Interpretation of Update: Standardized CT/HRCT Classification of Occupational and Environmental Thoracic Diseases in Germany published in 2014 / 中国职业医学

@#Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.

Interpretation of Update: Standardized CT/HRCT Classification of Occupational and Environmental Thoracic Diseases in Germany published in 2014 / 中国职业医学

@#Imaging diagnosis is one of the main bases for the diagnosis of occupational pneumoconiosis. At present the - diagnosis of occupational pneumoconiosis is mainly based on high kV X ray chest radiography or chest digital radiography. With （ ） ， （ ） the wide application of computed tomography CT in occupational lung diseases high resolution CT HRCT is increasingly Update： Standardized CT/HRCT Classification of Occupational valuable in the diagnosis of occupational pneumoconiosis. The and Environmental Thoracic Diseases in Germany， ， published in 2014 is the latest and highly reliable standard. The standard - - - recommends the use of low dose HRCT scanning regimens and whole lung thin layer volumetric scanning with a thickness of - ， ， 1.0 mm and high resolution reconstruction which classify CT image quality into four levels and describes methods for （ ， classification and quantitative recording of CT manifestations of lung lesions including round opacities irregular and/or linear ， ， ， ， ） opacities ground glass opacity honeycombing emphysema and large opacities and pleural lesions. It is beneficial for ， ， ， epidemiological research early screening diagnosis and differential diagnosis treatment and prognosis of occupational ， pneumoconiosis as well as the comparison of international data related to occupational pneumoconiosis.

Chest high-resolution CT features analysis in predicting the progression of asbestosis / 中华劳动卫生职业病杂志

Objective: To analyze the radiological characteristics of chest high-resolution computed tomography (HRCT) of patients with asbestosis, and to investigate the signs of predicting the disease progression of asbestosis. Methods: A prospective method was used to enroll 68 patients with asbestosis who were regularly followed up from 2013 to 2016. The radiological characteristics of patients with asbestosis were described by the International Classification of HRCT for Occupational and Environmental Respiratory Diseases (ICOERD) , and the differences between patients with and without progression were compared during the observation period. The Cox proportional hazards regression model was used to analyze the chest HRCT radiological signs predicting the progression of asbestosis. Results: The study included 68 patients with asbestosis aged (65.5±7.8) years old, of which 64.7% (44/68) were female, 29.4% (20/68) had a history of smoking. There was no significant difference in age, sex, smoking and asbestos exposure between patients with progressive asbestosis (20.6%, 14/68) and patients without progressive asbestosis (79.4%, 54/68) (P>0.05) . Chest HRCT of patients with asbestosis showed irregular and/or linear opacities, of which 5.9% (4/68) were accompanied by honeycombing. Irregular and/or linear opacities were mainly lower lung preponderant, often accompanied with ground glass opacity and mosaic perfusion. 98.5% (67/68) had pleural abnormalities, of which 39.7% (27/68) had diffuse pleural thickening with parenchymal bands and/or rounded atelectasis. The analysis of multivariable Cox proportional hazard regression showed that the risk of the progression of asbestosis was increased with higher irregular and/or linears opacities cores (HR=1.184, 95%CI: 1.012-1.384, P=0.034) and the appearance of honeycombing (HR=6.488, 95%CI: 1.447-29.097, P=0.015) . Conclusion: The irregular and/or linear opacities scores and honeycombing on chest HRCT are independent influencing factors for predicting the disease progression of asbestosis.

Brainstem auditory evoked potential combined with high resolution cranial base CT can optimize the diagnosis of auditory nerve injury / 中华创伤杂志(英文版)

PURPOSE@#Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury.@*METHODS@#Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman's classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference).@*RESULTS@#A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivity was significantly higher in the HRCT-positive group (20/30, 66.7%) than in the HRCT-negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion.@*CONCLUSION@#By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.

Early clinical and CT features of COVID-19 and community-acquired pneumonia from a fever observation ward in Ningbo, China

INTRODUCTION@#We aimed to compare the early clinical manifestations, laboratory results and chest computed tomography (CT) images of COVID-19 patients with those of other community-acquired pneumonia (CAP) patients to differentiate CAP from COVID-19 before reverse transcription-polymerase chain reaction results are obtained.@*METHODS@#The clinical and laboratory data and chest CT images of 51 patients were assessed in a fever observation ward for evidence of COVID-19 between January and February 2020.@*RESULTS@#24 patients had laboratory-confirmed COVID-19, whereas 27 individuals had negative results. No statistical difference in clinical features was found between COVID-19 and CAP patients, except for diarrhoea. There was a significant difference in lymphocyte and eosinophil counts between COVID-19 and CAP patients. In total, 22 (91.67%) COVID-19 patients had bilateral involvement and multiple lesions according to their lung CT images; the left lower lobe (87.50%) and right lower lobe (95.83%) were affected most often, and all lesions were located in the peripheral zones of the lung. The most common CT feature of COVID-19 was ground-glass opacity, found in 95.83% of patients, compared to 66.67% of CAP patients.@*CONCLUSION@#Diarrhoea, lymphocyte counts, eosinophil counts and CT findings (e.g. ground-glass opacity) could help to distinguish COVID-19 from CAP at an early stage of infection, based on findings from our fever observation ward.

Clinical characteristics and prognosis of young children with idiopathic arthritis combined with lung injury / 中华实用儿科临床杂志

Objective:To explore clinical manifestations, imaging features and prognosis of juvenile idiopathic arthritis (JIA) combined with lung injury, aiming to improve the understanding of the disease.Methods:Clinical data from 464 children with JIA who were hospitalized in Beijing Children′s Hospital from January 2016 to September 2019 were retrospectively analyzed.Their clinical manifestations, high resolution CT (HRCT) features, lung function and follow-up of children with lung injury were analyzed.Results:Among 464 children with JIA, 40 cases (8.62%) combined with lung injury.There were no significant differences in the age and sex between JIA children either combined with lung injury or not (all P>0.05). Among them, there were 125 cases of systemic-onset juvenile idiopathic arthritis (SoJIA) and 28 cases (22.4%) of JIA combined with lung injury, accounting for the highest proportion (70%, 28/40 cases) in JIA children combined with lung injury.Among 40 JIA children combined with lung injury, 22 cases (55.0%) had respiratory symptoms and 7 cases (17.5%) had obvious hypoxia.HRCT examination was performed in them, and the imaging findings included high-density strip or strip flocculation (75.0%, 30/40 cases), pleural thickening (45.0%, 18/40 cases), ground glass shadow (22.5%, 9/40 cases), nodular lesion (20.0%, 8/40 cases), vesicles or cystic emphysema (15.0%, 6/40 cases). Lung function was detected in 12/20 children with varying degrees of pulmonary function abnormalities, most of which were mixed ventilation dysfunction, and 2 cases still had pulmonary function abnormalities after treatment.During the follow-up for 3 months to 3.5 years, 4 cases (10%) JIA combined with lung injury died.A total of 29 children were re-examined by pulmonary CT in the follow-up visit, including 14 (48.28%) improved, 8 cases (27.58%) with no significant improvement, and 7 cases (24.14%) with repeated disease. Conclusions:JIA is a common rheumatic immune disease in children and all subtypes can be combined with lung injury, manifesting as interstitial lung disease mainly.The age and sex of JIA children combined with lung injury are not specific factors.The proportion of lung injury in SoJIA is significantly higher than that in other subtypes.SoJIA combined with macrophage activation syndrome can lead to respiratory failure, respiratory distress syndrome, and even death, which is one of the main factors leading to poor prognosis of JIA.HRCT is more sensitive to the diagnosis of lung injury.Lung function detection is a simple and easy method to evaluate and monitor lung injury.The prognosis of JIA children combined with lung injury is poor, which should be well concerned.

A study on diagnostic efficacy of pulmonary imaging tool in patients with rheumatoid arthritis

Background: Pulmonary complication in Rheumatoid arthritis is major health concern in the field of rheumatology. So this study is to find out the sensitive imaging tool for detecting different types of pulmonary changes seen in RA.Methods: This is a comparative, analytical, cross sectional, Institution- based, single centre study. We included all adult willing patients of Rheumatoid arthritis (age >18) and selected them based on 2010 ACR/EULAR criteria. Severity was assessed by number of joints involve in both upper and lower limb, along with ESR, CRP, Anti CCP level. Chest x ray, PFT and HRCT thorax were done in all RA patients.Results: Out of 50 RA patients, pulmonary involvement was observed in 25 patients identified by Spirometry, CXR, HRCT. Pulmonary involvement is more common in age group <40 years. Most common form of pulmonary involvement is ILD followed by obstructive lung disease like chronic bronchitis, bronchiectasis etc. HRCT is the most common tool for detection of Pulmonary involvement in rheumatoid arthritis. HRCT abnormality, most are Restrictive on spirometry (FEV1/FVC) <80% of predicted value. And this relation is statistically significant as P value is 0.001 (<0.05) by Chi-Square test. Patients having more the disease duration, more the pulmonary involvement. This association is statically significant as p value is 0.001 (<0.05).Conclusions: High resolution CT thorax is more sensitive modality for detection of pulmonary pathology in rheumatoid arthritis. Because of its high cost, availability of this imaging technique is beyond the lower socio-economic group where chest x ray may be useful.

Clinical thinking on diagnosis and treatment of childhood bronchiolitis / 中华实用儿科临床杂志

Although children bronchiolitis is often encountered in the clinical practice of pediatricians,the diagnosis and treatment of bronchiolitis in children is quite difficult because of its varied clinical manifestation and non-specific imaging. In this paper,the anatomy,definition,etiological classification,diagnosis,differential diagnosis,and therapeutic principles of bronchiolitis in children will be discussed. Then the diagnosis and therapy of bronchiolitis based on different etiology will be explored.

Study on the relationship between radiological fibrosis score in high-resolution computed tomography and the survival in rheumatoid arthritis-related interstitial lung disease / 中华风湿病学杂志

Objective Idiopathic pulmonary fibrosis, the fibrosis score (i.e., the combined extent of reticulation and honeycombing) is associated with worse survival. The aim of this study was to identify high-resolution computed tomography (HRCT) patterns and patient characteristics that could predict poor prognosis in rheumatoid arthritis-related ILD (RA-ILD). Methods We retrospectively analyzed 130 patients with newly diagnosed RA-ILD from 2011 to 2017 at Shanxi People's Hospital. The Pearson correlation analysis was used for the correlation between the fibrosis score and the worse survival of RA-ILD, and Using Cox regression analysis was used to identify the associations with mortality. A value of P less than 0.05 was considered statistically significant. Results During a median follow-up of 65 months, 32/130 (24.6％) patients died. Univariate analysis identified 6 significant poor prognostic factors: lower baseline ％ predicted forced vital capacity [HR=0.97, 95％CI(0.94, 0.99);P=0.008], total interstitial disease score [HR=1.06, 95％CI(1.03, 1.08);P<0.01], reticulation score [HR=1.07, 95％CI (1.04, 1.09); P<0.01], traction bronchiectasis score [HR=2.04, 95％CI (1.21, 3.40);P=0.008], fibrosis score [HR=1.07, 95％CI (1.01, 1.13);P<0.01], and definite UIP pattern [HR=4.18, 95％CI (1.40, 12.51); P=0.010]. Fibrosis score remained to be an independent significant poor prognostic factor of survival on bivariate analysis [HR=8.136, 95％CI (2.87, 28.35); P=0.001]. Patients with a fibrosis score>20％ had high mortality. Conclusion This study has shown that fibrosis score is strongly associated with worse survival in RA-ILD, and patients with fibrosis score>20％ have a 8.136-fold increased risk of mortality.

A pilot study of lung ultrasound B-lines in diagnosis of rheumatoid arthritis associated interstitial lung diseases / 中华风湿病学杂志

Objective To assess the clinical value of lung ultrasound (LUS) B-lines in diagnosis of rheumatoid arthritis (RA) associated interstitial lung diseases (RA-ILD).Methods Forty-five consecutive patients with RA who underwent a high resolution computed tomography (HRCT) scan of the chest,were also examined by LUS for detection of B-lines(within 1 month independently in all patients).The B-lines score was obtained by summing the number of total 50 inter-costal spaces (ICSs) of chest wall.Pulmonary fibrosis was quantified by HRCT as previously described by the 30-point Warrick score.Results B-lines score significantly correlated with the Warrick score [(r=0.778,95％CI(0.627,0.872),P＜0.05].Receiver operating characteristic (ROC) curve confirmed that B-lines cut-off point 77[sensitivity of 100％,specificity of 64.3％ respectively,area under curve [AUC] =0.86,95％CI(0.724,0.945)] and 108[sensitivity of 90％,specificity of 88.6％ respectively,AUC=0.879,95％CI(0.747,0.957)] had an optimal power to discriminate mild (Warrick score＜8) and severe fibrosis (Warrick score＞15):Conclusion The data confirm that LUS is a useful technique to identify ILD in RA.In RA-ILD,B-lines correlate significantly with HRCT and are able to identify mild and severe degree of fibrosis.LUS is a promising non-invasive and non-ionizing strategy for screening RA-ILD.

Comparative study of clinical and HRCT findings between idiopathic nonspecific interstitial pneumonia and connective tissue disease-associated nonspecific interstitial pneumonia / 实用医学杂志

Objective To investigate the difference in clinical features and chest HRCT findings between idiopathic nonspecific interstitial pneumonia(INSIP)and connective tissue disease-associated nonspecific interstitial pneumonia(CTD-NISP). Methods Totally 73 cases of NISP from 2011 to 2016 were retrospectively reviewed ,whose final diagnosis all were made after clinico-radiologic-pathologic discussion and 52 cases of them were diag-nosed as INSIP and 21 cases as CTD-NSIP. Clinical features ,lung function test results and chest HRCT findings of INSIP and CTD-NSIP were compared. Results Common underlying diseases of CTD-NSIP were poly-/dermato-myositis(PM/DM),rheumatoid arthritis(RA)and Sjogren syndrome(SS). The mean age of CTD-NSIP[(47.14 ± 9.24)y]was younger than that of INSIP[(59.09 ± 11.20)y](P<0.05). Compared to CTD-NSIP,expectoration was more common in patients with INSIP,while dry mouth/eyes,arthralgia and erythra were less common in INSIP (P < 0.05). Lung function test1 showed restrictive ventilatory dysfunction with dispersion function decline was found in both groups. There were no significant differences in lung function test results between INSIP and CTD-NSIP. In HRCT,the subpleural vertical line was more common in INSIP than that in CTD-NSIP,while patchy consolidation,subpleural curvilinear shadow,pleural effusion and esophageal dilation were less common in INSIP(P<0.05). Conclusions Specific difference of clinical and HRCT features between CTD-NSIP and INSIP are conducive to differentiating the two from each other.

High-resolution CT semi-quantitative score to determine the short-term efficacy of glucocorticoid in patients with idiopathic interstitial pneumonia / 中国生化药物杂志

Objective To investigate the short-term effects of glucocorticoid therapy on patients with idiopathic interstitial pneumonia using high resolution CT semi quantitative scores. Methods According to the different HRCT scores will be January 2015 -2017 year in January in our hospital for diagnosis and treatment of idiopathic interstitial pneumonia patients with 60 cases of groups: control group with HRCT score < 20%, the observation group with HRCT score more than 20%; the patients in the two groups of experimental data were recorded in detail and analyzed and discussed the high resolution CT semi quantitative score judgment of idiopathic interstitial pneumonia patients treated with glucocorticoid efficacy. Results The observation group (HRCT score≥20%) accuracy is higher than that of the control group (HRCT score<20%), the difference between groups was statistically significant (P<0.05). Conclusion The treatment of idiopathic interstitial pneumonia in patients with glucocorticoid selection of high resolution CT;semi quantitative score to determine significant short-term effect, HRCT score of the best critical value was 20%, the diagnostic accordance rate can obtain excellent.

Short term efficacy of glucocorticoids in patients with idiopathic interstitial pneumonia evaluated by high resolution CT semi quantitative scores / 中国生化药物杂志

Objective To study and analyze the short-term effect of glucocorticoid in patients with idiopathic interstitial pneumonia by analyzing the semi quantitative scores of high resolution CT.Methods 50 cases of idiopathic interstitial pneumonia treated in our hospital from May 2015 to October 2016 were selected as the research object.Clinical data were analyzed, including smoking, signs of hospitalization and dyspnea score.High resolution CT level for the right diaphragmatic top tube, bifurcation, left atrium roof, in 3 aspects from the calculation of cellular disease and shadow grid as a percentage of average, the critical point of high resolution CT scores were 10%, 20%, 30%, 40% and 50%.The accuracy, sensitivity and specificity of glucocorticoids were analyzed.The chi square test was used to examine the enumeration data.Results The accuracy was 72% when the high resolution CT score was 20% critical point.In patients treated with corticosteroids, the high resolution CT score was greater than or equal to 20% for patients and 25 for patients with a score of less than 20% for 25 patients.20% or more patients died during hospitalization, 10 cases, the mortality rate was 40%, and the effective rate of glucocorticoid treatment was 8%.Less than 20% of the patients died during hospitalization, 1 cases, the mortality rate was 4%, and the effective rate of glucocorticoid treatment was 50%.Conclusion High resolution CT semi quantitative score judgment of idiopathic interstitial pneumonia patients treated with glucocorticoid efficacy of high accuracy, high resolution 20% scores higher accuracy, and the diagnosis is well, with further clinical promotion and application significance.

Comparison of the diagnosis value of color echocardiography and high resolution CT for early left ventricular dysfunction / 中国医学装备

Objective:To compare the diagnosis value of color echocardiography and high resolution CT for early left ventricular dysfunction.Methods:72 cases of left ventricular dysfunction patients in our hospital were chosen, and all of patients were detected with color echocardiography and high resolution CT inspection. Each patient was followed-up for 18 months and then to compare the diagnosis values of the two kind methods.Results: After 18 months follow-up review, the diagnostic accuracy of color echocardiography and high resolution CT were 95.8% (69/72) and 97.2% (70/72), respectively. Both of two methods were higher, and the difference was not statistically significant (x2=0.207,P=0.649). All sorts of cardiac function detection result, such as LVSV, LVEF, LVEDV and LVESV, were similar between color echocardiography and high-resolution CT, and the difference was not statistically significant (t=-0.775,t=1.387,t=-0.624,t=-1.209;P>0.05). Conclusion: Both of the diagnostic accuracy of color echocardiography and high-resolution CT for early left ventricular dysfunction were higher. All of them are worthy generalization and applying in clinical diagnosis for early heart failure.

Clinical analysis of high resolution CT semi quantitative evaluation of glucocorticoid in the treatment of idiopathic interstitial pneumonia / 中国生化药物杂志

Objective To evaluate the short-term effect of glucocorticoid therapy in patients with idiopathic interstitial pneumonia by high resolution CT semi quantitative score. Methods 32 cases of idiopathic interstitial pneumonia were treated with conventional treatment, combined with glucocorticoids, the use of high resolution CT semi quantitative score, the short-term efficacy of its accurate judgement. Results The analysis shows that high resolution CT semi quantitative score below 20％ idiopathic interstitial pneumonia patients with hospital mortality period is only 5.26％, and the high resolution CT semi quantitative score during the high fatality rate of 38.46％ hospitalized patients with 20.00％ or more, the difference was statistically significant (P<0.05). Conclusion The application of high resolution CT semi quantitative score of received corticosteroid therapy for idiopathic interstitial pneumonia patients with curative effect to give accurate judgment to the doctor for the future development of drug treatment and guarantee its prognosis are of positive significance.

Correlations between emphysema quantification and severity of chronic obstructive pulmonary disease / 实用医学杂志

Objective To analyze the correlation between emphysema extent measured by high resolution computed tomography (HRCT) and pulmonary function tests, symptom score in patients with chronic obstructive pulmonary disease ( COPD ) , and to study the value of HRCT in the emphysema quantification in the clinical evaluation of COPD patients. Methods 78 patients with stable COPD were recruited to take the HRCT scan , and emphysema extent was qualified by measuring the proportion of low attenuation area in the whole lung (LAA%). Correlations between LAA% and indices of pulmonary function test, bronchial dilation test, mMRC scale, CAT score and six minutes walking distance (6MWD) were assessed. Results LAA% was negatively correlated with FEV1/FVC and DLCO%pred, and the correlation coefficients were -0.759 and -0.589 (P 0.05). Conclusions The severity of emphysema measured by HRCT is well correlated with the clinical symptoms , pulmonary function tests and exercise capacity in COPD patients. It can be used to diagnose emphysema early and to evaluate the severity of the disease com-prehensively. Thus, the risk factors of COPD can be controlled and the prognosis of the patients can be im-proved.

Correlation of high-resolution CT volumetric data with body mass index in patients with chronic obstructive pulmonary disease / 第二军医大学学报

Objective To explore the association of body mass index (BMI) with high-resolution CT (HRCT) volumetric data and HRCT phenotypes in patients with chronic obstructive pulmonary disease (COPD). Methods Sixty-two consecutive C0PD patients underwent HRCT and their weight and height were recorded. C0PD subjects were classified into three phenotypes based on the visual HRCT findings (with or without emphysema and/or bronchial wall thickening). With the volumetric HRCT data, the total lung volume (TLV) was calculated automatically by Extended Brilliance WorkspaceTM, the total emphysema volume (TEV) was obtained by applying density thresholds of-950 HU, and the TEV/TLV was calculated as an emphysema index (EI). The correlation between the volumetric HRCT data and BMI was assessed using Spearman correlation analysis. The three phenotypes of C0PD subjects were evaluated using one-way AN0VA. Results Visual HRCT findings showed that the C0PD patients were classified into 3 phenotypes: phenotype A (n = 42), phenotype E (n = 9) and phenotype M (n = 11). BMI of C0PD patientswas correlated with both TEV (r= - 0. 389, P = 0. 002) and EI (r= -0. 424, P = 0. 001). C0PD patientswith phenotype A had a significantly higher BMI ([23. 4±3. 4] kg/m2) compared with those with phenotype E ([20. 6±3. 1] kg/m2, P<0. 05). The BMI of patients with phenotype M ([21. 3±2. 7] kg/m2) was not significantly different from those of phenotypes A or E. Conclusion The TEV and El are negatively correlated with BMI in COPD patients. HRCT phenotype A compared with phenotype B and C is associated with a higher BMI in COPD patients.

The characteristics of high-resolution CT imaging of mycopalsma pneumonia in children / 国际儿科学杂志

Objective According to the clinical imaging for mycoplasma pneumoniae pneumonia,lung CT imaging features of mycoplasma pneumoniae pneumonia were summarized in children.Methods The CT findings and clinical features of 66 patients were retrospectively reviewed(average age was 7 years with 30 males and 36 females) with confirmed pneumoniae pneumonia.The CT images were analyzed by two experienced pulmonologists.Results The most common finding in the mycoplasma pneumoniae pneumonia group was bronchial wall thickening with 69.9％,air bronchogram up 65.1％,over all age groups there was no significant difference;ground-glass-like changes up to15.1％,scattered patchy shadows up to 45.5％,more common in infants; lung consolidation accounted for 48.4％, tree bud accounted for 34.8％,the above results more common in older children.Conclusions Mycoplasma pneumoniae pneumonia HRCT imaging features include:bronchial wall thickening inflatable, the tree bud tree fog sign,ground glass-like changes,scattered patchy shadows,dense coalescent consolidation,and lung CT may improve the early diagnosis of mycoplasma pneumonia.

The phantom and clinical study of low-dose protocol of volumetric high resolution CT / 中华放射医学与防护杂志

Objective To explore the optimal low-dose protocol of volumetric high-resolution CT (VHRCT) of the lung and evaluate its diagnostic value.Methods Catphan phantom were scanned using GE Lightspeed VCT with different parmeters from 120 kV,10 mAs to 120 kV,250 mAs in 10 mAs increments.Other parameters included 0.969 pitch,20 mm scan coverage,0.625 mm collimation and 30 cm display field of view and bone recon kernel.The spatial and density resolution,noise and radiation dose of each scanning were measured to determine the low-dose VHRCT protocol.In clinical study,105 patients with diffuse lung diseases underwent standard-dose VHRCT with 120 kV,250 mA according to the clinical needs.Low-dose VHRCT was performed with 120 kV,120 mAs in follow-up.Two radiologists who were unaware of the CT technique reviewed randomized images for the detail of diffuse lung diseases,including linear or reticular opacities,micro-nodules or tree-in-bud patterns,bronchiolectasis,ground-glass opacities and emphysema using a 4-point scale.Results In phantom study,the spatial-resolution maintained at 9 LP/cm from 250 mAs to 120 mAs.Below 120 mAs,the spatial-resolution and density-resolution decreased and noise increased with the decrease of tube-current.In clinical study,there were no statistical differences between standard-dose and low-dose VHRCT in demonstrating the detail of diffuse lung diseases(P ＞0.05).The CTDIvol was 23.44 mGy at 250 mAs and 11.25 mGy at 120 mAs,with 52％dose reduction by low-dose VHRCT.Conclusions Low-dose VHRCT at 120 kV,120 mAs offers maximum dose reduction without compromising spatial resolution and diagnostic value.

Radiologic Approach to the Idiopathic Interstitial Pneumonias / 대한내과학회지

Idiopathic interstitial pneumonias (IIP), a heterogeneous group of diffuse parenchymal lung diseases, include seven clinicopathologic entities: idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia (COP), acute interstitial pneumonia (AIP), respiratory bronchiolitis (RB)-associated interstitial lung disease (ILD), desquamative interstitial pneumonia (DIP), and lymphoid interstitial pneumonia (LIP). Each of these entities has a typical histologic pattern that correlates well with imaging features. Thus, imaging plays an essential role in classifying and differentiating this group of diseases. The characteristic HRCT findings of IPF are reticular opacity with honeycombing and traction bronchiectasis in a predominantly basal and peripheral distribution. NSIP manifests as basal ground-glass opacity and reticular opacity. Honeycombing is rare. COP is characterized by patchy peripheral or peribronchovascular consolidation. AIP appears as extensive, mixed ground-glass opacity and consolidation. RB-ILD and DIP are smoking-related diseases associated with CT features of poorly defined centrilobular nodules and ground-glass opacity. LIP is a rare disease characterized by ground-glass opacity sometimes associated with perivascular cysts. Although some of idiopathic interstitial pneumonias may show diagnostic CT features, the final diagnosis of IIPs is usually made by means of evaluation of all the combined clinical, radiologic, and pathologic findings.