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Objective:To explore the application value of 3.0T magnetic resonance imaging(MRI)combined with transvaginal ultrasound elastography technique in diagnosing uterine fibroids and adenomyosis.Methods:A retrospective analysis was performed on 56 patients with uterine fibroids and 41 patients with adenomyosis who admitted to Fengfeng General Hospital of North China Medical and Health Group from January 2021 to January 2022.MRI and transvaginal ultrasound elastography were respectively performed on all patients,and pathological diagnosis was taken as the"gold standard".The diagnostic results of MRI,transvaginal ultrasound elastography technique and their combination were compared,and the diagnostic situation of different examination methods were recorded.And then,the total coincidence rate was analyzed,and the sensitivity,specificity and accuracy were further calculated.Results:The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 96.43% in detecting uterine fibroids,and that of MRI was 75.00%,and that of transvaginal ultrasonography was 80.36%.The differences of totally diagnostic coincidence rates among combined detection and single detection were significant(x2=10.500,7.049,P＜0.05).The totally diagnostic coincidence rate of MRI combined with transvaginal ultrasound elastography was 97.56% in detecting adenomyosis,which was significantly higher than that(78.05%)of MRI and that(78.05%)of transvaginal ultrasound elastography,and the differences were significant(x2=7.289,7.289,P＜0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 71.74%,78.26% and 95.62% in detecting uterine fibroids,and the specificities of them were 90.00%,90.00% and 100.00%,and the accuracies of them were 75.00%,80.36% and 96.43%,respectively.The sensitivity and accuracy of the combined detection were significantly higher than those of single MRI detection(x2=5.029,10.500,P＜0.05),respectively.The accuracy of the combined detection was significantly higher than that of the single detection of vaginal ultrasonography(x2=7.049,P＜0.05).The sensitivities of single MRI,single transvaginal ultrasound elastography and the combined detection of them were 81.25%,78.73% and 96.88% in detecting adenomyosis,and the specificities of them were 66.67%,77.78% and 100.00%,and the accuracies of them were 78.05%,78.05% and 97.56%,respectively.The accuracy of the combined detection was significantly higher than that of single MRI detection(x2=7.289,P＜0.05),and the accuracy of the combined detection was significantly higher than that of single detection of vaginal ultrasonography(x2=7.289,P＜0.05).Conclusion:The diagnosis rate of MRI combined with transvaginal ultrasound elastography technique is higher for uterine fibroids and adenomyosis,which has better diagnostic value,and can provide reliable reference materials for clinicians in performing treatment.
RESUMO
Objective:To investigate the relationship between metabolic syndrome and 1-year poor outcome in elderly patients with acute cerebral infarction (ACI).Methods:The clinical data of elderly patients with ACI admitted to Renqiu Kangjixintu Hospital from January 2014 to November 2018 were selected and divided into metabolic syndrome group (931 cases) and non-metabolic syndrome group (1 851 cases). The clinical data of the two groups of elderly patients with ACI were compared, and the effect of metabolic syndrome on poor outcome (modified Rankin scale>2 scores) of elderly patients with ACI in 1 year was analyzed by multivariate Logistic regression.Results:The proportion of female, hypertension, diabetes, hyperlipidemia, coronary heart disease, smoking, excessive alcohol consumption and antiplatelet drug use in the metabolic syndrome group were higher than those in the non-metabolic syndrome group: 52.74%(491/931) vs. 32.58%(603/1 851), 79.16%(737/931) vs. 64.29% (1 190/1 851), 42.32% (394/931) vs. 6.43% (119/1 851), 17.19% (160/931) vs. 11.62% (215/1 851), 18.90% (176/931) vs. 14.10% (261/1 851), 62.73% (584/931) vs. 50.89% (942/1 851), 3.73% (69/931) vs. 1.61% (15/1 851), 19.23% (179/931) vs. 15.51% (287/1 851), the levels of body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FPG), fasting plasma glucose (TG), total cholesterol (TC), platelet (PLT), fibrinogen (FIB), fall score were higher than those in non-metabolic syndrome group: 26.67 (25.31, 28.60) kg/m 2 vs. 23.30 (21.48, 24.91) kg/m 2, (167.17 ± 22.96) mmHg (1 mmHg = 0.133 kPa) vs. (164.21 ± 24.90) mmHg, (87.06 ± 13.10) mmHg vs. (85.76 ± 12.99) mmHg, (7.33 ± 2.64) mmol/L vs. (5.35 ± 1.38) mmol/L, (2.12 ± 1.51) mmol/L vs. (1.13 ± 0.78) mmol/L, (4.97 ± 1.31) mmol/L vs. (4.65 ± 0.99) mmol/L, 213.00 (179.00, 256.00) × 10 9/L vs. 203.00 (172.00, 241.00) × 10 9/L, 3.07 (2.63, 3.52) g/L vs. 2.94 (2.55, 3.37) g/L, (6.12 ± 1.70) scores vs. (5.93±1.74) scores, the levels of age, high density lipoprotein cholesterol (HDL-C), homocysteine (Hcy) and pressure ulcer score were lower than those of non-metabolic syndrome group: (69.29 ± 6.96) years vs. (71.28 ± 7.66) years, (0.98 ± 0.34) mmol/L vs. (1.31 ± 0.88) mmol/L, (18.93 ± 13.07) mmol/L vs. (21.66 ± 16.39) mmol/L, (18.55 ± 2.42) vs. (19.02 ± 2.43), with statistical significance ( P<0.05). After 1-year follow-up, the proportion of poor outcomes in the metabolic syndrome group was higher than that in the non-metabolic syndrome group: 21.70%(202/931) vs. 18.69% (346/1 851), with statistical significance ( P<0.05). Multivariate Logistic regression analysis showed that age, stroke, national institutes of health stroke scale (NIHSS) score at admission, systolic blood pressure, Hcy, pressure ulcer score, fall score, metabolic syndrome were independent risk factors for poor outcome of ACI in 1 year ( OR = 1.056, 1.309, 1.138, 1.005, 1.006, 0.882, 1.076 and 1.285; 95% CI 1.040 to 1.072, 1.037 to 1.652, 1.097 to 1.180, 1.000 to 1.010, 1.000 to 1.013, 0.834 to 0.933, 1.004 to 1.152 and 1.001 to 1.657; P<0.05). Conclusions:Multiple risk factors for stroke are closely related to poor outcome of ACI in the elderly. And metabolic syndrome is an independent risk factor for poor outcome of ACI in the elderly in 1 year.