Purpose To evaluate the effectiveness of deep learning image reconstruction(DLIR)algorithms in reconstructing lumbar vertebrae images from abdominal CT scans,aiming to reduce radiation dose and eliminate the need for repeat lumbar CT examinations.Materials and Methods A retrospective collection was conducted from March to May 2024 in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.Thirty-two patients who underwent both abdominal and lumbar CT scans in a supine head-first position were enrolled.The abdominal CT(DLIR group)utilized a tube voltage of 120 kVp and a current of 200 mA with high-intensity DLIR for lumbar reconstruction.The standard lumbar CT(lumbar group)used the same voltage with a tube current of 260 mA and was reconstructed using 60%weighted adaptive statistical iterative reconstruction.Objective assessments was used to measure the CT values,noise(standard deviation,SD value),signal-to-noise ratio and contrast-to-noise ratio(excluding adipose tissue)at the third lumbar vertebral pedicle level and the L2/L3 intervertebral disc level for muscle,adipose tissue,cancellous bone,intervertebral discs,dura mater and cortical bone.Subjective assessments employed a five-point scale to evaluate image contrast,noise and sharpness.Results The volume CT dose index in lumbar group and DLIR group were 15.25 mGy and 11.74 mGy,respectively.There was no statistical difference in CT values between the structures of both groups(all P>0.05).Compared with the lumbar group,the DLIR group showed significant reductions in SD values across the measured tissues by 31.09%,35.66%,13.48%,27.82%,24.93%and 15.09%(t=5.09-7.21,all P<0.05).The signal-to-noise ratio improved by 36.40%,52.31%,16.56%,34.13%,38.39%and 18.81%,and the contrast-to-noise ratio improved by 51.70%,51.32%,36.24%,34.47%and 53.56%(t=-9.58--4.23,all P<0.001).The DLIR group significantly outperformed the lumbar group in image contrast[4.45(4.00,5.00)points vs.4.75(4.00,5.00)points],image noise[4.06(4.00,4.00)points vs.4.39(4.00,5.00)points],and spatial resolution of fine structures[4.00(4.00,4.00)points vs.4.27(4.00,5.00)points](Z=-3.80,-4.38,-3.55,all P<0.001).Conclusion Using high-intensity DLIR for abdominal examinations can achieve high-quality lumbar CT images with a 25%reduction in radiation dose,enabling simultaneous abdominal and lumbar scanning in a single session.

Purpose To evaluate the effectiveness of deep learning image reconstruction(DLIR)algorithms in reconstructing lumbar vertebrae images from abdominal CT scans,aiming to reduce radiation dose and eliminate the need for repeat lumbar CT examinations.Materials and Methods A retrospective collection was conducted from March to May 2024 in the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine.Thirty-two patients who underwent both abdominal and lumbar CT scans in a supine head-first position were enrolled.The abdominal CT(DLIR group)utilized a tube voltage of 120 kVp and a current of 200 mA with high-intensity DLIR for lumbar reconstruction.The standard lumbar CT(lumbar group)used the same voltage with a tube current of 260 mA and was reconstructed using 60%weighted adaptive statistical iterative reconstruction.Objective assessments was used to measure the CT values,noise(standard deviation,SD value),signal-to-noise ratio and contrast-to-noise ratio(excluding adipose tissue)at the third lumbar vertebral pedicle level and the L2/L3 intervertebral disc level for muscle,adipose tissue,cancellous bone,intervertebral discs,dura mater and cortical bone.Subjective assessments employed a five-point scale to evaluate image contrast,noise and sharpness.Results The volume CT dose index in lumbar group and DLIR group were 15.25 mGy and 11.74 mGy,respectively.There was no statistical difference in CT values between the structures of both groups(all P>0.05).Compared with the lumbar group,the DLIR group showed significant reductions in SD values across the measured tissues by 31.09%,35.66%,13.48%,27.82%,24.93%and 15.09%(t=5.09-7.21,all P<0.05).The signal-to-noise ratio improved by 36.40%,52.31%,16.56%,34.13%,38.39%and 18.81%,and the contrast-to-noise ratio improved by 51.70%,51.32%,36.24%,34.47%and 53.56%(t=-9.58--4.23,all P<0.001).The DLIR group significantly outperformed the lumbar group in image contrast[4.45(4.00,5.00)points vs.4.75(4.00,5.00)points],image noise[4.06(4.00,4.00)points vs.4.39(4.00,5.00)points],and spatial resolution of fine structures[4.00(4.00,4.00)points vs.4.27(4.00,5.00)points](Z=-3.80,-4.38,-3.55,all P<0.001).Conclusion Using high-intensity DLIR for abdominal examinations can achieve high-quality lumbar CT images with a 25%reduction in radiation dose,enabling simultaneous abdominal and lumbar scanning in a single session.

Objective: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). Methods: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: ① according to the degree of SMA stenosis, the patients were divided into group Ⅰ (stenosis degree ≤70%) and groupⅡ (stenosis degree > 70%); ② LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis. Results: The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group Ⅰ (n = 64) and group Ⅱ (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group Ⅰ, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group Ⅱ, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient. Conclusions Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.

Objective To investigate the diagnostic value of digital tomosynthesis in Schatzker classification of tibial plateau fractures.Methods A total of 43 patients with tibial plateau fractures who had underwent injured knee joints coronal tomosynthesis examinations and as well as digital radiography (DR) examinations including anteroposterior and lateral positions before the surgery were selected from January to June 2015.The imaging evaluation was performed by two diagnostic radiologists independently.Each radiologist consecutively performed Schatzker classification of the DR and tomosynthesis images of the knees of each patient.The consistent Schatzker classification results were finally given,while the inconsistent classification results were discussed.Recording the reading results of two methods and comparing the classification results of two methods with the subsequent intra-operative classification results,evaluating their consistency.Results Twenty-eight patients were included with 14 males and 14 females.The age ranged from 25 to 76 years old with an average of 48.5 years.Fifteen patients were excluded due to combined injuries and the low quality of imaging.Schatzker classification of tibial plateau fractures was performed with DR images,19 cases of fracture classification results were consistent with intra-operative classification,and 9 cases were inconsistent.Twenty-six cases of fracture classification results were consistent with intra-operative classification based on tomosynthesis images but 2 cases with inconsistent results.Intra-operative findings for each fracture were used as the gold standard for classification.The accuracy of the Schatzker classification for tibial plateau fractures were 68％ and 93％ in the two imaging techniques with significant difference (x2=5.143,P=0.016),respectively.The classification results of two imaging methods in 2 patients were both inconsistent with intra-operative classification.The fracture severity of 6 patients was underestimated when using DR images for interpretation,while 1 patient had a missed diagnosis of the lateral tibial plateau collapsed fracture.The consistency between the classification results of DR images as well as classification results of tomosynthesis images and intra-operative typing were moderately and highly consistent,respectively (Kappa coefficient were 0.604 and 0.908,respectively).Conclusion Schatzker classification of tibial plateau fractures was performed with DR images,the lateral tibial plateau collapsed fracture and the lateral plateau splitting fracture could be easily missed or misdiagnosed.However,tomosynthesis imaging could provide a higher accuracy.

Because X-ray digital tomosynthesis (DTS) imaging principle is different from that of CT, DTS has better spatial resolution than that of CT in sagittal and coronal planes, and since DTS is reconstructed to generate"layer" images, its power in the aspect of distinguishing 3D tissue structures is superior to that of general X-ray photography, so DTS can provide 3D information for clinical diagnosis; its radiation dose is markedly lower than that of CT. In recent years, DTS has made progress in the application of skeletal system imaging; the research progress and the possible direction of future application of DTS in bone fracture diagnosis, fracture healing estimation, vertebral bone quality assessment and fracture risk prediction, joint dislocation diagnosis, bone erosion evaluation and postoperative arthroplasty assessment were summarized.

OBJECTIVE: To investigate the correlation between the stenosis degree of superior mesenteric artery (SMA) and each artery within the scope of aorto-iliac artery in patients with lower extremity atherosclerotic occlusive disease (LEAOD). METHODS: Images of 70 patients who had undergone the aorta-iliac-femoral arteries CT angiography (CTA) examination and had a definite diagnosis of LEAOD due to intermittent claudication or resting pain admitted to Tianjin Hospital from January to December in 2017 were enrolled. The arteries in the aorta as well as iliac were surface-reconstructed, which were analyzed by advanced vascular analysis (AVA) combined with the original images, including SMA trunk, abdominal aorta (AA), left and right common iliac artery (LCIA, RCIA), left and right internal iliac artery (LIIA, RIIA), left and right external iliac artery (LEIA, REIA). The normal reference plane and the maximal stenosis plane were selected, and the stenosis rate of each artery in the reconstruction range was automatically calculated with software. The patient's imaging data were divided into groups with two methods: (1) according to the degree of SMA stenosis, the patients were divided into group I (stenosis degree ≤70%) and group II (stenosis degree > 70%); (2) LEAOD patients with different gender were respectively divided into three groups: middle-aged group (45-59 years old), pre-elderly group (60-74 years old) and elderly group (75-89 years old). The comparison between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery was analyzed with Pearson simple correlation analysis. RESULTS: The incidence of SMA stenosis in all LEAOD patients was 100%. Correlation analysis showed that there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in group I (n = 64) and group II (n = 6), respectively (r value was -0.021, 0.023, 0.023, -0.137, 0.182, -0.113, 0.141, respectively, in group I, and it was 0.020, -0.560, 0.010, 0.306, -0.204, -0.381, 0.393, respectively, in group II, all P > 0.05). In 52 male patients, there was no correlation between the stenosis degree of SMA and AA, LCIA, RCIA, LIIA, RIIA, LEIA, or REIA in middle-aged group (n = 16), pre-elderly group (n = 27) and elderly group (n = 9), respectively (r value was -0.032, 0.024, 0.324, 0.146, 0.312, 0.008, 0.344, respectively, in middle-aged group, it was -0.108, -0.116, -0.040, -0.249, -0.082, -0.052, 0.096, respectively, in pre-elderly group, and it was 0.182, 0.311, 0.400, 0.360, 0.688, 0.498, 0.406, respectively, in elderly group, all P > 0.05). In 18 female patients, there was also no correlation between the stenosis degree of SMA and above each artery within the scope of aorto-iliac artery in pre-elderly group (n = 11) and elderly group (n = 6), respectively (the r value was -0.170, 0.040, -0.019, 0.152, 0.508, 0.042, 0.456, respectively, in pre-elderly group, and it was -0.660, 0.008, -0.055, -0.056, -0.213, 0.344, 0.011, respectively, in elderly group, all P > 0.05). The correlation in middle-aged group was not analyzed because there was only 1 patient. CONCLUSIONS Although the atherosclerotic changes in LEAOD patients can affect SMA and aorto-iliac artery at the same time, there was no correlation between the stenosis degree of SMA and each artery within the scope of aorto-iliac artery which may due to the differences in the histological structure and hemodynamics among different arteries. SMA atherosclerotic stenosis and occlusion is a relatively independent disease process for LEAOD.
Aged ; Aged, 80 and over ; Computed Tomography Angiography ; Constriction, Pathologic ; Female ; Humans ; Iliac Artery ; Lower Extremity ; Male ; Mesenteric Artery, Superior ; Middle Aged

Objective To investigate the value of three-dimension (3D) ultrasound in identification of benign or malignant gastric ulceration. Methods A total of 88 patients with gastric ulcer were collected in Tianjin Nankai Hospital from March 2014 to May 2015, including 36 malignant cases and 52 benign cases confirmed by pathological results. Results of 2D ultrasound, 3D ultrasound and gastroscope diagnosis were compared, and the diagnostic values of the three methods were evaluated by the gold standard of pathologic results. Receiver operating characteristic (ROC) curves were plotted for the main measurement indicators (ulcer surface width, ulcer surface depth and thickness of stomach wall) of 3D ultrasound. The best cut-off value was determined. Results The positive rate of malignant gastric ulcer diagnosed by 3D ultrasound was significantly higher than that of 2D ultrasound (P=0.002), but there was no significant difference between 3D ultrasound and gastroscope detection (P=0.453). The diagnostic sensitivities of malignant gastric ulcer were 86.11%, 58.33%and 91.67%for 3D ultrasound, 2D ultrasound and gastroscope detection respectively. The diagnostic specificities were 100%, 100%and 96.15% respectively. The areas under the ROC curves measured by 3D ultrasound were 0.750, 0.940 and 0.977 for ulcer surface width, ulcer surface depth and thickness of stomach wall. And the best cut-off values of the three indicators were 16.55 mm, 8.05 mm and 9.90 mm. Conclusion The 3D ultrasound can show the form and structure of gastric ulcer more clearly and intuitively, which is valuable for the differential diagnosis of benign gastric ulcer and malignant gastric ulcer, and may be used for screening malignant gastric ulcer.

Objective To explore the motion features of cervical spine based on continuous X-ray images.Methods The cervical spontaneous continuous multi-frame sagittal images from flexion to extention positions were selected from cervical spondylosis patients (patients group) and healthy adult (normal group).After preprocessing and registration,the trajectory of single vertebral body were recorded,and the feature points of each vertebral body were extracted.Meanwhile,the rel ative geometry parameters and movement rate were calculated.Results The motion trajectory of patients' cervical spine C4-6 were different from healthy people.The angles between the left edge curve of the vertebral body (C4 and C5 vertebra) and the baseline of patients group were smaller than those of normal group in flexion position (all P＜0.05).There were instability in the movement of C4 vertebral body in patient group,and the volatility of the angle change,the rate of change and the frequency were larger.The relative position change of the adjacent single vertebral body in the patient group are smaller.Conclusion Through the preprocessing,registration,parameter extraction and result analysis,the changes of functional features in cervical spondylosis patients are truly reflected.And it also provides a new idea for dynamic analysis of cervical vertebrae based on X-ray images.

Purpose Accurate diagnosis of triangular fibrocartilage (TFC) tear is very important for treatment. MRI is most used for diagnosing TFC tear. This paper aims to evaluate MRI and MR arthrography (MRA) for diagnosing TFC tear by meta-analysis. Materials and Methods The articles were searched in the databases such as Wanfang, VIP, CNKI, Cochrane Library, Medline, Embase and PubMed. The QUADAS items were used to evaluate the quality of the included studies. Heterogeneity of the included articles was tested. The pooled weighted sensitivity and specificity of MRI and MRA in diagnosing TFC tear were calculated, and the pooled receiver operation curve was drawn. Results Fifteen articles met the inclusion criteria, 2 were Chinese articles and 13 were English articles. The subjects and methods of the articles were different and existed heterogeneity. The sensitivity and specificity of MRI for diagnosing TFC tear were 0.66 (95% CI 0.61-0.71) and 0.75 (95% CI 0.69-0.81), and those of MRA were 0.80 (95% CI 0.73-0.87) and 0.86 (95% CI 0.74-0.93). The area under curve and Q* index of SROC of MRI were 0.8566 and 0.7875, respectively. The area under curve and Q* index of SROC of MRA were 0.9123 and 0.8446, respectively. Conclusion The accuracy of TFC tear avulsion for MRA are higher than for MRI, when there is unclear of TFC avulsion using MRI, MRA can be used for diagnosis.