1.MR score system on spatium perilymphaticum gadolinium opacification and its application for diagnosis of Meniere's disease
Zheming FANG ; Ying LIU ; Dairong CAO ; Xi CHEN
Chinese Journal of Radiology 2012;46(8):719-723
Objective To propose a MR scoring methods for spatium perilymphaticum gadolinium opacification and explore the value of their diagnosis of Meniere' s disease. Methods Fifty-one asymptomatic and 65 symptomatic patients with Meniere's disease were enrolled in this study.MR imaging ofspatium perilymphaticum after intratypanic gadolinium injection were analyzed with following scoring method. ( 1 ) Semicircular canal not visualized equal to score 0 ; some visualized equal score 1 ; full visualized equal score 2.(2)There were high-signal and low-signal in the vestibule,low-signal areas above the lateral semicircular canal plane equal score 6 ; low signal areas down to lateral semicircular canal plane equal score 3 ; no higher signal in the vestibule area equal score 0.( 3 ) Basal turn of cochlea:full visualized equal score 3; part visualized equal score 2; scala vestibule of basal turn smaller than scala tympani equal score 1 regardless of full or visualized in basal turn; no visualized equal score 0. Medial turn of cochlea:full visualized equal score 2 ; part visualized equal score 1 ; no visualized equal score 0.Apical turn of cochlea: visualized equal score 1 ; no visualized equal score 0. One radiologist scored all cases with double blind. SPSS 17.0 software was used to conduct multiple independent-samples nonparametric tests,multivariate Logistic regression, and ROC curve analysis. Evaluate the sensitivity and specificity for diagnosis of Meniere's disease with the scoring system. Results ( 1 ) Meniere's disease summation score 0 to 12,median 9 (quarter spacing 4.5 ) ; no symptoms group summation score 15 to 18,median 17 (quarter spacing 3),two group differences has statistics significance (Wilcoxon rank and inspection U =-9.118,P =0.00).(2)Based on summation score for the diagnosis of Meniere's disease,tangent point was 14.5,Youden index 0.969,specificity 100.0%,sensitivity 96.9%.( 3 ) Let cochlear,vestibular,semicircular canal scoring for association variable,Logistic regression model:LogitP =61.216 - 7.381 × vestibular -3.056 × canal,based on the P value of ROC curves,diagnostic cut-off point 0.651 (vestibular ≤ 3 or semicircular canals ≤ 4 points ),Youden index 96.9%,specifisity 100.0%, sensitivity 96.9%.Conclusions Perilymphatic space of gadolinium contrast MR score in distinguishing Meniere's disease have practical value,any case meet one of following point could be diagnostic:( 1 ) Perilymphatic space of gadolinium contrast MRI total less than 14.5 ; (2) Vestibular low signal areas down more than lateral semicircular canal plane,namely vestibular score value ≤3;( 3 )Semicircular Canal scoring value ≤4.
2.Prediction of nuclear grade of renal clear cell carcinoma based on MRI texture analysis in combination with imaging features
Yu ZHANG ; Xinyuan CHEN ; Ning XU ; Dairong CAO ; Qunlin CHEN
Chinese Journal of Radiology 2021;55(1):53-58
Objective:To explore the application value of MRI texture analysis in combination with imaging features to predict the WHO/International Society of Urological Pathology (ISUP) nuclear grading in pre-operative patients with clear cell renal carcinoma (ccRCC).Methods:MRI images of 78 patients diagnosed as ccRCC by surgical pathology from July 2016 to July 2020 in First Affiliated Hospital of Fujian Medical University were retrospectively analyzed. According to the WHO/ISUP grading system, the patients were divided into low grade group (49 cases, grade Ⅰ in 2 cases and grade Ⅱ in 47 cases) and high grade group (29 cases, grade Ⅲ in 25 cases and grade Ⅳ in 4 cases), and then were assigned to training set ( n= 63) and validation set ( n=15) in a ratio of 7∶3 using random indicator method. MRI radiological features were evaluated and MRI imaging texture features were extracted. The largest-diameter slice of lesion on cross-sectional images was selected and ROIs were drawn on T 2WI and corticomedullary phase (CMP) images, respectively. Quantitative texture analysis software MaZda was used to extract texture features, including gray-scale histogram, co-occurrence matrix, run-length matrix, gradient, autoregressive model and wavelet transform. The extracted texture features were preliminarily selected by the combination of Fisher, probability of classification errorand average correlation coefficient, and interaction information, and then the reduced texture parameters or imaging features were tested by the independent sample t test, Mann-Whitney U test or χ 2 test. Parameters with statistically significant differences were used to construct a multi-factors binary logistic regression model and the ROC curve was used to analyze its effectiveness in predicting high grade ccRCC. Results:In training set, there were significant differences intumor length, shape and margin, enhancement degree of CMP, vein thrombosis and 47 texture features between the low and high grade ccRCC groups. In the training set, 7 multi-factors binary logistic regression model were constructed, including radiological features model (M1), T 2WI texture features model (M2), CMP image texture features model (M3) and combination radiological features of T 2WI texture features model (M4), combination radiological features of CMP images texture features model (M5), combination T 2WI texture features of CMP images texture features model (M6) and combination of all features model (M7). The area under ROC curve of M7 in predicting nuclear grading of ccRCC was the largest, which were 0.901 (95% CI 0.828-0.974) and 0.820 (95% CI 0.564-0.974) in the training set and validation set, respectively. Conclusion:MRI texture analysis combined with imaging features is hopeful to be an effective preoperative noninvasive method in predicting WHO/ISUP grading of ccRCC.
3.The value of gadobenate dimeglumine multi-phase enhanced MRI in predicting the expression of cytokeratin19 in hepatocellular carcinoma
Wanjing ZHENG ; Zhen XING ; Meilian XIONG ; Xiaojun LIN ; Dairong CAO
Chinese Journal of Radiology 2021;55(6):644-649
Objective:To investigate the predictive value of gadobenate dimeglumine (GD-BOPTA) multi-phase enhanced MRI for the expression of cytokeratin19 (CK19) in hepatocellular carcinoma (HCC).Methods:A total of 153 patients of HCC confirmed by pathology from June 2016 to February 2020 in First Affiliated Hospital of Fujian Medical University were enrolled retrospectively. According to the post-operative pathology, the patients were divided into CK19-negative group ( n=122) and CK19-positive group ( n=31). All the patients underwent MRI scan and Gd-BOPTA multi-phase enhanced scan before operation. MRI features on Gd-BOPTA MRI were compared between two groups. The qualitative indicators included tumor morphology, mosaic signs, intratumoral hemorrhage, intratumoral fat, non-rim arterial phase hyper-enhancement (APHE), non-peripheral washout, targetoid manifestation, enhanced capsule, corona enhancement, DWI signal, vascular invasion and hepatobiliary phase (HBP) enhancement. The quantitative indicator of tumor-to-liver signal ratio (SR) on HBP was recorded. The χ 2 test or Fisher exact probability method was used to compare the qualitative parameters between two groups, and student′s t test or Mann -Whitney U test was used for quantitative data. Predictive parameters were identified by univariate and multivariate logistic regression analysis to predict the value of the expression of CK19. The ROC curve was used to analyze the diagnostic efficacy of MRI parameters. Results:There were statistically significant differences between CK19-positive and CK19-negative groups ( P<0.05) in alpha fetoprotein, tumor morphology, non-rim APHE, non-peripheral washout, targetoid manifestation, corona enhancement, HBP enhancement and SR. Multivariate logistic regression analysis showed tumor morphology, corona enhancement, HBP enhancement and SR were independent predictors of CK19 expression in HCC. The area under the ROC curve of the combined four indicators for predicting CK19 expression in HCC was 0.823, and the sensitivity and specificity were 80.7% and 75.4%, respectively. Conclusions:Gd-BOPTA multi-phase enhanced MRI has an important value in the prediction of the expression of CK19 in HCC. The combination of signs of HBP can improve the prediction efficiency of CK19.
4.CT imaging features of anaplastic thyroid carcinoma
Zhenshan SHI ; Qian ZHUANG ; Ruixiong YOU ; Dairong CAO ; Yueming LI
Chinese Journal of Radiology 2013;(2):147-151
Objective To investigate the CT characteristics of anaplastic thyroid carcinoma and evaluate the diagnostic value of CT in this disease.Methods The CT findings of 10 patients with pathologically proved anaplastic thyroid carcinoma were retrospectively reviewed.The patients included 7 females and 3 males.Their age ranged from 25.0 to 78 years with median of 61 years.Multi-slices plain and post contrast CT scans were performed in all patients.Results Unilateral thyroid was involved in 6 patients.Unilateral thyroid and thyroid isthmus were both involved in 2 patients due to big size.Bilateral thyroid were involved in 2 patients.The maximum diameter of anaplastic thyroid carcinoma ranged from 2.9-12.8 cm with mean of (4.5 ± 1.4) cm.All lesions demonstrated unclear margins and envelope invasion.The densities of all lesions were heterogeneous and obvious necrosis areas were noted on precontrast images.Seven lesions showed varied calcifications,and coarse granular calcifications were found in 5 lesions among them.All lesions showed remarkable heterogenous enhancement on post-contrast CT.The CT value of solid portion of the tumor increased 40 HU after contrast media administration.The ratios of CT value which comparing of the tumor with contralateral sternocleidomastoid muscle were 0.69-0.82 (0.76 ± 0.18)and 1.25-1.41 (1.33 ± 0.28)on pre and post CT,respectively.Enlarged cervical lymph nodes were found in 6 cases (60.0%).It showed obvious homogeneous enhancement or irregular ring-like enhancement on post-contrast images and dot calcifications were seen in 1 case.Conclusions Relative larger single thyroid masses with coarse granular calcifications,necrosis,envelope invasion,remarkable heterogeneous enhancing and enlarged lymph nodes on CT are suggestive of anaplastic thyroid carcinoma.
5.MRI and MRS Study of Intracranial Hemangiopericytoma
Dairong CAO ; Yinguan LI ; Jian LI ; Ruixiong YOU
Chinese Journal of Medical Imaging 2009;(6):445-448
Purpose:To assess MRI and MRS features of intracranial hemangiopericytoma.Materials and Methods: The imaging data of MRI and MRS were analyzed retrospectively with seven cases of hemangiopericytoma.MR examinations were performed on seven cases,MRS on 4 cases.Results: The position of lesions were all located at the supratentorial area and extraaxial region.Six masses were lobulated in shape.Of seven cases,3 cases were isointense with cortical gray matter,3 iso- and hypointense,l hypointense with localized hyperintense resulted from hemorrhage on T1WI: 2 cases demonstrated isointense with cortical gray matter,4 iso- and hyperintense,1 complex hyperintense on T2WI.Five tumors had prominent internal or surficial serpentine signal voids.3 tumors showed homogeneous marked enhancement,4 heterogeneous enhancement.MRS of four tumors showed marked elevated Cho peak,Lip peak and diminished or disappeared NAA peak.Two cases were companied with marked elevated MI peak.Conclusion:The MR imaging findings of hemangiopericytoma has some characteristics,which can help differentiation from meningioma combined MRS.
6.Reproducibility of functional MR imaging during electroacupuncture stimulation at PC6(neiguan)
Jianping HU ; Yinguan LI ; Dairong CAO ; Shunbo GONG
Journal of Third Military Medical University 2003;0(20):-
Objective To assess the reproducibility of brain activation by functional MR imaging during electroacupuncture stimulation at PC6(neiguan).Methods Six healthy adult volunteers participated in three identical scan sessions during different interval time.Each scan session consists of two functional tasks,an electroacupuncture stimulation(2 Hz) at PC6 and a control task of simple finger tapping.The reproducibility of brain responses was analyzed in terms of the overlap ratio of active volume within sessions and the ICC of active signal intensity in ROIs.Results The Roverlap of the simple finger tapping task(34.24?9.49) was significantly higher than that of the electroacupuncture stimulation task(13.23?14.21).The range of ICC of ROIs in the simple finger tapping task(0.69-0.80) was significantly higher than that of the electroacupuncture stimulation task(0.18-0.68).The results above showed that the reliability of brain activation in the finger tapping task group was higher than that in the electroacupuncture stimulation task group.The active intensity of ROIs in the simple finger tapping task was significantly higher than that in the electroacupuncture stimulation task,indicating the signal to noise ratio of brain activation in the finger tapping task group was higher than that in the electroacupuncture stimulation task group.Conclusion In contrast to the relatively reliable activation evoked by the simple finger tapping task,the activation evoked by electroacupuncture stimulation task was much more variable.The main possible reason is that the relatively low signal to noise ratio of brain activation on fMRI and low sensitivity caused the lower reproducibility of electroacupuncture stimulation task.The group analysis in combination with the individual functional data may be utilized to improve the reproducibility of fMRI evoked by electroacupuncture stimulation at PC6(neiguan).
7.RAPD on natural populations in Ophiopogon japonicus in Sichuan Province
Ke XU ; Ming ZHENG ; Yi CAO ; Yan JIANG ; Dairong QIAO ;
Chinese Traditional and Herbal Drugs 1994;0(07):-
Object To assess the genetic diversity among ten natural populations in Ophiopogon japonicus (L f ) Ker Gawl and O. bodinieri Levl (Liliaceae) in Sichuan Province Methods Forty random decamer primers were screened for Random Amplified Polymophic DNA (RAPD) fragments Results Based on cluster analysis of 515 DNA bands amplified by 11 primers, a DNA molecular dendrogram was established, and the relationship of the populations and seeds between O japonicus and O bodinieri was set up Conclusion 1 Distinct genetic differences and extensive genetic diversity are presented among the samples The genetic differences are related to morphological differences, but not to geographic regions; 2 Quite genetic differences are presented between O japonicus and O bodinieri, it suggests that they have farther relationships
8.The clinical value of MRI in the diagnosis of small-bowel diseases
Xianying ZHENG ; Yinguan LI ; Ying ZOU ; Dairong CAO ; Xihe NI ; Ruixiong YOU ; Zheming FANG
Chinese Journal of Radiology 2009;43(10):1056-1061
Objective To evaluate the feasibility and the clinical value of MRI in the diagnosis of small-bowel disease. Methods Sixty-three patients with suspected small-bowel diseases and 3 volunteers without signs of small bowel disease underwent MRI examination. Thirty-one patients whose diagnoses were confirmed by pathology or clinical results were categorized into two groups (neoplastic and normeoplastic). The conspicuity of bowel wall, the sensitivity of MRI in detecting small-bowel lesions, and the accuracy rate of diagnosis were calculated. The average bowel wall thickness between the two groups was assessed by using Wilcoxon signed-rank test. Enlarged mesenteric lymph nodes, mesenteric infiltration, and small-bowel stenosis were analyzed by using Fisher's exact test in each group respectively. Results MRI examinations of all 66 subjects were successfully performed. Images were rated on a continuous 4-peint scale. Sixty-two cases (93.9%) were scored as 2 or 3. The diagnoses of 31 patients (neoplastic group (n = 10) and nonneoplastic group (n = 21) were confirmed by pathology or clinical results. The sensitivity, accuracy of MRI in identifying small bowel diseases were 100% (31/31) and 77.4% (24/31) respectively. The average bowel wall thickness of the two groups was 23 mm(7.0-65.0 mm) and 5 mm(2.0-35.0 mm) respectively, and there was a statistically significant difference between the two groups (Z = - 2.949, P < 0.01). Enlarged lymph nodes in mesentery were found in 7 cases in neoplastic group and 4 cases in nonneoplastic group, and there was a statistically significant difference between the two group (P < 0.05). Small-bowel stenosis was depicted in 10 cases in both groups and there was a statistically significant difference between the two groups (P <0.01). The mesenteric infiltration sign was seen in 5 cases and 17 cases respectively, and showed no significant difference between the two groups (P > 0.05). Conclusion MRI can depict the location and extension of the small-bowel disease accurately and it is an effective method in the diagnosis of small-bowel disease.
9.The influence of peritumoral edema at newly diagnosed glioma on recurrence patterns after total resection
Shuiyuan LIU ; Changfu ZHOU ; Zhixiong LIN ; Songsheng SHI ; Yanlin HUANG ; Hongji CHENG ; Dairong CAO ; Dezhi KANG
Chinese Journal of Nervous and Mental Diseases 2014;(4):223-229
Objective To explore the influence of peritumoral edema (PTE) on the tendency of recurrent location and morphological character after total resection using MRI. Methods MRI data was collected from 43 patients with recur-rent brain glioma after total resection from four clinical centers and then the influence of of PTE on recurrence patterns af-ter total resection was retrospectively analyzed based on the T2 weighted image. Results The PTE had a significant influ-ence on the recurrent patterns of brain gliomas after total resection. When PTE was mild, the shapes of recurrent gliomas tended to be focal (6/8) and the recurrent locations tended to be local (5/8). When PTE was severe, the shapes of the recur- rent gliomas tended to be spread(30/35 and the recurrent locations tended to be distant (25/35), followed by marginal (7/35), In addition, the morphological patterns and locations of recurrent gliomas were significantly different among different PTE types (all P<0.001). When PTE was ring shape, the shapes of recurrent gliomas tended to be focal (7/9) and the recur-rent locations tended to be local (6/9), followed by marginal (2/9) and distant (1/9). When PTE was irregular shape, most of recurrent locations tended to be distant (25/34), followed by marginal (7/34) but rarely local (2/34). Conclusions The de-grees and the types of brain glioma PTE can significantly influence the locations and morphological patterns of recurrent gliomas after total resection.
10.Contrast perilymphatic MRI findings of inner ear in sudden hearing loss with vertigo
Ying LIU ; Dairong CAO ; Zheming FANG ; Zhen XING ; Xi GU ; Xi CHEN
Chinese Journal of Radiology 2014;48(12):996-999
Objective To explore the contrast perilymphatic MRI characteristics of inner ears with sudden hearing loss with vertigo.Methods Forty three patients with sudden hearing loss with vertigo and 35 patients with unilateral tinnitus diagnosed by the department of Otolaryngology-Head and Neck Surgery were retrospectively included.Forty eight ears (38 ears with unilateral sudden hearing loss and 10 ears in 5 cases with bilateral sudden hearing loss) were regarded as sudden hearing loss group,35 asymptomatic ears (the opposite ears of the unilateral tinnitus ears) as control group.Thirty eight opposite ears of the 38 unilateral sudden hearing loss ears and 35 ears of the control group showed normal in the pure tone audiometry exam.One hundred and twenty one ears (48 hearing loss ears,38 opposite ears of the 38 unilateral sudden hearing loss ears and the 35 control group's ears) underwent contrast perilymphatic MR exams,0.4 to 0.5 ml gadolinium hydrate diluted with saline was injected through the tympanic membrane,twenty four hours later,three-dimensional fluid attenuated inversion recovery (3D-FLAIR) sequence was performed using a 3.0 T MRI scanner.After the contrast perilymphatic MR exam,success in the exam was judged through the raw image.The signal intensity ratio (SIR) of cochlea basal turn and homolateral brain stem was quantitatively calculated.The SIR difference of 48 ears with sudden hearing loss and 35 asymptomatic ears in control group was analyzed by t test.The SIR difference of the 38 unilateral sudden hearing loss ears and the contralateral asymptomatic ears was also analyzed.The presence of endolymphatic hydrops was judged.Results The contrast perilymphatic MRI of 121 inner ears with intratympanic gadolinium injection were all successful.Endolymphatic hydrops were observed in 12 sudden hearing loss ears with the occurrence rate of 25%(12/48).The SIR of basal turn and homolateral brain stem of the sudden hearing loss ears (2.062±0.907) were lower than the SIR of the control groups' asymptomatic ears (2.703± 0.640) with significant difference between them (t=3.619,P=0.001),the SIR of basal turn and homolateral brain stem of the unilateral sudden hearing loss ears (1.941 ±0.860) were also lower than the SIR of the contralateral asymptomatic ears (2.411±0.670) with statistical difference between them (t =3.270,P=0.002).Conclusions Endolymphatic hydrops were observed in sudden hearing loss with vertigo.The SIR of the cochlea in sudden hearing loss ears were lower than that of the asymptomatic ears,indicating the abnormal permeability of the round window membrane.