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1.
Neurology ; 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32241954

RESUMO

OBJECTIVE: To investigate the association of carotid atherosclerosis, dilation, and stiffness with imaging markers of cerebral small vessel disease (CSVD) in a community-based sample. METHODS: The study comprised 1,051 participants (age 57.5 ± 9.2 years). Carotid plaques, intima-media thickness (IMT), diastolic diameter, pulse wave velocity, and stiffness index (ß) were measured by ultrasound. Imaging markers of CSVD, including lacunes, cerebral microbleeds, dilated PVS, and white matter hyperintensities (WMH) volume, were assessed. RESULTS: Carotid plaque was associated with the presence of lacunes (odds ratio [OR] 2.78, 95% confidence interval [CI] 1.78-4.33; p < 0.001) and larger WMH volume (natural log transformed, ß ± SE, 0.32 ± 0.10; p = 0.002). The increased carotid diameter was associated with the presence of lacunes (OR 1.82, 95% CI 1.22-2.72; p = 0.003), larger WMH volume (ß ± SE, 0.37 ± 0.10; p < 0.001), and PVS in the basal ganglia (OR 1.59, 95% CI 1.20-2.11; p = 0.001). Associations of carotid dilation and CSVD were independent of carotid IMT and plaque. Most parenchymal lesions were located in the basal ganglia and deep white matter. Carotid IMT and stiffness were not associated with CSVD. CONCLUSIONS: Carotid atherosclerosis and dilation are associated with imaging markers of CSVD. The noninvasive carotid assessment would seem to be a rational approach to risk stratification of CSVD.

2.
Eur Radiol ; 2020 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-32140817

RESUMO

OBJECTIVES: To comprehensively evaluate the pelvic magnetic resonance imaging (MRI) findings of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome and summarize the typical and atypical characteristics. METHODS: A retrospective analysis of 201 consecutive MRKH patients was carried out. Pelvic MRI was reviewed by two experienced gynecological radiologists in consensus. Characteristics including the morphology, signal pattern and volumes of the uterine rudiments, location and volume of the ovaries, and the degree of vaginal dysgenesis were evaluated. Other noted abnormalities were also recorded. RESULTS: Morphologically, the majority (95%) of patients displayed bilateral uterine rudiments combined with a fibrous band. The minority of patients showed no (3.5%) or unilateral (1.5%) uterine rudiments. A total of 385 uterine rudiments were detected which showed four types of signal patterns: one-layer differentiation (325, 84.4%), two-layer differentiation (27, 7%), three-layer differentiation without subsequent alteration (23, 6.0%), and three-layer differentiation with hematometra and/or ipsilateral hematosalpinx (10, 2.6%). The median volumes of these four types of uterine rudiments were 2.6 ml (1.69-3.81 ml), 3.19 ml (2.67-4.51 ml), 6.05 ml (3.37-12.44 ml), and 31.97 ml (19.2-38.7 ml), respectively. The mean ovarian volume was 6.49 ± 3.91 ml. Abnormally located ovaries were detected in 63 (31.3%) patients. The distal vagina was discernable in 25.1% of patients. CONCLUSION: MRKH patients typically display bilateral uterine rudiments combined with a fibrous band and normally located ovaries. The uterine rudiments are generally small with only one-layer differentiation, a subset of which might be large and exhibited other atypical presentations, including two- or three-layer differentiation or even hematometra. Abnormally located ovaries are not rare. KEY POINTS: • Morphologically, MRKH patients typically displayed bilateral uterine rudiments combined with a fibrous band. • Typically, the uterine rudiments (84.4%) were small and displayed only one-layer differentiation. • About 15.6% of rudiments showed atypical characteristics including two- or three-layer differentiation, even complicated with hematometra or hematosalpinx.

3.
Eur Radiol ; 2020 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-32189051

RESUMO

OBJECTIVE: To evaluate the feasibility of one-stop pancreatic perfusion CT with mean temporal (MT) imaging replacing the combination of a bi-phasic scan plus a perfusion scan to detect insulinoma. MATERIAL AND METHODS: Forty-five patients with suspected insulinoma, who underwent both biphasic and perfusion CT, were enrolled in this retrospective study. MT datasets including images for different delineation purposes were generated by averaging 3 dynamic datasets from perfusion CT, which are MTA for arterial, MTPV for portal vein and MTO for lesions. Two readers assessed the image quality and diagnostic performance separately for biphasic and MT datasets. Radiation doses were also assessed. Paired t tests, Wilcoxon signed-rank tests and McNemar's tests were applied for comparison. RESULTS: Compared with bi-phasic CT images, image noise, SNR and CNR of the MTA and MTPV datasets were all non-inferior (noise and CNR of the portal vein, p = 0.565 and p = 0.227, respectively) or superior (p ≤ 0.001). The subjective image quality was better in the MTA and MTPV images (p < 0.001 to p = 0.004). The sensitivity and NPV of MT images were also better (95% vs 75% and 75% vs 37.5% for reader 1; 97.5% vs 72.5% and 85.7% vs 35.3% for reader 2). Omitting the bi-phasic scan resulted in a dose reduction of 25% ± 4%. CONCLUSION: MT imaging can allow pancreatic perfusion CT to be used alone without the need for an additional bi-phasic CT in the detection of insulinoma. KEY POINTS: • Mean temporal images reconstructed from perfusion CT with an averaging technique reproduce usual bi-phasic images (arterial and portal phases). • The image quality of mean temporal images is non-inferior or superior to native bi-phasic CT. The sensitivity and NPV for the diagnosis of insulinoma are better for mean temporal images than for traditional bi-phasic CT. • Mean temporal imaging can allow pancreatic perfusion CT to be used alone without the need for an additional bi-phasic CT in the detection of insulinoma. Radiation dose saving is important.

4.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 42(1): 67-72, 2020 Feb 28.
Artigo em Chinês | MEDLINE | ID: mdl-32131942

RESUMO

Objective To evaluate the relationship of volumetric changes and endoleaks after endovascular aneurysm repair(EVAR)for abdominal aortic aneurysms(AAAs). Methods We retrospectively evaluated the clinical and imaging data of 54 patients who had underwent EVAR within 1 month after their aneurysms were detected.All patients received abdominal and pelvic enhanced computed tomography(CTA)for two follow-up visits in Peking Union Medical College Hospital from July 2014 to February 2019.Three-dimensional volumes and maximum diameters on axial CT of the aortic aneurysms were calculated by dedicated semi-automated 3D segmentation software before surgery(V0 and D0),in the 4 th postoperative month(V1and D1),and in the 12 th postoperative month(V2and D2),respectively.The presence or absence of endoleak for each patient with the V1/V0,V2/V0,and V2/V1 were calculated to assess the significance of volume changes with respect to endoleaks and the correlation between volume changes and maximum diameter changes on axial CT images. Results Of the 54 patients,endoleaks were found in 11 patients at the first follow-up visit(4 months after surgery),among whom 8 patients were arranged a second follow-up visit(12 months after surgery),during which endoleaks were found in 5 patients.Fifteen of 43 non-leaked patients underwent a second CTA examination,which revealed endoleak in one case.Patients who did exhibit endoleaks[n =11,V1/V0=1.086(1.033,1.116)]showed significant increases in aneurysm volume when compared with those who did not exhbit endoleaks[n =43,V1/V0=1.019(0.970,1.065)]at the first follow-up visit(Z=-2.695,P=0.007),although no significant difference was found with regard to volume changes between endoleaks(n=6,V2/V0=1.1±0.2,V2/V1=1.0±0.1)and non-endoleaks(n=17,V2/V0=1.0±0.1,V2/V1=1.0±0.1)at the second follow-up visit(t=0.725,P=0.476)as well as between these two follow-up visits(t=-0.021,P=0.984).V0 and D0 were moderately correlated with V1 and D1,respectively(r=0.5,P<0.001)and strongly correlated with V2 and D2,respectively(r=0.8,P<0.001).V1 and D1 were strongly correlated with V2 and D2,respectively(r=0.8,P<0.001). Conclusions The changes of aneurysm volume cannot reliably reflect the occurrence of endoleaks.The change of maximum axial diameter of aneurysm has certain correlation with the changes of aneurysm volume.


Assuntos
Aneurisma da Aorta Abdominal/patologia , Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular , Endoleak/patologia , Procedimentos Endovasculares , Endoleak/diagnóstico por imagem , Humanos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
J Magn Reson Imaging ; 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-32181985

RESUMO

BACKGROUND: Biopsy Gleason score (GS) is crucial for prostate cancer (PCa) treatment decision-making. Upgrading in GS from biopsy to radical prostatectomy (RP) puts a proportion of patients at risk of undertreatment. PURPOSE: To develop and validate a radiomics model based on multiparametric magnetic resonance imaging (mp-MRI) to predict PCa upgrading. STUDY TYPE: Retrospective, radiomics. POPULATION: A total of 166 RP-confirmed PCa patients (training cohort, n = 116; validation cohort, n = 50) were included. FIELD STRENGTH/SEQUENCE: 3.0T/T2 -weighted (T2 W), apparent diffusion coefficient (ADC), and dynamic contrast enhancement (DCE) sequences. ASSESSMENT: PI-RADSv2 score for each tumor was recorded. Radiomic features were extracted from T2 W, ADC, and DCE sequences and Mutual Information Maximization criterion was used to identify the optimal features on each sequence. Multivariate logistic regression analysis was used to develop predictive models and a radiomics nomogram and their performance was evaluated. STATISTICAL TESTS: Student's t or chi-square were used to assess the differences in clinicopathologic data between the training and validation cohorts. Receiver operating characteristic (ROC) curve analysis was performed and the area under the curve (AUC) was calculated. RESULTS: In PI-RADSv2 assessment, 67 lesions scored 5, 70 lesions scored 4, and 29 lesions scored 3. For each sequence, 4404 features were extracted and the top 20 best features were selected. The radiomics model incorporating signatures from the three sequences achieved better performance than any single sequence (AUC: radiomics model 0.868, T2 W 0.700, ADC 0.759, DCE 0.726). The combined mode incorporating radiomics signature, clinical stage, and time from biopsy to RP outperformed the clinical model and radiomics model (AUC: combined model 0.910, clinical model 0.646, radiomics model 0.868). The nomogram showed good performance (AUC 0.910) and calibration (P-values: training cohort 0.624, validation cohort 0.294). DATA CONCLUSION: Radiomics based on mp-MRI has potential to predict upgrading of PCa from biopsy to RP. LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 5.

6.
Eur Radiol ; 2020 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-32020404

RESUMO

OBJECTIVE: The purpose of the study was to investigate the role of CT radiomics for the preoperative distinction of intestinal-type gastric adenocarcinomas. MATERIALS AND METHODS: A total of 187 consecutive patients with preoperative contrast CT examination and pathologically proven gastric adenocarcinoma were retrospectively collected. Patients were divided into a training set (n = 150) and a test set (n = 37). Arterial phase (AP), portal phase (PP), and delay phase (DP) images were retrieved for analysis. A dedicated postprocessing software was used to segment the lesions and extract radiomics features. Random forest (RF) algorithm was applied to construct the classifier models. A nomogram was developed by incorporating multiphase radiomics scores. Receiver operating characteristic (ROC) curves were used to evaluate the performance of the radiomics model and nomogram in both sets. RESULTS: The radiomics model showed a favorable capability in the distinction of intestinal-type gastric adenocarcinomas. The areas under curves (AUCs) of the AP, PP, and DP radiomics models were 0.754 (95% CI: 0.676, 0.820), 0.815 (95% CI: 0.744, 0.874), and 0.764 (95% CI: 0.688, 0.829) in the training set, respectively, which were confirmed in the test set with AUCs of 0.742 (95% CI: 0.572, 0.872), 0.775 (95% CI: 0.608, 0.895), and 0.857 (95% CI: 0.703, 0.950), respectively. The nomogram yielded excellent performance for distinguishing intestinal-type adenocarcinomas in both sets, with AUCs of 0.928 (95%: 0.875, 0.964) and 0.904 (95% CI: 0.761, 0.976). CONCLUSIONS: The multiphase CT radiomics nomogram holds promise for the individual preoperative discrimination of intestinal-type gastric adenocarcinoma. KEY POINTS: • CT radiomics has a potential role in the distinction of intestinal-type gastric adenocarcinomas. • Single-phase enhanced CT-based radiomics showed favorable capability in distinguishing intestinal-type tumors. • The nomogram which incorporates the multiphase radiomics scores could facilitate the individual prediction of intestinal-type lesions.

7.
Artigo em Inglês | MEDLINE | ID: mdl-32044280

RESUMO

BACKGROUND: The optimization of myocardial CT perfusion (CTP) assessment remains inconsistent and uncertain. Our aim was to explore the superior analysis selection and incremental improvement of myocardial blood flow (MBF) assessment on CTP in diagnosing hemodynamically significant coronary artery disease (CAD). METHODS: Sixty patients (43 men and 17 women; 61.38 ± 8.01 years) were prospectively recruited and underwent stress dynamic myocardial CTP examinations. Absolute and relative MBF was used for ischemia evaluation with the invasive coronary angiography and fractional flow reserve were used as the reference standard. Areas under the receiver operating characteristic curves (AUCs) and cutoff values were calculated and compared. RESULTS: There were 151 vessels in 60 patients finally enrolled for analysis. The sensitivity, specificity, PPV, NPV and diagnostic accuracy for the absolute MBF value and relative MBF ratio were 82.76%, 98.92%, 97.96%, 90.20%, and 92.72% and 74.14%, 93.56%, 87.76%, 85.29%, and 86.09%, respectively. The absolute MBF value was superior than the relative MBF ratio in detecting ischemia (AUC, 0.955 [95%CI: 0.919-0.990] vs.0.906 [95%CI:0.857-0.954])(P = 0.02). For territories with both sensitivity and specificity ≤90%, the diagnostic accuracy increased from 79.1% to 88.4% when the specific data were assessed using the absolute MBF value instead of the relative MBF ratio. CONCLUSIONS: The absolute MBF value from the endocardial myocardium on stress dynamic myocardial CTP showed superior diagnostic performance compared to the relative MBF ratio for the detection of myocardial ischemia in intermediate-to-high risk patients. The absolute MBF value provides an incremental benefit toward diagnostic performance for the relative MBF ratio evaluation.

8.
Eur J Radiol ; 124: 108779, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935594

RESUMO

PURPOSE: We sought to evaluate the image quality and compare the signal intensity (SI) and apparent diffusion coefficient (ADC) maps of ultra-high b-value (2000 s/mm2; B2) images against those of 800 s/mm2 b-value (B1) images of diffusion-weighted imaging (DWI) for cervical cancer. METHOD: This study was approved by the institutional review board. Sixty patients diagnosed with cervical cancer by pathology were prospectively included. Female pelvic magnetic resonance imaging was performed using a 3 T magnetic resonance scanner; B1 and B2 images were obtained for evaluation. Two radiologists blinded to the scan parameters evaluated the images for signal loss in the background, spatial distortion, image ghosting, confidence in the lesion delineation, and overall image quality using a 5-point scoring system. The scores were compared using a paired Wilcoxon test. SI was measured in the B1 and B2 images for the tumour and normal reference tissues. Additionally, the SI contrast ratios were calculated and compared using the Mann-Whitney U test, the ADC values of tumours and normal tissues were measured, and the maximum tumour diameters were measured from the B1 and B2 images and compared with those from the T2-weighted images, which was the reference standard. RESULTS: The signal loss in the background, confidence of the lesion delineation and overall image quality scores were higher for the B2 images than for the B1 images (all p < 0.001). The contrast ratios of the tumour-to-normal SI were also higher for the B2 images than for the B1 images (p < 0.01). The mean ADC values derived from the B2 images showed better correlations with the tumour differentiation grades than those from the B1 images. The tumour diameters measured from the B2 images experienced less bias than those from the B1 images. CONCLUSIONS: B2 images of DWI are technically feasible to acquire and provide more promising additional information for the delineation of cervical cancer tumours than B1 images of the female pelvis.

9.
Eur J Radiol ; 122: 108752, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31778965

RESUMO

PURPOSE: To study the characteristics of acute necrotizing pancreatitis (ANP) in different age stages and their correlations with the clinical outcomes using magnetic resonance imaging (MRI). METHOD: MRI of 716 patients with acute pancreatitis was retrospectively reviewed to assess the incidence and characteristics of ANP. On MRI, ANP was classified into three subtypes: extrapancreatic necrosis (EPN) alone, pancreatic necrosis (PN) alone and combined necrosis. The extent of necrosis was also quantified on MRI. All patients were divided into three age groups, that is, young,middle-aged and elderly groups, and these characteristics of ANP were compared among the three age groups. The endpoints of patients' clinical outcome were compared among different age groups and different characteristics of ANP. RESULTS: Of the 716 patients, 129(18 %) were identified as ANP on MRI. The prevalence of ANP in the elderly group was the highest (28.9 %, p < 0.05). The patients in the middle-age and the elderly groups exhibited a higher risk of combined necrosis (56.9 %, 55.8 %; respectively), and elderly patients more frequently had extensive extrapancreatic involvement compared with young patients (65.9 % vs 21.4 %; p = 0.004); however, PN alone was more common in young patients. These characteristics of ANP were significantly bound up with clinical outcomes. CONCLUSIONS: Different subtypes of ANP have different outcomes. More importantly, age needs to be considered as a factor of special concern in development of ANP.

10.
Eur Radiol ; 30(2): 976-986, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31468157

RESUMO

PURPOSE: To investigate the role of computed tomography (CT) radiomics for the preoperative prediction of lymph node (LN) metastasis in gastric cancer. MATERIALS AND METHODS: This retrospective study included 247 consecutive patients (training cohort, 197 patients; test cohort, 50 patients) with surgically proven gastric cancer. Dedicated radiomics prototype software was used to segment lesions on preoperative arterial phase (AP) CT images and extract features. A radiomics model was constructed to predict the LN metastasis by using a random forest (RF) algorithm. Finally, a nomogram was built incorporating the radiomics scores and selected clinical predictors. Receiver operating characteristic (ROC) curves were used to validate the capability of the radiomics model and nomogram on both the training and test cohorts. RESULTS: The radiomics model showed a favorable discriminatory ability in the training cohort with an area under the curve (AUC) of 0.844 (95% CI, 0.759 to 0.909), which was confirmed in the test cohort with an AUC of 0.837 (95% CI, 0.705 to 0.926). The nomogram consisted of radiomics scores and the CT-reported LN status showed excellent discrimination in the training and test cohorts with AUCs of 0.886 (95% CI, 0.808 to 0.941) and 0.881 (95% CI, 0.759 to 0.956), respectively. CONCLUSIONS: The CT-based radiomics nomogram holds promise for use as a noninvasive tool in the individual prediction of LN metastasis in gastric cancer. KEY POINTS: • CT radiomics showed a favorable performance for the prediction of LN metastasis in gastric cancer. • Radiomics model outperformed the routine CT in predicting LN metastasis in gastric cancer. • The radiomics nomogram holds potential in the individualized prediction of LN metastasis in gastric cancer.

11.
Acad Radiol ; 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31761666

RESUMO

RATIONALE AND OBJECTIVES: The aim of this study was to investigate the value of computed tomography (CT) radiomics for the differentiation between T2 and T3/4 stage lesions in gastric cancer. MATERIALS AND METHODS: A total of 244 consecutive patients with pathologically proven gastric cancer were retrospectively included and split into a training cohort (171 patients) and a test cohort (73 patients). Preoperative arterial phase and portal phase contrast enhanced CT images were retrieved for tumor segmentation and feature extraction by using a dedicated postprocessing software. The random forest method was used to build the classifier models. RESULTS: The performance of single phase radiomics models were favorable in the differentiation between T2 and T3/4 stage tumors. Arterial phase-based radiomics model exhibited areas under the curve of 0.899 (95% CI: 0.812-0.955) in the training cohort and 0.825 (95% CI: 0.718-0.904) in the test cohort. Portal phase-based radiomics model showed areas under the curve of 0.843 (95% CI: 0.746-0.914) and 0.818 (95% CI: 0.711-0.899) in the training and test cohort, respectively. CONCLUSION: CT radiomics approach has a potential role in differentiation between T2 and T3/4 stage tumors in gastric cancer.

12.
Acad Radiol ; 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31582193

RESUMO

RATIONALE AND OBJECTIVES: To determine the optimal keV for the visualization of gastric cancer and to investigate its value in depicting lesions and in identifying depth invasion using virtual monoenergetic images (VMIs) on a novel dual-layer spectral detector CT. MATERIALS AND METHODS: Eighty-two gastric cancer patients were retrospectively enrolled, and 41 patients who did not undergo surgery were evaluated for image quality in VMIs at different keVs (40 keV-70 keV with 10 keV increments) and in conventional 120 kVp polyenergetic images (PEIs) reconstructed from the portal venous phase. Objective image quality was assessed by the contrast-to-noise ratio of the gastric cancer, while subjective performance was compared using a 5-point Likert scale. Another 41 patients who underwent surgery were examined to compare the diagnostic performance of the VMIs taken at the optimal keV and that of the 120 kVp-PEIs. RESULTS: The contrast-to-noise ratio of gastric cancer at 40 keV (10.4 ± 4.6) was the highest among all the VMIs and was significantly superior to that of the 120 kVp-PEIs (3.5 ± 1.5, p < 0.001). Gastric-specific image quality was rated highest for the 40 keV-VMIs (4.92 ± 0.26), which was significantly superior to that of the 120 kVp-PEIs (4.15 ± 0.82, p < 0.001). In the diagnostic group, there were 13 pT1, 10 pT2, 9 pT3, and 9 pT4 gastric cancer patients. Compared with the 120 kVp-PEIs, the VMIs at 40 keV tended to have a higher detection rate of gastric cancer (82.9% vs. 92.7%, respectively, p = 0.125) and a significantly improved diagnostic accuracy in the T stage (from 41.5% to 78.11%, respectively) (p < 0.001), particularly in pT1 patients, whose diagnostic accuracy was improved by 53.8% (7.7% vs. 61.5%, respectively, p = 0.016). CONCLUSION: VMIs at 40 keV performed the best, both objectively and subjectively, for gastric cancer, leading to improved lesion depiction and higher T stage accuracy.

13.
Acad Radiol ; 2019 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-31606313

RESUMO

RATIONALE AND OBJECTIVES: Our aim was to evaluate the capability of textural and metabolic parameters measured at pretreatment 18F-fluorodeoxyglucose Positron emission tomography (PET)-MR in differentiating malignant from benign pancreatic cystic lesions. MATERIALS AND METHOD: Forty consecutive patients were prospectively enrolled in this study. They underwent simultaneous PET-MR for the diagnosis of pancreatic cysts. Thirty texture parameters were extracted from manually contoured axial T2-weighted imaging with fat suppression (T2FS) and apparent diffusion coefficient images, respectively. Maximal and mean standardized uptake values (SUVmax and SUVmean, respectively) of pancreatic cysts were measured at PET-MR imaging. The Mann-Whitney test was used to compare both textural and metabolic parameters between benign and malignant group. RESULTS: FDG uptake was significantly higher in patients with malignant pancreatic cysts (SUVmaxp = 0.002, SUVmeanp < 0.001). Malignant cysts showed significantly lower standard deviation for spatial scaling factor at 3-6mm on T2FS images and lower skewness for spatial scaling factor at 2-4mm on apparent diffusion coefficient images (p < 0.01). SUVmean had the highest Area under the curve of 0.892 on receiver-operating characteristic analysis with a sensitivity, specificity, and accuracy of 88.9%, 87.1%, and 87.6%, respectively. When metabolic and textural features were combined into a single diagnostic model, the AUC increased to 0.961, with a sensitivity, specificity, and accuracy of 88.9%, 96.8%, and 95.0%, respectively. CONCLUSION: Our study implied that PET-MR showed no obvious advantages over traditional PET-related imaging in differentiating malignant from benign pancreatic cystic lesions. Diagnostic model based on the combination of metabolic and textural parameters showed satisfactory performance.

15.
Chin Med Sci J ; 34(3): 194-198, 2019 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-31601302

RESUMO

Objective To depict imaging anatomy of bronchial artery (BA) using multidetector CT-angiography (MDCTA) and evaluate the value of MDCTA for management of hemoptysis patients requiring admission to emergency room. Methods We retrospectively studied the clinical and radiological data of patients with severe hemoptysis (≥100 ml of expectorated blood in a 24-hour period) requiring admission to emergency room from Jan 1, 2013 to Dec 31, 2015. Patients' images of MDCTA, treatment modalities, and outcome were discussed. Results A total of 108 patients underwent MDCTA scans. Etiology of hemoptysis was mainly bronchiectasis (44%), tuberculosis sequelae (26%) and tumor (18%). MDCTA visualized 197 traceable BAs and also suggested the involvement of 35 nonbronchial systemic arteries. The mean diameter of BAs, measured at the level of the bronchial bifurcation in the mediastinum, was 2.8±1.2 mm. The mean diameter of BAs, for 52 patients who only received conservative treatment, was 2.9±1.1 mm, and was not significantly larger than that of BAs for 56 patients who underwent bronchial artery embolization (BAE) for continued bleeding which did not resolve after conservative treatment (2.7±1.1 mm, P = 0.94). The technical success rate of embolization was 95% (53/56). Clinical success rate during follow-up was achieved in 50 (94%) of 53 patients who had undergone embolization. Conclusions MDCTA provides useful information for identifying the anatomical characteristics of bleeding-related BAs and nonbronchial systemic arteries for the management of patients with severe hemoptysis. However, MDCTA could not determine the individuals who need BAE through measuring diameter of BAs.


Assuntos
Angiografia , Artérias Brônquicas/diagnóstico por imagem , Embolização Terapêutica , Serviços Médicos de Emergência , Hemoptise , Tomografia Computadorizada Multidetectores , Adulto , Idoso , Feminino , Hemoptise/diagnóstico por imagem , Hemoptise/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
16.
Eur J Radiol ; 120: 108673, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31550640

RESUMO

PURPOSE: To evaluate the imaging pattern of pancreaticobiliary lesions in patients with treated type 1AIP, to determine the incidence of disease relapse and malignancy, and to identify the risk factors. METHOD: The institutional review board approval was acquired. All patients gave written informed consent. From a prospective clinico-radiological database since 2012, consecutive patients with type 1 AIP who were treated and followed up (≥18 months) were identified. The presence/absence of pancreaticobiliary lesion(s) development during follow-up were assessed. The etiology was determined and the imaging pattern was compared to the initial attack. Risk factors were identified by univariate and multivariate analysis. RESULTS: Among 103 patients with treated type 1 AIP, 44 (42.7%) developed pancreaticobiliary lesions during follow up (median time interval to initial diagnosis: 17 months, range 3-62 months), mostly after steroid discontinuation (63.6%) or during maintenance therapy (29.5%). All lesions were disease relapse, which responded to steroid treatment. At relapse, pancreatic involvement was less frequent (81.8% vs 100%, p = 0.003), and the pancreas size was smaller (p < 0.01), whereas extra-pancreatic bile duct (ExPanBD) involvement was more severe and extensive (both p < 0.01). Multivariate analysis revealed ExPanBD involvement at initial diagnosis (hazard ratio 2.437, 95% CI 1.343-7.402, p = 0.002) and serum IgG4 response ratio at the induction phase (hazard ratio 0.357, 95% CI 0.055-0.804, p = 0.011) as significant independent predictors of relapse. CONCLUSIONS: In treated type 1 AIP, although imaging pattern may differ, pancreaticobiliary lesions are usually manifestations of disease relapse. ExPanBD involvement and poor serum response suggests high risk of relapse.


Assuntos
/patologia , Doenças dos Ductos Biliares/patologia , Adulto , Idoso , Biomarcadores/metabolismo , Esquema de Medicação , Feminino , Glucocorticoides/administração & dosagem , Humanos , Imunoglobulina G/metabolismo , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Imagem Multimodal/métodos , Pâncreas/patologia , Prednisolona/administração & dosagem , Estudos Prospectivos , Recidiva , Fatores de Risco
17.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(4): 575-578, 2019 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-31484625

RESUMO

Autoimmune pancreatitis(AIP)is radiologically characterized by sausage-like diffuse swelling of the pancreatic parenchyma but may also be found as a localized mass that is easily misdiagnosed as a pancreatic neoplasm.AIP presenting as multifocal masses is rare.Here we report a case of multifocal IgG4-related AIP,in which the lesions grew in size and finally fused to become radiologically typical.


Assuntos
Doença Relacionada a Imunoglobulina G4/diagnóstico , Pancreatite/diagnóstico , Humanos , Doença Relacionada a Imunoglobulina G4/patologia , Pâncreas/patologia , Neoplasias Pancreáticas , Pancreatite/patologia
18.
J Alzheimers Dis ; 71(2): 559-567, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31424402

RESUMO

BACKGROUND: Few studies have investigated the correlation between cerebral microbleeds (CMBs), a hemorrhagic imaging marker of cerebral small vessel disease (CSVD), and brain volume. OBJECTIVE: We investigated the association between the burden and locations of CMBs and brain volume in community-dwelling populations. METHODS: Data were obtained from 1,029 participants who underwent brain magnetic resonance imaging (MRI) and APOE genotyping. Volumes of the whole brain, subcortical white matter (WM), cortical gray matter (GM), and hippocampus were extracted. Linear regression models were used to investigate the relationship between the CMB burden and their location with structural changes. RESULTS: Regarding burden, participants with≥3 CMBs had significantly lower whole brain (ß= -1.124, p = 0.0133), subcortical WM (ß= -1.020, p = 0.0043), and hippocampus (ß= -0.015, p = 0.0088) volumes than those without CMBs. Regarding location and burden, the presence of≥3 strictly lobar CMBs was negatively associated with whole brain volume (ß= -2.838, p = 0.0088). Additionally, higher CMB burdens in strictly lobar locations or deep/mixed locations were associated with lower subcortical WM volume (ß= -1.689, p = 0.0482; ß= -0.872, p = 0.0464, respectively). Finally, the presence of≥3 deep/mixed CMBs was associated with lower hippocampus volume (ß= -0.018, p = 0.0088), and these associations were independent of other ischemic markers of CSVD. However, the CMB burden and distributional pattern did not correlate with cortical GM volumes. CONCLUSION: A higher CMB burden, in specific locations, is associated with decreased brain volumes in community-dwelling populations.

19.
Chin Med J (Engl) ; 132(16): 1983-1989, 2019 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-31348029

RESUMO

OBJECTIVE: To review the application of radiomics in gastric cancer and its challenges as well as future prospects. DATA SOURCES: A research for relevant studies were performed in PubMed with the terms of "radiomics," "texture analysis," and "gastric cancer." The search was updated until February 28, 2019. STUDY SELECTION: All original articles regarding the investigation of texture analysis or radiomics in gastric cancer were retrieved. Only papers written in English were included. RESULTS: A total of 17 original articles were selected in final. It is shown that radiomics has yielded moderate to excellent performance in a spectrum of respects including differential diagnosis, assessment of histological differential degree, evaluation of tumor stage, prediction of response to therapy, and prognosis in gastric cancer. Yet, a number of challenges are facing both radiomics itself and its application in gastric cancer. CONCLUSIONS: Radiomics holds great potential in facilitating decision-making in gastric cancer. With the standardization of work-flow and advancement of machine learning methods, radiomics is expected to make great breakthroughs in precision medicine of gastric cancer.


Assuntos
Neoplasias Gástricas/diagnóstico , Tomada de Decisão Clínica , Humanos , Medicina de Precisão , Prognóstico , Neoplasias Gástricas/patologia
20.
Int Heart J ; 60(3): 608-617, 2019 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-31105142

RESUMO

The aim of the present study was to investigate the performance of low keV mono-energetic reconstructions in spectral coronary computed tomography angiography (CCTA) using spectral detector CT (SDCT) with reduced contrast media and radiation dose.Sixty patients were randomly assigned to Groups A and B (both n = 30) to undergo CCTA on a dual-layer SDCT with tube voltage 120 kVp and 100 kVp (average tube current: 108.5 and 73.8 mAs, respectively), with contrast media volume of 36 mL used in both groups. The mono-energetic 40-80 keV and conventional 120 kVp images in Group A and conventional 100 kVp images in Group B were reconstructed. Quantitative and qualitative image quality (IQ) were evaluated in the aortic root and distal segments of the coronary arteries.The patient characteristics were not significantly different between the two groups (all P≥ 0.47), nor was the effective radiation dose (1.5 ± 0.3 and 1.4 ± 0.3 mSv, P = 0.20). The quantitative IQ in aorta and coronary arteries of mono-energetic 40-60 keV was superior to conventional 120 kVp and 100 kVp images (all P < 0.05). The noise in spectral images was lower compared to conventional images (all P < 0.01). The subjective IQ score of 40-50 keV images was not significantly different from that of 100 kVp images (P > 0.8).The mono-energetic 40-50 keV reconstructions from spectral CCTA using SDCT provide improved IQ compared to conventional techniques while facilitating reduced radiation dose and contrast media.


Assuntos
Angiografia por Tomografia Computadorizada/instrumentação , Estenose Coronária/diagnóstico por imagem , Interpretação de Imagem Assistida por Computador/normas , Idoso , Meios de Contraste , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doses de Radiação , Distribuição Aleatória , Sensibilidade e Especificidade
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