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8. Diagnostic Performance of Magnetic Resonance Cholangiopancreatography in Malignant Obstructive Jaundice

Author

Liang Changhua, Mao Huajie, Li Yuxia, Yang Rui-min, Wang Qinghua, Han Dongming, Cui Hongkai, Sun Fengxia, and Yue Jun-yan

Subjects
Adult, Male, medicine.medical_specialty, Cholangiopancreatography, Magnetic Resonance, Biophysics, Constriction, Pathologic, Sensitivity and Specificity, Biochemistry, Patient Positioning, medicine, Humans, Medical diagnosis, Aged, Pancreatic duct, Porta hepatis, Magnetic resonance cholangiopancreatography, medicine.diagnostic_test, business.industry, Magnetic resonance imaging, Cell Biology, General Medicine, Middle Aged, Jaundice, Jaundice, Obstructive, medicine.anatomical_structure, Female, Obstructive jaundice, Bile Ducts, Radiology, medicine.symptom, Pancreas, business
Abstract

Malignant obstructive jaundice is caused by tumors arising from the head of the pancreas and biliary tree, or seen due to secondary metastases in the porta hepatis lymph nodes. Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive diagnostic technique that can be used for imaging the entire biliary tree and pancreatic duct system. The objective of this study was to evaluate the accuracy of MRCP in the diagnosis of malignant obstructive jaundice. The methods used involved comparative review of the images obtained by using magnetic resonance imaging and MRCP as well as comparison between MRCP- and pathology-based diagnoses. The accuracy of MRCP-based diagnosis of malignant obstructive jaundice was analyzed. Our data show that the positive rate of anatomical diagnosis and the detection rate of bile ducts on the proximal side of obstruction are 100%. The diagnostic accuracy of malignant obstruction was 82.9%. MRCP was found to have high diagnostic specificity for determining the location and extent of obstruction. We, therefore, concluded that MRCP had significance for clinical diagnosis of malignant obstructive jaundice. The positive rate of localization diagnosis was 100%. Distinguishing the quality of obstruction was also important. The diagnostic accuracy of MRCP for malignant obstructive jaundice was remarkably higher.

Published
2011

10. HR-MRI-based nomogram network calculator to predict stroke recurrence in high-risk non-disabling ischemic cerebrovascular events patients.

Author

Li ZA, Gao Y, Han L, Xie BC, Sun YC, Zhai XY, Zhang P, Li YD, Yue JY, Yan RF, and Cui HK

Abstract

Background and Objective: To investigate the use of high-resolution magnetic resonance imaging (HR-MRI) to identify the characteristics of culprit plaques in intracranial arteries, and to evaluate the predictive value of the characteristics of culprit plaques combined with the modified Essen score for the recurrence risk of high-risk non-disabling ischemic cerebrovascular events (HR-NICE) patients., Methods: A retrospective analysis was conducted on 180 patients with HR-NICE at the First Affiliated Hospital of Xinxiang Medical University, including 128 patients with no recurrence (non-recurrence group) and 52 patients with recurrence (recurrence group). A total of 65 patients with HR-NICE were collected from the Sixth Affiliated Hospital of Shanghai Jiaotong University as a validation group, and their modified Essen scores, high-resolution magnetic resonance vessel wall images, and clinical data were collected. The culprit plaques were analyzed using VesselExplorer2 software. Univariate and multivariate logistic regression analyses were used to identify independent risk factors for recurrence, and a nomogram was constructed using R software to evaluate the discrimination of the model. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was used to evaluate the model performance. Calibration curves and Decision Curve Analysis (DCA) were used to evaluate the model efficacy., Results: Intra-plaque hemorrhage (OR = 3.592, 95% CI = 1.474-9.104, p  = 0.006), homocysteine (OR = 1.098, 95% CI = 1.025-1.179, p  = 0.007), and normalized wall index (OR = 1.114, 95% CI = 1.027-1.222, p  = 0.015) were significantly higher in the recurrent stroke group than in the non-recurrent stroke group, and were independent risk factors for recurrent stroke. The performance of the nomogram model (AUC = 0.830, 95% CI: 0.769-0.891; PR-AUC = 0.628) was better than that of the modified Essen scoring model (AUC = 0.660, 95% CI: 0.583-0.738) and the independent risk factor combination model (AUC = 0.827, 95% CI: 0.765-0.889). The nomogram model still had good model performance in the validation group (AUC = 0.785, 95% CI: 0.671-0.899), with a well-fitting calibration curve and a DCA curve indicating good net benefit efficacy for patients., Conclusion: High-resolution vessel wall imaging combined with a modified Essen score can effectively assess the recurrence risk of HR-NICE patients, and the nomogram model can provide a reference for identifying high-risk populations with good clinical application prospects., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Li, Gao, Han, Xie, Sun, Zhai, Zhang, Li, Yue, Yan and Cui.)

Published
2024
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