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【Objective】 To compare the value of CT pulmonary angiography (CTPA) and echocardiography in predicting the degree pulmonary hypertension (PH). 【Methods】 Fifty-four patients in our hospital who underwent right heart catheterization, CTPA and echocardiography for suspected or confirmed PH from November 2013 to April 2021 were retrospectively recruited. Pulmonary artery systolic pressure (PASP) and mean pulmonary artery pressure (PAMP) were measured by right heart catheterization. According to PAMP, the patients were divided into non-PH group and mild, moderate, and severe PH groups. The three-dimensional model of the pulmonary artery was obtained by computer-aided segmentation, and the best fitting circle diameter (Dfit), inscribed circle diameter (Dmin), circumscribed circle diameter (Dmax), hydraulic diameter (Dh), cross-sectional area (Area), circumference (Scf), and the largest area and largest short diameter of the right ventricle were measured. Echocardiography was used to estimate PASP. The differences in the above parameters between different PH groups were compared, the correlations of the above parameters with PASP and PAMP were analyzed, and statistically significant indicators were included to establish three predictive models of PAMP (Model 1: CTPA pulmonary artery; Model 2: CTPA pulmonary artery+CTPA right ventricle; Model 3: CTPA pulmonary artery+CTPA right ventricle+echocardiography), and receiver operating characteristic (ROC) curves were used to compare the diagnostic performance of the three models. 【Results】 Some parameters of main pulmonary artery (Dfit, Dmin, Dmax, Dh, Area, Scf), right pulmonary artery (Dmax, Dh, Area, Scf), left pulmonary artery (Dfit), and right ventricular short diameter increased with the increase of PAMP (P<0.05). Dfit, Dmin, Dh, and area of main pulmonary artery, right pulmonary artery and left pulmonary artery were positively correlated with PASP and PAMP (P<0.05). Right ventricular short diameter and right ventricular maximum area were positively correlated with PASP (P<0.05), and right ventricular short diameter was positively correlated with PAMP (P<0.05). The estimated value of pulmonary artery systolic blood pressure in echocardiography was positively correlated with PASP and PAMP (P<0.05). Model 1, Model 2 and Model 3 could all be used to identify mild PH and moderate PH, among which Model 3 had the best performance in identifying non-PH and mild PH, moderate PH and severe PH. 【Conclusion】 CTPA and echocardiography are helpful in assessing the degree of PH, and the combination of the two has better accuracy in distinguishing non-PH from mild PH, moderate and severe PH.
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Objective:To investigate the development of intrapulmonary vascular volume (IPVV) in normal preschool children based on quantitative measurement on chest CT.Methods:The CT data of 407 normal preschool children (236 males and 171 females, aged 1-72 months, with a median of 36 months) who underwent chest CT examination from January 2014 to May 2017 in the "Digital Lung" imaging database were retrospectively collected. The pulmonary vessels were segmented by the "Digital Lung" automatic detection tool, and the IPVV of the whole lung, the right lung, the left lung and each lobe were obtained, and the IPVV upper/lower and IPVV left/right were calculated. According to the age, the subjects were divided into infant period (0-12 months), early childhood period (13-36 months) and preschool period (37-72 months), with 30 cases (17 males and 13 females), 175 cases (95 males and 80 females) and 202 cases (124 males and 78 females) respectively. Spearman correlation analysis was used to evaluate the correlation between IPVV and month age. One-way analysis of variance or Kruskal-Wallis H test was used to compare the differences of IPVV, IPVV upper/lower and IPVV left/right between different months of age. Independent sample t test or Mann-Whitney U test was used to compare the differences of IPVV between different genders, and the normal reference range of IPVV in normal preschool children of different months of age was established. Results:The IPVV of the whole lung, right lung, left lung and each lung lobe were positively correlated with age, the correlation coefficient was 0. 638-0.820 in males and 0. 683-0.791 in females (all P<0.001). There was no significant difference in IPVV of whole lung, right lung, left lung and each lobe between male and female from 0 to 12 months (all P>0.05), but there was significant difference in IPVV of whole lung, right lung, left lung and each lobe between male and female from 13 to 36 months (all P<0.05). There were significant differences in IPVV of the whole lung, right lung, left lung and upper lobe of both lungs between boys and girls from 37 to 72 months (all P<0.05). IPVV upper/lower in the right lung (χ 2=14.00, 12.87, P=0.001, 0.002) and IPVV upper/lower in the left lung (χ 2=6.65, 22.84, P=0.036,<0.001) were significantly different in both boys and girls among 3 months of age. And with the increase of age, it showed a decreasing trend. There was no significant difference in IPVV upper/lower between boys and girls at the same age (all P>0.05).There was no significant difference in IPVV left/right among different months and between different sexes (all P>0.05). Finally, the normal reference value range of IPVV of different genders in infancy, early childhood and preschool age was calculated. Conclusions:The increase of pulmonary vessels in normal preschool children is positively correlated with age. There is no significant difference in IPVV between boys and girls in infant period, but IPVV in boys is larger than that in girls in early childhood period and preschool period. IPVV in the lower lung increased faster than that in the upper lung, but there was no significant difference between the left and right lungs.
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Objective:To explore the value of biphasic quantitative CT on small airway disease and emphysema injury in patients with smoking combined with chronic obstructive pulmonary disease (COPD).Methods:A total of 186 male physical examination subjects who underwent biphasic CT and pulmonary function (PFT) examinations in the Affiliated Hospital of Yan′an University from July 2018 to September 2020 were enrolled in this retrospective study. These subjects were divided into 121 smokers with COPD (COPD group), aged 34 to 84 (64±8) years old and 65 smokers without COPD (non-COPD group) aged 34 to 72 (61±5) years old. According to the guidelines of the COPD global initiative, patients in COPD group were divided into Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) Ⅰ-Ⅳ grades. The original DICOM data of CT were imported into the "Digital Lung" test and analysis platform. Quantitative parameters of functional small airway disease percentage (fSAD%) and emphysema area percentage (Emph%) of each lobe were calculated. The differences of CT quantitative parameters among non-COPD group and each grade in COPD group were analyzed by One-Way ANOVA or Kruskal-Wallis H test. The correlation between the smoking index and CT quantitative parameters was analyzed by Spearman correlation analysis. Results:There were significant differences in fSAD% and Emph% of each lobe among non-COPD group and COPD group GOLD Ⅰ-Ⅳ ( P<0.001). Except that the Emph% in right middle lobe of GOLD grade Ⅰ was higher than that of GOLD grade Ⅱ in COPD group, the fSAD% and Emph% in other lobes increased gradually with the increase of GOLD grade in COPD group. The fSAD% and Emph% were larger in the right middle lobe and both upper lobes of COPD group GOLD Ⅰ-Ⅳ. The comparison among each lobe showed that the differences were statistically significant ( P<0.01), except for the fSAD% and Emph% of GOLD Ⅳ ( P=0.395, 0.840). The smoking index was positively correlated with fSAD% and Emph% in each lung lobe. Among them, smoking index was highly correlated with fSAD% in the lower right lobe and Emph% in the lower left lobe ( r=0.474, 0.619, P<0.001). Conclusion:The biphasic quantitative CT can early and sensitively reflect the degree of small airway disease and emphysema injury in smoking combined with COPD, which is of great significance for the early diagnosis and evolution of COPD.
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Chronic obstructive pulmonary disease (COPD) refers to a group of highly heterogeneous diseases with high prevalence rate and fatality rate, which has become a worldwide public health challenge. Quantitative CT can effectively evaluate the characteristic changes of pulmonary parenchyma, airway and pulmonary vessels, having great significances in early diagnosis, monitoring disease progression and individualized treatment of COPD.
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To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019 (COVID-19) based on computed tomography (CT) images. We retrospectively examined 44 confirmed COVID-19 cases. All cases were evaluated separately by radiologists (visually) and through an in-house computer software. The degree of lesions was visually scored by the radiologist, as follows, for each of the 5 lung lobes:0, no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement. Lesion density was assessed based on the proportion of ground-glass opacity (GGO), consolidation and fibrosis of the lesions. The parameters obtained using the computer tool included lung volume (mL), lesion volume (mL), lesion percentage (％), and mean lesion density (HU) of the whole lung, right lung, left lung, and each lobe. The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation. A Chi-square test was used to test the consistency of radiologist- and computer-derived lesion percentage in the right/left lung, upper/lower lobe, and each of the 5 lobes. The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software (r ranged from 0.7679 to 0.8373, P < 0.05), and a moderate correlation between the proportion of GGO and mean lesion density (r=-0.5894, P<0.05), and proportion of consolidation and mean lesion density (r=0.6282, P<0.05). Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists (x2 = 8.160, P = 0.004). Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.
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Objective To establish and validate a voxel-based method for the quantitative detection of air trapping (AT),and to explore its diagnostic value by preliminarily apply this method in chronic obstructive pulmonary disease (COPD) patients.Methods From March 2015 to February 2016,fifty healthy young volunteers and eighteen COPD patients who underwent both end-inspiratory and end-expiratory CT were included from the Digital Lung Multi-center Study.The quantitative parameters of AT and emphysema were measured by both the voxel-based quantitative method and the conventional threshold method,respectively.All subjects underwent pulmonary function examination within 3 days after CT examination.For healthy volunteers,paired sample rank-sum test was used to compare the difference of quantitative parameters between voxel-based method and threshold method,Spearman rank correlation analysis was used to investigate the correlation between quantitative parameters of the two methods and pulmonary function.For COPD patients,the distribution and extent of AT and emphysema in patients with similar degree of pulmonary function (PFT) injury were observed.Results There were varying degrees of AT in the asymptomatic youth,with a median value of 5.70％ for the voxel-based method and with a median value of 7.96％ for the conventional threshold method,there was significant difference(Z=-4.015,P＜0.001).The correlation between AT and emphysema parameters of the voxel-based method and PFT parameters (r=-0.399 and-0.494,-0.335 and-0.439 separately,P＜0.05) were higher than that of the conventional threshold method,respectively (r=-0.357 and-0.453,-0.284 and-0.391,respectively;all P＜0.05).Furthermore,the voxel-based method can classify COPD patients with similar degree of pulmonary function injury into three subtypes:AT-dominant,emphysema-dominant,and mixed.Conclusions The voxel-based AT quantitative measurement method not only has high sensitivity and accuracy,but also provides imaging phenotype for the diagnosis of COPD and provides assistant decision-making for clinical management.
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Objective To compare the predictive capability of multiple linear regression (MLR)and neural network model (NNM) for pulmonary artery obstruction index (PAOI) in pulmonary embolism.Methods One hundred and forty-seven APE patients (79 male,68 female) were collected from March 2015 to July 2016 in our hospital and randomly divided into training group and testing group with the ratio of 3 ∶ 1.Four indexes,including total volume (V),total length (L),total degree of embolism (D) and total number of clots (N) were calculated by computer assisted detection.Qanadli index (Q) as CT PAOI was calculated manually.With SPSS 14.2 modeler,the predictive value of Qanadli index ((Q)) was calculated by MLR and NNM respectively,with Qanadli index as dependent variable and V,L,D,N as independent variables.SPSS 22.0 Spearman test was used to analyze the correlation between (Q) and Q.Mean absolute error (MAE),mean relative error (MRE),root mean square error (RMSE) were used to quantify the accuracies of two methods.Results MLR equation was (Q)=10.98+ 1.37×V+0.06×L,model fitting was 0.764.NNM included one hidden layer and two neurons with accuracy of 0.868.In training group,the correlation between (Q) and Q in NNM (r=0.932,P＜0.01) was higher than MLR (r=0.879,P＜0.01);in testing group,the correlation between (Q) and Q in NNM (r=0.875,P＜0.01) was higher than MLR (r=0.868,P＜0.01).In training group,MAE,MRE and RMSE of NNM (5.144,0.274,6.957) were significantly lower (t=3.402,P=0.002) than MLR (6.784,0.282,8.700);in testing group,MAE,MRE and RMSE of NNM (6.643,0.312,9.195) were significantly lower (t=3.383,P=0.002) than MLR (8.505,0.334,10.361).Conclusion NNM is a better model in predicting CT pulmonary artery obstruction index of APE patients.
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Objective To investigate the changing curve of mean lung density (MLD)in normal preschool children based on CT quantitative measurement.Methods Chest CT data of 409 preschool children were reviewed retrospectively from the "digital lung"database.A computerized algorithm based on the "digital lung"was applied to all examinations in a batch manner.The MLD values of total lung,right lung,left lung and each lobe were obtained automatically.Results There was no correlation between the gender and MLD,however a moderately negative correlation was found between the age of month and MLD (P＜0.05).No significant difference of MLD was found between genders of the same age of month group,except in left lower lobe of 49-60 months of age (P=0.043). The MLD was decreased gradually with age (P＜0.05).Conclusion There is not a statistical difference in MLD between the preschool boys and preschool girls of the same age of month.With the growth of preschool children,the MLD is gradually decreased.
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Objective To compare the spatial resolution and density resolution balance algorithm(MBIRSTND)and spatial resolution preference algorithm (MBIRRP20)from new version of model-based iterative reconstruction(MBIRn),and adaptive statistical iterative reconstruction(ASIR) with lung kernel in routine dose about the performance of computer-aided detection (CAD)for quantitative analysis of airway.Methods 30 patients were involved who were scanned for pulmonary disease with spectrum CT.Data with a slice thinkness 0.625 mm were reconstructed with ASIR,MBIRSTNDand MBIRRP20.Airway dimensions from three reconstruction algorithm images were measured using an automated and quantitative software(Dexin-FACT)that was designed to segment and quantify the bronchial tree,and a skeletonization algorithm to extract the center-line of airway trees automatically.For each patient,reconstruction algorithm chose the right middle lobe bronchus,and the bronchial length of the matched airways was measured by this scheme.Two radiologists used a semiquantitative 5 scale (Score 0 stands for its image quality is similar to that with ASIR;Score±1 stand for a little better or a little worse;Score±2 stand for obviously better or obviously worse)to rate subjective image quality of airway trees about images reconstructed with MBIRSTNDand MBIRRP20.Paired t test and Wilcoxon signed-rank test were used.Results Algorithm impacts the measurement variability of bronchus length in chest CT.The bronchial length with MBIRRP20was longer than with MBIRSTND, while the length with ASIR were the shortest(P<0.05).In addition, the optimal reconstruction algorithm was found to affect the subjective noise,the continuity and completeness of bronchial wall,and the show of bronchial end.The subjective noise of MBIRSTNDwas better than that of MBIRRP20.The show of bronchial end of MBIRRP20was better than that of MBIRSTND(P<0.05).There was no significant difference in the continuity and completeness of bronchial wall compared with MBIRRP20and MBIRSTND(P>0.05),which was much better than with ASIR(P<0.05).Conclusion MBIRn can inmprove the analyzing ability of CAD airway.The MBIRSTNDcan significantly reduce the image noise,the MBIRRP20significantly improve the branching of the bronchial arteries,both of which can allow the desired airway quantification accuracy of CAD for chest CT of the bronchial wall.
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Objective To explore the value of the morphological quantitative indexes and the number of emboli in predicting heart function in patients with acute pulmonary embolism (APE)based on computer-aided diagnosis (CAD)technique.Methods One-hundred and forty-eight APE patients confirmed by CT pulmonary angiography (CTPA)in our hospital.Total number of emboli (N)and three morphological quantitative indexes,including total volume of emboli (V),total length (L)and total maximum cross-section embolism proportion (P)were obtained by CAD.The maximal short axis and area of left and right ventricular (LVd,RVd,LVS,RVS)were measured by hand on axial image to calculate the ratio of maximal short axis of right and left ventricular (RVd/LVd)and ratio of maximal area of right and left ventricular (RVS/LVS).The correlation of the above indexes was analyzed by the Pearson correlation of SPSS 22.0.Results The ranking of the correlation between CAD indexes and the heart function was in the order of V,L,P and N.The correlation between CAD indexes and the right heart function was greater than that of the left heart.The V had the strongest correlation with RVd (r=0.544,P=0.000),RVS (r=0.515,P=0.000),RVd/LVd (r=0.595,P=0.000)and RVS/LVS (r=0.579,P=0.000),respectively.While other the CAD indexes had lower correlation with the heart function (|r|:0.167-0.476,P<0.05),and there was no correlation between the N and the left heart function.Conclusion In embolic morphology and quantitative indexes,the V is the best quantitative index to reflect the change of right heart function in APE,which can reflect dys-function of right heart and severity of pulmonary embolism dis-ease in the APE embolism patient.
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Objective To evaluate the extent and anatomic distribution of air trapping in lung in young asymptomatic female subjects to achieve early diagnosis of small airway diseases.Methods Fifty young females with normal pulmonary function were included retrospectively in this study.All subjects underwent both inspiratory and expiratory CT scans,the percentage of the area of air trapping(AT)and the percentage of the area of emphysema(Emph)were quantitatively analyzed.Comparison between bilateral lungs was analyzed using independent-samples t test;Comparisons among lobes were done using one-way ANOVA or Kruskal-Wallis rank sum test;Pairwise comparisons between lobes were conducted using LSD test or paired comparison;The effects of each lobe on AT were analyzed using Spearman's rank correlation coefficient,simple linear regression and multiple stepwise regression.Results There was a certain degree of air trapping in lung and a small amount of emphysema in young asymptomatic females.Air trapping was mainly located in the right middle lobe (RML)and bilateral upper lobes.The ratio of air trapping to volume was the highest in RML and the change of air trapping in the bilateral upper lobes had the greatest influence on the air trapping degree of the whole lung.Conclusion There is a certain degree of air trapping in lung in young asymptomatic females.The occurrence and development of air trapping in RML may be a sensitive biomarker for the early detection of pathophysiological changes in small airway diseases using imaging procedures.
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Objective To explore the characteristics and significance signification of changes of cerebral glucose metabolism in patients with Alzheimer's disease (AD).Methods Seventeen patients diagnosed with AD based on standard clinical diagnostic criteria (AD group),and 15 healthy volunteers as normal control group (HC group)were enrolled in this study.Positron emission tomography (PET)were performed in both groups and three-dimensional reconstruction images were obtained.The visual evaluation,regions of interesting (ROI)technology and brain function analysis software were used to analyze PET results data in of each group.Results ①In AD group,glucose metabolisam was decreased and mainly distributed in the parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,but not in occipital lobe,basal ganglia,thalamus and cerebellum nuclei basales,thalamus and opisthencephalon.Ssomatic sensation and motor functionand were not affected.②Compared with mild AD patients,glucose metabolism inof moderate and severe AD patients was decreased more significantly in parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,with a wider range of lesionsthe range also expanded,and visual area and speech centerpartly followed by the disorder of visual center and speech center may bewere involved in some patients.③The built-in brain function analysis software of PET system software carried by PET system was more objectiveprecise and accurate than visual evaluation or and ROI technology,can accurately reflected the changes in brain glucose metabolism which and iwas suitable for popularization and application.Conclusion Because the distribution of impaired glucose metabolism in cerebral cortex hads certain characteristics and regularity laws in AD patients.18 F-FDG PET imaging can maybe meaningful valuable in diagnosis,differential diagnosis and therapeutic evaluation in AD.
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Objective To evaluate the relationship between the spatial structure of pulmonary vascular tree and oxygen partial pressure in patients with chronic obstructive pulmonary disease(COPD) by the fractal dimension method.Methods 106 patients with COPD and 100 healthy people without COPD as controls were included in this study.All of the patients underwent multidetector CT scan and blood gas analysis.The pulmonary vascular trees were generated using post-processing software,and the FD of the pulmonary vascular trees were determined with ImageJ software in a personal computer.The fractal dimension were evaluated in the two groups.The relationship between FD and oxygen partial pressure in patients with COPD was analyzed.Results The FD value of the patients with COPD was lower than that of the patients without COPD (t =5.21,P＜ 0.01).There was a significant correlation between FD and the PaO2 in patients with COPD (r=0.692,P＜ 0.01).Conclusion FD analysis can effectively evaluate the process of pulmonary vascular remodeling induced by hypoxia in patients with COPD,which may be used as an important index for quantitative evaluation of pulmonary vascular remodeling in the course of COPD.
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Objective To build an advanced clinical case collection and teaching system for the department of radiology, and thus to facilitate the scientific research and teaching.Methods By combining several free software, we built a network version of the case collection system with simple web pages, to achieve centralized storage of case text and image data, thus to facilitate the research and teaching work.Results This case collection system quickly saved text data and image data through simple operation, supported parallel work without the need for complex configuration on the client, and had good support for wide area network.This system had stable system operation and could be customized to meet the clinical needs well.Conclusion Using free software to establish the network version of the case collection and teaching system is low cost and has no legal risk.This system is a simple but powerful tool, and can meet the needs of hospitals with different sizes, which is a more perfect case collection system.
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Objective To discuss the MRI features of pyometra and its correlation with pathologic.Methods MRI and DWI data of 12 cases pyometra proved by surgery and pathology were analyzed retrospectively, and a comparision with pathologic findings was made.Mean ADC values were calculated.Results According to the homogeneity of MRI signal: Uniform signal type in 2 cases,T1WI showed slightly low signal,T2WI showed slightly high signal,DWI showed high signal,and the distribution of pus compositions is relatively uniform;Signal mixed type in 5 cases, T2 showed at the bottom of the pus or peripheral mixed slightly short signal, DWI showed mixed high signal, there was some sediment in the bottom of the pus;5 cases of liquid layer type, the upper displayed signal of water,and the lower signal was lower than the upper signal on T2WI, of which 3 cases showed uniform signal of the lower, DWI showed a uniform high signal, the distribution of pus compositions is uniform, the other 2 cases showed mixed signal of the lower, which was pyometra with bleeding,DWI showed high signal and low signal mixed together.The average ADC value of the 12 patients were 0.532×10-3 mm2/s.12 cases of uterine volume were increased, including 10 cases of uterine wall thinning, the other 2 cases with inflammatory invasion, the uterine wall thickening.8 cases with cervical cancer.5 cases with pelvic effusion.Conclusion MRI findings of pyometra are characteristic, its MRI manifestations and pathological components are highly correlated,and the ADC value is of great value in the diagnosis of pyometra.
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Objective To evaluate the clinical application value of CT angiography(CTA) in detection of the accessory renal artery(ARA).Methods The renal artery CTA in 100 cases was reconstructed retrospectively with volume rendering (VR), multiplanar reconstruction (MPR), maximum density projection (MIP) and curved surface reconstruction (CPR).Results In all 200 kidneys,ARA were 47 with an incidence of 23.5% (47/200).The incidence of ARA in male and female were about 17% and 13%, and there was no significant difference between them.The ARA in the upper pole of the kidney was 25 (53.1%), and in lower pole was 22 (46.9%).It was showed on MIP with a display rate of 100%, on MRP of 93.6%, on VR of 90.4% and on CPR of 85.1%.Conclusion CTA is a safe, rapid, noninvasive and economical method for the diagnosis of ARA.It is helpful for surgical renal operation, interventional therapy and renal transplantation.
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Objective To retrospectively summarize the normal reference range of trachea wall thickness,lumen diameter,wall area and wall area ratio[WA%=mean wall area/(mean wall area+lumen area)]of Chinese healthy adults,and its related factors. Also,to observe the difference of inner diameter between superior and inferior bronchus.Methods Based on computer measurement techniques of bronchus,a CT quantitative analysis was carried out in 701 cases of normal healthy people who had negative results in lung cancer screening of health examination at our hospital.Results The value of trachea wall thickness,lumen diameter,wall area and wall area ratio was(1.322 mm,18.024 mm,78.93 mm2 ,0.27)respectively.In different gender,the trachea wall thickness,lumen diameter,wall area and wall area ratio had statistical significance (P<0.05).Also,they had good consistency with gender (r=-0.512,-0.472,-0.559,0.315).In different gender and age,the difference of inner diameter between the superior bronchus and inferior bronchus was always a positive value.Conclusion The CT quantitative analysis method has advantages of convenience,direct-vie-wing and accuracy.It is good for quantitative detection and research of bronchus structure.Bronchial wall thickness,lumen diameter, wall area and wall area ratio have significant difference because of gender.The inner diameter of superior bronchus is always greater than that of the inferior bronchus.
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Objective To explore the characteristics and significance signification of changes of cerebral glucose metabolism in patients with Alzheimer's disease (AD).Methods Seventeen patients diagnosed with AD based on standard clinical diagnostic criteria (AD group),and 15 healthy volunteers as normal control group (HC group)were enrolled in this study.Positron emission tomography (PET)were performed in both groups and three-dimensional reconstruction images were obtained.The visual evaluation,regions of interesting (ROI)technology and brain function analysis software were used to analyze PET results data in of each group.Results ①In AD group,glucose metabolisam was decreased and mainly distributed in the parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,but not in occipital lobe,basal ganglia,thalamus and cerebellum nuclei basales,thalamus and opisthencephalon.Ssomatic sensation and motor functionand were not affected.②Compared with mild AD patients,glucose metabolism inof moderate and severe AD patients was decreased more significantly in parietal lobe,temporal lobe,frontal cortex,posterior cingultate and hippocampus,with a wider range of lesionsthe range also expanded,and visual area and speech centerpartly followed by the disorder of visual center and speech center may bewere involved in some patients.③The built-in brain function analysis software of PET system software carried by PET system was more objectiveprecise and accurate than visual evaluation or and ROI technology,can accurately reflected the changes in brain glucose metabolism which and iwas suitable for popularization and application.Conclusion Because the distribution of impaired glucose metabolism in cerebral cortex hads certain characteristics and regularity laws in AD patients.18 F-FDG PET imaging can maybe meaningful valuable in diagnosis,differential diagnosis and therapeutic evaluation in AD.
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Objective To observe the application value of PET glucose metabolic imaging and MR structural imaging in diagnosis of Alzheimer disease (AD) and mild cognitive impairment (MCI).Methods Totally 18 patients with AD (AD group),6 patients with MCI (MCI group) and 10 healthy volunteers (HC group) were enrolled.There were 11 cases of moderate or severe AD and 7 cases of mild AD in AD group.PET and structural MR imaging of the brain were performed.The radioactivity distribution in the brain and the hippocampal atrophy were observed through visually evaluation and quantitative analysis.Results The glucose metabolism reduced in certain regions of the brain in all AD patients (18/18,100％).Among them,11 patients with moderate or severe AD accompanied hippocampal atrophy,while 3 of 7 patients with mild AD showed hippocampal atrophy.No hippocampal atrophy was found in 5 patients with MCI (5/6,83.33 ％),but 2 of them showed decreased radioactivity in the brain.The symmetric mild diminution of radioactivity distribution without hippocampal atrophy was found in all subjects in HC group (10/10,100％).Two cases in HC group showed mild encephalanalosis.Conclusion Both of PET glucose metabolic imaging and MR structural imaging can be used to diagnose AD or MCI with different focus.Combination of these two techniques is helpful to improving diagnostic accuracy.
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Objective To explore the neural function analysis based on PET/CT imaging for the MRI negative localization in patients with refractory epilepsy.Methods 85 cases of drug refractory epilepsy patients (male 47,female 38,M/F:1.2 ︰ 1;age range from 6-35 years old),receiving head PET/CT conventional imaging in the interphase,compared to the normal PET cerebral metabolic databases.Surgery was carried out on the patients who with unilateral lobe of the brain,the efficacy was evaluated according to the Eagle standard.Results Epilepsy in unilateral was 63.5%(54/85 ),bilateral was 28.2%(24/85 )and unclear was 8.3%(7/85 ).6 months,12 months,18 months and 24 months later after surgery in patients who with unilateral lobe,the efficacy reaching the Eagle class Ⅰ and class Ⅱ standards was 61.1% (33/54),61.1% (33/54),61.1% (33/54),59.1% (29/49 ),respectively.Conclusion PET/CT neural function analysis could find epileptogenic zone which was negative in MRI imaging in patients with refractory epilepsy, is one of the important methods of preoperative localization.