Objective: To investigate the capabilities of ultrahighreso-lution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopath...Objective: To investigate the capabilities of ultrahighreso-lution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHROCT provides additional information on disease morphology, pathogenesis, and management. Design: Retrospective, observational, interventional case series. Participants: Nineteen eyes of 10 patients diagnosed with IJT in at least one eye. Method: All patients were imaged with UHR OCT and StratusOCT at the same visit. A subset of patients was also imaged before and after treatment of IJT. Main Outcome Measures: Ultrahigh-and standard-resolution cross-sectional tomograms of IJT pathology. Results: Using both standard-and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and disruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, (5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63%of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlatedwith visual acuity. Conclusions: Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, are revealed only by UHR OCT.展开更多
目的:探讨超高分辨率计算机断层扫描(CT)对小于3 cm肺孤立性磨玻璃密度结节(fGGN)的诊断价值。方法:选取龙岩市第一医院2020年1月至2022年6月收治的96例小于3 cm fGGN患者为研究对象,所有患者均进行高分辨率与超高分辨率CT检查。结果:96...目的:探讨超高分辨率计算机断层扫描(CT)对小于3 cm肺孤立性磨玻璃密度结节(fGGN)的诊断价值。方法:选取龙岩市第一医院2020年1月至2022年6月收治的96例小于3 cm fGGN患者为研究对象,所有患者均进行高分辨率与超高分辨率CT检查。结果:96例fGGN患者中,3例为不典型腺瘤样增生(3.13%),49例为浸润性腺瘤(51.04%),25例为原位癌(26.04%),19例为微浸润性腺瘤(19.79%)。相较于高分辨率CT,超高分辨率CT检查的分叶检出率更高,瘤肺界面清楚光整占比更高,差异均具有统计学意义(P <0.05)。相较于高分辨率CT检查,超高分辨率CT检查明确诊断率更高,差异具有统计学意义(χ^(2)=27.148,P <0.001)。超高分辨率CT的对比度噪声比(CNR)、信噪比(SNR)、图像噪声评分低于高分辨率CT,差异均具有统计学意义(P <0.05)。结论:在小于3 cm fGGN诊断中超高分辨率CT检查能够更加有效的诊断分叶征及瘤肺界面,且明确诊断率明显高于高分辨率CT检查。超高分辨率CT检查具有更为明显的本底噪声,且CNR、SNR评分较高分辨率CT检查均较低。检查过程中心跳、呼吸等造成的伪影虽然会在一定程度上影响超高分辨率CT检查效果,但对其临床诊断效能并无明显影响。展开更多
目的对比常规薄层图像和高分辨率联合最大密度投影(high resolution combined with maximum intensity projection,HR-MIP)重建图像在检出肺内结节方面的差异,评价HR-MIP对肺内结节的检出效能。方法随机选取天津医科大学朱宪彝纪念医院2...目的对比常规薄层图像和高分辨率联合最大密度投影(high resolution combined with maximum intensity projection,HR-MIP)重建图像在检出肺内结节方面的差异,评价HR-MIP对肺内结节的检出效能。方法随机选取天津医科大学朱宪彝纪念医院2021年12月至2022年6月期间行胸部CT检查的患者共90例,其中男性52例,女性38例,年龄18~82(43±12.5)岁。分别利用2 mm层厚的常规薄层图像和HR-MIP(厚度4 mm)重建图像观察肺内结节的情况,根据结节大小分为<5 mm和≥5 mm两组。两位诊断医师分别对两组图像进行阅片并记录结节的数量、大小及性质(实性、部分实性、磨玻璃),同时记录阅读每例患者阅片时所耗费的时间。比较常规薄层图像和HR-MIP在结节检出率及耗费时间方面的差异。采用配对t检验、χ^(2)检验进行统计学分析。结果90例患者共有结节313个,<5 mm 255个、≥5 mm 58个,其中常规薄层图像和HR-MIP分别检出结节的总数为253个(80.1%)、285个(91.0%),HR-MIP检出率高于常规薄层图像,差异有统计学意义(χ^(2)=13.523,P<0.001);其中常规薄层图像和HR-MIP检出<5 mm及≥5 mm结节的数量分别为(208比235)和(45比50),<5 mm组差异有统计学意义(χ^(2)=12.517,P<0.001),≥5 mm组差异无统计学意义(χ^(2)=1.408,P=0.237)。结节性质方面:实性、部分实性及磨玻璃密度结节分别有261、22、30个;常规薄层图像和HR-MIP检出实性、部分实性和磨玻璃密度结节分别为(210比245)、(15比17)和(28比23),其中两种方法实性结节检出率差异有统计学意义(χ^(2)=34.812,P<0.001),部分实性和磨玻璃密度结节检出率差异均无统计学意义(χ^(2)=0.631,P=0.407;χ^(2)=1.231,P=0.224)。常规薄层图像耗时为(215.3±23.8)s,HR-MIP耗时为(133.2±19.1)s,差异有统计学意义(t=18.013,P<0.001)。结论利用HR-MIP重建后阅片能够提高肺内实性小结节的检出率并且可以缩短阅片时间、提高诊断效率,但是对于部分实性及磨玻璃密度小结节仍需仔细观察。展开更多
文摘Objective: To investigate the capabilities of ultrahighreso-lution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHROCT provides additional information on disease morphology, pathogenesis, and management. Design: Retrospective, observational, interventional case series. Participants: Nineteen eyes of 10 patients diagnosed with IJT in at least one eye. Method: All patients were imaged with UHR OCT and StratusOCT at the same visit. A subset of patients was also imaged before and after treatment of IJT. Main Outcome Measures: Ultrahigh-and standard-resolution cross-sectional tomograms of IJT pathology. Results: Using both standard-and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and disruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, (5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63%of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlatedwith visual acuity. Conclusions: Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, are revealed only by UHR OCT.
文摘目的 观察高分辨磁共振成像(HR-MRI)和计算机断层扫描(CT)在颅脑动脉血栓中的诊断价值。方法 例单侧脑梗死患者为研究对象(发病时间8h~14d,男61例,女33例,年龄38~75岁)。所有患者均行HR-MRI[磁敏感加权成像(SWI)、Cube液体衰减反转恢复序列(FLAIR)]和128层螺旋CT检查,以数字减影血管造影(DSA)检查结果为金标准,分析HR-MRI和CT检查对颅脑动脉血栓的诊断价值。结果94例患者中,共有50例患者DSA明确诊断为动脉血栓,包括ICA颅内段5例、ACA 3例、MCA 26例、PCA 2例、VA 11例、BA 3例。HR-MRI共检出48例(SWI检出40例,Cube FLAIR检出43例),CT共检出38例。以DSA检查为“金标准”,HR-MRI和CT诊断颅脑血栓的灵敏度为96.00% vs 70.00%,特异度为100.00% vs 93.18%,准确度为95.83% vs 80.85% ,Kappa值为0.945 vs 0.516。结论 HR-MRI与CT在颅脑动脉血栓中均有较高的诊断价值,但HR-MRISWI及Cube FLAIR对颅脑动脉血栓的诊断价值更高。
文摘目的:探讨超高分辨率计算机断层扫描(CT)对小于3 cm肺孤立性磨玻璃密度结节(fGGN)的诊断价值。方法:选取龙岩市第一医院2020年1月至2022年6月收治的96例小于3 cm fGGN患者为研究对象,所有患者均进行高分辨率与超高分辨率CT检查。结果:96例fGGN患者中,3例为不典型腺瘤样增生(3.13%),49例为浸润性腺瘤(51.04%),25例为原位癌(26.04%),19例为微浸润性腺瘤(19.79%)。相较于高分辨率CT,超高分辨率CT检查的分叶检出率更高,瘤肺界面清楚光整占比更高,差异均具有统计学意义(P <0.05)。相较于高分辨率CT检查,超高分辨率CT检查明确诊断率更高,差异具有统计学意义(χ^(2)=27.148,P <0.001)。超高分辨率CT的对比度噪声比(CNR)、信噪比(SNR)、图像噪声评分低于高分辨率CT,差异均具有统计学意义(P <0.05)。结论:在小于3 cm fGGN诊断中超高分辨率CT检查能够更加有效的诊断分叶征及瘤肺界面,且明确诊断率明显高于高分辨率CT检查。超高分辨率CT检查具有更为明显的本底噪声,且CNR、SNR评分较高分辨率CT检查均较低。检查过程中心跳、呼吸等造成的伪影虽然会在一定程度上影响超高分辨率CT检查效果,但对其临床诊断效能并无明显影响。
文摘目的对比常规薄层图像和高分辨率联合最大密度投影(high resolution combined with maximum intensity projection,HR-MIP)重建图像在检出肺内结节方面的差异,评价HR-MIP对肺内结节的检出效能。方法随机选取天津医科大学朱宪彝纪念医院2021年12月至2022年6月期间行胸部CT检查的患者共90例,其中男性52例,女性38例,年龄18~82(43±12.5)岁。分别利用2 mm层厚的常规薄层图像和HR-MIP(厚度4 mm)重建图像观察肺内结节的情况,根据结节大小分为<5 mm和≥5 mm两组。两位诊断医师分别对两组图像进行阅片并记录结节的数量、大小及性质(实性、部分实性、磨玻璃),同时记录阅读每例患者阅片时所耗费的时间。比较常规薄层图像和HR-MIP在结节检出率及耗费时间方面的差异。采用配对t检验、χ^(2)检验进行统计学分析。结果90例患者共有结节313个,<5 mm 255个、≥5 mm 58个,其中常规薄层图像和HR-MIP分别检出结节的总数为253个(80.1%)、285个(91.0%),HR-MIP检出率高于常规薄层图像,差异有统计学意义(χ^(2)=13.523,P<0.001);其中常规薄层图像和HR-MIP检出<5 mm及≥5 mm结节的数量分别为(208比235)和(45比50),<5 mm组差异有统计学意义(χ^(2)=12.517,P<0.001),≥5 mm组差异无统计学意义(χ^(2)=1.408,P=0.237)。结节性质方面:实性、部分实性及磨玻璃密度结节分别有261、22、30个;常规薄层图像和HR-MIP检出实性、部分实性和磨玻璃密度结节分别为(210比245)、(15比17)和(28比23),其中两种方法实性结节检出率差异有统计学意义(χ^(2)=34.812,P<0.001),部分实性和磨玻璃密度结节检出率差异均无统计学意义(χ^(2)=0.631,P=0.407;χ^(2)=1.231,P=0.224)。常规薄层图像耗时为(215.3±23.8)s,HR-MIP耗时为(133.2±19.1)s,差异有统计学意义(t=18.013,P<0.001)。结论利用HR-MIP重建后阅片能够提高肺内实性小结节的检出率并且可以缩短阅片时间、提高诊断效率,但是对于部分实性及磨玻璃密度小结节仍需仔细观察。
