Table of Content

15 May 2022, Volume 40 Issue 3

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2022, 40(3):  0-0. 

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Review and Articles

Application of Transvaginal Three-dimensional Ultrasonography in the Diagnosis of Cornual Pregnancy and Tubal Interstitial Pregnancy

LIAO Fenghua, LI Rong, CHEN Chunlin, WANG Min, HU Hongbo, LIU Zongjiao

2022, 40(3):  443-447.  DOI: 10.7517/issn.1674-0475.211210

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This study discussed the value of transvaginal three-dimensional ultrasound in the differential diagnosis of cornual pregnancy and tubal interstitial pregnancy. 55 cases of cornual pregnancy and 60 cases of tubal interstitial pregnancy were selected retrospectively, and compared the differences of ultrasonic image characteristics and quantitative parameters between the two group. The gestational sac bulge, the proportion of intact uterine cavity and the end diastolic velocity (EDV) of trophoblast artery in cornual pregnancy were significantly lower than those in tubal interstitial pregnancy (P<0.05), while the proportion of peripheral myometrium is intact, endometrial wrapping or adjacent, the thickness of peripheral myometrial wrapping of gestational sac and the resistance index (RI) of trophoblast artery were significantly higher than those in tubal interstitial pregnancy (P<0.05). The area under ROC curve of myometrial wrapping thickness around gestational sac, trophoblastic artery EDV combined with trophoblastic artery RI in differentiating cornual pregnancy and tubal interstitial pregnancy was 0.865, P<0.05. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of transvaginal three-dimensional ultrasonography in differential diagnosis of cornual pregnancy and tubal interstitial pregnancy were higher than 80.00%, transvaginal three-dimensional ultrasound has good application value in the differential diagnosis of cornual pregnancy and tubal interstitial pregnancy.

Value Analysis of CT Three-dimensional Reconstruction before THA for Prosthesis Implantation Simulation

ZHANG Jingtang, ZHANG Binbin, LI Haiya

2022, 40(3):  448-452.  DOI: 10.7517/issn.1674-0475.211203

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This study investigated the clinical application value of prosthesis implant simulation using CT three-dimensional reconstruction before total hip arthroplasty (THA). Selected 93 patients who were to undergo THA surgery and divided them into reconstruction group with 47 cases (preoperative CT three-dimensional reconstruction to simulate acetabular prosthesis implantation) and conventional group with 46 cases by random number table. Both groups underwent direct anterior approach total hip arthroplasty in the lateral decubitus position. There was no significant difference in the outer diameter of the cup, cup abduction angle, horizontal distance of the cup rotation center and vertical distance of the cup rotation center between predicted by the preoperative CT three-dimensional reconstruction simulation in the reconstruction group and the intraoperative measurement results (P>0.05). One month after operation, the measured values of SLS and stride length in the reconstruction group were significantly higher than those in the conventional group, and the difference was statistically significant (P<0.05). The distribution of joint function was better than that of the conventional group and the difference was statistically significant (P<0.05). Using CT 3D reconstruction to perform prosthesis implantation simulation before THA can effectively improve the surgical effect, improve the accuracy of prosthesis implantation, and has a better effect on improving the patient's hip joint function and postoperative gait function.

The Relationship between Sinus CT Score, EOS Count and CRSwNP Patients Complicated with AAHR

XIE Huanqing, XU Guozhen

2022, 40(3):  453-458.  DOI: 10.7517/issn.1674-0475.211142

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This study investigated the value of sinus CT score and eosinophil (EOS) count in the diagnosis of chronic rhinosinusitis with nasal polyps (CRSwNP) complicated with asymptomatic airway hyperresponsiveness (AAHR). A clinical study was conducted on 127 confirmed CRSwNP patients, according to whether the patients were accompanied by AAHR, they were divided into observation group (71 cases) and CRSwNP patients without airway hyperresponsiveness (56 cases) as control group. Performed the sinus CT three-dimensional reconstruction and scoring, and detected the levels of EOS in nasal polyps and peripheral blood of the two groups. The expression levels of EOS in nasal polyps and peripheral blood tissues of the observation group were higher than those of the control group (P<0.05). The AUC value of EOS in nasal polyps to diagnose CRSwNP patients complicated with AAHR was 0.852, and in peripheral was 0.821. The CT scores of olfactory cleft and ethmoid sinus in the observation group were significantly higher than those in the control group (P<0.05). There was no significant difference in maxillary sinus CT scores between the observation group and the control group (P>0.05). The AUC value of olfactory fissure CT score in the diagnosis of CRSwNP patients complicated with AAHR was 0.761, and of ethmoid sinus was 0.864. CRSwNP patients complicated with AAHR are serious. The detection of EOS expression and sinus CT scores have a certain value in judging whether CRSwNP patients complicated with AAHR.

The Clinical Significance of TIBI Classification and TCD Blood Flow Reversal before and after Thrombolysis in MCA Occlusion Patients

CHEN Shangchao, HU Mingyan

2022, 40(3):  459-463.  DOI: 10.7517/issn.1674-0475.211116

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This study explored the relationship between the transcranial Doppler (TCD) assessment of cerebral ischemia thrombolytic classification (TIBI), TCD blood flow reversal and the prognosis of patients with acute middle cerebral artery (MCA) occlusive stroke. Chosen 144 MCA occlusive stroke patients as the research objects, all patients were treated with intravenous alteplase thrombolysis. According to the prognosis of patients within 90 days of onset, they were divided into a good prognosis group with 98 cases and a poor prognosis group with 46 cases, and compared the cerebral ischemia thrombolysis classification (TIBI) and TCD blood flow reversal before and after thrombolysis between the two groups. Re-examined 24 hours after the operation, the TIBI blood flow classification distribution of the good prognosis group was better than that of the poor prognosis group (P<0.05). The AUC values of TIBI blood flow improvement and TCD blood flow reversal rate predicted the prognosis of patients with MCA occlusive stroke after thrombolytic therapy were 0.757 and 0.578, respectively. The higher NIHSS scores, diabetes, coronary heart disease, and atrial fibrillation at admission would significantly increase the risk of poor prognosis on admission (P<0.05). After thrombolysis, TIBI blood flow was improved and TCD blood flow was improved and reversal reduced the risk of poor prognosis in patients (P<0.05). Through early observation of TIBI blood flow improvement after thrombolytic therapy and TCD blood flow reversal could have a certain clinical value for evaluating the prognosis of patients, and the two can effectively complement each other.

The Evaluation of Renal Blood Perfusion after Atherosclerotic Renal Artery Stenosis by rTCEUS

ZHANG Yan, XUE Yinghong, JI Donghui

2022, 40(3):  464-468.  DOI: 10.7517/issn.1674-0475.211125

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This paper explored the value of real-time contrast-enhanced ultrasonography (rTCEUS) in evaluating renal blood perfusion after percutaneous transluminal renal angioplasty and PTRAS in patients with severe atherosclerotic renal artery stenosis. 31 patients with severe atherosclerotic renal artery stenosis (ARAS 70%) who received PTRAS were selected as the research objects, and all patients underwent color-coded duplex ultrasound (CCDS) and rTCEUS, respectively and compared the time-intensity curve (TIC) parameters of rTCEUS contrast enhancement in patients before and after PTRAS. The morphological changes of TIC before and after PTRAS were recorded, and the correlation between the parameters before and after PTRAS and the estimated glomerular filtration rate (EGFR) was calculated. The peak intensity (PI) and rising slope (S) of the curve after PTRAS were significantly higher than those before PTRAS (P<0.05), while the peak time (TTP) and mean transit time (MTT) were significantly lower than those before PTRAS (P<0.05). There had no significant differences in the area under the curve (AUC), AUC-influx (AUC-WI) and AUC-clearance (AUC-WO) between pre-PTRAS and post-PTRAS (P>0.05). There was no correlation between ΔEGFR and ΔTTP, ΔMTT, ΔS, ΔAUC, ΔAUC-WI and ΔAUC-WO (all P>0.05) except ΔPI with positive correlation (P<0.05). Parameters obtained by rTCEUS have a great value in evaluating the changes of renal blood flow in patients with severe renal artery stenosis after PTRAS.

The Dose Rate Estimation and Medical Biomedical Protection of Iatrogenic Ionizing Radiation

DONG Yajun, CHENG Qiangli

2022, 40(3):  469-473.  DOI: 10.7517/issn.1674-0475.211135

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The dose of iatrogenic ionizing radiation suffered in the process of medical image shooting may induce cancer. How to accurately estimate the dose rate and reduce the technical error of iatrogenic ionizing radiation, this paper proposes a research method of dose rate estimation of iatrogenic ionizing radiation and medical biomedical protection. After constructing the survival model of human stem cells, the organ dose was estimated by passive efficiency calibration method combined with conversion coefficient, through the relevant theory of radiation accident dose to combine the available dose to obtain the parameter information required for estimation. The whole body effective dose was estimated by the measured air specific release kinetic energy, and the dose rate of iatrogenic ionizing radiation is quickly estimated. Through the comparison of quality assurance method and statistical method, it is verified whether the hypothetical radiation situation is the same as the actual situation. The experimental results showed that this method can quickly and accurately estimate the dose rate of iatrogenic ionizing radiation, and give the corresponding biomedical protection measures in time.

The Value of Transvaginal Three-dimensional Ultrasound in the Diagnosis of Type Ⅱ Cornual Pregnancy and Tubal Interstitial Pregnancy

WEI Xinglai, LV Wei, LIANG Jiemei, KONG Xiaoling, LIAO Liping, SU Qin, LI Rong

2022, 40(3):  474-478.  DOI: 10.7517/issn.1674-0475.211117

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This paper discussed the application value of transvaginal three-dimensional ultrasound in the diagnosis of type Ⅱ cornual pregnancy and tubal interstitial pregnancy. Chosen 44 cases of Ⅱ type cornual pregnancy and 38 cases of tubal interstitial pregnancy to analyzed the differences between the results of ultrasonography and surgical pathology. The accuracy of transvaginal three-dimensional ultrasound in the diagnosis of tubal interstitial pregnancy and cornual pregnancy were 78.95% and 86.36% with difference had no statistically significant (P>0.05). In the ultrasonic features of cornual pregnancy, the proportion of protruding lesion mass was significantly lower than that of tubal interstitial pregnancy (P<0.05), while the proportion of cornual intrauterine asymmetry was significantly higher than that of tubal interstitial pregnancy (P<0.05). There was no significant difference in the ultrasonic characteristics of lesion location, corneal myometrium symmetry, boundary, peripheral muscular layer, endometrial continuity and stromal line sign between uterine horn pregnancy and stromal pregnancy (P>0.05). The proportion of vaginal bleeding in cornual pregnancy was significantly higher than that in tubal interstitial pregnancy (P<0.05). Transvaginal three-dimensional ultrasound has good value in the diagnosis of type Ⅱ cornual pregnancy and tubal interstitial pregnancy.

The Study of Spectral CT Signs and Energy Attenuation Curve in Evaluating the Degree of Lung Adenocarcinoma Invasion

TIAN Xuetao, NIE Jun

2022, 40(3):  479-484.  DOI: 10.7517/issn.1674-0475.211217

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This paper explored the evaluation value of energy spectrum CT signs and energy attenuation curve in the evaluation of the degree of lung adenocarcinoma invasion and the guiding significance for the surgical plan. Selected 110 patients with lung adenocarcinoma, and according the degree of tumor invasion diagnosed by surgical pathology the were differently divided into group A (n=62) and group B (n=48), the spectral CT examination was performed in both groups before operation. The results showed that the proportion of mixed GGN, the slope of energy decay curve (K value), the maximum diameter of nodules, and the water-based value of nodules in group B were higher than those in group A (P<0.05). K value, maximum diameter of nodules and water-based values of BAP1-positive patients were lower than those of BAP1-negative patients, and K value, maximum diameter of nodules and water-based values of Ki-67-positive patients were higher than those of Ki-67-negative patients (P＜0.05). K value, maximum diameter of nodules, and water-based values were negatively correlated with the expression of BAP1 in lung adenocarcinoma tissues, and positively correlated with the expression of Ki-67 (P<0.05). The area under the curve (AUC) for mixed GGN, K value, maximum diameter of nodules, and water-based values combined assessment of lung adenocarcinoma invasion as IAC was 0.856. It can be seen that energy spectral CT signs and energy attenuation curve have certain value in evaluating the degree of lung adenocarcinoma invasion, and have guiding significance for the selection of appropriate surgical plan before surgery.

The Study of Conbercept and Vitrectomy Combined with Phacoemulsification in the Treatment of PDR with Cataract

LI Caibao, JIANG Huimin, XU Wanxin

2022, 40(3):  485-489.  DOI: 10.7517/issn.1674-0475.211110

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This study investigated the clinical effect of conbercept and vitrectomy combined with phacoemulsification in patients with proliferative diabetic retinopathy (PDR) complicated with cataract. Chosen 120 patients (120 eyes) with PDR complicated with cataract as the research objects, and divided them into the experimental group and the control group with 60 cases in each group through random number table. Three and six months after operation the BCVA values of experimental group were both less than those of control group (P＜0.05). Preoperative and postoperative 1, 3, 6 months there was no significant difference between the two groups in the astigmatism of the operated eyes (P＞0.05). After 1 month operation the intraocular pressure of the experimental group was lower than control group (P＜0.05). Compared with the measured values of foveal retinal thickness after 1, 3, 6 months, the experimental group was lower than those of control group (P＜0.05). The incidence of anterior chamber inflammation in the experimental group was 11.67% and lower than 30.00% in control group (P＜0.05). Conbercept, vitrectomy combined with phacoemulsification have a better visual improvement effect than without conbercept in the treatment of PDR combined with cataract. At the same time the correction effect of the postoperative foveal retinal thickness shows better and the incidence of postoperative anterior chamber inflammation was lower.

Efficiency Analysis of Transvaginal Color Doppler Ultrasound and Hysteroscopy in the Diagnosis of Endometrial Lesions

YANG Wenhui, DING Li, TANG Fei

2022, 40(3):  490-493.  DOI: 10.7517/issn.1674-0475.211221

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This study compared the diagnostic efficiency analysis of transvaginal color Doppler ultrasound and hysteroscopy in the screening of endometrial lesions. Selected 79 patients with endometrial lesions, through pathologically confirmation, threr were 60 patients with benign endometrial lesions and 19 patients with malignant endometrial lesions. The diagnosis of benign and malignant lesions of vaginal color Doppler ultrasound and hysteroscopy were analyzed. The results showed the age of patients with malignant lesions was significantly higher than that with benign lesions (P<0.05). The proportion of homogeneous internal echo and clear boundary between myometrium and endometrium in benign lesions were significantly higher than that in malignant lesions (P<0.05), while the thickness of endometrium was significantly lower than that in malignant lesions (P<0.05). The ROC curves of internal echo, boundary between muscular layer and intima, and endometrial thickness in the diagnosis of malignant lesions were 0.811, 0.692 and 0.813, respectively (P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of hysteroscopy in the diagnosis of malignant lesions were significantly higher than those of vaginal color Doppler ultrasound (P<0.05). Vaginal color Doppler ultrasound can provide quantitative parameters in the differential diagnosis of endometrial lesions, while hysteroscopy has high diagnostic efficiency in the differential diagnosis of endometrial lesions.

Application of DTI Fiber Bundle Reconstruction Combined with Intraoperative Ultrasound in Glioma Surgery of Brain Functional Areas

LI Xuzhao, CHENG Jingsheng, XU Lixin

2022, 40(3):  494-498.  DOI: 10.7517/issn.1674-0475.211214

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This paper investigated the value of diffusion tensor imaging (DTI) fiber bundle reconstruction combined with intraoperative ultrasound in the operation of gliomas in brain functional areas. 89 patients with gliomas in brain functional areas were selected, the observation group (n=46) was given DTI fiber bundle reconstruction combined with intraoperative ultrasound, and the control group was given intraoperative ultrasound localization, and both groups were given glioma resection surgery. The results showed that the total tumor resection rate, postoperative Karnofsky functional state (KPS) score, the proportion of symptom improvement, the score of Anderson brain tu(P<0.05). In the observation group, the high-level proportion and anisotropy score (FA) of pathological types in patients with no change or aggravation were higher than those in improved patients (P<0.05), and the apparent diffusion coefficient (ADC) was lower than those in improved patients (P<0.05). The areas under the ROC curve of FA value and ADC value predict the improvement of treatment in the observation group were 0.756 and 0.803, respectively, P<0.05. DTI fiber bundle reconstruction combined with intraoperative ultrasound has good value in the operation of gliomas in brain functional areas, which is worthy of clinical use.

Application of Prenatal Ultrasound Combined with NIPT in the Screening of Fetal Chromosomal Abnormalities in the Second Trimester of Pregnancy

HOU Dairong, SU Qinghai, LI Lijun

2022, 40(3):  499-503.  DOI: 10.7517/issn.1674-0475.211106

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This study investigated the clinical value of prenatal ultrasound combined with non-invasive prenatal testing (NIPT) in the screening of fetuses with chromosomal abnormalities in the second trimester. The imaging data and NIPT results of 6000 pregnant women performed prenatal ultrasound screening were retrospectively analyzed. Among the 6000 cases, 112 cases of abnormal soft index were totally detected, and 93 cases of abnormal structural index were detected by ultrasound. 47 cases of high-risk pregnant women were detected by NIPT, among them 33 cases of trisomy 21 syndrome and 14 cases of trisomy 18. Through the combined diagnosis of ultrasound soft index, ultrasound structural index, NIPT for fetal chromosomal abnormalities, the sensitivity, specificity, positive predictive value and negative predictive value were 86.44%, 99.95%, 94.44% and 99.87%, respectively. For women in the second trimester, prenatal ultrasound or NIPT screening for fetal chromosomal abnormalities has low sensitivity but both high specificity. So the combination of the two methods could effectively improve the sensitivity of screening, which may be useful for early detection important value, thereby improving the reproductive quality.

Application of Ultrasound-guided Intermuscular Sulcus Brachial Plexus Block Combined with Superficial Cervical Plexus Block in Clavicular Fracture Surgery

FU Xiuli, WANG Sen, SUN Zhipeng, LEI Fengqiong, FAN Li

2022, 40(3):  504-509.  DOI: 10.7517/issn.1674-0475.211220

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This paper analyzed the difference in anesthesia effect between ultrasound-guided intermuscular sulcus brachial plexus block combined with superficial cervical plexus block and traditional one-needle method of intermuscular sulcus brachial plexus block combined with superficial cervical plexus block in clavicle fracture surgery. 104 children with clavicular fractures who were to undergo surgical treatment were collected, and a prospective randomized trial plan was used to divide the 104 children with clavicular fractures into an ultrasound group and a traditional group, with 52 children in each group. Compared the effects of nerve block, anesthesia effect, mean arterial pressure (MAP), heart rate (HR), dynamic fluctuation of blood oxygen saturation (SpO₂), muscle strength parameters and adverse reactions caused by two anesthesia methods in the two groups. Comparative analysis of the onset time of sensory and motor blocks showed that the ultrasound group was shorter than the traditional group, while the duration of analgesia and motor block were longer than those of the traditional group (P<0.05). Ultrasound-guided intermuscular sulcus brachial plexus block combined with superficial cervical plexus block had better nerve block effect (P<0.05). The muscle strength of the elbow flexion joint of the children in the ultrasound group was higher than that in the traditional group at 2 h, 6 h, and 12 h after operation (P<0.05). The postoperative complication rate in the ultrasound group was lower than that in the traditional group (P<0.05). Ultrasound-guided intermuscular sulcus brachial plexus block combined with superficial cervical plexus block can perform more accurate operation than traditional one-needle method of intermuscular sulcus brachial plexus block combined with superficial cervical plexus block, with shorter operation time, and better anesthesia effect. As well as the side-effect on muscle strength recovery of children is smaller, and the rate of anesthesia complications is lower.

Application of SMART 3D-SMI in the Differential Diagnosis of Benign and Malignant in TI-RADS 4 Thyroid Nodules

LI Chaoxi, WEN Dehui, LIU Weiliang, LU Haiyong

2022, 40(3):  510-514.  DOI: 10.7517/issn.1674-0475.211204

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This study investigated the application value of 3-dimensional ultrasound imaging (smart 3D-SMI) in the differential diagnosis of benign and malignant in TI-RADS 4 thyroid nodules. 120 cases of patients (128 nodules) with TI-RADS type 4 nodules were selected and analyzed the diagnostic efficacy of CDFI, 2D-SMI and 3D-SMI for benign and malignant of TI-RADS type 4 nodules. Pathologically confirmed 84 cases benign and 44 cases malignant. TI-RADS had 87 grades 4a, 30 grades 4b and 11 grades 4c, with an accuracy rate of 67.97%. Compared with CDFI, 2D-SMI and 3D-SMI had higher blood flow grades, and detected more grade 3 blood flow. There was no statistically significant difference between 2D-SMI and 3D-SMI grades (P＞0.05). There was no significant difference in the blood flow distribution pattern of benign nodules in CDFI, 2D-SMI and 3D-SMI (P＞0.05). Compared with CDFI, malignant nodules showed more type Ⅲ in 2D-SMI and 3D-SMI modes (P＜0.05). TI-RADS combined with CDFI, 2D-SMI and 3D-SMI respectively in the differential diagnosis of benign and malignant thyroid nodules, compared of the three methods, TI-RADS +3D-SMI had higher sensitivity, accuracy and negative predictive value (P<0.05), and had no significant difference in diagnostic specificity and positive predictive value (P＜0.05). SMART 3D-SMI can accurately assess the microvascular spatial distribution and pattern of thyroid TI-RADS 4 nodules.

Diagnostic Value of Prenatal Ultrasonography on Placenta Previa with Placenta Accreta

ZOU Lihua, MIN Aiping, WANG Hui, LAI Yingying, LI Mingxing

2022, 40(3):  515-519.  DOI: 10.7517/issn.1674-0475.211213

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This study investigated the clinical value of prenatal ultrasonography in the diagnosis of placenta previa with placenta accreta. Seventy-two pregnant women with placenta previa were selected as clinical research subjects, and all of them unwent prenatal ultrasound examination. Among them, 37 pregnant women with placenta previa combined with placenta accreta (inplantation group) and 35 pregnant women with placenta previa only (control group) were compared. Analyzed the differences on sonographic features and ultrasonic scores of the two groups, and the value of the ultrasonic scores in the diagnosis of placenta previa combined with placenta accreta. In implantation group, the proportion of patients with placental tissue thickness ≥3.0 cm, the detection rate of recesses in placental parenchyma, the proportion of patients with intact retroplacental hypoechoic zone, the proportion of patients with the thickness of the thinnest part of the uterine basal layer ≤1.0 mm, and the patients with rough bladder surface, the proportion of patients with regular blood flow signals at the base of the placenta, and the detection rate of cervical and peripheral blood flow signals were all higher than those of the control group (P＜0.05). The prenatal ultrasound score of the implantation group was significantly higher than that of the control group (P＜0.05). The AUC value of the prenatal ultrasound score for the diagnosis of placenta previa combined with placenta accreta was 0.944. Prenatal ultrasound in pregnant women with placenta previa and placenta accreta has typical features such as increased placental tissue thickness and occurrence of placental intraparenchymal recesses. Prenatal ultrasound scoring has high sensitivity and specificity for the diagnosis of placenta previa complicated with accreta.

The Relationship between PCO Changes and Knee Flexion Function after TKA

SANG Peng, LIU Yi, YANG Jibin, SUN Pengpeng, ZOU Gang, JIN Ying

2022, 40(3):  520-524.  DOI: 10.7517/issn.1674-0475.211112

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This paper investigated the relationship between femoral posterior condyle eccentricity (PCO) and knee flexion function after total knee arthroplasty (TKA). Ninety-two patients underwent unilateral TKA were selected, according to the prooperative and postoperative change value of PCO the patients were divided into PCO change value ≥ 0 group (n=55) and PCO change value < 0 group (n=37). After 1 month surgery the knee flexion angle of patients with PCO changes ≥0 was significantly higher than those of patients with PCO changes < 0 (P<0.05). The total score of Western Ontario and McMaster University Osteoarthritis Index score (WOMAC), pain, daily activity and the mean trajectory error, mean strength difference and stability index in the PCO≥0 group at 12 months after surgery were significantly lower than those in the PCO changes < 0 group (P<0.05), while the New York Special Surgery Hospital (HSS) function and activity scores were significantly higher than those in PCO changes < 0 group (P<0.05). The unchanged or increased PCO contribute to the rapid recovery of knee flexion function after TKA, help to improve knee function, and patients have better proprioception.

Study of ERCP-guided sEST+balloon Dilatation for the Treatment of JPDD Complicated with Choledocholithiasis

CUI Leilei, LU Meng, KANG Jie, CHI Baoquan, JIANG Lijie, ZHAO Peng

2022, 40(3):  525-530.  DOI: 10.7517/issn.1674-0475.211201

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This study investigated endoscopic retrograde cholangiopancreatography (ERCP)-guided small endoscopic sphincterotomy (sEST) plus balloon dilatation in the treatment of juxtapapillary duodenal diverticulum (JPDD) complicated with choledocholithiasis. A total of 94 patients with JPDD complicated with choledocholithiasis were selected and divided into elderly group of 47 cases (60-85 years old) and non-elderly group of 47 cases (35-59 years old). Both of the group patients were treated with sEST+balloon dilation under the guidance of ERCP, and counted the gastrointestinal function, complications, liver function before and after surgery [direct bilirubin (DBIL), total bilirubin (TBIL), alanine aminotransferase (ALT)], stress response [adrenocorticotropic hormone (ACTH), corticosteroids (COR), adrenaline (A), norepinephrine (NE)] and inflammatory indicators [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] levels. The results showed that there was no significant difference in the completion of the operation, the recovery of gastrointestinal function, and the incidence of complications between the two groups. The postoperative liver function indexes were significantly decreased (P<0.05), while there was no significant difference between the two groups (P>0.05). After one and three days of operation, the levels of serum stress response and inflammatory indexes in the two groups were higher than those before operation, and the elderly group was significantly higher than the non-elderly group after one-day operation (P<0.05). The results showed that sEST+balloon dilation under the guidance of ERCP was safe and effective in the treatment of JPDD complicated with choledocholithiasis, but the elderly patients could have stronger stress and inflammatory reactions.

The Value of PET/CT Combined with Serum CEA and VEGF in the Diagnosis of Gastric Cancer

HOU Xiancun, ZHOU Qing, LIU Li, ZHANG Yanju, XU Xuening

2022, 40(3):  531-534.  DOI: 10.7517/issn.1674-0475.211108

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This article explored the value of positron emission tomography/computed tomography (PET/CT) combined with serum carcinoembryonic antigen (CEA) and vascular endothelial growth factor (VEGF) in the diagnosis of gastric cancer. Chosen 108 patients with suspected gastric cancer treated, and analyzed the value of PET/CT in the diagnosis of gastric cancer, then compared the differences of serum CEA and VEGF between gastric cancer with and without lymph node metastasis. Among the 108 suspected cases, Sixty-nine patients with gastric cancer were diagnosed pathologically. The kappa value of PET/CT diagnosis and pathological results was 0.764 (P<0.05) and consistency well. The serum CEA and VEGF in gastric cancer patients with lymph node metastasis were significantly higher than those in patients without lymph node metastasis (P<0.05). The sensitivity and negative predictive value of PET/CT combined with serum CEA and VEGF in the diagnosis of gastric cancer with lymph node metastasis were 90.00% and 90.32% respectively, which was higher than those of PET/CT diagnosis alone, while the difference was not statistically significant (P>0.05). PET/CT has good value in the diagnosis of gastric cancer, CEA and VEGF could have a certain application value in the diagnosis of gastric cancer with lymph node metastasis.

The Application of Color Ultrasound-guided Nano-carbon Tracing in Minimally Invasive Surgery of PTC Patients

CAO Yiming, QING Jialin, WANG Danying, ZHANG Minmin

2022, 40(3):  535-539.  DOI: 10.7517/issn.1674-0475.211226

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This article discussed the value of preoperative color Doppler ultrasound-guided injection of nano-carbon suspension to guide laparoscopic surgery in patients with papillary thyroid carcinoma (PTC). Ninety-eight patients with PTC were selected as the research objects, according whether the patients adopted the nano-carbon tracking technology with ultrasound-guided, the patients were divided into the tracer group with 58 cases and the traditional group with 40 cases. The patients in the tracer group were injected with nano-carbon suspension under the guidance of color Doppler ultrasound before operation, and the surgeons were instructed to perform lymph node dissection in the central area of the neck. The traditional group were performed lymph node dissection in the central area of the neck by traditional surgical methods. The calcium levels in blood were analyzed by biochemical assays and the serum PTH level was detected by linked immunosorbent assay. The operation time and intraoperative blood loss in the tracer group were significantly lower than those in the traditional group (P<0.05). The number of dissected central lymph nodes and the number of positive central lymph nodes in the tracer group were higher than those in the traditional group (P<0.05). At 24 hour and 72 hour after the operation, the serum PTH and blood calcium levels in the two groups were lower than 535those in the same group before the operation (P<0.05). Compared with the tracer group, the serum PTH and blood calcium levels in the traditional group were significantly lower (P<0.05). The postoperative complication rate in the tracer group was lower than that in the traditional group (P<0.05). Color Doppler-guided injection of nano-carbon suspension lymph node tracing to guide endoscopic central lymph node dissection in patients with PTC has higher practical value, which is benefit to shorten the operation time, reduce the difficulty of operation, improve the efficiency of lymph node dissection, and reduce parathyroid glands incidence of collateral injuries and surgical complications.

The Value Observation of Acute Cerebral Infarction and Carotid Atherosclerosis by CS-3D MERGE Technique Assessment

HUANG Guobiao, ZHENG Ying, FAN Xianyi, CHNE Chunbing

2022, 40(3):  540-544.  DOI: 10.7517/issn.1674-0475.211109

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This study discussed the value of rapid three-dimensional MRI of vascular wall (CS-3D MERGE) technology assessment for acute cerebral infarction and carotid atherosclerosis. Chosen 68 patients with ischemic cerebral infarction as observation group and 50 patients with transient ischemic attack as control group, both groups were examined by CS-3D MERGE. Analyzed the differences of the degree of middle cerebral artery stenosis, plaque remodeling index, enhancement degree and eccentricity index between the two groups, and CS-3D MERGE was analyzed to determine the degree of carotid artery stenosis and the nature of plaque in observation group. The index of middle cerebral artery plaque reconstruction index and intensification degree in observation group were significantly higher than those in control group (P<0.05). The area under the ROC curve of reconstruction index and intensification degree in diagnosis of cerebral infarction were 0.839 and 0.671 respectively (P<0.05). In the observation group the Kappa value of CS-3D MERGE diagnosis of carotid artery stenosis and digital subtraction angiography (DSA) results were 0.825 (P<0.05), which showed good consistency. The Kappa value of CS-3D MERGE in determining the nature of carotid atherosclerotic plaque and postoperative pathological results was 0.789 (P<0.05), which showed good consistency. CS-3D MERGE has a good application value in the diagnosis of acute cerebral infarction and carotid atherosclerosis.

The Diagnostic Analysis of Ultrasound Combined with CA125 and HE4 Detection in Ovarian Sex Cord Stromal Tumor

ZHOU Li, XUAN Zhidong, LI Xiujuan

2022, 40(3):  545-549.  DOI: 10.7517/issn.1674-0475.211122

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This study explored the clinical value of ultrasound combined with serum carbohydrate antigen 125 (CA125) and human epididymal protein 4 (HE4) in ovarian sex cord stromal tumors (OSCST). Selected 87 OSCST patients (OSCST group) and 90 patients (control group) with benign ovarian cysts confirmed by postoperative pathological examination, and analyzed the preoperative transvaginal color doppler ultrasound (CDFI) imaging characteristics and serum CA125 and HE4 levels (determined by chemiluminescence method) of the two groups. The diagnostic value of each index was analyzed by receiver operator characteristic (ROC) curve. The results showed that the levels of serum CA125 and HE4 in the OSCST group were significantly higher than those in the control group (P＜0.05). The echo attenuation behind the lesions in the OSCST group was more significant than that in the control group (P<0.05). The CDFI blood flow of the lesions in the OSCST group the grade Ⅱ and grade Ⅲ patients in the classification was higher than those in the control group (P<0.05). The sensitivity of ultrasound combined with serum CA125 and HE4 in the differential diagnosis of OSCST and benign ovarian cysts was 85.06%, specificity was 80.00%, missed diagnosis rate was 14.94%, and misdiagnosis rate was 20.00%. Ultrasound combined with serum CA125 and HE4 in the differential diagnosis of OSCST and ovarian benign cysts has higher clinical sensitivity and specificity. Compared with the three methods alone, it can significantly improve the accuracy of diagnosis.

The Effect of Preoperative Tranexamic Acid on Blood Coagulation Function and Blood Flow Parameters of Lower Limbs in KOA Patients

YUN Tianbin, DING Jie

2022, 40(3):  550-554.  DOI: 10.7517/issn.1674-0475.211119

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This study explored the effects of preoperative administration of tranexamic acid on surgical blood loss, blood coagulation status, and lower limb ultrasound blood flow parameters in KOA patients undergoing medial open wedge-shaped high tibial osteotomy. Ninety-four patients who intend to undergo medial open wedge tibial high osteotomy were selected for related research. Using the random number table generated by statistical software, the patients were divided into the test group and the control group with 47 cases in each. The patients in the test group were given preoperatively for tranexamic acid, while only given the same amount of normal saline in the control group instead, and the rest of the treatment measures remained the same. Compared the operation time, apparent blood loss, hidden blood loss, total blood loss and the length of hospital stay between the two groups, and the hemoglobin (Hb), hematocrit, D-dimer, thromboelastogram (TEG) parameters and the average blood flow velocity of the lower limb veins before and after the operation. The apparent blood loss, hidden blood loss, and total blood loss of the test groups were lower than in the control group (P<0.05). Seventy-two hours after the operation, the Hb value of the test group was higher than that in the control group (P<0.05). The incidence of deep vein thrombosis (DVT) in the test group was 4.26% compared 550with 2.13% in the control group, and the difference was not statistically significant (P>0.05). Preoperative intravenous infusion of tranexamic acid is beneficial to reduce surgical blood loss and postoperative hidden blood loss, but it could not significantly affect the patient’s TEG parameters and lower limb blood flow velocity, and could not significantly increase the incidence of DVT.

The Diagnostic Value of Ultrasonography for Pulmonary Infection and Its Correlation with Serum PCT and PCIS Scores

ZHAO Li, SUN Qiaoli

2022, 40(3):  555-559.  DOI: 10.7517/issn.1674-0475.211123

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This article exploreed the value of pulmonary ultrasound in the diagnosis of children with pulmonary infection and its correlation with serum procalcitonin (PCT) and pediatric critical illness score (PCIS). A total of 120 children with pulmonary infection (infection group) and 120 healthy children (control group) who underwent child care during the same period were selected. Both groups received pulmonary ultrasound examination. The LUS score and serum PCT of the infection group were significantly higher than those of the control group (P<0.05), and the PCIS score of the infection group was lower than that of the control group (P<0.05). After simple linear correlation analysis, in the infection group there was a significant positive correlation between the LUS score and serum PCT (r=0.704, P=0.000<0.05), and the LUS score and PCIS score were significantly negatively correlated (r=－0.742, P=0.000<0.05). The sensitivity of LUS score to diagnose children with pulmonary infection was 82.76%, specificity was 76.60%, and the area under the ROC curve was 0.845. Pulmonary ultrasound diagnosis of children with pulmonary infection has high clinical value, and has a good correlation with PCIS score and PCT. This examination method has benefits of being non-radioactive, safety and reliability.

The Diagnostic Efficacy of Two-dimensional Ultrasound and SWE in Parotid Space-occupying Lesions

LIU Qinjun, FAN Yiqun, ZHOU Xiaoling, TAN Jing

2022, 40(3):  560-564.  DOI: 10.7517/issn.1674-0475.211141

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This study investigated the diagnostic efficacy of two-dimensional ultrasound and shear wave elastography (SWE) in parotid space-occupying lesions. Choosing 80 patients with parotid space-occupying lesions to compared the ultrasonic characteristics and Young’s modulus between malignant and benign tumors. The pathological results confirmed 29 cases of parotid gland malignant tumors and 51 cases of benign. In ultrasonic features, the proportions of lobulated, incomplete capsule and unclear boundary of parotid gland malignant tumors were significantly higher than those of benign tumors (P<0.05). The sensitivity, specificity, accuracy of ultrasound in the diagnosis of parotid gland malignant tumors were 79.31%, 60.78%, 67.50%, respectively. In benign tumors, the maximum and average young’s modulus of mixed tumors were significantly higher than those of adenolymphoma (P<0.05). The area under the ROC curve of the maximum and average Young’s modulus to distinguish parotid gland mixed tumor and adenolymphoma were 0.768 and 0.759, P<0.05. Two-dimensional ultrasound has certain application value in differentiating benign and malignant tumors of parotid glands. Although SWE cannot distinguish benign and malignant tumors, it is more effective in distinguish mixed tumors and adenolymphoma among benign tumors.

Application of Transvaginal 4D-HyCoSy in the Diagnosis of Tubal Infertility

LIU Yujun, TAN Qingying, LI Rufei, WU Jingjing, PAN Huiyan

2022, 40(3):  565-569.  DOI: 10.7517/issn.1674-0475.211215

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This article discussed the application value of transvaginal four-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy) in patients with tubal infertility. 75 patients with suspected tubal infertility (150 fallopian tubes) were selected as the research subjects, and all underwent transvaginal 4D-HyCoSy examination. Taking the results of laparoscopic methylene blue as the gold standard, transvaginal 4D-HyCoSy diagnosed 86 fallopian tube obstruction, 64 fallopian tube obstruction was diagnosed, and 23 fallopian tube obstruction was misdiagnosed. Kappa analysis showed that 4D-HyCoSy examination has a good consistency with laparoscopic methylene blue pass examination (Kappa values were 0.528 and 0.709, respectively, P<0.05). The area under the ROC curve of vaginal 4D-HyCoSy examination of left and right fallopian tubes for infertility were 0.770 and 0.859, respectively, with 95%CI of 0.661-0.880 and 0.769-0.949, P<0.001, cut-off value ≤1, and the diagnostic sensitivity was 65.85% and 77.50%, the specificity was 88.24% and 94.29%, respectively. Transvaginal 4D-HyCoSy diagnosis of tubal infertility has a high consistency with the "gold standard" (laparoscopic malignant fluid examination), which could provide a new direction for the clinical diagnosis and treatment of tubal infertility.

The Application Value of Craniocerebral Ultrasound in the Diagnosis of Neonatal Intracranial Hemorrhage

WANG Chun, LV Xin, SHI Xinran

2022, 40(3):  570-573.  DOI: 10.7517/issn.1674-0475.211113

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This paper investigated the application value of craniocerebral ultrasound in the diagnosis of neonatal intracranial hemorrhage. Chosen 610 newborns who underwent craniocerebral ultrasound, and analyzed the value of brain ultrasound in the diagnosis of intracranial hemorrhage. The differences of peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI) of anterior and middle cerebral arteries in children with different grades of intraventricular hemorrhage were analyzed. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of craniocerebral ultrasound in the diagnosis of intracranial hemorrhage were 92.13%, 97.09%, 96.39%, 85.44% and 98.62%, respectively. The PSV and EDV of the middle cerebral artery in children with intraventricular hemorrhage in Papile grades Ⅲ-Ⅳ were significantly lower than those in grades Ⅰ-Ⅱ (P<0.05), while the RI was significantly higher than in grades Ⅰ-Ⅱ (P<0.05). There was no significant difference in PSV, EDV and RI of anterior cerebral artery in children with papile grade Ⅲ-Ⅳ and Ⅰ-Ⅱ intraventricular hemorrhage (P>0.05). The areas under the ROC curve of middle cerebral artery parameters PSV, EDV and RI in predicting Ⅲ-Ⅳ intraventricular hemorrhage were 0.750, 0.917 and 0.776, respectively (P<0.05). Craniocerebral ultrasound has a good application value in the diagnosis of neonatal intracranial hemorrhage, and the blood flow parameters of middle cerebral artery have a certain application value in predicting severe intraventricular hemorrhage.

Influence of Parent-participated Intervention in MRI Examination on Infant and Child Compliance and Image Quality

HOU Fengxiang, HUANG Xingquan

2022, 40(3):  574-578.  DOI: 10.7517/issn.1674-0475.211107

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This study explored the effectiveness of parent-participated intervention programs for magnetic resonance (MRI) examinations in infants and young children. 102 infants and young children needed MRI examination were selected, and divided them into control group with 51 cases undergoing routine care and observation group with 51 cases undergoing parenta-participated intervention. The examination conditions, image quality, stress response indexes at different time points [heart rate (HR), mean arterial pressure (MAP)], adverse reactions and parents' satisfaction were compared between the two groups. The results showed that the one-time success rate and inspection compliance rate of the observation group were higher than those of the control group, the use rate of phenobarbital sodium and the average inspection time was lower than that of the control group (P<0.05). The image quality of the observation group was better than the control group (P＜0.05). After 15 minutes and the end of inspection, the HR and MAP of the observation group were lower than those of the control group (P＜0.05). There was no significant difference in adverse reactions between the two groups (P＞0.05). The satisfaction of parents in observation group was higher 574than that in control group (P<0.05). Therefore, parent-participated intervention is beneficial to MRI examinations of infants and young children.

The Application of Phloroglucinol in Labor Analgesia and Its Effect on Ultrasonic Parameters of Uterine Artery

CUI Xiaojuan, ZHOU Ling, QI Yuying, LI Pinghua, YUAN Hong

2022, 40(3):  579-583.  DOI: 10.7517/issn.1674-0475.211115

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This article discusses the effects of intravenous injection of phloroglucinol in the analgesia of primiparous vaginal labor and its influence on the ultrasound parameters of the uterine artery. 180 primiparas were selected, observation group (n=93) was given intravenous injection of phloroglucinol and control group (n=87) was given intravenous injection of diazepam. Compared the differences of labor process time, VAS score, uterine artery ultrasound and so on between the two groups. The first and the second stage of labor in the observation group were significantly shorter than those in the control group (P<0.05). The VAS scores of the different stage of labor in the observation group were significantly lower than those in the control group (P<0.05). The proportion of vaginal delivery in the observation group was significantly higher than those in the control group (P<0.05). Before delivery, 30 minutes of injection and full-time cervix there were no significant differences in uterine artery, fetal middle cerebral artery pulsatility index (PI), resistance index (RI) and maximum peak blood flow velocity / end diastolic blood flow velocity (S/D) between the two groups (P>0.05). In vaginal delivery analgesia, the intravenous injection of phloroglucinol can accelerate the progress of labor, reduce labor pain, and has no significant effect on ultrasonic parameters such as uterine artery.

The Changes and Significance of Spine-pelvic Imaging Indexes in Lumbar Degenerative Diseases

LI Xiaojun, JIANG Hongnan, FAN Zhichang, YANG Jie, XU Yang

2022, 40(3):  584-589.  DOI: 10.7517/issn.1674-0475.211120

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This paper discussed the changes of spine-pelvic imaging parameters before and after surgery with lumbar degenerative disease and their relationship with chronic low back pain after surgery. 160 patients with lumbar degenerative disease were selected as the case group, and 80 healthy cases were selected as the control group. X-rays were used to measure the spine-pelvic imaging parameters of the two groups. The case group were treated with lumbar fusion and internal fixation. The patients were followed up for 6 months, and compared the changes of spine-pelvic imaging parameters before and after the operation, and the relationship between the preoperative spine-pelvic imaging parameters and the patient’s postoperative chronic low back pain was discussed. The measured values of the sagittal vertical axis of the spine (SVA), angle of incidence of the pelvis (PI), and the angle of inclination (PT) of the case group were greater than those of the control group (P<0.05). The lumbar lordosis angle (LL) of the case group was lower than of the control group (P<0.05). The measured values of SVA and PT of the low back pain group were greater than those of the non-back pain group, and the LL value of the low back pain group was lower than that of the non-back pain group 584 (P<0.05). The age, Segments ≥3, degeneration of adjacent segments after surgery, and increased PT value are risk factors for low back pain in patients with lumbar degenerative disease after surgery (P<0.05). There was abnormal changes of lumbar spine curvature in patients with degenerative diseases of the lumbar spine. At the same time, patients with poor postoperative PT value recovery, older age, surgical fusion segment≥3, postoperative adjacent segment degeneration can cause postoperative lumbar pain.

The Detection of Micro Tumor in Breast X-ray Image Based on Edge Geometric Features

LIU Yanan, LI Jingyu, XU Dongbin, MENG Hongyan, DONG Jing, ZHAO Tianyu, TANG Li, ZOU He

2022, 40(3):  590-595.  DOI: 10.7517/issn.1674-0475.211118

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Breast cancer is a high incidence of malignant diseases in women and mammography is the main basis for diagnosis. At present, because of the tumor edge feature extraction of micro tumor detection methods in breast X-ray images is not effectively, the false positive results overhigh, which affects the diagnosis and treatment of patients. Therefore, the micro tumor detection method in breast X-ray images based on edge geometric features was studied. According to the morphology principle, the breast X-ray image was enhanced. HOG feature extraction method was used to obtain the edge geometric features of breast micro tumors, and constructed a sparse representation Dictionary of tumor edge geometric features. Using edge dictionary and subtraction technology to complete microtumor detection. The experimental results showed that compared with the traditional detection methods, this method could effectively reduce the number of false positives and improve the detection accuracy of micro tumors. Therefore, the method in this paper has high feasibility.

The Changes of Pelvic Floor Ultrasound Parameters and Urodynamic Indexes after Hysterectomy and the Effect of Rehabilitation Treatment

ZHOU Qin, LI Qi, ZHANG Yuanyuan

2022, 40(3):  596-600.  DOI: 10.7517/issn.1674-0475.211124

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This study explored the changes of pelvic floor ultrasound parameters and urodynamic parameters before and after total hysterectomy in patients with cervical cancer and the effect of pelvic floor rehabilitation. 137 cases of cervical cancer patients undergoing total hysterectomy were selected for clinical research. All patients were tested for pelvic floor ultrasound parameters and urodynamic parameters before and 3 months after surgery, among them, 120 patients received pelvic floor rehabilitation after surgery. The results showed: the measured value of the bladder neck reduction, the urethral rotation angle, the posterior angle of the bladder neck in the resting state, the posterior angle of the bladder and the urethra in the maximum Valsalva state, and the vertical distance between the bladder neck and the underside of the pubic symphysis (BSD) all increased to a certain extent compared with those before the operation (P<0.05). After the operation, the patient’s bladder compliance, maximum urine flow rate, and maximum detrusor pressure were significantly lower than those before the operation (P<0.05), and the maximum bladder volume was significantly increased (P<0.05). Total hysterectomy will have obvious adverse effects on the pelvic floor function and bladder voiding function for patients with cervical cancer. This part of patients should be given appropriate rehabilitation after the operation to promote the recovery of function and improve the quality of life.

Application of Bedside Lung Ultrasound Score in the Diagnosis and Treatment of Premature Infants with Respiratory Distress Syndrome

LUO Yanhe, YANG Shuihua, TANG Yanni, LI Xinyan, HE Guidan, LIANG Mengfeng, PAN Baoxing, LIU Chunlin, QIN Yinbei, ZHAO Dan, HUANG Weibao

2022, 40(3):  601-605.  DOI: 10.7517/issn.1674-0475.211137

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This paper discussed the value of bedside lung ultrasound score in the diagnosis and treatment of premature infants with respiratory distress syndrome. 88 premature infants with respiratory distress syndrome treated were selected as the observation group, and 100 premature infants without respiratory distress syndrome were selected as the control group. Compared the differences of bedside lung ultrasound score (LUS) between the two groups, and each different clinical data in the observation group, further analyzed the value of LUS score in predicting respiratory distress syndrome complicated with bronchopulmonary dysplasia and extremely critical respiratory distress syndrome. The LUS scores of bilateral lung, left lung and right lung in the observation group were significantly higher than those in the control group (P<0.05). In the observation group, the lung LUS scores of children with bronchopulmonary dysplasia, respiratory distress score > 8, and extremely critical disease (neonatal critical case score <70) were significantly higher than those of other children (P<0.05). Bilateral lung LUS score was positively correlated with respiratory distress score (P<0.05), and negatively correlated with neonatal critical case score (P<0.05). Bedside high frequency ultrasound monitoring has certain application value in the diagnosis and treatment of premature infants with respiratory distress syndrome complicated with bronchopulmonary dysplasia and disease degree.

Evaluation of Fetal Central Nervous System and Vertebra Development by MRI

ZHANG Yong, WANG Xu

2022, 40(3):  606-609.  DOI: 10.7517/issn.1674-0475.211207

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This study investigated the clinical value of prenatal magnetic resonance (MRI) technology in the diagnosis of fetal central nervous system and vertebral malformations. Selected 336 pregnant women with suspected fetal central nervous system and vertebral malformations for clinical research. All pregnant women underwent MRI scans and color Doppler ultrasound examinations. The results of fetal pathology after delivery or termination of pregnancy were used as the gold standard to judge the value of MRI prenatal screening in the diagnosis of fetal central nervous system and vertebral malformations. There was no significant difference between MRI and prenatal color Doppler ultrasound in the diagnosis of various types of fetal central nervous system developmental malformations (P＞0.05), but the overall coincidence rate of diagnosis was higher than that of prenatal color Doppler ultrasound (P＜0.05). The sensitivity of MRI for central nervous system malformations was 87.50%, the specificity was 86.36%, and the area under the curve(AUC)of ROC was 0.869. The sensitivity and specificity of color Doppler ultrasound in the diagnosis of fetal central nervous system malformations were 69.44% and 81.82%, and the AUC was 0.756. The coincidence rate of MRI in diagnosing scoliosis was higher than that of color Doppler ultrasound (P＜0.05), the sensitivity and specificity of MRI in diagnosing fetal vertebral deformity were 86.36%, the specificity was 97.45%, and the AUC was 0.919. The sensitivity of color Doppler ultrasound was 50.00%, the specificity was 81.53%, and the AUC was 0.658. MRI technology had an obvious advantages over prenatal color Doppler ultrasound in diagnosing fetal central nervous system and vertebral malformation, and it could be worthy of clinical application.

The Study of LAD and Pd in Predicting Paroxysmal Atrial Fibrillation in Patients with Primary Hypertension

HUANG Shan, LI Qianling

2022, 40(3):  610-614.  DOI: 10.7517/issn.1674-0475.211138

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This study explored the value of combined detection of left atrial diameter (LAD) and P-wave dispersion (Pd) in predicting paroxysmal atrial fibrillation in patients with essential hypertension. 69 patients with essential hypertension with paroxysmal atrial fibrillation (observation group) and 207 patients with essential hypertension (control group) were selected in the study. Both of the two groups were performed by biochemical teests, echocardiography and ECG, and the differences of clinical data, Pd and LAD and so on between the two groups were compared. In observation group the comparison of B-type natriuretic peptide (BNP), C-reactive protein (CRP), maximum duration of P wave (Pmax), Pd, LAD, left ventricular mass index (LVMI) was significantly higher than those of the control group (P<0.05). Logistic regression analysis showed that Pd and LAD were the influencing factors of essential hypertension with paroxysmal atrial fibrillation (P<0.05). The ROC curve area of LAD combined with Pd in predicting essential hypertension with paroxysmal atrial fibrillation was 0.919, which was significantly higher than 0.815 and 0.745 predicted by LAD and Pd alone (P<0.05). LAD and Pd are the influencing factors of paroxysmal atrial fibrillation in patients with essential hypertension, the combination of LAD and Pd could have good application value in predicting paroxysmal atrial fibrillation.

Application of 320-slice CT in the Interventional Therapy for Congenital Heart Disease

GAO Haichao, LI Shucheng, KONG Fanqiang, LI Dongyang, WANG Qingsong, WANG Xibing, WANG Zhuxiu

2022, 40(3):  615-619.  DOI: 10.7517/issn.1674-0475.211139

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This study explored the application value of 320-slice CT in the interventional therapy for congenital heart disease (CHD). A retrospective study was carried out in 66 patients with CHD, including 33 cases of atrial septal defect (ASD) and 33 cases of ventricular septal defect (VSD). All patients underwent transthoracic echocardiography (TTE) and 320-slice CT four-dimensional volume dynamic imaging (4D-CCTA) before and after interventional occlusion surgery. The results showed that the difference between the maximum diameter of ASD, VSD and the waist diameter (POS) of the occluder measured by preoperative TTE and 4D-CCTA was smaller than the difference measured by TTE (P<0.05). The maximum diameter of ASD and VSD measured by preoperative TTE and 4D-CCTA both had a good correlation with POS and the selected type of occluder (P<0.05), and the latter had a higher correlation. The postoperative EF, EDVI, ESVI, SVI, and CI of CHD patients measured by 4D-CCTA were lower than those data measured by TTE (P<0.05). It can be seen that 320-slice CT could accurately measure the size of preoperative ASD and VSD, and total interval length of CHD patients, which could be helpful to guide doctors in selecting the type 615of occluder, and accurately evaluate the left ventricular function of patients after operation.

The Effect of TCD Observation on Microemboli Formation on the Prognosis of Patients with ACI Thrombolytic Therapy

HU Gaozhi, LIU Huiming

2022, 40(3):  620-624.  DOI: 10.7517/issn.1674-0475.211202

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This study investigated the clinical value of transcranial Doppler (TCD) in patients with acute cerebral infarction (ACI) to observe the changes of microemboli after intravenous thrombolysis. Selected 134 ACI patients treated with intravenous thrombolytic therapy with alteplase (rt-PA), and all the patients were monitored by TCD. They were divided into micro thrombus group (micro thrombus formation) with 55 cases and control group (no micro thrombus formation) with 79 cases. Compared the relationship of National Institutes of Health Stroke Scale (NIHSS) score, carotid plaque characteristics, and infarct size at different time points before and after thrombolytic therapy between the two groups. All patients were followed up for 3 months to observe and evaluate the prognosis, and to analyze the relationship between the microemboli formation and the recovery effect of patients. The NIHSS scores of the micro thrombus group at 7 days and 14 days of thrombolysis treatment were higher than those of the control group (P<0.05). The proportion of patients with large-area infarction was higher than that of the control group (P<0.05). Multivariate analysis showed that increased NIHSS score on admission, patients with coronary heart disease, large infarction lesions, and microembolism after thrombolysis were independent risk factors for poor prognosis in patients with ACI treated with rt-PA intravenous thrombolysis (P<0.05). Intravenous thrombolysis with rt-PA in ACI patients complicated with microembolism will adversely affect the prognosis and recovery of patients.

Effects of Coronary Artery Stenosis Degree on Ventricular Repolarization Indexes in Patients with Coronary Heart Disease

LI Dongmei, LIU Lianghua, MO Yanli, HUANG Junzhang

2022, 40(3):  625-630.  DOI: 10.7517/issn.1674-0475.211208

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The purpose of this study was to investigate the effect of coronary artery stenosis degree on ventricular repolarization indexes. Chosen 105 patients with coronary heart disease as observation group, including 63 cases of acute coronary syndrome (ACS) and 42 cases of stable angina pectoris (SAP), and chosen 60 patients with non coronary heart disease were selected as the control group. The differences of ECG and cardiac ultrasound parameters between the two groups were compared. QTV, QTc interval, TpTe, TpTe/QT, left atrial diameter, left ventricular posterior wall thickness, ventricular septal thickness and left 625 ventricular end diastolic diameter in the observation group were significantly higher than those in the control group (P<0.05), while the left ventricular ejection fraction was significantly lower than that in the control group (P<0.05). In observation group the TpTe, TpTe/QT and left atrial diameter of ACS patients were significantly higher than those of SAP patients (P<0.05), while the left ventricular ejection fraction was significantly lower than that of SAP patients (P<0.05). The QTV, QTc interval, TpTe, TpTe/QT and left ventricular end diastolic diameter of patients with severe stenosis in the observation group were significantly higher than those in patients with mild to moderate stenosis (P<0.05), while the left ventricular ejection fraction was significantly lower than those of patients with mild to moderate stenosis (P<0.05). Gensini score was positively correlated with QTV, QTc interval, TpTe and TpTe/QT (P<0.05), but negatively correlated with left ventricular ejection fraction (P<0.05). The area under ROC curve of QTV, QTc interval, TpTe, TpTe/QT combined with left ventricular ejection fraction in predicting severe stenosis was 0.931, P<0.05. The degree of coronary artery stenosis in coronary heart disease is positively correlated with ventricular repolarization index, ventricular repolarization index has a certain value in predicting the degree of stenosis.

Predictive Value of Tan Score for Recurrent Infarction in Elderly Patients with AIS

ZHAO Hongying, ZHANG Huifang, YANG Guotao, GU Qianqian, WANG Wenhao, WANG Haibin

2022, 40(3):  631-635.  DOI: 10.7517/issn.1674-0475.211209

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This paper discussed the predictive value of CT middle cerebral artery regional collateral scoring system - Tan score for recurrent infarction in elderly patients with acute ischemic stroke (AIS). 140 elderly AIS patients were selected, including 33 patients with recurrent infarction (observation group) and 107 patients without recurrent infarction (control group), the differences of clinical data, laboratory indexes and Tan score between the two groups were observed. The age of the observation group was significantly higher than that of the control group (P<0.05). Compared with the control group, the proportion of fibrinogen (FIB) and Tan score ≤1 in the observation group were higher (P<0.05), while the blood flow velocity of middle cerebral artery in the observation group were lower (P<0.05). Tan score was positively correlated with middle cerebral artery blood flow velocity (r=0.485, P<0.05). Logistic regression showed age, middle cerebral artery blood flow velocity and Tan score were the influencing factors of recurrent infarction in elderly AIS patients (P<0.05). The area under ROC curve of recurrent infarction predicted by Tan score was 0.685, P<0.05, and the sensitivity and specificity were 76.00% and 67.50% respectively. CT middle cerebral artery regional collateral scoring system Tan score has certain application value in predicting recurrent infarction

Study of Carotid Atherosclerotic Plaque in Stroke Patients with T2DM by MRI

ZHOU Yue, QI Enlin, LV Shiying, JIANG Lijie

2022, 40(3):  636-640.  DOI: 10.7517/issn.1674-0475.211211

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This study explored stroke patients with type 2 diabetes mellitus (T2DM), the value of magnetic resonance imaging (MRI) in evaluating carotid atherosclerotic plaque. 81 stroke patients with T2DM (observation group) and 90 stroke patients without T2DM (control group) were selected, the MRI Classification of carotid plaque and so on between the two groups were compared. The proportion of Carotid Plaque MRI types Ⅳ-Ⅴ and Ⅵ, total vessel area (TVA), wall area (WA), Normal Wall Index (NWI), degree of carotid stenosis and fibrinogen (Fib) in the observation group were significantly higher than those in the control group (P<0.05), the proportion of type Ⅲ was significantly lower than that in the control group (P<0.05). MRI has good application value in the analysis of plaque composition and quantitative measurement of carotid artery wall, especially when the carotid atherosclerosis of stroke patients with T2DM is severe.

Study of ECG Parameters in Predicting Variant Angina Pectoris Complicated with Malignant Ventricular Arrhythmia

WANG Chunmei, HAN Weixing

2022, 40(3):  641-645.  DOI: 10.7517/issn.1674-0475.211222

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This study explored the value of electrocardiogram (ECG) parameters such as the cardiac electrophysiological balance index in predicting variant angina pectoris complicated with malignant ventricular arrhythmia. 82 patients with variant angina pectoris complicated with malignant ventricular arrhythmia were selected as the observation group, and 100 patients with variant angina pectoris only were selected as the control group, the differences of ECG parameters between the two groups were analyzed and compared, at the same time the differences of ECG parameters between recurrent group and non-recurrent group were compared. The QT, cardiac electrophysiological balance index and TpTe in the observation group were significantly higher than those in the control group (P<0.05), while JTp was significantly lower than those in the control group (P<0.05). A total of 38 patients had recurrent angina pectoris. The age, QT, cardiac electrophysiological balance index and TpTe of recurrent patients were significantly higher than those of non-recurrent patients (P<0.05), while JTp was significantly lower than those of non-recurrent patients (P<0.05). ECG parameters have certain application value in predicting variant angina pectoris complicated with malignant ventricular arrhythmia and angina pectoris recurrence.

The Effect of Ultrasound Diagnosis of Essential Hypertension on Cardiac Function in Patients with Hypertrophic Obstructive Cardiomyopathy

WEI Rongwen, WEI Fangling, HUANG Huikun, WANG Huixiang, LIN Ying

2022, 40(3):  646-650.  DOI: 10.7517/issn.1674-0475.211223

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This study investigated the effect of essential hypertension on left ventricular remodeling and left heart failure in patients with hypertrophic obstructive cardiomyopathy. 140 patients with hypertrophic obstructive cardiomyopathy were selected, among them 54 patients were complicated with essential hypertension, and all patients were examined by echocardiography. The left ventricular end diastolic diameter and end systolic diameter in patients with hypertension were significantly higher than those in patients without hypertension (P<0.05), while the ventricular septal thickness and left ventricular ejection fraction were significantly lower than those in patients without hypertension (P<0.05). The incidence rate of left heart failure in patients with hypertension was significantly higher than that in patients without hypertension (P<0.05). Logistic regression analysis showed that the age, systolic blood pressure and left ventricular ejection fraction were the influencing factors of left heart failure in patients with hypertrophic obstructive cardiomyopathy with hypertension (OR=1.759, 2.273 and 0.576, P<0.05). Essential hypertension can aggravate left ventricular remodeling in patients with hypertrophic obstructive cardiomyopathy, and have an increased risk of left heart failure.

The Application of MSCT in Staging Diagnosis and Chemotherapy Efficacy Prediction of Gastric Cancer

QIN Jiamin, LIU Guangguo, WANG Hong

2022, 40(3):  651-654.  DOI: 10.7517/issn.1674-0475.211111

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This study aimed to investigate the value of multi-slice spiral CT (MSCT) in staging diagnosis and chemotherapy efficacy prediction of gastric cancer. One hundred patients with gastric cancer treated were selected, all patients were treated with neoadjuvant chemotherapy and accepted MSCT examination. According to the efficacy of chemotherapy, 100 patients were divided into effective group with 39 cases and ineffective group with 61 patients. The results showed that, the Kappa value of MSCT T stage and pathological T stage was 0.706 (P<0.05), and the diagnostic accuracy rate of MSCT T stage was 79.00%. The Kappa value of MSCT N stage and pathological N stage was 0.718 (P<0.05), and the diagnostic accuracy rate of MSCT N stage was 83.00. The reduction rate of CT tumor density and CT tumor volume in the effective group were significantly higher than those in the ineffective group (P<0.05). In predicting the effectiveness of chemotherapy the area under ROC curve of CT tumor density reduction rate and CT tumor volume reduction rate were 0.922 and 0.811, respectively (P<0.05). MSCT has a good diagnostic value in preoperative staging of gastric cancer, and could predict the efficacy of chemotherapy.

Influence of Knee Arthroplasty on Joint Function Recovery in Patients with Knee Unicompartmental Osteoarthritis

LIN Xiaoping, MIAO Decheng, LI Yawei

2022, 40(3):  655-658.  DOI: 10.7517/issn.1674-0475.211212

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This study explored the application value of knee arthroplasty in the treatment of unicompartmental knee osteoarthritis. 103 patients with knee single compartment osteoarthritis were divided into control group (n=53) and observation group (n=50) according the operation mode, the control group was treated with single condylar replacement, and the observation group was treated with knee joint replacement, the operation time and intraoperative bleeding volume of the two groups and so on were observed. The operation time and hospitalization time in the observation group were significantly longer than that in the control group, and the intraoperative bleeding amount was significantly more than that in the control group (P<0.05). There were no significant differences between the observation group and the control group in terms of the change value of femoral anterior condyle deviation, femoral prosthesis flexion angle, tibial retroinclination angle and tibial angle (P>0.05). The serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in the observation group at 24 hours after operation were significantly higher than those in the control group (P<0.05). There was no significant difference in knee mobility (ROM) and New York Special Surgery Hospital knee joint (HSS) between the observation group and control group (P>0.05). There was no significant difference in the incidence of complications between the observation group and the control group (P>0.05). Knee arthroplasty has a good effect on the treatment of knee unicompartmental osteoarthritis, but it has many disadvantages, such as large trauma, large amount of bleeding and so on.

Rapid MRI Combined with Maternal Serum Markers in the Diagnosis of Fetal CNS Developmental Malformations in the Second Trimester of Pregnancy

SUN Lingling, HU Rong, HU Jingjing

2022, 40(3):  659-664.  DOI: 10.7517/issn.1674-0475.211143

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This paper explored the application value of rapid MRI combined with maternal serum marker detection in the diagnosis of fetal central nervous system (CNS) developmental malformations in the second trimester of pregnancy. Selected 112 pregnant women with suspected fetuses CNS developmental malformations in the second trimester of pregnancy as research objects, and all of them underwent MRI examination and maternal serum marker detection. The results showed that the incidence of fetal CNS malformation was 18.75%; 19 cases of fetal CNS malformation were detected by rapid MRI, of which 18 were true positive. The serum levels of alpha-fetoprotein (AFP) and free β-human chorionic gonadotropin (Free-β-hCG) in the second trimester of mothers with fetal CNS malformation were higher than those of non-malformed mothers, while the levels of pregnancy-associated plasma protein-A (PAPP-A) and free estriol (uE3) were lower than those of non-malformed mothers (P<0.05). The levels of maternal serum AFP, Free-β-hCG, PAPP-A and uE3 were all independent influencing factors of fetal CNS malformation in the second trimester of pregnancy (P＜0.05). The area under the curve (AUC) for fetal CNS developmental malformations through rapid MRI combined with maternal serum AFP, Free-β-hCG, PAPP-A and uE3 diagnosis was 0.961. Rapid MRI combined with maternal serum marker detection has a high application value in the diagnosis of fetal CNS developmental malformations in the second trimester pregnancy.

The Sand Bed Rehabilitation Training Effect and Lateral Collateral Ligament Injury of Ankle Evaluation Through High-frequency Ultrasound Image

LIU Yunwu, GUO Qiming, HE Yinghui, SUN Fenghao, LI Shihao

2022, 40(3):  665-669.  DOI: 10.7517/issn.1674-0475.211129

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This article discussed the clinical value of high-frequency ultrasound in the diagnosis of ankle lateral collateral ligament injury and the rehabilitation training of sand bed. 120 patients with ankle lateral collateral ligament injury treated were selected as the research subjects. Among them, 78 patients were treated with conservative rehabilitation therapy combined with sand bed rehabilitation training (conservative group), and 42 patients were treated with surgery combined with sand bed rehabilitation training (operation group). There was no significant difference in the degree of injury of the anterior talofibular ligament diagnosed by high-frequency ultrasound compared with MRI in the conservative group (P>0.05). There were 34 cases patients with anterior calcaneofibular ligament injury in the conservative group, and there was no significant difference in diagnosis of anterior calcaneal and fibular ligament injury between high-frequency ultrasonography and MRI (P>0.05). There was no significant difference in the degree of injury of the anterior talofibular ligament and anterior calcaneofibular ligament in the high-frequency ultrasound diagnosis665of the operation group and intraoperative findings (P> 0.05); high-frequency ultrasound evaluation of the ankle joint function of the cured group was significantly better than that of the effective group (P<0.05). There is little difference between high-frequency ultrasound in diagnosing lateral ankle collateral ligament injury and MRI diagnosis and intraoperative findings. High-frequency ultrasound has certain clinical value as a preoperative diagnosis of ankle lateral collateral ligament injury and judgment of ankle function recovery.

Application of IVIM in the Diagnosis of Renal Transplantation Rejection

FAN Shuangli, WANG Xiaojing, FAN Shuangyuan, WANG Yuqiang

2022, 40(3):  670-674.  DOI: 10.7517/issn.1674-0475.211144

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This study explored the application value of voxel incoherent motion (IVIM) in the diagnosis of renal transplantation rejection. 53 patients with renal transplantation were selected as the research object. According to the pathological results, there were 24 patients with acute rejection (rejection group) and 29 patients with normal renal function (non-rejection group), and analyzed the difference of IVIM parameters between rejection group and non-rejection group. The total apparent diffusion coefficients (ADC_T) of renal cortex and medulla in the rejection group were significantly lower than those in the non-rejection group (P<0.05). There were no significant differences in the pure diffusion apparent diffusion coefficient (ADC_D), pseudo perfusion apparent diffusion coefficient (ADC_P) and volume fraction of pseudo diffusion (F_P) in renal cortex and medulla between the rejection group and non-rejection group (P>0.05). There were no significant differences in IVIM parameters between patients with cellular rejection, humoral rejection and mixed rejection (P>0.05). The areas under the ROC curve of renal cortex and medulla ADC_T in the diagnosis of acute rejection of transplanted kidney patients were 0.793 and 0.889, respectively, P<0.05. The total apparent diffusion coefficient of IVIM scan parameter has a good application value in the diagnosis of renal transplantation rejection.

MRI Diagnosis of Sports Meniscus Injury and Evaluation of Postoperative Rehabilitation Effect

LI Yan, ZHAO Hailing, LI Wei, ZHAO Dan

2022, 40(3):  675-679.  DOI: 10.7517/issn.1674-0475.211206

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This article investigated the value of magnetic resonance imaging (MRI) in diagnosing the degree of sports-induced meniscus injury in young and middle-aged patients and the postoperative rehabilitation effect of patients. A retrospective study was performed on 98 patients with sports-induced meniscus injury treated. All patients received high-frequency ultrasound and MRI examinations before surgery, and all patients received arthroscopic surgical repair. The results showed that the sensitivity and specificity of MRI in diagnosing knee meniscus injury by preoperative MRI were 90.00% and 88.16%, the sensitivity and specificity of knee ligament injury by MRI were 76.79% and 97.02% respectively. The MRI damage grade of knee meniscus at 3 months and 6 months after operation was significantly lower than that before operation, and the difference was statistically significant (P<0.05). 6 months after the operation, the knee joint function grade was positively correlated with MRI meniscus recovery grade (r=0.850, P<0.001). MRI has high diagnostic value in the diagnosis of young and middle-aged sports meniscus injury, and could also evaluate the postoperative rehabilitation effect of patients.

Diagnosis and Analysis of Rotator Cuff Injury in Female Badminton Athletes with MRI PDW-SPAIR Sequence

ZHANG Ling, AN Yifan, FAN Yong, QIU Mingqiang

2022, 40(3):  680-684.  DOI: 10.7517/issn.1674-0475.211131

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This research explored the value of magnetic resonance proton density-weighted spectral attenuated inversion recovery (PDW-SPAIR) sequence in the diagnosis of rotator cuff injury in female badminton players and its comparison with arthroscopic findings. 76 female badminton players treated for shoulder disease were selected and underwent magnetic resonance PDW-SPAIR sequence and arthroscopy. Through inspection and analysis, 68.42% of them were rotator cuff injuries; the sensitivity, specificity and accuracy of magnetic resonance PDW-SPAIR sequence in diagnosing patients with rotator cuff injury were 96.15%, 91.67%, and 94.74%, respectively, and compared with arthroscopic diagnosis, there was no significant difference (P>0.05). It was high consistency between magnetic resonance PDW-SPAIR sequence diagnosis of rotator cuff injury in patients with injury grading and arthroscopic diagnosis (Kappa value 0.981). The preoperative magnetic resonance PDW-SPAIR sequence rotator cuff fatty infiltration score of patients with rotator cuff injury confirmed by magnetic resonance PDW-SPAIR sequence examination was higher than that during surgery (P<0.05). This shows the magnetic resonance PDW-SPAIR sequence has high diagnostic performance in the diagnosis of rotator cuff injury in female badminton players, and its diagnosis of rotator cuff injury patients has a high consistency with arthroscopic diagnosis.

Analysis of the Relationship between Skeletal Muscle and Serum Free Amino Acid Changes and Sports Injury Based on CT Images

WANG Xiaona, WANG Wei

2022, 40(3):  685-689.  DOI: 10.7517/issn.1674-0475.211128

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This article aimed to explore the influence of the changes in skeletal muscle and serum free amino acid content on aerobics sports injuries based on CT images. 20 sports-injured athletes (experimental group) and 20 healthy aerobics athletes (control group) were selected, and their ankle joint injuries were analyzed by CT scan. The skeletal muscle index (SMI), serum albumin and free amino acid content, and the ratio of branched chain amino acids to tyrosine (BTR) of the subjects were measured. The results showed: (1) The CT images of the athletes in the experimental group showed bone abnormalities, ligament and tendon injuries, among which cartilage osteophytes accounted for 55.96% and triangular bone injuries accounted for 29.36%. (2) Compared with the control group, the athletes in the experimental group showed higher SMI (P<0.05), and the serum albumin content and BTR were lower (P<0.05). (3) Regression analysis showed that serum albumin content was negatively correlated with BTR and SMI (P<0.05). In short, the increase in skeletal muscle mass could accelerate the imbalance of amino acid circulation, and serum BTR may be a marker of the high metabolic state of aerobics athletes with sports injuries.

Application of MRI in Preoperative Examination and Postoperative Management of Sports-induced Ankle Fractures

ZHU Chao, MA Yiming

2022, 40(3):  690-695.  DOI: 10.7517/issn.1674-0475.211219

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This article explored the application of MRI in the preoperative examination and postoperative management of sports-induced ankle fractures. 98 patients with ankle fractures caused by sports were selected as research objects, and used MRI to scan the ankle joints in different body positions, and then scored the ankle function according to the AOFAS scoring system. The results showed that MRI multi-planar, multi-sequence scan can clearly show the anatomical structure around the ankle ligament, significantly improve the accuracy of clinical diagnosis. The single factors related to ankle fractures include: diabetes, smoking, trauma, violence, whether the syndesmosis of the tibia and fibula was fixed during the operation, fracture reduction, fracture classification. Multi-factor analysis of ankle fracture functional recovery was related to fracture reduction and fracture classification. In short, MRI could significantly improve the accuracy of preoperative examination of sports-induced ankle fractures, and in postoperative management, the classification of ankle fractures and the reduction of fractures need to be fully evaluated.