Nondestructive and three-dimensional visualization by identifying elements using synchrotron radiation microscale X-ray CT reveals microbial and cavity distributions in anaerobic granular sludge.

We developed a nondestructive three-dimensional microbial visualization method utilizing synchrotron radiation X-ray microscale computed tomography to better understand the relationship between microorganisms and their surrounding habitats. The method was tested and optimized using a mixture of axenic Escherichia coli and Comamonas testosteroni. The osmium-thiocarbohydrazide-osmium method was used to stain all the microbial cells, and gold in situ hybridization was used to detect specific phylogenetic microbial groups. The stained samples were embedded in epoxy resin for microtomographic analysis. Differences in X-ray absorbances were calculated by subtracting the pre-L3-edge images from the post-L3-edge images to visualize the osmium and gold signals. Although we successfully detected cells stained with osmium, those labeled with gold were not detected, probably because of the insufficient density of gold atoms in the microbial cells. We then applied the developed technique to anaerobic granules and visualized the distribution of microbial cells and extracellular polymeric substances. Empty spaces were highlighted to determine the cavity distribution in granules. Numerous independent cavities of different sizes were identified in the granules. The developed method can be applied to various environmental samples for deeper insights into microbial life in their habitats. IMPORTANCE: Microorganisms inhabit diverse environments and often form biofilms. One factor that affects their community structure is the surrounding physical environment. The arrangement of residential space within the formed biofilm plays a crucial role in the supply and transportation of substances, as well as the discharge of metabolites. Conventional approaches, such as scanning electron microscopy and confocal laser scanning microscopy combined with fluorescence in situ hybridization, have limitations as they provide information primarily from the biofilm surface and cross-sections. In this study, we developed a method for detecting microorganisms in biofilms using synchrotron radiation X-ray microscale computer tomography. The developed method allows nondestructive three-dimensional observation of biofilms at a single-cell resolution (voxel size of approximately 200 nm), facilitating an understanding of the relationship between microorganisms and their physical habitats.

Peripheral blood eosinophils: an important reference for radiologists to distinguish between pulmonary paragonimiasis and tuberculous pleurisy in children.

OBJECTIVE: In this study, we examined the value of chest CT signs combined with peripheral blood eosinophil percentage in differentiating between pulmonary paragonimiasis and tuberculous pleurisy in children. METHODS: Patients with pulmonary paragonimiasis and tuberculous pleurisy were retrospectively enrolled from January 2019 to April 2023 at the Kunming Third People's Hospital and Lincang People's Hospital. There were 69 patients with pulmonary paragonimiasis (paragonimiasis group) and 89 patients with tuberculous pleurisy (tuberculosis group). Clinical symptoms, chest CT imaging findings, and laboratory test results were analyzed. Using binary logistic regression, an imaging model of CT signs and a combined model of CT signs and eosinophils were developed to calculate and compare the differential diagnostic performance of the two models. RESULTS: CT signs were used to establish the imaging model, and the receiver operating characteristic (ROC) curve was plotted. The area under the curve (AUC) was 0.856 (95% CI: 0.799-0.913), the sensitivity was 66.7%, and the specificity was 88.9%. The combined model was established using the CT signs and eosinophil percentage, and the ROC was plotted. The AUC curve was 0.950 (95% CI: 0.919-0.980), the sensitivity was 89.9%, and the specificity was 90.1%. The differential diagnostic efficiency of the combined model was higher than that of the imaging model, and the difference in AUC was statistically significant. CONCLUSION: The combined model has a higher differential diagnosis efficiency than the imaging model in the differentiation of pulmonary paragonimiasis and tuberculous pleurisy in children. The presence of a tunnel sign on chest CT, the absence of pulmonary nodules, and an elevated percentage of peripheral blood eosinophils are indicative of pulmonary paragonimiasis in children.

Evaluating the consistency in different methods for measuring left atrium diameters.

BACKGROUND: The morphological information of the pulmonary vein (PV) and left atrium (LA) is of immense clinical importance for effective atrial fibrillation ablation. The aim of this study is to examine the consistency in different LA diameter measurement techniques. METHODS: Retrospective imaging data from 87 patients diagnosed with PV computed tomography angiography were included. The patients consisted of 50 males and 37 females, with an average age of (60.74 ± 8.70) years. Two physicians independently measured the anteroposterior diameter, long diameter, and transverse diameter of the LA using six different methods. Additionally, we recorded the post-processing time of the images. Physician 1 conducted measurements twice with a one-month interval between the measurements to assess intra-rater reliability. Using the intraclass correlation coefficient (ICC), the consistency of each LA diameter measurement by the two physicians was evaluated. We compared the differences in the LA diameter and the time consumed for measurements using different methods. This was done by employing the rank sum test of a randomized block design (Friedman M test) and the q test for pairwise comparisons among multiple relevant samples. RESULTS: (1) The consistency of the measured LA diameter by the two physicians was strong or very strong. (2) There were statistical differences in the anteroposterior diameter, long diameter, and transverse diameter of LA assessed using different methods (χ2 = 222.28, 32.74, 293.83, P < 0.001). (3) Different methods for measuring the diameters of LA required different amounts of time (χ2 = 333.10, P < 0.001). CONCLUSION: The results of left atrium (LA) diameter measurements conducted by different physicians were found to be reliable. However, the LA diameters obtained through various techniques exhibited variations. It was observed that measuring LA long diameters using only the VR (volume rendering) picture was the most clinically applicable method.

CT features of calcified micro-gastric gastrointestinal stromal tumors: a case series.

BACKGROUND: Due to the lack of corresponding clinical symptoms, small calcified gastric gastrointestinal stromal tumors (GISTs) are often overlooked in clinical practice. Therefore, there is an unmet need to define the imaging features of calcified micro-gastric GISTs to facilitate diagnosis. This study retrospectively analyzed the computed tomography (CT) features of pathologically confirmed calcified micro-gastric GISTs. METHODS: The medical records (gastroscopy, pre-treatment gastric CT imaging [pre- and post-contrast scans], pathology) of patients with calcified gastric GISTs < 1 cm in diameter confirmed pathologically after endoscopic submucosal dissection, endoscopic submucosal excavation, or endoscopic full-thickness resection were retrospectively reviewed. RESULTS: Seven patients had 8 calcified gastric GISTs < 1 cm in diameter. Six patients hadsingle lesions, and 1patients had multiple lesions. Six patients had lesions in the gastric fundus, 1 patient had a lesion in the body of the stomach. Lesions had a mean diameter of 5.2 mm (range, 1.3 mm ~ 7 mm). Unenhanced CT scans showed spots and high-density nodular calcifications in 3 submucosal lesions, 2 lesions in the muscularis propria, and 3 subserosal lesions that protruded outside the stomach. Among the 8 lesions, only two had solid soft tissue components surrounding the calcification, with one of these two showing post contrast enhancement of the solid soft tissue component. CONCLUSIONS: Novel CT features of gastric GISTs included: commonly found in the gastric antrum, small size (< 1 cm in diameter), calcification, few solid soft tissue components, and no abnormal enhancement in most cases.

Diagnostic value of computed tomography and magnetic resonance imaging in ovarian malignant mesothelioma.

OBJECTIVE: To investigate the diagnostic value of computed tomography (CT) and magnetic resonance imaging (MRI) in ovarian malignant mesothelioma (OMM). METHODS: The clinical and imaging data of 10 pathologically-confirmed OMM patients were analyzed retrospectively. RESULT: (1) The patients were 27 years to 70 years old, with an average age of 57.2 ± 15.4 years. Seven patients reported abdominal distension and pain, 1 reported lower abdominal discomfort and decreased appetite, and 2 patients had no symptoms. (2) Two cases of localized OMM with incomplete semi-annular "capsule" observed around the localized OMM tumors were reported while 8 cases had diffuse OMM in which the tumor parenchyma showed isointense or slightly hypointense on T1WI, inhomogeneous hyperintense on T2WI, and obviously hyperintense on DWI, with obvious inhomogeneous enhancement after enhancement. Diffuse OMM was not mainly composed of ovarian masses and was mainly characterized by mild ovarian enlargement, nodular and irregular thickening of the peritoneum, cloudy omentum, unclear fat gap, and reticular or irregular thickening, which can fuse into a "cake-shape". (3) All 10 patients underwent surgery, while 9 patients underwent systemic chemotherapy or immunotherapy after surgery. All patients with localized OMM survived. Out of the 8 diffuse-type patients, 5 died, 1 was lost to follow-up, and 2 survived. CONCLUSION: OMM has certain clinical and imaging characteristics. There is no liquefaction, calcification, or partition in the tumor. The ovarian enlargement in the diffuse lesion is not significant. The diffuse thickening of the peritoneum and omentum with early appearance of mural nodules and ascites in the upper abdomen, help the diagnosis of OMM.

Characterizing the Internal Structure of Chinese Steamed Bread during Storage for Quality Evaluation Using X-ray Computer Tomography.

Chinese steamed bread (CSB) is a traditional food of the Chinese nation, and the preservation of its quality and freshness during storage is very important for its industrial production. Therefore, it is necessary to study the storage characteristics of CSB. Non-destructive CT technology was utilized to characterize and visualize the microstructure of CSB during storage, and also to further study of quality changes. Two-dimensional and three-dimensional images of CSBs were obtained through X-ray scanning and 3D reconstruction. Morphological parameters of the microstructure of CSBs were acquired based on CT image using image processing methods. Additionally, commonly used physicochemical indexes (hardness, flexibility, moisture content) for the quality evaluation of CSBs were analyzed. Moreover, a correlation analysis was conducted based on the three-dimensional morphological parameters and physicochemical indexes of CSBs. The results showed that three-dimensional morphological parameters of CSBs were negatively correlated with moisture content (Pearson correlation coefficient range-0.86~-0.97) and positively correlated with hardness (Pearson correlation coefficient range-0.87~0.99). The results indicate the inspiring capability of CT in the storage quality evaluation of CSB, providing a potential analytical method for the detection of quality and freshness in the industrial production of CSB.

[Clinical Application of "Three-Low" Technique Combined with Artificial Intelligence Iterative Reconstruction Algorithm in Aortic CT Angiography].

Objective: To explore the application value of the "three-low" technique (low radiation dose, low contrast agent dosage and low contrast agent flow rate) combined with artificial intelligence iterative reconstruction (AIIR) in aortic CT angiography (CTA). Methods: A total of 33 patients who underwent aortic CTA were prospectively enrolled. Based on the time of their follow-up examinations, the imaging data were divided into Group A and Group B, with Group A being the control group (100 kV, 0.8 mL/kg, 5 mL/s) and Group B being the "three-low" technique group (70 kV, 0.5 mL/kg, 3 mL/s). In group A, the images were reconstructed by Karl iterative algorithm. Group B was divided into B1 and B2 subgroups, with their images being reconstructed by Karl iterative algorithm and AIIR, respectively. The CT and SD values of the ascending aorta, descending aorta, abdominal aorta, left common iliac artery and right common iliac artery were measured, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. The subjective scoring of image quality was performed. The radiation dose parameters were documented. Results: Differences in the CT value, SD value, SNR and CNR of the three groups were statistically significant ( P<0.001). The CT value, SNR and CNR of group B2 were significantly higher than those of group B1, while the SD value of group B2 was significantly lower than that of group B1 ( P<0.017). There was no significant difference between the CT values of group A and those of group B2 ( P>0.017). The SD values, SNR and CNR in group B2 were better than those in group A ( P>0.017). There was significant difference in the subjective evaluation of image quality among the three groups ( P<0.05), but there was no significant difference between group A and group B2 ( P>0.017). The radiation dose and contrast medium dosage in group B decreased 84.14% and 37.08%, respectively, compared with those of group A. Conclusion: With the "three-low" technique combined with AIIR algorithm, the image quality of aortic CTA obtained is comparable to that of conventional dose scanning, while the radiation dose, contrast agent dosage and contrast agent flow rate of patients are significantly reduced.

Morphological response of the red palm weevil, Rhynchophorus ferrugineus, to a transient low temperature analyzed by computer tomography and holographic microscopy.

The red palm weevil (RPW), Rhynchophorus ferrugineus, is one of the worst palm pests worldwide. Our study aims to assess its internal and external morphological response to a sudden but transient decrease in the environmental temperature. Wild pre-pupae were subjected for 7 days to either low (5.0 ± 0.5 °C) or ambient temperature (23 ± 1 °C). Such conditions mimic a thermal anomaly happening in the larval stage most exposed to environmental factors. We quantified the changes undergone at: 1) the internal morphology, by X-Ray Computer Tomography (CT); 2) the 3-D integument' architecture, by Digital Holographic Microscopy (DHM); and 3) the glucose in hemolymph as a potential endogenous cryoprotectant. From X-ray CT we found that both pre-pupae subjected to cold and those remaining at ambient temperature follow a development where their fat body content decreases while a thick and dense cuticle is formed. There was no difference between both groups in the rate of change of fat body/dense tissues. Nevertheless, the cold group presents a slight developmental delay at the level of hemolymph content. Through DHM we again obtained that pre-pupae subjected to cold have not experienced a stop in their development. However, a more obvious developmental delay is now observed in this group at the level of the integumental roughness. Finally, regarding glucose, we found similar levels in control and ambient temperature larvae, while it was clearly increased in 51,7% of those subjected to cold. Our whole results provide morphological and biochemical evidence showing that the larval-pupal transition of the RPW continues almost undisturbed even during the quiescent state induced by a sudden and severe cold event. Nevertheless, a certain developmental delay is observed in both internal and external morphology. Additionally, the increased glucose level only found in the cold group suggests that glucose is part of the RPW cold tolerance strategy.

Alkalinity and Its Consequences for the Performance of Steel-Reinforced Geopolymer Materials.

This paper investigates the development of the alkalinity and its impact on carbon steel reinforcement embedded in alkali-activated fly ashes (AAFA) and alkali-activated fly ashes with ten percentage mass (wt%) of blast furnace slag (AAFAS)-based materials (geopolymer-GP). The pH analysis of eluates indicates a remarkable decrease of alkalinity in AAFA and AAFAS in the first hours of the geopolymerization process. Phenolphthalein solution and pore solution tests on concretes also show a sharp decrease of alkalinity with increased Ca content in the binder due to carbonation. Micro X-ray computer tomography (µXCT) and electrochemical techniques indicate that the changed pH in the GP systems was accompanied by a decrease in the corrosion rates of steel reinforcement when compared to ordinary Portland cement (OPC) systems. In contrast to calcite and vaterite, which were detected in OPC and AAFAS after a carbonation process, only sodium carbonate natron was determined at lower levels in AAFA by X-ray diffraction (XRD).

Application of MRI and CT Energy Spectrum Imaging in Hand and Foot Tendon Lesions.

To deeply analyze the tendon lesions of hands and feet, the application of Computed Tomography (CT) energy spectrum imaging and magnetic resonance imaging (MRI) in anatomy and lesions is mainly studied. Firstly, the related information of the subjects is introduced in turn. Secondly, Gemstone Spectral Imaging (GSI) and MRI examinations are performed respectively. Through energy spectrum analysis software, suitable single energy value (KeV) is selected, the mixed energy image is converted into the single energy image, and a variety of image recombination methods are used to observe the energy spectrum CT image and compare the results with MRI. The results of the study show that GSI could display the morphology, continuous walking and dead point of the tendon, especially the three-dimensional spatial relationship of the tendon, bone and muscle, which is superior to MRI. There is no statistically significant difference between GSI and MRI in the display of tendon rupture, thickening, deletion and compression. And GSI is not as clear as MRI in the display of tendon adhesion, degeneration and tendon sheath lesions, and the difference is statistically significant. Therefore, MRI is still the first choice in hand and foot tendon lesions, especially in the display of early pathological changes of the tendon and tendon sheath diseases, as well as the evaluation of postoperative functional rehabilitation of the tendon. And CT energy spectrum imaging, as a new imaging mode, can clearly show the anatomy of normal tendon of hand and foot and most tendon lesions, especially in the observation of tendon morphology, which has a high diagnostic value.

Imaging of Pericardiophrenic Bundles Using Multislice Spiral Computed Tomography for Phrenic Nerve Anatomy.

INTRODUCTION: Phrenic nerve injury and diaphragmatic stimulation are common complications following arrhythmia ablation and pacing therapies. Preoperative comprehension of phrenic nerve anatomy via non-invasive CT imaging may help to minimize the electrophysiological procedure-related complications. METHODS: Coronary CT angiography data of 121 consecutive patients were collected. Imaging of left and right pericardiophrenic bundles was performed with volume rendering and multi-planar reformation techniques. The shortest spatial distances between phrenic nerves and key electrophysiology-related structures were determined. The frequencies of the shortest distances ≤5 mm, >5 mm and direct contact between phrenic nerves and adjacent structures were calculated. RESULTS: Left and right pericardiophrenic bundles were identified in 86.8% and 51.2% of the patients, respectively. The right phrenic nerve was <5 mm from right superior and inferior pulmonary veins in 92.0% and 3.2% of the patients, respectively. The percentage of right phrenic nerve, <5 mm from right atrium, superior caval vein, and superior caval vein-right atrium junction was 87.1%, 100%, and 62.9%, respectively. Left phrenic nerve was <5 mm from left atrial appendage, great cardiac vein, anterior and posterior interventricular veins, and left ventricular posterior veins in 81.9%, 1.0%, 39.1%, 28.6%, and 91.4% of the patients, respectively. Merely 0.06% left phrenic nerve had a distance <5 mm with left superior pulmonary vein, and none left phrenic nerve showed a distance <5 mm with left inferior pulmonary vein. CONCLUSION: One-stop enhanced CT scanning enabled detection of phrenic nerve anatomy, which might facilitate avoidance of the phrenic nerve-related complications in interventional electrophysiology.

CT differentiation of diffuse malignant peritoneal mesothelioma and peritoneal carcinomatosis.

BACKGROUND AND AIM: Diffuse malignant peritoneal mesothelioma (DMPM) and peritoneal carcinomatosis (PC) have similar imaging in computer tomography (CT). We aimed to distinguish them. METHODS: Computer tomography findings were evaluated in 48 DMPM and 47 PC for the peritoneal, mesenteric, omentum, lymph nodes, viscera infiltration, ascites and pleural plaques. RESULTS: Two groups had no difference in terms of thickness, clinical manifestation, diameter of lymph nodes, ascites, and viscera infiltration. But they showed differences in the following: Ratio of asbestos exposure in DMPM group was higher. Smooth and irregular peritoneal thickening were more seen in DMPM group; peritoneal nodules were more commonly detected in PC group. Forty-eight cases of peritoneum in DMPM showed mild enhanced, while 14 patients in PC showed severe enhanced. Nodular type of omentum was more common in PC group than in DMPM group; omental cake was more commonly detected in DMPM group. Mesentery involvement was more commonly seen in DMPM group. Location of enlarged lymph nodes in cardiophrenic region was more frequently identified in DMPM, whereas location of enlarged lymph nodes in retroperitoneal region was more frequently identified in PC. Lymph nodes fusion was more frequently visualized in PC. Fixation of the intestinal wall was more common in DMPM. Pleural plaque was more common in DMPM. PC had distant metastasis except primary foci and peritoneum. In PC, tumor origins were ovary in 10, digestive system in 21, breast in one. CONCLUSION: Using a combination of CT findings may increase our ability to distinguish PC from DMPM.

Radiological findings of malignant peripheral nerve sheath tumor: reports of six cases and review of literature.

BACKGROUND: Malignant peripheral nerve sheath tumor (MPNST) is a kind of rare neurogenic tumor. If associated with neurofibromatosis type 1, MPNST usually has a higher mortality. The aim of the article is to assess the imaging characteristics of MPNST and compare them with those of benign peripheral nerve sheath tumor (BPNST) to characterize this tumor. METHODS: Clinical and imaging data of six cases with MPNST and 28 cases with BPNST in our institution since 2011 were retrospectively reviewed. Thirty-three patients have available MR imaging data, and two patients of MPNST also accepted CT scan. One patient accepted CT scan only. Location, size, shape, signal or density, boundary, bone destruction, relation to adjacent nerve, contrast-enhanced features as well as some other signs were assessed and compared with statistical software. Student's t test was used for comparison of continuous variables. Fisher's exact test was used for analysis of nominal variable. A P value ≤0.05 was considered to be statistically significant. RESULTS: Differences existed between two groups in tumor size ((7.2 ± 3.3)cm in MPNST vs. (3.8 ± 1.4)cm in BPNST), unclear margin (4/6 in MPNST vs. 1/28 in BPNST), eccentricity to the nerve (1/6 in MPNST vs. 21/28 in BPNST), intratumoral lobulation (4/6 in MPNST vs. 2/28 in BPNST), peritumoral edema (3/6 in MPNST vs. 0 in BPNST), and peripheral enhancement (4/6 in MPNST (three of five MR, one CT) vs. 4/28 in BPNST). Bone destruction was observed in one MPNST. CONCLUSIONS: MR imaging is a valuable, non-invasive modality for the diagnosis of MPNST. Peripheral enhancement with non-cystic appearance or remarkable heterogeneous enhancement may be useful for differential diagnosis. Other imaging features such as large size (over 5 cm in diameter), ill-defined margin, intratumoral lobulation, peritumoral edema, and adjacent bone destruction are also supportive of MPNST.

Early recognition of lung cancer by integrin targeted imaging in K-ras mouse model.

Non-small cell lung cancer is characterized by slow progression and high heterogeneity of tumors. Integrins play an important role in lung cancer development and metastasis and were suggested as a tumor marker; however their role in anticancer therapy remains controversial. In this work, we demonstrate the potential of integrin-targeted imaging to recognize early lesions in transgenic mouse model of lung cancer based on spontaneous introduction of mutated human gene bearing K-ras mutation. We conducted ex vivo and fluorescence molecular tomography-X-ray computed tomography (FMT-XCT) in vivo imaging and analysis for specific targeting of early lung lesions and tumors in rodent preclinical model for lung cancer. The lesions and tumors were characterized by histology, immunofluorescence and immunohistochemistry using a panel of cancer markers. Ex vivo, the integrin-targeted fluorescent signal significantly differed between wild type lung tissue and K-ras pulmonary lesions (PL) at all ages studied. The panel of immunofluorescence experiments demonstrated that PL, which only partially show cancer cell features were detected by αvß3-integrin targeted imaging. Human patient material analysis confirmed the specificity of target localization in different lung cancer types. Most importantly, small tumors in the lungs of 4-week-old animals could be noninvasively detected in vivo on the fluorescence channel of FMT-XCT. Our findings demonstrated αvß3-integrin targeted fluorescent imaging to specifically detect premalignant pleural lesions in K-ras mice. Integrin targeted imaging may find application areas in preclinical research and clinical practice, such as early lung cancer diagnostics, intraoperative assistance or therapy monitoring.

Convergence analysis of a finite element skull model of Herpestes javanicus (Carnivora, Mammalia): implications for robust comparative inferences of biomechanical function.

Predictions of skull biomechanical capability based on virtual models constitute a valuable data source for testing hypotheses about craniodental form and feeding behavior. Such comparative analyses also inform dietary reconstruction in extinct species. 3D modeling using Finite Element (FE) methods is a common technique applied to the comparative analysis of craniodental function in extinct and extant vertebrates. However, taxonomically diverse skull models in the literature often are not directly comparable to each other, in part because of distinctions in how boundary conditions are defined, but also because of substantial differences in the number of FEs composing the models. In this study, we test whether a conventional convergence test is adequate in identifying the minimum number of FEs needed to achieve internally stable results for a single species. We constructed a series of skull models of Herpestes javanicus, and simulated unilateral biting across the dentition; the models differed in the number of FEs, degrees of freedom at the joint and bite point constraints, and type of tetrahedral FEs used. We found that convergence patterns differed across constraint types, FE quantities, and bite position simulated. Four-noded tetrahedral (tet-4) FE models with relaxed constraints produced the most stable measurements compared to over-constrained tet-4 models and to relaxed tet-10 models. In absence of an optimal FE quantity from convergence testing, we propose a broadly applicable sub-sampling protocol, whereby average measurement values across multiple models per specimen are used for among-species comparisons. A regime of sampling three low FE quantity models produced the closest estimates of mean measurement values relative to larger model sets, being within the 95% bootstrap estimated confidence intervals. Future studies should focus on identifying sources of variation associated with other FE modeling protocols, so that they can be accounted for before biomechanical attributes from these simulations are used to infer form-function linkage.

Diagnosis of bladder diverticulum: Retrograde cystography CT more valuable.

OBJECTIVES: To study CT finding and the value of retrograde cystography CT scan in the diagnosis of bladder diverticulum. MATERIAL AND METHODS: The study was performed in accordance with the regulations of the local institutional review board and ethics committee. Written, informed consent was obtained from all patients before the examination and enrolment into the study. 70 patients with bladder diverticulum (mean age 62 years; range 43-78 years, 39 males and 31 females) were examined, including ultrasound, X-ray cystogram, plain scan CT, contrast enhanced CT, the retrograde cystogram CT, compared the accuracy of these examination in diagnosis of bladder diverticulum and observed size, location, shape, opening of bladder diverticulum. Selection and diagnosis of all patients of enrolled into the study were confirmed by cystoscopy. But, this result was double-blind to the resident doctors for them examined and diagnosed. Three examination were selected for each patient, the first examination was random, the second was the plain scan CT, the third was the retrograde cystogram CT, all patients were must examined by the plain scan CT and retrograde cystogram CT. RESULTS: In 70 patients, 22 case were examined by ultrasonic, 15 cases were accurate diagnosed, 4 cases were examined by X-ray cystography, 3 cases were accurate diagnosed, 70 cases were examined by plain scan CT, 48 cases were accurate diagnosed, 17 cases were examined by contrast enhanced CT, 12 cases were accurate diagnosed, 70 cases were examined by retrograde cystography CT, 70 cases were accurate diagnosed, retrograde cystography CT well showed the size, location, shape, opening of the bladder diverticulum, while others examination showed these were poor. CONCLUSIONS: Retrograde cystography CT could accurately diagnose bladder diverticulum, clearly showed the size, location, shape and opening of bladder diverticulum, could provide accurate and detailed information for clinical, thus it is a simple, effective and economical method of the diagnosis of bladder diverticulum.

Appendicolith appendicitis: should we be operating sooner? A retrospective cohort study.

INTRODUCTION: Evidence suggests that delaying an appendicectomy for up to 24 hours does not increase the risk of complicated appendicitis. Appendicoliths are a risk factor for perforation. No study has explored the temporal relationship between appendicolith presence and time to perforation. In this retrospective cohort study, we hypothesise that the presence of an appendicolith confirmed on preoperative computerised tomography scan (pCT) leads to a shorter time to complicated appendicitis. METHODS: We undertook a retrospective single-centre study of patients admitted between 2018 and 2020. Inclusion criteria included: age ≥18 years, appendicitis confirmed on histopathology following an operation and a pCT scan. Complicated appendicitis was defined intraoperatively as an appendicular abscess, gangrenous or perforated appendix. RESULTS: Some 310 patients were included in the study. Forty-five per cent presented with complicated appendicitis (n = 138). Appendicoliths were present in 79 (25.5%) patients. Multivariate logistic regression identified an appendicolith as a significant risk factor for perforation (odds ratio 3.50, 95% confidence interval [CI] 1.16-10.59; p = 0.027). Within the first 12 hours of admission, patients with an appendicolith accounted for a significantly greater proportion of those with complicated appendicitis intraoperatively compared with those without (56.7% vs 43.3%, respectively; p = 0.003). Within 12 hours of admission, those with an appendicolith were 2.05 times more likely to suffer from complicated appendicitis than those without (95% CI 1.28-3.29). CONCLUSIONS: Patients with an appendicolith appendicitis should be considered for an early appendicectomy. Future large-scale multicentre prospective studies are required to explore this further, perhaps informing future guidelines.

Dual-energy computed tomography in the early evaluation of acute radiation pneumonia.

OBJECTIVE: To investigate the value of dual-energy dual-source computed tomography (DSCT) in evaluating pulmonary perfusion changes before and after radiotherapy for esophageal cancer, and its clinical use in the early diagnosis of acute radiation pneumonia (ARP). METHODS: We selected 45 patients with pathologically confirmed esophageal cancer who received radiotherapy (total irradiation dose of 60 Gy). Dual-energy DSCT scans were performed before and after radiotherapy and the normalized iodine concentrations (NIC) in the lung fields of the areas irradiated with doses of > 20 Gy, 10-20 Gy, 5-10 Gy, and < 5 Gy were measured. We also checked for the occurrence of ARP in the patients, and the differences in NIC values and NIC reduction rates before and after radiotherapy were calculated and statistically analyzed. RESULTS: A total of 16 of the 45 patients developed ARP. The NIC values in the lung fields of all patients decreased at different degrees after radiotherapy, and the NIC values in the area where ARP developed, decreased significantly. The rate of NIC reduction and incidence rate of ARP increased gradually with the increasing irradiation dose, and the inter-group difference in NIC reduction rate was statistically significant (P < 0.05). Based on the receiver operating characteristic (ROC) curve analysis, the areas under the curves of NIC reduction rate versus ARP occurrence in the V5-10 Gy, V10-20 Gy, and V> 20 Gy groups were 0.780, 0.808, and 0.772, respectively. Sensitivity of diagnosis was 81.3%, 75.0%, and 68.8% and the specificity was 65.5%, 82.8%, and 79.3%, when taking 12.50%, 16.50%, and 26.0% as the diagnostic thresholds, respectively. The difference in NIC values in the lung fields of V<5 Gy before and after radiotherapy was not statistically significant (P > 0.05). CONCLUSION: The dual-energy DSCT could effectively evaluate pulmonary perfusion changes after radiotherapy for esophageal cancer, and the NIC reduction rate was useful as a reference index to predict ARP and provide further reference for decisions in clinical practice.

Diagnostic Value of X-Map Images Reconstructed by Plain Dual-Energy Computed Tomography Scans in Acute Ischemic Stroke.

OBJECTIVE: This study aimed to evaluate the diagnostic value of X-Map reconstruction based on Dual-Energy Computed Tomography (DECT) in acute ischemic stroke (AIS). METHODS: Sixty-six cases of suspected AIS patients hospitalized from November, 2021 to April, 2022 were retrospectively selected. DECT, Computed Tomography Perfusion imaging (CTP), Computed Tomography Angiography (CTA), and MRI were all performed within 24 hours after symptom onset. As the gold standard for diagnosing AIS, a total of 53 patients were diagnosed with AIS based on the diffusion-weighted imaging positive results in MRI. The Chi-square test was used to evaluate the diagnostic efficacy of AIS among X-Map, CTP, and CTA. RESULTS: In the 53 patients with confirmed ASI, a total of 72 lesions were detected, including in the frontal lobes (n=33), parietal lobes (n=7), temporal lobes (n=12), basal ganglia regions (n=12), thalamus (n=3), and pons (n=5). The case detection rate of X-Map for AIS was similar to that of CTP (p=0.151) but was significantly higher than that of CTA (p<0.001). In terms of diagnostic efficacy, among the total 66 patients enrolled, X-Map achieved a higher diagnostic sensitivity (85%) than CTP and CTA. However, CTP achieved the best diagnostic specificity (84.6%) and diagnostic accuracy (77.4%) among the diagnostic tools used. CONCLUSION: X-Map provides a better or equal clinical value for the diagnosis of AIS as compared to CTA and CTP, respectively, highlighting its potential in clinical applications.

Construction of a predictive model for gastric cancer neuroaggression and clinical validation analysis: A single-center retrospective study.

BACKGROUND: This study investigated the construction and clinical validation of a predictive model for neuroaggression in patients with gastric cancer. Gastric cancer is one of the most common malignant tumors in the world, and neuroinvasion is the key factor affecting the prognosis of patients. However, there is a lack of systematic analysis on the construction and clinical application of its prediction model. This study adopted a single-center retrospective study method, collected a large amount of clinical data, and applied statistics and machine learning technology to build and verify an effective prediction model for neuroaggression, with a view to providing scientific basis for clinical treatment decisions and improving the treatment effect and survival rate of patients with gastric cancer. AIM: To investigate the value of a model based on clinical data, spectral computed tomography (CT) parameters and image omics characteristics for the preoperative prediction of nerve invasion in patients with gastric cancer. METHODS: A retrospective analysis was performed on 80 gastric cancer patients who underwent preoperative energy spectrum CT at our hospital between January 2022 and August 2023, these patients were divided into a positive group and a negative group according to their pathological results. Clinicopathological data were collected, the energy spectrum parameters of primary gastric cancer lesions were measured, and single factor analysis was performed. A total of 214 image omics features were extracted from two-phase mixed energy images, and the features were screened by single factor analysis and a support vector machine. The variables with statistically significant differences were included in logistic regression analysis to construct a prediction model, and the performance of the model was evaluated using the subject working characteristic curve. RESULTS: There were statistically significant differences in sex, carbohydrate antigen 199 expression, tumor thickness, Lauren classification and Borrmann classification between the two groups (all P < 0.05). Among the energy spectrum parameters, there were statistically significant differences in the single energy values (CT60-CT110 keV) at the arterial stage between the two groups (all P < 0.05) and statistically significant differences in CT values, iodide group values, standardized iodide group values and single energy values except CT80 keV at the portal vein stage between the two groups (all P < 0.05). The support vector machine model with the largest area under the curve was selected by image omics analysis, and its area under the curve, sensitivity, specificity, accuracy, P value and parameters were 0.843, 0.923, 0.714, 0.925, < 0.001, and c:g 2.64:10.56, respectively. Finally, based on the logistic regression algorithm, a clinical model, an energy spectrum CT model, an imaging model, a clinical + energy spectrum model, a clinical + imaging model, an energy spectrum + imaging model, and a clinical + energy spectrum + imaging model were established, among which the clinical + energy spectrum + imaging model had the best efficacy in diagnosing gastric cancer nerve invasion. The area under the curve, optimal threshold, Youden index, sensitivity and specificity were 0.927 (95%CI: 0.850-1.000), 0.879, 0.778, 0.778, and 1.000, respectively. CONCLUSION: The combined model based on clinical features, spectral CT parameters and imaging data has good value for the preoperative prediction of gastric cancer neuroinvasion.