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 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 evaluate which factors may affect magnetic resonance imaging(MRI)performance in the detection of pathologic complete response(pCR)after neoadjuvant chemotherapy(NAC).Methods This retrospective study involved 89 patients diagnosed with invasive breast carcinoma who received NAC at The Second Affiliated Hospital of Xi'an Jiaotong University from July 2019 to December 2021.Breast MRI was performed before and after NAC.Based on the pathological results obtained surgery after the completion NAC and using Miller-Payne classification as the evaluation standard,the patients were divided into two subgroups:pCR and non-pathological complete response(npCR).Chi-square test was used to compare the MRI characteristics of pre-NAC lesions between the two groups.ROC curve analysis was made to analyze the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of MRI after NAC;the diagnostic performance of MRI in predicting pCR in different tumor subtypes was analyzed.We made univariate and multivariate analyses of factors affecting radiographic complete response(rCR)and pCR concordance.Results MRI analysis after NAC showed rCR in 20 cases(22.5％)and pCR in 28 cases(31.5％).Considering rCR as a"positive"result of MRI analysis,MRI assessment was accurate in 79 cases,including 19 true positive cases and 60 true negative cases.MRI assessment was inaccurate in 10 cases,including 9 false negative cases and 1 false positive case.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of MRI assessment of pCR were 67.86％,98.36％,88.76％,95.00％,and 86.96％.MRI had the lowest diagnostic efficiency in evaluating pCR of ERBB2+breast cancer after NAC.Single factor analysis showed that estrogen receptor(ER),clinical stage,background parenchymal enhancement,and maximum tumor diameter all affected the consistency of rCR and pCR(P＜0.05).Multivariate Logistic regression analysis showed that the independent influencing factor affecting the consistency of rCR and pCR was clinical stage.Conclusion MRI demonstrated good accuracy in predicting pCR after NAC in the breast cancer patients examined.Pre-treatment MRI characteristics and tumor subtypes may be related to the diagnostic accuracy of post-NAC MRI in breast cancer patients.

【Objective】 To explore the clinical features of dermatomyositis and diagnostic value of MRI. 【Methods】 The clinical and imaging data of 61 patients with dermatomyositis were analyzed retrospectively. 【Results】 Among the 61 patients， there were 15 males and 46 females with the average age of 45.3 years. The course of disease was 10 days to 12 years. All of them had different degrees of skin lesions， including 57 cases of myasthenia and or myalgia， 4 cases of dysphagia， 2 cases of dyspnea， and 2 cases of drinking water and coughing. There were 18 cases complicated with interstitial lung disease， 1 case complicated with Sjogren’s syndrome， 1 case complicated with arthritis， 1 case complicated with rhabdomyolysis， and 1 case complicated with kidney damage and liver insufficiency. MRI examination performed in 46 patients with dermatomyositis detected 43 cases of abnormal manifestations， 41 cases of muscle inflammatory edema， 37 cases of subcutaneous adipose tissue edema， and 40 cases of myofascitis. 【Conclusion】 The clinical manifestations of dermatomyositis are complex and have certain imaging features. Combined with the laboratory examinations of muscle enzymes and autoantibodies， electromyography， skin and muscle biopsy， they can provide clinical diagnostic evidence. MRI is an important means to diagnose and evaluate the extent and progression of dermatomyositis.

【Objective】 To screen nucleic acid aptamers that can specifically recognize castration-resistant prostate cancer （CRPC） cells by Cell-SELEX. 【Methods】 For Cell-SELEX selection， CRPC cell lines C4-2 were used as positive control cells， while androgen-dependent prostate cancer cell lines LNCap were used as negative control cells. The 5’end of the upstream primers was labeled with FITC， and the 5’end of the downstream primers was labeled with biotin. Single-stranded DNA （ssDNA） collected from each round of screening was used as template for PCR amplification and purification. The biotin-streptavidin magnetic bead separation was used to isolate PCR product for the next round of screening. The process of Cell-SELEX was analyzed by flow cytometry. ssDNA products of the last round were collected for PCR amplification， purification， cloning and DNA sequencing. The secondary structure of selected DNA aptamers was predicted. Dissociation constants of the two aptamers were calculated. Flow cytometry and confocal microscopy were used to evaluate selective binding of aptamers to CRPC cells and tissues. 【Results】 The binding rate of DNA products to CRPC cells gradually increased with the increase of selection cycles， reaching the highest in the last round. DNA structure prediction analysis showed that the secondary structure of aptamers CRPC-1 and CRPC-2 was mainly stem-loop structure. Flow cytometry analysis and confocal images showed that both CRPC-1 and CRPC-2 could specifically target C4-2 cells. In addition， immunohistofluorescence assay showed that CRPC-1 could specifically target CRPC tissues. 【Conclusion】 Cell-SELEX can be used to screen aptamers that specifically target CRPC cells and tissues， which provides experimental basis for early screening and targeted diagnosis of CRPC. It is of significance for treatment plan adjustment and prognosis improvement of prostate cancer.

【Objective】 To explore the clinical features and the imaging diagnosis value of tuberous sclerosis. 【Methods】 We retrospectively analyzed the clinical data and imaging findings of 22 patients with tuberous sclerosis clinically diagnosed in our hospital. 【Results】 There were 12 male and 10 female patients, with the mean age of 7.3 years. Among them, 2 patients had a family history; 3 had unclear symptoms and the rest 19 ones except 1 had facial skin rashes for two years, which led to seek for medical help, and the other 18 had epilepsy attack, including 4 with mental retardation. All the 22 patients had characteristic subependymal nodules, including 21 patients with multiple abnormal changes in the bilateral cerebral hemispheres. There were 12 cases with abnormal skin appearance, 2 cases accompanied by facial cortical adenoma, 1 case with right subependymal giant cell astrocytoma, 1 case with bilateral ependymoma, 1 case with Dandy-Wallker malformation, 1 case with right renal duplication, 2 cases with renal hamartoma, 1 case with multiple renal nodules, 1 case with congenital patent ductus arteriosus, 2 cases with cardiac rhabdomyosarcoma, 1 case with multiple hepatic hamartoma, and 2 cases with multiple sclerotin sclerosis changes. 【Conclusion】 The clinical manifestations of tuberous sclerosis are complex and variable, and there are certain imaging characteristics associated with multi-organ involvement. Familiarity with the characteristics and imaging manifestations of lesions in various systems can make the clinical diagnosis more concise and accurate.

Objective:To investigate the diagnostic value of synthetic MRI methods in the differentiation of benign and malignant breast lesions.Methods:Clinical and imaging data of 93 breast patients confirmed by pathology in the Second Affifiliated Hospital of Xi′an Jiaotong University from May 2019 to April 2020 were analyzed retrospectively. All patients underwent synthetic MRI technique, and the quantitative parameters of T 1, T 2, and proton density (PD) values were measured. Independent samples t-test and Wilcoxon test were used to compare the differences in clinical and imaging characteristics between the benign and malignant breast lesions. ROC curve was used for the comparison of the diagnostic efficacy of the quantitative parameters in differentiating malignant from benign breast lesions. Results:Of the 93 patients with breast lesions, 62 cases were malignant and 31 cases were benign. The quantitative T 2 values for benign and malignant lesions were 103 (93, 126)ms and 83 (77, 90)ms respectively, and the quantitative PD values were 87.7 (72.7, 96.7)pu and 73.5(63.3, 79.4)pu respectively. There were statistically significant differences between benign and malignant lesion( P<0.05). Taking quantitative T 2 values of 90.5 ms and PD values of 84.8 pu as the cut-off value, the area under the ROC curve in differentiating benign from malignant breast lesions were 0.87 and 0.75, accuracy values were 80.6% and 78.5%, specificity values were 87.1% and 54.8%, sensitivity values were 77.4% and 90.3% respectively. Conclusion:Synthetic MRI methods can be applied in the examination of breast lesions and has the potential to be an effective diagnostic method for the differential diagnosis between benign and malignant lesions of breast.

Objective:To investigate the clinical characteristics of patients complicated with Hashimoto’s thyroiditis (HT) and papillary thyroid micro-carcinoma (PTMC) and risk factors for central lymph node metastasis (CLNM) by analyzing the clinical data.Methods:Clinical data of 770 patients with PTMC admitted to Head and Neck Surgery Center of Sichuan Cancer Hospital from May. 2015 to Nov. 2017 were retrospectively analyzed, including 250 HT-PTMC patients (observation group) and 520 non-HT-PTMC patients (control group) . There were 197 males and 573 females, with a male to female ratio of 1.00:2.91. Into observation indexes included patient’s age, gender, serum thyroid stimulating hormone (TSH) , thyroglobulin antibody (TG-Ab) , thyroid peroxidase antibody (TPO-Ab) , number of foci, diameter of foci, calcification of foci, location of foci (with or without extra-glandular invasion) , number of nodules (no matter benign or malignant) , and lymph node metastasis in central and lateral cervical regions. SPSS 22.0 software was used for statistical analysis. Normally distributed data were expressed ± s. The difference between observation group and control group was compared by chi-square test of single factor analysis. The risk factors of CLNM of the observation group were analyzed with multivariate Logistic regression, the difference was statistically significant if P<0.05. Results:There were statistically significant differences between the observation group and the control group in age ( P=0.006) , gender ( P<0.001) , TSH ( P<0.001) , TG-Ab ( P<0.001) , TPO-Ab ( P<0.001) , number of nodules ( P=0.016) , and central lymph node ( P<0.001) . Compared with non-HT-PTMC group, HT-PTMC group had a higher proportion of women under 55 years old, and both TG-Ab and TPO-Ab had higher positive rates. Patients with HT-PTMC were more likely to show polynodule changes, but their central lymph node metastasis rate was lower than that of the non-HT-PTMC group. Single-factor analysis showed that the number of cancer foci, calcification of cancer foci, and location of cancer foci were significantly correlated with the CLNM of HT-PTMC patients (all P<0.001) . Multivariate Logistic regression analysis showed that multiple cancer foci ( P<0.001) , invasion and capsule ( P<0.001) , and cancer foci with calcification ( P=0.005) were independent risk factors for CLNM. Conclusions:HT-PTMC is more common in women under 55 years of age, and most of them show multiple nodules in bilateral glandular lobes, often accompanied by elevated serum TSH, TG-Ab and TPO-Ab levels. Meanwhile, the lymph node metastasis rate of HT-PTMC is relatively low, and the prognosis may be relatively good. In HT-PTMC, the risk of multiple carcinoma foci, cancer foci with calcification, cancer foci invasion and the occurrence of CLNM is higher. Preventive central lymph node dissection helps to reduce the occurrence of postoperative cervical lymph node recurrence.

OBJECTIVE: To evaluate the diagnostic efficacy of Kaiser score for breast lesions presenting as non-mass enhancement. METHODS: We collected data from patients with breast lesions presenting as non-mass enhancement on preoperative DCE-MRI between January, 2014 and June, 2019. All the cases were confirmed by surgical pathology or puncture biopsy. With pathology results as the gold standard, we evaluated the diagnostic efficacy of Kaiser score and MRI BI-RADS classification and the consistency between the diagnostic results by the two methods and the pathological results. RESULTS: A total of 90 lesions were detected in 88 patients, including 28 benign lesions (31.1%) and 62 malignant lesions (68.9%). For diagnosis of the lesions, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Kaiser Score were 100%, 75%, 89.9%, 100% and 92%, as compared with 93.5%, 46.4%, 79.5%, 76.5% and 78.9% of MRI BI-RADS, respectively. The diagnostic specificity of Kaiser score was significantly higher than that of BI-RADS classification (=0.021). CONCLUSIONS The Kaiser score system provides a diagnostic strategy for BI-RADS classification of breast lesions with non-mass enhancement and has a better diagnostic efficacy than BI-RADS classification alone. The use of Kaiser score can significantly improve the diagnostic specificity of such breast lesions for inexperienced radiologists.
Breast ; Breast Diseases ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging

Objective To analyze the correlation between the molecular subtypes of non-mass enhancement (NME)breast cancer and MRI findings.Methods A retrospective analysis of MRI images and clinicopathological data of 62 patients with NME breast cancer who received 3.0T breast MRI multimodal scan from January 201 5 to June 201 9 was conducted.Molecular subtypes were classified by immunohistochemical staining.The differences between MRI findings of NME breast cancer and molecular subtypes were compared by ch-i square test and Fisher exact probability method,and the correlation between them was analyzed by cross contingency table.Results The differences of molecular subtypes of NME breast cancer in the internal enhancement and peritumoral edema were statistically significant (P＜0.05),while the differences in the TIC,lesion distribution type and peritumoral vascular were not statistically significant (P＞0.05).Conclusion Luminal A type was less prone to peritumoral edema in NME breast cancer.Luminal B type was mainly heterogeneous enhancement. HER-2 overexpression type and triple negative type are mainly clustered ring enhancement,and prone to peritumoraledema.Different molecular subtypes of NME breast cancer have certain MRI characteristics,which is expected to provide a non-invasive evaluation for the preoperative treatment of NME breast cancer.