IntroductionIn this study, we evaluated the efficacy of transcatheter intra-arterial infusion of lecithin-modified Bi-Ln nanoparticles (Bi-Ln NPs) combined with interventional photothermal therapy (IPTT) using a rabbit VX2 tumor model, employing intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for assessment. MethodsThirty-two rabbit liver VX2 tumor models were established, and transcatheter intra-arterial infusion of Bi-Ln NPs was performed using superselective intubation under digital subtraction angiography (DSA) guidance. IPTT was then carried out by inserting a near-infrared (NIR) optical fiber into the rabbit VX2 tumors under real-time ultrasound guidance. Magnetic resonance imaging (MRI) was performed one day before treatment and seven days after treatment to evaluate therapeutic efficacy, using T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), gadolinium-enhanced T1WI, and IVIM-DWI. After treatment, gross and histopathological examinations were conducted to categorize liver tumors into viable tumor, inflammatory reaction, and necrotic regions. IVIM-derived parameters were calculated and compared across these regions. Additionally, immunohistochemical analysis was performed to further assess treatment efficacy. ResultsThe tumor-bearing rabbits exhibited significant therapeutic effects, as shown by comparative analysis of MRI images and parameters before and after treatment. Both the mean apparent diffusion coefficient (ADC) and diffusion coefficient (D) increased significantly after treatment (P = 0.008 and P = 0.034, respectively). Pathological analysis also revealed an elevated apoptosis rate of tumor cells, with a mean of 43.26 ± 12.26%. Across the different lesion regions, the ADC and D values were significantly lower in the viable tumor region than in the inflammatory reaction region (both P < 0.001). However, the D* values in the viable tumor region did not differ significantly from those in the inflammatory reaction region. Additionally, the ADC, D, and f values were significantly reduced in the necrotic region compared with the inflammatory reaction region (P = 0.003, <0.001, and <0.001, respectively). In the receiver operating characteristic (ROC) analysis, the diffusion coefficient (D) demonstrated the highest area under the curve for distinguishing between the inflammatory reaction and viable tumor regions. DiscussionIVIM-DWI demonstrates strong potential for detecting early tumor responses to therapeutic interventions and for differentiating tissue types following treatment. The parameters derived from this technique may provide preliminary insight into therapy-induced physiological changes. ConclusionThe combination of transcatheter intra-arterial infusion and IPTT represents a promising strategy for effective tumor eradication, thereby improving therapeutic outcomes. IVIM-DWI offers a quantitative tool for monitoring early treatment responses in hepatic tumors and distinguishing between different tissue types after therapy.

Purpose The aim of this study was to investigate the application value of transcatheter arterial embolization (TAE) for mediastinal hemorrhage. Materials and Methods The study retrospectively analyzed the status of TAE treatment in 13 patients with mediastinal hemorrhage. Results Aortic angiography and bleeding artery angiography showed that the bleeding in 13 mediastinal hemorrhage patients, respectively, originated from intercostal artery, esophageal artery, or bronchial artery. All patients were embolized with gelatin sponge and (or) polyvinyl alcohol particles. Chest computed tomography scan found that all 13 patients showed reduced range of mediastinal hematoma after TAE. Conclusion TAE has the advantages of reduced trauma, rapid and direct hemostasis, and solid therapeutic effects in the treatment of mediastinal hemorrhage.

[目的]探究超声触发氧化响应性阿霉素(DOX)纳米前药对肿瘤的抑制效果,为癌症患者提供安全的声动力与化学疗法联合治疗方法.[方法]制备具有单线态氧(1O2)特异性响应性DOX前药胶束(PTDOX-M)和无响应性DOX前药胶束(PCDOX-M).以2种前药胶束为基础,在细胞和动物水平研究癌症声动力-化疗治疗疗效.[结果]溶液中,超声作用下,DOX产生的1O2无法触发PCDOX-M中的DOX释放,而PTDOX-M中的DOX释放量在12 h达到42％.在无超声处理下,PTDOX-M中无DOX释放.体内研究发现,超声触发下,PTDOX-M对4T1皮下移植瘤子的抑制率是PCDOX-M的3.2倍.[结论]超声作用下,PTDOX-M可以在局部释放化疗药物DOX,以此介导的声动力-化学疗法联合作用显著抑制了肿瘤生长,有望避免对正常组织造成损伤,为癌症治疗提供安全高效的方法.

Background: Today, the outbreak of coronavirus disease 2019 (COVID-19) is known as a public health emergency by the World Health Organization (WHO). Therefore, risk assessment is necessary for making a correct decision in disease management. Objectives: This study aimed to assess the risk of progression to the critical stage in COVID-19 patients, based on the early quantitative chest computed tomography (CT) parameters. Patients and Methods: In this case-control study, 39 laboratory-confirmed critical or expired COVID-19 cases (critical group), as well as 117 laboratory-confirmed COVID-19 patients including mild, moderate, and severe cases (non-critical group), were enrolled. Seven quantitative CT parameters, representing the lung volume percentages at different density intervals, were automatically calculated, using the artificial intelligence (AI) algorithms. Multivariable-adjusted logistic regression models, based on the quantitative CT parameters, were established to predict the adverse outcomes (critical vs. non-critical). The predictive performance was estimated using the receiver operating characteristic (ROC) curve analysis and by measuring the area under the ROC curve (AUC). The quantitative CT parameters in different stages were compared between the two groups. Results: No significant differences were found between the two groups regarding the lung volume percentages at different density intervals within 0 - 4 days (P = 0.596-0.938); however, this difference began to become significant within 5 - 9 days and persisted even after one month. Overall, the quantitative CT parameters could well predict the severity of COVID-19. The lung volume percentage of -7 Hounsfield units (-7 HUs) had the largest crude odds ratio (OR: 1.999; 95% CI, 1.453 ~ 2.750; P < 0.001) and adjusted OR (adjusted OR: 1.768; 95% CI, 1.114 ~ 2.808; P = 0.016). The lung volume percentage of -6 HU showed the best predictive performance with the largest AUC of 0.808; the cutoff value of 5.93% showed 71.79% sensitivity and 84.62% specificity. Conclusion: Early quantitative chest CT parameters can be measured to assess the risk of progression to the critical stage of COVID-19; this is of critical importance in the clinical management of this disease.

Purpose: To prospectively compare the differences in intravoxel incoherent motion (IVIM)-derived quantitative parameters in different anatomic locations of the normal pancreas with different breathing techniques in a healthy population. Method: Twenty-six volunteers successfully underwent pancreas axial IVIM imaging with a 3.0-T MR system using 11 b-values (from 0 to 1000 sec/mm(2)) with three different breathing techniques: free breath (FB), liver dome scout (LDS), and phase scout (PS). The IVIM-derived quantitative parameters in three anatomic locations (head, body, and tail of the pancreas) were calculated. The intra-, inter-, and short-term consistency of IVIM-derived quantitative parameters were assessed by comparing 95% confidence interval (CI) of limits of agreement (LOA) of difference between measurements and clinical maximum allowed difference using the Bland-Altman method. The Kruskal-Wallis test was used to compare pancreatic IVIM-derived parameters. Results: In Bland-Altman graph, the maximum values of the 95% CIs of LOAs of D-slow, D-fast, and f were (0.123 +/- 0.022) x 10(-3) mm(2)/sec, (22.093 +/- 4.997) x 10(-3) mm(2)/sec, and (3.942 +/- 0.621)%, and the consistency of D-slow and f was good and that of D-fast was poor overall. The D-slow, D-fast, and f values of normal pancreas were (1.056 +/- 0.121) x 10(-3) mm(2)/sec, (55.755 +/- 13.011) x 10(-3) m( ) /sec, and (26.036 +/- 2.361)%, respectively, and there aren't any breathing technique (P > 0.05) or location (P > 0.05) dependent differences. Conclusions: Our study shows that IVIM-derived quantitative parameters of the pancreas may not be affected by breathing techniques and anatomic locations. The f and D-slow values have good repeated measurement consistency under different breathing techniques.

Objective: The chest computed tomography (CT) features of coronavirus disease 2019 (COVID-19) and Streptococcus pneumoniae pneumonia (S. pneumoniae pneumonia) were compared to provide further evidence for the differential imaging diagnosis of patients with these two types of pneumonia. Methods: Clinical information and chest CT data of 149 COVID-19 patients between January 9, 2020 and March 15, 2020 and 97 patients with S. pneumoniae pneumonia between January 23, 2011 and March 18, 2020 in Zhongnan Hospital of Wuhan University were retrospectively analyzed. In addition, CT features were comparatively analyzed. Results: According to the chest CT images, the probability of lung segmental and lobar pneumonia in S. pneumoniae pneumonia was higher than that in COVID-19(P<0.001); the probabilities of ground-glass opacity (GGO), the "crazy paving" sign, and abnormally thickened interlobular septa in COVID-19 were higher than those in S. pneumoniae pneumonia(P = 0.005, P<0.001, P<0.001, respectively); and the probabilities of consolidation lesions, bronchial wall thickening, centrilobular nodules, and pleural effusion in S. pneumoniae pneumonia were higher than those in COVID-19 (P<0.001, P = 0.001, P = 0.003, P = 0.001, respectively). Conclusion: The findings of GGO, the crazy paving sign, and abnormally thickened interlobular septa on chest CT were significantly higher in COVID-19 than S. pneumoniae pneumonia. The most important differential points on chest CT signs between COVID-19 and S. pneumoniae pneumonia were whether disease lesions were distributed in entire lung lobes and segments and whether the crazy paving sign, interlobular septal thickening, and consolidation lesions were found.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People’s Republic of China; Department of Interventional Radiology, Hunan Provincial People’s Hospital, Changsha, People’s Republic of China; Department of Radiology, The SecondXiangya Hospital of Central South University, Changsha, People’s Republic of China; Department of Interventional Radiology, Cancer Hospital Affiliated to Guangxi Medical University, Nanning, People’s Republic of China; Department of Radiology, Xiangya Hospital General South University, Changsha, People’s Republic of China; Department of Interventional Radiology, Zhongnan Hospital of Wuhan University, Wuhan, People’s Republic of China; Department of Radiology, Wuhan General Hospital of Guangzhou Military Region, Wuhan, People’s Republic of China; Department of Interventional Radiology, Renmin Hospital of Wuhan University, Hubei General Hospital, Wuhan, People’s Republic of China

PURPOSE:This study aimed to compare the efficacy and safety between transarterial chemoembolization (TACE) with CalliSpheres® microspheres (CSM-TACE) and conventional TACE (cTACE) in patients with hepatocellular carcinoma (HCC). PATIENTS AND METHODS:Three hundred and thirty-five HCC patients receiving CSM-TACE or cTACE were consecutively enrolled in this multi-center, retrospective cohort study, and then divided into CSM-TACE group and cTACE group accordingly. Complete response (CR), objective response (ORR) and disease control response (DCR) was assessed according to mRECIST criteria at 1 month (M1), 3 months(M3) and 6 months(M6) after treatment. Progression-free survival (PFS) and overall survival (OS) were assessed. Liver function indexes and adverse events (AEs) were also evaluated. RESULTS:CR at M3 (P=0.020) and ORR at M1 (P<0.001), M3 (P<0.001) and M6 (P=0.017) after treatment were significantly higher in the CSM-TACE compared with cTACE group. DCRs, PFS (25.3 months vs 24.2 months, P=0.503) and OS (27.8 months vs 25.3 months, P=0.203) were similar between the two groups. CSM-TACE was independently correlated with higher ORR at M1 (P=0.002) and longer OS (P=0.023). Abnormal alkaline phosphatase (ALP) (P=0.049) was independently associated with lower ORR at M3, and history of alcohol intake (P=0.019) and largest nodule size ≥7 cm (P=0.015) independently correlated with lower ORR at M6 (P=0.015). Largest nodule size ≥7 cm (P=0.029) and abnormal albumin (ALB) (P=0.046) were independently associated with shorter PFS. Child-Pugh stage B/C (P=0.023), abnormal ALB (P=0.001), ALP (P=0.008) and alpha-fetoprotein (AFP) (P=0.005) were independently associated with shorter OS. Most liver function indexes and AEs were similar between the two groups (P>0.05), except that ALP (P=0.005), total bilirubin (P=0.031), pain during procedure (P=0.034) and occurrence of fever post(treatment (P=0.017) were significantly elevated in the CSM-TACE compared with cTACE group. CONCLUSION:CSM-TACE presents with a better treatment response and similar survival profile compared with cTACE in HCC patients.

BackgroundNeuroimaging studies have demonstrated disrupted brain functional networks in major depression disorder (MDD); however, alterations to whole‐brain networks specifically associated with adolescent MDD remain poorly understood.PurposeTo investigate the topological architecture of intrinsic brain functional networks in drug‐naïve, first‐episode adolescent MDD patients using graph theoretical analysis.Study typeProspective.SubjectsIn all, 109 adolescent MDD patients and 70 healthy control subjects.Field Strength/Sequences3.0T; gradient‐echo echo‐planar imaging sequence.AssessmentAfter the construction of whole‐brain functional networks by thresholding partial correlation matrices of 90 brain regions, we calculated the topological properties (eg, small‐world, efficiency, and nodal centrality) using graph theoretical analysis.Statistical TestsA chi‐squared test was used to compare the gender‐ratio difference, and a two‐sample t‐test was used in the comparison of age. We compared network measures between the two groups using nonparametric permutation tests. Exploratory partial correlation analyses were used to determine the relationships between the topological metrics showing significant between‐group differences and the clinical variables for adolescent MDD patients.ResultsSmall‐world architecture in brain functional networks was identified for both the MDD and control groups. However, depressed adolescents exhibited lower characteristic path length, normalized characteristic path length and clustering coefficient, and higher global efficiency than controls (false discovery rate [FDR] q < 0.05). Compared with controls, depressed adolescents exhibited increased nodal centralities in the default mode regions, including the right anterior cingulate and paracingulate gyri, left posterior cingulate gyrus, right superior frontal gyrus (medial part), bilateral hippocampus, and bilateral parahippocampal gyrus, and decreased nodal centralities in the orbitofrontal, temporal, and occipital regions (FDR q < 0.05).Data ConclusionThis study indicated that drug‐naïve, first‐episode adolescent MDD patients exhibit disruptions in whole‐brain functional networks.Level of Evidence1Technical Efficacy Stage2 J. MAGN. RESON. IMAGING 2020;52:1790–1798.

目的:探讨脊柱肿瘤外科治疗前经导管动脉栓塞术(TAE)的应用价值.方法:选取2016年1月至2019年3月我院38例脊柱肿瘤患者,分为栓塞组(n=18)和非栓塞组(n=20).栓塞组在手术前先行椎体肿瘤TAE,再进行外科椎体肿瘤切除及重建术;非栓塞组直接行椎体肿瘤切除及重建术,观察手术中的相关指标并进行对比分析.结果:栓塞组的术中出血量平均约2 152.78mL,手术时间约2～4.5 h;非栓塞组中,术中出血量平均约4 353.13mL,手术时间约为5～8 h,两组术中平均出血量与手术时间的差异有统计学意义(P＜0.01).所有患者随访1～3年各项功能恢复满意,椎体的稳定性良好.结论:外科治疗前行椎体肿瘤TAE是安全、有效和可行的治疗手段,可明显降低术中出血量、缩短手术时间,提高手术成功率.

Background Photothermal therapy (PTT) has great potential application in the treatment of tumors. However, due to the low penetration of near-infrared light (NIR) and the low concentration of nanomaterials in the tumor site, the application of PTT has been limited. Purpose The objective of this study was to investigate the therapeutic effect of transcatheter intra-arterial infusion of lecithin-modified Bi nanoparticles (Bi-Ln NPs) combined with interventional PTT (IPTT) on hepatocellular carcinoma. Methods Bi-Ln NPs were prepared by emulsifying the hydrophobic Bi nanoparticles and lecithin, and the photothermal conversion and cytotoxicity of Bi-Ln NPs were then measured by infrared imaging and MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, respectively. Twenty-four VX2 hepatic carcinoma rabbits were randomly divided into four groups. Rabbits in group A received Bi-Ln NPs by intra-arterial infusion and NIR laser treatment (IA Bi-Ln NPs + Laser), group B received Bi-Ln NPs by intravenous infusion and NIR laser treatment (IV Bi-Ln NPs + Laser), group C received PBS (phosphate buffer saline) via intra-arterial infusion with NIR laser treatment (IA PBS + Laser), group D received PBS via intra-arterial infusion (IA PBS). Transcatheter intra-arterial infusion was conducted by superselective intubation under digital subtraction angiography (DSA) guidance. IPTT was performed by introducing an NIR optical fiber access to the rabbit VX2 hepatic carcinoma under real-time ultrasound guidance. Magnetic resonance imaging (MRI) was performed to evaluate the tumor size. Hematoxylin and eosin (H&E) stain and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) were conducted 7 days after treatment to evaluate the necrosis rate and viability of tumor, respectively. Results The Bi-Ln NPs have the advantages of good biological compatibility and high photothermal conversion efficiency. Minimally invasive transcatheter intra-arterial infusion can markedly increase the concentration of Bi-Ln NPs in tumor tissues. IPTT can contribute to the significant improvement in the photothermal efficiency of Bi-Ln NPs. Compared to other groups, the group of IA Bi-Ln NPs + Laser showed a significantly higher tumor inhibition rate (TIR) of 93.38 ± 19.57%, a higher tumor necrosis rate of 83.12 ± 8.02%, and a higher apoptosis rate of (43.26 ± 10.65%) after treatment. Conclusion Transcatheter intra-arterial infusion combined with interventional PTT (IPTT) is safe and effective in eradicating tumor cells and inhibiting tumor growth and may provide a novel and valuable choice for the treatment of hepatocellular carcinoma in the future.

Background: A cluster of patients with coronavirus disease 2019 (COVID-19) pneumonia caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were reported worldwide, but there are few reports on age-related computed tomography (CT) signs and clinical characteristics of COVID-19 patients. Objectives: We aimed to analyze the CT imaging characteristics and clinical features of elderly patients with novel COVID-19 and compare them with young COVID-19 patients, in order to provide imaging basis for clinical diagnosis. Patients and Methods: The clinical and chest CT imaging data of elderly patients (≥ 60 years) and young patients (age of 20 - 60 years) with positive novel coronavirus nucleic acid admitted to our hospital from January 28, 2020 to February 16, 2020 were retrospectively analyzed, and the differences in clinical and imaging characteristics between the two groups were compared. Results: One hundred eighty three COVID-19 patients (96 elderly: mean age, 72.76 ± 5.65; 87 young: mean age, 42.69 ± 12.44) with positive novel coronavirus nucleic acid were retrospectively enrolled. The clinical symptoms of fever (79%), cough (64%) and weakness (59%) in elderly patients were higher than those of young patients (P < 0.01). Asymptomatic young patients (15%) were more common than the elderly (2%) (P < 0.01). Twenty-four patients (13%) had lesions that involved both the periphery and the center of the lung, while the lesions were located in the periphery of the lung in 159 patients (87%). Ground-glass opacification in young patients (71%) was significantly higher than that of the elderly (26%) (P < 0.001). Compared with the young group (37%), the proportion of extensive involvement of lung lobes was higher in the elderly group (72%) (P < 0.001). Conclusion: Elderly and young patients with corona virus disease had some common CT and clinical features, but elderly patients may have relatively severe CT findings, and these differences may be related to the severity and prognosis of COVID-19 pneumonia.

BACKGROUND:Transarterial chemoembolization (TACE) is widely applied in hepatocellular carcinoma (HCC) patients who are not suitable for surgical treatment. We aimed to investigate the treatment outcomes and comprehensive prognostic factors of CalliSpheres® microspheres (CSM) drug-eluting bead TACE (DEB-TACE) treatment and conventional TACE (cTACE) treatment in HCC patients.METHODS:Three hundred and thirty-five HCC patients received DEB-TACE or cTACE treatment were consecutively enrolled in multi-center, retrospective cohort study. Treatment response was conducted at M1, M3 or M6 after treatment. Progression free survival (PFS) and overall survival (OS) were recorded. Thirty-seven baseline factors including demographic characteristics, clinical features, biochemical indexes and previous treatment histories were selected.RESULTS:In total patients, history of drink and largest nodule size≥7cm independently predicted worse ORR, DEB-TACE predicted better OS, while largest nodule size≥7cm, increased Child-Pugh stage, ALB abnormal, ALP abnormal or AFP abnormal predicted worse survival. For DEB-TACE group, previous cTACE and ANC abnormal independently predicted worse ORR, and hepatic vein invasion, increased Child-Pugh stage or AFP abnormal independently predicted poor survival. For cTACE group, largest nodule size≥7cm independently predicted poor ORR, and multifocal disease as well as ALB abnormal predicted poor OS.CONCLUSIONS:History of drink, largest nodule size≥7cm, DEB-TACE, increased Child-Pugh stage, abnormal ALB, ALP or AFP are potential prognostic factors in total patients, previous cTACE and ANC abnormal, hepatic vein invasion, increased Child-Pugh stage or AFP abnormal are potential prognostic factors in DEB-TA group, and largest nodule size≥7cm, multifocal disease and ALB abnormal are potential prognostic factors in cTACE group.

The CT findings of 36 elderly patients with novel coronavirus disease 2019 (COVID-19)were analyzed to provide imaging diagnostic basis for clin diagnosis Methods: The clin date and chest CT images of 36 elderly patients with pos new coronavirus nucleic acid admitted to Zhongnan Hospital of Wuhan University were retrospectively analyzed Results:: Elderly COVID-19 patients had more underlying diseases, with more complicated clin symptoms than young patients, including fever (77 8%), cough (55 6%), and dyspnea (52 8%);CT signs are characterized by diversity and multi-focus, mainly showing the coexistence of ground-glass shadow and consolidation shadow (72 2%), mostly located in the outer lung field of bilateral lung (69 4%), and the air bronchus sign (58 3%) in the lesions COVID-19 in the elderly progresses relatively fast, and severe patients were more common, and 55 6% patients were male Conclusion:: CT images of elderly COVID-19 patients have certain characteristics Chest thin-section CT is helpful for early diagnosis and provides an effective supplement to nucleic acid detection for SARS-CoV-2

Purpose: To evaluate lung abnormalities on thin-section computed tomographic (CT) scans in patients with COVID-19 and correlate findings to duration of symptoms. Methods: In total, 348 CT scans in 112 patients were classified according to the time after the onset of the initial symptoms, namely stage-1 (0-4 days); stage-2 (5-9 days); stage-3 (10-14 days); stage-4 (15-21 days); stage-5 (22-28 days); and stage-6 (> 28 days). Each lung lobe was evaluated for extent affected by ground-glass opacities (GGO), crazy-paving pattern and consolidation, in five categories of percentual severity. Summation of scores from all five lung lobes provided the total CT score (maximal CT score, 25). Results: The predominant patterns of lung abnormalities were GGOs, crazy-paving pattern, consolidation and linear opacities. The frequency of crazy-paving pattern, consolidation and linear opacities peaked at stage-3 (62.7 %), stage-4 (75.0 %) and stage-5 (83.1 %), respectively, and decreased thereafter. Total CT scores increased from stage-1 to stage-2 (2.8 +/- 3.1, vs. 6.5 +/- 4.6, respectively, P < 0.01), and thereafter remained high. The lower lobes were more inclined to be involved with higher CT scores except for stage-1. At stage-6 98.1 % of CT scans still showed abnormalities (CT score 7.5 +/- 4.1). Conclusion: Thin-section CT could provide semi-quantitative analysis of pulmonary damage severity. This disease changed rapidly at the early stage, then tended to be stable and lasted for a long time.

Objective: To improve the imaging diagnosis of novel coronavirus disease 2019 (COVID-19) by comparing the chest CT imaging characteristics between COVID-19 and bacterial pneumonia Methods: CT data of 42 COVID-19 cases from January 16 to February 18, 2020 were retrospectively analyzed, and we also compared with the CT data of 36 cases of bacterial pneumonia collected from November 27, 2017 to February 6, 2020 Results: The incidence of bilateral lobes involvement in COVID-19 group was 73 8%, which was significantly higher than that in bacterial pneumonia group (vs 41 7%, P 0 01) The incidences of ground glass shadow (95 2%), mesh shadow (31 0%), and pavement sign (26 2%) were significantly higher than those of bacterial pneumonia (77 8%, 8 3% and 0, respectively, all P 0 05) The incidences of consolidation (35 7%), and central lobular nodule or tree-bud signs (9 5%) were lower than those of bacterial pneumonia (66 7% and 47 2%, respectively, both P 0 05) Conclusion: In COVID-19 patients, more CT signs such as ground glass shadow, mesh shadow and paved appearance were found than in bacterial pneumonia ones, whereas the consolidation shadow, central lobular nodules and tree-bud signs were less common © 2020, Editorial Board of Medical Journal of Wuhan University All right reserved

Background This study aimed to compare the live function change and adverse events (AEs) between drug-eluting beads (DEB) transarterial chemoembolization (TACE) with CalliSpheres® microspheres (CSM) and conventional TACE (cTACE) in treating hepatocellular carcinoma (HCC) patients. Methods Three hundred and thirty-five HCC patients underwent DEB-TACE with CSM (n=171, DEB-TACE group) or cTACE (n=164, cTACE group) were consecutively enrolled in this multi-center, retrospective cohort study. Liver function indexes were reviewed before treatment (W0), at 1 week (W1) and 1 month (M1) post treatment. Moreover, AEs during operation and hospitalization were retrieved as well. Results The changes of albumin (ALB) [–3.55 (–6.25 to –0.43) vs. –2.20 (–4.63–0.00), P=0.043] and total protein (TP) [–4.62 (–10.18–0.43) vs. –2.50 (–7.08–1.08), P=0.013] from W1 to W0 were lower in DEB-TACE group compared to cTACE group, while no difference was observed referring to the change of alanine aminotransferase (ALT) (P=0.494), aspartate aminotransferase (AST) (P=0.747), alkaline phosphatase (ALP) (P=0.895), total bilirubin (TBIL) (P=0.059), total bile acid (TBA) (P=0.491) from W1 to W0. And the changes of these seven indexes from M1 to W0 were all similar between DEB-TACE group and cTACE group (all P>0.05). Besides, the occurrence of pain during treatment (19.3% vs. 11.0%, P=0.034) and the occurrence of fever during hospitalization (18.1% vs. 9.1%, P=0.017) were both increased in DEB-TACE group compared to cTACE group. Conclusions DEB-TACE with CSM is non-inferior to cTACE in terms of liver function change, while DEB-TACE with CSM leads to higher incidences of pain and fever.

We aimed to compare the treatment response, survivals and safety of drug-eluting bead (DEB) transarterial chemoembolization (TACE) with CalliSpheres® microspheres (CSM) and conventional TACE (cTACE) as first-line treatment in Chinese HCC patients. 192 HCC patients from multiple centers received DEB-TACE with CSM or cTACE treatment as first-line treatment were included and assigned to DEB-TACE group (N=94) or cTACE group (N=98) accordingly. Treatment response was assessed at 1 month (M1), M3 and M6 after treatment. Progression-free survival (PFS) and overall survival (OS) was evaluated. Liver function indexes and adverse events were recorded. Complete response (CR) and objective response rate (ORR) were higher, while disease control rate (DCR) rate was similar in DEB-TACE group compared with cTACE group, and further multivariate logistic regression analysis validated that DEB-TACE vs cTACE independently predicted higher ORR. For survivals, no difference in PFS or OS was observed between DEB-TACE and cTACE groups, and multivariate Cox's proportional hazards regression revealed that DEB-TACE vs cTACE was not correlated with PFS or OS either. Additionally, no difference in liver function indexes at M1 or changes of liver function indexes from M0 to M1 between DEB-TACE and cTACE groups after treatment was observed, whereas DEB-TACE resulted in higher incidence of pain and fever during treatment or hospitalization. DEB-TACE with CSM discloses better treatment response, similar survival profiles and equal liver function injury but increased incidence of short-term adverse events than cTACE as the first-line therapy in treating HCC patients.

目的:探讨药物缓释微球肝动脉化疗栓塞术(DEB-TACE)治疗中晚期原发性肝癌的近期疗效及安全性.方法:回顾性分析我院2016年6月至2017年10月通过DEB-TACE及传统TACE(cTACE)两种不同方法初治的中晚期原发性肝癌患者共64例.其中DEB-TACE组34例,cTACE组30例.比较两组患者介入治疗前及治疗后1周、1个月肝功能的变化.随访12个月,比较术后6个月和12个月两组患者肿瘤反应.同时记录两组术后并发症发生情况.结果:患者基线临床特征无统计学差异(P＞0.05).术后1个月两组肝功能均改善,但DEB-TACE组肝功能指标ALT、AST和TBiL均优于cTACE组(P＜0.05).术后6个月和12个月DEB-TACE组肿瘤客观反应率均明显高于cTACE组(P＜0.05).DEB-TACE组栓塞后综合征及化疗药相关并发症发生率显著低于cTACE组(P＜0.05).结论:应用CalliSpheres可载药栓塞微球的DEB-TACE对治疗中晚期原发性肝癌近期疗效显著,且并发症较少,优于cTACE.远期临床疗效及生存率有待进一步随访复查.

To prospectively compare the reproducibility of normal pancreas-normalized apparent diffusion coefficient (ADC) measurements for the normal pancreas and mean normalized ADCs at different pancreas anatomic locations. In total, 22 healthy volunteers underwent pancreatic 3.0-T magnetic resonance (MR) imaging, including axial diffusion-weighted (DW) imaging with 3 b values used (0, 400, and 800s/mm(2)) and with the respiratory-triggered (RT) technique. The mean ADCs from 3 regions of interest (ROIs) in 5 anatomic locations (head [H], body [B], and tail [T] of pancreas and spleen [S] and erector spinae muscles [M]) were calculated. The pancreas-normalized ADC was defined as the ratio of the ADC for the pancreas to the ADC for the spleen or erector spinae muscle. Reproducibility of ADCs and normalized ADCs was assessed by the Bland-Altman method. The ADC and normalized ADC data were analyzed by repeated-measures ANOVA. Mean ADC and normalized ADC values did not differ (P >. 05) with repeated measurements at the different pancreas anatomic locations. Reproducibility of pancreas-normalized ADC measurements in each of the 3 pancreatic anatomic locations was better with the erector spinae muscle rather than the spleen used as a reference. Mean ADC and normalized ADC values significantly differed between the 3 pancreatic segments (H: 1.36 x 10(-3) mm(2)/s, B: 1.38 x 10(-3) mm(2)/s, T: 1.25 x 10(-3) mm(2)/s, P=.022; H/S: 1.75, B/S: 1.78, T/S: 1.59, P=.009; H/M: 0.91, B/M: 0.95, T/M: 0.85, P=.008). Mean ADC values and normalized ADC values showed a trend to decrease from the pancreatic head to tail. Our preliminary results suggest that normalized ADC measurements for the pancreas show good intra-and interobserver reproducibility, the erector spinae muscle is a better choice than the spleen for calculating normalized ADC values for the pancreas, and the normalized ADC values are lower for the pancreatic tail than other pancreatic segments.