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Introduction: Extrauterine endometrial stromal sarcoma (EESS) arising from Deep pelvic endometriosis (DPE) has a poor life quality and is difficult to diagnose pre-operatively. However, the patient’s quality of life can be improved when it is diagnosed precisely and managed successfully. Case report: A 35‑year‑old woman presented to our hospital with a 3-month history of hematochezia and anal pain. Initially, she was misdiagnosed as a rectal stromal tumor and then precisely diagnosed as having EESS from DPE following several multidisciplinary team (MDT) meetings. The lesion was shrunk by gonadotrophin-releasing hormone agonist (GnRH-α) treatment and then resected with minimal trauma. Conclusions: MDT is crucial in the treatment of the patient. It can promote individualized treatment and improve patient’s quality of life.

Diffusion-weighted imaging (DWI) is a useful technique to detect pancreatic lesion. In DWIs, field-of-view optimized and constrained undistorted single-shot (FOCUS) can improve the spatial resolution and multiplexed sensitivity-encoding (MUSE) can gain a high signal-to-noise ratio (SNR). Based on the advantage of FOCUS and MUSE, a new DWI sequence-named FOCUS-MUSE DWI (FOCUS combined with MUSE)-was developed to delineate the pancreas.To investigate the reliability of FOCUS-MUSE DWI compared to FOCUS, MUSE and single-shot (SS) DWI via the systematical evaluation of the apparent diffusion coefficient (ADC) measurements, SNR and image quality.Prospective.A total of 33 healthy volunteers and 9 patients with pancreatic lesion.A 3.0 T scanner. FOCUS-MUSE DWI, FOCUS DWI, MUSE DWI, SS DWI.For volunteers, ADC and SNR were measured by two readers in the pancreatic head, body, and tail. For all subjects, the diagnostic image quality score was assessed by three other readers on above four DWIs.Paired-sample T-test, intraclass correlation (ICC), Bland-Altman method, Friedman test, Dunn-Bonferroni post hoc test and kappa coefficient. A significance level of 0.05 was used.FOCUS-MUSE DWI had the best intersession repeatability of ADC measurements (head: 59.53, body: 101.64, tail: 42.30) among the four DWIs, and also maintained the significantly highest SNR (reader 1 [head: 19.68 ± 3.23, body: 23.42 ± 5.00, tail: 28.85 ± 4.96], reader 2 [head: 19.93 ± 3.52, body: 23.02 ± 5.69, tail: 29.77 ± 6.33]) except for MUSE DWI. Furthermore, it significantly achieved better image quality in volunteers (median value: 4 score) and 9 patients (most in 4 score).FOCUS-MUSE DWI improved the reliability of pancreatic images with the most stable ADC measurement, best image quality score and sufficient SNR among four DWIs.2 TECHNICAL EFFICACY: Stage 2.

Objective To investigate the prognostic value of baseline magnetic resonance imaging (MRI) texture analysis of hepatocellular carcinoma (HCC) treated with transcatheter arterial chemoembolization (TACE) and microwave ablation (MWA). Methods MRI was performed on 102 patients with HCC before receiving TACE combined with MWA in this retrospective study. The best 10 texture features were screened as a feature group for each MRI sequence by MaZda software using mutual information coefficient (MI), nonlinear discriminant analysis (NDA) and other methods. The optimal feature group with the lowest misdiagnosis rate was achieved on one MRI sequence between two groups dichotomized by 3-year survival, which was used to optimize the significant texture features with the optimal cutoff values. The Cox proportional hazards model was generated for the significant texture features and clinical variables to determine the independent predictors of overall survival (OS). The predictive performance of the model was further evaluated by the area under the ROC curve (AUC). Kaplan–Meier and log-rank tests were performed for disease-free survival (DFS) and Local recurrence-free survival (LRFS). Results The optimal feature group with the lowest misdiagnosis rate of 8.82% was obtained on T2WI using MI combined with NDA feature analysis. For Cox proportional hazards regression models, the independent prognostic factors associated with OS were albumin (P = 0.047), BCLC stage (P = 0.001), Correlat(1,− 1)T2 (P = 0.01) and SumEntrp(3,0)T2 (P = 0.015), and the prediction efficiency of multivariate model is AUC = 0.876, 95%CI = 0.803–0.949. Kaplan–Meier analyses further demonstrated that BCLC (P (1,− 1)T2 (P = 0.023) and SumEntrp(3,0)T2 (P P = 0.007) related to LRFS. Conclusions MR imaging texture features may be used to predict the prognosis of HCC treated with TACE combined with MWA.

Background: The various clinical manifestations of COVID-19 with RT-PCR positive patients have been reported. However, the differences in the clinical presentation between children and adults were unclear. Thus, we aimed to investigate the differences in the clinical manifestations and imaging characteristics between Chinese children and adults with COVID-19 by systematically analyzing the data derived from some latest literatures. Methods: An extensive search of COVID-19 papers was conducted in PubMed and Chinese medical journal network, and relevant articles were selected based on some standard requirements. The included papers were analyzed for differences in clinical manifestation between children and adults with COVID-19 after the quality evaluation with the QUADAS-2 tool. The differences in the clinical features and CT findings were analyzed using a Pearson χ2 test or Fisher's exact test. Patients who underwent CT examination were divided into the initial examination (0–4days) and follow-up examination groups (5–14 days). Results: A total of 345patients (70 children and 275 adults) with RT- PCR (+) were included in our study (5 papers for children and 5 papers for adult groups). Significant differences between children and adults were found in exposure history (p < 0.001, χ2 = 166.890), fever (p = 0.016, χ2 = 5.757), white cell count (p < 0.001, χ2 = 14.043), and CT features in the initial (p < 0.001, χ2 = 60.653) and follow-up stages (p < 0.001, χ2 = 52.924); and the involved lung in the follow-up stage (p ＜ 0.001, χ2 = 16.776). Conclusions: Some differences have been presented between children and adults with RT-PCR positive COVID-19, which are helpful in the management and protection of children with COVID-19.

To obtain the optimal simultaneous-multislice (SMS)—accelerated diffusion-weighted imaging (DWI) of the liver at 3.0 T MRI by systematically estimating the repeatability of apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR) and image quality of different breathing schemes in comparison to standard DWI (STD) and other SMS sequences. In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mm2) were performed in 23 volunteers on 3.0 T MRI using SMS and STD with breath-hold (BH-SMS, BH-STD), free-breathing (FB-SMS, FB-STD) and respiratory-triggered (RT-SMS, RT-STD). Reduction of scan time with SMS-acceleration was calculated. ADC and SNR were measured in nine anatomic locations and image quality was assessed on all SMS and STD sequences. An optimal SMS-DWI was decided by systematically comparing the ADC repeatability, SNR and image quality among above DWIs. SMS-DWI reduced scan time significantly by comparison with corresponding STD-DWI (27 vs. 42 s for BH, 54 vs. 78 s for FB and 42 vs. 97 s for RT). In all DWIs, BH-SMS had the greatest intraobserver agreement (intraclass correlation coefficient (ICC): 0.920–0.944) and good interobserver agreement (ICC: 0.831–0.886) for ADC measurements, and had the best ADC repeatability (mean ADC absolute differences: 0.046–0.058 × 10−3mm2/s, limits of agreement (LOA): 0.010–0.013 × 10−3mm2/s) in nine locations. BH-SMS had the highest SNR in three representative sections except for RT-STD. There were no significant differences in image quality between BH-SMS and other DWI sequences (median BH-SMS: 4.75, other DWI: 4.5–5.0; P > 0.0.5). BH-SMS provides considerable scan time reduction with good image quality, sufficient SNR and highest ADC repeatability on 3.0 T MRI, which is thus recommended as the optimal hepatic DWI sequence for those subjects with adequate breath-holding capability.

Objective To differentiate the clinical features and computed tomography imaging features in the two types of mixed epithelial and stromal tumor of the kidney (MESTK) and to establish a treatment plan for the MESTK types. Methods Seventeen patients who underwent multidetector computed tomography (MDCT) before surgery and had a pathological diagnosis of MESTK were enrolled. Their clinical information (R.E.N.A.L. nephrometry score (R.E.N.A.L.‐NS), radical nephrectomy (RN), partial nephrectomy (PN), etc.) were collected. The radiological features included renal sinus fat invagination (SFI), maximal diameter (MD), capsule and septa of the tumor, etc., were also analyzed. They were divided into two types according to the MDsolid/MDtumor ratio (solid type with >60%; cystic type with ≤60%). An independent‐sample t‐test and Fisher exact test were used to assess the differences between the two groups. Results MESTKs demonstrated a variable multi‐septate cystic and solid components with a delayed enhancement. There were nine patients for solid type and eight patients for cystic type. Compared with solid type, the lesions in cystic type have larger MD (81.00 ± 37.91 vs. 41.22 ± 24.19, p = 0.020), higher R.E.N.A.L.‐NS (10.03 ± 0.50 vs. 8.95 ± 1.26, p

PurposeTo investigate the significance of collagen in predicting the aggressiveness of rectal tumors in patients, examined in vivo based on tomoelastography quantified stiffness and ex vivo by histologically measured collagen volume fraction (CVF).Experimental Design170 patients with suspected rectal cancer were prospectively enrolled and underwent preoperative magnetic resonance imaging (MRI) and rectal tomoelastography, a technique based on multifrequency magnetic resonance elastography. Histopathologic analysis identified eighty patients with rectal cancer who were divided into subgroups by tumor-node (TN) stage, prognostic stage, and risk level. Rectal tumor stiffness was correlated with histopathologic CVF. Area-under-the-curve (AUC) and contingency analysis were used to evaluate the performance of rectal stiffness in distinguishing tumor stages which was compared to standard clinical MRIResultsIn vivo tomoelastography revealed that rectal tumor stiffened significantly with increased TN stage (pin vivo stiffness, CVF indicated an abnormally high collagen content in tumors with perineural invasion and poor differentiation status. CVF was also positively correlated with stiffness (pConclusionIn human rectal carcinomas, overexpression of collagen is correlated with increased tissue stiffness and high risk for tumor advancing more aggressively. In vivo tomoelastography quantifies rectal tumor stiffness which improves the diagnostic performance of standard MRI in the assessment of lymph nodes metastasis. Therefore, in vivo stiffness mapping by tomoelastography can predict rectal tumor aggressiveness and add diagnostic value to MRI.

Background To analyze the differences in clinical features and computed tomography characteristics in the two types of mixed epithelial and stromal tumor of the kidney (MESTK) and to establish a treatment plan for the MESTK types.Methods 17 patients underwent multidetector computed tomography (MDCT) before surgery and had a pathological diagnosis of MESTK were enrolled. Their clinical information (R.E.N.A.L.Nephrometry Score (R.E.N.A.L.－NS), radical nephrectomy (RN), partial nephrectomy (PN), etc.) were collected. The radiological features included renal sinus fat invagination (SFI), maximal diameter (MD), capsule and septa of the tumor, etc. were also analyzed. They were divided into two types according to the MDsolid/MDtumor ratio (type A with > 63%; type B with ≤ 63%). An independent-sample t-test and Fisher exact test were used to assess the differences between the two groups. Results MESTKs demonstrated a variable multi-septate cystic and solid components with a delayed enhancement. There were 9 patients for type A and 8 subjects for type B. Compared with type A, the lesions in type B have larger MD (79.13±39.06 vs. 41.22±24.19, p = 0.028), higher R.E.N.A.L.－NS (10.03±0.50 vs. 8.95±1.26, P＜0.001), higher RN (75.00% vs.22.22%, p =0.015), larger SFI (87.5% vs.33.3%, p=0.05), more septa (100% vs. 0%, p Conclusion Type B MESTK has more hazardous features compared with type A, suggesting that RN is more suitable for type B and PN for type A.

To obtain the optimal simultaneous-multislice (SMS)-accelerated diffusion-weighted imaging (DWI) of the liver at 3.0 T MRI by systematically estimating the repeatability of apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR) and image quality of different breathing schemes in comparison to standard DWI (STD) and other SMS sequences.In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mmSMS-DWI reduced scan time significantly by comparison with corresponding STD-DWI (27 vs. 42 s for BH, 54 vs. 78 s for FB and 42 vs. 97 s for RT). In all DWIs, BH-SMS had the greatest intraobserver agreement (intraclass correlation coefficient (ICC): 0.920-0.944) and good interobserver agreement (ICC: 0.831-0.886) for ADC measurements, and had the best ADC repeatability (mean ADC absolute differences: 0.046-0.058 × 10BH-SMS provides considerable scan time reduction with good image quality, sufficient SNR and highest ADC repeatability on 3.0 T MRI, which is thus recommended as the optimal hepatic DWI sequence for those subjects with adequate breath-holding capability.

Background: The various clinical manifestations of COVID-19 have been reported. However, the differences in the clinical presentation between children and adults were unclear. Thus, we aimed to investigate the differences in the clinical manifestations and imaging characteristics between children and adults with COVID-19 by systematically analyzing the data derived from some latest literatures. Methods: An extensive search of COVID-19 papers was conducted in PubMed and Chinese medical journal network, and relevant papers were selected based on some standard requirements. The included papers were analyzed for differences in clinical manifestation between children and adults with COVID-19 after the quality evaluation with the QUADAS-2 tool. The differences in the clinical features and CT findings were analyzed using a Pearson χ 2 test or Fisher's exact test. Patients who underwent CT examination were divided into the initial examination (0-4days) and follow-up examination groups (5-14 days). Findings: A total of 314 patients (39 children and 275 adults) with RT- PCR (+) were included in our study including 4 papers for child and 5 papers for adult groups. The significant differences between children and adults were found in exposure history ( p

Human stem-cell-derived extracellular vesicles (EVs) are currently being investigated for cell-free therapy in regenerative medicine applications, but their biodistribution and tropic properties for homing to injured tissues are largely unknown. Here, we labeled EVs with magnetic nanoparticles to create magneto-EVs that can be tracked by magnetic resonance imaging (MRI). Superparamagnetic iron oxide (SPIO) nanoparticles were coated with polyhistidine tags, which enabled purification of labeled EVs by efficiently removing unencapsulated SPIO particles in the solution. The biodistribution of systemically injected human induced pluripotent stem cell (iPSC)-derived magneto-EV was assessed in three different animal models of kidney injury and myocardial ischemia. Magneto-EVs were found to selectively home to the injury sites and conferred substantial protection in a kidney injury model. In vivo MRI tracking of magnetically labeled EVs represents a new powerful method to assess and quantify their whole-body distribution, which may help optimize further development of EV-based cell-free therapy.

Purpose Most existing non-contrast-enhanced methods for abdominal MR arteriography rely on a spatially selective inversion (SSI) pulse with a delay to null both static tissue and venous blood, and are limited to small spatial coverage due to the sensitivity to slow arterial inflow. Velocity-selective inversion (VSI) based approach has been shown to preserve the arterial blood inside the imaging volume at 1.5 T. Recently, velocity-selective saturation (VSS) pulse trains were applied to suppress the static tissue and have been combined with SSI pulses for cerebral MR arteriography at 3 T. The aim of this study is to construct an abdominal MRA protocol with large spatial coverage at 3 T using advanced velocity-selective pulse trains. Methods Multiple velocity-selective MRA protocols with different sequence modules and 3D acquisition methods were evaluated. Sequences using VSS only as well as SSI+VSS and VSI+VSS preparations were then compared among a group of healthy young and middle-aged volunteers. Using MRA without any preparations as reference, relative signal ratios and relative contrast ratios of different vascular segments were quantitatively analyzed. Results Both SSI+VSS and VSI+VSS arteriograms achieved high artery-to-tissue and artery-to-vein relative contrast ratios above aortic bifurcation. The SSI+VSS sequence yielded lower signal at the bilateral iliac arteries than VSI+VSS, reflecting the benefit of the VSI preparation for imaging the distal branches. Conclusion The feasibility of noncontrast 3D MR abdominal arteriography was demonstrated on healthy volunteers using a combination of VSS pulse trains and SSI or VSI pulse.

Purpose To compare the clinical utility of single-shot echo-planar imaging (SS-EPI) using different breathing schemes and readout-segmented EPI (RS-EPI) in the repeatability of apparent diffusion coefficient (ADC) measurements, signal-to-noise ratio (SNR) and image quality. Methods In this institutional review board-approved prospective study, hepatic DWIs (b = 50, 300, 600 s/mm2) were performed in 22 volunteers on 3.0 T MRI using SS-EPI with free-breathing diffusion-weighted imaging (FB-DWI), breath-hold (BH-DWI), respiratory-triggered (RT-DWI) and navigator-triggered (NT-DWI), and readout-segmented EPI (RS-DWI). ADC and surrogate SNR (sSNR) were measured in nine anatomic locations in the right lobe, and image quality was assessed on all FB-DWI, BH-DWI, RT-DWI, NT-DWI, and RS-DWI sequences. The sequence with the optimal clinical utility was decided by systematically comparing the ADC repeatability, sSNR and image quality of the above DWIs. Results In all the five sequences, NT-DWI had the most reliable intra-observer agreement (intraclass correlation coefficient (ICC): 0.900−0.922; all P > 0.05), and a better interobserver agreement (ICC: 0.853−0.960; all p > 0.05) than RS-DWI (ICC:0.881−0.916; some P Conclusion RS-DWI has the best SNR. However, NT-DWI can provide sufficient SNR, excellent image quality, and the best ADC repeatability on 3.0 T MRI. It is thus the recommended sequence for the clinical application of hepatic DWI.

DNAzymes are synthetic single-stranded DNA oligonucleotides that bind and cleave target mRNA in a sequence-specific manner. Although the therapeutic potential has been demonstrated in both preclinical and clinical settings, the efficient delivery and in vivo assessment of the DNAzyme efficacy remain the vital unsolved issue. In the present study, we examined the feasibility of using transcatheter arterial chemoembolization (TACE) strategy to deliver a DNAzyme targeting VEGFR-1 and monitoring its effect on tumor angiogenesis in vivo via dynamic contrast enhanced magnetic resonance imaging (DCE-MRI). In a rabbit liver cancer model (VX2), we showed that the DNAzyme was efficiently delivered into the tumor by TACE. DCE-MRI revealed that the VEGFR-1-targeted DNAzyme affected the tumor vasculature through inhibiting VEGFR-1 expression in vivo, which was reflected by a reduction of Ktrans and Kep, the parameters of tumor microvascular permeability. Our findings offer an efficient strategy of delivery and assessment of the VEGFR-1 DNAzyme, and further demonstrate the feasibility of DNAzyme for cancer therapy.

Background: Improving imaging quality of non-contrast enhanced magnetic resonance angiography (NCE-MRA) is essential to those renal function impairment patients especially patients with renal segmental branch disease in the renal parenchyma. Objectives: To investigate the relation between blood flow velocity (BFV) and blood suppression inversion time (BSP TI) for optimal visualization of the renal artery in NCE-MRA by spatial labeling with multiple inversion pulses (SLEEK) sequence. Patients and Methods: A catheter (simulated renal artery) was used to perform SLEEK with various BSP TI when injected saline with different velocity (simulated BFV). The relationship between BFV and BSP TI was evaluated by measuring signal-to-noise ratio (SNR) and was confirmed in nine hypertensive patients. Results: A negative relationship was found in vitro study between BFV and BSP TI with SLEEK sequence (r = -0.977, P = 0.023). For BSP TI = 200 ms, the simulated renal artery displayed hyper-intensity when simulated BFV = 96 - 128 cm/s and the maximum SNR was found when BFV = 128 cm/s (SNR = 0.927). For BSP TI = 500 ms, high signal appeared with BFV = 64 - 128 cm/s and the greatest SNR was found with BFV = 96 cm/s (SNR = 1.732). For BSP TI = 800 ms and 1100 ms, hyper-intensity arose with BFV = 16 - 128 cm/s and BFV = 6.4 - 128 cm/s separately, the highest SNR was described when BFV = 32 cm/s (SNR = 2.256) and BFV = 16 cm/s (SNR = 1.875). The different optimal BSP TI with best image quality was discovered in nine hypertensive patients. Conclusion: An optimal BSP TI based on BFV can improve the ability of delineating renal artery in SLEEK sequence.

Microvascular invasion (MVI) is regarded as one of the independent risk factors for recurrence and poor prognosis of hepatocellular carcinoma (HCC). The presence of MVI in HCCs was evaluated on the basis of pathological reports of surgical specimens and was defined as tumor within a vascular space lined by endothelium that was visible only on microscopy. The aim of the study was to investigate the usefulness of intravoxel incoherent motion (IVIM) diffusion weighted (DW) magnetic resonance (MR) imaging in predicting MVI of HCC. Preoperative IVIM DW imaging and Gd-EOB-DTPA-enhanced MRI (DCE-MRI) of 51 patients were analyzed. Standard apparent diffusion coefficient (ADC), D (the true diffusion coefficient), D* (the pseudodiffusion coefficient) and f (the perfusion fraction), relative enhancement (RE) and radiological features were evaluated and analyzed. Univariate analysis revealed that HCCs with MVI had a higher portion of an irregular tumor shape than HCCs without MVI (p = 0.009), the Standard ADC, D value were significantly lower in HCCs with MVI (p = 0.022, p = 0.007, respectively). Multivariate analysis revealed that an irregular shape (p = 0.012) and D value ≤ 1.16×10-3mm2/sec (p = 0.048) were independent predictors for MVI. Combining the two factors of an irregular shape and D value, a sensitivity of 94.4% and specificity of 63.6% for predicting MVI was obtained. In conclusion, we found that an irregular shape and D value ≤ 1.16×10-3mm2/sec may suggest the presence of MVI in HCCs.

Increasing evidence has suggested that dysregulation of microRNAs (miRNAs) could contribute to tumor progression. Previous miRNA microarray analysis illustrated that miR-335 is downregulated in various cancers; however, the role of miR-335 on hepatocellular carcinoma (HCC) has not been well elucidated. In this study, we investigated the biological functions and molecular mechanisms of miR-335 in human HCC in vitro, discussing whether it could be a therapeutic biomarker of HCC in the future. Four HCC cell lines and samples from 62 patients with HCC were analyzed for the expression of miR-335 by quantitative RT-PCR. Overexpression of miR-335 was established by transfecting mimics into HepG2 and HuH7 cells. Cell proliferation and cell migration were assessed by cell viability assay and transwell assay. Luciferase reporter assay and Western blot were to verify ROCK1 as a novel target gene of miR-335. We observed that miR-335 was downregulated in human HCC tissues and in all four HCC cell lines. The MTT assay revealed that overexpression of miR-335 subsequently inhibited cell growth. Furthermore, the transwell assay also showed significant cell migration inhibition in miR-335 transfectant. The expression of ROCK1 was decreased evidently after overexpression of miR-335, indicating that ROCK1 is a target gene for miR-335. Our data revealed that miR-335 could inhibit the proliferation and migration invasion of HCC cells via regulating ROCK1, suggesting that miR-335 could be a therapeutic biomarker of HCC in the future.

To study the CT features for solitary fibrous tumor (SFT) in the abdomen and pelvis and to improve the diagnostic accuracy. Methods: Fourteen patients with SFT were collected in our hospital from January, 2011 to December, 2015. Characteristic of images were analyzed and compared for 10 SFT, which located outside the abdominal organs with extragastrointestinal stromal tumors (EGIST), leiomyosarcoma, and schwannoma. Results: Necrosis and cystic formation were frequently present in SFT in the abdomen and pelvis. CE-CT showed serpentine vessels along the periphery, while pattern of enhancement was map-like inhomogeneous progressive. Comparing with the EGIST or schwannoma, the difference of CT value in non-contrast and the arterial phase were statistically significant (P0.05). The numbers of peritumoral circuity vessel were significantly different between SFT and EGIST (χ²=18.27, P0.008) or between SFT and schwannoma (χ²=19.25, P0.008). Comparing with the leiomyosarcoma or schwannoma, SFT located outside the abdominal organs. We found that tumor necrosis rate was significantly different between SFT and leiomyoscarcoma (χ²=8.00, P0.008). Conclusion: SFT in the abdomen and pelvis show certain CT characteristics. The CT value in non-contrast and at the arterial phase, tumor necrosis rate, and serpentine vessels along the periphery were pivotal in differentiating SFT from leiomyosarcoma, EGIST and schwannoma.目的：分析腹盆部孤立性纤维瘤(solitary fibrosis tumor，SFT)的CT表现，提高诊断正确率。方法：分析2011年1月至2015年12月湘雅医院经病理证实的14例SFT的CT特征，并将10例腹盆部脏器外SFT与同时期10例腹盆部脏器外平滑肌肉瘤、28例神经鞘瘤及18例胃肠外间质瘤(extragastrointestinal stromal tumors，EGIST)的影像表现进行对比分析。结果：腹盆部SFT大多呈“地图样”不均匀渐进性强化，易液化坏死，瘤周常见迂曲血管。SFT分别与EGIST、神经鞘瘤对比，其平扫CT值、动脉期强化程度差异有统计学意义(P0.05)；SFT分别与EGIST、平滑肌肉瘤对比，瘤周血管影出现率差异均有统计学意义(P0.008)。SFT与平滑肌肉瘤液化坏死率分类差异有统计学意义(P0.008)。结论：腹盆部SFT的CT表现有一定特征，平扫CT值及动脉期强化程度、坏死液化率、瘤周迂曲血管出现率对其与平滑肌肉瘤、神经鞘瘤及EGIST的鉴别诊断有一定价值。.

Rationale:Vasculitis is one of the common pathological hallmarks of systemic lupus erythematosus (SLE). Vascular lesions in SLE commonly involve medium- and small-sized vessels. Rarely, vasculitis in SLE may involve large vessels such as the aorta leading to life-threatening complications. R

To evaluate the diagnostic value of liver imaging reporting and classification criteria of data system (LI-RADS) MRI on primary hepatic carcinoma (HCC). The MRI images of 100 patients (72 patients with HCC, 4 with regenerative nodules, 13 with hemangioma, 4 with liver cyst, 3 with Liver abscess, 2 with inflammatory pseudotumor, 1 with hepatic arteriovenous fistula, 1 with Limitations of steatosis) with liver disease were collected in Xiangya Hospital from January, 2014 to January, 2015. All patients were at the risk of HCC. The images were reviewed according to the LI-RADS categorization by American College of Radiology (ACR) under a condition of blindness to the pathological data. The sensitivity, specificity and the area under the ROC curve in the diagnosis of HCC with the LI-RADS categorization were calculated by three associate professors from the Department of Radiology, Xiangya Hospital. The area under the ROC curve was 0.925 in the 100 patients with HCC. Of the 100 pathologically confirmed patients, 20 cases were LR1 and LR2. However, the post-operation pathological examination showed benign tumor (negative predictive value was 100%). There were 25 HCC in 31 cases of LR3, 27 HCC in 29 cases of LR4 (positive predictive value was 93.1%). All of 20 cases of LR5 were HCC (positive predictive value was 100%). If LR1 and LR2 were considered negative, and LR3, 4, 5 were positive, then the sensitivity, the specificity and the area under the ROC curve was 100%, 71.4% and 0.925, respectively. If LR1, 2 and 3 were considered negative and LR4 and LR5 were positive, the sensitivity, the specificity and the area under the ROC curve was 100%, 90.9% and 0.974, respectively. The MRI LI-RADS categorization is highly sensitive and specific in the diagnosis of HCC, which can improve the diagnostic accuracy.目的：初步探讨肝影像报告和数据系统(liver imaging reporting and data system，LI-RADS)磁共振成像(magnetic resonance imaging，MRI)分级标准对原发性肝癌的诊断价值。方法：搜集2014年1月至2015年1月在中南大学湘雅医院术后病理证实的100例(原发性肝癌72例，再生结节4例，血管瘤13例，肝囊肿4例，肝脓肿3例，炎性假瘤2例，肝动静脉瘘1例，局限性脂肪变性1例)具有原发性肝癌高危因素患者的MRI影像资料，由3位影像学副教授在不知道病理结果的前提下，严格按照LI-RADS MRI分级标准对图像进行评阅，计算出LI-RADS MRI分级标准诊断原发性肝癌的敏感性、特异性及ROC曲线下面积。结果：应用LI-RADS MRI分级标准诊断100例患者为原发性肝癌的ROC曲线下面积为0.925。100例患者图像的肝病变分类中LR1类和LR2类20例，术后病理检查均为良性(阴性预测值为100%)，31例LR3类中术后病理检查有25例为原发性肝癌，29例LR4类中术后病理检查有27例为原发性肝癌(阳性预测值为93.1%)，20例LR5类中术后病理检查表明全部为原发性肝癌(阳性预测值为100%)。将LR3，4，5类归为阳性，则该分级标准的敏感性和特异性分别为100%和71.4%，ROC曲线下面积为0.925。若将LR4，5类归为阳性，则敏感性和特异性可以达到100%和90.9%，ROC曲线下面积为0.974。结论：采用LI-RADS的MRI分级标准诊断原发性肝癌有很好的敏感性及特异性，具有较高的诊断正确率。.

In this study, the time-dependent changes on dynamic computed tomograph (CT) of radiation-induced liver injury in gastric cancer patients was examined. The CT images of 52 gastric cancer patients who had received chemoradiotherapies were reviewed on the PACS system. Dynamic CT scan was performed in all the subjects. Our results showed that 18 patients were found to have radiation-induced liver injury. The CT findings of radiation-induced liver injury in gastric cancer patients tend to show up one month after radiation treatment. The damaged area was of low density on all three phases, and then it was enhanced on portal vein phase or delay phase. The focal radiation reaction of liver without basic disease vanished 9-11 months later after treatment. We are led to conclude that dynamic CT is of help in the diagnosis of CRT-induced liver injury, and it may be the method of choice for following up the whole course of the CRT-induced liver injury, i.e., form hepatic damage to healing. The classification of CT findings we recommend can avoid the influence of technological factors, and thereby serve as a better guide for treatment of CRT-induced liver injury.

2GE Healthcare, Waukesha, WI 53188, USA Objective: To determine whether an optimal blood suppression inversion time (BSP TI) can boost arterial visibility and whether the optimal BSP TI is related to breathing rate (BR) and heart rate (HR) for hypertension subjects in spatial labeling with multiple inversion pulses (SLEEK). Materials and Methods: This prospective study included 10 volunteers and 93 consecutive hypertension patients who had undergone SLEEK at 1.5T MRI system. Firstly, suitable BSP TIs for displaying clearly renal artery were determined in 10 volunteers. Secondly, non-contrast enhanced magnetic resonance angiography with the suitable BSP TIs were performed on those hypertension patients. Then, renal artery was evaluated and an optimal BSP TI to increase arterial visibility was determined for each patient. Patients’ BRs and HRs were recorded and their relationships with the optimal BSP TI were analyzed. Results: The optimal BSP TI was negatively correlated with BR (r1 = -0.536, P1 < 0.001; and r2 = -0.535, P2 < 0.001) and HR (r1 = -0.432, P1 = 0.001; and r2 = -0.419, P2 = 0.001) for 2 readers (κ = 0.93). For improving renal arterial visibility, BSP TI = 800 ms could be applied as the optimal BSP TI when the 95% confidence interval were 17–19/min (BR1) and 74–82 bpm (HR1) for reader#1 and 17–19/min (BR2) and 74–83 bpm (HR2) for reader#2; BSP TI = 1100 ms while 14–15/min (BR1, 2) and 71–76 bpm (HR1, 2) for both readers; and BSP TI = 1400 ms when 13–16/min (BR1) and 63–68 bpm (HR1) for reader#1 and 14–15/min (BR2) and 64–70 bpm (HR2) for reader#2. Conclusion: In SLEEK, BSP TI is affected by patients’ BRs and HRs. Adopting the optimal BSP TI based on BR and HR can improve the renal arterial visibility and consequently the working efficiency. Index terms: Spatial labeling with multiple inversion pulses; Renal artery; Noncontrast magnetic resonance angiography; Optimal blood suppression inversion time; SLEEK

Background:Catheter-related thrombotic complications(TCs) can occur during the long term use of a chronic dialysis catheter (CDC), including fibrin sheath (FS), mural thrombosis (MT), venous thrombosis (VT), and intraluminal clots (IC), which has not been reported with MRI. The aim of our st