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Objective To investigate the value of endorectal ultrasonography (ERUS) and MRI examination in the preoperative evaluation of T staging and circumferential resection margin (CRM) of rectal cancer.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 193 patients [122 males and 71 females,age (60± 12)years with the range of 26-90 years] who underwent radical resection of rectal cancer at the First Hospital of Jilin University from May 2016 to January 2018 were collected.All patients underwent ERUS and MRI examination before surgery,total mesorectal excision during surgery and postoperative pathological examination.Postoperative pathological results as the gold standard,the sensitivity,specificity in T staging and the CRM diagnostic coincidence rate of rectal carcinoma by ERUS and MRI examination are evaluated.Observation indicators:(1) evaluation of T staging of rectal cancer by ERUS and MRI examination;(2) evaluation of CRM in rectal cancer by ERUS and MRI examination.Measurement data with normal distribution were represented as Mean±SD.Sensitivity,specificity and coincidence rate were calculated by chi-square test of paired fourfold table.McNemar test was used to compare the coincidence rate of T staging between ERUS and MRI examination.Consistency between CRM measurement by ERUS examination and pathological examination of rectal cancer was conducted by Kappa analysis.Fisher exact probability test was used to compare the coincidence rate of positive CRM between ERUS and MRI examination.Results (1) Evaluation of T staging of rectal cancer by ERUS and MRI examination.The overall coincidence rate of T staging of rectal cancer and coincidence rates of T1,T2,T3,T4 staging by ERUS examination were 74.61％ (144/193),93.78％ (181/193),80.83％ (156/193),79.79％ (154/193) and 94.82％ (183/193),respectively.The sensitivity ofT1,T2,T3 and T4 staging was 55.56％ (10/18),77.50％ (31/40),78.46％ (102/130),20.00％ (1/5),and the specificity was 97.71％ (171/175),81.70％ (125/153),82.54％ (52/63),96.81％ (182/188),respectively.The overall coincidence rate of T staging of rectal cancer and coincidence rates of T1,T2,T3,T4 staging by MRI examination were 50.78％ (98/193),90.67％ (175/193),74.09％ (143/193),58.55％ (113/193) and 78.24％ (151/193),respectively.The sensitivity of T1,T2,T3 and T4 staging was 0 (0/18),17.50％ (7/40),68.46％ (89/130),40.00％ (2/5),and the specificity was 100.00％ (175/175),88.89％ (136/153),38.10％ (24/63),79.26％ (149/188),respectively.There was statistically significant difference between the overall coincidence rate of ERUS and MRI examination for T staging of rectal cancer (x2 =8.631,P＜0.05).(2) Evaluation of CRM in rectal cancer by ERUS and MRI examination.The sensitivity and specificity of positive CRM evaluation of rectal cancer by ERUS examination were 100.00％ (5/5) and 97.34％ (183/188) respectively,and the coincidence rate with results of pathological examination was 97.41％ (188/193),showing a high consistency between positive CRM evaluation of rectal cancer by ERUS examination and pathological examination (Kappa value =0.655,P ＜ 0.05).The sensitivity and specificity of positive CRM evaluation of rectal cancer by MRI examination were 40.00％ (2/5) and 92.02％ (173/188),and the coincidence rate with pathological examination was 90.67％ (175/193),respectively,showing a high consistency between positive CRM evaluation of rectal cancer by MRI and pathological examination (Kappa value =0.206,P＜0.05).There were statistically significant differences in the diagnostic coincidence rate and specificity of CRM positive evaluation for rectal cancer between ERUS and MRI examination (x2 =5.896,P＜0.05).Conclusion ERUS examination has a high coincidence rate in the preoperative T staging of rectal cancer and a high consistency between positive CRM evaluation of rectal cancer with pathological examination,which are superior to MRI examination in the two aspects.
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Objective To study the value of video EEG combined with MRI in the diagnosis of intractable epilepsy.Methods40 patients with intractable epilepsy treated in our hospital from 2013 to 2015 were selected as the subjects.In 40 patients, 26 patients with hippocampal sclerosis, 2 cases of patients with temporal lobe atrophy with cerebral dysplasia, 4 cases of patients with cerebral gray matter and macrogyria, 3 cases of vascular malformation, 1 cases of patients with intracerebral cyst, 2 cases of patients with glioma, 2 cases of patients with traumatic epilepsy.Retrospective of The clinical data of the selected patients were analyzed and the manifestations of epileptic foci were reflected by MRI, The use of video EEG was used to detect the status and source of EEG during epileptic seizure and epilepsy Analysis, combined with MRI scan and video EEG results, control surgery pathological changes, analysis of the results, draw conclusions.ResultsThere were 21 cases of the accurate location of interictal EEG.The accuracy was 52.5%, and the accuracy of the location of epileptogenic foci was about 40, and the accuracy was about 100%.The accuracy of MRI in the diagnosis of epileptic foci and related lesions was 35 cases, the accuracy rate was 87.5%, and the number of lesions was qualitative and accurate in the case of 30 cases, with an accuracy rate of 75%.ConclusionVideo EEG combined with MRI examination for drug refractory epilepsy diagnosis has important clinical value, can make a more accurate diagnosis of patients with epileptogenic foci, provide information for surgical treatment of intractable epilepsy patients, with further clinical promotion and application significance.
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Objective To explore a method that restrain and dispel motion artifacts of MRI examination for better image quality and higher working efficiency.Methods The sponge package of CT tube was used to design and make sponge cushions in types of 2 cm?7.5 cm?22 cm,3 cm?7.5 cm?22 cm and 4 cm?7.5 cm?22 cm,which were used to MRI examination by quadrature coil of brain.Results The method of"adding cushion" was adopted to examine brain of MRI in 2 638 cases.Among them,2 633 cases were successfully scanned,which accounts for 99.81%;5 cases failed,accounts for 0.19%.For the failed cases,4 cases were successfully scanned in the second time by using medical bandage in cooperation,while 1 case failed.Conclusion The method of"adding cushion" in routine MRI examination of brain can restrain and dispel motion artifacts,improving image quality and work efficiency.It is an easy,reliable,ideal method for restraining and dispelling motion artifacts in brain MRI examination.