diagnostic imaging

诊断成像
  • 文章类型: English Abstract
    调查中国二级和三级医院放射科医学影像技术人员(MIT)的现状和需求,为医学影像技术产业的发展和卫生行政部门的相关决策提供参考和支持。
    问卷由中国影像技术学会制定。参与调查的每个医院的放射科都推荐了一个MIT填写在线问卷。内容包括:(a)医院的基本信息;(b)医院MIT的概述;(c)日常工作;(d)职业发展和晋升;(e)研究现状和需求,等。使用Mann-WhitneyU检验和卡方检验比较不同地区之间或不同级别医院之间需要的MIT的选定数量的差异。
    在这次调查中,最终从全国31个省份的5403家医院获得有效问卷。样本中涵盖的医院的MIT总数为67481。每个医院的MIT数量为9(5,16)。男女比例为1.41:1。20至40岁的MIT占78%。完成博士学位的MIT比例,master\'s,本科,大专,中专及以下学历为0.6%,3.3%,60.7%,30.8%,和4.55%,分别。主要MIT的比例,MIT副局长,主管MIT,主要MIT,助理技术员和以下人员为1.0%,4.21%,22.1%,51.8%,和20.9%,分别。MIT的整体专业满意度良好。“缺乏学习和交流机会”被引述为MIT在提高与工作相关的能力方面遇到的主要问题。59.2%的受访者在过去五年没有发表学术论文,在过去的五年中,只有7.0%的受访者在科学引文索引(SCI)中的期刊上发表过文章。
    中国的MIT平均相对年轻,MIT的数量大大增加。在这个阶段,应更加重视MIT的人才培养和继续教育,进一步加强学科建设,为我国医学影像技术产业的发展提供有力支撑。
    UNASSIGNED: To investigate the status quo and the needs of medical imaging technicians (MITs) in the radiology department of secondary and tertiary hospitals in China, so as to provide references and support for the development of the medical imaging technology industry and the relevant policymaking by health administrative departments.
    UNASSIGNED: The questionnaire was developed by the Chinese Society of Imaging Technology. The radiology department of each hospital involved in the survey recommended one MIT to fill out the online questionnaire. The contents included: (a) the basic information of the hospital; (b) a general overview of the MITs in the hospital; (c) daily work; (d) career development and promotion; (e) research status and needs, etc. Differences in the number of MIT staff were compared using the Mann-Whitney U test and the chi-square test was used to compare the differences in the selected numbers of MITs in need between regions or between different levels of hospitals.
    UNASSIGNED: In this investigation, valid questionnaires were finally obtained from a total of 5403 hospitals in 31 provinces in China. The total number of MITs of the hospitals covered in the sample was 67481. The number of MITs in each hospital was 9 (5, 16). The male-to-female ratio was 1.41:1. MITs who were 20 to 40 years old accounted for 78%. The proportions of MITs who had completed doctorate, master\'s, undergraduate, junior college, and technical secondary school or lower level education were 0.6%, 3.3%, 60.7%, 30.8%, and 4.55%, respectively. The proportions of chief MITs, deputy chief MITs, supervisor MITs, primary MITs, assistant technician and those below were 1.0%, 4.21%, 22.1%, 51.8%, and 20.9%, respectively. The overall professional satisfaction of MITs was good. \"Lack of opportunities for learning and communication\" was quoted as the main problem MITs encountered in regard to improving their job-related competency. 59.2% of the respondents had not published any academic papers in the past five years, and only 7.0% of the respondents had published in journals included in the Science Citation Index (SCI) in the past five years.
    UNASSIGNED: MITs in China are on average relatively young and the number of MITs has greatly increased. At this stage, more attention should be given to the cultivation of talents and continuing education of MITs and the construction of the discipline should be further strengthened, so as to provide strong support for the development of the medical imaging technology industry in China.
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  • 文章类型: Case Reports
    成釉细胞纤维瘤(AFD)是一种罕见的良性牙源性肿瘤,类似于具有发育不良牙本质的成釉细胞纤维瘤。本报告介绍了一名年轻患者的下颌AFD罕见病例,具有影像学特征。全景X线摄影和计算机断层扫描显示明确的病变,内部间隔和钙化灶,导致相邻磨牙的下移位以及颊舌皮质变薄和后下颌骨扩张。病灶通过肿块切除手术切除,受累牙齿在全身麻醉下拔除。在5年的随访期间,未观察到复发的证据.AFD的放射学特征通常显示中度至明确的混合病变,具有不同程度的射线不透性。反映牙本质形成的程度。放射科医师在鉴别诊断中当遇到少有密集射线不透性的多房性病变时,应考虑AFD。特别是如果它与延迟喷发有关,撞击,或者没有受累的牙齿,年轻患者的影像学图像。
    Ameloblastic fibrodentinoma (AFD) is a rare benign odontogenic tumor that resembles an ameloblastic fibroma with dysplastic dentin. This report presents a rare case of mandibular AFD with imaging features in a young patient. Panoramic radiography and computed tomography revealed a well-defined lesion with internal septa and calcified foci, causing inferior displacement of the adjacent molars as well as buccolingual cortical thinning and expansion of the posterior mandible. The lesion was surgically removed via mass excision, and the involved tooth was extracted under general anesthesia. During the 5-year follow-up period, no evidence of recurrence was observed. Radiologic features of AFD typically reveal a moderately to well-defined mixed lesion with varying degrees of radiopacity, reflecting the extent of dentin formation. Radiologists should consider AFD in the differential diagnosis when encountering a multilocular lesion with little dense radiopacity, particularly if it is associated with delayed eruption, impaction, or absence of involved teeth, on radiographic images of young patients.
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  • 文章类型: Journal Article
    先进的诊断成像模式,包括超声检查,计算机断层扫描,磁共振成像(MRI),是评估和管理急诊儿科患者的关键组成部分。成像技术的进步导致了更快,更准确的工具来改善患者护理的可用性。尽管取得了这些进展,这对医生来说很重要,医师助理,和护士从业人员了解与儿童高级成像相关的风险和局限性,并限制被认为价值低的成像研究,如果可能的话。本技术报告提供了针对急诊科通常考虑高级成像的特定条件的成像策略摘要。作为政策声明的伴奏,本文件提供了优化高级成像的资源和策略,包括临床决策支持机制,远程放射学,共同决策,以及将接受明确治疗的患者推迟成像的理由。
    Advanced diagnostic imaging modalities, including ultrasonography, computed tomography, and magnetic resonance imaging (MRI), are key components in the evaluation and management of pediatric patients presenting to the emergency department. Advances in imaging technology have led to the availability of faster and more accurate tools to improve patient care. Notwithstanding these advances, it is important for physicians, physician assistants, and nurse practitioners to understand the risks and limitations associated with advanced imaging in children and to limit imaging studies that are considered low value, when possible. This technical report provides a summary of imaging strategies for specific conditions where advanced imaging is commonly considered in the emergency department. As an accompaniment to the policy statement, this document provides resources and strategies to optimize advanced imaging, including clinical decision support mechanisms, teleradiology, shared decision-making, and rationale for deferred imaging for patients who will be transferred for definitive care.
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  • 文章类型: Journal Article
    先进的成像,包括超声检查,计算机断层扫描,磁共振成像(MRI),是急诊科评估和管理患病和受伤儿童的组成部分。与任何测试或干预一样,对管理层的利益和潜在影响必须与风险进行权衡,以确保提供高价值护理。对于儿科患者,有一些与高级成像的排序和解释有关的重要考虑因素。该政策声明为机构和照顾儿童的机构提供了指导方针,以优化急诊科设置中先进成像的使用,并由儿科和普通急诊医学专家共同撰写。儿科放射学,和儿科手术。目的是指导儿童可以获得护理的决策。
    Advanced imaging, including ultrasonography, computed tomography, and magnetic resonance imaging (MRI), is an integral component to the evaluation and management of ill and injured children in the emergency department. As with any test or intervention, the benefits and potential impacts on management must be weighed against the risks to ensure that high-value care is being delivered. There are important considerations specific to the pediatric patient related to the ordering and interpretation of advanced imaging. This policy statement provides guidelines for institutions and those who care for children to optimize the use of advanced imaging in the emergency department setting and was coauthored by experts in pediatric and general emergency medicine, pediatric radiology, and pediatric surgery. The intent is to guide decision-making where children may access care.
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  • 文章类型: Journal Article
    目的:评估氟-18氟脱氧葡萄糖正电子发射断层扫描和计算机断层扫描(18FDG-PET/CT)在检测初治头颈部鳞状细胞癌(HNSCC)患者的第二原发恶性肿瘤(SPM)中的诊断准确性。
    方法:Medline,Embase,科克伦图书馆,和Scopus从1946年到2022年12月进行搜索。
    方法:研究报告了18FDG-PET/CT在初治患者中的表现,包括用于检测SPM的HNSCC指标。参考标准是组织病理学,在研究期间的临床随访,和其他成像方式。多名研究者完成了深度全文分析。遵循系统评价和荟萃分析指南的首选报告项目。方法和诊断准确性数据由多个研究者独立提取。使用诊断准确性研究的质量评估工具独立进行偏倚风险评估。采用双变量随机效应模型meta分析和多变量meta回归模型。
    结果:最终分析中纳入了17项研究,检查了4624例患者,共475例SPM。11项研究被发现偏倚风险较低,其余则属于高风险类别。18FDG-PET/CT在检测SPMs时显示出0.73(95%置信区间[CI]:0.49-0.88)和0.99(95%CI:0.98-1.00)的合并敏感性和特异性。食管SPM的敏感性和特异性分别为0.47(0.30-0.64)和0.99(0.98-1.00),头颈部SPM的敏感性和特异性分别为0.86(0.73-0.94)和0.99(0.98-1.00)。最后,这种成像模式对肺SPM的敏感性和特异性分别为0.92(0.84-0.96)和0.99(0.98-1.00)。
    结论:这项研究的结果表明,18FDG-PET/CT在HNSCC初始检查期间检测SPM的准确性不同,强调高危患者食管镜检查等筛查方式的重要性。
    OBJECTIVE: To assess the diagnostic accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography (18FDG-PET/CT) in detecting second primary malignancies (SPMs) in patients with treatment naïve head and neck squamous cell carcinoma (HNSCC).
    METHODS: Medline, Embase, Cochrane Library, and Scopus searched from 1946 to December 2022.
    METHODS: Studies reporting the performance of 18FDG-PET/CT in patients with treatment-naïve, index HNSCC for detection of SPMs were included. The reference standard was histopathology, clinical follow-up over the duration of study, and other imaging modalities. Multiple investigators completed depth full-text analysis. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed. Methodologic and diagnostic accuracy data were abstracted independently by multiple investigators. Risk of bias assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies tool independently. Bivariate random-effects model meta-analysis and multivariable meta-regression modeling were used.
    RESULTS: Seventeen studies examining 4624 patients with a total of 475 SPMs were included in the final analysis. Eleven studies were found to be at low risk for bias, while the rest were in the high-risk category. 18FDG-PET/CT demonstrated pooled sensitivity and specificity of 0.73 (95% confidence interval [CI]: 0.49-0.88) and 0.99 (95% CI: 0.98-1.00) in detecting SPMs. Further subsite analysis revealed varied diagnostic performance across different anatomical regions, with sensitivity and specificity of esophageal SPMs being 0.47 (0.30-0.64) and 0.99 (0.98-1.00), and sensitivity and specificity of 0.86 (0.73-0.94) and 0.99 (0.98-1.00) for head and neck SPMs. Finally, this imaging modality showed sensitivity and specificity of 0.92 (0.84-0.96) and 0.99 (0.98-1.00) for lung SPMs.
    CONCLUSIONS: The findings of this study suggest varied accuracy of 18FDG-PET/CT in detecting SPMs during initial workup for HNSCC, highlighting the importance of screening modalities such as esophagoscopy in high-risk patients.
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  • 文章类型: Journal Article
    骨折被认为是导致严重并发症的医疗紧急情况。
    本研究旨在描述Ag-NPs-FG对兔骨折愈合的加速作用。
    用胡芦巴(FG)还原银NPs(AgNPs),装入淀粉凝胶基质中,并研究了它们的形态,尺寸,和收费。40只成年雄性兔随机组成4组。在每只兔的右胫骨的近端干meta处产生3.5mm直径的骨缺损。第1-4组注射安慰剂生理盐水,AgNPs-FG,普通凝胶,和骨缺损区的FG凝胶,分别。术后8周根据影像学评估愈合情况,骨转换标记,和组织病理学检查。
    获得的AgNPs-FG为淡红色,球形,吸光度为423nm,尺寸为118.0±1.7nm,和-7.8±0.518mV的表面电荷。制备的AgNPs-FG水凝胶清晰,半透明,和同质的。pH值为6.55-6.5±0.2,粘度为4,000和1,875cPs,FG和AgNPs-FG水凝胶的铺展性分别为1.6±0.14和2.0±0.15,分别。与其他治疗组相比,第2组的放射学结合量表显着改善(p<0.05),骨转换标志物显着增加(p<0.05)。组织病理学检查显示,第2组和第4组在术后第28天形成成熟骨。
    载有AgNPs-FG水凝胶的胶体纳米制剂可能是加速兔胫骨骨愈合过程的有前途的制剂。
    UNASSIGNED: A fracture is considered a medical emergency leading to considerable complications.
    UNASSIGNED: This study aimed to describe the accelerating action of Ag-NPs-FG on fracture healing in rabbits.
    UNASSIGNED: Silver NPs (AgNPs) were reduced with fenugreek (FG), loaded into a starch gel base, and investigated for their morphology, size, and charge. Four equal groups were randomly formed of 40 adult male rabbits. A 3.5 mm diameter bone defect was created at the proximal metaphysis of the right tibia in each rabbit. Groups 1-4 were injected with placebo saline, AgNPs-FG, plain gel, and FG-gel at the bone defect zone, respectively. The healing was assessed for 8 weeks postoperatively based on the radiographic, bone turnover markers, and histopathological examinations.
    UNASSIGNED: The AgNPs-FG was obtained as a faint reddish color, spherical in shape, with an absorbance of 423 nm, a size of 118.0 ± 1.7 nm, and a surface charge of -7.8 ± 0.518 mV. The prepared AgNPs-FG hydrogel was clear, translucent, and homogenous. The pH values were 6.55-6.5 ± 0.2, the viscosity of 4,000 and 1,875 cPs, and spreadability of 1.6 ± 0.14 and 2.0 ± 0.15 for both FG and AgNPs-FG hydrogel, respectively. The radiographic union scale was significantly (p < 0.05) improved in group 2 with a significant (p < 0.05) increase in bone turnover markers was found in comparison to other treated groups. Histopathological examination revealed the formation of mature bone on the 28th postoperative day in groups 2 and 4.
    UNASSIGNED: Colloidal nano-formulation of AgNPs-FG loaded hydrogel could be a promising formulation to accelerate rabbits\' tibial bone healing process.
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  • 文章类型: Journal Article
    目的:随着前列腺磁共振成像(MRI)的广泛应用,在前列腺MR中对病变检测和准确诊断的需求不断增加,这在很大程度上依赖于令人满意的图像质量。重点关注前列腺成像报告和数据系统(PI-RADS)中涉及的主要序列,这项研究评估了临床实践中常见的质量问题(如信噪比(SNR)、神器,边界,和增强)。该研究的目的是确定图像质量对临床意义的前列腺癌(csPCa)检测的影响,阳性预测值(PPV)和放射科医生在不同序列和前列腺区的诊断。
    方法:本回顾性研究包括2021年2月至2022年12月进行前列腺MRI检查并有明确病理报告的306例患者。所有组织病理学标本均根据国际泌尿外科病理学会(ISUP)的建议进行评估。ISUP等级组≥2被认为是csPCa。来自不同中心的三个放射科医生分别从以下十个方面对图像质量进行了二进制分类评估:(1)轴平面中的T2WI:SNR,前列腺边界条件,伪影的存在;(2)矢状面或冠状面中的T2WI:前列腺边界条件;(3)DWI:SNR,外围区和过渡区之间的轮廓,文物的存在,DWI和T2WI图像的匹配;(4)DCE:闭孔动脉增强的评价,动态对比度增强的评价。Fleiss\'Kappa用于确定读者之间的协议。使用Wilson的95%置信区间(95%CI)计算PPV。采用卡方检验计算统计学意义。P值<0.05被认为是统计学上显著的。
    结果:高质量的图像在轴向T2WI中具有更高的csPCa检出率(56.5%至64.3%),DWI,DCE,轴向T2WI的SNR有显著的统计学差异(p0.002),轴向T2WI中存在伪影(p0.044),DWI中存在伪影(p<0.001),DWI和T2WI图像的匹配(p<0.001)。高质量图像具有较高的PPV(72.5%至78.8%),并且在轴向T2WI中显示出显着的统计学意义,DWI,DCE。此外,我们发现PI-RADS3(24.0%至52.9%)比PI-RADS4-5(20.6%至39.3%)包含更多的低质量图像,在轴向T2WI(p0.048)和DWI中存在伪影(p0.001)的前列腺边界条件方面存在显着统计学差异。关于不同前列腺区的csPCa检测与图像质量之间的关系,这项研究发现,仅在外周区(PZ)的高图像(63.5%~75.7%)和低质量图像(30.0%~50.0%)之间观察到显著的统计学差异.
    结论:前列腺MRI质量可能对诊断性能有影响。较差的图像质量与较低的csPCa检测率和PPV相关,这可能导致放射科医生诊断模糊的增加(PI-RADS3),尤其是位于PZ的病变。
    OBJECTIVE: With the widespread clinical application of prostate magnetic resonance imaging (MRI), there has been an increasing demand for lesion detection and accurate diagnosis in prostate MR, which relies heavily on satisfactory image quality. Focusing on the primary sequences involved in Prostate Imaging Reporting and Data System (PI-RADS), this study have evaluated common quality issues in clinical practice (such as signal-to-noise ratio (SNR), artifacts, boundaries, and enhancement). The aim of the study was to determine the impact of image quality on clinically significant prostate cancer (csPCa) detection, positive predictive value (PPV) and radiologist\'s diagnosis in different sequences and prostate zones.
    METHODS: This retrospective study included 306 patients who underwent prostate MRI with definitive pathological reports from February 2021 to December 2022. All histopathological specimens were evaluated according to the recommendations of the International Society of Urological Pathology (ISUP). An ISUP Grade Group ≥ 2 was considered as csPCa. Three radiologists from different centers respectively performed a binary classification assessment of image quality in the following ten aspects: (1) T2WI in the axial plane: SNR, prostate boundary conditions, the presence of artifacts; (2) T2WI in the sagittal or coronal plane: prostate boundary conditions; (3) DWI: SNR, delineation between the peripheral and transition zone, the presence of artifacts, the matching of DWI and T2WI images; (4) DCE: the evaluation of obturator artery enhancement, the evaluation of dynamic contrast enhancement. Fleiss\' Kappa was used to determine the inter-reader agreement. Wilson\'s 95% confidence interval (95% CI) was used to calculate PPV. Chi-square test was used to calculate statistical significance. A p-value < 0.05 was considered statistically significant.
    RESULTS: High-quality images had a higher csPCa detection rate (56.5% to 64.3%) in axial T2WI, DWI, and DCE, with significant statistical differences in SNR in axial T2WI (p 0.002), the presence of artifacts in axial T2WI (p 0.044), the presence of artifacts in DWI (p < 0.001), and the matching of DWI and T2WI images (p < 0.001). High-quality images had a higher PPV (72.5% to 78.8%) and showed significant statistical significance in axial T2WI, DWI, and DCE. Additionally, we found that PI-RADS 3 (24.0% to 52.9%) contained more low-quality images compared to PI-RADS 4-5 (20.6% to 39.3%), with significant statistical differences in the prostate boundary conditions in axial T2WI (p 0.048) and the presence of artifacts in DWI (p 0.001). Regarding the relationship between csPCa detection and image quality in different prostate zones, this study found that significant statistical differences were only observed between high- (63.5% to 75.7%) and low-quality (30.0% to 50.0%) images in the peripheral zone (PZ).
    CONCLUSIONS: Prostate MRI quality may have an impact on the diagnostic performance. The poorer image quality is associated with lower csPCa detection rates and PPV, which can lead to an increase in radiologist\'s ambiguous diagnosis (PI-RADS 3), especially for the lesions located at PZ.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    先进的诊断成像模式,包括超声检查,计算机断层扫描,和磁共振成像,是评估和管理急诊儿科患者的关键组成部分。成像技术的进步导致了更快,更准确的工具来改善患者护理的可用性。尽管取得了这些进展,这对医生来说很重要,医师助理,和护士从业人员了解与儿童高级成像相关的风险和局限性,并限制被认为价值低的成像研究,如果可能的话。本技术报告提供了针对急诊科通常考虑高级成像的特定条件的成像策略摘要。作为政策声明的伴奏,本文件提供了优化高级成像的资源和策略,包括临床决策支持机制,远程放射学,共同决策,以及将接受明确治疗的患者推迟成像的理由。
    Advanced diagnostic imaging modalities, including ultrasonography, computed tomography, and magnetic resonance imaging, are key components in the evaluation and management of pediatric patients presenting to the emergency department. Advances in imaging technology have led to the availability of faster and more accurate tools to improve patient care. Notwithstanding these advances, it is important for physicians, physician assistants, and nurse practitioners to understand the risks and limitations associated with advanced imaging in children and to limit imaging studies that are considered low value, when possible. This technical report provides a summary of imaging strategies for specific conditions where advanced imaging is commonly considered in the emergency department. As an accompaniment to the policy statement, this document provides resources and strategies to optimize advanced imaging, including clinical decision support mechanisms, teleradiology, shared decision-making, and rationale for deferred imaging for patients who will be transferred for definitive care.
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  • 文章类型: Journal Article
    先进的成像,包括超声检查,计算机断层扫描,和磁共振成像,是急诊科评估和管理患病和受伤儿童的组成部分。与任何测试或干预一样,对管理层的利益和潜在影响必须与风险进行权衡,以确保提供高价值护理。对于儿科患者,有一些与高级成像的排序和解释有关的重要考虑因素。该政策声明为机构和照顾儿童的机构提供了指导方针,以优化急诊科设置中先进成像的使用,并由儿科和普通急诊医学专家共同撰写。儿科放射学,和儿科手术。目的是指导儿童可以获得护理的决策。
    Advanced imaging, including ultrasonography, computed tomography, and magnetic resonance imaging, is an integral component to the evaluation and management of ill and injured children in the emergency department. As with any test or intervention, the benefits and potential impacts on management must be weighed against the risks to ensure that high-value care is being delivered. There are important considerations specific to the pediatric patient related to the ordering and interpretation of advanced imaging. This policy statement provides guidelines for institutions and those who care for children to optimize the use of advanced imaging in the emergency department setting and was coauthored by experts in pediatric and general emergency medicine, pediatric radiology, and pediatric surgery. The intent is to guide decision-making where children may access care.
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