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Chronic esophageal dissection: Delayed diagnosis in a 15-year-old male 慢性食管夹层:一名15岁男性的延迟诊断
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-04-16 DOI: 10.25259/JCIS_3_2022
N. Vakharia, U. N. Sirisena, U. Mandalia
Esophageal dissection is a rare condition, characterized by disruption of the submucosa from the muscular layer of the esophageal wall. It is commonly iatrogenic in etiology and patients typically present with acute onset dysphagia, odynophagia, and retrosternal pain. The condition can be diagnosed endoscopically; however, contrast swallow studies either with CT or fluoroscopy carry less risk and are the imaging investigations of choice for this condition. Patients are managed conservatively in the majority of cases. In this case report, we present a case of chronic esophageal dissection in a 15-year-old male who had undergone endoscopic removal of a foreign body from the esophagus several years prior. We discuss the clinical features, radiological diagnosis, and management of this condition.
食管夹层是一种罕见的疾病,其特征是食管壁肌肉层粘膜下层的破坏。它的病因通常是医源性的,患者通常表现为急性发作的吞咽困难、吞咽困难和胸骨后疼痛。这种情况可以通过内窥镜诊断;然而,与CT或透视相结合的对比吞咽检查风险较小,是这种情况的首选影像学检查。在大多数情况下,对患者进行保守治疗。在这个病例报告中,我们提出了一个15岁的男性慢性食管夹层的病例,他在几年前接受了内窥镜从食管取出异物。我们将讨论这种疾病的临床特征、放射学诊断和治疗。
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引用次数: 0
The diagnostic utility of unenhanced computed tomography of the brain and D-dimer levels in acute cerebral venous sinus thrombosis: A quantitative study 非增强脑计算机断层扫描和d -二聚体水平在急性脑静脉窦血栓中的诊断价值:一项定量研究
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-04-16 DOI: 10.25259/JCIS_76_2021
Omar A. Alharbi, K. Alahmadi
Objectives (1) To calculate the sensitivity and specificity of the Hounsfield Unit (HU), the HU to hematocrit (H:H) ratio, and the D-dimer level in the diagnosis of acute CVST. (2) To assess the D-dimer level’s linear relationship with the HU and the H:H ratio. Materials and Methods A single-center retrospective case-control study was conducted from 2005 to 2020. The inclusion criteria for the thrombosed and control groups were specified. A region of interest (ROI) was plotted on the respective sinuses to calculate the HU. The H:H ratio was calculated by dividing the HU value by the hematocrit value. The receiver operating characteristic curve was used to calculate the sensitivity and specificity of the HU and the H:H ratio at different cutoff values. The Pearson correlation was used to assess the linear relationship between the D-dimer level and the HU and H:H ratio. Results There were 19 patients in the thrombosed group and 28 patients in the control group. There were significant differences in the mean HU (71 ± 6.3 vs. 45 ± 4.8, P < 0.001) and the mean H:H ratio (2.11 ± 0.38 vs. 1.46 ± 0.63,P < 0.001). An optimal HU value of 56 yielded 100% sensitivity and specificity. An H:H value of 1.48 yielded a sensitivity of 100% and a specificity of 65%, an H:H ratio of 1.77 demonstrated a sensitivity of 85% and a specificity of 90%, and an H:H ratio of 1.88 yielded a sensitivity of 79% and a specificity of 93%. D-dimer levels had a 95% and 71% sensitivity and specificity, respectively. There was a significant moderately positive linear correlation between the D-dimer level and the HU (r = 0.52, P < 0.001) and the H:H ratio (r = 0.61, P < 0.001). Conclusion Unenhanced CT of the brain can be a valuable objective diagnostic tool for acute CVST diagnosis. Hounsfield blood density and its normalized ratio with hematocrit are positively correlated with D-dimer levels, which may indicate active blood coagulation in a cerebral venous sinus.
目的(1)计算Hounsfield Unit (HU)、HU / hematocrit (H:H)比值、d -二聚体水平对急性CVST诊断的敏感性和特异性。(2)评价d -二聚体水平与HU和H:H比的线性关系。材料与方法2005 - 2020年采用单中心回顾性病例对照研究。明确了血栓形成组和对照组的纳入标准。在各自的鼻窦上绘制感兴趣区域(ROI)以计算HU。H:H比值由HU值除以红细胞压积值计算。采用受试者工作特征曲线计算不同截止值下HU和H:H比的灵敏度和特异性。采用Pearson相关性评估d -二聚体水平与HU和H:H比值之间的线性关系。结果血栓形成组19例,对照组28例。平均HU(71±6.3比45±4.8,P < 0.001)和平均H:H比(2.11±0.38比1.46±0.63,P < 0.001)差异有统计学意义。最佳HU值为56,灵敏度和特异性均为100%。当H:H值为1.48时,敏感性为100%,特异性为65%;当H:H值为1.77时,敏感性为85%,特异性为90%;当H:H值为1.88时,敏感性为79%,特异性为93%。d -二聚体水平的敏感性和特异性分别为95%和71%。d -二聚体水平与HU (r = 0.52, P < 0.001)和H:H比(r = 0.61, P < 0.001)呈显著的中正线性相关。结论CT对急性CVST的诊断是一种有价值的客观诊断工具。Hounsfield血密度及其与红细胞压积的归一化比值与d -二聚体水平呈正相关,可能提示脑静脉窦血凝活动。
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引用次数: 2
Parotid sebaceous lymphadenoma associated with Sjogren’s syndrome: Review of pathologic and radiologic characteristics and clinical presentation 与干燥综合征相关的腮腺皮脂腺淋巴结瘤:病理、放射学特征和临床表现的综述
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-04-06 DOI: 10.25259/JCIS_14_2022
J. Janus, Obaie Mzaik, A. Bhatt
Salivary lymphadenoma is an extremely rare neoplasm that is usually seen in the older patient population, arising sporadically on one side and almost exclusive to the parotid gland. Imaging and pathology findings can mimic both benign and malignant tumors, and therefore, this lesion may be misdiagnosed if not on the differential diagnosis. This article reviews the clinical presentation, as well as the pathology and imaging findings of salivary lymphadenoma in the setting of Sjogren’s syndrome.
涎腺淋巴结瘤是一种非常罕见的肿瘤,通常见于老年患者人群,零星地出现在一侧,几乎只发生在腮腺。影像学和病理表现可以模拟良性和恶性肿瘤,因此,如果不进行鉴别诊断,该病变可能被误诊。本文综述了干燥综合征涎腺淋巴结瘤的临床表现、病理和影像学表现。
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引用次数: 0
Mycotic and non-mycotic coronary artery aneurysms—A review of the rarity 真菌性和非真菌性冠状动脉动脉瘤的罕见性综述
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-03-30 DOI: 10.25259/JCIS_218_2021
Vishal Kukkar, H. Kapoor, A. Aggarwal
Sir William Osler coined the term “mycotic” to identify aneurysms secondary to an infectious cause, which may not be necessarily fungal and are caused mainly by bacteria. The literature’s reported incidence of coronary artery aneurysms (CAA) is from 1.5-5%. The right coronary artery (RCA) is mainly involved, followed by the left side coronary circulation. Mycotic aneurysms are more commonly associated with infective endocarditis. More recently, coronary artery stents, particularly drug-eluting stents, are typically causing mycotic coronary aneurysms. CT angiography (CTA) has been the forefront diagnostic modality, showing both the lumen and wall of the coronary arteries. It also aids in preoperative planning. MRI is useful in diagnosing and following children with Kawasaki’s disease. Smaller mycotic coronary aneurysms may resolve with antibiotic therapy; however, aneurysms more significant than 1-2 cm diameter needs corrective surgery. Early diagnosis and appropriate management are the critical factors in the successful treatment of infective coronary artery aneurysms.
威廉·奥斯勒爵士创造了“真菌性”一词来识别继发于感染性原因的动脉瘤,这种动脉瘤不一定是真菌引起的,主要是由细菌引起的。文献报道的冠状动脉瘤(CAA)发病率为1.5-5%。主要累及右冠状动脉(RCA),其次为左侧冠状动脉循环。霉菌性动脉瘤通常与感染性心内膜炎相关。最近,冠状动脉支架,特别是药物洗脱支架,通常会引起真菌性冠状动脉瘤。CT血管造影(CTA)一直是最前沿的诊断方式,显示冠状动脉管腔和壁。它也有助于术前计划。MRI对儿童川崎氏病的诊断和随访是有用的。较小的真菌性冠状动脉瘤可通过抗生素治疗解决;然而,直径大于1-2厘米的动脉瘤需要矫正手术。早期诊断和适当的治疗是成功治疗感染性冠状动脉瘤的关键因素。
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引用次数: 3
Whole-lesion histogram analysis of apparent diffusion coefficient for the assessment of non-mass enhancement lesions on breast MRI 乳腺MRI非肿块增强病灶的视扩散系数全病变直方图分析
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-03-23 DOI: 10.25259/JCIS_201_2021
N. Kunimatsu, A. Kunimatsu, Y. Uchida, I. Mori, Shigeru Kiryu
Objectives To investigate the application of apparent diffusion coefficient (ADC) histogram analysis in differentiating between benign and malignant breast lesions detected as non-mass enhancement on MRI. Materials and Methods A retrospective study was conducted for 25 malignant and 26 benign breast lesions showing non-mass enhancement on breast MRI. An experienced radiologist without prior knowledge of the pathological results drew a region of interest (ROI) outlining the periphery of each lesion on the ADC map. A histogram was then made for each lesion. Following a univariate analysis of 18 summary statistics values, we conducted statistical discrimination after hierarchical clustering using Ward’s method. A comparison between the malignant and the benign groups was made using multiple logistic regression analysis and the Mann-Whitney U test. A P -value of less than 0.05 was considered statistically significant. Results Univariate analysis for the 18 summary statistics values showed the malignant group had greater entropy (P < 0.001) and lower uniformity (P < 0.001). While there was no significant difference in mean and skewness values, the malignant group tended to show a lower mean (P = 0.090) and a higher skewness (P = 0.065). Hierarchical clustering of the 18 summary statistics values identified four values (10th percentile, entropy, skewness, and uniformity) of which the 10th percentile values were significantly lower for the malignant group (P = 0.035). Conclusions Whole-lesion ADC histogram analysis may be useful for differentiating malignant from benign lesions which show non-mass enhancement on breast MRI.
目的探讨表观扩散系数(ADC)直方图分析在乳腺MRI非肿块增强良恶性病变鉴别中的应用。材料与方法对乳腺MRI无肿块强化的乳腺恶性病变25例和良性病变26例进行回顾性分析。一位经验丰富的放射科医生在没有事先了解病理结果的情况下,在ADC图上绘制了一个兴趣区域(ROI),概述了每个病变的外围。然后绘制每个病变的直方图。在对18个汇总统计值进行单变量分析后,我们使用Ward 's方法进行分层聚类后的统计判别。恶性组与良性组比较采用多元logistic回归分析和Mann-Whitney U检验。P值小于0.05认为有统计学意义。结果18个汇总统计值的单因素分析显示,恶性组的熵值较大(P < 0.001),均匀性较低(P < 0.001)。平均值和偏度值差异无统计学意义,但恶性组的平均值较低(P = 0.090),偏度较高(P = 0.065)。对18个汇总统计值进行分层聚类,发现4个值(第10百分位、熵、偏度和均匀性),其中恶性组第10百分位值显著低于对照组(P = 0.035)。结论全病变ADC直方图分析可用于鉴别乳腺MRI非肿块强化病变的良恶性。
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引用次数: 1
Pictorial review of computed tomography features of diffuse cystic lung disease 弥漫性囊性肺疾病的计算机断层图像回顾
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-03-17 DOI: 10.25259/JCIS_210_2021
Yi Lam Priscilla Chan, Chun Hung Kevin Yu, W. Chong, K. Y. Kwok, Allen Li
Diffuse cystic lung disease represents a diverse group of uncommon disorders that has been increasingly diagnosed due to the increasing use of computed tomography. It poses a frequent diagnostic challenge to radiologists due to the similar clinical and radiological features these diseases share. This pictorial review includes selected cases from the Hospital Authority New Territories West Cluster (NTWC) in Hong Kong from the past 3 years. It will illustrate the spectrum of diffuse cystic lung diseases, including some rarer entities in our locality, and identify the pertinent differentiating imaging features on CT. A flowchart to summarize these features is provided at the end to aid in diagnosis.
弥漫性囊性肺疾病代表了一组不同的不常见疾病,由于计算机断层扫描的使用越来越多地被诊断出来。由于这些疾病具有相似的临床和放射学特征,因此对放射科医生提出了频繁的诊断挑战。本图片回顾包括医院管理局新界西联网过去三年的个案。它将说明弥漫性囊性肺疾病的频谱,包括一些罕见的实体在我们的地方,并确定相关的CT鉴别成像特征。最后提供了一个流程图来总结这些特征,以帮助诊断。
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引用次数: 0
Peripartum hemorrhage: Two cases of ruptured ovarian artery aneurysms with additional multifocal intact aneurysms 围产期出血:卵巢动脉瘤破裂伴多灶性完整动脉瘤2例
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-03-16 DOI: 10.25259/JCIS_145_2021
T. Arleo, G. Peters, N. Kokabi, B. Majdalany
We report two cases of peripartum ruptured ovarian artery aneurysms (OAA). One patient was treated through endovascular embolization and the other with percutaneous thrombin injection. Multiple additional unruptured OAAs were incidentally discovered in each patient. We describe the pathophysiologic basis for OAA rupture, approaches to treatment, and suggest management strategies for incidentally discovered ovarian aneurysms.
我们报告两例围产期卵巢动脉瘤破裂(OAA)。1例经血管内栓塞治疗,1例经皮注射凝血酶治疗。在每位患者中偶然发现了多个未破裂的OAAs。我们描述了OAA破裂的病理生理基础,治疗方法,并提出了偶然发现的卵巢动脉瘤的管理策略。
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引用次数: 1
Endovascular management of HIV vasculopathy HIV血管病变的血管内治疗
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-02-24 DOI: 10.25259/JCIS_226_2021
Jack B. Newcomer, Emad A. Chishti, D. Raissi
HIV is a multisystem disease process that can affect the cardiovascular system resulting in vasculopathy. As highly active anti-retroviral therapy has allowed patients to live longer with the disease, vascular complications such as aneurysms, occlusive disease, spontaneous arteriovenous fistulae, and arterial dissections have been described. The pathogenesis of vascular-related complications in HIV is poorly understood but is thought to involve an interplay between viral-induced inflammation, vascular smooth muscle changes, endothelial alterations, and circulating blood factors. The most well-described management strategies for symptomatic aneurysm-related complications are surgical in nature, with mostly anecdotal reports of endovascular intervention. We present a case of a 24-year-old male who was found to have findings consistent with HIV vasculopathy on angiography after presenting with acute GI hemorrhage secondary to left gastric artery bleeding. Our patient was managed with endovascular embolization. Although studies have shown promise regarding the endovascular management of HIV-related aneurysmal complications in the short term, more research is needed to evaluate the long-term success of these interventions.
HIV是一种多系统疾病过程,可影响心血管系统导致血管病变。由于高度活跃的抗逆转录病毒治疗可以延长患者的寿命,血管并发症,如动脉瘤、闭塞性疾病、自发性动静脉瘘和动脉夹层已被描述。HIV中血管相关并发症的发病机制尚不清楚,但被认为涉及病毒诱导的炎症、血管平滑肌改变、内皮改变和循环血液因子之间的相互作用。对于有症状的动脉瘤相关并发症,最广为人知的治疗策略是外科手术,大多数是关于血管内介入治疗的轶事报道。我们报告了一个24岁的男性病例,他在表现为急性胃肠道出血继发于左胃动脉出血后,在血管造影上发现了与HIV血管病变一致的结果。我们的病人接受了血管内栓塞治疗。尽管研究表明在短期内血管内治疗hiv相关动脉瘤并发症有希望,但还需要更多的研究来评估这些干预措施的长期成功。
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引用次数: 0
A case of spinal melorheostosis 脊柱骨质疏松症1例
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-02-21 DOI: 10.25259/JCIS_202_2021
Alban Wei Shern Leong, J. Langdon, Vivek Malhotra, U. Mandalia
Melorheostosis is a rare bone dysplasia of unknown etiology with an incidence of 0.9 cases per million. It typically affects the upper or lower limbs and can cause severe deformity and functional impairment. Diagnosis is radiological and is often described as a “flowing candle wax” appearance on the radiograph. Treatment is individualized depending on the site and severity of symptoms. We report a rare case of spinal melorheostosis. We demonstrate the imaging features of melorheostosis on CT and MRI. We discuss the classification, genetics, and management of this condition.
骨质疏松症是一种罕见的骨发育不良,病因不明,发病率为百万分之0.9。它通常会影响上肢或下肢,并可能导致严重的畸形和功能障碍。诊断是放射学的,通常被描述为x光片上的“流动的蜡烛蜡”外观。治疗根据部位和症状的严重程度进行个体化。我们报告一例罕见的脊柱骨质疏松症。我们在CT和MRI上展示了骨质疏松症的影像学特征。我们讨论了这种情况的分类、遗传学和管理。
{"title":"A case of spinal melorheostosis","authors":"Alban Wei Shern Leong, J. Langdon, Vivek Malhotra, U. Mandalia","doi":"10.25259/JCIS_202_2021","DOIUrl":"https://doi.org/10.25259/JCIS_202_2021","url":null,"abstract":"Melorheostosis is a rare bone dysplasia of unknown etiology with an incidence of 0.9 cases per million. It typically affects the upper or lower limbs and can cause severe deformity and functional impairment. Diagnosis is radiological and is often described as a “flowing candle wax” appearance on the radiograph. Treatment is individualized depending on the site and severity of symptoms. We report a rare case of spinal melorheostosis. We demonstrate the imaging features of melorheostosis on CT and MRI. We discuss the classification, genetics, and management of this condition.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"22 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80901381","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}
引用次数: 0
Pixel-based analysis of pulmonary changes on CT lung images due to COVID-19 pneumonia 基于像素的COVID-19肺炎CT肺部图像肺部改变分析
IF 0.9 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2022-02-19 DOI: 10.25259/JCIS_172_2021
Elif Soya, Nur Ekenel, R. Savaş, T. Toprak, J. Bewes, Ozkan Doganay
Objectives: Computed tomography (CT) plays a complementary role in the diagnosis of the pneumonia-burden of COVID-19 disease. However, the low contrast of areas of inflammation on CT images, areas of infection are difficult to identify. The purpose of this study is to develop a post-image-processing method for quantitative analysis of COVID-19 pneumonia-related changes in CT attenuation values using a pixel-based analysis rather than more commonly used clustered focal pneumonia volumes. The COVID-19 pneumonia burden is determined by experienced radiologists in the clinic. Previous AI software was developed for the measurement of COVID-19 lesions based on the extraction of local pneumonia features. In this respect, changes in the pixel levels beyond the clusters may be overlooked by deep learning algorithms. The proposed technique focuses on the quantitative measurement of COVID-19 related pneumonia over the entire lung in pixel-by-pixel fashion rather than only clustered focal pneumonia volumes. Material and Methods: Fifty COVID-19 and 50 age-matched negative control patients were analyzed using the proposed technique and commercially available artificial intelligence (AI) software. The %pneumonia was calculated using the relative volume of parenchymal pixels within an empirically defined CT density range, excluding pulmonary airways, vessels, and fissures. One-way ANOVA analysis was used to investigate the statistical difference between lobar and whole lung %pneumonia in the negative control and COVID-19 cohorts. Results: The threshold of high-and-low CT attenuation values related to pneumonia caused by COVID-19 were found to be between ₋642.4 HU and 143 HU. The %pneumonia of the whole lung, left upper, and lower lobes were 8.1 ± 4.4%, 6.1 ± 4.5, and 11.3 ± 7.3% for the COVID-19 cohort, respectively, and statistically different (P < 0.01). Additionally, the pixel-based methods correlate well with existing AI methods and are approximately four times more sensitive to pneumonia particularly at the upper lobes compared with commercial software in COVID-19 patients (P < 0.01). Conclusion: Pixel-by-pixel analysis can accurately assess pneumonia in COVID-19 patients with CT. Pixel-based techniques produce more sensitive results than AI techniques. Using the proposed novel technique, %pneumonia could be quantitatively calculated not only in the clusters but also in the whole lung with an improved sensitivity by a factor of four compared to AI-based analysis. More significantly, pixel-by-pixel analysis was more sensitive to the upper lobe pneumonia, while AI-based analysis overlooked the upper lung pneumonia region. In the future, this technique can be used to investigate the efficiency of vaccines and drugs and post COVID-19 effects.
目的:计算机断层扫描(CT)在COVID-19肺炎负担诊断中发挥补充作用。然而,CT图像上炎症区域对比度低,感染区域难以识别。本研究的目的是开发一种图像后处理方法,使用基于像素的分析来定量分析COVID-19肺炎相关CT衰减值的变化,而不是更常用的聚集性局灶性肺炎体积。COVID-19肺炎负担由临床经验丰富的放射科医生确定。以前的AI软件是基于局部肺炎特征的提取来测量COVID-19病变。在这方面,深度学习算法可能会忽略集群之外像素水平的变化。所提出的技术侧重于以逐像素的方式定量测量整个肺部的COVID-19相关肺炎,而不仅仅是聚集性局灶性肺炎体积。材料与方法:采用提出的技术和市售人工智能(AI)软件对50例COVID-19患者和50例年龄匹配的阴性对照患者进行分析。肺炎的百分比是根据经验定义的CT密度范围内的实质像素的相对体积计算的,不包括肺气道、血管和裂隙。采用单因素方差分析(One-way ANOVA)分析阴性对照组和COVID-19队列大叶性肺炎和全肺性肺炎的统计学差异。结果:与COVID-19肺炎相关的CT高低衰减值阈值在24.642.4 HU ~ 14.3hu之间。肺炎组全肺、左上肺叶、左下肺叶肺炎%分别为8.1±4.4%、6.1±4.5%、11.3±7.3%,差异有统计学意义(P < 0.01)。此外,基于像素的方法与现有的人工智能方法具有良好的相关性,并且与商业软件相比,对COVID-19患者的肺炎(特别是上肺叶)的敏感性约为四倍(P < 0.01)。结论:逐像素分析可准确评估COVID-19患者的肺炎。基于像素的技术比人工智能技术产生更敏感的结果。使用提出的新技术,不仅可以在群集中定量计算肺炎,而且可以在整个肺中定量计算,与基于人工智能的分析相比,灵敏度提高了四倍。更重要的是,逐像素分析对上肺肺炎更敏感,而基于人工智能的分析忽略了上肺肺炎区域。未来,该技术可用于研究疫苗和药物的效率以及COVID-19后的效果。
{"title":"Pixel-based analysis of pulmonary changes on CT lung images due to COVID-19 pneumonia","authors":"Elif Soya, Nur Ekenel, R. Savaş, T. Toprak, J. Bewes, Ozkan Doganay","doi":"10.25259/JCIS_172_2021","DOIUrl":"https://doi.org/10.25259/JCIS_172_2021","url":null,"abstract":"Objectives: Computed tomography (CT) plays a complementary role in the diagnosis of the pneumonia-burden of COVID-19 disease. However, the low contrast of areas of inflammation on CT images, areas of infection are difficult to identify. The purpose of this study is to develop a post-image-processing method for quantitative analysis of COVID-19 pneumonia-related changes in CT attenuation values using a pixel-based analysis rather than more commonly used clustered focal pneumonia volumes. The COVID-19 pneumonia burden is determined by experienced radiologists in the clinic. Previous AI software was developed for the measurement of COVID-19 lesions based on the extraction of local pneumonia features. In this respect, changes in the pixel levels beyond the clusters may be overlooked by deep learning algorithms. The proposed technique focuses on the quantitative measurement of COVID-19 related pneumonia over the entire lung in pixel-by-pixel fashion rather than only clustered focal pneumonia volumes. Material and Methods: Fifty COVID-19 and 50 age-matched negative control patients were analyzed using the proposed technique and commercially available artificial intelligence (AI) software. The %pneumonia was calculated using the relative volume of parenchymal pixels within an empirically defined CT density range, excluding pulmonary airways, vessels, and fissures. One-way ANOVA analysis was used to investigate the statistical difference between lobar and whole lung %pneumonia in the negative control and COVID-19 cohorts. Results: The threshold of high-and-low CT attenuation values related to pneumonia caused by COVID-19 were found to be between ₋642.4 HU and 143 HU. The %pneumonia of the whole lung, left upper, and lower lobes were 8.1 ± 4.4%, 6.1 ± 4.5, and 11.3 ± 7.3% for the COVID-19 cohort, respectively, and statistically different (P < 0.01). Additionally, the pixel-based methods correlate well with existing AI methods and are approximately four times more sensitive to pneumonia particularly at the upper lobes compared with commercial software in COVID-19 patients (P < 0.01). Conclusion: Pixel-by-pixel analysis can accurately assess pneumonia in COVID-19 patients with CT. Pixel-based techniques produce more sensitive results than AI techniques. Using the proposed novel technique, %pneumonia could be quantitatively calculated not only in the clusters but also in the whole lung with an improved sensitivity by a factor of four compared to AI-based analysis. More significantly, pixel-by-pixel analysis was more sensitive to the upper lobe pneumonia, while AI-based analysis overlooked the upper lung pneumonia region. In the future, this technique can be used to investigate the efficiency of vaccines and drugs and post COVID-19 effects.","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91304196","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}
引用次数: 2
期刊
Journal of Clinical Imaging Science
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