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Can We Differentiate Between Primary Sjögren Syndrome and Idiopathic Multicentric Castleman Disease Based on the Characteristics of Pulmonary Cysts? 我们能根据肺囊肿的特征区分原发性斯约格伦综合征和特发性多中心卡斯特曼病吗?
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-16 DOI: 10.1097/rti.0000000000000787
Jiamin Zhou, Lu Zhang, Xueqing Liu, Miaoyan Zhang, Ziwei Liu, Ye Jin, Ruie Feng, Juhong Shi, Jian Li, Weihong Zhang
To identify radiological characteristics that could help differentiate cystic lung diseases between primary Sjögren syndrome (pSS) and idiopathic multicentric Castleman disease (iMCD).
确定有助于区分原发性斯约格伦综合征(pSS)和特发性多中心卡斯特曼病(iMCD)的肺囊性疾病的放射学特征。
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引用次数: 0
Abnormal Cardiac Magnetic Resonance-Derived Ascending Aortic Area Strain Demonstrates Altered Ventriculo-Vascular Function in Marfan Syndrome. 异常心脏磁共振推导的升主动脉区应变显示马凡氏综合征的脑室-血管功能发生了改变
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-04-16 DOI: 10.1097/rti.0000000000000784
Xander Jacquemyn, Kyla Cordrey, Jef Van Den Eynde, Anthony L Guerrerio, Gretchen MacCarrick, Hal C Dietz, Shelby Kutty
There remains a need for improved imaging markers for risk stratification and treatment guidance in Marfan syndrome (MFS). After aortic root replacement (ARR), vascular remodeling and progressive aneurysm formation can occur due to alterations in up- and downstream wall biomechanics and hemodynamics. We aim to compare the ventriculo-vascular properties of patients with MFS with controls, and investigate the correlation between ascending aortic area strain and descending aortic area strain (DAAS) with other clinical variables.
马凡综合征(MFS)的风险分层和治疗指导仍需要更好的成像标记物。主动脉根部置换术(ARR)后,由于上下游血管壁生物力学和血流动力学的改变,可能会导致血管重塑和渐进性动脉瘤的形成。我们旨在比较 MFS 患者和对照组的心室血管特性,并研究升主动脉面积应变和降主动脉面积应变(DAAS)与其他临床变量之间的相关性。
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引用次数: 0
Feature-Tracking Strain Parameters Differ Between Highly Accelerated and Conventional Acquisitions: A Multisoftware Assessment. 特征跟踪应变参数在高加速和常规采集之间的差异:多软件评估。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2023-11-06 DOI: 10.1097/RTI.0000000000000762
Moritz C Halfmann, Tim Klimzak, U Joseph Schoepf, Roman Kloeckner, Teodora Chitiboi, Michaela Schmidt, Philip Wenzel, Lukas Müller, Martin Geyer, Akos Varga-Szemes, Karl-Friedrich Kreitner, Christoph Dueber, Tilman Emrich

Background: Cardiac magnetic resonance imaging protocols have been adapted to fit the needs for faster, more efficient acquisitions, resulting in the development of highly accelerated, compressed sensing-based (CS) sequences. The aim of this study was to evaluate intersoftware and interacquisition differences for postprocessing software applied to both CS and conventional cine sequences.

Materials and methods: A total of 106 individuals (66 healthy volunteers, 40 patients with dilated cardiomyopathy, 51% female, 38±17 y) underwent cardiac magnetic resonance at 3T with retrospectively gated conventional cine and CS sequences. Postprocessing was performed using 2 commercially available software solutions and 1 research prototype from 3 different developers. The agreement of clinical and feature-tracking strain parameters between software solutions and acquisition types was assessed by Bland-Altmann analyses and intraclass correlation coefficients. Differences between softwares and acquisitions were assessed using Kruskal-Wallis analysis of variances. In addition, receiver operating characteristic curve-derived cutoffs were used to evaluate whether sequence-specific cutoffs influence disease classification.

Results: There were significant intersoftware ( P <0.002 for all except LV end-diastolic volume per body surface area) and interacquisition differences ( P <0.02 for all except end-diastolic volume per body surface area from Neosoft, left ventricular mass per body surface area from cvi42 and TrufiStrain and global circumferential strain from Neosoft). However, the intraclass correlation coefficients between acquisitions were strong-to-excellent for all parameters (all ≥0.81). In comparing individual softwares to a pooled mean, Bland-Altmann analyses revealed smaller magnitudes of bias for cine acquisition than for CS acquisition. In addition, the application of conventional cutoffs to CS measurements did not result in the false reclassification of patients.

Conclusion: Significantly lower magnitudes of strain and volumetric parameters were observed in retrospectively gated CS acquisitions, despite strong-to-excellent agreement amongst software solutions and acquisition types. It remains important to be aware of the acquisition type in the context of follow-up examinations, where different cutoffs might lead to misclassifications.

背景:心脏磁共振成像方案已经适应了更快、更有效的采集需求,导致了高度加速、压缩的基于感知(CS)序列的发展。本研究的目的是评估应用于CS和传统电影序列的后处理软件的软件间和采集间差异。材料与方法:106例(健康志愿者66例,扩张型心肌病患者40例,女性51%,38±17岁)采用回顾性门控常规cine和CS序列在3T行心脏磁共振。后处理使用了来自3个不同开发商的2个商用软件解决方案和1个研究原型。通过Bland-Altmann分析和类内相关系数评估软件解决方案与采集类型之间临床和特征跟踪应变参数的一致性。软件和收购之间的差异使用Kruskal-Wallis方差分析进行评估。此外,使用受试者工作特征曲线衍生的截止值来评估序列特异性截止值是否影响疾病分类。结论:尽管软件解决方案和采集类型之间具有很强的一致性,但在回顾性门控CS采集中观察到的应变和体积参数值明显较低。在后续检查的背景下,了解获取类型仍然很重要,因为不同的截止值可能导致错误分类。
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引用次数: 0
In Memoriam: Robert D. Pugatch, MD (1945-2023). 悼念罗伯特-D-普加奇医学博士(1945-2023)。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2024-01-15 DOI: 10.1097/RTI.0000000000000775
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引用次数: 0
The Role of Artificial Intelligence in Coronary Calcium Scoring in Standard Cardiac Computed Tomography and Chest Computed Tomography With Different Reconstruction Kernels. 人工智能在标准心脏ct和不同重建核的胸部ct冠状动脉钙化评分中的作用。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2023-11-20 DOI: 10.1097/RTI.0000000000000765
Yenpo Lin, Gigin Lin, Meng-Ting Peng, Chi-Tai Kuo, Yung-Liang Wan, Wen-Jin Cherng

Purpose: To assess the correlation of coronary calcium score (CS) obtained by artificial intelligence (AI) with those obtained by electrocardiography gated standard cardiac computed tomography (CCT) and nongated chest computed tomography (ChCT) with different reconstruction kernels.

Patients and methods: Seventy-six patients received standard CCT and ChCT simultaneously. We compared CS obtained in 4 groups: CS CCT , by the traditional method from standard CCT, 25 cm field of view, 3 mm slice thickness, and kernel filter convolution 12 (FC12); CS AICCT , by AI from the standard CCT; CS ChCTsoft , by AI from the non-gated CCT, 40 cm field of view, 3 mm slice thickness, and a soft kernel FC02; and CS ChCTsharp , by AI from CCT image with same parameters for CS ChCTsoft except for using a sharp kernel FC56. Statistical analyses included Spearman rank correlation coefficient (ρ), intraclass correlation (ICC), Bland-Altman plots, and weighted kappa analysis (κ).

Results: The CS AICCT was consistent with CS CCT (ρ = 0.994 and ICC of 1.00, P < 0.001) with excellent agreement with respect to cardiovascular (CV) risk categories of the Agatston score (κ = 1.000). The correlation between CS ChCTsoft and CS ChCTsharp was good (ρ = 0.912, 0.963 and ICC = 0.929, 0.948, respectively, P < 0.001) with a tendency of underestimation (Bland-Altman mean difference and 95% upper and lower limits of agreements were 329.1 [-798.9 to 1457] and 335.3 [-651.9 to 1322], respectively). The CV risk category agreement between CS ChCTsoft and CS ChCTsharp was moderate (κ = 0.556 and 0.537, respectively).

Conclusions: There was an excellent correlation between CS CCT and CS AICCT , with excellent agreement between CV risk categories. There was also a good correlation between CS CCT and CS obtained by ChCT albeit with a tendency for underestimation and moderate accuracy in terms of CV risk assessment.

目的:评价人工智能(AI)获得的冠状动脉钙化评分(CS)与不同重建核数的心电图门控标准心脏计算机断层扫描(CCT)和非栅格胸部计算机断层扫描(ChCT)的相关性。患者和方法:76例患者同时接受标准CCT和ChCT。我们比较了四组CS: CSCCT,采用传统方法获得标准CCT, 25 cm视场,3 mm切片厚度,核滤波器卷积12 (FC12);CSAICCT,由AI从标准的CCT;CSChCTsoft,由人工智能从非门控CCT, 40厘米的视野,3毫米的切片厚度,和一个软核FC02;CSChCTsharp和CSChCTsharp,由人工智能从CSChCTsoft的CCT图像中获得相同的参数,只是使用了锐利内核FC56。统计分析包括Spearman等级相关系数(ρ)、类内相关系数(ICC)、Bland-Altman图和加权kappa分析(κ)。结果:CSAICCT与CSCCT结果一致(ρ = 0.994, ICC为1.00,P < 0.001),与Agatston评分的心血管(CV)危险类别吻合极好(κ = 1.000)。CSChCTsoft与CSChCTsharp的相关性较好(ρ = 0.912、0.963,ICC = 0.929、0.948,P < 0.001),有低估倾向(Bland-Altman平均差值和95%上下限分别为329.1[-798.9 ~ 1457]和335.3[-651.9 ~ 1322])。CSChCTsoft和CSChCTsharp的CV风险类别一致性中等(κ分别= 0.556和0.537)。结论:CSCCT和CSAICCT之间有很好的相关性,CV风险类别之间有很好的一致性。CSCCT与ChCT获得的CS之间也有良好的相关性,尽管在CV风险评估方面存在低估和中等准确性的倾向。
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引用次数: 0
Approach to Imaging of Patients Presenting With Acute Coronary Syndrome With No Culprit Lesion Identified at Angiography. 对急性冠状动脉综合征患者进行血管造影时未发现病灶的造影方法。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2024-01-19 DOI: 10.1097/RTI.0000000000000773
Tiffany T Ni, Wendy Tsang, Elsie T Nguyen

Chest pain is a common chief complaint among patients presenting to the emergency department. However, in the scenario where the clinical presentation is consistent with acute coronary syndrome and no culprit lesions are identified on angiography, clinicians and cardiac imagers should be informed of the differential diagnosis and appropriate imaging modalities used to investigate the potential causes. This review describes an imaging-based algorithm that highlights the diagnostic possibilities, their differentiating imaging features, and the important role of cardiovascular magnetic resonance imaging for narrowing the differential diagnosis.

胸痛是急诊科就诊患者的常见主诉。然而,如果临床表现与急性冠状动脉综合征一致,但血管造影检查未发现罪魁祸首病变,临床医生和心脏造影师应了解鉴别诊断以及用于调查潜在病因的适当造影模式。本综述介绍了一种基于影像学的算法,该算法强调了诊断的可能性、影像学的鉴别特征以及心血管磁共振成像在缩小鉴别诊断范围方面的重要作用。
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引用次数: 0
Functional Impairment in Small Airways Associated With the Breathlessness Symptoms in Long-Coronavirus Disease. 小型航空公司的功能损害和长期冠状病毒疾病的呼吸困难症状有关。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2023-10-09 DOI: 10.1097/RTI.0000000000000748
Minsuok Kim, Jeongeun Hwang, James T Grist, Gabriele Abueid, Soon Ho Yoon, Vicente Grau, Emily Fraser, Fergus V Gleeson

Purpose: This study aimed to determine the association between functional impairment in small airways and symptoms of dyspnea in patients with Long-coronavirus disease (COVID), using imaging and computational modeling analysis.

Patients and methods: Thirty-four patients with Long-COVID underwent thoracic computed tomography and hyperpolarized Xenon-129 magnetic resonance imaging (HP Xe MRI) scans. Twenty-two answered dyspnea-12 questionnaires. We used a computed tomography-based full-scale airway network (FAN) flow model to simulate pulmonary ventilation. The ventilation distribution projected on a coronal plane and the percentage lobar ventilation modeled in the FAN model were compared with the HP Xe MRI data. To assess the ventilation heterogeneity in small airways, we calculated the fractal dimensions of the impaired ventilation regions in the HP Xe MRI and FAN models.

Results: The ventilation distribution projected on a coronal plane showed an excellent resemblance between HP Xe MRI scans and FAN models (structure similarity index: 0.87 ± 0.04). In both the image and the model, the existence of large clustered ventilation defects was not identifiable regardless of dyspnea severity. The percentage lobar ventilation of the HP Xe MRI and FAN model showed a strong correlation (ρ = 0.63, P < 0.001). The difference in the fractal dimension of impaired ventilation zones between the low and high dyspnea-12 score groups was significant (HP Xe MRI: 1.97 [1.89 to 2.04] and 2.08 [2.06 to 2.14], P = 0.005; FAN: 2.60 [2.59 to 2.64] and 2.64 [2.63 to 2.65], P = 0.056).

Conclusions: This study has identified a potential association of small airway functional impairment with breathlessness in Long-COVID, using fractal analysis of HP Xe MRI scans and FAN models.

目的:本研究旨在通过成像和计算建模分析,确定长期冠状病毒病(COVID)患者小气道功能损伤与呼吸困难症状之间的关系。患者和方法:34名Long COVID患者接受了胸部计算机断层扫描和超极化Xenon-129磁共振成像(HP Xe MRI)扫描。22人回答了12项运动障碍问卷。我们使用基于计算机断层扫描的全尺寸气道网络(FAN)流量模型来模拟肺通气。将冠状面上投影的通气分布和FAN模型中建模的肺叶通气百分比与HP Xe MRI数据进行比较。为了评估小气道的通气异质性,我们计算了HP Xe MRI和FAN模型中受损通气区域的分形维数。结果:投影在冠状面上的通气分布显示,HP Xe MRI扫描与FAN模型非常相似(结构相似指数:0.87±0.04)。在图像和模型中,无论呼吸困难的严重程度如何,都无法识别是否存在大型聚集性通气缺陷。HP Xe MRI和FAN模型的肺叶通气百分比显示出很强的相关性(ρ=0.63,P<0.001)。低和高呼吸困难12分组之间通气受损区的分形维数差异显著(HP Xe MRI:1.97[1.89至2.04]和2.08[2.06至2.14],P=0.005;FAN:2.60[2.59至2.64]和2.64[2.63至2.65],P=0.056)这项研究通过对HP Xe MRI扫描和FAN模型的分形分析,确定了长期新冠肺炎患者小气道功能损伤和呼吸困难的潜在关联。
{"title":"Functional Impairment in Small Airways Associated With the Breathlessness Symptoms in Long-Coronavirus Disease.","authors":"Minsuok Kim, Jeongeun Hwang, James T Grist, Gabriele Abueid, Soon Ho Yoon, Vicente Grau, Emily Fraser, Fergus V Gleeson","doi":"10.1097/RTI.0000000000000748","DOIUrl":"10.1097/RTI.0000000000000748","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the association between functional impairment in small airways and symptoms of dyspnea in patients with Long-coronavirus disease (COVID), using imaging and computational modeling analysis.</p><p><strong>Patients and methods: </strong>Thirty-four patients with Long-COVID underwent thoracic computed tomography and hyperpolarized Xenon-129 magnetic resonance imaging (HP Xe MRI) scans. Twenty-two answered dyspnea-12 questionnaires. We used a computed tomography-based full-scale airway network (FAN) flow model to simulate pulmonary ventilation. The ventilation distribution projected on a coronal plane and the percentage lobar ventilation modeled in the FAN model were compared with the HP Xe MRI data. To assess the ventilation heterogeneity in small airways, we calculated the fractal dimensions of the impaired ventilation regions in the HP Xe MRI and FAN models.</p><p><strong>Results: </strong>The ventilation distribution projected on a coronal plane showed an excellent resemblance between HP Xe MRI scans and FAN models (structure similarity index: 0.87 ± 0.04). In both the image and the model, the existence of large clustered ventilation defects was not identifiable regardless of dyspnea severity. The percentage lobar ventilation of the HP Xe MRI and FAN model showed a strong correlation (ρ = 0.63, P < 0.001). The difference in the fractal dimension of impaired ventilation zones between the low and high dyspnea-12 score groups was significant (HP Xe MRI: 1.97 [1.89 to 2.04] and 2.08 [2.06 to 2.14], P = 0.005; FAN: 2.60 [2.59 to 2.64] and 2.64 [2.63 to 2.65], P = 0.056).</p><p><strong>Conclusions: </strong>This study has identified a potential association of small airway functional impairment with breathlessness in Long-COVID, using fractal analysis of HP Xe MRI scans and FAN models.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":"79-85"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Multiparametric Cardiovascular Magnetic Resonance in Nonhospitalized COVID-19 Infection Subjects: An Intraindividual Comparison Study. 非住院 COVID-19 感染者的多参数心血管磁共振成像:一项个体内比较研究。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2024-01-25 DOI: 10.1097/RTI.0000000000000774
Jun Zhang, Song Luo, Jun Cai, Xiang Kong, Lingyan Zhang, Li Qi, Long Jiang Zhang

Purpose: To investigate intraindividual cardiac structural and functional changes before and after COVID-19 infection in a previously healthy population with a 3T cardiac magnetic resonance (CMR).

Materials and methods: A total of 39 unhospitalized patients with COVID-19 were recruited. They participated in our previous study as non-COVID-19 healthy volunteers undergoing baseline CMR examination and were recruited to perform a repeated CMR examination after confirmed COVID-19 infection in December 2022. The CMR parameters were measured and compared between before and after COVID-19 infection with paired t tests. The laboratory measures including myocardial enzymes and inflammatory indicators were also collected when performing repeated CMR.

Results: The median duration was 393 days from the first to second CMR and 26 days from clinical symptoms onset to the second CMR. Four patients (10.3%, 4/39) had the same late gadolinium enhancement pattern at baseline and repeated CMR and 5 female patients (12.8%, 5/39) had myocardial T2 ratio >2 (2.07 to 2.27) but with normal T2 value in post-COVID-19 CMR. All other CMR parameters were in normal ranges before and after COVID-19 infection. Between before and after the COVID-19 infection, there were no significant differences in cardiac structure, function, and tissue characterization, no matter with or without symptoms (fatigue, chest discomfort, palpitations, shortness of breath, and insomnia/sleep disorders) (all P >0.05). The laboratory measures at repeated CMR were in normal ranges in all participants.

Conclusions: These intraindividual CMR studies showed unhospitalized patients with COVID-19 with normal myocardial enzymes had no measurable CMR abnormalities, which can help alleviate wide social concerns about COVID-19-related myocarditis.

目的:利用 3T 心脏磁共振(CMR)研究既往健康人群感染 COVID-19 前后个体内部心脏结构和功能的变化:共招募了 39 名未住院的 COVID-19 患者。他们作为非 COVID-19 健康志愿者参与了我们之前的研究,并接受了基线 CMR 检查。研究人员测量了CMR参数,并通过配对t检验比较了感染COVID-19前后的CMR参数。在进行重复CMR检查时,还收集了包括心肌酶和炎症指标在内的实验室指标:从第一次到第二次CMR检查的中位时间为393天,从临床症状出现到第二次CMR检查的中位时间为26天。4名患者(10.3%,4/39)在基线和重复CMR检查中出现相同的晚期钆增强模式,5名女性患者(12.8%,5/39)的心肌T2比值大于2(2.07至2.27),但在COVID-19后CMR检查中T2值正常。感染 COVID-19 前后,所有其他 CMR 参数均在正常范围内。感染 COVID-19 前后,无论有无症状(疲劳、胸部不适、心悸、气短和失眠/睡眠障碍),心脏结构、功能和组织特征均无明显差异(均 P>0.05)。所有参与者在重复进行 CMR 时的实验室指标均在正常范围内:这些个体内部 CMR 研究表明,心肌酶正常的 COVID-19 非住院患者没有可测量的 CMR 异常,这有助于减轻社会对 COVID-19 相关心肌炎的广泛担忧。
{"title":"Multiparametric Cardiovascular Magnetic Resonance in Nonhospitalized COVID-19 Infection Subjects: An Intraindividual Comparison Study.","authors":"Jun Zhang, Song Luo, Jun Cai, Xiang Kong, Lingyan Zhang, Li Qi, Long Jiang Zhang","doi":"10.1097/RTI.0000000000000774","DOIUrl":"10.1097/RTI.0000000000000774","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate intraindividual cardiac structural and functional changes before and after COVID-19 infection in a previously healthy population with a 3T cardiac magnetic resonance (CMR).</p><p><strong>Materials and methods: </strong>A total of 39 unhospitalized patients with COVID-19 were recruited. They participated in our previous study as non-COVID-19 healthy volunteers undergoing baseline CMR examination and were recruited to perform a repeated CMR examination after confirmed COVID-19 infection in December 2022. The CMR parameters were measured and compared between before and after COVID-19 infection with paired t tests. The laboratory measures including myocardial enzymes and inflammatory indicators were also collected when performing repeated CMR.</p><p><strong>Results: </strong>The median duration was 393 days from the first to second CMR and 26 days from clinical symptoms onset to the second CMR. Four patients (10.3%, 4/39) had the same late gadolinium enhancement pattern at baseline and repeated CMR and 5 female patients (12.8%, 5/39) had myocardial T2 ratio >2 (2.07 to 2.27) but with normal T2 value in post-COVID-19 CMR. All other CMR parameters were in normal ranges before and after COVID-19 infection. Between before and after the COVID-19 infection, there were no significant differences in cardiac structure, function, and tissue characterization, no matter with or without symptoms (fatigue, chest discomfort, palpitations, shortness of breath, and insomnia/sleep disorders) (all P >0.05). The laboratory measures at repeated CMR were in normal ranges in all participants.</p><p><strong>Conclusions: </strong>These intraindividual CMR studies showed unhospitalized patients with COVID-19 with normal myocardial enzymes had no measurable CMR abnormalities, which can help alleviate wide social concerns about COVID-19-related myocarditis.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":"86-92"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep Learning-Based Automated Labeling of Coronary Segments for Structured Reporting of Coronary Computed Tomography Angiography in Accordance With Society of Cardiovascular Computed Tomography Guidelines. 根据心血管计算机断层扫描学会指南,基于深度学习的冠状动脉段自动标记用于冠状动脉计算机断层扫描血管造影的结构化报告。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2023-10-11 DOI: 10.1097/RTI.0000000000000753
Verena Brandt, Andreas Fischer, Uwe Joseph Schoepf, Raffi Bekeredjian, Christian Tesche, Gilberto J Aquino, Jim O'Doherty, Puneet Sharma, Mehmet A Gülsün, Paul Klein, Asik Ali, William Evans Few, Tilman Emrich, Akos Varga-Szemes, Josua A Decker

Purpose: To evaluate a novel deep learning (DL)-based automated coronary labeling approach for structured reporting of coronary artery disease according to the guidelines of the Society of Cardiovascular Computed Tomography (CT) on coronary CT angiography (CCTA).

Patients and methods: A retrospective cohort of 104 patients (60.3 ± 10.7 y, 61% males) who had undergone prospectively electrocardiogram-synchronized CCTA were included. Coronary centerlines were automatically extracted, labeled, and validated by 2 expert readers according to Society of Cardiovascular CT guidelines. The DL algorithm was trained on 706 radiologist-annotated cases for the task of automatically labeling coronary artery centerlines. The architecture leverages tree-structured long short-term memory recurrent neural networks to capture the full topological information of the coronary trees by using a two-step approach: a bottom-up encoding step, followed by a top-down decoding step. The first module encodes each sub-tree into fixed-sized vector representations. The decoding module then selectively attends to the aggregated global context to perform the local assignation of labels. To assess the performance of the software, percentage overlap was calculated between the labels of the algorithm and the expert readers.

Results: A total number of 1491 segments were identified. The artificial intelligence-based software approach yielded an average overlap of 94.4% compared with the expert readers' labels ranging from 87.1% for the posterior descending artery of the right coronary artery to 100% for the proximal segment of the right coronary artery. The average computational time was 0.5 seconds per case. The interreader overlap was 96.6%.

Conclusions: The presented fully automated DL-based coronary artery labeling algorithm provides fast and precise labeling of the coronary artery segments bearing the potential to improve automated structured reporting for CCTA.

目的:根据心血管计算机断层扫描学会(CT)关于冠状动脉CT血管造影术(CCTA)的指南,评估一种新的基于深度学习(DL)的自动冠状动脉标记方法,用于结构化报告冠状动脉疾病。患者和方法:一个由104名患者(60.3±10.7岁,61%男性)组成的回顾性队列包括心电图同步CCTA。根据心血管CT学会指南,由2名专家读者自动提取、标记和验证冠状动脉中心线。DL算法在706个放射科医生注释的病例上进行了训练,用于自动标记冠状动脉中心线。该架构利用树结构的长短期记忆递归神经网络,通过使用两步方法来捕获冠状动脉树的完整拓扑信息:自下而上的编码步骤,然后是自上而下的解码步骤。第一模块将每个子树编码为固定大小的向量表示。解码模块然后选择性地关注聚合的全局上下文以执行标签的本地分配。为了评估软件的性能,计算了算法标签和专家读者之间的重叠百分比。结果:共鉴定出1491个片段。与专家读者的标签相比,基于人工智能的软件方法产生了94.4%的平均重叠,从右冠状动脉后降支的87.1%到右冠状动脉近端的100%。平均计算时间为每种情况0.5秒。标题间重叠为96.6%。结论:所提出的基于DL的全自动冠状动脉标记算法提供了对冠状动脉节段的快速精确标记,有可能改进CCTA的自动化结构化报告。
{"title":"Deep Learning-Based Automated Labeling of Coronary Segments for Structured Reporting of Coronary Computed Tomography Angiography in Accordance With Society of Cardiovascular Computed Tomography Guidelines.","authors":"Verena Brandt, Andreas Fischer, Uwe Joseph Schoepf, Raffi Bekeredjian, Christian Tesche, Gilberto J Aquino, Jim O'Doherty, Puneet Sharma, Mehmet A Gülsün, Paul Klein, Asik Ali, William Evans Few, Tilman Emrich, Akos Varga-Szemes, Josua A Decker","doi":"10.1097/RTI.0000000000000753","DOIUrl":"10.1097/RTI.0000000000000753","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate a novel deep learning (DL)-based automated coronary labeling approach for structured reporting of coronary artery disease according to the guidelines of the Society of Cardiovascular Computed Tomography (CT) on coronary CT angiography (CCTA).</p><p><strong>Patients and methods: </strong>A retrospective cohort of 104 patients (60.3 ± 10.7 y, 61% males) who had undergone prospectively electrocardiogram-synchronized CCTA were included. Coronary centerlines were automatically extracted, labeled, and validated by 2 expert readers according to Society of Cardiovascular CT guidelines. The DL algorithm was trained on 706 radiologist-annotated cases for the task of automatically labeling coronary artery centerlines. The architecture leverages tree-structured long short-term memory recurrent neural networks to capture the full topological information of the coronary trees by using a two-step approach: a bottom-up encoding step, followed by a top-down decoding step. The first module encodes each sub-tree into fixed-sized vector representations. The decoding module then selectively attends to the aggregated global context to perform the local assignation of labels. To assess the performance of the software, percentage overlap was calculated between the labels of the algorithm and the expert readers.</p><p><strong>Results: </strong>A total number of 1491 segments were identified. The artificial intelligence-based software approach yielded an average overlap of 94.4% compared with the expert readers' labels ranging from 87.1% for the posterior descending artery of the right coronary artery to 100% for the proximal segment of the right coronary artery. The average computational time was 0.5 seconds per case. The interreader overlap was 96.6%.</p><p><strong>Conclusions: </strong>The presented fully automated DL-based coronary artery labeling algorithm provides fast and precise labeling of the coronary artery segments bearing the potential to improve automated structured reporting for CCTA.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":"93-100"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54231946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
FFR CT and Static Computed Tomography Myocardial Perfusion Imaging for Therapeutic Decision-making and Prognosis in Patients With Coronary Artery Disease. FFRCT 和静态计算机断层扫描心肌灌注成像用于冠状动脉疾病患者的治疗决策和预后。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-03-01 Epub Date: 2023-05-22 DOI: 10.1097/RTI.0000000000000718
Su Yu Li, Jian Zhong, Hong Yan Qiao, U Joseph Schoepf, Tilman Emrich, W Nicholas Butler, Rui Zuo, Yi Xue, Ya Liu, Li Yan Dai, Chang Sheng Zhou, Guang Ming Lu, Chun Xiang Tang, Long Jiang Zhang

Purpose: The purpose of this study was to investigate the effect of integrated evaluation of resting static computed tomography perfusion (CTP) and coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFR CT ) on therapeutic decision-making and predicting major adverse cardiovascular events (MACEs) in patients with suspected coronary artery disease.

Materials and methods: In this post hoc analysis of a prospective trial of CCTA in patients assigned to either CCTA or CCTA plus FFR CT arms, 500 patients in the CCTA plus FFR CT arm were analyzed. Both resting static CTP and FFR CT were evaluated by using the conventional CCTA. Perfusion defects in the myocardial segments with ≥50% degree of stenosis in the supplying vessels were defined as resting static CTP positive, and any vessel with an FFR CT value of ≤0.80 was considered positive. Patients were divided into 3 groups: (1) negative CTP-FFR CT match group (resting static CTP-negative and FFR CT -negative group); (2) mismatch CTP-FFR CT group (resting static CTP-positive and FFR CT -negative or resting static CTP-negative and FFR CT -positive group); and (3) positive CTP-FFR CT match group (resting static CTP-positive and FFR CT -positive group). We compared the revascularization-to-invasive coronary angiography ratio and the MACE rate among 3 subgroups at 1- and 3-year follow-ups. The adjusted Cox hazard proportional model was used to assess the prognostic value of FFR CT and resting static CTP to determine patients at risk of MACE.

Results: Patients in the positive CTP-FFR CT match group were more likely to undergo revascularization at the time of invasive coronary angiography compared with those in the mismatch CTP-FFR CT group (81.4% vs 57.7%, P =0.033) and the negative CTP-FFR CT match group (81.4% vs 33.3%, P= 0.001). At 1- and 3-year follow-ups, patients in the positive CTP-FFR CT match group were more likely to have MACE than those in the mismatch CTP-FFR CT group (10.5% vs 4.2%, P= 0.046; 35.6% vs 9.4%, P <0.001) and the negative CTP-FFR CT match group (10.5% vs 0.9%, P <0.001; 35.6% vs 5.4%, P <0.001). A positive CTP-FFR CT match was strongly related to MACE at 1-year (hazard ratio=8.06, P= 0.003) and 3-year (hazard ratio=6.23, P <0.001) follow-ups.

Conclusion: In patients with suspected coronary artery disease, the combination of FFR CT with resting static CTP could guide therapeutic decisions and have a better prognosis with fewer MACE in a real-world scenario.

目的:本研究旨在探讨静息静态计算机断层扫描灌注(CTP)和冠状动脉计算机断层扫描血管造影(CCTA)得出的分数血流储备(FFRCT)的综合评估对疑似冠状动脉疾病患者的治疗决策和主要不良心血管事件(MACE)预测的影响:在这项前瞻性 CCTA 试验的事后分析中,对分配到 CCTA 或 CCTA 加 FFRCT 两组的 500 名患者进行了分析。静息静态 CTP 和 FFRCT 均通过传统的 CCTA 进行评估。供血血管狭窄程度≥50%的心肌段灌注缺损被定义为静息静态CTP阳性,FFRCT值≤0.80的任何血管均被视为阳性。患者被分为三组:(1)CTP-FFRCT匹配阴性组(静息CTP阴性和FFRCT阴性组);(2)CTP-FFRCT不匹配组(静息CTP阳性和FFRCT阴性或静息CTP阴性和FFRCT阳性组);(3)CTP-FFRCT匹配阳性组(静息CTP阳性和FFRCT阳性组)。我们比较了 3 个亚组在 1 年和 3 年随访时血管重建与有创冠状动脉造影的比率和 MACE 发生率。我们使用调整后的 Cox 危险比例模型来评估 FFRCT 和静息 CTP 的预后价值,以确定有 MACE 风险的患者:结果:与CTP-FFRCT匹配不匹配组(81.4% vs 57.7%,P=0.033)和CTP-FFRCT匹配阴性组(81.4% vs 33.3%,P=0.001)相比,CTP-FFRCT匹配阳性组患者在进行有创冠状动脉造影时更有可能接受血管重建。在1年和3年的随访中,CTP-FFRCT匹配阳性组患者发生MACE的几率高于CTP-FFRCT不匹配组(10.5% vs 4.2%,P=0.046;35.6% vs 9.4%,PC结论:对于疑似冠状动脉疾病患者,将 FFRCT 与静息静态 CTP 相结合可指导治疗决策,在真实世界中,预后更好,MACE 更少。
{"title":"FFR CT and Static Computed Tomography Myocardial Perfusion Imaging for Therapeutic Decision-making and Prognosis in Patients With Coronary Artery Disease.","authors":"Su Yu Li, Jian Zhong, Hong Yan Qiao, U Joseph Schoepf, Tilman Emrich, W Nicholas Butler, Rui Zuo, Yi Xue, Ya Liu, Li Yan Dai, Chang Sheng Zhou, Guang Ming Lu, Chun Xiang Tang, Long Jiang Zhang","doi":"10.1097/RTI.0000000000000718","DOIUrl":"10.1097/RTI.0000000000000718","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to investigate the effect of integrated evaluation of resting static computed tomography perfusion (CTP) and coronary computed tomography angiography (CCTA)-derived fractional flow reserve (FFR CT ) on therapeutic decision-making and predicting major adverse cardiovascular events (MACEs) in patients with suspected coronary artery disease.</p><p><strong>Materials and methods: </strong>In this post hoc analysis of a prospective trial of CCTA in patients assigned to either CCTA or CCTA plus FFR CT arms, 500 patients in the CCTA plus FFR CT arm were analyzed. Both resting static CTP and FFR CT were evaluated by using the conventional CCTA. Perfusion defects in the myocardial segments with ≥50% degree of stenosis in the supplying vessels were defined as resting static CTP positive, and any vessel with an FFR CT value of ≤0.80 was considered positive. Patients were divided into 3 groups: (1) negative CTP-FFR CT match group (resting static CTP-negative and FFR CT -negative group); (2) mismatch CTP-FFR CT group (resting static CTP-positive and FFR CT -negative or resting static CTP-negative and FFR CT -positive group); and (3) positive CTP-FFR CT match group (resting static CTP-positive and FFR CT -positive group). We compared the revascularization-to-invasive coronary angiography ratio and the MACE rate among 3 subgroups at 1- and 3-year follow-ups. The adjusted Cox hazard proportional model was used to assess the prognostic value of FFR CT and resting static CTP to determine patients at risk of MACE.</p><p><strong>Results: </strong>Patients in the positive CTP-FFR CT match group were more likely to undergo revascularization at the time of invasive coronary angiography compared with those in the mismatch CTP-FFR CT group (81.4% vs 57.7%, P =0.033) and the negative CTP-FFR CT match group (81.4% vs 33.3%, P= 0.001). At 1- and 3-year follow-ups, patients in the positive CTP-FFR CT match group were more likely to have MACE than those in the mismatch CTP-FFR CT group (10.5% vs 4.2%, P= 0.046; 35.6% vs 9.4%, P <0.001) and the negative CTP-FFR CT match group (10.5% vs 0.9%, P <0.001; 35.6% vs 5.4%, P <0.001). A positive CTP-FFR CT match was strongly related to MACE at 1-year (hazard ratio=8.06, P= 0.003) and 3-year (hazard ratio=6.23, P <0.001) follow-ups.</p><p><strong>Conclusion: </strong>In patients with suspected coronary artery disease, the combination of FFR CT with resting static CTP could guide therapeutic decisions and have a better prognosis with fewer MACE in a real-world scenario.</p>","PeriodicalId":49974,"journal":{"name":"Journal of Thoracic Imaging","volume":" ","pages":"101-110"},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9566106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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Journal of Thoracic Imaging
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