Dynamic contrast-enhanced MRI analysis for prognosis of intracranial dissecting aneurysm with intramural haematoma after endovascular treatment: an observational registry study

Differentiation of Cerebral Dissecting Aneurysm from Hemorrhagic Saccular Aneurysm by Machine-Learning Based on Vessel Wall MRI: A Multicenter Study

The differential diagnosis of a cerebral dissecting aneurysm (DA) and a hemorrhagic saccular aneurysm (SA) often depends on the intraoperative findings; thus, improved non-invasive imaging diagnosis before surgery is essential to distinguish between these two aneurysms, in order to provide the correct formulation of surgical procedure. We aimed to build a radiomic model based on high-resolution vessel wall magnetic resonance imaging (VW-MRI) and a machine-learning algorithm. In total, 851 radiomic features from 146 cases were analyzed retrospectively, and the ElasticNet algorithm was used to establish the radiomic model in a training set of 77 cases. A clinico-radiological model using clinical features and MRI features was also built. Then an integrated model was built by combining the radiomic model and clinico-radiological model. The area under the ROC curve (AUC) was used to quantify the performance of models. The models were evaluated using leave-one-out cross-validation in a training set, and further validated in an external test set of 69 cases. The diagnostic performance of experienced radiologists was also assessed for comparison. Eight features were used to establish the radiomic model, and the radiomic model performs better (AUC = 0.831) than the clinico-radiological model (AUC = 0.717), integrated model (AUC = 0.813), and even experienced radiologists (AUC = 0.801). Therefore, a radiomic model based on VW-MRI can reliably be used to distinguish DA and hemorrhagic SA, and, thus, be widely applied in clinical practice.

Application of Dynamic Contrast-Enhanced MRI in the Diagnosis of Rheumatoid Arthritis

In order to solve the application problem of dynamic contrast-enhanced MRI in the diagnosis of rheumatoid arthritis, this paper proposes application research based on dynamic contrast-enhanced MRI in the staging diagnosis of rheumatoid arthritis. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has a high value in evaluating the activity of patients with early rheumatoid arthritis (RA). This paper discusses the correlation between hemodynamic parameters and omeractramris score, clinical laboratory indexes, and activity score (DAS28), analyzes its feasibility in evaluating the prognosis of RA, and provides a reliable basis for the rational formulation of an early RA treatment plan. After reviewing the previous cases, 33 patients with subclinical synovitis of RA were selected for wrist joint contrast-enhanced ultrasonography. The data were analyzed by contrast-enhanced software, and the quantitative parameters of contrast-enhanced were obtained: start development time (AT), peak time (TTP), peak intensity (PI), grad gradient, and area under the curve (AUC). The synovial blood supply was classified by CEUS, and the CEUS blood supply classification and power Doppler (PDUS) blood supply classification were compared. The results of regression analysis showed that AUC (or = 1.026, 95% CI: 1.001–1.052) and PI (or = 1.561, 95% CI: 1.019–2.393) were independent risk factors for predicting the aggravation of the disease. The diagnostic efficacy of AUC and PI in predicting the aggravation of the disease was analyzed. The areas under the ROC curve of AUC and PI were 0.935 and 0.927, respectively, and the difference between them was not statistically significant.