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Objective@#To quantitatively assess biochemical alterations in the cartilage of the subtalar and midtarsal joints in chronic lateral ankle instability (CLAI) patients with isolated anterior talofibular ligament (ATFL) injuries and combined calcaneofibular ligament (CFL) injuries using MRI T2 mapping. @*Materials and Methods@#This study was performed according to regulations of the Committee for Human Research at our institution, and written informed consent was obtained from all participants. Forty CLAI patients (26 with isolated ATFL injuries and 14 with combined ATFL and CFL injuries) and 25 healthy subjects were recruited for this study. All participants underwent MRI scans with T2 mapping. Patients were assessed with the American Orthopedic Foot and Ankle Society (AOFAS) rating system. The subtalar and midtarsal joints were segmented into 14 cartilage subregions. The T2 value of each subregion was measured from T2 mapping images. Data were analyzed with ANOVA, the Student’s t test, and Pearson’s correlation coefficient. @*Results@#T2 values of most subregions of the subtalar joint and the calcaneal facet of the calcaneocuboid joint in CLAI patients with combined CFL injuries were higher than those in healthy controls (all p 0.05). Moreover, T2 values of the medial talar subregions of the posterior subtalar joint in patients with combined CFL injuries showed negative correlations with the AOFAS scores (r = -0.687, p = 0.007; r = -0.609, p = 0.021, respectively). @*Conclusion@#CLAI with combined CFL injuries can lead to cartilage degeneration in subtalar and calcaneocuboid joints, while an isolated ATFL injury might not have a significant impact on the cartilage in these joints.
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Objective To investigate the relationship of programmed death ligand-1 (PD-L1) with clinicopathological characteristics,radiosensitivity and prognosis of the patients with esophageal squamous cell carcinoma(ESCC). Methods Ninety ESCC patients who received radical radiotherapy diagnosed by ESCC in Affiliated Hospital of North Sichuan Medical College were enrolled. Twenty cases of normal esophageal mucosa were used as the controls. The expression of PD-L1 was detected by using immunohistochemical SP method. Results The expression of PD-L1 protein was not correlated with age, gender, the maximum diameter of tumor, the length of lesion, the local aggressive of tumor, clinical stage and primary tumor volume (all P> 0.05). However, it was statistically correlated with the lymphatic metastasis (χ2= 4.404, P= 0.036). Meanwhile, PD-L1 positive expression was sensitive to radiation(χ2=4.888, P< 0.05). Single factor analysis showed that the maximum diameter of tumor and radiosensitivity were correlated with progression-free survival (PFS) (χ2=6.239,P =0.013;χ2=6.852,P =0.008; χ2= 6.312, P= 0.012) and overall survival (OS) (χ2=8.170, P = 0.004; χ 2= 4.261, P = 0.039; χ2= 5.003, P= 0.025) of ESCC patients. Multifactor analysis showed that the radiosensitivity and the maximum diameter of tumor affected PFS (OR= 0.512, 95 % CI 0.275-0.954, P= 0.035) and OS (OR= 0.507, 95 % CI 0.266-0.968, P= 0.039) in ESCC patients, respectively.Conclusions The level of PD-L1 expression is increased significantly in ESCC tissues compared with the normal esophageal mucosa tissues. PD-L1 may be a novel biomarker for predicting metastatic potential and radiosensitivity in ESCC patients, rather than the prognosis predictors of ESCC patients treated by radiotherapy.
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Objective To study the portal venous systemic thrombosis (PVST) in early acute pancreatitis (AP) and its correlations with the classification and severity of AP. Methods A total of 396 patients with AP were admitted to the affiliated hospital of north sichuan medical college from January 2013 to May 2017 and underwent MRI in the early stage of AP. PVST was evaluated on the T1WI, T2WI fat-suppression, and dynamic-enhancement sequences. Evaluating the MR imaging, AP was graded as mild, moderate, and severe AP based on the MR severity index (MRSI) and was also classified into interstitial edematous AP and necrotizing AP. According to the New Revised Classification of AP 2012, AP in the clinic setting was graded as mild, moederately severeand severe AP. χ2 test or Fisher exact test calculated the differences of the prevalence of PVST in different severity and classification of AP, Mann-Whitney U test calculated the difference of hospitalization time between patients with PVST and those without PVST. Results Among the 396 patients with AP, PVST was detected in 30 patients (7.5％,30/396), it formed most frequently in splenic vein(73.3％, 22/30), followed by portal (30.0％, 9/30) and superior mesenteric(16.7％, 5/30) veins. According to MRSI, there were 205, 177, and 14 patients with mild, moderate, and severe AP, respectively;among mild, moderate, and severe AP, there were 2, 21, and 7 patients with PVST, respectively (χ2=41.455, P<0.01), there were also statistical differences in the prevalence of portal and splenic vein thrombosis (P<0.05), but there was no statistical difference in the prevalence of superior mesenteric vein thrombosis (P>0.05). Three hundred and eleven patients had interstitial edematous AP and 65 patients had necrotizing AP, among which there were 11 and 19 patients with PVST(χ2=48.447,P<0.01), the prevalence of portal, splenic and superior mesenteric vein thrombosis in necrotizing AP were all higher than that in interstitial edematous AP (P<0.05). Based on the New Revised Classification of AP 2012, there were 194, 184 and 18 patients with mild, moderately severe, and severe AP, respectively; among mild, moderately severe, and severe AP, there were 0, 25, and 5 patients with PVST, respectively (χ2=42.130, P<0.01), there was no statistical differences in the prevalence of portal, splenic and superior mesenteric vein thrombosis (P>0.05). Patients with PVST and those without PVST in the early AP, the hospitalization time [median (interquartile range)] were 18 (13 to 22) days and 13 (10 to 19) days (Z=-2.913, P=0.004). Conclusion PVST in early AP presented more frequently with the increase in severity of AP based on both the MRSI and Newly Revised Classification of AP 2012, along with longer duration ofhospitalization.
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Objective To compare the knee function recovery at different times of returning to sport after anterior cruciate ligament reconstruction(ACLR) among elite athletes using knee isokinetic muscle strength test and various hop test.Methods Forty-one elite athletes(14 males,27 females,mean age 22.6 ± 4.1 years) undergoing ACLR between January 2013 and September 2014 were chosen from the database of the National Institute of Sports Medicine and Shanghai Huashan Hospital.Rehabilitation was performed using the same protocol by professional physiotherapists and trainers,who recorded the time of returning to sport of each athlete.One week prior to the scheduled return,bilateral knee isokinetic muscle strength test(test value:peak torque;angle velocity:60°/s,180°/s;motion:flexion,extension) and four hop tests(single hop for distance,side-to-side hop,up-down hop and 8 hop) were applied with the limb symmetry index(LSI) calculated.The athletes were then grouped by their returntime referring to surgery into the premature group(6～8 months),timely return group(9～12 months) and delayed group(over 12 months).The tests results were recorded and compared among the three groups.Results Fourteen athletes were selected into the premature group,with 19 in the timely group and 8 in the delayed group.The average LSI of 60°/s flexion peak torque of the premature group (87.4％ ± 7.5％) was significantly lower than the timely group(95.8％ ± 6.6％) and the delayed group(96.0％ ± 2.4％) (P＜0.01).Significant differences were observed between the premature group and delayed group regarding the 60° extension peak torque(85.8％ ± 9.4％ and 94.8％ ± 4.8％,P＜0.05),180°/s flexion peak torque(90.7％ ± 8.7％ and 101.4％ ± 6.8％,P＜0.05),and 180°/s extension peak torque (90.6％ ± 5.2％ and 97.8％ ± 5.6％,P＜0.05).The average LSL of the premature group at single hop for distance,side-to-side hop and up-down hop(93.A％ ± 8.5％,84.7％ ± 7.3％ and 112.5％ ± 5.7％) was significantly lower than that of the timely group(95.7％ ± 6.0％,104.2％ ± 4.3％ and 105.3％ ± 7.9％) and the delayed group regarding(98.1％ ± 1.9％,104.7％ ± 4.0％ and 106.3％ ± 7.4％) (P＜0.01 for all).The relative peak torque of 60°/s extension of the premature group(2.48 ± 0.58 Nm/kg) was significantly lower than the delayed group(3.21 ± 0.51 Nm/kg) (P＜0.01).Conclusions For elite athletes,returning to sport within 9 months after ACLR results in insufficient restoration of the knee function.Delayed return to sport doesn't improve the outcomes of hop tests,but can enhance the maximum extension torque peak,which needs further study.
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Esophageal cancer is one of frequent malignant tumors worldwide. As a noninvasive technique, computed tomography (CT) perfusion imaging could be valuable to assess the microcirculation of esophageal cancer in vivo. Recently, multidetector row CT (MDCT) perfusion imaging has sparked new interest in the assessment of the microcirculation of esophageal cancer, and therapeutic effects of chemoradiotherapy on this tumor. In this paper, we reviewed the status quo of perfusion imaging with MDCT on esophageal cancer.
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Humans , Esophageal Neoplasms , Diagnostic Imaging , Models, Theoretical , Multidetector Computed Tomography , Methods , Perfusion Imaging , Methods , Regional Blood FlowABSTRACT
In order to investigate the fine distinction of the tomographic images and the dominant anatomic distributions, we carefully reviewed and analyzed the features and predominant anatomic distribution of forty-nine pneumoconiosis patients with confirmed diagnosis on multi-detector row CT (MDCT). It was found that the round and small opacity p and irregular small opacity were mostly shown in the MDCT features of pneumoconiosis, while the large opacity and progressive massive fibrosis (PMF) were less frequently depicted in the MDCT. Distributions of round and small opacity and irregular small opacity in the six lung lobes were significantly different (P < 0.01). The most common p opacity was significantly seen in the upper and lower left lungs as well as in the upper right lung's opacity was in the upper left lung as well as lower left and right lungs. The large opacity commonly distributed in upper left and right lungs, while the PMF was often shown in both of two lungs. The results demonstrated that the MDCT could be an effective modality for detecting tiny lesions and anatomic distribution of pneumoconiosis, and it would be helpful for early diagnosis and accurate staging of the pneumoconiosis disease.
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Adult , Aged , Female , Humans , Male , Middle Aged , Early Diagnosis , Lung , Diagnostic Imaging , Pathology , Multidetector Computed Tomography , Methods , Pneumoconiosis , Diagnostic Imaging , Pathology , Silicosis , Diagnostic Imaging , PathologyABSTRACT
To evaluate the global left and right ventricular function and establish the CT reference data of global ventricular function parameters in normal people, 56 normal subjects (male, 28 cases; female, 28 case) were scanned with retrospective ECG gated 64-detector row CT. Ten time-phases in the cardiac cycle were reconstructed and short-axis images were acquired. On the cardiac analysis software, endo-cardium and epi-cardium of left and right ventricle were delineated and global function parameters were calculated. Left and right ventricular end-diastolic volume (LV/RVEDV), end-systolic volume (LV/RVESV), stroke volume (LV/RVSV), and wall mass (LV/RVWM) were significantly greater (P < 0.05) in men than in women, but cardiac output (LV/RVCO) and ejection fraction (LV/RVEF) exhibited no difference in women and men. In man group and woman group, LVWM was greater than RVWM (P < 0.01). LVESV, RVESV and body mass Index (BMI) were shown to have significant negative-correlation; the correlation coefficient = -0.54 and r = -0.53. LV/RVSV, LV/RVEF and BMI were noted to have significant positive-correlation; the correlation coefficients were 0.87/0.97 and 0.69/0.62, respectively. The normal global left and right ventricular functions differ significantly according to gender and body size.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Electrocardiography , Heart Ventricles , Diagnostic Imaging , Image Processing, Computer-Assisted , Reference Values , Retrospective Studies , Stroke Volume , Tomography, Spiral Computed , Methods , Ventricular Function, Left , Physiology , Ventricular Function, Right , PhysiologyABSTRACT
This study sought to determine the value of portal venography with 64-slice MDCT in the evaluation of compensatory circulation resulting from decompensated posthepatitic cirrhosis (PHC), and in the clarification of its anatomic distribution. Thirty-six patients with clinically confirmed compensatory circulations resulting from PHC were enrolled in this study. They underwent thoracicoabdominal triphasic enhancement CT scans with 64-slice MDCT. The data of the portal venous phase acquired were used for obtaining CT-MIP (maximum intensity projection) images of portosystematic collaterals such as gastric fundic and esophageal varices, paraumbilical veins, spleno-renal shunts, and their inflowing and outflowing vessels. On CT-MIP portography, gastric fundic varices were shown in 35 cases (97%) and esophageal varices in 30 cases (83%). The left gastric vein was the common inflowing vessel of the varices in 34 cases (94%); it was mainly originated from splenic vein in 24 cases (67%). With regard to the outflowing vessels, they were commonly azygos vein in 30 cases (83%). As for paraumbilical veins in 7 cases (19%), the inflowing vessel was the left branch of portal vein, and the outflowing vesse was the superficial epigastric vein. Cavernous transformation of the portal vein was seen in 5 cases (14%) and cavernous transformation of splenic vein was seen in 16 cases (44%). CT-MIP venography with 64-row MDCT could be considered as an effective and noninvasive method for detecting the compensatory circulation resulting from decompensated PHC.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Collateral Circulation , Esophageal and Gastric Varices , Diagnostic Imaging , Epidemiology , Hepatitis B , Liver Cirrhosis , Diagnostic Imaging , Portal Vein , Diagnostic Imaging , Pathology , Portography , Methods , Tomography, Spiral Computed , MethodsABSTRACT
This is a prospective study using first-pass perfusion CT with volume-based technique to investigate perfusion features of gastric cancer. Perfusion CT was performed with 64-section MDCT on 35 patients with gastric cancer; these patients were subdivided into three subgroups according to the location of the tumor; besides, 24 patients with normal stomach served as controls. Four perfusion parameters, including perfusion (PF), peak enhancement (PE), time to peak (TTP), and blood volume (BV), were obtained and compared between the test and control groups, and between the groups with and without lymph-node metastases. ROC analysis was performed to determine the cutoff value for discriminating the microcirculation of gastric cancer from that of the normal stomach. The results showed that blood volume was significantly increased in the test group, compared with the control group. The threshold of 8.6 ml x 100 g(-1) of blood volume was noted to be corresponding to a sensitivity of 88.6% and a specificity of 62.9%. In conclusion, the first-pass perfusion CT with whole tumor acquisition technique could assess tumor vascularity and be useful for the diagnosis of gastric cancer.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Lymphatic Metastasis , Perfusion , Methods , Prospective Studies , Radiographic Image Interpretation, Computer-Assisted , Methods , Regional Blood Flow , Sensitivity and Specificity , Stomach Neoplasms , Diagnostic Imaging , Tomography, Spiral Computed , MethodsABSTRACT
Objective To explore the clinical value of therapeutic alliances of oviduct recanalization and video-laparoscope in the treatment of infertilitas feminis caused by multiple salpingemphraxis. Methods Sixty-seven patients with salpingemphraxis in 127 oviducts complicated with adhesions in fimbriated extremities were enrolled into our study. All the patients underwent separation of adherences in fimbriated extremities and neostomy using a video-laparoscope 2 to 3 days after selective oviduct recanalization. The therapeutic effects were retrospectively reviewed focusing on recanalization rate of proximal three segments, complete recanalization rate, and pregnancy rate and relevant complications during the follow-up period were analyzed. And patients with infertilitas feminis in the follow-up period underwent repeated salpingography to determine whether oviduct was repeatedly obstructed. Results The therapeutic alliance of oviduct recanalization and video-laparoscope were performed successfully in this cohort. Owing to the treatment of oviduct recanalization, recanalization rate of proximal three segments was 97.6% oviducts (124/127). Due to the alliance of oviduct recanalization and video-laparoscope, complete rate of oviduct were 98.4% (122/124). One year after operation, the pregnancy rate, ectopic pregnancy rate, and non pregnancy rate were 58.2% (39/67), 4.5% (3/67), and 37.3% (25/67), respectively. The patients with non pregnancy were composed by repeated oviduct obstruction in 25.4% (17/67) and non obstruction in 11.9% (8/67). Conclusion Therapeutic alliances of oviduct recanalization and video-laparoscope could be an effective method for the treatment of infertilitas feminis caused by multiple salpingemphraxis, and be helpful for the enhancement of pregnancy rate.
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To evaluate the regional left ventricular function (LVF) and to establish the reference data of LVF parameters in the normal people with retrospective ECG gating 64-detector row CT, ten time phases in the cardiac cycle were reconstructed. Scanning was performed on 42 normal adult, and short axis images of the left ventricular were acquired. Endo-cardium and epi-cardium were delineated along with function parameters based on the cardiac analysis software. End-systolic thickness (EST) was thicker than end-diastolic thickness (EDT) (P<0.05). EDT and EST increased, but thickness decreased from apical, mid-ventricular to basal segments. Statistically significant difference was noted between mid-ventricular and basal segments (P<0.05). EDT, EST, thickness and motion of anterior, lateral and inferior segments were greater than those of septal segments in the same ventricular slices (P<0.05). 64-detector row CT could depict the regional LVF accurately. The LVF parameters of normal adults might be useful in diagnosing abnormal left ventricular function.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Heart Ventricles , Diagnostic Imaging , Image Processing, Computer-Assisted , Myocardial Contraction , Physiology , Radiographic Image Interpretation, Computer-Assisted , Methods , Tomography, Spiral Computed , Methods , Ventricular Function, Left , PhysiologyABSTRACT
The aim of this study was to elucidate the characteristics of time attenuation curve and CT perfusion parameters for pulmonary adenocarcinomas and squamous cell carcinomas. 58 cases of pulmonary adenocarcinomas and 27 cases of squamous cell carcinomas underwent first pass CT perfusion imaging with 64-row MDCT. Data were analyzed using commercial software to generate time attenuation curve (TAC) and CT perfusion parameters, including perfusion, peak enhanced (PE), time to peak (TTP), and blood volume (BV). For TAC, there were 36.2% of type I and 63.8% of type II in adenocarcinomas, while there were 22.2% of type I and 77.8% of type II in squamous cell carcinomas. There was not significant difference (P>0.05). Perfusion, PE, TTP and BV of adenocarcinomas were 63.2 +/- 45.4 ml x min(-1) x ml(-1), 60.2 +/- 46.6 Hu, 34.8 +/- 10.2 s and 34.3 +/- 23.6 ml x 100 g(-1), respectively, while 54.3 +/- 50.2 ml x min(-1) x ml(-1), 48.5 +/- 34.9 Hu, 36.1 +/- 11.2 s and 27.6 +/- 21.7 ml x 100 g(-1), for squamous cell carcinoma, respectively. No significant differences were found between groups (P>0.05). No significant differences in TAC and CT perfusion parameters were found between adenocarcinomas and squamous cell carcinomas.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma , Diagnostic Imaging , Carcinoma, Squamous Cell , Diagnostic Imaging , Image Interpretation, Computer-Assisted , Methods , Lung Neoplasms , Diagnostic Imaging , Neovascularization, Pathologic , Diagnostic Imaging , Pathology , Perfusion , Methods , Prospective Studies , Tomography, Spiral Computed , MethodsABSTRACT
<p><b>BACKGROUND</b>To investigate the indication, complication and efficacy of bronchial artery embolization for the management of lung cancer with massive hemoptysis.</p><p><b>METHODS</b>Thirty-eight cases of lung cancer with massive hemoptysis were retrospectively analyzed in our hospital from January 1996 to January 2003. All cases presented with acute hemoptysis from 220 to 980 ml daily, with a mean of 290 ml daily. A digital subtracted bronchial arteriogram was perfomed and bleeding arteries were embolized.</p><p><b>RESULTS</b>Hemoptysis decreased gradually in all cases and ceased in 3 or 4 days after embolization. Recurrence was found only in one case 2 months after embolization and second embolization was applied to control hemoptysis. No serious complications occured.</p><p><b>CONCLUSIONS</b>Bronchial artery embolization is safe and efficient for the management of lung cancer with massive hemoptysis.</p>