Imaging modalities

成像方式
  • 文章类型: Case Reports
    食管穿孔是一种严重的医疗状况,其特征是肌肉层中的撕裂或孔。此案例报告详细介绍了演示文稿,诊断,并在急诊科治疗一例漏诊的食管穿孔患者。报告强调了治疗方案,漏掉了胸部X光的发现,和相关的案件细节。管理主要取决于及时检测和通过保守措施或手术修复进行干预。在演示后的最初几个小时内确定问题可以显着降低死亡率,可以高达30%。
    Esophageal perforation is a serious medical condition characterized by a tear or hole in the muscular layer. This case report details the presentation, diagnosis, and treatment of a patient with missed esophageal perforation at an emergency department. The report highlights treatment options, missed findings from the chest X-ray, and relevant case details. Management primarily depends on prompt detection and intervention through conservative measures or surgical repair. Identifying the issue within the initial hours after presentation can significantly decrease the mortality rate, which can be as high as 30%.
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  • 文章类型: Case Reports
    心脏结节病(CS)是一种肉芽肿性疾病,可表现为传导缺陷,室性心律失常,和心力衰竭。由于各种表现,CS的诊断本质上是困难的;因此,通常需要进行心内膜活检,但由于斑片状心肌受累而缺乏敏感性。此外,CS和致心律失常性心肌病的诊断标准重叠,特别是在右侧显性或双心室表现中,这使得本已具有挑战性的鉴别诊断更加复杂。
    一名53岁男性,既往无慢性疾病,出现室性心动过速(VT)和心力衰竭,射血分数降低。在心脏磁共振成像中发现他患有双心室心肌病和钆增强晚期,导致心律失常性心肌病的初步诊断。放置了植入式心律转复除颤器,但2个月后因复发性VT再次入院.尽管积极的室性心动过速治疗(抗心律失常药物的组合,心外膜和心内膜消融,和星状神经节阻滞),他继续患有难治性室性心动过速并出现心源性休克.体外膜氧合是心脏移植的桥梁。移植心脏的病理学显示潜在的疾病是CS。
    心脏结节病可以模拟致心律失常性双室心肌病,并且可能难以通过拟议的诊断标准进行区分。高度的临床怀疑和彻底的调查对于早期诊断和开始治疗是必要的。
    UNASSIGNED: Cardiac sarcoidosis (CS) is a granulomatous disease that can manifest as conduction defects, ventricular arrhythmias, and heart failure. The diagnosis of CS is inherently difficult due to variable presentations; as such, endomyocardial biopsy is often required but lacks sensitivity due to patchy myocardial involvement. Moreover, the diagnostic criteria of CS and arrhythmogenic cardiomyopathy overlap, particularly in right-side dominant or biventricular presentations, which further complicates an already challenging differential diagnosis.
    UNASSIGNED: A 53-year-old man with no prior chronic medical conditions presented with ventricular tachycardia (VT) and heart failure with reduced ejection fraction. He was found to have biventricular cardiomyopathy and late gadolinium enhancement on cardiac magnetic resonance imaging, resulting in an initial diagnosis of arrhythmogenic cardiomyopathy. Implantable cardioverter-defibrillator was placed, but he was readmitted for recurrent VT 2 months later. Despite an aggressive VT therapy (combination of antiarrhythmic drugs, epicardial and endocardial ablation, and stellate ganglion block), he continued with refractory VT and developed cardiogenic shock. Extra-corporeal membrane oxygenation was initiated as a bridge to heart transplantation. Pathology of the explanted heart revealed the underlying disease to be CS.
    UNASSIGNED: Cardiac sarcoidosis can mimic arrhythmogenic biventricular cardiomyopathy and may be difficult to distinguish by the proposed diagnostic criteria. High clinical suspicion and thorough investigation are necessary for an earlier diagnosis and initiation of treatment.
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  • 文章类型: Journal Article
    高乳腺密度(HBD)的女性患乳腺癌(BC)的风险增加。该研究的目的是提供有关女性对BC危险因素(BCRF)的认识和知识差距的数据,这是有效沟通筛查的基础。
    这是一项基于网络的调查,调查了来自六个国家的3000名年龄≥30和≤70岁的女性。共有45个问题。适用时进行了T检验和卡方检验,并进行了错误发现率调整,在α=0.05处报告了显著差异。
    三千名女性被纳入分析,733人(24.4%)患有HBD。总的来说,39%的女性熟悉BC背景下的HBD概念。31%的女性知道HBD为BCRF,而24%的女性HBD个人适用。与无HBD女性相比,HBD女性了解几乎所有BCRF的比例明显更高(p≤0.05)。同样,与无HBD女性相比,HBD女性接受筛查的比例明显更高(p≤0.05).HBD女性对BC的基本事实有更好的了解(p≤0.05)。共有1617名妇女接受了乳房X光检查,904次超声检查和150次核磁共振检查。关于不列颠哥伦比亚省最相关的信息来源是医疗保健专业人员,63%的女性报告。
    总体上39%的女性熟悉HBD作为BCRF。BCRF缺乏意识可能会导致筛查延迟,错过了早期发现的机会,对于乳腺组织致密的个体来说,结果可能更差。因此,这些信息应该更广泛地传播。
    UNASSIGNED: Women with high breast density (HBD) carry an increased risk for breast cancer (BC). The aim of the study was to provide data on awareness and knowledge gaps among women with vs w/o HBD about BC risk factors (BCRFs), which is the basis for effective communication about screening.
    UNASSIGNED: This was a web-based survey of 3000 women aged ≥30 and ≤70 from six countries. It comprised of 45 questions. T-tests and chi-square tests with False Discovery Rate adjustments were conducted as applicable, with significant differences reported at α=0.05.
    UNASSIGNED: Three-thousand women were included in the analysis, 733 (24.4%) had HBD. Overall, 39% of women were familiar with the concept of HBD in the context of BC. Thirty-one percent of women were aware of HBD as BCRF and for 24% of women HBD was personally applicable. A significantly higher proportion of women with HBD were aware of almost all BCRFs compared to women w/o HBD (p ≤ 0.05). Similarly, a significantly higher proportion of women with HBD have undergone screening procedures compared to women w/o HBD (p ≤ 0.05). Women with HBD were significantly better aware of basic facts about BC (p ≤ 0.05). A total of 1617 women underwent mammography, 904 ultrasound and 150 MRI during their last screening. The most relevant source of information about BC was the health care professional, as reported by 63% of women.
    UNASSIGNED: Overall 39% of women were familiar with HBD as BCRF. Lack of BCRF awareness may contribute to delayed screenings, missed opportunities for early detection, and potentially poorer outcomes for individuals with dense breast tissue. Thus, this information should be communicated more widely.
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  • 文章类型: Case Reports
    诸如宫内节育器(IUD)之类的长效宫内避孕药由于其长期疗效高,因此很受欢迎。易用性,和可逆性。虽然罕见,这些装置会引起子宫穿孔等并发症。体征和症状通常是模糊的腹部和骨盆疼痛,患者很少出现手术紧急情况。子宫穿孔可在放置宫内节育器时立即发生或以延迟的方式发生。此病例详细说明了放置后两年IUD子宫穿孔伴腹部迁移的例子。患者的病史因以下独特事实而变得复杂:在放置宫内节育器后,她怀孕并进行足月阴道分娩。她的怀孕使医疗保健提供者从以前的遭遇中相信宫内节育器已被自发驱逐。通过计算机断层扫描(CT)在患者的左下腹腔中发现了IUD,并通过手术顺利取出。
    Long-acting intrauterine contraceptives such as intrauterine devices (IUD) are popular due to their high rates of long-term efficacy, ease of use, and reversibility. Though rare, these devices can incur complications such as uterine perforation. Signs and symptoms are often vague abdominal and pelvic pain, and patients rarely present with a surgical emergency. This uterine perforation can happen immediately upon IUD placement or in a delayed manner. This case details an example of an IUD uterine perforation with abdominal migration two years after placement. The patient\'s history is complicated by the unique fact that she became pregnant and carried her pregnancy to a term vaginal delivery after the IUD had been placed. Her pregnancy led healthcare providers from previous encounters to believe that the IUD had been spontaneously expelled. The IUD was identified in the patient\'s left lower abdominal cavity via computed tomography (CT) and was surgically removed uneventfully.
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  • 文章类型: Journal Article
    影像质量在放射学疾病的准确诊断和有效管理中起着至关重要的作用。这篇评论探讨了这些原则,方法论,以及评估和优化各种成像模式的图像质量的策略,包括X光片,计算机断层扫描(CT),磁共振成像(MRI),超声,核医学。我们讨论了影响图像质量的关键因素,如空间分辨率,噪音,对比,和文物,突出质量保证技术,图像优化,在临床实践中减少剂量。
    Image quality plays a pivotal role in the accurate diagnosis and effective management of diseases in radiology. This review explores the principles, methodologies, and strategies for assessing and optimizing image quality across various imaging modalities, including X-ray, computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, and nuclear medicine. We discuss key factors influencing image quality, such as spatial resolution, noise, contrast, and artifacts, and highlight techniques for quality assurance, image optimization, and dose reduction in clinical practice.
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  • 文章类型: Journal Article
    肠系膜上动脉(SMA)综合征,也被称为威尔基综合征,由于其罕见且临床表现多样,因此构成了诊断挑战。这篇综述探讨了该综合征的病因,症状,诊断挑战,和管理策略。症状从早期饱腹感到严重腹痛,往往导致营养不良。诊断涉及彻底的胃肠道评估和各种成像方式。管理包括医疗干预,如鼻胃减压和营养支持,以及十二指肠空肠造口术等外科手术。全面了解SMA综合征的复杂性对其及时诊断和有效管理至关重要。特别是考虑到它与其他胃肠道疾病或饮食失调的潜在重叠。需要进一步的研究来增进理解并改善患者的预后。
    Superior mesenteric artery (SMA) syndrome, also known as Wilkie\'s syndrome, poses a diagnostic challenge due to its rarity and varied clinical manifestations. This review explores the syndrome\'s etiology, symptoms, diagnostic challenges, and management strategies. Symptoms range from early satiety to severe abdominal pain, often leading to malnutrition. Diagnosis involves a thorough gastrointestinal evaluation and various imaging modalities. Management includes medical interventions like nasogastric decompression and nutritional support, along with surgical interventions such as duodenojejunostomy. A thorough understanding of SMA syndrome\'s complexities is crucial for its timely diagnosis and effective management, especially considering its potential overlap with other gastrointestinal disorders or eating disorders. Further research is needed to enhance understanding and improve patient outcomes.
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  • 文章类型: Journal Article
    小儿肉瘤,间充质起源的罕见恶性肿瘤,提出诊断和治疗挑战。在这次审查中,我们探讨了影像组学在重塑我们对小儿肉瘤的理解中的作用,强调方法论的考虑和应用,如诊断和预测建模。截至2023年11月进行的系统评价确定了来自PubMed/MEDLINE的72篇关于小儿肉瘤的影像组学分析的论文,WebofKnowledge,还有Scopus.按照纳入和排除标准,本次审查包括10份报告。研究,主要是回顾性的,重点关注尤因肉瘤和骨肉瘤,利用不同的成像方式,包括CT,MRI,PET/CT,PET/MRI。手动分割是常见的,提取了35个特征的中位数。影像组学质量评分(RQS)和方法论影像组学评分(METRICS)评估揭示了对非影像组学特征的一致强调,验证标准,并在最近的出版物中改进了方法上的严谨性。诊断应用程序占主导地位,探索预后和治疗反应方面的创新研究。挑战包括特征异质性和样本大小差异。不断变化的景观强调了标准化方法的必要性。尽管面临挑战,影像组学在儿科肿瘤学中的诊断和预测潜力是显而易见的,为精准医学的进步铺平了道路。
    Pediatric sarcomas, rare malignancies of mesenchymal origin, pose diagnostic and therapeutic challenges. In this review, we explore the role of radiomics in reshaping our understanding of pediatric sarcomas, emphasizing methodological considerations and applications such as diagnostics and predictive modeling. A systematic review conducted up to November 2023 identified 72 papers on radiomics analysis in pediatric sarcoma from PubMed/MEDLINE, Web of Knowledge, and Scopus. Following inclusion and exclusion criteria, 10 reports were included in this review. The studies, predominantly retrospective, focus on Ewing sarcoma and osteosarcoma, utilizing diverse imaging modalities, including CT, MRI, PET/CT, and PET/MRI. Manual segmentation is common, with a median of 35 features extracted. Radiomics Quality Score (RQS) and Methodological Radiomics Score (METRICS) assessments reveal a consistent emphasis on non-radiomic features, validation criteria, and improved methodological rigor in recent publications. Diagnostic applications dominate, with innovative studies exploring prognostic and treatment response aspects. Challenges include feature heterogeneity and sample size variations. The evolving landscape underscores the need for standardized methodologies. Despite challenges, the diagnostic and predictive potential of radiomics in pediatric oncology is evident, paving the way for precision medicine advancements.
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  • 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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