Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes最新文献

{"title":"Digital Breast Tomosynthesis: One Step Forward.","authors":"Anabel Medeiros Scaranelo","doi":"10.1177/08465371211038765","DOIUrl":"https://doi.org/10.1177/08465371211038765","url":null,"abstract":"","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"276"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39445354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Added Value of Supplemental Breast Ultrasound Screening for Women With Dense Breasts: A Single Center Canadian Experience.","authors":"Tong Wu,&nbsp;Linda J Warren","doi":"10.1177/08465371211011707","DOIUrl":"https://doi.org/10.1177/08465371211011707","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the contribution to cancer detection of supplemental breast ultrasound screening in women with dense breasts based on a single center experience by comparing our results with similar programs elsewhere.</p><p><strong>Methods: </strong>We performed a retrospective review of handheld sonographer-performed screening ultrasound exams at our academic breast imaging center, from January 1st to December 31st, 2019. Breast density, breast cancer risk factors, BI-RADS assessment, and lesion pathology were reviewed and tallied, followed by derivation of the biopsy rate, breast cancer detection rate, PPV3 and average tumor size. These values were compared to published results of breast screening programs elsewhere.</p><p><strong>Results: </strong>695 screening breast ultrasounds for women with dense breasts and negative mammograms were performed in 2019. The biopsy rate was 1.3%, breast cancer detection rate was 7 in 1000, PPV3 was 42%, and the average tumor size was 9.0 ± 1.4 mm.</p><p><strong>Conclusions: </strong>The first-year data of the breast screening ultrasound program at our practice are promising, demonstrating comparable cancer detection rate, higher PPV3, and similar biopsy rate in those with dense breasts compared with similar programs elsewhere. Longitudinal analysis and larger sample size are required for validation. Comparison of incidence and prevalence screening data is also warranted to elucidate the true value of this program.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"101-106"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211011707","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39236682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on the Evolution of Diagnosis and Management of Acute Pulmonary Embolism.","authors":"Constantine A Raptis,&nbsp;Kacie L Steinbrecher,&nbsp;Kaitlin M Marquis","doi":"10.1177/08465371211026530","DOIUrl":"https://doi.org/10.1177/08465371211026530","url":null,"abstract":"","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"17-18"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211026530","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39226427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Power of Diffusion-Weighted Images and ADC Maps in Breast MRI.","authors":"Amr Elnayal,&nbsp;Ameya Kulkarni,&nbsp;Abdullah Alabousi,&nbsp;Amer Alaref","doi":"10.1177/08465371211022289","DOIUrl":"https://doi.org/10.1177/08465371211022289","url":null,"abstract":"We thoroughly read a recent publication by Tezcan et al that discussed the role of combined Diffusion-Weighted Imaging (DWI) and dynamic contrast-enhanced MRI for differentiating malignant from benign breast lesions that demonstrate a washout kinetics curve. We would like to highlight several relevant points pertaining to the role of DWI sequences in both 1.5 and 3 T MRI in differentiating benign from malignant breast lesions, as well as the potential value of establishing an ADC cut-off value in the grading of invasive cancers. A study performed by Tan et al found statistically significant differences between benign and malignant breast lesions, for both b-values of 500 s/mm and 1000 s/mm (p < 0.010). The ADC cut-off values for benign and malignant lesions were determined to be 1.21 � 10�3 s/mm for a b-value of 500 s/mm and 1.22 � 10�3 s/mm for a b-value of 1000 s/mm, respectively. Another study by Partridge et al demonstrated that incorporating ADC values and the washout curve demonstrated statistically significant diagnostic results (p-value 1⁄4 0.008 at b-value of 1000) in the prediction of malignancy as opposed to the use of either of these techniques alone. The ADC value can also be a good discriminator between low and high-grade tumors in invasive ductal carcinoma (IDC), and hence a potential good predictor of response to chemotherapy. In a prospective study of 156 patients with IDC by Azzam et al the mean ADC values for grade I, grade II, and grade III IDC were 1.01 + 0.06 � 10� 3 s/mm, 0.74 + 0.12 � 10� 3 s/mm, and 0.70+ 0.09� 10� 3 s/mm, respectively. There was a significant difference between the mean ADC values of grade I and III tumors (p 1⁄4 0.001), as well as between grade I and II tumors (p 1⁄4 0.002). However, there was no significant difference between grade II and III tumors (p 1⁄4 0.979). We thank the authors for showing the potential value of utilizing ADC maps with specific cut-off values as an additional useful predictive marker for malignant breast lesions, as well as a potentially helpful tool for tumor grading. Declaration of Conflicting Interests","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"274"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39335762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tweeting Bias in Diagnostic Test Accuracy Research: Does Title or Conclusion Positivity Influence Dissemination?","authors":"Zachary Hallgrimson,&nbsp;Nicholas Fabiano,&nbsp;Jean-Paul Salameh,&nbsp;Lee M Treanor,&nbsp;Robert A Frank,&nbsp;Anahita Dehmoobad Sharifabadi,&nbsp;Matthew D F McInnes","doi":"10.1177/08465371211006420","DOIUrl":"https://doi.org/10.1177/08465371211006420","url":null,"abstract":"<p><strong>Purpose: </strong>To examine if tweeting bias exists within imaging literature by determining if diagnostic test accuracy (DTA) studies with positive titles or conclusions are tweeted more than non-positive studies.</p><p><strong>Methods: </strong>DTA studies published between October 2011 to April 2016 were included. Positivity of titles and conclusions were assessed independently and in duplicate, with disagreements resolved by consensus. A negative binomial regression analysis controlling for confounding variables was performed to assess the relationship between title or conclusion positivity and tweets an article received in the 100 days post-publication.</p><p><strong>Results: </strong>354 DTA studies were included. Twenty-four (7%) titles and 300 (85%) conclusions were positive (or positive with qualifier); 1 (0.3%) title and 23 (7%) conclusions were negative; and 329 (93%) titles and 26 (7%) conclusions were neutral. Studies with positive, negative, and neutral titles received a mean of 0.38, 0.00, and 0.45 tweets per study; while those with positive, negative, and neutral conclusions received a mean of 0.44, 0.61, and 0.38 tweets per study. Regression coefficients were -0.05 (SE 0.46) for positive relative to non-positive titles, and -0.09 (SE 0.31) for positive relative to non-positive conclusions. The positivity of the title (<i>P</i> = 0.91) or conclusion (<i>P</i> = 0.76) was not significantly associated with the number of tweets an article received.</p><p><strong>Conclusions: </strong>The positivity of the title or conclusion for DTA studies does not influence the amount of tweets it receives suggesting that tweet bias is not present among imaging diagnostic accuracy studies. Study protocol available at https://osf.io/hdk2m/.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"49-55"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211006420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38823364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Immobilization Post Injection Reduce Contrast Extravasation in MR Arthrography of the Shoulder?","authors":"Caroline Muylaert,&nbsp;Cedric Boulet,&nbsp;Nico Buls,&nbsp;Scott Wuertzer,&nbsp;Nicole Pouliart,&nbsp;Freddy Machiels,&nbsp;Michel De Maeseneer","doi":"10.1177/08465371211005147","DOIUrl":"https://doi.org/10.1177/08465371211005147","url":null,"abstract":"<p><strong>Background: </strong>Contrast leakage after arthrography is common. We sought to investigate if immobilization could prevent it.</p><p><strong>Purpose: </strong>The purpose of this study was to determine the effects on contrast extravasation and image quality produced by strict immobilization of the shoulder between arthrography puncture and subsequent MR imaging.</p><p><strong>Material and methods: </strong>Fifty patients underwent shoulder MR arthrography using a standard shoulder puncture in the anteroinferior quadrant. Ten milliliters of contrast mixture of saline, iodinated contrast, and gadolinium contrast was injected by a senior musculoskeletal (MSK) radiologist using a 21G needle. Half of the patients were immediately immobilized using a shoulder sling, and the other half were allowed to move their shoulder and arm freely during the time before MR imaging. MR arthrography was performed with a 3 T system using standard T1 and PD weighted sequences. The MR images were reviewed independently by 2 MSK radiologists and graded for extravasation using a five-point scale (1: none, 2: less than 2 cm, 3: 2-5 cm, 4: 5-10 cm, 5: more than 10 cm) and for image quality using a 5 point scale (1: poor, 5: good). The Pearson correlation was calculated to assess the correlation between leakage and image quality.</p><p><strong>Results: </strong>There was no significant difference in amount of leakage between both groups, and global image quality was found equal in both groups. A negative correlation was found between leakage and quality assessment.</p><p><strong>Conclusion: </strong>This study shows that it cannot be avoided by strict shoulder immobilization and that it negatively affects image quality and interpretation.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"164-169"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211005147","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38889304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Assessment of Advanced MRI in Post-Treatment High Grade Gliomas Follow Up: Do We Agree?","authors":"Nader Zakhari,&nbsp;Michael Taccone,&nbsp;Carlos Torres,&nbsp;Santanu Chakraborty,&nbsp;John Sinclair,&nbsp;John Woulfe,&nbsp;Gerard Jansen,&nbsp;Greg Cron,&nbsp;Thanh B Nguyen","doi":"10.1177/08465371211013568","DOIUrl":"https://doi.org/10.1177/08465371211013568","url":null,"abstract":"<p><strong>Purpose: </strong>MRI is commonly used in follow up of high grade glioma. Our purpose is to assess the interrater agreement on the increasingly used visual qualitative assessment of various conventional and advanced MR techniques in the setting of treated high grade glioma in comparison to the well established quantitative measurements.</p><p><strong>Methods: </strong>We prospectively enrolled HGG patients who underwent reresection of a new enhancing lesion on post-treatment 3T MR examination including DWI, DCE and DSC sequences. Two neuroradiologists objectively assessed the diffusion and perfusion maps by placing ROI on representative post-processed maps. They subjectively assessed the post-contrast, perfusion and diffusion sequences. Interrater agreement and concordance correlation coefficient were calculated.</p><p><strong>Results: </strong>Twenty-eight lesions were included. The interrater agreement on the qualitative assessment was good for k-trans (k = 0.73), moderate for Vp (k = 0.52), fair for AUC and Ve maps (k = 0.37 and 0.21), fair for corrected CBV (k = 0.39) and poor for the enhancement pattern and presence of diffusion restriction (k = 0.02 and 0.07). The concordance between the quantitative measurements was substantial for AUC and Vp (ρc = 0.98 and 0.97), moderate for k-trans and corrected CBV (ρc = 0.94) and poor for Ve and ADC (ρc = 0.86 and 0.24).</p><p><strong>Conclusion: </strong>While the quantitative measurements of DSC and DCE perfusion maps show satisfactory inter-rater agreement, the qualitative assessment has lower interobserver agreement and should not be relied upon solely in the interpretation. Similarly, the suboptimal inter-rater agreement on the interpretation of enhancement pattern and diffusion restriction potentially limits their usefulness in differentiating glioma recurrence from treatment related changes.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"187-193"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211013568","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38920606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"US LI-RADS Visualization Score: Interobserver Variability and Association With Cause of Liver Disease, Sex, and Body Mass Index.","authors":"Lauren Kiri,&nbsp;Mohamed Abdolell,&nbsp;Andreu F Costa,&nbsp;Valerie Keough,&nbsp;Judy Rowe,&nbsp;Robinette Butt,&nbsp;Sharon E Clarke","doi":"10.1177/08465371211012104","DOIUrl":"https://doi.org/10.1177/08465371211012104","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the interobserver agreement between radiologists using the Ultrasound Liver Reporting And Data System (US LI-RADS) visualization score and assess association between visualization score and cause of liver disease, sex, and body mass index (BMI).</p><p><strong>Methods: </strong>This retrospective, single institution, cross-sectional study evaluated 237 consecutive hepatocellular carcinoma surveillance US examinations between March 4, 2017 and September 4, 2017. Five abdominal radiologists independently assigned a US LI-RADS visualization score (A, no or minimal limitations; B, moderate limitations; C, severe limitations). Interobserver agreement was assessed with a weighted Kappa statistic. Association between US visualization score (A vs B or C) and cause of liver disease, sex, and BMI (< or ≥ 25 kg/m²) was evaluated using univariate and multivariate analyses.</p><p><strong>Results: </strong>The average weighted Kappa statistic for all raters was 0.51. A score of either B or C was assigned by the majority of radiologists in 148/237 cases and was significantly associated with cause of liver disease (<i>P</i> = 0.014) and elevated BMI (<i>P</i> < 0.001). Subjects with viral liver disease were 3.32 times (95% CI: 1.44-8.38) more likely to have a score of A than those with non-alcoholic steatohepatitis (<i>P</i> = 0.007). The adjusted odds ratio of visualization score A was 0.249 (95% CI: 0.13-0.48) among those whose BMI was ≥25 kg/m² vs. BMI < 25 kg/m².</p><p><strong>Conclusion: </strong>Interobserver agreement between radiologists using US LI-RADS score was moderate. The majority of US examinations were scored as having moderate or severe limitations, and this was significantly associated with non-alcoholic steatohepatitis and increased BMI.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"68-74"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211012104","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38942662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Diagnostic Yield of Magnetic Resonance Cholangiopancreatography in the Setting of Acute Pancreaticobiliary Disease - A Single Center Experience.","authors":"Sultan Yahya,&nbsp;Abdullah Alabousi,&nbsp;Peri Abdullah,&nbsp;Milita Ramonas","doi":"10.1177/08465371211013786","DOIUrl":"https://doi.org/10.1177/08465371211013786","url":null,"abstract":"<p><strong>Purpose: </strong>To discern whether preceding ultrasound (US) results, patient demographics and biochemical markers can be implemented as predictors of an abnormal Magnetic Resonance Cholangiopancreatography (MRCP) study in the context of acute pancreaticobiliary disease.</p><p><strong>Methods: </strong>A retrospective study was performed assessing US results, age, gender, elevated lipase and biliary enzymes for consecutive patients who underwent an urgent MRCP following an initial US for acute pancreaticobiliary disease between January 2017-December 2018. Multivariable binary logistic regression models were constructed to assess for predictors of clinically significant MRCPs, and discrepant US/MRCP results.</p><p><strong>Results: </strong>A total of 155 patients (mean age 56, 111 females) were included. Age (OR 1.03, <i>P</i> < 0.05), hyperlipasemia (OR 5.33, <i>P</i> < 0.05) and a positive US (OR 40.75, <i>P</i> < 0.05) were found to be independent predictors for a subsequent abnormal MRCP. Contrarily, gender and elevated biliary enzymes were not reliable predictors of an abnormal MRCP, or significant MRCP/US discrepancies. Of 66 cases (43%) of discordant US/MRCPs, half had clinically significant discrepant findings such as newly discovered choledocholithiasis and pancreaticobiliary neoplasia. Age was the sole predictor for a significant US/MRCP discrepancy, with 2% increase in the odds of a significant discrepancy per year of increase in age.</p><p><strong>Conclusion: </strong>An abnormal US, hyperlipasemia and increased age serve as predictors for a subsequent abnormal MRCP, as opposed to gender and biliary enzyme elevation. Age was the sole predictor of a significant US/MRCP discrepancy that provided new information which significantly impacted subsequent management. In the remaining cases, however, MRCP proved useful in reaffirming the clinical diagnosis and avoiding further investigations.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"75-83"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/08465371211013786","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39009758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's Hot in Breast MRI.","authors":"Anabel M Scaranelo","doi":"10.1177/08465371211030944","DOIUrl":"https://doi.org/10.1177/08465371211030944","url":null,"abstract":"<p><p>Several articles in the literature have demonstrated a promising role for breast MRI techniques that are more economic in total exam time than others when used as supplement to mammography for detection and diagnosis of breast cancer. There are many technical factors that must be considered in the shortened breast MRI protocols to cut down time of standard ones, including using optimal fat suppression, gadolinium-chelates intravascular contrast administrations for dynamic imaging with post processing subtractions and maximum intensity projections (MIP) high spatial and temporal resolution among others. Multiparametric breast MRI that includes both gadolinium-dependent, i.e., dynamic contrast-enhanced (DCE-MRI) and gadolinium-free techniques, i.e., diffusion-weighted/diffusion-tensor magnetic resonance imaging (DWI/DTI) are shown by several investigators that can provide extremely high sensitivity and specificity for detection of breast cancer. This article provides an overview of the proven indications for breast MRI including breast cancer screening for higher than average risk, determining chemotherapy induced tumor response, detecting residual tumor after incomplete surgical excision, detecting occult cancer in patients presenting with axillary node metastasis, detecting residual tumor after incomplete breast cancer surgical excision, detecting cancer when results of conventional imaging are equivocal, as well patients suspicious of having breast implant rupture. Despite having the highest sensitivity for breast cancer detection, there are pitfalls, however, secondary to false positive and false negative contrast enhancement and contrast-free MRI techniques. Awareness of the strengths and limitations of different approaches to obtain state of the art MR images of the breast will facilitate the work-up of patients with suspicious breast lesions.</p>","PeriodicalId":444006,"journal":{"name":"Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes","volume":" ","pages":"125-140"},"PeriodicalIF":3.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39304518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}