Objective To evaluate the tumor targeting characteristic by observing signal varying of human gastric cancer transplanted nude mice (SGC-7901) using Folate-Receptor MR contrast agent. Methods As a Folate-Receptor MR contrast agent, Gd-DTPA-Folate was obtained by conjugation of DTPA-Folate and GdCl3 under specific conditions. Nude mice of subcutaneously transplanted human gastric cancer (SGC-7901) were used as animal models, 12 mice were divided into experimental group(n=6) and control group(n=6) randomly. Both were injected with Gd-DTPA-Folate and Gd-DTPA (contained same gadolinium) via abdominal cavity respectively. Tumor signal varying was observed by T1WI after injection of contrast agent immediately,1,2,3,4,6,12 and 24 h, and tumor signal changing of experimental group was compared with that of control group. CNR (contrast noise ratio) was regarded as evaluating mark. Results Tumor signal intensity of experimental group was increased evidently between 1-2 hours after injecting Gd-DTPA-Folate. Comparison with pre-injection, there was a significant difference(evaluating mark is CNR: q1=5.80, q2=4.64; P0.05). Conclusion Gd-DTPA-Folate shows definite characteristic of tumor targeting effect to nude mice of subcutaneously transplanted human gastric cancer (SGC-7901).

Background and purpose:A pre-surgery diagnosis of cervical invasion in endometrial cancer was usually determined by dilatations and curettage(D&C),so it could help in optimizing surgery,but the reliability of D&C still was controversial.This study was to compare MRI with D&C to estimate their accuracy for the diagnosis of cervical invasion in endometrial carcinoma respectively.Methods:34 endometrial cancer patients had been proved to have cervical invasion in endometrial cancer through examinations of either fractional dilatations and curettages(D&C),magnetic resonance imaging(MRI)before surgery or postoperative histopathologic examination.The results of D&C and MRI were compared with postoperative histopathologic examination,and the sensitivity,specificity were estimated for accuracy of cervical involvement in endometrial cancer.Results:21 of 34 patients were identified as having cervical invasion in endometrial cancer by histopathology after operation.D&C test matches 26.5% of them and MRI test matches 80%.The sensitivity was 35% vs.76.5% and the specificity 7.7% vs.100% for D&C and MRI methods respectively.All of them had significant statistical differences.Conclusions:MRI test is much better than D&C method for preoperative diagnosis of cervical invasion in endometrial carcinoma.

Objective To analyze the variable appearances of hepatic angiomyolipomas on CT and MRI, and to improve the diagnostic accuracy with CT and MRI. Methods All 13 cases were proved by surgical pathology. Helical CT scanning of pre- and post-contrast arterial phase, portal venous phase were performed in 12 cases, delayed phase scanning was performed in 5 of 12 cases. Magnetic resonance imaging with SE T 1WI, FSE T 2WI, and FMPSPGR axial dynamic multi-phase contrast scanning were performed in 7 cases. Results On pre-contrast CT scans, 11 of 12 lesions appeared as hypodensity, the other one appeared as slight hyperdensity. On the arterial phase scans, all lesions were markedly enhanced, the central vascular structure could be seen in 8 lesions. On the portal venous phase, 8 lesions remained enhanced and the central vascular structure could also be seen in 6 lesions. 5 of 7 lesions showed inhomogeneous hypointensity on SE T 1WI, and all of 7 lesions showed hyperintensity (from slight hyperintensity to strong hyperintensity) on FSE T 2WI. 6 lesions showed enhancement on the MR arterial phase scans, the other one showed no marked enhancement because the most parts of the lesion were fat. 4 lesions showed prolonged enhancement on the portal venous phase, and the other 3 lesions showed hypointensity. The central vascular structure could also be seen in 4 of 7 lesions on MR contrast dynamic scanning. Conclusion Both CT and MR could demonstrate the characterization of hepatic angiomyolipomas, especially the central vascular structure in the lesions strongly hint the diagnosis of angiomyolipomas. MR SE sequence with fat suppression is more sensitive than CT in the demonstration of the fat. CT and MR dynamic multi-phase contrast scanning can fully reflect the characterization of hepatic angiomyolipomas and can be helpful to improve the diagnostic accuracy.

Gadolinium DTPA ; Humans ; Magnetic Resonance Imaging ; Non-alcoholic Fatty Liver Disease

Objective To explore the effect on image quality and scanning time by changing parameters and using different scan-ning technique for the clinical application of axial FLAIR pulse sequence.Methods Seven different sets of parameters of T2-FLAIR Pulse Sequences were performed on thirty patients at a 3.0 T MR scanner.Group A was scanned with a routine sequence for refer-ence.Group B,reducing the matrix to 128.Group C,increasing the turbo factor parameter to 24.Group D,setting the contatena-tion to 1.Group E setting the Accel.factor PE to 4.Group F,using a BLADE-FLAIR sequence.Group G,using a HASTE-FLAIR sequence.The SNRs of all images were statistically analyzed by ANOVA among 7 sequences.The image quality of all images was statistically analyzed by Kruskal-Wallis test among 7 sequences.Results The SNR of seven groups of images were 54.69 ±8.12, 1 57.57±25.61,44.56±7.37,38.48 ± 9.32,44.1 9 ±8.79,45.60 ± 6.92,105.20 ± 18.25,respectively(F = 266.368,P =0.000). The scores of image quality were 3.87±0.09,2.50±0.12,3.72±0.1 6,3.10±0.10,1.88±0.10,3.92±0.07,2.08±0.10,re-spectively and the differences among groups were statistically significant(χ2 =1 93.361,P =0.000).Conclusion Suitable turto factor and BLADE technique can be the best option for FLAIR sequence in the head.HASTE-FLAIR sequence can act as the secondary op-tion for the uncooperative patients.

Objective To investigate the MRI features of hepatic IgG4?related inflammatory pseudotumor (IPT). Methods Nine patients with 11 histopathologically proven IgG4?related hepatic IPTs were retrospectively analyzed. The clinical, morphological and MRI signal features on T1WI, T2WI, dynamic?enhanced, and diffusion?weighted imaging were assessed in detail and correlated with pathological findings. The paired t test was used to compare the ADC values of the tumors and the hepatic tissue. Results Hepatic IgG4?related IPT displayed certain MRI features. The dominant lesions were subcapsularly distributed (n=7) with a clear boundary (n=8), which typically showed hypointensity on T1WI (n=11), mild hyperintensity on T2WI (n=8), progressive (n=5) or persistent (n=4) enhancement pattern. Accompanied signs included delayed capsule?like enhancement (n=6) and central nonenhanced areas (n=7). Two lesions showed atypical wash?out pattern with iso or hypointensity on portal and delayed phases. In diffusion weighted imaging, all lesions were hyperintense, and the mean ADC value of the lesions [(1.42 ± 0.36) × 10?3mm2/s] was mildly lower than that of surrounding liver [(1.55±0.31)×10?3mm2/s], although no statistical differences were found(t=0.78, P=0.46). Conclusions Hepatic IgG4?related IPTs display various MRI manifestations. The lesions normally show progressive enhancement pattern with diffuse homogeneous or heterogeneous hyperintensity, accompanied by delayed capsule?like enhancement and central nonenhanced areas.

Objective To discuss the diagnostic value of CT and MRI for primary anorectal malignant melanoma(AMM).Methods 5 patients(2 males and 3 females)with AMM confirmed pathologically were analyzed retrospectively,which were examined by CT(n=4)and 1.5T MRI(n=1).Results AMM presented as bulky intraluminal fungating masses without intestinal obstruction(n=4)and irregular rectal wall thickening(n=1).2 cases had perirectal fat infiltration and extended to the presacral space in one case,4 cases had perirectal enlarged lymph nodes and larger than 3 cm in diameter in one case.Nonenhanced CT showed a hypodense lesion and contrast-enhanced CT showed slight enhancement(n=1)and mild enhancement(n=3).The tumor scanned by MRI depicted high intensity on T1WI and low intensity on T2WI,so did the enlarged lymph nodes and bone metastasis.Fat-saturation T1WI significantly improved the extention of tumor and detection of metastasis.Conclusion Bulky intraluminal fungating masses without intestinal obstruction,perirectal fat infiltration and enlarged lymph nodes may be helpful to diagnose AMM.MRI is especially useful in differentiating melanotic AMM from other rectal tumors.

Objective To explore the value of time-resolved angiography with interleaved stochastic trajectories (TWIST)in providing hemodynamic indices and morphological imaging of calf arteries in patients with peripheral arterial occlusive disease(PAOD) with 3.0 T MR scanner. Methods Forty patients with confirmed or suspected PAOD underwent TWIST MRA for the calf arteries and conventional contrast-enhanced MRA(CE-MRA) for the whole lower peripheral arteries. TWIST MRA data were used to determine the bolus arriving time of the popliteal artery, the time difference of the bolus arrival in the popliteal artery between the two legs, calf artery transit time, and the mean peak enhancement time of calf arteries. The mean value of peak enhancement time of calf arteries was correlated with ankle-brachial index(ABI). The calf arteries were divided into 13 segments. The visible score of arterial segment was recorded, and the degree of arterial stenosis was graded too. In 16 patients, DSA was used as the gold standard to evaluate the sensitivity and specificity of TWIST MRA and CE-MRA. Results The bolus arriving time of the popliteal artery was (0.7±7.6) s the time difference of the bolus arrival in the popliteal artery between the two legs was (2.1±2.5) s, the calf artery transit time was (35.6±16.9) s, the mean value of peak enhancement time of calf arteries was (52.6±17.6) s. ABI was acquired from 24 patients and 48 legs, which correlated well with the mean value of peak enhancement time in calf arteries (r＝0.627,P＜0.01). The mean visible score was (2.83±0.48) of TWIST MRA images and (2.78±0.43) of CE-MRA images. There was no significant difference between them (P＞0.05). On CE-MRA, there were 38 legs with varying degrees of early venous enhancement; in contrast, there was no venous contamination on TWIST MRA. The sensitivity and specificity of TWIST MRA were 96.7% (118/122) and 100.0% (72/72) in showing normal artery and mild stenosis, 94.1% (32/34) and 96.2% (154/160) in showing severe stenosis, and 94.7% (36/38) and 98.7% (154/156) in showing occlusion. The sensitivity and specificity of CE-MRA were 95.9% (117/122) and 100.0% (72/72) in showing normal artery and mild stenosis, 91.2% (31/34) and 95.6% (153/160) in showing severe stenosis, and 94.7% (36/38) and 98.1% (153/156) in showing occlusion. Conclusion TWIST MRA is a preferable choice for calf arterial occlusive disease, which provided nice morphological images and useful hemodynamic indices with simple operation.

Objective To investigate the value of MR perfusion parameters and ADC in the diagnosis of pancreatic cancer and pancreatic mass at 3.0 T MR. Methods Twenty healthy volunteers and 25 patients with pancreatic cancers proven by pathological results underwent MR PWI at a 3.0 T scanner. A two-compartment model was used to quantify Ktrans, Kep and Ve in the pancreatic cancer, adjacent pancreatic tissue, distal inflammatory pancreatic tissue and normal pancreatic tissue. All parameters among different tissues were analyzed and compared with ANONA. Fifteen normal volunteers and 58 patients, including 30 patients with pancreatic cancer (proven histopathologically), 9 patients with pancreatitis pseudotumor (4 patients proven by histopathological results, 5 patients proven by follow-up after treatment), 9 patients with solid pseudopapillary tumor of pancreas (SPTP, proven histopathologically) and 10 patients with pancreatic neuroendocrine tumor (PET, proven by histopathology), underwent respiratory-triggered DWI on 3.0 T. ADC values of normal pancreas and all types of pancreatic lesions were statistically analyzed and compared with ANONA. ROC curve was used to analyze the diagnostic power of ADC value. Results Ktrans of pancreatic cancer, adjacent pancreatic tissue, distal inflammatory pancreatic tissue and normal pancreatic tissue were (1.66±1.25), (3.77±2.67),(1.16±0.94) and (2.69±1.46)/min respectively(F=8.160, P＜0.01). LSD test showed that Ktrans in the pancreatic cancer was statistically lower than that in normal pancreas (P=0.011)and adjacent pancreatic tissue(P=0.002). Kep of pancreatic cancer, adjacent pancreatic tissue, distal inflammatory pancreatic tissue and normal pancreatic tissue were (2.53±1.55), (5.64±2.64), (1.70±0.91) and (4.28±1.64)/min respectively(F=4.544, P＜0.01). LSD test revealed that Kep in pancreatic cancer was statistically lower than that in normal pancreatic tissue (P=0.035)and adjacent pancreatic tissue(P=0.041). The median of Ve among the pancreatic cancer, adjacent pancreatic tissue, distal inflammatory pancreatic tissue and normal pancreatic tissue were 0.926, 0.839, 0.798 and 0.659 respectively (χ2=12.040,P＜0.01). Ve in pancreatic cancer was statistically higher than that in normal pancreatic tissue (P=0.002). ADC values of the pancreatic cancer, pancreatitis pseudotumor, SPTP, PET and normal pancreas were(1.57±0.26)×10-3,(1.19±0.15)×10-3,(1.05±0.35)×10-3,(1.62±0.41)×10-3 and (1.82±0.25)×10-3 mm2/s(F=21.681, P＜0.01). LSD test showed there were significant statistical differences in ADC values among pancreatic cancer, pancreatitis pseudotumor and normal pancreatic tissue (P＜0.01). ROC curve disclosed that the sensitivity, specificity, positive predictive value and negative predictive value were 86.7%, 88.9%, 96.3% and 66.7% respectively, when ADC≥1.33×10-3 mm2/s was used as a cutoff value for differential diagnosis of PDCA from MLP. The sensitivity, specificity, positive predictive value and negative predictive value were 77.8%, 100.0%, 100.0% and 83.3% respectively when ADC≤1.25×10-3 mm2/s was used as a cutoff value for differential diagnosis of SPTP from PET. Conclusion Compared to normal pancreatic tissue, pancreatic cancer usually had a lower Ktrans, Kep and larger Ve. ADC values from respiratory-triggered DWI were well related to histopathological features of pancreatic entities and may be helpful in the differential diagnosis.

Objective To evaluate the relationship between the T1 relaxation times using gadoxetic acid-enhanced MRI with the organic anion transporter (OATP) and multi-drug resistance protein (MRP) values on colorectal liver metastasis and around normal liver parenchyma.Methods The perspective study included in fifteen patients with liver metastasis from colorectal cancer,who were confirmed colorectal cancer by colonoscopy,liver metastasis by CT scanning and would be underwent liver metastasis surgery.The lesion on the 15 patients was all single.The patients were performed plain scanning,diffusion weighted imaging and dynamic enhancement MRI examination using gadoxetic acid.Besides,for T1 mapping,a dual flip angle three-dimensional gradient echo sequence was performed before and at 20 minutes after gadoxetic acid administration.The reduction rate of T1 relaxation time (ΔT) (before and after gadoxetic-acid administration) of colorectal liver metastasis and around normal liver parenchyma was calculated.The specimens of hepatic metastases and around normal liver parenchyma were obtained during the colorectal liver metastasis operation.After that,they were analyzed by Western-blot and the values on OATP1,OATP8 and MRP2,MRP3 were recorded.The values on OATP1,OATP8 and MRP2,MRP3 and ΔT on hepatic metastases and around normal liver parenchyma were compared with t analysis.The correlation between the sum of the values (hepatic metastases adding around normal liver parenchyma) on OATPI,OATPS,MRP2,MRP3 with T1 relaxation times were calculated by Spearman.Results The scanning images on colorectal liver metastasis using gadoxetic acid MRI examination were as follows:relatively low signal intensity on T1WI; relatively higher signal intensity on T2WI; showing surrounding moderate enhancement on arterial phase and low signal intensity on portal venous phase,delay phase and hepatobililary phase.The values on OATP1,OATP8,MRP2,MRP3 and AT on the hepatic metastases were(0.21±0.09),(0.34±0.21),(0.41±0.22),(0.26±0.14)ng/ml and (33±9)％,respectively.The values on OATP1,OATP8,MRP2,MRP3 and ΔT around normal liver parenchyma were (0.46±0.24),(0.67±0.35),(0.22±0.13),(0.13±0.06) ng/ml and(68±9)％ (t values were 36.37,58.89,24.56,22.52 and 57.16;P＜0.05).The values on patients on OATP1,OATP8,MRP2 and MRP3 [(0.67±0.31),(1.00±0.37),(0.63±0.23),(0.40±0.13)ng/ml,respectively] showed relationship with the values on patients on ΔT(51±9)％ (r values were 0.491,0.432,-0.414 and-0.371;P values were 0.006,0.017,0.023 and 0.040).Conclusion The sum of the values (the hepatic metastases adding around normal liver parenchyma) on OATP1,OATP8,MRP2 and MRP3 showed correlation with the sum of values on the ΔT using gadoxetie acid-enhanced MRI examination,which explained relationship with the quantity of gadoxetic acid absorbed by hepatocyte and the T1 relaxation time on molecular level.