Correlation between diameter of sciatic nerve and symptoms or prognosis in patients with lumbar disc herniation / 中华骨科杂志

Objective To explore the effect of single level lumbar disc herniation on the morphology and diameter of sciatic nerve,and to identify the correlation between the diameter change in sciatic nerve and severity of clinical symptoms,as well as the prognosis of surgical treatment in patients with lumbar disc herniation.Methods From January 1,2017 to December 31,2017,Seventy lumbar disc herniation (LDH) patients who underwent single-level posterior lumbar spine surgery were recruited in this retrospective analysis study.Specific data including age,gender,the level of a disc herniation,the type of disc herniation,symptomatic side,surgical procedure were recorded respectively.In addition the morphological changes and the diameter of bilateral sciatic nerve were recorded preoperatively and postoperatively by B-mode ultrasound.Furthermore,the pain in patients and neurological function were evaluated by visual analogue scale (VAS,back pain and leg pain),Japanese orthopaedic association scores-lumbar (JOA) and Oswestry disability index (ODI).The correlation between the diameter of sciatic nerve and clinical features,as well as clinical prognosis of patients were identified in the present study.Results For patients with acute lumbar disc herniation,the diameter of sciatic nerve in affected side was 5.19±1.03 ram,which is significantly higher than that in the unaffected side (4.57±0.64 mm,t=6.735,P=0.000).In addition,preoperative ratio of the affected side to the healthy side of the sciatic nerve showed strong correlation with the VAS of leg pain (r=0.838,P=0.001),JOA (r=-0.857,P=0.001),and ODI score(r=0.881,P=0.000),but not with the VAS of back pain (r=-0.061,P=0.614).Three months after surgery,the diameter of sciatic nerve in the affected side decreased to 4.58±0.63 mm (t=6.865,P=0.000),while the unaffected side showed no significant change(t=0.300,P=0.765).Clinical improvement was observed in all the patients postoperatively.The changes in the diameter of sciatic nerve postoperatively in affected side showed strong correlation to the rate of improvement in VAS of leg (r=0.624,P=0.003),JOA(r=0.615,P=0.003) and ODI scores (r=0.722,P=0.002),but not to the rate of improvement in VAS of back (r=-0.025,P=0.836).Conclusion Single root compression in patients with single level disc herniation might cause morphological changes such as thickening and edema in sciatic nerve,which were closely related to the severity of clinical symptoms and the prognosis of surgical treatment.

Value of conventional ultrasound combined with contrast-enhanced ultrasound in differential diagnosis of thyroid TI-RADS 3-5 nodules / 中华超声影像学杂志

Objective To evaluate the diagnostic value of gray-scale ultrasound combined with contrast-enhanced ultrasound (CEUS) in thyroid imaging and reporting system ( TI-RADS) 3-5 nodules of American College of Radiology ( ACR) . Methods The 208 patients( 216 nodules) who underwent thyroid contrast-enhanced ultrasound examination from April 2014 to December 2016 were retrospectively analyzed . The ACR TI-RADS classification and contrast-enhanced mode of thyroid ultrasound were evaluated . The benign and malignant thyroid lesions were constructed through the analysis of contrast-enhanced mode of thyroid benign and malignant lesions in the past literature and the preliminary study of our group . Prediction model of gray scale combined with contrast-enhanced ultrasound for lesions were established . Besides ,the sensitivity ,specificity and accuracy of gray scale ultrasound combined with contrast-enhanced ultrasound prediction model for differential diagnosis of benign and malignant thyroid lesions were calculated based on the results of puncture biopsy or surgical pathology as the gold standard . Results Compared with pathological results , the positive predictive value , negative predictive value , accuracy , sensitivity and specificity of gray scale combined with contrast-enhanced ultrasound in evaluating thyroid nodules were 90 .8％ ,93 .3％ ,91 .2％ ,98 .8％ and 62 .2％ ,respectively . Conclusions Gray-scale ultrasound combined with contrast-enhanced ultrasound can provide clinical value in differential diagnosis of benign and malignant TI-RADS 3-5 thyroid nodules .

Echocardiographic diagnosis of congenital mitral valve malformation / 中华超声影像学杂志

Objective To investigate the clinical value of the echocardiography in the diagnosis of congenital mitral valve malformation and summarize its occurrence and type associated with other cardiac malformations.Methods The echocardiographic image data of 101 patients with congenital mitral valve malformation were retrospectively analyzed,the characteristics of different types were summarized and compared with operation results,CT,cardiac catheterization,transesophageal echocardiography,as well as the data of echocardiographic follow-up.Results Among 101 patients with echocardiographic examination showed mitral valve congenital malformation,63 cases were isolated valve set malformation (62.4％),and multiple valve set malformation were found in 38 cases (32.7％).In another side,39 cases were of single mitral valve malformation (38.6％),while 62 patients combined with other type cardiac malformations (61.4％).No significant difference of dynamic change was shown between patients with solitary and multiple malformation of mitral valve (P ＞0.05).Conclusions Echocardiography can display congenital mitral valve malformation in a fast,robust,real-time way.It has an important clinical value in the diagnosis of congenital mitral valve malformation.

Comparison of ultrasonography and X-ray in the assessment of peripheral joints invovement in psoriatic arthritis / 中华超声影像学杂志

Objective To compare and investigate the role of ultrasonography and X-ray examination in the assesment of peripheral joints in psoriatic arthritis (PsA).Methods One hundred and twenty-five groups joints of twenty-five patients with PsA underwent ultrasonography and X-ray examination,including knee joints,wrist joints,ankle joints,metacarpophalangeal joints and interphalangeal finger joints,metatarsophalangeal joints and interphalangeal toe joints.The results of the two examinations were analysed and compared.Results The numbers of patients with abnormal joints in knee joints,wrist joints,ankle joints,metacarpophalangeal/interphalangeal finger joints,and metatarsophalangeal/interphalangeal toe joints were 9,9,9,10,and 11,respectively.Ultrasonography found more abnormal joints than X-ray ( P ＜0.01 ).The cardinal ultrasonographic manifestations of PsA were synovitis (29),tendonitiS (16),and bone erosion (7).The cardinal X-ray manifestations of PsA were bone destruction (11 ),periarticular osteoporosis (5),periosteal reaction (3) and periarticular soft tissue swelling (4).Ultrasonography found more synovium and tendon abnormalities than X-ray (P ＜ 0.01 ),and X-ray found more bone abnormalities than ultrasonography ( P ＜0.01).Conclusions Ultrasonography has the ability of demonstrating early changes of peripheral joints in PsA.The combination of ultrasonography and X-ray can make the diagnosis of PsA more correct and comprehensive.

Nerve root lesion of brachial plexus intervertebral part diagnosed by high-resolution ultrasonography / 中华超声影像学杂志

Objective To evaluate the application of high-resolution ultrasonography in the diagnosis of nerve root lesion of cervical vertebra intervertebral foramen part. Methods Twenty-seven patients with root avulsion injury of brachial plexus intervertebral part and 8 patients with schwannoma of brachial plexus root were examined with high-resolution ultrasonography. Thirty healthy volunteers were involved for the sonographic imagings of normal brachial plexus intervertebral part. The ultrasound findings of the patients before operation were compared with surgical outcomes. Results The normal intervertebral part of brachial plexus were shown as hypoechoic tubular strucuture, which could be identified with cervical artery and transverse process used as landmarks for the intervertebral part of brachial plexus root. The detection ratios of normal intervertebral part for C5-C8 and outside part of braehial plexus were 100％. In 27 patients with root avulsion injury of intervertebral brachial plexus, the intervertebral nerve root were enlarged as hypoechoic area, with nerve dissected partly or disappearing, distal nerve parts outside the intervertebral foramen swelling, edema,or cerebrospinal fluid assembling as cystic masses. In 8 patients with schwannoma of brachial plexus root part, the spinal ganglia outside intervertebral foramen were shown as tumor-like hypoechoic mass, with blood supply shown inside. Conclusions High-resolution ultrasonography is of great value for early and convenient diagnosis of root avulsion injury and mass of brachial plexus intervertebral part, especially in community hospitals,which could provide important information for clinical therapy.

Ultrasound diagnosis of traumatic neuroma in peripheral nerve / 中华超声影像学杂志

Objective To analyze sonographic imagings of traumatic neuromas of peripheral nerves,and to investigate the applied values of uhrasonography in the traumatic neuroma of peripheral nerve. Methods The sonographic imagings of 38 patients who had evidences of traumatic neuromas in peripheral nerves were retrospectively reviewed by the last diagnostic results of operations. Results Among 38 cases, 2 incomplete traumatic neuromas were not detected, and 1 incomplete traumatic neuroma was misdiagnosised as neurilemoma by ultrasonography. The coincidence of uitrasonography in incomplete traumatic neuroma and complete severed neuroma was 82.4% and 100%. With regard to the echogenicity of 38 traumatic neuromas of peripheral nerves, the sonographic characteristics of neuromas were all hypoechoic. Thirty-three neuromas appearanced like shuttles and 5 neuromas appearaneed like humps. Conclusions The traumatic neuroma has distinctive ultrasonic appearance. Ultrasonography is useful to direct the diagnosis and treatment of traumatic neuroma.

THE RELATIONSHIP BETWEEN BODY WEIGHT AS WELL AS SERUM HIGH DENSITY LIPOPROTEIN CHOLESTEROL (HDL.C) AND THE RISK OF CORONARY HEART DISEASE / 营养学报

underweight group. There was a negative correlation between body mass index and HDL.C concentration (r = - 0.088, p