Ground Glass Shadows Research Articles

Asymptomatic COVID-19 CT image denoising method based on wavelet transform combined with improved PSO

The quality of asymptomatic corona virus disease 2019 (COVID-19) computed tomography (CT) image is reduced due to interference from Gaussian noise, which affects the subsequent image processing. Aiming at the problem that asymptomatic COVID-19 CT image often have small flake ground-glass shadow in the early lesions, and the density is low, which is easily confused with noise. A denoising method of wavelet transform with shrinkage factor is proposed. The threshold decreases with the increase of decomposition scale, and it reduces the misjudgment of signal points. In the advanced stage, the range of lesions increases, with consolidation and fibrosis in different sizes, which have similar gray value to the CT images of suspected cases. Aiming at the problems of low contrast and fuzzy boundary in the traditional wavelet transform, the threshold function based on the optimization of parameters combined with the improved particle swam optimization (PSO) is proposed, so that the parameters of wavelet threshold function can change adaptively according to the lung lobe and ground-glass lesions with fewer iterations. The simulation results show that the paper method is significantly better than other algorithms in peak signal-to-noise ratio (PSNR), signal-to-noise ratio (SNR) and mean absolute error (MSE). For example, aiming at the early asymptomatic COVID-19, compared with the comparison methods, the PSNR under the proposed method has increased by about 5 dB, the MSE has been greatly reduced, and the SNR has increased by about 6.1 dB. It can be seen that the denoising effect under the proposed method is the best.

Transformation of lymphoid interstitial pneumonia (LIP) into malignant lymphoma in patients with Sjogren's syndrome: a case report and literature review

BackgroundLymphoid interstitial pneumonia (LIP) is a very rare disease and its malignant transformation is even more rare. LIP is easily misdiagnosed by clinicians and radiologists.Case presentationThe medical record of a 64-year-old female with Sjogren's syndrome was reviewed. The clinical and pathological data along with chest CT images were obtained. The literature related to the transformation was reviewed. There were no specific clinical manifestations of LIP and its transformation into malignant lymphoma in the patient. The chest CT mainly displayed multiple cystic foci, with multiple nodules and ground-glass shadows in both lungs.ConclusionsMalignant transformation to lymphoma is suspected with findings of large nodules (> 11 mm) or their sizes doubly increased, pleural effusion and alveolar consolidation.

Dynamic Changes in Lung Function and Imaging in Patients with COVID-19.

Purpose To investigate the recovery of lung function and chest imaging in patients with COVID-19 three months after clinical cure and discharge and the correlation between them. Methods This study collected 80 patients diagnosed with 2019-nCoV infection who were discharged from the Taizhou Public Health Medical Center in Zhejiang Province between January 31, 2020, and March 10, 2020. Lung function examinations and lung CT scans were performed at discharge and three months after discharge. The dynamic changes examined at discharge and three months after discharge were observed, and their correlation was analyzed. All data collection ended on June 25, 2020. Results Among the 80 COVID-19 patients discharged from the hospital, the rate of abnormality indicated by lung CT images was 97.5%, mainly presenting as patchy shadows (95%), ground-glass shadows (75%), grid-like lesions, interlobular septal thickening or fiber strip shadows (30%), consolidation shadows, and nodules (10 cases each). At discharge, 72 patients (90%) had pulmonary dysfunction, 64 (80%) had restrictive ventilatory dysfunction, and 48 (60%) had small airway dysfunction. Three months after discharge, the rate of abnormality indicated by lung CT images was 12.5%. Eight cases (10%) showed residual patchy shadows, but the density was weak, and the scope was reduced. Two cases (2.5%) showed nodular shadows. Three months after discharge, 18 patients (22.5%) had residual restrictive ventilatory dysfunction, 28 patients (35%) had small airway dysfunction, and 32 patients (40%) had diffuse dysfunction. Moreover, patients with more severe chest imaging manifestations (bilateral lesions and ground-glass shadows combined with interstitial lesions) also had more obvious lung function impairment. Conclusion Three months after being clinically cured, patients with COVID-19 had good chest imaging absorption and no residual fibrosis. Some patients had mild to moderate pulmonary dysfunction, mainly restricted ventilation dysfunction, small airway dysfunction, and diffuse dysfunction.

Clinical characteristics and viral analysis of severe influenza A [H1N1]pdm09 in Guangzhou, 2019.

To understand the clinical characteristics of and analyze viral genes in patients with severe pneumonia due to [H1N1]pdm09 influenza virus in Guangzhou, 2019. The clinical data of 120 inpatients with laboratory-confirmed influenza A [H1N1]pdm09 virus from January to March 2019 were collected and analyzed. The subjects were diagnosed according to the criteria of the "Diagnosis and Treatment Program of Influenza A H1N1 (third Edition 2009)" issued by the Ministry of Health and were divided into severe and nonsevere groups. Serum samples during fever were collected for cytokine analysis, and the viral genes were analyzed after the virus cultured in MDCK cells. The data were analyzed by SPSS 16 software, and the results of gene sequencing were analyzed by MEGA 6 software. Among the 120 inpatients, 36 (30%) were severe and 84 (70%) were nonsevere patients. The average age of severe patients was 53.11 ± 19.94 years, the average age of nonsevere patients, at 44.03 ± 24.47 years. There was no significant difference between the two groups (p < 0.05). There were significant differences in the rates of moist rales and dyspnea in critically ill patients (p < 0.05). There were significant differences in the white blood cell count (WBC), lactate dehydrogenase (LDH), creatine kinase (CK), serum creatinine (sCr), procalcitonin (PCT) and C-reactive protein (CRP) in severe patients with type A H1N1. Chest radiologic findings in severe patients showed ground glass shadows or pulmonary solid changes, and the difference was statistically significant for pulmonary fibrosis. Chronic lung disease (52.8%) and cardiovascular disease (27.8%) were independent risk factors for severe disease (p < 0.05). There were significant differences in secondary infections by Staphylococcus aureus (11.1%), pulmonary Aspergillus (22%) and Acinetobacter baumannii (16.7%) in critically ill patients (p < 0.05). Serum IL-8 in critically ill patients was significantly higher than those in nonsevere patients and healthy controls. The origin of virus strains in severe and nonsevere patients was the same, and there was no obvious mutation in the amino acid region of the antigenic site of the HA protein, but compared with the results of gene sequencing in previous years, the mutation sites showed a trend of annual accumulation. In conclusion, there was a high risk of severe pneumonia caused by H1N1 influenza A virus in Guangzhou in spring 2019. Long-term continuous surveillance, prevention and control of the virus should be carried out to predict its epidemiology and distribution.

Clinical characteristics of patients with acquired immunodeficiency syndrome having respiratory symptoms as the initial manifestations: A retrospective study

The aim of the study was to investigate clinical features of patients with AIDS having respiratory symptoms as initial manifestations and help in the early diagnosis. Eighty-eight patients admitted to the Shanghai Pulmonary Hospital were included in the study. General data, clinical manifestations, laboratory tests, chest computed tomography (CT) imaging features, treatments, and prognosis were analyzed. Peripheral leukopenia, lymphopenia, hypoxemia, and reduced percentage of CD4+ T lymphocytes were found in 25.6%, 43.6%, 27.5%, and 94.9% of the patients, respectively. Pneumocystis jirovecii pneumonia (PCP) was the most frequent cause of opportunistic pulmonary infection. Patients with PCP had more bilateral lung involvement and ground-glass shadow in CT manifestations. A follow-up of the 43 patients transferred to the Public Health Center showed improvement in 27 (62.8%), stabilization in 4 (9.3%), worsening in 1 (2.3%), and death in 11 (25.6%) patients. Detailed medical history recording, screening of human immunodeficiency virus antibody, and flow cytometry would improve the diagnostic efficiency of AIDS in patients with diffuse ground-glass shadow in chest CT. Early and empirical treatment could improve the prognosis.

Clinical Characteristics and Prognostic Risk Factors of Patients With Proven Invasive Pulmonary Aspergillosis: A Single-Institution Retrospective Study

Background: The mortality and burden of medical costs associated with invasive pulmonary aspergillosis (IPA) is very high. Currently, the clinical features and prognostic factors of patients with proven IPA are not very clear, especially in the Chinese population. In this retrospective analysis, we aimed to identify the clinical features and prognostic factors of patients with proven IPA.Methods: The diagnostic criteria for proven IPA were based on the international consensus of the EORTC/MSG. Data of patients with proven IPA at the West China Hospital of Sichuan University between January 2012 and December 2018 were collected. The optimal cut-off value of continuous variables was determined by Receiver Operating Characteristic curve and maximum Youden's index. Finally, using the Cox regression analysis to identify correlations between the clinical parameters associated with morbidity.Results: A total of 117 patients with proven IPA were included in the study, and 32 (27.4%) patients died during the follow-up period. Compared with the survivor group, elderly, patients with comorbidities, and patients undergoing chemotherapy and the level of inflammatory biomarkers [erythrocyte sedimentation rate, platelet count, interleukin-6, C-reactive protein (CRP)] in the non-survivor group were higher, while the albumin level was lower (P = 0.018). The imaging features were consolidation, nodules, cavities, pleural effusion, ground-glass shadows, and halo signs in order. Overall, 41.0% patients had mixed imaging features. The results suggested the most appropriate cut-off value of age and CRP were 60 years and 14.1 mg/L, respectively. The multivariate Cox regression analysis suggested that advanced age (>60 years) [hazard ratio (HR): 10.7, confidence interval (CI): 2.5–44.9, P < 0.001), undergoing chemotherapy (HR: 9.5, CI: 2.7–32.9, P < 0.001), presence of pleural effusion (HR: 5.74, CI: 1.6–20.8, P = 0.008), and increased CRP levels (>14.1 mg/L) (HR: 6.3, CI: 1.2–34.3, P = 0.033) were risk factors for all-cause mortality in patients with proven aspergillosis.Conclusions: This study showed that the prognosis of proven IPA is poor, and the age >60 years, undergoing chemotherapy, pleural effusion on CT image, and CRP levels >14.1 mg/L may be as risk factors for mortality in patients with proven IPA. large samples and real-world studies are needed to confirm these results in the future.

Diagnostic Value of Deep Learning-Based CT Feature for Severe Pulmonary Infection.

The study aimed to explore the diagnostic value of computed tomography (CT) images based on cavity convolution U-Net algorithm for patients with severe pulmonary infection. A new lung CT image segmentation algorithm (U-Net+ deep convolution (DC)) was proposed based on U-Net network and compared with convolutional neural network (CNN) algorithm. Then, it was applied to CT image diagnosis of 100 patients with severe lung infection in The Second Affiliated Hospital of Fujian Medical University hospital and compared with traditional methods, and its sensitivity, specificity, and accuracy were compared. It was found that the single training time and loss of U-Net + DC algorithm were reduced by 59.4% and 9.8%, respectively, compared with CNN algorithm, while Dice increased by 3.6%. The lung contour segmented by the proposed model was smooth, which was the closest to the gold standard. Fungal infection, bacterial infection, viral infection, tuberculosis infection, and mixed infection accounted for 28%, 18%, 7%, 7%, and 40%, respectively. 36%, 38%, 26%, 17%, and 20% of the patients had ground-glass shadow, solid shadow, nodule or mass shadow, reticular or linear shadow, and hollow shadow in CT, respectively. The incidence of various CT characteristics in patients with fungal and bacterial infections was statistically significant (P < 0.05). The specificity (94.32%) and accuracy (97.22%) of CT image diagnosis based on U-Net + DC algorithm were significantly higher than traditional diagnostic method (75.74% and 74.23%), and the differences were statistically significant (P < 0.05). The network of the algorithm in this study demonstrated excellent image segmentation effect. The CT image based on the U-Net + DC algorithm can be used for the diagnosis of patients with severe pulmonary infection, with high diagnostic value.

Computed Tomography Image Texture under Feature Extraction Algorithm in the Diagnosis of Effect of Specific Nursing Intervention on Mycoplasma Pneumonia in Children.

To evaluate the effect of specific nursing intervention in children with mycoplasma pneumonia (MP), a feature extraction algorithm based on gray level co-occurrence matrix (GLCM) was proposed and combined with computed tomography (CT) image texture features. Then, 98 children with MP were rolled into the observation group with 49 cases (specific nursing) and the control group with 49 cases (routine nursing). CT images based on feature extraction algorithm of optimized GLCM were used to examine the children before and after nursing intervention, and the recovery of the two groups of children was discussed. The results showed that the proportion of lung texture increase, rope shadow, ground glass shadow, atelectasis, and pleural effusion in the observation group (24.11%, 3.86%, 8.53%, 15.03%, and 3.74%) was significantly lower than that in the control group (28.53%, 10.23%, 13.34%, 21.15%, and 8.13%) after nursing (P < 0.05). There were no significant differences in the proportion of small patchy shadows, large patchy consolidation shadows, and bronchiectasis between the observation group and the control group (P > 0.05). In the course of nursing intervention, in the observation group, the disappearance time of cough, normal temperature, disappearance time of lung rales, and absorption time of lung shadow (2.15 ± 0.86 days, 4.81 ± 1.14 days, 3.64 ± 0.55 days, and 5.96 ± 0.62 days) were significantly shorter than those in the control group (2.87 ± 0.95 days, 3.95 ± 1.06 days, 4.51 ± 1.02 days, and 8.14 ± 1.35 days) (P < 0.05). After nursing intervention, the proportion of satisfaction and total satisfaction in the experimental group (67.08% and 28.66%) was significantly higher than that in the control group (40.21% and 47.39%), while the proportion of dissatisfaction (4.26%) was significantly lower than that in the control group (12.4%) (P < 0.05). To sum up, specific nursing intervention was more beneficial to improve the progress of characterization recovery and the overall recovery effect of children with MP relative to conventional nursing. CT image based on feature extraction algorithm of optimized GLCM was of good adoption value in the diagnosis and treatment of MP in children.

Systematic review and meta-analysis of the CT imaging characteristics of infectious pneumonia.

Since December 2019, there have been cases of infectious pneumonia of unknown cause in Wuhan, Hubei Province, China. On January 12, 2020, the World Health Organization (WHO) named it COVID-19. There are few studies on the clinical characteristics of patients with COVID-19, and results vary widely in sample sizes. Chinese and English databases were searched with "Infectious pneumonia", "COVID-19", "CT", "SARS-COV-2", and "Diagnose" as keywords. Rev Man 5.3 software provided by the Cochrane system was used to assess the quality of the included literature. Of the 18 included studies, ground-glass shadow was the most common computed tomography (CT) sign [95% confidence interval (CI): 0.79-0.97], followed by thickening of the blood vessels (95% CI: 0.63-0.78), and pleural thickening (95% CI: 0.02-0.15). Of the 18 studies, 12 reported that the lesions were externally subpleural (95% CI: 0.132-0.173), and 6 reported that the lesions were distributed in a single lobe (95% CI: 0.598-0.841). The heterogeneity test results showed that the morphology of the lesions was cord-like (95% CI: 0.092-0.172), grid-like (95% CI: 0.152-0.193), patchy (95% CI: 0.192-0.313), and nodular (95% CI: 0.591-0.745). Ground-glass opacity was a typical CT manifestation for patients with infectious pneumonia, and CT signs were instrumental in diagnosing this disease.

Chest CT-Scan Findings of an Iraqi Patient with Symptomatic Covid-19 Disease

Background: On the first of June, 2021, 1,201,352 cases of covid-19 were reported by the Iraqi Ministry of Health, and 16375 patients died because of the disease. The aim of this paper is to describe chest CT-scan findings of an Iraqi patient who was observed early during June, 2021, and had symptomatic covid-19, but he didn’t need hospitalization. Patients and methods: A forty-year old school teacher developed covid-19 disease with fever, fatigue, anorexia, and cough. The patient recovered after about two weeks. Results: Chest CT-scan performed during first week of illness showed: (1) Multiple bilateral ground glass opacities. (2) Atelectatic bands. (3) Thickening of the interlobular septa. (4) Vascular thickening. Conclusion: The chest CT-scan findings in this Iraqi patient was rather typical of covid-19 disease and included the most commonly reported abnormality of ground-glass shadows.

Chest CT-scan findings of an Iraqi patient with symptomatic covid-19 disease

Background: On the first of June, 2021, the total number of the registered cases of covid-19 by the Iraqi Ministry of Health was 1,201,352 , and the total number of deaths was 16375 patients. The aim of this paper is to describe chest CT-scan findings of an Iraqi patient who was observed early during June, 2021, and had symptomatic covid-19, but he didn’t need hospitalization. Patients and methods: A forty-year old school teacher developed covid-19 disease with fever, fatigue, anorexia, and cough. The patient recovered after about two weeks. Results: Chest CT-scan performed during first week of illness showed: (1) Multiple bilateral ground glass opacities. (2) Atelectatic bands. (3) Thickening of the interlobular septa. (4) Vascular thickening. Conclusion: The chest CT-scan findings in this Iraqi patient was rather typical of covid-19 disease and included the most commonly reported abnormality of ground-glass shadows

Analysis of Image Features and TCM Syndrome Types of Lobar Pneumonia in Children Based on Mean Square Deviation Lung CT Image Registration Algorithm

The aim was to analyze the application of computed tomography (CT) images in the diagnosis of lesions, and the composition of traditional Chinese medicine (TCM) syndromes in children with lobar pneumonia. Lung CT image registration algorithm was constructed based on optimized mean square deviation (OMSD) algorithm, which was applied to CT images of 188 children patients with lobar pneumonia before and after treatment. Besides, free-form deformation (FFD) algorithm and mean square deviation (MSD) algorithm were introduced for comparison with OMSD. Results showed that sum of squared differences (SSD) of OMSD was significantly lower than that of MSD and FFD ( P &lt; 0.05 ). The mutual information (MI), relative overlap rate (ROR), and rcc of OMSD were markedly higher than those of MSD and FFD ( P &lt; 0.05 ). After treatment, the number of pulmonary interstitial thickening, lobular interstitial thickening, ground-glass shadow, patchy shadow, consolidation shadow, pleural thickening, pleural effusion, lymphadenopathy, pneumothorax, and mediastinal emphysema decreased sharply in contrast to before treatment ( P &lt; 0.05 ). Among the selected children, there were 184 children patients with empirical TCM syndrome, accounting for 97.85%, and its dominant syndrome was wind-heat closed lung syndrome (52.75%) and phlegm-heat closed lung syndrome (46.11%). The main symptoms of wind-heat closed and phlegm-heat closed lung syndrome were fever, cough, and pulmonary rales. In conclusion, OMSD was superior to MSD and FFD in lung CT image registration. CT registration image based on OMSD could clearly display the intrapulmonary and extrapulmonary manifestations of children patients, so as to enhance the clinical diagnosis effect. Besides, wind-heat closed lung syndrome and phlegm-heat closed lung syndrome were the common types of TCM syndrome of children pneumonia with the common symptoms of fever and cough.

Bronchiolitis Obliterans Organizing Pneumonia after Breast Cancer Radiotherapy and letrozole: A Case Report and Literature Review

Objectives: Bronchiolitis obliterans organizing pneumonia occurs with prevalence rate 1–3% after breast conservative treatment in series. In response to radiation of a lung or surrounding tissues, an inflammatory reaction can affect both lungs and is located within the radiation field. Characteristic imaging features include multiple alveolar opacities and diffuse ground-glass shadows. Letrozole may induce iatrogenic organizing pneumonia. Materials and methods: we report the case of a 76-year-old female who underwent conservative treatment for an invasive ductal carcinoma of the left breast. Hypofractionated radiotherapy was delivered with a total dose of 42.5 Gy in 16 sessions of 2.65 Gy using a three-dimensional technique. After the radiotherapy ended letrozole was indicated. Results: Several weeks after the radiotherapy ended and letrozole was introduced, she described a flu-like syndrome. Samples were negative, and there was no improvement after four courses of antibiotics. Imaging suggested bronchiolitis obliterans organizing pneumonia. Her symptomatology lessened after the letrozole was discontinued, and 11 months after radiotherapy finished, her imaging results were clear. Conclusion: Physicians must consider bronchiolitis obliterans organizing pneumonia. Cases may increase with hypofractionated radiation treatment and new drugs. Letrozole may potentiate the risk. Dosimetry may be adapted to the lung and subpleural areas for patients with risk factors and taking adjuvant or concurrent drugs with potential pneumotoxicity.

Bronchiolitis Obliterans Organizing Pneumonia after Breast Cancer Radiotherapy and letrozole: A Case Report and Literature Review

Objectives: Bronchiolitis obliterans organizing pneumonia occurs with prevalence rate 1–3% after breast conservative treatment in series. In response to radiation of a lung or surrounding tissues, an inflammatory reaction can affect both lungs and is located within the radiation field. Characteristic imaging features include multiple alveolar opacities and diffuse ground-glass shadows. Letrozole may induce iatrogenic organizing pneumonia. Materials and methods: we report the case of a 76-year-old female who underwent conservative treatment for an invasive ductal carcinoma of the left breast. Hypofractionated radiotherapy was delivered with a total dose of 42.5 Gy in 16 sessions of 2.65 Gy using a three-dimensional technique. After the radiotherapy ended letrozole was indicated. Results: Several weeks after the radiotherapy ended and letrozole was introduced, she described a flu-like syndrome. Samples were negative, and there was no improvement after four courses of antibiotics. Imaging suggested bronchiolitis obliterans organizing pneumonia. Her symptomatology lessened after the letrozole was discontinued, and 11 months after radiotherapy finished, her imaging results were clear. Conclusion: Physicians must consider bronchiolitis obliterans organizing pneumonia. Cases may increase with hypofractionated radiation treatment and new drugs. Letrozole may potentiate the risk. Dosimetry may be adapted to the lung and subpleural areas for patients with risk factors and taking adjuvant or concurrent drugs with potential pneumotoxicity.

Control study of chest CT imaging features of aluminosis and silicosis patients

Objective: To understand the chest CT features of aluminosis caused by alumina and to improve the understanding of the imaging findings of alumina pneumoconiosis. Methods: The chest CT findings of 17 cases of alumina-induced pneumoconiosis and 30 cases of silicosis (the control group) diagnosed in Zibo Occupational Disease Prevention Hospital from April 2015 to July 2020 were analyzed retrospectively. The characteristics of fibrosis of the two kinds of pneumoconiosis and the incidence of size, density, distribution, tractive bronchiectasis, pleural thickening and interlobular septal thickening of pneumoconiosis nodules were compared. Results: Alumina pneumoconiosis showed nodules with thickened interlobular septal of 66.67% (12/18) , honeycomb lung of 22.22% (4/18) , ground glass shadow of 61.11% (11/18) , simple nodules of 11.11% (2/18) , and no fusion mass. In the control group, the long-line fibrosis of nodules with thickened interlobular septal were 16.67% (5/30) , 6.67% (2/30) with honeycomb lung and ground glass density shadow, 23.33% (7/30) with fusion mass and 53.33% (16/30) with simple nodule. There were significant differences in CT findings of nodules with thickened interlobular septal, ground glass density shadow, fused mass and simple nodules between the two groups (P<0.05) . The interstitial beaded nodules were seen in 18 cases of alumina pneumoconiosis, 50.00% (9/18) of them were beaded nodules, 61.33% (46/75) of low density nodules and 38.89% (7/18) of central lobular nodules were seen in alumina pneumoconiosis. The average width of nodules was (1.29±0.38) mm. Central lobular nodules were seen in all 30 cases of silicosis, 10.00% (3/30) were mainly beaded nodules, low density nodules were 36.29% (90/248) , and the average width diameter of nodules was (1.85±0.58) mm. There were significant differences between the two groups (P<0.05) . Alumina pneumoconiosis was often accompanied by traction bronchiectasis, pleural thickening and interlobular septal thickening (11, 18, 17 cases, 61.11%, 100.00%, 94.44%) , compared with the control group (9, 18, 18 cases, 30.00%, 60.00%, 60.00%) . The differences were statistically significant (P<0.05) . The maximum CT value of noncalcified mediastinal lymphnodes in alumina pneumoconiosis was (103.43±26.33) HU, which was higher than that of the control group[ (75.22±16.70) HU], and the difference was statistically significant (P<0.05) . Conclusion: Alumina pneumoconiosis chest CT shows slightly low-density beaded nodules, thickened interlobular septal, and pulmonary interstitial fibrosis of ground-glass shadows, mostly combines with stretched bronchiectasis, thickened pleura, and mediastinum increased lymph node density.

Application of Multi-Slice Spiral CT in the Evaluation of Diffuse Lung Diseases

This article analyzes the manifestations, characteristics, and significance of multi-slice spiral CT for diffuse lung disease, and evaluates the diagnostic value of multi-slice CT multi-directional reconstruction for diffuse lung disease. After performing multi-slice spiral CT examination on the patient and collecting relevant data, the characteristic multi-slice CT imaging findings of diffuse lung disease were determined by statistical analysis. Diffuse lung disease is representative in multi-slice spiral CT image imaging manifestations of the disease include multiple disseminated small nodules, multiple voids, ground glass shadows, and lung consolidation. And analyze the correlation of image performance, and then use statistical methods to analyze and evaluate the value of multi-slice spiral CT characteristic images in the diagnosis of diffuse lung disease, and analyze the characteristics of these characteristic multi-slice CT image appearances. The use of high-resolution CT to screen the characteristic CT imaging findings of the same research object, and then to perform a statistical analysis of the diagnostic differences with multi-slice spiral CT, further confirmed the importance of multi-slice CT for diffuse lung disease Diagnostic value. Studies have shown that multi-slice CT imaging technology is of great significance in the evaluation of diffuse lung diseases.

Chest CT Findings and Differential Diagnosis of Mycoplasma pneumoniae Pneumonia and Mycoplasma pneumoniae Combined with Streptococcal Pneumonia in Children.

Background In this day and age, 17% of children less than 5 years of age died of pneumonia; it is the common cause of children death. It is one of the main children respiratory infectious diseases, i.e., mycoplasma pneumonia (MP). The imaging examination can be adopted to quickly observe the morphology and scope of the pulmonary lesions and know the effect of disease treatment and subsequent changes in the disease in order to provide a basis for treatment. Therefore, the most commonly applied technology for detecting pneumonia in children is imaging technology, including chest X-ray and CT. Objectives The main objective of the work is to investigate the chest computed tomography (CT) findings of children patients with Mycoplasma pneumoniae pneumonia (MPP) and MP combined with streptococcal pneumonia (SP). The mixed infection of MP and SP is very common clinically, and the diagnosis of this type of mixed pneumonia is a critical research topic faced by pediatric respiratory physicians. The comparison is done on the incidence of bronchial and pulmonary interstitial lesions, the degree of lymph node enlargement, the volume and depth of pleural effusion, and the location and morphology of the pulmonary lesions in the chest CT images of children patients from the two groups. Methods There were comparisons on the incidence of bronchial and pulmonary interstitial lesions, the degree of lymph node enlargement, the volume and depth of pleural effusion, and the location and morphology of the pulmonary lesions in the chest CT images of children patients from the two groups. All the experiments are done in the MATLAB. Results The results showed that the proportions of reticular shadow, ground glass shadow, bronchial inflation phase, tube wall thickening, and vascular bundle thickening on the CT images of children patients from the MPP group were dramatically higher than those of the MP + SP group (P < 0.05). The maximum transverse diameter of enlarged lymph node in children patients from the MPP group was obviously larger than the diameter of the MP + SP group (P < 0.05). The number of children patients with pleural effusion was 22 in the MP + SP group, which was greatly higher than the MPP group (P < 0.05). Conclusion In conclusion, the chest CT images of children patients from the MPP group were mainly pulmonary interstitial changes. Furthermore, the alveolar inflammation could be observed on the CT images shown when children patients were combined with SP infection. The more obvious manifestations were that the flaky shadows appeared in the lungs, the pleural effusion became thicker, and the transverse diameters of enlarged lymph nodes were bigger.

An Illustrated Guide to the Imaging Evolution of COVID in Non-Epidemic Areas of Southeast China.

Purpose: By analyzing the CT manifestations and evolution of COVID in non-epidemic areas of southeast China, analyzing the developmental abnormalities and accompanying signs in the early and late stages of the disease, providing imaging evidence for clinical diagnosis and identification, and assisting in judging disease progression and monitoring prognosis. Methods: This retrospective and multicenter study included 1,648 chest CT examinations from 693 patients with laboratory-confirmed COVID-19 infection from 16 hospitals of southeast China between January 19 and March 27, 2020. Six trained radiologists analyzed and recorded the distribution and location of the lesions in the CT images of these patients. The accompanying signs include crazy-paving sign, bronchial wall thickening, microvascular thickening, bronchogram sign, fibrous lesions, halo and reverse-halo signs, nodules, atelectasis, and pleural effusion, and at the same time, they analyze the evolution of the abovementioned manifestations over time. Result: There were 1,500 positive findings in 1,648 CT examinations of 693 patients; the average age of the patients was 46 years, including 13 children; the proportion of women was 49%. Early CT manifestations are single or multiple nodular, patchy, or flaky ground-glass–like density shadows. The frequency of occurrence of ground-glass shadows (47.27%), fibrous lesions (42.60%), and microvascular thickening (40.60%) was significantly higher than that of other signs. Ground-glass shadows increase and expand 3–7 days after the onset of symptoms. The distribution and location of lesions were not significantly related to the appearance time. Ground-glass shadow is the most common lesion, with an average absorption time of 6.2 days, followed by consolidation, with an absorption time of about 6.3 days. It takes about 8 days for pure ground-glass lesions to absorb. Consolidation change into ground glass or pure ground glass takes 10–14 days. For ground-glass opacity to evolve into pure ground-glass lesions, it takes an average of 17 days. For ground-glass lesions to evolve into consolidation, it takes 7 days, pure ground-glass lesions need 8 days to evolve into ground-glass lesions. The average time for CT signs to improve is 10–15 days, and the first to improve is the crazy-paving sign and nodules; while the progression of the disease is 6–12 days, the earliest signs of progression are air bronchogram signs, bronchial wall thickening, and bronchiectasis. There is no severe patient in this study. Conclusion: This study depicts the CT manifestation and evolution of COVID in non-epidemic origin areas, and provides valuable first-hand information for clinical diagnosis and judgment of patient’s disease evolution and prediction.

Time to Start Up: CT-Basted Radiomics in Children’s Lung Diseases

Time to Start Up: CT-Basted Radiomics in Children’s Lung Diseases

Effect of early whole lung lavage at different time-points for promoting the removal of depleted uranium from the lung

Purpose This study compared the effect of whole lung lavage (WLL) at different time-points early after exposure of the respiratory system to insoluble radioactive particles. Materials and methods Forty adult beagles were randomized into a control group and the 3-h, 8-h, 24-h, and 48-h lavage groups (n = 8). A canine model of acute lung injury was established by spraying a depleted uranium (DU) suspension using a superfine fiber bronchoscope, at a dose of 20 mg/kg. The lavage groups were subjected to WLL at 3 h, 8 h, 24 h, and 48 h post-DU exposure, while the control group received no treatment after exposure. Measurement of U in serum was performed using inductively coupled plasma mass spectrometry; measurements in the lavage fluid and left lung tissue were performed using inductively coupled plasma atomic emission spectrometry. The color of the lavage fluid was analyzed using colorimetry, and shadow changes in the lung were observed using chest computed tomography (CT). Results The lavage groups showed similarly increasing trends for serum U levels from DU exposure to 3 and 7 days after exposure; however, these values were significantly lower than those in the control group (p < .01). The U content in the lavage fluid was significantly higher in the 3-h group than in the 8-h, 24-h, and 48-h groups (p < .01), while that in the 8-h group was markedly higher than those in the 24-h and 48-h groups (p < .05). The average clearance rate of DU in the lungs varied in the range of 0.63‒7.06%. The U content in the left lung tissue of each lavage group was significantly lower than that in the control group (p < .01), while the content in the 8-h, 24-h, and 48-h groups was significantly higher than that in the 3-h group (p < .05). The colorimetric score of the lavage fluid in the 3-h group was significantly lower than those in the 8-h, 24-h, and 48-h groups (p < .05). Chest CT showed different degrees of consolidation and ground glass shadow changes in all groups. The score of the left lung shadow volume in the 3-h group was significantly lower than in the control, 8-h, 24-h, and 48-h groups (p < .01), while the score in the 8-h group was significantly higher than those in the 48-h and control groups (p < .05). Conclusions The best effect of WLL after exposure of the respiratory system to insoluble radioactive particles was achieved at 3 h, followed by 8 h; there was no difference in the effectiveness of lung lavage at 24 h and 48 h.