1文献来源,Herder GJ,van Tinteren H,Golding RP,et al.Clinical prediction model to characterize pulmonary nodules:Validation and added value of 18F-fluorodeoxyglucose positron emission tomography[J].Chest,2005,...1文献来源,Herder GJ,van Tinteren H,Golding RP,et al.Clinical prediction model to characterize pulmonary nodules:Validation and added value of 18F-fluorodeoxyglucose positron emission tomography[J].Chest,2005,128,2490-2496.2证据水平3。展开更多
1文献来源Gould,MK,Sanders GD,Barnett PG,etal.Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules[J].Ann Intern Med,2003,138(9):724-735.2证据水平1a。
突触密度活体可视化评估与定量分析在神经和精神疾病的诊断、治疗监测和机制研究方面具有广阔的临床应用前景。突触前膜囊泡蛋白2A(synaptic vesicle protein 2A,SV2A)可反映突触密度情况并与神经元兴奋性改变、致痫网络形成和癫痫耐药...突触密度活体可视化评估与定量分析在神经和精神疾病的诊断、治疗监测和机制研究方面具有广阔的临床应用前景。突触前膜囊泡蛋白2A(synaptic vesicle protein 2A,SV2A)可反映突触密度情况并与神经元兴奋性改变、致痫网络形成和癫痫耐药密切相关。为可视化评估突触密度,本研究采用GE Tracerlab FXFN模块高效合成与标记特异性靶向SV2A新型PET核素分子探针^(18)F-SynVesT-1,通过理化性质、稳定性、比活度、细菌内毒素等检测技术进行质量控制,利用癫痫动物模型对^(18)F-SynVesT-1显像效果进行验证。结果显示,Tracerlab FXFN模块能实现^(18)F-SynVesT-1的高效合成,未校准放化产率为(11.4±2.6)%,且产品溶液满足临床及注射要求。本研究合成的^(18)F-SynVesT-1质控表现良好,可用于活体脑突触显像、突触密度定量评估及致痫灶异常检测分析。展开更多
目的探讨基底动脉尖综合证(top of the basilar arteny syndrome,TOBS)的临床表现,诊断及治疗。方法对41例经CT或MRI证实的TOBS患者的临床资料进行分析。结果 TOBS的主要病因仍为高血压脑动脉粥样硬化(79.8%),其次是心源性(心房纤颤)栓...目的探讨基底动脉尖综合证(top of the basilar arteny syndrome,TOBS)的临床表现,诊断及治疗。方法对41例经CT或MRI证实的TOBS患者的临床资料进行分析。结果 TOBS的主要病因仍为高血压脑动脉粥样硬化(79.8%),其次是心源性(心房纤颤)栓子来源(14.3%)。影像检查以中脑,丘脑,枕叶病变最多见。结论 TOBS的临床表现的多样化与基底动脉尖部5支不同血管的血流分布有关,突发意识障碍又较快恢复,无明显运动、感觉障碍,但有瞳孔改变、动眼神经麻痹、有皮质盲或偏盲应想到TOBS的可能,尽早进行头颅MRI对早期诊断、治疗和预后有重要价值。展开更多
Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic c...Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic cyst from January 1983 to December 2007. Of all the patients, 28 were male and 22 were female, with an average age of 36.9 (range, 18 to 64) years. The symptoms, location of the cysts, imaging evaluation, surgical treatment manner, and outcome of these patients were analyzed. Results Symptoms were present in 33 of the 50 patients, and cough was the most common symptom. Thirteen patients presented with complications: hemoptysis, infected cyst, dysphagia, paralysis, and hoarseness. The locations of the cysts included the mediastinum (28 cases), pulmonary parenchyma (12 cases), hilar area (3 cases), visceral pleura (1 case), and some rare locations including the intestinal mesentery (1 case), retroperitoneum (1 case), adrenal gland (1 case), neck (2 cases), and dura matter of the cervical verte-brae (1 case). Chest X-ray was performed in 36 patients and computed tomography (CT) was performed in 41 patients. The bronchogenic cyst in CT was characterized as a round, well circumscribed, unilocular mass, with density ranging from that of water to high density (0-50 Hu). As for treatment, complete resection of the bronchogenic cyst was performed in 47 (94%) patients, subtotal resection was performed in 3 (6%) patients. Open surgery was performed in 45 (90%) patients, and thoracoscopy (video-assisted thoracic surgery) was performed in 5 (10%) paitients. Of the 12 patients with intrapulmonary cyst, 11 patients underwent lobectomy and 1 patient underwent wedge resection. Postoperative sequelae occurred in 2 patients, 1 with persistent air leakage and 1 with hoarseness. All patients were proved with bronchogenic cyst pathologically. The average follow-up period was 6.5 years (range, 4 months to 10 years), and no late sequelae or recurrence of the cyst occurred. Conclusions The clinical and imaging presentations of bronchogenic cyst in adults are variable. Surgical resection is the best way for diagnosis and treatment. Both open surgery and thoracoscopy are appropriate for the selected candidates.展开更多
Abdominal aortic aneurysm is a common vascular disease that affects elderly population.Open surgical repair is regarded as the gold standard technique for treatment of abdominal aortic aneurysm,however,endovaseular an...Abdominal aortic aneurysm is a common vascular disease that affects elderly population.Open surgical repair is regarded as the gold standard technique for treatment of abdominal aortic aneurysm,however,endovaseular aneurysm repair has rapidly expanded since its first introduction in 1990s.As a less invasive technique,endovascular aneurysm repair has been confirmed to be an effective alternative to open surgical repair,especially in patients with co-morbid conditions.Computed tomography (CT) angiography is currently the preferred imaging modality for both preoperative planning and post-operative follow-up.2D CT images are complemented by a number of 3D reconstructions which enhance the diagnostic applications of CT angiography in both planning and follow-up of endovascular repair.CT has the disadvantage of high cummulative radiation dose,of particular concern in younger patients,since patients require regular imaging follow-ups after endovascular repair,thus,exposing patients to repeated radiation exposure for life.There is a trend to change from CT to ultrasound surveillance of endovascular aneurysm repair.Medical image visualizations demonstrate excellent morphological assessment of aneurysm and stent-grafts,but fail to provide hemodynamic changes caused by the complex stent-graft device that is implanted into the aorta.This article reviews the treatment options of abdominal aortic aneurysm,various image visualization tools,and follow-up procedures with use of different modalities including both imaging and computational fluid dynamics methods.Future directions to improve treatment outcomes in the follow-up of endovascular aneurysm repair are outlined.展开更多
Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponad...Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography (CT). Only a few studies are reported in literature involving post-mortem (PM) cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.展开更多
Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislic...Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease. High diagnostic value has been achieved with multislice CT angiography with use of 64- and more slice CT scanners. In addition, multislice CT angiography shows accurate detection and analysis of coronary calcium, characterization of coronary plaques, as well as prediction of the disease progression and major cardiac events. Thus, patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures. The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease; prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques. Limitations of multislice CT angiography in coronary artery disease are also briefly discussed, and future directions are highlighted.展开更多
文摘1文献来源,Herder GJ,van Tinteren H,Golding RP,et al.Clinical prediction model to characterize pulmonary nodules:Validation and added value of 18F-fluorodeoxyglucose positron emission tomography[J].Chest,2005,128,2490-2496.2证据水平3。
文摘1文献来源Gould,MK,Sanders GD,Barnett PG,etal.Cost-effectiveness of alternative management strategies for patients with solitary pulmonary nodules[J].Ann Intern Med,2003,138(9):724-735.2证据水平1a。
文摘目的探讨基底动脉尖综合证(top of the basilar arteny syndrome,TOBS)的临床表现,诊断及治疗。方法对41例经CT或MRI证实的TOBS患者的临床资料进行分析。结果 TOBS的主要病因仍为高血压脑动脉粥样硬化(79.8%),其次是心源性(心房纤颤)栓子来源(14.3%)。影像检查以中脑,丘脑,枕叶病变最多见。结论 TOBS的临床表现的多样化与基底动脉尖部5支不同血管的血流分布有关,突发意识障碍又较快恢复,无明显运动、感觉障碍,但有瞳孔改变、动眼神经麻痹、有皮质盲或偏盲应想到TOBS的可能,尽早进行头颅MRI对早期诊断、治疗和预后有重要价值。
文摘Objective To investigate the clinical features and management of bronchogenic cyst in the adults. Methods We retrospectively reviewed 50 patients admitted to our hospital with histopathologically proved bronchogenic cyst from January 1983 to December 2007. Of all the patients, 28 were male and 22 were female, with an average age of 36.9 (range, 18 to 64) years. The symptoms, location of the cysts, imaging evaluation, surgical treatment manner, and outcome of these patients were analyzed. Results Symptoms were present in 33 of the 50 patients, and cough was the most common symptom. Thirteen patients presented with complications: hemoptysis, infected cyst, dysphagia, paralysis, and hoarseness. The locations of the cysts included the mediastinum (28 cases), pulmonary parenchyma (12 cases), hilar area (3 cases), visceral pleura (1 case), and some rare locations including the intestinal mesentery (1 case), retroperitoneum (1 case), adrenal gland (1 case), neck (2 cases), and dura matter of the cervical verte-brae (1 case). Chest X-ray was performed in 36 patients and computed tomography (CT) was performed in 41 patients. The bronchogenic cyst in CT was characterized as a round, well circumscribed, unilocular mass, with density ranging from that of water to high density (0-50 Hu). As for treatment, complete resection of the bronchogenic cyst was performed in 47 (94%) patients, subtotal resection was performed in 3 (6%) patients. Open surgery was performed in 45 (90%) patients, and thoracoscopy (video-assisted thoracic surgery) was performed in 5 (10%) paitients. Of the 12 patients with intrapulmonary cyst, 11 patients underwent lobectomy and 1 patient underwent wedge resection. Postoperative sequelae occurred in 2 patients, 1 with persistent air leakage and 1 with hoarseness. All patients were proved with bronchogenic cyst pathologically. The average follow-up period was 6.5 years (range, 4 months to 10 years), and no late sequelae or recurrence of the cyst occurred. Conclusions The clinical and imaging presentations of bronchogenic cyst in adults are variable. Surgical resection is the best way for diagnosis and treatment. Both open surgery and thoracoscopy are appropriate for the selected candidates.
文摘Abdominal aortic aneurysm is a common vascular disease that affects elderly population.Open surgical repair is regarded as the gold standard technique for treatment of abdominal aortic aneurysm,however,endovaseular aneurysm repair has rapidly expanded since its first introduction in 1990s.As a less invasive technique,endovascular aneurysm repair has been confirmed to be an effective alternative to open surgical repair,especially in patients with co-morbid conditions.Computed tomography (CT) angiography is currently the preferred imaging modality for both preoperative planning and post-operative follow-up.2D CT images are complemented by a number of 3D reconstructions which enhance the diagnostic applications of CT angiography in both planning and follow-up of endovascular repair.CT has the disadvantage of high cummulative radiation dose,of particular concern in younger patients,since patients require regular imaging follow-ups after endovascular repair,thus,exposing patients to repeated radiation exposure for life.There is a trend to change from CT to ultrasound surveillance of endovascular aneurysm repair.Medical image visualizations demonstrate excellent morphological assessment of aneurysm and stent-grafts,but fail to provide hemodynamic changes caused by the complex stent-graft device that is implanted into the aorta.This article reviews the treatment options of abdominal aortic aneurysm,various image visualization tools,and follow-up procedures with use of different modalities including both imaging and computational fluid dynamics methods.Future directions to improve treatment outcomes in the follow-up of endovascular aneurysm repair are outlined.
文摘Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathologi-cal relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography (CT). Only a few studies are reported in literature involving post-mortem (PM) cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemop-ericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.
文摘Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease. High diagnostic value has been achieved with multislice CT angiography with use of 64- and more slice CT scanners. In addition, multislice CT angiography shows accurate detection and analysis of coronary calcium, characterization of coronary plaques, as well as prediction of the disease progression and major cardiac events. Thus, patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures. The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease; prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques. Limitations of multislice CT angiography in coronary artery disease are also briefly discussed, and future directions are highlighted.