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.

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.

Discrimination of Metastatic from Non-metastatic Mesorectal Lymph Nodes in Rectal Cancer Using Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging

Preoperative detection of lymph nodes（LNs） metastasis is always highly challenging for radiologists nowadays. The utility of quantitative dynamic contrast-enhanced magnetic resonance imaging（QDCE-MRI） in identifying LNs metastasis is not well understood. In the present study, 59 patients with histologically proven rectal carcinoma underwent preoperative QDCE-MRI. The short axis diameter ratio, long axis diameter ratio, short-to-long axis diameter ratio and QDEC-MRI parameters（Ktrans, Kep, fPV and Ve） values were compared between the non-metastatic（n=44） and metastatic（n=35） LNs groups based on pathological examination. Compared with the non-metastatic group, the metastatic group exhibited significantly higher short axis diameter（7.558±0.668 mm vs. 5.427±0.285 mm）, Ktrans（0.483±0.198 min-1 vs. 0.218±0.116 min^-1） and Ve（0.399±0.118 vs. 0.203±0.096） values（all P〈0.05）. The short-to-long axis diameter ratio, long axis diameter ratio, Kep and fPV values did not show significant differences between the two groups. In conclusion, our results showed that for LNs larger than 5 mm in rectal cancer, there are distinctive differences in the Ktrans and Ve values between the metastatic and non-metastatic LNs, suggesting that QDCE-MRI may be potentially helpful in identifying LNs status.

Dual-input two-compartment pharmacokinetic model of dynamic contrast-enhanced magnetic resonance imaging in hepatocellular carcinoma

AIM: To investigate the feasibility of a dual-input two-compartment tracer kinetic model for evaluating tumorous microvascular properties in advanced hepatocellular carcinoma(HCC). METHODS: From January 2014 to April 2015, we prospectively measured and analyzed pharmacokinetic parameters [transfer constant(K_(trans)), plasma flow(F_p), permeability surface area product(PS), efflux rate constant(k_(ep)), extravascular extracellular space volume ratio(V_e), blood plasma volume ratio(V_p), and hepatic perfusion index(HPI)] using dual-input two-compartment tracer kinetic models [a dual-input extended Tofts model and a dual-input 2-compartment exchange model(2CXM)] in 28 consecutive HCC patients. A well-known consensus that HCC is a hypervascular tumor supplied by the hepatic artery and the portal vein was used as a reference standard. A paired Student's t-test and a nonparametric paired Wilcoxon rank sum test were used to compare the equivalent pharmacokinetic parameters derived from the two models, and Pearson correlation analysis was also applied to observe the correlations among all equivalent parameters. The tumor size and pharmacokinetic parameters were tested by Pearson correlation analysis, while correlations among stage, tumor size and all pharmacokinetic parameters were assessed by Spearman correlation analysis. RESULTS: The F_p value was greater than the PS value(F_P = 1.07 m L/m L per minute, PS = 0.19 m L/m L per minute) in the dual-input 2CXM; HPI was 0.66 and 0.63 in the dual-input extended Tofts model and the dualinput 2CXM, respectively. There were no significant differences in the K_(ep), V_p, or HPI between the dual-input extended Tofts model and the dual-input 2CXM(P = 0.524, 0.569, and 0.622, respectively). All equivalent pharmacokinetic parameters, except for V_e, were correlated in the two dual-input two-compartment pharmacokinetic models; both Fp and PS in the dualinput 2CXM were correlated with K_(trans) derived from the dual-input extended Tofts model(P = 0.002, r = 0.566; P = 0.002, r = 0.570); K_(ep), V_p, and HPI between the two kinetic models were positively correlated(P = 0.001, r = 0.594; P = 0.0001, r = 0.686; P = 0.04, r = 0.391, respectively). In the dual input extended Tofts model, V_e was significantly less than that in the dual input 2CXM(P = 0.004), and no significant correlation was seen between the two tracer kinetic models(P = 0.156, r = 0.276). Neither tumor size nor tumor stage was significantly correlated with any of the pharmacokinetic parameters obtained from the two models(P > 0.05).CONCLUSION: A dual-input two-compartment pharmacokinetic model(a dual-input extended Tofts model and a dual-input 2CXM) can be used in assessing the microvascular physiopathological properties before the treatment of advanced HCC. The dual-input extended Tofts model may be more stable in measuring the V_e; however, the dual-input 2CXM may be more detailed and accurate in measuring microvascular permeability.

Texture analysis on parametric maps derived from dynamic contrast-enhanced magnetic resonance imaging in head and neck cancer

AIM: To investigate the merits of texture analysis on parametric maps derived from pharmacokinetic modeling with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) as imaging biomarkers for the prediction of treatment response in patients with head and neck squamous cell carcinoma(HNSCC). METHODS: In this retrospective study,19 HNSCC patients underwent pre- and intra-treatment DCEMRI scans at a 1.5T MRI scanner. All patients had chemo-radiation treatment. Pharmacokinetic modeling was performed on the acquired DCE-MRI images,generating maps of volume transfer rate(Ktrans) and volume fraction of the extravascular extracellular space(ve). Image texture analysis was then employed on maps of Ktrans and ve,generating two texture measures: Energy(E) and homogeneity.RESULTS: No significant changes were found for the mean and standard deviation for Ktrans and ve between pre- and intra-treatment(P > 0.09). Texture analysis revealed that the imaging biomarker E of ve was significantly higher in intra-treatment scans,relative to pretreatment scans(P < 0.04). CONCLUSION: Chemo-radiation treatment in HNSCC significantly reduces the heterogeneity of tumors.

Dynamic contrast-enhanced magnetic resonance imaging of prostate cancer: A review of current methods and applications

In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusion characteristics. Tumor angiogenesis is an essential process for tumor growth, proliferation, and metastasis. Malignant lesions demonstrate rapid extravasation of contrast from the intravascular space to the capillary bed due to leaky capillaries associated with tumor neovascularity. DCE-MRI has the potential to provide information regarding blood flow, areas of hypoperfusion, and variations in endothelial permeability and microvessel density to aid treatment selection, enable frequent monitoring during treatment and assess response to targeted therapy following treatment. This review will discuss the current status of DCE-MRI in cancer imaging, with a focus on its use in imaging prostate malignancies as well as weaknesses that limit its widespread clinical use. The latest techniques for quantification of DCE-MRI parameters will be reviewed and compared.

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.

Role of pulmonary perfusion magnetic resonance imaging for the diagnosis of pulmonary hypertension:A review

Among five types of pulmonary hypertension,chronic thromboembolic pulmonary hypertension(CTEPH)is the only curable form,but prompt and accurate diagnosis can be challenging.Computed tomography and nuclear medicine-based techniques are standard imaging modalities to non-invasively diagnose CTEPH,however these are limited by radiation exposure,subjective qualitative bias,and lack of cardiac functional assessment.This review aims to assess the methodology,diagnostic accuracy of pulmonary perfusion imaging in the current literature and discuss its advantages,limitations and future research scope.

Quantitative parameters of dynamic contrast-enhanced magnetic resonance imaging of hepatic benign and malignant lesions and their clinical value

Objective:To determine the quantitative parameter levels of dynamic contrast-enhanced magnetic resonance imaging (MRI) of hepatic benign and malignant lesions and to explore their value for the evaluation of the disease.Methods: A total of 67 patients with primary liver cancer and 78 patients with hepatic benign lesion were selected as the liver cancer group and hepatic benign lesion group respectively. The preoperative quantitative parameter levels of dynamic contrast-enhanced MRI of the two groups were measured, and the correlation of the specific parameter levels with liver cancer-related proliferation and invasion gene expression was evaluated.Results: The mean time to enhance (MET) and maximum slope of increase (MSI) levels of the liver cancer group were lower than those of the hepatic benign lesion group while the maximum slope of decrease (MSD) level was higher than that of the hepatic benign lesion group. Proliferation genes PRMT5, CDCA5, SIRT2, XIAP and Cep55 mRNA expression in the lesion tissues of the liver cancer group were all higher than those of the hepatic benign lesion group;invasion genes Cripto-1 and IFITM3 mRNA expression were higher than those of the hepatic benign lesion group while KLF4 and HOXA9 mRNA expression were lower than those of the hepatic benign lesion group. Pearson test showed that the quantitative parameters MET, MSI and MSD levels of dynamic contrast-enhanced MRI in liver cancer tissues were directly correlated with the proliferation and invasion activity of cancer cells.Conclusion: The quantitative parameters MET, MSI and MSD levels of dynamic contrast-enhanced MRI of liver cancer are significantly abnormal, and the specific levels could objectively reflect the tumor malignancy.

Breast dynamic contrast-enhanced-magnetic resonance imaging and radiomics:State of art

Breast cancer represents the most common malignancy in women,being one of the most frequent cause of cancer-related mortality.Ultrasound,mammography,and magnetic resonance imaging(MRI)play a pivotal role in the diagnosis of breast lesions,with different levels of accuracy.Particularly,dynamic contrastenhanced MRI has shown high diagnostic value in detecting multifocal,multicentric,or contralateral breast cancers.Radiomics is emerging as a promising tool for quantitative tumor evaluation,allowing the extraction of additional quantitative data from radiological imaging acquired with different modalities.Radiomics analysis may provide novel information through the quantification of lesions heterogeneity,that may be relevant in clinical practice for the characterization of breast lesions,prediction of tumor response to systemic therapies and evaluation of prognosis in patients with breast cancers.Several published studies have explored the value of radiomics with good-to-excellent diagnostic and prognostic performances for the evaluation of breast lesions.Particularly,the integrations of radiomics data with other clinical and histopathological parameters have demonstrated to improve the prediction of tumor aggressiveness with high accuracy and provided precise models that will help to guide clinical decisions and patients management.The purpose of this article in to describe the current application of radiomics in breast dynamic contrast-enhanced MRI.

Perfusion magnetic resonance imaging of the liver

Perfusion magnetic resonance imaging (MRI) studies quantify the microcirculatory status of liver parenchyma and liver lesions, and can be used for the detection of liver metastases, assessing the effectiveness of antiangiogenic therapy, evaluating tumor viability after anticancer therapy or ablation, and diagnosis of liver cirrhosis and its severity. In this review, we discuss the basic concepts of perfusion MRI using tracer kinetic modeling, the common kinetic models applied for analyses, the MR scanning techniques, methods of data processing, and evidence that supports its use from published clinical and research studies. Technical standardization and further studies will help to establish and validate perfusion MRI as a clinical imaging modality.

Intraoperative perfusion magnetic resonance imaging: Cutting-edge improvement in neurosurgical procedures

The goal in brain tumor surgery is to remove the maxi-mum achievable amount of the tumor, preventing damage to "eloquent" brain regions as the amount of brain tumor resection is one of the prognostic factors for time to tumor progression and median survival. To achieve this goal, a variety of technical advances have been in-troduced, including an operating microscope in the late 1950 s, computer-assisted devices for surgical navigation and more recently, intraoperative imaging to incorporate and correct for brain shift during the resection of the lesion. However, surgically induced contrast enhancement along the rim of the resection cavity hampers interpretation of these intraoperatively acquired magnetic resonance images. To overcome this uncertainty, perfusion techniques [dynamic contrast enhanced magnetic resonance imaging(DCE-MRI), dynamic susceptibility contrast magnetic resonance imaging(DSC-MRI)] have been introduced that can differentiate residual tumor from surgically induced changes at the rim of the resec-tion cavity and thus overcome this remaining uncer-tainty of intraoperative MRI in high grade brain tumor resection.

Magnetic resonance imaging of the liver:New imaging strategies for evaluating focal liver lesions

The early detection of focal liver lesions,particularly those which are malignant,is of utmost importance.The resection of liver metastases of some malignancies(including colorectal cancer)has been shown to improve the survival of patients.Exact knowledge of the number,size,and regional distribution of liver metastases is essential to determine their resectability.Almost all focal liver lesions larger than 10 mm are demonstrated with current imaging techniques but the detection of smaller focal liver lesions is still relatively poor.One of the advantages of magnetic resonance imaging(MRI)of the liver is better soft tissue contrast(compared to other radiologic modalities),which allows better detection and characterization of the focal liver lesions in question.Developments in MRI hardware and software and the availability of novel MRI contrast agents have further improved the diagnostic yield of MRI in lesion detection and characterization.Although the primary modalities for liver imaging are ultrasound and computed tomography,recent studies have suggested that MRI is the most sensitive method for detecting small liver metastatic lesions,and MRI is now considered the pre-operative standard method for diagnosis.Two recent developments in MRI sequences for the upper abdomen comprise unenhanced diffusion-weighted imaging(DWI),and keyhole-based dynamic contrast-enhanced(DCE)MRI(4D THRIVE).DWI allows improved detection(b=10 s/mm2)of small(<10 mm)focal liver lesions in particular,and is useful as a road map sequence.Also,using higher b-values,the calculation of the apparent diffusion coefficient value,true diffusion coefficient,D,and the perfusion fraction,f,has been used for the characterization of focal liver lesions.DCE 4D THRIVE enables MRI of the liver with high temporal and spatial resolution and full liver coverage.4D THRIVE improves evaluation of focal liver lesions,providing multiple arterial and venous phases,and allows the calculation of perfusion parameters using pharmacokinetic models.4D THRIVE has potential benefits in terms of detection,characterization and staging of focal liver lesions and in monitoring therapy.

Clinical applications of advanced magnetic resonance imaging techniques for arthritis evaluation

Magnetic resonance imaging(MRI) has allowed a comprehensive evaluation of articular disease, increasing the detection of early cartilage involvement, bone erosions, and edema in soft tissue and bone marrow compared to other imaging techniques. In the era of functional imaging, new advanced MRI sequences are being successfully applied for articular evaluation in cases of inflammatory, infectious, and degenerative arthropathies. Diffusion weighted imaging, new fat suppression techniques such as DIXON, dynamic contrast enhanced-MRI, and specific T2 mapping cartilage sequences allow a better understanding of the physiopathological processes that underlie these different arthropathies. They provide valuable quantitative information that aids in their differentiation and can be used as potential biomarkers of articular disease course and treatment response.

Evaluation of tumor response to antiangiogenic therapy in patients with recurrent gliomas using contrast-enhanced perfusion-weighted magnetic resonance imaging techniques:A meta-analysis

BACKGROUND It is of vital importance to find radiologic biomarkers that can accurately predict treatment response. Usually, the initiation of antiangiogenic therapy causes a rapid decrease in the contrast enhancing tumor. However, the treatment response is observed only in a fraction of patients due to the partial radiological response secondary to stabilization of abnormal vessels which does not essentially indicate a true antitumor effect. Perfusion-weighted magnetic resonance imaging(PWMRI) techniques have shown implicitness as a strong imaging biomarker for gliomas since they give hemodynamic information of blood vessels. Hence, there is a rapid expansion of PW-MRI related studies and clinical applications.AIM To determine the diagnostic performance of PW-MRI techniques including:(A)dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI); and(B)dynamic susceptibility contrast magnetic resonance imaging(DSC-MRI) for evaluating response to antiangiogenic therapy in patients with recurrent gliomas.METHODS Databases such as PubMed(MEDLINE included), EMBASE, and Google Scholar were searched for relevant original articles. The included studies were assessed for methodological quality with the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Medical imaging follow-up or histopathological analysis was used as the reference standard. The data were extracted by two reviewers independently, and then the sensitivity, specificity, summary receiver operating characteristic curve, area under the curve(AUC), and heterogeneity were calculated using Meta-Disc 1.4 software.RESULTS This study analyzed a total of six articles. The overall sensitivity for DCE-MRI and DSC-MRI was 0.69 [95% confidence interval(CI): 0.53-0.82], and the specificity was 0.99(95%CI: 0.93-1) by a random effects model(DerSimonianeeLaird model). The likelihood ratio(LR) +, LR-, and diagnostic odds ratio(DOR)were 12.84(4.54-36.28), 0.35(0.22-0.53), and 24.44(7.19-83.06), respectively. The AUC(± SE) was 0.9921(± 0.0120), and the Q* index(± SE) was 0.9640(± 0.0323).For DSC-MRI, the sensitivity was 0.73, the specificity was 0.98, the LR+ was 7.82,the LR-was 0.32, the DOR was 31.65, the AUC(± SE) was 0.9925(± 0.0132), and the Q* index was 0.9649(± 0.0363). For DCE-MRI, the sensitivity was 0.41, the specificity was 0.97, the LR+ was 5.34, the LR-was 0.71, the DOR was 8.76, the AUC(± SE) was 0.9922(± 0.2218), and the Q* index was 0.8935(± 0.3037).CONCLUSION This meta-analysis demonstrated a beneficial value of PW-MRI(DSC-MRI and DCE-MRI) in monitoring the response of recurrent gliomas to antiangiogenic therapy, with reasonable sensitivity, specificity, +LR, and-LR.

Advanced magnetic resonance imaging findings in salivary gland tumors

Salivary gland tumors(SGTs)make up a small portion(approximately 5%)of all head and neck tumors.Most of them are located in the parotid glands,while they are less frequently located in the submandibular glands,minor salivary glands or sublingual gland.The incidence of malignant or benign tumors(BTs)in the salivary glands varies according to the salivary gland from which they originate.While most of those detected in the parotid gland tend to be benign,the incidence of malignancy increases in other glands.The use of magnetic resonance imaging(MRI)in the diagnosis of SGTs is increasing every day.While conventional sequences provide sufficient data on the presence,localization,extent and number of the tumor,they are insufficient for tumor specification.With the widespread use of advanced techniques such as diffusion-weighted imaging,semiquantitative and quantitative perfusion MRI,studies and data have been published on the differentiation of malignant or BTs and the specificity of their subtypes.With diffusion MRI,differentiation can be made by utilizing the cellularity and microstructural properties of tumors.For example,SGTs such as high cellular Warthin’s tumor(WT)or lymphoma on diffusion MRI have been reported to have significantly lower apparent diffusion values than other tumors.Contrast agent uptake and wash-out levels of tumors can be detected with semiquantitative perfusion MRI.For example,it is reported that almost all of the pleomorphic adenomas show an increasing enhancement time intensity curve and do not wash-out.On quantitative perfusion MRI studies using perfusion parameters such as Ktrans,Kep,and Ve,it is reported that WTs can show higher Kep and lower Ve values than other tumors.In this study,the contribution of advanced MRI to the diagnosis and differential diagnosis of SGTs will be reviewed.

Pancreatic carcinoma coexisting with chronic pancreatitis versus tumor-forming pancreatitis:Diagnostic utility of the time-signal intensity curve from dynamic contrast-enhanced MR imaging

AIM: To evaluate the ability of the time-signal intensity curve (TIC) of the pancreas obtained from dynamic contrast-enhanced magnetic resonance imaging (MRI) for differentiation of focal pancreatic masses, especially pancreatic carcinoma coexisting with chronic pancreatitis and tumor-forming pancreatitis. METHODS: Forty-eight consecutive patients who underwent surgery for a focal pancreatic mass, including pancreatic ductal carcinoma (n = 33), tumor-forming pancreatitis (n = 8), and islet cell tumor (n = 7), were reviewed. Five pancreatic carcinomas coexisted with longstanding chronic pancreatitis. The pancreatic TICs were obtained from the pancreatic mass and the pancreatic parenchyma both proximal and distal to the mass lesion in each patient, prior to surgery, and were classified into 4 types according to the time to a peak: 25 s and 1, 2, and 3 min after the bolus injection of contrast material, namely, type-Ⅰ, Ⅱ, Ⅲ, and Ⅳ, respectively, and were then compared to the corresponding histological pancreatic conditions. RESULTS: Pancreatic carcinomas demonstrated type-Ⅲ (n = 13) or Ⅳ (n = 20) TIC. Tumor-forming pancreatitis showed type-Ⅱ (n = 5) or Ⅲ (n = 3) TIC. All islet cell tumors revealed type-Ⅰ. The type-Ⅳ TIC was only recognized in pancreatic carcinoma, and the TIC of carcinoma always depicted the slowest rise to a peak among the 3 pancreatic TICs measured in each patient, even in patients with chronic pancreatitis.CONCLUSION: Pancreatic TIC from dynamic MRI provides reliable information for distinguishing pancreatic carcinoma from other pancreatic masses, and may enable us to avoid unnecessary pancreatic surgery and delays in making a correct diagnosis of pancreatic carcinoma, especially, in patients with longstanding chronic pancreatitis.

DCE-MRI和IVIM-DWI评估直肠癌微血管含量的比较研究

目的:探讨动态对比增强磁共振成像(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)和体素内不相干运动弥散加权成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)在评估直肠癌微血管含量中的差异。方法:研究2019年12月—2022年12月上海中医药大学附属曙光医院经病理学检查诊断为直肠腺癌并行IVIMDWI和DCE-MRI扫描的患者23例。Tofts模型计算DCE-MRI参数为容积分数(volume fraction,V_(e))、容量转移常数(space transport coefficient,K^(trans))和速率常数(rate constant,K_(ep))。IVIM-DWI参数:单纯弥散系数(simple diffusion coefficient,D),灌注相关弥散系数(perfusion related diffusion coefficient,D^(*)),灌注分数(perfusion fraction,f),通过计算双指数模型得到。对与直肠癌微血管含量相关的DCE-MRI和IVIM-DWI定量参数进行分析比较。结果:不同病理学分级的直肠癌K^(trans)和D差异有统计学意义(F=9.159,P=0.002;F=5.106,P=0.016)。在评估直肠癌病理学分级时,K^(trans)优于D。灌注参数K^(trans),K_(ep)和D^(*)与直肠癌微血管含量呈显著正相关(r=0.734,P<0.001;r=0.617,P=0.002;r=0.456,P=0.029)。其中DCE-MRI定量参数评估直肠癌微血管含量优于IVIM-DWI定量参数。结论:与IVIM-DWI相比,DCE-MRI评价直肠癌分化程度和微循状态方面效能更佳。但是考虑到IVIM-DWI不需要注射对比剂,IVIM-DWI仍然可以被推荐用于直肠癌分化程度和微循环状态。

超声造影与DCE-MRI对乳腺癌患者新辅助化疗的评估价值

目的探究超声造影(CEUS)与动态增强磁共振成像(DCE-MRI)对乳腺癌患者新辅助化疗(NAC)的评估价值。方法选取2020年1月~2023年1月于我院接受NAC的乳腺癌患者68例,对所有入选患者NAC治疗后行CEUS、DCE-MRI检查,以手术病理结果为金标准,将治疗后患者分为有效组与无效组,比较CEUS、DCE-MRI以及两者联合对乳腺癌患者NAC疗效的评估价值,对比有效组与无效组CEUS、DCEMRI检查的参数水平。结果68例乳腺癌患者NAC后,经手术病理诊断发现49例有效,19例无效。采用CEUS检查评估NAC疗效的敏感性、特异性及准确性分别为81.63%、68.42%、67.65%,经手术病理评估为有效患者的峰值强度(PI)、曲线下面积(AUC)水平低于无效患者(P<0.05);采用DCE-MRI检查时的敏感性、特异性及准确性分别为83.67%、73.68%、67.65%,经手术病理评估为有效患者的容量转移常数(K^(trans))、速率常数(K_(ep))均低于无效患者(P<0.05)。CEUS联合DCE-MRI评估NAC疗效的敏感性及准确性分别为97.96%、94.83%,均显著高于单一检查方法(P<0.05)。结论CEUS联合DCE-MRI能提高对乳腺癌患者NAC疗效的评估价值,其敏感性及准确性较高,值得推广。

DCE-MRI参数联合血清PSA水平对前列腺癌分化程度的鉴别价值

目的分析动态增强磁共振成像(DCE-MRI)参数联合血清前列腺特异性抗原(PSA)水平对前列腺癌分化程度的鉴别价值。方法回顾性分析2020年3月至2023年1月安阳市人民医院收治的148例前列腺癌患者的临床资料,患者均在治疗前行DCE-MRI检查及血清PSA水平检测。根据Gleason评分将前列腺癌患者分为低分化组(评分≥8分)和中高分化组(评分<8分),比较两组患者DCE-MRI参数[速率常数(K_(ep))、转运常数(K^(trans))、血管外细胞外容积分数(V_(e))]和血清PSA水平,并采用受试者工作特征(ROC)曲线分析DCE-MRI参数联合血清PSA水平对前列腺癌分化程度的鉴别价值。结果低分化组K_(ep)、K^(trans)及V_(e)和血清PSA水平均高于中高分化组(P<0.05);DCE-MRI参数联合鉴别的灵敏度、特异度、曲线下面积(AUC)分别为85.00%、67.05%、0.793;DCE-MRI参数和血清PSA水平联合鉴别的灵敏度、特异度、AUC分别为80.00%、88.64%、0.872。结论低分化前列腺癌相较于中高分化前列腺癌K_(ep)、K^(trans)、V_(e)和血清PSA水平更高,且上述指标联合鉴别效能良好,可在临床推广使用。