COMBINED IMAGING DIAGNOSIS OF PAROTID MASSES

Computed tomography (CT), ultrasonography, sialography, and 99mTc scintigraphy were applied before operation to 108 patients with parotid masses. The results of each technique and the combined study of them were compared with the pathological diagnosis. Ultrasonography was found to be a very effective diagnostic aid in determining the presence of space-occupying lesion in the parotid. CT was the best technique to provide adequately reliable informations regarding the location of the tumor and the relationship between tumor and surrounding tissues. For diagnosing the nature of tumors, ultrasonography combined with sialography was reliable. 99mTc scintigraphy was better than other techniques in diagnosis of adenolymphoma. The diagnostic accuracy of combined diagnosis (90.7%) was higher than those of ultrasonography (83%), CT (80.5%), sialography (79%), and 99mTc scintigraphy (13.9%) alone. The advantage of combined diagnosis was particularly obvious for the diagnosis of low-grade malignant tumors.

THE USEFULNESS OF ^(99)Tc-PMT DELAYED HEPATOBILIARY IMAGING IN THE DIAGNOSIS OF SMALL HEPATOCELLULAR CARCINOMA

This investigation was aimed to assess the usefulness of delayed hepalobillary Imaging in the diagnosis of small hepatocellular carcinoma (HCC). Sixty-two patients with this hepatic cancer were Included in the study. 56 males and 6 females, with a mean age of 50. 6 yr. (32 - 72 years old). All patients were performed by surgery, verified histologically, and these tumors were smaller than 5 cm. Liver scans were performed 5 minutes, 2 hours and 5 hours after the administration of radlopharmaceutices. In 31 of the 62 patients (50%), the tumor exhibited equal radioactivity uptake or greater radioactivity uptake than the surrounding liver in delayed imaging. And the sensitivity was 33. 3% (2/6), 41.2% (7/17), 60.0% (9/15) and 54.2% (13/24) In the tumor size was ≤2 cm, 2-3cm, 3-4 cm and 4 - 5 cm, respectively. The smallest mass to be detected was only 1. 2 cm. The uptake of radiopharmaceutic was nonsignificantly related to serum AFP level and hepatic cirrhosis (P>0. 05). These results show that 99-Tc-PMT delayed hepatobiliary imaging can be useful in the diagnosis of small hepatocellular carcinoma.

RADIONUCLIDE WHOLE BODY BONE IMAGING IN THE DIAGNOSIS OF SKELETAL METASTASES

Of 628 patients with extra-osseous malignancies diagnosed by surgery and/or pathology, 207 (33.0%) were identified as having skeletal metastasis by bone imaging. There was statistical significant difference in the incidence of metastasis in different malignancies (P<0.02). The metastatic rates of nasopharyn-geal, lung, prostate and breast cancers were higher than gastrointestinal, kidney, and other malignancies. There was significant differences in the different sites of skeletal metastasis (P<0.01). They were thorax, spine, pelvis, limbs and skull in order of incidence. Solitary metastatic rate was 15.9%. Biopsy is advised for patients suspected to have metastatic disease but with only one single 'hot spot' in skeletal imaging, particularly in the rib.

Far lateral lumbar disc herniation part 1: Imaging, neurophysiology and clinical features

Far lateral lumbar disc herniations(FLLDH)represent a separate category of disc pathology which includes both intraforaminal and extraforaminal lumbar disc herniations,that are characterized by a peculiar clinical presentation,diagnostic and treatment modalities as compared to the more frequent median and paramedian disc hernias.Surgical treatment often represents the only effective weapon for the cure of this disease and over the years different approaches have been developed that can reach the region of the foramen or external to it,with different degrees of invasiveness.The diagnosis is more demanding and still underestimated as it requires a more detailed knowledge in the spine anatomy and dedicated radiological studies.Computerized tomography and in particular magnetic resonance imaging are the appropriate tools for the diagnosis of FLLDH.Despite the widespread use of these diagnostic tests,many cases of FLLDH are overlooked due to insufficiently detailed radiological examinations or due to the execution of exams not focused to the foraminal or the extraforaminal region.Neurophysiological studies represent a valid aid in the diagnostic classification of this pathology and in some cases they can facilitate the differential diagnosis with other types of radiculopathies.In the present study,a comprehensive review of the clinical presentation,epidemiology,radiological study and the neurophysiological aspects is presented.

Measuring the density of the fissula antefenestram and the section of the basal turn of the cochlea:Are they useful in the radiological diagnosis of otosclerosis?

Introduction:The role of objective parameters in terms of improvement of the accuracy of highresolution computed tomography(HRCT)of the temporal bone in the diagnosis of otosclerosis remains unclear.Objectives:To investigate the relationship between the density of the fissula antefenestram(FAF)and of the width of the transversal section of the basal turn of the cochlea(BTC),and the diagnosis of otosclerosis.Methods:This is a retrospective study in which preoperative HRCT data from ears of patients submitted to stapedotomy due to otosclerosis(case group)were evaluated.For the control group,normal hearing ears having undergone HRCT for other purposes were included.Case and control HRCT images were objectively assessed by an experienced blinded radiologist.During this evaluation,measurements of the relative radiological density of the FAF and of the transversal section of the BTC were obtained.The results were compared between the groups.Also,a receiver operating characteristic curve was created and the area under the curve(AUC)was calculated for each variable.Significance level was set at.05.Results:40 ears were included in each group.Case ears presented reduced values for the relative radiological density on the FAF(p-value<0.0001).Moreover,ears with otosclerosis(p-value:0.022)presented lower transversal section of the BTC.The AUC for these variables reached 0.929 and 0.646,respectively.Conclusions:Otosclerotic ears present reduced radiological density on the FAF and narrower BTC.The relative density of the FAF also shows a great diagnostic power in the context of this disease.

Reversible lesions in the brain parenchyma in Wilson's disease confirmed by magnetic resonance imaging:earlier administration of chelating therapy can reduce the damage to the brain

The aim of this study was to evaluate the resolution of brain lesions in patients with Wilson’s disease during the long-term chelating therapy using magnetic resonance imaging and a possible signiifcance of the time latency between the initial symptoms of the disease and the introduction of this therapy. Initial magnetic resonance examination was performed in 37 patients with proven neurological form of Wilson’s disease with cerebellar, parkinsonian and dystonic presentation. Magnetic resonance reexamination was done 5.7 ± 1.3 years later in 14 patients. Patients were divided into： group A, where chelating therapy was initiated 〈 24 months from the ifrst symp-toms and group B, where the therapy started≥ 24 months after the initial symptoms. Symmetry of the lesions was seen in 100% of patients. There was a signiifcant difference between groups A and B regarding complete resolution of brain stem and putaminal lesions （P= 0.005 andP=0.024, respectively）. If the correct diagnosis and adequate treatment are not established less than 24 months after onset of the symptoms, irreversible lesions in the brain parenchyma could be ex-pected. Signal abnormalities on magnetic resonance imaging might therefore, at least in the early stages, represent reversible myelinolisis or cytotoxic edema associated with copper toxicity.

Convolutional Neural Network-Based Classificationof Multiple Retinal Diseases Using Fundus Images

Use of deep learning algorithms for the investigation and analysis of medical images has emerged as a powerful technique.The increase in retinal dis-eases is alarming as it may lead to permanent blindness if left untreated.Automa-tion of the diagnosis process of retinal diseases not only assists ophthalmologists in correct decision-making but saves time also.Several researchers have worked on automated retinal disease classification but restricted either to hand-crafted fea-ture selection or binary classification.This paper presents a deep learning-based approach for the automated classification of multiple retinal diseases using fundus images.For this research,the data has been collected and combined from three distinct sources.The images are preprocessed for enhancing the details.Six layers of the convolutional neural network(CNN)are used for the automated feature extraction and classification of 20 retinal diseases.It is observed that the results are reliant on the number of classes.For binary classification(healthy vs.unhealthy),up to 100%accuracy has been achieved.When 16 classes are used(treating stages of a disease as a single class),93.3%accuracy,92%sensitivity and 93%specificity have been obtained respectively.For 20 classes(treating stages of the disease as separate classes),the accuracy,sensitivity and specificity have dropped to 92.4%,92%and 92%respectively.

肺动脉血栓栓塞的影像诊断新进展及介入治疗研究

肺栓塞的影像学诊断方法多样,但不同的影像学表现特点和诊断的准确性影响了临床医生的选择。同时介入治疗原理及介入治疗适应证的选择对治疗结果有着很大的影响。本文对肺栓塞的影像学诊断及介入治疗的方法作一综述。

Review of Budd-Chiari Syndrome

This study aims to report the Budd-Chiari syndrome clinical research status and progress that has occurred in over nearly 30 years in China, and emphasize the value of imaging in facilitating the diagnosis of Budd-Chiari syndrome based on more than 2500 cases. Findings on ultrasonography, computed tomography, magnetic resonance imaging, and digital subtraction angiography images are used to propose new Budd-Chiari syndrome types and subtypes. The new subtype classification presented here has important value for guiding interventional treatment.This study also proposes a new concept of anatomical and functional obstruction of hepatic vein that stresses the compensatory value of accessory hepatic vein and azygos vein and describes the risk of manipulation of the communication branch of inferior vena cava obstruction in interventional therapy.

COMPARISON OF INFRARED LIGHTSCANNING AND MAMMOGRAPHY IN BREAST CANCER DETECTION

Purpose: This study is in an attempt to assess the diagnostic accuracy of infrared lightscanning by comparing with that of mammograpby- Methods: A total of 104 patients had been examined by both mammography and infrared lightscanning before surgery.All Patients were divided into two groups: cancer and non cancer. The diagnostic accuracy of these two modalities were calculated. Results: Of 104 Patients, 43 had breast cancer and 61 had benign lesions, the sensitivity and specificity for mammography were 84% and 83%, 82% and 77% for infrared lightscanning. The predictive values of positivity for mammograpby and lightscanning were 80% and 70%, the negative Predictive value for these two modalities were both 87%. Conclusion: Infrared lightscanning,being of assistance to mammography, could enhance sensitivity and predictive values of positivity in detecting breast cancer, especially, in mammographically dense breast.

THE MAMMOGRAPHIC CALCIFICATIONS IN BREAST CANCER

Objective: This study was performed to exam the relativeship between mammographic calcifications and breast cancer. Methods: All of the 184 patients with breast diseases underwent mammography before either an open biopsy or a mastectomy. The presence, morphology, and distribution of calcifications visualized on mammograms for breast cancer were compared with the controls who remained cancer free. Statistical comparisons were made by using the x 2 test. Results: Of the 184 patients with breast diaeases, 93 malignant and 91 benign lesions were histologically confirmed. Calcifications were visualized on mammograms in 60 (64%)of 93 breast cancers and 26(28%)of 91 non breast cancers. The estimated odds ratio (OR) of breast cancer was 4.5 in women with calcifications seen on mammo grams, compared with those having none ( P < 0.01). Of the 60 breast carcinomas having mammographic calcifi cations, 28 (47%) were infiltrating ductal carcinomas. There were only 8 (24%) cases with infiltrating ductal cancers in the group of without calcifications seen on the mammograms ( P <0.05). Conclusion: Our finding sug gests that mammographic calcification appears to be a risk factor for breast cancer. The granular and linear cast type calcification provide clues to the presence of breast cancer, especially when the carcinomas without associated masses were seen on mammograms.

Clear Cell Myo-Melanomas of Ligamentum Teres Hepatis: A Case Report and Literature Review

Introduction: Clear Cell Myomelanocytic Tumor (CCMMT) of ligamentum teres hepatis is a pathological classification of Perivascular Epithelioid Cell tumor (PEComa), which is rare clinically and easy to misdiagnose. Objective: To report a case of a rare type of PEComa located in the ligamentum teres hepatis. Case Report: A 22-year-old Asian female was diagnosed with abdominal mass during physical examination in September 2018, and was admitted to the general surgery department of our hospital that month. She was diagnosed with abdominal mass, the nature of which remains to be determined is: teratoma, pheochromocytoma or ganglioma. At the time of admission, the patient had no symptoms or signs, and no other medical history. The patient was diagnosed with an abdominal mass by abdominal plain scan and enhanced CT, whose nature was to be determined: pheochromocytoma, paragangliomas or other mesenchymal tumors, or giant lymph node hyperplasia. The patient underwent abdominal mass resection and appendectomy without incident, without any complications at discharge, and there was no significant difference in follow-up. Conclusions: The clinical data, imaging features and pathological features of one patient diagnosed with CCMMT in our hospital were retrospectively analyzed, and the literature was reviewed in combination with the research progress of CCMMT, in order to improve the understanding and diagnostic accuracy of this disease.

In-service Structural Health Monitoring of a Full-scale Composite Horizontal Tail

In-service structural health monitoring（SHM） technologies are critical for the utilization of composite aircraft structures. We developed a Lamb wave-based in-service SHM technology using built-in piezoelectric actuator/sensor networks to monitor delamination extension in a full-scale composite horizontal tail. The in-service SHM technology combine of damage rapid monitoring（DRM） stage and damage imaging diagnosis（DID） stage allows for real-time monitoring and long term tracking of the structural integrity of composite aircraft structures. DRM stage using spearman rank correlation coeffi cient was introduced to generate a damage index which can be used to monitor the trend of damage extension. The DID stage based on canonical correlation analysis aimed at intuitively highlighting structural damage regions in two-dimensional images. The DRM and DID stages were trialed by an in-service SHM experiment of CFRP T-joint. Finally, the detection capability of the in-service SHM technology was verified in the SHM experiment of a full-scale composite horizontal tail. Experimental results show that the rapid monitoring method effectively monitors the damage occurrence and extension tendency in real time; damage imaging diagnosis results are consistent with those from the failure model of the composite horizontal tail structure.

Artificial intelligence in gastrointestinal radiology: A review with special focus on recent development of magnetic resonance and computed tomography

Artificial intelligence(AI),particularly the deep learning technology,have been proven influential to radiology in the recent decade.Its ability in image classification,segmentation,detection and reconstruction tasks have substantially assisted diagnostic radiology,and has even been viewed as having the potential to perform better than radiologists in some tasks.Gastrointestinal radiology,an important subspecialty dealing with complex anatomy and various modalities including endoscopy,have especially attracted the attention of AI researchers and engineers worldwide.Consequently,recently many tools have been developed for lesion detection and image construction in gastrointestinal radiology,particularly in the fields for which public databases are available,such as diagnostic abdominal magnetic resonance imaging(MRI)and computed tomography(CT).This review will provide a framework for understanding recent advancements of AI in gastrointestinal radiology,with a special focus on hepatic and pancreatobiliary diagnostic radiology with MRI and CT.For fields where AI is less developed,this review will also explain the difficulty in AI model training and possible strategies to overcome the technical issues.The authors’insights of possible future development will be addressed in the last section.

Value of magnifying endoscopy with narrow-band imaging in diagnosis of 124 early gastric neoplastic lesions

Objective To investigate the value of intervening part(IP)ratio under magnifying endoscopy with narrowband imaging(ME-NBI)in the diagnosis of early gastric neoplastic lesions.Methods From September 2012 to May 2015,a total of 124 patients with suspected superficial gastric neoplastic lesions under white light endoscope(WLI)were enrolled,87 male with mean age of(63.

Myocardial perfusion imaging with a contrast agent at a low concentration in the diagnosis of myocardial infarction in the elderly

Objective To evaluate the clinical value of myocardial perfusion imaging with dual-source dual-energy CT and a contrast agent at a low concentration in the diagnosis of myocardial infarction in the elderly.Methods Onestop cardiac imaging with dual-source CT was conducted in 138 elderly patients diagnosed with myocardial infarction between October 2015 and May 2016.The

Multifunctional lymph-targeted platform based Mn@mSiO2 nanocomposites： Combining PFOB dual-mode imaging and DOX for cancer diagnose treatment on for and

A universal platform with M_n doping and hyaluronic acid （HA） modification, based on mesoporous silica （mSiO2）, was designed and used as a basic multifunctional material with magnetic resonance （MR） imaging. Furthermore, we added flexible functions through the addition of functional molecules. Specially, two typical compounds, hydrophobic perfluorooctyl bromide （PFOB） and hydrophilic doxorubicin （DOX）, were loaded into the channels to obtain PFOB@Mn@mSiO2@HA （PMMH） or DOX@Mn@mSiO2@HA （DMMH） or imaging and therapy, respectively. The were highly targeted to the lymph system in nanoparticles for dual-mode imaging PMMH and DMMH nanoparticles vitro and in vivo. MR and ultrasound imaging of PMMH nanoparticles were performed in the lymph system, while MR imaging and chemotherapy of DMMH nanoparticles was used to detect cancer. These results showed that both PMMH and DMMH nanoparficles can be designed with high lymph targeting efficiency. PMMH nanoparticles are a dual-mode contrast agent for both ultrasound and MR imaging for the lymph system and DMMH nanoparticles are powerful agents for the combined diagnosis and therapy of cancer in vivo.

Clinical value of optimized magnetic resonance imaging for evaluation of patients with painful hip arthroplasty

Background The imaging evaluation of pain in patients who have had a hip arthroplasty （HA） is challenging,and traditional imaging techniques,including magnetic resonance imaging （MRI） and computerized tomography （CT）,are limited by metallic artifact.The purpose of the present study was to investigate the use of modified MRI techniques to visualize periprosthetic soft tissues and the bone-implant interface,and to evaluate the value of MRI for the assessment of patients with painful hip arthroplasty.Methods Fifty-six painful hips in fifty-six patients following primary HA were assessed using optimized MRI,CT and standardized radiographs.The diagnosis of MRI was correlated with intraoperative findings as well as with microbiological and histological examinations （when available）.The sensitivity and the specificity of MRI diagnosis were determined according to final diagnosis.The chi-square test was performed to detect a difference between MRI and final diagnosis.Results Forty-eight patients have received revision surgery and final diagnosis were established.MRI was demonstrated high sensitivity and specificity in detecting aseptic loosening （93％ and 95％）,periprosthetic infection （94％ and 97％）,adverse local tissue reaction （100％ and 100％） and periprosthetic fracture （100％ and 100％）.MRI was determined to be the most sensitive technique in detecting implant loosening for any reason,with a sensitivity of 93.8％ for acetabular shell and 97.1％ for femoral stem,compared to 81.3％ and 80.0％ on CT,75.0％ and 77.1％ on radiographs.Conclusions Optimized MRI was effective for the assessment of the periprosthetic soft tissues and bone.The use of modified magnetic resonance imaging parameters provided a useful adjunct to conventional examinations for the evaluation of patients with painful hip arthroplasty.