Table of Content

15 November 2021, Volume 39 Issue 6

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2021, 39(6):  0-0. 

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Review and Articles

Recent Progress in Bio-responsive Gadolinium-based MRI Contrast Agent

LIU Yanyue, WU Yongjie, SUN Kang, TAO Ke

2021, 39(6):  781-789.  DOI: 10.7517/issn.1674-0475.210409

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The gadolinium-based contrast agent (GBCA), the most common contrast agent in clinical magnetic resonance (MR) imaging, lacks specificity when detecting diseases and thus makes it difficult to distinguish lesions. Many recent researches have focused on the development of bio-responsive contrast agents which can vary the intensity of MR signals with changes in physiological or pathological environment. This article reviews three current design concepts of bio-responsive GBCAs, expounds the specific methods of promoting relaxation rate and its application in imaging diagnosis, makes a prospect for the development of bio-responsive GBCA, and points out the problems to be solved in the conversion process for clinical application.

Study on Off-axis Dual-wavelength Holographic Imaging

GE Lei, WEN Yongfu, CHENG Haobo

2021, 39(6):  790-797.  DOI: 10.7517/issn.1674-0475.210801

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Digital holographic microscopy (DHM) is a commonly used technique to obtain quantitative information by measuring the phase shifts in light and changes in the refractive index of the sample. In view of the small measurement depth of the single-wavelength holographic microscopic imaging system and the phase ambiguity of the phase unwrapping algorithm, a reflective mode dual-wavelength digital holographic microscopy utilizing dichroic mirror for quantitative phase imaging of 3D structures with extended thickness range is presented, which is based on dual-wavelength off-axis interference technology. This is done by simultaneous acquisition of two off-axis interferograms, each at a different wavelength, and generation of a synthetic wavelength, allowing for an extension of the measurement range. This method is explored by numerical simulation, and then a dual-wavelength digital holographic experimental setup is constructed for imaging the polishing spots obtained by magnetorheological polishing technology and USAF target. In conclusion, the effectiveness and feasibility of the system are preliminarily verified.

Study on CT Multi-sign Diagnosis and Differential Diagnosis of Fungal Infection of Rhinosinus

HU Fengling, LI Yanyan, WANG Junda

2021, 39(6):  798-802.  DOI: 10.7517/issn.1674-0475.210731

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This study explored the diagnosis and differential diagnosis of rhinosinus sinuses with multiple CT signs and multiple signs combined in the diagnosis and differential diagnosis of rhinosinus fungal infections. A total of 107 patients with complete nasal sinus CT scan data and nasal endoscopic histopathological examination are selected with menstruation in the Department of Otolaryngology as the research objects. The gender, age, and CT signs are analyzed. The study showed that the CT signs of fungal infection of the nose and sinuses and other sinus diseases were statistically significant (P<0.05); multivariate logistic regression analysis showed that the soft tissues had high density and calcification in the soft tissues, adjacent to the sinus wall bone hyper-plasia and sclerosis, the lesion is located in the maxillary sinus, which is an independent risk sign; a combined drawing model of the three signs has the highest diagnostic value. Therefore, CT scan multiple signs are of great value for the diagnosis of rhinosinus fungal infections, which can im-prove the accuracy of diagnosis.

Changes and Significance of Enhanced CT Scanning Parameters in Patients with Hemorrhagic Transformation after Acute Cerebral Infarction

LUO Zhiyong, LIU Fuquan

2021, 39(6):  803-807.  DOI: 10.7517/issn.1674-0475.210512

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In order to explore the significance of CT enhanced scanning parameters in patients with hemorrhagic transformation (HT) after acute cerebral infarction (ACI), 200 patients with ACI were divided into bleeding group (n=84) and non bleeding group (n=116) according to whether they had HT. The influencing factors of HT after ACI and the correlation between CT enhanced scanning parameters and NIHSS score were analyzed. The diagnostic value of CT enhanced scanning parameters on HT after ACI was evaluated, and the prognosis was observed. It was found that age, infarct area, NIHSS score, ΔH value, ΔT value and ΔS value were the influencing factors of HT after ACI (P<0.05), and the parameters of CT enhanced scanning ΔH value, ΔT value, ΔS value and infarct area NIHSS score was positively correlated (P<0.05). The AUC of CT enhanced scanning parameters combined with HT after ACI is 0.896, which has a certain diagnostic efficiency, and the 90 day mortality of positive patients is higher than that of negative patients (P<0.05). Therefore, CT enhanced scanning parameters can early diagnose HT after ACI and help to estimate the prognosis of patients.

The Value of WBS Combined with SPECT/CT Tomographic Fusion in the Diagnosis of Solitary Bone Metastases in Extremities of Lung Cancer

WU Fengping, WU Jing

2021, 39(6):  808-812.  DOI: 10.7517/issn.1674-0475.210520

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The purpose of this study was to investigate the value of whole body bone scan (WBS) combined with single photon emission computed tomography (SPECT)/CT fusion in the diagnosis of single bone metastasis in lung cancer limbs. A retrospective study was conducted, 140 cases of lung cancer patients were selected and given WBS, SPECT/CT tomographic fusion examination. The proportion of adenocarcinoma in the bone metastasis group was significantly higher than that in benign bone lesions (P<0.05). The proportion of bone destruction, density change of bone marrow cavity and bone cortical defect in the bone metastasis group were significantly higher than that in benign bone lesions (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of WBS combined with SPECT/CT in diagnosis of bone metastasis were significantly higher than those of WBS (P<0.05). WBS combined with SPECT/CT fusion has a good value in the diagnosis of single bone metastasis in extremities of lung cance.

The Application of MS-CTPA Imaging Parameters in Diagnosis and Severity Evaluation of Acute Pulmonary Embolism

YANG Shenghui, WANG Qi, YANG Quan, CAO Zaimin

2021, 39(6):  813-817.  DOI: 10.7517/issn.1674-0475.210521

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In this study, the imaging parameters of MS-CTPA, including right ventricular diameter (RVD)/left ventricular diameter (LVD), main pulmonary artery (PA)/thoracic aorta (AO), ventricular septal displacement (VSB) and superior vena cava diameter (SVC) in the diagnosis and condition evaluation of acute pulmonary embolism (APE), were investigated in the diagnosis and severity evaluation of acute pulmonary embolism (APE). A total of 127 patients with suspected APE in our hospital were selected and divided into APE group (83 cases) and non APE group (44 cases) according to the results of clinical diagnosis. RVD/LVD, SVC, VSB and PA/AO in APE group were higher than those in non-APE group (P<0.05). ROC curve showed that the AUC of RVD/LVD, PA/AO, SVC and VSB in the diagnosis of APE were 0.844, 0.731, 0.764 and 0.746 respectively, and the AUC of combined diagnosis was 0.932, which was significantly higher than that of single index. RVD/LVD, SVC, PA/AO were positively correlated with paoi (P<0.05). Multiple linear regression analysis showed that RVD/LVD and SVC were significantly correlated with risk stratification after controlling other factors (P<0.05). MS-CTPA imaging parameters RVD/LVD, PA/AO, VSB and SVC are of great value in the diagnosis of APE. RVD/LVD and SVC are significantly correlated with the risk stratification 813 of APE, which can provide guidance for precision medicine.

Early Diagnostic Value of MRI Flair Sequences Combined with aEEG in Critically Ill Preterm Infants with Brain Injury

YAN Lijuan, ZHANG Xiaoli, ZHAI Lina, ZHAI Shufen, PING Lili

2021, 39(6):  818-822.  DOI: 10.7517/issn.1674-0475.210305

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The purpose of this study was to explore the value of magnetic resonance fluid attenuation reversal recovery (MRI FLAIR) sequence combined with amplitude integrated electroencephalography (aEEG) in the early diagnosis of severe preterm infants with brain injury. A total of 163 preterm infants born who were transferred to the neonatal intensive care unit (NICU) were selected. Among them, 85 infants diagnosed with brain injury were assigned to the brain injury group, and 78 preterm infants without brain injury were assigned to the non-brain injury group. The levels of interleukin-6 (IL-6) and neuron specific enolase (NSE) were compared between the two groups by MRI FLAIR sequence detection, aEEG detection and MRI FLAIR combined with aEEG detection. This study showed that compared with the non-brain injury group, the levels of IL-6 and NSE were abnormally increased in the brain injury group (P<0.05). Compared with the non-brain injury group, the values of upper boundary voltage and narrow-band width were higher in the brain injury group, while the values of lower boundary voltage were lower (P<0.05). There were no significant differences in the positive predictive value, specificity and accuracy of aEEG test, 818MRI FLAIR sequence test, MRI FLAIR sequence combined with aEEG test (P>0.05). Compared with aEEG detection and MRI FLAIR sequence detection, MRI FLAIR sequence combined with aEEG detection showed negative predictive value and higher sensitivity, with statistical difference (P<0.05). The results of this study indicate that the use of MRI FLAIR sequence combined with aEEG in the detection of critically premature infants with brain injury has better diagnostic efficacy and better diagnostic value in early diagnosis.

Preliminary Study on the Value of Ultrafast Pulse Wave Velocity in Quantitative Evaluation of Carotid Artery Elasticity in Patients with Systemic Lupus Erythematosus

YANG Yaqi, WEN Junye, GAO Li, CHEN Min, XUE Hongyuan

2021, 39(6):  823-826.  DOI: 10.7517/issn.1674-0475.210307

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The value of ultrafast pulse wave velocity (UFPWV) technique in quantitative evaluation of carotid elasticity in systemic lupus erythematosus (SLE) patients with different carotid intima-media thickness (IMT) was studied. A total of 52 SLE patients were selected and divided into carotid IMT normal group (32 cases) and carotid IMT thickening group (20 cases) according to IMT thickness. Thirty healthy volunteers were selected as healthy group. The results showed that the values of D_s, D_d, β, EP and PWVβ in patients with thickened carotid artery IMT were higher than those in carotid IMT normal group and healthy group (P<0.05).PWVBS and PWVES of patients with carotid IMT thickening group were higher than those of healthy group and carotid IMT normal group (P<0.05). The above research shows that UFPWV technology has important value in evaluating carotid elasticity changes in SLE patients with different carotid IMT, and has certain guiding significance in clinical evaluation of vascular wall lesions in SLE patients.

The Value of Liver/Spleen CT Value and Hepatic Parenchymal Perfusion Parameters in Predicting Anti-fibrosis Effect

ZHANG Di, LI Chunxia

2021, 39(6):  827-830.  DOI: 10.7517/issn.1674-0475.210401

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The study discussed the relationship between liver/spleen CT value, hepatic parenchymal perfusion parameters and hepatic fibrosis degree and predicted the reactive value of anti-fibrosis therapy. 110 patients with liver fibrosis of chronic hepatitis B treated (observation group), 100 healthy volunteers were selected as the control group. The CT value of liver/spleen, portal vein perfusion (PVP), total hepatic perfusion (TLP), hepatic blood flow (HBF) and blood volume (BV) in the observation group were significantly lower than those in the control group (P<0.05). The hepatic arterial perfusion (HAP) and the hepatic perfusion index (HPI) were significantly higher than that of the control group (P<0.05). CT value of liver/spleen, PVP, TLP, HBF and BV were negatively correlated with the degree of liver fibrosis. HAP and HPI were positively correlated with the degree of liver fibrosis. The area under the ROC curve of CT value of liver/spleen, HAP, PVP and TLP to judge the therapeutic effect were 0.661, 0.745, 0. 885 and 0.820, P<0.05. The CT value of liver/spleen and hepatic parenchymal perfusion parameters are correlated with the degree of liver fibrosis, which is valuable in predicting the response of antifibrotic therapy.

Comparative Study of Enhanced CT and Enhanced Magnetic Resonance Imaging in the Diagnosis of Hepatocellular Carcinoma

CHEN Yue, SHEN Junjie

2021, 39(6):  831-835.  DOI: 10.7517/issn.1674-0475.210403

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The purpose of this study was to explore the comparative study of contrast-enhanced CT and contrast-enhanced magnetic resonance imaging (CE-MRI) in the assessment of the size and blood supply of hepatocellular carcinoma (HCC), 112 lesions of 102 patients with HCC were selected, the contrast-enhanced CT and CE-MRI images were compared, chi square test was used to test the differences in sensitivity and specificity between the groups, and Kappa was used to test the consistency of the two methods.The HCC diagnostic sensitivity, specificity and accuracy of enhanced CT and CE-MRI were 90.29% and 94.17%, 88.89% and 88.89%, 90.18% and 93.75% respectively, and the difference was not statistically significant (P>0.05). The lesions measured by contrast-enhanced CT and CE-MRI was not statistically significant (P>0.05). In female and male patients, there was no significant difference in the volume of lesions measured by contrast-enhanced CT and CE-MRI (P>0.05). Among 112 lesions, 99 lesions with rich blood supply and 3 lesions with poor blood supply were determined by contrast-enhanced CT and CE-MRI. The consistency of Kappa value of blood supply was determined by contrast-enhanced CT and CE-MRI was 0.668, P< 0.05. There was no significant difference in blood supply between male and female patients by contrast-enhanced CT and CE-MRI (P>0.05). Contrast-enhanced CT and CE-MRI showed good consistency in the size and blood supply assessment of HCC.

Application Value of Ultrasound in Diagnosis and Treatment of Neonatal Obstructive Jaundice

ZHANG Lixia, ZHU Lei, LI Huifang

2021, 39(6):  836-839.  DOI: 10.7517/issn.1674-0475.210506

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This study discusses the application value of ultrasound in the diagnosis and treatment of neonatal obstructive jaundice. Eighty-two neonates with obstructive jaundice were selected. There were 39 cases of biliary atresia and 43 cases of hepatitis syndrome. The diameter of gallbladder in children with biliary atresia was significantly smaller than that in children with hepatitis syndrome (P<0.05), while the diameter of right hepatic artery, the diameter ratio of right hepatic artery to portal vein and TC syndrome were significantly higher than those in children with hepatitis syndrome (P<0.05). The flow velocity of portal vein in children with biliary atresia was significantly lower than that in children with hepatitis syndrome (P<0.05), while the portal vein congestion index and hepatic artery resistance index were significantly higher than those in children with hepatitis syndrome (P<0.05). Logistic regression analysis was established for gallbladder length, right hepatic artery diameter, right hepatic artery/portal vein diameter ratio, TC sign, portal vein velocity, portal vein congestion index and hepatic artery resistance index, the sensitivity and specificity of diagnosis of biliary atresia were 94.87% and 93.02%. Ultrasound has good application value in the diagnosis of neonatal obstructive jaundice and can provide help for differential diagnosis of biliary atresia and hepatitis syndrome.

The Relationship between Nuclide Imaging and Immunoinflammatory Injury in Patients with Ventricular Reconstruction after Acute Myocardial Infarction

YANG Lihui, DING Weiping

2021, 39(6):  840-844.  DOI: 10.7517/issn.1674-0475.210504

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The purpose of this study was to investigate the role of radionuclide imaging in evaluating ventricular remodeling after acute myocardial infarction and its relationship with immune inflammatory injury. 90 patients with acute myocardial infarction were selected, including 43 patients with left ventricular remodeling and 47 patients without left ventricular remodeling. The left ventricular remodeling in patients with left ventricular end-diastolic volume index (LVEDVI), left ventricular end systolic volume index (LVESVI), summed thickening score (STS), total perfusion defect (TPD), survival myocardium, scar myocardium, endothelin-1 (ET-1), high sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor α (TNF-α) were significantly higher than those without left ventricular remodeling (P<0.05). The level of serum nitric oxide (NO) and left ventricular ejection fraction (LVEF) in patients with left ventricular remodeling was significantly lower than that in patients without left ventricular 840 remodeling (P<0.05). STS was positively correlated with ET-1 and hs-CRP (r=0.333 and 0.429, P<0.05); STS, ET-1 and hs-CRP were the influencing factors of ventricular remodeling after acute myocardial infarction (P<0.05). Radionuclide imaging has a certain value in the evaluation of ventricular remodeling after acute myocardial infarction, which is related to vascular endothelial injury and inflammatory factors.

Preliminary Study of Enhanced CT Parameters in Differential Diagnosis of Benign and Malignant Renal Tumors

ZHANG Qinglin, ZHUANG Meixiang, LUO Xueping

2021, 39(6):  845-848.  DOI: 10.7517/issn.1674-0475.210505

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This study explored the value of enhanced CT scan parameters in differentiating benign and malignant renal tumors. 66 patients with renal tumors were selected, all patients were given enhanced CT scanning, 30 were malignant and 36 were benign. The CT value of lesions, the relative renal cortex corrected CT value and the relative renal cortex corrected CT value in the excretion phase in the malignant group were significantly lower than those in the benign group (P<0.05), and the gray value ratio in the malignant group was significantly higher than that in the benign group (P<0.05). The area under the ROC curve of CT value, gray value ratio, relative renal cortex corrected CT value and relative renal cortex corrected CT value in the diagnosis of renal malignant tumor were 0.732, 0.731, 0.772 and 0.843, respectively, P<0.05. Logistic regression was established for lesion CT value, grayscale value ratio, relative cortical corrected CT value in plain scan period and relative cortical corrected CT value in excretory period, the area under the ROC curve of this model for the diagnosis of renal malignant tumor was 0.940, P<0.05. The parameters of enhanced CT have a good application value in the differential diagnosis of benign and malignant renal tumors.

Application of Dynamic Contrast-enhanced MRI and CT in Differential Diagnosis of Adrenal Adenoma and Metastasis

YANG Guangyang, LONG Haiqing, ZHANG Ying, YANG Hailang, SU Qiang, ZHAO Weihua

2021, 39(6):  849-853.  DOI: 10.7517/issn.1674-0475.210508

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This study investigated the application of dynamic contrast-enhanced MRI and CT in the differential diagnosis of adrenal adenoma and metastasis. 73 patients with adrenal tumors were divided into adrenal adenoma group and adrenal metastasis group according to the type of adrenal tumors. All of patients underwent DCE MRI and CT. The relevant parameters were recorded to analyze the tumor clearance rates based on MRI examination with CT clearance rate at each time point. There were significant between-group differences about tumor size and morphology, T2WI signal, enhancement degree and plain scan CT value (P<0.05). After 3 min, 5 min, 7 min and 9 min of injection, CT clearance rates between groups were significantly different (P<0.05). After 5 min, 7 min and 9 min of injection, MRI clearance rate were positively correlated with CT clearance rate. Dynamic contrast-enhanced MRI and CT examination is important to differential diagnosis of adrenal adenoma and metastasis.

Application of OCTA Technique in Macular Microcirculation after Cataract Surgery

PENG Zhiwei, XU Fei, QIN Xianjie

2021, 39(6):  854-859.  DOI: 10.7517/issn.1674-0475.210509

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This paper exploresd the application value of optical coherence tomography angiography (OCTA) in the changes of macular microcirculation after cataract surgery. Sixty cases (60 eyes) of cataract patients in our hospital were divided into poor group and good group according to the best corrected visual acuity (BCVA) one month after operation. OCTA was performed before and after the operation. In the good group, the full-thickness and inner-layer average retinal thickness and DCP around the macular fovea were higher than those before the operation, and the macular FAZ area was smaller than that before the operation. In the bad group, the full-thickness and inner-layer average retinal thickness of the macular area was lower than that in the good group, and the macular FAZ area was larger than that in the good group, one month after operation, DCP around macular fovea was lower than that in good group (P<0.05). The mean retinal thickness of the whole and inner layers of the macular region before operation was positively correlated with BCVA, and the macular FAZ area was negatively correlated with BCVA. The mean retinal thickness of the whole and inner layers of the macular region before operation and 1 month after operation, the macular FAZ area, and the peripheral DCP of the macular fovea one month after operation were significantly correlated with poor postoperative visual recovery (P<0.05). It is suggested that the parameters of macular microcirculation measured by OCTA have a good evaluation effect on BCVA after cataract surgery.

The Value of Multimodal Magnetic Resonance Imaging Parameters in the Diagnosis of Mild to Moderate Neonatal Hypoxic-ischemic Encephalopathy

LIU Lu, QU Haixin, ZHANG Lina

2021, 39(6):  860-864.  DOI: 10.7517/issn.1674-0475.210507

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This study was to investigate the value of multimodal magnetic resonance imaging (MRI) parameters in the diagnosis of neonatal hypoxic-ischemic encephalopathy. A total of 54 neonates with mild hypoxic-ischemic encephalopathy and 34 neonates with moderate hypoxic-ischemic encephalopathy were selected, and received conventional MRI scan, diffusion tensor imaging and light proton magnetic resonance spectrum scan. The fractional anisotropy (FA) values of posterior limb and thalamus, N-acetylaspartate (NAA)/creatine (Cr) and NAA/choline complex (Cho) in moderate group were significantly lower than those in mild group (P<0.05). The area under ROC curve of basal ganglia score, watershed score, FA value of posterior limb of internal capsule, FA value of thalamus, NAA/Cr and NAA/Cho in the differentiation of mild to moderate neonatal hypoxic-ischemic encephalopathy were all more than 0.700 (P<0.05), while the sensitivity and specificity of combined detection reached 96.00% and 98.00%. MRI multimodal parameters have a good value in the diagnosis of neonatal hypoxic-is chemic encephalopathy, has a certain value in differentiating the degree of the disease.

Evaluation of 3.0T MRI on the Degree of Injury and Therapeutic Effect of Patients with Lateral Ankle Ligament Injury

LIU Junli, BAO Pengcheng

2021, 39(6):  865-870.  DOI: 10.7517/issn.1674-0475.210407

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A total of 80 patients with lateral ligament injury of ankle joint were selected as the research object to explore the significance of 3.0T magnetic resonance imaging (MRI) in the evaluation of injury degree and treatment effect. The thickness of the anterior talofibular ligament in the affected side was higher than that in the healthy side (P<0.05). The thickness of the anterior talofibular ligament in the affected side was positively correlated with the degree of injury (P<0.05). The degree of injury, course of disease, previous ankle injury, and the thickness of the anterior talofibular ligament at 4, 8 and 12 weeks after treatment were all the influencing factors for the poor curative effect of patients with lateral ankle ligament injury (P<0.05). The AUC values of talofibular anterior ligament thickness were 0.760, 0.823 and 0.869 at 4, 8 and 12 weeks after treatment, respectively. The AUC value was the highest at 12 weeks after treatment. Therefore, 3.0T MRI can clearly show the pathological changes after lateral ankle ligament injury, accurately evaluate the location and degree of injury, which is conducive to clinical efficacy evaluation, and provide accurate imaging basis for the selection of the best treatment method.

Significance of 256 Slice Spiral CT Angiography in Diagnosis of Coronary Artery Disease and Detection of Myocardial Bridge

XIE Linhong, LI Long, LU Lijian

2021, 39(6):  871-874.  DOI: 10.7517/issn.1674-0475.210510

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This study explored the significance of 256 slice spiral CT angiography (CTA) in the diagnosis of coronary artery disease and the detection of myocardial bridge.172 patients with suspected coronary heart disease were selected, the CTA and coronary angiography (CAG) were performed. The Kappa value of CTA and CAG in the diagnosis of coronary heart disease was 0.801, P<0.05, showed excellent consistency. The Kappa value of CTA and CAG in determining the degree of coronary artery stenosis was 0.817, P<0.05, which showed excellent consistency. The Kappa value of CTA and CAG in the diagnosis of myocardial bridge was 0.758, P<0.05, showed excellent consistency. The thickness of myocardial bridge in patients with myocardial bridge and coronary heart disease was significantly higher than that in patients without coronary heart disease (P<0.05). The area under the ROC curve for predicting myocardial bridge thickness in patients with myocardial bridge and coronary heart disease was 0.900, P<0.05. The 256-layer CTA has a good value in the diagnosis of coronary artery disease and myocardial bridge, and is worthy of clinical use.

Diagnostic Value of Ultrasound Features in Lymph Node Metastasis of PTMC

DONG Jun, LIU Jun

2021, 39(6):  875-878.  DOI: 10.7517/issn.1674-0475.210513

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This research to investigate the diagnostic value of ultrasound features in lymph node metastasis of thyroid papillary microcarcinoma (PTMC). Seventy patients with PTMC were detected by ultrasound examination, in which the age, extraglandular invasion, longitudinal image aspect ratio >1.0, transverse image aspect ratio >1.0, diameter ≥ 5 mm, microcalcification, unclear boundary, nodule contact (or invasion) capsule length/nodule perimeter ≥ 1/4 ratio of patients with cervical lymph node metastasis were significantly higher than those without cervical lymph node metastasis Patients with lymph node metastasis (P<0.05). Logistic regression analysis showed that age, extraglandular invasion, aspect ratio of longitudinal image >1.0, nodule contact (or invasion) capsule length/nodule perimeter ≥ 1/4 and microcalcification were the influencing factors of cervical lymph node metastasis in PTMC patients (P<0.05). The area under ROC curve of influencing factors to establish the Logistic regression equation was 0.822 (P<0.05), while the sensitivity and specificity of diagnosis of cervical lymph node metastasis were 81.50% and 83.00%, respectively. The ultrasound features has a good application value in the diagnosis of cervical lymph node metastasis of PTMC.

Application of Ultra-high Frequency Pure Wave Ultrasound Measurement of Fetal Third Ventricle in Prenatal Screening in Late Pregnancy

LIANG Yanling, WANG Jinsong, HE Jiahui, LIU Deyong

2021, 39(6):  879-882.  DOI: 10.7517/issn.1674-0475.210515

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A total of 300 pregnant women in our hospital who underwent routine antenatal secondary obstetric ultrasound examination were selected, all of whom underwent ultra-high frequency pure wave ultrasound examination at 28-40 weeks in the third trimester. The results showed that the morphology of the third ventricle of 300 fetuses was divided into 14 cases (4.67%) with similar single-line sign, 265 cases with parallel line sign (88.33%), and 21 cases with "V" sign (7.00%). The width and anteroposterior diameter of the third ventricle were positively correlated with the gestational age and biparietal diameter of pregnant women (P<0.05). The 95% reference values of the width and anteroposterior diameters of the third ventricle of 300 pregnant women were 1.21-1.64 mm and 10.00-10.41 mm, respectively. It is suggested that the use of ultra-high frequency pure wave ultrasound to measure the third ventricle of the fetus in the third trimester of pregnancy is helpful to obtain clearer ventricle morphology and measurement data. It can also provide an important reference for clinical prenatal diagnosis and screening of central nervous system malformations.

IVUS in the Diagnosis of Coronary Atherosclerotic Plaque and Nutrient Vessels

XI Jianfen, GUO Li, JIA Xiaojing

2021, 39(6):  883-887.  DOI: 10.7517/issn.1674-0475.210518

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This study was to investigate the value of intravascular ultrasound (IVUS) in the diagnosis of coronary atherosclerotic plaque and nourishing blood vessels. A total of 38 patients with acute coronary syndrome (ACS) and 52 patients with stable angina pectris (SAP) were selected. All patients were given IVUS examination. Meanwhile, serum lipoprotein associated phospholipase A2 (LP-PLA2) was detected by ELISA in patients with coronary heart disease. The vascular remodeling index, plaque eccentricity index, necrotic tissue area, the total incidence of vulnerable plaque and serum Lp-PLA2 in ACS group were significantly higher than those in SAP group (P<0.05), the calcified tissue area, fibrous tissue area and lipid/necrotic tissue area were significantly lower than SAP group (P<0.05). Serum Lp-PLA2 was positively correlated with IVUS parameters vascular remodeling index and lipid/necrotic tissue area. The number of nutrient vessels at the minimal lumen section, proximal section and distal section in ACS group were significantly more than those in SAP group (P<0.05). IVUS showed that the incidence of vulnerable plaque and the number of plaque nourishing vessels in ACS patients are significantly higher than those in SAP patients, some parameters of IVUS are correlated with serum Lp-PLA2.

The Characteristics and Value of Hemodynamic Parameters in CDFI Diagnosis of Infant with Biliary Atresia

WANG Lingling, QU Haixin

2021, 39(6):  888-891.  DOI: 10.7517/issn.1674-0475.210517

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This study explored the clinical application value of color Doppler flow imaging (CDFI) in the diagnosis of biliary atresia (BA). Sixty-eight infants with persistent jaundice and biliary atresia were selected as BA group, and 64 healthy newborns during the same period were selected as the control group. CDFI examination was performed on both groups to analyze the changes in ultrasonic characteristics. The results showed that the abnormality rate of gallbladder morphology in the BA group was 89.71%, the ultrasound display rate of the left and right hepatic ducts in the BA group was 100.00%, and the extrahepatic bile duct ultrasound display rate in the BA group was 100.00%, which were all higher than that of the control group (P<0.05). The AUC values of mean portal velocity (Vpv), anteroposterior diameter of portal vein (Dha), portal vein resistance index (RIha) and splenic vein resistance index (RIspa) were 0.899, 0.774, 0.731 and 0.648, respectively. CDFI has high clinical practical value as a non-invasive method for diagnosing children with BA, and it is of high value to make comprehensive judgments based on the gallbladder morphology and blood flow parameters.

Risk Factors of Aspiration after Stroke and Evaluation of Swallowing Function by VFSS

LI Yanfang, CHEN Wei, ZHOU Xiaoxiang, WANG Xuejiao, BAO Qing

2021, 39(6):  892-895.  DOI: 10.7517/issn.1674-0475.210315

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This article discussed the risk factors of aspiration in stroke patients and the value of using contrast examination to assess the swallowing function of patients. A total of 90 patients with aspiration after confirmed stroke were selected as aspiration group, and 90 patients without aspiration after stroke were selected as control group during the same period. The risk factors of aspiration were analyzed, and the swallowing function of the two groups was evaluated by video fluoroscopic swallowing study (VFSS). The results showed that the NIHSS score, past stroke rate, and stroke location of the aspiration group were compared with the control group, and the difference was statistically significant. High NIHSS scores in stroke patients, previous stroke history, and brainstem stroke were independent risk factors for aspiration. The measured values of OTT and STT of patients in the aspiration group were higher than those of the control group, while the measured values of DT were lower than those of the control group. It shows that severe neurological deficits, brainstem stroke, and past history of stroke are risk factors for aspiration in stroke patients. The use of VFSS has high clinical value for detecting and diagnosing swallowing dysfunction in stroke patients.

Value of Three-dimensional Tomographic Ultrasound Combined with Contrast-enhanced Ultrasound in the Evaluation in Patients with DTC

ZAHNG Shuo, WANG Shuwen, GUO Xuemin, XU Hong, WANG Yanxiang, ZHANG Xia, YANG Li

2021, 39(6):  896-901.  DOI: 10.7517/issn.1674-0475.210522

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The purpose of this study was to investigate the value of three-dimensional tomographic ultrasound imaging combined with contrast-enhanced ultrasound in the evaluation of cervical lymph node properties and extra-adenal invasion in patients with differentiated thyroid cancer (DTC). Nighty-three patients with DTC were selected, three dimensional tomographic ultrasound imaging combined with contrast-enhanced ultrasound was performed. The ratio of long to short diameter was lower than 1.5, disappearance of lymphatic portal structure, mixed blood flow, centripetal angiography, heterogeneous angiography of metastatic lymph nodes were significantly higher than those of non metastatic lymph nodes (P<0.05). Logistic regression analysis showed that the ratio of long to short diameter, the structure of lymph nodes, the mode of angiography, the degree of angiography, PI, MTT and TTP were the influencing factors of metastatic lymph nodes (P<0.05). Logistic regression analysis showed that the extension and breakthrough of thyroid capsule, MTT and TTP were the influencing factors of metastatic lymph nodes (P<0.05). Three dimensional tomographic ultrasound combined with contrast-enhanced ultrasound has a good effect in the evaluation of cervical lymph node metastasis and extra-glandular invasion in patients with DTC.

Energy Spectrum CT Omics Nomogram in the Detection and Misdiagnosis Analysis of Gastric Neurosecretory Tumors

YAN Jun, NIAN Weiguo, LI Xinjuan

2021, 39(6):  902-905.  DOI: 10.7517/issn.1674-0475.210503

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The purpose of this study was to explore the application of energy spectrum CT omics nomogram in the detection and misdiagnosis analysis of gastric neurosecretory tumors. A total of 34 patients with gastric neurosecretory tumors were selected and divided into training set (25 cases) and test set (9 cases) according to the completely random method. Energy spectrum CT imaging omics analysis of lesion characteristics; LASSO regression to establish imaging omics risk score; Bootstrap method to analyze the AUC, specificity, sensitivity and misdiagnosis rate under the ROC curve. The training set and the test set showed significant differences in tumor size, lymph node enlargement, and venous tumor thrombus (P<0.05). Compared with low-grade patients, high-grade patients had higher risk scores (P<0.05). Validated by Bootstrap method, the misdiagnosis rate in the training set is 8.00%, AUC 0.940, specificity 92.0%, and sensitivity 95.4%; the misdiagnosis rate in the test set is 11.11%, AUC 0.859, specificity 88.89%, and sensitivity 77.6%. In conclusion, the power spectrum CT omics nomogram has good predictive performance in the detection and misdiagnosis analysis of gastric neurosecretory tumors.

The Value of Magnetic Resonance Diffusion Tensor Imaging Combined with Acoustic Radiation Force Impulse in the Diagnosis of Renal Dysfunction

ZHANG Li, ZHANG Bin, LIU Hongjie, CHENG Jinxiu, LANG Xiaoyan, YANG Wen

2021, 39(6):  906-910.  DOI: 10.7517/issn.1674-0475.210316

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Magnetic resonance diffusion tensor imaging (DTI) combined with acoustic pulsed radiation force imaging (ARFI) was used to measure the renal cortex of both kidneys in renal insufficiency group and healthy control group, and the diagnostic value of DTI and ARFI combined in renal insufficiency was discussed. The results showed that the shear wave velocity (SWV) of renal parenchyma, renal sinus and the junction of renal parenchyma and renal sinus in renal insufficiency group was higher than that in healthy control group (P<0.05).The SWV values of renal parenchyma, renal sinus and the junction of renal parenchyma and renal sinus in stage Ⅳ were higher than those in stage Ⅲ, Ⅱ andⅠ in RENAL insufficiency group (P<0.05). The combination of DTI and ARFI techniques can quantitatively diagnose the degree of renal dysfunction qualitatively, with a high sensitivity, which can be 906 used as a diagnostic basis for staging renal dysfunction and has high clinical value.

Diagnostic Value of CT Myocardial Perfusion Imaging and ECV in OMI and Their Relationship with Myocardial Injury

LIU Shuo, ZHOU Hao, ZHANG Mengqi, Palidan Nyaz

2021, 39(6):  911-915.  DOI: 10.7517/issn.1674-0475.210511

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This study explored the value of CT myocardial perfusion imaging (CT-MPI) and extracellular volume (ECV) in the diagnosis of old myocardial infarction (OMI) and their correlation with myocardial injury. A total of 82 patients with OMI were selected as the observation group and 30 healthy subjects in the same period were selected as the control group. The CT-MPI parameters and ECV of the two groups were compared, the influencing factors of OMI and the relationship between CT-MPI parameters, ECV and myocardial injury indexes were analyzed, and the diagnostic value of CT-MPI parameters and ECV for OMI was evaluated. The levels of cTnI, cTnT and ECV in the observation group were higher than those in the control group, MBF and MBV were lower than those in the control group, and all indexes were the influencing factors of OMI (P<0.05); MBF and MBV were negatively correlated with cTnI and cTnT levels, while ECV was positively correlated with cTnI and cTnT levels (P<0.05). The maximum AUC of OMI diagnosed by MBF, MBV and ECV was 0.950. CT-MPI parameters MBF, MBV and ECV are related to myocardial injury in patients with OMI. The detection of CT-MPI parameters and ECV can effectively diagnose OMI and facilitate clinical diagnosis and treatment.

Clinical Application Value of GI-RADS Reporting System Combined with Serum Tumor Markers in Differentiating Benign and Malignant Ovarian Masses

YAN Ling, SUN Jianxia, ZHANG Ting, JIA Huaping

2021, 39(6):  916-919.  DOI: 10.7517/issn.1674-0475.210516

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This study was to investigate the value of gynecological imaging reporting and data system (GI-RADS) combined with serum tumor markers in the differential diagnosis of benign and malignant ovarian masses. The ultrasonic imaging data of 132 patients with ovarian masses were reviewed. There were 90 patients with benign masses and 42 patients with malignant masses. the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of parallel diagnosis of GI-RADS combined with serum tumor markers were 83.33%, 74.44%, 77.27%, 60.34% and 90.54%, respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of tandem method were 64.29%, 90.00%, 81.82%, 75.00% and 84.38%, respectively. GI-RADS combined with serum tumor markers has good clinical application value in the differential diagnosis of benign and malignant ovarian masses.