1.Diagnosis of Solitary Pulmonary Nodules with Spiral CT
Yuhao YIN ; Kang DENG ; Ju LIN
Journal of Chinese Physician 2002;0(S1):-
Objective To analyse the imaging characteristics of solitary pulmonary nodules(SPNs) with the spiral CT, and detection clinical values of the definitive diagnosis to SPNs. Methods 32 cases of SPNs were identified by spiral CT, 9 cases of them were examinated by enhancement scanning. The diffrentical imaging features were analyzed. Results 24 cases were malignant in imaging(18 cases were identified), 8 cases were benign in imaging(6 cases were identified). 15 cases of malignant SPNs by clinical identified were smooth at edge; 6 cases of benign SPNs by clinical identified. 5 cases of them were anomaly;4 cases of them were burr;2 cases of them were bronchial sign and vesiclat sign.6 cases of the SPNs were calcified. 6 cases of SPNs(9 cases with contrasting) were benign in imaging, 3 cases of them were malignant in imaging. Conclusion The differential diagnostic of SPNs is difficult by spiral CT, but enhancement scanning and epidemiology combined with spiral CT is very valuable for definitive diagnosis.
2.Microimaging evidences of hippocampal injury in radiotherapy avoiding hippocampus and its effects on cognition
Yuefeng LI ; Yang WANG ; Mengmiao XU ; Yuhang XIE ; Yuhao XU ; Yan ZHU ; Yajie CHEN ; Lin WANG ; Shenghong JU
Chinese Journal of Radiology 2021;55(4):377-382
Objective:To clarify the evidences of hippocampal injury after radiotherapy avoiding hippocampus and explore its relationships with cognition.Methods:A prospective design was adopted in this study.A total of 183 patients with nasopharyngeal carcinoma treated by intensity modulated radiation therapy (IMRT group) and 30 matched healthy control (HC group)were collected in the Affiliated Hospital of Jiangsu University and Southeast University Affiliated Zhongda Hospital from January 2017 to December 2019. All subjects were assessed by Montreal Cognitive Assessment (MoCA-B) at baseline and 6 months after radiotherapy, then the patients with nasopharyngeal carcinoma were divided into cognitive impairment group and non-cognitive impairment group. Subjects were scanned with Siemens 3.0 T MR, and T 1WI was used as analysis sequence.The individual standardized hippocampus ROIs were extracted based on Montreal Neurological Institute(MNI) brain template.All texture features were calculated using the Radiomics developed by C++and Delphi, and the intra group correlation coefficients (ICC), average direction, machine learning (random forest) and autocorrelation matrix were used for reducing the features dimension. One-way ANOVA and generalized linear models were used to compare the differences among different groups. Pearson correlations analyses were used to evaluate the relationships between important texture features and clinical data. Logistic regressions were used to calculate the abilities of texture features to predict cognitive impairment. Results:After 9 patients who lost follow-up were excluded, a total of 164 patients with nasopharyngeal carcinoma were included as IMRT group.Texture features of ROIs were extracted and dimensionally reduced successfully. Five differences features (Variance, Entropy, GlevNonU, RLNonUni and Contrast)were found among HC group, cognitive impairment group and non-cognitive impairment group, and the last three further showed significant differences within IMRT group (GlevNonU, P=0.011;RLNonUni, P<0.001;Contrast, P<0.001). Hippocampal doses were positively correlated with Variance ( r=0.448, P<0.05), and negatively correlated with Entropy ( r=-0.461, P<0.05). There was a positive correlation between MoCA-B scores with GlevNonU, RLNonUniand Contrast ( r=0.503, P<0.05; r=0.587, P<0.05; r=0.531, P<0.05). GlevNonU and Contrast were independent predictors of cognitive impairment in hippocampal avoidance of radiotherapy (OR=0.731, 95%CI 0.610-0.857; OR=0.651, 95%CI 0.496-0.853). Conclusion:Results of texture analysis could be used as micro imaging evidences of hippocampal injury in radiotherapy avoiding hippocampus, and could also effectively predict the occurrences of cognitive impairment.
4.An excerpt of EASL clinical practice guidelines on the management of liver diseases in pregnancy (2023)
Guanlun ZHOU ; Yuhao JU ; Jing XU ; Ping ZHANG ; Guorong HAN
Journal of Clinical Hepatology 2023;39(10):2328-2335
Recently, the European Association for the Study of the Liver organized the development of the clinical practice guidelines for the management of liver diseases in pregnancy, which include 105 recommendations for the clinical management of liver diseases in pregnancy. This article gives an excerpt of the main contents of the guidelines.
5.Clinical features of critically ill pregnant and parturient women infected with chronic hepatitis B virus: An analysis of 41 cases
Yuhao JU ; Wen LI ; Yu WANG ; Lingyan XIAO ; Yishan ZHENG ; Guorong HAN
Journal of Clinical Hepatology 2024;40(2):258-263
ObjectiveTo investigate the clinical features and outcomes of critically ill pregnant and parturient women with chronic hepatitis B virus (HBV) infection, and to provide clinical experience for the rescue of critically ill pregnant and parturient women and the prevention and treatment of the severe exacerbation of liver disease. MethodsA total of 41 pregnant and parturient women with chronic HBV infection who were admitted to Department of Critical Care Medicine, Nanjing Second Hospital, from March 2013 to March 2023 were enrolled in this study, and their clinical data were collected through the electronic medical record system of hospital to summarize the main causes of transfer to the intensive care unit (ICU), the causes of death, and treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between two groups. ResultsAmong the 41 patients, 13 (31.71%) did not receive regular antenatal examination and 8 (19.51%) with a high viral load (HBV DNA ≥2×105 IU/mL) did not receive antiviral therapy. Cesarean section was the main mode of delivery in 32 patients (78.05%); 23 patients (56.10%) had premature delivery, and 5 patients died (12.20%). The top three causes of transfer to the ICU were liver failure, postpartum hemorrhage, and hypertensive disorders of pregnancy. Liver failure mainly occurred in late pregnancy, with hepatic encephalopathy as the most common complication (28.57%) and intrahepatic cholestasis of pregnancy as the most common comorbidity (21.43%); among the 14 patients with liver failure, 6 (42.86%) received regular antenatal examination, and 13 (92.86%) did not receive antiviral therapy before admission. The mean length of ICU stay was 3.31±1.65 days for the patients with postpartum hemorrhage, among whom the patients with severe liver disease had coagulation disorders before delivery, which were difficult to correct after 48 hours of treatment. ConclusionPregnant and parturient women with chronic HBV infection tend to have complex conditions and a relatively high mortality rate. For pregnant and parturient women with chronic HBV infection, assessment of liver status, regular antenatal examination, and timely antiviral therapy are of vital importance to reduce severe exacerbation and mortality rate.