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1.
Article in Chinese | WPRIM | ID: wpr-908631

ABSTRACT

Objective:To evaluate the clinical effect of Toric design orthokeratology in myopic teenagers with mild-to-moderate astigmatism.Methods:A non-randomized controlled clinical study was conducted.Eighty juvenile myopia patients (160 eyes) diagnosed with mild to moderate astigmatism with myopia after mydriatic computer optometry and received the treatment of orthokeratology at Zhejiang Rongjun Hospital from January 2016 to June 2017 were enrolled.The patients were divided into regular spherical design orthokeratology group and Toric design orthokeratology group, with 80 eyes (40 cases) in each group.The patients wore orthokeratology for 8 to 10 hours every night and were re-examined at 1 day, 1 week and 1, 3, 6, 12 and 18 months after wearing, respectively.The visual acuity, refraction, corneal health status and central deviation of the treatment area in the corneal topography map were measured and recorded during the 18-month treatment.The complications during treatment were recorded.After 12-month wearing, the uncorrected visual acuity and the center deviation of the treatment area were compared between the two groups.After 18-month wearing, patients in the two groups stopped wearing the orthokeratology lens for 1 month, and then the refraction examination, IOLMaster and corneal topography were performed to compare the spherical equivalent, axial length and degree of astigmatism.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhejiang Rongjun Hospital (No.2020-10). Written informed consent was obtained from guardians prior to any medical examination.Results:After 12-month wearing, the center deviation of the shaping treatment area was (0.86±0.23)mm in the Toric design orthokeratology group, which was significantly lower than (1.16±0.44)mm in the regular spherical design orthokeratology group ( t=5.404, P<0.001). After 12-month wearing, the uncorrected visual acuity was (0.03±0.08) LogMAR in the Toric design orthokeratology group, which was significantly higher than (0.09±0.10) LogMAR in the regular spherical design orthokeratology group ( t=2.963, P=0.004). The spherical equivalent and the axial length of Toric design orthokeratology group were significantly smaller than those of the regular spherical design orthokeratology group ( t=2.542, 2.107; both at P<0.05), and there was no statistically significant difference in the degree of astigmatism between the two groups ( t=0.821, P=0.413). During the 18-month follow-up, the adverse reaction, punctate corneal epithelial opacity, occurred in 18 eyes.The incidence of adverse effect was 6.26%(5/80) in the Toric design orthokeratology group, which was significantly lower than the 16.25% (13/80) in the regular spherical design orthokeratology group ( χ2=3.897, P=0.048). Conclusions:The Toric design orthokeratology shows better efficacy in myopia control as well as reducing the adverse reaction rate in juvenile myopia, and it can better solve the deviation in corneal shaping in the use of regular spherical design orthokeratology.

2.
Article in Chinese | WPRIM | ID: wpr-910855

ABSTRACT

Objective:To investigate the relationship between abdominal visceral adipose tissue (VAT) and cardiometabolic risk (CMR) through quantitative computed tomography (QCT).Methods:The present study included 76226 participants. Abdominal fat areas were measured using the QCT Pro Model 4 system. Cardiometabolic indices were collected, including systolic and diastolic blood pressures, fasting plasma glucose, total cholesterol, triglyceride, and low-density and high-density lipoprotein cholesterols CMR score was the sum of abnormal blood pressure, fasting glucose, triglyceride, and high-density lipoprotein cholesterol. Restricted cubic spline and ordered logistic regression models were applied.Results:The mean age was 50±13 years and the percentage of men was 58.8%. The level of VAT area was higher in men than in women (191.7±77.1 cm 2 vs 116.4±56.2 cm 2, P<0.0001 for all). After adjustment for age, the cardiometabolic indices except high-density lipoprotein cholesterol increased with increasing VAT area. When VAT area was 300 cm 2, age-adjusted odds ratios and 95% confidence intervals of a CMR score ≥ 1 were 14.61 (13.31, 16.04) for men and 5.46 (4.06, 7.36) for women, and the age-adjusted probability of a CMR score ≥ 3 was 31.7% for men and 31.3% for women. Conclusions:QCT-derived VAT is closely related to CMR. The findings suggest that measurement of visceral fat is recommended for the management of abdominal obesity in subjects who agree to undergo lung cancer screening via low-dose CT without additional radiation exposure.

3.
Article in Chinese | WPRIM | ID: wpr-883234

ABSTRACT

Objective:To investigate the application value of spectral computed tomo-graphy (CT) multi-parameter imaging in predicting gastric cancer lymph node metastasis.Methods:The retrospective case-control study was conducted. The clinicopathological data of 86 patients with gastric cancer who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2014 to June 2017 were collected. There were 53 males and 33 females, aged from 22 to 87 years, with a median age of 53 years. All patients received abdominal plain scan and arterial and venous phase contrast spectral scan. Images of plain scan, 70 keV monochromatic and iodine-based images in arterial and venous phase were analyzed on post-processing working station. Observation indicators: (1) gastric cancer lymph node metastasis; (2) analysis of influencing factors for lymph node metastasis in gastric cancer; (3) introduction of special cases. Count data were described as absolute numbers. Univariate analysis was performed using the chi-square test or rank sum test. Multivariate analysis was conducted using the Logistic regression model.Results:(1) Gastric cancer lymph node metastasis: of the 86 patients, 64 cases had lymph nodes metastasis and 22 had no lymph nodes metastasis. (2) Analysis of influencing factors for lymph node metastasis in gastric cancer: results of univariate analysis showed that tumor growth pattern, tumor diameter, infiltration of peritumor fat, CT value in arterial phase, CT value in venous phase, iodine value in venous phase were related factors affecting lymph nodes metastasis in gastric cancer ( χ2=6.753, Z=-3.180, χ2=7.649, Z=-2.051, -2.971, -2.547, P<0.05). Results of multivariate analysis showed that infiltration of peritumor fat and the iodine value in venous phase were greater than 12(100 μg/cm 3) and not greater than 16(100 μg/cm 3), or greater than 16(100 μg/cm 3) were independent risk factors affecting lymph nodes metastasis in gastric cancer ( odds ratio=13.154, 3.761, 7.583, 95% confidence interval as 2.597-66.620, 1.893-8.572, 4.769-16.692, P<0.05). (3) Introduction of special cases: case 1 was male, aged 46 years. Results of preoperative spectral CT enhanced scan showed gastric antrum space occupying lesion combined with enlarged lymph nodes. During enhancement arterial phase, spectral CT 70 keV monochromatic images and corresponding iodine-based images of primary lesion layer in the transverse view showed gastric wall thickening with mild to moderate enhancement, clear fat space in serosa and enlarged lymph nodes in lesser curvature. The spectral CT 70 keV monochromatic images and corresponding iodine-based images below pylorus level in the transverse view showed subpyloric enlarged lymph nodes. During enhancement venous phase, the 70 keV monochromatic images and corresponding iodine-based images of primary lesion layer in the transverse view showed layered enhancement of gastric antrum lesions and mucosal enhancement, with a high iodine value. The patient was diagnosed as gastric antrum cancer with lymph node metastasis, no serosal or peritumoral fat invasion. Results of postoperative pathological examination showed moderately differentiated adenocarcinoma of gastric antrum with serosal invasion and lymph node metastasis. Case 2 was male, aged 53 years. Results of preoperative spectral CT enhanced scan showed gastric cancer of lesser curvature combined with enlarged lymph nodes. During enhancement arterial phase, 70 keV monochromatic images and corresponding iodine-based images of primary lesion layer in the transverse view showed gastric wall heterogeneous thickening of lesser curvature, with moderate enhancement, obscure peritumor fat space, unclear serosa, and multiple enlarged lymph nodes in lesser curvature. During enhancement venous phase, 70 keV monochromatic images in the transverse view showed unclear boundary between lesions and enlarged lymph nodes in lesser curvature, obscure peritumor fat. During enhancement arterial phase, 70 keV monochromatic images of celiac trunk layer in the transverse view showed parasplenic artery lymph nodes, with circular enhancement and no enhancement in central necrotic elements. The patient was diagnosed as gastric cancer of lesser curvature with lymph node metastasis, serosal and peritumor fat invasion. Results of postoperative pathological examination showed poorly differentiated adenocarcinoma of gastric antrum with serosal invasion and lymph node metastasis. Conclusion:The infiltration of peritumor fat and iodine value in venous phase are independent factors affecting gastric cancer lymph node metastasis.

4.
China Pharmacy ; (12): 1537-1542, 2021.
Article in Chinese | WPRIM | ID: wpr-881452

ABSTRACT

OBJECTIVE:To provide reference for the c onstruction of subject diagnosis and treatment scheme in drug clinical trials. METHODS :The subject diagnosis and treatment module was developed and implemented in our hospital on the basis of CTMS,and its effects were evaluated. RESULTS :A subject diagnosis and treatment module was established in CTMS of our hospital. Within one year from the launch of the module in the middle of October ,2019,the overall number of subjects in the group showed an increasing trend ,and the overall mean dropout rate of subjects was 0.16%. The data interface of CTMS system , hospital information system (HIS),laboratory information management system ,medical imaging information system had been established,so as to realize the synchronization of subject information (displaying subject identification in HIS system )and the interaction of diagnosis and treatment information and billing data (patients and subjects were charged separately ). Since the launch of the module ,the amount of data generated by the interface had been increasing ,and the number of departments producing the subject diagnosis and treatment business had been increasing month by month. Compared with subject diagnosis and treatment project based on HIS system ,the number of subject diagnosis and treatment business based on CTMS system was increased significantly(P<0.05). CONCLUSIONS :The subject diagnosis and treatment module based on CTMS improves the efficiency of subject diagnosis and treatment project implementation and financial settlement ,and realizes the efficient implementation of drug clinical trial projects in large general hospitals.

5.
Article in Chinese | WPRIM | ID: wpr-847289

ABSTRACT

BACKGROUND: The clinical effect of spinal cord injury is usually unfavorable due to the lack of axon regeneration and the formation of glial scar. Schwann cells, as the support cells for nerve regeneration, have poor migration ability in the central nervous system with abundant astrocytes, which limit its effect on axon regeneration. OBJECTIVE: To explore the effect on the migration of Schwann cells containing superparamagnetic nanoparticles loaded with chondroitinase ABC (ChABC) in the region of astrocytes in the external magnetic field. METHODS: Schwann cells and astrocytes were extracted from sciatic nerves and brachial plexus and cerebral cortex of Sprague-Dawley rats of postnatal day 1 to 3. Cell purity was identified by immunofluorescence staining. The toxicity of superparamagnetic nanoparticles (PEI-SPIONs) to Schwann cells was analyzed by live/dead cell staining. Schwann cells were transfected with PEI-SPIONS in an external magnetic field of 1.4Td for 2 days. The optimal transfection concentration of PEI-SPIONS used was 2 mg/L and the optimal mass ratio of PEI-SPIONS to ChABC was 1:4. Cell migration test was used to evaluate the migration ability of not-treated Schwann cells, PEI-SPIONs/ ChABC transfected Schwann cells, and PEI-SPIONs/ChABC transfected Schwann cells in an external magnetic field. RESULTS AND CONCLUSION: The purity of Schwann cells and astrocytes reached to (91.7±1.2)% and (93.3±2.2)%, respectively. Compared with the Schwann cells group, the number of PEI-SPIONs/ChABC-transfected Schwann cells that entered the region of astrocytes was significantly increased (P < 0.05). Under the external magnetic field, the number of PEI-SPIONs/ChABC-transfected Schwann cells that entered the region of astrocytes and the cell migration distance were significantly increased as compared with the Schwann cells group (P < 0.005). In summary, PEI-SPIONs/ChABC transfection can enhance the ability of Schwann cells to break the glial scar, and increase the fusion of astrocytes. Under the guidance of external magnetic field, the migration ability of Schwann cells is significantly elevated. This method may be a new strategy to promote nerve regeneration after spinal cord injury.

6.
Chinese Journal of Orthopaedics ; (12): 653-660, 2020.
Article in Chinese | WPRIM | ID: wpr-869008

ABSTRACT

Objective:To explore the clinical, imaging manifestations, treatment methods and prognosis of primary angiosarcoma of longbone, with the aim of improving the diagnosis and treatment.Methods:During April 2014 to April 2018, 5 patients with histopathologically-proven primary angiosarcoma of longbone were enrolled in this retrospective study, clinicaland imagingcharacteristics wereanalysiaed. Thetreatment and follow-up results werediscussed.There were 3 males and 2 females; the age ranged from 27 to 79 years and an average age of 45.2±3.5 years. Theproximal humeruswas1case. Thedistal humeruswas1case.The proximalfemur was 2 cases.Thediatalfemur was 1case. Pathological fracturewas2case.According to the tumor site and the presence or absence of pathological fractures, lesion curettage and large-scale resection were taken separately. Adjuvant treatment was given according to the patient's condition after surgery. The length of the lesion wasmeasured and recorded. The X-ray, CT, MRI and nuclear medicine imaging features of the tumor and its characteristics were recorded and analyzed. The pathological characteristics of the tumor were recorded and analyzed. The treatment of the tumor and treatment effect and prognosis were analyzed.Results:The clinical manifestations of angiosarcoma of long bone are non-specific,local pain and swelling. The imaging manifestationsin X-ray, CT and MRI imaging have certain characteristics, such as osteolytic bone destruction in bone marrow cavity and/orcorti-calmostly,without scleroticrim, soft tissue mass, centripetal non-progressive filling and unevenenhancement or nodules gradual enhancement. The length of the tumor lesion is usually larger, the size is about 6.6±1.2 cm. The expression of CD31 and CD34 inosteoangio sarcoma lesions was higher, and the positiverate of ERG expression was about 100%. The survival time of 2 patients who underwent adjuvant chemotherapy after surgery was15 months, 37 months with median survival time was28 months. One patient who survived radiotherapy survived for 40 months. The survival time of 2 patients who underwent surgery alone was 8 months, 30 months, and the median survival time was19 months.Conclusion:Imaging finding scan beused as adjunctive diagnois of the primary angio sarcoma of bone. ERG is the most specific and sensitive marker in the pathological diagnosis of osteoangiosarcoma. Surgical resectionis still the first choice of treatment for long bone angiosarcoma. Surgical combined with radiotherapy can appropriately extend the survival time, and this program can be used as a treatment method chosen by doctors and patients.

7.
Article in Chinese | WPRIM | ID: wpr-868768

ABSTRACT

Objective To study the use of abdominal enhanced CT imaging and quantitative index analysis in the differential diagnosis of hepatic epithelioid hemangioendothelioma (HEH) and hepatic metastasis.Methods A study group of 12 patients with HEH who underwent abdominal enhanced CT scanning at the First Affiliated Hospital of Zhengzhou University from February 2014 to October 2018 was retrospectively compared with a control group of 52 patients with hepatic metastases diagnosed clinically and by imaging examinations.The general information and imaging data of these patients were collected and analyzed.Results The lesions in the 2 groups mainly presented as multiple and diffuse lesions.The diffuse lesions of HEH often fused into strips.The hepatic metastasis group showed a higher CT attenuation and TNR in the portal vein phase than the HEH group (P < 0.05).The area under the ROC curves of the two indexes were 0.756 and 0.841 respectively.The centers of the lesions showed almost no or slightly homogeneous enhancement in the HEH group,while the liver metastasis group showed slightly and moderately heterogeneous enhancement,with a significant difference between the two groups (P < 0.05).Female,subcapsular distribution,capsular contraction,target ring sign and lollipop sign were independent risk factors for HEH (P <0.05),while a high CT attenuation and TNR in the portal vein phase,elevated tumor markers and lymph node metastasis were independent risk factors for liver metastasis on logistic regression analysis (P < 0.05).Conclusions CT attenuation,TNR,central enhancement features in the portal vein phase,special signs and secondary changes of lesions were helpful for the differential diagnosis between HEH and liver metastasis.

8.
Article in Chinese | WPRIM | ID: wpr-868519

ABSTRACT

Objective:To evaluate the image quality of dual-source computed tomography pulmonary angiography (DE-CTPA) with low-dose contrast agent using the advanced modeled iterative reconstruction (ADMIRE) method with 70 kVp and non-linear blending in overweight patients.Methods:Seventy patients (normal BMI, 35; overweight, 35) with suspected pulmonary embolization who underwent DE-CTPA between October 2018 and March 2019 were included in this study. The imaging protocol included assessments at 70 kV/sn150 kV with 30 ml of contrast agent, and images were obtained at 70 kVp and 150 kVp with and without linear blending. The CT value, SD value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of pulmonary arteries were compared and analyzed among groups 1 (70 kVp, normal BMI), 2 (non-linear blending, normal BMI), 3 (70 kVp, overweight), and group 4 (non-linear blending, overweight). The radiation dose parameters included CT volume dose index (CTDI vol), dose length product (DLP), and effective dose ( E). Results:The CT values for the pulmonary artery did not show significant differences among the four groups ( P>0.05). The SD value of the segmental artery in group 1 was higher than that in group 4 ( t=2.69, P<0.05). The SNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.44, 5.40, P<0.05), while the corresponding value of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.52, 1.52, P<0.05). The CNR values of the pulmonary artery trunk and sub-segmental artery in group 2 were higher than those in group 3 ( t=1.45, 5.01, P<0.05) and that of the left pulmonary artery trunk in group 2 was higher than those in groups 3 and 4 ( t=1.50, 1.50, P<0.05). The E values for normal BMI and overweight patients were(1.60±0.54)mSv and(1.88±0.45)mSv, respectively. Conclusions:For overweight patients, the CTPA protocol using ADMIRE with a 70 kV/sn150 kV scanning mode could yield diagnostic image quality with significantly lower radiation and contrast material doses.

9.
Chinese Journal of Radiology ; (12): 1085-1088, 2020.
Article in Chinese | WPRIM | ID: wpr-868369

ABSTRACT

Objective:To explore the CT imaging and clinical features of gastritis cystica profunda (GCP) and improve the level of diagnosis.Methods:From June 2015 to August 2019, the clinical and CT imaging data of 9 GCP patients confirmed by pathology in the First Affiliated Hospital of Zhengzhou University were retrospectively collected. These 9 GCP patients included 3 male and 6 female, aged from 44 to 66 years, with an avereage age of (59±7) years. All the 9 patients underwent plain and enhanced abdominal CT scan. The location, shape, size, margin, density, enhancement pattern and enhancement degree of the lesions were analyzed and summarized.Results:The lesions are more common in gastric antrum (3 cases) and gastric fundus (3 cases). CT imaging showed thickening gastric wall thickening in 3 cases, circular ovoid or circular mass shadow protruding into the gastric cavity in 6 cases. Solid components were dominant in 2 cases and cystic components were dominant in 7 cases. In arterial phase, solid components showed significantly enhancement in 6 cases and moderate enhancement in 3 cases, while muscle layer of lesions were characterized by mild enhancement in 5 cases and moderate enhancement in 4 cases. In venous phase, solid components illustrated as significantly enhancement in 6 cases with progressive pattern and moderate enhancement in 3 cases, while the muscle layer of lesions were featured as progressive moderate enhancement in 4 cases and there is no significant enhancement in the rest 5 cases whose enhancement degree were similar to that of normal gastric wall. Additionally, the surface of the cyst covered with intact mucosa in 7 cases and in other 2 cases without complete mucosa.Conclusion:On the basis of accurate localization, CT scan could provide rich information including size, shape, internal structure and state around the lesion, which is of great value for the diagnosis of GCP.

10.
Chinese Journal of Radiology ; (12): 408-412, 2020.
Article in Chinese | WPRIM | ID: wpr-868307

ABSTRACT

Objective:To investigate the diagnostic value of energy spectrum CT combined with high concentration iodine contrast agent (400 mg/ml) for hepatic venous system CT angiography in patients with Budd-Chiari syndrome (BCS).Methods:A total of 48 patients with BCS who underwent the hepatic venous system CT angiography were prospectively collected from March to August 2019 at the First Affiliated Hospital of Zhengzhou University. Patients were randomly divided into control group (350 mg /ml) and study group (400 mg /ml). In the control group, the dosage of iodine contrast agent was 1.6 ml/kg, and the flow rate was 4.0 ml/s. In the study group, the dosage of iodine contrast agent was 1.4 ml/kg. Double-flow rate injection protocol was used in the study group, i.e. 3.50 ml/s (80% dosage), 1.75 ml/s (20% dosage), 3.50 ml/s (40 ml normal saline). Revolution CT scanner was used for energy spectrum scanning. Quantitative parameters, qualitative visual parameters and radiation dose were compared between the two groups. Wilcoxon test, t test, χ 2 test and Mann-Whitney U test were used. Results:The dosage of iodine contrast agent in the study group [(94.53±16.02) ml] was lower than that in the control group [(106.40±20.19) ml, t=2.257, P<0.05]. The injection speed of the control group was higher than that of the study group (4.00 ml/s and 3.15 ml/s). CT values of portal vein, hepatic vein, inferior vena cava, and hepatic parenchyma, signal to noise ratio, contrast noise ratio, CT dose index, dose length product, effective dose and subjective scores showed no significant differences between the 2 groups (all P>0.05). Conclusion:For patients with BCS, high quality images could be obtained to meet the requirement of diagnosis in hepatic vein system CT angiography using high concentration iodine contrast agent (400 mg/ml) with low dosage of contrast agent and low flow rate.

11.
Article in Chinese | WPRIM | ID: wpr-864545

ABSTRACT

Objective:To analyze failure mode and effect analysis (FMEA) management model on the risk and satisfaction of PICC catheterization in children with leukemia undergoing chemotherapy.Methods:Totally 100 children with PICC catheterized leukemia were admitted to our hospital from June 2015 to December 2018, and their FMEA were managed. Find out the possible failure content and potential risk factors during PICC tube placement operation and maintenance, and calculate the risk value (RPN) according to the formula. Based on RPN values, specific prevention and treatment strategies were formulated and follow-up observation was monitored.Results:After the failure mode and effect analysis, the RPN scores of misevaluation, nonstandard operation, uncooperative children and insufficient preparation for use were (619.5 ± 11.7), (859.3 ± 18.7), (248.6 ± 20.6), (597.4 ± 8.4) points respectively, while those before the intervention were (1 347.5 ± 27.8), (1 127.4 ± 34.7), (427.3 ± 41.9) points, the difference was statistically significant ( t values were 9.563-14.279, P < 0.05). After the failure mode and effect analysis, the RPN scores of drug factor, child factor, ineffective sealing, infusion interruption, inadequate propaganda and maintenance were (598.4 ± 17.4), (537.2 ± 12.1), (407.3 ± 12.1), (178.4 ± 12.1), (8.4 ± 12.1) points, respectively. Before the intervention, the scores were (986.4 ± 30.7), (685.7 ± 17.8), (527.4 ± 23.6), (359.2 ± 29.4) and (148.3 ± 26.5) points, respectively. The differences were statistically significant ( t values were 11.092-19.634, P < 0.05). Conclusion:Failure mode and effect analysis applied to children with leukemia PICC pipeline placement and maintenance can improve the effectiveness of pipeline management and reduce the occurrence of pipeline maintenance risk events.

12.
Article in Chinese | WPRIM | ID: wpr-745258

ABSTRACT

Objective To investigate the clinical feasibility of spectral monochromatic imaging combined with adaptive statistical iterative reconstruction-V (ASIR-V) in upper abdominal enhanced scanning with double-low technique for severe liver cirrhosis.Methods Totally 126 cases performed abdominal contrast-enhanced CT scanning were collected prospectively and assigned to 3 groups with 42 cases in each group with random number table method.The filtered back projection algarithm,120 kV and contrast agent dose of 420 mgI/kg were used for the cases of control group.The cases for spectral group and combined group were scanned with spectral imaging mode and contrast agent dose of 300 mgI/kg.The 60 keV monochromatic images combined with pre-0% and post-40% ASIR-V were selected and analyzed for spectral group.Combined group with pre-40% ASIR-V was divided into 2 subgroups with 50 keV,post -50% ASIR-V and 60 keV,post-40% ASIR-V separately.One-way ANOVA test was used for analysis of radiation dose and quantitative parameters,and Rank sum test was used for image subject evaluation.Results The CT numbers and CNR had significant differences among spectral group,combined group and control group(F=4.293-13.134,P<0.05) except for the images of liver parenchyma in PVP and that of 50 keV combined 50%ASIR-V group were higher than that of control group (q=1.825-3.736,P<0.05).No significant differences existed for image noise and overall image quality scores of organs in four groups.The visualization of hepatic vascular branches in 50 keV combined 50%ASIR-V group was higher than that of other three groups(Z=2.793-6.328,P<0.05).The radiation dose of combined group was lower than that of spectral and control group (q =-4.879--2.531,P < 0.001).Conclusions Spectral monochromatic imaging combined with pre-and post-ASIR-V can reduce contrast agent dose and radiation dose without degrading image quality for the severe liver cirrhosis in upper abdominal enhanced scanning.

13.
Chinese Journal of Radiology ; (12): 57-62, 2019.
Article in Chinese | WPRIM | ID: wpr-745212

ABSTRACT

Objective To investigate the image quality and radiation dose of spectral CT with automatic spectral imaging mode selection (ASIS) and adaptive statistical iterative reconstruction (ASIR) at abdominal CT as compared with low-kVp CT with ASIR.Methods Two hundred patients underwent the plain and arterial-phase (AP) and portal venous-phase (PVP) contrast-enhanced abdominal CT scan were analyzed prospectively.The patients were randomly assigned to the control group (low-kVp CT scan) and study group (spectral CT scan),if BMI ≤ 23.9 kg/m2,patients were assigned into group A (80 kVp) or group B (spectral CT with ASIS);if 24.0 kg/m2 ≤ BMI<28.9 kg/m2,patients were assigned into group C (100 kVp) or group D (spectral CT with ASIS)(n=50 each).Groups A and B,groups C and D were matched by gender,age,body mass index,cross sectional area and contrast agent dose respectively.Low-kVp images and monochromatic images (40 to 60 keV) were all reconstructed by using ASIR.Radiation dose and quantitative parameters (image noise in HU and contrast-to-noise ratio of the liver,aorta and portal vein) were compared by using t test while overall image quality was assessed by Mann-Whitney U test between the matched groups.Results Radiation dose in the group B was significantly higher than group A (increased by 10%,P<0.05) but there was no significant differences between groups C and D (P>0.05).Compared to the control group,image noises in the study group were higher at 40 keV and 50 keV (P<0.05),but similar at 40 keV (P>0.05).At the energy level of 40 keV,the study group showed higher CNRs,but lower overall image quality scores than the control group except for the similar image quality scores between groups A and B during AP (P<0.05).At the energy level of 50 keV,the CNRs and overall image quality scores in the study group were higher than or similar to the control group.At the energy level of 60 keV,the study group showed lower or similar CNRs,but higher or similar overall image quality scores compared with the control group.Conclusions The radiation dose of spectral CT with ASIS technique was slightly higher than 80 kVp CT but similar to 100 kVp CT.By combining ASIR technique,monochromatic image at 50 keV can maintain or improve CNR and overall image quality as compared with low-kVp images.

14.
Journal of Practical Radiology ; (12): 378-382, 2019.
Article in Chinese | WPRIM | ID: wpr-743541

ABSTRACT

Objective Toanalyzethedifferencesofthecoronaryarterycalciumscore,andtheprevalence,severity,characteristics ofcoronaryarteryplaquesbetweenAIDSinfectedfemaleandmale.Methods 158AIDSpatients(72femalesand86 males)and102 HIVGuninfectedpatients(49femalesand53 males)withsuspectedcoronaryarterydiseaseinourhospitalwereenrolledbetween March2017andFebruary2018.Patientsunderwentcoronarycomputedtomographyangiography (CCTA)bythethirdgenerationdual sourceforceCT.Thedifferencesofcoronaryarteryplaquesbetweengenderswereassessed.Results In HIVGuninfectedpatients,the prevalenceoftotalplaque,mixedplaque,severestenosisandtwoGvesseldiseasewassignificantlyhigherinmalethanfemale(allP<0.05) andtheprevalenceofnonGcalcifiedplaquewassignificantlylowerinmalethanfemale(allP<0.05).InAIDSpatients,theprevalence oftotalplaque,calcifiedplaque,severestenosisandCACS>100wassignificantlyhigherin malethanfemale(allP<0.05)andthe prevalenceofnonGcalcifiedplaqueandmixedplaquesignificantlywaslowerinmalethanfemale(allP<0.05).Theprevalenceofthree ormorevesselsdiseasein maleAIDSpatientswassignificantlyhigherthanfemaleAIDSpatients.Conclusion MaleAIDSpatients havehighercoronarycalcifiedscoreandheaviercoronaryatherosclerosisburdens.Inaddition,femaleAIDSpatientshavelesscoronary atherosclerosisburdens,butmixedplaqueseemtobemorefrequently.

15.
Journal of Practical Radiology ; (12): 1116-1118,1135, 2019.
Article in Chinese | WPRIM | ID: wpr-752504

ABSTRACT

Objective ToimprovethediagnosticaccuracybyassessingtheCTfeaturesofganglioneuroblastoma(GNB).Methods 38patientswithGNBconfirmedbypathologicalresultsandunderwentplainandcontrast-enhancedCTscanwereanalyzedretrospectively. Results GNBoftenoccurredinchildren.Allthecasesappearedassolitarylesion,7werelocatedinthemediastinum,12intheadrenal,15inthe retroperitoneal,3inthethoraxcavityand1inthepelviccavity.PlainCTshowed36lesionswithheterogeneouslowdensitywithnecrosisand cysticdegeneration,and28caseswithcalcifications,2withhomogeneouslowdensity.Thesolidlessionofallcasesshowedprogressive enhancement(4casesshowedslightprogressivecontrastenhancement,11casesshowed moderateenhancement,23casesshowed markedlyenhancement).Peripheralvesselsweredisplacedbytumorin19casesandembeddedbytumorin13cases.13casesshowed thepresenceofsmallvesselsin/aroundthetumorarrangedinclumpsorinline.Conclusion ThespecificCTfindingsofheterogeneouslowdensity withnecrosis,calcifications,peripheralvesselsdisplaced,moderatetomarkedlyprogressiveenhancement,mightbeusefulforthediagnosisofGNB.

16.
Journal of Practical Radiology ; (12): 865-868, 2019.
Article in Chinese | WPRIM | ID: wpr-752451

ABSTRACT

Objective To diagnose correctly for paravertebral spinal hemangioma and neurilemmoma through retrospective analysis of characteristics of MRI.Methods Paravertebral spinal hemangiomas (n=11)and neurilemmomas (n=17)confirmed by surgery and pathology were analyzed retrospectively.Results Paravertebral spinal hemangiomas occurred in the thoracic epidural,hyperintense singal on T2 WI,obvious homogeneous enhancement,associated with vertebral body destruction and vertebral hemangioma.Paravertebral neurilemmomas were located in the middle and upper cervical segments and the thoracic epidural space.The solid area showed mild hyperintense singal on T2 WI,irregularly higher hyperintense signal inside,and obvious heterogeneous enhancement,without the cystic area being enhanced.The differences between the two tumors were significant in location,vertebral hemangioma,lesions of the same layer of bone destruction,relationship with the spinal cord,T2 WI signal,and enhanced performance (P<0.05 ).There were no significant differences in age,sex,clinical manifestation,shape,volume,affected attachment,and T1 WI signal (P>0.05 ).Conclusion The MRI findings of paravertebral spinal hemangioma and neurilemmoma are significantly different in the location,vertebral hemangioma,bone destruction,relationship with the spinal cord,T2 WI signal and enhanced performance.

17.
Journal of Practical Radiology ; (12): 647-650,654, 2019.
Article in Chinese | WPRIM | ID: wpr-752415

ABSTRACT

Objective Toexplorethevalueofmonochromaticenergyimaginggeneratedfrom RevolutionCTindetectingcoronary plaquesindifferentconcentrationsofcontrastagent.Methods Sixtesttubesnumbered3,4,5,6,8and9inthephantom wereselectedand filledupwithdifferentconcentrationsofiodinesolutions(20,10,5,2.5,0,13mgI/mL,respectively),fishbonesimulatingcalcified plaqueandstreakyporksimulatinglipid/fibrousplaque.EachtubeunderwentspectralCTscan(studygroup,70keV monochromatic energyimaging)and120kVpCTscan (controlgroup)respectivelyinRevolutionCT.Theabilityofplaquedetectionwasevaluated subjectively,andfurtheranalysis was madeontheimages withascoregreaterthanorequaltothreepoints.One-way ANOVA and Bonferroni m ethod w ere used to co m pare the C T values and C N R in different tubes in the intra-group co m parison ,w hile paired t test and M ann-W hitney U testwereusedfortheinter-groupcomparison.Results TheoverallimagequalityofNo.4,5and9testtubes inbothgroupsmettheclinicaldiagnosticlevel.Intheintra-groupcomparison,No.5testtubeshowedhigherCNRofcalcifiedplaque andNo.9testtubeshowedhigherCNRoflipidplaqueandfibrousplaquethantheothers(t=4.105-29.214,allP<0.001).Whilein theinter-groupcomparison,thestudygroupshowedsimilarCNRofcalcifiedplaqueinNo.9testtube(t=-1.576,P=0.130)tothecontrol group,andhigherCNRintheothersthanthecontrolgroup(Z=-4.074--3.815,t=-14.782--3.520,allP<0.05).Conclusion Comparedwith120kVpCTimages,monochromaticenergyimagingat70keVfrom RevolutionCTshowedbetteroverallimagequality andcoulddisplaycoronaryplaquesbetterwiththecontrastagent concentrationfrom5mgI/mLto13mgI/mL.

18.
Article in Chinese | WPRIM | ID: wpr-734415

ABSTRACT

Objective To explore the effect of single level lumbar disc herniation on the morphology and diameter of sciatic nerve,and to identify the correlation between the diameter change in sciatic nerve and severity of clinical symptoms,as well as the prognosis of surgical treatment in patients with lumbar disc herniation.Methods From January 1,2017 to December 31,2017,Seventy lumbar disc herniation (LDH) patients who underwent single-level posterior lumbar spine surgery were recruited in this retrospective analysis study.Specific data including age,gender,the level of a disc herniation,the type of disc herniation,symptomatic side,surgical procedure were recorded respectively.In addition the morphological changes and the diameter of bilateral sciatic nerve were recorded preoperatively and postoperatively by B-mode ultrasound.Furthermore,the pain in patients and neurological function were evaluated by visual analogue scale (VAS,back pain and leg pain),Japanese orthopaedic association scores-lumbar (JOA) and Oswestry disability index (ODI).The correlation between the diameter of sciatic nerve and clinical features,as well as clinical prognosis of patients were identified in the present study.Results For patients with acute lumbar disc herniation,the diameter of sciatic nerve in affected side was 5.19±1.03 ram,which is significantly higher than that in the unaffected side (4.57±0.64 mm,t=6.735,P=0.000).In addition,preoperative ratio of the affected side to the healthy side of the sciatic nerve showed strong correlation with the VAS of leg pain (r=0.838,P=0.001),JOA (r=-0.857,P=0.001),and ODI score(r=0.881,P=0.000),but not with the VAS of back pain (r=-0.061,P=0.614).Three months after surgery,the diameter of sciatic nerve in the affected side decreased to 4.58±0.63 mm (t=6.865,P=0.000),while the unaffected side showed no significant change(t=0.300,P=0.765).Clinical improvement was observed in all the patients postoperatively.The changes in the diameter of sciatic nerve postoperatively in affected side showed strong correlation to the rate of improvement in VAS of leg (r=0.624,P=0.003),JOA(r=0.615,P=0.003) and ODI scores (r=0.722,P=0.002),but not to the rate of improvement in VAS of back (r=-0.025,P=0.836).Conclusion Single root compression in patients with single level disc herniation might cause morphological changes such as thickening and edema in sciatic nerve,which were closely related to the severity of clinical symptoms and the prognosis of surgical treatment.

19.
Article in Chinese | WPRIM | ID: wpr-708378

ABSTRACT

Objective To investigate the use of spectral CT in assessing the treatment effect on hepatic function in patients with Budd-Chiari syndrome (BCS) before and after treatment.Methods From Dec.2015 to Mar.2017,41 patients with BCS underwent Spectral CT before and after treatment (mean time interval from treatment 1~3 months) in the First Affiliated Hospital of Zhengzhou University.The Iodine concentration (IC) measured on the hepatic section Ⅰ-Ⅷ in the portal venous phase were normalized to the aorta (NIC).The clinical indicators of liver function were studied including Prothrombin time (PT),Albumin (Alb),Total bilirubin (TBil),Aspartate transaminase (AST),and Alanine transarminase (ALT).The paired t test was used to compare NIC and the various indices of hepatic function before and after treatment.The correlation before and after treatment between NIC and the different liver functions were analyzed by the Pearson correlation analysis.Results While both PT and TBil were negatively correlated (P < 0.05),Alb was positively correlated with hepatic NIC (P < 0.05).The correlation of PT,Alb and TBil in patients with Child-Pugh class A liver function were higher than those in classes B and C (r =-0.749,0.658,-0.511).The NIC in the hepatic section Ⅰ-Ⅷ after treatment were higher than those before treatment,with significant differences in hepatic section Ⅱ-Ⅷ.The differences between after and before treatment in patients with Child-Pugh class C liver function were higher than those in classes A and B.The hepatic section Ⅳ,Ⅴ,Ⅷ of class A,the hepatic section Ⅲ-Ⅷ of class B,hepatic section Ⅱ-Ⅷ of classes C were statistically significant.Compared with patients before treatment,the indices of liver function in patients after treatment showed better results (shorter PT,higher ALB,lower TBil,ALT and AST).Conclusion Normalized iodine concentration from spectral CT was helpful in evaluating liver function in patients with BCS.

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Chinese Journal of Radiology ; (12): 24-29, 2018.
Article in Chinese | WPRIM | ID: wpr-666105

ABSTRACT

Objective To determine the consistency of spectral CT parameters in advanced gastric cancer using different region of interests (ROIs) and their relationship with tumor micro-vessel density (MVD).Methods Thirty patients with histologically proven gastric cancer were prospectively enrolled.All the patients were examined using spectral-dual-phase-abdominal CT and treated successfully with radical surgery within 2 weeks after CT scanning.Two observers independently acquired iodine concentration(IC), normalized IC(nIC),and CT value at workstation using three different ROI protocols:10 mm2 circular ROI near tumor border where enhanced obviously,30 mm2 near the tumor center and the freehand outline ROI. The Data of the two observers were tested with interclass correlation coefficient (ICC) and Bland-Altman plot.The mean value of each parameter was documented as the final result.Differences of each group of ROI data were compared using ANOVA test. All the specimen were pathologically examined and MVD was counted. The relationship of each parameter to tumor MVD was analyzed by Pearson correlation. Results All of the IC,nIC and CT values obtained by the 2 observers using three ROI measurements were consistent well,and the ROI-outline had the highest ICC than that of smaller circular ROIs(ICC:0.991 to 0.997).The 95% differences confident interval of nIC-AP and nIC-VP using freehand outline ROI by two observers were-0.003 to 0.002 and -0.001 to 0.012, respectively. The outline-ROI method had better inter-observer accuracy. There were significant differences between the means of the all parameters with three ROI protocols (P<0.05). Values of ROI-10 mm2 were highest, while the values of ROI-outline were lowest (P<0.05).The mean counts of tumor MVD was(29.0±8.4)/high magnification.The nIC in venous phase(VP)had good correlations with intra-tumoral MVD, especially the ROI-outline (r=0.670, P<0.01), within different ROI measurements.Conclusions The different ROI selection in tumor has significant impact on the final CT parameters. Outlined ROI protocol improves inter-observer consistency and nIC-VP obtained by this method can indirectly reflect the condition of tumor angiogenesis.

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