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Prediction of PD-L1 and Ki-67 status in primary central nervous system diffuse large B-cell lymphoma by diffusion and perfusion MRI: a preliminary study. 通过弥散和灌注 MRI 预测原发性中枢神经系统弥漫大 B 细胞淋巴瘤的 PD-L1 和 Ki-67 状态:一项初步研究。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-26 DOI: 10.1186/s12880-024-01409-y
Xiaofang Zhou, Feng Wang, Lan Yu, Feiman Yang, Jie Kang, Dairong Cao, Zhen Xing

Objective: To assess whether diffusion and perfusion MRI derived parameters could non-invasively predict PD-L1 and Ki-67 status in primary central nervous system diffuse large B-cell lymphoma (PCNS-DLBCL).

Methods: We retrospectively analyzed DWI, DSC-PWI, and morphological MRI (mMRI) in 88 patients with PCNS-DLBCL. The mMRI features were compared using chi-square tests or Fisher exact test. Minimum ADC (ADCmin), mean ADC(ADCmean), relative minimum ADC (rADCmin), relative mean ADC (rADCmean), and relative maximum CBV (rCBVmax) values were compared in PCNS-DLBCL with different molecular status by using the Mann-Whitney U test. The diagnostic performances were evaluated by receiver operating characteristic curves.

Results: PCNS-DLBCL with high PD-L1 expression demonstrated a significantly higher ADCmin value than those with low PD-L1. The ADCmean and rADCmean values were significantly lower in PCNS-DLBCL with high Ki-67 status compared with those in low Ki-67 status. Other ADC, CBV parameters, and mMRI features did not show any association with these molecular statuses The diagnostic efficacy of ADC values in assessing PD-L1 and Ki-67 status was relatively low, with area under the curves (AUCs) values less than 0.7.

Conclusions: DWI-derived ADC values can provide some relevant information about PD-L1 and Ki-67 status in PCNS-DLBCL, but may not be sufficient to predict their expression due to the rather low diagnostic performance.

目的评估弥散和灌注核磁共振成像衍生参数能否无创预测原发性中枢神经系统弥漫大B细胞淋巴瘤(PCNS-DLBCL)的PD-L1和Ki-67状态:我们对88例PCNS-DLBCL患者的DWI、DSC-PWI和形态学磁共振成像(mMRI)进行了回顾性分析。mMRI特征的比较采用秩方检验或费舍尔精确检验。采用 Mann-Whitney U 检验比较了不同分子状态的 PCNS-DLBCL 患者的最小 ADC(ADCmin)、平均 ADC(ADCmean)、相对最小 ADC(rADCmin)、相对平均 ADC(rADCmean)和相对最大 CBV(rCBVmax)值。通过接收者操作特征曲线评估诊断效果:结果:PD-L1 高表达的 PCNS-DLBCL 的 ADCmin 值明显高于 PD-L1 低表达的 PCNS-DLBCL。高Ki-67状态的PCNS-DLBCL的ADCmean和rADCmean值明显低于低Ki-67状态的PCNS-DLBCL。ADC值对评估PD-L1和Ki-67状态的诊断效力相对较低,其曲线下面积(AUC)值低于0.7:DWI衍生的ADC值可提供PCNS-DLBCL中PD-L1和Ki-67状态的一些相关信息,但由于诊断效能较低,可能不足以预测其表达情况。
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引用次数: 0
Machine learning model for non-alcoholic steatohepatitis diagnosis based on ultrasound radiomics. 基于超声放射组学的非酒精性脂肪性肝炎诊断机器学习模型。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-20 DOI: 10.1186/s12880-024-01398-y
Fei Xia, Wei Wei, Junli Wang, Yayang Duan, Kun Wang, Chaoxue Zhang

Background: Non-Alcoholic Steatohepatitis (NASH) is a crucial stage in the progression of Non-Alcoholic Fatty Liver Disease(NAFLD). The purpose of this study is to explore the clinical value of ultrasound features and radiological analysis in predicting the diagnosis of Non-Alcoholic Steatohepatitis.

Method: An SD rat model of hepatic steatosis was established through a high-fat diet and subcutaneous injection of CCl4. Liver ultrasound images and elastography were acquired, along with serum data and histopathological results of rat livers.The Pyradiomics software was used to extract radiomic features from 2D ultrasound images of rat livers. The rats were then randomly divided into a training set and a validation set, and feature selection was performed through dimensionality reduction. Various machine learning (ML) algorithms were employed to build clinical diagnostic models, radiomic models, and combined diagnostic models. The efficiency of each diagnostic model for diagnosing NASH was evaluated using Receiver Operating Characteristic (ROC) curves, Clinical Decision Curve Analysis (DCA), and calibration curves.

Results: In the machine learning radiomic model for predicting the diagnosis of NASH, the Area Under the Curve (AUC) of ROC curve for the clinical radiomic model in the training set and validation set were 0.989 and 0.885, respectively. The Decision Curve Analysis revealed that the clinical radiomic model had the highest net benefit within the probability threshold range of > 65%. The calibration curve in the validation set demonstrated that the clinical combined radiomic model is the optimal method for diagnosing Non-Alcoholic Steatohepatitis.

Conclusion: The combined diagnostic model constructed using machine learning algorithms based on ultrasound image radiomics has a high clinical predictive performance in diagnosing Non-Alcoholic Steatohepatitis.

背景:非酒精性脂肪性肝炎(NASH非酒精性脂肪性肝炎(NASH)是非酒精性脂肪性肝病(NAFLD)发展过程中的一个关键阶段。本研究旨在探讨超声特征和放射学分析在预测非酒精性脂肪性肝炎诊断中的临床价值:方法:通过高脂饮食和皮下注射 CCl4 建立 SD 大鼠肝脂肪变性模型。使用 Pyradiomics 软件从大鼠肝脏的二维超声波图像中提取放射学特征。然后将大鼠随机分为训练集和验证集,并通过降维进行特征选择。采用各种机器学习(ML)算法建立临床诊断模型、放射学模型和综合诊断模型。使用接收者操作特征曲线(ROC)、临床决策曲线分析(DCA)和校准曲线评估了每个诊断模型诊断 NASH 的效率:在预测 NASH 诊断的机器学习放射学模型中,临床放射学模型在训练集和验证集的 ROC 曲线下面积(AUC)分别为 0.989 和 0.885。决策曲线分析表明,在大于 65% 的概率阈值范围内,临床放射模型的净获益最高。验证集的校准曲线表明,临床综合放射模型是诊断非酒精性脂肪性肝炎的最佳方法:结论:基于超声图像放射组学的机器学习算法构建的联合诊断模型在诊断非酒精性脂肪性肝炎方面具有很高的临床预测性能。
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引用次数: 0
Deep learning based uterine fibroid detection in ultrasound images. 基于深度学习的超声图像子宫肌瘤检测
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-19 DOI: 10.1186/s12880-024-01389-z
Haibin Xi, Wenjing Wang

Uterine fibroids are common benign tumors originating from the uterus's smooth muscle layer, often leading to symptoms such as pelvic pain, and reproductive issues. Early detection is crucial to prevent complications such as infertility or the need for invasive treatments like hysterectomy. One of the main challenges in diagnosing uterine fibroids is the lack of specific symptoms, which can mimic other gynecological conditions. This often leads to under-diagnosis or misdiagnosis, delaying appropriate management. In this research, an attention based fine-tuned EfficientNetB0 model is proposed for the classification of uterine fibroids from ultrasound images. Attention mechanisms, permit the model to focus on particular parts of an image and move forward the model's execution by empowering it to specifically go to imperative highlights whereas overlooking irrelevant ones. The proposed approach has used a total of 1990 images divided into two classes: Non-uterine fibroid and uterine fibroid. The data augmentation methods have been connected to improve generalization and strength by exposing it to a wider range of varieties within the training data. The proposed model has obtained the value of accuracy as 0.99. Future research should focus on improving the accuracy and efficiency of diagnostic techniques, as well as evaluating their effectiveness in diverse populations with higher sensitivity and specificity for the detection of uterine fibroids, as well as biomarkers to aid in diagnosis.

子宫肌瘤是源自子宫平滑肌层的常见良性肿瘤,通常会导致盆腔疼痛和生殖问题等症状。早期发现对于预防不孕症等并发症或需要进行子宫切除术等侵入性治疗至关重要。诊断子宫肌瘤的主要挑战之一是缺乏特异性症状,这可能与其他妇科疾病相似。这往往会导致诊断不足或误诊,从而延误适当的治疗。本研究提出了一种基于注意力的微调 EfficientNetB0 模型,用于对超声图像中的子宫肌瘤进行分类。注意力机制允许模型将注意力集中在图像的特定部分,并通过使其能够特别关注必要的亮点而忽略不相关的亮点来推进模型的执行。所提出的方法共使用了 1990 幅图像,分为两类:非子宫肌瘤和子宫肌瘤。数据增强方法通过将其与训练数据中更广泛的品种联系起来,提高了通用性和强度。所提模型的准确率达到了 0.99。未来的研究应侧重于提高诊断技术的准确性和效率,并评估其在不同人群中的有效性,提高检测子宫肌瘤的灵敏度和特异性,以及辅助诊断的生物标志物。
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引用次数: 0
Morphological changes in flatfoot: a 3D analysis using weight-bearing CT scans. 扁平足的形态变化:利用负重 CT 扫描进行三维分析。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-19 DOI: 10.1186/s12880-024-01396-0
Yuchun Cai, Zhe Zhao, Jianzhang Huang, Zhendong Yu, Manqi Jiang, Shengjie Kang, Xinghong Yuan, Yingying Liu, Xiaoliu Wu, Jun Ouyang, Wencui Li, Lei Qian

Background: Flatfoot is a condition resulting from complex three-dimensional (3D) morphological changes. Most Previous studies have been constrained by using two-dimensional radiographs and non-weight-bearing conditions. The deformity in flatfoot is associated with the 3D morphology of the bone. These morphological changes affect the force line conduction of the hindfoot/midfoot/forefoot, leading to further morphological alterations. Given that a two-dimensional plane axis overlooks the 3D structural information, it is essential to measure the 3D model of the entire foot in conjunction with the definition under the standing position. This study aims to analyze the morphological changes in flatfoot using 3D measurements from weight-bearing CT (WBCT).

Method: In this retrospective comparative our CT database was searched between 4-2021 and 3-2022. Following inclusion criteria were used: Patients were required to exhibit clinical symptoms suggestive of flatfoot, including painful swelling of the medial plantar area or abnormal gait, corroborated by clinical examination and confirmatory radiological findings on CT or MRI. Healthy participants were required to be free of any foot diseases or conditions affecting lower limb movement. After applying the exclusion criteria (Flatfoot with other foot diseases), CT scans (mean age = 20.9375, SD = 16.1) confirmed eligible for further analysis. The distance, angle in sagittal/transverse/coronal planes, and volume of the two groups were compared on reconstructed 3D models using the t-test. Logistic regression was used to identify flatfoot risk factors, which were then analyzed using receiver operating characteristic curves and nomogram.

Result: The flatfoot group exhibited significantly lower values for calcaneofibular distance (p = 0.001), sagittal and transverse calcaneal inclination angle (p < 0.001), medial column height (p < 0.001), sagittal talonavicular coverage angle (p < 0.001), and sagittal (p < 0.001) and transverse (p = 0.015) Hibb angle. In contrast, the sagittal lateral talocalcaneal angle (p = 0.013), sagittal (p < 0.001) and transverse (p = 0.004) talocalcaneal angle, transverse talonavicular coverage angle (p < 0.001), coronal Hibb angle (p < 0.001), and sagittal (p < 0.001) and transverse (p = 0.001) Meary's angle were significantly higher in the flatfoot group. The sagittal Hibb angle (B =  - 0.379, OR = 0.684) and medial column height (B =  - 0.990, OR = 0.372) were identified as significant risk factors for acquiring a flatfoot.

Conclusion: The findings validate the 3D spatial position alterations in flatfoot. These include the abduction of the forefoot and prolapse of the first metatarsal proximal, the arch collapsed, subluxation of the talonavicular joint in the midfoot, adduction and valgus of the calcaneus, adduction and plantar ward movement of the talus in the hindfoot, along with the first metat

背景:扁平足是一种由复杂的三维(3D)形态变化引起的疾病。以往的研究大多受限于二维射线照片和非负重条件。扁平足的畸形与骨骼的三维形态有关。这些形态变化会影响后足/中足/前足的力线传导,导致进一步的形态改变。由于二维平面轴线忽略了三维结构信息,因此必须结合站立姿势下的定义测量整个足部的三维模型。本研究旨在利用负重 CT(WBCT)的三维测量结果分析扁平足的形态变化:在这项回顾性对比研究中,我们检索了 2021 年 4 月至 2022 年 3 月期间的 CT 数据库。纳入标准如下患者需表现出提示扁平足的临床症状,包括足底内侧区域肿胀疼痛或步态异常,并经临床检查和 CT 或 MRI 放射学检查结果证实。健康参与者必须没有任何足部疾病或影响下肢运动的疾病。在应用排除标准(平足伴有其他足部疾病)后,CT扫描结果(平均年龄=20.9375,SD=16.1)确认符合进一步分析的条件。两组患者在重建的三维模型上的距离、矢状面/横断面/冠状面角度和体积采用t检验进行比较。使用逻辑回归确定扁平足风险因素,然后使用接收器操作特征曲线和提名图进行分析:研究结果验证了扁平足的三维空间位置改变。这些改变包括前足内收、第一跖骨近端下垂、足弓塌陷、中足距骨关节半脱位、小关节内收和外翻、后足距骨内收和跖侧运动,以及前足第一跖骨内收和外翻。
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引用次数: 0
Application of improved Unet network in the recognition and segmentation of lung CT images in patients with pneumoconiosis. 改进型 Unet 网络在尘肺病患者肺部 CT 图像识别和分割中的应用。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-19 DOI: 10.1186/s12880-024-01377-3
Zhengsong Zhou, Xin Li, Hongbo Ji, Xuanhan Xu, Zongqi Chang, Keda Wu, Yangyang Song, Mingkun Kao, Hongjun Chen, Dongsheng Wu, Tao Zhang

Background: Pneumoconiosis has a significant impact on the quality of patient survival. This study aims to evaluate the performance and application value of improved Unet network technology in the recognition and segmentation of lesion areas of lung CT images in patients with pneumoconiosis.

Methods: A total of 1212 lung CT images of patients with pneumoconiosis were retrospectively included. The improved Unet network was used to identify and segment the CT image regions of the patients' lungs, and the image data of the granular regions of the lungs were processed by the watershed and region growing algorithms. After random sorting, 848 data were selected into the training set and 364 data into the validation set. The experimental dataset underwent data augmentation and were used for model training and validation to evaluate segmentation performance. The segmentation results were compared with FCN-8s, Unet network (Base), Unet (Squeeze-and-Excitation, SE + Rectified Linear Unit, ReLU), and Unet + + networks.

Results: In the segmentation of lung CT granular region with the improved Unet network, the four evaluation indexes of Dice similarity coefficient, positive prediction value (PPV), sensitivity coefficient (SC) and mean intersection over union (MIoU) reached 0.848, 0.884, 0.895 and 0.885, respectively, increasing by 7.6%, 13.3%, 3.9% and 6.4%, respectively, compared with those of Unet network (Base), and increasing by 187.5%, 249.4%, 131.9% and 51.0%, respectively, compared with those of FCN-8s, and increasing by 14.0%, 31.2%, 4.7% and 9.7%, respectively, compared with those of Unet network (SE + ReLU), while the segmentation performance was also not inferior to that of the Unet + + network.

Conclusions: The improved Unet network proposed shows good performance in the recognition and segmentation of abnormal regions in lung CT images in patients with pneumoconiosis, showing potential application value for assisting clinical decision-making.

背景:尘肺病对患者的生存质量有重大影响。本研究旨在评估改进型 Unet 网络技术在尘肺病患者肺部 CT 图像病灶区域识别和分割中的性能和应用价值:方法:该研究回顾性地纳入了1212例尘肺病患者的肺部CT图像。采用改进的 Unet 网络对患者肺部 CT 图像区域进行识别和分割,并通过分水岭算法和区域生长算法对肺部颗粒区域的图像数据进行处理。经过随机排序,848 个数据被选入训练集,364 个数据被选入验证集。实验数据集经过数据扩增,用于模型训练和验证,以评估分割性能。分割结果与 FCN-8s、Unet 网络(基础)、Unet(挤压-激发,SE + 整流线性单元,ReLU)和 Unet + + 网络进行了比较:在使用改进的 Unet 网络分割肺部 CT 颗粒区域时,Dice 相似度系数、正预测值(PPV)、灵敏度系数(SC)和平均交集大于联合度(MIoU)四项评价指标分别达到 0.848、0.884、0.895 和 0.885,与使用改进的 Unet 网络分割肺部 CT 颗粒区域时相比,分别提高了 7.6%、13.3%、3.9% 和 6.4%。与 Unet 网络(Base)相比,分别提高了 7.6%、13.3%、3.9% 和 6.4%;与 FCN-8s 相比,分别提高了 187.5%、249.4%、131.9% 和 51.0%;与 Unet 网络(SE + ReLU)相比,分别提高了 14.0%、31.2%、4.7% 和 9.7%:结论:所提出的改进型 Unet 网络在识别和分割尘肺病患者肺部 CT 图像中的异常区域方面表现良好,在辅助临床决策方面具有潜在的应用价值。
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引用次数: 0
A radiomics nomogram based on multiparametric MRI for diagnosing focal cortical dysplasia and initially identifying laterality. 基于多参数磁共振成像的放射组学提名图,用于诊断局灶性皮质发育不良并初步确定侧位。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-15 DOI: 10.1186/s12880-024-01374-6
Shi-Qi Chen, Liang Wei, Keng He, Ya-Wen Xiao, Zhao-Tao Zhang, Jian-Kun Dai, Ting Shu, Xiao-Yu Sun, Di Wu, Yi Luo, Yi-Fei Gui, Xin-Lan Xiao

Background: Focal cortical dysplasia (FCD) is the most common epileptogenic developmental malformation. The diagnosis of FCD is challenging. We generated a radiomics nomogram based on multiparametric magnetic resonance imaging (MRI) to diagnose FCD and identify laterality early.

Methods: Forty-three patients treated between July 2017 and May 2022 with histopathologically confirmed FCD were retrospectively enrolled. The contralateral unaffected hemispheres were included as the control group. Therefore, 86 ROIs were finally included. Using January 2021 as the time cutoff, those admitted after January 2021 were included in the hold-out set (n = 20). The remaining patients were separated randomly (8:2 ratio) into training (n = 55) and validation (n = 11) sets. All preoperative and postoperative MR images, including T1-weighted (T1w), T2-weighted (T2w), fluid-attenuated inversion recovery (FLAIR), and combined (T1w + T2w + FLAIR) images, were included. The least absolute shrinkage and selection operator (LASSO) was used to select features. Multivariable logistic regression analysis was used to develop the diagnosis model. The performance of the radiomic nomogram was evaluated with an area under the curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration and clinical utility.

Results: The model-based radiomics features that were selected from combined sequences (T1w + T2w + FLAIR) had the highest performances in all models and showed better diagnostic performance than inexperienced radiologists in the training (AUCs: 0.847 VS. 0.664, p = 0.008), validation (AUC: 0.857 VS. 0.521, p = 0.155), and hold-out sets (AUCs: 0.828 VS. 0.571, p = 0.080). The positive values of NRI (0.402, 0.607, 0.424) and IDI (0.158, 0.264, 0.264) in the three sets indicated that the diagnostic performance of Model-Combined improved significantly. The radiomics nomogram fit well in calibration curves (p > 0.05), and decision curve analysis further confirmed the clinical usefulness of the nomogram. Additionally, the contrast (the radiomics feature) of the FCD lesions not only played a crucial role in the classifier but also had a significant correlation (r = -0.319, p < 0.05) with the duration of FCD.

Conclusion: The radiomics nomogram generated by logistic regression model-based multiparametric MRI represents an important advancement in FCD diagnosis and treatment.

背景:局灶性皮质发育不良(FCD)是最常见的致痫性发育畸形。FCD 的诊断具有挑战性。我们根据多参数磁共振成像(MRI)生成了一个放射组学提名图,用于诊断FCD和早期识别侧位:回顾性入选了 2017 年 7 月至 2022 年 5 月间接受治疗的 43 例经组织病理学证实的 FCD 患者。对侧未受影响的半球作为对照组。因此,最终纳入了86个ROI。以2021年1月为时间分界线,2021年1月后入院的患者被纳入暂不入院组(n = 20)。其余患者随机(8:2)分为训练组(55 人)和验证组(11 人)。所有术前和术后磁共振图像,包括 T1 加权(T1w)、T2 加权(T2w)、体液增强反转恢复(FLAIR)和组合(T1w + T2w + FLAIR)图像,均被纳入其中。采用最小绝对收缩和选择算子(LASSO)来选择特征。多变量逻辑回归分析用于建立诊断模型。用曲线下面积(AUC)、净再分类改进(NRI)、综合辨别改进(IDI)、校准和临床实用性评估了放射组学提名图的性能:从联合序列(T1w + T2w + FLAIR)中选取的基于模型的放射组学特征在所有模型中表现最佳,在训练集(AUCs:0.847 VS. 0.664,p = 0.008)、验证集(AUCs:0.857 VS. 0.521,p = 0.155)和保留集(AUCs:0.828 VS. 0.571,p = 0.080)中的诊断性能均优于无经验的放射科医生。三组数据的 NRI(0.402,0.607,0.424)和 IDI(0.158,0.264,0.264)均为正值,表明模型组合的诊断性能显著提高。放射组学提名图与校准曲线拟合良好(p > 0.05),决策曲线分析进一步证实了提名图的临床实用性。此外,FCD 病变的对比度(放射组学特征)不仅在分类器中发挥了关键作用,而且还具有显著的相关性(r = -0.319,p 结论:FCD 病变的对比度(放射组学特征)不仅在分类器中发挥了关键作用,而且还具有显著的相关性(r = -0.319,p 结论):基于逻辑回归模型的多参数磁共振成像生成的放射组学提名图是 FCD 诊断和治疗的重要进步。
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引用次数: 0
Ultrasound evaluation of cardiac and diaphragmatic function at different positions during a spontaneous breathing trial predicting extubation outcomes: a retrospective cohort study. 通过超声波评估自主呼吸试验中不同体位的心脏和横膈膜功能,预测拔管结果:一项回顾性队列研究。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-15 DOI: 10.1186/s12880-024-01357-7
Ling Luo, Yidan Li, Lifang Wang, Bing Sun, Zhaohui Tong

Background: The ratio (E/Ea) of mitral Doppler inflow velocity to annular tissue Doppler wave velocity by transthoracic echocardiography and diaphragmatic excursion (DE) by diaphragm ultrasound have been confirmed to predict extubation outcomes. However, few studies focused on the predicting value of E/Ea and DE at different positions during a spontaneous breathing trial (SBT), as well as the effects of △E/Ea and △DE (changes in E/Ea and DE during a SBT).

Methods: This study was a reanalysis of the data of 60 difficult-to-wean patients in a previous study published in 2017. All eligible participants were organized into respiratory failure (RF) group and extubation success (ES) group within 48 h after extubation, or re-intubation (RI) group and non-intubation (NI) group within 1 week after extubation. The risk factors for respiratory failure and re-intubation including E/Ea and △E/Ea, DE and △DE at different positions were analyzed by multivariate logistic regression, respectively. The receiver operating characteristic (ROC) curves of E/Ea (septal, lateral, average) and DE (right, left, average) were compared with each other, respectively.

Results: Of the 60 patients, 29 cases developed respiratory failure within 48 h, and 14 of those cases required re-intubation within 1 week. Multivariate logistic regression showed that E/Ea were all associated with respiratory failure, while only DE (right) and DE (average) after SBT were related to re-intubation. There were no statistic differences among the ROC curves of E/Ea at different positions, nor between the ROC curves of DE. No statistical differences were shown in △E/Ea between RF and ES groups, while △DE (average) was remarkably higher in NI group than that in RI group. However, multivariate logistic regression analysis showed that △DE (average) was not associated with re-intubation.

Conclusions: E/Ea at different positions during a SBT could predict postextubation respiratory failure with no statistical differences among them. Likewise, only DE (right) and DE (average) after SBT might predict re-intubation with no statistical differences between each other.

背景:经胸超声心动图显示的二尖瓣多普勒血流速度与瓣环组织多普勒波速度之比(E/Ea)和膈肌超声显示的膈肌偏移(DE)已被证实可预测拔管结果。然而,很少有研究关注自主呼吸试验(SBT)期间不同体位下 E/Ea 和 DE 的预测价值,以及△E/Ea 和 △DE(自主呼吸试验期间 E/Ea 和 DE 的变化)的影响:本研究重新分析了2017年发表的一项研究中60名难断奶患者的数据。所有符合条件的参与者在拔管后 48 小时内分为呼吸衰竭(RF)组和拔管成功(ES)组,或在拔管后 1 周内分为再次插管(RI)组和未插管(NI)组。通过多变量逻辑回归分析了呼吸衰竭和再次插管的风险因素,包括不同体位的 E/Ea 和 △E/Ea、DE 和 △DE。分别比较了E/Ea(室间隔、侧壁、平均值)和DE(右侧、左侧、平均值)的接收者操作特征曲线(ROC):在 60 例患者中,29 例在 48 小时内出现呼吸衰竭,其中 14 例在 1 周内需要再次插管。多变量逻辑回归显示,E/Ea均与呼吸衰竭有关,而只有SBT后的DE(右侧)和DE(平均值)与再次插管有关。不同位置 E/Ea 的 ROC 曲线之间以及 DE 的 ROC 曲线之间没有统计学差异。RF 组和 ES 组之间的△E/Ea 没有统计学差异,而 NI 组的△DE(平均值)明显高于 RI 组。然而,多变量逻辑回归分析表明,△DE(平均值)与再次插管无关:结论:SBT 过程中不同体位的 E/Ea 均可预测拔管后呼吸衰竭,但两者之间无统计学差异。同样,只有 SBT 后的 DE(右侧)和 DE(平均值)可预测再次插管,但两者之间没有统计学差异。
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引用次数: 0
Systematic review and meta-analysis of the diagnostic value of computed tomography angiography for severe internal carotid artery stenosis. 计算机断层扫描血管造影术对严重颈内动脉狭窄诊断价值的系统回顾和荟萃分析。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-14 DOI: 10.1186/s12880-024-01390-6
Han-Lin Zeng, Fu-Qiang Shao, Xian-Feng Peng, Chun-Yu Lei

Background: Due to the increasing incidence of ischaemic cerebrovascular diseases, the accurate assessment of internal carotid artery (ICA) stenosis is crucial for the development of treatment plans. This systematic review and meta-analysis aimed to evaluate the diagnostic value of computed tomography angiography (CTA) for severe ICAstenosis, thereby providing support for clinical decision-making and promoting diagnostic updates.

Methods: The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database for Chinese Technical Periodicals (VIP), and Chinese Biomedical Literature (CBM) electronic databases were searched from inception to March 21, 2024, to identify publicly available research literature on the use of CTA to diagnose severe ICA stenosis. Literature screening, data extraction, and quality assessment were conducted based on the inclusion and exclusion criteria as well as the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) standards. Data analysis was performed using Stata 17.0 and Meta-Disc 1.4 software. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of the included studies were calculated using Stata 17.0 software, and forest plots and summary receiver operating characteristic (SROC) curves were generated. The area under the curve (AUC) was calculated, and funnel plots were constructed to assess publication bias.

Results: A total of 16 studies with 2368 vascular segments were included. The meta-analysis revealed that the combined sensitivity and specificity of CTA for severe ICA stenosis were 0.93 (95% CI: 0.88 ~ 0.96) and 0.99 (95% CI: 0.96 ~ 1.00), respectively. The combined positive likelihood ratio and negative likelihood ratio were 92.0 (95% CI: 24.2 ~ 349.6) and 0.07 (95% CI: 0.04 ~ 0.13), respectively. The diagnostic odds ratio was 1302 (95% CI: 257 ~ 6606), and the AUC of the SROC curve was 0.98. The Deeks funnel plot suggested no publication bias among the included studies.

Conclusion: CTA demonstrated high sensitivity and specificity for diagnosing severe ICA stenosis. Therefore, this study provided important evidence for the accurate diagnosis and treatment of severe ICA stenosis. However, there was considerable heterogeneity among the included studies, thus indicating the need for additional high-quality prospective studies to confirm the clinical applicability of CTA.

背景:由于缺血性脑血管疾病的发病率越来越高,准确评估颈内动脉(ICA)狭窄对制定治疗方案至关重要。本系统综述和荟萃分析旨在评估计算机断层扫描血管造影术(CTA)对重度颈内动脉狭窄的诊断价值,从而为临床决策提供支持并促进诊断更新:方法:检索PubMed、Embase、Cochrane图书馆、中国国家知识基础设施(CNKI)、万方数据库、中国科技期刊数据库(VIP)和中国生物医学文献(CBM)等电子数据库中从开始到2024年3月21日关于使用CTA诊断重度ICA狭窄的公开研究文献。根据纳入和排除标准以及诊断准确性研究质量评估(QUADAS)标准进行文献筛选、数据提取和质量评估。数据分析使用 Stata 17.0 和 Meta-Disc 1.4 软件进行。使用 Stata 17.0 软件计算了纳入研究的灵敏度、特异性、阳性似然比、阴性似然比和诊断几率比,并生成了森林图和汇总接收者操作特征曲线(SROC)。计算曲线下面积(AUC),并绘制漏斗图以评估发表偏倚:共纳入 16 项研究,2368 个血管节段。荟萃分析显示,CTA 对重度 ICA 狭窄的综合敏感性和特异性分别为 0.93(95% CI:0.88 ~ 0.96)和 0.99(95% CI:0.96 ~ 1.00)。阳性似然比和阴性似然比分别为 92.0 (95% CI: 24.2 ~ 349.6) 和 0.07 (95% CI: 0.04 ~ 0.13)。诊断几率比为 1302(95% CI:257 ~ 6606),SROC 曲线的 AUC 为 0.98。Deeks漏斗图显示纳入的研究无发表偏倚:结论:CTA 对诊断严重的 ICA 狭窄具有很高的灵敏度和特异性。因此,该研究为重度 ICA 狭窄的准确诊断和治疗提供了重要证据。然而,纳入的研究之间存在相当大的异质性,因此表明需要更多高质量的前瞻性研究来证实 CTA 的临床适用性。
{"title":"Systematic review and meta-analysis of the diagnostic value of computed tomography angiography for severe internal carotid artery stenosis.","authors":"Han-Lin Zeng, Fu-Qiang Shao, Xian-Feng Peng, Chun-Yu Lei","doi":"10.1186/s12880-024-01390-6","DOIUrl":"10.1186/s12880-024-01390-6","url":null,"abstract":"<p><strong>Background: </strong>Due to the increasing incidence of ischaemic cerebrovascular diseases, the accurate assessment of internal carotid artery (ICA) stenosis is crucial for the development of treatment plans. This systematic review and meta-analysis aimed to evaluate the diagnostic value of computed tomography angiography (CTA) for severe ICAstenosis, thereby providing support for clinical decision-making and promoting diagnostic updates.</p><p><strong>Methods: </strong>The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database for Chinese Technical Periodicals (VIP), and Chinese Biomedical Literature (CBM) electronic databases were searched from inception to March 21, 2024, to identify publicly available research literature on the use of CTA to diagnose severe ICA stenosis. Literature screening, data extraction, and quality assessment were conducted based on the inclusion and exclusion criteria as well as the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) standards. Data analysis was performed using Stata 17.0 and Meta-Disc 1.4 software. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of the included studies were calculated using Stata 17.0 software, and forest plots and summary receiver operating characteristic (SROC) curves were generated. The area under the curve (AUC) was calculated, and funnel plots were constructed to assess publication bias.</p><p><strong>Results: </strong>A total of 16 studies with 2368 vascular segments were included. The meta-analysis revealed that the combined sensitivity and specificity of CTA for severe ICA stenosis were 0.93 (95% CI: 0.88 ~ 0.96) and 0.99 (95% CI: 0.96 ~ 1.00), respectively. The combined positive likelihood ratio and negative likelihood ratio were 92.0 (95% CI: 24.2 ~ 349.6) and 0.07 (95% CI: 0.04 ~ 0.13), respectively. The diagnostic odds ratio was 1302 (95% CI: 257 ~ 6606), and the AUC of the SROC curve was 0.98. The Deeks funnel plot suggested no publication bias among the included studies.</p><p><strong>Conclusion: </strong>CTA demonstrated high sensitivity and specificity for diagnosing severe ICA stenosis. Therefore, this study provided important evidence for the accurate diagnosis and treatment of severe ICA stenosis. However, there was considerable heterogeneity among the included studies, thus indicating the need for additional high-quality prospective studies to confirm the clinical applicability of CTA.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices. 三相腹部 CT 检测食管静脉曲张的诊断准确性。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-14 DOI: 10.1186/s12880-024-01388-0
Suzana Lukoo, Balowa Musa, Lilian Salingwa, Gerard Mpemba, Ahmed Jusabani

Background: In Tanzania, triphasic abdominal Computed Tomography (CT) is a more accessible and non-invasive alternative for diagnosing esophageal varices, though its accuracy has not been thoroughly evaluated, therefore this study aimed to determine the diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices using esophagogastroduodenoscopy (OGD) as the gold standard among patients with upper gastrointestinal bleeding at Muhimbili National Hospital (MNH).

Methods: This cross-sectional study was conducted at MNH from January 2021 to May 2023. We sampled upper gastrointestinal bleeding patients who underwent both OGD and triphasic abdominal CT using non-probability consecutive sampling. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of triphasic abdominal CT were assessed against OGD findings.

Results: In a study of 200 participants, esophageal varices were detected in 54% by OGD and 53.5% by CT. We observed 105 true positives, 2 false positives, 90 true negatives, and 3 false negatives. Triphasic abdominal CT demonstrated a sensitivity of 97.2%, specificity of 97.8%, PPV of 98.1%, NPV of 96.8%, and an accuracy of 97.5%. Extraluminal findings included portal venous thrombosis in (22%), splenic collateral (51.5%), ascites (32%), hepatocellular carcinoma (13%), and periportal fibrosis (32%).

Conclusion: Triphasic abdominal Computed Tomography can be used as a reliable and non-invasive alternative modality for diagnosing and screening esophageal varices in resource-limited settings.

背景:在坦桑尼亚,三相腹部计算机断层扫描(CT)是诊断食管静脉曲张的一种更方便、无创的替代方法,但其准确性尚未得到全面评估,因此,本研究旨在确定三相腹部计算机断层扫描在以食管胃十二指肠镜检查(OGD)为金标准检测Muhimbili国立医院(MNH)上消化道出血患者食管静脉曲张方面的诊断准确性:这项横断面研究于2021年1月至2023年5月在MNH进行。我们采用非概率连续抽样法,对同时接受 OGD 和三相腹部 CT 检查的上消化道出血患者进行了抽样。我们对照胃镜检查结果评估了三相腹部 CT 的敏感性、特异性、阴性预测值 (NPV)、阳性预测值 (PPV) 和准确性:结果:在一项有 200 名参与者参加的研究中,54% 的人通过 OGD 发现了食管静脉曲张,53.5% 的人通过 CT 发现了食管静脉曲张。我们观察到 105 例真阳性、2 例假阳性、90 例真阴性和 3 例假阴性。三相腹部 CT 的敏感性为 97.2%,特异性为 97.8%,PPV 为 98.1%,NPV 为 96.8%,准确性为 97.5%。腔外检查结果包括门静脉血栓形成(22%)、脾侧支(51.5%)、腹水(32%)、肝细胞癌(13%)和肝周纤维化(32%):在资源有限的环境中,三相腹部计算机断层扫描可作为诊断和筛查食管静脉曲张的可靠、无创的替代方法。
{"title":"The diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices.","authors":"Suzana Lukoo, Balowa Musa, Lilian Salingwa, Gerard Mpemba, Ahmed Jusabani","doi":"10.1186/s12880-024-01388-0","DOIUrl":"10.1186/s12880-024-01388-0","url":null,"abstract":"<p><strong>Background: </strong>In Tanzania, triphasic abdominal Computed Tomography (CT) is a more accessible and non-invasive alternative for diagnosing esophageal varices, though its accuracy has not been thoroughly evaluated, therefore this study aimed to determine the diagnostic accuracy of triphasic abdominal CT in detecting esophageal varices using esophagogastroduodenoscopy (OGD) as the gold standard among patients with upper gastrointestinal bleeding at Muhimbili National Hospital (MNH).</p><p><strong>Methods: </strong>This cross-sectional study was conducted at MNH from January 2021 to May 2023. We sampled upper gastrointestinal bleeding patients who underwent both OGD and triphasic abdominal CT using non-probability consecutive sampling. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy of triphasic abdominal CT were assessed against OGD findings.</p><p><strong>Results: </strong>In a study of 200 participants, esophageal varices were detected in 54% by OGD and 53.5% by CT. We observed 105 true positives, 2 false positives, 90 true negatives, and 3 false negatives. Triphasic abdominal CT demonstrated a sensitivity of 97.2%, specificity of 97.8%, PPV of 98.1%, NPV of 96.8%, and an accuracy of 97.5%. Extraluminal findings included portal venous thrombosis in (22%), splenic collateral (51.5%), ascites (32%), hepatocellular carcinoma (13%), and periportal fibrosis (32%).</p><p><strong>Conclusion: </strong>Triphasic abdominal Computed Tomography can be used as a reliable and non-invasive alternative modality for diagnosing and screening esophageal varices in resource-limited settings.</p>","PeriodicalId":9020,"journal":{"name":"BMC Medical Imaging","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11325706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CT-based surrogate parameters for MRI-based disc height and endplate degeneration in the lumbar spine. 基于 CT 的腰椎间盘高度和终板退变 MRI 代理参数。
IF 2.9 3区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Pub Date : 2024-08-13 DOI: 10.1186/s12880-024-01395-1
Thorsten Jentzsch, Karin E Mantel, Ksenija Slankamenac, Georg Osterhoff, Clément M L Werner

Purpose: This study investigated potential use of computed tomography (CT)-based parameters in the lumbar spine as a surrogate for magnetic resonance imaging (MRI)-based findings.

Methods: In this retrospective study, all individuals, who had a lumbar spine CT scan and MRI between 2006 and 2012 were reviewed (n = 198). Disc height (DH) and endplate degeneration (ED) were evaluated between Th12/L1-L5/S1. Statistics consisted of Spearman correlation and univariate/multivariable regression (adjusting for age and gender).

Results: The mean CT-DH increased kranio-caudally (8.04 millimeters (mm) at T12/L1, 9.17 mm at L1/2, 10.59 mm at L2/3, 11.34 mm at L3/4, 11.42 mm at L4/5 and 10.47 mm at L5/S1). MRI-ED was observed in 58 (29%) individuals. CT-DH and MRI-DH had strong to very strong correlations (rho 0.781-0.904, p < .001). MRI-DH showed higher absolute values than CT-DH (mean of 1.76 mm). There was a significant association between CT-DH and MRI-ED at L2/3 (p = .006), L3/4 (p = .002), L4/5 (p < .001) and L5/S1 (p < .001). A calculated cut-off point was set at 11 mm.

Conclusions: In the lumbar spine, there is a correlation between disc height on CT and MRI. This can be useful in trauma and emergency cases, where CT is readily available in the lack of an MRI. In addition, in the middle and lower part of the lumbar spine, loss of disc height on CT scans is associated with more pronounced endplate degeneration on MRIs. If the disc height on CT scans is lower than 11 mm, endplate degeneration on MRIs is likely more pronounced.

Level and design: Level III, a retrospective study.

目的:本研究调查了基于计算机断层扫描(CT)的腰椎参数作为基于磁共振成像(MRI)结果的替代物的潜在用途:在这项回顾性研究中,对 2006 年至 2012 年期间接受过腰椎 CT 扫描和 MRI 检查的所有患者(n = 198)进行了回顾。评估了Th12/L1-L5/S1之间的椎间盘高度(DH)和终板退变(ED)。统计包括斯皮尔曼相关性和单变量/多变量回归(调整年龄和性别):结果:CT-DH的平均值呈颅内径向增加(T12/L1为8.04毫米,L1/2为9.17毫米,L2/3为10.59毫米,L3/4为11.34毫米,L4/5为11.42毫米,L5/S1为10.47毫米)。58人(29%)观察到 MRI-ED。CT-DH 和 MRI-DH 有很强到非常强的相关性(rho 0.781-0.904, p 结论):在腰椎中,CT 和 MRI 上的椎间盘高度之间存在相关性。这在创伤和急诊病例中非常有用,因为在缺乏核磁共振成像的情况下,CT 可以随时使用。此外,在腰椎的中下部,CT 扫描中椎间盘高度的降低与 MRI 上更明显的椎间盘终板退变有关。如果 CT 扫描显示的椎间盘高度低于 11 毫米,核磁共振成像显示的椎间盘终板退变可能会更明显:III级,回顾性研究。
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引用次数: 0
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