Search

Abstract Objective This paper aims to explore the diagnostic value of enhanced magnetic resonance imaging (MRI) combined with a carcinoembryonic antigen (CEA) and carbohydrate antigen in terms of the liver metastasis of colorectal cancer. Methods A total of 167 colorectal cancer patients with liver metastasis and 167 colorectal cancer patients without liver metastasis were selected as the subjects. An automatic electrochemiluminescence analyser was then used to detect the tumour markers CEA, CA19-9, CA125 and CA72-4. The consistency between the MRI examination and clinical pathological examination was also analysed, and the sensitivity, specificity and positive and negative predictive values of various combined detection methods were compared. Results The abnormal rates of CEA, CA19-9, CA125 and CA72-4 in the two groups were statistically significant (P < 0.05), while the results of the enhanced MRI and clinicopathological examination for liver metastasis in patients with colon cancer were largely consistent (Kappa coefficient = 0.788, P < 0.000). However, the two methods were inconsistent. The false positive rate of the enhanced MRI examination was 15.3%, while the false negative rate was 6.0%. The specificity (94.61%), positive predictive value (92.68%) and positive likelihood ratio (12.67%) were the highest for the MRI combined with serial CEA, while the sensitivity (98.80%) and negative predictive value (97.22%) were the highest with the MRI combined with parallel CEA, and this combination returned the lowest negative likelihood ratio (0.03). Conclusion The combination of MRI and CEA excludes non-metastatic patients and identifies colorectal liver metastasis cancer patients. Overall, it has a higher diagnostic value.

Splenic abscesses in children are very rare, and multiple splenic abscesses are rarer. These lesions are difficult to diagnose quickly because of their low incidence and the low specificity of the associated clinical and imaging findings. The treatment of splenic abscesses includes conservative treatment, percutaneous drainage, and splenectomy, but the selection criteria for treatment are still unclear. We present a case of a 13-year-old girl with multiple splenic abscesses. Her blood culture report was negative. We eventually confirmed the diagnosis by enhanced magnetic resonance imaging (MRI). The patient underwent a successful laparoscopic total splenectomy, and her symptoms were resolved thereafter.

Objective: This paper aims to explore the diagnostic value of enhanced magnetic resonance imaging (MRI) combined with a carcinoembryonic antigen (CEA) and carbohydrate antigen in terms of the liver metastasis of colorectal cancer. Methods: A total of 167 colorectal cancer patients with liver metastasis and 167 colorectal cancer patients without liver metastasis were selected as the subjects. An automatic electrochemiluminescence analyser was then used to detect the tumour markers CEA, CA19-9, CA125 and CA72-4. The consistency between the MRI examination and clinical pathological examination was also analysed, and the sensitivity, specificity and positive and negative predictive values of various combined detection methods were compared. Results: The abnormal rates of CEA, CA19-9, CA125 and CA72-4 in the two groups were statistically significant (P < 0.05), while the results of the enhanced MRI and clinicopathological examination for liver metastasis in patients with colon cancer were largely consistent (Kappa coefficient = 0.788, P < 0.000). However, the two methods were inconsistent. The false positive rate of the enhanced MRI examination was 15.3%, while the false negative rate was 6.0%. The specificity (94.61%), positive predictive value (92.68%) and positive likelihood ratio (12.67%) were the highest for the MRI combined with serial CEA, while the sensitivity (98.80%) and negative predictive value (97.22%) were the highest with the MRI combined with parallel CEA, and this combination returned the lowest negative likelihood ratio (0.03). Conclusion: The combination of MRI and CEA excludes non-metastatic patients and identifies colorectal liver metastasis cancer patients. Overall, it has a higher diagnostic value. [ABSTRACT FROM AUTHOR]

Objective To investigate the value of T1 relaxation time (T1post) and hepatocyte fraction through gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) in the evaluation of hepatic fibrosis stages. Methods Eighty-five patients with chronic hepatitis B were collected. According to the biopsy or surgical pathological examination results, there were 19 cases of hepatic fibrosis in stage 1 (S1), 21 cases of hepatic fibrosis in stage 2 (S2), 23 cases of hepatic fibrosis in stage 3 (S3), and 22 cases of hepatic fibrosis in stage 4 (S4); 20 patients without a history of hepatitis who underwent abdominal surgery due to liver benign lesions were selected as the control group, and the stage of hepatic fibrosis was S0. Patients were examined by MRI, and T1 mapping images were collected before and 20 minutes after Gd-EOB-DTPA enhancement. First, image reconstruction was performed, and then two experienced radiologists delineated the spleen and liver regions of interest respectively on the reconstructed images, measured and calculated the T1 relaxation time of the liver parenchyma (T1post), the reduction rate of T1 relaxation time (ΔT1), hepatocyte fraction (HeF), and uptake coefficient (K). Intragroup correlation coefficient (ICC) was used to analyze the consistency of T1post, ΔT1, HeF and K between the two radiologists. The values of T1post, ΔT1, HeF and K in each stage of hepatic fibrosis were compared. Spearman correlation analysis was utilized to assess the correlation between the parameters and stages of hepatic fibrosis. The ROC curve of MedCalc statistical software was used to identify the diagnostic efficacy of adjacent stages of hepatic fibrosis. Results The ICC of T1post，ΔT1，HeF，and K obtained by the two radiologists were 0. 998, 0. 996, 0. 996 and 0. 999, respectively, which were in good agreement. There were statistically significant differences in T1post, ΔT1, HeF, and K in each stage of hepatic fibrosis (all P<0. 05). T1post was positively correlated with hepatic fibrosis stage (r=0. 868，P<0. 01), while HeF, K and ΔT1 were negatively correlated with hepatic fibrosis stage (r=-0. 880, -0. 787, and-0. 710, all P<0. 01). T1post and HeF were significant for the evaluation of S0 and S1 stages of hepatic fibrosis (both P<0. 05), but there were no significant differences in sensitivity, specificity or accuracy in differentiating S0 and S1 of hepatic fibrosis between them (all P>0. 05). HeF and K were significant for the assessment of S1 and S2 of hepatic fibrosis (both P<0. 05), but there were no significant differences in their sensitivity, specificity or accuracy in differentiating S1 and S2 of hepatic fibrosis between them (all P>0. 05). T1post, HeF, K and Δ T1 were significant for the assessment of S2 and S3 of hepatic fibrosis (all P<0. 05), all parameters had higher sensitivity, specificity and accuracy in differentiating S2 and S3 of hepatic fibrosis, and there was no significant difference between every two of them (all P>0. 05). HeF and K were significant for the assessment of S3 and S4 of hepatic fibrosis (both P<0. 05), the sensitivity of HeF in differentiating S3 and S4 of hepatic fibrosis was lower than that of K, but its specificity was higher (both P<0. 05), and there was no significant difference in the accuracy between them (P>0. 05). Conclusion It is valuable to detect T1 relaxation time and hepatocyte fraction in different stages of hepatic fibrosis by Gd-EOB-DTPA-enhanced MRI. [ABSTRACT FROM AUTHOR]

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and has poor prognosis. Cytokeratin (CK)19-positive (CK19+) HCC is especially aggressive; early identification of this subtype and timely intervention can potentially improve clinical outcomes. In the present study, we developed a preoperative gadoxetic acid-enhanced magnetic resonance imaging (MRI)-based radiomics model for noninvasive and accurate classification of CK19+ HCC. A multicenter and time-independent cohort of 257 patients were retrospectively enrolled (training cohort, n = 143; validation cohort A, n = 75; validation cohort B, n = 39). A total of 968 radiomics features were extracted from preoperative multisequence MR images. The maximum relevance minimum redundancy algorithm was applied for feature selection. Multiple logistic regression, support vector machine, random forest, and artificial neural network (ANN) algorithms were used to construct the radiomics model, and the area under the receiver operating characteristic (AUROC) curve was used to evaluate the diagnostic performance of corresponding classifiers. The incidence of CK19+ HCC was significantly higher in male patients. The ANN-derived combined classifier comprising 12 optimal radiomics features showed the best diagnostic performance, with AUROCs of 0.857, 0.726, and 0.790 in the training cohort and validation cohorts A and B, respectively. The combined model based on multisequence MRI radiomics features can be used for preoperative noninvasive and accurate classification of CK19+ HCC, so that personalized management strategies can be developed.

Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and has poor prognosis. Cytokeratin (CK)19-positive (CK19+) HCC is especially aggressive; early identification of this subtype and timely intervention can potentially improve clinical outcomes. In the present study, we developed a preoperative gadoxetic acid-enhanced magnetic resonance imaging (MRI)-based radiomics model for noninvasive and accurate classification of CK19+ HCC. A multicenter and time-independent cohort of 257 patients were retrospectively enrolled (training cohort, n = 143; validation cohort A, n = 75; validation cohort B, n = 39). A total of 968 radiomics features were extracted from preoperative multisequence MR images. The maximum relevance minimum redundancy algorithm was applied for feature selection. Multiple logistic regression, support vector machine, random forest, and artificial neural network (ANN) algorithms were used to construct the radiomics model, and the area under the receiver operating characteristic (AUROC) curve was used to evaluate the diagnostic performance of corresponding classifiers. The incidence of CK19+ HCC was significantly higher in male patients. The ANN-derived combined classifier comprising 12 optimal radiomics features showed the best diagnostic performance, with AUROCs of 0.857, 0.726, and 0.790 in the training cohort and validation cohorts A and B, respectively. The combined model based on multisequence MRI radiomics features can be used for preoperative noninvasive and accurate classification of CK19+ HCC, so that personalized management strategies can be developed. [ABSTRACT FROM AUTHOR]

Objective To explore the diagnostic value of quantitative and qualitative parameters of rotator cuff space enhanced magnetic resonance scanning for adhesive arthritis. Methods 103 patients with complete arthroscopic results and enhanced magnetic resonance examination data (49 patients with adhesive arthritis, 54 patients in the control group) were selected. Using the arthroscopic results as the standard, the rotator cuff space was enhanced and the subcoracoid fat disappeared., The width of the rotator cuff gap and its thickness, the thickness of the coracohumeral ligament. Results Whether the rotator cuff gap was strengthened, whether the subcoracoid fat disappeared, the width and thickness of the rotator cuff gap (RI), and the thickness of the coracohumeral ligament were statistically different in the diagnosis of adhesive arthritis group and normal group (P<0.05). Whether the sleeve space is strengthened, whether the fat under the coracoid process disappears, the Kappa value is 0.98, 0.97, the sensitivity is 100%, 95.9%, the specificity is 77.6%, 96.3%; the RI width and thickness, and the thickness of the coracohumeral ligament ICC value 0.82, 0.81, 0.84, RI width cut-off value 11.95 mm, sensitivity 82%, specificity 90%, RI thickness cut-off value 5.95 mm, sensitivity 92%, specificity 90%. Conclusion The qualitative and quantitative parameters of the rotator cuff gap are strengthened, the fat under the coracoid process disappears, and the width and thickness of the rotator cuff gap are helpful for the diagnosis, evaluation and precise formulation of treatment plans for adhesive arthritis. [ABSTRACT FROM AUTHOR]

Background: Indentifying predictive factors for postoperative recurrence of hepatocellular carcinoma (HCC) has great significance for patient prognosis., Aim: To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) combined with clinical features in predicting early recurrence of HCC after resection., Methods: A total of 161 patients with pathologically confirmed HCC were enrolled. The patients were divided into early recurrence and non-early recurrence group based on the follow-up results. The clinical, laboratory, pathological results and Gd-EOB-DTPA enhanced MRI imaging features were analyzed., Results: Of 161 patients, 73 had early recurrence and 88 were had non-early recurrence. Univariate analysis showed that patient age, gender, serum alpha-fetoprotein level, the Barcelona Clinic Liver Cancer stage, China liver cancer (CNLC) stage, microvascular invasion (MVI), pathological satellite focus, tumor size, tumor number, tumor boundary, tumor capsule, intratumoral necrosis, portal vein tumor thrombus, large vessel invasion, nonperipheral washout, peritumoral enhancement, hepatobiliary phase (HBP)/tumor signal intensity (SI)/peritumoral SI, HBP peritumoral low signal and peritumoral delay enhancement were significantly associated with early recurrence of HCC after operation. Multivariate logistic regression analysis showed that patient age, MVI, CNLC stage, tumor boundary and large vessel invasion were independent predictive factors. External data validation indicated that the area under the curve of the combined predictors was 0.861, suggesting that multivariate logistic regression was a reasonable predictive model for early recurrence of HCC., Conclusion: Gd-EOB-DTPA enhanced MRI combined with clinical features would help predicting the early recurrence of HCC after operation., Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest for this article., (©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.)

Abstract Gadolinium doped carbon dots (Gd-CDs) were prepared as a dual-modal imaging agent for enhanced MR imaging and cell fluorescence imaging. The Gd-CDs were synthesized via one-step solvent free technique with Gd-DTPA and l -arginine as the Gd and carbon sources with a quantum yield of 57.78%. The Gd-CDs exhibited good crystal structure, excellent aqueous dispersity, high colloidal stability, intense fluorescence and low cytotoxicity. The bio-TEM images revealed that the Gd-CDs could be easily internalized by cancer cells and escape from the endosomes. Furthermore, the Gd-CDs demonstrated wonderful multi-color fluoresence cell labeling ability at various excitation wavelength and much better MR contrast effect compared with commercial Gd-DTPA with a high r 1 relaxivity value 6.27 mM−1s−1. In addition, Gd-CDs exhibited brighter MR signal than Gd-DTPA in the animal MR imaging test. Finally, the Gd-CDs also indicated low long-term toxicity by the serum biochemistry analysis. Thus, these results indicated that Gd-CDs would be an excellent dual-modal imaging probe for enhanced MR imaging and fluorescence imaging. Highlights • The Gd-CDs were prepared with high quantum yield and excellent colloidal stability. • Gd-CDs could be taken up and exhibited good multi-fluorescence labeling ability. • Gd-CDs revealed wonderful MR cell imaging and in vivo animal imaging ability. [ABSTRACT FROM AUTHOR]

Background: Previous studies showed that combining apparent diffusion coefficient (ADC) value with the Spondyloarthritis Research Consortium of Canada (SPARCC) index value might provide a reliable evaluation of the activity of ankylosing spondylitis (AS), and that contrast-enhanced (CE) magnetic resonance imaging (MRI) is unnecessary. However, the results were based on confirming only a small random sample. This study aimed to assess the role of CE-MRI in differentiating the disease activity of AS by comparing ADC value with a large sample. Methods: A total of 115 patients with AS were enrolled in accordance with Bath AS Disease Activity Index and laboratory indices, and 115 patients were divided into two groups, including active group (n = 69) and inactive group (n = 46). SPARCC, ΔSI, and ADC values were obtained from the short tau inversion recovery (STIR), diffusion-weighted imaging (DWI), and CE-MRI, respectively. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. Results: The optimal cutoff values (with sensitivity, specificity, respective area under the curve, positive likelihood ratio, and negative likelihood ratio) for the differentiation between active and inactive groups are as follows: SPARCC = 6 (72.06%, 82.61%, 0.836, 4.14, 0.34); ΔSI (%) = 153 (80.6%, 84.78%, 0.819, 5.3, 0.23); ADC value = 1.15 × 10−3 mm2/s (72.73%, 81.82%, 0.786, 4, 0.33). No statistical differences were found among the predictive values of SPARCC, ΔSI, and ADC. Multivariate analysis showed no significant difference between the combination of SPARCC and ADC values with and without ΔSI. Conclusions: Using large sample, we concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, and CE-MRI sequence is not routinely used in imaging of AS to avoid renal fibrosis and aggravation of kidney disease.

Purpose To use Ktrans to evaluate the aggressiveness and vascular permeability of peritumoral edema in cases of lung cancer brain metastases. Materials and methods A total of 68 lung cancer patients with 92 metastatic brain lesions were enrolled (20 metastatic lesions only in the gray matter - group 1; and 72 metastatic lesions located in the gray and white matter junction - group 2). All patients underwent MRI examination, which involved a dual angle (2° and 15°) enhanced T1W-VIBE (volume interpolated breath-hold examination) sequence to calculate the T1 parameter map. We used the enhanced T1-3D sequence to measure the tumor volume. The vascular permeability coefficient (Ktrans) was calculated using the single-compartment Tofts model, motion registration, and quick input mode. We examined the correlations of Ktrans with the edema index (EI), Ktrans with the tumor volume, and Ktrans with the histological expression of MMP-9 or VEGF in the original lung tumor using Pearson's' correlation analysis. Results Ktrans and EI were highly correlated in group 2 (r = 0.66687; P < 0.001) and not correlated in group 1 (r = 0.33096; P = 0.15405). Ktrans was also moderately related to the positive expression of MMP-9 (r = 0.50912; P < 0.001) and VEGF (r = 0.36995; P = 0.00138) There is statistical correlation between Ktrans and EI for group 2, and no statistical correlation between Ktrans and EI for group 1. Conclusion The Ktrans of the peritumoral brain edema may be used to indicate the aggressiveness and vascular permeability of brain metastases in patients with lung cancer. [ABSTRACT FROM AUTHOR]

Background: Many spine surgeons rely on reports of radiological studies for patients seen routinely in consultation. However, "best practice" should include the spine surgeon's individual assessment of the images themselves to better determine whether the diagnoses rendered were/are correct. Methods: A now 54yearold male had an original enhanced magnetic resonance imaging (MR) scan of the cervical spine performed in 2012 that was read as showing mild spondylotic changes at multiple levels. Results: In 2015, the patient presented with a severe spastic quadriparesis, right greater than left, which had markedly worsened over the prior 3 months. Review of the original enhanced MR from 2012 revealed a rightsided C5-C6 tumor (e.g., likely meningioma) filling the right neural foramen with extension into the spinal canal (7 mm × 8 mm × 11 mm): The tumor was originally "missed". The new 2015 enhanced MR scan documented the tumor had enlarged 6.7 fold (measuring 17 mm × 11 mm × 2.2 cm), and now filled 2/3 of the spinal canal, markedly compressing the cord and right C6 nerve root. Following a C4-C6 laminectomy, and a challenging tumor removal, and the patient was neurologically intact. Conclusion: This case underscores the need for spine surgeons to carefully review both images and reports of prior diagnostic studies that accompany patients. In this case, the original failure to recognize the tumor led to a 2.5year delay in surgery that resulted in the patient's severe preoperative quadriparesis, and a much more challenging surgery. [ABSTRACT FROM AUTHOR]

The process of tumor neoangiogenesis plays a central role in the growth and spread of tumors. It is currently a leading theme in oncology, and many new drugs targeting the tumor neoangiogenic process are under development. Expanding tumors become hypoxic and tumor cells express transcription factors, such as the hypoxia-inducible factor (HIF), which induce the release of proangiogenic growth factors such as vascular endothelial growth factors (VEGF) and transforming growth factors that promote the formation of new capillaries by recruiting, activating, and stimulating endothelial cells. Activated endothelial cells secrete matrix metalloproteases, which degrade the basement membrane and the extracellular matrix, and adhesion receptors such as integrins αvβ3, which allow their migration into the extracellular matrix toward the tumor cells. The newly grown vessels are immature and differ from normal capillaries. They are tortuous and irregular, resulting in poorly efficient perfusion, they are leaky (especially to macromolecules), and they are independent of the normal mechanisms of regulation of the capillary blood flow. Moreover, tumor microcirculation is heterogeneous. Evaluation of angiogenesis can be used as a prognostic marker to evaluate the aggressiveness of tumor and as a potential predictive marker of antiangiogenic treatment response. Histopathologic techniques of microvascular density indexes require invasive tissue sampling and need to be standardized. Hemodynamic characteristics of immature neovessels can be noninvasively assessed by dynamic contrast-enhanced magnetic resonance imaging or computed tomography. Tissue enhancement depends on arterial input function, kinetic of distribution of blood into the capillary bed, leakage across the capillary walls, and volume of the interstitial space. Pharmacodynamic models allow the evaluation of microvascular parameters of tissue blood flow, tissue blood volume, tissue interstitial volume, mean transit time, and permeability by surface of capillary wall. Methods based on dynamic contrast enhancement have been shown to correlate with conventional outcome methods such as histopathologic studies and survival. Radiologists must be convinced that, by using this emerging and promising approach, it is becoming possible to gain functional information during routine tumor imaging. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae invasion syndrome (KPIS) is a critical multi-site infection that is usually caused by highly virulent Klebsiella pneumonia . It is relatively common in Asian patients with diabetes and leads to sepsis, which has a high mortality rate. We report the case of a man in his early 40s who presented to the hospital with blurred vision in his left eye of 7 days' duration and fever of 1 day's duration. After a complete examination, he was diagnosed with KPIS on the basis of his liver abscessation, lung abscessation, endophthalmitis of the left eye and brain abscessation. After needle puncture and drainage of the left eye and liver abscess and anti-bacterial treatment with meropenem, the patient recovered well. When KPIS is suspected, attention should be paid to the sites of infection and the selection of the most appropriate antibiotics, but the most important aim should be to drain the lesions in a timely manner to improve the patient's prognosis.

This report describes magnetic resonance (MR) imaging of biopsy-proved cryptococcal central nervous system (CNS) infection in a 31-year-old HIV negative man. Initial MR imaging revealed multi-focal Gd-DTPA enhancement and showed more lesions than contrast enhanced CT. The lesions regressed after antifungal therapy. MR imaging aids in diagnosis as well as helps to monitor the response to the pharmacological therapy of cryptococcal meningoencephalitis and possibly provides valuable insights into the pathophysiology of this condition. [ABSTRACT FROM AUTHOR]

This study explored the predictive value of serum vascular endothelial growth factor (VEGF) and C-reactive protein (CRP) levels combined with enhanced magnetic resonance imaging (MRI) in hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE). One hundred and seventeen patients who received TACE from June 2010 to December 2012 in our hospital were included in this study. Serum VEGF and CRP levels before and after TACE were determined by ELISA and single immunodiffusion method for analyzing the association of serum levels with pathological features. Enhanced MRI was utilized before and after TACE to measure tumor size and ADC value in enhanced region and non-enhanced region. MRI data were combined with serum VEGF and CRP levels to analyze the predictive value in efficacy and prognosis for HCC patients after TACE. The serum VEGF and CRP levels after TACE were increased, but can return to normal levels in a certain time. VEGF and CRP levels were not statistically associated with tumor location, tumor staining or presence of membrane (all P > 0.05), but closely correlated with combined portal vein tumor thrombus, combined arteriovenous fistula and distant metastasis (all P < 0.05). Low levels of serum VEGF and CRP, small tumor size and low ADC value before treatment indicated a better prognosis. The sensitivity and specificity of serum VEGF and CRP levels, tumor size and ADC value were respectively 92.31% and 88.46%, 93.85% and 90.38%, 81.54% and 78.85% as well as 47.69% and 84.62%. Serum VEGF and CRP levels, tumor size and ADC value could predict the efficacy of TACE for HCC patients. Serum VEGF and CRP levels combined with enhanced MRI may serve as markers for efficacy and prognosis evaluation in HCC patients after TACE.