摘要
Objective:To study the feasibility and value of applying organ dose modulation technique in computed tomography(CT)scanning on eyes.Methods:A total of 330 patients who admitted to Beijing Friendship Hospital affiliated with Capital Medical University from August 2021 to August 2023 and underwent CT examination on eyes were selected.They were divided into modulation group,conventional group and low-dose group based on the control methods of tube current in scanning.The modulation group used organ dose modulation technique with intelligent automatic tube current of 70-150 mA,and the conventional dose group used a fixed tube current of 100 mA,and the low-dose group used a fixed tube current of 70 mA.The differences in radiation dose and CT imaging quality among 3 groups were compared.Results:The dose length product(DLP),volume CT dose index(CTDIvol)and effective dose(ED)of cross-sectional scan of the modulation group were respectively 62.37,12.83 and 0.143 mSv,which were significantly lower than 115.23,18.93 and 0.265mSv of conventional dose group,respectively,with statistically significant(F=2544.944,6009.596,2544.944,P<0.05).The DLP,CTDIvol and ED of coronary scan of the modulation group were 68.19,13.15 and 0.156,respectively,which were significantly lower than 122.41,19.20 and 0.282 mSv of the conventional dose group,respectively,with statistically significant(F=1232.413,3813.940,1232.413,P<0.05).The excellent rates of cross-sectional scans among the modulation group,conventional group and lower-dose group were respectively 98.83%,86.15%and 47.69%,and the difference among three groups was statistically significant(x2=53.908,P<0.05).The excellent rates of image qualities of the modulation group,conventional group and low-dose group were respectively 96.61%,80.70%and 48.28%,and the difference among three groups was statistically significant(x2=20.992,P<0.05).Conclusion:The application of organ dose modulation technique in CT scanning on eyes can significantly reduce radiation dose on patient under ensures imaging quality can meet diagnostic needs when undergoes cross-sectional and coronal scans,which has higher clinical feasibility and application value.
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Objective:To explore the application and diagnostic value of low-dose scan technique of chest computed tomography(CT)combined with three dimensional(3D)reconstruction for ribs in chest trauma.Methods:A total of 118 patients with highly suspected rib fracture who admitted to the 904th Hospital of People's Liberation Army Joint Service Support Force were selected,and all cases underwent low-dose scan technique of chest CT combined with 3D reconstruction for ribs.The image qualities of chest CT scans with different low-doses combined with 3D reconstruction for ribs were analyzed,and the diagnostic accuracies among low dose scan technique of chest CT,3D reconstruction for ribs and the combination of them for chest trauma were compared.Results:Both the sharpness and clarity of the edges of the bronchi,blood vessels,lung parenchyma,interlobular septum,mediastinum and ribs were poorer,and the artifacts of soft tissue were more and the noise were more when the tube current of CT scan was 50 Ma.Both the sharpness and clarity of the edges of the bronchi,blood vessels,lung parenchyma,interlobular septum,mediastinum and ribs were general,and a part of soft tissues existed artifacts and the noise amounts were less when the tube current of CT scan was 70 Ma,which did not affect the diagnosis.The radiation dose as 50 mA was significantly higher than that as 70 mA,with a statistically significant difference(t=10.969,P<0.05).In 118 patients with chest trauma,the examination of low-dose scan technique of chest CT combined with 3D reconstruction for ribs indicated that there were 112 cases of rib fractures and 7 cases of costal cartilage fractures.In the examined 388 fractures of rib and costal cartilage,355 fractures(91.49%)were rib fractures and 33 fractures(8.51%)were costal cartilage fractures.In 118 patients with chest trauma,76 cases(64.41%)complicated with pulmonary contusions and lacerations,and 41 cases(35.75%)complicated with pleural effusion,and 10 cases(8.47%)complicated with thoracic vertebral fractures,and 6 cases(5.08%)complicated with splenic contusions and lacerations,and 5 cases(4.24%)complicated with mediastinal and subcutaneous emphysemas.The most direct imaging sign of rib fracture was visible and transparent low-density shadow.Chest CT scan can generally better display dislocation of the fractured end.The 3D reconstruction image showed a visibly line-like shadow on one side of rib if only one side of ribs fractured and the other side was intact.A total of 395 rib and costal cartilage fractures were confirmed by 3D reconstruction,which included 363 rib fractures(91.90%)and 32 costal cartilage fractures(8.10%).A total of 410 rib and costal cartilage fractures were confirmed by low-dose scan technique of chest CT combined with 3D reconstruction for ribs,which included 375 rib fractures(91.46%)and 35 costal cartilage fractures(8.54%).In the comparison of 418 rib injuries that were confirmed during surgery,the accuracy of low-dose scan technique of chest CT was 92.82%(388/418)in diagnosing rib and costal cartilage fractures,and the accuracy of 3D reconstruction for ribs was 94.50%(395/418)in diagnosing that,and the accuracy of low-dose scan technique of chest CT combined with 3D reconstruction for ribs was 95.69%(410/418)in diagnosing that.There was a significant difference in accuracy among the three types of examinations(x2=13.062,P<0.05).Conclusion:Low dose scan technique of chest CT combines with 3D reconstruction for ribs can be used in the diagnosis of chest trauma,which has higher accuracy and can provide reliable imaging information for clinical diagnosis and treatment.
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Photon Counting Detector(PCD)is a device used to detect X-ray photons,which can directly convert the energy of photons into electrical signals to achieve photon counting and measurement.PCD-based energy spectrum computed tomography(PCD-CT)technology can provide additional energy spectral imaging information,and improve imaging quality while reducing radiation dose.Compared with energy integrating detectors(EID),PCD has advantages of high energy conversion efficiency,good imaging quality,exquisite structural design,and wide application range.It has broad application prospects in ultra-low-dose CT,specific disease diagnosis,and industrial inspection.The application of PCD-CT in spectral CT imaging was reviewed to provide a useful reference for its application in clinical medical diagnosis and industrial applications.
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Objective:To improve the perception of computed tomography(CT)images in detecting fine fracture through multi-task network of global attention,and to realize the detection of the target of fine fracture at case level through multi-task,and to quickly and accurately identify and locate fracture from a large number of CT images,so as to assist doctors to timely conduct treatment.Methods:A grouped Non-local network method was introduced to calculate the remote dependency relationship between each position of CT image continuous sections and channel.A single-stage detector of multi-objective detection model three dimension(3D)RetinaNet was integrated with the medical image semantic segmentation architecture(3D U-Net).A end-to-end multi-task 3D convolutional network was realized,which realized the detection of case level for fine fracture through multi-task collaboration.Select 600 CT scan images from the Rib Frac Dataset of rib fractures provided by the MICCAI 2020 Challenge,and they were divided into training set(500 cases)and test set(100 cases)as the ratio of 5:1 to test the precise performance of multi-task 3D convolutional network.Results:The precise performance of multi-task 3D convolutional network method was better than that of single-task FracNet,3D RetinaNet and 3D Retina U-Net in detection,which average precision was respectively higher 7.8%and 11.4%than 3D RetinaNet and 3D Retina U-Net.It was better than two kinds of single-task network detection method included 3D Faster R-CNN and 3D Mask R-CNN,and the average precision of that was respectively higher 6.7%and 3.1%than them.Conclusion:The integrated different modules of global attention multi-task network can improve the detection performance of fine fracture.The introduction of grouped Non-local network method can further improve the precise performance for the targets of fine fractures in detection.
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Objective:To investigate the effects of different tube voltages combined with artificial intelligence reconstruction algorithm(CI)on the computed tomography(CT)imaging quality and radiation dose of chest phantom on the basis of the CT scan for an adult male simulated chest phantom(PH-N1).Methods:A 512-slice CT scanner of ultrahigh-end was adopted to conduct scan,and the images were divided into 70 kV group,80 kV group,100 kV group and 120 kV group according to different tube voltage.For 4 groups of CT scan images with different tube voltages,the 10%,30%,50%,70%and 90%CI were adopted to reconstruct 1mm thin layer image.The CT volume dose index(CTDIvol)and the dose-length product(DLP)of the scans of 4 groups were compared.The CT values and standard deviation(SD)values of the aorta,abdominal wall fat and erector spine muscle were measured.Two senior diagnostic physicians with more than 5 years of work experience independently and double-blindly evaluated the image quality by using 5-point scale.A Kappa consistency test was conducted.One-way analysis of variance was adopted to compare the differences of CT values and SD values of the tissues of image targets.The Friedman rank-sum test was adopted to compare the differences of subjective image qualities among different groups.Results:The differences of CTDIvol and DLP among 4 groups with different tube voltages were significant(F=1855.617,3996.118,P<0.05),respectively.Under 70 kV tube voltage,there were no significant differences in CT values of the aorta,abdominal wall fat and erector spine muscle,which were reconstructed by using 10%,30%,50%,70%and 90%CI(P>0.05),while the differences of SD values among them were statistically significant(F=32.267,53.327,14.873,P<0.05),respectively.Under the different tube voltages of 4 groups,which were reconstructed by 90%CI,the CT values of aorta,abdominal wall fat and erector spine muscle gradually decreased with decreasing of tube voltage,the differences were significant(F=139.899,2563.93,219.231,P<0.05),respectively.The consistency of subjective scores between two diagnostic physicians was better for each group of images(Kappa=0.712～0.869).Conclusion:Compared with 80 kV,90 kV and 120 kV images,the reconstructed images with 90%CI algorithm under 70 kV tube voltage can significantly reduce the radiation dose,and the images have a favorable signal-to-noise ratio at the same time.
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Objective:To enhance comprehension of undifferentiated embryonal sarcoma of the liver(UESL)in children by analyzing ultra-sound,CT,and MRI imaging features.Methods:A retrospective analysis was conducted on 11 cases of UESL in children,confirmed through surgery and pathology,at the Children's Hospital,Affiliated Capital Institute of Pediatrics from December 2009 to December 2021.We ana-lyzed the ultrasound,CT,and MRI imaging features of all patients and summarized their characteristics.Results:All 11 cases presented with solitary hepatic masses ranging from 11.5 to 19.8 cm in diameter.Imaging manifestations of UESL correlated with component proportion and distribution within the masses.Lesions displayed clear boundaries in all cases.CT scans revealed mixed low density in 11 cases,with ir-regular floc soft tissue density shadows observed at the edge of cystic density areas or around partitions in a few cases.Ultrasound images of all six cases showed solid space-occupying masses,with varying sizes of anechoic regions within the solid mass.MRI T1WI showed mixed low intensity signal in three cases and strip/large high intensity signal areas in the lesion.T2WI revealed mixed high intensity signal and strip low intensity signal areas in 3 lesions.In the arterial phase,lesions displayed slightly to moderately heterogeneous strip/patch enhancement,primarily marginal enhancement in nine cases and thickened,tortuous arterial shadows in eight cases.In the delayed phase,lesions showed continuous uneven enhancement,with enhancement at the edge and peripheral-to-central filling observed in eight cases.Additionally,the enhancement range continuously increased in eight cases,with the false capsule sign identified in eight cases in the delayed stage.Conclu-sions:Imaging features of UESL in children exhibit distinct characteristics.Understanding these features,in conjunction with clinical findings,may aid in early diagnosis.
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Acute carbon monoxide poisoning and its delayed encephalopathy have obvious damage to the central nervous system. There are different neuroimaging changes in different stages of the disease, and they are relatively specific. This article reviews the clinical research progress on the imaging changes of carbon monoxide poisoning and delayed encephalopathy, including computed tomography (CT) , conventional magnetic resonance imaging (MRI) , diffusion weighted imaging (DWI) , diffusion tensor imaging (DTI) , diffusion kurtosis imaging (DKI) , magnetic resonance spectroscopy (MRS) and other imaging changes reflecting the function and metabolic state of the brain tissue.
Subject(s)
Humans , Brain Diseases/etiology , Carbon Monoxide Poisoning/diagnostic imaging , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Magnetic Resonance Spectroscopy摘要
OBJECTIVES@#The artificial intelligence-aided diagnosis model of rib fractures based on YOLOv3 algorithm was established and applied to practical case to explore the application advantages in rib fracture cases in forensic medicine.@*METHODS@#DICOM format CT images of 884 cases with rib fractures caused by thoracic trauma were collected, and 801 of them were used as training and validation sets. A rib fracture diagnosis model based on YOLOv3 algorithm and Darknet53 as the backbone network was built. After the model was established, 83 cases were taken as the test set, and the precision rate, recall rate, F1-score and radiology interpretation time were calculated. The model was used to diagnose a practical case and compared with manual diagnosis.@*RESULTS@#The established model was used to test 83 cases, the fracture precision rate of this model was 90.5%, the recall rate was 75.4%, F1-score was 0.82, the radiology interpretation time was 4.4 images per second and the identification time of each patient's data was 21 s, much faster than manual diagnosis. The recognition results of the model was consistent with that of the manual diagnosis.@*CONCLUSIONS@#The rib fracture diagnosis model in practical case based on YOLOv3 algorithm can quickly and accurately identify fractures, and the model is easy to operate. It can be used as an auxiliary diagnostic technique in forensic clinical identification.
Subject(s)
Humans , Rib Fractures/diagnostic imaging , Artificial Intelligence , Thoracic Injuries , Algorithms , Radiography , Retrospective Studies摘要
Cochlear implantation has been a standard rehabilitation for children and adult patients with severe to profound sensorineural deafness.The intracochlear localization of the electrode array is one of the key factors related to the postoperative auditory and speech outcomes.Preservation of the residual hearing is related to the trauma to the inner ear structures caused in the insertion process.Optimal insertion depth and positioning of the electrode array is important for frequency discrimination.The post-operative position of the electrode array is evaluated by using plain X ray or computed tomography(CT).Compared to the plain X ray,CT produces three-dimensional(3D)imaging.With the application of post-operative CT evaluation,the integrity of the electrode array can be verified for surgical safety and improving programming accuracy.Different 3D reconstruction techniques and methods based on the post-operative CT imaging have been proposed to facilitate the precise recognition of position of each electrode,thus helpful to evaluate the possible insertion trauma to inner ear structures and the potential effect on auditory and speech outcomes.The post-operative CT evaluation has helped the electrode array design,brought progress to the soft surgery procedure and promoted new technologies such as robotic surgery and navigation.Therefore,it is getting more and more attention.This article reviews the clinical application values and the progress of techniques in post-operative CT evaluation of cochlear implantation.
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Objective:To explore the evaluations of computed tomography(CT)perfusion imaging parameters and serum complement C1q/tumor necrosis factor related protein-3(CTRP-3),low density lipoprotein cholesterol(LDL-C),matrix metalloproteinase-9(MMP-9)on hemorrhagic transformation(HT)after acute cerebral infarction(ACI).Methods:A total of 206 ACI patients who admitted to the People's Hospital of Jianyang from August 2019 to July 2022 were retrospectively selected as the study objects.The patients were divided into HT group(45 cases)and non-HT group(161 cases)according to whether occurred HT after intravenous thrombolysis.The CT perfusion imaging parameters[blood flow(BF),blood volume(BV),mean transit time(MTT),permeability surface(PS)],CTRP-3,LDL-C,MMP-9 were compared between two groups.Receiver operating characteristic(ROC)curve model was used to analyze the area under curve(AUC)values,sensitivities and specificities of CT perfusion imaging parameters,CTRP-3,LDL-C and MMP-9 in diagnosing HT.Results:The BF and BV of HT group were lower than those of non-HT group,while the MTT and PS of HT group were higher than those of non-HT group,and the differences were statistically significant(t=-5.941,t=-5.777,t=5.863,t=6.954,P<005),respectively.The CTRP-3 and LDL-C of HT group were respectively lower than those of non-HT group,while the MMP-9 of HT group was higher than that of non-HT group,with statistical significances(t=-3.788,t=-5.835,t=6.935,P<0.05).The ROC curve analysis showed that the AUC values of BF,BV,MTT,PS,CT comprehensive parameters,CTRP-3,LDL-C and MMP-9 were respectively 0.790,0.779,0.738,0.775,0.949,0.692,0.777 and 0.785(P<0.05).The sensitivities of them were respectively 88.90%,100.00%,53.30%,66.70%,100.00%,88.90%,66.70%and 78.60%.The specificities of them were respectively 64.60%,51.60%,91.30%,77.60%,81.40%,47.80%,78.90%and 75.80%.The differences of the AUC values between CT comprehensive parameters and CTRP-3,and between that and LDL-C,and between that and MMP-9 were significant(Z=6.202,Z=4.563,Z=3.704,P<0.05),respectively.Conclusion:CT perfusion imaging parameters,serum CTRP-3,LDL-C and MMP-9 levels have close correlation with HT after ACI.The monitoring of the change degrees of them is helpful to provide important references for predicting the occurrence of HT in ACI patients after thrombolytic therapy.
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Objective:To investigate the computed tomography(CT)and magnetic resonance imaging(MRI)features of retroperitoneal ded-ifferentiated liposarcoma(DDL),and improve the understanding of DDL and the accuracy of preoperative diagnosis.Methods:Clinical and imaging features of 25 patients with retroperitoneal DDL from Tianjin Medical University Cancer Institute&Hospital,confirmed by patho-logy from January 2012 to June 2022,were retrospectively analyzed.Results:Among 25 cases of retroperitoneal DDL,19 and 6 had single and multiple tumors,respectively and 10 and 15 were oval and irregular shaped tumors,respectively.Most lesions had unclear boundaries,with 15 cases invading the surrounding tissues and organs.Small vessel shadows were visible in 15 cases,while calcifications or ossifications were observed in 7 cases,and cystic necrosis was observed in only 3 cases.Enhanced scanning exhibits a centripetal and progressive con-tinuous augmentation characteristic defined as"slow in and slow out."According to its manifestations in CT and MRI,it can be divided into two types:type I(soft tissue mass type),where the tumor has a soft tissue component with no fat content(14 cases);and type Ⅱ(fat con-taining),where the tumors exhibit both soft tissue and adipose components,most of which are clearly defined and rarely present in a mosa-ic shape.In abnormal fat areas,cord-like fibrous septa can be seen.Among them,the intratumoral fat composition<50%was Ⅱa type(10 cases).Intratumor fat composition≥50%was type Ⅱb(1 case).Conclusions:Combined with imaging classification,a comprehensive ana-lysis of the CT and MRI imaging characteristics of retroperitoneal DDL is of great value for its preoperative qualitative diagnosis.
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Objective:The purpose of this study was to investigate the clinical value of CT-guided localization of pulmonary nodules with soft wire hook-wire by trailing technique.Methods:The clinical data of 211 pulmonary nodules of 185 patients from November 2020 to March 2022 in Beijing Aerospace General Hospital were retrospectively analyzed. The pulmonary nodules were localized with soft wire hook-wire by trailing technique before video-assisted thoracic surgery (VATS). The success rate, complications, pathological results and localization operations related data were statistically analyzed.Results:The success rate of localization was 97.63% (206/211), and the success rate of VATS removal was 99.53% (210/211). The average operation time was (7.19 ± 2.62) min, and the average time required for resection of lesions was 27 min (10 to 126 min). During the surgery, the soft wire hook-wire of two patient was found to be dislocated and retracted into the chest wall. The pulmonary nodules were successfully located and removed according traces left by puncture points on the lung surface. It was found that the hook-wire was located in the interlobar fissure in 3 patients. The pulmonary nodules were successfully removed by the hook-wire position and appropriately expanding the resection range. A minor pneumothorax occurred in 49 patients, but no closed drainage was needed; 12 patients developed intrapulmonary hematoma; 15 patients with chest pain were treated with analgesia.Conclusions:For small pulmonary nodules requiring thoracoscopic surgery, the computed tomography-guided pulmonary nodule localization with soft wire hook-wire by trailing technique is more convenient, safe and effective, and is worthy of promotion to use.
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Background: Diagnosis of intrathoracic masses is a difficult challenge for clinicians. The compact anatomical arrangement of the medias?num with diverse pathologies is usually encountered. The present study was done to determine the efficiency of computed tomography (CT) guided Fine-Needle Aspira?on Cytology (FNAC) in the evalua?on of various thoracic mass lesions Methods : A total of n=46 pa?ents presen?ng as intrathoracic mass lesions, confirmed on contrast-enhanced CT, were included in the study. A commercially available CT (Ingenuity 128 slices, Philips) was used for biopsy. All pa?ents were subjected to detailed clinical history and physical examina?on. Inves?ga?ons: Complete blood count, Erythrocyte sedimenta?on rate, bleeding ?me, clo?ng ?me, Prothrombin ?me, Ac?vated par?al thromboplas?n ?me, HIV and HbsAg, Chest X-ray postero Anterior view, and Lateral view done in all cases. Chest X-ray AP view and Ultrasound was done wherever needed. Plain and contrast CT was done in all cases before FNAC. Results: The posi?ve diagnos?c yield in our study is noted in 45 of the 46 pa?ents(97.82%); the posi?ve yield for malignancy was 89.13% (41 of 46 pa?ents), benign in8.69 % (4/46), and undiagnosed in 1/46 (2.17%). Out of 46, 40(86.96%) were parenchymal lesions and 6(13.04%) were medias?nal lesions. Out of 40 parenchymal lesions, 38/40(95%) were malignant, which consisted of 55.3% Squamous cell carcinoma, 28.9% Adenocarcinoma. Conclusion: FNAC is useful for obtaining samples for the diagnosis of focal pulmonary infec?ons, even in immunocompromised pa?ents, and planning appropriate chemotherapy op?ons in lung cancer and metasta?c lesions.CT-guided FNAC is an ini?al approach for the diagnosis of small pulmonary nodules of less than 20mm, aiding in early diagnosis and treatment interven?ons improving prognosis.
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@#Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.
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@#Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.
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OBJECTIVES@#To study the correlation between CT imaging features of acceleration and deceleration brain injury and injury degree.@*METHODS@#A total of 299 cases with acceleration and deceleration brain injury were collected and divided into acceleration brain injury group and deceleration brain injury group according to the injury mechanism. Subarachnoid hemorrhage (SAH) and Glasgow coma scale (GCS), combined with skull fracture, epidural hematoma (EDH), subdural hematoma (SDH) and brain contusion on the same and opposite sides of the stress point were selected as the screening indexes. χ2 test was used for primary screening, and binary logistic regression analysis was used for secondary screening. The indexes with the strongest correlation in acceleration and deceleration injury mechanism were selected.@*RESULTS@#χ2 test showed that skull fracture and EDH on the same side of the stress point; EDH, SDH and brain contusion on the opposite of the stress point; SAH, GCS were correlated with acceleration and deceleration injury (P<0.05). According to binary logistic regression analysis, the odds ratio (OR) of EDH on the same side of the stress point was 2.697, the OR of brain contusion on the opposite of the stress point was 0.043 and the OR of GCS was 0.238, suggesting there was statistically significant (P<0.05).@*CONCLUSIONS@#EDH on the same side of the stress point, brain contusion on the opposite of the stress point and GCS can be used as key indicators to distinguish acceleration and deceleration injury mechanism. In addition, skull fracture on the same side of the stress point, EDH and SDH on the opposite of the stress point and SAH were relatively weak indicators in distinguishing acceleration and deceleration injury mechanism.
Subject(s)
Humans , Brain Contusion , Brain Injuries/diagnostic imaging , Hematoma, Epidural, Cranial , Hematoma, Subdural/etiology , Logistic Models , Skull Fractures/diagnostic imaging , Tomography, X-Ray Computed , Wounds, Nonpenetrating/diagnostic imaging摘要
To investigate the predictive value of [ 18F]fluorodeoxyglucose-positron emission computed tomography(PET)/CT for disease progression in patients with dermatomyositis (DM) and interstitial lung diseases (ILD). Sixty-seven DM patients who underwent [ 18F] FDG-PET/CT imaging were retrospectively analyzed from January 2012 to September 2017 at PLA General Hospital. Their clinical manifestations and imaging characteristics were recorded. Compared with those chronically progressed (C-ILD), patients with rapid progression (RP-ILD) had significantly higher erythrocyte sedimentation rate (ESR) and standardized uptake value (SUV) in lungs ( P<0.05). In patients with RP-ILD, SUV in lungs was positively correlated with age, disease course, and ESR. Receiver operating characteristic curve analysis suggested that when lung SUV cut off value was 2.25, the sensitivity and specificity to predict disease progression was 77.8% and 72.8%, respectively. Old age, longer disease course, low creatine kinase level, higher ESR, and high SUV are prognostic factors for DM-associated ILD.
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Objective To study the imaging characteristics of maxillary sinus effusion in drowned bodies, to explore its morphological characteristics and value in the diagnosis of the cause of death, and to provide objective evidence to support the study of virtual anatomy of drowning. Methods The 154 postmortem CT examination cases （31 cases of drowning, 123 cases of non-drowning） of Beijing Public Security Bureau Forensic Center in 2019 were collected. The bodies of all cases were scanned by multi-layer spiral CT before double-blind reading by clinical imaging experts. Maxillary sinus of corpses with maxillary sinus effusion in imaging findings was punctured. The detection rate of maxillary sinus effusion was calculated. The CT value and volume of maxillary sinus effusion were measured on 3D DICOM workstation. Results The detection rate of maxillary sinus effusion in the drowning was 100%, the shape was horizontal liquid level, the volume was 1.2-11.2 mL, the CT value was 6.08-19.02 Hu, with an average value of 12.85 Hu. The detection rate of maxillary sinus effusion in non-drowning was 19.51% （24/123）, the shape was wavy or irregular, and there were bubbles inside, the volume was 0.4-13.4 mL, the CT value was 23.68-77.75 Hu, with an average value of 42.08 Hu. The differences in CT value between the two groups had statistical significance. Conclusion The postmortem CT examination method can be used to observe the shape and measure the CT value of the maxillary sinus effusion in the bodies in water, which can be an auxiliary examination method for identification of drowning.
Subject(s)
Humans , Autopsy , Beijing , Drowning/diagnostic imaging , Maxillary Sinus/diagnostic imaging , Tomography, X-Ray Computed摘要
Tuberculosis is one of the leading causes of mortality in a developing country like India among the infectious diseases. Early diagnosis of tuberculosis is by chest X-Ray, sputum examination, culture and nucleic acid amplification. Chest X-Ray findings are not very specific, sputum examination and culture take many days thus delaying the diagnosis. CT scan is very fast, non-invasive and accurate. It can diagnose the cause of unexplained cough, chest pain, fever and other chest symptoms. Because of accuracy, high speed and better resolution, CT scan is the modality of choice for early detection of pulmonary TB. The aim of the study is to evaluate the role of CT and HRCT in pulmonary TB.METHODSIt is a cross sectional study conducted at Jawaharlal Nehru Institute of Medical Sciences from January 2016 to June 2016 in a series of cases sent for CT or HRCT using AQUILION, Toshiba 64 slice multi detector CT. All the data were entered in excel sheet and transferred to SPSS Version 2 and then analysed by using descriptive statistics like mean, standard deviation and percentage. Chi square test was used. p Value of <0.05 was taken as statistically significant.RESULTSAmong 358 cases, 49.7% (178 cases) were diagnosed as pulmonary tuberculosis. In cases diagnosed as pulmonary TB, 104 (58.4%) were male and 74 (41.7%) were female. Over 60 yrs. of age, 56.1% of the cases had TB with cavitary and parenchymal lesion, followed by TB with lung destruction & cicatrisation in 17.3% of the cases. In younger age group, 20 years and below, had TB with cavitary & parenchymal lesions in 75% of cases and TB with chronic empyema & fibrothorax in 25% cases. Incidence of TB in higher age groups was statistically significant (p<0.05).CONCLUSIONSCT and HRCT can diagnose different stages of pulmonary TB and any associated diseases. It helps in taking treatment decisions and preventing disease spread which is an important health issue. For early detection of pulmonary TB, CT and HRCT is a must for diagnosis.
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Objective:To explore the potential regularity and cause of the differences between magnetic resonance imaging (MRI) and computed tomography (CT) presenting electrodes after deep brain stimulation (DBS) for Parkinson's disease (PD), in order to provide reference for optimizing clinical decision. Methods:Forty-nine PD patients who underwent DBS treatment in Department of Functional Neurosurgery of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from Jan. 2016 to Dec. 2017 were selected. CT images were acquired 3-5 days after surgery and MRI images were acquired during 3-6 months by the follow-up of regular programming. The fused images of short-term CT combined with preoperative MRI and long-term MRI respectively were compared to show the difference by the tip contact positions of electrodes. Results:A total of 50 groups of postoperative CT fused images and MRI images were obtained. The space differences of the two types of images were 1.36 (0.98, 1.70) mm (P=0.021) and 1.28 (0.99, 1.88) mm (P=0.006), on the right and left electrodes, respectively. Bilateral electrodes in both short-term and long-term images had a tendency to move to the medial, rear, and bottom part of the brain. Conclusion:The potential tendency in shifts of DBS electrodes can provide reference for establishing the brain drift model and optimizing the position of the implanted electrode.