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Objective:To investigate the clinical efficacy of neuroendoscopic hematoma removal versus soft channel drainage in the treatment of chronic subdural hematoma. Methods:The clinical data of 102 patients with chronic subdural hematoma who received treatment in Jincheng People's Hospital from May 2018 to May 2020 were retrospectively analyzed. They were divided into the neuroendoscopy group ( n = 50) and the soft channel group ( n = 52) according to different surgical methods. Perioperative indexes, hematoma clearance rate, China Stroke Scale score, the activity of daily living score, and oxidative stress indexes were compared between the two groups. All patients were followed up for 3 months. The incidence of complications during the follow-up period was calculated. Results:The retention time of the drainage tube in the neuroendoscopy group was shorter than that in the soft channel group [(2.45 ± 0.63) days vs. (3.30 ± 0.78) days, t = 6.06, P < 0.001]. The length of hospital stay in the neuroendoscopy group was shorter than that in the soft channel group [(7.14 ± 1.65) days vs. (9.07 ± 2.11) days, t = 5.15, P < 0.001]. The hematoma clearance rate at postoperative 7 days in the neuroendoscopy group was higher than that in the soft channel group [(93.45 ± 5.50)% vs. (81.86 ± 7.24)%, χ2 = 9.12, P < 0.001]. There were no significant differences in operation time and intraoperative blood loss between the two groups (both P > 0.05). At postoperative 30 days, the China Stroke Scale score in the neuroendoscopy group was lower than that in the soft channel group [(12.74 ± 2.23) points vs. (18.67 ± 2.45) points, t = 12.79, P < 0.001]. The activity of daily life score in the neuroendoscopy group was significantly higher than that in the soft channel group [(77.69 ± 7.11) points vs. (91.35 ± 7.25) points, t = 9.60, P < 0.001]. At postoperative 7 days, glutathione peroxidase level in the neuroendoscopy group was significantly lower than that in the soft channel group [(130.75 ± 13.66) U/L vs. (148.60 ± 14.64) U/L, t = 6.37, P < 0.001]. Malondialdehyde level in the neuroendoscopy group was significantly lower than that in the soft channel group [(5.11 ± 0.65) nmol/L vs. (6.19 ± 0.74) nmol/L, t = 7.83, P < 0.001]. Superoxide dismutase level in the neuroendoscopy group was significantly higher than that in the soft channel group [(275.60 ± 22.33) U/L vs. (254.60 ± 18.55) U/L, t = 5.15, P < 0.001]. There was no significant difference in the incidence of complications between the two groups ( P > 0.05). Conclusion:Compared with soft channel drainage, neuroendoscopic hematoma removal can obtain better short-term curative effects and less oxidative stress response in the treatment of chronic subdural hematoma. Neuroendoscopic hematoma removal does not increase the incidence of postoperative complications and is highly safe.
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BACKGROUND: Prostate cancer (PCa) is poor response to the immunotherapy for its high heterogeneity of immune microenvironment. In this study, we aim to introduce a new immune subtype for PCa involving M2 tumour associated macrophages (M2-TAMs). METHODS: Three hundred and sixty-two PCa patients and matched normal prostate tissues were selected from the Cancer Genome Atlas and Gene Expression Omnibus databases. Patients' immune infiltration characters were then analyzed based on the gene expressions. The immune subtypes were identified by the method of unsupervised hierarchical clustering. Finally, the relationship between the M2-TAMs infiltration and anti-programmed death-ligand-1 (PD-L1) therapy was investigated in the IMvigor210 cohort. RESULTS: PCa expressed lower immune-related genes levels compared with the adjacent normal tissues. Based on the proved immunosuppressive mechanisms in PCa, tumour patients were classified into three independent subclasses with high infiltrated cytolytic activity (CYT), M2-TAMs and regulatory T cell (Tregs), respectively. Among these subtypes, M2-TAMs infiltration subtype showed the worst clinicopathological features and prognosis compared with the other two subtypes. The results of the IMvigor210 cohort demonstrated poor response of anti-PD-L1 therapy for patients with high M2-TAMs infiltration. CONCLUSION: Prostate tumours involved in significant immunosuppression, and high infiltration of M2-TAMs can be applied to predict the effect of anti-PD-L1 therapy.Key MessagesPCa patients can be classified into three immunotypes of high infiltrated CYT, M2-TAMS, and Tregs according to the immunosuppressive mechanisms.High M2-TAMs infiltration subtype reflected the worst clinical characters, immune infiltration, and lowest expression of immune checkpoint inhibitors among the three subclasses in PCa.High M2-TAMs infiltration predicts the low response rate of anti-PD-L1 therapy.
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Prostatic Neoplasms , Tumor-Associated Macrophages , Humans , Immune Checkpoint Inhibitors , Immunotherapy , Male , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/genetics , Tumor MicroenvironmentABSTRACT
OBJECTIVE: The aim of this study was to compare a new model-based iterative reconstruction algorithm with either spatial and density resolution balance (MBIRSTND) or spatial resolution preference (MBIRRP20) with the adaptive statistical iterative reconstruction (ASIR) in evaluating early small peripheral lung cancer (SPLC) with submillisievert chest computed tomography (CT). METHODS: Low-contrast and spatial resolutions were assessed in a phantom and with 30 pathologically confirmed SPLC patients. Images were reconstructed using 40% ASIR, MBIRSTND, and MBIRRP20. Computed tomography value and image noise were measured by placing the regions of interest on back muscle and subcutaneous fat at 3 levels. Two radiologists used a 4-point scale (1, worst, and 4, best) to rate subjective image quality in 3 aspects: image noise, nodule imaging signs, and nodule internal clarity. RESULTS: The phantom study revealed an improved detectability of low-contrast targets and small objects for MBIRSTND and MBIRRP20 compared with ASIR. The effective dose for patient scans was 0.88 ± 0.83 mSv. There was no significant difference in CT value between the 3 reconstructions (P > 0.05), but MBIRSTND and MBIRRP20 significantly reduced image noise compared with ASIR (P < 0.05): 15.69 ± 1.83 HU and 29.97 ± 3.84 HU versus 51.06 ± 11.02 HU in the back muscle, and 15.96 ± 3.07 HU and 27.37 ± 3.88 HU versus 38.04 ± 8.87 HU in subcutaneous fat, respectively. Among the 3 reconstructions, MBIRSTND was the best in reducing image noise and identifying the internal compositions of cancer nodules, and MBIRRP20 was the best in analyzing the internal and external signs of pulmonary nodules. CONCLUSIONS: Submillisievert chest CT reconstructed with MBIRSTND and MBIRRP20 provides superior images for the detailed analyses of SPLC compared with ASIR.
Subject(s)
Lung Neoplasms/diagnostic imaging , Radiographic Image Enhancement/methods , Tomography, X-Ray Computed/methods , Adult , Aged , Algorithms , Early Detection of Cancer , Female , Humans , Male , Middle Aged , Phantoms, Imaging , Prospective StudiesABSTRACT
Objective Toexploretheroleofmodel-basediterativereconstruction (MBIR)algorithminimprovingthequalityof thyroidCTimagesbyreducinghardeningartifactsattheentrancetothethorax.Methods ChestCTscansof20patientswiththyroidnoduleswere retrospectivelyreviewed.AlgorithmsofFBP,ASIR40,MBIRSTNDandMBIRNR40 wereusedtoreconstructatthe0.625mmslicethickness.Region ofinterestwasplacedonthecoronalimageswiththemostobvioushardeningartifacts.ThestandarddeviationsoftheCTvaluesof theleftandrightthyroidarteriesandthesurroundingnormalthyroidtissueweremeasured,furthermore,thevalueofthyroidartifact index(AI)andAI=sqrt(SDa2-SDb2)werecalculated.Tworadiologistsused4-pointmethodtoassessimageartifactssubjectivly.(1 point,severeartifacts,unclearthyroidrimsandnodules,undiagnosed;2points,moderateartifacts,poorlydisplayingthyroid margins andinternaldetails,affectivediagnosis;3points,mildartifacts,showingthyroid marginandinternaldetails,noaffectingthediagnosis;4 points ,no ribbon artifacts ,displaying thyroid edge and internal details very w ell ).ANOVA and paired t-test w ere used to co m pare the CTvaluesofnormalthyroidtissueofleftandrightlobeamongdifferentreconstructedimagesofthyroid.Subjectivescoredifferenceswere testedusingthe W ilcoxon symbolscale.Results ThevalueofCTreductionandAIatFBPandASIR40reconstructionimagesweresignificantly greaterthanthoseatMBIRSTNDandMBIRNR40reconstructionimages. Whiletherewerenodifferenceofleftandrightlobeofthyroid CTreductionand AIvalueatFBPand ASIR40reconstruction imagesnorthoseatMBIRSTNDandMBIRNR40reconstructionimages. SubjectiveevaluationofclavicleartifactswasincreasedatMBIRSTND and MBIRNR40image,andMBIRNR40imagehadoptimalsubjectiveevaluationresults(P<0.05).Conclusion MBIRcansignificantlyreducethe impactoftheclavicularharnesshardeningartifactsandnoiseonthethyroidanditsnodulesduringCTscans,especiallyoptimizingthe low-densitycontrastsettingofMBIRNR40.
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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 values of the lung nodule image quality by using two adaptive statistical iterative reconstruction (ASIR)in a chest phantom CT imaging study.Methods Non-enhanced CT of chest phantom with routine dose was obtained on both GE Discovery CT and Revolution CT.The scan parameters included tube voltage of 120 kVp,a noise index of 14 HU,slice thickness of 5 mm.All scans were reconstructed with FBP and different percentages of (20%－100% ASIR)when using Discovery CT,and different percentages of ASIR-V (20%－100% ASIR-V)when using Revolution CT.The CT attenuation values and SD (the SD represented image noise)of the subcutaneous uniform tissue were measured at the level of thoracic entry,trachea carina and hepatic portal.Based on the standard FBP(FBPs )algorithm,the image noise reduction rate of reconstructed images using different iterative percentage of standard algorithms ASIR and ASIR-V(ASIRs and ASIR-Vs )were compared.The paired t test was used to compare the noise of ASIRs and ASIR-Vs images under the same iterative percentage.The subj ective image quality was independently evaluated by two experienced radiologists,Kappa test was used to evaluate consistency,Wilcoxon test was used to compare subjective scores.Results For all ASIRs and ASIR-Vs images,the objective image noise of subcutaneous uniform tissue decreased along with increasing percentage.Comparison with the average noises of CT image reconstructed with the FBPs algorithm,the image noise reconstructed with ASIRs from 20% to 1 00% were reduced by 1 1.0 6%－48.9 7%,while the image noise reconstructed with ASIR-Vs from 20% to 100% were reduced by 17.06%－79.50%.The image noise of different percentage ASIR-Vs was significantly lower than that of same percentage ASIRs between 40% and 1 00% (P＜0.05 ).In terms of subj ective image evaluation,all ASIR1 and ASIR-V1 reconstructions had good diagnostic acceptability.Two readers scored good or moderate consistency in each iterative reconstruction of each lung nodule.Nodules of smaller size and less dense were more likely to have score differences.The 60%ASIR1 showed significantly superior visibility of lung nodules when compared to other percentages (P＜0.05).60% and 80% ASIR-V1 series showed significantly superior visibility of lung nodules when compared to the 60% ASIR1 and ASIR-V1 of other percentages (P＜0.05).Conclusion In routine dose non-enhanced chest CT, ASIR-V shows greater potential in reducing image noise and improves lung nodule image quality when compared to the same level ASIR algorithm. Combining both the obj ective and subj ective evaluation of images,reconstructed with 60% and 80% ASIR-V in the non-enhanced chest CT image is recommended for the observation and evaluation of pulmonary nodules.
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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 demonstrate the feasibility of high-resolution computed tomography(HRCT)reconstructed with a model-based iterative reconstruction (MBIR)for evaluating early peripheral lung cancer (≤3 cm),by comparing image quality obtained from MBIR,filtered back proj ection reconstruction(FBP)and state of the art adaptive statistical iterative reconstruction(ASIR)algorithm respectively.Methods A total of 30 patients confirmed with lung cancer by postoperative pathology were enrolled in the study.A chest phantom was also used to evaluate image noise,spatial resolution and density resolution.Both patients and chest phantom were received HRCT,and the images were reconstructed using FBP,ASIR(40% ASIR and FBP mix)and MBIR.The objective CT value, standard deviation(SD)and signal noise ratio(SNR)were measured.Two radiologists used a semi-quantitative to rate subjective image quality of lung nodules.Results There was no significant difference in CT value between the three reconstruction algorithms (P>0.05).But significant improvements in objective image noise were observed in MBIR compared with FBP and ASIR (P<0.05):including the SD value in back muscle [(12.63±1.70)with MBIR vs (31.58±5.21)with FBP and (24.55±4.14)with ASIR],and in subcutaneous fat [(12.77±2.53)vs (24.39±5.08)and (19.20±4.11)].Subjective image noise of the three group were also significantly difference:FBP with lowest subjective noise score;and MBIR with highest subjective noise score.The sharpness of small vessels and bronchi and diagnostic acceptability with MBIR were significantly better than with FBP and ASIR (P< 0.05).Conclusion Lung HRCT reconstructed with MBIR provides diagnostically more acceptable images for the detailed analyses of peripheral lung cancer compared with FBP and ASIR.
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[Abstraet] Purpose To explore the application of noise reduction settings among modelbased iterative reconstruction (MBIRn) on decreasing radiation dose in CTA through experimental study.Materials and Methods Spectral CT was used to scan vessel model which could accommodate 8 tubes under static condition under 120 kVp fixed tube voltage at 10 mA,50 mA,150 mA and 600 mA.The tubes were filled with purified water,1,2,5,10,20 and 30 mgI/ml solutions and 30 mgCa/ml solution.Algorithms of FBP (standard),ASIR40 (combined by 40％ ASIR and FBP),MBIRc and MBIRn with optimized spatial resolution setting as MBIRRP20,MBIRstnd (standard setting),and MBIRNR40 (noise reduction setting) were adopted for original scanning data to reconstruct images of 0.625 mm slice thickness for contrastive analysis.Three fixed layers were chosen and regions of interest were placed on central tube and surrounding ester matrix,and CT value and standard variation (SD) were measured to represent noise.Noise reduction setting MBIRNR40 and solution noise of other reconstruction algorithm images were calculated and compared and average value of contrast noise ratio (CNR) was compared.Results Compared to FBP under different tube currents,ASIR40,MBIRc,MBIRRP20,MBIRstnd and MBIRNR40 reduce noise and increase CNR at different levels.Average noise of MBIRNR40 was the lowest (reduced by 78.33％) and CNR the highest (increased by 241.74％),making it superior to other reconstruction algorithm images (P＜0.05).Meanwhile,the lower the radiation dose was,the more obvious its advantage was.Reconstruction image noise of MBIRNR40 at 10 mA was close to that of FBP and ASIR40 at 600 mA.CNR was obvious greater than that of FBP and ASIR40 at other tube voltage.Conclusion Reconstruction algorithms of MBIRc,MBIRn and ASIR can help enhance CTA image quality and reduce radiation dose.Noise reduction setting MBIRNR40 from MBIRn has the lowest noise and greatest CNR.The lower the radiation dose is,the more obvious its advantage is.
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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 compare the effect on image quality of low-dose upper abdominal CT reconstructed with the new version of model-based iterative reconstruction (MBIRn) focused on low-contrast resolution (MBIRNR40),conventional model-based iterative reconstruction (MBIRc),adaptive statistical iterative reconstruction (ASIR) and routine-dose CT reconstructed with filtered back projection (FBP).Methods Water plantom at rest was scanned with CT,and spatial resolution and density resolution were compared among FBP,ASIR,MBIRc,and MBIRNR40.Sixty patients with 2 times CT in the upper abdomen within a year were enrolled.The initial examination was acquired at a standard radiation dose (noise index [NI] of 10 HU) and reconstructed with the conventional FBP algorithm.The follow-up scan was acquired at a lowdose (NI=20 HU) and reconstructed with the standard ASIR,MBIRc and MBIRNR40.All images were obtained with 0.625 mm slice thickness.CT values and noise of fat,muscle as well as the liver and kidney parenchyma were measured and CNR of liver and kidney parenchyma using the fat SD as background image noise were calculated.Two radiologists independently graded images for noise,sharpness of details of structures and lesion.The quantitative image quality scores of different reconstructions were analyzed with one-way ANOVA using FBP reconstruction as reference of standard.The degree of interobserver consistency was evaluated using Kappa test.Results The phantom study revealed the highest spatial resolution with MBIRc and highest density resolution with MBIRNR40 among all reconstructions.The dose-length product and radiation dose for the first inspection was (93.18 ± 41.21) mGy · cm,(1.40 ± 0.62) mSv,respectively,and were (368.03 ± 146.25)mGy · cm,(5.52 ± 2.19)mSv for the second inspection,representing an approximate overall dose reduction of 74.68％ and 74.64％.The mean image noise of muscle and fat for MBIRNR40 was significantly lower than that of MBIR,ASIR and FBP(P＜0.05).The mean CNR values of liver and spleen for MBIRNR40 were significantly higher than that of ASIR,MBIRc and FBP (P＜0.05).Two radiologists had a good subjective score consistency.Low-dose MBIRNR40 subjective image noise was the lowest,showing the most detailed on the upper abdominal detail structure and lesion edge,better than MBIRc,MBIRc was superior to routine-dose FBP,low dose ASIR was worst,the difference was statistically significant (P＜0.05).Conclusion With 75％ dose reduction in upper abdominal CT,the MBIRNR40 can provide well objective and subjective image quality than MBIRc and ASIR40,and the routine-dose FBP.
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Objective To assess image quality of adaptive statistical iterative reconstruction (ASIR),conventional modelbased iterative reconstruction (MBIRc) and a new lung-specific setting (MBIRRP20 and MBIRNR40) from the new version of model-based iterative reconstruction (MBIRn) in submillisievert chest CT comparing with ASIR in standard-dose.Methods Two chest CT examinations were performed with standard-dose and low-dose in 30 patients.Low-dose CT images were reconstructed with ASIR,MBIRc and MBIRn,while standard-dose CT images were reconstructed with ASIR only.Objective image noise and SNR were measured on the same part from the back muscle and subcutaneous fat which located at the level of thoracic entry,trachea carina and hepatic portal.Image quality of lung,mediastinum and upper abdomen structures were evaluated on a 5-point scale.The results were compared with one-way ANOVA and Wilcoxon signed-rank tests.Results The effective dose equivalent for standard-dose CT was (3.01 ± 1.89) mSv,compared with (0.88 ± 0.83) mSv for low dose CT,which decreased by 70.76％.The mean image noise for low-dose MBIRNR40 was significantly lower than that of conventional-dose ASIR,low-dose ASIR and MBIRc (P＜0.05).The mean SNR for low-dose MRIRNR40 was significant ly higher than that of conventional dose ASIR,low-dose ASIR and MBIRc (P＜0.05).The subjective image noise score was significantly lower than that of ASIR and MBIRc,and the score of sharpness of details of the structures score for low dose MBIRn was significantly better than that of the ASIR and MBIRc (P＜0.05).Conclusion MBIRNR40 can significantly reduce image noise and improve SNR compared to ASIR and MBIRc in low-dose,even better than ASIR in standard dose,which reduce radiation dose by about 70％.In low-dose,MBIRPP20 can well display lung structures,and MBIRNR40 can display mediastinal and the upper abdominal structures.
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Objective To assess image quality of adaptive statistical iterative reconstruction (ASIR),conventional modelbased iterative reconstruction (MBIRc) and a new lung-specific setting (MBIRRP20 and MBIRNR40) from the new version of model-based iterative reconstruction (MBIRn) in submillisievert chest CT comparing with ASIR in standard-dose.Methods Two chest CT examinations were performed with standard-dose and low-dose in 30 patients.Low-dose CT images were reconstructed with ASIR,MBIRc and MBIRn,while standard-dose CT images were reconstructed with ASIR only.Objective image noise and SNR were measured on the same part from the back muscle and subcutaneous fat which located at the level of thoracic entry,trachea carina and hepatic portal.Image quality of lung,mediastinum and upper abdomen structures were evaluated on a 5-point scale.The results were compared with one-way ANOVA and Wilcoxon signed-rank tests.Results The effective dose equivalent for standard-dose CT was (3.01 ± 1.89) mSv,compared with (0.88 ± 0.83) mSv for low dose CT,which decreased by 70.76％.The mean image noise for low-dose MBIRNR40 was significantly lower than that of conventional-dose ASIR,low-dose ASIR and MBIRc (P＜0.05).The mean SNR for low-dose MRIRNR40 was significant ly higher than that of conventional dose ASIR,low-dose ASIR and MBIRc (P＜0.05).The subjective image noise score was significantly lower than that of ASIR and MBIRc,and the score of sharpness of details of the structures score for low dose MBIRn was significantly better than that of the ASIR and MBIRc (P＜0.05).Conclusion MBIRNR40 can significantly reduce image noise and improve SNR compared to ASIR and MBIRc in low-dose,even better than ASIR in standard dose,which reduce radiation dose by about 70％.In low-dose,MBIRPP20 can well display lung structures,and MBIRNR40 can display mediastinal and the upper abdominal structures.
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Cell therapy is a potential therapeutic approach for Parkinson's disease (PD). Mesenchymal stem cells derived from the human umbilical cord (hUC-MSCs) give priority to PD patients because of multiple advantages. The appropriate gene transduction of hUC-MSC before transplantation is a promising procedure for cell therapy. Fibroblast growth factor-20 (FGF-20) has been shown to protect dopaminergic neurons against a range of toxic insults in vitro. In this study, the hUC-MSCs were gene transduced with FGF-20, and then we transplanted them into the PD mice model. The results showed that MSC-FGF-20 treatment obviously improved the behavior of PD, accompanied by the increase of tyrosine carboxylase- (TH-) positive cell and dopamine (DA). Furtherly, immunohistochemistry disclosed that MSC-FGF-20 obviously promoted the degradation of nuclear factor-κB (NF-κB), a transcription factor that controls genes encoding proinflammatory cytokines, highly expressed in the nigrostriatal dopaminergic regions in PD patients. Therefore, MSC-FGF-20 has a potential for improving PD, closely related to the degradation of NF-κB.
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Objective To explore the value of the spectral CT iodine-based material decomposition technique in differential diagnosis of central pulmonary carcinoma from obstructive pneumonia and atelectasis.Methods 25 cases with central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis underwent CT plain scan and spectral contrast scan including pulmonary-arterial-phase (PAP) and bronchial-arterial-phase(BAP).Conventional CT images and iodine base images were generated in each phase by GSI viewer.The 4 groups of images differences between the tumor and the obstructive pneumonia and atelectasis were analyzed.Results The margin of the tumor was ill-defined in plain scan.The cases that showed difference between the tumor and the obstructive pneumonia and atelectasis in 4 groups of images were respectively as follows,10 in conventional CT images of PAP,1 6 in conventional CT images of BAP,1 9 in iodine base images of PAP,and 23 in iodine base images of BAP.The difference of the 4 groups was significant (χ2 =16.54,P0.05),but were better than that of the conventional CT images of PAP(χ2 =6.65,P <0.05).Conclusion Spectral CT iodine-based material decomposition technique is helpful to improve subjective diagnosis of central pulmonary carcinoma complicating with obstructive pneumonia and atelectasis,especially in iodine base images of BAP,it can provide accurate information for clinical stage and treatment.
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PurposeSupport vector machine (SVM) is a machine learning method based on statistical learning theory of Vapnik-Chervonenkis (VC) dimension structure and risk minimization theory. We analyzed the gem spectrum CT scan data of patients with thyroid nodules and established the SVM diagnostic model. The experimental targets were then reduced and the forecast analysis was carried out based on SVM model. The diagnostic model and experimental methods were proved to provide guidance for clinical diagnosis of thyroid nodules.
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Objective To evaluate the clinical value of spectral CT monochromatic imaging in improvement of imaging quality of bronchial arteries.Methods We retrospevtively analyzed the chest CT images in 38 patients who underwent the contrast-enhanced spectral CT.These images included a set of 140 kVp polychromatic images and default 70 keV monochromatic images.Using a standard Gemstone Spectral Imaging (GSI)viewer at an advanced workstation (AW4.6),an optimal energy level (in keV)for obtai-ning the best CNR of the bronchial artery could be automatically obtained.The SNR,CNR and objective imaging quality score for these 3 imaging sets (140 kVp,70 keV and optimal energy level)were obtained and compared with one-way ANOVA .Results The optimal energy levels for obtaining the best CNR were (62.58±2.74)keV.The SNR of the 140 kVp polychromatic images,70 keV monochromatic images,and the optimal keV monochromatic images were 1 6.44±5.85,20.96 ±8.32 and 24.91 ±9.91,the CNR were 13.30±5.45,1 7.25±6.97 and 20.67±8.62,and the subjective imaging quality scores were 1.97 ±0.82,3.24±0.75 and 4.47±0.60,respectively,exhibiting significant differences among groups (F =10.1 7,10.1 7 and 1 1 1.12,P <0.00).The optimal monochromatic group was superior to the 70 keV group and the 140 kVp mixed-energy group.Conclusion Monochromatic images at approximately 62 keV in dual-energy spectral CTA yields the best CNR and highest diagnostic confidence for imaging bronchial ar-teries,which may improve imaging quality for imaging bronchial arteries.
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Objective To study the value of microwave coagulation therapy for liver malignant tumors.Methods Under local anesthesia,19 cases with hepatic malignant tumors treated with microwave knife under CT-guided.Results There were totally 23 tumors in 19 cases,13 tumors with≤3.5 cm in diameters were destroyed absolutely after the first treatmet,10 tumors among them were followed-up for 6-12 months and no recurred.10 tumors with＞3.5 cm in diameters treated at multiple points or angle,3～6 months later,CT showed that the tumors were destroyed completely in 6 and mostly in 4,by the hot condensate treatment secondly,3 tumors of 4 were destroyed completely 3 months later.There were no obvious complications.Conclusion The therapeutic effect under CT-guided microwave coagulation therapy for liver tumor which are ≤3.5 cm in diameter of the tumors is very reliable,the tumors＞3.5 cm in diameter can be destroyed mostly or completely by microwave treatment.
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Capital logic is the first to be avoided in the construction of medical humane service system,for it is capital logic that manifest the current technical and commercialized time with an "indifferent" characteristic.Capital logic originated and distended from the western culture.As another spiritual pursuit and wisdom,traditional Chinese philosophy provides us with significant ideological resources and helpful revelation for improving medical humane service in current circumstances.
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AIM:To explore the effects of the new drug of sulfonylurea(1-{4-[2-(3-ethyl-4-methyl-2-oxo-3-pyrroline-1-carboxamido)ethyl]-phenylsulfonyl}-3-(1,4-tetramethylene)-urea,BGW) on the glucose uptake and the activation of Akt/PKB in SMMC7721 cells.METHODS:Cultured SMMC7721 cells were divided into control group,glibenclamide group,insulin group,BGW group and BGW+insulin group.Scintillation was used to detect the glucose uptake in SMM7721 cells.The activation of Akt/PKB was tested by Western blotting.RESULTS:Compared to control cells,gibenclamide,insulin,BGW and BGW+insulin significantly increased the glucose uptake(P
