Objective To evaluate the differential diagnostic value of IVIMGDWI in hepatocellular carcinoma (HCC)and atypical hepatic hemangioma (H H).Methods 3.0T MR images of 28 patients with HCC and atypical H H confirmed respectively by surgical or pathological diagnosis were retrospectively analyzed.3.0T MR routine and DWI multiple b value sequences were performed,and the related derivative parameters of IVIMGDWI (intravoxel incoherent motion diffusion,MRI)were obtained.GE ADW4.6 Functool automatic postGprocessing software and statistical methods were used for multiGparameters analyses,and the ROC curve was established to predict the value of the differential diagnosis.Results The values of ADC,slow diffusion coefficient (D)and perfusion fraction (PF)between HCC and atypical HH were statistically significant(P＝0.00,P＝0.021 ,P＜0.05 ),that was to say,there were significant differences in IVIMGDWI multiparameter comparisons between the HCC and atypical HH.And the value of fast diffusion coefficient (D?)was not statistically significant between HCC and atypical HH (P＝0.112,P＞0.05),that was to say,there was no significant difference in the multiparameter comparison between the HCC and atypical HH;The specificity and sensitivity of IVIMGDWI in HCC were from high to low:D (97.8%)＞ADC(97.4%)＞PF (82.9%),and the specificity and sensitivity of IVIMGDWI in atypical H H were D (9 7.1%)＞ADC (87.1%)＞PF (6 7.9%),from high to low,while D? was not statistically significant.Conclusion It is characteristic for the imaging manifestation of HCC and atypical HH with IVIMGDWI imaging,that is one of the important methods for clinical diagnosis and differential diagnosis of HCC and atypical HH.

Objective To evaluate the long-term prognostic value of coronary CT angiography-derived fractional flow reserve(CT-FFR)in elderly patients with coronary heart disease(CHD).Methods A retrospective analysis was performed on 1133 patients with clinically suspected CHD from a prospective observational study based on coronary CTA and CT-FFR at the General Hos-pital of Eastern Theater from April 2018 to March 2019,and 330 elderly CHD patients were even-tually included.According to major adverse cardiovascular events(MACE)occurred or not,295 patients were assigned into non-MACE group and 35 patients into the MACE group.Based on cor-onary CTA data,plaque features were analyzed and CT-FFR values were measured in all lesioned vessels.The relationship of plaque features and CT-FFR with MACE was evaluated by using Cox proportional risk regression model,Kaplan-Meier survival curve,and ROC curve analyses.Results The patients with coronary stenosis(≥50％)or CT-FFR value ≤0.8 had a higher risk of MACE(P＜0.01).Univariate Cox analysis showed that coronary stenosis ≥50％and CT-FFR value 0.8 were risk factors of MACE(P＜0.01).After adjusting confounding factors,multivariate Cox analysis indicated that CT-FFR ≤0.8(HR=17.037,95％CI:5.060-57.358,P=0.000)was only independent predictor for MACE.The risk prediction model based on CT-FFR presented better performance than the model based on coronary CTA stenosis(C-index:0.820 vs 0.696,P=0.000).Conclusion CT-FFR≤0.8 is an important independent predictor for long-term MACE in elderly CHD patients.Clinical risk stratification based on CT-FFR may optimize prognostic man-agement strategies in these patients.