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Objective:To investigate the risk factors of bone cement leakage after percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fracture (OVCF).Methods:A multi-center, large-sample, case-control study was carried out to analyze the clinical data of 2 273 OVCF patients (2 689 vertebrae) undergone PVP at four hospitals between May 2018 and October 2021, including 994 males and 1 279 females, with the age of 52-91 years [(69.1±3.1)years]. Of all, 581 patients (604 vertebrae) were allocated to leakage group and 1 692 patients (2 085 vertebrae) to no leakage group according to the occurrence of bone cement leakage. The gender, age, fracture sites, vertebral compression degree, endplate integrity of fractured vertebrae, surgical segments, surgical approaches and bone cement injection volume were recorded. Univariate analysis was used to investigate the correlation between those indicators with bone cement leakage. Multivariate Logistic regression analysis was used to identify the independent risk factors for bone cement leakage.Results:Univariate analysis showed that gender, age, fracture sites, vertebral compression degree, bone cement injection volume were related to bone cement leakage after PVP ( P<0.05 or 0.01), but no correlation was found in the endplate integrity of fractured vertebrae, surgical segments and surgical approaches (all P>0.05). Multivariate Logistic regression analysis showed that fracture sites ( OR=1.68, 95% CI 1.11-2.55, P<0.05), vertebral compression degree more than 40% ( OR=1.98, 95% CI 1.29-3.02, P<0.01), bone cement injection volume greater than or equal to 5.5 ml ( OR=1.55, 95% CI 1.07-2.26, P<0.05) were significantly associated with bone cement leakage after PVP. Conclusion:Thoracic vertebral fracture, vertebral compression degree more than 40% and bone cement injection volume greater than or equal to 5.5 ml are independent risk factors for bone cement leakage after PVP in OVCF.
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Objective To evaluate the value of spectral CT imaging for the differential diagnosis of squamous cell carcinoma (SQCC) and adenocarcinoma (ADC) of the esophagogastric junction. Methods Forty-five patients with a mass in the esophagogastric junction proved by pathology underwent enhanced scan with spectral CT, including 20 cases of SQCC and 25 cases of ADC. Iodine concentration (IC) , water concentration (WC) , effective atomic number (Eff-Z) and spectral curve slope (λHU) of arterial phase (AP) and venous phase (VP) in the ROI of the mass were measured with gemstone spectral imaging post-processing software. The independent samples t test was used to compare the quantitative parameters above between two groups on the premise of satisfying normal distribution. ROC curves were drawn for the parameters which showed statistical differences and area under the curve (AUC) was used to measure and compare their respective differential diagnostic performance as well as the best threshold value. Results In AP,the average IC, Eff-Z, andλHU of ADC were (1.75±0.40) mg/ml, 8.65±0.22, and 3.33±0.74, respectively. The corresponding parameters of SQCC were (1.40 ± 0.35) mg/ml, 8.50 ± 0.20, and 2.71 ± 0.66, respectively. These parameters of ADC were significantly higher than that of SQCC (t=-2.833,-2.879,-2.678;P<0.05) . In VP, the average IC, Eff-Z, and λHU of ADC were (2.17 ± 0.23) mg/ml, 8.87 ± 0.11, and 4.10 ± 0.44, respectively. The corresponding parameters of SQCC were (1.67 ± 0.20) mg/ml, 8.60 ± 0.11, and 3.19 ± 0.41, respectively. The difference between ADC and SQCC was statistically significant (t=-6.963,-7.218,-6.521;P<0.05). For the average WC, No difference between the two groups in AP and VP was found. ROC curve analysis showed that IC, Eff-Z, andλHU in VP had better differential diagnostic performances than IC, Eff-Z, and λHU in AP, especially Eff-Z in VP. The AUC for it was 0.97. Using 8.72 as a threshold value, the sensitivity and specificity for diagnosis were 88.9% and 94.7% , respectively. Conclusion Multi-parameters quantitative analysis with spectral CT could be useful in the differential diagnosis of SQCC and ADC of the esophagogastric junction.
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Objective To evaluate the correlations of emphysema and airway wall thickness to chronic obstructive pulmonary disease(COPD) of airflow limitation by quantitative CT.Methods 40 COPD patients and other 40 normal controls underwent pulmonary function tests and following MSCT exams with inspiration.The square root of wall area of an airway with an internal area of 8 mm2 (Ai8) and the percentage of low attenuation volume(LAV%) of the whole lung and each lobes at the threshold of-950 HU were measured by a software of Thoracic VCAR.The Ai8 between the observation group and the control one was compared using SPSS2.2.The contributions of LAV% and Ai8 to predictions of FEV1/FVC and FEV1% were also evaluated.Results There was a significantly statistical difference in the Ai8 between the observation group and the control one.There were correlations between airflow limitation markers and all of LAV% as well as Ai8 (P<0.05 for all standardized coefficients).Only the Ai8 of right inferior lobar made a significant contribution to airflow limitation in the whole lung bronchus, and the LAV% of each lobes made a stronger contribution to airflow limitation than the Ai8 of right inferior lobe.Conclusion There is a significantly statistical difference in the Ai8 between the observation group and the control one.The LAV% may make a greater contribution to airflow limitation than Ai8 in COPD group.The influential factors of airflow limitation in order were LAV%, Ai8 of right inferior lobe and Ai8 of the other lobes.
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Objective To explore the diagnostic value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in diagnosis of different pathological types of lung cancer.Methods 45 patients were performed traditional MR and multi-b value DWI scan by GE discovery 750 MR.The values of Slow-ADC,Fast-ADC and ffast measured on a AW4.5 workstation were analyzed between the different pathological types of lung cancers.The correlations between these IVIM-DWI parameters and the serum tumor markers of lung cancer were analyzed.The diagnostic efficiency of these parameters were evaluated by receiver operator characteristic curve (ROC).Results 27 cases NSCLC(13 cases squamous carcinoma;14 cases adenocarcinoma )and 18 cases SCLC were finally included in this study.There were significant differences in Slow-ADC values between SCLC group and NSCLC group (P =0.00),the adenocarcinoma group (P=0.03),the squamous carcinoma group(P=0.01).There were no significant difference in Fast-ADC as well as ffast value between any two groups.The AUC of Slow-ADC value was 0.874.There existed negative correlation between squamous cell carcinoma antigen(SCC-Ag)of squamous carcinoma group and Slow-ADC(r=-0.730).Conclusion The Slow-ADC of IVIM-DWI parameters is useful in differential diagnosis of NSCLC and SCLC,which has the largest diagnostic efficiency.The correlation between SCC-Ag and Slow-ADC value has a certain meaning in diagnosing different pathological types of lung cancers.
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Objective To find out the exposure level and distributional characteristics of risk factors for stroke in health checkup population. Methods Target population was selected from two health management centers including Qianfoshan Hospital Affiliated to Shandong University and Shandong Provincial Hospital Affiliated to Shandong University in Shandong province. Data were investigated with a questionnaire which included general information, physical examination, laboratory examination and electrocardiography. Exposure rate of risk factors and its distributional characteristics were described. Results A total of 95 909 individuals were enrolled into data analysis, including 59 686 males (age:44.48± 14.43), 36 223 females (age: 44.80 ± 13.90). The major risk factors were lack of exercises (68.02%), overweight (60.54%)and dyslipidemia (58.27%). There were significant differences in age groups and sex. Conclusion Exposure rate of risk factor for stroke was high and there were substantial differences between sex and age in health checkup population. Screening and health management for stroke risks might be a necessary strategy for the preventive intervention.
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Objective To determine the capability of quantitative low attenuation areas volume percentage(LAA%)in individual lobes to assess pulmonary function loss and disease severity in pulmonary COPD patients.Methods A total of 80 subjects (50 COPD patients;30 normal smokers),who all were smokers,underwent pulmonary function tests(PFTs)and Chest CT examination at full inspiration.For the quantitative assessment,percentage of low attenuation areas were automatically calculated for each lobe by the post processing software(Thoracic VCAR).To study the correlation between these CT parameters and lung function(FEV1% pre-dicted,FEV1/FVC,DLCO%predicted,RV/TLC),univariate linear regression analysis was performed.CT measurements were compared between the five groups with analysis of covariance(ANCOVA).Results FEV1 and FEV1/FVC had significant correla-tions with all of these CT parameters.DLCO、RV/TLC had significant correlations with these parameters,aside from the LAA% of right middle lobe and right inferior lobe.The LAA% in left upper lobe have the highest correlation with FEV1、DLCO、RV/TLC. However,FEV1/FVC have the highest correlation with the LAA% of right lower lobe.The LAA% of Right lung,right upper lobe,and whole lung were significantly different between the non-COPD group and GOLD1 group.Conclusion Whole lung and every lung lobe low attenuation areas volume percentage were reflected the lung function impairment in COPD patients.
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Objective To evaluate the image quality of hand tendons by using spectral CT,compared with conventional CT ima-ges.Methods Forty patients scanned with spectral CT were enrolled.The 65keV of optimal contrast-to-noise ratio (Optimal CNR) for viewing hand tendons was selected.The image quality of monochromatic GSI images (65 keV)and conventional CT images were compared with two different methods including subjective method and objective method by two radiologists respectively.Results In subjective method,the image quality in GSI images was superior to conventional CT images (P <0.05).And in objective method, the beam-hardening artifacts in the phalanges of fingers space were reduced markedly with hand tendons displaying more clearly in GSI images (P <0.05 ).There was no significant difference between the two radiologists in both methods with good correlation (Kappa=0.75,Kappa=0.85).Conclusion Spectral CT with the optimal 65keV monochromatic images could reduce the artifacts and increase image quality significantly in hand tendons imaging.It might be a very useful supplementary imaging method in detec-ting tendon diseases in routine work.
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Objective To investigate carotid atherosclerosis and its relevant risk factors of ischemic cerebral apoplexy in high-risk population and to explore new modes of behavioral influencing factors based on health management platform.Methods Using the carotid ultrasound screening of personnel undergoing physical examination,the differences of the related risk factors were studied among 1 152 cases of carotid atherosclerosis with differ ent gender and different age and different disease periods.Results High-risk population between 40-49 years wasmainly focused on mild lesions,and the numbers of serious lesions increased significantly among people older than 70;male patients numbered 51 were significantly much more than the females numbered 21 (P＜0.01)during mild lesion period,there was no statistical significance between male numbered 36 and female numbered 29 during serious lesion period (P＞0.05).Setting mild and serious period respectively as the dependent variables,and hypertension,overweight,dyslipidemia,diabetes mellitus,smnoking,physical activity and atrial fibrillation as the independent variables to conduct logistic regression analysis,it showed that mild lesions were related to overweight,hypertension and dyslipidemia.The risk factors of serious lesion period included hypertension,overweight,diabetes mellitus,dyslipidemia,atrial fibrillation,smoking and lack of physical activity.The female detection rates of hypertension and dyslipidemia in female patients,which were 83.8％ and 44.1％ respectively,were higher than those in male patients,which were 67.6％ and 31.0％ respectively.The detection rates of smoking and arterial fibrillation in female patients,which were 0.7％ and 0.3％ respectively,were lower than those in male patients,which were 20.7％ and 1.0％ respectively.Conclusions Early detection of carotid atherosclerosis lesions and its relevant risk factors as soon as possible,and early intervention influencing factors to mild lesions to prevent the atherosclerosis from getting worse.A new model of zero level prevention can be developed to control of ischemic stroke based on health management platform.
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Objective To investigate the value of spectral CT for the discrimination of benign and malignant lung lesions through multi-parameter quantitative measurement.Methods Eighty-one patients who had lung nodule or mass on X-ray or plain CT were scanned using spectral CT,generating iodine concentration,water concentration and 101 sets of monochromatic images.Iodine concentration,water concentration,spectrum energy curve and CT value at 40 keV were measured with spectral post-processing software.70 eligible patients were divided into pneumonia group and tumor group.ANOVA analysis was used for the statistic analysis in two groups.Results The iodine concentration in pneumonia group and tumor group were (1.47 ± 0.17) and (0.77 ± 0.19) g/L (F =203.97,P ＜ 0.05).The slope rates of spectrum energy curve in pneumonia group and tumor group were 1.65 ± 0.27 and 0.88 ± 0.22 (F =161.59,P ＜0.05).The CT values at 40 keV in pneumonia group and tumor group were (139.00 ± 16.25) and (83.29 ± 17.44) HU (F =160.45,P ＜ 0.05),there were significant differences in iodine concentration,slope rates and CT values at 40 keV between two groups.The water concentration in pneumonia group and tumor group were (1021.56 ± 11.68) and (1022.62 ±8.56) g/L (F=0.19,P＞0.05),there was no significant difference.Conclusion Spectral CT technique has very important value for the discrimination of benign and malignant lung lesions.
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Molecular imaging technologies are newly emerging subjects in recent years, which are the medical research hotspots today. Advances of several common molecular imaging technologies in the staging of non-small cell lung cancer were reviewed in this article.
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The angle of tibial torsion is an inherent angle in human bodies.The angle has been to knew of clinical workers.But the research of mechanism for angle of tibial torsion and relationship with some disease still in initial stage.Recent years,the angle of tibial torsion has been noticed with the concept of torsionaldeform appearance.This paper summarizes measurement of the angle of tibial torsion andits advancement of correlated research.
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Objective To compare the diagnostic value of PET-CT and bone scintigraphy in bone metastases. Methods Thirty-two patients with malignant neoplasm confirmed by pathology were undergone18F-FDG PET-CT and bone scan within two weeks.The sensitivity,specificity and accuracy of PET-CT and bone scan in detecting the focus were compared at the same scan filed.Results The diagnostic sensitivity,specificity and accuracy with PET-CT were 94.9%,91.7% and 94.1%,respectively,and 96.2%,54.2% and 86.3% with bone scan,respectively.18F-FDG PET-CT and99Tcm-MDP bone scan were the same in detecting metastatic tumor of bone,but the specificity of18F-FDG PET-CT was better than99Tcm-MDP bone scan in detecting bone metastasis.Conclusion Compared with99Tcm-MDP bone scan,18F-FDG PET-CT is more specific and helpful in detecting bone metastases.