Table of Content

23 January 2023, Volume 41 Issue 1

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2023, 41(1):  0-0. 

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Review and Articles

Research Progress of Ultrasound in Classification, Diagnosis and Treatment of Cesarean Scar Pregnancy

LIU Yingying, ZHANG Jieying, WAN Hui, DU Jianwen

2023, 41(1):  1-5.  DOI: 10.7517/issn.1674-0475.221036

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With an increased cesarean delivery rate and the advent of the "one couple two children" policy, the increase in the number of women who choose to become pregnant again despite having a previous cesarean section, and the incidence of abnormal placentation is steadily rising. Cesarean scar pregnancy is a special pregnancy in which the placenta position is abnormal and reaches the incision of the lower segment of uterus and invades the muscular layer. Because of the nonspecific clinical features, once CSP patients fail to receive reasonable diagnosis and treatment in the first trimester of pregnancy, serious obstetric complications may occur with the progress of gestational weeks, such as uterine rupture, severe hemorrhage, shock and so on, which pose a serious threat to the life and health of pregnant women. Therefore, pregnant women with a history of cesarean section need to use some auxiliary examinations in time to avoid risks as much as possible. Ultrasonography, as a common examination method in gynecology, shows great application potential in the diagnosis and treatment of CSP. This article reviews the progress of ultrasound in the diagnosis of scar pregnancy.

Application of MRI Combined with Transrectal Ultrasound Targeted Puncture in the Diagnosis of Prostate Cancer

NIU Ben, CAO Hui

2023, 41(1):  6-10.  DOI: 10.7517/issn.1674-0475.221024

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This study explored the application of MRI combined with transrectal ultrasound (TRUS) targeted puncture in the diagnosis of prostate cancer (PCA). 234 patients with prostate disease diagnosed by MRI combined with transrectal ultrasound targeted puncture were selected as the targeted group, including 114 patients with PCA (PCA group) and 120 patients with benign prostatic hyperplasia (benign group), and then the imaging features of the two groups were compared. In addition, 106 patients in the same period with prostate disease who received traditional 12-needle transrectal ultrasound puncture were selected as the control group. Compared the number of puncture needles and the length of cancer tissue obtained by the two puncture methods. The results showed that in MRI features, the proportion of patients with low T2WI signal, irregular lesion morphology, blurred lesion boundary and diffusion-weighted imaging with high signal in PCA group was significantly higher than that in benign group (P<0.05). Comparison of ultrasound imaging features, the proportion of patients with hypoecho, irregular shape of lesions, microcalcified lesions, posterior echo attenuation, and blood flow grade (2-3) in PCA group was significantly higher than that in benign group (P<0.05). The average number of puncture needles in the targeted group was significantly lower than that in the control group (P<0.05). The length of cancer tissue obtained by puncture in the targeted group was longer than that in the control group (P<0.05). MRI combined with transrectal ultrasound targeted puncture has higher clinical value in the diagnosis of prostate cancer.

The Role of DCE-MRI in the Evaluation of Blood-brain-barrier Alteration after Balanced Acupuncture in Migraine without Aura and Its Relationship with Analgesic Effect

ZHANG Qianqian, LI Yan, REN Hong, XIAO Aiwei, LIU Shanshan, YU Guiyong

2023, 41(1):  11-16.  DOI: 10.7517/issn.1674-0475.221012

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This paper investigated the role of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the assessment of blood-brain-barrier alterations after balanced acupuncture in migraine without aura and its relationship with analgesic effect. 157 patients with migraine without aura were divided into a total effective group (n=115) and ineffective group (n=42) according to the effect of balance acupuncture. Compared the DCE-MRI blood-brain barrier parameters[bilateral thalamus, basal ganglia, amygdala, white matter blood-brain barrier penetration (Ktrans), plasma fraction (Vp)] before and after 4 weeks of treatment between the two groups. The results showed that the headache degree score was lower in the total effective group than in the ineffective group, and the amygdala Vp was higher in the pre-treatment and after 4 weeks of treatment than in the ineffective group (P<0.05). The amygdala Vp was positively correlated with the treatment efficacy (P<0.001). The headache degree score and pre-treatment amygdala Vp were both independent factors influencing the analgesic effect (P<0.05), and the two combined prediction of analgesia ineffectiveness had the largest AUC. Thus Vp values of DCE-MRI can be used to reflect the efficacy of balanced acupuncture in migraine without aura, and also can be used to assess blood-brain barrier alterations, and has high diagnostic efficacy for analgesic effects.

Application of Preoperative 3D Printing Model Simulating Operation in Percutaneous Nephrolithotomy based on CT Three-dimensional Reconstruction Imaging

ZHAO Shuxiao, LI Feng, QIN Zhibiao, BI Gewen, LEI Hua, LI Qiguang, ZHENG Fang, NING Xin, HUANG Juezhuo, GU Nengyu

2023, 41(1):  17-22.  DOI: 10.7517/issn.1674-0475.221026

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This study investigated the effect of preoperative 3D printing model based on CT 3D reconstruction imaging to simulate surgical operation in the treatment o f patients with complex kidney stones by percutaneous nephrolithotomy. 96 patients with complex kidney stones were selected,and they were randomly divided into a 3D group and a routine group with 48 cases in each group. The patients in 3D group were treated with preoperative 3D printed model simulates the operation of percutaneous ephrolithotomy based on CT three-dimensional reconstruction imaging, and the routine group only takes preoperative CT three-dimensional reconstruction for percutaneous nephrolithotomy under surgical positioning. The operation time, operative blood loss, success rate of single puncture, postoperative stone clearance rate, and the changes of peripheral blood white blood cells (WBC), hemoglobin (Hb), serum procalcitonin (PCT), C-reactive protein (CRP), cystatin C (CysC), blood urea nitrogen (BUN) and serum creatinine (Scr) were compared between the two groups, and the operative complications of the two groups were recorded. The operation time and operative blood loss in the 3D group were lower than those in the conventional group, and the success rate of single puncture in the 3D group was higher than that in the conventional group (P<0.05). The level of CysC at 24 hours after operation was lower than that of the routine group (P<0.05). The changes of peripheral blood WBC, Hb, serum PCT, and CRP of the two groups of patients were monitored before surgery, 24 hours after surgery, and 72 hours after surgery. There was no significant difference in the change trends of peripheral blood WBC, Hb, serum PCT and CRP between 3D group and routine group (P>0.05). After surgery the complications were counted in the two groups, the complication rate of the 3D group was 4.17% which lower than that of the conventional group 16.67% (P<0.05). The preoperative 3D printing model simulation based on CT 3D reconstruction imaging can effectively shorten the operation time, reduce the blood loss, improve the single success rate, and reduce the degree of damage to the patient's renal function.

The Study of MRI and TEG Parameters in the Diagnosis of Hemorrhagic Transformation after Thrombolysis in ACI

ZOU Liwen, WANG Yue, PAN Yuling, ZENG Hongjun

2023, 41(1):  23-27.  DOI: 10.7517/issn.1674-0475.221016

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This study investigated the value of magnetic resonance imaging (MRI) and thrombela-stogram (TEG) parameters in the diagnosis of hemorrhagic transformation (HT) after thrombolysis in acute cerebral infarction (ACI). 62 ACI patients with HT who received thrombolytic therapy were selected as HT group, and 80 ACI patients without HT transformation who received thrombolytic therapy at the same time were selected as control group. The MRI parameters and TEG parameters of the two groups were compared, and the final clinical diagnosis results were used as the judgment basis to calculate the value of MRI parameters and TEG in diagnosing HT in ACI patients after thrombolysis. The results showed that the phase signal characteristics of susceptibility weighted imaging (SWI) in HT group were mainly characterized by high signal, the proportion of patients with high signal in HT group was significantly higher than that in control group (P<0.05), and the proportion of patients with low signal and mixed signal in HT group was lower than that in control group (P<0.05). The sensitivity of SWI, diffusion weighted imaging (DWI) and T1-weighted imaging (T1WI) in the diagnosis of HT were 88.71%, 62.90% and 69.35%, respectively, and the specificity were 86.25%, 80.00% and 82.50%, respectively. The coagulation composite index (CI) value of HT group was significantly lower than that of control group (P<0.05). The AUC values of SWI, DWI and T1WI in diagnosing HT in patients with ACI thrombolysis were 0.875, 0.715 and 0.759, respectively. The AUC value of CI value in TEG parameters for diagnosing HT in patients with ACI thrombolysis was 0.720. MRI and TEG parameters have high value in the diagnosis of HT in patients with ACI thrombolysis.

Application of Contrast-enhanced Ultrasound in the Diagnosis of Crohn's Disease

YE Xiaoli, PENG Yongji, ZHU Jiacheng

2023, 41(1):  28-32.  DOI: 10.7517/issn.1674-0475.221018

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This study investigated the clinical value of contrast-enhanced ultrasound (CEUS) in the diagnosis of Crohn's disease (CD). 123 patients with Crohn's disease diagnosed by colonoscopy were selected as the research objects, including 89 patients in active stage and 34 patients in remission stage. All patients underwent ultrasound and CEUS examination. The intestinal wall thickness, Limberg classification of intestinal wall blood flow and CEUS quantitative analysis parameters[rise time (RT), peak intensity (PI), time to peak (TTP)] were compared between the two groups. The intestinal wall thickness of 89 patients in active stage was significantly higher than that of patients in remission stage (P<0.05). The Limberg grade distribution of intestinal wall blood flow in active patients was higher than that in remission patients (P<0.05). The PI value of active stage patients was significantly higher than that of remission stage patients (P<0.05), and RT value and TTP value were significantly lower than those of remission stage patients (P<0.05). There was no significant difference in intestinal wall thickness between patients with severe, moderate and mild activity (P>0.05). The Limberg grade distribution of intestinal wall blood flow in patients with severe activity was higher than that in patients with mild and moderate activity (P<0.05). The PI value of patients with severe activity was significantly higher than that of patients with mild and moderate activity (P<0.05), and the RT and TTP value were significantly lower than those of patients with mild and moderate activity (P<0.05). The AUC values of PI, RT and TTP in the diagnosis of Crohn's disease in remission and active phase were 0.852, 0.711 and 0.746, respectively. CEUS examination has high clinical application value in the judgment of disease condition and disease activity degree of Crohn's disease patients.

Application of MR Routine and 3D-T1-VIBE Sequence Scanning in the Diagnosis of Knee Cartilage Motor Injury

GAO Haoran, YANG Lianjun, ZHANG Li, CHEN Jialin, WANG Feng

2023, 41(1):  33-37.  DOI: 10.7517/issn.1674-0475.221010

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This paper explored the application value of magnetic resonance (MR) routine and 3D volume-insert air-holding examination (3D-T1-VIBE) sequence scanning in the diagnosis of patients with unilateral knee cartilage motor injury. 198 patients with suspected knee cartilage motor injury were selected as the study subjects. According knee arthroscopic diagnosis as the gold standard, 170 patients were diagnosed with knee cartilage motor injury and 28 patients with non-knee cartilage motor injury. All patients underwent routine MR, 3D-T1-VIBE sequence scanning. Compared with the MR routine and 3D-T1-VIBE sequence scanning single-item diagnosis, the combined test has a higher diagnostic accuracy for the knee joint cartilage motor injury and injury grade (P>0.05). Compared with routine MR and 3D-T1-VIBE sequence scanning single-item diagnosis, the sensitivity (98.82%), specificity (89.28%) and accuracy (97.47%) with combined diagnoses were all higher (P<0.05) of knee cartilage injury. MR routine combined with 3D-T1-VIBE sequence scanning is beneficial to improve the diagnostic accuracy of knee cartilage motor injury.

Application of Coronary Z-value Combined with Kobayashi Risk Score System in the Diagnosis of Coronary Artery Damage in Kawasaki Disease

HUANG Baoying, JIANG Suhua, PENG Weibin, JIANG Wei

2023, 41(1):  38-42.  DOI: 10.7517/issn.1674-0475.221029

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This paper investigated the value of coronary Z-value combined with Kobayashi risk score system in evaluating coronary artery damage in Kawasaki disease(KD). 108 children with KD were selected as the research objects, and 68 children without coronary artery dilatation were finally diagnosed and included in the non-damage group. There were 40 patients in the damaged group, including 10 children with only coronary artery dilatation, 11 children with small coronary artery aneurysm, 9 children with medium coronary artery aneurysm, and 10 children with large coronary artery aneurysm. The proportion of clinical data, coronary Z-value and Kobayashi score were compared between the two groups. The proportions of age ≤ 1 year, fever duration ≥ 10 days, incomplete KD, delayed diagnosis and treatment, and Kobayashi score > 3 in the damage group were higher than those in the non-damage group (P<0.05). Logistic regression analysis showed that age, fever duration, diagnosis and treatment time and Kobayashi score were the influencing factors of coronary artery damage in children with KD (P<0.05). The Z-value of the left main coronary artery diameter, the Z-value of the left anterior descending coronary artery diameter, and the Z-value of the right proximal coronary artery diameter in children with medium/large coronary artery aneurysm were higher than those in children with no dilatation and only coronary artery dilatation/small coronary artery aneurysm (P<0.05). The proportion of Kobayashi score > 3 in children with medium/large coronary aneurysms was higher than that in children without dilatation (P<0.05). The area under the ROC curve of coronary Z-value combined with Kobayashi score in the diagnosis of medium coronary aneurysms/large coronary aneurysms was high. The incidence of coronary artery damage in Kawasaki disease is affected by age, fever duration, diagnosis and treatment time, Kobayashi score and other factors. Coronary Z-value combined with Kobayashi score has certain application value in diagnosing the severity of coronary artery damage.

The Value of the DKI Model in Magnetic Resonance Imaging for the Diagnosis of Soft Tissue Sarcoma and Its Guidance for Surgical Treatment

ZHOU Yue, QI Enlin, LIU Shurong, JIANG Lijie

2023, 41(1):  43-47.  DOI: 10.7517/issn.1674-0475.221037

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This paper investigated the value of diffusion kurtosis imaging (DKI) model in magnetic resonance imaging (MRI) for the diagnosis of soft tissue sarcoma and its significance in guiding surgical treatment. 108 eight patients with soft tissue tumors were selected and divided into benign group (45 cases) and malignant group (63 cases) according to the results of surgical pathological examination. All patients underwent MRI examination assisted by DKI model. The results showed that the mean diffusion kurtosis (MK) of tumour tissue in both groups was higher than that of normal muscle tissue at the same level of the tumour, and the mean apparent diffusion coefficient (MD) was lower than that of normal muscle tissue at the same level of the tumour, with the MK in the malignant group being higher than that in the benign group and the MD lower than that in the benign group (P<0.05). The AUC of MK and MD combined diagnosis of soft tissue sarcoma was 0.935, which was greater than that of diagnosis alone. MK was positively correlated with tumour diameter, pathological grade and invasion of blood vessels/nerves/bone in soft tissue sarcoma and MD was negatively correlated with tumour diameter, pathological grade and invasion of blood vessels/nerves/bone (P<0.05). The relative risk of 1-year recurrence or metastasis in soft tissue sarcoma patients with high levels of MK was 6.024 times that of patients with low levels, and the relative risk of 1-year recurrence or metastasis in patients with soft tissue sarcoma with low MD level was 4.825 times that of patients with high level. It indicated that the DKI model assisted MRI in diagnosing soft tissue sarcoma was reliable, and was significantly correlated with the pathological characteristics of soft tissue sarcoma, which had a good guiding significance for surgical treatment.

Influencing Factors of the Success Rate of Cecal Intubation in MSCT Virtual Colonoscopy

SUN Yifei, WANG Qing, HAN Ruina, QIU Shuang

2023, 41(1):  48-52.  DOI: 10.7517/issn.1674-0475.221105

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This study mainly analyzed the factors affecting the success rate of cecal intubation during multi-slice spiral CT(MSCT) virtual colonoscopy. 95 patients undergoing MSCT virtual colonoscopy were selected as the study subjects, and 95 patients were surveyed using self-made questionnaires, and 95 questionnaires were issued and 88 were recovered. The success rate of cecal intubation in MSCT virtual colonoscopy was counted, and the failure of blind intubation were included in the control group (14 cases), the successful blind intubation were included in the study group (74 cases). Comparing the anxiety self-rating scale score (SAS) and visual simulation score (VAS) between the two groups. With the dependent variable affecting cecal intubation rate in MSCT virtual colonoscopy, the variables with P<0.05 in univariate analysis was selected for multivariate Logistic regression analysis. The results showed that the SAS score and VAS score of the study group were lower than those of the control group (P<0.05). The success rate of cecal intubation during colonoscopy was related with age, BMI, quality of bowel preparation, bowel habits. Those who with advanced age, constipation, poor bowel preparation quality, and low cecal intubation during low BMI colonoscopy the rate of cecal intubation during colonoscopy was lower (P<0.05). The advanced age, constipation, poor bowel preparation quality, high SAS score, low BMI, and high VAS score are the risk factors affecting the success rate of cecal intubation in multilayer spiral CT simulation colonoscopy.

The Value of SWE Combined with Urinary Exfoliative Cytology Detection in the Identification of Bladder Urothelial Carcinoma Grades

YANG Beibei, XU Jinzhi, ZHENG Xiaoju

2023, 41(1):  53-58.  DOI: 10.7517/issn.1674-0475.221022

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This study investigated the application of shear wave elastography (SWE) combined with the urinary exfoliated cells detection in the diagnosis and grade judgment of bladder urothelial carcinoma. 87 patients with bladder urothelial carcinoma confirmed by pathological examination were selected as the case group, and 85 patients with simple urothelial hyperplasia were selected as the control group. The routine ultrasound characteristic parameters, SWE parameters, and fluorescence in situ hybridization (FISH) detection results of urinary exfoliated cells were compared between the two groups of patients, and the case groups were stratified according to the pathological grading results. Compared the ultrasound parameters of the case group and the control group, the rich lesion blood flow characteristics, the internal echo inhomogeneous rate, the multiple tumor lesion rate, and the surface roughness rate in the case group were significantly higher than those in the control group (P<0.05). The lesion SWE parameters Emax, Emean and Emin of the case group were significantly higher than those of the control group (P<0.05), the positive rate of FISH in the case group was higher than that in the control group (P<0.05). In patients with high-grade bladder urothelial carcinoma, the blood flow enrichment rate and the surface feature roughness rate of lesions were significantly higher than those in patients with low-grade lesions (P<0.05). The SWE parameters Emax, Emean and Emin of patients with high-grade bladder urothelial carcinoma were significantly higher than those of patients with low-grade lesions (P<0.05). The positive rate of FISH in patients with high-grade bladder urothelial carcinoma was higher than that in low-grade patients (P<0.05). The detection of SWE and urinary exfoliated cells has high clinical value in the diagnosis of bladder urothelial carcinoma and the assessment of lesion grade.

Application of 3D-MSCT in Laparoscopic Radical Resection of Right Colon Cancer

ZHANG Weixing, LI Gu'nan, XIAO Tiechen

2023, 41(1):  59-63.  DOI: 10.7517/issn.1674-0475.221001

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This study explored the application value of multi-slice spiral CT three-dimensional reconstruction (3D-MSCT) in laparoscopic radical resection of right colon cancer. Collected 100 patients with right colon cancer, among them there were 61 patients with 3D-MSCT before operation (the observation group) and 39 patients (control group) underwent routine CT examination. The preoperative T stage and N stage of the two groups were analyzed. The Kappa values of preoperative T stage and pathological stage in observation group and control group were 0.821 and 0.758, respectively (P<0.05), and the Kappa values of preoperative N stage and pathological stage were 0.825 and 0.813, respectively, P<0.05. The accuracy of preoperative T stage in observation group and control group were 88.52% and 84.62%, and the accuracy of preoperative N stage was 90.16% and 89.74%, respectively, and there was no significant difference (P>0.05). The operation time of the observation group was significantly shorter than that of the control group, and the intra-operative blood loss and the proportion of vascular injury were significantly lower than those of the control group (P<0.05). The levels of serum gastrin (GAS) and motilin (MTL) in the observation group were significantly higher than those in the control group (P<0.05), while the levels of cortisol (Cor) and adrenal corticotropin (ACTH) were significantly lower than those in the control group (P<0.05). In laparoscopic radical resection of right colon cancer, multi-slice spiral CT three-dimensional reconstruction is helpful in providing comprehensive information for the operation, avoid accidental vascular injury, and have little impact on patients' body stress and gastrointestinal function.

Effect Observation of Ultrasound-guided Nerve Block on Treating Herpes Zoster Neuralgia

LIU Chuang, WU Yong, DING Mengyao

2023, 41(1):  64-68.  DOI: 10.7517/issn.1674-0475.221104

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This study investigated the effect of ultrasound-guided nerve block in the treatment of acute herpes zoster herpetic neuralgia and its effect on serum immune response molecules. 80 patients with acute herpetic neuralgia were selected and randomly divided into observation group and control group, 40 cases in each group. The observation group was treated with ultrasound-guided intercostal nerve block plus oral analgesic drugs and antiviral drugs, while the control group was treated with oral analgesic drugs and antiviral drugs. The operation time and block onset time of the observation group were lower than those of the control group, and the first puncture success rate of the observation group was higher than that of the control group (P<0.05). The VAS scores of the observation group and the control group were decreased with the treatment time, and the VAS scores of the observation group were lower than those of the control group at the corresponding time points from the 1st week to the 4th week after treatment (P<0.05). After 4 weeks of treatment, the serum immunoglobulin G (IgG) of the observation group was higher than that of the control group (P<0.05). The levels of interleukin (IL) -10, IL-26, high mobility group protein 1 (HMGB1) and CXC chemokine ligand 10 (CXCL-10) in the observation group were lower than those in the control group (P<0.05). Ultrasound-guided intercostal nerve block can reduce the operation time, improve the success rate of the first puncture, more effectively relieve the patient's pain, improve the patient's immune function, and regulate the level of related cytokines.

Study of SMI Technique Combined with Serum miR-217-5p in the Diagnosis of Progressive Ischemic Stroke

ZHENG Li'na, XIE Xiaoshuang, LUO Zhouzhan, TANG Qi

2023, 41(1):  69-73.  DOI: 10.7517/issn.1674-0475.221023

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This study investigated the value of superb microvascular imaging (SMI) combined with serum miR-217-5p in the diagnosis of progressive ischemic stroke. 121 patients with acute ischemic stroke were selected as the research subjects, and the patients were divided into a non-progressive group (73 cases) and a progressive group (48 cases) according to the relevant diagnostic criteria of the European Progressive Stroke Study Group. All patients underwent SMI examination. In addition, 20 male and 10 female healthy subjects were selected as the control group. Serum miR-217-5p levels of subjects were detected by RT-qPCR. The results showed that the rate of severe carotid artery stenosis of patients in the progressive group (50.00%) was higher than that in the non-progressive group (20.55%), P<0.001. The SMI scores of patients in the progression group were higher than those in the non-progression group (P<0.001). Compared with the control group, the relative expression of serum miR-217-5p in the non-progressive and progressive groups were both decreased, and the progressive group was lower than that in the non-progressive group (P<0.001). Serum miR-217-5p level was negatively correlated with stenosis degree (r=-0.247, P=0.006), SMI score was positively correlated with stenosis degree (r=0.427,P<0.001). The area under the ROC curve (AUC) and specificity of the combination of serum miR-217-5p level and SMI score in the diagnosis of progressive ischemic stroke were higher than those of single diagnosis. The accuracy of serum miR-217-5p combined with SMI score in the diagnosis of progressive ischemic stroke is higher than that of the two indicators alone.

Correlation of Ultrasonic Parameters with TLR4, KL-6 and Its Significance in the Diagnosis of Pneumonia

ZHANG Yinghua, YANG Ling

2023, 41(1):  74-78.  DOI: 10.7517/issn.1674-0475.221006

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This paper analyzed the correlation of ultrasound parameters with Toll-like receptor 4 (TLR4), Kerbs von den lungen-6 (KL-6) and their diagnostic value in pneumonia. 105 patients with suspected pneumonia were selected as the research subjects. Bacterial culture was used as the gold standard for the diagnosis of pneumonia, and 53 patients with pneumonia were finally diagnosed as the research group and the remaining 52 cases were the control group. All patients underwent color Doppler ultrasound detection, and detected the serum TLR4 and KL-6 levels by enzyme-linked immunosorbent assay (ELISA). The quantitative ultrasound parameters of the two groups were compared. The correlation between lung ultrasound parameters and TLR4, KL-6 levels and the severity of the disease in patients with pneumonia were analyzed, and the diagnostic value of ultrasound parameters, TLR4, KL-6 levels for pneumonia was analyzed. Compared with the control group, the parameter levels of rise time (RT) and peak intensity (PI) in the research group increased, and the time to peak (TTP) level decreased (P<0.05). Compared with patients with mild and moderate pneumonia, the levels of RT and PI parameters, as well as the levels of TLR4 and KL-6 in patients with severe pneumonia were increased, while the levels of TTP parameters were decreased (P<0.05). RT and PI parameters were positively correlated with TLR4 and KL-6 levels (P<0.05), and TTP parameters were negatively correlated with TLR4 and KL-6 levels (P<0.05). Compared with lung ultrasound parameters, TLR4 and KL-6 levels, combined diagnosis had the highest diagnostic performance for pneumonia (P<0.05). Ultrasound parameters were correlated with TLR4, KL-6 levels and the severity of pneumonia, and the combined diagnosis of the above indicators has high diagnostic value for pneumonia.

Application of Musculoskeletal Ultrasound, SMI Combined with SWE in the Observation of the Changes of Relevant Muscle Characteristics in Patients with NLBP

HAO Zhenmin, GUO Zhenning, DENG Yuguang, WU Dongqian, ZHANG Shengnan

2023, 41(1):  79-83.  DOI: 10.7517/issn.1674-0475.221007

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This paper investigated the changes of related muscle characteristics and their clinical significance in patients with non-specific low back pain (NLBP) by musculoskeletal ultrasound, superb microvascular imaging (SMI) and real-time shear wave elastography (SWE). 200 patients with NLBP were selected as the NLBP group, and 100 healthy volunteers (without signs and manifestations of lumbar pain) were selected as the control group. SMI, SWE technology and musculoskeletal ultrasound were used to determine the injury, elastic modulus and thickness of external oblique muscle, transverse abdominis muscle, iliopsoas muscle, erector spinae muscle and multifidus muscle of the two groups. All NLBP patients received rehabilitation treatment, and the changes of elastic modulus and thickness of muscle groups were observed before and after rehabilitation treatment. The thickness measurement and elastic modulus of external oblique muscle, transverse abdominis muscle, iliopsoas muscle, erector spinae muscle and multifidus muscle in NLBP group were lower than those in control group (P<0.05). After SMI examination, the positive rate of external oblique muscle, erector spinae muscle and multifidus muscle injury in NLBP group were all higher than those in control group (P<0.05). The thickness measurement, thickness and elastic modulus of external oblique muscle, transverse abdominis muscle, iliopsoas muscle, erector spinae muscle and multifidus muscle in NLBP group after treatment were significantly higher than those before rehabilitation treatment (P<0.05). NLBP patients have muscle atrophy and poor muscle elastic strength, musculoskeletal ultrasound, SMI and SWE can effectively observe the changes of muscle injury, atrophy and elastic strength in patients, and quantify the rehabilitation situation.

Correlation between Coronary Angiographic SYNTAX Scores and PLR, NLR, RDW in Postmenopausal Women with Coronary Artery Disease

ZHENG Chunhua, GUO Jingtao, ZHOU Jiang, LIU Yonghua, ZHANG Lei, ZHANG Min

2023, 41(1):  84-89.  DOI: 10.7517/issn.1674-0475.221011

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This study investigated the correlation between coronary angiographic SYNTAX scores and neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and red blood cell distribution width (RDW) in postmenopausal women with coronary artery disease. 139 postmenopausal women with coronary artery disease (the coronary artery disease group) were selected, and 139 postmenopausal women in the same period with suspected coronary artery disease with symptoms such as chest pain, panic and chest tightness but confirmed free of coronary artery disease after coronary angiography (the control group) were selected. Compared the PLR, NLR and RDW of the two groups. The coronary group was performed the coronary angiography, and recorded the SYNTAX score, and compared the PLR, NLR and RDW levels in patients with different SYNTAX scores. Pearson and partial correlation analysis were applied to analyze the correlation between coronary artery angiography SYNTAX scores and PLR, NLR, and RDW. The results showed that the mean coronary angiography SYNTAX score was (26.68±9.15) in patients with coronary artery disease, PLR, NLR, RDW were higher in the coronary artery disease group than in the control group (P<0.05). PLR, NLR, RDW:high risk > medium risk > low risk, and the difference between two comparisons were statistically significant (P<0.05). Coronary angiography SYNTAX score was positively correlated with PLR, NLR and RDW (P<0.05), after controlling smoking, hyperlipidemia, diabetes mellitus and hyperuricemia, PLR, NLR and RDW were still correlated with coronary arteriography SYNTAX score (P<0.05). It can be seen that elevated PLR, NLR, and RDW in postmenopausal women with coronary artery disease are associated with the occurrence of coronary artery disease and coronary angiography SYNTAX score.

Characteristics Analysis of MRI in the Diagnosis of Invasive Pituitary Adenomas and Effect Observation of the Surgical Effect of Endoscopic Double Nostril Approach

WANG Yanjun, ZHAO Decai, SUN Zheng, ZHANG Peng, LU Lei

2023, 41(1):  90-95.  DOI: 10.7517/issn.1674-0475.221014

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This study investigated the magnetic resonance imaging (MRI) features of invasive pituitary adenomas and the clinical effects of endoscopic bilateral nostril approach. 35 patients with invasive pituitary adenoma were selected as the invasive group, and 25 patients in the same period with non-invasive pituitary adenoma were selected as the non-invasive group. The differences of MRI imaging parameters between the two groups were compared. Both groups were treated by endoscopic double-nostril approach, and the surgical effect and changes of serum growth hormone and prolactin levels of patients were observed. The invasive group was mainly characterized by large adenoma and giant adenoma, while the non-invasive group was mainly characterized by microadenoma (P<0.05). There was no significant difference in the composition of prolactin (PRL) adenoma, adrenocorticotropic hormone (ACTH) adenoma, growth hormone (GH) adenoma, mixed adenoma and non-functional pituitary adenoma between the invasive group and the non-invasive group (P>0.05). Patients in the invasion group mainly showed slow rising time-signal intensity curve and plateau time-signal intensity curve, while patients in the non-invasion group mainly showed rapid rising time-signal intensity curve (P<0.05). The serum levels of growth hormone and prolactin in the two groups at 1 week and 1 month after operation were both significantly lower than those before operation (P<0.05). There was no significant difference in the overall clinical efficacy between the invasive group and the non-invasive group (P>0.05). The tumor lesion of invasive pituitary adenoma was generally larger than that of non-invasive pituitary adenoma. The time-signal intensity curve of MRI was mainly of slow-rising type and plateau type, and endoscopic double-nostril approach for the treatment of invasive pituitary adenoma and non-invasive pituitary adenoma had a good effect.

Evaluation of the Severity of Coronary Atherosclerotic Lesions by Integrated Cervical Cerebral Ultrasound Combined with Hcy and hs-CRP

SHEN Jian, ZHANG Haoran, WANG Feng, LIU Yanwei, LI Sha, YANG Shaoshi

2023, 41(1):  96-101.  DOI: 10.7517/issn.1674-0475.221020

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This study investigated the value of intracranial and extracranial integrated cervical cerebral ultrasound features combined with homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in evaluating the degree of coronary atherosclerosis. 120 patients with suspected coronary heart disease were selected, and 82 patients were diagnosed with coronary heart disease by coronary angiography (CAG), including 45 patients with mild coronary artery stenosis and 37 patients with moderate to severe coronary artery stenosis. All patients underwent transcranial Doppler ultrasound and carotid artery ultrasound examination, compared the differences in clinical data and ultrasound parameters between patients with coronary heart disease and without coronary heart disease, patients with different degrees of coronary artery disease, and analyzed the influencing factors of moderate to severe coronary artery stenosis. The results showed that the levels of Hcy and hs-CRP in CHD patients were higher than those in non-CHD patients (P<0.05). The age, total cholesterol (TC), triglyceride (TG), Hcy, hs-CRP, carotid Crouse plaque score and intima-media thickness (IMT) of patients with moderate to severe stenosis were higher than those of patients with mild stenosis (P<0.05), while the mean intracranial artery velocity, end-systolic velocity (PSV) and end-diastolic velocity (EDV) were lower than those of patients with mild stenosis (P<0.05). Carotid crouse plaque score, carotid IMT, Hcy and hs-CRP were positively correlated with Gensini score (P<0.05). The Logistic regression equation showed that Hcy, hs-CRP, carotid Crouse plaque score and carotid IMT were the influencing factors of moderate to severe coronary artery stenosis in patients with coronary heart disease (P<0.05). The area under the ROC curve of Logistic regression equation for predicting moderate to severe stenosis was 0.962 (P<0.05). The intracranial and extracranial integrated cervical cerebral ultrasound features combined with Hcy and hs-CRP have a good effect on evaluating and predicting the degree of coronary atherosclerosis.

Study of Three-dimensional Speckle Tracking Imaging and DDIAS in the Diagnosis of Moderate and Severe Coronary Artery Stenosis

LING Jingxia, WANG Lei, DU Xin

2023, 41(1):  102-108.  DOI: 10.7517/issn.1674-0475.221017

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This study investigated the value of three-dimensional speckle tracking imaging (3D-STI) and DNA damage-induced apoptosis suppressor (DDIAS) in the diagnosis of moderate and severe coronary artery stenosis. 112 patients with suspected coronary heart disease were examined by 3D-STI, and coronary artery stenosis was confirmed by coronary angiography (CAG) within 24 hours. Based on CAG results, the patients were divided into slight, mild, moderate, and severe groups by percentage of stenosis. At the same time, 30 healthy subjects were selected as the control group. Serum DDIAS in patients with coronary heart disease and healthy subjects were detected by enzyme-linked immunosorbent assay (ELISA). The results showed that with the increase of stenosis degree, 3D-GAS, 3D-GLS, 3D-GCS and 3D-GRS all increased gradually (P<0.05). The level of serum DDIAS in patients with coronary heart disease was higher than that in healthy subjects, and the level of serum DDIAS gradually increased with the increase of stenosis degree (P<0.05). The area under the ROC curve (AUC) (0.846) and sensitivity (98.28%) of 3D-GAS for diagnosing moderate and severe coronary artery stenosis were higher, but the specificity was lower (57.41%). The AUC, sensitivity and specificity of serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were 0.910, 84.48% and 90.74%, respectively. The AUC, sensitivity and specificity of 3D-STI parameters combined with serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were 0.979, 96.55% and 96.30%, respectively. The AUC and specificity of 3D-STI parameters combined with serum DDIAS in the diagnosis of moderate and severe coronary artery stenosis were higher than those of single diagnosis, and the sensitivity was second only to that of 3D-GAS alone. It is helpful for the accurate diagnosis of coronary artery stenosis.

The Study of Quantitative Parameters of Carotid Ultrasound Combined with miR-128-3p in the Diagnosis of Acute Cerebral Infarction

WANG Ning, PENG Zhaokuai

2023, 41(1):  109-113.  DOI: 10.7517/issn.1674-0475.221019

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This study investigated the application value of quantitative parameters of carotid ultrasound combined with microRNA 128-3p (miR-128-3p) in the diagnosis and prognosis prediction of acute cerebral infarction(ACI). 120 patients with ACI were selected as the observation group, and 100 healthy volunteers matched for age and gender were selected as the control group. The levels of miR-128-3p in peripheral blood of the two groups were detected by RT-qPCR, and carotid ultrasound examination was performed in the observation group. At the same time, the quantitative parameters of carotid ultrasound and the level of miR-128-3p difference were compared between patients with different neurological impairment and patients with different prognosis in the observation group. The relative expression of miR-128-3p in peripheral blood of the observation group was higher than that of the control group (P<0.05). The peak systolic velocity (PSV) of patients with severe impairment was significantly lower than that of patients with mild and moderate impairment (P<0.05), while the relative expression levels of end diastolic blood flow velocity (EDV), carotid intima-media thickness (IMT) and miR-128-3p were significantly higher than those of patients with mild and moderate impairment (P<0.05). The PSV of patients with poor prognosis was lower than that of patients with good prognosis (P<0.05), while the relative expression levels of EDV, IMT and miR-128-3p were higher than those of patients with good prognosis (P<0.05). The area under the ROC curve of carotid ultrasound quantitative parameters combined with miR-128-3p for predicting poor prognosis of acute cerebral infarction was 0.986, which was higher than that predicted by each index alone (P<0.05). PSV, EDV, IMT and the relative expression of miR-128-3p were related to the degree of neurological impairment and prognosis of patients. Quantitative parameters of carotid ultrasound combined with miR-128-3p have a certain application value in predicting the prognosis of patients.

MSCT to Evaluate the Efficacy of HFNC in Patients with AECOPD Complicated with Mild Type Ⅱ Respiratory Failure

ZHAO Hongling, LIANG Jinpai, XIAO Cuijun

2023, 41(1):  114-118.  DOI: 10.7517/issn.1674-0475.221008

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This study investigated the value of multi-slice spiral CT (MSCT) in evaluating the effect of high-flow nasal cannula oxygen therapy (HFNC) in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by mild type Ⅱ respiratory failure. Selected 200 patients with AECOPD complicated with mild type Ⅱ respiratory failure and randomly divided them into control group and observation group according to the random number table method, with 100 cases in each group. The control group was treated with basic treatment + conventional oxygen inhalation, while the treatment group was treated with basic treatment +HFNC. Blood gas parameters[arterial partial pressure of oxygen (PaO₂), percutaneous oxygen saturation (SaO₂), arterial partial pressure of carbon dioxide (PaCO₂), pH value, oxygen and index (OI)] were compared between the two groups before and after treatment. MSCT was used to measure the single and whole lung volume (L), emphysema volume (E), pulmonary artery diameter and aortic diameter of the two groups. Color doppler ultrasound was used to detect the changes of right ventricular function indexes[right ventricular end diastolic diameter (RVDD), right ventricular anterior wall (RVAW) and right ventricular ejection fraction (RVEF)]. The results showed that after treatment, the measured values of PaO₂, SaO₂ and OI in the treatment group were higher than those in the control group, while the measured values of PaCO₂ were lower than those in the control group (P<0.05). After treatment the whole lung volume E/L, right lung E/L in the treatment group were lower than those in the control group. After treatment, the measured values of RVEF and RVAW in the treatment group were higher than those in the control group (P<0.05). The study found that patients with AECOPD complicated by mild type Ⅱ respiratory failure treated with HFNC had better effect, and MSCT could be used to observe the improvement of emphysema and pulmonary hypertension before and after treatment.

Diagnostic Analysis of Cerebrospinal Fluid CD64, Serum Inflammatory Factors Combined with MRI in Postoperative Secondary Nervous System Infection

YUAN Yongrui, LI Zhengmin, WANG Changping

2023, 41(1):  119-123.  DOI: 10.7517/issn.1674-0475.221002

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This paper explored the diagnostic value of cerebrospinal fluid CD64 and serum inflammatory factor levels combined with enhanced MRI in postoperative secondary nervous system infection. Selected 75 patients with meningitis after neurosurgery, and compared the levels of cerebrospinal fluid CD64, serum procalcitonin (PCT), C-reactive protein (CRP) and the differences of MRI signs between bacterial meningitis and aseptic meningitis patients. The area under the ROC curve(AUC) of cerebrospinal fluid CD64, serum PCT and CRP in differential diagnosis of bacterial meningitis were 0.949, 0.925 and 0.874, respectively. The MRI signs of bacterial meningitis and aseptic meningitis were different (P<0.05). Compared with MRI enhanced scan alone, the sensitivity of cerebrospinal fluid CD64, serum PCT, CRP combined with enhanced scan in the diagnosis of bacterial meningitis was improved, but there were no statistically significant difference (P>0.05). Cerebrospinal fluid CD64, serum PCT and CRP combined with MRI enhanced scanning have certain application value in the differential diagnosis of postoperative secondary nervous system infection, which is worthy for further study.

Study of Magnetic Resonance Diffusion-weighted Imaging Combined with Paired Box Gene 5 in the Diagnosis of Breast Lesion

HE Jiongming, WEI Cheng

2023, 41(1):  124-129.  DOI: 10.7517/issn.1674-0475.221027

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This study explored the diagnostic value of magnetic resonance diffusion-weighted imaging (DWI) combined with paired box gene 5 (PAX5) in breast lesions. 107 patients with breast lesions (126 lesions) underwent DWI examination in our hospital were selected, which including benign lesions (54 cases, 69 lesions) and malignant lesions (53 cases, 57 lesions). The apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (ADC-slow), diffusion heterogeneity index (α), and diffusion distribution index (DDC) were obtained through DWI examination. Serum PAX5 levels in patients with benign and malignant lesions were detected by ELISA. The results showed that ADC, ADC-SLOW, α and DDC in the malignant group were significantly lower than those in the benign group (P<0.001). The serum PAX5 level in the malignant group was significantly lower than that in the benign group. Serum PAX5 was significantly positively correlated with ADC, ADC-slow and DDC (P<0.05). The AUC of ADC, ADC-slow, α and DDC in the diagnosis of malignant lesions were 0.737, 0.757, 0.689 and 0.837 respectively. The AUC of serum PAX5 for the diagnosis of malignant lesions was 0.853. The AUC (0.973), sensitivity (100.00%) and specificity (88.41%) of DWI parameters combined with serum PAX5 in the diagnosis of malignant lesions were higher than those of single diagnosis. This study shows that the value of DWI parameters (ADC, ADC-slow, α and DDC) combined with serum PAX5 in the diagnosis of malignant lesions is higher than that of single diagnosis, and has a high clinical value.

Multi Slice Spiral CT Equipment Fault Finding Based on Binary Search Algorithm

WANG Jian, LI Yanjie

2023, 41(1):  130-135.  DOI: 10.7517/issn.1674-0475.221004

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Multi-slice spiral computed tomography equipment is very popular in the medical field, and the complex structure and high integration of the equipment bring great difficulty to fault finding and maintenance. In order to reduce the work intensity of maintenance personnel, find equipment faults accurately and improve the efficiency of fault diagnosis, the binary search algorithm was proposed. Classified according to the nature of equipment fault and formulated the fault category table for algorithm search. According to the Euclidean distance between two fault points, the mathematical model of equipment fault two-dimensional search problem was established, and the binary search algorithm was used to solve the two-dimensional search problem of equipment fault. Using the upper bound of the maximum value of the difference between two consecutive elements, optimized the binary search algorithm, added the fault point weight to the two-dimensional search problem model, minimized the fault point coordinates of the objective function, and obtained the intermediate elements of the algorithm, finally used the optimization algorithm to find the target elements from the remaining sequence of strongly correlated elements. According to the search results of equipment faults by the binary search algorithm, targeted maintenance measures can be taken for different types of equipment faults to improve the treatment level and diagnostic efficiency. Through the fault finding simulation analysis, it is further proved that this method can 130 find the equipment fault quickly and accurately, at the same time it also can greatly reduce the cost of detection and maintenance.

Changes of DCE-MRI Parameters in RA Patients Before and After Drug Treatment and Its Effect on Bone Erosion

ZHENG Yi, JIANG Yingchun, YANG Hao, DONG Zhanjun, CHEN Yan, LI Siqiang

2023, 41(1):  136-141.  DOI: 10.7517/issn.1674-0475.221034

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This paper investigated the changes in quantitative parameters of dynamic enhanced magnetic resonance imaging (DCE-MRI) before and after drug treatment for rheumatoid arthritis (RA) and the effects on bone erosion. 112 patients with RA were selected, and quantitative parameters[maximum enhancement (Emax), maximum relative enhancement (REmax), relative enhancement (RE), and slope of maximum enhancement (Slopemax)] were measured by DCE-MRI before and after drug treatment to compare quantitative DCE-MRI parameters and bone erosion scores before and after treatment in patients with and without response. The results showed that Emax, REmax, RE, and Slopemax in non-responders were higher than in responders before and after treatment, and the change values of Emax, REmax, RE, and Slopemax before and after treatment were lower than those of responders (P<0.05). The change values of Emax, REmax, RE, and Slopemax before and after treatment were positively correlated with drug treatment in RA patients(P<0.05). The area under the curve (AUC) of the combination of Emax, REmax, RE, and Slopemax before treatment to predict RA drug treatment responsiveness as non-response was 0.901 (95% CI:0.830-0.949). The bone erosion scores before and after treatment in non-responders were higher than in responders, and the change in bone erosion scores before and after treatment was lower than in responders (P<0.05). The values of Emax, REmax, RE, and Slopemax before and after treatment were positively correlated with the change in bone erosion score in RA patients (P<0.05). It can be seen that the quantitative parameters Emax, REmax, RE, and Slopemax of DCE-MRI before treatment can predict the responsiveness to RA drug treatment, and the change values of each parameter are closely related to the change of bone erosion.

Application of SWE Combined with Chloride Channel Protein-3 in the Diagnosis of Cervical Cancer

TAO Yuhua, MIAO Xian, JI Hongjuan, GU Xiaoxia

2023, 41(1):  142-146.  DOI: 10.7517/issn.1674-0475.221035

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This paper explored the value of real-time shear-wave elastography (SWE) combined with chloride channel protein-3 (ClC-3) in the diagnosis of cervical cancer. 105 patients with suspected cervical lesions were selected as the research objects, including 50 cases with benign lesions (benign lesion group) and 55 cases with cervical cancer (cervical cancer group). At the same time, 50 healthy people in the same period were selected as the control group. The maximum and average elastic modulus of all subjects were examined by SWE. Serum ClC-3 mRNA level was determined by real-time polymerase chain reaction(PCR). Using clinicopathological diagnosis as the gold standard, ROC curve was used to evaluate the diagnostic value of maximum elastic modulus, average elastic modulus and serum ClC-3 mRNA in cervical cancer. Compared with the control group and the benign lesion group, the maximum elastic modulus, the average elastic modulus, and the serum ClC-3 mRNA level were increased in the cervical cancer group (P<0.05). The maximum value of elastic modulus and the average value of elastic modulus were positively correlated with ClC-3 mRNA (r=0.447, P<0.001). Compared with single examination, the AUC and sensitivity of combined 142detection of the maximum elastic modulus, average elastic modulus and ClC-3 mRNA were increased (P<0.05). SWE imaging parameters and serum ClC-3 mRNA changes have a certain correlation with the occurrence of cervical cancer. SWE combined with serum CLC-3 mRNA examination has high diagnostic value for cervical cancer.

Differences of CT Imaging Indexes, Serological Indicators and VOCs in Exhaled Gas in Patients between Benign and Malignant Pulmonary Nodules

YAN Qibing, YU Maowen, TAN Hui

2023, 41(1):  147-152.  DOI: 10.7517/issn.1674-0475.221005

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This study investigated the differences between CT imaging indexes, serum blood indicators and volatile organic compounds (VOCs) in exhaled gas in patients with malignant and benign pulmonary nodules. 198 patients with pulmonary nodules were included, including 120 patients with lung cancer (malignant nodule group) and 78 patients with benign nodule (benign nodule group), all patients underwent chest CT examination based on artificial intelligence imaging screening system. The expression levels of miRNA-21-5p and miRNA-574-5p in serum were detected by qRT-PCR. The levels of tumor markers carcinoembryonic antigen (CEA), neuron specific enolase (NSE) and cytokeratin 19 fragment (CYFRA21-1) in the serum of the patients were detected by ELISA kit. VOCs in exhaled breath of patients were analyzed by gas chromatography-mass spectrometry (GC-MS). The results showed that the diameter of the malignant nodule group was longer than that of the benign nodule group, and the proportion of burr sign, trachea sign, blood vessel sign, vacuole sign and pleural stretch in the malignant nodule group was much higher than that in the benign nodule group (P<0.05). The serum levels of CYFRA21-1, NSE, CEA, miRNA-21-5p and miRNA-574-5p in the malignant nodule group were higher than those in the benign nodule group (P<0.05). There were significant differences in toluene, n-propylbenzene, toluene and B-cedrene and benign nodule group between the malignant and benign nodule group (P<0.05). This study shows that there are differences in CT imaging indicators, serological indicators and VOCs in exhaled air between patients with malignant and benign pulmonary nodules, and the combination of these three examination methods may be beneficial to the early screening and diagnosis of lung cancer.

The Differences of T1WI Signal Intensity, mI/Cr and Glx/Cr in Neonatal Jaundice Infants with Different TSB Levels and Their Diagnostic Value for ABE

ZHANG Jieyu, KANG Zhilei, LIU Zhaoyan, LI Yang, JIANG Lijie

2023, 41(1):  153-158.  DOI: 10.7517/issn.1674-0475.221033

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The purpose of this study was to analyze the differences between T1-weighted image (T1WI) signal intensity, mI/Cr and Glx/Cr in the neonatal phase of jaundice infants with different levels of total bilirubin (TSB) and to investigate its diagnostic value for acute bilirubin encephalopathy (ABE). Selected 118 children with jaundice in the neonatal period and divided into three groups (mild group, moderate group, severe group) according to TSB levels. All children underwent cranial magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). At the same time, according to whether complicated with ABE, they were divided into pure jaundice group and ABE group. Compared the changes of total bile acid (TBA), T1WI signal intensity of globus pallidus, myo-inositol (mI)/creatine complex (Cr), glutamate and glutamine phthalamide complex (Glx)/creatine complex (Cr) on MRS Images between each group. The results showed that there were significant differences in T1WI signal intensity, MRS image mI/Cr, Glx/Cr in different groups, and they were significantly correlated with TSB and TBA levels and neonatal jaundice condition. The AUC of left and right globus pallidus T1WI signal intensity, MRS image mI/Cr, Glx/Cr for the diagnosis of ABE were 0.847, 0.831, 0.742 and 0.840, respectively. The T1WI signal intensity of the left and right globus pallidus, MRS image mI/Cr, Glx/Cr were positively correlated with serum TSB and TBA levels in children with neonatal jaundice, and each index has good diagnostic value for ABE and facilitates the early diagnosis and treatment of ABE.

Application of Multi-slice Spiral CT in the Diagnosis of Knee Joint Injuries of Basketball Players

LU Yuanyuan, JIAO Miaomiao, MA Xianwei

2023, 41(1):  159-163.  DOI: 10.7517/issn.1674-0475.221101

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This paper investigated the diagnostic value of MSCT imaging technology in basketball players with knee injuries. The clinical data of 118 cases of basketball players with knee injury were retrospectively collected, and all of them were examined by MSCT. The results showed that the Kappa value of concordance between MSCT knee injury diagnosis and arthroscopic findings was 0.837 (95%CI:0.704-0.969). The posterior cruciate ligament angle and posterior cruciate ligament index of the affected knee were smaller than those of the healthy knee and the lateral tibial plateau tilt angle was larger than that of the healthy knee in basketball players (P<0.05). In basketball players with complete tears of the affected knee the posterior cruciate ligament angle and posterior cruciate ligament index were smaller than partial tears and normal, and the lateral tibial plateau oblique angle was larger than partial tears and normal (P<0.05). The degree of knee injury tear was negatively correlated with posterior cruciate ligament angle and posterior cruciate ligament index, and positively correlated with lateral tibial plateau tilt angle (P<0.05). The AUC of the combined value of the three diagnoses of knee ligament injuries in basketball players was superior to that of the single diagnosis. It can be seen that MSCT imaging technology has unique advantages in the diagnosis of knee injuries in basketball players and can guide clinical treatment.

Research on Prediction of Esophagogastric Variceal Bleeding in Cirrhotic Patients by Preoperative Portal Vein CTA

ZHAO Yongchang, XU Jing, CHEN Shixin, MA Yonggang

2023, 41(1):  164-168.  DOI: 10.7517/issn.1674-0475.221031

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This study evaluated the value of preoperative portal vein CT angiography (CTA) in predicting esophagogastric variceal bleeding in patients with liver cirrhosis. 90 patients with cirrhotic esophagogastric varices bleeding were selected as bleeding group, and 90 cirrhotic patients with esophagogastric varices without bleeding were selected as control group. Compared the preoperative CTA test results of the two groups, which including the diameter of main portal vein (MPV), splenic vein (SPV) and left gastric vein (LGV). The concentrations of serum total bilirubin (TBIL), serum alkaline phosphatase (ALP) and prothrombin activity (PTA) were compared between the two groups. Analyzed the statistically significant indexes which was valuable in predicting gastric variceal bleeding. The measured values of MPV diameter, SPV diameter and LGV diameter in the bleeding group were significantly higher than those in the control group(P<0.05). The AUC values of MPV diameter, SPV diameter and LGV diameter for predicting bleeding were 0.800, 0.660 and 0.743, respectively. There was no significant difference in TBIL and ALP between bleeding group and control group (P>0.05). The PTA in bleeding group was higher than that in control group, and the difference was statistically significant (P<0.05). Logistic regression model analysis showed that the increase of MPV diameter, SPV diameter, LGV diameter and PTA were the risks of esophagogastric variceal bleeding (P<0.05). Preoperative CTA examination of the diameters of MPV, SPV and LGV is of high value in predicting esophagogastric variceal bleeding in patients with liver cirrhosis, and the three parameters are closely related to esophagogastric variceal bleeding.

Evaluation of Extracranial Vertebral Artery Stenosis and Extracranial Vertebral Artery Dysplasia by Cervical CTA

JIN Zhaowei, ZHANG Dandan, MA Feilong, WANG Lu

2023, 41(1):  169-172.  DOI: 10.7517/issn.1674-0475.220703

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The value of cervical CT angiography (CTA) in evaluating extracranial vertebral artery stenosis and extracranial vertebral artery dysplasia was explored. Eighty patients with extracranial vertebral artery stenosis and dysplasia were selected as the study group, including 34 patients with extracranial vertebral artery stenosis (group A) and 46 patients with extracranial vertebral artery dysplasia (group B). During the same period, fifty healthy volunteers were selected as control group. All of them were given the CTA examination. The left vertebral artery (L-VA) diameter, L-VA area, right vertebral artery (R-VA) diameter, and R-VA area were recorded. Compared with the control group, the L-VA diameter, L-VA area, R-VA diameter and R-VA area of patients in group A and group B were all reduced (P<0.05). The total proportion of patients with extracranial vertebral artery stenosis and dysplasia on the right side was higher than that on the left side (P<0.05). The incidence of extracranial vertebral artery stenosis and dysplasia in female patients was higher than that in male patients (P<0.05). Cervical CTA can accurately assess extracranial vertebral artery stenosis and dysplasia, and has high clinical diagnosis and application value.

The Value of Real-time Shear Wave Elastography in Determining the Type and Surgical Outcome of Athletic Achilles Tendon Rupture

QIAO Hua, SHEN Suhong, WANG Hongli, SHEN Zehang

2023, 41(1):  173-176.  DOI: 10.7517/issn.1674-0475.221030

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This study aimed to analyze the value of real-time shear wave elastography(SWE) in determining the type and surgical outcome of athletic Achilles tendon rupture. 65 patients with athletic Achilles tendon rupture were selected as the research objects, including 45 patients with incomplete rupture and 20 patients with complete rupture. The mean elastic value (Emean) of Achilles tendon in longitudinal section was measured by real-time SWE. The American Orthopedic Foot and Ankle Society (AOFAS) score was used to evaluate the postoperative efficacy. The results showed that the Emean value of Achilles tendon in longitudinal section of was significantly lower in the complete rupture group than in the incomplete rupture group (P<0.01). With Emean ≤ 89.434 kPa as the cut-off value, the sensitivity, specificity and area under the curve of Emean in the longitudinal section of Achilles tendon were 95.00%, 73.33% and 0.832, respectively. Compared with the patients with good treatment effect, the Emean of the Achilles tendon in longitudinal section of the patients with poor treatment effect was significantly reduced(P<0.05). With Emean ≤ 184.81 kPa as the cut-off value, the sensitivity, specificity and area under the curve of Emean in the longitudinal section of Achilles tendon were 93.33%, 58.00% and 0.760. This study showed that Emean longitudinal section of Achilles tendon could be used to evaluate the type of Achilles tendon rupture and the recovery of Achilles tendon after surgery.

Application of Multi-Parameter MRI in the Diagnosis of Prostate Cancer and the Risk Stratification of Disease

ZHAO Yan, SUN Yong

2023, 41(1):  177-181.  DOI: 10.7517/issn.1674-0475.221102

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This study explored the value of multi-parameter magnetic resonance imaging (mpMRI) in the diagnosis of prostate cancer (PCA) and the stratified evaluation of disease risk. 42 patients with confirmed PCA patients diagnosed by pathological examination (PCA group) and 45 patients with benign prostatic hyperplasia (control group) were selected as subjects. All patients were examined by mpMRI with 3.0T magnetic resonance imaging. The apparent diffusion coefficient (ADC), true diffusion coefficient (D), diffusion distribution index (DDC), maximum enhancement degree (SImax), fastest enhancement rate (Rmax), time to peak (Tmax), average kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr) and average diffusion coefficient (MD) were compared between the two groups. Taking the pathological results as the gold standard, the clinical value of mpMRI parameters in the diagnosis of PCA was calculated. The measured values of SImax, Rmax, MK, Ka and Kr in the PCA group were significantly higher than those in the control group (P<0.05), while the values of ADC, D, DDC, Tmax and MD were significantly lower than those in the control group (P<0.05). According to the degree of risk, the PCA patients were divided into high risk group (n=19) and middle and low risk group (n=23). In high risk group the measured values of SImax, Rmax, MK, Ka and Kr were significantly higher than those in middle and low risk group, while the values of ADC, D, DDC, Tmax and MD in high risk group were significantly lower than those in middle and low risk group (P<0.05). The area under the ROC curve (AUC) of mpMRI parameter combined diagnosis for PCA was 1, the sensitivity was 100% and the specificity was 100%. There are differences in mpMRI parameters between patients with PCA and patients with benign prostatic hyperplasia, and there are also differences in mpMRI parameters in patients with PCA with different disease risk stratification. The combination of mpMRI parameters in the diagnosis of PCA and benign prostatic hyperplasia has a high clinical value.

Application of Color Doppler Ultrasound in the Diagnosis of Neonatal Hypoxic-Ischemic Encephalopathy

ZHAO Guigui, LIU Junxia, ZHU Fangqiao

2023, 41(1):  182-186.  DOI: 10.7517/issn.1674-0475.221009

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This study investigated the value of color doppler ultrasound in the diagnosis of neonatal hypoxic-ischemic encephalopathy. 92 neonates with hypoxic-ischemic encephalopathy were selected, and the parameters of color doppler ultrasound were observed and analyzed. The cerebral artery Vs, Vd and Vm of moderate to severe children were significantly lower than those of mild children (P<0.05), while RI was significantly higher than that of mild children (P<0.05). The areas under the ROC curve of Vs, Vd, Vm and RI in the diagnosis of moderate to severe children were 0.693、0.810, 0.835 and 0.800, respectively, P<0.05. The body weight, Vs, Vd and Vm of children with poor prognosis were significantly lower than those of children with good prognosis (P<0.05), and the proportion of acidosis, moderate to severe disease and RI were significantly higher than those of children with good prognosis (P<0.05). Logistic regression analysis showed that color doppler ultrasound parameters were the risk factors for poor prognosis of neonatal hypoxic-ischemic encephalopathy (P<0.05). The color doppler ultrasound parameters of neonates with hypoxic-ischemic encephalopathy are obviously abnormal, which is related to the degree of illness and prognosis, and has certain application value in the diagnosis of moderate and severe children.

Application Value of Bedside Ultrasound in Fluid Infusion of Patients with Septic Shock

ZHENG Xiaoyu, LIU Minsheng, ZHANG Yan, HUANG Bin

2023, 41(1):  187-190.  DOI: 10.7517/issn.1674-0475.221032

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This paper investigated the relationship and significance between bedside ultrasound inferior vena cava diameter (IVCD), distensibility index of the inferior vena cava (dIVC) and fluid volume responsiveness in septic shock. 140 patients with septic shock were selected and treated with fluid therapy, and then the clinical data of patients with positive and negative volume reaction were analyzed. The end inspiratory IVCD and end expiratory IVCD in patients with positive volume response were significantly lower than those in patients with negative volume response (P<0.05). There was a positive correlation between end inspiratory IVCD, end expiratory IVCD and stroke volume (SV) (P<0.05), and the dIVC was negatively correlated with SV (P<0.05). Logistic regression analysis showed that end inspiratory IVCD, end expiratory IVCD and dIVC were the influencing factors of positive volume response (P<0.05). The area under the ROC curve of positive volume response predicted by dIVC was 0.924, which was significantly higher than that of IVCD at the end of inspiration (0.789) and expiration (0.837), (P<0.05). Bedside ultrasound has a good application value in the treatment of septic shock fluid infusion. The IVCD and dIVC are the influencing factors of volume response, and dIVC has a higher value in predicting volume response.

Evaluation of MRI Parameters in Diagnosis and Postoperative Rehabilitation of Osteochondritis Dissecans in Basketball Players

ZHENG Dajun, WANG Niu, QIU Lei

2023, 41(1):  191-195.  DOI: 10.7517/issn.1674-0475.221106

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This paper investigated the diagnostic value of quantitative MRI parameters on exfoliative osteochondritis (OCD) in basketball players and the assessment value on rehabilitation effect after microfracture surgery. 100 patients with ankle OCD were selected as the observation group, and another 100 patients in the same period with non-OCD admitted for ankle injury were selected as the control group. All patients underwent 3.0T MRI scans, and the MRI quantitative parameters[T2 index, bone marrow edema (BME), and thickness index] were compared between the two groups as well as to analyze the diagnostic value of MRI quantitative parameters for ankle OCD. Compared the MRI quantitative parameters and American Foot and Ankle Surgery Society score (AOFAS) scores of patients with different rehabilitation outcomes after microfracture surgery treatment, and analyzed the correlation between MRI quantitative parameters and AOFAS scores, and evaluated the influence of MRI quantitative parameters on the risk of poor rehabilitation outcomes after microfracture surgery in patients with ankle OCD. The results showed that the quantitative MRI parameters T2 index and BME were higher and the thickness index was lower in the observation group than in the control group (P<0.05). The AUC of the combined T2 index, BME, and thickness index for the diagnosis of ankle OCD was 0.922, which was higher than that of the single index. The postoperative quantitative MRI parameters T2 index and BME were both lower in patients with good recovery after ankle OCD microfracture surgery than in patients with poor recovery, and the thickness index and AOFAS scores were higher than in patients with poor recovery (P<0.05). The preoperative MRI quantitative parameters T2 index and BME were negatively correlated with the AOFAS score and the thickness index was positively correlated with the AOFAS score after ankle OCD microfracture (P<0.05). The risk of poor postoperative rehabilitation after microfracture occurred 18.667, 10.625, and 0.135 times higher in patients with high levels of MRI quantitative parameters T2 index, BME, and thickness index than in patients with low levels. Patients with ankle OCD had higher MRI quantitative parameters T2 index, BME, and lower thickness index, and the MRI quantitative parameters were associated with the outcome of postoperative rehabilitation of microfractures.