光学相干断层扫描血管成像扫描信号强度对视盘周围血管密度的影响

目的:探讨光学相干断层扫描血管成像(optical coherence tomography angiography,OCTA)扫描信号强度对视盘周围血管密度的影响。方法:本研究为单中心横断面研究,所有受试者分别接受了身高、体重、血压、眼压、眼轴及视盘OCTA检查,利用广义估计方程分析OCTA扫描信号强度对视盘周围血管密度的影响。结果:共186人359眼纳入本研究,年龄为(47.86±17.86)岁,视盘周围血管密度为(17.75±1.99)mm−1。单因素分析显示视盘周围血管密度与眼轴呈负相关(β=−0.5120,P<0.001),与扫描信号强度呈正相关(β=1.0240,P<0.001)。在校正了年龄、性别、视盘面积及眼轴后的多因素分析中,OCTA扫描信号强度依然与视盘周围血管密度显著正相关(β=0.9721,P<0.001)。结论:视盘周围血管密度不仅与眼轴和视盘面积显著负相关,而且与OCTA扫描信号强度显著正相关,在临床应用或研究中,需要考虑其影响。

磁共振动态增强扫描时间-信号强度曲线联合磁共振扩散加权成像表观扩散系数在乳腺癌诊断中的应用价值

目的探讨磁共振动态增强扫描时间-信号强度曲线(DCE-TIC)联合磁共振扩散加权成像表观扩散系数(DWIADC)在乳腺癌诊断中的应用价值。方法回顾性分析2019年3月-2020年3月该院收治的84例乳腺良恶性病变患者的临床资料。所有患者均接受DCE-TIC和DWI-ADC检查,以病理诊断结果为金标准,分析DCE-TIC、DWI-ADC单一及联合诊断乳腺癌与病理结果的一致性。结果 84例患者均顺利完成DCE-TIC、DWI-ADC及病理诊断,病理诊断结果显示71例(84.52%)确诊为乳腺癌,DCE-TIC诊断结果显示64例(76.19%)确诊为乳腺癌,DWI-ADC诊断结果显示63例(75.00%)确诊为乳腺癌。DCE-TIC诊断乳腺癌的灵敏度为84.51%,特异度为69.23%,准确率为82.14%,阳性预测值为93.75%,阴性预测值为45.00%,与病理诊断一致性检验的Kappa值为0.44 (P<0.05)。DWI-ADC诊断乳腺癌的灵敏度为83.10%,特异度为69.23%,准确率为80.95%,阳性预测值为93.65%,阴性预测值为42.86%,与病理诊断一致性检验的Kappa值为0.42 (P<0.05)。DCE-TIC联合DWI-ADC诊断乳腺癌的灵敏度为94.37%,特异度为84.62%,准确率为92.86%,阳性预测值为97.10%,阴性预测值为73.33%,与病理诊断一致性检验的Kappa值为0.74 (P<0.05)。结论 DCE-TIC联合DWI-ADC诊断乳腺癌与病理诊断结果的一致性较好,临床可推广应用。

Diagnostic efficacy of gadoxetic acid-enhanced MRI for hepatocellular carcinoma and dysplastic nodule

AIM:To evaluate the relationship between the signal intensity of hepatobiliary phase images on gadoxetic acid-enhanced magnetic resonance imaging(MRI)and histological grade.METHODS:Fifty-nine patients with 82 hepatocellular lesions were evaluated retrospectively.Hepatobiliary phase images on gadoxetic acid-enhanced MRI were classified into 3 groups:low,iso or high.Angiographyassisted computed tomography(CT)findings were also classified into 3 groups:CT during arterial portography,and CT hepatic arteriography:A:iso,iso or low;B:slightly low,iso or low;;and C:low,high.We correlated angiography-assisted CT,hepatobiliary phase findings during gadoxetic acid-enhanced MRI and histological grades.Furthermore,correlations between MRI findings and histological grade for each hemodynamic pattern were performed.Correlations among radiologicaland pathological findings were statistically evaluated using the chi-square test and Fisher's exact test.RESULTS:There was a significant correlation between histological grade and hemodynamic pattern(P<0.05).There was a significant correlation between histological grade and signal intensity in the hepatobiliary phase(P<0.05)in group A lesions.There was no significant correlation between histological grade and signal intensity in the hepatobiliary phase in group B or C lesions(P>0.05).CONCLUSION:Signal intensity in the hepatobiliary phase correlated with histological grade in the lesions that maintained portal blood flow,but did not correlate in lesions that showed decreased or defective portal blood flow.

DCE-TIC及DWI-ADC单独及联合诊断乳腺病变良恶性的临床价值分析

目的:探究磁共振动态增强扫描时间—信号强度曲线(DCE-TIC)及扩散加权成像表观扩散系数值(DWI-ADC)单独及联合在乳腺病变良恶性中的诊断价值。方法:纳入100例2019年6月—2021年9月于我院经病理诊断明确乳腺病变性质的患者,所有患者均行磁共振(MRI)检查,应用DCE-TIC、DWI-ADC行图像分析。以病理结果作为“金标准”,分析病理检查结果、TIC类型分布及ADC值,另分析单独及联合检测在乳腺病变良恶性中的诊断价值,计算与病理结果的一致性。结果:病理结果显示,100例患者中良性病变37例,以纤维腺瘤检出率最高(45.95%);恶性病变63例,以浸润性癌检出率最高(85.71%);乳腺良性病变ADC值为(1.59±0.42)mm^(2)/s,高于恶性病变的(1.02±0.31)mm^(2)/s,差异有统计学意义(P<0.05);乳腺良性病变TIC曲线主要表现为Ⅰ型,恶性病灶为Ⅲ型,两组TIC曲线类型比较,差异有统计学意义(P<0.05);联合检查在乳腺病变良恶性诊断中灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于DCE-TIC、DWI-ADC单独检查,差异有统计学意义(P<0.05)。结论:DCE-TIC及DWI-ADC联合检查在乳腺病变良恶性诊断中具有较高的临床应用价值,能够有效提升疾病诊断效能,值得推广。