MR Features Research Articles

Dynamic susceptibility contrast perfusion MRI helps in differentiating double-expressor from non-double-expressor subtypes in primary central nervous system lymphoma.

In the 2016 WHO Classification of Lymphoid Tissue Neoplasms, co-expression of MYC and BCL2 is newly designated as double expressor lymphoma. Patients with primary central nervous system lymphoma with double expressor (DE-PCNSL) have been reported to have a higher risk of recurrence and a worse prognosis than those with PCNSL without double expressor (non-DE-PCNSL). The aim of this study was to determine whether DE-PCNSL has characteristic clinical and MR imaging features compared to non-DE-PCNSL. This study included 36 immunocompetent patients with PCNSL, including 16 with double expressor and 20 without double expressor. The enhancement pattern and the values of apparent diffusion coefficient (ADC), relative cerebral blood volume (rCBV), leakage-corrected rCBV, and K2 at enhancing lesions were compared between the DE-PCNSL and non-DE-PCNSL groups. The mean and minimum values from the ROI on ADC maps were designated as ADCmean and ADCmin, respectively. The data of rCBV, leakage-corrected rCBV and K2 were obtained from dynamic susceptibility contrast (DSC) perfusion MRI. The Kaplan-Meier method was used to estimate progression-free survival (PFS) differences. DE-PCNSL was significantly more common in women (12 of 16 patients, 75%) compared to non-DE-PCNSL (7 of 20 patients, 35%; P =.02). The rCBV ratio and leakage-corrected rCBV ratio were significantly lower in DE-PCNSL compared to non-DE-PCNSL (P =.02 and P =.03, respectively). There was no significant difference in the enhancement pattern and ADCmean, ADCmin and K2 values between the two groups. DE-PCNSL tended to have a shorter PFS than non-DE-PCNSL, although the difference was not significant. rCBV and leakage-corrected rCBV may help differentiate double-expressor from non-double-expressor subtypes in PCNSL.

Myopericytoma of the hand.

Myopericytoma is a rare benign smooth-muscle cell neoplasm of the subcutaneous soft tissues that is primarily found in young adults with a male predominance. We present the clinical, radiologic, and histopathologic features of a longstanding myopericytoma of the hand. We emphasize the features that help the radiologist and pathologist to accurately characterize this entity. Radiologic evaluation, particularly MRI, plays a crucial role in differentiating myopericytoma from other soft tissue masses. Characteristic MR features include a well-demarcated lesion with intense post-contrast enhancement, isointensity to muscle on T1-weighted imaging, and hyperintensity on T2-weighted imaging, often with a central vascular pedicle. Histopathologic examination reveals a concentric perivascular growth pattern, which helps to distinguish myopericytoma from other soft tissue tumors. Immunohistochemically, these myoid cell neoplasms stain positive for alpha-smooth muscle actin and h-caldesmon, lack nuclear atypia, and are not highly proliferative (relatively low Ki-67 index and very low mitotic activity). The vast majority stain negative for desmin and CD34. Treatment typically involves complete surgical resection, with excellent prognosis and rare recurrence. Despite its rarity, awareness of this entity is important for clinicians who encounter soft tissue masses of the extremities.

Image characteristics of retained medullary cord in secondary neurulation arrest: an observational study

Retained medullary cord (RMC) is a recently defined term denoting closed spinal dysraphism arising from the failure of regression in secondary neurulation. Despite the acknowledgment of this condition, there needs to be more literature elucidating the radiologic manifestations of RMC. This study aimed to describe the MR imaging findings of RMC. A retrospective analysis was conducted on spinal MRI scans of pediatric patients with surgically confirmed RMC, from January 2014 to August 2023. The investigation focused on evaluating the following image characteristics: level and morphology of the cord-like structure (C-LS), the signal intensity in the far distal C-LS, nerve root-like structures originating from the C-LS, intradural fatty lesions, and arachnoid cysts. This study included 38 patients (19 girls, mean age 7.3 months) who showed a low-lying cord in all cases. The morphology of C-LS was either smooth tapered (50%) or hourglass with fusiform cystic dilatation (50%). The C-LS exhibited aberrant T2 hypointense signal compared to the juxta-proximal level. T2 hypointense signal vestigial nerves emanating from the C-LS and intradural fatty masses were observed (89.5%). Sacral arachnoid cysts in extradural location were identified in eight patients. The characteristic MR features of RMC revealed an extremely low-lying distal C-LS with smooth tapering or hourglass-shaped cystic dilatation of the caudal part, accompanied by an intradural fatty stalk and the aberrant signal vestigial nerve. This study suggests those radiologic findings can be RMC instead of the previously called terminal syrinx with low-lying conus.

Lipid-mediated adaptation of proteins and peptides in cell membranes

The paper overviews the results of computational studies of the molecular mechanisms underlying the adaptation of model cell membranes taking place during their interaction with proteins and peptides. We discuss changes in the structural and dynamic parameters of the water–lipid environment, the hydrophobic/hydrophilic organization of the lipid bilayer surface (the so-called “mosaicity”), etc. Taken together, these effects are called the “membrane response” (MR) and constitute the most important ability of the cell membranes to respond specifically and consistently to the incorporation of extraneous agents, primarily proteins and peptides, and their subsequent functioning. The results of the authors’ long-term research in the field of molecular modeling of MR processes with various spatial and temporal characteristics are described, from the effects of binding of individual lipid molecules to proteins to changes in the integral macroscopic parameters of membranes. The bulk of the results were obtained using the “dynamic molecular portrait” approach developed by the authors. The biological role of the observed phenomena and potential ways of rationally designing artificial membrane systems with specified MR characteristics are discussed. This, in turn, is important for targeted changes in the activity profile of proteins and peptides exerting action on biomembranes, not least as promising pharmacological agents.

Post-Uterine Artery Embolization: 3-Day MRI Changes and Their Predictive Value for Therapeutic Efficacy in Symptomatic Uterine Fibroids.

To summarize and discuss3-days MRI changes after uterine artery embolization (UAE) and their predictive value for efficacy. From August 2016 to April 2023, 52 patients underwent enhanced MRI within 3 days post-embolization. We retrospectively analyzed clinical and imaging data, focusing on MR characteristics at the 3-day mark, comparing pre- and post-embolization images. Patients were categorized based on 3-day MR findings into complete and incomplete necrosis groups, with clinical efficacy compared over 6 months. Our study included 30 cases of multiple leiomyomas and 22 of single leiomyomas. Postoperative MRI revealed complete necrosis in 31 tumors and incomplete necrosis in 21 tumors. At 3 days, MR ADC imaging showed increased signals in necrotic areas, mildly increased signals on T2-weighted images, and minimal changes on T1-weighted images. Six-month follow-up showed no significant difference in symptom improvement between groups (p = 0.524, p = 0.587, p = 0.615). However, a significant difference was found in leiomyoma volume reduction, with 70.63 ± 15.53% in the complete necrosis group and 51.36 ± 25.20% in the incomplete necrosis group (p＜0.001), highlighting the impact of necrosis extent on volumetric reduction. Short-term MRI changes after UAE can reflect changes in blood supply to fibroids and normal uterine tissue, and have good predictive value for medium-term embolization efficacy. This study describes short-term MR manifestations of complete and incomplete embolism, aiding in predicting long-term outcome.

Primary spinal epidural abscess: magnetic resonance imaging characteristics and diagnosis

Rationale and objectiveTo investigate the MR characteristics of phlegmonous stage and abscess stage primary spinal epidural abscess.Materials and methodsThis study retrospectively analyzed the clinical and imaging characteristics of 27 cases of pathologically confirmed primary spinal epidural abscess. Predisposing conditions of all patients were collected. All patients underwent conventional magnetic resonance imaging, while fifteen patients also underwent post-contrast magnetic resonance imaging.ResultsThe initial symptoms included back pain in 25 patients, fever in 18, motor deficit in five, and sensory changes in 13. Underlying diseases included distant site of infection in seven, injection therapy in five, neoplasm in five, chronic inflammatory disease in five, diabetes mellitus in four, alcoholism in three, metabolic disorder in three, hepatopathy in three, and obesity in two. Abscess location was ventral epidural space in 15 patients (55.6%) and dorsal epidural space in 12 (44.4%). On T1-weighted image, the abscess was hypointense to the spinal cord in 23 patients (85%) and isointense in four (15%). All abscesses were hyperintense to the spinal cord on T2-weighted image. Among the 15 patients who underwent contrast-enhanced imaging, ring enhancement was present in 13 and homogeneous enhancement in two. Adjacent vertebrae body edema was present in four patients. The abscess was purely intraspinal in 25 patients (92.6%). Paraspinal extension was present in two (7.4%).ConclusionPrimary spinal epidural abscess patients have one or more predisposing conditions. Phlegmonous stage primary spinal epidural abscess appears isointense on T1WI and hyperintense on T2WI and enhancement is homogeneous. Abscess stage primary spinal epidural abscess hyperintense on T2WI and hypointense on T1WI and ring enhancement. Presence of vertebral body edema is an important sign to help diagnose primary spinal epidural abscess.

Characteristic MR Imaging Findings of Cerebral Air Embolism Infarcts: A Case Series.

Infarcts from cerebral air embolism are rare events with potentially catastrophic clinical consequences. The imaging features of cerebral air embolism are not well-defined in the literature. We report a novel constellation of MR imaging findings of cerebral arterial air emboli-induced infarcts in a series of 6 patients. Awareness of the more distinguishing MR imaging patterns of cerebral air embolism may help establish this diagnosis and facilitate implementation of timely treatment.

Automated MRI-based segmentation of intracranial arterial calcification by restricting feature complexity.

To develop an automated deep learning model for MRI-based segmentation and detection of intracranial arterial calcification. A novel deep learning model under the variational autoencoder framework was developed. A theoretically grounded dissimilarity loss was proposed to refine network features extracted from MRI and restrict their complexity, enabling the model to learn more generalizable MR features that enhance segmentation accuracy and robustness for detecting calcification on MRI. The proposed method was compared with nine baseline methods on a dataset of 113 subjects and showed superior performance (for segmentation, Dice similarity coefficient: 0.620, area under precision-recall curve [PR-AUC]: 0.660, 95% Hausdorff Distance: 0.848 mm, Average Symmetric Surface Distance: 0.692 mm; for slice-wise detection, F1 score: 0.823, recall: 0.764, precision: 0.892, PR-AUC: 0.853). For clinical needs, statistical tests confirmed agreement between the true calcification volumes and predicted values using the proposed approach. Various MR sequences, namely T1, time-of-flight, and SNAP, were assessed as inputs to the model, and SNAP provided unique and essential information pertaining to calcification structures. The proposed deep learning model with a dissimilarity loss to reduce feature complexity effectively improves MRI-based identification of intracranial arterial calcification. It could help establish a more comprehensive and powerful pipeline for vascular image analysis on MRI.

Accurate Whole-Brain Image Enhancement for Low-Dose Integrated PET/MR Imaging Through Spatial Brain Transformation.

Positron emission tomography/magnetic resonance imaging (PET/MRI) systems can provide precise anatomical and functional information with exceptional sensitivity and accuracy for neurological disorder detection. Nevertheless, the radiation exposure risks and economic costs of radiopharmaceuticals may pose significant burdens on patients. To mitigate image quality degradation during low-dose PET imaging, we proposed a novel 3D network equipped with a spatial brain transform (SBF) module for low-dose whole-brain PET and MR images to synthesize high-quality PET images. The FreeSurfer toolkit was applied to derive the spatial brain anatomical alignment information, which was then fused with low-dose PET and MR features through the SBF module. Moreover, several deep learning methods were employed as comparison measures to evaluate the model performance, with the peak signal-to-noise ratio (PSNR), structural similarity (SSIM) and Pearson correlation coefficient (PCC) serving as quantitative metrics. Both the visual results and quantitative results illustrated the effectiveness of our approach. The obtained PSNR and SSIM were 41.96 ± 4.91 dB (p < 0.01) and 0.9654 ± 0.0215 (p < 0.01), which achieved a 19% and 20% improvement, respectively, compared to the original low-dose brain PET images. The volume of interest (VOI) analysis of brain regions such as the left thalamus (PCC = 0.959) also showed that the proposed method could achieve a more accurate standardized uptake value (SUV) distribution while preserving the details of brain structures. In future works, we hope to apply our method to other multimodal systems, such as PET/CT, to assist clinical brain disease diagnosis and treatment.

Experimental study on characterization of resilient modulus and prediction model of saline aeolian sand

The dynamic resilience characteristics of aeolian sand subgrade are influenced by salt content and water content, exhibiting significant stress dependence and anisotropy. The resilient modulus(MR) of aeolian sand represents the stress-strain nonlinearity under cyclic loading, serving as an important parameter for the design of aeolian sand subgrade in desert areas. In order to investigate the variation of MR of aeolian sand subgrade with salt content and water content under traffic loading, as well as the MR characteristics under these conditions, three types of aeolian sand samples with varying water content and four sulphate contents were prepared. The variation of MR of aeolian sand under different confining pressures and deviator stress levels, as well as the influences of water content and salt content, was studied through indoor dynamic triaxial testing. Based on the pattern of the fitting parameters of the benchmark model, a prediction model suitable for the MR of aeolian sand was constructed. The results indicate a rise in aeolian sand's MR with increasing deviator stress and confining pressure, with confining pressure having a more significant impact than deviator stress. With the increase in water content, the MR of aeolian sand decreases nonlinearly, and with the increase in salt content, it exhibits a wave-shaped trend of "increasing-decreasing-increasing," which is related to the dissolution state of sodium sulfate in the soil. Based on the experimental results, a prediction model of the MR of aeolian sand was established, derived from the benchmark model, which can reflect the influence of salt content and water content on the MR, introducing them as variables within the model.

An Algorithmic Approach to MR Imaging of Hypomyelinating Leukodystrophies.

Hypomyelinating leukodystrophies (HLDs) are a heterogeneous group of white matter diseases characterized by permanent deficiency of myelin deposition in brain. MRI is instrumental in the diagnosis and recommending genetic analysis, and is especially useful as many patients have a considerable clinical overlap, with the primary presenting complains being global developmental delay with psychomotor regression. Hypomyelination is defined as deficient myelination on two successive MR scans, taken at least 6 months apart, one of which should have been obtained after 1 year of age. Due to subtle differences in MRI features, the need for a systematic imaging approach to diagnose and classify hypomyelinating disorders is reiterated. The presented article provides an explicit review of imaging features of a myriad of primary and secondary HLDs, using state of the art genetically proven MR cases. A systematic pattern-based approach using MR features and specific clinical clues is illustrated for a quick yet optimal diagnosis of common as well as rare hypomyelinating disorders. The major MR features helping to narrow the differential diagnosis include extent of involvement like diffuse or patchy hypomyelination with selective involvement or sparing of certain white matter structures like optic radiations, median lemniscus, posterior limb of internal capsule and periventricular white matter; cerebellar atrophy; brainstem, corpus callosal or basal ganglia involvement; T2 hypointense signal of the thalami; and presence of calcifications. The authors also discuss the genetic and pathophysiologic basis of HLDs and recent methods to quantify myelin in vivo using advanced neuroradiology tools. The proposed algorithmic approach provides an improved understanding of these rare yet important disorders, enhancing diagnostic precision and improving patient outcomes. EVIDENCE LEVEL: 4 TECHNICAL EFFICACY: Stage 5.

Direct correlation of MR-DWI and histopathology of Wilms' tumours through a patient-specific 3D-printed cutting guide.

The International Society of Paediatric Oncology-Renal Tumour Study Group (SIOP-RTSG) discourages invasive procedures to determine the histology of paediatric renal neoplasms at diagnosis. Therefore, the histological subtype of Wilms' tumours (WT) is unknown at the start of neoadjuvant chemotherapy. MR-DWI shows potential value as a non-invasive biomarker through apparent diffusion coefficients (ADCs). This study aimed to describe MR characteristics and ADC values of paediatric renal tumours to differentiate subtypes. Children with a renal tumour undergoing surgery within the SIOP-RTSG 2016-UMBRELLA protocol were prospectively included between May 2021 and 2023. In the case of a total nephrectomy, a patient-specific cutting guide based on the neoadjuvant MR was 3D-printed, allowing a correlation between imaging and histopathology. Whole-tumour volumes and ADC values were statistically compared with the Mann-Whitney U-test. Direct correlation on the microscopic slide level was analysed through mixed model analysis. Fifty-nine lesions of 54 patients (58% male, median age 3.0 years (range 0-17.7 years)) were included. Forty-four lesions involved a WT. Stromal type WT showed the lowest median decrease in volume after neoadjuvant chemotherapy (48.1 cm3, range 561.5-(+)332.7 cm3, p = 0.035). On a microscopic slide level (n = 240 slides) after direct correlation through the cutting guide, stromal areas showed a significantly higher median ADC value compared to epithelial and blastemal foci (p < 0.001). With a cut-off value of 1.195 * 10-3 mm2/s, sensitivity, and specificity were 95.2% (95% confidence interval 87.6-98.4%) and 90.5% (95% confidence interval 68.2-98.3%), respectively. Correlation between histopathology and MR-DWI through a patient-specific 3D-printed cutting guide resulted in significant discrimination of stromal type WT from epithelial and blastemal subtypes. Stromal Wilms' tumours could be discriminated from epithelial- and blastemal lesions based on high apparent diffusion coefficient values and limited decrease in volume after neoadjuvant chemotherapy. This may aid in future decision-making, especially concerning discrimination between low- and high-risk neoplasms. MR-DWI shows potential value as a non-invasive biomarker in paediatric renal tumours. The patient-specific cutting guide leads to a correlation between apparent diffusion coefficient values and Wilms' tumour subtype. Stromal areas could be discriminated from epithelial and blastemal foci in Wilms' tumours based on apparent diffusion coefficient values.

Comparison of lung lesion assessment using free-breathing dynamic contrast-enhanced 1.5-T MRI with a golden-angle radial stack-of-stars VIBE sequence and CT.

Few studies have investigated the feasibility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using a free-breathing golden-angle radial stack-of-stars volume-interpolated breath-hold examination (FB radial VIBE) sequence in the lung. To investigate whether DCE-MRI using the FB radial VIBE sequence can assess morphological and kinetic parameters in patients with pulmonary lesions, with computed tomography (CT) as the reference. In total, 43 patients (30 men; mean age = 64 years) with one lesion each were prospectively enrolled. Morphological and kinetic features on MRI were calculated. The diagnostic performance of morphological MR features was evaluated using a receiver operating characteristic (ROC) curve. Kinetic features were compared among subgroups based on histopathological subtype, lesion size, and lymph node metastasis. The maximum diameter was not significantly different between CT and MRI (3.66 ± 1.62 cm vs. 3.64 ± 1.72 cm; P = 0.663). Spiculation, lobulation, cavitation or bubble-like areas of low attenuation, and lymph node enlargement had an area under the ROC curve (AUC) >0.9, while pleural indentation yielded an AUC of 0.788. The lung cancer group had significantly lower Ktrans, Ve, and initial AUC values than the other cause inflammation group (0.203, 0.158, and 0.589 vs. 0.597, 0.385, and 1.626; P < 0.05) but significantly higher values than the tuberculosis group (P < 0.05). Morphology features derived from FB radial VIBE have high correlations with CT, and kinetic analyses show significant differences between benign and malignant lesions. DCE-MRI with FB radial VIBE could serve as a complementary quantification tool to CT for radiation-free assessments of lung lesions.

MR imaging features of uterine necrosis following modified B-Lynch sutures: a case report

BackgroundB-Lynch braided compression sutures are applied as a lifesaving procedure to control atonic post-partum hemorrhage if the patient is not responding to uterotonics and other conservative methods. These sutures are applied to avoid hysterectomy so as to preserve fertility. However, if not applied properly, these can lead to a rare but serious complication of uterine necrosis secondary to uterine ischemia and sepsis. The patient then ends up in hysterectomy defeating the sole purpose of maintaining fertility for which the sutures were applied at the first place.Case presentationHere we describe a case of primipara who had caesarian section complicated by post-partum hemorrhage which was managed with modified B-Lynch compression sutures for achieving hemostasis. The patient presented three weeks post-procedure with signs and symptoms of inflammation and sepsis. The MR imaging revealed features of uterine necrosis. The patient underwent hysterectomy unwillingly as no other option was left to save her life. A detailed MR imaging of this case has been described given the scarcity of MR features of uterine necrosis following compressive sutures in medical literature.ConclusionsThe case is reported to make the clinicians aware of the possibility of such a dreaded complication following compressive sutures for post-partum hemorrhage and to emphasize on early and timely follow-up of such patients so that uterus could be salvaged.

Application of individual brain connectome in chronic ischemia: mapping symptoms before and after reperfusion.

How brain functions in the distorted ischemic state before and after reperfusion is unclear. It is also uncertain whether there are any indicators within ischemic brain that could predict surgical outcomes. To alleviate these issues, we applied individual brain connectome in chronic steno-occlusive vasculopathy (CSOV) to map both ischemic symptoms and their postbypass changes. A total of 499 bypasses in 455 CSOV patients were collected and followed up for 47.8±20.5 months. Using multimodal parcellation with connectivity-based and pathological distortion-independent approach, areal MR features of brain connectome were generated with three measurements of functional connectivity (FC), structural connectivity, and PageRank centrality at the single-subject level. Thirty-three machine-learning models were then trained with clinical and areal MR features to obtain acceptable classifiers for both ischemic symptoms and their postbypass changes, among which, 11 were deemed acceptable (AUC>0.7). Notably, the FC feature-based model for long-term neurological outcomes performed very well (AUC>0.8). Finally, a Shapley additive explanations plot was adopted to extract important individual features in acceptable models to generate "fingerprints" of brain connectome. This study not only establishes brain connectomic fingerprint databases for brain ischemia with distortion, but also provides informative insights for how brain functions before and after reperfusion.

The diagnostic value of multimodal imaging based on MR combined with ultrasound in benign and malignant breast diseases

We aimed to construct and validate a multimodality MRI combined with ultrasound based on radiomics for the evaluation of benign and malignant breast diseases. The preoperative enhanced MRI and ultrasound images of 131 patients with breast diseases confirmed by pathology in Aerospace Center Hospital from January 2021 to August 2023 were retrospectively analyzed, including 73 benign diseases and 58 malignant diseases. Ultrasound and 3.0 T multiparameter MRI scans were performed in all patients. Then, all the data were divided into training set and validation set in a 7:3 ratio. Regions of interest were drawn layer by layer based on ultrasound and MR enhanced sequences to extract radiomics features. The optimal radiomic features were selected by the best feature screening method. Logistic Regression classifier was used to establish models according to the best features, including ultrasound model, MRI model, ultrasound combined with MRI model. The model efficacy was evaluated by the area under the curve (AUC) of the receiver operating characteristic, sensitivity, specificity, and accuracy. The F-test based on ANOVA was used to screen out 20 best ultrasonic features, 11 best MR Features, and 14 best features from the combined model. Among them, texture features accounted for the largest proportion, accounting for 79%.The ultrasound combined with MR Image fusion model based on logistic regression classifier had the best diagnostic performance. The AUC of the training group and the validation group were 0.92 and 091, the sensitivity was 0.80 and 0.67, the specificity was 0.90 and 0.94, and the accuracy was 0.84 and 0.79, respectively. It was better than the simple ultrasound model (AUC of validation set was 0.82) or the simple MR model (AUC of validation set was 0.85). Compared with the traditional ultrasound or magnetic resonance diagnosis of breast diseases, the multimodal model of MRI combined with ultrasound based on radiomics can more accurately predict the benign and malignant breast diseases, thus providing a better basis for clinical diagnosis and treatment.

Using Apparent Diffusion Coefficient (ADC) of Endometrial Cancer MRI to Determine P53 Molecular Subtypes.

Endometrial Cancer (EC) is a highly heterogeneous cancer comprising both histological and molecular subtypes. Using a non-invasive modality method to trigger these subtypes as early as possible can aid clinicians in establishing individualized treatment. The study aimed to clarify the value of the Apparent Diffusion Coefficient (ADC) of EC MRI in determining molecular subtypes. We retrospectively recruited 109 patients with pathologically proven EC (78 endometrioid cancers and 31 non-endometrioid cancers) with available molecular classification from a tertiary centre. MRI was prospectively performed a month prior to surgery; images were blindly interpreted by two experienced radiologists with consensus reading. The ADC value was measured by an experienced radiologist on the commercially available processing workstation. Interoperator measurement consistency was calculated. Our sample comprised 17 PLOE, 32 MSI-H, 31 NSMP, and 29 P53abn ECs. Clinical information did not differ significantly among the groups. The maximum diameter and volume of the lesions differed among the groups. The ADC value in the maximal area (ADCarea) or region of interest (ROI, ADCroi) in the P53abn group was higher than that in the other groups (894.0 ±12.6 and 817.5 ± 83.3 x10-6 mm2/s). The ADC mean values were significantly different between the P53abn group and the other groups (P = 0.000). The nomogram showed the highest discriminative ability to distinguish P53abn EC from other types (AUC: 0.859). Our results have suggested the quantitative MR characteristics (ADC values) derived from preoperative EC MRI to provide useful information in preoperatively determining P53abn cancer.

MRI of pelvic endometriosis: evaluation of the mr#Enzian classification and the importance of adenomyosis subtypes

PurposeThis study aimed to investigate the utility of the #Enzian classification in magnetic resonance imaging (MRI) for endometriosis assessment, focusing on inter-reader agreement, diagnostic accuracy, and the correlation of adenomyosis with deep endometriosis (DE).MethodsThis IRB- approved retrospective single-center study included 412 women who underwent MRI evaluation for endometriosis between February 2017 and June 2022. Two experienced radiologists independently analyzed MRI images using the #Enzian classification and assessed the type of adenomyosis, if any. The surgical #Enzian classification served as the gold standard for evaluating preoperative MRI results of 45 patients. Statistical analysis was performed to assess inter-reader agreement and diagnostic accuracy.ResultsInter-reader agreement was substantial to excellent (Cohen’s kappa 0.75–0.96) for most compartments except peritoneal involvement (0.39). The preoperative MRI showed mostly substantial to excellent accuracy (0.84–0.98), sensitivity (0.62–1.00), specificity (0.87–1.00), positive (0.58–1.00) and negative predictive values (0.86–1.00) for most compartments, except for peritoneal lesions (0.36, 0.17, 1.00, 1.00, 0.26 respectively). A trend with a higher prevalence of concordant DE in women with MR features of external adenomyosis compared to those with internal adenomyosis was visible (p = 0.067).ConclusionsThe mr#Enzian showed mostly high inter-reader agreement and good diagnostic accuracy for various endometriosis compartments. MRI’s role is particularly significant in the context of the current paradigm shift towards medical endometriosis treatment. The inclusion of information about the type of adenomyosis in the mr#Enzian classification could enhance diagnostic accuracy and inform treatment planning.Graphical

Nutritional, molecular, and functional properties of a novel enzymatically hydrolyzed porcine plasma product.

In the present study, an enzymatically hydrolyzed porcine plasma (EHPP) was nutritionally and molecularly characterized. EHPP molecular characterization showed, in contrast to spray-dried plasma (SDP), many peptides with relative molecular masses (Mr) below 8,000, constituting 73% of the protein relative abundance. IIAPPER, a well-known bioactive peptide with anti-inflammatory and antioxidant properties, was identified. In vivo functionality of EHPP was tested in C. elegans and two different mouse models of intestinal inflammation. In C. elegans subjected to lipopolysaccharide exposure, EHPP displayed a substantial anti-inflammatory effect, enhancing survival and motility by 40% and 21.5%, respectively. Similarly, in mice challenged with Staphylococcus aureus enterotoxin B or Escherichia coli O42, EHPP and SDP supplementation (8%) increased body weight and average daily gain while reducing the percentage of regulatory Th lymphocytes. Furthermore, both products mitigated the increase of pro-inflammatory cytokines expression associated with these challenged mouse models. In contrast, some significant differences were observed in markers such as Il-6 and Tnf-α, suggesting that the products may present different action mechanisms. In conclusion, EHPP demonstrated similar beneficial health effects to SDP, potentially attributable to the immunomodulatory and antioxidant activity of its characteristic low Mr bioactive peptides.

Amide proton transfer weighted and diffusion weighted imaging based radiomics classification algorithm for predicting 1p/19q co-deletion status in low grade gliomas

Background1p/19q co-deletion in low-grade gliomas (LGG, World Health Organization grade II and III) is of great significance in clinical decision making. We aim to use radiomics analysis to predict 1p/19q co-deletion in LGG based on amide proton transfer weighted (APTw), diffusion weighted imaging (DWI), and conventional MRI.MethodsThis retrospective study included 90 patients histopathologically diagnosed with LGG. We performed a radiomics analysis by extracting 8454 MRI-based features form APTw, DWI and conventional MR images and applied a least absolute shrinkage and selection operator (LASSO) algorithm to select radiomics signature. A radiomics score (Rad-score) was generated using a linear combination of the values of the selected features weighted for each of the patients. Three neuroradiologists, including one experienced neuroradiologist and two resident physicians, independently evaluated the MR features of LGG and provided predictions on whether the tumor had 1p/19q co-deletion or 1p/19q intact status. A clinical model was then constructed based on the significant variables identified in this analysis. A combined model incorporating both the Rad-score and clinical factors was also constructed. The predictive performance was validated by receiver operating characteristic curve analysis, DeLong analysis and decision curve analysis. P < 0.05 was statistically significant.ResultsThe radiomics model and the combined model both exhibited excellent performance on both the training and test sets, achieving areas under the curve (AUCs) of 0.948 and 0.966, as well as 0.909 and 0.896, respectively. These results surpassed the performance of the clinical model, which achieved AUCs of 0.760 and 0.766 on the training and test sets, respectively. After performing Delong analysis, the clinical model did not significantly differ in predictive performance from three neuroradiologists. In the training set, both the radiomic and combined models performed better than all neuroradiologists. In the test set, the models exhibited higher AUCs than the neuroradiologists, with the radiomics model significantly outperforming resident physicians B and C, but not differing significantly from experienced neuroradiologist.ConclusionsOur results suggest that our algorithm can noninvasively predict the 1p/19q co-deletion status of LGG. The predictive performance of radiomics model was comparable to that of experienced neuroradiologist, significantly outperforming the diagnostic accuracy of resident physicians, thereby offering the potential to facilitate non-invasive 1p/19q co-deletion prediction of LGG.