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Clinical diagnosis and treatment of alpha-fetoprotein-negative small hepatic lesions 被引量:7
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作者 Yiyao Xu Xin Lu +10 位作者 Yilei Mao Xinting Sang Haitao Zhao Shunda Du Haifeng Xu Yongliang Sun Huayu Yang Tianyi Chi Zhiying Yang Shouxian Zhong Jiefu Huang 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2013年第4期382-388,共7页
Objective: We examined 103 cases over the last five years and discussed diagnosis and treatment of alpha- fetoprotein (AFP)-negative small hepatic lesions. Background: Small hepatic lesions (less than 2 cm in dia... Objective: We examined 103 cases over the last five years and discussed diagnosis and treatment of alpha- fetoprotein (AFP)-negative small hepatic lesions. Background: Small hepatic lesions (less than 2 cm in diameter) usually have no typical imaging characteristics and therefore are difficult to diagnose, especially when AFP tests provide a negative result. Methods: A total of 103 patients with AFP-negative small hepatic lesions from January 2003 to December 2008 were retrospectively reviewed. Differential diagnosis was performed by digital subtraction angiography (DSA), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), contrast-enhanced ultrasound (CEUS), or positron emission tomography-computed tomography (PET-CT) based on the multiplicity of lesions. Ninety-four patients with suspected cancers underwent partial hepatectomy. Clinical data were collected from hospital records and follow-up questionnaires. Results: Hepatocellular carcinoma (HCC) diagnostic sensitivity of DSA, DCE-MRI, CEUS and PET-CT was 88.2%, 93.9%, 88.9% and 88.9%, respectively. The surgery-related complication rate was 6.4%. Prognosis was good, with 1- and 3-year survival rates of 98.8% and 76.1%, respectively. Conclusions: DSA, DCE-MRI, CEUS and PET-CT are valuable for diagnosis of small hepatic lesions. Partial hepatectomy is a preferred surgical procedure. Surgery for small liver cancers usually has little risk and good prognosis, therefore it can be actively applied in suspected HCC cases. 展开更多
关键词 Alpha-fetoprotein (AFP)-negative small hepatic lesions contrast-enhanced ultrasound (CEUS) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) hepatectomy
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Small bowel ulcerative lesions are common in elderly NSAIDs users with peptic ulcer bleeding 被引量:6
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作者 Panagiotis Tsibouris Chissostomos Kalantzis +4 位作者 Periklis Apostolopoulos Antonios Zalonis Peter Edward Thomas Isaacs Mark Hendrickse Georgios Alexandrakis 《World Journal of Gastrointestinal Endoscopy》 CAS 2014年第12期612-619,共8页
AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upp... AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upper gastrointestinal bleeding from a peptic ulceration(cases) and 60 matched patients with a non-bleeding peptic ulcer(controls) underwent small bowel capsule endoscopy, after a negative colonoscopy(compulsory in our institution). Controls were evaluated for non-bleeding indications. Known or suspected chronic inflammatory conditions and medication that could harm the gut were excluded. During capsule endoscopy, small bowel ulcerative lesions were counted thoroughly and classified according to Graham classification. Other small bowellesions were also recorded. Peptic ulcer bleeding was controlled endoscopically, when adequate, proton pump inhibitors were started in both cases and controls, and Helicobacter pylori eradicated whenever present. Both cases and controls were followed up for a year. In case of bleeding recurrence upper gastrointestinal endoscopy was repeated and whenever it remained unexplained it was followed by repeat colonoscopy and capsule endoscopy.RESULTS: Forty(67%) cases and 18(30%) controls presented small bowel erosions(P = 0.0001), while 22(37%) cases and 4(8%) controls presented small bowel ulcers(P < 0.0001). Among non-steroidal antiinflammatory drug(NSAID) consumers, 39(95%) cases and 17(33%) controls presented small bowel erosions(P < 0.0001), while 22(55%) cases and 4(10%) controls presented small bowel ulcers(P < 0.0001). Small bowel ulcerative lesions were infrequent among patients not consuming NSAIDs. Mean entry hemoglobin was 9.3(SD = 1.4) g/d L in cases with small bowel ulcerative lesions and 10.5(SD = 1.3) g/dL in those without(P = 0.002). Cases with small bowel ulcers necessitate more units of packed red blood cells. During their hospitalization, 6(27%) cases with small bowel ulcers presented bleeding recurrence most possibly attributed to small bowel ulcers, nevertheless 30-d mortality was zero. Presence of chronic obstructive lung disease and diabetes was related with unexplained recurrence of hemorrhage in logistic regression analysis, while absence of small bowel ulcers was protective(relative risk 0.13, P = 0.05).CONCLUSION: Among NSAID consumers, more bleeders than non-bleeders with peptic ulcers present small bowel ulcers; lesions related to more severe bleeding and unexplained episodes of bleeding recurrence. 展开更多
关键词 NON-STEROIDAL anti-inflammatory drugs Aspirin Wireless capsule endoscopy small bowel ULCERATIVE lesionS PEPTIC ULCER bleeding
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Non-small bowel lesion detection at small bowel capsule endoscopy: A comprehensive literature review 被引量:2
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作者 Apostolos Koffas Faidon-Marios Laskaratos Owen Epstein 《World Journal of Clinical Cases》 SCIE 2018年第15期901-907,共7页
Small bowel capsule endoscopy is a minimally-invasive endoscopic investigation that is often used in clinical practice to investigate overt or occult gastrointestinal(GI) bleeding among other clinical indications. Int... Small bowel capsule endoscopy is a minimally-invasive endoscopic investigation that is often used in clinical practice to investigate overt or occult gastrointestinal(GI) bleeding among other clinical indications. International guidance recommends small bowel capsule endoscopy as a first-line investigation to detect abnormalities in the small bowel, when gastroscopy and colonoscopy fail to identify a cause of GI bleeding. It can diagnose with accuracy abnormalities in the small bowel. However, there has been increasing evidence indicating that small bowel capsule endoscopy may also detect lesions outside the small intestine that are within the reach of conventional endoscopy and have been probably missed during prior endoscopic investigations. Such lesions vary from vascular deformities to malignancy and their detection often alters patient management, leading to further endoscopic and/or surgical interventions. The current study attempts to review all available studies in the literature and summarise their relevant findings. 展开更多
关键词 Obscure GASTROINTESTINAL BLEEDING small BOWEL capsule endoscopy NON-small BOWEL lesions Overt GASTROINTESTINAL BLEEDING OCCULT GASTROINTESTINAL BLEEDING Iron deficiency ANAEMIA
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Culprit for recurrent acute gastrointestinal massive bleeding: “Small bowel Dieulafoy's lesions”-a case report and literature review
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作者 Anjana Sathyamurthy Jessica N Winn +1 位作者 Jamal A Ibdah Veysel Tahan 《World Journal of Gastrointestinal Pathophysiology》 CAS 2016年第3期296-299,共4页
A Dieulafoy's lesion is a dilated,aberrant,submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion.It can be located anywhere in the gastrointestinal tract.We describe... A Dieulafoy's lesion is a dilated,aberrant,submucosal vessel that erodes the overlying epithelium without evidence of a primary ulcer or erosion.It can be located anywhere in the gastrointestinal tract.We describe a case of massive gastrointestinal bleeding from Dieulafoy's lesions in the duodenum.Etiology and precipitating events of a Dieulafoy's lesion are not well known.Bleeding can range from being self-limited to massive life- threatening.Endoscopic hemostasis can be achieved with a combination of therapeutic modalities.The endoscopic management includes sclerosant injection,heater probe,laser therapy,electrocautery,cyanoacrylate glue,banding,and clipping.Endoscopic tattooing can be helpful to locate the lesion for further endoscopic re-treatment or intraoperative wedge resection.Therapeutic options for re-bleeding lesions comprise of repeated endoscopic hemostasis,angiographic embolization or surgical wedge resection of the lesions.We present a 63-yearold Caucasian male with active bleeding from the two small bowel Dieulafoy's lesions,which was successfully controlled with epinephrine injection and clip applications. 展开更多
关键词 Dieulafoy’s lesion small INTESTINE Massive BLEEDING Endoscopic treatment Endoscopy Surgery
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Angiodysplasia Presenting with Multiple Polypoid Lesions: An Unusual Cause of Small Bowel Obstruction
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作者 Yoshiharu Takenaka Takahiro Sasaki +1 位作者 Nobuyoshi Miyajima Takehito Otsubo 《Case Reports in Clinical Medicine》 2014年第11期592-595,共4页
Angiodysplasia (AD), a morphologic vascular abnormality, is a common cause of gastrointestinal bleeding. We present a rare case of polypoid AD lesions. Three years after treatment for adhesive bowel obstruction, a 57-... Angiodysplasia (AD), a morphologic vascular abnormality, is a common cause of gastrointestinal bleeding. We present a rare case of polypoid AD lesions. Three years after treatment for adhesive bowel obstruction, a 57-year-old man was admitted with recurrent abdominal distension, anorexia, and lower extremity edema. Computed tomography showed his dilated proximal and collapsed distal small bowel loops had disparate calibers. The transition point demonstrated mucosal enhancement and mesenteric lymphadenopathy. We observed small intestinal wall outpouching with strong mucosal enhancement and polypoid lesions dotting the dilated intestine. Intraoperative findings revealed a hard but elastic intraluminal nodule causing small bowel obstruction and the outpouching’s occurrence on the ileum’s antimesenteric border. We performed partial resection of the small intestine involving the nodule and Meckel’s diverticulum. Macroscopically, the nodule, diverticulum, and intestinal mucosa had polypoid lesions. Histopathologically, these lesions had foci within dilated thin- or thick-walled vascular channels in the submucosa, without specific histological abnormalities. These features led to a diagnosis of AD. 展开更多
关键词 ANGIODYSPLASIA Polipoid lesions small BOWEL OBSTRUCTION Meckel’s DIVERTICULUM
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Uncovering the uncertainty: Risk factors and clinical relevance of P1 lesions on small bowel capsule endoscopy of anemic patients
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作者 Tiago Cúrdia Gon?alves Mara Barbosa +2 位作者 Bruno Rosa Maria Jo?o Moreira José Cotter 《World Journal of Gastroenterology》 SCIE CAS 2016年第38期8568-8575,共8页
AIM To identify risk factors for P1 lesions on small bowel capsule endoscopy(SBCE) and to describe the natural history of anemic patients with such type of lesions.METHODS One hundred patients were consecutively selec... AIM To identify risk factors for P1 lesions on small bowel capsule endoscopy(SBCE) and to describe the natural history of anemic patients with such type of lesions.METHODS One hundred patients were consecutively selected for a case-control analysis performed between 37 cases with P1 lesions and 63 controls with negative SBCE. Age, gender, comorbidities and regular medication were collected. Rebleeding, further investigational studies and death were also analyzed during the follow-up.RESULTS No significant differences on gender, median age or Charlson index were found between groups. Although no differences were found on the use of proton pump inhibitors, acetylsalicylic acid, anticoagulants or antiplatelet agents, the use of non-steroidal antiinflammatory drugs(NSAID) was associated with a higher risk of P1 lesions(OR = 12.00, 95%CI: 1.38-104.1). From the 87 patients followed at our center, 39 were submitted to additional studies for investigation of iron-deficiency anemia(IDA), and this was significantly more common in those patients with no findings on SBCE(53.7% vs 30.3%, P = 0.033). A total of 29 patients had at least one rebleeding or IDA recurrence episode and 9 patients died of non-anemia related causes but no differences were found between cases and controls.CONCLUSION P1 lesions are commonly found in patients with IDA submitted to SBCE. The use of NSAID seems to be a risk factor for P1 lesions. The outcomes of patients with P1 lesions do not differ significantly from those with P0 lesions or normal SBCE. 展开更多
关键词 P1 lesionS IRON-DEFICIENCY anemia small bowel capsule endoscopy Risk factors REBLEEDING
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改良式小切口病灶清除术联合功能性颈淋巴结清扫术对颈部淋巴结核的治疗效果观察
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作者 王文帅 孙满胜 +1 位作者 贾立茹 王倩 《中国医刊》 CAS 2024年第8期866-869,共4页
目的探讨改良式小切口病灶清除术联合功能性颈淋巴结清扫术(FND)治疗颈部淋巴结核的临床效果。方法选取2020年8月至2022年8月河北省胸科医院普外科收治的颈部淋巴结核患者104例,采用随机数字表法分为观察组和对照组,每组52例。观察组采... 目的探讨改良式小切口病灶清除术联合功能性颈淋巴结清扫术(FND)治疗颈部淋巴结核的临床效果。方法选取2020年8月至2022年8月河北省胸科医院普外科收治的颈部淋巴结核患者104例,采用随机数字表法分为观察组和对照组,每组52例。观察组采用改良式小切口病灶清除术联合FND治疗,对照组采用常规切口病灶清除术联合FND治疗。比较两组的治疗效果、手术相关指标、切口愈合情况、术后疼痛程度及并发症发生情况。结果两组治疗总有效率比较差异无统计学意义(P>0.05)。观察组术中出血量少于对照组,手术时间、切口长度、引流管拔除时间、住院时间、切口瘢痕长度、切口愈合时间短于对照组,切口愈合良好率高于对照组,术后12、24、48、72 h静息及活动状态下的疼痛视觉模拟量表评分低于对照组,差异均有统计学意义(P<0.05)。观察组术后并发症发生率为3.85%,明显低于对照组的17.31%,差异有统计学意义(P<0.05)。结论改良式小切口病灶清除术联合FND治疗颈部淋巴结核可促进术后恢复及切口愈合,减轻术后疼痛,且并发症较少,值得临床应用。 展开更多
关键词 颈部淋巴结核 改良式小切口病灶清除术 功能性颈淋巴结清扫术 创面愈合
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基于不同卷积神经网络构建小肠多病变自动检测的人工智能辅助系统
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作者 陈健 王甘红 +3 位作者 张子豪 夏开建 戴建军 徐晓丹 《兰州大学学报(医学版)》 2024年第9期23-29,共7页
目的基于不同卷积神经网络开发人工智能辅助系统,用于自动检测小肠胶囊内镜(CE)拍摄的11类小肠病变图像,提高诊断的效率、准确性和客观性。方法收集来自3个不同医学中心,使用3种不同品牌设备拍摄的CE图像,构建图像数据集,用于不同卷积... 目的基于不同卷积神经网络开发人工智能辅助系统,用于自动检测小肠胶囊内镜(CE)拍摄的11类小肠病变图像,提高诊断的效率、准确性和客观性。方法收集来自3个不同医学中心,使用3种不同品牌设备拍摄的CE图像,构建图像数据集,用于不同卷积神经网络模型的训练和测试,共含13683张图像和15117个注释标签。模型性能评估指标包括平均精度、准确率、敏感性、特异性、假阳性率、检测速度。结果构建了2种YOLO模型和2种RTMDet模型,在包含2729张CE图像(4801注释标签)的测试集上,RTMDet_m模型取得了最佳的mAP50(82.58%),但也展现出最慢的延迟时间(47.28帧/s)。模型达到了82.76%的整体敏感性和95.91%整体准确率;在具体类别的推理中,敏感性最高的类别是“出血”,而最低的类别是“黏膜下肿瘤”。结论使用混合品牌CE图像开发的人工智能模型能够快速准确地检测与分类11种小肠病变,在帮助医师提升CE诊断效率和准确性方面展现出很好的临床应用潜力。 展开更多
关键词 小肠病变 卷积神经网络 人工智能 胶囊内镜 目标检测
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512层螺旋CT薄层扫描结合计算机人工神经网络对小肠病变的诊断价值研究
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作者 廖忠剑 文兴林 +3 位作者 刘艳平 邓星星 范存庚 雷剑 《医学理论与实践》 2024年第9期1458-1461,1470,共5页
目的:运用图像识别和图像描述技术,研究512层螺旋CT薄层扫描结合计算机人工神经网络在小肠病变诊断上的应用价值。方法:建立基于ResNet 101、Faster R-CNN、LSTM的小肠CT图像识别描述人工神经网络模型,采用ResNet 101和Faster R-CNN联... 目的:运用图像识别和图像描述技术,研究512层螺旋CT薄层扫描结合计算机人工神经网络在小肠病变诊断上的应用价值。方法:建立基于ResNet 101、Faster R-CNN、LSTM的小肠CT图像识别描述人工神经网络模型,采用ResNet 101和Faster R-CNN联合提取图像特征信息进行ROI融合建立图像编码,采用LSTM进行图像解码输出CT图像诊断报告。设计11个病变图像特征标签,选择我院2020年1月—2022年1月行512层螺旋CT薄层扫描病例材料1572套,材料覆盖正常图像及出血、炎性息肉等9种病变类型,按7∶3随机分为训练组和测试组,对模型进行训练并展开性能测试,评价模型输出的CT诊断文字报告质量、诊断准确率及病变部位提取正确率。结果:文字报告质量评分为(4.0325±0.684)分,出现错误评估项样本占比0.8%,仅语句结合约35%存在不合理现象;各病变类型诊断准确率均在97%左右,仅腺癌存在轻微的诊断为腺瘤性息肉现象,整体病变类型诊断正确率97.17%;病变部位正确识别提取率99.43%。结论:基于ResNet 101、Faster R-CNN、LSTM建立人工神经网络模型,进行小肠512层螺旋CT扫描图像的诊断识别,可准确定位图像病变部位,根据病变部位图像特征准确进行病变类型诊断,并就11个CT图像特征进行文字化描述,输出符合医师阅读理解的图像诊断报告,并发现部分医师人工阅片遗漏错误的地方,可为医师提供更为丰富、有效、准确的CT图像诊断信息,有利于医师作出正确的诊断。 展开更多
关键词 小肠病变 人工智能 薄层扫描CT 图像诊断描述
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初发小血管闭塞型脑梗死患者合并脑白质变性危险因素的研究
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作者 凡奇 马龙 《心脑血管病防治》 2024年第3期19-22,共4页
目的探讨初发小血管闭塞(SAO)型脑梗死患者合并脑白质变性(WML)的危险因素。方法选择2019年1月至2022年7月亳州市人民医院神经内科收治的150例初发SAO型脑梗死患者,根据WML情况将患者分为无WML组30例、轻度WML组52例和中重度WML组68例... 目的探讨初发小血管闭塞(SAO)型脑梗死患者合并脑白质变性(WML)的危险因素。方法选择2019年1月至2022年7月亳州市人民医院神经内科收治的150例初发SAO型脑梗死患者,根据WML情况将患者分为无WML组30例、轻度WML组52例和中重度WML组68例。回顾性分析三组患者的临床资料后采用多因素Logistic回归分析初发SAO型脑梗死患者合并WML的相关危险因素,ROC曲线分析相关危险因素对初发SAO型脑梗死患者合并WML的预测价值。结果三组患者年龄、高血压、尿酸水平、美国国立卫生研究院卒中量表评分差异有统计学意义(χ2/F=6.350、12.600、6.630、5.485,P<0.05)。多因素Logistic回归分析显示,高血压和年龄是初发SAO型脑梗死合并WML的危险因素(OR=7.039、1.090,P<0.01)。ROC曲线显示高血压和年龄预测初发SAO型脑梗死患者合并WML的AUC分别为0.691、0.698,最佳截断值分别为150/90 mmHg、56.50岁,约登指数分别为0.383、0.389,敏感度分别为73.52%、71.70%,特异度分别为68.42%、67.20%。结论高血压和年龄是初发SAO型脑梗死患者合并WML的危险因素,高血压和年龄对预测初发SAO型脑梗死患者合并WML均有一定价值。 展开更多
关键词 初发小血管闭塞型脑梗死 脑白质变性 高血压 年龄
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超声小探头探查5、6级支气管路径对肺结节诊断的价值
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作者 聂云强 刘莉丽 +5 位作者 宋明 吴付梅 冀霞 魏莉 李大刚 康乐 《现代仪器与医疗》 CAS 2024年第4期76-79,96,共5页
目的 探讨超声小探头诊断5、6级支气管相关肺结节的影响因素。方法 收集2022年1月—2023年10月于临沂市人民医院薄层CT诊断肺外周结节的患者49例。薄层CT判断肺结节相关5级或6级支气管、测量结节的直径,评估实性结节、单纯磨玻璃结节。... 目的 探讨超声小探头诊断5、6级支气管相关肺结节的影响因素。方法 收集2022年1月—2023年10月于临沂市人民医院薄层CT诊断肺外周结节的患者49例。薄层CT判断肺结节相关5级或6级支气管、测量结节的直径,评估实性结节、单纯磨玻璃结节。超声小探头测量5级管口到结节的距离、测量支气管相关结节的长度,判断超声小探头与结节的位置,统计分析以上因素对活检结果的影响。结果 49例患者活检阳性率79.59%,超声小探头测量结节的长度阳性组15.0(10.0,23.0)mm,阴性组11.0(2.0,20.8)mm(z=-11.220 P=0.022)。超声小探头在结节内部阳性率90.33%明显高于超声小探头在结节边缘的阳性率61.11%(χ^(2)=5.982,P=0.014)。CT测量结节的直径阳性组22.0(16.0,29.0)mm阴性组19.5(15.0,30.0)mm(z=-5.261,P=0.017)。性别、年龄、5级管口到结节的距离、实性结节、磨玻璃结节、5级支气管肺相关结节、6级支气管相关肺结节对活检阳性结果影响无统计学差异。结论 CT测量肺结节直径越大,超声小探头经5、6支气管测得肺结节长度越长,超声图像呈同心圆样改变,活检阳性率越高。 展开更多
关键词 5级支气管 6级支气管 实性结节 磨玻璃结节 超声小探头1
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基于Swin Transformer网络与Adapt-RandAugment数据增强方法的小肠胶囊内镜图像分类方法研究
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作者 聂瑞 刘学思 +5 位作者 童飞 邓远阳 刘相花 杨利 张和华 段傲文 《医疗卫生装备》 CAS 2024年第6期9-16,共8页
目的:为提高小肠病变分类识别的准确性,提出一种基于Swin Transformer网络与Adapt-RandAugment数据增强方法的小肠胶囊内镜图像分类方法。方法:基于RandAugment数据增强子策略和增强小肠胶囊内镜图像时不丢失特征、不失真的原则提出Adap... 目的:为提高小肠病变分类识别的准确性,提出一种基于Swin Transformer网络与Adapt-RandAugment数据增强方法的小肠胶囊内镜图像分类方法。方法:基于RandAugment数据增强子策略和增强小肠胶囊内镜图像时不丢失特征、不失真的原则提出Adapt-RandAugment数据增强方法。在公开的小肠胶囊内镜图像Kvasir-Capsule数据集中,基于Swin Transformer网络,采用Adapt-RandAugment数据增强方法进行训练,以卷积神经网络ResNet152、DenseNet161为基准,验证Swin Transformer网络和Adapt-RandAugment数据增强方法组合对小肠胶囊内镜图像分类识别的性能。结果:提出的方法宏平均精度(macro average precision,MAC-PRE)、宏平均召回率(macro average recall,MAC-REC)、宏F1分数(macro average F1 score,MAC-F1-S)分别为0.3832、0.3148、0.2905,微平均精度(micro average precision,MIC-PRE)、微平均召回率(micro average recall,MIC-REC)、微平均F1分数(micro average F1 score,MIC-F1-S)均为0.7553,马修斯相关系数(Matthews correlation coefficient,MCC)为0.4523,均优于ResNet152和DenseNet161网络。结论:基于Swin Transformer网络与Adapt-RandAugment数据增强方法的小肠胶囊内镜图像分类方法具有较好的小肠胶囊内镜图像分类识别效果和较高的识别准确率。 展开更多
关键词 Swin Transformer网络 Adapt-RandAugment 数据增强 胶囊内镜 图像分类 小肠病变
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能谱CT成像对胃黏膜下微小病变检出率的应用价值
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作者 陈楠 叶德胜 邓满红 《现代医用影像学》 2024年第5期858-861,共4页
目的:分析比较能谱CT成像与常规CT成像对胃黏膜下微小病变的检出率。方法:选取我院2022年1月至9月收治的26例胃黏膜下微小病变患者作为研究对象,患者检查CT前均行胃超声内镜检查,且均通过手术治疗或胃镜活检取得病理资料。同一个患者,... 目的:分析比较能谱CT成像与常规CT成像对胃黏膜下微小病变的检出率。方法:选取我院2022年1月至9月收治的26例胃黏膜下微小病变患者作为研究对象,患者检查CT前均行胃超声内镜检查,且均通过手术治疗或胃镜活检取得病理资料。同一个患者,通过重建120kVp-like图像作为对照组,模拟常规CT扫描所成生的120kVP的混合能量图像,而实验组通过能谱多组单能量图像、能谱曲线等能谱数据对病灶进行诊断。比较两组对不同大小的胃黏膜下微小肿物的检出率。结果:对照组对黏膜下病变总检出率为30.8%(8/26),低于实验组的69.2%(18/26),差异有统计学意义(P<0.05)。对照组对<1cm病灶未能检出,实验组检出率为38.4%(5/13)。对照组对1cm~1.5cm病灶检出率为16.7%(1/6),实验组检出率为100%。对于>1.5cm,两组均能检测出病灶。结论:能谱CT成像能提供更丰富的参数,有助于胃黏膜下微小病灶的检出。 展开更多
关键词 胃黏膜下微小病变 能谱CT成像 检出率
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胶囊内镜中人工智能的应用现状
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作者 吴海迪 杨景玉 +1 位作者 吴振伦 吴瑞丽 《临床医学研究与实践》 2024年第7期195-198,共4页
胶囊内镜(CE)是检测小肠病变的主要手段,然而一次检查产生约6万张图像,筛选病变图像耗时、枯燥,且受医师经验和专业技术水平影响,易造成漏诊。近年来,人工智能(AI)逐渐深入医学领域,以卷积神经网络(CNN)为代表的深度学习(DL)模型对病灶... 胶囊内镜(CE)是检测小肠病变的主要手段,然而一次检查产生约6万张图像,筛选病变图像耗时、枯燥,且受医师经验和专业技术水平影响,易造成漏诊。近年来,人工智能(AI)逐渐深入医学领域,以卷积神经网络(CNN)为代表的深度学习(DL)模型对病灶具有快速识别能力,可在有效降低漏诊率的同时提高病变诊断率。本文就AI技术在CE图像识别中的应用现状作一综述,为其在CE领域的持续发展提供借鉴。 展开更多
关键词 胶囊内镜 小肠病变 人工智能 深度学习 卷积神经网络 图像识别
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ME-FICE联合超声小探头对早期胃癌及癌前病变的诊断价值研究
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作者 胡维 刘九洋 +2 位作者 陈玺 邓琴 李国珍 《中国医学装备》 2024年第8期65-69,共5页
目的:探究放大智能电子分光染色技术(ME-FICE)联合超声小探头在早期胃癌及其癌前病变诊断中的应用价值。方法:选取2021年4月至2022年4月期间武汉市红十字会医院收治的80例疑似胃癌患者,使用ME-FICE区分阳性和(或)阴性,再使用高频超声小... 目的:探究放大智能电子分光染色技术(ME-FICE)联合超声小探头在早期胃癌及其癌前病变诊断中的应用价值。方法:选取2021年4月至2022年4月期间武汉市红十字会医院收治的80例疑似胃癌患者,使用ME-FICE区分阳性和(或)阴性,再使用高频超声小探头对病灶进行浸润深度探查。检查结束后在ME-FICE模式下对病灶明显处进行活检,其病检阳性者根据患者意愿对病灶行内窥镜下黏膜切除术(EMR)、内窥镜黏膜下剥离术(ESD)或外科手术切除,以术后病检结果为诊断“金标准”。采用Kappa一致性检验评价ME-FICE联合超声小探头与病检结果对良恶性诊断、内窥镜下浸润深度评估以及术后浸润深度评估的一致性。结果:ME-FICE联合超声小探头良恶性诊断的灵敏度、特异度及准确率分别为90.63%、79.17%和83.75%,均处于较高水平,Kappa值为0.887,与病例活检结果具有良好的一致性;ME-FICE联合超声小探头检查浸润程度评估的灵敏度、特异度和准确率分别为66.67%、90.00%和81.25%,灵敏度较差,其余处于较高水平,Kappa值为0.803,与术后病理结果具有良好的一致性。结论:ME-FICE联合超声小探头适用于早期胃癌及癌前病变的诊断,能够提高疾病诊断灵敏度及准确率,并能在术前进行较为准确的浸润程度评估,为后续手术选择和治疗提供指导。 展开更多
关键词 放大内窥镜 放大智能电子分光染色技术(ME-FICE) 超声小探头 早期胃癌 癌前病变诊断
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血管源性脑白质病变的视网膜成像研究进展
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作者 陶锐 赵婕 +1 位作者 周育 周慧 《中外医疗》 2024年第19期195-198,共4页
血管源性脑白质病变(White Matter Lesions, WMLs)在老年人群中发病率高,往往引起血管性认知障碍和痴呆。视网膜血管在胚胎学起源和解剖结构上类似于脑小血管,而视网膜神经纤维层又是大脑的延伸白质。近年来越来越多的研究证实WMLs可引... 血管源性脑白质病变(White Matter Lesions, WMLs)在老年人群中发病率高,往往引起血管性认知障碍和痴呆。视网膜血管在胚胎学起源和解剖结构上类似于脑小血管,而视网膜神经纤维层又是大脑的延伸白质。近年来越来越多的研究证实WMLs可引起视网膜改变,本综述总结了现有的研究结果,概述了WMLs患者视网膜成像临床研究现状,以期指导临床对WMLs的筛查和预防。 展开更多
关键词 脑白质病变 血管性认知障碍 脑小血管病 视网膜成像 视网膜神经纤维层 视网膜血管
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Bleeding Dieulafoy's-like lesions of the gut identified by capsule endoscopy 被引量:8
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作者 Lidia Ciobanu Oliviu Pascu +3 位作者 Brindusa Diaconu Daniela Matei Cristina Pojoga Marcel Tantu 《World Journal of Gastroenterology》 SCIE CAS 2013年第29期4823-4826,共4页
Dieulafoy's-like lesions (DLs-like) represent a cause of obscure gastrointestinal bleeding, enteroscopy being the main diagnostic and therapeutic procedure. Frequently, more than one enteroscopy is needed to ident... Dieulafoy's-like lesions (DLs-like) represent a cause of obscure gastrointestinal bleeding, enteroscopy being the main diagnostic and therapeutic procedure. Frequently, more than one enteroscopy is needed to identify the bleeding vessel. In our practice, video capsule endoscopy (VCE) identified and guided therapy in four cases of DLs-like; three of them were localized on the small bowel. We report, for the first time, a diagnosis of colonic DL-like performed by colon capsule endoscopy. Two patients presented with severe cardiovascular disorders, being hemodynamically unstable during VCE examination. Based on the VCE findings, only one invasive therapeutic procedure per patient was necessary to achieve hemostasis. VCE and enteroscopy may be regarded as complementary procedures in patients with gut DLs-like. 展开更多
关键词 Obscure gastrointestinal BLEEDING Dieulafoy’ s-like lesion Video capsule endoscopy ENTEROSCOPY small bowel
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Latest developments in precancerous lesions of hepatocellular carcinoma 被引量:14
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作者 Zhao-Shan Niu Xiao-Jun Niu +1 位作者 Wen-Hong Wang Jing Zhao 《World Journal of Gastroenterology》 SCIE CAS 2016年第12期3305-3314,共10页
Hepatocarcinogenesis in human chronic liver diseases is a multi-step process in which hepatic precancerous lesions progress into early hepatocellular carcinoma(HCC) and progressed HCC, and the close surveillance and t... Hepatocarcinogenesis in human chronic liver diseases is a multi-step process in which hepatic precancerous lesions progress into early hepatocellular carcinoma(HCC) and progressed HCC, and the close surveillance and treatment of these lesions will help improve the survival rates of patients with HCC. The rapid development and extensive application of imaging technology have facilitated the discovery of nodular lesions of ambiguous significance, such as dysplastic nodules. Further investigations showed that these nodules may be hepatic precancerous lesions, and they often appear in patients with liver cirrhosis. Although the morphology of these nodules is not sufficient to support a diagnosis of malignant tumor, these nodules are closely correlated with the occurrence of HCC, as indicated by long-term follow-up studies. In recent years, the rapid development and wide application of pathology, molecular genetics and imaging technology have elucidated the characteristics of precancerous lesions. Based on our extensive review of the relevant literature, this article focuses on evidence indicating that high-grade dysplastic nodules are more likely to transform into HCC than low-grade dysplastic nodules based on clinical, pathological, molecular genetic and radiological assessments. In addition, evidence supporting the precancerous nature of large cell change in hepatitis B virus-related HCC is discussed. 展开更多
关键词 Hepatocellular carcinoma Precancerous lesions High-grade dysplastic nodule Large cell change small cell change
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药物洗脱球囊治疗冠状动脉极小血管原位病变有效性与安全性
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作者 张明多 周渊 +6 位作者 张闽 宋现涛 乔树宾 王乐丰 佟倩 张立 石蓓 《中国循证心血管医学杂志》 2023年第5期587-591,共5页
目的 分析药物洗脱球囊(DCB)治疗冠状动脉(冠脉)极小血管原位病变的安全性及有效性。方法 连续前瞻性入选2019年11月至2020年5月于北京安贞医院等六家医院心内科收入的冠脉病变血管<2.0 mm且接受DCB治疗的原位病变患者29例,在术后9... 目的 分析药物洗脱球囊(DCB)治疗冠状动脉(冠脉)极小血管原位病变的安全性及有效性。方法 连续前瞻性入选2019年11月至2020年5月于北京安贞医院等六家医院心内科收入的冠脉病变血管<2.0 mm且接受DCB治疗的原位病变患者29例,在术后9个月有18例(56.25%)患者行随访冠脉造影检查和定量分析。观察入组患者DCB治疗前后血管腔变化并记录不良事件发生率。观察终点是随访时冠脉造影的晚期管腔丢失(LLL)和主要不良心血管事件(MACE),包括靶病变血运重建、死亡、心肌梗死及复合终点。结果 纳入病例靶病变参考血管平均直径为(1.71±0.27) mm,靶病变术前最小管腔直径(MLD)为(0.31±0.24) mm,靶病变LLL平均为(0.13±0.28) mm,术后即刻MLD(1.19±0.20) mm及术后9个月靶血管MLD (1.06±0.31) mm均明显大于术前(P<0.05)。1例患者(5.56%)进行了再次血运重建,DCB处理后随访期间,无心梗或死亡发生。结论 DCB治疗冠脉极小血管原位病变有效、安全。 展开更多
关键词 药物洗脱球囊 经皮冠状动脉介入治疗 小血管病变 冠状动脉疾病
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超脉冲CO_(2)激光治疗睑缘小肿物的临床研究
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作者 王忠文 《鹿城学刊》 2023年第4期74-75,84,共3页
目的:超脉冲二氧化碳(CO_(2))激光气化治疗睑缘小肿物。方法:对睑缘小肿物200例患者,采用超脉冲二氧化碳激光进行治疗,根据眼睑小肿物病变情况,使用能量范围区间125-150mJ,光斑直径为0.21mm。6个月后,观察临床疗效。结果:148例患者术后... 目的:超脉冲二氧化碳(CO_(2))激光气化治疗睑缘小肿物。方法:对睑缘小肿物200例患者,采用超脉冲二氧化碳激光进行治疗,根据眼睑小肿物病变情况,使用能量范围区间125-150mJ,光斑直径为0.21mm。6个月后,观察临床疗效。结果:148例患者术后2周左右创面湿性愈合,其余52例患者愈合时间稍长。其中睑缘疣状物113例,一次性完全治愈;色素痣47例,42例一次治愈,2例进行二次复点治疗后完全治愈,3例复发;肉芽炎性增生10例,乳头状瘤4例,都一次治愈;皮肤血管瘤14例,1例复发,黄色瘤12例,2例复发。患者睑缘治疗部位愈合良好,无瘢痕,无睫毛损伤。治疗总有效率为97%。结论:超脉冲CO_(2)激光治疗睑缘小肿物,医师操作灵活方便,病变部位治疗面积和深度把控精准,病人不需要特殊检查化验,治疗费用低,无须住院,治疗完即可回家,后续涂药修复即可,而且治疗效果满意,值得临床推广。 展开更多
关键词 超脉冲CO_(2)激光 睑缘小肿物治疗
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