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Objective:To investigate the difference in left ventricular dysfunction between type 2 diabetes mellitus (T2DM) patients with hyperlipidemia and those without hyperlipidemia, and analyze the application value of three-dimensional speckle tracking technology.Methods:The clinical data of 70 patients with T2DM admitted to Heji Hospital Affiliated to Changzhi Medical College from January 2020 to June 2021 were retrospectively analyzed. Among these patients, 35 patients had hyperlipidemia and 35 patients had no hyperlipidemia. At the same time, 40 healthy subjects who concurrently underwent health checkups in the same hospital were included as healthy controls. All subjects underwent routine cardiac ultrasound and 3D-STE examinations. General clinical information and left ventricular function-related parameters, including global longitudinal strain, global circumferential strain, global area strain, and global radial strain were compared between healthy controls and T2DM patients with hyperlipidemia and those without hyperlipidemia.Results:The proportion of left ventricular remodeling increased in T2DM patients without hyperlipidemia, and the proportion of left ventricular hypertrophy was the highest in T2DM patients with hyperlipidemia. Global longitudinal strain and global circumferential strain in T2DM patients without hyperlipidemia were (-16.97 ± 2.59)% and (-17.41 ± 2.50)%, respectively, which were significantly higher than (-18.86 ± 2.46)% and (-18.71 ± 2.92)% in healthy controls ( t = 0.95, 0.57, both P < 0.05). Global longitudinal strain, global circumferential strain, and global area strain in T2DM patients with hyperlipidemia were (-14.98 ± 3.15)%, (-15.80 ± 3.16)%, (-27.17 ± 4.54)%, respectively, which were significantly higher than (-18.86 ± 2.46)%, (-18.71 ± 2.92)%, (-30.62 ± 4.02)% in healthy controls ( t = 0.46, 1.37, 0.98, all P < 0.05) and (-16.97 ± 2.59)%, (-17.41 ± 2.50)%, (-30.06 ± 3.59)% in T2DM patients without hyperlipidemia ( t = 0.37, 1.02, 0.77, all P < 0.05). Global radial strain in T2DM patients with hyperlipidemia was significantly higher than [(51.49 ± 8.94)%, t = 1.35, P < 0.05] in healthy controls and [(47.71± 8.46)%, t = 0.98, P < 0.05] in T2DM patients without hyperlipidemia. In patients with T2DM, fasting blood glucose and hyperlipidemia were independently correlated with all strain-related parameters. Conclusion:Hyperlipidemia can aggravate left ventricular remodeling and dysfunction in patients with T2DM and 3D-STE is one of the examination methods for subclinical left ventricular remodeling and dysfunction in T2DM patients with or without hyperlipidemia.
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Objective To study the imaging findings of the normal acromioclavicular joint and acromioclavicular dislocation.Methods CR films of normal shoulder in 68 cases and normal chest in 400 cases were collected.The distances of the acromioclavicular joint were measured,and the inferior cortex line of the acromioclavicular joint was observed on CR.MRI in 30 cases with normal shoulder,24 cases with acromioclavicular dislocation and 7 cases with shoulder impingement syndrome were also presented.Results The normal distance of the acromioclavicular joint was (3.36±0.44) mm.There was an arch line on the inferior cortex of the acromioclavicular joint for normal subjects.According to the Rockwood classification,acromioclavicular dislocation included type Ⅰ in 7/24 cases,type Ⅱ in 5/24 cases and type Ⅲ in 12 cases.The distances of the acromioclavicular joint were increased(＞4.3 mm) in type Ⅱ and type Ⅲ,and the inferior cortex lines of the acromioclavicular joint were not continual in type Ⅲ.MR imaging showed that the intra-articular fibrocartilaginous disk,the capsular and acromioclavicular ligament structure were ruptured in type Ⅱ,and coracoclavicular ligament torn in type Ⅲ.Conclusion The distance and the inferior cortex line of the acromioclavicular joint are of important value in diagnosis and classification of acromioclavicular dislocation.MRI is the most significant method in diagnosis of acromioclavicular dislocation.
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Objective To evaluate the apparant diffusion coefficient (ADC) values of cerebellar and the middle cerebellar peduncles in the differential diagnosis of multiple system atrophy (MSA) and Parkinson disease (PD). Methods Conventional MRI and DWI were performed in 18 clinically proved MSA patients with 7 cases of early cases (early-stage MSA group), 19 PD patients (PD group) and 18 agematched normal controls (the control group). DWI was performed using a single shot-spin echo-echo planar imaging sequences, and ADC values were measured in the ROIs (0. 16 cm2) of the bilateral cerebellum, the middle cerebellar peduncles and cerebral white matter. Then one way ANOVA test was used for statistical analysis. Results Of the 18 MSA patients, 11 had MR abnormalities, 8 had hot-cross bun sign in the pens on T2-weighted images, 11 patients had pontine, cerebellar and medulla oblongata atrophy, 10 patients had atrophy of the middle cerebellar peduncles, 2 patients had hyperintense rim of the putamen and putaminal atrophy on T2-weighted images. The ADC values in the middle cerebellar peduncles were significantly increased in the MSA group[ (0. 98 ±0. 07) × 103 mm2/s] and early-stnge MSA group [ (0. 95 ±0. 05) ×103 mm2/s] as compared to PD group [ (0. 77 ±0. 04) × 103 mm2/s] and control group[ (0. 78 ±0. 04) ×103 mm2/s]. There was statistical significant difference among them (F = 91.049,55. 301, P ＜ 0.01 ).There was no overlap in the distribution of ADC values of the middle cerebellar peduncles among the MSA group [ (0.86-1.13 ) × 103 mm2/s ], early-stage MSA group [ (0. 86-1.02 ) × 103 mm2/s ] and PD group [ (0. 68-0. 84) × 103 mm2/s] and the control group [ (0. 69-0. 82) × 103 mm2/s]. The ADC values in the cerebellum were significantly increased in the MSA group[ (0. 95 ±0. 09) × 103 mm2/s] and early-stage MSA group [ (0. 92 ±0. 07) × 103 mm2/s] as compared to PD group [ (0. 78 ±0. 05) × 103 mm2/s] and control group[ (0. 79 ± 0. 05 ) × 103 mm2/s ]. Statistically significant difference was found among them (F =39. 274,18. 623 ,P ＜0. 01 ). There was overlap in the distribution of ADC values of the cerebellum [ MSAgroup(0. 80-1.10) × 103 mm2/s,early stage MSA group (0. 80-0. 99) × 103 mm2/s,PD group(0. 72-0. 90) × 103 mm2/s,control group (0. 71-0. 87) × 103 mm2/s]. There was no significant difference among the ADC values of MSA group, MSA group(early stages) and PD group and the control group in the cerebral white matter( P ＞ 0. 05 ). Conclusions ADC values in the cerebellum and the middle cerebellar peduncles have very important significance in differential diagnosis between MSA and PD.
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Objective To study the imaging finding of the coracoclavicular ligament.Methods 400 cases of normal chest films 200 men and 200 women were collected.The presented rates of pseudoarthrosis of the coracoclavicular joints and the clavicular tuberosities which are the coracoclavicular ligament attachment were evaluated and the distances between the clavicle and coracoid process interval were measured.There were 30 cases of normal shoulder MRI,the displaying rate of coracoclavicular ligament, the length and width of the coracoclavicular ligament were measured at MR imaging.8 case with type Ⅱ(n=5) and type Ⅲ(n=3)of acromioclavicular injury were also included in this study.Results Among 400 cases(800 sides),one pseudoarthrosis(0.25%)and 198 clavicular tuberosities(24.8%)were found.The normal distance between the clavicle and coracoid process interval was (6.92±3.16)mm.On MRI study,30 cases of coracoclavicular ligament were all showed on oblique coronal slices. The acromioclavicular ligament and coracoclavicular ligament tear were found in type Ⅱ and type Ⅲ,of acromioclavicular injury respectively on MRI.The length and width of conoid ligament were(11.48±1.43) mm and (4.82±1.21) mm respectively,and the length and width of trapezoid ligament were(9.09±0.84) mm and (5.10±0.87) mm respectively.Conclusion The normal anatomic measurement standards of the coracoclavicular ligament are established on X-ray and MRI,which is important for diagnosis of coracoclavicular ligament lesions.The coracoclavicular ligament torn is showed in typeⅢ of acromioclavicular dislocation.