1.intravoxel incoherent motion MRI for prediction of histological grade and muscle invasion in bladder urothelial carcinoma
Miaomiao ZHANG ; Yan CHEN ; Xinying CONG
Chinese Journal of Medical Imaging Technology 2018;34(4):595-600
Objective To observe the utility value of MR intravoxel incoherent motion (IVIM) in histological grading and muscle invasion of bladder urothelial carcinoma.Methods According to postoperative histologic grade and T staging,60 patients with bladder urothelial carcinoma confirmed by surgery and pathology were divided into low grade (LG) group and high grade (HG) group,as well as muscle-noninvasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) group.MR IVIM parameters (apparent diffusion coefficient standard [ADCst],true diffusion coefficient [D],pseudodiffusion coefficient [D*] and perfusion fraction [f]) were compared with independent-samples t tests.A binary Logistic regression model was established to evaluate the predicted probability of combined IVIM parameters.ROC curves of IVIM parameters and their combination's predicted probability were drawn,and the diagnostic efficiency was evaluated.Results ADCst,D and f values of HG group were significantly lower than those of LG group (all P<0.05).Area under ROC curve (AUCs) for ADCst,D and f value to differentiate HG from LG were 0.88,0.86 and 0.72,respectively (all P<0.01),and AUCs for predicted probability of combined ADCst and D,combined ADCst and f and combined D and f were 0.91,0.90 and 0.88,respectively (all P<0.0001).ADCst,D and f values of M1BC group were significantly lower than those of NMIBC group (all P<0.0001).AUCs for ADCst,D and f value to differentiate MIBC from NMIBC were 0.91,0.85 and 0.88,respectively (all P<0.0001),and all AUCs for predicted probability of combined ADCst and D,combined ADCst and f and combined D and f were both 0.93 (all P<0.000 1).Conclusion Lower ADCst,D and f values may indicate greater possibility of high grade and muscle invasion of bladder urothelial carcinoma.Combination of IVIM parameters can improve diagnostic efficacy.
2.Application of diffusion-weighted intravoxel incoherent motion imaging in diagnosis of renal cell carcinoma subtypes
Xinying CONG ; Yan CHEN ; Jin ZHANG ; Xiaoduo YU ; Feng YE ; Weijun YU ; Miaomiao ZHANG ; Han OUYANG ; Xinming ZHAO
Chinese Journal of Oncology 2016;38(6):434-439
Objective To evaluate the value of parameters derived from intravoxel incoherent motion diffusion?weighted magnetic resonance imaging in differentiating histopathological subtypes of renal cell carcinoma ( RCC) . Methods Between May 2014 and December 2015, a total of 69 patients who were surgically and pathologically diagnosed as renal cell carcinoma were recruited for the study. We examined 61 clear cell RCC ( ccRCC) , and 8 non?clear cell carcinoma ( non?ccRCC, including 7 chromophobe RCC and 1 papillary RCC ) . All the ccRCC were divided into well differentiated group ( n = 46 ) , moderately differentiated group (n=8), and poorly differentiated group (n=7). In addition to routine renal magnetic resonance imaging examination performed on a 3. 0?Tesla MR system, all patients were imaged with axial intravoxel incoherent motion diffusion?weighted imaging. Using biexponential model, we calculated the diffusion coefficient ( D) , pseudodiffusion coefficient ( D?) , and perfusion fraction ( f) . Results The D and f values of the ccRCC were higher (each P<0.05) than that for non?ccRCC [D (1.29±0.30)×10-3mm2/s, D?(42.92±20.21)×10-3mm2/s, and f (35.71±6.61)% versus D (0.78±0.23)×10-3mm2/s, D?(32.60±11.33)×10-3mm2/s, and f (21.52±8.44)% ]. In the well differentiated group of ccRCC, we found D of (1.36±0.29)×10-3mm2/s, D?(38.39±18.51)×10-3mm2/s, and f (36.40±6.96)%. The D, D?, f values of moderately differentiated lesions were (1.10±0.24)×10-3mm2/s, (59.90±20.23)×10-3 mm2/s, and (32.88±4.02)%, respectively, those of the poorly differentiated group were (1.03±0.16)×10-3mm2/s, (53.28±18.74)×10-3mm2/s, and (34.42±6.21)%. The well differentiated group of ccRCC showed a higher D value than the moderately differentiated and poorly differentiated groups ( each P<0.05) . D? values were significantly lower for the well differentiated group than for the moderately differentiated group (P<0.05). The sensitivity and specificity of D values were 90. 2% and 87. 5% when focusing on the differentiation of ccRCC. For the diagnosis of ccRCC, the sensitivity and specificity of f values were 98. 4% and 75. 0%, respectively. Conclusions IVIM?DWI can provide certain reliable value in evaluating pathological subtype and differentiation degree of renal cell carcinomas. D and f values are useful to distinguish ccRCC from non?ccRCC. D value is also promising for estimating the differentiation degree of ccRCC, and to indicate the biological behavior of RCC.
3.Application of diffusion-weighted intravoxel incoherent motion imaging in diagnosis of renal cell carcinoma subtypes
Xinying CONG ; Yan CHEN ; Jin ZHANG ; Xiaoduo YU ; Feng YE ; Weijun YU ; Miaomiao ZHANG ; Han OUYANG ; Xinming ZHAO
Chinese Journal of Oncology 2016;38(6):434-439
Objective To evaluate the value of parameters derived from intravoxel incoherent motion diffusion?weighted magnetic resonance imaging in differentiating histopathological subtypes of renal cell carcinoma ( RCC) . Methods Between May 2014 and December 2015, a total of 69 patients who were surgically and pathologically diagnosed as renal cell carcinoma were recruited for the study. We examined 61 clear cell RCC ( ccRCC) , and 8 non?clear cell carcinoma ( non?ccRCC, including 7 chromophobe RCC and 1 papillary RCC ) . All the ccRCC were divided into well differentiated group ( n = 46 ) , moderately differentiated group (n=8), and poorly differentiated group (n=7). In addition to routine renal magnetic resonance imaging examination performed on a 3. 0?Tesla MR system, all patients were imaged with axial intravoxel incoherent motion diffusion?weighted imaging. Using biexponential model, we calculated the diffusion coefficient ( D) , pseudodiffusion coefficient ( D?) , and perfusion fraction ( f) . Results The D and f values of the ccRCC were higher (each P<0.05) than that for non?ccRCC [D (1.29±0.30)×10-3mm2/s, D?(42.92±20.21)×10-3mm2/s, and f (35.71±6.61)% versus D (0.78±0.23)×10-3mm2/s, D?(32.60±11.33)×10-3mm2/s, and f (21.52±8.44)% ]. In the well differentiated group of ccRCC, we found D of (1.36±0.29)×10-3mm2/s, D?(38.39±18.51)×10-3mm2/s, and f (36.40±6.96)%. The D, D?, f values of moderately differentiated lesions were (1.10±0.24)×10-3mm2/s, (59.90±20.23)×10-3 mm2/s, and (32.88±4.02)%, respectively, those of the poorly differentiated group were (1.03±0.16)×10-3mm2/s, (53.28±18.74)×10-3mm2/s, and (34.42±6.21)%. The well differentiated group of ccRCC showed a higher D value than the moderately differentiated and poorly differentiated groups ( each P<0.05) . D? values were significantly lower for the well differentiated group than for the moderately differentiated group (P<0.05). The sensitivity and specificity of D values were 90. 2% and 87. 5% when focusing on the differentiation of ccRCC. For the diagnosis of ccRCC, the sensitivity and specificity of f values were 98. 4% and 75. 0%, respectively. Conclusions IVIM?DWI can provide certain reliable value in evaluating pathological subtype and differentiation degree of renal cell carcinomas. D and f values are useful to distinguish ccRCC from non?ccRCC. D value is also promising for estimating the differentiation degree of ccRCC, and to indicate the biological behavior of RCC.
4.Relationship between impairment and magnetic resonance imaging finding in patients with traumatic cervical spinal cord injury after surgery
Yuan YUAN ; Hongjun ZHOU ; Xinying CONG ; Genlin LIU ; Bo WEI ; Ying ZHENG ; Chunxia HAO ; Ying ZHANG ; Yiji WANG ; Haiqiong KANG ; Xiaolei LU ; Qianru MENG
Chinese Journal of Rehabilitation Theory and Practice 2023;29(6):725-730
ObjectiveTo explore the application of Brain and Spinal Injury Center (BASIC) score in evaluation of traumatic cervical spinal cord injury. MethodsFrom January, 2015 to December, 2021, 175 patients with traumatic cervical spinal cord injury in Beijing Bo'ai Hospital were analyzed. Gender, age, cause of injury, injury mechanism and American Spinal Injury Association Impairment Scale (AIS) grade were collected. The sagittal and axial T2 weighted imaging (T2WI) of the patients were evaluated with BASIC score, single/multi-segment injury, and with/without intramedullary hemorrhage. According to the injury mechanism, the patients were divided into two groups: with fracture/fracture dislocation (n = 92) and without fracture and dislocation (n = 83). The baseline demographic indicators and T2WI evaluation indicators were compared between the two groups, and the relationship between AIS grade and BASIC score, intramedullary hemorrhage, single/multi-segment injury were investigated. ResultsThere were significant differences in gender, age and AIS grade, BASIC score, and the rates of inntramedullary hemorrhage and single segment injury of T2WI between two groups (t = -10.276, χ2 > 8.703, P < 0.01); however, no difference was found in the cause of injury (P > 0.05). The AIS grade was significantly correlated with the BASIC score (r = 0.790, P < 0.001). There was significant difference in AIS grade between intramedullary hemorrhage or not, and single/multi-segment injury (χ2 > 5.516, P < 0.05). ConclusionThe BASIC score of T2WI is a predictor of the severity of spinal cord injury after traumatic cervical spinal cord injury, and is different with the injury mechanisms.
5.Application of CT pulmonary angiography in acute pulmonary embolism and right heart function
Hongxia ZHANG ; Xinying CONG ; Tian ZHANG ; Ye WU ; Qing LI ; Xuejing LI ; Yifan CHEN ; Xiuting WANG ; Weiyong YU ; Zhenbo CHEN
Chinese Journal of Rehabilitation Theory and Practice 2023;29(12):1429-1438
ObjectiveTo explore the application value of CT pulmonary angiography (CTPA) in assessing the severity of acute pulmonary embolism (APE) and right heart function in rehabilitation patients. MethodsFrom January, 2013 to January, 2020, 133 inpatients (94 positive and 39 negative) who underwent CTPA examination in Beijing Bo'ai Hospital were involved. Positive patients were further divided into mild, moderate and severe groups based on the pulmonary artery obstruction index (PAOI). The clinical parameters and right heart function indicators were compared. Spearman correlation analysis was used to analyze the correlation between PAOI, and clinical parameters and right heart function indicators, and Logistic regression analysis was used to predict the risk factors of APE. ResultsThere was significant difference in lower extremity venous thrombosis, D-dimer, oxygen partial pressure, PAOI and left process of interventricular septum among four groups (H ≥ 12.350, P < 0.01). PAOI was moderately positively correlated with D-dimer (r = 0.443, P < 0.001) and left process of interventricular septum (r = 0.520, P < 0.001), and was weakly positively correlated with lower extremity venous thrombosis (r = 0.399, P < 0.001), left pulmonary artery diameter (r = 0.213, P = 0.014) and inferior vena cava regurgitation (r = 0.229, P = 0.008). Lower extremity venous thrombosis (OR = 7.708, P < 0.001) and left process of interventricular septum (OR = 3.641, P = 0.008) were independent risk factors for the onset of APE. The combination of the two indicators was effective for diagnosis of APE, and AUC was 0.795 (95% CI 0.715 to 0.874). ConclusionCTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.