Cone beam computed tomography aided diagnosis and treatment of endodontic cases:Critical analysis

Although intraoral radiographs still remain the imaging method of choice for the evaluation of endodontic patients, in recent years, the utilization of cone beam computed tomography(CBCT) in endodontics showed a significant jump. This case series presentation shows the importance of CBCT aided diagnosis and treatment of complex endodontic cases such as; root resorption, missed extra canal, fusion, oblique root fracture, nondiagnosed periapical pathology and horizontal root fracture. CBCT may be a useful diagnostic method in several endodontic cases where intraoral radiography and clinical examination alone are unable to provide sufficient information.

Prenatal Diagnosis of Proximal Femoral Focal Deficiency Combining Ultrasound and Computer Tomography

Four cases of proximal femoral focal deficiency (PFFD) in an otherwise healthy infant are described. Antenatal diagnosis was made at 27, 23, 23 and 18 weeks of gestation by routine ultrasound (US) examination. Computer Tomography (CT) was performed after 30 weeks of gestation and confirmed the images obtained by US. The diagnosis was confirmed after delivery. These cases illustrate the importance of combining US and CT to improve accuracy of prenatal diagnosis of skeletal disorders.

A handy review of carpal tunnel syndrome:From anatomy to diagnosis and treatment

Carpal tunnel syndrome(CTS) is the most commonly diagnosed disabling condition of the upper extremities. It is the most commonly known and prevalent type of peripheral entrapment neuropathy that accounts for about 90% of all entrapment neuropathies. This review aims to provide an outline of CTS by considering anat-omy, pathophysiology, clinical manifestation, diagnostic modalities and management of this common condition, with an emphasis on the diagnostic imaging evaluation.

A controlled study of positron-emission-tomography and positron-emission-tomography/computed tomography in differential diagnosis of solitary pulmonary nodules—report of 60 cases

The differential diagnosis of solitary pulmonary nodules （SPNs） remains a challenge. It is acknowledged that combining positron-emission tomography （PET） and computed tomography （CT） offers the most reliable noninvasive method for the diagnosis of SPNs. Since Townsend et al1 developed integrated PET/CT in 1999, this technique has increasingly been introduced into clinical practice. To date, nuclear medicine physicians have usually undertaken PET/CT diagnosis, but the question is surfacing as how to make full use of the information of CT image to improve the accuracy of SPN diagnosis. To answer this question, we performed a retrospective study on 60 patients with SPNs.

Differential diagnosis of coronavirus disease 2019 from community-acquired-pneumonia by computed tomography scan and follow-up

Objective Coronavirus disease 2019(COVID-19)is currently the most serious infectious disease in the world.An accurate diagnosis of this disease in the clinic is very important.This study aims to improve the differential ability of computed tomography(CT)to diagnose COVID-19 and other community-acquired pneumonias(CAPs)and evaluate the short-term prognosis of these patients.Methods The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province,China from January 21 to February 28,2020 were retrospectively analysed.The CT manifestations of the two groups were recorded and compared.A correlation analysis was used to examine the relationship between COVID-19 and age,size of lung lesions,number of involved lobes,and CT findings of patients.The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.Results The typical CT findings of COVID-19 are simple ground-glass opacities(GGO),GGO with consolidation or grid-like changes.The sensitivity and specificity of the combination of age,white blood cell count,and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%,respectively.Pulmonary consolidation,fibrous cords,and bronchial wall thickening were used as indicators to exclude COVID-19.The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%,respectively.The follow-up results showed that 67.8%(112/165)of COVID-19 patients had abnormal changes in their lung parameters,and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age.Conclusions Age,white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP.Patients aged over 60 years with COVID-19 have a poor prognosis.This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.

Computer-Aided Design of X-Ray Microtomographic Scanners

The article is to study the development of computer-aided design of X-ray microtomography—the device for investigating the structure and construction of three-dimensional images of organic and inorganic objects on the basis of shadow projections. This article provides basic information regarding CAD of X-ray microtomography and a scheme consisting of three levels. The article also shows basic relations of X-ray computed tomography, the generalized scheme of an X-ray microtomographic scanner. The methods of X-ray imaging of the spatial microstructure and morphometry of materials are described. The main characteristics of an X-ray microtomographic scanner, the X-ray source, X-ray optical elements and mechanical components of the positioning system are shown. The block scheme and software functional scheme for intelligent neural network system of analysis of the internal microstructure of objects are presented. The method of choice of design parameters of CAD of X-ray microtomography aims at improving the quality of design and reducing costs of it. It is supposed to reduce the design time and eliminate the growing number of engineers involved in development and construction of X-ray microtomographic scanners.

Value of CT scan in the diagnosis of primary large bowel lymphoma

Objective: To study the CT imaging of primary large bowel lymphoma and evaluate the value of CT scan. Methods: CT reports of 8 patients with proven primary large bowel lymphoma were retrospectively reviewed. Plain CT scans were done on all patients, enhanced CT scans simultaneously with 5-10 mm section thickness, and 5-10 mm table increments in 6 cases. Results: Primary involved sites were on the cecum (n=3), the ascending colon (n=2), and the rectum (n=1). The tumor was found in multiple areas of the large bowel in 2 cases. CT appearance fell into 3 typical patterns in our study. The first was focal mass type in 2 cases, with one combined with intussusception and retroperitoneal adenopathy; the second was segmental annular involvement type in 3 cases, with one of them combined with mesenteric adenopathy; the last was diffuse involvement type in 2 cases. Multiple nodules were seen in the rectum in 1 case. Conclusion: CT was found to be accurate in detecting the primary sites and complications of lymphoma, and evaluating invasion of adjacent structures; Focal mass type, segmental annular involvement type and diffuse involvement type are the main patterns of CT features in the primary large bowel lymphoma; The features revealed by CT scan are suggestive of primary large bowel lymphoma in some cases.

Multimodality imaging and treatment of paranasal sinuses nuclear protein in testis carcinoma:A case report

BACKGROUND Nuclear protein in testis(NUT) carcinoma is a rare aggressive malignant epithelial cell tumor, previously known as NUT midline carcinoma(NMC), characterized by an acquired rearrangement of the gene encoding NUT on chromosome 15q14. Due to the lack of characteristic pathological features, it is often underdiagnosed and misdiagnosed. A variety of methods can be used to diagnose NMC, including immunohistochemistry, karyotyping, fluorescence in situ hybridization, reverse transcription-polymerase chain reaction, and next-generation sequencing. So far, there is no standard treatment plan for NMC and the prognosis is poor, related to its rapid progression, easy recurrence, and unsatisfactory treatment outcome.CASE SUMMARY A 58-year-old female came to our hospital with a complaint of eye swelling and pain for 8 d. The diagnosis of NMC was confirmed after postoperative pathology and genetic testing. The patient developed nausea and vomiting, headache, and loss of vision in both eyes to blindness after surgery. Magnetic resonance imaging(MRI) and positron emission tomography/computed tomography(PET/CT) performed after 1.5 mo postoperatively suggested tumor recurrence. The patient obtained remission after radiation therapy to some extent and after initial treatment with anti-angiogenic drugs and sonodynamic therapy(SDT), but cannot achieve long-term stability and eventually developed distant metastases, with an overall survival of only 17 mo.CONCLUSION For patients with rapidly progressing sinus tumors and poor response to initial treatment, the possibility of NMC should be considered and immunohistochemical staining with anti-NUT should be performed as soon as possible, combined with genetic testing if necessary. CT, MRI, and PET/CT imaging are essential for the staging, management, treatment response assessment and monitoring of NMC. This case is the first attempt to apply heat therapy and SDT in the treatment of NMC, unfortunately, the prognosis remained poor.

Surgical treatment of abnormal systemic artery to the left lower lobe: A case report

BACKGROUND Abnormal systemic artery to the left lower lobe is a rare congenital abnormality characterized by anomalous communication between the systemic and pulmonary circulation.Owing to its rarity,there is limited clinical experience with respect to the diagnosis and treatment of this disease.CASE SUMMARY We report a 60-year-old man who presented with a history of hemoptysis for 20 d.Contrast-enhanced computed tomography of the chest confirmed the diagnosis of abnormal systemic artery to the left lower lobe,and surgical treatment was performed.The aberrant artery arising from the descending thoracic aorta was ligated,followed by removal of the left lower lobe.The patient showed good recovery and was discharged 6 d after the surgery.At the 1-year follow-up,the patient had recovered completely,and lung CT showed no abnormal findings.CONCLUSION We present a case of abnormal systemic artery to the left lower lobe that was successfully managed by surgical resection of the aberrant artery and the left lower lobe.This case report adds to the clinical experience of diagnosing and treating this rare entity.

Erythrodermic mycosis fungoides: A case report

BACKGROUND Mycosis fungoides is the most common primary cutaneous T-cell lymphoma,whereas generalized erythroderma is rare.In this report,we describe a case of mycosis fungoides with generalized erythroderma using complete clinical data and[18F]fluoroDglucose positron emission tomography/computed tomography(18F-FDG PET/CT)images.CASE SUMMARY Systemic skin redness with desquamation for three years confirmed mycosis fungoides within one month.The patient underwent left axillary lymphadenectomy biopsy;pathological biopsy suggested abnormal T-cell lesions consistent with mycosis fungoides involving lymph nodes.The patient received methotrexate,5 mg twice weekly,as part of their chemotherapy regimen.Patients January half after discharge,no obvious cause of high fever,left axillary lymph nodes with red heat pain,and rupture entered our hospital for treatment.CONCLUSION The 18F-FDG PET/CT is essential for early diagnosis and timely treatment.

Clinicopathological characteristics and typing of multilocular cystic renal neoplasm of low malignant potential

BACKGROUND Up until now,no research has been reported on the association between the cli-nical growth rate of multilocular cystic renal neoplasm of low malignant potential(MCRNLMP)and computed tomography(CT)imaging characteristics.Our study sought to examine the correlation between them,with the objective of distin-guishing unique features of MCRNLMP from renal cysts and exploring effective management strategies.AIM To investigate optimal management strategies of MCRNLMP.METHODS We retrospectively collected and analyzed data from 1520 patients,comprising 1444 with renal cysts and 76 with MCRNLMP,who underwent renal cyst decom-pression,radical nephrectomy,or nephron-sparing surgery for renal cystic disease between January 2013 and December 2021 at our institution.Detection of MC-RNLMP utilized the Bosniak classification for imaging and the 2016 World Health Organization criteria for clinical pathology.RESULTS Our meticulous exploration has revealed compelling findings on the occurrence of MCRNLMP.Precisely,it comprises 1.48%of all cases involving simple renal cysts,5.26%of those with complex renal cysts,and a noteworthy 12.11%of renal tumors coexisting with renal cysts,indicating a statistically significant difference(P=0.001).Moreover,MCRNLMP constituted a significant 22.37%of the patient po-pulation whose cysts demonstrated a rapid growth rate of≥2.0 cm/year,whereas it only represented 0.66%among those with a growth rate below 2.0 cm/year.Of the 76 MCRNLMP cases studied,none of the nine patients who underwent subsequent nephron-sparing surgery or radical nephrectomy following renal cyst decompression experienced recurrence or metastasis.In the remaining 67 patients,who were actively monitored over a 3-year postoperative period,only one showed suspicious recurrence on CT scans.CONCLUSION MCRNLMP can be tentatively identified and categorized into three types based on CT scanning and growth rate indicators.In treating MCRNLMP,partial nephrectomy is preferred,while radical nephrectomy should be minimi-zed.After surgery,active monitoring is advisable to prevent unnecessary nephrectomy.

淀粉样蛋白PET脑成像在阿尔茨海默病诊疗中的价值

阿尔茨海默病是最常见的神经退行性疾病,我国患病人数居全球首位,严重危害老年人健康,家庭照护和社会经济负担巨大。β-淀粉样蛋白PET脑成像技术可在分子水平无创、精准评估阿尔茨海默病患者脑内β-淀粉样蛋白沉积情况,是早期精准诊断及疗效评估的重要方法。

甲状腺相关眼病临床诊治规范的述评

甲状腺相关眼病(TAO)是一种自身免疫性眼眶炎症性疾病,是成年人最常见的眼眶疾病。在临床诊治过程中,很多医生对该病认识不足,诊断和处理方面存在一些误区。本文总结了TAO与甲状腺疾病的关系、TAO的诊断、影像检查、TAO病情判断、治疗方案选择等方面存在的误区,并对其作一评述,以提高内分泌科和眼科医生对该病的认识水平,避免误诊误治。

CT影像组学在肺癌中的应用研究进展

肺癌是全球恶性肿瘤患者死亡的重要原因,其发病率及病死率居高不下,严重影响人类健康。肺癌的早期诊断和治疗是提高患者存活率和改善预后的关键。传统影像学检查在肺癌临床评估方面存在局限性。而影像组学能够将影像数据转化为具有特异性的高维数据,从而提供更全面、高维度的患者影像信息,是目前肺癌研究的新方向。该研究对CT影像组学进行概述,并就CT影像组学在肺癌鉴别诊断、肺癌分型、基因表型与蛋白表达、淋巴结转移和非手术治疗效果评价等方面的研究进展作综述,以期为肺癌的精确诊断和治疗提供新的影像学参考。

特发性非肝硬化性门静脉高压症一例并文献复习

患者男,因间断腹胀1个月余,于2022年3月1日到我院就诊。实验室检查提示患者有脾功能亢进、高甘油三酯血症。腹部增强CT提示脾脏肿大、门静脉高压。胃镜检查提示食管胃底静脉曲张、反流性食管炎(LA-A级)、慢性非萎缩性胃炎伴糜烂。肝组织穿刺活检病理诊断为肝门静脉纤维化。免疫组织化学可见汇管区周围片状和带状肝窦内皮CD34(+),提示动脉供血优势。铁染色:大部分肝细胞质阳性,窦细胞阳性(考虑继发性),未见肝硬化。结合临床表现综合诊断为特发性非肝硬化性门静脉高压症。给予患者口服卡维地洛治疗后腹胀症状好转,出院。由于特发性非肝硬化性门静脉高压症较为罕见,早期症状隐匿,需要联合多种检查手段才能确诊。因此,笔者报道本例的诊疗过程,希望对临床医师提供参考。

80例股骨头坏死患者CT与核磁共振诊治比较

目的：比较采用CT与核磁共振诊治股骨头坏死患者的应用价值。方法选取2012年9月-2014年9月我院骨科收纳的股骨头坏死患者共80例，根据其诊治方法不同将其分为CT组（36例）与核磁共振组（44例）。结果核磁共振组患者中股骨头坏死检出阳性率、病灶检出个数与检出并发有关节积液比例均显著高于CT组（P〈0.05）。结论与CT相比较，采用核磁共振诊断股骨头坏死准确率显著增加，说明核磁共振在诊治股骨头坏死方面具有显著优势。

Utility of cardiac bioenzymes in predicting cardiovascular outcomes in SARS-CoV-2

The relationship between coronavirus disease-19(COVID-19)and cardiovascular diseases has been an important issue.Therefore,cardiac biomarkers and cardiac imaging have an important place in the diagnostic phase.It is important to know the relationship of biomarkers in COVID-19 so that we can understand the diagnosis of the disease,the predicted course and results after diagnosis.

多层螺旋CT三维重建在颌面骨折中的应用

目的 探讨多层螺旋CT三维重建成像在颌面骨折中的临床应用价值。 方法 对38例颌面骨折患者行多层螺旋CT扫描,层厚1 mm或2 mm,在此基础上进行骨密度三维重建和多平面重建,用不同的旋转轴观察不同角度骨折的三维病变图像,对获取的图像进行分析并与X线平片对照。结果多层螺旋CT三维重建成像再现了颌面骨折的病理解剖全貌,38例均能清晰直观地显示颌面骨折的部位、骨折线走向及骨折移住的方向和程度。据此分别制定和实施相应的治疗方案,其中33例行切开复位坚强内固定,5例采用保守疗法,治疗后咬合功能及面部外形均恢复正常。 结论 多层螺旋CT三维重建有助于理解颌面骨折的三维立体形态和复杂的病理解剖关系,为拟定治疗方案提供有价值的信息。

16层螺旋CT血管成像在脑动脉瘤诊断和治疗中的价值

目的评价16层螺旋CT血管成像(CTA)在脑动脉瘤诊断和治疗中的临床应用价值。方法382例临床怀疑脑动脉瘤的患者纳入本研究,全部行16层螺旋CTA检查。运用最大密度投影和容积再现技术评价动脉瘤的形态、大小、位置和瘤颈形态及动脉瘤与颅骨和周围血管的关系,并根据16层螺旋CTA结果选择血管内治疗或外科治疗。结果382例中的203例患者发现223个脑动脉瘤。16层螺旋CTA诊断所有动脉瘤的敏感性、特异性和准确性分别是97.8%、97.8%和97.8%。16层螺旋CTA对于动脉瘤诊断的准确性与DSA的结果差别没有统计学意义。通过CTA评价认为136个动脉瘤适合行血管内治疗,其中132个动脉瘤成功栓塞。53个动脉瘤适合外科夹闭治疗,术中认为所有的动脉瘤被成功夹闭。结论16层螺旋CTA在脑动脉瘤诊断方面具有很高的准确性,并且能够提供足够的诊断信息指导动脉瘤的治疗。

CT静脉成像在布加综合征诊疗中的应用

目的探讨CT静脉成像(CTV)技术在布加综合征(BCS)诊疗过程中的应用价值。方法对2012年1月至2014年1月该院收治的58例BCS患者进行CTV检查,对下腔静脉、肝静脉、门静脉及侧支血管进行重建分析。结果所有患者均完成CTV检查,被明确诊断为BCS。其中下腔静脉隔膜型19例,短段病变型15例,长段病变型8例,肝静脉型9例,合并血栓形成的7例。所有患者均见到侧支血管不同程度的代偿扩张,肝脏硬化及脾脏肿大等表现。结论 CTV技术的应用对于BCS的诊疗具有图像清晰、直观、全面,能够显示病变血管部位、性质及长度的优点,还能观察侧支血管扩张及肝硬化程度。