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Objective:To synthesize non-contrast-enhanced CT images from enhanced CT images using deep learning method based on convolutional neural network, and to evaluate the similarity between synthesized non-contrast-enhanced CT images by deep learning(DL-SNCT) and plain CT images considered as gold standard subjectively and objectively, as well as to explore their potential clinical value.Methods:Thirty-four patients who underwent conventional plain scan and enhanced CT scan at the same time were enrolled. Using deep learning model, DL-SNCT images were generated from the enhanced CT images for each patient. With plain CT images as gold standard, the image quality of DL-SNCT images was evaluated subjectively. The evaluation indices included anatomical structure clarity, artifacts, noise level, image structure integrity and image deformation using a 4-point system). Paired t-test was used to compare the difference in CT values of different anatomical parts with different hemodynamics (aorta, kidney, liver parenchyma, gluteus maximus) and different liver diseases with distinct enhancement patterns (liver cancer, liver hemangioma, liver metastasis and liver cyst) between DL-SNCT images and plain CT images. Results:In subjective evaluation, the average scores of DL-SNCT images in artifact, noise, image structure integrity and image distortion were all 4 points, which were consistent with those of plain CT images ( P>0.05). However, the average score of anatomical clarity was slightly lower than that of plain CT images (3.59±0.70 vs. 4) with significant difference ( Z = -2.89, P<0.05). For different anatomical parts, the CT values of aorta and kidney in DL-SNCT images were significantly higher than those in plain CT images ( t=-12.89, -9.58, P<0.05). There was no statistical difference in the CT values of liver parenchyma and gluteus maximus between DL-SNCT images and plain CT images ( P>0.05). For liver lesions with different enhancement patterns, the CT values of liver cancer, liver hemangioma and liver metastasis in DL-SNCT images were significantly higher than those in plain CT images( t=-10.84, -3.42, -3.98, P<0.05). There was no statistical difference in the CT values of liver cysts between DL-SNCT iamges and plain CT images ( P>0.05). Conclusions:The DL-SNCT image quality as well as the CT values of some anatomical structures with simple enhancement patterns is comparable to those of plain CT images considered as gold-standard. For those anatomical structures with variable enhancement and those liver lesions with complex enhancement patterns, there is still vast space for DL-SNCT images to be improved before it can be readily used in clinical practice.
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OBJECTIVES@#As the use of iodinated contrast media has become more widely with advances in imaging, several guidelines have suggested that anxiety increases the risk of acute adverse reactions associated with iodinated contrast media. This study aims to evaluate the impact of anxiety on the occurrence of acute adverse reactions (AAR) to iodinated contrast media in patients undergoing contrast-enhanced CT examinations.@*METHODS@#Inpatients who underwent contrast-enhanced CT examinations at the Third Xiangya Hospital between February and October 2021 were prospectively recruited. Prior to the imaging examinations, all patients completed the Generalized Anxiety Disorder Scale-7 (GAD-7) assessment before the imaging examinations to determine the severity of anxiety, which was categorized as mild, moderate, or severe. Based on the occurrence of AAR, patients were classified into an AAR group and a non-AAR group. The difference in anxiety was compared between the 2 groups. Multivariate logistic regression analysis was used to identify independent risk factors associated with AAR. To ensure comparability between the 2 groups, propensity score matching (PSM) was utilized to align the clinical characteristics. Subsequently, the difference in anxiety within the matched groups was analyzed.@*RESULTS@#The study comprised 880 patients, with 80 patients in the AAR group and 800 patients in the non-AAR group. There was a significant difference in proportion of patients with mild-severe anxiety between the 2 groups (75% in the AAR group and 36% in the non-AAR group, P<0.001). Additionally, differences were also observed in occupation, income, underlying diseases, and allergy history (all P<0.001). The results of multivariate logistic regression analysis revealed that patients' income, allergy history, and anxiety were independent risk factors for AAR to iodinated contrast media (all P<0.05). Following PSM, each matched group included 66 cases, and no significant differences in clinical characteristics were observed between the 2 groups (all P>0.05). However, the proportion of patients with mild-severe anxiety remained significantly higher in the AAR group compared to the non-AAR group (75% in the AAR group and 31% in the non-AAR group, P<0.001).@*CONCLUSIONS@#Anxiety is associated with an increased risk of AAR to iodinated contrast media in patients undergoing contrast-enhanced CT examinations, suggesting the clinical importance of screening for anxiety before imaging examinations.
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Humans , Contrast Media/adverse effects , Tomography, X-Ray Computed/methods , Risk Factors , Anxiety , Hypersensitivity/etiology , Retrospective StudiesABSTRACT
Background:The gold standard for pulmonary artery pressure measurement is right heart catheterization but its invasive nature precludes its routine use. Main pulmonary arterial trunk calibreincrease is a strong indicator of underlying pulmonary arterial hypertension. MDCT can accurately measure the diameter of main pulmonary artery. The objective of the study was to establish the normative values of main pulmonary artery caliber using contrast enhanced CT and try to ascertain any significant difference in main pulmonary artery calibers between two genders and correlation of age and main pulmonary artery diameter. Methods:Contrast enhanced CT images of 462 subjects were analysed on a PACS workstation monitor and widest diameter perpendicular to long axis of the main pulmonary artery as seen on reformatted axial image was measured with electronic caliper tool at the level of the main pulmonary artery bifurcation.Results:The mean main pulmonary artery diameter in females was 22.54±2.19 mm and 23.34±3.06 mm in males. The mean pulmonary artery diameter in males was larger than females with statistically significant difference seen (p<0.05). The correlation coefficient between age of whole sample and their mean main pulmonary artery was found to be 0.1006 with no statistically significant difference.Conclusions:There is a statistically significant difference in the mean main pulmonary artery calibre between males and femaleswith no strong correlation between the age and mean main pulmonary artery calibre. Further studies are warranted to find the complex interaction between main pulmonary artery diameter and sex, age and body mass index
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Objective To investigate the application effect of Power port in contrast-enhanced CT scans. Methods Totally 220 cancer patients who needed contrast- enhanced CT scans after chemotherapy were selected in Changhai hospital From September 2017 to September 2018, including 110 cases in the observation group and 110 cases in the control group with convenient sampling method. The observation group was injected contrast medium through Power port for CT scans. Contrast medium was injected into the control group by 22G of Peripheral venous access devices (Introcan?). The incidence of contrast medium exosmosis, nursing time and patient satisfaction were compared between the two groups. Results The incidence of extravasation of contrast medium in the observation group was 0, lower than that in the control group 9.1% (10/110), the difference was significant(χ2=10.476,P=0.015); the nursing time in the observation group was (2.60 ±0.15) minutes per time, which was lower than that in the control group (5.60 ± 5.29) minutes per time), the difference was significant (t=5.934,P =0.000); the patient satisfaction in the observation group was higher than that in the control group, the difference was statistically significant (Z=-12.695, P=0.000). Conclusions Contrast medium injection through Power port for CT scans can reduce the incidence of contrast medium exosmosis, reduce nursing hours and improve patient satisfaction.
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Nutcracker syndrome (NCS) is a syndrome caused by compression of the left renal vein (LRV), between the abdominal aorta and the superior mesenteric artery, resulting in hypertension of the LRV and hematuria. Doppler ultrasonography (US) has been commonly used for the diagnosis of NCS. However, several technical issues, such as Doppler angle and sample volume, need to be considered to obtain satisfactory results. In addition, morphologic changes of the LRV and a jetting phenomenon across the aortomesenteric portion of the LRV on contrast-enhanced computed tomography (CECT) are diagnostic clues of NCS. With proper Doppler US and CECT, NCS can be diagnosed noninvasively.
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Aorta, Abdominal , Diagnosis , Hematuria , Hypertension , Mesenteric Artery, Superior , Renal Veins , Tomography, X-Ray Computed , Ultrasonography, DopplerABSTRACT
Objective@#To investigate the application effect of Power port in contrast-enhanced CT scans.@*Methods@#Totally 220 cancer patients who needed contrast-enhanced CT scans after chemotherapy were selected in Changhai hospital From September 2017 to September 2018, including 110 cases in the observation group and 110 cases in the control group with convenient sampling method.The observation group was injected contrast medium through Power port for CT scans. Contrast medium was injected into the control group by 22G of Peripheral venous access devices (Introcan®). The incidence of contrast medium exosmosis, nursing time and patient satisfaction were compared between the two groups.@*Results@#The incidence of extravasation of contrast medium in the observation group was 0, lower than that in the control group 9.1% (10/110), the difference was significant(χ2=10.476,P=0.015); the nursing time in the observation group was (2.60 ±0.15) minutes per time, which was lower than that in the control group (5.60 ± 5.29) minutes per time), the difference was significant (t=5.934, P=0.000); the patient satisfaction in the observation group was higher than that in the control group, the difference was statistically significant (Z=-12.695, P=0.000).@*Conclusions@#Contrast medium injection through Power port for CT scans can reduce the incidence of contrast medium exosmosis, reduce nursing hours and improve patient satisfaction.
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Objective@#To compare the diagnostic performance of contrast-enhanced ultrasound (CEUS) with contrast-enhanced computed tomography (CECT) for the maximum diameter ≤2 cm metastatic liver cancer (MLC).@*Methods@#Sixty-nine pathologically diagnosed MLC patients (maximum diameter ≤2 cm) were retrospectively recruited. The lesion detection rate, diagnostic confidence and enhancement pattern of CEUS and CECT for MLC were analyzed. Diagnostic value of CEUS and CECT for MLC were evaluated and compared by using diagnostic test.@*Results@#The cases of 0, 1, 2, multiple lesions detected by CEUS and CECT in these 69 patients with ≤2 cm MLC were 0 case (0%), 41 cases(59.42%), 13 cases(18.84%), 15 cases(21.74%) and 9 cases(13.04%), 29 cases(42.03%), 13 cases(18.84%), 18 cases(26.09%), respectively. The positive cases detected by CEUS and CECT were 69 cases(100%) and 60 cases(86.96%) respectively, with a statistically significant difference between the two groups (P=0.006). However, for the detection rate of non-single-lesion cases, there was no statistical difference between CEUS and CECT (P=0.409). The cases showed typical manifestation in CEUS and CECT were 56 cases(81.16%)and 29 cases(42.03%)(P<0.001). The cases with diagnostic confidence level of 3, 4, 5 in CEUS were 3 cases(0.04%), 11 cases(15.94%), 55 cases(79.71%), and those of CECT were 19 cases(27.54%), 20 cases(28.99%), 20 cases(28.99%), respectively. The diagnostic sensitivity of CEUS and CECT for ≤2 cm MLC were 100% (69/69) and 85.51% (59/69), with statistically significant difference(P=0.001).@*Conclusions@#The lesion detection rate and diagnostic value of CEUS for the maximum diameter ≤2 cm MLC might be superior to that of CECT, but the detection rate shows no significant difference in the non-single-lesion cases. CEUS has important clinical value in the diagnosis of ≤2 cm MLC.
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Objective To compare contrast-enhanced ultrasonography (CEUS), contrast-enhanced CT (CECT) and combined detection of two methods in the diagnosis of small renal masses, and differential diagnosis of different types of small renal masses by CEUS. Methods In 95 cases of small renal masses, there were 79 patients with small renal cell carcinoma and 16 patients with benign tumor. The diagnostic results of the three methods were compared based on the pathological results, which were used as thegold standardfor the diagnostic efficacy. The ROC curve was drawn, and the area under the curve (AUC) was compared. The characteristics of the two groups were analyzed and compared by Q-Lab software in CEUS. The angiographic parameters included arrival time (AT), time to peak (TTP) and peak intensity (PI). CEUS patterns for several pathologic types of renal tumors with larger sample sizes were compared. The characteristic manifestations of small renal masses under CEUS were analyzed. Results The accuracy, sensitivity, specificity, positive predictive value, negative predictive value and AUC of CEUS were 87.37%, 93.67%, 56.25%, 91.36%, 64.29%and 0.750, the values for CECT were 88.42%, 93.67%, 62.50%, 92.50%, 66.67%and 0.775, and the values for combined detection of two methods were 95.79%, 98.73%, 81.25%, 96.30%, 92.86%and 0.869 respectively. The sensitivities of the three methods were high, but the specificities were the same. The combined detection showed better diagnostic efficacy than that of single diagnostic method. The AT and TTP of CEUS were earlier in small renal carcinoma group than those of benign nephrotic group, and PI was higher than that of benign nephrotic group (P<0.05). There were significant differences in the contrasts ofcontrast enhancement methods between clear cell carcinoma, papillary cell carcinoma, chromophobe cell carcinoma, and angiomyolipoma (P<0.01). There was little difference in contrast enhancement between the other types of carcinoma. False envelope can be observed by CEUS.'Cystic area'of the detection rate was increased significantly by CEUS than that of conventional ultrasound. Conclusion Combined detection of CEUS and CECT can improve the diagnostic accuracy of small renal tumors. CEUS has great clinical value in the differential diagnosis of small renal masses, which is worthy of clinical promoting.
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We report a rare case of primary pulmonary low-grade angiosarcoma on dynamic contrast-enhanced CT and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT imaging. A 38-year-old, asymptomatic woman was hospitalized because of an abnormality on chest radiography. A dynamic contrast-enhanced chest CT showed a 1.2 cm-sized irregular-margined nodule with strong and persistent enhancement in the right lower lobe. The lesion had low metabolic activity on an 18F-FDG PET/CT scan. The patient underwent a wedge resection for the lesion, and pathology revealed a primary pulmonary low-grade angiosarcoma.
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Adult , Female , Humans , Fluorodeoxyglucose F18/chemistry , Hemangiosarcoma/diagnosis , Ki-67 Antigen/metabolism , Lung Neoplasms/diagnosis , Multimodal Imaging , Positron-Emission Tomography , Radiopharmaceuticals/chemistry , Tomography, Spiral ComputedABSTRACT
OBJECTIVE: To describe the computed tomography (CT) features of neuroendocrine tumors (NETs) and solid pseudopapillary tumors (SPTs) with unilocular cyst-like appearance, and to compare them with those of unilocular cystic tumors of the pancreas. MATERIALS AND METHODS: This retrospective study was approved by our Institutional Review Board, and informed consent was waived. We included 112 pancreatic tumors with unilocular cyst-like appearance on CT (16 solid tumors [nine NETs and seven SPTs] and 96 cystic tumors [45 serous cystadenomas, 30 mucinous cystic neoplasms, and 21 branch-duct intraductal papillary mucinous neoplasms]). Two radiologists reviewed the CT images in consensus to determine tumor location, long diameter, morphological features, wall thicknesses, ratio of wall thickness to tumor size, wall enhancement patterns, intratumoral contents, and accompanying findings. Fisher's exact test was used to analyze the results. RESULTS: All 16 solid tumors had perceptible walls (mean thickness, 2.7 mm; mean ratio of wall thickness to tumor size, 7.7%) with variable enhancement. Four NETs and seven SPTs had hemorrhage, calcifications, and/or mural nodules. Six CT findings were specific for solid tumors with unilocular cyst-like appearance: a thick (> 2 mm) wall, uneven thickness of the wall, high ratio of wall thickness to tumor size, hyper- or hypo-attenuation of the wall in the arterial and portal phase, and heterogeneous internal contents. When three or more of the above criteria were used, 100% specificity and 87.5-92% accuracy were obtained for solid tumors with unilocular cyst-like appearance. CONCLUSION: A combination of CT features was useful for distinguishing solid tumors with unilocular cyst-like appearance from unilocular cystic tumors of the pancreas.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma, Mucinous/diagnosis , Carcinoma, Papillary/diagnosis , Cystadenoma, Serous , Diagnosis, Differential , Neuroendocrine Tumors/diagnosis , Pancreatic Neoplasms/diagnosis , Retrospective Studies , Sensitivity and Specificity , Tomography, X-Ray ComputedABSTRACT
In the present review we reported the value of 18F-fluorodeoxyglucose (FDG) PET/CT in face of uterine cancer, in terms of sensitivity, specificity and accuracy. Moreover, we made a comparison with the other imaging techniques currently used to evacuate these tumors including contrast-enhanced CT, contrast enhanced-MRI and transvaginal ultrasonography. FDG PET/CT has been reported to be of particular value in detecting occult metastatic lesions, in prediction of response to treatment and as a pro-gnostic factor.
Subject(s)
Female , Humans , Carcinoma/pathology , Fluorodeoxyglucose F18 , Magnetic Resonance Imaging , Neoplasm Staging , Positron-Emission Tomography/methods , Predictive Value of Tests , Sensitivity and Specificity , Tomography, X-Ray Computed/methods , Uterine Neoplasms/pathology , UterusABSTRACT
Objective To improve standards of diagnosis and therapy for acute focal bacterial nephritis bY comparing the characters of acute focal bacterial nephritis and acute pylonephritis.Methods Thirty-five patients of upper urinary tract infection whoever accepted ultrasonographic and computed tomographic (CT) examinations in Beijing Hospital from January 2007 to January 2013 were studied retrospectively.Eighteen patients were diagnosed as acute focal bacterial nephritis (AFBN) according to CT imaging features,the other 17 patients were diagnosed as acute pyelonephritis (non-AFBN).The clinical feature,laboratory and imaging examination were compared between the two groups.Results Leukocyte count,percentage of neutrophil,fasting blood-glucose,ESR,NAG/Cre of urine,the combination of more than one kind of antibiotics and duration of antibiotic treatment were higher or much more in AFBN group patients than non AFBN patients,the differences between two groups were statistical significance(P ＜ 0.05).Urine microorganism culture was mainly Escherichia coli no matter in AFBN group or non-AFBN group,microorganism species of AFBN patients were more complex than non-AFBN patients.The most common contrast-enhanced CT feature of AFBN included local distribution of inflammatory area,wedge-shaped or unregular-shaped hypodense lesions on bilateral or single kidney,and mass-like hypodense lesions in more severe cases.NAG/CRE of urine was higher in AFBN group patients with bilateral kidney lesions than with single kidney lesions and non AFBN patients.The remission time of AFBN and non-AFBN was (3.4 ± 2.9) d,(3.0 ± 1.8)d respectively.The relapsing rate of AFBN and non-AFBN within half a year was 2/18,2/17,respectively.Conclusions The symptoms of acute focal bacterial nephritis are not specific.Abdominal contrast-Enhanced CT,ESR,leukocyte count,urine NAG/CRE are probably a predictor of AFBN.Antibiotic treatment with appropriate usage and sufficient duration could bring satisfactory outcomes and prognosis in acute focal bacterial nephritis and pyelonephritis patients.
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Objective To assess the value of imaging examination technologies such as 2-D ultrasound(2-DUS),helical computed tomography (CT),contrast-enhanced ultrasonography (CEUS) and contrast-enhanced CT (CECT) in the positioning and qualitative diagnosis of pancreatic diseases.Methods 2-DUS,helical CT findings were comparatively reviewed to analyze in 44 cases(45 lesions) with pancreatic space-occupying lesions verified by operation and pathology,and investigated the enhanced mode and the perfusion features of CEUS and CECT in different phases.Results In 45 lesions,there were 29 malignant lesions and 16 benign lesions.CEUS and CECT had greater diagnostic value compared to 2-DUS and helical CT.The sensitivity,specificity and accuracy of 2-DUS for the malignant lesions were 72.41 ％,62.50％ and 66.67 ％,while the helical CT were 68.97％,75.00 ％ and 68.89 ％.The sensitivity,specificity and accuracy of CEUS for the malignant lesions were 93.10％,87.50％ and 91.11％,while the CECT were 86.21％,93.75％ and 86.67％.There was no statistical difference between CEUS and CECT in detecting pancreatic space-occupying lesions.Conclusions CEUS and CECT can provide more accurate diagnosis on for pancreatic space-occupying lesions than 2-DUS and helical CT.Following CECT,CEUS is a new technology for diagnosis on pancreatic space-occupying lesions.
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Clear cell tumor of the lung is a rare and very unusual benign pulmonary tumor. As clear cell tumor of the lung contains abundant cytoplasmic glycogen, this tumor is called "sugar tumor". We report a case of sugar tumor in a 64-yr-old man presenting as a round pulmonary nodule. On dynamic computed tomography (CT) scans, the solitary pulmonary nodule showed early wash-in enhancement with an early washout pattern like a lung malignancy. The patient underwent wedge resection for the tumor. Pathologic examination, including immunohistochemical studies, revealed that the nodule was a benign clear cell tumor, so-called "sugar tumor". Because only a small number of cases have been reported previously, clinical aspects, radiological characteristics on dynamic contrast-enhanced CT, and differential diagnosis of the tumor are not well established. Herein we present a clear cell tumor of the lung and discuss the clinical, radiological, and pathological features of the tumor.
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Humans , Male , Middle Aged , Antigens, Neoplasm/metabolism , Diagnosis, Differential , Lung/diagnostic imaging , Lung Neoplasms/diagnosis , Neoplasm Proteins/metabolism , Perivascular Epithelioid Cell Neoplasms/diagnosis , Solitary Pulmonary Nodule/diagnosis , Tomography, X-Ray ComputedABSTRACT
PURPOSE: Renal infarction is one of the uncommon causes of acute abdominal pain, and it is often difficult to make a clinical diagnosis. This study was designed to investigate clinical predictors of the acute renal infarction and to suggest useful diagnostic tools to use in the emergency department(ED). METHODS: We reviewed medical records of the patients with a final diagnosis of acute renal infarction, which was confirmed by contrast-enhanced computed tomography (CT) scan or angiography of the abdomen between Jan. 1998 and Dec. 2000. RESULTS: Among 24 patients with acute nontraumatic renal infarction, 17 patients (71.0%) had a thromboembolic disease. A number of patients presented with nonspecific abdominal pain. 23 patients (95.8%) had elevated serum LDH after 24 hours of presention. On initial urinalysis, 75.0% of patients (18/24) showed hematuria. CONCLUSION: This study suggests that the patients with pain in the flank or the abdomen or the low back area should be performed a contrast-enhanced CT scan as soon as possible to rule out the possibility of acute renal infaction, especially when the patient has the high-risk triad of thromboembolism, elevated serum LDH, and hematuria.