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Objective:To explore the difference of the vessel and plaque characteristics, myocardial perfusion and cardiac function between patients with ischemia with non-obstructive coronary artery disease (INOCA) and obstructive coronary artery disease (CAD).Methods:From July 2021 to June 2022, 101 patients with angina were referred to dynamic computed tomography myocardial perfusion (CTP) and coronary computed tomography angiography (CCTA) and retrospectively included in our hospital. Based on the results of CTP and CCTA, patients were divided into INOCA (27 cases), moderate obstructive CAD (26 cases) and severe obstructive CAD (48 cases). The anatomical coronary artery stenosis, plaque characteristics and myocardial perfusion features of all patients were analyzed. Furthermore, left ventricular global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) were obtained on full-phase reconstruction CCTA image by using Medis Suite 3.2 postprocessing software. Multigroup analysis used one way ANOVA or Kruskal Wallis H test. Results:Patients with INOCA were younger than patients with moderate and severe obstructive CAD ( P<0.001). INOCA patients (7.4%, 2/27) had lower rate of positive remodeling than both moderate (57.7%, 15/26, P<0.001) and severe obstructive CAD patients (33.3%, 16/48, P=0.017). The percentage of ischemic myocardium volume in patients with INOCA were similar with those in patients with severe CAD (all P>0.05), but significantly higher than those in patients with moderate CAD (all P<0.05). No significant difference in terms of GLS was detected between patients with INOCA [-17.4% (-21.6%, -11.6%)] and severe CAD [-17.6% (-21.9%, -14.8%), P=0.536], however, patients both with INOCA and severe CAD also had higher GLS than patients with moderate obstructive CAD [-22.3% (-29.8%, -19.0%), all P<0.05]. Conclusions:Based on"one-stop-shop"CTP combined with CCTA imaging, early cardiac functional changes including abnormal myocardial perfusion and myocardial strain in INOCA patients were similar to those in patients with severe obstructive CAD and more severe than those in patients with moderate obstructive CAD.
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Objective To analyze the clinical features and imaging findings of lesser trochanter osteoidosteoma,and to discuss the causes of its misdiagnosis as chronic osteomyelitis.Methods The clinical features,X-ray,CT and MRI findings of 6 cases with pathologically confirmed osteoidosteoma in the lesser trochanter were reviewed retrospectively.Symptoms included knee pain (1 case),thigh pain (4 cases)and hip joint pain(1 case);claudication(2 cases),and night pain(1 case).Five patients had right-side,and 1 patient had left-side involvement.All the 6 cases were misdiagnosed as chronic osteomyelitis before operation.Results Four patients had CT scan,which showed intra-cortical niduses at the lesser trochanters with peri-focal sclerosis,joint capsule swelling and joint effusion. Five patients had MRI exams,MR images showed bone marrow edema,synovial thickening,joint capsule swelling and joint effusion in all the 5 cases,but only 2 showed niduses.Six patients had X-ray imaging exams,X-ray images showed bone sclerosis without radiolucent nidus.Conclusion Osteoidosteoma in the lesser trochanter may display atypical clinical features that might be difficult to be differentiated from chronic osteomyelitis without sufficient examination.CT is best in showing niduses,except some niduses with atypical shape,superficial location and high-density calcification.MRI-T2WI is sensitive in showing the inflammation and bone marrow edema with high signal intensity,which may affect nidus displaying.X-ray images can only display bone sclerosis without niduses.
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Purpose To explore the application of intra voxel incoherent motion diffusionweighted imaging (IVIM-DWI) quantitative parameters in evaluating the pathological stage of pancreatic cancer by comparing the manifestations of IVIM-DWI in patients with pancreatic cancer in different differentiaed degrees as there lacked effective screening instrument for the early diagnosis of pancreatic cancer.Materials and Methods Sixteen patients with pathologically proved pancreatic cancer (10 with high-moderation differentiation while 6 with low differentiation) were enrolled,and 3.0T MRI was used to conduct pancreatic DWI with multiple b values.IVIM double-exponential model was used to analyze the measurement parameters of DWI with multiple b values,so as to measure the slow apparent diffusion coefficient (ADCslow),fast apparent diffusion coefficient (ADCfast) and filling fraction (f).Results The ADCslow value was evidently lower in patients with high-moderate differentiated pancreatic cancer than those with low differentiated pancreatic cancer [(0.546± 0.041)× 10-3 mm2/s vs.(0.677± 0.120)× 10-3 mm2/s,P＜0.05],and f value was notably higher in patients with high-moderate differentiated pancreatic cancer than those with low differentiated pancreatic cancer [(59.3 ± 8.8)％ vs.(41.7±22.4)％,P＜0.05].The area under the curve of ADCslow was higher than that of f when distinguishing high-moderate differentiated and low differentiated pancreatic cancer (0.850＞0.750).The sensitivity and specificity were 100.00％ and 83.33％ when ADCslow ≤ 0.599×10-3 mm2/s,and were 100.00％ and 66.67％ when f＞44.7％ in distinguishing high-moderate differentiated and low differentiated pancreatic cancer,respectively.Conclusion ADCslow and f,as the quantitative parameters for IVIM-DWI,can distinguish high-moderate differentiated and low differentiated pancreatic cancer,and predict the pathological stage of pancreatic cancer before operation.Moreover,they also have high diagnostic efficacy in distinguishing high-moderate differentiated and low differentiated pancreatic cancer.
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Objective To explore the application value of monoexponential, biexponential models multiple b values diffusion weighted imaging(DWI) in distinguishing pancreatic cancer from non-tumorous pancreas.Methods Subjects comprised 37 pancreatic cancers confirmed by clinical or surgery.Pancreas multiple b values DWI was performed using 3.0T scanner.Standard apparent diffusion coefficient (ADCstandard) was calculated using monoexponential diffusion model.Pure diffusion coefficient (ADCslow), pseudodiffusion coefficient (ADCfast) and perfusion fraction (f) were calculated using intravoxel incoherent motion(IVIM) diffusion model.Parameters of pancreatic cancers and non-tumorous pancreas were compared using independent samples t test.Results Mean ADCslow value of pancreatic cancer was higher than that of non-tumorous pancreas (0.611×10-3 mm2/s vs 0.521×10-3 mm2/s,P=0.037).Mean ADCfast and f values of pancreatic cancer were lower than that of non-tumorous pancreas (5.066×10-3 mm2/s vs 7.188×10-3 mm2/s,P=0.035;55.8% vs 64.0%,P=0.016;respectively).ADCslow of pancreatic cancer was positively correlated to ADCstandard (r=0.824,P=0.000).ADCfast of pancreatic cancer was negatively correlated to f(r=-0.558,P=0.000).Conclusion ADCslow, ADCfast and f derived from IVIM-DWI model can distinguish pancreatic cancer from non-tumorous pancreas.IVIM-DWI may be a promising and non-invasive tool for early diagnosing and differentiating pancreatic carcinoma from non-tumorous pancreas.
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Objective To study the imaging manifestations and clinical significance of simple cochlear nerve canal(CNC)stenosis. Methods The HRCT findings of 14 patients(1 7 ears)with simple CNC stenosis diagnosed sensorineural hearing loss(SNHL)were retrospectively analyzed.The width of CNC and internal auditory canal was measured and compared with the normal ears,the data were statisti-cally analyzed by SPSS1 6.0.Thin-sliced MRI of internal auditory canal (axial and oblique sagittal position)was performed in 8 cases. Results HRCT displayed obvious CNC stenosis in all 14 patients(1 7 ears),2 ears with cochlear nerve canal atresia.Width of CNC and internal auditory canal was (0.5±0.3)mm and (4.6±1.0)mm,it was (2.1±0.2)mm and (5.1 ±1.3)mm in normal ears (1 1 ears),the width of CNC was of significant difference between normal ears and ears with SNHL,and there was no statistical sig-nificant difference in width of internal auditory canal.12 ears(from 1 7 ears with simple CNC stenosis)were lacking of fissure in the cribriform area,1 1 ears(normal ear)were existence of fissure in the cribriform area;cochlear nerves were not shown in 8 patients with MRI examination.Conclusion CNC stenosis can be isolated from internal auditory canal stenosis,MRI could display cochlear nerve dysplasia(CND).
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A multi-step method for extracting the heart image from visible human project (VHP) data was proposed in this paper. In the first step, Otsu's thresholding segmentation based on mathematical morphological techniques called opening-by-reconstruction and closing-by-reconstruction was used to preprocess the original image in order to effectively overcome the disadvantages of using only thresholding segmentation. The second step was to extract heart data from the proposed image. This multi-step method improved the computation efficiency and attained higher precision, suggesting its significant value for application in VHP.
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Humanos , Algoritmos , China , Corazón , Aumento de la Imagen , Procesamiento de Imagen Asistido por Computador , Matemática , Proyectos Humanos VisiblesRESUMEN
Objective To investigate the optimum threshold value of tracking and triggering technique (surestart) in imaging of coronary artery by 16-slice row CT. Methods 60 patients enrolled in the enhanced scan of coronary artery imaging were divided into 2 groups (group a : heart rate 70 beats/per minute ). The quality of images collected under different threshold value and heart rate was compared. The image quality of coronary artery was ranked by 3 levels, namely, level A, B and C. The data were statistically analyzed. Results The image quality triggered by 160 HU of group b was level A. The image quality triggered by 180 HU of group a was level A. Conclusion The optimum surestart is 180 HU when the heart rate 70 beats/per minute.
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Objective To evaluate the clinical efficacy of MRA in the arteries of the pelvis and lower extremity with automatic table movement (MobiTrak).Methods 12 cases suspected of pelvis and lower extremity artery diseases underwent dynamic 3D contrast enhanced MRA and automatic table movement at the same time.Three cases underwent artery angiography,four cases were detected by operation.Results All diseased arteries were well demonstrated.Among them,lower extremity artery occlusion 8,failing vascular grafts 2,artery aneurysms 2.Conclusion Automatic table movement is of value in assessing pelvis and lower extremity artery diseases accurately.And it is a reliable and potential new technique.
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Objective To evaluate the value of dual-phase spiral CT scanning in diagnosis of small pancreatic carcinoma.Methods 21 cases with small pancreatic carcinoma (≤2 cm) underwent plain CT scan and dual-phase eahanced spiral CT including arterial phase(20~25 s after infusion)and pancreatic phase(50~60 s after infusion)with a 100 ml bolus injection of contrast material at 3~6 ml/s.CTattenuation values of tumor and normal pancreas in all scanning phase were obtained.Results The mean CT value of tumor was(42?14) HU(arterial phase)and (48?18) HU(pancreatic phase),the mean CT value of normal pancreas was (105?15) HU(arterial phase)and (86?11) HU(pancreatic phase).The dens difference of tumor-pancreas was significantly on arterial phase (69?15) HU.Conclusion The maximum dens difference of tumor-pancreas can be obtained on arterial phase CT scan,it has advantages in diagnosing pancreatic carcinoma of early period and to judge the resectionability of pancreatic carcinoma.