A 39-year-old male patient was admitted to hospital with abdominal distension, unconsciousness, and anuria. Head computed tomography (CT) showed subarachnoid hemorrhage and diffuse cerebral edema. The high-density area of contrast accumulation region in the high-density CT plaque was 38 HU, and the preliminary diagnosis was SAH, incomplete intestinal obstruction, and sepsis caused by acute cerebrovascular disease. After admission, the patient displayed upturned eyes, limb convulsions, serum procalcitonin level exceeding 100 ng/mL, low blood pressure and septic shock. Imipenem was given for intensive anti-infection therapy. After treatment, procalcitonin levels showed a slow decline, renal function, and intra-abdominal pressure returned to normal, urine volume gradually increased, but platelets still showed a downward trend. Lumbar puncture showed colorless and clear cerebrospinal fluid, and the biochemical and routine results of cerebrospinal fluid were normal. SAH and intracranial infection were excluded, and it was considered that the head CT showed pseudo-subarachnoid hemorrhage. On the 3rd day of admission, laparoscopic exploratory laparotomy+appendectomy+abdominal drainage under general anesthesia were performed. During surgery, purulent gangrene in the appendix was found, with pus adhering to the surface of the intestines and a large amount of pus present in the abdominal cavity. Rhabdomyolysis syndrome developed after surgery. After continuous renal replacement therapy, the indicators gradually returned to normal. The patient was conscious, and the head CT results were normal. The patient was discharged from the hospital on the 19th day after surgery, and no special discomfort and abdominal pain and distension occurred during the 3-month follow-up.
Humans ; Male ; Adult ; Tomography, X-Ray Computed ; Sepsis/diagnostic imaging* ; Multiple Organ Failure/etiology* ; Subarachnoid Hemorrhage/complications*

Cerebral hemorrhage is a serious cerebrovascular disease with high morbidity and high mortality, for which timely diagnosis and treatment are crucial. Electrical impedance tomography (EIT) is a functional imaging technique which is able to detect abnormal changes of electrical property of the brain tissue at the early stage of the disease. However, irregular multi-layer structure and different conductivity properties of each layer affect image reconstruction of the brain EIT, resulting in low reconstruction quality. To solve this problem, an image reconstruction method based on an improved densely-connected fully convolutional neural network is proposed in this paper. On the basis of constructing a three-layer cerebral model that approximates the real structure of the human head, the nonlinear mapping between the boundary voltage and the conductivity change is determined by network training, which avoids the error caused by the traditional sensitivity matrix method used for solving inverse problem. The proposed method is also evaluated under the conditions with or without noise, as well as with brain model change. The numerical simulation and phantom experimental results show that conductivity distribution of cerebral hemorrhage can be accurately reconstructed with the proposed method, providing a reliable basis for the diagnosis and treatment of cerebral hemorrhage. Also, it promotes the application of EIT in the diagnosis of brain diseases.
Humans ; Cerebral Hemorrhage/diagnostic imaging* ; Neural Networks, Computer ; Electric Impedance ; Image Processing, Computer-Assisted/methods* ; Tomography/methods* ; Brain/diagnostic imaging* ; Phantoms, Imaging ; Convolutional Neural Networks

Hepatocelluar carcinoma presenting as a biliary duct tumor thrombus is a relatively rare entity, with poor prognosis. The primary clinical manifestation of this disease is obstructive jaundice, which can often be misdiagnosed. A 59-year-old female patient was admitted with sudden onset of abdominal pain. Laboratory tests suggested obstructive jaundice, and enhanced magnetic resonance imaging of the upper abdomen did not show obvious biliary dilatation. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography suggested an occupying lesion in the upper bile duct. SpyGlass and biopsy finally confirmed hepatocellular carcinoma with right hepatic duct tumor thrombus hemorrhage. The SpyGlass Direct Visualization System, as an advanced biliary cholangioscopy device, showed the advantages of single-person operation as well as easy access to and visualization of the lesion.
Female ; Humans ; Middle Aged ; Carcinoma, Hepatocellular/diagnostic imaging* ; Jaundice, Obstructive/etiology* ; Liver Neoplasms/diagnostic imaging* ; Hepatic Duct, Common/pathology* ; Thrombosis/complications* ; Hemorrhage/complications*

Male ; Humans ; Urinary Bladder/diagnostic imaging* ; Prostate/diagnostic imaging* ; Multiparametric Magnetic Resonance Imaging ; Cystitis/diagnostic imaging* ; Hemorrhage/etiology* ; Urinary Bladder Neoplasms/complications*

Humans ; Data Warehousing ; East Asian People ; Intracranial Hemorrhages/diagnostic imaging* ; Asian People ; Cerebral Hemorrhage/diagnostic imaging*

Atypical polypoid adenomyoma (APA) is an uncommon type of polypoid characterized by fibroid stroma and endometrial glands. It occurs mostly in premenopausal women and rarely in postmenopausal women with irregular vaginal bleeding. In our current case, a 76-year-old woman presented with irregular vaginal bleeding. The final pathological diagnosis of the mass was APA. APA is not easy to diagnose before surgery. On the one hand, there was no obvious particularity in imaging features and clinical features, especially for uncomfortably identifying endometrial cancer. On the other hand, APA has a pedicle, attaching to any part of the uterine cavity, which can cause pseudocoel between the mass with the uterine cavity wall. So, when it comes to getting the pathological tissue in the absence of hysteroscopy, it is easy to access to the pseudocoel and obtain endometrial tissue rather than the pathological tissue of the mass. Therefore, preoperative imaging examination is of great significance diagnosis way of thinking to clinicians for APA. In the meantime, pathological tissue of APA can be obtained by hysteroscopy in visual conditions.
Adenomyoma/pathology* ; Aged ; Female ; Humans ; Hysteroscopy ; Magnetic Resonance Imaging ; Pregnancy ; Uterine Hemorrhage ; Uterine Neoplasms/diagnostic imaging*

OBJECTIVE: To investigate the performance of different low-dose CT image reconstruction algorithms for detecting intracerebral hemorrhage. METHODS: Low-dose CT imaging simulation was performed on CT images of intracerebral hemorrhage at 30%, 25% and 20% of normal dose level (defined as 100% dose). Seven algorithms were tested to reconstruct low-dose CT images for noise suppression, including filtered back projection algorithm (FBP), penalized weighted least squares-total variation (PWLS-TV), non-local mean filter (NLM), block matching 3D (BM3D), residual encoding-decoding convolutional neural network (REDCNN), the FBP convolutional neural network (FBPConvNet) and image restoration iterative residual convolutional network (IRLNet). A deep learning-based model (CNN-LSTM) was used to detect intracerebral hemorrhage on normal dose CT images and low-dose CT images reconstructed using the 7 algorithms. The performance of different reconstruction algorithms for detecting intracerebral hemorrhage was evaluated by comparing the results between normal dose CT images and low-dose CT images. RESULTS: At different dose levels, the low-dose CT images reconstructed by FBP had accuracies of detecting intracerebral hemorrhage of 82.21%, 74.61% and 65.55% at 30%, 25% and 20% dose levels, respectively. At the same dose level (30% dose), the images reconstructed by FBP, PWLS-TV, NLM, BM3D, REDCNN, FBPConvNet and IRLNet algorithms had accuracies for detecting intracerebral hemorrhage of 82.21%, 86.80%, 89.37%, 81.43%, 90.05%, 90.72% and 93.51%, respectively. The images reconstructed by IRLNet at 30%, 25% and 20% dose levels had accuracies for detecting intracerebral hemorrhage of 93.51%, 93.51% and 93.06%, respectively. CONCLUSION The performance of reconstructed low-dose CT images for detecting intracerebral hemorrhage is significantly affected by both dose and reconstruction algorithms. In clinical practice, choosing appropriate dose level and reconstruction algorithm can greatly reduce the radiation dose and ensure the detection performance of CT imaging for intracerebral hemorrhage.
Algorithms ; Cerebral Hemorrhage/diagnostic imaging* ; Humans ; Image Processing, Computer-Assisted/methods* ; Least-Squares Analysis ; Tomography, X-Ray Computed/methods*

Hemorrhage/etiology* ; Humans ; Image-Guided Biopsy ; Lung/diagnostic imaging* ; Lung Diseases/etiology* ; Lung Neoplasms ; Retrospective Studies ; Risk Factors ; Ultrasonography, Interventional

Adrenal gland trauma is a rare phenomenon, due to the small size and retroperitoneal location of the organ. The majority of adrenal gland trauma is due to blunt force injury and is only rarely encountered due to the penetrating mechanisms. A 20-year-old male sustained a gunshot wound to the left abdomen. Upon exploration, he was found to have a through and through injury to the left adrenal gland, among other injuries. Injury to the adrenal gland due to penetrating trauma is exceptionally rare. The principles of management are to control bleeding from the gland with debridement and hemostasis rather than attempt to resect the entire organ. The management of a penetrating injury to the adrenal gland is straightforward and should not be a contributor to a patient's morbidity or mortality.
Adrenal Glands ; diagnostic imaging ; injuries ; Adult ; Debridement ; Hemorrhage ; etiology ; therapy ; Hemostasis, Surgical ; Humans ; Laparotomy ; Male ; Multiple Trauma ; therapy ; Organ Sparing Treatments ; methods ; Tomography, X-Ray Computed ; Treatment Outcome ; Wounds, Gunshot ; complications ; diagnostic imaging ; therapy ; Young Adult

To explore the correlation between hematoma expansion within 24 hours of hypertensive intracerebral hemorrhage and signs on nonenhanced computed tomography(NECT). Methods The clinical data and CT images of 185 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed.The differences in CT parameters were compared between the expansion group and the unexpanded group.Binary logistic regression analysis was performed on the indicators with statistical significance between the two groups to identify the potential correlation between CT parameters and hematoma expansion.The roles of blend sign,lobulation sign,and black hole sign in predicting early hematoma expansion were assessed. Results The CT quantitative data including initial volume,maximum diameter,minimum diameter,maximum CT value,mean CT value,difference between maximum diameter and minimum diameter showed no significant difference between these two group(all >0.05).CT qualitative data including blend sign,lobulation sign,and black hole sign were significantly different(<0.05)but the differences became not significant after the hematoma broke into the ventricles.Binary logistic regression analysis showed that blend sign,lobulation sign,and black hole sign were independent risk factors for early hematoma expansion,with sensitivity,specificity,positive predictive value,and negative predictive value of the combined signs and the early hematoma expansion calculated by the four-fold table method being 78.4%,59.0%,42.1%,and 87.8%,respectively,and the Youden index was 0.374.Its Youden index was closer to 1 than the blend sign,the black hole sign,and the lobulation sign. Conclusion The blend sign,lobulation sign,and black hole sign in NECT can be used to predict hematoma expansion within 24 hours after hypertensive cerebral hemorrhage.
Cerebral Hemorrhage ; diagnostic imaging ; Hematoma ; diagnostic imaging ; Humans ; Intracranial Hemorrhage, Hypertensive ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed