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Seeds are the source for the production of Chinese medicinal materials. The seed authenticity and quality of directly affect the effectiveness and safety of Chinese medicinal materials. The seed quality is faced with the problems such as mixed sources， existence of adulterants and seeds stocked for years， low maturity， and low purity. To ensure the high-quality and sustainable development of the Chinese medicinal material industry， it is urgent to standardize the seed market and identify and evaluate the quality of the seeds circulating in the market. Seed identification methods include visual inspection， microscopic observation， micro-character identification， chemical fingerprinting， molecular identification， electronic nose， X-ray diffraction， electrochemical fingerprinting， spectral imaging， and artificial intelligence. These methods have different application scopes and unique advantages and disadvantages. According to the different species of Chinese herbal medicines and different requirements of testing sites， suitable methods can be selected to achieve rapid and accurate identification with low costs. In the future， the seed identification methods should be developed based on emerging technologies with interdisciplinary knowledge， and intelligent， nondestructive， and single-grain detection methods are needed for the modern Chinese medicinal material industry. This paper introduces the seed identification technologies currently applied in research and production， compares the principles， applicability， advantages， and disadvantages of different technologies， and provides an outlook on the future development of seed identification technologies， aiming to provide a reference for the identification and quality evaluation of seeds of Chinese medicinal material.
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Objective:To explore the clinical value of quantitative parameters on spectral CT in predicting the invasiveness of lung adenocarcinoma manifesting as ground-glass nodules (GGN).Methods:The clinical and imaging data of 129 patients with pathologically confirmed lung adenocarcinoma who were surgically resected in the First Affiliated Hospital of Zhengzhou University from March to October 2022 were retrospectively analyzed, including 45 males and 84 females, aged from 33 to 81. According to the pathological results, they were divided into the minimally invasive adenocarcinoma (MIA) group ( n=64) and the invasive adenocarcinoma (IAC) group ( n=65). All patients underwent enhanced spectral CT within two weeks before surgery. The iodine density map, Z-Effective (Z eff) map, and electron density (ED) map were reconstructed on the post-processing workstation, and the spectral parameters, including normalized iodine concentration (NIC), arterial enhancement fraction (AEF), Z eff, and ED were measured and calculated. Conventional CT features were analyzed, including maximum diameter, CT value, nodule types, margin, lobulation sign, spiculation sign, bubble sign, pleural retraction sign, abnormal vascular sign, and air bronchial sign. The clinical features, conventional CT characteristics and spectral CT parameters of two groups were compared using the independent sample t test, the Mann-Whitney U test, and the χ 2 test. Multivariate logistic regression analysis was used to evaluate the independent risk factors of lung adenocarcinoma invasiveness, and the model was constructed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the performance of parameters and models in predicting the invasiveness of lung adenocarcinoma. Results:There were significant differences between the MIA group and IAC group in maximum diameter, CT value, nodule type, margin, spiculation sign, pleural retraction sign, air bronchial sign, venous phase NIC, AEF, venous phase Z eff, arterial phase ED, venous phase ED ( P<0.05). Multivariate logistic regression analysis showed that the maximum diameter (OR=1.183, 95%CI 1.062-1.318), CT value (OR=1.004, 95%CI 1.001-1.007), venous phase NIC (OR=1.185, 95%CI 1.083-1.298), AEF(OR=0.975, 95%CI 0.957-0.994), venous phase Z eff (OR=0.031, 95%CI 0.005-0.196) were independent influence factors for the invasiveness of lung adenocarcinoma. The conventional CT model was established with the maximum diameter and CT value, and the spectral CT model was established with venous phase NIC, AEF, and venous phase Z eff. The combined model was established with all the parameters above. Areas under the ROC curve of the conventional CT model, the spectral CT model, and the combined model for predicting the invasiveness of lung adenocarcinoma were 0.828, 0.854, and 0.902, respectively. Conclusion:The quantitative parameters of double-layer detector spectral CT can be used as an indicator to predict the invasiveness of lung adenocarcinoma manifesting as GGN, and AEF has the highest diagnostic efficacy. Spectral CT combined with conventional CT features can further improve the diagnostic efficiency.
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Objective:To investigate the value of spectral CT based iodine concentration (IC) parameters for preoperative prediction of lymphovascular invasion (LVI) in gastric cancer.Methods:Between January 2021 and November 2021, 266 patients diagnosed as gastric adenocarcinomas by endoscopy and undergoing gastrectomy at the Affiliated Cancer Hospital of Zhengzhou University were recruited prospectively. They were divided into LVI and non-LVI groups according to pathological reports. Triple phase contrasted enhanced CT scans, including arterial phase (AP), venous phase (VP) and delayed phase (DP) were performed on a spectral CT platform within one week before surgery. The IC of gastric cancer lesions at three enhanced phases were measured based on iodine maps, and the normalized IC (nIC) was calculated. The thickness of the tumor was measured. Clinicopathological features were collected, including ulceration, pathological tumor staging (pT), pathological node staging (pN), histodifferentiation, Lauren subtype, perineural invasion (PNI), positive node numbers and positive node ratio. Student′s t tes t or Mann-Whitney U test were used to compare the differences of continuous variables between the two groups, while Chi-square test or Fisher′s exact test was used for categorical data. Multivariable logistic regression analysis was used to screen independent risk factors of LVI, and to build a combined parameter based on risk factors. The receiver operating characteristic curve analysis was performed to determine the predictive efficacy of IC parameters and the combined parameter for LVI. DeLong′s test was used to compare the differences among different area under the curve (AUC). Results:There were statistical differences in tumor thickness, ulceration, pT, pN, histodifferentiation, positive node numbers, positive node ratio, Lauren subtype and PNI between LVI and non-LVI groups ( P<0.05). The values of IC VP, IC DP, nIC VP, nIC DP in LVI group were statistically higher than those in non-LVI group ( t=3.77, 4.23, 4.25, 6.12, all P<0.001), with the AUC (95%CI) of 0.674 (0.610-0.738), 0.677 (0.614-0.741), 0.731 (0.671-0.792), 0.700 (0.636-0.764) for predicting LVI, respectively. Multivariable logistic regression analysis revealed that tumor thickness (OR=1.148, 95%CI 1.085-1.237, P<0.001) and nIC VP (OR=209.904, 95%CI 14.874-644.362, P<0.001) were independent predictors for LVI, the combined parameter incorporating these two factors yielded an AUC (95%CI) of 0.790 (0.736-0.937), which was statistically higher than any single parameter of IC VP, IC DP, nIC VP and nIC DP ( Z=3.07, 3.29, 2.10, 2.60, P=0.002, 0.001, 0.036, 0.009). Conclusion:The IC and nIC values of gastric cancer lesions derived from the VP and DP on spectral CT can effectively predict LVI status in gastric adenocarcinomas, and the combination of nIC VP and tumor thickness can further improve the predictive efficacy.
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Objective:To investigate the value of dual-layer detector spectral CT in preoperative evaluation of immunohistochemical expression levels in breast cancer patients.Methods:The clinical, pathological and imaging data of breast cancer patients who received preoperative spectral CT chest scan in Affiliated Hospital of Southwest Medical University from October 2020 to January 2021 were retrospectively analyzed. A total of 70 patients were divided into positive or negative estrogen receptor (ER) group, positive or negative progesterone receptor (PR) group, positive or negative human epithelial growth factor receptor 2 (HER2) group, and positive or negative Ki-67 group according to the immunohistochemistry. Philips workstation and Special Diagnostic Suite software were used for processing and analysis. The CT value and iodine concentration value (IC) of the lesion and the effective atomic number (Z eff) of the lesion in the arterial and venous phases were measured, and the standardized CT value (NCT), standardized iodine concentration value (NIC), slope (K) of the keV-CT value curve in the arterial and venous phases as well as the CT difference and the IC difference in the arteriovenous phase were calculated. Independent sample t test was used to compare the differences in spectral parameters between patients with positive and negative immunohistochemical parameters, and ROC curve was used to analyze the efficacy of spectral parameters in the differential diagnosis of positive and negative different immunohistochemical parameters. Results:Z eff, NIC, K value, CT value, IC value of arterial and venous phase and NCT value of venous phase in negative ER group were higher than those in positive ER group, the difference was statistically significant ( P<0.05). Z eff, NIC, K value, IC, CT difference in arteriovenous phase and IC difference in arteriovenous phase in positive HER2 group were higher than those in negative HER2 patients, the difference was statistically significant (P<0.05). The arterial K value in positive Ki-67 group was higher than that in negative Ki-67 group, the difference was statistically significant ( P<0.05). Taking arterial phase K value of 1.22 as the diagnostic threshold, it had the highest diagnostic efficiency in differential diagnosis of ER positivity versus negativity (area under curve of 0.791, sensitivity of 84.00%, specificity of 65.00%). Taking the arteriovenous phase IC difference of 0.47 mg/ml as the diagnostic threshold, it had the highest performance in differential diagnosis of HER2 positivity versus negativity (area under curve of 0.736, sensitivity of 76.32%, specificity of 65.62%). Conclusion:Dual-layer detector spectral CT has certain diagnostic value for the immunohistochemical expression of breast cancer patients, which can provide reference for clinical diagnosis and treatment.
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Objective:To explore the diagnostic efficiency of CT enterography (CTE) comprehensive score combined with spectral imaging for Crohn's disease (CD) in active phase.Methods:A retrospective analysis was performed on the case data of 87 CD patients who were admitted to the First People's Hospital of Chenzhou from October 2018 to October 2020. According to CD activity index (CDAI), they were divided into active phase group ( n=58) and remission phase group ( n=29). The results of CTE and spectral imaging in both groups were collected. The diagnostic value of CTE comprehensive score combined with spectral imaging for CD in active phase was analyzed. Multiple linear stepwise regression analysis was used to analyze the independent related factors affecting the active phase of CD. Receiver operating characteristic (ROC) curve was used to predict the area under curve (AUC), sensitivity, specificity and cutoff value of CTE comprehensive score combined with energy spectrum imaging (intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase) in active phase of CD. Results:The probability of comb sign, intestinal stenosis or expansion and target sign in CTE of patients with active CD was significantly higher than that in patients with remission CD, the probability of fat sign was significantly lower than that in patients with remission CD, and the CTE comprehensive score was significantly higher than that in patients with remission CD ( P<0.05). Multiple linear stepwise regression analysis showed that the thickness of intestinal wall, uniform enhancement of intestinal wall and iodine concentration in portal phase were independent related factors affecting the active phase of CD ( P<0.05). ROC curve analysis showed that AUC of CTE comprehensive score combined with intestinal wall thickness, intestinal wall uniform enhancement and iodine concentration in portal phase for predicting CD in active phase was 0.953, higher than 0.869, 0.907, 0.914 and 0.913 of single index. The cut-off values of CTE comprehensive score, intestinal wall thickness and iodine concentration in portal phase were 6.0 points, 0.89 cm and 2.68 mg/ml, respectively. There was no homogeneous enhancement of intestinal wall in spectral imaging. Conclusions:CTE comprehensive score combined with intestinal wall thickness, intestinal wall enhancement and iodine concentration in portal phase can more accurately determine CD in active phase, which provide a new quantitative diagnostic reference.
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Objective: To explore the value of specific spectral CT in evaluating antiangiogenic efficacy of Axitinib in rabbit VX2 liver tumors. Methods: Forty VX2 liver tumor-bearing rabbits were randomly assigned into study group (n=25, given Axitinib through intragastric administration for 14 days) and control group (n=15, given equal volume of normal saline through intragastric administration for 14 days). Rabbits in study group were scanned with one-stop perfusion and spectral CT mode, while in control group underwent arterial-phase spectral CT scan and perfusion CT scan, sequentially. The optimal scan time for control group was the maximum tumor contrast time based on the time-intensity curve of perfusion CT data of study group. The correlation coefficients of tumor perfusion parameters and the normalized iodine concentration (NIC) at different phases in study group were compared. Correlations between imaging features and vascular endothelial growth factor receptor-2 (VEGFR-2), and the differences among correlation coefficients were analyzed. Results: In control group, 73.33% (11/15) tumors achieved maximum contrast by using the optimal arterial scan time ([18±4]s) acquired from study group. The tumor blood flow (BF), blood volume (BV) and hepatic arterial fraction (HAF) had positive correlations with NIC. No statistical difference of correlation coefficients acquired in the optimal scan time and in the maximum correlation was found except for tumor BV. The tumor BF (r=0.828, P=0.008) and NIC (r=0.820, P=0.010) were positively correlated with VEGFR-2,while PS was negatively correlated with VEGFR-2 (r=-0.782, P=0.010), no statistical difference was found among the above three correlation coefficients (P>0.05). Conclusion: Single-phase contrast-enhanced spectral CT scan at tumor-specific and individual-specific acquisition time might be able to replace perfusion CT in evaluating antiangiogenic efficacy of Axitinib in rabbit VX2 liver tumors.
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Objective: To observe the manifestations of terminal ileitis on gemstone energy spectrum CT imaging (GSI) and its diagnostic efficacy compared conventional CT enterography (CTE), so as to evaluate the diagnosis value of GSI for terminal ileitis. Methods: Data of 120 patients with suspected terminal ileum diseases were retrospectively analyzed, including 115 cases of pathologically proved diseases (72 cases of terminal ileum enteritis, 6 cases of ileum polyps or tumorlike lesions, 30 cases of ileum Crohn's disease and 7 cases of ileum tuberculosis) and 5 cases without obvious abnormality. Among them 70 patients received conventional CTE (CTE group) and 50 received GSI (GSI group). Imaging characteristics of terminal ileitis were observed and compared between 2 groups. The consistency of the results of 2 methods for detecting terminal ileitis with pathological results were analyzed, and their sensitivities and specificities were compared. ROC curves of 2 methods for detecting terminal ileitis were drawn, and their relative diagnostic efficacy were analyzed. Results: Compared with conventional CTE, the lesions were clearer on low keV single energy imaging. The energy spectrum curve and iodide maps clearly identified the lesion's wall, normal wall, the fluid in intestinal cavity and the adjacent fat tissue. The iodine concentration of terminal ileitis at the arterial and venous phase was (10.90±0.55)μg/cm3 and (14.33±0.75)μg/cm3, respectively. Conventional CTE showed poor, while GSI showed high consistency with the pathological results for detecting terminal ileitis (Kappa=0.35, 0.72, P=0.16, <0.01). The sensitivity and specificity of GSI (86.21%, 85.71%) were bith higher than those of conventional CTE (65.12%, 51.85%, χ2=3.97, 6.10, both P<0.05). The AUC of GSI (0.86) was higher than that of conventional CTE (0.57, Z=2.42, P=0.02). Conclusion: GSI could clearly show lesions of terminal ileitis, therefore having high diagnostic efficacy for detecting terminal ileitis.
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Objective: To observe the energy spectral CT manifestations of focal organizing pneumonia (FOP) and peripheral lung cancer (PLC). Methods: Data of 40 patients with FOP (FOP group) and 60 patients with PLC (PLC group) confirmed by pathology who underwent chest dual-phase energy spectral CT were retrospectively analyzed. CT40~100 keV values on single energy images, iodine concentration, water concentration and effective atomic number at arterial and venous phase of lesions were measured and recorded, respectively. The corresponding energy spectral curve was drawn, and the slope of the curve was calculated. The quantitative parameters were compared between 2 groups. Results: There was no statistically differences of patients' age, gender, clinical symptoms nor lesions' size or location between 2 groups (all P>0.05). CT40 keV, CT50 keV, CT60 keV and CT 70 keV values, λ70 keV, iodine concentration, effective atomic number at arterial phase in PLC group were all higher than those in FOP group (t=3.46, 3.08, 3.08, 2.03, 2.32, 2.69, 2.73, all P0.05). Conclusion: Energy spectral CT findings of FOP and PLC had certain difference, providing references for differential diagnosis of FOP and PLC.
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Amyloid deposits are one of the hallmark pathological lesions of Alzheimer's disease (AD). They can be visualized by thioflavin-S, silver impregnation, Congo red staining, and immunohistochemical reactions. However, that amyloid deposits generate blue autofluorescence (auto-F) has been ignored. Here, we report that visible light-induced auto-F of senile plaques (SPs) was detected and validated with conventional methods. Brain slices from APP/PS1 (amyloid precursor protein/presenilin 1) transgenic mice were mounted on slides, rinsed, coverslipped and observed for details of the imaging and spectral characteristics of the auto-F of SPs. Then the slices were treated with the above classic methods for comparative validation. We found that the SP auto-F was greatest under blue-violet excitation with a specific emission spectrum, and was much easier, more sensitive, and reliable than the classic methods. Because it does not damage slices, observation of auto-F can be combined with all post-staining techniques in slices and for brain-wide imaging in AD.
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Objective@#To investigate the differences of gemstone spectral curve and CT value of gastric cancer with different pathological types and differentiation degrees.@*Methods@#91 cases of preoperative gemstone CT images with gastric cancer were collected, including 24 cases of mucinous carcinoma, 67 cases of non-mucinous carcinoma, 16 cases of signet ring cell carcinoma, 8 cases of mucinous adenocarcinoma, 32 cases of moderately differentiated adenocarcinoma and 35 cases of poorly differentiated adenocarcinoma. Gemstone CT spectral imaging was performed preoperatively, and the spectral curve of the lesion in venous phase was obtained by using GSI Viewer software, the slope of the curve was calculated, and 11 monoenergetic CT values of 40~140 keV (10 keV interval) were measured. The gemstone spectral curves and CT values of gastric cancer with different pathological types and differentiation degrees are compared.@*Results@#The curve slopes of non-mucinous carcinoma, signet ring cell carcinoma and poorly differentiated adenocarcinoma were -1.92±0.53, -1.73±0.37 and -2.14±0.54, respectively. The absolute values were higher than those of mucinous carcinoma (-1.45±0.54), mucinous adenocarcinoma (-0.90±0.34) and moderately differentiated adenocarcinoma (-1.67±0.41), and the differences were all statistically significant (P<0.05). There were significant differences in monoenergetic CT values between mucinous and non-mucinous carcinomas at 40-140 keV (all P<0.05). The former was lower than the latter in different degrees, and the lower the energy, the greater the difference was. There were significant differences in monoenergetic CT values between signet ring cell carcinoma and mucinous adenocarcinoma at 40-100 keV (all P<0.05); monoenergetic CT values between poorly differentiated adenocarcinoma and moderately differentiated adenocarcinoma at 40-90 keV showed statistically significant differences (P<0.05).@*Conclusions@#Gastric cancer with different pathological types and differentiation degrees have their characteristic spectral curves in venous phase, and the monoenergetic CT values are significantly different at low energy. The spectral curve of gemstone CT may be helpful to evaluate the pathological type and differentiation degree of gastric cancer before operation.
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Objective: To explore the application value of one-stop CT gemstone spectral and perfusion imaging quantitative parameters in predicting the properties of axillary lymph nodes. Methods Totally 60 purebred female New Zealand white rabbits were randomly divided into two groups, and rabbit models of axillary metastatic lymph nodes with VX2 implanted breast cancer (metastasis group) and inflammatory lymph nodes (inflammation group) were established, respectively. One-stop CT gemstone spectral and perfusion imaging scan was performed at the end of the fourth week after modeling. Then the axillary lymph nodes were taken for pathological examination and compared with CT images. Two independent samples t-test were used to compare the energy parameters and perfusion parameters between metastatic and inflammatory lymph nodes. Logistic regression and ROC curves were used to analyze the efficacy of single parameters and combined parameters in diagnosis of rabbit axillary lymph nodes. Results The blood flow (BF), blood volume (BV), arteriovenous iodine concentration (IC), standardized iodine value (NIC) and the slope (λ) of the energy spectrum curve from 40 keV to 70 keV in the metastasis group were higher than those in inflammation group (all P0.05). Taken 0.65 as the threshold, AUC of combined parameters (BF+arterial phase λ+venous phase λ) was 0.942, the sensitivity, specificity, positive predictive value and negative predictive value in diagnosis of axillary lympy nodes were 79.68%, 95.92%, 92.91% and 82.70%, respectively. Conclusion: The quantitative parameters of one-stop CT gemstone spectral and perfusion imaging show good diagnostic efficacy in identifying rabbit axillary breast cancer metastatic lymph nodes and inflammatory lymph nodes, while combined parameters (BF+arterial phase λ+venous phase λ) have higher diagnostic value.
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Breast cancer is the most common cancer in female population. Early detection of breast lesions and proper differentiation will directly impact on clinical treatment strategy and is related with prognosis. Breast tumors are usually rich in vascularity. Contrast-enhanced spectral mammography (CESM), based on K-edge effect of iodine, can acquire images of iodine contrast distribution in breasts through special computing and subtraction of images with both low- and high-energy X-ray exposures after intravenous induction of iodinated contrast media. It can eliminate the disturbance caused by overlapping breast tissues and demonstrate blood supply of the lesions, thus is sensitive to small lesion, more accurate in tumor delineating and able to help diagnosing. The current clinical applications and progresses of CESM were reviewed in this article.
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Objective: To explore the diagnostic value of dual-source CT energy parameters in qualitative diagnosis of metastatic cervical lymph nodes after surgical resection of thyroid papillary carcinoma (PTC). Methods Totally 30 postoperative PTC patients with 74 enlarged cervical lymph nodes were enrolled, including 49 metastatic lymph nodes (metastatic group) and 25 non metastasis lymph nodes (non-metastatic group). In addition, 30 cases with benign enlarged cervical lymph nodes were taken as benign group. All subjects underwent dual-source CT scanning. The iodine concentration value of nonenhanced phase (ICNP), arterial phase (ICAP) and venous phase (ICVP), normalized iodine concentration (NIC) and slope of energy spectrum curve (K) were detected and compared among 3 groups. Results: There were significant differences in ICNP, ICAP, ICVP, NIC and K among 3 groups (all P0.05). Conclusion: Dual-source CT energy parameters can be used to qualitatively diagnose cervical enlarged lymph nodes after surgical resection of PTC.
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The European Society of Intensive Care Medicine (ESICM) issued the second consensus on the assessment of sublingual microcirculation in critically ill patients. This paper interprets the consensus for clinicians about: what is microcirculation, how to observe microcirculation, and the details of microcirculation images collection and parameters analysis. Besides, this paper illustrates the relationship between microcirculation alternation and shock, it also evaluates the present situation and future development of microcirculation monitoring.
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Objective To explore the application value of virtual monochromatic imaging combined with adaptive statistical iterative reconstruction (ASIR) and automatic spectral imageing mode selection(ASIS) in reducing the radiation dose and contrast dose of CT portal venography.Methods We retrospectively collected 120 cases (80 males and 40 females) who underwent upper abdominal enhancement CT from January 2017 to April 2017.Patients were divided into 3 groups (40 cases in each group) according to the scanning program.Group A used conventional 120 kVp scan,NI =10,contrast agent dosage was 450 mgI/kg of body weight,image was reconstructed with 50％ ASIR technique;Groups B and C used spectral CT mode,NI =10 (Group B),NI =13 (Group C),the amount of contrast agent was 300 mgI/kg of body weight,and the image was reconstructed with 60 keV +50％ ASIR.One-way analysis of variance was used to compare the mean CT values and their differences,image noise,SNR and CNR of portal vein and liver parenchyma in three groups of images.Subjective image quality scores were performed on three groups of images by two senior radiologists.The patient's CTDIvol,DLP were recorded and the E was calculated.Results The amount of contrast agent in group B and C was reduced by about 30％ compared with group A.The portal vein CT values of groups A,B,and C were 168.22± 17.82,209.06±20.07,and 211.03±25.60.The portal vein CT values of group B and C were significantly higher than those of group A,respectively (t =-9.625,-8.680,P ＜ 0.05).The CT value difference between portal vein and liver parenchyma was 60.01± 17.01,106.63±25.83,107.72±25.39,respectively.SNRs were 8.48±1.41,12.64±2.94,10.77±1.94,and CNR were 5.16±1.80,8.13±2.54,7.32±1.84,respectively.The image quality scores were 3.53±0.68,4.75±0.54 and 4.53±0.64,respectively.The CT value difference,SNR,CNR and image quality scores of group B and group C were significantly higher than those in group A(t=-9.536,-9.857,-8.082,-6.064,-6.050,-5.308,-8.912,-6.779,P＜0.05).The CTDIvolof groups A,B and C were (12.15±5.02) mGy,(12.34±4.18) mGy,(10.03±3.13) mGy,DLP were (348.62± 155.99) mGy· cm,(355.56± 131.07) mGy·cm,(287.10±92.25) mGy·cm,respectively,E were (5.23±2.34) mSv,(5.33±1.97) mSv,(4.31±.1.38) mSv,compared with the A and B groups,the CTDI,ol,DLP and E of the C group were significantly lower(t=2.274,2.147,2.147,2.812,2.702,2.702,P＜0.05),and CTDIvol,DLP and E were decreased by 19％.Conclusions In CT portal venography,NI =13,60 keV combined with 50％ ASIR reconstruction and ASIS can be used to personalize the contrast dose and radiation dose of the patient and provide images that meet the diagnostic requirements.
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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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Tongue diagnosis is one of unique techniques of TCM diagnosis. Its subjective and empirical description of written words, spoken language and pictures have been used until now, however, which cannot express the complete information of tongue image comprehensively and objectively. The development of modern technology provides new ideas and methods for the study of tongue diagnosis in TCM. For example, the application of spectroscopy is of great significance for restoring tongue image information. This article briefly introduced the spectroscopy method, summarized its research and application in the field of TCM tongue diagnosis, and put forward the problems and prospects to provide references for further research.
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Objective To observe the value of dual-source CT energy spectral imaging in qualitative evaluation of metastatic lymph nodes in patients with gastric cancer.Methods Data of patients with pathologically diagnosed gastric cancer were collected,who underwent both dual-source CT abdomen plain scanning and energy spectrum double-phase enhanced scanning.The long diameter,short diameter,short length-diameter ratio,arterial phase and venous phase standardized iodine concentration of lymph nodes were measured and recorded.Energy spectrum attenuation curves were drawn,and the slopes were calculated.Parameters with statistical significant differences between metastatic and non-metastatic lymph nodes were used to plot ROC curves,and the thresholds for diagnosing metastatic lymph nodes of gastric cancer,and their diagnostic sensitivity and specificity were calculated.Results There were significant differences in short axis,short aspect ratio,normalized iodine concentration in arterial phase and venous phase between metastatic and non-metastatic lymph nodes in patients with gastric cancer (all P＜0.05),the area under the curve of ROC curve was 0.601 (P=0.006),0.881 (P＜0.001),0.865 (P＜0.001) and 0.834 (P＜0.001),respectively.When the short length to diameter ratio was 0.730,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 75.72％ and 93.64％.When standardized iodine concentration was 0.223 in arterial phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 69.81％ and 91.20％.When the standardized iodine concentration was 0.392 in the venous phase,the sensitivity and specificity in diagnosis of metastatic lymph nodes of gastric cancer was 78.33％ and 85.63％.Dual-phase energy spectrum curve of both gastric metastatic lymph nodes and non-lymph node decreased.Taken the arterial curve slope k=6.860 as the threshold,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 83.24％ and 84.72％.When the threshold venous phase slope k was set at 6.660,the sensitivity and specificity in diagnosis of metastatic lymph nodes was 64.62％ and 97.70％,respectively.Combining arterial phase length-to-diameter ratio,arterial phase standardized iodine concentration and spectral curve slope,the sensitivity and specificity in diagnosing metastatic lymph nodes was 97.34 ％ and 87.83 ％,which was 80.13 ％ and 90.31％ when combining venous phase short length-diameter ratio,venous phase standardized iodine concentration and spectral curve slope.Conclusion The short-length-to-diameter ratio,arterial-venous phase standardized iodine concentration and arterial-venous phase slope of lymph nodes are the main parameters for evaluating metastatic lymph nodes in patients with gastric cancer.Combination of the above three parameters can obviously improve the sensitivity and specificity in diagnosis of metastatic lymph nodes in patients with gastric cancer.
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Objective To investigate the value of spectral CT imaging in diagnosis of axillary lymphatic metastasis of breast carcinoma. Methods 27 cases of breast carcinoma who met the criteria underwent dual-phase enhanced spectra CT scan.The axillary lymph nodes were matched one-to-one between CT images and postoperative pathology.The four parameters,including NIC-A,NIC-V, λHU-A,and λHU-V were analyzed among primary tumors,metastasis and non-metastasis lymph nodes.The area under receiver operating characteristic (ROC)curves of the four parameters were used to evaluate the diagnostic accuracy in axillary lymphatic metastasis.Results The four parameters showed significant differences among the primary tumors,metastasis lymph nodes and non-metastasis lymph nodes. The four parameters were also significantly different between the primary tumors and non-metastasis lymph nodes,between metastasis lymph nodes and non-metastasis lymph nodes.Only NIC-V was significantly different between the primary tumors and metastasis lymph nodes.When NIC-A value of 0.148 was used as the threshold for diagnosing lymphatic metastasis,the sensitivity,specificity and the area under the curve were 80.00%,84.62% and 0.888,respectively.Conclusion The parameters of spectral CT imaging can significantly improve the diagnostic accuracy of axillary lymphatic metastasis of breast carcinoma,which can be used as a reference for clinical diagnosis.
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Objective To evaluate the lfexible spectral imaging color enhancement (FICE) system associated with mini-probe endoscopic ultrasonography in diagnosis of superifcial esophageal lesions.Methods 292 patients with superficial esophageal lesions were randomly assigned to control group or observation group. The common white light endoscopy and magnifying endoscopy were used in the control group while FICE associated with mini-probe endoscopic ultrasonography in the observation group. Findings were compared with the pathologic diagnosis.Result The magnifying FICE could reveal the IPCL of superifcial esophageal lesions and can accurately determine the pathological types of lesions. The diagnose accordance rate of esophagitis by magnifying FICE was 82.69%, mild and moderate atypical hyperplasia highly atypical hyperplasia 86.96%. The diagnostic accuracy rate of esophagus lesions between observation group and control group was 91.78 %, 76.02 % respectively. And the diagnostic sensitive rate between two groups was 85.71%, 44.44%. The former is superior to the latter. There were 5 lfat lesions found by FICE which were missed diagnosed by white light endoscopy.Conclusion FICE can enhance the ability of identiifcation of lesion which shows the outline and morphology of lesion and can improve the biopsy accuracy. FICE associated with mini-probe endoscopic ultrasonography has a certain clinical application value in the diagnosis and treatment of superifcial esophageal lesions.