采用随机对照临床试验标准评价《中华放射学杂志》发表的介入放射学文章质量

目的：评价近年来《中华放射学杂志》发表的介入放射学论文随机对照试验（RCTs）报告文章质量。方法：对发表在《中华放射学杂志》2000至2005年的RCTs文献进行手工检索，采用随机对照试验报告的统一标准（CONSORT声明）对所有介入放射学论文RCTs进行质量评价。结果：检索6卷72期，论文2186篇，其中临床试验文章236篇，介入放射学RCTs文章3篇，占临床试验的1．27％。在3篇RCTs文章中，有随机方法描述3篇，有终点指标1篇、多中心1篇。而在3篇RCTs文章中均没有样本含量计算、随机化执行、盲法、具体P值描述、流程图使用、依从性、阴性结果报告。结论：随着循证医学理念的深入，介入放射学临床试验报告质量已有提高，但与CONSORT标准比较尚有差距。     

我国影像学研究中诊断性试验现状的初步分析

目的 了解我国影像学研究中诊断性试验（diagnosis test)的现状及能否向临床提供可靠的诊断。方法 作者对我国医学影像界影响最大的《中华放射学杂志》进行了人工查阅,并根据国际公认标准对所发表的诊断性试验进行了分析。结果 检索1979－1999年《中华放射学杂志》21卷共162期,论著2888篇,无一期漏检。在所有论著类文章中,诊断试验仅占9％,其中仅8．9％与金标准进行独立盲法对比,同时计算了敏感性、特异性、准确性等较完整的统计学指标的仅占24％。计算似然比、阳性和阴性预检值的文章仅分别占0．5％、6％和5．7％、10％。结论 我国影像学领域诊断性试验的数量与质量还远远不能满足临床的需要。改进研究方法,更多地开展高质量的诊断性试验研究对提高影像诊断的水平具有重要意义。     

《实用放射学杂志》与《中华放射学杂志》基金论文定量分析

目的：定量分析《实用放射学杂志》与《中华放射学杂志》的基金论文,探讨提升《实用放射学杂志》期刊质量和学术水平的有效途径。方法采用文献计量学方法,对2种期刊2013年基金论文的发文量、基金论文比、级别分布、地域分布、机构分布和发表时滞分布等文献计量指标进行统计分析。结果《实用放射学杂志》2013年共发表论文618篇,其中基金论文共计137篇,占论文总数的22.2%,基金论文比0.22,省市级基金项目论文占59.2%;基金论文来自全国23个地区和82个机构;基金论文平均发表时滞235.6 d。《中华放射学杂志》2013年共发表论文313篇,其中基金论文共计97篇,占论文总数的31.0%,基金论文比0.31,国家级基金项目论文占32.0%;基金论文来自全国18个地区和70个机构;基金论文平均发表时滞228.4 d。结论《实用放射学杂志》有其自身优势,对比《中华放射学杂志》也存在显著的差距和不足。该刊要在选题策划、主动约稿、优稿优用、缩短发表时滞以及建立核心作者群和核心专家库等方面有所改进和突破,可进一步提升刊物的质量内涵和学术水平。     

《中华放射学杂志》引文分析

利用文献计量学方法和引文分析法，对《中华放射学杂志》１９９０￣１９９４年５年轮文引文的平均值、引文的类型进行了统计分析，并找到该领域文献的半衰期。统计结果表明：《中华放射学杂志》的论文平均引文量为６．２条，被引文献峰值（８．９％）是在发表后的第５年，文献半衰期为７￣８年。期刊是本学科论文的主要引文源（８４．４０％），并按照布拉德福的文献离散规律，找出该领域的１９种核心期刊。     

征求《介入放射学杂志》优秀论文通知

为了纪念《介入放射学杂志》创刊20周年,我们将征求优秀论文,凡是在本刊发表的获省部级以上奖项的论文,请尽快提供给我们。包括:作者、单位、论文题目、卷、期、页、获何奖项(最好提供获     

中华放射学杂志46年胃肠影像学论著的回顾性分析与思考

目的 对中华放射学杂志（简称《中放》）46年发表的胃肠影像学论著进行回顾性分析与思考,以迎接世纪之交我国胃肠影像学所面临的巨大挑战。方法 1953年10月于1999年10月,对在《中放》上发表的胃肠影像学论著从数量、内容和分布年代等方面进行回顾性分析。结果 在此46年中,《中放》共发表胃肠影像学论著211篇,占《中放》全部论著的8．43％。胃肠影像学论著211篇中属于X线诊断论著162篇（76．78％）,其中平片诊断和单对比造影诊断方面论著共79篇（37．44％）,双对比造影方面论著73篇,占胃肠影像学论著的34．59％;属于介入放射学论著21篇（9．95％）;属于CT、MR、计算机X线摄影（CR）诊断论著15篇（7．11％）;属于实验研究论著9篇（4．26％）;属于综合影像论著4篇（1．90％）。50－60年代《中放》发表的论著,着重平片诊断和胃肠单对比造影技术的应用;70－80年代《中放》发表的论著,着重双对比造影技术和CT技术的应用;90年代《中放》发表的论著,着重胃肠成像新技术（CT、MR、CR）的应用和综合应用,以及胃肠介入放射学的广泛应用。结论 胃肠影像学46年来主要以双对比造影的X线诊断技术为主,CT、MR、CR诊断技术仍是胃肠影像学的重要补充手段;介入放射学已成为90年代胃肠影像学的重要组成部分。     

第九届全国临床放射学学术会议暨安徽省放射学第八次学术年会召开

由临床放射学杂志编委会与安徽省放射学分会联合主办的“第九届全国临床放射学学术会议暨安徽省放射学第八次学术年会”，于2007年4月13日-16日在安徽省黄山市屯溪区隆重召开。会议收到专题讲座和论文共358篇．与会代表来自全国28个省、市包括香港特别行政区500余人。     

第五届全国临床放射学学术会议征文通知

由《中华放射学杂志》和《临床放射学杂志》两家杂志编委会共同主办的“第五届全国临床放射学学术会议”拟定于２０００年４月９日～１３日在福建省厦门市召开，现向全国征文。１－征文内容：ＭＲ、ＣＴ、介入、ＤＳＡ、传统放射学诊断、技术、护理、管理及质量控制等方面的专业学术论文，以及误诊病例（理）分析、特殊或罕见少见病例报告等。２－征文要求：（１）征文稿均应书写工整或用微机打印。（２）应附有介绍信。（３）投稿前未在公开出版的杂志上发表过。（４）论著文章一般不超过３０００字，并请附上１０００字以内的结构式中文摘…     

《中华放射学杂志》稿约

《中华放射学杂志》为中华医学会主办的放射学专业学术期刊，以广大放射学工作者为主要读者对象，报道放射学领域领先的科研成果和临床诊疗经验，以及对放射学临床有指导作用、且与放射学临床密切结合的基础理论研究。本刊的办刊宗旨是：贯彻党和国家的卫生工作方针政策，贯彻理论与实践、普及与提高相结合的方针，     

中华放射学杂志获中华医学会优秀期刊一等奖

20 0 1年 11月 15～ 17日 ,中华医学会第 4次杂志工作会议在京召开。在会议闭幕式上 ,中华放射学杂志被宣布获中华医学会优秀期刊一等奖。此前 ,中华医学会杂志社组织了会内、外的编辑学家对中华医学会系列杂志进行了审阅评选 ,从中产生一等奖 2名、二等奖 8名、三等奖 15名 ,另设优秀英文期刊及编译奖各 1名。本刊获一等奖 ,是全体编委和一贯长期关心、支持杂志工作的广大专家教授的光荣 ,编委会、编辑部向大家表示衷心的感谢 !希望我们再接再厉 ,为创我国放射学事业和杂志事业的新局面而携手共进 !中华放射学杂志获中华医学会优秀期刊一等…     

Comparison of two imaging protocols for acute stroke: unenhanced cranial CT versus a multimodality cranial CT protocol with perfusion imaging

The aim of the study was to validate a multimodality cranial computed tomography (CCT) protocol for patients with acute stroke in the United Arab Emirates as a basic imaging procedure for a stroke unit. Therefore, a comparative study was conducted between two groups: retrospective, historical group 1 with early unenhanced CCT and prospective group 2 undergoing a multimodality CCT protocol. Follow-up unenhanced CCT>48 h served as gold standard in both groups. Group 1: Early unenhanced CCT of 50 patients were evaluated retrospectively, using Alberta Stroke Program Early CT Score, and compared with the definite infarction on follow-up CCT. Group 2: 50 patients underwent multimodality CCT (unenhanced CCT, perfusion studies: cerebral blood flow, cerebral blood volume, mean transit time and CT angiography)<8 h after clinical onset and follow-up studies. Modified National Institute of Health Stroke Scale was used clinically in both groups. Group 1 showed 38 men, 12 women, clinical onset 2-8 h before CCT and modified National Institute of Health Stroke Scale 0-28. Group 2 included 38 men, 12 women, onset 3-8 h before CCT, modified National Institute of Health Stroke Scale 0-28. Sensitivity was 58.3% in group 1 and 84.2% in group 2. Computed tomography angiography detected nine intracranial occlusions/stenoses. The higher sensitivity of the multimodality CCT protocol justifies its use as a basic diagnostic tool for the set-up of a first-stroke unit in the United Arab Emirates.     

我国输卵管介入再通研究文献的质量评价

目的 了解我国输卵管介入再通术治疗输卵管性不孕文献的一般状况.方法 按照循证医学标准,分别按1997至2000年、2001至2004年、2005至2008年3个时间段对不同设计类型文献的一般情况进行分类.由2名评阅者对文献进行质量评价,对评阅者的评价结果进行Kappa检验,检验结果的一致性.参照Jadad评分量表,计算随机对照试验(RCT)和临床对照试验(CCT)文献的Jadad得分.对RCT和CCT中的内容进行描述性分析.结果 纳入临床治疗性文献157篇,其中叙述性研究127篇,RCT和CCT文献30篇,其中RCT文献25篇、CCT文献5篇.2名评价者间Kappa值为0.85,P＜0.05,说明评价的一致性较好.RCT文献中,Jadad量表评分为0分者2篇,1分者15篇,2分者8篇.RCT和CCT纳入与排除标准明确者9篇(30.0%),疗效标准明确者12篇(40.0%),随机方法明确者4篇(13.3%).样本量≥60例者27篇(90.0%),有基线可比性者14篇(46.7%),仅1篇提到采用单盲法(3.3%),交代统计学方法的有17篇(56.7%),交代随访者13篇(43.3%),交代失访者4篇(13.3%),有14篇(46.7%)在推导方面同时考虑了统计学意义和临床意义.结论 我国输卵管介入再通术临床治疗性文献总体研究的质量不高,证据的可信度级别较低,质量上与循证医学标准有一定的差距.     

Pentacam系统测量准分子激光角膜屈光手术前近视患者角膜厚度的临床观察

目的比较Pentacam系统与A型超声角膜测厚仪测量准分子激光手术前近视患者中央角膜最薄点厚度的差异。方法对准备行准分子激光角膜屈光手术的近视患者69例138只眼,分别采用Pentacam系统和A型超声角膜测厚仪测量角膜中央最薄点厚度,对测量结果进行统计学分析。结果 Pentacam系统、A型超声角膜测厚仪测量中央角膜最薄点厚度值分别为（548.0±28.9）μm和（538.8±29.4）μm,两者高度正相关（P〈0.05）。Pentacam系统比A型超声测得的中央角膜厚度厚（9.2±9.9）μm,差异有显著意义（P〈0.05）,该差值与A型超声测量角膜厚度值负相关（P〈0.05）,而与屈光度、年龄等无关。结论 Pentacam测量近视患者角膜厚度值略高于A型超声法,尽管二者有较好的一致性,但相互间还不能完全替代。     

Comparison of 64-slice cardiac computed tomography with myocardial perfusion scintigraphy for assessment of global and regional myocardial function and infarction in patients with low to intermediate likelihood of coronary artery disease

Background. Cardiac computed tomography (CCT) has the potential to assess both coronary anatomy and ventricular function in a single study. We examined the agreement between CCT and myocardial perfusion scintigraphy (MPS) for the assessment of global and regional ventricular function. Methods and Results. Research CCT was performed in 52 patients with a low to intermediate likelihood of coronary artery disease referred for MPS. Left ventricular enddiastolic volume, left ventricular end-systolic volume, left ventricular ejection fraction (LVEF), and myocardial wall motion and thickening were compared between techniques. In addition, myocardial contrast attenuation on CCT was compared with radiotracer uptake on MPS. LVEF values agreed well (mean difference, 4.1%; SD, 15.13%), but CCT left ventricular end-diastolic volume was greater compared with MPS (mean difference, 46.0 mL; SD, 33.34 mL) (P<.001). There was moderate agreement for segmental myocardial motion and thickening, with κ values of 0.57 (95% confidence interval, 0.51–0.63) and 0.47 (95% confidence interval, 0.41–0.53), respectively. Seventeen patients had hypoattenuation in at least 1 myocardial segment on CCT. Three of four patients with concomitant abnormalities of wall motion and thickening on CCT had infarction in the same territory on MPS. Conclusions. There was good agreement for LVEF between CCT and MPS but myocardial volumes differed, and these modalities cannot be used interchangeably. Mild abnormalities of regional function are detected more commonly by CCT than by MPS. Myocardial hypoattenuation on CCT is highly specific for myocardial infarction when associated with reduction of systolic wall thickening and regional wall motion abnormality. Dr Nicol received a grant from the Defence Postgraduate Medical Deanery.     

双期心脏CT成像在左心耳自发显影（≥2级）中的诊断价值

目的:以经食道超声心动图(TEE)为金标准,探讨双期心脏CT(CCT)定性及定量评估2级以上左心耳自发显影(LAASEC)的临床价值.方法:本院明确诊断房颤且行CCT及经食道超声心动图(TEE)两项检查的住院患者267例.以TEE为金标准,计算CCT定性评估LAASEC(≥2级)的敏感度、特异度、阳性预测值(PPV)、阴性预测值(NPV)及诊断符合率.测量左心耳(LAA)及升主动脉(AA) CT值,计算LAA/AA,绘制LAA/AA的ROC曲线.结果:TEE诊断LAASEC 0～1级患者共192例,CCT阴性162例(84.4％),阳性30例(15.6％).LAASEC 2～4级75例,CCT全部为阳性.以TEE为金标准,CCT定性检测LAASEC(≥2级)的敏感度、特异度、PPV、NPV及符合率分别为100.0％ 、84.4％、71.4％、100.0％及88.8％.LAA/AA最佳截断点为0.524时,CCT评价LAASEC(≥2级)的敏感度、特异度、PPV、NPV及符合率分别为98.7％、92.7％、84.1％、99.4％及94.4％.结论:双期CCT在评估LAASEC(≥2级)方面具有重要的临床排除和预警价值.当CCT首期左心耳部无充盈缺损时,可以排除2～4级LAASEC的可能,避免不必要的TEE检查.     

Feasibility of slice width reduction for spiral cranial computed tomography using iterative image reconstruction

Purpose

To prospectively compare image quality of cranial computed tomography (CCT) examinations with varying slice widths using traditional filtered back projection (FBP) versus sinogram-affirmed iterative image reconstruction (SAFIRE).

Materials and methods

29 consecutive patients (14 men, mean age: 72 ± 17 years) referred for a total of 40 CCT studies were prospectively included. Each CCT raw data set was reconstructed with FBP and SAFIRE at 5 slice widths (1–5 mm; 1 mm increments). Objective image quality was assessed in three predefined regions of the brain (white matter, thalamus, cerebellum) using identical regions of interest (ROIs). Subjective image quality was assessed by 2 experienced radiologists. Objective and subjective image quality parameters were statistically compared between FBP and SAFIRE reconstructions.

Results

SAFIRE reconstructions resulted in mean noise reductions of 43.8% in the white matter, 45.6% in the thalamus and 42.0% in the cerebellum (p < 0.01) compared to FBP on non contrast-enhanced 1 mm slice width images. Corresponding mean noise reductions on 1 mm contrast-enhanced studies were 45.7%, 47.3%, and 45.0% in the white matter, thalamus, and cerebellum, respectively (p < 0.01). There was no significant difference in mean attenuation of any region or slice width between the two reconstruction methods (all p > 0.05). Subjective image quality of IR images was mostly rated higher than that of the FBP images.

Conclusion

Compared to FBP, SAFIRE provides significant reductions in image noise while increasing subjective image in CCT, particularly when thinner slices are used. Therefore, SAFIRE may allow utilization of thinner slices in CCT, potentially reducing partial volume effects and improving diagnostic accuracy.     

太极拳锻炼对2型糖尿病的疗效观察及其机制探讨

目的 :观察太极拳锻炼对 2型糖尿病人的疗效 ,并对其机制进行探讨。方法 :1 2例老年2型糖尿病患者进行为期 8周的太极拳锻炼 ,观察锻炼前和锻炼后空腹、锻炼 8周结束时一次性运动前和运动后即刻空腹血糖 (glucose)、血浆胰岛素 (Ins)及红细胞胰岛素受体 (InR)等指标的变化。血糖、胰岛素的测定用临床常规检验法 ,红细胞胰岛素受体用改良Gambhir法。结果 :(1 )经过 8周锻炼后 ,糖尿病人安静状态下前后对比 :血糖水平降低(P <0 0 5 ) ,Ins水平未见显著变化 ,低亲和力胰岛素受体数目 (r2 )及低亲和力胰岛素受体结合容量 (R2 )增加 (P <0 0 5 )。 (2 )锻炼 8周结束时 ,一次性运动后即刻与运动前安静状态下比较 :血糖、高、低胰岛素受体数目 (r1、r2 )和高、低胰岛素受体结合容量(R1、R2 )均升高 (P <0 0 5 ) ,而胰岛素水平未见显著变化。结论 :(1 )长期太极拳锻炼在维持糖尿病患者正常的胰岛素分泌水平的基础上 ,能有效降低血糖水平 ;(2 )胰岛素受体活性的增加可能是太极拳运动对 2型糖尿病产生疗效的一种机制     

Feasibility of automatic assessment of four-chamber cardiac function with MDCT: Initial clinical application and validation

Background

The ability to perform a simultaneous analysis of ventricular and atrial volumes may provide clinically useful information for diagnosis and prognosis. We aimed to evaluate the feasibility and clinical value of a novel algorithm that performs fully automatic evaluation of the four cardiac chambers and myocardium from gated CT datasets.

Methods

50 patients were studied—Group 1: 30 consecutive unselected patients, Group 2A: 10 patients after myocardial infarction and Group 2B: 10 normal controls. Fully automatic, segmentation of the heart was performed with a model-based segmentation algorithm requiring no user input other than loading the datasets. Qualitative and quantitative evaluation of segmentation quality was performed. Left ventricular (LV) and right ventricular (RV) stroke volumes (SV) were compared.

Results

Overall, segmentation succeeded in all patients although 11/500 (2.2%) cardiac chambers achieved poor segmentation grading. Correlation coefficients between automatic and manually derived volumes were excellent (r > 0.98) for all chambers. Bland-Altman analysis showed minimal bias (−1.0 ml, 0.4 ml, −1.8 ml) for the LV and RV, and right atria, respectively, with mild overestimation of LV myocardial volume (5.2 ml). Significant, yet consistent, overestimation of left atrial volume (23.6 ml) due to inclusion of proximal pulmonary veins was observed. LV and RV ejection fraction (r = 0.91 and 0.98) and SV (r = 0.98 and 0.99) also correlated closely with minimal bias (<2%). Most significantly, LV SV (91.0 ± 21.6 ml) correlated highly with RV SV (81.7 ± 18.2 ml, r = 0.86). Outliers could usually be explained by valvular regurgitation.

Conclusions

Fully automatic segmentation of all cardiac chambers can be achieved with high accuracy over multiple cardiac phases, enabling reliable comprehensive evaluation of four-chamber cardiac function.     

Angiographic cerebral circulation time before and after endovascular therapy for symptomatic vasospasm

AIM: To investigate the correlation between angiographic cerebral circulation time (CCT) and cerebral blood flow (CBF) evaluated by single photon emission computed tomography (SPECT) before and after endovascular treatment for symptomatic vasospasm.MATERIALS AND METHODS: Seven patients with unilateral vasospasm as demonstrated by catheter angiography who underwent pre- and post-treatment SPECT were selected. All patients had angiographic vasospasm of unilateral middle cerebral artery (MCA). Eight vessels in seven patients underwent intra-arterial papaverine infusion and three vessels underwent percutaneous transluminal angioplasty. Angiographic CCT was defined as the interval from the first image in which contrast medium was visible at the origin of MCA to its disappearance from the cortical arteries in the MCA territory. In SPECT studies, the ischaemic degree in MCA territory was analysed by side to side comparison with calculating the asymmetry index (AI).RESULTS: The pre-treatment mean CCT was 4.1 +/- 0.8 s. The mean CCT immediately after treatment was 2.7 +/- 0.5 s. In the control subjects (n = 15) with unruptured aneurysm, mean CCT was 3.5 +/- 0.2 s. The pre-treatment mean CCT was significantly prolonged compared with that in the control subjects (P = 0.02). The post-treatment mean CCT was significantly shortened compared with that in the control subjects (P = 0.001). The pre-treatment mean AI was 71.2 +/- 7.4%, and that immediately after treatment was 90.5 +/- 3.6%. AI increased in all territories treated with endovascular treatment; the mean change was 19.3%. Angiographic CCT was closely correlated with AI in both pre- (r = - 0.95) and post-treatment (r = - 0.79).CONCLUSION: Measurement of CCT is useful in evaluating cerebral haemodynamics of endovascular treatments in patients with cerebral vasospasm.     

低温球囊治疗下肢动脉狭窄与闭塞的初步临床研究

目的 观察低温球囊治疗下肢动脉狭窄、闭塞的近期疗效及安全性。方法 纳入25例下肢动脉狭窄、闭塞的患者（共27条动脉）,按随机数字表分为低温球囊组及普通球囊组,分别行下肢动脉球囊成形术。低温球囊组10例,病变长度(6.7±0.9)cm,狭窄程度(91±6)％,Fontaine分级Ⅱ级7例、Ⅲ级3例,按泛大西洋介人学会协议(TASC)分型A型8例、B型2例,踝肱指数(ABI)0.46±0.07;普通球囊组15例,病变长度(6.5±0.7)cm,狭窄程度(89±7)％,Fontaine分级,Ⅱ级13例、Ⅲ级2例;TASC分型,A型13例、B型2例,ABI 0.48±0.08,两组患者一般临床症状和体征比较差异无统计学意义(P＞0.05)。按Rutherford治疗后肢体状态7级评估法,评估术后临床变化。采用重复测量方差分析比较两组术后2d及30 d疗效。结果 低温球囊组10例技术成功,术中未发生血管壁损伤,术后30 d临床症状显著改善8例,中度改善2例;ABI 0.84 ±0.04;狭窄程度(29±4)％。普通球囊组15例技术操作均成功,其中1例发生血管壁夹层,术后30 d临床症状显著改善13例,中度改善2例;ABI 0.84 ±0.05;狭窄程度(32±4)％。两组术前与术后的ABI(P ＜0.01)、狭窄程度(P＜0.01)差异均有统计学意义;两组之间的ABI(P ＝0.20)、狭窄程度(P＝0.55)差异无统计学意义。结论 低温球囊治疗下肢动脉狭窄闭塞安全并具有较好的近期疗效。