British Journal of Radiology最新文献

{"title":"Adding value in radiology-improved radiological diagnosis of osteoporotic vertebral fragility fractures following National UK Audit and Interventions.","authors":"David C Howlett, Hannah L Adams, Lamees Salman, Karl J Drinkwater","doi":"10.1093/bjr/tqaf054","DOIUrl":"10.1093/bjr/tqaf054","url":null,"abstract":"<p><p>Vertebral fragility fractures (VFFs) are the most common osteoporotic fracture, with significant associated morbidity, mortality, and risk of future fractures. Unfortunately, VFFs are frequently underdiagnosed and underreported. With this background, The Royal College of Radiologists (RCR), in collaboration with the Royal College of Physicians (RCP) and Royal Osteoporosis Society (ROS), undertook a UK-wide retrospective audit in 2019 to assess radiology reporting of incidental VFFs present on CT studies. The audit standards were not achieved; however, following a series of interventions, a re-audit in 2022 demonstrated generalized improvement in compliance with the audit parameters, in particular a 6-percentage point increase in moderate/severe VFFs reported. This article examines the potential benefits in terms of reductions in patient morbidity, mortality, and costs that could be expected if the improvements identified were translated to a national level, acknowledging and discussing other improvements that need to occur, with particular reference to onward referral pathways.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"650-652"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using 18F-FDG PET/CT to predict programmed cell death ligand expression in non-small cell lung cancer via metabolic tumour heterogeneity.","authors":"Ruxi Chang, Liang Luo, Cong Shen, Weishan Zhang, Xiaoyi Duan","doi":"10.1093/bjr/tqaf034","DOIUrl":"10.1093/bjr/tqaf034","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study is to evaluate the effectiveness of using 18F-FDG PET/CT metabolic heterogeneity to assess the programmed cell death ligand (PD-L1) expression in primary tumours.</p><p><strong>Methods: </strong>Data from 103 non-small cell lung cancer (NSCLC) patients undergoing 18F-FDG PET/CT were collected. PD-L1 expression was verified via biopsy or surgical specimens. The coefficient of variation (COV) assessed metabolic heterogeneity of the primary tumour. ROC curves evaluated the predictive potential of metabolic metrics and defined thresholds. Logistic regression examined predictors of PD-L1 expression.</p><p><strong>Results: </strong>The study included 103 patients (mean age: 63.65 ± 9.28 years), of whom 60 were male. Sixty-four patients had positive PD-L1 expression, while 39 had negative PD-L1 expression. COV was significantly higher in the PD-L1-positive group (Z = -2.529, P = 0.011), while no significant differences were noted in other parameters between the groups (P > 0.05 for all). The optimal cut-off value was proposed as 28.9, with sensitivity and specificity of 46.9% (34.3%-59.8%) and 82.1% (66.5%-92.5%), respectively (AUC: 0.649 (0.549, 0.741)) which can more effectively identify PD-L1-negative patients. Other metabolic parameters are less effective than COV (AUC< 0.6). In addition, COV-defined metabolic heterogeneity outperformed other metabolic parameters in predicting PD-L1 expression (P = 0.049) and emerged as an independent predictor.</p><p><strong>Conclusion: </strong>Metabolic heterogeneity, described by the COV of the primary lesion, is a marker for predicting PD-L1 expression in NSCLC patients. Therefore, the COV of the primary tumour may complement conventional imaging in providing immunohistochemical information before biopsy.</p><p><strong>Advances in knowledge: </strong>COV of the primary tumour can predict PD-L1 expression, potentially complementing conventional imaging for immunohistochemical information prior to biopsy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"715-720"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Head and neck manifestations of extramedullary plasmacytomas and their differential diagnoses: a pictorial review.","authors":"Sophie Wilkinson, Susan Jawad, Xin-Ying Kowa","doi":"10.1093/bjr/tqaf031","DOIUrl":"10.1093/bjr/tqaf031","url":null,"abstract":"<p><p>Solitary plasmacytoma and multiple myeloma are plasma cell dyscrasias that typically present as bone tumour(s) due to abnormal and unregulated proliferation of plasma cells in the skeletal marrow. Both can manifest as soft tissue lesions within the head and neck region, and they may pose a diagnostic challenge given their relative rarity. This review aims to highlight the key multimodality imaging features of plasma cell neoplasms with an emphasis on extraosseous/extramedullary presentations in the anatomically complex head and neck region, as well as the relevant anatomy of various head and neck subsites and the main differential diagnoses that the radiologist should consider. Familiarity with these entities is crucial and will help the radiologist facilitate the timely diagnosis of plasma cell neoplasia using the arsenal of increasingly available and sensitive imaging techniques.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"640-649"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural history and long-term follow-up of incidental thyroid nodules on CT imaging.","authors":"Eda Lyuman, Claire McArthur","doi":"10.1093/bjr/tqaf002","DOIUrl":"10.1093/bjr/tqaf002","url":null,"abstract":"<p><strong>Objectives: </strong>Incidental thyroid nodules (ITNs) are found in up to 25% of CT scans. Increased use of cross-sectional imaging has contributed to the increased incidence of thyroid cancer worldwide. ITNs pose a management dilemma since nodule malignancy rate is 5%-15% but most cancers are indolent and prognosis in differentiated thyroid cancer is excellent. Study aims are to determine prevalence of ITNs ≥1 cm on CT scans, evaluate reporting practices, assess for emergence of clinically evident thyroid cancer during 13-year follow-up and assess interim nodule growth and clinical outcomes in nodules that were further investigated.</p><p><strong>Methods: </strong>Direct image review of 1499 consecutive CT scans that included the thyroid, performed during January 2009 in a large NHS health board was performed. Clinical data up to January 2022 was analysed in 150 patients with at least 1 ITN ≥1 cm.</p><p><strong>Results: </strong>ITN prevalence was 11% with mean patient age 70 years and mean nodule diameter 17.5 mm. 30% of ITNs were mentioned in the CT report. During the follow-up period 11% proceeded to thyroid ultrasound, 5% fine needle aspiration, and 2% diagnostic hemithyroidectomy with no thyroid malignancy found. One hundred twenty patients (80%) were deceased by the study endpoint, none from thyroid malignancy. No patients presented with clinically evident thyroid malignancy during follow-up.</p><p><strong>Conclusions: </strong>None of 150 ITN cases developed clinically evident thyroid malignancy in a 13-year follow-up period with 80% of patients deceased by the study endpoint from non-thyroid causes.</p><p><strong>Advances in knowledge: </strong>This would suggest that ITNs detected on CT do not require further investigation unless malignant appearances or significant clinical concern for thyroid malignancy.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"686-692"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approvers, Disapprovers, and Strugglers: a Q-methodology study of rectal cancer MRI proforma use.","authors":"Sarah Alderson, Chand Muthoo, Hannah Rossington, Phil Quirke, Damian Tolan","doi":"10.1093/bjr/tqaf035","DOIUrl":"10.1093/bjr/tqaf035","url":null,"abstract":"<p><strong>Objectives: </strong>Rectal cancer MRI (rcMRI) allows accurate staging and informs treatment decisions in rectal cancer. There is variability in reporting completeness; however, template proforma reports can significantly increase the inclusion of key tumour descriptors. We aimed to identify socially shared viewpoints of radiologists relating to barriers to implementing proforma reporting. Measuring the subjectivity of opinions relative to other radiologists will allow identification of common patterns preventing implementation.</p><p><strong>Methods: </strong>Specialist gastrointestinal radiologists from 16 hospital trusts were invited to a Q-methodology study. Participants ranked 56 statements on barriers to using proforma reports (the Q-set) in a normal distribution (Q-grid). Factor analyses were undertaken to identify independent accounts, and additional survey data were used to support interpretation.</p><p><strong>Results: </strong>Twenty-seven radiologists participated; 11 (41%) had more than 10 years reporting rcMRIs. Three distinct accounts of radiologist attitudes to proforma-use were identified: Approvers, Disapprovers, and Struggling champions. The highest ranked barriers related to proforma format, individual radiologists' preferences and beliefs about efficacy and factors relating to wider multidisciplinary teams and health system-level implementation.</p><p><strong>Conclusions: </strong>Radiologists that disapprove of proformas are unlikely to use them unless external influences are applied, such as a requirement by treating clinicians. Increased internal and organizational support would also increase use. Targeted implementation strategies focusing on these barriers has the potential to increase uptake of similar interventions.</p><p><strong>Advances in knowledge: </strong>Specialist radiologists require a multi-level adaptive implementation strategy, tailored to proforma characteristics as well as individual and organizational barriers to increase proforma reporting for rcMRI to support accurate treatment decision making.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"701-708"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced blood vessel visualization and accelerated image acquisition using spiral magnetic resonance angiography in moyamoya disease: a comparative study with Cartesian magnetic resonance angiograhy.","authors":"Maoxue Wang, Yongbo Yang, Yujie Yu, Chuyue Chen, Kun Wang, Mahmud Mossa-Basha, Baochen Chu, Pin Lv, Mei Yao, Wen Zhang, Xin Zhang, Zhengyang Zhu, Xiance Zhao, Lei Zhou, Bing Zhang","doi":"10.1093/bjr/tqaf038","DOIUrl":"10.1093/bjr/tqaf038","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the blood vessel visualization with spiral MRA (MRAspiral) and compressed SENSE accelerated Cartesian MRA (MRACS) in moyamoya disease (MMD) patients, with digital subtraction angiography (DSA) as the reference standard.</p><p><strong>Methods: </strong>We prospectively collected MRAspiral with different acquisition windows (τ = 4, 6, 10 ms), MRACS, and DSA in MMD patients. Contrast-to-noise ratio (CNR) was measured in the M1, M2, M3, and M4 segments of the middle cerebral artery (MCA) for each MRA sequence. Vessel visualization of the distal MCA, leptomeningeal artery (LMA) collaterals, distal external carotid artery (ECA), and internal carotid artery (ICA) steno-occlusion was qualitatively analysed using three- and four-point Likert scales compared to DSA. A linear fixed-effects model was used to determine differences among the 4 sequences.</p><p><strong>Results: </strong>A total of 98 hemispheres from 55 MMD patients were included. CNR in the M2, M3, and M4 segments of the MCA was not significantly different between MRACS and MRAτ4 or MRAτ6, but it was significantly higher in MRACS than MRAτ10 (M2: P < .001, M3: P < .001, M4: P = .013). MRAspiral sequences provided better visualization of the distal MCA, LMA collaterals, and distal ECA compared to MRACS (all P < .001).</p><p><strong>Conclusions: </strong>MRAspiral offers improved vessel visualization in distal arteries with adequate image quality for patients with MMD. Compared to MRACS, MRAspiral can reduce scan time by 32.31% when the τ value is set to 6 ms, while also providing superior image quality.</p><p><strong>Advances in knowledge: </strong>Spiral MRA performs well in visualizing collateral vessels in moyamoya disease with shorter scan time.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"770-776"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quadriceps muscle injuries in athletes: a narrative review.","authors":"Sisith P Ariyaratne, Kapil Shirodkar, Rajesh Botchu, Steven L J James","doi":"10.1093/bjr/tqaf042","DOIUrl":"10.1093/bjr/tqaf042","url":null,"abstract":"<p><p>The quadriceps muscles are a large group of 4 muscles in the anterior compartment of the thigh, comprising the rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis, which in combination act as the primary extensors of the knee joint. The rectus femoris is also responsible for hip joint flexion. Quadriceps muscle injuries are frequently encountered in sports and athletic activities and present a significant challenge in the realm of sports medicine, impacting athletes across various disciplines and levels of competition. A spectrum of sporting injuries and imaging findings can affect this muscle group, including strains and tears, avulsions, contusions, degloving injuries, and exercise-related signal abnormalities. A thorough understanding of these various pathologies and imaging features is crucial to guide appropriate diagnosis, management, and rehabilitation, as well as ensure safe and prompt return to play, minimize risk of re-injury or long-term adverse sequelae, optimize performance, and improve career longevity of these athletes. This comprehensive review article aims to review the unique anatomy of the quadriceps muscle group and integrate current knowledge of the various forms of sporting injuries affecting it, with a specific emphasis on the imaging features.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"630-639"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and management of lymphedema in the era of precision oncology.","authors":"Pranjal Rai, Abhishek Mahajan, Shreya Shukla, Niyati Pokar","doi":"10.1093/bjr/tqaf029","DOIUrl":"10.1093/bjr/tqaf029","url":null,"abstract":"<p><p>Lymphedema is a common complication of cancer treatment, leading to significant morbidity. Early and accurate diagnosis through the combined expertise of radiology and nuclear medicine is crucial for preventing lymphedema progression and improving patient outcomes. Imaging techniques such as lymphoscintigraphy, duplex ultrasound, MRI, and CT as well as newer modalities including near-infra-red lymphangiography can diagnose and assess lymphedema severity. Bioimpedance spectroscopy provides a non-invasive tool for early detection by measuring extracellular fluid changes, aiding in identifying lymphedema at its earliest stages. Pre-treatment baseline measurements and prospective surveillance models are essential for tracking limb volume changes and mobility, enhancing early intervention outcomes. Recognizing the strengths and limitations of each imaging modality allows radiologists and nuclear medicine physicians to synergistically optimize lymphedema diagnosis and management. Effective management relies on multidisciplinary collaboration and includes conservative and surgical options tailored to disease severity. Advanced imaging modalities are pivotal for planning and monitoring interventional strategies. This review explores the development and management of secondary lymphedema in oncological patients, focusing chiefly on imaging and treatment strategies. It also briefly highlights the evolving role of artificial intelligence and machine learning in enhancing imaging precision and treatment outcomes.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"619-629"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12012379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroimaging Biomarkers of Post-acute Sequelae of Covid (PASC).","authors":"Swati Rane Levendovszky, Payal Patel, Chengcheng Zhu, Aaron M Rutman, Mahmud Mossa Basha","doi":"10.1093/bjr/tqaf090","DOIUrl":"https://doi.org/10.1093/bjr/tqaf090","url":null,"abstract":"<p><p>COVID-19, caused by SARS-CoV-2, has led to the condition known as Long COVID or post-acute sequelae of COVID-19 (PASC), where individuals experience persistent debilitating symptoms long after the initial infection. We provide here a comprehensive review of findings in the central nervous system associated with PASC. Neuroimaging has been instrumental in identifying brain changes associated with PASC. Structural MRI studies consistently reveal gray matter volume reductions in the frontal and temporal lobes and white matter hyperintensities, particularly in the periventricular regions. Studies especially found these changes to correlate strongly with cognitive deficits. Diffusion tensor imaging has shown increased tissue damage and edema in the brain's white matter tracts, particularly in the sagittal stratum and thalamic radiation. Resting-state functional MRI studies indicate altered brain connectivity in PASC patients, especially in those with post-traumatic stress symptoms. Reduced connectivity within and between critical networks, such as the default mode network and the executive control network, has been observed. These changes correlate with cognitive impairments, such as attention and memory deficits. Dynamic functional connectivity analyses further reveal that PASC patients spend less time in states with rich inter-regional connectivity, and transitions between connectivity states were linked to post-traumatic stress disorder symptoms. Positron emission tomography scans have shown hypometabolism in the frontal and temporal lobes, particularly in regions associated with memory and executive functions. Hypometabolism in the hippocampus and thalamus is linked to symptoms like anosmia and fatigue. Despite the heterogeneity in clinical presentations and diagnostic criteria, these neuroimaging findings underscore the significant impact of COVID-19 on brain structure and function. Continued research using advanced imaging techniques is essential for a deeper understanding of PASC's neurological effects. This will aid in developing targeted interventions and improving outcomes for those affected by Long COVID and inform studies investigating downstream effects of viral infections on the brain.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High resolution-dynamic characterisation of cardiac masses -Radio-frequency spoiled 3D gradient echo sequence.","authors":"Elif Peker, Sena Ünal, Ruhi Erdem Ergüden, Nil Sezer Yılmazer Zorlu, Sena Bozer Uludağ","doi":"10.1093/bjr/tqaf093","DOIUrl":"https://doi.org/10.1093/bjr/tqaf093","url":null,"abstract":"<p><strong>Introduction: </strong>Volumetric interpolated breath-hold examination (VIBE) sequence is a radio-frequency-spoiled gradient echo sequence that is mostly used in the evaluation of soft tissues, allows dynamic high-resolution images to be taken in 30 seconds of breath holding time in MRI, and is used to create 3-dimensional images. In this study, we aimed to determine the detectability of cardiac masses and thrombi and their differentiation from the blood pool with the T1 VIBE imaging method.</p><p><strong>Material and methods: </strong>Precontrast, early and late post-contrast VIBE images were evaluated. Lesion contours were drawn with a free-hand ROI in the phase in which the lesion better depicted. All ROIs were placed in the phase where the lesion appeared best and then copied to other phases.SNR was calculated as SI/SD of background intensity, CNR was calculated as SNR thrombus-SNR myocardium and SNR thrombus-SNR blood pool. SNR and CNR values of thrombus, blood pool and myocardium measured at maps and contrast-enhanced images were compared with each other.</p><p><strong>Conclusion: </strong>There are many sequences used routinely to detect cardiac masses and thrombi. Many of these techniques require long acquisiton time. With the VIBE sequence, precontrast, arterial and venous images of the lesion can be obtained quickly. Although the SNR and CNR values obtained with VIBE images are lower than those with routine post-contrast images, our study can be considered as a preliminary study for future studies to evaluate dynamic images.</p><p><strong>Advances in knowledge: </strong>For our knowledge this is the first paper written on the visual assessment of cardiac masses on VIBE images.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}