红外热成像技术在冠心病诊疗中的应用

目的我们应用自主研发的医用热成像诊断系统,采集冠心病病例术前热成像资料及冠状动脉旁路术中心肌热成像数据加以分析,以期为冠心病诊疗提供新的方法。方法同期临床确诊冠心病,多支病变患者12例常规行冠状动脉旁路移植术并于术前及术中行红外热成像数据采集。结果经红外热成像技术,所有研究对象顺利采集到相应心肌温度数据及相应热区分布变化,对比其他临床辅助检查手段证实了其有效性。结论红外热成像技术作为一种新型医学诊断技术手段,可安全、有效地应用于冠心病诊疗过程并具指导意义。     

医用红外热成像在脑卒中诊疗中的应用价值

目的:总结近年来国内外对于医用红外热像技术在脑卒中患者中的临床应用。方法:基于对医用红外热成像应用原理的分析,逐一总结医用红外热成像技术在脑卒中疾病诊断、治疗、并发症检测及预后判断中的具体应用。结果:医用红外热成像可以应用于脑卒中的发病前期,发病过程中的康复治疗评估,及相关并发症如:植物神经功能紊乱的评估、疼痛的评估、情绪状态的评估、下肢静脉血栓的检测,同时指导针灸治疗和中医辩证施治。结论:医用红外热像技术在脑卒中患者的临床应用前景广阔,值得我们进一步的研究。     

红外热成像在颈椎病诊断及治疗中的应用

目的:探讨对颈椎病患者诊治过程中应用红外热成像的临床价值。方法:选取我院收治的经红外热成像诊断患者共50例,设为观察组;另选同期在我院进行体检结果显示为健康的健康人共50名,设为对照组。对比两组红外热成像区别。结果:两组红外热成像比较有显著性差异(P0.05)。结论:对颈椎病患者应用红外热成像进行诊断能够准确了解病发位置,在治疗过程应用红外热成像则能够对其时效关系有精确的表达,值得临床推广。     

红外热图对跟痛症诊断价值的研究

红外热成像检查是近10年来用于临床影像学诊断的新方法[1],但其应用于跟痛症诊断尚未见报道。本实验选取门诊单侧跟痛症患者15例,在止血带加压试验前后采用红外热像仪对足跟部进行扫描,探讨红外热图对跟痛症的诊断价     

STIR技术对肺癌术前TNM分期的评价

目的:评价磁共振短时反转恢复(STIR)技术对肺癌术前分期的诊断价值。方法:对96例经病理证实的肺癌患者行STIR序列及SE序列成像,将STIR和SE序列术前分期与病理对照。结果:在肺癌T分期、N分期及远处转移方面,STIR序列明显优于SE序列(P<0.05)。结论:STIR技术能提高肺癌分期的准确性,特别对肺癌T分期和N分期有其独到之处。     

红外热成像技术在中医筋伤疾病中的应用概况

红外热成像技术目前是一种较成熟的检测技术,可以为诸多疾病的诊断和治疗提供帮助,是一种安全无创、经济便捷的检测方法,在临床上应用广泛.本文探析了红外热成像技术在中医筋伤疾病中的早期诊断、辨证分型、疗效评定及指导治疗方面的应用概况,以期为筋伤的临床诊疗及研究提供有益借鉴.     

红外热成像诊断增生、炎症和癌症的临床价值

目的：探讨红外热成像技术对增生性疾病;炎症和早期癌症的诊断价值。方法：运用红外热成像地5647例患者的不同部位进行检测,根据其体表热辐射温度高低和图形大小,区分增生性疾病、炎症和早期癌症。结果：正常人的体表温度分布均匀,增生性疾病、炎症和癌症和体表热辐射温度和热区均有独特的规律性变化。结论：红外热成像技术将X线、B超、CT等器械不容易发现的人体病变清楚地显示出来,对诊断增生性疾病、炎症和早期癌症有着重要价值。     

超声综合检查诊断乳腺放射状瘢痕

目的 探讨超声弹性成像和CEUS在诊断乳腺放射状瘢痕中的临床应用价值.方法 回顾性分析术前接受常规超声、弹性成像及CEUS检查的8例经手术病理证实为乳腺放射状瘢痕的患者资料.结果 8例患者中,常规超声准确诊断3例,弹性成像准确诊断4例,CEUS准确诊断7例.结论 超声弹性成像及CEUS有利于提高乳腺放射状瘢痕的诊断效能.     

多模态MRI术前诊断肝细胞癌微血管浸润应用进展

肝细胞癌（HCC）微血管浸润（MVI）是影响肿瘤术后复发及患者预后的重要因素。术前明确诊断MVI对改善HCC预后意义重大。目前诊断MVI主要依据HCC术后组织病理学检查,难以满足术前诊断的需要。随着影像学技术的发展,临床已将DWI、扩散峰度成像、体素内不相干运动、增强MRI及MRI影像组学分析等多模态MRI技术应用于术前诊断MVI。本文对上述多模态MRI应用于HCC术前诊断MVI的进展进行综述。     

MRCP检查在胆系结石及术前方案制定中的应用价值

磁共振胰胆管成像（MRCP）是近年来磁共振技术临床应用的新进展之一，它是一种无创性显示胰胆管结构的技术。自Wallner等于1991年首次报道并应用于临床以来，其成像方法不断改进，对胰胆管系统疾病的评价良好，目前已逐渐成为胆系结石术前诊断及制定手术方案的重要依据。回顾性分析本院2004年12月至2005年6月因胆系结石入院手术（包括腹腔镜、ERCP及开腹手术）术前常规行MRCP患120例，     

多频域后处理图像对计算机辅助检测数字胸片上肺结节能力的影响

目的评价多频域后处理数字胸片图像对计算机辅助检测系统输出结果的影响。方法选择经CT证实正常248名受检者的DR后前位胸片和30例有肺结节的DR后前位胸片,并应用Philips UNIQUE软件对其进行高频、低频处理。由2名10年以上经验的放射科医生结合CT图像阅读胸片,二人意见达成一致后,在数字化胸片上标记结节位置,保存标记结果并将其作为金标准。然后由CAD系统阅读后处理图像,由2名医师评价CAD系统在后处理图像上肺结节检测的假阳性区域和敏感度。结果 CAD系统在248例低频、常规和高频图像上分别显示了715、585和286个可疑区域,平均每例检出的假阳性区域分别为2.88个、2.36个和1.15个,3组图像检测的假阳性区域及组间差异均具有统计学意义。30例DR图像上共有38个金标准结节,CAD系统在低频、常规和高频图像上分别检测到33、30、28个结节,其检测敏感度分别为86.84%、78.95%和73.68%,ROC曲线下面积分别为0.722、0.670和0.618,3组图像之间检测的差异无统计学意义。结论高频、低频和常规图像模式对CAD系统检测能力无明显影响,但其在低频、常规和高频图像中检测的假阳性有逐渐增高的趋势,肺结节检测敏感度有逐步下降的趋势。     

Biomarkers along the continuum of care in lung cancer

Abstract

Blood-based biomarkers are valuable diagnostic tools for the management of lung cancer patients. They support not only differential diagnosis and histological subtyping, but are also applied for estimation of prognosis, stratification for specific therapies, monitoring of therapy response, surveillance monitoring and early detection of residual or progressive disease. Early diagnosis of lung cancer in high risk populations (screening) is a promising future indication but poses high medical and economic challenges to marker performance. The five mostly used classical ‘tumor markers’ show characteristic profiles of sensitivity and specificity for non-small cell lung cancer (NSCLC) like cytokeratin 19-fragments (CYFRA 21-1), carcino-embryonic antigen (CEA) and squamous cancer cell antigen (SCCA) as well as for small cell lung cancer (SCLC) like progastrin-releasing peptide (ProGRP) and neuron-specific enolase (NSE). Combined use and pattern recognition approaches enable highly accurate diagnosis, subtyping and therapy monitoring. For the interpretation of serial measurements on an individual level, marker-specific algorithms have to be developed. So-called companion diagnostics identify druggable molecular changes in signaling pathways of tumor tissue that can be addressed by targeted therapies. New highly sensitive technologies enable the convenient and serial molecular characterization on circulating tumor DNA (ctDNA) in the blood, too. This approach is helpful when biopsies are not available and to overcome tumor molecular heterogeneity and plasticity. As only a portion of patients have such druggable molecular changes, future strategies will imply the combined use of classical and new ctDNA-based biomarkers to optimize the management of lung cancer patients during the course of disease.     

Elevated carcinoembryonic antigen and bronchial obstruction caused by a rotten vegetable leaf mimic lung cancer: A case report

BackgroundTracheobronchial foreign body aspiration is a potentially risky medical event, while the condition often requires early detection and rapid intervention to improve respiratory symptoms and prevent major morbidity. Notably, foreign bodies may not be identified and they are likely to be mistaken for neoplastic lesions. However, CEA, as one of tumor markers, presents to be available for assisting in lung cancer diagnosis, especially for non–small‐cell lung cancer, while the specificity of CEA is not high.MethodsHere, we described a case of bronchial opening obstruction with elevated carcinoembryonic antigen (CEA) that was firstly misdiagnosed as lung cancer and proved as foreign body aspiration in the upper lobe bronchus of right lung by bronchoscopy.ResultsCarcinoembryonic antigen level increased. CT scan demonstrated a cavitation accompanied by multiple small nodular shadows appeared in the right upper lobe field. Bronchoscopy suggested right upper lobe bronchus was blocked by a brown smooth organism with plenty of purulent materials, which was proved as a rotten vegetable leaf.ConclusionsElevated CEA and bronchial obstruction are not typical manifestations of lung cancer. Bronchoscopy is crucial for making a reliable diagnosis.     

磁共振弥散张量成像图像后处理

目的 探讨医学图像处理方法在磁共振弥散张量成像后处理中的应用。方法 通过医学图像处理的方法,对弥散张量成像主要进行了图像变形纠正、标量图计算、体绘制生成、纤维束追踪的后处理。结果 实验证明弥散张量成像图像后处理方法有效、可靠。结论 医学图像后处理的方法能够有效提取原始数据信息,提高图像质量,方便诊疗。     

Olfactometric diagnosis of lung cancer by canine scent – A double-blinded study

BackgroundLung cancer is one of the most often diagnosed tumours in the world with the highest mortality. A major problem and reason for the high mortality from lung cancer is its diagnosis in the late stages. The main goal of preventing lung cancer deaths is early detection in the early stages and accurate diagnosis, which must be followed by targeted treatment. Nevertheless, even top diagnostic techniques do not have the same accuracy and sensitivity as a dog’s sense of smell.MethodsThe study aims to present the results of olfactometric detection of lung cancer using the smell of dogs in unblinded, single-blinded and double-blinded studies. 115 serum samples or breath from patients with lung cancer and 101 samples from healthy people were used for the training. The group consisted of women and men of Indo-European origin, mostly from the Moravian-Silesian region in Czech Republic. Two dogs were selected for the study.ResultsIn the case of tumor detection in the form of unblinded tests, Bugs had a sensitivity of 91% and a specificity of 92%. Boolomo had a sensitivity of 89% and a specificity of 81%. For single-blinded tests, Bugs had a sensitivity of 71%. The sensitivity of Boolomo was set at 90%. After meeting the sensitivity limit of 70%, dogs were included in the double-blinded studies. The highest accuracy was set at 68% for Bugs, 83% for Boolomo.ConclusionWhen a tumour is diagnosed in the late stages, it is a great burden on both the health and economic systems of the state. Unfortunately, there is still no suitable screening test to detect the tumour at an early stage, so any other method of detection seems desirable. Trained dogs are used in many fields, why not also in medicine and the diagnosis of tumours?     

基于深度学习的人工智能辅助肺腺癌胸水脱落细胞学诊断的方法

目的 应用深度学习模型对胸水脱落肺腺癌细胞进行检测和分类,探讨人工智能辅助肺癌细胞病理诊断的可行性。方法 收集2019年3月至2021年12月南通大学附属医院、上海交通大学附属胸科医院和复旦大学附属中山医院的肺腺癌胸水标本110例,非癌性胸水标本20例为对照组。采用常规法和单细胞分离液处理技术2种方法分离细胞标本,并进行液基制片和苏木精-伊红（H-E）染色,全切片数字扫描使细胞图像数字化后保存为数字文件,由人工智能辅助诊断。经过裁切与图像预处理后,使用LabelImg软件对胸水细胞进行标记,打方框并标注细胞类型,选用较典型细胞样本,分别标记淋巴细胞、间皮细胞和腺癌细胞,共标记800张图像用于训练。采用Yolo V4模型对疑似与确诊肺癌细胞进行训练,采用Inception V3模型对不同分类细胞进行训练,取另外250张图像进行测试。结果 训练后的Yolo V4模型能够对胸水脱落细胞H-E染色涂片中疑似+确诊肺腺癌细胞进行识别标注,全类平均正确率（mAP）为20%;训练后的Inception V3模型对胸水脱落细胞病理图像中单个细胞分割后的淋巴细胞、间皮细胞、疑似+确诊肺腺癌细胞进行分类,...     

Primary lung cancer with radioiodine avidity: A thyroid cancer cohort study

BACKGROUNDA proportion of lung cancers show sodium/iodide symporter (NIS) expression. Lung cancers with NIS expression may uptake radioiodine (RAI) and show RAI-avid lesions on RAI scan for differentiated thyroid cancer (DTC) surveillance.AIMTo investigate the possibility of RAI uptake by lung cancer in a cohort with thyroid cancer.METHODSRAI-avid lung cancers were analyzed using a prospectively maintained database of patients with thyroid cancer who were registered at a medical center between December 1, 1976 and May 28, 2018. NIS expression in lung cancer was assessed using immunohistochemical staining.RESULTSOf the 5000 patients with thyroid cancer from the studied dataset, 4602 had DTC. During follow-up, 33 patients developed primary lung cancer. Of these patients, nine received an iodine-131 (¹³¹I) scan within 1 year before the diagnosis of lung cancer. One of these nine lung cancers was RAI-avid. NIS expression was evaluated, and three of the eight available lung cancers revealed NIS expression. The proportions of lung cancer cells with NIS expression were 60%, 15%, and 10%. The RAI-avid lung cancer had the highest level of expression (60%). The RAI-avid lung cancer had a spiculated border upon single-photon emission computed tomography/computed tomography, which led to an accurate diagnosis.CONCLUSIONA proportion of lung cancer demonstrates NIS expression and is RAI-avid. Clinicians should be aware of this possibility in the interpretation of RAI scintigraphy.     

磨玻璃晕征环绕的周围型肺癌的CT特征及病理对照观察

目的 探讨表现为磨玻璃晕征环绕的周围型肺癌的CT影像特征,以提高对其的认识及诊断正确率. 方法 回顾性分析10例经手术病理证实的周围型肺癌患者,均有环形磨玻璃密度影环绕中心实性结节.另选取临床综合诊断或病理证实的具有晕征的炎性结节病变患者44例作为对照,其中球形肺炎21例,结核球15例,真菌病8例.所有患者均有详细的CT平扫和增强扫描资料,观察晕征及中心实性结节的影像特点,对肺癌及炎性结节各影像表现的发生率行χ2检验.肺癌患者与病理进行对照分析. 结果 10例周围型肺癌,磨玻璃影与肿瘤实性结节交界面、肺野交界面均境界清楚(100%).炎性结节磨玻璃影与实性结节交界面清楚者仅11例(25.00%),交界不清楚者33例(75.00%);炎性结节磨玻璃影与肺野交界面均不清楚(100%).10例周围型肺癌病灶中心实性结节边缘出现分叶征3例,毛刺征7例,胸膜凹陷征4例,恶性征象的发生率为100%;炎性结节病灶中心实性结节边缘无一出现上述征象.10例肺癌结节与21例球形肺炎均明显强化;结核球仅3例出现包膜强化,真菌病1例少许强化,与肺癌比较差异有统计学意义(P<0.05). 结论磨玻璃晕征环绕的周围型肺癌的CT表现具有特征性,综合分析磨玻璃影及中心实性结节的边缘及内部结构的影像表现,对良恶性结节的鉴别诊断具有重要意义.