AIM:To distinguish acinar cell carcinoma(ACC)from pancreatic adenocarcinoma(AC)by comparing their computed tomography findings.METHODS:Patients with ACC and AC were identified on the basis of results obtained using su...AIM:To distinguish acinar cell carcinoma(ACC)from pancreatic adenocarcinoma(AC)by comparing their computed tomography findings.METHODS:Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens.The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases(non-contrast,arterial,portal venous,and delayed phase)were compared.The scan delay times were 40,70,and 120 s for each contrast-enhanced phase.The visual pattern,tomographic attenuation value,and time attenuation curve were assessed and compared between AC and ACC cases using the 2test,Wilcoxon signed-rank test,and Mann Whitney U test.RESULTS:The adenocarcinomas tended to be hypodense in all 4 phases.The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhancedphases,although their computed tomographic attenuation values were higher.Further,5 of the 6 acinar cell carcinomas(83%)were isodense in the non-contrast phase.The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases,and all adenocarcinomas showed peak enhancement during the delayed phase.The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases.None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.CONCLUSION:The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas,and multidetector-row computed tomography can thus distinguish these tumors.展开更多
AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patie...AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patients.METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner(ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 m As. Imaging data were reviewed as axial and as multiplanar reconstructions(MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images(DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed.RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91(41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged(45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value(PPV) 80.4%, negative predictive value(NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the reference magnetic resonance images. The difference in accuracy was statistically significant(P = 0.02). CONCLUSION: New generation CT scanner, using high resolution MPR images, represents a reliable diagnostic tool in assessment of loco-regional and whole body staging of advanced rectal cancer, especially in patients with MRI contraindications.展开更多
Objective To evaluate the diagnostic value of three-dimensional multidetector-row computed tomogra- phy （MDCT） in detecting acquired renal arteriovenous malformation （RAVM） and to compare its perfor- mance with th...Objective To evaluate the diagnostic value of three-dimensional multidetector-row computed tomogra- phy （MDCT） in detecting acquired renal arteriovenous malformation （RAVM） and to compare its perfor- mance with that of ultrasonography and digital subtraction angiography （DSA）. Methods The institutional review board approved this retrospective study and written informed consent was obtained from all patients before examination. All 14 patients with acquired RAVM underwent MDCT, including cortical and medullary phase enhancement angiography and three-dimensional （3D） reconstruc- tion. Five and nine patients were further examined and their diagnoses confirmed by DSA and surgery, respectively. The MDCT images, including 3D reconstructions, were analyzed for RAVM independently and in consensus by two observers using a workstation. Results Among the 14 patients with acquired RAVM, 12 with maximum lesion diameter 〉 10 mm, and one with a maximum lesion diameter between 5 and 10 ram, were correctly diagnosed with MDCT angiog- raphy. Among these patients, four diagnoses were confirmed by DSA. One patient with a lesion 5-10 mm in diameter was misdiagnosed with a renal aneurysm by MDCT angiography. The other one with the maxi- mum diameter of the lesion between 5 mm and 10 mm was misdiagnosed as renal aneurysm with MDCT angiography, which was diagnosed as renal arteriovenous malformation with DSA. Among 14 lesions in 14 patients, eight and six originated in the left and right kidney, respectively. Conclusion MDCT angiography can accurately diagnose RAVM and improve our understanding of the disease, which will allow clinicians to provide better care.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
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
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
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
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
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
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
BACKGROUND Malignant pleural mesothelioma(MPM),a rare aggressive malignancy,is primarily caused by asbestos exposure.MPM typically affects older adults(median age,76 years),is uncommon in those under age 50 years and ...BACKGROUND Malignant pleural mesothelioma(MPM),a rare aggressive malignancy,is primarily caused by asbestos exposure.MPM typically affects older adults(median age,76 years),is uncommon in those under age 50 years and shows male predominance.Based on the American Society of Clinical Oncology guidelines,F-18 fluorodeoxyglucose positron emission tomography/computed tomography(F-18 FDG PET/CT)is essential for initial MPM staging.Integrating quantitative FDG metabolic data with computed tomography(CT)anatomy optimizes biopsy accuracy and staging.CASE SUMMARY A 21-year-old female college student presented with fever(peak 38.4°C),cough,and white mucoid sputum after cold exposure.Initial evaluation revealed elevated C-reactive protein[C-reactive protein(CRP);65.52 mg/L]and Mycoplasma pneumoniae IgM.Despite resolution of fever following a 14-day moxifloxacin regimen,persistent cough prompted chest CT,which demonstrated left pleural mass-like thickenings.Levofloxacin therapy for 2 weeks failed to alleviate symptoms,accompanied by 2.5-kg weight loss over 1 month.Re-evaluation showed rising CRP(88.87 mg/L)with stable CT lesions,and negative T-cell spot test for tuberculosis and tumor markers.Contrast-enhanced CT revealed heterogeneously enhancing masses,while PET/CT detected two broad-based pleural lesions with intense FDG avidity.CT-guided biopsy confirmed epithelioid MPM.Thoracoscopy exposed diffuse fragile,hemorrhagic nodules implanting on diaphragmatic and parietal pleura,confirming metastatic MPM with partial resection performed.This presentation challenges conventional imaging paradigms of MPM,underscoring its diagnostic complexity.CONCLUSION MPM should still be considered an important differential diagnosis in young patients presenting with solitary pleural masses and no history of typical asbestos exposure.F-18 FDG PET/CT,while serving as an essential component of initial staging for MPM,has some inherent limitations.展开更多
Computed Tomography(CT)reconstruction is essential inmedical imaging and other engineering fields.However,blurring of the projection during CT imaging can lead to artifacts in the reconstructed images.Projection blur ...Computed Tomography(CT)reconstruction is essential inmedical imaging and other engineering fields.However,blurring of the projection during CT imaging can lead to artifacts in the reconstructed images.Projection blur combines factors such as larger ray sources,scattering and imaging system vibration.To address the problem,we propose DeblurTomo,a novel self-supervised learning-based deblurring and reconstruction algorithm that efficiently reconstructs sharp CT images from blurry input without needing external data and blur measurement.Specifically,we constructed a coordinate-based implicit neural representation reconstruction network,which can map the coordinates to the attenuation coefficient in the reconstructed space formore convenient ray representation.Then,wemodel the blur as aweighted sumof offset rays and design the RayCorrectionNetwork(RCN)andWeight ProposalNetwork(WPN)to fit these rays and their weights bymulti-view consistency and geometric information,thereby extending 2D deblurring to 3D space.In the training phase,we use the blurry input as the supervision signal to optimize the reconstruction network,the RCN,and the WPN simultaneously.Extensive experiments on the widely used synthetic dataset show that DeblurTomo performs superiorly on the limited-angle and sparse-view in the simulated blurred scenarios.Further experiments on real datasets demonstrate the superiority of our method in practical scenarios.展开更多
BACKGROUND Lymph node metastasis(LNM)is a key prognostic factor in pancreatic cancer(PC).Accurate preoperative prediction of LNM remains challenging.Radiomics offers a noninvasive method to extract quantitative imagin...BACKGROUND Lymph node metastasis(LNM)is a key prognostic factor in pancreatic cancer(PC).Accurate preoperative prediction of LNM remains challenging.Radiomics offers a noninvasive method to extract quantitative imaging features that may aid in predicting LNM.AIM To investigate the potential value of a computed tomography(CT)-based radiomics model in prediction of LNM in PC.METHODS A retrospective analysis was performed on 168 pathologically confirmed PC patients who underwent contrast-enhanced-CT.Among them,107 cases had no LNM,while 61 cases had confirmed LNM.These patients were randomly divided into a training cohort(n=135)and a validation cohort(n=33).A total of 792 radiomics features were extracted,comprising 396 features from the arterial phase and another 396 from the portal venous phase.The Minimum Redundancy Maximum Relevance and Least Absolute Shrinkage and Selection Operator methods were used for feature selection and Radiomics model construction.The receiver operating characteristic curve was employed to assess the diagnostic potential of the model,and DeLong test was used to compare the area under the curve(AUC)values of the model.RESULTS Six radiomics features from the arterial phase and nine from the portal venous phase were selected.The Radscore model demonstrated strong predictive performance for LNM in both the training and test cohorts,with AUC values ranging from 0.86 to 0.94,sensitivity between 66.7% and 91.7%,specificity from 71.4% to 100.0%,accuracy between 78.8%and 91.1%,PPV ranging from 64.7% to 100.0%,and negative predictive value between 84.0% and 93.8%.No significant differences in AUC values were observed between the arterial and portal venous phases in either the training or test set.CONCLUSION The preoperative CT-based radiomics model exhibited robust predictive capability for identifying LNM in PC.展开更多
Computed tomography(CT)can inspect the internal structure of concrete with high resolution,but improving the accuracy of measurements remains a key challenge due to the reliance on complex image processing and signifi...Computed tomography(CT)can inspect the internal structure of concrete with high resolution,but improving the accuracy of measurements remains a key challenge due to the reliance on complex image processing and significant manual intervention.This study aims to optimize CT scanning parameters to enhance the accuracy of measuring crack widths and rebar volumes in reinforced concrete.Nine sets of specimens,each with varying rebar diameters and concrete cover thicknesses,were scanned before and after corrosion using an Optima CT scanner,followed by three-dimensional reconstructions using Avizo software.The effects of threshold values and“Erosion”coefficients on measurement accuracy were evaluated.The results demonstrated that an optimal lower threshold of 2950,combined with an‘Erosion’coefficient of 6,effectively limits the measurement error of rebar volumes to within 1%.The optimal threshold for measuring crack widths was influenced by the crack width,rebar diameter,and concrete cover thickness.Additionally,an optimized formula for determining crack measurement thresholds was proposed.This study significantly improves the accuracy of CT-based non-destructive testing(NDT)techniques,providing valuable insights for structural health monitoring(SHM).展开更多
BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM T...BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.METHODS Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically.Imaging characteristics,including tumor location,size,contour,ulceration,growth pattern,enhancement degree and pattern,cystic change,calcification,and perigastric lymph nodes(PLNs),were reviewed by two experienced radiologists.RESULTS Our sample included 18 females and 5 males,with a median age of 54.7 years.A total of 39.1%of cases were asymptomatic.GSs appeared as oval and well-defined submucosal tumors,with exophytic(43.5%)or mixed(endoluminal+exophytic;43.5%)growth patterns.The tumors were primarily located in the gastric body(78.3%).Ulcerations were observed in 8 cases(34.5%),and PLNs were observed in 15 cases(65%).The average degree of enhancement was 48.3 Hounsfield units.Twenty cases(87%)showed peak enhancement in the delayed phase.Most GSs were homogeneous,while cystic change(13.0%)and calcification(17.4%)were rare.CONCLUSION GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase.PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.展开更多
BACKGROUND Effective management of liver abscess depends on timely drainage,which is influenced by the liquefaction degree.Identifying predictive factors is crucial for guiding clinical decisions.AIM To investigate th...BACKGROUND Effective management of liver abscess depends on timely drainage,which is influenced by the liquefaction degree.Identifying predictive factors is crucial for guiding clinical decisions.AIM To investigate the predictive factors of liver abscess liquefaction and develop a predictive model to guide optimal timing of percutaneous drainage.METHODS This retrospective study included 110 patients with pyogenic liver abscesses who underwent percutaneous catheter drainage.Patients were divided into a poor liquefaction group(n=28)and a well liquefaction group(n=82)based on the ratio of postoperative 24-hour drainage volume to abscess volume,using a cutoff value of 0.3.Clinical characteristics,laboratory indicators,and computed tomography imaging features were compared.A predictive model was constructed using logistic regression and evaluated using receiver operating characteristic curves and five-fold cross-validation.RESULTS Independent predictive factors for good liquefaction included the absence of diabetes[odds ratio(OR)=0.339,P=0.044],absence of pneumonia(OR=0.218,P=0.013),left-lobe abscess location(OR=4.293,P=0.041),cystic features(OR=5.104,P=0.025),and elevated preoperative serum alanine aminotransferase(ALT)levels(OR=1.013,P=0.041).The logistic regression model based on these factors demonstrated an area under the curve of 0.814,with a sensitivity of 90.24%and specificity of 67.86%.Five-fold cross-validation yielded an average accuracy of 83.61%and a kappa coefficient of 0.5209.CONCLUSION Pneumonia,diabetes,abscess location,abscess composition,and preoperative serum ALT levels are significant predictors of liver abscess liquefaction.The model can guide clinical decision-making.展开更多
BACKGROUND:Previous studies have reported that early computed tomography(CT)findings significantly contribute to the outcomes of cardiac arrest(CA)patients.This study aims to evaluate the association between chest CT ...BACKGROUND:Previous studies have reported that early computed tomography(CT)findings significantly contribute to the outcomes of cardiac arrest(CA)patients.This study aims to evaluate the association between chest CT features and prognosis in CA patients treated with extracorporeal cardiopulmonary resuscitation(ECPR).METHODS:A retrospective observational study was conducted on adult CA patients treated with ECPR in a tertiary hospital between March 2015 and June 2023.All the patients underwent a wholebody CT scan within 1 h of ECPR.Data regarding demographic and clinical characteristics were collected from electronic medical records.The presence of gravity-dependent distribution and CT scores based on chest CT scans were determined for each patient.The primary outcome was 28-day survival.Receiver operating characteristic(ROC)curves were used to evaluate the ability of chest CT features(gravitydependent distribution and CT scores)to predict poor outcomes.The cut-off value of the CT score was determined.Kaplan-Meier curves were used to compare 28-day survival between the low-and high-CT score groups,which were classified using the estimated cut-off value.RESULTS:Among the 100 patients included,74 were non-survivors.The non-survivor patients showed a higher presence of gravity-dependent distribution and higher CT scores than survivors(P<0.05).Patients with gravity-dependent distribution had significantly higher CT scores than those with non-gravity-dependent distribution(P<0.05).The combination of CT score and gravity-dependent distribution predicted poor outcomes better than considering the features individually,demonstrating moderate performance(AUC:0.693,95%CI:0.568-0.801).According to the survival analysis,the risk of death increased as the CT score rose,with an estimated cut-off value of≥11(P=0.016).CONCLUSION:Chest CT features were associated with poor outcomes in CA patients following ECPR.展开更多
BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of lif...BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of life.However,the detection of TDs relies primarily on postoperative pathological examination,which may have a low detection rate due to sampling limitations.AIM To evaluate the spectral computed tomography(CT)parameters of primary tu-mors and the largest regional lymph nodes(LNs),to determine their value in predicting TDs in CRC.METHODS A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available.Patients were divided into the TDs+group and the TDs-group on the basis of their pathological results.Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured,including the normalized iodine concentration(NIC)in both the arte-rial and venous phases,and the LN-to-primary tumor ratio was calculated.Stati-stical methods were used to evaluate the diagnostic efficacy of each spectral para-meter.RESULTS Among the 121 CRC patients,33(27.2%)were confirmed to be TDs+.The risk of TDs positivity was greater in patients with positive LN metastasis,higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels.The NIC(LNs in both the arterial and venous phases),NIC(primary tumors in the venous phase),and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs(P<0.05).In mul-tivariate logistic regression analysis,the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs,demonstrating the highest diagnostic performance(area under the curve:0.812,sensitivity:0.879,specificity:0.648,cutoff value:1.145).CONCLUSION The spectral CT parameters of the primary colorectal tumor and the largest regional LNs,especially the LN-to-primary tumor ratio,have significant clinical value in predicting TDs in CRC.展开更多
文摘AIM:To distinguish acinar cell carcinoma(ACC)from pancreatic adenocarcinoma(AC)by comparing their computed tomography findings.METHODS:Patients with ACC and AC were identified on the basis of results obtained using surgically resected pancreatectomy specimens.The preoperative computer tomographic images of 6 acinar cell carcinoma patients and 67 pancreatic adenocarcinoma patients in 4 phases(non-contrast,arterial,portal venous,and delayed phase)were compared.The scan delay times were 40,70,and 120 s for each contrast-enhanced phase.The visual pattern,tomographic attenuation value,and time attenuation curve were assessed and compared between AC and ACC cases using the 2test,Wilcoxon signed-rank test,and Mann Whitney U test.RESULTS:The adenocarcinomas tended to be hypodense in all 4 phases.The acinar cell carcinomas also tended to be hypodense in the 3 contrast-enhancedphases,although their computed tomographic attenuation values were higher.Further,5 of the 6 acinar cell carcinomas(83%)were isodense in the non-contrast phase.The time attenuation curve of the adenocarcinomas showed a gradual increase through the 4 phases,and all adenocarcinomas showed peak enhancement during the delayed phase.The time attenuation curve of the acinar cell carcinomas showed peak enhancement during the portal venous phase in 4 cases and during the arterial phase in 2 cases.None of the 6 acinar cell carcinomas showed peak enhancement during the delayed phase.CONCLUSION:The tumor density in the non-contrast phase and time attenuation curve pattern clearly differ between acinar cell carcinomas and adenocarcinomas,and multidetector-row computed tomography can thus distinguish these tumors.
文摘AIM: To assess the diagnostic accuracy of multidetectorrow computed tomography(MDCT) as compared with conventional magnetic resonance imaging(MRI), in identifying mesorectal fascia(MRF) invasion in rectal cancer patients.METHODS: Ninety-one patients with biopsy proven rectal adenocarcinoma referred for thoracic and abdominal CT staging were enrolled in this study. The contrast-enhanced MDCT scans were performed on a 256 row scanner(ICT, Philips) with the following acquisition parameters: tube voltage 120 KV, tube current 150-300 m As. Imaging data were reviewed as axial and as multiplanar reconstructions(MPRs) images along the rectal tumor axis. MRI study, performed on 1.5 T with dedicated phased array multicoil, included multiplanar T2 and axial T1 sequences and diffusion weighted images(DWI). Axial and MPR CT images independently were compared to MRI and MRF involvement was determined. Diagnostic accuracy of both modalities was compared and statistically analyzed.RESULTS: According to MRI, the MRF was involved in 51 patients and not involved in 40 patients. DWI allowed to recognize the tumor as a focal mass with high signal intensity on high b-value images, compared with the signal of the normal adjacent rectal wall or with the lower tissue signal intensity background. The number of patients correctly staged by the native axial CT images was 71 out of 91(41 with involved MRF; 30 with not involved MRF), while by using the MPR 80 patients were correctly staged(45 with involved MRF; 35 with not involved MRF). Local tumor staging suggested by MDCT agreed with those of MRI, obtaining for CT axial images sensitivity and specificity of 80.4% and 75%, positive predictive value(PPV) 80.4%, negative predictive value(NPV) 75% and accuracy 78%; while performing MPR the sensitivity and specificity increased to 88% and 87.5%, PPV was 90%, NPV 85.36% and accuracy 88%. MPR images showed higher diagnostic accuracy, in terms of MRF involvement, than native axial images, as compared to the reference magnetic resonance images. The difference in accuracy was statistically significant(P = 0.02). CONCLUSION: New generation CT scanner, using high resolution MPR images, represents a reliable diagnostic tool in assessment of loco-regional and whole body staging of advanced rectal cancer, especially in patients with MRI contraindications.
基金Supported by grants from the National Natural Science Foundation of China(No.81271529)the Natural Science Foundation of Hubei Province(No.2014CFB298)the Health and Family Planning Research of Hubei Province(No.WJ2015MB066)
文摘Objective To evaluate the diagnostic value of three-dimensional multidetector-row computed tomogra- phy （MDCT） in detecting acquired renal arteriovenous malformation （RAVM） and to compare its perfor- mance with that of ultrasonography and digital subtraction angiography （DSA）. Methods The institutional review board approved this retrospective study and written informed consent was obtained from all patients before examination. All 14 patients with acquired RAVM underwent MDCT, including cortical and medullary phase enhancement angiography and three-dimensional （3D） reconstruc- tion. Five and nine patients were further examined and their diagnoses confirmed by DSA and surgery, respectively. The MDCT images, including 3D reconstructions, were analyzed for RAVM independently and in consensus by two observers using a workstation. Results Among the 14 patients with acquired RAVM, 12 with maximum lesion diameter 〉 10 mm, and one with a maximum lesion diameter between 5 and 10 ram, were correctly diagnosed with MDCT angiog- raphy. Among these patients, four diagnoses were confirmed by DSA. One patient with a lesion 5-10 mm in diameter was misdiagnosed with a renal aneurysm by MDCT angiography. The other one with the maxi- mum diameter of the lesion between 5 mm and 10 mm was misdiagnosed as renal aneurysm with MDCT angiography, which was diagnosed as renal arteriovenous malformation with DSA. Among 14 lesions in 14 patients, eight and six originated in the left and right kidney, respectively. Conclusion MDCT angiography can accurately diagnose RAVM and improve our understanding of the disease, which will allow clinicians to provide better care.
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.
基金Funded by Chinese National Natural Science Foundation of China(No.U2006224)。
文摘The paper presents experimental investigation results of crack pattern change in cement pastes caused by external sulfate attack(ESA).To visualize the formation and development of cracks in cement pastes under ESA,an X-ray computed tomography(X-ray CT)was used,i e,the tomography system of Zeiss Xradia 510 versa.The results indicate that X-CT can monitor the development process and distribution characteristics of the internal cracks of cement pastes under ESA with attack time.In addition,the C3A content in the cement significantly affects the damage mode of cement paste specimens during sulfate erosion.The damage of ordinary Portland cement(OPC)pastes subjected to sulfate attack with high C3A content are severe,while the damage of sulfate resistant Portland cement(SRPC)pastes is much smaller than that of OPC pastes.Furthermore,a quadratic function describes the correlation between the crack volume fraction and development depth for two cement pastes immermed in sulfate solution.
基金Supported by Natural Science Foundation of Anhui Medical University,No.2023xkj130.
文摘BACKGROUND Mucosal healing(MH)is the major therapeutic target for Crohn's disease(CD).As the most commonly involved intestinal segment,small bowel(SB)assessment is crucial for CD patients.Yet,it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.AIM To establish a noninvasive radiomic model based on computed tomography enterography(CTE)for MH assessment in SBCD patients.METHODS Seventy-three patients diagnosed with SBCD were included and divided into a training cohort(n=55)and a test cohort(n=18).Radiomic features were obtained from CTE images to establish a radiomic model.Patient demographics were analysed to establish a clinical model.A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features.The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic(ROC)curve analysis and decision curve analysis(DCA),respectively.RESULTS Of the 73 patients enrolled,25 patients achieved MH.The radiomic-clinical nomogram had an area under the ROC curve of 0.961(95%confidence interval:0.886-1.000)in the training cohort and 0.958(0.877-1.000)in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone,as demonstrated by DCA.CONCLUSION These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
文摘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.
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.
基金Supported by the Tianjin Science and Technology Project,No.TJWJ2025RC008。
文摘BACKGROUND Malignant pleural mesothelioma(MPM),a rare aggressive malignancy,is primarily caused by asbestos exposure.MPM typically affects older adults(median age,76 years),is uncommon in those under age 50 years and shows male predominance.Based on the American Society of Clinical Oncology guidelines,F-18 fluorodeoxyglucose positron emission tomography/computed tomography(F-18 FDG PET/CT)is essential for initial MPM staging.Integrating quantitative FDG metabolic data with computed tomography(CT)anatomy optimizes biopsy accuracy and staging.CASE SUMMARY A 21-year-old female college student presented with fever(peak 38.4°C),cough,and white mucoid sputum after cold exposure.Initial evaluation revealed elevated C-reactive protein[C-reactive protein(CRP);65.52 mg/L]and Mycoplasma pneumoniae IgM.Despite resolution of fever following a 14-day moxifloxacin regimen,persistent cough prompted chest CT,which demonstrated left pleural mass-like thickenings.Levofloxacin therapy for 2 weeks failed to alleviate symptoms,accompanied by 2.5-kg weight loss over 1 month.Re-evaluation showed rising CRP(88.87 mg/L)with stable CT lesions,and negative T-cell spot test for tuberculosis and tumor markers.Contrast-enhanced CT revealed heterogeneously enhancing masses,while PET/CT detected two broad-based pleural lesions with intense FDG avidity.CT-guided biopsy confirmed epithelioid MPM.Thoracoscopy exposed diffuse fragile,hemorrhagic nodules implanting on diaphragmatic and parietal pleura,confirming metastatic MPM with partial resection performed.This presentation challenges conventional imaging paradigms of MPM,underscoring its diagnostic complexity.CONCLUSION MPM should still be considered an important differential diagnosis in young patients presenting with solitary pleural masses and no history of typical asbestos exposure.F-18 FDG PET/CT,while serving as an essential component of initial staging for MPM,has some inherent limitations.
基金supported in part by the National Natural Science Foundation of China under Grants 62472434 and 62402171in part by the National Key Research and Development Program of China under Grant 2022YFF1203001+1 种基金in part by the Science and Technology Innovation Program of Hunan Province under Grant 2022RC3061in part by the Sci-Tech Innovation 2030 Agenda under Grant 2023ZD0508600.
文摘Computed Tomography(CT)reconstruction is essential inmedical imaging and other engineering fields.However,blurring of the projection during CT imaging can lead to artifacts in the reconstructed images.Projection blur combines factors such as larger ray sources,scattering and imaging system vibration.To address the problem,we propose DeblurTomo,a novel self-supervised learning-based deblurring and reconstruction algorithm that efficiently reconstructs sharp CT images from blurry input without needing external data and blur measurement.Specifically,we constructed a coordinate-based implicit neural representation reconstruction network,which can map the coordinates to the attenuation coefficient in the reconstructed space formore convenient ray representation.Then,wemodel the blur as aweighted sumof offset rays and design the RayCorrectionNetwork(RCN)andWeight ProposalNetwork(WPN)to fit these rays and their weights bymulti-view consistency and geometric information,thereby extending 2D deblurring to 3D space.In the training phase,we use the blurry input as the supervision signal to optimize the reconstruction network,the RCN,and the WPN simultaneously.Extensive experiments on the widely used synthetic dataset show that DeblurTomo performs superiorly on the limited-angle and sparse-view in the simulated blurred scenarios.Further experiments on real datasets demonstrate the superiority of our method in practical scenarios.
基金Supported by National Natural Science foundation of China,No.82202135,No.82371919,No.82372017,and No.82171925China Postdoctoral Science Foundation,No.2023M741808+4 种基金Young Elite Scientists Sponsorship Program by China Association of Chinese Medicine,No.2024-QNRC2-B16Jiangsu Provincial Key Research and Development Program,No.BE2023789Young Elite Scientists Sponsorship Program by Jiangsu Association for Science and Technology,No.JSTJ-2023-WJ027Project funded by Nanjing Postdoctoral Science Foundation,Natural Science Foundation of Nanjing University of Chinese Medicine,No.XZR2023036Foundation of Excellent Young Doctor of Jiangsu Province Hospital of Chinese Medicine,No.2023QB0112.
文摘BACKGROUND Lymph node metastasis(LNM)is a key prognostic factor in pancreatic cancer(PC).Accurate preoperative prediction of LNM remains challenging.Radiomics offers a noninvasive method to extract quantitative imaging features that may aid in predicting LNM.AIM To investigate the potential value of a computed tomography(CT)-based radiomics model in prediction of LNM in PC.METHODS A retrospective analysis was performed on 168 pathologically confirmed PC patients who underwent contrast-enhanced-CT.Among them,107 cases had no LNM,while 61 cases had confirmed LNM.These patients were randomly divided into a training cohort(n=135)and a validation cohort(n=33).A total of 792 radiomics features were extracted,comprising 396 features from the arterial phase and another 396 from the portal venous phase.The Minimum Redundancy Maximum Relevance and Least Absolute Shrinkage and Selection Operator methods were used for feature selection and Radiomics model construction.The receiver operating characteristic curve was employed to assess the diagnostic potential of the model,and DeLong test was used to compare the area under the curve(AUC)values of the model.RESULTS Six radiomics features from the arterial phase and nine from the portal venous phase were selected.The Radscore model demonstrated strong predictive performance for LNM in both the training and test cohorts,with AUC values ranging from 0.86 to 0.94,sensitivity between 66.7% and 91.7%,specificity from 71.4% to 100.0%,accuracy between 78.8%and 91.1%,PPV ranging from 64.7% to 100.0%,and negative predictive value between 84.0% and 93.8%.No significant differences in AUC values were observed between the arterial and portal venous phases in either the training or test set.CONCLUSION The preoperative CT-based radiomics model exhibited robust predictive capability for identifying LNM in PC.
文摘Computed tomography(CT)can inspect the internal structure of concrete with high resolution,but improving the accuracy of measurements remains a key challenge due to the reliance on complex image processing and significant manual intervention.This study aims to optimize CT scanning parameters to enhance the accuracy of measuring crack widths and rebar volumes in reinforced concrete.Nine sets of specimens,each with varying rebar diameters and concrete cover thicknesses,were scanned before and after corrosion using an Optima CT scanner,followed by three-dimensional reconstructions using Avizo software.The effects of threshold values and“Erosion”coefficients on measurement accuracy were evaluated.The results demonstrated that an optimal lower threshold of 2950,combined with an‘Erosion’coefficient of 6,effectively limits the measurement error of rebar volumes to within 1%.The optimal threshold for measuring crack widths was influenced by the crack width,rebar diameter,and concrete cover thickness.Additionally,an optimized formula for determining crack measurement thresholds was proposed.This study significantly improves the accuracy of CT-based non-destructive testing(NDT)techniques,providing valuable insights for structural health monitoring(SHM).
基金Supported by the National Natural Science Foundation of China,No.82101985.
文摘BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.METHODS Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically.Imaging characteristics,including tumor location,size,contour,ulceration,growth pattern,enhancement degree and pattern,cystic change,calcification,and perigastric lymph nodes(PLNs),were reviewed by two experienced radiologists.RESULTS Our sample included 18 females and 5 males,with a median age of 54.7 years.A total of 39.1%of cases were asymptomatic.GSs appeared as oval and well-defined submucosal tumors,with exophytic(43.5%)or mixed(endoluminal+exophytic;43.5%)growth patterns.The tumors were primarily located in the gastric body(78.3%).Ulcerations were observed in 8 cases(34.5%),and PLNs were observed in 15 cases(65%).The average degree of enhancement was 48.3 Hounsfield units.Twenty cases(87%)showed peak enhancement in the delayed phase.Most GSs were homogeneous,while cystic change(13.0%)and calcification(17.4%)were rare.CONCLUSION GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase.PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.
文摘BACKGROUND Effective management of liver abscess depends on timely drainage,which is influenced by the liquefaction degree.Identifying predictive factors is crucial for guiding clinical decisions.AIM To investigate the predictive factors of liver abscess liquefaction and develop a predictive model to guide optimal timing of percutaneous drainage.METHODS This retrospective study included 110 patients with pyogenic liver abscesses who underwent percutaneous catheter drainage.Patients were divided into a poor liquefaction group(n=28)and a well liquefaction group(n=82)based on the ratio of postoperative 24-hour drainage volume to abscess volume,using a cutoff value of 0.3.Clinical characteristics,laboratory indicators,and computed tomography imaging features were compared.A predictive model was constructed using logistic regression and evaluated using receiver operating characteristic curves and five-fold cross-validation.RESULTS Independent predictive factors for good liquefaction included the absence of diabetes[odds ratio(OR)=0.339,P=0.044],absence of pneumonia(OR=0.218,P=0.013),left-lobe abscess location(OR=4.293,P=0.041),cystic features(OR=5.104,P=0.025),and elevated preoperative serum alanine aminotransferase(ALT)levels(OR=1.013,P=0.041).The logistic regression model based on these factors demonstrated an area under the curve of 0.814,with a sensitivity of 90.24%and specificity of 67.86%.Five-fold cross-validation yielded an average accuracy of 83.61%and a kappa coefficient of 0.5209.CONCLUSION Pneumonia,diabetes,abscess location,abscess composition,and preoperative serum ALT levels are significant predictors of liver abscess liquefaction.The model can guide clinical decision-making.
基金approved by the Ethics Committee of the First Affiliated Hospital of Nanjing Medical University(2020-SR-226).
文摘BACKGROUND:Previous studies have reported that early computed tomography(CT)findings significantly contribute to the outcomes of cardiac arrest(CA)patients.This study aims to evaluate the association between chest CT features and prognosis in CA patients treated with extracorporeal cardiopulmonary resuscitation(ECPR).METHODS:A retrospective observational study was conducted on adult CA patients treated with ECPR in a tertiary hospital between March 2015 and June 2023.All the patients underwent a wholebody CT scan within 1 h of ECPR.Data regarding demographic and clinical characteristics were collected from electronic medical records.The presence of gravity-dependent distribution and CT scores based on chest CT scans were determined for each patient.The primary outcome was 28-day survival.Receiver operating characteristic(ROC)curves were used to evaluate the ability of chest CT features(gravitydependent distribution and CT scores)to predict poor outcomes.The cut-off value of the CT score was determined.Kaplan-Meier curves were used to compare 28-day survival between the low-and high-CT score groups,which were classified using the estimated cut-off value.RESULTS:Among the 100 patients included,74 were non-survivors.The non-survivor patients showed a higher presence of gravity-dependent distribution and higher CT scores than survivors(P<0.05).Patients with gravity-dependent distribution had significantly higher CT scores than those with non-gravity-dependent distribution(P<0.05).The combination of CT score and gravity-dependent distribution predicted poor outcomes better than considering the features individually,demonstrating moderate performance(AUC:0.693,95%CI:0.568-0.801).According to the survival analysis,the risk of death increased as the CT score rose,with an estimated cut-off value of≥11(P=0.016).CONCLUSION:Chest CT features were associated with poor outcomes in CA patients following ECPR.
文摘BACKGROUND Tumor deposits(TDs)are an independent predictor of poor prognosis in colorec-tal cancer(CRC)patients.Enhanced follow-up and treatment monitoring for TD+patients may improve survival rates and quality of life.However,the detection of TDs relies primarily on postoperative pathological examination,which may have a low detection rate due to sampling limitations.AIM To evaluate the spectral computed tomography(CT)parameters of primary tu-mors and the largest regional lymph nodes(LNs),to determine their value in predicting TDs in CRC.METHODS A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available.Patients were divided into the TDs+group and the TDs-group on the basis of their pathological results.Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured,including the normalized iodine concentration(NIC)in both the arte-rial and venous phases,and the LN-to-primary tumor ratio was calculated.Stati-stical methods were used to evaluate the diagnostic efficacy of each spectral para-meter.RESULTS Among the 121 CRC patients,33(27.2%)were confirmed to be TDs+.The risk of TDs positivity was greater in patients with positive LN metastasis,higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels.The NIC(LNs in both the arterial and venous phases),NIC(primary tumors in the venous phase),and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs(P<0.05).In mul-tivariate logistic regression analysis,the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs,demonstrating the highest diagnostic performance(area under the curve:0.812,sensitivity:0.879,specificity:0.648,cutoff value:1.145).CONCLUSION The spectral CT parameters of the primary colorectal tumor and the largest regional LNs,especially the LN-to-primary tumor ratio,have significant clinical value in predicting TDs in CRC.
