BACKGROUND:Pseudocirrhosis that may be triggered by the treatment of breast cancer liver metastasis often begins insidiously and progresses rapidly. This complicates the accurate assessment of tumor growth or regression. Without timely intervention, patients are at significant risk of death due to acute liver failure or bleeding from ruptured varices. OBJECTIVE:This study aims to explore the clinical and radiological characteristics of pseudocirrhosis, providing a theoretical basis for clinicians to facilitate early diagnosis and treatment, thereby reducing the misdiagnosis rate and mortality associated with this condition. METHODS:This study conducted a retrospective analysis of clinical data and CT and MRI images from 32 patients (the pseudocirrhosis group) with pathologically confirmed breast cancer liver metastasis and radiological features of pseudocirrhosis, and 28 patients (the control group) with breast cancer liver metastasis without pseudocirrhosis, at the First Affiliated Hospital of Zhejiang University from November 2012 to January 2024. All patients were female, with an average age of 58.3 ± 8.3 years in the pseudocirrhosis group and 56.5 ± 7.8 years in the control group. In the pseudocirrhosis group, 27 patients underwent CT scans and 23 underwent routine MRI examinations. In the control group, 24 patients underwent CT scans and 20 underwent routine MRI examinations. Image analysis included the number of lesions, morphology, enhancement patterns, degree of liver capsule retraction, presence of portal hypertension, gastric varices, ascites, and abnormal nodules, as well as an analysis of patients' chemotherapy regimens, prothrombin time (PT), albumin, and cholinesterase levels. RESULTS:In our study, liver metastases in both the pseudocirrhosis group and the control group were multiple and round-shaped, with enhanced lesions exhibiting moderate to marked ring or nodular enhancement. Among the 32 cases in the pseudocirrhosis group, one patient presented with multiple liver metastases and the development of pseudocirrhosis at initial diagnosis, while the remaining 31 patients developed pseudocirrhosis following chemotherapy or combined therapy. No abnormal nodules, were observed in either group aside from the metastatic tumors. In the pseudocirrhosis group, portal vein thickening was observed in 2 cases (6.3 %), ascites in 18 cases (56.3 %), splenomegaly in 11 cases (34.4 %), and gastric varices in 3 cases (9.4 %). The liver capsule retraction was classified as diffuse in 14 cases (43.7 %), extensive in 10 cases (31.3 %), and limited in 8 cases (25.0 %). Among the 24 patients with available laboratory data, the prothrombin time (PT) was normal in 21 cases (65.6 %) and prolonged in 3 cases (9.4 %), albumin levels were normal in 14 cases (58.3 %) and decreased in 10 cases (41.3 %), and cholinesterase levels were normal in 23 cases (95.8 %) with a decrease in 1 case (4.2 %). The control group showed no signs of portal hypertension or its decompensated manifestations; among the 26 patients with available data, albumin levels were normal in 18 cases (69.2 %) and decreased in 8 cases (30.8 %); PT was normal in 24 cases (92.3 %) and prolonged in 2 cases (7.7 %); cholinesterase levels were normal in 27 cases (96.4 %) with a decrease in 1 case (3.6 %). CONCLUSION:Chemotherapy or combined therapy may be a triggering factor for the development of pseudocirrhosis in patients with breast cancer liver metastasis. In the early stages of pseudocirrhosis, liver synthetic function does not appear to be significantly affected.

To discuss CT imaging characteristics of invasive adenocarcinoma of lung(IACL). CT revealed the nodule of lung which pathology confirmed as IACL of 290 cases. Imaging data were retrospectively analyzed by dividing into high-risk group of 115 cases and low-risk group of 175. Three dimensional (3D) and magnified technology were used to show the nodules, which were observed and measured. Data of density, size and location of nodule were collected, and T-test or Chi-square test were performed. In 290 cases with IACL, all lesions appeared as nodule with lobulated and vascular/cord shadows, which can be clearly shown by the 3D and magnified images. 153 (52.8

Background:Chronic rhinosinusitis (CRS) is a chronic inflammatory disorder of the paranasal sinus and nasal cavity. Previous studies have demonstrated that patients with CRS have an increased risk of emotional and cognitive disorders. Although neuroimaging studies have identified brain alterations in CRS, the specific etiology of these neurological changes remains unclear. This study thus examined the abnormal brain networks in patients with CRS through use of a voxel-wise degree centrality (DC) approach. Methods:In this cross-sectional study, 26 patients with CRS and 38 healthy controls (HCs) were enrolled for resting-state functional magnetic resonance imaging (rs-fMRI) scans. The DC value was calculated and correlated with clinical symptoms and with anxiety and depression scores in the CRS group. Moreover, receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic utility of DC in distinguishing patients from HCs. Results:Compared with HCs, patients with CRS had decreased DC values in the right precuneus and increased DC values in the left inferior temporal gyrus (ITG) (P<0.05, false-discovery rate corrected). In addition, a positive correlation was identified between the DC values in the left ITG and disease duration (R=0.5317; P=0.0052). ROC curves analysis indicated that the DC values in the right precuneus [area under the curve (AUC) =0.7945] and left ITG (AUC =0.7915) had significant diagnostic accuracy, indicating their potential utility as imaging biomarkers for CRS. Conclusions:Altered DC in the right precuneus and the left ITG may play important roles in the pathological changes underlying CRS-related brain dysfunction.

Background Abdominal CT scans are vital for diagnosing abdominal diseases but have limitations in tissue analysis and soft tissue detection. Dual-energy CT (DECT) can improve these issues by offering low keV virtual monoenergetic images (VMI), enhancing lesion detection and tissue characterization. However, its cost limits widespread use. Purpose To develop a model that converts conventional images (CI) into generative virtual monoenergetic images at 40 keV (Gen-VMI40keV) of the upper abdomen CT scan. Methods Totally 444 patients who underwent upper abdominal spectral contrast-enhanced CT were enrolled and assigned to the training and validation datasets (7:3). Then, 40-keV portal-vein virtual monoenergetic (VMI40keV) and CI, generated from spectral CT scans, served as target and source images. These images were employed to build and train a CI-VMI40keV model. Indexes such as Mean Absolute Error (MAE), Peak Signal-to-Noise Ratio (PSNR), and Structural Similarity (SSIM) were utilized to determine the best generator mode. An additional 198 cases were divided into three test groups, including Group 1 (58 cases with visible abnormalities), Group 2 (40 cases with hepatocellular carcinoma [HCC]) and Group 3 (100 cases from a publicly available HCC dataset). Both subjective and objective evaluations were performed. Comparisons, correlation analyses and Bland-Altman plot analyses were performed. Results The 192nd iteration produced the best generator mode (lower MAE and highest PSNR and SSIM). In the Test groups (1 and 2), both VMI40keV and Gen-VMI40keV significantly improved CT values, as well as SNR and CNR, for all organs compared to CI. Significant positive correlations for objective indexes were found between Gen-VMI40keV and VMI40keV in various organs and lesions. Bland-Altman analysis showed that the differences between both imaging types mostly fell within the 95% confidence interval. Pearson's and Spearman's correlation coefficients for objective scores between Gen-VMI40keV and VMI40keV in Groups 1 and 2 ranged from 0.645 to 0.980. In Group 3, Gen-VMI40keV yielded significantly higher CT values for HCC (220.5HU vs. 109.1HU) and liver (220.0HU vs. 112.8HU) compared to CI (p < 0.01). The CNR for HCC/liver was also significantly higher in Gen-VMI40keV (2.0 vs. 1.2) than in CI (p < 0.01). Additionally, Gen-VMI40keV was subjectively evaluated to have a higher image quality compared to CI. Conclusion CI-VMI40keV model can generate Gen-VMI40keV from conventional CT scan, closely resembling VMI40keV.

Objective This study aimed to examine the correlation between BRAFV600E status and computed tomography (CT) imaging characteristics in papillary thyroid carcinoma (PTC) and determine if suspicious CT imaging features could predict BRAFV600E status. Methods This retrospective study included patients with pathologically confirmed PTC at the Department of Thyroid Surgery of Zhongshan Hospital, Xiamen University, between July 2020 and June 2022. We compared the clinicopathologic factors and CT findings of nodules with and without the mutation, and the multiple logistical regression test was used to determine independent parameters of the BRAFV600E mutation. Results This study included 381 patients with PTC, among them, BRAFV600E mutation was detected in 314 patients (82.4%). Multivariate logistic regression analysis showed that gender (OR = 0.542, 95% CI [0.296–0.993], P = 0.047) and shape (OR = 0.510, 95% CI [0.275–0.944], P = 0.032) were associated with BRAFV600E mutation. Conclusions Compared to BRAFV600E mutation-negative, BRAFV600E-positive PTC lesions were more likely to be found in female patients and were characterized by irregular shape. However, the CT imaging finding is not enough to predict BRAFV600E status, but an indication.

背景:寰椎发育演变过程复杂,研究报道较少,CT成像能很好地显示寰椎解剖.明确寰椎正常发育过程、解剖结构、发育变异与畸形有着重要的临床意义.目的:利用CT影像解剖展示寰椎正常发育与变异.方法:收集厦门市儿童医院、厦门大学附属中山医院医学影像存档与通信系统内0-14岁患者的寰椎CT资料,最终纳入732例患者的CT资料,观察寰椎前弓及双侧椎弓骨化中心,椎弓、前正中、后正中骺板、横韧带结节及寰椎发育变异或畸形.结果 与结论:①732例患者中,CT图像显示寰椎正常发育679例(占92.76％);发育畸形或变异53例(占7.24％),其中骨环不完整27例,出现副骨化中心及副骺板23例,寰枕关节畸形3例;②寰椎骨化中心3个,包括椎弓侧块2个和前弓1个,2个椎弓出现于胎儿期,1个前弓出现于生后2 d-2岁,中位年龄为6个月,四分位距为4-11个月;③寰椎骺板4个,包括椎弓骺板2个、前正中骺板1个、后正中骺板1个,2个椎弓骺板闭合中位年龄是6.2岁,年龄四分位距为4.5-7岁;前正中骺板出现率为37.43％,闭合年龄中位数为4.8岁,年龄四分位距为2.8-6.0岁;后正中骺板闭合年龄中位数为2.8岁,年龄四分位距为2-3.8岁;④横韧带结节出现的中位年龄为9岁,年龄四分位距为5.5-10岁;⑤结果显示,寰椎骨化中心出现与骺板闭合时间存在相对特定的年龄区间,寰椎发育变异或畸形以寰椎骨环不完整、副骨化中心及副骺线多见,CT影像观察寰椎发育或畸形清楚、准确,具有明显优势.

Coronary heart disease (CHD) confers a high risk of cognitive and mental impairments in patients. This study aimed to explore the association of CHD with functional connectivity and topological properties of brain networks. A total of 27 patients with CHD and 44 healthy controls (HCs) participated in this study and underwent a resting-state functional magnetic resonance imaging (rs-fMRI) scan. Intra- and internetwork functional connectivity alterations were explored using independent component analysis in CHD patients. Furthermore, graph theoretical analysis was adopted to assess abnormalities in small-world properties and network efficiency metrics of brain networks. Compared to HCs, CHD patients exhibited increased functional connectivity between the posterior default mode network and posterior visual network, as well as decreased functional connectivity between the left frontoparietal network and auditory network. In terms of graph theoretical analysis, small-world network topology was identified in both CHD patients and HCs. Furthermore, the nodal local efficiency of the left putamen was significantly decreased in CHD patients compared to HCs. This study revealed alterations in brain functional connectivity and topological properties in CHD patients, shedding light on the potential neurological mechanism underlying cognitive and mental impairments in these patients and suggesting unexplored connections between CHD and higher order cognitive processing.

Background Chronic rhinosinusitis (CRS) poses a risk for developing emotional and cognitive disorders. However, the neural evidence for this association is largely unclear. Resting-state functional magnetic resonance imaging (rs-fMRI) analysis can demonstrate abnormal brain activity and functional connectivity and contribute to explaining the potential pathophysiology of CRS-related mood and cognitive alterations. Methods Chronic rhinosinusitis patients (CRS, n = 26) and gender- and age-matched healthy control subjects (HCs, n = 38) underwent resting-state functional MRI scanning. The amplitude of low-frequency fluctuations (ALFF) was calculated to observe the intrinsic brain activity. The brain region with altered ALFF was further selected as the seed for functional connectivity (FC) analysis. Correlation analysis was performed between the ALFF/FC and clinical parameters in CRS patients. Results Compared with HCs, CRS patients exhibited significantly increased ALFF in the left orbital superior frontal cortex and reduced connectivity in the right precuneus using the orbital superior frontal cortex as the seed region. The magnitude of the orbital superior frontal cortex increased with inflammation severity. In addition, ALFF values in the orbital superior frontal cortex were positively correlated with the hospital anxiety and depression scale (HADS) scores. The ROC curves of altered brain regions indicated great accuracy in distinguishing between CRS patients and HCs. Conclusion In this study, patients with CRS showed increased neural activity in the orbital superior frontal cortex, a critical region in emotional regulation, and this region also indicated hypoconnectivity to the precuneus with a central role in modulating cognition. This study provided preliminary insights into the potential neural mechanism related to mood and cognitive dysfunctions in CRS patients.

Previous studies have indicated that the airway epithelia of lung cancer-associated injury can extend to the nose and it was associated with abnormal gene expression. The aim of this study was to find the possible lung cancer-related genes from the nasal epithelium as bio-markers for lung cancer detection. WGCNA was performed to calculate the module-trait correlations of lung cancer based on the public microarray dataset, and their data were processed by statistics of RMA and t-test. Four specific modules associated with clinical features of lung cancer were constructed, including blue, brown, yellow, and light blue. Of which blue or brown module showed strong connection to genetic connectivity. From the brown module, it was found that HCK, NCF1, TLR8, EMR3, CSF2RB, and DYSF are the hub genes, and from the blue module, it was found that SPEF2, ANKFN1, HYDIN, DNAH5, C12orf55, and CCDC113 are the pivotal genes corresponding to the grade. These genes can be taken as the bio-markers to develop a noninvasive method of diagnosing early lung cancer.

目的:讨论计算机辅助诊断肺结节良恶性的效能及影响因素.方法:回顾性分析本院2018年10月至2020年2月胸部CT发现并经手术病理证实的肺结节324个(≤30mm),其中恶性244个,良性80个.依据计算机辅助诊断系统(依图"AI系统")记录每个结节的大小、密度、位置及影像特征,获得最终良恶性诊断并与病理报告进行对比.采用SPSS 23.0软件进行统计学比较.结果:1.结节AI检测率100％,并提取影像特征.准确率、敏感度、特异度、假阳性率、假阴性率分别为0.645、0.684、0.525、0.475、0.316.病灶大小、性别、密度及影像征象在良恶性组之间有统计学差异(P＜0.05),病灶大小ROC曲线显示AUC为0.673.最佳界值选择结节为9.5mm,其敏感度为73％,特异度为56.2％;小于等于10mm结节,敏感度、特异度分别为0.115、0.775.2.年龄、性别、病灶大小及征像在假阴性组及真阳性组之间存在统计学差异(P＜0.05).结论:AI肺结节检测效能达100％,结节大于10mm时鉴别诊断效能较高.影响AI诊断准确率的原因是性别、年龄、结节大小及典型征象,特别是女性、年龄小于40岁、磨玻璃或混合密度及小于10mm结节容易误判为良性.

目的 探讨IQon光谱CT对甲状腺乳头状癌(PTC)颈部淋巴结转移的诊断价值.方法 回顾性分析经病理证实为PTC患者86例164个淋巴结的术前光谱CT影像资料,其中转移淋巴结102个、非转移淋巴结62个.比较转移淋巴结组及非转移淋巴结组的CT形态学特征差异,以及平扫期碘浓度(IC)、有效原子序数(Zeff)、能谱曲线斜率(λHU),动静脉期的标准化碘浓度(NIC)、标准化有效原子序数(N-Zeff)、λHu的差异.并绘制受试者工作特征(ROC)曲线,分析各参数对PTC转移淋巴结的诊断效能.结果 两组淋巴结在短径、明显或不均匀强化、结内钙化、囊变坏死方面都存在明显统计学差异(P＜0.05);在平扫期IC、Zeff、λHU方面差异无统计学意义(P≥0.05);两组间动脉期及静脉期NIC、N-Zeff、λHU差异均有明显统计学意义(P＜0.05).形态学特征中淋巴结明显强化的诊断效能最高,其敏感度、特异度、准确率分别约为78.43％、90.32％、82.39％.ROC曲线分析显示动脉期NIC诊断转移淋巴结的曲线下面积(AUC)约为0.940,诊断阈值为0.246,其敏感度、特异度、准确率分别约为80.39％、96.77％、86.59％,较形态学参数的诊断特异度更高(54.84％),具有相似的敏感度(88.24％).结论 IQon光谱CT能谱定量参数在评估PTC颈部淋巴结转移方面具有较高的诊断价值.

Objective. This study is aimed at exploring the spontaneous brain activity changes by measuring the fractional amplitude of low-frequency fluctuations (fALFF) and their relationship with clinical characteristics in patients with coronary heart disease (CHD). Methods. Coronary heart disease patients (n=25) and age, gender, and education level-matched control subjects (controls, n=35) were included. The grey matter volume (GMV) and fALFF values were calculated to assess the difference in brain structure and function between the two groups, respectively. Correlation analyses between the fALFF values and clinical characteristics were further assessed in CHD patients. In addition, receiver operating characteristic (ROC) curves were conducted to access the diagnostic ability of the fALFF method. Results. There was no significant difference in GMV between the CHD and control groups. Compared with the control group, patients with CHD showed significantly decreased fALFF in the left precentral/postcentral gyrus and increased fALFF in the right inferior cerebellum. Patients with a history of myocardial infarction (MI) showed significantly decreased fALFF values of the right inferior cerebellum than patients without MI. There was no significant correlation between the fALFF values in specific brain regions and disease duration. Furthermore, the ROC curves of abnormal brain regions showed the perfect accuracy of the fALFF value in distinguishing between CHD patients and controls. Conclusion. CHD demonstrated aberrant neural activity in specific brain regions mainly related to sensorimotor networks and pain processing, which may contribute to understanding the underlying neurological mechanism of CHD.

目的:通过对硬脑膜动静脉瘘(DAVF)与脑动静脉畸形(AVM)的CT血管重建影像特征分析,探讨其在DAVF和AVM的影像鉴别诊断中的价值.方法:收集自2014年7月至2021年8月期间109例脑血管畸形患者,其中53例为DAVF,56例为AVM患者,所有患者都行CT平扫及CTA检查,以DSA作为金标准,对供血动脉、畸形血管、静脉窦边缘不规则、引流静脉窦扩张、异常穿颅血管、皮层静脉扩张、双侧颈内静脉密度不对称7个影像征像进行对比,并统计分析.结果:供血动脉、畸形血管、静脉窦边缘不规则、引流静脉窦扩张这4个征象有统计学意义,异常穿颅血管、皮层静脉扩张、双侧颈内静脉密度不对称这3个征象没有统计学意义.结论:多模态CT可以对DAVF和AVM提供一种安全、准确的诊断方法,供血动脉、畸形血管、引流静脉窦扩张在DAVF和AVM鉴别诊断中有高度提示作用.

目的 探讨超高分辨CT(U-HRCT)靶重建在新型冠状病毒肺炎(COVID-19)精准诊断中的价值.方法 回顾性分析13例COVID-19,44例其他肺炎,6例磨玻璃结节患者的CT图像,分为A组(C-HRCT)及B组(U-HRCT),分别采取iDose4-3、iDose4-5进行回顾性靶重建,评估不同重建图像在同一层面肺窗的CT值、噪声(SD)、信噪比(SNR);2名影像学医师以5分制对图像质量及显示病灶结构进行主观评分.结果 同一选代等级,U-HRCT图像的SNR低于C-HRCT图像,SD高于C-HRCT图像,差异有统计学意义(P＜0.05).二元logistic回归分析显示磨玻璃病灶内血管增粗、病灶胸膜下分布、小叶间隔显示和铺路石征象是判断COVID-19的独立预测因子.U-HRCT对磨玻璃病灶内血管增粗、支气管管壁及小叶间隔显示上优于C-HRCT,差异有统计学意义(P＜0.05).结论 U-HRCT在诊断COVID-19较C-HRCT有优势,特别是在显示病灶关键细节方面.

背景:探讨痛性足副舟骨的影像学诊断价值,指导临床实施治疗,最大限度提高治疗效果.目的:分析足副舟骨的发生率、解剖变异分型及损伤后的影像学表现,提高对痛性足副舟骨的认识.方法:回顾性收集本院2017-2019年期间336例(男212例,女124例)因外伤后足部疼痛或持续慢性足部疼痛的患者,拍摄患足X线正斜位片,其中15例行CT检查,5例行MRI检查.统计足副舟骨的发生率和解剖变异分型,分析不同摄片位置足副舟骨的显示率及其多种影像学特征.结果 与结论:足痛患者336例(男212例,女124例)中,发现副舟骨52例,发生率约为15.5％.在52例足副舟骨中分3型,Ⅰ型15例(28.8％),Ⅱ型32例(61.5％),Ⅲ型5例(9.7％).足正位及内、外斜位X光片显示率分别约为85.7％、66.1％、100％,三组间两两比较有统计学意义(P＜0.016).CT、MRI均能显示副舟骨,CT三维成像展现足副舟骨与舟骨关系清楚,MRI可显示局部骨髓水肿和软组织病变.足副舟骨Ⅱ型最常见,足正位及外侧斜位片是足舟骨损伤的首选影像学检查,CT、MRI检查显示更全面.足副舟骨并不少见,分析其解剖与分型,可以提高诊断准确率,减少临床误诊与误治.

目的 探讨双能CT的单能量图像和融合图像在下肢动脉的应用价值.方法 对行下肢动脉双能量成像的患者所采集图像数据进行回顾性重组得到权重配比为0.7的线性融合图像、最佳非线性融合图像(OCM),根据对比噪声比(CNR)能谱曲线优选的最佳单能量图像(Mono-E),比较三组图像下肢各段动脉(腹主动脉分叉、髂总动脉分叉、股动脉中段、腘动脉近端)的CT值、噪声(SD)、CNR、信噪比(SNR)及进行主观图像质量评分.结果 线性融合图像、OCM图像及Mono-E图像的下肢各段动脉平均CT值分别为(456.80±154.56)HU、(559.35±187.88)HU、(505.03±170.97) HU,三者间差异有统计学意义(P＜0.05);SD分别为(14.56±5.28) HU、(12.50±4.78)HU、(15.33±6.44) HU,三者间差异有统计学意义(P＜0.05);CNR分别为30.47±15.60、46.76±25.89、34.20±20.88,三者间差异有统计学意义(P＜0.05);SNR分别为34.86±16.85、50.67±26.45、38.67±22.55,三者间差异有统计学意义(P＜0.05).OCM图像的CT值、CNR、SNR均高于线性融合图像及Mono-E图像,差异具有统计学意义(P＜0.05).下肢动脉腘动脉段最佳CNR单能量水平在61 ～ 66 keY,平均(63.03±1.29) keV.图像质量主观评分方面,OCM与Mono-E图像评分高于线性融合图像,差异具有统计学意义(P＜0.05);在主髂动脉部分,三组图像评分差异无统计学意义(P＞ 0.05);在膝下动脉部分,Mono-E图像评分高于OCM图像,差异具有统计学意义(P＜0.05).结论 下肢动脉双能CT成像中OCM图像质量最好.最佳单能量(63 keY)图像成像质量有所提高,在膝下动脉分支显示上有优势,可以在临床血管成像方面广泛应用.

Objective:To establish and verify the prediction model of benign or malignant of solitary pulmonary nodules (SPNs≤20 mm) based on artificial intelligence.Methods:Totally 338 SPNs (≤20 mm) from 279 patients, confirmed by operation and pathology, were selected in Zhongshan Hospital Xiamen University from November 2018 to May 2020. Clinical data (age, gender, smoking history, individual and family history of malignancy), image features (maximum diameter, minimum diameter, solid proportion, volume, lobulation sign, burr sign, vacuole sign, cavity sign, pleural indentation sign, and radiomic features (maximum CT value, minimum CT value, average CT value, median CT value, CT value standard deviation, skewness, peak, energy, entropy) were analyzed retrospectively. All the data of patients were randomly divided into training set (271 SPNs) and test set (67 SPNs). In the training set, the clinical, image features and radiomic features were first selected by the least absolute shrinkage and selection operator (LASSO) regression, then the independent risk factors of SPN (≤20 mm) were screened out by multi-variate logistic regression analysis, and the nomogram prediction models were constructed. Finally, the data of test set were used to verify the prediction model by the ROC curve and calibration curve (CC).Results:In the training set of 271 SPNs, 81 SPNs were benign and 190 malignant. After analysis of LASSO regression and multi-factor logistics regression, the independent predictors of benign or malignant SPN were age, gender, largest diameter, vacuole sign and solid proportion. The prediction model was P=e x/(1+e x), x=-2.583+0.027×age+1.519×gender+0.127×maximum diameter-2.132×solid proportion+1.720×vacuole sign. The results of the model showed that the area under curve (AUC) of ROC was 0.850, and the sensitivity was 73.7%, specificity was 82.7% and accuracy was 82.3%. In the test set of 67 SPNs, 22 SPNs were benign and 45 malignant. The results showed that the AUC of ROC was 0.882, and the sensitivity was 82.2%, specificity was 81.8% and accuracy was 85.1%. The calibration nomogram of prediction model showed that CC from training set or test set well coincided with its individual ideal curve ( Ptraining=0.688, Ptest=0.618). Conclusion:Prediction model of benign or malignant SPN ≤20 mm is established based on AI; it can obtain the prediction probability and has good diagnostic efficiency.

目的 基于CTA扫描数据探讨椎基底动脉(VBA)影像解剖特征,为椎基底动脉延长症(VBD)诊断提供量化评估指标.方法 回顾性分析符合纳入标准的行头颈CTA检查者302例,根据VBA形态特点分为均衡型和非均衡型两组,非均衡组分为L型和S型,测量各组椎动脉(VA)颅内段和基底动脉(BA)的直径、长度及BA分叉高度.结合容积再现图像,计算VA及BA的迂曲度(TI).在寰枕关节水平层面、颈静脉孔水平、内听道水平、鞍背层面分别测量及计算VA、BA偏移正中矢状面的距离.血管的径线、长度及迂曲度均计算其95％可信区间(CI).结果 不同类型VBA年龄、性别构成上差异具有统计学意义(P＜0.05).左右VA直径、长度、迂曲度的95％CI分别为3.08～3.27 mm、2.68～2.87 mm,40.38～41.97 mm、39.89～41.75 mm、0.219～0.257 mm、0.140～0.203 mm.BA 直径、长度、高度及迂曲度95％CI 分别为3.14～3.29、28.13～29.16 mm、3.82～4.72 mm、0.091～0.119 mm.左右VA直径、迂曲度差异均具有统计学意义(P＜0.05).各类型VBA直径、长度、迂曲度差异具有统计学意义(P＜0.05).在颈静脉孔水平、内听道水平,各型VA、BA到正中矢状面的最大偏移距离差异具有统计学意义(P＜0.05).结论 CTA定量数据能直观反映VBA形态学特点,为VBD的诊断提供定量影像学依据.

Background Lung cancer brain metastases are very common and one of the common causes of treatment failure. We aimed to examine the clinical use of chemical exchange saturation transfer (CEST) technology in the evaluation of brain metastases for lung cancer diagnosis and prognosis. Methods We included26 cases of lung cancer brain metastases, 15 cases of gliomas, and 20 cases with normal tests. The magnetization transfer ratio (MTR;3.5 ppm) image from the GRE-EPI-CEST sequence was analyzed using the ASSET technique and APT technology. The MTR values were measured in the lesion-parenchymal, edema, and non-focus regions, and the MTR image was compared with the conventional MRI. ANOVA and t-test were used for statistical analysis. Results The lesion-parenchymal, edema, and non-focus areas in the metastatic-tumor-group were red-yellow, yellow-green, and green-blue, and the MTR values were 3.29 ± 1.14%,1.28 ± 0.36%,and 1.26 ± 0.31%, respectively. However, in the glioma-group, the corresponding areas were red, red-yellow, and green-blue, and the MTR values were 6.29 ± 1.58%, 2.87 ± 0.65%, and 1.03 ± 0.30%, respectively. The MTR values of the corresponding areas in the normal-group were 1.07 ± 0.22%,1.04 ± 0.23%, and 1.06 ± 0.24%, respectively. Traditional MR images are in black-white contrast and no metabolic information is displayed. The MTRvalues of the three regions were significantly different among the three groups. The values were also significantly different between the parenchymal and edema areas in the metastatic-tumor-group. There were significant differences in the MTR values between the non-lesion and edema regions, but there was no significant difference between the edema and non-focus areas. In the glioma-group, there were significant differences in the MTR values between the parenchymal and edema areas, between the parenchymal and non-focus areas, and between the edema and non-focus areas. Conclusions CEST reflects the protein metabolism; therefore, early diagnosis of brain metastases and assessment of the prognosis can be achieved using molecular imaging.

目的:探究能谱CT小肠造影(ECTE)在评估克罗恩病(CD)活动度效能.方法:回顾性分析2019年1月-2020年7月我院收治的120例CD患者临床资料,采用CD活动指数(CDAI)评分将其分为A组(缓解期和轻中度活动期)和B组(重度活动期).比较两组ECTE病变最严重处肠壁厚度、CT值、碘值差异,分析各参数与CDAI的相关性,并根据受试者工作特性(ROC)曲线获得各定量参数的诊断效能.结果:B组肠壁厚度、CT值、碘值明显高于A组(P＜0.05);各定量参数与CDAI呈现中度相关(r=0.589,0.587,0.568,P均＜0.001);如各定量参数诊断CD活动度的ROC曲线显示,Youden指数对应cut-off值分别为8.29mm、85.00HU、1.94mg,其中重度活动期碘值诊断效能最高.结论:CD活动度分级在ECTE定量特征方面表现出显著性差异,可为快速评估CD病情提供参考.