目的基于T2^(*)mapping定量分析业余马拉松运动员足踝部关节软骨的T2^(*)值,并分析其与性别、年龄、身体质量指数(body mass index,BMI)、跑龄、跑量之间的相关性。材料与方法于2023年7月份至2023年9月份招募重庆市长跑运动爱好者48名,...目的基于T2^(*)mapping定量分析业余马拉松运动员足踝部关节软骨的T2^(*)值,并分析其与性别、年龄、身体质量指数(body mass index,BMI)、跑龄、跑量之间的相关性。材料与方法于2023年7月份至2023年9月份招募重庆市长跑运动爱好者48名,其中跑量<300 km/月的36例(中低跑量组),跑量≥300 km/月的12例(高跑量组)。所有受试者均进行单侧无症状踝关节的MRI扫描,扫描序列包括T2^(*)mapping多回波自旋回波(spin echo,SE)序列矢状位、质子密度加权成像脂肪抑制(proton density-weighted imaging fat-saturated,PDWI-FS)序列矢状位、冠状位、横轴位以及T1加权脂肪抑制成像(T1-weighted imaging fat-saturated,T1WI-FS)序列横轴位。沿关节软骨轮廓边缘勾画距骨穹窿、跟骰关节跟骨面、骰骨面及后距下关节跟骨面、距骨面软骨作为感兴趣区(region of interest,ROI),获得相应的T2^(*)值。采用线性回归分析软骨T2^(*)值与年龄、BMI、跑龄的相关性,采用独立样本t检验分析不同跑量及不同性别间的软骨T2^(*)值差异。结果(1)距骨穹窿、跟骰关节跟骨面及骰骨面、后距下关节跟骨面及距骨面软骨T2^(*)值在性别上的差异均具有统计学意义(P=0.001、P<0.001、P=0.002、P=0.008、P=0.004);(2)高跑量组的距骨穹窿、后距下关节跟骨面软骨T2^(*)值高于中低跑量组(P=0.014、0.023),不同跑量的跟骰关节跟骨面及骰骨面、后距下关节距骨面软骨T2^(*)值的差异均无统计学意义(P=0.987、0.072、0.724);(3)距骨穹窿、跟骰关节跟骨面及骰骨面、后距下关节跟骨面、距骨面软骨T2^(*)值均与BMI呈正相关(r=0.376、0.384、0.300、0.422、0.455,P=0.005、0.004、0.019、0.001、0.001)。结论在业余马拉松运动员这一跑步群体中,与中低跑量相比,高跑量更有可能导致距骨穹窿、后距下关节跟骨面软骨损伤;而与较低的BMI相比,高BMI增加了距骨穹窿、跟骰关节跟骨面、骰骨面及后距下关节跟骨面、距骨面软骨损伤的风险。展开更多
Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer...Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.展开更多
文摘目的探讨增强T2^(*)加权血管成像(enhanced T2 star-weighted angiography,ESWAN)序列中R2^(*)值、相位值、幅度值在T2WI低信号肾脏病变良恶性鉴别诊断中的可行性。材料与方法回顾性收集行ESWAN检查、经病理组织学证实的145例T2WI低信号肾脏病变患者(共145个病灶,恶性病变112个,良性病变33个)的术前MRI图像。在肿瘤最大面积的层面上绘制肿瘤T2WI低信号的感兴趣区。通过Kruskal-Wallis检验、卡方检验对参数进行比较,将有统计学意义的参数进行联合,通过多变量logistic回归建立模型,分析差异有统计学意义的参数,并且绘制其鉴别T2WI低信号肾脏病变良恶性的受试者工作特征(receiver operating characteristic,ROC)曲线,采用DeLong检验评价其诊断效能。结果R2^(*)值和幅度值鉴别T2WI低信号肾脏病变良恶性差异具有统计学意义(P=0.001)。R2^(*)值的ROC曲线下面积(area under the curve,AUC)为0.891[95%置信区间(confidence interval,CI):0.829~0.937,P<0.001],敏感度、特异度分别为97.3%、72.7%;幅度值的AUC为0.869(95%CI:0.803~0.920,P<0.001),敏感度、特异度分别为86.6%、81.8%;相位值的AUC为0.563(95%CI:0.478~0.645,P=0.249),敏感度、特异度分别为67.9%、54.6%;R2^(*)值联合幅度值的AUC为0.886(95%CI:0.823~0.933,P<0.001),敏感度、特异度分别为97.3%、72.7%;R2^(*)值联合病变长径的AUC为0.894(95%CI:0.832~0.939,P<0.001),敏感度、特异度分别为92.0%、81.8%;幅度值联合病变长径的AUC为0.858(95%CI:0.790~0.910,P<0.001),敏感度、特异度分别为75.9%、90.9%。结论R2^(*)值、R2^(*)值联合病变长径、R2^(*)值联合幅度值是鉴别T2WI低信号肾脏病变良恶性的有效方法,R2^(*)值联合病变长径具有更好的诊断性能。
文摘Objective To qualitatively assess the diagnostic performance of dynamic contrast enhancement(DCE),diffusionweighted imaging(DWI),and T2-weighted imaging(T2WI),alone or in combination,in the evaluation of breast cancer.Methods We retrospectively reviewed the records of 394 consecutive patients with pathologically confirmed breast lesions who had undergone 3-T magnetic resonance imaging(MRI).The morphological characteristics of breast lesions were evaluated using DCE,DWI,and T2WI based on BI-RADS lexicon descriptors by trained radiologists.Patients were categorized into mass and non-mass groups based on MRI characteristics of the lesions,and the differences between benign and malignant lesions in each group were compared.Clinical prediction models for breast cancer diagnosis were constructed using logistic regression analysis.Diagnostic efficacies were compared using the area under the receiver operating characteristic curve(AUC)and DeLong test.Results For mass-like lesions,all the morphological parameters significantly differentiated benign and malignant lesions on consensus DCE,DWI,and T2WI(P<0.05).The combined method(DCE+DWI+T2WI)had a higher AUC(0.865)than any of the individual modality(DCE:0.786;DWI:0.793;T2WI:0.809)(P<0.05).For non-mass-like lesions,DWI signal intensity was a significant predictor of malignancy(P=0.036),but the model using DWI alone had a low AUC(0.669).Conclusion Morphological assessment using the combination of DCE,DWI,and T2WI provides better diagnostic value in differentiating benign and malignant breast mass-like lesions than assessment with only one of the modalities.
