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Abstract Objectives This study investigated the quantitative assessment and application of Synthetic MRI (SyMRI) for preoperative brain development in children with congenital heart disease (CHD). Methods Forty-three CHD patients aged 2–24 months were prospectively included in the observation group, and 43 healthy infants were included in the control group. The SyMRI scans were processed by postprocessing software to obtain T1, T2, and PD maps. The values of T1, T2, and PD in different brain regions were compared with the scores of the five ability areas of the Gesell Development Scale by Pearson correlation analysis. Results In the observation group, the T1 values of the posterior limb of the internal capsule (PLIC), Optic radiation (PTR), cerebral peduncle, centrum semiovale, occipital white matter, temporal white matter, and dentate nucleus were greater than those in the control group. In the observation group, the T2 values of the PLIC, PTR, frontal white matter, occipital white matter, temporal white matter, and dentate nucleus were greater than those in the control group. Pearson correlation analysis revealed that the observation group had significantly lower Development Scale scores. In the observation group, the T2 value of the splenium of the corpus callosum was significantly positively correlated with the personal social behavior score. The AUCs for diagnosing preoperative brain developmental abnormalities in children with CHD using T1 values of the temporal white matter and dentate nucleus were both greater than 0.60. Conclusions Quantitative assessment using SyMRI can aid in the early detection of preoperative brain development abnormalities in children with CHD. Critical relevance statement T1 and T2 relaxation values from SyMRI can be considered as a quantitative imaging marker to detect abnormalities, allowing for early clinical evaluation and timely intervention, thereby reducing neurodevelopmental disorders in these children. Key Points T1 and T2 relaxation values by SyMRI are related to myelin development. Evaluated development quotient markers were lower in the observation compared to the control group. SyMRI can act as a reference indicator for brain development in CHD children. Graphical Abstract

Clinically and through auxiliary examinations, distinguishing uterine leiomyoma from early-stage uterine sarcoma presents significant challenges. A 48-year-old patient underwent a laparoscopic hysterectomy for uterine leiomyoma, during which a large uterus was excised through the vagina and extracted. Four months post-operation, the patient developed abdominal distension, indicative of extensive pelvic-abdominal dissemination of uterine sarcoma. We hypothesize that unprotected fibroid fragmentation increases the risk of uterine sarcoma spread, thereby worsening the prognosis. Our literature review aims to thoroughly understand the risks associated with unprotected transvaginal laparoscopic tumor division.

Purpose: To investigate the applicability of perfusion-weighted imaging (PWI) in evaluating the curative effect of endostar (EN) combined with neoadjuvant chemotherapy (NAC) in advanced cervical cancer. Methods: Between January 2021 and December 2022, 85 patients from Gansu Provincial Maternity and Child-care Hospital, China with advanced cervical cancer received NAC intravenously and underwent pre and post-chemotherapy PWI. Neoadjuvant chemotherapy (NAC) consisted of paclitaxel (135 - 175 mg/m²) and carboplatin (300 - 400 mg/m²). The NAC regimen comprised three courses, with each course lasting three weeks. General data, gross tumor volume (GTV), maximum signal intensity loss rate (MSILR), tumor regression rate (TRR), and post-chemotherapy MSILR reduction were compared between effective and non-effective groups. Results: There was a significant difference in International Federation of Gynecology and Obstetrics (FIGO) staging, pathological types and proportion of lymph node metastasis between effective and noneffective groups (p < 0.05). At the end of 3 cycles of chemotherapy, ORR was 72.94 %. After treatment with EN combined with NAC, GTV and MSILR in effective group were significantly lower compared to non-effective group (p < 0.05). After chemotherapy, the mean relative ratio (MRR) and MSILR in effective group were significantly higher compared to non-effective group (p < 0.05). Also, MSILR before treatment (EN combined with NAC) was positively correlated with TRR after chemotherapy in patients with advanced cervical cancer (p < 0.05). Conclusion: Perfusion-weighted imaging effectively changes tumor volume in patients with advanced cervical cancer after treatment with EN combined with NAC, and this has high application in evaluating the drug's curative effect. [ABSTRACT FROM AUTHOR]