Amide Proton Transfer Magnetic Resonance Imaging of Alzheimer＇s Disease at 3.0 Tesla： A Preliminary Study

Background：Amide proton transfer （APT） imaging has recently emerged as an important contrast mechanism for magnetic resonance imaging （MRI） in the field of molecular and cellular imaging.The aim of this study was to evaluate the feasibility of APT imaging to detect cerebral abnormality in patients with Alzheimer＆#39;s disease （AD） at 3.0 Tesla.Methods：Twenty AD patients （9 men and 11 women; age range,67-83 years） and 20 age-matched normal controls （11 men and 9 women; age range,63-82 years） underwent APT and traditional MRI examination on a 3.0 Tesla MRI system.The magnetic resonance ratio asymmetry （MTRasym） values at 3.5 ppm of bilateral hippocampi （Hc）,temporal white matter regions,occipital white matter regions,and cerebral peduncles were measured on oblique axial APT images.MTRasym （3.5 ppm） values of the cerebral structures between AD patients and control subjects were compared with independent samples t-test.Controlling for age,partial correlation analysis was used to investigate the associations between mini-mental state examination （MMSE） and the various MRI measures among AD patients.Results：Compared with normal controls,MTRasym （3.5 ppm） values of bilateral Hc were significantly increased in AD patients （right 1.24% ± 0.21% vs.0.83% ± 0.19%,left 1.18% ± 0.18% vs.0.80%± 0.17%,t =3.039,3.328,P =0.004,0.002,respectively）.MTRasym （3.5 ppm） values of bilateral Hc were significantly negatively correlated with MMSE （right r =-0.559,P =0.013; left r=-0.461,P =0.047）.Conclusions：Increased MTRasym （3.5 ppm） values of bilateral Hc in AD patients and its strong correlations with MMSE suggest that APT imaging could potentially provide imaging biomarkers for the noninvasive molecular diagnosis of AD.

Amide proton transfer imaging of Alzheimer's disease and Parkinson's disease

Amide proton transfer (APT) magnetic resonance imaging (MRI) is an important molecularimaging technique at the protein level in tissue. Neurodegenerative diseases have a highlikelihood of causing abnormal protein accumulation in the brain, which can be detectedby APT MRI. This article briefly introduces the principles and image processing technologyof APT MRI, and reviews the current state of research on Alzheimer's disease and Parkinson's disease using this technique. Early applications of this approach in these twoneurodegenerative diseases are encouraging, which also suggests continued technicaldevelopment and larger clinical trials to gauge the value of this technique.

Multimodality imaging using proton magnetic resonance spectroscopic imaging and ^(18)F-fluorodeoxyglucose-positron emission tomography in local prostate cancer

AIM To assess the relationship using multimodality imaging between intermediary citrate/choline metabolism as seen on proton magnetic resonance spectroscopic imaging(1H-MRSI) and glycolysis as observed on ^(18)F-fluorodeoxyglucose positron emission tomography/computed tomography(^(18)F-FDG-PET/CT) in prostate cancer(PCa) patients. METHODS The study included 22 patients with local PCa who were referred for endorectal magnetic resonance imaging/1HMRSI(April 2002 to July 2007) and ^(18)F-FDG-PET/CT and then underwent prostatectomy as primary or salvage treatment. Whole-mount step-section pathology was used as the standard of reference. We assessed the relationships between PET parameters [standardized uptake value(SUVmax and SUVmean)] and MRSI parameters [choline + creatine/citrate(CC/Cmax and CC/Cmean) and total number of suspicious voxels] using spearman's rank correlation, and the relationships of PET and 1H-MRSI index lesion parameters to surgical Gleason score.RESULTS Abnormal intermediary metabolism on 1H-MRSI was present in 21/22 patients, while abnormal glycolysis on ^(18)F-FDG-PET/CT was detected in only 3/22 patients. Specifically, index tumor localization rates were 0.95(95%CI: 0.77-1.00) for 1H-MRSI and 0.14(95%CI: 0.03-0.35) for ^(18)F-FDG-PET/CT. Spearman rank correlations indicated little relationship(ρ =-0.36-0.28) between 1H-MRSI parameters and ^(18)F-FDG-PET/CT parameters. Both the total number of suspicious voxels(ρ = 0.55, P = 0.0099) and the SUVmax(ρ = 0.46, P = 0.0366) correlated weakly with the Gleason score. No significant relationship was found between the CC/Cmax, CC/Cmean or SUVmean and the Gleason score(P = 0.15-0.79). CONCLUSION The concentration of intermediary metabolites detected by 1H MRSI and glycolytic flux measured ^(18)F-FDG PET show little correlation. Furthermore, only few tumors were FDG avid on PET, possibly because increased glycolysis represents a late and rather ominous event in the progression of PCa.

Liver fat content determined by magnetic resonance imaging and spectroscopy

Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fatcontaining vacuoles within their cytoplasm, which is the key histological feature. In contrast to ALD, NAFLD is commonly associated with metabolic syndrome, obesity and insulin resistance. To determine increased liver fat content, liver biopsy is currently considered the gold standard. Besides the invasive technique, various other non-invasive techniques have been developed, such as ultrasound, computed tomography (CT), magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) based methods. Among these techniques, ultrasound and CT provide only qualitative information about hepatic steatosis, whereas MRS-or MRI-based methods are able to determine even small amounts of fat accurately. These non-invasive magnetic resonance techniques have already proven their great potential, especially in longitudinal and cross-sectional studies regarding various metabolic conditions and medical treatment regimens. In this review, the most common, non-invasive MRS/MRI techniques for assessment of intrahepatic lipid content are described with their inherent advantages and limitations.

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.

Detection Algorithm of Knee Osteoarthritis Based on Magnetic Resonance Images

Knee osteoarthritis(OA)is a common disease that impairs knee function and causes pain.Currently,studies on the detection of knee OA mainly focus on X-ray images,but X-ray images are insensitive to the changes in knee OA in the early stage.Since magnetic resonance(MR)imaging can observe the early features of knee OA,the knee OA detection algorithm based on MR image is innovatively proposed to judge whether knee OA is suffered.Firstly,the knee MR images are preprocessed before training,including a region of interest clipping,slice selection,and data augmentation.Then the data set was divided by patient-level and the knee OA was classified by the deep transfer learning method based on the DenseNet201 model.The method divides the training process into two stages.The first stage freezes all the base layers and only trains the weights of the embedding neural networks.The second stage unfreezes part of the base layers and trains the unfrozen base layers and the weights of the embedding neural network.In this step,we design a block-by-block fine-tuning strategy for training based on the dense blocks,which improves detection accuracy.We have conducted training experiments with different depth modules,and the experimental results show that gradually adding more dense blocks in the fine-tuning can make the model obtain better detection performance than only training the embedded neural network layer.We achieve an accuracy of 0.921,a sensitivity of 0.960,a precision of 0.885,a specificity of 0.891,an F1-Score of 0.912,and an MCC of 0.836.The comparative experimental results on the OAI-ZIB dataset show that the proposed method outperforms the other detection methods with the accuracy of 92.1%.

1H magnetic resonance spectroscopy and diffusion weighted imaging findings of medulloblastoma in 3.0T MRI A retrospective analysis of 17 cases

1H magnetic resonance spectroscopy and diffusion weighted imaging features of the cerebellar vermis in 17 medulloblastoma patients were retrospectively analyzed, and 17 healthy volunteers were selected as controls. 1H magnetic resonance spectroscopy showed that in all 17 medulloblastoma patients, N-acetyl aspartate and creatine peaks were significantly decreased, the choline peak was significantly increased, and there was evidence of a myo-inositol peak. Further, 11 patients showed a low taurine peak at 3.4 ppm, five patients showed a lipid peak at 0.9-1.3 ppm, and three patients showed a negative lactic acid peak at 1.33 ppm. Compared with the control group, the ratios of N-acetyl aspartate/choline and N-acetyl aspartate/creatine were significantly decreased, and the ratio of choline/creatine was increased, in medulloblastoma patients. Diffusion weighted imaging displayed hyperintensity and decreased apparent diffusion coefficient in medulloblastoma patients. These findings indicate that 1H magnetic resonance spectroscopy and diffusion weighted imaging are useful for qualitative diagnosis of medulloblastoma.

Numerical Analysis of the Magnetization Behavior in Magnetic Resonance Imaging in the Presence of Multiple Chemical Exchange Pools

The purpose of this study was to demonstrate a simple and fast method for solving the time-dependent Bloch-McConnell equations describing the behavior of magnetization in magnetic resonance imaging (MRI) in the presence of multiple chemical exchange pools. First, the time-dependent Bloch- McConnell equations were reduced to a homogeneous linear differential equation, and then a simple equation was derived to solve it using a matrix operation and Kronecker tensor product. From these solutions, the longitudinal relaxation rate (R1ρ) and transverse relaxation rate in the rotating frame (R2ρ) and Z-spectra were obtained. As illustrative examples, the numerical solutions for linear and star-type three-pool chemical exchange models and linear, star- type, and kite-type four-pool chemical exchange models were presented. The effects of saturation time (ST) and radiofrequency irradiation power (ω1) on the chemical exchange saturation transfer (CEST) effect in these models were also investigated. Although R1ρ and R2ρ were not affected by the ST, the CEST effect observed in the Z-spectra increased and saturated with increasing ST. When ω1 was varied, the CEST effect increased with increasing ω1 in R1ρ, R2ρ, and Z-spectra. When ω1 was large, however, the spillover effect due to the direct saturation of bulk water protons also increased, suggesting that these parameters must be determined in consideration of both the CEST and spillover effects. Our method will be useful for analyzing the complex CEST contrast mechanism and for investigating the optimal conditions for CEST MRI in the presence of multiple chemical exchange pools.

IN VIVO ~1 H MAGNETIC RESONANCE SPECTROSCOPY IN EVALUATION OF HEPATOCELLULAR CARCINOMA AND ITS EARLY RESPONSE TO TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION

Objective To investigate the value of in vivo proton magnetic resonance spectroscopy （MRS） in the assessment of hepatocelhilar carcinoma （HCC） and monitor its metabolic change shortly after transcatheter arterial chemoembolization （TACE）. Mothoda In this prospective study, 28 consecutive patients with large HCC （ ≥3 cm in diameter） confirmed by fine needle aspiration biopsy were recruited. The ^1H MRS of all hepatic lesions and some uninvolved liver parenchyma were performed with 1.5T whole body MR scanner. Among them, 15 cases were evaluated again about one week after TACE. The main metabolites such as choline and lipid before and after interventional therapy were measured to assess the early response of the tumor. The technical success rate of IH MRS in liver was high （33/41, 80% ）, closely related to breath motion, location of lesion, and size of voxeL In spectra, the choline compound peak of HCC elevated compared with uninvolved liver parenchyma. After TACE, both the amplitude and the area of choline resonance peak significantly descended （ choline-to-lipid ratios from 0.352±0. 080 to 0. 167±0. 030, P = 0. 026; from 0. 205±0. 060 to 0. 070±0. 020, P = 0. 042, respectively ） ; yet lipid resonance peak ascended. Conclusions In vivo tH MRS is technically feasible for the evaluation of large focal hepatic lesions, however, the reproducibility and stability are not as good as routine MR scan. IH MRS can monitor the early stage metabolic changes of HCC after TACE but limitation like quantification still exists.

Voxel-based analyses of magnetization transfer imaging of the brain in hepatic encephalopathy

AIM: To evaluate the spatial distribution of cerebral abnormalities in cirrhotic subjects with and without hepatic encephalopathy (HE) found with magnetization transfer imaging (MTI).METHODS: Nineteen cirrhotic patients graded from neurologically normal to HE grade 2 and 18 healthy control subjects underwent magnetic resonance imaging. They gave institutional-review-board-approved written consent. Magnetization transfer ratio (MTR) maps were generated from MTI. We tested for significant differences compared to the control group using statistical non-parametric mapping (SnPM) for a voxelbased evaluation.RESULTS: The MTR of grey and white matter was lower in subjects with more severe HE. Changes were found in patients with cirrhosis without neurological defi cits in the basal ganglia and bilateral white matter. The loss in magnetization transfer increased in severity and spatial extent in patients with overt HE. Patients with HE grade 2 showed an MTR decrease in white and grey matter: the maximum loss of magnetization transfer effect was located in the basal ganglia [SnPM (pseudo-)t = 17.98, P = 0.0001].CONCLUSION: The distribution of MTR changes in HE points to an early involvement of basal ganglia and white matter in HE.

三维酰胺质子转移成像在原发性肝癌临床扫描可行性及图像质量评估中的初步研究

目的 评估参数优化的三维酰胺质子转移加权(3 dimensions-amide proton transfer weighted,3D-APTw)成像在原发性肝癌扫描中的图像质量并分析其临床扫描的可行性。材料与方法 前瞻性招募2020年10月至2022年2月临床怀疑原发性肝癌患者,共109例。采用飞利浦3.0 T MRI设备进行扫描,分别采集T1WI、T2WI、弥散加权成像、酰胺质子转移加权(amide proton transfer weighted,APTw)及多期增强图像。机器自动生成经过B0校正的肝脏APTw图像。计算3D-APTw成像的扫描成功率及计算成功率。采用Kendall一致性系数对观察者内及观察者间主观评分进行一致性分析,对主观评分3分以上的病例测量3D-APTw图像的信噪比(signal-to-noise ratio,SNR)、肿瘤对比噪声比(contrast-to-noise ratio,CNR)、肿瘤及肝实质的APTw值并计算各参数值的变异系数,采用组内相关系数进行观察者内及观察者间可重复性测量的一致性分析。结果 109例患者中有11例患者3D-APTw图像中病变区域存在信号缺失,扫描成功率为89.91%(98/109),剩余98例患者中78例3D-APTw图像的主观评分为3分以上,计算成功率为71.56%(78/109)。观察者内及观察者间图像质量主观评分一致性分别为0.771和0.692,P<0.01。肿瘤组织APTw值观察者内及观察者间ICC分别为0.822和0.811,肝实质APTw值、SNR及CNR观察者ICC分别为0.675、0.634、0.666,肝实质APTw值、SNR及CNR观察者间ICC分别为0.614、0.290、0.560。肿瘤组织APTw值高于肝实质[(2.55±0.08)%vs.(1.45±0.07)%],两者间差异有统计学意义(P<0.001)。肿瘤组织和肝实质APTw值的变异系数分别为30.40%和44.40%。SNR和CNR为25.92±18.50和3.35±3.20。SNR变异系数为71.40%,CNR变异系数为90.00%。结论 参数优化后的3D-APTw成像可以用于原发性肝癌的临床扫描,但容易受呼吸运动、胆囊或血管的影响而出现信号缺失或伪影,在参数设置及成像技术上仍有需要改进和提高的空间,以进一步优化其图像质量。

我国正常人右肾三维酰胺质子转移成像的影响因素

目的探讨不同年龄、性别及体重指数(BMI)对正常中国人右肾酰胺质子转移加权(APTw)成像的影响。资料与方法前瞻性纳入西安高新医院2021年9月—2022年2月11~80岁健康志愿者182例,按照年龄每10岁为1组,共分7组;按照性别分为男、女2组;按照BMI分为消瘦组、正常组、超重组和肥胖组。采用间歇性屏气方式行右肾轴位3D-APTw成像。分析APTw值与年龄及BMI的相关性,分析不同年龄段、不同BMI组及不同性别间APT值的差异。结果最终纳入131例进行分析。APT值与年龄呈弱正相关(r=0.325,P<0.001)。各年龄段APT值组间分析,差异有统计学意义(F=3.566,P=0.003),11~20岁年龄组APT值[(1.853±0.357)%]低于41~50岁组[(2.387±0.432)%]、51~60岁组[(2.336±0.451)%,P<0.05]。男性APT值[1.980(2.320,1.820)%]低于女性[2.284(2.586,1.825)%;Z=2.301,P=0.021]。APT值与BMI呈极弱正相关(r=0.181,P=0.039)。各BMI组间APT值差异有统计学意义(F=3.265,P=0.024),消瘦组APT值低于正常组、超重组及肥胖组(P<0.05)。结论右肾APT值与年龄和BMI存在一定的相关性,男性APT值低于女性。在3D-APTw的临床应用中,应考虑到年龄、性别及BMI因素对APT值的影响。

3D氨基质子转移加权成像联合弥散加权成像鉴别良、恶性骨与软组织肿瘤

目的探讨3D氨基质子转移加权成像(APTWI)、弥散加权成像(DWI)及二者联合鉴别良、恶性骨与软组织肿瘤的价值。方法前瞻性对96例骨盆或下肢骨与软组织肿瘤患者采集平扫MRI、APTWI及DWI。分别基于APTWI及DWI获得偏移量为3.5 ppm的非对称性磁化传递率(MTRasym)图及表观弥散系数(ADC)图,测量病灶MTRasym(3.5 ppm)最大值(MTRasym_(max))、均值(MTRasym_(mean))及最小值(MTRasym_(min)),以及ADC最大值(ADC_(max))、均值(ADC_(mean))及最小值(ADC_(min));比较良、恶性肿瘤各参数差异,绘制受试者工作特征曲线,计算曲线下面积(AUC),评估APTWI、DWI及二者联合的鉴别诊断效能。结果96例中,良性41例、恶性55例。恶性肿瘤MTRasym(MTRasym_(max)、MTRasym_(mean)和MTRasym_(min))均明显高于,而ADC(ADC_(max)、ADC_(mean)和ADC_(min))均明显低于良性肿瘤(P均<0.05)。MTRasym_(max)和ADC_(min)鉴别良、恶性肿瘤的AUC分别为0.791和0.873,差异无统计学意义(P=0.122);二者联合的AUC为0.944,高于单一项(P<0.001、P=0.041)。结论APTWI联合DWI鉴别良、恶性骨与软组织肿瘤的效能较高。

酰胺质子转移成像和扩散加权成像在浸润性乳腺癌诊断中的价值

目的:探讨酰胺质子转移(amide proton transfer,APT)成像和扩散加权成像(diffusion weighted imaging,DWI)在浸润性乳腺癌中的诊断价值。方法:收集60例因临床触及或B超提示乳腺肿块接受MR检查的患者,所有患者均扫描3D-APT、DWI序列,并测量APT值和ADC值,根据手术病理结果共61个病灶,分成良性组(19例)、恶性组(42例),采用独立样本t检验比较良恶性组间各参数的差异,采用ROC曲线评价APT值、ADC值以及两者联合鉴别乳腺良恶性的诊断效能。结果:良恶性组APT值分别为(2.01±0.72)和(2.55±0.66),ADC值分别为(1.28±0.25)×10^(-3)mm^(2)/s和(1.08±0.26)×10^(-3)mm^(2)/s,两组APT和ADC值比较差异有统计学意义(P<0.05);APT、ADC值以及联合APT+ADC在鉴别乳腺肿块良恶性的AUC分别为0.660、0.756和0.796(P均<0.05)。结论:APT及DWI两种扫描技术均可用于诊断浸润性乳腺癌;APT诊断低于ADC值,两者联合可以进一步提升诊断效能。

月经相关性偏头痛患者脑代谢的磁共振波谱研究

目的采用氢质子磁共振波谱成像研究月经相关性偏头痛(MRM)不同状态下脑代谢情况,并探讨其与临床特征及雌激素孕激素的相关性。资料与方法招募2019年4月—2022年8月河南科技大学第一附属医院神经内科门诊确诊的MRM患者36例,同时招募年龄和受教育程度相匹配的正常女性29例。采用氢质子磁共振波谱成像分别于发作间期(卵泡后期)、发作期(围月经期)检测内侧前额叶皮层(mPFC)和丘脑的主要代谢物N-乙酰天门冬氨酸、γ-氨基丁酸(GABA)、谷氨酸复合物(Glx)和胆碱(Cho)与肌酸(Cr)的比值。每次MRI成像当天同时采集静脉血检测雌激素孕激素水平。比较发作间期、发作期各脑区两组间代谢物比值及激素水平、围月经期激素下降率的差异,同时观察MRM组从发作间期到发作期脑代谢的变化。结果MRM患者较正常人卵泡后期、围月经期雌激素孕激素水平及围月经期雌激素孕激素下降率均无显著差异(P>0.05)。在发作间期,MRM组左侧mPFC Cho/Cr较对照组降低(U=-2.957,P=0.003),且与发作频率呈负相关(r=-0.398,P=0.018)。在发作期,MRM组左侧mPFC GABA/Cr较对照组降低(U=-2.015,P=0.044),左侧丘脑Glx/Cr较对照组升高(t=2.213,P=0.033),上述结果与临床特点均无显著相关性(P>0.05)。MRM患者从发作间期到发作期GABA/Cr未发生显著变化(P>0.05),而右侧丘脑Glx/Cr显著升高(t=-2.181,P=0.038),右侧丘脑Cho/Cr显著升高(Z=-2.414,P=0.016)。结论MRM患者存在与正常人不同的脑代谢情况,且伴随头痛发作存在脑代谢的变化,但本研究未发现与月经周期相关雌激素孕激素的差别,其神经机制仍需进一步研究。

酰胺质子转移成像联合前列腺特异性抗原衍生指标对灰区前列腺癌的诊断价值

目的评估酰胺质子转移(APT)成像联合前列腺特异性抗原(PSA)衍生指标,建立列线图模型预测灰区前列腺癌的诊断价值。方法回顾性分析2021年6月—2024年3月在我院行前列腺MRI检查的患者临床及影像资料,根据纳入和排除标准进行筛选后,最终纳入128例,其中前列腺癌30例,前列腺增生98例。比较两组患者年龄、PSA及其衍生指标、APT最大值(APT_(max))、APT平均值(APT_(mean))、APT最小值(APT_(min))。采用单因素和多因素Logistic回归分析确定诊断灰区前列腺癌的独立预测指标,并建立列线图模型。绘制受试者工作特征(ROC)曲线评估上述参数的诊断效能并计算曲线下面积(AUC)。结果两组患者体积及前列腺特异性抗原密度(PSAD)差异均有统计学意义。前列腺癌组APT_(max)、APT_(mean)、APT_(min)值[(3.63±1.01)%、(2.60±0.857)%、(1.53±0.916)%]均大于增生组[(2.82±0.803)%、(1.95±0.092)%、(0.956±0.758)%],差异有统计学意义(P<0.004)。前列腺体积、PSAD、APT_(max)、APT_(min)值均是预测前列腺癌的独立危险因素,诊断灰区前列腺癌的AUC分别为0.781、0.762、0.772、0.731。列线图模型对灰区前列腺癌的诊断AUC值为0.856,高于各独立预测指标。结论APT_(max)、APT_(min)值联合前列腺体积、PSAD建立的列线图模型预测灰区前列腺癌具有较高的诊断价值,优于单独指标。

氨基质子转移成像对帕金森患者小脑微结构代谢变化的初步探究

目的 探讨利用MR氨基质子转移成像(amide proton transfer,APT)和弥散张量成像(diffusion tensor image,DTI)对帕金森病(parkinson’s disease,PD)患者小脑微结构变化的临床应用价值。方法 选取我院46例PD患者为PD组进行APT和DTI检查,并选取48例健康者作为对照组。根据APT和DTI分别对感兴趣区测出MTR值和FA值,并分析组间差异。以t检验评估其参数对PD是否有一定诊断价值。结果 PD组小脑髓质的FA值和ADC值与对照组相比FA值减低,ADC值增高,差异有统计学意义(P<0.001);PD组齿状核FA值低于对照组,MTR值低于对照组,差异有统计学意义(P<0.001)。PD组黑质FA值低于对照组,MTR值低于对照组,差异有统计学意义(P<0.001)。在ROC分析中齿状核与黑质在MTR值对PD具有一定的诊断准确性(P<0.05),小脑髓质、齿状核与黑质FA值对PD具有一定的诊断准确性(P<0.05)。结论 APT可以反映PD患者小脑微结构代谢的变化,其参考值可以作为PD患者评估指标。

超重/肥胖非酒精性脂肪性肝病儿童磁共振质子密度脂肪分数检测意义研究

目的探讨应用磁共振质子密度脂肪分数(MRI-PDFF)诊断超重和肥胖儿童非酒精性脂肪性肝炎(NASH)的效能。方法2022年12月~2023年12月江油市903医院诊治的超重/肥胖的非酒精性脂肪性肝病(NAFLD)儿童102例,其中超重儿童74例和肥胖儿童28例,使用3.0 T MRI扫描仪行肝脏检查,获取MRI-PDFF,使用FibroScan诊断仪检查获得肝脏硬度检测(LSM)和受控衰减参数(CAP),行肝穿刺诊断NASH,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估诊断效能。结果在102例超重/肥胖的NAFLD儿童中,经组织学检查诊断单纯性非酒精性脂肪肝(SNFL)75例和NASH 27例;NASH组BMI、血清ALT、AST、TG、MRI-PDFF、LSM和CAP分别为(32.2±3.4)kg/m^(2)、(92.7±31.3)U/L、(96.8±34.1)U/L、(3.1±1.2)mmol/L、(12.5±4.7)%、(11.7±1.4)kPa和(370.4±146.9)dB/m,与SNFL组【分别为(26.7±2.2)kg/m^(2)、(38.2±4.4)U/L、(33.0±3.4)U/L、(2.3±0.7)mmol/L、(7.7±2.0)%、(6.2±1.0)kPa和(262.3±61.2)dB/m】比,差异具有统计学意义(P<0.05),NASH组超重和肥胖占比分别37.0%和63.0%,与SNFL组的85.3%和14.7%比,差异具有统计学意义(P<0.05);经ROC曲线分析显示,以MRI-PDFF为11.9%为截断点,其诊断NASH的AUC为0.87(95%CI为0.80~0.93),敏感性为81.5%,特异性为85.3%,而分别以LSM为10.8 kPa和CAP为310.5dB/m为截断点,其诊断的AUC为0.81(95%CI为0.78~0.89),敏感性为85.2%,特异性为58.7%,后者的特异性较差。结论应用MRI-PDFF诊断儿童NASH的效能较优,但考虑到临床的便捷性,使用弹性成像检测诊断也可获得初步结果,以便必要时进一步检查。

氢质子磁共振波谱成像结合视频脑电图诊断癫痫的价值

目的探讨氢质子磁共振波谱成像结合视频脑电图对癫痫诊断的临床价值。方法选取2021-06—2023-06湖北医药学院附属东风总医院收治的65例疑似癫痫患者为研究对象,比较分析氢质子磁共振波谱成像、视频脑电图检查及联合检查的敏感性、特异性、准确性之间的差异,并制作3种检查方法的ROC曲线。结果65例疑似癫痫患者中,确诊阳性50例(76.92%),确诊阴性15例(23.08%)。3种检查方法特异度比较,差异无统计学意义(P>0.05)。联合检查、氢质子磁共振波谱成像及视频脑电图检查的灵敏度、准确率依次降低,差异有统计学意义(P<0.05)。氢质子磁共振波谱成像、视频脑电图检查、联合检查诊断脑梗死的ROC曲线下面积(AUC)分别为0.8187、0.7766、0.8519。结论氢质子磁共振波谱成像结合视频脑电图有利于提高癫痫患者诊断的灵敏度、准确率及AUC水平,值得推广应用。