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Objective:To explore the value of the static and dynamic pelvic floor MRI and diffusion tensor imaging (DTI) in evaluating the morphology and function of urethra in patients with stress urinary incontinence (SUI).Methods:From July 2020 to February 2021, a total of 28 patients with SUI and 45 age-matched healthy controls were prospectively collected at the First Affiliated Hospital of Zhengzhou University. The static and dynamic pelvic floor MRI and DTI were performed for all subjects. The thickness of internal and external sphincter of middle urethra were measured on static MRI images. The functional urethral length (FUL) was measured both on static and maximal strain phase of dynamic MRI images, then the difference of FUL was calculated. The presence of bladder neck funneling and urethra opening were observed on static and dynamic MRI. The muscle fiber bundle image of urethral sphincter complex was obtained by post-processing of DTI original images. The anisotropy fraction (FA), apparent diffusion coefficient (ADC) and three eigenvalues (λ1, λ2, λ3) of annular sphincter and central longitudinal muscle in middle urethra were measured. The independent sample t test and chi-square test were used to analyse the difference of measured parameters in MRI, parameters of DTI and imaging signs between the two groups. Results:Compared with healthy controls, the SUI patients showed that the thickness of external sphincter in middle urethral and FUL in static status and maximal strain phase were significantly decreased ( t=-3.95, -5.72, -8.41, all P<0.001), the difference of FUL between static status and maximal strain phase was significantly increased ( t=4.41, P<0.001). The positive rate of bladder neck funneling in static status and maximal strain phase, urethral opening in maximal strain phase of SUI group increased significantly (χ2=23.09 , 22.25, 26.59, all P<0.001). In SUI group, the FA value of middle urethral annular sphincter decreased significantly ( t=-3.48, P=0.001), while the ADC, λ2 and λ3 values increased significantly ( t=3.19, 2.15 , 2.06, and P=0.002, 0.038 , 0.046, respectively). There was no significant difference in DTI parameters of middle urethral longitudinal muscle between the two groups (all P>0.05). Conclusions:Static and dynamic MRI and DTI techniques can objectively evaluate the changes of urethral morphology and function of SUI patients. The thinning of the external sphincter in the middle urethra, shortening of the FUL and the destruction of the microstructure of the annular sphincter fiber bundle were the main alterations of SUI patients.
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Objective To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.Methods A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.Results Of the 42 elderly patients with gastric tumors,40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42,95.2％),with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42,90.5 ％),with Kappa value of 0.718 (P ＜ 0.05).Based on gold standard of surgical pathology results,the accuracies of T1,T2,T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0％ (38/40),95.0％ (38/40),100.0％ (40/40) and 100.0％(40/40),respectively.The sensitivity and specificity of T3 and T4 stage for oral contrastenhanced ultrasonography reached to 100.0 ％.The diagnostic accuracies of N0,N1-N3,M0 and M1 by oral contrast-enhanced ultrasonography were 95.0 ％ (38/40),95.0 ％ (38/40),100.0 ％ (40/40) and 100.0％(40/40).Conclusions Oral contrast-enhanced ultrasonography is a simple,painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy,it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.
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Objective@#To investigate the diagnostic value of ultrasonography.in elderly patients with gastric tumors.@*Methods@#A total of 42 elderly patients with gastric tumors confirmed by surgery pathology underwent oral contrast-enhanced ultrasonography and electronic gastroscopy.The diagnostic effect of oral contrast-enhanced ultrasonography and electronic gastroscopy were compared based on the gold standard of surgical pathology.@*Results@#Of the 42 elderly patients with gastric tumors, 40 patients were diagnosed by oral contrast-enhanced ultrasonography and the surgical pathology(40/42, 95.2%), with Kappa value of 0.812.And 38 cases were diagnosed by electronic gastroscopy and the surgical pathology(38/42, 90.5%), with Kappa value of 0.718(P<0.05). Based on gold standard of surgical pathology results, the accuracies of T1, T2, T3 and T4 stage by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40), respectively.The sensitivity and specificity of T3 and T4 stage for oral contrast-enhanced ultrasonography reached to 100.0%.The diagnostic accuracies of N0, N1-N3, M0 and M1 by oral contrast-enhanced ultrasonography were 95.0%(38/40), 95.0%(38/40), 100.0%(40/40)and 100.0%(40/40).@*Conclusions@#Oral contrast-enhanced ultrasonography is a simple, painless and non-invasive method for the diagnosis of gastric tumors in the elderly.And its qualitative coincidence rate of the tumors diagnosis is similar to that of gastroscopy.So it can be used as the first choice for the examination of gastric tumors in the elderly.Oral contrast-enhanced ultrasonography has a high diagnostic accuracy on TNM staging of gastric tumor.When combined with electronic gastroscopy, it may provide a more reliable basis for the choice of evaluation of treatment and prognosis in elderly patients with gastric tumor.
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Sixty patients underwent surgery for malignant thoracic tumor were evenly randomized into control group (group A) and treatment group (group B).0.3 ml low-molecular-weight heparin was injected per 12 h for 3 d in group B from 24 h after surgery.Bilateral venous sonography of lower extremities were performed before and d1,d3 after operation.Blood coagulation marks PLT,PT,APTT,Fibrinogen (FIB)and D-dimer were determined at the same time.Diagnosis of calf vein thrombosis after surgery was confirmed by color Doppler sonography in 7 patients:1 in group B (3％) and 6 in group A (20％) (P ＜ 0.05 ).Thrombosis at calf intermuscular vein was found in 6 patients and thrombosis at posterior tibial vein in 1 patient.FIB and D-dimer had no significant difference on the dl ( P ＞ 0.05 ) between two groups,but significantly lower on the d3 after surgery in group B than that in group A ( P ＜ 0.05 ).Low-molecularweight heparin reduced blood hypercoagulation state and thrombosis.Color Doppler sonography can be a valuable method for detecting asymptomatic deep vein thrombosis in the early stage after surgery and monitoring the efficacy of thrombosis prevention.
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Objective To evaluate the value of preoperative color Doppler flow imaging findings for predicting possible difficuulties encountered during laparoscopic cholecystectomy (LC).Methods Eighty-six Datients with acute cholecystitis underwent color Doppler flow imaging examination were divided into operation difficult group(67 cases)and operation easy group(19 cases)according to the diffculty score.The parameters were measured pre-operation including the volume of gallbladder,the thickness of the gallbladder wall,the condition of arterial flow in the gallbladder wall,the conditions of gallbladder cavity and gallbladder fossa and the intra-and extra-hepatic bile duet.The relationships among imaging results,operation difficulties and operation findings were investigated.Results Gallbladder volume,gallbladder wall thickness.the presence rates of plentiful arterial flow in the gallbladder wall,adhesion of gallbladder and stone incarceration In operation difficult group were significantly different from those in operation easy group [(52.6±14.6)mm~3 vs(32.6±10.4)mm~3,(9.7±4.1)mm vs(3.8±0.9)mm,89.5%(17/19)vs 17.9%(12/67),78.9%(15/19)vs 11.9%(8/67),10.5%(2,19)vs 0(0/67)](P<0.05 or<0.01).The accurate rate was 94.2%(81/86)in predicting.Conclusion Preoperative color Doppler flow imaging is helpful in predicting difficulties of LC.
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Objective To evaluate the application value of three-dimensional power Doppler imaging(3D-PDI) in diagnosis of carotid artery stenosis in the elderly. Methods A total of 72 elderly patients with history of hypertension, coronary atheroselerosis, diabetes mellitus or hyperlipidemia were included in the study. The condition of carotid artery stenosis was examined by colour doppler flow imaging (CDFI), 3D-PDI in free-hand mode, and measured by digital subtraction angiography (DSA) as a golden standard in 24 hours. The sensitivity, specificity, positive and negative predictive values were calculated, and all the results were compared with CDFI. Results 3D-PDI directly showed the stereo image, including surface character and exact position of plaque,volume of vessel lumen and spatial distribution of blood flow. Seventy two patients had 85 stenosis of carotid arteries. There was no statistical difference in diameter stenosis rate between CDFI and 3D-PDI [(49.2±0.7)% vs. (52.3±0.3)%,P>0.05], and the area stenosis rate measured by 3D-PDI was significantly lower than by CDFI[(53.24±0.7)% vs. (59.3±0.4)%, P<0.01]. In the diagnosis of stenosis classification, the diagnostic sensitivities of light, mild and severe stenosis were significantly different between CDFI(88.9%,100.0%,100.0%) and 3D-PDI(100.0%,70.4%,58.1%) all(P<0.01). The 3D-PDI was better in diagnostic sensitivity of mild and severe stenosis, but specificity was not better than CDFI. Conclusions 3D-PDI is an easy, convenient method with no-wound and good reproducibility in the diagnosis of carotid artery stenosis. It is more accurate than CDFI and similar to DSA.
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Objective To evaluate the changes of morphology, hemodynamics and endothelial function of the dorsal artery of foot in patients with early-stage type 2 diabetic mellitus (T2DM) by high-resolution ultrasound. Methods The changes of morphology, homodynamics and endothelial function of the dorsal artery of foot were measured in 25 elderly and 35 non-elderly T2DM patients and 35 elderly and 30 non-elderly healthy persons. Results (1) The change percentage of inside diameter of foot dorsal artery under reactive hyperemia situation was obviously reduced in elderly T2DM patients compared with elderly healthy controls [(10.52±2.79)% vs. (15.43±4.69)%, P<0.01] and there was significant difference between non-elderly T2DM versus healthy persons [(12.89±4.68)% vs. (17.97±4.61)%, P<0.01],and it was lower in elderly versus non-elderly T2DM ones (P<0.05). The change percentage of inside diameter of foot dorsal artery wassignificantly lower in elderly T2DM versus healthy subjects after taning nitroglycerin [(12.40± 3.23)% vs. (16.11±5.74)% , P<0.01]. (2) Compared with control groups, the intima-medial thickness (IMT) of dorsal artery of foot was thickened significantly, and the peak reverse velocity (PRV) in early diastole, the velocity in end diastole (EDV) and pulsatility index(PI) were reduced significantly in T2DM groups (P<0.05). The peak systolic velocity (PSV) had no significant differences among all the groups (P>0. 05). (3) In T2DM groups, the PI was correlated positively with the change percentage of inside diameter of dorsal artery of foot under reactive hyperemia situation (r=0.79, P<0.01) and after having taken nitroglycerin (r=0.71, P<0.01), respectively. Conclusions The changes of morphology, hemodynamics and the injuries of endothelial function of the dorsal artery of foot can be detected in patients with early-stage T2DM byhigh-resolution ultrasound, which has clinical significance and applicable value.