Zhi-ping Zhang, Lie-guang Zhang, S. Xia, Jinxin Liu
We report a case of a 45-year-old male patient who was admitted to our hospital due to the left upper extremity weakness and paroxysmal headaches. He was diagnosed with neurosyphilis by pathology. He was found to be human immunodeficiency virus-positive, with a CD4 count of 179 cells/μl. Ring-enhancing lesions were found in the right frontal cortex with adjacent dural thickening. The lesion almost disappeared after anti-syphilis treatment.
{"title":"Neurosyphilis with manifesting as cerebral ring enhanced in a patient with acquired immunodeficiency syndrome","authors":"Zhi-ping Zhang, Lie-guang Zhang, S. Xia, Jinxin Liu","doi":"10.4103/RID.RID_24_22","DOIUrl":"https://doi.org/10.4103/RID.RID_24_22","url":null,"abstract":"We report a case of a 45-year-old male patient who was admitted to our hospital due to the left upper extremity weakness and paroxysmal headaches. He was diagnosed with neurosyphilis by pathology. He was found to be human immunodeficiency virus-positive, with a CD4 count of 179 cells/μl. Ring-enhancing lesions were found in the right frontal cortex with adjacent dural thickening. The lesion almost disappeared after anti-syphilis treatment.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"1 1","pages":"33 - 37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79748326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qinqin Yan, Yijun Zhang, Yang Lu, Chenhang Ding, N. Shi, F. Song, Chao Huang, Fengjun Liu, F. Shan, Zhiyong Zhang, J. Buckey, Yuxin Shi
BACKGROUND: Early warning of severe coronavirus disease 2019 (COVID-19) pneumonia on admission is critical for reducing mortality. PURPOSE: The purpose of this study was to identify the risk factors for predicting severe COVID-19 pneumonia on admission. MATERIALS AND METHODS: Computed tomography (CT) scans on admission and initial clinical data were collected from 213 patients with COVID-19 pneumonia. Semi-quantitative CT scoring was performed, multiplying the CT patterns by their extent. CT patterns were graded on a four-point scale: 0, normal attenuation; 1, ground-glass opacities (GGOs); 2, mixed patterns of GGO and consolidation; and 3, consolidation. The extent of patterns was visually estimated as the percentage (to the nearest 10%) of the affected pulmonary lobe. Inter-observer agreement was evaluated using the inter-class correlation coefficient. CT scores and clinical data were compared between severe and nonsevere patients using parametric and nonparametric statistics, as appropriate. The least absolute shrinkage and selection operator (LASSO) with 10-fold cross-validation and logistic regression was used to select the risk factors and construct a predictive model. RESULTS: Age, respiratory rate, hypertension, procalcitonin, D-dimer, lactate dehydrogenase, high-sensitivity C-reactive protein (hs-CRP), cystatin C, brain natriuretic peptide (pro-BNP), and CT score were higher in severe COVID-19 infection. LASSO analysis revealed that the CT score coupled with hs-CRP was optimal for predicting progression to severe pneumonia. The areas under the curves for validation and testing data were 0.85 and 0.82, respectively, with sensitivity of 89.5% and 75.0%, specificity of 75.4% and 98.1%, and accuracy of 77.2% and 95.3%. CONCLUSION: The CT score combined with hs-CRP on admission predicted severe COVID-19 pneumonia.
{"title":"Predictors of severe coronavirus disease 2019 pneumonia","authors":"Qinqin Yan, Yijun Zhang, Yang Lu, Chenhang Ding, N. Shi, F. Song, Chao Huang, Fengjun Liu, F. Shan, Zhiyong Zhang, J. Buckey, Yuxin Shi","doi":"10.4103/RID.RID_17_22","DOIUrl":"https://doi.org/10.4103/RID.RID_17_22","url":null,"abstract":"BACKGROUND: Early warning of severe coronavirus disease 2019 (COVID-19) pneumonia on admission is critical for reducing mortality. PURPOSE: The purpose of this study was to identify the risk factors for predicting severe COVID-19 pneumonia on admission. MATERIALS AND METHODS: Computed tomography (CT) scans on admission and initial clinical data were collected from 213 patients with COVID-19 pneumonia. Semi-quantitative CT scoring was performed, multiplying the CT patterns by their extent. CT patterns were graded on a four-point scale: 0, normal attenuation; 1, ground-glass opacities (GGOs); 2, mixed patterns of GGO and consolidation; and 3, consolidation. The extent of patterns was visually estimated as the percentage (to the nearest 10%) of the affected pulmonary lobe. Inter-observer agreement was evaluated using the inter-class correlation coefficient. CT scores and clinical data were compared between severe and nonsevere patients using parametric and nonparametric statistics, as appropriate. The least absolute shrinkage and selection operator (LASSO) with 10-fold cross-validation and logistic regression was used to select the risk factors and construct a predictive model. RESULTS: Age, respiratory rate, hypertension, procalcitonin, D-dimer, lactate dehydrogenase, high-sensitivity C-reactive protein (hs-CRP), cystatin C, brain natriuretic peptide (pro-BNP), and CT score were higher in severe COVID-19 infection. LASSO analysis revealed that the CT score coupled with hs-CRP was optimal for predicting progression to severe pneumonia. The areas under the curves for validation and testing data were 0.85 and 0.82, respectively, with sensitivity of 89.5% and 75.0%, specificity of 75.4% and 98.1%, and accuracy of 77.2% and 95.3%. CONCLUSION: The CT score combined with hs-CRP on admission predicted severe COVID-19 pneumonia.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"30 1","pages":"12 - 18"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76145258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVE: To investigate the value of computed tomography (CT)-derived radiomics features in the differential diagnosis of pulmonary tuberculosis (PTB) and talaromycosis marneffei (TSM) in patients with acquired immunodeficiency syndrome (AIDS). MATERIALS AND METHODS: The venous phase images for 166 patients with AIDS (PTB, n = 66; TSM, n = 99) were retrospectively analyzed, and the radiomics features of lung lesions and mediastinal lymph nodes were extracted. The samples were divided into a training set and a test set in a ratio of 8:2. The optimal eigenvalues were used to establish four prediction models: radiomics model 1 (PTB group and TSM lung lesions), radiomics model 2 (PTB group and TSM lung lesions), radiomics model 3 (pulmonary lesions without lymph node enhancement), and radiomics model 4 (pulmonary lesions with lymph node enhancement). The working characteristic curve was used to evaluate the predictive performance of the model. RESULTS: The accuracy, sensitivity, specificity, and area under the curve values were 0.67, 0.78, 0.78, and 0.735, respectively, for the radiomics model 1 test set; 0.67, 0.62, 0.67, and 0.654, respectively, for radiomics model 2; 0.89, 0.76, 0.80, and 0.833, respectively, for radiomics model 3; and 0.76, 0.80, 0.88, and 0.886, respectively, for radiomics model 4. CONCLUSION: The prediction model based on CT-derived radiomics features has value for the identification of PTB and TSM. The radiomics model based on the optimal eigenvalues of lung lesions combined with lymph node plain scan images is compared with the establishment of a single lung. The focal omics feature model has better predictive power.
目的:探讨计算机断层扫描(CT)衍生放射组学特征在获得性免疫缺陷综合征(AIDS)患者肺结核(PTB)和马尔尼菲talaromycosis marneffei (TSM)鉴别诊断中的价值。材料与方法:166例艾滋病(PTB)患者静脉相图像，n = 66;回顾性分析TSM, n = 99)，提取肺病变及纵隔淋巴结放射组学特征。将样本按8:2的比例分为训练集和测试集。利用最优特征值建立4个预测模型:放射组学模型1 (PTB组及TSM肺病变)、放射组学模型2 (PTB组及TSM肺病变)、放射组学模型3(无淋巴结强化肺病变)、放射组学模型4(有淋巴结强化肺病变)。利用工作特性曲线对模型的预测性能进行评价。结果:放射组学模型1的准确度、灵敏度、特异性和曲线下面积值分别为0.67、0.78、0.78和0.735;放射组学模型2分别为0.67、0.62、0.67、0.654;放射组学模型3分别为0.89、0.76、0.80、0.833;放射组学模型4分别为0.76、0.80、0.88、0.886。结论:基于ct衍生放射组学特征的预测模型对PTB和TSM的鉴别具有一定的价值。基于肺病变最优特征值结合淋巴结平扫图像的放射组学模型与建立单个肺的放射组学模型进行比较。焦点组学特征模型具有较好的预测能力。
{"title":"Differential diagnosis of pulmonary tuberculosis and talsromycosis marneffei by computed tomography-derived radiomics in patients with acquired immunodeficiency syndrome","authors":"Jing-shi Zhou, Kai Li, Yibo Lu","doi":"10.4103/RID.RID_28_22","DOIUrl":"https://doi.org/10.4103/RID.RID_28_22","url":null,"abstract":"OBJECTIVE: To investigate the value of computed tomography (CT)-derived radiomics features in the differential diagnosis of pulmonary tuberculosis (PTB) and talaromycosis marneffei (TSM) in patients with acquired immunodeficiency syndrome (AIDS). MATERIALS AND METHODS: The venous phase images for 166 patients with AIDS (PTB, n = 66; TSM, n = 99) were retrospectively analyzed, and the radiomics features of lung lesions and mediastinal lymph nodes were extracted. The samples were divided into a training set and a test set in a ratio of 8:2. The optimal eigenvalues were used to establish four prediction models: radiomics model 1 (PTB group and TSM lung lesions), radiomics model 2 (PTB group and TSM lung lesions), radiomics model 3 (pulmonary lesions without lymph node enhancement), and radiomics model 4 (pulmonary lesions with lymph node enhancement). The working characteristic curve was used to evaluate the predictive performance of the model. RESULTS: The accuracy, sensitivity, specificity, and area under the curve values were 0.67, 0.78, 0.78, and 0.735, respectively, for the radiomics model 1 test set; 0.67, 0.62, 0.67, and 0.654, respectively, for radiomics model 2; 0.89, 0.76, 0.80, and 0.833, respectively, for radiomics model 3; and 0.76, 0.80, 0.88, and 0.886, respectively, for radiomics model 4. CONCLUSION: The prediction model based on CT-derived radiomics features has value for the identification of PTB and TSM. The radiomics model based on the optimal eigenvalues of lung lesions combined with lymph node plain scan images is compared with the establishment of a single lung. The focal omics feature model has better predictive power.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"31 1","pages":"1 - 5"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74823958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yusheng Chen, Hongru Li, Fan Wu, Wenxiang Yue, Jian Wu, Yunan Zhao, Xueying Yu, Chi Zhang, Xinlan Hu, Nengluan Xu, Ming Lin, Yan Xiao, Lili Ren
BACKGROUND: This study aimed to compare the clinical characteristics of infections caused by different pathogens and then establish a viral/bacterial infection prediction model to guide early clinical identification of pathogens in inpatients with community-acquired pneumonia (CAP). METHODS: A total of 687 patients who were diagnosed with CAP in our hospital between March 2012 and December 2018 were studied. Basic data, clinical symptoms, laboratory examinations, and imaging examinations of patients were collected, and a virus/bacteria prediction equation was established. In the prediction model, the relevant variables were screened according to a univariate logistic regression analysis, and then, a multivariate logistic regression analysis was performed to establish the prediction equation. RESULTS: The proportions of patients with muscle soreness and headaches were significantly higher in the viral infection group than in the bacterial infection group. Procalcitonin (PCT) concentrations, the erythrocyte sedimentation rate (ESR), and the neutrophil alkaline phosphatase (NAP) score were significantly higher in the bacterial infection group than in the viral infection group. Creatine kinase concentrations were significantly higher in the viral infection group than in the bacterial infection group (P < 0.05). A higher proportion of patients had lung degeneration in the atypical pathogen infection group than in other groups (P = 0.005). Patchy shadows were more common in the viral infection group than in the other groups. A binary logistic regression equation was obtained that could predict the probability of viral infection (sensitivity: 57.5%, specificity: 67.7%, and area under the receiver operating characteristics curve: 0.651). CONCLUSIONS: Adult patients with CAP and viral infection are more likely to have headaches and muscle soreness than those with bacterial infection. An elevated PCT concentration, NAP score, and ESR indicate a high possibility of bacterial infection. We successfully established a viral and bacterial infection prediction model.
{"title":"Clinical characteristics analysis and construction of a predictive diagnostic model of community-acquired pneumonia in adults requiring hospitalization in Fujian provincial hospital","authors":"Yusheng Chen, Hongru Li, Fan Wu, Wenxiang Yue, Jian Wu, Yunan Zhao, Xueying Yu, Chi Zhang, Xinlan Hu, Nengluan Xu, Ming Lin, Yan Xiao, Lili Ren","doi":"10.4103/rid.rid_4_23","DOIUrl":"https://doi.org/10.4103/rid.rid_4_23","url":null,"abstract":"BACKGROUND: This study aimed to compare the clinical characteristics of infections caused by different pathogens and then establish a viral/bacterial infection prediction model to guide early clinical identification of pathogens in inpatients with community-acquired pneumonia (CAP). METHODS: A total of 687 patients who were diagnosed with CAP in our hospital between March 2012 and December 2018 were studied. Basic data, clinical symptoms, laboratory examinations, and imaging examinations of patients were collected, and a virus/bacteria prediction equation was established. In the prediction model, the relevant variables were screened according to a univariate logistic regression analysis, and then, a multivariate logistic regression analysis was performed to establish the prediction equation. RESULTS: The proportions of patients with muscle soreness and headaches were significantly higher in the viral infection group than in the bacterial infection group. Procalcitonin (PCT) concentrations, the erythrocyte sedimentation rate (ESR), and the neutrophil alkaline phosphatase (NAP) score were significantly higher in the bacterial infection group than in the viral infection group. Creatine kinase concentrations were significantly higher in the viral infection group than in the bacterial infection group (P < 0.05). A higher proportion of patients had lung degeneration in the atypical pathogen infection group than in other groups (P = 0.005). Patchy shadows were more common in the viral infection group than in the other groups. A binary logistic regression equation was obtained that could predict the probability of viral infection (sensitivity: 57.5%, specificity: 67.7%, and area under the receiver operating characteristics curve: 0.651). CONCLUSIONS: Adult patients with CAP and viral infection are more likely to have headaches and muscle soreness than those with bacterial infection. An elevated PCT concentration, NAP score, and ESR indicate a high possibility of bacterial infection. We successfully established a viral and bacterial infection prediction model.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135609447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVE: The objective of this study was to investigate the clinical characteristics, imaging manifestations, and prognosis of patients with acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS: This retrospective study included 92 patients with AIDS-related NHL (ARL), who were treated at the Central South Hospital of Wuhan University between January 2005 and March 2022. Patients were divided into three groups according to their pathological type: diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), and plasmablastic lymphoma (PBL). Their clinical characteristics and imaging data were compared. In addition, some computed tomography (CT) features of the tumors were analyzed and summarized. SPSS 26.0 was used for statistical analysis. The prognostic factors were analyzed using the Kaplan–Meier method, Cox proportional risk regression model, and receiver operating characteristic curve. RESULTS: Among the 92 cases, 68 were DLBCL, 19 were BL, and five were PBL. BL patients had a higher risk profile than DLBCL and PBL patients. Most of the tumors had unclear borders, uneven densities on plain and enhanced CT scans, and signs of fusion and necrosis. The analyses indicated that the International Prognostic Index (IPI) score (odd ratio [OR] =15.699, 95% confidence interval [CI] =1.828–134.829, P = 0.012) and Eastern Cooperative Oncology Group (ECOG) score (OR = 28.869, 95% CI = 3.015–276.395, P = 0.004) were independent prognostic indicators of the overall survival. CONCLUSIONS: ARL is a heterogeneous and aggressive disease with a poor prognosis. Compared with DLBCL or PBL patients, BL patients have higher risk features. IPI and ECOG scores can effectively predict the prognosis of ARL.
{"title":"Features of human acquired immunodeficiency virus-associated non-Hodgkin's lymphoma","authors":"Liao Meiyan, Yun Long, Sufang Tian, Binchen Wang, Tian Gan, Jingting Wang","doi":"10.4103/rid.rid_45_22","DOIUrl":"https://doi.org/10.4103/rid.rid_45_22","url":null,"abstract":"OBJECTIVE: The objective of this study was to investigate the clinical characteristics, imaging manifestations, and prognosis of patients with acquired immunodeficiency syndrome (AIDS)-related non-Hodgkin's lymphoma (NHL). PATIENTS AND METHODS: This retrospective study included 92 patients with AIDS-related NHL (ARL), who were treated at the Central South Hospital of Wuhan University between January 2005 and March 2022. Patients were divided into three groups according to their pathological type: diffuse large B-cell lymphoma (DLBCL), Burkitt lymphoma (BL), and plasmablastic lymphoma (PBL). Their clinical characteristics and imaging data were compared. In addition, some computed tomography (CT) features of the tumors were analyzed and summarized. SPSS 26.0 was used for statistical analysis. The prognostic factors were analyzed using the Kaplan–Meier method, Cox proportional risk regression model, and receiver operating characteristic curve. RESULTS: Among the 92 cases, 68 were DLBCL, 19 were BL, and five were PBL. BL patients had a higher risk profile than DLBCL and PBL patients. Most of the tumors had unclear borders, uneven densities on plain and enhanced CT scans, and signs of fusion and necrosis. The analyses indicated that the International Prognostic Index (IPI) score (odd ratio [OR] =15.699, 95% confidence interval [CI] =1.828–134.829, P = 0.012) and Eastern Cooperative Oncology Group (ECOG) score (OR = 28.869, 95% CI = 3.015–276.395, P = 0.004) were independent prognostic indicators of the overall survival. CONCLUSIONS: ARL is a heterogeneous and aggressive disease with a poor prognosis. Compared with DLBCL or PBL patients, BL patients have higher risk features. IPI and ECOG scores can effectively predict the prognosis of ARL.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135609453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The pathological diagnostic criteria for early hepatocellular carcinoma (eHCC) were updated in 2009, but the imaging diagnostic criteria for eHCC have not yet been established in China or other countries. This consensus was formed based on the input of more than 40 experts from over 10 Chinese provinces and cities to assist doctors in diagnosing eHCC, and was endorsed by the Radiology of Infection Sub-Branch, Radiology Branch, Chinese Medical Association, together with the Committee on Radiology of Infection, Radiology Branch, Chinese Medical Doctor Association, the Radiology Committee on Infectious and Inflammatory Disease, Chinese Research Hospital Association, the Radiology of Infection Branch, Working and Treating Committee of HIV/AIDS and STD Association, the Radiology of Infectious Disease Management Sub-Branch, Infectious Disease Management Branch, Hospital Management Association in China, and the Beijing Imaging Diagnosis and Treatment Technology Innovation Alliance.
{"title":"Consensus on imaging techniques and diagnostic criteria for hepatitis B virus-related early hepatocellular carcinoma","authors":"Qiang Liu, Jie Bian, Hongjun Li","doi":"10.4103/rid.rid_5_23","DOIUrl":"https://doi.org/10.4103/rid.rid_5_23","url":null,"abstract":"The pathological diagnostic criteria for early hepatocellular carcinoma (eHCC) were updated in 2009, but the imaging diagnostic criteria for eHCC have not yet been established in China or other countries. This consensus was formed based on the input of more than 40 experts from over 10 Chinese provinces and cities to assist doctors in diagnosing eHCC, and was endorsed by the Radiology of Infection Sub-Branch, Radiology Branch, Chinese Medical Association, together with the Committee on Radiology of Infection, Radiology Branch, Chinese Medical Doctor Association, the Radiology Committee on Infectious and Inflammatory Disease, Chinese Research Hospital Association, the Radiology of Infection Branch, Working and Treating Committee of HIV/AIDS and STD Association, the Radiology of Infectious Disease Management Sub-Branch, Infectious Disease Management Branch, Hospital Management Association in China, and the Beijing Imaging Diagnosis and Treatment Technology Innovation Alliance.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135609981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
INTRODUCTION: Radiological phenotypes are observable radiological patterns or characteristics. Robust data are available regarding the role of high-resolution computed tomography (HRCT) in coronavirus disease 2019 (COVID-19) pneumonia. We evaluated the role of radiological phenotyping in assessing severity and predicting the response to therapy, as well as its association with outcomes in COVID-19 pneumonia. METHODS: This prospective observational study included 3000 COVID-19 reverse transcription polymerase chain reaction-confirmed cases with lung involvement who underwent thoracic HRCT on hospital admission and were categorized as mild, moderate, or severe according to lung segment bilateral involvement (mild 1–7, moderate 8–15, and severe 16–25). Follow-up thoracic CT imaging was also conducted 6 months after hospital discharge. Response to treatment phenotypes was categorized as “easy to treat” or “difficult to treat” based on the response and interventions required in indoor settings, including ventilatory support. Age, gender, comorbidities, laboratory parameters, the use of bilevel-positive airway pressure/noninvasive ventilation, and outcomes (with or without lung fibrosis) were key observations. The Chi-square test was used for statistical analysis. RESULTS: Easy-to-treat and difficult-to-treat radiological response phenotypes were observed in 20% and 80% of the cases, respectively. There were significant associations between the radiological phenotypes and the duration of illness at hospital admission. The duration of illness (<7 days, 7–14 days, and >14 days) could predict the radiological phenotype (P < 0.00001). Laboratory parameters at hospital admission (C-reactive protein, interleukin-6, ferritin, lactate dehydrogenase, and D-dimer) were significantly associated with the radiological phenotypes (P < 0.00001), as were interventions required in indoor units (P < 0.00001). The HRCT severity score at admission was significantly correlated with the radiological phenotype (P < 0.00001). Post-COVID lung fibrosis or sequelae were also significantly associated with the radiological phenotype (P < 0.00001). CONCLUSION: Easy-to-treat and difficult-to-treat phenotypic differentiation had a crucial role during the initial assessment of COVID-19 cases on hospitalization and was used for planning targeted intervention treatments in intensive care units. In addition, phenotypic differentiation had an important role in analyzing the radiological sequelae and predicting final treatment outcomes.
{"title":"Easy-to-treat and difficult-to-treat radiological phenotypes in coronavirus disease 2019 pneumonia: A single-center experience","authors":"S. Patil, U. Dhumal, D. Patil, Abhijit Acharya","doi":"10.4103/RID.RID_47_22","DOIUrl":"https://doi.org/10.4103/RID.RID_47_22","url":null,"abstract":"INTRODUCTION: Radiological phenotypes are observable radiological patterns or characteristics. Robust data are available regarding the role of high-resolution computed tomography (HRCT) in coronavirus disease 2019 (COVID-19) pneumonia. We evaluated the role of radiological phenotyping in assessing severity and predicting the response to therapy, as well as its association with outcomes in COVID-19 pneumonia. METHODS: This prospective observational study included 3000 COVID-19 reverse transcription polymerase chain reaction-confirmed cases with lung involvement who underwent thoracic HRCT on hospital admission and were categorized as mild, moderate, or severe according to lung segment bilateral involvement (mild 1–7, moderate 8–15, and severe 16–25). Follow-up thoracic CT imaging was also conducted 6 months after hospital discharge. Response to treatment phenotypes was categorized as “easy to treat” or “difficult to treat” based on the response and interventions required in indoor settings, including ventilatory support. Age, gender, comorbidities, laboratory parameters, the use of bilevel-positive airway pressure/noninvasive ventilation, and outcomes (with or without lung fibrosis) were key observations. The Chi-square test was used for statistical analysis. RESULTS: Easy-to-treat and difficult-to-treat radiological response phenotypes were observed in 20% and 80% of the cases, respectively. There were significant associations between the radiological phenotypes and the duration of illness at hospital admission. The duration of illness (<7 days, 7–14 days, and >14 days) could predict the radiological phenotype (P < 0.00001). Laboratory parameters at hospital admission (C-reactive protein, interleukin-6, ferritin, lactate dehydrogenase, and D-dimer) were significantly associated with the radiological phenotypes (P < 0.00001), as were interventions required in indoor units (P < 0.00001). The HRCT severity score at admission was significantly correlated with the radiological phenotype (P < 0.00001). Post-COVID lung fibrosis or sequelae were also significantly associated with the radiological phenotype (P < 0.00001). CONCLUSION: Easy-to-treat and difficult-to-treat phenotypic differentiation had a crucial role during the initial assessment of COVID-19 cases on hospitalization and was used for planning targeted intervention treatments in intensive care units. In addition, phenotypic differentiation had an important role in analyzing the radiological sequelae and predicting final treatment outcomes.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"27 1","pages":"19 - 29"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81445880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Ku, C. Varley, E. Epson, A. Deodhar, K. Winthrop
We present a case of prosthetic knee tuberculosis (TB), the management of which was complicated by simultaneous isolation of nontuberculous mycobacteria (NTM) from sputum. The TB was treated with medical therapy alone. The NTM isolated likely represented transient colonization and resolved during TB therapy. However, the positivity of the patient's sputum smear for NTM led to unnecessary isolation.
{"title":"Tuberculosis of prosthetic knee with simultaneous pulmonary infection with nontuberculous mycobacteria","authors":"J. Ku, C. Varley, E. Epson, A. Deodhar, K. Winthrop","doi":"10.4103/RID.RID_42_22","DOIUrl":"https://doi.org/10.4103/RID.RID_42_22","url":null,"abstract":"We present a case of prosthetic knee tuberculosis (TB), the management of which was complicated by simultaneous isolation of nontuberculous mycobacteria (NTM) from sputum. The TB was treated with medical therapy alone. The NTM isolated likely represented transient colonization and resolved during TB therapy. However, the positivity of the patient's sputum smear for NTM led to unnecessary isolation.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"45 1","pages":"30 - 32"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82881379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In recent years, neuroscience research has confirmed that the human immunodeficiency virus (HIV) may have adverse effects on brain function, involving mainly structural changes and cognitive impairment. Combination antiretroviral therapy reduces the prevalence of HIV-associated neurocognitive disorder (HAND), but the lighter, disabling HAND remains an unsolved challenge. The apolipoprotein E (ApoE4) gene, which is a common genetic variation in humans, is known to increase cognitive damage from HIV by affecting fat oxidation and cholesterol metabolism, accelerating the progression of and death from acquired immunodefciency syndrome (AIDS), and increasing susceptibility to opportunistic infections. Magnetic resonance imaging (MRI) has been widely used in the study of brain damage in HIV because it can clearly show brain structure and function. Moreover, MRI-related techniques can be used to detect the effects of the interaction between HAND and ApoE4 on cognitive impairment, but this complex mechanism needs to be further studied. This article reviews the current status of MRI neuroimaging research into the interaction mechanism between HAND and ApoE4.
{"title":"Status of current research into cognitive impairment in human immunodeficiency virus based on magnetic resonance imaging and apolipoprotein E4 interaction mechanism","authors":"Wei Wang, Zhongkai Zhou, Ying Shi","doi":"10.4103/rid.rid_2_23","DOIUrl":"https://doi.org/10.4103/rid.rid_2_23","url":null,"abstract":"In recent years, neuroscience research has confirmed that the human immunodeficiency virus (HIV) may have adverse effects on brain function, involving mainly structural changes and cognitive impairment. Combination antiretroviral therapy reduces the prevalence of HIV-associated neurocognitive disorder (HAND), but the lighter, disabling HAND remains an unsolved challenge. The apolipoprotein E (ApoE4) gene, which is a common genetic variation in humans, is known to increase cognitive damage from HIV by affecting fat oxidation and cholesterol metabolism, accelerating the progression of and death from acquired immunodefciency syndrome (AIDS), and increasing susceptibility to opportunistic infections. Magnetic resonance imaging (MRI) has been widely used in the study of brain damage in HIV because it can clearly show brain structure and function. Moreover, MRI-related techniques can be used to detect the effects of the interaction between HAND and ApoE4 on cognitive impairment, but this complex mechanism needs to be further studied. This article reviews the current status of MRI neuroimaging research into the interaction mechanism between HAND and ApoE4.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135609446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acquired immunodeficiency syndrome (AIDS)-associated pulmonary tuberculosis is one of the most common opportunistic infections in patients with AIDS and an important cause of death. Pulmonary tuberculosis associated with AIDS occurs in patients with low immunity, and its clinical manifestations are often atypical. Therefore, diagnosis of AIDS-associated pulmonary tuberculosis is difficult, and imaging plays a vital role. To standardize examinations and improve the level of imaging diagnosis, a group of experts in infection, inflammation, radiology, tuberculosis, and statistics have come together and published imaging diagnostic criteria for AIDS-related pulmonary tuberculosis with consideration of the methodological requirements for evidence-based guidelines and standards. Patients with clinical signs and symptoms of pulmonary infection who test positive for human immunodeficiency virus need to undergo further radiographic or computed tomography examination of the chest. AIDS-related pulmonary tuberculosis is suspected when there are pulmonary lesions and/or hilar and mediastinal lymph node enlargement. An imaging diagnosis of AIDS-related pulmonary tuberculosis is based on one of the following findings: mediastinal or hilar lymphadenectasis in multiple areas, diffuse miliary nodules randomly distributed in both lungs, multi-form, multi-lobular, and multi-segmental lesions dominated by exudative lesions, or pleural effusion. Further laboratory or pathological examinations are performed in suspected patients and those with an imaging diagnosis; if one of these additional examinations is positive, the diagnosis of AIDS-related tuberculosis is confirmed.
{"title":"Expert consensus on imaging diagnostic criteria for pulmonary tuberculosis associated with acquired immunodeficiency syndrome","authors":"Ruming Xie, Li Li, Hongjun Li","doi":"10.4103/rid.rid_6_23","DOIUrl":"https://doi.org/10.4103/rid.rid_6_23","url":null,"abstract":"Acquired immunodeficiency syndrome (AIDS)-associated pulmonary tuberculosis is one of the most common opportunistic infections in patients with AIDS and an important cause of death. Pulmonary tuberculosis associated with AIDS occurs in patients with low immunity, and its clinical manifestations are often atypical. Therefore, diagnosis of AIDS-associated pulmonary tuberculosis is difficult, and imaging plays a vital role. To standardize examinations and improve the level of imaging diagnosis, a group of experts in infection, inflammation, radiology, tuberculosis, and statistics have come together and published imaging diagnostic criteria for AIDS-related pulmonary tuberculosis with consideration of the methodological requirements for evidence-based guidelines and standards. Patients with clinical signs and symptoms of pulmonary infection who test positive for human immunodeficiency virus need to undergo further radiographic or computed tomography examination of the chest. AIDS-related pulmonary tuberculosis is suspected when there are pulmonary lesions and/or hilar and mediastinal lymph node enlargement. An imaging diagnosis of AIDS-related pulmonary tuberculosis is based on one of the following findings: mediastinal or hilar lymphadenectasis in multiple areas, diffuse miliary nodules randomly distributed in both lungs, multi-form, multi-lobular, and multi-segmental lesions dominated by exudative lesions, or pleural effusion. Further laboratory or pathological examinations are performed in suspected patients and those with an imaging diagnosis; if one of these additional examinations is positive, the diagnosis of AIDS-related tuberculosis is confirmed.","PeriodicalId":101055,"journal":{"name":"Radiology of Infectious Diseases","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135609450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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