Acta radiologica open最新文献_第9页

Early experience in avoiding biopsies for biopsy-naïve men with clinical suspicion of prostate cancer but non-suspicious biparametric magnetic resonance imaging results and prostate-specific antigen density < 0.15 ng/mL2: A 2-year follow-up study 临床怀疑患有前列腺癌症但无可疑双参数磁共振成像结果且前列腺特异性抗原密度<0.15 ng/mL的生物合成男性避免活检的早期经验2：一项为期2年的随访研究

Acta radiologica open

Pub Date : 2022-04-01 DOI: 10.1177/20584601221094825

Karen-Cecilie Kortenbach, V. Løgager, H. Thomsen, L. Boesen

Background Only limited data have been published on the diagnostic accuracy of combining biparametric (bp) magnetic resonance imaging (MRI) and prostate-specific antigen density (PSAd) to rule out biopsies. Purpose The purpose is to assess the 2-year risk of being diagnosed with sPCa following the strategy of avoiding immediate biopsies in men with non-suspicious bp MRIs and a PSAd <0.15 ng/mL2. Material and Methods Two hundred biopsy-naïve men with clinical suspicion of PCa underwent a pre-biopsy bp MRI from March to July 2019. Of these, 109 men had a Prostate Imaging Reporting and Data System (PI-RADS) score of 1–3 including 77 men with calculated PSAd <0.15 ng/mL2. As a result, no biopsies were performed in these 77 men, who were clinically followed up for at least 2 years and re-examined in case of rising suspicion of sPCa. The remaining 32 men with a calculated PSAd ≥0.15 ng/mL2 underwent systematic biopsies and targeted biopsies of any PI-RADS 3 lesion. Results One of the 77 men (1.3%) had an sPCa diagnosed within 2 years of follow-up. All men were referred back to their general practitioner within 1 year and 9% (7/77) were re-referred to the urology department during follow-up. Among these men, 43% (3/7) continued to have PSA levels that were above their individual thresholds at confirmatory testing and underwent secondary MRI scans. Conclusions No biopsies for men with bpMRI results exhibiting maximum PI-RADS 3 and with a PSAd <0.15 ng/mL2 resulted in a 2-year risk of being diagnosed with sPCa of 1.3%.

背景关于结合双参数（bp）磁共振成像（MRI）和前列腺特异性抗原密度（PSAd）排除活检的诊断准确性，只有有限的数据发表。目的本研究旨在评估在无可疑bp MRI和PSAd<0.15 ng/mL2的男性中，遵循避免立即活检的策略，诊断为sPCa的2年风险。材料和方法2019年3月至7月，200名临床怀疑前列腺癌的活检幼稚男性接受了活检前bp MRI检查。其中，109名男性的前列腺成像报告和数据系统（PI-RADS）评分为1-3，其中77名男性的PSAd计算值<0.15 ng/mL2。因此，在这77名男性中没有进行活检，他们进行了至少2年的临床随访，并在怀疑sPCa增加的情况下重新检查。其余32名计算PSAd≥0.15 ng/mL2的男性接受了系统活检和任何PI-RADS 3病变的靶向活检。结果77名男性中有1名（1.3%）在随访2年内被诊断为sPCa。所有男性在1年内被转诊回其全科医生，9%（7/77）在随访期间被转诊到泌尿外科。在这些男性中，43%（3/7）的PSA水平在确认测试中仍高于个人阈值，并接受了二次MRI扫描。结论对于bpMRI结果显示最大PI-RADS 3且PSAd＜0.15 ng/mL2的男性，没有活检导致诊断为sPCa的2年风险为1.3%。

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引用次数: 3

Magnification assessment of radiographs for knee replacement (MARKeR) – A pilot study in a low-resource setting 膝关节置换术（MARKeR）射线照片的放大率评估——一项低资源环境下的试点研究

Acta radiologica open

Pub Date : 2022-04-01 DOI: 10.1177/20584601221096297

M. Mencia, R. Goalan, Kimani White

Background Selecting the correct size of implants to be used in total knee arthroplasty is critical for a successful outcome. Marker-less templating systems use an institutionally derived magnification factor for all radiographs. Purpose To determine the institutional magnification of knee radiographs for patients awaiting total knee arthroplasty. Material and Methods Eighty patients awaiting total knee arthroplasty underwent preoperative knee radiographs using a standardized protocol. A marker attached to the patients’ knees at the level of the knee joint was used to calculate the magnification factor on both anteroposterior (AP) and lateral (LAT) views. Two independent observers estimated the magnification to determine the intra and inter-observer reliability. Results The mean magnification of the AP (15.3%) radiograph was significantly greater than the LAT (12.1%) radiograph (p< 0.0001). Patients with absent markers on their radiographs were heavier than patients in whom the marker was visible (84.7 kgs vs. 76.6 kgs, p=0.01). No marker was visible on the radiographs in 56.3% (45/80) of patients. There was excellent inter and intra-observer reliability of both the AP and LAT measurements. Conclusion After standardizing the protocol for preoperative knee radiographs, our results show significantly greater institutional magnification of the anteroposterior compared with the lateral images. Accurate templating in knee arthroplasty requires both radiographic images. To reduce errors in implant sizing, we recommend surgeons use different institutional magnification factors for the anteroposterior and lateral radiographs.

背景选择合适尺寸的植入物用于全膝关节置换术是取得成功的关键。无标记模板系统对所有射线照片使用制度推导的放大系数。目的确定等待全膝关节置换术的患者膝关节X线片的机构放大率。材料和方法80例等待全膝关节置换术的患者采用标准化方案进行了术前膝关节X线片检查。在患者膝盖的膝关节水平处贴上一个标记，用于计算前后（AP）和横向（LAT）视图的放大系数。两名独立观察者估计了放大倍数，以确定观察者内部和观察者之间的可靠性。结果AP（15.3%）的平均放大率明显高于LAT（12.1%）（p＜0.0001）。射线照片上没有标记的患者比可见标记的患者重（84.7 kgs对76.6 kgs，p＝0.01）。56.3%（45/80）的患者射线照片上看不到标记。AP和LAT测量的观察者间和观察者内均具有良好的可靠性。结论在规范了术前膝关节X线片的方案后，我们的结果显示，与侧位图像相比，前后位图像的机构放大率明显更高。膝关节置换术中的精确模板需要两种射线图像。为了减少植入物尺寸的误差，我们建议外科医生使用不同的机构放大系数进行前后和侧位射线照相。

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引用次数: 0

Contrast-enhanced ultrasound of breast tumors: an initial experience 乳腺肿瘤的超声造影:初步经验

Acta radiologica open

Pub Date : 2022-04-01 DOI: 10.1177/20584601221097458

Merete Kristiansen, Marit A Martiniussen, A. Larsen

Background The increase of neoadjuvant treatment for breast cancer creates a capacity challenge as response evaluation by magnetic resonance imaging (MRI) is a limited resource. Contrast-enhanced ultrasound (CEUS) has been proposed as an alternative imaging strategy. Purpose To get experience with examination of malignant breast tumors with CEUS and evaluate the potential for future use in response evaluation of neoadjuvant treatment. Material and methods In this pilot study, the dynamic contrast-enhancement of ultrasound and MRI examinations were analyzed in 14 women with histologically verified breast cancer. Results Analysis of the time intensity curve of CEUS demonstrated the difference between tumor and normal tissue. The peak intensity was five times higher in tumor tissue (mean increase 397%, 95% CI 250–545). The curve was steeper for tumor tissue (mean 1.76, 95% CI 1.26–2.26) than for normal tissue (mean 0.43, 95% CI 0.24–0.62). Conclusion CEUS is a feasible method of examining blood flow in malignant breast tumors.

背景癌症新辅助治疗的增加带来了能力挑战，因为磁共振成像（MRI）的反应评估是有限的资源。造影增强超声（CEUS）已被提出作为一种替代成像策略。目的总结CEUS检查乳腺恶性肿瘤的经验，评价其在新辅助治疗疗效评价中的应用潜力。材料与方法对14例经组织学证实的癌症患者的超声和MRI检查动态增强进行分析。结果CEUS时间-强度曲线分析显示肿瘤组织与正常组织存在差异。肿瘤组织中的峰值强度高出五倍（平均增加397%，95%CI 250–545）。肿瘤组织（平均1.76，95%CI 1.26–2.26）的曲线比正常组织（平均0.43，95%CI 0.24–0.62）的曲线更陡。结论CEUS是检测恶性乳腺肿瘤血流的一种可行方法。

引用次数: 0

Pseudohemothorax induced by residual contrast medium mimicking aortic dissection rupture 残余造影剂诱发假性血胸，模拟主动脉夹层破裂

Acta radiologica open

Pub Date : 2022-04-01 DOI: 10.1177/20584601221097468

K. Okamura, R. Yoshida, T. Yoshizako, H. Kitagaki

Hemothorax is an urgent condition, and its accurate diagnosis and the identification of the cause are important. Herein, we report a case of a 74-year-old man with end-stage renal disease who was presented with high-concentration pleural effusion owing to residual contrast medium. The case required differentiation from hemothorax owing to an aortic dissection and its rupture. In patients with end-stage renal disease, noncontrast-enhanced computed tomography after contrast-enhanced computed tomography may result in high-concentration pleural effusion owing to the existence of residual contrast medium. This realization is important to determine whether high-concentration pleural effusion symptoms reflect an urgent hemothorax case possibly related to an imminent rupture of an aortic aneurysm or intrathoracic penetration of aortic dissection, and whether invasive procedures, such as thoracentesis, ought to be avoided.

血胸是一种紧急情况，其准确诊断和病因鉴定至关重要。在此，我们报告了一例74岁的终末期肾病患者，他因残留造影剂而出现高浓度胸腔积液。由于主动脉夹层及其破裂，该病例需要与血胸鉴别。在终末期肾病患者中，由于残留造影剂的存在，在增强计算机断层扫描后进行非增强计算机断层摄影可能会导致高浓度胸腔积液。这一认识对于确定高浓度胸腔积液症状是否反映了可能与主动脉瘤即将破裂或主动脉夹层胸腔内穿透有关的紧急血胸病例，以及是否应避免胸腔穿刺等侵入性手术至关重要。

引用次数: 0

Bi-parametric MRI/TRUS fusion targeted repeat biopsy after systematic 10-12 core TRUS-guided biopsy reveals more significant prostate cancer especially in anteriorly located tumors. 系统性10-12核TRUS引导活检后的双参数MRI/TRUS融合靶向重复活检显示更显著的前列腺癌症，尤其是位于前方的肿瘤

IF 0.9 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Acta radiologica open

Pub Date : 2022-03-31 eCollection Date: 2022-03-01 DOI: 10.1177/20584601221085520

Michael Häggman, Pär Dahlman, Mats Ahlberg, Per Liss, Rafaele Cantera Ahlman, Anca Dragomir, Sam Ladjevardi

Background: MRI and fusion guided biopsy have an increased role in the diagnosis of prostate cancer.

Purpose: To demonstrate the possible advantages with Bi-parametric MRI fusion-guided repeat biopsy over systematic 10-12-core biopsy for the diagnosis of prostate cancer.

Material and methods: Four hundred and twenty-three consecutive men, with previous systematic 10-12-core TRUS-guided biopsy, and with suspicion of, or diagnosis of, low-risk prostate cancer underwent fusion-guided prostate biopsy between February 2015 and February 2017. The material was retrospectively assessed. In 220 cases no previous cancer was diagnosed, and in 203 cases confirmatory fusion guided biopsy was performed prior to active monitoring. MRI was classified according to PI-RADS. Systematic biopsy was compared to fusion guided biopsy for the detection of cancer, and PI-RADS was compared to the Gleason score.

Results: Fusion guided biopsy detected significantly more cancers than systematic (p < .001). Gleason scores were higher in the fusion biopsy group (p < .001). Anterior tumors were present in 54% of patients. Fusion biopsy from these lesions showed cancer in 53% with previously negative biopsy in systematic biopsies and 66% of them were upgraded from low risk to intermediate or high-risk cancers.

Conclusion: These results show superior detection rate and grading of bi-parametric MRI/TRUS fusion targeted repeat biopsy over systematic 10-12 core biopsies. Fusion guided biopsy detects more significant cancers despite using fewer cores. The risk group was changed for many patients initially selected for active surveillance due to upgrading of tumors. Bi-parametric MRI shows promising results in detecting anterior tumors in patients with suspected prostate cancer.

背景MRI和融合引导活检在诊断癌症中的作用越来越大。目的证明在诊断癌症时，双参数MRI融合引导重复活检优于系统10–12核活检的可能优势。材料和方法在2015年2月至2017年2月期间，连续423名男性，之前有系统的10-12核心TRUS引导活检，怀疑或诊断为低风险前列腺癌症，接受了融合引导前列腺活检。对材料进行了回顾性评估。在220例病例中，没有诊断出以前的癌症，在203例病例中在积极监测之前进行了验证性融合引导活检。MRI根据PI-RADS进行分类。将系统活组织检查与融合引导活组织检查进行比较，以检测癌症，并将PI-RADS与Gleason评分进行比较。结果融合引导活检发现的癌症明显多于系统性（p＜0.001）。融合活检组的Gleason评分更高（p＜.001）。54%的患者存在前部肿瘤。这些病变的融合活组织检查显示，53%的患者患有癌症，之前系统活组织检查呈阴性，66%的患者从低风险癌症升级为中风险或高风险癌症。结论这些结果表明，与系统的10-12核心活检相比，双参数MRI/TRUS融合靶向重复活检的检出率和分级更高。尽管使用较少的核心，但融合引导的活检可以检测到更显著的癌症。由于肿瘤升级，许多最初选择进行主动监测的患者的风险组发生了变化。双参数MRI在检测疑似前列腺癌症患者的前部肿瘤方面显示出有希望的结果。

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引用次数: 0

Effectiveness of radiofrequency ablation versus transarterial chemoembolization for recurrent hepatocellular carcinoma: A meta-analysis 射频消融与经动脉化疗栓塞治疗复发性肝癌的有效性:一项荟萃分析

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221085514

Haoxian Gou, Sheng Liu, Gang Zhu, Yisheng Peng, Xinkai Li, Xiao-li Yang, K. He

Background Both transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective methods for the treatment of recurrent hepatocellular carcinoma (RHCC). Thus far, it is unclear which method is more satisfactory in short- and long-term survival benefits. Purpose To compare the overall survival (OS) and complications of TACE and RFA used for the management of RHCC. Material and Methods A literature search was carried out using PubMed, the Cochrane Library and, Embase databases, and Google Scholar, keywords including “RHCC,” “TACEC,” and “RFA” with a cutoff date of 30 April 2021. Used Review Manager software was to calculate short- and long-term OS. The clinical outcomes are major complications and complete response (CR). Results Finally, nine clinical trials met the research standard, including 1326 subjects, of which 518 received RFA and 808 received TACE. The analysis showed that patients who underwent RFA had significantly higher 1-, 3-, and 5-year OS (OR1-year = 1.92, 95% confidence interval (CI) = 1.27–2.91, p = .002; OR3-year = 1.64, 95% CI = 1.30–2.08, p <.0001; OR5-year = 3.22, 95% CI = 1.34–7.72, p=.009). Besides, the patients who chose RFA had an obvious higher rate of CR than those receiving TACE (OR = 33.75, 95% CI = 1.73–658.24, p = .002). However, the major complications were consistency between these two groups. Conclusion Our study discovered that RFA had greater CR and incidence in both the short-term and long-term OS than TACE. In addition, obvious difference was not found in major complications in these two methods.

背景经动脉化疗栓塞（TACE）和射频消融（RFA）是治疗复发性肝细胞癌（RHCC）的有效方法。到目前为止，尚不清楚哪种方法在短期和长期生存效益方面更令人满意。目的比较TACE和RFA治疗RHCC的总生存率（OS）和并发症。材料和方法使用PubMed、Cochrane Library和Embase数据库以及Google Scholar进行文献检索，关键词包括“RHCC”、“TACEC”和“RFA”，截止日期为2021年4月30日。使用Review Manager软件计算短期和长期OS。临床结果为主要并发症和完全缓解（CR）。结果9项临床试验符合研究标准，包括1326例受试者，其中518例接受RFA，808例接受TACE。分析显示，接受RFA的患者具有显著更高的1年、3年和5年OS（OR1年=1.92，95%置信区间（CI）=1.27-2.91，p=0.002；OR3年=1.64，95%CI=1.30-2.08，p<.0001；OR5年=3.22，95%CI=1.34-7.72，p=0.009）。此外，选择RFA的患者的CR率明显高于接受TACE的患者（OR=33.75，95%CI=1.73-658.24，p=0.002）。然而，主要并发症是这两组之间的一致性。结论RFA在短期和长期OS中的CR和发生率均高于TACE。此外，两种方法在主要并发症方面没有发现明显差异。

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引用次数: 3

Sensitivity of DECT in ACL tears. A prospective study with arthroscopy as reference method DECT对ACL撕裂的敏感性。关节镜作为参考方法的前瞻性研究

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221075799

Ann-Sofi Björkman, H. Gauffin, A. Persson, S. Koskinen

Background CT is often used for fracture evaluation following knee trauma and to diagnose ACL injuries would also be valuable. Purpose To investigate the diagnostic accuracy of dual energy CT (DECT) for detection of ACL tears in acute and subacute knee injuries. Material and Methods Patients with suspected ACL injury were imaged with DECT and MRI. Clinically blinded DECT images were independently read twice by two radiologists. ACL was classified as normal or abnormal. Arthroscopy served as reference method. Sensitivity and positive predictive value (PPV) were calculated, and diagnostic performance between DECT and MRI was assessed. Results 48 patients (26 M, 22 F, mean age 23 years, range 15–37 years) were imaged with a mean of 25 days following trauma. Of these, 21 patients underwent arthroscopy with a mean of 195 days after trauma. Arthroscopy revealed 19 ACL tears and 2 ACLs with no tear. The combined sensitivity was 76.3% (95% CI 66.8–85.9) and 86.8 (95% CI 71.9–95.6) for DECT and MRI, respectively. There was no statistically significant difference between these two methods (p = .223). The positive predictive value (PPV) was 93.5 (95% CI 84.3–98.2) and 91.7 (95% CI 77.5–98.3) for DECT and MRI, respectively. Conclusion DECT has lower sensitivity to detect an ACL rupture than MRI, but the difference is not statistically significant. The PPV is high in both methods.

背景CT通常用于膝关节创伤后的骨折评估，诊断ACL损伤也很有价值。目的探讨双能CT（DECT）对急性和亚急性膝关节损伤前交叉韧带撕裂的诊断准确性。材料与方法对疑似ACL损伤的患者进行DECT和MRI检查。临床盲法DECT图像由两名放射科医生独立读取两次。ACL分为正常或异常。关节镜检查作为参考方法。计算敏感性和阳性预测值（PPV），并评估DECT和MRI之间的诊断性能。结果48名患者（26M，22F，平均年龄23岁，范围15-37岁）在创伤后平均25天内进行了成像。其中，21名患者在创伤后平均195天接受了关节镜检查。关节镜检查显示19个ACL撕裂，2个ACL无撕裂。DECT和MRI的综合灵敏度分别为76.3%（95%CI 66.8-85.9）和86.8（95%CI 71.9-95.6）。这两种方法之间没有统计学上的显著差异（p=.223）。DECT和MRI的阳性预测值（PPV）分别为93.5（95%CI 84.3–98.2）和91.7（95%CI 77.5–98.3）。结论DECT检测ACL断裂的敏感性低于MRI，但差异无统计学意义。两种方法的PPV都很高。

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引用次数: 0

Inverted intercostal hernia of elastofibroma dorsi mimicking well-differentiated liposarcoma in the chest wall 与胸壁高分化脂肪肉瘤相似的背弹性纤维瘤的内翻性肋间疝

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221080514

R. Yoshida, T. Yoshizako, K. Okamura, Shinji Ando, Megumi Nakamura, N. Ishikawa, H. Kitagaki

Elastofibroma dorsi is a well-known benign chest wall tumor. Herein, we present a case in which an elastofibroma protruded into the thoracic cavity, leading to inverted intercostal hernia. Imaging revealed a soft tissue mass containing fat, typical of elastofibroma dorsi; however, precise diagnosis was difficult owing to the location of this mass that protruded into the thoracic cavity. Liposarcoma had to be ruled out because it was a growing fat-containing mass. Considering that the tumor moved while the patient was undergoing computed tomography-guided biopsy in the prone position, a diagnosis of inverted intercostal hernia of elastofibroma dorsi was made. We report this case with a review of current literature.

背部弹力纤维瘤是一种众所周知的良性胸壁肿瘤。在此，我们报告一例弹性纤维瘤突入胸腔，导致肋间倒疝。影像显示一个含有脂肪的软组织肿块，典型的背部弹性纤维瘤；然而，由于这个突出到胸腔的肿块的位置，精确诊断是困难的。必须排除脂肪瘤，因为它是一个生长中的含脂肪肿块。考虑到肿瘤在患者俯卧位接受计算机断层扫描引导的活检时发生了移动，诊断为背部弹性纤维瘤倒肋间疝。我们通过对现有文献的回顾来报道这一案例。

引用次数: 1

Do the variations in ROI placement technique have influence for prostate ADC measurements? ROI放置技术的变化对前列腺ADC测量有影响吗?

Acta radiologica open

Pub Date : 2022-03-01 DOI: 10.1177/20584601221086500

Yoshiko Ueno, T. Tamada, K. Sofue, Y. Urase, N. Hinata, M. Fujisawa, Takamichi Murakami

Background Prostate apparent diffusion coefficient (ADC) values calculated from diffusion-weighted imaging have been used for evaluating prostate cancer (PCa) aggressiveness. However, the way of measuring ADC values has varied depending on the study. Purpose To investigate inter- and intra-reader variability and diagnostic performance of three kinds of shaped 2D regions of interests (ROIs) for tumor ADC measurements in PCa. Material and Methods Seventy-four patients with PCa undergoing 3-T MRI before surgery were included. Histologic findings from radical prostatectomy specimens were reviewed to define each patient’s dominant tumor. Three readers independently measured the tumor ADCs using three different ROI methods: freehand, large-circle, and small-circles ROIs. Readers repeated measurements after 3 weeks. Bland-Altman analysis was performed to evaluate the inter- and intra-reader variability. Receiver Operating Characteristic analysis was used for assessment of tumor aggressiveness for PCa. Results For intra-reader and inter-reader variability, the mean coefficient of repeatability for freehand ROIs, large-circle ROIs, and small-circles ROIs were as follows: 13.7%, 12.4%, and 11.5%; 9.4%, 9.7%, and 9.5%. For differentiating Gleason score (GS) = 3 + 3 from GS ≥ 3 + 4 tumors, the area under the curves were 0.90 for freehand ROIs, 0.89 for large-circle ROIs, and 0.94 small-circles ROIs (p = 0.31). Conclusion The variations in ROI method did not have a major influence on intra-reader or inter-reader reproducibility or diagnostic performance for prostate ADC measurements.

背景通过扩散加权成像计算的前列腺表观扩散系数（ADC）值已用于评估前列腺癌症（PCa）的侵袭性。然而，测量ADC值的方式因研究而异。目的研究三种形状的二维感兴趣区域（ROI）在前列腺癌中用于肿瘤ADC测量的读卡器间和读卡器内变异性和诊断性能。材料与方法74例前列腺癌患者术前接受3-T MRI检查。对根治性前列腺切除术标本的组织学检查结果进行回顾，以确定每位患者的主要肿瘤。三位读者使用三种不同的ROI方法独立测量肿瘤ADC：徒手、大圆和小圆ROI。读者在3周后重复测量。Bland-Altman分析用于评估读者之间和读者内部的变异性。受试者操作特征分析用于评估前列腺癌的肿瘤侵袭性。结果对于读者内部和读者之间的变异性，徒手ROI、大圆ROI和小圆ROI的平均重复系数分别为：13.7%、12.4%和11.5%；9.4%、9.7%和9.5%。对于区分Gleason评分（GS）=3+3和GS≥3+4的肿瘤，徒手ROI的曲线下面积为0.90，大圆ROI为0.89，小圆ROI为0.94（p=0.31）。结论ROI方法的变化对前列腺ADC测量的阅读器内或阅读器间再现性或诊断性能没有重大影响。

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引用次数: 2

TMJ contrast enhancement in CBCT images using a new algorithm. 一种新的CBCT图像TMJ对比度增强算法。

Acta radiologica open

Pub Date : 2022-02-17 eCollection Date: 2022-01-01 DOI: 10.1177/20584601221074565

María Florinda Otero, Pablo García Tahoces, Antonio Mera, Jorge Mira

Magnetic resonance imaging (MRI) is considered the gold standard to reliably diagnose inflammation in the temporomandibular joint (TMJ) of patients with juvenile idiopathic arthritis (JIA). However, even MRI imaging is dependent on the familiarity of the radiologist with the normal appearance of the TMJ; therefore, new approaches are needed. Our purpose here is to improve imaging quality of cone beam computed tomography (CBCT) as a tool to help in the diagnosis of JIA in the TMJ. We have designed and applied a filter (the Stacking Enhancement Filter) over a stock of CBCT images from the TMJs of two patients with JIA. We then made a visual comparison of the results with archival images from MRI of the same patients, to show that the filter substantially improves the visual quality of the image. The work on the image contrast and the increase of the difference of appearance between tissues of different densities (all the anatomical structures that are present within the joint) leads to an improvement of the resulting images of the TMJ without the use of a chemical contrast agent. We conclude that CBCT could be used as a filter tool for the analysis of the TMJs affected by arthritis. Our image processing technique yields images that possible improve the range of use of CBCT.

磁共振成像(MRI)被认为是可靠诊断幼年特发性关节炎(JIA)患者颞下颌关节(TMJ)炎症的金标准。然而，即使是MRI成像也依赖于放射科医生对TMJ正常外观的熟悉程度;因此，需要新的方法。我们的目的是提高锥形束计算机断层扫描(CBCT)的成像质量，以帮助诊断颞下颌关节的JIA。我们设计并应用了一个滤波器(堆叠增强滤波器)，对来自两名JIA患者tmj的CBCT图像进行处理。然后，我们将结果与同一患者的核磁共振成像档案图像进行了视觉比较，以表明过滤器大大提高了图像的视觉质量。在图像对比度和不同密度的组织(关节内存在的所有解剖结构)之间外观差异的增加方面的工作导致在不使用化学造影剂的情况下改善TMJ的最终图像。我们认为CBCT可以作为一种过滤工具来分析受关节炎影响的颞下颌关节。我们的图像处理技术产生的图像可能会提高CBCT的使用范围。

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引用次数: 1