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":"D C Howlett, H L Adams, L Salman, K J Drinkwater","doi":"10.1093/bjr/tqaf054","DOIUrl":"https://doi.org/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 generalised 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":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","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":"Deep learning based on ultrasound images predicting cervical lymph node metastasis in postoperative patients with differentiated thyroid carcinoma.","authors":"Fengjing Fan, Fei Li, Yixuan Wang, Tong Liu, Kesong Wang, Xiaoming Xi, Bei Wang","doi":"10.1093/bjr/tqaf047","DOIUrl":"https://doi.org/10.1093/bjr/tqaf047","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a deep learning (DL) model based on ultrasound (US) images of lymph nodes for predicting cervical lymph node metastasis (CLNM) in postoperative patients with differentiated thyroid carcinoma (DTC).</p><p><strong>Methods: </strong>Retrospective collection of 352 lymph nodes from 330 patients with cytopathology findings between June 2021 and December 2023 at our institution. The database was randomly divided into the training and test cohort at an 8:2 ratio. The DL basic model of longitudinal and cross-sectional of lymph nodes was constructed based on ResNet50 respectively, and the results of the two basic models were fused (1:1) to construct a longitudinal + cross-sectional DL model. Univariate and multivariate analysis were used to assess US features and construct a conventional US model. Subsequently, a combined model was constructed by integrating DL and US.</p><p><strong>Results: </strong>The diagnostic accuracy of the longitudinal + cross-sectional DL model was higher than that of longitudinal or cross-sectional alone. The AUC of the combined model (US＋DL) was 0.855 (95%CI: 0.767-0.942), and the accuracy, sensitivity and specificity were 0.786 (95%CI: 0.671-0.875), 0.972 (95%CI: 0.855-0.999) and 0.588 (95%CI: 0.407-0.754), respectively. Compared with US and DL models, the IDI and NRI of the combined model are both positive.</p><p><strong>Conclusions: </strong>This study preliminary shows that the DL model based on US images of lymph nodes has a high diagnostic efficacy for predicting CLNM in postoperative patients with DTC, and the combined model of US+DL is superior to single conventional US and DL for predicting CLNM in this population.</p><p><strong>Advances in knowledge: </strong>We innovatively used DL of lymph node US images to predict the status of cervical lymph nodes in postoperative patients with DTC.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143613477","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":"A british society of gastrointestinal and abdominal radiology (BSGAR) multi-Centre audit of imaging investigations in inflammatory bowel disease.","authors":"Katherine Taylor, Elizabeth Robinson, Ravivarma Balasubramaniam, Gauraang Bhatnagar, Stuart A Taylor, Damian Tolan, Anita Wale, Ian Zealley, Kieran Foley","doi":"10.1093/bjr/tqaf050","DOIUrl":"https://doi.org/10.1093/bjr/tqaf050","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate current UK practice for inflammatory bowel disease (IBD) imaging against recommendations from published international literature.</p><p><strong>Methods: </strong>A retrospective multi-centre audit was undertaken evaluating imaging modalities, protocols and pathways used to investigate IBD both in outpatient and inpatient settings during January-December 2022. Reporting practices and training provisions were also recorded.</p><p><strong>Results: </strong>Forty-one centres contributed: 35 centres provided complete data, 6 incomplete. Magnetic resonance enterography (MRE) was the most common modality for small bowel imaging across UK centres, comprising 13,099/18,784 (69.7%) investigations. There was regional variability in other modalities used, with 5 centres performing 81% of all intestinal ultrasound, and 3 centres performing 65% of all small bowel follow-through. Compared to outpatients, inpatients with suspected IBD were significantly more likely to be imaged with techniques imparting ionising radiation whether scanned either in-hours (p = 0.005) or out-of-hours (p < 0.001). Non-ionising radiation imaging modalities were significantly less available out-of-hours (p < 0.0001). Sequences included in MRE protocols were variable. Disparity in imaging follow-up for patients prescribed biologic therapies was observed.</p><p><strong>Conclusions: </strong>Considerable variation in UK IBD imaging practice has been identified. Improvements must be made to reduce the regional inequality of patient access to different imaging modalities and decrease reliance on ionising radiation for inpatients. Further research to standardise and optimise imaging pathways should be undertaken to improve uniformity, with emphasis placed on training and education.</p><p><strong>Advances in knowledge: </strong>This multi-centre audit showed considerable IBD imaging practice variation between UK centres, particularly for imaging modalities used between inpatient and outpatient groups, and in-hours versus out-of-hours.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596277","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":"Clinical photon-counting CT increases CT number precision and reduces patient size dependence compared to single- and dual- energy CT.","authors":"Jessica D Flores, Gavin Poludniowski, Adrian Szum, Georg Walther, Johan Lundberg, Patrik Nowik, Tobias Granberg","doi":"10.1093/bjr/tqaf052","DOIUrl":"https://doi.org/10.1093/bjr/tqaf052","url":null,"abstract":"<p><strong>Objectives: </strong>To study whether photon-counting computed tomography (PCCT) can improve CT number accuracy, precision and reduce patient size dependence compared to dual-energy CT (DECT) virtual monoenergetic imaging (VMI) and single-energy CT (SECT).</p><p><strong>Methods: </strong>Clinical PCCT, DECT and SECT scanners were used to image a multi-energy quality assurance phantom and tissue-equivalent inserts with/without an outer nested annulus, representing two object sizes (18 and 33 cm). CT numbers were converted to linear attenuation coefficients (LAC) and regions-of-interest applied. Theoretical monoenergetic LAC were calculated from known elemental compositions as a ground truth. Percent difference in mean LAC between phantom sizes, between mean and theoretical LAC, and its coefficient of variation (COV) were calculated.</p><p><strong>Results: </strong>Mean LAC percent differences between small and larger phantoms were highest in DECT (within -3% to 9%) and SECT (within 1% to 5%), particularly at higher calcium and iodine concentrations, while being relatively constant in PCCT over material concentrations and VMI energies (within ±2%). The COV in mean LAC was consistently lower (about 2 to 5 times) in PCCT relative to DECT and SECT for calcium in the large phantom. With consideration of the theoretical uncertainties of 2%, both PCCT and DECT showed comparable agreement to theoretical LAC.</p><p><strong>Conclusions: </strong>PCCT VMI produces CT numbers with less dependence on patient size and increased precision in large object sizes than DECT VMI and SECT.</p><p><strong>Advances in knowledge: </strong>Clinical PCCT provides less variable CT numbers than DECT and SECT with less sensitivity to the imaged object size.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584833","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":"The Impact of Plan Complexity on Dose Delivery Deviations Resulting from MLC Positioning Errors in Volumetric Modulated Arc Therapy.","authors":"Qinghe Peng, Peng Fan, Xunyu Wang, Fali Tao, Ruijun Niu, Li Chen","doi":"10.1093/bjr/tqaf053","DOIUrl":"https://doi.org/10.1093/bjr/tqaf053","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the effect of plan complexity on dosimetric alterations induced by multi-leaf collimator (MLC) misplacements in volumetric modulated arc therapy (VMAT).</p><p><strong>Methods: </strong>VMAT plans for 14 cervical and 10 lung cancer cases were reoptimized utilizing three distinct Aperture Shape Controller settings (none, very high, very low), resulting in three plan groups: ASC-none, ASC-vh, and ASC-vl. Four types of MLC position errors were simulated: total shifts (Type 1), open/closed (Type 2), right-side shifts (Type 3), and left-side shifts (Type 4). Plan complexity was assessed using the small aperture score (SAS). Dose deviations resulting from various MLC positioning errors and SAS values were calculated and compared among the three ASC groups.</p><p><strong>Results: </strong>The variations in planning target volume (PTV) D95% for cervical cancer were approximately 0.6%, 3.7%, 1.9%, and 1.8% per millimeter for Types 1-4 errors, respectively. In the case of lung cancer, the changes were 2.3%, 9.3%, 5.3%, and 4.6% per millimeter. The ASC-vh and ASC-vl groups exhibited significantly reduced dose changes and SAS values in response to MLC errors, as compared to the ASC-none group (p < 0.05).</p><p><strong>Conclusions: </strong>Highly complex plans exhibit greater dose sensitivity to MLC positional errors. The application of ASC proves effective in reducing plan complexity and mitigating the influence of MLC errors on dose deviation.</p><p><strong>Advances in knowledge: </strong>By elucidating the relationship between dosimetric impacts from MLC errors and plan complexity, this study offers valuable guidance for the design of radiotherapy plans, helping to enhance the accuracy and effectiveness of VMAT treatments.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584835","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":"Heart and lung sparing with isocentric lateral decubitus positioning compared with dorsal decubitus positioning during adjuvant localized breast cancer radiotherapy.","authors":"Pierre Loap, Jeremi Vu Bezin, Alain Fourquet, Youlia Kirova","doi":"10.1093/bjr/tqaf049","DOIUrl":"https://doi.org/10.1093/bjr/tqaf049","url":null,"abstract":"<p><strong>Objectives: </strong>The cardiac and pulmonary dosimetric benefit of alternative positioning in isocentric lateral decubitus compared with dorsal decubitus during adjuvant breast irradiation has yet to be proven, in spite of the relative long-standing use of isocentric lateral decubitus.</p><p><strong>Methods: </strong>Eight consecutive patients with an indication for adjuvant breast irradiation without boost or lymph node irradiation were scanned in both isocentric lateral and dorsal decubitus positions. For each patient, a plan delivering 40.05 Gy in 15 fractions in isocentric lateral decubitus and in dorsal decubitus using a field-in-field technique were calculated. Doses to the heart, to various cardiac substructures and to the lungs were compared.</p><p><strong>Results: </strong>Mean dose to the heart, to various cardiac structures (left ventricle, left coronary, right coronary), to the homolateral lung and to the contralateral lung were significantly lower in isocentric lateral decubitus than in dorsal decubitus. Average absolute mean dose reductions were -40 cGy for the heart, -27.5 cGy for the left ventricle, -56.5 cGy for the right coronary artery, -64.5 cGy for the left coronary artery, -45.5 cGy for the sino-atrial node, -74 cGy for the homolateral lung and -4.5 cGy for the contralateral lung. For all organs-at-risk, median dose-volume histograms in isocentric lateral decubitus showed lower relative volumes than in dorsal decubitus.</p><p><strong>Conclusion: </strong>lateral decubitus positioning significantly reduces dose to the heart, to various cardiac substructures, to the homolateral lung and to the contralateral lung, compared with dorsal decubitus.This technique is easily implemented and can be widely recommended to reduce heart and lung doses to a minimum.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584834","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":"Vertebral Augmentation for Cancer Patients.","authors":"Stefano Marcia, Stefano Marini, Giovanni Carlo Anselmetti, Matteo Bellini, Emanuele Piras, Salvatore Masala, Chiara Zini","doi":"10.1093/bjr/tqaf032","DOIUrl":"10.1093/bjr/tqaf032","url":null,"abstract":"<p><p>Vertebral augmentation has emerged as a crucial intervention for cancer patients suffering from vertebral compression fractures (VCFs) due to metastatic spinal tumors. These fractures significantly compromise patients' quality of life and exacerbate pain, leading to increased morbidity and decreased functional status. This comprehensive review explores the efficacy, safety, and outcomes of vertebral augmentation techniques, including vertebroplasty and kyphoplasty, in cancer patients. It examines the underlying pathophysiology of VCFs in cancer, patient selection criteria, procedural techniques, complications, and future directions in research and clinical practice. The review emphasizes the importance of a multidisciplinary approach involving oncologists, interventional radiologists, and pain management specialists to optimize patient outcomes and improve overall well-being.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582172","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":"Thoracic applications of photon-counting CT: where are WE after three years of clinical implementation?","authors":"Martine Remy-Jardin, Thomas Flohr, Jacques Remy","doi":"10.1093/bjr/tqaf026","DOIUrl":"https://doi.org/10.1093/bjr/tqaf026","url":null,"abstract":"<p><p>Photon-counting CT has now entered the field of clinical practice, raising expectations on the advantages that could be derived for patient management. Two main directions are under scrutinity for the medical community at large. At the present time, most attention is directed toward the confirmation of the expected improvement in image quality and the evaluation of its consequences in terms of decision-making. In parallel, new perspectives in the field of functional imaging as well as for spectral imaging are topics of active research that have not been translated in clinical practice. This review article provides an update on the current use of this technology, based on the last three years of clinical investigations. Early clinical experience is summarized, focusing on adult respiratory indications.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575692","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":"Radiomic phenotype of peri-coronary adipose tissue as a potential non-invasive imaging tool for detecting atrial fibrillation.","authors":"Wu Jingping, Meng Xiao, Wu Dan, Li Yuwei, Zhang Xinghua, Wang Zhenping, Wang Xue, Fan Zhang","doi":"10.1093/bjr/tqaf046","DOIUrl":"https://doi.org/10.1093/bjr/tqaf046","url":null,"abstract":"<p><strong>Objectives：: </strong>Epicardial adipose tissue (EAT) contribute to atrial fibrillation (AF). We sought to explore the role of FAI (fat attention index), volume, fat radiomic profile (FRP) from peri-coronary artery adipose tissue (PCAT) on coronary computed tomography angiography (CCTA) in determining the presence of AF and differentiating AF types.</p><p><strong>Methods: </strong>This study enrolled 300 patients underwent CCTA retrospectively and divided them into AF (n = 137) and non-AF groups (n = 163). The imaging parameters of FAI, volume and FRP were excavated and measured after PCAT segmentation. Every coronary artery extracted 853 radiomics and a total of 2559 radiomics were collected. Significant and relevant FRP was screened by random forest algorithm based on machine learning, and then compared three models of VF (FAI and volume), FRP and FRPC (FRP and clinical factors). Among AF individuals, the FRP and FRPC scores of persistent AF (PerAF, n = 44) and paroxysmal AF (PAF, n = 93) were compared with boxplot.</p><p><strong>Results：: </strong>In the test cohort, FRP score performed excellent distinctive ability to identify AF with an AUC of 0.89 compared with the model enrolling FAI and volume (AUC = 0.83), and FRPC model showed improved AUC of 0.98 combining clinical factors. Among AF types, FPR and FRPC scores are significantly higher in the PerAF than PAF patients (p < 0.001). And twenty most contributive features were selected in identifying AF.</p><p><strong>Conclusion: </strong>Textural radiomic features derived from PCAT on coronary CTA detect micro-pathophysiological information associated with AF, which may help identify and differentiate AF and provide a hopeful imaging target.</p><p><strong>Advances in knowledge: </strong>The analysis of epicardial tissue around coronary arteries help identify and differentiate atrial fibrillation and its types. Fat radiomic profiles derived from peri-coronary arteries fat could provide non-invasive tool for atrial fibrillation.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566191","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":"Enhanced Blood Vessel Visualization and Accelerated Image Acquisition Using Spiral MRA in Moyamoya Disease: A Comparative Study with Cartesian MRA.","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":"https://doi.org/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 analyzed using 3- and 4-point likert scales compared to DSA. A linear fixed-effects model was used to determine differences among the four 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 < 0.001, M3: P < 0.001, M4: P = 0.013). MRAspiral sequences provided better visualization of the distal MCA, LMA collaterals and distal ECA compared to MRACS (all P < 0.001).</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":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-04","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}