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Quantitative differentiation of malignant and benign thyroid nodules with multi-parameter diffusion-weighted imaging

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World Journal of Clinical Cases 2022年第24期10卷 8587-8598页

作者： Xiang Zhu Jia Wang Yan-Chun Wang Ze-Feng Zhu Jian Tang Xiao-Wei Wen Ying Fang Jun Han Department of Radiology The First Hospital of Jiaxing&The Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina Department of Head and Neck Surgery the First Hospital of Jiaxing&The Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina Department of Pathology The First Hospital of Jiaxing&The Affiliated Hospital of Jiaxing UniversityJiaxing 314000Zhejiang ProvinceChina

BACKGROUND The value of conventional magnetic resonance imaging in the differential diagnosis of thyroid nodules is limited;however,the value of multi-parameter diffusion-weighted imaging(DWI)in the quantitative evaluation of thyroid nodules has not been well *** To determine the utility of multi-parametric DWI including mono-exponential,biexponential,stretched exponential,and kurtosis models for the differentiation of thyroid *** Seventy-nine patients(62 with benign and 17 with malignant nodules)underwent multi-b value diffusion-weighted imaging of the *** DWI parameters were obtained for statistical *** Good agreement was found for diffusion parameters of thyroid *** lesions displayed lower diffusion parameters including apparent diffusion coefficient(ADC),the true diffusion coefficient(D),the perfusion fraction(f),the distributed diffusion coefficient(DDC),the intravoxel water diffusion heterogeneity(α)and kurtosis model-derived ADC(Dapp),and higher apparent diffusional kurtosis(Kapp)than benign entities(all Pdiffusion coefficient(D*)(P>0.05).The area under the ROC curve(AUC)of the ADC(0 and 1000)was not significantly different from that of the ADC(0 and 2000),ADC(0 to 2000),ADC(0 to 1000),D,DDC,Dapp and Kapp(all P>0.05),but was significantly higher than the AUC of D*,f andα(all P<0.05)for differentiating benign from malignant *** Multiple DWI parameters including ADC,D,f,DDC,α,Dapp and Kapp could discriminate benign and malignant thyroid *** metrics including D,DDC,Dapp and Kapp provide additional information with similar diagnostic performance of ADC,combination of these metrics may contribute to differentiate benign and malignant thyroid *** ADC calculated with higher b values may not lead to improved diagnostic performance.

关键词： Thyroid nodule Magnetic resonance imaging diffusion-weighted imaging Quantitative study Sensitivity Specificity

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diffusion-weighted imaging of biliopancreatic disorders:Correlation with conventional magnetic resonance imaging

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World Journal of Gastroenterology 2012年第31期18卷 4102-4117页

作者： Nam Kyung Lee Suk Kim Gwang Ha Kim Dong Uk Kim Hyung Il Seo Tae Un Kim Dae Hwan Kang Ho Jin Jang Department of Radiology Biomedical Research InstitutePusan National University HospitalSchool of MedicinePusan National UniversityBusan 602-739South Korea Department of Internal Medicine Biomedical Research InstitutePusan National University HospitalSchool of MedicinePusan National UniversityBusan 602-739South Korea Department of Surgery Biomedical Research InstitutePusan National University HospitalSchool of MedicinePusan National UniversityBusan 602-739South Korea Department of Radiology Yangsan Pusan National University HospitalSchool of MedicinePusan National UniversityYangsan 626-770South Korea Department of Internal Medicine Yangsan Pusan National University HospitalSchool of MedicinePusan National UniversityYangsan 626-770South Korea Department of Obstetrics and Gynecology Armed Forces Seoul HospitalSeoul 110-200South Korea

diffusion-weighted magnetic resonance imaging(DWI)is a well established method for the evaluation of intracranial diseases,such as acute *** for extracranial application is more difficult due to physiological motion artifacts and the heterogeneous composition of the ***,thanks to the newer technical development of DWI,DWI has become increasingly used over the past few years in extracranial organs including the abdomen and *** previous studies of DWI have been limited to the evaluation of diffuse parenchymal abnormalities and focal lesions in abdominal organs,whereas there are few studies about DWI for the evaluation of the biliopancreatic *** further studies are needed to determine its performance in evaluating bile duct,gallbladder and pancreas diseases,DWI has potential in the assessment of the functional information on the biliopancreatic tract concerning the status of tissue cellularity,because increased cellularity is associated with impeded diffusion,as indicated by a reduction in the apparent diffusion *** detection of malignant lesions and their differentiation from benign tumor-like lesions in the biliopancreatic tract could be improved using DWI in conjunction with findings obtained with conventional magnetic resonance ***,DWI can be useful for the assessment of the biliopancreatic tract in patients with renal impairment because contrast-enhanced computed tomography or magnetic resonance scans should be avoided in these patients.

关键词： Magnetic resonance imaging diffusion-weighted imaging Biliary tract Gallbladder Pancreas

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diffusion-weighted imaging and fluid-attenuated inversion recovery sequence in sporadic Creutzfeldt-Jakob disease:One-case report

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Neural Regeneration Research 2011年第29期6卷 2295-2297页

作者： Rosa Morabito Annalisa Baglieri Rosella Ciurleo Francesco Corallo Rosaria De Luca Simona De Salvo Silvia Guerrera Francesca Timpano Maria Adele Marino Placido Bramanti Silvia Marino Neurobioimaging Laboratory IRCCS Centro Neurolesi "Bonino Pulejo"MessinaItaly

The diagnosis of sporadic Creutzfeldt-Jakob disease （sCJD） is extremely difficult. diffusion-weighted imaging has been shown to be the most sensitive technique for the detection of signal alterations in sCJD patients. The present study analyzed the diagnostic value of diffusion-weighted imaging and fluid-attenuated inversion recovery sequence in the early stage of sCJD in one female patient and correlated the clinical symptoms during disease course and magnetic resonance manifestations. Thalamic and basal ganglia hyperintensities were observed on magnetic resonance images in a very early stage, i.e., when the clinical typical manifestations of the disease were not present. With the progression of the disease, cortical and basal ganglia hyperintensities were observed on magnetic resonance images, showing an obvious cerebral atrophy. These findings suggest that diffusion-weighted imaging and fluid-attenuated inversion recovery sequence are helpful in diagnosing sCJD.

关键词： Creutzfeldt-Jacob disease fluid-attenuated inversion recovery diffusion-weighted imaging magnetic resonance imaging

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diffusion-weighted imaging might be useful for reactive lymphoid hyperplasia diagnosis of the liver: A case report

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World Journal of Clinical Cases 2020年第21期8卷 5313-5319页

作者： Taro Tanaka Kazuhiro Saito Daisuke Yunaiyama Jun Matsubayashi Yuichi Nagakawa Maki Tanigawa Toshitaka Nagao Department of Radiology Tokyo Medical UniversityTokyo 1600023Japan Department of Anatomic Pathology Tokyo Medical UniversityTokyo 1600023Japan Department of Gastrointestinal and Pediatric Surgery Tokyo Medical UniversityTokyo 1600023Japan

BACKGROUND Reactive lymphoid hyperplasia(RLH)of the liver is a rare liver *** is considered difficult to differentiate radiologically from hepatocellular carcinoma,metastatic liver tumor and other *** SUMMARY A 54-year-old woman presented to our hospital with RLH of the *** patient had a diagnosis of metastatic carcinoma of the liver from an unknown origin and subsequently underwent partial ***,histopathological analysis revealed *** lesion showed perinodular enhancement in the arterial phase on contrast-enhanced computed tomography and magnetic resonance *** diffusion-weighted imaging(DWI),we encountered linear hyperintensity along the portal tract consecutive to the liver lesion,which is a new characteristic radiologic *** finding corresponded to the lymphoid cell infiltration of the portal ***,there was strongly restricted diffusion on the apparent diffusion coefficient *** used these characteristic radiologic findings to diagnose the lesion as a lymphoproliferative *** The linear hyperintensity consecutive to the liver lesion on DWI provided additional valuable diagnostic information.

关键词： Reactive lymphoid hyperplasia Pseudolymphoma Magnetic resonance imaging diffusion-weighted imaging Perinodular enhancement Portal tract infiltration Case report

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Characteristics and pathological mechanism on magnetic resonance diffusion-weighted imaging after chemoembolization in rabbit liver VX-2 tumor model

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World Journal of Gastroenterology 2007年第43期13卷 5699-5706页

作者： You-Hong Yuan En-Hua Xiao Jian-Bin Liu Zhong He Ke Jin Cong Ma Jun Xiang Jian-Hua Xiao Wei-Jian Chen Department of Radiology HunanProvince People's Hospital Changsha 410005 Hunan ProvinceChina Departmentof Radiology the Second Xiang-Ya Hospital Central SouthUniversity Changsha 410005 Hunan Province China Department of Pathology HunanProvince Children's Hospital Changsha 410005 Hunan ProvinceChina Department of Epidemiology Center for DiseaseControl of Hunan Province Changsha 410005 Hunan ProvinceChina

AIM: To investigate dynamic characteristics and pathological mechanism of signal in rabbit VX-2 tumor model on diffusion-weighted imaging (DWI) after chemoembolization. METHODS: Forty New Zealand rabbits were included in the study and forty-seven rabbit VX-2 tumor models were raised by implanting directly and intrahepatically after abdominal cavity opened. Forty VX-2 tumor models from them were divided into four groups. DWI was performed periodically and respectively for each group after chemoembolization. All VX-2 tumor samples of each group were studied by pathology. The distinction of VX-2 tumors on DWI was assessed by their apparent diffusion coefficient (ADC) values. The statistical significance between different time groups, different area groups or different b-value groups was calculated by using SPSS12.0 software. RESULTS: Under b-value of 100 s/mm2, ADC values were lowest at 16 h after chemoembolization in area of VX-2 tumor periphery, central, and normal liver parenchyma around tumor, but turned to increase with further elongation of chemoembolization treatment. The distinction of ADC between different time groups was significant respectively (F = 7.325, P < 0.001; F = 2.496, P < 0.048; F = 6.856, P < 0.001). Cellular edema in the area of VX-2 tumor periphery or normal liver parenchyma around tumor, increased quickly in sixteen h after chemoembolization but, from the 16th h to the 48th h, cellular edema in the area of normal liver parenchyma around tumor decreased gradually and that in the area of VX-2 tumor periphery decreased lightly at, and then increased continually. After chemoembolization, Cellular necrosis in the area of VX-2 tumor periphery was more significantly high than that before chemoembolization. The areas of dead cells in VX-2 tumors manifested low signal and high ADC value, while the areas of viable cells manifested high signal and low ADC value. CONCLUSION: DWI is able to detect and differentiate tumor necrotic areas from viable cellular

关键词： Liver VX-2 tumor diffusion-weighted imaging Apparent diffusion coefficient Chemoembolization

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Comparison of Magnetic Resonance Elastography and diffusion-weighted imaging for Staging Hepatic Fibrosis

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Chinese Medical Journal 2015年第5期128卷 620-625页

作者： Li-Qiu Zou Jie Chen Liang Pan Jin-Zhao Jiang Wei Xing Department of Radiology Peking University Shenzhen Hospital Shenzhen Guangdong 518036 China Department of Radiology Affiliated Third Hospital of Suzhou University Changzhou Jiangsu 213003 China Department of Radiology Hong Kong University Shenzhen Hospital Shenzhen Guangdong 518053 China

Background：To compare the diagnostic values of magnetic resonance elastography （MRE） and diffusion-weighted imaging （DWI） in staging hepatic fibrosis （HF） in an animal ***：This study consisted of 44 rabbits served as HF group and 9 normal *** group was divided into two subgroups：Group A （n =32） and Group B （n =12）.Rabbits in Group B were served as a complementary group when rabbits in Group A suddenly died during the *** from control and Group A underwent abdominal MR imaging （MRI）,MRE,and *** Group A,random eight rabbits underwent MRI examinations at 4,5,6,l0 weeks after carbon tetrachloride oil subcutaneous *** stiffness （LS） and apparent diffusion coefficient （ADC） values of liver parenchyma were *** diagnostic performance of MRE and DWI for staging HF was compared using the receiver operating characteristic curve analysis on the basis of the histopathological analysis of ***：Significant differences of LS and DWI values were present among HF stages （P 〈 0.005）.The LS values measured on MRE （r =0.838,P 〈 0.001） were more strongly correlated with the HF stages than with ADC values （r =-0.527,P 〈 0.001）.The area under the receiver operating characteristic curve values of LS were significantly larger than those of DWI were for discriminating two stages of HF （0.979 vs.0.712 for ≥ S 1,0.922 vs.0.699 for ≥ S2）.MRE showed higher specificity for predicting all stages of HF compared to ***：MRE more strongly correlated with the HF stages than DWI and is more specific in predicting all HF stages.

关键词： diffusion-weighted imaging Hepatic Fibrosis: Liver Stiffiness Magnetic Resonance Elastography Stage

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Gene expression and MR diffusion-weighted imaging after chemoembolization in rabbit liver VX-2 tumor model

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World Journal of Gastroenterology 2008年第36期14卷 5557-5563页

作者： You-Hong Yuan En-Hua Xiao Jian-Bin Liu Zhong He Ke Jin Cong Ma Jun Xiang Jian-Hua Xiao Wei-Jian Chen Department of Radiology Hunan Province People's Hospital Changsha 410005 HtmanProvince China Departmentof Radiology the Second Xiang-Ya Hospital Central SouthUniversity Changsha 410005 Hunan Province China Department of Pathology HunanProvince Children's Hospital Changsha 410005 HunanProvince China Department of Epidemiology Center forDisease Control of Hunan Province Changsha 410005 HunanProvince China

AIM: To investigate the dynamic characteristics and the correlation between PCNA, Bax, nm23, E-cadherin expression and apparent diffusion coefficient (ADC) on MR diffusion-weighted imaging (DWI) after chemoembolization in rabbit liver VX-2 tumor model. METHODS: Forty New Zealand rabbit liver VX-2 tumor models were included in the study. DWI was carried out periodically after chemoembolization. All VX-2 tumor samples in each group were examined by histopathology and Strept Avidin-Biotin Complex (SABC) immunohistochemical staining. RESULTS: The PCNA expression index in VX-2 tumors was higher than in the normal parenchyma around the tumor (P < 0.001). Nm23, Bax or E-caderin expression index in VX-2 tumors were lower than in the normal parenchyma around the tumor (all P < 0.001). PCNAand nm23 expression in the VX-2 tumor periphery first increased and then decreased (P < 0.001 and P = 0.03, respectively), while the expression of Bax and E-cadherin before and after chemoembolization was insignificant. When b-value was 100 s/mm2, there was a linear correlation between PCNA expression and ADC in the area of VX-2 tumor periphery (P < 0.001), and PCNA expression in VX-2 tumor periphery influenced the ADC. CONCLUSION: The potential of VX-2 tumor infiltrating and metastasizing decreases, while its ability to proliferate increases for a short time after chemoembolization. To some degree, the ADC value indirectly reflects the proliferation of VX-2 tumor cells.

关键词： Rabbit liver VX-2 tumor Chemoembolization diffusion-weighted imaging Gene expression

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Acute pancreatitis successfully diagnosed by diffusion-weighted imaging: A case report

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World Journal of Gastroenterology 2008年第35期14卷 5478-5480页

作者： Satoshi Shinya Takamitsu Sasaki Yoshifumi Nakagawa Zhang Guiquing Fumio Yamamoto Yuichi Yamashita Department of Gastroenterological Surgery Yamamoto Memorial Hospital88-4 HachiyagaramiNirimachiImariSaga 848-0031Japan Department of Gastroenterological Surgery Fukuoka University School of MedicineNanakuma 7-45-1Jonan-kuFukuoka 814-0180Japan

diffusion-weighted imaging (DWI) is an established diagnostic method of acute stroke. The latest advances in magnetic resonance imaging (MRI) technology have greatly expanded the utility of DWI in the examination of various organs. Recent studies have revealed the usefulness of DWI for imaging of the liver, kidney, ovary, and breast. We report a patient with acute pancreatitis detected by DWI and discussed the efficacy of DWI in diagnosing acute pancreatitis. A 50-year old man presented with a primary complaint of abdominal pain. We performed both DWI and computed tomography (CT) for this patient. The signal intensity in a series of DWI was measured and the apparent diffusion coefficient (ADC) values were calculated to differentiate inflammation from normal tissue. Two experienced radiologists evaluated the grade of acute pancreatitis by comparing the CT findings. Initially, the pancreas and multiple ascites around the pancreas produced a bright signal and ADC values were reduced on DWI. As the inflammation decreased, the bright signal faded to an iso-signal and the ADC values returned to their normal level. There was no difference in the abilities of DWI and CT images to detect acute pancreatitis. However, our case indicates that DWI can evaluate the manifestations of acute pancreatitis using no enhancement material andhas the potential to replace CT as a primary diagnostic strategy for acute pancreatitis.

关键词： diffusion-weighted imaging Apparent diffusion coefficients Magnetic resonance imaging Acute pancreatitis

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Dynamic contrast-enhanced magnetic resonance imaging and diffusion-weighted imaging in the activity staging of terminal ileum Crohn's disease

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World Journal of Gastroenterology 2020年第39期26卷 6057-6073页

作者： Yin-Chen Wu Ze-Bin Xiao Xue-Hua Lin Xian-Ying Zheng Dai-Rong Cao Zhong-Shuai Zhang Department of Radiology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005Fujian ProvinceChina Department of Biomedical Sciences University of PennsylvaniaPhiladelphiaPA 19104United States Department of Diagnosis imaging Siemens Healthcare LtdShanghai 201318China

BACKGROUND The activity staging of Crohn’s disease(CD)in the terminal ileum is critical in developing an accurate clinical treatment *** activity of terminal ileum CD is associated with the microcirculation of involved bowel *** contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusionweighted imaging(DWI)can reflect perfusion and permeability of bowel walls by providing microcirculation *** such,we hypothesize that DCE-MRI and DWI parameters can assess terminal ileum CD,thereby providing an opportunity to stage CD *** To evaluate the value of DCE-MRI and DWI in assessing activity of terminal ileum *** Forty-eight patients with CD who underwent DCE-MRI and DWI were *** patients’activity was graded as remission,mild and *** transfer constant(Ktrans),wash-out constant(Kep),and extravascular extracellular volume fraction(Ve)were calculated from DCE-MRI and the apparent diffusion coefficient(ADC)was obtained from *** Resonance Index of Activity(MaRIA)was calculated from magnetic resonance *** in these quantitative parameters were compared between normal ileal loop(NIL)and inflamed terminal ileum(ITI)and among different activity *** correlations between these parameters,MaRIA,the Crohn’s Disease Activity Index(CDAI),and Crohn’s Disease Endoscopic Index of Severity(CDEIS)were *** operating characteristic curve analyses were used to determine the diagnostic performance of these parameters in differentiating between CD activity *** Higher Ktrans(0.07±0.04 vs 0.01±0.01),Kep(0.24±0.11 vs 0.15±0.05)and Ve(0.27±0.07 vs 0.08±0.03),but lower ADC(1.41±0.26 vs 2.41±0.30)values were found in ITI than in NIL(all P<0.001).The Ktrans,Kep,Ve and MaRIA increased with disease activity,whereas the ADC decreased(all P<0.001).The Ktrans,Kep,Ve and MaRIA showed positive correlations with the CDAI(r=0.866 for Ktrans,0.870 for Kep,0.858 for Ve,0.890 for MaRIA

关键词： Crohn’s disease Ileum Magnetic resonance imaging diffusion-weighted imaging Perfusion imaging

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Optimal b value of diffusion-weighted imaging on a 3.0T magnetic resonance scanner in Crohn's disease

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World Journal of Gastroenterology 2014年第35期20卷 12621-12627页

作者： Qi Feng Yun-Qi Yan Jiong Zhu Jin-Lu Tong Jian-Rong Xu Department of Radiology Renji HospitalSchool of MedicineShanghai Jiao Tong University Department of Gastroenterology Renji HospitalSchool of MedicineShanghai Jiao Tong University

AIM: To determine the optimal b value of diffusion-weighted imaging for detecting active inflammation in Crohn’s disease.

关键词： Crohn’ s disease diffusion-weighted imaging b value Magnetic resonance image 3.0 Tesla

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