ObjectiveTo evaluate the diagnostic value of artificial intelligence (AI)-assisted diagnostic system for pulmonary cancer based on CT images.MethodsDatabases including PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and Chinese BioMedical Literature Database (CBM) were electronically searched to collect relevant studies on AI-assisted diagnostic system in the diagnosis of pulmonary cancer from 2010 to 2019. The eligible studies were selected according to inclusion and exclusion criteria, and the quality of included studies was assessed and the special information was identified. Then, meta-analysis was performed using RevMan 5.3, Stata 12.0 and SAS 9.4 softwares. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were pooled and the summary receiver operating characteristic (SROC) curve was drawn. Meta-regression analysis was used to explore the sources of heterogeneity.ResultsTotally 18 studies were included with 4 771 patients. Random effect model was used for the analysis due to the heterogeneity among studies. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the SROC curve were 0.87 [95%CI (0.84, 0.90)], 0.89 [95%CI (0.84, 0.92)], 7.70 [95%CI (5.32, 11.15)], 0.14 [95%CI (0.11, 0.19)], 53.54 [95%CI (30.68, 93.42)] and 0.94 [95%CI (0.91, 0.95)], respectively.ConclusionAI-assisted diagnostic system based on CT images has high diagnostic value for pulmonary cancer, and thus it is worthy of clinical application. However, due to the limited quality and quantity of included studies, above results should be validated by more studies.
ObjectiveTo measure L1-L5 lumbar isthmus thickness and to construct Chinese adult male lumbar (L1-L5) 3D model by Micro CT 3D reconstruction technique, in order to provide micro-anatomical data for clinical treatment of L1-L5 lumbar spondylolysis. MethodsDry, non-damaged specimens of L1-L5 lumbar isthmus from 60 Chinese adult males were randomly selected from September 2013 to January 2014. Micro CT scanning was carried out, followed by corresponding 3D model construction. The microscopic anatomical parameters such as superior, inferior, inner and outer edge thickness of left and right L1-L5 lumbar isthmus were measured. ResultsL1-L5 lumbar isthmus superior edge thickness was in the order of L1> L2> L3> L5> L4, with the variation ranging from (4.31±0.95) mm to (4.88±0.75) mm. L1-L5 lumbar isthmus inferior edge thickness was in the order of L1< L2< L3< L4< L5, gradually thickened with the variation ranging from (6.03±1.01) mm to (7.27±1.27) mm. L1-L5 lumbar isthmus inner edge thickness amplitude was not obvious, ranging from (6.33±1.21) mm to (6.57±1.27) mm. L1-L5 lumbar isthmus outer edge thickness was in the order of L1< L2< L3< L4< L5, gradually thickened with the variation ranging from (8.44±1.21) mm to (10.27±1.28) mm. ConclusionThere are certain rules within superior, inferior, inner and outer edge thickness of adult L1-L5 lumbar isthmus:the inferior and outer edge thickness of L1-L5 lumbar isthmus gradually becomes thicker, while superior edge gradually becomes thinner. From L1 to L5 lumbar isthmus, the outer edge of the lumbar isthmus is the thickest, followed by inner and inferior edge, and the upper edge is the thinnest.
Objective To probe CT grading criteria of vascular invasion in pancreatic cancer. Methods Retrieved articles in CNKI and PubMed about value of CT in preoperative assessment of vascular invasion in pancreatic cancer last ten years. Results Multislice helical CT is considered the best imaging method to assess the invaded peripancreatic vessels in pancreatic cancer. There are different CT criteria of vascular invasion in pancreatic cancer based on extension of hypodense tumor and its relation to blood vessels, on the degree of circumferential contiguity of tumor to vessel, on the degree of lumen stenosis, and on the degree of contiguity between tumor and vessels combined vascular caliber. Conclusion CT grading criteria are not uniform, each one has defects.
Objective To improve accuracy of clinical diagnosis through analyzing the CT characteristics and clinical manifestations of patients with benign lung diseases whose CT manifestations initially led to a suspicion of lung cancer. Methods This study collected 2 239 patients of benign lung disease verified by postoperative pathology in the Department of Thoracic Surgery, Beijing Chao-yang Hospital from June 2006 to December 2016. Lesions of 173 patients (101 males and 72 females with a mean age of 56.0 years) were considered very likely to be malignant on preoperative contrast CT scan, which were sorted to 20 types of lung diseases, and the 20 types of diseases contained 907 patients diagnosed or misdiagnosed. Statistical analyses were performed using the CT and clinical characteristics of the 173 patients. Results Among the 907 patients with benign lung disease, the benign pathologies that were most commonly misdiagnosed by preoperative enhanced CT were pulmonary leiomyoma (100.0%), pulmonary actinomycosis (75.0%), pulmonary cryptococcosis (71.4%), sclerosing hemangioma (50.0%) and organizing pneumonia (44.2%). Among the 173 patients with benign diseases, the most common diseases were tuberculosis (29.5%), organizing pneumonia (28.9%), pulmonary hamartoma (6.4%) and pulmonary abscess (6.4%). In the 173 patients, 17.3% had fever, 56.6% coughing, 8.7% yellow sputum, 28.9% hemoptysis, 16.2% chest pain, 18.5% elevated leukocyte counts and 4.6% elevated carcinoembryonic antigen levels. Most of the CT manifestations consisted of nodular or mass shadows, 70.5% of which had foci≤3 cm and manifestations were similar to those of lung cancer, such as a spiculated margin (49.1%), lobulation (33.5%), pleural indentation (27.2%) and significant enhancement (39.3%). Furthermore, some patients had uncommon tumor signs, such as calcification (12.7%), central liquefactive necrosis (18.5%), satellite foci (9.8%) and multiple pulmonary nodules (42.2%). Moreover, 24.3% of the patients had enlarged lymph nodes of the mediastinum or hilum. Conclusion As the CT manifestations of some benign lung conditions are similar to those of lung cancer, careful differential diagnosis is necessary to identify the basic characteristics of the disease when the imaging results are ambiguous, and the diagnosis of a lung disease need incorporate the patients' clinical characteristics and a comprehensive analysis.
ObjectiveTo evaluate the relationship between CT lesion changes in COVID-19 patients and different subgroups of T lymphocytes, providing reference information for assessing patient conditions, predicting outcomes, and evaluating treatment efficacy. MethodsClinical and imaging data of confirmed COVID-19 patients admitted to the Chongqing Public Health Medical Center from January 24 to March 15, 2020, were collected. Based on the absorption characteristics of lesions in CT images, patients were categorized into three groups: Group A (obviously continuously absorbed), Group B (stable-slow absorption), and Group C (progressive absorption). The relationship between CT changes and T lymphocyte subgroups was analyzed according to lesion absorption. ResultsA total of 47 patients were included, with 18 in Group A, 14 in Group B, and 15 in Group C. At different stages—admission, during treatment, and at the end of treatment—the levels of T lymphocytes were observed as follows: Group A>Group B>Group C. When lesions were absorbed, the average count of CD4+ T lymphocytes was (544.43 ± 163.34) cells/μl; when lesions showed little change or increased, CD4+ T lymphocyte levels decreased to varying degrees. During treatment, both Group A and Group B showed CD4+ T lymphocyte levels returning to above normal levels, with an average increase of 134 cells/μl in Group A, which was lower than that in Group B (192 cells/μl) and Group C (149 cells/μl). Finally, T lymphocyte levels reached normal in all groups, but Group A levels were higher than those in Groups B and C (P<0.05). Upon follow-up, the average CD4+ T lymphocyte count was (544.43 ± 163.34) cells/μl in 52 cases of lesion absorption, (339.06 ± 145.98) cells/μl in 31 cases of minimal change, and (230.50 ± 95.24) cells/μl in 16 cases of lesion progression, with statistically significant differences among the three groups (P<0.05). ConclusionsThe increase in lung lesions in patients indicates poor immune function, necessitating enhanced immune regulation. Conversely, if a decrease in T lymphocyte levels is detected during the course of the disease, attention should be given to the risk of lesion progression, and timely CT re-examinations should be conducted to monitor changes in lesions.
Objective To explore the reliability and accuracy of the arbitrary point method for measuring the anteversion angle of acetabular prosthesis after total hip arthroplasty (THA) based on pelvic X-ray films. Methods The clinical data of 23 patients (25 hips) who underwent THA between December 2018 and September 2023 and met the selection criteria were retrospectively analyzed. Among them, there were 16 males and 7 females, with an average age of 57.6 years (range, 34-81 years); 13 hips had THA on the left side and 12 on the right side. There were 19 cases (21 hips) of osteonecrosis of the femoral head, 2 cases (2 hips) of femoral neck fractures, 1 case (1 hip) of developmental dysplasia of the hip, and 1 case (1 hip) of osteoarthritis. After THA, all patients underwent X-ray examination and CT scan. Three physicians measured the anteversion angle of acetabular prosthesis using the arbitrary point method and the CT measurement method respectively, and repeated the measurements three times. The results of the two measurement methods were compared, and the intraclass correlation coefficient (ICC) was employed to assess the reproducibility of the methods. Results The anteversion angles of acetabular prosthesis were (15.87±7.73)° measured by the arbitrary point method, and (15.31±7.89)° measured by CT measurement method. There was no significant difference between the two methods (t=1.515, P=0.143). The ICC of the measurement results by the arbitrary point method for the three physicians were 0.97 (P<0.001), 0.96 (P<0.001), and 0.96 (P<0.001), respectively; and the ICC of the measurement results by CT method were 0.93 (P<0.001), 0.93 (P<0.001), and 0.94 (P<0.001), respectively. Conclusion The arbitrary point method for measuring the anteversion angle of acetabular prosthesis after THA based on pelvic X-ray film is easy to operate, accurate, and has high reproducibility.
Objective To investigate the methods of establishing 3-dimensional skull model using electron beam CT(EBCT) data rapid prototyping technique, andto discuss its application in repairing crainomaxillofacial trauma. Methods The data were obtained by EBCTcontinuous volumetric scanning with 1.0 mm slice at thickness. The data were transferred to workstation for 3-dimensional surface reconstruction by computeraided design software and the images were saved as STL file. The data can be usedto control a laser rapid-prototyping device(AFS-320QZ) to construct geometricmodel. The material for the model construction is a kind of laser-sensitive resinpower, which will become a mass when scanned by laser beam .The design and simulation of operation can be done on the model. The image data were transferred to the device slice by slice. Thus a geometric model is constructed according to the image data by repeating this process. Preoperative analysis, surgery simulation and implant of bone defect could be done on this computer-aided manufacture d3D model. One case of craniomaxillofacial bone defect resulting from trauma wasreconstructed with this method. The EBCT scanning showed that the defect area was 4 cm×6 cm. The nose was flat and deviated to left. Results The -3dimensional -skull was reconstructed with EBCT data and rapid prototyping technique. The model can display the structure of 3-dimenstional anatomyand their relationship.The prefabricated implant by 3-dimensional model was well-matched with defect .The deformities of flat and deviated nose were corrected. The clinical result wassatisfactory after a follow-up of 17 months. Conclusion The 3-dimensional model of skull can replicate the prototype of disease and play an important role in the diagnosis and simulation of operation for repairing craniomaxillofacial trauma.
【Abstract】 Objective Using 16-slice multi-detector row helical CT (16-slice MDCT) to investigate the value of multiplanar reformation technique (MPR) in the diagnosis of bowel obstruction. Methods Thirty patients with surgically (27 cases) or clinically (3 cases) proofed diagnosis of bowel obstruction underwent 16-slice MDCT examination of the entire abdomen. All cases had plain CT scan, while 20 cases had additional contrast-enhanced CT scan at portal venous phase. In addition to the conventional axial images, the original CT raw data were then reconstructed into both coronal and sagittal images using MPR technique. Imaging findings were analyzed on axial, MPR coronal and sagittal images. Results Among the 30 patients with bowel obstruction, there were 8 cases caused by adhesion, 7 by simple intestinal tumor, 5 by intussusception (including caused by instestinal tumor), 4 by abdominal hernia, 2 by volvulus, 1 by ileocecal abscess, 1 by stenosis of mesenteric artery，1 by retroperitoneal cyst, and 1 by carcinoma in pancreatic tail. Six patients developed intestinal ischemia or strangulation. Both axial and MPR images correctly depicted the presence of bowel obstruction. Based on CT axial view （AV）, the site and the underlying etiology of bowel obstruction were determined in 26 (86.7%) and 22 (73.3%) patients respectively, while the combination with MPR coronal and sagittal images improved the diagnostic performance to 29 (96.7%) and 27 (90.0%) patients respectively. Both axial and MPR images correctly revealed the presence of intestinal ischemia or strangulation in 5 （83.3%）patients. Conclusion MPR technique of MDCT is very useful for evaluating the site and etiology of bowel obstruction, as well as the circulation status of involved bowel loop.
Objective To discuss the diagnostic value of multidetector CT(MDCT) on encapsulated fat necrosis after operation of abdominal cancer, and to investigate the key differences of CT features between encapsulated fat necrosis and postoperative recurrence or metastasis. Methods CT data of 36 patients with encapsulated fat necrosis after operation of abdominal cancer, who received CT in our hospital between Feb. 2012 to May. 2014 during followed-up were retrospectively analyzed, for the purpose of summarizing the CT characteristics. In addition, the clinical presentation, level of carcinoembryonic antigen (CEA) and CA-125 before and after operation were also taken into account, to explore the difference between encapsulated fat necrosis with tumor recurrence and metastasis. Results Among the 36 patients who had suffered from encapsulated fat necrosis after operation of abdominal cancer, 3 patients (8.3%) had 2 lesions and the rest of 33 patients (91.7%) had solitary lesion(a total of 39 lesions). All lesions showed non homogeneous masses consistent with the surgery path and surrounded by fat density ring and soft tissue density capsule. The size of most lesions (94.8%, 37/39) decreased over time. All lesions were found slightly enhancement in portal phase. Five patients with postoperative tumor metastasis, 31 patients had no recurrence or metastasis. Among the 5 patients who had postoperative tumor metastasis at the same time, postoperative CEA was positive in 3 patients, and postoperative CA-125 was positive in 2 patient. Among the other 31 patients who had no recurrence or metastasis, the levels of postoperative CEA and CA-125 of 1 patient were unknown, and the postoperative CEA and CA-125 of 27 patients in the rest patients(90.0%, 27/30) were both negative. Most of them had no special clinical symptoms, only a few (1 patient)patient had mild abdominal pain without other associated symptoms. Conclusion CT is a valuable tool to reveal and diagnose encapsulated fat necrosis in postoperative abdominal cancer. Combined CT findings(such as location, shape, and density) with CEA, CA-125, and clinical presentation, that is easy to differ it from postoperative recurrence and metastasis.
Objective To evaluate the reporting quality of randomized controlled trials (RCTs) on acupuncture for acute ischemic stroke. Methods Six databases including The Cochrane Central Register of Controlled Trials (CENTRAL, Issue 4, 2005), MEDLINE (1966 to December 2005), EMbase (1984 to December 2005), China National Knowledge Infrastructure (CNKI, 1994 to December 2005), China Biomedicine Database disc (CBMdisc, 1980 to December 2005), VIP (a full text issues database of China, 1989 to December 2005) were searched systematically. Handsearch for further references was conducted. Language was limited to Chinese and English. We identified 74 RCTs that used acupuncture as an intervention and assessed the quality of these reports against the Consolidated Standards for Reporting of Trials (CONSORT) statement and Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA).Results In regard to the items in the CONSORT statement, 54 (73%) RCTs described baseline demographic and clinical characteristics in each group. Twenty-six (35%) mentioned the method of generating the random sequence, with 4 (5%) using a computer allocation. Only 6 (8%) RCTs had adequate allocation concealment, with 5 RCTs using sealed opaque envelopes and 1 RCT using centralized computer allocation. Only 8 (11%) RCTs used blinding, including 5 described as double-blind. Four (5%) RCTs reported the sample size calculation and 5 (7%) RCTs reported that an intention-to-treat (ITT) analysis. In regard to the items in STRICTA , only 4 (5%) RCTs reported the numbers of needles inserted. In 35 (47%) RCTs the needle type was reported, but only 26 (35%) mentioned the depths of insertion. Only 1 (1%) RCT mentioned the length of clinical experience and 6 (8%) RCTs reported the background of the acupuncture practitioners, but none stated the duration of their training.Conclusion The reporting quality of RCTs of acupuncture for acute ischemic stroke was low. The CONSORT statement and STRICTA should be used to standardize the reporting of RCTs of acupuncture.