Objective To analyze the status of applying diagnostic test in imaging scientific study internationally and domestically, and to compare the application of the image diagnostic studies of our country with that of abroad. Method We hand-searched the diagnosis tests published in the "Chinese Journal of Radiology", the most influential in China, and in "Radiology’’, the most influential abroad, from 1998 to 1999 respectively. Then we evaluated each of the diagnosis tests according to the international standards. Results We searched 408 original articles in "Chinese Journal of Radiology" in which the diagnostic test articles were 12%, and 796 original articles in "Radiology" with the diagnostic test articles 23% from 1998 to 1999 respectively. In these diagnosis tests, by comparing the "Chinese journal of radiology" with the "Radiology", it was found that 19% applied blind comparison with Gold Standard, 28% calculated sensitivity, specificity and accuracy, 9% both calculated negative predictive value and positive predictive value and none calculated likelihood ratios in the former versus 64%, 57%, 33% and 26% and 3% respectivdy in the latter. Conclusions Compared with the international level, both the quality and the quantity of the diagnosis tests applied in the specialty of imaging scientific study in China are much lower and far from meeting the clinical requirement. Improving the methods of scientific study and carrying on more diagnosis tests with high qualities are of important significance in improving the diagnostic level of imaging.
Objective To investigate the value of contrast-enhanced ultrasonography in detection and diagnosis of small primary liver cancer. Methods SonoVue-enhanced ultrasonography were performed on 353 patients with 378 primary liver cancer, less than 3 cm in diameter. Enhancement patterns and enhancement phases of hepatic lesions on contrast-enhanced ultrasonography were analyzed and compared with the results of histopathology. Results In all hepatic tumors, 96.6% （365/378） lesions enhanced in the arterial phase. Among them, 317 (83.9%) tumors enhanced earlier than liver parenchyma and 48 (12.7%) tumors enhanced synchronously with liver parenchyma, and 342 (90.5%) tumors showed early wash-out in the portal and late phases. With regard to the enhancement pattern, 329 (87.0%) tumors presented whole-lesion enhancement, 35 (9.3%) to be mosaic enhancement and 14 (3.7%) to be rim-like enhancement. If taking the whole-lesion enhancement and mosaic enhancement in arterial phase as diagnotic standard for primary liver cancer on contrast-enhanced ultrasonography, the sensitivity was 92.9%(351/378), and if the earlier or synchronous enhancement of the tumor compared with liver parenchyma in arterial phase and the wash-out in portal phase were regarded as the stardand, the sensitivity was 87.3%(330/378). Conclusion Contrast-enhanced ultrasonography could display real-time enhancement patterns as well as the wash-out processes both in hepatic tumors and the liver parenchyma. It might be of clinical value in diagnosis of primary liver cancer based on the hemodynamics of hepatic tumors on contrast-enhanced ultrasonography.
Objective To analyze the clinical presentations and radiological characteristics of acute exacerbation of idiopathic pulmonary fibrosis ( IPF) . Methods Clinical and radiological data of 2 patients with acute exacerbation of IPF from April 2006 to July 2008 were retrospectively analyzed and literatures were reviewed. Results Both patients were senior male patients over 60 years old. Dyspnea, cough and inspiratory crackles were the major symptoms and signs. Two patients were experiencing an exacerbation of dyspnea for one week and half of month, respectively. PaO2 /FiO2 of both patients was less than225 mm Hg. In both patients, high-resolution computed tomography ( HRCT) scans at the exacerbation showed typical signs of IPF including peripheral predominant, basal predominant reticular abnormality, with honeycombing and traction bronchiectasis and bronchiolectasis, and newly developing alveolar opacity. HRCT scan showed peripheral area of ground-glass attenuation adjacent to subpleural honeycombing in one patient, and diffusely distributed ground-glass opacity in another patient. Two patients had received corticosteroid treatment. For one patient, the symptoms improved, and ground-glass attenuation adjacent to subpleural honeycombing had almostly resolved. The other patient died of respiratory failure. Conclusions Some acute exacerbation in idiopatic pulmonary fibrosis can be idiopathic. The clinical presentations mainly include the worsening of dyspnea within short time. HRCT generally demonstrates new bilateral ground-glass abnormality with or without areas of consolidation, superimposed on typical changes of IPF.
Objective To evaluate the sonographic characteristics of peripheral focal inflammation of lung, and to improve the diagnosis and differential diagnosis potency of sonography for pulmonary peripheral lesions. Methods The sonogram of 44 patients with peripheral focal inflammation of lung were retrospectively analyzed and compared with the sonogram of other lesions. Independent variables included lesion’s margin, echotype, the secondary change of visceral pleura, the angulation of lesion’s inner surface and air bronchogram. Lesion’s nature was as dependent variable. The data was analyzed by Logistic regression analysis. Pathological results were confirmed by biopsy. Results The angulation of lesion’s inner surface and air bronchogramwere significant factors affecting the diagnosis of peripheral focal inflammation of lung( P lt;0. 01) . Compared to the pathological yield by biopsy, angulation of lesion’s inner surface being acute angle for diagnosis of peripheral focal inflammation of lung had an accuracy rate of 82. 6% , a sensitivity of 72. 7% , a specificity of 84. 7% , a positive predictive value of 51. 0% , and a negative predictive value of 93. 4%. Conclusions The acute angle of lesion’s inner surface and air bronchogram are sonographic characteristics of peripheral focal inflammation of lung. Bedside lung ultrasound is useful to the diagnosis of peripheral focal inflammation of lung.
Objective To approach the clinical values of computer tomography (CT) examination technique and imaging features in abdominal cavity parenchymal organs injury. Methods One hundred and fifty-nine patients with abdominal cavity parenchymal organs injury were examined by CT of plain scan and (or) contrast enhancement, the enhancement included arterial phase, parenchymal phase and the kidney scanning delay phase, the results of CT scanning were compared. Results Ninty-eight cases among 159 patients were diagnosed as the abdominal cavity parenchymal organs injury by the CT, the diagnosis accordance rate was 98.1% (156/159) by operation and follow-up, 22 cases were simple viscus damage or back bone and pelvic fracture, 39 cases were negative, the examination positive rate was 75.5% (120/159). Conclusion The CT can display the parenchymal organ traumatic condition, subcapsule hematoma, retroperitoneal hematoma, seroperitoneum and injured grade. It is the first selective examination to use CT scanning in abdominal cavity parenchymal organ damage, and it has important clinic values to use correct scanning techniques in abdominal injury examination.
ObjectiveTo investigate the recommendations on imaging diagnosis in Chinese clinical practice guidelines (CPGs). MethodsWe electronically searched WanFang Data, VIP, CNKI and CBM databases from inception to December 31, 2014. Two reviewers independently screened literature and extracted data. The method of bibliometrics was used to analyze the data (including basic characteristics, strength of recommendation, quality of evidence, etc.). ResultsA total of 341 CPGs formulating the recommendations on diagnosis were included. 48.7% (166/341) guidelines developed the recommendations on imaging diagnosis (a total of 534). 25.7% (137/534) recommendations were with the symbols of quality of evidence and strength of recommendation, and 18.9% (101/534) with special words such as recommend, suggest. 22.3% (119/534) recommendations reported the strength of recommendation. Of which, 38.7% (46/119) were strong and 16.0% (19/119) were weak. However, 23.9% (11/46) strong recommendations were based on low quality of evidence. And 42.1% (8/19) weak recommendations were based on high quality of evidence. ConclusionAmong Chinese CPGs formulating the recommendations on diagnosis, the number of CPGs with recommendations on imaging is about 50%. And the quantity increases by years. The proportions of recommendations on imaging which report the strength of recommendation and/or quality of evidence are low. Meanwhile, the rating systems are uniform. Then the developers do not report the explanation for the strong recommendations based on low quality of evidence or the weak recommendations based on high quality of evidence in guideline.
ObjectiveTo investigate the citation status of systematic reviews on imaging diagnosis in clinical practice guidelines (CPGs) and provide reference for the development of Chinese imaging diagnosis guidelines. MethodsWe electronically searched PubMed databases to collect systematic reviews on imaging diagnosis. The date was limited from January 1st 2010 to December 31th 2012. Two reviewers independently screened literature and extracted data. The citation data of included systematic reviews were obtained on the Web of Science. Citation analysis method was used to analyze the citation frequency of systematic reviews on imaging diagnosis in CPGs. Results292 systematic reviews on imaging diagnosis were included, of which 94% (275/292) were indexed by Science Citation Index. The total citation frequency of these systematic reviews was 5413 (medium:20, range:0 to 131). 28% (78/275) were cited by CPGs. Of which, 7% (19/275) were used as the source of the evidence of recommendations in CPGs. ConclusionThe ratio of systematic reviews cited by CPGs is low, the ratio of being the source of evidence of recommendations of systematic reviews in CPGs is lower, and furthermore, the citation is time-delayed.