Interpreting experimental diagnostics data in tokamaks,while considering non-ideal effects,is challenging due to the complexity of plasmas.To address this challenge,a general synthetic diagnostics(GSD)platform has bee...Interpreting experimental diagnostics data in tokamaks,while considering non-ideal effects,is challenging due to the complexity of plasmas.To address this challenge,a general synthetic diagnostics(GSD)platform has been established that facilitates microwave imaging reflectometry and electron cyclotron emission imaging.This platform utilizes plasma profiles as input and incorporates the finite-difference time domain,ray tracing and the radiative transfer equation to calculate the propagation of plasma spontaneous radiation and the external electromagnetic field in plasmas.Benchmark tests for classical cases have been conducted to verify the accuracy of every core module in the GSD platform.Finally,2D imaging of a typical electron temperature distribution is reproduced by this platform and the results are consistent with the given real experimental data.This platform also has the potential to be extended to 3D electromagnetic field simulations and other microwave diagnostics such as cross-polarization scattering.展开更多
Pancreatic transplantation is considered by the American Diabetes Association and the European Association for the Study of Diabetes an acceptable surgical procedure in patients with type 1 diabetes also undergoing ki...Pancreatic transplantation is considered by the American Diabetes Association and the European Association for the Study of Diabetes an acceptable surgical procedure in patients with type 1 diabetes also undergoing kidney transplantation in pre-final or end-stage renal disease if no contraindications are present.Pancreatic transplantation,however,is a complex surgical procedure and may lead to a range of postoperative complications that can significantly impact graft function and patient outcomes.Postoperative computed tomography(CT)is often adopted to evaluate perfusion of the transplanted pancreas,identify complications and as a guide for interventional radiology procedures.CT assessment after pancreatic transplantation should start with the evaluation of the arterial Y-graft,the venous anastomosis and the duodenojejunostomy.With regard to complications,CT allows for the identification of vascular complications,such as thrombosis or stenosis of blood vessels supplying the graft,the detection of pancreatic fluid collections,including pseudocysts,abscesses,or leaks,the assessment of bowel complications(anastomotic leaks,ileus or obstruction),and the identification of bleeding.The aim of this pictorial review is to illustrate CT findings of surgical-related complications after pancreatic transplantation.The knowledge of surgical techniques is of key importance to understand postoperative anatomic changes and imaging evaluation.Therefore,we first provide a short summary of the main techniques of pancreatic transplantation.Then,we provide a practical imaging approach to pancreatic transplantation and its complications providing tips and tricks for the prompt imaging diagnosis on CT.展开更多
Liver disease is a major health concern globally,with high morbidity and mortality rates.Precise diagnosis and assessment are vital for guiding treatment approaches,predicting outcomes,and improving patient prognosis....Liver disease is a major health concern globally,with high morbidity and mortality rates.Precise diagnosis and assessment are vital for guiding treatment approaches,predicting outcomes,and improving patient prognosis.Magnetic resonance imaging(MRI)is a non-invasive diagnostic technique that has been widely used for detecting liver disease.Recent advancements in MRI technology,such as diffusion weighted imaging,intravoxel incoherent motion,magnetic resonance elastography,chemical exchange saturation transfer,magnetic resonance spectroscopy,hyperpolarized MR,contrast-enhanced MRI,and radiomics,have significantly improved the accuracy and effectiveness of liver disease diagnosis.This review aims to discuss the progress in new MRI technologies for liver diagnosis.By summarizing current research findings,we aim to provide a comprehensive reference for researchers and clinicians to optimize the use of MRI in liver disease diagnosis and improve patient prognosis.展开更多
BACKGROUND Paraduodenal pancreatitis(PP)represents a diagnostic challenge,especially in non-referral centers,given its potential imaging overlap with pancreatic cancer.There are two main histological variants of PP,th...BACKGROUND Paraduodenal pancreatitis(PP)represents a diagnostic challenge,especially in non-referral centers,given its potential imaging overlap with pancreatic cancer.There are two main histological variants of PP,the cystic and the solid,with slightly different imaging appearances.Moreover,imaging findings in PP may change over time because of disease progression and/or as an effect of its risk factors exposition,namely alcohol intake and smoking.AIM To describe multimodality imaging findings in patients affected by PP to help clinicians in the differential diagnosis with pancreatic cancer.METHODS The systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses 2009 guidelines.A Literature search was performed on PubMed,Embase and Cochrane Library using(groove pancreatitis[Title/Abstract])OR(PP[Title/Abstract])as key words.A total of 593 articles were considered for inclusion.After eliminating duplicates,and title and abstract screening,53 full-text articles were assessed for eligibility.Eligibility criteria were:Original studies including 8 or more patients,fully written in English,describing imaging findings in PP,with pathological confirmation or clinical-radiological follow-up as the gold standard.Finally,14 studies were included in our systematic review.RESULTS Computed tomography(CT)findings were described in 292 patients,magnetic resonance imaging(MRI)findings in 231 and endoscopic ultrasound(EUS)findings in 115.Duodenal wall thickening was observed in 88.8%of the cases:Detection rate was 96.5%at EUS,91.0%at MRI and 84.1%at CT.Second duodenal portion increased enhancement was recognizable in 76.3%of the cases:Detection rate was 84.4%at MRI and 72.1%at CT.Cysts within the duodenal wall were detected in 82.6%of the cases:Detection rate was 94.4%at EUS,81.9%at MRI and 75.7%at CT.A solid mass in the groove region was described in 40.9%of the cases;in 78.3%of the cases,it showed patchy enhancement in the portal venous phase,and in 100%appeared iso/hyperintense during delayed phase imaging.Only 3.6%of the lesions showed restricted diffusion.The prevalence of radiological signs of chronic obstructive pancreatitis,namely main pancreatic duct dilatation,pancreatic calcifications,and pancreatic cysts,was extremely variable in the different articles.CONCLUSION PP has peculiar imaging findings.MRI is the best radiological imaging modality for diagnosing PP,but EUS is more accurate than MRI in depicting duodenal wall alterations.展开更多
The shortage of deceased donor organs has prompted the development of alternative liver grafts for transplantation.Living-donor liver transplantation(LDLT)has emerged as a viable option,expanding the donor pool and en...The shortage of deceased donor organs has prompted the development of alternative liver grafts for transplantation.Living-donor liver transplantation(LDLT)has emerged as a viable option,expanding the donor pool and enabling timely transplantation with favorable graft function and improved long-term outcomes.An accurate evaluation of the donor liver’s volumetry(LV)and anatomical study is crucial to ensure adequate future liver remnant,graft volume and precise liver resection.Thus,ensuring donor safety and an appropriate graftto-recipient weight ratio.Manual LV(MLV)using computed tomography has traditionally been considered the gold standard for assessing liver volume.However,the method has been limited by cost,subjectivity,and variability.Automated LV techniques employing advanced segmentation algorithms offer improved reproducibility,reduced variability,and enhanced efficiency compared to manual measurements.However,the accuracy of automated LV requires further investigation.The study provides a comprehensive review of traditional and emerging LV methods,including semi-automated image processing,automated LV techniques,and machine learning-based approaches.Additionally,the study discusses the respective strengths and weaknesses of each of the aforementioned techniques.The use of artificial intelligence(AI)technologies,including machine learning and deep learning,is expected to become a routine part of surgical planning in the near future.The implementation of AI is expected to enable faster and more accurate image study interpretations,improve workflow efficiency,and enhance the safety,speed,and cost-effectiveness of the procedures.Accurate preoperative assessment of the liver plays a crucial role in ensuring safe donor selection and improved outcomes in LDLT.MLV has inherent limitations that have led to the adoption of semi-automated and automated software solutions.Moreover,AI has tremendous potential for LV and segmentation;however,its widespread use is hindered by cost and availability.Therefore,the integration of multiple specialties is necessary to embrace technology and explore its possibilities,ranging from patient counseling to intraoperative decision-making through automation and AI.展开更多
Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was...Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was a retrospective descriptive study, carried out over a period of 3 years (from January 2018 to December 2020) at the Diagnostic Imaging Center (C.I.D) “TERIYA” in BAMAKO. It concerned all patients who came for a mammogram/ultrasound examination of the breast. All women admitted for mammogram or breast ultrasound who were diagnosed with a breast injury during the study period were included. Incomplete records and radiological checks were not included. The variables analyzed were age, sex, clinical data, and ultrasound and mammography aspects. The devices used are: a Voluson 730 PRO ultrasound machine and a G 600T type mammography machine. Results: At the end of our study, we collected 254 breast pathologies on a number of 382 women, i.e. a frequency of 66.49%. The average age of our patients was 41 years old. The dominant clinical data were mastodynia (41.88%) and mammary nodule (21.70%). On imaging (mammo-ultrasound) the lesions predominated on the left in 36% of cases, bilateral in 28% of cases and in the upper-outer quadrants in 31.5% of cases. Tumor pathologies represented 66.54% of which 45.27% were benign mainly composed of fibro-adenoma (20.88%) and cyst (18.50%), 11.8% of suspected cases and 9.45% of cancers. Non-tumor pathologies represented 33.46%, mainly mastitis (16.14%), galactophoric dilations (11.02%) and abscesses (5.51%). These pathologies were classified in 50.3% in ACR2, 17.75% in ACR3 and 4, and in 14.20% in ACR5. Lymphadenopathy was present in 73.21% of cases.展开更多
The early implementation of treatment therapies necessitates the swift and precise identification of COVID-19 pneumonia by the analysis of chest CT scans.This study aims to investigate the indispensable need for preci...The early implementation of treatment therapies necessitates the swift and precise identification of COVID-19 pneumonia by the analysis of chest CT scans.This study aims to investigate the indispensable need for precise and interpretable diagnostic tools for improving clinical decision-making for COVID-19 diagnosis.This paper proposes a novel deep learning approach,called Conformer Network,for explainable discrimination of viral pneumonia depending on the lung Region of Infections(ROI)within a single modality radiographic CT scan.Firstly,an efficient U-shaped transformer network is integrated for lung image segmentation.Then,a robust transfer learning technique is introduced to design a robust feature extractor based on pre-trained lightweight Big Transfer(BiT-L)and finetuned on medical data to effectively learn the patterns of infection in the input image.Secondly,this work presents a visual explanation method to guarantee clinical explainability for decisions made by Conformer Network.Experimental evaluation of real-world CT data demonstrated that the diagnostic accuracy of ourmodel outperforms cutting-edge studies with statistical significance.The Conformer Network achieves 97.40% of detection accuracy under cross-validation settings.Our model not only achieves high sensitivity and specificity but also affords visualizations of salient features contributing to each classification decision,enhancing the overall transparency and trustworthiness of our model.The findings provide obvious implications for the ability of our model to empower clinical staff by generating transparent intuitions about the features driving diagnostic decisions.展开更多
In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the patholo...In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the pathologies would be through Computed Tomographic Imaging of the Thorax and abdomen with oral and intravenous contrast in the context of triple phase imaging.The causes of pneumomediastinum should be differentiated between traumatic and non-traumatic.Oesophageal perforation(Boerhaave syndrome)is associated with Mackler’s triad in upto 50%of patients(severe retrosternal chest pain,pneumomediastinum,mediastinitis).Whereas in cases of lung pathology this can be associated with pneumothorax and pleural effusion.展开更多
Background: Nosocomial infections have become a major challenge in healthcare facilities as they affect the quality of medical care. Radiological imaging plays a crucial role in medical diagnosis. However, the equipme...Background: Nosocomial infections have become a major challenge in healthcare facilities as they affect the quality of medical care. Radiological imaging plays a crucial role in medical diagnosis. However, the equipment and accessories used increase the risk of transmission of nosocomial bacteria. Objective: This study aims to reveal the extent and nature of microbiological contamination in four hospital diagnostic imaging departments to determine their potential role in the spread of nosocomial bacteria and to evaluate the effectiveness of routine daily disinfection practices in controlling microorganisms in diagnostic imaging departments. Methods & Results: In each department, swabs were taken from the surfaces of selected parts of the equipment and accessories three times a day (early morning, noon, and evening) for five consecutive days. Bacteria were isolated from 65 swabs (36.1% of all samples). The bacteria were isolated 3 times (4.6%) in the morning, 16 times (24.6%) at midday, and 46 times (70.7%) in the evening. The bacteria isolated were Escherichia coli (isolated 34 times;52.3%), Staphylococcus aureus (20 times;30.8%), Staphylococcus epidermidis (6 times;9.3%), and Klebsiella species (5 times;7.7%). Discussion & Conclusion: Findings demonstrated that radiology equipment and accessories are not free of bacteria and further improvements in the sterilization and disinfection of radiology equipment and accessories are needed to protect staff and patients from nosocomial infections.展开更多
Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hyperte...Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.展开更多
AIM:To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).METHODS: A total of 20 patients with pathologically-...AIM:To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).METHODS: A total of 20 patients with pathologically-confirmed intraductal papillary mucinous neoplasms (IPMNs) were included in this study. Axial MDCT images combined with CT angiography (CTA) and multiplanar volume reformations (MPVR) or curved reformations (CR) were preoperatively acquired. Two radiologists (Tan L and Wang DB) reviewed all the images in consensus using an interactive picture archiving and communication system. The disputes in readings were resolved through consultation with a third experienced radiologist (Chen KM). Finally, the findings and diagnoses were compared with the pathologic results.RESULTS: The pathological study revealed 12 malignant IPMNs and eight benign IPMNs. The diameters of the cystic lesions and main pancreatic ducts (MPDs) were significantly larger in malignant IPMNs compared with those of the benign IPMNs (P<0.05). The combined-type IPMNs had a higher rate of malignancy than the other two types of IPMNs (P<0.05). Tumors with mural nodules and thick septa had a significantly higher incidence of malignancy than tumors without these features (P<0.05). Communication of side-branch IPMNs with the MPD was present in nine cases at pathologic examination. Seven of them were identified from CTA and MPVR or CR images. From comparison with the pathological diagnosis, the sensitivity, specificity, and accuracy of MDCT in characterizing the malignancy of IPMN of the pancreas were determined to be 100%, 87.5% and 95%, respectively.CONCLUSION: MDCT with CTA and MPVR or CR techniques can elucidate the imaging features of IPMNs and help predict the malignancy of these tumors.展开更多
AIM To establish the ability of magnetic resonance(MR) and computer tomography(CT) to predict pathologic dimensions of pancreatic neuroendocrine tumors(Pan NET) in a caseload of a tertiary referral center.METHODS Pati...AIM To establish the ability of magnetic resonance(MR) and computer tomography(CT) to predict pathologic dimensions of pancreatic neuroendocrine tumors(Pan NET) in a caseload of a tertiary referral center.METHODS Patients submitted to surgery for Pan NET at the Surgical Unit of the Pancreas Institute with at least 1 preoperative imaging examination(MR or CT scan) from January 2005 to December 2015 were included and data retrospectively collected. Exclusion criteria were: multifocal lesions, genetic syndromes, microadenomas or mixed tumors, metastatic disease and neoadjuvant therapy. Bland-Altman(BA) and Mountain-Plot(MP) statistics were used to compare size measured by each modality with the pathology size. Passing-Bablok(PB) regression analysis was used to check the agreement between MR and CT.RESULTS Our study population consisted of 292 patients. Seventy-nine(27.1%) were functioning Pan NET. The mean biases were 0.17 ± 7.99 mm, 1 ± 8.51 mm and 0.23 ± 9 mm, 1.2 ± 9.8 mm for MR and CT, considering the overall population and the subgroup of non-functioning-Pan NET, respectively. Limits of agreement(LOA) included the vast majority of observations, indicating a good agreement between imaging and pathology. The MP further confirmed this finding and showed that the two methods are unbiased with respect to each other. Considering ≤ 2 cm non-functioning-Pan NET, no statistical significance was found in the size estimation rate of MR and CT(P = 0.433). PBR analysis did not reveal significant differences between MR, CT and pathology.CONCLUSION MR and CT scan are accurate and interchangeable imaging techniques in predicting pathologic dimensions of Pan NET.展开更多
Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men...Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men, it is also observed in individuals with normal fertility. Determining which men are negatively affected by varicocele would enable clinicians to better select those men who will benefit from treatment. To assess the functional status of the testes in men with varicocele, color Doppler sonographic parameters were evaluated. Testicular arterial blood flow was significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis. An improvement in the testicular blood supply was found after varicocelectomy on spectral Doppler analysis. Testicular contrast harmonic imaging and elastography might improve our knowledge about the influence of varicocele on intratesticular microcirculation and tissue stiffness, respectively, providing possible information on the early damage of testicular structure by varicocele. Magnetic resonance imaging(MRI), with measurement of apparent diffusion coefficient has been used to assess the degree of testicular dysfunction and to evaluate the effectiveness of varicocele repair. Large prospective studies are needed to validate the possible role of functional sonography and MRI in the assessment of early defects of spermatogenesis in testes with varicocele.展开更多
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 ...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.展开更多
BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies with high mortality and short survival time.Computed tomography(CT)plays an important role in the diagnosis,staging and treatment...BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies with high mortality and short survival time.Computed tomography(CT)plays an important role in the diagnosis,staging and treatment of pancreatic tumour.Pancreatic cancer generally shows a low enhancement pattern compared with normal pancreatic tissue.AIM To analyse whether preoperative enhanced CT could be used to predict postoperative overall survival in patients with PDAC.METHODS Sixty-seven patients with PDAC undergoing pancreatic resection were enrolled retrospectively.All patients underwent preoperative unenhanced and enhanced CT examination,the CT values of which were measured.The ratio of the preoperative CT value increase from the nonenhancement phase to the portal venous phase between pancreatic tumour and normal pancreatic tissue was calculated.The cut-off value of ratios was obtained by the receiver operating characteristic(ROC)curve of the tumour relative enhancement ratio(TRER),according to which patients were divided into low-and high-enhancement groups.Univariate and multivariate analyses were performed using Cox regression based on TRER grouping.Finally,the correlation between TRER and clinicopathological characteristics was analysed.RESULTS The area under the curve of the ROC curve was 0.768(P<0.05),and the cut-off value of the ROC curve was calculated as 0.7.TRER≤0.7 was defined as the low-enhancement group,and TRER>0.7 was defined as the high-enhancement group.According to the TRER grouping,the Kaplan-Meier survival curve analysis results showed that the median survival(10.0 mo)with TRER≤0.7 was significantly shorter than that(22.0 mo)with TRER>0.7(P<0.05).In the univariate and multivariate analyses,the prognosis of patients with TRER≤0.7 was significantly worse than that of patients with TRER>0.7(P<0.05).Our results demonstrated that patients in the low TRER group were more likely to have higher American Joint Committee on Cancer stage,tumour stage and lymph node stage(all P<0.05),and TRER was significantly negatively correlated with tumour size(P<0.05).CONCLUSION TRER≤0.7 in patients with PDAC may represent a tumour with higher clinical stage and result in a shorter overall survival.展开更多
Probability-based diagnostic imaging(PDI)is one of the most well-known damage identification methods using guided waves.It is usually applied to diagnose damage in plates.The previous studies were dependent on the cer...Probability-based diagnostic imaging(PDI)is one of the most well-known damage identification methods using guided waves.It is usually applied to diagnose damage in plates.The previous studies were dependent on the certain damage index(DI)which is always calculated from the guided wave signals.In conventional methods,DI is simply defined by comparing the real-time data with the baseline data as reference.However,the baseline signal is easily affected by varying environmental conditions of structures.In this paper,a reference-free diagnostic imaging method is developed to avoid the influence of environmental factors,such as temperature and load conditions.The DI is defined based on the mode conversion of multi-mode guided waves with realtime signals without baseline signals.To improve the accuracy of diagnosis,two terms are included in the reference-free DI.One is called energy DI,which is defined based on the feature of signal energy.The other is called correlation DI and is defined based on the correlation coefficient.Then the PDI algorithm can be carried out instantaneously according to the reference-free DI.The real-time signals which are used to calculate DI are collected by the piezoelectric lead zirconate titanate(PZT)transducers placed on both sides of a plate.The numerical simulations by the finite element(FE)method on aluminum plates with PZT arrays are performed to validate the effectiveness of the reference-free damage diagnostic imaging.The approach is validated by two different arrays:a circle network and a square network.The results of diagnostic imaging are demonstrated and discussed in this paper.Furthermore,the advantage of reference-free DI is investigated by comparing the accuracy of defined reference-free DI and energy DI.展开更多
Objective: To discuss imaging features of the adrenal glands in female pseudo-hermaphroditism. Methods: 11 cases of female pseudohermaphroditism (8-27 years old) were analyzed retrospectively. Results: In 9 of the 11 ...Objective: To discuss imaging features of the adrenal glands in female pseudo-hermaphroditism. Methods: 11 cases of female pseudohermaphroditism (8-27 years old) were analyzed retrospectively. Results: In 9 of the 11 patients with female pseudohermaphroditism who did no receive hormone replacement therapy, both internal and external branches of bilateral adrenal glands were found to be thickened, prolonged and twisted, and in 2 of the 9 patients they were found to be macronodularly hyperplasic. In one of the remaining two patients who had received long-term hormone replacement therapy, the adrenal glands were not thickened or twisted, though prolonged; and in the other patient imaging presentation of the adrenal glands was the same as that of those who did not receive hormone replacement therapy, but with co-existence of adrenal myelolipoma. Among the 11 patients agenesis of the uterus and the vagina was found in 4 cases. Conclusion: Female pseudohermaphroditism is a hereditary disease, where hyperplasia of the adrenal glands and agenesis of the uterus and the vagina were secondary. Early detection of these abnormalities by imageology would prove to be helpful in early detection and treatment of the condition.展开更多
Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies because of its high invasiveness and metastatic potential.Computed tomography(CT)is often used as a preliminary diagnostic tool for pancreat...Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies because of its high invasiveness and metastatic potential.Computed tomography(CT)is often used as a preliminary diagnostic tool for pancreatic cancer,and it is increasingly used to predict treatment response and disease stage.Recently,a study published in World Journal of Gastroenterology reported that quantitative analysis of preoperative enhanced CT data can be used to predict postoperative overall survival in patients with PDAC.A tumor relative enhancement ratio of≤0.7 indicates a higher tumor stage and poor prognosis.展开更多
We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume ...We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India. Although the final diagnosis of the skeletal tuberculosis like tubercular arthritis is made by bacteriological and histological studies, few demographic, clinical and radiological features might help making early diagnosis.展开更多
BACKGROUND Challenging lesions,difficult to diagnose through non-invasive methods,constitute an important emotional burden for each patient regarding a still uncertain diagnosis(malignant x benign).In addition,from a ...BACKGROUND Challenging lesions,difficult to diagnose through non-invasive methods,constitute an important emotional burden for each patient regarding a still uncertain diagnosis(malignant x benign).In addition,from a therapeutic and prognostic point of view,delay in a definitive diagnosis can lead to worse outcomes.One of the main innovative trends currently is the use of molecular and functional methods to diagnosis.Numerous liver-specific contrast agents havebeen developed and studied in recent years to improve the performance of liver magnetic resonance imaging(MRI).More recently,one of the contrast agents introduced in clinical practice is gadoxetic acid(gadoxetate disodium).AIM To demonstrate the value of the hepatobiliary phases using gadoxetic acid in MRI for the characterization of focal liver lesions(FLL)in clinical practice.METHODS Overall,302 Lesions were studied in 136 patients who underwent MRI exams using gadoxetic acid for the assessment of FLL.Two radiologists independently reviewed the MRI exams using four stages,and categorized them on a 6-point scale,from 0(lesion not detected)to 5(definitely malignant).The stages were:stage 1-images without contrast,stage 2-addition of dynamic phases after contrast(analogous to usual extracellular contrasts),stage 3-addition of hepatobiliary phase after 10 min(HBP 10’),stage 4-hepatobiliary phase after 20 min(HBP 20’)in addition to stage 2.RESULTS The interobserver agreement was high(weighted Kappa coefficient:0.81-1)at all stages in the characterization of benign and malignant FLL.The diagnostic weighted accuracy(Az)was 0.80 in stage 1 and was increased to 0.90 in stage 2.Addition of the hepatobiliary phase increased Az to 0.98 in stage 3,which was also 0.98 in stage 4.CONCLUSION The hepatobiliary sequences improve diagnostic accuracy.With growing potential in the era of precision medicine,the improvement and dissemination of the method among medical specialties can bring benefits in the management of patients with FLL that are difficult to diagnose.展开更多
基金supported by the National Magnetic Confinement Fusion Energy Program of China(No.2019YFE03020001)the Collaborative Innovation Program of Hefei Science Center,CAS(No.2021HSC-CIP010)the Fundamental Research Funds for the Central Universities。
文摘Interpreting experimental diagnostics data in tokamaks,while considering non-ideal effects,is challenging due to the complexity of plasmas.To address this challenge,a general synthetic diagnostics(GSD)platform has been established that facilitates microwave imaging reflectometry and electron cyclotron emission imaging.This platform utilizes plasma profiles as input and incorporates the finite-difference time domain,ray tracing and the radiative transfer equation to calculate the propagation of plasma spontaneous radiation and the external electromagnetic field in plasmas.Benchmark tests for classical cases have been conducted to verify the accuracy of every core module in the GSD platform.Finally,2D imaging of a typical electron temperature distribution is reproduced by this platform and the results are consistent with the given real experimental data.This platform also has the potential to be extended to 3D electromagnetic field simulations and other microwave diagnostics such as cross-polarization scattering.
文摘Pancreatic transplantation is considered by the American Diabetes Association and the European Association for the Study of Diabetes an acceptable surgical procedure in patients with type 1 diabetes also undergoing kidney transplantation in pre-final or end-stage renal disease if no contraindications are present.Pancreatic transplantation,however,is a complex surgical procedure and may lead to a range of postoperative complications that can significantly impact graft function and patient outcomes.Postoperative computed tomography(CT)is often adopted to evaluate perfusion of the transplanted pancreas,identify complications and as a guide for interventional radiology procedures.CT assessment after pancreatic transplantation should start with the evaluation of the arterial Y-graft,the venous anastomosis and the duodenojejunostomy.With regard to complications,CT allows for the identification of vascular complications,such as thrombosis or stenosis of blood vessels supplying the graft,the detection of pancreatic fluid collections,including pseudocysts,abscesses,or leaks,the assessment of bowel complications(anastomotic leaks,ileus or obstruction),and the identification of bleeding.The aim of this pictorial review is to illustrate CT findings of surgical-related complications after pancreatic transplantation.The knowledge of surgical techniques is of key importance to understand postoperative anatomic changes and imaging evaluation.Therefore,we first provide a short summary of the main techniques of pancreatic transplantation.Then,we provide a practical imaging approach to pancreatic transplantation and its complications providing tips and tricks for the prompt imaging diagnosis on CT.
基金the National Natural Science Foundation of China,No.81571784the Provincial Natural Science Foundation of Hunan,No.2022JJ70142the Clinical Research Center for Medical Imaging in Hunan Province,2020SK4001.
文摘Liver disease is a major health concern globally,with high morbidity and mortality rates.Precise diagnosis and assessment are vital for guiding treatment approaches,predicting outcomes,and improving patient prognosis.Magnetic resonance imaging(MRI)is a non-invasive diagnostic technique that has been widely used for detecting liver disease.Recent advancements in MRI technology,such as diffusion weighted imaging,intravoxel incoherent motion,magnetic resonance elastography,chemical exchange saturation transfer,magnetic resonance spectroscopy,hyperpolarized MR,contrast-enhanced MRI,and radiomics,have significantly improved the accuracy and effectiveness of liver disease diagnosis.This review aims to discuss the progress in new MRI technologies for liver diagnosis.By summarizing current research findings,we aim to provide a comprehensive reference for researchers and clinicians to optimize the use of MRI in liver disease diagnosis and improve patient prognosis.
文摘BACKGROUND Paraduodenal pancreatitis(PP)represents a diagnostic challenge,especially in non-referral centers,given its potential imaging overlap with pancreatic cancer.There are two main histological variants of PP,the cystic and the solid,with slightly different imaging appearances.Moreover,imaging findings in PP may change over time because of disease progression and/or as an effect of its risk factors exposition,namely alcohol intake and smoking.AIM To describe multimodality imaging findings in patients affected by PP to help clinicians in the differential diagnosis with pancreatic cancer.METHODS The systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-analyses 2009 guidelines.A Literature search was performed on PubMed,Embase and Cochrane Library using(groove pancreatitis[Title/Abstract])OR(PP[Title/Abstract])as key words.A total of 593 articles were considered for inclusion.After eliminating duplicates,and title and abstract screening,53 full-text articles were assessed for eligibility.Eligibility criteria were:Original studies including 8 or more patients,fully written in English,describing imaging findings in PP,with pathological confirmation or clinical-radiological follow-up as the gold standard.Finally,14 studies were included in our systematic review.RESULTS Computed tomography(CT)findings were described in 292 patients,magnetic resonance imaging(MRI)findings in 231 and endoscopic ultrasound(EUS)findings in 115.Duodenal wall thickening was observed in 88.8%of the cases:Detection rate was 96.5%at EUS,91.0%at MRI and 84.1%at CT.Second duodenal portion increased enhancement was recognizable in 76.3%of the cases:Detection rate was 84.4%at MRI and 72.1%at CT.Cysts within the duodenal wall were detected in 82.6%of the cases:Detection rate was 94.4%at EUS,81.9%at MRI and 75.7%at CT.A solid mass in the groove region was described in 40.9%of the cases;in 78.3%of the cases,it showed patchy enhancement in the portal venous phase,and in 100%appeared iso/hyperintense during delayed phase imaging.Only 3.6%of the lesions showed restricted diffusion.The prevalence of radiological signs of chronic obstructive pancreatitis,namely main pancreatic duct dilatation,pancreatic calcifications,and pancreatic cysts,was extremely variable in the different articles.CONCLUSION PP has peculiar imaging findings.MRI is the best radiological imaging modality for diagnosing PP,but EUS is more accurate than MRI in depicting duodenal wall alterations.
基金Supported by Part by The Coordenação de Aperfeiçoamento de Pessoal de Nível Superior–Brasil(CAPES).
文摘The shortage of deceased donor organs has prompted the development of alternative liver grafts for transplantation.Living-donor liver transplantation(LDLT)has emerged as a viable option,expanding the donor pool and enabling timely transplantation with favorable graft function and improved long-term outcomes.An accurate evaluation of the donor liver’s volumetry(LV)and anatomical study is crucial to ensure adequate future liver remnant,graft volume and precise liver resection.Thus,ensuring donor safety and an appropriate graftto-recipient weight ratio.Manual LV(MLV)using computed tomography has traditionally been considered the gold standard for assessing liver volume.However,the method has been limited by cost,subjectivity,and variability.Automated LV techniques employing advanced segmentation algorithms offer improved reproducibility,reduced variability,and enhanced efficiency compared to manual measurements.However,the accuracy of automated LV requires further investigation.The study provides a comprehensive review of traditional and emerging LV methods,including semi-automated image processing,automated LV techniques,and machine learning-based approaches.Additionally,the study discusses the respective strengths and weaknesses of each of the aforementioned techniques.The use of artificial intelligence(AI)technologies,including machine learning and deep learning,is expected to become a routine part of surgical planning in the near future.The implementation of AI is expected to enable faster and more accurate image study interpretations,improve workflow efficiency,and enhance the safety,speed,and cost-effectiveness of the procedures.Accurate preoperative assessment of the liver plays a crucial role in ensuring safe donor selection and improved outcomes in LDLT.MLV has inherent limitations that have led to the adoption of semi-automated and automated software solutions.Moreover,AI has tremendous potential for LV and segmentation;however,its widespread use is hindered by cost and availability.Therefore,the integration of multiple specialties is necessary to embrace technology and explore its possibilities,ranging from patient counseling to intraoperative decision-making through automation and AI.
文摘Breast pathology is varied, bringing together tumor and non-tumor lesions. Objective: To study the contribution of the ultrasound-mammography pair in the diagnosis of breast pathologies. Materials and Method: This was a retrospective descriptive study, carried out over a period of 3 years (from January 2018 to December 2020) at the Diagnostic Imaging Center (C.I.D) “TERIYA” in BAMAKO. It concerned all patients who came for a mammogram/ultrasound examination of the breast. All women admitted for mammogram or breast ultrasound who were diagnosed with a breast injury during the study period were included. Incomplete records and radiological checks were not included. The variables analyzed were age, sex, clinical data, and ultrasound and mammography aspects. The devices used are: a Voluson 730 PRO ultrasound machine and a G 600T type mammography machine. Results: At the end of our study, we collected 254 breast pathologies on a number of 382 women, i.e. a frequency of 66.49%. The average age of our patients was 41 years old. The dominant clinical data were mastodynia (41.88%) and mammary nodule (21.70%). On imaging (mammo-ultrasound) the lesions predominated on the left in 36% of cases, bilateral in 28% of cases and in the upper-outer quadrants in 31.5% of cases. Tumor pathologies represented 66.54% of which 45.27% were benign mainly composed of fibro-adenoma (20.88%) and cyst (18.50%), 11.8% of suspected cases and 9.45% of cancers. Non-tumor pathologies represented 33.46%, mainly mastitis (16.14%), galactophoric dilations (11.02%) and abscesses (5.51%). These pathologies were classified in 50.3% in ACR2, 17.75% in ACR3 and 4, and in 14.20% in ACR5. Lymphadenopathy was present in 73.21% of cases.
基金funded by King Saud University,Riyadh,Saudi Arabia.Researchers Supporting Project Number(RSP2024R167),King Saud University,Riyadh,Saudi Arabia.
文摘The early implementation of treatment therapies necessitates the swift and precise identification of COVID-19 pneumonia by the analysis of chest CT scans.This study aims to investigate the indispensable need for precise and interpretable diagnostic tools for improving clinical decision-making for COVID-19 diagnosis.This paper proposes a novel deep learning approach,called Conformer Network,for explainable discrimination of viral pneumonia depending on the lung Region of Infections(ROI)within a single modality radiographic CT scan.Firstly,an efficient U-shaped transformer network is integrated for lung image segmentation.Then,a robust transfer learning technique is introduced to design a robust feature extractor based on pre-trained lightweight Big Transfer(BiT-L)and finetuned on medical data to effectively learn the patterns of infection in the input image.Secondly,this work presents a visual explanation method to guarantee clinical explainability for decisions made by Conformer Network.Experimental evaluation of real-world CT data demonstrated that the diagnostic accuracy of ourmodel outperforms cutting-edge studies with statistical significance.The Conformer Network achieves 97.40% of detection accuracy under cross-validation settings.Our model not only achieves high sensitivity and specificity but also affords visualizations of salient features contributing to each classification decision,enhancing the overall transparency and trustworthiness of our model.The findings provide obvious implications for the ability of our model to empower clinical staff by generating transparent intuitions about the features driving diagnostic decisions.
文摘In the context of mediastinal emphysema/pneumomediastinum,the main aetiologies are associated with oesophageal perforation,lung pathology or post head and neck surgery related.The main way to differentiate the pathologies would be through Computed Tomographic Imaging of the Thorax and abdomen with oral and intravenous contrast in the context of triple phase imaging.The causes of pneumomediastinum should be differentiated between traumatic and non-traumatic.Oesophageal perforation(Boerhaave syndrome)is associated with Mackler’s triad in upto 50%of patients(severe retrosternal chest pain,pneumomediastinum,mediastinitis).Whereas in cases of lung pathology this can be associated with pneumothorax and pleural effusion.
文摘Background: Nosocomial infections have become a major challenge in healthcare facilities as they affect the quality of medical care. Radiological imaging plays a crucial role in medical diagnosis. However, the equipment and accessories used increase the risk of transmission of nosocomial bacteria. Objective: This study aims to reveal the extent and nature of microbiological contamination in four hospital diagnostic imaging departments to determine their potential role in the spread of nosocomial bacteria and to evaluate the effectiveness of routine daily disinfection practices in controlling microorganisms in diagnostic imaging departments. Methods & Results: In each department, swabs were taken from the surfaces of selected parts of the equipment and accessories three times a day (early morning, noon, and evening) for five consecutive days. Bacteria were isolated from 65 swabs (36.1% of all samples). The bacteria were isolated 3 times (4.6%) in the morning, 16 times (24.6%) at midday, and 46 times (70.7%) in the evening. The bacteria isolated were Escherichia coli (isolated 34 times;52.3%), Staphylococcus aureus (20 times;30.8%), Staphylococcus epidermidis (6 times;9.3%), and Klebsiella species (5 times;7.7%). Discussion & Conclusion: Findings demonstrated that radiology equipment and accessories are not free of bacteria and further improvements in the sterilization and disinfection of radiology equipment and accessories are needed to protect staff and patients from nosocomial infections.
文摘Portal hypertension is a common clinical syndrome, defined by a pathologic increase in the portal venous pressure. Increased resistance to portal blood flow, the primary factor in the pathophysiology of portal hypertension, is in part due to morphological changes occurring in chronic liver diseases. This results in rerouting of blood flow away from the liver through collateral pathways to low-pressure systemic veins. Through a variety of computed tomographic, sonographic, magnetic resonance imaging and angiographic examples, this article discusses the appearances and prevalence of both common and less common portosystemic collateral channels in the thorax and abdomen. A brief overview of established interventional radiologic techniques for treatment of portal hypertension will also be provided. Awareness of the various imaging manifestations of portal hypertension can be helpful for assessing overall prognosis and planning proper management.
基金Supported by Shanghai Leading Academic Discipline Project,No.S30203
文摘AIM:To retrospectively evaluate the imaging features of pancreatic intraductal papillary mucinous neoplasms (IPMNs) in multi-detector row computed tomography (MDCT).METHODS: A total of 20 patients with pathologically-confirmed intraductal papillary mucinous neoplasms (IPMNs) were included in this study. Axial MDCT images combined with CT angiography (CTA) and multiplanar volume reformations (MPVR) or curved reformations (CR) were preoperatively acquired. Two radiologists (Tan L and Wang DB) reviewed all the images in consensus using an interactive picture archiving and communication system. The disputes in readings were resolved through consultation with a third experienced radiologist (Chen KM). Finally, the findings and diagnoses were compared with the pathologic results.RESULTS: The pathological study revealed 12 malignant IPMNs and eight benign IPMNs. The diameters of the cystic lesions and main pancreatic ducts (MPDs) were significantly larger in malignant IPMNs compared with those of the benign IPMNs (P<0.05). The combined-type IPMNs had a higher rate of malignancy than the other two types of IPMNs (P<0.05). Tumors with mural nodules and thick septa had a significantly higher incidence of malignancy than tumors without these features (P<0.05). Communication of side-branch IPMNs with the MPD was present in nine cases at pathologic examination. Seven of them were identified from CTA and MPVR or CR images. From comparison with the pathological diagnosis, the sensitivity, specificity, and accuracy of MDCT in characterizing the malignancy of IPMN of the pancreas were determined to be 100%, 87.5% and 95%, respectively.CONCLUSION: MDCT with CTA and MPVR or CR techniques can elucidate the imaging features of IPMNs and help predict the malignancy of these tumors.
文摘AIM To establish the ability of magnetic resonance(MR) and computer tomography(CT) to predict pathologic dimensions of pancreatic neuroendocrine tumors(Pan NET) in a caseload of a tertiary referral center.METHODS Patients submitted to surgery for Pan NET at the Surgical Unit of the Pancreas Institute with at least 1 preoperative imaging examination(MR or CT scan) from January 2005 to December 2015 were included and data retrospectively collected. Exclusion criteria were: multifocal lesions, genetic syndromes, microadenomas or mixed tumors, metastatic disease and neoadjuvant therapy. Bland-Altman(BA) and Mountain-Plot(MP) statistics were used to compare size measured by each modality with the pathology size. Passing-Bablok(PB) regression analysis was used to check the agreement between MR and CT.RESULTS Our study population consisted of 292 patients. Seventy-nine(27.1%) were functioning Pan NET. The mean biases were 0.17 ± 7.99 mm, 1 ± 8.51 mm and 0.23 ± 9 mm, 1.2 ± 9.8 mm for MR and CT, considering the overall population and the subgroup of non-functioning-Pan NET, respectively. Limits of agreement(LOA) included the vast majority of observations, indicating a good agreement between imaging and pathology. The MP further confirmed this finding and showed that the two methods are unbiased with respect to each other. Considering ≤ 2 cm non-functioning-Pan NET, no statistical significance was found in the size estimation rate of MR and CT(P = 0.433). PBR analysis did not reveal significant differences between MR, CT and pathology.CONCLUSION MR and CT scan are accurate and interchangeable imaging techniques in predicting pathologic dimensions of Pan NET.
文摘Varicocele is characterized by an abnormal dilatation and retrograde blood flow in the spermatic veins. Varicocele is the leading correctable cause of male infertility. Although it is highly prevalent in infertile men, it is also observed in individuals with normal fertility. Determining which men are negatively affected by varicocele would enable clinicians to better select those men who will benefit from treatment. To assess the functional status of the testes in men with varicocele, color Doppler sonographic parameters were evaluated. Testicular arterial blood flow was significantly reduced in men with varicocele, reflecting an impairment of spermatogenesis. An improvement in the testicular blood supply was found after varicocelectomy on spectral Doppler analysis. Testicular contrast harmonic imaging and elastography might improve our knowledge about the influence of varicocele on intratesticular microcirculation and tissue stiffness, respectively, providing possible information on the early damage of testicular structure by varicocele. Magnetic resonance imaging(MRI), with measurement of apparent diffusion coefficient has been used to assess the degree of testicular dysfunction and to evaluate the effectiveness of varicocele repair. Large prospective studies are needed to validate the possible role of functional sonography and MRI in the assessment of early defects of spermatogenesis in testes with varicocele.
基金supported by a grant from the Ministry of Science and Technological Development of Serbia,Scientific Project Number 175090
文摘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.
基金Supported by the Medical Centre of Minimally Invasive Technology of Fujian Province,No.2017[171],and No.2017[4]Joint Funds for the Innovation of Science and Technology,Fujian Province,No.2017Y9059the United Fujian Provincial Health and Education Project for Tackling the Key Research,No.2019-WJ-07.
文摘BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies with high mortality and short survival time.Computed tomography(CT)plays an important role in the diagnosis,staging and treatment of pancreatic tumour.Pancreatic cancer generally shows a low enhancement pattern compared with normal pancreatic tissue.AIM To analyse whether preoperative enhanced CT could be used to predict postoperative overall survival in patients with PDAC.METHODS Sixty-seven patients with PDAC undergoing pancreatic resection were enrolled retrospectively.All patients underwent preoperative unenhanced and enhanced CT examination,the CT values of which were measured.The ratio of the preoperative CT value increase from the nonenhancement phase to the portal venous phase between pancreatic tumour and normal pancreatic tissue was calculated.The cut-off value of ratios was obtained by the receiver operating characteristic(ROC)curve of the tumour relative enhancement ratio(TRER),according to which patients were divided into low-and high-enhancement groups.Univariate and multivariate analyses were performed using Cox regression based on TRER grouping.Finally,the correlation between TRER and clinicopathological characteristics was analysed.RESULTS The area under the curve of the ROC curve was 0.768(P<0.05),and the cut-off value of the ROC curve was calculated as 0.7.TRER≤0.7 was defined as the low-enhancement group,and TRER>0.7 was defined as the high-enhancement group.According to the TRER grouping,the Kaplan-Meier survival curve analysis results showed that the median survival(10.0 mo)with TRER≤0.7 was significantly shorter than that(22.0 mo)with TRER>0.7(P<0.05).In the univariate and multivariate analyses,the prognosis of patients with TRER≤0.7 was significantly worse than that of patients with TRER>0.7(P<0.05).Our results demonstrated that patients in the low TRER group were more likely to have higher American Joint Committee on Cancer stage,tumour stage and lymph node stage(all P<0.05),and TRER was significantly negatively correlated with tumour size(P<0.05).CONCLUSION TRER≤0.7 in patients with PDAC may represent a tumour with higher clinical stage and result in a shorter overall survival.
基金This work was supported by the National Key Research and Development Program of China(Grant No.2016YFF0203002)the National Natural Science Foundation of China(Grant No.11702051)+1 种基金China Post-doctoral Science Foundation(Grant No.2017M610176)the Fundamental Research Funds for the Central Universities(DUT16ZD214).
文摘Probability-based diagnostic imaging(PDI)is one of the most well-known damage identification methods using guided waves.It is usually applied to diagnose damage in plates.The previous studies were dependent on the certain damage index(DI)which is always calculated from the guided wave signals.In conventional methods,DI is simply defined by comparing the real-time data with the baseline data as reference.However,the baseline signal is easily affected by varying environmental conditions of structures.In this paper,a reference-free diagnostic imaging method is developed to avoid the influence of environmental factors,such as temperature and load conditions.The DI is defined based on the mode conversion of multi-mode guided waves with realtime signals without baseline signals.To improve the accuracy of diagnosis,two terms are included in the reference-free DI.One is called energy DI,which is defined based on the feature of signal energy.The other is called correlation DI and is defined based on the correlation coefficient.Then the PDI algorithm can be carried out instantaneously according to the reference-free DI.The real-time signals which are used to calculate DI are collected by the piezoelectric lead zirconate titanate(PZT)transducers placed on both sides of a plate.The numerical simulations by the finite element(FE)method on aluminum plates with PZT arrays are performed to validate the effectiveness of the reference-free damage diagnostic imaging.The approach is validated by two different arrays:a circle network and a square network.The results of diagnostic imaging are demonstrated and discussed in this paper.Furthermore,the advantage of reference-free DI is investigated by comparing the accuracy of defined reference-free DI and energy DI.
文摘Objective: To discuss imaging features of the adrenal glands in female pseudo-hermaphroditism. Methods: 11 cases of female pseudohermaphroditism (8-27 years old) were analyzed retrospectively. Results: In 9 of the 11 patients with female pseudohermaphroditism who did no receive hormone replacement therapy, both internal and external branches of bilateral adrenal glands were found to be thickened, prolonged and twisted, and in 2 of the 9 patients they were found to be macronodularly hyperplasic. In one of the remaining two patients who had received long-term hormone replacement therapy, the adrenal glands were not thickened or twisted, though prolonged; and in the other patient imaging presentation of the adrenal glands was the same as that of those who did not receive hormone replacement therapy, but with co-existence of adrenal myelolipoma. Among the 11 patients agenesis of the uterus and the vagina was found in 4 cases. Conclusion: Female pseudohermaphroditism is a hereditary disease, where hyperplasia of the adrenal glands and agenesis of the uterus and the vagina were secondary. Early detection of these abnormalities by imageology would prove to be helpful in early detection and treatment of the condition.
文摘Pancreatic ductal adenocarcinoma(PDAC)is one of the most lethal malignancies because of its high invasiveness and metastatic potential.Computed tomography(CT)is often used as a preliminary diagnostic tool for pancreatic cancer,and it is increasingly used to predict treatment response and disease stage.Recently,a study published in World Journal of Gastroenterology reported that quantitative analysis of preoperative enhanced CT data can be used to predict postoperative overall survival in patients with PDAC.A tumor relative enhancement ratio of≤0.7 indicates a higher tumor stage and poor prognosis.
文摘We present a case of tubercular arthritis who underwent numerous unnecessary investigations what is known as "victims of modern imaging technology" or VOMIT. Today there is an exponential rise in the volume of the medical imaging, part of which is contributed by unnecessary and unjustified indications. We discuss about the untoward effects of the uninhibited and careless use of modern imaging modalities and possible ways to avoid. Skeletal manifestation of the tuberculosis is still common in the endemic countries like India. Although the final diagnosis of the skeletal tuberculosis like tubercular arthritis is made by bacteriological and histological studies, few demographic, clinical and radiological features might help making early diagnosis.
文摘BACKGROUND Challenging lesions,difficult to diagnose through non-invasive methods,constitute an important emotional burden for each patient regarding a still uncertain diagnosis(malignant x benign).In addition,from a therapeutic and prognostic point of view,delay in a definitive diagnosis can lead to worse outcomes.One of the main innovative trends currently is the use of molecular and functional methods to diagnosis.Numerous liver-specific contrast agents havebeen developed and studied in recent years to improve the performance of liver magnetic resonance imaging(MRI).More recently,one of the contrast agents introduced in clinical practice is gadoxetic acid(gadoxetate disodium).AIM To demonstrate the value of the hepatobiliary phases using gadoxetic acid in MRI for the characterization of focal liver lesions(FLL)in clinical practice.METHODS Overall,302 Lesions were studied in 136 patients who underwent MRI exams using gadoxetic acid for the assessment of FLL.Two radiologists independently reviewed the MRI exams using four stages,and categorized them on a 6-point scale,from 0(lesion not detected)to 5(definitely malignant).The stages were:stage 1-images without contrast,stage 2-addition of dynamic phases after contrast(analogous to usual extracellular contrasts),stage 3-addition of hepatobiliary phase after 10 min(HBP 10’),stage 4-hepatobiliary phase after 20 min(HBP 20’)in addition to stage 2.RESULTS The interobserver agreement was high(weighted Kappa coefficient:0.81-1)at all stages in the characterization of benign and malignant FLL.The diagnostic weighted accuracy(Az)was 0.80 in stage 1 and was increased to 0.90 in stage 2.Addition of the hepatobiliary phase increased Az to 0.98 in stage 3,which was also 0.98 in stage 4.CONCLUSION The hepatobiliary sequences improve diagnostic accuracy.With growing potential in the era of precision medicine,the improvement and dissemination of the method among medical specialties can bring benefits in the management of patients with FLL that are difficult to diagnose.