on the functional activities of the relevant brain areas in the anterior cerebellum may be an effective acupuncture mechanism for anisometropic amblyopia.

Shale primary porosimetry based on 2D nuclear magnetic resonance of T_(1)-T_(2)

Porosity,a key parameter in assessing the physical properties of shale reservoirs and the reserves,is of great significance to the selection and evaluation of shale sweet spots.There are many methods at present to characterize shale porosity,most of which are aimed at post-core cleaning shale,such as those involving helium and saturated fluid(namely liquid-involved porosimetry).However,due to the low efficiency of shale core cleaning and the possible damage to pore structure during the core cleaning process,it's hard to guarantee the accuracy of porosity measurement.In this regard,we resort to the two-dimensional(2D)nuclear magnetic resonance(NMR)technology of T1-T2 in characterizing the primary shale porosity with samples taken from pressure coring in the 4th member of Shahejie Formation(Sha 4 Member)in well Fanxie 184 in the Jiyang Depression.Moreover,comparative experiments of shale porosity measurement by three methods,namely the simultaneous distillation extraction(SDE),helium and fluid measurement,are carried out simultaneously.The results show that the values obtained by SDE,gas and liquid measurement are similar,which are about 0.6 times of 2D NMR porosimetry.Core cleaning efficiency tends to seriously affect the results involving gas and liquid.In addition,the core cleaning treatment is bound to change the shale pore structure,and this is especially true in clay which tends to swell;consequently,porosity results are to be distorted by gas and liquid methods.It is thereby recommended to utilize the 2D NMR technology to characterize the primary total porosity of shale samples without core cleaning.The effective porosity of samples from pressure coring is determined by T2 cutoff value of around 0.3 ms.

Pre-operative enhanced magnetic resonance imaging combined with clinical features predict early recurrence of hepatocellular carcinoma after radical resection

BACKGROUND Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma(HCC)has great significance for patient prognosis.AIM To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)combined with clinical features in predicting early recurrence of HCC after resection.METHODS A total of 161 patients with pathologically confirmed HCC were enrolled.The patients were divided into early recurrence and non-early recurrence group based on the follow-up results.The clinical,laboratory,pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed.RESULTS Of 161 patients,73 had early recurrence and 88 were had non-early recurrence.Univariate analysis showed that patient age,gender,serum alpha-fetoprotein level,the Barcelona Clinic Liver Cancer stage,China liver cancer(CNLC)stage,microvascular invasion(MVI),pathological satellite focus,tumor size,tumor number,tumor boundary,tumor capsule,intratumoral necrosis,portal vein tumor thrombus,large vessel invasion,nonperipheral washout,peritumoral enhancement,hepatobiliary phase(HBP)/tumor signal intensity(SI)/peritumoral SI,HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation.Multivariate logistic regression analysis showed that patient age,MVI,CNLC stage,tumor boundary and large vessel invasion were independent predictive factors.External data validation indicated that the area under the curve of the combined predictors was 0.861,suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC.CONCLUSION Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation.

Evaluating pediatric ureteropelvic junction obstruction:Dynamic magnetic resonance urography vs renal scintigraphy 99mtechnetium mercaptoacetyltriglycine

BACKGROUND Ureteropelvic junction obstruction(UPJO)is a common congenital urinary tract disorder in children.It can be diagnosed as early as in utero due to the presence of hydronephrosis or later in life due to symptomatic occurrence.AIM To evaluate the discrepancy between dynamic contrast-enhanced magnetic resonance urography(dMRU)and scintigraphy 99m-technetium mercaptoacetyltriglycine(MAG-3)for the functional evaluation of UPJO.METHODS Between 2016 and 2020,126 patients with UPJO underwent surgery at Robert DebréHospital.Of these,83 received a prenatal diagnosis,and 43 were diagnosed during childhood.Four of the 126 patients underwent surgery based on the clinical situation and postnatal ultrasound findings without undergoing functional imaging evaluation.Split renal function was evaluated preoperatively using scintigraphy MAG-3(n=28),dMRU(n=53),or both(n=40).In this study,we included patients who underwent surgery for UPJO and scintigraphy MAG-3+dMRU but excluded those who underwent only scintigraphy MAG-3 or dMRU.The patients were divided into groups A(<10%discrepancy)and B(>10%discrepancy).We examined the discrepancy in split renal function between the two modalities and investigated the possible risk factors.RESULTS The split renal function between the two kidneys was compared in 40 patients(28 boys and 12 girls)using scintigraphy MAG-3 and dMRU.Differential renal function,as determined using both modalities,showed a difference of<10%in 31 children and>10%in 9 children.Calculation of the relative renal function using dMRU revealed an excellent correlation coefficient with renal scintigraphy MAG-3 for both kidneys.CONCLUSION Our findings demonstrated that dMRU is equivalent to scintigraphy MAG-3 for evaluating split renal function in patients with UPJO.

Estimation of unfrozen water content of saturated sandstones using nuclear magnetic resonance, mercury intrusion porosimetry, and ultrasonic tests

The unfrozenwater content(UWC)is a crucial parameter that affects the strength and thermal properties of rocks in relation to engineering construction and geological disasters in cold regions.In this study,three different methods were employed to test and estimate the UWC of saturated sandstones,including nuclear magnetic resonance(NMR),mercury intrusion porosimetry(MIP),and ultrasonic methods.The NMR method enabled the direct measurement of the UWC of sandstones using the free induction decay(FID).The MIP method was used to analyze the pore structures of sandstones,with the UWC subsequently calculated based on pore ice crystallization.Therefore,the MIP test constituted an indirect measurement method.Furthermore,a correlation was established between the P-wave velocity and the UWC of these sandstones based on the mixture theory,which could be employed to estimate the UWC as an empirical method.All methods demonstrated that the UWC initially exhibited a rapid decrease from 0C to5C and then generally became constant beyond20C.However,these test methods had different characteristics.The NMR method was used to directly and accurately calculate the UWC in the laboratory.However,the cost and complexity of NMR equipment have precluded its use in the field.The UWC can be effectively estimated by the MIP test,but the estimation accuracy is influenced by the ice crystallization process and the pore size distribution.The P-wave velocity has been demonstrated to be a straightforward and practical empirical parameter and was utilized to estimate the UWC based on the mixture theory.This method may be more suitable in the field.All methods confirmed the existence of a hysteresis phenomenon in the freezing-thawing process.The average hysteresis coefficient was approximately 0.538,thus validating the GibbseThomson equation.This study not only presents alternative methodologies for estimating the UWC of saturated sandstones but also contribute to our understanding of the freezing-thawing process of pore water.

Epicardial adipose tissue in obesity with heart failure with preserved ejection fraction: Cardiovascular magnetic resonance biomarker study

BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various complications.It is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evaluating HFpEF in obesity is crucial.Epicardial adipose tissue(EAT)has emerged as a valuable tool for validating prognostic biomarkers and guiding treatment targets.Hence,assessing EAT is of paramount importance.Cardiovascular magnetic resonance(CMR)imaging is acknowledged as the gold standard for analyzing cardiac function and mor-phology.We hope to use CMR to assess EAT as a bioimaging marker to evaluate HFpEF in obese patients.AIM To assess the diagnostic utility of CMR for evaluating heart failure with preserved ejection fraction[HFpEF;left ventricular(LV)ejection fraction≥50%]by measuring the epicardial adipose tissue(EAT)volumes and EAT mass in obese patients.METHODS Sixty-two obese patients were divided into two groups for a case-control study based on whether or not they had heart failure with HFpEF.The two groups were defined as HFpEF+and HFpEF-.LV geometry,global systolic function,EAT volumes and EAT mass of all subjects were obtained using cine magnetic resonance sequences.RESULTS Forty-five patients of HFpEF-group and seventeen patients of HFpEF+group were included.LV mass index(g/m2)of HFpEF+group was higher than HFpEF-group(P<0.05).In HFpEF+group,EAT volumes,EAT volume index,EAT mass,EAT mass index and the ratio of EAT/[left atrial(LA)left-right(LR)diameter]were higher compared to HFpEF-group(P<0.05).In multivariate analysis,Higher EAT/LA LR diameter ratio was associated with higher odds ratio of HFpEF.CONCLUSION EAT/LA LR diameter ratio is highly associated with HFpEF in obese patients.It is plausible that there may be utility in CMR for assessing obese patients for HFpEF using EAT/LA LR diameter ratio as a diagnostic biomarker.Further prospective studies,are needed to validate these proof-of-concept findings.

Correlation between cerebral neurotransmitters levels by proton magnetic resonance spectroscopy and HbA1c in patients with type 2 diabetes

BACKGROUND Cognitive dysfunction is the main manifestation of central neuropathy.Although cognitive impairments tend to be overlooked in patients with diabetes mellitus(DM),there is a growing body of evidence linking DM to cognitive dysfunction.Hyperglycemia is closely related to neurological abnormalities,while often disregarded in clinical practice.Changes in cerebral neurotransmitter levels are associated with a variety of neurological abnormalities and may be closely related to blood glucose control in patients with type 2 DM(T2DM).AIM To evaluate the concentrations of cerebral neurotransmitters in T2DM patients exhibiting different hemoglobin A1c(HbA1c)levels.METHODS A total of 130 T2DM patients were enrolled at the Department of Endocrinology of Shanghai East Hospital.The participants were divided into four groups according to their HbA1c levels using the interquartile method,namely Q1(<7.875%),Q2(7.875%-9.050%),Q3(9.050%-11.200%)and Q4(≥11.200%).Clinical data were collected and measured,including age,height,weight,neck/waist/hip circumferences,blood pressure,comorbidities,duration of DM,and biochemical indicators.Meanwhile,neurotransmitters in the left hippocampus and left brainstem area were detected by proton magnetic resonance spectroscopy.RESULTS The HbA1c level was significantly associated with urinary microalbumin(mALB),triglyceride,low-density lipoprotein cholesterol(LDL-C),homeostasis model assessment of insulin resistance(HOMA-IR),and beta cell function(HOMA-β),N-acetylaspartate/creatine(NAA/Cr),and NAA/choline(NAA/Cho).Spearman correlation analysis showed that mALB,LDL-C,HOMA-IR and NAA/Cr in the left brainstem area were positively correlated with the level of HbA1c(P<0.05),whereas HOMA-βwas negatively correlated with the HbA1c level(P<0.05).Ordered multiple logistic regression analysis showed that NAA/Cho[Odds ratio(OR):1.608,95%confidence interval(95%CI):1.004-2.578,P<0.05],LDL-C(OR:1.627,95%CI:1.119-2.370,P<0.05),and HOMA-IR(OR:1.107,95%CI:1.031-1.188,P<0.01)were independent predictors of poor glycemic control.CONCLUSION The cerebral neurotransmitter concentrations in the left brainstem area in patients with T2DM are closely related to glycemic control,which may be the basis for the changes in cognitive function in diabetic patients.

Vulnerable brain regions in adolescent major depressive disorder:A resting-state functional magnetic resonance imaging activation likelihood estimation meta-analysis

BACKGROUND Adolescent major depressive disorder(MDD)is a significant mental health concern that often leads to recurrent depression in adulthood.Resting-state functional magnetic resonance imaging(rs-fMRI)offers unique insights into the neural mechanisms underlying this condition.However,despite previous research,the specific vulnerable brain regions affected in adolescent MDD patients have not been fully elucidated.AIM To identify consistent vulnerable brain regions in adolescent MDD patients using rs-fMRI and activation likelihood estimation(ALE)meta-analysis.METHODS We performed a comprehensive literature search through July 12,2023,for studies investigating brain functional changes in adolescent MDD patients.We utilized regional homogeneity(ReHo),amplitude of low-frequency fluctuations(ALFF)and fractional ALFF(fALFF)analyses.We compared the regions of aberrant spontaneous neural activity in adolescents with MDD vs healthy controls(HCs)using ALE.RESULTS Ten studies(369 adolescent MDD patients and 313 HCs)were included.Combining the ReHo and ALFF/fALFF data,the results revealed that the activity in the right cuneus and left precuneus was lower in the adolescent MDD patients than in the HCs(voxel size:648 mm3,P<0.05),and no brain region exhibited increased activity.Based on the ALFF data,we found decreased activity in the right cuneus and left precuneus in adolescent MDD patients(voxel size:736 mm3,P<0.05),with no regions exhibiting increased activity.CONCLUSION Through ALE meta-analysis,we consistently identified the right cuneus and left precuneus as vulnerable brain regions in adolescent MDD patients,increasing our understanding of the neuropathology of affected adolescents.

Alterations of sleep deprivation on brain function:A coordinatebased resting-state functional magnetic resonance imaging metaanalysis

BACKGROUND Sleep deprivation is a prevalent issue that impacts cognitive function.Although numerous neuroimaging studies have explored the neural correlates of sleep loss,inconsistencies persist in the reported results,necessitating an investigation into the consistent brain functional changes resulting from sleep loss.AIM To establish the consistency of brain functional alterations associated with sleep deprivation through systematic searches of neuroimaging databases.Two metaanalytic methods,signed differential mapping(SDM)and activation likelihood estimation(ALE),were employed to analyze functional magnetic resonance imaging(fMRI)data.METHODS A systematic search performed according to PRISMA guidelines was conducted across multiple databases through July 29,2023.Studies that met specific inclusion criteria,focused on healthy subjects with acute sleep deprivation and reported whole-brain functional data in English were considered.A total of 21 studies were selected for SDM and ALE meta-analyses.RESULTS Twenty-one studies,including 23 experiments and 498 subjects,were included.Compared to pre-sleep deprivation,post-sleep deprivation brain function was associated with increased gray matter in the right corpus callosum and decreased activity in the left medial frontal gyrus and left inferior parietal lobule.SDM revealed increased brain functional activity in the left striatum and right central posterior gyrus and decreased activity in the right cerebellar gyrus,left middle frontal gyrus,corpus callosum,and right cuneus.CONCLUSION This meta-analysis consistently identified brain regions affected by sleep deprivation,notably the left medial frontal gyrus and corpus callosum,shedding light on the neuropathology of sleep deprivation and offering insights into its neurological impact.

Application of proton magnetic resonance spectroscopy in metabolic alterations of prefrontal white and gray matter in depression adolescents

BACKGROUND Cases of depression among adolescents are gradually increasing.The study of the physiological basis of cognitive function from a biochemical perspective has therefore been garnering increasing attention.Depression has been hypothesized to be associated with the brain biochemical metabolism of the anterior cingulate gyrus,frontal lobe white matter,and the thalamus.AIM To explore the application of proton magnetic resonance spectroscopy(1H-MRS)in the metabolic alterations in the prefrontal white matter(PWM)and gray matter(GM)in adolescents with depression.METHODS 1H-MRS was performed for semi-quantitative analysis of the biochemical metabolites N-acetylaspartate(NAA),choline(Cho)complexes,creatine(Cr),and myoinositol(mI)in bilateral PWM,anterior cingulate GM,and thalami of 31 adolescent patients with depression(research group)and 35 healthy adolescents(control group),and the NAA/Cr,Cho/Cr,and mI/Cr ratios were calculated.Meanwhile,Hamilton Depression Scale(HAMD)and Wechsler Memory Scale were used to assess the degree of depression and memory function in all adolescents.The correlation of brain metabolite levels with scale scores was also analyzed.RESULTS The research group had markedly higher HAMD-24 scores and lower memory quotient(MQ)compared with the control group(P<0.05).Adolescents with depression were found to have lower bilateral PWM NAA/Cr and Cho/Cr ratios compared with healthy adolescents(P<0.05).The mI/Cr ratios were found to be similar in both groups(P>0.05).The bilateral anterior cingulate GM NAA/Cr,Cho/Cr,and mI/Cr also did not demonstrate marked differences(P>0.05).No statistical inter-group difference was determined in NAA/Cr of the bilateral thalami(P>0.05),while bilateral thalamic Cho/Cr and mI/Cr were reduced in teenagers with depression compared with healthy adolescents(P<0.05).A significant negative correlation was observed between the HAMD-24 scores in adolescents with depression with bilateral PWM NAA/Cr and Cho/Cr and were inversely linked to bilateral thalamic Cho/Cr and mI/Cr(P<0.05).In adolescents with depressions,MQ positively correlated with right PWH NAA/Cr,left PWH Cho/Cr,and bilateral thalamic Cho/Cr and mI/Cr.CONCLUSION PWM and thalamic metabolic abnormalities might influence teen depression,and the reduction in bilateral PWM NAA/Cr and Cho/Cr could be related to the neuropathology of adolescents with depression suffering from memory impairment.There exists a possibility of dysfunction of nerve cell membrane phospholipids in the thalami of adolescent patients with depression.

Resting-state functional magnetic resonance imaging and support vector machines for the diagnosis of major depressive disorder in adolescents

BACKGROUND Research has found that the amygdala plays a significant role in underlying pathology of major depressive disorder(MDD).However,few studies have explored machine learning-assisted diagnostic biomarkers based on amygdala functional connectivity(FC).AIM To investigate the analysis of neuroimaging biomarkers as a streamlined approach for the diagnosis of MDD in adolescents.METHODS Forty-four adolescents diagnosed with MDD and 43 healthy controls were enrolled in the study.Using resting-state functional magnetic resonance imaging,the FC was compared between the adolescents with MDD and the healthy controls,with the bilateral amygdala serving as the seed point,followed by statistical analysis of the results.The support vector machine(SVM)method was then applied to classify functional connections in various brain regions and to evaluate the neurophysiological characteristics associated with MDD.RESULTS Compared to the controls and using the bilateral amygdala as the region of interest,patients with MDD showed significantly lower FC values in the left inferior temporal gyrus,bilateral calcarine,right lingual gyrus,and left superior occipital gyrus.However,there was an increase in the FC value in Vermis-10.The SVM analysis revealed that the reduction in the FC value in the right lingual gyrus could effectively differentiate patients with MDD from healthy controls,achieving a diagnostic accuracy of 83.91%,sensitivity of 79.55%,specificity of 88.37%,and an area under the curve of 67.65%.CONCLUSION The results showed that an abnormal FC value in the right lingual gyrus was effective as a neuroimaging biomarker to distinguish patients with MDD from healthy controls.

From strength to precision: A systematic review exploring the clinical utility of 7-Tesla magnetic resonance imaging in abdominal imaging

BACKGROUND After approval for clinical use in 2017 early investigations of ultra-high-field abdominal magnetic resonance imaging(MRI)have demonstrated the feasibility as well as diagnostic capabilities of liver,kidney,and prostate MRI at 7-Tesla.However,the elevation of the field strength to 7-Tesla not only brought advantages to abdominal MRI but also presented considerable challenges and drawbacks,primarily stemming from heightened artifacts and limitations in Specific Absorption Rate,etc.Furthermore,evidence in the literature is relatively scarce concerning human studies in comparison to phantom/animal studies which necessitates an investigation into the evidence so far in humans and summarizing all relevant evidence.AIM To offer a comprehensive overview of current literature on clinical abdominal 7T MRI that emphasizes current trends,details relevant challenges,and provides a concise set of potential solutions.METHODS This systematic review adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A PubMed search,utilizing Medical Subject Headings terms such as"7-Tesla"and organ-specific terms,was conducted for articles published between January 1,1985,and July 25,2023.Eligibility criteria included studies exploring 7T MRI for imaging human abdominal organs,encompassing various study types(in-vivo/ex-vivo,method development,reviews/meta-analyses).Exclusion criteria involved animal studies and those lacking extractable data.Study selection involved initial identification via title/abstract,followed by a full-text review by two researchers,with discrepancies resolved through discussion.Data extraction covered publication details,study design,population,sample size,7T MRI protocol,image characteristics,endpoints,and conclusions.RESULTS The systematic review included a total of 21 studies.The distribution of clinical 7T abdominal imaging studies revealed a predominant focus on the prostate(n=8),followed by the kidney(n=6)and the hepatobiliary system(n=5).Studies on these organs,and in the pancreas,demonstrated clear advantages at 7T.However,small bowel studies showed no significant improvements compared to traditional MRI at 1.5T.The majority of studies evaluated originated from Germany(n=10),followed by the Netherlands(n=5),the United States(n=5),Austria(n=2),the United Kingdom(n=1),and Italy(n=1).CONCLUSION Further increase of abdominal clinical MRI field strength to 7T demonstrated high imaging potential,yet also limitations mainly due to the inhomogeneous radiofrequency(RF)excitation field relative to lower field strengths.Hence,further optimization of dedicated RF coil elements and pulse sequences are expected to better optimize clinical imaging at high magnetic field strength.

High-resolution magnetic resonance imaging in the diagnosis and management of vertebral artery dissection:A case report

BACKGROUND Vertebral artery dissection(VAD)is a rare but life-threatening condition characterized by tearing of the intimal layer of the vertebral artery,leading to stenosis,occlusion or rupture.The clinical presentation of VAD can be heterogeneous,with common symptoms including headache,dizziness and balance problems.Timely diagnosis and treatment are crucial for favorable outcomes;however,VAD is often missed due to its variable clinical presentation and lack of robust diagnostic guidelines.High-resolution magnetic resonance imaging(HRMRI)has emerged as a reliable diagnostic tool for VAD,providing detailed visualization of vessel wall abnormalities.CASE SUMMARY A young male patient presented with an acute onset of severe headache,vomiting,and seizures,followed by altered consciousness.Imaging studies revealed bilateral VAD,basilar artery thrombosis,multiple brainstem and cerebellar infarcts,and subarachnoid hemorrhage.Digital subtraction angiography(DSA)revealed vertebral artery stenosis but failed to detect the dissection,potentially because intramural thrombosis obscured the VAD.In contrast,HRMRI confirmed the diagnosis by revealing specific signs of dissection.The patient was managed conservatively with antiplatelet therapy and other supportive measures,such as blood pressure control and pain management.After 5 mo of rehabilitation,the patient showed significant improvement in swallowing and limb strength.CONCLUSION HR-MRI can provide precise evidence for the identification of VAD.

Nomogram based on multimodal magnetic resonance combined with B7-H3mRNA for preoperative lymph node prediction in esophagus cancer

Accurate preoperative prediction of lymph node metastasis(LNM)in esophageal cancer(EC)patients is of crucial clinical significance for treatment planning and prognosis.AIM To develop a clinical radiomics nomogram that can predict the preoperative lymph node(LN)status in EC patients.METHODS A total of 32 EC patients confirmed by clinical pathology(who underwent surgical treatment)were included.Real-time fluorescent quantitative reverse transcription-polymerase chain reaction was used to detect the expression of B7-H3 mRNA in EC tissue obtained during preoperative gastroscopy,and its correlation with LNM was analyzed.Radiomics features were extracted from multi-modal magnetic resonance imaging of EC using Pyradiomics in Python.Feature extraction,data dimensionality reduction,and feature selection were performed using XGBoost model and leave-one-out cross-validation.Multivariable logistic regression analysis was used to establish the prediction model,which included radiomics features,LN status from computed tomography(CT)reports,and B7-H3 mRNA expression,represented by a radiomics nomogram.Receiver operating characteristic area under the curve(AUC)and decision curve analysis(DCA)were used to evaluate the predictive performance and clinical application value of the model.RESULTS The relative expression of B7-H3 mRNA in EC patients with LNM was higher than in those without metastasis,and the difference was statistically significant(P<0.05).The AUC value in the receiver operating characteristic(ROC)curve was 0.718(95%CI:0.528-0.907),with a sensitivity of 0.733 and specificity of 0.706,indicating good diagnostic performance.The individualized clinical prediction nomogram included radiomics features,LN status from CT reports,and B7-H3 mRNA expression.The ROC curve demonstrated good diagnostic value,with an AUC value of 0.765(95%CI:0.598-0.931),sensitivity of 0.800,and specificity of 0.706.DCA indicated the practical value of the radiomics nomogram in clinical practice.CONCLUSION This study developed a radiomics nomogram that includes radiomics features,LN status from CT reports,and B7-H3 mRNA expression,enabling convenient preoperative individualized prediction of LNM in EC patients.

Predicting distant metastasis in nasopharyngeal carcinoma using gradient boosting tree model based on detailed magnetic resonance imaging reports

BACKGROUND Development of distant metastasis(DM)is a major concern during treatment of nasopharyngeal carcinoma(NPC).However,studies have demonstrated im-proved distant control and survival in patients with advanced NPC with the addition of chemotherapy to concomitant chemoradiotherapy.Therefore,precise prediction of metastasis in patients with NPC is crucial.AIM To develop a predictive model for metastasis in NPC using detailed magnetic resonance imaging(MRI)reports.METHODS This retrospective study included 792 patients with non-distant metastatic NPC.A total of 469 imaging variables were obtained from detailed MRI reports.Data were stratified and randomly split into training(50%)and testing sets.Gradient boosting tree(GBT)models were built and used to select variables for predicting DM.A full model comprising all variables and a reduced model with the top-five variables were built.Model performance was assessed by area under the curve(AUC).RESULTS Among the 792 patients,94 developed DM during follow-up.The number of metastatic cervical nodes(30.9%),tumor invasion in the posterior half of the nasal cavity(9.7%),two sides of the pharyngeal recess(6.2%),tubal torus(3.3%),and single side of the parapharyngeal space(2.7%)were the top-five contributors for predicting DM,based on their relative importance in GBT models.The testing AUC of the full model was 0.75(95%confidence interval[CI]:0.69-0.82).The testing AUC of the reduced model was 0.75(95%CI:0.68-0.82).For the whole dataset,the full(AUC=0.76,95%CI:0.72-0.82)and reduced models(AUC=0.76,95%CI:0.71-0.81)outperformed the tumor node-staging system(AUC=0.67,95%CI:0.61-0.73).CONCLUSION The GBT model outperformed the tumor node-staging system in predicting metastasis in NPC.The number of metastatic cervical nodes was identified as the principal contributing variable.

Transient elastography and diffusion-weighted magnetic resonance imaging for assessment of liver fibrosis in children with chronic hepatitis C

BACKGROUND Chronic hepatitis C(CHC)is a health burden with consequent morbidity and mortality.Liver biopsy is the gold standard for evaluating fibrosis and assessing disease severity and prognostic purposes post-treatment.Noninvasive altern-atives for liver biopsy such as transient elastography(TE)and diffusion-weighted magnetic resonance imaging(DW-MRI)are critical needs.AIM To evaluate TE and DW-MRI as noninvasive tools for predicting liver fibrosis in children with CHC.METHODS This prospective cross-sectional study initially recruited 100 children with CHC virus infection.Sixty-four children completed the full set of investigations including liver stiffness measurement(LSM)using TE and measurement of apparent diffusion coefficient(ADC)of the liver and spleen using DW-MRI.Liver biopsies were evaluated for fibrosis using Ishak scoring system.LSM and liver and spleen ADC were compared in different fibrosis stages and correlation analysis was performed with histopathological findings and other laboratory parameters.RESULTS Most patients had moderate fibrosis(73.5%)while 26.5%had mild fibrosis.None had severe fibrosis or cirrhosis.The majority(68.8%)had mild activity,while only 7.8%had moderate activity.Ishak scores had a significant direct correlation with LSM(P=0.008)and were negatively correlated with both liver and spleen ADC but with no statistical significance(P=0.086 and P=0.145,respectively).Similarly,histopatho-logical activity correlated significantly with LSM(P=0.002)but not with liver or spleen ADC(P=0.84 and 0.98 respectively).LSM and liver ADC were able to significantly discriminate F3 from lower fibrosis stages(area under the curve=0.700 and 0.747,respectively)with a better performance of liver ADC.CONCLUSION TE and liver ADC were helpful in predicting significant fibrosis in children with chronic hepatitis C virus infection with a better performance of liver ADC.