Objective To access the value of MRI in differential diagnosis between intrahepatic cholangiocarcinoma and atypical hepatic abscess. Methods Retrospectively collecting and analyzing the clinical and MRI imaging data of 19 patients with intrahepatic cholangiocarcinoma (ICC) and 17 patients with atypical hepatic abscess, confirmed by reexamination after anti‐inflammation therapy, surgery or puncture etiology, from June 2011 to July 2018 in Central Hospital of Lishui City.They were divided into ICC and abscess groups.All patients underwent routine liver plain MRI, DWI and contrast‐enhanced MR scan. The MRI features of the two groups (including morphology, boundary, cystic change and necrosis, pseudocapsule, hemorrhage, lipid composition, the signature of lesion in different phases of MRI and surrounding tissue) were studied. Fisher exact test and t test were used. Result This study showed that there was statistical difference between the two groups in the following aspects, the presence of cystic degeneration, the degree of annular enhancement in arterial phase, the homogeneous enhancement in portal venous phase and balanced phase and the central filling enhancement sign (P<0.05).The results showed that necrotic cystic lesion was more common in the abscess group (15/17 cases) than in the ICC group (0/19 cases);in the cases with annular enhancement in arterial phase,the degree of enhancement in the ICC group (13/16 cases) was higher than that in the abscess group (2/9 cases); the enhancement of the central parenchyma of lesion on out‐of‐phase images (1/19 cases) was slower in the ICC group than that in the abscess group (14/17 cases);and the ICC group was likely to present as central filling enhancement compared to the abscess group. Conclusion The presence of cystic lesions in DWI, the enhancement degree of marginal parenchyma, the enhancement speed of central parenchyma and the whole enhancement pattern are essential signs for differentiating intrahepatic cholangiocarcinoma and atypical hepatic abscess. 图1 女,53岁,右肝脓肿.病灶最大径4.0 cm,病灶中的小囊变区在DWI上呈高信号(↑) 图2 女,39岁,右肝脓肿.病灶最大径3.1 cm,病灶中的小囊变区在DWI上呈高信号(↑) 图3 女,66岁,右肝肝内胆管细胞癌(ICC).病灶最大径5.3 cm,横轴面T2WI病灶整体呈不均匀高信号,内见相对更高信号的富黏液区(↑) 图4 男,45岁,右肝ICC.病灶最大径5.8 cm,横轴面T2WI病灶整体呈高低混杂信号,内见散在片状低信号的凝固性坏死区(↑) 图5 与图1为同一患者.横轴面T2WI病灶实质部分呈均匀高信号,小囊变区呈明显高信号(↑) 图6 与图2为同一患者.横轴面T2WI病灶实质部分呈等信号,小囊变区呈明显高信号(↑)图7 与图3为同一患者.增强扫描动脉期横轴面示病灶边缘轻度不规则环形强化 图8 与图4为同一患者.增强扫描动脉期横轴面示病灶强化环有多处中断征象(↑) 图9,10 男,45岁,右肝ICC.病灶最大径5.8 cm,增强扫描动脉期横轴面(图9)示病灶边缘局部显著环形强化,局部强化环明显中断(↑).平衡期横轴面像(图10)示病灶中央有填充强化 图11 与图3,7为同一患者.平衡期横轴面示病灶内富黏液区出现轻微中央填充强化(↑) 图12 与图4、8为同一患者.平衡期横轴面像示病灶中央有填充强化 图13,14 男,59岁,右肝脓肿.病灶最大径4.3 cm,动脉期横轴面像(图13)示脓壁散在强化,周围见片状异常灌注.平衡期横轴面像(图14)示脓壁均匀强化,其内囊变区无强化 图15 与图2,6为同一患者.平衡期横轴面像示脓壁均匀强化呈相对等信号,其内囊变区无强化(↑) 图16 与图1,5为同一患者.平衡期横轴面像示脓壁均匀强化呈相对等信号,其内囊变区无强化(↑)

Objective:To investigate the correlation between the enhancement characteristics in arterial phase and the prognosis of patients with massive intrahepatic cholangiocarcinoma (IMCC).Methods:The imaging and clinical data of 92 patients with IMCC who were pathologically confirmed and underwent enhanced MRI or CT in Central Hospital of Lishui from June 2004 to February 2019 were retrospectively analyzed. According to the enhancement pattern of the primary lesion in the arterial phase, patients were divided into rich arterial blood supply group （17 cases） and deficient arterial blood supply group （75 cases）. The clinical data and imaging features of these patients were studied. Differences between measurement data and count data between the two groups were compared using t test and Fisher test. Kaplan-Meier analysis and log-rank test were used to analyze overall survival. The Cox regression multivariate analysis was used to study the relationship between the variables and the risk of death. Result:The enlargement of lymph nodes, long diameter of the primary lesion, CA19-9, treatment and HPD around the primary lesion in arterial phase were statistically different in the two groups ( P<0.05), others were no statistical difference. CA19-9>200 U/ml, lymph node enlargement, HPD around the primary lesion in arterial phase and deficient arterial blood supply were independent factors for the prediction of prognosis in IMCC patients with surgery ( P values were 0.008, 0.002, 0.049 and 0.005, respectively). Lymph node enlargement and deficient arterial blood supply were independent risk factors for the prediction of prognosis in IMCC patients with surgery ( P values are 0.049 and 0.045, respectively). Conclusion:The blood supply characteristics of arterial phase are independent factors for the prognosis of patients with IMCC.

OBJECTIVE To optimize the extraction technology fo r phenylethanol glycosides from Cistanche deserticola by natural deep eutectic solvents （NADESs），and to provide reference for the development and utilization of C. deserticola . METHODS The optimal NADESs was selected using total extraction efficiency of echinacoside ，acteoside and isoacteoside as indexes. Based on single factor test ，response surface methodology was used to select the optimal NADESs molar ratio ，the optimal NADESs water content ，the optimal liquid-solid ratio ；and the results were optimized by genetic algorithm . Using vitamin C （VC） as positive control ，the extraction effects of NADESs and traditional solvent （50％ methanol）were compared in respects of extraction efficiency and antioxidant activities. RESULTS The optimal extraction solution was NADES- 11 composed of 1， 4-butanediol and malonic acid. The optimal extraction technology was as follows as the molar ratio of 1，4-butanediol-malonic acid was 1 ∶ 2.5，water content of NADES- 11 was 18％，liquid-solid ratio was 30 mL/g，extraction time was 30 min and extraction temperature was 30 ℃. The extraction efficiency of NADES- 11 was significantly higher than that of 50％ methanol（P＜0.05）. IC 50 values of NADES- 11 extract（261.17 and 744.34 µg/mL）to 1，1-diphenyl-2-trinitrophenylhydrazine radical and hydroxyl radical were all lower than those of 50％ methanol extract （420.97 and 1 175.12 μg/mL）. Ascorbic acid equivalent antioxidant capacity of Δ 基金项目 内蒙古自治区科技创新引导项目（No.00120209）；内 NADES-11 extract（17.19 and 360.80 mg VC/g ）was higher 蒙古自治区自然科学基金资助项目 （No.2021MS08011）；内蒙古自治 than that of 50％ methanol extract （10.67 and 228.54 mg 区医疗卫生科技计划项目（No.202201367）；包头医学院“花蕾计划”项 VC/g）. CONCLUSIONS The optimized extraction process of 目（No.HL2021046） phenylethanol glycosides from C. deserticola using NADESs is ＊第一作者 硕士研究生。研究方向：中蒙药药效成分。E-mail： environmental，stable and feasible. dongjiani369@126.com