ABSTRACT
BACKGROUND:The ankle joint is capable of flexion and extension, including plantar flexion and dorsiflexion, to act as a support and a lever. An ankle injury, often accompanied by fracture and ligament injury, seriously threatens the ankle joint function. Previous diagnosis of ankle injury mainly relied on clinical signs and X-ray examination. However, X-ray examination is not accurate enough for ankle injury diagnosis because it cannot clearly diagnose damage to the surrounding ligaments, tendons and other soft tissues except for obvious fractures. Mutlisequence and multiplanar MRI is currently the optimal noninvasive method for high-resolution determination of soft tissue deformations, but little has been reported on the diagnostic accuracy of ankle ligament and tendon injury. OBJECTIVE:To observe the diagnostic value of MRI for ligament and tendon injury of the ankle in its normal position, and during complete plantar flexion and dorsiflexion. METHODS:It is a single-center, prospective, diagnostic trial that wil be completed at the First Hospital of Hebei Medical University, China. Sixty cases were recruited, including 30 cases of normal ankle joint and 30 cases of ankle ligament and tendon injury. MRI scans of the ankle joint in normal position, complete plantar flexion and complete dorsiflexion were performed in al the cases, and the multi-position MRI results were compared. The primary outcome measure is the sensitivity of MRI to ligament and tendon injury of the ankle during complete plantar flexion. The secondary outcomes include the specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of MRI to ligament and tendon injury of the ankle during the complete plantar position as wel as rate of correct diagnosis;specificity and sensitivity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio in normal position or during the complete dorsiflexion as wel as rate of correct diagnosis;the morphology of the ankle on the multi-position MRI. This study design was registered at ClinicalTrial.gov (03049423) on February 8, 2017. This study protocol has been approved by the Medical Ethics Committee of Qinghai University Affiliated Hospital of China (approval No. 2015076) and wil be performed in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. Signed informed consent regarding trial procedure and treatment was obtained from each volunteer. DISCUSSION:This study aims to determine the rate of correct diagnosis of ankle ligament and tendon injury using the MRI, to clarify the diagnostic value of MRI for ankle ligament and tendon injury, and to provide a quantitative MRI diagnostic standard for developing a reasonable surgical treatment.
ABSTRACT
Objective To explore the changes of white matter microstructure by using DTI in children with developmental delay (DD)with normal routine MRI results.Methods We performed routine MRI and DTI in 23 children with DD and 23 age-matched normal children,FA values of five deep white matters (limb of internal capsule,anterior limb,genu and knee of corpus callosum and optic radiation)and four shallow white matters (frontal lobe,temporal lobe,occipital cortex,centrum ovale)were measured.FA values of the white matter for two groups were assessed by paired t tests for each region of interest.Results FA values on the deep white matter for DD,and on the deep white matter and the shallow white matter for normal development group increased with age significantly (P 0.05).The FA values on the shallow white matter and deep white matter (corpus callo-sum knee,optic radiation)for children with DD were lower than that for the control group (P 0.05).Conclusion DTI may detect the changes of white matter microstructure in children with developmental delay,and provides an objective basis for quantitative diagnosis.
ABSTRACT
Objective To evaluate the value of diffusion tensor imaging (DTI)in diagnosing MCI.Methods DTI and conventional MRI were performed in 26 patients with MCI and 26 age-matched normal control subjects (NC).FA were measured in the 10 select-ed white matter regions,included bilateral frontal lobe,temporal lobe,parietal lobe,parahippocampal gyrus and cingulate gyrus,in the patients with MCI (n=26)and NC (n=26).FA of each ROI (region of interest)between the patients and controls were com-pared by using independent sample t-test.The correlation between the FA values and the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)scores was analyzed by using Spearman correlation analysis.Results Compared with NC,the FA values of the right frontal lobe,temporal lobe white matter and bilateral cingulate gyrus in the patients were significant-ly reduced (P <0.05).FA values of the left temporal lobe,right frontal lobe and bilateral parahippocampal gyrus were significant correlated with MoCA scores,and FA values of the bilateral parahippocampal gyrus were significant correlated with MMSE scores (P <0.05).Conclusion DTI can be used as a diagnosis index of MCI.It has important value in early intervention and improving the quality of life of patients to early diagnosing MCI.
ABSTRACT
Purpose To investigate the correlation between the brain white matter changes of MR diffusion tensor imaging (DTI) and cognitive function in the patients with mild cognitive impairment. Materials and Methods The patients (40 cases) were classified into two groups:group A (20 patients with ischemic foci in the deep white matter ) and group B (20 patients without ischemic foci in the deep white matter), and 20 normal controls was enrolled. Conventional MRI, DTI, mini-mental state examination (MMSE) and montreal cognitive assessment (MoCA) were applied, then fractional anisotropy (FA) value and apparent diffusion coefficient (ADC) value were compared among three groups. The scores of MoCA was analyzed between the patient groups. Results The decreased FA value, increased ADC value and decreased MoCA scores was demonstrate in group A, and showed significant difference compared with group B (t=-4.229,-3.251,-7.533,-2.702,-2.660;P<0.05). The increased ADC value and decreased FA value in the frontal and hippocampus region were detected in group B compared with normal controls (t=-7.790,-2.785,-4.415,-5.164;P<0.05). Conclusion The early and special structural changes can be detected using DTI compared with conventional MRI. The severe white matter lesions can be demonstrated in the patients with ischemic foci in the deep white matter, who is prone to dementia.