Objective To investigate the utility value of monoexponential and biexponential DWI in the differential diagnosis between benign and malignant liver neoplasms.Methods Seventy three patients with pathologically or clinically confirmed liver mass,were analyzed retrospectively and categorized into benign and malignant groups between January 2013 and October 2013.Malignant group included 46 patients with 53 lesions,while 27 patients in benign group had 35 lesions.All patients underwent MR examinations on 3.0T system (GE 750).Conventional MR T1WI,T2WI,DWI(b=0,800 s/mm2) (to obtain ADC with monoexponential modeling),multi-b value DWI(b=0,20 50,100,200,400,600,800 and 1 200 s/mm2) (to obtain Slow-ADC,Fast-ADC,f with biexponential modeling) and dynamic enhancement were performed.The ADC,Slow-ADC,Fast-ADC and f mean values of benign and malignant liver neoplasms were measured and analyzed by using independent samples t test.Diagnostic efficacy of these parameters in malignant group was evaluated by using receiver operating characteristic curve,with histopathologic findings as the gold standard.Results ADC,Slow-ADC,Fast-ADC and f of malignant group were lower than those of benign group [ADC:(1.79±0.35)× 10-3 mm2/s vs (1.16±0.36) × 10-3 mm2/s; Slow-ADC:(1.67±0.25) × 10-3 mm2/s vs(0.94±0.22)×10-3mm2/s; Fast-ADC(72.40±23.70)×10-3mm2/s vs(34.62±17.43)×10-3mm2/s; and f:(33.59± 11.77)％ vs (22.28±8.97)％ in benign and malignant groups,respectively).Significant inter-group difference was observed in ADC,Fast-ADC,Slow-ADC and f (t=0.89,14.77,8.96 and 5.47,respectively and P＜0.05).The areas under the ROC curve (AUC) of ADC,Slow-ADC,Fast-ADC and fwere 0.938,0.974,0.895 and 0.789,respectively.The sensitivity and specificity of ADC,Slow-ADC,Fast-ADC and fwere 90.6％ (48/53),96.2％ (51/53),90.6％ (48/53) and 90.6％ (48/53) and 85.7％ (30/35),91.4％ (32/35),82.9％ (29/35) and 57.1％ (20/35)respectively for differentiating benign from malignant hepatic lesions.Conclusion ADC obtained with mono-exponential modeling and Fast-ADC,Slow-ADC,f obtained with biexponential modeling are useful parameters in distinguishing benign and malignant hepatic lesions,among which slow-ADC demonstrates the highest diagnostic efficacy.

Objective To discuss MRI manifestations of overlap syndrome of autoimmune liver diseases and the diagnostic value of the MRI .Methods Seven patients of overlap syndrome of autoimmune liver diseases were recruited .The MRI examination (inclu‐ding T1WI ,T2WI ,DWI and MRCP )were underwent on these patients .MR features of overlap syndrome were reviewed by two ra‐diologists by consensus .Two radiologists independently reviewed the studies in a blinded fashion .Results AIH/PBC 4 cases ,AIH/PSC 1 case ,PBC/PSC 1 case ,AIH/PBC/PSC 1 case was collected .MRI of AIH/PBC has the MRI feature of AIH and PBC .MRI of AIH/PSC has the MRI feature of AIH and PSC .MRI of PBC/PSC has the MRI feature of PBC and PSC .MRI feature of AIH/PBC/PSC has the MRI feature of AIH ,PBC and PSC .Conclusion If the patients who sufferd autoimmune liver diseases displayed the MIR images of other autoimmune liver diseases ,the patients were considered that had developed into overlap syndrome of autoim‐mune liver diseases .

Objective To identify the diagnostic value of ADC combined with DWI in benign lesions and malignant lesions of testis. Methods 35 patients with testicular lesions confirmed by operation and pathological examination in our hospital were analyzed retrospectively, including 18 benign lesions and 17 malignant lesions.The mean ADC values of normal tissue and parenchyma of testicular lesions were measured and statistically analyzed by K ruskal-W allis test,and receiver operating characteristic(ROC)curve was delineated. The optimum ADC value for differential diagnosis of malignant testicular lesions was analyzed and determined.Results In 33 cases of normal testicular tissue DWI showed homogeneous high signal,and mean ADC was(1.137 ± 0.119)×10-3mm2/s.18 cases of benign lesions mostly showed unrestricted diffusion,and mean ADC was(1.104 ± 0.463)×10-3mm2/s.In 17 cases of malignant lesions DWI showed high signal,and mean ADC was(0.778 ± 0.198)×10-3mm2/s.The comparison of ADC mean values between malignant testicular lesions and normal tissue as well as benign lesions of testis showed significant difference(P<0.05).The optimum ADC to distinguish malignant testicular lesions from benign testicular lesions was 0.911×10 -3mm2/s(82.4% sensitivity and 82.4% specificity). Conclusion DWI combined with ADC value is beneficial to the preoperative diagnosis and differential diagnosis between malignant testicular lesions and benign lesions of testis.

Objective:To study the effects of conservative treatment versus percutaneous interventional treatment(PCI)on symptoms and prognosis of chronic coronary syndrome patients aged over 75 years with fractional flow reserve(FFR)in the grey zone(0.75≤FFR≤0.80).Methods:A total of 96 coronary heart disease(CHD)patients aged over 75 years undergone FFR examination in our hospital from January 2011 to December 2017 were retrospectively selected.All patients showed stenosis of 50%-90% in at least one main coronary artery and had FFR values within the range of 0.75-0.80(0.75≤FFR≤0.80). According to the treatment, patients were divided into the optimized medication group(OMT group, n=35)and the PCI group(n=61). The degree of angina alleviation assessed by the Seattle Angina Questionnaire(SAQ)and the incidence of major adverse cardiovascular endpoints(death, myocardial infarction, stroke, and repeated revascularization)were recorded during the one-year follow-up after treatment.Results:There was no significant difference in baseline data including age, gender and comorbidities between the OMT and PCI groups( P>0.05). The incidence of previous myocardial infarction, and the basal level of low-density lipoprotein cholesterol(LDL-C)were higher in the PCI group than in the OMT group( P<0.05). One-year follow-up showed that there was no significant difference between the OMT and PCI groups in the score of SAQ(77.6 ± 19.5 vs. 83.1 ± 22.8, P>0.05)and the incidence of composite MACEs(11.4% or 4 / 35 vs. 9.8% or 6/61, P>0.05). However, the incidence of repeated target vessel revascularization was lower in the PCI group than in the OMT group(1.6% or 1 case vs. 5.8% or 2 cases, P<0.05). Conclusions:In elderly CHD patients aged over 75 years with FFR values between 0.75-0.8 in the grey zone, optimal medication treatment has similar effects as the PCI on symptom alleviation, and no significant increase in composite MACEs is found at one-year follow-up.