Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20200206-00098
Chengcheng Yu, Jing Qu, Lie-guang Zhang, Song-feng Jiang, Bi-hua Chen, W. Guan, Qingxin Gan, D. Huang, Zhoukun Ling, R. Jiang, Lin Lin, Jinxin Liu
Objective To investigate the initial high resolution CT (HRCT) manifestations and clinical features of imported COVID-19 in Guangzhou. Methods A retrospective analysis of 91 COVID-19 patients admitted to the Guangzhou Eighth People's Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years,then their clinical features and HRCT characteristics were analyzed. Results The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry cough in 39 cases). The first time HRCT showed that 24 cases with COVID-19 were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung. Conclusion The initial images of COVID-19 in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of COVID-19 patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner. Key words: COVID-19; Tomography, X-ray computed
{"title":"High resolution CT findings and clinical features of COVID-19 in Guangzhou","authors":"Chengcheng Yu, Jing Qu, Lie-guang Zhang, Song-feng Jiang, Bi-hua Chen, W. Guan, Qingxin Gan, D. Huang, Zhoukun Ling, R. Jiang, Lin Lin, Jinxin Liu","doi":"10.3760/CMA.J.CN112149-20200206-00098","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200206-00098","url":null,"abstract":"Objective \u0000To investigate the initial high resolution CT (HRCT) manifestations and clinical features of imported COVID-19 in Guangzhou. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis of 91 COVID-19 patients admitted to the Guangzhou Eighth People's Hospital from January 22 to 30, 2020 was performed including 39 males and 52 females, with a median age of 50 (33-62) years,then their clinical features and HRCT characteristics were analyzed. \u0000 \u0000 \u0000Results \u0000The main clinical presentations included fever in 70 cases and cough in 57 cases(mainly dry cough in 39 cases). The first time HRCT showed that 24 cases with COVID-19 were normal, however other 67 cases were abnormal. The ground glass opacity in the lung on HRCT was found in 65 cases, including 64 cases with dilated blood vessel crossing the lesion, 50 cases with thickened adjacent pleura, and 47 cases with thickening of interstitial septum. The patchy opacity was seen in 42 cases, and no enlarged lymph nodes were observed in all patients. As for the lesion distribution, there were two cases with bilateral diffuse changes, 57 cases with multiple lesions, 8 cases with the lesion in only one lobe. The lesions were mainly located under the pleura area in 46 cases, including 39 cases in the lower lobe and other 7 cases in the upper lobe. And there were 13 cases without characteristic distribution in the lung. \u0000 \u0000 \u0000Conclusion \u0000The initial images of COVID-19 in Guangzhou mainly showed multiple ground glass opacity, which were mostly seen in the subpleural and lower lung fields, most of them with thickened pulmonary interstitium. Guangzhou has a higher proportion of COVID-19 patients with mild and general patients, and some confirmed patients show negative HRCT for the first time. Patients without HRCT changes should be reviewed in a timely manner. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Tomography, X-ray computed","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45207681","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}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20190510-00411
He-xiang Wang, Jihua Liu, D. Hao, S. Duan, Wenjian Xu
Objective To explore the value of T1WI based optimal radiomics and machine learning model in predicting histological grades of soft tissue sarcoma. Methods The preoperative MR T1WI data of 113 patients with soft tissue sarcoma in Affiliated Hospital of Qingdao University from May 2009 to November 2018 was analyzed retrospectively. The patients were divided into training set (n=80) and validation set (n=33) using randomly stratified sampling mothed. According to the French Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system, the soft tissue sarcomas were divided into 3 pathological levels (grade Ⅰ-Ⅲ). Grade Ⅰ was defined as low grade, grade Ⅱ and Ⅲ were defined as high grade. In the training set, there were 18 cases with low-grade lesions, 62 cases with high-grade lesions. In the validation set, there were 7 cases with low-grade lesions and 26 cases with high-grade lesions. After a normalizationapproach applied on the image, the radiomics features were extracted in the regions of interest using A.K software. Based on different feature selection methods [with or without recursive feature elimination (RFE)], machine learning algorithm [random forest (RF) or support vector machine (SVM)] and sampling technology [without subsampling, with the synthetic minority oversampling technique (SMOTE) or with random oversampling examples], a total of 12 models were built and each machine-learning combination model was trained using leave-one-out cross validation. The receiver operating characteristic (ROC) curves were used to evaluate the efficacy of the model in predicting the pathological grade of soft tissue sarcoma. Results Among the 12 different machine learning models, the optimal classification model for the prediction of soft tissue sarcoma pathological grade was a combination of RF, RFE and SMOTE, with an area under the curve of 0.909 (95% confidence interval, 0.808-1.000) in the validation set, and the accuracy, sensitivity, and specificity were 84.85%, 86.21%, and 75.00%, respectively. Conclusion The radiomics based machine learning model can be used as an attractive application approach for predicting histological grades of soft tissue sarcoma. Key words: Magnetic resonance imaging; Soft tissue neoplasms; Sarcoma; Radiomics; Artificial intelligence
{"title":"MR T1WI based radiomics and machine learning model for predicting the histopathological grades of soft tissue sarcomas","authors":"He-xiang Wang, Jihua Liu, D. Hao, S. Duan, Wenjian Xu","doi":"10.3760/CMA.J.CN112149-20190510-00411","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190510-00411","url":null,"abstract":"Objective \u0000To explore the value of T1WI based optimal radiomics and machine learning model in predicting histological grades of soft tissue sarcoma. \u0000 \u0000 \u0000Methods \u0000The preoperative MR T1WI data of 113 patients with soft tissue sarcoma in Affiliated Hospital of Qingdao University from May 2009 to November 2018 was analyzed retrospectively. The patients were divided into training set (n=80) and validation set (n=33) using randomly stratified sampling mothed. According to the French Federation Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system, the soft tissue sarcomas were divided into 3 pathological levels (grade Ⅰ-Ⅲ). Grade Ⅰ was defined as low grade, grade Ⅱ and Ⅲ were defined as high grade. In the training set, there were 18 cases with low-grade lesions, 62 cases with high-grade lesions. In the validation set, there were 7 cases with low-grade lesions and 26 cases with high-grade lesions. After a normalizationapproach applied on the image, the radiomics features were extracted in the regions of interest using A.K software. Based on different feature selection methods [with or without recursive feature elimination (RFE)], machine learning algorithm [random forest (RF) or support vector machine (SVM)] and sampling technology [without subsampling, with the synthetic minority oversampling technique (SMOTE) or with random oversampling examples], a total of 12 models were built and each machine-learning combination model was trained using leave-one-out cross validation. The receiver operating characteristic (ROC) curves were used to evaluate the efficacy of the model in predicting the pathological grade of soft tissue sarcoma. \u0000 \u0000 \u0000Results \u0000Among the 12 different machine learning models, the optimal classification model for the prediction of soft tissue sarcoma pathological grade was a combination of RF, RFE and SMOTE, with an area under the curve of 0.909 (95% confidence interval, 0.808-1.000) in the validation set, and the accuracy, sensitivity, and specificity were 84.85%, 86.21%, and 75.00%, respectively. \u0000 \u0000 \u0000Conclusion \u0000The radiomics based machine learning model can be used as an attractive application approach for predicting histological grades of soft tissue sarcoma. \u0000 \u0000 \u0000Key words: \u0000Magnetic resonance imaging; Soft tissue neoplasms; Sarcoma; Radiomics; Artificial intelligence","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44942882","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 application value of phase contrast MR angiography (PC MRA) in quantitative assessment for the hemodynamic features of functional posterior communicating artery (F-PCoA) in the patients with posterior circulation ischemia (PCI). Methods Data of PC MRA in our Hospital from April 2015 to March 2017 were collected retrospectively. Twenty-six patients (PCI group) were diagnosed as PCI with F-PCoA, and other 25 patients were defined as non-PCI group including 10 patients with F-PCoA (non-PCI group 1) and 15 patients without F-PCoA (non-PCI group 2). The cross-sectional area, mean flux, mean velocity, minimum flux, maximum flux, minimum velocity, and maximum velocity were recorded, and the peak height of flux (maximum flux-minimum flux) and peak height of velocity (maximum velocity - minimum velocity) of basilar artery (BA) were calculated. The subtype, cross-sectional area, mean flux, mean velocity, blood flow direction, and absolute flux of F-PCoA in anterior-posterior direction(sum of both sides)were recorded and analyzed statistically. Results The F-PCoA of 36 cases in PCI group and non-PCI group 1 were divided into three types: type A: the F-PCoA was consistent with anatomical posterior communicating artery (A-PCoA), accounting for 83.3%(30/36 cases); type B: the F-PCoA was not consistent with A-PCoA, accounting for 13.9%(5/36 cases);and type C: a mixed type with the F-PCoA was consistent with A-PCoA in only one side, accounting for 2.8%(1/36 cases). There were no significant differences in the composition of F-PCoA subtype (χ2=0.609, P=0.737) and the absolute flux of F-PCoA in anterior-posterior direction(t=-0.576, P=0.568) between PCI group and non PCI group 1. It could be unidirectional or bidirectional blood flow forasingle F-PCoA during a cardiac cycle. The blood flow direction of bilateral F-PCoA was similar or not in one single case. The obviously main wave peak of the absolute flux curve of F-PCoA in anterior-posterior direction in PCI group were observed. There was a significant difference in the cross-sectional area of BA between non PCI group 1 and 2(t=-2.856, P=0.009), however no significant differences were found in the genders, mean flux, mean velocity, minimum flux, maximum flux, peak height of flux, minimum velocity, maximum velocity, and peak height of velocity of BA. Conclusions PC MRA can be used to quantificationally assess the hemodynamic characteristics of F-PCoA such as flow direction, velocity and flux direction, absolute flux in anterior-posterior direction and morphological changes of F-PCoA, which may provide more information for the PCI diagnosis and treatment. Key words: Brain ischemia; Haemodynamics; Magnetic resonance imaging
{"title":"Application value of phase contrast MR angiography in assessment of the functional posterior communicating artery in patients with posterior circulation ischemia","authors":"Wei Zhou, Zhengjie Chen, Minru Lu, Jun Li, Feng Chen, Jiali Zhang","doi":"10.3760/CMA.J.CN112149-20190408-00135","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190408-00135","url":null,"abstract":"Objective \u0000To investigate the application value of phase contrast MR angiography (PC MRA) in quantitative assessment for the hemodynamic features of functional posterior communicating artery (F-PCoA) in the patients with posterior circulation ischemia (PCI). \u0000 \u0000 \u0000Methods \u0000Data of PC MRA in our Hospital from April 2015 to March 2017 were collected retrospectively. Twenty-six patients (PCI group) were diagnosed as PCI with F-PCoA, and other 25 patients were defined as non-PCI group including 10 patients with F-PCoA (non-PCI group 1) and 15 patients without F-PCoA (non-PCI group 2). The cross-sectional area, mean flux, mean velocity, minimum flux, maximum flux, minimum velocity, and maximum velocity were recorded, and the peak height of flux (maximum flux-minimum flux) and peak height of velocity (maximum velocity - minimum velocity) of basilar artery (BA) were calculated. The subtype, cross-sectional area, mean flux, mean velocity, blood flow direction, and absolute flux of F-PCoA in anterior-posterior direction(sum of both sides)were recorded and analyzed statistically. \u0000 \u0000 \u0000Results \u0000The F-PCoA of 36 cases in PCI group and non-PCI group 1 were divided into three types: type A: the F-PCoA was consistent with anatomical posterior communicating artery (A-PCoA), accounting for 83.3%(30/36 cases); type B: the F-PCoA was not consistent with A-PCoA, accounting for 13.9%(5/36 cases);and type C: a mixed type with the F-PCoA was consistent with A-PCoA in only one side, accounting for 2.8%(1/36 cases). There were no significant differences in the composition of F-PCoA subtype (χ2=0.609, P=0.737) and the absolute flux of F-PCoA in anterior-posterior direction(t=-0.576, P=0.568) between PCI group and non PCI group 1. It could be unidirectional or bidirectional blood flow forasingle F-PCoA during a cardiac cycle. The blood flow direction of bilateral F-PCoA was similar or not in one single case. The obviously main wave peak of the absolute flux curve of F-PCoA in anterior-posterior direction in PCI group were observed. There was a significant difference in the cross-sectional area of BA between non PCI group 1 and 2(t=-2.856, P=0.009), however no significant differences were found in the genders, mean flux, mean velocity, minimum flux, maximum flux, peak height of flux, minimum velocity, maximum velocity, and peak height of velocity of BA. \u0000 \u0000 \u0000Conclusions \u0000PC MRA can be used to quantificationally assess the hemodynamic characteristics of F-PCoA such as flow direction, velocity and flux direction, absolute flux in anterior-posterior direction and morphological changes of F-PCoA, which may provide more information for the PCI diagnosis and treatment. \u0000 \u0000 \u0000Key words: \u0000Brain ischemia; Haemodynamics; Magnetic resonance imaging","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46998005","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 explore the value of 3.0 T high resolution MRI (HR-MRI) in the follow-up of drug treatment in acute and non-acute ischemic stroke caused by middle cerebral artery (MCA) plaque. Methods The perspective study enrolled patients with ischemic stroke caused by MCA stenosis from October 2012 to October 2015 in the department of Neurology and Neurosurgery of Changhai Hospital Affiliated to Naval Medical University. All the patients underwent HR-MRI and then were divided into acute and non-acute stroke groups according to the intervels of the last symptom onset to the time of HR-MRI examination. All patients were informed consent to receive antiplatelet drug and intensive lipid therapy and followed up with HR-MRI. The HR-MRI sequence including T2WI, T1WI and contrast-enhanced T1WI of vessel wall, and T2WI and DWI of brain were routinely performed. T-test of paired samples was used to evaluate the changes of stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden on HR-MRI, and the NIHSS score of nervous system and blood biochemical indicators of the patients before and after treatment. Chi square test was used to compare the difference in ischemic event recurrcence between the acute and the non-acute stroke group. Results A total of 31 acute stroke patients and 20 non-acute stroke patients were enrolled in the study. The mean follow-up time of acute stroke group was (671.71±522.86) days. Compare with the baseline, the stenosis rate of vascular lumen (P=0.039), plaque enhancement degree (P 0.05). There were no significant changes in NIHSS score of nervous system, TC, triglyceride (TG) and LDL-C (P>0.05), however the high density lipoprotein cholesterol (HDL-C) was significantly increased than that in the baseline (P=0.02). During the follow-up period, no new cerebral infarction was found in the DWI images of the two groups. Six patients had transient ischemic attack (TIA) recurrence in the acute stroke group and 5 patients in the non-acute stroke group, there was no significant difference between both groups(χ2=0.229, P= 0.632). Conclusion HR-MRI can be used as an important evaluation method for the follow-up of MCA atherosclerotic plaque therapy. After antiplatelet therapy and intensive lipid-lowering therapy, the plaque volume and burden of MCA offending plaque, and plaque enhancement decreased in acute stroke patients but there was no significant change in non-acute patients. Key words: Atherosclerosis; Magnetic resonance imaging; Stroke; Follow-up studies
{"title":"Evaluate the follow-up effect of drug treatment for middle cerebral artery atherosclerotic plaques using high resolution MRI","authors":"Xuefeng Zhang, Shuai Li, Zhang Shi, Shiyue Chen, Q. Zhan, Wenjia Peng, X. Tian, Qi Liu, Jianping Lu","doi":"10.3760/CMA.J.CN112149-20190415-00288","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190415-00288","url":null,"abstract":"Objective \u0000To explore the value of 3.0 T high resolution MRI (HR-MRI) in the follow-up of drug treatment in acute and non-acute ischemic stroke caused by middle cerebral artery (MCA) plaque. \u0000 \u0000 \u0000Methods \u0000The perspective study enrolled patients with ischemic stroke caused by MCA stenosis from October 2012 to October 2015 in the department of Neurology and Neurosurgery of Changhai Hospital Affiliated to Naval Medical University. All the patients underwent HR-MRI and then were divided into acute and non-acute stroke groups according to the intervels of the last symptom onset to the time of HR-MRI examination. All patients were informed consent to receive antiplatelet drug and intensive lipid therapy and followed up with HR-MRI. The HR-MRI sequence including T2WI, T1WI and contrast-enhanced T1WI of vessel wall, and T2WI and DWI of brain were routinely performed. T-test of paired samples was used to evaluate the changes of stenosis rate of vascular lumen, plaque enhancement degree, plaque volume and plaque burden on HR-MRI, and the NIHSS score of nervous system and blood biochemical indicators of the patients before and after treatment. Chi square test was used to compare the difference in ischemic event recurrcence between the acute and the non-acute stroke group. \u0000 \u0000 \u0000Results \u0000A total of 31 acute stroke patients and 20 non-acute stroke patients were enrolled in the study. The mean follow-up time of acute stroke group was (671.71±522.86) days. Compare with the baseline, the stenosis rate of vascular lumen (P=0.039), plaque enhancement degree (P 0.05). There were no significant changes in NIHSS score of nervous system, TC, triglyceride (TG) and LDL-C (P>0.05), however the high density lipoprotein cholesterol (HDL-C) was significantly increased than that in the baseline (P=0.02). During the follow-up period, no new cerebral infarction was found in the DWI images of the two groups. Six patients had transient ischemic attack (TIA) recurrence in the acute stroke group and 5 patients in the non-acute stroke group, there was no significant difference between both groups(χ2=0.229, P= 0.632). \u0000 \u0000 \u0000Conclusion \u0000HR-MRI can be used as an important evaluation method for the follow-up of MCA atherosclerotic plaque therapy. After antiplatelet therapy and intensive lipid-lowering therapy, the plaque volume and burden of MCA offending plaque, and plaque enhancement decreased in acute stroke patients but there was no significant change in non-acute patients. \u0000 \u0000 \u0000Key words: \u0000Atherosclerosis; Magnetic resonance imaging; Stroke; Follow-up studies","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48695901","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}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20190430-00210
S. Shang, Jing Ye, X. Luo, Qingqiang Zhu, Hongying Zhang, Jingtao Wu
Objective To evaluate image quality and diagnostic performance of silent MR angiography (MRA) and discuss the feasibility of silent MRA in diagnosing intracranial aneurysms. Methods Twenty seven patients suspected with cerebrovascular disorders and 30 intracranial aneurysms in Northern Jiangsu People's Hospital, were enrolled prospectively in this study from December 2015 to December 2018. Silent and time of flight (TOF) MRA were performed on the same day prior to CTA examination. The corresponding MRA images were independently and blindly evaluated by two experienced neuroradiologists in the aspects of signal homogeneity, lesion conspicuity, venous signal/artifact and diagnostic confidence (4-point scale). The aneurysms were divided into tiny (≤ 3 mm) and non-tinyaneurysm groups(> 3 mm) according to the measured diameters of aneurysms. The differences in image quality ratings between silent MRA and TOF MRA were analyzed using Wilcoxon signed rank tests. Intra-class correlation coefficients (ICC) were used to test the consistency of measurements between MRAs (silent MRA, TOF MRA) and CTA. Results CTA revealed 32 intracranial aneurysms. For silent MRA and TOF MRA, the scores of signal homogeneity were 3.38±0.49 and 3.00±0.62, andthe scores of venous signal/artifact were 3.77±0.42 and 2.65±0.48.Significant differences were found between the two MRAs in these aspects (Z=-2.21, P=0.02; Z=-5.69, P=0.01). The scores of lesion conspicuity were 3.19±0.56 and 3.15±0.46, and the scores of diagnostic confidence were 3.27±0.44 and 3.12±0.51.There were no significant differences found in these aspects (P>0.05).The ICC coefficient was excellentfor silent MRA (0.94, 95%CI 0.82- 0.98)and was good for TOF MRA (0.72, 95%CI 0.30-0.91) in tiny aneurysm group. The ICC coefficient was excellent (silent MRA, 0.98, 95%CI 0.95-0.99; TOF MRA, 0.95, 95%CI 0.87-0.98) for both MRA in non-tiny aneurysm group. Conclusions Compared with TOF MRA, silent MRA could achieve higher image quality and higher diagnostic confidence, and higher consistency with CTA. Silent MRA can be a promising non-contrast-enhanced alternative MRA technique in clinical setting. Key words: Magnetic resonance imaging; Intracranial aneurysm; Diagnosis, differential; Comparative study
{"title":"Silent MR angiography in the detection of intracranial aneurysm: a feasibility study","authors":"S. Shang, Jing Ye, X. Luo, Qingqiang Zhu, Hongying Zhang, Jingtao Wu","doi":"10.3760/CMA.J.CN112149-20190430-00210","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190430-00210","url":null,"abstract":"Objective \u0000To evaluate image quality and diagnostic performance of silent MR angiography (MRA) and discuss the feasibility of silent MRA in diagnosing intracranial aneurysms. \u0000 \u0000 \u0000Methods \u0000Twenty seven patients suspected with cerebrovascular disorders and 30 intracranial aneurysms in Northern Jiangsu People's Hospital, were enrolled prospectively in this study from December 2015 to December 2018. Silent and time of flight (TOF) MRA were performed on the same day prior to CTA examination. The corresponding MRA images were independently and blindly evaluated by two experienced neuroradiologists in the aspects of signal homogeneity, lesion conspicuity, venous signal/artifact and diagnostic confidence (4-point scale). The aneurysms were divided into tiny (≤ 3 mm) and non-tinyaneurysm groups(> 3 mm) according to the measured diameters of aneurysms. The differences in image quality ratings between silent MRA and TOF MRA were analyzed using Wilcoxon signed rank tests. Intra-class correlation coefficients (ICC) were used to test the consistency of measurements between MRAs (silent MRA, TOF MRA) and CTA. \u0000 \u0000 \u0000Results \u0000CTA revealed 32 intracranial aneurysms. For silent MRA and TOF MRA, the scores of signal homogeneity were 3.38±0.49 and 3.00±0.62, andthe scores of venous signal/artifact were 3.77±0.42 and 2.65±0.48.Significant differences were found between the two MRAs in these aspects (Z=-2.21, P=0.02; Z=-5.69, P=0.01). The scores of lesion conspicuity were 3.19±0.56 and 3.15±0.46, and the scores of diagnostic confidence were 3.27±0.44 and 3.12±0.51.There were no significant differences found in these aspects (P>0.05).The ICC coefficient was excellentfor silent MRA (0.94, 95%CI 0.82- 0.98)and was good for TOF MRA (0.72, 95%CI 0.30-0.91) in tiny aneurysm group. The ICC coefficient was excellent (silent MRA, 0.98, 95%CI 0.95-0.99; TOF MRA, 0.95, 95%CI 0.87-0.98) for both MRA in non-tiny aneurysm group. \u0000 \u0000 \u0000Conclusions \u0000Compared with TOF MRA, silent MRA could achieve higher image quality and higher diagnostic confidence, and higher consistency with CTA. Silent MRA can be a promising non-contrast-enhanced alternative MRA technique in clinical setting. \u0000 \u0000 \u0000Key words: \u0000Magnetic resonance imaging; Intracranial aneurysm; Diagnosis, differential; Comparative study","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43012617","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}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20191025-00865
Li Ma, Biao Wang, Xiao Liu, P. Qiao, W. Jiao, T. Jiang
Objective To investigate the application value of MRI in evaluating the disorders of pelvic floor in female stress urinary incontinence (SUI). Methods From January 2017 to January 2019, the patients in the SUI group and the control group of Beijing Chaoyang Hospital, Capital Medical University were prospectively collected. Some patients in the SUI group were treated with tension-free vaginal tape (TVT). The dynamic MR was performed in both SUI patients and volunteers, and the following functional MR parameters were assessed between two groups: the urethral length and urethral hypermobility; the opening of urethral and bladder neck; and the pelvic organ prolapse. For SUI patients, the functional changes of the pelvic floor on MRI after TVT was also analyzed. Chi-square test, rank-sum test and t test were used. Results Comparing with the control groups (n=25), the urethral hypermobility, shortening functional urethral length, bladder neck funneling and urethra opening were significantly associated with SUI group (n=33). Thirty one patients were treated with TVT, 12 of them were reexamined with MRI at 3 to 6 months after operation. Postoperative MR showed that SUI patients had lower risk of the urethral opening and bladder neck funneling (P 0.05). Conclusion MRI can accurately evaluate pelvic floor function of SUI patients. However, TVT did not significantly improve weak pelvic supporting structures and pelvic organ prolapse. Key words: Urinary incontinence, stress; Magnetic resonance imaging; Tension-free vaginal tape; Pelvic floor disfunction; Pelvic floor
{"title":"The value of MRI in assessment of the functional disorders of stress urinary incontinence in women","authors":"Li Ma, Biao Wang, Xiao Liu, P. Qiao, W. Jiao, T. Jiang","doi":"10.3760/CMA.J.CN112149-20191025-00865","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20191025-00865","url":null,"abstract":"Objective \u0000To investigate the application value of MRI in evaluating the disorders of pelvic floor in female stress urinary incontinence (SUI). \u0000 \u0000 \u0000Methods \u0000From January 2017 to January 2019, the patients in the SUI group and the control group of Beijing Chaoyang Hospital, Capital Medical University were prospectively collected. Some patients in the SUI group were treated with tension-free vaginal tape (TVT). The dynamic MR was performed in both SUI patients and volunteers, and the following functional MR parameters were assessed between two groups: the urethral length and urethral hypermobility; the opening of urethral and bladder neck; and the pelvic organ prolapse. For SUI patients, the functional changes of the pelvic floor on MRI after TVT was also analyzed. Chi-square test, rank-sum test and t test were used. \u0000 \u0000 \u0000Results \u0000Comparing with the control groups (n=25), the urethral hypermobility, shortening functional urethral length, bladder neck funneling and urethra opening were significantly associated with SUI group (n=33). Thirty one patients were treated with TVT, 12 of them were reexamined with MRI at 3 to 6 months after operation. Postoperative MR showed that SUI patients had lower risk of the urethral opening and bladder neck funneling (P 0.05). \u0000 \u0000 \u0000Conclusion \u0000MRI can accurately evaluate pelvic floor function of SUI patients. However, TVT did not significantly improve weak pelvic supporting structures and pelvic organ prolapse. \u0000 \u0000 \u0000Key words: \u0000Urinary incontinence, stress; Magnetic resonance imaging; Tension-free vaginal tape; Pelvic floor disfunction; Pelvic floor","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45029655","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 formation, growth, and rupture of intracranial aneurysms are not only passive dilation of vascular structures, but also accompanied by significant inflammatory reactions and tissue degeneration, such as tumor wall remodeling. Traditional imaging methods can only display the morphological features of intracranial aneurysm cavities, while the latest high-resolution MRI imaging can evaluate the pathological changes of intracranial aneurysm walls. The author provides a systematic review of existing research on this technology and further discusses its potential value in optimizing risk assessment and management of intracranial aneurysms in clinical applications.
{"title":"Progress in assessment of intracranial aneurysms by using high resolution MRI","authors":"Qichang Fu, Jin Cheng, S. Guan, Yanjiang Chen","doi":"10.3760/CMA.J.CN112149-20190414-00158","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20190414-00158","url":null,"abstract":"颅内动脉瘤的形成、生长和破裂不仅是血管结构的被动扩张，还伴随着明显的炎症反应和组织变性等瘤壁重构。传统的影像学方法仅能显示颅内动脉瘤腔的形态特征，最新的高分辨率MRI成像则能评估颅内动脉瘤壁的病理变化。笔者对该技术的现有研究做一系统回顾，并对其在临床应用中优化颅内动脉瘤风险评估及管理方式的潜在价值做进一步论述。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46618587","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}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20200204-00085
Xuefang Lu, Wei Gong, Li Wang, Liang Li, Baojun Xie, Zhoufeng Peng, Y. Zha
Objective To summarize the clinical and high resolution CT(HRCT) characteristics of 141 patients with COVID-19. Methods From January 20 to 28, 2020, 141 COVID-19 patients, 77 males and 64 females, with a median age of 49 (9, 87), were enrolled in the study. The clinical features, laboratory test results and HRCT findings of all patients were analyzed retrospectively. Results In all of the patients, the decreasing leukocyte countin 38 (26.95%) and lymphocyte ratio in 71 (50.35%), a fever over 37.5 ℃ in 139 (98.58%), coughing in 106 (75.18%), headache in 11 (7.80%), expectoration in 41 (29.08%), chest distress in 93 (65.96%), and diarrhea in 4 (2.84%) were found. The HRCT of all patients were abnormal, including ground glass opacity (GGO) with patchy opacity in 52 (36.88%) mainly distributed along subpleural area, GGO with focal consolidation in 23 (16.31%),small patchy opacity in 27 (19.15%),large patchy consolidation in 20 (14.18%),thickened bronchovascular bundleing and blood vessel crossing the lesion in 48 (34.04%), air bronchus sign in 5 (3.55%), small nodule in 7 (4.96%),fibrous stripes and reticular opacities in 5 (3.55%), bilateral pleural effusion in 7 (4.96%), and mediastinal or bilateral hilar lymphadenopathy in 4 (2.84%). Conclusions The clinical and HRCT manifestations of COVID-19 are various. Under the specific epidemiological background of COVID-19, chest HRCT scan should be carried out as soon as possible for early warning of this disease. Key words: COVID-19; Tomography, X-ray computed
{"title":"Clinical features and high resolution CT imaging findings of preliminary COVID-19","authors":"Xuefang Lu, Wei Gong, Li Wang, Liang Li, Baojun Xie, Zhoufeng Peng, Y. Zha","doi":"10.3760/CMA.J.CN112149-20200204-00085","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200204-00085","url":null,"abstract":"Objective \u0000To summarize the clinical and high resolution CT(HRCT) characteristics of 141 patients with COVID-19. \u0000 \u0000 \u0000Methods \u0000From January 20 to 28, 2020, 141 COVID-19 patients, 77 males and 64 females, with a median age of 49 (9, 87), were enrolled in the study. The clinical features, laboratory test results and HRCT findings of all patients were analyzed retrospectively. \u0000 \u0000 \u0000Results \u0000In all of the patients, the decreasing leukocyte countin 38 (26.95%) and lymphocyte ratio in 71 (50.35%), a fever over 37.5 ℃ in 139 (98.58%), coughing in 106 (75.18%), headache in 11 (7.80%), expectoration in 41 (29.08%), chest distress in 93 (65.96%), and diarrhea in 4 (2.84%) were found. The HRCT of all patients were abnormal, including ground glass opacity (GGO) with patchy opacity in 52 (36.88%) mainly distributed along subpleural area, GGO with focal consolidation in 23 (16.31%),small patchy opacity in 27 (19.15%),large patchy consolidation in 20 (14.18%),thickened bronchovascular bundleing and blood vessel crossing the lesion in 48 (34.04%), air bronchus sign in 5 (3.55%), small nodule in 7 (4.96%),fibrous stripes and reticular opacities in 5 (3.55%), bilateral pleural effusion in 7 (4.96%), and mediastinal or bilateral hilar lymphadenopathy in 4 (2.84%). \u0000 \u0000 \u0000Conclusions \u0000The clinical and HRCT manifestations of COVID-19 are various. Under the specific epidemiological background of COVID-19, chest HRCT scan should be carried out as soon as possible for early warning of this disease. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Tomography, X-ray computed","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41768424","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 December 2019, novel coronavirus pneumonia broke out in China, and the epidemic quickly spread to the whole country and overseas with Wuhan as the center. As a frontline department for epidemic prevention and control, the imaging department faces challenges in many aspects such as pneumonia screening and diversion, imaging diagnosis and differentiation, efficacy evaluation and follow-up, workflow and management, personnel control and scheduling, and even the department's ability to prevent and control infections. In the face of sudden outbreaks, there are many issues worth discussing and considering on how to respond quickly and make correct decisions.
{"title":"The role of medical imaging in the diagnosis and treatment of COVID-19","authors":"Y. Xiao, Y. Guo, S. Liu","doi":"10.3760/CMA.J.CN112149-20200208-00114","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200208-00114","url":null,"abstract":"2019年12月，新型冠状病毒肺炎在中国爆发，疫情迅速以武汉市为中心蔓延至全国和境外。影像科作为疫情防控一线科室，在肺炎筛查和分流、影像诊断与鉴别、疗效评估和随访、工作流程和管理、人员管控和排班乃至科室感染防控能力等诸多方面都面临考验。面对突发疫情，如何迅速响应和正确决策，有许多值得讨论和思考的问题。","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41350158","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}
Pub Date : 2020-04-10DOI: 10.3760/CMA.J.CN112149-20200202-00080
H. Liu, D. Zhang, Y. Yang, B. Long, L. Yin, M. Zhao, Y. Peng
Objective: To investigate the initial chest high resolution CT (HRCT) manifestations of the patients with COVID-19. Methods: A retrospective analysis of the first chest HRCT images of 106 patients with COVID-19 was performed who were confirmed in our hospital from January 3 to 25, 2020. Lesion distribution, morphology and surrounding involvement were analyzed. Results: The lesions were found on all initial HRCT images of 106 patients, with unilateral lung distribution in 11 cases (10.4%) and bilateral lung distribution in other 95 cases(89.6%), peripheral distribution of lung in 65 cases (61.3%) and peripheral and central distribution in other 41 cases (38.7%). HRCT showed 8 cases (7.5%) with 1 lesion, 5 cases (4.7%) with 2 lesions, and other 93 cases (87.8%) with multiple lesions. HRCT also showed the nodular lesions in 12 cases(11.3%), ground-glass opacities in 94 cases (88.7%), fibrous stripes in 7 cases (6.6%), and mixed lesions in 15 cases (14.2%). Only one lung lobe was involved in 10 cases (9.4%), while more than two lobes were involved in other 96 cases (90.6%). In addition, 24 cases (22.6%) with enlarged mediastinal lymph nodes (over 60 years old in 19 cases, accounting for 79.2%), 3 cases with pleural effusion (2.8 %), 1 case with pericardial effusion (0.9%), and 2 cases with pleural involvement/thickening (1.9%) were found. Patients over 60 years old mostly presented with multiple lesions, various appearances, peripheral and central distributions of lungs, involving multiple lobes, and enlarged mediastinal lymph nodes. Conclusions: Lung COVID-19 lesions can be shown by the initial chest HRCT, which is the preferred imaging method. Thoracic HRCT scans play an important role in the early diagnosis of COVID-19.
{"title":"Analysis of the initial chest high resolution CT manifestations of COVID-19/ 新型冠状病毒肺炎首次胸部高分辨率CT影像分析","authors":"H. Liu, D. Zhang, Y. Yang, B. Long, L. Yin, M. Zhao, Y. Peng","doi":"10.3760/CMA.J.CN112149-20200202-00080","DOIUrl":"https://doi.org/10.3760/CMA.J.CN112149-20200202-00080","url":null,"abstract":"Objective: To investigate the initial chest high resolution CT (HRCT) manifestations of the patients with COVID-19. Methods: A retrospective analysis of the first chest HRCT images of 106 patients with COVID-19 was performed who were confirmed in our hospital from January 3 to 25, 2020. Lesion distribution, morphology and surrounding involvement were analyzed. Results: The lesions were found on all initial HRCT images of 106 patients, with unilateral lung distribution in 11 cases (10.4%) and bilateral lung distribution in other 95 cases(89.6%), peripheral distribution of lung in 65 cases (61.3%) and peripheral and central distribution in other 41 cases (38.7%). HRCT showed 8 cases (7.5%) with 1 lesion, 5 cases (4.7%) with 2 lesions, and other 93 cases (87.8%) with multiple lesions. HRCT also showed the nodular lesions in 12 cases(11.3%), ground-glass opacities in 94 cases (88.7%), fibrous stripes in 7 cases (6.6%), and mixed lesions in 15 cases (14.2%). Only one lung lobe was involved in 10 cases (9.4%), while more than two lobes were involved in other 96 cases (90.6%). In addition, 24 cases (22.6%) with enlarged mediastinal lymph nodes (over 60 years old in 19 cases, accounting for 79.2%), 3 cases with pleural effusion (2.8 %), 1 case with pericardial effusion (0.9%), and 2 cases with pleural involvement/thickening (1.9%) were found. Patients over 60 years old mostly presented with multiple lesions, various appearances, peripheral and central distributions of lungs, involving multiple lobes, and enlarged mediastinal lymph nodes. Conclusions: Lung COVID-19 lesions can be shown by the initial chest HRCT, which is the preferred imaging method. Thoracic HRCT scans play an important role in the early diagnosis of COVID-19.","PeriodicalId":39377,"journal":{"name":"Zhonghua fang she xue za zhi Chinese journal of radiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48625997","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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