Reactive lymphoid hyperplasia of the liver:Perinodular enhancement on contrast-enhanced computed tomography and magnetic resonance imaging

We report the case of a 69-year-old woman with reactive lymphoid hyperplasia(RLH) of the liver.She underwent partial hepatectomy under a preoperative diagnosis of hepatocellular carcinoma; however,histopathological analysis revealed RLH.The liver nodule showed the imaging feature of perinodular enhancement in the arterial dominant phase on contrast-enhanced computed tomography and magnetic resonance imaging,which could be a useful clue for identifying RLH in the liver.Histologically,the perinodular enhancement was compatible with prominent sinusoidal dilatation surrounding the liver nodule.

基于动态增强MRI瘤内和瘤周的影像组学模型在预测三阴性乳腺癌的诊断价值

目的探讨基于动态增强磁共振(DCE-MRI)瘤内和最佳瘤周区域影像组学模型来预测三阴性乳腺癌(TNBC)。方法回顾性分析东部战区总医院2017年6月至2022年5月入院治疗并行手术病理证实的232例乳腺癌患者。采用随机抽样的方法按照8∶2比例分为训练集(n=185)和测试集(n=47)。所有患者均行乳腺DCE-MRI检查,在DCE-MRI序列上手动逐层勾画感兴趣区(ROI),瘤周区域分别等距外扩。线性相关阈值和方差分析用于特征筛选,联合逻辑回归(LR)的机器学习方法构建影像组学模型。融合模型由瘤内及最佳瘤周影像组学特征共同组成。采用受试者工作特性曲线(ROC)来评价各模型的诊断性能,Delong检验来比较各模型预测性能。结果瘤内模型的训练集和测试集的ROC曲线下面积(AUC)分别为0.833、0.768。瘤周特征建模以瘤周6 mm范围结果最佳,在训练集和测试集AUC分别为0.814、0.790。瘤内和瘤周的融合模型的预测效能最佳,在训练集和测试集AUC分别为0.924、0.881。结论基于乳腺DCE-MRI瘤内和瘤周的融合影像组学模型可以很好的预测三阴性乳腺癌。

Diffusion-weighted imaging might be useful for reactive lymphoid hyperplasia diagnosis of the liver: A case report

BACKGROUND Reactive lymphoid hyperplasia(RLH)of the liver is a rare liver lesion.It is considered difficult to differentiate radiologically from hepatocellular carcinoma,metastatic liver tumor and other pathologies.CASE SUMMARY A 54-year-old woman presented to our hospital with RLH of the liver.The patient had a diagnosis of metastatic carcinoma of the liver from an unknown origin and subsequently underwent partial hepatectomy.However,histopathological analysis revealed RLH.The lesion showed perinodular enhancement in the arterial phase on contrast-enhanced computed tomography and magnetic resonance imaging.On diffusion-weighted imaging(DWI),we encountered linear hyperintensity along the portal tract consecutive to the liver lesion,which is a new characteristic radiologic finding.This finding corresponded to the lymphoid cell infiltration of the portal tract.Furthermore,there was strongly restricted diffusion on the apparent diffusion coefficient map.We used these characteristic radiologic findings to diagnose the lesion as a lymphoproliferative disease.CONCLUSION The linear hyperintensity consecutive to the liver lesion on DWI provided additional valuable diagnostic information.

动态增强MRI瘤内与瘤周影像组学特征对三阴性乳腺癌的诊断价值研究

目的探讨乳腺动态增强MRI(DCE-MRI)瘤内与瘤周影像组学特征对三阴性乳腺癌(TNBC)的诊断价值。方法选取2012年12月至2017年5月在浙江中医药大学附属第一医院接受治疗的乳腺癌患者143例。其中TNBC患者23例,非TNBC患者120例,均经手术病理证实,并在术前行乳腺DCE-MRI检查。采用3D Slicer软件在动态增强第二期上勾画病灶,瘤周区域选择瘤体向外扩5 mm进行自动勾画,然后手动调整确认勾画范围。按照7:3的比例随机分为训练集与验证集,使用Analysis Kit(AK)分析软件对训练集提取396个影像组学特征,用mRMR算法及LASSO回归分析对影像组学特征进行降维,用优化的特征集建立模型,并对模型性能进行Hosmer-Lemeshow(H-L)检验。结果经过特征降维,瘤内、瘤周及瘤内加瘤周分别剩余6个影像组学特征被用来建立模型。在验证集中,瘤内、瘤周及瘤内加瘤周的模型ROC曲线AUC分别为0.74、0.71、0.81;灵敏度分别为0.83、0.67、0.83;特异度分别为0.64、0.83、0.83。H-L检验的结果也表明3个模型与实际结果有较好的一致性(P>0.05)。结论乳腺联合DCE-MRI瘤内及瘤周影像组学特征有助于提高TNBC的诊断能力。