Tomography

体层摄影术
  • 文章类型: Journal Article
    肺部监测对于呼吸系统疾病的诊断和管理至关重要,尤其是在冠状病毒病流行之后。电阻抗断层成像(EIT)是用于监测肺部状况的替代非放射性断层成像工具。这篇综述提供了当前EIT在肺部监测方面的技术原理和应用,其中全面总结了应用于胸部的EIT,并鼓励其广泛用于临床医生。详细解释了涉及EIT仪器和图像重建算法的技术原理,根据临床应用场景推荐条件选择。对于应用程序,具体来说,通气/灌注(V/Q)监测是最发达的EIT应用之一。V/Q的匹配相关性可以提示多种肺部疾病,例如,急性呼吸窘迫综合征,气胸,肺栓塞,和肺水肿。还简要介绍了一些最近出现的应用,例如肺移植,作为具有潜力并将在未来开发的补充应用。此外,的局限性,缺点,讨论了企业所得税的发展趋势,表明在大规模临床应用之前,EIT仍将处于长期发展阶段。
    Pulmonary monitoring is crucial for the diagnosis and management of respiratory conditions, especially after the epidemic of coronavirus disease. Electrical impedance tomography (EIT) is an alternative non-radioactive tomographic imaging tool for monitoring pulmonary conditions. This review proffers the current EIT technical principles and applications on pulmonary monitoring, which gives a comprehensive summary of EIT applied on the chest and encourages its extensive usage to clinical physicians. The technical principles involving EIT instrumentations and image reconstruction algorithms are explained in detail, and the conditional selection is recommended based on clinical application scenarios. For applications, specifically, the monitoring of ventilation/perfusion (V/Q) is one of the most developed EIT applications. The matching correlation of V/Q could indicate many pulmonary diseases, e.g., the acute respiratory distress syndrome, pneumothorax, pulmonary embolism, and pulmonary edema. Several recently emerging applications like lung transplantation are also briefly introduced as supplementary applications that have potential and are about to be developed in the future. In addition, the limitations, disadvantages, and developing trends of EIT are discussed, indicating that EIT will still be in a long-term development stage before large-scale clinical applications.
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  • 文章类型: Journal Article
    相角肌肉成像已经提出了在EMS下通过相角电阻抗断层成像来长期监测肌肉质量的改善,尤其是关注小腿肌肉.在实验中,将24名受试者随机分为三组:对照组(CG,n=8),低压强度EMS训练组(LG,n=8),和EMS训练组的最佳电压强度(OG,n=8)。从实验结果来看,相角分布图像通过ΦEIT清除重建为四个肌肉隔室,经过五周的实验,它们被称为由腓肠肌组成的M1,M2由比目鱼组成,M3由胫骨后肌组成,趾长屈肌,和长屈肌,M4由胫骨前肌组成,趾长伸肌,还有PeronusLongus.与年龄成反比,即随着年龄的增长而减少。通过生物电阻抗分析,参照常规相位角Φ,进行了成对样本t检验,阐明了空间平均相位角在各域<Φ>Ω和各肌室<Φ>M中的统计显著性,肌肉灰阶肌肉通过超声波,和最大动态强度SMax通过一次重复最大测试。从t检验结果来看,<Φ>Ω与Φ和SMax具有良好的相关性。在OG中,<ΦW5>Ω,ΦW5和(SMax)W5显著高于第一周(n=8,p<0.05)。在LG和OG组中,五周后观察到M1和M4肌肉区室的相位角均显着增加。只有OG组在五周后显示M2的相位角显著增加。然而,各组M3的空间平均相位角均无明显变化.总之,ΦEIT可以令人满意地监测小腿肌肉中每个隔室对长期EMS训练的反应。
    Objectives. Phase angle muscle imaging has been proposed by phase angle electrical impedance tomography (ΦEIT) under electrical muscle stimulation (EMS) for long-term monitoring of muscle quality improvement, especially focusing on calf muscles.Approach. In the experiments, twenty-four subjects are randomly assigned either to three groups: control group (CG,n= 8), low voltage intensity of EMS training group (LG,n= 8), and optimal voltage intensity of EMS training group (OG,n= 8).Main results. From the experimental results, phase angle distribution imagesФare cleared reconstructed by ФEIT as four muscle compartments over five weeks experiments, which are called theM1muscle compartments composed of gastrocnemius muscle,M2muscle compartments composed of soleus muscle,M3muscle compartments composed of tibialis-posterior muscle, flexor digitorum longus muscle, and flexor pollicis longus muscle, andM4muscle compartment composed of the tibialis anterior muscle, extensor digitorum longus muscle, and peroneus longus muscle.Фis inversely correlated with age, namely theФdecreases with increasing age. A paired samplest-test was conducted to elucidate the statistical significance of spatial-mean phase angle in all domain <Ф>Ωand in each muscle compartment <Ф>Mwith reference to the conventional phase angle Ф by bioelectrical impedance analysis, muscle grey-scaleGmuscleby ultrasound, and maximal dynamic strengthSMaxby one-repetition maximum test.Significance. From thet-test results, <Ф>Ωhave good correlation with Ф andSMax. In the OG, <ФW5>Ω,ФW5, and (SMax)W5were significantly higher than in the first week (n= 8,p< 0.05). A significant increase in the phase angle of bothM1andM4muscle compartments is observed after five weeks in LG and OG groups. Only the OG group shows a significant increase in the phase angle ofM2muscle compartment after five weeks. However, no significant changes in the spatial-mean phase angle ofM3compartment are observed in each group. In conclusion, ФEIT satisfactorily monitors the response of each compartment in calf muscle to long-term EMS training.
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  • 文章类型: Journal Article
    目的:建立基于能谱计算机断层扫描(CT)的预测模型,以评估临床T1/2N0浸润性乳腺癌中腋窝淋巴结(ALN)的大转移。
    方法:回顾性纳入217例接受能谱CT扫描的T1/2N0浸润性乳腺癌临床患者,并分为训练组(n=151)和验证组(n=66)。这些患者分为ALN非大转移(pN0期或pN0[i]或pN1mi)和ALN大转移(pN1-3期)亚组。测量并比较了最可疑的ALN的形态学标准和定量能谱CT参数。使用最小绝对收缩和选择算子(Lasso)筛选预测指标以建立逻辑模型。采用受试者工作特征(ROC)曲线和决策曲线分析(DCA)对模型进行评价。
    结果:动静脉期能谱CT联合模型在ALN非大转移和ALN大转移的鉴别中产生了最好的诊断性能,AUC最高(训练组0.963和验证组0.945)。在单相光谱CT模型中,静脉相谱CT模型表现最佳(训练队列AUC=0.960,验证队列AUC=0.940).3个模型的AUC无显著差异(DeLong检验,每次比较P>0.05)。
    结论:Lasso-logistic模型结合了形态学特征和基于对比增强能谱成像的定量能谱CT参数,有可能用作非侵入性工具,用于临床T1/2N0浸润性乳腺癌的个体术前ALN状态预测。
    OBJECTIVE: To develop a prediction model based on spectral computed tomography (CT) to evaluate axillary lymph node (ALN) with macrometastases in clinical T1/2N0 invasive breast cancer.
    METHODS: A total of 217 clinical T1/2N0 invasive breast cancer patients who underwent spectral CT scans were retrospectively enrolled and categorized into a training cohort (n = 151) and validation cohort (n = 66). These patients were classified into ALN nonmacrometastases (stage pN0 or pN0 [i+] or pN1mi) and ALN macrometastases (stage pN1-3) subgroups. The morphologic criteria and quantitative spectral CT parameters of the most suspicious ALN were measured and compared. Least absolute shrinkage and selection operator (Lasso) was used to screen predictive indicators to build a logistic model. The receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to evaluate the models.
    RESULTS: The combined arterial-venous phase spectral CT model yielded the best diagnostic performance in discrimination of ALN nonmacrometastases and ALN macrometastases with the highest AUC (0.963 in the training cohort and 0.945 in validation cohorts). Among single phase spectral CT models, the venous phase spectral CT model showed the best performance (AUC = 0.960 in the training cohort and 0.940 in validation cohorts). There was no significant difference in AUCs among the 3 models (DeLong test, P > .05 for each comparison).
    CONCLUSIONS: A Lasso-logistic model that combined morphologic features and quantitative spectral CT parameters based on contrast-enhanced spectral imaging potentially be used as a noninvasive tool for individual preoperative prediction of ALN status in clinical T1/2N0 invasive breast cancers.
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  • 文章类型: Journal Article
    去除金属引起的射束硬化伪影的常用方法通常依赖于在双能量计算机断层扫描(CT)中使用具有高管电压或高能量虚拟单能量图像的高能光子,辐射剂量通常相对较高,以产生足够的信号。这项回顾性研究旨在评估金属伪影减少(MAR)算法在减少术后小儿低辐射剂量脊柱CT图像中椎弓根螺钉金属引起的射束硬化伪影中的应用。
    纳入77名接受140或100kV低剂量CT检查的儿童(3-15岁)。3-8岁儿童的辐射剂量为1.40mGy,9-15岁儿童的辐射剂量为2.61mGy。评估了116枚椎弓根螺钉。原始数据用自适应统计迭代重建-V(ASIR-V)在50%强度下重建,ASIR-V与MAR(AV-MAR),高强度深度学习图像重建(DLIR)和带MAR的DLIR(DL-MAR)。根据射束硬化伪影(LHA)的长度和伪影指数(AI)客观地评估了椎弓根螺钉的图像质量。主观上使用4点量表(4点:最好,3分:可接受)。
    AV-MAR和DL-MAR均显着减少了具有较小LHA(15.76±10.12mm,减少57.24%和15.66±10.49毫米,减少了57.40%,分别),和AI值(62.50±33.51,减少64.65%和61.03±32.61,减少65.01%,分别)与ASIR-V和DLIR相比(均P<0.01),使用AV-MAR和DL-MAR,有关螺钉的主观图像质量评分分别为3.37±0.49和3.47±0.50,分别,高于无MAR的1.73±0.44和1.76±0.43(均P<0.01)。
    MAR显着减少了手术后儿科低剂量脊柱CT图像中金属螺钉引起的低密度伪影,跨不同的管电压,辐射剂量水平和重建算法。结合DL-MAR进一步提高了低辐射剂量条件下的整体图像质量。
    UNASSIGNED: The commonly used methods for removing metal-induced beam hardening artifacts often rely on the use of high energy photons with either high tube voltage or high energy virtual monoenergetic images in dual-energy computed tomography (CT), the radiation dose was usually relatively high in order to generate adequate signals. This retrospective study is designed to evaluate the application of a metal artifact reduction (MAR) algorithm in reducing pedicle screw metal-caused beam hardening artifacts in post-surgery pediatric low radiation dose spine CT images.
    UNASSIGNED: Seventy-seven children (3-15 years) who had undergone a low dose CT with 140 or 100 kV were enrolled. The radiation dose was 1.40 mGy for the 3-8 years old and 2.61 mGy for 9-15 years old children. There were 116 pedicle screws evaluated. The raw data were reconstructed with adaptive statistical iterative reconstruction-V (ASIR-V) at 50% strength, ASIR-V with MAR (AV-MAR), deep learning image reconstruction (DLIR) at high strength and DLIR with MAR (DL-MAR). The image quality concerning pedicle screws was evaluated objectively in terms of the length of beam-hardening artifact (LHA) and artifact index (AI), and subjectively using a 4-point scale (4 points: best, 3 points: acceptable).
    UNASSIGNED: Both AV-MAR and DL-MAR significantly reduced metal-induced beam hardening artifacts with smaller LHA (15.76±10.12 mm, a reduction of 57.24% and 15.66±10.49 mm, a reduction of 57.40%, respectively), and AI value (62.50±33.51, a reduction of 64.65% and 61.03±32.61, a reduction of 65.01%, respectively) compared to ASIR-V and DLIR (all P<0.01), The subjective image quality scores concerning the screws were 3.37±0.49 and 3.47±0.50 with AV-MAR and DL-MAR, respectively, higher than the respective value of 1.73±0.44 and 1.76±0.43 without MAR (all P<0.01).
    UNASSIGNED: MAR significantly reduces the low-density artifacts caused by metal screws in post-surgery pediatric low-dose spine CT images, across different tube voltages, radiation dose levels and reconstruction algorithms. Combining DL-MAR further improves the overall image quality under low radiation dose conditions.
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  • 文章类型: Journal Article
    固体废物填埋场的急剧增加对环境构成了严重威胁。与钻孔方法相比,地球物理方法是有效的,描绘污染物分布的非侵入性技术。在这项研究中,电阻率层析成像(ERT)和感应极化(IP)用于研究固体废物沉积物。ERT/IP成像的结果说明了该方法在环境研究中的潜力。根据21条勘测线的结果,地电信号可以概括为三种类型:只有高电阻率的建筑和拆除废物(CDW)区域(RO型),高荷电率的污染土壤(CO型),和CDW层下的污染物具有高电阻率和带电性(RC型)。超过10.2mV/V的带电性值对应于总浓度大于75mg/kg的污染土壤。根据三维插值结果和确定的带电性标准,污染土壤的总体积为40555立方米。最后,比较效率,IP和钻井采样方法的成本和结果表明,IP是一种有效的,低成本和高分辨率的污染表征。结果支持ERT/IP信息可以作为工程和环境调查中的可靠工具进行快速和初步识别。
    The whopping increase in solid waste landfills poses serious threats to the environment. Compared to the drilling method, geophysical methods are effective, non-invasive techniques for delineating the contaminant distribution. In this study, electrical resistivity tomography (ERT) and induced polarization (IP) were used to investigate a solid waste deposit. The results of ERT/IP imaging illustrate the potential of the method in environmental studies. Based on the results of 21 survey lines, geo-electrical signals can be summarized as three types: with only high resistivity for construction & demolition wastes (CDWs) areas (RO type), contaminated soil for high chargeability (CO type), and contaminants under CDWs layer have both high resistivity and chargeability (RC type). Chargeability values over 10.2 mV/V correspond to contaminated soil with an overall concentration larger than 75 mg/kg. With the three-dimensional interpolation results and the determined chargeability criteria, the total volume of contaminated soil is 40,555 cubic meters. Finally, comparing the efficiency, cost and results of IP and drilling sampling methods shows that the IP is an efficient, low-cost and high-resolution contamination characterization. The results support that ERT/IP information can fulfill rapid and initial identification as a reliable tool in engineering and environmental investigations.
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  • 文章类型: Journal Article
    背景:经皮内窥镜腰椎间盘切除术(PELD)由于其微创和快速恢复,已成为腰椎间盘突出症(LDH)的常规治疗方法。然而,PELD需要外科医生的高精度,由于术中并发症的风险很大,包括对神经根和硬脑膜的潜在损害,手术后复发的可能性更高。因此,术前计划利用CT和MRI成像至关重要.
    方法:在本研究中,回顾性分析2021年1月至2023年12月140例接受PELD治疗的LDH患者的临床资料.根据是否采用CT和MRI配准(CMR)进行手术计划,将患者分为两组:CMR组(n=68)和对照组(n=72)。收集的数据包括手术时间,住院时间,和下腰和腿部疼痛的视觉模拟量表(VAS)评分,以及日本骨科协会腰椎评分(JOA)。使用Studentt检验评估两组之间的差异。
    结果:两组间住院时间无显著差异(P=0.277)。CMR组手术时间明显缩短(P<0.001)。手术前,两组之间的腿部疼痛和下腰痛的VAS评分没有显着差异(分别为P=0.341和P=0.131);然而,术后2个月,CMR组的两项评分均显著降低(分别为P<0.001和P=0.002).同样,术前JOA评分无差异(P=0.750),但术后2个月,CMR组的评分明显较高(P<0.001).
    结论:与传统PELD相比,术前使用CMR已显示出减少手术时间,缓解腿部和腰痛,术后2个月增加腰椎JOA评分,强调其在提高手术效果方面的功效。
    BACKGROUND: Percutaneous Endoscopic Lumbar Discectomy (PELD) has emerged as routine treatment for lumbar disc herniation (LDH) due to its minimal invasiveness and quick recovery. However, PELD demands high precision from the surgeon, as the risk of intraoperative complications is substantial, including potential damage to the nerve root and dura, and a higher likelihood of recurrence post-surgery. Thus, preoperative planning utilizing CT and MRI imaging is essential.
    METHODS: In this study, the clinical data of 140 patients treated with PELD for LDH from January 2021 to December 2023 were retrospectively analyzed. Patients were categorized into two groups based on whether CT and MRI registration (CMR) was employed for surgical planning: a CMR group (n=68) and a control group (n=72). Data collected included surgery time, hospital stay duration, and scores from the Visual Analog Scale (VAS) for low back and leg pain, as well as the Japanese Orthopaedic Association Lumbar Spine Score (JOA). Differences between the two groups were assessed using the Student\'s t-test.
    RESULTS: No significant difference was found in hospital stay length between the groups (P=0.277). Surgery time was significantly shorter in the CMR group (P<0.001). Prior to surgery, no significant differences in VAS scores for leg and low back pain were observed between the groups (P=0.341 and P=0.131, respectively); however, at 2 months postoperatively, both scores were significantly lower in the CMR group (P<0.001 and P=0.002, respectively). Similarly, no difference in preoperative JOA scores was noted (P=0.750), but at 2 months postoperative, the CMR group exhibited significantly higher scores (P<0.001).
    CONCLUSIONS: Compared with the traditional PELD, the preoperative use of CMR has shown to reduce surgery time, alleviate leg and low back pain, and increase the lumbar JOA score at 2 months after surgery, underscoring its efficacy in enhancing surgical outcomes.
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  • 文章类型: Journal Article
    背景:本研究旨在调查计算机视觉综合征(CVS)合并调节性导线的患者的脉络膜血管指数(CVI)。
    方法:这项回顾性病例对照研究纳入了2022年7月至2023年5月在XXX大学附属XXX医院诊断为CVS和调节导线的患者。对照组包括没有任何眼部疾病的个体。眼科评估包括基本视力,折射,眼睛生物参数,和CVI。
    结果:共有85名参与者被纳入研究,CVS组45例,对照组40例。与右眼对照组相比,CVS组的中央角膜厚度明显变薄(532.40±30.93vs.545.78±19.99µm,P=0.019)和左眼(533.96±29.57vs.547.56±20.39,P=0.014)。与对照组相比,CVS组表现出较高的CVI较低(0.40±0.08vs.0.43±0.09,P=0.001),时间(0.40±0.08vs.0.44±0.10,P<0.001),劣等(0.41±0.08与0.46±0.08,P<0.001),和鼻(0.41±0.08vs.0.44±0.08,P=0.001)象限。在1-3毫米半径内的所有四个象限中观察到类似的差异,在1-6mm和3-6mm半径内的时间(P=0.004)和下(P=0.002)象限(均P<0.05)。
    结论:与没有眼部问题的个体相比,发现CVS和调节性导联的患者角膜中央厚度较薄,CVI较低.
    BACKGROUND: This study aimed to investigate the choroidal vascularity index (CVI) in patients with computer vision syndrome (CVS) combined with accommodative lead.
    METHODS: This retrospective case-control study enrolled patients diagnosed with CVS and accommodative lead at University-Town Hospital of Chongqing Medical University between July 2022 and May 2023. The control group included individuals without any ocular diseases. Ophthalmic assessments included basic visual acuity, refraction, ocular biometric parameters, and CVI.
    RESULTS: A total of 85 participants were included in the study, with 45 in the CVS group and 40 in the control group. The central corneal thickness of CVS group was found to be significantly thinner compared to the control group in both the right eye (532.40±30.93 vs. 545.78±19.99 µm, P = 0.019) and left eye (533.96±29.57 vs. 547.56±20.39, P = 0.014). In comparison to the control group, the CVS group exhibited lower CVI in the superior (0.40±0.08 vs. 0.43±0.09, P = 0.001), temporal (0.40±0.08 vs. 0.44±0.10, P < 0.001), inferior (0.41±0.08 vs. 0.46±0.08, P < 0.001), and nasal (0.41±0.08 vs. 0.44±0.08, P = 0.001) quadrants. Similar differences were observed in all four quadrants within the 1-3 mm radius, and in the temporal (P = 0.004) and inferior (P = 0.002) quadrants within the 1-6 mm and 3-6 mm radii (all P < 0.05).
    CONCLUSIONS: Compared to individuals without ocular issues, patients with CVS and accommodative lead were found to have thinner corneal central thickness and lower CVI.
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  • 文章类型: Case Reports
    肾上腺外骨髓脂肪瘤(EAM)是一种罕见的良性肿瘤,由成熟的脂肪和造血组织组成。其病因仍有待阐明,很少有病例报道描述中枢神经系统EAM的临床特征和治疗。本研究介绍了我们在右额叶区域EAM病例的临床管理中的经验和实践。在头部计算机断层扫描(CT)上发现一名56岁的妇女患有占位性右额叶病变。未增强的磁共振成像(MRI)显示约1.5x1.2cm的病变。全腹增强CT显示右侧骶前肿块,直径2.0厘米,有明显的利润。术后组织病理学发现主要为成熟脂肪组织混合髓外造血成分。这证实了(骨)骨髓脂肪瘤的诊断。中枢神经系统髓质脂肪瘤极为罕见。据作者所知,只有两例颅内髓脂肪瘤被报道,本研究介绍了第一例以英语报道的中国患者。然而,当CT显示高密度和MRI显示混合密度在肿瘤区域,即使没有增强,在鉴别诊断中应考虑髓脂肪瘤的可能性。
    Extra-adrenal myelolipoma (EAM) is a rare benign tumor composed of mature adipose and hematopoietic tissues. Its etiology remains to be elucidated and there are few case reports describing the clinical features and treatment of EAMs in the central nervous system. The present study presented our experience and practice in the clinical management of a case of EAM in the right frontal region. A 56-year-old woman was found to have a space-occupying right frontal lesion on computed tomography (CT) of the head. Unenhanced magnetic resonance imaging (MRI) showed a lesion of ~1.5x1.2 cm. Enhanced whole abdominal CT showed a right presacral mass, 2.0 cm in diameter, with clear margins. The postoperative histopathological findings showed mainly mature adipose tissue mixed with extramedullary hematopoietic components. This confirmed the diagnosis of a (bone) marrow lipoma. Myelolipoma of the central nervous system is extremely rare. to the best of the authors\' knowledge, only two cases of intracranial myelolipoma have been reported, and the present study introduced the first case in a Chinese patient reported in English. However, when CT shows high density and MRI shows mixed density in the tumor area even without enhancement, the possibility of myelolipoma should be considered in the differential diagnosis.
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  • 文章类型: English Abstract
    Objective:To explore the imaging features of rare tumors of nasal cavity and sinuses, and to improve the understanding of these diseases, thereby aiding clinical diagnosis and treatment. Methods:The CT and MRI findings of 79 cases of rare neoplasm of nasal cavity and sinuses confirmed by pathology were retrospectively analyzed, and the imaging features were summarized. Results:Among the 79 cases, there were 16 cases of neuroendocrine carcinoma, most showing expansive and infiltrative bone destruction without hyperosteogeny and sclerosis. The sphenoid sinus exhibited a \"pigeon\" shape. In 28 cases of malignant melanoma, MRI signals were diverse, typical signals were rare, but mixed signals were more common. In 12 cases of rhabdomyosarcoma, MRI enhancement mostly showed \"grape-like\" enhancement and partial ring enhancement; There were 10 cases of olfactory neuroblastoma, the lesions were consistent with the distribution area of olfactory mucosa, most of them were lobulated, marginal nodules, and \"flower ring\" enhancement, and 2 cases grew across intracranial and external, with multiple cystic lesions and surrounding flaky edema bands. In 5 cases of solitary fibrous tumor, Benign tumors had regular shape and uniform density, while malignant tumors had irregular shape and uneven density, The enhancement was obviously uneven and showed a \"pattern\" change. There were 2 cases of sarcomatoid carcinoma, both with lobed appearance, uneven density, lamellar low-density shadow, and osteolytic bone destruction. In 4 cases of schwannoma, the enhancement showed obvious inhomogeneous enhancement. One case showed cystic necrosis, one case showed calcification, and the surrounding structure was compressed without damage. There was 1 case of neurofibroma, with many cystic components, low signal separation and compartmentalized enhancement. One case of paraganglioma showed moderate enhancement in the arterial phase and progressive enhancement in the venous phase, accompanied by significant swelling bone destruction. Conclusion:Rare tumors of nasal cavity and paranasal sinuses have distinctive imaging features. CT and MRI can effectively show the extent of the lesions and the degree of infiltration into adjacent tissues and organs, which is helpful for early clinical diagnosis and staging. However, definitive diagnosis still depends on pathology and immunohistochemistry.
    目的:探讨鼻腔鼻窦少见肿瘤的影像学特点,提高对该类疾病的认识,为临床诊断和治疗提供帮助。 方法:回顾性分析经病理证实的79例鼻腔鼻窦少见肿瘤的CT和MRI表现,总结其影像学特征。 结果:79例中,神经内分泌癌16例,骨质破坏多表现为膨胀性骨质破坏与浸润性骨质破坏并存,而不伴骨质增生硬化,位于蝶窦者双侧对称呈“鸽”形;恶性黑色素瘤28例,MRI信号表现多样,典型者少见,而以混杂信号多见;横纹肌肉瘤12例,MRI增强多呈“葡萄状”强化、部分环状强化;嗅神经母细胞瘤10例,病灶与嗅黏膜分布区一致,多呈分叶状,边缘结节状,“花环状”强化,2例跨颅内外生长,颅内病灶见多发囊变及周围片状水肿带;孤立性纤维性肿瘤5例,良性者形态规则,密度均匀,恶性者形态不规则,密度不均,增强明显不均匀强化,呈“地图样”改变;肉瘤样癌2例,形态似分叶,密度不均,内见片状低密度影,均有溶骨性骨质破坏;神经鞘瘤4例,增强呈明显欠均匀强化,1例见囊变坏死,1例见钙化,周围结构受压而无破坏;神经纤维瘤1例,囊变成分多,内见低信号分隔,增强呈分隔样强化;副神经节瘤1例,增强动脉期中度强化,静脉期进行性明显强化,伴有明显膨胀性骨质破坏。 结论:鼻腔鼻窦少见肿瘤具有一定的影像学特征,CT和MRI能更好地显示病灶范围及对邻近组织器官的浸润程度,有助于临床早期诊断和分期,确诊仍需依靠病理和免疫组织化学。.
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  • 文章类型: Journal Article
    构建并验证计算机断层扫描(CT)影像组学模型,以区分肺神经内分泌肿瘤(LNEN)和肺腺癌(LADC),表现为外周实性结节(PSN),以帮助早期临床决策。
    从2016年6月至2023年7月,共有445例经病理证实为LNEN和LADC的患者从五个医疗中心回顾性纳入。将这些患者分为训练集(n=316;158LNEN)和外部测试集(n=129;43LNEN),前者包括交叉验证(CV)训练集和使用十倍CV的CV测试集。支持向量机(SVM)分类器用于开发语义,影像组学和合并模型。通过受试者工作特征曲线下面积(AUC)评估诊断性能,并通过Delong检验进行比较。收集术前神经元特异性烯醇化酶(NSE)水平作为临床预测因子。
    在训练集中,影像组学模型(0.878[95%CI:0.836,0.915])和合并模型(0.884[95%CI:0.844,0.919])的AUC显著优于语义模型(0.718[95%CI:0.663,0.769],p均<.001)。在外部测试集中,影像组学模型的AUC(0.787[95%CI:0.696,0.871]),合并模型(0.807[95CI:0.720,0.889])和语义模型(0.729[95%CI:0.631,0.811])无统计学差异。在训练集(85.3%vs20.0%;p<.001)和外部测试集(88.9%vs40.7%;p=.002)中,影像组学模型的灵敏度优于NSE。
    CT影像组学模型可以是非侵入性的,有效和灵敏地预测LNEN和LADC作为PSN,以帮助选择治疗策略。
    UNASSIGNED: To construct and validate a computed tomography (CT) radiomics model for differentiating lung neuroendocrine neoplasm (LNEN) from lung adenocarcinoma (LADC) manifesting as a peripheral solid nodule (PSN) to aid in early clinical decision-making.
    UNASSIGNED: A total of 445 patients with pathologically confirmed LNEN and LADC from June 2016 to July 2023 were retrospectively included from five medical centers. Those patients were split into the training set (n = 316; 158 LNEN) and external test set (n = 129; 43 LNEN), the former including the cross-validation (CV) training set and CV test set using ten-fold CV. The support vector machine (SVM) classifier was used to develop the semantic, radiomics and merged models. The diagnostic performances were evaluated by the area under the receiver operating characteristic curve (AUC) and compared by Delong test. Preoperative neuron-specific enolase (NSE) levels were collected as a clinical predictor.
    UNASSIGNED: In the training set, the AUCs of the radiomics model (0.878 [95% CI: 0.836, 0.915]) and merged model (0.884 [95% CI: 0.844, 0.919]) significantly outperformed the semantic model (0.718 [95% CI: 0.663, 0.769], p both<.001). In the external test set, the AUCs of the radiomics model (0.787 [95% CI: 0.696, 0.871]), merged model (0.807 [95%CI: 0.720, 0.889]) and semantic model (0.729 [95% CI: 0.631, 0.811]) did not exhibit statistical differences. The radiomics model outperformed NSE in sensitivity in the training set (85.3% vs 20.0%; p <.001) and external test set (88.9% vs 40.7%; p = .002).
    UNASSIGNED: The CT radiomics model could non-invasively, effectively and sensitively predict LNEN and LADC presenting as a PSN to assist in treatment strategy selection.
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