The tubal obstruction and the resulting hydrosalpinx are common causes of female infertility.Through the natural lumen of the human body,interventional therapy can perform fallopian tubal dredging or fallopian tubal embolization.The treatment methods include fallopian tubal recanalization with guidewire intervention dredging,selective salpingography,fallopian tubal embolization with micro-coils,etc.This paper systematically introduces the history and development of interventional fallopian tubal recanalization,medication,postoperative ectopic pregnancy and pregnancy rate,and surgical strategies in special cases.Besides,the different methods of fallopian tubal embolization for hydrosalpinx as well as their advantages and disadvantages are summarized,the controversial issues in clinical practice nowadays are discussed,and the future development direction of tubal interventional therapy is proposed,aiming to provide useful reference for clinical diagnosis and treatment of fallopian tubal obstruction.

Objective To explore the clinical value of preoperative MR T2 weighted imaging(T2WI)radiomics in predicting the short-term efficacy of uterine artery embolization(UAE)for the treatment of uterus adenomyosis.Methods The clinical data of 140 patients with uterus adenomyosis,who received initial UAE treatment,were retrospectively analyzed.Pelvic MRI examination was performed within one week before treatment,and the patients were followed up with pelvic MRI at 6 months and 12 months after treatment.The efficacy of UAE was evaluated according to the criteria for remission of adenomyosis.Using stratified sampling,patients were divided into a training group(n=98)and a testing group(n=42)at a 7∶3 ratio.According to the treatment response,patients were divided into an effective group(n=101)and an ineffective group(n=39).ITK-SNAP software was used to delineate the lesion area on preoperative MR T2WI and the radiomics features were extracted.Using univariate analysis,the minimum absolute shrinkage and selection operator regression method to screen out the radiomics features and to establish an radiomics model.By using receiver operating characteristic(ROC)curve the predictive efficacy of radiomics model for ineffective treatment of adenomyosis after UAE was evaluated,and the area under the curve(AUC)was calculated.Decision curve analysis was adopted to evaluate the clinical practical value of the model.Results Nine most valuable radiomics features were enrolled in the predictive model.The AUC of the radiomics model for predicting ineffective treatment after UAE in patients with uterus adenomyosis was 0.838(95％CI:0.751-0.924)in the training group and 0.817(95％CI:0.677-0.954)in the testing group.Decision curve analysis showed that the radiomics model had a high clinical net benefit.Conclusion The model constructed based on MR T2WI radiomics can effectively predict the short-term effect of UAE treatment for adenomyosis,which helps to identify the risk of ineffective treatment early,and the treatment strategy can be timely adjusted.

Objective: To investigate the changes of whole brain functional connections in cognitively impaired patients with nasopharyngeal carcinoma after radiotherapy. Methods: Totally 76 patients with pathologically proved nasopharyngeal carcinoma were collected, including 20 in radiotherapy-cognitive impairment group (RT-CI group), 34 in radiotherapy-no-cognitive impairment group (RT-NO-CI group) and 22 in the no-radiotherapy group (NO-RT group). Patients' gender, age, years of education, radiotherapy time and total measurement of radiotherapy were recorded, and the Beijing Montreal Cognitive Assessment (MoCA) scale was used for cognitive function scoring. Resting brain function MRI were collected, and brain functional connections were analyzed to obtain abnormal brain areas in RT-CI group and RT-NO-CI group. The general data and MoCA scores of 3 groups were compared, and the relationships between Z value of abnormal brain functional connectivity areas and MoCA score were analyzed. Results: There was no significant difference of age (F=2.78, P=0.30), years of education (F=3.95, P=0.37)nor gender (χ2=3.11, P=0.33) among 3 groups. MoCA score of RT-CI group was lower than that of RT-NO-CI group and NO-RT group (both P<0.01), and MoCA score of RT-NO-CI group was lower than that of NO-RT group (P<0.01). Compared with RT-NO-CI group, there was positive correlation between Z value of 1 pair of brain region and MoCA scale score in RT-CI group (P<0.01). Compared with NO-RT group, Z values of 8 pairs of brain areas in RT-CI group were correlated with MoCA scale scores (all P<0.01). Compared with NO-RT group, Z values of 5 pairs of brain areas in RT-NO-CI group were correlated with MoCA scale scores (all P<0.01). In RT-CI group, brain areas with abnormal functional connections mainly located in parahippocampal gyrus, parietal occipital cortex, prefrontal cortex and default mode network area. In RT-No-CI group, brain areas with abnormal functional connections mainly located in hippocampal gyrus, prefrontal lobe and parietal cortex. Conclusion: Early cognitive impair in patients with nasopharyngeal carcinoma after radiotherapy might manifest as abnormal brain functional connectivity in some specific brain regions.

Objective To discuss the value of CT and MRI in diagnosis of laryngeal non-Hodgkin's lymphoma(NHL).Methods The clinical data,CT and MRI findings and pathology of 26 patients with laryngeal NHL were analyzed retrospectively.Results Of 26 patients with laryngeal NHL,14 were diffuse large B-cell lymphoma,6 were NK/T-cell lymphoma,2 were follicular lymphoma,2 were small lymphocytic lymphoma(SLL),1 was angioimmunoblastic lymphoma and 1 was peripheral T-cell lymphoma.CT and MRI findings of laryngeal NHL:(1)laryngeal NHL showed homogeneous density on CT,slightly high signal intensity on T2WI,intermediate signal intensity on T1WI and moderate homogeneous enhancement;(2)laryngeal NHL was symmetrical and diffuse in appearance;(3)laryngeal NHL tended to spread through the submucosal and fat space,while muscle or cartilage invasion was quite rare but existed;(4)multisite lesions in Waldeyer's ring were obseverd occasionally.For those young male presenting diffuse multisite laryngeal lesion without a history of tuberculosis,a diagnosis of NHL should be raised.Conclusion CT and MRI can show the characteristics of the laryngeal NHL exactly,thus have applied value in detecting laryngeal NHL.

Objective To investigate the value of MRI in the diagnosis and differential diagnosis of bladder leiomyoma.Methods Clinical data,pathological files and MRI findings of 8 patients with bladder leiomyoma that verified by pathologic were analyzed retrospectively.Results 4 cases of bladder leiomyoma were located in front bladder wall, 3 cases were in post bladder wall and 1 case in right bladder wall;meanwhile, 6 cases were endovesical(75.0%),1 case was intramural(12.5%) and another 1 case was extravesical(12.5%).All lesions displayed equal signals on T1WI, equal or slightly high signals on T2WI with mild and moderate enhancements;bladder wall adjacent to tumors and structures around were not invaded by tumors.6 cases of all displayed inhomogeneous signals on T2WI and with some patchy or stripe high signals in it, the signals turned to equal on a fat-saturated T1WI which was similar with muscle of pelvic wall.Conclusion MRI features of bladder leiomyoma showed certain characteristics.