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1.
Clin Oral Investig ; 28(7): 390, 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38902486

RESUMO

OBJECTIVES: to understand the morphological characteristics of iliac crest and provide advice and assistance for jaw bone reconstruction with iliac bone flap by evaluating the thickness and curvature of iliac crest. MATERIALS AND METHODS: 100 patients who had taken Spiral CT of the Abdominal region before surgeries between 2020 and 2022 were included in this study. 3D reconstruction images of the iliac bones were created. 5 vertical planes perpendicular to the iliac crest were made every 2 cm along the centerline of the iliac crest (VP2 ~ VP10). On these vertical planes, 4 perpendicular lines were made every 1 cm along the long axis of the iliac crest (D1 ~ D4). The thicknesses at these sites, horizontal angle (HA) of iliac crest and the distance between inflection point and the central point of anterior superior iliac spine (DIA) were measured. RESULTS: The thickness of iliac bone decreased significantly from D1 ~ D4 on VP6 ~ VP10 and from VP2 ~ VP10 on D3 and D4 level (P<0.05). HA of iliac crests was 149.13 ± 6.92°, and DIA was 7.36 ± 1.01 cm. Iliac bone thickness, HA and DIA had very weak or weak correlation with patient's age, height and weight. CONCLUSIONS: The average thicknesses of iliac crest were decreased approximately from front to back, from top to bottom. The thickness and curvature of the iliac crest were difficult to predict by age, height and weight. CLINICAL RELEVANCE: Virtual surgical planning is recommended before jaw bone reconstruction surgery with iliac bone flap, and iliac crest process towards alveolar process might be a better choice.


Assuntos
Ílio , Imageamento Tridimensional , Humanos , Ílio/transplante , Ílio/diagnóstico por imagem , Ílio/cirurgia , Feminino , Masculino , Pessoa de Meia-Idade , Adulto , Imageamento Tridimensional/métodos , Tomografia Computadorizada Espiral , Idoso , Retalhos Cirúrgicos , Procedimentos de Cirurgia Plástica/métodos , Transplante Ósseo/métodos
2.
BMC Med Imaging ; 24(1): 143, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867154

RESUMO

OBJECTIVE: This study developed and validated a nomogram utilizing clinical and multi-slice spiral computed tomography (MSCT) features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma. Additionally, we assessed the predictive accuracy of Ki-67 expression levels, as determined by our model, in estimating the prognosis of stage IA lung adenocarcinoma. MATERIALS AND METHODS: We retrospectively analyzed data from 395 patients with pathologically confirmed stage IA lung adenocarcinoma. A total of 322 patients were divided into training and internal validation groups at a 6:4 ratio, whereas the remaining 73 patients composed the external validation group. According to the pathological results, the patients were classified into high and low Ki-67 labeling index (LI) groups. Clinical and CT features were subjected to statistical analysis. The training group was used to construct a predictive model through logistic regression and to formulate a nomogram. The nomogram's predictive ability and goodness-of-fit were assessed. Internal and external validations were performed, and clinical utility was evaluated. Finally, the recurrence-free survival (RFS) rates were compared. RESULTS: In the training group, sex, age, tumor density type, tumor-lung interface, lobulation, spiculation, pleural indentation, and maximum nodule diameter differed significantly between patients with high and low Ki-67 LI. Multivariate logistic regression analysis revealed that sex, tumor density, and maximum nodule diameter were significantly associated with high Ki-67 expression in stage IA lung adenocarcinoma. The calibration curves closely resembled the standard curves, indicating the excellent discrimination and accuracy of the model. Decision curve analysis revealed favorable clinical utility. Patients with a nomogram-predicted high Ki-67 LI exhibited worse RFS. CONCLUSION: The nomogram utilizing clinical and CT features for the preoperative prediction of Ki-67 expression in stage IA lung adenocarcinoma demonstrated excellent performance, clinical utility, and prognostic significance, suggesting that this nomogram is a noninvasive personalized approach for the preoperative prediction of Ki-67 expression.


Assuntos
Adenocarcinoma de Pulmão , Antígeno Ki-67 , Neoplasias Pulmonares , Estadiamento de Neoplasias , Nomogramas , Humanos , Antígeno Ki-67/metabolismo , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/metabolismo , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/metabolismo , Adenocarcinoma de Pulmão/patologia , Adenocarcinoma de Pulmão/cirurgia , Prognóstico , Idoso , Tomografia Computadorizada Espiral/métodos , Adulto
3.
Pediatr Radiol ; 54(7): 1197-1204, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38769141

RESUMO

BACKGROUND: Reports comparing field lens doses between helical scans with a 40-mm detector width and axial scans with a 160-mm detector width using different computed tomography (CT) scanners are currently scarce. OBJECTIVE: To compare scatter doses for lenses between a helical scan with a 40-mm detector width and an axial scan with a 160-mm detector width when using different CT scanners in the context of pediatric chest examinations. MATERIALS AND METHODS: Two different CT machines were used: Revolution CT (GE Healthcare, Waukesha, WI) with a 256-row, 0.625-mm multidetector; and Aquilion ONE GENESIS Edition (Canon Medical Systems, Otawara, Japan) with a 320-row, 0.5-mm multidetector. Three pediatric anthropomorphic phantoms were used, with optically stimulated luminescence dosimeters (OSLDs) placed on the left and right lenses. The scatter dose values measured by the OSLDs were compared between a helical scan with a 40-mm detector width and an axial scan with a 160-mm detector width during pediatric chest CT examinations. RESULTS: Median equivalent doses for the helical and axial scans were 0.12 and 0.12 mSv/mGy for the newborn, 0.17 and 0.16 mSv/mGy for the 1-year-old, and 0.18 and 0.15 mSv/mGy for the 5-year-old, respectively, when using the Revolution CT. With the Revolution CT, no significant differences were observed in the scatter doses between helical and axial scans in the newborn and 1-year-old phantoms. However, the lens scatter dose for the helical scan was approximately 20-35% higher than that for the axial scan in the 5-year-old phantom (P<0.01). The median equivalent doses of eye lenses for the helical and axial scans were 0.12 and 0.07 mSv/mGy for the newborn, 0.07 and 0.05 mSv/mGy for the 1-year-old, and 0.14 and 0.12 mSv/mGy for the 5-year-old, respectively, when using the Aquilion ONE. With the Aquilion ONE, lens scatter doses for the helical scan were approximately 70%, 40%, and 30% higher in the newborn, 1-year-old, and 5-year-old phantoms, respectively, than those for the axial scan (P<0.01). CONCLUSIONS: When using the Aquilion ONE, lens scatter doses for the helical scan were significantly higher in all three phantoms than those for the axial scan. In contrast, when using the Revolution CT, the lens scatter dose for the helical scan was significantly higher in the 5-year-old phantom than that for the axial scan. These results suggest that although scattered doses may vary with respect to the CT scanner and body size, they are generally lower in the case of axial scans.


Assuntos
Cristalino , Imagens de Fantasmas , Doses de Radiação , Espalhamento de Radiação , Humanos , Cristalino/diagnóstico por imagem , Cristalino/efeitos da radiação , Tomografia Computadorizada Espiral/métodos , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada por Raios X/instrumentação , Desenho de Equipamento , Radiometria/métodos , Criança , Exposição à Radiação/análise , Lactente , Recém-Nascido
4.
J Contemp Dent Pract ; 25(3): 250-259, 2024 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-38690699

RESUMO

AIM AND BACKGROUND: To compare the root canal volume in primary teeth using hand and rotary instruments and to evaluate root canal filling techniques and flow of root canal obturation materials in the postinstrumented root canal volume using spiral computed tomography (SCT). MATERIALS AND METHODS: Freshly extracted 16 primary molars were randomly divided into two groups and subjected to SCT analysis before and after instrumentation. For the manual technique (group I) with eight teeth were prepared using K files, and rotary (group II) eight teeth preparation was performed with ProTaper files. The filled volume in each canal was measured using SCT, and the percentage of obturated volume was calculated. The data were statistically analyzed using the Mann-Whitney U test. RESULTS: There was a statistically significant difference in both groups' volume of root canals enlarged. Even though both K files and the ProTaper system brought about enlarged canals after instrumentation, there was a statistically significant increase in volume after using K files in two canals. In three canals, there was a statistically significant increase in volume after using ProTaper. Irrespective of the obturation technique and materials used, there is no statistically significant difference in the volume after obturation. CONCLUSION: From the results of this study, the ProTaper file system shows suitable volumetric enlargement up to an optimum level, which is needed in primary root canal walls, and is better in canal shaping, as evidenced by good postobturation volume. CLINICAL SIGNIFICANCE: The traditional method of cleaning and shaping the root canals in permanent teeth using manual stainless-steel files can lead to undesirable curvatures in root canal morphology, making correctly filling the root canals difficult. It is also time-consuming and sometimes leads to iatrogenic errors. Rotary nickel-titanium (Ni-Ti) instrumentation techniques have been developed to overcome these problems. How to cite this article: Yadav DBUC, Varma RB, Kumar JS, et al. Volumetric Analysis of Hand and Rotary Instrumentation, Root Canal Filling Techniques, and Obturation Materials in Primary Teeth Using Spiral CT. J Contemp Dent Pract 2024;25(3):250-259.


Assuntos
Cavidade Pulpar , Dente Molar , Materiais Restauradores do Canal Radicular , Obturação do Canal Radicular , Preparo de Canal Radicular , Tomografia Computadorizada Espiral , Dente Decíduo , Humanos , Obturação do Canal Radicular/métodos , Dente Decíduo/diagnóstico por imagem , Preparo de Canal Radicular/instrumentação , Preparo de Canal Radicular/métodos , Cavidade Pulpar/diagnóstico por imagem , Cavidade Pulpar/anatomia & histologia , Tomografia Computadorizada Espiral/métodos , Dente Molar/diagnóstico por imagem , Instrumentos Odontológicos , Técnicas In Vitro
5.
BMC Med Imaging ; 24(1): 102, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38724896

RESUMO

Precision and intelligence in evaluating the complexities of middle ear structures are required to diagnose auriculotemporal and ossicle-related diseases within otolaryngology. Due to the complexity of the anatomical details and the varied etiologies of illnesses such as trauma, chronic otitis media, and congenital anomalies, traditional diagnostic procedures may not yield accurate diagnoses. This research intends to enhance the diagnosis of diseases of the auriculotemporal region and ossicles by combining High-Resolution Spiral Computed Tomography (HRSCT) scanning with Deep Learning Techniques (DLT). This study employs a deep learning method, Convolutional Neural Network-UNet (CNN-UNet), to extract sub-pixel information from medical photos. This method equips doctors and researchers with cutting-edge resources, leading to groundbreaking discoveries and better patient healthcare. The research effort is the interaction between the CNN-UNet model and high-resolution Computed Tomography (CT) scans, automating activities including ossicle segmentation, fracture detection, and disruption cause classification, accelerating the diagnostic process and increasing clinical decision-making. The suggested HRSCT-DLT model represents the integration of high-resolution spiral CT scans with the CNN-UNet model, which has been fine-tuned to address the nuances of auriculotemporal and ossicular diseases. This novel combination improves diagnostic efficiency and our overall understanding of these intricate diseases. The results of this study highlight the promise of combining high-resolution CT scanning with the CNN-UNet model in otolaryngology, paving the way for more accurate diagnosis and more individualized treatment plans for patients experiencing auriculotemporal and ossicle-related disruptions.


Assuntos
Ossículos da Orelha , Tomografia Computadorizada Espiral , Humanos , Tomografia Computadorizada Espiral/métodos , Ossículos da Orelha/diagnóstico por imagem , Aprendizado Profundo , Otopatias/diagnóstico por imagem , Osso Temporal/diagnóstico por imagem , Adulto , Redes Neurais de Computação
6.
Technol Health Care ; 32(S1): 313-320, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38669497

RESUMO

BACKGROUND: With the widespread use of low-dose spiral computed tomography (LDCT) and increasing awareness of personal health, the detection rate of pulmonary nodules is steadily rising. OBJECTIVE: To evaluate the success rate and safety of two different models of Hook-Wire needle localization procedures for pulmonary small nodule biopsy. METHODS: Ninety-four cases with a total of 97 pulmonary small nodules undergoing needle localization biopsy were retrospectively analyzed. The cases were divided into two groups: Group A, using breast localization needle steel wire (Bard Healthcare Science Co., Ltd.); Group B, using disposable pulmonary nodule puncture needle (SensCure Biotechnology Co., Ltd.). All patients underwent video-assisted thoracoscopic surgery (VATS) for nodule removal on the same day after localization and biopsy. The puncture localization operation time, success rate, complications such as pulmonary hemorrhage, pneumothorax, hemoptysis, and postoperative comfort were observed and compared. RESULTS: In Group A, the average localization operation time for 97 nodules was 15.47 ± 5.31 minutes, with a success rate of 94.34%. The complication rate was 71.69% (12 cases of pneumothorax, 35 cases of pulmonary hemorrhage, 2 cases of hemoptysis), and 40 cases of post-localization discomfort were reported. In Group B, the average localization operation time was 25.32 ± 7.83 minutes, with a 100% success rate. The complication rate was 29.55% (3 cases of pneumothorax, 15 cases of pulmonary hemorrhage, 0 cases of hemoptysis), and 3 cases reported postoperative discomfort. According to the data analysis in this study, Group B had a lower incidence of puncture-related complications than Group A, along with a higher success rate and significantly greater postoperative comfort. CONCLUSIONS: The disposable pulmonary nodule puncture needle is safer and more effective in pulmonary small nodule localization biopsy, exhibiting increased comfort compared to the breast localization needle. Additionally, the incidence of complications is significantly lower.


Assuntos
Nódulo Pulmonar Solitário , Cirurgia Torácica Vídeoassistida , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Cirurgia Torácica Vídeoassistida/métodos , Cirurgia Torácica Vídeoassistida/instrumentação , Nódulo Pulmonar Solitário/cirurgia , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/diagnóstico por imagem , Idoso , Adulto , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Biópsia por Agulha/métodos , Biópsia por Agulha/instrumentação , Agulhas , Duração da Cirurgia , Tomografia Computadorizada Espiral/métodos
7.
Sci Rep ; 14(1): 9358, 2024 04 23.
Artigo em Inglês | MEDLINE | ID: mdl-38653758

RESUMO

The goal of this experimental study was to quantify the influence of helical pitch and gantry rotation time on image quality and file size in ultrahigh-resolution photon-counting CT (UHR-PCCT). Cervical and lumbar spine, pelvis, and upper legs of two fresh-frozen cadaveric specimens were subjected to nine dose-matched UHR-PCCT scan protocols employing a collimation of 120 × 0.2 mm with varying pitch (0.3/1.0/1.2) and rotation time (0.25/0.5/1.0 s). Image quality was analyzed independently by five radiologists and further substantiated by placing normed regions of interest to record mean signal attenuation and noise. Effective mAs, CT dose index (CTDIvol), size-specific dose estimate (SSDE), scan duration, and raw data file size were compared. Regardless of anatomical region, no significant difference was ascertained for CTDIvol (p ≥ 0.204) and SSDE (p ≥ 0.240) among protocols. While exam duration differed substantially (all p ≤ 0.016), the lowest scan time was recorded for high-pitch protocols (4.3 ± 1.0 s) and the highest for low-pitch protocols (43.6 ± 15.4 s). The combination of high helical pitch and short gantry rotation times produced the lowest perceived image quality (intraclass correlation coefficient 0.866; 95% confidence interval 0.807-0.910; p < 0.001) and highest noise. Raw data size increased with acquisition time (15.4 ± 5.0 to 235.0 ± 83.5 GByte; p ≤ 0.013). Rotation time and pitch factor have considerable influence on image quality in UHR-PCCT and must therefore be chosen deliberately for different musculoskeletal imaging tasks. In examinations with long acquisition times, raw data size increases considerably, consequently limiting clinical applicability for larger scan volumes.


Assuntos
Fótons , Humanos , Tomografia Computadorizada por Raios X/métodos , Cadáver , Rotação , Doses de Radiação , Tomografia Computadorizada Espiral/métodos
8.
Otolaryngol Head Neck Surg ; 170(6): 1561-1569, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38557958

RESUMO

OBJECTIVE: This study aims to use machine learning techniques together with radiomics methods to build a preoperative predictive diagnostic model from spiral computed tomography (CT) images. The model is intended for the differential diagnosis of common jaw cystic lesions. STUDY DESIGN: Retrospective, case-control study. SETTING: This retrospective study was conducted at Sun Yat-sen Memorial Hospital of Sun Yat-sen University (Guangzhou, Guangdong, China). All the data used to build the predictive diagnostic model were collected from 160 patients, who were treated at the Department of Oral and Maxillofacial Surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University between 2019 and 2023. METHODS: We included a total of 160 patients in this study. We extracted 107 radiomic features from each patient's CT scan images. After a feature selection process, we chose 15 of these radiomic features to construct the predictive diagnostic model. RESULTS: Among the preoperative predictive diagnostic models built using 3 different machine learning methods (support vector machine, random forest [RF], and multivariate logistic regression), the RF model showed the best predictive performance. It demonstrated a sensitivity of 0.923, a specificity of 0.643, an accuracy of 0.825, and an area under the receiver operating characteristic curve of 0.810. CONCLUSION: The preoperative predictive model, based on spiral CT radiomics and machine learning algorithms, shows promising differential diagnostic capabilities. For common jaw cystic lesions, this predictive model has potential clinical application value, providing a scientific reference for treatment decisions.


Assuntos
Aprendizado de Máquina , Humanos , Estudos Retrospectivos , Feminino , Masculino , Diagnóstico Diferencial , Estudos de Casos e Controles , Adulto , Pessoa de Meia-Idade , Cistos Maxilomandibulares/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodos , Valor Preditivo dos Testes , Idoso , Radiômica
9.
Neurol Sci ; 45(8): 3901-3905, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38429470

RESUMO

OBJECTIVE: To investigate the clinical value of multi-slice spiral computed tomography angiography (MSCTA) in the diagnosis of intracranial aneurysms (ICA). METHODS: The imaging data of 68 patients suspected of having ICA who were examined in the Department of Radiology of the First Affiliated Hospital of Nanjing Medical University from March 2018 to March 2021 were retrospectively analyzed. MSCTA and digital subtraction angiography (DSA) were performed on each patient, and the MSCTA imaging analysis was compared with DSA. RESULTS: The accuracy of DSA in the diagnosis of ICA was 98.53% (67/68), while the accuracy of MSCTA in the diagnosis of ICA was 97.06% (66/68), with no significant difference in diagnostic accuracy (P > 0.05). There were no significant differences in the diameter of the aneurysm, the width of the aneurysm neck, or the location of the aneurysm in the comparison of the ICA image between DSA and MSCTA (P > 0.05). CONCLUSION: MSCTA offers high accuracy and has favorable clinical value in the diagnosis of ICA. It is worth popularizing as the recommended examination method in clinical practice.


Assuntos
Angiografia Digital , Angiografia por Tomografia Computadorizada , Aneurisma Intracraniano , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Angiografia Digital/métodos , Angiografia por Tomografia Computadorizada/normas , Angiografia por Tomografia Computadorizada/métodos , Adulto , Idoso , Angiografia Cerebral/métodos , Angiografia Cerebral/normas , Tomografia Computadorizada Espiral/métodos
10.
J Craniomaxillofac Surg ; 52(5): 606-611, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38448338

RESUMO

Our study aimed to evaluate modified patient-specific surgical-guide-assisted precise treatment of unilateral comminuted zygomaticomaxillary complex (ZMC) fractures. The retrospective non-randomized study was conducted in a single hospital in China. All patients diagnosed with unilateral comminuted ZMC fractures between January 1, 2018 and December 31, 2022 were retrospectively reviewed. All patients underwent preoperative spiral computed tomography (CT). CT data were processed using software to DICOM format and transferred to Proplan CMF3.0 for preoperative virtual surgical planning and postoperative evaluation. All data were extracted from standardized electronic medical records. All statistical analyses were performed using SPSS version 20.0. The chi-square test and t-test were used for statistical analyses. The 54 included patients were divided into two comparable, equal cohorts of 27 patients, and followed up for at least 6 months. Fracture reduction was assisted using the modified patient-specific surgical guides in the guide group (23 males, four females; mean age 37.74 ± 12.07 years) and without the modified patient-specific surgical guides in the control group (20 males, seven females; mean age 37.44 ± 13.58 years). In the guide group, the mean eminence deviation between the affected and unaffected sides was 1.01 ± 0.92 mm, and the mean width deviation between the affected and unaffected sides was 1.29 ± 1.32 mm. In the control group, the mean eminence deviation between the affected and unaffected sides was 1.99 ± 1.69 mm, and the mean width deviation between the affected and unaffected sides was 2.68 ± 2.01 mm. The differences in facial protrusion (p = 0.001) and width (p = 0.003) symmetry between the affected and healthy sides of the two groups were statistically significant (p < 0.05). In conclusion, applying the modified patient-specific surgical guides to unilateral comminuted zygomaticomaxillary complex fracture reduction has the advantages of greater predictability and effectiveness, and improved bilateral ZMC symmetry. It should be noted that this approach would be especially beneficial for less-experienced surgeons.


Assuntos
Fraturas Cominutivas , Fraturas Maxilares , Cirurgia Assistida por Computador , Fraturas Zigomáticas , Humanos , Estudos Retrospectivos , Masculino , Feminino , Fraturas Zigomáticas/cirurgia , Fraturas Zigomáticas/diagnóstico por imagem , Adulto , Fraturas Cominutivas/cirurgia , Fraturas Cominutivas/diagnóstico por imagem , Fraturas Maxilares/cirurgia , Fraturas Maxilares/diagnóstico por imagem , Pessoa de Meia-Idade , Cirurgia Assistida por Computador/métodos , Tomografia Computadorizada Espiral , Imageamento Tridimensional/métodos , Fixação Interna de Fraturas/métodos , Fixação Interna de Fraturas/instrumentação
11.
Zhonghua Wei Chang Wai Ke Za Zhi ; 27(3): 268-273, 2024 Mar 25.
Artigo em Chinês | MEDLINE | ID: mdl-38532589

RESUMO

Objective: To evaluate the relationships between the location and extent of diffusion of free intraperitoneal air by multi-slice spiral CT (MSCT) and between the location and size of acute gastrointestinal perforation. Methods: This was a descriptive case series. We examined abdominal CT images of 33 patients who were treated for intraoperatively confirmed gastrointestinal perforation (excluding appendiceal perforation) in the Department of General Surgery, Nanfang Hospital between January and September 2022. We identified five locations of intraperitoneal air: the subphrenic space, hepatic portal space, mid-abdominal wall, mesenteric space, and pelvic cavity. We allocated the 33 patients to an upper gastrointestinal perforation (n=23) and lower gastrointestinal perforation group (n=10) base on intraoperative findings and analyzed the relationships between the locations of free gas and of gastrointestinal perforation. Additionally, we established two models for analyzing the extent of diffusion of free gas in the abdominal cavity and constructed receiver operating characteristic (ROC) curves to analyze the relationships between the two models and the size of the gastrointestinal perforation. Results: In the upper gastrointestinal perforation group, free gas was located around the hepatic portal area in 91.3% (21/23) of patients: this is a significantly greater proportion than that found in the lower gastrointestinal perforation group (5/10) (P=0.016). In contrast, free gas was located in the mesenteric interspace in 8/10 patients in the lower gastrointestinal perforation group; this is a significantly greater proportion than was found in the upper gastrointestinal perforation group (8.7%, 2/23) (P<0.010). The sensitivity of diagnosis of upper gastrointestinal perforation base on the presence of hepatic portal free gas was 84.8% and the specificity 71.4%. Further, the sensitivity of diagnosis of lower gastrointestinal perforation base on the presence of mesenteric interspace free gas was 80.0% and the specificity 91.3%. The rates of presence of free gas in the subdiaphragmatic area, mid-abdominal wall, and pelvic cavity did not differ significantly between the two groups (all P>0.05). Receiver operating characteristic curves showed that when free gas was present in four or more of the studied locations in the abdominal cavity, the optimal cutoff for perforation diameter was 2 cm, the corresponding sensitivity 66.7%, and the specificity 100%, suggesting that abdominal free gas diffuses extensively when the diameter of the perforation is >2 cm. Another model revealed that when free gas is present in three or more of the studied locations, the optimal cutoff for perforation diameter is 1 cm, corresponding to a sensitivity of 91.7% and specificity of 76.2%; suggesting that free gas is relatively confined in the abdominal cavity when the diameter of the perforation is <1 cm. Conclusion: Identifying which of five locations in the abdominal cavity contains free intraperitoneal air by examining MSCT images can be used to assist in the diagnosis of the location and size of acute gastrointestinal perforations.


Assuntos
Cavidade Abdominal , Perfuração Intestinal , Trato Gastrointestinal Superior , Humanos , Tomografia Computadorizada Multidetectores , Tomografia Computadorizada Espiral , Fígado , Estudos Retrospectivos
12.
Zhongguo Gu Shang ; 37(2): 153-8, 2024 Feb 25.
Artigo em Chinês | MEDLINE | ID: mdl-38425066

RESUMO

OBJECTIVE: To explore the potential value of three-dimensional fast spin echo(3D-SPACE) combined with multilayer spiral CT (MSCT) in the diagnosis of knee cruciate ligament injury, to provide a new direction for the optimization of subsequent clinical diagnosis. METHODS: A total of 120 patients with knee cruciate ligament injury were treated from April 2020 to April 2021, aged from 21 to 68 with an average of(41.52±4.13) years old. For all patients, separate MSCT scanner scans, 3D-SPACE sequence scans alone and 3D-SPACE sequence combined with MSCT scans were used. The injury and classification of the anterior and posterior cruciate ligament of the knee were compared, the length of the anterior-medial bundle and posterolateral bundle and its angle of the knee with the horizontal plane were observed, the diagnostic value of 3 diagnostic methods in knee cruciate ligament injury were determined. RESULTS: There was no significant difference between the 3D-SPACE sequence scan alone and the MSCT test alone on the total diagnostic rate and grading total diagnostic rate(P>0.05). The total diagnostic rate and grading total diagnostic rate of 3D-SPACE scan combined with MSCT were significantly higher than those of 3D-SPACE scan or MSCT alone(P<0.05). The 3D-SPACE sequence scan alone and the MSCT detection alone had no significant difference in the measurement values related to the anterior and posterior cruciate ligaments of the knee joint(P>0.05). 3D-SPACE sequence scanning combined with MSCT detection on the knee joint anterior and posterior cruciate ligament related measurements were significantly higher than the 3D-SPACE sequence scan or MSCT detection alone(P<0.05). The area under the ROC curve estimated by 3D-SPACE sequence scanning combined with MSCT was 0.960, which was significantly higher than that of 3D-SPACE sequence scanning and MSCT alone evaluating the area under the ROC curve line of 0.756 and 0.795. The combined 3D-SPACE sequence scanning and 3D-SPACE sequence scanning MSCT analysis and prediction models were statistically different(Z=2.236, P<0.05), and MSCT alone and 3D-SPACE sequence scanning combined with MSCT analysis and prediction models were statistically different(Z=2.653, P<0.05). CONCLUSION: The application of 3D-SPACE sequence combined with MSCT scanning for knee cruciate ligament injury can improve the diagnosis rate of patients with knee cruciate ligament injury.It can be used as a diagnostic tool for patients with knee cruciate ligament injury and is worthy of clinical application.


Assuntos
Lesões do Ligamento Cruzado Anterior , Traumatismos do Joelho , Ligamento Cruzado Posterior , Lesões dos Tecidos Moles , Humanos , Adulto , Pessoa de Meia-Idade , Imageamento por Ressonância Magnética/métodos , Artroscopia , Traumatismos do Joelho/diagnóstico por imagem , Articulação do Joelho/diagnóstico por imagem , Ligamento Cruzado Posterior/lesões , Tomografia Computadorizada Espiral , Lesões do Ligamento Cruzado Anterior/diagnóstico por imagem
13.
Pediatr Radiol ; 54(5): 758-763, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38308740

RESUMO

BACKGROUND: Adaptive collimation reduces the dose deposited outside the imaged volume along the z-axis. An increase in the dose deposited outside the imaged volume (to the lens and thyroid) in the z-axis direction is a concern in paediatric computed tomography (CT). OBJECTIVE: To compare the dose deposited outside the imaged volume (to the lens and thyroid) between 40-mm and 80-mm collimation during thoracic paediatric helical CT. MATERIALS AND METHODS: We used anthropomorphic phantoms of newborns and 5-year-olds with 40-mm and 80-mm collimation during helical CT. We compared the measured dose deposited outside the imaged volume using optically stimulated luminescence dosimeters (OSLD) at the surfaces of the lens and thyroid and the image noise between the 40-mm and 80-mm collimations. RESULTS: There were significant differences in the dose deposited outside the imaged volume (to the lens and thyroid) between the 40-mm and 80-mm collimations for both phantoms (P < 0.01). CONCLUSION: Compared with that observed for 80-mm collimation in helical CT scans of the paediatric thorax, the dose deposited outside the imaged volume (to the lens and thyroid) was significantly lower in newborns and 5-year-olds with 40-mm collimation.


Assuntos
Cristalino , Imagens de Fantasmas , Doses de Radiação , Radiografia Torácica , Glândula Tireoide , Humanos , Glândula Tireoide/diagnóstico por imagem , Recém-Nascido , Cristalino/diagnóstico por imagem , Cristalino/efeitos da radiação , Radiografia Torácica/métodos , Radiografia Torácica/instrumentação , Pré-Escolar , Tomografia Computadorizada por Raios X/métodos , Tomografia Computadorizada Espiral/métodos
14.
Jpn J Radiol ; 42(6): 622-629, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38381250

RESUMO

PURPOSE: To evaluate the diagnostic accuracy of abdominal contrast-enhanced multi-slice spiral CT after oral diluted iodide in a time segment (post-ODI ACE-MSCT) for gastrointestinal fistula (GIF) in severe acute pancreatitis (SAP). MATERIALS AND METHODS: Patients with SAP who underwent both post-ODI ACE-MSCT and endoscopy/surgery from 2017 to 2023 were continuously retrospectively involved. Their demographic information and clinical features were recorded prospectively in an in-hospital database. Using endoscopy/surgery results as the reference standard, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of post-ODI ACE-MSCT for diagnosing GIF in SAP were calculated by a four-cell table. The consistency of the two diagnostic methods was evaluated by the Kappa test and McNemar's test. RESULTS: Using endoscopy/surgery as the reference standard, a total of 86 cases were divided into the GIF group (N = 52) and the non-GIF group (N = 34). Among the 52 cases of GIF, 88.5% (46/52) cases had a positive result and 11.5% (5/52) cases had a negative result of post-ODI ACE-MSCT for GIF. Among the 34 cases of non-GIF, 2.9% (1/34) case had a positive result and 97.1% (33/34) cases had a negative result of post-ODI ACE-MSCT for GIF. Post-ODI ACE-MSCT had a sensitivity of 88.5% (95% CI 75.9%-95.2%), a specificity of 97.1% (95% CI 82.9%-99.8%), a positive predictive value of 97.9% (95% CI 87.3%-99.9%), a negative predictive value of 84.6% (95% CI 68.8%-93.6%), and an accuracy of 91.9% (83.4%-96.4%). The kappa value was 0.834, and P < 0.001 by McNemar's test. There were no significant differences in diagnostic test characteristics between the two modalities. CONCLUSION: Post-ODI ACE-MSCT can diagnose GIF in SAP in a simple, noninvasive, and accurate way, and can provide earlier imaging evidence for clinical diagnosis and treatment.


Assuntos
Meios de Contraste , Pancreatite , Sensibilidade e Especificidade , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos Retrospectivos , Pancreatite/diagnóstico por imagem , Tomografia Computadorizada Espiral/métodos , Idoso , Adulto , Administração Oral , Fístula Intestinal/diagnóstico por imagem , Reprodutibilidade dos Testes
15.
Med Phys ; 51(3): 1597-1616, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38227833

RESUMO

BACKGROUND: Multislice spiral computed tomography (MSCT) requires an interpolation between adjacent detector rows during backprojection. Not satisfying the Nyquist sampling condition along the z-axis results in aliasing effects, also known as windmill artifacts. These image distortions are characterized by bright streaks diverging from high contrast structures. PURPOSE: The z-flying focal spot (zFFS) is a well-established hardware-based solution that aims to double the sampling rate in longitudinal direction and therefore reduce aliasing artifacts. However, given the technical complexity of the zFFS, this work proposes a deep learning-based approach as an alternative solution. METHODS: We propose a supervised learning approach to perform a mapping between input projections and the corresponding rows required for double sampling in the z-direction. We present a comprehensive evaluation using both a clinical dataset obtained using raw data from 40 real patient scans acquired with zFFS and a synthetic dataset consisting of 100 simulated spiral scans using a phantom specifically designed for our problem. For the clinical dataset, we utilized 32 scans as training set and 8 scans as validation set, whereas for the synthetic dataset, we used 80 scans for training and 20 scans for validation purposes. Both qualitative and quantitative assessments are conducted on a test set consisting of nine real patient scans and six phantom measurements to validate the performance of our approach. A simulation study was performed to investigate the robustness against different scan configurations in terms of detector collimation and pitch value. RESULTS: In the quantitative comparison based on clinical patient scans from the test set, all network configurations show an improvement in the root mean square error (RMSE) of approximately 20% compared to neglecting the doubled longitudinal sampling by the zFFS. The results of the qualitative analysis indicate that both clinical and synthetic training data can reduce windmill artifacts through the application of a correspondingly trained network. Together with the qualitative results from the test set phantom measurements it is emphasized that a training of our method with synthetic data resulted in superior performance in windmill artifact reduction. CONCLUSIONS: Deep learning-based raw data interpolation has the potential to enhance the sampling in z-direction and thus minimize aliasing effects, as it is the case with the zFFS. Especially a training with synthetic data showed promising results. While it may not outperform zFFS, our method represents a beneficial solution for CT scanners lacking the necessary hardware components for zFFS.


Assuntos
Artefatos , Aprendizado Profundo , Humanos , Tomografia Computadorizada Espiral/métodos , Tomógrafos Computadorizados , Imagens de Fantasmas , Processamento de Imagem Assistida por Computador/métodos , Algoritmos
16.
Zhongguo Fei Ai Za Zhi ; 27(1): 13-24, 2024 Jan 20.
Artigo em Chinês | MEDLINE | ID: mdl-38296622

RESUMO

BACKGROUND: Low-dose spiral computed tomography (LDCT) has been recommended for lung cancer screening in high-risk populations. However, evidence from Chinese populations was limited due to the different criteria for high-risk populations and the short-term follow-up period. This study aimed to evaluate the effectiveness in Chinese adults based on the Lung Cancer Screening Program in Minhang District of Shanghai initiated in 2013. METHODS: A total of 26,124 subjects aged 40 years or above were enrolled in the Lung Cancer Screening Program during the period of 2013 and 2017. Results of LDCT examination, and screen-detected cancer cases in all participants were obtained from the Reporting System of the Lung Cancer Screening Program. The newly-diagnosed cases and their vital status up to December 31, 2020 were identified through a record linkage with the Shanghai Cancer Registry and the Shanghai Vital Statistics. Standardized incidence ratio (SIR) and 95%CI were calculated using the local population at ages of 40 or above as the reference. Proportions of early-stage cancer (stage 0-I), pathological types, and 5-year observed survival rates of lung cancer cases were estimated and compared between the cases derived from the screened and non-screened populations. Cox regression models were applied to evaluate the hazard ratio (HR) and 95%CI of LDCT screening with all-cause death of the lung cancer cases. RESULTS: The crude and age-standardized incidence of lung cancer in screened population were 373.3 (95%CI: 343.1-406.1) and 70.3 per 100,000 person-years, respectively, with an SIR of 1.8 (95%CI: 1.6-1.9), which was observed to decrease with following-up time. The early-stage cancer accounted for 49.4% of all lung cancer cases derived from the screened population, significantly higher than 38.4% in cases from the non-screened population during the same period (P<0.05). The proportion of lung adenocarcinoma (40.7% vs 35.9%) and 5-year survival rate (53.7% vs 41.5%) were also significantly higher in the cases from the screened population (all P<0.05). LDCT screening was associated with 30% (HR=0.7, 95%CI: 0.6-0.8) reduced all-cause deaths of the cases. CONCLUSIONS: The participants of the screening program are at high-risk of lung cancer. LDCT favors the early-detection of lung cancer and improves 5-year survival of the screened cases, indicating a great potential of LDCT in reducing the disease burden of lung cancer in Chinese populations.


Assuntos
Neoplasias Pulmonares , Adulto , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/epidemiologia , Tomografia Computadorizada por Raios X , Detecção Precoce de Câncer/métodos , China/epidemiologia , Tomografia Computadorizada Espiral/métodos , Programas de Rastreamento
18.
Technol Health Care ; 32(1): 1-8, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37270822

RESUMO

BACKGROUND: Juxta-papillary duodenal diverticula (JPDD) are common but are usually asymptomatic, and they are often diagnosed by coincidence. OBJECTIVE: To analyse the anatomy and classification of JPDD and its relationship with biliary and pancreatic disorders, and to explore the diagnostic value of multi-slice spiral computed tomography (MSCT) in patients with JPDD. METHODS: The imaging data of patients with JPDD, which was obtained via abdominal computed tomography examination and confirmed via gastroscopy and/or upper gastrointestinal barium enema, in our hospital from 1 January 2019 to 31 December 2020 were retrospectively analysed. All patients were scanned using MSCT, and the imaging findings, classification and grading were analysed. RESULTS: A total of 119 duodenal diverticula were detected in 96 patients, including 73 single diverticula and 23 multiple diverticula. The imaging findings were mainly cystic lesions of the inner wall of the duodenum protruding to the outside of the cavity. The thin layer showed a narrow neck connected with the duodenal cavity, and the shape and size of the diverticula were different: 67 central-type cases and 29 peripheral-type cases. There were 50 cases of type I, 33 cases of type II, 19 cases of type III and six cases of type IV. Furthermore, there were seven small, 87 medium and 14 large diverticula. The differences in the location and size of the JPDD in MSCT grading were statistically significant (P< 0.05). CONCLUSION: The MSCT method has an important diagnostic value for the classification of JPDD, and MSCT images are helpful in the clinical evaluation of patients with JPDD and the selection of treatment options.


Assuntos
Divertículo , Duodenopatias , Humanos , Estudos Retrospectivos , Duodenopatias/diagnóstico por imagem , Divertículo/diagnóstico por imagem , Divertículo/patologia , Tomografia Computadorizada por Raios X , Tomografia Computadorizada Espiral
19.
Altern Ther Health Med ; 30(2): 118-123, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37820681

RESUMO

Objective: This study aimed to assess the clinical efficacy of combining multi-slice spiral CT with gastrointestinal angiography for diagnosing gastric cancer. Methods: We conducted a retrospective analysis of clinical data from 151 patients with suspected gastric cancer admitted to our hospital between January 2014 and January 2022. Among them, 70 patients underwent multi-slice spiral CT alone (control group), while the remaining 81 patients underwent multi-slice spiral CT in combination with gastrointestinal barium contrast (combination group). Finally, pathological examination confirmed gastric cancer in 81 patients. We analyzed the diagnostic efficacy of multi-slice spiral CT combined with gastrointestinal angiography for staging gastric cancer and detecting lymph node metastasis. Results: The sensitivity and accuracy of diagnosing gastric cancer using multi-slice spiral CT combined with gastrointestinal angiography were significantly superior to CT alone (P < .05). This combined approach exhibited substantial advancements in detecting stage I and II tumors compared to a single CT, although the difference in stage III detection rate was marginal (P < .05). Furthermore, among the 81 gastric cancer cases, 67 were confirmed to have lymph node metastasis through surgical and pathological examination. The lymph node detection rate with multi-slice spiral CT combined with gastrointestinal angiography was significantly higher than that achieved with single CT (P < .05). Conclusions: Combining multi-slice spiral CT with gastrointestinal angiography proved to be an effective diagnostic strategy for gastric cancer.


Assuntos
Neoplasias Gástricas , Humanos , Metástase Linfática/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/patologia , Estudos Retrospectivos , Tomografia Computadorizada Espiral , Angiografia
20.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1010106

RESUMO

BACKGROUND@#Low-dose spiral computed tomography (LDCT) has been recommended for lung cancer screening in high-risk populations. However, evidence from Chinese populations was limited due to the different criteria for high-risk populations and the short-term follow-up period. This study aimed to evaluate the effectiveness in Chinese adults based on the Lung Cancer Screening Program in Minhang District of Shanghai initiated in 2013.@*METHODS@#A total of 26,124 subjects aged 40 years or above were enrolled in the Lung Cancer Screening Program during the period of 2013 and 2017. Results of LDCT examination, and screen-detected cancer cases in all participants were obtained from the Reporting System of the Lung Cancer Screening Program. The newly-diagnosed cases and their vital status up to December 31, 2020 were identified through a record linkage with the Shanghai Cancer Registry and the Shanghai Vital Statistics. Standardized incidence ratio (SIR) and 95%CI were calculated using the local population at ages of 40 or above as the reference. Proportions of early-stage cancer (stage 0-I), pathological types, and 5-year observed survival rates of lung cancer cases were estimated and compared between the cases derived from the screened and non-screened populations. Cox regression models were applied to evaluate the hazard ratio (HR) and 95%CI of LDCT screening with all-cause death of the lung cancer cases.@*RESULTS@#The crude and age-standardized incidence of lung cancer in screened population were 373.3 (95%CI: 343.1-406.1) and 70.3 per 100,000 person-years, respectively, with an SIR of 1.8 (95%CI: 1.6-1.9), which was observed to decrease with following-up time. The early-stage cancer accounted for 49.4% of all lung cancer cases derived from the screened population, significantly higher than 38.4% in cases from the non-screened population during the same period (P<0.05). The proportion of lung adenocarcinoma (40.7% vs 35.9%) and 5-year survival rate (53.7% vs 41.5%) were also significantly higher in the cases from the screened population (all P<0.05). LDCT screening was associated with 30% (HR=0.7, 95%CI: 0.6-0.8) reduced all-cause deaths of the cases.@*CONCLUSIONS@#The participants of the screening program are at high-risk of lung cancer. LDCT favors the early-detection of lung cancer and improves 5-year survival of the screened cases, indicating a great potential of LDCT in reducing the disease burden of lung cancer in Chinese populations.


Assuntos
Adulto , Humanos , Neoplasias Pulmonares/epidemiologia , Tomografia Computadorizada por Raios X , Detecção Precoce de Câncer/métodos , China/epidemiologia , Tomografia Computadorizada Espiral/métodos , Programas de Rastreamento
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