Thorax

胸部
  • 文章类型: Journal Article
    人工智能(AI)的出现正在彻底改变医学,尤其是放射学。随着新型号的发展,人工智能应用在临床环境中表现出改进的性能和通用的实用性。胸部成像是一个令人感兴趣的领域,考虑到胸部影像学的患病率和胸部疾病对健康的重大影响。这篇综述旨在强调AI在胸部成像中的有希望的应用。它研究了人工智能的作用,包括其对改善诊断评估和解释的贡献,增强工作流程,并协助侵入性程序。接下来,它进一步强调了人工智能当前面临的挑战和局限性,例如“大数据”的必要性,道德和法律考虑,和代表性的偏见。最后,探讨了人工智能在胸部放射学中的潜在应用方向。
    The advent of artificial intelligence (AI) is revolutionizing medicine, particularly radiology. With the development of newer models, AI applications are demonstrating improved performance and versatile utility in the clinical setting. Thoracic imaging is an area of profound interest, given the prevalence of chest imaging and the significant health implications of thoracic diseases. This review aims to highlight the promising applications of AI within thoracic imaging. It examines the role of AI, including its contributions to improving diagnostic evaluation and interpretation, enhancing workflow, and aiding in invasive procedures. Next, it further highlights the current challenges and limitations faced by AI, such as the necessity of \'big data\', ethical and legal considerations, and bias in representation. Lastly, it explores the potential directions for the application of AI in thoracic radiology.
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  • 文章类型: Case Reports
    背景:Mycetoma是一种皮下组织的慢性肉芽肿性炎症性疾病,影响深层结构和骨骼。大多数放线菌瘤是由诺卡氏菌属成员引起的。
    方法:这里我们报道了一个43岁男性前臂上出现播散性肌瘤的病例,胸部和颈部,以肥大和红斑性病变为特征,血清脓性物质通过该病变排出,和许多萎缩性疤痕。通过16S基因扩增和测序进行分子鉴定。墨西哥诺卡氏菌被鉴定为100%的同一性。甲氧苄啶-磺胺甲恶唑,二氨基二苯砜和阿米卡星是6个月后成功的治疗方法。
    结论:墨西哥诺卡氏菌是一种罕见的细菌,可引起肌瘤。我们报告了一例前臂广泛的肌瘤,并与小腿嘴的操纵有关,扩散到颈部和胸部。
    BACKGROUND: Mycetoma is a chronic granulomatous inflammatory disease of the subcutaneous tissue, which affects deep structures and bone. Most cases of actinomycetoma are caused by members of the genus Nocardia.
    METHODS: Here we report the case of a 43-year-old male who presented a disseminated mycetoma on the forearm, chest and neck, characterized by enlarged and erythematous lesions through which seropurulent material drains, and numerous atrophic scars. Molecular identification was performed by 16S gene amplification and sequencing. Nocardia mexicana was identified with 100% identity. Trimethoprim-sulfamethoxazole, diaminodiphenyl sulfone and amikacin was a successful treatment after 6 months.
    CONCLUSIONS: Nocardia mexicana is a rare organism that causes mycetoma. We report a case of extensive mycetoma on the forearm with spread to the neck and thorax associated with manipulation of the mouth of a calf.
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  • 文章类型: Journal Article
    目的比较美国胸科学会的诊断表现,日本呼吸学会,和拉丁美洲协会(ATS/JRS/ALAT)与美国胸科医师学会(ACCP)对过敏性肺炎(HP)的成像分类。材料和方法在作者机构(2006年1月1日至2021年4月1日)的机构审查委员会批准的间质性肺病(ILD)注册中的患者在MDD被诊断为ILD时被纳入本回顾性研究。MDD诊断包括HP、结缔组织病-ILD,和特发性肺纤维化。两名对诊断不知情的心胸放射科医生一致对薄层CT图像进行了回顾性审查。使用两种分类方法确定了薄层CT图像的诊断模式。确定了不一致率。灵敏度,特异性,正预测值,负预测值,以MDD诊断为参考标准,评估准确性.结果本研究共纳入297例患者:200例(67%)患有HP,49(16%)患有结缔组织病-ILD,和48(16%)在MDD的特发性肺纤维化。两种分类之间的不一致率为21%。假设HP患病率较低(10%),ATS/JRS/ALAT分类优于ACCP分类,具有更高的准确性(92.3%vs87.6%)和更大的阳性预测值(60.7%vs42.9%)。假设患病率高(50%),使用ACCP分类的准确性和阴性预测值优于(81.7%vs79.7%和77.7%vs72.6%,分别),使用ATS/JRS/ALAT分类的阳性预测值更好(93.3%vs87.1%)。结论在HP患病率低和高的环境中,ATS/JRS/ALAT和ACCPHP分类的准确性更高,分别。在少数病例中,两种分类的诊断性能不一致。关键词:CT,胸部,过敏性肺炎,间质性肺病补充材料可用于本文。©RSNA,2024.
    Purpose To compare the diagnostic performance of the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax (ATS/JRS/ALAT) versus the American College of Chest Physicians (ACCP) imaging classifications for hypersensitivity pneumonitis (HP). Materials and Methods Patients in the institutional review board-approved Interstitial Lung Disease (ILD) registry referred for multidisciplinary discussion (MDD) at the authors\' institution (January 1, 2006-April 1, 2021) were included in this retrospective study when ILD was diagnosed at MDD. MDD diagnoses included HP, connective tissue disease-ILD, and idiopathic pulmonary fibrosis. Retrospective review of thin-section CT images was performed in consensus by two cardiothoracic radiologists blinded to the diagnosis. Diagnostic patterns were determined for thin-section CT images using both classifications. Discordance rates were determined. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were assessed using MDD diagnosis as the reference standard. Results A total of 297 patients were included in the study: 200 (67%) with HP, 49 (16%) with connective tissue disease-ILD, and 48 (16%) with idiopathic pulmonary fibrosis at MDD. The discordance rate between the two classifications was 21%. Assuming low HP prevalence (10%), ATS/JRS/ALAT classification outperformed ACCP classification, with greater accuracy (92.3% vs 87.6%) and greater positive predictive value (60.7% vs 42.9%). Assuming high prevalence (50%), accuracy and negative predictive value were superior using ACCP classification (81.7% vs 79.7% and 77.7% vs 72.6%, respectively), and positive predictive value was superior using ATS/JRS/ALAT classification (93.3% vs 87.1%). Conclusion Accuracy of the ATS/JRS/ALAT and ACCP HP classifications was greater in settings with low and high HP prevalence, respectively. Diagnostic performance of both classifications was discordant in a minority of cases. Keywords: CT, Thorax, Hypersensitivity Pneumonitis, Interstitial Lung Disease Supplemental material is available for this article. © RSNA, 2024.
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  • 文章类型: Case Reports
    肺轻链沉积病是一种罕见的实体,其特征是免疫球蛋白在肺实质内沉积,具有不同于肺淀粉样变性的病理特征。这里,作者介绍了临床表现,协会,4例患者肺轻链沉积病的影像学特征,并讨论其与淀粉样变性的区别。本病例系列强调了CT时囊肿和结节的频繁存在。临床上,淋巴瘤和/或自身免疫性疾病通常相关。
    Pulmonary light chain deposition disease is a rare entity characterized by immunoglobulin deposition within the lung parenchyma with pathologic features distinct from pulmonary amyloidosis. Here, the authors present the clinical presentation, associations, and radiologic features of pulmonary light chain deposition disease in a series of 4 patients as well as discuss the distinctions from amyloidosis. The present case series highlights the frequent presence of both cysts and nodules at CT. Clinically, lymphoma and/or autoimmune disease are often associated.
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  • 文章类型: Journal Article
    背景:关于体育锻炼对犬体成分影响的研究有限。这项研究的目的是调查体育锻炼计划对体重的影响,身体状况评分(BCS)和胸部,狗的腹部和大腿周围。21只不同品种的健康狗在为期八周的计划中与主人一起锻炼,包括慢跑和力量锻炼。在站立的狗上用卷尺一式三份进行标准化测量。在三个解剖位置测量胸围,腹部在两个,大腿在一个。体重数据,使用混合模型重复测量分析对BCS(9点量表)和圆周进行分析,以评估程序后的变化和目标距离的影响。
    结果:七个狗主人选择2公里的目标距离,14个主人选择5-10公里。治疗后平均BCS降低(P=0.007)(5.1±0.9vs.4.7±0.6),但目标距离没有影响。几乎所有的胸围和腹围测量值都降低了(P≤0.007),其中2km组驱动胸围降低,5-10km组驱动腹围降低。相比之下,大腿围(28.8±0.4vs.30.2±0.4)增加(P=0.007),同时保持体重。程序前后BCS与腹/胸比率之间存在正相关(皮尔逊相关性;R平方≤0.43,P≤0.0012),但平均比率保持不变。
    结论:结果表明,在体育锻炼计划后,正常体重的狗的身体组成中的总脂肪和肌肉质量之间的重新分布。单独使用体重不是补充BCS评估的可靠评估方法。然而,反复测量胸部,腹部和大腿围可能有助于评估进行体育锻炼的狗的身体成分。进一步的研究应包括对照组和对总脂肪和瘦体重的客观评估,为了研究体育锻炼作为减少超重犬BCS和增加肌肉质量的独立方法的有效性。
    BACKGROUND: Research on the effects of physical exercise on canine body composition is limited. The aim of this study was to investigate the effects of a physical exercise programme on bodyweight, body condition score (BCS) and chest, abdominal and thigh circumferences in dogs. Twenty-one healthy dogs of different breeds exercised together with their owners during an eight-week programme consisting of jogging and strength exercises. Standardised measurements were performed in triplicates with a measuring tape on standing dogs. Chest circumference was measured at three anatomical locations, abdomen at two and thigh at one. Data on bodyweight, BCS (9-point scale) and circumferences were analysed with mixed model repeated measures analyses to evaluate changes after the programme and effects of target distance.
    RESULTS: Seven dog owners choose a target distance of 2 km and 14 owners choose 5-10 km. Mean BCS decreased (P = 0.007) after the programme (5.1 ± 0.9 vs. 4.7 ± 0.6) but there was no effect of target distance. Almost all chest and abdominal circumference measurements decreased (P ≤ 0.007) with the 2 km group driving the reduction in chest circumference and the 5-10 km group driving the reduction in abdominal circumference. In contrast, thigh circumference (28.8 ± 0.4 vs. 30.2 ± 0.4) increased (P = 0.007) while bodyweight was maintained. There were positive correlations between BCS and abdominal/chest ratios before and after the programme (Pearson correlation; R square ≤ 0.43, P ≤ 0.0012) but the mean ratio remained constant.
    CONCLUSIONS: Results indicated a redistribution between total body fat and muscle mass in body composition of normal weight to slightly overweight dogs after the physical exercise programme. The use of bodyweight alone was not a reliable evaluation method to complement the BCS assessment. However, repeated measurements of chest, abdominal and thigh circumference might aid in the assessment of body composition in dogs performing physical exercise. Further research should include a control group and objective evaluations of total body fat and lean mass, in order to investigate the effectiveness of physical exercise as a freestanding method for decreasing BCS and increasing muscle mass in overweight dogs.
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  • 文章类型: Journal Article
    Objective.几十年来,电阻抗断层扫描(EIT)已用于确定人类的局部肺通气分布,然而,几乎从未研究过生物性别对研究结果的影响。我们研究的目的是确定EIT在安静呼吸期间评估的通气空间分布是否受生物性别的影响。&#xD;方法219名没有已知急性或慢性肺部疾病的成年人以坐姿进行检查,并将EIT电极放置在下胸部(第六肋间空间)周围。在安静呼吸60s期间,以33张图像/s的速度记录EIT数据。在所有EIT图像像素中计算区域潮汐阻抗变化,并使用已建立的腹背通气中心(CoVvd)和从右到左方向(CoVrl)的EIT测量值确定值的空间分布。背侧和右侧的通气部分,和通气缺陷评分。 主要结果。由于电极接触不足而排除一名受试者后,分析了218个数据集(120名男性,98名女性)(年龄:53±18vs50±16岁(p=0.2607),体重指数:26.4±4.0vs26.4±6.6kg/m2(p=0.9158),平均值±标准差)。在左右胸侧之间,男性和女性之间的通气分布存在高度显着差异(CoVrl:47.0±2.9vs胸径的48.8±3.3%(p<0.0001),右通气分数:0.573±0.067vs0.539±0.071(p=0.0004))和##xD;腹背方向不太明显(CoVvd:胸径的55.6±4.2vs54.5±3.6%(p=0.0364),背侧通气分数:0.650±0.121vs0.625±0.104(p=0.1155))。在42.5%的男性中发现通气缺陷评分高于1,但仅在16.6%的女性中发现。 意义。当解释在相当尾的检查平面中在直立受试者中获得的EIT发现时,需要考虑生物性别。胸部解剖和胸腹力学的性别差异可以解释结果。
    Objective.Electrical impedance tomography (EIT) has been used to determine regional lung ventilation distribution in humans for decades, however, the effect of biological sex on the findings has hardly ever been examined. The aim of our study was to determine if the spatial distribution of ventilation assessed by EIT during quiet breathing was influenced by biological sex.Approach.219 adults with no known acute or chronic lung disease were examined in sitting position with the EIT electrodes placed around the lower chest (6th intercostal space). EIT data were recorded at 33 images/s during quiet breathing for 60 s. Regional tidal impedance variation was calculated in all EIT image pixels and the spatial distribution of the values was determined using the established EIT measures of centre of ventilation in ventrodorsal (CoVvd) and right-to-left direction (CoVrl), the dorsal and right fraction of ventilation, and ventilation defect score.Main results.After exclusion of one subject due to insufficient electrode contact, 218 data sets were analysed (120 men, 98 women) (age: 53 ± 18 vs 50 ± 16 yr (p= 0.2607), body mass index: 26.4 ± 4.0 vs 26.4 ± 6.6 kg m-2(p= 0.9158), mean ± SD). Highly significant differences in ventilation distribution were identified between men and women between the right and left chest sides (CoVrl: 47.0 ± 2.9 vs 48.8 ± 3.3% of chest diameter (p< 0.0001), right fraction of ventilation: 0.573 ± 0.067 vs 0.539 ± 0.071 (p= 0.0004)) and less significant in the ventrodorsal direction (CoVvd: 55.6 ± 4.2 vs 54.5 ± 3.6% of chest diameter (p= 0.0364), dorsal fraction of ventilation: 0.650 ± 0.121 vs 0.625 ± 0.104 (p= 0.1155)). Ventilation defect score higher than one was found in 42.5% of men but only in 16.6% of women.Significance.Biological sex needs to be considered when EIT findings acquired in upright subjects in a rather caudal examination plane are interpreted. Sex differences in chest anatomy and thoracoabdominal mechanics may explain the results.
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  • 文章类型: Journal Article
    缺氧等因素造成的持续伤害,感染,或物理损伤可能会引起不适当的组织修复和结缔组织的异常沉积,导致纤维化。这种现象可能发生在任何器官,最终导致他们的功能障碍和最终失败。还发现组织纤维化在癌发生和癌症进展过程中都是重要的。因此,其及时诊断和定期监测对于实施旨在降低死亡率和改善整体生活质量的有效疾病改善干预措施是必要的.虽然已经对这些主题进行了大量研究,如何通过现代成像技术,他们的关系表现的全面理解还有待建立。这项工作旨在提供与检测影响胸部器官的纤维化相关的成像技术的全面概述,并探索该领域的潜在未来进展。
    Sustained injury from factors such as hypoxia, infection, or physical damage may provoke improper tissue repair and the anomalous deposition of connective tissue that causes fibrosis. This phenomenon may take place in any organ, ultimately leading to their dysfunction and eventual failure. Tissue fibrosis has also been found to be central in both the process of carcinogenesis and cancer progression. Thus, its prompt diagnosis and regular monitoring is necessary for implementing effective disease-modifying interventions aiming to reduce mortality and improve overall quality of life. While significant research has been conducted on these subjects, a comprehensive understanding of how their relationship manifests through modern imaging techniques remains to be established. This work intends to provide a comprehensive overview of imaging technologies relevant to the detection of fibrosis affecting thoracic organs as well as to explore potential future advancements in this field.
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    文章类型: Journal Article
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  • 文章类型: Journal Article
    到目前为止,通过分析肢体长度的差异,艾伦和伯格曼的规则在现代人类中得到了研究,高度,或体重。然而,没有出版物研究纬度对胸腔3D结构的影响。为了评估这个问题,我们以数字方式重建了109个全球分布的成年个体的平衡样本。使用几何形态计量学量化胸腔的形状和大小。我们的结果表明,与生活在高纬度地区的其他人相比,属于热带个体的胸腔更小,更苗条。这符合艾伦和伯格曼的规则,并表明大小和形状之间的异速关系。尽管在整个样本中都观察到了性二态,仅在热带种群中发现了显着差异。我们的建议是,除了潜在的性选择,避免热量损失可能是冷适应人群性二态性的限制因素。
    Up to now, Allen and Bergmann\'s rules have been studied in modern humans by analyzing differences in limb length, height, or body mass. However, there are no publications studying the effects of latitude in the 3D configuration of the ribcage. To assess this issue, we digitally reconstructed the ribcages of a balanced sample of 109 adult individuals of global distribution. Shape and size of the ribcage was quantified using geometric morphometrics. Our results show that the ribcage belonging to tropical individuals is smaller and slenderer compared to others living in higher latitudes, which is in line with Allen and Bergmann\'s rules and suggests an allometric relationship between size and shape. Although sexual dimorphism was observed in the whole sample, significant differences were only found in tropical populations. Our proposal is that, apart from potential sexual selection, avoiding heat loss might be the limiting factor for sexual dimorphism in cold-adapted populations.
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  • 文章类型: Journal Article
    胎儿胸部的异常需要超声和MR成像的高级成像以及解释儿科放射科医生的专业知识。先天性膈疝和先天性肺畸形是最常见的,在这两种情况下,放射科医师应提供详细的解剖描述和测量数据以进行预测.这篇文章提供了一个详细的方法来成像的解剖,对可用测量和预后价值的深入解释,以及确定胎儿干预候选人的关键。还回顾了较少见的先天性肺肿瘤以及纵隔和胸壁肿块。
    Anomalies of the fetal chest require advanced imaging with ultrasound and MR imaging as well as expertise on the part of the interpreting pediatric radiologist. Congenital diaphragmatic hernia and congenital lung malformation are the most frequently seen, and in both conditions, the radiologist should provide both detailed anatomic description and measurement data for prognostication. This article provides a detailed approach to imaging the anatomy, in-depth explanation of available measurements and prognostic value, and keys to identifying candidates for fetal intervention. Less common congenital lung tumors and mediastinal and chest wall masses are also reviewed.
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