Objective To study the feasibility of dual-source CT double low-dose scanning technology in dual-energy head and neck CTA.Methods A total of 102 patients with CTA due to vascular diseases of the head and neck in our hospital from January 2021 to May 2021 were prospectively collected and included into the study,and randomly divided into CD and DLD groups.The CD group underwent conventional dose scanning(tube voltage 100/Sn140kV,pitch 0.9,70mL contrast agent),and the DLD group underwent double low dose scanning(tube voltage 80/Sn140kV,pitch 1.2,P＜0.05).The CD group underwent FBP reconstruction,linear fusion(M=0.6)to obtain the equivalent 120kV image,the DLD group underwent SAFIRE iterative reconstruction(iterative intensity level 3),and the 65keV energy spectrum was obtained by virtual monoenergetic technology.The two groups of images were processed with dual energy bone removal and calcification,MIP,VR,MPR,CPR and other post-processing technique.The X-ray dose parameters of the two groups were recorded,including CTDIvol(mGy)and DLP(mGy·cm),and the effective dose ED(mSv)was calculated.The iodine ingestion of the two groups was calculated,and the image quality of the two groups was evaluated subjectively and objectively,and the results were statistically analyzed.Results The image quality scores of CD group and DLD group were both＞3,which could meet the requirements of diagnosis.The two radiologists had good consistency in image quality evaluation of the two groups(Kappa values were 0.817 and 0.825).There was no significant difference in subjective image quality scores between the two groups(Z=-0.572,-0.283,both P＞0.05).There was no significant difference in the CT value of blood vessels at each level between the CD group and the DLD group(t=-0.705,0.689,0.906,all P＞0.05).There was no significant difference in vessel noise,SNR and CNR between the initial part of internal carotid artery and the M1 segment of middle cerebral artery(t=-0.830～1.842,all P＞0.05).However,the noise of the initial part of the common carotid artery in the CD group was higher than that in the DLD group(t=2.855,P＜0.05),SNR and CNR were lower than those in the DLD group(t=-4.959,-5.041,all P＜0.05).CTDIvol,DLP and ED in the DLD group were 36.9％,35.3％and 35.2％lower than those in the CD group,respectively(t=186.138,37.753,37.753,all P＜0.05).Iodine intake in the DLD group was 57.1％lower than that in the CD group(10.5g VS.24.5g).Conclusion The dual-low dose dual-energy head and neck CTA scanning technology can reduce the radiation dose and iodine intake of contrast medium without affecting the image quality.
Objective Resting-state functional magnetic resonance imaging(rs-fMRI)was used to evaluate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with mild cognitive impairment(MCI)and its modulation mechanism on resting functional brain networks.Methods Thirty-eight patients with MCI were enrolled and randomly assigned to real rTMS group or sham rTMS group.Both groups received detailed cognitive function assessment and rs-fMRI image examination before and after 10 days of treatment.The changes of cognitive assessment scores and resting functional network in MCI patients before and after rTMS treatment were calculated and analyzed.The correlation coefficient between the change of functional connectivity and cognitive scores after rTMS was further calculated.Results After rTMS treatment,the comparison results showed that patients in real rTMS group had more significant changes in other cognitive function scores than the sham group except for the AFT and TMT-B scores.The functional connectivity between L-DLPFC and the left orbital middle frontal gyrus,superior frontal gyrus and bilateral anterior cingulate gyrus were significantly increased in the real group.While the functional connectivity between L-DLPFC and the right temporal middle gyrus was significantly decreased.The changes of functional connectivities in the middle frontal gyrus and anterior cingulate gyrus were positively correlated with the changes of MoCA-B and TMT-A scores,respectively.The change of functional connectivity in the middle temporal gyrus was negatively correlated with the change of AVLT-I and AVLT-LR scores.After treatment,the functional connectivites between L-DLPFC and left middle frontal gyrus,right middle temporal gyrus,and right inferior parietal lobule were significantly correlated with AVLT score.Conclusion RTMS stimulation of the left DLPFC in patients with MCI can significantly improve cognitive function in patients with MCI,and can regulate the resting functional network of relevant brain regions.
Objective In this study,1.5-t magnetic resonance imaging(MRI)combined with three-dimensional ultrasound was used to screen fetal Craniosynostosis and analyze its clinical value and cost-effectiveness.Methods 150 cases of suspected fetal Craniosynostosis in our hospital from November 2020 to November 2022 were selected,all of which underwent prenatal three-dimensional ultrasound and MRI examination.The prenatal three-dimensional ultrasound and MRI characteristics of fetuses with Craniosynostosis were analyzed,and the ultrasound thickness of cervical hyaline layer(NT),maternal serum alpha-fetoprotein(AFP),Free estradiol(μE3)and free human chorionic gonadotropin(Free beta-hCG)levels were compared between fetuses with Craniosynostosis and fetuses without Craniosynostosis.The correlation between fetal ultrasound NT value and serum AFP,μE3 and Free-β-hCG levels with Craniosynostosis was analyzed.The results of fetal MRI or autopsy during postpartum review were used as the"gold standard"to compare the diagnostic efficacy of prenatal three-dimensional ultrasound and MRI alone and in combination with the"gold standard"in diagnosing fetal Craniosynostosis.The cost-benefit analysis is carried out by decision tree model.Results The ultrasonic NT value,serum AFP and Free beta-HCG levels of fetuses with Craniosynostosis were higher than those of fetuses without Craniosynostosis,and μE3 levels were lower than those of fetuses without Craniosynostosis(P＜0.05).The ultrasound NT value of the fetus with Craniosynostosis was positively correlated with the serum levels of AFP and Free-β-hCG,and negatively correlated with the serum levels of μE3(P＜0.05).The consistency and sensitivity of prenatal three-dimensional ultrasound combined with MRI in the diagnosis of fetal Craniosynostosis were higher than those of prenatal three-dimensional ultrasound combined with MRI alone,and the diagnostic accuracy was higher than that of prenatal three-dimensional ultrasound alone(P＜0.05).The benefit/cost of prenatal three-dimensional ultrasound combined with MRI in the diagnosis of fetal Craniosynostosis was the largest(3.48).Conclusion MRI combined with three-dimensional ultrasound screening for fetal Craniosynostosis has high accuracy and sensitivity,and combined with related maternal serum indicators,it is helpful to improve the detection rate of fetal Craniosynostosis,but the combination of the two is cost-effective.
Objective This paper discussed the application effect of 3D-GRASE sequence in MRCP in elderly patients.Methods A total of 63 patients(over 60 years old)undergoing MRCP examination in radiology department were included.2D-FSE sequence of breath holding,3D-GRASE sequence of breath holding and respiratory-triggered 3D-FSE sequence were scanned at the same patients using a 3.OT MRI scanner.SNR,CNR and CR were calculated according to images.The image quality was subjectively evaluated,including artifacts,background suppression,overall image quality and the display ability of each biliary and pancreatic duct branch.One-way ANOVA test and nonparametric Kruskal-Wallis test were used for comparison between groups.Results The artifact score of GRASE sequence was higher than that of 2D-FSE sequence,and the difference was statistically significant(4.24±0.69 vs 3.76±1.03,P＜0.05),but there was no significant difference between 3D-FSE sequence and 3D-FSE sequence.The score of background suppression of GRASE sequence is higher than that of 2D-FSE sequence.For the overall image quality score,GRASE sequence was slightly higher than 3D-FSE sequence,and there was no significant difference(4.29±0.83 vs 4.16±0.79,P＞0.05).Both of them were higher than 2D sequence,and the difference was statistically significant(P＜0.05).The CNR and CR of GRASE sequence was similar to that of 3D-FSE sequence,but higher than that of 2D-FSE sequence(P＜0.05).The display ability of GRASE sequence in common bile duct,common hepatic duct,left and right hepatic duct was not different from that of 3D-FSE sequence.The display ability of GRASE sequence on the anterior branch of right hepatic duct was not as good as that of 3D-FSE sequence(3.43±1.27 vs 3.86±1.13,P＜0.05),but there was no difference between GRASE sequence and 3D-FSE sequence in displaying the posterior branch of right hepatic duct,the medial and lateral branches of left hepatic duct.Conclusion The image quality of GRASE sequence is close to 3D-FSE sequence,higher than 2D-FSE sequence,which can provide imaging basis for the diagnosis of diseases in the elderly.
Objective To analyze the application value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)parameters combined with serum tumor markers in the diagnosis and differentiation assessment of cervical cancer.Methods 94 patients with cervical cancer and 50 healthy individuals(control group)were selected as the subjects at the same time.According to pathological examination,the patients were divided into poor differentiation group,moderate differentiation group and high differentiation group.All patients were examined with IVIM-DWI.The IVIM-DWI parameters[pseudo diffusion coefficient(D*),pure diffusion coefficient(D),perfusion fraction(f)and apparent diffusion coefficient(ADC)]and serum tumor markers[carbohydrate antigen-125(CA125),carbohydrate antigen-199(CA199),carcinoembryonic antigen(CEA)and squamous cell carcinoma antigen(SCCA)]were compared between the cervical cancer group and the control group,and between patients with different differentiation degrees.The value of IVIM-DWI parameters combined with serum tumor markers in the diagnosis of cervical cancer and high differentiation was analyzed using the receiver operating characteristic(ROC)curve.Results D,f and ADC values in the cervical cancer group were significantly lower than those in the control group(P＜0.05).Serum levels of CA125,CA199,CEA and SCCA in the cervical cancer group were significantly higher than those in the control group(P＜0.05).There was no significant difference in D*or f between patients with different differentiation degrees(P＞0.05).D and ADC value increased in order from the poor differentiation group,the moderate differentiation group to the high differentiation group(P＜0.05).The levels of CA125,CA199,CEA and SCCA decreased in order from the poor differentiation group,the moderate differentiation group to the high differentiation group(P＜0.05).The AUC values of D,f,ADC,CA125,CA199,CEA,SCCA,and their combination for diagnosing cervical cancer were 0.605,0.788,0.788,0.870,0.921,0.898,0.843 and 0.992.The sensitivity and specificity of combined diagnosis were 97.93％and 94.02％.The AUC values of D,f,ADC,CA125,CA199,CEA,SCCA,and their combination for assessing high differentiation were 0.734,0.818,0.661,0.838,0.923,0.790 and 0.965.The sensitivity and specificity were 99.23％and 81.38％.Conclusion IVIM-DWI parameters combined with serum CA125,CA199,CEA and SCCA is of high value in the diagnosis of cervical cancer,and can provide effective guidance for assessing differentiation degree.
Objective To investigate the clinical value of MRI conventional plain scan and enhancement combined with ADC value in the preoperative differential diagnosis of solitary fibrous tumor(SFT)and meningioma.Methods The preoperative data of 12 patients with SFT and 25 patients with meningioma confirmed by surgery and pathology were retrospectively collected.All patients underwent conventional MR Scan,enhancement and DWI.T test,chi-square test,rank sum test and ROC curve were used to analyze the data of the two groups.Results (1)SFT mainly occurs in the occipital region,while meningioma mainly occurs in the forehead.There was no significant difference in the flow void signal,meningeal tail sign and peritumoral edema between the two groups(P＞0.05).However,the incidence of lobulated morphology,cystic necrosis,enhancement pattern and bone destruction in SFT was significantly higher than that in meningioma,and the difference was statistically significant(P＜0.05).(2)The median ADC values of SFT and meningioma were 1.21×10-3mm2/s and 0.83×10-3mm2/s,respectively,and the difference was statistically significant(t=-4.478,P＜0.001).When the ADC value was 0.948×10-3mm2/s,the ROC curve was plotted.The AUC was 0.960,and the sensitivity and specificity were 100％and 84.0％,respectively.Conclusion MR Conventional plain scan+enhancement combined with ADC value can significantly improve the differential diagnosis of SFT and meningioma.
Objective To investigate the effects of MRI findings,clinical signs and laboratory results on the survival time of patients with pancreatic ductal adenocarcinoma(PDA).Methods 45 PDA patients were collected who were treated in the second affiliated hospital of Shandong first medical university.We retrospectively analyzed their MRI and clinical data to count their effects on the survival time of patients.The correlation analysis was made by the cox regression analysis,and then the survival curve was drawn.Results Surgical or conservative treatment,lymph node metastasis,the invasion and metastasis to adjacent organs had statistically significant impacts on patient's survival time,while other signs had no statistical significance.Conclusion The dynamic enhanced MRI combined with clinical data and laboratory results can predict the prognosis of PDA patients.They can help clinicians make more suitable treatment plans.
Objective To explore the value of CT texture analysis in differentiating ovarian clear cell carcinoma(ovarian clear cell carcinoma,OCCC)from high-grade ovarian serous cystadenocarcinoma(high-grade ovarian serous cystadenocarcinoma,HGSC).Methods The clinical data of 23 patients with ovarian clear cell carcinoma and 35 patients with high-grade serous cystadenocarcinoma hospitalized in Weifang people's Hospital from January 2020 to April 2022 were analyzed retrospectively.The texture parameters of plain scan phase,arterial phase,venous phase and delayed phase of CT were measured and recorded by ImageJ software,including histogram parameters(mean,standard deviation,skewness,kurtosis)and gray co-occurrence matrix parameters(energy,contrast,correlation,inverse difference moment,entropy).The differences of texture parameters between the two groups were compared.Two independent samples t-test or Mann-WhitneyU test were used to analyze the parameters,and ROC curves were used to analyze the texture parameters with statistically significant differences,so as to judge the efficiency of differential diagnosis.Results The mean,standard deviation and skewness of the plain scan period were significantly different between the two groups(P＜0.05),and the mean and standard deviation of the OCCC group were smaller than those of the HGSC group,and the skewness of the OCCC group was greater than that of the HGSC group;kurtosis,energy,There was no significant difference in contrast,correlation,inverse difference moment and entropy(P＞0.05).The mean and standard deviation of the arterial phase were significantly different between the two groups(P＜0.05),and the mean and standard deviation of the OCCC group were smaller than those of the HGSC group;skewness,kurtosis,energy,contrast,correlation,inverse difference moment,entropy differences No statistical significance(P＞0.05).The mean and skewness of the venous phase were significantly different between the two groups(P＜0.05),and the mean of the OCCC group was smaller than that of the HGSC group,and the skewness of the OCCC group was greater than that of the HGSC group;standard deviation,kurtosis,energy,contrast,correlation,There was no significant difference in inverse difference moment and entropy(P＞0.05).The mean and skewness of the delay period were significantly different between the two groups(P＜0.05),and the mean of the OCCC group was smaller than that of the HGSC group,and the skewness of OCCC was greater than that of the HGSC group;standard deviation,kurtosis,energy,contrast,correlation,inverse There was no statistically significant difference in the inverse difference moment and entropy(P＞0.05).Among them,the best diagnostic performance was the mean value of plain scan,AUC=0.881(P＜0.001),the sensitivity was 65.22％,and the specificity was 97.14％.Conclusion CT texture analysis is helpful to distinguish ovarian clear cell carcinoma from high-grade serous cystadenocarcinoma,which can provide important reference value for clinical and imaging diagnosis.
Objective To explore the correlation between TG/HDL-C ratio and revolution CT determination of liver fat content.Methods 108 patients with non-alcoholic fatty liver disease(NAFLD)were selected as THE NAFLD group.According to the TG/HDL-C ratio,the NAFLD group was divided into low quantile group(＜1),middle quantile group(1-1.5)and high quantile group(＞1.5).In addition,80 healthy people without NAFLD were selected as the control group,and all of them were examined by Revolution CT energy spectrum imaging,and the correlation between TG/HDL-C ratio and CT indexes was analyzed,and the related influencing factors of NAFLD were analyzed,and the diagnostic efficiency of each index for NAFLD was analyzed.Results The proportion of basic diseases(diabetes,hyperlipidemia),BMI and TC were higher in high score group and middle score group than in low score group and control group(P＜0.05).Ldl-c index was higher in high score group than in middle score group and lower score group than in control group(P＜0.05).TG index:high score group＞middle score group＞low score group and control group(P＜0.05);Hdl-c,70Kev CT value and CTL/S:high score group＜middle score group＜low score group＜control group(P＜0.05);Liver fat fraction(FF)and CT energy spectrum curves were as follows:high score group＞middle score group＞low score group＞control group(P＜0.05);Correlation analysis showed that TG/HDL-C ratio was positively correlated with FF and ENERGY spectrum curve slope(r=0.735,0.467,all P＜0.001),and negatively correlated with 70Kev CT value(r=-0.687,r=-0.664,all P＜0.01).logistic regression analysis showed that TG/HDL-C(OR=3.159)and FF(OR=3.832)were independent risk factors for NAFLD(P＜0.05).ROC analysis showed that AUC values of TG/HDL-C and FF in diagnosing NAFLD were 0.844 and 0.953,and cut-off values were 2.17 and 5.109％(P＜0.05).Conclusion The TG/HDL-C ratio was closely correlated with revolution CT index,and TG/HDL-C ratio and FF had better performance as reference indexes for evaluating NAFLD.
Objective rs-fMRI was used to characterize changes in brain function in patients with migraine without aura(MwoA).Methods rs-fMRI was performed on 26 patients with MwoA and 26 healthy people.Spontaneous brain activity was evaluated using local consistency(ReHo)and low-frequency amplitude(ALFF),brain regions with significantly different signals between the two groups were used as regions of interest(ROIs),functional connectivity(FC)between ROIs and the whole brain was calculated,and the difference in horizontal activity of brain networks between the two groups was evaluated.Correlation analysis was used to study the relationship between ReHo value,ALFF value and FC value of different brain regions in the two groups with disease course,attack frequency,duration of onset and migraine correlation scale.Results In the patient group,the smReHo value of bilateral inferior temporal gyrus and right lingual gyrus increased,the smReHo value of the left insular operculum decreased the mALFF value,the mALFF value of the left inferior temporal gyrus increased,and the mALFF value of the left insular inferior frontal gyrus and the right medial frontal gyrus decreased.FC analysis found that the patient group had abnormal functional connections throughout the brain.Correlation analysis showed a positive correlation between headache frequency,headache duration,and MIDAS scores and index values of multiple brain regions in the patient group.Conclusion MwoA patients have multiple brain regions with abnormal functional activity,which can be used as an evaluation index for the severity of MWoA disease,and provide an objective basis for in-depth understanding of the brain characteristics of MwoA patients.
Objective To investigate the value and difference of multislice CT enterography in the diagnosis of colorectal mucosa.Methods The clinical questionnaires,colonoscopy and imaging data of 60 patients admitted to our hospital from January 2021 to February 2023 were reviewed,including 28 by oral method and 32 by perfusion method.Results The mean acceptance scores for oral,infused MSCTE and colonoscopy were 4.22,3.36,3.25,respectively.The average preparation time before the examination was 3.85h,1.55h,4.20h.Oral diagnosis＞2.0cm,＞1.0cm,≤2.0cm,＞0.5cm,≤1.0cm and＜0.5cm(12/12),(18/20),(35/60),(2/33),and(10/10),(23/24),(61/70),(22/68).The perfusion of colon onic lesions with long diameter＜0.5cm and long diameter＞0.5cm,≤1.Ocm was significantly better than the oral method(P＜0.05),and there was no statistical difference between the other two groups(P＞0.05).Conclusion Penetration method MSCTE has a short preparation time,good diagnostic effect,better than oral method,and can be used as one of the screening methods for colorectal lesions.
Objective To explore the application value of magnetic resonance imaging(MRI)in evaluating the severity of cartilage damage and clinical staging of knee osteoarthritis(KOA).Methods The data of 62 patients with KOA in the hospital were retrospectively analyzed between January 2020 and December 2022.All underwent MRI examination.Taking arthroscopy results as the golden standard,accuracy of MRI in evaluating the severity of cartilage damage and clinical staging in KOA patients was analyzed.Results Arthroscopy showed that there were 182 cartilage surface damage in the 62 patients with KOA,including 33(18.13％)in tibial condyle of medial articular surface,32(17.58％)in medial femoral condyle,8(4.40％)in tibial condyle of lateral articular surface,10(5.49％)in lateral femoral condyles,45(24.73％)in femoral trochlea of patellofemoral articular surface and 54(29.67％)in patella.In terms of different severity of cartilage damage,there were 54(29.67％)lesions with cartilage damage at grade 1,40(21.98％)lesions at grade 2A,51(28.02％)lesions at grade 2B and 37(20.33％)lesions at grade 3.In terms of clinical staging:there were 13 cases,10 cases,22 cases and 17 cases in preliminary,early,middle and late stages,respectively.The total accuracy rate of MRI in the diagnosis of the severity of cartilage damage was 87.36％(159/182),and accuracy rates in the diagnosis of cartilage damage at grade 1,grade 2A,grade 2B and grade 3 were 83.33％(45/54),90.00％(36/40),84.31％(43/51)and 94.59％(35/37),respectively.The total accuracy rate of MRI in the diagnosis of clinical staging of KOA patients was 80.65％(/62),and its accuracy rates in the diagnosis of preliminary,early,middle and late stages were 76.92％(10/13),80.00％(8/10),77.27％(17/22)and 88.24％(15/17),respectively.Conclusion MRI has high diagnostic value for KOA,which can guide clinical evaluation of cartilage damage severity and clinical staging.
Objective To investigate the clinical and imaging features of primary pulmonary mucosa-associated lymphoid tissue lymphoma(PPMALT)to improve the level of awareness and diagnosis.Methods Patients with PPMALT confirmed by tissue biopsy and pathology result from April 2011 to March 2023 were collected retrospectively.Clinical indicators as age,gender,smoking history and laboratory examination were observed.Chest CT manifestations as lesion number,location,shape,margin,density,and degree of enhancement were recorded,respectively.Five subtypes were classified as nodular/mass,consolidation pneumonia,bronchial vascular lymphatic,miliary and mixed type according to CT findings.The SUVmax of the lesion was measured in patients who underwent 18F-FDG PET/CT examination.Results A total of 15 patients with PPMALT were included finally(7 males and 8 females;average age,56.3±9.6 years;age range:37～70 years).There were 8 cases in nodular/mass type,4 cases in consolidation pneumonia type,1 case in vascular broncholymphatic type,and 2 cases in mixed type.Air bronchial sign were identified in 10 cases and bronchiectasis were showed in 7 cases.Ground glass opacity on the edge of the lesion was presented in 7 cases.4 cases were accompanied by pleural effusion.CT enhancement was performed in 13 patients,12 cases with homogeneous enhancement and 1 case with heterogeneous enhancement.9 cases showed mild to moderate enhancement.Angiographic signs were found in 9 cases.9 patients underwent PET/CT examination and all lesions showed various increased metabolism(SUVmax average:(3.8±1.9);range:1.8～6.7).Conclusion The incidence of PPMALT is low and the clinical manifestations lack specificity.Chest CT imaging findings such as air bronchial sign,bronchiectasis sign,edge ground glass density shadow,angiography and mild to moderate homogeneous enhancement are helpful for differential diagnosis.
Objective To explore the value of 1.5T MRI multi-parameter imaging in evaluating the curative effect of high-intensity focused ultrasound(HIFU)and determining prognosis in uterine fibroid.Methods A total of 102 patients with uterine fibroids admitted to the hospital were retrospectively analyzed between January 2016 and December 2021.According to different treatment methods,they were divided into HIFU group(n=47)and 1.5T MRI combined evaluation group(n=55).The HIFU group was treated with HIFU,while 1.5T MRI combined evaluation group was given 1.5T MRI multi-parameter imaging evaluation before treatment.The main HIFU parameter(power,duration,total energy,energy efficiency factor,ablation rate,complete inactivation rate).T1WI,T2WI signal intensity and apparent diffusion coefficient(ADC value)of all subjects before and after treatment.The above research objects were followed up regularly,and postoperative absorption rate and cumulative ablation rate in the two groups were compared at 3 months after surgery.All the objects were re-examined at 1 year after surgery to compare fibroid recurrence rate.Results After HIFU,surgical power,total energy and energy efficiency factor in 1.5T MRI combined evaluation group were lower than those in HIFU group,while ablation rate and complete inactivation rate were higher than those in HIFU group(P＜0.05).The follow-up results showed that cumulative ablation rate in 1.5T MRI combined evaluation group was significantly higher than that in HIFU group(P＜0.05).However,there was no significant difference in 3 month postoperative absorption rate or fibroid recurrence rate at 1 year after surgery between the two groups(P＞0.05).Before treatment,there was no significant difference in the enhanced signal values of normal uterine wall in all subjects(P＞0.05).After treatment,T1WI showed an increasing trend,T2WI and ADC showed a decreasing trend,and the differences were statistically significant(P＜0.05).Conclusion The application value of 1.5T MRI multi-parameter imaging is high in evaluating curative effect of HIFU and cumulative ablation rate at 3 months after surgery in uterine fibroid,which is worthy of reference for clinical staffs.
Objective To analyze the effect of radiofrequency thermocoagulation combined with epidural block thermotherapy on the treatment of lumbar disc herniation on patients with low back pain,dysfunction and magnetic resonance imaging(MRI).Methods 64 patients with lumbar disc herniation treated in our hospital from March 2017 to November 2018 were divided into the control group and the observation group by computer-generated random numbers,32 cases in each group.The control group was given epidural blockade treatment.The observation group was combined with radiofrequency thermocoagulation treatment on the basis of the control group.Both groups were followed up for 1 year.The scores of visual analogue scale(VAS),the Japanese Orthopaedic Association(JOA),and the MRI morphological measurements of the intervertebral discs before and after treatment;the symptom disappearance time during treatment;and the efficacy after 1 year were compared between the 2 groups.Results After 1 year of follow-up,the total effective rate in the observation group was 93.75％,which was significantly higher than that in the control group,71.86％(P＜0.05).After treatment,the JOA scores of both groups increased,and the observation group was higher than the control group(P＜0.05);the VAS scores decreased,and the observation group was lower than the control group(P＜0.05).After treatment,the degree of disc bulging and prolapse in the observation group were significantly lower than those in the control group(P＜0.05).The pain and soreness of the waist and lower limbs of the observation group were shorter than those of the control group(P＜0.05).Conclusion On the basis of nerve block,the application of radiofrequency thermocoagulation has a good effect on the treatment of lumbar disc herniation.It can quickly relieve patients1 clinical symptoms,relieve pain and dysfunction.MRI observation of disc morphology has also improved.
Objective To analyze the diagnostic efficacy of quantitative parameters of GE Revolution energy dispersive imaging in pulmonary embolism(PE).Methods The clinical data of 42 PE patients who received GE Revolution CT scanning in our hospital from January 2020 to January 2022 were retrospectively selected as the observation group,and 50 PE patients who received GE Lightspeed 64 slice spiral CT scanning at the same time were selected as the control group.The scanning image quality,examination time,pulmonary artery CT value,effective radiation dose,and background noise(BN)of the two groups were compared,and the signal to contrast to noise ratio(CNR)and noise ratio(SNR)were calculated to evaluate the diagnostic value of GE Revolution quantitative parameters for PE.Result The image quality of the observation group included 40 cases(95.24％)of grade 1,1 case(2.38％)of grade 2 and 1 case(2.38％)of grade 3.The control group included 40 cases(80.00％)of grade 1,8 cases(16.00％)of grade 2 and 2 cases(4.00％)of grade 3.These has a statistically significant difference(P＜0.05).The inspection time of observation group was shorter than that of control group(3.35±1.30 vs 7.62±1.12,s),and the effective radiation dose was lower than that of control group(0.84±0.09 vs 1.95±0.74,mSv)(P＜0.05).Conclusion PWV,ABI,FAR are closely related to the prognosis quality of cardiovascular disease,and the combined detection of indicators has a high predictive value for poor prognosis of cardiovascular disease.
Objective To explore the correlation between dynamic contrast-enhanced MRI(DCE-MRI)quantitative parameters and the pathological characteristics of advanced pancreatic cancer and the value of predicting the early efficacy of chemotherapy.Methods 84 patients had advanced pancreatic cancer from April 2020 to April 2022.DCE-MRI was conducted within 2 weeks before and 1 month of treatment,measured Ktrans value,Kep value,Vp value,analyzed the correlation between DCE-MRI quantitative parameters and pathological characteristics,comparing DCE-MRI quantitative parameters between progressive group and stable group,and subject working characteristics(ROC)curve analyzed the value of DCE-MRI quantitative parameters to predict the early efficacy of chemotherapy.Results 84 pre-treatment Ktrans of advanced pancreatic cancer was(0.112±0.026)min,Kep was(0.339±0.089)min,Vp was(0.077±0.016),pancreatic head was Vp was higher than the tail(P＜0.05),low differentiation,Kep,Vp than vascular invasion(P＜0.05),and(P＜0.05).After 1 month of treatment,Ktrans and Kep did not change significantly(P＞0.05),and those in stable group were significantly lower than those before treatment(P＜0.05).After 1 month of treatment,Ktrans and Kep in progressive group were higher than those in stable group(P＜0.05).ROC showed that the maximum AUC value of Ktransvalue and Kep value was 0.783,corresponding to a sensitivity of 88.37％and a specificity of 58.54％.Conclusion The DCE-MRI quantitative parameters can be used to evaluate the clinical and pathological status of pancreatic cancer,and the parameter Ktrans value and Kep value can predict the efficacy of early chemotherapy.
1病例资料 患者女,39岁.因"间断腹胀20余天"入院.患者于20余天前出现间断性腹胀,无恶心、呕吐,无畏寒、发热.体格检查:腹部外形正常,腹部触诊未见明显异常.实验室检查:总胆红素26.4μmol/L、直接胆红素 10.2μmol/L、HBV DNA2.38E+03;大三阳.上腹部MR检查,采用GE Discoverry MR750 3.0设备,选用肝胆特异性MRI对比剂(普美显)增强,影像学表现示:肝左叶(S4段)下缘可见一类圆形异常信号灶,T1WI呈低信号,T2WI呈略高信号,边界较清楚,直径约1.3cm,动态增强早期见病灶呈快进快出强化,肝胆期呈明显低信号,DWI弥散受限.诊断为:肝左叶(S4段)异常信号灶,考虑小肝癌可能.
Objective To compare the value of the Gd-EOB-DTPA enhanced MR imaging and CT enhanced imaging in the diagnosis of liver localized lesions.Methods 70 patients with post-operative pathological diagnosis who underwent pre-operative Gd-EOB-DTPA enhanced MR imaging and CT enhanced imaging in our hospital from 2015 to 2021 were included.Based on post-operative pathological results,the diagnostic value and accuracy of the Gd-EOB-DTPA enhanced MR imaging and CT enhanced imaging for focal liver lesions were compared.Results Among the 66 patients,29 were hepatocellular carcinoma,15 were cholangiocarcinoma,12 were hepatic hemangioma,4 were focal hyperplasia,3 were hepatic adenoma,3 were liver abscess.The diagnostic accuracy of the CT enhanced imaging was 83％,80％,75％,67％,50％,67％,respectively.And the diagnostic accuracy of the Gd-EOB-DTPA enhanced MR imaging was 97％,100％,92％,67％,100％,100％,respectively.The accuracy of the MR imaging was higher than that of the CT enhanced imaging,the difference has statistical significance(P=0.005).Conclusion the Gd-EOB-DTPA enhanced MR imaging has a higher diagnostic value for hepatic focal lesions than that of the CT enhanced imaging.
Objective To explore the application value of diffusion tensor imaging(DTI)combined with diffusion-weighted imaging(DWI)in evaluating the relationship between changes of cerebral microstructure and cognitive impairment in patients with cerebral infarction(CI).Methods A total of 102 patients with Cl confirmed in the hospital were enrolled between October 2020 and October 2022.According to Montreal Cognitive Assessment(MoCA),they were divided into cognitive impairment group(n=48)and non-impairment group(n=54).All underwent DTI and DWI examinations.DTI and DWI parameters[fractional anisotropy(FA),mean diffusivity(MD),apparent diffusion coefficient(ADC),mean diffusion coefficient(Dcavg)]in brain region related to cerebral microstructure changes were compared between the two groups.Pearson correlation analysis was conducted to determine the correlation between MoCA score of cognitive function and DTI and DWI imaging parameters of brain microstructure.Results FA,ADC and Dcavg of frontal white matter and splenium in cognitive impairment group were lower than those in non-impairment group,while MD was higher than that in non-impairment group(P＜0.05).FA,ADC and Dcavg of cingulate gyrus and fornix in cognitive impairment group were lower than those in non-impairment group,while MD was higher than that in non-impairment group(P＜0.05).Pearson correlation analysis showed that the parameters of FA,ADC and Dcavg in frontal white matter,corpus callosum pressure,cingulate gyrus and fornix-related brain areas in Cl patients were positively correlated with MoCA score,while the parameters of MD were negatively correlated with MoCA score(P＜0.05).Conclusion DTI and DWI can better evaluate the cerebral microstructures of frontal white matter,corpus callosum pressure,cingulate gyrus and fornix in patients with cerebral infarction,and have certain diagnostic value in the assessment of cognitive impairment in patients with cerebral infarction.
