Skeletal Radiology最新文献

{"title":"Implementing tin-prefiltration in routine clinical CT scans of the lower extremity: impact on radiation dose.","authors":"Thomas Marth, Georg Wilhelm Kajdi, Christoph Stern, Reto Sutter","doi":"10.1007/s00256-025-04897-3","DOIUrl":"10.1007/s00256-025-04897-3","url":null,"abstract":"<p><strong>Objectives: </strong>Several studies have demonstrated the potential of tin-prefiltration to reduce radiation dose while maintaining diagnostic image quality for musculoskeletal imaging. Still, no study has reported data on the impact of tin-prefiltration on radiation dose reduction for clinical routine scanning.</p><p><strong>Materials and methods: </strong>Retrospective inclusion of 300 clinically indicated CT scans of the pelvis, knee, and ankle before January 2020 (without tin filter) and after December 2020 (with tin filter). For each joint, 50 examinations with tin-prefiltration and 50 examinations without tin-prefiltration were selected. Dose parameters were extracted, calculated, and compared. Subjective and quantitative parameters for image quality were assessed.</p><p><strong>Results: </strong>The CTDI_vol, DLP, and effective dose were reduced significantly in all tin-prefiltered examinations compared to the non-tin-prefiltered examinations (p < 0.001): CTDI_vol was 65% lower in the pelvis, 73% lower in the knee, and 54% lower in the ankle. This reduced the effective dose of 61%, 71%, and 60%, respectively. In absolute numbers, the reduction of the median effective dose delivered in a single CT scan of the pelvis was - 2.29 mSv, - 0.15 mSv for the knee, and - 0.03 mSv for the ankle. No difference in diagnostic image quality, depiction of bone anatomy and soft tissues, and image artifacts was observed (p > 0.05). Subjective and objective image noise was higher in tin-prefiltered pelvis CT (p < 0.001).</p><p><strong>Conclusion: </strong>The implementation of tin-prefiltration in clinical routine scan protocols significantly reduced the effective radiation dose for unenhanced CT scans of the lower extremities between 60 and 70%.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1915-1925"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI as teacher: effectiveness of an AI-based training module to improve trainee pediatric fracture detection.","authors":"Sean O'Rourke, Sophia Xu, Stephanie Carrero, Harrison M Drebin, Ariel Felman, Andrew Ko, Adam Misseldine, Sofia G Mouchtaris, Brett Musialowicz, Tony T Wong, John R Zech","doi":"10.1007/s00256-025-04927-0","DOIUrl":"10.1007/s00256-025-04927-0","url":null,"abstract":"<p><strong>Objective: </strong>Prior work has demonstrated that AI access can help residents more accurately detect pediatric fractures. We wished to evaluate the effectiveness of an unsupervised AI-based training module as a pediatric fracture detection educational tool.</p><p><strong>Materials and methods: </strong>Two hundred forty radiographic examinations from throughout the pediatric upper extremity were split into two groups of 120 examinations. A previously developed open-source deep learning fracture detection algorithm ( www.childfx.com ) was used to annotate radiographs. Four medical students and four PGY-2 radiology residents first evaluated 120 examinations for fracture without AI assistance and subsequently reviewed AI annotations on these cases via a training module. They then interpreted 120 different examinations without AI assistance. Pre- and post-intervention fracture detection accuracy was evaluated using a chi-squared test.</p><p><strong>Results: </strong>Overall resident fracture detection accuracy significantly improved from 71.3% pre-intervention to 77.5% post-intervention (p = 0.032). Medical student fracture detection accuracy was not significantly changed from 56.3% pre-intervention to 57.3% post-intervention (p = 0.794). Eighty-eight percent of responding participants (7/8) would recommend this model of learning.</p><p><strong>Conclusion: </strong>We found that a tailored AI-based training module increased resident accuracy for detecting pediatric fractures by 6.2%. Medical student accuracy was not improved, likely due to their limited background familiarity with the task. AI offers a scalable method for automatically generating annotated teaching cases covering varied pathology, allowing residents to efficiently learn from simulated experience.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1949-1957"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-like image based on 3D fast low-angle shot: superior diagnostic performance of ossification of the posterior longitudinal ligament.","authors":"Sujin Kim, Guen Young Lee, Bo Mi Chung","doi":"10.1007/s00256-025-04891-9","DOIUrl":"10.1007/s00256-025-04891-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the diagnostic performance of 3D fast low-angle shot (FLASH) compared with conventional MRI sequences for detecting OPLL.</p><p><strong>Materials and methods: </strong>This retrospective study included 106 patients who underwent cervical spine MRI and CT. Thirty-nine and 67 patients were enrolled in the OPLL and control groups, respectively. Diagnostic performance and reader confidence for detecting OPLL were compared between conventional MRI using turbo spin echo (TSE) and conventional MRI plus 3D FLASH. Interobserver agreement was also calculated. Three subgroups were defined within the OPLL group according to the sequences required for detecting OPLL (TSE group: cases that were diagnosed as OPLL by reviewing only TSE; 3D FLASH group: cases that were diagnosed by reviewing both TSE and 3D FLASH; none group: cases that were not diagnosed on MRI). The thickness of the OPLL was compared between the subgroups.</p><p><strong>Results: </strong>The diagnostic performance of both readers improved when 3D FLASH was added to conventional MRI, and the difference was statistically significant for reader 2 (p = 0.006). After adding 3D FLASH, reader confidence significantly increased (p < 0.001), and interobserver agreement improved from good to excellent. The three subgroups exhibited significantly different OPLL thicknesses (p = 0.008), with the thickest in the TSE group (4.5 mm), followed by the 3D FLASH (3.4 mm) and None groups (2.4 mm).</p><p><strong>Conclusion: </strong>3D FLASH can be helpful for detecting OPLL when combined with conventional T1- and T2-weighted imaging.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1905-1913"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cauda equina movements during the Valsalva maneuver in patients with lumbar spinal stenosis: introducing a novel method for redundant nerve evaluations.","authors":"Ryo Yamakuni, Shiro Ishii, Koji Otani, Shinya Seino, Takuya Nikaido, Kazuyuki Watanabe, Kinshi Kato, Hiroshi Kobayashi, Masataka Nakamura, Takeyasu Kakamu, Hironobu Ishikawa, Hirofumi Sekino, Kenji Fukushima, Yoshihiro Matsumoto, Hiroshi Ito","doi":"10.1007/s00256-025-04888-4","DOIUrl":"10.1007/s00256-025-04888-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether inchworm-like cauda equina movements can be observed in patients with lumbar spinal stenosis using a novel Valsalva maneuver cine MRI (cMRI) protocol.</p><p><strong>Materials and methods: </strong>Fifteen lumbar spinal stenosis patients (11 males; mean age, 73.9 years) underwent lumbar static MRI (sMRI) and sagittal 60-s cMRI. The cMRI protocol, called the Kinematic Assessment of Redundant Nerves (KAoRN), included three resting and Valsalva maneuver sets. Two radiologists independently evaluated cauda equina movement and lumbar spinal stenosis severity from L1/2 to L5/S1 using an MRI lumbar spinal stenosis score. Scores from both analysts were averaged; the most severe averaged score from all levels was extracted and defined as the worst score. Moreover, the level at which severe stenosis (averaged score ≥ 3.5) was observed was counted.</p><p><strong>Results: </strong>KAoRN-positive cauda equina movement was observed in 11 participants (73.3%). KAoRN-negative participants tended to have non-significantly higher worst lumbar spinal stenosis scores (4.0, interquartile range 3.9-4.0) than those of KAoRN-positive participants (3.5, interquartile range 3.0-4.0) (p = 0.310, χ² test). KAoRN-negative participants tended to have more severe stenosis than that of KAoRN-positive participants, though the difference was not significant (p = 0.182, Wilcoxon rank sum test).</p><p><strong>Conclusion: </strong>KAoRN-positive cauda equina movement is frequently observed in participants with lumbar spinal stenosis; however, it is not observed in all such cases. Further exploration of the differences in the presence or absence of KAoRN-positive findings may provide new insights into the diagnosis of clinically relevant LSS requiring surgical intervention.</p><p><strong>Trail registration: </strong>The UMIN clinical trial number: UMIN000052276.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1873-1885"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of neurovascular bundle involvement by an extremity sarcoma on MRI: a critical decision for sarcoma surgeon.","authors":"Dharmendra Kumar Singh, Divesh Jalan, Aarushi Narwani, Nishith Kumar, Ashish Rustagi, Alfa Shamim Saifi, Upinderjeet Singh, Supriya Kaur, Neha Nischal","doi":"10.1007/s00256-025-04924-3","DOIUrl":"10.1007/s00256-025-04924-3","url":null,"abstract":"<p><p>Bone or soft tissue sarcoma of the extremity represents a varied group of mesenchymal tumors, with an extensive range of histopathology, epidemiology, and anatomical involvement. Many of these tumors grow to involve the adjacent major neurovascular bundles, leading to a paradigm shift of management between limb salvage and limb amputation. MRI is the gold standard imaging modality for assessing neurovascular involvement, primarily on T2-weighted fat suppressed (T2 W FS) axial and T1-weighted (T1 W) axial sequences. The differential imaging pattern or appearance of peritumoral edema and tumor has led to further insights in managing extremity sarcoma. This article aims to unfurl the various intricacies of neurovascular involvement by extremity sarcoma on MRI for a multidisciplinary management approach.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1803-1810"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of molecular pathology in soft tissue tumor diagnosis: what the radiologist needs to know.","authors":"Naveen Parasu, Denny Mathew, Sharief Aboelmagd, Snezana Popovic, Hadas Benhabib","doi":"10.1007/s00256-025-04934-1","DOIUrl":"10.1007/s00256-025-04934-1","url":null,"abstract":"<p><p>For both general radiologists and those specializing in soft tissue sarcoma imaging, understanding the importance and basic concepts of molecular pathology is becoming increasingly relevant to current clinical practice. As molecular research identifies the most fundamental causes and markers of disease, diagnostic testing is increasingly focused on the cell nucleus and its genetic material. Identifying molecular abnormalities, such as mutations, deletions, and amplifications, has advanced our ability to diagnose genetic diseases, including a variety of cancers. Over the past two decades, molecular pathology has rapidly evolved, enhancing our understanding of sarcoma pathogenesis, diagnosis, and classification. This progress forms the foundation of the 2020 WHO classification of soft tissue and bone tumors. This article will highlight cases where molecular diagnostics are crucial for the definitive classification and diagnosis of select soft tissue tumors, with MRI correlation and key teaching points.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1821-1840"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scanogram leg length measurement after total hip arthroplasty: not all landmarks are created equal.","authors":"Brian T N Le, Yoan Bourgeault-Gagnon, Matthew C Lyons, Samuel L McCaffrey, Lucy J Salmon, Michael D O'Sullivan","doi":"10.1007/s00256-025-04895-5","DOIUrl":"10.1007/s00256-025-04895-5","url":null,"abstract":"<p><strong>Objective: </strong>To compare the magnitude of post-arthroplasty leg length discrepancy (LLD) and incidence of clinically significant LLD measured on CT scanogram using a commonly used measurement method (from the acetabular apex to tibial plafond) to an alternative technique avoiding the use of the acetabular prosthesis as a landmark and to assess inter-observer and intra-rater reliability of the new technique.</p><p><strong>Materials and methods: </strong>In this retrospective study, post-arthroplasty LLD measurements were conducted in 100 hips by two interpreters on CT scanogram scout views from the acetabular apex to the tibial plafond (AA-TP) and the inter-teardrop line to the tibial plafond (IT-TP). Aggregate means and proportions of clinically relevant LLD (≥ 10 mm) were compared between methods. Inter-rater reliability was calculated, and both interpreters repeated measurements on ten randomly selected patients to calculate intra-rater reliability.</p><p><strong>Results: </strong>The commonly used AA-TP technique overestimated LLD by 3.7 mm compared to the IT-TP technique. The odds of LLD measurement exceeding the clinically significant threshold of 10 mm were 3.8 times higher when using the AA-TP technique. Excellent inter-rater (ICC 0.984, 0.958) and intra-rater reliability (ICC > 0.9) were found for both techniques.</p><p><strong>Conclusion: </strong>CT scanogram measurements from the acetabular apex to the tibial plafond often overestimate operative limb length due to reference landmarks in different axial planes. Measurements from the inter-teardrop line to the tibial plafond yield significantly lower LLD values, possibly reflecting actual limb length better. The authors recommend using the inter-teardrop line and tibial plafond as reference landmarks to improve LLD assessment accuracy post-arthroplasty.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1897-1904"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical vertebral body stress fracture in the setting of diffuse idiopathic skeletal hyperostosis.","authors":"Fielding S Fischer, Austin T Gregg, Arvin B Kheterpal, F Joseph Simeone","doi":"10.1007/s00256-025-04911-8","DOIUrl":"10.1007/s00256-025-04911-8","url":null,"abstract":"<p><p>Diffuse idiopathic skeletal hyperostosis (DISH) is a non-inflammatory arthritis characterized by bridging ossification along the anterolateral spine. Bridging osteophytes in DISH can result in fusion, altering the biomechanics and increasing the risk of unstable spinal fractures. This report details two cases of unusual vertebral body stress fractures in the setting of DISH: a T6 fracture in a 76-year-old male presenting without definite precedent trauma, and an L2 fracture in an 82-year-old female associated with 1 month of prodromal lower back pain radiating to the groin. CT and MR imaging for both patients demonstrated incomplete fractures arising from the midportion of the anterior vertebral body, rounded sclerosis bordering the fracture site as would be seen in a stress fracture, and a marrow edema sign within the vertebral bodies. We propose that these fractures are a subacute atypical vertebral body stress fracture in the setting of DISH that, to our knowledge, has not previously been reported in the literature. It remains unclear whether the fractures detailed in this report are at risk of progressing to complete fractures, potentially resulting in spinal instability. The subacute fracture pattern described in this report should be recognized by radiologists on CT and MR imaging to avoid the potentially devastating consequences of progression to complete fracture and neurologic injury.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1963-1967"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the American College of Radiology Bone Reporting and Data System™ (ACR Bone-RADS™) for classifying osteolytic bone tumors.","authors":"Youngjune Kim, Choong Guen Chee, Yusuhn Kang","doi":"10.1007/s00256-025-04881-x","DOIUrl":"10.1007/s00256-025-04881-x","url":null,"abstract":"<p><strong>Objective: </strong>To validate the performance of the American College of Radiology (ACR) Bone-RADS™ in identifying malignant osteolytic bone tumors and to evaluate the inter-observer agreement between musculoskeletal radiologists performing ACR Bone-RADS™ assessments.</p><p><strong>Methods: </strong>This single-center, retrospective study included patients who visited our orthopedic oncology department on January 2019-December 2020 for bone tumors. Three radiologists evaluated the initial radiographs and assessed whether the tumor was eligible for ACR Bone-RADS™ assessment considering its transverse location and radiodensity. For eligible tumors, the radiologists rated the descriptors of ACR Bone-RADS™ and calculated the Bone-RADS™ categories. Using multi-reader, multi-case analysis, the performance in identifying malignant bone tumors was assessed in terms of sensitivity and area under the receiver-operating-characteristic curve (AUC), while dichotomizing the Bone-RADS™ categories into potentially benign (categories 1-2) and potentially malignant (categories 3-4). Gwet's AC1 was calculated to evaluate inter-observer agreement on the categories. The proportion of malignancy in each Bone-RADS™ category was calculated.</p><p><strong>Results: </strong>In total, 278 patients (mean age ± standard deviation, 40 ± 22 years; 161 men; and 93 with malignant tumors) were eligible for assessment. The sensitivity and AUC for discriminating malignancy using ACR Bone-RADS™ were 95.0% and 0.915, respectively. There was moderate inter-observer agreement on the ACR Bone-RADS™ category, with a Gwet's AC1 of 0.594 (95% confidence interval, 0.536-0.652). The proportions of malignancy were 0.0-1.2% in Bone-RADS™ category 1; 4.0-9.0% in category 2; 18.2-30.3% in category 3; and 77.7-83.3% in category 4.</p><p><strong>Conclusion: </strong>The ACR Bone-RADS™ showed high diagnostic performance in detecting malignant osteolytic bone tumors, with moderate inter-observer agreement.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1841-1850"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous pseudotumour of tibial plateau following migration of viscosupplementation material: a rarely documented complication.","authors":"Mark Wilsher, Samuel Rajaratnam, Wendy Brown, Sally F Bonar","doi":"10.1007/s00256-025-04914-5","DOIUrl":"10.1007/s00256-025-04914-5","url":null,"abstract":"<p><p>Intraosseous pseudotumour following intra-articular injection of hyaluronic acid polymers (viscosupplementation) is very rare and has only once previously been documented in the tibial plateau. Herein reported is a further example in a 63-year-old female who underwent total knee replacement 11 months following a diagnosis of breast carcinoma for which low-level suspicion for intraarticular metastasis persisted following extensive investigation. On imaging and gross examination, there was moderate osteoarthritis. Symptoms warranted total knee arthroplasty which was performed with subchondral bone sampling. Histologically, there was mild degenerative articular change and within the subchondral marrow space, there was deposition of uniform, Alcian blue positive mucoid material, surrounding a small degenerative cyst. No associated epithelial cells were demonstrated. A subsequent history of viscosupplementation administration was obtained by pathology, and the material was determined to represent intraosseous displacement of hyaluronic acid polymer. The breast carcinoma was also discovered to represent in situ disease. This case is a cautionary tale of the importance of careful history taking and a multidisciplinary approach to patient management.</p>","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1969-1975"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}