Abstract:Objective To explore the diagnostic value of diffusion weighted imaging(DWI)combined with CT perfusion im-aging(CTP)in ischemic cerebrovascular disease.Methods 108 patients with ischemic cerebrovascular disease(observation group)and 67 patients with non-ischemic cerebrovascular disease(control group)were selected and confirmed by digital sub-traction angiography(DSA).On the next day after admission,the subjects underwent DWI and CTP examinations,and the ap-parent diffusion coefficient(ADC),relative ADC(rADC),cerebral blood volume(CBV),cerebral blood flow(CBF),peak time(TTP),and mean transit time(MTT)of DWI parameters were obtained.With DSA as the gold standard,Kappa test was used to analyze the consistency of DWI,CTP and DSA in diagnosing ischemic cerebrovascular disease.Receiver operating char-acteristic(ROC)curve was used to analyze the diagnostic efficacy of DWI and CTP alone and in combination with ischemic cere-brovascular disease.Results ADC,rADC and CBV and CBF of CTP parameters in observation group were lower than those in control group,and TTP and MTT of CTP parameters were higher than those in control group(all P<0.05).The diagnosis of isch-emic cerebrovascular disease by DWI and CTP alone was consistent with that by DSA(Kappa value was 0.751 and 0.747,re-spectively),while,the diagnosis of ischemic cerebrovascular disease by DWI combined with CTP was consistent with that by DSA(Kappa value=0.904).ROC curve analysis showed that the AUC of DWI and CTP alone in the diagnosis of ischemic cere-brovascular disease was 0.865 and 0.856,respectively;the AUC of DWI and CTP combined in the diagnosis of ischemic cerebro-vascular disease was 0.957,and the AUC of DWI and CTP combined in the diagnosis of ischemic cerebrovascular disease was significantly higher than that of DWI and CTP alone(Z were 2.447 and 2.625,respectively,all P<0.05).Conclusion Both DWI and CTP have a certain diagnostic value in ischemic cerebrovascular disease,and the combined value is higher.

Abstract:Sudden sensorineural hearing loss(SSNHL)is an abrupt disorder of the inner ear,typically presenting as a rapid and sudden decline in hearing,with generally poor treatment outcomes.Resting-state functional magnetic resonance imaging(rs-fMRI)is a technique that reflects spontaneous neuronal activity by detecting blood oxygenation level-dependent signals in the brain.It is characterized by its non-invasive nature and reproducibility,which is widely used to investigate the pathogenesis,im-aging diagnosis,and prognosis of SSNHL.The analytical approaches of rs-fMRI are mainly divided into three categories:local brain function analysis,global functional connectivity analysis,and graph theory-based brain network analysis.Common meth-ods for local brain function analysis include amplitude of low-frequency fluctuations and regional homogeneity,which can reveal the characteristics of local neuronal activity in brain regions.Global analysis focuses on assessing functional connectivity between different brain regions,commonly using independent component analysis and seed-based functional connectivity analysis.Graph theory-based brain network analysis can elucidate the complexity and small-world properties of brain connectivity from a network topology perspective.

Abstract:Objective To compare the application effects of high-resolution CT(HRCT)and digital-radiography(DR)chest films in the screening of early-stage lesions of pneumoconiosis.Methods 39 dust-exposed workers from gold mine mining and foundry industries were selected.Through DR chest films,suspected pneumoconiosis-like changes in the lungs were detected.To avoid missed diagnosis,chest HRCT examinations were carried out.The imaging manifestations of early-stage pneumoconiosis le-sions detected by the two examination methods were compared,and conclusions on pneumoconiosis screening were drawn.Results The DR chest films of 39 examinees showed suspected pneumoconiosis-like changes.Through chest HRCT scans,27 of them were shown early-stage pneumoconiosis changes.In accordance with the"Diagnosis of Occupational Pneumoconiosis"GBZ 70-2015 standard,DR chest films of 27 examinees were evaluated for pneumoconiosis staging,11 cases met the diagnos-tic criteria for stage Ⅰ pneumoconiosis,16 cases did not meet the diagnostic criteria of pneumoconiosis(the latter being early-stage lesions caused by dust accumulation in the lungs).The remaining 12 examinees showed no pneumoconiosis changes on HRCT and were classified as having no pneumoconiosis.Conclusion Compared to DR chest films,HRCT provides more accu-rate and reliable imaging information for early-stage pneumoconiosis,effectively avoiding missed or misdiagnoses.Therefore,HRCT is better suited for precise detection of early-stage pneumoconiosis lesions.

Abstract:Objective To construct a predictive model for postpartum stress urinary incontinence(PSUI)based on clinical data and pelvic floor 4D ultrasound parameters,and to validate the model's diagnostic efficacy and calibration accuracy.Methods Thirty-six patients with postpartum PSUI(study group)and 36 women with a history of childbirth but no postpartum PSUI(control group)were selected.Baseline data including age,Body Mass Index(BMI),and history of vaginal delivery were collected from both groups.All participants underwent pelvic floor 4D ultrasound examination to obtain dynamic parameters,in terms of bladder neck mobility,descent distance of the posterior bladder wall,incidence of proximal urethral orifice funneling,retrovesical angle,urethral inclination angle,urethral rotation angle,and levator hiatal area.Variables with statistically signifi-cant differences between groups were screened by univariate analysis and were subsequently included in a multivariate Logistic regression analysis to construct a predictive model for PSUI.The predictive performance of the model was evaluated using the re-ceiver operating characteristic(ROC)curve,and the calibration accuracy was verified by the calibration curve.Results Com-pared with the control group,the study group showed increases in age,BMI,bladder neck mobility,descent distance of the pos-terior bladder wall,incidence of proximal urethral orifice funneling,retrovesical angle,urethral inclination angle,urethral rota-tion angle,and levator hiatal area(all P<0.05).Multivariate Logistic regression analysis indicated that age,BMI,bladder neck mobility,descent distance of the posterior bladder wall,incidence of proximal urethral orifice funneling,retrovesical angle,ure-thral inclination angle,urethral rotation angle,and levator hiatal area were independent risk factors for PSUI(all P<0.05).Based on these independent risk factors,a nomogram model for the individualized prediction of PSUI risk was successfully con-structed.This model demonstrated the highest diagnostic efficacy(AUC=0.989),which was superior to all single parameters(all P<0.05).The calibration curve indicated a good fit between the predicted probabilities of the model and the actual observed prob-abilities.Conclusion A predictive model for PSUI is successfully constructed based on clinical data and pelvic floor 4D ultra-sound parameters.This model exhibits superior predictive performance for PSUI compared to any single parameter and maintains good calibration accuracy across the overall risk distribution.

Abstract:Objective To explore the diagnostic value of zero echo time(ZTE)and T2 mapping sequences for knee joint car-tilage injury.Methods A total of 600 patients with suspected knee joint cartilage injury were selected,and all of them under-went ZTE and T2 mapping sequence scans.Using arthroscopy as the gold standard for diagnosis,the diagnostic efficacy of differ-ent MR sequences for knee joint cartilage injury was compared.Results Among the 600 patients with suspected knee joint car-tilage injury,492 cases were positive and 108 cases were negative according to arthroscopy.447 cases were positive and 153 cases were negative according to MR ZTE sequence scans.479 cases were positive and 121 cases were negative according to MR T2 mapping sequence scans.The sensitivity,accuracy,and negative predictive value of MR T2 mapping sequence scans for diag-nosing knee joint cartilage injury were all higher than those of ZTE sequence scans,and the missed diagnosis rate was lower than that of ZTE sequence scans(all P<0.05).However,there were no statistically significant differences in specificity,misdiagno-sis rate,and positive predictive value among different MR scanning sequences for diagnosing knee joint cartilage injury(all P>0.05).Conclusion Among the ZTE and T2 mapping sequences,the T2 mapping sequence has the highest diagnostic value for knee joint cartilage injury.

Abstract:Objective To analyze the differential diagnostic value of dynamic contrast enhanced magnetic resonance imaging(DCE-MRI)in plasma cell mastitis(PCM)and non-mass-like invasive breast cancer(IBC-NML).Methods Thirty patients with PCM(PCM group)and thirty patients with IBC-NML(IBC-NML group)who underwent DCE-MRI were retrospectively ana-lyzed.MRI features,including involvement of the areolar region,distribution pattern,dendritic dilatation of breast ducts,inter-nal enhancement pattern,degree of enhancement in the first phase,apparent diffusion coefficient(ADC)value,and time-signal intensity curve(TIC)type,were compared between the two groups.The multiple Logistic regression analysis was used to screen independent predictive factors that could distinguish PCM and IBC-NML.ROC curves were drawn to analyze the diagnostic effi-cacy of single and combined MRI features in differentiating PCM from IBC-NML.Results Significant differences were ob-served between the two groups in terms of areolar involvement,distribution pattern,ductal dendritic dilatation,internal enhance-ment pattern,degree of enhancement in the first phase,and ADC value(all P<0.05).The areas under the curve(AUC)for single and combined MRI features including areolar involvement,multi-regional distribution,ductal dendritic dilatation,mul-tiple annular nodules,mild enhancement in the first phase,and ADC value in differentiating PCM from IBC-NML were 0.700,0.667,0.800,0.817,0.650,0.690,and 0.912,respectively.The combined diagnostic model showed a significantly higher AUC than any single MRI feature(all P<0.05).Conclusion Areolar involvement,multi-regional distribution,ductal dendritic dilatation,multiple annular nodules,mild enhancement in the first phase,and ADC value contribute to the differentiation be-tween PCM and IBC-NML.The combination of multiple MRI features can improve diagnostic performance.

Abstract:Objective To compare the diagnostic efficacy of microscopy coil and flexible coil in diagnosis of medial collateral ligament(MCL)injuries in magnetic resonance imaging(MRI).Methods A total of 49 patients(68 knees)with MCL injuries were enrolled.The patients underwent MRI examinations using microscopy coil and flexible coil,respectively.Weighted Kappa test was employed to evaluate the consistency between radiologic diagnostic results with microscopy coil and flexible coil and clinical outcomes confirmed by surgery or arthroscopy.The receiver operating characteristic(ROC)analysis was conducted to evaluate the diagnostic performance of microscopy coil and flexible coil in diagnosis of MCL injuries.Results In the 68 cases of MCL injuries,according to clinical results,there were 10 Grade 0 injuries,21 Grade I injuries,25 Grade Ⅱ injuries,and 12 Grade Ⅲ injuries.In the consistency analysis,the Kappa coefficient was 0.769(95%CI:0.666-0.873),between the radiologic diagnostic results with flexible coil and clinical results,while,the Kappa coefficient was 0.848(95%CI:0.767-0.930)between the diagnostic results with microscopy coil and clinical results.In the ROC analysis,for Grade 0 MCL injuries examined with mi-croscopic coil,the AUC value,sensitivity,specificity were 0.874,80.00%and 94.83%,respectively.For Grade Ⅰ MCL inju-ries examined with microscopic coil,the AUC value,sensitivity,specificity were 0.907,85.71%and 95.74%,respectively.For Grade Ⅱ MCL injuries,the AUC value,sensitivity,specificity were 0.960,92.00%and 100.00%,respectively.There was a significant difference in diagnostic performance between the applications of microscopic coil and flexible coil(P=0.002).For Grade Ⅲ MCL injuries with microscopic coil,the AUC value,sensitivity,specificity were 0.982,100.00%and 96.43%,respec-tively.Conclusion Compared to flexible coils,employing microscopy coils in MRI examinations showed greater consistency between radiological diagnosis grades and clinical proved grades.For Grade Ⅱ MCL injuries,using the microscopy coils demon-strated superior diagnostic efficacy.

Abstract:Ovarian cancer(OC)is the deadliest malignant tumour of female reproductive system,which is mostly found in end stage with poor prognosis and easy to recur.Current diagnostic methods for ovarian cancer are mainly imaging and pathologi-cal examinations,but,with limited sensitivity and specificity.The emerging radiomics technology is able to extract quantitative imaging features from medical images and transform visual image information into deeper features to quantitatively assess lesions.The combination of artificial intelligence,a computer algorithm capable of simulating computers and surpassing human intelli-gence,and radiomics further promotes the development of ovarian cancer in terms of identification,segmentation,diagnosis,classification,lymph node metastasis,efficacy evaluation,survival prediction and recurrence monitoring.At present,3D U-Net can achieve automated segmentation of OC,and the combination of radiomics and deep learning(DL)can non-invasively distinguish between benign and malignant OC before surgery.The combination of radiomics and clinical indicators can assist in preoperative diagnosis of lymph node metastasis,and radiomics and convolutional neural networks(CNNs)can improve the ac-curacy of survival prediction and recurrence risk.In this paper,we review the progress of the application of artificial intelligence and radiomics in the field of ovarian cancer.

Abstract:Objective To explore the predictive value of magnetic resonance diffusion-weighted imaging(MR-DWI)com-bined with serum miR-328-5p and miR-193b-3p for the efficacy of concurrent chemoradiotherapy in non-small cell lung cancer(NSCLC).Methods 100 patients with NSCLC were selected,all of whom received concurrent radiotherapy and chemotherapy.According to the therapeutic effect,47 cases were divided into treatment insensitive group and 53 cases were into treatment sensi-tive group.MR-DWI scanning was performed one week before treatment and during treatment(radiotherapy 30 Gy),and the ap-parent diffusion coefficient(ADC)value was obtained and the ΔADC value was calculated.The next day,fasting peripheral ve-nous blood was collected,and serum was collected by centrifugation.The expression of miR-328-5p and miR-193b-3p in serum was detected by RT-qPCR.Multivariate Logistic regression model was used to analyze the influencing factors of the curative effect of synchronous radiotherapy and chemotherapy in NSCLC patients.ROC curve was used to analyze the predictive value of MR-DWI and the expression of serum miR-328-5p and miR-193b-3p on the efficacy of concurrent chemoradiotherapy in NSCLC pa-tients.Results The ADCpre value in the treatment-sensitive group was lower than that in the treatment-insensitive group(P<0.05),and the ΔADC value was higher than that in the treatment-insensitive group(P<0.05),but there was no significant difference in ADCmed treatment between the two groups(P>0.05).The relative expression levels of serum miR-328-5p and miR-193b-3p in the treatment-sensitive group were lower than those in the treatment-insensitive group(all P<0.05).Multivariate Lo-gistic regression analysis showed that the expression of serum miR-328-5p,miR-193b-3p,ADCpre value and ΔADC value were the influencing factors of the curative effect of synchronous radiotherapy and chemotherapy in NSCLC patients(all P<0.05).The area under the curve of MR-DWI combined with the expression of serum miR-328-5p and miR-193b-3p in predicting the effi-cacy of concurrent chemoradiotherapy in NSCLC patients was higher than that predicted by the three methods alone(all P<0.05).Conclusion MR-DWI and the expression of serum miR-328-5p and miR-193b-3p have certain predictive value for the efficacy of concurrent chemoradiotherapy in NSCLC patients,and the combined prediction value of the three is higher.

Abstract:Objective To analyze the value of real-time three-dimensional echocardiography(RT-3DE)with velocity vector imaging(VVI)in the evaluation of right ventricular function in elderly patients with connective tissue disease(CTD)compli-cated with pulmonary hypertension.Methods 121 cases of elderly CTD(observation group)were selected,50 cases of pulmo-nary hypertension and 71 cases of normal pulmonary artery pressure were diagnosed by right heart catheterisation,and 121 volun-teers with healthy physical examination were screened by 1∶1 using propensity score matching method(control group).Right ventricular function was measured using RT-3DE and VVI,including early peak diastolic flow velocity,late peak diastolic flow velocity,peak systolic velocity,peak atrial systolic velocity,early peak diastolic velocity(e'),Tei index,tricuspid annular sys-tolic displacement(TAPSE),right ventricular ejection fraction(RVEF),right ventricular end-systolic volume index(RVESVI),right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),right ventricu-lar volume per beat(RVSV),volume-per-beat index,rate of change of right ventricular area(FAC),right ventricular end-diastolic volume index,mean strain(GS),right ventricular longitudinal strain standard deviation of time to peak(TLS-SD),and right ventricular free wall Longitudinal strain(FWS).The pulmonary artery systolic pressure(PASP),pulmonary artery dia-stolic pressure(PADP),pulmonary artery mean pressure(PAMP),right atrial pressure(RAP),and pulmonary capillary wedge pressure(PCWP)were measured via right heart catheterisation.The serum amino-terminal brain natriuretic peptide pre-cursor(NT-proBNP)was detected by ELISA.Then,we analysed the relationship between parameters related to right ventricular function and biomarkers(NT-proBNP)and haemodynamics,i.e.,PASP,PADP,PAMP,RAP,PCWP,in elderly CTD pa-tients.Results PASP and serum NT-proBNP levels were higher in the observation group than in the control group(all P<0.05).PASP and serum NT-proBNP levels were higher in the observation group than in those with normal pulmonary arterial pressure(all P<0.05).The right ventricular anteroposterior diameter and Tei index of the observation group were higher than those of the control group,and e'was lower than those of the control group(all P<0.05).The right ventricular anteroposterior di-ameter and Tei index of the observation group's patients with pulmonary hypertension were higher than those of their patients with normal pulmonary arterial pressure,and e'was lower than those of their patients with normal pulmonary arterial pressure(all P<0.05).TAPSE,RVEF,and FAC were lower in the observation group than those in the control group(all P<0.05),and TAPSE,RVEF,and FAC were lower in the observation group than those whose pulmonary artery pressure was normal(all P<0.05).TLS-SD of the observation group was higher than that of the control group,and FWS and GS were lower than those of the control group(all P<0.05).TLS-SD of pulmonary hypertension patients in the observation group was higher than that of those with normal pulmonary artery pressures,and FWS and GS were lower than those of those with normal pulmonary artery pressures(all P<0.05).PADP,PAMP,RAP,and PCWP were higher in the observation group than those in the control group(all P<0.05),and PADP,PAMP,RAP,and PCWP were higher in the observation group than those whose pulmonary artery pres-sure was normal(all P<0.05).Pearson correlation analysis showed that TAPSE,RVEF,FAC,GS,and FWS were negatively correlated with PASP,serum NT-proBNP levels and PADP,PAMP,RAP,and PCWP in elderly CTD patients(all P<0.05),while,TLS-SD was negatively correlated with PASP,serum NT-proBNP levels,and PADP,PAMP,RAP,and PCWP were posi-tively correlated(all P<0.05).Conclusion RT-3DE and VVI can accurately assess right ventricular impairment in elderly pa-tients with CTD combined with pulmonary hypertension who have reduced right ventricular systolic function.

Abstract:Objective To evaluate the value of combined ultrasound contrast parameters with serum Wnt1-induced signaling pathway protein 1(WISP1)and anterior gradient protein 2(AGR2)in assessing chemotherapy efficacy for hormone-sensitive metastatic prostate cancer(mHSPC).Methods A total of 164 patients with mHSPC were enrolled and divided into an effec-tive group(78 patients)and a non-effective group(86 patients)based on chemotherapy response.Two sets of baseline data were collected.Using ultrasound contrast imaging,we obtained the following results:area under the ultrasound contrast curve(AUC of Ultrasound Contrast),peak intensity(PI),half-life of intensity(HT),mean transit time(MTT),and rising slope(WIS).The serum WISP1 and AGR2 levels were detected by the ELISA method.Factors influencing the efficacy of chemo-therapy for mHSPC were analyzed by multivariate Logistic regression analysis.The value of ultrasound contrast-enhanced imag-ing combined with serum WISP1 and AGR2 for assessing treatment response in mHSPC was evaluated by ROC curve analysis.Results There were no statistically significant differences in baseline data between the effective and ineffective groups(all P>0.05).The AUC of ultrasound contrast,PI,HT,MTT,WIS,and serum WISP1 and AGR2 levels in the ineffective group were all higher than those in the effective group(all P<0.05).AUC of ultrasound contrast,PI,HT,MTT,WIS,and serum WISP1 and AGR2 levels were factors influencing the efficacy of mHSPC chemotherapy(all P<0.05).The AUC for predicting mHSPC chemotherapy efficacy using combined contrast-enhanced ultrasound parameters and serological markers was higher than that for each parameter alone,each serological marker alone,and combined ultrasound parameters alone(all P<0.05).Con-clusion Patients with mHSPC who did not respond to chemotherapy exhibited elevated levels of both contrast-enhanced ultra-sound quantitative parameters and serum WISP1 and AGR2.The combined assessment of contrast-enhanced ultrasound quantita-tive parameters with serum WISP1 and AGR2 levels demonstrated high value in evaluating chemotherapy efficacy.

Abstract:Objective To explore the application effect of an MRI high-density flexible detection array(hereinafter referred to as the flexible coil)in the stereotactic technology of the brain of Bama miniature pigs.Methods Twelve healthy female Bama miniature pigs were selected and randomly divided into a flexible coil group of 6 pigs and a hard detection array(hereinaf-ter referred to as the hard coil)group of 6 pigs.Cranial MR scans were performed using flexible coils and commercial hard coils respectively.The signal-to-noise ratio(SNR)of MRI T1WI and T2WI sequence images in the two groups was compared.Three heads were randomly selected from each of the flexible coil group and the rigid coil group for cranial 3.0T MR scanning.Based on the MR scan data,thermosensitive hydrogel was injected into the substantia nigra under a framed stereotactic brain apparatus.Af-ter the operation,MRI T1WI sequence scanning was performed to measure the target error.MRI T1WI sequence scans were per-formed on the remaining Bama miniature pigs in the flexible coil group and the hard coil group.The MR scan data were imported into the Huake SR1 surgical robot workstation.The surgical robot was used to perform substantia nigra puncture biopsy under the frame-free brain stereotactic instrument.After the operation,MRI T1WI sequence scanning was performed to measure the target error.Results The SNR of MRI T1WI and T2WI sequences in the flexible coil group was higher than that in the hard coil group(all P<0.05).After injecting thermosensitive hydrogel into the substantia nigra with a framed brain stereotactic device,there were no statistically significant differences in the sagittal,coronal,and three-dimensional spatial target errors of MR scan images between the flexible coil group and the rigid coil group(all P>0.05).After substantia nigra biopsy with a frameless brain stereo-tactic instrument,there were statistically significant differences in the sagittal,coronal and three-dimensional spatial target er-rors of MR scan images between the flexible coil group and the rigid coil group(all P<0.05).Conclusion The MRI flexible coil independently developed by our research team can not only significantly improve the SNR of brain MR scan images in Bama miniature pigs,but also significantly enhance the puncture accuracy of frameless brain stereotactic technology,without affecting the puncture accuracy of frameless brain stereotactic technology.

Abstract:Objective To evaluate the clinical efficacy of jiawei sijunzi decoction combined with the new quadruple therapy in the treatment of heart failure(HF)based on echocardiographic parameters.Methods A total of 120 HF patients with re-duced left ventricular systolic function were selected and randomly divided into a control group and an observation group,with 60 cases in each group.The control group was given the new quadruple therapy(ACEI/ARB/ARNI,β-blockers,SGLT2i,and aldo-sterone receptor antagonists),while,the observation group was additionally treated with jiawei sijunzi decoction,which was composed of Panax ginseng,Atractylodes macrocephala,Poria cocos,Astragalus membranaceus,Lycium barbarum,Ophical-cite,Dioscorea opposita,Zingiber officinale,Ziziphus jujuba,and honey-fried Glycyrrhiza uralensis on the basis of the control group's regimen.After 12 weeks of treatment,echocardiography was performed to measure indicators,including left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and left ventricular end-systolic diameter(LVESD)in both groups;the improvement of clinical symptoms was also observed.Results Compared with the pre-treatment state of the same group,both groups showed an increase in LVEF and a decrease in LVEDD and LVESD(all P<0.05);com-pared with the control group,the LVEF of the observation group increased after treatment,and LVEDD and LVESD decreased(all P<0.05).After treatment,43 cases in the observation group were markedly effective,12 cases were effective,and the total effective rate was 91.7%(55/60).34 cases in the control group were markedly effective,11 cases were effective,and the total effective rate was 75.0%(45/60).The comparison of the total effective rates between the two groups showed P<0.05.Conclusion Jiawei sijunzi decoction combined with the new quadruple therapy can more effectively improve left ventricular function and alleviate clinical symptoms in HF patients with reduced left ventricular systolic function,which is superior to the New Quadruple Therapy alone.

Abstract:Objective To investigate the clinical application of on-rail CT system in percutaneous lung biopsy(PLB).Methods A total of 897 patients undergoing PLB were enrolled,including 476 patients who received conventional CT-guided PLB(control group)and 421 patients who received on-rail CT-guided PLB(observation group).The maximum lesion diameter,skin to lesion depth,pathological diagnostic performance,duration of procedure,radiation dose(DLP),and complication rate were compared between the two groups.Results There were no statistically significant differences in the maximum lesion diam-eter,skin to lesion depth,or pathological diagnostic performance between the two groups(all P>0.05).The duration of proce-dure in the observation group was longer than that in the control group,while,the DLP was lower than that in the control group(both P<0.05).The incidence of pneumothorax and the overall complication rate in the observation group were lower than those in the control group(both P<0.05),while,there were no statistically significant differences in the incidence of hemoptysis or chest wall/pleural hemorrhage between the two groups(both P>0.05).Conclusion The application of on-rail CT system in PLB can reduce the incidence of pneumothorax and radiation dose(DLP),while maintaining the accuracy of the biopsy,which is worthy of clinical promotion and application.

Abstract:Objective To explore the changes of ocular ultrasound examination parameters before and after maintenance hemodialysis(MHD)in patients with stage 5 chronic kidney disease(CKD)and their relationship with complications.Methods A total of 84 patients with stage 5 chronic kidney disease(CKD)were selected as the observation group,including 30 cases with diabetes,78 cases with hypertension,and 48 cases with anemia.Meanwhile,42 healthy volunteers who underwent physical examinations were also selected as the control group.Thirty minutes before dialysis and 30 minutes after dialysis in the observation group,and on the day of physical examination in the control group,ocular ultrasound examinations were performed to measure the diameter of the optic nerve sheath(ONSD)and the central retinal artery,the peak systolic velocity(PSV)and end-diastolic velocity(EDV)of CRA and ophthalmic artery(OA).Then,we calculated the systolic/diastolic flow velocity ratio(S/D)and resistance index(RI),and analyzed the linear relationship between each ultrasound examination parameter before di-alysis and comorbidities in patients with stage 5 CKD.Results The average ONSD of the left and right eyes in the observation group before and after dialysis was higher than that in the control group(all P<0.05).The average ONSD of the left and right eyes in the observation group after dialysis was higher than that before dialysis.After dialysis,the average PSV and EDV of both eyes in CRA and OA of the observation group were lower than those before dialysis(all P<0.05),and the average PSV and EDV of both eyes in CRA and OA of the observation group before and after dialysis were lower than those of the control group(all P<0.05),while,the RI of both eyes in CRA of the observation group before and after dialysis was higher than that of the control group(all P<0.05).The average ONSD of both eyes before dialysis in CKD patients with diabetes was higher than that in patients without diabetes(P<0.05).The PSV,EDV of CRA and PSV of OA before dialysis were all lower than those of patients without diabetes(all P<0.05),and the RI of CRA before dialysis was higher than that of patients without diabetes(P<0.05).Among CKD patients with hypertension,the PSV and EDV of OA before dialysis were lower than those of patients without hypertension(all P<0.05),and the RI of OA was higher than that of patients without hypertension(P<0.05).There was no statistically signifi-cant difference in each ultrasound examination parameter before dialysis between CKD patients with anemia and those without anemia(all P>0.05).The results of multiple linear regression analysis showed that diabetes was an independent risk factor affect-ing the average ONSD of both eyes,EDV of CRA and PSV of OA in CKD patients before dialysis.Hypertension was an indepen-dent risk factor affecting the EDV of OA in CKD patients before dialysis.Conclusion Patients with stage 5 CKD already have optic nerve sheath dilation and abnormal ocular microcirculation hemodynamics before dialysis.Dialysis can further aggravate op-tic nerve sheath dilation and abnormal ocular microcirculation hemodynamics.Combined diabetes and combined hypertension can aggravate optic nerve sheath dilation and abnormal ocular microcirculation hemodynamics to varying degrees,while,combined anemia has a relatively small impact on nerve sheath dilation and ocular microcirculation hemodynamics.

Abstract:Breast cancer has become the most common cancer among women and a leading cause of cancer-related deaths.Ul-trasound examination is currently the primary method for breast cancer screening and diagnosis,however,due to the complex di-versity of breast tissue,many breast diseases do not present as lumps but rather as non-mass lesions without clear boundaries.Two-dimensional ultrasound diagnosis of breast diseases primarily relies on the acoustic properties of tissues.It can clearly iden-tify the precise location of lesions,their internal structural characteristics,and the relationship between lesions and surrounding tissues,however,it has limitations in sensitivity and specificity,potentially leading to misdiagnosis.The emergence of new ultra-sound technologies has addressed the limitations of two-dimensional ultrasound,which relies solely on tissue acoustic characteris-tics for diagnosing breast diseases.Advances from color Doppler flow imaging to contrast-enhanced ultrasound and superb micro-vascular imaging enable non-invasive,safe visualization of microcirculation in breast diseases.Furthermore,the proliferation of fibrous connective tissue in the stroma response of malignant breast diseases provides the theoretical foundation for ultrasound elastography in breast cancer diagnosis.The development of ultrasound viscoelastic imaging technology provides a more compre-hensive and objective understanding of breast diseases,recognizing that they are not characterized solely by elastic properties but rather exhibit dual characteristics of both viscoelasticity and elasticity,thereby reducing misdiagnosis rates associated with the assumption that breast tissue is a homogeneous medium.The combined application of different ultrasound techniques in breast cancer diagnosis significantly improves diagnostic accuracy and reduces unnecessary needle biopsies.In recent years,the com-bined use of artificial intelligence with multimodal ultrasound examinations,the integration of multimodal ultrasound with breast cancer multi-omics research,and the joint application of multimodal ultrasound with genomic testing have all demonstrated sig-nificant diagnostic value.

Abstract:Objective The aim of this study was to investigate the diagnostic value of different imaging evaluation systems in the preoperative assessment of rectal mesenteric lymph node metastasis(LNM)in rectal cancer.Methods 102 patients with rectal cancer were selected and divided into non metastatic group(59 cases)and metastatic group(43 cases)according to post-operative pathological examination results.MRI examination was performed on both groups,and imaging evaluation indicators in terms of lymph node diameter,Node RADS score,and ESGAR classification,morphological prediction were obtained based on MRI images.ROC curves were used to analyze the diagnostic value of different imaging indicators for lymph node metastasis in rectal cancer.Results The comparison of lymph node short diameter,Node RADS score,ESGAR classification,and morpho-logical prediction between the two groups before treatment showed P<0.05.In the preoperative prediction of pN+status,the diag-nostic performance of short-axis lymph node diameter yielded an AUC of 0.739,with a sensitivity and specificity of 72.1%and 67.8%,respectively.The Node-RADS score demonstrated the highest diagnostic efficacy,with an AUC of 0.876,coupled with a sensitivity of 83.7%and a specificity of 86.4%.The ESGAR classification achieved an AUC of 0.800,with a sensitivity of 65.1%and a specificity of 94.9%.Meanwhile,the morphological prediction showed an AUC of 0.745,with a sensitivity and specificity of 74.4%and 74.6%,respectively.Conclusions The Node-RADS score demonstrated superior diagnostic performance for pre-dicting lymph node metastasis(LNM)in rectal cancer compared to the short-axis diameter and morphological prediction,achiev-ing high sensitivity and specificity.

Abstract:Objective To investigate the CT and MRI features of Ewing's sarcoma/primary neuroectodermal tumor(ES/PNET)of kidney.Methods The clinical data and imaging findings of 5 patients with kidney ES/PNET confirmed by operation and pathology were retrospectively analyzed,and their CT and MRI manifestations were analyzed combined with the literature.Results Among the 5 cases of kidney ES/PNET,there were 4 females and 1 male,with age ranged from 28 to 51 years.The me-dian age was 33 years.The tumors were all large solitary masses(4 cases in the left kidney and 1case in the right kidney)with a maximum diameter from 9.0 to 18.5 cm.Plain CT revealed soft tissue mass shadows with uneven density.Among these,four cases showed internal septas and cystic areas within the lesions,with mild enhancement of the solid components and septas on contrast-enhanced scans.One case exhibited no significant cystic areas within the lesion,demonstrating mild homogeneous en-hancement on contrast-enhanced scans.On MRI non-contrast scans,all five lesions showed iso-or slightly hypointense signals on T1WI and heterogeneous signals on T2WI.Diffusion-weighted imaging(DWI)revealed restricted diffusion in the solid compo-nents of the masses.Contrast-enhanced MRI demonstrated mild enhancement in the solid portions and septas of the lesions.All tumors were associated with ipsilateral renal vein and inferior vena cava tumor thrombus.Conclusion Renal ES/PNET is a rare neoplasm occurring in young adults.It presents as a unilateral large endophytic infiltrating mass,often accompanied by multiple irregular septas,rare calcification,and inhomogeneous mild enhancement.And it is highly prone to develop with the combina-tion of ipsilateral renal vein and inferior vena cava tumor thrombosis.