multidetector computed tomography

多探测器计算机断层扫描
  • 文章类型: Journal Article
    背景:细胞外体积分数的心脏计算机断层扫描定量(CT-ECV)是心肌纤维化的新兴生物标志物,已证明具有高可重复性,诊断和预后效用。然而,文献中的CT-ECV方案差异很大,有用的疾病界限尚未确定.这项荟萃分析的目的是描述平均CT-ECV估计值,并估计CT-ECV方案参数对研究间变异的影响。
    方法:我们对健康和患病参与者的CT-ECV评估研究进行了荟萃分析。我们使用荟萃分析方法汇集CT-ECV的估计值,并进行荟萃回归以确定方案参数对CT-ECV异质性的贡献。
    结果:13项研究共有248名健康参与者接受了CT-ECV评估。健康参与者的研究在CT-ECV方案参数上有很大差异。健康参与者的CT-ECV的汇总估计值为27.6%(95CI25.7%-29.4%),具有显著的异质性(I2​=93%),而淀粉样变性为50.2%(95CI46.2%-54.2%)。重度主动脉瓣狭窄占31.2%(28.5%-33.8%),非缺血性扩张型心肌病占36.9%(31.6%-42.3%)。Meta回归显示,CT方案参数约占CT-ECV估计异质性的25%。
    结论:文献中健康个体的CT-ECV估计值差异很大,与心脏病的估计值存在显著重叠。这种异质性的四分之一由CT-ECV协议参数的差异解释。CT-ECV方案的标准化对于广泛实施CT-ECV评估以进行诊断和预后是必要的。
    BACKGROUND: Cardiac computed tomography quantification of extracellular volume fraction (CT-ECV) is an emerging biomarker of myocardial fibrosis which has demonstrated high reproducibility, diagnostic and prognostic utility. However, there has been wide variation in the CT-ECV protocol in the literature and useful disease cut-offs are yet to be established. The objectives of this meta-analysis were to describe mean CT-ECV estimates and to estimate the effect of CT-ECV protocol parameters on between-study variation.
    METHODS: We conducted a meta-analysis of studies assessing CT-ECV in healthy and diseased participants. We used meta-analytic methods to pool estimates of CT-ECV and performed meta-regression to identify the contribution of protocol parameters to CT-ECV heterogeneity.
    RESULTS: Thirteen studies had a total of 248 healthy participants who underwent CT-ECV assessment. Studies of healthy participants had high variation in CT-ECV protocol parameters. The pooled estimate of CT-ECV in healthy participants was 27.6% (95%CI 25.7%-29.4%) with significant heterogeneity (I2 ​= ​93%) compared to 50.2% (95%CI 46.2%-54.2%) in amyloidosis, 31.2% (28.5%-33.8%) in severe aortic stenosis and 36.9% (31.6%-42.3%) in non-ischaemic dilated cardiomyopathies. Meta-regression revealed that CT protocol parameters account for approximately 25% of the heterogeneity in CT-ECV estimates.
    CONCLUSIONS: CT-ECV estimates for healthy individuals vary widely in the literature and there is significant overlap with estimates in cardiac disease. One quarter of this heterogeneity is explained by differences in CT-ECV protocol parameters. Standardization of CT-ECV protocols is necessary for widespread implementation of CT-ECV assessment for diagnosis and prognosis.
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  • 文章类型: Journal Article
    背景:良性神经鞘瘤表现为孤立性腹膜后肿块(RBNSTs),对多学科团队在鉴别诊断方面提出了复杂的诊断挑战,分期,和治疗计划。本文回顾了不同成像技术在评估RBNST中所起的作用,并阐明了其典型的病理特征,特别强调了成像与组织学发现之间的相关性。此外,报道了一些腹膜后肿瘤的例子,这些例子值得在基于横断面调查(CSIs)的鉴别诊断过程中考虑.组织结构与影像学表现之间的相关性可以帮助提高CSIs与其他腹膜后肿瘤的鉴别诊断的准确性。
    本教育综述严格检查了孤立性腹膜后良性神经鞘瘤的影像学和组织学特征之间的相关性,为提高临床放射学鉴别诊断的准确性提供有价值的见解。
    结论:RBNST的诊断具有挑战性,因为它们缺乏特定的放射学特征。影像学上RBNST与其他腹膜后肿瘤的鉴别诊断很复杂。为了准确诊断,建议手术切除RBNST。
    BACKGROUND: Benign nerve sheath tumors presenting as solitary retroperitoneal masses (RBNSTs) pose a complex diagnostic challenge for multidisciplinary teams regarding differential diagnosis, staging, and treatment planning. This article reviews the role played by different imaging techniques in assessing RBNSTs and elucidates their typical pathological features with a particular emphasis on the correlation between imaging and histological findings. Furthermore, some examples of retroperitoneal tumors that merit consideration in the process of differential diagnosis based on cross-sectional investigations (CSIs) are reported. The correlation between tissue architecture and appearance on imaging can help increase the accuracy of differential diagnosis with other retroperitoneal neoplasms at CSIs.
    UNASSIGNED: This educational review critically examines the correlation between imaging and histological features in solitary retroperitoneal benign nerve sheath tumors, offering valuable insights for improving the accuracy of differential diagnosis in clinical radiology.
    CONCLUSIONS: RBNSTs are challenging to diagnose because they lack specific radiological features. Differential diagnosis of RBNSTs from other retroperitoneal neoplasms on imaging is complex. Surgical removal of RBNSTs is recommended for an accurate diagnosis.
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  • 文章类型: Systematic Review
    背景和目的:胰腺,藏在腹腔内,需要大量复杂的成像方式来进行全面评估,超声检查作为主要的调查技术。无数的胰腺病理,包括胰腺肿瘤和一系列炎性疾病,可以通过这些成像策略检测到。然而,复杂的解剖学汇合和胰腺的深层地形使其病理的可视化和准确诊断成为一项艰巨的任务。我们论文的目的是回顾胰腺的最佳诊断影像工具。材料和方法:我们使用Prisma指南收集了几篇文章,以确定最佳的意象方法。胰腺扫描的必要性超越了其诊断效用,被证明是众多临床专科的关键要素,尤其是肿瘤外科.在这个领域,胰腺的多探测器计算机断层扫描(MDCT)具有重要的成像模态的区别,认可其无与伦比的能力来描述胰腺癌的分期和进展。与MDCT协同,近年来,前卫成像技术的出现显着。这些先进的方法,包括超声检查,超声内镜,超声造影,磁共振成像(MRI)与磁共振胰胆管造影(MRCP)相结合,拓宽了肿瘤表征的视野,在肿瘤评估中提供无与伦比的深度和精确度。其他新兴的诊断技术,比如弹性成像,对胰腺成像的未来也有很大的潜力和希望。细针抽吸(FNA)是一种快速,使用细针提取组织进行分析,以评估肿块的微创程序。与手术活检相比,侵入性较小,通常作为门诊进行,恢复快。其准确性取决于样品质量,风险包括最小的出血或不适。Results,指导进一步治疗,通常在一周内可用。弹性成像是一种非侵入性医学成像技术,可绘制软组织的弹性特性和刚度。这种方法,通常与超声或MRI结合使用,有助于区分组织中的硬区域和软区域,提供有价值的诊断信息。它对评估肝纤维化特别有用,甲状腺结节,乳房肿块,和肌肉骨骼疾病。该技术是无痛的,涉及对被检查的区域施加轻柔的压力。得到的图像显示组织硬度,表明潜在的异常。弹性成像对于其早期检测疾病和监测治疗有效性的能力是有利的。程序很快,安全,不需要特别的准备,结果通常立即可用。结果:收集和收集的数据显示了各种技术在辨别胰腺内肿瘤病变的性质和程度方面的功效。结论:目前用于诊断胰腺肿瘤的最常见的成像方式是多探测器计算机断层扫描(MDCT)。超声内镜(EUS),磁共振成像(MRI),除了新技术,比如弹性成像。
    Background and Objectives: The pancreas, ensconced within the abdominal cavity, requires a plethora of sophisticated imaging modalities for its comprehensive evaluation, with ultrasonography serving as a primary investigative technique. A myriad of pancreatic pathologies, encompassing pancreatic neoplasia and a spectrum of inflammatory diseases, are detectable through these imaging strategies. Nevertheless, the intricate anatomical confluence and the pancreas\'s deep-seated topography render the visualization and accurate diagnosis of its pathologies a formidable endeavor. The objective of our paper is to review the best diagnostic imagistic tools for the pancreas. Materials and Methods: we have gathered several articles using Prisma guidelines to determine the best imagistic methods. The imperative of pancreatic scanning transcends its diagnostic utility, proving to be a pivotal element in a multitude of clinical specialties, notably surgical oncology. Within this domain, multidetector computed tomography (MDCT) of the pancreas holds the distinction of being the paramount imaging modality, endorsed for its unrivaled capacity to delineate the staging and progression of pancreatic carcinoma. In synergy with MDCT, there has been a notable advent of avant-garde imaging techniques in recent years. These advanced methodologies, including ultrasonography, endoscopic ultrasonography, contrast-enhanced ultrasonography, and magnetic resonance imaging (MRI) conjoined with magnetic resonance cholangiopancreatography (MRCP), have broadened the horizon of tumor characterization, offering unparalleled depth and precision in oncological assessment. Other emerging diagnostic techniques, such as elastography, also hold a lot of potential and promise for the future of pancreatic imaging. Fine needle aspiration (FNA) is a quick, minimally invasive procedure to evaluate lumps using a thin needle to extract tissue for analysis. It is less invasive than surgical biopsies and usually performed as an outpatient with quick recovery. Its accuracy depends on sample quality, and the risks include minimal bleeding or discomfort. Results, guiding further treatment, are typically available within a week. Elastography is a non-invasive medical imaging technique that maps the elastic properties and stiffness of soft tissue. This method, often used in conjunction with ultrasound or MRI, helps differentiate between hard and soft areas in tissue, providing valuable diagnostic information. It is particularly useful for assessing liver fibrosis, thyroid nodules, breast lumps, and musculoskeletal conditions. The technique is painless and involves applying gentle pressure to the area being examined. The resulting images show tissue stiffness, indicating potential abnormalities. Elastography is advantageous for its ability to detect diseases in early stages and monitor treatment effectiveness. The procedure is quick, safe, and requires no special preparation, with results typically available immediately. Results: The assembled and gathered data shows the efficacy of various techniques in discerning the nature and extent of neoplastic lesions within the pancreas. Conclusions: The most common imaging modalities currently used in diagnosing pancreatic neoplasms are multidetector computed tomography (MDCT), endoscopic ultrasound (EUS), and magnetic resonance imaging (MRI), alongside new technologies, such as elastography.
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  • 文章类型: Journal Article
    脊椎盘炎的定义是涉及脊柱的感染性疾病。该疾病的发病率在过去几十年中不断增加。成像在疾病的每个阶段都起着关键作用。的确,放射学工具是(i)脊柱盘炎的初步诊断识别的基础,(ii)对炎症的区分,退化,或钙化病因,(iii)疾病分期,以及(iv)提供线索,以定向所涉及的微生物。后一个目标可以通过微创手术来实现(例如,CT引导活检)或可以通过CT分析进行非侵入性假设,正电子发射断层扫描(PET)CT,或显示MRI特征。因此,本综述旨在总结脊柱椎间盘炎的所有多模态影像学特征。这个,目标是作为医生的参考(传染病专家,脊柱外科医生,放射科医生)参与这些患者的护理。尽管如此,这篇综述文章可能为未来的研究文章提供起点。
    Spondylodiscitis is defined by infectious conditions involving the vertebral column. The incidence of the disease has constantly increased over the last decades. Imaging plays a key role in each phase of the disease. Indeed, radiological tools are fundamental in (i) the initial diagnostic recognition of spondylodiscitis, (ii) the differentiation against inflammatory, degenerative, or calcific etiologies, (iii) the disease staging, as well as (iv) to provide clues to orient towards the microorganisms involved. This latter aim can be achieved with a mini-invasive procedure (e.g., CT-guided biopsy) or can be non-invasively supposed by the analysis of the CT, positron emission tomography (PET) CT, or MRI features displayed. Hence, this comprehensive review aims to summarize all the multimodality imaging features of spondylodiscitis. This, with the goal of serving as a reference for Physicians (infectious disease specialists, spine surgeons, radiologists) involved in the care of these patients. Nonetheless, this review article may offer starting points for future research articles.
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  • 文章类型: Journal Article
    背景:肺癌,第二常见的癌症,持续令人沮丧的预后。Radiomics,一个有前途的领域,旨在提供新的成像生物标志物以改善结果。然而,临床翻译面临重复性挑战,尽管努力用质量评分工具来解决这些问题。
    目的:本研究有两个目的:1)确定放疗后III/IV期非小细胞肺癌(NSCLC)患者的放射组学生物标志物,2)使用CLEAR(CheckList_for_Evaluation_of_Radiomics_research)评估研究质量,RQS(Radiomics_Quality_Score)框架,并制定合并的CLEAR-RQS工具以增强科学严谨性。
    方法:进行了关于III/IV期NSCLC的系统文献综述(2023年6月至8月,MEDLINE/PubMed/SCOPUS),放射治疗,和放射学特征(RF)。提取的数据包括研究设计细节,例如样本量,放射治疗/CT技术,选定的RF,和端点。CLEAR和RQS合并为CLEAR-RQS清单。三位读者用清晰的方式评价了文章,RQS,和CLEAR-RQS指标。
    结果:在871篇文章中,11符合纳入/排除标准。队列的中位数为91(范围:10-337),其中9项研究为单中心。没有确定常见的RF。合并的CLEAR-RQS清单包括61个项目。大多数未报告的项目都在CLEAR的“方法”和“开源”中,\"和RQS\"内\"幻影校准,\"\"注册登记前瞻性试验设计,\"和\"成本效益分析\"部分。没有一项研究在RQS上得分超过50%。CLEAR得分中位数为55.74%(32.33/58分),对于RQS来说,17.59%(6.3/36点)。CLEAR-RQS文章排名在CLEAR和RQS之间下降,与CLEAR一致。
    结论:放疗后III/IV期非小细胞肺癌的影像组学研究表现出变异性和经常低质量的报告。制定的CLEAR-RQS清单可以促进教育,并有望提高影像组学研究质量。
    结论:目前III/IV期放疗后NSCLC领域的影像组学研究是异质性的,缺乏可重复性,没有确定的成像生物标志物。影像组学研究质量评估工具可以增强科学严谨性,从而促进影像组学转化为临床实践。
    BACKGROUND: Lung cancer, the second most common cancer, presents persistently dismal prognoses. Radiomics, a promising field, aims to provide novel imaging biomarkers to improve outcomes. However, clinical translation faces reproducibility challenges, despite efforts to address them with quality scoring tools.
    OBJECTIVE: This study had two objectives: 1) identify radiomics biomarkers in post-radiotherapy stage III/IV nonsmall cell lung cancer (NSCLC) patients, 2) evaluate research quality using the CLEAR (CheckList_for_EvaluAtion_of_Radiomics_research), RQS (Radiomics_Quality_Score) frameworks, and formulate an amalgamated CLEAR-RQS tool to enhance scientific rigor.
    METHODS: A systematic literature review (Jun-Aug 2023, MEDLINE/PubMed/SCOPUS) was conducted concerning stage III/IV NSCLC, radiotherapy, and radiomic features (RF). Extracted data included study design particulars, such as sample size, radiotherapy/CT technique, selected RFs, and endpoints. CLEAR and RQS were merged into a CLEAR-RQS checklist. Three readers appraised articles utilizing CLEAR, RQS, and CLEAR-RQS metrics.
    RESULTS: Out of 871 articles, 11 met the inclusion/exclusion criteria. The Median cohort size was 91 (range: 10-337) with 9 studies being single-center. No common RF were identified. The merged CLEAR-RQS checklist comprised 61 items. Most unreported items were within CLEAR\'s \"methods\" and \"open-source,\" and within RQS\'s \"phantom-calibration,\" \"registry-enrolled prospective-trial-design,\" and \"cost-effective-analysis\" sections. No study scored above 50% on RQS. Median CLEAR scores were 55.74% (32.33/58 points), and for RQS, 17.59% (6.3/36 points). CLEAR-RQS article ranking fell between CLEAR and RQS and aligned with CLEAR.
    CONCLUSIONS: Radiomics research in post-radiotherapy stage III/IV NSCLC exhibits variability and frequently low-quality reporting. The formulated CLEAR-RQS checklist may facilitate education and holds promise for enhancing radiomics research quality.
    CONCLUSIONS: Current radiomics research in the field of stage III/IV postradiotherapy NSCLC is heterogenous, lacking reproducibility, with no identified imaging biomarker. Radiomics research quality assessment tools may enhance scientific rigor and thereby facilitate radiomics translation into clinical practice.
    CONCLUSIONS: There is heterogenous and low radiomics research quality in postradiotherapy stage III/IV nonsmall cell lung cancer. Barriers to reproducibility are small cohort size, nonvalidated studies, missing technical parameters, and lack of data, code, and model sharing. CLEAR (CheckList_for_EvaluAtion_of_Radiomics_research), RQS (Radiomics_Quality_Score), and the amalgamated CLEAR-RQS tool are useful frameworks for assessing radiomics research quality and may provide a valuable resource for educational purposes in the field of radiomics.
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  • 文章类型: English Abstract
    在过去的几十年中,颅面结构的锥形束计算机断层扫描(CBCT)已证明其在牙科领域的有用性。因此它已经成为诊断的基本工具,规划,和治疗评估,虽然它不是为牙科专用而开发的,正如人们通常认为的那样,它用于其他领域,如医药。它专门用于不同医疗专业相互作用的头部和颈部区域,同时这些与牙科专业相互作用,因此,了解CBCT在医疗领域中相对于不同成像技术的优势是必要的。这篇综述的目的是描述观察的应用,诊断,规划,以及在不同医学专业中使用颌面部HSCT治疗的演变。这项工作突出了TCHC在不同医疗应用中的使用,并突出了它与其他技术相比最有用的地方。
    Cone-beam computed tomography (CBCT) of the craniofacial structure has demonstrated its usefulness in the dental area during the last decades, thus it has become a fundamental tool in the diagnosis, planning, and evaluation of treatment, and although it was not developed for the exclusive use in dentistry, as it is commonly considered, it is used in other areas such as medicine. It is specifically used in the head and neck area where different medical specialties interact, and at the same time these interact with dental specialties, so knowing the advantages of CBCT over different imaging technologies in the medical area is necessary. The purpose of this review was to describe the applications of observation, diagnosis, planning, and evolution of treatments using maxillofacial HSCT in different medical specialties. This work highlights the use of TCHC in different medical applications and highlights where it is most useful compared to other technologies.
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  • 文章类型: Case Reports
    我们介绍了一个14岁的青春期男孩,其哮喘控制不佳,最终诊断为与左肺动脉吊带相关的桥支气管。关于案件报告,我们描述了胸部计算机断层扫描多探测器的特征发现,其分类,以及这个畸形的相关信息.在无症状或有症状的呼吸道患者的情况下,可能会发生气管支气管树的先天性畸形。这些畸形可能与其他血管有关,气管,和多器官受累综合征。尽管大多数患者无症状,他们中的一些会有非特异性症状,但没有明确的病因,或者会在其他病理的诊断评估中被偶然诊断出来。重要的是要了解和认识正常的解剖结构及其变化,由于放射学无疑在这些畸形的诊断和术前评估中起着至关重要的作用,尽管它们的发病率很低,必须由专家及时识别诊断图像。
    We present the case of a 14-year-old adolescent boy with a history of poorly controlled asthma and a final diagnosis of a bridge bronchus associated with sling of the left pulmonary artery. Regarding the case report, we describe the characteristic findings in computerized tomography multidetector of the thorax, its classification, and the most relevant information about this malformation. Congenital malformations of the tracheobronchial tree may occur in the context of asymptomatic or symptomatic respiratory patients. These malformations may be associated with other vascular, tracheal, and syndromes with multiorgan involvement. Although most patients are asymptomatic, some of them will have nonspecific symptoms without a clear etiology or will be diagnosed incidentally during the diagnostic evaluation of other pathologies. It is important to know and recognize the normal anatomy and its variations, since radiology undoubtedly plays a fundamental role in the diagnosis and preoperative assessment of these malformations, which although they have low incidence, must be identified in a timely manner by the specialist in diagnostic images.
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  • 文章类型: Comparative Study
    文献报道,欧洲和东亚国家之间冠状病毒病(COVID-19)大流行的医疗影响存在显着差异;具体而言,欧洲的COVID-19死亡率明显高于东亚。考虑到这种差异,我们的叙述性综述旨在比较欧洲和东亚国家幸存者中严重或危重COVID-19后1年随访计算机断层扫描(CT)残留肺部异常的患病率和特征.进行了文献检索,以确定有关严重或危重COVID-19幸存者CT肺部异常的患病率和特征的文章。数据库分析确定了16篇研究文章,9来自欧洲,7来自东亚(全部来自中国)。我们的分析发现,欧洲的CT肺部异常患病率高于中国的研究(82%vs.52%)。虽然在中国研究中最普遍的肺部异常是毛玻璃混浊(35%),欧洲研究中最普遍的肺部异常是线性(59%)和网状混浊(55%),其次是支气管扩张(46%)。虽然我们的发现需要确认,与中国的COVID-19幸存者相比,欧洲人的肺部异常患病率和严重程度更高,这可能反映了由于更严重的肺损伤而导致的更大的结构扭曲。
    The literature reports that there was a significant difference in the medical impact of the coronavirus disease (COVID-19) pandemic between European and East Asian countries; specifically, the mortality rate of COVID-19 in Europe was significantly higher than that in East Asia. Considering such a difference, our narrative review aimed to compare the prevalence and characteristics of residual lung abnormalities at one-year follow-up computed tomography (CT) after severe or critical COVID-19 in survivors of European and East Asian countries. A literature search was performed to identify articles focusing on the prevalence and characteristics of CT lung abnormalities in survivors of severe or critical COVID-19. Database analysis identified 16 research articles, 9 from Europe and 7 from East Asia (all from China). Our analysis found a higher prevalence of CT lung abnormalities in European than in Chinese studies (82% vs. 52%). While the most prevalent lung abnormalities in Chinese studies were ground-glass opacities (35%), the most prevalent lung abnormalities in European studies were linear (59%) and reticular opacities (55%), followed by bronchiectasis (46%). Although our findings required confirmation, the higher prevalence and severity of lung abnormalities in European than in Chinese survivors of COVID-19 may reflect a greater architectural distortion due to a more severe lung damage.
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  • 文章类型: Journal Article
    医源性损伤是手术和微创手术不可避免的并发症。它们通常分为血管和非血管损伤,并根据损伤时间分为早期和晚期损伤。医源性损伤,尤其是血管损伤,增加死亡率和发病率,延长住院时间。多探测器计算机断层扫描(MDCT)是一种高度敏感的,通常是疑似医源性损伤的第一种成像方式。这篇图片综述阐明了MDCT上腹部盆腔器官医源性损伤的影像学考虑和表现。
    Iatrogenic injuries are unavoidable complications of surgeries and minimally invasive procedures. They are generally classified into vascular and nonvascular injuries and based on the time of injury into early and late injuries. Iatrogenic injuries, particularly vascular injuries, increase the mortality and morbidity, with prolongation of hospital-stay. Multidetector computed tomography (MDCT) is a highly sensitive, and often the first imaging modality in suspected iatrogenic injuries. This pictorial review elucidates the imaging considerations and appearances of iatrogenic injuries of the abdominopelvic organs on MDCT.
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  • 文章类型: Systematic Review
    目的:目前尚不确定现代碘基或钆基造影剂(CM)给药是否会导致重症肌无力患者症状增加。
    方法:在Medline中对描述重症肌无力患者在接受静脉(IV)CM之前和之后的症状的研究进行了系统搜索,并有一个匹配的对照组的重症肌无力患者没有接受静脉CM。
    结果:选择了三项回顾性研究,共374例重症肌无力患者接受碘基CM治疗,313例重症肌无力患者接受未增强CT检查并作为对照。汇集来自三项回顾性研究的数据显示,在374例患者中,有23例,描述了基于碘的CM给药后症状增加(6.1%).未增强CT后,313例患者中的11例也出现了症状学增加(3.5%)。当更深入地研究三项研究的数据时,发现了相互矛盾的结果,因为两篇文章没有发现CM和重症肌无力症状之间有任何关系。其余研究仅在CT扫描后1天内发现症状学显着增加:对比增强CT组有7名患者(6.3%),未增强CT组有1名患者(0.6%)(p=0.01)。
    结论:关于CM与重症肌无力症状之间关系的证据有限。在绝大多数重症肌无力患者中,CM是安全的。可能,在不到5%的患者中,基于碘的CM给药可能导致在给药后的第一个24小时内症状的严重程度增加。
    结论:请注意,静脉注射碘基造影剂可导致重症肌无力患者在最初24小时内症状增加。这可能发生在不到5%的患者中。
    结论:•目前尚不清楚现代造影剂是否可导致重症肌无力患者静脉给药后症状增加。•静脉内服用碘基造影剂后24小时内,重症肌无力症状增加的风险似乎很小,可能在不到5%的行政部门中。•基于钆的造影剂对重症肌无力患者是安全的。
    OBJECTIVE: It is uncertain whether modern iodine-based or gadolinium-based contrast media (CM) administration can lead to increased symptoms in patients with myasthenia gravis.
    METHODS: A systematic search in Medline was conducted for studies describing the symptomatology of myasthenia gravis patients before and after receiving intravenous (IV) CM and having a matched control group of myasthenia gravis patients who did not receive IV CM.
    RESULTS: Three retrospective studies were selected with a total of 374 myasthenia gravis patients who received iodine-based CM and a total of 313 myasthenia gravis patients who underwent unenhanced CT and served as controls. Pooling of the data from the three retrospective studies showed that in 23 of 374 patients, increased symptoms after iodine-based CM administration were described (6.1%). Increased symptomatology also occurred in 11 of 313 patients after unenhanced CT (3.5%). When looking more deeply into the data of the three studies, conflicting results were found, as two articles did not find any relationship between CM and myasthenia gravis symptoms. The remaining study only found a significant increase in symptomatology within 1 day after CT scanning: seven patients (6.3%) in the contrast-enhanced CT group and one patient (0.6%) in the unenhanced CT group (p = 0.01).
    CONCLUSIONS: There is limited evidence on the relationship between CM and myasthenia gravis symptoms. In the vast majority of myasthenia gravis patients, CM are safe. Probably, in less than 5% of the patients, iodine-based CM administration may lead to increased severity of the symptoms within the first 24 h after administration.
    CONCLUSIONS: Be aware that intravenous administration of iodine-based contrast media can lead to an increase of symptoms in patients with myasthenia gravis within the first 24 h. This can probably happen in less than 5% of the patients.
    CONCLUSIONS: • It is unclear whether modern contrast media can lead to increased symptoms in myasthenia gravis patients after intravenous administration. • There seems to be a small risk of increased myasthenia gravis symptoms within 24 h after intravenous administration of iodine-based contrast media, probably in less than 5% of the administrations. • Gadolinium-based contrast media are safe for patients with myasthenia gravis.
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