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Resumen Introducción : Las diferentes modificaciones estructu rales que han sido descritas en el corazón del deportista de alto rendimiento dependen de factores como la edad, el género, el tipo de deporte, la intensidad y el tiempo dedicados al entrenamiento. Objetivos : Evaluación de atletas de élite por medio de la ecocardiografía para la descripción de la estructura y la función cardíacas, y la comparación entre deportistas de resistencia cardiorrespiratoria y el resto de los deportistas. Métodos : Realizamos el examen ecocardiográfico en 224 deportistas de élite, 96 mujeres y 128 varones con edades de 15 a 38 años (21.7±5.3 años) y se dividieron en 2 grupos: "Grupo de Resistencia" (resistencia cardiorres piratoria) y "Grupo de no Resistencia" el cual incluyó al resto de los deportes. Se realizó la comparación univaria da de 14 variables ecocardiográficas entre los dos grupos. Resultados : En los hombres se identificaron valores estadísticamente significativos más altos en el grupo de resistencia para septum interventricular, pared posterior, grosor parietal relativo, índice de masa del ventrículo iz quierdo y aurícula izquierda. En las mujeres, el grupo de resistencia tuvo valores de frecuencia cardíaca más bajos con diámetro diastólico e índice de masa del ventrículo izquierdo, significativamente mayores. Conclusiones : La mayoría de las variables ecocar diográficas mostró valores mayores en los atletas de resistencia. En los hombres del Grupo de Resistencia, predominó la hipertrofia excéntrica con mayor incre mento en el grosor parietal y del diámetro de la aurícula izquierda, mientras que en las mujeres las variables indi caron hipertrofia excéntrica a expensas de un aumento del diámetro del ventrículo izquierdo, sin incremento del grosor parietal.
Abstract Introduction : The different structural modifications that have been described in the heart of the high-per formance athlete depend on factors such as age, gender, type of sport, and the intensity and time dedicated to training. Objectives : Evaluation of elite athletes through echo cardiography for the description of cardiac structure and function, and the comparison between athletes with cardiorespiratory endurance and the rest of the athletes. Methods : We performed the echocardiographic ex amination in 224 elite athletes, 96 women and 128 men aged 15 to 38 years (21.7±5.3 years) and they were di vided into 2 groups: "Endurance Group" (cardiorespira tory endurance) and "Non-Endurance Group" which included the rest of the sports. Univariate comparison between the two groups was performed by measuring 14 echocardiographic variables. Results : In men, statistically significant higher values were identified in the endurance group for interventricu lar septum, left ventricular posterior wall, relative wall thickness (RWT), left ventricular mass index and left atrial dimension. In women, the endurance group had signifi cantly lower heart rate values, and significantly higher left ventricular diastolic dimension with normal RWT. Conclusions : Most of the echocardiographic vari ables showed higher sample means in the endurance athletes. In the subgroup of men from the Endurance Group, eccentric hypertrophy prevailed with a greater increase in wall thickness, as well as in the diameter of the left atrium, while in women the variables indicated eccentric hypertrophy at the expense of an increase in left ventricle diameter, without increased wall thickness.
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Cardiac disease is an important cause of maternal morbidity and mortality. It can invariably affect fetus with variable intensity depending upon nature of cardiac disease in mother. Cardiac disease can affect women antenatally, in labor and even in post-partum period. It is a case series of 12 cases who presented to labor room in a particular unit at SSG hospital, Baroda over a period of 1 year starting from 1st May 2022 to 30th April 2023. Mean age at presentation was 24.8. 3 women were having valvular heart disease while 4 were having peri-partum cardiomyopathy (PPCM), 4 were having atrial septal defect (ASD), 1 was having ventricular septal defect (VSD). Associated medical comorbidities and obstetrical factors were evaluated. 2D ECHO findings of all cases were recorded. Risk assessment must be done for the mother and fetus to minimize the effect of cardiac disease in pregnancy. Joint consultation with cardiologist should be done in already known case of cardiac disease.
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Pituitary tumors are growths that form in the gland these tumors are rare representing 10-15% of all brain tumors. They can disrupt the production of hormones, in the body leading to symptoms related to hormone imbalance. This review offers an overview of the methods used for diagnosing and treating tumors. It is worth noting that relying solely on references may restrict the scope and depth of discussions about tumors in this paper. Suggestions for research include exploring diagnostic tools like molecular imaging and liquid biopsy to enhance early detection and accurate assessment of these tumors. Additionally, more research is required to understand the long-term effects and quality of life outcomes for patients undergoing treatment options for tumors. In conclusion, significant progress has been made in diagnosing and treating tumors over time. Advances in imaging technologies such as diffusion-weighted imaging and magnetic resonance spectroscopy have enhanced precision and treatment strategies for these tumors. The discussion also covers the roles of surgery, radiation therapy and medical interventions, in managing tumor growth and hormonal imbalances further advancements, in research and innovation are crucial, for enhancing our knowledge and treatment of tumors ultimately bringing outcomes for both patients and healthcare professionals.
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Objective To evaluate the gender differences in fat water fraction(FWF)related to fat metabolism in supraclavicular region of neck with iterative decomposition of water and fat with echo asymmetry and least square estimation iron quantification(IDEAL-IQ)sequence quantitatively.Methods Twenty healthy female and twenty healthy male volunteers were selected for a MRI examination with IDEAL-IQ,then the FWF of R2*,brown adipose tissue(BAT)and white adipose tissue(WAT)were obtained by post-processing.The differences of FWF between the two groups were compared by Mann-Whitney U test.Results There was sig-nificant difference in the FWF of BAT and WAT between the two groups(P＜0.05).The FWF of BAT in the female was higher than that the male,and the FWF of WAT in the male was higher than that the female,there was no significant difference in the R2*between the two groups(P＞0.05).Conclusion IDEAL-IQ sequence can be used to evaluate the FWF in supraclavicular region of neck quantitatively,and classify BAT and WAT,then provide clinical according to the quantitative study of fat content.
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Objective To explore the feasibility of the multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)sequence in neck MRI,and to compare with traditional single-shot echo-planar imaging diffusion weighted imaging(SS-EPI-DWI)sequence.Methods Thirty healthy volunteers underwent MUSE-DWI and SS-EPI-DWI sequences scanning in neck.Two groups of images were independently scored by two radiologists for magnetic sensitivity artifact,chemical shift artifact,geometric distortion and overall image quality.The noise,signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)of the regions of interest(ROI)of the two groups of images were measured and compared on the nasopharyngeal fossa layer,parotid gland layer,glottic layer and thyroid layer.Results Qualitative analysis showed that the image quality scores of MUSE-DWI sequence were significantly better than those of SS-EPI-DWI sequence in terms of magnetic sensitivity artifact,chemical shift artifact,geometric distortion and overall image quality(P<0.001).Quantitative analysis showed that the noise values of ROIs of MUSE-DWI sequence were significantly lower than those of SS-EPI-DWI sequence(P<0.001).The SNR and CNR of ROIs of MUSE-DWI sequence were higher than those of SS-EPI-DWI sequence(P<0.001).Conclusion MUSE-DWI sequence can significantly reduce geometric distortion,magnetic sensitivity artifact and chemical shift artifact,and SNR and CNR of images are significantly increased compared with SS-EPI-DWI sequence,which is more suitable for neck MRI scanning.
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Objective To analyze the morphological alterations of corpus callosum in children with spastic cerebral palsy(SCP)using three-dimensional magnetization prepared rapid acquisition gradient echo(3D-MPRAGE)technology and to investigate the correlation between morphological indexes and gross motor function.Methods Sagittal T1WI 3D-MPRAGE data was collected from 136 children with SCP(SCP group)and 132 age-and gender-matched healthy controls(HC)(HC group),and the gross motor function measure-88(GMFM-88)was applied to assess the gross motor function.Independent sample t-test was used to compare the corpus callosum surface area,volume,maximum anterior-posterior diameter,median sagittal area(total area and area of Ⅰ-Ⅴ zone)between the two groups.Partial correlation analysis was performed to calculate the correlation between morphological indexes of the corpus callosum and GMFM-88 with age as a covariate.Results Children under 3 years old,the corpus callosum surface area of the SCP group(3 914.51 mm2±1 207.97 mm2)was lower than that of the HC group(5 725.51 mm2±1 412.66 mm2).The volume of the corpus callosum(6 108.46 mm3±2 803.97 mm3)in the SCP group was lower than that of the HC group(11 297.96 mm3±4 109.02 mm3).Also,the maximum anterior-posterior diameter of the corpus callosum in the SCP group(53.40 mm±6.31 mm)was lower than that of the HC group(57.74 mm±6.04 mm)(all P<0.05).Children over 3 years old,the corpus callosum surface area of the SCP group(4 970.06 mm2±1 191.31 mm2)was lower than that of the HC group(6 372.55 mm2±1 445.59 mm2).The volume of the corpus callosum(8 330.20 mm3±2 888.20 mm3)in the SCP group was lower than that of the HC group(13 599.82 mm3±3 429.81 mm3)(all P<0.05).Partial correlation analysis showed significant correlation between corpus callosum volume,median sagittal area and gross motor score(P<0.01)with age as a covari-ate.Conclusion The 3D-MPRAGE technology can be useful for the comprehensive assessment of morphological alterations of the corpus callosum in SCP.The corpus callosum volume,and median sagittal area may become neuroimaging references for the assess-ment of motor development in cerebral palsy(CP).
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Objectives:To investigate the relationships between vertebral marrow fat in lumbar spine and age and gender in adults using iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation(IDE AL-IQ)magnetic resonance imaging technology.Methods:The IDEAL-IQ fat fraction images from 298 subjects(Male:138,Female:160,age range:20-69 years old)were collected.All the patients were divided into 5 groups based on age,with each group spanning a range of 10 years:age range 20-29 years(Twenties):24 males,20 females;30-39 years(Thirties):47 males,39 females;40-49 years(Forties):36 males,47 females;50-59 years(Fifties):20 males,37 females;60～69 years(Sixties):11 males,17 females.The bone marrow proton density fat fration(PDFF)were measured using GE ADW4.6 processing work station.Results:In the same age group,there were differences in vertebral bone marrow PDFF between gen-ders.PDFF of L1-L5 vertebrae was significantly higher in males than females in twenties,thirties and forties(P＜0.05).In the fifties,there was no statistically significant difference in the L1-L5 vertebrae PDFF between males and females(P＞0.05);while in the sixties,the PDFF of the L1-L5 vertebrae was lower in males than that in females(P＜0.05).The PDFF of lumbar vertebral bone marrow was positively correlated with age,with a higher correlation observed in females(r=0.72,P＜0.05)than that in males(r=0.32,P＜0.05).From the age of 20 to 69,the L4 vertebra PDFF in males had the highest growth rate(21.08％),while the L1 vertebra PDFF in female had the highest growth rate(65.68％).For males,the growth of PDFF was primarily concentrated in the thirties and fifties;The PDFF of L1,L4,and L5 vertebrae showed the largest increase in the fifties,while that of L2 and L3 vertebrae had the highest increase rate in the thirties.For females,vertebral PDFF showed a slight decrease trend in the group of thirties,which gradually increased subsequently in all vertebare in the group of forties,fifties,and sixties,with the largest increase rate observed in the fifties.Conclusions:There are differences in vertebral fat distribution between males and females across different age groups,and the growth rates of vertebral PDFF also vary;the PDFF of vertebral bodies in different segments of the lumbar spine is positively correlated with age.
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Abstract Objective: Aortic Dissection (AD) is one of the most fatal acute diseases in cardiovascular diseases, with rapid onset and progression and a high fatality rate. This study aims to investigate the clinical values of non-enhancement peripheral pulse-gating rapid magnetic resonance imaging in deterministic diagnosis of AD. Methods: Aorta magnetic resonance imaging was performed in 21 healthy volunteers at a 1.5t MR scanner sequences including cardiac-gated and peripheral pulse-gated True-FISP and HASTE were carried out separately. Acquisition Time (TA), Signal to Noise Ratio (SNR), Contrast Noise Ratio (CNR), and entirety of vessel wall blood flow artifacts were measured and compared. A total of 56 AD cases were displayed by non-enhancement peripheral pulse-gating fast MR imaging, and the results were compared with pathological findings or CTA of the aorta. The dissection rupture, tear film, true and false lumen, thrombosis, hydropericardium, and the main branches of AD were evaluated respectively. Results: There were no significant differences in SNR, CNR, entirety of the vessel wall, and blood flow artifact between cardiac-gated and peripheral pulse-gated fast MR imaging. Non-enhancement pulse-gated fast scanning takes less TA time. By the pulse-gated non-enhancement fast MR imaging, the dissection rupture, tear film, true and false cavity, thrombosis, hydropericardium, and the main branches of aortic dissection were shown clearly. Multi-planar and multi-angle scans helped to show the extent of entrapment rupture, whereas partial complex tears or bi-directional tears were slightly less well visualized. Conclusion: Non-enhancement peripheral pulse-gated rapid magnetic resonance imaging can be used for deterministic diagnosis of AD.
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Background: Children with attention deficit hyperactivity disorder (ADHD) have complex unmet needs. Physicians cite lack of knowledge, skills and resources as barriers to meeting these. ECHO (Extension of community health outcomes) ADHD, a case based tele-mentoring model was designed to address gaps in physician knowledge and skills regarding ADHD. A study was conducted to assess 1. Acceptability and feasibility of the program 2. Change in knowledge, self-efficacy and perception about appropriateness and feasibility of role in ADHD diagnosis and management pre and post program. Methods: The 6-month pilot trained pediatricians, developmental pediatricians, psychiatrists, neurologists through 14 sessions comprising lectures, case discussions. Participants completed measures for knowledge (KADDS-knowledge of attention deficit disorders scale), self-efficacy, and acceptability and feasibility of role at baseline and endline. Descriptive and non-parametric analysis assessed acceptability and feasibility of program and change in knowledge, self-efficacy, appropriateness and feasibility of role. De-identified case summaries helped in analysing participant queries.Results: Sixty four percent (57/88) participants completed baseline and endline evaluations and were included. Most were pediatricians and developmental pediatricians who found the model acceptable and feasible. Significant improvement was noted in knowledge about ADHD diagnosis, self-efficacy and perceptions about appropriateness and feasibility of role. Improvement in knowledge about ADHD comorbidities and management was not significant on KADDS. Case summaries, questions to hub team, discussions indicated participant focus on ADHD diagnosis. Conclusions: ECHO ADHD is an acceptable and feasible model in low- and middle-income country (LMIC) setting which improved knowledge and self-efficacy among participants.
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Background: The echocardiogram (ECHO) has a better diagnostic performance for left ventricular hypertrophy (LVH) than the electrocardiogram (ECG), but ECG is most widely used diagnostic method. We aimed to assess the correlation between ECG based diagnosis of LVH with echocardiography-based diagnosis of LVH as standard. Methods: Patients with evidence of LVH using echocardiographic criteria were included in the study. Patients were subjected to four electrocardiographic criteria to assess the LVH: 1. Sokolow-Lyon criteria; 2. Romhilt and Estes scoring system; 3. Cornell voltage criteria; and 4. Gubner voltage criteria. After assessing the results of ECG and echocardiography diagnostic validity tests (by calculating specificity and sensitivity), the Kappa measure of agreement was performed. Results: In maximum patients (52.8%) LVH was detected by using ECG LVH Sokolow Lyon criteria, followed by Cornell voltage CR criteria that detected LVH in 38.9% cases. Sokolow Lyon ECG criteria showed high sensitivity while Romhilt and Estes criteria showed maximum 98% specificity in diagnosing LVH. Sokolow Lyon’s ECG criteria was highly sensitive in assessing all co-morbidities, except CKD where it was diagnosed better by using Cornell voltage criteria. Conclusions: In cases of diagnosing LVH in patients with co-morbidities, ECG LVH Sokolow Lyon CR was found to be the most sensitive criteria except CKD where it was diagnosed better by using Cornell voltage criteria. For assessing the patients for LVH, the role of ECG with all the commonly used criteria is of limited value and ECHO should be the method of choice.
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A autora revê o conceito de narcisismo desenvolvido por Freud e o contrapõe ao conceito de individuação de Jung. A partir do mito de Eco e Narciso e seguindo a descrição de C. Byington das funções estruturantes criativas e defensivas, a autora descreve as polaridades narcisismo ecoísmo como funções estruturantes criativas e defensivas. Faz uma releitura do mito desde a normalidade até a desestruturação psicótica das personalidades de Eco e Narciso, dentro da inter-relação criativa-defensiva da polaridade narcisismo-ecoísmo. Conclui citando Jung para ressaltar a importância da relação Eu-Tu no processo de individuação.
The author reviews the concept of narcissism in psychoanalysis contrasting it with Jung's concept of individuation. Starting with the myth of Echo and Narcissus following C. Byington's description of creative and defensive structuring functions, the author describes the narcissismechoism polarity in a similar way. She interprets the myth of Echo and Narcissus from normality to the psychotic reaction of their personalities, within the creative-defensive inter-relationship of the narcissism-echoism polarity. She concludes by quoting Jung to emphasize the importance of the ego-other relationship in the individuation process.
La autora revisa el concepto de narcisismo desarrollado por Freud y lo contrapone al concepto de individuación de Jung. A partir del mito de Eco y Narciso, y siguiendo la descripción de C. Byington sobre las funciones estructurantes creativas y defensivas, la autora describe las polaridades narcisismo-ecoísmo como funciones estructurantes creativas y defensivas. Hace una relectura del mito desde la normalidad hasta la desestructuración psicótica de las personalidades de Eco y Narciso, dentro de la interrelación creativa-defensiva de la polaridad narcisismo-ecoísmo. Concluye citando a Jung para resaltar la importancia de la relación Yo-Tu en el proceso de individuación.
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Introduction: Echocardiography is an essential investigationin patients with suspected heart failure. It provides proper assessment of valvular function, ejection fraction, chamber size etc. Material and methods: A total of 185 consecutive heart failure patients aged >18 years (mean age 58.4 years; 57.3%males) underwent 2d echo testing and findings were assessed.Data was analyzed using SPSS 21.0 software.Result: On 2-D Echo, the most common diagnosis was Ischemic Heart Disease (IHD) (n=59; 31.9%) followed by Dilated Cardiomyopathy (DCMP) (n=39; 21.1%), Ischemic Cardiomyopathy (ICMP) (n=35; 18.9%) and Rheumatic Heart Disease (n=32; 17.3%) respectively. A total of 20 (10.8%) patients were placed under other categories (3 LVH, 2 PPCM, 1 each CHD, Ebstein anomaly, LA Myxoma, mild MR/TR, Severe MR).Majority of cases (72.4%) had ejection fraction <50%. There were 51 (27.6%) cases with ejection fraction>50% .Conclusions: On 2-D Echo, the three most common diagnoses were Ischemic Heart Disease (31.9%), DCMP (21.1%) and ICMP (18.9%) respectively. Majority of cases (72.4%) had ejection fraction <50%. So we concluded that 2d echo should be done at the earliest hospital visit in heart failure patients which can impact the physician’s decision on their treatment,prognosis and long term follow-up.
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@#Objective To analyze the echocardiographic characteristics of above grade 3+ mitral regurgitation (MR) patients by 3D transesophageal echocardiography (3D-TEE) in transcatheter edge-to-edge repair (TEER) and compare the intervention rate of TEER treatment in patients with different risk stratification. Methods We retrospectively analyzed the clinical data of 91 patients with above grade 3+ MR in Anzhen Hospital between June 2021 and April 2022. There were 45 males and 46 females aged 66.5±15.9 years. According to pathogenesis, the patients were divided into different anatomical groups and risk stratification groups. There were 34 patients in a simple degenerative group (simple DMR group), 28 patietns in a complex disease group (Complex group), 14 patients in a simple ventricular functional reflux group (simple VFMR group), 9 patients in a simple atrial functional reflux group (simple AFMR group), and 6 patients in a mixed functional reflux group (mixed FMR group). All patients were examined with a unified standard of transthoracic echocardiography (TTE) and 3D-TEE to compare the characteristic three-dimensional structural changes of the mitral valve in each group. According to the three partition strategy of preoperative anatomical evaluation of TEER, the risk stratification was conducted for the enrolled patients, which was divided into three regions from light to heavy: green area, yellow area, and red area. TEER treatment intervention rate of patients with different risk stratification was calculated. Results Ant leaf angle and post leaf angle were negative in the simple DMR and Complex groups, and non-planar angle, prolapse height and prolapse volume were higher than those of the other groups (P=0.000). Ant leaf angle and post leaf angle were positive in the VFMR group and the mixed FMR group. Anterior and posterior (AP) diameter of valve ring (P=0.036), tenting height and tenting volume were higher than those of other groups (P=0.000). AP diameter, tenting height and tenting volume were changed mildly in patients with simple AFMR. MR patients in red and yellow zone achieved a 28.1% TEER intervention rate. Conclusion Standardized TTE and TEE examinations are crucial for the qualitative and quantitative diagnosis of MR in the echo core-lab. 3D-TEE mitral valve parameter can help determine the exact pathogenesis of MR and to improve the interventional rate of challenging MR patients.
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Radioactive 125I seed implantation has definite curative effect in the treatment of local liver cancer. Currently, percutaneous implantation guided by CT, nuclear magnetism or ultrasound can be adopted, which is safe and minimally invasive. However, the images of some patients with metastatic liver cancer show isodensity or iso-echo imaging under CT or ultrasound, which is easy to miss diagnosis and treatment, seriously affecting the quality of life of patients. A case of terminal cholangiocarcinoma of the biliary tract with metastasis to the liver was admitted to China-Japan Union Hospital of Jilin University. Ultrasound image showed iso-echo, and radio 125I seed implantation was performed under the guidance of contrast-enhanced ultrasound. The operation was completed according to the preoperative treatment plan.
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Objective:To explore the value of ultra-short echo time magnetization transfer (UTE-MT) techniques for quantitatively dynamic monitoring of anterior patellar tendon (patellar tendon, quadriceps tendon) changes in amateur marathon runners before and after competition.Methods:Between October 2020 and January 2021, 23 amateur marathoners in Zhuhai, aged 28-50 (40±6) years, were prospectively recruited. Three-dimensional UTE-MT and dual-echo UTE-T 2* sequence scans of bilateral knee joints were performed before, 48 hours and 4 weeks after the marathon running, respectively. Another 5 non-running volunteers were recruited for verification of sequence stability. UTE-magnetization transfer ratio (MTR) and UTE-T 2* value of the patellar tendon, quadriceps tendon, and 3 tendon-bone insertion points (patellar tendon-tibial insertion point, patellar tendon-patellar insertion point, and quadriceps tendon-patellar insertion point) were measured independently on sagittal images of the knee joint by 2 radiologists. The stability of the 2 serial measurements and consistency tests between the 2 radiologists were assessed with a two-way mixed intraclass correlation coefficient (ICC). Repeated-measures analysis of variance was used to compare the differences in UTE-MTR and UTE-T 2* values of the prepatellar tendon before and after the marathon running. Results:Both UTE-MT and dual-echo UTE-T 2* sequence measurements had good stability, with ICC values of 0.98 and 0.92, respectively. Measurements of UTE-MTR and UTE-T 2* value of the patellar tendon, quadriceps tendon, and the 3 tendon-bone insertion points by the 2 radiologists were in good agreement (ICC>0.80). Forty-eight hours after the marathon running, the UTE-MTR of the patellar tendon, quadriceps tendon, and the 3 tendon-bone insertion points decreased, and UTE-MTR of the patellar tendon continued to decrease 4 weeks after the race, while UTE-MTR of other regions increased. Only the difference in UTE-MTR for the patellar tendon was statistically significant ( F=7.46, P=0.001) among pre-marathon (0.34±0.04), 48 h after the race (0.32±0.04), and 4 weeks after the race (0.31±0.04). UTE-T 2* value was mildly elevated in all regions at 48 h after the marathon running, but the differences among the three points were not statistically significant ( P>0.05). Conclusion:The UTE-MT has better reproducibility and inter-rater reliability. The UTE-MT can be used to monitor the dynamic changes of the prepatellar tendon before and after marathon exercise, where the UTE-MTR of the patellar tendon consistently decreases after marathon exercise.
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Objective:To explore the consistency of MRI fast field echo resembling a CT using restricted echo-spacing (FRACTURE) and CT in the evaluation of knee and ankle bone changes.Methods:From November 2020 to November 2021, seventeen patients who underwent CT and MRI FRACTURE examinations of knee joint or ankle joint in the First Affiliated Hospital of Dalian Medical University were retrospectively collected, including 14 patients with knee joint examinations and 3 patients with ankle joint examinations. According to the number of joint components, 80 components were included, including 14 for femur and patella, 17 for tibia and fibula, and 3 for talus, scaphoid, medial cuneiform, medial cuneiform, lateral cuneiform and calcaneus, respectively. The fracture, hyperosteogeny, and bone destruction of the joint bones were evaluated by two observers using CT and FRACTURE images, respectively. Kappa test was used to analyze the consistency of CT and FRACTURE images between observers in the evaluation of joint bone lesions.Results:The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by CT and FRACTURE images were 0.925 (0.823-1.027), 0.905 (0.799-1.011) and 0.895(0.752-1.038) respectively for observer 1, and were 0.963 (0.892-1.034), 0.933 (0.843-1.023) and 0.886 (0.731-1.041) respectively for observer 2. The Kappa values (95%CI) of the consistency evaluation of fracture, hyperosteogeny, and bone destruction by observers 1 and 2 via CT images were 1.000 (1.000-1.000), 0.937(0.851-1.023) and 0.945 (0.839-1.051) respectively, and that by FRACTURE images were 0.962 (0.888-1.036), 0.966 (0.899-1.033) and 0.836 (0.656-1.016) respectively.Conclusion:For the evaluation of fracture, hyperosteogeny, and bone destruction of knee joint and ankle joint, MRI FRACTURE sequence is highly consistent with CT.
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Objective:To explore the value of echo-planar imaging correction (EPIC) for improving image quality of diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI) of cervical cord.Methods:A total of 33 subjects (20 males, 13 females) were scanned on a 3.0 T MR scanner from January to March 2022, and the sequences included T 1WI, DWI and DTI (with and without corrections). Two observers delineated the regions of interest (ROIs) on the fused images of DWI and DTI with T 1WI before and after correction, and measured the average diffusion coefficient (ADC), fractional anisotropy (FA), and offset distance of ROIs between images with and without corrections. The subjective scores of image quality were also evaluated. The ICC or Kappa was used to test the consistency of the quantitative measurement and subjective scores by the two observers. The average values by the two observers would be used for subsequent analysis. The independent pair t-test and Wilcoxon test were used for comparison of objective measurements and Mann-Whitney U test was used for subjective image assessments between images with and without corrections. Results:The measurement data and the subjective scores of the two observers were in good agreement (ICC 0.912-0.999, Kappa 0.778-0.816). The independent sample t-test showed the subjective scores were significantly different for the DWI and DTI images between before and after geometry and/or ADC corrections. The ADC values of C6, the offset distances measured by DWI before and after correction of C4, C5, and C6 and subjective scores were significantly different ( P<0.05); The FA values of C1 and C3, ADC values of C1 and C3, offset distance of C4, C5 and C6 measured by DTI before and after correction and subjective scores were statistically significant ( P<0.001). Conclusion:EPI geometry correction and ADC value correction can significantly reduce geometric distortion, increase image quality, and thus improve the diagnosis accuracy of essential diseases.
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Objective To observe the value of zero echo time(ZTE)3.0T MRI for detecting lung cancer nodules.Methods Totally 126 lung cancer patients(176 lung nodules)were prospectively enrolled and underwent 3.0T MR axial lung scanning,including T1-volumetric interpolated breath-hold examination(VIBE),T2-BLADE,T2-half-Fourier acquisition single-shot turbo spin-echo(HASTE)and ZTE sequences.The consistency between ZTE MRI and previous CT for displaying characteristics of pulmonary nodules was analyzed,and the sensitivity of different MR sequences for detecting pulmonary nodules were observed.Results Among 176 pulmonary nodules showed on CT,ZTE MRI detected 140 and missed 36 ones.The consistency between ZTE MRI and CT for displaying the maximum diameter and actual maximum diameter of pulmonary nodules were both good(ICC=0.954,0.943,both P＜0.001),and the difference between ZTE MRI and CT was small.The consistency between ZTE MRI and CT for displaying tracheal vascular bundles,pleural indentation and internal bronchial inflation signs were all good(Kappa=0.894,0.912,0.917),while for displaying the type and shape of nodules were both moderate(Kappa=0.661,0.501).The sensitivity of ZTE MRI for detecting pulmonary nodules was higher than that of other individual MR sequences(all P＜0.05),of combination of ZTE and T2 BLADE was higher than that of other sequence combinations(all P＜0.05).Conclusion ZTE 3.0T MRI could be used to detect lung cancer nodules,which was superior to conventional MRI.Combination of ZTE 3.0T MRI with T2-BLADE could improve the sensitivity for detecting pulmonary nodules.
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Objective To explore the diagnostic value of transcranial substantia nigra ultrasound in Parkinson's disease(PD)and the clinical characteristics of patients with different substantia nigra(SN)echoes.Methods Sixty patients with PD admitted to Yichun Hospital of Traditional Chinese Medicine from October 2020 to January 2023 were included in study group,and another 60 normal persons who received health examination in our hospital during the same period were included in control group.Both groups were examined by transcranial substantia nigra ultrasound.The SN high-echo area and ratio of total area of hyperechoic substantia nigra to total area of mesencephalon(S/M)of two groups were compared,and the positive rate of PD diagnosed by transcranial substantia nigra ultrasound was calculated.According to the intensity of SN echo,PD patients were divided into PD-SN-group and PD-SN+ group,and the clinical characteristics of patients with different SN echo were compared.Results The SN high-echo area and S/M of study group were significantly higher than those of control group(P<0.05).Transcranial substantia nigra ultrasound showed PD-SN-in 10 cases and PD-SN+ in 50 cases.The positive rate of PD diagnosed by transcranial substantia nigra ultrasound was 83.33%(50/60).There were statistically significant differences between PD-SN+ group and PD-SN-group in gender,age,H-Y stage,age of onset,score of mini mental status examination and score of Montreal cognitive assessment(P<0.05).Conclusion Transcranial substantia nigra ultrasound can better help clinical screening and detection of PD,and improve the positive detection rate of PD.
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Background: Left ventricular outflow tract obstruction (LVOTO) is commonly observed in patients with hypertrophic cardiomyopathy (HCM) or left ventricular hypertrophy (LVH). Some patients develop LVOTO provoked by physical exertion, and hence termed dynamic LVOTO (DLVOTO). However, its precise prevalence and mechanism are still unclear. Aim: Two-dimensional speckle tracking echocardiography (2D STE) seems to be helpful for the detection of early LV structural abnormalities. This study aimed to examine the possible role of segmental as well as global longitudinal strain in identifying DLVOTO non-HCM patients as detected by dobutamine stress echocardiography (DSE). Methods and results: Two hundred and fifty patients without structural heart disease had undergone conventional transthoracic echocardiography, 2D STE, and DSE. All patients with non-ischemic evidence were divided into two groups according to the DSE results; DLVOTO (þ) and DLVOTO (). Among 250 patients, 50 patients (36%) had shown DLVOTO after DSE (15 males, 35 females; mean age 55±7years). They were compared with 90 non -LVOTO obstruction patients (43 males, 47 females; mean age 57±6years). Based on multivariate logistic regression analysis, the independent predictors of provoked DLVOTO during DSE were resting basal septal longitudinal strain BS-LS average (p < 0.001), resting LA reservoir strain (p < 0.001), and systolic LVOT diameter (p ¼ 0.03). Resting BS-LS average with cut-off - 17.5% was recognized as a critical indicator of DLVOTO, with sensitivity 78%, and specificity 95% (better than systolic LVOT diameter of sensitivity 76%, and specificity 15% and resting LA reservoir strain which showed poor AUC at ROC curve 0.007). Conclusion: We demonstrate that provoked LVOTO during DSE in non HCM symptomatic patients is directly correlated to resting regional LS, where the increased BS-LS of 17.5% was a key determinant of LVOT gradient provocation. Assessment of baseline BS-LS average might be a bedside simple tool for detection of patients with DLVOTO not able to do DSE.