Clinical and multimodal imaging features of acute macular neuroretinopathy lesions following recent SARS-CoV-2 infection

AIM:To describe the clinical characteristics of eyes using multimodal imaging features with acute macular neuroretinopathy(AMN)lesions following severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.METHODS:Retrospective case series study.From December 18,2022 to February 14,2023,previously healthy cases within 1-week infection with SARS-CoV-2 and examined at Tianjin Eye Hospital to confirm the diagnosis of AMN were included in the study.Totally 5 males and 9 females[mean age:29.93±10.32(16-49)y]were presented for reduced vision,with or without blurred vision.All patients underwent best corrected visual acuity(BCVA),intraocular pressure,slit lamp microscopy,indirect fundoscopy.Simultaneously,multimodal imagings fundus photography(45°or 200°field of view)was performed in 7 cases(14 eyes).Near infrared(NIR)fundus photography was performed in 9 cases(18 eyes),optical coherence tomography(OCT)in 5 cases(10 eyes),optical coherence tomography angiography(OCTA)in 9 cases(18 eyes),and fundus fluorescence angiography(FFA)in 3 cases(6 eyes).Visual field was performed in 1 case(2 eyes).RESULTS:Multimodal imaging findings data from 14 patients with AMN were reviewed.All eyes demonstrated different extent hyperreflective lesions at the level of the inner nuclear layer and/or outer plexus layer on OCT or OCTA.Fundus photography(45°or 200°field of view)showed irregular hypo-reflective lesion around the fovea in 7 cases(14 eyes).OCTA demonstrated that the superficial retinal capillary plexus(SCP)vascular density,deep capillary plexus(DCP)vascular density and choriocapillaris(CC)vascular density was reduced in 9 case(18 eyes).Among the follow-up cases(2 cases),vascular density increased in 1 case with elevated BCVA;another case has vascular density decrease in one eye and basically unchanged in other eye.En face images of the ellipsoidal zone and interdigitation zone injury showed a low wedge-shaped reflection contour appearance.NIR image mainly show the absence of the outer retinal interdigitation zone in AMN.No abnormal fluorescence was observed in FFA.Corresponding partial defect of the visual field were visualized via perimeter in one case.CONCLUSION:The morbidity of SARS-CoV-2 infection with AMN is increased.Ophthalmologists should be aware of the possible,albeit rare,AMN after SARS-CoV-2 infection and focus on multimodal imaging features.OCT,OCTA,and infrared fundus phase are proved to be valuable tools for detection of AMN in patients with SARS-CoV-2.

Features of primary pancreatic lymphoma:A bi-institutional review with an emphasis on typical and atypical imaging features

BACKGROUND Primary pancreatic lymphoma(PPL)is a rare neoplasm.Being able to distinguish it from other pancreatic malignancies such as pancreatic ductal adenocarcinoma(PDAC)is important for appropriate management.Unlike PDAC,PPL is highly sensitive to chemotherapy and usually does not require surgery.Therefore,being able to identify PPL preoperatively will not only direct physicians towards the correct avenue of treatment,it will also avoid unnecessary surgical intervention.AIM To evaluate the typical and atypical multi-phasic computed tomography(CT)imaging features of PPL.METHODS A retrospective review was conducted of the clinical,radiological,and pathological records of all subjects with pathologically proven PPL who presented to our institutions between January 2000 and December 2020.Institutional review board approval was obtained for this investigation.The collected data were analyzed for subject demographics,clinical presentation,laboratory values,CT imaging features,and the treatment received.Presence of all CT imaging findings including size,site,morphology and imaging characteristics of PPL such as the presence or absence of nodal,vascular and ductal involvement in these subjects were recorded.Only those subjects who had a pre-treatment multiphasic CT of the abdomen were included in the study.RESULTS Twenty-nine cases of PPL were diagnosed between January 2000 and December 2020(mean age 66 years;13 males/16 females).All twenty-nine subjects were symptomatic but only 4 of the 29 subjects(14%)had B symptoms.Obstructive jaundice occurred in 24%of subjects.Elevated lactate dehydrogenase was seen in 81%of cases,whereas elevated cancer antigen 19-9 levels were present in only 10%of cases for which levels were recorded.The vast majority(90%)of tumors involved the pancreatic head and uncinate process.Mean tumor size was 7.8 cm(range,4.0-13.8 cm).PPL presented homogenous hypoenhancement on CT in 72%of cases.Small volume peripancreatic lymphadenopathy was seen in 28%of subjects.Tumors demonstrated encasement of superior mesenteric vessels in 69%of cases but vascular stenosis or occlusion only manifested in 5 out of the twentynine individuals(17%).Mild pancreatic duct dilatation was also infrequent and seen in only 17%of cases,whereas common bile duct(CBD)dilation was seen in 41%of subjects.Necrosis occurred in 10%of cases.Size did not impact the prevalence of pancreatic and CBD dilation,necrosis,or mesenteric root infiltration(P=0.525,P=0.294,P=0.543,and P=0.097,respectively).Pancreatic atrophy was not present in any of the subjects.CONCLUSION PPL is an uncommon diagnosis best made preoperatively to avoid unnecessary surgery and ensure adequate treatment.In addition to the typical CT findings of PPL,such as homogeneous hypoenhancement,absence of vascular stenosis and occlusion despite encasement,and peripancreatic lymphadenopathy,this study highlighted many less typical findings,including small volume necrosis and pancreatic and bile duct dilation.

Atypical imaging features of the primary spinal cord glioblastoma:A case report

BACKGROUND Primary spinal cord(PSC)glioblastoma(GB)is an extremely rare but fatal primary tumor of the central nervous system and associated with a poor prognosis.While typical tumor imaging features are generally easy to recognize,glioblastoma multiforme can have a wide range of imaging findings.Atypical GB is often misdiagnosed,which usually delays the optimal time for treatment.In this article,we discuss a clinical case of pathologically confirmed PSC GB under the guise of benign tumor imaging findings,as well as the most recent literature pertaining to PSC GB.CASE SUMMARY A 70-year-old female complained of limb weakness lasting more than 20 d.Irregular masses were observed inside and outside the left foramina of the spinal canal at C7-T1 on medical imaging.Based on the imaging features,radiologists diagnosed the patient with schwannoma.Tumor resection was performed under general anesthesia.The final histopathological findings revealed a final diagnosis of PSC GB,world health organization Grade IV.The patient subsequently underwent a 4-wk course of radiotherapy(60 Gy in 20 fractions)combined with temozolomide chemotherapy.The patient was alive at the time of submission of this manuscript.CONCLUSION Atypical GB presented unusual imaging findings,which led to misdiagnosis.Therefore,a complete recognition of imaging signs may facilitate early accurate diagnosis.

Imaging features of intrathoracic complications of lung transplantation:What the radiologists need to know

Lung transplantation has been a method for treating end stage lung disease for decades. Despite improvements in the preoperative assessment of recipients and donors as well as improved surgical techniques, lung transplant recipients are still at a high risk of developing postoperative complications which tend to impact negatively the patients' outcome if not recognised early. The recognised complications post lung transplantation can be broadly categorised into acute and chronic complications. Recognising the radiological features of these complications has a significant positive impact on patients' survival post transplantation. This manuscript provides a comprehensive review of the radiological features of post lung transplantations complications over a time continuum.

Lung imaging characteristics in a patient infected with Elizabethkingia miricola following cerebral hemorrhage surgery: A case report

BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium,which was first isolated from the condensate of the Russian peace space station in 2003.Most studies on this bacterium have been carried out in the laboratory,and clinical case studies are rare.To date,a total of 6 clinical cases have been reported worldwide.CASE SUMMARY We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola.The imaging character-istics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed.CONCLUSION Elizabethkingia miricola infection is rare.When pulmonary infection occurs,computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs,the air containing bronchial sign in local areas,thickening of bronchial vascular bundle,and pleural effusion.

Imaging Features of Symptomatic Radiation-induced Cervical Artery Stenosis

Recently,the survival rate of head and neck cancer patients has increased with the improvement of radiotherapy （RT） technology and comprehensive treatment.Cancer survivors after RT are at increased risk for cerebrovascular events. Radiation-induced cervical artery stenosis （RICAS） has its own characteristics compared with those lesions without a history of RT.

The clinical and imaging features of 118 patients with spontaneous cerebral arterial dissections presenting with ischemic stroke

Objective To investigate the clinical and radiologic features of patients with spontaneous cerebral arterial dissections(CADs)presenting with ischemic stroke and to explore the effect of gender and age on those features.Methods Patients admitted to our stroke center diagnosed as ischemic stroke secondary to CADs from August 2008to April 2015 were prospectively registered.

New Fragile Watermarking Technique to Identify Inserted Video Objects Using H.264 and Color Features

The transmission of video content over a network raises various issues relating to copyright authenticity,ethics,legality,and privacy.The protection of copyrighted video content is a significant issue in the video industry,and it is essential to find effective solutions to prevent tampering and modification of digital video content during its transmission through digital media.However,there are stillmany unresolved challenges.This paper aims to address those challenges by proposing a new technique for detectingmoving objects in digital videos,which can help prove the credibility of video content by detecting any fake objects inserted by hackers.The proposed technique involves using two methods,the H.264 and the extraction color features methods,to embed and extract watermarks in video frames.The study tested the performance of the system against various attacks and found it to be robust.The evaluation was done using different metrics such as Peak-Signal-to-Noise Ratio(PSNR),Mean Squared Error(MSE),Structural Similarity Index Measure(SSIM),Bit Correction Ratio(BCR),and Normalized Correlation.The accuracy of identifying moving objects was high,ranging from 96.3%to 98.7%.The system was also able to embed a fragile watermark with a success rate of over 93.65%and had an average capacity of hiding of 78.67.The reconstructed video frames had high quality with a PSNR of at least 65.45 dB and SSIMof over 0.97,making them imperceptible to the human eye.The system also had an acceptable average time difference(T=1.227/s)compared with other state-of-the-art methods.

Imaging characteristics of orbital peripheral nerve sheath tumors:Analysis of 34 cases

BACKGROUND Peripheral nerve sheath tumors(PNSTs),a rare group of neoplasms in the orbit,comprise only 4%of all orbital tumors.At present,there are very few studies detailing the features of these tumors identified using imaging technology.AIM To compare the differences in location,morphology,magnetic resonance imaging(MRI)signal intensity/computed tomography(CT)value,and enhancement degree of tumors of different pathological PNSTs types.METHODS Clinical,pathological,CT,and MRI data were analyzed retrospectively in 34 patients with periorbital sheath tumors diagnosed using histopathology from January 2013 to August 2021.RESULTS Among 34 cases of orbital peripheral nerve sheath tumors,21 were schwannomas,12 were neurofibromas,and 1 was a plexiform neurofibroma.Common clinical symptoms presented by patients with these types of tumors include eyelid swelling,exophthalmos,and limited eye movement.Schwannomas mostly occur in the intramuscular space with small tumor volume and rare bone involvement.Neurofibromas develop in the extrapyramidal space with larger tumor volume and more bone involvement.Radiologically,schwannomas and neurofibromas are characterized by regular morphology and uneven density and signal.One case of plexiform neurofibroma showed tortuous and diffuse growth along the nerve,with a worm-like appearance on imaging.CONCLUSION Different pathological types of orbital peripheral nerve sheath tumors have unique imaging characteristics.Comprehensive consideration of the patient's clinical and imaging manifestations is of great value in the diagnosis of orbital peripheral nerve sheath tumors.

Role of the texture features of images in the diagnosis of solitary pulmonary nodules in different sizes

Objective： To explore the role of the texture features of images in the diagnosis of solitary pulmonary nodules （SPNs） in different sizes. Materials and methods： A total of 379 patients with pathologically confirmed SPNs were enrolled in this study. They were divided into three groups based on the SPN sizes： ≤10, 11-20, and 〉20 mm. Their texture features were segmented and extracted. The differences in the image features between benign and malignant SPNs were compared. The SPNs in these three groups were determined and analyzed with the texture features of images. Results： These 379 SPNs were successfully segmented using the 2D Otsu threshold method and the self-adaptive threshold segmentation method. The texture features of these SPNs were obtained using the method of grey level co-occurrence matrix （GLCM）. Of these 379 patients, 120 had benign SPNs and 259 had malignant SPNs. The entropy, contrast, energy, homogeneity, and correlation were 3.5597±0.6470, 0.5384±0.2561, 0.1921±0.1256, 0.8281±0.0604, and 0.8748±0.0740 in the benign SPNs and 3.8007±0.6235, 0.6088±0.2961, 0.1673±0.1070, 0.7980±0.0555, and 0.8550±0.0869 in the malignant SPNs （all P〈0.05）. The sensitivity, specificity, and accuracy of the texture features of images were 83.3%, 90.0%, and 86.8%, respectively, for SPNs sized 〈10 mm, and were 86.6%, 88.2%, and 87.1%, respectively, for SPNs sized 11-20 mm and 94.7%, 91.8%, and 93.9%, respectively, for SPNs sized 〉20 mm. Conclusions： The entropy and contrast of malignant pulmonary nodules have been demonstrated to be higher in comparison to those of benign pulmonary nodules, while the energy, homogeneity correlation of malignant pulmonary nodules are lower than those of benign pulmonary nodules. The texture features of images can reflect the tissue features and have high sensitivity, specificity, and accuracy in differentiating SPNs. The sensitivity and accuracy increase for larger SPNs.

Development of a machine learning-based model for predicting risk of early postoperative recurrence of hepatocellular carcinoma

BACKGROUND Surgical resection is the primary treatment for hepatocellular carcinoma(HCC).However,studies indicate that nearly 70%of patients experience HCC recurrence within five years following hepatectomy.The earlier the recurrence,the worse the prognosis.Current studies on postoperative recurrence primarily rely on postoperative pathology and patient clinical data,which are lagging.Hence,developing a new pre-operative prediction model for postoperative recurrence is crucial for guiding individualized treatment of HCC patients and enhancing their prognosis.AIM To identify key variables in pre-operative clinical and imaging data using machine learning algorithms to construct multiple risk prediction models for early postoperative recurrence of HCC.METHODS The demographic and clinical data of 371 HCC patients were collected for this retrospective study.These data were randomly divided into training and test sets at a ratio of 8:2.The training set was analyzed,and key feature variables with predictive value for early HCC recurrence were selected to construct six different machine learning prediction models.Each model was evaluated,and the bestperforming model was selected for interpreting the importance of each variable.Finally,an online calculator based on the model was generated for daily clinical practice.RESULTS Following machine learning analysis,eight key feature variables(age,intratumoral arteries,alpha-fetoprotein,preoperative blood glucose,number of tumors,glucose-to-lymphocyte ratio,liver cirrhosis,and pre-operative platelets)were selected to construct six different prediction models.The XGBoost model outperformed other models,with the area under the receiver operating characteristic curve in the training,validation,and test datasets being 0.993(95%confidence interval:0.982-1.000),0.734(0.601-0.867),and 0.706(0.585-0.827),respectively.Calibration curve and decision curve analysis indicated that the XGBoost model also had good predictive performance and clinical application value.CONCLUSION The XGBoost model exhibits superior performance and is a reliable tool for predicting early postoperative HCC recurrence.This model may guide surgical strategies and postoperative individualized medicine.

Delineation of Mesoscale Features of Ocean on Satellite IR Image

An ICSED (Improved Cluster Shade Edge-Detection) algorithm and a series of post-processing technique are discussed for automatic delineation of mesoscale structure of the ocean on digital IR images. The popular derivative-based edge operators are shown to be too sensitive to edge fine-structure and to weak gradients. The new edge-detection algorithm is ICSED (Improved Cluster Shade Edge-detection) method and it is found to be an excel lent edge detector that exhibits the characteristic of fine-structure rejection while retaining edge sharpness. This char acteristic is highly desirable for analyzing oceanographic satellite images. A sorting technique for separating clouds or land well from ocean at both day and night is described in order to obtain high quality mesoscale features on the IR image This procedure is evaluated on an AVHRR (Advanced Very High Resolution Radiometer) image with Kuroshio. Results and analyses show that the mesoscale features can be well identified by using ICSED algorithm.

Improved preprocessed Yaroslavsky filter based on shearlet features

An improved preprocessed Yaroslavsky filter（IPYF）is proposed to avoid the nick effects and obtain a better denoising result when the noise variance is unknown.Different from its predecessors,the similarity between two pixels is calculated by shearlet features.The feature vector consists of initial denoised results by the non-subsampled shearlet transform hard thresholding（NSST-HT）and NSST coefficients,which can help allocate the averaging weights more reasonably.With the correct estimated noise variance,the NSST-HT can provide good denoised results as the initial estimation and high-frequency coefficients contribute large weights to preserve textures.In case of the incorrect estimated noise variance,the low-frequency coefficients will mitigate the nick effect in cartoon regions greatly,making the IPYF more robust than the original PYF.Detailed experimental results show that the IPYF is a very competitive method based on a comprehensive consideration involving peak signal to noise ratio（PSNR）,computing time,visual quality and method noise.

Clinical analysis of Wernicke encephalopathy after liver transplantation

Background:Wernicke encephalopathy(WE)is an acute neurological disease resulting from vitamin B1 deficiency,and there are only very few case reports of WE after liver transplantation.The present study aimed to investigate the clinical characteristics,etiology,magnetic resonance imaging(MRI)features,treatment and prognosis of patients with WE after liver transplantation.Methods:Twenty-three patients with WE after liver transplantation from the First Affiliated Hospital,Zhejiang University School of Medicine and Jiangxi Provincial People’s Hospital between January 2011 and December 2021 were retrospectively analyzed.Results:Among the 23 patients diagnosed with WE after liver transplantation,6(26%)had a classic triad of impaired consciousness,oculomotor palsy and ataxia,and 17(74%)had two features.The misdiagno-sis rate was 65%.After treatment with high-dose vitamin B1,19(83%)patients showed improvement,whereas 4(17%)showed no improvement,including 3 with residual short-term memory impairments and 1 with residual spatial and temporal disorientation and ataxia.Conclusions:The misdiagnosis rate is high in the early stage of WE,and the prognosis is closely asso-ciated with whether WE is diagnosed early and treated timely.High-dose glucose or glucocorticoids can trigger WE and cannot be administered before vitamin B1 treatment.Vitamin B1 is suggested to be used as a prophylactic treatment for patients with WE after liver transplantation.

Early postsurgical lethal outcome due to splenic littoral cell angioma:A case report

BACKGROUND Littoral cell angioma(LCA)is a rare benign vascular tumor of the spleen.Given its rarity,standard diagnostic and therapeutic recommendations have yet to be developed for reported cases.Splenectomy is the only method of obtaining a pathological diagnosis and providing treatment to obtain a favorable prognosis.CASE SUMMARY A 33-year-old female presented with abdominal pain for one month.Computed tomography and ultrasound revealed splenomegaly with multiple lesions and two accessory spleens.The patient underwent laparoscopic total splenectomy and accessory splenectomy,and splenic LCA was confirmed by pathology.Four months after surgery,the patient presented with acute liver failure,was readmitted,rapidly progressed to multiple organ dysfunction syndrome and died.CONCLUSION Preoperative diagnosis of LCA is challenging.We systematically reviewed online databases to identify the relevant literature and found a close relationship between malignancy and immunodysregulation.When a patient suffers from both splenic tumors and malignancy or immune-related disease,LCA is possible.Due to potential malignancy,total splenectomy(including accessory spleen)and regular follow-up after surgery are recommended.If LCA is diagnosed after surgery,a comprehensive postoperative examination is needed.

Diagnostic value of preoperative examination for evaluating margin status in breast cancer

BACKGROUND A positive resection margin is a major risk factor for local breast cancer recurrence after breast-conserving surgery(BCS).Preoperative imaging examinations are frequently employed to assess the surgical margin.AIM To investigate the role and value of preoperative imaging examinations[magnetic resonance imaging(MRI),molybdenum target,and ultrasound]in evaluating margins for BCS.METHODS A retrospective study was conducted on 323 breast cancer patients who met the criteria for BCS and consented to the procedure from January 2014 to July 2021.The study gathered preoperative imaging data(MRI,ultrasound,and molybdenum target examination)and intraoperative and postoperative pathological information.Based on their BCS outcomes,patients were categorized into positive and negative margin groups.Subsequently,the patients were randomly split into a training set(226 patients,approximately 70%)and a validation set(97 patients,approximately 30%).The imaging and pathological information was analyzed and summarized using R software.Non-conditional logistic regression and LASSO regression were conducted in the validation set to identify factors that might influence the failure of BCS.A column chart was generated and applied to the validation set to examine the relationship between pathological margin range and prognosis.This study aims to identify the risk factors associated with failure in BCS.RESULTS The multivariate non-conditional logistic regression analysis demonstrated that various factors raise the risk of positive margins following BCS.These factors comprise non-mass enhancement(NME)on dynamic contrastenhanced MRI,multiple focal vascular signs around the lesion on MRI,tumor size exceeding 2 cm,type III timesignal intensity curve,indistinct margins on molybdenum target examination,unclear margins on ultrasound examination,and estrogen receptor(ER)positivity in immunohistochemistry.LASSO regression was additionally employed in this study to identify four predictive factors for the model:ER,molybdenum target tumor type(MT Xmd Shape),maximum intensity projection imaging feature,and lesion type on MRI.The model constructed with these predictive factors exhibited strong consistency with the real-world scenario in both the training set and validation set.Particularly,the outcomes of the column chart model accurately predicted the likelihood of positive margins in BCS.CONCLUSION The proposed column chart model effectively predicts the success of BCS for breast cancer.The model utilizes preoperative ultrasound,molybdenum target,MRI,and core needle biopsy pathology evaluation results,all of which align with the real-world scenario.Hence,our model can offer dependable guidance for clinical decisionmaking concerning BCS.

Image Feature Extraction and Matching of Augmented Solar Images in Space Weather

Augmented solar images were used to research the adaptability of four representative image extraction and matching algorithms in space weather domain.These include the scale-invariant feature transform algorithm,speeded-up robust features algorithm,binary robust invariant scalable keypoints algorithm,and oriented fast and rotated brief algorithm.The performance of these algorithms was estimated in terms of matching accuracy,feature point richness,and running time.The experiment result showed that no algorithm achieved high accuracy while keeping low running time,and all algorithms are not suitable for image feature extraction and matching of augmented solar images.To solve this problem,an improved method was proposed by using two-frame matching to utilize the accuracy advantage of the scale-invariant feature transform algorithm and the speed advantage of the oriented fast and rotated brief algorithm.Furthermore,our method and the four representative algorithms were applied to augmented solar images.Our application experiments proved that our method achieved a similar high recognition rate to the scale-invariant feature transform algorithm which is significantly higher than other algorithms.Our method also obtained a similar low running time to the oriented fast and rotated brief algorithm,which is significantly lower than other algorithms.

Improved Blending Attention Mechanism in Visual Question Answering

Visual question answering(VQA)has attracted more and more attention in computer vision and natural language processing.Scholars are committed to studying how to better integrate image features and text features to achieve better results in VQA tasks.Analysis of all features may cause information redundancy and heavy computational burden.Attention mechanism is a wise way to solve this problem.However,using single attention mechanism may cause incomplete concern of features.This paper improves the attention mechanism method and proposes a hybrid attention mechanism that combines the spatial attention mechanism method and the channel attention mechanism method.In the case that the attention mechanism will cause the loss of the original features,a small portion of image features were added as compensation.For the attention mechanism of text features,a selfattention mechanism was introduced,and the internal structural features of sentences were strengthened to improve the overall model.The results show that attention mechanism and feature compensation add 6.1%accuracy to multimodal low-rank bilinear pooling network.

Applying Wide & Deep Learning Model for Android Malware Classification

Android malware has exploded in popularity in recent years,due to the platform’s dominance of the mobile market.With the advancement of deep learning technology,numerous deep learning-based works have been proposed for the classification of Android malware.Deep learning technology is designed to handle a large amount of raw and continuous data,such as image content data.However,it is incompatible with discrete features,i.e.,features gathered from multiple sources.Furthermore,if the feature set is already well-extracted and sparsely distributed,this technology is less effective than traditional machine learning.On the other hand,a wide learning model can expand the feature set to enhance the classification accuracy.To maximize the benefits of both methods,this study proposes combining the components of deep learning based on multi-branch CNNs(Convolutional Network Neural)with wide learning method.The feature set is evaluated and dynamically partitioned according to its meaning and generalizability to subsets when used as input to the model’s wide or deep component.The proposed model,partition,and feature set quality are all evaluated using the K-fold cross validation method on a composite dataset with three types of features:API,permission,and raw image.The accuracy with Wide and Deep CNN(WDCNN)model is 98.64%,improved by 1.38%compared to RNN(Recurrent Neural Network)model.

Postmenopausal women with hyperandrogenemia:Three case reports

BACKGROUND Diagnosing hyperandrogenemia in postmenopausal women is very difficult.It occasionally manifests as excessive hair growth or with no clinical manifestations,and is therefore often misdiagnosed or missed altogether.Ovarian steroid cell tumors that cause hyperandrogenemia in women account for approximately 0.1%of all ovarian tumors.Due to the low incidence,corresponding imaging reports are rare,so ovarian steroid cell tumors lacks typical imaging findings to differ-entiate it from other ovarian tumors.Therefore,we summarized its clinical and imaging characteristics through this case series,and elaborated on the differential diagnosis of steroid cell tumors.CASE SUMMARY We report three cases of postmenopausal women with hyperandrogenemia.Only 1 patient showed virilization symptoms,the other two patients were completely asymptomatic.All patients underwent total hysterectomy+bilateral adnexe-ctomy.Histological results showed one case of Leydig cell tumor and two cases of benign,non-specific steroid cell tumor.After the operation,the androgen levels of all patients returned to normal,and there was no clinical recurrence since follow-up.CONCLUSION Although virilization caused by increased serum testosterone levels is an important clinical feature of ovarian steroid cell tumors,it is often asymptomatic.A solid,slightly hypoechoic,round or oval mass with uniform internal echo,richer blood flow in the solid part,and low resistance index are typical imaging features of ovarian steroid cell tumors.Diagnosis of ovarian steroid cell tumors after menopause is challenging,but surgery can be used for both diagnosis and clear treatment.