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Objective:To investigate the characteristics of thymus in patients with COVID-19, and to analyze the CT features and dynamic changes of thymus.Methods:Data of 241 patients diagnosed with COVID-19 admitted to Chongqing Three Gorges Central Hospital from Jan. to Mar. 2020 were retrospectively analyzed, and 242 consecutive subjects were selected as the control group from Nov. to Dec. 2019. The thymus classification, size, and average CT values between COVID-19 patients and the control group were compared, as well as those among different clinical types for COVID-19 patients, before and after treatment, were analyzed.Results:① The attenuation of the thymus: 64.7% (156/241) complete fatty replacement thymus, 17.8% (43/241) predominantly fatty thymus, 11.2% (27/241) approximately one-half fatty and one-half soft-tissue-attenuation thymus, and 6.2% (15/241) predominantly soft-tissue thymus in COVID-19 patients were found. 48.3% (117/242) complete fatty replacement thymus, 25.6% (62/242) predominantly fatty thymus, 10.3% (25/242) approximately one-half fatty and one-half soft-tissue-attenuation thymus, and 15.7% (38/242) predominantly soft-tissue thymus were found in the control group. Complete fatty replacement thymus was an independent factor affecting COVID-19 in 40 to 59 years old patients ( OR=3.071, P=0.000) . The rate of complete fatty replacement thymus: severe or critical type > common type > mild type. ② Size: There was no statistical difference of the thymus size between COVID-19 patients and the control group ( P>0.05) , no statistical difference among the mild type, common type and severe or critical type ( P>0.05) , no statistical difference between before and after treatment ( P>0.05) , and there was no correlation with treatment duration ( r=0.047, r=0.071) . ③ Density: There was no statistical difference of the CT value of thymus between COVID-19 patients and the control group ( P>0.05) , no statistical difference among the mild, common and severe type ( P>0.05) . One patient had a 17 HU increase in thymus density after treatment, but there was no statistical difference in 78 patients in thymus CT values between before and after treatment ( P>0.05) , and there was no correlation with treatment duration (r=0.013) . Conclusions:COVID-19 patients have a high rate of complete fatty replacement thymus. And the heavier the clinical classification, the higher the rate of complete fatty replacement thymus. Complete fatty replacement thymus is a risk factor for COVID-19 patients in 40 to 59 years old.
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Objective@#To investigate the value of initial CT quantitative analysis of ground-glass opacity (GGO), consolidation, and total lesion volume and its relationship with clinical features for assessing the severity of coronavirus disease 2019 (COVID-19). @*Materials and Methods@#A total of 84 patients with COVID-19 were retrospectively reviewed from January 23, 2020 to February 19, 2020. Patients were divided into two groups: severe group (n = 23) and non-severe group (n = 61). Clinical symptoms, laboratory data, and CT findings on admission were analyzed. CT quantitative parameters, including GGO, consolidation, total lesion score, percentage GGO, and percentage consolidation (both relative to total lesion volume) were calculated. Relationships between the CT findings and laboratory data were estimated. Finally, a discrimination model was established to assess the severity of COVID-19. @*Results@#Patients in the severe group had higher baseline neutrophil percentage, increased high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and lower baseline lymphocyte count and lymphocyte percentage (p < 0.001). The severe group also had higher GGO score (p < 0.001), consolidation score (p < 0.001), total lesion score (p < 0.001), and percentage consolidation (p = 0.002), but had a lower percentage GGO (p = 0.008). These CT quantitative parameters were significantly correlated with laboratory inflammatory marker levels, including neutrophil percentage, lymphocyte count, lymphocyte percentage, hs-CRP level, and procalcitonin level (p < 0.05). The total lesion score demonstrated the best performance when the data cut-off was 8.2%. Furthermore, the area under the curve, sensitivity, and specificity were 93.8% (confidence interval [CI]: 86.8–100%), 91.3% (CI: 69.6–100%), and 91.8% (CI: 23.0–98.4%), respectively. @*Conclusion@#CT quantitative parameters showed strong correlations with laboratory inflammatory markers, suggesting that CT quantitative analysis might be an effective and important method for assessing the severity of COVID-19, and may provide additional guidance for planning clinical treatment strategies.
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Objective Toexplorethecorrelationbetween MRIcharacteristicsandaxillarylymphnode metastasisofmass-type breastcancer.Methods MRIcharacteristicsandpathologicalresultsofpostoperativeaxillarylymphnode metastasisin187cases withmass-typebreastcancerwereanalyzedretrospectively.Accordingtothenumberoflymphnodemetastases,allofthepatients weredividedintothefourgroups:pN0,pN1,pN2andpN3.Thecorrelationbetween MRIsignsand N pathologicalstagesineach groupwereanalyzed.Results Therewere108casesinpN0group,33casesinpN1group,22casesinpN2groupand24casesinpN3 groupI.nthedifferentgroups,therewere15,5,1and1casewithroundmassrespectively;8,1,1and0casewithlobularmasserespectively;85, 27,20and23caseswithirregularmasserespectively.Theshapeswerenotsignificantlydifferentamongthedifferentgroups(P>0.05)I.nthe differentgroups,therewere7,0,1and0casewithclearmarginrespectively;69,14,7and8caseswithirregularmarginrespectively;32,19,14and16caseswithspiculatedmarginrespectively.Themarginsweresignificantlydifferentamongthedifferentgroups(P<0.05)I.nthe differentgroups,therewere55,16,14and18caseswithheterogenousenhancementrespectively;43,14,5and6caseswithringenhancement respectively;3,1,1and0casewithcentralenhancementrespectively;7,2,2and0casewithseptumenhancement.Theenhancement patternswerenotsignificantlydifferentamongthedifferentgroups (P>0.05).ThenumbersofthemasswithtypeⅠ,ⅡandⅢtime-signalcurvesandtheADCvalueswerenotsignificantlydifferentamongthedifferentgroups(P>0.05).Conclusion MRIfeaturesof mass-typebreastcancershavelimitedvalueindeterminingaxillarylymphnodemetastasis.However,thespiculatedmarginofmassis valuableindeterminingaxillarylymphnodemetastasis.
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Objective To investigate the diagnostic value of susceptibility-weighted imaging (SWI)in the application of mild traumatic brain injury.Methods The clinical data of 78 patients with mild traumatic brain injury were analyzed retrospectively.All patients received SWI and conventional MRI examination (T1WI, T2WI and FLAIR), and the number of intracerebral hemorrhagic lesions was compared between SWI and conventional MRI.Results The number of intracerebral hemorrhagic lesions of SWI examination was significantly much than that of conventional MRI examination: 39.74% (31/78)vs.21.79%(17/78),and there was statistical difference(χ2=5.898,P=0.015).SWI depicted 156 hemorrhagic lesions,and conventional MRI(T1WI,T2WI and FLAIR)depicted 16,26 and 37 hemorrhagic lesions.SWI depicted a significantly higher number of hemorrhagic lesions than conventional MRI,and there was statistical difference(Z=-4.563,-4.476 and-4.478;P<0.01).The Glasgow coma score on admission in patients with hemorrhagic lesions of SWI examination was significantly lower than that in patients without hemorrhagic lesions of SWI examination:(14.23 ± 0.80)scores vs.(14.84 ± 0.48)scores, and there was statistical difference (Z =- 3.956, P<0.01).The number of intracerebral hemorrhagic lesions in SWI examination was negative correlation with Glasgow coma score on admission(rs=-0.471, P = 0.008).Conclusions SWI has higher sensitivity in detecting intracerebral hemorrhages compared with conventional MRI.It can objectively and accurately evaluate the severity of patients with mild traumatic brain injury.
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Objective To describe the MSCT manifestations of different pathological grading of gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN)and to improve the understanding of CT characteristics of this disease.Methods MSCT images and pathological results of 38 GEP-NEN proved by surgical pathology were analyzed retrospectively in our hospital.All of the tumors were graded as G1 to G3.Measured respectively the CT value of the same location of each tumor in the noncontrast enhanced phase, arterial and venous phase.And divided them into mild,moderate and obvious.Statistically analyzed the number of tumors with different degree of enhancement.Results In arterial and venous phase of G1 group,the number of mild enhancement was respectively 3 and 0 case, the number of moderate enhancement was respectively 6 and 8 cases,and the number of obvious enhancement was respectively 7 and 8 cases.In arterial and venous phase of G2 group,the number of mild enhancement was respectively 2 and 0 case,the number of moderate enhancement was respectively 4 and 6 cases,and the number of obvious enhancement was respectively 4 and 4 cases.In arterial and venous phase of G3 group,the number of mild enhancement was respectively 9 and 4 cases,the number of moderate enhancement was respectively 3 and 8 cases,and the number of obvious enhancement was respectively 0 and 0 case.Kruskal-Wallis rank sum test was performed for the number of tumor enhancement,the result was P<0.05.Conclusion MSCT multi-phase enhancement is valuable in judging the pathological grade of GEP-NEN.Arterial phase usually shows moderate to obvious enhancement in G1 group.The enhancement of tumors with higher grade shows a trend of decrease in arterial phase,while shows mild to moderate enhancement in venous phase.
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Objective To investigate the diagnosis value of 128-slice spiral CT in patients with adult intussusception. Methods Direct features of 128-slice spiral CT of 63 adult intussusception patients confirmed by operation and pathology were analyzed retrospectively. Results In 63 cases of intussusceptions, 1 case had idiopathic intussusception, and the other 62 cases had secondary intussusception (1 case with multiple intussusceptions). Direct signs included:target signin 60 cases,double intestines signin 59 cases,blood vessel curling signin 56 cases, andcomet-tail signandkidney signin 51 cases. Lipoma was the most common benign lesions of intussusception, and colon cancer was the most common malignant lesions of intussusception. Conclusions The 128-slice spiral CT combined with multiple plane restructuring has the important value in diagnosing adult intussusception.
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Objective To compare imaging features and to evaluate clinical values of aortic dissection(AD) with MRI and spiral CT.Methods MRI and spiral CT findings of AD in 18 cases confirmed by clinical or surgical pathology were analysed retrospectively.Results The sensitivity and specificity of two advanced techniques in diagnosis of AD were high.MRI and CT showed the dimension,true or false lumen,intimal flap,intimal tear,thrombus and intramural hematoma of AD,aortic dilatation or stenosis and the major aortic branches.Conclusion The two techniques are important for the suspect AD,two techniques are similar to display the features of dimension,classification,true or false lumen and aortic dilatation or stenosis,MRI plays an important role in diagnosis of AD and is better than CT in demonstrating the intimal flap,intimal tear,thrombus,intramural hematoma and the involvement of the major aortic branches,there were limitation in demonstrating calcification of intimal flap or vascular wall and emergency patients.