摘要
SUMMARY: Diabetes is a form of endocrine disease. Dual-energy X-ray Absorptiometry (DXA) provides a detailed view of the body composition to find out what makes people with diabetes different from those with other diseases. We scanned 371 patients with DXA to analyze their body composition parameters. Three hundreds and seventy one patients (178 women/193 men), who with different diseases, with a mean±SD Body Mass Index (BMI) of 25.32±8.3 kg/m2 were included. The body composition of 371 patients was assessed. Bone Mineral Density (BMD), Fat Weight, Lean Weight, waist-to-hip ratio, Lean Mass Index (LMI), Fat Mass Index (FMI), the relationship between Fat percentage and BMI were analyzed. The 371 patients included 156 diabetics and 215 non-diabetics. Non-diabetic patients also included 5 obesity patients, 9 patients with fatty liver, 39 patients with hypertension, 22 patients with hyperlipidemia, 18 patients with cardiovascular disease, 11 patients with chest and lung disease, 4 patients with chronic disease, 14 patients with brain disease and 93 patients with other diseases. Among 156 diabetic patients, 129 had VAT > 100 cm2 and 27 had VAT ≤100 cm2. The lean weight (LW) of male diabetic patients was significantly higher than that of female diabetic patients. The fat weight (FW) of female patients with diabetes was significantly higher than that of male patients. The waist-hip ratio (WHR) was 1.37 ± 0.25 in male diabetic patients and 1.18 ± 0.21 in female diabetic patients. Among the 215 non-diabetic patients, the obese and fatty liver patients, which the weight (WT) (obesity: 83.87 ± 8.34 kg fat liver: 85.64±28.60 kg), FW (obesity: 28.56 ± 4.18 kg fat liver: 28.61 ± 10.79 kg), LW (obesity: 52.62 ± 9.64 kg fat liver: 54.29±17.58 kg), BMI (obesity: 28.76 ± 1.88 kg/m2 fat liver: 29.10 ± 5.95 kg/m2), was much higher than other patients. Diabetes patients had less fat mass than non- diabetic patients; the difference was around 2 kg. BMI is also a modest number. BMD doesn't differ all that much. Non-diabetic patients with fatty liver obesity and cardiovascular disease had higher fat mass and BMI than patients with other illnesses. Body composition can provide precise information on the makeup of different body areas, but further in-depth exams are required to ascertain the body's endocrine profile.
La diabetes es una enfermedad endocrina. La absorciometría de rayos X de energía dual (DXA) proporciona una vista detallada de la composición corporal para descubrir qué diferencia a las personas con diabetes de aquellas con otras enfermedades. Escaneamos a 371 pacientes con DXA para analizar sus parámetros de composición corporal. Se incluyeron 371 pacientes (178 mujeres/193 hombres), con diferentes enfermedades, con un Índice de Masa Corporal (IMC) medio ± DE de 25,32 ± 8,3 kg/m2. Se evaluó la composición corporal de 371 pacientes. Se analizaron la densidad mineral ósea (DMO), el peso graso, el peso magro, la relación cintura-cadera, el índice de masa magra (LMI), el índice de masa grasa (FMI), y la relación entre el porcentaje de grasa y el IMC. De los 371 pacientes 156 eran diabéticos y 215 no diabéticos. Los pacientes no diabéticos también incluyeron 5 con obesidad, 9 con hígado graso, 39 con hipertensión, 22 con hiperlipidemia, 18 con enfermedad cardiovascular, 11 con enfermedad torácica y pulmonar, 4 con enfermedad crónica, 14 con enfermedad cerebral y 93 pacientes con otras enfermedades. Entre los 156 pacientes diabéticos, 129 tenían un IVA > 100 cm2 y 27 tenían un IVA ≤100 cm2. El peso magro (PV) de los hombres diabéticos fue significativamente mayor que el de las mujeres diabéticas. El peso graso (FW) de las mujeres diabéticas fue significativamente mayor que el de los hombres diabéticos. El índice cintura-cadera (ICC) fue de 1,37 ± 0,25 en hombres diabéticos y de 1,18 ± 0,21 en mujeres diabéticas. Entre los 215 pacientes no diabéticos, los pacientes obesos y con hígado graso, cuyo peso (WT) (obesidad: 83,87 ± 8,34 kg hígado graso: 85,64 ± 28,60 kg), FW (obesidad: 28,56 ± 4,18 kg hígado graso: 28,61 ± 10,79 kg), PV (obesidad: 52,62 ± 9,64 kg, hígado graso: 54,29 ± 17,58 kg), IMC (obesidad: 28,76 ± 1,88 kg/m2, hígado graso: 29,10 ± 5,95 kg/m2), fue mucho mayor que otros pacientes. Los pacientes diabéticos tenían menos masa grasa que los pacientes no diabéticos; la diferencia fue de alrededor de 2 kg. La DMO no difiere mucho. Los pacientes no diabéticos con obesidad debido al hígado graso y enfermedades cardiovasculares tenían mayor masa grasa e IMC que los pacientes con otras enfermedades. La composición corporal puede proporcionar información precisa sobre la composición de diferentes áreas del cuerpo, pero se requieren exámenes más profundos para determinar el perfil endocrino del cuerpo.
Subject(s)
Humans , Male , Female , Body Composition , Absorptiometry, Photon , Diabetes Mellitus , Bone Density , Adipose Tissue摘要
Resumo A doença veno-oclusiva pulmonar (DVOP) e a hemangiomatose capilar pulmonar são tipos raros de substratos histopatológicos dentro do espectro da hipertensão arterial pulmonar (HAP) com prognóstico muito ruim. Caracterizam-se por um processo fibroproliferativo generalizado das veias e/ou capilares de pequeno calibre com preservação das veias maiores, resultando em um fenótipo de hipertensão pulmonar pré-capilar. A apresentação clínica é inespecífica e semelhante a outras etiologias de HAP. O diagnóstico definitivo é obtido por meio de análise histológica, embora a biópsia pulmonar não seja aconselhada devido ao maior risco de complicações. No entanto, alguns achados adicionais podem permitir um diagnóstico clínico presuntivo de DVOP, especialmente história de tabagismo, uso de drogas quimioterápicas, exposição a solventes orgânicos (particularmente tricloroetileno), baixa capacidade de difusão do monóxido de carbono (DLCO), dessaturação ao esforço e evidências de doença venosa sem doença cardíaca esquerda no exame de imagem, manifestada por uma tríade clássica de opacidades em vidro fosco, linhas septais, e linfadenopatias. O transplante pulmonar é o único tratamento eficaz e os pacientes devem ser encaminhados no momento do diagnóstico, devido à rápida progressão da doença e ao prognóstico ruim. Apresentamos o caso de um homem de 58 anos com HAP com características de envolvimento venoso/capilar em que a suspeita clínica, o pronto diagnóstico e o encaminhamento precoce para transplante pulmonar foram determinantes para um bom desfecho.
Abstract Pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangiomatosis are rare types of histopathological substrates within the spectrum of pulmonary arterial hypertension (PAH) with a very poor prognosis. They are characterized by a widespread fibroproliferative process of the small caliber veins and/or capillaries with sparing of the larger veins, resulting in a pre-capillary pulmonary hypertension phenotype. Clinical presentation is unspecific and similar to other PAH etiologies. Definitive diagnosis is obtained through histological analysis, although lung biopsy is not advised due to a higher risk of complications. However, some additional findings may allow a presumptive clinical diagnosis of PVOD, particularly a history of smoking, chemotherapy drug use, exposure to organic solvents (particularly trichloroethylene), low diffusing capacity for carbon monoxide (DLCO), exercise induced desaturation, and evidence of venous congestion without left heart disease on imaging, manifested by a classical triad of ground glass opacities, septal lines, and lymphadenopathies. Lung transplant is the only effective treatment, and patients should be referred at the time of diagnosis due to the rapid progression of the disease and associated poor prognosis. We present a case of a 58-year-old man with PAH with features of venous/capillary involvement in which clinical suspicion, prompt diagnosis, and early referral for lung transplantation were determinant factors for the successful outcome.
摘要
ABSTRACT Identifying the presence, size, type and location of voids in an endodontic obturation is of great clinical importance because it enables evaluation of the three-dimensionality of the sealing techniques, which can be related to the success of the endodontic treatment. Aim To analyze by micro-CT the presence of voids in lower single-rooted premolar root canal obturations prepared using the single cone and ultrasound vibration technique. Materials and methods Twenty extracted single-rooted lower premolars were selected, and the root canal prepared surgically and chemically. In GROUP 1 - Without Vibration, the canal was obturated with a single cone and bioceramic, without applying vibration. In GROUP 2 - With Vibration, the gutta-percha cone inside the root canal was held with a cotton plier to which ultrasound vibration was applied for 3 periods of 3 seconds each. A micro-CT scanner was used to acquire and reconstruct images for analysis. Results No significant difference was found between obturation techniques, though there were differences between thirds, with the cervical third having a higher percentage of voids than the middle and apical thirds. Conclusions The results suggest that the volume of closed, open and total voids does not differ between treatments with and without ultrasound vibration. In the cervical third, the highest volume of voids was related to oval geometry in the teeth evaluated.
RESUMEN La presencia de vacíos en la obturación endodóntica, su tamaño y el tipo y localización tiene gran importancia clínica ya que permite evaluar la tridimensionalidad de las técnicas de sellado y relacionarlas con el éxito del tratamiento endodóntico. Objetivo analizar mediante microtomografía la presencia de vacíos en la obturación del conducto radicular de premolares inferiores unirradiculares, utilizando la técnica de cono único y vibración con ultrasonido. Materiales y Método se seleccionaron 20 premolares inferiores unirradiculares a los que se les realizó la preparación quirúrgica y química del conducto radicular. Se realizó la obturación con cono único y biocerámico GRUPO 1- sin vibración. En el GRUPO 2 - con vibración se aplicó vibración por ultrasonido, se tomó del cono de gutapercha colocado en el interior del conducto con pinza de algodón que fue vibrada durante 3 períodos de 3 segundos cada uno. Las mismas fueron adquiridas y reconstruidas en un microtomógrafo para posterior análisis de las imágenes obtenidas. Resultados No se evidenciaron diferencias significativas entre ambas técnicas de obturación comparadas, pero si entre los tercios analizados, siendo el cervical el que mayor porcentaje de vacíos presenta en comparación a los cortes correspondientes al tercio medio y apical. Conclusiones Los resultados sugieren que el volumen de vacíos cerrados, abiertos y total no varía en los tratamientos donde se aplica vibración por ultrasonido. En el tercio cervical, el mayor volumen de vacíos se relaciona con la geometría oval que presentaron las piezas dentarias evaluadas en este estudio.
摘要
ABSTRACT Differentiating orofacial odontogenic pain/disorders from pain/disorders associated with maxillary sinusitis is important to avoid unnecessary dentalprocedures and to properly refer patients to colleagues/dentists and vice versa. Aim To analyze the association between apical lesions and sinus changes and to evaluate the agreement between the diagnoses of an endodontist, a radiologist, an oral and maxillofacial surgeon, and an otolaryngologist. Materials and Method 385 axial, coronal, and sagittal MSCT scans were selected using an image archiving andcommunication system (PACS). The examinations had been performed between 2018 and 2022. Results Apical lesions were observed in 36.10% of sinusitis cases, 73.8% of unilateralsinusitis cases, 48.7% of sinus floor discontinuity cases, and 67.2% of cases in which endodontic treatment had been performed. Agreement between the diagnoses made by the endodontist and those made by the other investigators was high for most study variables (k > 0.60). The exceptions were mucosal thickening, for which agreement between the endodontist and the other investigators was intermediate (k=0.397), and the presence of periapicallesions (k=0.010), previous endodontic treatment (k=0.013), and mucosal thickness (k=0.024), for which agreement between endodontists and radiologists was low. Conclusions: There was an association between sinus changes and apical lesions.
RESUMO Diferenciar a dor/desordens odontogénicas orofaciais da dor/desordens as sociadas á sinusite maxilar é importante para evitar procedimentos odontológicos desnecessários e para encaminhar adequadamente os pacientes aos colegas/dentistas e vice-versa. Objetivo Analisar a associagdo entre lesoes apicais e alteragóes sinusais e avaliar a concordáncia entre os diagnósticos de um endodontista, um radiologista, um cirurgido bucomaxilofacial e um otorrinolaringologista. Material e Método foram avaliadas 385 imagens. Resultados Aslesoes apicais foram observadas em 36,10% dos casos de sinusite, em 73,8% dos casos de sinusite unilateral, em 48,7% dos casos de descontinuidade do assoalho do seio e em 67,2%odos casos em que o tratamento endodontico havia sido realizado. A concordancia entre os diagnósticos feitos pelo endodontista e os feitos pelos outros pesquisadores foi alta para a maioria das variáveis do estudo (k > 0,60). As excegoes foram o espessamento da mucosa, para o qual a concordáncia entre o endodontista e os outros pesquisadores foi intermediária (k=0,397) e a presenga delesoes periapicais (k=0,010), tratamento endodontico prévio (k=0,013) e espessura da mucosa (k=0,024), para os quais a concordáncia entre endodontistas e radiologistas foi baixa. Conclusoes Houve uma associagdo entre as alteragóes sinusais e aslesoes apicais.
摘要
RESUMEN Introducción: El cáncer hepático es la séptima neoplasia más frecuente a nivel mundial y la segunda causa de mortalidad asociada directamente a cáncer. En México presenta una incidencia del 3.9% en toda la población. A pesar de que la tomografía axial computada es el estudio diagnóstico inicial de elección, el diagnóstico final se establece con el estudio anatomopatológico de la lesión. Objetivo: Correlacionar los hallazgos tomográficos con el resultado histopatológico en pacientes con lesiones hepáticas con sospecha de malignidad, a los que se les tomó biopsia dirigida por USG. Material y métodos: Estudio descriptivo, de correlación, retrolectivo, homodémico y unicéntrico. El tiempo de estudio fue de septiembre 2021 a febrero 2022. Se seleccionó a pacientes mayores de 18 años con lesiones hepáticas sospechosas de malignidad, a los que se les realizó tomografía y biopsia guiada por ultrasonido. Se utilizó pruebas de Shapiro-Wilk (de normalidad) y se utilizó ꭕ2 para un análisis de asociación de variables categóricas. Resultados: Se incluyeron a 24 pacientes, a los cuales se les realizó tomografía y biopsia de lesión, encontrando un tamaño promedio de las lesiones de 2.39cm. Los resultados de la correlación entre el diagnóstico tomográfico y el diagnóstico histopatológico definitivo no tuvieron significancia estadística p=0.069. Conclusiones: No se encontró correlación significativa entre el estudio histopatológico y los hallazgos tomográficos en lesiones hepáticas sugerentes de malignidad.
ABSTRACT Introduction: Liver cancer is the seventh most common neoplasm worldwide and the second cause of mortality directly associated with cancer. In Mexico it has an incidence of 3.9% in the entire population. Although computed tomography (CT) is the imaging study of choice, the final diagnosis is established with the anatomopathological study of the lesion. Objective: Correlate the tomographic findings with the histopathological result in patients with liver lesions with suspicion of malignancy, who underwent USG-guided biopsy. Methods: Descriptive, correlation, retrolective, homodemographic and single-center study. The study period was from September 2021 to February 2022. Patients older than 18 years with liver lesions suspicious of malignancy were selected and underwent Computed Axial Tomography and ultrasound-guided biopsy. Shapiro Wilk tests (for normality) were used and chi-square was used for an analysis of association of categorical variables. Results: Twenty-four patients were included, who underwent Tomography and lesion biopsy, finding an average size of lesions of 2.39cm. The results of the correlation between the tomographic diagnosis and the definitive histopathological diagnosis did not have statistical significance p=0.069. Conclusions: No significant correlation was found between the histopathological study and tomographic findings in liver lesions suggestive of malignancy.
摘要
ABSTRACT Introduction: Osteoarthritis (OA) is a chronic inflammatory degenerative disease, characterized by progressive degeneration of the articular cartilage, affecting mostly the knee joint. The elderly population is the most affected, intensifying the aging process. The concentration of intramuscular adipose tissue in the thigh muscles and knee OA at different ages remains under investigation. Objective: Investigate the cross-sectional area of thigh muscles at different ages with the relationship of the presence of intramuscular fat and knee OA. Methods: 80 participants were paired into 4 groups: Young Osteoarthritis Group and Old Osteoarthritis Group, both sedentary with knee OA diagnosis II or III; Healthy Young Group and Healthy Old Group, both healthy and sedentary. The groups were paired according to gender and body mass index, submitted to physiotherapeutic evaluation, WOMAC questionnaire, knee X-ray and thigh CT scans. Morphometric analysis was performed manually with ITK-SNAP software (version 3.6), by a single evaluator. Statistical analysis used the one-way ANOVA test followed by Bonferroni post-hoc for dependent variables (p≤0.05). Results: Comparison of the cross-sectional area of the rectus femoris, vastus lateralis, semitendinosus, sartorius and gracilis muscles between the groups indicated no significant differences (p>0.05). The study of attenuation for muscle adipose tissue indicated no significant difference in the values of between the OA-Young and Aged-S groups for all the muscles evaluated. Conclusion: Young individuals with knee OA present muscle morphological characteristics similar to those found during the aging process, characterizing early aging of the thigh muscles. Level of Evidence III; Retrospective cross-sectional and observational study.
RESUMEN Introducción: La artrosis (OA) es una enfermedad inflamatoria degenerativa crónica, caracterizada por la degeneración progresiva del cartílago articular, que afecta principalmente a la articulación de la rodilla. La población anciana es la más afectada, intensificándose el proceso de envejecimiento. La concentración de tejido adiposo intramuscular en los músculos del muslo y la OA de rodilla a diferentes edades sigue siendo objeto de investigación. Objetivo: Investigar el área transversal de los músculos del muslo a diferentes edades con la relación de la presencia de grasa intramuscular y la OA de rodilla. Métodos: Se emparejó a 80 participantes en 4 grupos: Grupo de jóvenes con osteoartritis y Grupo de mayores con osteoartritis, ambos sedentarios y con diagnóstico de OA de rodilla II o III; Grupo de jóvenes sanos y Grupo de mayores sanos, ambos sanos y sedentarios. Los grupos fueron emparejados según sexo e índice de masa corporal, sometidos a evaluación fisioterapéutica, cuestionario WOMAC, exámenes radiográficos de las rodillas y tomografía computarizada del muslo. El análisis morfométrico se realizó manualmente con el software ITK-SNAP (versión 3.6), por un único evaluador. En el análisis estadístico se utilizó la prueba ANOVA unidireccional seguida del post-hoc de Bonferroni para las variables dependientes (p≤0,05). Resultados: La comparación del área transversal de los músculos recto femoral, vasto lateral, semitendinoso, sartorio y gracilis entre los grupos no indicó diferencias significativas (p>0,05). El estudio de la atenuación para el tejido adiposo muscular no indicó diferencias significativas en los valores de entre los grupos OA-Young y Aged-S para todos los músculos evaluados. Conclusión: Individuos jóvenes con OA de rodilla presentan características morfológicas musculares similares a las encontradas durante el proceso de envejecimiento, caracterizando el envejecimiento precoz de los músculos del muslo. Nivel de Evidencia III; Estudio transversal y observacional retrospectivo.
RESUMO Introdução: A osteoartrite (OA) é uma doença inflamatória crônico-degenerativa, caracterizada pela degeneração progressiva da cartilagem articular, acometendo em maior parte a articulação do joelho. A população idosa é a mais atingida, intensificando o processo de envelhecimento. A concentração de tecido adiposo intramuscular nos músculos da coxa e a OA de joelho em diferentes idades permanece em investigação. Objetivo: Investigar a área de secção transversa dos músculos da coxa em diferentes idades com a relação da presença de gordura intramuscular e OA de joelho. Métodos: 80 participantes foram pareados em 4 grupos: Grupo Osteoartrite Jovem e Grupo Osteoartrite Idoso, ambos sedentários com diagnóstico de OA de joelho II ou III; Grupo Jovem Saudável e Grupo Idoso Saudável, ambos saudáveis e sedentários. Os grupos foram pareados de acordo com sexo e índice de massa corporal, submetidos à avaliação fisioterapêutica, questionário WOMAC, exames de raio-x dos joelhos e tomografia computadorizada da coxa. A análise morfométrica foi realizada manualmente com software ITK-SNAP (versão 3.6), por um único avaliador. Análise estatística utilizou o teste ANOVA one-way seguido pelo post-hoc de Bonferroni, para variáveis dependentes (p≤0,05). Resultados: A comparação da área de secção transversa dos músculos reto femoral, vasto lateral, semitendinoso, sartório e grácil, entre os grupos, não indicou diferenças significativas (p>0,05). O estudo da atenuação para o tecido adiposo muscular não indicou diferença significativa nos valores de entre os grupos OA-Jovem e Idoso-S para todos os músculos avaliados. Conclusão: Indivíduos jovens com OA de joelho apresentam características morfológicas musculares semelhantes às encontradas durante o processo de envelhecimento, caracterizando um envelhecimento precoce dos músculos da coxa.Nível de Evidência III; Estudo retrospectivo transversal e observacional.
摘要
La neurofibromatose de type 1 ou maladie de Von Recklinghausen, maladie héréditaire la plus fréquente parmi les phacomatoses, caractérisée par la présence d'au moins deux critères diagnostiques, dont le neurofibrome. Nous rapportons le cas d'un patient de 37 ans, contact direct d'un patient tuberculeux, atteint de neurofibromatose dont la radiographie pulmonaire mimait des images en « lâcher de ballon ¼ coexistant avec une tuberculose pulmonaire. Nous insistons à travers ce cas et à la lumière d'une revue de la littérature sur l'importance d'avoir un esprit critique et un raisonnement diagnostic médical devant toute image ne correspondant pas à l'indication clinique.
Neurofibromatosis type 1 or Von Recklinghausen disease, most common hereditary disease of phacomatosis, which is characterized by the presence of at least two diagnostic criteria, including neurofibroma. We report the case of a 37-year-old patient, direct contact of a tuberculosis patient, suffering from neurofibromatosis whose chest X-ray mimicked images of "balloon release" coexisting with pulmonary TBC. We insist through this observation and in the light of a literature review on the importance of having a critical mind and medical diagnostic reasoning in front of any image that does not match the clinical indication.
Subject(s)
Humans , Female , Adult摘要
Objective:To investigate the effect of risk warning management mode on patients undergoing an emergency enhanced CT examination.Methods:This is a case-control study. A total of 40 patients who underwent emergency enhanced CT examination using routine management mode at No. 1 People's Hospital of Pinghu from January 2020 to June 2021 were included in the routine group. An additional 40 patients who underwent emergency enhanced CT examinations using risk warning management mode at the same hospital from July 2021 to December 2022 were included in the study group. The two groups were compared in terms of CT examination, image quality, adverse reactions, patient satisfaction, Self-rating Depression Scale score, and Self-rating Anxiety Scale score.Results:The Self-rating Depression Scale and Self-rating Anxiety Scale scores in the study group were significantly lower than those in the routine group ( t = -3.17, -2.90, both P < 0.05). The waiting time for CT examination, primary CT scan time, secondary CT scan time, and tertiary CT scan time in the study group were significantly shorter than those in the routine group ( t = 18.15, 4.89, 2.24, all P < 0.05). The completion rate of CT scans in the study group was 100% (40/40), which was significantly higher than that in the routine group [90% (36/40)], χ2 = 4.21, P < 0.05). The excellent and good image quality rate in the study group was 98% (39/40), which was significantly higher compared with the routine group [85% (34/40)], χ2 = 3.91, P < 0.05). The incidence of adverse reactions in the study group was 5% (2/40), which was significantly lower compared with the routine group [23% (9/40), χ2 = 5.17, P < 0.05]. Conclusion:The risk warning management mode for emergency CT enhanced examination can shorten the examination time, increase the completion rate of CT scans, enhance image quality, improve patients' psychological status, and reduce adverse reactions.
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Objective To observe the value of multi-slice spiral CT(MSCT)post-processing technologies for diagnosing otosclerosis.Methods Clinical data and original axial plain MSCT of 47 patients with otosclerosis(92 ears)and 65 patients with non-otosclerosis hearing impairment(79 ears)were retrospectively enrolled.MSCT post-processing images,including multi-planar reformation(MPR)of stapes and cochleas and curved planar reformation(CPR)of ossicular chains were obtained.The diagnostic value of original MSCT images alone and raw data of MSCT combing with post-processing images for diagnosing otosclerosis were compared.Results Otosclerosis was correctly diagnosed in 66 ears according to original MSCT images alone,but in 89 ears combined with MSCT post-processing images.The sensitivity of original MSCT images alone and combined with MSCT post-processing images was 71.74％and 96.74％,respectively,and the diagnostic accuracy was 81.29％and 96.49％,respectively,those of the latter were both higher than of the former(both P＜0.05),which had specificities being not significantly different(92.41％vs.96.20％,P＞0.05).Conclusion Combining with post-processing technologies could increase the sensitivity and accuracy of MSCT for diagnosing otosclerosis.
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Objective To observe the value of augmented reality(AR)navigation system for assisting CT-guided puncture of pulmonary nodules in dog models.Methods Five healthy dogs were selected,and 4 target lung rings were implanted in each dog to build pulmonary nodule models.Deferring to crossover design,CT-guided punctures were performed with or without AR navigation 2 and 4 weeks after successful modeling,respectively,while punctures with AR navigation were regarded as AR group and the others as conventional group,respectively.The time duration of puncturing,the times of CT scanning,of needle adjustment,and the deviation distance between needle pinpoint to the center of pulmonary nodule shown on three-dimensional reconstruction were compared between groups.Results The duration time of puncture in AR group and conventional group was(13.62±5.11)min and(20.16±4.76)min,respectively.In AR group,the times of CT scanning,of needle adjustment,and the deviation distance was 2.40±0.50,2.75±0.44 and(2.94±1.92)mm,respectively,while in conventional group was 3.10±0.64,3.70±0.57 and(4.90±3.38)mm,respectively.The introduction of AR navigation was helpful to shortening the duration of puncture,reducing times of CT scanning and needle adjustment,also decreasing positioning error of needle pinpoint(all P＜0.05).In contrast,the variance of puncture sequences and dogs had no obvious effect on the results(both P＞0.05).Conclusion AR navigation system could improve accuracy and efficiency in CT-guided puncture of pulmonary nodules in dog models.
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Objective To observe the safety and feasibility of gelatin sponge-prothrombin-iohexol for blocking needle path of CT-guided percutaneous liver biopsy.Methods Totally 101 patients who underwent CT-guided needle biopsy of liver due to unexplained liver diseases,cirrhosis or space-occupying lesions of liver with coagulation dysfunction were retrospectively analyzed.After biopsy,the puncture needle path was blocked with gelatin sponge-prothrombin-iohexol.The effect and complications of puncture,also patients'coagulation and liver function indicators before and after puncture were observed.Results Successful puncture and sampling were performed in all 101 cases,with both technical success rate and adequacy of histological specimens of 100%.Accurate pathological diagnose was acquired in all 101 cases.Complications including mild pain at the puncture site,penetration of the blocking agent into the liver capsule or subcutaneous tissue were observed in a total of 18 cases(18/101,17.82%),while no severe complication such as bleeding,pneumothorax or bile duct injury occurred.No significant difference of coagulation nor liver function indicators was found before and after CT-guided needle biopsy(all P＞0.05).Conclusion Gelatin sponge-prothrombin-iohexol were safe and reliable for blocking needle path of percutaneous liver biopsy,which could reduce complications such as bleeding.
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Objective To observe the value of the ratio of cerebral hyperdensities(PCHD)/venous sinus maximum density for predicting hemorrhagic transformation(HT)after endovascular treatment(EVT)in patients with acute ischemic stroke(AIS).Methods Data of 79 AIS patients with PCHD immediately after EVT were retrospectively analyzed.The patients were divided into HT group(n=41)or non-HT group(n=38)based on the presence of HT or not.Clinical data and CT parameters were compared between groups.The value of the ratio of PCHD/venous sinus maximum density for predicting HT was evaluated.Results The maximum density of PCHD and the ratio of PCHD/venous sinus maximum density in HT group were both higher than those in non-HT group(both P＜0.001).Taken 87 HU as the best cut-off value of the maximum density of PCHD,the sensitivity,specificity and area under the curve(AUC)for predicting HT after EVT in AIS patients was 90.24%,71.05%and 0.79,respectively.Taken 0.94 as the best cut-off value of the ratio of PCHD/venous sinus maximum density,the sensitivity,specificity and AUC was 97.56%,71.05%and 0.81,respectively.No significant difference of AUC was found between the former and the latter(P＞0.05).Conclusion The ratio of PCHD/venous sinus maximum density immediately after EVT could be used to predict HT in AIS patients.
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Objective To observe the clinical and imaging features of invasive Klebsiella pneumoniae liver abscess syndrome(IKPLAS).Methods Data of 68 patients with Klebsiella pneumoniae liver abscess(KPLA)were retrospectively analyzed.The patients were divided into IKPLAS group(n=25)or non-IKPLAS group(n=43)according to extrahepatic invasive infection or not.Clinical data as well as CT and/or MRI findings were compared between groups.Results The patients'age was lower,while glycated hemoglobin and D-dimer levels were higher in IKPLAS group than those in non-IKPLAS group(all P＜0.05).Hepatic venous thrombophlebitis was detected in 18 cases in IKPLAS group and 6 cases in non-IKPLAS group,while arterial phase abnormal high perfusion around abscess was noticed in 10 cases in IKPLAS group and 28 cases in non-IKPLAS group,both being significantly different between groups(both P＜0.05).The extrahepatic infection in IKPLAS group mainly observed in lungs(19/25,76.00%).Conclusion The ages were lower,while glycated hemoglobin and D-dimer levels were both higher in IKPLAS than in the other KPLA patients.Often appeared hepatic venous thrombophlebitis and extrahepatic infection mainly affecting lungs were imaging characteristics of IKPLAS.
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Objective To explore the value of CT radiomics combined with clinical data and CT features for predicting TNM stage of thymic epithelial tumor(TET).Methods Data of 216 single TET patients confirmed by surgical pathology were retrospectively analyzed.Totally 151 cases with TNM stage Ⅰ TET were divided into early group,while 27 with TNM stage Ⅲ and 38 with TNM stage Ⅳ TET were divided into late group(n=65).Univariate analysis was used to analyze clinical data and chest CT manifestations.Based on non-contrast-enhanced CT(NECT)and contrast-enhanced CT(CECT),the best radiomics features were extracted and screened to establish radiomics models(RMNECT,RMCECT)for predicting TNM stage of TET.RMNECT-clinic,RMCECT-clinic,RMNECT-clinic-CT and RMCECT-clinic-CT were constructed based on combination of clinical and CT features being significantly different between groups,respectively.The patients were divided into training set(n=151)and validation set(n=65)at the ratio of 7∶3.The above models were trained in the training set using repeated 5-fold cross validation method,and their efficacy were verified in the validation set.Results Significant differences of clinical symptoms and CT manifestations including fat infiltration around the lesion,mediastinal lymph node enlargement and pleural effusion were found between groups(all P＜0.05).Based on NECT and CECT,2 and 9 best radiomics features were selected to construct the corresponding models.In validation set,the area under the curve(AUC)of RMNECT-clinic-CT for predicting TNM stage of TET(0.864)was higher than that of RMNECT and RMNECT-clinic(AUC=0.634,0.721,Z=3.081,2.937,P=0.002,0.003),while AUC of RMCECT-clinic-CT(0.920)was also higher than that of RMCECT and RMCECT-clinic(AUC=0.689,0.751,Z=2.698,2.390,P=0.007,0.017).Conclusion CT radiomics combined with clinical data and CT features could effectively predict TNM stage of TET.
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Objective To observe the value of radiomics combined with CT features for distinguishing mycoplasma pneumonia(MP)and non-MP in children.Methods Data of 153 children with pneumonia were retrospectively analyzed.The children were divided into MP group(n=101)and non-MP group(n=52)according to mycoplasma RNA detection,and also were divided into training set(n=107,including 71 MP and 36 non-MP)and validation set(n=46,including 30 MP and 16 non-MP)at the ratio of 7∶3.CT findings were compared between groups.Six best CT features were selected in training set using F test algorithm,and a CT model was constructed using logistic regression(LR)method.The best radiomics features were extracted and screened in training set,and machine learning(ML)models were constructed using LR,support vector machine(SVM),random forest(RF),linear discriminant analysis(LDA)and stochastic gradient descent(SGD)classifiers,respectively.Based on the best CT features and radiomics features,CT-ML models were constructed using the above classifiers.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated,the efficacy of each model for distinguishing MP and non-MP was evaluated.Results Lesions involved the upper,middle and lower lobe of right lung,thickened bronchial wall,tree bud sign and edge retract sign were the best CT features.AUC of CTLR was 0.710,of MLLR,MLSVM,MLRF,MLLDA and MLSGD in validation set was 0.715,0.663,0.623,0.706 and 0.494,respectively,and MLLR was the optimal radiomics model.AUC of CT-MLLR,CT-MLSVM,CT-MLRF,CT-MLLDA and CT-MLSGD in validation set was 0.813,0.823,0.649,0.796 and 0.665,respectively,and CT-MLSVM was the optimal CT-ML model.In training set,AUC of CT-MLSVM(0.840)was higher than that of CTLR and MLLR model(AUC=0.713,0.740,both P＜0.05).In validation set,no significant difference of AUC was found among CTLR,MLLR and CT-MLSVM(AUC=0.710,0.715 and 0.823,all P＞0.05).Conclusion Radiomics combined with CT features could effectively distinguish MP and non-MP in children.
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Objectives:To finely divide the aortic sinus into sections and accurately localize the coronary ostium through CARTO three-dimensional mapping,and to assess the clinical effects of treating aortic sinus cusps premature ventricular contraction(ASC-PVC)and the ablation risk in the corresponding area with zero X-ray radiofrequency ablation. Methods:A total of 66 patients who underwent radiofrequency ablation for ASC-PVC from January 2020 to January 2023 were included in this analysis,patients were divided into experimental group(n=34)and conventional group(n=32).In the conventional group,the CARTO 3 system was used to create an aortic sinus model through the conventional method.The earliest stimulating target was identified by using electrical stimulation mapping(ESM).Radiofrequency ablation treatment was performed after the distance between the target and the coronary ostium was precisely measured by coronary angiography through the hollow tube of the ablation catheter or coronary angiography tube.In the experimental group,the CARTO 3 system was used to build a model of the aortic sinus and the coronary ostium and aortic sinus were divided into sections.The earliest stimulating target was identified by ESM.After localizing coronary ostium through the impedance changing pattern on the ablation catheter tips,catheter ablation was performed with zero X-ray.The data regarding the impedance of the ablation catheter in the aortic sinus were collected.The total operative time,the operative time in the aortic sinus,contrast dosage,X-ray exposure time,immediate and short-term success rates of the operation and complication rates were compared between the two groups.Besides,the distribution of successfully ablated targets and their relationship with the risk of ablation were analyzed in both groups. Results:There was no significant statistical difference in the immediate and short-term success rates between the two groups(93.8%vs.94.1%;90.6%vs.88.2%,both P>0.05).The experimental group did not receive contrast agents during the operation,and the total operation time and intra-aortic sinus operation time in the experimental group were significantly shorter than those in the conventional group([58.76±4.94]min vs.[66.91±5.94]min,P<0.001;[43.12±4.49]min vs.[50.31±5.18]min,P<0.001).During the process of moving the ablation catheter from the intra-aortic sinus to the coronary artery opening and into the coronary artery,the impedance suddenly increased,which was significantly different from the impedance in other parts of the intra-aortic sinus(all P<0.001). Conclusions:Radiofrequency ablation of ASC-PVC with zero X-ray can simplify the procedures and shorten the operative time.The steep increase in impedance at the tip of the ablation catheter can be used as a basis for localizing the coronary ostium.Dividing the aortic sinus into sections allows a detailed assessment of the risk for ablation treatment at the targets.
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@#Abstract: It is well-known that crystal form of a drug is a key factor impacting the physicochemical properties of the drug, which in turn affects its in vivo efficacy, safety and stability. The study on crystal forms of solid-state drugs is crucial for drug quality control, selection of production process and evaluation of clinical efficacy. The combination of chemometric and analytical techniques exhibited its great ability to analyze a large amount of multidimensional data, providing the possibility for quantification of trace amount of crystals (< 1%). Meanwhile, using the process analytical technology (PAT) to monitor the crystal content real-time during prescription preparation process can further realize the control on formulation quality and serve as a core technology to support the patent protection of crystalline forms. In this review, the combined application of crystal analytical techniques and chemometric methods for the quantitative analysis of trace crystals were summarized, aiming to provide guidance for the manufacturing of pharmaceutical preparations and their quality control.
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OBJECTIVE To analyze the MSCT and MRI imaging manifestations of patients with duplication of the internal auditory canal(DIAC),improve understanding of the deformity,to provide preoperative basis for cochlear implantation.METHODS Retrospective observation of 20 cases(24 ears)of DIAC inner ear multi-spiral CT(MSCT)and MRI data,measurement and analysis of the width of the internal auditory canal(IAC)and cochlear nerve canal in the lesion group and the control group.RESULTS All DIACs had stenosis of the IAC cambined with other temporal bone malformations.MSCT shows that the 21 ears IAC,while MRI hydrography shows the 16 ears IAC divided into double tubes by bone.MRI hydrography shows a slender vestibulocochlear nerve.There were statistically significant differences(P<0.001)in the width of IAC and cochlear nerve canal between the lesion group and the control group.Six cases(8 ears)had varying degrees of hearing recovery after cochlear implant surgery.CONCLUSION DIAC shows stenosis of the IAC;The bone septa shown on MSCT are its characteristic fertures;MRI hydrography shows underdeveloped vestibular and cochlear nerves;The combination of two imaging examination methods can provide objective reference for the diagnosis of this disease and artificial auditory implantation.
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OBJECTIVE To investigate the HRCT and MRI characteristic of external auditory canal cholesteatoma(EACC)in children.METHODS A total of 40 patients(45 lesions)with EACC confirmed by pathology were retrospectively analyzed with HRCT and MRI characteristics and clinical therapeutic value.Imaging findings of 40 patients(45 lesions)with EACC were retrospectively analyzed.RESULTS Soft tissues were found in all the external auditory canal(EAC).Of the forty-five soft tissues,7 manifested as inhomogeneous strip soft tissues and 38 as lesions solid soft tissues;30 located in medial part of the EAC and covered the tympanic membrane,while the other 15 presented as tympanic membrane perforation and involved the tympanic cavity.The MRI of the 3 ears showed high signal on T2/T1 iso-intensity,high signal on DWI,and low signal on ADC.Normal whole bony EAC was observed in 17 cases and enlarged medial EAC in 28 cases.Seven cases only involved in the superior wall,but 38 cases displayed as multiple bone wall involved,of which 6 involved in circumferential walls.Thirty-three cases displayed atactic ear bone margin,11 displayed blunted or disappeared drum shield plate.Destroy of long crus of incus and manubrium mallei occurred in 15 cases,of short crus of incus in 8 cases,of stapes in 2 cases,and mastoiditis in 5 cases.According to the pneumatization degree of mastoid air cell,37 cases were classified into pneumatic type,7 cases into mixed type,and the last one into diploic type.CONCLUSION The children EACC tends to be limited and rarely involved in middle ear and mastoid process.No patient with peri-ear infection was found.Application of HRCT and MRI help accurate location and determination of cholesteatoma.According to the extent of the lesion,selecting the appropriate surgical method is an effective method to remove cholesteatoma,improve hearing and reduce recurrence.
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An increasing number of studies have shown that neuroimaging techniques, including CT- and MRI-related imaging biomarkers, are associated with the clinical outcome after intravenous thrombolysis in patients with acute ischemic stroke. Therefore, as a necessary diagnostic item for acute ischemic stroke, imaging examinations and related biomarkers have important value in predicting the outcome after intravenous thrombolysis in patients with acute ischemic stroke.