目的:探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者CT平扫(non-contrast computed tomography,NCCT)Alberta卒中项目早期CT评分(Alberta stroke program early computed tomography score,ASPECTS)与CT灌注成像(CT perfusion,C...目的:探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者CT平扫(non-contrast computed tomography,NCCT)Alberta卒中项目早期CT评分(Alberta stroke program early computed tomography score,ASPECTS)与CT灌注成像(CT perfusion,CTP)梗死核心体积不匹配的影响因素及预后特征。方法:回顾性分析2019年10月—2023年8月449例行NCCT及CTP评估的前循环大血管闭塞型AIS患者的临床及影像资料。采用RAPID软件自动计算NCCT-ASPECTS和CTP梗死核心体积。“NCCT-CTP不匹配”定义为低NCCT-ASPECTS、小梗死核心体积(low ASPECTS and small ischemic core volume,LASC)(NCCT-ASPECTS<6分,CTP梗死核心体积<70 mL)以及高NCCT-ASPECTS、大梗死核心体积(high ASPECTS and large ischemic core volume,HALC)(NCCT-ASPECTS≥6分,CTP梗死核心体积≥70 m L)。采用血管内取栓治疗(endovascular thrombectomy,EVT)后90 d随访基线改良Rankin量表(mRS)评分0~2分定义预后良好。采用多因素逻辑回归分析NCCT-CTP不匹配的独立影响因素。结果:449例AIS患者中有145例出现NCCT-CTP不匹配,其中52例(35.9%)患者血管内取栓治疗(endovascular thrombectomy,EVT)后获得良好预后。多因素逻辑回归分析结果提示,影像评估前接受静脉溶栓(intravenous thrombolysis,IVT)(OR=1.833;95%CI:1.205~2.790,P=0.005)、更高的基线NIHSS评分(OR=1.055;95%CI:1.028~1.083,P<0.001)是AIS患者出现NCCT-CTP不匹配的独立影响因素。NCCT-CTP不匹配亚组分析提示,LASC患者卒中发病至基线影像检查的时间间隔大于HALC患者[306(219,482)min vs.125(63,307)min;P=0.004]。LASC患者EVT术后出血性脑梗死发生率高于HALC患者(66.9%vs.33.3%;P=0.021)。结论:约35%的NCCT-CTP不匹配患者可从EVT中获益。影像评估前接受IVT以及更高的基线NIHSS评分是出现NCCT-CTP不匹配的独立影响因素。展开更多
Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This...Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB.Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment,at treatment completion and five years post-treatment.Assessments included lung function and chest CT,analyzing longitudinal trends and airflow obstruction risk factors.Results Among 53 patients(mean age 36.9±13.9 years;64.2%male),7 patients(13.2%)exhibited airflow obstruction.At the 5-year follow-up,the mean FEV_(1)/FVC declined significantly(76.27%±12.04%vs.80.23%±11.02%,P<0.001)and 9 patients(17.0%)exhibited airflow obstruction.Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT,aligning with TB-COPD phenotype.Notably,four young-to-middle-aged patients(<60 years old)had persistent obstruction over the five years.Conclusion The initial test revealed that 13.2%of patients presented with airflow obstruction.By the 5-year follow-up,this proportion had increased to 17.0%,with most cases demonstrating imaging findings aligning with TB-COPD,even among younger,non-smoking individuals.These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.展开更多
Albira SI小动物单光子发射断层显像-X线计算机体层成像仪(SPECT-CT)是单光子放射性药物临床前研究的先进影像工具,其质量控制及检测性能是图像质量和实验数据可靠性的基本保障。为评价Albira SI SPECT-CT设备应用的真实性、可靠性,采...Albira SI小动物单光子发射断层显像-X线计算机体层成像仪(SPECT-CT)是单光子放射性药物临床前研究的先进影像工具,其质量控制及检测性能是图像质量和实验数据可靠性的基本保障。为评价Albira SI SPECT-CT设备应用的真实性、可靠性,采用临床常用单光子核素^(99m)Tc对Albira SI小动物SPECT-CT进行季度性质量控制,同时进行测量结果的线性、稳定性、偏差的检测,并初步尝试小动物骨代谢扫描。结果表明,该设备与放射性活度之间线性关系良好,稳定性强,与常用活度测量设备测量结果差异较小。Albira SI小动物SPECT-CT能够准确反映单光子核素^(99m)Tc的放射性活度分布,小鼠骨代谢显像效果好,适用于临床前放射性药物研究。本研究中建立的系统研究SPECT-CT性能的方法可为类似设备的操作提供方法学依据。展开更多
目的评估SPECT/CT骨显像结合定量分析在SAHPO综合征(Synovitis,acne,pustulosis,hyperostosis and osteitis,SAPHO)诊疗中的临床应用价值。方法纳入自2023-05—2024-12临床确诊的35例SAPHO综合征,收集患者详细资料,包括存在骨关节症状...目的评估SPECT/CT骨显像结合定量分析在SAHPO综合征(Synovitis,acne,pustulosis,hyperostosis and osteitis,SAPHO)诊疗中的临床应用价值。方法纳入自2023-05—2024-12临床确诊的35例SAPHO综合征,收集患者详细资料,包括存在骨关节症状的部位、发病时间、有无皮肤改变等,所有患者均进行全身骨显像及局部病灶SPECT/CT检查,通过数据处理软件获取SUV参数,记录显像前后1周内红细胞沉降率、C-反应蛋白,分析比较SPECT/CT图像及定量参数与临床数据的相关性。结果全身骨显像显示所有患者均存在前胸壁不同程度放射性摄取增多,SPECT/CT融合图像能够清晰显示各部位骨质改变及代谢情况,表现为前胸壁骨质破坏、硬化、肥厚,关节间隙变窄或消失,肋软骨或肋锁韧带骨化,伴或不伴周围软组织肿胀。SPECT/CT定量参数SUVmax与红细胞沉降率呈正相关(r=0.338,P=0.047),SUVmax与C-反应蛋白呈正相关(r=0.346,P=0.042)。结论SPECT/CT骨显像能够全面显示SAPHO综合征骨关节受累及局部骨质破坏、修复状况,较平面骨显像更为准确,结合SUV定量摄取值可以更为直观显示受累骨骼的代谢状态,但是其与病变所处阶段及临床症状间的关联性还需深入探讨。展开更多
文摘目的:探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者CT平扫(non-contrast computed tomography,NCCT)Alberta卒中项目早期CT评分(Alberta stroke program early computed tomography score,ASPECTS)与CT灌注成像(CT perfusion,CTP)梗死核心体积不匹配的影响因素及预后特征。方法:回顾性分析2019年10月—2023年8月449例行NCCT及CTP评估的前循环大血管闭塞型AIS患者的临床及影像资料。采用RAPID软件自动计算NCCT-ASPECTS和CTP梗死核心体积。“NCCT-CTP不匹配”定义为低NCCT-ASPECTS、小梗死核心体积(low ASPECTS and small ischemic core volume,LASC)(NCCT-ASPECTS<6分,CTP梗死核心体积<70 mL)以及高NCCT-ASPECTS、大梗死核心体积(high ASPECTS and large ischemic core volume,HALC)(NCCT-ASPECTS≥6分,CTP梗死核心体积≥70 m L)。采用血管内取栓治疗(endovascular thrombectomy,EVT)后90 d随访基线改良Rankin量表(mRS)评分0~2分定义预后良好。采用多因素逻辑回归分析NCCT-CTP不匹配的独立影响因素。结果:449例AIS患者中有145例出现NCCT-CTP不匹配,其中52例(35.9%)患者血管内取栓治疗(endovascular thrombectomy,EVT)后获得良好预后。多因素逻辑回归分析结果提示,影像评估前接受静脉溶栓(intravenous thrombolysis,IVT)(OR=1.833;95%CI:1.205~2.790,P=0.005)、更高的基线NIHSS评分(OR=1.055;95%CI:1.028~1.083,P<0.001)是AIS患者出现NCCT-CTP不匹配的独立影响因素。NCCT-CTP不匹配亚组分析提示,LASC患者卒中发病至基线影像检查的时间间隔大于HALC患者[306(219,482)min vs.125(63,307)min;P=0.004]。LASC患者EVT术后出血性脑梗死发生率高于HALC患者(66.9%vs.33.3%;P=0.021)。结论:约35%的NCCT-CTP不匹配患者可从EVT中获益。影像评估前接受IVT以及更高的基线NIHSS评分是出现NCCT-CTP不匹配的独立影响因素。
基金supported by the National Science and Technology Major Project for the Prevention and Control of Emerging and Major Infectious Diseases[2025ZD01908702]Peking University Medicine Fund of Fostering Young Scholars’Scientific&Technological innovation[BMU2024YFJHP014]supported by Fundamental Research Funds for the Central Universities+1 种基金Key Clinical Projects of Peking University Third Hospital[BYSYZD2022014]Peking University Third Hospital[2025024].
文摘Objective Post tuberculosis lung disease(PTLD)manifests in various forms,including tuberculosisassociated chronic obstructive pulmonary disease(TB-COPD),yet the clinical features of PTLD remain undercharacterized.This study aimed to assess longitudinal changes in lung function over a 5-year period and to identify predictors of airflow obstruction in a cohort of patients treated for active pulmonary TB.Methods Patients with active pulmonary TB were enrolled in this study and were followed during treatment,at treatment completion and five years post-treatment.Assessments included lung function and chest CT,analyzing longitudinal trends and airflow obstruction risk factors.Results Among 53 patients(mean age 36.9±13.9 years;64.2%male),7 patients(13.2%)exhibited airflow obstruction.At the 5-year follow-up,the mean FEV_(1)/FVC declined significantly(76.27%±12.04%vs.80.23%±11.02%,P<0.001)and 9 patients(17.0%)exhibited airflow obstruction.Seven of these patients predominantly showed air trapping consistent with small airway disease on chest CT,aligning with TB-COPD phenotype.Notably,four young-to-middle-aged patients(<60 years old)had persistent obstruction over the five years.Conclusion The initial test revealed that 13.2%of patients presented with airflow obstruction.By the 5-year follow-up,this proportion had increased to 17.0%,with most cases demonstrating imaging findings aligning with TB-COPD,even among younger,non-smoking individuals.These findings emphasize the importance of long-term follow-up and routine lung function assessments in TB survivors.
文摘目的评估SPECT/CT骨显像结合定量分析在SAHPO综合征(Synovitis,acne,pustulosis,hyperostosis and osteitis,SAPHO)诊疗中的临床应用价值。方法纳入自2023-05—2024-12临床确诊的35例SAPHO综合征,收集患者详细资料,包括存在骨关节症状的部位、发病时间、有无皮肤改变等,所有患者均进行全身骨显像及局部病灶SPECT/CT检查,通过数据处理软件获取SUV参数,记录显像前后1周内红细胞沉降率、C-反应蛋白,分析比较SPECT/CT图像及定量参数与临床数据的相关性。结果全身骨显像显示所有患者均存在前胸壁不同程度放射性摄取增多,SPECT/CT融合图像能够清晰显示各部位骨质改变及代谢情况,表现为前胸壁骨质破坏、硬化、肥厚,关节间隙变窄或消失,肋软骨或肋锁韧带骨化,伴或不伴周围软组织肿胀。SPECT/CT定量参数SUVmax与红细胞沉降率呈正相关(r=0.338,P=0.047),SUVmax与C-反应蛋白呈正相关(r=0.346,P=0.042)。结论SPECT/CT骨显像能够全面显示SAPHO综合征骨关节受累及局部骨质破坏、修复状况,较平面骨显像更为准确,结合SUV定量摄取值可以更为直观显示受累骨骼的代谢状态,但是其与病变所处阶段及临床症状间的关联性还需深入探讨。
