目的 探讨妇科癌肉瘤(CS)的影像特征及其临床价值.方法 回顾性分析经病理确诊的42 例女性原发性生殖系统癌肉瘤患者的影像资料,观察并评估病灶的位置、形态、大小、数目、边缘以及强化方式,分析邻近器官受侵及转移情况,总结特征并与病理相对照.结果 15 例卵巢癌肉瘤病灶呈囊实性巨大肿块,多类圆形或椭圆形,瘤体最大径为5.3～24.2 cm;27 例子宫癌肉瘤病灶多呈类圆形、椭圆形、类三角形,Ⅰ型瘤体最大径 3.5～11.8cm,Ⅱ型子宫内膜厚度为1.3～2.8 cm.妇科CS密度、信号混杂,多边界欠清或不清,增强扫描多轻中度强化,可见包膜及迂曲增粗血管影,周围可见侵犯征象,腹盆腔可见淋巴结转移及少至大量腹腔积液.结论 妇科CS 在影像表现上具有一定的特征,影像检查可以评估病变的位置、大小、数目、边缘、与邻近结构的关系、是否存在转移等,为临床诊治提供重要依据.

BACKGROUND:Coronavirus Disease 2019(COVID-19)is currently a global pandemic.Information about predicting mortality in severe COVID-19 remains unclear.METHODS:A total of 151 COVID-19 in-patients from January 23 to March 8,2020,were divided into severe and critically severe groups and survival and mortality groups.Differences in the clinical and imaging data between the groups were analyzed.Factors associated with COVID-19 mortality were analyzed by logistic regression,and a mortality prediction model was developed.RESULTS:Many clinical and imaging indices were significantly different between groups,including age,epidemic history,medical history,duration of symptoms before admission,routine blood parameters,inflammatory-related factors,Na+,myocardial zymogram,liver and renal function,coagulation function,fraction of inspired oxygen and complications.The proportions of patients with imaging Stage III and a comprehensive computed tomography score were significantly increased in the mortality group.Factors in the prediction model included patient age,cardiac injury,acute kidney injury,and acute respiratory distress syndrome.The area under the receiver operating characteristic curve of the prediction model was 0.9593.CONCLUSIONS:The clinical and imaging data reflected the severity of COVID-19 pneumonia.The mortality prediction model might be a promising method to help clinicians quickly identify COVID-19 patients who are at high risk of death.

Objectives: This study aimed to identify the clinical features of cardiac injury complicating with acute kidney injury (AKI) and its risk for a fatal outcome in patients infected with coronavirus disease 2019 (COVID-19) pneumonia. Methods: Initial signs and symptoms and clinical laboratory, radiological, and treatment information were obtained from seven hospitals in China from January 23, 2020, to March 15, 2020. Results: Of 438 patients, 36 (8.22%) displayed isolated cardiac injury, 17 (3.88%) had isolated AKI, and 17 (3.88%) displayed cardiac injury complicating with AKI. Compared with patients without cardiac injury or AKI, patients with isolated cardiac injury, isolated AKI, and cardiac injury complicating with AKI were older (55, 65, 74 vs. 48 years, P < 0.0001) and critically severe. More patients displayed fatigue, dyspnea, and comorbidities in the group with cardiac injury complicating with AKI. Moreover, the indexes reflecting myocardial, renal, liver, and coagulation dysfunctions and infection-related factors were significantly different among the four groups. After adjustment for covariates, patients with cardiac injury complicating with AKI had a higher hazard ratio for mortality (6.64; 95% confidence interval, 1.51–29.30). Conclusion: Cardiac injury complicating with kidney injury significantly increased the risk for in-hospital mortality in COVID-19 pneumonia patients. Therefore, early detection at admission and careful monitoring of myocardial and renal injury through biomarkers during hospitalization is recommended to reduce the harm to patients.

BACKGROUND:Novel coronavirus disease 2019 (COVID-19) pneumonia remains a matter of concern. Chest CT findings of COVID-19 pneumonia have been reported widely, while there is relatively rare research on chest X-ray (CXR).OBJECTIVE:The study was aimed to compare the CXR and chest CT findings of patients with confirmed COVID-19 infection and to explore their respective clinical values.METHODS:28 inpatients with COVID-19 pneumonia who underwent both CXR and CT were included. The pulmonary manifestations of the lesions were recorded. Ground-glass opacity (GGO), consolidation, and fibrosis were quantified in CXR and chest CT separately. Consistency was analyzed using Fleiss' kappa and intraclass correlation coefficient. The stages of the disease in CXR and chest CT were evaluated.RESULTS:Approximately 67.9% (19/28) of subjects had abnormal findings on CXR. The common manifestations in CXR were ground-glass opacities (GGO) (100%, 19/19) and consolidation (68.4%, 13/19). 92.9% (26/28) of patients had abnormal manifestations on CT. The common manifestations in CT were GGO (88.5%, 23/26), consolidation (69.2%, 18/26), reticular opacity (69.2%, 18/26) and nodule (46.2%, 12/26). Among the abnormalities between CXR and CT, only consolidation was consistent (κ=0.510). GGO (ICC=0.501) and consolidation (ICC=0.431) scores were consistent in CXR and chest CT. The results of staging were the same in 14 cases, most of them were in stage I and stage II. While in other cases with inconsistent results, CT was more advanced in the disease stage than CXR, mainly stage III and stage IV.CONCLUSION:CXR is helpful to observe the change of the pulmonary lesions in patients with confirmed COVID-19 pneumonia. CT can be used for early diagnosis and staging of lesions.

BACKGROUND:An outbreak of coronavirus disease 2019 (COVID-19) has occurred worldwide. However, the small-airway disease in patients with COVID-19 has not been explored.AIM:This study aimed to explore the small-airway disease in patients with COVID-19 using inspiratory and expiratory chest high-resolution computed tomography (CT).METHODS:This multicenter study included 108 patients with COVID-19. The patients were classified into five stages (0-IV) based on the CT images. The clinical and imaging data were compared among CT images in different stages. Patients were divided into three groups according to the time interval from the initial CT scan, and the clinical and air trapping data were compared among these groups. The correlation between clinical parameters and CT scores was evaluated.RESULTS:The clinical data, including age, frequency of breath shortness and dyspnea, neutrophil percentage, lymphocyte count, PaO2, PaCO2, SaO2, and time interval between the onset of illness and initial CT, showed significant differences among CT images in different stages. A significant difference in the CT score of air trapping was observed between stage I and stage III. A low negative correlation was found between the CT score of air trapping and the time interval between the onset of symptoms and initial CT. No significant difference was noted in the frequency and CT score of air trapping among different groups.CONCLUSION:Some patients with COVID-19 developed small-airway disease. Air trapping was more distinguished in the early stage of the disease and persisted during the 2-month follow-up. Longer-term follow-up studies are needed to confirm the findings.

Background: Coronavirus Disease 2019 (COVID-19) is currently a global pandemic. Information about the death predicting of severe COVID-19 is not clear. Methods: 151 in-patients from January 23th to March 8th 2020 were divided into severe and critically severe group, as well as survival and death group. The analysis of differences of clinical and imaging data were performed between groups. The logistic regression analysis of factors associated with death in COVID-19 were conducted, and the prediction model of death risk was developed. Results: Many clinical and imaging indices were significantly different between groups, including the age, the epidemic history, the past medical history, the duration of symptoms prior to admission, blood routine, inflammatory related factors, Na + , myocardial zymogram, liver and renal function, coagulation function, fraction of inspired oxygen and complications. The proportion of patients in imaging stage III and comprehensive CT scores was increased significantly in death group. The area under receiver operating characteristic curve of the prediction model was 0.9593. Conclusions: The clinical and imaging data reflect the severity of COVID-19 pneumonia. The prediction model of death risk might be a promising method to help clinicians to quickly identify and screen potential individuals who had a high-risk of death.

OBJECTIVE:The study was aimed to describe the clinical characteristics and evaluate the dynamic changes of chest CT features in the first three weeks in the common type fo COVID-19 pneumonia patients in Jiangsu Province.METHODS:307 patients infected SARS-CoV-2 classified as common type were enrolled in the study. 628 chest CT scans were divided into three groups based on the time interval between symptoms and chest CT scan. The clinical characteristics were descriptively analyzed.The chest CT features were quantitatively evaluated. Mann-Whitney U test was used to test the differences in three groups and between men and women. Spearman rank correlation was used to test the association between the arterial blood gas(ABG) analysis results and chest CT scores.RESULTS:Fever (69.1%) and cough (62.8%) were common symptoms. 111(36.2%) patients were anorexia. GGO was the most common manifestation of COVID-19 pneumonia, which could be followed by consolidation and fibrosis. Lower lobe or subpleural region was the most common distribution form of lesion. More lung lobes were involved in the third week. Total chest CT scores in the second week were higher than the first week. Fibrosis Scores increased in the second and third week. Total CT score, GGO score and fibrosis score of male patients were significantly higher than female in the second week. Male patients had higher consolidation score and fibrosis score than female in the third week. Total CT score and GGO score had weak to moderate correlation with arterial blood gas indices.CONCLUSION:Changes in chest CT were difficult to assess quantitatively in the first third weeks. Male patients recovered slower than female in the second week. Although CT score had correlations with arterial blood gas indices, long-term follow-up of pulmonary function test is needed to determine the recovery of lung.

Background Computed tomography (CT) and reverse-transcription polymerase chain reaction (RT-PCR) are the recommended tools for the diagnosis of coronavirus disease 2019 (COVID-19). The present study aimed to investigate the correlation between chest CT and RT-PCR while describing the atypical CT imaging features of COVID-19. Methods In this study, 418 patients in Jiangsu, China, clinically diagnosed with COVID-19 from January 10 to February 17, 2020, were included. Patients who fulfilled the following conditions were evaluated further: (1) Patients had positive RT-PCR and negative CT; (2) Patients had initial negative RT-PCR and positive CT, and follow-up PT-PCR tests were positive; (3) Patients had atypical CT findings. Results Of the 418 initial chest CT scans, 30 (7.2%) patients had normal CT presentation, and 6 (1.4%) patients had initial negative RT-PCR results and positive CT scans. Next, 10 (2.4%) cases of patients showed atypical CT findings, including 2 case of solid nodule, 4 cases of halo sign (solid nodule or mass surrounded by ground glass opacity), and 4 cases of predominant fibrous stripes. Conclusions False-negative results can be found on both chest CT and RT-PCR; hence, the diagnosis of COVID-19 should consider both CT and RT-PCR. CT manifestations, such as solitary nodule, halo sign, and pulmonary fibrous stripes, might indicate the possibility of COVID-19 to the radiologists.

胸腺区支气管源性囊肿为临床少见病例，但随着胸部CT体检检查量的逐年增加，胸腺区占位的检出量也明显增加，此病的误诊率较高。本研究通过121例经手术病理证实的胸腺区支气管源性囊肿患者术前胸部CT表现进行分析、总结及归纳，发现其影像学表现具有一定的特征性。通过CT平扫联合增强扫描，认识病灶的典型形态，测量病灶CT值，可以有效提高该病的诊断准确率。

Background: A pneumonia associated with the coronavirus disease 2019 (COVID-19) recently emerged in China. It was recognized as a global health hazard. Methods: 234 inpatients with COVID-19 were included. Detailed clinical data, chest HRCT basic performances and certain signs were recorded Ground-glass opacity (GGO), consolidation, fibrosis and air trapping were quantified. Both clinical types and CT stages were evaluated. Results: Most patients (approximately 90%) were classified as common type and with epidemiologic history. Fever and cough were main symptoms. Chest CT showed abnormal attenuation in bilateral multiple lung lobes, distributed in the lower and/or periphery of the lungs (94.98%), with multiple shapes. GGO and vascular enhancement sign were most frequent seen, followed by interlobular septal thickening and air bronchus sign as well as consolidation, fibrosis and air trapping. There were significant differences in most of CT signs between different stage groups. The SpO2 and OI were decreased in stage IV, and the CT score of consolidation, fibrosis and air trapping was significantly lower in stage I (P < 0.05). A weak relevance was between the fibrosis score and the value of PaO2 and SpO2 (P < 0.05). Conclusions: Clinical performances of patients with COVID-19, mostly with epidemiologic history and typical symptoms, were critical valuable in the diagnosis of the COVID-19. While chest HRCT provided the distribution, shape, attenuation and extent of lung lesions, as well as some typical CT signs of COVID-19 pneumonia.

Neuroimaging studies have implicated abnormal brain microstructure in episodic migraine (EM), but whether the pattern is altered during migraine chronification is not well known. Fifty-six patients with migraine without aura, including 39 EM patients and 17 chronic migraine (CM) patients, and 35 healthy controls (HCs) were enrolled. Voxel-based morphometry analysis was performed to assess gray matter (GM) volume differences among groups and their association with clinical feature was examined. Compared with the HC group, both migraine groups showed increased GM volume in the periaqueductal grey matter (PAG) and decreased GM volume in the anterior cingulate cortex (ACC). The left hippocampus/parahippocampal gyrus (PHG) volume of the HC group was smaller than that of the EM group, but was larger than that of the CM group. For the dorsolateral prefrontal cortex (dlPFC), the EM group showed the smallest GM volume while the CM group had the largest volume. Higher headache frequency was associated with greater GM volume in the PAG and dlPFC, but was associated with smaller GM volume in the ACC and hippocampus/PHG across all patients. GM volume changes in regions involved in pain generation and control are potential neural mechanism underlying migraine, and are associated with migraine types and headache frequency.

目的 分析归纳原发性中枢神经系统淋巴瘤(PCNSL)的常规磁共振成像及弥散加权成像(DWI)特征.方法 回顾性分析16例手术病理证实的PCNSL的常规磁共振成像特点,测量病灶表观扩散系数(ADC)值,统计学分析病灶的ADC值特点.结果 16例PCNSL的ADC值(0.628±0.093)×10-3mm/s.结论 ADC值测量对PCNSL的诊断具有一定的价值.

Objective To investigate CT and MRI characteristics of lateral ventricular tumors to improve the diagnostic accuracy.Methods CT and MRI findings were analyzed retrospectively in 46 cases of tumors in the lateral ventricle proved by surgery and pathology,imaging features were concluded in comparison with the pathological findings.Results Ependymoma (n=5),astrocytoma (n=8),glioblastoma (n=2),central neurocytoma (n=4),meningioma (n=7),metastatic tumor (n=4),lymphoma (n=4),cavernous hemangioma (n=7),hemangiopericytoma (n=l),subependymoma (n=2),subependymal giant cell astrocytoma (n=l) and neuroepithelial cyst (n=1) were included in 46 patients.Central neurocytoma was mostly found in young men compared to metastatic tumor.Predilection site of subependymoma,subependymal giant cell astrocytoma,central neurocytoma was cornu anterius and interventricular foramen in common,while meningioma and neuroepithelial cyst were located in ventricular trigone.The density and signal of meningioma,neuroepithelial cyst,lymphoma were relatively homogeneous.Cystic area were showed in most astrocytoma,glioblastoma,central neurocytoma,ependymoma and hemangiopericytoma.Conclusion Lateral ventricular tumors have some characteristics using CT and MRI,combining image features with the patient's age and the specific tumor location would contribute to the diagnosis and differential diagnosis of lateral ventricular tumors.

Objective To explore the value of contrast enhanced susceptibility weighted imaging (SWI) in 3.0 T for grading of gliomas.Methods16 adults with gliomas (7 for low-grade gliomas, 9 for high-grade gliomas) confirmed by craniotomy surgery and histopathology underwent conventional MRI, contrast enhanced T1WI and SWI. Magnitude maps and phase maps were acquired separately. Filtering of phase maps, reconstruction of SWI maps and minimum intensity projection were accomplished in the software SPIN. The maximum transverse sections images of the masses were collected as the standard images. Intratumoral susceptibility signal intensity (ITSS) was graded by two senior radiologists respectively. Results The average ITSS score of high-grade gliomas was (2.2778±0.7519). The average ITSS score of low-grade gliomas was (1.2143±1.1217).Mann-Whitney U test showed the signifi cant difference of ITSS between high-grade and low-grade gliomas.Conclusion ITSS between high-grade and low-grade gliomas has signifi cant difference. Contrast enhanced SWI can be used to assist grading of gliomas.