Imaging modalities

成像方式
  • 文章类型: Journal Article
    背景技术随着涉及电离辐射的成像技术的越来越多的使用,扫描的身体区域应限于回答临床问题所需的范围。因此,这是一项回顾性审核,旨在评估在泌尿系症状评估过程中肾脏计算机断层扫描(CT)扫描图像中是否存在过度扫描.目的本研究旨在减少因泌尿症状而接受CT扫描的患者不必要的扫描长度和辐射暴露。材料和方法在两个月内,来自不同诊所的患者接受了CT成像,并收集和分析所得的射线照相图像。过扫描被定义为超过总扫描的10%。随后,测量了CT扫描的总长度,该总长度用于测量最高肾脏边缘上方不必要的过扫描占总长度的百分比。结果88例患者中,100%不符合肾脏CT成像指南,并暴露于高辐射剂量。然而,超扫描患者的最小百分比为20-40%.结论大量扫描显示最高肾脏上方的过度扫描。因此,建议采取识别合适的解剖标志进行扫描并建立后续审核的措施,以最大程度地减少辐射暴露的有害影响。
    Background With the increasing use of imaging techniques involving ionizing radiation, the area of the body scanned should be restricted to what is required to answer the clinical question. Therefore, this is a retrospective audit that intends to evaluate the presence of overscanning in renal computed tomography (CT) scan images during the process of evaluation for urinary symptoms. Objective This study aims to reduce the unnecessary scan length and exposure to radiation in patients who undergo CT scans for urinary symptoms. Materials and Methods In two months duration, patients from different clinics underwent CT imaging, and the resulting radiographic images were collected and analyzed. Overscanning was defined to be more than 10% of the total scan. Subsequently, the total length of the CT scan was measured which is used to measure the unnecessary overscan above the highest kidney margin as a percentage of the total length. Results Out of the 88 patients who were evaluated, 100% did not meet the guidelines for renal CT imaging and were exposed to a high radiation dose. However, the minimum percentage of overscanned patients was 20-40%. Conclusion A significant number of scans demonstrated surplus overscanning above the highest kidney. Therefore, recognizing the suitable anatomical landmarks for scanning and establishing a follow-up audit are suggested measures to minimize the noxious effects of radiation exposure.
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  • 文章类型: Journal Article
    为了回顾成像方式在评估糖尿病视网膜疾病(DRD)的血管成分方面的证据,以通知DRD暂存系统的更新。
    由国际专家工作组对文献进行标准化叙述审查,作为DRD暂存系统更新工作的一部分,玛丽·泰勒·摩尔视觉倡议的一个项目。总的来说,有6个工作组:血管视网膜,神经视网膜,系统健康,基本和细胞机制,视觉功能,和生活质量。
    血管视网膜工作组,包括来自4个国家的16名参与者。
    使用5种方式的标准化证据网格进行文献综述:标准彩色眼底照相(CFP),宽视场彩色摄影(WFCP),标准荧光素血管造影(FA),广域FA(WFFA),和OCT血管造影(OCTA)。在从I(最高)到V(最低)的验证量表上确定证据的汇总水平。举行了五次虚拟讲习班进行讨论和达成共识。
    每种模式的证据级别。
    标准CFP的证据水平,WFCP,标准FA,WFFA,OCTA是我,II,I,I,和II分别。标准CFP的传统血管病变应继续纳入更新的分期系统,但需要更多的研究才能将它们用于治疗后的眼睛。宽场彩色照片可用于标准CFP覆盖区域内的严重程度分级,尽管这些等级可能无法直接互换。可以考虑评估WFCP上的周边视网膜,但分级方法需要澄清和验证。标准FA和WFFA提供独立的预后价值,但是应该考虑染料给药的需要。OCT血管造影术在DRD分期系统中具有巨大的潜力,但是首先需要解决各种障碍。
    本研究为评估DRD血管成分的各种成像方式的实用性提供了基于证据的建议,可以通知DRD分段系统的未来更新。尽管新的成像模式提供了丰富的信息,在实现这一潜力之前,仍然存在重大差距和未满足的研究需求。
    专有或商业披露可在本文末尾的脚注和披露中找到。
    UNASSIGNED: To review the evidence for imaging modalities in assessing the vascular component of diabetic retinal disease (DRD), to inform updates to the DRD staging system.
    UNASSIGNED: Standardized narrative review of the literature by an international expert workgroup, as part of the DRD Staging System Update Effort, a project of the Mary Tyler Moore Vision Initiative. Overall, there were 6 workgroups: Vascular Retina, Neural Retina, Systemic Health, Basic and Cellular Mechanisms, Visual Function, and Quality of Life.
    UNASSIGNED: The Vascular Retina workgroup, including 16 participants from 4 countries.
    UNASSIGNED: Literature review was conducted using standardized evidence grids for 5 modalities: standard color fundus photography (CFP), widefield color photography (WFCP), standard fluorescein angiography (FA), widefield FA (WFFA), and OCT angiography (OCTA). Summary levels of evidence were determined on a validated scale from I (highest) to V (lowest). Five virtual workshops were held for discussion and consensus.
    UNASSIGNED: Level of evidence for each modality.
    UNASSIGNED: Levels of evidence for standard CFP, WFCP, standard FA, WFFA, and OCTA were I, II, I, I, and II respectively. Traditional vascular lesions on standard CFP should continue to be included in an updated staging system, but more studies are required before they can be used in posttreatment eyes. Widefield color photographs can be used for severity grading within the area covered by standard CFPs, although these gradings may not be directly interchangeable with each other. Evaluation of the peripheral retina on WFCP can be considered, but the method of grading needs to be clarified and validated. Standard FA and WFFA provide independent prognostic value, but the need for dye administration should be considered. OCT angiography has significant potential for inclusion in the DRD staging system, but various barriers need to be addressed first.
    UNASSIGNED: This study provides evidence-based recommendations on the utility of various imaging modalities for assessment of the vascular component of DRD, which can inform future updates to the DRD staging system. Although new imaging modalities offer a wealth of information, there are still major gaps and unmet research needs that need to be addressed before this potential can be realized.
    UNASSIGNED: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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  • 文章类型: Journal Article
    Barrett食管是食管腺癌(OAC)的唯一已知前体。尽管Barrett食管存在筛查和监测指南,目前的战略是不够的。食管胃十二指肠镜检查(OGD)是筛查Barrett食管的金标准方法。这种侵入性方法价格昂贵,存在相关风险,无法将其用作当前的Barrett食管筛查工具。这篇综述探讨了当前的定义,流行病学,生物标志物,监视,在Barrett的食道中进行筛查.讨论了适用于这种情况的成像方式,除了未来的发展。迫切需要一种替代的非侵入性筛查和/或监测方法,该方法可能对减少等待时间非常有益。减轻患者的恐惧并降低当前医疗保健服务的未来成本。振动光谱学已被证明在将Barrett的食道分类至高度发育不良(HGD)和OAC方面是有前途的。这些技术需要通过多中心试验进一步验证。
    Barrett\'s oesophagus is the only known precursor to oesophageal adenocarcinoma (OAC). Although guidelines on the screening and surveillance exist in Barrett\'s oesophagus, the current strategies are inadequate. Oesophagogastroduodenoscopy (OGD) is the gold standard method in screening for Barrett\'s oesophagus. This invasive method is expensive with associated risks negating its use as a current screening tool for Barrett\'s oesophagus. This review explores current definitions, epidemiology, biomarkers, surveillance, and screening in Barrett\'s oesophagus. Imaging modalities applicable to this condition are discussed, in addition to future developments. There is an urgent need for an alternative non-invasive method of screening and/or surveillance which could be highly beneficial towards reducing waiting times, alleviating patient fears and reducing future costs in current healthcare services. Vibrational spectroscopy has been shown to be promising in categorising Barrett\'s oesophagus through to high-grade dysplasia (HGD) and OAC. These techniques need further validation through multicentre trials.
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  • 文章类型: Journal Article
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