To establish a multi-delay pseudocontinuous arterial spin labeling (MD pCASL) protocol on a 5 T ultra-high-field MRI system and to compare the performance of three-dimensional echo-planar imaging (3D-EPI) and three-dimensional gradient and spin echo (3D-GRASE) readout sequences in cerebral perfusion imaging. The study also aims to assess the potential of 3D-EPI for high-resolution MD pCASL at ultra-high field strength.

Ten healthy volunteers underwent MD pCASL examinations on a 5 T MRI system with post-labeling delays ranging from 500 to 3,000 ms. Both 3D-EPI and 3D-GRASE sequences were acquired using the same spatial resolution. Cerebral blood flow (CBF) and arterial transit time (ATT) were calculated using the BASIL toolbox in the FMRIB Software Library. Image quality was evaluated using the blur quality metric (BQM) and subjective scoring.

Both sequences produced perfusion images of acceptable quality. Quantitative and qualitative assessments showed that 3D-EPI had significantly lower through-plane blurring than 3D-GRASE (BQM: 0.23±0.02 vs. 0.35±0.02). The subjective scores were also higher for 3D-EPI [3D-GRASE: 4.00 (4.00, 4.00); 3D-EPI: 10.00 (8.00, 11.00)], indicating better anatomical clarity. In addition, 3D-EPI achieved a shorter scan time (4 min 13 s vs. 5 min 18 s). CBF and ATT values derived from the two sequences showed strong correlations across the whole brain and within gray and white matter.

In 5 T MD pCASL imaging, 3D-EPI provides improved structural sharpness and reduced scan time compared with 3D-GRASE, while maintaining good agreement in CBF and ATT quantification. These results suggest that 3D-EPI is a promising readout option for high-resolution ASL at ultra-high field and may enhance the detection of small lesions and the evaluation of complex hemodynamic features.

This study aims to evaluate the application of 5.0 T ultra-high-field MRI in knee joint imaging and directly compare its performance to the widely used 3.0 T MRI to explore its primary advantages.

This prospective study recruited healthy volunteers and patients with chronic knee pain between December 2023 and August 2024. All subjects underwent both 3.0 T and 5.0 T knee joint MRI scans. The imaging sequences included T1WI, 2D FS_PDWI, and 3D FS_PDWI sequences. Three musculoskeletal radiologists independently evaluated the image quality. Quantitative analysis measured the signal-to-noise ratio (SNR) of muscles, cartilage, and bone, while semi-quantitative analysis assessed overall image quality, diagnostic confidence, artifacts, homogeneity of fat suppression, and the visualization of knee structures, including cartilage, ligaments, menisci, and bone marrow edema. Statistical analysis was conducted using the Wilcoxon signed-rank test, and inter-rater agreement was evaluated using the Fleiss kappa coefficient.

A total of 48 healthy volunteers and 55 patients with chronic knee pain were included. Quantitative analysis showed that the SNR of muscles, cartilage, and bone in all sequences was significantly higher with 5.0 T MRI compared to 3.0 T (mean difference range -1.1 to -7.7, P<0.05). Semi-quantitative analysis indicated that the image quality of 5.0 T in 2D sequences was superior to 3.0 T (mean difference -0.24 to -0.50, P<0.05), whereas no significant advantage was observed for 3D PDWI sagittal imaging (mean difference -0.12, P=0.054). There was no significant difference between 5.0 T and 3.0 T in terms of artifacts and homogeneity of fat suppression (P>0.05). Although 5.0 T did not show significant advantages in reading outcomes, it significantly improved diagnostic confidence (mean difference -0.14 to -0.37, P<0.001) and demonstrated superior imaging of various knee structures (mean difference -0.11 to-0.35, all P<0.05). The inter-rater agreement among the three radiologists ranged from moderate to high (kappa 0.486 to 0.969).

Compared with 3.0 T MRI, 5.0 T ultra-high-field MRI demonstrated significant advantages in knee joint imaging, particularly in the quality of muscle, cartilage, and bone imaging as well as in diagnostic confidence. Additionally, 5.0 T did not show any disadvantages in terms of artifact control and fat suppression uniformity. However, no significant advantage was noted in 3D PDWI image quality.

To investigate the alteration of brain regional homogeneity (ReHo) in Parkinson's disease (PD) patients with excessive daytime sleepiness (EDS) by resting-state functional MRI.

Total of 56 PD patients and age, gender and education level-matched 25 healthy controls underwent clinical assessments and resting-state functional magnetic resonance imaging (rs-fMRI). Patients were further divided into PD with EDS (n=27) and PD without EDS (n=29), according to the Epworth sleepiness scale (ESS). The data was processed by DPABI based on MATLAB. ANCOVA and post hoc two-sample t-tests were performed to examine between-groups differences of ReHo. Correlation analyses were performed between ReHo values of the regions showing group differences and ESS scores respectively.

Compared to the HC group, the ReHo values of the left superior temporal gyrus, left pallidum and left caudate in the PD with EDS group were decreased, while the right angular and right superior frontal gyrus were increased (P<0.05, FDR corrected). Compared to the PD without EDS group, the ReHo values of the left superior temporal gyrus in the PD with EDS group were decreased, while the left thalamus and left middle occipital gyrus were increased (P<0.05, FDR corrected). Additionally, ReHo values of the left superior temporal gyrus in the PD with EDS group differing brain regions was negatively correlated with ESS scores (r=-0.45, P<0.05).

There are abnormal brain activities of the basal ganglia region and dorsal attention network in PD with EDS, it is helpful to exlpain the neurophysiological mechanisms of PD with EDS.

To construct a CT radiomics model combined with clinical-imaging features based on the tabular prior-data fitted network (TabPFN) algorithm to enhance the preoperative prediction accuracy for the invasiveness of subsolid lung adenocarcinoma.

This retrospective study enrolled 330 patients with postoperative pathologically confirmed subsolid lung adenocarcinoma who underwent surgical treatment at multiple centers between January 2019 and January 2023. Patients were randomly divided into a training set (n=231) and a validation set (n=99) at a 7:3 ratio. Preoperative thin-slice high-resolution CT images were segmented to extract 1,239 quantitative radiomics features. A feature engineering pipeline was applied to optimize the feature set, involving: batch t-test for screening differential features, Pearson correlation analysis to remove redundant features (|r|≥0.9), and LASSO regression to construct a radiomics score (Radscore). Clinical-imaging features including patient age, sex, nodule size, consolidation-to-tumor ratio (CTR), lesion location, and morphological signs were also extracted. Multiple machine learning models were built for the binary classification task using “Radscore + clinical-imaging features” as input, including TabPFN, random forest (RF), extreme gradient boosting (XGBoost), and light gradient boosting machine (LightGBM). Model performance was evaluated using the area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1 score.

Among the 330 patients, pathology confirmed 101 cases (30.61%) as non-invasive adenocarcinoma and 229 cases (69.39%) as invasive adenocarcinoma. The TabPFN model demonstrated the best performance, achieving an AUC of 0.839, accuracy of 0.798, precision of 0.853, recall of 0.877, and an F1 score of 0.865. The interpretation of the model based on SHAP analysis indicated that Radscore and CTR are the most reliable features for predicting the invasiveness of subsolid lung adenocarcinoma in the TabPFN model.

The analysis combining CT radiomics and clinical-imaging features based on the TabPFN model can effectively achieve preoperative prediction of invasiveness in subsolid lung adenocarcinoma. This provides an objective reference for clinical decision-making regarding individualized surgical strategies, such as lobectomy versus sublobar resection, and holds significant clinical application value.

To investigate the clinical efficacy of transcranial magnetic stimulation combined with cognitive behavioral therapy in adolescents with mild depression.

A total of 160 adolescents diagnosed with mild depression at Taixing City Hospital of Traditional Chinese Medicine from January 2023 to January 2025 were selected and randomly divided into a control group (80 cases) and an observation group (80 cases) using a random number table. The control group received cognitive behavioral therapy, while the observation group received transcranial magnetic stimulation in addition to the cognitive behavioral therapy regimen. The total effective rate of treatment, anxiety scores, coping style scores, somatization scores, depression scale scores, and levels of disease-related factors before and after treatment were compared between the two groups.

The total effective rate in the observation group (96.25%) was higher than that in the control group (77.50%), with a statistically significant difference (P<0.05). Before treatment, there were no significant differences in anxiety scores, coping style scores, or somatization scores between the two groups (P>0.05). After treatment, the observation group showed better results than the control group in anxiety scores, coping style scores, and somatization scores, with statistically significant differences (P<0.05). Before treatment, there was no significant difference in depression scale scores between the two groups (P>0.05), whereas after treatment, the observation group had lower depression scale scores than the control group, with a statistically significant difference (P<0.05). Before treatment, there were no significant differences in levels of disease-related factors between the two groups (P>0.05). After treatment, the observation group had better levels of disease-related factors than the control group, with statistically significant differences (P<0.05).

Cognitive behavioral therapy combined with transcranial magnetic stimulation can enhance clinical efficacy in adolescents with mild depression, improve anxiety and depressive responses, alleviate disease severity, and achieve good therapeutic outcomes.

To explore the evaluation value of the QRS-T angle on the electrocardiogram plane for the prognosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

The clinical data of 121 patients with NSTE-ACS who were treated in our hospital from March 2023 to March 2024 were retrospectively included. They were followed up for one consecutive year. The patients were divided into the good prognosis group and the poor prognosis group based on whether major adverse cardiac events occurred during the follow-up period. The clinical data and electrocardiogram parameters of the two groups were compared. Logistic regression was used to analyze the factors influencing the prognosis of patients with NSTE-ACS. Pearson correlation was used to analyze the relationship between the global registry of acute coronary events (GRACE) risk score, the level of high-sensitivity myocardial troponin I (hs-cTnI) at admission and the QRS-T angle on the electrocardiogram plane in patients with NSTE-ACS. The receiver operating characteristic (ROC) curve was applied to evaluate the value of GRACE risk score, the level of hs-cTnI at admission, and the QRS-T angle in predicting the prognosis of patients with NSTE-ACS.

Among 121 patients with NSTE-ACS, 35 major adverse cardiac events occurred, and the rate of major adverse cardiac events was 28.93%. The GRACE risk score, admission hs-cTnI level and QRS-T angle in the poor prognosis group were all higher than those in the good prognosis group (P<0.05). High GRACE risk score, high hs-cTnI level, and increased QRS-T angle are risk factors for poor prognosis in patients with NSTE-ACS (P<0.05); The GRACE risk score of patients with NSTE-ACS, the hs-cTnI level at admission and the QRS-T angle were moderately positively correlated (P<0.05). GRACE risk score, admission hs-cTnI level, and QRS-T angle all have certain predictive values for the poor prognosis of patients with NSTE-ACS. Among them, the combined detection of the three has the highest predictive efficacy, with an AUC of 0.931, a sensitivity of 97.14%, and a specificity of 72.09%.

The QRS-T angle on the electrocardiogram plane is significantly increased in patients with poor prognosis of NSTE-ACS. The increase in the QRS-T angle is a risk factor and predictor of poor prognosis in patients with NSTE-ACS, but it has the highest predictive efficacy when combined with GRACE risk score and admission hs-cTnI level.

To analyze the association between CT features and histopathology of lung adenocarcinoma presenting as pure ground-glass nodules under high-resolution CT examination conditions.

A retrospective analysis was conducted on the CT manifestations of lung adenocarcinoma with pure ground-glass nodules confirmed by pathology in our hospital from October 2021 to December 2024. The main objective factors to be observed are the size and density of ground-glass nodules, as well as the CT manifestations such as vacuole sign, bronchial changes, vascular changes, presence or absence of spicules, lobulation and nodule - lung interface. Compare the differences in CT features among different histopathological subtypes: pre-invasive group [including atypical adenomatous hyperplasia (AAH) and adenocarcinoma in situ (AIS)] and invasive group [including minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma cancer (IAC)].

This study enrolled a total of 419 patients with pulmonary nodules. The pathological subtypes included 21 cases (5.0%) of AAH, 133 cases (31.7%) of AIS, 123 cases (29.4%) of MIA, and 142 cases (33.9%) of IAC. The invasive group showed significantly greater lesion size, long-to-short diameter ratio, mean CT attenuation, CT enhancement, and standard deviation of CT values than the pre-invasive group (P<0.05). The incidences of vascular abnormality, air-space change, and tumor–lung interface abnormality were also higher in the invasive group than in the pre-invasive group (P<0.05).

A diagnostic framework for the precise preoperative grading of pure ground-glass nodule pulmonary adenocarcinoma can be constructed from high-resolution CT features, providing important basis for assessment of invasion degree and treatment decision-making.

To obtain the target center positioning errors and the maximum tumor displacement positioning errors within the target volume for lung cancer patients during radiotherapy through cone-beam computed tomography (CBCT) image registration, and to determine two corresponding expansion margin respectively. To explore the influence of these two expansion margins on radiotherapy planning and treatment delivery for lung cancer patients, thereby improving the accuracy of clinical target volume to planning target volume (CTV-PTV) margin delineation.

A retrospective analysis was conducted on CBCT images from 40 lung cancer patients who underwent itensity-modulated radiation therapy (IMRT) in the Radiotherapy Department of Southern Hospital, Southern Medical University, between March and September 2024. Displacement data were collected using two registration methods: target center registration and maximum tumor displacement registration within the target volume. The expansion margins for both registration methods were calculated based on the classic formula for MPTV (margin of planning target volume) expansion.

A total of 227 CBCT scans from the 40 lung cancer patients were analyzed. Statistics showed that under the target center registration method, the positioning errors in the anterior-posterior (AP), head-foot (HF), and left-right (LR) directions were (-0.019±0.218) cm, (0.028±0.239) cm, and (0.022±0.217) cm, respectively. Under the maximum tumor displacement registration method, the positioning errors in the AP, HF, and LR directions were (-0.017±0.205) cm, (0.038±0.290) cm, and (0.025±0.241) cm, respectively. The intra-class correlation coefficient (ICC) method confirmed a high consistency between the two datasets. Using the classic formula, the calculated expansion margins for the target center registration method in the AP, HF, and LR directions were 0.373 cm, 0.477 cm, and 0.466 cm, respectively. For the maximum tumor displacement registration method, the corresponding margins were 0.429 cm, 0.602 cm, and 0.506 cm.

The target center registration and maximum tumor displacement registration within the target volume were performed using CBCT images of lung cancer patients, two sets of positioning errors and expansion margins were obtained. The ICC consistency test demonstrated good agreement between the two datasets. These results can serve as a theoretical basis for determining CTV-PTV margins in lung cancer radiotherapy and possess practical clinical application value.

To investigate the efficacy of a multidimensional intervention approach in enhancing the success rate of initial gadoxetic acid disodium-enhanced magnetic resonance imaging (MRI) scans and to offer evidence for improving image quality and streamlining the examination process.

A total of 100 patients who underwent their first gadoxetic acid disodium-enhanced MRI scan at Nanfang hospital between June 2024 and June 2025 were selected using convenience sampling. A non-concurrent controlled study was conducted: 50 patients scanned from June to December 2024 comprised the control group, receiving standard examination education; the remaining 50 patients, examined from January to June 2025, constituted the observation group, which received education through a blend of science popularization videos, nursing guidance, and process optimization. The two groups were compared for differences in examination success rate, patient compliance, nursing satisfaction, image quality, and examination duration.

There were no statistically significant differences in gender or age between the two groups (P>0.05). The one-time success rate of the observation group was 90%, significantly higher than the 62% of the control group (χ²=10.750, P<0.05). Median compliance score in the observation group was 10.00 (interquartile range, IQR 10.00, 10.00), which was significantly higher than that in the control group [8.00 (IQR 6.75, 9.00)] (Z=-7.00, P<0.05). Median nursing satisfaction score in the observation group was 10.00 (IQR 10.00, 10.00), significantly higher than the control group's score [10.00 (IQR 9.00, 10.00)] (Z=-4.61, P<0.05). Median image quality score in the observation group was 10.00 (IQR 10.00, 10.00), significantly higher than the control group's [9.00 (IQR 9.00, 10.00)] (Z=-2.95, P<0.05). Median examination duration in the observation group was 22.00 (IQR 21.00, 23.25) minutes, significantly shorter than the control group's 24.00 (IQR 22.00, 27.00) minutes (Z=-3.21, P<0.05).

This study demonstrates that the combination of science popularization videos, nursing guidance, and process optimization in the first gadoxetic acid disodium-enhanced MRI examination effectively improves the one-time success rate, patient compliance, nursing satisfaction, and image quality, while reducing examination duration. This multidimensional intervention mode is therefore worthy of clinical promotion to enhance the efficiency and quality of MRI examinations.