Phytobezoar is the most common type of bezoar.It is composed of indigestible vegetable matter and is usually found in the stomach.Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively.The path...Phytobezoar is the most common type of bezoar.It is composed of indigestible vegetable matter and is usually found in the stomach.Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively.The pathogenesis is not clear,and there have been only a few reports of biliary bezoars associated with sphincteric impairmentat the ampulla of Vater.Here,we present a report of biliary bezoar that resulted in jejunal obstruction.We were unable to identifythe bezoar in the extrahepatic bile duct until it obstructed the small bowel lumen.To our knowledge,this is the first report of small bowel obstruction resulting frommigration of a biliary bezoar.展开更多
BACKGROUND Axial and coronal reformations have been a widely used image post-processing protocol for the ordinary multidetector computed tomography(MDCT)examination of patients with small bowel obstruction(SBO) or oth...BACKGROUND Axial and coronal reformations have been a widely used image post-processing protocol for the ordinary multidetector computed tomography(MDCT)examination of patients with small bowel obstruction(SBO) or other abdominal diseases. The diagnostic accuracy of MDCT for assessing SBO is expected to be further improved through the use of multiple post-processing techniques.AIM To systemically evaluate the diagnostic accuracy and efficiency of an optimized protocol using multiple post-processing techniques for MDCT assessment of SBO and secondary bowel ischemia.METHODS This retrospective cross-sectional study included 106 patients with clinically suspected SBO. Two readers applied three protocols to image post-processing and interpretation of patients' MDCT volume data. We compared the three protocols based on time spent, number of images, diagnostic self-confidence,agreement, detection rate, and accuracy of detection of SBO and secondary bowel ischemia.RESULTS Protocol 2 resulted in more time spent and number of images than protocols 1 and 3(P < 0.01), but the results of the two readers using the same protocol were not different(P > 0.05). Using protocol 3, both readers added multiple postprocessing techniques at frequencies of 29.2% and 34.9%, respectively, for obstruction cause, and 32.1% and 30.2%, respectively, for secondary bowel ischemia. Protocols 2 and 3 had higher total detection rates of obstruction cause and secondary bowel ischemia than protocol 1(P < 0.01), but no difference was detected between protocols 2 and 3(P > 0.05). The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of protocols 2 and 3 were superior to those of protocol 1 for evaluating obstruction cause and secondary bowel ischemia.CONCLUSION Our optimized protocol of multiple post-processing techniques can both guarantee efficiency and improve diagnostic accuracy of MDCT for assessing SBO and secondary bowel ischemia.展开更多
Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 16...Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level.展开更多
目的研究能谱CT成像（GSI）定量分析在评估结肠癌分化程度中的价值。资料与方法纳入经结肠镜或手术病理确诊为结肠癌的47例患者,按照病理将其分为中高分化组18例和低分化与未分化组29例。所有患者术前均行GSI双期增强扫描,获得动脉期和...目的研究能谱CT成像（GSI）定量分析在评估结肠癌分化程度中的价值。资料与方法纳入经结肠镜或手术病理确诊为结肠癌的47例患者,按照病理将其分为中高分化组18例和低分化与未分化组29例。所有患者术前均行GSI双期增强扫描,获得动脉期和静脉期单能量图像,测量并比较两组病灶40～140 ke V不同单能量的CT值、碘浓度、标准化碘浓度比（NIC）及各期能谱曲线斜率。采用受试者操作特征（ROC）曲线计算各参数曲线下面积（AUC）,比较各参数评定直肠癌分化程度的最佳诊断阈值、AUC、敏感度、特异度及Youden指数,评估各项指标的诊断效能。结果高分化腺癌11例,中分化腺癌7例,低分化癌20例,未分化癌9例。两组动脉期碘浓度、NIC、能谱曲线斜率及70 ke V CT值差异均有统计学意义（P〈0.05）,而以上指标静脉期差异均无统计学意义（P〉0.05）。动脉期碘浓度、动脉期NIC、动脉期能谱曲线斜率、70 ke V时CT值的ROC AUC分别为0.854、0.747、0.753和0.701,当其诊断阈值分别设为〉1.13 mg/ml、〉0.13、〉1.61、〉53.11 HU时,其判定直肠癌分化程度的敏感度、特异度、Youden指数分别为81.8%、71.4%、0.53;77.3%、64.3%、0.42;69.2%、71.4%、0.40;64.7%、62.3%、0.26。结论结肠癌能谱CT多参数定量分析评估肿瘤组织学分化程度有一定的特异度和敏感度,动脉期碘浓度的诊断效能明显优于70 ke V（相当于常规CT扫描）。展开更多
文摘Phytobezoar is the most common type of bezoar.It is composed of indigestible vegetable matter and is usually found in the stomach.Biliary phytobezoar is extremely rare and difficult to diagnose preoperatively.The pathogenesis is not clear,and there have been only a few reports of biliary bezoars associated with sphincteric impairmentat the ampulla of Vater.Here,we present a report of biliary bezoar that resulted in jejunal obstruction.We were unable to identifythe bezoar in the extrahepatic bile duct until it obstructed the small bowel lumen.To our knowledge,this is the first report of small bowel obstruction resulting frommigration of a biliary bezoar.
基金the National Natural Science Foundation of China,No.81671943
文摘BACKGROUND Axial and coronal reformations have been a widely used image post-processing protocol for the ordinary multidetector computed tomography(MDCT)examination of patients with small bowel obstruction(SBO) or other abdominal diseases. The diagnostic accuracy of MDCT for assessing SBO is expected to be further improved through the use of multiple post-processing techniques.AIM To systemically evaluate the diagnostic accuracy and efficiency of an optimized protocol using multiple post-processing techniques for MDCT assessment of SBO and secondary bowel ischemia.METHODS This retrospective cross-sectional study included 106 patients with clinically suspected SBO. Two readers applied three protocols to image post-processing and interpretation of patients' MDCT volume data. We compared the three protocols based on time spent, number of images, diagnostic self-confidence,agreement, detection rate, and accuracy of detection of SBO and secondary bowel ischemia.RESULTS Protocol 2 resulted in more time spent and number of images than protocols 1 and 3(P < 0.01), but the results of the two readers using the same protocol were not different(P > 0.05). Using protocol 3, both readers added multiple postprocessing techniques at frequencies of 29.2% and 34.9%, respectively, for obstruction cause, and 32.1% and 30.2%, respectively, for secondary bowel ischemia. Protocols 2 and 3 had higher total detection rates of obstruction cause and secondary bowel ischemia than protocol 1(P < 0.01), but no difference was detected between protocols 2 and 3(P > 0.05). The accuracy, sensitivity,specificity, positive predictive value and negative predictive value of protocols 2 and 3 were superior to those of protocol 1 for evaluating obstruction cause and secondary bowel ischemia.CONCLUSION Our optimized protocol of multiple post-processing techniques can both guarantee efficiency and improve diagnostic accuracy of MDCT for assessing SBO and secondary bowel ischemia.
文摘Objective To observe the correlations of chest CT quantitative parameters in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)with blood eosinophil(EOS)level.Methods Chest CT data of 162 AECOPD patients with elevated eosinophils were retrospectively analyzed.The patients were divided into low EOS group(n=105)and high EOS group(n=57)according to the absolute counting of blood EOS.The quantitative CT parameters,including the number of whole lung bronchi and the volume of blood vessels,low-attenuation area percentage(LAA%)of whole lung,of left/right lung and each lobe of lung,as well as the luminal diameter(LD),wall thickness(WT),wall area(WA)and WA percentage of total bronchial cross-section(WA%)of grade 3 to 8 bronchi were compared between groups.Spearman correlations were performed to analyze the correlations of quantitative CT parameters with blood EOS level.Results LAA%of the whole lung,of the left/right lung and each lobe of lung,as well as of the upper lobe of right lung LD grade 4,middle lobe of right lung WT grade 5,upper lobe of right lung WA grade 4,middle lobe of right lung WA grade 5 and lower lobe of left lung WA grade 3 in low EOS group were all higher than those in high EOS group(all P<0.05).Except for the upper lobe of right lung LD grade 4,the above quantitative CT indexes being significant different between groups were all weakly and negatively correlated with blood EOS level(r=-0.335 to-0.164,all P<0.05).Conclusion Chest CT quantitative parameters of AECOPD patients were correlated with blood EOS level,among which LAA%,a part of WT and WA were all weakly negatively correlated with blood EOS level.
文摘目的研究能谱CT成像（GSI）定量分析在评估结肠癌分化程度中的价值。资料与方法纳入经结肠镜或手术病理确诊为结肠癌的47例患者,按照病理将其分为中高分化组18例和低分化与未分化组29例。所有患者术前均行GSI双期增强扫描,获得动脉期和静脉期单能量图像,测量并比较两组病灶40～140 ke V不同单能量的CT值、碘浓度、标准化碘浓度比（NIC）及各期能谱曲线斜率。采用受试者操作特征（ROC）曲线计算各参数曲线下面积（AUC）,比较各参数评定直肠癌分化程度的最佳诊断阈值、AUC、敏感度、特异度及Youden指数,评估各项指标的诊断效能。结果高分化腺癌11例,中分化腺癌7例,低分化癌20例,未分化癌9例。两组动脉期碘浓度、NIC、能谱曲线斜率及70 ke V CT值差异均有统计学意义（P〈0.05）,而以上指标静脉期差异均无统计学意义（P〉0.05）。动脉期碘浓度、动脉期NIC、动脉期能谱曲线斜率、70 ke V时CT值的ROC AUC分别为0.854、0.747、0.753和0.701,当其诊断阈值分别设为〉1.13 mg/ml、〉0.13、〉1.61、〉53.11 HU时,其判定直肠癌分化程度的敏感度、特异度、Youden指数分别为81.8%、71.4%、0.53;77.3%、64.3%、0.42;69.2%、71.4%、0.40;64.7%、62.3%、0.26。结论结肠癌能谱CT多参数定量分析评估肿瘤组织学分化程度有一定的特异度和敏感度,动脉期碘浓度的诊断效能明显优于70 ke V（相当于常规CT扫描）。
