Volume 95  ·  Issue 43  ·  2015

With the enhancement of people's health awareness and the progress of examination technology, in recent years, a large number of lung nodules have been detected, some of which are early lung cancer. This article only sorts out the screening, diagnosis and follow-up of early lung cancer, so as to provide reference for further standardization of related work.

To identify mutations of the type Ⅰ collagen genes (COL1A1 and COL1A2) in the affected with osteogenesis imperfecta (OI) , to establish the spectrum of COL1A1/2 mutations in Chinese OI patients, and to provide prenatal gene diagnosis to the fetuses at high risk.

Genomic DNA was extracted from peripheral blood by the standard SDS-proteinase K-phenol/chloroform method.All the coding regions and exon/intron boundaries of COL1A1/2 were screened in 200 OI cases by conventional Sanger sequencing and targeted next-generation sequencing (NGS) on Ion Torrent-personalized genome sequencing operation(Ion PGM™). For familial cases, candidate mutations were validated in all available family members using high resolution melting analysis (HRM). In sporadic cases, only parents were examined to determine the origin of the identified mutation.Prenatal gene diagnosis was carried out by PCR direct sequencing and linkage analysis using microsatellite markers.

In total, the authors identified 125 differently pathogenic mutations, including 74 in COL1A1 and 51 in COL1A2, in 158 probands, with a mutation detection rate of 79% (158/200). Among the 125 identified mutations, there were 63 novel mutations (33 in COL1A1 and 30 in COL1A2) and 13 recurrent mutations found in 46 probands (seven mutations recurring for two times, and the other six mutations recurring for more than 4 times). They performed prenatal genetic testing in 74 fetuses and found that 40 ones carried COL1A1/2 mutations identified in the corresponding probands.

The authors have developed a combined approach for genetic testing of OI, extended the COL1A1/2 mutation spectrum in Chinese OI patients, and confirmed gene diagnosis in a relatively large cohort of OI probands and fetuses.

To investigate the influence of recombinant human tumor necrosis factor α receptor-antibody fusion protein(rhTNFR: Fc) to the Hepatitis B virus(HBV) infection status and liver function of Spondyloarthritis(SpA) patients under different HBV infection status.

Active SpApatients with normal liver function were enrolled in Sun Yat-sen Memorial hospital from February 2012 to August 2014. All were treated with rhTNFR: Fc based therapy(monotherapy or combined therapy) for at least 12 weeks. SpA disease activity, HBV infection status and liver function were evaluated at each interview(baseline, 4^th and 12^th week, as primary endpoint). Part of the patients were evaluated at 24^th week with or withoutextendedrhTNFR: Fc treatment(as secondary endpoint) based on their choice.

Eighty-one patientswho completed 12-week follow-up visit were divided into chronic HBV carrier group(n=21), past HBV exposure group(n=25) and free of HBV infection group(n=35). Alanine transaminase(ALT) elevated(no more than 3-fold of normal) in 3 patients from 3 groups respectively at 4th week. During 24-week follow-up, none in past HBV exposure group or in free of HBV infection group developed HBV reactivation or HBV infection; and 4 patients in chronic HBV carrier group developed HBV reactivation without more than 2-fold of normalelevation of ALT. Among 7 patients with negative baseline HBV-DNA and without antiviral prophylaxis, 2 patients developed HBV reactivation at 10^th, 24^th week of rhTNFR: Fc therapy respectively and 1 patient developed reactivation at 16^th week(12-week rhTNFR: Fc+ thalidomide therapy and following 4-week thalidomide monotherapy), whose HBV-DNA load returned to normal spontaneously or after antiviral therapy. Four chronic HBV carriers with low-load of baseline HBV-DNA did not develop reactivation. One of 9 chronic HBV carriers with high-load of baseline HBV-DNA developed reactivation due to resistance of antiviral prophylaxis.

Short-term rhTNFR: Fc based therapy may induce mild and transient HBV reactivation, usually without hepatitis.

To study the association between site of onset and ventilation dysfunction in Chinese patients with amyotrophic lateral sclerosis.

The clinical data of 344 patients with sporadic amyotrophic lateral sclerosis (SALS) in Department of Neurology of Peking University Third Hospital from January 2009 to September 2013 were retrospectively reviewed.The differences of Forced Vital Capacity (FVC) between groups with distinct site of onset were analyzed.

There were 55, 200 and 89 patients in the group with bulbar, upper limb and lower limb onset, respectively.The values of FVC were 84%±14%, 83%±17% and 88%±16%, and the cases of FVC < 80% were 24 (43.64%), 81 (40.50%) and 25 (28.09%) in each group.The mean value of FVC was significantly lower and the frequency of FVC< 80% statistically higher in the group with upper limb onset in comparison with the group with lower limb onset.The mean value of FVC was lower and the frequency of FVC< 80% higher in the group with bulbar onset than in the group with lower limb onset.However, the differences were not significant between the two groups.

Compared with SALS with upper limb onset, ventilation function disorder may occur less and later in patients with lower limb onset, who may also require noninvasive positive pressure ventilation (NIPPV) less and later.

To explore the clinical efficacy and experiences of superficial temporal artery-middle cerebral artery anastomosis (STA-MCA) for the treatment of adult Moyamoya disease.

Preoperative and postoperative clinical data of 60 patients with moyamoya disease from affiliated hospital of jining medical college were analyzed retrospectively, including 46 cases of ischemic lesion and 14 cases of hemorrhage lesion.All patients were diagnosed with moyamoya disease by DSA and received STA-MCA anastomosis.

The clinical symptoms of 52 patients disappeared after surgery; the clinical symptoms were improved in 6 patients; 1 patient complicated with cerebral infarction; 1 patients reoccurred cerebral hemorrhage broken into ventricles 1 year after anastomosis.

STA-MCA anastomosis can improve the symptoms of ischemic moyamoya disease effectively and reduce the recurrence of cerebral hemorrhage.STA-MCA anastomosis is a rational and effective approach for the treatment of adult Moyamoya disease.

To explore the imaging anatomic features of symptomatic cerebral venous sinus stenosis, and evaluate the efficacy and feasibility of different treatment methods.

From August 2001 to September 2004, 173 patients (transverse sinus stenosis 150, middle of the superior sagittal sinus stenosis 18, proximal part of sigmoid sinus stenosis 3, straight sinus stenosis 2; combined with sinus diverticulum 14, combined with Labbe's vein stenosis 3) were confirmed venous sinus stenosis by digital subtraction angiography (DSA). Among these patients, 121 were treated by stent implantation and the other 52 with mild symptoms by anticoagulation and/or thrombolysis treatment.

The treatment procedures were succeeded in all patients.2 patients developed temporal and occipital hemorrhage during the procedure of artery thrombolysis, and 1 patient developed epidural hematoma in the transverse sinus area.All the 3 patients had a satisfactory prognosis through symptomatic treatment.There was no recurrence for all the patients during the follow-up period ranging from 1 to 9 years.9 patients who had recurring dizziness were confirmed no stent stenosis or thrombosis by DSA.The sites of stenosis in 168 patients (97%) were in the connect area of sigmoid and transverse sinuses or in the middle segment of superior sagittal sinus, where arachnoid granulations were focused on according to the anatomic characteristics.

There is significant correlation between the cerebral venous sinuses stenosis and the abnormal growth of arachnoid granulations in the sinuses; the neurologic deficits caused by venous sinus stenosis can be relieved and eliminated by anticoagulation, thrombolysis, or stent implantation. Favorable medium-long term outcome is showed in the study population.

To evaluate clinical characteristics and outcome of acute ischemic stroke patients with atrial fibrillation.

Consecutive acute ischemic stroke patients who were hospitalized in the neurology department of General Hospital of Jinan Military Region were prospectively recruited from August 2010 to November 2013.The baseline datum including age, sex, National Institute of Health Stroke Scale (NIHSS), type of Oxfordshire Community Stroke Project (OCSP: total anterior circulation infarct, partial anterior circulation infarction, posterior circulation infarction and lacunar infarction), serum creatinine, serum albumin levels etc.were recorded.Atrial fibrillation (AF) was defined as a history of persistent atrial fibrillation or paroxysmal atrial fibrillation, supported by past electrocardiogram or diagnosed by the attending physicians based on physical examination, electrocardiogram and/or 24-hour electrocardiogram monitoring during hospitalization.Outcome was assessed by modified Rankin Scale (mRS) which was obtained 180 days after stroke by telephone interview (mRS≤2 reflected good prognosis, and mRS>2 reflected unfavorable prognosis), and death defined as all-cause mortality.Multivariate regression model was used to analyze predictors of mortality and disability.

Of the 965 patients included in this study, 113 (11.71%) had AF; valvular AF was observed in 11 patients (9.7%) among them.Only 4 patients with valvular AF and none of the patients with non-valvular AF took warfarin before the stroke event.14.2% (16/113) acute ischemic stroke patients with AF took aspirin.Compared to patients without AF, patients with AF had a higher NIHSS score on admission (median 11 vs 5, P=0.000); were more often with diabetes (26.55% vs 9.74%, P=0.028), congestive heart failure (12.37% vs 11.03%, P=0.000), prior stroke (31.86% vs 21.83%, P=0.023), total anterior circulation infarct subtype (51.33% vs 19.37%, P=0.000); they were less often smokers (20.35% vs 37.32%, P=0.000), alcohol consumers (13.27% vs 27.58%, P=0.001), partial anterior circulation infarction subtype (24.78% vs 36.74%, P=0.012), lacunar infarct subtype (0 vs 17.61%, P=0.000); they had less often experienced myocardial infarction (11.50% vs 11.74%, P=0.041). AF was a significant independent prognostic factor for long-term poor outcomes (OR=2.227, 95%CI: 1.262-3.933, P=0.006).

Oral anticoagulants are underused in AF patients.Brain infarction patients with AF is more severe than patients without AF; have higher frequency of total anterior circulation infarct subtype, prior stroke and lower frequency of lacunar infarct subtype.AF is a significant independent prognostic factor for long-term poor outcome in patients with acute brain infarction.

To discuss the hemodynamic changes in patients with acute supratentorial spontaneous intracerebral hemorrhage (within 72 hours) by using 320-slice of low-dose volume CT perfusion imaging.

Twenty-six patients of The First Affiliated Hospital of Wenzhou Medical University during December 2012 to December 2013 with acute supratentorial SICH diagnosed by plain CT scanning and clinic were enrolled. With hematoma maximum level for reference, the hematoma volume, edema area and perfusion defect area were measured, and the perfusion parameters values of the marginal area and outer area of the intracerebral hematoma and contralateral mirror area were measured, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time-to-peak (TTP), and rCBF, rCBV, rMTT and rTTP were calculated by ipsilateral/contralateral value.

The CBF, CBV of the marginal area were lower than the contralateral mirror area(t_CBF=-8.125, t_CBV=-8.671, P_{CBF, CBV}<0.01); the MTT of the marginal area was shorter than the contralateral mirror area (t_MTT=-3.246, P_MTT<0.05); the TTP of the marginal area was longer than the contralateral mirror area (t_TTP=5.027, P_TTP<0.01). The CBV of the outer area was lower than the contralateral mirror area (t_CBV=-2.337, P_CBV<0.05); the MTT of the outer area was shorter than the contralateral mirror area (t_MTT=-2.421, P_MTT<0.05); the TTP of the outer area was longer than the contralateral mirror area (t_TTP=2.077, P_TTP<0.05). There was a siginificant relationship between the volume of acute hematoma and rCBV, rMTT, rTTP of the marginal area (r_rCBV=-0.412, P_rCBV<0.05,r_rMTT=-0.437, P_rMTT<0.05,r_rTTP=0.475, P_rMTT<0.05). Perihematomal CBF perfusion defect area showed a positive linear relation with the volume of acute hematoma (r=0.440, P<0.05). There was a positive linear relationship between the maximum level edema area and the hematoma volume, perihematomal CBF perfusion defect area (r=0.400, r=0.81, P<0.05).

320-slice of low-dose and volume CT perfusion imaging can perfectly reflect the hemodynamic changes in brain tissuse after acute supratentorial SICH.Hypoperfusion was appeared in perihematomal area of acute supratentorial SICH.The perihematomal brain tissue may exists ischemic injury associated with the size of hematoma.The hematoma placeholder effect, ischemic injury are the important cause of acute brain edema formation.

To compare the difference between the different perfusional regions in solid thyroid nodules.

From October 2013 to May 2015, CEUS was performed in 59 patients who hospitalizated in Zhoushan Hospital with solid thyroid nodules before operation. The time-intensity curve (TIC) of normal thyroid tissue, tumor edge and tumor center was drawn to collect perfusion index like the peak intensity (PI), time to peak (TP), area under the curve (AUC), mean transit time (MTT). After surgery, immunohistochemical staining was performed to evaluate the MVD in surgical specimens.Quantitative parameters and MVD were assessed by the Spearman correlation analysis.

There were 31 thyroid papillary carcinomas and 28 nodular goiters. In malignant tumor group, the PI of normal thyroid tissue, tumor edge and tumor center were 28%±6%, 21%±7% and 14%±5%, respectively, while the AUC and MVD of the same regions were (1 865±1 079)%S, (1 376±595)%S, (805±412)%S and(33±6), (27±6)/HP, (17±6)/HP, respectively. The differences were statistically significant. However, in benign tumor group, there was no obvious statistic difference in the quantitative parameters and MVD between the three regions. The PI values of thyroid carcinomas and nodular goiters all were positively correlated with MVD(r=0.819, r=0.838, P<0.05).

The variance of perfusion parameters were valuable diagnostic basis in differential diagnosis between benign and malignant thyroid nodules. They were associated with MVD, which might reflect the microvessel distributional characteristics of neoplasm and might be one of bases used to evaluate neoplasm angiogenesis.

To explore the occurrence and development of sepsis-induced cardiomyopathy (SIC) and its correlation with left ventricular arterial coupling.

A total of 46 SIC patients were recruited and divided into non-survival and survival groups.And hemodynamics parameters, lactate, cardiac elastance (Ees), arterial elastance (Ea) and ventricular-arterial coupling (Ea/Ees), stroke work (SW), total mechanical work (PVA) and cardiac work efficiency (SW/PVA) were recorded before and after an onset of SIC.

The occurrence and development of SIC had close correlations with left ventricular arterial coupling.Heart and arterial elastance affected the occurrence and outcome of SIC.The former was a underlying cause while the latter a precipitating factor; the primary treatment goal of SIC was improving ventricular-arterial coupling.And the short-term objective was reducing arterial elastance and long-term strategy improving cardiac elastance; Ea declined initially when SIC recovered.And it was consistent with ventricular-arterial coupling improvement.Ees recovery was delayed; before and after SIC, low peripheral vascular resistance within 36 h could reduce arterial elastance Ea; ventricular artery coupling affected cardiac external work, work efficiency and stroke volume and was associated with tissue perfusion.

The occurrence and outcome of SIC are simultaneously influenced by Ees and Ea and are closely correlated with Ea/Ees. Treatment goal of SIC is improving ventricular-arterial coupling.Ea should be reduced within 36 h and Ees should be boosted after 48 h.

To compare the outcomes of anterior cruciate ligament (ACL) reconstruction in patients aged over 40 years and under 25 years at least 24 months follow-up after operation.

Fifty-seven patients who underwent ACL reconstruction for ACL rupture in Institute of Sports Medicine, Peking University Third Hospital, from October 2010 to December 2012 were selected for this retrospective study.The patients aged over 40 years consisted of 13 men and 15 women with an average age of 46.5 years (range, 41 to 63 years). The patients younger than 25 years consisted of 19 men and 10 women with an average age of 21.0 years (range, 18 to 24 years). The average follow-up time was 26.0 months (range, 24 to 45 months). Clinical functional evaluation for all patients was performed according to Lysholm, Tegner and IKDC scores both before and after surgery.In addition, a pre- and post-operative arthrometric evaluation was also performed with KT-2000.

The average postoperative Lysholm, Tegner and IKDC scores in patients aged over 40 years and under 25 years were 89 (74 to 100), 5 (3 to 6), 90 (70 to 100) and 94 (79 to 100), 5 (4 to 7), 93 (74 to 100) respectively.The average postoperative KT-2000 arthrometer anterior laxity in 30° and 90° in both groups was 2 mm (0 to 4 mm), 1 mm (-1 to 4 mm) and 2 mm (0 to 4 mm), 1 mm (0 to 4 mm) respectively.The postoperative functional scores and side-to-side difference improved more significantly than preoperative values, with no significant difference in both groups.

ACL reconstruction provides the comparable clinical outcomes between middle-aged patients and young patients

To explore the different effects in ex vivo bovine liver between multiple cool-tip internally cooled electrodes synchronous radiofrequency ablation via switching controller and conventional single electrode overlapping radiofrequency ablation.

The above two methods were used to ablate in ex vivo bovine liver respectively.Electrode exposed end was 3 cm or 4 cm in length.The morphological characteristics of lesions created by two methods were observed, the sizes of the ablated lesions were measured and compared.

The formation of lesions ablated by both two methods was ellipsoidal.The longitudinal diameter, transverse diameter, front-end diameter and volume of the lesions ablated 16 mins by multi-electrode synchronous radiofrequency ablation via switching controller were (7.12±0.52) cm, (5.71±0.47) cm, (1.77±0.29) cm, (102±20) cm³, respectively.All of them are larger than the lesions ablated 36 mins by conventional single electrode overlapping radiofrequency ablation(P<0.01). At the same 16 mins, multi-electrode synchronous radiofrequency ablation via switching controller created longer longitudinal diameter and large volume(P<0.01) with longer exposed end electrodes(4 cm vs 3 cm). But the transverse diameter, the front-end diameter had no statistical difference (P>0.05).

Compared with the conventional single electrode overlapping radiofrequency ablation, multi-electrode synchronous radiofrequency ablation via switching controller create larger lesion in the shorter time.It may provide a new attempt for the clinical treatment of large hepatocellular carcinoma.

To explore the effect of emodin-8-O-β-D-glucoside (EG) on cell apoptosis and expression levels of Bcl-2 family proteins in human ovarian cancer SKOV3 cells.

SKOV3 cells were cultured and divided into two groups (control group and experimental group). Cell viabilities were determined by the methyl thiazolyl tetrazolium (MTT) method; apoptosis and cell cycle were analyzed by flow cytometry; the changes of protein expression of cleaved caspase-3, cleaved caspase-9, Bcl-2 and Bax were detected by Western blot.

From the data of MTT, the cell proliferation of human ovarian cancer SKOV3 cells was inhibited by EG (20, 40, 80 mg/L) in a dose- and time-dependent manner. Flow cytometry assays showed that EG significantly induced apoptosis in SKOV3 cells. 48 h after treated with EG (20, 40, 80 mg/L), the apoptosis rate of the experimental group were increased gradually, and they were 23.8%, 35.5%, 59.6%, respectively, which were higher than these of the control group significantly. The data of Western blot showed that EG down-regulated Bcl-2 and up-regulated cleaved caspase-3, cleaved caspase-9, Bax in a dose-dependent manner.

EG can inhibit the proliferation of SKOV3 cells and promote apoptosis, and the anticancer effect of EG may be associated with the down regulation of Bcl-2 expression and up regulation of Bax expression, as well as the increase of relative activity of caspase 3 and caspase 9. EG may be a promising antitumor agent for cancer treatment.

To explore the effects of mild hypothemia on hemodynamics of systemic and renal of dog with septic shock.

40 healthy dogs were randomly and evenly divided into the normal temperature non-infected group (NTNS), normal temperature infected group (NTS), hypothermia non-infected group (MHNS) and hypothermia infected group (MHS). NTS and MHS were pumped through the femoral vein of Escherichia coli (E.coli 1×10⁹ cfu/ml) by 0.5 ml·kg^-1·h^-1, producting septic shock model with high-power cycle.Combining with blood pump devices and low temperature thermostat bath, the MHNS and MHS implemented extracorporeal blood cooling method to maintain the blood in temperature (33±1) ℃.0, 24, 48, 72 h point, tested specimens from femoral vein for renal function.In the 0-72 h. Pulse indicates the continuous cardiac output monitor (PiCCO) monitored systemic hemodynamics on each time point.In the 0-72 h, color Doppler ultrasound (CDFI) measured renal hemodynamic on each time point.

There was an increase of SBP (P<0.05), SVR [(2 415±651) dyn·s·cm^-5vs (1 613±223) dyn·s·cm^-5, P=0.01] and RI (P=0.04) in the MHS group comparing with the NTS group from 24 to 72 h. CO [(3.58±0.44) L/min vs (4.18±0.60) L/min, P=0.04], HR and PSV was decreased in the MHS group. BUN [(8.6±1.6) mmol/L vs (21.2±4.8) mmol/L, P<0.01] and Scr [(167.6±31.2) μmol/L vs (383.8±35.2) μmol/L,P<0.01] was decreased in MHS group comparing with the NTS group.There was a positively correlation between CO and PSV in the canine model of septic shock (P<0.01); and CO was negatively correlated with RI (P<0.01).

In this canine model of septic shock, hypothermia can stable systemic and renal hemodynamics, and improve kidney function.

A 39-year-old female, married, was admitted to Naval General Hospital mainly for "numbness of left limb for more than 1 month and intermittent headache for 20 days". The patient developed numbness on the lateral side of left upper limb and trunk without obvious trigger on 20 November 2013, and the numbness on the lateral side of left trunk gradually disappeared after 1 week. On November 26, 2013, he developed numbness in his left knee. He went to the neurology department of a hospital. The MRI of his neck was considered to be "spinal cord demyelinating disease". He was given oral B vitamins and other drugs, but his condition was not significantly relieved, and he experienced loss of appetite and general weakness. On December 20, 2013, I had an intermittent headache, which was dull, the location of the pain was uncertain, and hallucinations occurred. When I looked at someone else's head, I felt my scalp beating outward, and something like jujube shook on my chest, which was not paid attention to. On December 23, 2013, he suddenly became unable to speak and unconscious. He was rushed to a local hospital. After being dehydrated with mannitol, his consciousness gradually became clear and he could speak. However, he could only describe the nature and use of some things, but he could not name them, and he felt that his vision was incomplete. Skull MRI performed on December 27, 2013 showed that the left temporal insula occupied space, and glioblastoma was likely; Odontoid level cervical intramedullary mass occupation, glioma? The patient lost 5 kg of weight since the onset of the disease. Past history: In May 2013, I gave birth to a daughter at full term. She is currently lactating, and there is no special remainder.

coronary artery spasm (CAS) is one of the common pathological bases of many ischemic heart diseases. It is not only an important pathological mechanism of variant angina pectoris, but also can lead to acute coronary syndrome and even sudden cardiac death^[1]。 The pathogenesis of CAS is not fully understood, and it is currently believed that it may be related to endothelial dysfunction and chronic inflammatory reaction. Inflammatory reaction is also closely related to the occurrence and development of atherosclerosis^[2]。 C-reactive protein (CRP) is not only an important inflammatory marker in human body, but also an important cause of coronary vascular disease. In early 2003, the Centers for Disease Control and Prevention and the American Heart Association (CDC/AHA) jointly recommended the inclusion of high-sensitivity C-reactive protein (hs-CRP) levels in clinical coronary vascular disease risk assessments. A large number of studies have focused on CRP as a predictive marker of coronary spasm, but there is little attention to the pathogenic role of CRP in the occurrence and progression of CAS.

Microcirculation refers to the circulatory system between arterioles and venules. Its main components include endothelial cells and smooth muscle cells arranged on the inner wall of microvessels and red blood cells, white blood cells, platelets and plasma components in the lumen. The perfusion of microcirculation is regulated by myogenic, neurological and humoral metabolic factors. Early studies were influenced by monitoring methods. There were relatively few observational studies on microcirculation. With the development of microcirculation monitoring technology and its clinical application, the observation of microcirculation in sepsis became more intuitive^[1,2]。 A large number of studies have shown that microcirculation disorders exist in sepsis, and their severity and duration are significantly correlated with prognosis^[3,4,5]。 Microcirculation plays an important role in the mechanism of hemodynamic disorders in sepsis^[6]Studies have shown that microcirculatory disorders occur earlier than systemic circulation^[7,8]and can cause and exacerbate systemic circulatory disorders. Microcirculatory alterations in sepsis involve different pathophysiological changes of multiple components.

Liver cancer is a serious threat to human life and health, and is one of the common malignant tumors. In China, its morbidity and mortality are second only to lung cancer, ranking second^[1]。 Its therapeutic methods include surgery, radiotherapy and chemotherapy, and novel molecular targeted therapy. The formation of neovascularization is a necessary condition for the growth of liver cancer, and it is also the structural basis of hematogenous metastasis. The accurate evaluation of the degree of vascularization in tumors is not only beneficial to the differential diagnosis of lesions, but also can understand the biological behavior of tumors, and provide guiding information for diagnosis and curative effect. With the development of molecular imaging, quantitative analysis of magnetic resonance imaging (MRI) has become one of the main methods in the diagnosis and efficacy evaluation of liver cancer by monitoring the blood flow of the lesions.