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Objective: To evaluate the efficacy of artificial intelligence (AI)-assisted pulmonary nodule diagnosis system in predicting the malignant probability of pulmonary subsolid nodule (SN). Methods: Pulmonary SN from 86 patients who underwent surgical resection for pulmonary space-occupying lesions were enrolled and divided into 3 groups according to post operation pathological results, i.e. preinvasive lesions (including atypical adenomatous hyperplasia[AAH]and adenocarcinoma in situ [AIS]) in group 1, microinvasive adenocarcinoma in group 2 and invasive adenocarcinoma in group 3, respectively. Preoperative chest CT data were imported into AI pulmonary nodule diagnosis system to measure CT value and volume, also malignant probability prediction value of each SN. The differences of volume, CT value and malignant probability of SN based on plain and enhanced CT were compared among 3 groups, while the volume, CT value and malignant probability of SN were compared between plain CT and enhanced CT in each group, respectively. The correlations of the predicted malignant probability of all SN according to 3 phase CT images and nodule density and volume were analyzed, respectively. Results: A total of 88 SN were enrolled, including 27 in group 1, 28 in group 2 and 33 in group 3. The sensitivity of all SN detected by AI system was 100% (88/88). The malignant probability of SN based on plain CT, arterial phase and delayed phase of enhanced CT was (85.18 [56.64, 92.08])%, (67.15 [58.99,90.30])% and (89.82 [56.64, 92.23])% in group 1, (93.10 [85.72, 95.75])%, (89.61 [74.44,95.35])% and (92.21 [86.74, 95.59])% in group 2, (97.05 [92.81, 98.74])%, (96.89 [90.40, 98.60])% and (96.49 [89.89, 98.69])% in group 3, respectively. Statistical differences of nodule volume, CT value and the malignant probability of 3 phases CT images were found among 3 groups (all P0.05). The nodule CT values of arterial phase and delayed phase in each group were significantly higher than that of plain CT (all P<0.01).The predicted malignant probabilities according to plain CT, arterial phase and delayed phase enhanced CT were all positively correlated with CT value and volume of SN (all P<0.01). Conclusion: The deep learning-based AI-assisted pulmonary nodule diagnosis system can assist in evaluation on the invasiveness of SN of pulmonary adenocarcinoma based on plain CT data, while enhanced CT has no significant effect on the efficiency of predicting malignant probability.
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Objective: To explore the value of evaluation of the diaphragmatic motion in chronic obstructive pulmonary disease (COPD) patients with dynamic X-ray chest radiography under calm breathing. Methods: Dynamic X-ray chest radiographs were performed in 96 COPD patients (COPD group) and 50 healthy controls (control group) under calm breathing. The range, speed and time of the diaphragmtic motion were obtained and analyzed. Results of lung function tests of 2 groups were recorded. Dynamic X-ray chest radiographs and pulmonary function parameters were compared between 2 groups, and the correlations of diaphragmatic motion parameters and lung function parameters were analyzed, respectively. Results: The left and right side diaphragmatic motion amplitude in COPD group ([18.63±7.45]mm, [15.64±5.98]mm) were larger than those in control group ([14.69±5.40]mm, [13.13±4.84]mm, both P0.05). Conclusion: Using dynamic X-ray chest radiograph could quantitatively analyze the diaphragmatic movement of COPD patients, providing a new examination method for accurate clinical evaluation of COPD.
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Objective To study the value of umbilical artery(UA)combined with fetal middle cerebral artery(MCA)for detecting fetal intrauterine hypoxia.Methods A total of 349 pregnant women undergoing childbirth in our hospital from February 2015 and February 2016 were divided into the observation group(fetal intrauterine hypoxia group)and control group(normal fetus group)according to the existence of fetal intrauterine hypoxia.Then the systolic peak velocity and end-diastolic velocity ratio(S/D),pulse index(PI),resistance index(RI),(S/D)MCA/(S/D)UA,PIMCA/PIUA,RIMCA/RIUA of UA and MCA were compared between the two groups.The sensitivity,specific degree and Youden index of each index for diagnosing fetal hypoxia were statistically analyzed.Results The S/D,PI and RI values of UA at 28-35+6 pregnant weeks and at 36-41 pregnant weeks in the observation group were higher than those in the control group(P＜0.05),while the S/D,PI,RI value of MCA and(S/D)MCA/(S/D)UA,PIMCA/PIUA and RIMCA/RIUA values were lower than those in the control group(P＜0.01).The resistance index corresponding ratios of MCA and UA for diagnosing fetal hypoxia had the highest Youden index.Conclusion The combined use of fetal UA and MCA resistance index ratios has higher clinical value for predicting fetus intrauterine hypoxia.
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Objective To investigate the improvement of postpartum pelvic floor by rehabilitation training assessed with three-dimensional transperineal ultrasound . Methods One hundred cases of healthy postpartum women were randomly divided into two groups :control group and training group .The control group received the customary education ,and the training group received pelvic floor rehabilitation training . At 6 and 12 weeks postpartum ,levator hiatus area ,thickness of the levator ani muscle ,bladder neck mobility ,and bladder posterior horn were measured with three-dimensional transperineal ultrasound in all the subjects . Meanwhile ,the muscle strength situations were tested . Results At 12 weeks postpartum ,the anal levator hiatal area ,bladder neck mobility and bladder posterior horn in the training group were lower than those of the control group[ ( 21 .6 ± 3 .2) cm 2 vs ( 25 .6 ± 2 .4 ) cm 2 ,( 27 .9 ± 5 .3) mm vs ( 31 .5 ± 5 .9) mm ,( 126 .3 ± 21 .2)° vs (135 .3 ± 11 .6)°] ( P < 0 .05) . Compared with control group ,the thickness of the levator ani muscle increased in training group [ ( 13 .6 ± 2 .3) mm vs ( 15 .3 ± 2 .5) mm ] ( P < 0 .05) . The incidence of stress urinary incontinence in the training group ( 5% ) was significantly lower than the control group ( 12 .5% ) at 12 weeks postpartum ( χ2 = 5 .487 , P = 0 .025) . The muscle strength had no significant difference at 6 weeks postpartum . At 12 weeks postpartum ,the pass rate of class Ⅰ muscle fiber was 78 .5% ,and that of class Ⅱ muscle fiber was 83 .3% in the training group ;the pass rate of class Ⅰ muscle fiber was 28 .5% ,and class Ⅱ muscle fiber was 37 .3% in the control group , the improvement was significant at 12 weeks postpartum . Conclusions The result of the transperineal real-time ultrasonographic evaluation of post-natal pelvic floor rehabilitation training has high consistency with the measurement of muscle strength . The ultrasound examination is simple and accurate ,and has highly applicable value in evaluating the effect of post-pelvic rehabilitation training .
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OBJECTIVE: To evaluate image quality of female pelvic computed tomography (CT) scans reconstructed with the adaptive statistical iterative reconstruction (ASIR) technique combined with low tube-voltage and to explore the feasibility of its clinical application. MATERIALS AND METHODS: Ninety-four patients were divided into two groups. The study group used 100 kVp, and images were reconstructed with 30%, 50%, 70%, and 90% ASIR. The control group used 120 kVp, and images were reconstructed with 30% ASIR. The noise index was 15 for the study group and 11 for the control group. The CT values and noise levels of different tissues were measured. The contrast to noise ratio (CNR) was calculated. A subjective evaluation was carried out by two experienced radiologists. The CT dose index volume (CTDIvol) was recorded. RESULTS: A 44.7% reduction in CTDIvol was observed in the study group (8.18 +/- 3.58 mGy) compared with that in the control group (14.78 +/- 6.15 mGy). No significant differences were observed in the tissue noise levels and CNR values between the 70% ASIR group and the control group (p = 0.068-1.000). The subjective scores indicated that visibility of small structures, diagnostic confidence, and the overall image quality score in the 70% ASIR group was the best, and were similar to those in the control group (1.87 vs. 1.79, 1.26 vs. 1.28, and 4.53 vs. 4.57; p = 0.122-0.585). No significant difference in diagnostic accuracy was detected between the study group and the control group (42/47 vs. 43/47, p = 1.000). CONCLUSION: Low tube-voltage combined with automatic tube current modulation and 70% ASIR allowed the low CT radiation dose to be reduced by 44.7% without losing image quality on female pelvic scan.
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Body Mass Index , Feasibility Studies , Genital Diseases, Female/diagnosis , Pelvis/diagnostic imaging , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted , Signal-To-Noise Ratio , Tomography, X-Ray ComputedABSTRACT
Objective To observe the effects of low-frequency pulsed electromagnetic fields (LFPEMFs) on microcirculation angiogenesis in the hindlimbs of diabetic rats with acute ischemia. Methods Models of acute hindlimb ischemia were established in 60 male Sprague-Dawley diabetic rats. The diabetes model was established using 60 mg/kg intraperitoneal injections of streptozotocin (STZ). Fasting blood glucose levels were greater than 300 mg/dL. The rats were randomly divided into experimental and control groups. The rats in the experimental group were exposed to low-frequency pulsed electromagnetic fields for 2 hours each day, while the control group was not given any treatment. Laser-Doppler perfusion was used to measure blood flow in the ischemic hindlimb on days 0,7, 14 and 28 after the operation. The immunofluorescence of rat endothelial cell antigen-1 ( RECA-1) was used to evaluate the changes in angiogenesis. The levels of vascular endothelial growth factor (VEGF) and fibroblast growth factor-2 (FGF-2) were determined by both Western blotting and ELISA, and VEGFR2 and FGFR1 levels in the ischemic skeletal muscle were determined by Western blotting on days 7, 14 and 28 after the operation. Results The average perfusion ratio was significantly greater in the experimental group at days 14 and 28 compared with the control group. RECA-1 density in the tissues had increased significantly in the experimental group at the 14th and 28th day. The same was observed for FGF-2 and its receptor, but there was no significant difference for VEGF or its receptor in either group. Conclusions LFPMEFs can promote angiogenesis in acute hindlimb ischemia of diabetic rats by up-regulating FGF-2. This suggests that LFPMEFs may be useful for preventing and treating lower limb ischemia in diabetic humans.
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<p><b>OBJECTIVE</b>To study the early X-ray and CT findings of patients with severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>Chest radiography and CT were performed in 28 patients with SARS within one to three days after onset of the disease. CT examinations included conventional spiral CT and high-resolution CT (HRCT). The radiographic and CT findings of these patients were analyzed retrospectively.</p><p><b>RESULTS</b>Abnormal CT findings were noted in all the patients, but abnormal chest radiographic findings in 17 cases (60.7%, 17/28). CT showed single small focal patchy opacities in 23 patients (82.1%, 23/28), including oval ground-glass opacities in 20 patients, lobular distribution ground-glass opacities in 2 and small patchy consolidation in one. Multi-focal ground-glass opacities were found in 2 patients and extensive opacities in three. In the 28 patients, a total of 31 lesions were found in the upper (7, 22.6%), middle (3, 9.7%), and lower lobes (21, 67.7%). The diameter of the lesions ranged from 20 to 35 mm.</p><p><b>CONCLUSION</b>The dominant feature of early SARS patients is focal patchy opacity in the lung, and oval small ground-glass opacities are the common morphological findings on CT.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Radiography, Thoracic , Severe Acute Respiratory Syndrome , Diagnostic Imaging , Pathology , Tomography, X-Ray ComputedABSTRACT
Objective To observe the clinical efficacy of Daidzein Capsules(DC) on female climacteric syndrome.Methods Sixty eight patients with climacteric syndrome were randomized into DCgroup(n=37) and Gengnian'an control group (n=31).The treatment group and the control group were orally administered DC 150 mg and Gengnian'an Tablet 4.8 g,three times a day,respectively.The course of treatment lasted three months.Results The total effective rate in DC group was 91.89 %,which was superior to that in the control group.Time of drug becoming effective was shorter in DC group than that in the control group.After treatment,the level of E2 was significantly increased and the content of LH decreased significantly in DC group.Conclusion DC is safe and effective for the treatment of female climacteric syndrome.