Table of Content

23 November 2022, Volume 40 Issue 6

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2022, 40(6):  0-0. 

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Review and Articles

Imaging Analysis of Wrist Sprain in Adults with MSCT and MRI

ZHANG Hongguang, QIN Xupei, WANG Kangni

2022, 40(6):  1323-1327.  DOI: 10.7517/issn.1674-0475.220902

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The wrist sprain is mostly caused by external violence. Generally, imaging examination is performed only after the sprain occurs in patients. However, due to the complex structure of wrist joint, it is still impossible to completely and accurately judge the sprain in clinical practice, and its diagnostic criteria also have some limitations, which makes it difficult to analyze the condition of wrist sprain. Due to the existence of bone overlap, X-ray is not effective in the diagnosis of wrist sprain, which is prone to image distortion, misdiagnosis and missed diagnosis. Multi slice spiral CT (MSCT) and magnetic resonance imaging (MRI) have powerful post-processing functions, which can provide accurate, intuitive and comprehensive imaging information for wrist sprain. However, there are some limitations in using the two methods alone, and joint detection can significantly reduce the occurrence of misdiagnosis and missed diagnosis. This article reviews the application of MRI combined with MSCT in wrist sprain examination, and analyzes the application value of the combined detection method to provide a basis for clinical practice.

Multimodal MRI Parameters Combined with Thyroid Hormones to Assess Cognitive Impairment in Cerebral Small Vessel Disease

WANG Xinli, ZHEN Na, YANG Hailong, ZHU Jianguo

2022, 40(6):  1328-1333.  DOI: 10.7517/issn.1674-0475.220719

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This paper investigated the value and clinical significance of multimodal magnetic resonance imaging (MRI) technique combined with thyroid hormone to assess cognitive impairment in cerebral small vessel disease (CSVD). According to the presence or absence of cognitive impairment, the 112 patients with CSVD were divided into damaged group (n=49) and non-damaged group (n=63). The multimodal MRI parameters [white matter lesions (WMLs) score, volume of WMLs, number of cerebral microhemorrhages (CMBs), fraction anisotropy (FA) values, apparent diffusion coefficient (ADC) values], thyroid hormones [parathyroid hormone (PTH), triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH)] were compared between the two groups. The results showed that WMLs scores, WMLs volume, and CMBs number in the damaged group were higher than in the non-damaged group, and FA values in the basal ganglia area, parietal lobe, and frontotemporal lobe were lower than in the non-damaged group (P<0.05). PTH and TSH in the damaged group were higher than in the non-damaged group, and T3 and T4 were lower than in the non-damaged group (P<0.05). AUC of WMLs score, volume of WMLs, number of CMBs, FA value of basal ganglia area, FA value of parietal lobe, FA value of frontotemporal lobe combined with PTH, T3, T4 and TSH to assess cognitive impairment in CSVD was greater than any single index; WMLs score, volume of WMLs, number of CMBs and PTH and TSH were negatively correlated with MMSE score (P<0.001). Basal ganglia area, parietal and frontotemporal FA values and T3 and T4 were positively correlated with MMSE scores (P<0.001). Multimodal MRI parameters and thyroid hormones are associated with CSVD cognitive impairment and its severity, and the combined test can be one of the effective protocols to assess the cognitive impairment status of patients.

Application of TVS 4D-HyCoSy in the Judgment of Tubal Patency and Contrast Medium Reflux

ZHOU Qiong, LONG Xiangdang, LIU Xuefei, WANG Linling, WANG Xiaoli

2022, 40(6):  1334-1338.  DOI: 10.7517/issn.1674-0475.220614

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This paper explored the application value of transvaginal four-dimensional hysterosalpingography (TVS 4D-HyCoSy) in the diagnosis of tubal patency and contrast medium reflux. 102 cases of female infertility were examined by TVS 4D-HyCoSy and laparoscopy. Laparoscopy confirmed that of the 204 fallopian tubes, 43 were smooth, 89 were distal obstruction and 72 were proximal obstruction. The consistency Kappa of TVS 4D-HyCoSy and laparoscopic diagnosis of fallopian tube was 0.732 (P<0.05). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of TVS 4D-HyCoSy in the diagnosis of fallopian tube obstruction were more than 80.00%. The incidence of contrast medium reflux in secondary infertility was significantly higher than that in primary infertility (P<0.05). In contrast medium reflux patients, the diagnostic accuracy of TVS 4D-HyCoSy was significantly lower than that of patients without contrast medium (P<0.05). TVS 4D-HyCoSy has a good application value in the judgment of tubal patency and contrast medium reflux, contrast medium reflux has a certain relationship with the type of infertility, the reverse flow of contrast medium affects the diagnostic accuracy of TVS 4D-HyCoSy.

Sensitivity and Accuracy Analysis of Energy Spectrum CT for the Diagnosis of Hepatocellular Carcinoma

WANG Xueling, YUAN Qingling, YANG Juan

2022, 40(6):  1339-1342.  DOI: 10.7517/issn.1674-0475.220720

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This study investigated the value of spectral CT in the diagnosis of hepatocellular carcinoma. 110 cases of liver space occupying lesions were selected, all of them were given spectral CT and spiral CT examination. Among the 110 patients, 88 were diagnosed as hepatocellular carcinoma and 22 as focal nodular hyperplasia. The sensitivity, accuracy and negative predictive value of spectral CT in the diagnosis of hepatocellular carcinoma were significantly higher than those of spiral CT (P<0.05). In tumor diameter <3 cm, the detection rate of spectral CT was higher than that of spiral CT (P<0.05). The ratio of iodine uptake (IUR) in arterial phase, IUR in portal vein phase, standardized iodine concentration (NIC) in arterial phase, slope of energy spectrum curve (S) in arterial phase and S in portal vein phase of hepatocellular carcinoma were significantly lower than those in focal nodular hyperplasia (P<0.05). The area under the ROC curve (AUC) of arterial IUR, portal IUR, arterial NIC, arterial S and portal S in the diagnosis of hepatocellular carcinoma were 0.846, 0.767, 0.753, 0.811 and 0.715, respectively (P<0.05), the AUC of the combined diagnosis of the above parameters was 0.921, and the sensitivity and specificity were 90.00% and 88.00%, respectively. Energy spectrum CT has good application value in the diagnosis of hepatocellular carcinoma and is worthy of clinical use.

Changes of Fragmented QRS Wave, Echocardiography and 2D-STI Parameters in Patients with AMI after PCI

WEI Wei, LAN Feifei, QIU Yuyu, QIN Honghui

2022, 40(6):  1343-1348.  DOI: 10.7517/issn.1674-0475.220809

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This study investigated the relationship between fragmented QRS complex in electrocardiogram, echocardiography, two-dimensional speckle tracking (2D-STI) and left ventricular remodeling in patients with acute myocardial infarction (AMI). A total of 113 patients who were diagnosed with AMI and received percutaneous coronary intervention (PCI) were selected for clinical research. According to whether the patients had left ventricular remodeling within 12 months after PCI, they were divided into a remodeling group of 41 cases and a non-remodeling group of 72 cases. The dynamic electrocardiogram fragmentation QRS complex at admission, echocardiogram and 2D-STI indexes at 6 months after PCI were compared between the two groups, and the relationship between the above indexes and left ventricular remodeling was analyzed by Logistic regression model. The positive rate of fragmented QRS complex in the remodeling group was higher than that in the non-remodeling group (P<0.05). The measured values of left ventricular end-diastolic volume (LVEDV), interventricular septal thickness (IVST) and left ventricular posterior wall thickness (LVPWT) in the remodeling group were significantly higher than those in the non-remodeling group (P<0.05). The measured values of left ventricular ejection fraction (LVEF) and left ventricular end-systolic volume (LVESV) in the remodeling group were lower than those in the non-remodeling group. The measured values of overall circumferential strain (CS), overall radial strain (RS), and longitudinal strain (LS) in the remodeling group were lower than those in the non-remodeling group (P<0.05). Complicated hypertension, coronary artery disease branch number ≥3, increased IVST, increased LVPWT, and positive fragmented QRS complex were positively correlated with left ventricular remodeling in patients with AMI after PCI (P<0.05). The LVEF, CS, RS, LS measured values were negatively correlated with left ventricular remodeling in patients with AMI after PCI (P<0.05). Observation of ECG, echocardiography and 2D-STI after PCI in patients with AMI has certain clinical value in evaluating whether patients have left ventricular remodeling after operation.

The Role of Contrast-enhanced Ultrasound in Puncture Biopsy of Peri-pulmonary Lesions

ZHU Pengfei, HE Ying

2022, 40(6):  1349-1353.  DOI: 10.7517/issn.1674-0475.220622

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This paper investigated the application value of ultrasound and contrast-enhanced ultrasound-guided coarse needle biopsy in peripheral pulmonary lesions. 158 patients with peripheral pulmonary lesions diagnosed by CT or MRI were selected as the research objects. They were divided into conventional ultrasound group and contrast-enhanced ultrasound group. The conventional ultrasound group underwent puncture biopsy under the guidance of ordinary ultrasound, while the contrast-enhanced ultrasound group underwent ultrasound contrast examination on the basis of ordinary ultrasound, and then percutaneous puncture biopsy under its guidance. The puncture success rate, the display rate of intrafocal necrosis, the diagnostic accuracy of subtype (classification), the positive rate of epidermal growth factor receptor (EGFR) and the complications after puncture were compared between the contrast-enhanced ultrasound group and the conventional ultrasound group. According to the pathological results, the success rate of contrast-enhanced ultrasound group (100%) was higher than that of conventional ultrasound group (90%), P<0.05. The display rate of necrosis in the contrast-enhanced ultrasound group (46%) was much higher than that in the conventional ultrasound group (21%), P<0.05. The diagnostic accuracy rate of subtype (classification) in the contrast-enhanced ultrasound group (96%) was slightly higher than that in the conventional ultrasound group (94%),the difference was not statistically significant (P>0.05). The positive rate of EGFR in the contrast-enhanced ultrasound group (32%) was lower than that in the conventional ultrasound group (35%),the difference was not statistically significant (P>0.05). Ultrasound and contrast-enhanced ultrasound-guided puncture are of great value in the diagnosis of peripheral lung lesions, and contrast-enhanced ultrasound has more advantages over conventional ultrasound in the relationship between the lesion and the surrounding tissue structure and the blood flow inside the lesion, which can effectively improve the success rate of puncture.

CBCT Evaluation of the Application Effect of Transitional Dentures in the Restoration of Complete Dentures

LIU Zilve, WANG Zhi, SONG Wenshang, LI Suna, CAI Shixin

2022, 40(6):  1354-1358.  DOI: 10.7517/issn.1674-0475.220813

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The application value of cone beam CT technology (CBCT) in evaluating transitional dentures in complete denture restoration was explored in this study. 107 patients with complete denture restoration were selected. Transitional denture restorations were divided into restoration failure group (n=26) and restoration success group (n=81) according to restoration effect. CBCT examination was performed before and after the repair, and the changes in the anterior space, middle space, and posterior space of the temporomandibular joint between the two groups were compared. The results showed that the changes in the anterior space, middle space and posterior space of the temporomandibular joint with the new and old dentures in the repair failure group were greater than those in the repair success group (P<0.05). The changes of the anterior space, middle space, and posterior space of the temporomandibular joint with the new and old dentures were negatively correlated with the jaw position relationship index, chewing efficiency, aesthetic score, and comfort (P<0.05). Logistic univariate and multivariate regression analysis showed that the changes in the anterior space, middle space and posterior space of temporomandibular joint were independently correlated with the restoration effect of complete denture (P＜0.05). The AUC of the combined evaluation of the changes in the anterior space, middle space and posterior space of the temporomandibular joint was 0.905, the sensitivity was 80.77%, and the specificity was 88.89%, which was significantly better than the individual evaluation of each index. CBCT examination indicators can effectively evaluate the application effect of transitional dentures in the restoration of complete dentures, and provide a reliable reference for clinical practice.

Study of UVC Blood Flow Spectrum Parameters in the First Trimester Combined with Four-dimensional Color Doppler Ultrasound in the Second Trimester in the Diagnosis of Cardiac Developmental Malformations

LIU Haining, ZHAO Guodong, QI Haiying

2022, 40(6):  1359-1363.  DOI: 10.7517/issn.1674-0475.220707

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This paper explored the clinical value of umbilical venous catheter (UVC) color Doppler ultrasound blood flow spectrum parameters in the first trimester combined with four-dimensional color Doppler ultrasound in the second trimester in the diagnosis of fetal congenital cardiac developmental malformations. A total of 62 fetuses with congenital cardiac developmental malformations were selected as the observation group, and 180 fetuses with normal heart development during the same period were selected as the control group. Both groups received UVC color Doppler ultrasound examination at 11 to 13 weeks of gestation, and four-dimensional color Doppler ultrasound examination at 17 to 27 weeks of gestation. The results showed that the measured values of fetal UVC color Doppler ultrasound blood flow spectrum parameters atrial systolic peak velocity (A), ventricular diastolic peak velocity (D), ventricular systolic velocity (S) and A wave maximum velocity (Tamax) in the observation group were lower than those in the control group (P<0.05). The measured values of fetal UVC color Doppler ultrasound blood flow spectrum parameters pulsatility index (PI), venous preload index (PLI) and venous peak velocity index (PVIV) in the observation group were higher than those in the control group (P<0.05). The AUC values of S, D, A, Tamax, PI, PLI and PVIV in the first trimester were 0.702, 0.849, 0.647, 0.768, 0.826, 0.757 and 0.676, respectively. The overall coincidence rate of four-dimensional color Doppler ultrasound in the diagnosis of fetal cardiac malformation in the second trimester was 93.55%. The sensitivity and specificity of four-dimensional color Doppler ultrasound in the diagnosis of cardiac developmental malformations were 93.55% and 98.33%. The application of UVC color Doppler ultrasound blood flow spectrum parameters in the first trimester combined with the four-dimensional color ultrasound screening in the second trimester has a better effect on the detection of fetal congenital cardiac malformations and measures.

Application of CCTA Three-dimensional Morphological Pre Academic Evaluation in One-stop Catheter Ablation for Left Atrial Appendage Occlusion

HE Ying, GAO Lvping, CAO Chengying, ZHU Youyi, LUO Huan

2022, 40(6):  1364-1369.  DOI: 10.7517/issn.1674-0475.220804

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This article discusses the application value of three-dimensional morphological pre-academic evaluation of cardiac CT angiography (CCTA) in the one-stop treatment of left atrial appendage occlusion catheter ablation. A total of 98 patients with atrial fibrillation were selected. 48 patients underwent preoperative CCTA assessment (CCTA group), and 50 patients underwent transesophageal echocardiography (TEE) assessment (TEE group). The cardiac ultrasound parameters and the success rate of Watchman device implantation were compared between the two groups. The success rate of Watchman device implantation in the CCTA group was 100.00%, which was significantly higher than that in the TEE group (P<0.05), while the operation time and X-ray exposure time were significantly shorter than those in the TEE group (P<0.05). The difference between the actual and predicted size of the occluder in the CCTA group was significantly lower than that in the TEE group (P<0.05). The predicted size of the occluder in the CCTA group was positively correlated with the actual size of the occluder, and the consistency was high (P<0.05). The pre-academic assessment of CCTA three-dimensional morphology has good application value in the one-stop treatment of left atrial appendage occlusion catheter ablation, which is beneficial to the successful implantation of the occluder and shortens the operation time and X-ray exposure time.

Diagnostic Analysis of 4D-HyCoSy and HSG Examination in Tubal Infertility

WANG Muzhe, LI Xianghong, XING Xiuyue, WANG Lina, ZHOU Ye, LI Xiaoli

2022, 40(6):  1370-1374.  DOI: 10.7517/issn.1674-0475.220716

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This paper discussed the differences between four-dimensional hyterosalpingo-contrast-sonography (4D-HyCoSy) and hysterosalpingography (HSG) under X-ray in the diagnosis of tubal infertility. 92 patients with suspected tubal infertility were selected, they were examined by 4D-HyCoSy, HSG and laparoscopic staining solution experiment (LSC), and the uterine pressure was measured during the 4D-HyCoSy examination. LSC examination was taken as the gold standard, and the Kappa value of 4D-HyCoSy and LSC was 0.810 (P<0.05). The Kappa value of HSG and LSC was 0.905 (P<0.05). There was no significant difference in the diagnostic accuracy of 4D-HyCosy and HSG for tubal status (P>0.05). The peak values of intrauterine pressure in patients with tubal obstruction during 4D-HyCoSy and HSG were significantly higher than those in patients with partially obstructed and unobstructed (P<0.05). In the diagnosis of tubal infertility, 4D-HyCoSy and HSG have high diagnostic value in the judgement of tubal patency.

Evaluation of Resectability of Breast Cancer Lesions by Contrast-enhanced Ultrasound Combined with Shear Wave Elastography

GONG Wenliang, ZHOU Jian, ZHU Daowei

2022, 40(6):  1375-1380.  DOI: 10.7517/issn.1674-0475.220826

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The value of contrast-enhanced ultrasound (CEUS) combined with shear wave elastography (SWE) in evaluating the resectability of breast cancer lesions were investigated. In this study, 103 breast cancer patients were selected as the research subjects, and they were divided into a surgical resection group (61 cases) and an inoperable group (42 cases) according to clinical conditions, all of whom underwent CEUS and SWE examinations. The results showed that the time to peak (TTP) in the inoperable group was shorter than that in the surgical resection group. The peak intensity (PI), the wash in slop (WIS), the mean value of Young’s modulus (Emean), the minimum value of Young’s modulus (Emin) and maximum value of Young’s modulus (Emax) were higher than those in the surgical resection group. TTP was negatively correlated with Emean, Emin and Emax, while PI and WIS were positively correlated with Emean, Emin and Emax (P<0.05). The risk of inoperable resection was 2.084 times higher in patients with low levels of TTP than in patients with high levels. The risk of inoperable resection in patients with high PI, WIS, Emean, Emin, and Emax levels was 1.883 times, 2.179 times, 2.443 times, 1.894 times, and 2.003 times higher than that in patients with low levels, respectively. The combined AUC of TTP, PI, WIS, Emean, Emin, and Emax for assessing the resectability of breast cancer lesions was 0.916, with a sensitivity of 85.71% and specificity of 83.61%, which was better than each parameter individually. It is suggested that the value of CEUS combined with SWE to assess the resectability of breast cancer lesions is more reliable and can provide a reference basis for accurate clinical assessment of surgical feasibility.

Application of MRI Combined with Serum AFP in the Diagnosis of CSP and Placenta Accrete

JIAO Yue, YAO Shuiping, GUO Li, GUO Chunlei

2022, 40(6):  1381-1385.  DOI: 10.7517/issn.1674-0475.220702

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This study investigated the value of magnetic resonance imaging (MRI) combined with serum alpha-fetoprotein (AFP) in diagnosing cesarean scar pregnancy (CSP) and evaluating placenta accreta. 73 patients with suspected CSP were selected as the CSP group, 63 normal pregnant women were selected as the normal pregnancy group, and 63 healthy non-pregnant patients were selected as the healthy non-pregnant group. MRI examination was performed, serum AFP was detected by radioimmunoassay, and the data were analyzed statistically. The results showed that among 73 patients with suspected CSP, 63 were confirmed to be CSP by surgery and/or pathological examination. The accuracy rate of MRI diagnosis of CSP was 95.24%, of which 48 were type Ⅰ (76.19%), and 10 cases type Ⅱ (15.87%), 2 cases of type Ⅲ (3.17%), the accuracy rate of diagnosing placenta accreta was 88.24%. Comparison of serum AFP levels, CSP group > normal pregnancy group > healthy non-pregnant group (P<0.05). The AUC for the diagnosis of CSP was 0.784, and the AUC of serum AFP combined with MRI for the diagnosis of CSP was 0.850. The serum AFP of patients with placenta accreta was higher than that of non-accreta patients. The AUC of serum AFP to evaluate placenta accreta was 0.748, and the AUC of serum AFP combined with MRI to evaluate placenta accreta was 0.881. Therefore, MRI combined with serum AFP can be an effective solution for the diagnosis of CSP and placenta accreta.

The Study of MSCT in Evaluating Postoperative Healing and Functional Rehabilitation of Thoracolumbar Fractures

ZHANG Delong, LI Yumei, ZHOU Jianhua

2022, 40(6):  1386-1389.  DOI: 10.7517/issn.1674-0475.220814

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This study investigated the value of multi-slice spiral CT (MSCT) in the detection and evaluation of fracture healing and functional rehabilitation in patients undergoing intravertebral osteoplasty after thoracolumbar fractures. A total of 102 patients with thoracolumbar burst fractures treated by open reduction and intravertebral bone grafting were selected for clinical research. According to the modified Prolo function score of the patients 6 months after operation, the patients were divided into an excellent group of 72 cases and a general group of 30 cases, compared the CT value of the bone graft area and the change trend of the imaging parameters of the spine and vertebral body in the two groups. At 3 and 6 months after operation, the compression rate of the anterior edge of the injured vertebrae and the Cobb angle of the patients in the excellent group were lower than those in the general group (P<0.05). At 3 and 6 months after operation, the CT value of patients in the excellent group was higher than that in the general group, and the Oswestry Disability Index (ODI) value of patients in the excellent group was lower than that in the general group (P<0.05). The changes of CT values in the bone graft area of patients undergoing intravertebral osteoplasty after thoracolumbar fractures can reflect the effect of fracture healing.

Diagnostic Value of Spectral CT in Lymph Node Metastasis in Gastric Cancer and Analysis of Influencing Factors

LI Haoran, ZHANG Peng, CHEN Chong

2022, 40(6):  1390-1395.  DOI: 10.7517/issn.1674-0475.220705

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This study investigated the value of spectral CT in the diagnosis of lymph node metastasis in patients with gastric cancer and its influencing factors. Selected 87 gastric cancer patients with lymph node metastasis as the metastasis group, and 90 gastric cancer patients without lymph node metastasis as the control group. All patients received energy spectral CT scan before, and the related parameters of energy spectral CT were compared between the two groups, and the receiver operating characteristic (ROC) curve was drawn to analyze the value of each parameter in the diagnosis of lymph node metastasis in gastric cancer. The related factors affecting the accuracy of spectral CT in preoperative diagnosis of lymph node metastasis in gastric cancer was analyzed. The results showed that the ratio of the length and diameter of lymph nodes, the IC in the arterial phase, the IC in the venous phase, the nIC in the arterial phase, and the nIC in the venous phase in the metastatic group were significantly higher than those in the non-metastatic group (P<0.05). The AUC values of lymph node length and diameter ratio, arterial phase IC, venous phase IC, arterial phase nIC, and venous phase nIC values for the diagnosis of lymph node metastasis in patients with gastric cancer were 0.809, 0.669, 0.734, 0.769 and 0.778,respectively. Logistic model results showed that: rough fat around the lesion, TNM stage ≤ stage Ⅱ, and tumor invasion depth not reaching the submucosa were the influencing factors for the accurate diagnosis of lymph node metastasis in patients with gastric cancer before energy spectrum CT (P<0.05). Spectral CT parameters can more accurately determine whether lymph node metastases occur in gastric cancer patients before surgery, and have certain value for the treatment and prognosis evaluation of patients.

The Relationship between the Characteristics of CMBs and ACVS Based on SWI and the Prognosis of Patients with Acute Cerebral Infarction

CHEN Pianpian, WANG Yaoguang, SHEN Chunyun, CAI Linjiang, CHEN Shaoqun, CHEN Hongen, GAO Junjie

2022, 40(6):  1396-1401.  DOI: 10.7517/issn.1674-0475.220619

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This study investigated the relationship between cerebral microbleeds (CMBs) and asymmetric cortical vein sign (ACVS) detected by susceptibility-weighted imaging (SWI) and the prognosis of patients with acute cerebral infarction (ACI). A total of 87 patients diagnosed with ACI and receiving intravenous thrombolysis were selected as the research subjects. All subjects underwent SWI scanning. According to the modified Rankin scale (mRS), the patients were divided into good prognosis (58 cases in the good group), poor prognosis (29 cases in the poor group) two groups. The detection rates of CMBs and ACVS were compared between the two groups, and the receiver operating characteristic (ROC) curve method was used to explore the prediction of the two indicators in the prognosis of patients after ACI intravenous thrombolysis. aspects of the role. The results showed that the detection rate of CMBs and ACVS in the good group was significantly lower than that in the poor group (P<0.05). Logistic model results showed that higher baseline NIHSS score, higher NIHSS score at 24 h of thrombolysis, combined hypertension, severe middle cerebral artery stenosis, CMBs, and ACVS were independent risk factors for poor prognosis in ACI patients (P<0.05). Decreased ASPECTS infarct area score was an independent risk factor for poor prognosis in ACI patients (P<0.05). SWI can early detect the characteristics of CMBs and ACVS after intravenous thrombolysis in ACI patients, and can evaluate the risk of poor prognosis of patients.

The Role of Contrast-enhanced Ultrasound in the Detection of Carotid Intraplaque Neovascularization in Coronary Heart Disease and Its Relationship with the Expression of Serum Hcy

SUN Xiang, TAN Jie

2022, 40(6):  1402-1406.  DOI: 10.7517/issn.1674-0475.220725

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This study investigated the role of contrast-enhanced ultrasonography (CEUS) in the detection of carotid plaque neovascularization (IPN) in coronary artery disease and its relationship with the expression of serum homocysteine (Hcy) and blood lipids. A total of 167 patients with stable coronary heart disease (CAD) and carotid plaque (thickness ≥1.5 mm) were selected as the research subjects. IPN was examined by CEUS, and the patients were divided into IPN group (n=82) and non-IPN group (n=85). The baseline data, carotid ultrasound characteristics, blood lipid metabolism indexes, serum Hcy levels, and the incidence and occurrence time of major adverse cardiovascular events (MACE) were compared between the two groups. The results showed that the maximum plaque thickness in the IPN group was higher than that in the non-IPN group [(3.23±1.07) mm vs (2.85±0.87) mm,P＜0.05]. There was no significant difference in TC, TG, HDL-C and LDL-C between the two groups (P>0.05). The serum Hcy level in the IPN group was higher than that in the non-IPN group (P＜0.05). The overall incidence of MACE was 7.19% (12/167). The Kaplan-Meier survival curve of patients’ MACE showed that the occurrence time of MACE in patients with IPN was earlier than in non-IPN group at follow-up (P＜0.05). This study suggests that IPN, maximum plaque thickness and serum Hcy levels may be predictors of adverse cardiovascular events in patients with coronary heart disease.

Analysis of MRI Parameters Combined with β-CTX and PAI-1 in the Diagnosis and Staging of Femoral Head Necrosis

DING Juan, LI Yuhong, ZHAO Hongchun, GUO Yi, LIU Yuxi, CAO Wenbin

2022, 40(6):  1407-1411.  DOI: 10.7517/issn.1674-0475.220604

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This paper analyzed the diagnostic value of magnetic resonance imaging (MRI) combined with β-C-terminal cross-linking telopeptide of type 1 collagen (β-CTX) and plasminogen activator inhibitor-1 (PAI-1) in the diagnosis of femoral head necrosis. A total of 112 patients with suspected femoral head necrosis were selected as the research objects. According to the operative pathological examination as the "gold standard", 80 cases diagnosed with femoral head necrosis were set as the research group,32 cases of non-femoral head necrosis were set as the control group. MRI examination was performed in both groups, and the levels of β-CTX and PAI-1 in both groups were also examined. Compared with the control group, the first maximum reinforcement peak (fEmax) and the maximum reinforcement peak (Emax) in the study group were decreased, and the parameters of time to peak (TTP) were increased (P<0.05). In patients with femoral head necrosis stage Ⅰ-Ⅳ, the patients with stage Ⅳ necrosis of the femoral head, the levels of fEmax, Emax and β-CTX were the lowest, while the levels of TTP parameters and PAI-1 were the highest (P<0.05). fEmax, Emax, TTP, β-CTX and PAI-1 were correlated with different clinical stages (P＜0.05). Compared with the single diagnosis of fEmax (AUC=0.605), Emax (AUC=0.594), TTP (AUC=0.822), β-CTX (AUC=0.617), and PAI-1 (AUC=0.816), the five-item combination (AUC=0.831) had higher diagnostic value for femoral head necrosis (P<0.05). MRI combined with β-CTX and PAI-1 has high diagnostic value in the diagnosis and staging of femoral head necrosis.

The Relationship between Color Doppler Ultrasound Parameters and Disease Severity and Curative Effect in Patients with BRVO Combined with ME

SUN Hongshuang, YIN Dan, LIU Ying, SUN Hongwen, SUN Xia, LI Yuefeng

2022, 40(6):  1412-1416.  DOI: 10.7517/issn.1674-0475.220824

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This study investigated the relationship between colour Doppler ultrasound parameters and the disease severity and outcome of patients with branch retinal vein occlusion (BRVO) combined with macular oedema (ME). Eighty-six patients with BRVO combined with ME were selected as the study group, and 86 patients with BRVO alone were included as the control group. Colour Doppler ultrasound examinations were performed to analyse the relationship between colour Doppler ultrasound parameters [peak systolic flow velocity (PSV), end-diastolic flow velocity (EDV) and resistance index (RI)] of the central retinal artery (CRA) and ophthalmic artery (OA) and the disease severity and its outcome. The results showed that the EDV, PSV and RI of CRA in the study group were lower than those of the control group, and macular cystoid edema < diffuse < restrictive (P<0.05). EDV, PSV and RI of CRA in patients with BRVO combined with ME were negatively correlated with the degree of disease (P<0.05). The EDV, PSV and RI of CRA were higher in effective patients than in ineffective patients after treatment, and the difference before and after treatment was higher than in ineffective patients (P<0.05). The combined value of EDV, PSV and RI difference predicted the efficacy of BRVO combined with ME better than the single prediction. It can be seen that colour Doppler ultrasound parameters are closely related to the disease severity and efficacy of BRVO combined with ME, which can guide clinical management.

Application and Analysis of DCE-MRI Combined with Ultrasound in the Clinical Diagnosis of Breast Cancer

CHEN Yuna, WU Yunhu, ZHOU Meijuan, DONG Jiandang

2022, 40(6):  1417-1422.  DOI: 10.7517/issn.1674-0475.220602

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This study investigated the application value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) combined with ultrasound in clinical diagnosis of breast cancer. The relevant data of 100 patients with breast tumors were retrospectively analyzed. All of the patients completed ultrasound and DCE-MRI examinations. The DCE-MRI characteristics of benign and malignant tumors were comparatively analyzed. The value of the Breast Imaging Reporting and Data System (BI-RADS) in evaluating benign and malignant breast tumors under the two examination methods was analyzed. The diagnostic value of the combination of the two was analyzed. DCE-MRI showed that the shapes, edges, internal enhancement features, and TIC curves of benign and malignant tumors were significantly different. The volume transfer constant (Ktrans) and rate constant (Kep) of malignant tumors were higher than those of benign tumors, and extracellular space volume percentage (Ve) was lower than that of benign tumors. The sensitivity, specificity and accuracy of ultrasound to diagnose benign and malignant breast tumors were 94.12%, 83.67% and 89.00%. The sensitivity, specificity and accuracy of DCE-MRI were 98.04%, 89.79% and 94.00%. The sensitivity, specificity and accuracy of combined diagnosis with the two were 100.00%, 97.95% and 99.00%. The accuracy of combined diagnosis was higher than that of ultrasonic diagnosis (P＜0.05). The above results indicate that both DCE-MRI and breast ultrasound are helpful in nature diagnosis of breast lesions, and combined use of the two can provide more reference for the diagnosis.

The Diagnostic Value of Ultrasound-guided Thyroid Fine-needle Aspiration Biopsy for PTMC

WANG Jing, LIU Ying, CUI Quanzhe, ZHOU Yang

2022, 40(6):  1423-1427.  DOI: 10.7517/issn.1674-0475.220714

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This study investigated the diagnostic value of ultrasound-guided thyroid fine-needle aspiration biopsy (US-FNAB) for papillary thyroid microcarcinoma (PTMC). A total of 203 patients (203 nodules) with thyroid micronodules confirmed by pathological examination were selected. All patients underwent US-FNAB examination. The relationship between thyroid micronodules with different cytological characteristics and Bethesda classification of thyroid was analyzed. The pathological examination results were used as the gold standard to analyze the value of US-FNAB in the diagnosis of PTMC. According to the Bethesda classification of thyroid, there were 0 nodules of class Ⅰ, 33 nodules of class Ⅱ, 49 nodules of class Ⅲ, 51 nodules of class Ⅳ, 40 nodules of class Ⅴ, and 30 nodules of class Ⅵ. The proportion of solid nodules, hypoechoic nodules, nodules with blurred borders, and nodule aspect ratio≥1 in malignant thyroid nodules was higher than that in benign nodules (P<0.05); US-FNAB The sensitivity and specificity of differential diagnosis of PTMC and benign thyroid nodules were 85.29% and 91.11%; the sensitivity and specificity of ultrasound in differential diagnosis of PTMC and benign thyroid nodules were 75.00% and 83.70%.The diagnostic value of US-FNAB for PTMC is higher than that of ultrasonography, and it is of great significance for the formulation of clinical individualized treatment plans.

Comparison of MSCT Plain Scan and Enhanced Scan in Determining the Properties of Pulmonary Nodules

SUN Jingxi, SHI Yibing, WANG Xiuling

2022, 40(6):  1428-1432.  DOI: 10.7517/issn.1674-0475.220611

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The purpose of this paper was to analyze the difference between the multi-slice spiral computed tomography (MSCT) chest plain and contrast-enhanced scans in judging the nature of pulmonary nodules. The clinical data and MSCT chest plain scan and MSCT enhanced scan images of 125 patients with pulmonary nodules were retrospectively analyzed, and the pulmonary nodule images under MSCT plain scan and MSCT enhanced scan were analyzed. The results showed that the display rate of lobulation sign, pleural stretch sign, vascular bundle sign and vacuole sign under enhanced scan was significantly higher than that of MSCT plain scan (P<0.05). The enhanced CT value and CT value increment of benign nodular lesions [(56.84±11.36) Hu and (25.67±13.65) Hu, respectively] were lower than those of malignant nodular lesions [(79.52±12.32) Hu and (48.95±12.35) Hu, respectively, P<0.05]. The diagnostic sensitivity, specificity and accuracy of MSCT plain scan were 65.96%, 67.95% and 67.20%, respectively. The diagnostic sensitivity, specificity and accuracy of MSCT enhanced scan were 80.85%, 80.77% and 80.80%, MSCT enhanced scan was closer to pathological results. Both plain MSCT scan and MSCT enhanced scan have good clinical value in judging the nature of pulmonary nodules, but MSCT enhanced scan has more prominent diagnostic value for the nature of pulmonary nodules.

Evaluation of Cerebral Blood Flow in Chronic Cerebral Infarction by 3D-ASL and Its Correlation with Cognitive Function

MENG Qingning, SHI Gang, WANG Runqiang

2022, 40(6):  1433-1437.  DOI: 10.7517/issn.1674-0475.220708

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In this study, 3D arterial spin labeling perfusion imaging (3D-ASL) was used to evaluate cerebral blood flow (CBF) in chronic cerebral infarction and its correlation with cognitive function. 64 patients with chronic cerebral infarction were selected as the chronic group, 60 patients with acute cerebral infarction were selected as the acute group, and 50 patients with subacute cerebral infarction were selected as the subacute group. The CBF and relative cerebral blood flow (rCBF) of the affected side and the healthy side were compared among the three groups. The CBF and rCBF of the affected side in the chronic phase group were significantly lower than those in the acute phase group and the acute phase group (P<0.05). The Mini Mental State Scale (MMSE) and Montreal Cognitive Assessment Scale (MoCA) and Fugl-Meyer score of patients in chronic stage group were significantly lower than those in subacute stage group and acute stage group (P<0.05). Ipsilateral CBF and rCBF were positively correlated with MMSE score and MoCA score (P<0.05). Logistic regression analysis showed that age, diabetes, ipsilateral CBF and rCBF were the influencing factors of cognitive dysfunction in patients with chronic cerebral infarction (P<0.05). CBF is correlated with cognitive function in patients with chronic cerebral infarction. 3D-ASL assessment of CBF is helpful to understand the cognitive function impairment in patients with chronic cerebral infarction.

Application of CCTA Coronal Fai Combined with Upper Chest Supplementary Scanning and Image Wide Field Reconstruction in Coronary Heart Disease Screening

JIA Lei, ZHAO Wenxing, WANG Xin, WANG Shengyuan, YANG Lingjun

2022, 40(6):  1438-1443.  DOI: 10.7517/issn.1674-0475.220807

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This paper discussed the value of coronary CT angiography (CCTA) in screening coronary heart disease with peripheral fat attenuation index (FAI) combined with upper chest supplementary scanning and image wide field reconstruction. 80 patients with suspected coronary heart disease were selected to receive CCTA and coronary angiography (CAG). After CAG, there were 56 patients with coronary heart disease and 24 patients without coronary heart disease. The FAI value of the coronary heart disease group was significantly lower than that of the non coronary heart disease group (P<0.05). The FAI value of severe stenosis in CHD group was significantly lower than that of mild and moderate stenosis (P<0.05). FAI was negatively correlated with the degree of stenosis (r=－0.511, P<0.05). The area under ROC curve of coronary heart disease predicted by FAI was 0.947 (P<0.05). Forty-six patients with extracardiac lesions were found after wide field reconstruction, and 12 patients with extracardiac lesions were found after supplementary chest scanning, a total of 73 lesions were found. CCTA coronal FAI has good value in the diagnosis of coronary heart disease. At the same time, combined with supplementary upper chest scanning and image large field reconstruction, it is helpful to find the extracardiac lesions.

Value of Dual-energy CT Cerebral Perfusion Imaging Combined with FGF21 in the Diagnosis of the Severity of Cerebral Infarction

DENG Jing, ZHANG Heling, WANG Yuanjiang, TAN Chunmiao

2022, 40(6):  1444-1448.  DOI: 10.7517/issn.1674-0475.220620

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This study aimed to reveal the value of dual- energy CT (DECT) cranial perfusion imaging combined with fibroblast growth factor 21 (FGF21) in the diagnosis of the severity of cerebral infarction. 100 patients with acute cerebral infarction were examined by DECT cranial perfusion imaging to obtain relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCBV). Plasma fibroblast growth factor 21 (FGF21) levels in 100 patients and 30 healthy subjects were detected by enzyme-linked immunosorbent assay (ELISA). Patients were classified as mild, moderate, and severe according to the National Institutes of Health stroke scale (NIHSS) score. The diagnostic value of each parameter on the severity of cerebral infarction was analyzed by receiver operating characteristic (ROC). The levels of rCBF and rCBV decreased with the increase of cerebral infarction severity (P<0.05). With the increase of the severity of cerebral infarction, the level of plasma FGF21 increased gradually (F=65.212, P=0.002). The AUC, sensitivity and specificity of rCBF and rCBV combined with plasma FGF21 in diagnosing the severity of cerebral infarction were 0.955, 84.91% and 95.74%, respectively. The diagnostic value of rCBF and rCBV combined with plasma FGF21 for the severity of cerebral infarction is higher than that of single diagnosis.

Application of CEUS Combined with Conventional US in the Diagnosis of Thick-walled Gallbladder Lesions and Gallbladder Polypoid Lesions

XIANG Shufang, ZHANG Mei, WANG Shouneng, LIU Wen, LIU Can

2022, 40(6):  1449-1454.  DOI: 10.7517/issn.1674-0475.220808

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This article discussed the value of contrast-enhanced ultrasonography (CEUS) combined with conventional ultrasonography (US) in the diagnosis of thick-walled gallbladder lesions and gallbladder polypoid lesions. Forty-six patients with thick-walled gallbladder lesions and 60 patients with gallbladder polypoid lesions were selected. The clinical data, CEUS and US imaging features of patients were analyzed, and the diagnostic value of CEUS combined with conventional US was analyzed. The thickness of gallbladder wall, the proportion of discontinuous inner and outer gallbladder walls, and the proportion of high enhancement in patients with thick-walled gallbladder malignant lesions were higher than those in benign lesions (P<0.05), while the onset time and resolution time were faster than those in benign lesions (P<0.05). The patients with malignant gallbladder polypoid lesions had blood flow, unclear boundary with the cyst wall, and the proportion of gallbladder wall discontinuity was higher than that of benign lesions (P<0.05), and the time of onset and regression was faster than that of benign lesions (P<0.05). The Kappa value of CEUS combined with conventional US in the diagnosis of benign and malignant thick-walled gallbladder lesions was 0.870 (P<0.05), and the consistency was high. The sensitivity, specificity and accuracy of diagnosing malignant lesions were 91.67%, 95.45% and 93.48%, respectively. The Kappa value of CEUS combined with conventional US in the diagnosis of benign and malignant gallbladder polypoid lesions and pathological results was 0.832 (P<0.05), and the consistency was high. The sensitivity, specificity and accuracy of diagnosing malignant lesions were 90.91%, 92.59% and 91.67%, respectively. CEUS combined with conventional US has good application value in the diagnosis of benign and malignant thick-walled gallbladder lesions and benign and malignant gallbladder polypoid lesions.

Comparison of Ultrasound-guided ESP and TAP in the Treatment Effect of Colorectal Cancer Patients Undergoing Radical Resection

LAN Hao, ZHAN Rui, WANG Yue, ZHANG Xiaoqin

2022, 40(6):  1455-1459.  DOI: 10.7517/issn.1674-0475.220704

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The objective of this study was to compare the postoperative analgesic effects of ultrasound-guided erector spinae plane block (ESP) and ultrasound-guided transverse abdominis plane block (TAP) on patients undergoing radical resection of colorectal cancer. A total of 120 patients who underwent radical resection of colorectal cancer were selected as the research objects, and divided into the control group and the study group according to the random number table method with 60 cases in each group. The control group underwent ultrasound-guided TAP, the study group underwent ultrasound-guided ESP, and the heart rate, mean arterial pressure, visual analogue scale (VAS) score, Ramsay sedation score, stress-reaction questionnaire (SRQ) score, drug dose, recovery index detection, and complication response were detected in the two groups. Compared with T₀,T₁, and T₂, the heart rate and mean arterial pressure of the two groups increased at T₃, but the study group was lower than the control group (P<0.05). Compared with the control group, the VAS scores of the patients in the study group were lower at 2 h, 4 h, 8 h, and 12 h after the operation, and the Ramsay sedation score was higher (P<0.05). Compared with preoperative, the scores of emotional response, physical response and behavioral response in the two groups decreased at 48 h after surgery, and the scores in the study group were lower than those in the control group (P<0.05). Compared with the control group, the patients in the study group had less dosage of remifentanil and propofol, the recovery time, wake time and tracheal extubation time were shorter, and the incidence of complications was lower (P<0.05). Compared with ultrasound-guided TAP, ESP has better postoperative analgesia, which can reduce the incidence of complications and speed up the postoperative recovery of patients.

The Value of Ultrasound Elastography Combined with Mts1 Protein in the Diagnosis of Thyroid Cancer

GAO Jie, PENG Yuexiang, ZHAO Shanshan, LUO Chi, GAO Weiyuan

2022, 40(6):  1460-1464.  DOI: 10.7517/issn.1674-0475.220801

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This study aimed to clarify the value of ultrasound elastography (UE) combined with S100 calcium binding protein A4 (Mts1/S100A4) protein in the diagnosis of thyroid cancer (TC) and its lymph node metastasis. Patients with thyroid lesions who underwent UE examination in our hospital were selected as the research objects. Among them, 107 patients (107 lesions) diagnosed with TC were included in the TC group, and 101 patients (101 lesions) diagnosed with benign thyroid nodules were included in the benign group. Among 107 patients with TC, 64 patients did not develop lymph node metastasis and 43 patients developed lymph node metastasis. All patients underwent UE examination, and serum Mts1 was detected using human Mts1 enzyme-linked immunosorbent assay (ELISA) kit. The results showed that compared with the benign group, the SR and serum Mts1 in the TC group were increased (P<0.001). Correlation analysis showed that SR and serum Mts1 levels were significantly positively correlated (r=0.463, P<0.001). The area under the curve (AUC) (0.859), the sensitivity (68.18%) and the specificity (97.37%) of SR and serum Mts1 for diagnosing TC were higher than those for single diagnosis. Compared with the non-metastatic group, both SR and serum Mts1 in the metastatic group were increased (P<0.01). The combined AUC (0.817) and specificity (89.06%) of SR and serum Mts1 for the diagnosis of lymph node metastases were higher than those for single diagnosis, but the sensitivity (65.12%) was lower than that of serum Mts1. This study shows that SR combined with serum Mts1 is of high value in the diagnosis of TC and lymph node metastasis, and may be helpful for early diagnosis and prediction of lymph node metastasis in patients with TC.

Imaging Diagnosis Types of Lower Extremity Sports Injuries in Winter Sports Athletes and Their Influence on Return to Competition Rate

JIANG Liang, SU Pingchang, HE Gang

2022, 40(6):  1465-1470.  DOI: 10.7517/issn.1674-0475.220728

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This paper analyzed the imaging diagnosis types of lower extremity sports injuries in winter sports athletes and their influence on the rate of returning to competition. The clinical data of 357 patients with lower extremity sports injuries of winter sports athletes were collected, and the general data of the patients, the cause of the injury, the location of the injury, and the imaging examination to diagnose the type of injury were analyzed. The results showed that the main causes of injury were movement technical mistakes (49.86%), collision and fierce confrontation (19.05%), and fatigue (17.09%). The main injury sites were knee joint (53.78%) and ankle joint (31.93%). The main injury types were ligament injury (40.62%) and fracture (37.25%).The incidence of lower limb fractures in male athletes (42.31%) was higher than that in female athletes (30.20%), and the incidence of ligament injury (35.10%) was lower than that of female athletes (48.32%) (P＜0.05). The rate of returning to competition within one year in athletes with lower extremity muscle strain and soft tissue injury was 100.00%, which was higher than that in athletes with fractures (88.72%) and ligament injury (68.97%) (P<0.05). The imaging diagnosis types of lower extremity sports injuries among athletes in winter sports are mainly ligament injuries and fractures. Among them, the rate of return of athletes with lower extremity ligament injuries to the game within 1 year is low, and it is very necessary to strengthen prevention and treatment.

Analysis of the Value of 4D-CTA in the Evaluation of ASD and VSD before Interventional Surgery

GAO Haichao, YOU Li, LI Shucheng, KONG Fanqiang, SHEN Jing

2022, 40(6):  1471-1475.  DOI: 10.7517/issn.1674-0475.220606

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This study investigated the application value of 320-slice spiral CT cardiac four-dimensional volume dynamic imaging (4D-CTA) in the preoperative examination of atrial septal defect (ASD) and ventricular septal defect (VSD) minimally invasive intervention. 66 patients who underwent ASD and VSD interventional occlusion were selected as the research subjects. All patients received 4D-CTA and two-dimensional echocardiography (2D-TTE) check. The differences of ASD parameters, VSD parameters and left ventricular function parameters measured by 4D-CTA and 2D-TTE were compared, and the correlation between ASD parameters and VSD parameters measured by 4D-CTA and 2D-TTE and the waist diameter of the occluder was analyzed. In 35 patients with ASD, there was no significant difference in ASD maximum diameter, ASD minimum diameter, total atrial septum length, EDV, ESV, and SV values measured by 4D-CTA and 2D-TTE (P>0.05), but EF value was greater than that of 2D-TTE assay (P<0.05). In 31 patients with VSD, there was no significant difference between the maximum diameter of VSD, the minimum diameter of VSD, total length of ventricular septum, EDV, ESV, SV, and EF measured by 4D-CTA and 2D-TTE (P>0.05). The correlation r value of ASD, VSD maximum diameter and occluder waist diameter determined by 4D-CTA was greater than that of 2D-TTE. 4D-CTA can more accurately measure the extent of ASD and VSD defect before operation, and at the same time evaluate the left ventricular function of patients after operation. 4D-CTA preoperative measurement has more advantages in guiding the selection of occluder.

Value of Bedside Echocardiography Combined with Pcv-aCO₂ in Predicting Volume Reactivity of Septic Shock

ZHANG Huaiwei, SHAO Min, SHAN Nanbing, LI Binbin

2022, 40(6):  1476-1480.  DOI: 10.7517/issn.1674-0475.220818

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This study investigated the predictive value of bedside echocardiography combined with central venous arterial blood carbon dioxide differential pressure (Pcv-aCO₂) in the volume response of septic shock. A total of 110 patients with septic shock were selected as the study subjects. According to the change of cardiac index (ΔCI) before and after fluid infusion, they were divided into volume response group (n=66) and non-response group (n=44). The Pcv-aCO₂ and respiratory variation index (RVI) of volume responsive patients were significantly lower than those of volume unresponsive patients (P<0.05), while the diameter of inferior vena cava (IVCD) was significantly higher than that of volume unresponsive patients (P<0.05). After rehydration, Pcv-aCO₂ and RVI were negatively correlated with ΔCI (r=－0.432、－0.411,P<0.05). The area under the ROC curve of Pcv-aCO₂, RVI, and their combination for predicting volume reactivity was 0.772, 0.709, and 0.819, respectively (P<0.05). Bedside echocardiography combined with Pcv-aCO₂ has good application value in predicting the volume reactivity of septic shock.

Application of HR-HPV Gene Combined with TV-CDFI in Cervical Cancer Screening and Diagnosis

CHENG Mingyan, JIANG Hao, SUN Yanan, WANG Yanchun, YANG Tao, MEI Yanfang, DU Jianwen, WANG Jinghua

2022, 40(6):  1481-1485.  DOI: 10.7517/issn.1674-0475.220603

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This study investigated the application value of high-risk human papillomavirus (HR-HPV) genetic testing combined with transvaginal color Doppler ultrasonography (TV-CDFI) in cervical cancer screening and diagnosis. 84 patients with cervical cancer (cervical cancer group), 100 patients with cervical epithelial neoplasia (CIN group), and 100 patients with cervicitis (inflammatory group) were selected. Three groups of patients were detected by HPV E6/E7 mRNA detection method and second-generation hybrid capture technology (HC2) method to detect the positive rate of HPV infection in cervical tissue, and pathological results were regarded as the gold standard to analyze the two methods to differentially diagnose cervical cancer and cervical epithelial tumor changing value. Detected the cervical cancer adler grade by TV-CDFI. The results showed that the sensitivity and specificity of HPV E6/E7 mRNA detection in the differential diagnosis of cervical cancer and CIN patients were 95.24% and 20.00%, respectively. The sensitivity and specificity of HC2 method in the differential diagnosis of cervical cancer and CIN patients were 97.62% and 17.00%, respectively. The sensitivity and specificity of HPV E6/E7 mRNA detection in the differential diagnosis of cervical cancer and cervicitis were 95.24% and 89.00%. The sensitivity and specificity of HC2 method in the differential diagnosis of cervical cancer and cervicitis were 97.62% and 92.00%. HPV E6/E7 mRNA detection method and HC2 method have high clinical value in the differential diagnosis of cervicitis and cervical cancer. TV-CDFI detection of cervical cancer Adler grading is closely related to disease progression, therefore, the combination of HR-HPV detection and TV-CDFI in cervical cancer screening has high clinical value.

Observation on the Changes of Pelvic Floor Function after Repeat Cesarean Section with Scarred Uterus

YAN Jinling, LIU Yongli, JIAO Ruifang, ZHAO Liqin

2022, 40(6):  1486-1490.  DOI: 10.7517/issn.1674-0475.220820

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This study investigated the characteristics of pelvic floor structure, pelvic floor function and muscle strength after cesarean section in re-pregnancy with scar uterus with a history of cesarean section. Selected 100 cases of pregnant women with scar uterus re-pregnancy and performed cesarean section as the observation group, and then selected 100 primiparas who received cesarean section during the same period as the control group. Transperineal pelvic floor ultrasound was used to evaluate and compare the pelvic organ movement parameters, levator ani muscle thickness, pelvic diaphragm hiatus parameters and muscle strength of the two groups from resting state to Valsalva state. The moving distance of bladder neck, external cervical orifice and rectum ampulla from resting state to Valsalva state in the observation group were all greater than those in the control group (P<0.05). In the resting state, Valsalva state, and retraction state, the thickness of the levator ani muscle of the observation group was smaller than that of the control group, and the transverse diameter of the pelvic hiatus, the anterior-posterior diameter of the pelvic fissure, and the area of the pelvic hiatus were larger than those of the control group (P<0.05). The surface electrical signals of pelvic floor muscle type I muscle fibers and type II muscle fibers in the observation group were lower than those in the control group, and the proportion of patients with abnormal vaginal pressure and pelvic floor muscle strength in the observation group was greater than that in the control group (P<0.05). Two weeks postpartum, the modified Oxford scale (MOS) pelvic floor muscle strength classification of the observation group was lower than that of the control group as a whole (P<0.05). The pelvic floor structure, pelvic floor function and muscle strength of the scarred uterus with a history of cesarean section are more serious than those of the first cesarean section, and postpartum rehabilitation should be strengthened for this group of people.

The Effect of Intravascular Drug Balloon in the Treatment of Lower Extremity ASO and Its Influence on the Ultrasound Parameters of the Affected Extremity

YANG Yanlin, WU Guoliang, TIAN Shaoyong, WANG Chunyan, ZHAO Pengfei

2022, 40(6):  1491-1496.  DOI: 10.7517/issn.1674-0475.220609

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The aim of the study was to investigate the therapeutic effect of lower extremity arteriosclerotic occlusive disease (ASO) and its effect on the ultrasonographic parameters of the affected limb. A total of 120 lower limb ASO patients were divided into an observation group (n=58) and a control group (n=62). The observation group was treated with intracavitary drug balloon and the control group was treated with ordinary balloon, the levels of serum C-reactive protein (CRP), interleukin-16 (IL-16) and SF-36 and so on were observed. At 24 hours after operation, CRP, High sensitivity C-reactive protein (hs-CRP), IL-6 and endothelin-1 (ET-1) in the observation group were significantly lower than those in the control group (P<0.05), while nitric oxide (NO) was significantly higher than those in the control group (P<0.05). The scores of ankle brachial index (ABI), ultrasonic parameters of affected limband SF-36 in the observation group were significantly higher than those in the control group 12 months after operation (P<0.05). The restenosis rate and late lumen loss (LLL) of target vessels in the observation group were significantly lower than those in the control group (P<0.05). Endovascular drug balloon has a good effect in the treatment of lower extremity ASO, improves affected limb function and the quality of life, reduces the inflammatory reaction of patients.

Changes of MSCT Anatomical Parameters before and after FAI Combined Labral Injury Surgery

CHEN Hong, ZHANG Wei, PENG Chao, SHANG Ruisong

2022, 40(6):  1497-1501.  DOI: 10.7517/issn.1674-0475.220802

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This study investigated the changes of anatomical parameters of multi-slice spiral CT (MSCT) before and after surgery for femoroacetabular impingement (FAI) complicated with labral injury and its correlation with clinical symptom improvement and joint function. All 266 patients with FAI combined with glenoid labrum injury were selected for this study and underwent hip arthroscopic osteotomy combined with glenoid labrum repair, and were divided into excellent (n=228) and non-excellent (n=38) groups according to the outcome at 3 months after surgery. The general data, preoperative and 3-month postoperative central marginal angle (LCE), eccentric distance (Offset), femoral head prominence index (FEI), acetabular anterior-posterior margin angle (EE), α-angle and the difference of each MSCT parameter were compared between the two groups. Pearson’s analysis was applied to analyze the relationship between preoperative and 3-month postoperative LCE, Offset, FEI, EE, α-angle difference and modified Harris Hip Score (mHHS) and pain visual analog scoring method (VAS), and multiple linear regression equation was used to analyze the influencing factors related to surgical outcomes. The results showed that the LCE and α-angle were lower than those before surgery, and Offset, FEI and EE were higher than those before surgery in the excellent and non-excellent groups at 3 months after surgery (P<0.05). LCE and α-angle at 3 months after surgery were lower in the superior group than in the non-excellent group, and Offset, FEI, and EE were higher than in the non-excellent group (P<0.05). The absolute values of LCE, Offset, FEI, EE, and α-angle differences at 3 months postoperatively versus preoperatively were greater in the superior group than in the non-excellent group (P<0.05). The absolute values of LCE, Offset, FEI, EE, and alpha angle difference were positively correlated with mHHS scores and negatively correlated with VAS scores at 3 months postoperatively versus preoperatively (P<0.05). LCE, Offset, FEI, EE, and α-angle were significantly correlated with mHHS score at 3 months postoperatively (P<0.05). The changes in MSCT anatomical parameters before and after surgery for FAI combined with glenoid labral injury can reflect the degree of clinical symptom improvement and are related to joint function, and have application value in clinical treatment and assessment of patient prognosis.

Analysis of the Value of CT and MRI in Diagnosis of Intracranial Infection in Patients

JIA Zheyong, LI Xuzhao, TANG Yanli, CHEN Lie, XIAO Wei, MEI Tao

2022, 40(6):  1502-1506.  DOI: 10.7517/issn.1674-0475.220709

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This study observed the value of CT and MRI in the diagnosis of intracranial infection in patients after craniocerebral surgery, and analyzed the risk factors affecting the occurrence of intracranial infection in patients. Patients with suspected intracranial infection after craniocerebral surgery were selected as the research objects. All patients underwent MRI and CT examinations. After cerebrospinal fluid culture, 54 of 300 patients with suspected intracranial infection were finally diagnosed. The main infectious pathogens were Gram-positive bacteria, accounting for 61.11%, and Gram-negative bacteria accounted for 38.89% of patients. The sensitivity of CT in the diagnosis of intracranial infection in patients with craniocerebral surgery was 77.78%, the specificity was 79.67%, and the accuracy was 79.33%. The sensitivity of MRI in diagnosing intracranial infection in patients with craniocerebral surgery was 83.33%, the specificity was 87.80%, and the accuracy was 87.00%. Open surgery, more than one operation, more than 6 hours of operation time, and more than 5 days of extraventricular drainage will increase the risk of postoperative intracranial infection (OR values were 1.806, 2.160, 1.626, 1.694, respectively, P<0.05). The accuracy of MRI in diagnosing intracranial infection in patients after craniocerebral surgery is higher than that of CT examination. There are many factors that cause intracranial infection after craniocerebral surgery, which should be paid attention to and timely targeted intervention to reduce the risk of intracranial infection.

Changes and Clinical Significance of aEEG, MRI, Serum MMP and TIMP in Neonates with Intracranial Hemorrhage

YAN Yonglei, LI Wen, LUO Bin, TANG Jing, REN Xinyue, FU Tianli, ZHAO Jing, YIN Meile, CHEN Liqi

2022, 40(6):  1507-1512.  DOI: 10.7517/issn.1674-0475.220827

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This study investigated the characteristic changes of amplitude-integrated electroencephalography (aEEG), magnetic resonance imaging (MRI) and serum levels of matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase (TIMP-1) in neonates with intracranial hemorrhage, and its meaning. A total of 63 neonates with confirmed intracranial hemorrhage were selected as the hemorrhage group, and 80 healthy neonates during the same period were selected as the control group. In 63 neonates with intracranial hemorrhage, the detection rate of contralateral ventricular hemorrhage by SWI (50.79%) was higher than that of conventional MRI sequence (33.33%) (P<0.05). The proportion of children with continuous background activity in the continuous voltage and the proportion of children with sleep-wake cycles in the bleeding group were lower than those in the control group (P<0.05). The measured values of the lower boundary voltage of the QS phase and the lower boundary voltage of the AS phase of the children in the hemorrhage group were lower than those of the control group, and the measured values of the QS phase bandwidth and the AS phase bandwidth of the children in the hemorrhage group were higher than those of the control group (P<0.05). The serum levels of MMP-9 and TIMP-1 in the hemorrhage group were significantly higher than those in the control group (P<0.05). The serum levels of MMP-9 and TIMP-1 in the mall bleeding volume group, the medium bleeding volume group, and the large bleeding volume group gradually increased (P<0.05),and the difference between the two groups was statistically significant (P<0.05). SWI examination in neonates with intracranial hemorrhage can more accurately assess the bleeding site. aEEG has high diagnostic value for intracranial hemorrhage. Serum MMP-9 and TIMP-1 are related to the amount of intracranial hemorrhage. Comprehensive analysis of MRI, aEEG and serum MMP-9 and TIMP-1 levels is conducive to better clinical diagnosis of neonatal intracranial hemorrhage.

Evaluation of Prognostic Outcomes in Patients with Acute Myocardial Infarction by 2D-STI Combined with Dynamic Electrocardiogram

WANG Lijuan, LI Lunlun, YANG Linlin

2022, 40(6):  1513-1518.  DOI: 10.7517/issn.1674-0475.220715

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This study investigated the value of two-dimensional speckle tracking (2D-STI) combined with dynamic electrocardiography in evaluating the prognosis of patients with acute myocardial infarction (AMI). AMI patients treated with percutaneous coronary intervention (PCI) were selected as the research subjects. All patients were followed up for 1 year after surgery. Among them, 47 patients with major adverse cardiovascular events (MACE) were selected as the MACE group, and the other 80 patients without patients with MACE served as a control group. The two groups of patients received dynamic ECG and 2D-STI examinations before operation, and the differences in the dynamic ECG and 2D-STI indexes of the two groups were analyzed, and the relationship between each index and MACE was analyzed by Logistic model. The dynamic electrocardiogram index standard deviation of NN interval (SDNN) and oscillation slope (TS) in the MACE group were lower than those in the control group, and the measured value of shock onset (TO) was greater than that in the control group (P<0.05). The values of left atrial maximum volume (LAVmax), left atrial minimum volume (LAVmin) and left atrial presystolic volume (LAVp) were higher than those of the control group. Left atrial active ejection fraction (LAAEF),Passive ejection fraction (LAPEF), left atrial systolic mean peak strain rate (mSRs), left atrial mean early diastolic strain rate (mSRe), left atrial late diastolic mean peak strain rate (mSRa), left atrial mean peak strain rate (mSs) measured value were lower than those of the control group (P<0.05). By observing the dynamic ECG parameters and 2D-STI parameters before PCI in AMI patients, early assessment of the risk of MACE after PCI can be carried out to a certain extent, which is beneficial to the early preventive treatment of patients.

The Evaluation Value of MSCT Quantitative Technique in the Rehabilitation of Distal Radius Fractures in Gymnasts and Its Correlation with Bone Metabolism

GAO Yan, CHEN Xiaolei

2022, 40(6):  1519-1523.  DOI: 10.7517/issn.1674-0475.220803

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The objective of this paper was to explore the evaluation value of multi-slice spiral CT (MSCT) quantitative technology in the rehabilitation effect of distal radius fractures in gymnasts and its correlation with bone metabolism. Eighty-six patients with distal radius fractures of gymnasts were selected, all of them underwent conservative treatment. The rehabilitation effect of wrist joint was evaluated 3 months after treatment. The results showed that the levels of serum alkaline phosphatase (ALP), osteocalcin (BGP), and osteoprotegerin (OPG) in patients with poor recovery were lower than those in patients with good recovery 3 months after treatment (P<0.05). Before treatment and 3 months after treatment, MSCT quantitative parameters of fracture end mechanical strength index (BSI), cortical bone mineral density (cBMD), ΔBSI and ΔcBMD in patients with poor recovery were lower than those in patients with good recovery (P＜0.05). Three months after treatment, BSI and cBMD were positively correlated with serum ALP, BGP and OPG levels (P＜0.05). ΔBSI and ΔcBMD were positively correlated with rehabilitation effect (P＜0.05). The area under the curve (AUC) of poor rehabilitation effect assessed by ΔBSI and ΔcBMD was 0.934. It can be seen that the quantitative parameters of MSCT are closely related to the level of bone metabolism in patients with distal radius fractures in gymnasts, and have a good value in evaluating the rehabilitation effect.

Study on the Relationship between Hyperintense Vessel Sign and the Degree of Middle Cerebral Artery Stenosis and Cerebral Infarction Area

YANG Yuanfang, TENG Yuehua, SHAO Shuai

2022, 40(6):  1524-1528.  DOI: 10.7517/issn.1674-0475.220721

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This paper discussed the occurrence of hyperintense vessel sign (HVS) on T2 fluid attenuation inversion recovery sequence (MRI T2-FLAIR) of acute middle cerebral artery donor cerebral infarction and its relationship with middle cerebral artery stenosis and cerebral infarction area. 125 patients with acute cerebral infarction in the blood supply area of middle cerebral artery were given MRI T2-FLAIR sequence scanning, the clinical data, stenosis degree of middle cerebral artery, cerebral infarct area and collateral circulation and so on of HVS positive and negative patients were analyzed. The National Institutes of Health stroke scale (NIHSS) score of HVS positive patients was significantly higher than that of HVS negative patients (P<0.05). The degree of middle cerebral artery stenosis, cerebral infarction area and the proportion of collateral circulation in HVS positive patients were significantly higher than those in HVS negative patients (P<0.05). HVS was positively correlated with NIHSS score, middle cerebral artery stenosis, cerebral infarction area and collateral circulation (P<0.05). The NIHSS score and the degree of middle cerebral artery stenosis in distal HVS positive patients were significantly lower than those in proximal HVS positive patients (P<0.05). HVS is found on T2-FLAIR of MRI in patients with acute cerebral infarction in the blood supply area of middle cerebral artery, has severe stenosis of middle cerebral artery and large cerebral infarction area.

Application of MRI in the Diagnosis and Severity Evaluation of AD Patients

LI Xilin, ZHANG Wei, ZHANG Qiudong

2022, 40(6):  1529-1533.  DOI: 10.7517/issn.1674-0475.220701

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This study explored the application value of magnetic resonance imaging (MRI) examination of lobe volume changes and leukoaraiosis in the diagnosis of Alzheimer's disease (AD) patients and disease assessment. A total of 90 diagnosed AD patients were selected as the AD group, and 90 volunteers who received physical examinations during the same period were selected as the control group. Both groups underwent MRI examination, and the differences in various indicators and leukoaraiosis (LA) severity grading were compared. The value of each index in the diagnosis of AD patients were analyzed. According to the Clinical Dementia Rating Scale (CDR), the patients were divided into mild, moderate and severe for stratified comparison. The proportion of parietal, occipital and temporal lobe volume in the AD group was smaller than that in the control group (P＜0.05). The measured value of hippocampal height in the AD group was lower than that in the control group (P＜0.05). There was statistically significant difference in LA grade between the AD group and the control group (P＜0.05). The proportion of parietal lobe volume, the proportion of occipital lobe volume, the proportion of temporal lob volume and hippocampal height in patients with severe AD were lower than those in patients with mild to moderate AD (P＜0.05) in the severe AD group. The LA grades of the patients were mainly grade 2 and grade 3, and the patients with mild to moderate AD were mainly grade 0 and grade 1 patients. There was a statistically significant difference in LA grade between the severe AD group and the mild to moderate AD patients (P＜0.05). The lobe volume and hippocampal height of AD patients all changed, and the changes in leukoaraiosis were more obvious. The clinical evaluation of MRI has a certain value.

Effects of Different Approaches of Transforaminal Lumbar Interbody Fusion on Curative Effect and Sagittal Imaging Parameters of Isthmic Lumbar Spondylolisthesis

ZUO Bingguang, WANG Zhipei

2022, 40(6):  1534-1538.  DOI: 10.7517/issn.1674-0475.220615

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This study investigated the efficacy of transforaminal lumbar interbody fusion (TLIF) with different approaches in patients with isthmic lumbar spondylolisthesis and the differences in the effects of sagittal imaging parameters. A total of 102 patients with isthmic spondylolisthesis were selected and randomly divided into a minimally invasive group and an open group, with 51 cases in each group. The minimally invasive group underwent Wiltse approach and minimally invasive TLIF under the MAST Quadrant channel, and the open group underwent traditional TLIF. The surgical conditions and excellent and good rates of treatment in the two groups were calculated. X-ray was used to determine the lumbar lordosis angle (LL), lumbosacral angle (LSA), distance between L1 plumb line and S1 (LASD), pelvic tilt angle (PT), sacral tilt angle (SS), pelvic incidence angle (PI), slip angle (SA) before and after surgery. The operation time, hospital stay, and postoperative bed rest time in the minimally invasive group were shorter than those in the open group, and the incision length, intraoperative blood loss, and postoperative drainage volume were lower than those in the open group (P<0.05). There was no significant difference in the excellent and good rates between the two groups (P>0.05). 6 months after operation, LL increased and SA decreased in both groups compared with preoperative (P<0.05), but there was no significant difference between the two groups (P>0.05). Both TLIF approaches can improve lumbar-pelvic sagittal imaging parameters with comparable efficacy, but the Wiltse approach and MAST Quadrant canal are more minimally invasive.

Application of Spectral CT Combined with Long Non-coding RNA UCA1 in the Diagnosis of Lymph Node Metastasis of Gastric Adenocarcinoma

ZHANG Jian, REN Xiaoyan

2022, 40(6):  1539-1544.  DOI: 10.7517/issn.1674-0475.220722

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This study investigated the value of spectral CT parameters combined with long non-coding RNA (lncRNA) urothelial carcinoma-associated gene 1 (UCA1) in the diagnosis of lymph node metastasis in gastric adenocarcinoma. A total of 103 patients with gastric adenocarcinoma were selected as the research objects. All patients underwent spectral CT examination to obtain the normalized iodine concentration value in the arterial phase (NICAP) and the normalized iodine concentration value in the venous phase (NICVP). Serum UCA1 levels in patients with gastric adenocarcinoma were detected by RT-PCR. The results showed that NICAP and NICVP in the metastatic group were significantly higher than those in the non-metastatic group (P＜0.001). Taking NICAP>0.132 and NICVP>0.431 as cutoff values, the AUC, sensitivity and specificity of NICAP and NICVP for the diagnosis of lymph node metastasis were (0.742, 68.52% and 76.09%) and (0.932, 85.19% and 86.96%), respectively. The relative expression of serum UCA1 in the metastatic group was significantly higher than that in the non-metastatic group (P＜0.001). Taking the relative expression of serum UCA1>2.071 as the cut-off value, the AUC, sensitivity and specificity of serum UCA1 in the diagnosis of lymph node metastasis were 0.884, 87.04% and 82.61%, respectively. The AUC, sensitivity and specificity of NICAP+NICVP+UCA1 in the diagnosis of lymph node metastasis were 0.985, 94.44% and 100.00%, respectively. Spectral CT parameters (NICAP and NICVP) combined with serum UCA1 have high value in the diagnosis of lymph node metastasis of gastric adenocarcinoma.

Effects of Phloroglucinol Combined with Ritodrine Hydrochloride on Placental Blood Flow Indexes and Serum Eph A5, SFlt-1 in Patients with Placenta previa

LI Jing, YANG Hong

2022, 40(6):  1545-1549.  DOI: 10.7517/issn.1674-0475.220806

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This study investigated the effect of phloroglucinol combined with ritodrine hydrochloride on serum erythropoietin-producing hepatocyte receptor (Eph) A5, soluble vascular endothelial growth factor receptor-1 (SFlt-1) and placental blood flow indicators (energy ultrasound) in patients with placenta previa. A total of 96 patients with placenta previa were divided into single drug group and combination group according to different treatment plans, 48 cases in each group. The single drug group was given ritodrine hydrochloride, and the combination group was given phloroglucinol combined with ritodrine hydrochloride. The success rate of miscarriage protection, term rate of pregnancy, vaginal bleeding time, prolonged gestational age, drug onset time, 1 min Apgar score, serum alpha-fetoprotein (AFP), creatine kinase (CK), Eph A5, SFlt-1, placental blood flow (energy ultrasound) indexes [vascular flow index (VFI), vascularization index (VI), flow index (FI)] and safety. The success rate of miscarriage preservation and the full-term pregnancy rate in the combination group were higher than that in the single drug group (P＜0.05). The prolongation time of gestational weeks in the combination group was higher than that in the single drug group (P<0.05). After treatment, the levels of serum CK, AFP and sFlt-1 in the combination group were lower than those in the single drug group, and the level of Eph A5 was higher than that in the single drug group (P<0.05). VFI and VI in the combination group were lower than those in the single-drug group after treatment, and there was no significant difference in FI between the two groups (P>0.05). There was no significant difference in the total adverse reaction rate between the two groups (P>0.05). Phloroglucinol combined with ritodrine hydrochloride can improve the therapeutic effect of patients with placenta previa, and can effectively improve placental blood flow and promote embryonic development, decreased SFlt-1 levels, increased Eph A5 levels.

The Effect of Azithromycin Combined with Methylprednisolone in the Treatment of Children with Mycoplasma pneumoniae Pneumonia and the Changes of Chest CT Signs

ZHAO Mengjiao, WANG Xi

2022, 40(6):  1550-1554.  DOI: 10.7517/issn.1674-0475.220723

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This study investigated the effect of azithromycin combined with methylprednisolone in the treatment of children with Mycoplasma pneumoniae pneumonia(MPP) and the changes of chest CT signs. In the randomized controlled clinical trial research method, 90 children with Mycoplasma pneumoniae were selected as the MP group, 90 children with bacterial pneumonia diagnosed during the same period were selected as the bacterial group, and 90 children with viral pneumonia were selected as the virus group. The three groups of children all received chest CT examination, and the CT signs of the three groups were compared; the MP children were treated with azithromycin combined with methylprednisolone, and the serum inflammatory factors, clinical symptom relief, and changes in CT signs were compared before and after treatment. The detection rate of ground-glass opacity and gravel sign in the MP group and virus group was higher than that in the bacteria group (P<0.05). After 7 days of treatment, the children in the MP group underwent lung CT re-examination, which showed that the detection rates of ground-glass opacity, lung consolidation, air bronchus sign, bronchial wall thickening, lithotripsy sign and lymphadenopathy were significantly decreased (P<0.05). CT examination of children with severe pneumonia has a certain value in the preliminary differential diagnosis of infectious pathogens. The combination of azithromycin and methylprednisolone in children with MP can achieve good clinical results, and CT can observe the absorption of lung lesions in children.

MRI Evaluation of the Morphological Characteristics of Exercise-induced Tibial Plateau Fracture and Its Correlation with Meniscus Tear

CHEN Juan, HUANG Chunxiang

2022, 40(6):  1555-1559.  DOI: 10.7517/issn.1674-0475.220618

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The purpose of this study was to evaluate the imaging characteristics of exercise-induced tibial plateau fracture by magnetic resonance imaging (MRI) and its correlation with meniscus tear. 102 patients with tibial plateau fracture were selected to analyze the difference of the incidence of meniscus tear in different types of tibial plateau fracture, and to compare the difference of clinical data and MRI parameters between patients with and without meniscus tear. The incidence of meniscus tear in Schatzker type Ⅱ tibial plateau fracture was significantly higher than that in type Ⅳ (P<0.05). The proportion of tibial plateau fracture collapse in the anterolateral part and the relative area in patients with meniscus tear were significantly higher than those without meniscus tear (P<0.05), and the area under the ROC curve for predicting meniscus tear was 0.630 and 0.765, respectively (P<0.05). Different Schatzker types of tibial plateau fractures have different meniscus tears, MRI has a certain application value in predicting meniscus tears.

The Relationship between Mean SWV and MGMT and Prognosis of Breast Invasive Ductal Carcinoma

LIU Zhiwei, LIU Qing, HU Maofei, WEN Wei

2022, 40(6):  1560-1564.  DOI: 10.7517/issn.1674-0475.220726

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The relationship between the mean shear wave velocity (SWV) and the expression of O⁶ methylguanine DNA methyltransferase (MGMT) in female invasive ductal carcinoma and the prognosis of patients was investigated. 90 patients with breast invasive ductal carcinoma were selected as the observation group, 90 patients with benign breast lesions were selected as the control group. The SWV value of the two groups of patients was detected by color ultrasonography, and the expression of MGMT in the tumor tissue was detected by immunohistochemical method. The relationship between the mean value of SWV, the positive expression of MGMT and the clinicopathological characteristics of the observation group was analyzed. The average value of SWV and the positive expression rate of MGMT in the observation group were significantly higher than those in the control group (P<0.05). The mean value of SWV was related to lesion diameter, degree of differentiation, TNM stage and lymph node metastasis (P<0.05). The positive expression rate of MGMT in estrogen receptor (ER)-negative patients in the observation group was significantly higher than that in ER-positive patients (P<0.05). The progression free survival time of patients with SWV≥5.60 m/s was significantly shorter than that of patients with SWV<5.60 m/s (P<0.05). There was no significant relationship between MGMT expression and progression free survival time (P>0.05). The mean value of SWV and the expression of MGMT in female invasive ductal carcinoma are related to clinicopathological features, the mean value of SWV is related to the prognosis of patients, while MGMT is not significantly related to the prognosis.

Determination of Fetal Lateral Ventricle Dilatation by Prenatal Ultrasound and Its Relationship with Early Neonatal Neurodevelopment

WU Junli, HE Zhiquan, WANG Kaibi, XIONG Rongqin

2022, 40(6):  1565-1569.  DOI: 10.7517/issn.1674-0475.220823

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This article explored the prenatal ultrasound imaging features, the ratio of the width of the posterior horn of the lateral ventricle to the biparietal diameter, its value in determining the degree of fetal lateral ventriculomegaly (VM), and its relationship with early neonatal neurodevelopment. A total of 120 pregnant women with fetal VM were selected as the research objects,and they were divided into mild group (n=61), moderate group (n=37) and severe group (n=22) according to the degree of VM. All subjects underwent prenatal ultrasound to obtain fetal prenatal ultrasound imaging characteristics, the ratio of the width of the posterior horn of the lateral ventricle to the biparietal diameter. The results showed that the prenatal ultrasound imaging features of lateral VM fetuses were: as the degree of lateral VM increased, the ultrasound showed that the lateral ventricle widened gradually. The ratio of the width of the posterior horn of the lateral ventricle to the biparietal diameter of the fetal prenatal in the severe group was greater than that in the mild group and the moderate group, and the moderate group was greater than that in the mild group (P＜0.05). The ratio of posterior horn width to biparietal diameter of prenatal lateral ventricle was positively correlated with the degree of lateral VM (P＜0.05). The ratio of posterior horn width to biparietal diameter and width of lateral ventricle in neonates with early neurodevelopmental abnormality were higher than those in neonates with normal early neurodevelopment (P＜0.05). The ratio of posterior horn width and biparietal diameter of prenatal lateral ventricle, lateral ventricle width and early NBNA score were negatively correlated (P＜0.05). The area under the curve (AUC) of the ratio of prenatal posterior horn width to biparietal diameter combined with lateral ventricle width in predicting early neonatal neurodevelopmental abnormalities was 0.938. It indicated that the prenatal ultrasound imaging features of the fetus with lateral VM and the ratio of the width of the posterior horn of the lateral ventricle to the biparietal diameter could determine the degree of lateral VM, and the ratio of the width of the posterior horn of the lateral ventricle to the biparietal diameter was closely related to the early neonatal neurodevelopmental outcome.

Application of ¹⁸F-FDG PET/CT Metabolic Parameters Combined with Serum FOXM1 in the Diagnosis of Lymph Node Metastasis in Colorectal Cancer

WANF Ping, XIE Lixuan

2022, 40(6):  1570-1575.  DOI: 10.7517/issn.1674-0475.220717

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This study investigated the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission/computed tomography (PET/CT) metabolic parameters combined with serum forkhead box protein M1 (FOXM1) in the diagnosis of lymph node metastasis of colorectal cancer. A total of 103 patients with colorectal cancer were included in this study, and the lymph node metastasis was confirmed by pathological examination, and then the patients were divided into the metastasis group (51 cases) and the non-metastasis group (52 cases). All patients underwent ¹⁸F-FDG PET/CT examination, and then three metabolic parameters of maximum normalized uptake value (SUVmax), total glycolysis (TLG) and tumor metabolic volume (MTV) were obtained. In addition, serum FOXM1 levels of patients were detected by the ELISA method. The results showed that the SUVmax of non-metastasis was significantly higher than that of metastasis group (P<0.001). The MTV and TLG of the non-metastatic group was significantly lower than that of the metastatic group (P<0.001). Serum FOXM1 in the non-metastatic group was significantly lower than that in the metastatic group (P<0.001). Serum FOXM1 was significantly negatively correlated with SUVmax (P<0.01), while significantly positively correlated with MTV and TLG (P<0.01). The AUC (0.974) and sensitivity (92.16%) of SUVmax+MTV+TLG+serum FOXM1 in the diagnosis of lymph node metastasis were higher than those of ¹⁸F-FDG PET/CT metabolic parameters and serum FOXM1 alone, and the specificity (94.23%) was only lower than that of TLG alone. The three metabolic parameters (SUVmax, MTV and TLG) of ¹⁸F-FDG PET/CT combined with serum FOXM1 have high value in the diagnosis of lymph node metastasis.

Efficacy of Pulp Revascularization and Calcium Hydroxide Root Canal Sealing in the Treatment of Pulp Necrosis in Young Permanent Teeth

LI Yang, LI Hu, ZHAO Mengjun, WU Jiayuan

2022, 40(6):  1576-1580.  DOI: 10.7517/issn.1674-0475.220805

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This study investigated the effect of root canal sealing drugs on the treatment of pulp necrosis in young permanent teeth and the changes of imaging indicators during pulp revascularization. Eighty children (80 teeth) with pulp necrosis in young permanent teeth were retrospectively studied. According to the treatment method, 44 cases (44 teeth) in the study group and 36 cases (36 teeth) in the control group. Both groups were treated with revascularization. The study group was treated with calcium hydroxide root canal sealing medicine, and the control group was treated with root canal sealing drug with triple antibiotic paste. The clinical efficacy of the two groups before and after treatment was compared, and Cone Beam CT (CBCT) was used to examine the crown-to-root ratio and root canal wall thickness of the affected teeth at different times before and after treatment in the two groups. After 12 months of treatment, the crown-to-root ratio of the affected teeth in the study group was lower than that in the control group. After 6 months of treatment and 12 months of treatment, the measured value of the root canal wall thickness in the study group was greater than that in the control group (P<0.05). After 3 months of treatment, the therapeutic effect of the study group was better than that of the control group (P<0.05). Pulp revascularization combined with calcium hydroxide root canal sealing is effective in treating pulp necrosis of young permanent teeth. CBCT can observe the redevelopment of permanent teeth in children after treatment, which is beneficial to improve the treatment effect.

The Application of MRI Imaging in the Condition Evaluation and Curative Effect Evaluation of Lumbar Disc Herniation in Swimmers

DU Huiling, LIU Changpi

2022, 40(6):  1581-1585.  DOI: 10.7517/issn.1674-0475.220822

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This study explored the application value of MRI imaging in the condition evaluation and efficacy evaluation of lumbar disc herniation (LDH) in swimmers. Seventy-two swimmers with LDH were selected, and all underwent MRI examination to obtain MRI parameters [nucleus pulposus (NP) area T2 value,annulus fibrosus (AF) area T2 value]. Compared to the general data, Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) score and MRI parameters of patients with different Severity of disease. The results showed that the comparison of JOA score, NP area T2 value, and AF area T2 value showed that severe patients were less than moderate patients, and moderate patients were less than mild patients. Compared with VAS scores, severe patients were greater than moderate patients, and moderate patients were greater than mild patients (P<0.05). The T2 value in NP area and AF area was negatively correlated with the severity of LDH and VAS score, and positively correlated with JOA score (P＜0.05). The ΔT2 value of NP area, the ΔT2 value of AF area, and the area under the curve (AUC) of combined evaluation of poor efficacy before treatment and after 2 weeks of treatment were 0.753, 0.814, and 0.931, respectively. The T2 values of NP area and AF area of MRI parameters are related to the severity of LDH, and have good application value in the evaluation of curative effect.

Evaluation of CT Combined with HFUS in the Diagnosis and Reduction of Intussusception in Children

GUO Jiankang, BAI Yanhong, LIANG You, LIU Yana, XU Hua

2022, 40(6):  1586-1590.  DOI: 10.7517/issn.1674-0475.220817

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This study investigated the value of CT combined with high-frequency ultrasonography (HFUS) in diagnosing intussusception and evaluating the effect of reduction in children. A total of 91 children with suspected intussusception were selected for clinical study, of which 67 cases were clinically diagnosed as intussusception (observation group), 24 cases were clinically diagnosed as acute appendicitis, obturator hernia and other diseases (control group). All children received abdominal HFUS and CT examination after admission. The above imaging data of the two groups of children were analyzed. The value of the two methods alone and in combination in the differential diagnosis of children with intussusception and the ability to evaluate the effect of reduction were observed. The detection rates of concentric circle sign and pseudo-kidney sign in the observation group were significantly higher than those in the control group (P<0.05). The incidence rates of target-shaped mass, comet-tail and kidney-shaped mass in the observation group were significantly higher than those in the control group (P<0.05). 67 children with confirmed intussusception, 61 cases were successfully reset with warm normal saline, and 6 cases were treated with surgery after the failure of warm normal saline reset. The measured values of the length and thickness of the intussusception in children with successful reduction were lower than those in children with failure (P<0.05). The ileum cross-sectional ultrasound of the children with successful reduction showed grape-like sign and the detection rate of copper coins were higher than those of the failure group (P<0.05). The sensitivity and specificity of CT combined with HFUS in diagnosing children with intussusception were 95.52% and 91.67%, respectively. Diagnosing children with intussusception based on abdominal CT features combined with abdominal HFUS sonographic features can significantly improve the sensitivity and specificity, and can evaluate the effect of repositioning with warm normal saline in children.

Application of CT and MRI in the Diagnosis of Ankle Sports Fracture Classification

GUO Dingming, WEN Kaiyuan

2022, 40(6):  1591-1595.  DOI: 10.7517/issn.1674-0475.220621

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This study investigated the application of CT and magnetic resonance imaging (MRI) in the classification and diagnosis of ankle sports fractures. A total of 184 patients (184 ankles) with ankle joint injury were selected for clinical research. All patients received CT and MRI examinations before the operation. The relationship between MRI ankle fracture classification and fracture grade was analyzed. According to the patient's ankle function recovery 6 months after operation, the patients were divided into an excellent group of 118 cases and a general group of 66 cases, and the differences in CT, characteristics and MRI characteristics of the two groups of patients after operation were compared. The results showed that,the main fracture classification of patients with fracture grade Ⅰ was supination and adduction type. The main fracture classification of patients with fracture grade Ⅱ was supination and external rotation type. The main fracture types of patients with grade Ⅲ were supination and external rotation type, pronation and abduction type. The main fracture type of patients with fracture grade Ⅳ was pronation and dorsiflextion type. The correct rates of CT and MRI in diagnosing different types of ankle fracture were all over 85%, and there was no significant difference in the correct rates of the two methods (P>0.05). 6 months after operation, the proportion of patients with anterior and posterior displacement of the lateral malleolus <2.0 mm, overlapping anterior and posterior displacement of the medial malleolus <2.0 mm, and posterior malleolus displacement value <2.0 mm in the excellent group was higher than that in the general group (P<0.05). Both CT and MRI have high practical value in the preoperative classification and diagnosis of ankle fractures, and postoperative joint function rehabilitation effects can be evaluated based on imaging parameters.

Application of Dual-source CT Combined with miR-10b-3p in the Diagnosis of Stroke Carotid Artery Stenosis

SI Yandong, CHEN Kuntao, LIU Liang, PENG Xinghui

2022, 40(6):  1596-1601.  DOI: 10.7517/issn.1674-0475.220811

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This article explored the application value of dual-source CT (DSCT) combined with miR-10b-3p in the diagnosis of carotid artery stenosis in patients with ischemic stroke. A total of 133 patients with confirmed acute ischemic stroke were selected as the research objects. All patients underwent DSCT examination, and the stenosis rate and calcification were measured. Serum miR-10b-3p levels of patients were detected by RT-qPCR. The results showed that the AUC of DSCT for diagnosing 50% stenosis was 0.995, the sensitivity was 100.00%, and the specificity was 94.20%. With the increase of stenosis rate, the level of serum miR-10b-3p decreased gradually (P<0.05). Compared with the soft plaque group and the fibrous plaque group, the serum miR-10b-3p level in the calcified plaque group was significantly lower (P<0.05). The AUC of serum miR-10b-3p for diagnosing calcified plaque was 0.823. The AUC of miR-10b-3p for the diagnosis of 50% carotid artery stenosis was 0.815. The AUC, sensitivity and specificity of DSCT combined with miR-10b-3p in the diagnosis of 50% carotid stenosis were 0.995, 100.00% and 94.20%, respectively. DSCT has high diagnostic value for carotid artery stenosis in patients with stroke. Serum miR-10b-3p can be used as an auxiliary index for DSCT to detect carotid artery stenosis and a biomarker for carotid plaque formation.

Changes of MR T2 mapping Quantitative Parameters in Patients with Rotator Cuff Tear and Their Relationship with SSV and DASH

LI Tiejun, WEI Chao, TANG Lichun, JIANG Xiling

2022, 40(6):  1602-1606.  DOI: 10.7517/issn.1674-0475.220706

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The changes of MR T2 mapping quantitative parameters in exercise-induced rotator cuff tear (RCT) patients and their relationship with the prognosis and functional outcome were explored in this paper. A total of 80 patients with exercise-induced RCT were selected as the research objects. All of them underwent MRI routine scanning and MR T2 mapping scan, and divided into group A (level Ⅰ, n=25), group B (level Ⅱ, n=39), and group C (level Ⅲ, n=16) according to the RCT classification. Through comparative analysis, it was found that the medial, lateral, and intermediate T₂ values of the supraspinatus tendon in group A were lower than those in groups B and C, and group B was lower than that of group C (P<0.05); the medial, lateral, and middle T₂ values of the supraspinatus tendon were all lower than the RCT grading was positively correlated (P<0.05); the medial, lateral, and intermediate T₂ values of the supraspinatus tendon and the upper extremity Disability of arm shoulder and hand (DASH) scores of the RCT patients were lower than the preoperative, subjective shoulder value (SSV) scores were higher than preoperative (P<0.05); the medial, lateral, and middle ΔT₂ values of supraspinatus tendon before and after surgery were positively correlated with ΔSSV and ΔDASH scores (P＜0.05). It can be seen that the quantitative parameters of MR T2 mapping are positively correlated with the RCT grading of patients with exercise-induced RCT, and the change values of each parameter are closely related to the prognostic function outcome.

Study of DWI Combined with FLAIR-HVS on Ischemic Penumbra Viability and the Degree of Neurological Deficit in ACI

FANG Lei, SUN Huiqin, LI Hongfeng

2022, 40(6):  1607-1611.  DOI: 10.7517/issn.1674-0475.220821

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This paper discussed the value of diffusion weighted imaging (DWI) combined with fluid-attenuated inversion recovery (FLAIR) hyperintense vessel sign (HVS) in evaluating the viability of ischemic penumbra and the degree of neurological deficit in patients with acute cerebral infarction (ACI). 120 patients with ACI were scanned with DWI and FLAIR sequences, apparent dispersion coefficient (ADC) value, relative apparent dispersion coefficient (rADC) value of infarcted area, ischemic penumbra and survivable area were analyzed. ADC values in ischemic penumbra and viable areas were significantly higher than those in infarcted areas (P<0.05), and rADC values in viable areas were significantly higher than those in ischemic penumbra and infarcted areas (P<0.05). The area under ROC curve of viable areas predicted by rADC value was 0.715, P<0.05. The good prognosis rate of patients with HVS-DWI mismatch was significantly higher than that of patients without HVS-DWI mismatch (P<0.05) at 3 months of follow-up. The mismatch ratio of HVS-DWI decreased significantly with the increase of neurological deficit, infarct volume and vascular stenosis (P<0.05). DWI has certain application value in predicting the viability of ischemic penumbra in ACI. HVS-DWI mismatch is related to the degree of neurological deficit, infarct volume, degree of vascular stenosis and prognosis.

The Clinical Value of MRI in Evaluating Spinal Cord Function Injury after Spinal Trauma

FENG Shibo, WANG Wei, ZHANG Li, ZHENG Bin

2022, 40(6):  1612-1616.  DOI: 10.7517/issn.1674-0475.220816

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This study investigated the clinical value of magnetic resonance imaging (MRI) in assessing spinal cord injury in patients with spinal trauma. Fifty patients with spinal trauma and spinal cord injury were selected as the observation group, and 30 patients without spinal cord injury after spinal surgery injury during the same period were selected as the control group. The magnetic resonance diffusion tensor imaging (DTI) was performed in all patients. According to the degree of spinal cord injury, the patients were divided into mild and moderately severe subgroups to compare the DTI parameters, and the receiver operating curve(ROC)was used to analyze the clinical value of each DTI parameter in diagnosing spinal cord injury in patients with spinal cord injury. The results showed that the apparent diffusion coefficient(ADC)value, λ1 value and λ2 value of the observation group were significantly higher than those of the control group, and the fractional anisotropy(FA)value was lower than that of the control group (P<0.05). The AUC values of FA value, λ1 value, ADC value and λ2 value for the diagnosis of spinal cord injury were 0.885, 0.877, 0.834 and 0.733, respectively. The ADC value, λ1 value and λ2 value of patients with moderate to severe spinal cord injury were significantly higher than those of patients with mild spinal cord injury, the FA value was lower than that of mild patients (P<0.05). After treatment, the ADC value, λ1 value and λ2 value of the observation group were significantly lower than those before treatment, and the FA value was significantly higher than before treatment (P<0.05). Using MRI DTI parameters to evaluate spinal cord injury in patients with spinal trauma has certain clinical value, and can also evaluate the functional recovery of patients before and after treatment.

Diagnosis of Adenoid Hypertrophy in Children by Nasopharyngeal CT and Its Correlation with SIL-2R

WANG Hongjing, YE Yusheng, JIANG Wenting

2022, 40(6):  1617-1620.  DOI: 10.7517/issn.1674-0475.220713

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This study analyzed the diagnosis of adenoid hypertrophy in children by nasopharyngeal CT and its correlation with soluble interleukin-2 receptor (SIL-2R). A total of 155 children with suspected adenoid hypertrophy were selected as the research objects. Among them, 80 children with adenoid hypertrophy confirmed by nasopharyngeal endoscopy were selected as the study group, and 75 children with non-adenoid hypertrophy were selected as the control group. Compared with the children in the control group, the ratio of adenoids to nasopharynx (A/N) in the children in the study group was higher (P<0.05). Compared with children with first degree hypertrophy, children with second degree and third degree hypertrophy had higher adenoid thickness, adenoid A/N value, and higher expression level of sIL-2R (P<0.05). Compared with children with degree Ⅱ hypertrophy, children with degree Ⅲ hypertrophy had higher adenoid thickness, adenoid A/N value, and higher expression level of sIL-2R (P<0.05). Adenoid thickness, adenoid A/N value were positively correlated with the expression level of sIL-2R (P<0.05). Nasopharyngeal CT has a high value in the diagnosis of adenoid hypertrophy in children and has a certain correlation with sIL-2R, which can be used for the diagnosis of adenoid hypertrophy in children.

Application of Diffusion-weighted Imaging and TRIM44 in the Diagnosis and Pathological Staging of Endometrial Cancer

ZHENG Xiaoju, SHAN Zhengyi, YANG Beibei

2022, 40(6):  1621-1627.  DOI: 10.7517/issn.1674-0475.220815

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This article explored the diagnostic value of diffusion-weighted imaging (DWI) parameters combined with tripartite motif-containing protein 44 (TRIM44) gene in pathological staging of endometrial cancer (EC). A total of 140 patients with endometrial lesions were included in this study, all of whom underwent DWI examination. According to the surgical and pathological results, 83 patients were diagnosed with EC (EC group), and 57 patients were diagnosed with benign endometrial lesions (benign group). Serum TRIM44 mRNA levels of patients were detected by qRT-PCR. The results showed that compared with the benign group, the mean apparent diffusion coefficient (ADCmean) and minimum apparent diffusion coefficient (ADCmin) of the EC group were significantly decreased, while the relative expression of serum TRIM44 mRNA was significantly increased (P<0.001). ADCmean and ADCmin were negatively correlated with serum TRIM44 (r=－0.305, －0.325,P<0.001). Compared with the FIGO stage Ⅰ group, the ADCmean of stage Ⅱ-Ⅳ group was significantly decreased, while the relative expression of serum TRIM44 mRNA was significantly increased (P<0.05). The ROC curve analysis showed that the AUC of ADCmean, ADCmin and serum TRIM44 mRNA relative expression in the diagnosis of EC were 0.808, 0.830 and 0.818, respectively, and the AUC of combined diagnosis (0.936) was higher than that of single diagnosis. The AUC of ADCmean, ADCmin and serum TRIM44 mRNA relative expression in the diagnosis of FIGO stage Ⅱ-Ⅳ were 0.657, 0.632 and 0.733,respectively. The AUC (0.769) and specificity (87.50%) of combined diagnosis were higher than those of single diagnosis. DWI parameters (ADCmean, ADCmin) combined with serum TRIM44 can improve the diagnostic accuracy of EC and FIGO staging.

Nomogram Based on CT Parameters to Perdict the Risk of Distalradius Fracture in Athletes

LI Tiexin, LIU Changpi

2022, 40(6):  1628-1632.  DOI: 10.7517/issn.1674-0475.220901

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This paper explored the risk of distal radius fracture in gymnasts based on quantitative CT parameters. A total of 135 forearm trauma gymnasts with suspected distal radius fractures were recruited as the research objects,and divided into the occurrence group (n=20) and the non-occurrence group (n=115) according to whether the distal radius fracture occurred or not. The general data, quantitative CT parameters [bone scan index (BSI), cortical bone mineral density (cBMD)] and imaging characteristics of the two groups were counted, and the Logistic regression equation was used to analyze the influencing factors of distal radius fractures in gymnasts, and a nomogram was constructed. Predict the model and verify the prediction effect. The results showed that pre-exercise preparation activities, wearing protective measures, BSI, cBMD, and dorsal bone fragment thickness were the influencing factors of the risk of distal radius fractures in gymnasts (P<0.05). A total of 5 influencing factors were included in the nomogram model, and the C-index was 0.899. The Bootstrap self-sampling method showed that the predicted value was basically consistent with the actual observed value; the ROC curve showed that the AUC of the nomogram prediction model was 0.815 (95%CI: 0.638-0.863). It is concluded that the construction of a nomogram model for the risk of distal radius fractures in gymnasts based on quantitative CT parameters has good predictive performance, which is beneficial to guiding clinical diagnosis and treatment.