Application of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with magnetic resonance spectroscopy(MRS)in prostate cancer diagnosis

Objective The aim of the study was to investigate the application of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)combined with magnetic resonance spectroscopy(MRS)in prostate cancer diagnosis.Methods In the outpatient department of our hospital(Sichuan Cancer Hospital,Chengdu,China),60 patients diagnosed with prostate disease were selected randomly and included in a prostate cancer group,60 patients with benign prostatic hyperplasia were included in a proliferation group,and 60 healthy subjects were included in a control group,from January 2013 to January 2017.Using Siemens Avanto 1.5 T high-field superconducting MRI for DCE-MRI and MRS scans,after the MRS scan was completed,we used the workstation spectroscopy tab spectral analysis,and eventually obtained the crest lines of the prostate metabolites choline(Cho),creatine(Cr),citrate(Cit),and the values of Cho/Cit,and(Cho+Cr)/Cit.Results Participants who had undergone 21-s,1-min,and 2-min dynamic contrast-enhanced MR revealed significant variations among the three groups.The spectral analysis of the three groups revealed a significant variation as well.DCE-MRI and MRS combined had a sensitivity of 89.67%,specificity of 95.78%,and accuracy of 94.34%.Conclusion DCE-MRI combined with MRS is of great value in the diagnosis of prostate cancer.

Dynamic contrast-enhanced MRI versus ^(18)F-FDG PET/CT: Which is better in differentiation between malignant and benign solitary pulmonary nodules?

Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.

Evaluation of dynamic contrast-enhanced MRI in monitoring early response of locally advanced breast cancer to neoadjuvant chemotherapy

Objective： The aim of our study was to assess the value of dynamic contrast-enhanced magnetic resonance imaging （DMRI） in predicting early response to neoadjuvant chemotherapy （NAC） in patients with locally advanced breast cancer （LABC） and to assess the accuracy of DMRI in evaluating residual disease after NAC. Methods： DMRI were per- formed in 43 women with LABC （44 lesions, all were invasive ductal carcinoma） before, after the first and final cycle of NAC. Tumour volume, early enhanced ratio （El）, maximum enhanced ratio （Emax）, and maximum enhanced time （Tmax）, dynamic signal intensity-time curve were obtained during treatment. Residual tumour volumes obtained using DMRI were compared with pathological findings to assess the accuracy of DMRI. Results： After 1st cycle of NAC, the mean volume of responders decreased insignificantly, P 〉 0.05, but after NAC, mean volume of residual tumor decreased significantly （P 〈 0.01）. Morphol- ogy change： 29 cases showed a concentric shrinkage pattern while 7 cases showed a dendritic shrinkage pattern. Significant differences were found in El, Emax and Tmax between responders and non-responders （P 〈 0.05）. After 1st cycle of NAC, El, Emax and Tmax of responders changed significantly （P 〈 0.001）; while there is no significant change in non-responders （P 〉 0.05）. After NAC, dynamic signal intensity-time types were changed in responders, and tended to be significantly flat- tening, while no significant change was found in non-responders. The residual tumour volume correlation coefficient between DMRI and pathology measurements was very high （r = 0.866, P = 0.000）. Conclusion： DMRI is useful to evaluate the early response to NAC in LABC. The presence and volume of residual disease in LABC patients treated with NAC could be ac- curately evaluated by DMRI.

Correlation of dynamic contrast-enhanced MRI parameters of uterine sarcoma with sarcoma cell proliferation and invasion in lesions

Objective:To investigate the correlation of dynamic contrast-enhanced MRI parameters of uterine sarcoma with sarcoma cell proliferation and invasion in lesions.Methods: A total of 38 patients with uterine sarcoma undergoing surgical treatment in this hospital between August 2015 and June 2017 were selected as uterine sarcoma group, and 50 patients with uterine fibroids undergoing surgical treatment in this hospital during the same period were selected as uterine fibroids group. The differences in dynamic contrast-enhanced MRI parameter levels as well as the expression of proliferation and invasion-related genes in lesion tissue were compared between the two groups of patients. Pearson test was used to assess the internal relationship between dynamic contrast-enhanced MRI parameters of uterine sarcoma and sarcoma cell malignancy.Results: The ADC and TTP levels in uterine sarcoma group were lower than those in uterine fibroids group;AgNOR, KIT and c-kit mRNA expression in the lesion tissue of uterine sarcoma group were higher than those of uterine fibroids group whereas PTEN mRNA expression was lower than that of uterine fibroids group;HOXA10 and Dickkopf mRNA expression in the lesion tissue of uterine sarcoma group were lower than those of uterine myoma group whereas Matriptase, PDGF and PRL-3 mRNA expression were higher than those of uterine fibroids group. Correlation analysis showed that the ADC and TTP levels in patients with uterine sarcoma were directly correlated with the expression of proliferation genes and invasion genes in the lesion tissue.Conclusion: Dynamic contrast-enhanced MRI parameters of uterine sarcoma are significantly different from those of benign uterine fibroids, and the specific parameter levels are directly correlated with tumor cell proliferation and invasion activity.

Dynamic contrast-enhanced MRI parameters of breast cancer tissue and their correlation with cancer cell proliferation and invasion

Objective:To study the dynamic contrast-enhanced MRI (DCE-MRI) parameters of breast cancer tissue and their correlation with cancer cell proliferation and invasion.Methods: A total of 92 patients with breast mass who underwent surgical treatment in our hospital between July 2012 and June 2016 were collected as research subjects. According to the results of pathological examination, the patients were divided into breast adenoma group (n=52) and breast cancer group (n=40). DCE-MRI parameter levels of breast mass were analyzed between two groups of patients, and the mRNA expression of proliferation and invasion genes in tumor samples were compared. Pearson test was used to further evaluate the relationship between the DCE-MRI parameter levels of breast cancer tissue and the malignant degree of tumor.Results:The DCE-MRI parameter TTP level in breast cancer group was lower than that in breast adenoma group while EER and SLOPE levels were higher than those in breast adenoma group. Proliferation genes C6orf106, HMGB2, ETS-1 and BRG1 mRNA expression in tumor tissue of breast cancer group were higher than those of breast adenoma group, and invasion genes ADAM9, Ezrin and Nanog mRNA expression were higher than those of breast adenoma group while CRM197 and EBP50 mRNA expression were lower than those of breast adenoma group. The Pearson test showed that the DCE-MRI parameter levels of breast cancer tissues were directly correlated with the mRNA expression of proliferation and invasion genes.Conclusion:DCE-MRI parameter levels are abnormal in breast cancer tissues, and the abnormal degree is directly correlated with the malignant biological behavior of tumor cells.

Comparison of clinical value of dynamic contrast-enhanced MRI and SPECT renal dynamic imaging of GFR measurement in the evaluation of renal function in renal transplantation

Objective:To compare the clinical value of dynamic contrast-enhanced MRI(DCE-MRI)and single-photon emission computed tomography(SPECT)renal dynamic imaging in the measurement of glomerular filtration rate(GFR)in the evaluation of renal function in renal transplantation.Methods:A total of 70 recipients who underwent renal transplantation in Baogang Hospital of Inner Mongolia from April of 2015 to April of 2018 were selected as research objects.GFR was measured in renal transplant recipients by use of DCE-MRI and SPECT(GFR-MRI and GFR-SPECT respectively),and was compared with creatinine clearance rate(Ccr).The safety of contrast media was evaluated in DCE-MRI detection.Results:The bias of GFR-MRI against Ccr value was higher than that of GFR-SPECT against Ccr value,with 30%and 50%accuracy of GFR-MRI higher than that of GFR-SPECT,and the difference was statistically significant(p<.05).Pearson correlation analysis showed that GFR-MRI and GFR-SPECT values were positively correlated to Ccr(p<.05),and the correlation coefficient of GFR-MRI and Ccr was higher than that of GFR-SPECT and Ccr,with the difference statistically significant(p<.05).By Bland-Altman analysis,95%confidence interval of GFR-SPECT was 95.49 ml/(min·1.73 m^(2)),and 95%confidence interval of GFR-MRI was 62.35 ml/(min·1.73m^(2)),which was much narrower.Only 2 cases of patients developed mild rash among 70 cases of patients,and recovered spontaneously without any treatment.Conclusions:Compared with SPECT,the bias of GFR measured by DCE-MRI against Ccr is much greater.However,DCE-MRI has a higher accuracy,correlation and consistency in comparison with Ccr,and it has a narrower confidence interval.DCE-MRI can more accurately evaluate renal function in renal transplantation by measuring GFR,and it has a high safety.

Usefulness of dynamic contrast-enhanced MR imaging in the evaluation of pulmonary isolated lesions

Objective： The aim of our study was to investigate the value of dynamic contrast-enhanced MRI for evaluating differential diagnosis of pulmonary isolated lesions. Methods： Twenty-nine consecutive patients enrolled in this study, all of whom underwent DCE-MRI examinations and received a histologic and clinical diagnosis. Among these, lung tuberculoma 7 cases, harmatoma 3 cases, peripheral lung cancer 19 cases. DCE-MRI was acquired with 3D LAVA technique, total 18 phases were acquired, scanner time of per phase was 5-7″. After contrasting agent, twice successive scanning was acquired at 10″ and 50″. Then 1′30″, 2′, 2′30″, 3′, 3′30″, 4′, 5′, 6′, 7′, 8′, 9′, 10′, 11′, 12′ performed scanning. Region of interest was placed on the Maximum level in the tumors. According to Schaefer＇s standard, four types of time signal intensity curve （TIC） were classified, which were A, B, C and D. Compared the dynamic parameters between benign and malignant nodules. Results： Lung tuberculoma may display three curves： A type 1 case, ring-shaped enhancement 4 cases （periphery ring A type, central region D type）, D type 2 cases. Harmatoma may display three curves： A type 1 case, C type 2 case. Peripheral lung cancer may display A type. Except 2 cases D type lung tuberculoma, we compared curve data of 8 cases benign nodules （including tuberculoma Atype and periphery ring Atype, harmatoma Atype and C type） and lung cancer. SlEP%： benign nodules 0.7885 ±0.5543, lung cancer 1.2623 ±0.3059, P 〈 0.05; MER： benign nodules 1.0007 ± 0.4251, lung cancer 1.3694 ±0.2740, P 〈 0.05; washout： P 〉 0.05. Conclusion： Lung MR imaging is helpful to diagnosis and differential diagnosis of isolated benign and malignant nodules. SIEP% and MER could offer valuable information. The evolution of global tuberculosis may be from A type to ring-shaped ennoblement to D type. It was easy to do right diagnosis to lung tuberculoma with ring-shaped ennoblement and D type. Peripheral lung cancer commonly displayed A type and needed identification with acute inflammation. So, it is important to anti-inflammatory follow-up for a few A type nodules.

Correlation of dynamic contrast-enhanced magnetic resonance imaging parameters before colon cancer surgery with the angiogenesis and cell proliferation in tumor lesions

Objective: To discuss the correlation of dynamic contrast-enhanced magnetic resonance imaging parameters before colon cancer surgery with the angiogenesis and cell proliferation in tumor lesions. Methods: A total of 186 patients with colon cancer who were treated in the hospital between January 2015 and January 2017 were collected as colon cancer group;100 patients with multiple polyposis of colon who received colonoscopy in the hospital during the same period were selected as colon polyp group. The differences in DCE-MRI parameters as well as the expression of angiogenesis and cell proliferation genes were compared between the two groups, and Pearson test was used to evaluate the correlation of preoperative DCE-MRI parameters with angiogenesis and cell proliferation gene expression in patients with colon cancer. Results: Preoperative DCE-MRI parameters Ktrans and Kep levels in colon cancer group were significantly higher those in colon polyp group;Cyr61, HIF-α, VEGF, MMP-9, CXCR7, EZH2, SphK1 and IFT57 mRNA expression in lesion tissue of colon cancer group were significantly higher than those of colon polyp group while Kiss-1 mRNA was lower than that of colon polyp group. Pearson test showed that the DCE-MRI parameters Ktrans and Kep levels before colon cancer surgery were directly correlated with the expression of angiogenesis and cell proliferation genes in lesion tissues. Conclusion: Preoperative DCE-MRI parameters can accurately reflect the severity of colon cancer.

Prediction of radiosensitivity in primary central nervous system germ cell tumors using dynamic contrast-enhanced magnetic resonance imaging

Objective： To evaluate the feasibility of dynamic contrast-enhanced magnetic resonance imaging（DCEMRI） for predicting tumor response to radiotherapy in patients with suspected primary central nervous system（CNS） germ cell tumors（GCTs）.Methods： DCE-MRI parameters of 35 patients with suspected primary CNS GCTs were obtained prior to diagnostic radiation, using the Tofts and Kermode model. Radiosensitivity was determined in tumors diagnosed 2 weeks after radiation by observing changes in tumor size and markers as a response to MRI. Taking radiosensitivity as the gold standard, the cut-off value of DCE-MRI parameters was measured by receiver operating characteristic（ROC） curve. Diagnostic accuracy of DCE-MRI parameters for predicting radiosensitivity was evaluated by ROC curve.Results： A significant elevation in transfer constant（K^trans） and extravascular extracellular space（Ve）（P=0.000）, as well as a significant reduction in rate constant（Kep）（P=0.000） was observed in tumors. K^trans, relative K^trans, and relative Kep of the responsive group were significantly higher than non-responsive groups. No significant difference was found in Kep, Ve, and relative Ve between the two groups. Relative K^trans showed the best diagnostic value in predicting radiosensitivity with a sensitivity of 100%, specificity of 91.7%, positive predictive value（PPV） of 95.8%, and negative predictive value（NPV） of 100%.Conclusions： Relative K^trans appeared promising in predicting tumor response to radiation therapy（RT）. It is implied that DCE-MRI pre-treatment is a requisite step in diagnostic procedures and a novel and reliable approach to guide clinical choice of RT.

Evaluating treatment via flexibilityof dynamic MRI community structures in depression

The flexibility of dynamic community structure is adopted to analyze the depressive resting-state functional magnetic resonance imaging( rf MRI) signals in order to improve the accuracy of evaluating depression treatment. The rf MRI signals of each brain network were obtained by the independent component correlation algorithm( ICA). Dynamic functional connections were computed with sliding windows and L1 norm. Then, the connections were used to calculate the dynamic community structure via the community-detection algorithm. The result of structure's community assignment has the general character with the brain activity changing over time. The flexibility index is one of traits of dynamic community structure, meaning the number of times a region changes. In this study, 16 patients who achieved clinical remission joined the experiment and were scanned before and after treatment. Pair permutation tests compare the difference of six brain networks' flexibility between pre-therapy and posttreatment. The results showthat the distribution of the flexibility values declines in a default network and cognitive control network between pre-therapy and post-treatment patients with statistical difference. Therefore, flexibility is a suitable approach to accurately evaluate the depression treatment effect.

Advances in Assessing Preoperative Liver Function with Gd-EOB-DTPA Dynamic Contrast Enhanced MRI

Liver cancer is the common malignant tumor in China and current treatment is based on surgery. However, liver function of many liver cancer patients is impaired before surgery, so there’s a high possibility of occurrence of liver failure after the tumor resection. Therefore, it’s necessary to accurately evaluate liver function before surgery. Currently, clinical methods are mostly limited to assess the function of overall liver. But the application of hepatocyte-specific contrast agent—gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) makes it possible to assess the function of local liver segment accurately. This paper reviewed the progress of using Gd-EOB-DTPA dynamic contrast enhanced magnetic resonance imaging (MRI) to assess liver function preoperatively, such as parameters selection for liver function assessment, clinical factors affecting Gd-EOB-DTPA enhanced MRI and so on.

动态增强MRI定量参数及肿瘤标记物对乳腺癌新辅助化疗疗效的评估价值分析

目的:探索动态增强磁共振成像(DCE-MRI)定量参数及肿瘤标记物对乳腺癌新辅助化疗疗效的评估价值。方法:选取2019年5月至2022年5月在济宁市第一人民医院接受新辅助化疗联合手术干预的75例乳腺癌患者,根据实体瘤疗效评价标准(RECIST)将其分为有效组(54例)和无效组(21例),比较化疗前和化疗后两组患者DCE-MRI定量参数血管外细胞外间隙容积比(V_(e))、速率常数(K_(ep))及容积转换常数(K^(trans))指标与肿瘤标志物癌胚抗原(CEA)、糖类抗原(CA125)及糖类抗原15-3(CA15-3)水平,采用受试者工作特征(ROC)曲线分析各项诊断方式预测效能。结果:化疗后,有效组患者DCEMRI定量参数Ve、K_(ep)及K^(trans)与无效组比较,差异有统计学意义(t=7.237、51.695、16.879,P<0.05)。有效组患者肿瘤标志物CEA、CA125及CA15-3与无效组比较,差异有统计学意义(t=44.201、6.736、6.885,P<0.05)。V_(e)、K_(ep)、K^(trans)、CEA、CA125及CA15-3的6项指标联合预测乳腺癌新辅助化疗疗效ROC曲线下面积(AUC)值为0.979,显著高于各项指标单独检测的AUC值,差异有统计学意义(Z=2.993、2.679、2.510、2.731、3.215、3.071,P<0.05)。结论:肿瘤标记物联合DCE-MRI定量参数可更好预测乳腺癌新辅助化疗疗效情况,间接评估预后。

基于多模态MRI定量分析诊断宫颈癌宫旁浸润的研究

目的探讨多模态MRI定量分析诊断宫颈癌宫旁浸润的价值。方法回顾性分析2019年1月~2021年12月新疆维吾尔自治区人民医院收治的86例宫颈癌患者临床资料,根据病理结果分为宫旁浸润组31例与非宫旁浸润组55例。所有患者均接受MRI常规平扫及扩散加权成像(DWI)扫描、动态对比增强磁共振成像(DCE-MRI)扫描,获得感兴趣区表观弥散系数(ADC)值和对比剂容积转换常量(K^(trans))、速率常数(K_(ep))、血管外细胞间隙容积分数(V_(e))值等多模态MRI定量参数。比较宫旁浸润组和非宫旁浸润组临床特征、ADC值和DCE-MRI定量参数;Pearson相关性分析宫颈癌宫旁浸润患者ADC值和K^(trans)、K_(ep)、V_(e)的关系;受试者工作特征曲线(ROC)分析ADC值和K^(trans)、K_(ep)、V_(e)对宫颈癌宫旁浸润的诊断效能。结果宫旁浸润组与非宫旁浸润组肿瘤直径和病理分级的分布差异比较,差异有统计学意义(P<0.05);宫旁浸润组K^(trans)、K_(ep)和V_(e)均明显高于非宫旁浸润组(P<0.05);Pearson相关性显示,宫颈癌宫旁浸润患者ADC值与V_(e)值呈明显的正相关(P<0.05);ROC显示,K^(trans)、K_(ep)、V_(e)值诊断宫颈癌宫旁浸润的曲线下面积(AUC)分别为0.876、0.821和0.864(P<0.05)。结论多模态MRI定量参数对宫颈癌宫旁浸润具有较好的诊断价值,可为宫颈癌宫旁浸润的影像诊断提供量化参考。

1.5T磁共振动态对比增强(DCE-MRI)技术联合表观弥散系数(ADC)值对乳腺肿块样强化病变良恶性的鉴别诊断价值

目的:分析1.5T磁共振动态对比增强(DCE-MRI)技术联合表观弥散系数(ADC)值对乳腺肿块样强化病变良恶性的鉴别诊断价值。方法:选取2021年10月至2024年4月在三明市第二医院治疗的163例乳腺肿块样强化病变患者的临床资料进行回顾性分析。选取的患者均接受1.5T DCE-MRI检查。根据强化方式、时间-信号强度(TIC)曲线、病灶形态、病灶边界,计算ADC值。以病理诊断结果为金标准,以1.5T DCE-MRI诊断结果为对照1组,以ADC诊断结果为对照2组,以联合诊断结果为观察组。对比三种诊断方式在乳腺肿块样强化病良恶性鉴别诊断中的应用价值。结果:以病理诊断结果为金标准,对比对照1组与对照2组的各项诊断效能指标,差异无统计学意义(P>0.05)。观察组的各项诊断效能指标均明显优于对照1组以及对照2组,差异具有统计学意义(P<0.05)。结论:在乳腺肿块样强化病变良恶性的鉴别诊断中,应用1.5T DCE-MRI联合ADC值具有更高的诊断效能,临床应用价值显著。

CT和MRI动态增强扫描诊断和评估原发性肝癌患者微血管浸润价值研究

目的研究使用电子计算机断层扫描(CT)和磁共振(MRI)动态增强扫描诊断和评估原发性肝癌(PLC)患者微血管浸润(MVI)的价值。方法2020年1月~2023年1月我院收治的PLC患者50例,术前均接受腹部CT和MRI检查,记录肿瘤边缘模糊征象、瘤内新月征、静脉浸润的双预测因子(TTPVI)、门静脉癌栓(PVTT)和表观弥散系数(ADC)。行肝叶切除术治疗,取术后组织行病理学检查诊断MVI。结果经术后组织病理学检查,诊断肝细胞癌(HCC)32例和胆管细胞癌18例,存在MVI者29例,无MVI者21例;CT检查MVI患者肿瘤边缘模糊、局部外凸结节、包膜不完整、多结节融合、瘤内新月征、TTPVI和PVTT等影像学征象占比分别为82.8%、17.2%、31.0%、17.2%、13.8%、65.5%和17.2%,显著高于无MVI患者(分别为14.3%、4.8%、4.8%、4.8%、0.0%、9.5%和0.0%,P<0.05);MRI检查MVI患者肿瘤边缘模糊、局部结节、包膜不完整、多结节融合、瘤内新月征、TTPVI和PVTT等影像学征象占比为89.7%、24.1%、37.9%、27.6%、13.8%、72.4%和24.1%,显著高于无MVI患者(分别为23.8%、9.5%、9.5%、9.5%、0.0%、14.3%和0.0%,P<0.05);经Logistic回归分析显示,CT和MRI检查发现病灶边缘模糊、TTPVI和PVTT是PLC患者发生MVI的独立影响因素(P<0.05)。结论CT和MRI动态增强扫描可通过特殊征象判断PLC患者MVI的存在,可帮助临床医生做出合理的诊治策略。

A double-network hydrogel for the dynamic compression of the lumbar nerve root

Current animal models of nerve root compression due to lumbar disc herniation only assess the mechanical compression of nerve roots and the inflammatory response. Moreover, the pressure applied in these models is static, meaning that the nerve root cannot be dynamically compressed. This is very different from the pathogenesis of lumbar disc herniation. In this study, a chitosan/polyacrylamide double-network hydrogel was prepared by a simple two-step method. The swelling ratio of the double-network hydrogel increased with prolonged time, reaching 140. The compressive strength and compressive modulus of the hydrogel reached 53.6 and 0.34 MPa, respectively. Scanning electron microscopy revealed the hydrogel's crosslinked structure with many interconnecting pores. An MTT assay demonstrated that the number of viable cells in contact with the hydrogel extracts did not significantly change relative to the control surface. Thus, the hydrogel had good biocompatibility. Finally, the double-network hydrogel was used to compress the L4 nerve root of male sand rats to simulate lumbar disc herniation nerve root compression. The hydrogel remained in its original position after compression, and swelled with increasing time. Edema appeared around the nerve root and disappeared 3 weeks after operation. This chitosan/polyacrylamide double-network hydrogel has potential as a new implant material for animal models of lumbar nerve root compression. All animal experiments were approved by the Animal Ethics Committee of Neurosurgical Institute of Beijing, Capital Medical University, China(approval No. 201601006) on July 29, 2016.

基于多模态MRI成像特征的综合评分在前列腺癌诊断中的价值

目的探讨基于多模态MRI成像(multimodal MRI,mp-MRI)特征的综合评分在前列腺癌诊断中的应用价值。方法选取2022年3月—2023年12月南通市第二人民医院收治的95例疑似前列腺癌患者为研究对象,均行3.0 T磁共振T2加权成像(T2 weighted imaging,T2WI)、弥散加权成像(diffusion weighted imaging,DWI)、动态对比增强(dynamic contrast-enhanced,DCE)检查,并进行综合评分,以病理结果为金标准,计算各参数单独及mp-MRI对前列腺癌诊断的灵敏度、特异度、准确度、阴性预测值和阳性预测值,对比各参数的诊断效能。结果95例疑似患者中,病理检出59例前列腺癌,36例为良性病变。T2WI诊断前列腺癌54例,非前列腺癌41例;DWI诊断前列腺癌57例,非前列腺癌38例;DCE-MRI诊断前列腺癌60例,非前列腺癌35例;mp-MRI诊断前列腺癌60例,非前列腺癌35例。mp-MRI诊断前列腺癌的灵敏度为94.92%(56/59)、准确度为92.63%(88/95)、阴性预测值为91.43%(32/35),均明显高于T2WI的74.58%(44/59)、73.68%(70/95)、63.41%(26/41),DWI的81.36%(48/59)、78.95%(75/95)、71.05%(27/38),DCE-MRI的79.66%(47/59)、73.68%(70/95)、65.71%(23/35),差异有统计学意义(χ^(2)=9.298、14.121、8.832,P均<0.05)。而4种检查方式的特异度、阳性预测值比较,差异无统计学意义(P均>0.05)。结论联合运用T2WI、DWI及DCE-MRI成像开展的多模态MRI综合评分能提高前列腺癌的诊断效能。

MRI动态增强与DWI扫描结合在乳腺癌诊断及新辅助化疗疗效评估中的应用研究

目的分析MRI动态增强(DCE-MRI)与扩散加权成像(DWI)扫描结合在乳腺癌诊断及新辅助化疗疗效评估中的应用。方法选取2019年2月至2023年2月本院收治的乳腺肿瘤患者80例。手术前后均行DWI和DCE-MRI扫描。以手术病理结果作为金标准,分析DWI、DCE-MRI以及联合检查与病理结果的Kappa一致性。比较乳腺癌患者治疗前后肿瘤表观弥散系数(ADC)值、前后、左右、上下直径和肿瘤体积以及乳腺癌患者化疗前后病灶时间-信号强度曲线(TIC)曲线的类型例数。结果80例患者经手术病理学检查确诊恶性肿瘤患者16例,良性肿瘤患者64例。以手术病理结果作为金标准,DWI检查乳腺良恶性的敏感度和特异度分别为87.50%、71.88%,Kappa值=0.432;DCE-MRI检查乳腺良恶性的敏感度和特异度分别为81.25%、75.00%,Kappa值=0.431。DWI+DCE-MRI联合乳腺良恶性的敏感度和特异度分别为93.75%、71.88%,Kappa值=0.469。化疗后,肿瘤前后、左右、上下直径和体积明显小于化疗前(P<0.05)。化疗前后,肿瘤ADC值比较,差异无统计学意义(P>0.05)。化疗前后Ⅰ型、Ⅱ型和Ⅲ型TIC曲线例数比较,差异具有统计学意义(P<0.05)。结论DCE-MRI联合DWI检查有效诊断乳腺良恶性,并精准反映出肿瘤新辅助化疗后组织形态学及TIC曲线变化,具有较高的临床应用价值。

DCE-MRI在乳腺良性病变与乳腺癌诊断中的应用价值

目的探讨磁共振成像动态增强扫描(DCE-MRI)在乳腺良性病变与乳腺癌诊断中的应用价值。方法选取2021年1月—2023年12月四川省西昌市人民医院收治的289例乳腺疾病患者作为本次研究对象。以术后病理检查结果为金标准,分析弥散加权成像(DWI)、DCE-MRI对乳腺良性病变与乳腺癌的诊断价值,并比较乳腺良性病变与乳腺癌患者表观扩散系数(ADC)值、DCE-MRI影像学表现。结果病理结果显示,289例乳腺疾病患者中乳腺良性病变212例,占73.36%,乳腺癌77例,占26.64%。乳腺良性病变组、乳腺癌组患者的ADC值、病灶边缘情况、病灶形状情况、时间-信号强度(TIC)类型、强化特征情况比较,差异均有统计学意义(P<0.05)。DWI诊断乳腺良性病变188例,乳腺癌101例,诊断准确率为72.66%;DCE-MRI诊断乳腺良性病变179例,乳腺癌110例,诊断准确率为66.44%;二者联合诊断乳腺良性病变203例,乳腺癌86例,诊断准确率为87.54%(P<0.05)。DWI、DCE-MRI及二者联合诊断乳腺良性病变与乳腺癌的曲线下面积(AUC)分别为0.871、0.806、0.911,特异度分别92.21%、89.61%、90.91%,灵敏度分别为85.85%、80.66%、92.45%。结论DWI、DCE-MRI在乳腺良性病变与乳腺癌的鉴别诊断中具有较高的临床价值,且二者联合可提高诊断准确率。

动态增强MRI时间-信号强度曲线与乳腺癌分子分型的关系分析

目的 探讨动态增强MRI时间-信号强度曲线与乳腺癌分子分型的关系。方法 选取乳腺癌患者110例,根据患者的雌激素受体、孕激素受体、人表皮生长因子受体-2的表达状态,将患者分为Luminal A型、Luminal B型、HER-2阳性型及三阴性。对4型患者进行动态增强MRI检测,分析不同亚型乳腺癌的容量转移常数(Ktrans)、速率常数(Kep)及时间-信号强度曲线(TIC)。结果 110例标本中,Luminal A型33例、占30.00%,Luminal B型30例,占27.27%,HER-2阳性型34例,占30.90%,三阴性型13例,占11.81%。Luminal A型和Luminal B型的Ktrans与Kep值差异无统计学意义,HER-2阳性型和三阴性型的Ktrans与Kep值差异无统计学意义(P>0.05),Luminal A型和Luminal B型的Ktrans、Kep水平低于HER-2阳性型和三阴性型(P<0.05)。Luminal A型中,有5例流入型TIC、20例平台型TIC、8例流出型TIC;Luminal B型中,有2例流入型TIC、10例平台型TIC、18例流出型TIC;HER-2阳性型中,有4例流入型TIC、11例平台型TIC、19例流出型TIC;三阴性型中,有4例流入型TIC、3例平台型TIC、6例流出型TIC。不同分子亚型乳腺癌DCE-MRI的时间-信号强度曲线差异有统计学意义(P<0.05)。结论 不同分子分型乳腺癌的DCE-MRI的血流动力学特点不同,可通过DCE-MRI的时间-信号强度曲线乳腺癌的分子分型进行初步预测。