Purpose To evaluate the differential diagnostic value of 5.0T MRI susceptibility-weighted imaging(SWI)in hepatocellular carcinoma(HCC)and mass-forming intrahepatic cholangiocarcinoma(MICC).Materials and Methods A total of 56 patients with HCC and 36 patients with MICC confirmed by pathology from March 2023 to November 2024 in Anhui Provincial Hospital were retrospectively enrolled.Two radiologists independently analyzed three features of the lesions,including the low-signal rims around the lesion,hemorrhage within the lesion,and the relationship between lesions and adjacent vessels,on the SWI sequence between the two groups,respectively,via inter-rater consistency analysis.These above features between the two groups were compared and contrasted them with those obtained from conventional MR plain and enhanced scans,respectively.For intralesional hemorrhages,the diagnostic value was quantified by calculating the internal tissue susceptibility signal.Results The radiologists showed good consistency in the low-signal rims,intratumoral hemorrhage as well as the relationship between the lesion and the blood vessel on the SWI in the HCC group and the MICC group(Kappa=0.802-0.929,all P<0.001).Compared with conventional MR plain,SWI significantly enhanced the detection rates of perilesional low-signal rims and intratumoral hemorrhage(χ2=89.409,46.210,both P<0.001).These findings were more prevalent in HCC patients.The internal tissue susceptibility signal grading showed that HCC predominantly exhibited grade 3,whereas MICC predominantly exhibited grade 1,with statistically significant differences(Z=-4.059,P<0.05).Additionally,compared with enhanced MRI,SWI demonstrated higher accuracy in diagnosing the relationship between lesions and blood vessels in both groups;however,these differences were not statistically significant(χ2=0.275,0.247,P=0.871,0.619).In the HCC group,the relationship between tumors and blood vessels was primarily characterized by compression and tumor thrombus formation,while in the MICC group,it was predominantly marked by invasive changes,including vessel encasement,stenosis or occlusion,with a statistically significant difference between the two groups(Z=-6.809,P<0.001).Conclusion SWI sequence of 5.0T MRI provides clear visualization of the internal and peripheral structures of HCC and MICC.It can accurately delineate the relationship between lesions and blood vessels without the need for contrast agents,offering significant clinical utility in differentiating these two conditions.

Objective To observe and compare the therapeutic effects of aflibercept biosimilar and originator afliber-cept through intravitreal injection in patients with age-related wet macular degeneration(AMD).Methods This retro-spective study enrolled 60 AMD patients(60 eyes)who were diagnosed and treated at the Department of Ophthalmology,Zibo Central Hospital,from January 2024 to May 2024.These patients were divided into two groups.Specifically,30 pa-tients(30 eyes)(the originator group)received the intravitreal injection of originator aflibercept,while another 30 patients(30 eyes)(the biosimilar group)received the intravitreal injection of aflibercept biosimilar.All patients followed a 3+PRN treatment regimen with a follow-up period of at least 6 months.Relevant examinations including best-corrected visual acui-ty(BCVA),optical coherence tomography,corneal endothelial microscopy,and multifocal electroretinogram(mfERG)were performed before and after treatment.Moreover,the BCVA,central retinal thickness(CRT),pigment epithelial de-tachment(PED)height,corneal endothelial cell density,hexagonal cell ratio,coefficient of variation(CV)of corneal en-dothelial cells,P1 wave amplitude density of the first ring,number of intravitreal injections,and incidence of complications were compared between both groups.Results No statistically significant differences were observed in the age,sex ratio,or disease duration between both groups(all P＞0.05).After treatment,the BCVA,CRT,and PED height of patients in both groups decreased,and the P1 wave amplitude density of the first ring increased in both groups,with statistically sig-nificant differences compared with baseline values(all P＜0.05).In the originator group,the corneal endothelial cell den-sity,hexagonal cell ratio,and CV of corneal endothelial cells of patients in both groups increased after treatment,while the biosimilar group showed a decrease in the corneal endothelial cell density and hexagonal cell ratio,alongside an increase in the CV of corneal endothelial cells;however,these changes were not statistically significant compared with baseline values(all P＞0.05).No significant difference was observed in the number of intravitreal injections between both groups(P＞0.05).The correlation analysis results revealed positive associations between disease duration and post-treatment BCVA(logMAR)in both groups(r=0.901 and 0.905,respectively;both P＜0.000 1).No severe ocular complications or cardio-vascular/cerebrovascular events occurred in all patients.Conclusion There is no significant difference in the short-term efficacy between originator aflibercept and aflibercept biosimilar in the treatment of patients with wet AMD.

Objective To observe and compare the therapeutic effects of aflibercept biosimilar and originator afliber-cept through intravitreal injection in patients with age-related wet macular degeneration(AMD).Methods This retro-spective study enrolled 60 AMD patients(60 eyes)who were diagnosed and treated at the Department of Ophthalmology,Zibo Central Hospital,from January 2024 to May 2024.These patients were divided into two groups.Specifically,30 pa-tients(30 eyes)(the originator group)received the intravitreal injection of originator aflibercept,while another 30 patients(30 eyes)(the biosimilar group)received the intravitreal injection of aflibercept biosimilar.All patients followed a 3+PRN treatment regimen with a follow-up period of at least 6 months.Relevant examinations including best-corrected visual acui-ty(BCVA),optical coherence tomography,corneal endothelial microscopy,and multifocal electroretinogram(mfERG)were performed before and after treatment.Moreover,the BCVA,central retinal thickness(CRT),pigment epithelial de-tachment(PED)height,corneal endothelial cell density,hexagonal cell ratio,coefficient of variation(CV)of corneal en-dothelial cells,P1 wave amplitude density of the first ring,number of intravitreal injections,and incidence of complications were compared between both groups.Results No statistically significant differences were observed in the age,sex ratio,or disease duration between both groups(all P＞0.05).After treatment,the BCVA,CRT,and PED height of patients in both groups decreased,and the P1 wave amplitude density of the first ring increased in both groups,with statistically sig-nificant differences compared with baseline values(all P＜0.05).In the originator group,the corneal endothelial cell den-sity,hexagonal cell ratio,and CV of corneal endothelial cells of patients in both groups increased after treatment,while the biosimilar group showed a decrease in the corneal endothelial cell density and hexagonal cell ratio,alongside an increase in the CV of corneal endothelial cells;however,these changes were not statistically significant compared with baseline values(all P＞0.05).No significant difference was observed in the number of intravitreal injections between both groups(P＞0.05).The correlation analysis results revealed positive associations between disease duration and post-treatment BCVA(logMAR)in both groups(r=0.901 and 0.905,respectively;both P＜0.000 1).No severe ocular complications or cardio-vascular/cerebrovascular events occurred in all patients.Conclusion There is no significant difference in the short-term efficacy between originator aflibercept and aflibercept biosimilar in the treatment of patients with wet AMD.

Purpose To evaluate the differential diagnostic value of 5.0T MRI susceptibility-weighted imaging(SWI)in hepatocellular carcinoma(HCC)and mass-forming intrahepatic cholangiocarcinoma(MICC).Materials and Methods A total of 56 patients with HCC and 36 patients with MICC confirmed by pathology from March 2023 to November 2024 in Anhui Provincial Hospital were retrospectively enrolled.Two radiologists independently analyzed three features of the lesions,including the low-signal rims around the lesion,hemorrhage within the lesion,and the relationship between lesions and adjacent vessels,on the SWI sequence between the two groups,respectively,via inter-rater consistency analysis.These above features between the two groups were compared and contrasted them with those obtained from conventional MR plain and enhanced scans,respectively.For intralesional hemorrhages,the diagnostic value was quantified by calculating the internal tissue susceptibility signal.Results The radiologists showed good consistency in the low-signal rims,intratumoral hemorrhage as well as the relationship between the lesion and the blood vessel on the SWI in the HCC group and the MICC group(Kappa=0.802-0.929,all P<0.001).Compared with conventional MR plain,SWI significantly enhanced the detection rates of perilesional low-signal rims and intratumoral hemorrhage(χ2=89.409,46.210,both P<0.001).These findings were more prevalent in HCC patients.The internal tissue susceptibility signal grading showed that HCC predominantly exhibited grade 3,whereas MICC predominantly exhibited grade 1,with statistically significant differences(Z=-4.059,P<0.05).Additionally,compared with enhanced MRI,SWI demonstrated higher accuracy in diagnosing the relationship between lesions and blood vessels in both groups;however,these differences were not statistically significant(χ2=0.275,0.247,P=0.871,0.619).In the HCC group,the relationship between tumors and blood vessels was primarily characterized by compression and tumor thrombus formation,while in the MICC group,it was predominantly marked by invasive changes,including vessel encasement,stenosis or occlusion,with a statistically significant difference between the two groups(Z=-6.809,P<0.001).Conclusion SWI sequence of 5.0T MRI provides clear visualization of the internal and peripheral structures of HCC and MICC.It can accurately delineate the relationship between lesions and blood vessels without the need for contrast agents,offering significant clinical utility in differentiating these two conditions.

Objective:To explore the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in different regions of the kidney in distinguishing IgA nephropathy (IgAN) patients from healthy volunteers.Methods:This study was a cross-sectional study. Eighty-four patients diagnosed with IgAN (IgAN group) who underwent renal biopsy (lower pole of the left kidney) and were pathologically confirmed at the First Medical Center of PLA General Hospital from February 2022 to September 2023 and thirty-four healthy volunteers (control group) were included prospectively. The regions of interest were outlined in the right renal cortex, medulla, and parenchyma for all subjects, and the apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D *), and perfusion fraction (f) were measured in the corresponding regions. The differences in IVIM-DWI parameters between the IgAN group and the control group were compared using the student′s t-test or the Mann-Whitney U test. Receiver operating characteristic curve analysis was performed on the parameters with statistically significant differences, and the area under the curve (AUC) was calculated. Results:There were statistically significant differences in renal cortical ADC, renal parenchymal ADC, renal cortical D, renal parenchymal D, and renal medullary f values between the IgAN group and the control group ( Z=-3.03, -2.21, -2.62, -2.03, -2.03; P=0.002, 0.027, 0.009, 0.043, 0.042). The AUCs (95% CI) for diagnosing IgAN using renal cortical ADC, renal parenchymal ADC, renal cortical D, renal parenchymal D, and renal medullary f values were 0.679 (0.586-0.762), 0.630 (0.537-0.717), 0.654 (0.535-0.774), 0.619 (0.497-0.742), and 0.620 (0.495-0.745), respectively. There were no statistically significant differences in renal medullary ADC, D, renal cortex, medulla and parenchyma D *, renal cortical and renal parenchymal f values between the two groups ( P>0.05). Conclusion:The quantitative parameters of renal IVIM-DWI are influenced by different measurement regions, among which the ADC, D of renal cortex and parenchyma, and f of renal medulla can be used for the initial diagnosis of IgAN.

Objective To observe the value of susceptibility weighted imaging(SWI)based on 5.0T MRI for diagnosing hepatocellular carcinoma(HCC)complicated with vein tumor thrombi.Methods Totally 63 HCC patients were retrospectively enrolled,among them 17 complicated with vein tumor thrombi.The efficacy of 5.0T SWI for detecting vein tumor thrombus was observed,and the image quality were compared between 5.0T and 3.0T.Results 5.0T SWI displayed vein tumor thrombi in 16 cases,except for 1 case with vein tumor thrombi in the upper segment of the left lateral lobe of the left portal vein.The liver edge score,overall image quality score,signal-to-noise ratio and contrast-to-noise ratio of portal venous phase and hepatobiliary phase in 5.0T enhanced MRI were all higher than those in 3.0T(all P＜0.05).Conclusion 5.0T SWI was helpful for diagnosing HCC complicated with vein tumor thrombi.

Objective:To investigate the value of MR subtraction images in improving the interobserver agreement for Bosniak Ⅱ, ⅡF, and Ⅲ cystic renal masses (CRMs) with Bosniak classification version 2019.Methods:From January 2009 to August 2020, 323 patients (335 CRMs) with surgical pathology results and complete preoperative MRI examination (T 2WI, T 1WI precontrast images and enhanced MRI in corticomedullary, nephrographic, and excretory phases) were retrospectively collected in the First Medical Center of PLA General Hospital. The CRMs of Bosniak Ⅱ, ⅡF, and Ⅲ were selected and classified by 2 experienced genitourinary radiologists according to the Bosniak classification version 2019. The "Subtraction" function in the American GE ADW 4.4 workstation was used to perform subtraction images reconstruction on the enhanced images in the corticomedullary, nephrographic, and excretory phases. Blinded to pathologic information, the other 2 radiologists independently classified the enrolled CRM cases with and without subtraction MR images, respectively, with an interval of 1 month. Ultimately, by using weighted Kappa value, interobserver agreement was evaluated, and the differences in weighted Kappa value were compared using the Gwet coefficient. Results:A total of 187 patients with 187 CRMs were enrolled in the study. The results of the classification of Bosniak Ⅱ, ⅡF, and Ⅲ CRMs categorized by 2 radiologists without and with subtraction images showed that 119 and 141 cases were consistent, and 68 and 46 were inconsistent, respectively. The weighted Kappa value for interobserver agreement among two radiologists without and with subtraction MR images was 0.60 (95%CI 0.53-0.68) and 0.73 (95%CI 0.66-0.80), respectively. The interobserver agreement was higher with subtraction images than that without subtraction images ( t=-2.56, P=0.011). Conclusion:According to the MRI criteria of Bosniak classification version 2019, the interobserver agreement for Bosniak Ⅱ, ⅡF, and Ⅲ CRMs could be improved using subtraction MR images, which may facilitate the popularization and application of Bosniak classification version 2019.

Objective:To explore the related factors influencing the length of hospital stay(LOS) of pregnant women with heart disease (PWHD) after cesarean section.Methods:A total of 306 patients with PWHD who underwent cesarean section from January 2012 to March 2019 were collected. Among them, 203 patients had not undergone heart surgery (uncorrected group) and 103 patients who had undergone heart surgery (corrected group) during the same period. Demographic, perioperative and postoperative data were recorded. Predictors associated with postoperative LOS were determined using univariate and multivariate linear regression analysis models.Results:(1) The median LOS after cesarean section in the uncorrected group was 6 days (5-8 days). The results of univariate linear regression analysis showed that 38 parameters had significant impact on LOS ( P<0.05). The results of multivariate linear regression analysis showed that 5 parameters were independent risk factors for prolonged LOS in the uncorrected group; among them, the median LOS in uncorrected group with hypertensive disorders of pregnancy was 3 days longer than that in patients with PWHD alone [7 days (5-8 days) vs 4 days (4-5 days), β=0.195, P=0.001]; the median LOS in uncorrected group with high serum creatinine was 3 days longer than normal patients [7 days (5-13 days) vs 4 days (4-5 days), β=0.145, P=0.015]; the LOS of patients who chose general anesthesia was 2 days longer than that of patients who chose spinal anesthesia [6 days (4-8 days) vs 4 days (4-5 days), β=0.154, P=0.007]; the LOS of patients with postoperative pulmonary infection was 4 days longer than that of patients without pulmonary infection [8 days (5-15 days) vs 4 days (4-5 days), β=0.269, P<0.01]; the LOS of patients who admitted to ICU after surgery was 2 days longer than that not admitted patients [6 days (5-8 days) vs 4 days (4-5 days), β=0.268, P<0.01]. (2) The median LOS after cesarean section in corrected group was 4 days (4-5 days). The results of univariate linear regression analysis showed that 8 parameters had significant impact on the LOS (all P<0.05). The results of multivariate linear regression analysis showed that 2 parameters, which were American Society of Anesthesiologists (ASA) grade ( β=0.198, P=0.028) and intraoperative blood loss ( β=0.285, P=0.003), were the independent risk factors for prolonged LOS in corrected group. Conclusion:Preoperative with hypertensive disorders of pregnancy, preoperative creatinine increase, intraoperative general anesthesia, postoperative pulmonary infection, and postoperative admission to ICU are independent predictors of prolonged LOS in uncorrected patients with PWHD; ASA classification and intraoperative bleeding are independent predictor of prolonged postoperative LOS in patients with corrected PWHD.

Objective:To study the clinical features, diagnosis and treatment of primary sphenoid sinus tumors and to improve the understanding of clinicians.Methods:The clinical data of 5 cases of primary sphenoid sinus tumors diagnosed by pathology from August 2014 to June 2017 in Affiliated Shengjing Hospital of China Medical University were collected and reviewed. The clinical characteristics, diagnosis and treatment were analyzed.Results:Of the 5 patients, 1 patient was first diagnosed in neurology with headache, 2 patients were first diagnosed in ophthalmology with periorbital pain, and 2 patients were diagnosed with nasal symptoms such as decreased olfactory, nasal congestion, blood stasis, and pharyngeal foreign body sensation. In the otolaryngology department, all patients had no history of head and neck surgery before surgery. All patients underwent sinus CT and MRI. They were suspected of malignant ECT examination. There were no distant metastatic lesions and surgical contraindications. General anesthesia and endoscopic sphenoid sinus surgery was used. And assisted image navigation systems were used in 3 patients. Postoperative pathological returns showed chordoma in 1 case, adenoid cystic carcinoma in 1 case, plasmacytoma in 1 case, poorly differentiated carcinoma in 1 case, and focal malignant transformation of inverted papilloma in 1 case. Patients with chordoma, adenoid cystic carcinoma, poorly differentiated carcinoma and inverted papilloma received foci surgery and were transferred to our hospital for oncology and chemotherapy. Patients with plasmacytoma only had surgery, and received no further treatment for personal reasons. Follow-up lasted 16-50 months and ended on October 1, 2018. Patients with poorly differentiated cancer were followed up for 12 months and died after liver metastases, and the other 4 patients lived well. Our department continued to follow up.Conclusions:The clinical manifestations of primary sphenoid sinus tumors are non-specific. Many of them are in advanced stage. Imaging examination plays an important role in the diagnosis of diseases and the development of surgical methods. Surgery is the main method for the treatment of this disease. Postoperative adjuvant chemotherapy and radiotherapy is of great significance to improve the survival rate of patients.

Objective To investigate the prevalence of sexual dysfunction in aged men and associated risk factors in Beijing. Methods A cross-sectional study was performed in communities of Beijing involved 1656 men aged over 50 years.The International Index of Erectile Function-5 (IIEF-5),Brief Male Sexual Function Inventory for Urology ( O'Leary 1995 ) and the International Prostate Symptom Score (IPSS)questionnaires was recorded.The body mass index (BMI),prostate size was measured.The survey was conducted to make sure if the patients had diabetes,high blood pressure,hyperlipidemia,cerebrovascular history,and smoking and drinking situation.Pearson's X2 test and unconditional logistic regression were used to investigate the factors associated with sexual dysfunction. Results 1644 subjects were enrolled.The incidence of ED,reduction of sexual desire and defective ejaculation was 90.45％,60.04％ and 38.81％ respectively,and significantly different according to age ( P ＜ O.05 ). Age was positively correlated with ED (3 =0.12,P＜0.05),reduction of sexual desire (β =0.10,P＜0.05) and defective ejaculation (β =0.10,P ＜ 0.05 ) ; ED was significantly associated with BMI (β =0.07,P ＜ 0.05 ).Hypertension and prostate size were risk factors for reduction of sexual desire and defective ejaculation; There was correlation between drinking and defective ejaculation ( β =- O.31,P ＜ 0.05 ). Conelusions Compared with high prevalence of ED and lower sexual desire,the incidence of defective ejaculation were lower; this may reflect the sexual activities of aged male were more active compared with the less success of really erection.The prevalence of ED,reduction of sexual desire or defective ejaculation increased with age.BMI was the risk factor for ED.Enlarged prostate and hypertension was associated with reduction of sexual desire,and drinking was the risk factor for defective ejaculation.