Objective To construct a radiomic model based on intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI ) for preoperative prediction of hepatocellular carcinoma (HCC ) differentiation and validate its clinical value.Methods Clinical and imaging data of 187 HCC patients who received surgical treatment in the Third Affiliated Hospital of Chongqing Medical University from June 2018 to January 2024 were collected and retrospectively analyzed.According to the postoperative pathological results,they were divided into low-differentiation group (n=58)and non-low-differentiation group (n=129),andrandomly divided into the training group (n=149)and the validation group (n=38)with the ratio of 8∶2. Univariate analysis was used to assess the clinical indicators related to HCC differentiation,and then a clinical model was constructed. Pyramidimics software was used to extract the radiomic features of IVIM-DWI functional images,and minimum absolute contraction and selection operator logistic regression algorithm were employed to screen those highly correlated indicators with HCC differentiation.Support vector machine (SVM),logistic regression (LR)and random forest (RF)algorithms were utilized to construct different image omics models.SVM algorithm was applied to construct the combined imaging omics and clinical model. The internal verification of the model was carried out by using ten-fold cross-validation.Receiver operating characteristic (ROC)curve,area under the curve (AUC),calibration curve,and decision curve analysis (DCA)were used to evaluate the diagnostic value and clinical benefits of clinical model,radiomic model,and their combination.Results A total of 4060 radiological features were extracted,and after feature screening and dimensionality reduction,24 features were finally included to construct the model.Among all models,the predictive performance of the radiomic model and the radiomic-clinical combined model was better than that of the clinical model.In the comparison between the radiomic model constructed by SVM algorithm and the radiomics-clinical combined model,the AUC value was 0.954 (0.908～1.000)for the former model,and was 0.943 (0.905～0.982)for the latter model in the training set,and there was no significant difference between them.In the validation set,the AUC value was 0.807 (0.640～0.975 )and 0.876 (0.743～1.000),respectively,with statistical difference between the 2 models (P<0.05).Calibration curve analysis showed that the radiomic model and the radiomics-clinical combined model had good goodness of fit.DCA indicated that the net benefit was higher and the threshold probability range was larger in both the radiomic model and the radiomics-clinical combined model,and the net benefit of the combined model was larger. Conclusion Both the radiomic model and the combined radiomics-clinical model constructed on the basis of IVIM-DWI functional images can better predict the severity of HCC differentiation before surgery.

Objective:To observe the changes of cognitive function, subcortical nuclei volumes, and diffusion kurtosis imaging (DKI) parameters (values of fractional anisotropy [FA], mean diffusivity [MD] and mean kurtosis [MK]) after surgery in patients with aneurysmal subarachnoid hemorrhage (aSAH), and analyze the correlations of cognitive dysfunction with subcortical nuclei volumes and DKI parameters.Methods:A prospective sutdy was conducted;17 patients with aSAH confirmed by surgery in our hospital from September 2019 to June 2020 were selected as patient group, and 16 healthy volunteers whose age, gender, and education level were matched with the patient group were recruited as control group. Neuropsychological tests and MR imaging were performed in the patients 3 months after surgery and the controls right after enrollment. The structural image data of all subjects were post-processed. Bilateral subcortical nuclei volumes and DKI parameters were analyzed. The differences of general clinical data, subcortical nuclei volumes and DKI parameters were compared between the two groups. The correlations of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scores with subcortical nuclei volumes and DKI parameters were analyzed.Results:As compared with the control group, the patient group had significantly lower MMSE and MoCA scores, and statistically decreased volumes of ipsilateral hippocampus, ipsilateral thalamus and ipsilateral lentiform nucleus ( P<0.05). The FA values of the contralateral caudate nucleus, bilateral thalamus and bilateral lentiform nucleus and MK values of the ipsilateral hippocampus in the patient group were significantly decreased as compared with those in the control group ( P<0.05); while the MD values of the ipsilateral caudate nucleus in the patient group were significantly increased as compared with those in the control group ( P<0.05). The volume of ipsilateral hippocampus was positively with MoCA scores ( r=0.604, P=0.038); the FA values of contralateral caudate nucleus were negatively correlated with MMSE scores ( r=-0.579, P=0.049). Conclusions:Cognitive dysfunction, atrophy of ipsilateral hippocampus, thalamus and lenticular nucleus, and changes of DKI parameters exist in patients with aSAH after surgery. The changes in ipsilateral hippocampus volume and FA values of caudate nucleus may be related to the postoperative cognitive dysfunction in these patients.

Objective: To observe the effects of probiotics on gut microecology, immune function, and inflammatory index in patients with critical cerebral infarction. Methods: A total of 70 patients with critical cerebral infarction treated in our hospital from January 2015 to January 2019 were retrospectively studied.They were randomly divided into a control group(n=35)receiving routine treatment and an observation group(n=35)receiving routine treatment added to capules containing live Bifidobacterium, Lactobacillus, and Enterococcus for 4 weeks.The changes of gut microflora, immune function and inflammatory index were compared between the two groups. Results: The number of Bifidobacterium, Lactobacillus, and Enterococcus colonies were significantly increased and the colony count of yeast was decreased in the observation group after treatment versus pre-treatment(P<0.05). There were no significant differences between pre-versus post-treatment in the colony count in the control group(P>0.05). The level of CD4⁺ and CD4⁺/CD8⁺ ratio were significantly higher in observation group than in the control group(P<0.05), and the level of CD8⁺ was lower in observation than in the control group(P<0.05)after treatment.The levels of hemoglobin(Hb), total protein(TP), albumin(Alb), interleukin(IL)-6 and tumor necrosis factor(TNF)were decreased in the two groups, but the decrement of the levelsof IL-6 and TNF was more marked in the observation group than in the control group(P<0.05), However, the levels of Hb, TP, A1b in the observation group were lower tan those in te control group(all P<0.05). Conclusions Probiotics can significantly improve the intestinal flora and immune function, release the deterioration of nutritional status, and inhibit the inflammatory response in patients with critical cerebral infarction, which is worthy of clinical promotion.

Objective To evaluate the clinical value of the oral contrast-enhanced three-dimensional spiral CT cholangiography to display better the intrahepatic and extrahepatic bile ducts. Methods Before spiral CT scanning, the preparation was similar to the conventional X-ray oral cholecystography. The collected parameters included 3-5 mm slice, 1 or 1.5 pitch, 120 kV, 220-250 mAs, and 1 mm reconstruction image. Volume rendering was used to construct the 3D bile duct images. Results In the 20 patients without serious biliary obstruction, oral three-dimensional CT cholangiography displayed the grade Ⅰ branch of hepatic ducts clearly and the displaying rate was 100%. The displaying of the grade Ⅱ branch of hepatic ducts was not good enough and the rate was 60%. The grade Ⅲ branch of hepatic ducts could not be displayed. Conclusion As the substitute and supplement of invasive ERCP, spiral CT 3D cholangiography is safe, simple, painless, and non-invasive. Furthermore, spiral CT 3D cholangiography can display the space structure of bile duct tree more clearly than ERCP. This technique is of great clinical value.

Objective To use high and low condition to get contrast radiography of nasal bone photograph to raise the image quality. Methods 75 cases with nasal bone injury were adopted as the subjects. Results In 75 cases of nasal bone wound,93% could meet the demand. Conclusion Nasal bone side position photography in high and low codition can rasie the image quality and meet the clinical diagnosis demand in maxium degraee.

Objective To assess the clinical application value and advantages of DSCT Angiography on artery injury in Extremities. Methods Seven suspected patients with artery injury in extremities underwent DSCT Angiography, including three cases on artery injury of upper extremity and four cases on artery injury of lower extremity. All the seven patients were performed with DSCT Angiography after the operation. The data of thin slice cross section were reconstructed by MPR, MIP and VR, employing Somatom Definition, German. Contrast-concentration was 350 or 370mg i/ml, total amount was 80-100ml and injection rates was 4.0 ml/s. Results All the images of angiography displayed many clear blood vessels and smooth vessels verge, contrasting with surrounding issues well. They also displayed no ladder artifact or truncation artifact. The image quality was good enough to meet the requirements of clinical diagnosis. Meanwhile the coincidence between preoperative diagnosis and postoperative diagnosis was 100%. Conclusion To suspected patients with artery injury in extremities, DSCT Angiography may be the first choice. Three-dimensional reconstruction angiographys by means of different reconstruction techniques are very helpful in diagnosing and formulating treatment perscription.

Objective To contrast the image qualities and the display percentage of vessel branches in cerebral angiography by two techniques, namely, Digital Subtraction CT Angiography (DSCTA) and Dual Energy Subtraction CT Angiography (DECTA). Methods 40 patients were divided averagely into Group A and Group B. All of them underwent head CTA exam, employing Somaton Definition Dual-Source CT of Siemens. The patients in Group A were under the mode of single tube and single energy by DSCTA, meanwhile the patients in Group B were under the mode of dual tube and dual energy by DECTA. Then the image quality of two groups and the display percentage of main vessels and branch were contrasted. Results 18 patients out of 20 in Group A succeeded in subtraction while 2 cases failed because of patients′ motion. The rate of success was 90%; 20 patients in Group B did subtraction successfully and the achievement ratio was 100%; there was no great difference on cerebral main vessels and branches which displayed in image between two groups. But the image quality of group A was superior to that of Group B. Conclusion As the development of dual-source CT′s hardware and software, DECTA Cerebral Angiography will be applied widely in clinic.

Fierce earthquake could result in mass casualties. The patient is sent to the hospital after simple trauma management for further treatment. Emergency response to hospital infection management in station hospital can effectively prevent the occurrence and spreading of infectious diseases.

Objective To make up the common X-ray examination methods of the shoulder joint and afford more medical inmormation for the radiologist and clinican. Methods More projection posture and angle were used to obtain more information of the shoulder joint. Results Y posture and outlet posture could afford more anatomy information than the traditional posture. It solved the problem of the overlap of different tissues in traditional X-ray examination. Conclusion Combinating the Y posture, outlet posture and A-P position projection is very important for X-ray examination of disease and injury of the shoulder joint.

OBJECTIVETo explore and evaluate the effect of radio frequency ablation (RFA) in treatment of hepatic VX(2) tumor in rabbits.

METHODSThe hepatoma was treated with RFA in rabbits. The complete necrotic rate of the tumors, pathological changes, CT images and the animals' survival time were observed.

RESULTS(1) ALT in serum increased significantly on the first day and decreased to the control level during 4th-7th day following RFA. (2) On the second week, CT scans showed that complete necrotic foci became larger, and the density of which was asymmetrical. Enhanced CT scans showed no obvious intensification inside; however, ringed intensification appeared along edges of the foci. Biopsy showed that the dark necrotic tissue was surrounded by ringed granulation tissue. Incomplete necrotic tumor foci resembled the complete necrotic foci in no enhanced CT images; however, asymmetrical intensification was observed in enhanced CT scans in the incomplete necrotic foci. Macroscopic observation showed irregular tumor tissue between the necrotic tissue and the peripheral normal tissue. Biopsy showed tumor recurrence in it. (3) Compared with the control, survival time of the animals was longer, and metastases rate in lungs and the fatality rate were lower in the treatment group.

CONCLUSIONSRFA, with little injury, is an effective method in the treatment of hepatoma. Enhanced CT scans are consistent with pathological morphometrics of the tumor foci after RFA. The enhanced CT scan is a valuable check-up, which could be used to observe the therapeutic effect after RFA.

Animals ; Carcinoma, Hepatocellular ; Catheter Ablation ; Liver Neoplasms ; diagnostic imaging ; surgery ; Necrosis ; Neoplasm Recurrence, Local ; Rabbits ; Radionuclide Imaging ; Tomography, X-Ray Computed