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Objective:To investigate the value of tumor hemodynamics and morphological features from conventional dynamic contrast-enhanced MRI (DCE-MRI) scan before surgery in predicting postoperative recurrence time in breast cancer patients.Methods:A retrospective analysis of 58 patients with breast cancer who had recurred after operation from November 2012 to December 2014 in Liaoning Cancer Hospital was performed. According to the recurrence time, the patients were divided into early recurrence group (≤2 years after surgery, 33 cases) and late recurrence group (>2 years after surgery, 25 cases). All patients underwent routine DCE-MRI scans before surgery, and hemodynamic features of the three-dimensional volume of the tumor and the morphological and textural features of the tumor in each phase were extracted by computer. The counts and measurement data of patients in early recurrence group and late recurrence group were compared by Fisher′s exact probability method and Mann-Whitney U test, and receiver operating characteristic (ROC) curves were drawn. The multivariate logistic regression was used to calculate the combined efficacy in predicting early recurrence and late recurrence. Kaplan-Meier method was used to analyze the survival prognosis, and Log-Rank test was used to compare the differences in survival curves between groups. Results:There was no significant difference in background parenchymal enhancement, lesion margin, lesion internal enhancement characteristics, lesion morphology, time-signal intensity curve type and the degree of whole-breast vascularity increase between early recurrence and late recurrence groups ( P>0.05).There were significant differences in the maximum concentration of contrast (Max Conc), the area under the time signal curve (AUC) and the maximum slope value of the time signal curve (Max Slope) ( P<0.05). Comparative analysis of the radiomics parameters of 8 phases DCE-MRI found that the sphericity of morphological characteristic parameters in the phase 3 was statistically different between the early recurrence and late recurrence groups ( P=0.03). Area under the ROC curve of AUC, Max Conc, Max Slope and parameter sphericity of phase 3 morphological characteristics for predicting early and late recurrence were 0.664, 0.659, 0.684 and 0.670, respectively. The area under the ROC combined with the above four parameters for prediction was 0.765, with a specificity of 63.6% and a sensitivity of 84.0%; the predictive efficacy was higher than that of univariate. Fifty-eight patients were followed up for 17 to 64 months with a median follow-up of 47 months. The disease-free survival and overall survival in the early recurrence group were significantly lower than those in the late recurrence group, and the difference was statistically significant ( P<0.05). Conclusion:It is of certain value to predict the postoperative recurrence time of breast cancer based on the tumor hemodynamic characteristics combined with morphological characteristics from preoperative non-invasive conventional DCE-MRI.
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Objective ToquantitativelystudythecorrelationbetweenT2mappingvalueofthesupraspinatuswithfattydegenerationand supraspinatustendontear.Methods From MarchtoSeptemberin2016,patientswithsupraspinatustendontearinourhospitalwere enrolled.TheT2mappingvalueofthesupraspinatuswasmeasured.Accordingtothesupraspinatustendontearclassification,patients weredividedintogroupA,BandC.ThecorrelationwasanalyzedbetweenT2mappingvalueandsupraspinatustendontear.Results 45patientswereenrolled,including30malesand15females,aged15－85years,withanaverageageof(45.4±16.6)years.Among the45shoulderjoints,12jointswereingroupA withnotendontear,14jointswereingroupBwithincompletetomoderatetear,and 19jointswereingroupCwithmosttofulllayertear.TheT2mappingvaluesofsupraspinatusingroupA,BandCwere46.0±7.0,51.5± 10.6and65.0±8.4,respectively.TheT2mappingvalueincreased withtheseverityofthesupraspinatustendontear (P＜0.001), whichwaspositivelycorrelated.Conclusion ThemeasurementofT2mappingisareliable methodforquantitativelyevaluatingthe fattydegenerationinthesupraspinatus.ThatthehigherT2mappingvalue,thehigherfatcontentinthesupraspinatusmuscle,suggests thetearofsupraspinatustendonismoreserious.T2mappingisanotheroptionalmethodforclinicaldiagnosisandprognosisevaluation oftherotatorcufftear.
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Objective Exploring the imaging findings of solitary lesions in spine to improve the diagnosis level of these diseases. Methods 158 cases of solitary lesions in spine confirmed by pathology from Jan 2011 to Jan 2018 were retrospectively analyzed on bone destruction, intralesional density, signal features, marginal sclerosis, boundary, soft tissue mass, periosteum reaction and involvement of intervertebral disc. Results There were 100 cases of primary bone tumors and tumor-like lesions, 25 cases of metastatic tumors and 33 cases of infectious diseases. 87 male and 71 female were included, with a mean age of (46.3 ± 7.2) years (range: 5 ～76).There were 13 cases (8.23％) of benign bone tumors and 11 cases (6.96％) of benign tumor-like lesions, 21 cases (13.29％) of intermediate bone tumors and 4 cases (2.53％) of intermediate tumor-like lesions, 76 cases (48.10％) of malignant tumors and 33 cases (20.89％) of infectious diseases. Osteochondroma and fibrous dysplasia were the most common type of benign bone tumors and tumor-like lesions, respectively. Giant cell tumor and langerhans cell histiocytosis were the most common type of intermediate bone tumors and tumor-like lesions, respectively. Metastases and solitary plasmacytoma were the most common types of malignant tumors. Tuberculosis was the most common type of infectious diseases. Benign lesions usually have no or mild bone destruction. Clear boundary and marginal sclerosis were common, while periosteum reaction and soft tissue mass were rarely seen in benign lesions. Bone destruction with soft tissue mass and periosteum reaction were common in intermediate and malignant lesions. Moreover, malignant tumors usually had obscure boundary. Involvement of adjacent intervertebral disc was the most significant difference between infectious diseases and tumors and tumor-like lesions.Conclusions Solitary lesions in spine have certain regularity, which is helpful for the diagnosis and differential diagnosis of benign, malignant tumors and tumor-like lesions and infectious diseases.
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Objective Based on MRI m-Dixon-Quant technique to quickly quantify bone marrow fat content in the vertebral body of middle-aged and elderly patients,and provide a scientific basis for the diagnosis of osteoporosis(OP).Methods A total of 74 middle-aged and elderly patients who were admitted to our hospital from July 2016 to July 2017 were collected.The age,sex and body mass index (BMI)of the patients were collected.All subjects were evaluated for bone mineral density (BMD)and fat fraction (FF)and other indicators of measurement.According to the guidelines for bone mineral density measurement by the American College of Radiology(ACR),the subject was classified by the bone mineral density value,and receiver operating characteristic(ROC)curve was used for the diagnosis and analysis of FF.Results The average age of the subjects was (59.50±8.72)years.There was a positive correlation between MRI m-Dixon-Quant FF and age(r=0.436),which was highly negatively correlated with the average bone density(r=-0.739).By ROC analysis,the sensitivity and specificity were 74.2% and 83.3% for normal and low bone mass groups,92.0% and 88.9% for the normal and OP groups,and 72.0% and 87.1% for the low bone mass and OP groups.FF could be used for the evaluation of OP.If FF<54.60,normal bone mass was considered.If 54.60≤FF≤65.20,low bone mass was considered,if FF>65.20,OP was considered.Conclusion The MRI m-Dixon-Quant FF index can be rapidly and quantitatively used for the diagnosis of OP,which provides a new reference for the diagnosis of OP.
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Objective To investigate MR and US diagnotic value of long head of the biceps tendon injury.Methods A total of 80 patients with suspected injury of long head of the biceps tendon underwent arthroscopy surgery.All patients had MR and US examination preoperatively.The preoperative results were compared with the findings during the arthroscopy in order to assess the effectiveness of two methods.Results Among 80 patients, there were completely torn in 19 cases, partly torn in 45 cases, biceps tendon tenosynovitis in 10 cases, biceps tendon slippage in 6 cases.The accuracy of MR and US in the diagnosis of completely torn, partly torn, biceps tendon tenosynovitis, biceps tendon slippage were 98.7%,92.5%,97.5%,100% and 96.2%,85.0%,96.3%,98.7% respectively.There was no statistic difference between MR and US in diagnosing completely torn,biceps tendon tenosynovitis and biceps tendon slippage(P>0.05),but the accuracy of MR in diagnosing partly torn was higer than US(P<0.05).Conclusion MR determination of biceps tendon partial tear is of obvious advantages.US examination can be used as a routine method for the investigation of patients with suspected biceps tendon injury.
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Objective To investigate the current status of nurses′ work performance and job involvement, and to analyze the impact of nurses′job involvement on work performance. Methods Self-made questionnaires were used to investigate 309 nurses in a 3A military hospital in Beijing. The military hospital is in a high standardization level, which may be properly representative of both military hospitals and 3A hospitals. Results The total score of nurses′work performance was 192.04 ± 31.25. The total score of nurses′ job involvement was 55.48 ± 9.94. The multiple regression analysis showed that the nurses′ work performance would be influenced by staff type, vigor and absorption. Conclusions The nurses′work performance and job involvement were at a high level. Managers should take methods to keep a high level of nurses′job involvement, which may improve work performance.
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Objective To investigate the improvement of postpartum pelvic floor by rehabilitation training assessed with three-dimensional transperineal ultrasound . Methods One hundred cases of healthy postpartum women were randomly divided into two groups :control group and training group .The control group received the customary education ,and the training group received pelvic floor rehabilitation training . At 6 and 12 weeks postpartum ,levator hiatus area ,thickness of the levator ani muscle ,bladder neck mobility ,and bladder posterior horn were measured with three-dimensional transperineal ultrasound in all the subjects . Meanwhile ,the muscle strength situations were tested . Results At 12 weeks postpartum ,the anal levator hiatal area ,bladder neck mobility and bladder posterior horn in the training group were lower than those of the control group[ ( 21 .6 ± 3 .2) cm 2 vs ( 25 .6 ± 2 .4 ) cm 2 ,( 27 .9 ± 5 .3) mm vs ( 31 .5 ± 5 .9) mm ,( 126 .3 ± 21 .2)° vs (135 .3 ± 11 .6)°] ( P < 0 .05) . Compared with control group ,the thickness of the levator ani muscle increased in training group [ ( 13 .6 ± 2 .3) mm vs ( 15 .3 ± 2 .5) mm ] ( P < 0 .05) . The incidence of stress urinary incontinence in the training group ( 5% ) was significantly lower than the control group ( 12 .5% ) at 12 weeks postpartum ( χ2 = 5 .487 , P = 0 .025) . The muscle strength had no significant difference at 6 weeks postpartum . At 12 weeks postpartum ,the pass rate of class Ⅰ muscle fiber was 78 .5% ,and that of class Ⅱ muscle fiber was 83 .3% in the training group ;the pass rate of class Ⅰ muscle fiber was 28 .5% ,and class Ⅱ muscle fiber was 37 .3% in the control group , the improvement was significant at 12 weeks postpartum . Conclusions The result of the transperineal real-time ultrasonographic evaluation of post-natal pelvic floor rehabilitation training has high consistency with the measurement of muscle strength . The ultrasound examination is simple and accurate ,and has highly applicable value in evaluating the effect of post-pelvic rehabilitation training .
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Objective To comparative evaluation the application value of high frequency ultrasound (HFU)and magnetic reso-nance imaging (MRI)in the diagnosis of rotator cuff tears(RCT).Methods 86 patients of unilateral RCT confirmed by shoulder ar-throscopy were chosen.The detection rate by HFU and MRI before the surgery was compared.Shoulder arthroscopic finding was as the evaluation standard,the accuracy of HFU and MRI in the diagnosis of RCT was calculated which included:total (full and partial) RCT,full RCT,partial RCT.Chi-square test was used to compare the accuracy rate.Results Among 86 patients,30 patients with full RCT and 56 patients with partial RCT were detected by shoulder arthroscopy,in which 28 patients with full RCT and 43 patients with partial RCT were found by HFU,and 28 patients with full RCT and 5 1 patients with partial RCT were found by MRI respec-tively.The accuracy of HFU and MRI in the diagnosis of total,full,partial tear RCT were 82.6%,93.3%,76.8% and 91.9%,93.3%, 91.6% respectively.There was no significant difference between HFU and MRI in diagnosing total and full RCT(P >0.05),the ac-curacy on HFU in diagnosing partial RCT was slightly lower than that on MRI (P <0.05).Conclusion Both HFU and MRI have relatively high accuracy in diagnosing full RCT,HFU is slightly lower than MRI in diagnosing partial RCT.
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Objective:To examine the effects of chronic intermittent hypoxia(CIH)on the NF-κB,IL-6 and PGE2 level in rats with periodontitis.Methods:32 male SD rats(6 weeks old)were randomly divided into 4 groups(n =8),group A(normoxic control),B (normoxic periodontitis),C(CIH)and D(periodontitis +CIH).Periodontitis model was established in the upper second molars by liga-tion technique and high-glucose diet in the rats of group B and D.The rats in the group C and D were subjected to CIH in a cycle of al-ternative nitrogen and oxygen in a closed chamber.The chamber was filled with nadir and zenith ambient oxygen every 1 20 seconds per cycle for 8 hours per day.The rats were sacrificed and the gingival tissues were examined for the detection of IL-6 and PGE2 expression by ELISA,and NF-κB expression by immunohistochemistry.Results:Histology revealed apical migration of junctional epithetlium and crestal alveolar bone resorption in group B and D,and in the above phenomena of group D was the severest.The content of NF-κB,IL-6 and PGE2 in group B,C,D was higher than that in group A(P <0.05),and in group D was the highest(P <0.05).Conclusion:Chro-nic intermittent hypoxia can aggravate the inflammation of periodontitis.
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OBJECTIVE@#To explore the value of fiber laryngoscope in the diagnosis of congenital laryngeal stridor (CLS).@*METHOD@#The clinical data of One hundred and thirty children who had been examen by laryngofiberscopy and had laryngeal stridor were analyzed retrospectively.@*RESULT@#We found 73 children having CLS, 2 children having laryngeal web, 5 children having congenital epiglottic cyst, 20 children having mass and cyst of tongue root, 1 child having laryngocele, 3 children having laryngeal papilloma, unilateral or bilateral cricoarytenoid joint of 9 children having poor activities, 17 children were normal.@*CONCLUSION@#CLS is misdiagnosed easily. Laryngeal strio caused by other diseases soule be excluded before CLS is diagnosed. Our proposal is that fiber laryngoscope should be used as a routine method in the diagnosis of CLS. CT and MRI could also be used if it is necessary.
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Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Laryngeal Diseases , Diagnosis , Laryngoscopy , Methods , Respiratory Sounds , Retrospective StudiesABSTRACT
Objective To assess the value of MR Grs3d sequences in evaluating knee meniscal injury and complication with low field MR unit.Methods MR imaging of knee was performed in 73 patients with sagittal Grs3d,sagittal SE T1WI + PDWI.The efficiency of both sagittal Grs3d and sagittal SE T1WI+PDWI in showing knee meniscal injury and complications were evaluated comparatively.Results The rate in showing meniscal injury and complications with Grs3d sequence was higer in comparison with SE T1WI+PDWI and was of significantly different(P
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Objective To evaluate the value of CT and MRI in diagnosis and directing clinical management of vertebral burst fracture.Methods The imaging features of vertebral burst fracture in 66 cases were analyzed,including cervical vertebrae 6,thoracic vertebrae 3,thoracolumbar area 48,and lumbar vertebrae 9 cases.There were 50 male and 16 female,the average age was 35 years.CT and MRI were taken in all patients.Results CT clearly demonstrated the vertebrae and accompanying appendix fracture,spinal canal stenosis and retropulsed fragment.While MRI in showing injury and tear of ligament and intervertebral disc,abnormal signals due to spinal cord compression were superior to CT.Conclusion CT in combination with MRI in diagnosis and directing surgical management is of important value.
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Objective To evaluate the diagnostic value of three-dimensional CT(3DCT)in atlantoaxial lesions.Methods The findings of 3DCT were analyzed and compared with conventional CT and radiography in 124 patients with atlantoaxial disease.Results 124 cases of atlantoaxial lesion included fracture in 42,atlantoaxial rotatory dislocation in 73,hypoplasia of the dens in 4,and congenital atlantoaxial deformity in 5.Among the 124 cases,89 cases were diagnosed by X-ray,109 cases by conventional CT,121 cases by MIP,122 cases by SSD,124 cases by MPR and VR.Conclusion 3DCT can find the slight rotatory dislocation,so it is the most effective means for the diagnosis of atlantoaxial rotatory dislocation.3D and MPR of spiral CT are useful in the diagnosis of atantoaxial fracture.Combining conventional CT and X-ray film with 3DCT can improve the acuracy of the diagnosis.