Abstract:Objective To construct a diagnostic model for benign and malignant differentiation of thyroid imaging reporting and data system(TI-RADS)category 4 thyroid nodules based on sonographic features combined with clinical features,and to verify its differential diagnostic value.Methods A total of 112 patients with TI-RADS category 4 thyroid nodules were selected as the training set,and divided into the malignant nodule group(n=66)and benign nodule group(n=46)based on pathological results.According to a 7∶3 ratio,another 48 patients with TI-RADS category 4 thyroid nodules were enrolled as the validation set,including 30 cases of malignant nodules and 18 cases of benign nodules.Clinical data,in terms of sex,age,body mass in-dex(BMI),smoking,drinking,clinical manifestations,thyroid stimulating hormone(TSH),thyroglobulin(TG),TSH/TG,thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb),serum adiponectin(ADPN),and ultrasound features,such as,structure,number,echogenicity,echo texture,shape,margin,presence of calcification,aspect ratio,Adler blood flow grading,ultrasonic elastography score,enhancement intensity,enhancement pattern,enhancement uniformity,and pres-ence of peripheral rim enhancement of the lesion,were compared between the malignant and benign nodule groups in the training set.The LASSO algorithm was used to screen variables with non-zero coefficient features affecting the benign and malignant na-ture of TI-RADS category 4 thyroid nodules.Logistic regression model was applied to analyze the influencing factors of malig-nancy in TI-RADS category 4 thyroid nodules and to evaluate the diagnostic efficacy of the model.Three models,i.e.,clinical feature model,sonographic features model,and combined model,were established based on clinical data and ultrasound fea-tures.The predictive efficacy of the models was assessed using receiver operating characteristic(ROC)curves,calibration curves,and clinical decision curves.Results In the training set,statistically significant differences were observed between the malignant and benign nodule groups in TSH,TG,TSH/TG,TgAb,TPOAb,ADPN,lesion shape,Adler blood flow grading,elastography score,enhancement intensity,enhancement pattern,and peripheral annular enhancement(all P<0.05).The LASSO algorithm screened out 11 most relevant characteristic variables with non-zero coefficients,including 6 clinical feature variables,including TSH,TG,TSH/TG,TgAb,TPOAb,ADPN and 5 ultrasound feature variables,including lesion shape,Adler blood flow grading,elastography score,enhancement pattern,peripheral annular enhancement.Logistic regression analy-sis showed that all 11 variables were independent influencing factors for malignancy in TI-RADS category 4 thyroid nodules(all P<0.05).The clinical feature model,sonographic features model,and combined model were constructed using these variables,and significant differences were found in the model scores between the malignant and benign nodule groups(all P<0.05).ROC curve analysis revealed that the area under the curve(AUC)of the combined model was higher than that of the clinical feature model and sonographic features model in both the training and validation sets.Calibration curves demonstrated high predictive ac-curacy of the combined model.Clinical decision curve analysis indicated that the combined model was superior to the other two models in terms of safety,net benefit,and clinical practicality.Conclusion A diagnostic model for benign and malignant dif-ferentiation of TI-RADS category 4 thyroid nodules based on sonographic features and clinical features is successfully con-structed,which has high clinical differential diagnostic value.

Abstract:Objective The CT and pathological features of mesenteric inflammatory myofibroblastoma(IMT)in children were analyzed to improve its diagnosis.Methods The clinical data and CT findings of 9 children with mesenteric IMT con-firmed by surgery and pathology were selected.Results In 9 children,there were 8 cases with solitary lesions and 1 case with multiple lesions.The maximum diameter of the tumor ranged from 5.0 to 11.1 cm.On plain scan CT,the lesions were lobed in 8 cases,and heterogeneous solid density in 7 cases.The lesions all showed asymptotic enhancement,with 8 cases showing signifi-cant enhancement;1 case showed mostly cystic degeneration and the remaining solid part showed mild to moderate enhancement.In the arterial phase,8 lesions were supplied by mesenteric arteries,and the"umbilical concave sign","vascular pedicle sign",and focal nodular obvious enhancement were observed.6 cases showed spoke wheel-like enhancement from the center to the pe-riphery.There were enlarged mesenteric lymph nodes in 8 cases,and unclear boundaries in 5 cases.Histologically,the tumor consisted of differentiated myofibroblastic spindle cells with interstitial inflammatory cell infiltration.Immunohistochemistry showed that 8 cases were SMA(+),7 cases were Vimentin(+),and 7 cases wereALK(+).Conclusion The features of IMT enhancement,such as progressive enhancement pattern,the umbilical concave sign,vascular pedicle sign,and obvious focal enhancement,combined with immunomarkers can effectively differentiate from other mesenteric tumors.

Abstract:Objective To explore the relationship between hepatic fat fraction(HFF),abdominal fat volume,and carotid ar-tery plaque by using the technology namely iterative decomposition of water and fat with echo asymmetry and the least squares es-timation quantification sequence(IDEAL-IQ)to measure the HFF and the volume of abdominal fat in patients suffering from non-alcoholic fatty liver disease(NAFLD).Methods 98 patients with NAFLD were divided into the normal carotid artery group(n=53),the intima-media thickening group(n=13),and the plaque group(n=32)according to the results of carotid ultrasound examination.MRI IDEAL-IQ scans of the upper abdominal were performed to measure the HFF of liver segments(S1-S8),the volume of visceral adipose tissue(VAT),and subcutaneous adipose tissue(SAT)at L1-L2 intervertebral space.Clinical data,liver function,and other laboratory test results were collected.The differences in clinical data,HFF,VAT volume,SAT vol-ume,total fat(VAT+SAT)volume,and related fat ratio were compared between the three groups.Logistic regression analysis was conducted to identify the risk factors for carotid atherosclerosis in NAFLD patients.Results The comparison of clinical data of the three groups showed that there were statistically significant differences in age,TG,and ALT(P<0.05).The compari-son of image data among the three groups showed that S2-HFF and HFF/SAT volume in the carotid intima-media thickening group were lower than those in the normal carotid artery group(P<0.05).Age(OR=1.141,95%CI:1.081～1.203,P<0.001)and ALT(OR=0.979,95%CI:0.959～1.000,P<0.05)were independent risk factors for carotid atherosclerosis in NAFLD pa-tients.Conclusion The S2-HFF and HFF/SAT volume measured quantitatively by IDEAL-IQ were different in NAFLD pa-tients with carotid atherosclerosis,and the values were relatively low in the intima-media thickening group that might be associ-ated with early atherosclerosis.

Abstract:Objective To investigate the characteristics of shear wave elastography(SWE)and the difference of exo-somal annexin A6(ANXA6)mRNA expression in patients with breast cancer and its clinical value in predicting prognosis.Methods A total of 240 patients with breast cancer were selected.According to the results of immunohistochemical staining,they were assigned into 90 cases of Luminal A type,76 cases of Luminal B type,33 cases of HER-2 overexpression type and 41 cases of TNBC type.All patients received SWE examination after admission,and the relative expression of ANXA6 mRNA in breast cancer tissues was detected.The patients were followed up regularly,according to the prognosis,they were divided into patients with good prognosis and poor prognosis.The quantitative parameters of SWE and the expression of ANXA6 mRNA in pa-tients with different molecular subtypes of breast cancer were compared.By the end of follow-up,the prognosis and survival of breast cancer patients were counted.The clinicopathological data,SWE quantitative parameters and ANXA6 mRNA expression in tumor tissues of patients with different prognosis were compared.Logistic regression equation was used to analyze the influenc-ing factors of breast cancer patients.ROC was used to analyze the prognostic value of SWE quantitative parameters and ANXA6 mRNA in breast cancer patients.Results Compared with HER-2 overexpression type,Luminal B type and Luminal A type,Emax,Emean,and Emin of TNBC type were higher,and ANXA6 mRNA was lower(P<0.05).By the end of follow-up,the overall survival rate of breast cancer patients was 74.35%,and the overall survival rate of TNBC was 48.78%.There were significant dif-ferences in tumor stage,lymph node metastasis,Emax,Emean,Emin and ANXA6 mRNA expression in patients with different progno-sis(all P<0.05).Logistic regression analysis showed that ANXA6 mRNA,Emax,Emean,and Emin were still the prognostic factors of breast cancer patients after adjusting for tumor stage and lymph node metastasis(all P<0.05).The ROC curve showed that the area under the curve(AUC)of Emax,Emean,Emin and ANXA6 mRNA in predicting the prognosis of breast cancer patients was 0.872(95%CI:0.734-0.947),which was higher than that of single prediction(P<0.05).Conclusion The quantitative param-eters of SWE and ANXA6 mRNA are abnormal in patients with TNBC breast cancer,both of which are the influencing factors of poor prognosis of breast cancer.The combined detection has certain predictive value for poor prognosis,which can be used as an auxiliary scheme for clinical judgment of pathological types and prediction of prognosis,which can guide clinical work.

Abstract:Endometriosis,polycystic ovary syndrome,uterine fibroids,etc.are common benign gynecological diseases in clinical practice.Traditional diagnostic methods,including conventional ultrasound,CT,and MRI have limited ability to detect early or microscopic lesions,as well as their restricted reflection of lesion functional status,metabolic activity,and molecular characteristics,results in limited specificity for differential diagnosis,disease activity assessment,and efficacy monitoring.Mo-lecular imaging plays a significant role in the diagnosis of benign gynecological diseases.This article aims to systematically re-view the latest applications of nuclear medicine imaging,magnetic resonance molecular imaging,fluorescence imaging,and ul-trasound molecular imaging in benign gynecological diseases,providing a theoretical foundation for further in-depth research.

Abstract:Pericoronary adipose tissue(PCAT)is located around the coronary arteries,adjacent to the adventitia,and exhib-its a bidirectional interaction mechanism with the coronary arterial wall.PCAT can secrete bioactive chemicals through paracrine and endocrine pathways,mediating immune-inflammatory responses in the coronary arteries.Under physiological conditions,PCAT exerts a protective effect on the coronary arteries;however,in pathological states,it contributes to the development of coronary artery disease.Conversely,when coronary arteries become diseased,they also influence PCAT by releasing inflamma-tory factors.Imaging features of PCAT derived from coronary computed tomography angiography(CCTA)demonstrate unique value in predicting vulnerable plaques and plaque progression,assessing hemodynamic changes in diseased vessels,evaluating the occurrence and development of acute coronary syndromes,prognosticating coronary heart disease,and identifying in-stent re-stenosis,which can offer new insights for optimizing the identification and risk stratification of the condition.

Abstract:Periosteal osteosarcoma is a moderately malignant chondroblastic osteosarcoma originating from the surface connec-tive tissue or periosteum of bone,also referred to as parosteal chondroblastic osteosarcoma.It is clinically rare and seldom occurs in the jaw.This article reports a case of pathologically confirmed periosteal osteosarcoma of the mandible.CT revealed a soft tis-sue nodule adjacent to the right side of the mandibular body with inhomogeneous rim enhancement on post-contrast images,while the adjacent mandibular bone showed no osseous destruction.On MRI,the lesion exhibited low signal intensity on T1-weighted images and high signal intensity on T2-weighted images.No abnormal signal intensity was observed within the adjacent mandibular medullary cavity.18F-FDG PET/CT imaging demonstrated high metabolic activity in the solid components of the tu-mor.These imaging findings are of significance for improving the understanding of this disease.

Abstract:Objective To investigate the relationship between shear wave elastography(SWE),contrast-enhanced ultra-sound(CEUS),and color Doppler flow imaging(CDFI)parameters and the histological grade of breast cancer as well as lymph node metastasis.Methods A total of 96 patients with breast cancer(malignant group)and 96 patients with benign breast nod-ules(benign group)were selected,and all underwent SWE,CEUS and CDFI examinations.All of them underwent SWE,CEUS and CDFI.The parameters of SWE,CEUS and CDFI in patients with different pathological characteristics in the malignant group,the benign group and the malignant group were analyzed,and the correlation between SWE,CEUS and CDFI parameters and pathological characteristics was analyzed.Results The Emin,Emean,Emax,AUC,PI,PSV and RI in the malignant group were higher than those in the benign group,and the TTP was lower than that in the benign group(all P<0.05).There were signifi-cant differences(all P<0.05)in Emin,Emean,Emax,AUC,PI,PSV,RI,and TTP among patients with different histological grades and lymph node metastasis.As the histological grade increased and lymph node metastasis occurred,Emin,Emean,Emax,AUC,PI,PSV,and RI showed an increasing trend,while,TTP showed a decreasing trend(all P<0.05).Emin,Emean,Emax,AUC,PI,PSV and RI were significantly positively correlated with histological grade and lymph node metastasis,while,TTP was significantly negatively correlated with histological grade and lymph node metastasis(all P<0.05).Conclusion The change of SWE,CEUS,CDFI parameters of breast cancer is closely related to histological grade and lymph node metastasis.

Abstract:Objective To explore the utility of CT radiomics in assessing acute traumatic bone marrow edema in the knee.Methods A total of 86 patients with acute traumatic bone marrow edema were enrolled,and all underwent non-contrast CT scans of the knee.In this paired-design study,the knees with traumatic bone marrow edema on the affected side taken as the ob-servation group provided radiomic signatures of bone marrow edema lesions,whereas,the contralateral healthy knees served as controls to establish normative imaging baselines,effectively controlling for inter-individual anatomical and physiological con-founders.The 3D-Slicer software was utilized to delineate the region of interest(ROI)on both axial and coronal CT images of the bone marrow edema area and the contralateral healthy side.Texture features were extracted in bulk using a radiomics texture ex-tractor programmed in Python.The 86 patients with acute traumatic bone marrow edema were divided into a training set(n=60)and a validation set(n=26)in a ratio of 7∶3.Following this,a multivariate Logistic regression model was constructed using the validation set,after performing an independent sample t-test,Mann-Whitney U test,and employing CT image texture parameter reduction with LASSO regression.Results For each knee,1595 feature parameters were acquired.Following dimension reduc-tion,18 axial parameters and 16 coronal parameters were chosen.In the training set,the multivariate Logistic regression model exhibited an ROC area under the curve(AUC)of 0.91 and 0.84,with predictive accuracies of 82.0%and 79.0%,sensitivities of 82.0%and 81.0%,specificities of 82.0%and 77.0%,positive predictive values of 82.0%and 78.0%,and negative predictive values of 82.0%and 80.0%,respectively.Additionally,the ROC AUC for the model in the training set was 0.76 and 0.72,pre-diction accuracies were 72.0%and 71.0%,sensitivities were 75.0%and 69.0%,specificities were 68.0%and 73.0%,positive predictive values were 70.0%and 72.0%,and negative predictive values were 73.0%and 70.0%,respectively.Conclusion CT-based radiomics can be applied in knee joint trauma and demonstrates good diagnostic value for acute traumatic bone marrow edema,with the axial model being superior.This holds promise as a potential tool for auxiliary diagnosis.

Abstract:Objective To analyze the value of magnetic resonance(MR)half-Fourier acquisition single-shot fast spin echo(HASTE)sequence scanning combined with serum silent information regulator 1(SIRT1)in the differential diagnosis of medias-tinal hilar lymph nodes.Methods A total of 120 patients(149 lymph nodes)who underwent mediastinal and hilar MRI were selected as the modeling set.Additionally,51 patients(65 lymph nodes)who underwent MR examinations of the mediastinum and hilar region were selected as the external validation dataset.The clinical pathological results of the 120 patients were statisti-cally analyzed to compare the MR manifestations and serum SIRT1 levels of lymph nodes with different properties.LOO Oogistic regression models were used to analyze the influencing factors of lymph node malignancy.ROC curves were employed to evaluate the diagnostic value of MR manifestations and serum SIRT1 levels for lymph node properties individually and in combination.The consistency between the diagnostic results of the combined diagnostic model and the clinical pathological results was ana-lyzed using the Kappa value.Results A total of 149 lymph nodes were detected in 120 patients.Pathological examination showed 104(69.80%)malignant lymph node metastases and 45(30.20%)benign lesions.The short diameter of malignant lymph nodes(13.48±2.01)mm was larger than that of benign lymph nodes(9.16±2.74)mm.The proportions of high signal in-tensity on DWI,high signal intensity on T2-weighted imaging(T2WI),and low signal intensity on T1-weighted imaging(T1WI)were 80.77%,75.00%,and 76.92%,respectively,which were higher than those in benign lymph nodes(60.00%,51.11%,and 46.67%).The serum SIRT1 level(4.98±1.65)ng/mL was lower than that in benign lymph nodes(8.04±2.66)ng/mL,and the differences were statistically significant(all P<0.05).The results of logistic regression model analysis showed that short diam-eter,high signal intensity on DWI,high signal intensity on T2WI,and low signal intensity on T1WI were risk factors for malig-nant lymph node lesions,while elevated SIRT1 was a protective factor(all P<0.05).ROC analysis showed that the area under the curve(AUC)of short diameter,high signal intensity on DWI,high signal intensity on T2WI,low signal intensity on T1WI,and SIRT1 for diagnosing lymph node properties ranged from 0.604 to 0.744.The AUC of combined diagnosis using these vari-ables was 0.891,significantly higher than that of single variable diagnosis.Consistency analysis showed that the diagnostic re-sults of the combined diagnosis model had a concordance rate of 92.31%with clinical pathological results,with a Kappa value of 0.797.Conclusion MR HASTE sequence combined with serum SIRT1 has good consistency with clinicopathological results in the diagnosis of mediastinal hilar lymph nodes,which can be used as an effective scheme for clinical diagnosis,so as to guide individualized intervention.

Abstract:Objective To explore the predictive accuracy of non-sentinel lymph node metastasis(NSLN)in patients with sentinel lymph node(SLN)-positive triple-negative breast cancer(TNBC)by combining ultrasound features and clinicopathologi-cal features.Methods A total of 140 SLN-positive TNBC patients were divided into metastatic group(n=44)and non-metastatic group(n=96)according to whether the patients had NSLN metastasis.The ultrasound characteristics and clinicopatho-logical characteristics of two groups were compared.Logistic regression analysis was performed to identify the influencing factors of NSLN metastasis in SLN-positive TNBC patients.ROC curve analysis was used to analyze the predictive performance of ultra-sound features combined with clinicopathological features on NSLN metastasis in SLN-positive TNBC patients.Results The proportion of tumor size≥2 cm,burr sign,blood flow grade Ⅱ-Ⅲ,T2 stage and SLN positive number>the metastasis group were higher than those in the non-metastasis group(all P<0.05).The results of multivariate logistic regression analysis showed that the spur sign,blood flow grade Ⅱ-Ⅲ,and the number of SLN-positive>2 were independent risk factors for NSLN metasta-sis in patients with SLN-positive TNBC(all P<0.05,OR>1).The results of ROC analysis showed that the AUC of burr sign,blood flow grade and number of SLN positive in predicting NSLN metastasis alone and in combination were 0.734,0.716,0.749 and 0.876,respectively.The prediction performance of the three joint tests was higher than that of the individual tests(Z=2.547,3.012,2.448,all P<0.05).Conclusion Ultrasonography is closely related to the number of spurs,blood flow grade Ⅱ-Ⅲ,and the number of positive SLNs>2,which are closely related to NSLN metastasis,and the combination of the three can help im-prove the predictive performance of NSLN.

Abstract:Objective To investigate the clinical and imaging characteristics of intracranial lesions caused by IgG4-related middle ear disease(IgG4-related disease,IgG4-RD),in order to provide evidence for early and precise intervention and to re-duce complications.Methods A retrospective analysis was performed on three cases of intracranial involvement secondary to IgG4-RD of the ear.All cases met established diagnostic criteria and were confirmed through clinical manifestations and histopa-thology.Each patient underwent routine temporal bone CT and middle ear/cranial MRI with DWI sequences.Imaging findings were compared with clinical features.Results All three patients presented with hearing loss in the affected ear(ranging from moderate to profound),accompanied by otalgia and headache.Temporal bone imaging findings were as follows:CT demon-strated diffuse soft-tissue-density opacification within the middle ear cavity.Mild osseous erosion with poorly defined margins was observed in the vestibule and semicircular canal regions.The extent of involvement and imaging characteristics differed markedly from those of cholesteatoma.MRI revealed abnormal soft-tissue signals in the tympanic cavity and mastoid.Lesions showed high signal intensity on T1-weighted images and variable signal intensity on T2-weighted images(either high or relatively low).Contrast-enhanced MRI demonstrated marked enhancement,either homogeneous or heterogeneous.DWI showed relatively high signal intensity(cholesteatoma typically demonstrates markedly high signal),while,ADC values were similar to adjacent nor-mal brain tissue(cholesteatoma exhibits significantly reduced ADC).Intracranial MRI findings included diffuse meningeal thick-ening,peripheral or ring enhancement distinct from cholesteatoma-related brain abscess,and diffuse cerebral parenchymal swelling.Conclusion Patients with intracranial lesions secondary to middle ear IgG4-RD commonly present with moderate to profound hearing loss and headache.Characteristic imaging findings include focal osseous destruction of the temporal bone with ground-glass-like margins on CT.MRI features inflammatory soft-tissue changes,with DWI showing relatively high signal.Intra-cranial MRI demonstrates diffuse inflammatory changes with peripheral lesion enhancement.

Abstract:Objective To explore the diagnostic value of musculoskeletal high-frequency ultrasonography combined with MRI in traumatic superficial soft tissue injuries.Methods A total of 97 patients with suspected traumatic superficial soft tissue injuries were enrolled.Pathological examination confirmed traumatic superficial soft tissue injuries were 86 cases,Non-traumatic superficial soft tissue injuries were 11 cases.All patients underwent musculoskeletal high-frequency ultrasound and MRI exami-nations.The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of musculoskeletal high-frequency ultrasound and MRI examinations for diagnosing traumatic superficial soft tissue injuries were analyzed.Then,we com-pared the diagnostic concordance rates between two examination methods for different types of traumatic superficial soft tissue in-juries and analyzed the diagnostic efficacy of high-frequency musculoskeletal ultrasound combined with MRI.Results The sen-sitivity of high-frequency musculoskeletal ultrasound examination is 77.91%,specificity is 54.55%,accuracy is 75.26%,posi-tive predictive value is 93.06%,and negative predictive value is 24.00%.The sensitivity of MRI examination is 80.23%,speci-ficity is 45.45%,accuracy is 76.29%,positive predictive value is 92.00%,and negative predictive value is 22.73%.The accu-racy of combined musculoskeletal high-frequency ultrasound and MRI is 90.72%,higher than that of either modality alone.The negative predictive value and sensitivity of combined musculoskeletal high-frequency ultrasound and MRI diagnosis are superior to those of either modality alone(both P<0.05).Conclusion High-frequency musculoskeletal ultrasound combined with MRI demonstrates high diagnostic value for traumatic superficial soft tissue injuries.Among these,MRI exhibits a higher diagnostic concordance rate for cystic mass types compared to high-frequency musculoskeletal ultrasound.

Abstract:Objective To develop a recognition and classification system for developmental dysplasia of the hip(DDH)based on AI algorithms.Methods A total of 541 hip radiographs were collected,and 529 radiographs were finally included and divided into normal radiographs and DDH radiographs.DDH radiographs were divided into types Ⅰ,Ⅱ,and Ⅲ according to Hartofilakidis classification.A new classification framework of DDH was designed,and DDH was diagnosed and classified by DL model training and X-ray recognition.At the same time,a new method for the diagnosis of type Ⅲ by locating key points was defined.The trained model was used for test set evaluation,and the probability value of each image classification result was given.Finally,six models were selected for training and the performance was evaluated on the test set to find the best fit.Results For the classification of normal and DDH,the specificity,sensitivity,positive predictive value and negative predictive value of DenseNet in the test set were 98.7％,97.8％,98.7％and 97.8％,respectively.The specificity,sensitivity,positive pre-dictive value and negative predictive value of DDH Ⅲ were 90.0％,87.0％,89.7％and 87.4％,respectively.For DDH Ⅰ and Ⅱ,the specificity,sensitivity,positive predictive value and negative predictive value were 90.4％,86.7％,90％and 87.1％,respectively.Conclusion The AI algorithm can diagnose DDH and classify it with high accuracy by identifying hip X-ray films,which can reach the level of professional doctors.

Abstract:Objective To investigate the SPECT imaging changes of the radionuclide 99mTc-labeled cyclic nonapeptide CGRRAGGSC(99mTc-DTPA-CGRRAGGSC)in nude mice bearing human non-small cell lung cancer A549 cells.Methods 99mTc-DTPA-CGRRAGGSC was prepared using the stannous chloride reduction method.The radiochemical purity and stability of the labeled product in PBS and serum were determined by high performance liquid chromatography(HPLC).The binding ability of the labeled product to A549 cells in vitro was assessed by chemical fluorescence receptor binding localization assay and binding competition inhibition assay.A549 cells were subcutaneously implanted to establish a tumor-bearing nude mouse model.The labeled product was injected via the tail vein,and the mice were sacrificed at 0.5,1.0,2.0,4.0,6.0,and 8.0 h post-injection.Tissues including brain,heart,liver,lung,kidney,muscle,bone,and tumor were collected for radioactivity counting.The percentage of injected dose per gram of tissue(％ID/g)was calculated to observe the biodistribution of the labeled product in tumor-bearing nude mice.SPECT imaging was performed to visualize the labeled product in nude mice,and the target-to-nontarget ratio(T/NT)of mean radioactivity in the tumor region versus the contralateral symmetric non-target region was calcu-lated.Results The radiochemical purity of 99mTc-DTPA-CGRRAGGSC was 96.8％.The radiochemical purity of the labeled product in serum was lower than that in PBS immediately and at 3.0 h after labeling(all P<0.05),while no significant difference was observed between serum and PBS at 6.0 and 12.0 h(all P>0.05).Chemical fluorescence receptor binding localization assay showed that the 99mTc-DTPA-CGRRAGGSC-FITC complex bound to A549 cells exhibited yellow-green fluorescence,but no fluo-rescence was observed when bound to AT Ⅱ cells.Chemical fluorescence receptor binding competition inhibition assay showed that the 99mTc-DTPA-CGRRAGGSC-FITC complex bound to A549 cells exhibited green fluorescence,which weakened after the addition of a competitive inhibitor.The radioactivity in tumor tissue was higher than that in blood,brain,heart,liver,lung,kid-ney,muscle,and bone at 1.0,2.0,4.0,6.0,and 8.0 h after injection(all P<0.05).At 8.0 h post-injection,tumor tissue still maintained high radioactivity,while radioactivity in vital tissues and organs gradually decreased compared to that at 0.5 h(all P<0.05).Throughout SPECT imaging,mild whole-body visualization of tumor-bearing nude mice was observed and gradually faded.At 0.5 h post-injection,the bladder and tumor site were visualized.At 2.0 h post-injection,the tumor site was clearly visualized with distinct boundaries,reaching the most significant visualization at 4.0 h,which persisted until 8.0 h.Bladder visualization gradually faded at 4.0 h.The T/NT ratio first increased and then decreased over time post-injection,with the T/NT at 6.0 h being higher than that at other time points(all P<0.05).Conclusion 99mTc-DTPA-CGRRAGGSC is easy to prepare,exhibits good biological stability,and shows favorable targeting to nude mice bearing human non-small cell lung cancer A549 cells.Its radioac-tivity metabolizes rapidly in non-target areas without obvious abnormal accumulation.

Abstract:Objective To explore the application value of ultrasound autonomous diagnosis system in the diagnosis of ab-dominal effusion.Methods A total of 172 patients with suspected abdominal effusion who underwent abdominal ultrasound ex-amination were selected.Ultrasound examinations were performed by professional sonographers,with the examination video re-cords retained and diagnostic conclusions drawn,serving as the control group.The self-developed ultrasound autonomous diagno-sis system was used to perform autonomous analysis and diagnosis on the retained video data,serving as the study group.Using the diagnostic results of the control group as the standard,the differences and consistency between the study group and the con-trol group in diagnosis were analyzed,along with their diagnostic performance.Results In the control group,51 cases were di-agnosed as negative for abdominal effusion and 121 cases as positive(61 with small amount,60 with moderate to large amount).In the study group,60 cases were diagnosed as negative and 112 cases as positive(54 with small amount,58 with moderate to large amount).The diagnostic consistency of the two groups was good(Kappa=0.756,P<0.01).The study group demonstrated a diagnostic sensitivity of 88.43%,specificity of 90.20%,accuracy of 88.95%,positive predictive value of 95.53%,and negative predictive value of 76.67%.Conclusion The ultrasound autonomous diagnosis system has a high accuracy in diagnosing ab-dominal effusion,which has certain clinical value in the auxiliary diagnosis of abdominal effusion.

Abstract:Objective To investigate the value of multi-modal MRI in the evaluation of precancerous lesions of hepatocellu-lar carcinoma.Methods 171 lesions in 98 patients with liver diseases were selected.107 lesions were diagnosed as malignant and 64 lesions as benign by pathological examination.All patients underwent MRI plain scan,dynamic contrast-enhanced imag-ing(DCE),diffusion weighted imaging(DWI),diffusion kurtosis imaging(DKI),and the apparent diffusion coefficient(ADC),fractional anisotropy(FA),mean diffusion coefficient(MD)and mean kurtosis(MK)were measured.The diagnostic value of multi-modal MRI in precancerous lesions of hepatocellular carcinoma was analyzed.Results Among the 27 precancer-ous lesions,multimodal MRI diagnosed 22 as precancerous and 5 as non-precancerous;among the 144 non-precancerous le-sions,multimodal MRI diagnosed 5 as precancerous and 139 as non-precancerous.The sensitivity,specificity and accuracy of multimodal MRI in the diagnosis of precancerous lesions of liver cancer were 81.48%,96.52%and 94.15%,respectively.Com-pared with cirrhosis,the proportion of round,ADC and MD of precancerous lesions were lower,and the proportion of non-marginal washout and MK were higher(all P<0.05).Compared with malignant nodules,the proportion of circular,edge sharp-ness,ADC,FA and MD of precancerous lesions were lower(all P<0.05).Enhanced pseudocapsule,non-marginal washout and MK were higher(P<0.05).Conclusion The multimodal MRI has certain diagnostic value in precancerous lesions of hepatocel-lular carcinoma.

Abstract:Objective To evaluate the efficacy of musculoskeletal ultrasound(MSK-US)-guided surgical treatment for pain-ful lumbosacral fascial lipomas(fat hernias).Methods A total of 28 patients with painful lumbosacral fascial lipomas were en-rolled.The location of the lesion was identified using MSK-US.Under local anesthesia,a small incision was made,and the herni-ated fat tissue was dissected and excised under ultrasound guidance.Visual Analog Scale(VAS)and Oswestry Disability Index(ODI)were used to assess pain and functional impairment before surgery and 3 days postoperatively.Clinical outcomes were evaluated 1 month after surgery.Results MSK-US revealed discontinuity in the echogenic line of the fascial layer,with fat tis-sue herniating through the fascial defect.Combined with clinical symptoms,MSK-US effectively located the herniated lipoma.Through a small incision,the herniated tissue was completely excised at its base under continuous ultrasound monitoring.Postop-erative symptoms were relieved.VAS and ODI scores significantly decreased compared to preoperative values(all P<0.05).At the 1-month follow-up,23 patients were cured,5 patients were improved,resulting in a cure rate of 82.14%(23/28).Conclu-sion MSK-US-guided treatment for painful lumbosacral fascial lipomas offers the advantages of real-time,dynamic,and visual-ized imaging,allowing for precise localization of the lesion.This approach enables effective symptom relief with minimal inci-sion,highlighting its value in the surgical management of this condition.

Abstract:Objective To investigate the impact of deep learning image reconstruction algorithm(DLIR)on coronary artery calcification score(CACS)quantification and cardiovascular risk classification.Methods A total of 120 patients with sus-pected coronary artery disease underwent coronary CT angiography for CACS assessment.Image reconstruction was performed us-ing four algorithms:the filtered back projection(FBP)algorithm and the low,medium,and high-intensity DLIR(DLIR-L,DLIR-M,and DLIR-H)algorithms.The reconstructed images were analyzed to compare the CT values of the aortic root and its standard deviation(SD),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)and maximum CT value of coronary artery calcification(CAC)plaques.Furthermore,the consistency of cardiovascular event risk classification between the DLIR algo-rithms and the FBP algorithm was evaluated.Results There was no statistically significant difference in the CT values of the aortic root among the four reconstruction algorithms(P>0.05).Compared with the FBP algorithm,as DLIR intensity increased,the SD value and the maximum CT value of the calcification gradually decreased,while,the SNR and the CNR increased(both P<0.05).Pairwise comparisons of SD,SNR,CNR,and maximum CT value of the CAC among the four algorithms showed statisti-cally significant(all P<0.05).Compared with the FBP algorithm,the Agatston scores,calcification volume,and calcification mass progressively decreased with increasing DLIR intensity(all P<0.05).With the exception of the Agatston score comparison between the DLIR-L and DLIR-M and the volume comparison between the FBP and DLIR-L,all other pairwise comparisons of Agatston scores,volume,and mass showed statistically significant(all P<0.05).Compared with the FBP algorithm,the DLIR-L algorithm misclassified 5 cases,the DLIR-M algorithm misclassified 10 cases,and the DLIR-H algorithm misclassified 10 cases.Conclusion Compared with the FBP algorithm,the DLIR algorithm progressively improves image quality as the inten-sity increases but underestimates the Agatston scores,calcification volume,and calcification mass,which may result in a lower risk class for cardiovascular events.Therefore,the DLIR algorithm should be used with caution in the quantitative assessment of CACS in the clinical setting.