1.Improving children's cooperativeness during magnetic resonance imaging using interactive educational animated videos: a prospective, randomised, non-inferiority trial.
Evelyn Gabriela UTAMA ; Seyed Ehsan SAFFARI ; Phua Hwee TANG
Singapore medical journal 2024;65(1):9-15
INTRODUCTION:
A previous prospective, randomised controlled trial showed that animated videos shown to children before magnetic resonance imaging (MRI) scan reduced the proportion of children needing repeated MRI sequences and improved confidence of the children staying still for at least 30 min. Children preferred the interactive video. We hypothesised that the interactive video is non-inferior to showing two videos (regular and interactive) in improving children's cooperativeness during MRI scans.
METHODS:
In this Institutional Review Board-approved prospective, randomised, non-inferiority trial, 558 children aged 3-20 years scheduled for elective MRI scan from June 2017 to March 2019 were randomised into the interactive video only group and combined (regular and interactive) videos group. Children were shown the videos before their scan. Repeated MRI sequences, general anaesthesia (GA) requirement and improvement in confidence of staying still for at least 30 min were assessed.
RESULTS:
In the interactive video group ( n = 277), 86 (31.0%) children needed repeated MRI sequences, two (0.7%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 22.1% after the video. In the combined videos group ( n = 281), 102 (36.3%) children needed repeated MRI sequences, six (2.1%) needed GA and the proportion of children who had confidence in staying still for more than 30 min increased by 23.2% after the videos; the results were not significantly different between the two groups.
CONCLUSION
The interactive video group demonstrated non-inferiority to the combined videos group.
Child
;
Humans
;
Anesthesia, General
;
Magnetic Resonance Imaging
;
Prospective Studies
;
Simulation Training
;
Child, Preschool
;
Adolescent
;
Young Adult
;
Video Recording
2.Is non-contrast-enhanced magnetic resonance imaging cost-effective for screening of hepatocellular carcinoma?
Genevieve Jingwen TAN ; Chau Hung LEE ; Yan SUN ; Cher Heng TAN
Singapore medical journal 2024;65(1):23-29
INTRODUCTION:
Ultrasonography (US) is the current standard of care for imaging surveillance in patients at risk of hepatocellular carcinoma (HCC). Magnetic resonance imaging (MRI) has been explored as an alternative, given the higher sensitivity of MRI, although this comes at a higher cost. We performed a cost-effective analysis comparing US and dual-sequence non-contrast-enhanced MRI (NCEMRI) for HCC surveillance in the local setting.
METHODS:
Cost-effectiveness analysis of no surveillance, US surveillance and NCEMRI surveillance was performed using Markov modelling and microsimulation. At-risk patient cohort was simulated and followed up for 40 years to estimate the patients' disease status, direct medical costs and effectiveness. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio were calculated.
RESULTS:
Exactly 482,000 patients with an average age of 40 years were simulated and followed up for 40 years. The average total costs and QALYs for the three scenarios - no surveillance, US surveillance and NCEMRI surveillance - were SGD 1,193/7.460 QALYs, SGD 8,099/11.195 QALYs and SGD 9,720/11.366 QALYs, respectively.
CONCLUSION
Despite NCEMRI having a superior diagnostic accuracy, it is a less cost-effective strategy than US for HCC surveillance in the general at-risk population. Future local cost-effectiveness analyses should include stratifying surveillance methods with a variety of imaging techniques (US, NCEMRI, contrast-enhanced MRI) based on patients' risk profiles.
Humans
;
Adult
;
Carcinoma, Hepatocellular/diagnostic imaging*
;
Liver Neoplasms/diagnostic imaging*
;
Cost-Effectiveness Analysis
;
Cost-Benefit Analysis
;
Quality-Adjusted Life Years
;
Magnetic Resonance Imaging/methods*
4.Temporal Unfolding of Racial Ingroup Bias in Neural Responses to Perceived Dynamic Pain in Others.
Chenyu PANG ; Yuqing ZHOU ; Shihui HAN
Neuroscience Bulletin 2024;40(2):157-170
In this study, we investigated how empathic neural responses unfold over time in different empathy networks when viewing same-race and other-race individuals in dynamic painful conditions. We recorded magnetoencephalography signals from Chinese adults when viewing video clips showing a dynamic painful (or non-painful) stimulation to Asian and White models' faces to trigger painful (or neutral) expressions. We found that perceived dynamic pain in Asian models modulated neural activities in the visual cortex at 100 ms-200 ms, in the orbitofrontal and subgenual anterior cingulate cortices at 150 ms-200 ms, in the anterior cingulate cortex around 250 ms-350 ms, and in the temporoparietal junction and middle temporal gyrus around 600 ms after video onset. Perceived dynamic pain in White models modulated activities in the visual, anterior cingulate, and primary sensory cortices after 500 ms. Our findings unraveled earlier dynamic activities in multiple neural circuits in response to same-race (vs other-race) individuals in dynamic painful situations.
Adult
;
Humans
;
Brain Mapping
;
Pain
;
Empathy
;
Racism
;
Gyrus Cinguli/physiology*
;
Magnetic Resonance Imaging
;
Brain/physiology*
5.Reshaping the Cortical Connectivity Gradient by Long-Term Cognitive Training During Development.
Tianyong XU ; Yunying WU ; Yi ZHANG ; Xi-Nian ZUO ; Feiyan CHEN ; Changsong ZHOU
Neuroscience Bulletin 2024;40(1):50-64
The organization of the brain follows a topological hierarchy that changes dynamically during development. However, it remains unknown whether and how cognitive training administered over multiple years during development can modify this hierarchical topology. By measuring the brain and behavior of school children who had carried out abacus-based mental calculation (AMC) training for five years (starting from 7 years to 12 years old) in pre-training and post-training, we revealed the reshaping effect of long-term AMC intervention during development on the brain hierarchical topology. We observed the development-induced emergence of the default network, AMC training-promoted shifting, and regional changes in cortical gradients. Moreover, the training-induced gradient changes were located in visual and somatomotor areas in association with the visuospatial/motor-imagery strategy. We found that gradient-based features can predict the math ability within groups. Our findings provide novel insights into the dynamic nature of network recruitment impacted by long-term cognitive training during development.
Child
;
Humans
;
Cognitive Training
;
Magnetic Resonance Imaging
;
Brain
;
Brain Mapping
;
Motor Cortex
8.Retrospective analysis of BI-RADS 4 and 5 lesions additionally detected by breast MRI.
Lei JIANG ; Jia Yin GAO ; Zhu Jin XU ; Shu Rong HE ; Bin HUA
Chinese Journal of Surgery 2023;61(2):100-106
Objectives: To establish a newly-designed scoring system for breast imaging-reporting and data system (BI-RADS) 4 and 5 breast lesions only visible on MRI, and to examine their clinical pathway of biopsy. Methods: The BI-RADS 4 and 5 breast lesions only visible on MRI but not suspected on mammograms or ultrasound between June 2007 and December 2021 at Beijing Hospital were evaluated retrospectively. A total of 209 lesions from 184 patients were finally included. All patients were female, aged (50±11) years (range: 27 to 76 years). All lesions were confirmed by pathology and divided into malignancy and non-malignancy. The lesions were divided into mass and non-mass type using BI-RADS. The receiver operator characteristic (ROC) curve was used to evaluate the diagnostic performance of the new scoring system. Four types of pathology-obtaining pathway were used: biopsy guided by second-look ultrasound, local excision guided by lesion position information on MRI, intraductal lesion excision guided by methylene blue stain and mastectomy. The data between mass and non-mass lesions were compared by Mann-Whitney U test, χ2 test or Fisher exact test,respectively. Results: There were 124 malignant and 85 non-malignant lesions, while 100 mass and 109 non-mass lessions. The sizes between mass and non-mass lesions showed significant difference(M(IQR)) (7.0 (3.0) mm vs. 25.0 (25.0) mm, U=568.000, P<0.01) and their BI-RADS diagnostic accuracy had no significant difference (53.0% (53/100) vs. 65.1% (71/109), χ2=3.184, P=0.074). The areas under ROC curve of the new scoring system for evaluating mass and non-mass were 0.841 and 0.802, respectively. When taking Score 3 as threshold, it can potentially avoid 14.0% (14/100) and 4.6% (5/109) of biopsies in mass and non-mass, respectively. As to pathway of obtaining pathology, second-look ultrasound succeeded more easily in mass than non-mass (41.0% (41/100) vs.26.6% (29/109), χ2=4.851, P=0.028). More MRI-guided local excisions were performed in non-mass than mass (52.3% (57/109) vs. 34.0% (34/100), χ2=7.100, P=0.008). Conclusions: For suspicious breast lesions detected by MRI but not suspected on X-ray or ultrasound, the new scoring system can further increase diagnostic accuracy. The second-look ultrasound plays an important role for obtaining pathology, especially for mass-type lesion.
Humans
;
Female
;
Male
;
Retrospective Studies
;
Breast Neoplasms/diagnostic imaging*
;
Mastectomy
;
Radiography
;
Magnetic Resonance Imaging
9.Clinical evaluation of platelet-rich plasma in the treatment of early and middle stage knee osteoarthritis under 3.0T MRI T2 mapping sequence.
Zhao Yang WANG ; Wen Fei GAO ; Yi Ming SHAO ; Yi Chuan GAO ; Xue Shan XU ; Bing Jie LIU ; Ming Sheng ZHANG
Chinese Journal of Surgery 2023;61(2):138-144
Objective: To quantitatively evaluate the clinical effect of platelet-rich plasma(PRP) intra-articular injection for early and middle stage knee osteoarthritis(KOA) treatment by 3.0T MRI T2 mapping sequence. Methods: Clinical data of 26 patients with early or middle stage KOA who received treatment from April to December 2021 at Department of Orthopaedic Surgery,the Second Affiliated Hospital,Zhengzhou University were retrospectively analyzed. In total, 8 patients were male and 18 were female,with age of (66.4±12.0)years(range:51 to 94 years). Four patients were bilateral KOA and 22 patients were unilateral KOA.All patients received PRP intra-articular injection. Patients underwent 3.0T MRI T2 mapping sequence scanning pre-treatment,3-month-after and 6-month-after treatment respectively. Those were used to measure and compare T2 values of medial and lateral femoral articular surface and patellofemoral articular surface. Visual analogue scale(VAS) and Western Ontario and McMaster Osteoarthritis Index (WOMAC) score were recorded and evaluated. The results were analyzed using repeated measure ANOVA followed by Bonferroni multiple comparison test.The correlation between WOMAC scores and T2 values at pre-treatment and 6 months post-treatment was analyzed using Pearson correlation test. Results: After treatment, the patients' International Cartilage Regeneration&Joint Preservation Society(ICRS) classification were partly improved(one case improved from grade Ⅲ to grade Ⅱ, one case improved from grade Ⅱ to grade Ⅰ),and all patients generally improved after treatment in clinical symptoms. Compared with pre-treatment,VAS and WOMAC scores of grade Ⅰ,Ⅱ,and Ⅲ of 6-month after treatment were declined significantly(all P<0.05).The T2 values of articular cartilage declined to varying degrees(the decrease in T2 values was about 2.06 ms in grade Ⅰ, 2.66 ms in grade Ⅱ, and 3.72 ms in grade Ⅲ).Three-month (VAS:4.8±1.3,WOMAC:21.5±4.0) and 6-month (VAS:4.2±1.4,WOMAC:17.2±2.9) after treatment, the VAS and WOMAC score were significantly higher than those before treatment (VAS:6.0±1.2, WOMAC:29.0±2.3) (F=48.846, F=346.746;both P<0.01). Multiple comparisons showed a statistically significant difference between pre-treatment and post-treatment VAS (P<0.01) and it also was significantly different between 3-month and 6-month post-treatment (P<0.01).At 3- and 6-month after treatment,WOMAC scores were significantly different from before treatment.And it also was significantly different between 3-month and 6-month post-treatment (P<0.01).There was a statistically significant improvement in T2 values of patellofemoral articular surface, medial and lateral femoral articular surface at pre-treatment((44.64±4.02)ms,(44.17±3.64)ms and(43.53±3.91)ms) and 3-month ((43.19±3.91)ms,(43.24±3.34)ms and (42.47±3.80)ms), 6-month ((41.49±3.64)ms,(41.83±3.15)ms and (41.10±3.42)ms) after treatment(F=148.845,F=73.657,F=86.268;all P<0.01).The results of the multiple comparisons showed a statistically significant difference in the T2 values of medial and lateral femoral articular surface and patellofemoral articular surface at each time point(all P<0.01).The Pearson correlation analysis suggested that the WOMAC score at pre-treatment was positively correlated with the medial condyle (r=0.856,P<0.01) and the patellofemoral joint surface T2 values (r=0.840,P<0.01);The WOMAC score at 6-month post-treatment was positively correlated with the medial condyle (r=0.731,P<0.01) and the patellofemoral joint surface T2 values (r=0.691,P<0.01). Conclusions: In the treatment of early and mid-stage KOA,MRI T2 mapping sequences are able to indicate the integrity of cartilage morphology and quantitatively evaluate cartilage repair. PRP has a good therapeutic effect on cartilage repair and reconstruction.
Humans
;
Female
;
Male
;
Osteoarthritis, Knee/therapy*
;
Retrospective Studies
;
Orthopedic Procedures
;
Platelet-Rich Plasma
;
Magnetic Resonance Imaging
10.Research on migraine time-series features classification based on small-sample functional magnetic resonance imaging data.
Ang SUN ; Ning CHEN ; Li HE ; Junran ZHANG
Journal of Biomedical Engineering 2023;40(1):110-117
The extraction of neuroimaging features of migraine patients and the design of identification models are of great significance for the auxiliary diagnosis of related diseases. Compared with the commonly used image features, this study directly uses time-series signals to characterize the functional state of the brain in migraine patients and healthy controls, which can effectively utilize the temporal information and reduce the computational effort of classification model training. Firstly, Group Independent Component Analysis and Dictionary Learning were used to segment different brain areas for small-sample groups and then the regional average time-series signals were extracted. Next, the extracted time series were divided equally into multiple subseries to expand the model input sample. Finally, the time series were modeled using a bi-directional long-short term memory network to learn the pre-and-post temporal information within each time series to characterize the periodic brain state changes to improve the diagnostic accuracy of migraine. The results showed that the classification accuracy of migraine patients and healthy controls was 96.94%, the area under the curve was 0.98, and the computation time was relatively shorter. The experiments indicate that the method in this paper has strong applicability, and the combination of time-series feature extraction and bi-directional long-short term memory network model can be better used for the classification and diagnosis of migraine. This work provides a new idea for the lightweight diagnostic model based on small-sample neuroimaging data, and contributes to the exploration of the neural discrimination mechanism of related diseases.
Humans
;
Time Factors
;
Migraine Disorders/diagnostic imaging*
;
Magnetic Resonance Imaging
;
Brain/diagnostic imaging*
;
Neuroimaging

Result Analysis
Print
Save
E-mail