Imaging findings

影像学发现
  • 文章类型: Journal Article
    目的/背景乳腺白血病(BL)是一种罕见的乳腺恶性肿瘤,其治疗方法与其他恶性肿瘤不同。然而,它很容易与其他条件混淆;因此,如何准确诊断至关重要。我们回顾性分析了13例患者的影像学表现,以提供诊断参考。方法回顾性分析2015年1月至2023年4月在北京大学人民医院行影像学检查的13例经活检证实的BL患者的临床资料。通过超声(US)获得的成像结果,乳房X线摄影(MMG),磁共振成像(MRI),和正电子发射断层扫描/计算机断层扫描(PET/CT)进行了分析,并比较了这些方法诊断BL的检出率。结果13例患者共检出29个病灶。这些患者在白血病治疗后几个月出现明显的肿块或乳房肿胀,主要涉及双侧乳房。对13例患者进行了超声检查,并检测到所有病变。大多数已确定的肿块是低回声的,边界不清,不规则形状,后回声没有增强,没有充足的血液流动。对五名患者进行了MMG,露出的乳房肿块,建筑扭曲,也没有异常.对四名患者进行了MRI检查,并检测到所有病变;大多数病变在T1加权成像上为低信号,在T2加权成像和弥散加权成像上为高强度,具有降低的表观扩散系数和不均匀增强。增强曲线主要为流入模式。4例患者行PET/CT检查,2例患者出现代谢亢进,另外两个没有明显的放射性吸收。结论与MMG和PET/CT相比,US和MRI具有较高的检出率。此外,与MRI相比,美国便宜,方便高效;因此,应该是诊断BL的首选.
    Aims/Background Breast leukaemia (BL) is a rare breast malignancy that is treated differently from other malignant conditions. However, it is easily confused with other conditions; therefore, how to accurately diagnose is crucial. We retrospectively analysed the imaging findings of 13 patients to provide a diagnostic reference. Methods From January 2015 to April 2023, 13 patients with BL confirmed by biopsy who underwent imaging in Peking University People\'s hospital were retrospectively analysed. The imaging findings obtained via ultrasound (US), mammography (MMG), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) were analysed, and the detection rates of these methods for diagnosing BL were compared. Results Twenty-nine lesions were detected in the 13 patients. These patients presented with palpable masses or breast swelling several months after treatment for leukaemia, mainly involving the bilateral breasts. Ultrasonography was performed for 13 patients, and all lesions were detected. Most of the identified masses were hypoechoic and had indistinct boundaries, irregular shapes, no enhancement of the posterior echo, and no abundant blood flow. MMG was performed for five patients, revealing breast masses, architectural distortion, and no abnormalities. MRI was performed for four patients, and all lesions were detected; most of the lesions were hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging and diffusion-weighted imaging, with a decreased apparent diffusion coefficient and inhomogeneous enhancement. The enhancement curves were mostly inflow patterns. PET/CT was performed for four patients; two patients had hypermetabolism, and the other two had no obvious radioactive uptake. Conclusion Compared to MMG and PET/CT, US and MRI have higher detection rates. Furthermore, compared to MRI, US is inexpensive, convenient and efficient; therefore, it should be the first choice for diagnosing BL.
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  • 文章类型: Case Reports
    原发性透明细胞肝癌(PCCCL)是肝细胞癌(HCC)的一种特殊且相对罕见的亚型,这在50岁以上的人中更常见,偏爱男性,有乙型肝炎或丙型肝炎和/或肝硬化病史。在这里,我们介绍了一个60岁的妇女,她来我们医院寻求右上腹痛的医疗帮助。影像学检查显示他的肝脏右叶有低密度肿块。在对比增强计算机断层扫描(CT)或T1加权成像中,在动脉期肿瘤周围可以出现明显的增强,随着时间的推移,肿瘤的增强程度逐渐降低。在正电子发射断层扫描/CT上显示氟18氟脱氧葡萄糖(18F-FDG)的摄取明显增加。这些影像学发现有助于PCCCL的诊断并将其与其他类型的肝肿瘤区分开。
    Primary clear cell carcinoma of liver (PCCCL) is a special and relatively rare subtype of hepatocellular carcinoma (HCC), which is more common in people over 50 years of age, with a preference for men and a history of hepatitis B or C and/or cirrhosis. Herein, we present a case of a 60-year-old woman who came to our hospital for medical help with right upper abdominal pain. The imaging examination showed a low-density mass in the right lobe of his liver. In contrast enhanced computed tomography (CT) or T1-weighted imaging, significant enhancement can appear around the tumor during the arterial phase, and over time, the degree of enhancement of the tumor gradually decreases. The lession showed obviously increased fluorine-18 fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography/CT. These imaging findings contribute to the diagnosis of PCCCL and differentiate it from other types of liver tumors.
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  • 文章类型: Journal Article
    这项研究旨在评估2018年9月至2021年9月在RasoolAkram医院接受vonHippel-Lindau(VHL)治疗的患者神经系统症状的患病率和相关影像学检查结果。这项分析观察性研究在2018年9月至2021年9月期间检查了符合条件的患者。我们收集了人口统计信息(年龄,性别)以及影像学发现以及神经系统和眼科检查的结果。定性变量之间的比较也使用卡方检验或Fisher精确检验。此外,采用独立t检验比较两组的定量变量.采用SPSS22版软件对数据进行统计分析。显著水平被认为小于或等于0.05。在54例接受检查的患者中(男性占48.1%,女性占51.9%),平均年龄为36.42±13.37岁。绝大多数(87.0%)报告了该疾病的阳性家族史。最常见的疾病类型是在94.4%的病例中观察到的1型,而2A型是第二常见的疾病(3.7%)。检查中最常见的视网膜病理病变与双侧病变有关(79.6%)。最常见的病理发现与小脑磁共振成像中肿块的存在有关(48.1%)。考虑到本研究的结果,这突出了双侧视网膜病变的显著频率以及中枢神经系统和内分泌系统的肿块,很明显,患者在被诊断患有该疾病后需要仔细的随访和各种干预措施。这种方法对于管理和潜在缓解与这些病症相关的并发症至关重要。
    This study aimed to assess the prevalence of neurological symptoms and related imaging findings in patients with von Hippel-Lindau (VHL) at Rasool Akram Hospital from September 2018 to September 2021. This analytical observational study examined eligible patients over the period from September 2018 to September 2021. We collected demographic information (age, gender) along with imaging findings and results of neurological and eye examinations. Comparison between qualitative variables was also done using the Chi-square test or Fisher\'s exact test. Also, an independent t-test was used to compare quantitative variables between the two groups. SPSS version 22 software was used for statistical analysis of data. A significant level was considered less than or equal to 0.05. Of the 54 examined patients (48.1% were male and 51.9% were female) with an average age of 36.42 ± 13.37 years. A significant majority (87.0%) reported a positive family history of the disease. The most common type of disease was Type 1 observed in 94.4% of cases and Type 2A was the next most frequent (3.7%). The most common pattern of retinal pathological lesions seen in the examination was related to bilateral lesions (79.6%). The most common pathological finding was related to the presence of a mass in cerebellar magnetic resonance imaging (48.1%). Considering the findings of the present study, which highlight a significant frequency of bilateral retinal lesions as well as masses in the central nervous system and endocrine system, it is evident that patients require careful follow-up and various interventions after being diagnosed with the disease. This approach is essential to manage and potentially mitigate the complications associated with these conditions.
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  • 文章类型: Journal Article
    背景与目的印度的COVID-19大流行和毛霉菌病流行使研究COVID-19相关毛霉菌病的放射学发现势在必行。本研究旨在描述COVID-19相关毛霉菌病的影像学表现,特别关注颅内表现。方法所有实验室证实的毛霉菌病和COVID-19后状态的患者的磁共振成像(MRI)扫描,两个月,在印度三级护理转诊中心,进行回顾性审查,进行描述性统计分析。结果共58例患者(男性47例,81%,11个女人,19%)进行了评价。在47例(81%)中观察到血糖水平紊乱。31例(53.4%)患者出现颅内侵犯。颅内侵犯最常见的发现是厚膜强化(28/31,90.3%)。其次是梗塞(17/31,55%),海绵窦血栓形成(11/58,18.9%),真菌脓肿(11/31,35.4%),颅内出血(5/31,16.1%)。在21.6%(11/51)的病例中观察到神经周围扩散。眼眶的发现包括脂肪和肌肉受累,颅内受累,眼眶炎,视神经炎,全眼炎,和眼眶脓肿形成的频率依次递减。视神经受累和海绵窦血栓形成的评估者间可靠性的Cohen\skappa系数为0.7。科恩对所有其他发现的系数为0.8-0.9。结论COVID-19相关的鼻-流脑毛霉菌病具有过多的眼眶和颅内表现。MRI,凭借其优越的软组织分辨率和较高的评分者间可靠性,正如这项研究所阐明的,是加速初步诊断的首选成像模式,准确绘制疾病范围,及时识别和严格控制并发症。
    Background and objective The COVID-19 pandemic and mucormycosis epidemic in India made research on the radiological findings of COVID-19-associated mucormycosis imperative. This study aims to describe the imaging findings in COVID-19-associated mucormycosis, with a special focus on the intracranial manifestations.  Methodology Magnetic resonance imaging (MRI) scans of all patients with laboratory-proven mucormycosis and post-COVID-19 status, for two months, at an Indian Tertiary Care Referral Centre, were retrospectively reviewed, and descriptive statistical analysis was carried out. Results A total of 58 patients (47 men, 81%, and 11 women, 19%) were evaluated. Deranged blood glucose levels were observed in 47 (81%) cases. The intracranial invasion was detected in 31 (53.4%) patients. The most common finding in cases with intracranial invasion was pachymeningeal enhancement (28/31, 90.3%). This was followed by infarcts (17/31, 55%), cavernous sinus thrombosis (11/58, 18.9%), fungal abscesses (11/31, 35.4%), and intracranial hemorrhage (5/31, 16.1% cases). The perineural spread was observed in 21.6% (11/51) cases. Orbital findings included extraconal fat and muscle involvement, intraconal involvement, orbital apicitis, optic neuritis, panophthalmitis, and orbital abscess formation in decreasing order of frequency. Cohen\'s kappa coefficient of interrater reliability for optic nerve involvement and cavernous sinus thrombosis was 0.7. Cohen\'s coefficient for all other findings was 0.8-0.9. Conclusions COVID-19-associated rhino-orbito-cerebral mucormycosis has a plethora of orbital and intracranial manifestations. MRI, with its superior soft-tissue resolution and high interrater reliability, as elucidated in this study, is the imaging modality of choice for expediting the initial diagnosis, accurately mapping out disease extent, and promptly identifying and scrupulously managing its complications.
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  • 文章类型: English Abstract
    Objective:To explore strategies for preserving facial nerve function during surgeries for rare tumors of the internal auditory canal. Methods:A total of 235 cases of internal auditory canal tumors treated between 2010 and 2023 were included, encompassing vestibular schwannomas, cavernous hemangiomas, meningiomas, and other rare tumors. Various data, including clinical presentations, imaging classifications, and treatment processes, were meticulously analyzed to delineate the characteristics of rare tumors and assess pre-and postoperative facial nerve function. Results:Among all internal auditory canal tumors, vestibular schwannomas accounted for 91.9%. In rare tumors, facial nerve schwannomas constituted 5.3%, cavernous hemangiomas 26.3%, meningiomas 15.8%, and arterial aneurysms 10.5%. Significantly, patients with cavernous hemangiomas displayed pronounced invasion of the facial nerve by the tumor, in contrast to other tumor types where clear boundaries with the facial nerve were maintained. During surgery, individualized approaches and strategies for facial nerve protection were implemented for different tumor types, involving intraoperative dissection, tumor excision, and facial nerve reconstruction. Conclusion:Preservation of the facial nerve is crucial in the surgical management of rare tumors of the internal auditory canal. Accurate preoperative diagnosis, appropriate timing of surgery, selective surgical approaches, and meticulous intraoperative techniques can maximize the protection of facial nerve function. Personalized treatment plans and strategies for facial nerve functional reconstruction are anticipated to enhance surgical success rates, reduce the risk of postoperative facial nerve dysfunction, and ultimately improve the quality of life for patients.
    目的:探索内听道少见肿瘤手术过程中面神经保护的策略。 方法:纳入2010至2023年就诊的235例内听道肿瘤患者,其中包括前庭神经鞘瘤、海绵状血管瘤、脑膜瘤等少见肿瘤。通过临床表现、影像学分类和治疗过程等多方面数据,详细分析少见肿瘤的特点,术前术后的面神经功能情况。 结果:在所有内听道肿瘤中,前庭神经鞘瘤占91.9%;在少见肿瘤中,面神经鞘瘤占5.3%,海绵状血管瘤占26.3%,脑膜瘤占15.8%,动脉瘤占10.5%。海绵状血管瘤患者中肿瘤侵袭面神经的情况明显,而其他肿瘤与面神经边界清晰。手术过程中,对于不同类型的肿瘤,采取了个体化的手术入路和面神经保护策略,包括术中分离、肿瘤切除、面神经重建等。 结论:面神经在内听道少见肿瘤手术中的保护至关重要。通过精准的术前诊断、合适的手术时机、选择性的手术入路以及术中的细致操作,可以最大限度地保护面神经功能。个体化的治疗方案和面神经功能的重建策略有望提高手术成功率,减轻患者术后面神经功能障碍的风险,从而改善患者的生活质量。.
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  • 文章类型: Case Reports
    狂犬病是中枢神经体系的一种急性致命疾病。神经影像学发挥着重要作用,特别是在建立早期诊断和区分它与其他类型的脑炎。此病例报告旨在对这种情况进行简要回顾,并报告该疾病不太常见的MRI发现。我们在此报告一例61岁的男性被流浪狗咬伤,并出现发烧,呕吐,头痛,流涎,构音障碍,吞咽困难,上肢无力在第二天发展到下肢。T2W和FLAIR图像显示深灰质中微妙的双侧高强度信号,额叶和顶叶白质中的信号强度更明显地增加,显示出轻度的弥散限制,但没有对比后增强。狂犬病脑炎的诊断是根据典型的暴露史做出的,兼容的临床表现,和MRI检查结果。狂犬病的诊断基本上是临床的。从唾液等生物样品中分离出病毒,CSF,头发,或检测狂犬病抗原或抗体。磁共振成像(MRI)大脑用作将其与其他脑炎区分开的研究方式之一。狂犬病本身在MRI大脑上没有任何特征性特征。
    Rabies is an acute fatal disease of the central nervous system. Neuroimaging plays an important role, especially in establishing an early diagnosis and distinguishing it from other types of encephalitis. This case report aims to give a brief review of this condition and report the less common MRI findings of the disease. We herein report a case of a 61-year-old male bitten by a stray dog who presented with fever, vomiting, headache, sialorrhea, dysarthria, dysphagia, and upper limb weakness which progressed to lower limbs on the next day. T2W and FLAIR images demonstrated subtle bilateral hyperintense signal in the deep gray matter with more apparent increased signal intensity in the white matter of the frontal and parietal lobes which shows mild diffusion restriction but no postcontrast enhancement. The diagnosis of rabies encephalitis was made based on a typical history of exposure, a compatible clinical presentation, and MRI findings. Rabies diagnosis is essentially clinical. It is definitively confirmed by the isolation of the virus from biological samples such as saliva, CSF, hair, or detection of rabies antigens or antibodies. Magnetic resonance imaging (MRI) brain used as one of the modalities of investigation for distinguishing it from other encephalitis. Rabies per se does not have any characteristic features on the MRI brain.
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  • 文章类型: Journal Article
    腹膜假粘液瘤(PMP)是一种轻微发作的腹痛的临床实体,腹水,以及与特征性成像相关的扩张。在大多数情况下,腹腔镜探查将提供明确的诊断和组织病理学验证。然而,这种疾病的诊断通常有困难。
    这里,我们介绍了一例51岁女性,她在5个月内出现腹水。一项研究性剖腹手术确定了PMP的诊断,在发现粘液后,灰褐色肿瘤,CK20阳性,CK7阴性。随后,奥沙利铂联合5-FU(FOLFOX4方案)化疗,开始,患者存活30个月。我们还对有关这种罕见实体的不同症状和放射学发现的英文文献进行了全面回顾。根据文献综述,已描述了35例具有不同临床和放射学发现的PMP。在大多数情况下,超声,在诊断性剖腹手术之前,计算机断层扫描或磁共振成像正朝着正确的诊断方向发展.
    将临床表现与特征性影像学表现相结合,可以迅速诊断PMP,使预后更有利。
    UNASSIGNED: Pseudomyxoma peritonei (PMP) is a clinical entity of subtle onset abdominal pain, ascites, and distention associated with characteristic imaging. In most cases, laparoscopic exploration will give the definitive diagnosis and histopathologic verification. However, usually there are difficulties in the diagnosis of this disease.
    UNASSIGNED: Herein, we present a case of a 51-year-old female who developed ascites over 5 months. An investigational laparotomy established the diagnosis of PMP, after the discovery of a mucinous, grey-brown tumor that was CK20 positive and CK7 negative. Subsequently, chemotherapy with oxaliplatin combined with 5-FU (FOLFOX4 regimen), was initiated and the patient survived for 30 months. We also present a comprehensive review of the English literature concerning the different symptoms and radiological findings of this rare entity. According to the literature review, 35 cases of PMP with different clinical and radiological findings have been described. In the majority of the cases, ultrasound, computed tomography or magnetic resonance imaging was orientating towards a proper diagnosis before a diagnostic laparotomy.
    UNASSIGNED: The combination of a clinical picture with the characteristic imaging findings enables a prompt diagnosis of PMP, making prognosis more favorable.
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  • 文章类型: Case Reports
    我们描述了一个眼眶脂肪形成的孤立性纤维性肿瘤(SFT)的典型影像学发现,可以提高对眼眶脂肪形成的SFT的认识。
    一名88岁的女性出现眼球突出和右眼疼痛。术前成像显示椭圆形,具有软组织密度的明确定义的肿块,散布有界限清楚的病变。病变在计算机断层扫描(CT)扫描中显示低密度,磁共振成像(MRI)扫描的T1/T2加权图像中的高强度和MRI扫描的脂肪抑制图像中的低信号。肿瘤全部切除,病理检查诊断为低度恶性脂肪形成SFT。术后9个月没有复发的证据。
    眼眶脂肪形成SFT的成像特征是散布有脂肪组织的明确定义的实体瘤。这些发现对于术前诊断和治疗的选择至关重要。
    UNASSIGNED: We describe a case of fat-forming solitary fibrous tumor (SFT) of the orbit with typical findings on imaging that may improve the awareness of orbital fat-forming SFT.
    UNASSIGNED: An 88-year-old female presented with exophthalmos and pain in her right eye. Preoperative imaging showed an oval, well-defined mass with soft-tissue density, interspersed with a well-circumscribed lesion. The lesion showed low-density in computed tomography (CT) scans, hyperintense in T1/T2 weighted images of magnetic resonance imaging (MRI) scans and hypointense in fat-suppressed images of MRI scans. The tumor was removed en bloc and diagnosed as low-grade malignant fat-forming SFT by pathological examination. There was no evidence of recurrence 9-month postoperatively.
    UNASSIGNED: The imaging feature of orbital fat-forming SFT is a well-defined solid tumor interspersed with adipose tissue. Such findings are vital for the preoperative diagnosis and the choice of the treatment.
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  • 文章类型: Case Reports
    背景:原发性肺脑膜瘤(PPM)是一种极为罕见的肺原发性肿瘤。诊断应首先通过影像学排除中枢神经系统MPM转移。最终诊断主要取决于组织病理学和免疫组织化学结果。恶性PPM更为罕见,缺乏明确的病理学定义来区分良性和恶性PPM。
    方法:一名47岁妇女在一个月前的体检中发现肺部肿块后入院。该患者的影像学发现显示左肺下叶有较大的肿块,并伴有支气管浸润。大脑的对比增强MRI正常。支气管镜检查显示左下基底支开口处有肿块,粘膜浸润,突出,和开口的狭窄。患者接受了左肺癌根治术,用苏木精-伊红染色的病理标本显示肿瘤细胞局灶性浸润支气管软骨。免疫组织化学染色为上皮膜抗原(EMA)阳性,生长抑素受体2(SSTR2),孕激素受体(PR),Ki-67(5%-10%),CD34和D2-40和p53弱阳性。病理诊断为原发性肺脑膜瘤(PPM)。肿瘤标志物CA-125在术后2个月内明显升高。
    结论:恶性PPM更为罕见,缺乏明确的病理学定义来区分良性和恶性PPM。潜在病例应根据影像学综合评估,实验室,和病理结果。需要长期定期随访以排除PPM的转移或复发。
    BACKGROUND: Primary pulmonary meningioma (PPM) is an extremely rare primary tumor of the lung. The diagnosis should first exclude metastasis of central nervous system MPM by using imaging, and the final diagnosis depends mainly on the tissue pathology and immunohistochemical results. Malignant PPM is even rarer, and a clear pathological definition to distinguish between benign and malignant PPM is lacking.
    METHODS: A 47-year-old woman was admitted to the hospital after a lung mass was found during a physical examination one month earlier. The imaging findings for this patient showed a large mass in the lower lobe of the left lung with bronchial invasion. A contrast-enhanced MRI of the brain was normal. Bronchoscopy shows a mass at the opening of the left lower basal branch, with mucosal infiltration, protrusion, and stenosis of the opening. The patient underwent radical left lung cancer surgery, and the pathology specimens stained with hematoxylin-eosin demonstrated tumor cells with the focal invasion of the bronchial cartilage. Immunohistochemical staining was positive for epithelial membrane antigen(EMA), somatostatin receptor 2 (SSTR2), progesterone receptor (PR), Ki-67 (5%-10%), CD34, and D2-40 and weakly positive for p53.The pathologic diagnosis was primary pulmonary meningioma (PPM). The tumor marker CA-125 had significantly increased in the 2 months after surgery.
    CONCLUSIONS: Malignant PPM is rarer, and a clear pathological definition to distinguish between benign and malignant PPM is lacking. Potential cases should be comprehensively evaluated based on imaging, laboratory, and pathology results. A long-term regular follow-up will be required to rule out metastasis or recurrence of PPM.
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  • 文章类型: Case Reports
    原发性肝鳞状细胞癌(SCC)极为罕见,迄今为止只报告了几十例。在组织病理学检查之前几乎不能诊断出来,这就需要排除转移性肿瘤。在这种情况下,我们介绍一名60岁女性患者,无合并症.由于实验室检查和影像学检查不能诊断,在超声(US)引导下进行肝活检,最终发现肝SCC的明确病理诊断。排除转移后,原发性肝SCC的诊断已确立,然后进行化疗和免疫治疗。此外,使用PubMed对原发性肝SCC进行了全面的文献检索,谷歌学者,和WebofScience,共检索到53篇文章,时间范围为1972年至2022年。然后进行了关键分析,以评估以前的文献,重点是临床特征,成像特征,治疗,和预后。
    Primary hepatic squamous cell carcinoma (SCC) is extremely rare, and only a few dozen cases have been reported to date. It can barely be diagnosed before histopathological examination, which necessitates the exclusion of metastatic tumors. In this case, we present a 60-year-old female patient with no comorbidity. As laboratory tests and imaging examinations were not diagnostic, ultrasonography (US)-guided liver biopsy was performed and eventually revealed a definitive pathological diagnosis of hepatic SCC. After excluding metastasis, the diagnosis of primary hepatic SCC was established, and then chemotherapy and immunotherapy were performed. Additionally, a comprehensive literature search was conducted on primary hepatic SCC using PubMed, Google Scholar, and Web of Science, and a total of 53 articles were retrieved with a time range from 1972 to 2022. A critical analysis was then performed to evaluate previous literature focusing on the clinical characteristics, imaging features, treatments, and prognosis.
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