OBJECTIVE:To investigate the predictive value of MOLLI T1 mapping imaging for the longitudinal changes in Minimal Clinical Important Difference (MCID) after surgery for patients with Cervical Spondylotic Myelopathy (CSM). METHODS:A prospective study enrolled 163 surgically treated CSM patients (October 2022-October 2023). All underwent preoperative conventional MRI and MOLLI T1 mapping. The MCID was determined based on the difference in Modified Japanese Orthopedic Association (m JOA) scores before and at 3, 6, and 12 months after surgery. Patients with an MCID less than 2 were defined as the poor prognosis group, while those with an MCID of 2 or higher were defined as the good prognosis group. Patients were classified into the good prognosis and poor prognosis groups at 3, 6,12 months postoperatively. The differences in conventional MRI features and T1 values between the two groups at these time points were compared. Univariate and multivariate logistic regression identified recovery predictors, with forest plots generated. Receiver operating characteristic (ROC) curve analysis assessed diagnostic performance. RESULTS:At 3 months, (27 good vs 136 poor). Only T2WI hyperintensity differed between groups [Area under the receiver operating characteristic curve (AUC)=0.597, cut off = 0.1942; sensitivity = 40.74 %, specificity = 78.68 %]. At 6 months (60 good vs 103 poor), T1 values showed significance (AUC = 0.690, cut off = 0.3091; sensitivity = 83.33 %, specificity = 47.57 %). At 12 months (100 good vs 63 poor), T1 values demonstrated superior prediction (AUC = 0.875,cut off = 0.6389; sensitivity = 75.00 %, specificity = 88.89 %). CONCLUSION:MOLLI T1 mapping effectively predicts CSM recovery at 6,12 months postoperatively, with optimal diagnostic performance at 12 months. CRITICAL RELEVANCE STATEMENT:This study first employs MRI T1 mapping to predict MCID outcomes in CSM patients, demonstrating its high predictive value for favorable postoperative prognosis and providing a reliable imaging parameter for outcome assessment.
ObjectiveTo retrospectively analyze cases of whole-body 18F-FDG PET/CT imaging, identify abnormal images of subcutaneous nodules, and explore the clinical application value of PET/CT in detecting subcutaneous soft tissue metastases and its impact on survival.MethodAn analysis was conducted on cases from August 2019 to August 2024, and 57 cases of subcutaneous nodules were found to have positive 18F-FDG imaging, all of which underwent pathological puncture or biopsy. Collect patient histological subtypes, metastasis patterns, treatment, and survival rates. Kaplan Meier curves were used to estimate survival time, and Mantel-Cox univariate analysis was used to determine the correlation between extensive metastasis, degree of soft tissue involvement, systemic and local treatment, and survival time.ResultAmong the 57 patients confirmed by pathology, 10 were benign and 47 were malignant. Among 47 cases of malignant tumors, 39 cases were postoperative cases, 8 cases were preoperative cases, and 4 cases had unknown primary lesions. A total of 88 subcutaneous lesions were found, including 28 patients with a single lesion, 12 patients with two lesions, and 8 patients with three or more lesions. One patient with unknown primary lesion reported abdominal wall nodules as the main symptom. PET/CT assisted in qualitative localization in 11 cases. Univariate analysis showed that the median survival time (22 months) of patients who did not receive local radiotherapy was significantly shorter than that of patients who did receive local radiotherapy (60 months) (P<0.05). There is no correlation between gender, metastasis pattern, metastasis at initial diagnosis, use of chemotherapy, and survival time.ConclusionWhole body PET/CT imaging has important application value in the diagnosis of subcutaneous soft tissue metastasis. By comprehensively evaluating the patient’s overall condition and accurately determining whether there is a simple soft tissue metastasis, local intervention measures can bring more favorable prognosis for patients with good general condition and only soft tissue metastasis.
To develop and validate a machine learning (ML) model which combined computed tomography (CT) semantic and radiomics features to preoperatively predict Ki-67 expression in gastrointestinal stromal tumors (GISTs) patients. We retrospectively collected the clinical, imaging and pathological data of 149 GISTs patients. We randomly assigned the patients in a ratio of 7:3 to a training set (104 cases) and a validation (45 cases) set. We divided the patients into low and high Ki-67 expression group according to postoperative pathology. CT semantic features were analyzed from preoperative enhancement CT images and radiomics features were extracted from venous phase-enhanced images. We used intraclass correlation coefficient, maximal relevance and minimal redundancy and least absolute shrinkage and selection operator method to screen radiomics features and build radiomics label. 6 ML models were used for model construction. Receiver operating characteristic curves were used to evaluate the predictive efficiency of ML models. SHAP analysis was used to explain the contribution of different variables and their risk threshold. AUC of radscores in predicting Ki-67 expression of GIST patients were 0.749 and 0.729 in training and validation set. Among the 6 ML models, SVM exhibited best prediction accuracy. AUC of SVM model in predicting Ki-67 expression of GIST patients were 0.840, 0.767 and 0.832 in training, validation and test set. SHAP analysis showed that radscores and tumor diameter had highly positive contribution to the model. Therefore, the interpretable SVM model can predict Ki-67 expression of GISTs patients individually before surgery, which can provide reliable imaging biomarkers for clinical treatment decisions.
Rationale and Objective To evaluate the ability of the radiomic characteristics of pericoronary adipose tissue (PCAT) as determined by coronary computed tomography angiography (CCTA) to predict the likelihood of major adverse cardiovascular events (MACEs) within the next five years. Materials and Methods In this retrospective casecontrol study, the case group consisted of 210 patients with coronary artery disease (CAD) who developed MACEs within five years, and the control group consisted of 210 CAD patients without MACEs who were matched with the case group patients according to baseline characteristics. Both groups were divided into training and testing cohorts at an 8:2 ratio. After data standardization and the exclusion of features with Pearson correlation coefficients of |r| ≥ 0.9, independent logistic regression models were constructed using selected radiomics features of the proximal PCAT of the left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA) via least absolute shrinkage and selection operator (LASSO) techniques. An integrated PCAT radiomics model including all three coronary arteries was also developed. Five models, including individual PCAT radiomics models for the LAD artery, LCX artery, and RCA; an integrated radiomics model; and a fat attenuation index (FAI) model, were assessed for diagnostic accuracy via receiver operating characteristic (ROC) curves, calibration curves, and decision curves. Results Compared with the FAI model (AUC=0.564 in training, 0.518 in testing), the integrated radiomics model demonstrated superior diagnostic performance (area under the curve [AUC]=0.923 in training, 0.871 in testing). The AUC values of the integrated model were greater than those of the individual coronary radiomics models, with all the models showing goodness of fit (P > 0.05). The decision curves indicated greater clinical utility of the radiomics models than the FAI model. Conclusion PCAT radiomics models derived from CCTA data are highly valuable for predicting future MACE risk and significantly outperform the FAI model.
Objective To investigate the diagnostic value of combined 99Tcm-DX lymphoscintigraphy and CT lymphangiography (CTL) in primary chylopericardium. Methods ༚Fifty-five patients diagnosed with primary chylopericardium clinically were retrospectively analyzed. 99Tcm-DX lymphoscintigraphy and CTL were performed in all patients. Primary chylopericardium was classified into three types, according to the 99Tcm-DX lymphoscintigraphy results. The evaluation indexes of CTL include: (1) abnormal contrast distribution in the neck, (2) abnormal contrast distribution in the chest, (3) dilated thoracic duct was defined as when the widest diameter of thoracic duct was > 3 mm, (4) abnormal contrast distribution in abdominal. CTL characteristics were analyzed between different groups, and P < 0.05 was considered a statistically significant difference. Results Primary chylopericardium showed 12 patients of type Ⅰ, 14 patients with type II, and 22 patients with type III. The incidence of abnormal contrast distribution in the posterior mediastinum was greater in type I than type III (P = 0.003). The incidence of abnormal contrast distribution in the pericardial and aortopulmonary windows, type I was greater than type III (P = 0.008). And the incidence of abnormal distribution of contrast agent in the bilateral cervical or subclavian region was greater in type II than type III (P = 0.002). Conclusion The combined application of the 99Tcm-DX lymphoscintigraphy and CTL is of great value for the localized and qualitative diagnosis of primary chylopericardium and explore the pathogenesis of lesions.
Rationale and Objectives: To develop a fully automated deep-learning (DL) model using digital radiography (DR) with relatively high accuracy for predicting the efficacy of non-vascularized fibular grafting (NVFG) and identifying suitable patients for this procedure. Materials and Methods: A retrospective analysis was conducted on osteonecrosis of femoral head patients who underwent NVFG between June 2009 and June 2021. All patients underwent standard preoperative anteroposterior (AP) and frog-lateral (FL) DR. Subsequently, the radiographs were pre-processed and labeled based on the follow-up results. The dataset was randomly divided into training and testing datasets. The DL-based prediction model was developed in the training dataset and its diagnostic performance was evaluated using the testing dataset. Results: A total of 339 patients with 432 hips were included in this study, with a hip preservation success rate of 71.52% as of June 2023. The hips were randomly divided into a training dataset (n = 324) and a testing dataset (n = 108). The ensemble model in predicting the efficacy of NVFG, reaching an accuracy of 78.9%, a precision of 78.7%, a recall of 96.0%, a F1-score of 86.5%, and an area under the curve (AUC) of 0.780. FL views (AUC, 0.71) exhibited better performance compared to AP views (AUC, 0.66). Conclusion: The proposed DL model using DR enables automatic and efficient prediction of NVFG efficacy without additional clinical and financial burden. It can be seamlessly integrated into various clinical scenarios, serving as a practical tool to identify suitable patients for NVFG.
Background:Epicardial adipose tissue (EAT) is related to atrial fibrillation. The association between EAT volume and premature ventricular complexes (PVCs) remains unclear. Our study aimed to investigate the effect of EAT volume on the risk of frequent PVCs and burden levels of PVCs.Methods:This observational study retrospectively recruited consecutive patients who had consultation between 2019 and 2021 at the First Affiliated Hospital of Zhengzhou University. Frequent PVC patients (n = 402) and control patients (n = 402) undergoing non-contrast computed tomography (CT) were enrolled. We selected evaluation criteria for the conduct of a 1:1 propensity score matching (PSM) analysis. Multivariable logistic analysis was used to investigate factors related to frequent PVCs. Furthermore, the determinants of EAT volume and the burden levels of PVCs were evaluated.Results:Patients with PVCs had a significantly larger EAT volume than control patients. EAT volume was significantly larger in male PVC patients with BMI ≥24 kg/m2, diabetes mellitus, and E/A ratio <1. EAT volume was independently associated with PVCs. Moreover, the larger EAT volume was an independent predictor for the high burden level of PVCs. We revealed that the risk of high PVC burden level was increased with the rising of EAT volume by restricted cubic splines.Conclusions:EAT volume was larger in frequent PVC patients than in control patients, regardless of other confounding factors. A large EAT volume was independently associated with high burden levels of PVCs. EAT volume may be a new mechanism to explain the pathogenesis of PVCs.
Purpose: To develop models based on radiomics and genomics for predicting the histopathologic nuclear grade with localized clear cell renal cell carcinoma (ccRCC) and to assess whether macro-radiomics models can predict the microscopic pathological changes. Method: In this multi-institutional retrospective study, a computerized tomography (CT) radiomic model for nuclear grade prediction was developed. Utilizing a genomics analysis cohort, nuclear grade-associated gene modules were identified, and a gene model was constructed based on top 30 hub mRNA to predict the nuclear grade. Using a radiogenomic development cohort, biological pathways were enriched by hub genes and a radiogenomic map was created. Results: The four-features-based SVM model predicted nuclear grade with an area under the curve (AUC) score of 0.94 in validation sets, while a five-gene-based model predicted nuclear grade with an AUC of 0.73 in the genomics analysis cohort. A total of five gene modules were identified to be associated with the nuclear grade. Radiomic features were only associated with 271 out of 603 genes in five gene modules and eight top 30 hub genes. Differences existed in the enrichment pathway between associated and un-associated with radiomic features, which were associated with two genes of five-gene signatures in the mRNA model. Conclusion: The CT radiomics models exhibited higher predictive performance than mRNA models. The association between radiomic features and mRNA related to nuclear grade is not universal.
目的 基于CT形态学参数,比较颅内多发动脉瘤破裂组与未破裂组的形态学特征,并分析颅内多发动脉瘤破裂相关风险因素.方法 回顾性搜集31 例患者的临床及影像学资料.所有患者均经颅内血管造影(DSA)或手术确诊.31 例颅内多发动脉瘤患者共66 个动脉瘤,66 个颅内动脉瘤按是否破裂分为破裂组(31 个)和未破裂组(35 个).将CTA影像在工作站上进行重建后处理,获得动脉瘤最大径、纵横比(SR)、尺寸比(AR)、入射角、不规则形态等动脉瘤形态特征;利用动脉瘤最大径、位置、形态进行动脉瘤特异性预测分数计算.采用SPSS 26.0 统计学软件进行数据处理,符合正态分布的计量资料,两组间比较采用t检验;非正态分布的计量资料,两组间比较采用Mann-Whitney U检验.χ2 检验或Fisher精确概率.以P<0.05 为差异有统计学意义.结果 与未破裂动脉瘤组相比,破裂动脉瘤组最大径、AR、SR、入射角、不规则形态在破裂动脉瘤与非破裂动脉瘤组间比较差异有统计学意义(均P<0.05).破裂组以后交通动脉、大脑中动脉、前交通动脉最常见,后交通动脉占比最大;未破裂组动脉瘤以颈内动脉居多.破裂组的动脉瘤特异性预测分数显著高于非破裂组,差异具有统计学意义(P<0.05).结论 动脉瘤最大径、SR、AR、入射角、不规则形态是判断颅内多发动脉瘤破裂状态的可靠形态学参数,动脉瘤特异性预测分数判断颅内多发动脉瘤破裂状态具有较高诊断准确性.
目的 运用Meta分析评价涂层可生物降解药物洗脱支架(BP-SES)在小血管介入中的疗效.方法 检索知网、维普、万方、SinoMed、Embase、PubMed、Cochrane Library、Web of Science数据库,搜集BP-SES治疗小血管病变的随机对照实验,时间为建库起至2022 年8 月15 日,采用Revman 5.4.1 软件进行Meta分析.结果 共纳入5项RCTs,共4248 例患者,结果显示:BP-SES在改善大、小血管病变支架内再狭窄[RR =0.77,95%CI(0.31,1.90),P =0.58]、支架内血栓[RR =1.34,95%CI(0.54,3.37),P =0.53]、靶血管血运重建[RR =1.18,95%CI(0.80,1.74),P =0.39]、全因死亡[RR =1.25,95%CI(0.85,1.83),P =0.26]、心因性死亡[RR =1.62,95%CI(0.54,4.86),P =0.39]、非致死性心梗[RR =1.28,95%CI(0.84,1.93),P =0.25]和MACE事件[RR =1.42,95%CI(0.91,2.21),P =0.12]发生率差别不具有统计学意义.结论 BP-SES治疗冠状动脉小血管病变的有效性和安全性与大血管相近,可以在临床上应用.
目的 运用Meta分析评价旋磨联合切割球囊治疗冠状动脉中、重度钙化病变的可行性与安全性.方法 检索中文(知网、维普、万方、中国生物医学文献服务系统)和英文(Embase、PubMed、Cochrane Library、Web of sci-ence)数据库,搜集旋磨联合切割球囊技术治疗冠状动脉中、重度钙化病变的随机对照实验,时间为建库起至2022年2月15日,采用Revman5.4.1软件进行Meta分析.结果 共纳入6项RCTs,共522例患者,Meta分析显示:与对照组相比,观察组患者预处理后即刻获取管腔直径[MD=0.20,95％CI(0.11,0.28),P＜0.00001]和即刻获取管腔横截面积[MD=0.84,95％CI(0.73,0.95),P＜0.00001]明显更高,经皮冠状动脉介入术后支架内最小管腔直径[MD=0.16,95％CI(0.10,0.23),P＜0.00001]和支架内最小管腔横截面积[MD=0.57,95％CI(0.30,0.84),P＜0.0001]明显更高,管腔横截面积残余狭窄[MD=-2.99,95％CI(-5.13,-0.85),P=0.006]明显更低,观察组患者重复血管重建例数显著低于对照组[MD=-0.05,95％CI(-0.09,-0.01),P=0.02],两组患者MACE事件例数无统计学差异[OR=0.75,95％CI(0.26,2.14),P=0.59].结论 对于冠状动脉中、重度钙化病变,旋磨联合切割球囊预处理效果优于旋磨联合普通半顺应性球囊,且术后血运重建发生率低,安全可靠.
目的 分析颈内动脉颅内闭塞(IICAO)患者CTA图像,判断经Willis环的初级侧支循环,评估血管内机械取栓术(EVMT)预后良好的相关因素.方法 对162例行EVMT治疗的IICAO患者进行分析.搜集基线资料包括人口统计学特征、血管危险因素、ASPECTS评分、NIHSS初始评分、术后再出血例数.根据CTA图像将Willis环的形态分为4种,并结合颈动脉闭塞位置及Willis环变异情况,将初级侧支循环分为4组.通过90天后改良Rankin量表(mRS)评分来衡量术后临床结局,判断取栓术预后良好的相关因素.结果 在162例IICAO患者中,出院38.3％(62例)取栓治疗后mRS 0～2分;预后良好29.0％(47例)mRS 3～5分;死亡32.7％(53例)mRS 6分.三组间基线资料中年龄、入院NIHSS评分及房颤有统计学差异(P＜0.05),Willis发育变异比例无统计学差异(P＞0.05),有无初级侧支循环有统计学差异(P＜0.05),其中无初级侧支循环的患者死亡率57.1％.在多变量Logistic回归中,房颤及血流循环分组为预后良好的相关因素.结论 基于颈动脉闭塞位置,结合Willis环变异联合判断是否存在初级侧支循环可能是IICAO患者EVMT后疗效的预测因子.
目的 探讨基于全视野数字化乳腺X线摄影(FFDM)的影像组学在预测乳腺癌患者腋窝淋巴结(ALN)转移中的价值.方法 回顾性分析407 例乳腺癌患者的FFDM图像和临床资料,将患者以 7∶ 3 的比例随机分为训练集(n =285)和测试集(n =122).对FFDM图像的肿瘤病灶进行分割和影像组学特征提取,通过LASSO回归进行特征筛选并建立影像组学模型,计算影像组学评分.通过Logistic回归分析ALN未转移组(n =242)与转移组(n =165)间的临床危险因素并建立临床模型.根据临床危险因素和影像组学评分构建联合预测模型,并绘制列线图.绘制ROC曲线及校准曲线评价模型的效能.结果 经筛选得到 6 个影像组学特征和 3 个临床特征,分别建立影像组学、临床以及二者的联合模型,3 种模型在训练集中的曲线下面积分别为0.740、0.812、0.859,在测试集中的曲线下面积分别为0.749、0.794、0.803.联合模型列线图包含了影像组学评分、肿瘤大小、淋巴结触诊状态和FFDM观察淋巴结状态.结论 基于FFDM影像组学特征与临床危险因素构建的列线图,可以作为一种无创性的预测工具,帮助临床医师在术前评估乳腺癌患者的ALN状态.
结直肠癌是最常见的恶性肿瘤之一,其发病率居全球恶性肿瘤第三位,死亡率居第二位[1] ,其中直肠癌约占三分之一,并呈逐渐年轻化的趋势[2] . 由于不同的临床分期和肿瘤特征,直肠癌的生存率和复发率存在较大差异,低分化肿瘤、肿瘤穿孔、淋巴血管浸润、神经周围浸润和微卫星不稳定性等病理和分子特征已确定为不良预后因素. 大量证据表明壁外血管侵犯(extramural vascular invasion,EMVI)是局部肿瘤复发、异时性淋巴结转移和远处转移以及总体死亡率的独立预测因子[3 ～7] . 同时,无论在初始诊断时还是新辅助治疗后,EMVI阳性状态都可以通过MRI以高精度和可重复性进行检测. 本文就直肠癌EMVI的MRI影像及相关基础研究进行综述.
目的 探讨基于CT图像影像组学特征的不同机器学习模型对非小细胞肺癌表皮生长因子受体(EGFR)突变的预测价值.方法 回顾性分析有完整 EGFR突变检测结果的非小细胞肺癌患者,将 CT图像导入 ITK-SNAP软件勾画感兴趣区,通过Python提取影像组学特征.按照 7∶ 3 划分为训练集和验证集,在训练集中通过F检验和最小绝对收缩和选择算法(LASSO)回归筛选最具有预测价值的影像组学特征,分别构建逻辑回归(LR)、决策树(DT)、随机森林(RF)、神经网络(NN)、支持向量机(SVM)、朴素贝叶斯(NB)、K-最近邻法(KNN)等7 种机器学习模型,在验证集中进行评价.结合最优机器学习模型和有预测价值的一般资料建立列线图,校准曲线评估列线图的预测误差.绘制受试者工作特征曲线,曲线下面积(AUC)、F1 Score、准确率、精确率、召回率、特异度、敏感度等评估模型预测效能,DeLong检验用来比较AUC之间的差异.结果 共纳入198 例患者,每例提取1050 个影像组学特征,最终筛选出16 个组学特征,机器学习模型中随机森林模型效能最优,在训练集中的AUC、F1 Score分别为0.988、0.983,验证集中AUC、F1 Score分别为0.793、0.653.结论 基于CT图像影像组学特征的随机森林模型预测非小细胞肺癌EGFR突变的性能最优,一般资料的加入未能显著提高预测能力.
目的 研究心房颤动(AF)患者心脏CT血管造影(CCTA)左心耳(LAA)充盈缺损病例中提示左心耳血栓(LAAT)的影像征象.方法 搜集行CCTA检查并出现LAA充盈缺损的AF患者64 例,分析充盈缺损区与正常密度心腔交界面的形状、走行和清晰度,充盈缺损区密度均匀度,环绕征、飘带征等征象,与最终结果对照,分析上述征象诊断LAA的敏感度(TPR)、特异度(TNR)、阳性预测值(PPV)、阴性预测值(NPV).结果 64 例最终诊断LAAT 27 例,所有征象中,交界面走行的 TPR(100%)和 NPV(100%)最高,TNR(59%)较低;环绕征的 TNR(100%)和PPV(100%)最高,TPR(33%)较低,交界面形状的 TPR(78%)和 TNR(73%)最为均衡;飘带征 TPR(11%)和TNR(70%)均较低,但征象特殊;通过交界面形状与清晰度两征象联合应用,可显著提高TNR(95%)和PPV(90%),而交界面形状、清晰度与密度均匀度三征象联合应用,可获得除环绕征外最佳的TNR(97%)和PPV(94%).结论 对LAA出现充盈缺损的AF患者重点从交界面走行、形态、清晰度、密度均匀度进行综合分析,交界面走行呈曲面且形态不规则、密度不均匀,是LAAT的高风险征象,环绕征是LAAT的特异性征象;飘带征可能预示LAA处于高凝状态,值得进一步研究.
目的 探究经颈静脉肝内门体静脉分流术(TIPS)后显性肝性脑病(OHE)的发生率并分析相关危险因素.方法 回顾性分析接受TIPS术治疗的263 例肝硬化患者的临床资料.搜集患者基线资料,统计术后 3 个月OHE发生情况,筛选出与TIPS术后OHE发生密切相关的因素,获取有统计学意义的变量,进行二元Logistic回归分析,构建受试者特征曲线,建立TIPS术后OHE发生的预测模型.结果 术后OHE的发生率为 22.1%(58/263).OHE组和无OHE组在年龄、糖尿病史、乙肝病史、TBIL、INR、PT、血氨、门静脉流速、Child-Pugh评分、Child-Pugh分级、MELD评分、MELD-Na +评分、术后门静脉压力比较,差异有统计学意义(P<0.05).年龄、糖尿病史、乙肝病史、血氨、Child-Pugh分级为TIPS术后OHE发生的独立危险因素(P<0.05).联合年龄、糖尿病史、乙肝病史、血氨、Child-Pugh分级构建的临床预测模型曲线下面积为 0.841.结论 TIPS术后OHE发生的独立危险因素为年龄、糖尿病史、乙肝病史、血氨和Child-Pugh分级.基于Logistic回归分析构建临床预测模型可进行个体化预测,实现临床获益最大化.
目的 探讨基于无线整合型MRI放大器(WAND)耦合头颈联合线圈高分辨MRI扫描技术在牙齿及牙周疾病检查中的可行性.方法 对 15 例健康志愿者双侧下颌牙行常规(采用头颈联合线圈)MRI 扫描和高清(WAND耦合头颈联合线圈)MRI扫描后获两组图像,比较两组图像的主观评分及客观评价,其主观评分包括对下颌管、下牙槽神经血管束及牙髓腔(牙髓、根管及根尖)等细微结构的显示情况;客观评价包括图像的信号强度、噪声、SNR及CNR.结果 与常规组比较,高清组图像的信号强度、噪声、SNR及CNR差异均具有统计学意义(t = 15.51,P<0.05;t =2.97,P<0.05;t =10.85,P<0.05;t =11.31,P<0.05),高清组图像信号强度为 1595.19±414.20,较常规组提高 41%;SNR为 135.00±47.26,较常规组提高 108%;CNR为 125.23±45.22,较常规组提高131%;与常规组相比,高清组对下颌管、下牙槽神经血管束及牙髓腔(牙髓、根管及根尖)结构的主观评分明显提高且差异有统计学意义(P值均<0.05),高清组对各细微结构成像效果更清晰准确.结论 WAND高分辨MRI扫描技术可提高牙髓腔及下牙槽神经血管束等超精细结构的显示能力,为牙齿及牙周疾病精准治疗提供可靠依据.
目的 探讨对比增强能谱乳腺摄影(CESM)的辐射剂量影响因素.方法 回顾性搜集200 例患者的临床基本资料、乳腺摄影参数和诊断结果,包括:年龄、体重、月经状态、腺体厚度、压迫力度、平均腺体剂量(AGD)、腺体密度、病理学结果、BI-RADS分类结果等.使用单因素及多元逐步回归对各因素的影响进行统计分析.结果 单因素分析显示除健患侧(U =-0.52,P =0.60),其余因素均对AGD有影响.多元逐步回归分析显示ADG随腺体厚度的增加而增加(B =0.053,P<0.05),随腺体密度的增加而减小(B =-0.083,P<0.05);随压迫力度的增加而减小(B =-0.016,P<0.05);阳极材料为钼靶时AGD大于铑靶(B =-0.380,P<0.05);内外侧斜位的AGD大于头尾位(B =0.077,P<0.05).腺体厚度、靶材料、腺体密度、压迫力度、体位的标准回归系数分别为 0.873、-0.273、-0.153、-0.148、0.064.结论 腺体厚度、靶材料、腺体密度、压迫力度、体位均为影响AGD的独立因素.其中腺体厚度对AGD的影响最大.
患者 男,11 岁. 无明显诱因出现右侧腹部刺痛不适7 天余,刺痛呈持续性,不可忍受,无尿频、尿急、尿不尽,肉眼血尿,无其他伴随症状. 5 年前行阑尾切除术,术后恢复良好. 专科查体:右肾区轻微压痛及叩击痛.
