Objective To explore the value of MRI radiomics in the differential diagnosis of cerebral alveolar echinococcosis(CAE)and brain metastases(BM).Methods The clinical and imaging data of 30 patients with CAE confirmed by postoperative pathology in the First Affiliated Hospital of Xinjiang Medical University and 38 patients with BM in the Affiliated Hospital of Traditional Chi-nese Medicine of Xinjiang Medical University during the same period were retrospectively analyzed.Preoperative T1-enhanced axial images using 3D Slicer software were used to delineate the volume of interest(VOI)of the lesions,and Python was used to extract 18 radiomics features including the 10th and 90th percentile and median of the lesions.The radiomics parameters of the two groups were compared and statistically analyzed,respectively.The efficacy of each parameter in the differential diagnosis of CAE and BM was explored.Results There was no significant difference in age and body mass index(BMI)between CAE and BM.There was sig-nificantly more males in CAE than that in BM(P<0.001).Previous history of primary tumor and life history in epidemic area were the key to the differential diagnosis of CAE and BM.High correlation features were filtered from 18 radiomics,and statistical differ-ences were found in 7 features such as 90th percentile and entropy(P<0.05).The combined analysis of these seven features had the best diagnostic performance,with area under the curve(AUC)of 0.732,sensitivity of 79.5%,specificity of 61.1%,and accuracy of 72.3%,respectively.Logistic regression analysis showed that kurtosis odds ratio(OR)value was 0.10,95%confidence interval was 0.01,0.83(P<0.05).Conclusion For CAE and BM with very similar conventional imaging findings,clinical history combined with radiomics can provide better differential diagnosis basis.

Objective To investigate the clinical and diffusion imaging of brain damage in patients with neurosyphilis.Methods Eighty patients with neurosyphilis with brain damage were retrospectively selected as the study group,and were divided into mild group(n=38)and moderate to severe group(n=42)according to imaging results.Another 80 healthy subjects in the same period were selected as the control group.The values of apparent diffusion coefficient(ADC)and fractional anisotropy(FA)were compared among the three groups.Pearson test was used to analyze the correlation between ADC and FA values in various brain regions and cognitive function in patients with neurosyphilis brain damage.Results ADC values in parieto-occipital lobe,frontal lobe,basal gan-glia and hemioval center in moderate to severe group were significantly higher than those in mild group and control group,and FA values were significantly lower than those in mild group and control group(P<0.05).The results of Pearson analysis showed that the ADC and FA values of parieto-occipital lobe,frontal lobe and hemioval center were significantly correlated with Wechsler adult intel-ligence scale-revised of China(WAIS-RC)knowledge,WAIS-RC arithmetic,verbal fluency test(VFT),Montreal cognitive assess-ment(MoCA),forward digit span test(FDST),trail making test A(TMT-A)and trail making test B(TMT-B)scores(P<0.05).Conclusion The ADC and FA values of parieto-occipital lobe,frontal lobe,basal ganglia and hemioval center are closely related to the severity of brain damage,which is helpful for clinical diagnosis.

Objective To construct and validate a diagnostic model based on mammography,MRI,and multimodal ultrasound for diagnosing benign and malignant for the breast imaging reporting and data system(BI-RADS)4 category breast nodule with malig-nant microcalcifications.Methods The data of 243 patients with BI-RADS 4 category breast nodule with malignant microcalcifica-tions were retrospectively analyzed and randomly divided into training set(194 cases)and validation set(49 cases)according to a ratio of 8︰2.According to the pathological results,the factors affecting the benign and malignant diagnosis for BI-RADS 4 category breast nodule with malignant microcalcifications were analyzed,then constructed a diganostic model and validated it.Results There were 118 cases and 29 cases with malignant nodules and 76 cases and 20 cases with benign nodules in the training and validation sets,respectively.Logistic regression analysis of the training set showed that fine pleomorphic microcalcification morphology,apparent dif-fusion coefficient(ADC)value,low or very low echogenicity,and heterogeneous enhancement of microvesicle distribution within the nodules were the risk factors for benign and malignant diagnosis for BI-RADS 4 category breast nodule with malignant microcalcifica-tions(P<0.05).The nomogram prediction model based on the above factors corresponded to a risk rate range of 0.05 to 0.86,and the calibration curve for diagnosing benign and malignant BI-RADS 4 category breast nodule with malignant microcalcifications tended to be close to the ideal curve(P>0.05).The nomogram model for diagnosing malignant nodule for BI-RADS 4 category breast nod-ule with malignant microcalcifications showed that the sensitivity was 81.39%and 88.73%,the specificity was 90.02%and 82.51%,and the area under the curve(AUC)was 0.874 and 0.891 in the training set and validation set,respectively.Conclusion The model constructed based on mammography,MRI,and multimodal ultrasound has good diagnostic efficacy for BI-RADS 4 category breast nodule with malignant microcalcifications.

Objective To explore the efficacy of a model combining clinicopathological characteristics and multiparametric MRI features for predicting BRCA-mutated breast cancer(BC).Methods A total of 256 BC patients were retrospectively selected and divided into BRCA mutation group(116 cases)and BRCA wild group(140 cases)based on the BRCA results.Chi-square tests or independ-ent sample t-tests were used to compare the differences in clinicopathological characteristics and multiparametric MRI features between the BRCA mutation group and the wild group.Risk factors for BRCA-mutated BC were identified through univariate and multivariate logistic regression ananlyses,and a combined predictive model was constructed.Receiver operating characteristic(ROC)curve was used to ana-lyze the diagnostic efficacy of the model.Results There were statistically significant differences in T stage,human epidermal growth factor receptor 2(HER-2),Ki-67,non-mass enhancement,enhancement pattern,time-signal intensity curve(TIC)type,and apparent diffusion coefficient(ADC)values between the BRCA mutation group and the wild group.Univariate logistic regression analysis showed that T stage,HER-2,Ki-67,non-mass enhancement,enhancement pattern,TIC type,and ADC values were risk factors for BRCA-mutated BC(P<0.05).Multivariate logistic regression analysis revealed that T stage,HER-2,Ki-67,enhancement pattern,and TIC type were independent risk factors for BRCA-mutated BC(P<0.05).The combined model incorporating T stage,HER-2,Ki-67,enhancement pattern,and TIC type had the best diagnostic efficacy in predicting BRCA-mutated BC,with an area under the curve(AUC)of 0.751.Conclusion The combined model integrating T stage,HER-2,Ki-67,enhancement pattern,and TIC type has good efficacy in predicting BRCA-mutated BC.

Objective To explore the MRI images and clinical characteristics of right ventricular outflow tract obstruction(RVOTO)in hypertrophic cardiomyopathy(HCM)patients.Methods The clinical and imaging data of 30 patients with RVOTO and 55 randomly selected patients with simple left ventricular outflow tract obstruction(LVOTO)were retrospectively analyzed,and the data between the two groups were statistically analyzed.Results The N-terminal pro-B type natriuretic peptide(NT-proBNP)value,the average thickness of left ventricular basal end diastolic anterior wall and anterior septum,the proportion of"scallop sign"on imaging,and the mass percentage of myocardial late gadolinium enhancement(LGE)in RVOTO group were significantly higher than those in LVOTO group(P<0.01).Conclusion RVOTO is the result of multiple factors,including the thickening of interventricular septum,as well as the right ventricular free wall.When the"scallop sign"appears in MRI examinations of HCM patients,it is necessary to be highly vigilant for the presence of RVOTO.

Objective To investigate the short-term efficacy and prognostic factors of donafenib combined with transcatheter arterial chemoembolization(TACE)in the treatment of spontaneously ruptured hepatocellular carcinoma.Methods A retrospective analysis was conducted on the data of patients diagnosed with spontaneously ruptured hepatocellular carcinoma.According to the treatment meth-ods,patients were categorized into simple group(TACE)and combined group(donafenib combined with TACE).Median progres-sion-free survival(mPFS),objective remission rate(ORR),disease control rate(DCR),and median overall survival(mOS)were calculated,and treatment-related adverse events were counted.Finally,prognostic survival factors were analyzed by Cox regression.Results The mPFS for the simple group was 4.6 months,compared to 13.6 months for the combined group(χ2=9.081,P=0.003).Similarly,the mOS for the simple group was 7.6 months,compared to 17.4 months for the combined group(χ2=6.351,P=0.012).Both mPFS and mOS were significantly lower in the simple group than those in the combined group.The ORR of 25.7%and DCR of 57.1%in the simple group were significantly lower than the ORR of 55.6%and DCR of 81.5%in the combined group,and the difference between the two groups was statistically significant(P<0.05).However,there was no statistically significant difference in the incidence of rebleeding,abdominal pain and fever between the two groups(P>0.05).Additionally,age,portal vein tumor thrombus(PVTT),Child-Pugh grade,tumor diameter,and total biliru-bin(TBIL)were identified as prognostic factors(P<0.05).Conclusion Donafenib combined with TACE is an effective and safe treatment option for spontaneously ruptured hepatocellular carcinoma.Furthermore,factors such as age,PVTT,Child-Pugh grade,tumor diameter,and TBIL serve as prognostic indicators for spontaneously ruptured hepatocellular carcinoma.

Objective To explore the application value of dual-energy computed tomography(DECT)pulmonary perfusion parameters in the evaluation of pulmonary hypertension(PH).Methods A retrospective selection was performed on 214 patients with suspec-ted PH who underwent DECT pulmonary perfusion examination,and the patients were divided into PH group(n=97)and non-PH group(n=117)according to the pulmonary artery systolic pressure measured by echocardiography.Inter-group comparison,univari-ate and multivariate logistic regression,and the receiver operating characteristic(ROC)curve were used to analyze the two-phase DECT pulmonary perfusion parameters and traditional CT anatomical parameters of the two groups of patients,so as to obtain the best parameters and models for predicting PH.Results There were statistically significant differences in DECT pulmonary perfusion parameters and traditional CT anatomical parameters between the PH group and the non-PH group(P<0.05).In DECT pulmonary perfusion parameters,the ratio of main pulmonary artery enhancement to whole lung enhancement in the pulmonary arterial phase(MPAenh1/WLenh1),the difference between the whole lung enhancement in the pulmonary venous phase and the whole lung enhancement in the pulmonary arterial phase(WLenh2-WLenh1),and in traditional CT anatomical parameters,the main pulmonary artery diam-eter(MPAD)and the ratio of right ventricular diameter to left ventricular diameter(RVD/LVD)were independent predictors of PH.The DECT pulmonary perfusion parameters model had similar diagnostic efficacy to the traditional CT anatomical parameters model for PH,and the combined model of the two parameters had the best diagnostic efficacy,with an area under the curve(AUC)of 0.955 and sensitivity and specificity of 0.866 and 0.940,respectively.Conclusion DECT pulmonary perfusion parameters can be used to evaluate PH,and the combination of traditional CT anatomical parameters and DECT pulmonary perfusion parameters can significantly improve the diagnostic efficacy of PH.

Objective To analyze the differences of brain activity between first-episode untreated depressive patients with and without suicidal ideation(SI),and its correlations with clinical characteristics.Methods A total of 40 major depressive disorder(MDD)patients with SI(MDD+SI group),40 patients without SI MDD(MDD+NSI group),and 40 healthy controls(HC)(HC group)were enrolled.The 17-item Hamilton depression scale(HAMD-17)and Beck scale for suicide ideation(BSI)were used to assess the severity of depression and SI,respectively.MRI data were collected.The values of fractional amplitude of low-frequency fluctuation(fALFF)were calculated.Results(1)Compared with the HC group,the MDD+NSI group showed decreases in the fALFF val-ues of the default network and attention network.The fALFF values of the attention network in the MDD+SI group showed decreases.Compared with the MDD+NSI group,the MDD+SI group showed decreases in the fALFF values of the attention network.(2)The fALFF values in the left middle frontal gyrus were negatively correlated with the total score of HAMD-17(r=-0.55;P<0.001)in the MDD+NSI group,while the fALFF values in the left middle frontal gyrus were negatively correlated with the total score of HAMD-17(r=-0.53;P<0.001)and the total score of BSI(r=-0.51;P<0.001)in the MDD+SI group.(3)The optimal critical value of fALFF value in left middle frontal gyrus for predicting SI occurrence in MDD patients was-0.039,area under the curve(AUC)was 0.76,sensitivity was 0.63,and specificity was 0.80.Conclusion The decreased local activity intensity in the left middle frontal gyrus of the brain might be the central mechanism for the occurrence of SI in MDD patients.In addition,the left middle frontal gyrus might have certain value in identifying SI and predicting the severity of SI.

Objective To explore the value of nomogram model based on MR T1WI enhanced radiomics features and clinical fac-tors in predicting the prognosis of gliomas.Methods A retrospective selection was conducted on 135 patients with postoperative pathologically confirmed gliomas,who were categorized into poor prognosis group(n=59)and good prognosis group(n=76)according to survival condition at 20 months postoperatively.All patients were randomly divided into training group(n=94)and validation group(n=41)in a 7︰3 ratio.Radiomics features were extracted by 3D Slicer software,and the extracted radiomics features were downscaled by intraclass correlation coefficient(ICC),t-test,least absolute shrinkage and selection operator(LASSO)regression,and a total of 1 058 features were extracted for each patient,and 10 optimal radiomics features were obtained,to finally get the Radiomics score(Radscore).After combining clinical features and Radscore,a nomogram model was constructed.Results In the training group,Radscore was significantly higher in the poor prognosis group than that in the good prognosis group(t=8.773,P<0.05).The area under the curve(AUC)of receiver operating characteristic(ROC)curve of the training and validation groups of the radiomics model were 0.751[95%confidence interval(CI)0.654-0.849]and 0.606(95%CI 0.426-0.787),respectively.The AUC of the nomogram model were 0.899(95%CI 0.839-0.960)and 0.908(95%CI 0.823-0.994)in the training and validation groups,respectively,with much better predictive efficacy of the nomogram model.Conclusion A nomogram model based on MR T1WI enhanced radiomics features and clinical factors has good predictive efficacy in the prognosis of gliomas after surgery.

Objective To explore the value of 18F-fluorodeoxyglucose(18F-FDG)PET/CT in predicting the stage of untreated elderly esophageal cancer.Methods The clinical data of 83 esophageal cancer patients who had not received any treatment were ret-rospectively analyzed,including age,body mass index(BMI),lesion length and width,TNM stage,and clinical stage.Spearman correlation analysis was used to evaluate the correlation between TNM stage and clinical stage and the maximum standardized uptake value(SUVmax)of the primary tumor.Linear correlation analysis was used to evaluate the correlation between age,BMI,lesion length and width,and SUVmax.The receiver operating characteristic(ROC)curve of the primary tumor SUVmax in predicting the newly diagnosed elderly esophageal cancer T3-T4 stage and clinical stage Ⅲ-Ⅳ was plotted,the area under the curve(AUC)was obtained,and the best cut off value of the primary tumor SUVmax in the diagnosis of T3-T4 stage and clinical stage Ⅲ-Ⅳ was obtained.Results The T stage and clinical stage were positively correlated with the SUVmax of the primary tumor(r=0.688,P<0.001;r=0.313,P=0.004),while the N stage,M stage,lesion location,age,BMI,lesion length and width were not correlated with the SUVmax(P>0.05).There were significant differences in SUVmax between the T1-T2 stage and the T3-T4 stage,as well as between the clinical stageⅠ-Ⅱ and the Ⅲ-Ⅳ(P<0.05).According to the analysis of ROC curve,the AUC for diagnosing T3-T4 stage and clinical stageⅢ-Ⅳ with the SUVmax of the primary tumor were 0.904[95%confidence interval(CI)0.835-0.973]and 0.700(95%CI 0.570-0.829),respectively,with cut off values of 12.40 and 12.70.The sensitivities were 0.918 and 0.708,respectively,and the specificities were 0.712 and 0.729,respectively.Conclusion 18F-FDG PET/CT primary tumor SUVmax has a good predictive value for the diagnosis of untreated elderly esophageal cancer before treatment of T3-T4 stage and clinical stage Ⅲ-Ⅳ,which can improve the accuracy of esophageal cancer stage.