Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed...Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.展开更多
Modern computer techniques have been in use for several years to generate three-dimensional visualizations of human anatomy. Very good 3-D computer models of the human body are now available and used routinely in anat...Modern computer techniques have been in use for several years to generate three-dimensional visualizations of human anatomy. Very good 3-D computer models of the human body are now available and used routinely in anatomy instruction. These techniques are subsumed under the heading “virtual anatomy” to distinguish them from the conventional study of anatomy entailing cadavers and anatomy textbooks. Moreover, other imaging procedures (X-ray, angiography, CT and MR) are also used in virtual anatomy instruction. A recently introduced three-dimensional post-processing technique named Cinematic Rendering now makes it possible to use the output of routine CT and MR examinations as the basis for highly photo-realistic 3-D depictions of human anatomy. We have installed Cinematic Rendering (enabled for stereoscopy) in a high-definition 8K 3-D projection space that accommodates an audience of 150. The space’s projection surface measures 16 × 9 meters;images can be projected on both the front wall and the floor. A game controller can be used to operate Cinematic Rendering software so that it can generate interactive real-time depictions of human anatomy on the basis of CT and MR data sets. This prototype installation was implemented without technical problems;in day-to-day, real-world use over a period of 22 months, there were no impairments of service due to software crashes or other technical problems. We are already employing this installation routinely for educational offerings open to the public, courses for students in the health professions, and (continuing) professional education units for medical interns, residents and specialists—in, so to speak, the dissecting theater of the future.展开更多
Objective: To discuss the correlation of contrast-enhanced CT quantitative parameters with proliferation and invasion gene expression in pancreatic cancer. Methods: A total of 100 patients with pancreatic cancer who w...Objective: To discuss the correlation of contrast-enhanced CT quantitative parameters with proliferation and invasion gene expression in pancreatic cancer. Methods: A total of 100 patients with pancreatic cancer who were treated in the hospital between May 2015 and May 2017 were selected as pancreatic cancer group, and 48 patients with necrotic pancreatitis who received surgical treatment in the hospital during the same period were selected as pancreatitis group. Differences in pancreatic contrast-enhanced CT value as well as the expression of proliferation-related genes and invasion-related genes in lesion tissue were compared between the two groups, and Pearson test was used to evaluate the correlation of pancreatic cancer tissue CT value with proliferation and invasion gene expression. Results: Contrast-enhanced CT value of pancreatic cancer tissue was lower than that of pancreatitis tissue;proliferation-related genes Bmi-1, Ezrin and FOXC1 mRNA expression in lesion tissue of pancreatic cancer group were higher than those of pancreatitis group while EphB2 and RGC-32 mRNA expression were lower than those of pancreatitis group;invasion-related genes FHL1, JDP2, Let-7f and TFPI-2 mRNA expression in lesion tissue of pancreatic cancer group were lower than those of pancreatitis group while Twist and HOXB7 mRNA expression were higher than those of pancreatitis group. Pearson test showed that the contrast-enhanced CT value of pancreatic cancer was directly correlated with the proliferation and invasion gene expression in lesion tissue. Conclusion: Contrast-enhanced CT value of pancreatic cancer tissue was lower than that of normal pancreas tissue, and the specific CT value was directly correlated with the tumor proliferation and invasion-related gene expression, and can be used as a simple and reliable method for early diagnosis of disease and judgement of illness severity.展开更多
Objective:To study the changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation (RFA) and their correlation with serum tumor markers.Methods:A total...Objective:To study the changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation (RFA) and their correlation with serum tumor markers.Methods:A total of 60 patients who were diagnosed with lung adenocarcinoma in the Second Hospital of Yulin City between May 2015 and January 2017 were selected and randomly divided into the RFA group and control group who received RFA combined with GP chemotherapy and GP chemotherapy alone respectively. Before and after treatment, CT dynamic contrast-enhanced scan was performed to calculate blood perfusion parameters, and serum was collected to determine the contents of cancer cell proliferation activity molecules, angiogenesis molecules and cell invasion molecules.Results: After treatment, BF, BV, MTT and PS levels as well as serum CYFRA21-1, SCC-Ag, TK-1, HE-4, TPS, HDGF, VEGF, PCDGF, bFGF, NGAL, MMP7, MMP9 and OPN contents of both groups of patients were significantly lower than those before treatment, and BF, BV, MTT and PS levels as well as serum CYFRA21-1, SCC-Ag, TK-1, HE-4, TPS, HDGF, VEGF, PCDGF, bFGF, NGAL, MMP7, MMP9 and OPN contents of RFA group after treatment were significantly lower than those of control group.Conclusions:The changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation suggest that the blood perfusion significantly reduces and is closely related to cancer cell proliferation and invasion as well as angiogenesis.展开更多
Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomog...Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomography (NCT) with those obtained using contrast-enhanced CT (CECT). Materials and Methods: This single-center, retrospective study included 25 patients who underwent EVAR for abdominal aortic aneurysm at our institution. A 1-mm horizontal cross-sectional slice of NCT and CECT from each patient was retrospectively reviewed. The area from the abdominal aorta to the common iliac artery was divided into four zones. A centerline was created using the NCT by manually plotting the center points. Subsequently, the centerlines were automatically extracted and manually corrected during the arterial phase of CECT. The diameter and length of each zone were measured for each modality. The mean diameters and lengths of the target vessels were compared between NCT and CECT. Results: The measurements obtained using both methods were reproducible and demonstrated good agreement. The mean differences in vessel length and diameter measurements for each segment between NCT and CECT were not statistically significant, indicating good consistency. Conclusion: NCT may be useful for preoperative EVAR evaluation in patients with renal dysfunction or allergies to contrast agents.展开更多
Objective To assess the sensitivity of high-resolution CT (HRCT) in detecting pulmonary involvement attributed to systemic lupus erythematosus (SLE). Methods Plain chest radiography, HRCT, and pulmonary function testi...Objective To assess the sensitivity of high-resolution CT (HRCT) in detecting pulmonary involvement attributed to systemic lupus erythematosus (SLE). Methods Plain chest radiography, HRCT, and pulmonary function testing of 36 patients with SLE were analyzed. Results The sensitivity of the pulmonary involvement by HRCT, plain chest radiography and pulmonary function testing were 88.9%,36.1%,and 33.3%, respectively. Conclusion HRCT played an important role in detecting pulmonary involvemen due to SLE, especially in early and mild cases.展开更多
Severe acute respiratory syndrome (SARS) is an acute respiratory infectious disease caused by a novel coronavirus, firstly broke out in November 2002 in Guangdong and prevailed quickly in Beijing, Hong Kong, Taiwan an...Severe acute respiratory syndrome (SARS) is an acute respiratory infectious disease caused by a novel coronavirus, firstly broke out in November 2002 in Guangdong and prevailed quickly in Beijing, Hong Kong, Taiwan and other regions of China. It was one of the most potential pandemic diseases and had affected more than 20 other countries.^(1,2) There have been a lot of resear-ches^(2-7) in terms of its etiology, epidemiology, pathogenesis, clinical characteristics, diagnostics, treatment and prevention, vaccines and so on.Along with control of the epidemic situation, a great number of SARS patients were in the recovery phase, therefore, we undertook a half-year follow-up investigation on their clinical, laboratory and image situations.展开更多
Effective methods for visualizing neurovascular morphology are essential for understanding the normal spinal cord and the morphological alterations associated with diseases.However,ideal techniques for simultaneously ...Effective methods for visualizing neurovascular morphology are essential for understanding the normal spinal cord and the morphological alterations associated with diseases.However,ideal techniques for simultaneously imaging neurovascular structure in a broad region of a specimen are still lacking.In this study,we combined Golgi staining with angiography and synchrotron radiation micro-computed tomography(SRμCT)to visualize the 3D neurovascular network in the mouse spinal cord.Using our method,the 3D neurons,nerve fibers,and vasculature in a broad region could be visualized in the same image at cellular resolution without destructive sectioning.Besides,we found that the 3D morphology of neurons,nerve fiber tracts,and vasculature visualized by SRjiCT were highly consistent with that visualized using the histological method.Moreover,the 3D neurovascular structure could be quantitatively evaluated by the combined methodology.The method shown here will be useful in fundamental neuroscience studies.展开更多
BACKGROUND The treatment for ampullary cancer is pancreatoduodenectomy or local ampullectomy.However,effective methods for the preoperative investigation of hilar biliary invasion in ampullary cancer patients have not...BACKGROUND The treatment for ampullary cancer is pancreatoduodenectomy or local ampullectomy.However,effective methods for the preoperative investigation of hilar biliary invasion in ampullary cancer patients have not yet been identified.AIM To determine the necessity of and an appropriate method for investigating hilar biliary invasion of ampullary cancer.METHODS Among 43 ampullary cancer patients,34 underwent endoscopic treatment(n=9)or surgery(n=25).The use of imaging findings(thickening and enhancement of the bile duct wall on contrast-enhanced computed tomography,irregularity on endoscopic retrograde cholangiography,thickening of the entire bile duct wall on intraductal ultrasonography(IDUS),and partial thickening of the bile duct wall on IDUS)and biliary biopsy results for diagnosing hilar biliary invasion of ampullary cancer was compared.RESULTS Hilar invasion was not observed in every patient.Among the patients who did not undergo biliary stent insertion,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results showed the highest accuracy(100%)for diagnosing hilar biliary invasion.However,each imaging method and biliary biopsy yielded some false-positive results.CONCLUSION Although some false-positive results were obtained with each method,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results was useful for diagnosing hilar biliary invasion of ampullary cancer.However,hilar invasion of ampullary cancer is rare;therefore,the investigation of hilar biliary invasion of ampullary cancer might be unnecessary.展开更多
Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extrem...Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extremely variable clinical presentations. Contrasted computer tomography(CT),oesophagastroduodenoscopy(OGDS)or angiography should be prompted in a timely manner based on a high index of clinical suspicion. In this article,a case of primary AEF(PAEF)with herald gastroenteric tract haemorrhage is presented. In addition to the pathophysiology and managements,the pitfalls of the diagnostic studies are discussed,pinpointing the importance of high index of clinical suspicion.展开更多
Purpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures.However,there is currently a lack of auxiliary examination methods for its direct diagnosis.The purpose of thi...Purpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures.However,there is currently a lack of auxiliary examination methods for its direct diagnosis.The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.Methods:Through retrospectively analyzing the results of brainstem auditory evoked potential(BAEP)and high-resolution CT(HRCT)in 37 patients with hearing impairment following trauma from January 1,2018 to July 31,2020,the role of the two inspection methods in the diagnosis of auditory nerve injury was studied.Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma;while exclusion criteria were:(1)severe patient with a Glasgow coma scale score<5 because these patients were classified as severe head injury and admitted to the intensive care unit,(2)patient in the subacute stage admitted 72 h after trauma,and(3)patient with prior hearing impairment before trauma.According to Goodman's classification of hearing impairment,the patients were divided into low/medium/severe injury groups.In addition,patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results.The positive rates of BEAP for each group were observed,and the results were analyzed by Chi-square test(p<0.05,regarded as statistical difference).Results:A total of 37 patients were included,including 21 males and 16 females.All of them were hospitalized patients with GCS score of 6-15 at the time of admission.The BAEP positive rate in the medium and severe injury group was 100%,which was significantly higher than that in the low injury group(27.27%)(p<0.01).The rate of BEAP positivity was significantly higher in the HRCT-positive group(20/30,66.7%)than in the HRCT-negative group(1/7,14.3%)(p<0.05).Twenty patients(54.05%)were both positive for BEAP and HRCT test,and considered to have auditory nerve damage.Six patients(16.22%)were both negative for BEAP and HRCT test,and 10 patients(27.03%)were BAEP-negative but HRCT-positive:all the 16 patients were considered as non-neurological injury.The rest 1 case(2.70%)was BAEP-positive but HRCT-negative,which we speculate may have auditory nerve concussion.Conclusion:By way of BAEP combining with skull base HRCT,we may improve the accuracy of the diagnosis of auditory nerve injury.Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.展开更多
Background:Successful liver resection in oncologic surgery depends on safety,precision,and efficacy,all of which require a thorough understanding of liver anatomy.Contrast-enhanced computed tomography(CT)-generated th...Background:Successful liver resection in oncologic surgery depends on safety,precision,and efficacy,all of which require a thorough understanding of liver anatomy.Contrast-enhanced computed tomography(CT)-generated three-dimensional(3D)models have been proposed as a valuable tool to enhance this understanding.However,a systematic comparison of different display modalities across professional groups has not yet been performed.Methods:In this prospective,monocentric randomized trial,we compared high-resolution twodimensional(2D)CT images of liver malignancies with their corresponding standardized,non-colored 3D virtual and printed models in facilitating anatomical and spatial understanding as well as surgical decision-making.A total of 91 participants,including 40 surgeons,10 radiologists,and 41 students,evaluated six clinical cases(three centrally and three peripherally located liver malignancies).Each participant assessed one central and one peripheral case per display modality,presented in a random order.Results:Compared to 2D CT images,both 3D virtual and printed models significantly improved the identification of tumor location(P<0.001),enhanced the comprehension of spatial relationships with adjacent liver and portal veins(P<0.001 and P=0.019,respectively),and facilitated clinical decisionmaking(P<0.001).No significant difference was observed between virtual and printed models in terms of effectiveness.Within the different groups,surgeons and students,but not radiologists,more accurately identified tumor location and spatial relationships with adjacent liver and portal veins using 3D models.Subjectively,most surgeons and students preferred 3D printed models over virtual models and 2D CT images.Conclusions:This study demonstrated that standardized,non-colored 3D virtual and printed models equally help preoperative anatomical understanding and decision-making,particularly for surgeons and students.By isolating the influence of display modality,our findings clarify prior inconsistent results and support the integration of cost-effective 3D visualization by applying virtual models into surgical planning and education.Preference for printed models despite comparable efficacy highlights the importance of user-centered implementation strategies.展开更多
基金supported by the Jiangsu Province Natural Science Foundation (No. BK20161291)the Nantong Science Foundation of China (No. MS2201507)the Nantong Municipal Commission of Health and Family Planning Young Fund (No. WQ2014047)
文摘Objective： To prospectively compare the discriminative capacity of dynamic contrast enhanced-magnetic resonance imaging（DCE-MRI） with that of^18F-fluorodeoxyglucose（^18F-FDG） positron emission tomography/computed tomography（PET/CT） in the differentiation of malignant and benign solitary pulmonary nodules（SPNs）.Methods： Forty-nine patients with SPNs were included in this prospective study. Thirty-two of the patients had malignant SPNs, while the other 17 had benign SPNs. All these patients underwent DCE-MRI and ^18F-FDG PET/CT examinations. The quantitative MRI pharmacokinetic parameters, including the trans-endothelial transfer constant（K^trans）, redistribution rate constant（Kep）, and fractional volume（Ve）, were calculated using the Extended-Tofts Linear two-compartment model. The ^18F-FDG PET/CT parameter, maximum standardized uptake value（SUV（max））, was also measured. Spearman＇s correlations were calculated between the MRI pharmacokinetic parameters and the SUV（max） of each SPN. These parameters were statistically compared between the malignant and benign nodules. Receiver operating characteristic（ROC） analyses were used to compare the diagnostic capability between the DCE-MRI and ^18F-FDG PET/CT indexes.Results： Positive correlations were found between K^trans and SUV（max）, and between K（ep） and SUV（max）（P〈0.05）.There were significant differences between the malignant and benign nodules in terms of the K^trans, K（ep） and SUV（max） values（P〈0.05）. The areas under the ROC curve（AUC） of K^trans） K（ep） and SUV（max） between the malignant and benign nodules were 0.909, 0.838 and 0.759, respectively. The sensitivity and specificity in differentiating malignant from benign SPNs were 90.6% and 82.4% for K^trans; 87.5% and 76.5% for K（ep）; and 75.0% and 70.6%for SUV（max）, respectively. The sensitivity and specificity of K^trans and K（ep） were higher than those of SUV（max）, but there was no significant difference between them（P〉0.05）.Conclusions： DCE-MRI can be used to differentiate between benign and malignant SPNs and has the advantage of being radiation free.
文摘Modern computer techniques have been in use for several years to generate three-dimensional visualizations of human anatomy. Very good 3-D computer models of the human body are now available and used routinely in anatomy instruction. These techniques are subsumed under the heading “virtual anatomy” to distinguish them from the conventional study of anatomy entailing cadavers and anatomy textbooks. Moreover, other imaging procedures (X-ray, angiography, CT and MR) are also used in virtual anatomy instruction. A recently introduced three-dimensional post-processing technique named Cinematic Rendering now makes it possible to use the output of routine CT and MR examinations as the basis for highly photo-realistic 3-D depictions of human anatomy. We have installed Cinematic Rendering (enabled for stereoscopy) in a high-definition 8K 3-D projection space that accommodates an audience of 150. The space’s projection surface measures 16 × 9 meters;images can be projected on both the front wall and the floor. A game controller can be used to operate Cinematic Rendering software so that it can generate interactive real-time depictions of human anatomy on the basis of CT and MR data sets. This prototype installation was implemented without technical problems;in day-to-day, real-world use over a period of 22 months, there were no impairments of service due to software crashes or other technical problems. We are already employing this installation routinely for educational offerings open to the public, courses for students in the health professions, and (continuing) professional education units for medical interns, residents and specialists—in, so to speak, the dissecting theater of the future.
文摘Objective: To discuss the correlation of contrast-enhanced CT quantitative parameters with proliferation and invasion gene expression in pancreatic cancer. Methods: A total of 100 patients with pancreatic cancer who were treated in the hospital between May 2015 and May 2017 were selected as pancreatic cancer group, and 48 patients with necrotic pancreatitis who received surgical treatment in the hospital during the same period were selected as pancreatitis group. Differences in pancreatic contrast-enhanced CT value as well as the expression of proliferation-related genes and invasion-related genes in lesion tissue were compared between the two groups, and Pearson test was used to evaluate the correlation of pancreatic cancer tissue CT value with proliferation and invasion gene expression. Results: Contrast-enhanced CT value of pancreatic cancer tissue was lower than that of pancreatitis tissue;proliferation-related genes Bmi-1, Ezrin and FOXC1 mRNA expression in lesion tissue of pancreatic cancer group were higher than those of pancreatitis group while EphB2 and RGC-32 mRNA expression were lower than those of pancreatitis group;invasion-related genes FHL1, JDP2, Let-7f and TFPI-2 mRNA expression in lesion tissue of pancreatic cancer group were lower than those of pancreatitis group while Twist and HOXB7 mRNA expression were higher than those of pancreatitis group. Pearson test showed that the contrast-enhanced CT value of pancreatic cancer was directly correlated with the proliferation and invasion gene expression in lesion tissue. Conclusion: Contrast-enhanced CT value of pancreatic cancer tissue was lower than that of normal pancreas tissue, and the specific CT value was directly correlated with the tumor proliferation and invasion-related gene expression, and can be used as a simple and reliable method for early diagnosis of disease and judgement of illness severity.
文摘Objective:To study the changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation (RFA) and their correlation with serum tumor markers.Methods:A total of 60 patients who were diagnosed with lung adenocarcinoma in the Second Hospital of Yulin City between May 2015 and January 2017 were selected and randomly divided into the RFA group and control group who received RFA combined with GP chemotherapy and GP chemotherapy alone respectively. Before and after treatment, CT dynamic contrast-enhanced scan was performed to calculate blood perfusion parameters, and serum was collected to determine the contents of cancer cell proliferation activity molecules, angiogenesis molecules and cell invasion molecules.Results: After treatment, BF, BV, MTT and PS levels as well as serum CYFRA21-1, SCC-Ag, TK-1, HE-4, TPS, HDGF, VEGF, PCDGF, bFGF, NGAL, MMP7, MMP9 and OPN contents of both groups of patients were significantly lower than those before treatment, and BF, BV, MTT and PS levels as well as serum CYFRA21-1, SCC-Ag, TK-1, HE-4, TPS, HDGF, VEGF, PCDGF, bFGF, NGAL, MMP7, MMP9 and OPN contents of RFA group after treatment were significantly lower than those of control group.Conclusions:The changes of CT dynamic contrast-enhanced scan parameters in patients with lung cancer before and after radiofrequency ablation suggest that the blood perfusion significantly reduces and is closely related to cancer cell proliferation and invasion as well as angiogenesis.
文摘Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomography (NCT) with those obtained using contrast-enhanced CT (CECT). Materials and Methods: This single-center, retrospective study included 25 patients who underwent EVAR for abdominal aortic aneurysm at our institution. A 1-mm horizontal cross-sectional slice of NCT and CECT from each patient was retrospectively reviewed. The area from the abdominal aorta to the common iliac artery was divided into four zones. A centerline was created using the NCT by manually plotting the center points. Subsequently, the centerlines were automatically extracted and manually corrected during the arterial phase of CECT. The diameter and length of each zone were measured for each modality. The mean diameters and lengths of the target vessels were compared between NCT and CECT. Results: The measurements obtained using both methods were reproducible and demonstrated good agreement. The mean differences in vessel length and diameter measurements for each segment between NCT and CECT were not statistically significant, indicating good consistency. Conclusion: NCT may be useful for preoperative EVAR evaluation in patients with renal dysfunction or allergies to contrast agents.
文摘Objective To assess the sensitivity of high-resolution CT (HRCT) in detecting pulmonary involvement attributed to systemic lupus erythematosus (SLE). Methods Plain chest radiography, HRCT, and pulmonary function testing of 36 patients with SLE were analyzed. Results The sensitivity of the pulmonary involvement by HRCT, plain chest radiography and pulmonary function testing were 88.9%,36.1%,and 33.3%, respectively. Conclusion HRCT played an important role in detecting pulmonary involvemen due to SLE, especially in early and mild cases.
文摘Severe acute respiratory syndrome (SARS) is an acute respiratory infectious disease caused by a novel coronavirus, firstly broke out in November 2002 in Guangdong and prevailed quickly in Beijing, Hong Kong, Taiwan and other regions of China. It was one of the most potential pandemic diseases and had affected more than 20 other countries.^(1,2) There have been a lot of resear-ches^(2-7) in terms of its etiology, epidemiology, pathogenesis, clinical characteristics, diagnostics, treatment and prevention, vaccines and so on.Along with control of the epidemic situation, a great number of SARS patients were in the recovery phase, therefore, we undertook a half-year follow-up investigation on their clinical, laboratory and image situations.
基金by the National Natural Science Foundation of China(82030071,81874004,and 81672174)the Key R&D Program of the Hunan Provincial Science&Technology Department(2017SK2061)+1 种基金Hunan Provincial Department of Finance[(2018)2]by the Fundamental Research Funds for the Central Universities of Central South University(2018zzts254).
文摘Effective methods for visualizing neurovascular morphology are essential for understanding the normal spinal cord and the morphological alterations associated with diseases.However,ideal techniques for simultaneously imaging neurovascular structure in a broad region of a specimen are still lacking.In this study,we combined Golgi staining with angiography and synchrotron radiation micro-computed tomography(SRμCT)to visualize the 3D neurovascular network in the mouse spinal cord.Using our method,the 3D neurons,nerve fibers,and vasculature in a broad region could be visualized in the same image at cellular resolution without destructive sectioning.Besides,we found that the 3D morphology of neurons,nerve fiber tracts,and vasculature visualized by SRjiCT were highly consistent with that visualized using the histological method.Moreover,the 3D neurovascular structure could be quantitatively evaluated by the combined methodology.The method shown here will be useful in fundamental neuroscience studies.
文摘BACKGROUND The treatment for ampullary cancer is pancreatoduodenectomy or local ampullectomy.However,effective methods for the preoperative investigation of hilar biliary invasion in ampullary cancer patients have not yet been identified.AIM To determine the necessity of and an appropriate method for investigating hilar biliary invasion of ampullary cancer.METHODS Among 43 ampullary cancer patients,34 underwent endoscopic treatment(n=9)or surgery(n=25).The use of imaging findings(thickening and enhancement of the bile duct wall on contrast-enhanced computed tomography,irregularity on endoscopic retrograde cholangiography,thickening of the entire bile duct wall on intraductal ultrasonography(IDUS),and partial thickening of the bile duct wall on IDUS)and biliary biopsy results for diagnosing hilar biliary invasion of ampullary cancer was compared.RESULTS Hilar invasion was not observed in every patient.Among the patients who did not undergo biliary stent insertion,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results showed the highest accuracy(100%)for diagnosing hilar biliary invasion.However,each imaging method and biliary biopsy yielded some false-positive results.CONCLUSION Although some false-positive results were obtained with each method,the combination of partial thickening of the bile duct wall on IDUS and biliary biopsy results was useful for diagnosing hilar biliary invasion of ampullary cancer.However,hilar invasion of ampullary cancer is rare;therefore,the investigation of hilar biliary invasion of ampullary cancer might be unnecessary.
文摘Aorto-enteric fistula(AEF)is a rare entity that accounts for high mortality. Early diagnosis is paramount to improving the survivals of patients with AEF but the diagnosis tends to be delayed in practice due to extremely variable clinical presentations. Contrasted computer tomography(CT),oesophagastroduodenoscopy(OGDS)or angiography should be prompted in a timely manner based on a high index of clinical suspicion. In this article,a case of primary AEF(PAEF)with herald gastroenteric tract haemorrhage is presented. In addition to the pathophysiology and managements,the pitfalls of the diagnostic studies are discussed,pinpointing the importance of high index of clinical suspicion.
文摘Purpose:Auditory nerve injury is one of the most common nerve injury complications of skull base fractures.However,there is currently a lack of auxiliary examination methods for its direct diagnosis.The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.Methods:Through retrospectively analyzing the results of brainstem auditory evoked potential(BAEP)and high-resolution CT(HRCT)in 37 patients with hearing impairment following trauma from January 1,2018 to July 31,2020,the role of the two inspection methods in the diagnosis of auditory nerve injury was studied.Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma;while exclusion criteria were:(1)severe patient with a Glasgow coma scale score<5 because these patients were classified as severe head injury and admitted to the intensive care unit,(2)patient in the subacute stage admitted 72 h after trauma,and(3)patient with prior hearing impairment before trauma.According to Goodman's classification of hearing impairment,the patients were divided into low/medium/severe injury groups.In addition,patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results.The positive rates of BEAP for each group were observed,and the results were analyzed by Chi-square test(p<0.05,regarded as statistical difference).Results:A total of 37 patients were included,including 21 males and 16 females.All of them were hospitalized patients with GCS score of 6-15 at the time of admission.The BAEP positive rate in the medium and severe injury group was 100%,which was significantly higher than that in the low injury group(27.27%)(p<0.01).The rate of BEAP positivity was significantly higher in the HRCT-positive group(20/30,66.7%)than in the HRCT-negative group(1/7,14.3%)(p<0.05).Twenty patients(54.05%)were both positive for BEAP and HRCT test,and considered to have auditory nerve damage.Six patients(16.22%)were both negative for BEAP and HRCT test,and 10 patients(27.03%)were BAEP-negative but HRCT-positive:all the 16 patients were considered as non-neurological injury.The rest 1 case(2.70%)was BAEP-positive but HRCT-negative,which we speculate may have auditory nerve concussion.Conclusion:By way of BAEP combining with skull base HRCT,we may improve the accuracy of the diagnosis of auditory nerve injury.Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.
文摘Background:Successful liver resection in oncologic surgery depends on safety,precision,and efficacy,all of which require a thorough understanding of liver anatomy.Contrast-enhanced computed tomography(CT)-generated three-dimensional(3D)models have been proposed as a valuable tool to enhance this understanding.However,a systematic comparison of different display modalities across professional groups has not yet been performed.Methods:In this prospective,monocentric randomized trial,we compared high-resolution twodimensional(2D)CT images of liver malignancies with their corresponding standardized,non-colored 3D virtual and printed models in facilitating anatomical and spatial understanding as well as surgical decision-making.A total of 91 participants,including 40 surgeons,10 radiologists,and 41 students,evaluated six clinical cases(three centrally and three peripherally located liver malignancies).Each participant assessed one central and one peripheral case per display modality,presented in a random order.Results:Compared to 2D CT images,both 3D virtual and printed models significantly improved the identification of tumor location(P<0.001),enhanced the comprehension of spatial relationships with adjacent liver and portal veins(P<0.001 and P=0.019,respectively),and facilitated clinical decisionmaking(P<0.001).No significant difference was observed between virtual and printed models in terms of effectiveness.Within the different groups,surgeons and students,but not radiologists,more accurately identified tumor location and spatial relationships with adjacent liver and portal veins using 3D models.Subjectively,most surgeons and students preferred 3D printed models over virtual models and 2D CT images.Conclusions:This study demonstrated that standardized,non-colored 3D virtual and printed models equally help preoperative anatomical understanding and decision-making,particularly for surgeons and students.By isolating the influence of display modality,our findings clarify prior inconsistent results and support the integration of cost-effective 3D visualization by applying virtual models into surgical planning and education.Preference for printed models despite comparable efficacy highlights the importance of user-centered implementation strategies.
