To explore the accuracy of controlled attenuation parameter(CAP)in assessing liver steatosis in chronic hepatitis B,and to analyze factors affecting the diagnostic accuracy of CAP.The clinical data of 215 patients with chronic hepatitis B were retrospectively collected,the diagnostic performance of CAP was analyzed using the receiver operating characteristic(ROC)curve,and the optimal cutoff value of CAP to evaluate different degrees of hepatic steatosis was obtained to distinguish different degrees of hepatic steatosis.To analyze the inconsistency between CAP and magnetic resonance proton density fat fraction(MRI-PDFF)in assessing the stage of hepatic steatosis.Logistic regression was used to analyze risk factors for CAP misdiagnosis.The results showed that in the entire study population,CAP had good diagnostic performance in diagnosing steatosis with or without steatosis,mild steatosis,and moderate to severe steatosis.According to the inconsistency in the diagnosis of steatosis stage between CAP and MRI-PDFF,patients were divided into a diagnostic consistency group and a diagnostic inconsistency group.Logistic regression results showed that age and BMI were independent risk factors for misdiagnosis of CAP.Although CAP has a certain misdiagnosis rate in assessing hepatic steatosis in chronic hepatitis B,it still has good diagnostic accuracy.
The purpose of this study was to investigate the role of CT signs in the perforation of acute appendicitis in the elderly,so as to improve the diagnosis level of the disease.The CT imaging data of 36 cases of acute appendicitis perforated by laparoscopic appendectomy and pathologically confirmed were retrospectively analyzed and compared with 102 cases of acute appendicitis without perforation.Appendiceal diameter,appendiceal fecalith,air accumulation in appendiceal cavity,air accumulation outside appendiceal cavity,peritoneal thickening and abdominal and pelvic effusion were clearly shown,with statistical differences(P＜0.05).There was no significant difference in fat density around the appendix(P＞0.05).The most direct sign in the qualitative diagnosis of perforation of appendicitis was extravehicular gas(100％).Binary Logistic regression analysis showed that appendix diameter,peritoneal thickening and abdominal and pelvic effusion were the risk factors for appendix perforation(P＜0.05).The ROC curve showed that the diameter of the appendix increased(AUC=0.769),the peritoneum thickened(AUC=0.696)and the abdominal pelvic effusion(AUC=0.601).When appendectomy diameter thickened ≥12.35 mm,peritoneal thickening combined with abdominal and pelvic effusion combined diagnosis,the area under ROC curve was up to 0.840.It can be seen that CT image features can provide reliable imaging indicators for the perforation of acute appendicitis in the elderly,and have guiding significance for clinical treatment.
Multivariate Logistic regression analysis was used to construct an MRI multiparametric diagnostic prediction model of breast nodules and to verify the diagnostic efficacy of this model.A total of 205 lesions were retrospective analysis in patients with breast lesions,including 113 malignant lesions and 92 benign lesions.The morphological and kinetic characteristics of the benign and malignant lesions were observed.Using the malignant group as the experimental group and the benign group as the control group,205 lesions were randomly divided into 174 samples in the training set and 31 samples in the external validation test set.Through statistical analysis,build the prediction model with the training set data and draw its nomogram;use the external verification test set sample to verify the consistency of model diagnosis;draw the receiver operator characteristic(ROC)curve and verify the differentiation of the model by calculating the area under the curve(AUC)to evaluate the sensitivity,specificity and accuracy of the model in the differential diagnosis of benign and malignant breast nodules.After screening,the independent risk factors included in the prediction model were patient age and lesion ADC value,TIC curve,lesion size.and enhancement characteristics.After the study,the prediction accuracy of the prediction model for benign and malignant breast nodules reached 92.2％in this sample.Therefore,the nomogram based on Logistic regression analysis has a high reference value for the prediction of benign and malignant breast nodules.
Studying the diagnostic sensitivity of abdominal ultrasound combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in ovarian tumor-like lesions.In patients with clinically suspected ovarian tumor-like lesions.All patients underwent abdominal ultrasound DOS combined with DCE-MRI,with the postoperative pathological results as the"gold standard".To explore the positive and negative findings of abdominal ultrasound combined with DCE-MRI.Compare the diagnostic efficacy of abdominal ultrasound combined with DCE-MRI(specificity,sensitivity).Also compare the resistance index(RI)of abdominal ultrasound combined with DCE-MRI examination.Automatic calculation of volume transfer constant(Ktrans),rate constant(Kep)and the vascular extracellular space volume ratio(Ve)using matching software.Receiver operator characteristic(ROC)curve analysis model diagnostic value.The results found that the sensitivity of abdominal ultrasound combined with DCE-MRI(96.77％)and specificity(98.55％)were higher than those of single abdominal ultrasound and DCE-MRI(P＜0.05).The RI index of ovarian tumor group was higher than that of ovarian tumor group,and Ktrans,Kep and Ve levels were lower than that of ovarian tumor group(P＜0.05).The optimal cut-off value of drawing ROC curve prediction model was 0.088,suggesting that the diagnostic value of abdominal ultrasound combined with DCE-MRI in ovarian tumor lesions was high.
To explore the risk factors affecting intraoperative bleeding volume in cesarean scar pregnancy(CSP)after cesarean section,and to search for clinical and ultrasound indicators that can predict intraoperative bleeding volume in CSP.A retrospective study was conducted to analyze the clinical and ultrasound data of 133 patients with CSP,and the patients were divided into group A(bleeding volume＜100 mL)and group B(bleeding volume≥100 mL)based on whether the intraoperative bleeding volume was more than 100 mL.Logistic regression model was used to analyze the risk factors related to intraoperative bleeding volume in patients.Logistic regression model screened the maximum diameter of gestational sac and the residual myometrial thickness as independent risk factors for predicting intraoperative bleeding volume,with cutoff values of 32.5 mm and 2.45 mm,respectively.In this study,we concluded that residual myometrial thickness and the maximum diameter of gestational sac are independent risk factors for predicting intraoperative bleeding volume during CSP.
Deep learning algorithm is an important branch in the field of artificial intelligence,and intelligent technologies represented by deep learning algorithms have gradually applied to the medical field.Hepatocellular carcinoma is a common malignant tumor of the digestive system in China,and its incidence and mortality remain high,which seriously endangers people's life and health.Timely diagnosis,precise treatment and prognosis evaluation of patients with hepatocellular carcinoma to improve their survival quality and survival rate have always been the key and difficulties in clinical research.Deep learning provides an intelligent method for the diagnosis and treatment of hepatocellular carcinoma.This study summarizes the relevant research on the application of deep learning algorithm to the imaging diagnosis and treatment of hepatocellular carcinoma at home and abroad.
The differences of intracranial vascular plaque parameters between high-resolution magnetic resonance imaging(HR-MRI)in elderly patients with primary and recurrent cerebral infarction were compared,and the relationship between the characteristic parameters of intracranial vascular plaque and the prognosis of patients was discussed.A total of 179 elderly patients with cerebral infarction were retrospectively selected.All patients underwent HR-MRI examination before treatment.According to the cause of hospitalization,the patients were divided into primary group and recurrent group.The differences of HR-MRI intracranial vascular plaque parameters between the two groups were compared.According to the clinical outcomes,the patients were divided into good prognosis group and poor prognosis group.Univariate and multivariate Logistic regression analysis were used to analyze the relationship between HR-MRI intracranial vascular plaque parameters and other factors and the prognosis of patients with cerebral infarction.The receiver operating characteristic(ROC)curve was used to analyze the efficacy of HR-MRI intracranial vascular plaque parameters in predicting the poor prognosis of patients with cerebral infarction.The results indicate there was no significant difference in plaque remodeling and eccentricity index between the initial and recurrent cerebral infarction groups(P＞0.05).There were significant differences in intracranial vascular plaque area,plaque load,plaque hemorrhage ratio and plaque enhancement degree between the two groups(P＜0.05).Univariate and multivariate results showed that recurrent cerebral infarction,infarct size,increased NIHSS score,increased plaque load,and intraplaque hemorrhage were independent influencing factors for poor prognosis in patients with cerebral infarction.The AUC of plaque burden,intraplaque hemorrhage,plaque enhancement and predictive probability based on HR-MRI in predicting the risk of poor prognosis in patients with cerebral infarction were 0.658,0.604 and 0.616,respectively,and the specificities were 77.8％,76.9％and 82.9％,respectively.The combined prediction AUC was 0.727,the sensitivity was 79.0％,and the specificity was 53.8％.The above findings the characteristics of intracranial vascular plaques in patients with primary and recurrent acute cerebral infarction are different.The characteristics of intracranial vascular plaques are closely related to the prognosis of patients with cerebral infarction.The characteristics of intracranial vascular plaques in cerebral infarction by HR-MRI are helpful to predict the prognosis of patients with cerebral infarction.
To explore the feasibility of low dose combined with low concentration contrast agent in 320-row coronary computer tomography(CT)angiography.153 patients who underwent coronary computer tomography angiography were prospectively collected.49 patients were included in group A,52 patients were included in group B,and 52 patients were included in group C.The tube voltage of three groups were 80 kV,100 kV and 100 kV,respectively.The concentration of contrast agent of three groups were 300 mgI/mL,300 mgI/mL and 350 mgI/mL,respectively.Statistical data are shown,there were no significant differences in the CT values of the middistal left anterior descending(LAD)and the distal left circumflex(LCX)of three groups(P＞0.05),and the CT values of the other segments in group A were higher than those in group B and C(P＜0.05).There were no significant differences in the noise values of the middistal LAD,LCX and right coronary artery(RCA)in the three groups(P＞0.05).There were no significant differences in signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR)and subjective scores among the three groups(P＞0.05).The radiation dose of group A was significantly lower than that of group B and group C(P＜0.05).In conclusion,low dose combined with low concentration contrast agent can be used in 320-row coronary CTA,which is conducive to reducing the harm of X-ray radiation and high concentration of contrast agent to patients.
To investigate the clinical application value of metal artifact correction(MAC)to reduce metal artifact in CT after total ankle arthroplasty.40 patients who underwent CT reexamination after total ankle arthroplasty were retrospectively collected.The original data were reconstructed by MAC technique and KARL-3D iterative reconstruction and divided into two groups,group A was reconstructed by MAC technique and group B was reconstructed by KARL-3D iterative reconstruction.In group A and group B,the same two layers(tibial prosthesis and talus prosthesis)were selected to characterize the region of interest(ROI),measured the CT value and image noise,calculated the mean value,and calculated the signal-to-noise ratio(SNR)and contrastive noise ratio(CNR)using muscle as reference.Group A and group B were scored subjectively by two radiologists through blind method.The results show that,compared with group B,the CT values of the metal high density area,joint space beside prosthesis and bone tissue in group A were reduced,while the CT values of the metal low density area were increased.The image noise values in group A were all lower than those in group B,with statistical significance(P＜0.05).SNR,CNR and image score of group A were higher than those of group B,with statistical significance(P＜0.05).MAC reconstruction technique can reduce metal artifacts in CT examination after total ankle joint replacement,improve image quality,and has good clinical application value.
This study aims to improve the understanding of cardiovascular complications of KDSS by retrospectively analyzing the echocardiographic manifestations of children with Kawasaki disease shock syndrome(KDSS)in the acute phase.A total of 20 children diagnosed as KDSS and 41 children diagnosed as hemodynamically stable Kawasaki disease(KD)were collected as study subjects to compare their echocardiographic characteristics in the acute phase.There were no statistically significant differences in age and sex between the KDSS group and the control group;the incidence of coronary artery dilatation and mitral regurgitation in the acute phase of echocardiographic manifestation was significantly higher than that of the control group,and the differences were statistically significant(P＜0.05).KDSS is more likely to cause cardiovascular system complications and requires closer echocardiographic monitoring;mitral regurgitation is a characteristic manifestation of KDSS in the acute phase.
This article explores the factors leading to brain injury in children with patent ductus arteriosus(PDA)based on ultrasound cerebral blood flow parameters.207 premature infants with PDA were divided into a non brain injury group(148 cases)and a brain injury group(59 cases)as the study subjects.Compare the clinical data and cerebral blood flow parameters of two groups of research subjects,and analyze the risk factors that may cause brain injury.The efficacy of combining clinical indicators and cerebral blood flow parameters in predicting the occurrence of brain injury.Build a column chart model and validate it.The results showed that birth weight,chorioamnionitis,5-minute Apgar score,middle cerebral artery resistance index(RI),and anterior cerebral artery RI were all influencing factors for the occurrence of brain injury in premature infants with PDA(OR＞1,P＜0.05).The column chart prediction model has good discrimination,accuracy,and effectiveness.The combination of cerebral blood flow parameters and clinical indicators has higher diagnostic efficacy in predicting brain injury.
To evaluate the value of imaging tumor burden score(TBS)combined with serum alpha-fetoprotein(AFP)in the prognosis of hepatocellular carcinoma(HCC)after transarterial chemo-embolization(TACE).Clinical and imaging data of 87 HCC patients who underwent TACE were collected.The TBS scores were calculated from CT-enhanced images.OS was compared between groups using Kaplan-Meier survival curves and log-rank test.The median survival of HCC patients after TACE was 20.5 months,and the mean TBS score was 9.52±3.26.The results showed that the 3-year OS decreased progressively with increasing TBS(P＜0.001);the difference in OS between patients with TBS≤9.9 and TBS＞9.9 was statistically significant(P＜0.001).Patients'pre-TACE AFP levels were moderately negatively correlated with OS(r=-0.519;P＜0.001),and OS was worse in patients with AFP≥400 ng/mL compared with those with AFP＜400 ng/mL(P=0.001).Multifactorial analysis showed that patients with TBS≤9.9 and AFP≥400 ng/mL(HR:5.449;95％CI:1.951-15.217;P=0.01),TBS＞9.9 and AFP＜400 ng/mL(HR:13.576;95％CI:5.873-31.382;P＜0.001)and TBS＞9.9 and AFP≥400 ng/mL(HR:27.854;95％CI:8.950-86.683;P＜0.001)were both independent predictors of OS after TACE in patients with hepatocellular carcinoma,and the OS of patients with TBS≤9.9 and AFP＜400 ng/mL was better than the other three groups(P＜0.05).Therefore,the image-based TBS score combined with AFP level has a high value in the prognosis assessment of HCC patients with TACE.
In this study,the distribution,metabolism and tumor targeting efficiency of Enolase 1(ENO1)monoclonal antibody(mAb)in cervical cancer bearing mice were investigated by near infrared fluorescence imaging.The relationship between ENO1 expression and tumor stage,prognosis and tumor immune invasion was analyzed by cancer genome atlas.Cy7-NHS and FITC were coupled with ENOl mAb to form Cy7-ENO1 mAb and FITC-ENOl mAb,and the localization of ENOl mAb in cervical cancer cell TC-1 was verified by laser confocal microscopy,and the subcutaneous tumor model of cervical cancer was established.Near infrared fluorescence(NIRF)imaging was performed at 1,6,24,48,72.and 120 h after caudal intravenous injection of Cy7-ENO1 mAb.After 24 h of imaging,major organs were rapidly dissected for in vitro imaging.Bioinformatics results showed significant differences in the expression of ENOl between normal cervical tissue and cervical cancer tissue while immunohistochemistry(IHC)indicated higher ENOl protein expression in cervical cancer tissues.In addition,the expression of ENOl was significantly correlated with tumor stage and lymph node stage,and the high expression of ENO1 was correlated with multiple glycolytic enzymes.Confocal laser microscopy showed that FITC-ENOl mAb could specifically bind to the surface of TC-1 cell membrane,and no cell internalization was observed.Near infrared fluorescence imaging showed that Cy7-ENO1 mAb was mainly enriched in liver,kidney and tumor tissues,and had high tumor targeting efficiency.NIRF imaging allows real-time and dynamic monitoring of ENOl mAb distribution in cervical cancer bearing mice,whose metabolic organs are mainly liver and kidney,and confirms ENOl mAb's targeting of cervical cancer.
系统评价术前计算机体层灌注成像(CTPI)参数对肝癌经肝动脉化疗栓塞(TACE)术后早期反应的预测价值.通过计算机检索中国知网、万方、维普、PubMed、Medline、Web of Science、Embase数据库中有关CT灌注成像和TACE预后关系的研究,使用RevMan 5.4软件进行Meta分析,效应量为均数差(MD),各效应量以95％置信区间(CI)表示.共纳入7篇文献,包括433名患者,共475个肿瘤病灶.Meta分析结果显示,肝癌TACE术后有反应组和无反应组肝动脉灌注量(ALP)差异有统计学意义(MD=16.84,95％CI 2.06～31.62,P＜0.05),有反应组ALP明显高于无反应组,最佳截断值范围为9.885～22.175 mL/(100 mL·min);肝癌TACE术后早期有反应组和无反应组门静脉灌注量(PVP)、肝动脉灌注指数(HPI)、血流量(BF)、血容量(BV)、平均通过时间(MTT)、达峰时间(TTP)差异无统计学意义(P＞0.05).术前高ALP可以预测肝癌TACE术后早期有效,但是ALP更确切的截断值需要进一步研究.
超微血流成像(SMI)、能量多普勒超声(PDUS)在痛风性关节炎诊断中的应用价值.选取痛风性关节炎患者98例,均给予SMI、PDUS检查,分析不同时期及不同水平超敏C反应蛋白(hs-CRP)患者痛风石和滑膜增生血流分级情况.结果显示,痛风性关节炎患者的超声影像学表现为关节腔积液、多点状高回声、痛风石、双轨征、滑膜增厚.急性期患者hs-CRP水平高于缓解期患者(P＜0.05).与PDUS模式相比,痛风石与滑膜增生SMI模式血流分级中高分级(2、3级)例数更多(P＜0.05),低分级(0、1级)例数更少(P＜0.05).与缓解期患者相比,急性期患者不同模式下(痛风石与滑膜增生血流分级)高分级(2、3级)更多(P＜0.05),低分级(0、1级)更少(P＜0.05).hs-CRP明显升高组患者不同模式下(痛风石与滑膜增生血流分级)高分级(2、3级)多于hs-CRP轻度增高组和正常组(P＜0.05),低分级(0、1级)少于hs-CRP轻度增高组和正常组(P＜0.05).Spearman相关分析显示,hs-CRP水平与不同模式下(痛风石与滑膜增生血流分级)呈正相关(P＜0.05),且hs-CRP水平与SMI模式分级的相关性更高(P＜0.05).因此,与PDUS相比,SMI能更多的检测出痛风性关节炎(痛风石和滑膜增生)内的血流信号,与hs-CRP水平的相关性更强,更有利于反映痛风性关节炎患者的活动性.
评价基于高分辨T2WI联合表观扩散系数图像(ADC)影像组学对前列腺癌的鉴别诊断价值.回顾性分析120例前列腺疾病患者,包括71例前列腺癌患者和49例非前列腺癌患者.将这些患者的病变分别分为外周带(PZ)和中央区(CZ)组.利用Radcloud平台对MRI图像进行数据分析,通过受试者操作特征曲线(ROC)计算曲线下面积(AUC)、敏感性、特异性,比较T2WI、ADC、T2WI+ADC影像组学诊断模型及前列腺影像报告和数据系统第二版(Pl-RADS v2)对前列腺癌的鉴别诊断价值.结果显示,在测试集中,外周带区,T2WI+ADC模型对前列腺良恶性病灶的鉴别诊断价值优于T2WI模型及PI-RADS v2(P＜0.05);在中央区,ADC模型的诊断价值优于T2WI模型及PI-RADS v2(P＜0.05);对于PI-RADS评分为3分的病灶,T2WI+ADC模型的AUC在外周带及中央区分别为0.89和0.94.基于高分辨T2WI联合ADC影像组学模型对前列腺癌的鉴别诊断价值优于PI-RADS v2,同时对于前列腺PI-RADS评分为3分的病灶也有一定的鉴别诊断价值.
探索四维动脉自旋标记(4D-ASL)在缺血性脑卒中(CIS)疗效评价中的应用价值.选取2021年8月至2023年1月期间就诊于陈家桥医院的48例发病7天内的CIS患者,分别于治疗前后行三维动脉自旋标记(3D-ASL)、4D-ASL磁共振血管造影(MRA)和功能独立性评定(FIM)评分,记录梗死核心区、健侧镜像区的脑血流量(CBF),分析治疗前后的CBF值的关系.依据3D-ASL图像梗死区周围的点状或带状高信号来判断侧支循环,分析有、无侧支循环的相对CBF(rCBF)与FIM的相关性.4D-ASL MRA观察脑血管形态.结果显示,治疗前、后梗死核心区的CBF值低于健侧镜像区的CBF值,且治疗前CBF值低于治疗后CBF值,差异具有统计学意义(P＜0.05).治疗前的rCBF、FIM评分低于治疗后的rCBF、FIM评分,治疗前后的rCBF与FIM评分呈正相关,差异具有统计学意义(P＜0.05).在梗死核心区周围,有侧支循环的rCBF高于无侧支循环的rCBF,差异有统计学意义(P＜0.05).4D-ASL MRA显示侧支血管12例,与3D-ASL的符合率为75％.4D-ASL技术可有效评估CBF和侧支循环情况,动态显示脑血管形态,达到类数字减影血管造影效果,4D-ASL在CIS疗效评价中有一定的预测价值.
近年来,水性光固化技术被越来越多地应用于生物医学领域,如牙科材料、3D生物打印、体外聚合、细胞封装等.水溶性好、细胞毒性低、引发效率高的水性光引发剂是光固化技术在生物医学领域广泛发展应用的关键物质.为此,研究人员做了大量的工作,设计开发了一系列性能优良的水性光引发剂,并研究了其在药物控释、生物仿生解毒器、细胞传感器、软骨修复、断层扫描体积生物打印、生物组织粘合剂、光动力肿瘤治疗等方面的应用效果.本文概述了水性光引发剂的种类、作用机制以及在生物医学中的一些应用研究,并对水性光引发剂的发展方向进行了展望,希望能为水性光引发剂的发展以及应用带来一些启发.
探讨联合低频振幅(ALFF)和度中心性(DC)方法在高度近视(HM)患者静息状态下局部大脑的功能变化.选取45例患者作为HM组,选择与之匹配的46例双眼正常视力参与者作为对照组.所有被试进行静息态功能磁共振成像扫描.ALFF和DC的方法进行局部脑功能差异的分析.组间比较采用基于体素层面的独立样本t检验.结果显示与对照组相比,HM组在左眶部额下回、右距状裂周围皮层、右前扣带与旁扣带脑回、左丘脑、左顶下缘角回、右顶下缘角回和左中央旁小叶的ALFF值存在统计学差异(P＜0.05);HM组在右颞下回、左颞下回、右前扣带与旁扣带脑回、左眶内额上回、左距状裂周围皮层、右梭状回、左顶下缘角回和左中央旁小叶的DC值存在统计学差异(P＜0.05).联合低频振幅和度中心性在HM患者大脑神经元活动及脑功能网络改变判断中具有较高的应用价值.
探究彩色多普勒超声检测脾静脉内径(SVD)、门静脉内径(PVD)及半定量评分与乙型肝炎肝纤维化的关系.选取202例乙型肝炎患者行超声引导下肝穿刺活检,根据肝穿刺活检结果将其分为肝纤维化组(n=112)和无肝纤维化组(n=90).多因素Logistic回归分析各指标水平与乙型肝炎患者肝纤维化之间的关系,构建乙型肝炎患者肝纤维化的预测模型和乙型肝炎患者肝纤维化风险评分系统及划分风险等级.结果显示,SVD升高、PVD升高、脾门厚度升高、脾脏面积升高、胆囊壁厚度升高、肝表面被膜升高、肝固有动脉峰值血流速度(HAVmax)升高、肝脏硬度测量(LSM)升高、丙氨酸转氨酶(ALT)升高是乙型肝炎患者肝纤维化的独立危险因素,脾脏长度降低、肝实质回声降低、肝静脉清晰度降低、门静脉峰值血流最大速度(PVVmax)升高、脾静脉峰值血流速度(SVVmax)升高是其保护因素(P＜0.05);SVD和PVD与乙型肝炎肝纤维化呈明显非线性关系(P＜0.05);对各影响因素进行风险评分,总分在0.5～24分,根据百分位数进行评分分级,低危组(n=84)＜9分,中危组(n=67)9～17分,高危组(n=51)＞17分,高危组患者肝纤维化发生率显著高于低危组和中危组(P＜0.05).乙型肝炎纤维化患者的SVD和PVD明显高于无纤维化患者,与不同程度的肝纤维化密切相关.
