Optimal b value of diffusion-weighted imaging on a 3.0T magnetic resonance scanner in Crohn's disease

AIM: To determine the optimal b value of diffusion-weighted imaging for detecting active inflammation in Crohn’s disease.

T2* magnetic resonance imaging of the liver in thalassemic patients in Iran

AIM: To investigate the accuracy of T2*-weighted magnetic resonance imaging (MRI T2*) in the evaluation of iron overload in beta-thalassemia major patients. METHODS: In this cross-sectional study, 210 patients with beta-thalassemia major having regular blood transfusions were consecutively enrolled. Serum ferritin levels were measured, and all patients underwent MRI T2* of the liver. Liver biopsy was performed in 53 patients at an interval of no longer than 3 mo after the MRIT2* in each patient. The amount of iron was assessed in both MRI T2* and liver biopsy specimens of each patient. RESULTS: Patients’ ages ranged from 8 to 54 years with a mean of 24.59 ± 8.5 years. Mean serum ferritin level was 1906 ± 1644 ng/mL. Liver biopsy showed a moderate negative correlation with liver MRI T2* (r = -0.573, P = 0.000) and a low positive correlation with ferritin level (r = 0.350, P = 0.001). Serum ferritin levels showed a moderate negative correlation with liver MRI T2* values (r = -0.586, P = 0.000). CONCLUSION: Our study suggests that MRI T2* is a non-invasive, safe and reliable method for detecting iron load in patients with iron overload.

Magnetic Resonance Imaging and Histopathological Analysis of Experimental Muscle Injuries in a Rabbit

Objective To investigate the correlation of magnetic resonance imaging （MRI） with histopathologica changes, and to evaluate T2 mapping in assessing muscle trauma in a rabbit model of muscle injury. Methods We divided 35 rabbits into seven groups that each represented a different time point after intramuscular hemorrhage and muscle injury. Hemorrhage was created by injecting autologous blood into the left legs, and muscle injury was created by scalpel incision of the biceps femoris of the right legs. At different time points, the rabbits underwent Tl-weighted imaging and T2-weighted imaging （TzWl and T2Wl） and T2 mapping. T2 relaxation times were measured, and the corresponding samples were evaluated for pathological changes. Results After 2 h, the intramuscular hemorrhage model demonstrated an increased signal intensity on both TlWl and T2Wl. Histological examination showed erythrocytes within the muscle bundle. On days 1 and 3, the MRI signals were decreased, and there were no significant changes after day 7. From 2 h to 3 days, the muscle-injury model showed a high signal on both TzWl and T2Wl. Corresponding pathological changes included rupture and edema of muscle fibers, and inflammation. The abnormal signals were reduced on day 7. After day 14, the T2Wl intensity remained high. TlWl showed no abnormal changes, but some models showed a high signal, representing fresh bleeding and fatty tissue. T2 relaxation times were significantly different between the central and marginal regions, and between the marginal and normal regions. Conclusion MRI clearly demonstrates intramuscular hemorrhage and muscle injury, which correlate well with histopathological changes. Tz mapping is useful in assessing the extent of injury.

A multiple-tissue-specific magnetic resonance imaging model for diagnosing Parkinson’s disease: a brain radiomics study

Brain radiomics can reflect the characteristics of brain pathophysiology.However,the value of T1-weighted images,quantitative susceptibility mapping,and R2*mapping in the diagnosis of Parkinson’s disease(PD)was underestimated in previous studies.In this prospective study to establish a model for PD diagnosis based on brain imaging information,we collected high-resolution T1-weighted images,R2*mapping,and quantitative susceptibility imaging data from 171 patients with PD and 179 healthy controls recruited from August 2014 to August 2019.According to the inclusion time,123 PD patients and 121 healthy controls were assigned to train the diagnostic model,while the remaining 106 subjects were assigned to the external validation dataset.We extracted 1408 radiomics features,and then used data-driven feature selection to identify informative features that were significant for discriminating patients with PD from normal controls on the training dataset.The informative features so identified were then used to construct a diagnostic model for PD.The constructed model contained 36 informative radiomics features,mainly representing abnormal subcortical iron distribution(especially in the substantia nigra),structural disorganization(e.g.,in the inferior temporal,paracentral,precuneus,insula,and precentral gyri),and texture misalignment in the subcortical nuclei(e.g.,caudate,globus pallidus,and thalamus).The predictive accuracy of the established model was 81.1±8.0%in the training dataset.On the external validation dataset,the established model showed predictive accuracy of 78.5±2.1%.In the tests of identifying early and drug-naïve PD patients from healthy controls,the accuracies of the model constructed on the same 36 informative features were 80.3±7.1%and 79.1±6.5%,respectively,while the accuracies were 80.4±6.3%and 82.9±5.8%for diagnosing middle-to-late PD and those receiving drug management,respectively.The accuracies for predicting tremor-dominant and non-tremor-dominant PD were 79.8±6.9%and 79.1±6.5%,respectively.In conclusion,the multiple-tissue-specific brain radiomics model constructed from magnetic resonance imaging has the ability to discriminate PD and exhibits the advantages for improving PD diagnosis.

Quantitative multiparametric magnetic resonance imaging can aid non-alcoholic steatohepatitis diagnosis in a Japanese cohort

BACKGROUND Non-invasive assessment of non-alcoholic steatohepatitis(NASH)is increasing in desirability due to the invasive nature and costs associated with the current form of assessment;liver biopsy.Quantitative multiparametric magnetic resonance imaging(mpMRI)to measure liver fat(proton density fat fraction)and fibroinflammatory disease[iron-corrected T1(cT1)],as well as elastography techniques[vibration-controlled transient elastography(VCTE)liver stiffness measure],magnetic resonance elastography(MRE)and 2D Shear-Wave elastography(SWE)to measure stiffness and fat(controlled attenuated parameter,CAP)are emerging alternatives which could be utilised as safe surrogates to liver biopsy.AIM To evaluate the agreement of non-invasive imaging modalities with liver biopsy,and their subsequent diagnostic accuracy for identifying NASH patients.METHODS From January 2019 to February 2020,Japanese patients suspected of NASH were recruited onto a prospective,observational study and were screened using noninvasive imaging techniques;mpMRI with LiverMultiScan®,VCTE,MRE and 2DSWE.Patients were subsequently biopsied,and samples were scored by three independent pathologists.The diagnostic performances of the non-invasive imaging modalities were assessed using area under receiver operating characteristic curve(AUC)with the median of the histology scores as the gold standard diagnoses.Concordance between all three independent pathologists was further explored using Krippendorff’s alpha(a)from weighted kappa statistics.RESULTS N=145 patients with mean age of 60(SD:13 years.),39%females,and 40%with body mass index≥30 kg/m2 were included in the analysis.For identifying patients with NASH,MR liver fat and cT1 were the strongest performing individual measures(AUC:0.80 and 0.75 respectively),and the mpMRI metrics combined(cT1 and MR liver fat)were the overall best non-invasive test(AUC:0.83).For identifying fibrosis≥1,MRE performed best(AUC:0.97),compared to VCTE-liver stiffness measure(AUC:0.94)and 2D-SWE(AUC:0.94).For assessment of steatosis≥1,MR liver fat was the best performing non-invasive test(AUC:0.92),compared to controlled attenuated parameter(AUC:0.75).Assessment of the agreement between pathologists showed that concordance was best for steatosis(a=0.58),moderate for ballooning(a=0.40)and fibrosis(a=0.40),and worst for lobular inflammation(a=0.11).CONCLUSION Quantitative mpMRI is an effective alternative to liver biopsy for diagnosing NASH and non-alcoholic fatty liver,and thus may offer clinical utility in patient management.

Three-dimensional time-of-flight magnetic resonance angiography combined with high resolution T2-weighted imaging in preoperative evaluation of microvascular decompression

BACKGROUND Neurovascular compression(NVC) is the main cause of primary trigeminal neuralgia(TN) and hemifacial spasm(HFS). Microvascular decompression(MVD) is an effective surgical method for the treatment of TN and HFS caused by NVC. The judgement of NVC is a critical step in the preoperative evaluation of MVD, which is related to the effect of MVD treatment. Magnetic resonance imaging(MRI) technology has been used to detect NVC prior to MVD for several years. Among many MRI sequences, three-dimensional time-of-flight magnetic resonance angiography(3D TOF MRA) is the most widely used. However, 3D TOF MRA has some shortcomings in detecting NVC. Therefore, 3D TOF MRA combined with high resolution T2-weighted imaging(HR T2WI) is considered to be a more effective method to detect NVC.AIM To determine the value of 3D TOF MRA combined with HR T2WI in the judgment of NVC, and thus to assess its value in the preoperative evaluation of MVD.METHODS Related studies published from inception to September 2022 based on PubMed, Embase, Web of Science, and the Cochrane Library were retrieved. Studies that investigated 3D TOF MRA combined with HR T2WI to judge NVC in patients with TN or HFS were included according to the inclusion criteria. Studies without complete data or not relevant to the research topics were excluded. The Quality Assessment of Diagnostic Accuracy Studies checklist was used to assess the quality of included studies. The publication bias of the included literature was examined by Deeks’ test. An exact binomial rendition of the bivariate mixed-effects regression model was used to synthesize data. Data analysis was performed using the MIDAS module of statistical software Stata 16.0. Two independent investigators extracted patient and study characteristics, and discrepancies were resolved by consensus. Individual and pooled sensitivities and specificities were calculated. The I_(2) statistic and Q test were used to test heterogeneity. The study was registered on the website of PROSERO(registration No. CRD42022357158).RESULTS Our search identified 595 articles, of which 12(including 855 patients) fulfilled the inclusion criteria. Bivariate analysis showed that the pooled sensitivity and specificity of 3D TOF MRA combined with HR T2WI for detecting NVC were 0.96 [95% confidence interval(CI): 0.92-0.98] and 0.92(95%CI: 0.74-0.98), respectively. The pooled positive likelihood ratio was 12.4(95%CI: 3.2-47.8), pooled negative likelihood ratio was 0.04(95%CI: 0.02-0.09), and pooled diagnostic odds ratio was 283(95%CI: 50-1620). The area under the receiver operating characteristic curve was 0.98(95%CI: 0.97-0.99). The studies showed no substantial heterogeneity(I2 = 0, Q = 0.001 P = 0.50).CONCLUSION Our results suggest that 3D TOF MRA combined with HR T2WI has excellent sensitivity and specificity for judging NVC in patients with TN or HFS. This method can be used as an effective tool for preoperative evaluation of MVD.

3.0 Tesla magnetic resonance imaging: A new standard in liver imaging?

An ever-increasing number of 3.0 Tesla(T) magnets are installed worldwide. Moving from the standard of 1.5 T to higher field strength implies a number of potential advantage and drawbacks, requiring careful optimization of imaging protocols or implementation of novel hardware components. Clinical practice and literature review suggest that state-of-the-art 3.0 T is equivalent to 1.5 T in the assessment of focal liver lesions and diffuse liver disease. Therefore, further technical improvements are needed in order to fully exploit the potential of higher field strength.

Linear-fitting-based similarity coefficient map for tissue dissimilarity analysis in T2^＊-w magnetic resonance imaging

Similarity coefficient mapping（SCM） aims to improve the morphological evaluation of T＊2weighted magnetic resonance imaging（T＊2-w MRI）. However, how to interpret the generated SCM map is still pending. Moreover, is it probable to extract tissue dissimilarity messages based on the theory behind SCM？ The primary purpose of this paper is to address these two questions. First, the theory of SCM was interpreted from the perspective of linear fitting. Then, a term was embedded for tissue dissimilarity information. Finally, our method was validated with sixteen human brain image series from multiecho T＊2-w MRI. Generated maps were investigated from signal-to-noise ratio（SNR） and perceived visual quality, and then interpreted from intra- and inter-tissue intensity. Experimental results show that both perceptibility of anatomical structures and tissue contrast are improved. More importantly, tissue similarity or dissimilarity can be quantified and cross-validated from pixel intensity analysis. This method benefits image enhancement, tissue classification, malformation detection and morphological evaluation.

Feasibility of imaging superficial palmar arch using microultrasound,7T and 3T magnetic resonance imaging

AIM To demonstrate feasibility of vessel wall imaging of the superficial palmar arch using high frequency microultrasound, 7T and 3T magnetic resonance imaging(MRI).METHODS Four subjects(ages 22-50 years) were scanned on a micro-ultrasound system with a 45-MHz transducer(Vevo 2100, Visual Sonics). Subjects' hands were then imaged on a 3T clinical MR scanner(Siemens Biograph MMR) using an 8-channel special purpose phased array carotid coil. Lastly, subjects' hands were imaged on a 7T clinical MR scanner(Siemens Magnetom 7T Whole Body Scanner) using a custom built 8-channel transmit receive carotid coil. All three imaging modalities were subjectively analyzed for image quality and visualization of the vessel wall. RESULTS Results of this very preliminary study indicated that vessel wall imaging of the superficial palmar arch was feasible with a whole body 7T and 3T MRI in comparison with micro-ultrasound. Subjective analysis of image quality(1-5 scale, 1: poorest, 5: best) from B mode, ultrasound, 3T SPACE MRI and 7T SPACE MRI indicated that the image quality obtained at 7T was superior to both 3T MRI and micro-ultrasound. The 3D SPACE sequence at both 7T and 3T MRI with isotropic voxels allowed for multi-planarreformatting of images and allowed for less operator dependent results as compared to high frequency microultrasound imaging. Although quantitative analysis revealed that there was no significant difference between the three methods, the 7T Tesla trended to have better visibility of the vessel and its wall. CONCLUSION Imaging of smaller arteries at the 7T is feasible for evaluating atherosclerosis burden and may be of clinical relevance in multiple diseases.

Patient’s Comfort and Technical Quality Exams at 1.5 and 3.0 T Magnetic Resonance Imaging

Increased interest of clinicians for using 3.0 T magnetic resonance imaging (MRI), as imaging modality of choice for their patients, has been evident in the past few years. The aim of this study was to compare the technical quality of the obtained tomography using 3.0 T and 1.5 T MRI, and to compare the subjective feeling of discomfort of patients and subjective acoustic noise experience during imaging using MRI at 3.0 T and 1.5 T. Brain MRI (1.5 and 3.0 T) was performed in 58 patients, according to a standardized protocol. All studies have been randomly described by independent two radiologists. The reference standard for the existence of technical artifact is established on the basis of both radiologists’ consensus. We also compared the subjective feelings of the discomfort and acoustic noise during the both MRI (1.5 T and 3.0 T) exams. Artifacts were significantly more common during 3.0 T MRI in comparison with the 1.5 T MRI (χ2 = 5.286, P < 0.05), as well as in male patients (χ2 = 8.841, P < 0.05), and sub-jective assessments of discomfort and acoustic noise were higher in patients who underwent imaging using 3.0 T MRI, (χ2 = 125.959, df = 1, P < 0.001) and in females (χ2 = 195.449, df = 1, P < 0.001). Additional research is needed to prove that appropriate information for patients about the discomfort during 3.0 T MRI and their psychological preparation is very important element for optimal use of 3.0 T MRI in daily clinical practice.

The Diagnostic Value of Brain Magnetic Resonance Imaging in Detecting CNS Diseases Among Advanced AIDS Patients

Objective To investigate the diagnostic value of brain magnetic resonance imaging in detecting central nervous system diseases among AIDS patients of different levels of T cells. Methods Total of 164 AIDS patients who did not receive antiviral treatment were divided into 2 groups according to their baseline CD4+ T cell counts. Group A had CD4+ T cell below or equal to 50 cells/μl(n = 81) and group B had CD4+ T cells over 50 cells/μl(n = 83). All patients underwent brain MRI scan. Imaging analysis and the prevalence of the central nervous system disorders were compared between two groups. Results Among them 48 cases were found of abnormal brain MRI, group A was higher than group B(35.8% vs. 22.9%) although without statistical significance(P = 0.065). Altogether 48 cases were diagnosed as AIDS related central nervous system disorders based on clinical symptoms, signs and laboratory findings. The prevalence of CNS disorders was higher in group A than in group B(41.9% vs. 16.8%) with statistical significance(P < 0.01). Conclusions The patients with CD4+ T cell count less than or equal to 50 cells/μl had high prevalence of CNS diseases. Brain MRI plays an important role in the diagnosis and differentiation of CNS diseases in advanced AIDS patients. This study suggests patients with low CD4+ T cell count(≤ 50/μl) should routinely undergo MRI examination.

3.0T MRI联合DWI及MSCT对直肠癌分期及分化程度的诊断价值

目的 探究3.0T磁共振成像(MRI)联合弥散加权成像(DWI)及多层螺旋CT(MSCT)对直肠癌分期及分化程度的诊断价值。方法 回顾性分析2018年2月至2021年11月宝鸡市人民医院收治的82例直肠癌患者的临床资料,所有患者均在术前完成3.0T MRI、DWI和MSCT检查,以术后病理学结果为“金标准”,分析3.0T MRI联合DWI及MSCT在诊断直肠癌T、N分期的正确率,比较不同分化程度直肠癌患者的表观扩散系数(ADC)值和指数化表观扩散系数(eADC)值。结果 MRI联合DWI、MSCT诊断T分期直肠癌的总正确率为97.56%,明显高于MRI+MSCT、DWI+MSCT和MRI+DWI联合检查(分别为75.61%、81.71%、67.07%),差异均有统计学意义(P<0.05);MRI联合DWI、MSCT诊断N分期直肠癌的总正确率为100.00%,明显高于MRI+MSCT、DWI+MSCT和MRI+DWI联合检查(分别为71.95%、80.49%、85.37%),差异均有统计学意义(P<0.05);ADC值和e ADC值随着直肠癌分化程度的增加而提高,即高分化直肠癌患者的ADC值和eADC值明显高于中分化和低分化患者,中分化患者的ADC值和e ADC值明显高于低分化,差异均有统计学意义(P<0.05)。结论 3.0T MRI联合DWI及MSCT能够在术前较为准确地对直肠癌患者的T、N分期进行评价,ADC值和e ADC值与直肠癌的分化程度有关。

3.0T磁共振在胃癌术前TN分期中的诊断价值

目的探讨3.0T磁共振成像(MRI)在胃癌术前T、N分期中的诊断价值。方法将2018年6月-2019年12月接受手术治疗的64例胃癌患者纳入本次研究,依据AJCC胃癌TNM分期标准,对入组患者进行影像学T、N分期,并将术前影像分期与术后病理结果进行比较。结果入组的64例患者均接受根治性手术,术后经病理组织学验证发现:MRI评估胃癌T分期总准确度为82.81%,其中T1分期的准确度为66.67%,T2分期的准确度为78.95%,T3分期的准确度为88.0%,T4分期的准确度为85.7%,与病理诊断一致性较好(κ=0.784);磁共振扩散加权成像(DWI)序列扫描,胃周转移淋巴结ADCmin值[(1.012±0.068)×10^(-3)mm^(2)/s比(1.427±0.139)×10^(-3)mm^(2)/s]显著低于非转移淋巴结;DWI序列ADCmin值评估胃癌N分期总准确度为81.25%,其中N0分期准确度为83.33%,N1分期准确度为75.0%,N2分期准确度为71.43%,N3分期准确度为85.71%,与病理诊断一致性较好(κ=0.722)。ADCmin值评估胃周淋巴结转移的ROC曲线下面积为0.796,ADCmin值取最佳阈值1.129×10^(-3)mm^(2)/s时,其敏感度为86.8%,特异度为77.4%。结论3.0T磁共振成像对胃癌患者术前T、N分期的诊断准确率较高,与病理诊断的一致性好,值得临床推广。

7T超高场磁共振颅内血管壁成像在缺血性脑卒中病因分型中的研究进展

缺血性脑卒中的病因分型对临床治疗决策和预后判断有重要价值。近年来,随着高分辨率磁共振血管壁成像(high-resolution vessel wall magnetic resonance imaging,HR-VW-MRI)在脑卒中临床研究和实践中的应用增加,7 T MRI以其更高信噪比和更优图像质量,可发现脑血管早期、细微的病理变化,为深入了解各种脑血管疾病的病理机制提供了新思路。然而,超高场强也存在B1场不均、扫描时间长等技术挑战。本文就7 T HR-VW-MRI在缺血性卒中病因分型及临床应用中的进展进行综述,深入分析7 T HR-VW-MRI在提升临床诊断精确性与指导临床治疗中的潜在价值,为临床实践与科研探索提供参考。

飞利浦Ingenia 3.0 T磁共振成像仪射频系统故障三例

磁共振成像无电离辐射且软组织成像效果较好,已成为常规体检和疾病诊断非常重要的医学影像诊疗技术之一。磁共振设备结构复杂,维修及维护成本较高,长期高负荷的运转会导致磁共振设备故障率增加。本文总结了本院飞利浦Ingenia 3.0 T磁共振设备射频系统故障三例,包括de-tuned印刷电路板故障、射频放大器故障及体线圈故障。文中对三例飞利浦磁共振设备射频系统故障的表现进行了描述,对故障产生的原因进行了分析并介绍了故障排除过程,包括观察外观、提取后台日志参数、测量疑似受损部件指标、更换受损部件以及系统测试。通过深入分析射频系统故障案例,分享维修经验,以期提高设备使用率。

肝硬化结节及小肝癌患者3.0T MRI检查结果分析

目的评价3.0 T MRI检查在肝硬化再生性结节(RN)、异型增生性结节(DN)和小肝癌(SHCC)诊断和鉴别诊断中价值。方法回顾性分析经病理检查确诊的69例RN、DN及SHCC患者的3.0 T MRI平扫及容积采集技术(LAVA)三期动态增强扫描特点。结果 RN主要表现为T2WI低信号,动态增强方式呈"缓慢上升型";DN主要表现为T2WI高、低信号,信号较均匀结节的动态方式以"速升缓降型"为主,可有"结中结"(特征表现);SHCC主要表现为T1WI低信号、T2WI高信号,动态增强方式为"速升速降型"。结论肝硬化结节及小肝癌在3.0 T MRI上各有较为典型的表现,临床可据此进行诊断与鉴别诊断;对其他强化类型的肝脏病灶应结合肿瘤血管的扭曲增粗及包膜等表现排除SHCC。

3.0T MRI多b值弥散加权成像诊断膀胱癌的临床研究

目的探讨3.0T核磁共振(MRI)多b值弥散加权成像(DWI)在膀胱癌诊断中的临床价值。方法选择我院86例膀胱癌患者进行3.0T MRI多b值弥散加权成像,比较在T分期中的价值、准确性、特异度、敏感度以及膀胱癌患者弥散加权成像在不同b值下的平均弥散系数(ADC)值及肿瘤、正常膀胱壁的信号噪声比(SNR)与断层图像的增强噪声比(CNR)。结果 3.0T MRI多b值弥散加权成像诊断出T1、T2a、T2b、T3以及T4期分别有25(75.76%)、21(95.45%)、10(83.33%)、11(100%)与7(87.50%),3.0T MRI多b值弥散加权成像在诊断T分期方面准确率较高;3.0T MRI多b值弥散加权成像诊断对膀胱癌良恶性的准确度为92.56%,特异度为86.67%,敏感度为100%;膀胱癌病变区的SNRC与正常膀胱壁的SNRB平均值随着b值得增加而降低,比较有统计学意义(P<0.05);膀胱癌病变区的CNRCB与正常膀胱壁的CNRCU平均值随着b值得增加而升高,比较也有统计学意义(P<0.05);病变区ADC值随b值得增加有小幅降低,但是比较无统计学意义(P>0.05)。结论 3.0T MRI多b值弥散加权成像诊断对于T分期准确率较高,当b取1500时更有利于T分期诊断,并且3.0T MRI多b值弥散加权成像诊断有较高的准确度、特异性以及敏感度,值得在临床上推广。

磁共振多序列成像在结肠癌T分期中的诊断性能探究

目的探讨磁共振多序列成像(magnetic resonance imaging,MRI)在结肠癌(colon cancer,CC)T分期的诊断性能。方法回顾性收集河南大学淮河医院于2022年1月至2022年12月收治的结肠癌患者32例。所有结肠癌患者术前均接受MRI检查。依次使用T2加权成像快速自旋回波序列(T2 weighted imaging,T2WI)快速自旋回波序列(冠状面、轴面、矢状面)、扩散加权成像序列(diffusion weighted imaging,DWI)序列(轴面)及对比增强T1加权成像(T1 weighted imaging,T1WI)序列(冠状面)完成对全腹部和肝脏的扫描。分别对肿瘤的位置、肠壁浸润深度及是否侵犯浆膜层进行记录,并与术后病理结果进行比较。采用受试者工作(receiver operating characteristic,ROC)曲线分析MRI中T2WI序列、对比增强T1WI序列对术前CC患者T分期的诊断效能。结果MRI中T2WI序列对结肠癌患者T分期的准确性、敏感性、特异性分别为81.25%,84.21%,66.67%。此外,MRI中增强T1WI序列的准确性、敏感性、特异性分别为93.75%,94.12%,75%。结论MRI是结肠癌患者术前T分期检测的一种潜在的和有价值的影像学方法,且T1WI具有更高的诊断价值。

3.0T高分辨MRI在直肠癌术前精细分期的评估价值

目的探讨3.0T高分辨MRI对直肠癌术前精细分期(T分期、N分期,环周切缘)评估的准确性,为直肠癌的个体化治疗提供准确的影像学依据。方法回顾性分析109例经病理活检确诊的直肠癌患者。MRI评估肿瘤的大小和肿瘤邻近的结构,评估T分期、N分期、CRM的情况,与手术后病理结果对照。结果在109例患者中,MRI对直肠系膜和直肠系膜筋膜显示清晰,能够显示腹膜返折,对T分期的评估,MRI正确分期102例,总准确性为93.58%(102/109)。MRI错误分期7例,包括过低分期3例,过高分期4例。MRI和病理对T分期的一致性检验,Kappa值=0.873,P=0.000,显示两种诊断方法具有较高一致性。对N分期的评估,MRI正确分期92例,N分期总的准确性为84.40%(92/109),11例过高分期,6例过低分期。对环周切缘的评估,MRI评估CRM受累10例,未受累99例。和DFS相符合率为94.50%(103/109)。结论 3.0T高分辨MRI能够清晰显示直肠系膜和直肠系膜筋膜的结构,对直肠癌术前分期的准确性较好,MRI能够为直肠癌的个体化治疗提供准确的影像学依据。

基于颗粒酶B启动子的磁共振报告基因成像监测CAR-T细胞激活状态

目的利用颗粒酶B(granzyme B,GB)启动子控制铁蛋白(ferritin heavy chain,FTH1)报告基因表达,探讨通过磁共振成像(magnetic resonance imaging,MRI)监测嵌合抗原受体T细胞(chimeric antigen receptor T cells,CAR-T细胞)激活状态的可行性。方法通过Ficoll密度梯度离心法以及流式分选得到细胞毒性T淋巴细胞(cytotoxic T lymphocytes,CTLs)。将GB启动子和FTH1基因连接,连同二唾液酸神经节苷脂(disialoganglioside 2,GD2)嵌合抗原受体(chimeric antigen receptor,CAR)以慢病毒为载体转入CTLs,构建GD2-CAR-T/pGB-FTH1细胞,以GD2-CAR-T/pCMV-FTH1、GD2-CAR-T和T细胞为对照。CytoTox96@非放射性细胞毒性检测各组细胞与人神经母细胞瘤细胞(SK-N-SH)共培养后的杀伤效果,ELISA检测共孵育因子以及GB分泌量,Western blot、普鲁士蓝染色、细胞MRI检测共培养后FTH1基因的表达。结果成功获得CTLs并构建GD2-CAR-T/pGB-FTH1、GD2-CAR-T/pCMV-FTH1、GD2-CAR-T细胞,3组细胞对肿瘤细胞杀伤效果、共孵育因子以及GB分泌量均显著高于T细胞组,GB表达水平在与SK-N-SH细胞共培养后1 d最高,3 d和7 d依次降低。GD2-CAR-T/pGB-FTH1组FTH1相对表达量以及铁含量变化趋势与GB表达一致,MRI信号呈逐渐升高趋势。GD2-CAR-T/pCMV-FTH1组FTH1相对表达量、铁含量及MRI信号在各时间点均无显著差异。GD2-CAR-T和T细胞组无明显FTH1表达及聚铁效应。结论基于GB启动子的MRI报告基因成像可实时反映CAR-T细胞的GB表达水平和肿瘤杀伤作用,为CAR-T治疗提供了一种监测细胞激活状态的可视化手段。