ABSTRACT
Objective: To investigate the accuracy of calcicum supression (CaSupp) technique derived from double-layer detector spectral computed tomography (DSCT) in the diagnosis of traumatic bone marrow edema in the knee. Methods: Twenty-three patients with trauma in the knee who underwent DSCT and Magnetic Resonance Imaging (MRI) in the Third Hospital of Hebei Medical University from October 2021 to March 2022 were retrospectively collected. To make the evaluation more detailed and accurate, each knee was divided into 10 partitions. Bone marrow edema in each partition of the knee was evaluated by two physicians (physician A and B) using CaSupp images combined with conventional CT-CaSupp fusion false-color images. MRI results were used as the gold standard and the accuracy of the CaSupp technique was analyzed in the diagnosis of traumatic bone marrow edema in the knee. The CaSuppCT values of the normal bone marrow area and the bone marrow edema area were delineated, and receiver operating curve (ROC curve) was drawn to find the optimal cut-off value of CaSuppCT as the quantitative parameter for the diagnosis of bone marrow edema. Results: The diagnostic sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of physician A were 83.1 %, 98.1 %, 95.5 % and 92.1 %, respectively; those of physician B were 93.5 %, 97.4 %, 94.7 % and 96.8 %, respectively. The CaSuppCT values in the bone marrow edema areas were higher than those in the normal areas, and the difference was statistically significant. The area under the receiver operating characteristic curve (AUC) of the CaSuppCT values was 0.979, and the cut-off value was 7.05Hu*. The corresponding diagnostic sensitivity was 87.0 %, and specificity was 100.0 %. Conclusion: The CaSupp technique derived from DSCT has high sensitivity and specificity in the detection of traumatic bone marrow edema in the knee, and can provide more imaging information for clinical practice.
ABSTRACT
BACKGROUND: It now seems that all pulmonary hamartomas (PHs) are large cystic-solid lesions that are difficult to diagnose. However, few cases of large cystic-solid PHs have been reported. The present case report presents a large cystic-solid PH and provides a literature review of the imaging features, formation mechanism and histopathological basis of PHs. CASE SUMMARY: A 53-year-old woman with no clinical symptoms underwent a chest computed tomography (CT) examination at our hospital. Nonenhanced CT images revealed a large, flat tumor with multiple air-containing cysts in the left thoracic cavity and a cystic part confined to the medial side of the tumor; the solid part of the tumor showed abundant fat and lamellar soft tissue components. Multiple small blood vessels were detected in the solid part of the tumor on contrast-enhanced CT images. Given the large size of the lesion, the patient elected to undergo surgery. Histological examination revealed PH. A detailed review of the patient's CT imaging showed that the lesion had a small vascular pedicle to the left lower lobe, which was a clue to its lung tissue histological origin. According to immunohistochemical staining, the confined multiple air-containing cysts were caused by the entrapment of respiratory/alveolar epithelium. CONCLUSION: This case shows the imaging manifestations of a large PH. Heightened awareness of its formation mechanism and histopathological basis may alert radiologists to consider this diagnosis in their daily workflow.
ABSTRACT
PURPOSE: To evaluate the accuracy of pulmonary nodule (PN) detection in overweight or obese adult patients using ultralow-dose computed tomography (ULDCT) with tin filtration at 100 kV and advanced model-based iterative reconstruction (ADMIRE). METHODS: Eighty-one patients with body mass indices of ≥25 kg/m2 were enrolled. All patients underwent low-dose chest CT (LDCT), followed by ULDCT. Two radiologists experienced in LDCT established the standard of reference (SOR) for PNs. The number, type, size, and location of PNs were identified in the SOR. Effective dose, objective image quality (IQ), and subjective IQ based on two radiologists' scores were compared between ULDCT and LDCT. The detection performances of radiologists based on ULDCT were calculated according to the nodule analyses. Logistic regression was used to test for independent predictors of PN detection sensitivity. RESULTS: Both the effective dose and objective IQ were lower for ULDCT than for LDCT (both p < 0.001). Both radiologists rated the subjective IQ of the overall IQ on ULDCT to be diagnostically sufficient. In total, 234 nodules (mean diameter, 3.4 ± 1.9 mm) were classified into 32 subsolid, 149 solid, and 53 calcified nodules according to the SOR. The overall sensitivity of ULDCT for nodule detection was 93.6%. Based on multivariate analyses, the nodule types (p = 0.015) and sizes (p = 0.013) were independent predictors of nodule detection. CONCLUSIONS: Compared with LDCT, ULDCT with tin filtration at 100 kV and ADMIRE could significantly reduce the radiation dose in overweight or obese patients while maintaining good sensitivity for nodule detection.
Subject(s)
Lung Neoplasms , Multiple Pulmonary Nodules , Adult , Humans , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/radiotherapy , Multiple Pulmonary Nodules/diagnostic imaging , Obesity/complications , Overweight , Radiation Dosage , Radiographic Image Interpretation, Computer-Assisted/methods , Tin , Tomography, X-Ray Computed/methodsABSTRACT
OBJECTIVES: To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia. METHODS: A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis. RESULTS: Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, P<0.05) or with severe asphyxia (19.8% vs 8.1%, P<0.05) or hypothermia therapy (4.8% vs 1.5%, P<0.05), as well as a significantly higher incidence rate of disorder of glucose metabolism (18.8% vs 12.5%, P<0.05). Compared with the good prognosis group, the poor prognosis group had a significantly higher incidence rate of disorder of glucose metabolism at 1, 2, and 6 hours after birth (P<0.05). The multivariate logistic regression analysis showed that recurrent hyperglycemia (adjusted odds ratio=2.380, 95% confidence interval: 1.275-4.442, P<0.05) was an independent risk factor for poor prognosis in neonates with asphyxia. CONCLUSIONS: Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.
