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...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.展开更多
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 occurr...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.展开更多
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） ...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.展开更多
目的研究体素内不相干运动DWI(IVIMDWI)联合动态增强MRI(DCE-MRI)定量参数在克罗恩病(CD)活动性评估中的价值,并与基于磁共振肠造影(MRE)的活动性分级比较,讨论两者鉴别CD活动性的效能差异。方法回顾性收集CD患者96例,所有患者均接受常...目的研究体素内不相干运动DWI(IVIMDWI)联合动态增强MRI(DCE-MRI)定量参数在克罗恩病(CD)活动性评估中的价值,并与基于磁共振肠造影(MRE)的活动性分级比较,讨论两者鉴别CD活动性的效能差异。方法回顾性收集CD患者96例,所有患者均接受常规MRE、IVIM-DWI和DCE-MRI扫描。于病变最显著区测量功能MRI定量参数;依据临床活动性评分(HBI)分为缓解组、轻中度活动组和重度活动组,比较MRE活动性分级及功能MRI定量参数的组间差异,对组间具有统计学意义的IVIM-DWI和DCE-MRI定量参数进一步行多元有序Logistic回归分析,采用ROC曲线比较MRE活动性分级和功能MRI定量参数鉴别CD活动性的诊断效能。结果随病情加重,MRE活动性分级提高(P<0.001);ADC_(fast)升高(P<0.001),Fraction of ADC_(fast)降低(P=0.001);K^(trans)和K_(ep)升高(P<0.001、P=0.005)。有序Logistic回归显示K^(trans)和ADC_(fast)是鉴别CD活动性的独立预测因子。ROC曲线分析显示功能MRI组合定量参数(K^(trans)+ADC_(fast))(AUC=0.871)鉴别缓解组和活动组的诊断效能优于MRE活动性分级(AUC=0.744)(P=0.027)。结论功能MRI模型在鉴别CD活动性方面比MRE活动性分级具有更好的诊断效能。展开更多
目的 探讨动态增强磁共振成像(Dynamic Contrast-Enhanced MRI,DCE-MRI)定量参数在子宫肌瘤患者下腹部皮下脂肪微循环特点研究中的应用价值。方法 收集71例接受高强度聚焦超声治疗的子宫肌瘤患者的术前DCE-MRI图像,采用盆腔轴位动态增强...目的 探讨动态增强磁共振成像(Dynamic Contrast-Enhanced MRI,DCE-MRI)定量参数在子宫肌瘤患者下腹部皮下脂肪微循环特点研究中的应用价值。方法 收集71例接受高强度聚焦超声治疗的子宫肌瘤患者的术前DCE-MRI图像,采用盆腔轴位动态增强LAVA序列进行感兴趣区(Region of Interest,ROI)勾画,取轴位上两侧髂结节所作结节间平面为初始层面进行测量,共测量3个平面,于各层面左右两侧分别进行测量,每例患者均测量18个ROI,计算各ROI皮下脂肪定量参数:容积转运常数(Volume Transfer Constant,Ktrans)、速率常数(Rate Constant,Kep)、血管外细胞外间隙容积分数(Extravascular Extracellular Space Volume Fraction Per Unit of Tissue Volume,Ve)以及血浆容积指数(Blood Plasma Volume Per Unit Volume of Tissue,Vp)。结果 每一层各点的Ktrans、Kep、Ve值差异有统计学意义(P<0.05),且均表现为:点1>点2>点3,两点间差异有统计学意义(P<0.05);L1、L2层的Vp值差异有统计学意义(P<0.05),R1~R3及L3层Vp值差异均无统计学意义。结论 DEC-MRI可以通过定量参数量化皮下脂肪微循环的情况,不同位置皮下脂肪微循环情况有差异,各层靠近腹部中心区域的微循环较外周区域丰富。展开更多
基金supported by the Jiangsu Province Natural Science Foundation (No. BK20161291)the Nantong Science Foundation of China (No. MS2201507)the Nantong Municipal Commission of Health and Family Planning Young Fund (No. WQ2014047)
文摘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.
文摘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.
基金supported by Beijing Natural Science Foundation(No.7122029)
文摘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.
文摘目的研究体素内不相干运动DWI(IVIMDWI)联合动态增强MRI(DCE-MRI)定量参数在克罗恩病(CD)活动性评估中的价值,并与基于磁共振肠造影(MRE)的活动性分级比较,讨论两者鉴别CD活动性的效能差异。方法回顾性收集CD患者96例,所有患者均接受常规MRE、IVIM-DWI和DCE-MRI扫描。于病变最显著区测量功能MRI定量参数;依据临床活动性评分(HBI)分为缓解组、轻中度活动组和重度活动组,比较MRE活动性分级及功能MRI定量参数的组间差异,对组间具有统计学意义的IVIM-DWI和DCE-MRI定量参数进一步行多元有序Logistic回归分析,采用ROC曲线比较MRE活动性分级和功能MRI定量参数鉴别CD活动性的诊断效能。结果随病情加重,MRE活动性分级提高(P<0.001);ADC_(fast)升高(P<0.001),Fraction of ADC_(fast)降低(P=0.001);K^(trans)和K_(ep)升高(P<0.001、P=0.005)。有序Logistic回归显示K^(trans)和ADC_(fast)是鉴别CD活动性的独立预测因子。ROC曲线分析显示功能MRI组合定量参数(K^(trans)+ADC_(fast))(AUC=0.871)鉴别缓解组和活动组的诊断效能优于MRE活动性分级(AUC=0.744)(P=0.027)。结论功能MRI模型在鉴别CD活动性方面比MRE活动性分级具有更好的诊断效能。
文摘目的 探讨动态增强磁共振成像(Dynamic Contrast-Enhanced MRI,DCE-MRI)定量参数在子宫肌瘤患者下腹部皮下脂肪微循环特点研究中的应用价值。方法 收集71例接受高强度聚焦超声治疗的子宫肌瘤患者的术前DCE-MRI图像,采用盆腔轴位动态增强LAVA序列进行感兴趣区(Region of Interest,ROI)勾画,取轴位上两侧髂结节所作结节间平面为初始层面进行测量,共测量3个平面,于各层面左右两侧分别进行测量,每例患者均测量18个ROI,计算各ROI皮下脂肪定量参数:容积转运常数(Volume Transfer Constant,Ktrans)、速率常数(Rate Constant,Kep)、血管外细胞外间隙容积分数(Extravascular Extracellular Space Volume Fraction Per Unit of Tissue Volume,Ve)以及血浆容积指数(Blood Plasma Volume Per Unit Volume of Tissue,Vp)。结果 每一层各点的Ktrans、Kep、Ve值差异有统计学意义(P<0.05),且均表现为:点1>点2>点3,两点间差异有统计学意义(P<0.05);L1、L2层的Vp值差异有统计学意义(P<0.05),R1~R3及L3层Vp值差异均无统计学意义。结论 DEC-MRI可以通过定量参数量化皮下脂肪微循环的情况,不同位置皮下脂肪微循环情况有差异,各层靠近腹部中心区域的微循环较外周区域丰富。
