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Objective:To investigate the efficiency of deep learning image reconstruction (DLIR) algorithm in the image quality and detection of hypovascular hepatic metastases under low radiation doses in comparison with adaptive statistical iterative construction-V (ASiR-V).Methods:Fifty-six patients with suspected hypovascular hepatic metastases who needed abdominal enhanced CT scans were collected prospectively in the First Affiliated Hospital of Zhengzhou University from January to April 2021. The patients received conventional radiation dose with tube current-time products of 400 mA CT scans in the first venous phase, low-dose CT scans in the second venous phase, which were set as tube current-time products of 280 mA for group A (19 cases), 200 mA for group B (19 cases) and 120 mA for group C (18 case), respectively. The images of first venous phase and 3 groups of second venous phase were both reconstructed with ASiR-V60% and high-DLIR (DLIR-H). Quantitative parameters [image noise, liver and portal vein signal to noise ratio (SNR), contrast to noise ratio (CNR)] and qualitative parameters (overall image quality, lesion conspicuity, diagnostic confidence) were compared between ASiR-V60% and DLIR-H images, and the effective radiation dose (ED) and the lesion detectability of each group was recorded. The paired t test was used to compare quantitative parameters, whereas the Wilcoxon signed-rank test of paired data was used to compare qualitative parameters. Results:In the second venous phase, ED was (5.56±0.35) mSv in group A, (3.88±0.23) mSv in group B, and (2.42±0.23) mSv in group C, with a decrease of 30%, 50% and 70% compared with the first venous phase, respectively. Moreover, with the decrease of radiation dose, the noise gradually increased, and the CNR lesions, SNR liver and SNR portal vein all gradually decreased. DLIR-H images had statistically better quantitative scores than ASiR-V60% images when the same radiation dose was applied (all P<0.001). Furthermore, the qualitative parameters of each group decreased with the decrease of radiation dose. Under the same radiation dose, the overall image quality, lesion conspicuity and diagnostic confidence of DLIR-H were higher than those of ASiR-V60% (all P<0.001). All lesions [100% (84/84)] were detected by ASIR-V60% and DLIR-H in group A, 92.0% (75/81) in group B, and 88.0% (79/89) in group C. Conclusions:Compared with ASiR-V60%, DLIR-H could reduce image noise, improve overall image quality and lesion conspicuity of hypovascular hepatic metastases as well as increase diagnostic confidence under different radiation doses.
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With the development of detection methods, various biomarkers of liver cancer have been detected constantly, which is of great significance for the early diagnosis and real-time monitoring of liver cancer after treatment. Based on the differences in the sensitivity and specificity of different biomarkers, exploration of the value of diverse biomarkers in the diagnosis and prognosis assessment of liver cancer can provide an important reference for clinicians to scientific and rational application of distinct biomarkers.
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Objective@#To explore the therapeutic value of interventional methods for hemorrhage caused by mandibular arteriovenous malformations.@*Methods@#The clinical data of 7 patients (3 males and 4 females) with mandibular arteriovenous malformations treated by interventional therapy from January 2012 to January 2018 in the First Affiliated Hospital, Zhengzhou University were retrospectively analyzed. Of all patients, 4 patients suffered from sudden massive hemorrhage and 3 patients suffered from spontaneous repeated bleeding. The age ranged from 8.0 to 13.0 (10.6±1.7) years. Of the 7 patients, 3 underwent interventional embolization via arteries and veins, and 4 underwent embolization only via arteries. The embolic materials were polyvinyl alcohol granules and coils. The follow-up period was 9—18 months and the curative effect was observed.@*Results@#Among the 7 patients, 4 cases of acute massive hemorrhage were effectively controlled after interventional operation, 3 cases of chronic bleeding disappeared after interventional operation. No recurrence of bleeding occurred during the follow-up period, only 1 patient presented with oral infection and gingival swelling and hyperplasia. The symptoms were effectively controlled after anti-infection and debridement. No severe complications occurred in all patients.@*Conclusion@#Interventional therapy for ateriovenous malformation with hemorrhage is effective, safe and feasible, which is worthy of clinical application.
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Objective:To explore the therapeutic value of interventional methods for hemorrhage caused by mandibular arteriovenous malformations.Methods:The clinical data of 7 patients (3 males and 4 females) with mandibular arteriovenous malformations treated by interventional therapy from January 2012 to January 2018 in the First Affiliated Hospital, Zhengzhou University were retrospectively analyzed. Of all patients, 4 patients suffered from sudden massive hemorrhage and 3 patients suffered from spontaneous repeated bleeding. The age ranged from 8.0 to 13.0 (10.6±1.7) years. Of the 7 patients, 3 underwent interventional embolization via arteries and veins, and 4 underwent embolization only via arteries. The embolic materials were polyvinyl alcohol granules and coils. The follow-up period was 9—18 months and the curative effect was observed.Results:Among the 7 patients, 4 cases of acute massive hemorrhage were effectively controlled after interventional operation, 3 cases of chronic bleeding disappeared after interventional operation. No recurrence of bleeding occurred during the follow-up period, only 1 patient presented with oral infection and gingival swelling and hyperplasia. The symptoms were effectively controlled after anti-infection and debridement. No severe complications occurred in all patients.Conclusion:Interventional therapy for ateriovenous malformation with hemorrhage is effective, safe and feasible, which is worthy of clinical application.
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Objective To investigate the safety and feasibility of the interventional therapy on hemobilia induced by hepatic artery pseudoaneurysm(PsAn).Methods The clinical data of 28 patients with hemobilia in our department was analyzed retrospectively.All the patients were firstly treated with internal medicine,and then treated by interventional therapy.The angiography clearly displayed the shape,size and location of the PsAn,and superselective embolism was performed during the operation.The symptomatic treatment and the bile duct drainage were performed after operation.Postoperative follow-up time was 1-3 6 months,and the follow-up endpoint was the death of patient.Results 28 patients were diagnosed as hepatic artery PsAn.The interventional embolization therapy on hemobilia was completely effective.A total of 110 spring coils were applicated in the study,there was no complication related to interventional therapy.One patient with hilar cholangiocarcinoma was dead due to infection and liver failure after four weeks of operation.Two patients with choledochal carcinoma died of tumor progression after 11.5 and 14.2 months of interventional therapy,respectively.In addition,2 patients with gastric carcinoma died of tumor progression after 4 and 6.5 months of operation,respectively,and 1 patient with common bile duct stones who underwent laparoscopic surgery died of complications of coronary heart disease after 5 months of interventional therapy. The other patients all had satisfactory therapeutic effect and recovered well.Conclusion The interventional therapy has definite therapeutic effect on hemobilia induced by hepatic artery PsAn.The technique is worthy of popularized clinically due to its features of simplicity,safety and reliablity.