atypical cyst

非典型囊肿
  • 文章类型: Journal Article
    Mayo成像分类模型(MICM)需要进行步骤前定性评估,以确定患者是在1类(典型)还是2类(非典型),其中被分配到2级的患者被排除在MICM申请之外。
    我们开发了一种基于深度学习的方法,可以从磁共振(MR)图像中自动分类1类和2类,并利用来自486名受试者的腹部T2加权MR图像提供分类置信度。应用迁移学习的地方。此外,说明了可解释的人工智能(XAI)方法可以增强自动分类结果的可解释性。对于绩效评估,产生混淆矩阵,绘制受试者工作特性曲线,测量曲线下面积。
    所提出的方法对第1类(97.7%)和第2类(100%)的分类表现出优异的性能,其中组合测试准确度为98.01%。预测1类的准确率和召回率分别为1.00和0.98,F1评分为0.99;而预测2级的分别为0.87和1.00,F1-得分为0.93。准确率和召回率的加权平均值分别为0.98和0.98,显示分类置信度得分,而XAI方法突出显示了分类的贡献区域。
    所提出的自动化方法可以将1类和2类病例分类得与人类专家的水平一样准确。此方法可能是促进研究不同类型肾脏形态的临床试验以及常染色体显性多囊肾病(ADPKD)患者的临床治疗的有用工具。
    UNASSIGNED: The Mayo imaging classification model (MICM) requires a prestep qualitative assessment to determine whether a patient is in class 1 (typical) or class 2 (atypical), where patients assigned to class 2 are excluded from the MICM application.
    UNASSIGNED: We developed a deep learning-based method to automatically classify class 1 and 2 from magnetic resonance (MR) images and provide classification confidence utilizing abdominal T 2 -weighted MR images from 486 subjects, where transfer learning was applied. In addition, the explainable artificial intelligence (XAI) method was illustrated to enhance the explainability of the automated classification results. For performance evaluations, confusion matrices were generated, and receiver operating characteristic curves were drawn to measure the area under the curve.
    UNASSIGNED: The proposed method showed excellent performance for the classification of class 1 (97.7%) and 2 (100%), where the combined test accuracy was 98.01%. The precision and recall for predicting class 1 were 1.00 and 0.98, respectively, with F 1 -score of 0.99; whereas those for predicting class 2 were 0.87 and 1.00, respectively, with F 1 -score of 0.93. The weighted averages of precision and recall were 0.98 and 0.98, respectively, showing the classification confidence scores whereas the XAI method well-highlighted contributing regions for the classification.
    UNASSIGNED: The proposed automated method can classify class 1 and 2 cases as accurately as the level of a human expert. This method may be a useful tool to facilitate clinical trials investigating different types of kidney morphology and for clinical management of patients with autosomal dominant polycystic kidney disease (ADPKD).
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  • 文章类型: Case Reports
    子宫内膜异位症(EM)是不孕的常见原因,卵巢子宫内膜异位囊肿可能会影响卵巢储备,排卵,和子宫内膜容受性。大多数EM病例是良性的;然而,EM也可能容易发生恶性转化,与渗透生长有关,和复发或远处转移。在这项研究中,我们报道了在控制性卵巢刺激(COS)之前通过卵巢子宫内膜异位囊肿穿刺发现的非典型囊肿的处理.
    由于EM和双侧输卵管阻塞,患者需要进行体外受精治疗。在开始促性腺激素(Gn)治疗之前,右侧卵巢EM囊肿穿刺,所得液体细胞学病理显示形态不典型。随后,与患者讨论了该病例并进行了伦理审查。Gn是根据患者的意愿启动的,最终获得6个第3天的胚胎并冷冻保存。之后,卵巢子宫内膜瘤的腹腔镜膀胱切除术未发现恶变。该患者在复苏和移植胚胎后实现了临床妊娠。
    总之,EM相关性不孕症患者在接受辅助生殖治疗时存在卵巢癌形成的风险;在开始此类治疗之前,应评估并尽量减少这种风险。
    UNASSIGNED: Endometriosis (EM) is a common cause of infertility, and an ovarian endometriotic cyst may affect the ovarian reserve, ovulation, and endometrial receptivity. The majority of EM cases are benign; however, EM may also be prone to malignant transformation, associated with infiltrative growth, and recurrent or distant metastasis. In this study, we report the management of an atypical cyst discovered through ovarian endometriotic cyst puncture prior to controlled ovarian stimulation (COS).
    UNASSIGNED: The patient required in vitro fertilization treatment due to EM and bilateral fallopian tube obstruction. Prior to initiating gonadotropin (Gn) treatment, the right ovarian EM cyst was punctured; cytological pathology of the obtained fluid revealed an atypical morphology. Subsequently, the case was discussed with the patient and ethically reviewed. Gn was initiated according to the patient\'s wishes, and six day-3 embryos were finally obtained and cryopreserved. Afterwards, laparoscopic cystectomy of the ovarian endometrioma revealed no malignant transformation. The patient achieved clinical pregnancy after resuscitation and transplantation of the embryo.
    UNASSIGNED: In summary, patients with EM-associated infertility are at risk of ovarian cancer formation when undergoing assisted reproduction treatment; therefore, this risk should be evaluated and minimized before initiating such treatment.
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