• 文章类型: Journal Article
    研究人员深入研究了慢性肾脏疾病中肾脏纤维化(RF)的非侵入性诊断方法,包括超声(美国),磁共振成像(MRI),和放射组学。然而,这些诊断方法在射频无创诊断中的价值仍存在争议.因此,本研究旨在系统地描述射频无创诊断的准确性。
    涵盖PubMed,Embase,科克伦图书馆,和WebofScience数据库为符合条件的研究进行了截至2023年7月28日的所有可用数据.
    我们纳入了21项研究,涵盖4885名参与者。其中,九项研究将US用作非侵入性诊断方法,八项研究使用核磁共振成像,和四篇文章采用了影像组学。US检测RF的敏感性和特异性分别为0.81(95%CI:0.76-0.86)和0.79(95%CI:0.72-0.84)。MRI的敏感性和特异性分别为0.77(95%CI:0.70-0.83)和0.92(95%CI:0.85-0.96)。影像组学的敏感性和特异性分别为0.69(95%CI:0.59-0.77)和0.78(95%CI:0.68-0.85)。
    当前射频的早期无创诊断方法包括US,MRI,和放射组学。然而,这项研究表明,与MRI相比,US对RF的检测具有更高的灵敏度。与美国相比,基于美国的影像组学研究并未显示出优越的优势.因此,目前诊断射频的影像组学方法仍然存在挑战,需要进一步探索优化的人工智能(AI)算法和技术。
    UNASSIGNED: Researchers have delved into noninvasive diagnostic methods of renal fibrosis (RF) in chronic kidney disease, including ultrasound (US), magnetic resonance imaging (MRI), and radiomics. However, the value of these diagnostic methods in the noninvasive diagnosis of RF remains contentious. Consequently, the present study aimed to systematically delineate the accuracy of the noninvasive diagnosis of RF.
    UNASSIGNED: A systematic search covering PubMed, Embase, Cochrane Library, and Web of Science databases for all data available up to 28 July 2023 was conducted for eligible studies.
    UNASSIGNED: We included 21 studies covering 4885 participants. Among them, nine studies utilized US as a noninvasive diagnostic method, eight studies used MRI, and four articles employed radiomics. The sensitivity and specificity of US for detecting RF were 0.81 (95% CI: 0.76-0.86) and 0.79 (95% CI: 0.72-0.84). The sensitivity and specificity of MRI were 0.77 (95% CI: 0.70-0.83) and 0.92 (95% CI: 0.85-0.96). The sensitivity and specificity of radiomics were 0.69 (95% CI: 0.59-0.77) and 0.78 (95% CI: 0.68-0.85).
    UNASSIGNED: The current early noninvasive diagnostic methods for RF include US, MRI, and radiomics. However, this study demonstrates that US has a higher sensitivity for the detection of RF compared to MRI. Compared to US, radiomics studies based on US did not show superior advantages. Therefore, challenges still exist in the current radiomics approaches for diagnosing RF, and further exploration of optimized artificial intelligence (AI) algorithms and technologies is needed.
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  • 文章类型: Journal Article
    目的:除了甲状腺影像报告和数据系统(TIRADS)分类以外,在决定进行细针抽吸术(FNA)时,必须权衡其他因素.在这项研究中,我们旨在确定超声分类的Chinese-TIRADS(C-TIRADS)4A结节患者的恶性肿瘤危险因素.
    方法:纳入2021年5月至2022年9月在我们机构接受甲状腺FNA的患者。我们收集了人口统计数据,包括年龄,性别,以前的辐射暴露,和家族史。使用当面问卷收集生活方式数据,例如吸烟习惯和饮酒。计算体重指数(BMI)。血清促甲状腺激素(TSH)水平,甲状腺过氧化物酶抗体(TPOAb),测量甲状腺球蛋白抗体(TGAb)。在FNA之前,超声检查报告进行了审查。甲状腺结节FNA的细胞学诊断遵循Bethesda甲状腺细胞病理学报告系统(2017年)。
    结果:在252个C-TIRADS4A结节中,103是恶性的。与良性组相比,恶性组患者年龄较小(42.2±13.6vs.51.5±14.0年,P<0.001)。Logistic回归分析显示,高龄与C-TIRADS4A结节的恶性风险较低相关(OR=0.95,95%CI0.93~0.97,P<0.001)。我们证明了48.5岁或以上患者的恶性肿瘤风险降低。
    结论:高龄与C-TIRADS4A结节患者的恶性肿瘤风险降低相关。这项研究表明,除了超声特征外,在评估恶性肿瘤风险时,应考虑患者年龄.
    OBJECTIVE: Beyond the Thyroid Imaging Reporting and Data System (TIRADS) classification of thyroid nodules, additional factors must be weighed in the decision to perform fine needle aspiration (FNA). In this study, we aimed to identify risk factors for malignancy in patients with ultrasound-classified Chinese-TIRADS (C-TIRADS) 4 A nodules.
    METHODS: Patients who underwent thyroid FNA at our institution between May 2021 and September 2022 were enrolled. We collected demographic data, including age, sex, previous radiation exposure, and family history. An in-person questionnaire was used to collect lifestyle data, such as smoking habits and alcohol consumption. Body mass index (BMI) was calculated. The serum levels of thyroid stimulating hormone (TSH), thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TGAb) were measured. Prior to FNA, ultrasonic inspection reports were reviewed. The cytologic diagnoses for FNA of thyroid nodules followed the Bethesda System for Reporting Thyroid Cytopathology (2017).
    RESULTS: Among the 252 C-TIRADS 4 A nodules, 103 were malignant. Compared to those in the benign group, the patients in the malignant group had a younger age (42.2 ± 13.6 vs. 51.5 ± 14.0 years, P < 0.001). Logistic regression showed that advanced age was associated with a lower risk of malignancy in C-TIRADS 4 A nodules (OR = 0.95, 95% CI 0.93 ~ 0.97, P < 0.001). We demonstrated a decreased risk of malignancy in patients with 48.5 years or older.
    CONCLUSIONS: Advanced age was associated with a decreased risk of malignancy in patients with C-TIRADS 4 A nodules. This study indicated that in addition to sonographic characteristics, patient age should be considered when assessing the risk of malignancy.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    目的:评估定量超声系统脂肪分数(USFF)和质子磁共振波谱(1H-MRS)之间的一致性以及USFF在评估代谢相关脂肪性肝病(MAFLD)中的诊断价值。
    方法:前瞻性招募患有或怀疑患有MAFLD的参与者,并接受1H-MRS,USFF,和受控衰减参数(CAP)测量。使用Pearson相关系数评估USFF和1H-MRS之间的相关性。使用受试者工作特征曲线分析(ROC)评估不同等级脂肪变性的USFF诊断性能,并与CAP进行比较。视觉肝脏脂肪变性分级(VHSG)。
    结果:共有113名参与者(平均年龄44.79岁±13.56(SD);71名男性)入组,其中98例(86.73%)患有肝脂肪变性(1H-MRS≥5.56%)。USFF与1H-MRS呈良好的相关性(Pearsonr=0.76),呈线性关系,优于CAP与1H-MRS的相关性(Pearsonr=0.61)。USFF为不同级别的肝脂肪变性提供了高诊断性能,ROC为0.84~0.98,诊断性能优于CAP和VHSG。不同等级的脂肪变性的USFF的截断值不同,S1、S2和S3的截止值为12.01%,19.98%,和22.22%,分别。
    结论:USFF和1H-MRS之间存在良好的相关性。同时,USFF对肝脂肪变性具有良好的诊断性能,优于CAP和VHSG。USFF代表了一种用于MAFLD的非侵入性定量评估的优越方法。
    定量超声系统脂肪分数(USFF)可准确评估肝脏脂肪含量,并与磁共振波谱(1H-MRS)具有良好的相关性,可评估代谢相关的脂肪肝疾病(MAFLD),以及提供肝脂肪变性的准确定量评估。
    结论:目前代谢相关脂肪肝的诊断和监测模式存在局限性。USFF与1H-MRS相关性良好,优于CAP。USFF对脂肪变性具有良好的诊断性能,优于CAP和VHSG。
    OBJECTIVE: To evaluate the agreement between quantitative ultrasound system fat fraction (USFF) and proton magnetic resonance spectroscopy (1H-MRS) and the diagnostic value of USFF in assessing metabolic-associated fatty liver disease (MAFLD).
    METHODS: The participants with or suspected of MAFLD were prospectively recruited and underwent 1H-MRS, USFF, and controlled attenuation parameter (CAP) measurements. The correlation between USFF and 1H-MRS was assessed using Pearson correlation coefficients. The USFF diagnostic performance for different grades of steatosis was evaluated using receiver operating characteristic curve analysis (ROC) and was compared with CAP, visual hepatic steatosis grade (VHSG).
    RESULTS: A total of 113 participants (mean age 44.79 years ± 13.56 (SD); 71 males) were enrolled, of whom 98 (86.73%) had hepatic steatosis (1H-MRS ≥ 5.56%). USFF showed a good correlation (Pearson r = 0.76) with 1H-MRS and showed a linear relationship, which was superior to the correlation between CAP and 1H-MRS (Pearson r = 0.61). The USFF provided high diagnostic performance for different grades of hepatic steatosis, with ROC from 0.84 to 0.98, and the diagnostic performance was better than that of the CAP and the VHSG. The cut-off values of the USFF were different for various grades of steatosis, and the cut-off values for S1, S2, and S3 were 12.01%, 19.98%, and 22.22%, respectively.
    CONCLUSIONS: There was a good correlation between USFF and 1H-MRS. Meanwhile, USFF had good diagnostic performance for hepatic steatosis and was superior to CAP and VHSG. USFF represents a superior method for noninvasive quantitative assessment of MAFLD.
    UNASSIGNED: Quantitative ultrasound system fat fraction (USFF) accurately assesses liver fat content and has a good correlation with magnetic resonance spectroscopy (1H-MRS) for the assessment of metabolic-associated fatty liver disease (MAFLD), as well as for providing an accurate quantitative assessment of hepatic steatosis.
    CONCLUSIONS: Current diagnostic and monitoring modalities for metabolic-associated fatty liver disease have limitations. USFF correlated well with 1H-MRS and was superior to the CAP. USFF has good diagnostic performance for steatosis, superior to CAP and VHSG.
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  • 文章类型: Journal Article
    目的:本研究旨在探索和验证基于超声图像组学特征的不同机器学习模型在胰腺癌(PC)淋巴结转移术前诊断中的价值。
    方法:本研究涉及189例经手术病理证实的PC患者(训练队列:n=151;测试队列:n=38),其中淋巴结转移50例。从超声图像中提取图像组学特征。经过降维和筛选,八种机器学习算法,包括逻辑回归(LR),支持向量机(SVM),K-最近邻(KNN),随机森林(RF),额外的树木(ET),极端梯度提升(XGBoost),光梯度增压机(LightGBM),和多层感知器(MLP),建立图像组学模型预测PC淋巴结转移。通过ROC曲线分析选择最佳组学预测模型。使用机器学习模型来分析临床特征并确定变量以建立临床模型。通过结合超声图像组学和临床特征来构建组合模型。使用决策曲线分析(DCA)和列线图评估模型的临床应用价值。
    结果:从超声图像中提取了1561个图像组学特征。通过正则化确定了15个有价值的图像组学特征,降维,和算法选择。在图像组学模型中,LR模型表现出更高的预测效率和鲁棒性,训练集中的ROC曲线下面积(AUC)为0.773,测试集中的AUC为0.850。临床模子由超声图象中病灶界限和临床特点CA199构成(AUC=0.875)。组合模型具有最好的预测性能,训练集中的AUC为0.872,测试集中的AUC为0.918。根据DCA,联合模型显示出更好的临床获益,和列线图评分提供了临床预测解决方案。
    结论:结合临床特征建立的联合模型具有良好的诊断能力,可用于预测PC患者的淋巴结转移。有望为临床决策提供一种有效的无创方法,从而提高PC的诊断和治疗。
    OBJECTIVE: This study was designed to explore and validate the value of different machine learning models based on ultrasound image-omics features in the preoperative diagnosis of lymph node metastasis in pancreatic cancer (PC).
    METHODS: This research involved 189 individuals diagnosed with PC confirmed by surgical pathology (training cohort: n = 151; test cohort: n = 38), including 50 cases of lymph node metastasis. Image-omics features were extracted from ultrasound images. After dimensionality reduction and screening, eight machine learning algorithms, including logistic regression (LR), support vector machine (SVM), K-nearest neighbors (KNN), random forest (RF), extra trees (ET), extreme gradient boosting (XGBoost), light gradient boosting machine (LightGBM), and multilayer perceptron (MLP), were used to establish image-omics models to predict lymph node metastasis in PC. The best omics prediction model was selected through ROC curve analysis. Machine learning models were used to analyze clinical features and determine variables to establish a clinical model. A combined model was constructed by combining ultrasound image-omics and clinical features. Decision curve analysis (DCA) and a nomogram were used to evaluate the clinical application value of the model.
    RESULTS: A total of 1561 image-omics features were extracted from ultrasound images. 15 valuable image-omics features were determined by regularization, dimension reduction, and algorithm selection. In the image-omics model, the LR model showed higher prediction efficiency and robustness, with an area under the ROC curve (AUC) of 0.773 in the training set and an AUC of 0.850 in the test set. The clinical model constructed by the boundary of lesions in ultrasound images and the clinical feature CA199 (AUC = 0.875). The combined model had the best prediction performance, with an AUC of 0.872 in the training set and 0.918 in the test set. The combined model showed better clinical benefit according to DCA, and the nomogram score provided clinical prediction solutions.
    CONCLUSIONS: The combined model established with clinical features has good diagnostic ability and can be used to predict lymph node metastasis in patients with PC. It is expected to provide an effective noninvasive method for clinical decision-making, thereby improving the diagnosis and treatment of PC.
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  • 文章类型: Journal Article
    不受限制的微型软机器人由于其空间可达性和安全的人机交互,在生物医学和工业领域具有巨大的应用潜力。然而,缺乏选择性和强有力的驱动在革命性和释放其多功能性方面仍然具有挑战性。这里,我们提出了一种聚焦超声控制的相变策略,用于实现软机器人的毫米级空间选择性致动和牛顿级力,它利用超声波引起的加热来触发机器人内部的相变,通过通货膨胀实现强大的驱动。毫米级空间分辨率使单个机器人能够根据特定要求执行多项任务。作为示范概念,我们设计了用于液体货物输送的软机器人和用于组织采集和修补的活检机器人。此外,自主控制系统与超声成像集成,以实现自动声场对准和控制。提出的方法提高了无束缚微型软机器人的时空响应能力,持有扩大其多功能性和适应性的承诺。
    Untethered miniature soft robots have significant application potentials in biomedical and industrial fields due to their space accessibility and safe human interaction. However, the lack of selective and forceful actuation is still challenging in revolutionizing and unleashing their versatility. Here, we propose a focused ultrasound-controlled phase transition strategy for achieving millimeter-level spatially selective actuation and Newton-level force of soft robots, which harnesses ultrasound-induced heating to trigger the phase transition inside the robot, enabling powerful actuation through inflation. The millimeter-level spatial resolution empowers single robot to perform multiple tasks according to specific requirements. As a concept-of-demonstration, we designed soft robot for liquid cargo delivery and biopsy robot for tissue acquisition and patching. Additionally, an autonomous control system is integrated with ultrasound imaging to enable automatic acoustic field alignment and control. The proposed method advances the spatiotemporal response capability of untethered miniature soft robots, holding promise for broadening their versatility and adaptability.
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