Journal of Clinical Imaging Science最新文献

{"title":"Computed tomography and magnetic resonance imaging features of struma ovarii: A retrospective case series.","authors":"Lihua Xiang, Xin He, Nan Jiang, Ying Shen, Guangzheng Li, Ling Yang","doi":"10.25259/JCIS_167_2025","DOIUrl":"10.25259/JCIS_167_2025","url":null,"abstract":"<p><strong>Objectives: </strong>Struma ovarii (SO) is an extremely rare clinical condition. This study retrospectively analyzes clinical and imaging data from 11 misdiagnosed cases of struma ovarii to identify key diagnostic and differential imaging features.</p><p><strong>Material and methods: </strong>A retrospective analysis was performed on the clinical and imaging features of 11 patients with initially misdiagnosed but postoperatively confirmed ovarian struma, who were treated at our hospital. Imaging features analyzed included lesion size, computed tomography (CT) density, calcification status, magnetic resonance imaging (MRI) signal characteristics (cystic/solid components), enhancement intensity, and lymph node or distant metastasis. Clinical features analyzed comprised patient symptoms and laboratory test results.</p><p><strong>Results: </strong>All 11 unilateral ovarian lesions measured 10.77 ± 4.43 cm. MRI demonstrated markedly hypointense foci on T2-weighted images in the cyst wall septa in 90.9% of cases (10/11), isointense to mildly hyperintense signal on T1-weighted images in cystic cavities in 63.6% (7/11), and small to moderate volume ascites in 81.8% (9/11). On contrast-enhanced MRI, the solid components exhibited a honeycomb-like enhancement pattern: enhancement was comparable to the myometrium in 4 cases, greater in 4 cases, and slightly lower in 3 cases. One case demonstrated restricted diffusion on diffusion-weighted imaging along with multiple pelvic disseminated nodules. On non-contrast CT, all cases showed slightly high-density foci (66.56 ± 8.23 HU), with punctate or nodular calcifications in 54.5% (6/11). In the subset of three patients who underwent contrast-enhanced CT, marked enhancement of the solid components was observed in all cases.</p><p><strong>Conclusion: </strong>The radiological manifestations of SO demonstrate distinct characteristic features. When combined with clinical findings, these imaging features may assist in diagnosis and improve diagnostic accuracy.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"27"},"PeriodicalIF":1.1,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic resonance imaging findings of degenerating uterine fibroids: A pictorial review.","authors":"Nga Nguyen, Anas Al-Zubaidi, Karen Rojas, Anjali Ramachandran, Noha Kabeel, Peeyush Bhargava","doi":"10.25259/JCIS_301_2025","DOIUrl":"10.25259/JCIS_301_2025","url":null,"abstract":"<p><p>Although uterine leiomyomas (fibroids) are benign and frequently seen in genitourinary imaging, their degeneration features may overlap with malignant entities. Accurate characterization of uterine fibroids (UFs) and its differentiation from other malignancies not only helps alleviate patients' anxiety but also assists with treatment plans, either medical or surgical. This article aims to outline the main magnetic resonance imaging characteristics of each fibroid degenerating type with case-based illustrations. This will also outline essential imaging features to differentiate degenerating UFs from other malignant entities.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"26"},"PeriodicalIF":1.1,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction of an ultrasound feature-based diagnostic model for predicting triple-negative breast cancer using 108 machine learning algorithm combinations.","authors":"Xin Zhang, Xiaomin Zhang, Shan Zhu, Ningxia Ao, Yali Cao, Guangfei Yang","doi":"10.25259/JCIS_283_2025","DOIUrl":"10.25259/JCIS_283_2025","url":null,"abstract":"<p><strong>Objectives: </strong>Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer lacking estrogen receptor, progesterone receptor, and human epidermal growth factor R expression. This study aimed to identify ultrasound features associated with TNBC and construct a robust diagnostic model using machine learning techniques.</p><p><strong>Material and methods: </strong>A total of 433 BC patients (47 TNBC and 386 non-TNBC) with complete clinical and ultrasound data were retrospectively analyzed. Univariate and multivariate logistic regression analyses identified independent ultrasound predictors of TNBC. Subsequently, 108 combinations of feature selection methods and machine learning classifiers were systematically evaluated to identify the optimal diagnostic model. Model performance was assessed using receiver operating characteristic curves, decision curve analysis (DCA), and calibration plots in both training and validation cohorts. The ethical approval was obtained from the institutional review board, and the requirement for individual written informed consent was waived due to the retrospective nature of the study.</p><p><strong>Results: </strong>Multivariate analysis identified posterior acho, margins, calcification, and aspect ratio as independent predictors of TNBC (<i>p</i> < 0.05). Among all model combinations, the Stepwise Generalized Linear Model combined with Random Forest model achieved the best performance, with an area under the curve (AUC) of 1.000 in the training set and 0.913 in the validation set. Subgroup analysis revealed higher model accuracy in patients aged ≤50 years (AUC = 0.911) compared to those >50 years (AUC = 0.706). DCA and calibration plots indicated high clinical utility and excellent calibration performance.</p><p><strong>Conclusion: </strong>Specific ultrasound features can effectively distinguish TNBC from non-TNBC. A machine learning-based diagnostic model that integrates multiple algorithmic combinations demonstrates strong generalizability and may serve as a valuable clinical tool, particularly for younger patients.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"25"},"PeriodicalIF":1.1,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic yield and utilization patterns of head and neck computed tomography angiography.","authors":"Kolos Kalman Nagy, Jantzen Brandt Orton, Abdul Awal, Roy Jacob, Laszlo Nagy","doi":"10.25259/JCIS_275_2025","DOIUrl":"10.25259/JCIS_275_2025","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the diagnostic yield and utilization patterns of head and neck computed tomography angiography (CTAHN) in screening patients in the emergency department (ED) for blunt cerebrovascular injury. This study was conducted at a Level 1 trauma center serving a large geographical area with a high number of regional transfers. This study evaluates the prevalence of CTAHN overutilization in the ED and examines whether diagnostic yield correlates with adherence to the modified Denver criteria, transfer status, and trauma severity.</p><p><strong>Material and methods: </strong>A retrospective chart review was conducted of patients presenting to the ED between January 01, 2021, and December 31, 2023. Patients over the age of 16 were included in this study if they presented with blunt traumatic injury and subsequently underwent CTAHN or neck CTA (CTAN) imaging during their ED evaluation. A multivariable regression analysis was performed to evaluate the association between CTA yield and factors including patient transfer status, trauma severity designation, and adherence to the modified Denver criteria.</p><p><strong>Results: </strong>A total of 643 patients met the inclusion criteria. A substantial proportion (74.2%) of CTAHN and CTAN examinations yielded negative results, with significant correlation to nonadherence to the modified Denver criteria. We found no significant association between CTAHN yield and transfer status or trauma level designation. Of the patients found to have trauma related actionable findings, 71.8% had adherence to the modified Denver criteria during triage screening.</p><p><strong>Conclusion: </strong>A high proportion of CTAHN and CTAN studies ordered from the ED yield low-value diagnostic results, with overutilization closely linked to nonadherence to the modified Denver criteria. Our findings carry important implications for quality improvement efforts, including unnecessary radiation exposure to patients and reduced efficiency in the ED. Enhanced guideline compliance may serve as a modifiable target to reduce diagnostic imaging overutilization.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"24"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term changes in breast density reporting after implementation of BI-RADS 5^th edition guidelines.","authors":"Brielle Marie Paolini, Ian Smith, Rebecca Leddy, Abbie Cluver, Frank Vento, Madelene C Lewis, Heather R Collins, Abid Irshad","doi":"10.25259/JCIS_285_2025","DOIUrl":"10.25259/JCIS_285_2025","url":null,"abstract":"<p><strong>Objectives: </strong>The objectives of the study are to investigate if there is a long-term change in density assessment between the 4^th and 5^th Editions of Breast Imaging Reporting and Data System (BI-RADS). Specifically, to assess the density reporting patterns of radiologists at a single institution several years after changes were made in density assessment criteria in BI-RADS 5^th Edition, which focused on masking effect of tissue and removed the percent-density value system as a criterion for density assessment.</p><p><strong>Material and methods: </strong>Health Insurance Portability and Accountability Act (HIPAA) compliant, single institution study where mammographic density data were obtained for 4 years before the BI-RADS 5^th Edition change and 4 years after it. The total sample size was 132,326 mammograms. Comparison of non-dense versus dense breast categories was specifically made to evaluate any changes that could have led to a change in the needs for supplemental screening after the new guidelines. Chi-square tests were used to evaluate the distribution of density type among mammograms evaluated before and after the new guidelines were implemented. Statistical significance was considered at the α = 0.05 threshold, and two-sided <i>p</i>-values are reported.</p><p><strong>Results: </strong>After implementation of the 5^th Edition, there was an overall increase in mammograms described as dense (39.1%) compared to the old guidelines (38.4%, <i>p</i> = 0.01); however, the effect size of this difference was statistically significant but of negligible practical magnitude (Phi = 0.01).</p><p><strong>Conclusion: </strong>This large single-institution analysis demonstrates that the adoption of the BI-RADS 5^th Edition Density Assessment Guidelines has led to a modest but sustained increase in the proportion of mammograms categorized as dense. While the effect size is small, even slight shifts in density classification may influence patient management and supplemental screening utilization in the new era of mandatory breast density notification.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"23"},"PeriodicalIF":1.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional transfer of children with appendix-related concerns to outside cross-sectional imaging.","authors":"Sindhu Vasini Mannava, R Cartland Burns","doi":"10.25259/JCIS_138_2025","DOIUrl":"10.25259/JCIS_138_2025","url":null,"abstract":"<p><strong>Objectives: </strong>Diagnostic discordance between general and pediatric radiologists with respect to abdominal computed tomography (CT) and magnetic resonance imaging (MRI) is established, particularly with respect to acute appendicitis. In this study, we aimed to identify the negative pediatric radiologist interpretation rate among patients transferred to our institution for appendix-related concerns.</p><p><strong>Material and methods: </strong>We retrospectively reviewed all children transferred from statewide outside facilities to our standalone tertiary care children's hospital from June 2018 to July 2023 for appendix-related concerns.</p><p><strong>Results: </strong>Out of 1041 appendix-related transfers during the 5-year study period, 889 had outside abdominal CT or MRI. Of this cohort, 103 (11.6%) patients had a negative interpretation by pediatric radiologists. Thirty-nine patients (37.9%) were given pre-transfer antibiotics, primarily due to concern for appendicitis (92.3%). Other acute findings noted on pediatric radiologist review included a thickened bladder and increased stool burden. Additional imaging was performed post-transfer in 30 (29.1%) patients as follows: Appendix ultrasound (US) (60%), abdomen US (3.3%), right upper quadrant US (13.3%), testicular US (3.3%), and pelvic US (43.3%). Sixty-seven (65%) patients were discharged home from the emergency department with the remainder admitted. The median (Q1, Q3) length of stay at our institution was 6.9 (4.2, 16.2) h. Only one patient underwent post-discharge appendectomy.</p><p><strong>Conclusion: </strong>During the study period, 11.6% of transferred patients with outside CT/MRI had negative interpretations by our pediatric radiologists. Despite barriers, teleradiology has the potential to transform appendix-related transfers by enabling diagnostic clarity. The financial and social burdens incurred by potentially avoidable transfers could be significant, warranting further investigation.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"22"},"PeriodicalIF":1.1,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic contrast-enhanced computed tomography for small bowel bleeding: Two cases of arteriovenous malformation and gastrointestinal stromal tumor.","authors":"Tomochika Sato, Junichi Arita, Katsunori Iijima, Naoko Mori","doi":"10.25259/JCIS_303_2025","DOIUrl":"10.25259/JCIS_303_2025","url":null,"abstract":"<p><p>Small bowel bleeding is an uncommon cause of gastrointestinal hemorrhage and is often difficult to diagnose when upper and lower endoscopy fail to identify the bleeding source. Dynamic contrast-enhanced computed tomography (DCE-CT) has emerged as an important imaging modality for localizing lesions, estimating the underlying etiology, and guiding treatment strategies. We report two cases of small bowel bleeding with distinct etiologies: Arteriovenous malformation (AVM) and gastrointestinal stromal tumor (GIST). In the first case, DCECT demonstrated a mass-like lesion with intense arterial-phase enhancement comparable to adjacent arteries and early venous drainage, strongly suggesting a vascular lesion. Elective surgical resection was performed, and histopathological examination confirmed AVM. In the second case, CT revealed a well-defined mass with relatively persistent enhancement and contrast extravasation, indicating active bleeding from a neoplastic lesion. Due to hemodynamic deterioration, emergency surgical resection was required, and the lesion was diagnosed as GIST. These cases indicate that systematic evaluation of enhancement patterns and associated CT findings, including early venous drainage and contrast extravasation, can facilitate differentiation between vascular and neoplastic causes of small bowel bleeding and support appropriate treatment selection.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"21"},"PeriodicalIF":1.1,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the uterus: Metastatic leiomyoma.","authors":"Breanna M Koetter, Claire S Adcock, Francis Vento, Brielle Marie Paolini","doi":"10.25259/JCIS_231_2025","DOIUrl":"10.25259/JCIS_231_2025","url":null,"abstract":"<p><p>Uterine leiomyomas are common benign smooth muscle tumors typically confined to the uterus and hormonally responsive to estrogen and progesterone, typically regressing after menopause. Rarely, they demonstrate metastatic behavior despite benign histology, a condition known as benign metastasizing leiomyoma (BML). BML is exceedingly rare and can mimic malignancy, posing diagnostic challenges. We report a rare case of a 53-year-old woman with a history of hysterectomy for leiomyomas who presented with dyspnea and chest pain. Imaging revealed numerous bilateral pulmonary nodules, later confirmed to be smooth muscle tumors. After being lost to follow-up, she returned 2 years later with new breast and forearm masses. Imaging and biopsy confirmed metastatic smooth muscle tumors consistent with BML. Breast lesions mimicked benign cysts on ultrasound, underscoring the importance of clinical and histological correlation. The patient responded well to treatment with symptom improvement. This case highlights the rare phenomenon of BML metastasizing to multiple extrauterine sites, including the breast and soft tissues, locations infrequently reported. Imaging findings, particularly in the breast, can mimic benign lesions such as simple cysts, underscoring the need for biopsy and correlation with clinical history. BML should be considered in women with a history of uterine fibroids and indolent-appearing metastases without fludeoxyglucose uptake on positron emission tomography, computed tomography, and cystic appearance on ultrasound of breast lesions. Early recognition is crucial to avoid misclassification as malignancy and to guide effective hormonal treatment.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"20"},"PeriodicalIF":1.1,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glenohumeral septic arthritis in intravenous drug users: 10-year retrospective analysis.","authors":"Beth Vettiyil, Sijin Wen, Leo Ware, Oganes Ashikyan","doi":"10.25259/JCIS_235_2025","DOIUrl":"10.25259/JCIS_235_2025","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study is to assess cases of septic arthritis of the glenohumeral joint and its association with intravenous drug use.</p><p><strong>Material and methods: </strong>Retrospective data from the past 10 years were obtained from the University Hospital System in Appalachia. 53 shoulders in 50 patients fit the inclusion criteria for glenohumeral septic arthritis and are included in the study. Statistical analyses were carried out using statistical software R (version 3.6.3, R Foundation, Vienna, Austria). Comparisons were made between cases with intravenous drug use versus all other cases.</p><p><strong>Results: </strong>The mean age for intravenous drug users with glenohumeral septic arthritis is lower than non-users. Intravenous drug users with glenohumeral septic arthritis also had higher rates of sepsis, bacteremia, endocarditis, septic emboli, and involvement of other joints compared to non-users.</p><p><strong>Conclusion: </strong>A younger age, the involvement of other joints, and presence of other severe infections should prompt the radiologist to further probe into any intravenous drug use, which may not always be previously divulged. Conversely, having a known history of intravenous drug use should prompt the radiologist to be on the lookout for other joint infections, endocarditis, and septic emboli.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"18"},"PeriodicalIF":1.1,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse subependymoma of the bilateral lateral ventricles.","authors":"Jiayi Chen, Xiangrong Yu","doi":"10.25259/JCIS_268_2025","DOIUrl":"10.25259/JCIS_268_2025","url":null,"abstract":"<p><p>A 55-year-old female presented with a persistent headache in the left parietal region for more than 2 months. Non-contrast computed tomography demonstrated irregular cast-like soft tissue densities along the walls of both lateral ventricles, with a cystic-solid mass located in the anterior horn of the left lateral ventricle. Magnetic resonance imaging findings strongly suggested a subependymoma involving both lateral ventricles. The patient underwent tumor resection, and histopathology confirmed subependymoma (World Health Organization Grade I) with cystic degeneration and hemosiderin deposition. This case is a rare diffuse subependymoma of both lateral ventricles with cystic degeneration and old hemorrhage. The clinical and imaging features are reported as follows.</p>","PeriodicalId":15512,"journal":{"name":"Journal of Clinical Imaging Science","volume":"16 ","pages":"19"},"PeriodicalIF":1.1,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}