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Objective:To investigate the value of preoperative MRI measurements of hamstring (semitendinosus+gracilis) tendon cross-sectional area in predicting intraoperative graft diameter for anterior cruciate ligament reconstruction (ACLR).Methods:A total of 265 preoperative MRI were retrospectively collected in the Third Affiliated Hospital of Southern Medical University from January 2013 to August 2020 for patients who underwent single-bundle ACLR of hamstring tendon. Patients were divided into a graft diameter≥8 mm group (129 patients) and a graft diameter<8 mm group (136 patients) according to intraoperative graft diameter. The cross-sectional areas of the semitendinosus and gracilis tendons were measured at the largest level of the femoral condyle on preoperative MRI cross-sectional images, and the two were summed to obtain the cross-sectional area of the hamstring tendon. The independent samples t-test was used to compare the differences in the cross-sectional area of each tendon between the graft diameter≥8 mm group and the graft diameter<8 mm group. The Spearman correlation analysis was used to assess the correlation between tendon cross-sectional area and intraoperative graft diameter. Multi-factor logistic regression analysis was used to screen the influence of tendon cross-sectional area on intraoperative graft diameter. The effectiveness of intraoperative graft diameter≥8 mm was assessed by plotting the receiver operating characteristic curves. Results:Intraoperative measurement of graft diameter was 7.5 (7.5, 8.0) mm. The cross-sectional area of the popliteal tendon was (21.4±4.6) mm 2 in the graft diameter≥8 mm group and (15.6±3.7) mm 2 in the graft diameter<8 mm group. Statistically significant differences were found in the cross-sectional areas of the semitendinosus, soleus and hamstring tendons between the graft diameter≥8 mm group and graft diameter<8 mm group ( t=-10.26, -10.29, -11.47, P<0.001). Intraoperative graft diameter was positively correlated with the cross-sectional area of the semitendinosus, gracilis, and hamstring, with correlation coefficients of 0.57 ( P<0.001), 0.58 ( P<0.001), and 0.62 ( P<0.001), respectively. Multi-factor logistic regression showed that popliteal tendon cross-sectional area was a predictor of intraoperative graft diameter (OR=1.45, 95%CI 1.32-1.59, P<0.001). The area under the curve for popliteal tendon cross-sectional area to predict intraoperative graft diameter≥8 mm was 0.838 (95%CI 0.792-0.885), with a critical value of 20.0 mm 2, a sensitivity of 0.581, and a specificity of 0.941. Conclusion:The measurement of the cross-sectional area of the hamstring muscle on preoperative MRI can predict the diameter of the autologous hamstring graft of ACLR.
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Objective To assess the diagnostic value of coronary CTA (CCTA) combined myocardial CT perfusion imaging (CTP) in coronary artery disease (CAD) with Meta-analysis.Methods Chinese and English literatures evaluating CCTA combined CTP in diagnosis of CAD in PubMed,Wed of Science,Cochrane Library,China National Knowledge Infrastructure (CNKI) and Wanfang Periodical Database from inception to December 2016 were searched.The extraction was conducted according to the criteria for diagnostic recommended by Cochrane Method Group.The quality of included studies was assessed with quality assessment of diagnostic accuracy studies-2 instrument.The statistical analysis was performed by Meta-disc 1.4 software,the diagnosis efficacy was calculated and the symmetric receiver operating characteristic curves (SROC) was drawn to obtain the area under curve (AUC).Results Five studies involving a total of 611 vessels were included.The pooled sensitivity (SEN),specificity (SPE),diagnostic odds ratio (DOR),positive likelihood ratio (PLR),negative likelihood ratio (NLR) were 0.96 (95％CI [0.92,0.98]),0.91 (95％CI [0.88,0.94],206.14 (95％CI [100,424.94]),9.33 (95％CI [5.57,15.61]),0.06 (95％CI [0.03,0.13]),respectively.The AUC of SROC was 0.977.Conclusion CCTA combined CTP has significant value in diagnosis of CAD.