Objective: To investigate the clinical value of thin-section chest computed tomography (CT) in the typing of coronavirus disease 2019 (COVID-19). Methods: A retrospective analysis was performed on 134 patients diagnosed with COVID-19 in our hospital’s Department of Infectious Diseases from December 20, 2022, to December 31, 2022. All patients underwent thin-section chest CT scan with complete clinical data. According to clinical classification, patients were divided into the non-severe and severe groups. Clinical data and imaging features of the two groups were compared and analyzed, and statistical analysis was conducted. Results: There was a statistically significant difference with respect to diabetes mellitus between the two groups, and the incidence of diabetes mellitus in the severe group (45.8%) was higher than that in the non-severe group (25.5%); There were no significant differences in sex, age, average course of disease, and clinical symptoms between the two groups; There were significant differences in the number of lesions, symmetrical distribution, predominant peripheral distribution, diffuse distribution, blurred edge, morphology of large flake and band, vascular bundle thickening, paving stone sign, arcade sign, and fried egg sign between the two groups, the number of lesions >10, diffuse distribution, morphology of large flake and band, vascular bundle thickening, paving stone sign, and arcade sign were more common in the severe group than in the non-severe group, while predominant peripheral distribution, blurred edge, and fried egg sign were more common in the non-severe group than in the severe group. Conclusions: Thin-section chest CT scan can identify the abnormal imaging manifestations of the lung in patients with COVID-19 and evaluate the number, distribution range, and morphological characteristics of the lesions. Combined background diseases, number, distribution characteristics, blurred edge, large flake and band morphology, vascular bundle thickening, paving stone sign, arcade sign, and fried egg sign can effectively indicate the classification of patients with COVID-19. This can provide imaging evidence for the diagnosis and treatment of COVID-19.

Objective: To investigate the imaging characteristics of coronavirus disease 2019 (COVID-19) patients with diabetes mellitus using deep learning-based quantitative computed tomograpgh (CT) indicators. Materials and methods: The clinical and imaging data of 112 COVID-19 patients admitted to the Department of Infection, Beijing Shijitan Hospital, Capital Medical University, from December 2022 to January 2023 were retrospectively collected. The patients were divided into diabetic and non-diabetic groups according to their diabetes history, and the clinical and quantitative CT imaging characteristics of the two groups were analyzed using univariate analysis. Results: A total of 112 patients with COVID-19, aged 26-95 years (mean, (70.4±14.4) years), were included in the study, and 44.6% (50/112 cases) were female. In terms of clinical features, C-reactive protein levels were significantly higher in the diabetic group. In terms of CT quantitative indicators, patients in the diabetic group had higher number of whole lung and left lung lesions, lesion volume, and mediastinal lymph nodes than patients in the non-diabetic group. In addition, patients in the diabetic group had a larger volume of ground glass opacity and solid opacity, and patients in the diabetic group had a smaller volume ratio of ground glass opacity and solid opacity in terms of imaging signs, patients in the diabetic group had a higher proportion of lesions with large patchy and banded patterns, and they had a higher proportion of halo signs, air bronchial signs, air trapping signs, mosaic perfusion signs, and subpleural black bands. Conclusion: Pulmonary lesions in patients with diabetes combined with COVID-19 have characteristic features, and deep learning-based quantitative CT indicators, particularly the solid opacity observed in the lungs, can provide valuable information on the extent and severity of lesions in these patients.

目的 评估磁敏感加权成像(SWI)、三维动脉自旋标记(3D-ASL)成像及体素内不相干运动(IVIM)成像鉴别高、低级别脑胶质瘤的诊断价值.方法 纳入97例确诊为胶质瘤的病例(低级别35例,高级别62例),术前进行SWI、3D-ASL及IVIM成像,然后进行手术,对照术后病理.测量参数包括瘤灶内的敏感性信号(ITSS)、瘤灶所在区域的血流量最大值(maximum cerebral blood flow,TBFmax)、灌注相关扩散系数(fast ADC)、扩散系数(slow ADC)及灌注分数f值,并获得TBFmax的相对值:r1(TBFmax/对侧正常白质区血流量)、r2(TBFmax/对侧正常灰质区血流量)及r3(TBFmax/镜像区脑血流量).用统计学分析所得各参数值.然后应用受试者工作特性曲线(ROC曲线),进行诊断效能的分析.结果 SWI、3D-ASL及IVIM各参数在鉴别高低级别脑胶质瘤中具有统计意义,P<0.05.联合SWI、3D-ASL及IVIM得到的曲线下面积(AUC)数值最大.结论 通过对SWI、3D-ASL及IVIM三种技术进行分析,优化了胶质瘤术前高低级别分级的方法.

Objective: To retrospectively analyze the clinical value of chest plain computed tomography (CT) for the initial diagnosis and dynamic changes of early novel coronavirus pneumonia (2019 novel Coronavirus, 2019-nCoV, referred to as new coronavirus pneumonia). Materials and methods: Fifty-two patients with confirmed new coronavirus pneumonia diagnoses and positive chest CT manifestations from November 12, 2022, to January 6, 2023, in the infection department of our hospital were collected. All patients had two chest thin-section CT examinations within 1 month from the onset of the disease and had complete clinical data. Patients were divided into two groups according to their age (≤60 years and >60 years), and the differences in CT performance characteristics between the two groups were compared. The CT review of all patients was also observed. Results: Among the 52 patients, 52 involved the lungs (100%), 24 involved the airways (46.2%), and 21 involved the bloodways (40.4%). Comparison between age groups showed statistically significant differences in lesion location (single/both lungs, airways), tree-in-bud pattern, large morphology, fibrous striae, interstitial changes, and pleural thickening. Among the 52 patients, review CT showed lesion progression in 18 cases (34.6%), which showed an increase in extent in 18 cases (100%), aggravation of solid changes in 7 (38.9), aggravation of GGO in 14 (77.8%), and increase in pleural effusion in 6 (33.3%); review CT showed lesion remission in 18 cases (34.6%), which showed a decrease in extent in 31 (91.2%), 6 (17.6%) with reduced density, 12 (35.3%) with fibrosis, 2 (5.9%) with complete resorption, and 4 (11.8) with reduced pleural effusion. Conclusion: The CT scan of the chest in neocoronary pneumonia has certain characteristics, and for the first time, it mostly showed multiple patchy signs or large patchy ground glass opacity (GGO) with mainly subpleural distribution in the periphery of both lungs, mostly accompanied by "halo sign," "anti-halo sign," and "paving stone sign." The lung is more susceptible to change following treatment. After treatment, the lung lesions change rapidly, with most patients showing absorption and shrinkage, density fading, or fibrosis and a few patients showing increased extent, solidity or aggravation of GGO, and pleural effusion. Chest plain CT helps clinicians in the early diagnosis and dynamic evaluation of neocoronary pneumonia.

目的:评价磁敏感加权成像(susceptibility weighted imaging,SWI)、三维动脉自旋标记(three-dimen-sional arterial spin labeling,3D-ASL)成像及体素内不相干运动(intravoxel incoherent motion,IVIM)成像在鉴别Ⅱ级/Ⅲ级/Ⅳ级胶质瘤中的价值.方法:纳入92例脑胶质瘤患者(Ⅱ级:35例,Ⅲ级:13例,Ⅳ级:44例),所有患者术前均接受SWI、3D-ASL和IVIM扫描,然后进行肿瘤内敏感性信号强度(intratumoral susceptibility signal intensity,ITSS)评分,测量肿瘤最大血流量(TBFmax)、快速表观扩散系数(fast apparent difficious,fast ADC)、慢速表观扩散系数(slow ADC)和灌注分数(perfusion fraction,f),并将TBFmax与对侧正常白质、对侧正常灰质和镜像区的脑血流量进行对比,取相对值r1、r2和r3.探究这些参数在Ⅱ级与Ⅲ级、Ⅲ级与Ⅳ级以及Ⅱ级与Ⅳ级肿瘤之间的差异.利用受试者工作特性(receiver operating characteristic,ROC)曲线分析评估这些参数的诊断效能.结果:ITSS评分在鉴别Ⅱ级与Ⅲ级、Ⅲ级与Ⅳ级、Ⅱ级与Ⅳ级肿瘤之间有统计学差异,并且较高级别的脑胶质瘤显示出较高的ITSS评分(P＜0.05).fast ADC、slow ADC和f值在鉴别Ⅱ级与Ⅲ级、Ⅱ级与Ⅳ级肿瘤之间有统计学差异(P＜0.05),但是TBFmax、rl、r2和r3只在鉴别Ⅱ级与Ⅳ级胶质瘤中有统计学差异(P＜0.05).其中slow ADC为鉴别Ⅱ级和Ⅲ级提供了最高的AUC值(0.94),ITSS评分为鉴别Ⅱ级和Ⅳ级提供了最高的AUC值(0.96),而ITSS值在鉴别Ⅲ级与Ⅳ级胶质瘤中的AUC值为0.72.结论:SWI、3D-ASL和IVIM的参数可用于鉴别各级脑胶质瘤.

Objective: To compare and analyze the clinical and chest computed tomography (CT) imaging features of COVID-19 patients with different disease courses. Methods: A retrospective analysis was performed for 161 cases with confirmed COVID-19 and positive chest CT lung infections from December 2022 to January 2023 at the fever clinic of Beijing Shijitan Hospital affiliated with Capital Medical University. The patients were divided into two groups based on the time of CT examination: <10 days and ≥10 days. We statistically analyzed the clinical manifestations and chest CT imaging characteristics of the two groups. Results: Of the 161 cases, 92 cases (57.1%) were in the <10-day group, and 69 cases (42.9%) were in the ≥10-day group. The clinical symptoms of the two groups showed that there was a statistical difference in the proportion of sore throat and myalgia between the two groups. Laboratory indicators showed that the C-reactive protein and lymphocyte count were significantly higher in the <10-day group. In terms of CT imaging features, the proportion of patients with perivascular, mixed distribution, large area, and air bronchogram was higher in the patients from the <10-day group, while the patients in the ≥10-day group had a significantly higher proportion of irregular boundaries, intralesional cord, reversed halo sign, pleural tail sign, subpleural line, and subpleural palisade. Conclusion: The clinical symptoms, laboratory indexes, and CT imaging features of COVID-19 pulmonary infection differed depending on the disease course, and exploring these differences can help clinicians diagnose and treat COVID-19 lung infections more effectively.

Objective: This study aimed to explore the clinical value of thin slice computed tomography (CT) plain scan in the analysis of CT features of vascular abnormalities associated with coronavirus disease 2019 (COVID-19). Materials and methods: A total of 73 patients with COVID-19 confirmed by the Department of Infection of Beijing Shijitan Hospital from December 5, 2022 to December 17, 2022, were included in the study. Chest thin CT plain scan images showed that the lesions involved blood vessels were retrospectively collected. All patients had complete chest thin CT plain scan and relatively complete clinical data. According to age (>60 and ≤60 years), the patients were divided into the young and elderly groups. The chest imaging manifestations of all patients were observed and statistically analyzed between different age groups. Results: Among the 73 patients with COVID-19, the imaging indexes with statistical significance between the young and elderly groups were as follows: the distribution of the lesion around the central blood vessel, size of the lesion (10~30 mm), size of the lesion (>30 mm), percentage of the lesion to the volume of the lung lobe (≤30), percentage of the lesion to the volume of the lung lobe (>50) (white lung), shape of the lesion was large, the dominant type of the lesion was acinar, vascular distortion, vascular margin fuzzy, and tree-bud sign thick fiber rope. Conclusion: (1) Chest thin-slice CT plain scan can identify the number, location, involved location, scope, vascular abnormality, and pathological type of COVID-19-related vascular abnormality, which has certain significance for the qualitative and differential diagnosis of COVID-19 vascular abnormality. (2) The chest thin CT plain scan is of great significance for finding elderly patients with COVID-19 involving blood vessels. (3) COVID-19-related "blood vessel thickening" can be caused by either the diameter of the blood vessel itself or the inflammatory edema of the perivascular interstitium.

Objective: This study aimed to investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR) and chest high-resolution computed tomography (HRCT) findings of coronavirus disease 2019 (COVID-19). Materials and Methods: NLR and chest HRCT findings of 132 patients diagnosed with COVID-19 in the department of infectious diseases of Beijing Shijitan Hospital Capital Medical University from December 1, 2022 to February 1, 2023 were retrospectively analyzed. The patients were divided into two groups with NLR cut-off value of 3.0, and their HRCT characteristics and imaging manifestation patterns were analyzed. For the measurement data of normal distribution, the t-test of continuous variables was used between the groups. The data of non-normal distribution are expressed as median and quartile and compared using Mann-Whitney U test. The counting data are expressed as frequency, and the chi-squared or Fisher's exact test was used for comparison between the groups. P<0.05 indicates that the difference is statistically significant. Results: The number of lesions ≤5 and the proportion of lesions ≤10% were higher in the low NLR group than that in the high NLR group. The number of lesions >10 and the proportion of lesions >50% were higher in the high NLR group than that in the low NLR group. The high NLR group was prone to mixed density shadow, crazy-paving pattern, mosaic sign, anti-halo sign, subpleural black belt, arcade-like sign than that in the low NLR group. The high NLR group was most likely to have nonspecific interstitial pneumonia-like, organizing pneumonia-like, and diffuse alveolar damage-like patterns than that in the low NLR group. Conclusion: Different NLRs have different manifestations of COVID-19 chest HRCT. The high NLR group is more prone to mixed density shadow, crazy-paving pattern, mosaic sign, anti-halo sign, subpleural black belt, and arcade-like sign, as well as most likely to have radiologic patterns of nonspecific interstitial pneumonia, organizing pneumonia, diffuse alveolar damage.

目的 探讨直接淋巴管造影术后CT(PLCT)在不同分型的特发性乳糜尿中的影像特征.方法 回顾性分析临床确诊为特发性乳糜尿的患者51例,所有患者均行PLCT检查,由两名放射科医师盲法阅片,包括:(1)泌尿系统及腹膜后异常对比剂分布;(2)腹盆部其他部位异常对比剂分布;(3)反流;(4)胸部及颈部异常对比剂分布;(5)水肿样改变.根据乳糜尿临床表现的严重程度,将其分为轻型和重型两组,对两组影像指标的组间差异应用卡方检验,进行比较及统计学分析,P＜0.05认为差异有统计学意义.结果 51例特发性乳糜尿男18例,女33例,平均年龄(44±19)岁,临床分型为轻型21例,重型30例,两组间性别、年龄比较差异无统计学意义.影像学表现为:(1)泌尿系统及腹膜后异常对比剂分布48例,其中肾门45例,肾实质40例,膀胱30例,肾周筋膜内15例.腹膜后包括椎旁48例、腰大肌旁11例、皮下6例;(2)腹腔肠系膜间隙异常对比剂分布19例;腹腔其他部位包括肝门、胰腺、脾分布6例;(3)28例对侧髂血管旁及18例对侧腹股沟淋巴管反流;(4)35例颈部胸导管出口梗阻,其中右侧颈部反流11例、腋下异常引流5例;3例肺、13例胸膜、23例纵隔内异常对比剂分布;(5)3例其他部位乳糜瘘,包括乳糜胸2例,乳糜腹1例.盆腔内异常扩张淋巴管13例,重型组明显高于轻型组(36.7％vs.9.5％,P＜0.05),其他区域差异均无统计学意义.结论 PLCT可准确定位特发性乳糜尿的异常淋巴管的部位、分布和范围,临床分型为重型的特发性乳糜尿更易累及盆腔淋巴管.

放射科是医院重要的公共平台科室,目前已成为临床医学专业医师规范化培训的必选科室.轮转放射科的医师来自不同的临床医学专业科室,专业背景不同,对于放射科培训中需要掌握的内容也各不相同.如何在较短的时间内使不同专业、不同水平的医师有针对性地对影像学知识提高是放射科培训亟待解决的问题.通过探索非影像专业医师规范化培训的基本模式,完善临床医学专业医师在放射科培训中具体实施的细节并规范管理,有效提升临床住院医师的影像阅片能力.

目的 探讨胸部多层螺旋CT(multi-sliecs spiral CT,MSCT)及乳腺X线摄影对乳腺良恶性肿块的诊断价值.方法 收集经手术病理证实的45例患者(共50个病灶)的术前胸部MSCT及乳腺X线摄影的影像学资料.分析乳腺良恶性肿块在胸部MSCT及X线摄影中的影像特征,并对比两种检查对乳腺肿块的诊断效能.结果 胸部MSCT与乳腺X线摄影均能较好显示乳腺良恶性肿块的特征.胸部MSCT、乳腺X线摄影单独使用及二者联合使用对乳腺良、恶性肿块诊断准确率分别为:81.25％、68.75％、81.25％和76.47％、79.41％、91.18％.结论 胸部MSCT对乳腺肿块的检出以及定性具有较高价值.胸部MSCT和乳腺X线摄影两种检查对乳腺肿块的定性诊断部分优势互补,联合使用可提高诊断准确率.

目的:探讨胸部多层螺旋CT(MSCT)对乳腺肿块的诊断价值.方法:收集经手术病理证实的72例乳腺肿块患者的术前胸部MSCT及乳腺X线摄影的影像学资料,包括乳腺恶性肿块54例,良性肿块18例.根据患者乳腺腺体类型分为非致密型组(23例)、致密型组(49例).以病理检查结果为参考,评价胸部MSCT检查及乳腺X线摄影对不同腺体类型乳腺肿块的诊断效能.结果:致密型乳腺组,胸部MSCT对恶性肿块诊断准确率为89.19％,高于乳腺X线摄影的67.57％,差异有统计学意义(P=0.024,χ2=5.103);胸部MSCT对良性肿块诊断准确率为75％,高于乳腺X线摄影的58.33％.非致密型乳腺组,乳腺X线摄影对恶性肿块诊断准确率94.12％,略高于胸部MSCT 82.35％.胸部MSCT、乳腺X线摄影对全部乳腺肿块诊断准确率分别为86.11％和75％.胸部MSCT对转移性淋巴结及胸部转移灶的检出率优于乳腺X线摄影.结论:胸部MSCT对乳腺肿块的定性诊断具有较高价值.胸部MSCT对致密型乳腺中肿块的诊断较乳腺X线摄影可提供更多信息、提高诊断准确率.

目的:探讨第3代双源CT能谱纯化Sn100 kV超低剂量扫描与64排螺旋CT低剂量扫描对比在乳腺及肺联合筛查中对图像质量和辐射剂量的影响.方法:回顾性分析40例行第3代双源CT Sn100 kV胸部超低剂量扫描的女性体检者为实验组,另选取40例采用64排螺旋CT扫描机行低剂量胸部CT筛查的女性体检者为对照组,比较两种扫描方案乳腺和肺的图像质量和辐射剂量.结果:在乳腺及肺客观图像质量对比中,实验组气管、腋下脂肪、肩胛下肌噪声值较对照组均有所下降(P＜0.05),差异有统计学意义;同时,实验组信噪比(SNR)较对照组均有所提升,差异有统计学意义(P＜0.05).实验组乳腺腺体噪声亦较对照组下降(P=0.00).实验组的肺及乳腺图像质量主观评分均优于对照组,评分差异有统计学意义(P＜0.05),两名评价者之间一致性强Kappa=0.82.实验组的剂量长度乘积(DLP)及有效辐射剂量(ED)较对照组明显下降(约达86％).结论:第3代双源CT Sn100 kV超低剂量扫描方案较64排螺旋CT低剂量扫描可在提高乳腺及肺图像质量的同时显著降低辐射剂量,为临床通过胸CT扫描对女性体检者进行肺癌及乳腺癌联合筛查提供了新的参考,达到“一查双筛”的目的.

目的 评价磁敏感加权成像(susceptibility weighted imaging,SWI)及三维动脉自旋标记(three-dimensional arterial spin labeling,3D-ASL)成像在脑胶质瘤分级中的价值.材料与方法 纳入92例脑胶质瘤患者(Ⅱ级35例,Ⅲ级13例,Ⅳ级44例),于术前完成SWI及3D-ASL扫描,术后经过组织病理证实.通过后处理,得到肿瘤内的敏感性信号强度(intratumoral susceptibility signal intensity,ITSS)、肿瘤区域最大脑血流量值(maximum cerebral blood flow,CBFmax)、r1(CBFmax/健侧脑白质区CBF1)、r2(CBFmax/健侧脑灰质区CBF2)及r3(CBFmax/对侧镜像区正常脑组织CBF3),然后进行统计学分析.ITSS采用非参数Mann-Whitney U检验,3D-ASL各参数值采用单因素方差ANOVA分析,P<0.05表示差异有统计学意义.利用受试者工作特性曲线(receiver operator characteristic curve,ROC曲线)评估SWI及3D-ASL对胶质瘤分级的诊断效能.结果 ITSS在鉴别(Ⅱ与Ⅲ)、(Ⅱ与Ⅳ)、(Ⅲ与Ⅳ)中均有统计学差异,肿瘤级别越高,ITSS值越大(P<0.05).而CBFmax、r1、r2及r3仅在(Ⅱ与Ⅳ)组中,具有统计学意义(P<0.05).联合SWI及3D-ASL对胶质瘤分级,得到的ROC曲线下面积(the area under the curve,AUC)、敏感性和特异性均最大.结论 联合SWI及3D-ASL对胶质瘤分级的诊断效能大于单独应用某一种技术,其中SWI比3D-ASL诊断效能高一些.

目的 评价磁敏感加权成像(Susceptibility Weighted Imaging,SWI)及氢质子波谱(1H Magnetic Resonance Spectroscopy,1H-MRS)成像在鉴别各级脑胶质瘤中的诊断价值.方法 按照WHO分级方法将81例脑胶质瘤患者分为3组:Ⅱ级30例,Ⅲ级13例,Ⅳ级38例.所有患者均于术前完成SWI及1H-MRS成像,并经过术后组织病理学证实.通过后处理测量SWI及1H-MRS各个参数值,并进行统计学分析.结果 r NAA在鉴别Ⅱ级与Ⅲ级中有统计学意义(P<0.05).r Cho/NAA、r NAA/Cr在鉴别Ⅱ级与Ⅲ级、Ⅱ级与Ⅳ级中有统计学意义(P<0.05).SWI在各组间均具有显著的统计学差异(P<0.05).联合两种技术的ROC曲线下面积AUC、敏感性和特异性均大于单独应用某一种技术.结论 联合SWI及1H-MRS对脑胶质瘤分级的诊断效能大于单独应用某一种技术;SWI比1H-MRS的诊断效能高.

目的:评价磁敏感加权成像(susceptibility weighted imaging,SWI)及体素内不相干运动(intravoxel incoherent motion,IVIM)成像在脑胶质瘤术前分级中的诊断价值.方法:纳入104例脑胶质瘤患者(低级别33例,高级别71例),术前进行SWI及IVIM成像,术后经病理学检查证实.记录肿瘤内磁敏感信号强度(intratumoral susceptibility signal intensity,ITSS)、快速表观扩散系数(fast apparent diffusion coefficient,fast ADC)、慢速表观扩散系数(slow apparent diffusion coefficient,slow ADC)、灌注分数f值及单指数模型参数标准表观扩散系数(standard apparent diffusion coefficient,standard ADC),用统计学方法对各参数进行分析.结果:高级别脑胶质瘤组的fast ADC、slow ADC、standard ADC和f值分别为(31.2±12.1) ×10-3、(0.46±0.22)×10-3、(0.92±0.22)×10-3 mm2/s和0.48±0.13,而低级别脑胶质瘤组的fast ADC、slow ADC、standard ADC和f值分别为(14.0±6.9) ×10-3、(0.88±0.24)×10-3、(1.08±0.25)×10-3 mm2/s和0.29±0.13.高级别胶质瘤组的ITSS、fast ADC及f值均高于低级别胶质瘤组,差异均有统计学意义(P＜0.05).高级别胶质瘤组的slow ADC及standard ADC值均低于低级别胶质瘤组,差异均有统计学意义(P＜0.05).结论:通过对SWI及IVIM成像进行对比及联合分析,可进一步提高术前脑胶质瘤分级的灵敏度和特异度.