Résumé
Objective To investigate the onset of liver inflammation and related predictive factors in patients with HBeAg-positive chronic hepatitis B virus (HBV) infection who have normal alanine aminotransferase (ALT) and a high viral load. Methods A retrospective analysis was performed for the clinical data of 183 patients with HBeAg-positive chronic HBV infection who had normal ALT and a high viral load and were treated from October 2008 to May 2015, and according to the results of liver biopsy, they were divided into hepatitis group and non- hepatitis group. The t -test or Mann-Whitney U testwas used for comparison of normally distributed continuous data between groups, the chi-square test was used for comparison of categorical data. The predictive factors were analyzed by univariate binary logistic regression, the multivariate binary logistic regression was carried out by stepback method, and the cut-off values were analyzed by receiver operating characteristic curve (ROC) and Jordan index. Results There were 37 patients (20.2%) in the hepatitis group and 146 patients (79.8%) in the non-hepatitis group. Compared with the non-hepatitis group, the hepatitis group had a significantly lower proportion of male patients (45.9% vs 68.5%, χ 2 =6.508, P =0.011), a significantly higher level of aspartate aminotransferase [24 (21.25~35.55) U/L vs 21.2 (18.08~ 24.65) U/L, Z =-3.344, P =0.001], and a significantly lower log(HBsAg) value [4.4(4.28~4.49) vs 4.46(4.4~4.74), Z =-2.184, P =0.029]. Log(HBsAg) value was a predictive factor for hepatitis (odds ratio=0.077, P =0.017), and the cutoff value of HBsAg was 33884.4I U/mL. Conclusion Among the patients with HBeAg-positive chronic HBV infection who have normal ALT and a high viral load, 20.2% have liver inflammation, and HBsAg may be a predictive factor for liver inflammation.
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Objective: To observe cervical changes in pregnant women at high risk of preterm delivery with MRI. Methods: Twenty high-risk preterm women (observation group) and 20 non-preterm women (control group) were collected. T2WI and DWI signals, cervical length, the width of inner cervix and ADC values were measured and compared between 2 groups. Results: In observation group, the length of cervix was significantly shorten, with an average (25.16±15.68)mm, while the width of inner cervix was widen like bell-mouthed, with an average (20.46±1.82)mm. On sagittal T2WI and DWI, signal of in subglandular region increased in observation group. The mean ADC value of cervical subglandular region was (1.87±0.52)×10-3 mm2/s and the mean ADC value of cervical stromal layer was (1.50±0.43)×10-3 mm2/s in observation group, while in control group was(1.37±0.06)×10-3 mm2/s and(1.27±0.08)×10-3 mm2/s, respectively (both P<0.05). Conclusion: MRI can display cervical changes of pregnant women at high risk of preterm delivery, having great value for early prediction and clinical intervention of premature delivery.
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Objective To investigate the clinical value of routine MRI and functional imaging modality in the diagnosis of neonatal hypoglycemic encephalopathy.Methods Twelve diagnosed cases of neonatal hypoglycemic encephalopathy were obtained.Routine MRI sequence and DWI and SWI were performed in all cases.The MRI findings of each sequence as well as the sensitivity and the effect of each sequence were analyzed.Results The lesions were mainly located in corpus callosum (1 2 cases)followed by white matter of occipital lobe,frontal lobe and temporal lobe.Bilateral symmetrical distribution was found in 6 cases.The lesions were manifested as dot and flake like shape with different sizes,low signal intensity in T1WI,high in T2WI,bright in DWI and low in ADC maps and low SWI signal lesions.The total number of lesions in each sequence were displayed as follows:31 lesions in DWI,10 lesions in FLAIR,9 lesions in T2WI,6 lesions in T1WI and 5 lesions in SWI.The signal values were 1 898.30±290.46 and 933.71± 450.34 in T2WI and DWI respectively.The signal to noise ratio in T2WI and DWI were 9.28±5.73 and 22.40±15.59 respectively, and the DWI contrast signal ratio was significantly higher than that of T2WI (F=7.48,P=0.012).Conclusion The signal features and distribution of MRI in neonatal hypoglycemic encephalopathy are characteristic.DWI is more sensitive than other sequences in displaying lesions and SWI sequence could detect micro hemorrhagic foci.MRI routine sequence with function imaging is a valuable method for the diagnosis of neonatal hypoglycemic encephalopathy.