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Retinal vein occlusion (RVO) is a common retinal vascular disease that causes painless visual impairment in clinical practice.Currently, fluorescein fundus angiography (FFA) is the gold standard for its diagnosis.However, FFA is an invasive examination, which has poor reproducibility and lacks the ability to distinguish and depict deep capillaries.Optical coherence tomography angiography (OCTA) has the characteristics of the non-invasive, safe, simple, efficient, and high axial resolution, making it a powerful tool for the diagnosis and efficacy evaluation of RVO.OCTA not only rapidly analyzes microvascular images of RVO patients, but also evaluates the morphologic structure and perfusion status of capillaries qualitatively and quantitatively in each layer in the macular and optic disc area of both eyes.The article comprehensively reviewed the application of OCTA in RVO patients, including the detection of changes in retinal structure and blood flow in the macula and optic disc area of the affected eye and healthy contralateral eye, the evaluation of visual prognosis and the effect of anti-vascular endothelial growth factor treatment, the investigation of the recurrence mechanism of macular edema, and the limitations and development prospects.The article aimed to help ophthalmologists have a more comprehensive understanding of the characteristics of RVO disease and lay an important foundation for accurately and effectively guiding disease treatment and predicting patients' prognosis vision.
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Objective:To observe the multimodal imaging characteristics of tamoxifen retinopathy.Methods:A retrospective case study. From January 2019 to December 2021, 4 patients (8 eyes) with tamoxifen retinopathy diagnosed in Tangshan Eye Hospital were included in the study. All patients were female, with sick binoculus. The age was 59.5±4.6 years. After breast cancer resection, tamoxifen 20 mg/d was taken orally consecutively, including 1, 1, and 2 cases who took tamoxifen orally for 5, 7, and ≥10 years. All eyes were examined by fundus color photography, optical coherence tomography (OCT), OCT angiography (OCTA), fundus fluorescein angiography (FFA), and fundus autofluorescence (AF). The multi-mode image features of the fundus of the affected eyes were observed.Results:The yellow white dot crystal like material deposition in the macular area was observed in all eyes. In fundus AF examination, macular area showed patchy strong AF. FFA examination showed telangiectasia and fluorescein leakage in macular area at late stage. OCT showed that punctate strong reflexes could be seen between the neuroepithelial layers in the macular region with the formation of a space between the neuroepithelial layers, the interruption of the elliptical zone (EZ), and the formation of a hole in the outer lamella including 4, 5 and 3 eyes; The thickness of ganglion cells in macular region decreased in 7 eyes. OCTA showed that the blood flow density of the superficial retinal capillary plexus around the arch ring was decreased, and the retinal venules were dilated in 2 eyes; Deep capillary plexus (DCP) showed telangiectasia.Conclusion:Deposition of yellowish white dot like crystals can be seen in the macular region of tamoxifen retinopathy; dotted strong reflex between neuroepithelial layers, cavity formation, thinning of ganglion cell layer, EZ middle fissure and outer lamellar fissure; DCP capillaries and venules around the arch were dilated; telangiectasia in macular region; flaky strong AF in macular region.
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Objective:To observe the multimodal imaging characteristics of the eyes in patients with presumed tuberculous retinal vasculitis.Methods:A retrospective case series study. A total of 15 patients (22 eyes) diagnosed with presumed tuberculous retinal vasculitis and receiving anti-tuberculosis treatment (ATT) effectively in Department of Ophthalmology, Subei People's Hospital Affiliated to Yangzhou University from January 2018 to April 2021 were included. Among them, there were 5 males and 10 females. Seven had bilateral involvement and 8 had unilateral involvement. The age was 49.3±11.1 years old. The best corrected visual acuity (BCVA), fundus colour photography, wide-angle fundus fluorescein angiography (FFA), and optical coherence tomography (OCT) were performed in all patients. Indocyanine green angiography (ICGA) was performed in 7 eyes. The BCVA examination was performed with the international standard visual acuity chart, which was converted into the logarithm of minimal angel resolution vision (logMAR). Systemic tuberculosis-related examinations included chest CT, serum T-spot, purified protein derivative and other tuberculosis-related tests. All patients were treated with systemic anti-tuberculosis therapy. The follow-up time was >12 months. The multimodal imaging characteristics for affected eyes. Nonparametric test was used to compare BCVA before and after treatment.Results:The retinal vessels of all the affected eyes were tortuously dilated, including 3 eyes with vascular white scabbard, 5 eyes with scattered bleeding point at the retina inculding 3 eyes walking along the vessels. The lesions were mainly distributed in the middle and periphery of the retina, and some of them involved the posterior pole; 12 eyes (54.5%, 12/22) with simple retinal vasculitis and 10 eyes (45.5%, 10/22) with retinal vasculitis complicated with choroiditis. Tuberculous retinal vasculitis showed different degrees of retinal vascular leakage on FFA, mainly retinal vein and capillary leakage, not involving arteries; 16 eyes (72.7%, 16/22) of retinal vasculitis showed peripheral occlusive retinal vasculitis and 4 eyes (18.2%, 4/22) were associated with retinal neovascularization. In 10 eyes with choroiditis, there were multiple focal choroiditis lesions of different sizes under the retina. Of the 7 eyes examined by ICGA, the choroidal inflammatory lesions showed hypofluorescent dark dots (HDD) in 5 eyes (71.4%,5/7), showing HDDs of different sizes, most of which were distributed in the posterior pole and middle periphery. In 10 eyes with retinal vasculitis complicated with choroiditis after ATT, the accumulation of hyper-reflective substances above and below the retinal pigment epithelium layer of the retina was gradually absorbed, but not completely disappeared, and most of the disorders of retinal structure could not be recovered. The average logMAR visual acuity was 0.61±0.57 before treatment and 0.36±0.55 after treatment. The BCVA after treatment was significantly higher than that before treatment ( Z=-3.102, P<0.01). Conclusions:Peripheral occlusive retinal vasculitis is the most common manifestation of tuberculous retinal vasculitis in FFA, which may be accompanied by focal choroidal inflammatory lesions. Wide-angle FFA and ICGA are more important in the diagnosis of tuberculous retinal vasculitis. OCT can be used for monitoring the changes of inflammation.
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OBJECTIVES@#Pulmonary alveolar proteinosis (PAP) is a rare disease with non-specific and various clinical manifestations, often leading to misdiagnosis. This study aims to raise the awareness of this disease via summarizing the clinical characteristics, diagnosis, and therapy of PAP.@*METHODS@#We retrospectively analyzed clinical data of 25 hospitalized cases of PAP during 2008 and 2019 in the Department of Respiratory and Critical Care Medicine of the Second Xiangya Hospital of Central South University.@*RESULTS@#Cough with unkown reason and dyspnea were common clinical manifastations of PAP. Five patients had a history of occupational inhalational exposure. Sixteen patients had typical image features including ground-glass opacification of alveolar spaces and thickening of the interlobular and intralobular septa, in typical shapes called crazy-paving and geographic pattern. Fourteen patients underwent pulmonary function tests, revealing a reduction in the diffusing capacity for carbon monoxide. The positive rate of transbronchial biopsy was 95%. Five patients received the whole lung lavage and the symptoms and imaging fcauters significantly relieved after five-years follow-up.@*CONCLUSIONS@#PAP is characterized by radiographic pattern and pathology. Transbronchial lung biopsy is effective to make diagnosis of PAP. The whole lung lavage remains a efficient therapy.
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Humans , Biopsy , Bronchoalveolar Lavage , Cough , Dyspnea , Pulmonary Alveolar Proteinosis/therapy , Retrospective StudiesABSTRACT
To identify Glycyrrhizae Radix et Rhizoma from different geographical origins, spectrum and image features were extracted from visible and near-infrared(VNIR, 435-1 042 nm) and short-wave infrared(SWIR, 898-1 751 nm) ranges based on hyperspectral imaging technology. The spectral features of Glycyrrhizae Radix et Rhizoma samples were extracted from hyperspectral data and denoised by a variety of pre-processing methods. The classification models were established by using Partial Least Squares Discriminate Analysis(PLS-DA), Support Vector Classification(SVC) and Random Forest(RF). Meanwhile, Gray-Level Co-occurrence matrix(GLCM) was employed to extract textural variables. The spectrum and image data were implemented from three dimensions, including VNIR and SWIR fusion, spectrum and image fusion, and comprehensive data fusion. The results indicated that the spectrum in SWIR range performed better classification accuracy than VNIR range. Compared with other four pre-processing methods, the second derivative method based on Savitzky-Golay(SG) smoothing exhibited the best performance, and the classification accuracy of PLS-DA and SVC models were 93.40% and 94.11%, separately. In addition, the PLS-DA model was superior to SVC and RF models in terms of classification accuracy and model generalization capability, which were evaluated by confusion matrix and receiver operating characteristic curve(ROC). Comprehensive data fusion on SPA bands achieved a classification accuracy of 94.82% with only 28 bands. As a result, this approach not only greatly improved the classification efficiency but also maintained its accuracy. The hyperspectral imaging system, a non-invasively, intuitively and quickly identify technology, could effectively distinguish Glycyrrhizae Radix et Rhizoma samples from different origins.
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Drugs, Chinese Herbal , Hyperspectral Imaging , TechnologyABSTRACT
Objective To analyze the clinical and CT imaging features of some patients diagnosed having corona virus disease 2019 (COVID-19) with delayed diagnosis and treatment in Wuhan, Hubei Province for providing a reference for diagnosis and treatment of the disease. Methods A total of 55 patients diagnosed as having COVID-19 by RT-PCT or CT admitted to Wuhan Taikang Tongji COVID-19 Specialized Hospital from 2020-02-15 to 2020-02-25 were retrospectively analyzed. Case data were collected on the first-day history, and the chest CT, blood routine and C-response protein measurements. The clinical manifestations, laboratory examinations and CT imaging features of the patients were analyzed. Results The first symptoms included fever in 33 cases (60.0%), cough in 30(54.6%) expectoration in 7(12.7%), dyspnea in 9(16.4%), chest distress in 15(27.3%), headache in 4(7.3%), fatigue in 33(60.0%), muscle soreness in 10(18.2%) and diarrhea in 7(12.7%). Most of the patients had normal white blood cell, lymphocyte and C-reactive protein levels. The imaging manifestations of CT lesions can be roughly divided into three categories: stripe shadow and consolidation as main clinical manifestations (26 cases, 47.3%), stripe shadow and consolidation mixed with ground glass opacity (10 cases, 18.2%) and patchy ground glass opacity (19 cases, 34.5%). Patients with more than two lobes involved were older, while other clinical and laboratory indexes were not closely related to imaging findings. Conclusions Most of the COVID-19 patients with delayed diagnosis and treatment may improve their clinical symptoms at the time of hospitalization with normal white blood cell, lymphocyte and C-reactive protein levels. Stripe shadow, consolidation, and patchy ground glass opacity are the major CT imaging findings. The patients with extensive lesions are older than these with localized CT imaging findings.
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@#Objective To investigate CT image features of ground glass opacity (GGO)-like 2019 novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) and early-stage lung carcinoma for control and therapy of this acute severe respiratory disease. Methods We retrospectively analyzed the clinical data of 71 GGO-like COVID-19 patients who received therapy in Tongji Hospital of Huazhong University of Science and Technology between January 17th and February 13th, 2020. These 71 GGO-like COVID-19 patients were as a COVID-19 group. And 80 GGO-like early-stage lung carcinoma patients who underwent resection were as a lung carcinoma group. Clinical features such as sex, age, symptoms including fever, cough, fatigue, myalgia and dyspnea, detailed exposure history, confirmatory test (SARS-CoV-2 quantitative RT-PCR) and pathologic diagnosis were analyzed. Results Significantly different symptoms and exposure history between the two groups were detected (P<0.001). More lesions (61 patients at percentage of 85.92%, P<0.001), relative peripheral locations (69 patients at percentage of 97.18%, P<0.001) and larger opacities (65 patients at percentage of 91.55%, P<0.001) were found in chest radiographs of GGO-like COVID-19 compared with GGO-like early-stage lung carcinoma. Similar features appeared in early-stage of COVID-19 and lung carcinoma, while pneumonia developed into more extensive and basal predominant lung consolidation. Coexistence of GGO-like COVID-19 and early-stage lung carcinoma might occur. Conclusion Considering these similar and unique features of GGO-like COVID-19 and early-stage lung carcinoma, it is necessary to understand short time re-examination of chest radiographs and other diagnostic methods of these two diseases. We believe that the findings reported here are important for diagnosis and control of COVID-19 in China.
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ABSTRACT The objective of this work is to identify the malignant lung nodules accurately and early with less false positives. 'Nodule' is the 3mm to 30mm diameter size tissue clusters present inside the lung parenchyma region. Segmenting such a small nodules from consecutive CT scan slices are a challenging task. In our work Auto-seed clustering based segmentation technique is used to segment all the possible nodule candidates. Efficient shape and texture features (2D and 3D) were computed to eliminate the false nodule candidates. The change in centroid position of nodule candidates from consecutive slices was used as a measure to remove the vessels. The two-stage classifier is used in this work to classify the malignant and benign nodules. First stage rule-based classifier producing 100 % sensitivity, but with high false positive of 12.5 per patient scan. The BPN based ANN classifier is used as the second-stage classifier which reduces a false positive to 2.26 per patient scan with a reasonable sensitivity of 88.8%. The Rate of Nodule Growth (RNG) was computed in our work to measure the nodules growth between the two scans of the same patient taken at different time interval. Finally, the nodule growth predictive measure was modeled through the features such as compactness (CO), mass deficit (MD), mass excess (ME) and isotropic factor(IF). The developed model results show that the nodules which have low CO, low IF, high MD and high ME values might have the potential to grow in future.
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Radiomics enables extraction of innumerable quantitative features from medical images with high-throughput computing for diagnosis and prediction. The practice of radiomics involves image acquisition, identifying and segmenting the volumes of interest, extracting and analyzing of quantitative features, and classification or prediction model development. Compared with traditional visual interpretation of medical images, the deep mining of medical images by computer technology from radiomics makes feature uptake more efficient, relatively objective and rich in feature types. Whereas, radiomic analysis requires high image quality and consistent scan parameters. The features extracted are confined to the segmented area. Radiomics is promising in tumor screening, early diagnosis, accurate grading and staging, treatment and prognosis, molecular characteristics and so on. Combined with traditional visual interpretation of medical images, radiomics is helpful in tumor diagnosis and prediction.
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The accurate diagnosis and precise prediction of tumor radiation sensitivity and normal tissue radiation-induced injury are the preconditions of precise radiotherapy for lung cancer.Radiomics is defined as a set of milestone,assistive tools in the develop-ment of precise treatment for lung cancer,which can extract many quantitative features from medical images by applying automatic or semi-automatic methods and determine the deep relationship between clinical diagnosis and treatment data.Thus,the occurrence, development,and clinical outcome of lung cancer may be revealed.Radiomics holds immense potential in the classification of benign and malignant lung nodules,prediction of lung cancer genetic phenotypes,and treatment response to radiation therapy,because it can obtain information regarding the global heterogeneity of tumors via a noninvasive approach.In the present review,we summarize the latest process of CT-based radiomics in precise radiotherapy for lung cancer.
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AIM: To observe of optical coherence tomography angiography (OCTA) and indocyanine green angiography (ICGA) image feature in polypoidal choroidal vasculopathy (PCV).METHODS: Selected 21 patients 21 eyes with PCV in our hospital from January 2016 to December 2016.All the eyes were examined by ICGA, and was examined by OCTA after ICGA examination 1h.We observed the characteristics of OCTA and ICGA images.RESULTS:ICGA examination showed that there were 8 cases of choroidal abnormal branch vascular network (BVN), polypoid lesions 10 eyes, BVN with polypoid lesions 2 eyes, no abnormal performance 1 eyes.OCTA examination showed 8 eyes of BVN, and the location, range and shape of BVN were similar to ICGA in OCTA examination.ICGA examination showed 10 cases of polypoid lesions.OCTA showed strong signal highlights.ICGA examination showed 2 cases of BVN complicated with polypoid lesions, and OCTA examination showed strong signal highlights of BVN and corresponding parts.ICGA examination showed no abnormal performance in 1 eyes, and no abnormal findings in OCTA examination.CONCLUSION: OCTA and ICGA are similar in the location and morphology of PCV lesions, and OCTA may play a role in the diagnosis of PCV restricted ICGA.
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Purpose To analyze the clinicopathologic features, immunophenotypes, image features and diagnosis of hemangioblastoma.Methods The clinical and pathological features were studied with HE and immunohistochemical staining in 40 cases of hemangioblastoma.The image features were studied with CT and MRI.Results The clinical symptoms of these cases were dizziness,headache,vomitting, optic disc edema and ataxia. The CT and MRI showed a sharply demarcated tumor with cystic areas and a solid mural nodule. After enhancement scanning, the mural nodule was usually enhanced and the wall of the cystic area was not. Histopathologically, this tumor was characterized by two main components: capillary and stromal cells. Immunohistochemically, the endotheliocyte was positive for CD34 and FⅧRAg, but most of the stromal cells were positive for S-100 and part of the cells were also positive for NSE. The endotheliocyte and the stromal cell were all positive for vimentin, but negative for GFAP, EMA and p53. The expression of Ki-67 was very low.Conclusions Hemangioblastoma is characterized by stromal cells and numerous capillary, but the origin of the stromal cell is not clear. Its image features have some characteristics. It needs to be distinguished from pilocytic astrocytoma, angiomatous meningioma and renal carcinoma.
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Objective To evaluate the therapeutic effect of collagenase chemolysis after 1,2,3 years and analyse the relationship between the therapeutic effect and image features. Probing the image features for the indication, 1 254 patients with integral data who received collagenase chemolysis procedure were followed. Methods According to standard unification diagnostic criteria and therapeutic method, 1 254 patients with lumbar intervertebral disc herniation who had intergral data and received collagenase chemolysis from January 1996 to January 1999 in our department were followed up (by visit, letter or telephone call etc). The therapeutic effects of collagenase chemolysis after 1,2,3 years were evaluated with unified therapeutic effect criteria. Results For the simple lumbar intervertebral disc herniation, 1 year effective rate was 93.1%, 2 year effective rate 90.3% and 3 year effective rate 90.9%. Conclusions The simple lumbar intervertebral disc herniation is the absolute indication of collagenase chemolysis, but those combined with other factors dosen't adapt to collagenase chemolysis.