经影像学诊断确认冠心病家族史阳性青中年患者初次急性心肌梗死的危险因素回顾性分析

目的分析冠心病(CHD)家族史阳性青中年初次急性心肌梗死(AMI)患者的危险因素,为AMI的防治提供科学理论依据。方法收集医院2006年12月-2014年6月行冠脉介入治疗(PCI)并且年龄<60岁的CHD家族史阳性患者513例,初次AMI 199例为阳性组,非AMI 314例为阴性组。收集基线资料包括性别、年龄、体质指数(BMI)和CHD一般危险因素包括吸烟、饮酒、糖尿病、高血压、高脂血症和遗传类型。结果在513例患者中,年龄34~59(52.17±5.71)岁。年龄、吸烟、高血压和高脂血症是CHD家族史初次AMI的危险因素。在40~49岁组中,吸烟、糖尿病是CHD家族史初次AMI的危险因素。在50~59岁组中,吸烟、饮酒及高血压是CHD家族史阳性青中年患者初次AMI的重要危险因素。男427例,女86例;男性年龄大于女性,吸烟、饮酒发生率高于女性,高血压发生率低于女性,差异均有统计学意义(P<0.05)。结论在影像学诊断的CHD家族史阳性初次AMI的患者中,吸烟是青中年初次AMI的重要危险因素,虽然糖尿病、高血压和高脂血症为CHD的重要危险因素,但并不增加CHD家族史阳性青中年初次AMI的发病率。

多模态影像融合在颅底肿瘤的诊断、治疗中的应用价值

目的探讨多模态影像融合在颅底肿瘤的诊断、治疗中的应用价值。方法 9例颅底肿瘤术前均行DynaCTA检查及MRI薄层(2 mm)增强扫描检查,将多组影像数据输入工作站,采用"双容积重建"技术进行脑血管及MRI的影像融合,通过静态及动态融合影像观察肿瘤与脑结构、血管及颅骨的毗邻关系,并对肿瘤的诊断、手术治疗及预防血管并发症进行分析。结果 9例均获得满意的影像融合、具有很好的空间一致性,在一张影像上可以清晰显示病变及其周围脑结构、血管及颅骨解剖关系,提高精准性诊断,并应用于指导治疗策略、设计手术划及预防并发症。9例均恢复满意出院。结论多模态影像融合对提高颅底肿瘤的诊断精准性、提高肿瘤全切除率、降低病死率和残疾率效果肯定,对血管损伤并发症治疗疗效肯定。

A patient with spinal metastasis from hepatocellular carcinoma discovered from neurological findings

Although spinal tumors are uncommon, they may reduce survival or cause serious functional disorders in the extremities. Metastatic spinal tumors from malignant tumors can induce symptoms of spinal cord compression, such as paraplegia, quadriplegia, and vesicorectal disturbance, which are aggravated with progression of the diseases and time. We report a patient with hepatocellular carcinoma (HCC) who was suspected of having spinal lesions based on neurological findings, and a metastatic spinal tumor was found by imaging examination. Assuming that metastasis had occurred at the time lumbar pain developed, the patient reached the level of gait disturbance within only 4 mo, showing a rapid advancement of symptoms. If early diagnosis had been possible, treatment could be performed before acute myelopathy progressed to complete paralysis. We speculate that the terminal stage of HCC is not only liver failure associated with intrahepatic lesions but also metastasis to other regions, treatment for individual pathologies therefore, will be needed, which constitutes an important issue.

Hepatic schwannoma:Imaging findings on CT,MRI and contrast-enhanced ultrasonography

A primary benign schwannoma of the liver is extremely rare and is difficult to preoperatively discriminate from a malignant tumor.We compared the imaging and pathological findings,and examined the possibility of preoperatively diagnosing a benign liver schwannoma.A 72-year-old woman was admitted to our hospital because of a 4.6-cm mass in the liver.A malignant tumor was suspected,and a right hepatectomy was performed.After this,the diagnosis of a primary benign schwannoma of the liver was made through pathological examination.Contrast-enhanced ultrasonography(CEUS) with Sonazoid showed minute blood flows into the septum and solid areas of the tumor in the vascular phase;most likely due to increased arterial flow associated with infiltration of chronic inflammatory cells.In the postvascular phase,CEUS showed contrast defect of cystic areas and delayed enhancement of solid areas;most likely due to aggregation of siderophores.Because discriminating between a benign and malignant schwannoma of the liver is difficult,surgery is generally recommended.However,the two key findings from CEUS may be useful in discriminating ancient schwannoma by recognizing the hemorrhage involved in the secondary degeneration and aggregation of siderophores.

DIAGNOSIS AND TREATMENT OF MEDIASTINAL NEUROGENIC TUMORS--REPORT OF 110 CASES

Object.To study the clinical manifestations,diagnostic methods,surgical management ,and prognosis of various neurogenic mediastinal tumors.Method.One hundred and ten cases of neurogenic tumors of mediastinum were reviewed and retro-spectively analyzed.Results.Operative or hospitalization death happened in2cases,complications occurred in8cases,mostly were Horner’s syndrome or recurrent nerve paralysis.During the follow?up,there were2recur-rences in102benign tumors,and4cases of neurofibrosarcoma or malignant neurilemmoma died within3years postoperatively.Conclusion.Most mediastinal neurogenic tumors are benign.It is enough to establish diagnosis by chest X?ray and CT scan.There are different features in the clinical manifestations,diagnosing methods,and surgical management for the dumbbell tumors.Minimal invasive surgery and video?assisted thora-coscopy surgery(VATS)have a special value in treatment of the selected neurogenic mediastinal tumors.Benign neurogenic tumors rarely recur after complete resection,whereas malignant neurogenic tumors have poor prognosis.

精神病风险综合征的研究现状

数十年来,精神病风险综合征人群的识别已经变成精神卫生领域一个重要的研究方向。随着时间的推移,精神病风险综合征人群中有相当比例会发展成精神疾病。尽早有效的发现精神病风险综合征并且给予适当的干预措施可以改善精神病性症状,延缓精神病病程进展,减少疾病致残风险。

Cerebral perfusion SPECT imaging for assessment of the effect of hyperbaric oxygen therapy on patients with postbrain injury neural status

Objective: To evaluate the effects of hyperbaric oxygen (HBO) therapy on patients with postbrain injury neural status. Methods: Two to 4 courses of HBO therapy and/or medications were used to treat 320 patients who were randomly divided into two groups. Assessment was made with 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD) single photon emission computed tomography (SPECT) before and after treatment. Results: There was a significant difference between the HBO therapy group and the non-HBO therapy group. HBO therapy was superior to medication treatment alone in the recovery of clinical symptoms, control of epilepsy, and resolution of hydrocephalus (P< 0.01). Conclusions: HBO therapy has specific curative effects on patients with postbrain injury neural status, and 99m Tc-ECD SPECT could play an important role in diagnosing postbrain injury neural status and monitoring the therapeutic effects of HBO.

Classification of hyperspectral images based on a convolutional neural network and spectral sensitivity

In recent years,deep learning methods have gradually come to be used in hyperspectral imaging domains.Because of the peculiarity of hyperspectral imaging,a mass of information is contained in the spectral dimensions of hyperspectral images.Also,different ob jects on a land surface are sensitive to different ranges of wavelength.To achieve higher accuracy in classification,we propose a structure that combines spectral sensitivity with a convolutional neural network by adding spectral weights derived from predicted outcomes before the final classification layer.First,samples are divided into visible light and infrared,with a portion of the samples fed into networks during training.Then,two key parameters,unrecognized rate(δ)and wrongly recognized rate(γ),are calculated from the predicted outcome of the whole scene.Next,the spectral weight,derived from these two parameters,is calculated.Finally,the spectral weight is added and an improved structure is constructed.The improved structure not only combines the features in spatial and spectral dimensions,but also gives spectral sensitivity a primary status.Compared with inputs from the whole spectrum,the improved structure attains a nearly 2%higher prediction accuracy.When applied to public data sets,compared with the whole spectrum,on the average we achieve approximately 1%higher accuracy.