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2024 Vol. 47, No. 2
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2024, 47(2): 111-117.
doi: 10.12122/j.issn.1674-4500.2024.02.01
Abstract:
Objective To investigate the effects of scanning voltage and X-ray filter on image quality and radiation dose of whole body fat scanning in mice. Methods Six C57BL/6 mice were selected, including three were normal control mice and three obese mice fed with high fat diet. Micro-CT was used to scan the whole body of mice, and the radiation dose under different scanning conditions was calculated. The subcutaneous and visceral fat were extracted by Analyze12.0 software, and the image quality and fat distribution were evaluated. Results The scanning results of normal mice and obese mice showed that under the scanning voltage of 70 kV and Al 1.0 mm X-ray filter, the boundary between mice subcutaneous fat and visceral fat was clear and without artifacts, with high image quality and low radiation dose. The subcutaneous fat and visceral fat of mice separated by analyze12.0 software were continuous and smooth with complete fat display. Conclusion This study provides a theoretical basis for the clinical study of subcutaneous fat and visceral fat in patients, and provides data reference for the selection of CT scan voltage and filter. Under the premise of reducing the scanning voltage and ensuring the image quality, the radiation dose to the patient was reduced to the maximum.
2024, 47(2): 118-125.
doi: 10.12122/j.issn.1674-4500.2024.02.02
Abstract:
Objective To fabricate nanoprobes consisting of tumor microenvironment stimuli-responsive mesoporous silicon dioxide@doxorubicin@manganese dioxide (mSiO2@DOX@MnO2) and assess their efficacy in terms of MRI and drug release in ovarian cancer cells. Methods The preparation of MnO2 involved ultrasonic disperion with transferrin serving as both a stabilizer and a targeted agent. The mSiO2@DOX@MnO2 nanoprobes were synthesized through electrostatic interaction utilizing MnO2 nanosheets as a gate. The nanoprobes were subsequently characterized for zeta potential, morphology, drug release kinetics, optical properties, and MRI properties. The cytotoxicity of the nanocomplexes was assessed against HO-8910 ovarian cancer cells and CHO hamster ovarian cells using the cell counting Kit-8 (CCK-8) assay. The drug release within tumor cells was investigated using a confocal laser scanning microscope. Furthermore, the MRI imaging effect of the nanoprobes on HO-8910 cells was evaluated. Statistical analysis was performed using one-way analysis of variance and the LSD test. Results The mSiO2@DOX@MnO2 nanoprobes exhibited minimal magnetic resonance signal and a low drug release rate (less than 10%) in a normal physiological microenvironment. However, in the presence of glutathione (GSH), a strong T1 weighted signal was obseved, with a T1 relaxation efficiency of 5.86 mmol/(L·s). It could be observed that in an acidic environment with a pH of 5.0, the release rate of DOX reaches a relatively stable level at approximately 15 h, maintaining around 33%. Under the same condition with a pH of 7.4, the high concentration group exhibits significantly higher GSH release rate compared to the low concentration group, reaching about 55%. The highest release rate is achieved when both pH and GSH concentration are set at 5.0 and 10 mmol/L respectively, reaching up to 80%. The mSiO2@DOX@MnO2 nanoprobe demonstrates potent toxicity against tumor cells while exhibiting minimal toxicity towards normal CHO cells at experimental concentrations. When the DOX content in the mSiO2@DOX@MnO2 nanocomplex was about 100 μg/mL, HO-8910 cell survival rate is only about 24%, whereas CHO cell survival rate remains around 86%. Cell cytotoxicity tests demonstrated significant differences in the survival rates of HO-8910 cells and CHO cells when treated with varying concentrations of mSiO2@DOX@MnO2 (P < 0.05). When the concentration of manganese ions was 1.12 mmol/L, the T1 relaxation time of the HO-8910 cell group was 467.60±4.45 ms, while that of the CHO cell group was 1681.47±1.88 ms. The T1 values of the HO-8910 cells and CHO cells groups showed significant differences when treated with equivalent concentrations of mSiO2@DOX@MnO2 (P < 0.05). Conclusion The developed mSiO2@DOX@MnO2 nanoprobe exhibits targeted identification and localization capabilities towards ovarian cancer cells, enabling T1-weighted imaging and precise drug release in acidic tumor microenvironments with high levels of GSH stimulation response, thereby facilitating targeted magnetic resonance imaging and treatment at the cellular level for ovarian cancer.
2024, 47(2): 126-131.
doi: 10.12122/j.issn.1674-4500.2024.02.03
Abstract:
Objective To analyze the diagnostic value of MRI radiomics in the classification of anterior cruciate ligament (ACL) injury. Methods A total of 212 patients with abnormal signals of the ACL suggested by proton density weighted imaging in the Department of Radiology of the Affiliated Hospital of Binzhou Medical University from 2017 to 2022 were reviewed. The parents were divided into severe injury group (n=141) and mild injury group (n=71) based on arthroscopic findings, which was the gold standard in the classification of ACL injury. The radiomics features of the ACL images were extracted including shape features, first order features, texture features and wavelet features. The imbalance problem of data was solved by performing oversampling using SMOTE method. Consistency test was performed by intra-group and inter-group correlation coefficients. Patients were randomly divided into a training set and a test set at 7:3. The best radiomics features were selected by LASSO algorithm, and the radiomics model was established by Logistic regression. The radiomics model was established based on the radiomics features and the clinical model was established based on the clinical parameters of the two groups. The Nomogram model was established by the radiomics features and the clinical parameters as mentioned above. The diagnostic efficacy of the model was evaluated by ROC curves, sensitivity, specificity and accuracy in the training set and the test set. The difference between the model's predicted values and the actual observed values was evaluated by the calibration curve, and the clinical efficacy was evaluated by the clinical decision curve analysis. Results A total of 2553 features were obtained from proton density weighted imaging transverse, coronal and sagittal positions through feature extraction, and 12 feature parameters were retained through feature filtering and dimensionality reduction. The area under the curve (AUC) was 0.9105 for the training set of the radiomics model and 0.8561 for the test set. The best feature sets of diagnosing severe ACL injury were gender, joint instability, joint interlock and radiomics. In the clinical model, the AUC values of the training set was 0.6989 and the test set was 0.6415. In the Nonogram model, the AUC values of the training set was 0.9449 and the test set was 0.8661. The difference between the Nomogram model and the clinical model was statistically significant (P < 0.05). The AUC of the Nomogram was higher than that of the radiomics model, but the difference was not statistically significant in the test set(P> 0.05). Conclusion The radiomics method based on MRI images can provide a new diagnostic method in classification of ACL injury which can greatly improve the clinical diagnosis accuracy of ACL injury. Furthermore, the diagnostic efficiency of the Nomogram model is the best compared with the clinical model and the radiomics model.
2024, 47(2): 132-137.
doi: 10.12122/j.issn.1674-4500.2024.02.04
Abstract:
Objective To investigate the clinical utility of artificial intelligence (AI) utilizing CT images for screening and evaluating the risk of pulmonary nodules. Methods A total of 100 patients with pulmonary nodules who underwent surgery or puncture and pathological examination at Gezhouba Central Hospital of Sinopharm from January 2022 to December 2022 were selected. AI and physicians performed nodule diagnoses independently and compared the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of groups A (manual diagnosis, n=98), B (AI diagnosis, n=99), and C (manual+AI joint diagnosis, n=99). The value of AI-assisted physician prediction of benign and malignant was analyzed using the pathological results as the "gold standard". Results There were no significant differences in the risk of pulmonary nodules between groups A and B (P>0.05). Group C was superior to group A and B in terms of sensitivity (98.75%), negative predictive value (91.67%), and accuracy (90.00%). group C could significantly improve diagnostic efficiency, better than groups A and B in reading films alone, and the diagnosis was more consistent with pathological results (Kappa value=0.632, P < 0.01). Conclusion AI-based screening and grading of pulmonary nodules can greatly enhance sensitivity and accuracy, decrease missed diagnosis rates, and provide substantial clinical value in assisting radiologists in image interpretation. AI-assisted risk assessment of pulmonary nodules also holds significant reference and clinical application value in the pre-judgment of benign and malignant nodules.
2024, 47(2): 138-142.
doi: 10.12122/j.issn.1674-4500.2024.02.05
Abstract:
Objective To evaluate the diagnostic value of spectral CT with quantitative enhancement parameters in the papillary thyroid carcinoma (PTC). Methods Fifty cases with PTC were retrospectively studied by analyzing spectrum base image at the Hainan Hospital of PLA General Hospital from May 2019 to January 2023, which would generate arterial enhancement fraction (AEF) and extracellular volume fraction (ECV) images. The AEF and ECV value were measured in the lesion and normal thyroid tissue on the same level. Mann-Whitney U test was used for the group comparison, and ROC curve was used to evaluate the diagnostic efficacy of AEF and ECV with Z test for the area under the curve. Results The AEF and ECV value of PTC were significantly lower than that of normal thyroid tissue (UAEF=1311.00, PAEF=0.02; UECV=394.50, PECV < 0.0001). The area under the curve of AEF, ECV and AEF combined with ECV were 0.623, 0.887 and 0.907, and Youden index were 0.271, 0.661and 0.678, respectively. The diagnostic model for the AEF combined with ECV was Y=-0.033×AEF-0.185×ECV+10.084 (PTC was diagnosed when Y>0.697). Conclusion The spectrum CT quantitative parameters AEF combined with ECV could have a relative higher diagnostic value for PTC, which could be considered as imaging biomarker for the diagnosis of PTC.
2024, 47(2): 143-150.
doi: 10.12122/j.issn.1674-4500.2024.02.06
Abstract:
Objective To explore the value of three-dimensional ultrasound combined with clinical indicators in uterine incision diverticulum after cesarean section. Methods From January 2017 to April 2023, the data of 126 patients with uterine incision diverticulum after cesarean section who underwent vaginal ultrasound examination in Shihezi People's Hospital were collected. According to the bleeding after cesarean section, the patients were divided into group 1 (no abnormal bleeding, n= 72) and group 2 (abnormal bleeding, n=54). All patients underwent vaginal ultrasound (two-dimensional ultrasound and three-dimensional ultrasound) examination. The clinical characteristics (uterine location, cesarean section frequency, cesarean section suture method, etc.) To establish a prediction model based on clinical and ultrasound characteristics, to explore independent risk factors for abnormal uterine bleeding in patients with uterine incision diverticulum after cesarean section, and to evaluate the predictive value of this model. Results There were statistically significant differences in the number of cesarean sections, uterine position, endometrial thickness, diverticulum depth, diverticulum length, diverticulum volume, diverticulum ratio, and residual base layer thickness between the two groups (P < 0.05), multivariate regression analysis showed that uterine location, cesarean section frequency, diverticulum volume, diverticulum ratio and residual muscle thickness were independent risk factors for abnormal uterine bleeding (OR=0.087, 10.385, 4.658, 12.892, 0.001, P < 0.05), compared with each single factor, the AUC of this model for predicting abnormal uterine bleeding was 0.936, which was significantly higher than each single factor (AUC=0.567, 0.705, 0.836, 0.895, 0.870, P < 0.05). When -6.28 was the cut-off value, the sensitivity was 87.04%, the specificity was 91.67%, and the accuracy was 89.68%, which was in good agreement with the clinical diagnosis results (Kappa=0.789, P < 0.001). Conclusion Uterine location, number of cesarean sections, volume of diverticulum, ratio of diverticulum and thickness of residual muscle layer are independent risk factors for uterine incision diverticulum combined with abnormal uterine bleeding after cesarean section. Abnormal uterine bleeding caused by incisional diverticulum has important predictive value.
2024, 47(2): 151-156.
doi: 10.12122/j.issn.1674-4500.2024.02.07
Abstract:
Objective To explore the application value of magnetic resonance diffusion-weighted imaging (DWI) in CT-guided lung mass aspiration biopsy. Methods We retrospectively analyzed 152 patients who had undergone CT-guided lung mass puncture at the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from October 2022 to October 2023 and divide them into group A (without DWI, n=85) and group B (with DWI, n=67) based on the presence of preoperative chest DWI examination, then compared the baseline data, pathologic positivity rate, number of needle adjustments, target skin distance, length of trocar in the lung, and complications between the two groups. Results The pathological diagnosis of group A was malignant tumors in 65 cases, benign lesions in 9 cases, and unspecified diagnosis in 11 cases, while the pathological diagnosis of group B was malignant tumors in 57 cases, benign lesions in 8 cases, and unspecified diagnosis in 2 cases; and the pathology-positive rates in group A and group B were respectively 87.06% and 97.01%, which were statistically significant (P= 0.029). The difference between the total complication rate and pneumothorax rate of the 2 groups was not statistically significant, but the hemorrhage rate of group A and B was successively 30.59% and 13.43%, with statistical significance (P < 0.05). Conclusion Chest DWI examination before CT-guided lung mass puncture biopsy, with good clinical practical value, can contribute to guiding the selection of the puncture target point, improving the positive rate of pathological diagnosis, and reducing the occurrence of puncture-related bleeding.
2024, 47(2): 157-162.
doi: 10.12122/j.issn.1674-4500.2024.02.08
Abstract:
Objective To investigate the value of multi- modal ultrasound features combined with machine learning in predicting high expression of Ki-67 in breast invasive ductal carcinoma. Methods A retrospective analysis was conducted in 155 patients with invasive ductal carcinoma and 155 lesions confirmed by pathology. Preoperative conventional ultrasound and acoustic radiation force impulse were performed, immunohistochemical staining was used to record the expression of Ki-67, and the patients were divided into overexpression groups(n=105)and low expression groups(n=50). Logistic regression analysis was used to analyze the differential indicators to obtain independent risk factors, and random forest and Logistic regression models were used for prediction. Results Univariate analysis showed that there were significant differences in the expression of Ki-67 and the maximum diameter, boundary, axillary lymph node status, resistance index, virtual touch tissue imaging and virtual touch tissue quantification of the lesion (P < 0.05). Multivariate analysis showed that the maximum diameter, boundary, virtual touch tissue quantification and resistance index were independent risk factors for Ki-67 expression. The random forest model showed that the influencing factors for Ki-67 expression were ranked in order of importance as the maximum diameter, virtual touch tissue quantification, resistance index and boundary. The areas under the curve of the random forest and logistic regression models in predicting high expression of Ki-67 in breast invasive ductal carcinoma were 0.871 and 0.866, respectively. There was a positive correlation between the expression level of Ki-67 and the diameter of the lesion (r=0.319, P < 0.001). Conclusion Multi-modal ultrasound features combined with machine learning can be used to predict the level of Ki-67 expression in invasive ductal carcinoma, providing reference value for clinical diagnosis and treatment.
2024, 47(2): 163-169.
doi: 10.12122/j.issn.1674-4500.2024.02.09
Abstract:
Objective To analyze the characteristics of atherosclerotic plaques that lead to mild to moderate narrowing in the middle cerebral artery, utilizing high-resolution magnetic resonance imaging of the vascular wall (VW-HRMRI), and explore the connection between these characteristics and the formation of culprit plaques, in addition to their clinical diagnostic significance. Methods A retrospective analysis was performed on both symptomatic (n=33) and asymptomatic (n=19) patients experiencing mild to moderate stenosis of the middle cerebral artery at Xuzhou Central Hospital. VW-HRMRI was employed to examine each patient, resulting in the identification of 68 plaques. These plaques were then classified into two categories: those deemed to be culprit plaques (n=33) and those identified as non-culprit plaques (n=35). Binary Logistic regression analysis and ROC curve analysis were applied to determine the relationship between the characteristics of these plaques and the risk of ischemic stroke, as well as their clinical diagnostic relevance. Results Culprit plaques were identified by notably higher remodeling indices (P=0.03), enhancement grades (P=0.01), volumes (P=0.003), and slopes (P=0.002) in comparison to non-culprit plaques. Logistic regression analysis showed that positive remodeling (OR=5.400, 95% CI: 1.334-21.857), enhancement grade (OR=4.431, 95% CI: 1.750-11.219), plaque volume (OR=1.09, 95% CI: 1.004-1.171), and slope (OR=1.112, 95% CI: 1.038-1.214) were independently associated with the occurrence of culprit plaques. The AUC for the four risk factors, which include positive remodeling, enhancement grade, plaque volume, and slope, was measured at 0.631, 0.696, 0.705 and 0.693. Subsequently, the predictive model that integrates these risk factors reached an AUC of 0.875, showing a sensitivity of 0.818 and a specificity of 0.800. Conclusion Positive remodeling, enhancement grade, plaque volume, and slope stand as independent risk factors for culprit plaques. The collective use of these four imaging features significantly enhances the predictive accuracy for identifying culprit plaques, thereby offering crucial imaging-based evidence to support early clinical interventions.
2024, 47(2): 170-176.
doi: 10.12122/j.issn.1674-4500.2024.02.10
Abstract:
Objective To evaluate the value of preoperative prediction of fibrous adipose tissue infiltration around rectal cancer using MRI-based radiomics. Methods The preoperative MRI of 75 patients with rectal cancer confirmed by pathology in The People's Hospital of Tongling City from December 2019 to March 2022 were analyzed retrospectively. According to the pathological results, the patients were divided into two groups: the fibrous adipose tissue infiltration group (n=33) and the fibrous adipose tissue noninfiltration group (n=42). The image group features for T2WI and arterial phase contrast-enhanced T1-weighted imaging (CE-T1WI) were extracted. The data were divided into a training group (n=54) and a verification group (n=21) at a ratio of 7:3. The training set data were reduced by maximum correlation minimum redundancy and LASSO regression, and feature dimension reduction was used to select the optimal imaging features. Three image group models (T2WI model, CE-T1WI model, T2WI + CE-T1WI model) were constructed. The best model had been selected in the three models. Based on the ROC curves and multivariate Logistic regression analysis in accordance with such parameters as upper and lower diameter of tumour, thickest diameter of tumour, unsmoothed edges, blurred boundary, CE-T1WI relative signal intensity (RCE-T1WI), T2WI relative signal intensity (RT2), DWI relative signal intensity (RDWI) and ADC, a combined model was constructed, and its predictive efficiency and clinical benefits were evaluated. Results In total, 851 imaging features were extracted from T2WI and CE-T1WI, and 10 and 14 optimal features were obtained, respectively, which were used to construct the combined model. In the training group, the AUC for the T2WI model, CE-T1WI model and T2WI+CE-T1WI model for predicting fibrous adipose tissue infiltration around rectal cancer were 0.87 (95% CI: 0.75-0.95), 0.82 (95% CI: 0.70-0.91) and 0.84 (95% CI: 0.71-0.92), respectively. In the verification group, the AUC were 0.76 (95% CI: 0.53-0.92), 0.73 (95% CI: 0.50-0.90) and 0.76 (95% CI: 0.52-0.92), respectively. The T2WI modle was the best model. For the combined model, the AUC for predicting fibrous adipose tissue infiltration of rectal cancer was 0.91 (95% CI: 0.80-0.97) in the training group and 0.80 (95% CI: 0.57-0.94) in the verification group. Decision curve analysis suggested that when the threshold was 0:1, the net return of combined model was higher than that of the T2WI model. Conclusion The combined model of MRI-based radiomics is effective in inevaluateing the preoperative of fibrous adipose tissue infiltration in rectal cancer.
2024, 47(2): 177-182.
doi: 10.12122/j.issn.1674-4500.2024.02.11
Abstract:
Objective To explore the sensitive imaging indicators of effective recognition of type 2 diabetes mellitus (T2DM) complicated with interstitial lung abnormalities by quantitative CT, aim at contributing to the early diagnosis of T2DM complicated with interstitial lung disease and effectively delaying the progression of diabetic lung damage. Methods Seventy patients with clinically diagnosed T2DM with interstitial lung abnormalities detected on chest CT from January 2022 to August 2023 at the Affiliated Hospital of Shaanxi University of Chinese Medicine were retrospectively collected, and 62 non-diabetic physical examination screeners without abnormal changes on chest CT were also collected. The chest CT images were postprocessed by Dexin-FACT "digital lung" software, and the quantitative parameters of CT were obtained, including whole lung volume, emphysema index (LAA-950%), pulmonary fibrosis evaluation index (LAA-700~-200%), pulmonary small vessel index (the ratio of lumen area to number of blood vessels around the bronchus with a diameter of 2mm in the lower lobe of the lung, TAV/TNV). The differences of quantitative CT parameters between the two groups were compared and the indexes with statistical significance were analyzed by ROC curve. Results the LAA-700--200% in the T2DM group was significantly higher than that in the control group (Z=-4.229, P < 0.001), while the LAA-950% and TAV/TNV in the T2DM group were significantly lower than those in the control group (Z=- 2.173, P < 0.05; t=- 3.904, P < 0.001), but there was no significant difference in whole lung volume between the two groups (P > 0.05). LAA-700--200% had the highest diagnostic efficiency in distinguishing T2DM complicated with interstitial lung abnormalities, with an AUC of 0.71. Conclusion The quantitative parameters of lung CT in patients with T2DM complicated with interstitial lung abnormalities are different from those in the control group, and small blood vessel injury in the lung may be a key target organ for lung injury in T2DM patients.
2024, 47(2): 183-188.
doi: 10.12122/j.issn.1674-4500.2024.02.12
Abstract:
Objective To explore the clinical value of left ventricular pressure strain loop in evaluating myocardial work in obese patients with hypertension. Methods Thirty-five patients with simple obesity (obese group), 39 patients with obesity combined with hypertension (obese hypertension group) and 38 healthy subjects (control group) were selected from Shanxi Bethune Hospital from May 2020 to August 2022. Conventional echocardiographic parameters, global longitudinal strain (GLS) and myocardial work parameters were measured. The myocardial work parameters included global constructive work (GCW), global work index (GWI), global wasted work(GWW)and global work efficiency (GWE), and the differences of these parameters among the three groups were compared. Results The GLS of the obese group and the obese hypertensive group was lower than that of the control group (P < 0.05). Compared with the control group, the GCW, GWI and GWE of the obesity group decreased, and GWW increased (P < 0.05). Compared with the obesity group and the control group, the GCW, GWI and GWW of the obesity and hypertension group increased, and GWE decreased (P < 0.05). Systolic blood pressure and diastolic blood pressure were positively correlated with GCW, GWI and GWW, and negatively correlated with GLS (P < 0.01). BMI was negatively correlated with GCW, GWI and GLS, and positively correlated with GWW (P < 0.05). Conclusion Hypertension can aggravate left ventricular dysfunction in obese patients. Left ventricular pressure- strain loop can identify left ventricular myocardial dysfunction in obesity patients with hypertension, which has certain clinical value.
2024, 47(2): 189-195.
doi: 10.12122/j.issn.1674-4500.2024.02.13
Abstract:
Objective To evaluate the left ventricular function in patients with type 2 diabetes mellitus (T2DM) by left ventricular automatic strain analysis, and to verify whether hyperlipidemia aggravates left ventricular dysfunction in patients with T2DM, and to explore the risk factors related to left ventricular strain. Methods Eighty-six patients with T2DM were divided into DM1 group (without hyperlipidemia, n=43) and DM2 group (with hyperlipidemia, n=43). Forty- three healthy volunteers were selected as the control group. All participants underwent conventional echocardiography and left ventricular automatic strain analysis to obtain conventional ultrasound measurements and left ventricular apical four- chamber global longitudinal strain (GLSA4c), left ventricular apical three-chamber global longitudinal strain (GLSA3C), left ventricular apical two-chamber global longitudinal strain (GLSA2C), left ventricular mean global longitudinal strain (GLSavg), left atrial storage strain (LASr), left atrial channel strain (LAScd), left atrial systolic strain (LASct). The differences of observation indexes between groups were compared, and multiple linear regression analysis was used to determine the independent risk factors affecting left ventricular strain. Results Compared with the control group, LVGLSA4C, LVGLSA3C, LVGLSA2C, LVGLSavg, LASr and LAScd were significantly decreased in DM1 group (P < 0.05). LVGLSA4C, LVGLSA3C, LVGLSA2C, LVGLSavg, LASr and LAScd in DM2 group were significantly lower than those in the other two groups (P < 0.05).It was estimated that total cholesterol was negatively correlated with the absolute values of left ventricular LVGLSA4C, LVGLSA3C, LVGLSA2C, LVGLSavg, LASr and LAScd (P < 0.001), triglyceride was negatively correlated with the absolute values of left ventricular LVGLSA4C, LVGLSA3C, LVGLSA2C, LVGLSavg, LASr and LAScd (P < 0.001).The results of multiple linear regression analysis showed that the absolute values of LVGLSA4C, LVGLSA3C, LVGLSA2C, LVGLSavg, LASr and LAScd were independently correlated to TG (P < 0.05). Conclusion The left ventricular strain in patients with T2DM is significantly impaired, and hyperlipidemia can aggravate the deterioration of left ventricular strain in diabetic patients. TG may be an independent risk factor for predicting left ventricular strain reduction.
2024, 47(2): 196-200.
doi: 10.12122/j.issn.1674-4500.2024.02.14
Abstract:
Objective To investigate the value of high- frequency ultrasound for the early diagnosis of subclinical adhesion pointitis in different parts of ankylosing spondylitis (AS). Methods A total of 100 patients with AS attending Gansu Provincial People's Hospital from January 2017 to November 2023 were selected. Fifty patients with clinical adhesion pachydermatitis (divided into 2 groups of patients with subjective symptoms and those with no subjective symptoms but with tenderness), 50 patients with subclinical adhesion pachydermatitis (with no subjective symptoms and tenderness, and need to be diagnosed with the help of MRI or ultrasound) and 50 healthy volunteers were grouped according to the world's first clinical practice guideline on screening and assessment of adhesion pachydermatitis in 2022. High-frequency ultrasonography was performed on the proximal plantar fascia, distal Achilles tendon, distal patellar ligament, proximal patellar ligament, distal quadriceps tendon, and triceps tendon attachment points, and the specificity, sensitivity, and accuracy of ultrasonography were analyzed according to the thickness, structure, calcification, bone erosion, bursal thickness, and energy Doppler signals of the attachment points at different sites. Results Ultrasonography of the examined AS patients included abnormal attachment points with subjective symptoms (positive rate of 54%), mainly quadriceps tendon attachment points; abnormal attachment points without subjective symptoms but with pressure pain (positive rate of 46%), mainly plantar fascia attachment points; abnormal attachment points of the AS patients with subclinical attachment point inflammation (positive rate of 61%), mainly Achilles tendon attachment points. High- frequency ultrasound ultrasonography of different subclinical attachment point lesions had a higher detection rate of subclinical attachment point inflammation in AS patients compared with clinical examination (P < 0.05). Compared with normal controls, high- frequency ultrasound had a high detection rate of subclinical attachment points, with tendon thickening and bursa thickening being the most common positive manifestations (P < 0.05). Compared with clinical examination, high- frequency ultrasound had higher specificity, sensitivity, and accuracy in the early diagnosis of subclinical attachment points in different parts of AS. Conclusion Compared with unitary clinical examination, high-frequency ultrasound can effectively improve the detection rate and diagnostic value in the early diagnosis of subclinical attachment points in different parts of AS patients, making up for the underestimation of subclinical attachment point inflammation that clinical examination has always been.
2024, 47(2): 201-205.
doi: 10.12122/j.issn.1674-4500.2024.02.15
Abstract:
Objective To explore the sonographic features in pure mucinous breast carcinoma (PMBC) by propensity score matching analysis. Methods Fourty- seven female patients (age at 54.6 ± 14.5 years old) with PMBC were retrospectively enrolled in the First People's Hospital Foshan from March 2019 to August 2022 as the research object, and 550 patients (average age 38.8±9.7 years) with breast fibroadenoma (BF) were enrolled as the control group in the same time. The propensity score matching analysis was performed to adjust the baseline differences, and the clinical characteristics, sonographic features and BI- RADS category were compared between the PMBC and BF groups. Results There was no significant difference in age, tumor size and tumor location between the two groups after propensity score matching (P > 0.05). Absence of tumor capsule, not circumscribed tumor margin, mixed echoic with cystic and solid component, and internal blood flow were significantly more frequent in PMBC group than in BF group (P < 0.05). The incidence of BI-RADS category 4 or above was 87.2% (41/47) and 61.7% (29/47) in PMBC and BF group, respectively. The incidence of BI-RADS category 4 or above was significantly higher in PMBC group than BF group (P=0.005). Five cases with axillary lymph node metastasis confirmed by pathology were detected on ultrasound in PMBC group. Conclusion The sonographic features can help early identification of PMBC and avoid misdiagnosis, so as to provide basis for clinical personalized treatment and evaluation of patient prognosis.
2024, 47(2): 206-211.
doi: 10.12122/j.issn.1674-4500.2024.02.16
Abstract:
Primary aldosteronism (PA) is a common cause of secondary hypertension and prones to cause damage to the end-organs, such as heart and kidney. Consequently, early diagnosis and adequate treatment can improve the prognosis of PA patients. Lateralization analysis of PA is a crucial stage in clinical practice. While adrenal vein sampling is recommended by guidelines as the gold standard for lateralization analysis of PA, the technique's invasiveness and technical difficulty limit its widespread application in regional hospitals. However, functional molecular imaging, which is easy to use and non-invasive, can offset the shortcomings of adrenal vein sampling in PA lateralization analysis, and can also provide powerful support in treatment decisions for PA. In order to provide a reference basis for lateralization analysis and subtype diagnosis of PA, we described the current state and progression of functional molecular imaging in PA both domestically and internationally. The physiological mechanisms, benefits, drawbacks and clinical applications of various adrenal functional molecular imaging techniques were also addressed in detail. Finally, we proposed the potential breakthrough and development direction of adrenal functional molecular imaging technology in the future.
Primary aldosteronism (PA) is a common cause of secondary hypertension and prones to cause damage to the end-organs, such as heart and kidney. Consequently, early diagnosis and adequate treatment can improve the prognosis of PA patients. Lateralization analysis of PA is a crucial stage in clinical practice. While adrenal vein sampling is recommended by guidelines as the gold standard for lateralization analysis of PA, the technique's invasiveness and technical difficulty limit its widespread application in regional hospitals. However, functional molecular imaging, which is easy to use and non-invasive, can offset the shortcomings of adrenal vein sampling in PA lateralization analysis, and can also provide powerful support in treatment decisions for PA. In order to provide a reference basis for lateralization analysis and subtype diagnosis of PA, we described the current state and progression of functional molecular imaging in PA both domestically and internationally. The physiological mechanisms, benefits, drawbacks and clinical applications of various adrenal functional molecular imaging techniques were also addressed in detail. Finally, we proposed the potential breakthrough and development direction of adrenal functional molecular imaging technology in the future.
2024, 47(2): 212-215.
doi: 10.12122/j.issn.1674-4500.2024.02.17
Abstract:
Early onset of primary liver cancer is insidious and difficult to diagnose, and most of the patients with liver cancer are already in the middle or late stage of liver cancer when they are diagnosed. These patients are prone to relapse and have a low survival rate after treatment. Recent studies have found that the development of hepatocellular carcinoma is not determined by the unilateral action of epithelial cells or mesenchymal cells, but by the tumor microenvironment formed by the interaction of the two. Tumor microenvironment is mainly composed of tumor-associated fibroblasts, which play an important role in the regulation of tumor cells through the secretion of various cytokines and proteases, etc. Fibroblast-activated protein is one of the products of the tumor microenvironment, and the overexpression of fibroblast- activated protein has been correlated with the growth, invasion, and metastasis of tumors. Radionuclide- labeled fibronectin- activated protein inhibitor (68Ga- FAPI), as a new type of PET/CT imaging agent, has demonstrated good sensitivity and specificity in a variety of malignant tumors, especially in primary hepatocellular carcinoma, due to the lower background uptake in the liver, and has demonstrated higher sensitivity and specificity in the diagnosis of early- stage primary hepatocellular carcinoma, staging of primary hepatocellular carcinoma, and differentiation of benign and malignant liver nodules. This article mainly describes the research progress of 68Ga- FAPI, a new PET/CT imaging agent, in the diagnosis of early primary liver cancer, staging of primary liver cancer, recurrence of primary liver cancer after treatment, and differentiation of benign and malignant liver nodules, with the aim of benefiting the diagnosis and treatment of primary liver cancer in the clinic..
Early onset of primary liver cancer is insidious and difficult to diagnose, and most of the patients with liver cancer are already in the middle or late stage of liver cancer when they are diagnosed. These patients are prone to relapse and have a low survival rate after treatment. Recent studies have found that the development of hepatocellular carcinoma is not determined by the unilateral action of epithelial cells or mesenchymal cells, but by the tumor microenvironment formed by the interaction of the two. Tumor microenvironment is mainly composed of tumor-associated fibroblasts, which play an important role in the regulation of tumor cells through the secretion of various cytokines and proteases, etc. Fibroblast-activated protein is one of the products of the tumor microenvironment, and the overexpression of fibroblast- activated protein has been correlated with the growth, invasion, and metastasis of tumors. Radionuclide- labeled fibronectin- activated protein inhibitor (68Ga- FAPI), as a new type of PET/CT imaging agent, has demonstrated good sensitivity and specificity in a variety of malignant tumors, especially in primary hepatocellular carcinoma, due to the lower background uptake in the liver, and has demonstrated higher sensitivity and specificity in the diagnosis of early- stage primary hepatocellular carcinoma, staging of primary hepatocellular carcinoma, and differentiation of benign and malignant liver nodules. This article mainly describes the research progress of 68Ga- FAPI, a new PET/CT imaging agent, in the diagnosis of early primary liver cancer, staging of primary liver cancer, recurrence of primary liver cancer after treatment, and differentiation of benign and malignant liver nodules, with the aim of benefiting the diagnosis and treatment of primary liver cancer in the clinic..
2024, 47(2): 216-219.
doi: 10.12122/j.issn.1674-4500.2024.02.18
Abstract:
Radiomics plays a crucial role in extracting information from medical images, holding significant importance in the diagnosis, prognosis, and prediction of treatment efficacy in cancer. Currently, immunotherapy has emerged as a focal point in cancer treatment, greatly advancing the field of oncology. Radiomic features offer advantages such as non- invasiveness, repeatability, routine accessibility, and quantitative assessment of tumor heterogeneity. Consequently, these features serve as valuable biomarkers for evaluating the efficacy of immunotherapy. This review elucidates the extraction and analysis of radiomic features, highlighting their role as biomarkers in the study of immunotherapy. It explores advancements in predicting treatment responses and adverse events, providing novel insights into the application of radiomics in personalized cancer treatment.
Radiomics plays a crucial role in extracting information from medical images, holding significant importance in the diagnosis, prognosis, and prediction of treatment efficacy in cancer. Currently, immunotherapy has emerged as a focal point in cancer treatment, greatly advancing the field of oncology. Radiomic features offer advantages such as non- invasiveness, repeatability, routine accessibility, and quantitative assessment of tumor heterogeneity. Consequently, these features serve as valuable biomarkers for evaluating the efficacy of immunotherapy. This review elucidates the extraction and analysis of radiomic features, highlighting their role as biomarkers in the study of immunotherapy. It explores advancements in predicting treatment responses and adverse events, providing novel insights into the application of radiomics in personalized cancer treatment.
2024, 47(2): 220-224.
doi: 10.12122/j.issn.1674-4500.2024.02.19
Abstract:
Lymphoma, a highly heterogeneous tumor primarily derived from lymphocytes, can be effectively staged, restaged, and assessed for treatment response using 18F-FDG PET/CT. This imaging technique evaluates the heterogeneous FDG uptake in tumor cells and changes in the tumor microenvironment. However, conventional PET parameters alone are insufficient for a comprehensive assessment of tumor heterogeneity. This article provides an overview of the role of PET/CT in diagnosing, staging, treating, and assessing the prognosis of lymphoma. Furthermore, it explores the future development direction of PET/CT, including the investigation of new PET parameters, the development of novel agents, and the integration of artificial intelligence. Significant advancements have been made in tumor detection, quantification of heterogeneity, identification, midterm efficacy evaluation, and prognosis prediction.
Lymphoma, a highly heterogeneous tumor primarily derived from lymphocytes, can be effectively staged, restaged, and assessed for treatment response using 18F-FDG PET/CT. This imaging technique evaluates the heterogeneous FDG uptake in tumor cells and changes in the tumor microenvironment. However, conventional PET parameters alone are insufficient for a comprehensive assessment of tumor heterogeneity. This article provides an overview of the role of PET/CT in diagnosing, staging, treating, and assessing the prognosis of lymphoma. Furthermore, it explores the future development direction of PET/CT, including the investigation of new PET parameters, the development of novel agents, and the integration of artificial intelligence. Significant advancements have been made in tumor detection, quantification of heterogeneity, identification, midterm efficacy evaluation, and prognosis prediction.
