Cavitary Pulmonary Metastases: CT Features and Their Correlation with the Pathology of the Primary Malignancy

Objective: To study CT features of cavitary pulmonary metastases and to investigate the pos- sible relationship between CT features and the pathology of the primary lesions. Methods: CT ?ndings of 131 cavitary metastatic nodules in 40 patients with pathologically-proved pulmonary metastases were retrospectively analyzed. A comparison between CT signs and the pathologic types of the primary tumors was made. Results: Cavitary metastases and multiple solid nodules coexisted in all patients. Cavitary metastases presented as bubble (n=41), irregular (n=33), cystic (n=26) or small circular (n=31) cavities, with even (n=61) or uneven (n=70) thickness of the cavity wall. Of 131 cavitary nodules, diameter less than 15 mm was seen in 44, between 15–25 mm in 66, 25–40 mm in 17 and larger than 40 mm in 4 respectively. And the wall thickness of the cavity below 4 mm, between 4–15 mm and over 15 mm was respectively seen in 69, 44 and 18 metastatic nodules. Cavitary pulmonary metastases mainly occurred in patients whose primary malignancy was squamous cell carcinoma (n=13) or adenocarcinoma (n=22). Both squamous cell carcinoma and adenocarcinoma had its own CT characteristics. The occurrence of cavity bore no relationship to its site in the lung. Conclusion: Cavitary pulmonary metastases carries certain CT features and its occurrence is related to the pathologic type of the primary malignancy.

NLRP3-mediated autophagy dysfunction links gut microbiota dysbiosis to tau pathology in chronic sleep deprivation

Emerging evidence indicates that sleep deprivation(SD)can lead to Alzheimer’s disease(AD)-related pathological changes and cognitive decline.However,the underlying mechanisms remain obscure.In the present study,we identified the existence of a microbiota-gut-brain axis in cognitive deficits resulting from chronic SD and revealed a potential pathway by which gut microbiota affects cognitive functioning in chronic SD.Our findings demonstrated that chronic SD in mice not only led to cognitive decline but also induced gut microbiota dysbiosis,elevated NLRP3 inflammasome expression,GSK-3βactivation,autophagy dysfunction,and tau hyperphosphorylation in the hippocampus.Colonization with the“SD microbiota”replicated the pathological and behavioral abnormalities observed in chronic sleep-deprived mice.Remarkably,both the deletion of NLRP3 in NLRP3-/-mice and specific knockdown of NLRP3 in the hippocampus restored autophagic flux,suppressed tau hyperphosphorylation,and ameliorated cognitive deficits induced by chronic SD,while GSK-3βactivity was not regulated by the NLRP3 inflammasome in chronic SD.Notably,deletion of NLRP3 reversed NLRP3 inflammasome activation,autophagy deficits,and tau hyperphosphorylation induced by GSK-3βactivation in primary hippocampal neurons,suggesting that GSK-3β,as a regulator of NLRP3-mediated autophagy dysfunction,plays a significant role in promoting tau hyperphosphorylation.Thus,gut microbiota dysbiosis was identified as a contributor to chronic SD-induced tau pathology via NLRP3-mediated autophagy dysfunction,ultimately leading to cognitive deficits.Overall,these findings highlight GSK-3βas a regulator of NLRP3-mediated autophagy dysfunction,playing a critical role in promoting tau hyperphosphorylation.

Hysterectomies for Gynaecological Pathology: 56 Cases at the Segou Regional Hospital in Mali

Introduction: Hysterectomy is a surgical procedure involving partial or total removal of the uterus. It is the most common gynaecological surgery in the world. Objective: To describe the epidemio-clinical and prognostic aspects of gynaecological hysterectomies. Patients and methods: This was an 18-month retrospective prospective descriptive study with a six-month follow-up period from 1 December 2020 to 31 May 2022 carried out in the gynaecology department of the Segou regional hospital. Results: Fifty-six (56) hysterectomies were performed out of 118 gynaecological surgical procedures (47.45%). The mean age was 47 ± 11.77 years. Large multiparous women were the most common (50%), with an average parity of 4.58. The main indications were uterine fibroids (30.4%), precancerous lesions of the cervix (17.85%) and uterine prolapse (17.85%). The abdominal route was the most commonly used surgical route (82.14%). Hysterectomy was total in 100% of cases and associated with bilateral adnexectomy in 48.2% of cases. The intra- and post-operative prognosis was satisfactory in 94.6% of cases. No deaths were recorded. The average length of stay was 3.28 days, irrespective of the surgical approach. Three cases of dyspareunia were noted among those who had resumed sexual activity.

Using MsfNet to Predict the ISUP Grade of Renal Clear Cell Carcinoma in Digital Pathology Images

Clear cell renal cell carcinoma(ccRCC)represents the most frequent form of renal cell carcinoma(RCC),and accurate International Society of Urological Pathology(ISUP)grading is crucial for prognosis and treatment selection.This study presents a new deep network called Multi-scale Fusion Network(MsfNet),which aims to enhance the automatic ISUP grade of ccRCC with digital histopathology pathology images.The MsfNet overcomes the limitations of traditional ResNet50 by multi-scale information fusion and dynamic allocation of channel quantity.The model was trained and tested using 90 Hematoxylin and Eosin(H&E)stained whole slide images(WSIs),which were all cropped into 320×320-pixel patches at 40×magnification.MsfNet achieved a micro-averaged area under the curve(AUC)of 0.9807,a macro-averaged AUC of 0.9778 on the test dataset.The Gradient-weighted Class Activation Mapping(Grad-CAM)visually demonstrated MsfNet’s ability to distinguish and highlight abnormal areas more effectively than ResNet50.The t-Distributed Stochastic Neighbor Embedding(t-SNE)plot indicates our model can efficiently extract critical features from images,reducing the impact of noise and redundant information.The results suggest that MsfNet offers an accurate ISUP grade of ccRCC in digital images,emphasizing the potential of AI-assisted histopathological systems in clinical practice.

A Multi-Task Deep Learning Framework for Simultaneous Detection of Thoracic Pathology through Image Classification

Thoracic diseases pose significant risks to an individual's chest health and are among the most perilous medical diseases. They can impact either one or both lungs, which leads to a severe impairment of a person’s ability to breathe normally. Some notable examples of such diseases encompass pneumonia, lung cancer, coronavirus disease 2019 (COVID-19), tuberculosis, and chronic obstructive pulmonary disease (COPD). Consequently, early and precise detection of these diseases is paramount during the diagnostic process. Traditionally, the primary methods employed for the detection involve the use of X-ray imaging or computed tomography (CT) scans. Nevertheless, due to the scarcity of proficient radiologists and the inherent similarities between these diseases, the accuracy of detection can be compromised, leading to imprecise or erroneous results. To address this challenge, scientists have turned to computer-based solutions, aiming for swift and accurate diagnoses. The primary objective of this study is to develop two machine learning models, utilizing single-task and multi-task learning frameworks, to enhance classification accuracy. Within the multi-task learning architecture, two principal approaches exist soft parameter sharing and hard parameter sharing. Consequently, this research adopts a multi-task deep learning approach that leverages CNNs to achieve improved classification performance for the specified tasks. These tasks, focusing on pneumonia and COVID-19, are processed and learned simultaneously within a multi-task model. To assess the effectiveness of the trained model, it is rigorously validated using three different real-world datasets for training and testing.

A Correlative Study of CT, MR and Pathology in Rabbit Liver after Embolization by a China-Formulated Lipiodol Emulsion

OBJECTIVE To explore the MR characteristics following lipiodol retention in rabbit liver and to evaluate the sensitivity of CT （CT value 〉400 HU） and MR in displaying the hepatic degeneration and necrosis following embolization. METHODS Thirty-two rabbits were randomly divided into 3 groups. In the control group （n=8）, 2 ml of normal saline was injected into the right branch of the portal vein. In the first experimental group（n= 12）, 4 ml of lipiodol emulsion was injected into the main portal vein. In the second experimental group （n= 12）, 2 ml of lipiodol emulsion was injected into the right branch of the portal vein. CT and MR images were obtained before and after surgery in each group. The histopathologic condition was determined for all liver tissue specimens. RESULTS In the control group, CT and MR did not show any significant changes in the livers after surgery. After the operations in the experimental groups, the regional CT attenuation was 601±101 HU in the largest slice, which had no abnormal signals on T1Wl and T2Wl. In the first group, histologic examinations showed there were concentrated lipiodol droplets around the portal areas. In the second group, serious degeneration and necrosis in the right hepatic lobe occurred in 9 rabbits. T1Wl displayed homogenous or non-homogenous low signals and T2Wl mainly displayed a high signal. However, these pathologic changes did not appear on CT scanning due to high attenuation of the lipiodol. CONCLUSION There were no remarkable hepatic changes on MR in rabbits following good retention of the formulated lipiodol emulsion mixture of lipiodol and urografin（CT value 〉 400 HU）. MR displayed serious degeneration and necrosis of the liver following embolization.

Microvascular structural changes in esophageal squamous cell carcinoma pathology according to intrapapillary capillary loop types under magnifying endoscopy

BACKGROUND The intrapapillary capillary loop(IPCL)characteristics,visualized using magnifying endoscopy,are commonly assessed for preoperative evaluation of the infiltration depth of esophageal squamous cell carcinoma(ESCC).Japan Esophageal Society(JES)classification is the most widely used classification.Microvascular structural changes are evaluated by magnifying endoscopy for the presence or absence of each morphological factor:tortuosity,dilatation,irregular caliber,and different shapes.However,the pathological characteristics of IPCLs have not been thoroughly investigated,especially the microvascular structures corresponding to the deepest parts of the lesions'infiltration.AIM To investigate differences in pathological microvascular structures of ESCC,which correspond to the deepest parts of the lesions'infiltration.METHODS Patients with ESCC and precancerous lesions diagnosed at Peking University Third Hospital were enrolled between January 2019 and April 2023.Patients first underwent magnified endoscopic examination,followed by endoscopic submucosal dissection or surgical treatment.Pathological images were scanned using a threedimensional slice scanner,and the pathological structural differences in different types,according to the JES classification,were analyzed using nonparametric tests and t-tests.RESULTS The 35 lesions were divided into four groups according to the JES classification:A,B1,B2,and B3.Statistical analyses revealed significant differences(aP<0.05)in the short and long calibers,area,location,and density between types A and B.Notably,there were no significant differences in these parameters between types B1 and B2 and between types B2 and B3(P>0.05).However,significant differences in the short calibers,long calibers,and area of IPCL were observed between types B1 and B3(aP<0.05);no significant differences were found in the density or location(P>0.05).CONCLUSION Pathological structures of IPCLs in the deepest infiltrating regions differ among various IPCL types classified by the JES classification under magnifying endoscopy,especially between the types A and B.

The Use of CT Perfusion to Determine Microvessel Density in Lung Cancer: Comparison with FDG-PET and Pathology

Objective： To investigate the validity of CT perfusion in assessing angiogenic activity of lung cancer. Methods： Fifty-six patients with lung cancer scheduled for elective surgical resection received 16-slice helical CT perfusion imaging. Time-density curve （TDC）, blood flow （BF）, blood volume （BV）, mean transmit time （MTT） and permeability surface area product （PS） were calculated. 18F-deoxyglucose-positron emission tomography （FGD-PET） was carried out in 14 out of the 56 patients to calculate standardized uptake values （SUVs）. Tumor microvessel density （MVD） was examined using CD34 immunohistochemical staining of the resected tumor tissue. Pearson’s correlation analysis was used to evaluate potential correlation between CT perfusion parameters and MVD or SUV. Results： Average time to peak height （TPH） of the TDCs （including two types of TDC） was 24.38±5.69 seconds. Average BF, BV, MTT and PS were 93.42±53.45 ml/100g/min,93.42±53.45 ml/100g,6.83±4.51 s and 31.92±18.73 ml/100g/min, respectively. Average MVD was 62.04±29.06/HPF. The mean SUV was 6.33±3.26. BF was positively correlated with MVD （r=0.620,P0.01） and SUV （r=0.891, P0.01）. PS was also positively correlated with SUV （r=0.720, P0.05）. A positive correlation was also observed between tumor MVD and SUV （r=0.915, P0.01）. Conclusions： CT perfusion imaging is a reliable tool to evaluate the tumor neovascularity of lung cancer.

Multi-detector CT angiography for the assessment of anterior spinal artery and artery of Adamkiewicz patency in patients suspected of having thoracic aortic pathology

Objective To evaluate the visualization of the anterior spinal artery (ASA) and the artery of Adamkiewicz (AKA) as well as the affecting factors for the detection rate using multidetector row CT (MDCT). Methods Ninety-nine consecutive patients (31 women and 68 men; age range, 25-90 years; average age 61.3 years) with suspicion for thoracic aortic lesions necessitating surgical intervention (31 aortic aneurysm, 45 dissection, 5 intramural hematoma, and 18 normal), underwent 16-slice MDCT angiography from the aortic arch to the aortic bifurcation. Transverse sections, multiplanar reformations (MPR) and thin maximum intensity projections (MIP) were used to assess the ASA and AKA. The level of the ASA and AKA origins and CT acquisition parameters were recorded. The contrast-to-noise ratio (CNR) of the image, an index of the mass of the T11 body (vertebral mass index), the subcutaneous fat thickness,and the CT value within the aortic arch and at the T11 level were measured. The detection of the ASA and AKA was evaluated relative to the acquisition parameters, scan characteristics, and aortic lesion type. Differences were assessed with Wilcoxon rank-sum and t tests. Results The ASA was visualized in 51 patients (52%) and the AKA in 18 patients (18 %). The ASA was identified in 36/67 (54%)patients with 1.25 mm thickness and in15/32 (47%) patients with 2.5-3.0 mm thickness. This difference did not achieve significance (P=0.13). The detection rate of the ASA and the AKA was influenced by vertebral mass index and the CNR (P＜0.05). The amount of subcutaneous fat affected the detection rate of the ASA (P＜0.05) but not the AKA. In CT scans with ASA detection, the mean CT values in the aorta at the arch and at T11 were 360 and 358 HU, respectively; whereas in CT scans without ASA detection, the CT values in the aorta at the arch and at T11 were lower (297 and 317 HU, respectively; both P＜0.05). Conclusion The ASA and AKA were less frequently detected in our cohorts than previous reports. The visualization of the ASA and AKA was significantly affected by aortic enhancement, the 'vertebral mass index', and the CNR.

Spiral CT in gastric carcinoma:Comparison with barium study,fiberoptic gastroscopy and histopathology

AIM: To evaluate spiral computed tomography (CT) including virtual gastroscopy for diagnosis of gastric carcinoma in comparison with upper gastrointestinal series (UGI),fiberoptic gastroscopy (FG) and histopathology.METHODS: Sixty patients with histologically proven gastric carcinoma (54 advanced and 6 early) were included in this study. The results of spiral CT were compared with those of UGI and FG. Two observers blindly evaluated images of spiral CT and UGI and video recording of FG with consensus in terms of diagnostic confidence with a five-point scale.Sensitivities of lesion detection, Borrmann′s classification of spiral CT, UGI and FG, as well as the accuracy of TNM staging of spiral CT were determined by comparing them to surgical and histological findings.RESULTS: The lesion detection rate was 98 % (59/60),95 % (57/60) and 98 % (59/60) for spiral CT, UGI and FG,respectively. There were no statistical differences in the detection sensitivity among the three techniques (P＞0.05).For the sensitivity in Borrmann′s classification, spiral CT was higher than that of UGI (P=0.025) and similar to that of FG (P＞0.05). The accuracy of spiral CT in staging the gastric carcinoma was 76.7 %. Six cases of early gastric carcinoma were all detected by spiral CT as well as FG.CONCLUSION: Spiral CT is equivalent to UGI and FG in the detection of gastric carcinoma, and superior to UGI but similar to FG in the Borrmann′s classification of advanced gastric carcinoma. Spiral CT is more valuable than FG in the staging of gastric carcinoma.

Accuracy and Utility of Vessel Analysis Using Non-Contrast CT for Planning Endovascular Aortic Repair

Objectives: This study aimed to determine whether errors in vascular measurements would affect device selection in endovascular aortic repair (EVAR) by comparing measurements obtained using non-contrast computed tomography (NCT) with those obtained using contrast-enhanced CT (CECT). Materials and Methods: This single-center, retrospective study included 25 patients who underwent EVAR for abdominal aortic aneurysm at our institution. A 1-mm horizontal cross-sectional slice of NCT and CECT from each patient was retrospectively reviewed. The area from the abdominal aorta to the common iliac artery was divided into four zones. A centerline was created using the NCT by manually plotting the center points. Subsequently, the centerlines were automatically extracted and manually corrected during the arterial phase of CECT. The diameter and length of each zone were measured for each modality. The mean diameters and lengths of the target vessels were compared between NCT and CECT. Results: The measurements obtained using both methods were reproducible and demonstrated good agreement. The mean differences in vessel length and diameter measurements for each segment between NCT and CECT were not statistically significant, indicating good consistency. Conclusion: NCT may be useful for preoperative EVAR evaluation in patients with renal dysfunction or allergies to contrast agents.

Expanding role and scope of artificial intelligence in the field of gastrointestinal pathology

Digital pathology(DP)and its subsidiaries including artificial intelligence(AI)are rapidly making inroads into the area of diagnostic anatomic pathology(AP)including gastrointestinal(GI)pathology.It is poised to revolutionize the field of diagnostic AP.Historically,AP has been slow to adopt digital technology,but this is changing rapidly,with many centers worldwide transitioning to DP.Coupled with advanced techniques of AI such as deep learning and machine learning,DP is likely to transform histopathology from a subjective field to an objective,efficient,and transparent discipline.AI is increasingly integrated into GI pathology,offering numerous advancements and improvements in overall diagnostic accuracy,efficiency,and patient care.Specifically,AI in GI pathology enhances diagnostic accuracy,streamlines workflows,provides predictive insights,integrates multimodal data,supports research,and aids in education and training,ultimately improving patient care and outcomes.This review summarized the latest developments in the role and scope of AI in AP with a focus on GI pathology.The main aim was to provide updates and create awareness among the pathology community.

Axial length,vitreoretinal pathology,and anterior chamber depth can predict postoperative refractive outcomes in phacovitrectomy/silicone oil removal

AIM:To evaluate the postoperative refractive prediction error(PE)and determine the factors that af fect the refractive outcomes of combined pars plana vitrectomy(PPV)or silicone oil removal(SOR)with cataract surgery.METHODS:The study is a retrospective,case-series study.Totally 301 eyes of 301 patients undergoing combined PPV/SOR with cataract surgery were enrolled.Eligible individuals were separated into four groups according to their preoperative diagnoses:silicone oil-filled eyes after PPV(group 1),epiretinal membrane(group 2),macular hole(group 3),and primary retinal detachment(RD;group 4).The variables af fecting postoperative refractive outcomes were analyzed,including age,gender,preoperative best-corrected visual acuity(BCVA),axial length(AL),keratometry average,anterior chamber depth(ACD),intraocular tamponade,and vitreoretinal pathology.The outcome measurements include the mean refractive PE and the proportions of eyes with a PE within±0.50 diopter(D)and±1.00 D.RESULTS:For all patients,the mean PE was-0.04±1.17 D,and 50.17%of patients(eyes)had a PE within±0.50 D.There was a significant difference in refractive outcomes among the four groups(P=0.028),with RD(group 4)showing the least favorable refractive outcome.In multivariate regression analysis,only AL,vitreoretinal pathology,and ACD were strongly associated with PE(all P<0.01).Univariate analysis revealed that longer eyes(AL>26 mm)and a deeper ACD were correlated with hyperopic PE,and shorter eyes(AL<26 mm)and a shallower ACD were correlated with myopic PE.CONCLUSION:RD patients have the least favorable refractive outcome.AL,vitreoretinal pathology,and ACD are strongly associated with PE in the combined surgery.These three factors affect refractive outcomes and thus can be used to predict a better postoperative refractive outcome in clinical practice.

GE LightSpeed Pro 16 CT伪影故障维修3例

介绍了GE LightSpeed Pro 16 CT的组成,分析了该设备出现的3例伪影故障的现象、原因并提出了具体的排除方法,为临床工程人员维修类似故障提供了参考。

Force CT高级建模迭代重建算法对门静脉图像质量的影响

目的:探讨Force CT高级建模迭代重建算法(ADMIRE)对门静脉图像质量影响。方法:回顾性分析2022年1—4月于中山大学附属第八医院行上腹部CT平扫及增强的40例患者影像资料,在syngo.via后处理工作站重建,采用门脉期原始数据重建出滤波反投影算法(FBP)、ADMIRE1、ADMIRE3、ADMIRE5 4组不同重建算法的图像,在4组不同算法图像上测量门静脉干中心位置、肝实质及同层竖脊肌的CT值和噪声值,计算门静脉和肝实质的信噪比(SNR)和对比噪声比(CNR)。此外,由两位具有5年以上诊断经验的医生对图像进行主观评分。结果:随着迭代等级的增高,图像的CNR、SNR呈现上升的趋势,图像的噪声值呈现下降的趋势,其中ADMIRE5组图像中门静脉和肝脏具有最高的CNR和SNR且具有最低的噪声值,以及最高的主观评分,采用ADMIRE5重建算法的门静脉与周围组织对比非常好,门静脉5级分支显示良好。结论:高级建模迭代重建ADMIRE算法相比于FBP重建算法,降噪效果更好,门静脉的显示更加锐利,能提升门静脉的图像质量。

CTAI分析系统与Philips CT后处理工作站在预测急性脑梗死预后中的一致性分析

目的探讨CT脑灌注成像(CTP)智能(AI)分析系统与Philips CT后处理工作站在预测急性脑梗死(ACI)预后中的一致性。方法选取我院2021年6月至2023年6月ACI患者100例,根据90 d预后情况分为预后良好组(77例)与预后不良组(23例)。入院时均行CTP检查,比较AI分析系统与Philips CT后处理工作站测量的患侧最大层面与对应健侧血流参数[脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对平均通过时间(rMTT)、缺血区最大层面CBF、CBV面积]预测ACI患者预后的一致性。结果AI分析系统、Philips CT后处理工作站测量的预后不良组患侧最大层面CBF、CBV、rCBF、rCBV低于预后良好组,患侧最大层面MTT、rMTT、缺血区最大层面CBF、CBV面积高于预后良好组(P<0.05);AI分析系统、Philips CT后处理工作站测量的两组患侧最大层面与对应健侧CBF、CBV、MTT、rCBF、rCBV、rMTT、缺血区最大层面CBF、CBV面积差异无统计学意义(P>0.05);患侧最大层面CBF、CBV、MTT、rCBF、rCBV、rMTT、缺血区最大层面CBF、CBV面积均是ACI预后的影响因素(P<0.05);AI分析系统测量的患侧最大层面CBF、CBV、MTT、rCBF、rCBV、rMTT、缺血区最大层面CBF、CBV面积预测ACI预后AUC分别为0.742、0.776、0.842、0.809、0.782、0.755、0.742、0.787;Philips CT后处理工作站测量的患侧最大层面CBF、CBV、MTT、rCBF、rCBV、rMTT、缺血区最大层面CBF、CBV面积预测ACI预后的AUC分别为0.742、0.722、0.816、0.803、0.772、0.761、0.750、0.781;两种方式测量出的CTP参数预测ACI预后的AUC差异均无统计学意义(P>0.05),一致性Kappa值均>0.7。结论CTP AI分析系统与Philips CT后处理工作站测量的血流参数在预测ACI预后中一致性良好,可将AI分析系统作为优选的图像后处理方式。

基于Micro CT的铜导线短路熔痕孔洞特征分析

导线短路是造成电气火灾的重要原因之一。现行国家标准中将导线短路熔痕分为起火前发生的一次短路熔痕和起火后造成的二次短路熔痕,然而现行国家标准中的鉴定仅停留在定性判断的阶段。火灾现场铜导线短路熔痕特征的量化分析研究是国内外研究人员主要关注的重点。本文应用Micro CT技术对铜导线短路熔痕进行断层扫描检测并重构铜导线短路熔痕的3D图像数据,在此基础上统计、归纳、总结铜导线短路熔痕内部孔洞形态及分布等孔洞特征。研究表明,Micro CT能够全面采集铜导线短路熔痕的整体形态和内部孔洞特征,一次短路熔痕与二次短路熔痕内部孔洞半径、表面积、紧密度的特征数据存在差别,可为短路熔痕定性和定量分析判据研究提供新的理论依据。

MRI and CT into Pathology Tumor and Liver Bile Duct

Background: Tumor pathologies of the liver and bile ducts are relatively commonly diagnosed and the primary goal is to differentiate these lesions in the fastest possible time which determines the apropriate method of treatment. Aims and Objectives: Aim of this study is tracking and diagnostic imaging correlation of tumor pathologies of liver and bile ducts and determining the early diagnostic approach. Data obtained from this study are important for treatment procedures and succes of treatment. All cases with liver tumor pathologies from period 2012-2016 were examined with CT and MRI followed by other complementary imaging methods. Methods: CT examination was performed according to standard triple-phase protocol: non-enhanced phase, arterial phase and porto-venous phase, and in some cases with late phase after 5 minutes. In MRI examinations, standard protocol was performed: coronal T2 single-shot fast spin-echo (coronal T2 SSFs), Axial T2 respiratory-triggered fast spin-echo (axial T2-FRE)/or breath-hold fast-recovery fast spin-echo T2 body coil sizes XL, (axial T2-FRFSE-XL), Axial in-phase/out-of-phase, Axial/ coronal three-dimensional liver acquisition with volume acceleration (3D coronal pre lava). Results: For comparation, only patients with liver focal lesions were included in the study, and and patient were examined with both diagnostic imaging modalities (CT and MRI). 168 patients with liver tumor pathologies and biliary tree tumor pathologies are included in the study. Gender ratio was 85 males and 83 female (M/F ratio 1.03:1). Average age of patients was 58.41 years, (minimum age 1.5 years old and maximum 88 years of age). The most frequent age on diagnosis was 61 - 70 years (total of 49 patients or 29.16%). Benign tumors were found with 93 patients (55.35%) and malignant tumors in 79 patients (47.02%). Distribution in liver parenchyma was found in 113 patients (67.26%), while in 49 patients (29.17%) pathology was found in the biliary tract. The most affected liver segment was the fifth segment in 35 patients (20.83%), while the less affected segment was the second liver segment in 8 patients (4.73%). most of patients (62 patients or 36.90%) had more than two affected segments in time of diagnosis. Diagnostic criteria in this study require further future evaluation. Conclusion: Early diagnosis of are tumors remains a real challenge and has great impact in the survival rate of patients. Finally, our study showed that for our country’s institutions that there was no significant difference between both CT and MRI modalities in liver focal lesions assessment.

4D CTA-CTP联合血清S100B评估风痰阻络型急性缺血性脑卒中侧支循环及预后的研究

目的四维CT血管成像-CT灌注(4DCTACTP)综合技术评价风痰阻络型急性缺血性卒中(AIS)患者的脑侧支循环,探讨以脑侧支循环和血清S100B蛋白浓度预测AIS患者预后的可行性。方法回顾分析32例经4DCTA-CTP治疗的前循环AIS患者的临床资料。通过多期CT血管成像(MCTA)评分和局部软脑膜侧支循环(RLMC)评分评价脑侧支循环水平。结合血清S100B蛋白浓度进行二元Logistic回归分析,寻找可独立预测AIS神经功能预后的指标。结果单因素分析显示NIHSS评分、rLMC评分和MCTA评分与AIS患者的神经预后相关,多因素分析显示MCTA脑侧支循环评分是唯一可以独立预测AIS患者神经预后的指标(OR=0.065,P=0.030)。基线血清S100B蛋白浓度不能独立预测AIS患者的神经预后。结论MCTA脑侧支循环评分可独立预测风痰阻络型AIS患者的神经预后。对于评估AIS患者的神经预后,脑侧支循环时相评分优于局部评分。

Revolution CT联合不同权重ASIR-V在胸痛三联征成像中的应用价值比较

目的探讨Revolution CT联合不同权重多模型迭代重建技术(ASIR-V)在胸痛三联征(TRO)成像中的应用价值。方法选取我院2022年8月~2023年3月收治的90例胸痛患者进行研究,入院后接受TRORevolution CT平扫。按随机数字表法分成滤波反投影(FBP)组与ASIR-V组各45例。FBP组采用FBP技术进行图像重组,ASIR-V组采用不同权重(10%、30%、50%、70%、90%)前置ASIR-V技术重组。记录两组辐射剂量长度乘积(DLP)、有效剂量(ED),比较不同重组方式及不同权重下冠状动脉、升主动脉、降主动脉、肺动脉干的平均CT值、噪声值、信噪比(SNR)、对比信噪比(CNR),由2名经验丰富的影像科医生进行主观图像质量评分。结果ASIR-V组DLP、ED低于FBP组(P<0.05)。ASIR-V不同权重的血管腔噪声值低于FBP,血管腔SNR、CNR与主观图像质量评分高于FBP(P<0.05)。ASIR-V权重50%、70%、90%的噪声值低于ASIR-V权重10%、30%的噪声值(P<0.05)。ASIR-V权重50%、70%、90%的SNR、CNR高于ASIR-V权重10%、30%的SNR、CNR(P<0.05)。ASIR-V权重50%、70%的主观评分高于ASIR-V权重10%、30%、90%的主观评分(P<0.05)。结论Revolution CT联合ASIR-V技术能减少辐射剂量,ASIR-V权重50%、70%时对血管腔与解剖结构的显示良好,血管腔噪声值较低,SNR、CNR较高,能满足诊断需求。