Objective To explore the advantage of advanced diffusion weighted imaging(DWI)over single index DWI in distin-guishing low-grade transitional zone prostate cancer(TZ-PCa)from benign prostatic hyperplasia(BPH)with inflammation.Methods Thirty-two patients with low-grade TZ-PCa(low-grade TZ-PCa group)and 38 patients with BPH with inflammation(BPH with inflammation group)confirmed by pathology were selected.All patients underwent routine MR sequence,single index DWI,and advanced DWI[including introvoxel incoherent motion diffusion weighted imaging(IVIM-DWI),stretched-exponential model(SEM),diffu-sion kurtosis imaging(DKI)]sequences scans.The related parameters of the lesion area[including apparent diffusion coefficient(ADC),diffusion coefficient(D),distributed diffusion coefficient(DDC),and mean kurtosis(MK)values]were measured.Independ-ent sample t-tests were used to compare differences in parameters values between the two groups.The receiver operating characteris-tic(ROC)curve was used to calculate the area under the curve(AUC)of varous parameters values in the differential diagnosis of low-grade TZ-PCa and BPH with inflammation.The difference in AUC between advanced DWI and single index DWI was compared using Z-test.Results The ADC,D,and DDC values of the low-grade TZ-PCa group were lower than those of the BPH with inflammation group(P<0.05).The MK value of the low-grade TZ-PCa group was higher than that of the BPH with inflammation group(P<0.05).The D,DDC,and MK values,and a combination of these parameters(D+DDC+MK)exhibited high diagnostic effi-cacy(all AUC>0.9).The diagnostic efficacy of these parameters was significantly higher than that of the ADC value(AUC 0.902,0.904,0.966,0.994 vs 0.725,all P<0.05).The combined param-eter demonstrated the highest AUC.Although the diagnostic efficacy of the combined parameter was not statistically different from the individual D,DDC,and MK values(P>0.05),the diagnostic specificity was significantly improved compared to the individual parame-ters.Conclusion Advanced DWI(IVIM-DWI,SEM,DKI)has a higher diagnostic efficacy in distinguishing low-grade TZ-PCa from BPH with inflammation than single index DWI.Combining the parameters(D+DDC+MK)further improves diagnostic specificity.

Objective To explore the advantage of advanced diffusion weighted imaging(DWI)over single index DWI in distin-guishing low-grade transitional zone prostate cancer(TZ-PCa)from benign prostatic hyperplasia(BPH)with inflammation.Methods Thirty-two patients with low-grade TZ-PCa(low-grade TZ-PCa group)and 38 patients with BPH with inflammation(BPH with inflammation group)confirmed by pathology were selected.All patients underwent routine MR sequence,single index DWI,and advanced DWI[including introvoxel incoherent motion diffusion weighted imaging(IVIM-DWI),stretched-exponential model(SEM),diffu-sion kurtosis imaging(DKI)]sequences scans.The related parameters of the lesion area[including apparent diffusion coefficient(ADC),diffusion coefficient(D),distributed diffusion coefficient(DDC),and mean kurtosis(MK)values]were measured.Independ-ent sample t-tests were used to compare differences in parameters values between the two groups.The receiver operating characteris-tic(ROC)curve was used to calculate the area under the curve(AUC)of varous parameters values in the differential diagnosis of low-grade TZ-PCa and BPH with inflammation.The difference in AUC between advanced DWI and single index DWI was compared using Z-test.Results The ADC,D,and DDC values of the low-grade TZ-PCa group were lower than those of the BPH with inflammation group(P<0.05).The MK value of the low-grade TZ-PCa group was higher than that of the BPH with inflammation group(P<0.05).The D,DDC,and MK values,and a combination of these parameters(D+DDC+MK)exhibited high diagnostic effi-cacy(all AUC>0.9).The diagnostic efficacy of these parameters was significantly higher than that of the ADC value(AUC 0.902,0.904,0.966,0.994 vs 0.725,all P<0.05).The combined param-eter demonstrated the highest AUC.Although the diagnostic efficacy of the combined parameter was not statistically different from the individual D,DDC,and MK values(P>0.05),the diagnostic specificity was significantly improved compared to the individual parame-ters.Conclusion Advanced DWI(IVIM-DWI,SEM,DKI)has a higher diagnostic efficacy in distinguishing low-grade TZ-PCa from BPH with inflammation than single index DWI.Combining the parameters(D+DDC+MK)further improves diagnostic specificity.

Objective To investigate the application value of Revolution CT dual-low technique coronary angiography in coronary heart disease.Methods One hundred patients with suspected coronary heart disease were retrospectively selected and randomly divided into control group and observation group,who all were examined by Revolution CT.In the control group(50 cases),the tube voltage was 120 kV,the contrast agent iohexol was 350 mg I/mL,and the dose of contrast agent was 1 mL/kg.In the observation group(50 cases),the tube voltage was 100 kV,the contrast agent iohexol was 350 mg I/mL,and the dose of contrast agent was 0.8 mL/kg.All patients underwent coronary digital subtraction angiography(DSA)examination at the same time.The image quality(subjective and objective evaluation indexes)and radiation dose of the two groups were compared,the diagnostic value of the two methods for coronary artery stenosis was compared,and the diagnostic consistency with coronary DSA between the two methods were compared using the Kappa test,as well as the typical coronary images of the two groups were analyzed.Results There were no significant differences in the sub-jective image quality grade and excellence rate between the observation group and the control group(P＞0.05).The CT value and noise of the observation group were higher than those of the control group(P＜0.05).There were no statistically significant differ-ences in the signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the right coronary proximal and the left coronary main trunk between the two groups(P＞0.05).Compared with the control group,the volume CT dose index(CTDIvol),dose length product(DLP),and effective dose(ED)were lower in the observation group(P＜0.05).Compared with the results of coronary DSA,the positive predictive value,negative predictive value,sensitivity,specificity and accuracy of the two methods were＞80％,while there was no significant difference between the two groups(P＞0.05).The Kappa value of the observation group versus coronary DSA diagnosis was 0.871,the Kappa value of the control group ver-sus coronary DSA diagnosis was 0.889,and the consistency of both methods versus coronary DSA diagnosis was good.Conclusion Revolution CT dual-low technigue coronary angiography has good diagnostic value for coronary heart disease and can significantly reduce the radiation dose while ensuring image quality.

【Objective】 To investigate dynamic regional homogeneity (dReHo) abnormality in end-stage renal disease (ESRD) patients by using resting-state functional magnetic resonance imaging (rs-fMRI). 【Methods】 A total of 26 ESRD patients and 26 healthy controls (HC) matched in gender, education level and age were included. Rs-fMRI scanning was performed in all subjects. All the subjects were tested by using auditory verbal learning test Huashan version (AVLT-H) and Montreal Cognitive Assessment (MoCA) to assess cognitive function before collection of MRI data. T-test was used to observe the difference in dReHo at global level between the two groups. Pearson and Spearman correlation analyses were made to estimate the correlation between abnormal brain regions and clinical scales. 【Results】 Compared with HC group, the dReHo value in ESRD patients reduced on the bilateral superior margin gyrus, left insula, left posterior central gyrus, and left putamen (P<0.05, replacement test correction). The dReHo values of left superior margin gyrus (r=-0.534, P=0.005) and left insula in ESRD patients (r=-0.422, P=0.032) were negatively correlated with the LR-S score, and the dReHo value of the left margin was negatively correlated with the SR-S score (r=-0.468, P=0.016). 【Conclusion】 There are abnormal dReHo values in several brain regions in ESRD patients during resting state, which is related to the patients’ cognitive function. The variation of dReHo value provides a new objective imaging basis for evaluating the cognitive function of ESRD patients.

Objective:To investigate the long-term survival and safety in patients with muscle-invasive bladder cancer (MIBC) who experienced a noninvasive down-staging (≤pT 1)after transurethral resection of bladder tumor (TURBT) plus systemic chemotherapy and received bladder-sparing treatment. Methods:The records of patients with MIBC who underwent maximal TURBT plus systemic chemotherapy-guided bladder-sparing treatment were reviewed retrospectively from Dec 2013 to Dec 2020. Eventually, 22 patients who achieved noninvasive down-staging underwent conservative management. The total patient cohort contained 10 males and 12 females. A majority of patients had single lesion and stage T2 disease. The median age of the patients was 66 years and the median tumor size was 3.0 cm. All patients underwent maximal TURBT to resect all visible diseases and followed by 3-4 cycles platinum-based systemic chemotherapy. After achieving noninvasive down-staging, 14 patients received concurrent chemoradiotherapy, and the other 8 patients underwent surveillance. Overactive bladder symptom score (OABSS) was used to assess the bladder function after treatment.Results:Twelve patients achieved pT 0 and 10 patients were down-staged to cT a-T 1. At a median follow-up of 36.7 months, 90.9%(20/22) patients retained their bladder function successfully. Among the 14 patients who received concurrent chemoradiotherapy, 4 had grade 3 or 4 adverse events. Among the 8 patients who underwent surveillance, 3 had grade 3 or 4 adverse events after systemic chemotherapy.Nine patients experienced tumor recurrence in the bladder, and 2 patients died of bladder cancer. Seven (31.8%) patients experienced Ⅲ/Ⅳ grade complications. The 5-year recurrence-free survival (RFS) and overall survival (OS) in patients achieved pT0 were 66.7% and 100.0%, respectively. The 5-year RFS and OS in patients achieved cTa-T1 were 40% and 72%, respectively. The OABSS score of 20 patients who retained their bladder successfully was (1.00±1.03). Conclusions:MIBC patients who achieved noninvasive down-staging might be candidates for the bladder-sparing treatment with maximum TURBT followed by systemic chemotherapy.The patients who achieved pT 0 might have better prognosis with functional bladder.

Purpose: Reduced quality of life after cystectomy has made bladder preservation a popular research topic for muscle-invasive bladder cancer (MIBC). Previous research has indicated significant tumor downstaging after neoadjuvant chemotherapy (NAC). However, maximal transurethral resection of bladder tumor (TURBT) was performed before NAC to define the pathology, impacting the real evaluation of NAC. This research aimed to assess real NAC efficacy without interference from TURBT and apply combined modality therapies guided by NAC efficacy. Materials and Methods: Patients with cT2-4aN0M0 MIBC were confirmed by cystoscopic biopsy and imaging. NAC efficacy was assessed by imaging, urine cytology, and cystoscopy with multidisciplinary team discussion. Definite responders (≤ T1) underwent TURBT plus concurrent chemoradiotherapy. Incomplete responders underwent radical cystectomy or partial cystectomy if feasible. The primary endpoint was the bladder preservation rate. Results: Fifty-nine patients were enrolled, and the median age was 63 years. Patients with cT3-4 accounted for 75%. The median number of NAC cycles was three. Definite responders were 52.5%. The complete response (CR) was 10.2%, and 59.3% of patients received bladder-sparing treatments. With a median follow-up of 44.6 months, the 3-year overall survival (OS) was 72.8%. Three-year OS and relapse-free survival were 88.4% and 60.0% in the bladder-sparing group but only 74.3% and 37.5% in the cystectomy group. The evaluations of preserved bladder function were satisfactory. Conclusion After stratifying MIBC patients by NAC efficacy, definite responders achieved a satisfactory bladder-sparing rate, prognosis, and bladder function. The CR rate reflected the real NAC efficacy for MIBC. This therapy is worth verifying through multicenter research.

Objective To evaluate the clinical application value of CT angiography(CTA) in detection of the accessory renal artery(ARA).Methods The renal artery CTA in 100 cases was reconstructed retrospectively with volume rendering (VR), multiplanar reconstruction (MPR), maximum density projection (MIP) and curved surface reconstruction (CPR).Results In all 200 kidneys,ARA were 47 with an incidence of 23.5% (47/200).The incidence of ARA in male and female were about 17% and 13%, and there was no significant difference between them.The ARA in the upper pole of the kidney was 25 (53.1%), and in lower pole was 22 (46.9%).It was showed on MIP with a display rate of 100%, on MRP of 93.6%, on VR of 90.4% and on CPR of 85.1%.Conclusion CTA is a safe, rapid, noninvasive and economical method for the diagnosis of ARA.It is helpful for surgical renal operation, interventional therapy and renal transplantation.

Objective To retrospectively summarize the normal reference range of trachea wall thickness,lumen diameter,wall area and wall area ratio[WA%=mean wall area/(mean wall area+lumen area)]of Chinese healthy adults,and its related factors. Also,to observe the difference of inner diameter between superior and inferior bronchus.Methods Based on computer measurement techniques of bronchus,a CT quantitative analysis was carried out in 701 cases of normal healthy people who had negative results in lung cancer screening of health examination at our hospital.Results The value of trachea wall thickness,lumen diameter,wall area and wall area ratio was(1.322 mm,18.024 mm,78.93 mm2 ,0.27)respectively.In different gender,the trachea wall thickness,lumen diameter,wall area and wall area ratio had statistical significance (P<0.05).Also,they had good consistency with gender (r=-0.512,-0.472,-0.559,0.315).In different gender and age,the difference of inner diameter between the superior bronchus and inferior bronchus was always a positive value.Conclusion The CT quantitative analysis method has advantages of convenience,direct-vie-wing and accuracy.It is good for quantitative detection and research of bronchus structure.Bronchial wall thickness,lumen diameter, wall area and wall area ratio have significant difference because of gender.The inner diameter of superior bronchus is always greater than that of the inferior bronchus.