Table of Content

23 July 2022, Volume 40 Issue 4

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2022, 40(4):  0-0. 

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Review and Articles

Study on Dynamic Speckle Field Digital Holographic Microscopy

CHEN Jianbing, GE Lei, WEN Yongfu

2022, 40(4):  697-703.  DOI: 10.7517/issn.1674-0475.211227

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Quantitative phase microscopy (QPM) has found significant applications in the field of biomedical imaging which works on the principle of interferometry. The theory behind achieving interference in QPM with conventional light sources such as white light and lasers is very well developed. Recently, the use of dynamic speckle illumination (DSI) in QPM has attracted attention due to its advantages over conventional light sources. The present article provides the basic understanding of DSI through experiments that is essential to build interference optical microscopy systems such as QPM, digital holographic microscopy and optical coherence tomography. The experimental results preliminarily verify that the DSI-based digital holography system has the advantages of low space, high time coherence, high spatial phase sensitivity, expandable field of view and resolution.

Synthesis and Properties of Coumarin-based Alicyclic Oxime-esters as Visible Light Photoinitiators

LI Mengqi, ZHU Junzhe, HU Peng, LI Zhiquan, LIU Ren

2022, 40(4):  704-713.  DOI: 10.7517/issn.1674-0475.220205

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A series of visible light photoinitiators, containing coumarins as chromophores and oxime-esters as initiating groups, were designed and synthesized. The alicyclic groups with different structures were introduced at the end of the oxime esters to study the behavior of alicyclic radicals as active species. The oxime-ester photoinitiators show strong absorption at 350-500 nm and rapid photolysis occurs under LED visible light irradiation with photobleaching characteristics. The active species generated after photolysis can effectively initiate free radical photopolymerization of acrylate monomers and thiol-ene monomers. The novel photoinitiators can be further applied to DLP 3D printing to construct luminescent 3D structures with high precision.

UV-curing and Properties of Fluorine-containing Cycloaliphatic Diepoxides

QIN Yue, WANG Yuechuan

2022, 40(4):  714-720.  DOI: 10.7517/issn.1674-0475.220337

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Although cycloaliphatic epoxides are highly active in photocuring reaction, they need to be improved in refractive index, dielectric constant and resistance to water to satisfy the requirement for optoelectronic applications. In this work we comparatively study two cycloaliphatic fluorine-containing diepoxides, 2,2'-((2,2,3,3-tetrafluorobutane-1,4-diyl)bis(oxy))bis(7-oxabicyclo[4.1.0]heptane) (TCE) and 2,2'-((2,2,3,3,4,4,5,5-octafluorohexane-1,6-diyl)bis(oxy))bis(7-oxabicyclo[4.1.0]heptane) (OCE), with a commercial available cycloaliphatic epoxy resin ERL-4221 with the similar structure in their photocuring kinetics, dynamic mechanical, thermal, optical and surface energy properties. TCE and OCE are reactive in photocuring similar to ERL-4221, but are more sensitive in the effects of photocuring temperature on curing rate and conversion. The DMA and TGA data show that both the UV-cured fluorine-containing epoxy compounds, C-TCE and C-OCE, exhibited glass transition temperature higher than 150℃, and are more thermally resistant than the cured C-ERL-4221. The contact angle tests indicate that the hydrophobicity and oleophobicity of the material surfaces of C-TCE and C-OCE are greatly improved by the fluorine atoms. C-TCE and C-OCE are optically transparent in the range from visible to near infrared. This work shows that TCE and OCE have great application prospects as advanced photocurable materials.

Transvaginal s-Flow Technology to Monitor Endometrial Parameters to Evaluate Female Endometrial Receptivity During Pregnancy

XIN Yanli, DU Jianwen

2022, 40(4):  721-724.  DOI: 10.7517/issn.1674-0475.211228

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This study explored the application value of s-Flow technology in evaluating female endometrial receptivity during pregnancy. The clinical data of 104 pregnant women who underwent follicle monitoring, underwent transvaginal ultrasonography during the proliferative phase and receptivity phase, and performed color Doppler ultrasound and s-Flow technology to detect blood flow imaging. The endometrial thickness, blood flow parameters, echo type, endometrial-subendometrial blood flow type and other indexes of two different phases were compared. The endometrial thickness and the blood flow parameters of the uterine spiral artery of the pregnant women were significantly different between the two phases (P<0.05). In the proliferative phase, the endometrial is mainly "third-line sign", and it is mainly hyperecho in the receptivity phase. Correlation analysis showed that there was a positive correlation between endometrial echo type and endometrial-subendometrial blood flow type, CDFI(r=0.710,P<0.05), s-Flow(r=0.692,P<0.05). s-Flow technology is better than CDFI in the display of endometrial-subendometrial blood flow, the difference is statistically significant (P<0.05). The transvaginal s-Flow technology can sensitively display the endometrial-subendometrial blood flow, evaluate the endometrial receptivity, and provide an effective reference for women preparing for pregnancy.

Application of CT in the Diagnosis of Nephrolithiasis Complicated with Pyonephrosis and Preoperative Localization

LIAO Shubin, YANG Dongshen, SU Xiaolin

2022, 40(4):  725-729.  DOI: 10.7517/issn.1674-0475.220315

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This study investigated the application value of CT in the diagnosis of calculous pyonephrosis and preoperative localization. Selected 165 patients with nephrolithiasis complicated with pyonephrosis who were to undergo surgical treatment through randomized clinical study mode, all patients underwent CT examination before surgery. Using surgical results as the gold standard, among them 78 patients were diagnosed with nephrolithiasis complicated with pyonephrosis, and 87 cases were not with nephrolithiasis, analyzed the value of of CT in the diagnosis of nephrolithiasis complicated with pyonephrosis. According to the way of preoperative positioning of stones, the 78 patients with pyonephrosis were divided into CT group with 39 cases (preoperative CT localization) and ultrasound group with 39 cases (preoperative ultrasonic localization) and then compared the influence of two preoperative positioning methods on the surgical outcome. The results showed that the CT value, peripheral white blood cells (WBC), and C-reactive protein (CRP) of the kidney stone combined with pus kidney group were significantly higher than those of the kidney stone group (P<0.05). The sensitivity of CT value, WBC and CRP in the diagnosis of nephrolithiasis complicated with pyonephrosis were 87.81%, 72.57%, and 77.96%, respectively, and the specificity was 82.60%, 76.04%, and 75.75%, respectively,the AUC values were 0.904, 0.759, and 0.810, respectively. The mean operation time, mean lithotripsy time, and hemoglobin (Hb) decrease in the CT group were lower than those in the ultrasound group (P<0.05), the stone clearance rate in the CT group was higher than that in the ultrasound group (P<0.05). There was no significant difference in hospitalization time between the CT group and the ultrasound group (P>0.05). Preoperative CT examination has higher diagnostic sensitivity in patients with renal calculi and pyonephrosis, and CT can be used for calculus localization, and the localization effect is better than ultrasound localization.

Application of Endoscopic Ultrasonography in the Diagnosis of the Nature of Gastric Diseases

MU Leixia, WANG Lei, SUN Junjun, GAO Yaping

2022, 40(4):  730-734.  DOI: 10.7517/issn.1674-0475.220109

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This study investigated the value of endoscopic ultrasonography (EUS) in differential diagnosis of benign and malignant gastric diseases and preoperative TNM staging of gastric cancer. The case control study was used in this paper, 94 patients with gastric cancer (gastric cancer group) and 98 patients with benign gastric diseases (benign group) confirmed by pathological examination were selected. All patients underwent EUS examination. The sensitivity of EUS in the differential diagnosis of benign and malignant gastric tumors was 92.55% and the specificity was 92.86%, the AUC value was 0.927. EUS correctly diagnosed 23 cases of T1 stage, 21 cases of T2 stage, 11 cases of T3 stage, and 8 cases of T4 stage. The Spearman correlation between EUS-diagnosed T stage and postoperative pathology was 0.818, Kappa=0.616 (all P<0.05). EUS correctly diagnosed 35 cases of N0 stage, 21 cases of N1 stage and 6 cases of N2 stage. Spearman correlation between N stage and postoperative pathology by EUS was 0.584, Kappa=0.523 (all P<0.05). EUS correctly diagnosed 64 cases of M0 stage and 15 cases of M1 stage. Spearman correlation between M stage and postoperative pathology by EUS was 0.733, Kappa=0.731 (all P<0.05). EUS has high sensitivity and specificity in the differential diagnosis of benign and malignant gastric tumors. At the same time, as a preoperative TNM staging evaluation method, it has a high consistency with the pathology of surgical results, so it could be used clinically as a gastric cancer patient methods of diagnosis and pathological judgment.

The Value of CCTA in Diagnosing Left Coronary Artery Bifurcation Lesions and Its Risk Factors

TANG Yunjun, ZHANG Hailin, YANG Shengjie

2022, 40(4):  735-740.  DOI: 10.7517/issn.1674-0475.220316

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This article investigated the clinical value and risk factors of spiral CT coronary angiography (CCTA) in the diagnosis of left coronary bifurcation lesions. Selected 200 patients with coronary heart disease who received CCTA and coronary angiography for analysis. Taking coronary angiography results as the diagnostic gold standard, the patients were divided into the left coronary angle proximal lumen stenosis group (93 cases) and non-stenosis group (107 cases). In the stenosis group, the included angle of the left coronary artery was negatively correlated with the lumen diameter and the measured value of the lumen cross-sectional area (P<0.05). The area under the ROC curve (AUC) of the left coronary angle in the diagnosis of the proximal lumen stenosis of the left coronary angle was 0.894, the diagnostic sensitivity was 81.36%, the specificity was 83.55%, and the critical value of the left coronary angle was 81.3°. Smoking, combined hypertension, family history of coronary heart disease, increased serum TG, increased HDL-C, increased hs-CRP, increased FPG, and left coronary angle > 81.3° were the independent risk factors (P<0.05) for the occurrence of proximal lumen stenosis in the left coronary angle. Increased serum HDL-C level can reduce the risk of stenosis in the proximal segment of the left coronary angle (P<0.05). The use of CCTA to examine the included angle of the left coronary artery has a high clinical value in predicting and diagnosing the proximal lumen stenosis of the left coronary angle. The proximal lumen stenosis of the left coronary angle in patients with coronary heart disease is affected by many factors, among them the increased included angle of arteries (>81.3°) can significantly increase its risk.

Relationship between CTP Parameters and Cerebral Infarction Condition in Patients with Severe Stenosis or Occlusion of MCA

ZOU Shechang, LING Rong, ZHANG Zewei, WEN Yanbin, ZHENG Lifang

2022, 40(4):  741-745.  DOI: 10.7517/issn.1674-0475.220139

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This study investigated the relationship between CT perfusion imaging (CTP) parameters and cerebral infarction and the establishment of collateral circulation in patients with severe middle cerebral artery (MCA) stenosis or occlusion. 143 patients with severe MCA stenosis or occlusive cerebral infarction were selected as the research subjects. Analyzed the patients' CTP parameters, including cerebral blood flow (CBF), time to peak (TTP), cerebral blood volume (CBV), mean transit time (MTT), according the size of the lesion, the location of the lesion, and the level of collateral circulation established in the patients with cerebral infarction. The relationship between CTP parameters and the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after patients' admission were analyzed. Among the patients with severe MCA stenosis or occlusive cerebral infarction, the CBF value of patients with large-area cerebral infarction was lower than that of patients with moderate-area cerebral infarction, and the TTP value was higher than that of patients with moderate-area cerebral infarction (P<0.05). The CBF and CBV values of patients with collateral circulation grade 0 to 1 were lower than those of patients with collateral circulation grade 2 to 3, and the TTP value was higher than those of patients with collateral circulation grade 2 to 3 (P<0.05). The values of CBF, CBV and MTT in the core of cerebral infarction were lower than those in the penumbra area, and the value of TTP was higher than that in the penumbra area (P<0.05). The patient's NIHSS score was significantly negatively correlated with CBF (r=-0.664, P<0.000) and significantly positively correlated with TTP (r=0.690, P=0.000). There was no significant correlation between NIHSS score and CBV, MTT (P>0.05). CTP can better evaluate the size of infarct focus, the establishment of collateral circulation and the degree of neurological impairment in patients with severe stenosis or occlusion of MCA.

Observation of the Relationship between the Characteristics of Intracranial Vascular Plaque and Patients Prognosis Based on HR-MRI

YANG Shuyin, WANG Zheng

2022, 40(4):  746-751.  DOI: 10.7517/issn.1674-0475.220203

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This study explored the relationship between middle cerebral artery (MCA) and basilar artery (BA) plaque characteristics and patients prognosis with acute ischemic stroke (AIS) assessed by high resolution magnetic resonance imaging (HR-MRI). Chosen 114 AIS patients with MCA or BA stenosis as research objects to conduct the retrospective study, and all patients received MRI and HR-MRI examinations before surgery. According to the prognostic outcome, the patients were divided into the good group with 73 cases and the poor group with 41 cases. Compared and analyzed the differences of MCA and BA plaque parameters between the two groups, and analyzed the plaque characteristics and the relationship between various factors and the prognosis of AIS patients through the logistic multivariate model. In the poor group, the coincidence value of intracranial vascular plaque, the non-positive remodeling rate, the obvious enhancement of plaque signal, and the proportion of patients with intra-plaque hemorrhage were higher than those in the good group, and the difference was statistically significant (P<0.05). The area under the curve (AUC)value of block load predicting the adverse outcome of AIS patients was 0.690, the sensitivity was 78.95%, and the specificity was 57.29%; the three factors of vascular remodeling pattern, plaque signal showing obvious enhancement characteristics, and intraplaque hemorrhage predict the AUC value of the adverse outcome of patients were 0.535, 0.662, 0.645, the sensitivity was 65.85%, 70.73%, 53.66%, and the specificity was 58.90%, 61.64%, 75.34%, respectively. There are many factors which affect AIS patients, the characteristics of intracranial vascular plaques are closely related to the patient prognosis. Observing the characteristics of intracranial plaques through HR-MRI has a certain reference value for evaluating the prognosis of patients.

Application of T2 Mapping and DWI Imaging Technology in the Diagnosis of Patellar Cartilage Injury

LI Chunyi, LI Chunyan

2022, 40(4):  752-756.  DOI: 10.7517/issn.1674-0475.220105

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This paper explored the application value of T2 mapping and diffusion-weighted imaging (DWI) imaging technology in the diagnosis of patellar cartilage injury and its correlation with injury grading. Fifty-five patients with patellar cartilage injury were selected as the research subjects. All of them underwent T2 mapping and DWI examination of the patellar cartilage, and measured the T2 and ADC value of patellar cartilage injury area and the control area. The T2 value and ADC value in the patellar cartilage injury area were higher than those in the control area (P<0.05), the T2 value and ADC value in the patellar cartilage injury area were positively correlated (r=0.713, P<0.001). The areas under the curve (AUC) through T2 value and ADC value diagnosis of patellar cartilage injury were 0.832 and 0.761, respectively, and the cut-off values were 40.73 ms and 17.13×10^-4 mm²/s, respectively. The AUC of the combined diagnosis was 0.931, the sensitivity was 85.45%, and the specificity was 85.45%, which was significantly higher than the two alone. The T2 value and ADC value of the patellar cartilage injury area were significantly correlated with the patellar cartilage injury grade. It suggested that the combination of T2 mapping and DWI was reliable in diagnosing patellar cartilage injury and evaluating the degree of injury.

Application of MSCT and MRI in the Diagnosis of Volleyball Players’ Shoulder Joint Injury

HAN Panxing, WANG Wende

2022, 40(4):  757-762.  DOI: 10.7517/issn.1674-0475.220121

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This study explored the value of multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) in the diagnosis of volleyball players' shoulder joint injuries and their correlation with bone structure. 72 cases of volleyball athletes with shoulder joint injuries were selected, and they were all examined by MSCT and MRI. The results of arthroscopy were regarded as the "gold standard" to compare the value of MSCT and MRI in diagnosing volleyball athletes' shoulder joint injuries and their correlation with bone structure. The results showed that the accuracy of MSCT combined with MRI in diagnosing the types of volleyball players' shoulder joint injuries was higher than MSCT and MRI alone (P<0.05). The Kappa value for the consistency of MSCT combined with MRI in diagnosing volleyball players' shoulder joint injury degree and arthroscopy results was 0.789, and the accuracy was 87.50%. MSCT and MRI detected HTRA on the side of the humeral head on the affected side were greater than the healthy side (P<0.05). MSCT and MRI showed that the IA of the ipsilateral scapular glenoid side was greater than that of the healthy side, while the VA was smaller than that of the healthy side. The MRI examination showed the AVCA of the ipsilateral scapular glenoid side was greater than that of the healthy side (P<0.05), the HAD of the ipsilateral shoulder joint was smaller than the healthy side, and the ACD greater than the healthy side (P<0.05). It can be seen that the combination of MSCT and MRI has a high accuracy in the diagnosis of volleyball players' shoulder joint injury and the determination of the degree of injury, and MRI can more accurately measure the changes of the bone structure for shoulder joint.

Evaluation of Bladder Outlet Patency after Prostate Cancer Operation by Transrectal Three-dimensional Ultrasound and Strain Elastography

ZHAO Jiangrui, QIAO Baoping, YU Xiaoqi, ZHAO Yaosong, XU Xiaolei, YU Shimeng

2022, 40(4):  763-767.  DOI: 10.7517/issn.1674-0475.220129

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This paper analyzed the diagnostic value of transrectal three-dimensional ultrasound and strain elastography for bladder outlet patency in elderly patients after prostatectomy. 130 elderly patients with prostate cancer were selected as the research object. According to the postoperative bladder outlet patency, they were divided into control group and study group, with 65 cases in each group. All patients underwent transrectal three-dimensional ultrasound, strain elastography and urodynamic examination. The results showed that the measured values of maximum bladder perfusion volume and maximum urinary flow rate (Qmax) in the study group were lower than those in the control group (P<0.05). The postvoid residual ruine (PVR), maximum detrusor pressure (Pdetmax), ultrasound measured bladder weight (UEBW), maximum elasticity score, arterial resistance index, transitional zone index and inrush index in the study group were higher than those in the control group (P<0.05). Compared with the single diagnosis of transrectal three-dimensional ultrasound and strain force elastography, the combination of the two has a higher diagnostic value for bladder outlet patency in elderly patients with prostate cancer,the area under the curve (AUC) was 0.868 (P<0.05). Transrectal three-dimensional ultrasound and strain elastography have a high value in the diagnosis of bladder outlet patency after prostatectomy in the elderly patients.

Evaluation of DKI Combined with DWI Quantitative Indicators in the Pathological Characteristics of HCC and the Efficacy of TACE

GUO Yonggang, DU Ying, YE Pengfei

2022, 40(4):  768-772.  DOI: 10.7517/issn.1674-0475.220120

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This study investigated the value of quantitative indicators of diffusion kurtosis imaging (DKI) and diffusion weighted imaging (DWI) in assessing the pathological characteristics of hepatocellular carcinoma (HCC) and evaluating the therapeutic effect of transcatheter arterial chemoembolization (TACE). Selected 98 confirmed HCC patients as the case group,and 100 patients with benign liver tumors as the control group. Compared the DKI and DWI quantitative parameters of the two groups of patients, as well as the differences of DKI and DWI parameters in HCC patients with different tumor differentiation and microvascular invasion, all the above parameters were used to evaluate the effect of TACE in the treatment of HCC. The results showed the mean diffusivity (MD), mean kurtosis (MK) and apparent diffusion coefficient (ADC) values of patients in the case group were lower than those in the control group (P<0.05). The AUC value of MD, MK, ADC to differentially diagnose liver benign and malignant tumors was 0.734, 0.857, 0.898, respectively. The MD, MK and ADC values of HCC patients in (Ⅰ+Ⅱ) stage were higher than those of HCC patients in (Ⅲ+Ⅳ) stage (P<0.05). MD, MK and ADC values in HCC patients with microvascular invasion were all lower than those of HCC patients without microvascular invasion (P<0.05). The values of MD, MK and ADC in the lesions tissue of HCC patients after TACE were higher than those of lesion tissue before TACE (P<0.05). The quantitative parameters of magnetic resonance DKI and DWI have a high value in the differential diagnosis of benign and malignant liver tumors, especially the ADC value. At the same time, they could effectively evaluate the changes of lesion tissue after TACE treatment of HCC.

Study on CEUS Characteristics and Parameter Changes in Patients with Thyroid Cancer

LI Mei, ZHENG Suili, LIU Chu, HUANG Yuechun

2022, 40(4):  773-777.  DOI: 10.7517/issn.1674-0475.220507

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This study investigated the clinical value of contrast-enhanced ultrasound (CEUS) in the differential diagnosis of benign and malignant thyroid tumors, and judging whether thyroid cancer has lymph node metastasis and capsule invasion. 68 patients with confirmed thyroid cancer were selected as the thyroid cancer group and 70 patients with benign thyroid tumor as the control group. Both groups of patients underwent ultrasound and CEUS. The ultrasonic image characteristics, CEUS characteristics and parameter differences between the two groups were compared and analyzed. According to whether the thyroid cancer has envelope invasion and lymph node metastasis, the patients with thyroid cancer were stratified, and the differences of CEUS parameters were compared and analyzed. The proportion of patients with unclear boundary and aspect ratio ≥ 1 in thyroid cancer group was significantly higher than that in control group (P<0.05). The proportion of patients with unclear boundary, uneven enhancement mode and obvious early regression in thyroid cancer group was significantly higher than that in control group (P<0.05). The peak intensity (PI), time to peak (TTP) and mean transit time (MTT) of nodules in thyroid cancer group were significantly lower than those in control group (P<0.05). The PI, TTP and MTT values of thyroid cancer patients with lymph node metastasis were lower than those without lymph nodes (P<0.05). CEUS characteristic parameters and imaging features are of great value in differential diagnosis of benign and malignant thyroid tumors and in judging the degree of malignancy of thyroid cancer.

Study of CTA and CTP in Evaluating the Establishment of Collateral Circulation and Cerebral Perfusion in Patients with AIS

WU Lei, HU Dong, GAO Xu, CAO Xuehua, LIU Jing

2022, 40(4):  778-783.  DOI: 10.7517/issn.1674-0475.211225

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This study investigated the value of CT angiography (CTA) and whole brain CT perfusion imaging (CTP) in assessing the establishment of collateral circulation and cerebral perfusion in patients with acute ischemic stroke (AIS), and analyzed the relationship between CTA, CTP and patient prognosis. 139 patients with AIS were selected for 256-slice spiral CT scan. According to the Glasgow outcome scale (GOS), the patients were divided into a good group with 95 cases and a poor group with 44 cases. Taking the detection results of DSA collateral circulation as the diagnostic gold standard, the sensitivity and specificity of CTA in diagnosing the establishment of intracranial arterial collateral circulation in patients with AIS were 95.12% and 91.23%, respectively. The scores of collateral circulation degree, cerebral blood volume (CBV), cerebral blood flow velocity (CBF), time to peak (TTP) and mean transit time (MTT) in the good group were higher than those in the poor group (P<0.05). Higher NIHSS score, larger infarct size, and cerebral vascular occlusion were independent risk factors of poor prognosis for AIS patients at admission (P<0.05). Good collateral circulation, higher levels of CBV and CBF cerebral perfusion are benefit for the recovery of patients' later prognosis (P<0.05). CTA has a higher sensitivity in detecting the establishment of intracranial arterial collateral circulation in patients with AIS. At the same time, early observation of the establishment of collateral circulation and cerebral perfusion level in patients has certain clinical value for evaluating the prognosis and recovery of patients.

Effects of Multi-slice Spiral CT Combined with Iodixanol on Image Quality and Renal Function

YANG Jingyi, YAN Qingyu, WEN Lin

2022, 40(4):  784-788.  DOI: 10.7517/issn.1674-0475.211224

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This paper discussed the effect of multi-slice spiral CT combined with isotonic contrast agent iodixanol on image quality and renal function was discussed. 110 coronary heart disease patients underwent multi-slice spiral CT were selected, and divided them into observation group (n=60) and control group (n=50) according to different contrast media, both groups were given multi-slice spiral CT examination. The observation group was given isosmotic contrast agent iodixanol, and the control group was given iohexol, the image quality and renal function of the two groups were analyzed. There was no significant difference in the subjective evaluation results of image quality between the observation group and the control group (P>0.05). There were no significant differences in CT values, noise value (SD), signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of ascending aortic root, left main artery and right coronary artery between observation group and control group (P>0.05). The serum creatinine (Scr) and blood urea nitrogen (BUN) after angiography in observation group were significantly lower than those in control group (P<0.05). The incidence of adverse reactions in observation group was 1.67%, which was significantly lower than that in control group (P<0.05). Multi slice spiral CT combined with isotonic contrast agent iodixanol has high application value, good image quality and no significant effect on renal function.

Application Analysis of DWI ADC Value in the Diagnosis of Rectal Cancer

CHEN Qian, ZHANG Yannan, LIU Jie, HUANG Shuo

2022, 40(4):  789-793.  DOI: 10.7517/issn.1674-0475.220103

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This study explored the correlation and clinical predictive value of the apparent diffusion coefficient (ADC) value of diffusion weighted imaging (DWI) with the type and degree of pathological differentiation of rectal cancer. Using a retrospective study, 105 patients with rectal cancer were selected as observation group, and 50 patients with benign rectal lesions were selected as the control group. Compared the difference of ADC value between the two groups, and then analyzed the differences of ADC values in rectal cancer patients with different clinicopathological and prognosis. The results showed that, the ADC value of lesions in the observation group was significantly lower than that in the control group (P<0.05). The ADC values of patients with low differentiation, Dukes stage C-D, extranodal tumor implantation and Ki-67 ≥ 14% were significantly lower than that of patients with medium and high differentiation, stage A-B, no extranodal tumor implantation and Ki-67<14% (P<0.05). The ADC value of rectal cancer lesions was negatively correlated with Ki-67 (r=-0.578, P<0.05). ADC value predicted the areas under ROC curve of poorly differentiated and Dukes stages C-D were 0.827 and 0.770, respectively (P<0.05). ADC value predicted the area under ROC curve with extranodal tumor implantation was 0.620 (P>0.05). The ADC value of lesions in deceased patients was lower than that of surviving patients (P<0.05). The area under ROC curve of ADC value predicting prognosis was 0.602 (P>0.05). The ADC value of rectal cancer has certain application value in predicting the degree of differentiation and Dukes stage.

The Application of Ultrasonic Pedicle Artery Hemodynamic Monitoring Combined with ESA in Oral and Maxillofacial Defect Repair

FAN Yiqun, LIU Qinjun, HU Yanhe, WANG Yanqing

2022, 40(4):  794-798.  DOI: 10.7517/issn.1674-0475.211134

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This study explored the application value of color Doppler ultrasound pedicle arterial hemodynamic monitoring combined with end-to-side arterial anastomosis (ESA) in the repair of oral and maxillofacial defects. 80 patients with oral and maxillofacial defects repaired were selected, and they were divided into observation group (n=42) and control group (n=38) according to the parity of the end of hospitalization number.The observation group was treated with color Doppler ultrasound pedicle artery hemodynamic monitoring combined with ESA, the control group was treated with ESA. The results showed the valve removal time and arterial anastomosis time in the observation group were significantly shorter than those in the control group (P<0.05). peak systolic velocity (PSV) and blood flow in the observation group at 1 d, 3 d and 7 d after operation were significantly higher than those in the control group (P<0.05), while resistance index (RI) was significantly lower than that in the control group (P<0.05). 7 days after operation, the serum interleukin-2 (IL-2) of the observation group was significantly higher than that of the control group (P<0.05), while the soluble interleukin receptor-2 (sIL-2R) and sialic acid (SA) were significantly lower than that of the control group (P<0.05). Color Doppler ultrasound pedicle arterial hemodynamic monitoring combined with ESA has the advantages of less valve retrieval time and arterial anastomosis time, and excellent hemodynamic indexes of skin flap early after surgery. It is good in oral and maxillofacial defect repair value.

Application of Interventional Closure Under the Guidance of TEE in VSD Closure Surgery

CHEN Menghui, LIANG Zheng, ZHANG Guoliang, GONG Rui

2022, 40(4):  799-803.  DOI: 10.7517/issn.1674-0475.220106

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This study investigated the clinical effect of transesophageal echocardiography (TEE)-guided interventional closure surgery for ventricular septal defect (VSD). 53 patients with simple perimembranous VSD were selected for retrospective analysis. Among them, 29 patients underwent VSD occlusion through TEE-guided retrograde intubation through the femoral artery (study group), and 24 patients underwent traditional radiotherapy, the arteriovenous channel was established to perform transcatheter VSD interventional closure surgery (traditional group). The operation time, size of occluder, perioperative and postoperative complications, and echocardiographic indexes of left ventricular function of patients before and after surgery were compared between the two groups. The results showed that there was no significant difference in the size of the occluder between the research group and the traditional group (P>0.05), and the operation time of the research group was shorter than that of the traditional group (P<0.05). At 3 and 6 months after operation the measured values of Tie index, LVEDV, LVESV, peak E and peak A in the two groups were significantly lower than those before operation in the same group (P<0.05), and the measured values of LVEF were significantly higher than those in the same group. TEE-guided retrograde femoral artery intubation to complete VSD closure surgery is not much different from that of establishing arteriovenous passages under traditional radiation to implement transcatheter VSD interventional closure surgery, but the former simplifies surgical procedures and reduces X-ray damage.

Relationship between HRV Parameters and Infarct Site, Number of Diseased Blood Vessels and Prognosis in Patients with AMI

CHEN Zhijie, WANG Chunqing, KANG Xiaoqin, XU Xin, ZHANG Zhiyu

2022, 40(4):  804-809.  DOI: 10.7517/issn.1674-0475.220310

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This study investigated the differences and significance of heart rate variability (HRV) parameters with different infarct sites, different coronary artery disease branch numbers and different prognosis outcomes in patients with acute myocardial infarction (AMI). 200 confirmed AMI patients were selected as the AMI group, and 200 non-coronary heart disease patients were selected as the control group. The HRV parameters of the AMI group and the control group were detected. Patients were stratified according to the number of coronary artery lesions, different infarct sites and major adverse cardiac events (MACE) after 18 months of follow-up, and the changes of HRV parameters were analyzed. The results showed the SDNN, SDANN, SDNNI, RMSSD, and PNN50 in the AMI group were all lower than those in the control group (P<0.05). In the AMI group, there were 28 patients with non-ST segment elevation, 114 patients with myocardial infarction of anterior wall and 58 patients with myocardial infarction of inferior wall. The SDNN, SDANN and SDNNI of patients with anterior wall AMI were lower than those of patients with non-ST segment elevation and inferior wall AMI (P<0.05). The SDNN and SDANN of patients with MACE events were lower than those of AMI patients without MACE (P<0.05). Observing the early HRV parameters of AMI patients has a certain clinical reference value for the diagnosis of myocardial infarction site and patient prognosis.

Diagnostic Analysis of Anterior Cruciate Ligament Rupture Caused by Taekwondo Exercise through NWI and NSI

CAI Linlin, MA Lin, XIONG Yongrui

2022, 40(4):  810-814.  DOI: 10.7517/issn.1674-0475.220134

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This study explored the value and clinical significance of MRI measurement of intercondylar fossa width index (NWI) and intercondylar fossa shape index (NSI) in the diagnosis of anterior cruciate ligament (ACL) rupture caused by taekwondo. 82 patients with ACL rupture caused by taekwondo were selected as the research objects. The affected knee joint was taken as the fracture group and the healthy knee joint was taken as the normal group. MRI was used to scan the knee joint, measure the height of intercondylar fossa (ICH), width of intercondylar fossa (ICW) and width of femoral condyle (EW), and calculate NWI and NSI. The results showed that the levels of ICW, NWI and NSI in the fracture group were lower than those in the normal group (P<0.05). NWI and NSI were significantly correlated with the incidence of ACL rupture caused by taekwondo (P<0.05). The area under the curve (AUC) of the combined diagnosis of NWI and NSI was 0.911, the diagnostic specificity was 81.71%, and the sensitivity was 91.46%. After treatment, the levels of NWI and NSI in rehabilitated patients were higher than those in non-rehabilitated patients (P<0.05). NWI and NSI in patients with ACL rupture caused by taekwondo were positively correlated with the treatment effect (P<0.05). Therefore, MRI measurement of NWI and NSI has certain value in the diagnosis of ACL rupture caused by taekwondo, and is significantly related to the curative effect of patients.

The Anesthesia Effect of Ultrasound-guided Transversus Abdominis Plane Block on Senile Laparoscopic Appendectomy

YI Fanyan, CHEN Tangbin

2022, 40(4):  815-820.  DOI: 10.7517/issn.1674-0475.220202

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This study investigated the anesthesia effect of senile laparoscopic appendix surgery under general anesthesia combined with ultrasound. Chosen 160 patients underwent laparoscopic appendectomy, with a prospective randomized trial protocol they were divided into ultrasound group and control group with 80 cases respectively. Both groups were treated with laparoscopic surgery under general intravenous anesthesia. Patients in the ultrasound group were combined with ultrasound-guided transversus abdominis plane block anesthesia based on the above anesthesia methods, and the control group was combined with anatomical methods to locate the transversus abdominis plane based on the above anesthesia methods, and intravenous self-controlled analgesia was used in both groups after operation. The results showed that the operation time of the ultrasound-guided abdominal transverse muscle plane block in the ultrasound group was shorter than in the control group, and the ultrasound-guided block was more accurate, and the block onset time was shorter than the control group (P<0.05). In terms of the dose of anesthesia-related drugs (propofol, remifentanyl), the ultrasound group was lower than that in the control group, and the amount of anesthetic drugs was lower in the ultrasound group (P<0.05). The VAS score at 6 hour and 12 hour after surgery at rest and the VAS score at 2 hour, 6 hour and 12 hour after surgery at cough state in the ultrasound group were all lower than in the control group (P<0.05). General anesthesia and ultrasound-guided anesthesia is more accurate and has better anesthesia effect, and patients have lower postoperative pain degree and higher comfort level.

The Study on TCD Quantitative Evaluation of Collateral Circulation in Patients with Ischemic Stroke Caused by ICA Stenosis

LIU Huiming, HU Gaozhi

2022, 40(4):  821-825.  DOI: 10.7517/issn.1674-0475.220108

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This study investigated the value of clinical application of transcranial Doppler (TCD) to quantitatively evaluate the establishment of collateral circulation and neurological rehabilitation in patients with ischemic stroke caused by internal carotid artery (ICA) stenosis. 138 patients with ischemic stroke caused by unilateral ICA stenosis or occlusion diagnosed by digital silhouette angiography (DSA) were selected as research objects, and all patients underwent TCD examination. DSA was used as the gold standard to evaluate the value of TCD in diagnosing the establishment of collateral circulation in patients. The coincidence rates of TCD in diagnosing collateral circulation of anterior communicating artery, posterior communicating artery and ophthalmic artery with DSA were 91.53%, 90.91% and 86.05%, respectively. The diagnostic sensitivity and specificity of diagnosing collateral circulation in patients with ischemic stroke caused by unilateral ICA stenosis or occlusion were 89.88% and 90.65%. Among 138 patients with ischemic stroke caused by unilateral ICA stenosis or occlusion, including 60 patients with good collateral circulation and 78 patients with poor collateral circulation, the TCD quantitative score of the patients in the good group was significantly higher than that in the poor group (P<0.05). The brain CBF and CBV values were higher than those of the poor group (P<0.05), while the brain MTT and TTP values were lower than those of the unhealthy group (P<0.05). Clinically, TCD Diagnosis and quantitative evaluation of the establishment of collateral circulation in patients with ischemic stroke caused by ICA stenosis has a high accuracy, and the establishment of collateral circulation can be quantitatively evaluated by TCD to judge the degree of neurological deficit and recovery.

Application of Simplified Joint Ultrasound Score in Patients with Rheumatoid Arthritis

PEI Xufeng, HUANG Fang, CHEN Yue

2022, 40(4):  826-831.  DOI: 10.7517/issn.1674-0475.220110

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This study investigate the relationship between the simplified joint ultrasound score and joint inflammation and bone destruction in patients with rheumatoid arthritis (RA), as well as the evaluation value of disease outcome. 112 patients with RA were selected as the research subjects, all of them received intensive treatment for 3 months. According to the disease outcome they were divided into an effective group (n=95) and an ineffective group (n=17). The scores of DAS28, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Wnt inhibitor Dickkopf-1, receptor activator of nuclear factor kappa B ligand (RANKL), and simplified ultrasound scores in the effective group were higher than those in the ineffective group, and all indexes were the influencing factors of RA disease outcome (P<0.05). The simplified joint ultrasound score of RA patients was positively correlated with DAS28 score, joint inflammation index ESR, CRP, bone destruction index Dickkopf-1, RANKL (P<0.05). The AUC of simplified joint ultrasound score and the final score which evaluated the prognosis of RA patients were higher than 0.7. Simplified joint ultrasound score is related to joint inflammation and bone destruction in RA patients, and could provide a strong reference for the evaluation of the disease outcome of RA up-to-standard treatment, and provide a basis for timely effective and individualized treatment.

The Diagnostic Value of DCE-MRI on Epithelial Ovarian Cancer and Its Relationship with Microvessel Density

FENG Jie, LI Mengshuang, DUAN Xinxiu

2022, 40(4):  832-836.  DOI: 10.7517/issn.1674-0475.220114

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This paper explored the diagnostic value of dynamic enhanced magnetic resonance imaging (DCE-MRI) on epithelial ovarian cancer and its relationship with the microvessel density. 60 patients with epithelial ovarian cancer were selected as the observation group, and 60 patients with benign ovarian tumors admitted during the same period were selected as the control group. All patients underwent DCE-MRI examination, then got the date of maximum concentration (Cmax), area under the concentration-time curve (AUC), maximum slope (MS), rate constant (Kep), transport constant (Ktrans), extravascular cell space volume fraction (Ve), and detected the microvessel density by immunohistochemical SABC method. The results showed that the Cmax, AUC, MS, Kep, Ktrans, Ve of observation group were higher than those of control group, except TTP (P<0.05). The Ktrans, Kep, Ve, TTP, Cmax, AUC, MS were all independently related to the onset of epithelial ovarian cancer (P<0.05). The area under curve of ROC in DCE-MRI combined with microvessel density diagnosis was 0.915, which was more valuable than the single diagnosis above. The microvessel density of patients in the observation group was higher than that in the control group (P<0.05).The Ktrans, Kep, Ve, Cmax, AUC, MS were positively correlated with microvessel density in patients with epithelial ovarian Abstract:cancer, and TTP was negatively correlated with microvessel density (P<0.05). Therefore, DCE-MRI has good diagnostic performance in the diagnosis of epithelial ovarian cancer through quantitative analysis, and its quantitative and semi-quantitative parameters are both related to microvessel density.

Evaluation of Blood Flow Status after TACE in PHC Patients by CT Liver Perfusion Imaging

MENG Mingming, DONG Jian, LIU Fuquan, LIU Hong

2022, 40(4):  837-842.  DOI: 10.7517/issn.1674-0475.220301

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In this study,the blood supply characteristics of primary hepatic carcinoma (PHC) were observed by CT liver perfusion imaging, and the blood perfusion after tanscatheter arterial chemoembolization (TACE) was evaluated. Seventy patients confirmed as PHC by liver biopsy were selected for TACE treatment, and CT liver perfusion imaging was performed before and after TACE intervention to evaluate the effect, and analyze the value of CT liver perfusion imaging for short-term efficacy in PHC patients. Compared with non-tumor tissues, the hepatic blood flow (HBF), hepatic artery perfusion index (HPI), hepatic artery perfusion (HAP) in tumor active lesions were higher, and the time to peak (TTP) was lower (P<0.05). Compared with ineffective patients, microvascular density (MVD) and vascular endothelial growth factor (VEGF) were lower in effective patients (P<0.05). Compared with the before intervention, HBF, HPI and HAP were lower and TTP was higher after intervention (P<0.05). The AUC of HBF, HPI, HAP and TTP combined diagnosis was 0.940 (P<0.05), and the diagnostic efficiency of short-term efficacy in patients with PHC was higher (P<0.05). CT liver perfusion imaging is helpful in assessing the postoperative blood flow status after TACE in patients with PHC, with high clinical value.

Predictive Analysis of CTP Parameters on the Prognosis of Patients with Middle Cerebral Artery Stenosis

WANG Jianbing, HUANG Shuchun, ZHAO Yanwen, WANG Bibai, LU Wei, HU Dingju, LIU Yinyin

2022, 40(4):  843-847.  DOI: 10.7517/issn.1674-0475.220112

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This study explored the application value of CT perfusion (CTP) parameters in evaluating the prognosis and cognitive function of patients with middle cerebral artery stenosis. Selected 109 patients with middle cerebral artery stenosis and analyzed the ratio of affected side to healthy side of cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT) and delay time (Delay) in patients with different prognosis and cognitive function, as well as the value of CBV, TTP, MTT and Delay patient health ratio in predicting prognosis and cognitive impairment. The ratio of affected side to healthy side of CBV in patients with middle cerebral artery severe stenosis and poor prognosis was significantly lower than that in patients with moderate stenosis and good prognosis (P<0.05). The ratio of affected side to healthy side of MTT and Delay were significantly higher than those with moderate stenosis and good prognosis (P<0.05). The ratio of affected side to healthy side of CBV in patients with middle cerebral artery stenosis and cognitive impairment was significantly lower than that in patients without cognitive impairment (P<0.05). The areas under the ROC curve of ratio of affected side to healthy side of CBV, MTT and Delay in predicting middle cerebral artery stenosis poor prognosis were 0.852, 0.677 and 0.895, respectively (P<0.05). The area under the ROC curve of ratio of affected side to healthy side of CBV in predicting middle cerebral artery stenosis with cognitive impairment was 0.700 (P<0.05). The ratio of affected side to healthy side of CBV, MTT and Delay patient health ratio have certain application value in predicting the prognosis and cognitive function of patients with middle cerebral artery stenosis.

Ultrasound Combined with NCE-MRA to Evaluate the Dialysis Function of Uremia and the Identification Analysis of Serum FGF-23 and klotho

LIU Hong, HUANG Junbo, WAN Lei

2022, 40(4):  848-853.  DOI: 10.7517/issn.1674-0475.220204

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The purpose of this paper was to evaluate cardiovascular calcification, left ventricular function and identification of serum standard FGF-23 (fibroblast growth factor-23) and klotho of uremic dialysis patients as the combination of ultrasound with contrast enhanced magnetic resonance angiography (NCE-MRA). The clinical data of 56 patients undergoing hemodialysis treatment were collected to evaluate the dialysis function of uremia content through ultrasound combined with NCE-MRA was used. The results showed:(1) compared with before dialysis the left ventricular function showed that, the left ventricular ejection fraction (LVEF), diastolic volume (LVEDV), systolic dyssynchrony index (SDI16), and diastolic dyssynchrony index (DDI16) of uremic patients after dialysis were significantly increased (P<0.05); (2) the level of serum standard FGF-23 was positively correlated with the contents of creatinine, alkaline phosphatase, phosphorus, calcium, etc. (P<0.05), and was positively correlated with residual renal function, urea clearance index, the protein content of klotho was negatively correlated (P<0.05). This study found that hemodialysis could significantly improve the intraventricular function of uremic patients; serum FGF-23 and klotho protein could be used to diagnose cardiovascular calcification in uremic dialysis patients.

Correlation of MCTSI, cf-DNA/NETs, D-dimer and Prognosis of Patients with Acute Pancreatitis

XU Li, CHEN Youying

2022, 40(4):  854-858.  DOI: 10.7517/issn.1674-0475.220113

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This study explored the prognosis correlation analysis and degree of illness of modified CT severity index (MCTSI), peripheral blood free DNA/neutrophil extracellular traps (cf-DNA/NETs), D-dimer and the severity and prognosis of acute pancreatitis (AP). 175 AP patients were selected as the research objects, and they were divided into mild AP group (75 cases), moderate-severe AP group (56 cases), and severe AP group (44 cases) according to the extent of disease. And they also divided into survival group (163 cases) and death group (12 cases) based on patient survival within 3 months. Compared the levels of MCTSI, cf-DNA/NETs and D-dimer of patients with different severity and prognosis, and analyzed the prognostic value of MCTSI, cf-DNA/NETs and D-dimer. The results showed that the levels of MCTSI, cf-DNA/NETs, and D-dimer in the severe AP group were higher than those in the moderate-severe AP group, and the moderate-severe AP group was higher than the mild AP group, and the differences were statistically significant (P<0.05). The difference was statistically significant at the levels of MCTSI, cf-DNA/NETs and D-dimer in the death group were higher than those in the survival group (P<0.05). ROC curve analysis showed that the AUCs of MCTSI, cf-DNA/NETs and D-dimer in predicting the prognosis of AP patients were 0.950, 0.997, and 0.974, respectively. Z test was used to compare the AUCs of each index, and there was no statistical significance (P>0.05). With the aggravation of AP, MCTSI, cf-DNA/NETs and D-dimer tend to increase, and MCTSI, cf-DNA/NETs and D-dimer were closely related to the prognosis and death of patients, which could be used to evaluate the prognosis a reference indicator of death.

Study of the Structural Parameters of Bladder after Pelvic Floor Reconstruction by Ultrasound

FU Min, LI Qiumei, ZHANG Fan, JIA Li, ZHENG Hongyan

2022, 40(4):  859-862.  DOI: 10.7517/issn.1674-0475.220116

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In this paper, the changes of bladder structural parameters under conditions of resting, anal retraction and maximal Valsalva maneuver after pelvic floor reconstruction were evaluated and analyzed by ultrasound. 87 patients underwent pelvic floor reconstruction surgery were selected as observation group, and 80 women without pelvic organ prolapse were selected as control group. The bladder neck mobility (BND), the urethral bladder posterior angle under the conditions of resting, anal retraction and Valsalva maneuver were compared between the two groups. At the same time, the observation group was given pelvic floor reconstruction surgery, and the changes of bladder structure parameters before and after surgery were compared. The BND, urethral bladder posterior angle under resting, anal retraction and Valsalva in observation group were significantly higher than those in control group (P<0.05). In observation group the postoperative BND, urethral bladder posterior angle under resting, anal retraction and Valsalva were significantly lower than those before operation (P<0.05). The BND, the urethral bladder posterior angle under resting and Valsalva maneuver in patients with postoperative pelvic floor dysfunction questionnaire (PFDI-20) scores ≤ 75 points were significantly lower than those in patients with postoperative PFDI-20 score > 75 points (P<0.05). Ultrasonography can visually and effectively observe the bladder structure, and provide an objective reference for disease diagnosis and pelvic floor reconstruction surgery evaluation.

HRCT Evaluation of Ossicular Destruction in Patients with Suppurative Otitis Media before Minimally Invasive Surgery and its Efficacy Analysis

BAO Qingming, XIE Xiaoyi

2022, 40(4):  863-867.  DOI: 10.7517/issn.1674-0475.220314

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This study investigated the value of high-resolution computed tomography (HRCT) in evaluating ossicular destruction for patients with chronic suppurative otitis media before surgery and the effect of minimally invasive surgery. 128 patients with suppurative chronic otitis media were selected as the research subjects. Among them, 68 patients were treated with minimally invasive surgery (the minimally invasive group), and 60 patients were treated with traditional open surgery (the traditional group). All patients underwent HRCT examination before operation, and analyzed the differences between the degree of ossicular destruction diagnosed by HRCT before operation and those seen during operation, and then compared the therapeutic effects of the two groups. The results showed that, the lesions of the malleus head, the shank of the malleus, the incus body, the incus long foot, the incus short foot, the lentiform process and the stapes in 51 patients with chronic suppurative otitis media of bone ulcer type were examined by preoperative HRCT, and compared with what was seen during operation, there was no significant difference between the two groups (P>0.05). Compared with surgical findings the preoperative HRCT examination of the head of malleus, shank of malleus, body of incus, long foot of incus, short foot of incus, lenticular process, stapes lesions and operation in 77 patients with cholesteatoma-type chronic suppurative otitis media, there was no statistically significant difference between the two groups (P>0.05). Re-examination after surgery, the air conduction hearing threshold of the patients in the minimally invasive group was significantly lower than that of the traditional group (P<0.05). Compared the clinical efficacy 1 month after the operation, the surgical effect of the minimally invasive group was better than that of the traditional group (P<0.05). HRCT preoperative evaluation of the degree of ossicular destruction in patients with chronic suppurative otitis media was highly consistent with surgical findings, and minimally invasive surgery was more effective in patients with chronic suppurative otitis media.

Comparison of Ultrasonography and Mammography in the Diagnosis of Small Breast Lumps in Menopausal Women

ZHANG Xiaohua, WEI Zhanyou

2022, 40(4):  868-872.  DOI: 10.7517/issn.1674-0475.220117

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The purpose of this study was to explore the value of ultrasound and molybdenum target X-ray in the diagnosis of small breast lumps in climacteric women. 115 climacteric female patients with small breast lumps were selected, including 79 cases of benign and 36 cases of malignant lesions. All patients were examined by ultrasound and molybdenum target X-ray, and the image characteristics and diagnostic value of the two methods were analyzed. The ultrasonic image edge of malignant lesions was not smooth, microcalcifications, the proportion of aspect ratio more than 0.8, and the proportion of microcalcifications in molybdenum target X-ray was significantly higher than that in benign lesions (P<0.05). The sensitivity, accuracy and negative predictive value of ultrasound in the diagnosis of malignant lesions were significantly higher than those of molybdenum target X-ray (P<0.05). The diagnostic accuracy of molybdenum target X-ray for malignant lesions with a diameter of 1-2 cm was significantly higher than that of malignant lesions with a diameter less than 1 cm (P<0.05). When the diameter of malignant lesions was less than 1 cm, the diagnostic accuracy of ultrasound was significantly higher than that of molybdenum target X-ray (P<0.05). The value of ultrasound in the diagnosis of small breast lumps for climacteric women is better than molybdenum target X-ray, especially when the lesions diameter less than 1 cm.

Application of 2D-STI in Evaluating Left Ventricular Function in Patients with Coronary Heart Disease and Paroxysmal Atrial Fibrillation after RFCA

NONG Jun, XU Jian, NONG Huaping, LAN Xuedan

2022, 40(4):  873-877.  DOI: 10.7517/issn.1674-0475.220306

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This study investigated the value of two-dimensional speckle tracking imaging (2D-STI) in the evaluation of left ventricular function in patients with coronary heart disease with paroxysmal atrial fibrillation after radiofrequency catheter ablation (RFCA). A total of 78 patients with coronary heart disease and paroxysmal atrial fibrillation who underwent RFCA treatment were selected as the case group, and 80 patients with non-atrial fibrillation received 2D-STI examination during the same period. Coronary heart disease patients served as the control group, and the case group received RFCA treatment. Two-dimensional ultrasound and 2D-STI were used to measure the left ventricular function parameters and myocardial mechanical parameters of the two groups of subjects. Left ventricular end-diastolic diameter (LVDd), mitral valve regurgitation area (MRA), left atrial end-diastolic area (LAA), forward flow velocity in the early diastole of the mitral valve/early diastolic mitral valve annulus,and the measured values of wind velocity (E/E') in the case group were higher than those in the control group (P<0.05). The measured value of left ventricular ejection fraction (LVEF) in the case group was lower than that in the control group (P<0.05). The systolic left atrial peak strains (SLAs) and strain rates (SRLAs), the early diastolic left atrial peak strains (SLAed) and strain rates (SRLAed), and the atrial systolic left atrial peak strains (SLAac) and strain rates (the measured values of SRLAac) were lower than those of the control group (P<0.05). Re-examination 3 months after RFCA treatment, the measured values of LVDd, MRA, LAA, and E/E' in the case group were significantly lower than those before treatment, and the LVEF value was significantly higher than those before treatment (P<0.05). The measured values of SLAs, SRLAs, SLAed, SRLAed, SLAac, and SRLAac in the case group were significantly higher than those before operation (P<0.05). 2D-STI can well evaluate the left ventricular function of patients with paroxysmal atrial fibrillation of coronary heart disease before and after RFCA treatment, and RFCA has a significant effect on the treatment of paroxysmal atrial fibrillation of coronary heart disease.

Study on the Effect of Ultrasound-guided Hydraulic Enema in the Treatment of Acute Intussusception in Children

GUO Jiankang, BAI Yanhong, LIU Yana, YU Guo

2022, 40(4):  878-882.  DOI: 10.7517/issn.1674-0475.220119

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This paper investigated the effect and the risk factors for treatment failure of ultrasound-guided hydraulic enema in the treatment of acute intussusception in children. 113 children with acute intussusception underwent ultrasound-guided hydraulic enema in our hospital were selected to analyze the success of reduction, and the differences in clinical data between successful and failed reduction. Children with unsuccessful reduction were younger than those with successful reduction (P<0.05), The ultrasound characteristics of children with reduction failure were concentric circle diameter ≥ 3 cm, intussusception length ≥ 5 mm, cuff located in the transverse colon and colon and spleen area and beyond, lobulated cuff, the proportion of time from onset to admission ≥ 12 h, and C-reactive protein (CRP) level were significantly higher than those of children with successful reduction (P<0.05). Logistic regression analysis showed that age, diameter of concentric circles, length of intussusception, position of head, lobulated head, and time from onset to admission were the influencing factors for failure of reduction under ultrasound-guided hydraulic enema (P<0.05). Ultrasound-guided hydraulic enema has a good effect on the treatment of acute intussusception in children, and the reduction situation is affected by the age of the child, the time from onset to admission, and the position of the head.

Comparative Analysis of Prospective ECG Gated Dual-Source CT in the Diagnosis of Coronary Heart Disease at Different Tube Voltages

JIA Lei, GAO Lvping, CAO Chengying, ZHAO Fengping

2022, 40(4):  883-887.  DOI: 10.7517/issn.1674-0475.220124

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This study investigated the value of prospective ECG gated dual-source CT at low tube voltage in the diagnosis of coronary heart disease. Retrospectively selected 60 patients with coronary heart disease, and divided them into observation group (tube voltage 80 kV) and control group (tube voltage 100 kV) according to tube voltage, then compared the differences of diagnosis and image quality and so on between the two groups. There was no significant difference in sensitivity, specificity, accuracy, positive predictive value, negative predictive value and coronary segment image quality score between the observation group and the control group (P>0.05). There were no significant differences in CT valuesin ascending aortic root, right coronary artery opening and left coronary artery opening, signal-to-noise ratio (SNR) and contrastive noise ratio (CNR) between the observation group and the control group (P>0.05). The dose length product (DLP), volume CT dose index (CTDIvol) and effective radiation dose (ED) in the observation group were significantly lower than those in the control group (P<0.05). The image quality of coronary artery segments in patients with heart rate<75 beats/min in the observation group was better than patients with heart rate ≥ 75 beats/min (P<0.05). So the prospective ECG gated dual-source CT low tube voltage has good application value in the diagnosis of coronary heart disease, which has the advantages of good image quality and low radiation dose, and the heart rate will affect the image quality.

Ultrasound Evaluation of α1-Receptor Blocker Combined with 5α-Testosterone Reductase Inhibitor in the Treatment of Benign Prostatic Hyperplasia

GUAN Yiman, FANF Qinmao, DENG Heping, ZHANG Weiwei, WU Xia, ZHANG Bo

2022, 40(4):  888-892.  DOI: 10.7517/issn.1674-0475.220125

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This paper aimed to explore the ultrasound evaluation of prostate volume, internal circulation and tissue hardness combined with α1-receptor blocker and 5α-testosterone reductase inhibitor in patients with benign prostatic hyperplasia. 100 cases of patients with benign prostatic hyperplasia were selected as research objects and randomized into 50 in the control group and 50 in the combination group. All patients were routinely treated, the patients in control group were given the patient 5α-testosterone reductase inhibitor, while the combination group were given 5α-testosterone reductase inhibitor combined with α1-receptor blocker. The patient's prostate volume was evaluated by color Doppler ultrasound test, according to elastography to assess tissue hardness, and detected the post void residual (PVR), the maximum flow rate (Qmax), prostate specific antigen (PSA). The changes of benign prostatic hyperplasia were observed and the treatment effect was counted. After treatments the IPSS score, PV, PVR and PSA of the combination group were lower than the control group, and QOL score and Qmax were higher than the control group (P<0.05). The total response rate of the combination group was higher (P<0.05). The combination of α1-receptor blocker and 5α-testosterone reductase inhibitor can improve prostate volume, internal circulation, and tissue hardness in patients with benign prostatic hyperplasia to promote patient recovery.

Diagnostic Analysis for Proximal Humeral Fractures by MRI Combined with X-ray

LIU Zihao, SHANG Hongtao, DONG Guixian, LIU Yumin, ZHANG Ning

2022, 40(4):  893-896.  DOI: 10.7517/issn.1674-0475.220130

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This paper analyzed the diagnostic value of MRI combined with X-ray imaging for proximal humerus fractures. 120 cases of suspected proximal humerus fracture were selected as the research objects, with multilayer spiral CT (MSCT) examination as the "gold standard", finally 90 cases were diagnosed as proximal humeral fracture, 30 cases with non-proximal humeral fracture. All patients underwent nuclear resonance imaging, X-ray examination, and then analyzed the diagnostic value of nuclear magnetic resonance imaging combined with X-ray for proximal humerus fracture. The results showed that the diagnostic detection rate of Neer classification of proximal humerus fractures by MRI combined with X-ray was 93.33%, which was higher than 66.67% for X-ray and 72.22% for MRI, and difference was statistically significant (P<0.05). Compared with the X-ray and MRI single diagnosis, the two combinations had a high diagnostic value (P<0.05). In conclusion, MRI combined with X-ray have a high diagnostic value for proximal humerus fractures, which can provide a reference for the clinical classification of proximal humerus fractures.

Application of DTI in the Grading Assessment of Knee ACL Injury Caused by Football Sports

HUO Lei, ZHANG Chunwang

2022, 40(4):  897-901.  DOI: 10.7517/issn.1674-0475.220136

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This paper explored the value and clinical significance of magnetic resonance diffusion tensor imaging (DTI) in assessing the grading of knee anterior cruciate ligament (ACL) injuries caused by football. 76 patients with knee ACL injury caused by football sports were selected, and the self-controlled was used as research method with the affected knee joint as the injury group and the unaffected knee joint as the control group. Both the groups underwent magnetic resonance DTI to measure the apparent diffusion coefficient (ADC) and fractional anisotropy (FA). The results showed that the IKDC, Lysholm score and FA in the injury group were all lower than those in the control group, while the ADC was higher (P<0.05). The ADC of the affected limb was negatively correlated with the IKDC score and Lysholm score, and the FA was positively correlated with the IKDC score and Lysholm score (P<0.05). ADC of patients with ACL injury grade Ⅲ was higher than patients with grades II and I, and patients with grade II were higher than those of patients with grade Ⅰ (P<0.05). The FA of grade Ⅲ patients was lower than that of grade Ⅱ and grade Ⅰ patients, and the FA of grade Ⅱ was lower than that of grade Ⅰ (P<0.05). ADC was positively correlated with ACL injury grade, and FA was negatively correlated with ACL injury grade (P<0.05). The area under curve (AUC) of ADC and FA in diagnosing ACL injury with grade Ⅱ were 0.738 and 0.759, respectively, and 0.772 and 0.748 for grade Ⅲ respectively. Magnetic resonance DTI parameters ADC and FA are closely related to knee function and injury classification in patients with knee ACL injury caused by football sports, and also can diagnose ACL injury classification non-invasively.

Diagnostic Analysis for Multi-slice Spiral CT Combined with miR-142-5p in Diagnosis of Cervical Cancer Lymph Node Metastasis

YAO Yujie, DU Chunling, LIU Yaning, ZHANG Chai

2022, 40(4):  902-906.  DOI: 10.7517/issn.1674-0475.220132

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This paper mainly analyzed the diagnostic value of multilayer spiral CT combined with miR-142-5p for cervical cancer lymph node metastasis. 125 patients with suspected cervical cancer lymph node metastasis were selected as study subjects, 70 patients with confirmed lymph node metastasis were assigned as the study group and 55 patients with non-lymph node metastasis as the control group. Both groups were examined by multicoil CT and the expression of miR-142-5p was determined by real-time fluorescence. The results showed that compared with the control group, the blood volume (BV), perfusion value (PF), peak enhancement (PEI) parameters of the study group increased, while the time to peak (TTP) and the expression of miR-142-5p decreased. The parameters of BV, PF, and PEI were the highest in patients with lymph node metastasis ≥ 1.0 cm, and the expression of TTP parameters and miR-142-5p were the lowest (P<0.05). The BV, TTP, PF, PEI, miR-142-5p were related to different lymph node metastasis distances, and BV, TTP, PF, PEI were related to miR-142-5p. The combination test of BV, TTP, PF, PEI, and miR-142-5p had a high diagnostic value for cervical cancer lymph node metastasis, the area under the curve of ROC was 0.827 (P<0.05). In summary, multi-slice spiral CT combined with miR-142-5p has a high diagnostic value for cervical cancer lymph node metastasis, and has a certain clinical promotion value.

Diagnostic Analysis of Uterine Fibroids Based on Transvaginal Color Doppler Ultrasonography and Effect Evaluation of HIFU

HE Wenfeng, HU Yuxin, TANG Shuqiong, LI Jinqian

2022, 40(4):  907-911.  DOI: 10.7517/issn.1674-0475.220312

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The main purpose of this study was to explore the diagnostic analysis of uterine fibroids based on transvaginal ultrasonography and to evaluate the therapeutic effect of high intensity focused ultrasound (HIFU). A total of 133 female patients suspected of uterine fibroids were selected as the research object, 55 confirmed cases as the observation group, and the remaining 78 normal-health people as the control group. Transvaginal color ultrasound blood flow imaging was performed to observe the end diastolic blood flow velocity (ED), peak systolic blood flow velocity (PS), resistance index (RI), and the correlation between blood flow parameters and disease severity. The results showed that compared with the control group, ED, PS, RI were higher in observation group (P<0.05). The ED, PS, RI of mild patients were lower than those of moderate and severe patients (P<0.05). Compared with ED, PS and RI, the combined diagnosis had higher sensitivity and accuracy in the diagnosis of uterine fibroids (P<0.05). Compared with 1 month after HIFU treatment, the tumor diameters were both reduced at 3 and 6 months after HIFU treatment (P<0.05), and the total effective rate was 96.36%. Vaginal color ultrasonography has a high diagnostic value for patients with uterine fibroids. After high-intensity focused ultrasound (HIFU) treatment, the diameter of uterine fibroids reduce significantly, and the clinical effect is significant.

Application of Endometrial Blood Flow Parameters Combined with β-hCG and VEGF in the Diagnosis of Early Ectopic Pregnancy

LI Qi, WANG Jun, MEI Chunxiu

2022, 40(4):  912-916.  DOI: 10.7517/issn.1674-0475.220128

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This study explored the correlation between endometrial blood flow parameters and β-human chorionic gonadotropin (β-hCG), vascular endothelial growth factor (VEGF) and the diagnostic value of early ectopic pregnancy. 176 cases of suspected early ectopic pregnancy were selected, and according the diagnostic curettage examination as the gold standard 86 cases of early ectopic pregnancy were confirmed as the study group, and 90 cases of early ectopic pregnancy were excluded as the control group. Comparing endometrial flow parameters, and diastolic velocity (VD), maximum systolic velocity (VS), resistance index (RI), β-hCG, and VEGF levels and their correlation in different disease severity. Compared with mild ectopic pregnancy, the VS, VD, RI, and VEGF increased in order, β-hCG decreased in order for patients with moderate and severe ectopic pregnancy. VS, VD, RI, VEGF were positively correlated with the severity of the disease, while β-hCG was negatively correlated with the severity of the disease. The sensitivity, specificity and AUC of VS, VD and RI combined in the diagnosis of ectopic pregnancy were 98.84%, 83.33% and 0.937, respectively. And the diagnostic value of combined examination was higher than that of single examination (P<0.05). Combined detection of endometrial blood flow parameters, β-hCG and VEGF is beneficial for the diagnosis of early ectopic pregnancy, and VS, VD, RI are correlated with β-hCG and VEGF.

Analysis of Intracranial Infection Factors and Diagnostic Value of CT and MRI in Patients after Craniocerebral Surgery

ZHANG Hongqiang, LI Rushen, WU Mingmin, SU Yuandong

2022, 40(4):  917-921.  DOI: 10.7517/issn.1674-0475.220323

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This paper investigated the factors of intracranial infection and the diagnostic value of CT and MRI in patients after craniocerebral surgery. 988 patients who underwent craniocerebral surgery were selected as study subjects. Patients with intracranial infection after craniocerebral surgery were examined by CT and MRI, and then analyzed the factors of intracranial infection and the diagnostic value of CT and MRI in patients after craniotomy. 988 questionnaires were sent out and 970 were returned, among them there were 65 patients with craniocerebral surgery developed intracranial infection, the incidence rate was 6.70%. As shown in univariate analysis, the occurrence of intracranial infection in patients after craniotomy was associated with operative time, number of operations, postoperative cerebrospinal fluid leakage, extraventricular drainage, surgical site, and whether comorbid diabetes mellitus (P<0.05). Multivariate Logistic regression analysis shows that the operative time, number of operations, postoperative cerebrospinal fluid leakage, extraventricular drainage, surgical site, whether comorbid diabetes mellitus were the main factors affecting postoperative intracranial infection in patients undergoing cranial surgery (P<0.05). The positive diagnostic yield of MRI examination for intracranial infection with different pathogenic bacteria and different abnormal classes was higher than that of CT examination (P<0.05). In conclusion, the risk factors of intracranial infection after craniotomy are operative time, number of surgical procedures, postoperative CSF leakage, extraventricular drainage, surgical site, whether combined with diabetes mellitus, and MRI has a high diagnostic accuracy for intracranial infection.

Changes of CEUS Quantitative Parameters before and after Neoadjuvant Chemotherapy of Breast Cancer

LIU Jun, HUANG Lei, SHI Jiakun, CHEN Tong, CHEN Yunlong

2022, 40(4):  922-926.  DOI: 10.7517/issn.1674-0475.220137

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This study explored the changes of contrast-enhanced ultrasound (CEUS) quantitative parameters before and after neoadjuvant chemotherapy of breast cancer and its clinical application value. 102 breast cancer patients were selected, and they were all given neoadjuvant chemotherapy and CEUS examination, the CEUS quantitative parameters of patients with effective and ineffective chemotherapy were compared. Among the 102 patients, neoadjuvant chemotherapy was effective in 48 patients and ineffective in 54 patients. The peak reaching time, peak intensity and curve rising slope of patients with effective chemotherapy after chemotherapy, showing statistically significant differences with patients with ineffective chemotherapy (P<0.05). The change values of peak reaching time, peak intensity and curve rising slope before and after chemotherapy in patients with effective chemotherapy after chemotherapy were significantly higher than those of ineffective patients (P<0.05). The area under the ROC curve of change value of peak reaching time, peak intensity the curve rising slope before and after chemotherapy predicted the efficacy of neoadjuvant chemotherapy were 0.845, 0.708 and 0.909, respectively (P<0.05). The change value of CEUS quantitative parameters has a certain application value in efficacy of neoadjuvant chemotherapy of breast cancer.

Application of CT Perfusion Imaging Combined with miR-195 in Diagnosis and Prognosis of Acute Cerebral Infarction

HAN Long, ZHANG Hailian, MA Qiong

2022, 40(4):  927-931.  DOI: 10.7517/issn.1674-0475.220135

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The purpose of this study was to explore the value of CT perfusion imaging (CTP) combined with microRNA-195 (miR-195) in the diagnosis and prognosis of acute cerebral infarction. 158 patients with acute cerebral infarction (the observation group) and 100 healthy people were selected (the control group). The serum miR-195 levels of patients in the two groups were detected by PCR, and the differences of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time to peak (TTP) in the infarct area of different patients in the observation group were compared, at the same time the value of each parameter in predicting poor prognosis was analyzed. The level of serum miR-195 in the observation group was significantly higher than that in the control group (P<0.05). The CBF, CBV, MTT and TTP in the infarct area of patients with NIHSS score ≥ 5 and poor prognosis were significantly lower than those with NIHSS score <5 and good prognosis (P<0.05), while TTP and serum miR-195 relative expression was significantly higher than those with NIHSS score <5 and good prognosis (P<0.05). CBF, CBV and MTT were negatively correlated with NIHSS score (P<0.05), and the relative expression of TTP and serum miR-195 were positively correlated with NIHSS score (P<0.05). The areas under the ROC curve of CBF, CBV, MTT, TTP, miR-195 and combined prediction of poor prognosis of acute cerebral infarction were 0.685, 0.867, 0.630, 0.736, 0.669 and 0.936, respectively (P<0.05). CBF, CBV, MTT, TTP combined with miR-195 can predict the prognosis of patients with acute cerebral infarction effectively.

Correlation of MRI Parameters with E-cadherin and CA153 in Breast Cancer Patients

LI Jiali, SHAN Hangsheng, ZHANG Yayun, SONG Ninglin

2022, 40(4):  932-936.  DOI: 10.7517/issn.1674-0475.220127

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This study explored the correlation between magnetic resonance imaging (MRI) and epithelial cadherin (E-cadherin), cancer antigen 153 (CA153) and its diagnostic value in breast cancer patients. 113 patients diagnosed as breast cancer were selected as the study group, and another 75 healthy volunteers were selected as the control group. Detected E-cadherin by enzyme-linked immunosorbent assay (ELISA), and detected serum CA153 by liaison automatic chemiluminescence immunoanalyzer. The two groups were examined by magnetic resonance imaging. The volume transfer constant (Ktrans), the rate constant (Kep) and extravascular extracellular volume fraction (Ve) were compared between the two groups, and the correlation between them, and the diagnostic value of them were also analyzed. The results showed that the E-cadherin level of breast cancer patients was lower, the more serious the disease was, the lower the E-cadherin level was. The level of CA153 increased in breast cancer patients, the more serious the disease was, the higher the CA153 level was. E-cadherin was negatively correlated with Ktrans, Kep and Ve, and CA153 was positively correlated with Ktrans, Kep and Ve (P<0.05). Ktrans、Kep、Ve combination had higher diagnostic value for breast cancer patients (P<0.05). MRI has a high diagnostic value for breast cancer patients, and the expression level of E-cadherin in breast cancer patients is low and the expression level of CA153 is high.

Application of Multi-slice CT and Ultrasound Combined with Serum DGCR8 and cTnT in Diagnosis of Congenital Heart Disease in Children

CHEN Yexin, GAO Hui, MENG Qingqing

2022, 40(4):  937-941.  DOI: 10.7517/issn.1674-0475.220311

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This paper analyzed the diagnostic value of multilayer spiral CT, ultrasound combined with serum DiGeorge syndrome crisis region gene 8 (DGCR8) and Cardiac troponin T (cTnT) in children with congenital heart disease. Selecting 90 children with suspected congenital heart disease, and the surgical pathological diagnosis was taken as the "gold standard", then the 60 cases diagnosed with congenital heart disease were set as the study group, and 30 non-congenital heart disease were set as the control group. Multi-slice spiral CT and echocardiography were performed in both groups, and the expression of DGCR8 and the level of cTnT in the two groups were detected. The diagnostic coincidence rate of congenital heart disease subtype was higher than that of the single detection of cardiac ultrasound and multilayer spiral CT (P<0.05). Compared with the control group the study group had lower DGCR8 expression and higher cTnT levels (P<0.05). Children with middle-grade congenital heart disease with different NYHA cardiac function grades had the lowest DGCR8 expression and the highest cTnT level (P<0.05). Correlation analysis showed that DGCR8 and cTnT were related to different severity of illness in the study group (P<0.05). The specificity and sensitivity of the four combinations for the diagnosis of congenital heart disease were 96.67% and 70.00%, respectively (P<0.05). Multilayer spiral CT, cardiac ultrasound combined with serum DGCR8 and cTnT have high diagnostic value for congenital heart disease, which can provide some reference for the formulation of surgical plan for children with congenital heart disease.

Diagnosis Analysis of Knee Joint Synovitis by Musculoskeletal Ultrasound

PENG Xiaosong, QU Xiaoyu, LIU Peilin

2022, 40(4):  942-946.  DOI: 10.7517/issn.1674-0475.220104

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This paper discussed the diagnostic value of musculoskeletal ultrasound (MSUS) in the knee joint synovitis and its relationship with disease severity. A total of 86 patients (112 knees) with suspected knee synovitis were selected, the differences of X-ray and MSUS in the diagnosis of knee synovitis were compared, and the relationship between semi quantitative analysis of MSUS and Lysholm score, Ayral score was analyzed. Through arthroscopy, 43 knees of 33 patients were diagnosed as synovitis, and 69 knees of 53 patients had no synovial lesions. The sensitivity, accuracy and negative predictive value of MSUS in the diagnosis of knee synovitis were significantly higher than those of X-ray (P<0.05). There was no significant difference in specificity and positive predictive value between MSUS and X-ray in the diagnosis of knee synovitis (P>0.05). The blood flow signals, synovial hyperplasia, joint effusion and bone erosion Ⅱ level and above proportion of knee with Lysholm score ≥ 70 points were significantly higher than those of Lysholm score<70 knee (P<0.05). The blood flow signals, synovial hyperplasia, joint effusion and bone erosion Ⅱ level and above proportion of knee with Ayral score ≥ 60 points were significantly higher than the knee with Ayral score < 60 (P<0.05). The Lysholm score was positively correlated with MSUS score of synovial hyperplasia and bone erosion (r_s=0.714 and 0.741, P<0.05). Ayral score was positively correlated with MSUS synovial hyperplasia (r_s=0.613, P<0.05). MSUS has a good value in the diagnosis of knee synovitis, and the semi quantitative classification of MSUS is related to the function of knee joint and the degree of synovium.

Application of MRI in Diagnosis of Cervical Lymph Node Metastasis Caused by Tongue Squamous Cell Carcinoma

GAN Meixiang, LI Qiulan, ZHANG Xiaodan

2022, 40(4):  947-951.  DOI: 10.7517/issn.1674-0475.220118

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This study investigated the application value of magnetic resonance imaging (MRI) in evaluating the depth of cervical lymph node metastasis and tumor invasion caused by tongue squamous cell carcinoma of before surgery. 71 patients with tongue squamous cell carcinoma who underwent surgery were selected as clinical subjects for retrospective analysis. All patients received MRI examination before surgery to evaluate the positive rate of metastasis and the depth of tumor invasion in seven lymph node regions of the neck. The physical results were used as the diagnostic gold standard to calculate the value of MRI in evaluating cervical lymph node metastasis before operation. The correlation between the depth of tumor invasion detected by MRI and the results of pathological diagnosis was analyzed. Comparing preoperative MRI results with pathological results, the diagnostic coincidence rate of zone Ⅰ was 87.50%, the diagnostic coincidence rate of zone Ⅱ was 77.78%, the diagnostic coincidence rate of zone Ⅲ was 75.00%, the diagnostic coincidence rate of zone Ⅳ was 75.00%, and the diagnostic coincidence rate of zone Ⅴ was 100.00%. The diagnostic sensitivity of MRI to correct the cervical lymph nodes metastasis was 79.59% and the specificity was 86.36%. There was no significant difference between the preoperative T1WI, T2WI diagnosis of tongue squamous cell carcinoma infiltration depth and pathological results after surgery (P>0.05). MRI has a high sensitivity and specificity to evaluate the cervical lymph node metastasis caused by tongue squamous cell carcinoma before surgery. The preoperative assessment of tumor invasion depth has a high correlation with pathological results.

Application of HRCT and CTVR in Diagnosis of Ossicular Destruction in Patients with Suppurative Otitis Media

DU Ying, GUO Yonggang, WANG Yali, WANG Xiaosheng

2022, 40(4):  952-955.  DOI: 10.7517/issn.1674-0475.220133

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This study investigated the value of high-resolution CT (HRCT) and volume reconstruction (CTVR) in the diagnosis of ossicular destruction in suppurative otitis media. 150 patients with suppurative otitis media were selected, all patients received surgical treatment, and the preoperative patients received HRCT and CTVR examinations. The findings during and after surgery as the basis for diagnosis calculated the diagnostic value of HRCT and CTVR in diagnosing the destruction of different parts of the ossicular bone. There was no significant difference between the results of CTVR examination in the diagnosis of complete destruction or partial destruction of the malleus head, malleus stem, incus body, incus foot, malleus-anvil joint, incus-stapedius joint, and stapes with the surgical results (P>0.05). There was no significant difference between the results of HRCT examination in the diagnosis of complete destruction or partial destruction of the malleus head, malleus stem, incus body, incus foot, malleus-anvil joint, incus-stapedius joint, and stapes with what was seen during surgery (P>0.05). CTVR and HRCT combined diagnosis of malleus head, malleus stem, incus body, incus foot, malleus-anvil joint, incus-stapedius joint, and stapes have a higher sensitivity than the two methods alone. HRCT scan has a high sensitivity in diagnosing the destruction of different parts of the ossicle in patients with suppurative otitis media, and CTVR has a high specificity in diagnosing the destruction of different parts of the ossicle in patients with suppurative otitis media. Moreover, the combination of the two can be used in clinical practice to improve the diagnostic effect.

Application of MRI Imaging Quantitative Evaluation in the Diagnosis of Discoid Meniscus Sports Injuries

RAO Yao, ZOU Shubiao

2022, 40(4):  956-961.  DOI: 10.7517/issn.1674-0475.220111

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This paper investigated the diagnostic value of MRI quantitative evaluation in discoid meniscus sports injuries. 113 patients with suspected discoid meniscus sports injury were selected and divided into intact group (27 cases), degeneration group (61 cases), and tear group (25 cases) according to the results of knee arthroscopy. All patients underwent MRI imaging to examine the discoid injuries of the lateral meniscus, the results showed that the lateral discoid meniscus body width (WDLM), WDLM/lateral femoral condyle width (WLFC), free border height (HF)/body height in the intact group, the degeneration group, and the tear group (HM) showed a gradually increasing trend, while the joint capsule edge height (HP) and HP/HM showed a gradually decreasing trend (P<0.05). AUC of WDLM/WLFC, HF/HM combined diagnosis of discoid meniscus sports injury and injury type was greater than that of each parameter alone. WDLM, HF, WDLM/WLFC, HF/HM were positively correlated with knee cartilage damage, and HP, HP/HM were negatively correlated with knee cartilage damage (P<0.05). It is suggested that MRI imaging quantitative examination has good diagnostic value for discoid meniscus sports injury and injury type, and both of them are significantly related to knee cartilage injury, which can provide a basis for clinical diagnosis and treatment.

Application of RT-3DE in Ventricular Remodeling in Heart Failure Patients with Reduced LVEF

ZHANG Hui, TONG Suxia

2022, 40(4):  962-965.  DOI: 10.7517/issn.1674-0475.220107

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This paper discussed the left ventricular remodeling in heart failure patients with reduced left ventricular ejection fraction (LVEF) by real-time three-dimensional echocardiography (RT-3DE). 110 patients with heart failure with reduced LVEF were selected as the observation group and 50 healthy people were selected as the control group. They all underwent RT-3DE, and observed the ventricular parameters of the two groups. The results showed the right ventricular end diastolic volume index (RVEDVI), right ventricular end systolic volume index (RVESVI) and right ventricular basal long diameter (RVLD) were significantly higher than that in the control group (P<0.05), while the LVEF was significantly lower than that in the control group (P<0.05). The RVEDVI, RVESVI and RVLD of patients with pulmonary hypertension (PH) ≥ 80 mmHg were higher than those of other patients (P<0.05) in the observation group, while LVEF was lower than that of other patients (P<0.05). There had correlations between PH and RVEDVI, RVESVI and LVEF (r=0.454, 0.420 and -0.331, P<0.05). PH in patients with heart failure with reduced LVEF has a certain effect on ventricular remodeling, which is worthy of further study.

Predicitve Value of MRI Quantitative in the Supraspinatus Tendon Injury

CAI Zhanfeng, CHEN Xiaolei

2022, 40(4):  966-970.  DOI: 10.7517/issn.1674-0475.220101

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This study explored the value of MRI quantitatively in determining the injury of the supraspinatus tendon in shot putters. 82 cases of shot putters with supraspinatus tendon injury were selected as the research objects. All of them underwent MRI examination. They were divided into degeneration group (n=35), partial tear group (n=27), and complete-tear group (n=20) according to the degree of tendon tear severity (TTS), and another 25 healthy shot putters during the same period were selected as the control group. The results showed that, comparing the fat fraction (FF), complete tear group>partial tear group>degeneration group>control group; comparing the relative size of supraspinatus muscle, complete tear group < partial tear group < degeneration groupP<0.05). The TTS of supraspinatus was positively correlated with FF, and negatively correlated with relative size of supraspinatus (P<0.05); the area under the curve (AUC) of FF and relative size of supraspinatus for diagnosing supraspinatus tendon tear were 0.846 and 0.836, respectively, and the AUC of the combined diagnosis was the largest, which was 0.867; the FF of patient was lower at 6 months after treatment than before, the relative size of the supraspinatus, the University of California shoulder score (UCLA), and the subjective shoulder score (SSV) scores were higher than those before treatment (P<0.05); the relative size of ΔFF and Δsupraspinatus was positively correlated with ΔUCLA and ΔSSV (P<0.05). The MRI quantitative index FF and the relative size of the supraspinatus have good value in judging the injury of the supraspinatus tendon in shot put players.

Application of MSCT Combined with MRI in the Diagnosis of Knee Joint Injuries in Marathon Athletes

REN Haijuan, WEI Jianbo, LIU Ying, CHEN Jianxin

2022, 40(4):  971-975.  DOI: 10.7517/issn.1674-0475.220142

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This paper explored the value of multi-slice spiral CT (MSCT) combined with magnetic resonance imaging (MRI) in the diagnosis of knee injuries in marathon runners. 95 patients with knee injuries of marathon runners were selected as research subjects, and all underwent MSCT and MRI examinations. The results showed that with the results of arthroscopy or surgery as the "gold standard", the accuracy rates of MSCT and MRI alone in diagnosing the types of knee injuries in marathon runners were 86.32% and 93.68%, respectively, and the accuracy rate of combined diagnosis reached 100.00%. The Kappa values of MSCT combined with MRI for the grading of knee ligament injury, meniscus injury and the results of arthroscopy or surgery were 0.944 and 0.933, respectively. Compared with the results of arthroscopy or surgery, the accuracy of MSCT combined with MRI to diagnose occult knee fractures in marathon runners is 100.00%. It can be seen that MSCT combined with MRI imaging technology has a high accuracy in diagnosing the types of knee injuries in marathon runners, and can further accurately assess the classification of knee ligament injury, meniscus injury, and occult fracture sites.

Application of MRI in the Diagnosis and Prognosis of Ankle Fractures for Football Players

LIU Dongxu, LI Jiayi, TANG Zhaoming

2022, 40(4):  976-980.  DOI: 10.7517/issn.1674-0475.220102

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The purpose of this study was to investigate the value of MRI imaging technology in the diagnosis of ankle fractures for football players and the correlation of postoperative skeletal structures. Ninety-five football players with ankle fractures were selected as research subjects, and all underwent MRI examination. Taking the results of surgery or arthroscopy as the "gold standard", the accuracy rate of MRI in diagnosing ankle fractures in football players was 94.74%, and the Kappa values of the diagnosis of ankle fracture classification and classification with the results of surgery or arthroscopy were 0.844 and 0.861 (P<0.05). The Δ1 (absolute value of changes before and 1 month after operation) of medial ankle space, TT, and ATT in patients with excellent ankle joint recovery were all>good patients>fair/poor patients (P<0.05). Δ1 of medial malleolus, TT and ATT were positively correlated with the ankle joint recovery in football players with ankle fractures (P<0.05). MRI has high accuracy in diagnosing ankle fractures in football players, and can accurately assess the changes of bone structure in patients before and after surgery, which is helpful to guide the clinical formulation of a comprehensive treatment plan.

Diagnostic Analysis of High-frequency Ultrasound Parameters Combined with BGP and MMP-1 in Knee Cartilage Injury after Exercise

LI Yanjiang, XU Lijuan

2022, 40(4):  981-985.  DOI: 10.7517/issn.1674-0475.220140

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This study investigated the diagnostic value of high frequency ultrasound parameters combined with bone-γ-carboxyglutamic acid-containing protein (BGP) and matrix metalloproteinase 1 (MMP-1) on knee cartilage injury after exercise, and analyzed its correlation with ultrasound parameters, BGP and MMP-1. 88 patients suspected of postmotor knee cartilage injury were selected as the study subjects. 56 patients who were eventually diagnosed with postmotor knee cartilage injury were set to the observation group, and the remaining 32 patients were set to the control group. All patients underwent high-frequency ultrasound examination and compared the surface roughness coefficient (URI), reflection coefficient (RC) of cartilage surface and cartilage thickness in ultrasound parameters between the two groups. Compared with the control group, the observation group had higher URI index (P<0.05), and lower RC and thickness indexes (P<0.05). Compared with RC, URI and cartilage thickness single diagnosis, the combined diagnosis was more effective in the diagnosis of knee cartilage injury after exercise, and the AUC was 0.822 (P<0.05). RC and cartilage thickness were positively correlated with BGP and MMP-1 (P<0.05). URI was negatively correlated with BGP and MMP-1 (P<0.05). Combined diagnosis of high-frequency ultrasound parameters can effectively determine the cartilage tissue damage of the knee joint after exercise, and its parameters were also related to BGP and MMP-1.

Application of Ultrasonic Parameters of Fetal Umbilical Artery, Serum FFA and PL in the Diagnosis of FGR in GDM Pregnant Women in Late Pregnancy

FAN Limin, ZHANG Xuewei, LIU Peilin, ZHOU Hui

2022, 40(4):  986-990.  DOI: 10.7517/issn.1674-0475.220141

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This study investigated the relationship between fetal umbilical artery (UA) color Doppler ultrasound, serum free fatty acids (FFA), phospholipids (PL) and fetal growth restriction (FGR) in pregnant women with gestational diabetes mellitus (GDM) in late pregnancy. 113 pregnant women with GDM who were diagnosed with FGR were selected as the FGR group, and the other 120 pregnant women with GDM who were pregnant during the same period were selected as the control group. Color Doppler ultrasonography was used to detect the blood flow parameters of the fetuses UA in the two groups, and the serum levels of FFA and PL. The receiver operating curve analyzed the value of various parameters in the diagnosis of FGR in pregnant women with GDM. The levels of serum FFA and PL in FGR group were significantly higher than those in control group (P<0.05). The AUC values of serum FFA and PL levels in the diagnosis of FGR were 0.842 and 0.738, respectively. The S/D, PI and RI of fetal umbilical artery in FGR group were significantly higher than those in control group (P<0.05). The AUC values of umbilical artery S/D, PI, and RI in the diagnosis of FGR were 0.827, 0.719, and 0.757, respectively. Serum FFA, PL in FGR group were positively correlated with S/D, PI and RI (P<0.05). The blood flow parameters of the fetus UA with GDM and FGR changed significantly, and the serum FFA and PL levels of pregnant women increased. The detection of the above indicators in the late pregnancy has a certain value for evaluating FGR. At the same time, S/D value, PI and RI are related to hypoxia at birth.

Evaluation of Lower Limb Alignment and Its Relationship with Knee Function after Internal Fixation of Tibial Plateau Fracture by MSCT

HUA Wei, ZHANG Chunwang

2022, 40(4):  991-995.  DOI: 10.7517/issn.1674-0475.220122

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Based on multi-slice spiral CT this study evaluated the changes of lower limb alignment and its relationship with knee joint function after internal fixation of tibial plateau fractures. The clinical data of 125 patients with tibial plateau fractures treated with internal fixation were retrospectively analyzed. Compared the posterior tilt angle of tibial plateau (PA), tilt angle of tibial plateau (TPA), femoro tibia angle (FTA), knee joint space width and platform collapse between the affected side and the healthy side 3 days after operation. Compared the changes of PA, TPA, FTA, knee joint space width and platform collapse on the affected side at different times after surgery. And then compared the differences between the affected side and the healthy side of PA, TPA, FTA, knee joint gap width, and platform collapse in patients with joint function. The results showed that the PA, TPA, knee joint space width difference and platform collapse between the affected side and the healthy side in patients with excellent, good and fair + poor knee function increased in sequence at 6 months after operation (P<0.05). The difference of PA, TPA, knee joint space width and platform collapse between the affected side and the healthy side were negatively correlated with knee joint function (P<0.05). It can be seen that multi-slice spiral CT can accurately evaluate the changes of lower limb alignment after internal fixation of tibial plateau fractures. Among them, PA, TPA, knee joint space width and platform collapse are related to postoperative knee joint function.