1.Increased CT Attenuation of Pericolic Adipose Tissue as a Noninvasive Marker of Disease Severity in Ulcerative Colitis
Jun LU ; Hui XU ; Jing ZHENG ; Tianxin CHENG ; Xinjun HAN ; Yuxin WANG ; Xuxu MENG ; Xiaoyang LI ; Jiahui JIANG ; Xue DONG ; Xijie ZHANG ; Zhenchang WANG ; Zhenghan YANG ; Lixue XU
Korean Journal of Radiology 2025;26(5):411-421
Objective:
Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity.
Materials and Methods:
This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC).
Results:
The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85.
Conclusion
Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.
2.Increased CT Attenuation of Pericolic Adipose Tissue as a Noninvasive Marker of Disease Severity in Ulcerative Colitis
Jun LU ; Hui XU ; Jing ZHENG ; Tianxin CHENG ; Xinjun HAN ; Yuxin WANG ; Xuxu MENG ; Xiaoyang LI ; Jiahui JIANG ; Xue DONG ; Xijie ZHANG ; Zhenchang WANG ; Zhenghan YANG ; Lixue XU
Korean Journal of Radiology 2025;26(5):411-421
Objective:
Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity.
Materials and Methods:
This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC).
Results:
The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85.
Conclusion
Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.
3.Supine bicycle exercise stress echocardiographic assessment of the right heart-pulmonary circulation unit after high-altitude exposure in healthy adults
Yun XU ; Yi WANG ; Qingfeng ZHANG ; Kai WANG ; Sijia WANG ; Lixue YIN ; Yong JING
Chinese Journal of Ultrasonography 2025;34(1):33-38
Objective:To observe the adaptive changes in the cardiovascular system after travelling to high altitude in healthy people using supine bicycle exercise stress echocardiography(SE),and to reveal the changes in right heart function,pulmonary vascular reserve and right ventricular systolic reserve in healthy people after acute high altitude exposure.Methods:Thirty-six healthy adults were prospectively collected to undergo SE at low altitude(500 m)and high altitude(3 600 m). Offline analysis was conducted to acquire resting and peak exercise ultrasound parameters at high and low altitudes:tricuspid regurgitant velocity(TRV),tricuspid annular peak systolic velocity(TV-s′),right ventricular end-diastolic area(RVEDA),right ventricular end-systolic area(RVESA),right ventricular fractional area change(RVFAC),right ventricular basal transverse dimension(RVD1),right ventricular mid-ventricular transverse dimension(RVD2),right ventricular longitudinal dimension(RVD3),right ventricular free wall longitudinal strain(RVFWS),right ventricular global longitudinal strain(RVGLS),left ventricular cardiac output(CO),pulmonary artery systolic pressure(PASP),mean pulmonary artery pressure(mPAP),pulmonary resistance(PVR)and the ratio of tricuspid annular systolic displacement(TAPSE)to PASP(TAPSE/PASP). The pulmonary vascular reserve and right ventricular systolic reserve indices including pulmonary vascular reserve and right ventricular systolic reserve indices(mPAP/CO slope,change in tricuspid annular systolic displacement(ΔTAPSE),change in fractional area change(ΔRVFAC),change in overall long-axis strain of the right ventricle(ΔRVGLS),and change in peak velocity of the lateral wall of the tricuspid annulus(ΔTV-s′)were calculated. The differences of these parameters betweet high and low altitudes were compared.Results:During the resting period,the values of TRV,PASP,mPAP,PVR,RVD2,and RVD3 were higher at high altitude than at low altitude(all P<0.05). TAPSE/PASP,RVFAC,RVGLS,and RVFWS were lower at high altitude than at low altitude(all P<0.05). During the peak exercise period,TRV,PASP,mPAP,PVR,RVAD,RVAS,RVD2,and RVD3 were all higher at high altitude than at low altitude(all P<0.05),and RVFAC at high altitude was lower than at low altitude( P<0.05). Right ventricular systolic reserve and pulmonary vascular reserve:mPAP/CO slope at high altitude was higher than at low altitude,ΔTV-s′ and RVFAC were lower than at low altitude(all P<0.05),there were no significant differences in ΔTAPSE and ΔRVGLS between the two altitudes(all P>0.05). Conclusions:Acute high altitude exposure causes adaptive dilatation of the right ventricle accompanied by a reduction in pulmonary vascular reserve and right ventricular contractile reserve function.
4.Report on the clinical application status and quality control directions of provocation/stress echocardiography in the diagnosis of hypertrophic cardiomyopathy in large grade A tertiary hospitals in China
Mingjun XU ; Yi WANG ; Haohui ZHU ; Chunyan MA ; Lixue YIN ; Mei ZHANG
Chinese Journal of Ultrasonography 2025;34(6):471-480
Objective:To assess the current clinical application status of provocation/stress echocardiography in hypertrophic cardiomyopathy(HCM)among echocardiography physicians from large grade A tertiary hospitals,located in 24 provinces or directly administered municipalities,and to achieve a relatively clear and comprehensive overview of the current clinical application status of provocation/stress echocardiography in HCM. This study was conducted by the Chinese Society of Ultrasound in Medicine(CSUM)and Chinese Society of Echocardiography(CSE).Methods:An online survey was anonymously conducted using Question Star application from 20 March to 30 September 2023. The survey covered the following topics including the echocardiographic diagnostic overview,the selection of views and measurement parameter of echocardiography,and the cognition and application,awareness and management of risk,and clinical demand of provocation/stress echocardiography.Results:A total of 337 valid responses were included in the final statistical analysis. The study revealed that the number of HCM patients seen by echocardiography physicians was very few(0-10%),with a low proportion of diagnosed obstructive HCM patients. There was incomplete mastery of the left ventricular outflow tract(LVOT)obstruction criteria(68.25%),insufficient awareness of the importance of LVOT pressure gradient measurement(7.12% echocardiographic doctors routinely performed LVOT gradient measurement for suspect HCM patients),non-standardized selection of echocardiographic views and measurement parameters for HCM,and significant deficiencies in knowledge and application of Valsalva provocation/stress echocardiography(17.21% and 79.23% doctors were quite aware of the principles of Valsalva provocation/stress echocardiography,respectively). The risk awareness of provocation/stress echocardiography(13.65% physicians were fully aware of the potential risk)and the ability to manage associated risks(19.29% physicians were able to handle all emergencies)were lacking. Existing guidelines did not sufficiently standardize the clinical practice of provocation/stress echocardiography(23.44%),and there was diversity in learning formats requirements and unmet clinical needs.Conclusions:This survey revealed insufficient fundamental theoretical knowledge and a need for further standardization and training in the application of provocation/stress echocardiography for HCM among echocardiography physicians. Additionally,risk awareness and adequate response skills need improvement. There is a need for more practical and guiding guidelines for clinical practice,as well as numerous unmet clinical needs.
5.Increased CT Attenuation of Pericolic Adipose Tissue as a Noninvasive Marker of Disease Severity in Ulcerative Colitis
Jun LU ; Hui XU ; Jing ZHENG ; Tianxin CHENG ; Xinjun HAN ; Yuxin WANG ; Xuxu MENG ; Xiaoyang LI ; Jiahui JIANG ; Xue DONG ; Xijie ZHANG ; Zhenchang WANG ; Zhenghan YANG ; Lixue XU
Korean Journal of Radiology 2025;26(5):411-421
Objective:
Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity.
Materials and Methods:
This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC).
Results:
The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85.
Conclusion
Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.
6.Increased CT Attenuation of Pericolic Adipose Tissue as a Noninvasive Marker of Disease Severity in Ulcerative Colitis
Jun LU ; Hui XU ; Jing ZHENG ; Tianxin CHENG ; Xinjun HAN ; Yuxin WANG ; Xuxu MENG ; Xiaoyang LI ; Jiahui JIANG ; Xue DONG ; Xijie ZHANG ; Zhenchang WANG ; Zhenghan YANG ; Lixue XU
Korean Journal of Radiology 2025;26(5):411-421
Objective:
Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity.
Materials and Methods:
This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC).
Results:
The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85.
Conclusion
Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.
7.A preliminary exploration of influenza-like illness surveillance and influenza vaccination in Jing’an District of Shanghai, 2017‒2023
Ruijue HUA ; Lixue LYU ; Biao XU ; Jin HUANG ; Ping YU
Shanghai Journal of Preventive Medicine 2025;37(4):313-318
ObjectiveTo understand the surveillance of influenza-like illness (ILI) and influenza vaccination status in Jing’an District, Shanghai, and to provide a basis for optimizing influenza prevention and control strategies. MethodsThe sentinel surveillance data for ILI and virological surveillance data of influenza viruses in Jing’an District were collected from the Chinese influenza surveillance information system, and data for influenza vaccination were collected from Shanghai immunization information system from September 2017 to August 2023. Epidemiological characteristics of ILI, influenza etiology, and the temporal and population distributions of influenza vaccination were analyzed using descriptive epidemiological methods. ResultsILI as a percentage of total visit surveillance units (ILI%) reported by sentinel hospital was increased in Jing’an District of Shanghai from September 2017 to August 2023 (F=18.841, P=0.012). The peak of the influenza cases mainly appeared in winter-spring, but there were two peaks in winter-spring and summer from September 2019 to August 2020, from September 2020 to August 2021, and from September 2021 to August 2022. In particular, there were two peaks in winter-spring from September 2022 to August 2023, with a rebound during the descending process. The average positive rate of ILI was 21.64% (2 421/11 189) during the 6 years. There was a peak in winter-spring during every year with the exception of the period from September 2020 to August 2021. The dominant strains were B/Yamagata and A/H1N1 in winter-spring from September 2017 to August 2018. The dominant strain was A/H1N1 in winter-spring from September 2018 to August 2019 and from September 2022 to August 2023. The dominant strain was B/Victoria in winter-spring from September 2019 to August 2020 and from September 2021 to August 2022. Different subtype strains occurred alternately, and the dominant strains were A/H1N1 and A/H3N2 in recent years. The influenza vaccination coverage was 2.94% from September 2017 to August 2023, and the vaccination coverage was highest in young children. The vaccination coverage for females was higher than that for males (χ2=546.963, P<0.001), and the vaccination coverage for registered residents was higher compared to that for migrants (χ2=123.141, P<0.001). ConclusionILI% exhibits an upward trend in Jing’an District of Shanghai, and the dominant strain is A subtype. The influenza vaccination coverage is still low, which is insufficient to have an impact on the spread of influenza. It is recommended that the surveillance of ILI and variations of influenza virus strains should be improved continuously, and effective steps should be taken to promote influenza vaccination.
8.Increased CT Attenuation of Pericolic Adipose Tissue as a Noninvasive Marker of Disease Severity in Ulcerative Colitis
Jun LU ; Hui XU ; Jing ZHENG ; Tianxin CHENG ; Xinjun HAN ; Yuxin WANG ; Xuxu MENG ; Xiaoyang LI ; Jiahui JIANG ; Xue DONG ; Xijie ZHANG ; Zhenchang WANG ; Zhenghan YANG ; Lixue XU
Korean Journal of Radiology 2025;26(5):411-421
Objective:
Accurate evaluation of inflammation severity in ulcerative colitis (UC) can guide treatment strategy selection. The potential value of the pericolic fat attenuation index (FAI) on CT as an indicator of disease severity remains unknown.This study aimed to assess the diagnostic accuracy of pericolic FAI in predicting UC severity.
Materials and Methods:
This retrospective study enrolled 148 patients (mean age 48 years; 87 males). The fat attenuation on CT was measured in four different locations: the mesocolic vascular side (MS) and opposite side of MS (OMS) around the most severe bowel lesion, the retroperitoneal space (RS), and the subcutaneous area. The fat attenuation indices (FAI MS, FAI OMS, and FAI RS) were calculated as the fat attenuation measured in MS, OMS, and RS, respectively, minus that of the subcutaneous area, and were obtained in the non-enhanced, arterial, and delayed phases. Correlations between the FAI and UC Endoscopic Index of Severity (UCEIS) were assessed using Spearman’s correlation. Predictors of severe UC (UCEIS ≥7) were selected by univariable analysis. The performance of FAI in predicting severe UC was evaluated using the area under the receiver operating characteristic curve (AUC).
Results:
The FAIMS and FAI OMS scores were significantly higher than FAI RS in three phases (all P < 0.001). The FAIMS and FAI OMS scores moderately correlated with the UCEIS score (r = 0.474–0.649 among the three phases). Additionally, FAI MS and FAI OMS identified severe UC, with AUC varying from 0.77 to 0.85.
Conclusion
Increased CT attenuation of pericolic adipose tissue could serve as a noninvasive marker for evaluating UC severity. FAI MS and FAI OMS of three phases showed similar prediction accuracies for severe UC identification.
9.SAPHO syndrome in elderly patients with organizing pneumonia: a case report and literature review
Jia CUI ; Jianing WEN ; Lixue HUANG ; Fang FANG ; Min ZHANG ; Yanming LI ; Xiaomao XU ; Yanfei GUO
Chinese Journal of Geriatrics 2025;44(11):1556-1561
Objective:To summarize the clinical characteristics of SAPHO syndrome in elderly patients with organizing pneumonia.Methods:We reported a case of SAPHO syndrome in an elderly patient with organizing pneumonia.Relevant reports on SAPHO syndrome with organizing pneumonia at home and abroad were retrieved, and the literature was summarized an analyzed.Results:The patient was a 63-year-od female who was admitted to the hospital due to "intermittent fever and cough for more than two months". Before admission, she was previously diagnosed with pneumonia in another hospital with poor response to anti-infective treatment.Chest CT showed multiple bilateral patchy consolidations in both lungs, with migratory changes and reversed halo signs.Her medical history included bone and joint pain(e.g., sternoclavicular joints)and palmoplantar pustulosis.Lung biopsy pathology confirmed organizing pneumonia. 99mTc-MDP bone scintigraphy revealed abnormal bone salt metabolism in multiple bone and joint areas.The final diagnosis was SAPHO syndrome with organizing pneumonia.Both symptoms and imaging significantly improved after prednisone treatment.Two related cases were retrieved from the literature.One was a 57-year-old female reported in the UK, who had been diagnosed with SAPHO syndrome before and was found to have lung consolidations due to respiratory symptoms.Lung biopsy confirmed organizing pneumonia, and she improved after glucocorticoid treatment.The other was a 59-year-old Chinese female who visited hospital due to pain in the lumbosacral part and left lower limb.After being diagnosed with SAPHO syndrome, a chest CT scan was performed and lung consolidations were found.The pathology confirmed organizing pneumonia.The patient improved after treatment with Tripterygium wilfordii. Conclusion:SAPHO syndrome complicated with organizing pneumonia is rare, with diverse clinical manifestations, and responds well to glucocorticoid therapy.
10.SAPHO syndrome in elderly patients with organizing pneumonia: a case report and literature review
Jia CUI ; Jianing WEN ; Lixue HUANG ; Fang FANG ; Min ZHANG ; Yanming LI ; Xiaomao XU ; Yanfei GUO
Chinese Journal of Geriatrics 2025;44(11):1556-1561
Objective:To summarize the clinical characteristics of SAPHO syndrome in elderly patients with organizing pneumonia.Methods:We reported a case of SAPHO syndrome in an elderly patient with organizing pneumonia.Relevant reports on SAPHO syndrome with organizing pneumonia at home and abroad were retrieved, and the literature was summarized an analyzed.Results:The patient was a 63-year-od female who was admitted to the hospital due to "intermittent fever and cough for more than two months". Before admission, she was previously diagnosed with pneumonia in another hospital with poor response to anti-infective treatment.Chest CT showed multiple bilateral patchy consolidations in both lungs, with migratory changes and reversed halo signs.Her medical history included bone and joint pain(e.g., sternoclavicular joints)and palmoplantar pustulosis.Lung biopsy pathology confirmed organizing pneumonia. 99mTc-MDP bone scintigraphy revealed abnormal bone salt metabolism in multiple bone and joint areas.The final diagnosis was SAPHO syndrome with organizing pneumonia.Both symptoms and imaging significantly improved after prednisone treatment.Two related cases were retrieved from the literature.One was a 57-year-old female reported in the UK, who had been diagnosed with SAPHO syndrome before and was found to have lung consolidations due to respiratory symptoms.Lung biopsy confirmed organizing pneumonia, and she improved after glucocorticoid treatment.The other was a 59-year-old Chinese female who visited hospital due to pain in the lumbosacral part and left lower limb.After being diagnosed with SAPHO syndrome, a chest CT scan was performed and lung consolidations were found.The pathology confirmed organizing pneumonia.The patient improved after treatment with Tripterygium wilfordii. Conclusion:SAPHO syndrome complicated with organizing pneumonia is rare, with diverse clinical manifestations, and responds well to glucocorticoid therapy.

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