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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.
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Objective To explore the diagnostic value of dual syringe and dual-channel direct multi-slice computed tomography venography(MSCTV) for lower extremity deep venous obstructive disease.Methods 100 patients highly suspected deep vein thrombosis by clinic wereunderwent dual syringe and dual-channel direct MSCTV.The original data processed with technology of subtraction,and put into workstation and reconstructed with maximum intensity projection(MIP),multiplanar reformation(MPR) and volume rendering (VR).Images of deep venous obstructive lesions were analysed and graded.All patients were underwent DSA in one week.Results Direct MSCTV showed that the reconstructed images and the vascular contrast were very clear.In the evaluation of deep venous,excellent proportion was 95 ％ for the inferior vena cava,94 ％ for the common iliac vein,95 ％ for the external iliac vein,95.5 ％ for the femoral vein,96.5％ for the popliteal vein and 92 ％ for the low leg vein.Direct MSCTV displayed complete and regular vein in 8 normal patients,92 cases displayed different parts and different degrees of thrombosis.On original axial images,eccentric filling defect of vascular were showed (there were 64 multiple vein occlusion cases and 28 solitary obstruction cases).The occlusion locations in deep venous were as following:3 in the inferior vena cava,67 in the common iliac vein,28 in the external iliac vein,50 in the femoral vein,26 in the popliteal vein,89 in the anterior tibial vein,35 in the posterior tibial vein and 5 in the peroneal vein.There were 7 normal patients and 93 patients with different parts and different degrees of thrombosis.Conclusion Direct MSCTV can accurately show deep vein thrombosis,which image is clear and reliable for displaying the scope and extent of lesions of the vascular and whether the collateral circulation established.Direct MSCTV has a significant clinical value in diagnosing the thrombotic disease of deep vein obstructive lesions.
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Objective The hepatitis B virus (HBV) core protein assembly inhibitors GLS4JHS could destroy HBV capsid assembly and the formation of non-capsid polymer structure.The aim of this study is to explore the mechanisms of GLS4JHS in inhibiting HBV replication.Methods HepAD38 cells was used as the study model.TaqMan real-time polymerase chain reaction (PCR) and quantitative real-time PCR with specific primers were used to measure the change in pregenomic RNA (pgRNA) and covalently closed circular DNA (cccDNA) levels under different concentrations.ChIP assay in HepAD38 cells was used to assess the recruitment of HBV core protein and histone modifications.Results The amount of cccDNA and pgRNA decreased with the increasing GLS4JHS concentrations.After the drug concentrations reached 400 nmol/L, cccDNA and pgRNA declined by 94% and 84%, respectively.Both HBV core protein occupancy on the cccDNA and cccDNA-bound H3 histone acetylation were reduced by GLS4JHS.Conclusions GLS4JHS decreases transcriptional activity of cccDNA and reduces pgRNA production by inhibiting cccDNA minichromosome bound to HBV core protein and acetylated histone H3, which results in HBV DNA formation.
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Objective To explore the value of 3‐dimensional volumetric diagnosis system in quantitative measurement of pulmona‐ry lobar volumetry using a 64 row MDCT .Methods Seventy‐seven adult volunteers were scanned twice on a 64 row MDCT at the end of the maximum inspiratory and maximum expiratory end respectively .On a volumetric computer‐aided diagnosis system ,the en‐tire lung was semiautomatically separated into 5 anatomy lobes including the right upper lobe ,right middle lobe ,right lower lobe ,left upper lobe ,and left lower lobe .Each lobar volume was measured .Results The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in male volunteers were 1 303 .90 mL and 938 .31 mL ,1 276 .90 mL and 737 .69 mL , 1 204 .47 mL and 678 .67 mL ,1 048 .49 mL and 754 .83 mL ,519 .53 mL and 407 .86 mL at the end of the inspiratory and expiratory respectively .The lung volume of left upper lobe ,right lower lobe ,left lower lobe ,right upper lobe ,right middle lobe in female volun‐teers were 915 .78 mL and 666 .23 mL ,913 .87 mL and 576 .62 mL ,822 .17 mL and 509 .30 mL ,734 .20 mL and 530 .23 mL ,389 .13 mL and 316 .70 mL at the end of the inspiratory and expiratory respectively .The values of each lobe volume between the full inspiration phase and expiration phase group showed significant difference the same sex group (P<0 .05) .The values of each lobe volume in the man group were significantly larger than those of female group in both respiratory phase (P<0 .05) .Of the D‐value in the each lobe volume in 5 anatomy lobe at full inspiration phase and expiration phase in both sex group ,both of the lower lobes were the largest , followed by the left upper lobe ,right upper lobe and right middle lobe .The D‐value in the each lobe volume at full inspiration phase and expiration phase in the man group were significantly larger than those of female group .Conclusion Three‐dimensional volumet‐ric diagnosis system and 64 row MDCT images can be used to assess the volume of each lung lobe .
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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.
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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.
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In this paper,to evaluate the existence and extent of MRI artifacts caused by frequently used metallic dental materials and to compare the influence of different MRI sequences on artifacts. The artifact of Au-Pt-Pd alloy crown were the smallest and Au-Ag-Pd alloy crown, pure Titanium crown were smaller. But the artifact of Ni-Gr alloy crown were the largest.With the same scan sequences, the different metal materials can make different effects on MRI images with the different scan sequences, the MRI artifact is not obvious caused by the same metal materials. Artifacts produced by oral metallic materials related closely to the type of the materials.The high quality MRI can be gained by choosing proper metallic materials.
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OBJECTIVE@#The utility of virtual endoscopy is compared to fiberoptic endoscopy and was also investigated with respect to accuracy of diagnosis and reproduction of images in patients with obstructive sleep apnea hypopnea syndrome (OSAHS).@*METHOD@#Twenty-one patients with OSAHS were examined by helical spiral CT axial images and fiberoptic endoscopy. The helical spiral CT axial data was reconstructed using a VE software program. The results were compared to the fiberoptic endoscopic findings done by the otolaryngologists. All the patients were examined both in the sleeping and nonsleeping status. The dimensions of soft palate, uvula, lingua and epiglottis region were evaluated.@*RESULT@#The results both in the virtual endoscopy evaluation and fiberoptic endoscopy was statistically significant difference in all of region. In the palate region, there was statistically significant difference in the left-and-right dimension, but no difference in the fore-and-aft dimension both in the sleeping and nonsleeping status.@*CONCLUSION@#The dimensions of upper airway were more difference between in the sleeping and nonsleeping status. The change of dimension was more in the left-and-right; the fiberoptic endoscopy has more diagnostic significance in evaluation of dynamic movement of the upper airway; virtual endoscopy evaluation of the upper airway was accurate in assessing stenosis width and length; virtual endoscopy added more information about anatomic structure and pathological change of the upper airway.
Sujets)
Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Endoscopie , Méthodes , Laryngoscopie , Syndrome d'apnées obstructives du sommeil , Diagnostic , Imagerie diagnostique , Tomodensitométrie hélicoïdale , TomodensitométrieRésumé
Objective To study the finding and patterns of chronic inflammatory sinonasal disease on CT. Methods All of 93 patients with chronic inflammatory sinonasal disease by clinical observations and operation,the appearances and patterns of chronic inflammatory sinonasal disease were analyszed.Results Six radiological patterns of inflammatory sinonasal disease were identified:( 1) infundibular,16/93 or 17%;( 2) osteaomeatal unit,27/93 or 28% ; (3) sphenoethmoidal recess,5/93 or 6%;(4) sinonasal polyposis,17/93 or 18%;(5) sporadic ( unclassifiabal ) ,13/93 or 14%;(6) mixing pattern,15/93 or 16% .Conclusion Assignment of patients to radiological patterns allows tailored endoscopic sinonasal surgical approach.