computed tomography scan

计算机断层扫描
  • 文章类型: Journal Article
    脊柱外科文献中越来越多地报道了使用计算机断层扫描(CT)和磁共振成像(MRI)进行骨密度评估的新方法。这些较新的测量与传统的双能X射线吸收法(DEXA)之间的相关性尚不为人所知。这项研究的目的是对CT或MRI的骨矿物质密度(BMD)与DEXA之间的相关性进行更新的系统评价。
    2011年至2021年发表的文章报道了CT-HU或MRI测量值与DEXAt评分或腰椎或髋部BMD之间的相关性。
    总共25项研究(15项CT,10MRI)符合纳入标准,患者总数为2,745例。脊柱CT-HU与脊柱DEXA的合并相关系数,脊柱CT-HU与髋部DEXA和脊柱CT-HU与最低t评分分别为0.60、0.50和0.60。关于脊柱DEXA参数,脊柱CT-HU与脊柱t评分的合并r2为0.684,脊柱CT-HU与脊柱BMD的合并r2为0.598.此外,在四项研究中接受脊柱手术的患者中,脊柱CT与脊柱DEXA的合并相关性为(r2:0.64).在核磁共振研究中,脊柱MRI与脊柱DEXA以及脊柱MRI与髋部DEXA的合并r2分别为-0.41和-0.44。
    CT-HU与DEXA的相关性比MRI测量值强。腰椎CT-HU与脊柱DEXA的合并相关性最高(r2=0.6),骨骼t评分最低,其次是腰椎CT-HU与髋部DEXA(r2=0.5),腰椎MRI与髋部(r2=0.44)和脊柱(r2=0.41)DEXA。两种成像方式与DEXA仅具有中等相关性。在这两种方式中,很少有研究调查脊柱手术人群的相关性,现有数据表明,退行性脊柱人群的相关性更差。在评估BMD时,应仔细中断CTHU和MRI测量,因为它们仅与DEXA评分中度相关。此时,目前尚不清楚哪种方式能更好地预测脊柱手术患者的机械并发症和临床结局.
    UNASSIGNED: Novel methods of bone density assessment using computed tomography (CT) and magnetic resonance imaging (MRI) have been increasingly reported in the spine surgery literature. Correlations between these newer measurements and traditional Dual-Energy X-ray Absorptiometry (DEXA) is not well known. The purpose of this study is to perform an updated systematic review of correlations between bone mineral density (BMD) from CT or MRI and DEXA.
    UNASSIGNED: Articles published between 2011 and 2021 that reported correlations between the CT-HU or MRI measurements to DEXA t-scores or BMD of lumbar spine or hip were included in this systematic review.
    UNASSIGNED: A total of 25 studies (15 CT, 10 MRI) met the inclusion criteria with a total number of 2,745 patients. The pooled correlation coefficient of spine CT-HU versus spine DEXA, spine CT-HU versus hip DEXA and spine CT-HU versus lowest t-score were 0.60, 0.50 and 0.60 respectively. Regarding spine DEXA parameters, the pooled r2 for spine CT-HU versus spine t-score was 0.684 and spine CT-HU versus spine BMD was 0.598. Furthermore, in patients undergoing spine surgery in four studies, the pooled correlation between spine CT and spine DEXA was (r2: 0.64). In MRI studies, the pooled r2 of spine MRI versus spine DEXA and spine MRI versus hip DEXA were -0.41 and -0.44 respectively.
    UNASSIGNED: CT-HU has stronger correlations with DEXA than MRI measurements. Lumbar CT-HU has the highest pooled correlation (r2 = 0.6) with both spine DEXA and lowest skeletal t-score followed by lumbar CT-HU with hip DEXA (r2 = 0.5) and lumbar MRI with hip (r2 = 0.44) and spine (r2 = 0.41) DEXA. Both imaging modalities achieved only a moderate correlation with DEXA. Few studies in both modalities have investigated the correlation in spine surgery populations and the available data shows that the correlations are worse in the degenerative spine population. A careful interruption of CT HU and MRI measurement when evaluation of BMD as they only moderately correlated with DEXA scores. At this time, it is unclear which modality is a better predictor of mechanical complications and clinical outcomes in spine surgery patients.
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  • 文章类型: Case Reports
    未经证实:Rosai-Dorfman-Destombes病(RDD)是一种病因不明的罕见组织增生性疾病。它通常发生在淋巴结中,并且可以影响结外组织和器官。肾RDD极为罕见,只有少数病例报告,其临床症状和影像学表现是非特异性的。迄今为止,在大量病例中没有文献总结其影像学表现。由于受累于不同的组织和器官,RDD没有标准治疗方法。据报道,肾脏受累的RDD患者预后不良。因此,对肾脏RDD的认识还需进一步深入。
    UASSIGNED:我们在一名无症状的67岁男性中介绍了一例罕见的肾RDD病例。超声检查结果表明,两个肾脏都被低回声软组织病变包围,左肾有一个巨大的肿块,与肾包膜有清晰的边界。超声造影(CEUS)结果显示双侧肾周病变和肿块增强不足。然而,计算机断层扫描尿路造影(CTU)结果显示无明显增强。然后病人接受了一系列的实验室检查,但没有找到相关信息。为了做出明确的诊断,然后泌尿科医生切除了左肾周肿块和一些肾周组织,最终病理诊断为结外RDD。病人仍然无症状,到目前为止还没有治疗。
    UNASSIGNED:该病例可能是第一例报告的行CEUS的病例,也是第二例无症状肾RDD的病例。根据以前的文献报道,我们发现肾RDD的一些特殊特征包括双侧肾周病变,表现为“毛状肾”。CEUS和/或CTU可用于帮助区分RDD的孤立肿块与常见肿瘤。避免误诊导致不必要的肾切除术。
    UNASSIGNED: Rosai-Dorfman-Destombes disease (RDD) is a rare histioproliferative disease with unknown etiology. It commonly occurs in lymph nodes and can affect extra-nodal tissues and organs. Renal RDD is extremely rare, only a few cases have been reported, and its clinical symptoms and imaging findings are non-specific. To date, no literature has summarized its imaging manifestations in a large number of cases. Due to the involvement of different tissues and organs, there is no standard treatment for RDD. It has been reported that RDD patients with kidney involvement have a poor prognosis. Thus, understanding of renal RDD need to be extended.
    UNASSIGNED: We present a rare case of renal RDD in an asymptomatic 67-year-old male. The results of an ultrasound examination indicated that both kidneys were surrounded by hypoechoic soft tissue lesions, and there was a huge mass in the left kidney, which had a clear boundary with the renal capsule. The results of contrast-enhanced ultrasound (CEUS) showed hypo-enhancement in the bilateral perinephric lesions and mass. However, the computed tomography urography (CTU) findings revealed no obvious enhancement. The patient then underwent a series of laboratory tests, but no relevant information was found. To make a clear diagnosis, the urologist then removed the left perirenal mass and some perirenal tissues, and the patient was finally pathologically diagnosed with extra-nodal RDD. The patient remains asymptomatic, and no treatment has been administered to date.
    UNASSIGNED: This case may be the first reported case in which CEUS was performed and the second reported case of asymptomatic renal RDD. Based on the previous literature reports, we found that some specific characteristics of renal RDD include bilateral perirenal lesions with a \"hairy kidney\" appearance. CEUS and/or CTU can be used to help differentiate a solitary mass of RDD from common tumors, to avoid misdiagnosis leading to unnecessary nephrectomy.
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  • 文章类型: Case Reports
    ParryRomberg综合征(PRS),也被称为进行性半颜面萎缩,是一种非常罕见的自限性疾病,影响皮肤和皮下组织,底层肌肉组织,软骨,和一半面部的骨结构,导致偏侧萎缩和斑秃。它存在于儿童和年轻人中,萎缩缓慢发展了几年,然后变得稳定。头颅的磁共振成像(MRI)或计算机断层扫描(CT)扫描非常清楚地显示了偏侧萎缩的放射学特征。我们报告了一个9岁女孩的PRS病例,该女孩具有根据病史诊断的特征性特征,临床体征,头颅CT扫描和MRI的放射学发现。
    Parry Romberg syndrome (PRS), also known as progressive hemifacial atrophy, is a very rare self-limiting disease, which affects the skin and subcutaneous tissues, underlying musculature, cartilage, and bony structures of one half of the face with a resultant hemiatrophy and alopecia areata. It presents in children and young adults, with a slow progression of the atrophy for several years, and then becomes stable. Magnetic resonance imaging (MRI) or computed tomography (CT) scan of the cranium demonstrates the radiological feature of hemiatrophy very clearly. We report a case of PRS in a nine-year-old girl with characteristic features which was diagnosed based on medical history, clinical signs, and radiological findings on cranial CT scan and MRI.
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  • 文章类型: Journal Article
    CT扫描在成人足踝手术中起着重要作用。X线平片通常是评估脚和踝骨以及关节结构异常的一线成像方式。然而,尽管CT扫描更昂贵并且与更高的辐射暴露有关,它为评估骨科和创伤中的骨性病变提供了更好的成像质量。证据表明,与普通X射线相比,从CT扫描可以获得更准确的测量结果。负重多重检测CT扫描通过提供更详细的评估而走得更远,尤其是关节内骨折,与传统的非负重CT扫描相比,反映了现实生活中的脚和脚踝动态。与常规CT扫描相比,它还具有相对较低的辐射剂量。CT扫描是评估骨性病变的最佳方式,而MRI对软组织病理学更好。了解CT扫描在足踝解剖评估中的作用将有助于改善整形外科医生之间的沟通,放射科医生,还有放射技师.与其他成像方式相比,彻底了解何时使用CT扫描也将导致更好的手术结果,降低成本,并降低辐射暴露的风险。这篇评论文章分析了CT在评估成人足踝手术诊断和手术计划的相关影像学建筑测量中的作用。
    CT scan plays an important role in adult foot and ankle surgery. Plain radiographs are usually the first-line imaging modality for assessing foot and ankle bone and joint architectural abnormalities. However, despite the fact that a CT scan is more expensive and associated with higher radiation exposure, it offers better imaging quality for the assessment of bony lesions in orthopaedics and trauma. Evidence has shown that more accurate measurements can be obtained from a CT scan compared to plain radiographs. Weight-bearing multi-detection CT scanning goes the extra mile by providing a more detailed assessment, especially for intra-articular fractures, and mirrors the real-life foot and ankle dynamics compared to conventional non-weight-bearing CT scans. It also has a relatively lower radiation dose compared to conventional CT scans. CT scan is the best modality for assessing bony lesions whereas MRI is better for soft tissue pathology. An understanding of the role of CT scan in the anatomical assessment of the foot and ankle will help improve communication between orthopaedic surgeons, radiologists, and radiographers. A thorough understanding of when to use a CT scan compared to the other imaging modalities will also lead to better surgical outcomes, reduced cost, and reduced risk from radiation exposure. This review article analyzes the role of CT in assessing relevant radiographic architectural measurements for diagnosis and surgical planning in adult foot and ankle surgery.
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  • 文章类型: Journal Article
    局部晚期头颈部鳞状细胞癌(HNSCC)主要由存在有或没有囊外扩散(ECS)的病理性颈淋巴结(LN)定义。目前将LN分类为非病理性的放射学标准,病理性,或病理性ECS主要基于形状。然而,成像模式中包含了更多的定量信息。该定量信息可用于通过人工智能(AI)对局部晚期HNSCC患者的LN进行分类。目前,有各种探讨AI在HNSCC中的作用的评论。然而,专门针对AI在HNSCC患者中对LN进行分类的当前作用的综述很少。本工作系统地回顾了原创文章,这些文章专门探讨了AI在本地高级HNSCC中对LN进行分类的作用,这些文章应用了用于系统评价和荟萃分析(PRISMA)指南的首选报告项目和美国国立卫生研究院(NIH)的研究质量评估工具。在2001年至2022年之间,在69项研究中,共有13项回顾性研究,主要是单心,研究被确定。大多数研究包括口咽和口腔患者(13项研究中有9项和7项,分别)HNSCC。在13项研究中的9项研究中将组织病理学发现定义为参考。机器学习被应用于13项研究中,其中9个应用深度学习。纳入患者的平均人数为75(SD±72;范围10-258),LN为340(SD±268;范围21-791)。训练集的平均诊断准确性为86%(SD±14%;范围:43-99%),测试集的平均诊断准确性为86%(SD±5%;范围76-92%)。因此,所有确定的研究都认为AI是HNSCC中LN分类的潜在有前途的诊断支持工具.然而,足够的动力,prospective,迫切需要随机对照试验进一步评估AI在局部晚期HNSCCLN分类中的作用。
    Locally-advanced head and neck squamous cell carcinoma (HNSCC) is mainly defined by the presence of pathologic cervical lymph nodes (LNs) with or without extracapsular spread (ECS). Current radiologic criteria to classify LNs as non-pathologic, pathologic, or pathologic with ECS are primarily shape-based. However, significantly more quantitative information is contained within imaging modalities. This quantitative information could be exploited for classification of LNs in patients with locally-advanced HNSCC by means of artificial intelligence (AI). Currently, various reviews exploring the role of AI in HNSCC are available. However, reviews specifically addressing the current role of AI to classify LN in HNSCC-patients are sparse. The present work systematically reviews original articles that specifically explore the role of AI to classify LNs in locally-advanced HNSCC applying Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines and the Study Quality Assessment Tool of National Institute of Health (NIH). Between 2001 and 2022, out of 69 studies a total of 13 retrospective, mainly monocentric, studies were identified. The majority of the studies included patients with oropharyngeal and oral cavity (9 and 7 of 13 studies, respectively) HNSCC. Histopathologic findings were defined as reference in 9 of 13 studies. Machine learning was applied in 13 studies, 9 of them applying deep learning. The mean number of included patients was 75 (SD ± 72; range 10-258) and of LNs was 340 (SD ± 268; range 21-791). The mean diagnostic accuracy for the training sets was 86% (SD ± 14%; range: 43-99%) and for testing sets 86% (SD ± 5%; range 76-92%). Consequently, all of the identified studies concluded AI to be a potentially promising diagnostic support tool for LN-classification in HNSCC. However, adequately powered, prospective, and randomized control trials are urgently required to further assess AI\'s role in LN-classification in locally-advanced HNSCC.
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  • 文章类型: Journal Article
    为COVID-19肺炎的孕妇和新生儿建立适合风险的护理方法对于预防主要的妊娠并发症至关重要。
    这项研究回顾了孕妇COVID-19肺炎的垂直传播(VT)潜力。总结母婴分娩前后的关键相关症状及不良临床结局。还提出了一些实用的疗法和预防性健康解决方案。
    孕妇对COVID-19感染有很高的易感性,尤其是在怀孕的第三个三个月。感染COVID-19的22-40岁患者最常见的症状是发热(87.6%),咳嗽(52.3%),呼吸困难(27.6%),疲劳(22.4%),喉咙痛(13.5%),萎靡不振(9.4%),和腹泻(3.4%),分别。病毒感染导致早产和剖宫产增加,没有任何宫内感染和严重的新生儿窒息。尽管VT现象的风险很高,但未报告新生儿感染。最重要的疗法是接受抗病毒和抗生素药物,氧合疗法,心理干预,和具有健康促进作用的食品补充剂。控制COVID-19感染的最佳建议医学策略是每两个月进行一次筛查,并跟踪母亲和胎儿的健康状况,不使用强效的广谱抗生素和皮质类固醇,为分娩室提供紧急剖宫产的负压,分娩后立即隔离新生儿,没有直接母乳喂养。
    患有呼吸系统疾病的婴儿可能是一些患有COVID-19的母亲所生的,他们的免疫系统较弱。因此,应通过整合个人健康指南来中断病毒传播周期,以防止不良的母婴结局,有效的医疗护理疗法,医院的预防措施。
    The establishment of a risk-appropriate care approach for pregnant women and newborn infants under the COVID-19 pneumonia is vital to prevent the main pregnancy complications.
    This study reviewed the vertical transmission (VT) potential of COVID-19 pneumonia in pregnant women. Key-related symptoms and adverse clinical outcomes for mothers and infants before and after childbirth were summarized. Some practical therapies and preventive health solutions were also proposed.
    There was a high susceptibility in pregnant women to COVID-19 infection, especially in the third trimester of pregnancy. The most common symptoms in 22-40-year-old patients infected with COVID-19 were fever (87.6%), cough (52.3%), dyspnea (27.6%), fatigue (22.4%), sore throat (13.5%), malaise (9.4%), and diarrhea (3.4%), respectively. The viral infection led to an increase in preterm labor and cesarean delivery without any intrauterine infection and severe neonatal asphyxia. No infection in the newborn infants was reported despite a high risk of the VT phenomenon. The most important therapies were the reception of antiviral and antibiotic drugs, oxygenation therapy, psychological interventions, and food supplements with health-promoting effects. The best proposed medical strategies to control the COVID-19 infection were bi-monthly screening and following-up the mothers\' and fetuses\' health, not using the potent broad-spectrum antibiotics and corticosteroids, providing the delivery room with negative pressure for emergency cesarean section, and the immediate isolation of newborns after childbirth without direct breastfeeding.
    Babies with respiratory problems may be born to some mothers with COVID-19, who have weak immune systems. Thus, the virus transmission cycle should be disrupted to prevent adverse maternal and fetal outcomes by integrating individual health guidelines, efficient medical care therapies, and hospital preventive practices.
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  • 文章类型: Case Reports
    Obturator hernia is a rare type of pelvic hernia and considers more common in female patients. The obturator canal is a narrow space, leading to high chances of bowel strangulation. It is rarely diagnoses, especially on the left side. The mortality rate of obturator hernia is high due to delayed diagnosis. We are presenting a case of a 70-year-old woman, admitted with the clinical features of acute intestinal obstruction. On clinical examination, she had a nontender, distended abdomen, and all hernial orifices were normal. Per rectal and vaginal examination was also normal. She diagnosed a left-sided obturator hernia with the help of a computed tomography scan abdomen. We should consider a differential diagnosis of obturator hernia, especially in old, thin-built female patients with recurrent episodes of obstructive features. Early diagnosis and timely operative intervention may reduce the chances of complications and mortality.
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  • 文章类型: Journal Article
    这项研究的目的是回顾已发表的文献,了解2019年冠状病毒感染患者的影像学发现范围。这种新型冠状病毒目前是全球大流行的原因。肺部症状和体征在临床表现中占主导地位,放射科医生被要求评估胸部X光片(CXR)和计算机断层扫描(CT)图像,以评估浸润并确定其程度。分布和进展。多项研究试图通过观察相对于症状发作的成像时间来表征疾病进程。总的来说,普通CXR显示双侧疾病,有向肺外周的趋势,并且外观与病毒性肺炎最一致。胸部CT图像最明显的是显示双侧和周围磨玻璃和合并混浊,并伴有肺结节。空化,腺病和胸腔积液。发表的文献提到除了肺部表现之外的器官系统相对较不常见,但目前并在本次审查中得到解决。同样,在这种不断发展的危机中,除了CXR和胸部CT之外,重点关注成像方式的出版物很少,本综述也同样对此进行了讨论。目前医学界正在讨论成像的作用,考虑到严重急性呼吸系统综合症冠状病毒2的高度传染性,这一点也不令人惊讶。
    The purpose of this study is to review the published literature for the range of radiographic findings present in patients suffering from coronavirus disease 2019 infection. This novel corona virus is currently the cause of a worldwide pandemic. Pulmonary symptoms and signs dominate the clinical picture and radiologists are called upon to evaluate chest radiographs (CXR) and computed tomography (CT) images to assess for infiltrates and to define their extent, distribution and progression. Multiple studies attempt to characterize the disease course by looking at the timing of imaging relative to the onset of symptoms. In general, plain CXR show bilateral disease with a tendency toward the lung periphery and have an appearance most consistent with viral pneumonia. Chest CT images are most notable for showing bilateral and peripheral ground glass and consolidated opacities and are marked by an absence of concomitant pulmonary nodules, cavitation, adenopathy and pleural effusions. Published literature mentioning organ systems aside from pulmonary manifestations are relatively less common, yet present and are addressed in this review. Similarly, publications focusing on imaging modalities aside from CXR and chest CT are sparse in this evolving crisis and are likewise addressed in this review. The role of imaging is examined as it is currently being debated in the medical community, which is not at all surprising considering the highly infectious nature of Severe Acute Respiratory Syndrome coronavirus 2.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    目标:鉴于在精神病患者的调查中包括常规结构神经影像学的建议仍然存在矛盾,我们小组的目标是增加颅内病理学的数据,具体来说,年轻的成年精神病患者。这是一项新颖的研究,因为它包括所有的演讲(躁狂症,抑郁症,精神病,焦虑,物质使用障碍)和呈现,根据作者的知识,该组中最大的成像结果队列.方法:对224例接受年轻成人评估的患者进行神经影像学(CT和MRI)报告,评估和重新整合单位(12-A)在艾伯塔省医院埃德蒙顿(AHE)在2012-2015年间进行了回顾,所有发现都分为四类之一(正常,异常/良性,异常且不太可能与症状有关,和异常,可能与症状有关)。这项研究主要是对CT扫描的回顾,因为研究人群中只有6例MRI报告。结果:总的来说,86.6%的发现被归类为正常。在有异常发现的扫描中,10.7%被认为是良性和非特异性的。1.8%的异常发现需要外部咨询或随访,但不太可能与症状有关;0.9%被认为可能与症状有因果关系,尽管随访成像被认为是另外的。最普遍的发现是脑萎缩(n=6),蛛网膜囊肿(n=5),心室不对称(n=3),透明隔腔(n=3)。结论:这项研究代表了年轻成年精神病人群中最大的偶然发现队列。这些发现不支持在年轻成人(17-26岁)精神病人群中订购结构成像测试的做法。这项建议同意最近关于这个问题的建议,并强调需要在这一领域进行持续审查。
    Objective: Given that there continue to be conflicting recommendations on the inclusion of routine structural neuroimaging amongst the investigations ordered in psychiatric patients, our group aimed to add to the data on intracranial pathology amongst, specifically, the young adult psychiatric population. This is a novel study in that it includes all presentations (mania, depression, psychosis, anxiety, substance use disorders) and presents, to the authors\' knowledge, the largest cohort of imaging results amongst this group. Method: The neuroimaging (CT and MRI) reports of 224 patients admitted to the Young Adult Assessment, Evaluation and Reintegration Unit (12-A) at the Alberta Hospital Edmonton (AHE) between the years of 2012-2015 were reviewed, and all findings were classified into one of four categories (normal, abnormal/benign, abnormal and unlikely linked to symptoms, and abnormal with possible link to symptoms). This study is largely a review of CT scans, as there were only six MRI reports available in the study population. Results: In total, 86.6% of findings were classified as normal. Amongst the scans with abnormal findings, 10.7% were deemed benign and non-specific. 1.8% of abnormal findings required an outside consultation or follow-up, but were unlikely linked to symptoms; and 0.9% were deemed possibly causally related to symptoms, though follow-up imaging deemed otherwise. The most prevalent findings were cerebral atrophy (n=6), arachnoid cysts (n=5), ventricular asymmetry (n=3), and cavum septum pellucidum (n=3). Conclusions: This study represents the largest cohort of incidental findings in the young adult psychiatric population. These findings do not support the practice of ordering structural imaging tests in the young adult (17-26 years) psychiatric population. This suggestion agrees with recent recommendations on this question, and highlights the need for ongoing review in this area.
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