Background Hospital-acquired pneumonia （HAP） is the most common and most serious nosocomial infection for cardiac surgery patients, with high incidence and fatality ratel. It is important for cardiac surgeons to cor...Background Hospital-acquired pneumonia （HAP） is the most common and most serious nosocomial infection for cardiac surgery patients, with high incidence and fatality ratel. It is important for cardiac surgeons to correctly identify HAP, assess the severity, and then adjust anti-infection method, which can reduce the mortality rate, shorten hospitalization time, and reduce the waste of medical resources. The purpose of this research is to evaluate the application value of lung CT in diagnosis and treatment of HAP after cardiac surgery. Methods A retrospective analysis was conducted for clinical data about 76 cardiac surgery patients who were diagnosed with HAP during January to December 2013. The clinical data mainly included symptoms, physical signs, laboratory examinations （such as routine blood tests and serum procalcitonin）, and lung CT and X-ray data. Our focus is on the comparison between lung CT and X-ray data. Results The positive diagnostic rate, false negative rate, and false positive rate of lung CT were 71/76 （93.4%）, 5/76 （6.6%）, and 1/76 （1.3%） respectively. The coincidence rate of X-ray and CT was 45/76 （59.2%）, and the false negative rate of X-ray was 23/76 （30.3%）. Conclusion Lung CT is better than X-ray in diagnosis of HAP after cardiac surgery and assessment of severity, and has greater significance for guiding the rational useof antibiotics. Therefore, lung CT is worthy of application and popularization.展开更多
Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations ...Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.展开更多
基金supported by the National Natural Science Fund(No.81300034)
文摘Background Hospital-acquired pneumonia （HAP） is the most common and most serious nosocomial infection for cardiac surgery patients, with high incidence and fatality ratel. It is important for cardiac surgeons to correctly identify HAP, assess the severity, and then adjust anti-infection method, which can reduce the mortality rate, shorten hospitalization time, and reduce the waste of medical resources. The purpose of this research is to evaluate the application value of lung CT in diagnosis and treatment of HAP after cardiac surgery. Methods A retrospective analysis was conducted for clinical data about 76 cardiac surgery patients who were diagnosed with HAP during January to December 2013. The clinical data mainly included symptoms, physical signs, laboratory examinations （such as routine blood tests and serum procalcitonin）, and lung CT and X-ray data. Our focus is on the comparison between lung CT and X-ray data. Results The positive diagnostic rate, false negative rate, and false positive rate of lung CT were 71/76 （93.4%）, 5/76 （6.6%）, and 1/76 （1.3%） respectively. The coincidence rate of X-ray and CT was 45/76 （59.2%）, and the false negative rate of X-ray was 23/76 （30.3%）. Conclusion Lung CT is better than X-ray in diagnosis of HAP after cardiac surgery and assessment of severity, and has greater significance for guiding the rational useof antibiotics. Therefore, lung CT is worthy of application and popularization.
基金supported by National Natural Science Foundation of China (No. 91959116)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No. ZYLX 201803)+1 种基金“Beijing Hospitals Authority” Ascent Plan (No. DFL20191103)National Key R&D Program of China (No. 2017YFC1309101, 2017YFC1309104).
文摘Objective: To explore the correlation between the spectral computed tomography(CT) imaging parameters and the Ki-67 labeling index in lung adenocarcinoma.Methods: Spectral CT imaging parameters [iodine concentrations of lesions(ICLs) in the arterial phase(ICLa)and venous phase(ICLv), normalized IC in the aorta(NICa/NICv), slope of the spectral HU curve(λHUa/λHUv)and monochromatic CT number enhancement on 40 keV and 70 keV images(CT40 keVa/v, CT70keVa/v)] in 34 lung adenocarcinomas were analyzed, and common molecular markers, including the Ki-67 labeling index, were detected with immunohistochemistry. Different Ki-67 labeling indexes were measured and grouped into four grades according to the number of positive-stained cells(grade 0, ≤1%;1%<grade 1≤10%;10%<grade 2≤30%;and grade 3, >30%). One-way analysis of variance(ANOVA) was used to compare the four different grades, and the Bonferroni method was used to correct the P value for multiple comparisons. A Spearman correlation analysis was performed to further research a quantitative correlation between the Ki-67 labeling index and spectral CT imaging parameters.Results: CT40keVa, CT40 keVv, CT70keVa and CT70keVv increased as the grade increased, and CT70keVa and CT70keVv were statistically significant(P<0.05). These four parameters and the Ki-67 labeling index showed a moderate positive correlation with lung adenocarcinoma nodules. ICL, NIC and λHU in the arterial and venous phases were not significantly different among the four grades.Conclusions: The spectral CT imaging parameters CT40keVa, CT40keVv, CT70keVa and CT70keVv gradually increased with Ki-67 expression and showed a moderate positive correlation with lung adenocarcinomas.Therefore, spectral CT imaging parameter-enhanced monochromatic CT numbers at 70 keV may indicate the extent of proliferation of lung adenocarcinomas.
