Objective To investigate the situation and prospect of local recurrence of rectal cancer by using CT and MRI. Method Relevant references about the imaging diagnosis of local recurrence of rectal cancer， which were published domestic and abroad in recent years， were collected and reviewed. Results In the diagnosis of local recurrence of rectal cancer， the sensitivity of CT was higher than that of MRI， while the specificity and accuracy were not. Perfusion CT， dynamic contrast-enhanced MRI， and diffusion weighted imaging were valuable in diagnosing local recurrence of rectal cancer， as new diagnostic techniques. Conclusion Both CT and MRI are important and valuable methods in diagnosing for local recurrence of rectal cancer.
Objective To investigate multi-slice spiral CT (MSCT) and MRI features of stasis cirrhosis and the diagnostic value of MSCT and MRI. Methods MSCT and MRI findings of 35 patients with stasis cirrhosis were studied. The size of liver and spleen, the diameter of hepatic vein (HV), enhancement pattern of liver parenchyma, contrast medium reflux in inferior vena cava (IVC) and (or) HV, ascites, number of varices and correlated abnormalities were reviewed. Results The volume index of liver and spleen of 35 patients was 4434.95 cm3 and 621.92 cm3 respectively. The mean diameter of HV of 27 patients (77.1%) was 3.61 cm and HV of other 8 patients (22.9%) were too small to show. Number of patients showed waves of borderline, inhomogeneous pattern of parenchymal contrast enhancement, contrast medium reflux in IVC and (or) HV, varices and ascites was 5 (14.3%), 29 (82.9%), 20 (57.1%), 16 (45.7%), and 6 (17.1%), respectively. Correlated abnormalities included cardiac enlargement 〔4 cases (11.4%)〕, pericardium thickening 〔11 cases (31.4%)〕, and pericardial effusion 〔2 cases (5.7%)〕. Conclusions Stasis cirrhosis mainly demonstrate liver enlargement, inhomogeneous pattern of parenchymal contrast enhancement, contrast medium reflux in IVC and (or) HV, and slight portal hypertension. MSCT and MRI play invaluable roles in diagnosis, differential diagnosis and etiological diagnosis of stasis cirrhosis.
ObjectiveTo systematically review the diagnostic accuracy of MRI in preschool children with autism spectrum disorder. MethodsDatabases including Web of Science, PubMed, The Cochrane Library, EMbase, CBM, CNKI, WanFang Data, and VIP were electronically searched for studies on MRI in diagnosis of preschool children with autism spectrum disorder from inception to January 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias the included studies. Then, meta-analysis was performed using Meta-Disc, RevMan 5.4 and Stata 16.0 software. ResultsA total of 17 studies were finally included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the curve of SROC were 0.78 (95%CI 0.76 to 0.81), 0.77 (95%CI 0.75 to 0.79), 3.92 (95%CI 2.83 to 5.41), 0.28 (95%CI 0.23 to 0.35), 14.8 (95%CI 9.31 to 23.52) and 0.86, respectively. Subgroup analysis revealed that the source of patients, age, prediction methods and analysis features were potential sources of heterogeneity. Heterogeneity in the subgroup of 1-3 years old was small, and the pooled sensitivity, specificity and area under the curve of SROC were 0.81 (95%CI 0.76 to 0.85), 0.82 (95%CI 0.78 to 0.86) and 0.87, respectively. The pooled sensitivity, specificity and area under the curve of SROC for non-site studies were 0.80 (95%CI 0.75 to 0.84), 0.80 (95%CI 0.76 to 0.85) and 0.86, respectively. ConclusionMRI has a high accuracy in the diagnosis of preschool children with autism spectrum disorder; however, the possibility of misdiagnosis and missed diagnosis should be considered. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Objective To evaluate the values of magnetic resonance imaging (MRI) in the diagnosis of acetabular labral tears (ALT) by meta-analysis. Methods The studies concerning the diagnosis of ALT tears by using MRI from January 1990 to October 2016 were searched in the databases such as CBM, VIP, WanFang Data, CNKI, PubMed, EMbase, The Cochrane Library and Web of Science. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by using the QUADAS-2 tool. Then, meta-analysis was performed by using Stata 12.0 software. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (–LR) and the diagnostic odds ratio (DOR) were calculated, and the summary receiver operating characteristic curve (SROC) was drawn and the area under the carve was calculated. Results A total of 25 studies from 21 articles were included, involving 1 123 hips from 1 099 patients. The results of meta-analysis showed that, the pooled Sen, Spe, +LR, –LR, DOR and area under SROC curve of MRI for diagnosing ALT were 0.66 (95% CI 0.38 to 0.86), 0.72 (95% CI 0.47 to 0.89), 2.37 (95% CI 1.18 to 4.67), 0.48 (95% CI 0.25 to 0.92), 4.97 (95% CI 1.60 to 15.47), 0.75 (95% CI 0.71 to 0.79). The pooled Sen, Spe, +LR, –LR, DOR and area under SROC curve of MRA for diagnosing ALT were 0.86 (95% CI 0.80 to 0.90), 0.71 (95% CI 0.55 to 0.83), 2.91 (95% CI 1.77 to 4.80), 0.20 (95% CI 0.13 to 0.32), 14.44 (95% CI 5.80 to 35.95), 0.87 (95% CI 0.84 to 0.90), respectively. Conclusion MRI is efficiency diagnostic method for acetabular labral tears.
ObjectiveTo investigate the clinical features of Hirayama disease (HD). MethodsWe analyzed the clinical manifestations and assistant examination results of one patient with HD diagnosed in November, 2010. In addition, we reviewed the related literatures. ResultsThe patient was a young man, and the main symptoms were bilateral hand weakness with muscular atrophy. The muscle bundles trembled when he stretched his fingers. The electromyography showed neurogenic damage of both the thenar muscles and the first interosseous muscles. Brain magnetic resonance imaging (MRI) showed normal; cervical spine flexion MRI showed thinning cervical spinal cord with spinal canal narrowing at C5-C7 plane. In addition, epidural fat gap widened at C4-T1 plane, and enhanced scan showed cord-like changes, patchy strengthening and blood flow void shadow. ConclusionWhen asymmetric distal upper limb muscle weakness with muscle atrophy appears in adolescents, HD should be considered. The combination of neuroelectrophysiological examination and cervical spine flexion MRI scan is helpful for diagnosis. Wearing cervical collar may slow disease progression.
Objective To evaluate the sensitivity， specificity, and accuracy of magnetic resonance imaging （MRI） in characterizing adnexal masses. Methods The databases such as the Cochrane Library, PubMed， EMbase， CNKI， and WanFang Data were searched on computer from 1991 to 2011. The reviewers screened the trials according to inclusion and exclusion criteria strictly, extracted the data， and assessed the methodology quality. Meta-analysis were performed using the Metadisc 1.40 software. The acquired pooled sensitivity, specificity， and summary receiver operating characteristic curve （SROC） were used to describe the diagnostic value. The pooled likelihood ratios were calculated based on the pooled sensitivity and specificity. Results Ten case-control studies involving 649 women who were suspected to have pelvic masses were included and 729 masses were confirmed by the postoperative histopathology. The pooled statistical results of meta-analysis showed that：the sensitivity and specificity of MRI were 〔89%（84%-92%）， P=0.046 6〕 and 〔87% （83%-90%）， P=0.000 2〕 respectively, the positive and negative likelihood ratios of MRI were 6.25（P=0.008 5） and 0.14（P=0.029 1） respectively, and the area under the SROC curve （AUC） was 0.941. The sensitivity and specificity of ultrasound were 〔87%（82%-91%）， P=0.000 0〕 and 〔73%（69%-77%）, P=0.000 0〕 respectively, the positive and negative likelihood ratios of MRI were 3.07（P=0.000 0） and 0.18（P=0.000 1） respectively， and the AUC was 0.897. The speci?city and accuracy of MRI in characterizing female pelvic masses were higher than ultrasound obviously. Conclusion According these evidences， the MRI should be recommended to the women who are suspected to have pelvic masses as a preferred.
Objective To determine the safety of the fetal olfactory ensheathing cell(OEC) transplantation in patients with chronic spinal cord injury (SCI) by examination of the magnetic resonance imaging (MRI). Methods A prospective clinical study involving 16 patients with chronic SCI was designed to investigate the feasibility and biological safety of the fetal OEC transplantation in treatment of SCI. The olfactory bulbs from the 3-4-month-old aborted human fetuses following the strict ethical guidelines were harvested and trypsinized down to single fetal OEC. These cells were then cultured for 12-17 days and were prepared for a clinical use. From November 2001 to December 2002, 16 patients with chronic SCI were randomly enrolled. The patients suffered from SCI for1.5-8 years (average 4-3 years) after the injury. The suspension (50 μl) containing about 1×106 fetal OECs was transplanted by an injection into the patients’ spinal cords above and below the injury site. All the patients were assessed before thetransplantation and were followed up with MRI for 29-42 months (average 38 mon)after the transplantation. Results No cell-related adverse effects were observed in any patient during the followup period. The follow-up with MRI did not reveal any development of optic glial tumor, tumor-like mass, new hemorrhage,edema, expanding cyst, new cyst formation, infection or disruption of the neuralstructure in the transplant site of all the patients. Conclusion This is the first clinical study demonstrating the long-term safety of theOEC therapy for SCI. The results indicate that our protocol is feasible and safe in treatment of patients with chronic SCI within 38 months after the injury. Although the size of the samples for our study was not big enough, the positive results of the study have encouraged us to make a further research in this field.
ObjectiveTo conduct a meta-analysis comparing the accuracy of artificial intelligence (AI)-assisted diagnostic systems based on 18F-fluorodeoxyglucose PET/CT (18F-FDG PET/CT) and structural MRI (sMRI) in the diagnosis of Alzheimer's disease (AD). MethodsOriginal studies dedicated to the development or validation of AI-assisted diagnostic systems based on 18F-FDG PET/CT or sMRI for AD diagnosis were retrieved from the Web of Science, PubMed, and Embase databases. Studies meeting the inclusion criteria were collected, and the risk of bias and clinical applicability of the included studies were assessed using the PROBAST checklist. The pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve (AUC) were calculated using a bivariate random-effects model. ResultsTwenty-six studies met the inclusion criteria, yielding a total of 38 2×2 contingency tables related to diagnostic performance. Specifically, 24 contingency tables were based on 18F-FDG PET/CT to distinguish AD patients from normal cognitive (NC) controls, and 14 contingency tables were based on sMRI for the same purpose. The meta-analysis results showed that for 18F-FDG PET/CT, the AI-assisted diagnostic systems had a pooled sensitivity, specificity, and SROC-AUC of 89% (95%CI 88% to 91%), 93% (95%CI 91% to 94%), and 0.96 (95%CI 0.93 to 0.97), respectively. For sMRI, the AI-assisted diagnostic systems had a pooled sensitivity, specificity, and SROC-AUC of 88% (95%CI 85% to 90%), 90% (95%CI 87% to 92%), and 0.94 (95%CI 0.92 to 0.96), respectively. ConclusionAI-assisted diagnostic systems based on either 18F-FDG PET/CT or sMRI demonstrated similar performance in the diagnosis of AD, with both showing high accuracy.
ObjectiveTo investigate the role of amygdala volume index(AVI) in surgcial evaluation in patients with mesial temporal lobe epilepsy (mTLE), including clinical features, etiologies and surgical outcome. MethodsThirty six patients were diagnosed as mTLE after surgical evaluation including clinical manifestations, video-electroencephalogram (VEEG) and magnetic resonance imaging (MRI) at the Second Affiliated Hospital of Zhejiang University between March 2013 and March 2016. Bilateral amygdala AVI was then calculated from amygdala volumes on MRI, which were measured with region of interest (ROI) analysis. All patients were treated surgically. Etiologies of mTLE were further confirmed by the histopathology of the resected tissue. ResultsAmong the 35 patients, there is a strong correlation between AVI on the lesion side and age of onset (R =-0.389, P = 0.019) as well as age of surgery (R =-0.357, P = 0.032). No obvious relation can be seen between AVI and gender, history of febrile convulsion, duration of epilepsy, secondary generalized seizure, side of lesion, presurgical seizure frequency and electrode implantation. There is no significant difference in AVI among the five etiologies. At follow-up, thirty patients (80.5%) reached seizure-free, AVI on the lesion side is nota predictor of surgical failure (P > 0.05). ConclusionAVI plays a role in etiology evaluation in patients with mesial temporal lobe epilepsy. Moreover, a larger AVI on the lesion side is correlated with an earlier age of onset. There is limited value of amygdala volume insurgical outcome prediction of patients with mTLE.
Objective To investigate the effects on myocardial perfusion of simultaneous antegrade/retrograde cardiopiegia （SARC） through a single coronary artery and coronary sinus （CS）. Methods SARC was conducted in isolated pig hearts through CS in conjunction with the left anterior descending （LAD）, the left circumflex （LCX）, or the right coronary artery （RCA） respectively. After injecting magnetic resonance （MR） contrast agent （gadolinium diethyienetriamine pentaacetic acid, Gd-DTPA） into arterial or venous route, the distribution of Gd-DTPA with magnetic resonance imaging（MRI） was monitored and the effluent from the venting coronary arteries to assess the efficacy of SARC for myocardial perfusion was measured. Results Injection of Gd-DTPA into a perfusing artery during SARC resulted in increased signal intensity not only in the territory of the perfusing artery but also in the areas normally served by the other two venting coronary arteries （including the right ventrieuiar free wall）. With Gd DTPA given into the CS during SARC, the myocardium in the territories of the two venting coronary arteries was lightened. Signal intensity of the myocardium in the perfusing artery territory and right ventricuiar free wall remained unchanged. Moreover, a significant amount of effluent was collected from the venting coronary arteries during SARC： the LAD 10.5-17.7 ml/min; LCX 9.7-15.2 ml/min, and RCA 4.7-7.8 ml/min. Conclusion SARC through a single coronary artery and CS can provide homogeneous perfusion to the entire heart and is sufficient to prevent ischemic injury in the myocardium normally supported by the venting coronary arteries.