1.A nomogram model integrating LI-RADS features based on MRI for predicting microvascular invasion in hepatocellular carcinoma following Milan criteria
Wenxin ZHONG ; Haifeng LIU ; Liqiu ZOU ; Hao ZHANG ; Xiaofei MAI ; Wei XING
Chinese Journal of Radiology 2023;57(12):1346-1352
Objective:To establish and verify a nomogram model based on MRI liver imaging reporting and data system (LI-RADS) features for predicting microvascular invasion (MVI) in hepatocellular carcinoma (HCC) following the Milan criteria.Methods:A retrospective analysis was conducted on data from 118 HCC patients (121 lesions) confirmed by pathology from June 2016 to June 2022 at the Third Affiliated Hospital of Soochow University. Forty-seven HCCs were diagnosed as MVI-positive and 74 HCCs as MVI-negative. The data was randomly divided into the training set (83 patients with 84 HCCs, including 31 MVI-positive and 53 MVI-negative HCCs) and the test set (35 patients with 37 HCCs, including 16 MVI-positive and 21 MVI-negative HCCs) using cross-validation method. HCC imaging features were evaluated based on LI-RADS (version 2018). In the training set, the χ 2 test was used to compare the differences in LI-RADS features between the MVI-positive group and the MVI-negative group. The logistic regression analysis was conducted to identify independent risk factors for predicting MVI-positive and to construct the nomogram model. The receiver operating characteristic (ROC) curves and decision curve analysis (DCA) were used to evaluate the performance and clinical benefits of the nomogram model in predicting MVI tumors. Results:There were statistically significant differences between the MVI-positive group and the MVI-negative group in terms of tumor size, tumor margin, mosaic architecture, and corona enhancement ( P<0.05). Multivariate logistic analysis results showed that HCC maximum diameter>3 cm (OR=1.427, 95%CI 1.314-12.227, P=0.009), nonsmooth tumor margin (OR=3.167, 95%CI 1.227-461.232, P=0.041), mosaic architecture (OR=1.769, 95%CI 1.812-61.434, P=0.022), and corona enhancement (OR=4.015, 95%CI 3.327-836.384, P=0.011) were independent risk factors for predicting MVI-positive tumors. Based on the independent predictors, the constructed nomogram model demonstrated an area under the ROC curve of 0.863 (95%CI 0.768-0.947) and 0.887 (95%CI 0.804-0.987) in the training and test sets for predicting MVI tumors, respectively. DCA showed that the curve of the nomogram model was consistently above the treat-all and treat-none strategies across all reasonable threshold probabilities in the training set, indicating that patients could obtain clinical benefits from the model. Conclusions:The preoperative nomogram model based on MRI LI-RADS features can effectively predict MVI in HCC following the Milan criteria, which could benefit the patients.
2.Accumulation of Dry Matter and Nutrients in Curcuma phaeocaulis at Different Growth Stages
Yayi QU ; Haohan WANG ; Yingxin CHEN ; Yemin ZHONG ; Wenxin LIAO ; Jie CHEN ; Xiaoyang CAI ; Min LI ; Yuming GAO ; Ying LIU
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(24):197-207
ObjectiveTo study the accumulation and absorption of dry matter and nutrients in Curcuma phaeocaulis from Sichuan, the origin of Curcumae Radix (tuber) and Curcumae Rhizoma (rhizome), to explore the growth and development laws and nutrient demand characteristics of the medicinal species, and thus to lay a theoretical basis for rational fertilization. MethodThe plant growth indexes, dry matter accumulation, and nutrient content of C. phaeocaulis at different growth stages in Sichuan were measured and analyzed. ResultThis medicinal species featured the dominant growth of aboveground leaves and stems before October and growth of underground part (particularly the rhizomes and tubers) from October. During the whole growth period, the accumulation of nitrogen, phosphorus, potassium, calcium, magnesium, iron, manganese, zinc, and copper per plant was 2 450.31, 907.09, 3 171.18, 625.94, 493.38, 14.53, 2.24 , 2.93, 0.46 mg, respectively, with the order of potassium > nitrogen > phosphorus > calcium > magnesium > iron > zinc > manganese > copper. ConclusionThe species needs sufficient potassium and nitrogen, appropriate amount of phosphorus, calcium, and magnesium, a small amount of iron, and very little zinc, manganese, and copper for growth, and potassium is particularly important. Nitrogen, phosphorus, and potassium fertilizers supply macroelements and nitrogen fertilizer should be supplemented at seedling stage, leafy stage, early rhizome expansion stage, tuber expansion stage, and the second expansion stage of rhizome. Phosphorus and potassium fertilizers should be applied at seedling stage, tuber expansion stage, secondary expansion stage of rhizome, and dry matter accumulation stage of tuber and rhizome. At seedling stage, leafy stage, early rhizome expansion stage, tuber expansion stage, and the second expansion stage of rhizome, a variety of medium and trace elements-containing foliar fertilizers should be used.
3.Effect of hepatic fibrosis on proton density fat fraction based on histogram analysis in evaluating hepatic steatosis: an experimental study
Liqiu ZOU ; Xiaofei MAI ; Hao ZHANG ; Qing WANG ; Wenxin ZHONG ; Yanan DU ; Haifeng LIU ; Wei XING
Chinese Journal of Radiology 2022;56(12):1376-1382
Objective:To explore the value of proton density fat fraction(PDFF) based on histogram analysis for quantification hepatic steatosis and fibrosis in rabbit model and the interference of hepatic fibrosis to the evaluation of hepatic steatosis with PDFF.Methods:From March to November 2020, 135 New Zealand white rabbits were randomly divided into control group ( n=30) and experimental group ( n=105) using a random number table. The volume ratio of CCl 4 and olive oil was 1∶1 to prepare 50% CCl 4 oil solution, and experimental rabbits were subcutaneously injected with the oil solution. An equal dose of normal saline was subcutaneously injected for control group rabbits. At the end of the 4 th, 8 th, and 12 th week, 35 in the experimental group and 10 rabbits in the control group were randomly selected to conduct the mDixon-Quant scanning, and histogram analysis of PDFF was analyzed including volume, mean, median, standard deviation, 25 th, 50 th, 75 th, 90 th quantile, skewness, kurtosis, entropy and inhomogeneity. After the examination, the rabbits were sacrificed and the liver percentage of steatosis (PSH) and fibrosis (POF) were recorded by semi-quantitative analysis. Spearman correlation analysis was used to correlate PDFF with PSH and POF. Multiple linear regression analysis was used to determine independent PDFF histogram parameters for evaluating PSH and POF. A receiver operator characteristic (ROC) curve was used to assess the diagnostic accuracy of PDFF for discriminating mild from moderate-severe hepatic steatosis and mild from moderate-severe hepatic fibrosis with median of PSH or POF for dichotomy, and DeLong test was used to compare the area under the curve (AUC). With the correction of hepatic fibrosis, correlation coefficient and AUC were compared of PDFF for discrimination mild from moderate-severe hepatic steatosis. Results:The PDFF mean, median, standard deviation, 75 th, 90 th showed correlation with PSH ( r=0.558, 0.522, 0.319, 0.723, 0.646, -0.589, all P<0.05). The entropy and 75 th were independent parameters for evaluating PSH (β=2.347, -5.960, P=0.018, 0.001). The PDFF 75 th was the optimal parameter for discriminating mild from moderate-severe hepatic steatosis with AUC=0.915 ( P=0.001). The PDFF volume, mean, median, standard deviation, 75 th, 90 th, entropy showed correlation with POF ( r=0.355, 0.393, 0.376, 0.298, 0.485, 0.426, -0.681, all P<0.05). The entropy, standard deviation and volume (β=-11.041, 1.356, 0.190, P=0.001, 0.026, 0.016) were independent parameters for evaluation of hepatic fibrosis, and the entropy was the optimal parameter for hepatic fibrosis (AUC=0.771, P=0.001). The correlation between PSH and PDFF 75 th was less pronounced when fibrosis was present ( r=0.512, P=0.001) than when fibrosis was absent ( r=0.751, P=0.002). The PDFF 75 th showed a significant difference in discriminating mild hepatic steatosis from moderate-severe hepatic steatosis after correction of POF (AUC=0.895, 0.950, Z=2.970, P=0.025). Conclusions:PDFF based on histogram analysis provided a noninvasive, accurate estimation of quantification for hepatic steatosis and fibrosis. Hepatic fibrosis reduced the correlation between hepatic steatosis and PDFF and the presence of hepatic fibrosis can confound the quantification of hepatic steatosis with PDFF.
4.An experimental study of MR elastography and Gd-EOB-DTPA dynamic contrast-enhanced MRI in quantitative evaluation of liver fibrosis
Liqiu ZOU ; Hao ZHANG ; Wenxin ZHONG ; Liang PAN ; Yang YANG ; Wei XING
Chinese Journal of Radiology 2021;55(11):1202-1208
Objective:To compare the diagnostic efficacy of MR elastography (MRE), Gd-EOB-DTPA dynamic contrast-enhanced MRI (DCE-MRI) in early quantitative evaluation of liver fibrosis (LF) staging of experimental rabbits.Methods:From April to December 2019, 200 healthy rabbits were randomly divided into LF group ( n=160) and control group ( n=40). LF group were injected subcutaneously with 50% CCl 4 oil solution, while control group were injected with normal saline solution. The LF group ( n=40) and control group ( n=10) were randomly selected at the end of the 4th, 8th, 12th and 16th weeks respectively to undergo axial MRI scan including MRE and Gd-EOB-DTPA DCE-MRI. The quantitative parameter values were obtained, including liver stiffness (LS), volume transfer constant (K trans), reflux rate constant (K ep), volume fraction of extravascular extracellular space (V e) and volume fraction of plasma (V p). Histopathological LF staging was based on Scheuer staging. One-way ANOVA analysis was used to evaluate the differences of LS, K trans, K ep, V e and V p among different LF stages. The Spearman correlation analysis was used to evaluate the correlations between pathological LF staging and quantitative parameter values. The ROC curve was used to compare the diagnositic performance of all quantitative parameter values. Results:Among the final qualified 150 rabbits, there were 32 in F0, 32 in F1, 35 in F2, 30 in F3, 21 in F4. Significant differences of LS, K trans, K ep, V e and V p were found among different LF stages. There was correlation between LS, K trans, K ep and LF stages ( r=0.832, 0.730, -0.617, all P<0.001), respectively. However, no statistically correlation was found between V e, V p and LF stages ( r=-0.074, P=0.367; r=-0.078, P=0.342). The area under the ROC curve (AUCs) of LS were the greatest (0.920 for F0 vs F1-F4, 0.900 for F0 vs F1-F2, 0.945 for F0 vs F3-F4, 0.926 for F1-F2 vs F3-F4), while the AUCs of K trans were 0.897, 0.863, 0.942, 0.809, respectively. Conclusion:The early quantitative diagnostic efficacy for LF staging by MRE was superior to Gd-EOB-DTPA DCE-MRI in rabbits.
5.Experimental study on early diagnosis of liver fibrosis using multi?parametric MRI
Hao ZHANG ; Liqiu ZOU ; Kai ZHANG ; Wenxin ZHONG ; Hui GAO ; Shoufang YAN
Chinese Journal of Radiology 2019;53(10):900-904
Objective To assess diagnostic performance of multi?parametric MRI including MR elastography (MRE), susceptibility?weighted imaging (SWI) and T1ρ imaging in detecting the early stage of liver fibrosis (LF). Methods Eighty healthy rabbits were randomly divided into LF group (n=60) and control group (n=20). The LF group (n=12) and control group (n=5) were randomly selected at the end of the 4th, 5th, 6th, 15th week after injection of 50% CCl4 oil solution, respectively. All rabbits underwent 3.0 T MRI scans and histopathological Scheuer staging. Differences between groups were examined using one?way analysis of variance with Dunnett's T3 test. Spearman correlation was used to analyze the correlation between liver stiffness (LS), liver?to?muscle SI ratio (SIR), T1ρ value in different LF stages. ROC curve analysis was used to assess the diagnostic performance. Results Fifty?five rabbits were included in our study, which covered F0 (n=14), F1 (n=11), F2 (n=10), F3 (n=9) and F4 (n=11). Significant differences of all characteristic values were found among different LF stages (P<0.05).There were significant differences in LS values between F0 and F2, F3, F4, respectively; F1 and F3, F4, respectively; F2 and F4; F3 and F4 (P<0.05). There were significant differences in SIR between F0 and F2, F3, F4, respectively; F1 and F2, F3, F4, respectively; F2 and F4 (P<0.05). T1ρ value showed significant differences between F0, F1, F2, F3 and F4, respectively (P<0.05). LS, SIR, and T1ρ values were correlated with LF stage (r=0.910, -0.808, 0.512, respectively, P<0.01). The area under curve (AUC) for LS value were greater than those for the other two methods (0.953 for≥F1, 0.949 for≥F2, 0.986 for≥F3, 0.979 for F4). The AUCs of the combination of MRE and SWI for detecting≥F1 was 0.965, for≥F2 was 0.983, for≥F3 was 0.991, and for F4 was 0.950. Combining all three MR methods showed the highest diagnostic performance for staging LF with AUCs of 0.969, 0.985, 0.996 and 1.000.Conclusion MRE is the most prominent MRI method, and combination of MRE and SWI show higher diagnostic performance than the others for staging LF; however, combining all three MR methods exhibits the most excellent diagnostic efficacy.
6. Experimental study on early diagnosis of liver fibrosis using multi-parametric MRI
Hao ZHANG ; Liqiu ZOU ; Kai ZHANG ; Wenxin ZHONG ; Hui GAO ; Shoufang YAN
Chinese Journal of Radiology 2019;53(10):900-904
Objective:
To assess diagnostic performance of multi-parametric MRI including MR elastography (MRE), susceptibility-weighted imaging (SWI) and T1ρ imaging in detecting the early stage of liver fibrosis (LF).
Methods:
Eighty healthy rabbits were randomly divided into LF group (
7.Comparative experiment study of susceptibility weighted imaging with T1ρ imaging in staging of hepatic fibrosis in rabbits
Wei LAI ; Liqiu ZOU ; Jinzhao JIANG ; Hui GAO ; Shoufang YAN ; Wenxin ZHONG ; Hao ZHANG
Chinese Journal of Radiology 2018;52(11):875-879
Objective To investigate the value of susceptibility weighted imaging (SWI) with T1ρimaging in staging of hepatic fibrosis(HF) in rabbits. Methods Eighty selected white rabbits from New Zealand were randomly divided into the HF group (n=60) and the control group (n=20). Rabbits in the HF group were injected subcutaneously with 50%CCl4 oil solution to establish HF model,and the normal control rabbits were injected with saline solution subcutaneously.The HF group(n=15) and control group(n=5) were randomly selected at the 4th, 5th, 6th and 10th week after injection, to undergo liver MR scan. The liver signal intensity (SI liver), the muscle signal intensity (SI muscle),liver-to-muscle SI ratios (SIR) and liver T1ρvalues were measured. Scheuer was adopted to stage the rabbits in HF. One-way analysis of variance was used to compare the differences between SIR and T1ρ values in different stages of HF pathological. Spearman correlation was used to analyze the correlation between SIR and T1ρ values in the different stage of HF pathological.The ROC were used to compare the efficacy between SIR and T1ρvalues in the diagnosis of HF pathological stage. Results Among the final qualified 68 rabbits in the study, 17 in F0 phase, 11 in F1 phase, 16 in F2 phase, 11 in F3 phase, and 13 in F4 phase. The SIR were (0.977 ± 0.013), (0.960 ± 0.015), (0.802 ± 0.026), (0.786 ± 0.022), (0.541 ± 0.116); T1ρ values were (22.301 ± 1.849), (24.034 ± 0.867), (25.374 ± 1.309),(25.364±1.945),(30.948±2.925) ms.There were statistically significant in SIR between F0 and F2,F0 and F3, F0 and F4, F1 and F2, F1 and F3, F1 and F4, F2 and F4, F3 and F4 (P<0.01). There were statistically significant in T1ρvalues between F0 and F1,F0 and F2,F0 and F3,F0 and F4,F1 and F2,F1 and F4,F2 and F4, F3 and F4(P<0.05). SIR were negatively correlated with HF staging while T1ρ values were positively. ROC showed that the AUC of the T1ρvalues was slightly larger than SIR in the F4 group(0.992>0.966),and the AUC of the SIR was greater than T1ρvalues in the other groups. Conclusion SWI and T1ρvalues can provide an important objective basis in staging of HF. Both of them have great clinical application prospects but SIR diagnostic efficiency is slightly better than that of T1ρvalues.
8.Noninvasive assessment of hepatic fibrosis staging with MR elastography versus T1ρ imaging
Liqiu ZOU ; Jinzhao JIANG ; Wenxin ZHONG ; Gangqiang HOU ; Jie CHEN ; Wei XING
Chinese Journal of Radiology 2017;51(6):460-463
Objective To compare the diagnostic values of magnetic resonance elastography (MRE) and T1ρ imaging in staging hepatic fibrosis (HF) in a rabbit model.Methods The institutional animal care and use committee approved all experiments.Sixty healthy rabbits were divided into HF group (n=44) and control group (n=16).Each eight rabbits in the HF group and 4 rabbits in the control group were randomly selected at the 4th,5th,6th week and the remaining rabbits at the 10th week after subcutaneous injection with 0.1 ml 50% CCl4 oily solution per kilogram of body respectively,to undergo liver MR scan including axial liver MRE and T1ρ imaging.The values of liver stiffness (LS) and T1ρ were measured.Masson trichrome staining of liver tissue was used.According to the Scheuer scoring system,rabbits were classified into F0 to F4 group based on the percentage of hepatic fibrosis.The difference of LS values and Tip values among stage F0 to F4 were compared by the one-way ANOVA analysis.The correlations between pathological staging and LS,T1ρ values were performed by the Spearman correlation analysis.ROC curve analysis was performed to compare the value of MRE with T1ρ imaging.Results Forty three rabbits were included,there were 10,8,8,8,9 rabbits in F0,F1,F2,F3 and F4 stage,respectively.LS values were (1.051±0.155),(1.335±0.235),(1.401±0.163),(2.001±0.499) and (2.981±0.714) kPa in F0,F1,F2,F3 and F4,respectively,while T1 p values were (23.20±4.02),(24.28±2.93),(25.40± 1.82),(24.69± 1.85) and (31.54±3.39) ms (all P<0.05).The correlation of LS values with hepatic fibrosis staging measured on MRE was stronger than T19 values (r values were 0.916 and 0.608,all P<0.01).Area under ROC curve of LS value for differentiating hepatic fibrosis stage were 0.938 to 0.989,while the areas of T1ρ were 0.771 to 0.954.Conclusion MR elastography is an accurate technique for quantitatively staging hepatic fibrosis and superior to T1ρ imaging.
9.Comparison study on sampling methods of Oncomelania hupensis snail sur-vey in marshland schistosomiasis epidemic areas in China
An ZHAO ; Wenxin ZHANG ; Zhong YAO ; Yukuan MA ; Qing LIU ; Houlang DUAN ; Yidi SHANG
Chinese Journal of Schistosomiasis Control 2016;28(5):507-512
Objective To optimize and simplify the survey method of Oncomelania hupensis snail in marshland endemic re?gion of schistosomiasis and increase the precision,efficiency and economy of the snail survey. Methods A quadrate experimen?tal field was selected as the subject of 50 m×50 m size in Chayegang marshland near Henghu farm in the Poyang Lake region and a whole?covered method was adopted to survey the snails. The simple random sampling,systematic sampling and stratified ran?dom sampling methods were applied to calculate the minimum sample size,relative sampling error and absolute sampling error. Results The minimum sample sizes of the simple random sampling,systematic sampling and stratified random sampling meth?ods were 300,300 and 225,respectively. The relative sampling errors of three methods were all less than 15%. The absolute sampling errors were 0.221 7,0.302 4 and 0.047 8,respectively. Conclusion The spatial stratified sampling with altitude as the stratum variable is an efficient approach of lower cost and higher precision for the snail survey.
10.Clinical evaluation of the (1, 3)-β-D-glucan assay as an aid to diagnosis of fungal infections in severe pneumonia patients
Wenxin ZENG ; Yuan HUANG ; Yu DENG ; Miaoyun WEN ; Yongli HAN ; Wenhong ZHONG ; Hongke ZENG
Chinese Journal of Emergency Medicine 2016;25(5):659-662
Objective To evaluate (1,3)-β-D-glucan (BG) assay as an aid for invasive fungal infection (IFI) diagnosis in severe pneumonia patients (diagnosis followed 2007 American Thoracic Society (ATS) and Infectious Disease Society of America (IDSA) severe pneumonia standard).Methods BG antigenemia was measured by BG Assay Box.IFIs was classified according to the blood fungal laboratory reports.Results 558 patients (185 females,373 males,mean age 64.7) were included.41 patients were proven to be fungal infected to be classified in exposure group.BG assay mean value in exposure group and unexposure group were (568.53 ±796.57) pg/mL,(51.4 ±63.27) pg/mL,respectively.Patients in the exposure group had significantly higher BG assay value than patients in the unexposure group (P <0.05).For the cutoff 100 pg/mL recommended by manufacturer,the sensitivity,specificity,positive predict value and negative predict value of the BG assay were 92.7%,92.5%,49.4% and 0.6%,respectively.Conclusion BG assay has positive clinical value in invasive fungal infection diagnosis in severe pneumonia patients.

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