Objective To explore the feasibility and clinical value of low radiation dose scanning combined with deep learning reconstruction (DLIR) algorithm in CT-guided lung puncture biopsy. Methods Patients who underwent CT-guided lung puncture at the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2023 to March 2024 were selected, and according to the different scanning protocols, 60 lung puncture biopsy patients were divided into a conventional dose group (group A) and a low-dose group (group B). Group A was 100 kV, with a noise index (NI)=15; Group B had an NI=45; the rest of the scanning parameters were the same. The first and last whole-lung scans in the conventional dose group were scanned with the parameters of group A and B, respectively. They were used to evaluate the image quality improvement potential of the deep learning reconstruction algorithm (DLIR). The first whole-lung scan in group A was reconstructed with filtered back projection (FBP) and weighted 50% adaptive statistical iterative reconstruction-V (50% ASIR-V), and the last whole-lung scan was reconstructed with the three intensities of the deep learning reconstruction algorithm (DLIR-L, DLIR-M, DLIR-H) reconstructed images. The CT and SD values of paraspinal muscles, subcutaneous fat, and aortic vessels were measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The baseline characteristics of the patients, the total radiation dose during puncture, the pathological positivity rate, and the complication rate were compared between group A and B. Results The differences in CT values at muscle, subcutaneous fat, and aortic vessels in the reconstructed images under the five different conditions were not statistically significant (P>0.05). The differences in SD, SNR, and CNR values were statistically significant (P<0.05). The two-by-two comparative analyses between the groups showed that there were no statistically significant differences between the DLIR-H images and the 50% ASIR-V images in muscle, fat, and vessel SD and SNR (P>0.05); the differences in CNR values between FBP vs DLIR-H and DLIR-L vs DLIR-H groups were statistically significant (P<0.05). Compared with group A's total radiation dose, group B's total radiation dose was reduced by about 93.6% (P<0.001). The image quality of both groups could meet the needs of clinical puncture, and the differences in baseline characteristics, pathological positivity rate, and complication rate between the two groups were not statistically significant (P>0.05). Conclusion Low-dose CT scanning combined with DLIR reconstruction significantly reduces image noise and improves image quality without compromising the safety of puncture or pathology positivity.

Objective To investigate the relationship between contrast-enhanced ultrasound (CEUS) Liver imaging reporting and data system (LI-RADS) classification and the degree of pathological differentiation and microvascular invasion (MVI) in hepatocellular carcinoma (HCC) within the context of liver cirrhosis. Methods A retrospective analysis was conducted on 368 HCC patients who underwent liver CEUS at the Department of Ultrasound Medicine, West China Hospital, Sichuan University from June 2021 to December 2022, including 298 males and 70 females, aged 25-85(55.72±10.60) years old. Clinical features, CEUS characteristics, and LI-RADS classification were analyzed and compared in relation to the degree of pathological differentiation of the lesions and MVI. Results According to the Edmondson-Steiner grading system for pathological differentiation, 112 cases were classified as poorly differentiated, 239 as moderately differentiated, and 17 as well-differentiated. Pathological examination revealed 142 MVI-positive cases and 226 MVI-negative cases. The size of HCC lesions was inversely correlated with the degree of differentiation (P<0.001), with MVI-positive lesions being significantly larger than MVI-negative lesions (P<0.001). The proportions of HCC lesions presenting with mild or late washout were 59.8%, 67.4%, and 70.6% for poorly, moderately, well-differentiated lesions, respectively. Similarly, the proportions of lesions classified as LI-RADS 5 were 58.0%, 66.5%, 70.6%, respectively, with both proportions increasing with higher degrees of pathological differentiation. In contrast, the proportions of lesions presenting with early or marked washout were 38.4%, 28.0%, 5.9% for poorly, moderately, and well-differentiated HCC, respectively. The proportions classified as LI-RADS M were 40.2%, 28.9%, 5.9%, respectively, showing a decreasing trend with increasing differentiation. Furthermore, a higher degree of differentiation was associated with a greater proportion of patients without MVI (P<0.001). There were no statistically significant differences observed in CEUS features, including arterial phase enhancement, washout patterns, and LI-RADS classification between MVI-positive and MVI-negative patients (P>0.05). Conclusion In cirrhotic patients, a correlation was identified between the CEUS LI-RADS classification of HCC and the degree of tumor differentiation. Well-differentiated lesions were more frequently categorized as LI-RADS 5, whereas poorly differentiated lesions were predominantly classified as LI-RADS M.

Objective To explore the uptake of tau PET in meningioma by ¹⁸F-PI-2620 PET brain imaging, its correlation with lesion size and calcification, and its potential application. Methods A retrospective analysis was performed on 311 subjects who underwent ¹⁸F-PI-2620 PET brain examinations at our hospital from January 2020 to December 2023. Patients with meningioma diagnosed by final MRI enhancement were screened. The size and maximum standardized uptake value (SUV_max) of the meningioma lesions were measured for all included subjects, and the SUV_max of the lesion to the background (T/N) were obtained using the normal cerebral cortex on the opposite side as the background. Statistical analysis was performed using SPSS 26.0 statistical software, and the correlation between SUV_max, T/N values and lesion size and calcification was compared. Results Eight meningioma patients were included, including 3 males and 5 females, aged at 65-78 (69.8±4.86) years old. There was a statistically significant difference in SUV_max between the meningioma and the background (P<0.05). The T/N in the meningioma group was higher than that of the background (P<0.001). There was no statistically significant difference in SUVmax and T/N ratio between the meningioma calcification group and the non-calcification group (P>0.05). The volume of the lesion was significantly correlated with the T/N ratio of uptake (R=0.89, P<0.01). Conclusion The tau uptake value of ¹⁸F-PI-2620 in meningioma is related to the size of the lesion, but not whether the lesion is calcified.

Objective To explore the feasibility of constructing a machine learning model based on mammography signs and clinical informations to predict the histological grade in the ductal carcinoma in situ. Methods A retrospective analysis were conducted on the mammography signs and clinical informations of 239 patients who had histologically confirmed breast ductal carcinoma in situ (DCIS). Based on pathological results, these patients were categorized into : non-high-grade group (n=109) and high-grade group (n=130). The collected 10 clinical informations and 15 mammography signs were statistically analyzed, and the features with statistical differences were selected to construct three machine learning models, namely eXtreme Gradient Boosting, logistic regression and multinomial naive bayes, with the area under the ROC curve (AUC) was used as the main index to select the optimal mode. Results The AUC values for the training sets of eXtreme Gradient Boosting, logistic regression and multinomial Naive Bayes were 0.790, 0.794, 0.802, and the AUC values of text sets were 0.760, 0.758, 0.774, and the accuracies were 0.760, 0.759, 0.774,the sensitivities were 0.725, 0.825, 0.800, the specificities were 0.625, 0.434, 0.625. Conclusion The histological grade models of ductal carcinoma in situ based on machine learning have better prediction efficiency, and the multinomial naive Bayes has the best prediction efficiency.

Objective To establish a predictive model by extracting radiomic features from multi-parametric MRI data and combining them with clinical characteristics, and identify the machine learning model with the highest predictive value for triple-negative breast cancer (TNBC). Methods A total of 175 breast cancer patients, including 40 cases of TNBC and 135 cases of non-triple negative breast cancer (NTNBC), were collected and divided into training set (n=123) and validation set (n=52)according to 7:3. Multiparameter predictive models were developed using various machine learning algorithms and combined with clinical features for joint modeling. The predictive performance of different models was assessed using ROC curves. Results In the training and validation sets, Boundary, WHO classification and T2WI signals of lesions were statistically different in TNBC and NTNBC (P<0.05), among the nine models established using rbf_SVM, including Model-T2WI, Model-DWI, Model-DCE_Phase2, Model-DCE_Phase7, Model-T2WI+DWI, Model-DCE_Phase7+T2WI, Model-DCE_Phase7+T2WI+DWI, and Model-DCE_Phase7+T2WI+DWI+Clinic, the radiomics-based predictive model of Model-DCE_Phase7+T2WI+DWI+Clinic demonstrated the highest performance, with areas under the curve (AUC) of 0.992 and 0.936 in the training and validation sets, respectively. Conclusion The radiomics model based on multi-parametric MRI can accurately predict TNBC, contributing to the clinical diagnosis and treatment management of TNBC.

Objective To analyze the causes of trigeminal neuralgia without vascular compression by MRI. Methods The clinical data of 86 patients with trigeminal neuralgia diagnosed in the second neurosurgery ward of Zhoukou Central Hospital from January 2018 to September 2023, who underwent microvascular decompression without preoperative MRI findings of vascular compression, were retrospectively analyzed, and 74 of them met the inclusion criteria. Endoscopic images obtained during microvascular decompression and postoperative follow-up were used as reference standards, and the images were read separately by radiologists with more than five years of experience, and the images of responsible vessels not found in MRI preoperative examination were analyzed. Postoperative outcomes were assessed using the Barrow neurological institute pain intensity score, and the differences were compared using a repeated measures analysis of variance. Results Among the 74 patients with trigeminal neuralgia, 30 cases (40.5%) had intraoperative venous compression, 15 cases (20.3%) had venous compression with arachnoid adhesion, 12 cases (16.2%) had arterial branch compression, 11 cases (14.9%) had arachnoid adhesion, 3 cases (4.1%) had tumor compression, and 3 cases (4.1%) had no intraoperative vascular compression or arachnoid adhesion. Compared with before operation, the pain of patients was significantly relieved at all time points after operation, and the difference was statistically significant (P<0.05). Conclusion MRI is commonly used in the preoperative diagnosis of trigeminal neuralgia, which can clearly show the neurovascular interaction. Different surgical strategies should be adopted for different causes of trigeminal neuralgia.A specific test sequence is required for trigeminal neuralgia patients without vascular compression and whose secondary cause is unknown, and imaging doctors should check the medical history carefully and make comprehensive analysis to improve the diagnostic accuracy.

Immune checkpoint inhibitors that target the programmed death receptor (PD-1) and its ligand (PD-L1) pathway have emerged as a promising strategy for cancer therapy. The expression level of PD-L1 in tumors is strongly correlated with the effectiveness of this form of immunotherapy. Clinically, PD-L1 expression is typically evaluated through immunohistochemistry, an invasive technique that has significant limitations due to the spatial and temporal heterogeneity of PD-L1 expression within tumor tissues. Consequently, this method may not provide a comprehensive assessment of PD-L1 expression. In contrast, molecular imaging techniques in nuclear medicine offer a non-invasive, real-time, and dynamic means of visualizing PD-L1 expression. Technetium-99m is the most commonly used radionuclide for single-photon emission computed tomography (SPECT) imaging, as it is inexpensive, easily available, and possesses suitable energy and half-life characteristics. SPECT is the most frequently employed imaging modality in nuclear medicine globally. Accordingly, technetium-99m-labeled molecular probes targeting PD-L1 hold significant potential for widespread clinical application. This review aims to summarize current advancements in the development of technetium-99m-labeled molecular probes for PD-L1 to guide future efforts to identify novel probes for SPECT imaging of PD-L1.

Objective To investigate the advantages of incorporating morphological analyses of contrast-enhanced mammography (CEM) and ultrasound for various subtypes of papillary breast lesions, and to compare the diagnostic characteristics and performance of this imaging method in distinguishing between these subtypes. Methods This study involved 70 female patients diagnosed with papillary breast lesions from January 2020 to July 2024. For each patient, BI-RADS lesion features of the CEM and ultrasound were recorded. And the different measurements of diagnostic performance were recorded. Results Among the 70 female patients, 90 lesions were identified, including 18 malignant ones, 4 intraductal papillomas without atypical proliferation, and 48 benign papillary lesions. The areas under ROC curves for CEM combined with ultrasound was 0.863. Specificity and accuracy of CEM combined with ultrasound showed highest values was 79.1% and 84.2%, respectively. However, the sensitivity and negative predictive value of the CEM with ultrasound were similar to those of CEM alone. Conclusion For BI-RADS 3-5 papillary breast lesions, incorporating CEM combined with ultrasound can improved the confidence level in diagnosis.

Objective To investigate the innovation and effectiveness of two-dimensional ultrasonography and shear wave elastography (SWE) combined with the XGBoost machine learning model in the differential diagnosis of benign and malignant thyroid nodules. Methods 2D-ultrasound images and SWE measurements were analyzed in 156 patients with thyroid nodules (209 nodules) from the North District of the First Affiliated Hospital of Anhui Medical University from May 2021 to September 2022 with pathology as the gold standard. A machine learning model based on two-dimensional ultrasonography and SWE was developed using the XGBoost algorithm. The feature importance was assessed using the Shapley additive interpretation method. ROC curves were plotted, and the AUC was calculated to assess the performance of the XGBoost model and SWE. Additionally, decision curve analysis and calibration curves were used to evaluate the application value and diagnostic efficacy of the XGBoost model. Results The AUC, accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of the XGBoost model in the diagnosis of benign and malignant thyroid nodules were 0.890, 0.776, 89.6%, 65.7%, 83.3%, 76.7% in the training cohort and 0.913, 0.788, 92.7%, 64.9%, 82.9%, 82.8% in the validation cohort, respectively. Decision curve analysis and calibration curve analysis showed that the XGBoost model showed good clinical application value in the diagnosis of benign and malignant thyroid nodules, as well as high accuracy and reliability. Conclusion The XGBoost machine learning model based on two-dimensional ultrasound features and SWE has important application value in the differential diagnosis of benign and malignant thyroid nodules and provides a new and efficient tool for clinical decision-making.

Objective To investigate the value of uterine artery polyflow parameters combined with peripheral blood D-dimer (D-D) in the assessment of adverse pregnancy outcomes in pregnant women with recurrent miscarriage in early pregnancy. Methods Eighty cases of early pregnancy recurrent miscarriage admitted to Huai'an Maternal and Child Health Hospital from January 2021 to June 2023 were selected as the study group and followed up until 28 weeks of gestation, and they were categorized into the pregnancy loss group (n=35) and the pregnancy success group (n=45) according to the pregnancy outcome, and 92 pregnant women with normal pregnancies who underwent obstetric examination in the same period of time in the hospital were selected as the control group. The uterine artery early diastolic index (NI), resistance index (RI), ratio of maximum peak systolic flow rate to end-diastolic flow rate (S/D), pulsatility index (PI), and levels of peripheral blood D-D were compared between the study group and the control group, the pregnancy loss group and the pregnancy success group, and the pregnancy loss group was included as positive and the pregnancy success group was included as negative, and the predictive value of uterine artery NI, RI, S/D, PI, peripheral blood D-D single and combined tests for the diagnosis of adverse pregnancy outcomes in pregnant women with recurrent miscarriages in the early stages of pregnancy was analyzed by plotting the ROC curves. Results Uterine artery NI was lower in the study group than in the control group (P<0.05); uterine artery RI, S/D, PI and peripheral blood level of D-D were higher than in the control group (P<0.05). Uterine artery NI was lower in the pregnancy loss group than in the pregnancy success group (P<0.05); uterine artery RI, S/D, PI, and peripheral blood level of D-D were higher than those in the pregnancy success group (P<0.05). ROC curve analysis showed that the AUC value of the joint test for predicting adverse pregnancy outcomes in pregnant women with recurrent miscarriage in early pregnancy was higher than that of NI, RI, S/D, PI and peripheral blood D-D in a single test (P<0.05). Conclusion The combination of uterine artery multiflow parameters and peripheral blood D-D testing was more advantageous in predicting adverse pregnancy outcomes in women with recurrent miscarriages in early pregnancy, and the clinical follow-up could be carried out by means of the combination of uterine artery multiflow parameters and peripheral blood D-D testing for timely assessment of the adverse pregnancy outcomes of pregnant women with recurrent miscarriages, so as to promote the improvement of the pregnancy outcomes of pregnant women with recurrent miscarriages.

Objective To investigate the correlation between the imaging of contrast-enhanced mammography (CEM) and different molecular subtypes of mass breast cancer. Methods The clinical, pathological and imaging data from 220 patients who were initially diagnosed with mass breast cancer were collected from February 2018 to December 2021. All patients underwent routine CEM before surgery, and were divided into Luminal A, Luminal B, HER2-enriched, and triple-negative subtype according to immunohistochemistry. According to the breast imaging report and data system (BI-RADS) of CEM, the imaging signs of patients with low energy images and subtraction images were extracted respectively, including 11 features such as tumor shape, margin and enhancement degree. Finally, the relationship between different molecular types and the signs of CEM-BI-RADS was analyzed. Results A total of 220 patients with breast cancer were diagnosed, including 50 patients with Luminal A, 128 patients with Luminal B, 15 patients with HER2-enriched, and 27 patients with triple-negative. Among the clinicopathologic characteristics of different molecular subtypes of breast cancer, only the pathological type and molecular subtype of breast cancer had statistical significance ( P=0.012). Invasive breast cancer was the main pathological type of the four molecular types of breast cancer, and there was no significant statistical significance between age, menopause and lymph node metastasis and molecular subtype of breast cancer ( P>0.05). In low-energy maps, there were statistically significant differences in mass margins and mass with calcification among different molecular subtypes. Luminal A breast cancer tumor margins were mostly spiculated (64.0%, 32/50), while other breast cancer molecular subtypes were mostly indistinct, and most HER2-enriched breast cancer tumors (66.7%, 10/15) were mostly accompanied by calcification. In subtraction images, there were statistically significant differences between the margin, length diameter, internal enhancement and molecular classification of breast cancer. The maximum diameter of Luminal A and Luminal B breast cancers is less than 2.0 cm, while the maximum diameter of HER2-enriched and triple-negative breast cancers is 3.1-5.0 cm. In addition, although the edges of the four molecular subtypes of tumor enhancement were most common with obscured edges and the internal enhancement was uneven, compared with other molecular subtypes of breast cancer, the internal enhancement of some triple-negative breast cancer tumors showed circular enhancement (22.2%, 6/27). Conclusion The imaging signs of different molecular subtypes of mass breast cancer in CEM have certain characteristics, which can provide important reference value in guiding the diagnosis, treatment and prognosis evaluation of breast cancer.

Objective To explore the imaging characteristics of ¹⁸F-FDG PET/CT in patients with dermatomyositis accompanied by malignant tumors, with the aim of enhancing understanding of this disease. Methods A retrospective analysis was conducted on 14 patients diagnosed with dermatomyositis and malignant tumors through pathology, spanning from April 2018 to March 2023. The degree of muscle uptake throughout the body was analyzed by manually delineating regions of interest. Meanwhile, a normal control group (n=14) was established, and the muscle uptake values of the control group were measured. Differences in muscle uptake values between the two groups were then compared. Results Among the 14 patients with dermatomyositis, there were 4 cases of gastric cancer, 3 cases of ovarian cancer, 2 cases of lymphoma, 1 case each of lung cancer, esophageal cancer, nasopharyngeal cancer, and breast cancer, as well as 1 case of poorly differentiated adenocarcinoma of unknown origin. The average muscle uptake value of the patients with dermatomyositis was 3.5±1.8, which was significantly higher than the average value of 1.3±0.1 in the control group, and the difference was statistically significant (P<0.001). Conclusion ¹⁸F-FDG PET/CT imaging not only enables the assessment of disease activity through the diffuse uptake degree of muscles and provide a basis for biopsy of the lesions, but also facilitates the staging and evaluation of accompanying malignant tumors, offering significant imaging reference value for clinicians in further precise diagnosis and treatment.

Objective To analyze the value of MRI and squamous cell carcinoma antigen (SCC-Ag) in combination to predict lymph node metastasis of cervical cancer. Methods The clinical and MRI data of 151 patients with cervical cancer who attended the First Affiliated Hospital of Bengbu Medical University from October 2022 to July 2024 were collected and analyzed. All the patients were categorized into non-lymph node metastasis group (n=83) and lymph node metastasis group (n=68) based on postoperative pathological results. Age, maximum tumor diameter, minor diameter of lymph noder, paracervical infiltration, vaginal involvement and the level of SCC-Ag between the two groups of patients were compared, and the prognostic value of lymph node metastasis of cervical cancer was assessed by multiple indicators. Results The results of univariate analysis showed that the factors affecting lymph node metastasis were the maximum diameter of the tumor, minor diameter of lymph noder, vaginal involvement, and the level of SCC-Ag (P<0.05). Binary Logistic regression analysis showed that maximum tumor diameter, minor diameter of lymph node, SCC-Ag, paracentral infiltration, and vaginal involvement were all independent influencing factors that could predict the risk of lymph node metastasis (P<0.05). The area under ROC curve of maximum tumor diameter, minor diameter of lymph node, SCC-Ag, maximum tumor diameter and minor diameter of lymph node, combined with SCC-Ag, multiple indicators combined (maximum tumor diameter, minor diameter of lymph node, SCC-Ag, paracentral invasion, and vaginal involvement) were 0.658, 0.972, 0.682, 0.979, 0.988, respectively, sensitivity was 62.4%, 65.7%, 59.3%, 78.7%, 89.8%, and specificity was 76.7%, 88.2%, 72.1%, 84.5%, 86.9%, respectively. The cut-off values of minor diameter of lymph node, and SCC-Ag were 8.5 mm and 5.85 ng/mL, respectively, and the maximum entry index were 0.652 and 0.543, respectively. Conclusion MRI and SCC-Ag used alone for lymph node metastasis prediction have low sensitivity, while sensitivity and specificity improve significantly when multiple metrics are used in combination, and the predictive value of lymph node metastasis is higher when MRI and SCC-Ag are used together.

Type 1 diabetes mellitus (T1DM)-related cognitive dysfunction and potential brain impairment have attracted increasing attention with the rising incidence of T1DM and the extension of patient life expectancy. Several studies have demonstrated an association between T1DM and cognitive dysfunction. In recent years, the widespread application of MRI technology has provided objective imaging evidence for exploring the neuropathophysiological mechanisms of brain impairment in T1DM. This article reviews the manifestations of cognitive dysfunction, the application of MRI technology in brain impairment, and the underlying pathological mechanism in patients with T1DM. By summarizing previous research, it aims to help clinicians gain a deeper understanding of the relationship between T1DM and cognitive dysfunction, and to provide new perspectives for future research, with the hope of early identification and intervention for cognitive dysfunction in patients with T1DM.

Objective To validate the feasibility of the deep learning image reconstruction (DLIR) algorithm in coronary computed tomography angiography (CCTA) under low radiation dose and low contrast agent volume conditions. Methods This prospective study included 86 patients with normal BMI who underwent CCTA at the Affiliated BenQ Hospital of Nanjing Medical University from November 2021 to April 2022. The patients were randomly divided into group A and group B. Both groups employed Smart-mA tube current automatic control technology, Auto Gating, Smart Phase and Motion correction algorithm techniques, with a noise index set at 12.2 HU. Iodixanol (350 mgI/mL) was used as the contrast agent. The tube voltage was set to 70 kV, with the contrast agent volume calculated as (body weight ×0.275) mL in group A, and the tube voltage was set to 120 kV, the contrast agent volume was (body weight ×0.55) mL in group B. Group A used the DLIR algorithm for image reconstruction, while group B used the 50% ASIR-V algorithm. The CT values and noise levels of the aortic root, left main, left anterior descending artery, left circumflex artery, and right coronary artery proximal segments were measured and calculated. Objective evaluation parameters, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and edge rise distance were computed. A double-blind method was used to compare the subjective image quality of the two reconstruction methods. Results Except for no significant differences in CNR of the left main artery and SNR of the left circumflex artery proximal segment (P=0.358, 0.252), the CNR and SNR of all other regions of interest in group A were significantly higher than those in group B (P<0.001). The edge rise distance of the left anterior descending proximal segment in group A was smaller than in group B (P<0.001). Image quality in both groups met diagnostic requirements, but group A demonstrated significantly better subjective image quality than group B (P<0.001). Radiation dose: The effective dose in group A was 0.81±0.40 mSv, compared to 2.84±1.50 mSv in group B, with a statistically significant difference (P<0.001). Contrast agent volume: The volume in group A was 22.11±3.31 mL, while in group B it was 34.40±2.98 mL, with a statistically significant difference (P<0.001). Conclusion The DLIR algorithm can effectively reduce radiation dose and contrast agent volume in CCTA, demonstrating potential for wider application.

Objective To investigate the correlation between preoperative serum inflammatory indicators combined with enhanced CT image features and the risk classification of gastrointestinal stromal tumor (GIST), and analyze its diagnostic efficacy for GIST risk classification. Methods A lot of 148 patients with pathologically confirmed GISTs were collected from March 2022 to March 2024 in Yancheng First People's Hospital and classified according to the National Institutes of Health revised criteria. Preoperative serum inflammatory indicators [neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), systemic immunoinflammatory index (SII)] and enhanced CT image features [tumor length, tumor location, enhancement pattern, shape, intratumor cystic or necrosis, calcification, surface ulcer] were retrospectively analyzed. These patients were divided into low risk group (n=73, very low risk, low risk) and high risk group (n=75, intermediate risk, high risk). The differences of relevant indicators between low and high risk groups were compared, and Spearman correlation was used to analyze the correlation between inflammatory indicators, enhanced CT image features and risk classification. Results NLR, PLR, SII, tumor length, tumor location, intratumoral cystic or necrosis, enhancement pattern, and shape were positively correlated with different risk classification. The optimal cut-off values for high risk group were NLR>2.285(AUC=0.741), PLR>167.135(AUC=0.654), SII>410.495 (AUC=0.711), tumor length>4.65(AUC=0.931), the AUC of combining multi-indexes was 0.941, better than the above single index. Conclusion Preoperative serum inflammatory indicators combined with enhanced CT imaging features can better predict the risk classification of GIST, the combined diagnosis has the best efficiency, and provides reference for patients to make personalized plan.

Objective To construct a staging prediction model on deep vein thrombosis (DVT) based on the deep learning and black-blood magnetic resonance thrombus imaging (BTI), and investigate its prediction value. Methods A retrospective observational study was conducted, where clinical data and BTI from 196 patients admitted to Guangzhou Panyu Central Hospital from November 2015 to July 2022 were collected and analyzed. The dataset was split into a training set (70%, n=136), a validation set (15%, n=30), and a test set (15%, n=30). The experimental group were annotated in rectangular boxes manually, then the corresponding minimum bounding rectangular boxes of the lesion areas were cropped, resized, and sliced, and input to the deep learning model. The three models, ResNet50, Vit and EfficientNet, were established for lower limb staging prediction. Their predict value were compared by accuracy rate and the area under the curve (AUC). Results The accuracy of ResNet50, Vit and EfficientNet-b0 in the testing set were 0.693, 0.733, 0.787. The EfficientNet-b0 outperforms than other two models in the test set. The area under the curve of the acute, sub-acute and chronic phase were 0.700(0.568-0.811), 0.778(0.652-0.875), 0.850(0.737-0.914), respectively. Conclusion Deep learning combined with BTI has certain application values in staging prediction of DVT. It provides an effective technique for the precisive staging for DVT.

Objective To investigate the clinical significance of susceptibility-weighted imaging (SWI) combined with dual post-labelling delay (PLD) 3D arterial spin labelling (3D-ASL) technique for evaluating patients with acute cerebral infarction and predicting early infarct growth. Methods Thirty-two patients with acute ischaemic cerebral infarction underwent routine MRI, DWI, SWI and 3D-ASL (PLD of 1.5 s and 2.5 s) within 24 h after onset. Among these patients, 21 were re-examined with routine MRI and DWI on day 7 after onset. The following parameters were recorded: NIHSS scores, prominent venous signs (PVS) and scores, DWI infarct size, the bilateral cerebral blood flow (CBF) values (infarct area and mirror area, peri-infarct area and mirror area), rCBF values (CBF value on the affected side/CBF value on the mirror side), ischaemic penumbra area (PLD of 1.5 s and 2.5 s), increase in DWI infarct size between two examinations and 90 d modified Rankin scale (mRS) scores. The patients were divided into PVS positive and PVS negative groups according to the presence of PVS. The differences in imaging parameters among 32 patients were analysed, and Spearman correlation was used to detect the correlation of cerebral infarction growth values with SWI and ASL parameters in 21 patients. Results Significant differences in the first NIHSS score, DWI infarct size, CBF_{1.5 s peri-infarct area}, rCBF_{1.5 s peri-infarct area}, rCBF_{2.5 s peri-infarct area}, CBF_{2.5 s infarct area}, rCBF_{2.5 s infarct area}, PLD 1.5 s and 2.5 s ischaemic penumbra area, difference in PLD 1.5-2.5 s penumbra area and increase in infarct size after 7 d were observed between the PVS positive and negative groups (P<0.05). Specifically, the increase in infarct size was positively correlated with the PVS score, DWI infarct size, and ischaemic penumbra areas (PLD of 1.5 s and 2.5 s) at the first examination (P<0.05) but negatively correlated with the rCBF_{1.5 s infarct area}, rCBF_{1.5 s peri-infarct area}, rCBF_{2.5 s infarct area} and rCBF_{2.5 s peri-infarct area} (P<0.05). Conclusion SWI-based examination of PVS reflects low blood perfusion, large infarct size, large ischaemic penumbra area and high admission severity, demonstrating a certain predictability for the short-term increase in infarct size. Combined with ASL multimodality functional imaging, this approach can provide an accurate assessment of the blood perfusion status in the infarct area and hypoxia in brain tissue, making it crucial for guiding treatment decisions and prognosis in clinical practice.

Objective To develop a combined nomogram model based on enhanced CT imaging features and clinical indicators for predicting early recurrence (ER) in untreated intermediate-stage hepatocellular carcinoma (HCC) patients after transcatheter arterial chemoembolization (TACE), and to compare the performance of this model with radiomics and clinical models. Methods In this retrospective, two-center study, 55 HCC patients who underwent enhanced CT before TACE at Affiliated Hefei First People's Hospital from February 2020 to February 2024 were randomly divided into training and validation groups using five-fold cross-validation. Clinical data, CT radiomics data, pathological data, and serum markers collected within one week before TACE were collected and evaluated for all patients. Radiomic features were selected using univariate rank sum tests and Spearman correlation analysis. Radscore was calculated based on the linear product of logistic regression model coefficients and feature values. Significant variables were identified using univariate and multivariate logistic regression, and a nomogram was constructed. The model's performance was assessed using ROC curves and decision curve analysis. Results In both the training and validation groups, the combined nomogram model had AUCs of 0.787 (95% CI: 0.52-1.05) and 0.847 (95% CI: 0.54-1.14), respectively, for predicting early recurrence after TACE. Univariate and multivariate regression analysis indicated that prothrombin time (P<0.05) was an independent serum marker associated with early recurrence after TACE. In both the training and validation groups, the AUC, accuracy, sensitivity, and specificity of the clinical model and the radiomic nomogram model alone were lower than those of the combined clinical-radiomic nomogram model. Decision curve analysis showed that the combined nomogram model had greater net benefit. Conclusion The proposed combined nomogram model has the potential to accurately predict early recurrence in HCC patients after TACE.

Objective To explore the value of Neuromelanin magnetic resonance imaging (NM-MRI) combined with quantitative susceptibility mapping (QSM) in staging and assessment of cognitive function in PD. Methods NM-MRI and QSM scans were conducted on 62 patients with PD diagnosed by the neurology department in our hospital and 22 age and gender matched healthy controls (HC). The contrast-to-noise ratio (CNR) and the magnetic susceptibility (MSV) values of the substantia nigra (SN) were obtained by post-processing software, then comparing the CNR and MSV values among different stages of PD. The diagnostic efficacy of each single and combined parameter for PD in staging and assessment of cognitive function were assessed using subject operating characteristic curves and binary logistic regression analyses. Results The CNR values of SN were lower in PD group than in HC group (P<0.05) and the MSV values of SN were higher in PD group than in HC group (P<0.05), and the differences were statistically significant. Inter-group comparisons of PD revealed that the CNR values of early PD group were higher than those of the middle and advanced PD groups (P<0.05), the MSV values of advanced PD group were higher than those of the early and middle PD groups (P<0.05), and the differences were statistically significant. The CNR values of PD group showed a positive correlation with MoCA scores and MMSE scores, while showing a negative correlation with UPDRS-III scores (P<0.05); the MSV values of PD group showed a negative correlation with MoCA scores and MMSE scores but showed a positive correlation with the UPDRSIII scores (P<0.05). The ROC curve demonstrated that the AUC values for NM-MRI, QSM and combined of NM-MRI and QSM were 0.778, 0.783 and 0.820 in the distinguish of early and middle PD group. The ROC curve demonstrated that the AUC values for NM-MRI, QSM and combined of NM-MRI and QSM were 0.821, 0.787 and 0.830 in assessment of cognitive function. The combination of above two sequences was more effective in distinguishing different stages and assessing cognitive function of PD than any single technique. Conclusion NM-MRI combined with QSM technology has a high diagnostic efficiency in staging and assessment of cognitive function in PD, which can identify early PD patients and provide imaging evidence for PD cognitive assessment.

Objective To analyze the effectiveness of CT and magnetic resonance imaging in evaluating lymph node metastasis in elderly patients with rectal cancer. Methods Ninety elderly patients with rectal cancer admitted to our hospital from March 2022 to May 2024 were included. Surgical and pathological results were used as the gold standard, and 128 slice spiral CT examination provided by Philips (scanning the diaphragm to the lower edge of the pubic bone, accompanied by enhanced scanning) and Discovery 3.0T magnetic resonance imaging examination provided by GE (scanning the lower edge of the pubic symphysis to the level of iliac bifurcation) were provided to evaluate the effectiveness of CT and magnetic resonance imaging in assessing lymph node metastasis in elderly patients with rectal cancer. Results According to the gold standard results, there were 85 positive cases and 5 negative cases. CT examination results showed 60 positive cases and 30 negative cases. CT and magnetic resonance imaging results showed 84 positive cases and 6 negative cases; There are differences in sensitivity, accuracy, and other indicators between CT examination and CT combined with magnetic resonance imaging for the diagnosis of lymph node metastasis in rectal cancer, and CT combined with magnetic resonance imaging has a higher diagnostic value (P<0.05). There is no statistically significant difference in the specificity, positive predictive value, negative predictive value, and other indicators between the two measures (P>0.05); The diameter, number, short to long diameter ratio, venous entrapment sign, serosal infiltration, and mixed signal sign of perirectal fat in positive patients were higher than those in negative patients (P<0.05). Conclusion For elderly patients with rectal cancer, CT combined with magnetic resonance imaging for intervention has good sensitivity and accuracy, it can effectively determine the signs of the disease.

Objective To evaluate the degeneration of joint cartilage in patients with chronic ankle instability before and after surgery by exploring T2 mapping quantitative analysis. Methods Sixty patients with chronic ankle instability who underwent anterior talofibular ligament (ATFL) repair or reconstruction treatment in our hospital from January 2021 to June 2022 were selected as the research subjects. They were divided into ATFL repair group ( n=30) and ATFL reconstruction group ( n=30) according to the treatment method. Another 30 healthy subjects were selected as the control group. The ATFL repair group and ATFL reconstruction group underwent MRI T2 mapping scan, ankle plantar flexion, back extension mobility, pain visual analog score (VAS) and American ankle-hind foot functional system (AOFAS) and Karlsson ankle function score (KAFS) evaluation before and one year after surgery, the control group underwent MRI T2 mapping scans, and the T2 values of the anterior medial, lateral, and central medial, lateral, and posterior medial, and lateral cartilaginous regions of the talus were measured and calculated in three groups. Results The T2 values of the ATFL repair group were higher than those of the control group ( P<0.05) in the medial, anteromedial, and lateral cartilage areas before surgery; The T2 values in the medial, lateral, anteromedial, and lateral cartilage regions of the ATFL repair group were higher than those in the control group one year after surgery ( P<0.05); The T2 values in the medial and anterior medial and lateral cartilaginous regions of the bone crest in the ATFL repair group were higher than those before surgery at 1 year ( P<0.05). The T2 values of the ATFL reconstruction group were higher than those of the control group ( P<0.05) in the medial, lateral, anteromedial, and lateral cartilaginous areas before surgery; The T2 values in the medial, lateral, anteromedial, and lateral cartilage regions of the ATFL reconstruction group were higher than those in the control group one year after surgery ( P<0.05); The T2 values in the central lateral and anterolateral cartilaginous regions of the bone crest in the ATFL reconstruction group were higher than those before surgery one year after surgery ( P<0.05). There was no statistically significant difference in T2 values between the ATFL repair group and the ATFL reconstruction group in each cartilage region before and 1 year after surgery ( P>0.05). One year after surgery, the ankle plantar flexion and dorsal extension activities in the ATFL repair group and ATFL reconstruction group were greater than preoperative ( P<0.05), the VAS scores were lower than preoperative ( P<0.05), the AOFAS and KAFS scores were higher than preoperative. Conclusion Patients with chronic ankle instability may still experience talar cartilage degeneration after ATFL repair or reconstruction treatment, mainly on the anterior and central sides of the talus. T2 quantitative analysis can evaluate the degree of talar cartilage degeneration in patients with chronic ankle instability after surgery.

Objective To explore the application value of double-layer detector spectral CT motion correction reconstruction algorithm (MCR) in patients with high heart rate. Methods 30 patients with heart rate ≥80 b/min in Renji Hospital, Shanghai Jiao Tong University were retrospectively included, all patients with the inclusion criteria completed coronary artery CT angiography, compared the standard reconstruction (STD) optimal phase and MCR images, compared the CNR and SNR of the two groups, and evaluated the quality of coronary artery images using a 5-point method. Results There was a statistically significant difference between the two groups in CNR and SNR (P<0.05). the SD value of the aorta, CT value of the left anterior descending coronary artery, and CT value of the left circumflex coronary artery between STD and MCR were not statistically significant (P>0.05); but the CT value of the right coronary artery was 346.46±60.17 in STD and 363.54±54.40 in MCR (P<0.05). There was a statistically significant difference between STD and MCR in image noise and subjective scoring of coronary artery segments (P<0.05). Conclusion MCR algorithm can effectively reduce motion artifacts without additional scanning, improve image quality, and increase the success rate of coronary artery CT angiography.

Lung cancer, being one of the cancers with the highest global incidence and the main reason for cancer deaths, usually exhibits as pulmonary nodules in the early stage. CT represents a crucial imaging examination approach for the assessment of pulmonary nodules. With the advancement of technology, dual-energy CT is widely used in clinical practice. By acquiring images at two different energy spectra, dual-energy CT enables material decomposition, allowing generation of material- and energy-specific images. Existing research has demonstrated that dual-energy CT can be employed not merely for differentiating between benign and malignant pulmonary nodules, predicting pathological types of lung cancer, assessing the degree of tumor differentiation as well as the gene expression, but also for assessing therapy response and prognosis of lung cancer. This article reviews the clinical applications of dual-energy CT material decomposition images in distinguishing between benign and malignant pulmonary nodules, predicting the pathological types of lung cancer, the degree of tumor differentiation, the gene expression of lung cancer, evaluating therapy response and prognosis of lung cancer. It aims to systematically sort out the clinical application progress of dual-energy CT material decomposition images in pulmonary nodules, provide a more scientific and accurate basis for clinical decision-making, and promote the further development of precision medicine for lung cancer.

Objective To analyze the value of imaging data, clinical-laboratory data model and fusion model in predicting prognosis of patients with spontaneous intracerebral hemorrhage. Methods A total of 363 patients diagnosed with spontaneous cerebral hemorrhage by head CT in Lu'an People's Hospital from September 2021 to March 2023 were retrospectively collected. The functional recovery of patients 6 months after discharge was evaluated using the modified Rankin scale. According to the results, the patients were divided into two groups: the good outcome (n=175) and the poor outcome (n=188). Clinical data such as age and gender, neutrophil and lymphocyte counts and their percentages, D-dimer, and hematoma image data outlined and extracted from the first head CT scan on admission were recorded. Multiple logistic regression method was used to construct clinical-laboratory data model, image data model and fusion model, respectively. Results Clinical and laboratory data of statistical significance between the two groups included GCS score, number and percentage of neutrophils, and percentage of lymphocytes (P<0.001). Imaging data included ventricle presence or absence of hematoma, hematoma sphericity, surface area, and feret diameter (P<0.001). The AUC of clinical-laboratory data model, image data model and fusion model were 0.82(95% CI: 0.78-0.86), 0.80(95% CI: 0.75-0.84) and 0.86(95% CI: 0.82-0.89). Delong test showed that the performance of fusion model was significantly different from that of single clinical-laboratory data model and imaging data model (P<0.05). Conclusion The fusion model of imaging data combined with clinical and laboratory data has significant value in predicting the prognosis of spontaneous intracerebral hemorrhage.

Objective To investigate the changes in brain functional network before and after acupuncture in patients with primary dysmenorrhea (PDM) using resting-state functional MRI (rs-fMRI) graph theory and edge analysis. Methods Thirty-five women with PDM were enrolled in this study, and the patients with PDM were treated with acupuncture 7 days before menstruation until the onset of menstruation, taking Guanyuan point and bilateral Sanyinjiao for 30 min per day. The data of visual analogue score (VAS), the cox menstrual symptom score (CMSS), self-rating anxiety score (SAS), self-rating depression score (SDS) and brain fMRI of PDM patients before and after acupuncture and moxibustion were collected. GRETNA software was used to analyze the brain function data of PDM patients before and after acupuncture and moxibustion by graph theory and edge analysis, and correlated with the clinical score. Results After acupuncture, the menstrual VAS, CMSS, SAS, and SDS were reduced in PDM patients (P<0.05). The global efficiency of brain networks increases, while the mean clustering coefficient and average path length decrease (P<0.05). Functional connectivity (FC) was enhanced between the right insula and the right middle frontal gyrus, and between the left rolandic operculum and the right superior temporal gyrus. between the right precentral gyrus and bilateral thalamus and the right putamen, between the right postcentral gyrus and the left middle frontal gyrus and the left supplementary motor area, between the right anterior cingulate and the left anterior cingulate and right posterior cingulate, between the left precentral gyrus and the left thalamus, between the right posterior cingulate gyrus and the left middle temporal gyrus, and between the left postcentral gyrus and the left thalamus with diminished FC (P<0.001). the change in FC between the left precentral gyrus and the left thalamus was positively correlated with the change in SDS (r=0.516, P=0.002). Conclusion The present acupuncture therapy had good efficacy. Acupuncture and moxibustion may improve the integration efficiency of pain related information in the brain network of PDM patients, and inhibit the transmission efficiency of pain related information. The neural pathways involved in the onset of acupuncture and moxibustion may be the thalamus sensorimotor cortex circuit, cingulate cortex circuit, and salience network. The three main lines jointly shoulder the tasks of analgesia, emotional relief, and painful attention transfer.

Breast cancer has become the most common type of cancer that threatens women's health worldwide. Radiomics provides intrinsic heterogeneity information of tumors that cannot be recognized by traditional imaging examinations and human eyes through in-depth excavation and analysis of deep-seated information of medical images. However, previous studies mostly focused on tumor ontology features, ignoring the role of peritumoral region features in the occurrence, development and metastasis of breast cancer. Therefore, more and more studies have begun to explore the potential application value of peritumoral radiomics features. This article will centre on the application of peritumoral radiomics based on mammography, magnetic resonance imaging and ultrasound imaging in the differential diagnosis of benign and malignant breast cancer, molecular typing prediction, evaluation of therapeutic efficacy, lymph node metastasis and prognosis prediction of patients, expound the existing limitations, and look forward to its future development, provide ideas for deeper research, expect to promote the further development of precision medicine for breast cancer.

In recent years, the incidence of differentiated thyroid cancer (DTC) has been increasing significantly. The application of PET/CT in the integration of diagnosis and treatment of DTC has attracted much attention. It provides molecular information by combining anatomical with functional imaging. Fluorodeoxyglucose (¹⁸F-FDG) has been confirmed as a marker of cellular glucose metabolism and is the most widely used PET radiopharmaceutical. In addition to ¹⁸F-FDG, multiple new PET molecular probes are also expected to be applied from basic research to clinical practice for imaging and guiding treatment of DTC. This article reviews the mechanism and research progress of new PET molecular probes, aiming to provide valuable reference for the development and application of new molecular probes in the diagnosis and treatment of DTC.

Objective To evaluate the diagnostic utility of amide proton transfer (APT) imaging for assessing the ischemic penumbra in patients with acute ischemic stroke and to predict patient prognosis. Methods Fifty-eight patients with acute ischemic stroke who were treated at the Fifth Affiliated Hospital of Zhengzhou University from January to November 2023 were retrospectively analyzed. All patients underwent routine 3T MRI sequences, including arterial spin labeling and APT examinations. The infarct core (IC), ischemic penumbra (IP), and contralateral normal-appearing white matter (CNAWM) were measured using diffusion weighted imaging and arterial spin labeling. APT values and their differences were analyzed. Neurologists assessed the patients using the National Institutes of Health Stroke Scale (NIHSS) on the first day of admission. Patient prognosis was followed up via telephone after three months, assessing modified Rankin Scale (mRS) scores to evaluate neurological recovery. Patients were divided into good prognosis group (n=24, mRS<2) and poor prognosis group (n=34, mRS≥2). Clinical data and APT values for the IC and CNAWM were compared between the two groups. The difference in APT signal intensity between the IC and contralateral CNAWM (ΔAPT) was calculated. Then the analysis of variance was performed, and ROC curve were plotted to determine the AUC based on ΔAPT values. Additionally, correlations between ΔAPT and NIHSS scores were analyzed. Results APT imaging effectively differentiated between the IC, IP and CNAWM regions (P<0.05). The difference in APT values between the IC region and the ΔAPT values of patients in the good and poor prognosis groups was also statistically significant (P<0.001). Additionally, there was a statistically significant difference in NIHSS scores between the two groups (P<0.001). In contrast, no significant differences were found in the remaining clinical data as well as the APT values in the CNAWM region between the two groups (P>0.05). The ΔAPT values served as a better predictor of patient prognosis (AUC=0.732, cut-off value: 1.00, 95%CI: 0.605-0.860). ΔAPT correlated with NIHSS scores on day 1 (r=0.569, P<0.001). Conclusion APT imaging can more accurately delineate a patient's ischemic penumbra and predict their prognosis.

Objective To evaluate the effectiveness of integrating MRI qualitative and quantitative parameters with the prostate health index (PHI) to differentiate between benign and malignant prostate lesions in patients with elevated prostate-specific antigen (PSA) levels. Methods The study involved 346 patients with elevated PSA levels who underwent prostate MRI at the North China University of Science and Technology Affiliated Hospital from April 2022 to June 2024. These patients had prostate imaging reporting and data system (PI-RADS) scores ranging from 3 to 5. Based on biopsy pathology results, which served as the gold standard, patients were categorized into benign group ( n=118) and malignant group ( n=228). The PI-RADS score, apparent diffusion coefficient (ADC), slow ADC (D), fast ADC (D ^*), perfusion-related volume fraction (f), and PHI between these groups were compared. Logistic regression and decision tree classification were employed to develop models using these parameters, and the diagnostic performance of each model was assessed through ROC curves, calibration curves and decision analysis curves. Results The malignant group exhibited higher PI-RADS 5 proportion, pro-2 PSA, and PHI, while the values of ADC, D, D ^*, and f were lower compared to the benign group ( P<0.05). The area under the ROC curve for model 4B, a decision tree classification model initially including PI-RADS, PHI, ADC, D, D ^*, and f, but ultimately retaining PHI, ADC, D, and D ^*, was comparable to model 3B, which incorporated PI-RADS, ADC, D, D*, f ( P>0.05). However, model 4B outperformed other models (models 1A-4A, 1B, 2B) ( P<0.05). The calibration curves for models 3B and 4B closely aligned with the diagonal, indicating high calibration accuracy, whereas the other models showed greater deviation. Model 4B demonstrated the highest net benefit across all threshold ranges. Conclusion The decision tree classification model constructed with PHI, ADC, D and D ^* exhibited superior discriminative ability, calibration accuracy, and clinical utility in distinguishing between benign and malignant prostate lesions in patients with elevated PSA and PI-RADS scores of 3 to 5.

Objective To assess the impact of continuous noninvasive arterial blood pressure monitoring (CNAP) on maternal and neonatal outcomes during cesarean section under combined spinal-epidural anesthesia (CSEA), as compared to the conventional noninvasive cuff arterial pressure (NCAP). Methods In a prospective, randomized controlled clinical trial conducted from January to June 2024 at Shunde Hospital of Southern Medical University, we enrolled 284 eligible parturients scheduled for elective cesarean delivery under CSEA. Participants were randomly assigned to two groups, with 142 parturients in each. Due to factors such as movement, shivering, or other reasons, 14 parturients were excluded from the study. The final analysis included 139 parturients in the NCAP group and 131 in the CNAP group. NCAP group, blood pressure was monitored using an intermittent cuff during the procedure, with measurements taken at 3-minute intervals; CNAP group: blood pressure was continuously monitored using CNAP. When systolic blood pressure (SBP) fell below 80% of the baseline value or mean arterial pressure (MAP) dropped below 65 mmHg, hypotension was promptly treated with an intravenous bolus of norepinephrine at a dose of 6-10 μg, with additional doses administered as necessary based on the patient's blood pressure response. At each time point, we recorded hemodynamic changes, the requirement for norepinephrine administration, maternal adverse effects, fetal umbilical artery flow indices, and the results of neonatal umbilical artery blood gas analysis. Results Compared with the NCAP group, the CNAP group detected hypotension at an earlier stage (P=0.008) and exhibited a higher rate of hypotension detection(P=0.024). Owing to the CNAP group's earlier and more frequent detection of hypotension, which allowed for timely intervention to prevent further blood pressure drops, the incidence of severe maternal hypotension was significantly reduced (P=0.005). Additionally, the median dose of norepinephrine required (P=0.014) and the frequency of its administration (P=0.012) were higher in the CNAP group. SBP was significantly higher in the CNAP group compared to the NCAP group from the 4th to the 28th minute following anesthesia induction (P<0.05). Additionally, the CNAP group exhibited a lower incidence of hypotension at multiple time points after anesthesia (specifically at 7, 10, 13, 16, 19, 22, 25 min) compared to the NCAP group (P<0.05). The incidence of maternal nausea and vomiting was significantly lower in the CNAP group compared to the NCAP group (P=0.017). The fetal umbilical artery's peak systolic peak velocity/diastolic velocity (S/D), resistance index (RI), and pulsatility index (PI) were all elevated compared to pre-anesthesia values, with a more pronounced increase observed in the NCAP group than in the CNAP group at 3 minutes post-anesthesia induction (P<0.001). However, for mothers with MAP below 60 mmHg, the neonatal umbilical arterial blood gas pH was significantly lower in the NCAP group compared to the CNAP group (P=0.026). There were no significant differences between the two groups in the fetal umbilical artery S/D ratio, RI, PI, neonatal Apgar score and umbilical artery blood gas pH, BE, PaO₂, and PaCO₂ at 6 minutes post-anesthesia (P>0.05). Conclusion CNAP significantly augments anesthesiologists' ability to swiftly detect and manage hemodynamic fluctuations by providing continuous real-time monitoring of maternal blood pressure. This proactive surveillance results in a decreased incidence of intraoperative maternal hypotension, which in turn enhances the safety of surgical procedures and patient comfort. Additionally, it mitigates the risk of neonatal acidosis, contributing to improved perinatal outcomes.