Objective To evaluate the diagnostic performance of diffusion kurtosis imaging (DKI) and its combination with DWI and proton MR spectroscopy (1H-MRS) in differentiating malignancy from benign breast lesions. Methods Fifty-three patients with 38 histopathologically confirmed malignant and 15 benign breast lesions were retrospectively studied. The patients were examined by breast MRI at 3.0 T prior to operation, including conventional T1WI, fat-suppression imaging, DWI, DKI and 1H-MRS. The shape and margin of breast lesions, and their corresponding mean values for ADC, mean kurtosis (MK) and mean diffusivity (MD) were determined by two blinded radiologists in consensus. The presence or absence of choline (Cho) peak was identified using LCModel software. Independent-samples t test or χ2 test was performed for the comparison of clinical characteristics, shape and margin of lesions, and imaging parameters between malignancy and benign lesions. ROC analysis was performed to evaluate the diagnostic accuracy of DKI, DWI and 1H-MRS alone or in combination, in comparison with the histopathologic findings. Results The onset age of breast malignancy was higher than that of benign ones, and the difference has statistical significant (P<0.05). Malignant lesions were most often seen in postmenopausal women, with unclear margin. There was no significant differences for body mass index (BMI), fiber type, the size and shape of lesions between benign lesions and malignancy (P>0.05). The mean ADC,MD and MK of benign lesions were(1.464 ± 0.348)× 10-3mm2/s,(1.726 ± 0.268)× 10-3mm2/s and(0.692 ± 0.227), the mean ADC,MD and MK of malignancy were(0.963 ± 0.170)× 10-3mm2/s,(1.158 ± 0.262)× 10-3mm2/s and(1.311 ± 0.218), respectively. Significant differences were obtained between benign and malignant lesions for all parameters (P<0.05).The area under the ROC curve (AUC) of ADC, MD and MK for differentiating malignancy from benign lesions was 0.913, 0.933 and 0.968, respectively. Taken the maximum Youden's index of MK (1.110) as the ROC optimal cut-off point, MK exhibited better diagnostic sensitivity, specificity and accuracy for distinguishing malignancy from benign lesions [89.5%(34/38),93.3%(14/15) and 90.6%(48/53), respectively], compared with MD and ADC. Multiparametric imaging with combination of DKI, DWI and 1H-MRS improves the diagnostic specificity (with the highest as 100.0%) but decreases the sensitivity (with the highest as 81.6% and lowest as 71.1% ), compare with the single parametric imaging. Conclusions MK generated from DKI enables differentiation of breast lesions with a higher diagnostic sensitivity and specificity than DWI and 1H-MRS. DKI combined with DWI and 1H-MRS increase specificity but decrease sensitivity for breast cancer characterization.

With persistent advancement of surgical instruments, methods and techniques, clinical efficacy of liver transplantation has been steadily enhanced. However, the length of anhepatic phase is still an important factor affecting the efficacy of liver transplantation. Rat is one of the major animal models for liver transplantation-related basic research. In this article, multiple approaches for prolonging the anhepatic phase and shortening the operation time during anhepatic phase in rat liver transplantation were reviewed, which consisted of sevoflurane inhalation anesthesia, intravenous infusion via jugular vein indwelling needle, clamping of the abdominal aorta before anhepatic phase, injection of normal saline into portal vein before anhepatic phase, subcutaneous transposition of the spleen, electrocoagulation of hepatic esophageal artery, magnetic ring anastomosis of the superior and inferior hepatic vena cava, cannula anastomosis of the superior and inferior hepatic vena cava, stent anastomosis of the superior and inferior hepatic vena cava, rapid connection device and cannula of portal vein, and ring-shaped cannula of hepatic tissue-preserving inferior hepatic vena cava, aiming to add evidence for prolonging the duration of anhepatic phase, improving the operation efficiency during anhepatic phase and elevating the success rate of rat liver transplantation.

Objective To characterize the biomarkers of urine samples for early diagnosis of colorectal cancer(CRC)using proton nuclear magnetic resonance (1H-NMR)combined with pattern recognition.Methods 400 MHz 1H-NMR was used to test the urine samples obtained from 23 patients with Ⅰ/Ⅱ stage CRC,40 healthy controls (HC)and 18 patients with esophageal cancer (EC). Pattern recognition through orthogonal partial least squares-discriminant analysis (OPLS-DA)was applied on 1H-NMR data to find urine metabolic differences between CRC and HC.Results OPLS-DA could effectively determine HC,patients withⅠ/Ⅱstage CRC and patients with esophageal cancer.Compared with HC,early stage CRC had significant decreases of choline,isocitric acid,lactamine,phenylalan, cysteine,creatinine,aspartic acid,hippurate acid,methylamine,dimethyl sulfone,and increases of acetoacetate,glutamine,glycocyamine,cis-aconitate, trans-aconitate,homocycteine in the urine samples.Conclusion Urine metabonomics based on NMRIndicates that glucose metabolism,amino acid metabolism,choline metabolism,energy metabolism and intestinal microflora are disturbance in colorectal cancer patients,which provide valuable metabolic information on the molecular level for early diagnosis of colorectal cancer.

Correlated with such hepatic-systemic factors as cirrhosis, inflammation and immunity, portal vein thrombosis (PVT) is common in perioperative period of liver transplantation (LT) recipients.It affects negatively surgical procedures and outcomes due to its insidious onset and atypical clinical symptoms.With continuous improvements of LT techniques and refining of medical imaging, researchers have gained further insights into the pathophysiological processes, screening, diagnoses, evaluations, classifications and perioperative managements of PVT.This review focused upon perioperative managements of LT recipients with PVT to enhance the clinical problem-solving capability and long-term patient survival.

Adult ; Humans ; Non-alcoholic Fatty Liver Disease/complications* ; Cross-Sectional Studies ; Folic Acid/therapeutic use* ; Risk Factors