AIM:To determine the utility of computed tomography(CT) scanning in localizing colon tumors.METHODS:At a single tertiary care teaching hospital,a retrospective chart review was conducted on patients who underwent surg...AIM:To determine the utility of computed tomography(CT) scanning in localizing colon tumors.METHODS:At a single tertiary care teaching hospital,a retrospective chart review was conducted on patients who underwent surgery for colon malignancies between January 2004 and May 2006.One hundred and four charts containing all of the following data were reviewed:preop erative colonoscopy report,preoperative CT report,surgical operative report,tumor pathology report.The colon was divided into five segments from the cecum to the sigmoid and the location of the lesions was categorized into one of these areas.The tumor location was considered "erroneous" if its location determined during surgery differed from the location determined by colonoscopy or CT.RESULTS:Over all,tumor location was accurately determined via colonoscopy in 83/104 cases(79.8%) and erroneously in 21/104(20.2%) of cases.CT scan accurately localized colon tumors in 52/104(50.0%) of cases,incorrectly localized tumors in 18/104(17.3%) of cases,and did not detect known tumors in 34/104(32.7%) of cases.Of the 21 tumors erroneously located by colonoscopy,11(52.4%) were accurately localized by CT scan.The average tumor size for all patients in this study was 5.72(+/-3.11) cm.The average size of tumors properly located by colonoscopy and CT was 5.39(+/-3.34) cm and 6.79(+/-3.48) cm,respectively.The average size of the tumors not detected by CT was 3.98(+/-1.75) cm.CONCLUSION:CT scanning may be used in concert with colonoscopy to help localize colon tumors.展开更多
AIM:To compare the results from computed tomography (CT) colonography with conventional colonoscopy in symptomatic patients referred for colonoscopy. METHODS: The study included 227 adult outpatients, mean age 60 year...AIM:To compare the results from computed tomography (CT) colonography with conventional colonoscopy in symptomatic patients referred for colonoscopy. METHODS: The study included 227 adult outpatients, mean age 60 years, with appropriate indications for colonoscopy. CT colonography and colonoscopy were performed on the same day in a metropolitan teaching hospital. Colonoscopists were initially blinded to the results of CT colonography but there was segmental unblinding during the procedure. The primary outcome measures were the sensitivity and specificity of CT colonography for the identification of polyps seen at colonoscopy (i.e. analysis by polyp). Secondary outcome measures included an analysis by patient, extracolonic findings at CT colonography, adverse events with both procedures and patient acceptance and preference. RESULTS: Twenty-five patients (11%) were excluded from the analysis because of incomplete colonoscopy or poor bowel preparation that affected either CT colonography, colonoscopy or both procedures. Polyps and masses (usually cancers) were detected at colonoscopy and CT colonography in 35% and 42% of patients, respectively. Of nine patients with a finaldiagnosis of cancer, eight (89%) were identified by CT colonography as masses (5) or polyps (3). For polyps analyzed according to polyp, the overall sensitivity of CT colonography was 50% (95% CI, 39%-61%) but this increased to 71% (95% CI, 52%-85%) for polyps ≥ 6 mm in size. Similarly, specificity for all polyps was 48% (95% CI, 39%-58%) increasing to 67% (95% CI, 56%-76%) for polyps ≥ 6 mm. Adverse events were uncommon but included one colonic perforation at colonoscopy. Patient acceptance was high for both procedures but preference favoured CT colonography. CONCLUSION: Although CT colonography was more sensitive in this study than in some previous studies, the procedure is not yet sensitive enough for widespread application in symptomatic patients.展开更多
AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the i...AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the ‘colon polyp survey group’. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients （M：F 29：18, mean age 53.8 years）, which we call the ‘CT colonoscopy group’. All the 47 patients underwent successive CTC and colonoscopy on the same day. RESULTS： Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the inddence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy. CONCLUSION： The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma and postoperative surveillance of gastric cancer patients.展开更多
BACKGROUND Colonoscopy within 24 h of hospital admission for colonic diverticular bleeding(CDB)is recommended.However,little is known about rates of rebleeding within 30 d.We posited that a group of patients who under...BACKGROUND Colonoscopy within 24 h of hospital admission for colonic diverticular bleeding(CDB)is recommended.However,little is known about rates of rebleeding within 30 d.We posited that a group of patients who underwent contrast-enhanced computed tomography(CT)within 4 h of the last hematochezia and colonoscopy within 24 h would experience fewer incidences of rebleeding.AIM To evaluate the outcomes of early colonoscopy for CDB among different groups of patients.METHODS Data from 182 patients with CDB who underwent contrast-enhanced CT and colonoscopy between January 2011 and December 2018 at the study site were retrospectively reviewed.Patients were divided into groups based on the timing of the CT imaging,within or at 4 h were defined as urgent CTs(n=100)and those performed after 4 h were defined as elective CTs(n=82).Main outcomes included rebleeding within 30 d and the identification of stigmata of recent hemorrhage(SRH)(i.e.,active bleeding,non-bleeding visible vessels,or adherent clots).RESULTS In total,182 patients(126 men and 56 women)with median ages of 68.6(range,37-92)and 73.7(range,48-93)years,respectively,underwent CT imaging and colonoscopy within 24 h of the last hematochezia.Patients for whom CT was performed within 4 h of the last hematochezia were included in the urgent CT group(n=100)and patients for whom CT was performed after 4 h were included in the elective CT group(n=82).SRH were identified in 35.0%(35/100)of the urgent CT cases and 7.3%(6/82)of the elective CT cases(P<0.01).Among all patients with extravasation-positive images on CT,SRH was identified in 31 out of 47 patients(66.0%)in the urgent CT group and 4 out of 20 patients(20.0%)in the elective CT group(P<0.01).Furthermore,rates of rebleeding within 30 d were significantly improved in the urgent CT and extravasation-positive cases(P<0.05).Results from the evaluation of early colonoscopy did not show a difference in the ability to detect SRH identification or rebleeding rates.Only cases by urgent CT reduced risk of rebleeding due to the evidence of active bleeding on the image.CONCLUSION To improve rates of rebleeding,colonoscopy is recommended within 24 h in patients with extravasation-positive CT images within 4 h of the last hematochezia.Otherwise,elective colonoscopy can be performed.展开更多
AIM:To assess the value of computed tomography(CT)for diagnosis of synchronous colorectal cancers(SCRCs)involving incomplete colonoscopy.METHODS:A total of 2123 cases of colorectal cancer(CRC)were reviewed and divided...AIM:To assess the value of computed tomography(CT)for diagnosis of synchronous colorectal cancers(SCRCs)involving incomplete colonoscopy.METHODS:A total of 2123 cases of colorectal cancer(CRC)were reviewed and divided into two groups according to whether a complete or incomplete colonoscopy was performed.CT results and final histological findings were compared to calculate the sensitivity and specificity associated with CT for detection of SCRCs following complete vs incomplete colonoscopy.Factors affecting the CT detection were also analyzed.RESULTS:Three hundred and seventy-four CRC patients underwent incomplete colonoscopy and 1749received complete colonoscopy.Fifty-six cases of SCRCs were identified by CT,and 36 were missed.In the incomplete colonoscopy group,the sensitivity and specificity of CT were 44.8%and 93.6%,respectively.The positive and negative predictive values were 23.6%and 95.0%,respectively.In contrast,the sensitivity and specificity of CT for the complete colonoscopy group were 68.3%and 97.0%,while the positive and negative predictive values were 22.2%and 98.7%,respectively.In both groups,the mean maximum dimension of the concurrent cancers identified in the CT-negative cases was shorter than in the CT-positive cases(incomplete group:P=0.02;complete group:P<0.01)Topographical proximity to synchronous cancers was identified as a risk factor for missed diagnosis(P=0.03).CONCLUSION:CT has limited sensitivity in detecting SCRCs in patients receiving incomplete colonoscopy.Patients with risk factors and negative CT results should be closely examined and monitored.展开更多
BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector compu...BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.展开更多
Post-colonoscopic colorectal cancer(PCCRC),also known as interval CRC,is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected.It typically arises from missed lesions or inc...Post-colonoscopic colorectal cancer(PCCRC),also known as interval CRC,is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected.It typically arises from missed lesions or incomplete resections and is now recognized as one of the most reliable quality indicators for assessing colonoscopy performance.With an incidence rate of 3.6%to 9.3%,PCCRC remains a significant concern,highlighting the limitations of colonoscopy in CRC screening—not only in terms of diagnostic accuracy but also in its preventive role and effectiveness in treating lesions.A range of clinical,endoscopic,and biological factors has been associated with an increased risk of PCCRC.Identifying these factors can help stratify high-risk patients,enabling earlier detection and improving preventive strategies for interval CRC.Reducing PCCRC should be a top priority for every endoscopy unit.While technological advancements will enhance polyp detection,minimize missed lesions,prevent incomplete resections,and improve overall procedural quality,the most impactful strategy remains internal self-assessment within each unit.This review should evaluate key performance metrics,including cecal intubation rate,adenoma detection rate,withdrawal time,PCCRC incidence,and incomplete resections—both at the individual endoscopist level and across the entire unit.展开更多
Photon-counting computed tomography(PCCT)represents a significant advancement in pediatric cardiovascular imaging.Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible ligh...Photon-counting computed tomography(PCCT)represents a significant advancement in pediatric cardiovascular imaging.Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible light,whereas PCCT utilizes photon-counting detectors that directly transform X-ray photons into electric signals.This direct conversion allows photon-counting detectors to sort photons into discrete energy levels,thereby enhancing image quality through superior noise reduction,improved spatial and contrast resolution,and reduced artifacts.In pediatric applications,PCCT offers substantial benefits,including lower radiation doses,which may help reduce the risk of malignancy in pediatric patients,with perhaps greater potential to benefit those with repeated exposure from a young age.Enhanced spatial resolution facilitates better visualization of small structures,vital for diagnosing congenital heart defects.Additionally,PCCT’s spectral capabilities improve tissue characterization and enable the creation of virtual monoenergetic images,which enhance soft-tissue contrast and potentially reduce contrast media doses.Initial clinical results indicate that PCCT provides superior image quality and diagnostic accuracy compared to conven-tional CT,particularly in challenging pediatric cardiovascular cases.As PCCT technology matures,further research and standardized protocols will be essential to fully integrate it into pediatric imaging practices,ensuring optimized diagnostic outcomes and patient safety.展开更多
BACKGROUND Colorectal cancer(CRC)can be prevented by screening and early detection.Colonoscopy is used for screening,and adenoma detection rate(ADR)is used as a key quality indicator of sufficient colonoscopy.However,...BACKGROUND Colorectal cancer(CRC)can be prevented by screening and early detection.Colonoscopy is used for screening,and adenoma detection rate(ADR)is used as a key quality indicator of sufficient colonoscopy.However,ADR can vary significantly among endoscopists,leading to missed polyps or cancer.Artificial intelligence(AI)has shown promise in improving ADR by assisting in real-time polyp identification or diagnosis.While multiple randomized controlled trials(RCTs)and metanalyses highlight the benefits of AI in increasing detection rates and reducing missed polyps,concerns remain about its real-world applicability,impact on procedure time,and cost-effectiveness.AIM To explore the current status of AI assistance colonoscopy in adenoma detection and improving quality of colonoscopy.METHODS This systematic review followed PRISMA guidelines,both PubMed and Web of Science databases were used for articles search.Metanalyses and systematic reviews that assessed AI's role during colonoscopy.English article only published between January 2000 and January 2025 were included.Articles related to nonadenoma indications were excluded.Data extraction was independently performed by two researchers for accuracy and consistency.RESULTS 22 articles met the inclusion criteria,with significant heterogeneity(I2=28%-91%)observed in multiple studies.The number of studies per metanalysis ranged from 5 to 33,with higher heterogeneity in analyses involving more than 18 RCTs.AI demonstrated improvement in ADR,with an approximate 20%increase across multiple studies.However,its effectiveness in detecting flat or serrated adenomas remains unproven.Endoscopists with low ADR benefit more from AI-colonoscopies,while expert endoscopists outperformed AI in ADR,adenoma miss rate,and the identification of advanced lesions.No significant change in withdrawal time was observed when comparing AI-assisted colonoscopy to conventional endoscopy.CONCLUSION While AI-assisted colonoscopy has been shown to improve procedural quality,particularly for junior endoscopists and those with lower ADR,its performance decreases when compared to expert endoscopists in real-time clinical practice.This is especially evident in non-randomized studies,where AI demonstrates limited real-world benefits despite its benefit in controlled settings.Furthermore,no meta-analyses have specifically examined AI's impact on the learning experience of fellows and residents.Some experts caution that reliance on AI may prevent trainees from developing essential observational skills,potentially leading to less thorough examinations.Further research is needed to determine the actual benefits of AI-colonoscopy,particularly its role in cancer prevention.As technology advances,improved outcomes are expected,especially in detecting small,flat,and lesions at difficult anatomical locations.展开更多
BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intr...BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intraoperative strategies.AIM To evaluate the predictive performance of machine learning(ML)algorithms for DCI by comparing three modeling approaches,identify factors influencing DCI,and develop a preoperative prediction model using ML algorithms to enhance colonoscopy quality and efficiency.METHODS This cross-sectional study enrolled 712 patients who underwent colonoscopy at a tertiary hospital between June 2020 and May 2021.Demographic data,past medical history,medication use,and psychological status were collected.The endoscopist assessed DCI using the visual analogue scale.After univariate screening,predictive models were developed using multivariable logistic regression,least absolute shrinkage and selection operator(LASSO)regression,and random forest(RF)algorithms.Model performance was evaluated based on discrimination,calibration,and decision curve analysis(DCA),and results were visualized using nomograms.RESULTS A total of 712 patients(53.8%male;mean age 54.5 years±12.9 years)were included.Logistic regression analysis identified constipation[odds ratio(OR)=2.254,95%confidence interval(CI):1.289-3.931],abdominal circumference(AC)(77.5–91.9 cm,OR=1.895,95%CI:1.065-3.350;AC≥92 cm,OR=1.271,95%CI:0.730-2.188),and anxiety(OR=1.071,95%CI:1.044-1.100)as predictive factors for DCI,validated by LASSO and RF methods.Model performance revealed training/validation sensitivities of 0.826/0.925,0.924/0.868,and 1.000/0.981;specificities of 0.602/0.511,0.510/0.562,and 0.977/0.526;and corresponding area under the receiver operating characteristic curves(AUCs)of 0.780(0.737-0.823)/0.726(0.654-0.799),0.754(0.710-0.798)/0.723(0.656-0.791),and 1.000(1.000-1.000)/0.754(0.688-0.820),respectively.DCA indicated optimal net benefit within probability thresholds of 0-0.9 and 0.05-0.37.The RF model demonstrated superior diagnostic accuracy,reflected by perfect training sensitivity(1.000)and highest validation AUC(0.754),outperforming other methods in clinical applicability.CONCLUSION The RF-based model exhibited superior predictive accuracy for DCI compared to multivariable logistic and LASSO regression models.This approach supports individualized preoperative optimization,enhancing colonoscopy quality through targeted risk stratification.展开更多
Caustic ingestion is a relatively rare but potentially catastrophic gastroentero-logical emergency.Upper gastrointestinal(GI)endoscopy is currently regarded as the gold standard modality not only to assess the depth a...Caustic ingestion is a relatively rare but potentially catastrophic gastroentero-logical emergency.Upper gastrointestinal(GI)endoscopy is currently regarded as the gold standard modality not only to assess the depth and the extension of GI caustic injury,but also to guide the appropriate treatment.Intriguingly,contrast-enhanced computed tomography(CECT)has recently emerged as a promising non-invasive and more accurate alternative to endoscopy in this setting.However,to date,evidence concerning the role of CECT as an alternative or complementary diagnostic tool to endoscopy in caustic ingestion is still limited.The aim of our review was to summarize and discuss the current evidence concerning the role of CECT in the emergency diagnosis of caustic ingestion and its value in assessing injury severity among non-pediatric patients.展开更多
The term“gut microbiota”primarily refers to the ecological community of various microorganisms in the gut,which constitutes the largest microbial community in the human body.Although adequate bowel preparation can i...The term“gut microbiota”primarily refers to the ecological community of various microorganisms in the gut,which constitutes the largest microbial community in the human body.Although adequate bowel preparation can improve the results of colonoscopy,it may interfere with the gut microbiota.Bowel preparation for colonoscopy can lead to transient changes in the gut microbiota,potentially affecting an individual’s health,especially in vulnerable populations,such as patients with inflammatory bowel disease.However,measures such as oral pro-biotics may ameliorate these adverse effects.We focused on the bowel prepa-ration-induced changes in the gut microbiota and host health status,hypothesized the factors influencing these changes,and attempted to identify measures that may reduce dysbiosis,thereby providing more information for individualized bowel preparation for colonoscopy in the future.展开更多
Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomog...Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomography/CT as well as virtual colonoscopy for early detection, the CRC related mortality is still high. The objective of CRC screening is to reduce the burden of CRC and thereby the morbidity and mortality rates of the disease. It is believed that this goal can be achieved by regularly screening the average-risk population, enabling the detection of cancer at early, curable stages, and polyps before they become cancerous. Large-scale screening with multimodality imaging approaches plays an important role in reaching that goal to detect polyps, Crohn's disease, ulcerative colitis and CRC in early stage. This article reviews kinds of presentative imaging procedures for various screening options and updates detecting, staging and re-staging of CRC patients for determining the optimal therapeutic method and forecasting the risk of CRC recurrence and the overall prognosis. The combination use of virtual colonoscopy and conventional endoscopy, advantages and limitations of these modalities are also discussed. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.展开更多
Pericoronary adipose tissue(PCAT)plays an important role in the pathogenesis and progression of cardiovascular diseases due to its bidirectional communication with the coronary artery wall.In recent years,PCAT paramet...Pericoronary adipose tissue(PCAT)plays an important role in the pathogenesis and progression of cardiovascular diseases due to its bidirectional communication with the coronary artery wall.In recent years,PCAT parameters measured using coronary computed tomography have emerged as potential noninvasive imaging biomarkers for quantifying coronary artery inflammation,with significant clinical value in the early detection,disease progression assessment,treatment efficacy evaluation,and prognosis prediction of cardiovascular diseases.Furthermore,new technologies such as PCAT radiomics analysis have broadened its potential applications in evaluating coronary plaque vulnerability,predicting cardiovascular events,and improving risk stratification.This review discusses recent advances in PCAT research,focusing on its role in coronary artery disease risk identification and inflammation monitoring,and aims to offer imaging-based insights to support its future clinical use in cardiovascular disease management.展开更多
Angiomyolipomas(AMLs)represent the most common benign solid renal tumors.The frequency of their detection in the general population is increasing owing to advances in imaging technology.The objective of this review is...Angiomyolipomas(AMLs)represent the most common benign solid renal tumors.The frequency of their detection in the general population is increasing owing to advances in imaging technology.The objective of this review is to discuss computed tomography(CT)and magnetic resonance imaging findings for both typical and atypical renal AMLs,along with their associated complications.AMLs are typically defined as solid triphasic tumors composed of varying amounts of dysmorphic and tortuous blood vessels,smooth muscle components and adipose tissue.In an adult,a classical renal AML appears as a solid,heterogeneous renal cortical mass with macroscopic fat.However,up to 5%of AMLs contain minimal fat and cannot be reliably diagnosed by imaging.Fat-poor AMLs can appear as hyperattenuating masses on unenhanced CT and as hypointense masses on T2WI;other AMLs may be isodense or exhibit cystic components.Hemorrhage is the most common complication,and AMLs with hemorrhage can mimic other tumors,making their diagnosis challenging.Understanding the variable and heterogeneous nature of this neoplasm to correctly classify renal AMLs and to avoid misdiagnosis of other renal lesions is crucial.展开更多
The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an ...The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.展开更多
BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significan...BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.展开更多
BACKGROUND Among patients referred for colonoscopy to evaluate bowel bleeding,many present with hemorrhoidal disease-associated bleeding and prolapse.AIM To compare endoscopic band ligation(EBL)with rigid proctoscope ...BACKGROUND Among patients referred for colonoscopy to evaluate bowel bleeding,many present with hemorrhoidal disease-associated bleeding and prolapse.AIM To compare endoscopic band ligation(EBL)with rigid proctoscope band ligation(RPBL)in patients referred for colonoscopy due to internal hemorrhoids.METHODS This retrospective cohort study included 171 patients with previous anal bleeding and hemorrhoidal prolapse complaints who underwent routine colonoscopy who were referred for band ligation treatment.Seventy-five patients underwent EBL,and 96 underwent RPBL.Control of bleeding,prolapse recurrence,pain,tenesmus,overall satisfaction,and cost were analyzed.A log-binomial regression model was used to analyze and compare binary outcomes between the ligation types,which allowed for the direct estimation of relative risks.RESULTS EBL achieved hemorrhoid symptom control in 92%of patients after a single session,compared with 63.5%for RPBL,which typically required three to four sessions(P<0.01).Short-term prolapse was significantly lower with EBL(13.3%)than with RPBL(55.2%,P<0.01),and long-term prolapse recurrence remained lower(8% vs 36.5%,P<0.01).Short-term bleeding was also reduced with EBL(4% vs 19%,P<0.01),while long-term bleeding control was comparable between groups(97.3% vs 92.7%).RPBL patients were more likely to report pain(relative risk=1.29;95%confidence interval:1.08-1.54;P<0.01).Overall satisfaction was markedly higher in the EBL group(86.7%“very satisfied”)than in the RPBL group(24%,P<0.01).CONCLUSION EBL demonstrated superior control of hemorrhoidal symptoms,lower prolapse recurrence,and better short-term bleeding outcomes compared with RPBL.Long-term bleeding control and tenesmus rates were comparable;however,numerical trends favored EBL.Despite a higher per-session cost,the reduced number of sessions made overall expenses similar.EBL appears to be a more effective,efficient,and well-tolerated minimally invasive option for treating symptomatic internal hemorrhoids.展开更多
Bowel preparation is necessary for a successful colonoscopy,allowing for a smooth treatment procedure and an enhanced success rate.However,inadequate bowel preparation remains common in clinical practice,and no standa...Bowel preparation is necessary for a successful colonoscopy,allowing for a smooth treatment procedure and an enhanced success rate.However,inadequate bowel preparation remains common in clinical practice,and no standardized approach exists in clinical practice.Therefore,this article reviews the primary methods available for bowel preparation and discusses their application status,efficiency,safety,and the associated patient experiences.This review aims to summarize and analyze the current status of various approaches,providing valuable reference to assist healthcare professionals in making informed decisions that lead to improved outcomes,patient comfort,and patient satisfaction.展开更多
Biliary tract cancer(BTC)is a group of heterogeneous sporadic diseases,including intrahepatic,hilar,and distal cholangiocarcinoma,as well as gallbladder cancer.BTC is characterized by high invasiveness and extremely p...Biliary tract cancer(BTC)is a group of heterogeneous sporadic diseases,including intrahepatic,hilar,and distal cholangiocarcinoma,as well as gallbladder cancer.BTC is characterized by high invasiveness and extremely poor prognosis,with a global increased incidence due to intrahepatic cholangiocarcinoma(ICC).The 18Ffludeoxyglucose positron emission tomography(PET)computed tomography(18F-FDG PET/CT)combines glucose metabolic information(reflecting the glycolytic activity of tumor cells)with anatomical structure to assess tumor metabolic heterogeneity,systemic metastasis,and molecular characteristics noninvasively,overcoming the limitations of traditional imaging in the detection of micrometastases and recurrent lesions.18F-FDG PET/CT offers critical insights in clinical staging,therapeutic evaluation,and prognostic prediction of BTC.This article reviews research progress in this field over the past decade,with a particular focus on the advances made in the last 3 years,which have not been adequately summarized and recognized.The research paradigm in this field is shifting from qualitative to quantitative studies,and there have been significant breakthroughs in using 18F-FDG PET/CT metabolic information to predict gene expression in ICC.Radiomics and deep learning techniques have been applied to ICC for prognostic prediction and differential diagnosis.Additionally,PET/magnetic resonance imaging is increasingly demonstrating its value in this field.展开更多
文摘AIM:To determine the utility of computed tomography(CT) scanning in localizing colon tumors.METHODS:At a single tertiary care teaching hospital,a retrospective chart review was conducted on patients who underwent surgery for colon malignancies between January 2004 and May 2006.One hundred and four charts containing all of the following data were reviewed:preop erative colonoscopy report,preoperative CT report,surgical operative report,tumor pathology report.The colon was divided into five segments from the cecum to the sigmoid and the location of the lesions was categorized into one of these areas.The tumor location was considered "erroneous" if its location determined during surgery differed from the location determined by colonoscopy or CT.RESULTS:Over all,tumor location was accurately determined via colonoscopy in 83/104 cases(79.8%) and erroneously in 21/104(20.2%) of cases.CT scan accurately localized colon tumors in 52/104(50.0%) of cases,incorrectly localized tumors in 18/104(17.3%) of cases,and did not detect known tumors in 34/104(32.7%) of cases.Of the 21 tumors erroneously located by colonoscopy,11(52.4%) were accurately localized by CT scan.The average tumor size for all patients in this study was 5.72(+/-3.11) cm.The average size of tumors properly located by colonoscopy and CT was 5.39(+/-3.34) cm and 6.79(+/-3.48) cm,respectively.The average size of the tumors not detected by CT was 3.98(+/-1.75) cm.CONCLUSION:CT scanning may be used in concert with colonoscopy to help localize colon tumors.
文摘AIM:To compare the results from computed tomography (CT) colonography with conventional colonoscopy in symptomatic patients referred for colonoscopy. METHODS: The study included 227 adult outpatients, mean age 60 years, with appropriate indications for colonoscopy. CT colonography and colonoscopy were performed on the same day in a metropolitan teaching hospital. Colonoscopists were initially blinded to the results of CT colonography but there was segmental unblinding during the procedure. The primary outcome measures were the sensitivity and specificity of CT colonography for the identification of polyps seen at colonoscopy (i.e. analysis by polyp). Secondary outcome measures included an analysis by patient, extracolonic findings at CT colonography, adverse events with both procedures and patient acceptance and preference. RESULTS: Twenty-five patients (11%) were excluded from the analysis because of incomplete colonoscopy or poor bowel preparation that affected either CT colonography, colonoscopy or both procedures. Polyps and masses (usually cancers) were detected at colonoscopy and CT colonography in 35% and 42% of patients, respectively. Of nine patients with a finaldiagnosis of cancer, eight (89%) were identified by CT colonography as masses (5) or polyps (3). For polyps analyzed according to polyp, the overall sensitivity of CT colonography was 50% (95% CI, 39%-61%) but this increased to 71% (95% CI, 52%-85%) for polyps ≥ 6 mm in size. Similarly, specificity for all polyps was 48% (95% CI, 39%-58%) increasing to 67% (95% CI, 56%-76%) for polyps ≥ 6 mm. Adverse events were uncommon but included one colonic perforation at colonoscopy. Patient acceptance was high for both procedures but preference favoured CT colonography. CONCLUSION: Although CT colonography was more sensitive in this study than in some previous studies, the procedure is not yet sensitive enough for widespread application in symptomatic patients.
文摘AIM： TO examine the diagnostic yield of colorectal neoplasia at computed tomographic colonoscopy （CTC） as well as the feasibility of contrast enhanced CTC in patients with gastric cancer. METHODS： To examine the incidence of colon polyp we selected postoperative 188 gastric cancer patients, which we refer to as the ‘colon polyp survey group’. To examine the feasibility of CTC for early detection of colon cancer or advanced colon adenoma, we selected 47 gastric cancer patients （M：F 29：18, mean age 53.8 years）, which we call the ‘CT colonoscopy group’. All the 47 patients underwent successive CTC and colonoscopy on the same day. RESULTS： Totally 109 colon polyps were observed from 59 out of 188 gastric cancer patients, the inddence rate of colon polyps in gastric cancer patients being 31.4%. The sensitivity of CTC in detecting individuals with at least 1 lesion of any size was 57.1%, the specificity was 72.7%, the positive predictive value was 47.1%, and the negative predictive value was 71.9%. When the cutoff size was decreased to 6 mm, the sensitivity and specificity were 80.0% and 92.9%, respectively, with positive and negative predictive values of 57.1% and 97.5%, respectively. Only one patient was classified as false negative by virtual colonoscopy. CONCLUSION： The diagnostic yield of colorectal polyp was 31.4% in patients with gastric cancer, and contrast enhanced CTC is an acceptable tool for the detection of synchronous colorectal advanced adenoma and postoperative surveillance of gastric cancer patients.
文摘BACKGROUND Colonoscopy within 24 h of hospital admission for colonic diverticular bleeding(CDB)is recommended.However,little is known about rates of rebleeding within 30 d.We posited that a group of patients who underwent contrast-enhanced computed tomography(CT)within 4 h of the last hematochezia and colonoscopy within 24 h would experience fewer incidences of rebleeding.AIM To evaluate the outcomes of early colonoscopy for CDB among different groups of patients.METHODS Data from 182 patients with CDB who underwent contrast-enhanced CT and colonoscopy between January 2011 and December 2018 at the study site were retrospectively reviewed.Patients were divided into groups based on the timing of the CT imaging,within or at 4 h were defined as urgent CTs(n=100)and those performed after 4 h were defined as elective CTs(n=82).Main outcomes included rebleeding within 30 d and the identification of stigmata of recent hemorrhage(SRH)(i.e.,active bleeding,non-bleeding visible vessels,or adherent clots).RESULTS In total,182 patients(126 men and 56 women)with median ages of 68.6(range,37-92)and 73.7(range,48-93)years,respectively,underwent CT imaging and colonoscopy within 24 h of the last hematochezia.Patients for whom CT was performed within 4 h of the last hematochezia were included in the urgent CT group(n=100)and patients for whom CT was performed after 4 h were included in the elective CT group(n=82).SRH were identified in 35.0%(35/100)of the urgent CT cases and 7.3%(6/82)of the elective CT cases(P<0.01).Among all patients with extravasation-positive images on CT,SRH was identified in 31 out of 47 patients(66.0%)in the urgent CT group and 4 out of 20 patients(20.0%)in the elective CT group(P<0.01).Furthermore,rates of rebleeding within 30 d were significantly improved in the urgent CT and extravasation-positive cases(P<0.05).Results from the evaluation of early colonoscopy did not show a difference in the ability to detect SRH identification or rebleeding rates.Only cases by urgent CT reduced risk of rebleeding due to the evidence of active bleeding on the image.CONCLUSION To improve rates of rebleeding,colonoscopy is recommended within 24 h in patients with extravasation-positive CT images within 4 h of the last hematochezia.Otherwise,elective colonoscopy can be performed.
文摘AIM:To assess the value of computed tomography(CT)for diagnosis of synchronous colorectal cancers(SCRCs)involving incomplete colonoscopy.METHODS:A total of 2123 cases of colorectal cancer(CRC)were reviewed and divided into two groups according to whether a complete or incomplete colonoscopy was performed.CT results and final histological findings were compared to calculate the sensitivity and specificity associated with CT for detection of SCRCs following complete vs incomplete colonoscopy.Factors affecting the CT detection were also analyzed.RESULTS:Three hundred and seventy-four CRC patients underwent incomplete colonoscopy and 1749received complete colonoscopy.Fifty-six cases of SCRCs were identified by CT,and 36 were missed.In the incomplete colonoscopy group,the sensitivity and specificity of CT were 44.8%and 93.6%,respectively.The positive and negative predictive values were 23.6%and 95.0%,respectively.In contrast,the sensitivity and specificity of CT for the complete colonoscopy group were 68.3%and 97.0%,while the positive and negative predictive values were 22.2%and 98.7%,respectively.In both groups,the mean maximum dimension of the concurrent cancers identified in the CT-negative cases was shorter than in the CT-positive cases(incomplete group:P=0.02;complete group:P<0.01)Topographical proximity to synchronous cancers was identified as a risk factor for missed diagnosis(P=0.03).CONCLUSION:CT has limited sensitivity in detecting SCRCs in patients receiving incomplete colonoscopy.Patients with risk factors and negative CT results should be closely examined and monitored.
文摘BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.
文摘Post-colonoscopic colorectal cancer(PCCRC),also known as interval CRC,is defined as CRC diagnosed more than six months after a colonoscopy in which no cancer was detected.It typically arises from missed lesions or incomplete resections and is now recognized as one of the most reliable quality indicators for assessing colonoscopy performance.With an incidence rate of 3.6%to 9.3%,PCCRC remains a significant concern,highlighting the limitations of colonoscopy in CRC screening—not only in terms of diagnostic accuracy but also in its preventive role and effectiveness in treating lesions.A range of clinical,endoscopic,and biological factors has been associated with an increased risk of PCCRC.Identifying these factors can help stratify high-risk patients,enabling earlier detection and improving preventive strategies for interval CRC.Reducing PCCRC should be a top priority for every endoscopy unit.While technological advancements will enhance polyp detection,minimize missed lesions,prevent incomplete resections,and improve overall procedural quality,the most impactful strategy remains internal self-assessment within each unit.This review should evaluate key performance metrics,including cecal intubation rate,adenoma detection rate,withdrawal time,PCCRC incidence,and incomplete resections—both at the individual endoscopist level and across the entire unit.
文摘Photon-counting computed tomography(PCCT)represents a significant advancement in pediatric cardiovascular imaging.Traditional CT systems employ energy-integrating detectors that convert X-ray photons into visible light,whereas PCCT utilizes photon-counting detectors that directly transform X-ray photons into electric signals.This direct conversion allows photon-counting detectors to sort photons into discrete energy levels,thereby enhancing image quality through superior noise reduction,improved spatial and contrast resolution,and reduced artifacts.In pediatric applications,PCCT offers substantial benefits,including lower radiation doses,which may help reduce the risk of malignancy in pediatric patients,with perhaps greater potential to benefit those with repeated exposure from a young age.Enhanced spatial resolution facilitates better visualization of small structures,vital for diagnosing congenital heart defects.Additionally,PCCT’s spectral capabilities improve tissue characterization and enable the creation of virtual monoenergetic images,which enhance soft-tissue contrast and potentially reduce contrast media doses.Initial clinical results indicate that PCCT provides superior image quality and diagnostic accuracy compared to conven-tional CT,particularly in challenging pediatric cardiovascular cases.As PCCT technology matures,further research and standardized protocols will be essential to fully integrate it into pediatric imaging practices,ensuring optimized diagnostic outcomes and patient safety.
文摘BACKGROUND Colorectal cancer(CRC)can be prevented by screening and early detection.Colonoscopy is used for screening,and adenoma detection rate(ADR)is used as a key quality indicator of sufficient colonoscopy.However,ADR can vary significantly among endoscopists,leading to missed polyps or cancer.Artificial intelligence(AI)has shown promise in improving ADR by assisting in real-time polyp identification or diagnosis.While multiple randomized controlled trials(RCTs)and metanalyses highlight the benefits of AI in increasing detection rates and reducing missed polyps,concerns remain about its real-world applicability,impact on procedure time,and cost-effectiveness.AIM To explore the current status of AI assistance colonoscopy in adenoma detection and improving quality of colonoscopy.METHODS This systematic review followed PRISMA guidelines,both PubMed and Web of Science databases were used for articles search.Metanalyses and systematic reviews that assessed AI's role during colonoscopy.English article only published between January 2000 and January 2025 were included.Articles related to nonadenoma indications were excluded.Data extraction was independently performed by two researchers for accuracy and consistency.RESULTS 22 articles met the inclusion criteria,with significant heterogeneity(I2=28%-91%)observed in multiple studies.The number of studies per metanalysis ranged from 5 to 33,with higher heterogeneity in analyses involving more than 18 RCTs.AI demonstrated improvement in ADR,with an approximate 20%increase across multiple studies.However,its effectiveness in detecting flat or serrated adenomas remains unproven.Endoscopists with low ADR benefit more from AI-colonoscopies,while expert endoscopists outperformed AI in ADR,adenoma miss rate,and the identification of advanced lesions.No significant change in withdrawal time was observed when comparing AI-assisted colonoscopy to conventional endoscopy.CONCLUSION While AI-assisted colonoscopy has been shown to improve procedural quality,particularly for junior endoscopists and those with lower ADR,its performance decreases when compared to expert endoscopists in real-time clinical practice.This is especially evident in non-randomized studies,where AI demonstrates limited real-world benefits despite its benefit in controlled settings.Furthermore,no meta-analyses have specifically examined AI's impact on the learning experience of fellows and residents.Some experts caution that reliance on AI may prevent trainees from developing essential observational skills,potentially leading to less thorough examinations.Further research is needed to determine the actual benefits of AI-colonoscopy,particularly its role in cancer prevention.As technology advances,improved outcomes are expected,especially in detecting small,flat,and lesions at difficult anatomical locations.
基金the Chinese Clinical Trial Registry(No.ChiCTR2000040109)approved by the Hospital Ethics Committee(No.20210130017).
文摘BACKGROUND Difficulty of colonoscopy insertion(DCI)significantly affects colonoscopy effectiveness and serves as a key quality indicator.Predicting and evaluating DCI risk preoperatively is crucial for optimizing intraoperative strategies.AIM To evaluate the predictive performance of machine learning(ML)algorithms for DCI by comparing three modeling approaches,identify factors influencing DCI,and develop a preoperative prediction model using ML algorithms to enhance colonoscopy quality and efficiency.METHODS This cross-sectional study enrolled 712 patients who underwent colonoscopy at a tertiary hospital between June 2020 and May 2021.Demographic data,past medical history,medication use,and psychological status were collected.The endoscopist assessed DCI using the visual analogue scale.After univariate screening,predictive models were developed using multivariable logistic regression,least absolute shrinkage and selection operator(LASSO)regression,and random forest(RF)algorithms.Model performance was evaluated based on discrimination,calibration,and decision curve analysis(DCA),and results were visualized using nomograms.RESULTS A total of 712 patients(53.8%male;mean age 54.5 years±12.9 years)were included.Logistic regression analysis identified constipation[odds ratio(OR)=2.254,95%confidence interval(CI):1.289-3.931],abdominal circumference(AC)(77.5–91.9 cm,OR=1.895,95%CI:1.065-3.350;AC≥92 cm,OR=1.271,95%CI:0.730-2.188),and anxiety(OR=1.071,95%CI:1.044-1.100)as predictive factors for DCI,validated by LASSO and RF methods.Model performance revealed training/validation sensitivities of 0.826/0.925,0.924/0.868,and 1.000/0.981;specificities of 0.602/0.511,0.510/0.562,and 0.977/0.526;and corresponding area under the receiver operating characteristic curves(AUCs)of 0.780(0.737-0.823)/0.726(0.654-0.799),0.754(0.710-0.798)/0.723(0.656-0.791),and 1.000(1.000-1.000)/0.754(0.688-0.820),respectively.DCA indicated optimal net benefit within probability thresholds of 0-0.9 and 0.05-0.37.The RF model demonstrated superior diagnostic accuracy,reflected by perfect training sensitivity(1.000)and highest validation AUC(0.754),outperforming other methods in clinical applicability.CONCLUSION The RF-based model exhibited superior predictive accuracy for DCI compared to multivariable logistic and LASSO regression models.This approach supports individualized preoperative optimization,enhancing colonoscopy quality through targeted risk stratification.
文摘Caustic ingestion is a relatively rare but potentially catastrophic gastroentero-logical emergency.Upper gastrointestinal(GI)endoscopy is currently regarded as the gold standard modality not only to assess the depth and the extension of GI caustic injury,but also to guide the appropriate treatment.Intriguingly,contrast-enhanced computed tomography(CECT)has recently emerged as a promising non-invasive and more accurate alternative to endoscopy in this setting.However,to date,evidence concerning the role of CECT as an alternative or complementary diagnostic tool to endoscopy in caustic ingestion is still limited.The aim of our review was to summarize and discuss the current evidence concerning the role of CECT in the emergency diagnosis of caustic ingestion and its value in assessing injury severity among non-pediatric patients.
文摘The term“gut microbiota”primarily refers to the ecological community of various microorganisms in the gut,which constitutes the largest microbial community in the human body.Although adequate bowel preparation can improve the results of colonoscopy,it may interfere with the gut microbiota.Bowel preparation for colonoscopy can lead to transient changes in the gut microbiota,potentially affecting an individual’s health,especially in vulnerable populations,such as patients with inflammatory bowel disease.However,measures such as oral pro-biotics may ameliorate these adverse effects.We focused on the bowel prepa-ration-induced changes in the gut microbiota and host health status,hypothesized the factors influencing these changes,and attempted to identify measures that may reduce dysbiosis,thereby providing more information for individualized bowel preparation for colonoscopy in the future.
文摘Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomography/CT as well as virtual colonoscopy for early detection, the CRC related mortality is still high. The objective of CRC screening is to reduce the burden of CRC and thereby the morbidity and mortality rates of the disease. It is believed that this goal can be achieved by regularly screening the average-risk population, enabling the detection of cancer at early, curable stages, and polyps before they become cancerous. Large-scale screening with multimodality imaging approaches plays an important role in reaching that goal to detect polyps, Crohn's disease, ulcerative colitis and CRC in early stage. This article reviews kinds of presentative imaging procedures for various screening options and updates detecting, staging and re-staging of CRC patients for determining the optimal therapeutic method and forecasting the risk of CRC recurrence and the overall prognosis. The combination use of virtual colonoscopy and conventional endoscopy, advantages and limitations of these modalities are also discussed. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
基金Supported by the Health Commission of the Sichuan Province Medical Science and Technology Program,China,No.24WXXT10the Sichuan Province Science and Technology Support Program,China,No.2021YJ0242the 23rd Batch of Student Scientific Research Project Approval of Jiangsu University,China,No.Y23A164.
文摘Pericoronary adipose tissue(PCAT)plays an important role in the pathogenesis and progression of cardiovascular diseases due to its bidirectional communication with the coronary artery wall.In recent years,PCAT parameters measured using coronary computed tomography have emerged as potential noninvasive imaging biomarkers for quantifying coronary artery inflammation,with significant clinical value in the early detection,disease progression assessment,treatment efficacy evaluation,and prognosis prediction of cardiovascular diseases.Furthermore,new technologies such as PCAT radiomics analysis have broadened its potential applications in evaluating coronary plaque vulnerability,predicting cardiovascular events,and improving risk stratification.This review discusses recent advances in PCAT research,focusing on its role in coronary artery disease risk identification and inflammation monitoring,and aims to offer imaging-based insights to support its future clinical use in cardiovascular disease management.
文摘Angiomyolipomas(AMLs)represent the most common benign solid renal tumors.The frequency of their detection in the general population is increasing owing to advances in imaging technology.The objective of this review is to discuss computed tomography(CT)and magnetic resonance imaging findings for both typical and atypical renal AMLs,along with their associated complications.AMLs are typically defined as solid triphasic tumors composed of varying amounts of dysmorphic and tortuous blood vessels,smooth muscle components and adipose tissue.In an adult,a classical renal AML appears as a solid,heterogeneous renal cortical mass with macroscopic fat.However,up to 5%of AMLs contain minimal fat and cannot be reliably diagnosed by imaging.Fat-poor AMLs can appear as hyperattenuating masses on unenhanced CT and as hypointense masses on T2WI;other AMLs may be isodense or exhibit cystic components.Hemorrhage is the most common complication,and AMLs with hemorrhage can mimic other tumors,making their diagnosis challenging.Understanding the variable and heterogeneous nature of this neoplasm to correctly classify renal AMLs and to avoid misdiagnosis of other renal lesions is crucial.
基金Funded by Chinese National Natural Science Foundation of China(No.U2006224)。
文摘The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.
基金Supported by Natural Science Foundation of Anhui Medical University,No.2023xkj130.
文摘BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
文摘BACKGROUND Among patients referred for colonoscopy to evaluate bowel bleeding,many present with hemorrhoidal disease-associated bleeding and prolapse.AIM To compare endoscopic band ligation(EBL)with rigid proctoscope band ligation(RPBL)in patients referred for colonoscopy due to internal hemorrhoids.METHODS This retrospective cohort study included 171 patients with previous anal bleeding and hemorrhoidal prolapse complaints who underwent routine colonoscopy who were referred for band ligation treatment.Seventy-five patients underwent EBL,and 96 underwent RPBL.Control of bleeding,prolapse recurrence,pain,tenesmus,overall satisfaction,and cost were analyzed.A log-binomial regression model was used to analyze and compare binary outcomes between the ligation types,which allowed for the direct estimation of relative risks.RESULTS EBL achieved hemorrhoid symptom control in 92%of patients after a single session,compared with 63.5%for RPBL,which typically required three to four sessions(P<0.01).Short-term prolapse was significantly lower with EBL(13.3%)than with RPBL(55.2%,P<0.01),and long-term prolapse recurrence remained lower(8% vs 36.5%,P<0.01).Short-term bleeding was also reduced with EBL(4% vs 19%,P<0.01),while long-term bleeding control was comparable between groups(97.3% vs 92.7%).RPBL patients were more likely to report pain(relative risk=1.29;95%confidence interval:1.08-1.54;P<0.01).Overall satisfaction was markedly higher in the EBL group(86.7%“very satisfied”)than in the RPBL group(24%,P<0.01).CONCLUSION EBL demonstrated superior control of hemorrhoidal symptoms,lower prolapse recurrence,and better short-term bleeding outcomes compared with RPBL.Long-term bleeding control and tenesmus rates were comparable;however,numerical trends favored EBL.Despite a higher per-session cost,the reduced number of sessions made overall expenses similar.EBL appears to be a more effective,efficient,and well-tolerated minimally invasive option for treating symptomatic internal hemorrhoids.
文摘Bowel preparation is necessary for a successful colonoscopy,allowing for a smooth treatment procedure and an enhanced success rate.However,inadequate bowel preparation remains common in clinical practice,and no standardized approach exists in clinical practice.Therefore,this article reviews the primary methods available for bowel preparation and discusses their application status,efficiency,safety,and the associated patient experiences.This review aims to summarize and analyze the current status of various approaches,providing valuable reference to assist healthcare professionals in making informed decisions that lead to improved outcomes,patient comfort,and patient satisfaction.
文摘Biliary tract cancer(BTC)is a group of heterogeneous sporadic diseases,including intrahepatic,hilar,and distal cholangiocarcinoma,as well as gallbladder cancer.BTC is characterized by high invasiveness and extremely poor prognosis,with a global increased incidence due to intrahepatic cholangiocarcinoma(ICC).The 18Ffludeoxyglucose positron emission tomography(PET)computed tomography(18F-FDG PET/CT)combines glucose metabolic information(reflecting the glycolytic activity of tumor cells)with anatomical structure to assess tumor metabolic heterogeneity,systemic metastasis,and molecular characteristics noninvasively,overcoming the limitations of traditional imaging in the detection of micrometastases and recurrent lesions.18F-FDG PET/CT offers critical insights in clinical staging,therapeutic evaluation,and prognostic prediction of BTC.This article reviews research progress in this field over the past decade,with a particular focus on the advances made in the last 3 years,which have not been adequately summarized and recognized.The research paradigm in this field is shifting from qualitative to quantitative studies,and there have been significant breakthroughs in using 18F-FDG PET/CT metabolic information to predict gene expression in ICC.Radiomics and deep learning techniques have been applied to ICC for prognostic prediction and differential diagnosis.Additionally,PET/magnetic resonance imaging is increasingly demonstrating its value in this field.
