摘要:目的:探討血清CA153和BAKP在乳腺癌骨轉移顯像診斷中的應用。方法:對92例乳腺癌患者的核素骨顯像結果、血清CA153和BAKP結果進行回顧性研究。結果:①血清CA15-3和B-AKP的值隨著骨轉移分期的增高而逐步升高,且差異顯著(Plt;0. 01);②血清CA15-3和B-AKP與骨轉移的數目呈正相關;③血清CA15-3gt;25 U/mL時,骨轉移的陽性率為63.3%,血清CA15-3lt;25 U/mL時,骨轉移的陰性預測值為94. 5%;血清B-AKPgt;20 U/L時,骨轉移的陽性率為59. 6%時,骨轉移的陰性預測值為73.5%;當血清CA15-3lt;25 U/mL同時B-AKPlt;20 U/L時,骨轉移的陰性預測值為100%。結論:血清CA15-3和BAKP測定在乳腺癌骨顯像診斷中具有重要的應用價值。Abstract: Objective: To evaluate the diagnosis value of serum CA153 and BAKP measurements for scanning bone metastatic images in patients with mammary Cancer. Methods: Retrospective study on the bone scan images and serum CA153 (with CLIA) and bone alkaline phosphatase (BAKP, with ELISA) levels were performed in 92 patients with confirmed mammary gland cancer. Results: ①The serum levels of CA153 and BAKP were increased step by step along with the advancement of bone metastatic grading from M0 to M3 with significant difference between values in successive gradings (Plt;0. 01).②The levels of CA153 and BAKP were significantly positively correlated. ③With serum CA153gt;25 U/mL the positive rate of bone metastasiswas 63.2%, with CA153lt;25 U/mL the negativepredictive value of bone metastasis was 94.5%, with BAKPgt;20 U/L,the positive rate of bone metastasis was 596%, with BAKPlt;20 U/L, the negative predictive value of bone metastasis was 73. 5%.However with Serum CA153lt;25 U/mL and BAKPlt;20 U/L, the negative predictive value of bone metastasis was100%. Conclusion: The combined measurement of the serum CA153 and BAKP levels would play an important role for diagnosis of bone scan images in patients with prostate cancer.
ObjectiveTo observe the in vivo three-dimensional (3-D) transient motion characteristics of the subaxial cervical spine in healthy adults.
MethodsSeventeen healthy volunteers without cervical spine related diseases were recruited for this study, including 8 males and 9 females with a mean age of 26 years (range, 23-41 years). The vertebral segment motion of each subject was reconstructed with CT, and Rhinoceros 4.0 solid modeling software were used for 3-D reconstruction model of the subaxial cervical spine. In vivo cervical vertebral motion in flexionextension, left and right bending, left and right rotation was observed with dual fluoroscopic imaging system (DFIS). Coordinate systems were established at the vertebral center of C3-7 to obtain the intervertebral range of motion (ROM) and displacement at C3, 4, C4, 5, C5, 6, and C6, 7. The X-axis pointed to the left along the coronal plane, the Y-axis pointed to the back along the sagittal plane, and the Z-axis perpendicular to the X-Y plane pointed to the head. The ROM along X, Y, and Z axises were represented by rotation in flexion-extension (α), in left-right bending (β), and in left-right twisting (γ) respectively, and the displacement in left-right direction (x), in anterior-posterior direction (y), and in proximaldistal direction (z), respectively.
ResultsIn flexion and extension, the displacement in anterior-posterior direction of C6, 7 was significantly less that of other segments (P<0.05), but the displacements in left-right direction and in proximaldistal direction showed no significant difference between segments (P>0.05); the ROM values in flexion-extension of C4, 5 and C5, 6 were significantly larger than those of C3, 4 and C6, 7 (P<0.05), and the ROM value in left-right twisting of C4, 5 was significantly larger than those of C5, 6 and C6, 7 (P<0.05), but the ROM value in left-right bending showed no significant difference between segments (P>0.05). In left and right bending, there was no significant difference in the displacement between other segments (P>0.05) except that the displacement in anterior-posterior direction of C3, 4 was significantly larger than that of C4, 5 (P<0.05), and that the displacement in proximal-distal direction of C6, 7 was significantly less than that of C3, 4 and C4, 5 (P<0.05); no significant difference was shown in the ROM value between segments (P>0.05), except that the ROM value in left-right twisting of C3, 4 was significantly larger than that of C5, 6 and C6, 7 (P<0.05). In left and right rotation, the ROM value in left-right twisting of C3, 4 was significantly larger than that of C4, 5 and C6, 7 (P<0.05), and the displacement and ROM value showed no significant differece between other segments (P>0.05).
ConclusionThe intervertebral motions of the cervical spine show different characters at different levels. And the 6-degree-of-freedom data of the cervical vertebrae are obtained, these data may provide new information for the in vivo kinematics of the cervical spine.
Since January 2020, due to the epidemic of coronavirus disease 2019, all universities in China have postponed their studies or even suspend their studies. In response to the teaching policy of “suspending class, but keeping teaching and learning” , college teachers have rapidly changed into online teaching mode. However, how to ensure the quality and effect of online teaching still needs further exploration. Through analyzing the course characteristics of medical imaging diagnostics and students’ learning situations, this study discusses how to design detailed online teaching projects and improve the teaching quality and how to select online software suitable for the course. A questionnaire survey was conducted to evaluate the effect of online teaching during the spring course in 2020, selecting a total of 297 clinical and other undergraduate students of grade 2017 from West China School of Medicine of Sichuan University. The results showed that the detailed online teaching programs including “video learning” “distance teaching” “periodic examination” “weakness tutorial” were helpful to the learning process agreed by the majority of students. During the epidemic period, online teaching method can help students master the content of medical imaging diagnosis. In the era of Internet, the “online+offline” teaching mode is expected to be popularized in the future.
This study aims to determine the salient brain regions with abnormal changes in white matter structures from diffusion tensor imaging (DTI) images of the patients with temporal lobe epilepsy (TLE), and to discriminate the patients with TLE from normal controls (NCs). Firstly, the DTI images from 50 subjects (28 NCs and 22 TLE) were acquired. Secondly, the four measures including the fractional anisotropy (FA), the mean diffusivity (MD), the axial diffusivity (AD) and the radial diffusivity (RD) were calculated. Thirdly, the tract-based spatial statistics (TBSS) was adopted to extract the measures in brain regions with significant differences between the two compared groups. Fourthly, the obtained measures were used as input features of the support vector machine (SVM) for classification, and the support vector machine-recursive feature elimination (SVM-RFE) was compared with the support vector machine-tract-based spatial statistics (SVM-TBSS) method. Finally, the essential brain regions and their spatial distribution were analyzed and discussed. The experimental results showed that the FA measures of the TLE group decreased significantly in the corpus callosum, superior longitudinal fasciculus, corona radiata, external capsule, internal capsule, inferior fronto-occipital fasciculus, fasciculus uncinatus and sagittal stratum, which were nearly bilaterally distributed, while the MD and RD increased significantly in most of these brain regions of the TLE group. Although the AD also increased, the differences were not statistically significant. The SVM-TBSS classifier obtained accuracies of 82%, 76% and 76% using the FA, MD and RD for classification, respectively, and 80% using combined measures. The SVM-RFE classifier obtained accuracies of 90%, 90% and 92% using the FA, MD and RD respectively, while the highest accuracy was 100% using combined measures. These results demonstrated that the SVM-RFE outperformed the SVM-TBSS, and the dominant characteristic influencing classification in brain regions were in associative and commissural fibers. These results illustrated that the measures of DTI images could reveal the abnormal changes in white matter structure of patients with TLE, providing effective information to clarify its pathological mechanism, localize the focus and diagnose automatically.
Inflammatory myofibroblastic tumor (IMT) occurring in the pancreas was rare and few clinical cases had been reported. The specificity of clinical presentation of IMT was lacked and its CT imaging manifestations were diverse. The enhanced CT images of a rare patient with IMT of the pancreas with liver metastases were presented to the readers, and the pathophysiological mechanisms associated with the CT imaging manifestations were briefly described, so as to enhance the readers’ understanding and knowledge of the CT imaging manifestations and raise the diagnostic awareness of the disease.
【Abstract】Objective To compare radiologists’ performance on combined unenhanced and feridexs-enhanced MR imaging （MRI） with their performance on helical CT enhanced, unenhanced MRI, and feridexs-enhanced MR alone imaging for the characteristics of local hepatic lesions. Methods MR images and CT scans obtained in 26 patients with 57 local hepatic lesions were analyzed with reviewer operator characteristic (ROC) curve analysis. The imaging of patient were divided into 4 groups including combined unenhanced and feridexs-enhanced MRI group, helical CT enhanced group, unenhanced MRI group, and feridexsenhanced MR alone group. Results The combined approach resulted in larger area under the ROC curve (Az=0.926 0) and accuracy (86.8%),P＜0.05，as compared with the others methods. There were no significant differences among the other three methods. Conclusion Feridexs-enhanced MRI was more accurate than enhanced helical CT scan in characterization of local hepatic lesion. The combined analysis of unenhanced and feridexs-enhanced images was more accurate in the characterization of focal hepatic lesions than was review of feridexs-enhanced images alone.
Objective To evaluate the three-dimensional acetabular orientation in asymptomatic population and patients of developmental dysplasia of the hip (DDH) using a semi-automated measurement software, which provides data for the differential diagnosis, surgical planning, surgical instrument design, and postoperative evaluation of hip related diseases. MethodsEighty-four cases of CT data in asymptomatic population (asymptomatic group) and 47 cases of CT data in DDH patients (DDH group) were collected. There was no significant difference in gender and age (including age of male and female subgroups) between the two groups (P<0.05). MaxTHA, a semi-automatic measurement software, was used to measure acetabular inclination and anteversion, including operative inclination (OI), radiographic inclination (RI), anatomic inclination (AI), operative anteversion (OA), radiographic anteversion (RA), and anatomic anteversion (AA). Comparisons were made between the two populations, between different Crowe classification subgroups, between different gender subgroups, and between left and right sides of acetabula. Results The comparison between asymptomatic group, healthy side of DDH group, and affected side of DDH group showed that there was no significant difference in acetabular orientation between asymptomatic group and healthy side of DDH group (P>0.05). The OI, RI, and AI of affected side of DDH group were significantly higher than those in healthy side of DDH group and asymptomatic group, and AA was significantly lower than that in healthy side of DDH group and asymptomatic group (P<0.05). The comparison between the normal acetabula and DDH acetabula with different Crowe classifications showed that there was no significant difference in the acetabulum orientation between Crowe Ⅰ group and the normal group (P>0.05). The OI, RI, and AI of Crowe Ⅱ, Ⅲ, and Ⅳ groups were significantly higher than those of normal group (P<0.05), the OI of Crowe Ⅲ group, RI and AI of Crowe Ⅳ group were significantly higher than those of Crowe Ⅰ group (P<0.05), the AI of Crowe Ⅳ group was significantly higher than that of Crowe Ⅱ group (P<0.05), and the OA, RA, and AA of Crowe Ⅲ group were significantly lower than other subgroups (P<0.05) except Crowe Ⅰ group. The OA, RA, and AA in asymptomatic female group, and the OA and AI in DDH female group were significantly higher than those in all male groups (P<0.05). The OI, RI, AI, and OA of the right acetabula in asymptomatic male group, and the RI and AI of the right acetabula in asymptomatic female group were significantly higher than those on the left side (P<0.05). ConclusionThere were significant differences in acetabular orientation between asymptomatic and DDH populations, inter-group differences among Crowe classification subgroups, inter-gender differences among subgroups, and bilateral differences among asymptomatic individuals.
The TNM staging of lung cancer which is now widely used in clinic was formally proposed in 1997. It has played quite an important role in directing the diagnosis and treatment of lung cancer as well as the clinical research in the past decade. However, at the same time, there are some insufficiencies which are emerging gradually. By collecting the clinical information from 100 869 patients, in 2007, International Association for the Study of Lung Cancer(IASLC) made a deep analysis on the relativity between TNM staging and prognosis, and put forward the suggestions to revise the Seventh Edition of the TNM staging of lung cancer: (1) According to the size of tumor, the primary T staging is divide into T1a (the maximum tumor diameter≤2 cm), T1b (3 cm≥the maximum tumor diameter＞2 cm), T2a (5 cm≥the maximum tumor diameter＞3 cm) and T2b (7 cm≥the maximum tumor diameter＞5 cm); (2) T 2c (the maximum tumor diameter gt;7 cm) and additional nodules in the same lobe are classified as T3, while nodules in the ipsilateral nonprimary lobe are classified as T4;(3) Cancerous hydrothorax, pericardial effusion and the additional nodules in the contralateral lung are classified as M1a, while the extrapulmonary metastases are classified as M1b. It is believed that the new revised edition will has higher international authority and identification degree, and it will play a more meticulous and accurate guiding role in the treatment of lung cancer and its predicting prognosis in the future. At the same time, it will provide a new starting point to the research of lung cancer.
Objective To review the current status of magnetic resonance imaging (MRI) techniques in the evaluation of hepatic fibrosis. Methods The application and recent advances of various kinds of MRI techniques in evaluating hepatic fibrosis were summarized by literature review. Results The state-of-the-art of MRI evaluating of hepatic fibrosis included common contrast-enhanced MRI, double contrast-enhanced MRI, and various functional MRI techniques. Common contrast-enhanced MRI could detect morphological changes of the liver, but little value in phasing. Double contrast-enhanced MRI markedly increased the contrast to noise ratio. Except diagnosis liver fibrosis, functional MRI also could phase it by its serverity. Conclusion MRI techniques, especially those functional MRI techniques, are advancing very fast and have very great potentiality in both the diagnosis and severity assessment of hepatic fibrosis.
Objective
To investigate the role of preoperative serum thyroid stimulating hormone (TSH) in evaluating differentiated thyroid cancer (DTC).
Methods
A total of 551 patients with thyroid nodules met the study criteria, who got treatment in the First Affiliated Hospital of Jiamusi University between Aug. 2017 and Dec. 2017. And the patients were divided into DTC group (n=110) and benign group (n=441) according to the postoperative pathological results. The difference of serum TSH level between the 2 groups was compared and then explored the diagnostic significance of serum TSH level, thyroid imaging report and data system (TI-RADS), and serum TSH combined withTI-RADS.
Results
The serum TSH level was higher in the DTC group than that of the benign group (Z=5.198, P<0.05). The sensitivity of preoperative serum TSH level in the diagnosis of DTC was 80.9% (89/110), the specificity was 74.4% (328/441), and the area under receiver operating characteristic (ROC) curve was 0.660 ［95%CI was (0.602, 0.719), P<0.05］. The sensitivity of TI-RADS in the diagnosis of DTC was 82.7% (91/110), the specificity was 73.5% (324/441), and the area under the ROC curve was 0.772 ［95%CI was (0.711, 0.823), P<0.05］. The sensitivity of preoperative serum TSH combined with TI-RADS in the diagnosis of DTC was 91.8% (101/110), the specificity was 87.5% (386/441), and the area under the ROC curve was 0.831 ［95%CI was (0.786, 0.876), P<0.05］.
Conclusions
Preoperative serum TSH level may be a potential risk factor for the occurrence of DTC. Preoperative serum TSH level combined with TI-RADS classification can improve the accuracy of preoperative diagnosis of DTC, not only to reduce the misdiagnosis of thyroid cancer, but also can avoid excessive treatment.
