Artificial intelligence software for assessing brain ischemic penumbra/core infarction on computed tomography perfusion:A real-world accuracy study

BACKGROUND With the increasingly extensive application of artificial intelligence(AI)in medical systems,the accuracy of AI in medical diagnosis in the real world deserves attention and objective evaluation.AIM To investigate the accuracy of AI diagnostic software(Shukun)in assessing ischemic penumbra/core infarction in acute ischemic stroke patients due to large vessel occlusion.METHODS From November 2021 to March 2022,consecutive acute stroke patients with large vessel occlusion who underwent mechanical thrombectomy(MT)post-Shukun AI penumbra assessment were included.Computed tomography angiography(CTA)and perfusion exams were analyzed by AI,reviewed by senior neurointerventional experts.In the case of divergences among the three experts,discussions were held to reach a final conclusion.When the results of AI were inconsistent with the neurointerventional experts’diagnosis,the diagnosis by AI was considered inaccurate.RESULTS A total of 22 patients were included in the study.The vascular recanalization rate was 90.9%,and 63.6%of patients had modified Rankin scale scores of 0-2 at the 3-month follow-up.The computed tomography(CT)perfusion diagnosis by Shukun(AI)was confirmed to be invalid in 3 patients(inaccuracy rate:13.6%).CONCLUSION AI(Shukun)has limits in assessing ischemic penumbra.Integrating clinical and imaging data(CT,CTA,and even magnetic resonance imaging)is crucial for MT decision-making.

HkV和HRCT检查在职业性尘肺病诊断中的价值

目的探究高千伏胸片(HkV)和高分辨率计算机体层X线摄影术(HRCT)检查在职业性尘肺病诊断中的临床应用价值。方法回顾性分析133例进行职业病诊断的尘肺病患者资料,患者均接受HkV和HRCT检查,以临床病理检查为金标准,比较HkV和HRCT对尘肺患者肺部阴影的显示情况、图片质量、分期诊断符合率及尘肺合并症的检出情况。结果HRCT对肺部P影、小阴影检出率高于HkV(P<0.05),两组大阴影检出率比较,差异无统计学意义(P>0.05);HRCT检查图像质量有效率高于HkV检查(P<0.05);HRCT诊断总准确率高于HkV诊断(P<0.05);HRCT对肺部感染、肺气肿、胸膜增厚、气胸的检出率高于HkV(P<0.05),HRCT与HkV对肺结核、肺大泡检出率差异无统计学意义(P>0.05)。结论HRCT检查对职业性尘肺病患者肺部阴影、临床分期及合并症的诊断效果高于HkV,图片质量更高。

HRCT评分与血清标志物对类风湿关节炎合并肺间质病变的诊断价值

目的:探讨HRCT评分与血清标志物的相关性,为类风湿关节炎合并肺间质病变(RA-ILD)的早期诊断与治疗提供参考。方法:回顾性分析284例RA患者的临床资料和胸部HRCT图像,其中单纯RA 152例,RA-ILD 132例。对2组行HRCT评分和28个关节疾病活动评分(DAS28)。收集2组病情活动指标:血沉(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸多肽抗体(ACCPA)、癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原724(CA724)、糖类抗原(CA19-9)、转铁蛋白(FeD)、纤维蛋白原(FIB)及D-二聚体(DDI3)。采用logistic回归分析及ROC曲线分析HRCT评分与各指标相关性,绘制各指标检测的AUC。结果:2组性别、年龄、DAS28、ESR、RF、CEA、CA19-9、HRCT评分差异均有统计学意义(均P<0.05);RA-ILD组患者年龄偏大,DAS28、RF、CEA、CA19-9、HRCT评分更高。多因素logistic回归分析表明,DAS28、RF、CEA、CA19-9可作为RA-ILD的独立预测指标。2组HRCT评分与年龄、DAS28、ESR、CEA、CA19-9、FIB均呈正相关(均P<0.05)。2组胸部HRCT评分及影像学特征比较,差异均有统计学意义(均P<0.05)。HRCT评分、ESR、RF、CA19-9、CEA、DAS28对应的AUC分别为0.762、0.486、0.526、0.786、0.778、0.870,敏感度分别为80.5%、73.2%、63.4%、75.6%、87.8%、80.5%。HRCT评分+RF+CEA+CA19-9、HRCT评分+ESR+DAS28+风湿3项+肿瘤标志物5项+凝血2项的AUC分别为0.947、0.959,敏感度分别为88.3%、82.9%。结论:HRCT评分+RF+CEA+CA19-9对可能存在继发ILD风险的RA患者具有潜在的诊断价值,可提高RA-ILD的早期诊断准确率和敏感度。

冠状动脉树重建扩大到较小动脉提高FFRCT准确性的研究

目的本研究旨在通过在计算流体动力学(CFD)领域扩展冠脉树来提高基于冠状动脉CT血管成像(coronary CT angiography,CCTA)的血流储备分数(FFR)的准确性。进行了一项观察性研究,以评估将冠状动脉树分析从最小直径1.2mm扩展到0.8 mm的效果。方法对接受CCTA和介入性FFR治疗的患者进行回顾性研究。76名患者符合纳入标准。重建三维冠状动脉树,生成具有不同管腔直径下限(1.2 mm和0.8 mm)的有限元网格。根据Murray定律定义了出口边界条件。应用NKS方法求解CFD控制方程,得到FFRCT。结果在个体患者水平上,将冠状动脉树的最小直径从1.2mm扩大到0.8mm,FFRCT的灵敏度提高了16.7%(P=0.022),这导致四个假阴性病例转变为真阳性病例。ROC曲线的AUC值由0.74增至0.83。此外,NKS方法可以解决在2160个处理器核的情况下,在10.5分钟内将冠状动脉树扩展到0.8 mm管腔直径的计算问题。结论将重建的冠脉扩大到较小的管腔直径可以显著提高FFRCT的敏感性,NKS方法可以为未来的临床应用提供良好的计算时间。

先天性感音神经性耳聋患儿内耳道狭窄与蜗神经管异常的HRCT表现

目的:探讨先天性感音神经性耳聋(SNHL)患儿内耳道狭窄与蜗神经管异常的HRCT表现及2种畸形的相关性。方法:回顾性分析67例(75耳)存在先天性SNHL,且HRCT诊断为内耳道狭窄和/或蜗神经管异常患儿的CT资料。结果:67例(75耳)均有蜗神经管异常,双侧8例、单侧59例(左耳30例、右耳29例);其中30耳合并内耳道狭窄,16耳合并其他内耳结构畸形。28例(30耳)内耳道狭窄中,双侧2例、单侧26例(左耳11例、右耳15例),8耳合并半规管、前庭或耳蜗畸形。内耳道狭窄与蜗神经管异常均以单侧发病为主,左右耳均可发病,差异均无统计学意义(均P>0.05)。结论:SNHL患儿中蜗神经管异常比内耳道狭窄更常见,也更具临床意义,但易漏诊,应引起高度重视,建议行内耳HRCT检查常规测量蜗神经管宽度。

Omental infarction diagnosed by computed tomography,missed with ultrasonography:A case report

BACKGROUND Omental infarction(OI)is a surgical abdominal disease that is not common in adults and is very rare in children.Similar to various acute abdominal pain diseases including appendicitis,diagnosis was previously achieved by diagnostic laparotomy but more recently,ultrasonography or computed tomography(CT)examination has been used.CASE SUMMARY A 6-year-old healthy boy with no specific medical history visited the emergency room with right lower abdominal pain.He underwent abdominal ultrasonography by a radiologist to rule out acute appendicitis.He was discharged with no significant sonographic finding and symptom relief.However,the symptoms persisted for 2 more days and an outpatient visit was made.An outpatient abdominal CT was used to make a diagnosis of OI.After laparoscopic operation,his symptoms resolved.CONCLUSION In children’s acute abdominal pain,imaging studies should be performed for appendicitis and OI.

基于迭代算法的FFRCT测量系统对急性ST段抬高型心肌梗死PCI术患者生存预后的影响

目的:观察基于迭代算法的无创血流储备分数(FFR)计算技术(FFRCT)测量系统诊断应用于急性ST段抬高型心肌梗死(STEMI)行急诊经皮冠状动脉介入治疗(PCI)治疗后对患者生存预后的影响。方法:前瞻性选取2022年10月至2024年2月内蒙古医科大学附属医院多支合并血管病变(MVD)的急性STEMI患者98例纳入研究,所有患者按随机双盲法分为FFRCT组(49例)和冠状动脉造影(CAG)组(49例)。FFRCT组以FFRCT为诊断依据,根据FFRCT检查结果执行完全血运重建策略;CAG组以CAG为指导处理梗死相关血管。观察两组患者基本临床资料、PCI手术操作细节和(或)技术指标以及相关资源利用指标,观察随访两组心绞痛发作和主要的心脏血管不良事件(MACE)等相关生存预后指标,主要观察终点为随访24个月的全因死亡、心衰、卒中、主要的MACE、及再次血运重建的复合终点事件等。结果:FFRCT组行非梗死相关血管PCI处理占比为55.10%(27/49);两组PCI术后手术操作细节/技术指标比较,FFRCT组手术用时为(65±10)min,较CAG组(60±8)min有所延长,支架总长度为(31±10)mm,短于CAG组(36±10)mm,两组比较差异均有统计学意义(t=-4.062、-6.710,P<0.05),两组造影剂用量、平均支架直径、住院时间等比较,差异均无统计学意义(P>0.05);与CAG组比较,FFRCT组随访24个月时非致死性心肌梗死、主要终点事件、再发心绞痛、再次血运重建发生率均显著降低,组间比较差异有统计学意义(χ2=4.926、5.273、6.091、5.804,P<0.05)。结论:多支合并MVD的急性ST段抬高型心肌梗死患者在急诊PCI过程中使用基于迭代算法的FFRCT测量系统检查指导血运重建,其安全性、有效性值得肯定,在降低PCI后心脑血管事件发生风险、改善预后方面较CAG指导方式具有明显优势。

Deep learning-based inpainting of saturation artifacts in optical coherence tomography images

Limited by the dynamic range of the detector,saturation artifacts usually occur in optical coherence tomography(OCT)imaging for high scattering media.The available methods are difficult to remove saturation artifacts and restore texture completely in OCT images.We proposed a deep learning-based inpainting method of saturation artifacts in this paper.The generation mechanism of saturation artifacts was analyzed,and experimental and simulated datasets were built based on the mechanism.Enhanced super-resolution generative adversarial networks were trained by the clear–saturated phantom image pairs.The perfect reconstructed results of experimental zebrafish and thyroid OCT images proved its feasibility,strong generalization,and robustness.

Multilocular thymic cysts can be easily misdiagnosed as malignant tumor on computer tomography:A case report

BACKGROUND Multilocular thymic cyst(MTC)is a rare mediastinal lesion which is considered to occur in the process of acquired inflammation.It is usually characterized by well-defined cystic density and is filled with transparent liquid.CASE SUMMARY We report on a 39-year-old male with a cystic-solid mass in the anterior mediastinum.Computer tomography(CT)imaging showed that the mass was irregular with unclear boundaries.After injection of contrast agent,there was a slight enhancement of stripes and nodules.According to CT findings,it was diagnosed as thymic cancer.CONCLUSION After surgery,MTC accompanied by bleeding and infection was confirmed by pathological examination.The main lesson of this case was that malignant thymic tumor and MTC of the anterior mediastinum sometimes exhibit similar CT findings.Caution is necessary in clinical work to avoid misdiagnosis.

Glaucoma surgery experiments using digital microscope-integrated optical coherence tomography and OCT-compatible instruments

There is a certain failure rate in traditional glaucoma surgery because of the lack of depth information in microscope images.In this work,we present a digital microscope-integrated optical coherence tomography(MIOCT)system and several custom-made OCT-compatible instruments for glaucoma surgery.Sixteen ophthalmologists were asked to perform trabeculectomy and canaloplasty on live porcine eyes using the system and instruments.After surgery,a subjective feedback survey about the user experience was taken.The experiment results showed that our system can help surgeons easily locate important tissue structures during surgery.The custom-made instruments also solved the shadowing problem in OCT imaging.Surgeons preferred to use the system in their future practice.

Preoperative prediction of lymphovascular and perineural invasion in gastric cancer using spectral computed tomography imaging and machine learning

BACKGROUND Lymphovascular invasion(LVI)and perineural invasion(PNI)are important prognostic factors for gastric cancer(GC)that indicate an increased risk of metastasis and poor outcomes.Accurate preoperative prediction of LVI/PNI status could help clinicians identify high-risk patients and guide treatment deci-sions.However,prior models using conventional computed tomography(CT)images to predict LVI or PNI separately have had limited accuracy.Spectral CT provides quantitative enhancement parameters that may better capture tumor invasion.We hypothesized that a predictive model combining clinical and spectral CT parameters would accurately preoperatively predict LVI/PNI status in GC patients.AIM To develop and test a machine learning model that fuses spectral CT parameters and clinical indicators to predict LVI/PNI status accurately.METHODS This study used a retrospective dataset involving 257 GC patients(training cohort,n=172;validation cohort,n=85).First,several clinical indicators,including serum tumor markers,CT-TN stages and CT-detected extramural vein invasion(CT-EMVI),were extracted,as were quantitative spectral CT parameters from the delineated tumor regions.Next,a two-step feature selection approach using correlation-based methods and information gain ranking inside a 10-fold cross-validation loop was utilized to select informative clinical and spectral CT parameters.A logistic regression(LR)-based nomogram model was subsequently constructed to predict LVI/PNI status,and its performance was evaluated using the area under the receiver operating characteristic curve(AUC).RESULTS In both the training and validation cohorts,CT T3-4 stage,CT-N positive status,and CT-EMVI positive status are more prevalent in the LVI/PNI-positive group and these differences are statistically significant(P<0.05).LR analysis of the training group showed preoperative CT-T stage,CT-EMVI,single-energy CT values of 70 keV of venous phase(VP-70 keV),and the ratio of standardized iodine concentration of equilibrium phase(EP-NIC)were independent influencing factors.The AUCs of VP-70 keV and EP-NIC were 0.888 and 0.824,respectively,which were slightly greater than those of CT-T and CT-EMVI(AUC=0.793,0.762).The nomogram combining CT-T stage,CT-EMVI,VP-70 keV and EP-NIC yielded AUCs of 0.918(0.866-0.954)and 0.874(0.784-0.936)in the training and validation cohorts,which are significantly higher than using each of single independent factors(P<0.05).CONCLUSION The study found that using portal venous and EP spectral CT parameters allows effective preoperative detection of LVI/PNI in GC,with accuracy boosted by integrating clinical markers.

Double contrast-enhanced ultrasonography improves diagnostic accuracy of T staging compared with multi-detector computed tomography in gastric cancer patients

BACKGROUND Gastric cancer(GC)is the most common malignant tumor and ranks third for cancer-related deaths among the worldwide.The disease poses a serious public health problem in China,ranking fifth for incidence and third for mortality.Knowledge of the invasive depth of the tumor is vital to treatment decisions.AIM To evaluate the diagnostic performance of double contrast-enhanced ultrasonography(DCEUS)for preoperative T staging in patients with GC by comparing with multi-detector computed tomography(MDCT).METHODS This single prospective study enrolled patients with GC confirmed by preoperative gastroscopy from July 2021 to March 2023.Patients underwent DCEUS,including ultrasonography(US)and intravenous contrast-enhanced ultrasonography(CEUS),and MDCT examinations for the assessment of preoperative T staging.Features of GC were identified on DCEUS and criteria developed to evaluate T staging according to the 8th edition of AJCC cancer staging manual.The diagnostic performance of DCEUS was evaluated by comparing it with that of MDCT and surgical-pathological findings were considered as the gold standard.RESULTS A total of 229 patients with GC(80 T1,33 T2,59 T3 and 57 T4)were included.Overall accuracies were 86.9%for DCEUS and 61.1%for MDCT(P<0.001).DCEUS was superior to MDCT for T1(92.5%vs 70.0%,P<0.001),T2(72.7%vs 51.5%,P=0.041),T3(86.4%vs 45.8%,P<0.001)and T4(87.7%vs 70.2%,P=0.022)staging of GC.CONCLUSION DCEUS improved the diagnostic accuracy of preoperative T staging in patients with GC compared with MDCT,and constitutes a promising imaging modality for preoperative evaluation of GC to aid individualized treatment decision-making.

Lymphatic plastic bronchitis and primary chylothorax: A study based on computed tomography lymphangiography

BACKGROUND This study presents an evaluation of the computed tomography lymphangio-graphy(CTL)features of lymphatic plastic bronchitis(PB)and primary chylotho-rax to improve the diagnostic accuracy for these two diseases.AIM To improve the diagnosis of lymphatic PB or primary chylothorax,a retrospective analysis of the clinical features and CTL characteristics of 71 patients diagnosed with lymphatic PB or primary chylothorax was performed.METHODS The clinical and CTL data of 71 patients(20 with lymphatic PB,41 with primary chylothorax,and 10 with lymphatic PB with primary chylothorax)were collected retrospectively.CTL was performed in all patients.The clinical manifestations,CTL findings,and conventional chest CT findings of the three groups of patients were compared.The chi-square test or Fisher's exact test was used to compare the differences among the three groups.A difference was considered to be statistically significant when P<0.05.RESULTS(1)The percentages of abnormal contrast medium deposits on CTL in the three groups were as follows:Thoracic duct outlet in 14(70.0%),33(80.5%)and 8(80.0%)patients;peritracheal region in 18(90.0%),15(36.6%)and 8(80.0%)patients;pleura in 6(30.0%),33(80.5%)and 9(90.0%)patients;pericardium in 6(30.0%),6(14.6%)and 4(40.0%)patients;and hilum in 16(80.0%),11(26.8%)and 7(70.0%)patients;and(2)the abnormalities on conven-tional chest CT in the three groups were as follows:Ground-glass opacity in 19(95.0%),18(43.9%)and 8(80.0%)patients;atelectasis in 4(20.0%),26(63.4%)and 7(70.0%)patients;interlobular septal thickening in 12(60.0%),11(26.8%)and 3(30.0%)patients;bronchovascular bundle thickening in 14(70.0%),6(14.6%)and 4(40.0%)patients;localized mediastinal changes in 14(70.0%),14(34.1%),and 7(70.0%)patients;diffuse mediastinal changes in 6(30.0%),5(12.2%),and 3(30.0%)patients;cystic lesions in the axilla in 2(10.0%),6(14.6%),and 2(20.0%)patients;and cystic lesions in the chest wall in 0(0%),2(4.9%),and 2(4.9%)patients.CONCLUSION CTL is well suited to clarify the characteristics of lymphatic PB and primary chylothorax.This method is an excellent tool for diagnosing these two diseases.

基于CONSORT和STRICTA的浮针治疗肩周炎RCT报告质量评价

目的对浮针治疗肩周炎的临床随机对照试验进行质量评价。方法检索中国知网(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WF)及PubMed等各大数据库中自2001年1月—2021年12月期间发表的所有文献,通过CONSORT声明、STRICTA标准及Cochrane进行质量评价。结果共纳入34篇文献。1篇可从题目直接知晓为RCT;24篇(70.59%)提及随机分组方法;无文献对研究过程中的盲法实施、样本量确定、试验注册、基金资助、操作者资历等信息进行报告;大部分文献对于受试者基线资料变化、试验存在的局限性、机体反应与对照组干预措施的合理性等细则报告不充分。结论目前发表的浮针治疗肩周炎的RCT报告质量总体较低,一定程度影响了结果可靠性。建议后续严格遵循CONSORT声明和STRICTA标准设计与实施临床试验,发表规范且高质量的RCT研究报告,提高证据体系公信力,促使科研成果更好的回馈临床治疗。

Evaluation of retinal and choroidal thickness changes in overweight and obese adults without ocular symptoms by swept-source optical coherence tomography

AIM:To evaluate the relationship of overweight and obesity with retinal and choroidal thickness in adults without ocular symptoms by swept-source optical coherence tomography(SS-OCT).METHODS:According to the body mass index(BMI)results,the adults enrolled in the cross-sectional study were divided into the normal group(18.50≤BMI<25.00 kg/m^(2)),the overweight group(25.00≤BMI<30.00 kg/m^(2)),and the obesity group(BMI≥30.00 kg/m^(2)).The one-way ANOVA and the Chi-square test were used for comparisons.Pearson’s correlation analysis was used to evaluate the relationships between the measured variables.RESULTS:This research covered the left eyes of 3 groups of 434 age-and sex-matched subjects each:normal,overweight,and obesity.The mean BMI was 22.20±1.67,26.82±1.38,and 32.21±2.35 kg/m^(2) in normal,overweight and obesity groups,respectively.The choroid was significantly thinner in both the overweight and obesity groups compared to the normal group(P<0.05 for all),while the retinal thickness of the three groups did not differ significantly.Pearson’s correlation analysis showed that BMI was significantly negatively correlated with choroidal thickness,but no significant correlation was observed between BMI and retinal thickness.CONCLUSION:Choroidal thickness is decreased in people with overweight or obesity.Research on changes in choroidal thickness contributes to the understanding of the mechanisms of certain ocular disorders in overweight and obese adults.

Computed tomography-based nomogram of Siewert type Ⅱ/Ⅲ adenocarcinoma of esophagogastric junction to predict response to docetaxel, oxaliplatin and S-1

BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.

Three-dimensional choroidal vascularity index and choroidal thickness in fellow eyes of acute and chronic primary angle-closure using swept-source optical coherence tomography

AIM:To compare the three-dimensional choroidal vascularity index(CVI)and choroidal thickness between fellow eyes of acute primary angle-closure(F-APAC)and chronic primary angle-closure glaucoma(F-CPACG)and the eyes of normal controls.METHODS:This study included 37 patients with unilateral APAC,37 with asymmetric CPACG without prior treatment,and 36 healthy participants.Using swept-source optical coherence tomography(SS-OCT),the macular and peripapillary choroidal thickness and three-dimensional CVI were measured and compared globally and sectorally.Pearson’s correlation analysis and multivariate regression models were used to evaluate choroidal thickness or CVI with related factors.RESULTS:The mean subfoveal CVIs were 0.35±0.10,0.33±0.09,and 0.29±0.04,and the mean subfoveal choroidal thickness were 315.62±52.92,306.22±59.29,and 262.69±45.55μm in the F-APAC,F-CPACG,and normal groups,respectively.All macular sectors showed significantly higher CVIs and choroidal thickness in the F-APAC and F-CPACG eyes than in the normal eyes(P<0.05),while there were no significant differences between the F-APAC and F-CPACG eyes.In the peripapillary region,the mean overall CVIs were 0.21±0.08,0.20±0.08,and 0.19±0.05,and the mean overall choroidal thickness were 180.45±54.18,174.82±50.67,and 176.18±37.94μm in the F-APAC,F-CPACG,and normal groups,respectively.There were no significant differences between any of the two groups in all peripapillary sectors.Younger age,shorter axial length,and the F-APAC or F-CPACG diagnosis were significantly associated with higher subfoveal CVI and thicker subfoveal choroidal thickness(P<0.05).CONCLUSION:The fellow eyes of unilateral APAC or asymmetric CPACG have higher macular CVI and choroidal thickness than those of the normal controls.Neither CVI nor choroidal thickness can distinguish between eyes predisposed to APAC or CPACG.A thicker choroid with a higher vascular volume may play a role in the pathogenesis of primary angle-closure glaucoma.

Intravascular photoacoustic and optical coherence tomography imaging dual-mode system for detecting spontaneous coronary artery dissection: A feasibility study

In this work,we present an intravascular dual-mode endoscopic system capable of both intravascular photoacoustic imaging(IVPAI)and intravascular optical coherence tomography(IVOCT)for recognizing spontaneous coronary artery dissection(SCAD)phantoms.IVPAI provides high-resolution and high-penetration images of intramural hematoma(IMH)at different depths,so it is especially useful for imaging deep blood clots associated with imaging phantoms.IVOCT can readily visualize the double-lumen morphology of blood vessel walls to identify intimal tears.We also demonstrate the capability of this dual-mode endoscopic system using mimicking phantoms and biological samples of blood clots in ex vivo porcine arteries.The results of the experiments indicate that the combined IVPAI and IVOCT technique has the potential to provide a more accurate SCAD assessment method for clinical applications.

Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety

BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.

Simultaneous fluorescence and Compton scattering computed tomography based on linear polarization X-ray

Purpose To propose a method for simultaneous fluorescence and Compton scattering computed tomography by using linearly polarized X-rays.Methods Monte Carlo simulations were adopted to demonstrate the feasibility of the proposed method.In the simulations,the phantom is a polytetrafluoroethylene cylinder inside which are cylindrical columns containing aluminum,water,and gold(Au)-loaded water solutions with Au concentrations ranging between 0.5 and 4.0 wt%,and a parallel-hole collimator imaging geometry was adopted.The light source was modeled based on a Thomson scattering X-ray source.The phantom images for both imaging modalities were reconstructed using a maximumlikelihood expectation maximization algorithm.Results Both the X-ray fluorescence computed tomography(XFCT)and Compton scattering computed tomography(CSCT)images of the phantom were accurately reconstructed.A similar attenuation contrast problem for the different cylindrical columns in the phantom can be resolved in the XFCT and CSCT images.The interplay between XFCT and CSCT was analyzed,and the contrast-to-noise ratio(CNR)of the reconstruction was improved by correcting for the mutual influence between the two imaging modalities.Compared with K-edge subtraction imaging,XFCT exhibits a CNR advantage for the phantom.Conclusion Simultaneous XFCT and CSCT can be realized by using linearly polarized X-rays.The synergy between the two imaging modalities would have an important application in cancer radiation therapy.