Table of Content

15 September 2021, Volume 39 Issue 5

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2021, 39(5):  0-0. 

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Review and Articles

The Relationship between Heart Rate Variability Parameters of Electrocardiogram and Myocardial Injury in Patients with AMI and Analysis of Joint Predictive Prognosis

XIN Xiaowen, DONG Yanni, SUN Lingyun

2021, 39(5):  625-630.  DOI: 10.7517/issn.1674-0475.210215

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One hundred and forty-five cases of acute myocardial infarction (AMI) patients in our hospital were selected as the research objects to explore the relationship between electrocardiogram (ECG) heart rate variability (HRV) parameters and myocardial injury in patients with AMI and the application value of combined prediction of prognosis. The results showed that the age ≥ 60 years old, the time from onset to treatment > 6 hours, smoking history, hyperlipidemia history, the increase of myocardial injury markers (CK-MK, cTnI, and NT-proBNP) and LF/HF, and the decrease of SDNN, SDANN, RMSSD and pNN50 were the risk factors of death in patients with AMI, while emergency intervention was the protective factor (P<0.05). CK-MK, cTnI and NT-proBNP were negatively correlated with SDNN, SDANN, RMSSD and pNN50, and positively correlated with LF/HF (P<0.05). The AUC of CK-MK, cTnI, NT proBNP, SDNN, SDANN, RMSSD, pNN50 and LF/HF in predicting the prognosis of patients with AMI was 0.914, which was higher than that of single prediction. HRV parameters of ECG are related to myocardial injury in patients with AMI, and the combination of these parameters can be used as an important means to predict prognosis and provide basis for clinical practice.

Prognostic Value of Nasopharyngeal X-ray Parameters in Children with Adenoid Hypertrophy

ZHAO Xiaoyang, SUN Guo, ZHUANG Qianger, ZOU Feng

2021, 39(5):  631-636.  DOI: 10.7517/issn.1674-0475.210214

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This study explored the predictive value of the parameters of nasopharyngeal X-ray lateral film in children with adenoid hypertrophy. A total of 146 children with adenoid hypertrophy were selected, all of them received surgical treatment, and they were divided into two groups according to the prognosis of 3 months after operation. The relationship between preoperative adenoid thickness and nasopharyngeal width ratio (A/N), posterior airway width (PAS) and myocardial enzymes, the predictive value of A/N ratio and PAS for prognosis were analyzed. The A/N ratio increased and PAS decreased with the degree of hypertrophy before operation, 1 month and 3 months after operation (P<0.05). The AUC value of A/N ratio and PAS at 1 month after operation was higher than that of other time parameters (P<0.05). The parameters of nasopharynx X-ray lateral film in children with adenoid hypertrophy are closely related to the degree of hypertrophy and myocardial enzyme spectrum, and are the main related factors of prognosis, which can provide reference for clinical evaluation of prognosis and guidance of improvement of treatment plan.

Study on the Diagnostic Effect of Optical Coherence Tomography Angiography Combined with Color Doppler Ultrasound on Anterior Ischemic Optic Neuropathy

QIAN Jin, CHEN Jie, LI Binyi, DENG Chengyu

2021, 39(5):  637-641.  DOI: 10.7517/issn.1674-0475.210103

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The application value of optical coherence tomography angiography (OCTA) and color Doppler ultrasound in the diagnosis of non-arteritic anterior ischemic optic neuropathy (NAIOA) were explored in this study. A total of 78 monocular NAIOA patients admitted to our hospital were selected as the research subjects, and they received OCTA and color Doppler ultrasound examinations. After OCTA examination, the upper GCC thickness, lower GCC thickness and average macular ganglion cell complex (GCC) thickness of the affected side were all lower than those of the healthy side, and the difference was statistically significant (P<0.05). Compared with the thickness of the retinal nerve fiber layer (RNFL) around the upper optic disc, the thickness of the lower RNFL and the average RNFL thickness of the affected side was lower than those of the healthy side (P<0.05). After color Doppler ultrasound examination, the PSV, EDV and RI of OA on the affected side were compared with those of the healthy side (P>0.05). The EDV and RI of CRA were compared between the affected side and the healthy side, and the difference was not statistically significant (P>0.05). The PSV of CRA of the affected eye was lower than that of the healthy side (P<0.05). The sensitivity of CRA-PSV combined with average RNFL thickness and average GCC thickness for diagnosis of NAIOA patients was 95.27%, the specificity was 83.90%, and the AUC value of the area under the ROC curve was 0.930. The results of the study showed that OCTA combined with color Doppler ultrasound is more conducive to improve the sensitivity of diagnostic indicators in the diagnosis of NAIOA patients.

The Value of Musculoskeletal Ultrasound in the Evaluation of Rheumatoid Arthritis Disease Staging and the Correlation of Serum SOD and PCSK9 Expression

ZHU Min, LIU Pei, HU Xiaoli

2021, 39(5):  642-646.  DOI: 10.7517/issn.1674-0475.210109

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The purpose of this study is to investigate the value of musculoskeletal ultrasound in the evaluation of internal rheumatoid arthritis disease staging and the relationship with the expression of serum superoxide dismutase (SOD) and proprotein convertase subtilisin/kexin type 9 (PCSK9). A total of 140 patients with rheumatoid arthritis treated were selected as the observation group, and 100 healthy people were selected as the control group. The expression of serum SOD and PCSK9 in the two groups were detected, the patients in the observation group were given musculoskeletal ultrasound. The results showed that the serum SOD in the observation group was significantly lower than that in the control group, while PCSK9 was significantly higher than that of the control group (P<0.05). In the observation group, the ultrasonic score of the moderate and high activity disease group was significantly higher than that of the low activity group. The area under the ROC curve of ultrasound score in the diagnosis of moderate and high activity diseases was 0.824 (P<0.05). The TC, TG and PCSK9 of moderate and high activity disease group were significantly higher than those of low activity disease group, while SOD was significantly lower than that of low activity disease group (P<0.05). Ultrasound score was positively correlated with DAS28 score, SOD and PCSK9 (P<0.05). Multiple linear regression analysis showed that TC, DAS28 score, SOD and PCSK9 were related to ultrasound score (P<0.05). Therefore, musculoskeletal ultrasound has a certain value in the evaluation of rheumatoid arthritis disease staging, which is positively correlated with serum SOD and PCSK9 levels.

The Value of Lumbar CT Quantitative Parameters in the Diagnosis of LDH and Its Relationship with the Degree of Degeneration

LI Pei, ZHANG Zhipeng

2021, 39(5):  647-652.  DOI: 10.7517/issn.1674-0475.201222

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The lumbar CT imaging data of 130 patients (observation group) with lumbar disc herniation (LDH) were retrospectively analyzed. 130 cases of lumbar spine CT examination for other reasons during the same period were selected as the control group. The comparison found that the flexion angle of L₄ upper and lower endplates, the L₅ upper and lower endplates, the S₁ upper endplate, and the difference in the cross-sectional area of the bilateral psoas major muscle of L_4-5 and L₅-S₁ in the observation group were greater than those of the control group, and were positively correlated with the modified Pfirrmann classification of LDH (P<0.05). The flexion depths of the L₄ upper and lower endplates, L₅ upper and lower endplates, and S₁ upper endplates of the observation group were lower than those of the control group, and were negatively correlated with the modified Pfirrmann classification of LDH (P<0.05). The sensitivity of each parameter cut-off value obtained by ROC analysis was >70%. Therefore, it can be considered that the sagittal flexion angle of the lumbar CT, the depth of endplate flexion, and the difference in the cross-sectional area of the bilateral psoas major can provide an effective reference value for the diagnosis of LDH and the judgment of the degree of degeneration.

Correlation between Quantitative Cochlear Parameters of HRCT and DTI Parameters of Auditory Pathway in Children with Congenital Sensorineural Hearing Loss

DU Ling, DIAO Feng, JI Ming

2021, 39(5):  653-657.  DOI: 10.7517/issn.1674-0475.210101

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The purpose of this study was to investigate the relationship between quantitative parameters of high resolution CT (HRCT) and diffusion tensor imaging (DTI) parameters of auditory pathway in children with congenital sensorineural hearing loss (CSNHL). A total of 62 children with CSNHL were selected as the observation group, and 50 cases of children with normal hearing were selected as the control group, the HRCT and DTI parameters of each group were analyzed. The experimental results showed that:The length and width of cochlear canal and cochlear height of the observation group were significantly lower than those of the control group (P<0.05). The fractional anisotropy (FA) values of transverse temporal gyrus, superior temporal gyrus, posterior limb of internal capsule, auditory radiation and superior olivary nucleus in the observation group were significantly lower than those in the control group (P<0.05), the apparent diffusion coeffecient (ADC) values were significantly higher than those in the control group (P<0.05). The length and width of cochlear canal and cochlear height of the mild children in the observation group were significantly higher than those of moderate severe and extremely severe children (P<0.05), FA value and ADC value of hearing radiation were significantly lower than that of moderate severe and extremely severe children (P<0.05). The length and width of cochlear canal and height of cochlear were positively correlated with auditory radiation FA (P<0.05), and negatively correlated with ADC of auditory radiation (P<0.05). This study confirmed that some HRCT and DTI parameters of CSNHL with different severity are different, the length and width of the cochlear canal and the height of the cochlea are correlated with FA and ADC of auditory radiation.

Clinical Value of Color Doppler Ultrasound in Differential Diagnosis of Gastric Stromal Tumor

TANG Minxuan, DUAN Ruishan, ZHOU Dazhi, HE Liantu, TANG Qing

2021, 39(5):  658-662.  DOI: 10.7517/issn.1674-0475.210104

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The purpose of this study was to investigate the clinical value of color Doppler ultrasound in differential diagnosis of gastric stromal tumor. A total of 88 patients with suspected gastric stromal tumors were selected as the study subjects. The differences of color Doppler ultrasound characteristics between gastric stromal tumors and non gastric stromal tumors were compared. Postoperative pathological diagnosis revealed 63 cases of gastric stromal tumor and 25 cases of non-gastric stromal tumor. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of color ultrasound in the diagnosis of gastric stromal tumor were 87.30%, 84.00%, 86.36%, 93.22% and 72.41%, respectively. The tumor diameter, resistance index, blood flow enrichment ratio and liquefaction ratio of gastric stromal tumor were significantly higher than those of non-gastric stromal tumor (P<0.05). The tumor diameter and liquefaction ratio of medium-risk and high-risk gastric stromal tumors were significantly higher than those of extremely low and low-risk gastric stromal tumors (P<0.05). Color Doppler ultrasound has certain value in the diagnosis of gastric stromal tumor.

The Application of DTI and DTT in the Diagnosis of Different Grades of Gliomas

WAN Zhengguo, JIA Wen, SUN Yuanyuan, LV Xiaoqing, MENG Kailong

2021, 39(5):  663-666.  DOI: 10.7517/issn.1674-0475.210105

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The purpose of this study was to investigate the value of MR diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in the diagnosis of glioma of different grade. 84 patients with glioma were selected, the DTI and DTT parameters of low grade and high grade gliomas were compared. The experimental results showed that the damage rate of peritumor white matter fiber bundle in high-grade was significantly higher than that in low-grade (P<0.05). The fractional anisotropy (FA) value of focal parenchymal area in high-grade was significantly higher than that of the low-grade (P<0.05), and the apparent diffusion coefficient (ADC) value was significantly lower than that of the low-grade (P<0.05). The value of fiber density index (FDi) in the peritumor edema area of high-grade was (0.53±0.08), which was significantly lower than that of low-grade (P<0.05). The area under ROC curve of peritumor white matter fiber bundle destruction, FA value and ADC value of lesion parenchyma area, and FDi value of peritumor edema area in differential diagnosis of high grade were 0.857, 0.877, 0.965 and 0.828, respectively (P<0.05). This study confirmed that:DTI and DTT parameters are different in different grades of glioma, which has certain application value in differential diagnosis.

Value Analysis of Multislice Spiral CT in the Diagnosis of Foot Type 2 Diabetes

ZHOU Xin, SHI Yizhi, WANG Zhen

2021, 39(5):  667-670.  DOI: 10.7517/issn.1674-0475.210107

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The purpose of this study was to investigate the diagnostic value of multislice spiral CT (MSCT) in diabetic foot of patients with diabetes mellitus type 2 (T2DM). 130 patients with T2DM were selected, including 35 patients with diabetic foot (22 patients with Wagner grade 0~2, 13 patients with grade 3~4, no grade 5), and 95 patients with simple T2DM, the MSCT was performed. In patients with diabetic foot, the posterior tibial artery, popliteal artery and femoral artery cross-sectional area were significantly smaller than those in patients with T2DM alone (P<0.05). The posterior tibial artery, popliteal artery and femoral artery cross-sectional area of Wagner class 3 to 4 diabetic foot patients were significantly smaller than Wagner class 0 to 2 diabetic foot patients (P<0.05). The area under ROC curve of posterior tibial artery, popliteal artery and femoral artery cross-sectional area in diagnosing Wagner's grade 3 to 4 diabetic feet were 0.685, 0.927 and 0.822, respectively. These results confirm that MSCT has certain application value in the diagnosis of diabetic foot severity in T2DM patients and is worthy of clinical use.

Correlation between CTPI Parameters, sdLDL-C, Annexin A2, Hcy and the Severity of Acute Cerebral Infarction and the Value of Evaluating the Intravenous Thrombolytic Effect of Alteplase

XU Yan, GAO Yang

2021, 39(5):  671-677.  DOI: 10.7517/issn.1674-0475.210111

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The purpose of this study is to investigate the relationship between CT perfusion imaging (CTPI) combined with small and dense low density lipoprotein cholesterol (sdLDL-C), Annexin A2, and homocysteine (Hcy) and the severity of acute cerebral infarction (ACI), and to evaluate the value of intravenous thrombolytic effect of alteplase. The results of the study found that CTPI parameters[cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT)] were significantly correlated with the severity of ACI patients, as well as the serum sdLDL-C, Annexin A2 and Hcy levels (P<0.05). There was a significant correlation between CTPI parameters and serum sdLDL-C, Annexin A2, and Hcy (P<0.05). The AUC evaluated by CBV, CBF, MTT, TTP, sdLDL-C, Annexin A2, and Hcy at admission and after thrombolysis were all above 0.7, and they all had good evaluation performance, especially after thrombolysis, the AUC of the combined evaluation of thrombolytic effect was 0.929. These results can confirm that CTPI parameters, sdLDL-C, Annexin A2, Hcy are significantly related to the severity of ACI. The combination of various indicators after thrombolysis has high application value in evaluating the effect of thrombolysis, and can provide an important reference for clinical treatment plans.

The Application Value of MRA Technique in the Diagnosis of Ruptured Intracranial Aneurysm and the Predictive Performance of Postoperative Recurrence

LI Li, MENG Zhihua, LIU Ganhui

2021, 39(5):  678-683.  DOI: 10.7517/issn.1674-0475.210115

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A total of 45 patients with intracranial aneurysm (IA) rupture were selected as the rupture group, and 81 patients with unruptured IA during the same period were selected as the unruptured group. All patients received magnetic resonance angiography (MRA) technical examination and endovascular embolization treatment. The patients were divided into relapsers and non-relapsers according to whether there was relapse at 3 months after operation. The results showed that the AUC of IA rupture diagnosed by the aspect ratio (AR) of the tumor, the normalized wall shear stress maximum(NWSSM), and the oscillating shear index (OSI) was the highest. The size of aneurysm, the effect of immediate embolization were important factors influencing recurrence after IA, as well as the AR, NWSSM and OSI. The sensitivity and specificity of the combination of AR, NWSSM and OSI in predicting postoperative recurrence of IA were 76.47% and 90.83%, respectively. It is suggested that the application of MRA technology to monitor the morphology and hemodynamics of IA can provide scientific evidence-based guidance for clinical diagnosis of IA rupture and prediction of postoperative recurrence.

Correlation Analysis and Clinical Application of HER-2 Protein Expression with Multi-slice Spiral CT Signs of Gastric Cancer

LI Yuzhu, LI Yaping, LI Yanliang

2021, 39(5):  684-688.  DOI: 10.7517/issn.1674-0475.210119

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The purpose of this study was to investigate the relationship between the expression of human epidermal growth factor receptor-2 (HER-2) protein and multi-slice spiral CT (MSCT) signs of gastric cancer. A retrospective study was conducted, 134 cases of gastric cancer patients were selected, the expression of HER-2 was detected by immunohistochemical staining, and the relationship between HER-2 expression and clinicopathological and MSCT signs was analyzed. The results show that the positive expression rate of HER-2 in high differentiated tissues was 57.41%, which was higher than that in low and moderately differentiated tissues (P<0.05). The positive expression rate of HER-2 in tissues with lymph node metastasis was 48.28%, which was higher than that in tissues without lymph node metastasis (P<0.05). The CT value of HER-2 positive expression lesions in venous phase was (87.82±14.45) HU, which was significantly lower than that of HER-2 negative expression lesions (P<0.05). The proportion of highly differentiated tissues with HER-2 expression (+++) was 84.62%, which was higher than that of HER-2 (++) (P<0.05). This study confirmed that HER-2 protein expression is related to gastric cancer differentiation and lymph node metastasis, and is related to the CT value of MSCT venous phase.

Significance of Changes in Quantitative Parameters of Elastic Modulus of SWE Technique in Patients with TI-RADS Grade 4 Hashimoto's Thyroiditis and Thyroid Nodules

ZHAO Hengda, WANG Yi

2021, 39(5):  689-694.  DOI: 10.7517/issn.1674-0475.210121

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The purpose of this study was to investigate the effect of shear wave elastography (SWE) elastic modulus quantification parameters on the differentiation of TI-RADS4 Hashimoto's thyroiditis (HT) with thyroid nodules and its relationship with the biological behavior of malignant nodules. Selected 312 patients (356 nodules) who found suspicious nodules in TI-RADS 4 HT combined with thyroid nodules before thyroid surgery, 215 benign nodules, and malignant nodules 141, malignant nodules Emean, Emax, Esd and angiogenesis genes (VEGF, COX-2, Gal-3), proliferation genes (BRAF, TPX2, MCM7), invasion genes (Sixl) mRNA are higher than benign nodules (P<0.05). The AUC value of Emean, Emax and Esd in differentiating malignant nodules was higher than that of single diagnosis. The mRNA of VEGF, COX-2, Gal-3, BRAF, TPX2, MCM7 and Sixl in malignant nodules were positively correlated with Emean, Emax and Esd, while the mRNA of BRMSI, TSHR, CCNG2, P53 and PTEN were negatively correlated with Emean, Emax and Esd (P<0.05). The elastic modulus parameters Emean, Emax and Esd of SWE technology have a good differential diagnosis value for benign and malignant thyroid nodules, and the specific level can reflect the angiogenesis, cancer cell proliferation and invasive activity of malignant nodules, which can provide reference for clinical diagnosis and treatment and prognosis evaluation of patients.

The Clinical Application Value of MSCT Quantitative Parameters in Evaluating Fatty Liver Disease

WANG Jing, YANG Pengchun, YAN Caihua, DAI Chibing, QIN Tao

2021, 39(5):  695-699.  DOI: 10.7517/issn.1674-0475.210205

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This study was to investigate the practical value of quantitative parameters of multi-slice spiral CT (MSCT) in clinical evaluation of hepatic steatosis. 139 patients with fatty liver who were clearly diagnosed were selected as the fatty liver group, and 70 volunteers who underwent physical examination without liver disease during the same period were selected as the control group. Fatty liver group's liver fat percentage β value, total abdominal fat area (TFA), intra-abdominal fat area (VFA), subcutaneous fat area (SFA) measured values were higher than those of the control group (P<0.05). The liver CT values and liver bone mineral density (BMD) values of the fatty liver group were lower than those of the control group (P<0.05). The AUC values of liver CT value, liver BMD value, liver fat content percentage β value, TFA, VFA and SFA in diagnosing fatty liver were 0.609, 0.567, 0.896, 0.725, 0.848 and 0.674, respectively. MSCT quantitative parameters have high practical value in the clinical evaluation of liver fatty lesions, which can be comprehensively judged from several aspects such as the percentage of liver fat content β value and the area of fat in the abdominal cavity.

The Value of MSCT Three-dimensional Reconstruction Combined with Serum NSE and SCC-Ag in the Diagnosis of the Nature of Small Pulmonary Nodules

HOU Qing, WANG Xin, YANG Huijuan

2021, 39(5):  700-704.  DOI: 10.7517/issn.1674-0475.210211

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This article discusses the value of multi-slice spiral CT (MSCT) three-dimensional reconstruction combined with serum neuron specific enolase (NSE) and squamous cancinoma-associated antigen (SCC-Ag) in the diagnosis of lung malignant nodules. A total of 113 patients with malignant pulmonary nodules diagnosed pathologically after surgery were selected as the malignant group, and 100 patients with benign pulmonary nodules were selected as the benign group. The MSCT three-dimensional reconstruction characteristics, serum NSE and SCC-Ag levels of the two groups were compared, and three were calculated. The value of the method alone or in combination in the diagnosis of malignant pulmonary nodules. The results showed that the detection rate of nodule lobules, outer edge burr, pleural depression, and vascular clustering signs in the malignant group was higher than that in the benign group (P<0.05); the serum NSE and SCC-Ag levels in the malignant group were higher than those in the benign group Patients (P<0.05). The sensitivity of the combined application of serum NSE, SCC-Ag, and MSCT three-dimensional reconstruction in differential diagnosis of pulmonary benign and malignant nodules was 95.58%, and the specificity was 86.00%. It shows that the combined application of the three-dimensional reconstruction features of MSCT, serum NSE, and SCC-Ag has high sensitivity and specificity in the diagnosis and differentiation of small pulmonary nodules.

Chest CT Signs of Patients with Bacterial Infectious Pneumonia and Their Relationship with Lung Inflammation and Prognosis

YANG Haoran, ZHANG Xueqin

2021, 39(5):  705-710.  DOI: 10.7517/issn.1674-0475.210212

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Aim of this study was to investigate the relationship between CT imaging characteristics and inflammatory condition and treatment outcome in patients with bacterial infectious pneumonia. One hundred patients who were clearly diagnosed with bacterial infectious pneumonia by pathogenic examinations were selected as the bacterial group, and 100 patients with viral infectious pneumonia confirmed by serological examinations during the same period were selected as the virus group. The imaging characteristics of the two groups of patients in the advanced stage of the CT examination were compared. According to the critical condition of the patients, the bacterial group was divided into high-risk and intermediate-risk groups, and the bacterial group was divided into survival and death groups according to the 28-day treatment outcome, and compared Differences in lung CT features. In the incidence of lung lobe consolidation and CT signs of aerated bronchial sign, the bacterial group was higher than that of the virus group (P<0.05). As to the comparison of the detection results of ground glass shadow characteristics of the lungs, the bacterial group was lower than the virus group (P<0.05). The detection rate of lung lobe consolidation, lung segment consolidation, pulmonary ground glass shadow, pleural effusion, and air bronchial signs in the high-risk group were higher than those in the intermediate-risk group (P<0.05). The incidence of lung lobe consolidation, segment consolidation, and pleural effusion in the death group were higher than those in the survival group (P<0.05). The death group and the survival group had lung glass shadows, mesh strips, and air-filled bronchial signs. There was no statistically significant difference in incidence (P>0.05). According to the characteristics of chest CT examination, the type of pathogen can be identified to a certain extent, and it has certain reference value for the disease degree and prognosis evaluation of patients with bacterial pneumonia.

Analysis of the Value of S/D Value of Ultrasound Umbilical Artery Combined with Fetal Heart Monitoring in the Diagnosis of Neonatal Asphyxia

LIU Xiaojing, WU Hongxia, ZHU Lijuan

2021, 39(5):  711-715.  DOI: 10.7517/issn.1674-0475.210213

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The aim of this study was to analyze the clinical diagnostic value of maximum blood flow velocity at the end of systole (S)/peak blood flow velocity at end of diastole (D) combined with fetal heart rate monitoring in the clinical diagnosis of neonatal asphyxia. Ninety-eight parturients with neonatal asphyxia were regarded as the asphyxia group, and normal newborns were regarded as the non-asphyxia group (n=98). The fetal heart rate monitoring and the umbilical artery hemodynamic index resistance index (RI), pulsatility index (PI) and S/D values were compared between the two groups. The correlation between fetal heart rate monitoring, S/D value and Apgar score was analyzed. The diagnostic efficacy of fetal heart rate monitoring and S/D value single or combined monitoring for neonatal asphyxia was compared. The abnormal rate of fetal heart rate monitoring in the asphyxia group (87.76%) was higher than that in the non-asphyxia group (18.37%) (P<0.05). The RI, PI and S/D values of the umbilical artery in the asphyxia group were higher than those in the non-asphyxia group (P<0.05). Abnormal fetal heart rate monitoring and S/D value were negatively correlated with Apgar score (P<0.05). The sensitivity and accuracy of combined detection of fetal heart rate monitoring and S/D value were significantly higher than that of single detection (P<0.05). Ultrasound umbilical artery S/D value combined with fetal heart rate monitoring is more effective than single detection in the diagnosis of neonatal asphyxia.

The Value of MET-PET/CT in the Diagnosis of MRI Suspected Glioma and the Evaluation of Malignant Proliferative Behavior

WEI Lin, TANG Wuru, LIAO Yun, WEI Jingjing, LU Yongliang

2021, 39(5):  716-720.  DOI: 10.7517/issn.1674-0475.210312

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A total of 91 cases of patients with glioma suspected to be diagnosed as gliomas after magnetic resonance imaging (MRI) examinations were selected as the research objects. All patients underwent pathological examinations. The sensitivity, specificity and accuracy of ¹¹C-methionine positron emission tomography (MET-PET/CT) technique in the diagnosis of MRI suspected gliomas were 96.72%, 96.67%, and 96.70%, respectively, based on the pathological examination results. The standardized uptake value (SUV) and tumor/normal brain tissue ratio (T/N) were positively correlated with the WHO glioma grade (P<0.05). SUV value, T/N value and Ki-67 proliferation index were positively correlated (P<0.05). It is suggested that the SUV value and T/N value obtained by MET-PET/CT technology can not only non-invasively differentiate the grading of glioma, but also assess the proliferation dynamics and malignant biological behavior of glioma cells. It is expected to become an important supplementary method for MRI diagnosis of glioma.

The Relationship between the Five Parameters of DCE-MRI and the Disease Activity of Rheumatoid Arthritis and Its Clinical Value

ZHENG Jing, REN Shuiming, ZHANG Fengxiang, GAO Qian, GAO Jing, YANG Yongmei, GAO Kaile

2021, 39(5):  721-726.  DOI: 10.7517/issn.1674-0475.210309

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The correlation between the five parameters of dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and the disease activity of patients with rheumatoid arthritis (RA) and the clinical value of joint prediction of short-term prognosis. A total of 105 RA patients were selected as the research objects. They were divided into a good prognosis group (80 cases) and a poor prognosis group (25 cases) according to the treatment response after 6 months of treatment. The results showed that RE, MRE, ME, Slope_max and AUC in DCE-MRI showed an increasing trend with the increase of disease activity, and were positively correlated with disease activity (r=0.759, 0.803, 0.763, 0.666, 0.724, P<0.05). Significantly related to the short-term prognosis. The five parameters of DCE-MRI examination combined predict the short-term prognosis AUC of 0.937, 95%CI of 0.872-0.975, P<0.001, sensitivity of 80.00%, specificity of 95.00%, significantly better than individual forecast.It is suggested that the five parameters of DCE-MRI examination can be used as a reliable method to clinically evaluate the severity of RA and predict the short-term prognosis, and provide a scientific evidence-based basis for the clinic.

The Value of US-FNAB, Serum TSH, TTF-1 in the Diagnosis of Thyroid Microcarcinoma and Its Relationship with Pathological Factors

QIU Shuang, WANG Qingwen, ZHANG Qian, YAN Huishan, LIAO Qian

2021, 39(5):  727-731.  DOI: 10.7517/issn.1674-0475.210310

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A total of 106 patients with thyroid micro carcinoma (TMC) were selected as the study group, and 94 patients with benign thyroid tumors during the same period were selected as the control group. All patients underwent ultrasound-guided fine needle aspiration biopsy (US-FNAB), serum thyroid stimulating hormone (TSH), thyroid transcription factor-1 (TTF-1) examination, and found the positive rate of US-FNAB, serum TSH, TTF-1 and cancer embryonic antigen (CEA), galectin-3 (Gal-3), cytokeratin 19 (CK-19), tumor stage, lymph node metastasis, thyroid cancer invasion are positively correlated, and negatively correlated with the degree of differentiation (P<0.05); US-FNAB, serum TSH, TTF-1 combined diagnosis of TMC with the highest AUC, which is 0.892. It can be seen that US-FNAB, serum TSH, and TTF-1 are all related to the pathological factors of TMC patients, and the combined detection of the three can provide an important basis for clinical diagnosis of TMC and assessment of the severity of TMC.

Application Value of Three-dimensional Ultrasound Quantitative Parameters in the Diagnosis of Intrauterine Adhesions

HUANG Wei, SU Haiqing, LI Yezhao, ZHANG Xia

2021, 39(5):  732-735.  DOI: 10.7517/issn.1674-0475.210311

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The value of three-dimensional ultrasound in the early diagnosis of intrauterine adhesions was explored in this paper. A total of 110 patients with suspected intrauterine adhesions were selected and given three-dimensional vaginal ultrasound and hysteroscopy. Finally, 72 cases were diagnosed as intrauterine adhesions. The proportion of pregnancy times ≥ 2, abortion times ≥ 2 and curettage times ≥ 2 in patients with intrauterine adhesions were significantly higher than those in patients with normal uterine cavity (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of three-dimensional vaginal ultrasound in the diagnosis of intrauterine adhesions were higher than 80.00%. The Kappa value of three-dimensional ultrasound and hysteroscopy was 0.797, P<0.05. The endometrial volume (V), vascularization index (VI), flow index (FI), vascularization flow index (VFI) and endometrial thickness (ET) of patients with moderate to severe adhesions were significantly lower than those of patients with mild adhesions (P<0.05). The area under the ROC curve of moderate and severe adhesion predicted by V, VI, FI, VFI and ET was high, P< 0.05. Three-dimensional ultrasonography has good application value in the early diagnosis of intrauterine adhesions and the degree of adhesions, which is worthy of clinical use.

Analysis of the Characteristics and Influencing Factors of Missed and Misdiagnosed Cases of Breast Cancer Screening by Breast Ultrasonography

SONG Yujuan, LIU Sheng, LIU Meihua, ZHU Lina

2021, 39(5):  736-740.  DOI: 10.7517/issn.1674-0475.210218

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The characteristics of early diagnosis of breast ultrasound in breast cancer were analyzed. The results showed that the diagnosis of breast mass was performed in 2548 cases of breast mass by convenient sampling method. The characteristics of misdiagnosis and missed diagnosis were analyzed in 132 cases of false negative (missed diagnosis) and false positive (misdiagnosis). The missed diagnosis and misdiagnosis of breast cancer by breast ultrasound were not related to the age of patients and the number of lesions (P>0.05). The independent risk factors of missed diagnosis and misdiagnosis in early screening of breast cancer were the maximum diameter of lesion, benign lesion, inflammatory lesion, edge of ultrasound image, microcalcification, axillary lymph node echo, obvious blood flow signal, complex and diverse lesion structure (P<0.05). Early screening of breast cancer using breast ultrasound diagnosis of missed diagnosis, misdiagnosis by a variety of factors, clinical diagnosis should pay special attention to reduce missed diagnosis, misdiagnosis rate.

Use of RT-3DE to Assess Right Ventricular Systolic Function in Patients with Moderate and Severe PAH

CHEN Haifeng, ZHAI Jiang, LI Xiaodong, LIU Hongqiang

2021, 39(5):  741-744.  DOI: 10.7517/issn.1674-0475.210306

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In order to explore the application of real-time three-dimensional echocardiography (RT-3DE) technology in the evaluation of right ventricular systolic function in patients with moderate and severe pulmonary hypertension, 185 patients with pulmonary hypertension admitted were prospectively selected as the research object, and another 150 healthy people in the same period were selected as the control group. The parameters of right ventricular global volume fraction, three-dimensional echocardiography and tricuspid annular displacement were compared. The results showed that the levels of EDV, ESV, RVEDV, RVESV and RVSV in moderate and severe group were higher than those in control group, and the levels of SV, EF, EDV and RVEF in moderate and severe group were lower than those in control group (P<0.05). The values of T1, T2, TM and TM% in moderate and severe group were higher than those in control group (P<0.05). It can be seen that the use of RT-3DE technology in the detection of moderate and severe pulmonary hypertension patients has more accurate diagnostic results.

Study on the Screening Effect of Four-dimensional Transperineal Ultrasound on Mild Pelvic Floor Dysfunction in Postpartum Women with Different Delivery Modes

YAN Chenming, WANG Rui, WANG Miaoying, LI Pengzhou

2021, 39(5):  745-748.  DOI: 10.7517/issn.1674-0475.210201

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This study was to investigate the screening effect of perineal four-dimensional ultrasound on mild pelvic floor dysfunction in postpartum women with different delivery methods. 75 patients with pelvic floor dysfunction were divided into natural delivery group (n=50), forceps delivery group (n=25) and control group (n=85). Four-dimensional ultrasonography of the perineum was performed with color Doppler ultrasonography to diagnose uterine prolapse, prolapse of the anterior vaginal wall, bulge of the anterior rectal wall, puborectalis muscle tear, and bladder neck motion. Check the anterior and posterior diameter of the pelvic diaphragm hiatus (LHAP), the left and right diameter of the pelvic diaphragm hiatus (LHLR), the area of the pelvic diaphragm hiatus (LHA), and the maximum movement of the bladder neck under resting, Valsalva maneuvers and anal contraction maneuvers. The results showed that the detection rate of perineal four-dimensional ultrasound in 75 patients with anterior vaginal wall prolapse, anterior rectal wall bulge, puborectalis muscle tear, and increased bladder neck motion were all higher than that of clinical examination (P<0.05). Under resting, Valsalva maneuvers, and anal contraction maneuvers, the levels of LHLR, LHAP, and LHA in the natural delivery group and forceps delivery group were higher than those in the control group (P<0.05), and there was no significant difference in LHLR, LHAP and LHA between the natural delivery group and the forceps delivery group (P>0.05). The maximum mobility of bladder neck in natural delivery group and forceps delivery group was higher than that of control group (P<0.05). It is confirmed that transperineal four-dimensional ultrasound plays an important role in screening pelvic floor dysfunction in early postpartum women.

Application Value of Magnetic Resonance Imaging, Ultrasonic Elastography and X-ray in Clinical Diagnosis of Breast Cancer

LIU Di, HE Song, NIU Xiangxin, LI Jiaojiao, YANG Fan, ZHANG Bin

2021, 39(5):  749-753.  DOI: 10.7517/issn.1674-0475.210209

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This paper aims to study the application value of magnetic resonance imaging (MRI), ultrasonic elastography (UE) and X-ray in the clinical diagnosis of breast cancer. A total of 147 patients with breast masses were selected, including 10 cases of benign lesions and 137 cases of malignant lesions. MRI, UE and X-ray were performed respectively. Compared with patients with benign lesions, MRI score, SR and X-ray score of patients with malignant lesions were higher (P<0.05). In malignant lesions, the detection rate of MRI in class Ⅴ patients was higher than that of UE and X-ray examination, and the difference was statistically significant (P<0.05). The detection rate of breast cancer in MRI and UE was higher than that in X-ray (P<0.05). The sensitivity and accuracy of three combined detection of breast cancer were higher than three single detection, and the specificity was lower than three single detection (P<0.05). MRI, UE and X-ray play an important role in the diagnosis of benign and malignant breast cancer.

Correlation between MR Diffusion Kurtosis Imaging Parameters and Serum miR-181c, miR-210 Levels in Patients with Acute Cerebral Infarction

ZHANG Yufeng, LIU Yanwu

2021, 39(5):  754-759.  DOI: 10.7517/issn.1674-0475.201205

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The purpose of this study was to investigate the correlation and significance of diffusion kurtosis imaging (DKI) parameters and serum microRNA (miR)-181c, miR-120 levels in patients with acute cerebral infarction. A total of 155 patients with acute cerebral infarction were selected as observation group and 100 healthy people were selected as control group. The levels of serum miR-181c and miR-210 in the two groups were detected, the MRI examination was performed in the observation group, mean kurtosis (MK), radial kurtosis (RK), axial kurtosis (AK), axial diffusion (AD) and mean diffusion (MD) and radial diffusion (RD) were analyzed. The experimental results showed that:The relative expression of miR-181c in the observation group was significantly higher than that in the control group (P<0.05), while the relative expression of miR-120 in the observation group was significantly lower than that in the control group (P<0.05). The MK, RK and AK in the lesion side of the observation group were significantly higher than those in the control side (P<0.05), while those of AD, MD and RD in the observation group were significantly lower than those in the control side (P<0.05). miR-181c was positively correlated with MK and RK (P<0.05), while miR-210 was negatively correlated with AK (P<0.05). Multiple linear regression analysis showed that the relative expression of miR-181c, miR-210, MK, RK, AK were the influencing factors of NIHSS score (P<0.05). This study confirmed that:In patients with acute cerebral infarction, MRI DKI parameters are positively correlated with serum miR-181c, negatively correlated with miR-210, and to some extent with the degree of nerve defect in patients.

Diagnostic Value of CT Examination and Image Post-processing in Lumbar Disc Herniation and Localization Significance of Radiofrequency Ablation

QIAN Xianghui, WANG Bo

2021, 39(5):  760-763.  DOI: 10.7517/issn.1674-0475.201226

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The purpose of this study was to explore the diagnostic value of CT in lumbar disc herniation and the positioning significance of radiofrequency ablation. 103 patients with lumbar disc herniation were selected and given CT examination and CT-guided radiofrequency ablation. The experimental results showed that the accuracy rate of CT examination in the diagnosis of lumbar disc herniation was 90.29%.The proportion of hill-shaped protrusion, nerve root compression or adhesion in severe patients were higher than those in mild to moderate patients (P<0.05), the sagittal diameter and anterior-posterior diameter of dural sac were lower than that of mild to moderate patients (P<0.05).The areas under ROC curve predicted by sagittal diameter and anterior-posterior diameter of dural sac in severe patients were 0.866 and 0.848, respectively (P<0.05). The proportion of hill-shaped protrusion, nerve root compression or adhesion in patients with excellent curative effect were lower than those in patients with non-excellent curative effect (P<0.05), the sagittal diameter and anterior-posterior diameter of dural sac were higher than that of non-excellent patients (P<0.05). This study confirmed that CT has a high value in the diagnosis of lumbar disc herniation, and the effect of CT-guided radiofrequency ablation is good.

Features and Differential Diagnosis of Ultrasound Elastography and Shear Wave Elastography in Non-mass Breast Diseases

LU Xiangfen, HU Xiaohua

2021, 39(5):  764-767.  DOI: 10.7517/issn.1674-0475.210117

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The value of ultrasound elastography (UE) and shear wave elastography (SWE) in non-mass breast lesions was explored in this study. One hundred patients with non-mass breast disease were selected to receive UE and SWE examination, and were compared with the pathological results. The results show that 67 cases of benign lesions and 33 cases of malignant lesions were confirmed by pathology. The rate of UE score ≥ 4 in malignant lesions was 72.37%, which was significantly higher than that in benign lesions (P<0.05). The maximum value of elastic modulus (Emax), the average value of elastic modulus (Emean) and the ratio of elastic modulus of lesions to surrounding tissues (Eratio) were significantly higher than those of benign lesions (P<0.05). There was no significant difference in minimum value of elastic modulus (Emin) of malignant lesions and benign lesions (P>0.05). The accuracy of UE, SWE and UE combined with SWE in differentiating benign and malignant lesions were 80.00%, 87.00% and 92.00%, and the accuracy of UE combined with SWE in differentiating benign and malignant lesions was higher than UE (P<0.05). The results showed that UE and SWE have better application value in differential diagnosis of non-mass breast lesions, is worthy of clinical use.

Application Analysis of Transvaginal Color Doppler Ultrasound in Diagnosis of Uterine Fibroids

WAN Yan, XU Guangguo

2021, 39(5):  768-772.  DOI: 10.7517/issn.1674-0475.210206

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The purpose of this study is to investigate the clinical value of transvaginal color Doppler flow imaging (CDFI) in the diagnosis of uterine fibroids. 100 patients with uterine fibroids were selected as fibroids group and 50 patients with uterine sarcoma were selected as the sarcoma group, all of them confirmed by pathology. The ultrasound imaging characteristics and blood flow distribution of the two groups of patients were compared. The pathological results were used as the standard to analyze the value of CDFI in the differential diagnosis of uterine fibroids and uterine sarcomas. The rate of definition of tumor body boundary, internal solid appearance of fibroids, and the detection rate of hypoechoic tissue in the fibroids group were higher than those in the sarcoma group (P<0.05). The blood flow signal sparse rate of the fibroids group was 78.00%, no blood flow signal rate was 13.00%, and rich blood flow signal rate was 9.00%. The blood flow signal sparse rate of the sarcoma group was 52.00%, no blood flow signal rate was 4.00%, and rich blood flow signal rate was 44.00% (P<0.05). The sensitivity and specificity of the differential diagnosis of uterine fibroids and sarcomas are 82.00% and the specificity is 60.00% by the sound image characteristics; the sensitivity and the specificity are 68.00% and 80.00% for the differential diagnosis of uterine fibroids and sarcomas by the blood flow signal; The sensitivity of signal differential diagnosis of uterine fibroids and sarcomas is 93.00%, and the specificity is 76.00% By analyzing the sound image characteristics and blood flow signals of uterine fibroids and uterine sarcomas, it is possible to effectively differentially diagnose uterine fibroids and uterine sarcomas.

Ultrasound Evaluation of the Relationship between Changes in Pelvic Floor Structure and Stress Urinary Incontinence after Hysterectomy

ZHOU Huili, MI Wanqin, FENG Yuling, TIAN Li, XIANG Hong

2021, 39(5):  773-777.  DOI: 10.7517/issn.1674-0475.210203

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The use of transperineal pelvic floor ultrasound to evaluate the pelvic floor structure changes in patients with stress urinary incontinence after hysterectomy. Collect 91 patients who underwent total hysterectomy as the case group, and 100 healthy women as the control group. The perineal basin ultrasound was used to detect the pelvic floor structure characteristics and change parameters of the two groups of subjects in the resting state and the Valsalva state. And according to whether the patients in the case group suffer from stress urinary incontinence, the patients were stratified and analyzed. The β measured value, Rα value and BND value of patients in the resting state and Valsalva state of the case group were greater than those of the control group, and the difference was statistically significant (P<0.05). The X and D values of patients in the resting state and Valsalva state of the case group were lower than those of the control group, and the difference was statistically significant (P<0.05). In resting state and Valsalva state, the measured β, Rα and BND values of patients with stress urinary incontinence were greater than those of patients without stress urinary incontinence, and there was a significant difference between the two groups (P<0.05). The measured values of X and D were lower than those of patients without stress urinary incontinence and the difference was significant (P<0.05). In the Valsalva state, the α value of patients with stress urinary incontinence was greater than that of patients without stress urinary incontinence, and the difference was statistically significant (P<0.05). Compared with healthy women, the pelvic floor structure parameters of women undergoing total hysterectomy have changed significantly, and the pelvic floor structure changes in patients undergoing stress urinary incontinence are more significant. Transperineal pelvic floor ultrasound can more accurately evaluate the pelvic floor structure changes.