Actual measurement verification of dose calculation accuracy based on cone-beam CT images / 中华放射肿瘤学杂志

Objective:To evaluate the dose calculation accuracy of cone-beam CT (CBCT) image by actual measurement method.Methods:CBCT images of 60 patients in the Second Affiliated Hospital of Soochow University from September, 2021 to May, 2022 were retrospectively analyzed. CBCT images of full-fan and half-fan scanning of the head, half-fan scanning of the chest and pelvis were obtained by the Varian OBI system. Hounsfield unit - electron density (HU-ED) curves corresponding to the scanning conditions were established with CIRS electron density phantom. The radiotherapy plans were designed on the CBCT images, and the dose calculation results of the detection point were compared with the ionization chamber measurement results to analyze the dose error. Then, three-dimensional dose verification system was adopted to detect the accuracy of the CBCT image radiotherapy plans implementation process in 60 patients, and the accuracy of dose calculation was verified according to the D 99%, D mean, D 1% of target volume, D mean and D 1% of organs at risk (OAR), and the γ pass rate. Results:In point dose detection in phantom, the dose calculation errors of CBCT images in the above four scanning patterns were -1.06%±0.87%、-1.67%±0.86%, 0.91%±0.73%, -1.54%±0.90%, respectively. In dosimetric verification based on patients' CBCT image treatment plan, the mean difference of D mean, D 99%, and D 1% of planning target volume (PTV) in all scanning modes were not higher than 2%, and the D mean and D 1% differences of other OAR were not higher than 3%, except for the lens of patients in the head. The average γ values of target volume and OAR were less than 0.5 under the criteria of 3%/2 mm. Conclusions:Under the condition of correctly establishing HU-ED curves, intensity-modulated radiation therapy (IMRT) / volumetric-modulated arc therapy (VMAT) planning based on CBCT images can be employed to estimate and monitor the actual dose to target volume and OAR in adaptive radiotherapy. Full-fan scanning patterns can further improve the accuracy of dose calculation for the head of patients.

Value of dual-layer spectral detector CT in evaluating the intramedullary invasion of limb osteosarcoma / 中华放射学杂志

Objective:To explore the optimal keV value of the virtual monoenergetic image (VMI) for displaying the osteosarcoma by using the dual-layer spectral detector CT and to evaluate its application value in determining the extent of intramedullary invasion of osteosarcoma.Methods:From August 2021 to August 2022, 57 patients with conventional osteosarcoma of long bone confirmed by biopsy in Beijing Jishuitan Hospital, Capital Medical University were retrospectively analyzed. All patients completed dual-layer spectral CT enhanced examination before limb salvage surgery, and tumor segment resection specimens were obtained after surgery. Conventional 120 kVp image and VMI of 40, 50, 60, 70 and 80 keV were obtained by spectral CT examination, and the CT values of tumors, image noise were measured and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the corresponding images were calculated. The objective evaluation among the six groups of images were assessed with the Friedman test, and then determined the optimal keV value. The maximum distance between the intramedullary boundary of osteosarcoma and the adjacent articular surfaces was measured on the best keV VMI and the tumor segment resection specimens. The Wilcoxon signed rank test was used to find the differences and the Spearman correlation analysis was used to evaluate the correlation between the distance measured from the best keV VMI and the specimens.Results:There were significant differences in CT value, image noise, SNR and CNR between 40-80 keV VMI and 120 kVp conventional CT images ( P<0.05). The CT value, SNR and CNR of 40 and 50 keV VMI were better than 120 kVp ( P<0.001). The 50 keV VMI was chosen as the best keV VMI to measure the intramedullary extent of osteosarcoma. The distance measured from 50 keV VMI was 103.9 (80.4, 131.4) mm, while the distance measured from specimens was 113.5 (94.0, 142.0) mm, and the difference was statistically significant ( Z=-5.76, P<0.001). The 50 keV VMI measurements in 51 patients were smaller than the gross specimens, which underestimated the tumor intramedullary extent, with the difference was 11.1 (6.6, 13.8) mm. The Spearman correlation analysis demonstrated a high positive correlation of distance measured on gross specimens with the 50 keV VMI ( r s=0.960, P<0.001). Conclusions:Dual-layer spectral detector CT with 50 keV VMI is the best image to show the limb osteosarcoma. Compared with gross specimens, the distance measured from CT underestimated the intramedullary invasion range of limb osteosarcoma about 10 mm, but the two show a good correlation.

Estudio de la morfología de los conductos radiculares de los primeros premolares superiores en tomografía computarizada de haz cónico / Study of the morphology of root canals of the first upper premolars in cone beam computed tomography

Objetivo: analizar, mediante tomografía computarizada de haz cónico (TC o CBCT [Cone Beam Computed Tomograph]) la frecuencia del tipo de morfología interna de los conductos radi- culares según la clasificación de Vertucci y el número de raíces de los primeros premolares superiores. Material y métodos: en una población argentina de 50 pacientes, 30 de sexo femenino y 20 masculino, que concurrieron a la Cátedra de Diagnóstico por Imá- genes de la Facultad de Odontología de la Universidad de Buenos Aires, se evaluaron 100 primeros premolares superiores con CBCT. Se estudiaron las variables: número de raíces, tipo de morfología interna, edad, sexo y lado. Fueron seleccionadas las tomografías de maxilar superior que incluyeron ambos primeros premolares en salud dental, periodontal y con ápice cerrado. Se realizó una adquisición volumétrica 100 × 90 mm y tamaño de vóxel de 150 µm. Se realizó la exploración de las imágenes en el plano axial de los tercios apical, medio y cervical de las piezas 1.4 y 2.4. Se utilizó un corte axial, observando en él, el tercio apical, medio y cervical de las piezas 1.4 y 2.4. Cada premolar fue analizado con 30 cortes transversales. Se utilizó la clasificación de Vertucci para agrupar las distintas variables anatómicas de los conductos radiculares de los primeros premolares superiores, la cual consta de VIII tipolo- gías. Resultados: el tipo más representativo entre los 100 primeros premolares superiores, dentro de la clasificación de Vertucci, fue el tipo IV (dos conductos separados desde la cámara al ápice). La coincidencia de tipos entre los lados derecho (78%; IC 95%: 65 a 87%) e izquierdo (70%; IC 95%: 56 a 81%) fue significativa. La distribución según el número de raíces en el lado derecho (χ 2 = 2.88) e izquierdo (χ2 = 0.72) no presentó una heterogeneidad significativa. La coincidencia del número de raíces entre los lados derecho e izquierdo fue significativa. Conclusión: se comprobó el tipo de morfología interna más frecuente, el número de raíces y su variabilidad de acuerdo al lado, sexo, y edad; lo cual es de una relevante importancia para realizar una correcta instrumentación y obturación del sistema de conductos radiculares (AU)

Objective: to analyze, using cone beam computed tomography (CBCT), the frequency of the type of internal morphology of the root canals according to the Vertucci classification and the number of roots of the first upper premolars. Material and methods: 100 first upper premolars were evaluated with CBCT, which corresponded to 30 female and 20 male patients in the Chair of Diagnostic Imaging of the Faculty of Dentistry, University of Buenos Aires. Variables were studied: number of roots, type of internal morphology, age, sex and side. The tomography of the upper jaw with both first premolars in dental, periodontal and closed apex health, a 100 × 90 mm volumetric acquisition and a voxel size of 150 µm were selected. An axial cut was used, observing the apical, middle and cervical third of pieces 1.4 and 2.4. Each premolar was analyzed with 30 paraxial cuts. The Vertucci classification was used to group the different anatomical variables of the root canals of the first upper premolars which consists of VIII typologies. Results: the most representative type among the top 100 upper premolars within the Vertucci classification was type IV (two separate ducts from the chamber to the apex). The type coincidence between the right (78%; 95% CI: 65 to 87%) and left (70%; 95% CI: 56 to 81%) los primeros premolares superiores, la cual consta de VIII tipolo gías. Resultados: el tipo más representativo entre los 100 primeros premolares superiores, dentro de la clasificación de Vertucci, fue el tipo IV (dos conductos separados desde la cámara al ápice). La coincidencia de tipos entre los lados derecho (78%; IC 95%: 65 a 87%) e izquierdo (70%; IC 95%: 56 a 81%) fue significativa. La distribución según el número de raíces en el lado derecho (χ 2 = 2.88) e izquierdo (χ2 = 0.72) no presentó una heterogeneidad significativa. La coincidencia del número de raíces entre los lados derecho e izquierdo fue significativa. Conclusión: se comprobó el tipo de morfología interna más frecuente, el número de raíces y su variabilidad de acuerdo al lado, sexo, y edad; lo cual es de una relevante importancia para realizar una correcta instrumentación y obturación del sistema de conductos radiculares (AU))

SPECT/CT imaging of PD-L1 expression in non-small cell lung cancer based on 99Tc m labeled anti-PD-L1 nanoantibodies / 中华核医学与分子影像杂志

Objective:To explore the value of SPECT/CT imaging on programmed death receptor 1 ligand (PD-L1) expression in patients with non-small cell lung cancer (NSCLC) based on 99Tc m labeled anti-PD-L1 nanoantibodies (NM-01). Methods:From January 2019 to March 2020, a total of 14 patients (11 males, 3 females; age: (61.9±11.0) years) with pathologically confirmed NSCLC in Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine were prospectively enrolled. NM-01 were labeled with 99Tc m, and patients were recruited for SPECT/CT imaging 2 h after injection with 99Tc m-NM-01((359.1±68.0) MBq). The differences of SUV max in primary and metastatic lesions between PD-L1 positive and negative patients were compared by independent sample t test. The correlation between the SUV max and PD-L1 expression of primary lesions was analyzed by Pearson correlation analysis. Results:Of 14 patients, 6 were PD-L1 positive and 8 were PD-L1 negative. 99Tc m-NM-01 showed obviously increased uptake in kidneys and liver, while mildly increased uptake in spleen and bone marrow. The SUV max of primary lesions was 4.69±1.88 and the SUV max of metastatic lesions was 2.04±1.32. The SUV max of primary lesions in PD-L1 positive patients was significantly higher than that of PD-L1 negative patients (5.99±1.99 vs 3.72±1.10; t=5.98, P=0.039). There was no significant difference in the SUV max of metastatic lesions between PD-L1 positive and negative patients (1.66±1.03 vs 2.35±1.46; t=-1.77, P=0.084). The SUV max of primary lesions was positively correlated with PD-L1 expression ( r=0.648, P=0.042). Conclusion:99Tc m-NM-01 can demonstrate the expression of PD-L1 in primary and metastatic lesions in NSCLC.

Diurnal variation in subfoveal and peripapillary choroidal vascularity index in healthy eyes

Purpose: To report the diurnal variation in choroidal vascularity index (CVI) in subfoveal (SF-CVI) and peripapillary area in healthy eyes. Methods: The study was a cross-sectional study including 12 healthy subjects. Swept-source optical coherence tomography scans were taken at 9 am, 11 am, 1 pm, 3 pm, and 5 pm. Subfoveal choroidal thickness (SFCT) and CVI were calculated using automated segmentation techniques and previously validated algorithms. Systemic parameters including systolic blood pressure (SBP), diastolic blood pressure, mean arterial pressure, and mean ocular perfusion pressure were calculated and correlated with SFCT and CVI. Results: A total of 12 eyes (right eye) of 12 patients (mean age: 26 ± 3.77 years) were analyzed. The mean (±standard deviation) amplitude of SFCT and SF-CVI variation was 35.91 ± 14.8 ?m (range, 15–69 ?m) and 0.05 ± 0.02 (range, 0.02–0.08). The mean CVI showed a significant diurnal variation in the temporal quadrant of the peripapillary region (P = 0.02). Conclusion: SFCT and SF-CVI showed a significant diurnal variation in amplitude (peak–trough analysis) and SF-CVI correlated well with SBP suggestive of a direct influence of blood pressure on choroidal vascularity. The mean peripapillary CVI in the temporal quadrant also showed a significant diurnal variation with no significant change in other quadrants.

Ewing's Sarcoma: imaging findings of a patient with primary tumor in the femur and mandibular metastasis / Sarcoma de Ewing: achados imaginológicos de um paciente com tumor primário no femur e metástase mandibular

ABSTRACT Ewing's Sarcoma, a common primary bone malignancy that usually occurs in childhood and young adults, has a predilection for males and occurs mostly in the diaphysis of long bones and pelvis. This tumor rarely affects the head and neck. Histologically, this neoplasm is a small round cell tumor and there is evidence of a neuroectodermal origin. Radiographic findings of ES show an osteolytic lesion, that is not a pathognomonic feature for this neoplasm. The association of conventional imaging methods such radiography, Computed Tomograph (CT), magnetic resonance imaging (MRI), combined with scintigraphy or Positron Emission Tomography/ Computed tomography PET /CT), is essential for a correct diagnosis and treatment. Therefore, the aim of this report was to present image findings of a patient who presented with ES in the femur, and a metastasis in the mandible after eighteen months, and discuss the importance of imaging methods for a correct diagnosis, treatment and consequently, prognosis.

RESUMO O Sarcoma de Ewing é uma malignidade óssea primária comum que usualmente afeta crianças e adultos jovens. O Sarcoma de Ewing tem predileção por homens e acomete na maioria das vezes a diáfise dos ossos longos e a pelve. Raramente esse tumor afeta a região de cabeça e pescoço. Histologicamente essa neoplasia é composta por células redondas e há evidências de uma origem neuroectodérmica. Os Achados radiográficos do SE mostram uma lesão osteolítica que não é característica patognomonica. A associação dos métodos convencionais, como radiografia, tomografia computadorizada, ressonância magnética combinadas com cintilografia ou tomografia por emissão de positron são essenciais para o correto diagnóstico e tratamento. Desta forma,o objetivo desse trabalho é apresentar os achados imaginológicos de um paciente que apresentou Sarcoma de Ewing primário no femur e uma metástase mandibular após dezoito meses e discutir a importância dos métodos de imagem adequados para um correto diagnóstico, tratamento e consequentemente o prognóstico.

Estado perirradicular e radicular de dentes tratados endodonticamente: estudo piloto utilizando a tomografia computadorizada de feixe cônico / Periapical and root status of endodontically treated teeth: a pilot study using cone-beam computed tomograph

As imagens radiográficas periapicais, essenciais para a realização e para o acompanhamento do sucesso do tratamento endodôntico, em virtude de limitações técnicas, não são capazes de oferecer visualização anatômica de toda a estrutura dos elementos dentários. Técnicas contemporâneas de obtenção de imagens, como a tomografia computadorizada realizada pela técnica de feixe cônico (TCFC) parecem ter o potencial de avaliar de forma mais adequada a qualidade da obturação e do remanescente radicular, e o estado perirradicular. O objetivo deste trabalho foi realizar uma avaliação descritiva das imagens obtidas pela técnica de TCFC de 100 elementos dentários tratados endodonticamente, buscando os achados referentes ao estado perirradicular, as lesões de furca, à presença de núcleos intrarradiculares e as fraturas radiculares. Nos 100 dentes analisados, 83 (83%) apresentavam áreas compatíveis com a presença de alteração perirradicular. Dos dentes multirradiculares, 51% apresentavam presença de lesão de furca e 91% apresentavam rarefação perirradicular. Vinte dos 83 dentes com alterações perirradiculares (24%) apresentavam imagem sugestiva de fratura radicular. A TCFC revelou a existência de diversas alterações radiculares e perirradiculares nos dentes tratados endonticamente estudados nesta amostra, sugerindo sua utilidade no acompanhamento imaginológico após o tratamento endodôntico.

Periapical radiographs are essential for endodontic treatment and for following the tooth response after finishing the treatment. Unfortunately, due to their technical limitations, they are not capable of offering a complete anatomical view of the dental structure. More recent image techniques, such as cone-beam computed tomograph (CBCT), seem to offer a more complete picture of the pulp chamber obturation and the remaining dental structure, as well as the periradicular status. The aim of our study was to analyze CBCT images obtained from 100 endodontically treated teeth, focusing on the obturation of the pulp chamber, periapical status, interadicular alterations and root fractures. From the 100 teeth, 83 (83%) presented periradicular alterations. From multiradicular teeth, 51% presented with alterations in the interadicular area and 91% showed periradicular alterations. Twenty out 83 teeth presenting periradicular alterations (24%) showed also root fractures. CBCT images revealed the presence of several root and periradicular alterations in the endodontically treated teeth studied in this sample, suggesting its utility as an adjunctive auxiliary in the follow-up of teeth after endodontic treatment.

Angio-Computed Tomograph-Guided Immediate Lipiodol Computed Tomograph for Diagnosis of Small Hepatocellular Carcinoma Lesions during Transarterial Chemoembolization / 中华医学杂志(英文版)

<p><b>Background</b>The diagnosis and treatment of small hepatocellular carcinoma (HCC) play a vital role in the prognosis of patients with HCC. The purpose of our study was to evaluate angio-computed tomography (angio-CT)-guided immediate lipiodol CT (a CT scan performed immediately after transarterial chemoembolization [TACE]) in the diagnosis of potential HCCs ≤1 cm in diameter.</p><p><b>Methods</b>This study retrospectively analyzed 31 patients diagnosed with HCCs after routine imaging (contrast-enhanced CT or magnetic resonance imaging) or pathologic examinations with undefined or undetermined tumor lesions (diameter ≤1 cm) from February 2016 to September 2016. After TACE guided by digital subtraction angiography of the angio-CT system, potential HCC lesions with a diameter ≤1 cm were diagnosed by immediate lipiodol CT. The number of well-demarcated lesions was recorded to calculate the true positive rate. The correlation between the number of small HCCs detected by immediate lipiodol CT and the size of HCC lesions (diameter >1 cm) diagnosed preoperatively was analyzed 1 month after TACE. A paired t-test was used to analyze differences in liver function. Pearson analysis was used to analyze correlation. Chi-square test was used to compare the rates.</p><p><b>Results</b>Fifty-eight lesions were detected on preoperative routine imaging examinations in 31 patients including 15 lesions with a diameter ≤1 cm. Ninety-one lesions were detected on immediate lipiodol CT, of which 48 had a diameter ≤1 cm. After 1 month, CT showed that 45 lesions had lipiodol deposition and three lesions had lipiodol clearance. Correlation analysis showed that the number of small HCCs detected by lipiodol CT was positively correlated with the size of HCC lesions diagnosed by conventional imaging examination (R = 0.54, P < 0.05).</p><p><b>Conclusion</b>Immediate lipiodol CT may be a useful tool in the diagnosis of potential HCC lesions with a diameter of ≤1 cm.</p>

mRNA Expression of SLC5A5 and SLC2A Family Genes in Papillary Thyroid Cancer: An Analysis of The Cancer Genome Atlas

PURPOSE: The present study investigated the dynamics and prognostic role of messenger RNA (mRNA) expression responsible for 18F-fluorodeoxyglucose (FDG) uptake in FDG positron emission tomography (PET) and radioactive iodine (131I) uptake in whole-body radioactive iodine scans (WBS) in papillary thyroid cancer (PTC) patients. MATERIALS AND METHODS: The primary and processed data were downloaded from the Genomic Data Commons Data Portal. Expression data for sodium/iodide symporter (solute carrier family 5 member 5, SLC5A5), hexokinase (HK1–3), glucose-6-phosphate dehydrogenase (G6PD), and glucose transporter (solute carrier family 2, SLC2A1–4) mRNA were collected. RESULTS: Expression of SLC5A5 mRNA were negatively correlated with SLC2A1 mRNA and positively correlated with SLC2A4 mRNA. In PTC with BRAF mutations, expressions of SLC2A1, SLC2A3, HK2, and HK3 mRNA were higher than those in PTC without BRAF mutations. Expression of SLC5A5, SLC2A4, HK1, and G6PD mRNA was lower in PTC without BRAF mutation. PTCs with higher expression of SLC5A5 mRNA had more favorable disease-free survival, but no association with overall survival. CONCLUSION: Expression of SLC5A5 mRNA was negatively correlated with SLC2A1 mRNA. This finding provides a molecular basis for the management of PTC with negative WBS using 18F-FDG PET scans. In addition, higher expression of SLC5A5 mRNA was associated with less PTC recurrence, but not with deaths.

Comparison on application of five kinds of elastic registration methods in the CT image registration of radiotherapy / 中国医学装备

Objective: To compare the applications of five kinds of routine elastic registration methods included of Horn-Schunck optical flow method, Demons algorithm, accelerated Demons algorithm, level set algorithm and fast free deformation algorithm in radiotherapy. Methods: 10 patients who underwent radiotherapy on pelvic cavity were enrolled in the research. And their CT images at the time of location and during radiotherapy were collected, and the five kinds of routine elastic registration methods were applied in the research, and through autonomic programming to implement elastic registration, and then the registered results were further compared. Results: The average minimum mean square error (MSE) of five kinds of routine elastic registration methods have been decreased 6.7%-26.0%, and the average correlation coefficient(CC) has been increased 2.6%-3.7%, and the average registration time was 107.5s-220.8s. Conclusions: All of the five kinds of elastic registration methods get better results, and it is recommended to use Horn-Schunck optical flow method for elastic registration of radiotherapy CT. And through using elastic registration model can more accurate simulate the movement of organ, and it is a direction of further study that monitor individual dosage of organ at risk.

Result of central retinal subfield thickness measurement in patient with diabetes mellitus on cirrus optical coherence tomography / Шинэ санаа Шинэ нээлт

Diabetic macular edema (DME) is the leading cause of visual impairment in people with diabetes mellitus. Last few years, as a result of the introduction of the latest diagnostic technology and new treatment managements in our practice, we were able to diagnose and treat patients with DME at a qualitatively new level. The purpose of this study was to evaluate central retinal subfield thickness (CRST) on Cirrus OCT™ in patients with diabetes mellitus but minimal or no retinopathy. Our study was aimed to evaluate central retinal subfield thickness in patients with diabetes mellitus but minimal or no retinopathyThis cross-sectional study were included 101 patients (189 eyes) with diabetes mellitus with no or minimal diabetic retinopathy and no central retinal thickening on clinical examination and on a Cirrus™ (Carl Zeiss Meditec, Dublin, CA) optical coherence tomography (OCT). The study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Ethical Committee of the School of Medicine, Mongolian National University of Medical Sciences. All study participants provided written informed consent before entering the study. The investigators assessed the BCVA using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing chart, and the stereoscopic color fundus photography was performed by the fundus camer VX-10 (Kowa Company, Ltd, Nagya, Japan) and CRST were measured by the Cirrus OCT™ (Carl Zeiss Meditec, Germany) for all patients. The main outcome measurement was central retinal subfield thickness fast macular scan on Cirrus OCT™.The study enrolled 101 patients. Average age was 52.94±9.85 years, 54% were men and 46% women. Type 1 diabetes was present in 2.1% and type 2 in 97.9% participants. The average duration of diabetes was 6.03±4.94 years, mean HbA1c was 10.23±2.97 and ETDRS BCVA was 78.32±8.47 letter score. On average, central subfield thickness was 251.26±21.23 µm. Central subfield thickness was significantly greater in retinas from men than retinas from women participants (mean 256.12±22.27 µm versus 245.56±18.49 µm, p=0.001). The proportion of participants with a CRST <200 µm were 1.1%, 201-250 µm 43.9%, 251-270 µm 37.6% and ≥271 µm 17.5% respectively.The average central subfield thickness on Cirrus OCT™ in patients with diabetes mellitus and minimal or no retinopathy are were 251.26±21.23 µm. Central subfield thickness is greater in men than in women.

The study of cystic duct and cystic artery imaging of calculus cholecystitis with multi-slice CT / 实用放射学杂志

Objective To assess the displaying of the cystic artery and the cystic duct in calculus cholecystitis patients using MSCT.Methods One hundred and three patients with calculus cholecystitis (the experimental group)and 71 patients with non-gallbladder disease (the control group)performed the cystic artery and the cystic duct imaging using MSCT.The data in two groups were recorded and statistical analyzed.Results (1)The display rate of the cystic duct were 93.2% (96/103)in the experimental group and 100% (71/71)in the control group with the significant difference between the two groups (P 0.05).The variation rate of the cystic artery running were 13.5% (13/96)in the experimental group and 1 5.5% (1 1/71)in the control group.There was no significant difference between the groups (P >0.05).Conclusion The cystic duct and the cystic artery could be evaluted well in calculus cholecystitis using CT.The displaying of the cystic duct is relatively poor in acute cholecystitis.

Result of central retinal subfield thickness measurement in patient with diabetes mellitus on cirrus optical coherence tomography / Шинэ санаа Шинэ нээлт

Diabetic macular edema (DME) is the leading cause of visual impairment in people with diabetes mellitus. Last few years, as a result of the introduction of the latest diagnostic technology and new treatment managements in our practice, we were able to diagnose and treat patients with DME at a qualitatively new level. The purpose of this study was to evaluate central retinal subfield thickness (CRST) on Cirrus OCT™ in patients with diabetes mellitus but minimal or no retinopathy. Our study was aimed to evaluate central retinal subfield thickness in patients with diabetes mellitus but minimal or no retinopathy This cross-sectional study were included 101 patients (189 eyes) with diabetes mellitus with no or minimal diabetic retinopathy and no central retinal thickening on clinical examination and on a Cirrus™ (Carl Zeiss Meditec, Dublin, CA) optical coherence tomography (OCT). The study was conducted in accordance with the Declaration of Helsinki. Ethical approval was obtained from the Ethical Committee of the School of Medicine, Mongolian National University of Medical Sciences. All study participants provided written informed consent before entering the study. The investigators assessed the BCVA using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity testing chart, and the stereoscopic color fundus photography was performed by the fundus camer VX-10 (Kowa Company, Ltd, Nagya, Japan) and CRST were measured by the Cirrus OCT™ (Carl Zeiss Meditec, Germany) for all patients. The main outcome measurement was central retinal subfield thickness fast macular scan on Cirrus OCT™. The study enrolled 101 patients. Average age was 52.94±9.85 years, 54% were men and 46% women. Type 1 diabetes was present in 2.1% and type 2 in 97.9% participants. The average duration of diabetes was 6.03±4.94 years, mean HbA1c was 10.23±2.97 and ETDRS BCVA was 78.32±8.47 letter score. On average, central subfield thickness was 251.26±21.23 µm. Central subfield thickness was significantly greater in retinas from men than retinas from women participants (mean 256.12±22.27 µm versus 245.56±18.49 µm, p=0.001). The proportion of participants with a CRST <200 µm were 1.1%, 201-250 µm 43.9%, 251-270 µm 37.6% and ≥271 µm 17.5% respectively. The average central subfield thickness on Cirrus OCT™ in patients with diabetes mellitus and minimal or no retinopathy are were 251.26±21.23 µm. Central subfield thickness is greater in men than in women.

A digital volumetric tomography (DVT) study in the mandibular molar region for miniscrew placement during mixed dentition

OBJECTIVE: To assess bone thickness for miniscrew placement in the mandible during mixed dentition by using digital volumetric tomograph (DVT). MATERIAL AND METHODS: A total of 15 healthy patients aged 8-10 years old, with early exfoliated mandibular second deciduous molar, were included. DVT images of one quadrant of the mandible were obtained using Kodak extraoral imaging systems and analyzed by Kodak dental imaging software. The error of the method (EM) was calculated using Dahlberg's formula. Mean and standard deviation were calculated at 6 and 8 mm from the cementoenamel junction (CEJ).Paired t-test was used to analyze the measurements. RESULTS: Buccal cortical bone thickness, mesiodistal width and buccolingual bone depth at 6 mm were found to be 1.73 + 0.41, 2.15 + 0.49 and 13.18 + 1.22 mm, respectively; while at 8 mm measurements were 2.42 + 0.34, 2.48 + 0.33 and 13.65 + 1.25 mm, respectively. EM for buccal cortical bone thickness, mesiodistal width and buccolingual bone depth was 0.58, 0.40 and 0.48, respectively. The difference in measurement at 6 and 8 mm for buccal cortical plate thickness (P < 0.05) and buccolingual bone thickness (P < 0.05) was found to be significant, whereas for mesiodistal width it was insignificant (P > 0.05). CONCLUSION: Bone thickness measurement has shown promising evidence for safe placement of miniscrews in the mandible during mixed dentition. The use of miniscrew is the best alternative, even in younger patients. .

OBJETIVO: avaliar, por meio de tomografia volumétrica digital (TVD), a espessura óssea necessária para a instalação de mini-implante na arcada inferior durante a fase de dentição mista. MÉTODOS: um total de 15 pacientes saudáveis, com idades entre 8 e 10 anos, com segundo molar inferior decíduo irrompido recentemente, foram incluídos no presente estudo. Imagens de TVD da hemiarcada inferior foram obtidas utilizando sistemas de imagens extrabucais Kodak. As imagens foram analisadas por meio do programa de imagens Kodak. O erro do método (EM) foi calculado utilizando a fórmula de Dahlberg. Médias e desvios-padrão foram calculados de 6 a 8mm aquém da junção amelocementária. O teste t foi utilizado para a análise das medidas. RESULTADOS: a espessura do osso cortical vestibular, largura mesiodistal e profundidade óssea vestibulolingual, a 6mm, foram de 1,73 + 0,41; 2,15 + 0,49; e 13,18 + 1,22 mm, respectivamente. Já a 8mm, os valores foram de 2,42 + 0,34; 2,48 + 0,33; e 13,65 + 1,25mm. O EM para a espessura do osso cortical vestibular, largura mesiodistal e profundidade óssea vestibulolingual foi de 0,58, 0,40 e 0,48mm, respectivamente. A diferença entre as medidas a 6 e 8mm para a espessura do osso cortical vestibular (p < 0,05) e a espessura óssea vestibulolingual (p < 0,05) foi significativa, embora não tenha sido significativa para a largura mesiodistal (p < 0,05). CONCLUSÃO: a mensuração da espessura óssea demonstra evidências promissoras para a segura instalação de mini-implantes na arcada inferior e na fase de dentição mista. O uso de mini-implantes tem se mostrado a melhor alternativa, mesmo nos casos de pacientes mais jovens. .

Prognostic value of maximum standard uptake of pretreatment 18F-FDG PET-CT in newly diagnosed soft tissue sarcoma / 肿瘤研究与临床

Objective To determine the prognostic value of maximum standard uptake (SUVmax) of pretreatment 18F-FDG PET-CT in patients with newly diagnosed soft tissue sarcomas (STS).Methods The clinical data of 34 patients with STS undergoing 18F-FDG PET-CT before treatment were analyzed retrospectively.The relationship between SUVmax of PET-CT and prognostic factors was evaluated by MannWhitney' s non-paraetric test and Spearman' s rank correlation test.The prognostic factors were analyzed by univariate and multivariate analysis.Results Among 34 patients, the median SUVmax was 10.3 (1.5-28.2), and the median maximum diameter was 6.7 cm (1.8-17.2 cm) with positively association between them (r =0.389, P =0.028).SUVmax was also associated with pathological grade, AJCC staging and distant metastasis, respectively (all P ＜ 0.05).In univariate analysis, distant metastasis, pathological grade, AJCC staging, and SUVmax were found to be the prognostic factors (all P ＜ 0.05).Multivariate analysis results indicated that only the SUVmax and distant metastasis were the independent unfavorable prognostic factors (both P ＜ 0.05).Conclusions The SUmax of pretreatment 18F-FDG PET-CT is well correlated with prognostic factors, and it can predict the prognosis of patients with STS.

Feature analysis for 31 cases of multislice CT angiography in mycoplasma pneumonia / 中国医学装备

Objective: To analyze the imaging features of mycoplasma pneumonia in order to improve the early diagnosis and treatment of mycoplasma pneumonia as well as reduce misdiagnosis. Methods:Multislice CT data of 31 mycoplasma pneumonia patients during 2012.4 to 2014.4 in our hospital were retrospectively analyzed. Results:Multislice CT results showed that 22 cases(70.97%) occurred in one side of lung, in which 12 cases (38.71%) located in the left lung(two cases located in the lobi superior(6.45%)and 10 cases located in the lobi inferior(32.26%));10 cases (32.26%) located in the right lung , in which 4 cases located on the lobi superior (12.90%), four cases at the lobi inferior(12.90%), two cases involved both lobi medius pulmonis and lobi inferior(6.45%). 9 cases (29.03%) were double lung involvement. The changes of CT are diverse which included glass-like images, consolidation, air bronchogram, bronchial vascular bundle thickening, pleural effusion and mediastinal lymph nodes enlargement. Conclusion:Patients with mycoplasma pneumonia always have varied radiographic changes and chest multislice CT has a certain sense of early diagnosis.

Infecção orbitária: experiência no manejo de seis casos / Orbital infeccion: experience on the management of six cases

Infecções orbitárias são enfermidades, que requerem atenção e cuidados especiais. Os principais fatores etiológicos associados são sinusites paranasais e o trauma local. Essas infecções classificam-se em pré-septal e pós-septal e distinguem-se clinicamente, de acordo com a manutenção da acuidade visual e motilidade do globo ocular. O curso da infecção pode agravar com disfunção da motilidade ocular extrínseca, perda de visão e trombose do seio cavernoso. A tomografia computadorizada (TC) é o principal exame imaginológico para a classificação do abscesso, investigação etiológica, determinação da gravidade e a relação do processo com o sistema nervoso central. Este trabalho apresenta e discute o manejo de seis pacientes admitidos com infecção orbitária pelo serviço de Cirurgia e Traumatologia Bucomaxilofacial do Hospital Geral Roberto Santos e em Salvador, Bahia. A TC mostrou não haver disseminação do processo inflamatório para o sistema nervoso central em nenhum dos casos tendo esse achado sido fundamental para determinar que a conduta estivesse restrita à drenagem, sem necessidade de craniotomia. As intervenções cirúrgicas e a antibioticoterapia estavam indicadas devido à importante congestão tecidual e intensa sintomatologia dolorosa. Todos os pacientes apresentaram remissão da infecção e acuidade visual preservada... (AU)

Orbital infections are diseases that require special attention and care. The main risk factors are associated with paranasal sinusitis and local trauma. These infections are classified into pre-septal and post-septal and distinguished clinically according to the maintenance of visual acuity and eye motility. The course of the infection may worsen with extrinsic ocular motility dysfunction, loss of vision and cavernous sinus thrombosis. Computed tomography (CT) is the primary imaging examination for the classification of the abscess, etiologic investigation, determining the severity of the process and the relationship with the central nervous system. This paper presents and discusses the management of six patients admitted with orbital infection by service Oral and Maxillofacial Surgery General Hospital Roberto Santos in Salvador, Bahia. A CT scan showed no spread of the inflammatory process in the central nervous system and in any case this finding was important to determine that the drainage duct was confined without requiring craniotomy. Surgical interventions and antibiotics were given because of the important tissue congestion and intense painful symptoms. All patients had remission of infection and preserved visual acuity... (AU)

Clinical application of renal vessel angiography with 256-slice spiral CT in laparoscopic surgery for renals / 中国综合临床

Objective To investigate the clinical application of renal vessel angiography with 256-slice spiral CT in laparoscopic surgery for renals.Methods One hundred and fifty-five cases underwent computed tomograph angiography(CTA) who were all confirmed by operations.According to preoperative renal artery CTA case shown,the initial plan intraoperative renal artery was compared with the situation with the actual surgery.AIl axial images were reconstructed using technique.Results All patients underwent preoperative renal artery CTA operative findings correspond with the actual rate of 100％.CTA stereoscopic images were good at reflecting renal vascular anatomy and ectopic blood vessels line.Conclusion CTA can accurately evaluate out of shape and variation of the renal arteriesvariation.It has important significance of processing of renal arteries intraoperative rapid,dealing with the renal artery accurately and reducing blood loss or damage and other complications.

The impact of refractive errors and axial length on the structural parameters of the optic disc / 中华实验眼科杂志

Background Heidelberg Retinal Tomograph (HRT) has been widely used in clinical diagnosis of glaucomatous optic neuropathy,importantly,the measurement results of HRT may be affected by myopia.Therefore,studying the effect of different refractive status and axial length on structural parameters of the optic disc is important.Objective This study was to evaluate the influence of refractive error and axial length to optic nerve head parameter measured by HRT.Methods The parents who participate in Guangzhou Twin Study were enrolled in this investigation from July 2006 to August 2011.The regular eye examinations,including visual acuity,slit lamp,fundus,auto-refraction,HRT-Ⅲ and intraocular lens (IOL) Master,were performed on all the subjects.Thc data from right eyes of subjects were collected and analyzed.The linear correlation analysis and multiple linear regression analysis were applied to analyze the correlation between HRT optic papilla configuration parameter and equivalent sphere and ocular axis length.Results A pilot prospective series cases observational study was designed.1748subjects were enrolled in this study.The disc area (DA) (P=0.021),rim area (RA) (P＜0.001),rim volume (RV) (P＜0.001),mean retinal nerve fiber layer thickness (mRNFLt) (P＜0.001) and retinal nerve fiber layer cross section area (RNFLcsa) in the high myopia were greater than those of the emmetropic group,with significant difference between the two groups (P＜0.001).However,the cup area (CA),cup/disk area ratio (C/DAR) and cup volume (CV) were less in the high myopic group than those of the emmetropic group (P=0.004,P＜0.001 and P＜O.001),respectively.In the mild-moderatc myopic group,the RV,mRNFLt and RNFLcsa were greater than those of the emmetropic group (all of the P value less than 0.001),but the numbers of DA,CA,C/DAR,and CV were less than those of the emmetropic group,the differences were significant and their P valuables were 0.038,＜ 0.001,＜0.001 and 0.001 respectively.The differences of structure parameters between the hyperopia group and the emmetropic group were not statistically significant (P＞0.05).The DA,CA,RA,C/DAR,CV,RV,mean cup depth (MCD),maximum cup depth (MxCD),cup shape measure (CSM),mRNFLt and RNTLcsa were (2.04±0.43) mm2,(0.49±0.34) mm2,(1.55 ± 0.34) mm2,0.23-0.13,(0.11 ± 0.12) mm3,(0.45 ± 0.19) mm3,(0.21 ± 0.09) mm,(0.60±0.21) mm,-0.21 ± 0.07,(0.29 ± 0.07) mm and (1.46 ± 0.36)mm2,respectively,in the 1748 eyes of 1748 subjects.No significant correlation was found between the DA value with SE (r=-0.032,P =0.186).However,weaker positive correlations were seen between the CA,C/DAR,CV,MCD,MxCD with SE (r=0.139,0.163,0.130,0.004,0.054,P＜ 0.05) and negative correlation between RA,RV,mRNFLt and RNFLcsa with SE (r =-0.178,-0.331,0.241,-0.239,P＜0.001).With the increase of the ocular axial length,the DA,RA,RV,mRNFLt and RNFLcsa values were enlarged,and the CV value was smaller.With the increase of CA,the RA,C/DAR,CV,RV,MCD,MxCD,CSM and RNFLcsa values elevated,but mRNFLt value was decreased.Conclusions Refractive error is not associated with DA,but the measuring results are different among various refractive groups.Refractive error,ocular axial length and DA affect the measuring result of HRT.

Tomographic characteristics of optic nerve head on Heidelberg retina tomograph Ⅲ in healthy Chinese subjects / 中华实验眼科杂志

Background Normal adult optic disc rim width follows inferior ≥ superior ≥ nasal ≥ temporal (ISNT) rule.Analysis of the optic disc structural parameters with Heidelberg retina tomograph (HRT) can understand whether ISNT principle is suitable to other optic disc structure parameters.Objective This study was to investigate the characteristics of optic nerve head structure parameters in normal Chinese adults.Methods The parents of twins who participated Guangzhou Twin Eye Study were enrolled in Zhongshan Ophthalmic Center from 2006 June to 2011 August.All subjects received the routine eye examinations,including visual acuity,slit lamp microscope,direct ophthalmoscope examination,auto-refraction examination and HRT Ⅲ examination.All data from the right eyes were collected and analyzed.HRT values from different quadrants of optical nerve head were compared with one-way analysis of variance,and the multiple comparison between quadrants was carried out by Bonferroni test.The differences of optical nerve head parameters in different gender were analyzed using independent sample t test and Bland-Altman test.Results In this study,1672 eyes of 1672 subjects were included,with the 759 male and 913 female persons and average age of (41.8±5.3)years.No significant differences were seen in the disc area (DA)between the superior and inferior,as well as the nasal and temporal quadrants among the subjects (P＞0.05).In addition,there were not significantly different in the rim area (RA) between the superior and nasal disc as well as the rim volume (RV) among the inferior,superior and nasal disc (P＞O.05).However,significant differences were found in the cup area (CA),cup/disk area ratio (C/DAR),cup volume (CV),mean cupdepth (MCD),maximum cup depth (MxCD),height variation contour (HVC),cup shape measure (CSM),mean retinal nerve fiber layer thickness (mRNFLT) and retinal nerve fiber layer cross section area (RNFLcsa) among the different quadrants (P＜0.001).The local differences from only DA and RA complied with an ordination of the ISNT rule.The values of DA,CA,C/DAR,CV,MCD,MxCD from male individuals were higher,but those of the RV,HVC,mRNFLT RNFLcsa were lower in comparison with female individuals.Nevertheless,all the differences were ＜ 0.1 with a maximal mean difference in DA and CA (both 0.07 mm2).Conclusions The optical nerve head configurations measured by HRT have different distributing characteristics in four quadrants in normal adults.Most parameters show the higher values in the inferior and superior than those in nasal and temporal of disc,but DA and RA meet ISNT rule.The differences of most parameters between male and female subjects can be ignored.