Objective:To compare the quantitative parameters of lung HRCT and clinical manifestations of anti-melanoma differentiation-associated gene 5(MDA5)antibody-positive idiopathic inflammatory myopathy(IIM)patients with different prognoses.Methods:The clinical and imaging data of 19 MDA5 antibody-positive IIM patients admitted to Beijing Shijitan Hospital Affiliated with Capital Medical University between February 2017 and November 2022 were retrospectively analyzed.According to the prognoses,the patients were divided into the good prognoses group(14 cases)and the poor prognoses(intubation or death)group(5 cases).The clinical and laboratory indexes,types of interstitial lung disease(ILD),and CT quantitative indexes were compared between the two groups.Results:There were significant differences in gender;carcinoembryonic antigen;blood oxygen saturation;and the percentages of lymphocytes,monocytes,neutrophils,lymphocytes,and neutrophils between the good versus the poor prognoses groups.The proportion of abnormal respiratory system changes was higher in the poor prognoses group.In terms of the type of ILD,acute interstitial pneumonia(AIP)-like lesions were the main type in the poor prognoses group,and nonspecific interstitial pneumonia(AIP)lesions were the main type in the good prognoses group.For NSIP-like lesions,there was a statistically significant difference between the two groups.The semi-quantitative score of the poor prognoses group was higher,and the volume of whole lung lesions as well as the proportion of whole lung lesions were also higher.Spearman correlation analysis showed that the blood oxygen saturation,monocyte percentage,semi-quantitative score,whole lung lesion volume,and proportion of whole lung lesion were negatively correlated,while carcinoembryonic antigen,neutrophil percentage,and neutrophils were positively correlated with the semi-quantitative score,whole lung lesion volume,and proportion of whole lung lesion.Conclusions:The lung HRCT quantitative indicators,clinical manifestations,and laboratory indicators are different in MDA5 antibody-positive IIM patients with different prognoses.Early evaluation of HRCT imaging manifestations,clinical manifestations,and laboratory indicators is of great significance in determining the prognosis of MDA5 antibody-positive IIM patients,which provides corresponding support for clinical diagnosis and treatment.

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.

目的:探讨早期新型冠状病毒肺炎(COVID-19)的胸部薄层平扫CT表现特征.材料与方法:收集2022年11月至12月我院感染科确诊COVID-19且胸部CT表现阳性的患者153例,所有患者自发病后1～14天行胸部薄层平扫CT检查和有较完整的临床资料.根据患者年龄(≤60岁和＞60岁)和发病与CT检查的时间间隔(≤7天和＞7天)将患者各分为两组,比较两组患者的CT表现特征的差异性.结果:153例COVID-19患者中,累及肺部(100％)、血管(93.5％)、气道(73.4％)和胸膜(70.1％),其中年龄组间的对比显示病变数量、部位、大小、容积和束带影的差异有统计学意义;发病与CT检查时间间隔分组患者之间,病变的形态、密度、机化和纤维化以及胸膜受累等差异有统计学意义.结论:胸部薄层平扫CT可明确早期COVID-19的病变位置和范围,对COVID-19的定性诊断和鉴别有一定的特征,即以形态的多样化、胸膜内和血管周分布、肺泡为单元的间质性病变、早期混合性磨玻璃影常伴明显的机化和纤维化、胸膜局限性增厚而胸水极少等有助于COVID-19的诊断和鉴别.

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.

Objective: Objective: To explore and analyze the clinical features and chest thin-slice non-enhanced computed tomography (CT) imaging features of patients with coronavirus disease 2019 (COVID-19) at initial diagnosis in a fever clinic. Methods: A retrospective analysis was performed on 140 patients with COVID-19 at initial diagnosis in a fever clinic, including 101 and 39 cases in the moderate and severe and critical groups , respective-ly. Baseline, clinical characteristics, complete blood count + C-reactive protein (CBC+CRP), and chest thin-slice non-enhanced CT imaging characteristics of the patients were analyzed. Results: (1) The comparison between the moderate and severe and criti-cal groups showed that there were statistically significant differences in age (66.05±14.38 vs. 77.90±13.12,), course of initial diagnosis (5.40±3.81 vs. 3.97±3.12), SPO2 (97.88±1.73 vs. 92.92±4.01), and Tmax (38.32±0.66 vs. 38.68±0.63).(2) CT features between the two groups showed statistically significant differences in semi-quantitative volume (18.85±13.51 vs. 34.41±19.34). (3) The comparison between the moderate and severe and critical groups showed that there were statistically significant differ-ences in CRP (29.42±26.93 vs. 80.67±48.01), LYM (1.64±0.68 vs. 0.95±0.64), and NLR (3.48±2.46 vs. 9.36±10.42). (4) Six indicators, namely age, the course of initial diagnosis, SPO2, semi-quantitative volume, CRP, and LYM, were screened for multivariate logistic regression analysis. The result show that age (OR=1.090, 95%CI 1.006 ~ 1.181), semi-quantitative (OR=1.086, 95%CI 1.086 ~ 1.019), and SPO2 (OR=0.261, 95%CI 0.089 ~ 0.762), are related to the occurrence of severe and critical COVID-19 infection, and the difference is statistically significant; CRP (OR=1.054, 95%CI 1.023 ~ 1.087) and LYM (OR=0.039, 95%CI 0.04 ~ 0.391) are related to the occurrence of severe and critical COVID-19 infection, and the difference is significant statistically significant. Conclusion: Age, lower SPO2 and LYM, a shorter course; a higher Tmax, semi-quantitative volume, CRP, and NLR are associ-ated with severe and critical cases and required early identification.

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 探讨腹膜假黏液瘤(PMP)患者增强CT征象与Ki-67表达水平的关系.方法 连续性纳入明确诊断的88例PMP患者.所有患者在术前均行腹部增强CT检查.将Ki-67指数>25％定义为Ki-67高表达组(48例),≤25％定义为Ki-67低表达组(40例).应用两独立样本t检验、Wilcoxon秩和检验、卡方检验及Fisher精确检验比较2组患者的差异.应用Logistic回归分析与Ki-67高表达相关的CT征象.结果 2组患者在腹膜病变表现形式上有差别(P=0.012),Ki-67高表达组腹膜实性结节更常见.病灶内钙化在Ki-67高表达组更常见(χ2=5.569,P=0.018).多因素Logistic回归显示腹膜实性结节[优势比(OR)=4.412,95％ 置信区间(CI)=1.156～16.845,P=0.030]、病灶内钙化(OR=3.201,95％CI=1.040～9.852,P=0.043)均是Ki-67高表达的独立预测因素.结论 不同表达水平的Ki-67患者CT表现不同,腹膜实性结节及病灶内钙化有助于预测PMP患者Ki-67高表达,可作为评估预后的指标之一.

目的:分析外周性原始神经外胚层肿瘤(pPNET)的CT表现,以提高对该病的诊断能力.方法:回顾性分析14例经病理学证实的pPNET的CT图像,总结其影像学特征性表现,包括病灶部位、大小、形态、密度、边界、强化方式及转移情况等.结果:女性6例,男性8例,年龄8～71岁,中位年龄34岁.14例pPNET中发生于腹腔4例,腹膜后3例,盆腔3例,后纵隔2例,肋骨1例,骨盆1例.8例为单发肿块,6例表现为多发肿块或结节.12例(85.71％)患者病灶直径 ≥5 cm.单发者多呈不规则分叶状.CT平扫密度不均匀,病灶内部见低密度坏死区,4例病灶内见点片状钙化.病灶实性部分平均CT值约为41.18 HU,增强扫描病灶呈轻中度持续强化,动脉期、门脉期和延迟期平均CT值分别增加了14.85 HU、21.42 HU和22.50 HU.多发者呈大小不等的结节或肿块,密度、边界及强化方式与单发者近似.合并病灶周围静脉血栓者2例.12例胸腹盆部患者中7例有周围淋巴结转移.3例患者合并腹膜转移.结论:pPNET的CT表现有一定特点,增强CT可清楚显示病变范围,周围侵犯及转移情况,为临床提供重要诊断信息.

目的:探讨增强CT成像对肝窦阻塞综合征(HSOS)的诊断价值.材料和方法:收集临床和影像诊断为HSOS的6例(男2例,女4例)纳入本研究,所有患者均行增强CT检查,观察分析增强CT成像上肝实质、肝脏相关血管及其他扫描范围相关影像变化,并参考肝脏血管超声、血管造影或增强MR检查结果,总结分析HSOS增强CT的特征.结果:CT平扫6例均表现肝脏肿大,肝实质密度不均匀减低.增强后6例均表现为"斑片状"或"地图样"异常强化,1例除此之外还可见特征性的以第二肝门为中心沿三支肝静脉周围"放射状"异常强化.5例三支肝静脉均未见显示,1例肝左静脉未显影,肝中静脉和肝右静脉变细成线样改变.下腔静脉肝段3例重度狭窄,3例稍受压,但所有病例经肝脏血管超声、血管造影或增强MR检查均证实肝静脉及下腔静脉血流通畅.结论:CT平扫所显示肝脏肿大、密度不均匀减低和增强扫描所显示肝实质"斑片状"或"地图样"异常强化或特征性的以第二肝门为中心沿三支肝静脉周围"放射状"异常强化特点有助于HSOS的诊断.但增强CT对诊断肝静脉和下腔静脉肝段是否狭窄或闭塞有一定的局限性.

Objective To explore the clinical and imaging findings of chyloptysis.Methods The complete clinical,direct lymphangiography and post-procedural CT data of 6 cases of chyloptysis were collected.1 case had an additional to bronchoscopy.The CT imaging and abnormal lymphatic reflux was analyzed.Results The 6 patients with chyloptysis had milk white sputum from 5 months to 27 years,accompanied by various degrees of chylothorax and/or chyloperitonium.Chyloptysis showed acinar and/or patchy ground glass exudation,accompanied by interval thickening of the lung in 2 cases.In the 6 cases,5 had thoracic duct end obstruction,accompanied by abnormal distribution of contrast agent in right lymphatic duct in 3 cases,in mediastinum in 3 cases,in lung in 2 cases.All of 6 cases had tortuous and dilated iliac and lumbar lymphatic vessels.One case showed lymphatic vessels dilation of bronchial submucosa under bronchoscopy.Conclusion The chyloptysis has characteristic clinical manifestations.The direct lymphangiography and post-procedural CT can provide a certain amount of information for abnormal lymphatic circumfluence of chyloptysis.

Purpose:To investigate the feasibility of low tube voltage indirect CT venography (CTV) in superficial venous system in varicose veins (VV) of lower limbs.Materials and Methods:This prospective study has been approved by the hospital institutional review board.Fifty-five consecutively patients (F/M,23/32,age range 15-77 years) suspicious of varicose veins were recruited in this study.All the patients were performed CT venography (CTV) in lower limbs.The signal intensity (SI) of great saphenous vein (GSV) and varicose vein (VV) was measured,and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated.Subjective image quality of MPR and 3D volume rendering (VR) were assessed by two experienced radiologists using a 3-point scale.Perforator veins larger than 5 mm in the VV were marked.The radiation doses were recorded.Results:Forty-four patients were diagnosed as VV,including 31 unilateral and 13 bilateral VV,while 2 patients with arteriovenous fistula,3 hypovenosity and 6 deep venous thrombosis.All GSVs in 44 patients were demonstrated the entire length in Low tube voltage CTV.There is no statistical significance in quantitative indexes between the proximal point in GSV and VV,with the mean SI,SNR and CNR (122 ± 16.4 Versus (125.9--23.6)HU),(9.62±2.71 Versus 9.91 ± 3.12),(4.0 ± 2.39 Versus 4.36 ± 2.81),respectively.For subjective image quality,35 (79.5％) were excellent,8 (18.2％) fair and 1 (2.3％) poor.Twenty-two perforator veins were detected in 15 patients,and the mean diameter of perforator veins marked by CTV was 3.21 ± 0.87 mm,which were ligated during the surgery thereafter.The mean radiation dose was (804.7 ± 96.7)mGy·cm.Conclusions:Low tube voltage indirect CT venography with iterative reconstruction accommodates available image quality for diagnosis of varicose vein in lower extremities,and provides the road map in preoperative assessment,especially for deep-seated perforating veins,which demonstrates the potential ability to navigate the varicose vein surgery.

<正>与传统CT比较,256层智能CT(iCT)具有扫描速度快、分辨率高、图像清晰和一站式大范围扫描等优点[1]。CT检查过程中碘造影剂的使用频率越来越高,对于对比剂的注射速度和剂量、对比剂副作用的诊治以及检查过程中的护理配

Objective To study the valve of time-resolved imaging of contrast kinetics(TRICKS)in the diagnosis of extremity musculoskeletal neoplasms.Methods First,22 cases of extremity musculoskeletal neoplasms were scanned with conventional sequences.Second,contrast medium was injected and TRICKS was performed,then enhanced images were obtained in axial plane,sagittal plane and coronal plane.The overall image quality and the demonstration of neoplasms were analyzed,and the qualitative diagnosis was compared with surgical and pathological results.Results TRICKS was successfully performed in all patients.TRICKS demonstrated the arterio-venous structures dynamically.The qualitative diagnosis was consistent with surgical and pathological results.Conclusion The operation of TRICKS is simple,and it can observe arterio-venous structures without interfere enhanced scan.TRICKS should be a conventional sequence in the examination of extremity musculoskeletal diseases.

慢性阻塞性肺疾病(COPD)是一种常见的慢性呼吸系疾病,严重影响患者的劳动能力和生活质量.长期氧疗是目前唯一影响CoPD预后的重要因素,随着人民生活水平的提高,社区服务的深入开展,氧疗进入家庭,家庭氧疗的护理工作越来越得到重视.

目的:研究应用多糖(以氨基多糖为主)及胶原蛋白复合生物膜对小型猪牙行直接盖髓术的作用.方法:用多糖及胶原蛋白复合生物膜做小型猪牙的直接盖髓术并与氢氧化钙对照.分别于术后2、4、12 周、6 个月将小型猪快速处死,本文是随机抽样不同时期的4 个对照牙经固定,超声快速脱钙做组织切片,在光镜下观察.结果:4 个术后不同时期的牙在穿髓孔处均有不同程度的修复性牙本质形成.周边造牙本质细胞排列整齐,牙髓无炎症及变性,根髓及牙周组织正常,最终形成牙本质桥将穿髓孔封闭使牙髓保存了活力.结论:实验结果证明了含有多糖及胶原蛋白复合生物膜对小型猪牙有良好的直接盖髓作用,从而推动实验深入进行.