Objective To explore the clinical value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid （Gd-EOB-DTPA） enhanced magnetic resonance （MR） imaging for cirrhosis-related nodules. Methods Nineteen patients who were suspected cirrhosis with lesions of liver were prospectively included for Gd-EOB-DTPA enhanced MR imaging test between Nov. 2011 and Jan. 2013. The hepatobiliary phase （HBP） images were taken in 20 minutes after agents’ injection. The images were diagnosed independently in two groups： group A， including the plain phase and dynamic phase images； group B， including plain phase， dynamic phase， and HBP phase images. The signal intensity （SI） of lesions in HBP images， background liver SI， and background noise standard deviation were measured by using a circular region of interest， then the lesion signal to noise ratio （SNR） and contrast signal to noise ratio （CNR） were calculated. Results Nineteen patients had 25 tumors in all， including 18 hepatocelluar carcinoma （HCC） and 7 regenerative nodule （RN） or dysplastic nodule （DN）， with the diameter ranged from 0.6 cm to 3.2 cm （average 1.3 cm） . Sixteen HCC manifested hypo SI relative to the normal liver， while 2 HCC manifested hyper SI at HBP. Five HCC had cystic necrosis with the necrotic area， and there were no enhancement in artery phase， while performed flocculent enhancement at HBP. Six RN or DN showed hyper SI while another 1 showed iso SI to background liver at HBP. The diagnostic accuracy rates of group A and group B were 80.0% （20/25） and 92.0% （23/25）. SNR of RN or DN at HBP was 132.90±17.21， and of HCC was 114.35±19.27， while the CNR of RN or DN was 19.47±8.20， and of HCC was 112.15±33.52. Conclusion Gd-EOB-DTPA enhanced MR imaging can improve the diagnosis capacity of cirrhosis-related nodules， so as to develop more accurate and reasonable treatment options.
ObjectiveTo explore the diagnostic value of sonography in thyroid imaging reporting and data system (TI-RADS) for thyroid nodules. MethodsA total of 292 patients (423 nodules) underwent thyroid examination with high frequency ultrasound. The results were retrospectively compared with histopathological diagnosis and TI-RADS lexicon. ResultsThe category 1-5 of 423 thyroid nodules were evaluated by using TI-RADS, and it’s frequency of being malignancy rate was 0(0/129), 6.3%(11/176), 33.3%(10/30), 86.8%(46/53), and 100% (35/35), respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value for benign thyroid nodule of ultrasound in TI-RADS was 96.3%（309/321）, 83.3%（85/102）, 93.1%（394/423）, 94.8%（309/326）, and 87.6%（85/97）, respectively. Positive likelihood ratio, negative likelihood ratio, and Youden’ index was 5.77, 0.04, and 79.6%, respectively. The benign and malignancy nodule of TI-RADS category were statistically difference in shape, margin, echogenicity, echotexture, composition, and calcification inside the nodule (Plt;0.001). ConclusionsTI-RADS lexicon has an important guiding value for clinical diagnosis and treatment in ultrasound examination of thyroid nodule.
ObjectiveBy integrating biological assays with imaging evaluations, a clinical prediction model is developed based on a cohort of ten thousand individuals to enhance the accuracy of distinguishing between benign and malignant pulmonary nodules. MethodsA retrospective analysis was conducted on the clinical data of 1,017 patients with pulmonary nodules who underwent chest CT and testing for seven types of lung cancer-related serum autoantibodies (7-AABs) at the First Affiliated Hospital of Zhejiang University School of Medicine from January 2020 to April 2024, all of whom had definitive pathological diagnosis results. Statistical analysis was performed using R and MSTATA software, with the development of univariate and multivariate logistic regression models, as well as a nomogram model. The performance of the models was evaluated using ROC curves, calibration curves, and decision curve analysis (DCA). ResultsA total of 1,017 patients with pulmonary nodules were included in the study. The training set consisted of 712 patients, including 291 males and 421 females, with a mean age of (58.12±12.41) years. The validation set included 305 patients, comprising 129 males and 176 females, with a mean age of (57.99±12.56) years. Univariate ROC curve analysis indicated that the combination of CT and 7-AABs testing achieved the highest AUC value (0.794), surpassing the diagnostic efficacy of CT alone (AUC=0.667) or 7-AABs alone (AUC=0.514). Multivariate logistic regression analysis included age, imaging nodule diameter, nodule characteristics, and the combination of CT and 7-AABs testing as independent predictive factors to construct a nomogram prediction model. The AUC values for this model were 0.831 and 0.861 in the training and validation sets, respectively, demonstrating excellent performance in decision curve analysis (DCA). ConclusionThe combination of 7-AABs with CT significantly enhances the accuracy of distinguishing between benign and malignant pulmonary nodules. The developed predictive model provides strong support for clinical decision-making and contributes to achieving precise diagnosis and treatment of pulmonary nodules.