首页期刊导航|Chinese journal of academic radiology.
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Chinese journal of academic radiology.
Springer Singapore
Chinese journal of academic radiology.

Springer Singapore

2520-8985

Chinese journal of academic radiology./Journal Chinese journal of academic radiology.
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    Liver abscess after transcatheter arterial chemoembolization for hepatocellular carcinoma: clinical manifestations, risk factors, diagnosis, prevention, and treatment

    Chao YangJiaywei TsauoXiao Li
    5页
    查看更多>>摘要：Transcatheter arterial chemoembolization (TACE) is the recommended first-line treatment for Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma. However, TACE is associated with several major complications, such as liver abscess. Although liver abscess is an uncommon complication of TACE, it is associated with a high mortality rate. Early diagnosis and treatment of this complication are the keys to reducing the mortality rate and the length of hospital stay. However, no guidelines exist to guide the management of liver abscess after TACE. Herein, we review the clinical manifestations, risk factors, prevention, diagnosis, and treatment of liver abscess after TACE.
      原文链接:
    • NSTL

    Research progress on anti-tumor immune effect of cryoablation

    Ying LiuTao HuangLujun ShenYing Wu...
    8页
    查看更多>>摘要：As one of the local treatments, cryoablation plays an increasingly important role in the comprehensive treatment of malignant tumors with its advantages of less trauma, fewer complications, fast recovery, and high reproducibility. Cryoablation uses the lethal temperature to destroy the malignant tissue locally and allow the tumor antigens released in situ to be exposed to the immune system, leading to the generation of cryo-immunological responses. The immune effect induced by cryoablation may lead to immunostimulatory or immunosuppression, which is influenced by many factors. In recent years, immunotherapy has greatly improved the efficacy of tumor treatment. Unfortunately, tumor cells develop immune tolerance through multiple pathways to evade the host’s immune attack, thus affecting the therapeutic effect. Therefore, utilizing the immune effect caused by cryoablation, and combined it with immunotherapy such as immune adjuvant, adoptive cell therapy, and immune checkpoint inhibitors may improve the treatment of malignant tumors. In this paper, we overview the research progress about the immune effect of cryoablation and its combination with different forms of immunotherapy.
      原文链接:
    • NSTL

    Imaging features of renal lipid-poor angiomyolipomas: a pictorial review

    Ze-Liang LiuYan Tan
    17页
    查看更多>>摘要：Renal lipid-poor angiomyolipomas (lipid-poor AMLs) are usually difficult to differentiate from clear-cell renal cell carcinomas (RCCs), papillary RCCs, epithelioid AMLs, and oncocytomas, while the differentiation is important due to different treatments and prognoses. This pictorial review presents clinical, histopathological, and imaging (ultrasound [US], CT, and MRI) features of lipid-poor AMLs and the keys to differentiate them from the main subtypes of RCCs, epithelioid AMLs, and oncocytomas. Lipid-poor AMLs are small lesions, mostly occur in young female patients. They are often hyperechoic or isoechoic on US and show homogeneous hyperdensity without calcification on CT. MRI typical features include hypointensity on T2WI, discrete and focal signal intensity (SI) decrease on opposed-phase image, and with wash-in and wash-out enhancement. Clear-cell RCCs show heterogeneous hyperintensity on T2WI and diffuse decrease in SI on opposed-phase images. Papillary RCCs show SI drop on in-phase images (which reflects intratumoral hemorrhage) and a progressive enhancement. Epithelioid AMLs are big (7 cm) and heterogeneous with potential malignancy. Immunohistochemistry markers (such as HMB-45 antigen and melan-A) matter for their diagnosis. Oncocytomas may show typically central stellate scars with segmental enhancement inversion. In addition, combining clinical information, CT, and MRI features could further facilitate diagnostic accuracy.
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    • NSTL

    Diagnostic reference levels (DRLs) for chest radiography, non-contrast head computed tomography and mammography examinations in Nigeria: review of national data

    Ukamaka Dorothy ItanyiBlessing Ose-Emenim IgbinedionGodwin Inalegwu OgboleGbolahan Olusegun Awosanya...
    8页
    查看更多>>摘要：Aims and objectives To establish the national diagnostic reference levels (DRLs) for chest radiography, non-contrast head computed tomography (CT) and mammography examinations of adults in Nigeria. Materials and methods The study consisted of review of published studies on DRLs in Nigeria found in the internet using Google search engine from 2005 to 2019. Only publications containing substantial parts of the exposure parameters were used for the studies. Result For chest radiography, the mean parameters for posterior-anterior (PA) view were, tube voltage 80 (33-100) kV, tube current 30.8 (0.05-100) mAs, film-focus distance (FFD) 140 (62-178) cm, mean entrance dose 2.6 (0.12-7.7) mGy and mean effective dose (MED) 0.05 (0.018-0.16) mSv. For head CT, tube voltage 120 (100-140) kV, tube current 390 (215-550) mA, CT dose index (CTDI vol) 67 (25-88) mGy, dose length product (DLP) 1410 (320-1903) mGy cm and MED 2.8 (1.8-3.99) mSv. For breast mammography, tube voltage 23.90 (20.5-31)kV and 23.80 (20.03-31) kV, tube current 110.54 (60-417) mA and 110.46 (35-417) mA, entrance skin dose 0.83 (0.08-5.36) mSv and 3.12 (0.26-21.26) mSv, and mean glandular dose (MGD) 1.32 (0.02-6.41) mGy and 2.03 (0.07-8.59) mGy for craniocaudal and mediolateral views, respectively. For both breasts combined, the mean entrance skin dose is 2.5 (0.30-5.1) mSv while the MGD is 1.66 (0.31-2.5) mGy. Conclusion Patients in Nigeria receive comparative higher radiation doses for chest radiography and head CT but are exposed to lower radiation doses for breast mammography than obtained in the European Union (EU).
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    • NSTL

    Application of deep-learning reconstruction algorithm for enhanced CT scan of upper abdomen under different radiation doses: focus on noise, contrast-to-noise ratio and image quality

    Yanrong XieYuan-Cheng WangShan HuangShenghong Ju...
    15页
    查看更多>>摘要：Objectives To compare the effect of deep-learning image reconstruction (DLIR) and adaptive statistical iterative reconstruction-Veo (ASiR-V) for upper abdominal-enhanced CT. The foci of this study were to validate whether the image effect of DLIR would be better than that of ASiR-V under the same dose and whether the image effect of DLIR under low dose would be not lower than that of ASiR-V under routine dose, and the two algorithms were studied from different layer thickness. Methods A total of 17 patients with hepatic lesions undergoing upper abdominal-enhanced CT examination were randomly divided into two groups: low dose (LD, n?=?7) with 150 mAs and ultralow dose (ULD, n?=?10) with 100 mAs; routine dose (RD) scans were subsequently performed in both groups (n?=?17). Images were reconstructed with DLIR with low, medium, and high strength (DL-L, -M, and -H, respectively) and ASiR-V with standard 30% and 70% (ASiR-V 30% and 70%) on thin (0.625 mm) and thick (5 mm) slices. Noise and contrast-to-noise ratio (CNR) measurements were performed. Two radiologists, blinded to examination details, scored four categories of image quality while comparing reconstructions for vascular significance, image noise and texture, lesion conspicuity and lesion diagnosis confidence. Results Under the same dose, DLIR had better performance in noise, CNR and image quality scores than ASiR-V did, DL-H performed the best. Under different radiation doses, ULD-DL-M did not differ significantly from RD-ASiR-V 30% in noise and CNR (P?>?0.05), but had lower image quality scores (P?<?0.05). Noise, CNR and image quality scores of the LD-DL-H were comparable to those of RD-ASiR-V 30% (P?>?0.05). Conclusion DLIR can significantly improve the image quality of enhanced abdominal CT under the same dose. By decreasing the radiation dose to 150mAs, DL-H showed comparable image quality to that of RD-ASiR-V 30%.
      原文链接:
    • NSTL

    White matter microstructural integrity and BOLD fluctuation alterations mediated the effects of insulin resistance on cognitive function in patients with type 2 diabetes mellitus

    Xin WangYan BiZhou ZhangJiaming Lu...
    10页
    查看更多>>摘要：Aims To explore the neural mechanism of white matter related cognitive dysfunction in patients with type 2 diabetes mellitus. Methods This prospective study between 2016 and 2018 included 55 patients with type 2 diabetes mellitus and 40 participants without type 2 diabetes mellitus. Detailed neuropsychological assessment, clinical and biochemical information, diffusion tensor imaging and resting-state functional MRI were collected. The fractional anisotropy (FA), mean diffusivity (MD) and amplitude of low-frequency fluctuation (ALFF) in white matter were compared between the two groups and then extracted for correlation and mediation analysis with clinical parameters and cognitive assessments. Results The current research showed that three parameters changed in several white matter areas of patients with type 2 diabetes mellitus. Meanwhile, FA in the corpus callosum mediated the effect of insulin resistance on executive function in both two groups. In the group without type 2 diabetes mellitus, ALFF moderated the effect of FA on executive function. Conclusion Patients with type 2 diabetes mellitus showed alterations in structural integrity and activation of white matter, which played a mediating and regulating role in the cognitive impairment caused by insulin resistance.
      原文链接:
    • NSTL

    Application of coronary artery calcium score measurement on coronary CT angiography

    Zhang ZhangJingjing GuoYuanlin DengYan Yan...
    9页
    查看更多>>摘要：Objective To verify the accuracy and the clinical application of the coronary artery calcium score measurement on coronary CT angiography (CCTA). Methods The study enrolled 1093 patients (56.86 ± 9.47 years old, 454 males) who underwent both coronary artery calcium score plain CT and CCTA scans from 2018 to 2019. Calcium volume (CCTA-CV) and Agatston score (CCTA-AS) were both measured from the CCTA images taking the mean aortic attenuation value pluses twice the standard deviation as the calcium detection threshold. Calcium volume (Plain CT-CV) and Agatston score (Plain CT-AS) were also measured on plain CT as the gold standard. Results Pearson correlation analysis showed good correlations between the CCTA-CV and Plain CT- CV in main branches and total volume (r2 = 0.96, 0.96, 0.92, 0.93, 0.96 for LM, LAD, LCX, RCA, and total volume, respectively, ps<0.001). CCTA-AS also correlated linearly with Plain CT-AS with a good correlation coefficient (r2 = 0.96, 0.97, 0.93, 0.94, 0.97 for LM, LAD, LCX, RCA, and total Agatston score, respectively, ps<0.001).Radiation dose were 1.42±0.13 mSv, and 1.87 + 0.12 mSv for CCTA scan only and for Plain CT + CCTA (t = - 11.82, p < 0.001). CCTA missed 35 cases’ calcification with the mean calcium volume = 4.59 mm3 and mean Agatston score = 2.31, while CCTA also rediscovered 13 cases’ calcification with the mean calcium volume = 3.92 mm3 and mean Agatston score = 5.21. Agatston grades Kappa between the two methods was 0.864 (p< 0.001). Additionally, age, male, diabetes mellitus, typical symptoms, smoke, and cerebrovascular disease were the impact factors for both Plain CT-AS and CCTA-AS (ps < 0.001). Conclusions Calcium volume and Agatston score can be accurately measured from CCTA images only with ~25% radiation dose reduction. Even though there were several missing or newly found calcification cases, CCTA-AS could indicate the risk stratification in the clinics.
      原文链接:
    • NSTL

    The correlation study on chest CT features and kidney injury in severe COVID-19 pneumonia from a multicenter cohort study

    Guangming LuGuan LiZhiyuan SunSong Luo...
    10页
    查看更多>>摘要：Background Among confirmed severe COVID-19 patients, although the serum creatinine level is normal, they also have developed kidney injury. Early detection of kidney injury can guide doctors to choose drugs reasonably. Study found that COVID-19 have some special chest CT features. The study aimed to explore which chest CT features are more likely appear in severe COVID-19 and the relationship between related (special) chest CT features and kidney injury or clinical prognosis. Methods In this retrospective study, 162 patients of severe COVID-19 from 13 medical centers in China were enrolled and divided into three groups according to the estimated glomerular filtration rate (eGFR) level: Group A (eGFR< 60 ml/ min/1.73 m2), Group B (60 ml/min/1.73 m2≤eGFR<90 ml/min/1.73 m2), and Group C (eGFR >90 ml/min/1.73 m2). The demographics, clinical features, auxiliary examination, and clinical prognosis were collected and compared. The chest CT features and eGFR were assessed using univariate and multivariate Cox regression. The influence of chest CT features on eGFR and clinical prognosis were calculated using the Cox proportional hazards regression model. Results Demographic and clinical features showed significant differences in age, hypertension, and fatigue among the Group A, Group B, and Group C (all P < 0.05). Auxiliary examination results revealed that leukocyte count, platelet count, C-reactive protein, aspartate aminotransferase, creatine kinase, respiratory rate > 30 breaths/min, and CT images rapid progression (>50%) within 24-48 h among the three groups were significantly different (all P<0.05). Compared to Group C (all P< 0.017), Groups A and B were more likely to show crazy-paving pattern. Logistic regression analysis indicated that eGFR was an independent risk factor of the appearance of crazy-paving pattern. The eGFR and crazy-paving pattern have a mutually reinforcing relationship, and eGFR (HR = 0.549, 95% CI = 0.331-0.909, P = 0.020) and crazy-paving pattern (HR = 2.996, 95% CI = 1.010-8.714, P = 0.048) were independent risk factors of mortality. The mortality of severe COVID-19 with the appearance of crazy-paving pattern on chest CT was significantly higher than that of the patients without its appearance (all P < 0.05). Conclusions The crazy-paving pattern is more likely to appear in the chest CT of patients with severe COVTD-19. In severe COVID-19, the appearance of the crazy-paving pattern on chest CT indicates the occurrence of kidney injury and proneness to death. The crazy-paving pattern can be used by doctors as an early warning indicator and a guidance of reasonable drug selection.
      原文链接:
    • NSTL