Objective To explore the clinical manifestations and imaging diagnostic value of fibrocystic osteitis secondary to hyperparathyroidism(HPT).Methods The clinical and imaging data of 33 patients with fibrocystic osteitis secondary to HPT confirmed by clinical and pathological diagnosis were retrospectively analyzed.Results Among the 33 patients,there were 17 cases of primary hyperparathyroidism(PHPT),of which 9 cases were parathyroid adenomas,5 cases were parathyroid hyperplasia and 3 cases were parathyroid adenoma with hyperplasia.All 16 cases were secondary HPT,all with a history of chronic kidney disease;9 cases were secondary to end-stage renal disease,and 7 cases were secondary to stage 3 chronic kidney disease.Laboratory examinations showed elevated parathyroid hormone(PTH)levels in all cases.Among the 33 patients,26 cases had multiple skeletal involvements,with the pelvis being the most commonly involved site;7 cases had single-bone involvement;19 cases had associated pathological fractures;23 cases had multiple osteoporosis,and 10 cases had osteosclerosis.All cases showed that lesions were osteolytic or expansive bone destruction with sclerotic boundary.The soft tissues surrounding bone lesions were thickened in 11 cases,and the soft tissue masses were formed in 9 cases.Conclusion The clinical manifestations of fibrocystic osteitis are complex,but it exhibits certain imaging characteristics,which presents generalized osteoporosis with/without increased bone mineral density.Lesions of varying sizes show osteolytic or expansive bone destruction with sclerotic boundary.The pelvis is the most commonly affected site.Combined use of X-ray and CT laboratory tests such as serum calcium and PTH levels aids in the early diagnosis of this disease.

Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in predicting the clinical and pathological features of prostate cancer(PCa).Methods We recruited 47 patients who underwent bpMRI combined with IVIM-DWI in our hospital from July 2022 to October 2023 and pathologically confirmed with PCa.Among these cases,20 were transitional zone PCa(TZ-PCa),and 27 were peripheral zone PCa(PZ-PCa).According to the International Society of Urological Pathology(ISUP)risk grades,the patients were divided into high-risk group(ISUP≥3)and low-risk group(ISUP≤2).Differences in the risk levels between TZ-PCa group and PZ-PCa group were compared.Factors including age,total prostate-specific antigen(tPSA),diffusion coefficient(D)value,pseudo diffusion coefficient(D*)value,perfusion fraction(F)value,and apparent diffusion coefficient(ADC)as independent variables were compared between the two groups.Binary logistic regression analysis was further used to identify the factors associated with high or low risk of PCa.Receiver operation characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of PSA,D value,anatomical zones,and the combined model of PSA+D value+anatomical zones in predicting the risk level of PCa.Results The risk level was higher in PZ-PCa group than in TZ-PCa group(P=0.015).Binary logistic regression analysis showed that the tPSA level in the high-risk group of PCa was higher than that in the low-risk group(OR=1.026,95％CI:1.004-1.049,P=0.014),but the Dmean value was lower than that in the low-risk group(OR=0.993,95％CI:0.987-0.999,P=0.034).PCa in the high-risk group was more distributed in the peripheral zone(OR=5.250,95％CI:1.468-18.772,P=0.023).The diagnostic efficacy of the combined model(AUC=0.887,95％CI:0.787-0.987)was higher than that of tPSA,Dmean,or anatomical partitioning alone(P=0.001,0.043,and 0.003,respectively).Conclusion PZ-PCa has a higher risk level than TZ-PCa.Combining bpMRI localization of anatomical zones with PSA and D value provides the highest efficacy in predicting the risk level of PCa,which can potentially support the development of precise and personalized clinical diagnosis and treatment strategies for PCa.

Objective To evaluate the diagnostic concordance rates between zonal localization and diffusion weighted imaging(DWI)localization of prostate cancer,and to investigate the diagnostic efficacy of DWI for prostate cancer in the transition zone and peripheral zone.Methods Patients with localized prostate cancer who underwent radical prostatectomy were selected.5-grade Lik-ert-scale was used to determine the suspicion level of prostate cancer in DWI sequnence.Patients were divided into no suspicious lesion group(91 cases)(grade≤2 points)and suspicious lesion group(194 cases)(grade≥3 points).The t test,Mann-Whitney U test and χ2 test were used to compare the clinicopathological features between the two groups.Multiple regression analysis was used to detect the correlation between DWI grading and pathological features in the suspicious lesion group.Patients were also divided into transition zone and peripheral zone groups according to zonal localization of lesions.The diagnostic concordance rates between DWI image localization and zonal localization in the suspicious lesion group were compared by χ2 test.Results The study included 285 prostate cancer patients,the prostate-specific antigen(PSA),Gleason score,clinical/pathological stages,tumor volume and extracapsular extension of the sus-picious lesion group were higher than those of the no suspicious lesion group with significant differences(P<0.05).Multiple regres-sion test results showed significant positive correlations between DWI grading and pathological features,including pathological Glea-son score,pathological stages,tumor volume and extracapsular extension(P<0.05).The diagnostic concordance rates of DWI for prostate cancer in different zonal origins increased with the increase of DWI grading.The diagnostic concordance rates of peripheral zone group were higher than those of transition zone group,with more significant differences showed in DWI grade>3 points(P<0.05).Conclusion Prostate cancer with higher DWI grading may have more aggressive clinicopathological features,and show a better diag-nostic concordance rate than those with lower DWI grading.In addition,the diagnostic concordance rate of peripheral zone prostate cancer is higher than that of transition zone prostate cancer,with significant differences in higher DWI grading.

Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in predicting the clinical and pathological features of prostate cancer(PCa).Methods We recruited 47 patients who underwent bpMRI combined with IVIM-DWI in our hospital from July 2022 to October 2023 and pathologically confirmed with PCa.Among these cases,20 were transitional zone PCa(TZ-PCa),and 27 were peripheral zone PCa(PZ-PCa).According to the International Society of Urological Pathology(ISUP)risk grades,the patients were divided into high-risk group(ISUP≥3)and low-risk group(ISUP≤2).Differences in the risk levels between TZ-PCa group and PZ-PCa group were compared.Factors including age,total prostate-specific antigen(tPSA),diffusion coefficient(D)value,pseudo diffusion coefficient(D*)value,perfusion fraction(F)value,and apparent diffusion coefficient(ADC)as independent variables were compared between the two groups.Binary logistic regression analysis was further used to identify the factors associated with high or low risk of PCa.Receiver operation characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of PSA,D value,anatomical zones,and the combined model of PSA+D value+anatomical zones in predicting the risk level of PCa.Results The risk level was higher in PZ-PCa group than in TZ-PCa group(P=0.015).Binary logistic regression analysis showed that the tPSA level in the high-risk group of PCa was higher than that in the low-risk group(OR=1.026,95％CI:1.004-1.049,P=0.014),but the Dmean value was lower than that in the low-risk group(OR=0.993,95％CI:0.987-0.999,P=0.034).PCa in the high-risk group was more distributed in the peripheral zone(OR=5.250,95％CI:1.468-18.772,P=0.023).The diagnostic efficacy of the combined model(AUC=0.887,95％CI:0.787-0.987)was higher than that of tPSA,Dmean,or anatomical partitioning alone(P=0.001,0.043,and 0.003,respectively).Conclusion PZ-PCa has a higher risk level than TZ-PCa.Combining bpMRI localization of anatomical zones with PSA and D value provides the highest efficacy in predicting the risk level of PCa,which can potentially support the development of precise and personalized clinical diagnosis and treatment strategies for PCa.

Objective To explore the clinical manifestations and imaging diagnostic value of fibrocystic osteitis secondary to hyperparathyroidism(HPT).Methods The clinical and imaging data of 33 patients with fibrocystic osteitis secondary to HPT confirmed by clinical and pathological diagnosis were retrospectively analyzed.Results Among the 33 patients,there were 17 cases of primary hyperparathyroidism(PHPT),of which 9 cases were parathyroid adenomas,5 cases were parathyroid hyperplasia and 3 cases were parathyroid adenoma with hyperplasia.All 16 cases were secondary HPT,all with a history of chronic kidney disease;9 cases were secondary to end-stage renal disease,and 7 cases were secondary to stage 3 chronic kidney disease.Laboratory examinations showed elevated parathyroid hormone(PTH)levels in all cases.Among the 33 patients,26 cases had multiple skeletal involvements,with the pelvis being the most commonly involved site;7 cases had single-bone involvement;19 cases had associated pathological fractures;23 cases had multiple osteoporosis,and 10 cases had osteosclerosis.All cases showed that lesions were osteolytic or expansive bone destruction with sclerotic boundary.The soft tissues surrounding bone lesions were thickened in 11 cases,and the soft tissue masses were formed in 9 cases.Conclusion The clinical manifestations of fibrocystic osteitis are complex,but it exhibits certain imaging characteristics,which presents generalized osteoporosis with/without increased bone mineral density.Lesions of varying sizes show osteolytic or expansive bone destruction with sclerotic boundary.The pelvis is the most commonly affected site.Combined use of X-ray and CT laboratory tests such as serum calcium and PTH levels aids in the early diagnosis of this disease.

Objective To evaluate the diagnostic concordance rates between zonal localization and diffusion weighted imaging(DWI)localization of prostate cancer,and to investigate the diagnostic efficacy of DWI for prostate cancer in the transition zone and peripheral zone.Methods Patients with localized prostate cancer who underwent radical prostatectomy were selected.5-grade Lik-ert-scale was used to determine the suspicion level of prostate cancer in DWI sequnence.Patients were divided into no suspicious lesion group(91 cases)(grade≤2 points)and suspicious lesion group(194 cases)(grade≥3 points).The t test,Mann-Whitney U test and χ2 test were used to compare the clinicopathological features between the two groups.Multiple regression analysis was used to detect the correlation between DWI grading and pathological features in the suspicious lesion group.Patients were also divided into transition zone and peripheral zone groups according to zonal localization of lesions.The diagnostic concordance rates between DWI image localization and zonal localization in the suspicious lesion group were compared by χ2 test.Results The study included 285 prostate cancer patients,the prostate-specific antigen(PSA),Gleason score,clinical/pathological stages,tumor volume and extracapsular extension of the sus-picious lesion group were higher than those of the no suspicious lesion group with significant differences(P<0.05).Multiple regres-sion test results showed significant positive correlations between DWI grading and pathological features,including pathological Glea-son score,pathological stages,tumor volume and extracapsular extension(P<0.05).The diagnostic concordance rates of DWI for prostate cancer in different zonal origins increased with the increase of DWI grading.The diagnostic concordance rates of peripheral zone group were higher than those of transition zone group,with more significant differences showed in DWI grade>3 points(P<0.05).Conclusion Prostate cancer with higher DWI grading may have more aggressive clinicopathological features,and show a better diag-nostic concordance rate than those with lower DWI grading.In addition,the diagnostic concordance rate of peripheral zone prostate cancer is higher than that of transition zone prostate cancer,with significant differences in higher DWI grading.

[Objective] To compare the clinicopathological characteristics of localized prostate cancers between peripheral zone and transition zone and to evaluate biochemical recurrence-free survival rates between the two groups following radical prostatectomy. [Methods] Between February 2016 and August 2021, prostate cancer candidates meeting the eligibility criteria of the study were retrospectively enrolled and divided into transition zone group and peripheral zone group based on the zonal origin. The patients were followed regularly after radical prostatectomy. Unpaired t-test, χ²-test and Mann-Whitney U-test were used to compare age, serum prostate specific antigen (PSA), tumor volume, Gleason score, laterality of positive biopsy core, mean percentage of positive biopsy cores, clinical/pathological stage, seminal vesicle invasion, lymph node metastasis, and positive surgical margin between the two groups. The biochemical recurrence-free survival rates of the two groups were evaluated by Kaplan-Meier and the differences were determined by log-rank test. [Results] A total of 273 cases were included in the study, among which 176 were peripheral zone cancers and 97 were transition zone cancers. The mean tumor volume of the transition zone group was greater than that of peripheral zone group (P=0.002). The serum PSA of transition zone group was higher than that of the latter (P=0.047); however, both mean percentage of positive biopsy cores and the percentage of seminal vesicle invasion were higher in transition zone group than in peripheral zone group (P=0.028, 0.047). Furthermore, there was no significant difference in biochemical recurrence-free survival rate between the two groups (P=0.783). [Conclusion] Despite the greater tumor volume and higher PSA compared with those in peripheral zone cancers, transition zone cancers have similar biochemical recurrence-free survival rates following radical prostatectomy, suggesting that transition zone cancers may have a lower degree of aggressiveness than the latter.

Objective To explore the computed tomography angiography(CTA)and clinical features of Takayasu's arteritis(TA)with peripheral artery involvement.Methods In this retrospective study,CTA scan was performed in a total of 184 TA patients.TA patients were divided into two groups:60 patients within peripheral artery involvement(peripheral artery involvement group)and 124 patients without peripheral artery involvement(peripheral artery non-involvement group).The difference in comparison of clini-cal data and CTA findings were analyzed.Results A total of 194 peripheral arteries were involved in 60 patients.The most suscep-tible peripheral artery were axillary artery(52,26.8％),middle cerebral artery(26,13.4％)and femoral artery(22,11.3％).In the peripheral artery involvement group,the most common CTA manifestation was luminal stenosis(141,72.7％).The lumen dilata-tion,lumen stenosis with dilatation and wall calcification were not easy to be observed.The age and duration of disease in peripheral artery involvement group were significantly greater than those in peripheral artery non-involvement group(P＜0.05).The proportion of the peripheral artery involvement group in the active phase was significantly lower than that of the peripheral artery non-involvement group(P＜0.05).The incidence of pain in the limbs in peripheral artery involvement group was significantly higher than that in peripheral artery non-involvement group(P＜0.05).The utilization rate of tocilizumab in the peripheral artery involvement group was significantly higher than that in the peripheral artery non-involvement group(P＜0.05).Conclusion TA involving peripheral arteries is more common in patients with a long course of disease and in the inactive phase.Patients are prone to pain in their limbs.The CT A manifestations of these patients are also special,that is,the involved peripheral arteries are not prone to lumen dilatation and wall calcification.

Objective To explore the correlation between exponential apparent diffusion coefficient(eADC)value before radical hysterectomy and postoperative clinical results in patients with International Federation of Gynecology and Obstetrics(FIGO)stageⅠ/Ⅱ cervical cancer,and to find MR quantitative indicators for predicting the prognosis of patients with early stage cervical cancer.Methods Patients with FIGO stage Ⅰ/Ⅱ cervical cancer who underwent surgical treatment were retrospectively collected.All patients underwent MRI plain scan and diffusion weighted imaging(DWI)scan before surgery.Baseline parameters included age,menopause,stage,tumor size,pathological differentiation and type,lymph node involvement,and postoperative adjuvant therapy.MR parameters included mean apparent diffusion coefficient(ADCmean),normalized apparent diffusion coefficient(nADC),eADC,SIDWI,and SIT2.Baseline and MRI parameters associated with recurrence were determined by Cox regression analysis.Results The progression-free survival(PFS)in the low eADC group was longer than that in the high eADC group(P=0.010).Univariate analysis showed that ADC,nADC and eADC were associated with recurrence(P<0.05).In multivariate analysis,only eADC[hazard ratio(HR)3.610;95%confidence interval(CI)1.467-8.886;P=0.005]was associated with recurrence.Conclusion Preoperative eADC is associated with PFS in patients with surgically treated FIGO stage Ⅰ/Ⅱ cervical cancer and is helpful in evaluating the prognosis of patients with cervical cancer.

Objective:To improve the understanding of adult primary hemophagocytic syndrome (HPS) with aggressive natural killer cell leukemia (ANKL).Methods:The clinicopathological data of one adult patient with suspected primary HPS complicated with ANKL in Huiqiao Medical Center, Nanfang Hospital of Southern Medical University in October 2017 were retrospectively analyzed, and literatures were reviewed.Results:A 21-year-old male patient presented with persistent fever, hemocytopenia, splenomegaly, low fibrinogen, a significant increase in ferritin, hemophagocytes in bone marrow, decreased natural killer (NK) cell activity, and increased soluble CD25. Flow cytometry detection showed that the expression of NK cells was abnormal, and there were familial lysosomal trafficking regulator (LYST) and UNC13D gene defects. He was suspected of primary HPS complicated with ANKL. The patient was given 4 courses of EPOCH+PEG-Asp (etoposide, dexamethasone, vindesine, cyclophosphamide, doxorubicin hydrochloride liposome, pegaspargase) regimen chemotherapy, 20 mg of citalopidine twice a week maintenance therapy and matched unrelated hematopoietic stem cell transplantation. After 35 months of follow-up, he got sustained remission.Conclusions:Even if there are secondary causes of adult HPS, it is necessary to screen out related genes to avoid misdiagnosis. HPS patients with ANKL progress rapidly, and the early mortality is high. EPOCH+ PEG-Asp regimen induction therapy and allogeneic hematopoietic stem cell transplantation should be used as early as possible after diagnosis.