Magnetic resonance

磁共振
  • 文章类型: Journal Article
    磁共振血管壁成像(MR-VWI)是一种新兴的成像技术,用于评估未破裂颅内动脉瘤(UIA)的进行性风险。与标准评估模型不同,MR-VWI仍然有争议。这项研究旨在进一步确定动脉瘤壁增强(AWE)与动脉瘤稳定性之间的潜在关系。使用“颅内动脉瘤”,“磁共振”,和“增强”作为关键字,相关研究在PubMed中进行了系统搜索,Embase,还有Cochrane,纳入合格的研究进行进一步分析.有13项病例对照研究,4项队列研究,2,678例颅内动脉瘤纳入荟萃分析。结果表明,AWE与颅内动脉瘤破裂相关(OR=35.90,95%CI:15.58至82.75,p<0.001)。生长(OR=6.69,95%CI:2.69至16.63,p<0.001),和症状的存在(OR=14.46,95%CI:9.07至23.05,p<0.001)。这一发现具有很高的诊断价值,但这种相关性可能与动脉瘤大小无关.随访研究的汇总相对风险显示,使用AWE的UIA进展风险约为不使用AWE的3.33倍(RR=3.33,95%CI:2.33至4.78,p<0.001)。此外,汇总结果表明,VWI增强的定量指标与动脉瘤稳定性具有同等的相关性(OR=19.61,95%CI:10.63~36.17,p<0.001).AWE是评估UIAs稳定性的有效成像方法,它可以成为未来预防性治疗小的未破裂颅内动脉瘤的标志,这还有待大样本前瞻性研究的验证。
    Magnetic resonance vessel wall imaging (MR-VWI) is an emerging imaging technology used to assess the progressive risk of unruptured intracranial aneurysms (UIAs). Unlike the standard evaluation model, MR-VWI is still debatable. This study aims to further define the potential relationship between aneurysm wall enhancement (AWE) and aneurysm stability. Using \"intracranial aneurysm\", \"magnetic resonance\", and \"enhancement\" as keywords, relevant studies were systematically searched in PubMed, Embase, and Cochrane, and the qualified studies were enrolled for further analysis. There were 13 case-control studies, 4 cohort studies, and 2,678 cases of intracranial aneurysms included in the meta-analysis. It was shown that AWE was correlated with intracranial aneurysm rupture (OR = 35.90, 95% CI: 15.58 to 82.75, p < 0.001), growth (OR = 6.69, 95% CI: 2.69 to 16.63, p < 0.001), and presence of symptoms (OR = 14.46, 95% CI: 9.07 to 23.05, p < 0.001). This finding had a high diagnostic value, but the correlation was probably not independent of aneurysm size. The pooled relative risks of the follow-up studies revealed that the risk of UIA progression was approximately 3.33 times higher with AWE than without AWE (RR = 3.33, 95% CI: 2.33 to 4.78, p < 0.001). In addition, the pooled results demonstrated that quantitative indices of VWI enhancement were equally linked with aneurysm stability (OR = 19.61, 95% CI: 10.63 to 36.17, p < 0.001). AWE is an effective imaging method to assess the stability of UIAs, and it can be a marker for the prophylactic treatment of small unruptured intracranial aneurysms in the future, which remains to be validated by prospective studies with large samples.
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  • 文章类型: Journal Article
    背景:探讨影响前置胎盘(PP)患者的危险因素,构建PP患者PAS严重程度的有效预测模型。
    方法:本研究共纳入240名患有PP的孕妇。建立了基于MRI+超声的模型,将患者分为胎盘植入组和非胎盘植入组。基于成像特征创建多变量列线图。使用受试者工作特征(ROC)曲线分析评估模型。通过校准图和决策曲线分析评估列线图的预测准确性。
    结果:基于MRI+超声的预测模型显示出胎盘植入组和非胎盘植入组之间的良好区别。校准曲线显示出胎盘植入的估计概率和实际概率之间的一致性。此外,决策曲线分析表明,在广泛的概率阈值范围内,临床获益较高.ROC曲线下面积(AUC)为0.911(95%CI:0.76-0.947),敏感性为88.40%,特异性为88.10%。
    结论:基于MRI+超声的预测模型可能是术前预测植入百分比的有价值的工具。我们的研究使产科医生能够进行更充分的术前评估。
    BACKGROUND: To investigate the risk factors affecting patients with placenta previa (PP) and to construct an effective prediction model for the severity of PAS in PP.
    METHODS: A total of 240 pregnant women with PP were enrolled in this study. An MRI+Ultrasound-based model was developed to classify patients into placental implantation and non-placental implantation groups. Multivariate nomograms were created based on imaging features. The model was evaluated using Receiver Operating Characteristic (ROC) curve analysis. The predictive accuracy of the nomogram was assessed through calibration plots and decision curve analysis.
    RESULTS: The MRI+Ultrasound-based prediction model demonstrated favorable discrimination between the placental implantation and non-placental implantation groups. The calibration curve exhibited agreement between the estimated and actual probability of placental implantation. Additionally, decision curve analysis indicated a high clinical benefit across a wide range of probability thresholds. The Area under the ROC curve (AUC) was 0.911 (95 % CI: 0.76-0.947), with a sensitivity of 88.40 % and specificity of 88.10 %.
    CONCLUSIONS: The MRI+Ultrasound-based prediction model could be a valuable tool for preoperative prediction of the percentage of implantation. Our study enables obstetricians to conduct more adequate preoperative evaluations.
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  • 文章类型: Journal Article
    目的:本研究旨在评估常规二维(2D)盆腔超声与三维(3D)超声结合在评估梗阻性穆勒异常中的实际应用。
    方法:三级转诊医院的相关研究方法:使用计算机存储的数据收集2022年12月至2023年10月之间手术证实的梗阻性穆勒异常病例,并评估术前影像。需要急性出现腹痛和临床怀疑梗阻性苗勒管异常。所有研究参与者在确定性手术前都接受了盆腔超声检查,如果在入院前进行了MRI,则有或没有重复MRI。排除MRI和超声均未进行的情况,比如阴道横隔,无孔处女膜,仅有医源性宫颈损伤或穆勒畸形,没有阻塞性流出异常,如didelphys,bicornuate,或纵隔子宫。
    方法:29例女性中有27例(93.1%)经手术证实的诊断与盆腔超声检查结果一致。相比之下,在这项研究中,29例中只有24例通过MRI正确诊断(82.8%)。这项试点研究对两种技术进行了比较,特别关注阻塞性穆勒异常。盆腔超声的使用不仅有助于我们的外科手术实践,而且还显着改善了患者-医生咨询。
    结论:在处理梗阻性穆勒异常时,发现3D增强的常规盆腔超声可有效诊断,并且与MRI相当。
    OBJECTIVE: This study aimed to assess the practical application of conventional two-dimensional (2D) pelvic ultrasound in conjunction with three-dimensional (3D) ultrasound for evaluating obstructive Müllerian abnormalities.
    METHODS: Respective study in tertiary referral hospital METHOD: Computerized stored data was used to collect surgical confirmed obstructive Müllerian anomalies cases between December 2022 and October 2023 with presurgical imagings being evaluated. Acute presentation with abdominal pain and clinical suspicion of obstructive Müllerian abnormality were required for inclusion. All study participants underwent pelvic ultrasound prior to the definitive surgery, with or without a repeat MRI if one was performed previous to admission. Those situations where both MRI and ultrasound were not conducted were excluded, such as the transverse vaginal septum, imperforate hymen, iatrogenic cervical injury or Müllerian malformation alone without obstructive outflow anomalies like didelphys, bicornuate, or septate uterus.
    METHODS: The concordance between the surgically confirmed diagnosis and the pelvic ultrasound was reported in 27 of 29 women (93.1%). In contrast, only 24 of 29 cases were correctly diagnosed with MRI in this study (82.8%). This pilot study presents a comparison of two techniques, with a specific focus on obstructive Müllerian anomalies. The use of pelvic ultrasound not only assisted in our surgical practice but also significantly improved patient-doctor counseling.
    CONCLUSIONS: In managing obstructive Müllerian abnormalities, 3D-enhanced conventional pelvic ultrasound was found effective in diagnosis and was comparable to MRI.
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  • 文章类型: Journal Article
    我们旨在整合MR放射组学和动态血液学因素,以建立模型来预测食管鳞状细胞癌(ESCC)对新辅助放化疗(NCRT)的病理完全缓解(pCR)。
    回顾性纳入2014年9月至2022年9月接受NCRT和食管切除术的ESCC患者。所有患者均接受治疗前T2加权成像以及治疗前和治疗后的血液检查。以7:3的比例将患者随机分为训练集和测试集。基于MR影像组学和血液学因素构建机器学习模型来预测pCR,分别。开发了一个列线图模型来整合MR放射组学和血液学因素。通过曲线下面积(AUC)评估模型性能,灵敏度,特异性,阳性预测值和阴性预测值。
    共纳入82名患者,其中39人(47.6%)达到pCR。用四个血液学因子构建的血液学模型在测试集中具有0.628(95CI0.391-0.852)的AUC。选择1106个提取特征中的两个来构建AUC为0.821(95CI0.641-0.981)的影像组学模型。整合血液学因素和MR影像组学的列线图模型具有最好的预测性能。测试集中的AUC为0.904(95CI0.770-1.000)。
    构建了使用动态血液学因素和MR影像组学的集成模型,以准确预测ESCC中对NCRT的pCR,这可能有助于食道的个体化保留治疗。
    UNASSIGNED: We aimed to integrate MR radiomics and dynamic hematological factors to build a model to predict pathological complete response (pCR) to neoadjuvant chemoradiotherapy (NCRT) in esophageal squamous cell carcinoma (ESCC).
    UNASSIGNED: Patients with ESCC receiving NCRT and esophagectomy between September 2014 and September 2022 were retrospectively included. All patients underwent pre-treatment T2-weighted imaging as well as pre-treatment and post-treatment blood tests. Patients were randomly divided to training set and testing set at a ratio of 7:3. Machine learning models were constructed based on MR radiomics and hematological factors to predict pCR, respectively. A nomogram model was developed to integrate MR radiomics and hematological factors. Model performances were evaluated by areas under curves (AUCs), sensitivity, specificity, positive predictive value and negative.
    UNASSIGNED: A total of 82 patients were included, of whom 39 (47.6 %) achieved pCR. The hematological model built with four hematological factors had an AUC of 0.628 (95%CI 0.391-0.852) in the testing set. Two out of 1106 extracted features were selected to build the radiomics model with an AUC of 0.821 (95%CI 0.641-0.981). The nomogram model integrating hematological factors and MR radiomics had best predictive performance, with an AUC of 0.904 (95%CI 0.770-1.000) in the testing set.
    UNASSIGNED: An integrated model using dynamic hematological factors and MR radiomics is constructed to accurately predicted pCR to NCRT in ESCC, which may be potentially useful to assist individualized preservation treatment of the esophagus.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    OBJECTIVE: Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients.
    METHODS: All enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group.
    RESULTS: There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, respectively.
    CONCLUSIONS: GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.
    胃癌腹腔游离癌细胞可对疾病进展和患者预后产生不利影响。本研究旨在探讨金角径向采样动态增强磁共振成像(GRASP DCE-MRI)预测胃癌患者腹膜游离癌细胞存在的可行性。对胃癌患者进行术前磁共振成像(MRI)扫描和灌注后处理,并采集患者术前腹腔灌洗标本进行检测。根据患者入组顺序将其分为实验组及验证组,将实验组数据进行多元回归分析并筛选有意义的变量,建立预测腹膜灌洗液阳性率的nomogram预测模型,并根据验证组数据对模型的有效性进行验证。研究发现,GRASP DCE-MR预测的腹膜灌洗细胞学(PLC)阳性病例比例与实际的PLC检测结果无统计学差异。肿瘤T分期、肿瘤厚度和灌注参数容积转移常数(Ktrans)均是腹膜灌洗液阳性的独立预测因子。用这些预测因子构建的nomogram模型可以帮助临床医生更好地预测胃癌患者腹膜游离癌细胞存在的风险。.
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  • 文章类型: Journal Article
    OBJECTIVE: Peritoneal free cancer cells can negatively impact disease progression and patient outcomes in gastric cancer. This study aimed to investigate the feasibility of using golden-angle radial sampling dynamic contrast-enhanced magnetic resonance imaging (GRASP DCE-MRI) to predict the presence of peritoneal free cancer cells in gastric cancer patients.
    METHODS: All enrolled patients were consecutively divided into analysis and validation groups. Preoperative magnetic resonance imaging (MRI) scans and perfusion were performed in patients with gastric cancer undergoing surgery, and peritoneal lavage specimens were collected for examination. Based on the peritoneal lavage cytology (PLC) results, patients were divided into negative and positive lavage fluid groups. The data collected included clinical and MR information. A nomogram prediction model was constructed to predict the positive rate of peritoneal lavage fluid, and the validity of the model was verified based on data from the verification group.
    RESULTS: There was no statistical difference between the proportion of PLC-positive cases predicted by GRASP DCE-MR and the actual PLC test. MR tumor stage, tumor thickness, and perfusion parameter Tofts-Ketty model volume transfer constant (Ktrans) were independent predictors of positive peritoneal lavage fluid. The nomogram model featured a concordance index (C-index) of 0.785 and 0.742 for the modeling and validation groups, respectively.
    CONCLUSIONS: GRASP DCE-MR could effectively predict peritoneal free cancer cells in gastric cancer patients. The nomogram model constructed using these predictors may help clinicians to better predict the risk of peritoneal free cancer cells being present in gastric cancer patients.
    胃癌腹腔游离癌细胞可对疾病进展和患者预后产生不利影响。本研究旨在探讨金角径向采样动态增强磁共振成像(GRASP DCE-MRI)预测胃癌患者腹膜游离癌细胞存在的可行性。对胃癌患者进行术前磁共振成像(MRI)扫描和灌注后处理,并采集患者术前腹腔灌洗标本进行检测。根据患者入组顺序将其分为实验组及验证组,将实验组数据进行多元回归分析并筛选有意义的变量,建立预测腹膜灌洗液阳性率的nomogram预测模型,并根据验证组数据对模型的有效性进行验证。研究发现,GRASP DCE-MR预测的腹膜灌洗细胞学(PLC)阳性病例比例与实际的PLC检测结果无统计学差异。肿瘤T分期、肿瘤厚度和灌注参数容积转移常数(Ktrans)均是腹膜灌洗液阳性的独立预测因子。用这些预测因子构建的nomogram模型可以帮助临床医生更好地预测胃癌患者腹膜游离癌细胞存在的风险。.
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  • 文章类型: Journal Article
    目的:为了促进利用计算机断层扫描(CT)和磁共振(MR)成像模式信息的头颈部(HaN)放射治疗(RT)计划的自动分割方法的发展,我们组织了HaN-Seg:头颈部危险器官CT和MR分割挑战。
    方法:挑战任务是在有42个公开可用的培训案例的情况下,在14个保留的测试案例中自动分割HaN区域的30个危险器官(OAR)。每例病例均由同一患者的HaN区域的1张对比增强CT和1张T1加权MR图像组成,与多达30个相应的参考OAR划定蒙版。根据骰子相似系数(DSC)和95百分位数Hausdorff距离(HD95)评估性能,通过使用Wilcoxon符号秩检验对提交的方法进行成对比较,对每个度量进行统计排名。
    结果:虽然有23个团队报名参加了这项挑战,只有七个提交了最后阶段的方法。表现最好的团队实现了76.9%的DSC和3.5毫米的HD95。所有参与团队都使用基于U-Net的架构,获胜团队利用刚性MR到CT注册,结合两种模式的网络入门级串联。
    结论:这一挑战通过提供具有不同视场和体素大小的非配准MR和CT图像来模拟真实世界的临床场景。值得注意的是,表现最好的团队在同一数据集上取得了超过观察者间协议的细分绩效。这些结果为该公开可用数据集和配对多模态图像分割的未来研究设定了基准。
    To promote the development of auto-segmentation methods for head and neck (HaN) radiation treatment (RT) planning that exploit the information of computed tomography (CT) and magnetic resonance (MR) imaging modalities, we organized HaN-Seg: The Head and Neck Organ-at-Risk CT and MR Segmentation Challenge.
    The challenge task was to automatically segment 30 organs-at-risk (OARs) of the HaN region in 14 withheld test cases given the availability of 42 publicly available training cases. Each case consisted of one contrast-enhanced CT and one T1-weighted MR image of the HaN region of the same patient, with up to 30 corresponding reference OAR delineation masks. The performance was evaluated in terms of the Dice similarity coefficient (DSC) and 95-percentile Hausdorff distance (HD95), and statistical ranking was applied for each metric by pairwise comparison of the submitted methods using the Wilcoxon signed-rank test.
    While 23 teams registered for the challenge, only seven submitted their methods for the final phase. The top-performing team achieved a DSC of 76.9 % and a HD95 of 3.5 mm. All participating teams utilized architectures based on U-Net, with the winning team leveraging rigid MR to CT registration combined with network entry-level concatenation of both modalities.
    This challenge simulated a real-world clinical scenario by providing non-registered MR and CT images with varying fields-of-view and voxel sizes. Remarkably, the top-performing teams achieved segmentation performance surpassing the inter-observer agreement on the same dataset. These results set a benchmark for future research on this publicly available dataset and on paired multi-modal image segmentation in general.
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  • 文章类型: Case Reports
    盆腔肿块通常起源于盆腔,通常与子宫有关。卵巢,或肠道疾病。本报告描述了我院诊断为腹膜后皮样囊肿的盆腔肿块患者的情况。我们对这个案例进行了分析和文献综述,减少误诊风险,加强腹膜后肿块的治疗。
    Pelvic masses frequently originate from the pelvic cavity and are often associated with uterine, ovarian, or intestinal disorders. This report describes the case of a patient with a pelvic mass diagnosed as a retroperitoneal dermoid cyst at our hospital. We analyzed this case and conducted a literature review, to mitigate the risk of misdiagnosis and enhance the treatment of retroperitoneal masses.
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  • 文章类型: Journal Article
    目前,缺乏客观的定量措施来全面评估axSpA的炎症活性,这对准确评估疾病活动提出了一定的挑战。
    探讨骶髂关节(SIJs)MRI弛豫测量和外周血黏膜相关不变T(MAIT)细胞联合参数模型在评估轴性脊柱关节炎(axSpA)炎症活动中的价值。
    这项回顾性临床研究包括88名axSpA患者(中位年龄31.0(22.0,41.8)岁,21.6%的女性)和20个对照组(中位年龄28.0(20.5,49.5)岁,40.0%女性)。根据ASDAS-CRP将axSpA组分为有活性亚组(n=50)和无活性亚组(n=38)。所有参与者均接受SIJsMRI检查,包括T1和T2*标测,和MAIT细胞(定义为CD3+Vα7.2+CD161+)及其活化标志物(CD69)的外周血流式细胞术分析。T1和T2*值,比较不同组之间MAIT细胞和CD69+MAIT细胞的百分比。使用逻辑回归建立组合参数模型,采用ROC曲线评价诊断效能。
    axSpA组及其亚组SIJs和%CD69MAIT细胞的T1值均高于对照组(p<0.05),而MAIT细胞%均低于对照组(p<0.05)。T1值与%CD69+MAIT细胞呈正相关,而%MAIT细胞负相关,与ASDAS-CRP(r=0.555,0.524,-0.357,p<0.001)。在对照组和axSpA组之间,在不活跃和活跃的亚组之间,联合参数模型T1映射+%CD69+MAIT细胞具有最佳疗效(AUC=0.959,0.879,灵敏度=88.6,70%,特异性=95.0,94.7%,分别)。
    组合参数模型T1作图%CD69MAIT细胞可以更准确地评估炎症活性水平。
    UNASSIGNED: Currently, there is a lack of an objective quantitative measure to comprehensively evaluate the inflammatory activity of axSpA, which poses certain challenges in accurately assessing the disease activity.
    UNASSIGNED: To explore the value of combined-parameter models of sacroiliac joints (SIJs) MRI relaxometry and peripheral blood Mucosal-associated invariant T (MAIT) cells in evaluating the inflammatory activity of axial spondyloarthritis (axSpA).
    UNASSIGNED: This retrospective clinical study included 88 axSpA patients (median age 31.0 (22.0, 41.8) years, 21.6% females) and 20 controls (median age 28.0 (20.5, 49.5) years, 40.0% females). The axSpA group was classified into active subgroup (n=50) and inactive subgroup (n=38) based on ASDAS-CRP. All participants underwent SIJs MRI examination including T1 and T2* mapping, and peripheral blood flow cytometry analysis of MAIT cells (defined as CD3+Vα7.2+CD161+) and their activation markers (CD69). The T1 and T2* values, as were the percentages of MAIT cells and CD69+MAIT cells were compared between different groups. Combined-parameter models were established using logistic regression, and ROC curves were employed to evaluate the diagnostic efficacy.
    UNASSIGNED: The T1 values of SIJs and %CD69+MAIT cells in the axSpA group and its subgroup were higher than the control group (p<0.05), while %MAIT cells were lower than the control group (p<0.05). The T1 values and %CD69+MAIT cells correlated positively, while %MAIT cells correlated negatively, with the ASDAS-CRP (r=0.555, 0.524, -0.357, p<0.001). Between the control and axSpA groups, and between the inactive and active subgroups, the combined-parameter model T1 mapping+%CD69+MAIT cells has the best efficacy (AUC=0.959, 0.879, sensibility=88.6, 70%, specificity=95.0, 94.7%, respectively).
    UNASSIGNED: The combined-parameter model T1 mapping+%CD69+MAIT cells allows a more accurate evaluation of the level of inflammatory activity.
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