Objective To explore the value of apparent diffusion coefficient(ADC)value combined with ovarian-adnexal reporting and data system(O-RADS)MRI score in differentiating benign and malignant adnexal lesions with score 3-5.Methods The imaging data of 241 adnexal lesions with O-RADS MRI score 3-5 proved by pathology were analyzed retrospectively.The ADC values of all lesions were measured,and the optimal thresholds were determined by receiver operating characteristic(ROC)curve analysis,the comprehensive model was established using binary logistic regression analysis,the corresponding diagnostic efficacy was calculated.Results The median ADC values of the benign,borderline and malignant groups were 2.166 × 10-3 mm2/s,1.383 ×10-3 mm2/s and 0.839× 10-3mm2/s,respectively(P＜0.05).The area under the curve(AUC)of the combination of ADC value with O-RADS MRI score for differentiating benign and malignant adnexal lesions was 0.928[95％ confidence interval(CI)0.888-0.958],which was higher than that of O-RADS MRI score and ADC value alone(P＜0.05).The sensitivity and specificity of the three models in differ-entiating benign and malignant adnexal lesions were 93.5％,98.9％,83.9％,respectively;and 79.1％,58.8％,79.1％,respectively.Conclusion ADC value combined with O-RADS MRI score can be the most effective in the diagnosis of benign and malignant adnexal lesions,which is higher than O-RADS MRI score and ADC value.Compared with O-RADS MRI score,ADC value combined with O-RADS MRI score maintained good sensitivity and increased diagnostic specificity.

Objective To observe the value of training about ovarian-adnexal reporting and data system((O-RADS)for risk stratification of adnexal lesions diagnostic efficacy of different seniority physicians before and after training.Methods A total of 575 O-RADS 1-5 point lesions from 470 patients who received non-contrast enhanced pelvic MR and dynamic contrast-enhanced MRI(DCE-MRI)were retrospectively included.The lesions were scored by 1 junior radiologist(radiologist A)and 1 senior radiologist(radiologist B)independently according to O-RADS risk stratification,and the results were recorded as R1 and R2,respectively.Three months later,the lesions were rescored by radiologist A and B after receiving systematic training from gynecological imaging experts,and the results were recorded as R11 and R22,respectively.Two gynecological imaging experts conducted a consensus scoring,and the results were recorded as R0.Taken O-RADS score＞3 as the criterion for malignant,the diagnostic efficacy of radiologist A and B before and after training were evaluated,while taken R0 as the reference,the intra-observer,inter-observer consistency between radiologist A and B,as well as their consistency with R0 were calculated.Results The diagnostic sensitivity and specificity of R0 was 95.21%and 93.14%,respectively.The diagnostic sensitivity of radiologist A before and after training was 92.22%and 95.21%,with specificity of 83.33%and 89.46%,respectively.For radiologist B,the sensitivity before and after training was 95.81%and 95.21%,with specificity of 92.89%and 91.91%,respectively.Good intra-observer consistency of O-RADS score was observed both in radiologist A and B,with Kappa value of 0.845 and 0.884,respectively,which also noticed between radiologist A and B,with Kappa value of 0.761,and the Kappa value of R1,R2 and R0 was 0.781 and 0.911,respectively.After training,the inter-observer consistency of radiologist A and B increased,and Kappa value of R11,R22 and R0 was 0.844 and 0.915,respectively.Conclusion Training about O-RADS for risk stratification was helpful to improving diagnostic specificity of benign and malignant adnexal lesions,especially for junior radiologists.

Objective:To identify the risk factors that predict pathological upstaging of low-grade intraepithelial neoplasia (LGIN) or low-grade dysplasia (LGD) in forceps biopsy after endoscopic resection.Methods:A systematic search of Web of Science, Embase, PubMed and Cochrane Library was conducted using the terms "Risk Factor" "Low-Grade Dysplasia or Low-Grade Intraepithelial Neoplasia" "gastric or stomach" with a deadline of October 2022. Observational studies related to risk factors for biopsy pathology diagnosis of gastric LGIN or LGD lesions with pathology escalation after endoscopic resection were included. Meta-analysis was performed using random-effects models to calculate pooled odds ratio ( OR). Results:Fifteen studies were identified on pathologic upstaging associated with 5 different risk factors: erythema, lesion diameter, depressed lesions, nodularity, and lesion location. Factors that significantly increase the risk of upgrading the pathological diagnosis after endoscopic resection included erythema ( P<0.01, OR=2.87, 95% CI: 1.94-4.25), lesion diameter ( P<0.01, OR=2.50, 95% CI: 1.85-3.37), depressed morphology ( P=0.02, OR=1.70, 95% CI: 1.09-2.64), and nodularity ( P<0.01, OR=2.95, 95% CI: 1.81-4.81). The risk of pathologic diagnostic escalation after endoscopic resection was similar for lesions in the upper 1/3 of the stomach compared to lesions in the lower 1/3 of the stomach ( P=0.86, OR=1.03, 95% CI: 0.72-1.47), whereas the risk of pathologic diagnostic escalation for lesions in the middle 1/3 of the stomach was even lower ( P<0.01, OR=0.75, 95% CI: 0.60-0.93). Conclusion:Several endoscopic factors, including lesion diameter, location and surface morphology, are associated with the pathologic upstaging of LGIN/LGD on pre-treatment forceps biopsy. Clinical attention should be paid to the risk of pathological diagnosis upgrading after endoscopic resection of large lesions, including redness, depression, and nodular surface lesions in the lower 1/3 of the stomach.

Objective The aim of this study is to investigate the plaque characteristics of different subtypes of middle cerebral artery(MCA)infarction,lenticulostriate artery(LSA)characteristics,and hemodynamic characteristics through high-resolution magnetic resonance vessel wall imaging(HR-MRI VWI)and perfusion weighted imaging(PWI).Methods A retrospective analysis was conducted on patients with unilateral acute or subacute MCA infarction who underwent HR-MRI VWI and PWI examinations at Qinhuangdao First Hospital from January 2022 to April 2024.Patients were divided into three groups according to the type of infarction:artery-to-artery embolism(AA),branch occlusive disease(BOD),branch occlusive disease and artery-to-artery embolism(BOD-AA).Clinical data,plaque characteristics,lenticulostriate artery characteristics,and hemodynamic characteristics were compared and analyzed among the three groups.To determine factors associated with BOD,the BOD and BOD-AA groups were merged into a BOD+group which was then compared with the AA group.To determine factors associated with the AA group,the BOD-AA and AA groups were combined into an AA+group,followed by comparison with the BOD group.Results A total of 42 patients with unilateral acute or subacute MCA infarction were included according to the inclusion and exclusion criteria.Among them,9 patients were classified as having AA,14 patients as having BOD,and 19 as having BOD-AA.The results showed that the degree of stenosis was higher in the AA+group than in the BOD group,and the difference was statistically significant(Z=-2.536,P<0.05);The number of LSA on the affected side was higher in the BOD+group than in the AA group[2.00(1.50,3.00)vs.3.00(3.00,4.00)],and the difference was statistically significant(Z=-2.889,P<0.05);The relative cerebral blood flow(rCBF)of the centrum semiovale was lower in the AA+group than in the BOD group[0.90(0.84,0.93)vs.0.99(0.97,1.03)],and the difference was statistically significant(Z=-4.555,P<0.05);The rCBF in the basal ganglia was lower in the BOD+group than in the AA group[0.89(0.83,0.93)vs.1.01(0.98,1.04)],and the difference was statistically significant(Z=-4.280,P<0.05).Conclusion Patients in BOD+have a lower degree of stenosis compared to AA group.The spatial relationship between plaques and LSA varies across different subtypes of MCA infarction.Plaques in BOD+patients are positioned closer to the LSA orifice and thus have a higher tendency to occlude the LSA orifice.The affected side has few LSAs and the rCBF in the LSA perfusion area.is lower.

Objective To evaluate the value of deep learning(DL)-based artificial intelligence(AI)automatic reconstruction for evaluation of grafts in patients who underwent coronary artery bypass grafting(CABG).Methods Coronary CT angiography data of 90 patients who underwent CABG with a total of 197 grafts were retrospectively analyzed.Taken manual evaluation results(manual group)as the standards,the efficacy of AI(AI group)for evaluating the degree of stenosis of graft and distal autologous blood vessels were assessed.The consistency between calculating unprotected coronary territory(UCT)and the total time for image post-processing and diagnosis were compared between groups.Results AI group showed average consistency with manual group for evaluating the number of grafts([intra-class correlation coefficient,ICC]=0.743,P＜0.05),average to excellent for evaluating the maximum degree of graft stenosis(Kappa=0.310-1.000,all P＜0.05),also average to good consistency for evaluating the maximum degree of stenosis of the native vessel distal to the graft insertion(Kappa=0.292-0.795,all P＜0.05).AI group had moderate consistency with manual group for UCT(ICC=0.469,P＜0.05),achieved an area under the curve of 0.811.The overall time of image post-processing and diagnosis in AI group were both significantly shorter than that in manual group(P＜0.05).Conclusion Having acceptable consistency with manual evaluation and ability for assistant,AI was efficient for automatic reconstructing coronary artery bypass graft and quantifying the degree of graft stenosis.

Objective To explore the value of apparent diffusion coefficient(ADC)value combined with ovarian-adnexal reporting and data system(O-RADS)MRI score in differentiating benign and malignant adnexal lesions with score 3-5.Methods The imaging data of 241 adnexal lesions with O-RADS MRI score 3-5 proved by pathology were analyzed retrospectively.The ADC values of all lesions were measured,and the optimal thresholds were determined by receiver operating characteristic(ROC)curve analysis,the comprehensive model was established using binary logistic regression analysis,the corresponding diagnostic efficacy was calculated.Results The median ADC values of the benign,borderline and malignant groups were 2.166 × 10-3 mm2/s,1.383 ×10-3 mm2/s and 0.839× 10-3mm2/s,respectively(P＜0.05).The area under the curve(AUC)of the combination of ADC value with O-RADS MRI score for differentiating benign and malignant adnexal lesions was 0.928[95％ confidence interval(CI)0.888-0.958],which was higher than that of O-RADS MRI score and ADC value alone(P＜0.05).The sensitivity and specificity of the three models in differ-entiating benign and malignant adnexal lesions were 93.5％,98.9％,83.9％,respectively;and 79.1％,58.8％,79.1％,respectively.Conclusion ADC value combined with O-RADS MRI score can be the most effective in the diagnosis of benign and malignant adnexal lesions,which is higher than O-RADS MRI score and ADC value.Compared with O-RADS MRI score,ADC value combined with O-RADS MRI score maintained good sensitivity and increased diagnostic specificity.

Objective The aim of this study is to investigate the plaque characteristics of different subtypes of middle cerebral artery(MCA)infarction,lenticulostriate artery(LSA)characteristics,and hemodynamic characteristics through high-resolution magnetic resonance vessel wall imaging(HR-MRI VWI)and perfusion weighted imaging(PWI).Methods A retrospective analysis was conducted on patients with unilateral acute or subacute MCA infarction who underwent HR-MRI VWI and PWI examinations at Qinhuangdao First Hospital from January 2022 to April 2024.Patients were divided into three groups according to the type of infarction:artery-to-artery embolism(AA),branch occlusive disease(BOD),branch occlusive disease and artery-to-artery embolism(BOD-AA).Clinical data,plaque characteristics,lenticulostriate artery characteristics,and hemodynamic characteristics were compared and analyzed among the three groups.To determine factors associated with BOD,the BOD and BOD-AA groups were merged into a BOD+group which was then compared with the AA group.To determine factors associated with the AA group,the BOD-AA and AA groups were combined into an AA+group,followed by comparison with the BOD group.Results A total of 42 patients with unilateral acute or subacute MCA infarction were included according to the inclusion and exclusion criteria.Among them,9 patients were classified as having AA,14 patients as having BOD,and 19 as having BOD-AA.The results showed that the degree of stenosis was higher in the AA+group than in the BOD group,and the difference was statistically significant(Z=-2.536,P<0.05);The number of LSA on the affected side was higher in the BOD+group than in the AA group[2.00(1.50,3.00)vs.3.00(3.00,4.00)],and the difference was statistically significant(Z=-2.889,P<0.05);The relative cerebral blood flow(rCBF)of the centrum semiovale was lower in the AA+group than in the BOD group[0.90(0.84,0.93)vs.0.99(0.97,1.03)],and the difference was statistically significant(Z=-4.555,P<0.05);The rCBF in the basal ganglia was lower in the BOD+group than in the AA group[0.89(0.83,0.93)vs.1.01(0.98,1.04)],and the difference was statistically significant(Z=-4.280,P<0.05).Conclusion Patients in BOD+have a lower degree of stenosis compared to AA group.The spatial relationship between plaques and LSA varies across different subtypes of MCA infarction.Plaques in BOD+patients are positioned closer to the LSA orifice and thus have a higher tendency to occlude the LSA orifice.The affected side has few LSAs and the rCBF in the LSA perfusion area.is lower.

Objective To observe the value of training about ovarian-adnexal reporting and data system((O-RADS)for risk stratification of adnexal lesions diagnostic efficacy of different seniority physicians before and after training.Methods A total of 575 O-RADS 1-5 point lesions from 470 patients who received non-contrast enhanced pelvic MR and dynamic contrast-enhanced MRI(DCE-MRI)were retrospectively included.The lesions were scored by 1 junior radiologist(radiologist A)and 1 senior radiologist(radiologist B)independently according to O-RADS risk stratification,and the results were recorded as R1 and R2,respectively.Three months later,the lesions were rescored by radiologist A and B after receiving systematic training from gynecological imaging experts,and the results were recorded as R11 and R22,respectively.Two gynecological imaging experts conducted a consensus scoring,and the results were recorded as R0.Taken O-RADS score＞3 as the criterion for malignant,the diagnostic efficacy of radiologist A and B before and after training were evaluated,while taken R0 as the reference,the intra-observer,inter-observer consistency between radiologist A and B,as well as their consistency with R0 were calculated.Results The diagnostic sensitivity and specificity of R0 was 95.21%and 93.14%,respectively.The diagnostic sensitivity of radiologist A before and after training was 92.22%and 95.21%,with specificity of 83.33%and 89.46%,respectively.For radiologist B,the sensitivity before and after training was 95.81%and 95.21%,with specificity of 92.89%and 91.91%,respectively.Good intra-observer consistency of O-RADS score was observed both in radiologist A and B,with Kappa value of 0.845 and 0.884,respectively,which also noticed between radiologist A and B,with Kappa value of 0.761,and the Kappa value of R1,R2 and R0 was 0.781 and 0.911,respectively.After training,the inter-observer consistency of radiologist A and B increased,and Kappa value of R11,R22 and R0 was 0.844 and 0.915,respectively.Conclusion Training about O-RADS for risk stratification was helpful to improving diagnostic specificity of benign and malignant adnexal lesions,especially for junior radiologists.

Objective To evaluate the value of deep learning(DL)-based artificial intelligence(AI)automatic reconstruction for evaluation of grafts in patients who underwent coronary artery bypass grafting(CABG).Methods Coronary CT angiography data of 90 patients who underwent CABG with a total of 197 grafts were retrospectively analyzed.Taken manual evaluation results(manual group)as the standards,the efficacy of AI(AI group)for evaluating the degree of stenosis of graft and distal autologous blood vessels were assessed.The consistency between calculating unprotected coronary territory(UCT)and the total time for image post-processing and diagnosis were compared between groups.Results AI group showed average consistency with manual group for evaluating the number of grafts([intra-class correlation coefficient,ICC]=0.743,P＜0.05),average to excellent for evaluating the maximum degree of graft stenosis(Kappa=0.310-1.000,all P＜0.05),also average to good consistency for evaluating the maximum degree of stenosis of the native vessel distal to the graft insertion(Kappa=0.292-0.795,all P＜0.05).AI group had moderate consistency with manual group for UCT(ICC=0.469,P＜0.05),achieved an area under the curve of 0.811.The overall time of image post-processing and diagnosis in AI group were both significantly shorter than that in manual group(P＜0.05).Conclusion Having acceptable consistency with manual evaluation and ability for assistant,AI was efficient for automatic reconstructing coronary artery bypass graft and quantifying the degree of graft stenosis.