《放射学实践》杂志常务副主编 华中科技大学同济医学院附属同济医院放射科夏黎明主任/教授团队获AlexanderR.Margulis科学卓越奖

近日,北美放射学会(RSG NA)发布最新消息,《放射学实践》杂志常务副主编、华中科技大学同济医学院附属同济医院放射科主任夏黎明教授团队的新冠肺炎相关研究论文“Correlation of Chest CT and RT-PCR Testing for Coronavirus Disease 2019(COVID-19)in China:A Report of 1014Cases”(2019年发生在中国的冠状病毒疾病胸部CT与核酸检测的对比研究:1014例报道)荣获RSNA2020年Alexander R.Margulis科学卓越奖.     

《放射学实践》杂志常务副主编华中科技大学同济医学院附属同济医院放射科夏黎明主任/教授团队获Alexander R.Margulis科学卓越奖

近日,北美放射学会(RSG NA)发布最新消息,?放射学实践?杂志常务副主编、华中科技大学同济医学院附属同济医院放射科主任夏黎明教授团队的新冠肺炎相关研究论文“Correlation of Chest CT and RTG-PCR Testing for Coronavirus Disease 2019(COVIDG19)in China:A Report of 1014 Cases”(2019年发生在中国的冠状病毒疾病胸部CT与核酸检测的对比研究:1014例报道)荣获RSNA2020年Alexander R.Margulis科学卓越奖.     

Ablation margin assessment of liver tumors with intravenous contrast-enhanced C-arm computed tomography

AIM:To determine the influence of anthropomorphic parameters on the relationship between patient centering,mean computed tomography(CT) numbers and quantitative image noise in abdominal CT.METHODS:Our Institutional Review Board approved study included 395 patients(age range 21-108,years;male:female = 195:200) who underwent contrast-enhanced abdominal CT on a 16-section multi-detector row scanner(GE LightSpeed 16).Patient centering in the gantry isocenter was measured from the lateral localizer radiograph(off center S = patient off centered superior to isocenter;off center I = patient off centered inferior to isocenter).Mean CT numbers(Hounsfield Units:HU) and noise(standard deviation of CT numbers:SD) were measured in the anterior(aHU,aSD) and posterior(pHU,pSD) abdominal wall subcutaneous fat and liver parenchyma(LivHU,LivSD) at the level of the porta hepatis.Patients’ age,gender,weight,body mass index and maximal anteroposterior diameter were recorded.The data were analyzed using linear regression analysis.RESULTS:Most patients(81%;320/395) were not correctly centered in the gantry isocenter for abdominal CT scanning.Mean CT numbers in the abdominal wall increased significantly with an increase in the offcentering distance,regardless of the direction of the off-center(P < 0.05).There was a substantial increase in pSD(P = 0.01) and LivSD(P = 0.017) with off-centering.Change in mean CT numbers and image noise along the off-center distance was influenced by the patient size(P < 0.01).CONCLUSION:Inappropriate patient centering for CT scanning adversely affects the reliability of mean CT numbers and image noise.     

Computed tomography versus transthoracic echocardiography in the detection of complex congenial heart diseases in china:a meta-analysis

Objective:To perform a meta-analysis to evaluate the diagnostic performance of computed tomography(CT) and transthoracic echocardiography(TTE) in complex congenital heart diseases(CHD) in China.Methods:MEDLINE,Cochrane library and China National Knowledge Infrastructure(CNKI) database from January 1966 to October 2010,were searched for initial studies in China.All the studies,published in English or Chinese,used TTE,CT,or both as diagnostic tests for CHD and reported the rate of true-positive,true-negative,false-positive and false-negative diagnoses of CHD from TTE and CT findings with the surgical results as the "gold-standard"(15 studies,XX patients) were collected.The statistic software package,"Meta-Disc 1.4",was used to conduct data analysis.A covariate analysis was used to evaluate the influence of patient or study-related factors on sensitivity.Results:Pooled sensitivity for diagnosis of CHD were 95% [95% confidence interval(CI):94%~96%] for CT studies and 87%(95% CI:85%~88%) for TTE studies.The difference between the pooled sensitivity of CT and that of TTE was statistically significant(P<0.001).TTE had higher sensitivity [0.96(95% CI:0.94~0.97)] for cardiac malformation but lower sensitivity [0.78(95% CI:0.76~0.81)] for extracardiac malformation than CT.Conclusion:CT can provide added diagnostic information compared with TTE in patients with CHD in China,especially for patients suspected of extracardiac malformation.     

不同体位固定方式在乳腺癌放疗中的应用

目的:研究真空垫(VP)、真空垫联合乳腺托架(VB)和发泡胶联合乳腺托架(PB)对乳腺癌放疗中分次间摆位误差、分次内患者移动及剂量学的影响。方法:前瞻性收集2019-2021年在江苏省肿瘤医院接受放射治疗乳腺癌患者共96例,按简单随机法分为VP组、VB组和PB组,每组32例。利用锥形束CT(CBCT)和计划系统获取患者...     

Quantitative measurement of contrast enhancement of esophageal squamous cell carcinoma on clinical MDCT

AIM:To investigate contrast-enhanced computed tomography(CECT)for discriminating esophageal squamous cell carcinoma(ESCC)from normal esophagus and evaluating outcomes within tumors after chemoradiotherapy(CRT).METHODS:Sixty-four patients with surgical ESCC served as group A,and underwent thoracic contrastenhanced scan with 16-section multidetector row CT 1 wk before surgery.Thirty-five patients with advanced ESCC receiving 4-wk CRT and showing response to CRT served as group B,and underwent CT scans similar with group A 4 wk after completion of CRT.In group A,differences in CT attenuation values(in HU)between the preoperative ESCC and background normal esophageal wall(delta CT1),or between different background normal esophageal walls(delta CT2)were compared.Furthermore,delta CT1 between group A and B was also compared.RESULTS:In group A,mean delta CT1 was higher than delta CT2(23.86±10.59 HU vs 6.24±3.06 HU,P<0.05).When a delta CT1 of 10.025 HU was employed at a cut-off value to discriminate ESCC from normal esophagus,a sensitivity of 89.1%and specificity of 90.6%were achieved.Mean delta CT1 was lower in group B than in group A(9.25±10.86 vs 23.86 ±10.59,P<0.05),and a delta CT1 of 15.45 HU was obtained at a cut-off value to assess the CRT changes with a sensitivity of 76.6%and specificity of 77.1%.CONCLUSION:CECT might be a clinical technique for discriminating ESCC from normal esophagus,and evaluating outcome in the tumors treated with CRT.     

2019新型冠状病毒（2019-nCoV）的CT影像特征

正摘要回顾性分析来自中国的21例感染2019年新型冠状病毒(2019-nCoV)且有症状病人的胸部CT,重点是识别最常见的影像表现并对其进行表征。典型的CT表现包括双肺     

Comparison of computed tomography findings between bacteremic and non-bacteremic acute pyelonephritis due to Escherichia coli

AIM:To identify computed tomography(CT)findings that are associated with the presence of bacteremia in patients with acute pyelonephritis(APN)due to Escherichia coli(E.coli).METHODS:The clinical data and contrast-enhanced CT findings of 128 patients who were diagnosed with APN due to E.coli and showed renal abnormality on contrast-enhanced CT between January 2003 and November 2013 were retrospectively reviewed.The patients were divided into two groups according to the presence of bacteremia:The bacteremia group and the non-bacteremia group.The abnormality on contrast-enhanced CT were categorized into 5 renal and 4 extrarenal CT findings and compared between the two groups using the χ~2 test and multivariate logistic regression.RESULTS:Among the 128 patients,34 patients(26.6%)were classified into the bacteremia group and 94 patients(73.4%)into the non-bacteremia group.There was no statistically significant difference in gender between the two groups(P = 0.09),but the age of thepatients in the bacteremia group was higher than that of the patients in the non-bacteremia group(P < 0.01).Compared to the non-bacteremia group,1 renal CT finding such as urothelial thickening and 3 extrarenal CT findings such as diffuse peritoneal thickening,cystitis and pulmonary congestion were more frequently observed in the bacteremia group with statistical significance.The logistic regression analysis revealed that CT findings,including urothelial thickening,diffuse peritoneal thickening,cystitis and pulmonary congestion were suggested as the predictive CT findings of bacteremic APN.CONCLUSION:On CT,urothelial thickening,diffuse peritoneal thickening,cystitis,and pulmonary congestion are more frequently observed in patients with bacteremic APN due to E.coli.     

COPD的CT影像表型与肺腺癌手术预后的关系

目的:探讨肺腺癌患者不同慢性阻塞性肺病(COPD)CT影像表型与手术预后的关系.方法:将2017年1月-2019年12月在我院行手术治疗的396例肺腺癌患者纳入本研究.其中,男222例,女174例,年龄61～81岁,平均(66.0±16.8)岁.手术方式均为肺叶切除术加淋巴结清扫.记录每例患者的基线信息、临床表现、手术...     

2019—2020年某院眼科住院患者X射线检查模式的变化及其对辐射剂量水平的影响

目的通过分析比较眼科病房住院患者X射线检查部位及辐射剂量构成, 探讨近年X射线检查模式的变化与推行的技术优化对患者辐射剂量水平的影响。方法采用简单随机抽样法回顾性调取浙江大学医学院附属第二医院2019年7月1日至2019年11月31日及2020年7月1日至2020年11月31日眼科病房住院患者的影像学资料, 共516例, 根据检查时间选取2019年258例、2020年258例。依据前期研究成果并结合低剂量CT筛查的相关文献, 项目组在2020年对CT扫描参数与流程进行了一系列优化, 统计优化前后单次检查剂量, 统计两年数字X射线摄影(Digital Radiography, DR)和CT检查的人次、人均检查次数、CT与DR的构成比、人均X射线受检剂量。结果 2020年眼科住院患者胸部CT、眼眶CT的平均有效剂量分别为2.587±1.586 mSv和0.877±0.733 mSv, 明显低于2019年(F=0.52、0.72, P<0.05), 分别降低34.82%、37.13%;胸部DR与头颅CT的平均有效剂量2020年与2019年比较差异无统计学意义(F=6.01、1.81, ...     

基于 99Tc m标记纳米抗体的SPECT/CT显像探测非小细胞肺癌PD-L1表达的研究

目的:探讨 99Tc m标记抗程序性死亡受体1配体(PD-L1)纳米抗体(NM-01)的SPECT/CT显像探测非小细胞肺癌(NSCLC)PD-L1表达的价值。 方法:前瞻性纳入2019年1月至2020年3月间于上海交通大学附属第一人民医院病理确诊为NSCLC且未经治疗的患者14例[男...     

螺旋CT检查对胸腹部创伤的诊断价值

目的 探讨胸腹部创伤应用螺旋计算机体层扫描(computed tomography,CT)检查的诊断价值.方法 将2019年12月-2020年12月收治的214例胸腹部创伤患者作为研究对象,所有患者均采用X线检查与螺旋CT检查,将手术结果作为两种检查方式的金标准,比较两组诊断正确率.P＜0.05.结果 螺旋CT检查脾脏...     

儿童青少年体力活动与建成环境研究热点与演进脉络

本文基于CiteSpace软件对Web of Science核心合集数据库中1993~2019年有关儿童青少年体力活动与建成环境的1388篇文献进行可视化图谱分析,从文献时间分布与演进脉络和研究热点切入,进行全面系统分析。结果发现,文献的爆发年份为2014~2019年,峰值出现在2019年。演进脉络为从主观测量的研究方法向着科学化、规范化的客观测量的研究方法演进;从大方向、大主题的研究内容朝着深入化、具体化、生态化的研究内容演进。研究的热点主要有3个:(1)学校建成环境及社区建成环境与体力活动的研究;(2)建成环境与个人行为的研究;(3)建成环境与体力活动及个人健康的研究。     

基于深度学习在CT图像上分割肾上腺的研究

目的:探索使用3D U-Net模型在CT图像上自动分割肾上腺并完成自动测量的可行性,并尝试使用模型输出值初探多期增强CT检查中正常肾上腺的强化特点及肾上腺体积随年龄段的体积变化规律。方法:第一步,训练肾上腺自动分割模型。回顾性收集2016年1月1日-2019年3月14日本中心腹盆部CT检查且结果未见异常的图像,共纳入520个薄层序列(434个检查)作为模型训练数据集。分别标注双侧肾上腺后随机分为训练集(左侧N=419,右侧N=413)、调优集(左侧N=53,右侧N=55)、测试集(左侧N=48,右侧N=52)训练3D U-Net分割模型,模型客观评价指标为测试集的Dice系数。第二步,验证肾上腺分割模型用于自动测量的可行性。回顾性收集2019年3月15日-2019年4月30日本中心住院成人患者腹盆部CT检查且结果未提示肾上腺病变的图像,共纳入988个薄层序列(523个检查)作为外部验证数据集。使用第一步建立的模型对双侧肾上腺进行分割并检查结果,对自动分割满意的图像统计其肾上腺的体积、三维径线、平均CT值,分析增强规律,并在门静脉期图像中按每15岁年龄段统计肾上腺体积随年龄变化的关系。结...     

Utility of arterial phase of dynamic CT for detection of intestinal ischemia associated with strangulation ileus

AIM:To clarify the usefulness of arterial phase scans in contrast computed tomography (CT) imaging of stran-gulation ileus in order to make an early diagnosis. METHODS:A comparative examination was carried out with respect to the CT value of the intestinal tract wall in each scanning phase, the CT value of the content in the intestinal tract, and the CT value of ascites fluid in the portal vein phase for a group in which ischemia was observed (Group Ⅰ) and a group in which ischemia was not observed (Group N) based on the pathological findings or intra-surgical findings. Moreover, a comparative examination was carried out in Group Ⅰ subjects for each scanning phase with respect to average differences in the CT values of the intestinal tract wall where ischemia was suspected and in the intestinal tract wall in non-ischemic areas. RESULTS:There were 15 subjects in Group Ⅰ and 30 subjects in Group N. The CT value of the intestinal tract wall was 41.8 ± 11.2 Hounsfield Unit (HU) in Group Ⅰ and 69.6 ± 18.4 HU in Group N in the arterial phase, with the CT value of the ischemic bowel wall being significantly lower in Group Ⅰ. In the portal vein phase, the CT value of the ischemic bowel wall was 60.6 ± 14.6 HU in Group Ⅰ and 80.7 ± 17.7 HU in Group N, with the CT value of the ischemic bowel wall being significantly lower in Group Ⅰ; however, no significant differences were observed in the equilibrium phase. The CT value of the solution in the intestine was 18.6 ± 9.5 HU in Group Ⅰ and 10.4 ± 5.1 HU in Group N, being signifi-cantly higher in Group Ⅰ. No significant differences were observed in the CT value of the accumulation of ascites fluid. The average difference in the CT values between the ischemic bowel wall and the non-ischemic bowel wall for each subject in Group Ⅰ was 33.7 ± 20.1 HU in the arterial phase, being significantly larger compared to the other two phases. CONCLUSION:This is a retrospective study using a small number of subjects; however, it suggests that there is a possibility that CT scanning in the arterial phase is useful for the early diagnosis of strangulation ileus.     

Bachmann束及其血供的双源CT冠状动脉成像表现

目的 探讨健康志愿者(对照组)和冠状动脉病变(CAL)患者Bachmann束(BB)及其血供的双源CT冠状动脉成像(DSCTCA)形态学特征.方法 分析206名受检者(对照组100例,CAL组106例)的临床病史、ECG和DSCTCA影像,CAL组患者均行冠状动脉造影(CCA),采用Gensini评分系统评价CCA结果,按照Gensini积分的三分位间距将CAL患者分为3组(35例:0.00～9.33分;36例:9.34～33.34分;35例:33.35～258.00分).对BB的长度、宽度、上下径、CT值和血供进行研究.连续变量用秩和检验,类别变量采用联列表的x2检验.结果 (1)对照组BB显示率(86.0%,86/100)高于CAL组(51.9%,55/106;x2=27.726,P＜0.01);CAL各亚组中Gensini评分越高组其BB的显示率越低[80.0%(28/35)、55.6%(20/36)、20.0%(7/35);x2=25.530,P＜0.01].(2)对照组和CAL组BB各径线测量值(长度、宽度、上下径的中位数分别为:13.0和13.8、5.0和5.2、5.9和6.2 mm;P值均＞0.05).(3)对照组BB区域CT值(中位数42.6 HU)高于CAL组(中位数13.0 HU;Z=-7.061,P＜0.01),CAL组BB未显示患者BB区域CT值(中位数-16.0 HU)低于BB显示者(中位数32.5 HU;Z=-6.530,P＜0.01)CAL组BB区域CT值与Gensini积分(中位数19.0)呈负相关(r=-0.553,P＜0.01).(4)BB及BB区域的血供主要来自右窦房结动脉(SNA,58.7%,121/206),其次是左SNA(35.9%,74/206)和双侧SNA(5.3%,11/206).结论 DSCTCA可以了解BB及其血供的解剖特点.CAL程度越严重,BB的显示率越低,ECG异常的发生率越高,提示BB病变的发生可能与局部缺血有关.

Abstract：

Objective To investigate the morphologic features of Bachmann bundle (BB) and its vascular supply on dual-source CT coronary angiography(DSCTCA) in healthy volunteers and patients with coronary artery lesion (CAL). Methods Clinical histories, electrocardiograms (ECGs), and images of DSCTCA of 106 patients ( CAL group) and 100 healthy volunteers ( Control group) were reviewed. All 106 patients underwent conventional coronary angiography ( CCA ). The Gensini scoring system was used to assess the results of CCA. The patients were divided into three groups according to their Gensini scores. The length, width and superoinferior diameter, CT value, and vascular supply of BB were studied. Rank sum test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results ( 1 ) BB visualization rate of control group was higher than CAL group [86.0% (86/100) vs 51.9%(55/106), x2 = 27.726, P ＜ 0.01]. The higher the Gensini score of CAL subgroup, the lower the visualization rate of its BB [80.0% ( 28/35 ), 55.6% ( 20/36 ), 20.0% ( 7/35 ), x2 = 25.530, P ＜ 0.01].(2)The median of measurements of length,width and superoinferior diameter of control and CAL group were 13.0 vs 13.8,5.0 vs 5.2 and 5.9 vs 6.2 mm, respectively ( P ＞ 0.05 ). (3) The CT value of the BB region in control group( median :42.6 HU ) was higher than that of CAL group( median: 13.0 HU) ( Z = - 7.061, P ＜0.01). The CT values of BB regions in patients with nonvisualized BB (median: -16.0 HU) were lower. The CT values of the BB regions in CAL group were negatively-correlated with Gensini scores( median:19.0) (r = -0.553, P ＜0.01 ). (4)The blood supply of BB and BB region was provided by right sinuatrial node artery ( SNA, 58.7%, 121/206 ), left SNA ( 35.9%, 74/206 ) or both SNAs ( 5.3%, 11/206 ).Conclusions DSCTCA could can show the anatomical characteristics of BB and its arterial supply. The serious the degree of CAL , the lower the BB display rate, and the higher the abnormal ECG incidence,which indicate that the occurrence of BB lesions is probably related to ischemia.     

慢性阻塞性肺疾病CT形态测量与气道阻塞关系的系统回顾和Meta分析

目的确定肺气肿或外周气道的CT测量与慢性阻塞性肺疾病(COPD)气道阻塞之间的相关性。方法检索1976—2011年PubMed、Embase和Web of Knowledge数据库。两名独立研究者通过筛选1763篇有关应用CT测量慢性阻塞性肺病病人肺功能测试的气道阻塞参数的引用文章来评价研究的质量并总结相关的信息。研究者应用3种CT测量方法及2个气道阻塞参数进行评价,3种CT测量方法为:肺衰减面积百分比<-950HU(CT单位),平均肺密度及气道壁面积百分比;2个气道阻塞参数为:第1秒用力呼气量占预计值百分比(FEV1%预计值)和FEV1除以最大用力肺容量。结果系统回顾中有79篇(9559人)文章在不同的测量方法、测量数值及CT气道阻塞之间表现出相关性。选取15篇高质量文章(2095人)进行Meta分析。绝对汇集相关系数:吸气相CT为0.48(95%CI:0.40～0.54)～0.65(0.58～0.71),呼气相CT为0.64(0.53～0.72)～0.73(0.63～0.80)。结论肺气肿或外周气道的CT测量与慢性阻塞性肺病病人的气道阻塞显著相关。在研究慢性阻塞性肺疾病的气道阻塞时CT提供了形态学方法。     

后腹膜腺泡状软组织肉瘤转移1例

1 病例简介 男,44岁,主诉:发热,胸部及上腹部CT平扫示右肾后上方巨大肿块.既往史:2019年7月15日因右前臂肿块(图1A、B)于我院关节外科行手术治疗,病理提示为腺泡状软组织肉瘤(alveolar soft part sarcoma, ASPS)(图1C),术前腹部增强CT示右肾后方腹腔内结节灶(图1D、E),...     

Melanoma metastases in the abdomen and pelvis: Frequency and patterns of spread

AIM: To investigate the frequency, typical and atypical locations and patterns of melanoma metastases identifiable by computed tomography (CT) in the abdomen and pelvis. METHODS: We performed a retrospective review of index CT examinations of the abdomen and pelvis in patients with melanoma and recorded all findings suggestive of metastatic disease. RESULTS: Metastases were present on 36% (181/508) of the index examinations and most commonly involved the liver (47%) and pelvic lymph nodes (27%). Lower extremity primaries had the highest rate of metastasis (52%). Ocular and head and neck melanomas have a predilection to metastasize to the liver (hepatic involvement in 70% and 63%, respectively, of patients with metastatic disease) and metastases from lower extremity primaries most commonly involve pelvic lymph nodes (54% of patients with metastatic disease). Metastases to atypical locations were present in 14% of patients and most commonly occurred in the subcutaneous tissue and spleen. Primary tumors of the lower extremity, back and head and neck were most commonly associated with atypical metastases. Pelvic metastases are more common with lower extremity primaries (accounting for 70% of cases with pelvic metastases) but 5% of patients with supraumbilical primaries also had pelvic metastases. CONCLUSION: The distribution of metastatic melanoma in the abdomen and pelvis that we have defined should help guide the interpretation of CT exams in these patients.     

Correlation of the CT values of abdominal aorta,renal artery and renal cortex with its thickness on 64-MDCT contrast en-hanced images

【Abstract】Objective: To investigate the correlation of abdominal aorta CT value,renal artery CT value and renal cortex thickness with renal cortex CT value on contrast enhanced 64-slice CT images. Methods: 96 patients (50 men and 46 women;16~74 years) with normal kidney function,which was confirmed by kidney function test were enrolled in this study,including bilateral kidneys of 92 cases and unilateral kidney of 4 cases (total of 188 kidneys;92 left,96 right).After intravenous (IV) injection of contrast agent the kidneys of the selected patients were scanned by MDCT.The scans were performed in arterial,venous and 3min delayed phases.All statistical analyses were performed by using IBM SPSS 20.0.Graphs were generated using Graph Pad Prism 5 software.Quantitative data were presented as mean±standard deviation,while qualitative data were presented as frequency (%).P<0.05 was considered to be statistically significant. Results: The mean renal cortex thickness was （5.19±0.81）mm in all kidneys.In the arterial phase,a statistically significant positive correlation between renal cortex CT values and abdominal aortic CT values was showed (r=0.584;P<0.001).A statistically significant positive correlation between renal cortex CT values and renal cortex thickness was demonstrated (r=0.533,P<0.0001).Likewise,there was a positive correlation between renal cortex CT value and renal artery CT values (r=0.43,P<0.001). Conclusion: It is a promising approach to assess the individual kidney function by measuring abdominal aorta CT value,renal artery CT value,renal cortex CT value and renal cortex thickness using contrast MDCT.