Objective: To investigate the value of multi-parameter quantitative CT combining with HRCT in evaluating the prognosis of coronavirus disease 2019 (COVID-19) Methods: Sixty-nine cases were included in this retrospective study All of the cases were primarily diagnosed with common type of COVID-19 when admitted to hospital According to the clinical prognosis and the changes of image appearance, three groups were divided Group A with decreasing extent of lesions (21 cases) and group B with increasing extent of lesions (25 cases) were both common type of COVID-19 without converting into severe type Group C (23 cases) converted common type into severe type during hospitalization Multiple CT parameters among the groups were compared Results: The changes of the multiple parameters of CT after treatment, such as the total volume of lesions, GGO volume, and the volume of the consolidation and MLA, had a significant difference among the three groups When the cut-off values for the increasing total volume, GGO volume, consolidation volume, and MLA were determined to be 231 46 cm3, 168 58 cm3, 74 46 cm3, and 57 Hu, the sensitivity (95 7%, 82 6%, 73 9%, and 78 3%) and specificity (91 3%, 91 3%, 93 5%, and 87%) of the diagnosis of common type converting into severe type were optimal and the areas under ROC curve were 0 961, 0 914, 0 885, and 0 885 Conclusion: The changes of the volumes of total lesions, GGO and consolidation and the change of MLA between follow-up CT and first CT are important prognostic factors in patients with COVID-19 Common type COVID-19 patients with total volume of lesions increasing >231 46 cm3, GGO volume increasing >168 58 cm3, consolidation volume increasing >74 46 cm3, or MLA increasing >57 Hu are more likely to convert into severe type The multiparameter quantitative CT combined with HRCT has an effect on evaluating the prognosis of COVID-19 © 2021, Editorial Board of Medical Journal of Wuhan University All right reserved

In this work, amino functionalized CdSe-silica core-shell nanoparticles (NH2-CdSe@SiO2 NPs) were constructed as probe to detect picric acid (PA). The CdSe QDs were embedded in SiO2 nanopartides and modified with amino groups on the surface. The nitro explosives are electron deficient in nature, which will have stronger affinity for amines and resulted in fluorescence quenching of quantum dots. It was proved that this strategy is selective, easy and sensitive enough for sensing PA with a detection limit of 0.5 x 10(-7) M. (C) 2020 Published by Elsevier B.V.

目的 探讨原发睾丸淋巴瘤(PTL)的MRI表现特征及诊断价值.方法 回顾性分析经手术病理及免疫组化证实的6例PTL的MRI表现及相关临床资料,并与同期6例睾丸精原细胞瘤临床资料比较.采用高场1.5～3.0T MR仪行下腹-盆腔-睾丸的常规平扫(6例)、增强4例(其中动态增强或灌注3例)及扩散成像3例,观察病变大小、形态、信号强度及均匀度、强化特征以及DWI扩散特征和附睾及精索、淋巴结受累转移情况,分析其特征.结果 6例PTL平均发病年龄65岁(44～88岁),病变呈类圆形或卵圆形、信号较均匀,T1 WI等信号(6/6),T2 WI低信号(5/6),1例欠均匀;T2 WI,病变-睾丸组织-睾丸鞘膜积液呈阶梯分层信号;增强后渐进性中度强化,持续时间长,增强曲线呈平台型(3/4),平扫及增强病变区均可见小血管穿行,类似正常睾丸组织;DWI病变呈高信号,ADC值减低(n=3).结论 PTL在MRI表现为T1WI等信号结节或肿块并渐进性中度强化,T2WI均匀低信号以及DWI呈明显扩散受限,后2项可视为特征性改变.

目的 采用前列腺影像报告与数据系统(PI-RADS v2)评估不同年资医师间评分一致性的主要影响因素.方法 回顾性分析60例前列腺癌(PCa)患者MRI图像,其中Gleason评分3+3、3+4、4+3、4+4、4+5、5+5每组各10例;5名影像诊断经验分别为21(R1)、10(R2)、5(R3)、3(R4)、1(R5)年的医师作为观察者.根据PI-RADSv2标准,培训5名医师并独立评分,R1独立重复一次评分并结合病理,将其作为评分参考标准;5名医师独立评估熟悉程度与是否遵从双盲原则自我评分;采用Kappa检验两医师间一致性;采用Kruskal-Wallis检验5名医师整体是否存在差异,采用Mann-Whitney两两比较5名医师的差异;采用受试者工作特征曲线(ROC)分析不同年资医师的诊断效能,计算曲线下面积(AUG)及95％可信区间(95％CI).结果 60例MRI资料共计1500幅有效图像,涉及责任病灶共计431幅.5名观察者中熟悉程度评分均较高,双盲依从性较好;5名医师与最后诊断结果的Kappa一致性检验显示,R1、R2、R3的Kappa系数＞0.75,R4(K =0.607)与R5(K=0.584)的诊断一致性良好;R1前后两次评分无统计学差异(P=0.759);医师间评分存在差异(H=2.643,P=0.027),医师年资越高,评分一致性越好;低年资医师评分(R4与R5)差异不明显,但与R1评分存在显著差异;不同医师主观评分间的AUC随着医师的年资降低逐渐降低,R5的AUC最低.结论 观察者间评分差异的来源是多样的,工作年资是影响主观评分准确性的主要因素.

构造控砂一直为断陷盆地分析调查工作的重点和难点.综合井-震、岩心和镜下鉴定资料,以渤海湾盆地济阳坳陷沾化凹陷东部始新统沙四上亚段—沙三段(SQ1-SQ3)为例,探讨构造主导下的控砂机制和沉积充填过程,取得认识如下:1)Ⅰ级构造转换带奠定盆地宏观构造-沉积格局,多阶构造坡折叠合湖平面升降控制三级层序内部体系域之间的砂体加积与沉积体系旋回性变化,Ⅱ级构造坡折和次级断层控制体系域内局部输砂系统和砂体展布,陡坡带往往不利于碎屑物质注入湖盆;2)SQ1-SQ2存在孤北和孤南两个独立输砂系统,SQ3两个输砂系统合二为一,SQ1主要发育进退积不明显的、小而多的扇三角洲,SQ2开始发育三角洲、(半)深湖和滑塌砂体,SQ3主要发育大型三角洲,(半)深湖区广泛发育滑塌砂体;3)构造活动通过构造转换带、坡折带、次级断层和陡坡带等主导多断湖盆控砂机制和沉积充填过程,气候仅可强化或弱化前者的控制作用,但不会改变盆地充填过程.

Aspergillosis is a serious pathologic condition caused by Aspergillus organisms and is frequently seen in immunocompromised patients. Invasive pulmonary aspergillosis (IPA) which is rare, has been identified as one of the histological subtypes of aspergillosis. It is one of the rare chronic infectious diseases of respiratory system in China, and presents high morbidity, high drug resistance and specific imaging characteristics. This paper focused on a rare case report of invasive pulmonary aspergillosis with chronic mass calcification. CT imaging was discussed by contrast with clinical manifestations, aiming to survey the invasive pulmonary aspergillosis and the mass calcification and to improve the clinical differential diagnosis.

Karjalainen et al 1 Karjalainen P.P. Niemelä M. Laine M. Airaksinen J.K. Ylitalo A. Nammas W. Usefulness of post-coronary dilation to prevent recurrent myocardial infarction in patients treated with percutaneous coronary intervention for acute coronary syndrome (from the BASE ACS trial). Am J Cardiol. 2017; 119: 345-350 Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar performed a post hoc analysis of the BASE ACS trial, a prospective randomized trial of titanium-nitride-oxide-coated bioactive stents versus everolimus-eluting stents in acute coronary syndrome (ACS). The primary end point was the first occurrence of major adverse cardiac events: a composite of cardiac death, nonfatal myocardial infarction (MI), or ischemia-driven target lesion revascularization. The secondary end points were noncardiac death and definite stent thrombosis. Their analysis showed that the rates of nonfatal MI were significantly lower among those who underwent postdilation versus those who did not (4.5% vs 8.5%, p = 0.02), while no significant differences were observed for other end points, including cardiac death, ischemia-driven target lesion revascularization, noncardiac death, or definite stent thrombosis. And the rates of the composite end point, major adverse cardiac events, were similar at long-term follow-up among patients who underwent stent postdilation versus those who did not (15.7% vs 15.1%, p = 0.81). Based on these findings, the investigators conclude that stent postdilation is useful in treating ACS. However, in our opinion, this is an uncritical acceptance of stent postdilation at face value without considering the increased risk of death.

The aim of the present study was to investigate how matrine affects the proliferation of A549 human lung adenocarcinoma cells via the p53/p21/proliferating cell nuclear antigen (PCNA)/eukaryotic translation initiation factor 4E (eIF4E) signaling pathway. The effect of different concentrations of matrine on the proliferation of A549 cells was investigated using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. The migration of A549 cells following exposure to varied concentrations of matrine was detected using a Transwell cell migration assay. The effect of 240 mg/l matrine on the apoptotic rate of A549 cells was determined using flow cytometry. The change in the mRNA and protein expression levels of p53, p21, PCNA and eIF4E following exposure to matrine were detected using reverse transcription-quantitative polymerase chain reaction and western blotting, respectively. The increase of matrine from 60–240 mg/l led to reduced cell migration and inhibition of A549 cell proliferation. The apoptotic rate of A549 cells when treated with 240 mg/l matrine was significantly different when compared with the untreated control. The mRNA expression levels of p53 and p21 in the group treated with 240 mg/l matrine were significantly higher compared with the control group. The mRNA expression levels of PCNA and eIF4E were significantly lower in the 240 mg/l matrine-treated group compared with the control. The protein expression levels of p53 and p21 were significantly higher in the 240 mg/l matrine group compared with the control group. Treatment with 240 mg/l matrine reduced the protein expression levels of PCNA and eIF4E. Matrine also reduced the migration ability of A549 cells and inhibited their proliferation, which may be associated with the overexpression of p53 and p21, and the reduction of PCNA and eIF4E expression levels.

目的 探讨艾滋病合并肺孢子菌肺炎(PCP)的临床及HRCT表现特征.方法 回顾性分析50例艾滋病合并肺孢子菌肺炎的临床、影像学资料,总结其临床及影像学表现及特征.结果 50例艾滋病合并PCP患者中,HRCT常见影像征象为磨玻璃密度影.影像学表现可分为7型,即单纯磨玻璃型、实变合并磨玻璃型、间质合并磨玻璃型、结节型、气囊型、混合型及其他.结论 艾滋病合并PCP的特征性影像学表现是双肺弥漫、对称分布的磨玻璃影,伴或不伴有斑片实变、网状影、结节和肺气囊.HRCT可以发现肺内细微病灶,有助于早期诊断.

The aim of the present study was to delineate the radiographic and clinical features of primary hepatic lymphoma (PHL). Four histopathologically confirmed cases of PHL were analyzed with respect to the radiological, clinical and pathological characteristics. The main clinical manifestations included upper right quadrant pain and lymphoma-associated B symptoms, such as fever, night sweating and weight loss. All the patients had elevated serum levels of lactate dehydrogenase. Furthermore, all the patients underwent plain and enhanced computed tomography examinations, which identified low-density lesions without marked enhancement. Solitary masses were observed in two cases, while multiple focal lesions were noted in one case and diffuse multi-speckled nodules were observed in one case. Two patients underwent abdominal magnetic resonance imaging, which revealed lesions that were hyperintense on T1-weighted imaging (WI) scans and hypointense on T2WI scans, and exhibited slight to moderate enhancement with a dynamic contrast-enhanced protocol. In one case, vessels were visible within the lesion. Therefore, the present study concluded that PHL is a rare condition that exhibits non-specific clinical and radiological features. A combination of imaging results and clinical manifestations can be used to facilitate a diagnosis of PHL.

ObjectiveThe aim of this study was to discuss the radiographic manifestations of type-II diabetes mellitus (DM) in patients with caseous tuberculosis (TB).MethodsWe performed a retrospective analysis of the chest radiographs and CT scans of 18 type-II diabetic patients with caseous tuberculosis, treated at Zhongnan Hospital, from January 1997 to December 2012.ResultsEighteen cases of type-II diabetic patients with caseous tuberculosis (DMTB) showed different degrees of cough, cough phlegm and hemoptysis. Imaging performance: All eighteen cases showed big flake and multiple small pieces of integration high-density shadows. All showed caseous pneumonia, and two cases also showed atelectasis. CT examination revealed a number of small hollows in the lesions. Fourteen cases of the lesions were in the right lung, one in the left lung, and three cases in the bilateral lungs. Six cases were confirmed after Sputum examination or bronchoscopy, eight cases were confirmed one month later with a variety of ineffective treatments, and the rest were confirmed through operation.ConclusionType-II diabetic patients with caseous tuberculosis mainly showed consolidation and atypical lung field lesions on chest radiographs. Becoming familiar with these features will be helpful to imaging diagnosis of DMTB.

为了探讨双断湖盆的沉积充填特征、控制因素及其与单断湖盆的差异,本文充分利用岩心、粒度、地震、测录井等资料,以孤北洼陷沙四上亚段沉积期为研究对象,以沙河街组构造演化分析为基础,对其进行了系统的研究.认为研究区沙河街组构造演化可分为4个期次:Ek-Esx4为隆起形成前期;Es4为隆起初始形成期;Esx3为隆起完全形成期;Esx3至今为继承性发育期.主要发育扇三角洲、三角洲以及湖相,不发育大面积的滩坝沉积;扇三角洲位于洼陷短轴两侧的陡坡带;三角洲发育在长轴方向的缓坡带.研究结果表明:沉积体系展布主要受到两条边界断层的控制:活动强弱控制相类型;速率差异控制发育位置;古地貌控制延伸方向.相比于单断湖盆,双断湖盆沉积充填更为复杂,具有沉积相展布较为对称,长轴方向牵引流沉积占主导、相变慢,短轴方向重力流沉积比重加大,相变快的特点.

原发性肝淋巴瘤（primary liver lymphoma, PLL）为起源于肝内淋巴组织和残留造血组织的恶性肿瘤，有别于常见的全身淋巴瘤累及肝脏。本病发病率低，占肝恶性肿瘤的1%，占全身非霍奇金淋巴瘤0.01%，临床上多为个案报道［1,2］。本文搜集2007年~2013年经手术或病理证实的原发性肝淋巴瘤3例，分析其CT/MRI影像资料，以提高对本病的认识。

Objective:To investigate the imaging findings of chest wall tuberculosis(TB),in order to improve the knowledge of the disease.Methods:CT,ultrasonography and radiographic findings as well as the clinical manifestations of 29 patients with pathologically proved chest wall tuberculosis were retrospectively analyzed.Multi-slice(16-slice,64-slice) CT without or with contrast enhanced scanning and post-processing were performed.Results:The main clinical manifestations were fever,local pain and swelling.The main CT findings included:①bony destruction,including rib(n=8),costal cartilage(n=3),sternum(n=3) and scapula(n=1),showing mouse bitten erosion(n=2) or expansive bone destruction(n=12);②chest wall cold abscess(n=10),showed as plate-like or fusiform cystic lesion,which located anterior/posterior to sternum or ribs,or behind the mammary gland;③soft tissue thickening,lumps and calcification of chest wall(n=4);④ extra-pleural mass of the chest wall(n=2).The other findings included mediastinal calcifications(n=3),lesions in pulmonary(n=16),liver(n=1) and abddominal wall(n=2).Most of the lesions(n=15) located at anterior chest wall,1.0cm×2.0cm~8.5cm×4.3cm in size,well-or ill-defined margin,with ring-like enhancement and well circumscribed inner surface after contrast administration.The thickened chest wall showed mild to moderate heterogeneous enhancement.Only bone destruction could be seen on radiography and cystic changes(n=7) was shown on ultrasonography as hypoechoic areas with no blood flow inside.Thin slice reformatted CT images with proper window technique can detect microcalcifications or minor bone destruction.According to CT findings,there were 4 types of chest wall TB appearance including bone destruction(n=13),cystic lesions(n=10),soft tissue thickening(n=4) and parietal pleural tuberculoma(n=2).Conclusion:The location of chest wall TB could be clearly demonstrated on CT,showing bone destruction,cold abscess,soft tissue mass or thickening,or extra-chest wall lesions.Enhanced CT might further clarify the extent,depth or nature of lesion and play an important role for clinical treatment guidance.

It is very common that increased carotid intima media thickness (CIMT) and carotid plaque coexist in a single subject in elderly patients with white matter lesions (WMLs). In this study we investigated whether the coexistence of increased CIMT and carotid plaque is more strongly associated with the presence and extent of WMLs than either alone. All patients were classified into 1 of the following 4 groups: without either increased CIMT (I) or carotid plaque (P): I(−)P(−); with only increased CIMT: I(+)P(−); with only carotid plaque: I(−)P(+); and with both increased CIMT and carotid plaque: I(+)P(+). The presence and severity of periventricular WMLs (PWMLs) and deep WMLs (DWMLs) were assessed and the prevalence of MRI findings by the Cochran-Armitage trend test was calculated. The characteristics of subjects showed that the percentages of patients with increased CIMT and carotid plaque in the DWMLs group and the PWMLs group were significantly higher than those without WMLs group. Both DWMLs and PWMLs were strongly associated with age, carotid plaque and CIMT. Furthermore, the Cochran-Armitage trend test indicated that the prevalence of MRI findings of PWMLs and DWMLs increased in the order of I(−)P(−)< I(+)P(−)< I(−)P(+)< I(+)P(+) (P<0.0001). For the patients with DWMLs, the grades of both I(+)P(−) and I(+)P(+) were increased significantly compared to I(−)P(−) (P<0.0025, P<0.05, respectively) without such a difference found in patients with PWMLs. Our results suggested that the coexistence of increased CIMT and carotid plaque is most closely associated with WMLs, and that increased CIMT is associated with the severity of DWMLs, whereas carotid plaque is related to the presence of WMLs.

Clinical data and manifestations on muhi-slice spiral CT (MSCT) of 11 patients with disseminated peritoneal adenomucinosis (DPAM) were retrospectively reviewed.The CT manifestations were also compared with surgical and histopathological findings.MSCT findings showed a large amount of gel-like ascites in 9 cases and local cystic masses in 2 cases.Among 9 cases with a large amount ascites,abdominal multiple cystic masses were shown in 5 case,and infiltration of the greater omentum and mesentery in 5 cases.Hepatic scalloping was found in 6 cases ; parenchymal invasion of the liver or spleen were showed in 5 cases; calcification of the cystic masses in 5 cases.Ovary mueinous cystadenoma was presented in 3 female patients.Enlarged lymph nodes and omental cake were not found in all cases.The results indicate that the characteristic MSCT manifestations of DPAM include diffuse gel-like ascites,multiple cystic masses with or without calcification,hepatic scalloping and parenchyma invasion.

Objective To delineate the imaging findings of primary vertebral spinal chondrosarcoma and to find the correlation with pathology.Materials and Methods Eight cases of primary vertebral spinal chondrosarcoma histopathologically confirmed were collected.The clinical,pathological and radiological chararacteristics were analyzed retrospectively.Results Lesions were located in thoracic vertebras in 3,sacrum in 3,lumbar in 1 and cervical vertebra in one.All the lesions showed osteolytic destruction combined with soft masses.Ring or arch like calcifications were showed in 7 lesions on conventional radiographs and CT images.Histopathological results included conventional type in 4,mesenchymal type in 2,clear cell and myxoid variants in one each.Three conventional and 1 clear cell type lesions showed lobulated or irregular masses with typical line or septa enhancement on MR images.Except one presented heterogeneous,three of them showed hyperintensity signal on T2 weighted images.Among them,2 were conventional type lesions combined with aneurismal bone cyst and 1 clear cell type lesion fulled of hyaline cartilage inside.The myxoid type lesion showed a heterogeneous MRI signal intensity.The mass was diffusely enhanced except the area of calcification.Obvious masses with heterogeneous MRI signal were found in 2 mesenchymal type lesions.Conclusion Primary spinal chondrosarcomas have certain specific imaging features that may correlate to the pathological subtypes.Recognizing the specific manifestations of each type is useful for the diagnosis of primary spinal chondrosarcoma.

PURPOSE:The aim of this study was to delineate radiological-pathological correlation in primary vertebral chondrosarcoma. METHODS:Eight histopathologically confirmed cases were analyzed for pathological and radiological characteristics. RESULTS:Magnetic resonance images of three conventional and one clear cell cases showed lobulated or irregular masses with line or septa enhancement. Two conventional lesions showed signal intensity of high water content on T2-weighted images, in which aneurismal bone cysts were confirmed. The myxoid lesion showed a relatively diffuse signal and enhancement. Marked masses were found in the two mesenchymal patients, either dumbbell-like or round-like. CONCLUSION:Primary spinal chondrosarcomas have certain radiological findings that may correlate to the pathological subtypes.

Primary malignant melanoma occurring at an extra cutaneous site is rare. A case of primary malignant melanoma located in the retroperitoneum of an 18-year-old female is presented in this study. Histopathological examination of the tissue biopsies at laparotomy with immunohistochemical stains confirmed a diagnosis of malignant melanoma. Further extensive clinical and radiological investigations proved the retroperitoneum to be the primary site.

>恶性黑色素瘤常见于皮肤,腹部器官罕见发病,临床表现缺乏特异性。搜集我院自2001年2月至2008年9月收治的腹部恶性黑色素瘤6例,分析其临床和CT特征,旨在加深临床医生对该病的认识。一、临床资料1.一般资料:患者6例,男女各3例。年龄18～74岁,平均57岁。发生于肛管或直肠3例,临床表现为便血、慢性腹泻、肛门坠胀等,肛诊触及肿块;发生于腹膜后、宫颈及小