Publications by authors named "Zhenchang Wang"

126 Publications

Magnetic resonance radiomics signatures for predicting poorly differentiated hepatocellular carcinoma: A SQUIRE-compliant study.

Medicine (Baltimore) 2021 May;100(19):e25838

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Abstract: Radiomics contributes to the extraction of undetectable features with the naked eye from high-throughput quantitative images. In this study, 2 predictive models were constructed, which allowed recognition of poorly differentiated hepatocellular carcinoma (HCC). In addition, the effectiveness of the as-constructed signature was investigated in HCC patients.A retrospective study involving 188 patients (age, 29-85 years) enrolled from November 2010 to April 2018 was carried out. All patients were divided randomly into 2 cohorts, namely, the training cohort (n = 141) and the validation cohort (n = 47). The MRI images (DICOM) were collected from PACS before ablation; in addition, the radiomics features were extracted from the 3D tumor area on T1-weighted imaging (T1WI) scans, T2-weighted imaging (T2WI) scans, arterial images, portal images and delayed phase images. In total, 200 radiomics features were extracted. t test and Mann-Whitney U test were performed to exclude some radiomics signatures. Afterwards, a radiomics signature model was built through LASSO regression by RStudio Software. We constructed 2 support vector machine (SVM)-based models: 1 with a radiomics signature only (model 1) and 1 that integrated clinical and radiomics signatures (model 2). Then, the diagnostic performance of the radiomics signature was evaluated through receiver operating characteristic (ROC) analysis.The classification accuracy in the training and validation cohorts was 80.9% and 72.3%, respectively, for model 1. In the training cohort, the area under the ROC curve (AUC) was 0.623, while it was 0.576 in the validation cohort. The classification accuracy in the training and validation cohorts were 79.4% and 74.5%, respectively, for model 2. In the training cohort, the AUC was 0.721, while it was 0.681 in the validation cohort.The MRI-based radiomics signature and clinical model can distinguish HCC patients that belong in a low differentiation group from other patients, which helps in the performance of personal medical protocols.
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http://dx.doi.org/10.1097/MD.0000000000025838DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8133272PMC
May 2021

Stapes visualization by ultra-high resolution CT in cadaveric heads: A preliminary study.

Eur J Radiol 2021 May 21;141:109786. Epub 2021 May 21.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China. Electronic address:

Purpose: This study aimed to assess stapes visualization using an ultra-high resolution computed tomography (U-HRCT).

Method: Sixty ears from 30 cadaveric human heads were scanned by both U-HRCT and 128-section multislice CT (MSCT) with clinical parameters. Image quality of the stapes head, anterior and posterior crura, footplate, incudostapedial joint and stapedial muscle within the pyramidal eminence was scored using a 3-point Likert scale. Linear measurements of the stapes configuration were performed on U-HRCT.

Results: The interobserver agreement for image qualitative score on U-HRCT was good to excellent (interobserver agreement coefficients 0.65-0.86). With the exception of the stapes head, U-HRCT achieved significantly higher qualitative scores than MSCT across all anatomical structures (Ps < 0.05). The total height of the stapes was measured to be 3.48 ± 0.33 mm. The height and width of the obturator foramen were 1.77 ± 0.28 mm and 2.19 ± 0.33 mm, respectively. The widths of the anterior and posterior crura were 0.20 ± 0.06 mm and 0.22 ± 0.06 mm, respectively. The thickness of the footplate was 0.22 ± 0.06 mm, and the angle of the incudostapedial joint was 95.91 ± 10.69°.

Conclusions: U-HRCT is capable of delineating fine structures of the stapes and provides linear data on dimensions of the stapes, which could be helpful for detecting stapes disease and making individualized surgical plans in the clinical setting.
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http://dx.doi.org/10.1016/j.ejrad.2021.109786DOI Listing
May 2021

Characterization of Brain Microstructural Abnormalities in High Myopia Patients: A Preliminary Diffusion Kurtosis Imaging Study.

Korean J Radiol 2021 May 4. Epub 2021 May 4.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Objective: To evaluate microstructural damage in high myopia (HM) patients using 3T diffusion kurtosis imaging (DKI).

Materials And Methods: This prospective study included 30 HM patients and 33 age- and sex-matched healthy controls (HCs) with DKI. Kurtosis parameters including kurtosis fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), and radial kurtosis (RK) as well as diffusion metrics including FA, mean diffusivity, axial diffusivity (AD), and radial diffusivity derived from DKI were obtained. Group differences in these metrics were compared using tract-based spatial statistics. Partial correlation analysis was used to evaluate correlations between microstructural changes and disease duration.

Results: Compared to HCs, HM patients showed significantly reduced AK, RK, MK, and FA and significantly increased AD, predominately in the bilateral corticospinal tract, right inferior longitudinal fasciculus, superior longitudinal fasciculus, inferior fronto-occipital fasciculus, and left thalamus (all < 0.05, threshold-free cluster enhancement corrected). In addition, DKI-derived kurtosis parameters (AK, RK, and MK) had negative correlations ( = -0.448 to -0.376, all < 0.05) and diffusion parameter (AD) had positive correlations ( = 0.372 to 0.409, all < 0.05) with disease duration.

Conclusion: HM patients showed microstructural alterations in the brain regions responsible for motor conduction and vision-related functions. DKI is useful for detecting white matter abnormalities in HM patients, which might be helpful for exploring and monitoring the pathogenesis of the disease.
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http://dx.doi.org/10.3348/kjr.2020.0178DOI Listing
May 2021

Evaluation of hemodynamic changes in nonarteritic anterior ischemic optic neuropathy using multimodality imaging.

Quant Imaging Med Surg 2021 May;11(5):1932-1945

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Background: Nonarteritic anterior ischemic optic neuropathy (NAION) patients experience hypo-perfusion in the short posterior ciliary arteries (SPCAs), however, the cause of hypo-perfusion is unclear. Real-time dynamic hemodynamic observations may provide clues into specific NAION pathogenic mechanisms. We aim to analyze hemodynamic changes occurring in NAION using multimodality imaging. Our specific focus is identifying pathogenic mechanisms underlying SPCA insufficiency in NAION.

Methods: Three-dimensional arterial spin labeling (3D ASL) magnetic resonance imaging (MRI) and three-dimensional time-of-flight (3D-TOF) magnetic resonance angiography (MRA) were performed on 25 NAION patients (50 eyes) and 22 (44 eyes) normal cases were recruited. The diameter of the initial part of the ophthalmic artery and internal carotid artery siphon were measured using MRA. Blood vessel identification and blood flow (BF) were detected using 3D ASL MRI. We measured BF values of the optic nerve head (ONH) region of the retina/choroid complex, optic nerve (ON), temporal lobe, and occipital lobe.

Results: We studied 32 NAION affected eyes, 18 NAION uninvolved eyes, and 44 normal eyes. Diameter of the initial part of ophthalmic artery in the NAION affected eyes was significantly larger than the uninvolved eyes (P=0.026). Diameter of the NAION eyes was 1.33±0.19 mm [mean ± standard deviation (SD)], uninvolved eyes were 1.15±0.21 mm. At a photolabeling delay times (PLD) of 1,500 and 2,500 ms, BF of the ONH and ON in NAION affected eyes was significantly less than uninvolved and normal eyes (pONH <0.001 both at 1,500 and 2,500 ms, pON <0.001 and pON =0.001 at 1,500 and 2,500 ms, respectively). ONH of uninvolved eyes was also significantly less than normal eyes. Additionally, BF of the ONH region correlated with temporal lobe BF, with an R=0.3231 and 0.2397 at 1,500 and 2,500 ms, respectively. BF of the ONH region also correlated with occipital lobe BF, with an R=0.2534 and 0.4397 at 1,500 and 2,500 ms, respectively. ON and temporal lobe BF also correlated, with an R=0.226 and 0.1504 at 1,500 and 2,500 ms, respectively.

Conclusions: Abnormal hemodynamics of small cerebral vessels existed prior to the onset of NAION. A candidate mechanism underlying NAION appears to be transient insufficiency of blood supply and decompensation of ocular vascular regulation.
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http://dx.doi.org/10.21037/qims-20-699DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047350PMC
May 2021

Sound therapy can modulate the functional connectivity of the auditory network.

Prog Neuropsychopharmacol Biol Psychiatry 2021 Apr 7;110:110323. Epub 2021 Apr 7.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address:

The functional connectivity of the auditory network is considered to be important in the development of tinnitus. We hypothesized that sound therapy, as a commonly used effective treatment for tinnitus, can modulate the functional connectivity of the auditory network. In this prospective observational study, we recruited 27 tinnitus patients who had undergone 12 weeks of sound therapy and 27 matched healthy controls. For the two groups of subjects, resting-state functional magnetic resonance imaging was acquired both at baseline and at the 12th week. We utilized independent component analysis and seed-based functional connectivity analysis to characterize the connectivity features of the auditory network. Interaction effects between the two groups and the two scans within the auditory network were observed, which were driven by increased functional connectivity in the left primary auditory cortex (PAC) and decreased values in the secondary auditory cortex (SAC) in tinnitus patients after treatment. Increased connections between the auditory network and limbic network, as well as decreased values with the bilateral thalami, were identified. The effects were mainly driven by the functional connectivity alterations of the SAC rather than that of the PAC. Significant positive correlations between the percent improvement in the Tinnitus Handicap Inventory (THI) score and the percentage change rates of functional connectivity between the SAC and bilateral thalami were observed. Our study contributes to the understanding of the mechanism of tinnitus and effective sound therapy, providing evidence to support the theory of a gain adaptation mechanism that quantifies the recovered gating function of the thalamus in tinnitus patients.
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http://dx.doi.org/10.1016/j.pnpbp.2021.110323DOI Listing
April 2021

Lateralization effects in brain white matter reorganization in patients with unilateral idiopathic tinnitus: a preliminary study.

Brain Imaging Behav 2021 Apr 8. Epub 2021 Apr 8.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.

Idiopathic tinnitus can cause significant auditory-related brain structural and functional changes in patients. However, changes in patterns of the lateralization effects in idiopathic tinnitus have yet to be established, especially on white matter (WM) reorganization. In this study, we studied 19 left-sided and 19 right-sided idiopathic tinnitus (LSIT, RSIT) patients and 19 healthy controls (HCs). We combined applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analyses to investigate altered features of the auditory-related brain WM. We also conducted correlation analyses between the clinical variables and WM changes in the patients. Compared with the HCs, both sided tinnitus patients showed significant auditory-related brain WM alterations. More interestingly, the LSIT patients demonstrated a greater decrease in white matter volume (WMV) in the right medial superior frontal gyrus (SFG) than the RSIT; meanwhile, we also found that compared with the RSIT group, the LSIT group showed significantly increased fractional anisotropy (FA) in the body of the corpus callosum (CC), left cingulum, and right superior longitudinal fasciculus (SLF) and decreased mean diffusivity (MD) in the body of CC. Moreover, relative to the RSIT group, the LSIT group also exhibited increases in WM axial diffusivity (AD) in the left SLF, left cingulum, right middle cerebellar peduncle (MCP), left thalamus, and bilateral forceps major (FM) and decreases in radial diffusivity (RD) in the genu of CC. Additionally, the FA value of the right SLF was closely associated with tinnitus severity in the LSIT. Our study suggests that lateralization has a significant effect on WM reorganization in patients with idiopathic tinnitus; in particular, LSIT patients may experience more severe and widespread alterations in WMV and WM microstructure than the RSIT group, and all these changes are indirectly auditory related. These findings provide new useful information that can lead to a better understanding of the tinnitus mechanisms.
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http://dx.doi.org/10.1007/s11682-021-00472-1DOI Listing
April 2021

Brain Structural and Functional Reorganization in Tinnitus Patients Without Hearing Loss After Sound Therapy: A Preliminary Longitudinal Study.

Front Neurosci 2021 11;15:573858. Epub 2021 Mar 11.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Sound therapy is one of the most common first-line treatments for idiopathic tinnitus. We aimed to investigate the brain structural and functional alterations between patients with idiopathic tinnitus without hearing loss (HL) and healthy controls (HCs) and between patients before and after sound therapy (narrow band noise). Structural and resting-state functional images were acquired from 13 tinnitus patients without HL and 18 HCs before and after 6 months of narrow band sound therapy (only patients received the treatment). Voxel-based morphometry (VBM) and independent component analysis (ICA) were conducted to separately investigate the brain structural and functional changes. Associations between brain changes and clinical variables were also performed. After the treatment, the % improvement of THI score was -1.30% (± 63.40%). Compared with HCs, tinnitus patients showed gray matter and white matter atrophy in the left middle temporal gyrus at baseline, and the gray matter volume was further reduced after the treatment. The patients also showed increased white matter volume in the cingulum (cingulate), right calcarine, left rolandic operculum, and left parietal and frontal lobes. Additionally, compared with HCs, tinnitus patients exhibited positive [medial visual network (mVN) and sensorimotor network (SMN), mVN and auditory network (AN)] and negative [mVN and lateral visual network (lVN)] internetwork functional connectivity (FC) at baseline and negative [left frontoparietal network (LFPN) and dorsal attention network (DAN), AN and posterior default mode network (pDMN)] internetwork FC after the narrow band sound therapy. The patients also showed negative [LFPN and right frontoparietal network (RFPN), LFPN and RFPN, anterior default mode network (aDMN) and AN, aDMN and DAN] internetwork FC after the treatment when compared with baseline. Our findings suggest that although the outcomes of idiopathic tinnitus patients without HL were not very good when the improvement of THI scores was used as an evaluation indicator, the patients experienced significant differences in auditory-related and non-auditory-related brain reorganization before and after the narrow band sound therapy, that is, sound therapy may have a significant effect on brain reorganization in patients with idiopathic tinnitus. This study may provide some new useful information for the understanding of mechanisms underlying idiopathic tinnitus.
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http://dx.doi.org/10.3389/fnins.2021.573858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7991098PMC
March 2021

Computed Tomography Evaluation of Unilateral Chronic Maxillary Sinusitis With Osteitis.

Ear Nose Throat J 2021 Mar 23:145561321993936. Epub 2021 Mar 23.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.

Background: Computed tomography (CT) is the preferred noninvasive method for the evaluation of osteitis in chronic sinusitis. Some scholars believe that the bone changes associated with chronic sinusitis always show high attenuation (high density) and are positively correlated with the severity of the disease. However, sinus bone remodeling is a complex process that may cause high or low attenuation. There have been few reports on the spread of osteitis. Therefore, additional research on sinus CT is necessary.

Objective: To observe bony changes in chronic maxillary sinusitis (CMS) by CT and reveal the mechanism.

Methods: A retrospective study was conducted in 45 patients with unilateral CMS with bony changes in the sinus walls. The patients' clinical data and CT results were analyzed and compared between the affected and normal sides. We propose the location, involvement, attenuation, and thickness method to evaluate CMS with osteitis.

Results: Of the 45 patients, 40 (88.9%), 2, 12, and 7 had posterior external, medial, anterior, and superior lesions, respectively. The nasal region, sphenoid bone, palatine bone, and zygomatic arch were involved in 3, 12, 8, and 18 (40%) patients, respectively. Computed tomography indicated high attenuation in 30 (75.0%) and low attenuation in 10 (25.0%) patients; 6 (15.0%) showed new bone marrow cavities. The bone thickness was significantly different between the affected and normal sides in 40 patients ( < .001), including members of both the high- and low-attenuation groups (high-attenuation group: < .001; low-attenuation group: < .01). However, there was no significant difference in the thickness of the affected side between the high- and low-attenuation groups ( > .05).

Conclusions: Chronic rhinosinusitis with bony changes may occur in the maxillary sinus walls and spread to adjacent bones. Both increased and decreased attenuation may occur in these circumstances. Analyzing the CT features of bone changes in unilateral CMS can improve the accuracy of disease diagnosis.
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http://dx.doi.org/10.1177/0145561321993936DOI Listing
March 2021

Correlation between glucose metabolism parameters derived from FDG and tumor TNM stages and metastasis-associated proteins in colorectal carcinoma patients.

BMC Cancer 2021 Mar 9;21(1):258. Epub 2021 Mar 9.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, China.

Background: The aim of this study was to investigate the relationship between multiple metabolism parameters derived from FDG and tumor TNM stages as well as tumor metastasis-associated protein of GLUT-1 and MACC1 in colorectal carcinoma (CRC).

Methods: Thirty-eight patients (24 males and 14 females) with primary CRC confirmed by elective surgery pathological, who also accepted F-FDG PET/CT scans during 2017 to 2019 were included in this study. The tumor classification of T, N and M is explained by the 7th American Joint Committee on Cancer (AJCC). F-FDG parameters of SUVmax, SUVmean, TLG and MTV were measured by drawing a region of interest on the primary lesions. The expression of GLUT-1 and MACC1 was quantified by immunohistochemical, and the correlation between metabolism parameters and tumor biomarkers were analyzed.

Results: According to our analysis, the F-FDG parameters of SUVmean was significantly correlated with tumor M status (P = 0.000) of primary CRC. The primary tumor lesion with higher SUVmax, TLG and MTV values prone to a high-T status (P = 0.002, 0.002 and 0.001, respectively). The high expression of GLUT-1/MACC1 weas more frequently involved with T3-4 stage and was poorly differentiated in CRC patients. Multivariate analysis found that the expression of GLUT-1 protein was correlated with SUVmax and MTV (R = 0.42, P = 0.013 and 0.004, respectively), moreover, the expression of MACC1 protein was correlated with TLG (R = 0.372, P = 0.000).

Conclusion: Glucose metabolism parameters derived from FDG provides a noninvasive assessment of M status and T status in CRC patients. The expression of GLUT-1 and MACC1 was associated with F-FDG uptake in CRC patients.
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http://dx.doi.org/10.1186/s12885-021-07944-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7941722PMC
March 2021

Cortical Thickness Alterations in Patients With Tinnitus Before and After Sound Therapy: A Surface-Based Morphometry Study.

Front Neurosci 2021 5;15:633364. Epub 2021 Mar 5.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

This study aimed to explore brain surface-based morphometry cortical thickness changes in patients with idiopathic tinnitus before and after 24 weeks of sound therapy. In this prospective observational study, we recruited 33 tinnitus patients who had undergone 24 weeks of sound therapy and 26 matched healthy controls. For the two groups of subjects, a 3D-BRAVO pulse sequence was acquired both at baseline and at the 24th week. Structural image data preprocessing was performed using the DPABISurf toolbox. The Tinnitus Handicap Inventory (THI) score was assessed to determine the severity of tinnitus before and after treatment. Two-way mixed-model analysis of variance (ANOVA) and Pearson's correlation analysis were used in the statistical analysis. Student-Newman-Keuls (SNK) tests were used in the analysis. Significantly lower cortical thickness was found in the left somatosensory and motor cortex (SMC), left posterior cingulate cortex (PCC), and right orbital and polar frontal cortex (OPFC) of the participants in the tinnitus group at baseline than in the participants in the HC group at baseline and after 24 weeks; in the tinnitus group, significantly higher cortical thickness was found after the 24 weeks sound therapy in comparison to the baseline in the left SMC, bilateral superior parietal cortex (SPC), left inferior parietal cortex (IPC), left PCC, and right OPFC. In the HC group, no statistically significant difference in cortical thickness was found after the 24 weeks treatment in comparison to the baseline in the bilateral SMC, bilateral SPC, left IPC, left PCC, or right OPFC. The changes in cortical thickness before and after sound therapy can provide certain reference values for clinical tinnitus treatment. These brain regions could serve as potential targets for neuroimaging.
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http://dx.doi.org/10.3389/fnins.2021.633364DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973008PMC
March 2021

Altered cerebral blood flow in patients with unilateral venous pulsatile tinnitus: an arterial spin labeling study.

Br J Radiol 2021 Apr 18;94(1120):20200990. Epub 2021 Mar 18.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Objectives: Abnormal neuronal activity and functional connectivity have been reported in patients with venous pulsatile tinnitus (PT). As neuronal activity is closely coupled to regional brain perfusion, the purpose of this study was to investigate the cerebral blood flow (CBF) alterations in patients with unilateral venous PT using arterial spin labeling (ASL).

Methods: This study included patients with right-sided PT between January 2018 and July 2019. A healthy control (HC) group matched 1:1 for gender and age was also recruited. All subjects underwent ASL scanning using 3.0T MRI. The correlation between altered CBF and Tinnitus Handicap Inventory (THI) score as well as PT duration was analyzed.

Results: Twenty-one patients with right-sided PT and 21 HCs were included. The mean PT duration of the patients was 35.9 ± 32.2 months, and the mean THI score was 64.1 ± 20.3. Compared with the HCs, the PT patients exhibited increased CBF in the left inferior parietal gyrus and decreased CBF in the bilateral lingual gyrus (family-wise error corrected, < 0.05). The increased CBF in the left inferior parietal gyrus showed a positive correlation with the THI score in PT patients ( = 0.501, = 0.021).

Conclusions: PT patients exhibit regional CBF alterations. The increased CBF in the left inferior parietal gyrus may reflect the severity of PT.

Advances In Knowledge: This study not only presents evidence for the potential neuropathology of PT from the perspective of CBF alterations but also offers a new method for investigating the neuropathological mechanism of PT.
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http://dx.doi.org/10.1259/bjr.20200990DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8010559PMC
April 2021

Bone Marrow Fat Measured by a Chemical Shift-Encoded Sequence (IDEAL-IQ) in Patients With and Without Metabolic Syndrome.

J Magn Reson Imaging 2021 Jul 16;54(1):146-153. Epub 2021 Mar 16.

Radiology Department, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China.

Background: Metabolic syndrome increases the risk of chronic diseases such as cardiovascular disease and diabetes. Metabolic syndrome also has an impact on bone mineral density. However, the relationship between metabolic syndrome and bone marrow fat is unclear.

Purpose: To determine factors associated with bone marrow fat concentration in subjects with and without metabolic syndrome.

Study Type: Retrospective.

Population: One hundred and one women with metabolic syndrome (31.0 years ±5.1) and 96 female living liver transplant donors (32.0 years ±3.7). Our institutional review board approved the study. Each subject signed written informed consent.

Field Strength/sequence: 3.0 T MRI system and a commercially available chemical shift-encoded 3D sequence (Iterative Decomposition of water and fat with Echo asymmetry and Least Square Estimation).

Assessment: Proton density fat fraction (PDFF) in liver, vertebral body, and paraspinal muscle (erector spinae) were measured from a single acquisition by a 15-year-experience orthopedic radiologist. The factors associated with PDFF were acquired.

Statistical Tests: The analysis of covariance test, after adjustment for body mass index and age, was used to analyze the differences between metabolic syndrome and non-metabolic syndrome groups. A stepwise multiple regression analysis was used to determine which variables were independently associated with PDFF.

Results: Mean vertebral PDFF and alanine aminotransferase (ALT) were significantly lower in donors than subjects with metabolic syndrome (both P < 0.05). Serum vitamin D concentration, ferritin, and high-density lipoprotein (HDL) cholesterol were significantly higher in donors than subjects with metabolic syndrome (all P < 0.05). Multiple regression analysis revealed antidiabetic medicine, higher serum vitamin D concentration, lower waist circumference, lower ferritin, lower HDL, absence of metabolic syndrome, and lower ALT were significantly associated with lower vertebral PDFF (all P < 0.05).

Data Conclusion: Multiple factors affect bone marrow fat concentration in subjects with metabolic syndrome. Serum vitamin D concentration and antidiabetic medicine are associated with low bone marrow fat, whereas waist circumference, serum ferritin, metabolic syndrome, imbalanced lipid metabolism, and abnormal liver function are associated with high bone marrow fat.

Level Of Evidence Level: 3 TECHNICAL EFFICACY STAGE: 1.
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http://dx.doi.org/10.1002/jmri.27548DOI Listing
July 2021

Radiology residency training in China: results from the first retrospective nationwide survey.

Insights Imaging 2021 Feb 17;12(1):25. Epub 2021 Feb 17.

Vanke School of Public Health, Tsinghua University, Haidian District, Beijing, 100084, China.

Objectives: This was the first study to systematically landscape and examine China's nationwide standardized residency training in radiology.

Methods: In this retrospective cross-sectional study, we used data from the 2019 national survey of the first two cohorts of 3679 radiology residents who completed training in 2017 and 2018 across all 31 provinces in China. A total of 1163 (32%) residents participated in the survey. Multivariable logistic regression was used to examine the implementation frequency of 24 identified training tasks (categorized into six competencies) by region, demographics, and other residency information.

Results: Among the 1163 respondents, 592 (51%) were trained in the more developed eastern region. Of the 24 identified training tasks, 15 were implemented significantly differently across regions, while the frequency of the most frequently conducted tasks (e.g., CT, MR, and radiograph interpretation and reporting) was consistent. The top 10 tasks all fell into the patient care and medical knowledge competency domains, while other competencies tended to be neglected. We found region and marital status were the most influential factors of training task implementation frequencies. Respondents trained in the northeast and the west were more likely to report, for instance, radiological examination recommendation (OR = 1.91, 95%CI = 1.27-2.88), as "very frequent." Married respondents were more likely to report first-line night shift as "very frequent" (OR = 1.71, 95%CI = 1.29-2.26).

Conclusions: Despite the fast-win achievements of developing a national radiology residency training program, there is a gap to train quality and homogeneous radiologists across regions. Future improvement should be more tailored to residents' personal characteristics and emphasize some "soft" competencies (e.g., communication skills).
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http://dx.doi.org/10.1186/s13244-021-00970-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7889775PMC
February 2021

Optic Perineuritis and Its Association With Autoimmune Diseases.

Front Neurol 2020 29;11:627077. Epub 2021 Jan 29.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Optic perineuritis (OPN) is a special optic neuropathy that has a distinct etiology from neuromyelitis optica spectrum disorders (NMOSDs) or multiple sclerosis (MS)-related optic neuritis (ON). The mechanisms of how this inflammation developed and invaded the nerve sheath remain unknown. This study is aimed to analyze the etiology and different clinical characteristics of OPN in a Chinese patient population. Neuro-ophthalmological examination, orbit magnetic resonance imaging (MRI) and a series of blood samples were used in this retrospective observational cohort study to compare characteristics of OPN with idiopathic demyelination optic neuritis (IDON). Forty-four OPN cases (74 eyes) and 61 IDON cases (78 eyes) were analyzed. OPN cases included 33 cases (59 eyes) were associated with specific autoimmune diseases, 10 cases (13 eyes) were associated with infection diseases, 1 case was idiopathic disease. The causes of OPN with CTD were Graves' disease, Immunoglobulin G4-related disease (IgG-4 RD), granulomatosis with polyangiitis (GAP), systemic lupus erythematosus (SLE), Sarcoidosis, Rheumatoid arthritis, scleroderma, Behcet's disease, and gout. All patients received orbital MRI. Overall, 33 cases showed orbit fat infiltration. Specifically, nine cases with IgG-4 RD showed trigeminal nerve branch involvement, 12 cases with Graves' disease showed extraocular muscle belly enlargement, and 4 cases with GAP showed pterygopalatine fossa pseudotumor. Compared to IDON patients, OPN patients were older ( = 0.004) and more likely bilateral involvement 26 (78.79%) patients had bilateral involvement in OPN group vs. 17 (27.87%) in the IDON group ( < 0.001). Visual acuity scores using LogMAR testing was better in OPN patients compared to those with IDON, 0.55 ± 0.91 vs. 1.19 ± 1.24 ( < 0.001). Other ophthalmologic findings unique to the OPN group include 11 (33.33%) cases of ptosis, nine (27.27%) cases of diplopia, and 10 (30.30%) cases of exophthalmos, compared to zero cases of these conditions in the IDON group. Eight (13.11%) IDON patients also had multiple sclerosis (MS) and 7 (11.48%) patients had neuromyelitis which was significantly more than the zero patients in OPN group ( = 0.04). OPN had distinct etiologies and clinical characteristics from IDON and is more often associated with autoimmune diseases. Using OPN characteristics to diagnose autoimmune diseases should prove useful for clinicians when presented with patients that have multiorgan dysfunction that include ophthalmologic findings.
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http://dx.doi.org/10.3389/fneur.2020.627077DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7880123PMC
January 2021

Vestibule segmentation from CT images with integration of multiple deep feature fusion strategies.

Comput Med Imaging Graph 2021 Apr 27;89:101872. Epub 2021 Jan 27.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Vestibule Segmentation is of great significance for the clinical diagnosis of congenital ear malformations and cochlear implants. However, automated segmentation is a challenging task due to the tiny size, blur boundary, and drastic changes in shape and size. In this paper, a vestibule segmentation method from CT images has been proposed specifically, which exploits different deep feature fusion strategies, including convolutional feature fusion for different receptive fields, channel attention based feature channel fusion, and encoder-decoder feature fusion. The experimental results on the self-established vestibule segmentation dataset show that, compared with several state-of-the-art methods, our method can achieve superior segmentation accuracy.
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http://dx.doi.org/10.1016/j.compmedimag.2021.101872DOI Listing
April 2021

Neuroanatomical Alterations in Patients With Tinnitus Before and After Sound Therapy: A Combined VBM and SCN Study.

Front Hum Neurosci 2020 18;14:607452. Epub 2021 Jan 18.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Many neuroanatomical alterations have been detected in patients with tinnitus in previous studies. However, little is known about the morphological and structural covariance network (SCN) changes before and after long-term sound therapy. This study aimed to explore alterations in brain anatomical and SCN changes in patients with idiopathic tinnitus using voxel-based morphometry (VBM) analysis 24 weeks before and after sound therapy. Thirty-three tinnitus patients underwent magnetic resonance imaging scans at baseline and after 24 weeks of sound therapy. Twenty-six age- and sex-matched healthy control (HC) individuals also underwent two scans over a 24-week interval; 3.0T MRI and high-resolution 3D structural images were acquired with a 3D-BRAVO pulse sequence. Structural image data preprocessing was performed using the VBM8 toolbox. The Tinnitus Handicap Inventory (THI) score was assessed for the severity of tinnitus before and after treatment. Two-way mixed model analysis of variance (ANOVA) and analyses were performed to determine differences between the two groups (patients and HCs) and between the two scans (at baseline and on the 24th week). Student-Newman-Keuls (SNK) tests were used in the analysis. Interaction effects between the two groups and the two scans demonstrated significantly different gray matter (GM) volume in the right parahippocampus gyrus, right caudate, left superior temporal gyrus, left cuneus gyrus, and right calcarine gyrus; we found significantly decreased GM volume in the above five brain regions among the tinnitus patients before sound therapy (baseline) compared to that in the HC group. The 24-week sound therapy group demonstrated significantly greater brain volume compared with the baseline group among these brain regions. We did not find significant differences in brain regions between the 24-week sound therapy and HC groups. The SCN results showed that the left superior temporal gyrus and left rolandic operculum were significantly different in nodal efficiency, nodal degree centrality, and nodal betweenness centrality after FDR correction. This study characterized the effect of sound therapy on brain GM volume, especially in the left superior temporal lobe. Notably, sound therapy had a normalizing effect on tinnitus patients.
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http://dx.doi.org/10.3389/fnhum.2020.607452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847901PMC
January 2021

Effects of different morphologic abnormalities on hemodynamics in patients with venous pulsatile tinnitus: A four-dimensional flow magnetic resonance imaging study.

J Magn Reson Imaging 2021 06 24;53(6):1744-1751. Epub 2021 Jan 24.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

The effects of morphologic abnormalities, including sigmoid sinus wall dehiscence (SSWD), transverse sinus stenosis (TSS), and sigmoid sinus diverticulum (SSD), on hemodynamics in venous pulsatile tinnitus (PT) patients have not been established. The aim of this study was to evaluate the effects of SSWD, TSS, and SSD on the hemodynamics of transverse-sigmoid sinus in venous PT patients. This was a prospective study with 44 venous PT patients and 12 healthy controls. A 3 T/four-dimensional (4D) flow magnetic resonance imaging with fast field echo was used. Computed tomography arteriography/venography was used to assess ipsilateral SSWD, TSS, and SSD. Maximum velocity (V ), average velocity (V ), and average flow (Flow ) were measured. Blood flow patterns were independently assessed by three neuroradiologists. One-way analysis of variance or Kruskal-Wallis test was also used. On the symptomatic side, all patients had SSWD, 33 patients had TSS, and 22 patients had SSD. Compared with healthy controls, patients with TSS, without TSS, with SSD, and without SSD all showed higher V (all p < 0.050), V (all p < 0.050), and Flow (all p < 0.050). Patients with TSS showed higher V (p < 0.050) and V (p < 0.050) than those without TSS, and no significant difference in Flow was found between the two groups (p = 0.408). No significant differences in V , V , and Flow were found between patients with and without SSD (all p = 1.000). Jet-like flow in the stenosis and downstream of the stenosis was observed in all patients with TSS. Vortex in SSD was observed in 15 patients with SSD (68%). High blood velocity and flow may be characteristic markers of venous PT. SSWD may be a necessary condition for venous PT. TSS may further increase the blood velocity and form a jet-like flow. SSD may be related to vortex formation but had no significant effect on blood velocity and flow. LEVEL OF EVIDENCE: 2 TECHNICAL EFFICACY STAGE: 3.
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http://dx.doi.org/10.1002/jmri.27503DOI Listing
June 2021

Risk of vertebral fractures: evaluation on vertebral trabecular attenuation value and hydroxyapatite concentration in patients by chest spectral CT.

Br J Radiol 2021 Mar 19;94(1119):20200234. Epub 2021 Jan 19.

Radiology Department, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, China.

Objectives: To analyze vertebral fractures risk in patients with chest scans by evaluating vertebral hydroxyapatite concentration measured on spectral CT compared to trabecular attenuation value measured on conventional CT.

Methods: Our retrospective study reviewed CT of 216 patients. Analysis of vertebral (T11 - L1) hydroxyapatite concentration by spectral imaging and trabecular attenuation value by conventional CT imaging were performed in patients with chest CT examinations. Specificity, sensitivity, negative predictive value (NPV), and positive predictive value (PPV) were performed by using receiver operating characteristic (ROC) curves in patients with and without vertebral fractures.

Results: In male patients, vertebral hydroxyapatite concentration had high area under the ROC curve (0.916), by using the optimal threshold of 72.27 mg/cm, specificity, sensitivity, NPV, and PPV were 91.7, 80.2, 36.7, and 98.7%, respectively. In female patients, vertebral hydroxyapatite concentration also had high area under the ROC curve (0.870), by using the optimal threshold of 74.79 mg/cm, specificity, sensitivity, NPV, and PPV were 100.0, 77.8, 47.4, and 100.0%, respectively. Area under the ROC curve was significantly different between spectral CT-measured bone hydroxyapatite concentration and conventional CT-measured attenuation value in distinguishing vertebral fractures ( = 0.007 for males; = 0.005 for females).

Conclusions: Quantitative assessment with spectral CT may appear as higher accuracy than that of conventional CT imaging to analyze risk of vertebral fractures. Hydroxyapatite concentration measured with chest spectral CT may be used to evaluate risk of bone fractures.

Advances In Knowledge: Hydroxyapatite concentration measured with chest spectral CT may be used to evaluate risk of bone fractures.
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http://dx.doi.org/10.1259/bjr.20200234DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8011241PMC
March 2021

Lateralization Effects on Cerebral Blood Flow in Patients With Unilateral Pulsatile Tinnitus Measured With Arterial Spin Labeling.

Front Hum Neurosci 2020 17;14:591260. Epub 2020 Nov 17.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

To investigate cerebral blood flow (CBF) differences in patients with left- and right-sided pulsatile tinnitus (LPT and RPT) and healthy controls (HCs) to further explore the lateralization effects of PT using arterial spin labeling (ASL). ASL data from 21 RPT patients, 17 LPT patients and 21 HCs were reviewed. Voxel-wise analysis and region of interest analysis were performed to explore differences in CBF among the three groups. Tinnitus Handicap Inventory (THI) score and tinnitus duration were obtained from each patient. Voxel-wise analysis showed that the CBF of the left inferior parietal gyrus was increased in both RPT and LPT patients compared with HCs ( < 0.001). Region of interest analysis revealed that the CBF of the left primary auditory cortex (PAC) was higher than that of the right, while the CBF of the right secondary auditory cortex (SAC) and auditory association cortex was higher than that of the left. These lateralization effects were present in all three groups. Compared with HCs, RPT patients showed increased CBF in the left PAC and SAC (PAC: = 0.036; SAC: = 0.012). No significant correlations were found between PT duration or THI score and altered CBF in above regions. Increased CBF in the left inferior parietal gyrus is a common feature in both RPT and LPT patients, regardless of the perceived side of PT. The lateralization effects of auditory cortices may be a physiological characteristic of the normal brain. These findings may provide a new perspective for understanding the neurological pathophysiology of PT.
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http://dx.doi.org/10.3389/fnhum.2020.591260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705237PMC
November 2020

Hemodynamic study of the therapeutic effects of the different degrees of sigmoid sinus diverticulum reconstruction on patients.

Med Eng Phys 2020 12 9;86:8-15. Epub 2020 Oct 9.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China. Electronic address:

Sigmoid sinus diverticulum (SSD) is a common pathophysiology of pulsatile tinnitus (PT) and mainly treated by SSD reconstruction surgery. The degree of reconstruction is an important indicator of SSD reconstruction surgery, but its impact on the effect of SSD reconstruction is unclear. This study aimed to clarify the effect of the degree of SSD reconstruction on diverticulum reconstruction surgical treatment. One patient-specific case (control subject) was reconstructed based on the computed tomography angiography (CTA) images of patients with PT. The SSD reconstruction degree was used as a new index in this study. And the case of 30% (case 1), 60% (case 2), and 100% (case 3) of the diverticulum reconstruction degree of control subject were constructed. Transient-state computational fluid dynamics was performed. Wall pressure distribution, wall average pressure (P) of SSD, flow pattern (velocity streamlines and velocity vector), wall shear stress (WSS) and averaged WSS (WSS) were calculated and used in evaluating the hemodynamic differences among the DRD cases. Results demonstrated that change in SSD pressure was not linear with increase in DRD. The DRD that reached 60% of the original diverticulum was effective. At the peak point of the inlet boundary condition (T1 = 0.22s), the P of SSD had a nonlinear change (control subject, 126.967 Pa vs. case 1, 126.274 Pa vs. case 2, 106.897 Pa vs. case 3, 94.116 Pa). Flow vorticity decreased gradually, and the smoothness of the streamlines increased with DRD. WSS slightly changed with increasing DRD. The high-speed flow blood hit the diverticulum entrance and then swirled to hit the area of the sigmoid sinus wall abnormal. It was concluded that flow patterns related to PT differ with DRD. In diverticulum reconstruction surgery, there is a threshold value, and only when the DRD exceeds this value (60% or 70% or 80%), it will have a noticeable effect. In this study, DRD should at least reach 60% of the original diverticulum. When DRD is insufficient, hemodynamic change in the diverticulum is small, and the PT may have remained. SSD may be caused by high-speed blood flow.
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http://dx.doi.org/10.1016/j.medengphy.2020.10.008DOI Listing
December 2020

Ocular Blood Flow Measurements in Diabetic Retinopathy Using 3D Pseudocontinuous Arterial Spin Labeling.

J Magn Reson Imaging 2021 03 2;53(3):791-798. Epub 2020 Nov 2.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Background: Distinguishing between the two broad categories of diabetic retinopathy (DR), nonproliferative DR (NPDR) and proliferative DR (PDR), is significant, as the therapeutic strategies for each are completely different.

Purpose: To characterize the ocular blood flow (OBF) of DR patients and evaluate the potential utility of OBF values in categorizing DR.

Study Type: Prospective.

Subjects: A total of 41 DR patients (82 eyes) were recruited in our study. Group 1 comprised 48 eyes with NPDR, and Group 2 comprised 34 eyes with PDR.

Field Strength/sequence: 3D pseudocontinuous arterial spin labeling (3D-pcASL) with two postlabeling delays (PLDs) was acquired at 3.0T MR.

Assessment: OBF values were independently obtained by two doctors from the OBF map.

Statistical Tests: OBF values and clinical characteristics were compared between the groups using two-sample t-tests and chi-square tests. Receiver operating characteristic (ROC) curves were obtained, and the area under the curve (AUC) was calculated. The consistency of OBF values reported by the two doctors was evaluated using the intraclass correlation coefficient (ICC).

Results: OBF values at PLDs of 1.5 seconds and 2.5 seconds were significantly lower in Group 2 than in Group 1 (P < 0.05 for both PLDs). The OBF values of Group 2 showed a greater increase than those of Group 1 from PLD 1.5 to 2.5 seconds. The AUC of OBF at the 1.5 seconds PLD was 0.90, with a cutoff of 7.73 mL/min/100 g, and the AUC of the OBF at the 2.5 seconds PLD was 0.75, with a cutoff of 8.44 mL/min/100 g. The ICC between the two observers was 0.844 for the OBF at 1.5 seconds PLD and 0.872 for the OBF at 2.5 seconds PLD.

Data Conclusion: PDR can be differentiated from NPDR by the value of OBF as measured by 3D-pcASL.

Level Of Evidence: 1 TECHNICAL EFFICACY STAGE: 1.
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http://dx.doi.org/10.1002/jmri.27398DOI Listing
March 2021

The effects of sound therapy in tinnitus are characterized by altered limbic and auditory networks.

Brain Commun 2020 21;2(2):fcaa131. Epub 2020 Aug 21.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China.

To determine the neural mechanism underlying the effects of sound therapy on tinnitus, we hypothesize that sound therapy may be effective by modulating both local neural activity and functional connectivity that is associated with auditory perception, auditory information storage or emotional processing. In this prospective observational study, 30 tinnitus patients underwent resting-state functional magnetic resonance imaging scans at baseline and after 12 weeks of sound therapy. Thirty-two age- and gender-matched healthy controls also underwent two scans over a 12-week interval; 30 of these healthy controls were enrolled for data analysis. The amplitude of low-frequency fluctuation was analysed, and seed-based functional connectivity measures were shown to significantly alter spontaneous local brain activity and its connections to other brain regions. Interaction effects between the two groups and the two scans in local neural activity as assessed by the amplitude of low-frequency fluctuation were observed in the left parahippocampal gyrus and the right Heschl's gyrus. Importantly, local functional activity in the left parahippocampal gyrus in the patient group was significantly higher than that in the healthy controls at baseline and was reduced to relatively normal levels after treatment. Conversely, activity in the right Heschl's gyrus was significantly increased and extended beyond a relatively normal range after sound therapy. These changes were found to be positively correlated with tinnitus relief. The functional connectivity between the left parahippocampal gyrus and the cingulate cortex was higher in tinnitus patients after treatment. The alterations of local activity and functional connectivity in the left parahippocampal gyrus and right Heschl's gyrus were associated with tinnitus relief. Resting-state functional magnetic resonance imaging can provide functional information to explain and 'visualize' the mechanism underlying the effect of sound therapy on the brain.
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http://dx.doi.org/10.1093/braincomms/fcaa131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7585694PMC
August 2020

CT venography correlate of transverse sinus stenosis and venous transstenotic pressure gradient in unilateral pulsatile tinnitus patients with sigmoid sinus wall anomalies.

Eur Radiol 2021 May 30;31(5):2896-2902. Epub 2020 Oct 30.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95, Yongan Road, Xicheng District, Beijing, 100050, China.

Objectives: To investigate the correlation between transverse sinus stenosis (TSS) and transstenotic pressure gradient (TPG) in unilateral pulsatile tinnitus (PT) patients with sigmoid sinus wall anomalies (SSWA).

Methods: Fifty-seven patients with unilateral venous PT were retrospectively included. All of them underwent CT venography and catheter manometry, accompanied with SSWA. The degree, length, shape (intrinsic/extrinsic/dysplasia), location (proximal/middle/distal, referring to the relative position of TSS and the Labbé vein junction) of TSS, the types of SSWA (dehiscence/diverticulum), and the degree of transverse sinus outflow laterality were assessed, and the correlations with ipsilesional TPG were analyzed.

Results: The mean value of ipsilesional TPG was 7.61 ± 0.52 mmHg. The degree and length of ipsilesional TSS were positively correlated with TPG (p < 0.001, p' < 0.001), respectively. TPG was significantly larger in patients with contralateral transverse sinus dysplasia than those without (p = 0.023) and significantly smaller in patients with ipsilesional sigmoid sinus diverticulum than those with isolated dehiscence (p = 0.001). No statistical difference in TPG was shown between ipsilesional TSSs of different shapes or locations (p > 0.05). No correlation was noted between the degree of ipsilesional transverse sinus outflow laterality and TPG (p = 0.051). Stepwise linear regression indicated that the degree (β = 9.207, 95% CI = 3.558-14.856), length (β = 0.122, 95% CI = 0.025-0.220) of ipsilesional TSS, and contralateral transverse sinus dysplasia (β = 1.875, 95% CI = 0.220-3.530) were significantly correlated with TPG (R = 0.471).

Conclusions: The degree, length of ipsilesional TSS, and contralateral transverse sinus dysplasia may be used to predict TPG in unilateral PT patients with SSWA.

Key Points: • CT venography may act as a screening tool to help low-probability unilateral pulsatile tinnitus (PT) patients with sigmoid sinus wall anomalies (SSWA) avoid invasive catheter manometry. • The degree and length of ipsilesional transverse sinus stenosis (TSS) are positively correlated with transtenotic pressure gradient (TPG) in unilateral PT patients with SSWA. • Ipsilesional TPG is larger in unilateral PT patients with contralateral transverse sinus dysplasia than those without and is smaller in unilateral PT patients with sigmoid sinus diverticulum than those with isolated dehiscence.
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http://dx.doi.org/10.1007/s00330-020-07415-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8043956PMC
May 2021

Prediction of the progression of femoral head collapse in ARCO stage 2-3A osteonecrosis based on the initial bone resorption lesion.

Br J Radiol 2021 Jan 12;94(1117):20200981. Epub 2020 Nov 12.

Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Objectives: To predict the progression of femoral head collapse in Association Research Circulation Osseous (ARCO) Stage 2-3A osteonecrosis based on the initial bone resorption lesion.

Methods: A retrospective analysis of the location, attenuation, and maximum area in coronal position (MAC) of the initial bone resorption lesion in ARCO Stage 2 and 3A was conducted in 85 cases of osteonecrosis of the femoral head (ONFH). The cases were divided into rapid and slow progression groups according to whether femoral head collapse at follow-up was greater than 2 mm. The characteristics of the bone resorption lesion between the two groups were compared by analysis of variance. Receiver operating characteristic curve was used to analyze the MAC, regions of A2, and C1 of bone resorption lesion in predicting collapse progression.

Results: The MAC of initial bone resorption lesion in rapid progression group (117.8 ± 72.1 mm) was significantly larger than slow (53.1 ± 39.5 mm) ( < 0.001). Regions of A2 and C1 involved were significantly higher in rapid than slow progression group. The area under the receiver operating characteristic curve of MAC, regions of A2 and C1 of bone resorption lesion to predict collapse progression were 0.81, 0.72 and 0.62 respectively. A threshold MAC of 49 mm had sensitivity of 86.1% and specificity of 61.9% to predict collapse progression.

Conclusions: The MAC of initial bone resorption lesion in ARCO Stage 2-3A ONFH can predict the progression of femoral head collapse. If it is greater than 49 mm and located in regions of A2 and C1, the possibility of rapid progression is high, active monitoring and intervention should be recommended.

Advances In Knowledge: This study is the first to find that the maximum area in coronal position of initial bone resorption lesion in ARCO Stage 2 or 3A can predict progression of the femoral head collapse with a threshold of 49 mm. If the maximum area is larger than 49 mm and located in the anterolateral or lateral column of the femoral head, the possibility of rapid collapse progression is high, therefore, monitoring should be strengthened and active intervention should be considered.
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http://dx.doi.org/10.1259/bjr.20200981DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774699PMC
January 2021

Outcomes at 6 months are related to brain structural and white matter microstructural reorganization in idiopathic tinnitus patients treated with sound therapy.

Hum Brain Mapp 2021 Feb 24;42(3):753-765. Epub 2020 Oct 24.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China.

This study aimed to explore brain structural and white matter microstructural reorganization in the early stage of tinnitus and identify brain alterations that contribute to its relief after 6 months of sound therapy. We studied 64 patients with idiopathic tinnitus, including 29 patients who were categorized into an effective group (EG) and 35 who were categorized into an ineffective group (IG) according to the 6-month follow-up improvement of the Tinnitus Handicap Inventory score, along with 63 healthy controls (HCs). All participants underwent structural and diffusion tensor imaging scanning on a 3-T magnetic resonance system. Differences in brain gray/white matter volume and white matter microstructure were evaluated using voxel-based morphometry analysis and tract-based spatial statistics among the three groups. Associations between brain reorganization and the improvement of tinnitus symptoms were also investigated. Compared with EG patients, IG patients experienced a significant gray matter volume decrease in the right middle frontal gyrus (MFG)/right precentral gyrus (PreCG). Meanwhile, both EG and IG patients showed significant changes (decrease or increase) in brain white matter integrity in the auditory-related or nonauditory-related white matter fiber tracts compared with HCs, while EG patients showed decreased axial diffusivity in the bilateral middle cerebellar peduncle (MCP) compared with IG patients. We combined the gray matter change of the MFG/PreCG and the white matter integrity of the bilateral MCP as an imaging indicator to evaluate the patient's prognosis and screen patients before treatment; this approach reached a sensitivity of 77.1% and a specificity of 82.8%. Our study suggests that there was a close relationship between brain reorganization and tinnitus improvement. The right MFG/PreCG and bilateral MCP may be indicators that can be used to predict prognoses in patients with idiopathic tinnitus and may be used to screen patients before sound therapy. These findings may provide new useful information that can lead to a better understanding of the tinnitus mechanism.
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http://dx.doi.org/10.1002/hbm.25260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814769PMC
February 2021

Evaluating postoperative anal fistula prognosis by diffusion-weighted MRI.

Eur J Radiol 2020 Nov 21;132:109294. Epub 2020 Sep 21.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China; Department of Radiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Purpose: The purpose of this study was to explore whether preoperative diffusion-weighted magnetic resonance imaging (DW-MRI) can be used to evaluate the prognosis of anal fistula and identify the influence factors of postoperative recurrence.

Methods: This is a retrospective study of 117 patients with anal fistula who have undergone preoperative DW-MRI and surgery. All patients were followed up by telephone or reexamination within 2 years after surgery. Of the 117 patients, 35 were excluded due to loss of follow-up and only 82 were included in this study. MRI fistula imaging-related data were analyzed, and fistula severity was scored using criteria of both local extension of fistulas and active inflammation for a total maximum score of 22. The apparent diffusion coefficient (ADC) value of the fistula in patients with anal fistula during preoperative MRI examination was measured. According to whether anal fistula patients are accompanied by perianal abscess, they are divided into two groups, namely anal fistula group and anal fistula with abscess group. Based on whether patients with anal fistula recur after surgery, they were further divided into recurrent group and non-recurrent group.

Results: 82 patients with anal fistula were included in this analysis, 23 of them recurred and 59 were cured. Among patients with perianal abscess, the mean ADC value of the recurrent group was (1.19 ± 0.21)×10 mm/s, which is significantly lower than that of the non-recurrent group (1.36 ± 0.19)×10 mm/s. There were significant statistical differences in ADC values between the two groups (p = 0.03). Among patients with anal fistulas without abscesses, 15 patients recurred after surgery, with a mean ADC value of (1.45 ± 0.27) ×10 mm/s, and 33 patients didn't occur, with a mean ADC value of (1.44 ± 0.31)×10 mm/s. The ADC value of preoperative fistula in patients was negative significant correlation with MRI findings score (r= -0.332, P = 0.002). Risk factors for the recurrence after anal fistula surgery include the time interval between MRI and operation, multiple fistula tracks. Fatigue, excessive intake of spicy or greasy food and diarrhea may also be external risk factors for postoperative recurrence of patients with anal fistula.

Conclusions: DW-MRI has important application value for the prognosis evaluation of anal fistula. Complex type of anal fistula and improper lifestyle are the main risk factors affecting the recurrence after anal fistula surgery.
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http://dx.doi.org/10.1016/j.ejrad.2020.109294DOI Listing
November 2020

Neuroanatomical Alterations in Patients With Tinnitus Before and After Sound Therapy: A Voxel-Based Morphometry Study.

Front Neurosci 2020 8;14:911. Epub 2020 Sep 8.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

According to previous studies, many neuroanatomical alterations have been detected in patients with tinnitus. However, few studies have reported on the morphological changes observed following sound therapy. To explore the brain anatomical alterations in patients with idiopathic tinnitus using voxel-based morphometry (VBM) analysis before and after effective 12 weeks sound therapy. The protocol was registered on ClinicalTrials.gov, ID: NCT02774122. In this study, we collected data from 27 matched healthy control (HC) individuals and 27 idiopathic tinnitus patients before and after 12 weeks of sound therapy by using adjusted narrow band sound. 3.0T MRI system and high-resolution 3D structural images were acquired with a 3D-BRAVO pulse sequence. Structural image data preprocessing was performed using the VBM8 toolbox. The Tinnitus Handicap Inventory (THI) score was acquired in the tinnitus group to assess the severity of tinnitus and tinnitus-related distress. Mann-Whitney Test, Wilcoxon Signed-Ranks test, and Pearson's correlation analysis were used in the statistical analysis. We found significantly decreased gray matter (GM) volume in the left thalami, right thalami, and cochlear nucleus among the tinnitus patients before sound therapy (baseline) compared to the HC group. However, we did not find significant differences in brain regions between the 12-week treatment and HC groups. According to the results of Wilcoxon Signed-Ranks test, the 12-week sound therapy group demonstrated significant greater brain volume compared with the baseline group among these brain regions. Decreased THI score and changed GM volume were not correlated. This is a useful study for observing the characteristics of neuroanatomical changes in patients with idiopathic tinnitus before and after sound treatment. The study characterized the effect of sound therapy on brain volume. It found that sound therapy had a normalizing effect on the bilateral thalami and cochlear nucleus. www.ClinicalTrials.gov, NCT02774122.
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http://dx.doi.org/10.3389/fnins.2020.00911DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506156PMC
September 2020

Why does unilateral pulsatile tinnitus occur in patients with idiopathic intracranial hypertension?

Neuroradiology 2021 Feb 3;63(2):209-216. Epub 2020 Sep 3.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95th Yong'an Road, Xicheng District, Beijing, 100050, China.

Purpose: To investigate the relevant factors of unilateral pulsatile tinnitus (PT) in patients with idiopathic intracranial hypertension (IIH) using CT.

Methods: CT angiography images of IIH patients with unilateral PT (n = 19), without PT (n = 13), and controls (n = 32) were reviewed. The characteristics including transverse sinus stenosis (TSS), venous outflow laterality (VOL), sigmoid sinus wall dehiscence (SSWD), and sigmoid sinus diverticulum (SSD) were quantitatively or/and qualitatively detected. VOL was compared between the symptomatic side of IIH patients with PT and the larger side of IIH patients without PT and the controls. TSS, SSWD, and SSD were compared between the symptomatic side of IIH patients with PT, and both sides of the latter two groups.

Results: There was no statistical difference in body mass index or cerebrospinal fluid pressure between IIH patients with and without PT. The prevalence of TSS was significantly higher in IIH patients than that in the controls (p = 0.000), but TSS had no correlation with PT within IIH patients. The prevalence of SSWD successively decreased in IIH patients with PT, without PT, and the controls, with significant differences between each two of three groups (p = 0.000, p' = 0.000, p″ = 0.031). The proportion of VOL and the prevalence of SSD were significantly larger in IIH patients with PT than in the latter groups respectively (p = 0.005, p' = 0.000; p = 0.040, p' = 0.000). All SSDs in IIH patients with PT were accompanied with SSWD.

Conclusion: The dominant VOL and ipsilateral SSWD with/without SSD may be correlated with the occurrence of unilateral PT in IIH patients.
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http://dx.doi.org/10.1007/s00234-020-02541-6DOI Listing
February 2021

Three-dimensional assessment of pharyngeal volume and cross-sectional area in Chinese infants and preschool children.

Int J Pediatr Otorhinolaryngol 2020 Sep 11;136:110253. Epub 2020 Jul 11.

Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China. Electronic address:

Objective: The cross-sectional area (CSA) and the volume of the pharyngeal airway normative reference data aren't established, although they are closely associated with the pathogenesis of obstructive sleep apnea syndrome (OSAS) in infants and preschool children. Our objective is to measure the cross-sectional area (CSA) and volume of pharyngeal airway subregions and investigate the effects of age and sex in infants and preschool children using computerized tomography (CT).

Methods: After applying strict inclusion criteria, 57 infants and preschool children (27 females, 30 males) aged from 1 day to 72 months who underwent maxillofacial CT scans due to trauma were selected. The sample was stratified into three age groups (1 day-24 months, 25-48 months, and 49-72 months). The CSA and the volume of the naso-, palato-, glosso-, and laryngopharyngeal airway were calculated using a 3-dimensional image processing software. Linear regression analysis was performed to express the effect of age, height, and weight. One-way analysis of covariance with height as a covariate was used to analyze the statistical significance of the difference between males and females within each age group.

Results: The CSA and volume of all pharyngeal airway subregions increased with age, height, and weight (P < 0.05) in children under 6 years old. Multiple linear regression analysis showed an age effect, identified in all measurements (P < 0.001), whereas no height or weight effect were found. There were no differences in any measurements between males and females within each age group.

Conclusion: The normative reference data of CSA and volume of pharyngeal airway subregions were established after applying strict inclusion and exclusion criteria in infants and preschool children. Results may be useful in screening and assist in the timely diagnosis and management of pediatric OSAS.
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September 2020

lncRNA TMPO-AS1 Exerts Oncogenic Roles in HCC Through Regulating miR-320a/SERBP1 Axis.

Onco Targets Ther 2020 3;13:6539-6551. Epub 2020 Jul 3.

Department of Infection Diseases, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, People's Republic of China.

Background: Previous evidence have shown that long non-coding RNA (lncRNA) TMPO antisense RNA 1 (TMPO-AS1) is involved in the aggressiveness of several cancers. Nevertheless, the precise functions of TMOP-AS1 in hepatocellular carcinoma (HCC) are still unresolved.

Materials And Methods: The expressions of TMPO-AS1 and miR-320a were detected in HCC tissues and cells by qRT-RCR. The cell growth, migration and invasion were detected by colony formation, wound healing assay and Transwell assay, respectively. The targeting relation between miR-320a and TMPO-AS1 was predicted by bioinformatics analysis and identified by luciferase reporter gene as well as FISH assay. The expression of SERPINE1 MRNA Binding Protein 1 (SERBP1) was detected by Western blot. The growth of HCC cell was analyzed using transplanted tumor model.

Results: Currently, we revealed that TMPO-AS1 was overexpressed in clinical HCC samples and a panel of HCC cell lines. Clinically, a higher level of TMPO-AS1 was connected to the advanced stage of HCC and worse prognosis of patients. Depletion of TMPO-AS1 repressed HCC cell viability, migration ability and invasiveness. Nevertheless, upregulation of TMPO-AS1 caused opposite results. Further studies revealed that lncRNA TMPO-AS1 was largely located in the cytoplasm of HCC cell and sponge miR-320a, resulting in increasing the level of SERBP1 in HCC cell. Finally, TMPO-AS1 silencing suppressed tumor growth of HCC cell in vivo.

Conclusion: Collectively, our results suggested that TMPO-AS1 was a promoting factor for the aggressive behaviors of HCC cell.
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http://dx.doi.org/10.2147/OTT.S250355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342364PMC
July 2020