Imaging modalities

成像方式
  • 文章类型: Case Reports
    Erdheim-Chester病(ECD)是一种罕见的组织细胞增生症,其特征是受影响器官的黄瘤浸润。我们介绍了一例62岁的ECD患者,最初表现为缩窄性心包炎。综合影像学显示全身受累,包括骷髅,轨道,垂体,肺,肾,和腹膜后,尽管没有相关症状。通过CT引导活检的组织病理学证据最终证实了ECD的诊断。患者对干扰素-α2b治疗反应良好,在5个月的随访期内,症状逐渐改善,影像学和实验室检查结果也有所改善。该病例强调了在缩窄性心包炎的鉴别诊断中考虑ECD的重要性,以及多模态成像对这种罕见疾病的准确诊断和治疗的实用性。患者对治疗的积极反应也突出了有效管理ECD的潜力,特别是早期诊断和干预。
    Erdheim-Chester Disease (ECD) is a rare form of histiocytosis characterized by xanthomatous infiltration of affected organs. We present a case of a 62-year-old man with ECD initially presenting with constrictive pericarditis. Comprehensive imaging revealed systemic involvement, including the skeleton, orbit, pituitary, lung, kidney, and retroperitoneum, despite the absence of related symptoms. The diagnosis of ECD was eventually confirmed through histopathological evidence from a CT-guided biopsy. The patient responded well to interferon-α2b treatment, with gradual symptom amelioration and improvement in imaging and laboratory findings over a 5-month follow-up period. This case highlights the importance of considering ECD in the differential diagnosis of constrictive pericarditis and the utility of multimodal imaging for accurate diagnosis and management of this rare disease. The patient\'s positive response to treatment also highlights the potential for effective management of ECD, particularly with early diagnosis and intervention.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fcvm.203.1292142。].
    [This corrects the article DOI: 10.3389/fcvm.2023.1292142.].
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  • 文章类型: Journal Article
    阿尔茨海默病(AD),指的是认知功能的逐渐恶化,包括记忆力减退和思维能力受损,已经成为一个重大的世界性挑战,具有深远的社会和经济影响。随着AD的患病率持续上升和人口老龄化,迫切需要创新的成像技术,以帮助提高我们对这些复杂条件的理解。光声(PA)成像通过集成光学成像的高对比度和超声成像的深度穿透形成混合成像模态。PA成像可实现高分辨率的组织结构和多功能信息的可视化和表征,在AD的研究和诊断中已经证明了有希望的初步结果。本文旨在全面概述PA成像在AD诊断和治疗中的当前应用和潜力。首先,结构,功能,将总结与PA成像捕获的AD相关脑成像相关的分子参数变化,塑造这篇综述的诊断观点。然后,进一步讨论了针对AD的治疗方法。最后,提出了将PA成像范围扩展到更深层次AD场景的潜在解决方案和临床应用。虽然某些方面可能无法完全涵盖,这篇小型综述通过利用创新的组织光热效应,为AD的诊断和治疗提供了有价值的见解。我们希望它将引发在这一领域的进一步探索,促进AD的改良和早期治疗。
    Alzheimer\'s disease (AD), referring to a gradual deterioration in cognitive function, including memory loss and impaired thinking skills, has emerged as a substantial worldwide challenge with profound social and economic implications. As the prevalence of AD continues to rise and the population ages, there is an imperative demand for innovative imaging techniques to help improve our understanding of these complex conditions. Photoacoustic (PA) imaging forms a hybrid imaging modality by integrating the high-contrast of optical imaging and deep-penetration of ultrasound imaging. PA imaging enables the visualization and characterization of tissue structures and multifunctional information at high resolution and, has demonstrated promising preliminary results in the study and diagnosis of AD. This review endeavors to offer a thorough overview of the current applications and potential of PA imaging on AD diagnosis and treatment. Firstly, the structural, functional, molecular parameter changes associated with AD-related brain imaging captured by PA imaging will be summarized, shaping the diagnostic standpoint of this review. Then, the therapeutic methods aimed at AD is discussed further. Lastly, the potential solutions and clinical applications to expand the extent of PA imaging into deeper AD scenarios is proposed. While certain aspects might not be fully covered, this mini-review provides valuable insights into AD diagnosis and treatment through the utilization of innovative tissue photothermal effects. We hope that it will spark further exploration in this field, fostering improved and earlier theranostics for AD.
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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
    异常乳头状肌(APM)插入二尖瓣小叶很少见,但在肥厚型梗阻性心肌病(HOCM)中具有重要临床意义。在这项研究中,我们报告了术前影像学检查对APM插入二尖瓣的检出率以及患者的手术结果.
    通过回顾性回顾2020年1月至2023年6月在我们中心接受单手术组手术治疗的HOCM患者的临床记录,确定了APM插入二尖瓣膜的患者。基线数据,图像特征,并对手术结果进行分析。
    APM插入二尖瓣前叶的发生率为5.1%(8/157)。6例插入部位位于A3,这比A2(n=2)更常见。术前超声心动图用于识别两名插入APM的患者(25%)。我们观察到HOCM患者APM的特殊超声心动图特征,被标记为“唇痣符号”,具有较高的检出率(62.5%)。所有患者均成功通过经主动脉(n=5)或经二尖瓣(n=3)的方法进行了室间隔肌切除术,同时进行了APM切除或二尖瓣置换术。平均年龄为49.0±17.4岁,其中7例(87.5%)为女性。室间隔厚度(17.0mmvs.13.3mm,P=0.012)和左心室流出梯度(117.5mmHgvs.7.5mmHg,P=0.012)术后均显著下降。残余流出阻塞,前收缩运动,≥3+二尖瓣反流为阴性。随访26.2±12.2个月,没有报告的行动,不良事件,二尖瓣反流加重,流出道阻塞复发,或SAM的实例。
    插入二尖瓣lea-et的乳头状肌是HOCM瓣膜下畸形的一种亚型,需要手术矫正。超声心动图上的唇痣征是HOCM中APM插入的特征,可以提高术前检出率。适当的肌切除术合并异常乳头状肌切除术在降低流出梯度和消除二尖瓣反流方面取得了良好的效果,在短期到中期随访中取得了良好的结果。
    Anomalous papillary muscle (APM) insertion into the mitral valve leaflet is rare but clinically important in hypertrophic obstructive cardiomyopathy (HOCM). In this study, we report the detection rate of APM insertion into the mitral valve using preoperative imaging modalities and the surgical outcomes of the patients.
    By retrospectively reviewing the clinical records of patients with HOCM who underwent surgical treatment by a single operation group at our center from January 2020 to June 2023, patients with APM insertion into the mitral valve leaflet were identified. Baseline data, image characteristics, and surgical outcomes were analyzed.
    The incidence of APM insertion into the mitral valve leaflet was 5.1% (8/157). The insertion site was located at A3 in six cases, which was more common than at A2 (n = 2). Preoperative echocardiography was used to identify two patients (25%) with APM insertion. We observed a particular echocardiographic feature for APM in HOCM patients, which was noted as a \"lip nevus sign\", with a higher detection rate (62.5%). All patients successfully underwent septal myectomy with concomitant APM excision or mitral valve replacement via the transaortic (n = 5) or transmitral (n = 3) approach. The mean age was 49.0 ± 17.4 years and seven patients (87.5%) were female. Interventricular septum thickness (17.0 mm vs. 13.3 mm, P = 0.012) and left ventricular outflow gradient (117.5 mmHg vs. 7.5 mmHg, P = 0.012) were significantly decreased after surgery. Residual outflow obstruction, systolic anterior motion, and ≥3+ mitral regurgitation were negative. During the follow-up of 26.2 ± 12.2 months, there were no reported operations, adverse events, mitral regurgitation aggravations, recurrences of outflow obstruction, or instances of SAM.
    Papillary muscles inserted into the mitral valve leaflet are a subtype of subvalvular malformation in HOCM that requires surgical correction. The lip nevus sign on echocardiography is a characteristic of APM insertion in HOCM and may improve the preoperative detection rate. Adequate myectomy with anomalous papillary muscle excision has achieved good results in reducing the outflow gradient and eliminating mitral regurgitation, with good outcomes at short-to-intermediate follow-up.
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  • 文章类型: Journal Article
    糖尿病视网膜病变(DR)是糖尿病的主要眼部并发症,是一个对全球健康产生重大影响的问题。诊断的重大进展,技术和治疗已经彻底改变了我们在21世纪早期管理DR的方式。例如,光学相干断层扫描成像的可及性,抗血管内皮生长因子(VEGF)治疗的发展只是过去几十年中形成DR格局的一些具有里程碑意义的发展。然而,还有更令人兴奋的进展正在取得。展望2030年,许多正在进行的事态发展可能会进一步改变该领域。首先,流行病学预测表明,DR的全球负担不仅在增加,但也从高收入国家转向中低收入地区。第二,对疾病病理生理学的更好理解越来越重视视网膜神经功能障碍和糖尿病视网膜疾病的非血管方面。第三,大量的信息正变得可从新的成像模式,如宽场成像系统和光学相干断层扫描血管造影。第四,用于筛查的人工智能,DR的诊断和预后将变得越来越容易和重要。第五,靶向其他非VEGF驱动途径的新药物,和新的治疗策略,如基因治疗正在开发用于DR。最后,糖尿病视网膜疾病的分类系统需要不断更新,以跟上新的发展。在这篇文章中,我们讨论了我们预计在2030年及以后看到的DR的这些主要趋势。
    Diabetic retinopathy (DR) is the major ocular complication of diabetes mellitus, and is a problem with significant global health impact. Major advances in diagnostics, technology and treatment have already revolutionized how we manage DR in the early part of the 21st century. For example, the accessibility of imaging with optical coherence tomography, and the development of anti-vascular endothelial growth factor (VEGF) treatment are just some of the landmark developments that have shaped the DR landscape over the last few decades. Yet, there are still more exciting advances being made. Looking forward to 2030, many of these ongoing developments are likely to further transform the field. First, epidemiologic projections show that the global burden of DR is not only increasing, but also shifting from high-income countries towards middle- and low-income areas. Second, better understanding of disease pathophysiology is placing greater emphasis on retinal neural dysfunction and non-vascular aspects of diabetic retinal disease. Third, a wealth of information is becoming available from newer imaging modalities such as widefield imaging systems and optical coherence tomography angiography. Fourth, artificial intelligence for screening, diagnosis and prognostication of DR will become increasingly accessible and important. Fifth, new pharmacologic agents targeting other non-VEGF-driven pathways, and novel therapeutic strategies such as gene therapy are being developed for DR. Finally, the classification system for diabetic retinal disease will need to be continually updated to keep pace with new developments. In this article, we discuss these major trends in DR that we expect to see in 2030 and beyond.
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  • 文章类型: Meta-Analysis
    目的:研究大梗死灶(LIC)患者在90天的神经功能独立率(NFI),在血管内血栓切除术(EVT)之前通过不同的成像方式进行评估。
    方法:在从开始到2021年9月28日接受EVT治疗的LIC患者中,搜索了PubMed和EMBASE在90天的临床功能结果的原始研究。根据不同的成像方式和标准,使用随机效应模型计算合并的NFI率。
    结果:我们纳入了34项纳入2997例LIC患者的研究。NFI率为23%(95%置信区间,CI15-32%)和24%(95%CI10-38%),当LIC分别定义为计算机断层扫描灌注的核心体积≥50ml和≥70ml时,当LIC在磁共振弥散加权成像(DWI)上分别定义为核心体积≥50ml和≥70ml时,分别为36%(95%CI23-48%)和21%(95%CI17-25%),当LIC分别定义为DWI-ASPERTS≤5和≤6时,为28%(95%CI24-32%)和37%(95%CI21-53%),当LIC分别定义为NCCT-ASPECTS≤5和≤6时,分别为23%(95%CI19-27%)和32%(95%CI18-46%)。
    结论:如果根据影像学模式选择适当的LIC标准,则LIC患者在EVT后可以获得相似的NFI率。
    OBJECTIVE: To investigate the rate of neurological functional independence (NFI) at 90 days in patients with large infarct core (LIC), which was evaluated by different imaging modalities before endovascular thrombectomy (EVT).
    METHODS: PubMed and EMBASE were searched for original studies on clinical functional outcomes at 90 days in LIC patients who received EVT treatment from inception to 28 September 2021. The pooled NFI rates were calculated using random effects model according to different imaging modalities and criteria.
    RESULTS: We included 34 studies enrolling 2997 LIC patients. The NFI rates were 23% (95% confidence interval, CI 15-32%) and 24% (95% CI 10-38%) when LIC was defined as core volume ≥50 ml and ≥ 70 ml separately on computed tomography perfusion, 36% (95% CI 23-48%) and 21% (95% CI 17-25%) when LIC was defined as core volume ≥ 50 ml and ≥ 70 ml separately on magnetic resonance diffusion-weighted imaging (DWI), 28% (95% CI 24-32%) and 37% (95% CI 21-53%) when LIC was defined as DWI-ASPECTS ≤ 5 and ≤ 6 separately, 23% (95% CI 19-27%) and 32% (95% CI 18-46%) when LIC was defined as NCCT-ASPECTS ≤ 5 and ≤ 6 separately.
    CONCLUSIONS: Similar NFI rates could be obtained after EVT in LIC patients if proper LIC criteria were select according to the imaging modality.
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