Background: It is well known that estrogen is closely related to bone and joint tissue. Findings indicate that estradiol, injected during pregnancy, passes through the placental barrier and reaches the fetuses in utero where it exerts its action. Since trochlea appears well established in the prenatal period, however, whether trochlear dysplasia is related to estradiol exposure has not been confirmed, and the pathological process of estradiol exposure-induced trochlear dysplasia remains unclear. This study aimed to establish an estradiol exposure animal model in fetuses and to analyze the morphology of the femoral trochlear in neonatal rats. Methods: 30 pregnant Wistar rats provided by the local Animal Center were assigned randomly into 3 groups, a high dose estradiol injection group, a low dose estradiol injection group and a blank control group. The pregnant rats in high dose group were intramuscular injected with estradiol benzoate, 200 μg/kg body weight, intramuscularly injected until the neonatal rats were born, and low dose group with 100 μg/kg body weight. Gross, cross-sectional observation and histological staining measurement of the rat offspring were conducted to evaluate the morphological changes of the femoral trochlea. Results: The incidence of trochlear dysplasia increased with the concentration of estradiol injection. Neonatal rats in the high dose group had the high prevalence of trochlea dysplasia (53 of 60), followed by low dose of trochlea dysplasia (49 of 60). Gross and cross-sectional observation showed a shallower trochlea groove in two groups with estradiol injection. Histological staining measurement indicated that the trochlear sulcus angle and trochlear sulcus depth were significantly different between the two groups with estradiol injection and the blank control group at 0,5 and 10 days after birth. Conclusion: In this study, estradiol exposure in fetuses had an adverse effect on intrauterine development and could induce trochlear dysplasia in rat offspring. In addition, this study also showed that the higher concentration of estradiol injection in pregnant rats, the more incidence of trochlear dysplasia in rat offspring.

Objective: Accurate preoperative prediction of sinonasal inverted papilloma (SNIP) malignant transformation is essential and challenging. In this study, 3.0T magnetic resonance was used for qualitative, quantitative, and multi-parametric analysis to evaluate the predictive value of magnetic resonance imaging (MRI) in malignant transformation. Methods: The data of patients with SNIP (n=83) or SNIP-transformed squamous cell carcinoma (SNIP-SCC) (n=21) were analysed retrospectively. Univariate analysis and multivariate logistic regression were used to establish models to predict the risk factors for the malignant transformation of SNIP. Receiver operating characteristic (ROC) curves were used to evaluate the ability of independent risk factors and related combination models to predict malignant transformation of SNIP. Result: Convoluted cerebriform pattern (CCP) mutation, apparent diffusion coefficient ratio (ADCr), and wash-in index (WII) 2 and 3 were independent risk factors for predicting malignant transformation of SNIP, with area under the ROC curve (AUC) values of 0.845, 0.862, 0.727, and 0.704, respectively. The AUC of the quantitative parameter model combined with ADCr and WII 2 and 3 was 0.910 for diagnosing malignant transformation. The AUC of the comprehensive model comprising all independent risk factors was 0.937, with a sensitivity, specificity, and accuracy of 90.48%, 90.36%, and 92.31%, respectively. Conclusion: Compared with assessing independent risk factors of CCP mutation, ADCr and WII, and the quantitative parameter model, the comprehensive model could improve the differential diagnosis ability of SNIP and SNIP-SCC, which provides an important imaging basis for the possible accurate preoperative evaluation of malignant transformation of SNIP.