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Analysis of Age Distribution of Bone Mineral Density by Dual-Energy X-Ray Absorptiometry 双能x线骨密度仪分析骨密度的年龄分布
Pub Date : 2023-06-01 DOI: 10.20862/0042-4676-2023-104-1-21-29
A. Petraikin, Z. R. Artyukova, N. Kudryavtsev, D. Semenov, A. Smorchkova, S. S. Repin, E. Akhmad, F. A. Petriaikin, L. A. Nisovtsova, A. V. Vladzimirskyy
Objective: to conduct the study of age distribution of bone mineral density (BMD) by the database of dualenergy X-ray absorptiometry (DXA) and to compare it with datа of population NHANES study. Material and methods. We used data from the densitometry of three-zone (total hip (TH), femoral neck (FN), and lumbar spine) measured by DXA from two outpatient clinics. The obtained data were compared with NHANES III for TH and FN and with NHANES 2005-08 for lumbar spine. The BMD value was corrected with the calibration coefficient for each DXA scanner. Adjustments were also made for the population distribution by sex and age. Results. Compared with NHANES for FN and TH, the obtained BMD values were significantly decreased for patients aged less than 50 years (men and women). The BMD values for FN and TH were unsignificantly decreased in men older 50 years. In women older 50 years unsignificantly decreased BMD values for FN and a significantly increased BMD values for TH were observed. The BMD values were decreased for lumbar spine in men and women throughout this age interval (more than 50 years old). Conclusion. The population BMD distribution in men and women was assessed by DXA method. The obtained dependence of the BMD for FN in women older 50 years was in good agreement with the results given by Russian and foreign authors.
目的:利用双能x线骨密度仪(DXA)数据库研究骨密度(BMD)的年龄分布,并与人口NHANES研究数据进行比较。材料和方法。我们使用了来自两个门诊诊所的DXA测量的三个区域(全髋关节(TH),股骨颈(FN)和腰椎)的密度测量数据。将获得的数据与NHANES III (TH和FN)和NHANES 2005-08(腰椎)进行比较。用每个DXA扫描仪的校准系数校正BMD值。按性别和年龄划分的人口分布也作了调整。结果。与FN和TH的NHANES相比,年龄小于50岁的患者(男性和女性)获得的BMD值显着降低。在50岁以上的男性中,FN和TH的骨密度值没有明显下降。在50岁以上的女性中,观察到FN骨密度值无显著下降,而TH骨密度值显著增加。在这个年龄段(超过50岁),男性和女性腰椎的骨密度值都有所下降。结论。采用DXA法评估男女人群骨密度分布。所获得的骨密度对50岁以上妇女FN的依赖性与俄罗斯和国外作者给出的结果很好地一致。
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引用次数: 0
Rare Form of Breast Cancer and Lung Foci: Do We Always Have to Wait for Metastases? 罕见的癌症和肺部病灶:我们总是要等待转移吗?
Pub Date : 2022-10-27 DOI: 10.20862/0042-4676-2022-103-4-6-88-93
Е. V. Meskikh, N. Nudnov, G. Z. Mukhutdinova, V. О. Vorob’eva
Will the detected lung foci in patients with a burdened oncological history (breast cancer) always be metastatic? In response to the question posed, we present a clinical case of pulmonary sarcoidosis mimicking the metastatic lesion of metaplastic breast cancer. And we remind of the need for a differential diagnosis, despite the oncological history of a patient and radiation diagnostics data.
在有肿瘤病史(癌症)的患者中检测到的肺部病灶是否总是转移性的?为了回答这个问题,我们提出了一个肺结节病的临床病例,模仿癌症化生的转移病灶。我们提醒需要进行鉴别诊断,尽管患者有肿瘤病史和放射诊断数据。
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引用次数: 0
A Rare Case of Asymptomatic Bilateral Naso-Orbital Meningoencephalocele 一例罕见的无症状双侧鼻眶脑膜脑膨出
Pub Date : 2022-10-27 DOI: 10.20862/0042-4676-2022-103-4-6-101-107
I. I. Litovets, T. S. Litovets
Meningoencephalocele is a rare pathology. By origin, it can be congenital and acquired. As a rule, congenital menigoencephaloceles are combined with various congenital skull structure anomalies, and are rarely asymptomatic. This pathology is most often solitary, and cases of multiple meningoencephalocele in one patient are extremely rare. The presented clinical case demonstrates an accidental finding: an unusual variant of symmetrically located bilateral naso-orbital meningoencephalocele with asymptomatic course in a 17-year-old patient.
脑膜膨出是一种罕见的病理。从起源上讲,它可以是先天性的,也可以是后天性的。通常,先天性半月板脑膨出与各种先天性颅骨结构异常相结合,很少没有症状。这种病理通常是孤立的,一名患者的多发性脑膜脑膨出病例极为罕见。该临床病例显示了一个意外发现:一名17岁患者出现对称定位的双侧鼻眶脑膜脑膨出的异常变体,病程无症状。
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引用次数: 0
Histologycally Confirmed Synchronous Pancreatic and Duodenal Double Cancer 组织学证实的胰腺和十二指肠双癌
Pub Date : 2022-10-27 DOI: 10.20862/0042-4676-2022-103-4-6-94-100
E. Yelshibayeva, R. U. Kapi, D. Mardenkyzy, S. K. Gadylkan, M. M. Khoyshibay, A. N. Sapkina
Pancreatic adenocarcinoma is the most pervasive form of cancer with high mortality rates. Being obscure at the early stages, non-specific symptoms and their onset only in the late stages of the disease lead to detection of the III–IV stages cancer on initial diagnistics. Gastrointestinal stromal tumor (GIST) is an intramucosal tumor of gastrointestinal tract, which is a derivate of interstitial cells of Cajal. The unicity of the presented clinical case is the rareness of GIST, which was an incidental finding during diagnostics of pancreatic adenocarcinoma. Diagnosed by intravenous contrast computed tomography, synchronous pancreatic and duodenal double cancer was confirmed histologically after Whipple surgery. The opportunities of intravenous contrast computed tomography in diagnostics of synchronous cancer were demonstrated.
胰腺癌是癌症最常见的形式,死亡率很高。由于早期不清楚,非特异性症状及其仅在疾病晚期发病,因此在初步诊断中可检测到癌症的III至IV期。胃肠道间质瘤(GIST)是胃肠道粘膜内肿瘤,是Cajal间质细胞的衍生物。临床病例的唯一性是GIST的罕见,这是胰腺癌诊断过程中的偶然发现。通过静脉造影计算机断层扫描诊断,Whipple手术后组织学证实同步胰腺和十二指肠双重癌症。证明了静脉造影计算机断层扫描在诊断同步癌症中的机会。
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引用次数: 0
Scintigraphy in Thyroid Nodular Pathology 甲状腺结节病理学中的闪烁扫描
Pub Date : 2022-10-27 DOI: 10.20862/0042-4676-2022-103-4-6-108-116
S. Mironov, V. Sergienko
Thyroid scintigraphy is a method that formed more than 60 years ago and retains its importance for the diagnosis and assessment of the risk of nodular malignancy. The review examines the use of the scintigraphic method in functional and metabolic assessment of nodular goiter. Prerequisites for functional thyroid nodes screening with short-lived 99mTc-pertechnetate are outlined. Information is provided on the principles of its preparation and pharmacokinetics, as well as variants of the thyroid nodes functional activity, their possible malignant potential and indications for metabolic screening. The characteristic of metabolic activity allows to assess the risk of functionally “cold” thyroid nodes malignancy. The main stages of the use of nonspecific tumorotropic radiopharmaceuticals, the mechanism of their accumulation and metabolism in the thyroid tumors, the possibilities of the differential diagnosis of various types of nodular formations are presented. Modern views on the diagnostic capabilities of two-phase scintigraphy with 99mTс-methylisobutylisonitrile are reflected taking into account the relationship of radiopharmaceuticals accumulation with factors of proliferative activity and ultrastructural cell types, a variant of oncocytic pathology and multidrug-resistant protein expression.
甲状腺显像是一种60多年前形成的方法,在诊断和评估结节性恶性肿瘤的风险方面仍然具有重要意义。本文综述了在结节性甲状腺肿的功能和代谢评估中使用的显影方法。用短时99mtc -高技术酸盐筛查功能性甲状腺淋巴结的先决条件概述。提供了有关其制备原理和药代动力学的信息,以及甲状腺淋巴结功能活动的变异,其可能的恶性潜能和代谢筛查的适应症。代谢活动的特征允许评估功能性“冷”甲状腺淋巴结恶性肿瘤的风险。本文介绍了非特异性致瘤性放射性药物使用的主要阶段,它们在甲状腺肿瘤中的积累和代谢机制,以及各种类型结节形成的鉴别诊断的可能性。考虑到放射性药物积累与增殖活性因素、超微结构细胞类型、癌细胞病理变异和多药耐药蛋白表达的关系,反映了99mt -甲基异丁基异腈两相闪烁成像诊断能力的现代观点。
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引用次数: 0
Texture Analysis of CT Images in Head and Neck Tumors Differentiation 头颈部肿瘤分化的CT图像纹理分析
Pub Date : 2022-10-26 DOI: 10.20862/0042-4676-2022-103-4-6-28-35
Yulduz Khodjibekova, M. Khodjibekov, B. R. Akhmedov, A. Pattokhov, A. S. Nigmatdjanov
Objective: to determine the diagnostic significance of computed tomography texture analysis (CTTA) in differentiating head and neck tumors.Material and methods. The study included 118 patients aged from 4 to 80 years with a verified diagnosis of benign and malignant (37 and 81, respectively) head and neck tumors. CTTA was performed using the LIFEx program, version 6.30. Thirty eight (38) texture indices extracted from routine CT images were tested by regression analysis with creation of logistic texture models with associations of four indices as independent predictors.Results. The possibility of using derived models – probability textural indices for benign and malignant tumors differentiation was established: area under ROC-curve (AUC) 0.854 ± 0.035 (p < 0.001); for differentiation of locally spread from locally limited tumors: AUC 0.840 ± 0.049 (p < 0.001); for differentiation of moderately, poorly, and undifferentiated cancer (G2, G3, G4) from well-differentiated (G1) head and neck cancer: AUC 0.826 ± 0.085 (p < 0.001).Conclusion. CT images texture analysis allows to make non-invasive prognosis of benign or malignant nature of a visualized head and neck tumor, as well as to determine the extent and degree of tumor malignancy.
目的:探讨ct织构分析(CTTA)在头颈部肿瘤鉴别中的诊断意义。材料和方法。该研究纳入118例年龄在4至80岁之间,确诊为良性和恶性头颈部肿瘤(分别为37例和81例)的患者。使用版本6.30的LIFEx程序执行CTTA。对常规CT图像中提取的38个纹理指标进行回归分析,并建立logistic纹理模型,以4个指标的相关性作为独立预测因子。建立了应用衍生模型-肿瘤良恶性分化概率纹理指数的可能性:roc曲线下面积(AUC) 0.854±0.035 (p < 0.001);局部扩散与局部局限肿瘤的鉴别:AUC为0.840±0.049 (p < 0.001);中度、低分化和未分化头颈癌(G2、G3、G4)与高分化头颈癌(G1)鉴别的AUC: 0.826±0.085 (p < 0.001)。CT图像纹理分析可以对可见的头颈部肿瘤的良恶性进行无创预后,确定肿瘤的恶性程度和程度。
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引用次数: 0
Prognostic Value of Radiological and Laboratory Biomarkers for Assessing Risk of Adverse Outcome in Patients with COVID-19 评估COVID-19患者不良结局风险的放射学和实验室生物标志物的预后价值
Pub Date : 2022-10-26 DOI: 10.20862/0042-4676-2022-103-4-6-78-87
А. D. Strutynskaya, M. Karnaushkina, L. I. Dvoretskiy, I. Tyurin
Objective: to study associations between laboratory and radiological biomarkers of COVID-19, to develop prognostic model of deterioration and lethal outcome in a patient with COVID-19.Material and methods. The study included 162 patients with COVID-19 stratified according to the presence or absence of deterioration during hospitalization. We evaluated chest computed tomography (CT) data, assessed empirically and using a semi-quantitative scale, blood cell counts and parameters of biochemical blood test. The predictive model was built using gradient boosting and artificial neural network with sigmoid activation function.Results. Both CT signs (crazy-paving pattern, bronchial dilatation inside a lesion, peripheral distribution of symptoms, absence of a predominant distribution pattern, lesion grade and extent), and most of laboratory markers were associated with deterioration and its criteria. The CT severity index correlated positively with the levels of leukocytes, neutrophils, urea, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, glucose, C-reactive protein, and negatively with the concentrations of albumin, calcium and the number of lymphocytes. Based on the results of the selection and training of classifying models, the optimal method for stratifying patients with COVID-19 on the basis of deterioration during hospitalization, the need for transfer to the intensive care unit, mechanical ventilation, and adverse outcome was gradient boosting.Conclusion. The prognostic model obtained in our study, based on a combination of radiological and laboratory parameters, makes it possible to predict the nature of COVID-19 course with high reliability.
目的:研究新冠肺炎实验室和放射学生物标志物之间的关系,建立新冠肺炎患者病情恶化和死亡结局的预后模型。材料和方法。该研究包括162名新冠肺炎患者,根据住院期间是否恶化进行分层。我们评估了胸部计算机断层扫描(CT)数据,根据经验进行评估,并使用半定量量表、血细胞计数和生化血液测试参数进行评估。利用梯度增强和具有S型激活函数的人工神经网络建立了预测模型。后果两种CT征象(疯狂铺路模式、病变内支气管扩张、症状的外周分布、没有主要分布模式、病变分级和程度)和大多数实验室标志物都与恶化及其标准有关。CT严重程度指数与白细胞、中性粒细胞、尿素、天冬氨酸转氨酶、乳酸脱氢酶、肌酸激酶、葡萄糖、C反应蛋白水平呈正相关,与白蛋白、钙浓度和淋巴细胞数量呈负相关。根据分类模型的选择和训练结果,根据住院期间病情恶化、转入重症监护室的需要、机械通气和不良结果对新冠肺炎患者进行分层的最佳方法是梯度增强。结论在我们的研究中获得的基于放射学和实验室参数组合的预后模型,使预测新冠肺炎病程的性质具有高可靠性成为可能。
{"title":"Prognostic Value of Radiological and Laboratory Biomarkers for Assessing Risk of Adverse Outcome in Patients with COVID-19","authors":"А. D. Strutynskaya, M. Karnaushkina, L. I. Dvoretskiy, I. Tyurin","doi":"10.20862/0042-4676-2022-103-4-6-78-87","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-4-6-78-87","url":null,"abstract":"Objective: to study associations between laboratory and radiological biomarkers of COVID-19, to develop prognostic model of deterioration and lethal outcome in a patient with COVID-19.Material and methods. The study included 162 patients with COVID-19 stratified according to the presence or absence of deterioration during hospitalization. We evaluated chest computed tomography (CT) data, assessed empirically and using a semi-quantitative scale, blood cell counts and parameters of biochemical blood test. The predictive model was built using gradient boosting and artificial neural network with sigmoid activation function.Results. Both CT signs (crazy-paving pattern, bronchial dilatation inside a lesion, peripheral distribution of symptoms, absence of a predominant distribution pattern, lesion grade and extent), and most of laboratory markers were associated with deterioration and its criteria. The CT severity index correlated positively with the levels of leukocytes, neutrophils, urea, aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase, glucose, C-reactive protein, and negatively with the concentrations of albumin, calcium and the number of lymphocytes. Based on the results of the selection and training of classifying models, the optimal method for stratifying patients with COVID-19 on the basis of deterioration during hospitalization, the need for transfer to the intensive care unit, mechanical ventilation, and adverse outcome was gradient boosting.Conclusion. The prognostic model obtained in our study, based on a combination of radiological and laboratory parameters, makes it possible to predict the nature of COVID-19 course with high reliability.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44539183","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
Rhinocerebral Mucormycosis in Patients with Diabetes Mellitus After a New Coronavirus Infection (COVID-19): СT and MRI Patterns Data 新型冠状病毒感染(COVID-19)后糖尿病患者的鼻-脑毛霉菌病:СT和MRI模式数据
Pub Date : 2022-10-26 DOI: 10.20862/0042-4676-2022-103-4-6-36-51
I. S. Gabdulganieva, N. R. Munirova, A. R. Zaripova, V. Anisimov
Objective: to study the computed tomography (CT) and magnetic resonance imaging (MRI) manifestations of rhinocerebral mucormycosis (RCM) in patients with diabetes mellitus and new coronavirus infection, to develop attentive attitude of radiologists for early detection of this pathology, rapid surgery and followup examinations.Material and methods. Totally 53 head (facial skull, soft facial tissues and brain) CT and MRI studies were performed in 13 patients with RCM. The number of CT and MRI studies varied from 1 to 9 per one patient, depending on the severity of his condition and clinical indications; the follow-up period was 1–4 months. All patients received surgical aid; diagnosis was verified by microscopy of surgical samples of excised necrotic tissues. A detailed descriptive analysis of pathological changes on CT and MRI characterizing RCM was carried out. The sequence of pathological signs manifestations was described, the prevalence of the lesion was estimated for planning the scope of surgical intervention. A comparative analysis of the identified RCM signs with the literature data was performed.Results. Lesions of the nasal cavity and paranasal sinuses in RCM were found in 100% of our observations, with approximately equal single and bilateral lesions of 54% and 46%, respectively. Lesions of the perimaxillar fatty tissue and pterygoid fossa were determined in 77% of patients, unilateral orbital lesions – in 23%, superior orbital vein and cavernous sinus thrombosis – in 31%, facial soft tissue lesion – in 15.5%, intracranial spread through the perineural spaces – in 7.7%, internal carotid artery arteritis – in 15.5%. Brain substance and meninges involvement in the pathological process was observed in the form of cerebritis in 23% of patients and meningitis in 46%. The formation of brain abscess was noted in follow up examinations in 15.5% of patients, skull bones osteomyelitis was diagnosed in 46%. The mortality rate was 15%. In cases of long-term observation, the manifestations of pathological changes started from the nasal cavity, then spreaded in the perimaxillary adipose tissue and orbit, and were followed by the development of intracranial complications.Conclusion. The accumulated experience in identifying the combination of CT and MRI signs and patterns of RCM combined with clinical and anamnestic data allows to increase the alertness of clinicians and radiologists for earlier diagnosis and selection of the optimal volume of surgical intervention.
目的:探讨糖尿病合并新型冠状病毒感染患者鼻脑毛霉菌病(RCM)的CT和MRI表现,培养放射科医师对该病理的早期发现、快速手术和随访检查的关注态度。材料和方法。对13例RCM患者共53例头部(面部颅骨、面部软组织和脑部)进行CT和MRI检查。每位患者的CT和MRI检查次数从1到9不等,取决于病情的严重程度和临床适应症;随访1 ~ 4个月。所有患者均接受手术辅助;通过手术切除坏死组织的显微镜检查证实了诊断。我们对RCM的CT和MRI病理变化进行了详细的描述性分析。描述了病理体征表现的顺序,估计了病变的患病率,以规划手术干预的范围。将识别的RCM体征与文献数据进行比较分析。在我们的观察中,RCM的鼻腔和鼻窦病变的发生率为100%,单侧和双侧病变的发生率分别约为54%和46%。腋窝周围脂肪组织和翼状窝病变占77%,单侧眼眶病变占23%,眶上静脉和海绵窦血栓形成占31%,面部软组织病变占15.5%,颅内通过神经周围间隙扩散占7.7%,颈内动脉炎占15.5%。23%的患者以脑炎和46%的患者以脑膜炎的形式累及脑物质和脑膜。15.5%的患者在随访检查中发现脑脓肿的形成,46%的患者被诊断为颅骨骨髓炎。死亡率为15%。在长期观察的病例中,病理改变的表现从鼻腔开始,然后扩散到腋窝周围脂肪组织和眼眶,随后发生颅内并发症。结合临床和记忆数据,在识别RCM的CT和MRI征象和模式方面积累的经验可以提高临床医生和放射科医生的警觉性,以便进行早期诊断和选择最佳的手术干预量。
{"title":"Rhinocerebral Mucormycosis in Patients with Diabetes Mellitus After a New Coronavirus Infection (COVID-19): СT and MRI Patterns Data","authors":"I. S. Gabdulganieva, N. R. Munirova, A. R. Zaripova, V. Anisimov","doi":"10.20862/0042-4676-2022-103-4-6-36-51","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-4-6-36-51","url":null,"abstract":"Objective: to study the computed tomography (CT) and magnetic resonance imaging (MRI) manifestations of rhinocerebral mucormycosis (RCM) in patients with diabetes mellitus and new coronavirus infection, to develop attentive attitude of radiologists for early detection of this pathology, rapid surgery and followup examinations.Material and methods. Totally 53 head (facial skull, soft facial tissues and brain) CT and MRI studies were performed in 13 patients with RCM. The number of CT and MRI studies varied from 1 to 9 per one patient, depending on the severity of his condition and clinical indications; the follow-up period was 1–4 months. All patients received surgical aid; diagnosis was verified by microscopy of surgical samples of excised necrotic tissues. A detailed descriptive analysis of pathological changes on CT and MRI characterizing RCM was carried out. The sequence of pathological signs manifestations was described, the prevalence of the lesion was estimated for planning the scope of surgical intervention. A comparative analysis of the identified RCM signs with the literature data was performed.Results. Lesions of the nasal cavity and paranasal sinuses in RCM were found in 100% of our observations, with approximately equal single and bilateral lesions of 54% and 46%, respectively. Lesions of the perimaxillar fatty tissue and pterygoid fossa were determined in 77% of patients, unilateral orbital lesions – in 23%, superior orbital vein and cavernous sinus thrombosis – in 31%, facial soft tissue lesion – in 15.5%, intracranial spread through the perineural spaces – in 7.7%, internal carotid artery arteritis – in 15.5%. Brain substance and meninges involvement in the pathological process was observed in the form of cerebritis in 23% of patients and meningitis in 46%. The formation of brain abscess was noted in follow up examinations in 15.5% of patients, skull bones osteomyelitis was diagnosed in 46%. The mortality rate was 15%. In cases of long-term observation, the manifestations of pathological changes started from the nasal cavity, then spreaded in the perimaxillary adipose tissue and orbit, and were followed by the development of intracranial complications.Conclusion. The accumulated experience in identifying the combination of CT and MRI signs and patterns of RCM combined with clinical and anamnestic data allows to increase the alertness of clinicians and radiologists for earlier diagnosis and selection of the optimal volume of surgical intervention.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45051628","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
Results of Two-Years Mammographic Screening in the Kaluga Region 卡卢加地区两年乳房x光检查结果
Pub Date : 2022-10-26 DOI: 10.20862/0042-4676-2022-103-4-6-18-27
K. S. Drzhevetskaya, G. P. Korzhenkova
Objective: approbation of the project of mass breast cancer mammographic screening in the Kaluga Region.Material and methods. From April 2018 to December 2019, screening mammography was performed in 35,439 women aged from 38 to 93 years (mean age 57.33 ± 8.07 years). The study was carried out on mobile mammography complexes assembled on Russian KamAZ vehicles with Russian-made equipment from Amiko company. Mammography was performed in frontal and oblique projections. BI-RADS ACR international classification was used to standardize the identified changes and assess the sensitivity and specificity of the study method.Results. Out of the total number of women examined, pathological changes (BI-RADS IV–V) were assumed according to mammography data in 778 (2.2%) cases, of which 700 (1.98%) patients appealed to an oncological institution. Benign processes were found in 394 (1.11%) patients, breast cancer in 164 (0.46%). Without verification of the diagnosis, 137 (0.39%) patients remained under the supervision of oncologists. Distribution of detected tumors by stages for 2 years of observation: stage 0 – 7, stage 1 – 73, stage 2 – 56, stage 3 – 13, stage 4 – 3. The stage was not set in 4 cases. The total number of those examined with verification of the diagnosis in the oncological institution was 596. The proportion of correct diagnoses was 94%. The total number of diagnostic errors that would occur in the absence of a true double scan accounted for 36 (6%) cases.Conclusion. The proposed screening method makes it possible to increase the breast cancer detection in the early preclinical stages of the disease, to provide the available diagnostics for the population due to mobile mammography complexes, and to speed up the process of diagnostics and further hospitalization for examination and necessary treatment according to the disease stage in a specialized oncological institution.
目的:批准卡卢加地区大规模乳腺癌乳房x线摄影筛查项目。材料和方法。2018年4月至2019年12月,对35439名年龄38 ~ 93岁(平均年龄57.33±8.07岁)的女性进行了乳房x光筛查。这项研究是在俄罗斯KamAZ车辆上组装的移动乳房x线照相术综合体上进行的,这些设备是由Amiko公司制造的俄罗斯设备。在额位和斜位投影处进行乳房x光检查。采用BI-RADS ACR国际分级对所发现的变化进行标准化,并评估研究方法的敏感性和特异性。在接受检查的妇女总数中,778例(2.2%)的病例根据乳房x光检查数据推定病理改变(BI-RADS IV-V),其中700例(1.98%)的患者向肿瘤机构求助。良性病变394例(1.11%),乳腺癌164例(0.46%)。在诊断未经证实的情况下,137例(0.39%)患者仍在肿瘤学家的监督下。2年观察发现肿瘤分期分布:0 ~ 7期、1 ~ 73期、2 ~ 56期、3 ~ 13期、4 ~ 3期。4例未定台。在肿瘤机构检查并确认诊断的总人数为596人。正诊率为94%。在没有真正的双重扫描的情况下,诊断错误的总数占36例(6%)。所提出的筛查方法可以在疾病的早期临床前阶段增加乳腺癌的检测,通过移动乳房x线照相术为人群提供可用的诊断,并加快诊断过程,根据疾病阶段进一步住院检查和必要的治疗到专门的肿瘤机构。
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引用次数: 0
Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study) 新型冠状病毒感染患者肝脏x线衰减(多层螺旋ct研究)
Pub Date : 2022-10-26 DOI: 10.20862/0042-4676-2022-103-4-6-71-77
А. Nikogosova, А. B. Berdalin, I. Gubskiy, V. Lelyuk
Objective: to analyze the X-ray liver attenuation values in hospitalized patients with novel coronavirus infection (COVID-19) in relation to the time of disease onset, the severity of pulmonary parenchymal involvement, and the disease outcome.Material and methods. Chest computed tomography (CT) findings in 635 patients hospitalized with COVID-19 were analyzed. CT was performed at various times after the disease onset. The attenuation (CT density) values of the visualized liver upper part were measured by selecting the region of interest on CT images. The extent of the affected lung parenchyma was assessed according to the five-step CT0–4 scale, where CT0 corresponds to the absence of viral pneumonia, CT1 – lung parenchyma involvement less than 25%, CT2 – 25–50% lung volume lesion, CT3 – 50–75% lung volume lesion, CT4 – lung parenchyma involvement more than 75%.Results. In patients with CT0, the liver attenuation was significantly higher than in those with CT1, CT2, CT3, and CT4 (p < 0.01). During the first week of the disease, there was a decrease in liver CT density followed by its increase and return to the initial values (p < 0.0005). The dynamics of liver attenuation in the group of patients who died did not differ significantly from those who survived and recovered (p = 0.107). In the early stage of the disease (0–4 days), the liver attenuation in the group of patients who subsequently died turned out to be significantly lower than in the survivors (p < 0.05).Conclusion. The course of COVID-19 is characterized by a transient decrease in liver CT density. The reduction in liver attenuation does not correlate with the volume of the affected lung parenchyma in patients with CT2–4. The dynamics of liver CT density is not associated with the disease outcome. There is a trend towards more pronounced values of liver attenuation decrease in the early stage of the disease in patients who subsequently died, which requires further research.
目的:分析新型冠状病毒感染(COVID-19)住院患者x线肝脏衰减值与发病时间、肺实质受累程度及疾病转归的关系。材料和方法。分析635例新冠肺炎住院患者的胸部CT表现。发病后不同时间行CT检查。通过在CT图像上选择感兴趣的区域来测量肝脏上部的衰减(CT密度)值。根据CT0 - 4五步分级法评估肺实质受累程度,其中CT0对应无病毒性肺炎、CT1 -肺实质受累小于25%、CT2 -肺体积病变25-50%、CT3 -肺体积病变50-75%、CT4 -肺实质受累大于75%。CT0患者肝脏衰减明显高于CT1、CT2、CT3、CT4患者(p < 0.01)。在发病第1周,肝脏CT密度呈下降趋势,随后呈上升趋势并恢复到初始值(p < 0.0005)。死亡患者组的肝脏衰减动态与存活和康复患者组无显著差异(p = 0.107)。在疾病早期(0 ~ 4 d),死亡组肝脏衰减明显低于存活组(p < 0.05)。新冠肺炎病程的特点是肝脏CT密度一过性降低。在CT2-4患者中,肝脏衰减的减少与受影响的肺实质的体积无关。肝脏CT密度动态变化与疾病预后无关。在随后死亡的患者中,肝脏衰减值在疾病早期有更明显下降的趋势,这需要进一步的研究。
{"title":"Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study)","authors":"А. Nikogosova, А. B. Berdalin, I. Gubskiy, V. Lelyuk","doi":"10.20862/0042-4676-2022-103-4-6-71-77","DOIUrl":"https://doi.org/10.20862/0042-4676-2022-103-4-6-71-77","url":null,"abstract":"Objective: to analyze the X-ray liver attenuation values in hospitalized patients with novel coronavirus infection (COVID-19) in relation to the time of disease onset, the severity of pulmonary parenchymal involvement, and the disease outcome.Material and methods. Chest computed tomography (CT) findings in 635 patients hospitalized with COVID-19 were analyzed. CT was performed at various times after the disease onset. The attenuation (CT density) values of the visualized liver upper part were measured by selecting the region of interest on CT images. The extent of the affected lung parenchyma was assessed according to the five-step CT0–4 scale, where CT0 corresponds to the absence of viral pneumonia, CT1 – lung parenchyma involvement less than 25%, CT2 – 25–50% lung volume lesion, CT3 – 50–75% lung volume lesion, CT4 – lung parenchyma involvement more than 75%.Results. In patients with CT0, the liver attenuation was significantly higher than in those with CT1, CT2, CT3, and CT4 (p < 0.01). During the first week of the disease, there was a decrease in liver CT density followed by its increase and return to the initial values (p < 0.0005). The dynamics of liver attenuation in the group of patients who died did not differ significantly from those who survived and recovered (p = 0.107). In the early stage of the disease (0–4 days), the liver attenuation in the group of patients who subsequently died turned out to be significantly lower than in the survivors (p < 0.05).Conclusion. The course of COVID-19 is characterized by a transient decrease in liver CT density. The reduction in liver attenuation does not correlate with the volume of the affected lung parenchyma in patients with CT2–4. The dynamics of liver CT density is not associated with the disease outcome. There is a trend towards more pronounced values of liver attenuation decrease in the early stage of the disease in patients who subsequently died, which requires further research.","PeriodicalId":34090,"journal":{"name":"Vestnik rentgenologii i radiologii","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43461558","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
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