Objective: This prospective study evaluated the feasibility of chemical exchange saturation transfer (CEST) MRI for assessing disease activity in thyroid-associated ophthalmopathy (TAO). Materials and Methods: A total of 88 patients with active TAO, 76 with inactive TAO, and 30 healthy controls were enrolled. CEST MRI-derived magnetization transfer ratio (MTR) and MTR asymmetry (MTRasym) at 1 ppm, 2 ppm, and 3.5 ppm were calculated. Clinical data, MTR, and MTRasym values for the extraocular muscles (one representative muscle per eye, yielding two measurements per participant) were compared among the groups. Spearman’s correlation was used to examine associations between imaging parameters and the clinical activity score (CAS) in patients with TAO. Logistic regression analysis was used to identify independent associations between imaging parameters and disease activity in patients with TAO (active vs. inactive). Receiver operating characteristic (ROC) analysis was conducted to evaluate the diagnostic performance for discriminating active from inactive TAO. Results: Patients with active TAO showed lower MTR values (P < 0.001) and higher MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) (all P < 0.001) compared with those with inactive TAO. MTR was negatively correlated with CAS (r = -0.402; P < 0.001), while MTRasym (1 ppm), MTRasym (2 ppm), and MTRasym (3.5 ppm) were positively correlated with CAS (r = 0.369, 0.350, and 0.349, respectively;all P < 0.001). MTR and MTRasym (1 ppm) were independently associated with TAO activity. The areas under the ROC curve (AUCs) for MTR and MTRasym (1 ppm) in discriminating active from inactive TAO were 0.772 and 0.730, respectively. Combining MTR with MTRasym (1 ppm) significantly improved diagnostic performance compared with either parameter alone, achieving an AUC of 0.805 (P = 0.029 and 0.001). Conclusion MTR and MTRasym (1 ppm) were independently associated with TAO activity. Their combination further enhanced diagnostic performance in distinguishing active from inactive TAO, suggesting their potential as quantitative imaging biomarkers to guide treatment in patients with TAO.

Objective A random forest model was used to analyze the risk of immune reconstitution dysfunction(INR)after antiviral therapy(HAART)in HIV/AIDS patients.Methods A total of 67 HIV/AIDS patients treated in our hospital from January 2019 to December 2022 were selected and all of them received HAART treatment.After 18 months of follow-up,patients were divided into INR group and non-INR group according to prognosis.The clinical data of the two groups were compared,and the importance of the indicators affecting INR in patients was ranked by random forest model,and the related factors affecting INR in HIV/AIDS patients after HAART were analyzed by Logistic regression model.Results During the follow-up period of 18 months,a total of 13(19.40％)of 67 HIV/AIDS patients developed INR.There were statistically significant differences in the time interval from diagnosis to treatment and baseline CD4+T lymphocyte count between INR group and non-INR group(P＜0.05).Random-forest model results showed that variables were ranked in descending order of importance as baseline CD4+T lymphocyte count and time interval between diagnosis and treatment.Logistic multivariate regression analysis showed that more than 1 year between diagnosis and treatment and baseline CD4+T lymphocyte count≤ 200/μl are all risk factors for INR in HIV/AIDS patients after HAART treatment(P＜0.05).Conclusion More than 1 year between diagnosis and treatment and baseline CD4+T lymphocyte count≤200/μl are all risk factors for INR in HIV/AIDS patients after HAART.In addition,the random forest model is of great significance for health care workers to identify high-risk groups of INR after HAART and formulate intervention plans.

Objective A random forest model was used to analyze the risk of immune reconstitution dysfunction(INR)after antiviral therapy(HAART)in HIV/AIDS patients.Methods A total of 67 HIV/AIDS patients treated in our hospital from January 2019 to December 2022 were selected and all of them received HAART treatment.After 18 months of follow-up,patients were divided into INR group and non-INR group according to prognosis.The clinical data of the two groups were compared,and the importance of the indicators affecting INR in patients was ranked by random forest model,and the related factors affecting INR in HIV/AIDS patients after HAART were analyzed by Logistic regression model.Results During the follow-up period of 18 months,a total of 13(19.40％)of 67 HIV/AIDS patients developed INR.There were statistically significant differences in the time interval from diagnosis to treatment and baseline CD4+T lymphocyte count between INR group and non-INR group(P＜0.05).Random-forest model results showed that variables were ranked in descending order of importance as baseline CD4+T lymphocyte count and time interval between diagnosis and treatment.Logistic multivariate regression analysis showed that more than 1 year between diagnosis and treatment and baseline CD4+T lymphocyte count≤ 200/μl are all risk factors for INR in HIV/AIDS patients after HAART treatment(P＜0.05).Conclusion More than 1 year between diagnosis and treatment and baseline CD4+T lymphocyte count≤200/μl are all risk factors for INR in HIV/AIDS patients after HAART.In addition,the random forest model is of great significance for health care workers to identify high-risk groups of INR after HAART and formulate intervention plans.

CT angiography is an important method for vascular examination of head and neck. This examination should focus not only on endovascular contrast to meet the needs of post-processing and diagnosis,on radiation dose from extensive scans and multiple follow-up examinations,but also on the potential risk of renal impairment. Achieving low contrast agent dosage and low radiation dose,while ensuring good image quality,is the ultimate clinical pursuit for head and neck CT angiography examination. Clinical practice shows that the image noise caused by low contrast agent and low radiation dose has become a disturbing factor for imaging quality and diagnostic accuracy,so how to properly apply and combine the low contrast agent and low radiation dose conditions has always been a key point. Starting from the clinical needs,this paper reviews and sorts out the current progress and principles of low contrast agent as well as low radiation dose technology,the significant effect of image reconstruction algorithm on image quality improvement,and the current application research of deep learning reconstruction algorithms in this direction.

CT angiography is an important method for vascular examination of head and neck. This examination should focus not only on endovascular contrast to meet the needs of post-processing and diagnosis,on radiation dose from extensive scans and multiple follow-up examinations,but also on the potential risk of renal impairment. Achieving low contrast agent dosage and low radiation dose,while ensuring good image quality,is the ultimate clinical pursuit for head and neck CT angiography examination. Clinical practice shows that the image noise caused by low contrast agent and low radiation dose has become a disturbing factor for imaging quality and diagnostic accuracy,so how to properly apply and combine the low contrast agent and low radiation dose conditions has always been a key point. Starting from the clinical needs,this paper reviews and sorts out the current progress and principles of low contrast agent as well as low radiation dose technology,the significant effect of image reconstruction algorithm on image quality improvement,and the current application research of deep learning reconstruction algorithms in this direction.

Objective To investigate the effect of acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction on hemiplegia,hemorheology and neurotrophic factors in pa-tients with cerebral infarction differentiated as type of Qi deficiency and blood stasis.Methods A to-tal of 84 hospitalized patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis from March 2018 to June 2023 were selected as research objects,and they were randomly divid-ed into observation group and control group,with 42 cases in each group.The control group was con-ducted with acupuncture and routine treatment,while the observation group was conducted with modi-fied Buyang Huanwu Decoction on the basis of the control group.Clinical efficacy after 2 weeks of treatment as well as the scores of main symptoms,neurological function,limb function,hemorheologi-cal indicators and levels of neurotrophic factors before and after treatment were compared between two groups.Results After 2 weeks of treatment,the total effective rate of the observation group was sig-nificantly higher than that of the control group(P＜0.05);after treatment,the scores of symptoms such as hemiplegia,deviated mouth and awkward speech in both groups decreased significantly when compared to those before treatment,and these scores in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the score of the National Institutes of Health Stroke Scale(NIHSS)in both groups decreased significantly when compared to that before treat-ment,and the score in the observation group was significantly lower than that in the control group(P＜0.05);the score of the Motor Function Assessment Scale(Fugl-Meyer)after treatment in both groups was significantly higher than that before treatment,and the observation group was significant-ly higher than that in the control group(P＜0.05).After treatment,the plasma viscosity,red blood cell aggregation index,whole blood high shear viscosity and whole blood low shear viscosity in both groups decreased significantly when compared to those before treatment,and these indexes in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the levels of serum brain derived neurotrophic factor(BDNF),nerve growth factor(NGF)and glial cell line-derived neurotrophic factor(GDNF)in both groups increased significant-ly when compared to those before treatment,and the levels of these indexes in the observation group were significantly higher than those in the control group(P＜0.05).Conclusion Acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction can enhance the therapeutic effect for patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis,im-prove clinical symptoms,repair nerve damage,and promote the recovery of limb function.

Objective To investigate the effect of acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction on hemiplegia,hemorheology and neurotrophic factors in pa-tients with cerebral infarction differentiated as type of Qi deficiency and blood stasis.Methods A to-tal of 84 hospitalized patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis from March 2018 to June 2023 were selected as research objects,and they were randomly divid-ed into observation group and control group,with 42 cases in each group.The control group was con-ducted with acupuncture and routine treatment,while the observation group was conducted with modi-fied Buyang Huanwu Decoction on the basis of the control group.Clinical efficacy after 2 weeks of treatment as well as the scores of main symptoms,neurological function,limb function,hemorheologi-cal indicators and levels of neurotrophic factors before and after treatment were compared between two groups.Results After 2 weeks of treatment,the total effective rate of the observation group was sig-nificantly higher than that of the control group(P＜0.05);after treatment,the scores of symptoms such as hemiplegia,deviated mouth and awkward speech in both groups decreased significantly when compared to those before treatment,and these scores in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the score of the National Institutes of Health Stroke Scale(NIHSS)in both groups decreased significantly when compared to that before treat-ment,and the score in the observation group was significantly lower than that in the control group(P＜0.05);the score of the Motor Function Assessment Scale(Fugl-Meyer)after treatment in both groups was significantly higher than that before treatment,and the observation group was significant-ly higher than that in the control group(P＜0.05).After treatment,the plasma viscosity,red blood cell aggregation index,whole blood high shear viscosity and whole blood low shear viscosity in both groups decreased significantly when compared to those before treatment,and these indexes in the observation group were significantly lower than those in the control group(P＜0.05).After treatment,the levels of serum brain derived neurotrophic factor(BDNF),nerve growth factor(NGF)and glial cell line-derived neurotrophic factor(GDNF)in both groups increased significant-ly when compared to those before treatment,and the levels of these indexes in the observation group were significantly higher than those in the control group(P＜0.05).Conclusion Acupuncture at Yangming meridian combined with modified Buyang Huanwu Decoction can enhance the therapeutic effect for patients with cerebral infarction differentiated as type of Qi deficiency and blood stasis,im-prove clinical symptoms,repair nerve damage,and promote the recovery of limb function.

Objective To investigate the value of early?phase enhancement ratio combined with peripheral vascular diameter in the differential diagnosis of benign and malignant breast lesions using 3.0 T dynamic contrast?enhanced magnetic resonance imaging (DCE?MRI). Methods Sixty seven cases of patients (35 with malignant lesions and 32 with benign lesions in the breasts) were retrospectively analyzed. Their diagnoses were confirmed by surgery and pathology and all the patients underwent breast MRI plain scan and DCE?MRI in the two weeks before surgery. Lesion ROIs were drawn and time?signal intensity curves in the DCE?MRI were generated. Early?phase enhancement rate, time to peak, early?phase enhancement ratio, numbers of tumor vessel within 3 cm of the lesion and diameter of the largest vessel were recorded. Mann?Whitney U test was used to compare the difference of DCE?MRI between benign and malignant lesions, and the ROC curve was used to evaluate the efficiency of early?phase enhancement rate, early?phase enhancement ratio and vascular diameter in differentiating benign and malignant lesions. Results With breast malignant lesions, the medians of time to peak, early?phase enhancement rate, early?phase enhancement ratio, numbers of tumor vessel and vascular diameter were 2.2 s, 176.0%, 100.0%, 4 and 2.96 mm respectively, while with benign lesions of these parameters were 4.7 s, 113.3%, 81.9%, 0 and 0.00 mm respectively, and the differences were statistically significant (all P<0.05).When early?phase enhancement rate was used for differential diagnosis of breast benign and malignant lesions, the area under the ROC curve was 0.702 and the sensitivity and specificity were 82.86%and 56.25%with a threshold of 120.0%. When early?phase enhancement ratio was used, the area under the ROC curve was 0.854 and the sensitivity and specificity were 94.29% and 68.75% with a threshold of 86.0%. When peripheral vascular diameter was used, the area under the ROC curve was 0.896 and the sensitivity and specificity were 74.29%and 84.38% with a threshold of 2.78 mm. When early?phase enhancement ratio was combined with peripheral vascular diameter, the area was 0.925 and the sensitivity and specificity were 97.14% and 62.50%. Conclusion In the differential diagnosis of benign and malignant breast lesions under DCE?MRI, early?phase enhancement ratio combining with peripheral vascular diameter has improved sensitivity.

Objective To optimize the parameters for the diffusion tensor imaging (DTI)of the ulnar nerve in elbow.Methods 5 groups of DTI sequences with different b values and numbers of diffusion gradient directions (NDGDs)were used to collect ulnar nerve images from 13 volunteers,and then the diffusion tensor tractography (DTT)was established.The fractional anisotropy (FA),apparent diffusion coefficient (ADC),length of ulnar nerve fiber and DTI image quality were compared under different imaging parameters. Results DTI results for 18 normal ulnar nerves were included in the study.Under different imaging conditions,FAs showed no significant differences.With constant NDGDs,increasing b value decreased both image quality and ADCs of the ulnar nerve.NDGDs had no significant effects on ADCs or image quality.When b=1 000 s/mm2 and NDGDs=20,the length of the ulnar nerve fiber was the longest and DTT had the best subjective scoring in image quality.Conclusion b=1 000 s/mm2 and NDGDs=20 is recommended for DTI of elbow ulnar nerve,so as to obtain high image quality and stable observing targets.

Objective To evaluate the diagnostic ability of fusion images of SWI and DWI in ischemic penumbra(IP)of patients with acute ischemic stroke(AIS).Methods 47 AIS patients were retrospective analyzed.Two neuroradiologists analyzed the fusion images of SWI and DWI respectively.SDM was defined as that the hypo-intensity signals of intramedullary or sulcal veins were dilated or increased on fusion images compared with contralateral areas.The results compared with the PDM,which was considered as the“gold standard”.Areas under the receiver operating characteristic curve(AUC)were used to assess the efficacy of SDM which determined by fusion images and compared to PDM.Chi-square test was used to analyze the consistency between the two neuroradiologists and also the consistency between SDM and PDM in IP assessment Results The fusion images of SWI and DWI had a high diagnostic efficacy compared to PDM, AUC of the two radiologists were 0.885,0.877,the diagnostic sensitivity were 84.2%,78.9% and specificity were 92.9%,96.4%respectively.There was also a high consistency in SDM assessment through fusion images between the two neuroradiologists (Kappa=0.908,P >0.05). Conclusion Fusion images of SWI and DWI have a high diagnostic efficacy in IP assessment,which may be considered as a simple approach for IP assessment in patients with AIS.