Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary a...Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary angiography. The latest 64-row multi-detector computed tomography (MDCT) technology is non-invasive, has high specificity and negative predictive values for the detection of significant coronary disease. Our aim was to investigate if this modality can provide more information in the assessment of outpatients with ACCP in addition to established cardiovascular risk scores. Methods Seventy consecutive patients presenting to the outpatient clinic with ACCP underwent 64-row MDCT scan of the coronary arteries. They were categorized into low, medium or high risk groups based upon the Framingham and PROCAM scores. We defined a clinically abnormal MDCT scan as coronary stenosis =50% or calcium score ＞400 Agatston. Results Fifty-three (75.7%) patients did not have clinically abnormal scans. Framingham score classified 43 patients as low-risk while PROCAM classified 59 patients as low-risk. MDCT scans were abnormal for 18.6% and 22.0% of the respective low-risk group of patients. For patients with medium-to-high risk, 33.3% and 36.4% of Framingham and PROCAM patient groups respectively had abnormal MDCT scans. Conclusion MDCT adds valuable information in the assessment of patients with ACCP by identifying a significant proportion of patients categorized as low-risk to have underlying significant coronary stenosis and coronary calcification by established cardiovascular risk scores.展开更多
AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively id...AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively identified 52 consecutive adult patients with hPIDs who underwent 64-row HRCT and PFTs at the time of diagnosis. On a per-patient basis, an experienced radiologist recorded airway abnormalities(bronchiectasis,airway wall thickening, mucus plugging, tree-in-bud, and air-trapping) and parenchymal-interstitial abnormalities(consolidations, ground-glass opacities,linear and/or irregular opacities, nodules, and bullae/cysts) found on HRCT.The chi-square test was performed to compare the prevalence of each abnormality among patients with different subtypes of hPIDs. Overall logistic regression analysis was performed to assess whether HRCT findings predicted obstructive and/or restrictive PFTs results(absent-to-mild vs moderate-tosevere).RESULTS Thirty-eight of the 52 patients with hPIDs showed common variable immunodeficiency disorders(CVID), while the remaining 14 had CVID-like conditions(i.e., 11 had isolated IgG subclass deficiencies and 3 had selective IgA deficiencies). The prevalence of most HRCT abnormalities was not significantly different between CVID and CVID-like patients(P > 0.05), except for linear and/or irregular opacities(prevalence of 31.6% in the CVID group and 0 in the CVID-like group; P = 0.0427). Airway wall thickening was the most frequent HRCT abnormality found in both CVID and CVID-like patients(71% of cases in both groups). The presence of tree-in-bud abnormalities was an independent predictor of moderate-to-severe obstructive defects at PFTs(Odds Ratio, OR, of 18.75, P < 0.05), while the presence of linear and/or irregular opacities was an independent predictor of restrictive defects at PFTs(OR = 13.00; P < 0.05).CONCLUSION CVID and CVID-like patients showed similar HRCT findings. Tree-in-bud and linear and/or irregular opacities predicted higher risks of, respectively,obstructive and restrictive defects at PFTs.展开更多
AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with...AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.展开更多
Background The correct diagnosis of etiology of fungal infection after bone marrow transplantation is very important to the choice of antifungal drugs and a premise for improvement of therapeutic efficacy. This study ...Background The correct diagnosis of etiology of fungal infection after bone marrow transplantation is very important to the choice of antifungal drugs and a premise for improvement of therapeutic efficacy. This study aimed to compare high-resolution computed tomography （HRCT） findings of the pulmonary fungal infections to determine whether the etiology of various fungal infections could be diagnosed with HRCT. Methods Eighty-five cases were enrolled. According to the pathogens responsible for fungal infections, the patients were classified into three groups including invasive aspergillosis （n=52）, candidiasis （n=19） and cryptococcosis （n=14） groups. All the patients underwent HRCT scans. Two independent radiologists retrospectively analyzed the HRCT scans regarding CT patterns and distribution of lung abnormality. Results Most fungal infections in the three groups occurred in the neutropenic phase. There was no significant difference in the constituent ratio of fungal infections at different phases after bone marrow transplantation among the three groups. Agreement between the two observers for all the CT characteristics of fungal infections was excellent （k 〉0.75）. There was a significant difference in occurrence ratio of mass among the three groups （P=-0.02）. Occurrence ratio of mass （43.3%, 13/30） in the group with invasive aspergillosis was higher than in each of other two groups （20.0%, 2/10; 14.3%, 1/7）. There was no significant difference in other CT characteristics of nodules or masses; including number, margin, halo sign, cavitation and air-crescent sign. There was no significant difference in number, margin, air bronchogram and distribution of air-space consolidation. Conclusions The HRCT appearance of various pulmonary fungal infections has a great deal of overlap and is nonspecific. Mass is more common in invasive aspergillosis, which is helpful to the diagnosis of invasive aspergillosis after bone marrow transplantation.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
Mineral dissemination and pore space distribution in ore particles are important features that influence heap leaching performance.To quantify the mineral dissemination and pore space distribution of an ore particle,a...Mineral dissemination and pore space distribution in ore particles are important features that influence heap leaching performance.To quantify the mineral dissemination and pore space distribution of an ore particle,a cylindrical copper oxide ore sample(I center dot 4.6 mm x 5.6 mm)was scanned using high-resolution X-ray computed tomography(HRXCT),a nondestructive imaging technology,at a spatial resolution of 4.85 mu m.Combined with three-dimensional(3D)image analysis techniques,the main mineral phases and pore space were segmented and the volume fraction of each phase was calculated.In addition,the mass fraction of each mineral phase was estimated and the result was validated with that obtained using traditional techniques.Furthermore,the pore phase features,including the pore size distribution,pore surface area,pore fractal dimension,pore centerline,and the pore connectivity,were investigated quantitatively.The pore space analysis results indicate that the pore size distribution closely fits a log-normal distribution and that the pore space morphology is complicated,with a large surface area and low connectivity.This study demonstrates that the combination of HRXCT and 3D image analysis is an effective tool for acquiring 3D mineralogical and pore structural data.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
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
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
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
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
Ultrasound computed tomography(USCT)is a noninvasive biomedical imaging modality that offers insights into acoustic properties such as the sound speed(SS)and acoustic attenuation(AA)of the human body,enhancing diagnos...Ultrasound computed tomography(USCT)is a noninvasive biomedical imaging modality that offers insights into acoustic properties such as the sound speed(SS)and acoustic attenuation(AA)of the human body,enhancing diagnostic accuracy and therapy planning.Full waveform inversion(FWI)is a promising USCT image reconstruction method that optimizes the parameter fields of a wave propagation model via gradient-based optimization.However,twodimensional FWI methods are limited by their inability to account for three-dimensional wave propagation in the elevation direction,resulting in image artifacts.To address this problem,we propose a three-dimensional time-domain full waveform inversion algorithm to reconstruct the SS and AA distributions on the basis of a fractional Laplacian wave equation,adjoint field formulation,and gradient descent optimization.Validated by two sets of simulations,the proposed algorithm has potential for generating high-resolution and quantitative SS and AA distributions.This approach holds promise for clinical USCT applications,assisting early disease detection,precise abnormality localization,and optimized treatment planning,thus contributing to better healthcare outcomes.展开更多
Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposi...Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposition and virtual monoenergetic images.Material decomposition helps in the generation of virtual nonenhanced,iodine,pulmonary lung blood volume,lung vessel,automated bone removal,and renal stone characterization images.DECT offers a broad spectrum of clinical applications in pediatric imaging,including vascular,neurological,thoracic,abdominal,skeletal,and oncologic assessments.Additionally,it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality.This technique provides unique qualitative and quantitative information about the composition of the tissue,allowing differentiation of materials,including iodinated contrast agents.The radiation dose of DECT is equivalent to or lower than that of a singleenergy CT,adding to the advantages of DECT,especially in children who are more sensitive to the harmful effects of radiation.In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.展开更多
Photon-counting computed tomography(PCCT)represents a transformative advancement in neuroimaging,offering superior spatial resolution,spectral imaging capabilities,reduced radiation dose,and enhanced contrast-to-noise...Photon-counting computed tomography(PCCT)represents a transformative advancement in neuroimaging,offering superior spatial resolution,spectral imaging capabilities,reduced radiation dose,and enhanced contrast-to-noise ratios.This review explores the technical foundations of PCCT,its advantages over conventional CT,and its growing applications in neuroimaging.PCCT has shown promise in improving neurovascular imaging,detecting small vessels,and reducing artifacts near metallic implants.It also enhances the visualization of spontaneous intracranial hypotension and cerebrospinal fluid leaks and provides superior diagnostic accuracy in acute ischemic stroke imaging.However,current limitations,including protocol complexity,high data volume,and the absence of integrated artificial intelligence noise reduction algorithms,pose challenges to widespread adoption.Future research should address these limitations and refine PCCT’s applications to unlock its full clinical potential.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
Soft tissue sarcomas(STS)are rare malignant tumors originating from mesoder-mal tissues with a poor prognosis,accounting for approximately 1%of all malig-nancies and comprising around 50 distinct subtypes.Conventional...Soft tissue sarcomas(STS)are rare malignant tumors originating from mesoder-mal tissues with a poor prognosis,accounting for approximately 1%of all malig-nancies and comprising around 50 distinct subtypes.Conventional imaging mo-dalities,such as computed tomography(CT)and magnetic resonance imaging(MRI),primarily provide anatomical information,whereas 18F-fluorodeoxyglucose positron emission tomography/CT(18F-FDG PET/CT)integrates functional metabolic and anatomical imaging,serving as a critical complementary tool in the diagnosis and management of STS.This article reviews recent advances in the application of 18F-FDG PET/CT for STS.The advantages of 18F-FDG PET/CT in STS include:(1)Early detection of metabolic activity changes in tumors,partic-ularly when morphological alterations are insignificant;(2)Effective differen-tiation between benign and malignant soft tissue tumors,as well as aiding in distinguishing high-grade from low-grade sarcomas;(3)Identification of occult metastatic lesions,improving staging accuracy,and facilitating restaging in cases of recurrence or metastasis;(4)Utilization of parameters such as maximum stan-dardized uptake value and metabolic tumor volume to assist in tumor grading and prognostic evaluation;and(5)Monitoring treatment response to guide adjust-ments in personalized therapeutic strategies.However,18F-FDG PET/CT has limitations in diagnosis of certain STS subtypes(e.g.,myxoid liposarcoma),detection and biopsy of metastatic lymph nodes,necessitating integration with clinical evaluation and other imaging techniques.18F-FDG PET/CT is poised to play an increasingly vital role in the precision diagnosis and treatment of STS.展开更多
Acute appendicitis remains one of the most common causes of emergency abdominal surgery globally.Imaging plays a pivotal role in confirming or excluding the diagnosis and identifying complications that influence manag...Acute appendicitis remains one of the most common causes of emergency abdominal surgery globally.Imaging plays a pivotal role in confirming or excluding the diagnosis and identifying complications that influence management pathways.This narrative review synthesizes contemporary evidence and consensusbased imaging protocols for appendicitis,with a focus on computed tomography,magnetic resonance imaging,and ultrasound.The article explores advanced diagnostic criteria,interpretation challenges,imaging algorithms derived from professional society guidelines,and special considerations including pregnancy and pediatric populations.Clinical practice recommendations by the World Society of Emergency Surgery,European Association of Endoscopic Surgery,American College of Radiology,and Infectious Diseases Society of America are incorporated to frame best practices.展开更多
BACKGROUND Inguinal hernias are common after surgery.Tension-free repair is widely accepted as the main method for managing inguinal hernias.Adequate exposure,coverage,and repair of the myopectineal orifice(MPO)are ne...BACKGROUND Inguinal hernias are common after surgery.Tension-free repair is widely accepted as the main method for managing inguinal hernias.Adequate exposure,coverage,and repair of the myopectineal orifice(MPO)are necessary.However,due to differences in race and sex,people’s body shapes vary.According to European guidelines,the patch should measure 10 cm×15 cm.If any part of the MPO is dissected,injury to the nerves,vascular network,or organs may occur during surgery,thereby leading to inguinal discomfort,pain,and seroma formation after surgery.Therefore,accurate localization and measurement of the boundary of the MPO are crucial for selecting the optimal patch for inguinal hernia repair.AIM To compare the size of the MPO measured on three-dimensional multislice spiral computed tomography(CT)with that measured via laparoscopy and explore the relevant factors influencing the size of the MPO.METHODS Clinical data from 74 patients who underwent laparoscopic tension-free inguinal hernia repair at the General Surgery Department of the First Affiliated Hospital of Anhui University of Science and Technology between September 2022 and July 2024 were collected and analyzed retrospectively.Transabdominal preperitoneal was performed.Sixty-four males and 10 females,with an average age of 58.30±12.32 years,were included.The clinical data of the patients were collected.The boundary of the MPO was measured on three-dimensional CT images before surgery and then again during transabdominal preperitoneal.All the preoperative and intraoperative data were analyzed via paired t-tests.A t-test was used for comparisons of age,body mass index,and sex between the groups.In the comparative analysis,a P value less than 0.05 indicated a significant difference.RESULTS The boundaries of the MPO on 3-dimensional CT images measured 7.05±0.47 cm and 6.27±0.61 cm,and the area of the MPO was 19.54±3.33 cm^(2).The boundaries of the MPO during surgery were 7.18±0.51 cm and 6.17±0.40 cm.The errors were not statistically significant.However,the intraoperative BD(the width of the MPO,P=0.024,P<0.05)and preoperative AC(the length of the MPO,P=0.045,P<0.05)significantly differed according to sex.The AC and BD measurements before and during surgery were not significantly different according to age,body mass index,hernia side or hernia type(P>0.05).CONCLUSION The application of this technology can aid in determining the most appropriate dissection range and patch size.展开更多
BACKGROUND Accurate identification of tumor invasion depth and lymph node(LN)involve-ment in patients with colon cancer(CC)is critical for guiding treatment strategies.However,the preoperative prediction of tumor inva...BACKGROUND Accurate identification of tumor invasion depth and lymph node(LN)involve-ment in patients with colon cancer(CC)is critical for guiding treatment strategies.However,the preoperative prediction of tumor invasion depth and LN metastasis in CC remains challenging.As the intestinal tumor develops,the fat density in the mesentery increases.METHODS Patients,who were diagnosed with CC and underwent surgery,were included and divided into the training and validation cohorts.CT-T values of the mesen-tery were extracted from the CT images.Cutoff points were determined using the receiver operating characteristic(ROC)curve,and the area under the ROC curve was employed to assess the performance of the CT-T value for tumor invasion depth and LN status prediction.RESULTS Cutoff values of 11.83 and 17.17 were identified to discriminate T1/2 vs T3/4 and N0 vs N1/2,respectively.With a cutoff CT-T value of 11.83,the total diagnostic accuracy for T stage was 83.1%(81.5%for the training cohort and 86.2%for the validation cohort).With a cutoff CT-T value of 17.17,the total diagnostic accuracy for N stage was 77.3%(75.8%for the training cohort and 80.1%for the validation cohort),which was higher than that of CT-reported LN metastasis.CONCLUSION In this study,we explored an efficient method for predicting preoperative T and N stages using the tumor-contributed CT value of the mesentery in CC,which displayed superior predictive accuracy.展开更多
文摘Background and objective Atypical 'cardiac' chest pain (ACCP) is not usually caused by myocardial ischaemia. Current noninvasive investigations for these symptoms are not yet as accurate as invasive coronary angiography. The latest 64-row multi-detector computed tomography (MDCT) technology is non-invasive, has high specificity and negative predictive values for the detection of significant coronary disease. Our aim was to investigate if this modality can provide more information in the assessment of outpatients with ACCP in addition to established cardiovascular risk scores. Methods Seventy consecutive patients presenting to the outpatient clinic with ACCP underwent 64-row MDCT scan of the coronary arteries. They were categorized into low, medium or high risk groups based upon the Framingham and PROCAM scores. We defined a clinically abnormal MDCT scan as coronary stenosis =50% or calcium score ＞400 Agatston. Results Fifty-three (75.7%) patients did not have clinically abnormal scans. Framingham score classified 43 patients as low-risk while PROCAM classified 59 patients as low-risk. MDCT scans were abnormal for 18.6% and 22.0% of the respective low-risk group of patients. For patients with medium-to-high risk, 33.3% and 36.4% of Framingham and PROCAM patient groups respectively had abnormal MDCT scans. Conclusion MDCT adds valuable information in the assessment of patients with ACCP by identifying a significant proportion of patients categorized as low-risk to have underlying significant coronary stenosis and coronary calcification by established cardiovascular risk scores.
基金funded by Department of Medicine, University of Udine (Udine, Italy) in accordance with Good Publication Practice (GPP3) guidelines (http://www.ismpp.org/gpp3)
文摘AIM To compare high-resolution computed tomography(HRCT) findings between humoral primary immunodeficiencies(hPIDs) subtypes; to correlate these findings to pulmonary function tests(PFTs).METHODS We retrospectively identified 52 consecutive adult patients with hPIDs who underwent 64-row HRCT and PFTs at the time of diagnosis. On a per-patient basis, an experienced radiologist recorded airway abnormalities(bronchiectasis,airway wall thickening, mucus plugging, tree-in-bud, and air-trapping) and parenchymal-interstitial abnormalities(consolidations, ground-glass opacities,linear and/or irregular opacities, nodules, and bullae/cysts) found on HRCT.The chi-square test was performed to compare the prevalence of each abnormality among patients with different subtypes of hPIDs. Overall logistic regression analysis was performed to assess whether HRCT findings predicted obstructive and/or restrictive PFTs results(absent-to-mild vs moderate-tosevere).RESULTS Thirty-eight of the 52 patients with hPIDs showed common variable immunodeficiency disorders(CVID), while the remaining 14 had CVID-like conditions(i.e., 11 had isolated IgG subclass deficiencies and 3 had selective IgA deficiencies). The prevalence of most HRCT abnormalities was not significantly different between CVID and CVID-like patients(P > 0.05), except for linear and/or irregular opacities(prevalence of 31.6% in the CVID group and 0 in the CVID-like group; P = 0.0427). Airway wall thickening was the most frequent HRCT abnormality found in both CVID and CVID-like patients(71% of cases in both groups). The presence of tree-in-bud abnormalities was an independent predictor of moderate-to-severe obstructive defects at PFTs(Odds Ratio, OR, of 18.75, P < 0.05), while the presence of linear and/or irregular opacities was an independent predictor of restrictive defects at PFTs(OR = 13.00; P < 0.05).CONCLUSION CVID and CVID-like patients showed similar HRCT findings. Tree-in-bud and linear and/or irregular opacities predicted higher risks of, respectively,obstructive and restrictive defects at PFTs.
文摘AIM:To investigate pulmonary involvement via pulmonary function tests (PFT) and high-resolution computed tomocjraphy (HRCT) in patients with chronic hepatitis C virus (HCV) infection. METHODS:Thirty-four patients with chronic HCV infection without diagnosis of any pulmonary diseases and 10 healthy cases were enrolled in the study,PFT and HRCT were performed in all cases. RESULTS:A decrease lower than 80% of the predicted value was detected in vital capacity in 9/34 patients,in forced expiratory volume in one second in 8/34 patients,and in forced expiratory flow 25-75 in 15/34 patients,respectively.Carbon monoxide diffusing capacity (DLCO) was decreased in 26/34 patients.Findings of interstitial pulmonary involvement were detected in the HRCT of 16/34 patients.Significant difference was found between controls and patients with HCV infection in findings of HRCT (X^2=4.7,P=0.003).Knodell histological activity index (KHAI) of 28/34 patients in whom liver biopsy was applied was 9.0±4.7.HRCT findings,PFT values and DLCO were not affected by KHAI in patients with HCV infection.In these patients,all the parameters were related with age. CONCLUSION:We suggest that chronic hepatitis C virus infection may cause pulmonary interstitial involvement without evident respiratory symptoms.
文摘Background The correct diagnosis of etiology of fungal infection after bone marrow transplantation is very important to the choice of antifungal drugs and a premise for improvement of therapeutic efficacy. This study aimed to compare high-resolution computed tomography （HRCT） findings of the pulmonary fungal infections to determine whether the etiology of various fungal infections could be diagnosed with HRCT. Methods Eighty-five cases were enrolled. According to the pathogens responsible for fungal infections, the patients were classified into three groups including invasive aspergillosis （n=52）, candidiasis （n=19） and cryptococcosis （n=14） groups. All the patients underwent HRCT scans. Two independent radiologists retrospectively analyzed the HRCT scans regarding CT patterns and distribution of lung abnormality. Results Most fungal infections in the three groups occurred in the neutropenic phase. There was no significant difference in the constituent ratio of fungal infections at different phases after bone marrow transplantation among the three groups. Agreement between the two observers for all the CT characteristics of fungal infections was excellent （k 〉0.75）. There was a significant difference in occurrence ratio of mass among the three groups （P=-0.02）. Occurrence ratio of mass （43.3%, 13/30） in the group with invasive aspergillosis was higher than in each of other two groups （20.0%, 2/10; 14.3%, 1/7）. There was no significant difference in other CT characteristics of nodules or masses; including number, margin, halo sign, cavitation and air-crescent sign. There was no significant difference in number, margin, air bronchogram and distribution of air-space consolidation. Conclusions The HRCT appearance of various pulmonary fungal infections has a great deal of overlap and is nonspecific. Mass is more common in invasive aspergillosis, which is helpful to the diagnosis of invasive aspergillosis after bone marrow transplantation.
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.
基金financially supported by the National Natural Science Foundation of China(No.51304076)the Natural Science Foundation of Hunan Province,China(No.14JJ4064)
文摘Mineral dissemination and pore space distribution in ore particles are important features that influence heap leaching performance.To quantify the mineral dissemination and pore space distribution of an ore particle,a cylindrical copper oxide ore sample(I center dot 4.6 mm x 5.6 mm)was scanned using high-resolution X-ray computed tomography(HRXCT),a nondestructive imaging technology,at a spatial resolution of 4.85 mu m.Combined with three-dimensional(3D)image analysis techniques,the main mineral phases and pore space were segmented and the volume fraction of each phase was calculated.In addition,the mass fraction of each mineral phase was estimated and the result was validated with that obtained using traditional techniques.Furthermore,the pore phase features,including the pore size distribution,pore surface area,pore fractal dimension,pore centerline,and the pore connectivity,were investigated quantitatively.The pore space analysis results indicate that the pore size distribution closely fits a log-normal distribution and that the pore space morphology is complicated,with a large surface area and low connectivity.This study demonstrates that the combination of HRXCT and 3D image analysis is an effective tool for acquiring 3D mineralogical and pore structural data.
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.
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.
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.
基金supported by the National Key Research and Development Program of China(2022YFA1404400)the National Natural Science Foundation of China(62122072,12174368,61705216,62405306)+4 种基金Anhui Provincial Department of Science and Technology(202203a07020020,18030801138)Anhui Provincial Natural Science Foundation(2308085QA21,2408085QF187)the USTC Research Funds of the Double First-Class Initiative(YD2090002015)the Institute of Artificial Intelligence at Hefei Comprehensive National Science Center(23YGXT005)the Fundamental Research Funds for the Central Universities(WK2090000083).
文摘Ultrasound computed tomography(USCT)is a noninvasive biomedical imaging modality that offers insights into acoustic properties such as the sound speed(SS)and acoustic attenuation(AA)of the human body,enhancing diagnostic accuracy and therapy planning.Full waveform inversion(FWI)is a promising USCT image reconstruction method that optimizes the parameter fields of a wave propagation model via gradient-based optimization.However,twodimensional FWI methods are limited by their inability to account for three-dimensional wave propagation in the elevation direction,resulting in image artifacts.To address this problem,we propose a three-dimensional time-domain full waveform inversion algorithm to reconstruct the SS and AA distributions on the basis of a fractional Laplacian wave equation,adjoint field formulation,and gradient descent optimization.Validated by two sets of simulations,the proposed algorithm has potential for generating high-resolution and quantitative SS and AA distributions.This approach holds promise for clinical USCT applications,assisting early disease detection,precise abnormality localization,and optimized treatment planning,thus contributing to better healthcare outcomes.
文摘Dual-energy CT(DECT)is an advancement in CT technology that allows for the acquisition of images at two different energy levels.Two main post-processing tools,which form the backbone of DECT,include material decomposition and virtual monoenergetic images.Material decomposition helps in the generation of virtual nonenhanced,iodine,pulmonary lung blood volume,lung vessel,automated bone removal,and renal stone characterization images.DECT offers a broad spectrum of clinical applications in pediatric imaging,including vascular,neurological,thoracic,abdominal,skeletal,and oncologic assessments.Additionally,it contributes to shorter scan times and enables the use of lower contrast media volumes while maintaining diagnostic image quality.This technique provides unique qualitative and quantitative information about the composition of the tissue,allowing differentiation of materials,including iodinated contrast agents.The radiation dose of DECT is equivalent to or lower than that of a singleenergy CT,adding to the advantages of DECT,especially in children who are more sensitive to the harmful effects of radiation.In this minireview we outlined the basic principles of the DECT technique and its post-processing techniques with emphasis on clinical applications in pediatric imaging.
文摘Photon-counting computed tomography(PCCT)represents a transformative advancement in neuroimaging,offering superior spatial resolution,spectral imaging capabilities,reduced radiation dose,and enhanced contrast-to-noise ratios.This review explores the technical foundations of PCCT,its advantages over conventional CT,and its growing applications in neuroimaging.PCCT has shown promise in improving neurovascular imaging,detecting small vessels,and reducing artifacts near metallic implants.It also enhances the visualization of spontaneous intracranial hypotension and cerebrospinal fluid leaks and provides superior diagnostic accuracy in acute ischemic stroke imaging.However,current limitations,including protocol complexity,high data volume,and the absence of integrated artificial intelligence noise reduction algorithms,pose challenges to widespread adoption.Future research should address these limitations and refine PCCT’s applications to unlock its full clinical potential.
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Soft tissue sarcomas(STS)are rare malignant tumors originating from mesoder-mal tissues with a poor prognosis,accounting for approximately 1%of all malig-nancies and comprising around 50 distinct subtypes.Conventional imaging mo-dalities,such as computed tomography(CT)and magnetic resonance imaging(MRI),primarily provide anatomical information,whereas 18F-fluorodeoxyglucose positron emission tomography/CT(18F-FDG PET/CT)integrates functional metabolic and anatomical imaging,serving as a critical complementary tool in the diagnosis and management of STS.This article reviews recent advances in the application of 18F-FDG PET/CT for STS.The advantages of 18F-FDG PET/CT in STS include:(1)Early detection of metabolic activity changes in tumors,partic-ularly when morphological alterations are insignificant;(2)Effective differen-tiation between benign and malignant soft tissue tumors,as well as aiding in distinguishing high-grade from low-grade sarcomas;(3)Identification of occult metastatic lesions,improving staging accuracy,and facilitating restaging in cases of recurrence or metastasis;(4)Utilization of parameters such as maximum stan-dardized uptake value and metabolic tumor volume to assist in tumor grading and prognostic evaluation;and(5)Monitoring treatment response to guide adjust-ments in personalized therapeutic strategies.However,18F-FDG PET/CT has limitations in diagnosis of certain STS subtypes(e.g.,myxoid liposarcoma),detection and biopsy of metastatic lymph nodes,necessitating integration with clinical evaluation and other imaging techniques.18F-FDG PET/CT is poised to play an increasingly vital role in the precision diagnosis and treatment of STS.
文摘Acute appendicitis remains one of the most common causes of emergency abdominal surgery globally.Imaging plays a pivotal role in confirming or excluding the diagnosis and identifying complications that influence management pathways.This narrative review synthesizes contemporary evidence and consensusbased imaging protocols for appendicitis,with a focus on computed tomography,magnetic resonance imaging,and ultrasound.The article explores advanced diagnostic criteria,interpretation challenges,imaging algorithms derived from professional society guidelines,and special considerations including pregnancy and pediatric populations.Clinical practice recommendations by the World Society of Emergency Surgery,European Association of Endoscopic Surgery,American College of Radiology,and Infectious Diseases Society of America are incorporated to frame best practices.
基金Supported by the 2022 Provincial Quality Engineering Project for Higher Education Institutions,No.2022sx031the 2023 Provincial Quality Engineering Project for Higher Education Institutions,No.2023jyxm1071.
文摘BACKGROUND Inguinal hernias are common after surgery.Tension-free repair is widely accepted as the main method for managing inguinal hernias.Adequate exposure,coverage,and repair of the myopectineal orifice(MPO)are necessary.However,due to differences in race and sex,people’s body shapes vary.According to European guidelines,the patch should measure 10 cm×15 cm.If any part of the MPO is dissected,injury to the nerves,vascular network,or organs may occur during surgery,thereby leading to inguinal discomfort,pain,and seroma formation after surgery.Therefore,accurate localization and measurement of the boundary of the MPO are crucial for selecting the optimal patch for inguinal hernia repair.AIM To compare the size of the MPO measured on three-dimensional multislice spiral computed tomography(CT)with that measured via laparoscopy and explore the relevant factors influencing the size of the MPO.METHODS Clinical data from 74 patients who underwent laparoscopic tension-free inguinal hernia repair at the General Surgery Department of the First Affiliated Hospital of Anhui University of Science and Technology between September 2022 and July 2024 were collected and analyzed retrospectively.Transabdominal preperitoneal was performed.Sixty-four males and 10 females,with an average age of 58.30±12.32 years,were included.The clinical data of the patients were collected.The boundary of the MPO was measured on three-dimensional CT images before surgery and then again during transabdominal preperitoneal.All the preoperative and intraoperative data were analyzed via paired t-tests.A t-test was used for comparisons of age,body mass index,and sex between the groups.In the comparative analysis,a P value less than 0.05 indicated a significant difference.RESULTS The boundaries of the MPO on 3-dimensional CT images measured 7.05±0.47 cm and 6.27±0.61 cm,and the area of the MPO was 19.54±3.33 cm^(2).The boundaries of the MPO during surgery were 7.18±0.51 cm and 6.17±0.40 cm.The errors were not statistically significant.However,the intraoperative BD(the width of the MPO,P=0.024,P<0.05)and preoperative AC(the length of the MPO,P=0.045,P<0.05)significantly differed according to sex.The AC and BD measurements before and during surgery were not significantly different according to age,body mass index,hernia side or hernia type(P>0.05).CONCLUSION The application of this technology can aid in determining the most appropriate dissection range and patch size.
基金Supported by National Natural Science Foundation of China,No.82303785and Medical Scientific Research Foundation of Guangdong Province,No.A2024096.
文摘BACKGROUND Accurate identification of tumor invasion depth and lymph node(LN)involve-ment in patients with colon cancer(CC)is critical for guiding treatment strategies.However,the preoperative prediction of tumor invasion depth and LN metastasis in CC remains challenging.As the intestinal tumor develops,the fat density in the mesentery increases.METHODS Patients,who were diagnosed with CC and underwent surgery,were included and divided into the training and validation cohorts.CT-T values of the mesen-tery were extracted from the CT images.Cutoff points were determined using the receiver operating characteristic(ROC)curve,and the area under the ROC curve was employed to assess the performance of the CT-T value for tumor invasion depth and LN status prediction.RESULTS Cutoff values of 11.83 and 17.17 were identified to discriminate T1/2 vs T3/4 and N0 vs N1/2,respectively.With a cutoff CT-T value of 11.83,the total diagnostic accuracy for T stage was 83.1%(81.5%for the training cohort and 86.2%for the validation cohort).With a cutoff CT-T value of 17.17,the total diagnostic accuracy for N stage was 77.3%(75.8%for the training cohort and 80.1%for the validation cohort),which was higher than that of CT-reported LN metastasis.CONCLUSION In this study,we explored an efficient method for predicting preoperative T and N stages using the tumor-contributed CT value of the mesentery in CC,which displayed superior predictive accuracy.
