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Neonatal and Infant Lung Disorders: Glossary, Practical Approach, and Diagnoses. 新生儿和婴儿肺部疾病:术语表,实用方法和诊断。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-01 Epub Date: 2023-11-03 DOI: 10.1097/RTI.0000000000000758
Se-Young Yoon, Nathan David P Concepcion, Olivia DiPrete, Sara O Vargas, Abbey J Winant, Pilar Garcia-Peña, Winnie C Chu, Joanna Kasznia-Brown, Pedro Daltro, Edward Y Lee, Bernard F Laya

A multitude of lung disorders ranging from congenital and genetic anomalies to iatrogenic complications can affect the neonate or the infant within the first year of life. Neonatal and infant chest imaging, predominantly by plain radiography and computed tomography, is frequently employed to aid in diagnosis and management; however, these disorders can be challenging to differentiate due to their broad-ranging, and frequently overlapping radiographic features. A systematic and practical approach to imaging interpretation which includes recognition of radiologic patterns, utilization of commonly accepted nomenclature and classification, as well as interpretation of imaging findings in conjunction with clinical history can not only assist radiologists to suggest the diagnosis, but also aid clinicians in management planning. The contents of this article were endorsed by the leadership of both the World Federation of Pediatric Imaging (WFPI), and the International Society of Pediatric Thoracic Imaging (ISPTI).

许多肺部疾病,从先天性和遗传异常到医源性并发症,都可能在出生后的第一年影响新生儿或婴儿。新生儿和婴儿胸部成像,主要是通过x线平片和计算机断层扫描,经常用于帮助诊断和管理;然而,由于这些疾病范围广泛,并且经常重叠的影像学特征,因此很难区分。一种系统实用的影像学解释方法,包括对放射学模式的识别,普遍接受的命名法和分类的使用,以及结合临床病史对影像学结果的解释,不仅可以帮助放射科医生提出诊断建议,还可以帮助临床医生制定管理计划。本文的内容得到了世界儿科影像联合会(WFPI)和国际儿科胸部影像学会(ISPTI)领导的认可。
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引用次数: 0
Magnetic Resonance Imaging of Pediatric Lungs and Airways: New Paradigm for Practical Daily Clinical Use. 小儿肺和气道的磁共振成像:实用日常临床应用的新范例。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-01 Epub Date: 2023-03-31 DOI: 10.1097/RTI.0000000000000707
Mark C Liszewski, Pierluigi Ciet, Abbey J Winant, Edward Y Lee

Disorders of the lungs and airways are among the most common indications for diagnostic imaging in infants and children. Traditionally, chest radiograph has been the first-line imaging test for detecting these disorders and when cross-sectional imaging is necessary, computed tomography (CT) has typically been the next step. However, due to concerns about the potentially harmful effects of ionizing radiation, pediatric imaging in general has begun to shift away from CT toward magnetic resonance imaging (MRI) as a preferred modality. Several unique technical challenges of chest MRI, including motion artifact from respiratory and cardiac motion as well as low signal-to-noise ratios secondary to relatively low proton density in the lung have slowed this shift in thoracic imaging. However, technical advances in MRI in recent years, including developments in non-Cartesian MRI data sampling methods such as radial, spiral, and PROPELLER imaging and the development of ultrashort TE and zero TE sequences that render CT-like high-quality imaging with minimal motion artifact have allowed for a shift to MRI for evaluation of lung and large airways in centers with specialized expertise. This article presents a practical approach for radiologists in current practice to begin to consider MRI for evaluation of the pediatric lung and large airways and begin to implement it in their practices. The current role for MRI in the evaluation of disorders of the pediatric lung and large airways is reviewed, and example cases are presented. Challenges for MRI of the lung and large airways in children are discussed, practical tips for patient preparation including sedation are described, and imaging techniques suitable for current clinical practice are presented.

肺部和气道疾病是婴幼儿诊断成像最常见的适应症之一。传统上,胸片是检测这些疾病的一线成像检查方法,当需要进行横断面成像时,计算机断层扫描(CT)通常是下一步检查方法。然而,由于担心电离辐射的潜在危害,儿科成像已开始从 CT 转向磁共振成像 (MRI) 作为首选方式。胸部核磁共振成像存在一些独特的技术难题,包括呼吸和心脏运动造成的运动伪影,以及肺部质子密度相对较低导致的低信噪比,这些都减缓了胸部成像的转变。然而,近年来磁共振成像技术的进步,包括非笛卡尔磁共振成像数据取样方法(如径向、螺旋和 PROPELLER 成像)的发展,以及超短 TE 和零 TE 序列的开发,这些技术可提供类似 CT 的高质量成像,同时将运动伪影降到最低。本文介绍了一种实用的方法,让放射科医生在目前的实践中开始考虑用磁共振成像评估小儿肺部和大气管,并开始在他们的实践中实施。文章回顾了磁共振成像目前在评估小儿肺部和大气管疾病中的作用,并列举了一些病例。讨论了儿童肺部和大气道核磁共振成像所面临的挑战,介绍了包括镇静在内的患者准备实用技巧,并介绍了适合当前临床实践的成像技术。
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引用次数: 0
Editors' Recognition for Reviewing in 2023. 编辑表彰 2023 年评审。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-01 Epub Date: 2023-12-21 DOI: 10.1097/RTI.0000000000000769
U Joseph Schoepf, Jeffrey P Kanne, Dorith Shaham
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引用次数: 0
Cardiothoracic Imaging Guidelines Update: Pulmonary Embolism in Pediatrics. 心胸成像指南更新:儿科肺栓塞。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-01-01 Epub Date: 2023-10-05 DOI: 10.1097/RTI.0000000000000751
Paolo Ciliberti, Teresa Pia Santangelo, Alessandra Ottavianelli, Federica Porcaro, Aurelio Secinaro
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引用次数: 0
Risk and Time to Diagnosis of Lung Cancer in Incidental Pulmonary Nodules. 偶发肺结节患肺癌的风险和确诊时间
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-11-27 DOI: 10.1097/rti.0000000000000768
Mark M Hammer
To determine the risk of lung cancer in incidental pulmonary nodules, as well as the time until cancer growth is detected.
确定偶然发现的肺结节罹患肺癌的风险,以及发现癌细胞生长的时间。
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引用次数: 0
Chest Computed Tomography Findings in Unilateral Pulmonary Fibrosis Secondary to Chronic Hypoperfusion. 单侧肺纤维化继发于慢性灌注不足的胸部计算机断层扫描结果。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-11-24 DOI: 10.1097/rti.0000000000000764
Cristina Marrocchio, Stephen M Humphries, David A Lynch
Unilateral lung fibrosis is uncommon and few cases secondary to parenchymal hypoperfusion have been reported, requiring further understanding of this entity. This study aims to report the chest computed tomography (CT) findings of patients with unilateral lung fibrosis related to parenchymal hypoperfusion observed in our institution.
单侧肺纤维化并不常见,继发于肺实质灌注不足的病例也鲜有报道,因此需要进一步了解这一实体。本研究旨在报告我院观察到的与肺实质灌注不足有关的单侧肺纤维化患者的胸部计算机断层扫描(CT)结果。
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引用次数: 0
Identification of Mitral Valve Prolapse on Non-electrocardiography-gated Enhanced Chest Computed Tomography. 非心电图门控增强胸部计算机断层扫描鉴定二尖瓣脱垂。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-11-20 DOI: 10.1097/RTI.0000000000000766
Min Ji Son, Eun Ju Chun, Seung Min Yoo, Soo Jeong Lee, Charles S White

Purpose: The primary imaging modality for the diagnosis of mitral valve prolapse (MVP) is echocardiography supplemented by electrocardiography (ECG)-gated cardiac computed tomography (CT) angiography. However, we have recently encountered patients with MVP who were initially identified on non-ECG-gated enhanced chest CT. The purpose of this study is to evaluate the diagnostic accuracy of non-ECG-gated enhanced chest CT to predict the presence of MVP.

Patients and methods: Of 92 patients (surgically confirmed MVP who underwent non-ECG-gated chest CT), 27 patients were excluded for motion artifact or insufficient surgical correlation, and 65 patients were ultimately included. As a control, 65 patients with dyspnea and without MVP (non-ECG-gated chest CT and echocardiography were performed within 1 month) were randomly selected. We retrospectively analyzed an asymmetric double line sign on axial CT images for the presence of MVP. The asymmetric double line sign was defined as the presence of a linear structure, not located in the plane traversing the mitral annulus.

Results: Use of the asymmetric double line sign to predict MVP on non-ECG-gated CT showed modest sensitivity, high specificity, modest negative predictive value, and high positive predictive value of 59% (38/65), 99% (64/65), 70% (64/91), and 97% (38/39), respectively.

Conclusion: The asymmetric double line sign on non-ECG-gated enhanced chest CT may be a valuable finding to predict the presence of MVP. Familiarity with this CT finding may lead to prompt diagnosis and proper management of MVP.

目的:诊断二尖瓣脱垂(MVP)的主要成像方式是超声心动图辅助心电图(ECG)门控心脏计算机断层扫描(CT)血管造影。然而,我们最近遇到的MVP患者最初是在非ecg门控增强胸部CT上发现的。本研究的目的是评估非ecg门控增强胸部CT诊断MVP存在的准确性。患者和方法:92例患者(手术证实MVP,行非心电图门控胸部CT)中,27例患者因运动伪影或手术相关性不足被排除,最终纳入65例患者。作为对照,随机选择呼吸困难且无MVP的患者65例(1个月内进行非心电图门控胸部CT和超声心动图检查)。我们回顾性分析了轴向CT图像上的不对称双线征,以确定MVP的存在。不对称双线标志被定义为存在线性结构,不位于穿过二尖瓣环的平面上。结果:应用非ecg门控CT非对称双线征象预测MVP,灵敏度适中,特异性高,阴性预测值适中,阳性预测值较高,分别为59%(38/65)、99%(64/65)、70%(64/91)和97%(38/39)。结论:非ecg门控增强胸部CT上的不对称双线征可能是预测MVP存在的一个有价值的发现。熟悉这一CT表现有助于及时诊断和正确处理MVP。
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引用次数: 0
Utilizing Deep Learning and Computed Tomography to Determine Pulmonary Nodule Activity in Patients With Nontuberculous Mycobacterial-Lung Disease 利用深度学习和计算机断层扫描确定非结核分枝杆菌肺病患者的肺结节活动
4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-11-02 DOI: 10.1097/rti.0000000000000745
Andrew C. Lancaster, Mitchell E. Cardin, Jan A. Nguyen, Tej I. Mehta, Dilek Oncel, Harrison X. Bai, Keira A. Cohen, Cheng Ting Lin
To develop and evaluate a deep convolutional neural network (DCNN) model for the classification of acute and chronic lung nodules from nontuberculous mycobacterial-lung disease (NTM-LD) on computed tomography (CT). We collected a data set of 650 nodules (316 acute and 334 chronic) from the CT scans of 110 patients with NTM-LD. The data set was divided into training, validation, and test sets in a ratio of 4:1:1. Bounding boxes were used to crop the 2D CT images down to the area of interest. A DCNN model was built using 11 convolutional layers and trained on these images. The performance of the model was evaluated on the hold-out test set and compared with that of 3 radiologists who independently reviewed the images. The DCNN model achieved an area under the receiver operating characteristic curve of 0.806 for differentiating acute and chronic NTM-LD nodules, corresponding to sensitivity, specificity, and accuracy of 76%, 68%, and 72%, respectively. The performance of the model was comparable to that of the 3 radiologists, who had area under the receiver operating characteristic curve, sensitivity, specificity, and accuracy of 0.693 to 0.771, 61% to 82%, 59% to 73%, and 60% to 73%, respectively. This study demonstrated the feasibility of using a DCNN model for the classification of the activity of NTM-LD nodules on chest CT. The model performance was comparable to that of radiologists. This approach can potentially and efficiently improve the diagnosis and management of NTM-LD.
目的:建立并评价一种深度卷积神经网络(DCNN)模型在计算机断层扫描(CT)上对非结核性分枝杆菌性肺病(NTM-LD)急性和慢性肺结节进行分类。材料和方法:我们从110例NTM-LD患者的CT扫描中收集了650个结节(316个急性和334个慢性)的数据集。数据集按4:1:1的比例分为训练集、验证集和测试集。使用边界框将2D CT图像裁剪到感兴趣的区域。使用11个卷积层构建DCNN模型,并对这些图像进行训练。模型的性能在保留测试集上进行评估,并与3名独立审查图像的放射科医生的性能进行比较。结果:DCNN模型鉴别急慢性NTM-LD结节的受试者工作特征曲线下面积为0.806,敏感性为76%,特异性为68%,准确性为72%。该模型的性能与3名放射科医生相当,他们的受者工作特征曲线下面积、灵敏度、特异性和准确度分别为0.693 ~ 0.771、61% ~ 82%、59% ~ 73%和60% ~ 73%。结论:本研究证明了使用DCNN模型对胸部CT上NTM-LD结节活动性进行分类的可行性。该模型的性能可与放射科医生相媲美。该方法可以有效地改善NTM-LD的诊断和治疗。
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引用次数: 0
Imaging Features of Idiopathic Interstitial Lung Diseases. 特发性间质性肺疾病的影像学特征。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-11-01 Epub Date: 2023-07-12 DOI: 10.1097/RTI.0000000000000728
Kiran Batra, Traci N Adams

Idiopathic interstitial pneumonias (IIPs) are a group of diffuse parenchymal lung diseases of unclear etiology and are distinguished from diffuse parenchymal lung diseases of known cause, such as connective tissue disease-related interstitial lung diseases or hypersensitivity pneumonitis by history, physical exam, imaging, serologic testing, and, when necessary, histopathology. The 2013 American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines are the most widely accepted classification of IIPs and include the following diagnoses: idiopathic pulmonary fibrosis, idiopathic nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, idiopathic lymphocytic interstitial pneumonia, idiopathic pleuro-parenchymal fibroelastosis, respiratory bronchiolitis-interstitial lung disease, and desquamative interstitial pneumonia. The gold standard for diagnosis of IIP involves multidisciplinary discussion among pulmonologists, radiologists, and pathologists. The focus of this review will be to discuss the imaging features of the most common IIPs and the role of multidisciplinary discussion as the gold standard for diagnosis.

特发性间质性肺炎(IIPs)是一组病因不明的弥漫性肺实质疾病,通过病史、体格检查、影像学、血清学检查以及必要时的组织病理学,与已知病因的弥漫性实质性肺疾病(如结缔组织病相关的间质性肺疾病或超敏性肺炎)区分开来。2013年美国胸科学会(ATS)/欧洲呼吸学会(ERS)指南是IIP最广泛接受的分类,包括以下诊断:特发性肺纤维化、特发性非特异性间质性肺炎、隐源性组织性肺炎、急性间质性炎、,特发性胸膜实质弹性纤维变性、呼吸性细支气管炎间质性肺病和脱屑性间质性肺炎。IIP诊断的金标准涉及肺科医生、放射科医生和病理学家之间的多学科讨论。这篇综述的重点将是讨论最常见IIP的成像特征,以及多学科讨论作为诊断金标准的作用。
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引用次数: 2
The Role of Radiology in Multidisciplinary Discussion of Patients With Interstitial Lung Diseases. 放射学在间质性肺疾病患者多学科讨论中的作用。
IF 3.3 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2023-11-01 Epub Date: 2023-08-25 DOI: 10.1097/RTI.0000000000000721
Justin T Stowell, Andy Abril, Andras Khoor, Augustine S Lee, Hassan Z Baig

Radiologists fulfill a vital role in the multidisciplinary care provided to patients with interstitial lung diseases and other diffuse parenchymal lung disorders. The diagnosis of interstitial lung diseases hinges on the consensus of clinical, radiology, and pathology medical subspecialists, but additional expertise from rheumatology, immunology, or hematology can be invaluable. The thin-section computed tomography (CT) features of lung involvement informs the diagnostic approach. Radiologists should be familiar with radiologic methods (including inspiratory/expiratory and prone imaging) and be well versed in the recognition of the CT features of fibrosis, assessment of the overall pattern of lung involvement, and classification according to the latest guidelines. We present a case-based review that highlights examples wherein CT features and subspecialist radiologist interpretation informed the multidisciplinary team consensus diagnosis and care pathways.

放射科医生在为间质性肺病和其他弥漫性实质性肺病患者提供的多学科护理中发挥着至关重要的作用。间质性肺部疾病的诊断取决于临床、放射学和病理学医学亚专业人员的共识,但风湿病学、免疫学或血液学的额外专业知识可能是非常宝贵的。肺部受累的薄层计算机断层扫描(CT)特征为诊断方法提供了依据。放射科医生应熟悉放射学方法(包括吸气/呼气和俯卧成像),并精通纤维化CT特征的识别、肺部受累的总体模式的评估以及根据最新指南的分类。我们提出了一个基于病例的综述,重点介绍了CT特征和亚专业放射科医生解释为多学科团队共识诊断和护理途径提供信息的例子。
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引用次数: 2
期刊
Journal of Thoracic Imaging
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