目的:探讨基于增强CT影像组学模型和临床特征模型评估进展期胃癌浆膜侵犯的价值。方法:收集351例术前2周内行腹部增强CT检查进展期胃癌患者资料并以7:3比例随机分为训练组247例和验证组104例。基于动静脉期CT图像在A.K软件中共提取3190...目的:探讨基于增强CT影像组学模型和临床特征模型评估进展期胃癌浆膜侵犯的价值。方法:收集351例术前2周内行腹部增强CT检查进展期胃癌患者资料并以7:3比例随机分为训练组247例和验证组104例。基于动静脉期CT图像在A.K软件中共提取3190个影像组学特征,通过降维筛选后建立影像组学模型,比较进展期胃癌浆膜侵犯阳性和阴性组之间的临床特征差异,并构建临床模型。模型效能评估采用受试者工作特征曲线分析。结果:在训练组和验证组中,N、M分期在浆膜侵犯阳性组和阴性组间的差异有统计意义(P<0.05)。基于动静脉期图像最终筛选出14个影像组学特征。在验证组中,影像组学模型预测进展期胃癌浆膜侵犯的诊断效能高于基于联合N分期和M分期构建临床模型的诊断效能(AUC:0.854 vs 0.793)。结论:基于增强CT影像组模型和基于N、M分期的临床模型均能够成功预测进展期胃癌浆膜侵犯,前者诊断效能较优。展开更多
目的:观察描述多发性一过性白点综合征(multiple evanescent white dot syndrome,MEWDS)的临床表现。方法:回顾性分析2003-01/2012-11在我院确诊为MEWDS并进行治疗的25例病例临床资料,并对各种影像检查资料进行分析,总结MEWDS的临床及...目的:观察描述多发性一过性白点综合征(multiple evanescent white dot syndrome,MEWDS)的临床表现。方法:回顾性分析2003-01/2012-11在我院确诊为MEWDS并进行治疗的25例病例临床资料,并对各种影像检查资料进行分析,总结MEWDS的临床及影像学特征。结果:所有患者均伴轻-中度近视,不同程度的视野缺损。MEWDS的荧光素血管造影(FFA)表现为:病灶处呈圆形强荧光斑,随时间延迟荧光强度增强,晚期呈边界不清的强荧光染色,伴有视盘荧光增强,部分伴有节段状血管管壁染色。吲哚青绿血管造影(ICGA)表现为:早期后极部散在的大小不等的相对弱荧光,中晚期渐呈边界清晰的斑片状弱荧光。OCT表现为:病灶部位光感受细胞层厚度不规则、视细胞内节/外节(IS/OS)层的光带局部变薄或缺失,伴反光强度减弱(该部位与血管造影中的异常荧光灶对应),而视网膜内网状层至外核层均未见明显异常。结论:MEWDS患者眼底的斑点状病灶在FFA、ICGA、OCT中均有特征性改变,这些特征性改变提示病变位于视网膜色素上皮和光感受器,这些特征对MEWDS疾病的诊断和鉴别诊断有重要意义。展开更多
Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinic...Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinical features and radiological aspects in 145 cases ofmeningiomas undergoing operation during 1993-1997 were retrospectively studied. The data of only 83cases of all 145 cases were available. The factors were evaluated with univariate and multivariateanalysis. Results: With univariate analysis, 7 factors showed highly significance to recurrence ofmeningiomas: tumor size, tumor location, tumor shape, edema, extent of resection, pathologicalgrade, CT enhancement. With multivariate analysis, 4 factors showed significant danger to recurrenceof meningiomas: pathological grade, extent of resection, tumor shape and CT enhancement.Conclusion: The main factors that affect the recurrence of meningioma patients are pathologicalgrade, extent of resection, tumor shape and CT enhancement.展开更多
The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010....The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010. After an initial treatment,the injurers were rapidly transported from Yushu at an altitude of 4 000 m via air to Xining at 2 260 m within 6~8 h,and promptly admitted to Qinghai Provincial People’s Hospital. A total of 130 wounded injurers who had high suspicion of chest injuries all had examinations of Chest X-ray and computed tomography(CT)images. Of them 63 injurers presented at least one of the features of the chest trauma in imaging with a positive rate of 48.5 %. Of these,37 cases (28.5 %) were multi-system with multiple injuries ,33 cases (25.4 %) were chest trauma with multi-injury types,which included thoracic fractures in 54 cases (85.7 %),pleural injury in 56 cases (88.9 %),lung injury in 54 cases (85.7 %),lungs complications in 37 cases (58.7 %),and extrapulmonary complications of 35 cases (55.6 %). The radiological data were analyzed retrospectively. The features of chest trauma in Yushu Earthquake,the complications of chest injuries,and the relation between imaging findings and clinical manifestations,as well as the differences of chest trauma between Yushu Earthquake and Wenchuan Earthquake were discussed in detail.展开更多
文摘目的:探讨基于增强CT影像组学模型和临床特征模型评估进展期胃癌浆膜侵犯的价值。方法:收集351例术前2周内行腹部增强CT检查进展期胃癌患者资料并以7:3比例随机分为训练组247例和验证组104例。基于动静脉期CT图像在A.K软件中共提取3190个影像组学特征,通过降维筛选后建立影像组学模型,比较进展期胃癌浆膜侵犯阳性和阴性组之间的临床特征差异,并构建临床模型。模型效能评估采用受试者工作特征曲线分析。结果:在训练组和验证组中,N、M分期在浆膜侵犯阳性组和阴性组间的差异有统计意义(P<0.05)。基于动静脉期图像最终筛选出14个影像组学特征。在验证组中,影像组学模型预测进展期胃癌浆膜侵犯的诊断效能高于基于联合N分期和M分期构建临床模型的诊断效能(AUC:0.854 vs 0.793)。结论:基于增强CT影像组模型和基于N、M分期的临床模型均能够成功预测进展期胃癌浆膜侵犯,前者诊断效能较优。
文摘目的探讨循环肿瘤细胞(circulating tumor cells,CTCs)联合影像学特征建立的模型对肺亚实性结节肿瘤浸润性的预测价值。方法回顾性纳入2019年2月—2022年2月在兰州大学第一医院胸外科就诊的296例患者,其中男130例、女166例,中位年龄62.00岁。采用随机数字表法按3∶1的比例将患者分为训练集和内部验证集,其中训练集213例、内部验证集83例。根据病理诊断结果分为浸润前病变组(非典型腺瘤样增生和原位腺癌)和浸润性病变组(微浸润性腺癌和浸润性腺癌)。对训练集进行单因素和多因素logistic回归分析,筛选出独立危险因素(P≤0.05)并构建Nomogram预测模型。通过受试者工作特征曲线和校准曲线分别验证模型的准确性和一致性;对不同直径结节进行亚组分析,进一步验证模型的性能。计算出敏感性、特异性、阳性预测率、阴性预测率和准确性。结果Logistic回归分析结果显示,年龄、CTCs、结节成分、分叶征、毛刺征是肺亚实性结节浸润性的独立危险因素(P<0.05)。训练集中Nomogram预测模型的曲线下面积(area under the curve,AUC)为0.914(0.872,0.956),显著优于影像学特征预测模型的AUC[0.856(0.794,0.917),P=0.003]和单独CTCs预测模型的AUC[0.750(0.675,0.825),P=0.001];训练集的C指数为0.914,矫正C指数为0.902;内部验证集的C指数为0.894,矫正C指数为0.843;训练集在结节直径范围为5~20 mm、10~20 mm和21~30 mm时,Nomogram预测模型的AUC为0.902(0.848,0.955)、0.913(0.860,0.966)和0.873(0.730,1.000)。结论本研究建立的预测模型可以提高肺亚实性结节浸润性的诊断价值,更有效地辅助临床诊断疾病。
文摘目的:观察描述多发性一过性白点综合征(multiple evanescent white dot syndrome,MEWDS)的临床表现。方法:回顾性分析2003-01/2012-11在我院确诊为MEWDS并进行治疗的25例病例临床资料,并对各种影像检查资料进行分析,总结MEWDS的临床及影像学特征。结果:所有患者均伴轻-中度近视,不同程度的视野缺损。MEWDS的荧光素血管造影(FFA)表现为:病灶处呈圆形强荧光斑,随时间延迟荧光强度增强,晚期呈边界不清的强荧光染色,伴有视盘荧光增强,部分伴有节段状血管管壁染色。吲哚青绿血管造影(ICGA)表现为:早期后极部散在的大小不等的相对弱荧光,中晚期渐呈边界清晰的斑片状弱荧光。OCT表现为:病灶部位光感受细胞层厚度不规则、视细胞内节/外节(IS/OS)层的光带局部变薄或缺失,伴反光强度减弱(该部位与血管造影中的异常荧光灶对应),而视网膜内网状层至外核层均未见明显异常。结论:MEWDS患者眼底的斑点状病灶在FFA、ICGA、OCT中均有特征性改变,这些特征性改变提示病变位于视网膜色素上皮和光感受器,这些特征对MEWDS疾病的诊断和鉴别诊断有重要意义。
文摘Objective: To evaluate the clinical and radiological factors that affect therecurrence of the meningioma patient so as to effectively prevent and cure recurrence of meningiomapatients more earlier. Methods: The clinical features and radiological aspects in 145 cases ofmeningiomas undergoing operation during 1993-1997 were retrospectively studied. The data of only 83cases of all 145 cases were available. The factors were evaluated with univariate and multivariateanalysis. Results: With univariate analysis, 7 factors showed highly significance to recurrence ofmeningiomas: tumor size, tumor location, tumor shape, edema, extent of resection, pathologicalgrade, CT enhancement. With multivariate analysis, 4 factors showed significant danger to recurrenceof meningiomas: pathological grade, extent of resection, tumor shape and CT enhancement.Conclusion: The main factors that affect the recurrence of meningioma patients are pathologicalgrade, extent of resection, tumor shape and CT enhancement.
基金Project of Qinghai Development of Science and Technology (No.2011-N-150)
文摘The purpose of this study was focused on the imaging features of the chest trauma and its relation to clinical characteristics. All the injured patients were from the Yushu Earthquake areas on days April 14 - 23,2010. After an initial treatment,the injurers were rapidly transported from Yushu at an altitude of 4 000 m via air to Xining at 2 260 m within 6~8 h,and promptly admitted to Qinghai Provincial People’s Hospital. A total of 130 wounded injurers who had high suspicion of chest injuries all had examinations of Chest X-ray and computed tomography(CT)images. Of them 63 injurers presented at least one of the features of the chest trauma in imaging with a positive rate of 48.5 %. Of these,37 cases (28.5 %) were multi-system with multiple injuries ,33 cases (25.4 %) were chest trauma with multi-injury types,which included thoracic fractures in 54 cases (85.7 %),pleural injury in 56 cases (88.9 %),lung injury in 54 cases (85.7 %),lungs complications in 37 cases (58.7 %),and extrapulmonary complications of 35 cases (55.6 %). The radiological data were analyzed retrospectively. The features of chest trauma in Yushu Earthquake,the complications of chest injuries,and the relation between imaging findings and clinical manifestations,as well as the differences of chest trauma between Yushu Earthquake and Wenchuan Earthquake were discussed in detail.
