Imaging diagnosis

  • 文章类型: Journal Article
    光声成像(PAI)是一种新兴的混合成像模式,将高对比度光学成像与高空间分辨率超声成像相结合。PAI可以利用组织独特的光谱特性提供高空间分辨率和显著的成像深度,这使它在生物医学和临床前研究中具有广泛的应用。此外,它是非电离和非侵入性的,和光声(PA)信号由短脉冲激光在热膨胀下产生。在这项研究中,我们描述了PAI的基本原理,人类和动物组织研究的最新进展,和未来的前景。
    Photoacoustic imaging (PAI) is an emerging hybrid imaging modality that combines high-contrast optical imaging with high-spatial-resolution ultrasound imaging. PAI can provide a high spatial resolution and significant imaging depth by utilizing the distinctive spectroscopic characteristics of tissue, which gives it a wide variety of applications in biomedicine and preclinical research. In addition, it is non-ionizing and non-invasive, and photoacoustic (PA) signals are generated by a short-pulse laser under thermal expansion. In this study, we describe the basic principles of PAI, recent advances in research in human and animal tissues, and future perspectives.
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  • 文章类型: Journal Article
    该研究的目的是研究18F氟代脱氧葡萄糖(FDG)正电子发射断层扫描(PET)/计算机断层扫描(CT)对弥漫性大B细胞淋巴瘤(DLBCL)患者的诊断和预后价值。PET/CT的诊断敏感性(Sen)(94.75%)明显高于B-US的83.56%。年龄≥65岁,最大焦点直径≥5cm,临床III-IV期,全身症状,乳酸脱氢酶水平升高,高修正国际预后指数评分,Ecog评分≥1,B细胞淋巴瘤2(Bcl-2)基因,MYC蛋白表达率,代谢性肿瘤体积(MTV),和总病变糖酵解(TLG)均是影响DLBCL复发或进展的因素。有了更高的MTV和TLG,患者复发或进展的可能性更大.18F-FDGPET/CT在淋巴瘤病变中显示高诊断率,能准确指导临床分期。结合临床参数,实验室指标,和代谢参数,可以更准确地评估患者的预后指标。
    The objective of the study was to research diagnostic and prognostic values of 18F fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B-cell lymphoma (DLBCL). The diagnostic sensitivity (Sen) of PET/CT (94.75 %) was remarkably higher than 83.56 % of B-US. Age ≥ 65 years old, maximum focal diameter ≥5 cm, clinical stages III-IV, systemic symptoms, increased lactate dehydrogenase level, high modified international prognostic index score, Ecog score ≥1, B-cell lymphoma 2 (Bcl-2) gene, MYC protein expression rate, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were all factors that influenced the recurrence or progression of DLBCL. With higher MTV and TLG, patients would have a greater probability of recurrence or progression. 18F-FDG PET/CT showed a high diagnostic Sen in lymphoma lesions, and could accurately guide clinical staging. Combined with clinical parameters, laboratory indicators, and metabolic parameters, prognostic indicators of patients could be evaluated more accurately.
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  • 文章类型: Journal Article
    直肠癌(RC)是一种普遍存在的恶性肿瘤,具有显着的发病率和死亡率。RC的准确分期对于最佳治疗计划和患者预后至关重要。本文旨在总结目前在RC分期评估中使用的影像学和代谢诊断方法的文献。各种成像方式在RC的初步评估和分期中起着关键作用。这些包括磁共振成像(MRI),计算机断层扫描(CT),直肠内超声(ERUS)。MRI由于其优越的软组织分辨率和评估肿瘤浸润深度的能力,已成为局部分期的金标准。淋巴结受累,以及壁外血管侵犯的存在。CT成像提供了有关远处转移的有价值的信息,并有助于确定手术切除的可行性。ERUS有助于评估肿瘤深度,直肠周围淋巴结,括约肌参与。了解每种诊断方式的优势和局限性对于RC的准确分期和治疗决策至关重要。此外,多种成像和代谢方法的整合,如PET/CT或PET/MRI,可以提高诊断准确性并提供有价值的预后信息。因此,进行了文献综述,以调查和评估诊断方法的有效性和准确性,成像和代谢,在RC的阶段评估中。
    Rectal cancer (RC) is a prevalent malignancy with significant morbidity and mortality rates. The accurate staging of RC is crucial for optimal treatment planning and patient outcomes. This review aims to summarize the current literature on imaging and metabolic diagnostic methods used in the stage assessment of RC. Various imaging modalities play a pivotal role in the initial evaluation and staging of RC. These include magnetic resonance imaging (MRI), computed tomography (CT), and endorectal ultrasound (ERUS). MRI has emerged as the gold standard for local staging due to its superior soft tissue resolution and ability to assess tumor invasion depth, lymph node involvement, and the presence of extramural vascular invasion. CT imaging provides valuable information about distant metastases and helps determine the feasibility of surgical resection. ERUS aids in assessing tumor depth, perirectal lymph nodes, and sphincter involvement. Understanding the strengths and limitations of each diagnostic modality is essential for accurate staging and treatment decisions in RC. Furthermore, the integration of multiple imaging and metabolic methods, such as PET/CT or PET/MRI, can enhance diagnostic accuracy and provide valuable prognostic information. Thus, a literature review was conducted to investigate and assess the effectiveness and accuracy of diagnostic methods, both imaging and metabolic, in the stage assessment of RC.
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  • 文章类型: Journal Article
    在造血干细胞移植后(HSCT后)患者中存在CMV肺炎的诊断挑战,尽管早期的射线照相变化。
    该研究旨在采用一种深度学习模型,将CMV肺炎与COVID-19肺炎区分开来,社区获得性肺炎,和HSCT后的正常肺。
    最初,对6个神经网络模型进行了COVID-19肺炎预训练,社区获得性肺炎,和来自KaggleCOVID多类数据集(数据集A)的正常肺部CT图像,然后将数据集A与我们中心的CMV肺炎图像相结合,我们使用少量迁移学习策略对数据集B中的预训练模型进行微调,并在数据集B中评估模型性能。
    在HSCT后的2018年1月至2022年12月期间发现了34例CMV肺炎。数据集A包含来自Kaggle的每个子组的1681张图像。结合数据集A,数据集B最初由98张CMV肺炎和正常肺的图像形成。最优模型(Xception)达到了0.9034的精度。Precision,召回,F1得分均达到0.9091,数据集B测试集的AUC为0.9668。
    该框架展示了深度学习模型利用少量CT图像区分罕见肺炎类型的能力,促进HSCT后CMV肺炎的早期检测。
    UNASSIGNED: Diagnostic challenges exist for CMV pneumonia in post-hematopoietic stem cell transplantation (post-HSCT) patients, despite early-phase radiographic changes.
    UNASSIGNED: The study aims to employ a deep learning model distinguishing CMV pneumonia from COVID-19 pneumonia, community-acquired pneumonia, and normal lungs post-HSCT.
    UNASSIGNED: Initially, 6 neural network models were pre-trained with COVID-19 pneumonia, community-acquired pneumonia, and normal lung CT images from Kaggle\'s COVID multiclass dataset (Dataset A), then Dataset A was combined with the CMV pneumonia images from our center, forming Dataset B. We use a few-shot transfer learning strategy to fine-tune the pre-trained models and evaluate model performance in Dataset B.
    UNASSIGNED: 34 cases of CMV pneumonia were found between January 2018 and December 2022 post-HSCT. Dataset A contained 1681 images of each subgroup from Kaggle. Combined with Dataset A, Dataset B was initially formed by 98 images of CMV pneumonia and normal lung. The optimal model (Xception) achieved an accuracy of 0.9034. Precision, recall, and F1-score all reached 0.9091, with an AUC of 0.9668 in the test set of Dataset B.
    UNASSIGNED: This framework demonstrates the deep learning model\'s ability to distinguish rare pneumonia types utilizing a small volume of CT images, facilitating early detection of CMV pneumonia post-HSCT.
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  • 文章类型: Case Reports
    原发性肝淋巴瘤(PHL)是罕见的,它的早期诊断是困难的。本文介绍1例原发性肝非霍奇金淋巴瘤(NHL)。一名52岁女子因发烧入院。经过实验室检查,对比增强计算机断层扫描(CT),超声,和超声造影(CEUS),只有CEUS提示恶性肿瘤。然后,患者接受了腹腔镜肝活检,诊断为NHL。以前的研究表明,肝淋巴瘤是一种低血糖肿瘤,增强的CT和磁共振成像(MRI)扫描大多轻度增强。同时,二维和彩色多普勒超声大多不典型。CEUS在显示微血管方面具有独特的优势,有助于原发性肝淋巴瘤的诊断。
    Primary hepatic lymphoma (PHL) is rare, and its early diagnosis is difficult. This article presents a primary hepatic non-Hodgkin\'s lymphoma (NHL) case report. A 52-year-old woman was admitted to the hospital due to a fever. After undergoing laboratory examination, contrast-enhanced computed tomography (CT), ultrasound, and contrast-enhanced ultrasound (CEUS), only CEUS suggested malignancy. Then, the patient underwent a laparoscopic liver biopsy, which diagnosed NHL. Previous studies have shown that hepatic lymphoma is a hypoglycemic tumor, and the enhanced CT and magnetic resonance imaging (MRI) scans are mostly mildly intensified. At the same time, the two-dimensional and color Doppler ultrasonography are mostly atypical. CEUS has unique advantages in displaying micro-vessels, which can be helpful in the diagnosis of primary hepatic lymphoma.
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  • 文章类型: Case Reports
    主动脉移植物感染是一种罕见但高度致命的并发症。正确的诊断和及时的治疗有些挑战性。本研究提供了成功识别和治疗这种并发症的病例报告。
    Aortic graft infection is an uncommon but highly fatal complication. Correct diagnosis and timely treatment are somewhat challenging. This study presents a case report of successful recognition and treatment of this complication.
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  • 文章类型: Journal Article
    旨在探讨多层螺旋CT(MSCT)在原发性气管肿瘤的诊断和手术治疗中的价值。
    选择2020年3月至2021年3月在无锡市第二人民医院确诊的64例原发性气管肿瘤患者作为研究对象。所有患者均行MSCT成像,和合适的手术方法。将病理结果与原始CT进行比较,CT仿真内窥镜(CTVE),并使用CT三维重建图像进行比较,以评估MSCT诊断的准确性。观察术后并发症和生存率等参数以评估手术有效性和安全性。
    与原始CT图像相比(70%,72%,70%),VR图像的诊断准确率(80%,80%,80%),MPVR图像(85%,90%,92%),和CTVE图像(100%,100%,100%)显著提高(P<0.05)。平滑肌肿瘤患者的3年生存率,恶性肿瘤,唾液腺腺瘤,乳头状肿瘤,炎性息肉明显低于一年生存率,具有显著性差异(P<0.05)。术后并发症发生率为14.1%,3例导致并发症相关死亡。
    MSCT成像对原发性气管肿瘤的诊断准确率高。CTVE的诊断准确率高于VR和MPVR。此外,原发性气管肿瘤的手术治疗有实质性的效果,术后无严重并发症。
    UNASSIGNED: it aimed to explore the value of multislice helical computed tomography (MSCT) in the diagnosis and surgical treatment of primary tracheal tumors.
    UNASSIGNED: 64 patients with the primary tracheal tumor who were diagnosed in Wuxi Second People\'s Hospital from March 2020 to March 2021 were selected as the research objects. MSCT imaging was performed on all patients, and suitable surgical methods. The pathological results were compared with original CT, CT virtual endoscopy (CTVE), and Comparisons were made using CT three-dimensional reconstruction images to evaluate the accuracy of MSCT diagnosis. Parameters such as postoperative complications and survival rates were observed to assess surgical effectiveness and safety.
    UNASSIGNED: Compared with original CT images (70%, 72%, 70%), the diagnostic accuracy of VR images (80%, 80%, 80%), MPVR images (85%, 90%, 92%), and CTVE images (100%, 100%, 100%) was remarkably improved (P<0.05). The three-year survival rate of patients with smooth muscle tumors, malignant tumors, salivary gland adenoma, papillary tumors, and inflammatory polyp was markedly lower than that of the one-year survival rate, with a significant difference (P<0.05). The incidence of postoperative complications was 14.1%, with three cases resulting in complication-related deaths.
    UNASSIGNED: the diagnostic accuracy of MSCT imaging of primary tracheal tumor was high. The diagnostic accuracy of CTVE was higher than that of VR and MPVR. Besides, surgical treatment of primary tracheal tumor had a substantial effect, with no serious postoperative complications.
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  • 文章类型: Case Reports
    华支睾吸虫感染在全球人类中持续存在。这些病原体主要存在于肝内胆道系统。大多数华支睾吸虫病患者表现出轻度症状。没有明显的症状往往导致延误诊断和治疗,可能导致慢性感染。我们在此报告一例29岁女性,有一年的腹胀和消化不良病史。影像学显示肝内胆管扩张,肝内胆管囊肿,和相关的存款。膀胱切除术后一个月,患者出现大量腹水和嗜酸性粒细胞计数显著增加.治疗后,在引流管中观察到多个蠕虫。形态学和DNA宏基因组分析证实了C.sinensis的存在。C.sinensis的临床表现差异很大。成像在流行地区是一种有价值的诊断工具,特别是在检测肝内导管扩张的地方,吸虫。除了肝内胆管扩张,胆管内的异常回声和胆囊中漂浮物体的存在显着帮助诊断。临床医生可能会意外地遇到这些寄生虫病,强调在常规实践中低估此类病例的重要性,并有助于我们更广泛地理解在临床环境中管理类似病例。
    Clonorchis sinensis infections persist globally among humans. These pathogens mainly inhabit the intrahepatic biliary system. Most individuals with clonorchiasis exhibit mild symptoms. The absence of distinctive symptoms often results in delayed diagnosis and treatment, potentially leading to chronic infection. We herein report a case of a 29-year-old female presented with a year-long history of abdominal distention and dyspepsia. Imaging revealed intrahepatic bile duct dilatation, intrahepatic bile duct cyst, and associated deposits. One month post-cystectomy, the patient developed massive ascites and a significant increase in eosinophil count. After treatment, multiple worms were observed in the drainage tube. Morphological and DNA metagenomic analyses confirmed the presence of C. sinensis. Clinical manifestations of C. sinensis vary widely. Imaging serves as a valuable diagnostic tool in endemic areas, especially in detecting intrahepatic duct dilation where the flukes reside. In addition to intrahepatic bile duct dilation, abnormal echoes within the bile duct and the presence of floating objects in the gallbladder significantly aid in diagnosis. Clinicians may encounter these parasitic diseases unexpectedly, underscoring the importance of understating such cases in routine practice and contributing to our broader understanding of managing similar cases in clinical settings.
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  • 文章类型: Case Reports
    促纤维增生性小圆细胞瘤(DSRCT)是一种罕见的多灶性腹膜肉瘤,通常在青少年和年轻成年男性中发现。症状是非特异性的,并因肿瘤受累而异。诊断主要是组织病理学,尽管成像结果可以帮助诊断过程。虽然不是pathognomonic,某些放射学发现可以帮助缩小潜在的诊断范围,有时可以提示病情,从我们的案例中可以看出。治疗选择并不完善或有效,尽管采用了各种治疗方法,预后仍然很差。我们介绍了两例11岁和10岁的男孩,最终诊断为DSRCT,强调成像发现。
    Desmoplastic small round cell tumor (DSRCT) is a rare multifocal peritoneal sarcoma, typically found in adolescent and young adult males. Symptoms are nonspecific and vary depending on tumor involvement. Diagnosis is primarily histopathological, although imaging results can assist in the diagnostic process. Although not pathognomonic, certain radiologic findings can help narrow down potential diagnoses and sometimes suggest the condition, as seen in our cases. Treatment options are not well-established or effective, and despite employing various therapeutic approaches, the prognosis remains poor. We present two cases of boys aged 11 and 10 with a final diagnosis of DSRCT, emphasizing the imaging findings.
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  • 文章类型: Case Reports
    上皮样血管内皮瘤(EHE)是一种罕见的低度恶性血管肿瘤。它主要发生在肝脏,肺,骨头,和身体的其他部位。腮腺上皮样血管内皮瘤的报道在国内和国际文献中都很少见。这里,我们提出了一个腮腺上皮样血管内皮瘤的病例报告,包括其完整的临床过程和影像学检查结果,改善这种不寻常疾病的诊断和治疗。
    病人,一位75岁的女性,出现右耳肿胀2个月和疼痛20天。增强的腮腺MRI显示明确的,具有均匀信号强度的圆形质量。肿块在T1加权成像上显示低信号强度,在T2加权成像上的高信号强度,结节内信号强度低,DWI序列上显著的高信号强度,ADC序列的信号强度低,静脉注射Gd-DTPA后动脉期的异质性增强。内部观察到结节非增强低信号强度,静脉期有轻微的间隙。手术前的初步诊断是良性病变,但经过组织病理学和免疫组织化学检查,证实为上皮样血管内皮瘤。
    进行完全肿瘤切除。
    患者恢复良好,进行了长达1年的细致随访,未发现复发或转移的迹象。持续的患者监测正在进行中,以证实和验证治疗的长期疗效。
    由于腮腺上皮样血管内皮瘤极为罕见,它经常导致高误诊率。最常见的误诊是涎腺淋巴瘤,其次是上皮样血管肉瘤.当病变是多灶性的,梭形,内部坏死,并在T2加权成像上显示点状低信号强度,动脉期显着增强,特别是更明显的外周增强,静脉和延迟期持续增强,应考虑上皮样血管内皮瘤。然而,目前上皮样血管内皮瘤的临床诊断仍主要依靠免疫组织化学方法。
    Epithelioid hemangioendothelioma (EHE) is a rare low-grade malignant vascular tumor. It mainly occurs in the liver, lungs, bones, and other parts of the body. Reports of epithelioid hemangioendothelioma in the parotid gland are rare in both domestic and international literature. Here, we present a case report of a parotid gland epithelioid hemangioendothelioma, including its complete clinical course and imaging findings, to improve the diagnosis and treatment of this unusual disease.
    UNASSIGNED: The patient, a 75-year-old female, presented with a swelling around the right ear for 2 months and pain for 20 days. Enhanced MRI of the parotid gland revealed a well-defined, round mass with homogeneous signal intensity. The mass showed low signal intensity on T1-weighted imaging, high signal intensity on T2-weighted imaging, nodular low signal intensity within, significant high signal intensity on DWI sequence, low signal intensity on ADC sequence, and heterogeneous enhancement in the arterial phase after intravenous injection of Gd-DTPA. Nodular non-enhancing low signal intensity was observed internally, and slight clearance was seen in the venous phase. The initial diagnosis before surgery was a benign lesion, but after histopathological and immunohistochemical examination, it was confirmed as epithelioid hemangioendothelioma.
    UNASSIGNED: Complete tumor resection was performed.
    UNASSIGNED: The patient experienced a favorable recovery, with meticulous follow-up conducted for up to 1 year revealing no signs of recurrence or metastasis. Continued patient surveillance is ongoing to substantiate and validate the long-term efficacy of the treatment.
    UNASSIGNED: Due to the extreme rarity of parotid gland epithelioid hemangioendothelioma, it often leads to a high misdiagnosis rate. The most common misdiagnosis is salivary gland lymphoma, followed by epithelioid hemangiosarcoma. When the lesion is multifocal, fusiform, with internal necrosis, and shows punctate low signal intensity on T2-weighted imaging, significant enhancement in the arterial phase, particularly with more pronounced peripheral enhancement, and persistent enhancement in the venous and delayed phases, epithelioid hemangioendothelioma should be considered. However, the current clinical diagnosis of epithelioid hemangioendothelioma still primarily relies on immunohistochemical methods.
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