[Quantitative study of supraspinatus tendon injury grading based on synthetic magnetic resonance imaging].

Objective: To investigate the diagnostic value of quantitative parameters of synthetic magnetic resonance imaging (SyMRI) in the grade of supraspinatus tendon injury. Methods: Ninety-seven patients with clinical definite of supraspinatus tendon injury from July 2021 to July 2022 in General Hospital of Ningxia Medical University were prospectively collected (case group), including 54 males and 43 females, with an age of 29 to 56 (37.4±9.6) years. According to the results of shoulder arthroscopy, the case group were divided into three subgroups included tendinopathy group (37 cases, grade Ⅱ), partial tear group (34 cases, grade Ⅲ) and complete tear group (26 cases, grade Ⅳ). During the same period, 28 normal rotator cuff volunteers without supraspinatus tendon injury were recruited (control group), including 16 males and 12 females, aged 23 to 49 (36.1±7.2) years, and marked as grade Ⅰ. All the subjects underwent MRI scan of articulatio humeri included T1-weighted imaging(T1WI) fast spin echo(FSE) sequences in axial view, T2-weighted imaging(T2WI) fat suppression(FS) sequences in axial view, T2WI FS sequences in oblique coronal view, proton density-weighted (PDW) imaging in oblique sagittal view and SyMRI in oblique coronal view. The supraspinatus tendon was divided into lateral, medial and middle subregions according to its shape in oblique coronal T2WI view, two radiologists measured the T1, T2 and PD values of the supraspinatus tendon. The interclass correlation coefficient (ICC) were used to compare the consistency between and within observers. One-way analysis of variance or Kruskal-Wallis H test were used to compare the differences of quantitative parameters in different grades, the multivariate logistic regression model was used to analyze the risk factors of supraspinatus tendon injury grade, and the receiver operating characteristic (ROC) curves and area under curve (AUC) was drawn and calculated to evaluate the diagnostic efficacy. The Spearman correlation was used to analyze the correlation between the quantitative values and grades of supraspinatus tendon injury. Results: The ICC values of T1, T2 and PD values for the three subregions of the supraspinatus tendon were greater than 0. 700. The differences of T1 values in the lateral subregion, T2 values in the lateral and middle subregions were statistically significant in the overall comparison across different grades (all P<0. 001).The differences of T1 values in the middle and medial subregions, T2 values in the medial subregion and PD values in the lateral, middle and medial subregions were not statistically significant in the overall comparison of different grades (all P>0. 05). Multiple logistic regression model analysis showed that T2 values in the lateral and middle subregions were related factors for the grade of supraspinatus tendon injury[ OR (95%CI):1.123 (1.037-1.216), 0.122 (1.151-1.197);all P<0.001 ]. The AUC of the T2 values in lateral subregion diagnosing grade Ⅰ vs grade Ⅳ, grade Ⅱ vs grade Ⅳ and grade Ⅲ vs grade Ⅳ were 0.891(95%CI: 0.801-0.981), 0.797(95%CI: 0.680-0.914), 0.723(95%CI: 0.594-0.853) (all P<0.001), and the AUC of the T2 values in middle subregion diagnosing grade Ⅰ vs Ⅳ, grade Ⅱ vs Ⅳ, grade Ⅱ vs Ⅲ, and grade Ⅰ vs Ⅲ were 0.946 (95%CI: 0.849-0.989), 0.886 (95%CI: 0.809-0.962), 0.746 (95%CI: 0.631-0.861), 0.843 (95%CI: 0.745-0.941)(all P<0.001). The T2 values in the lateral and middle subregions were positively correlated with the grade of supraspinatus tendon injury (r=0.542, 0.615; both P<0.001), while T1 values and T2 values in the medial subregions were not significantly correlated with the grade of supraspinatus tendon injury (both P>0.05). Conclusion: SyMRI has high clinical application value in the grading of supraspinatus tendon injury, especially T2 value can be used as an effective quantitative parameter for the grading of supraspinatus tendon injury.

Differences in genotype and allele frequency distributions of polymorphic drug metabolizing enzymes CYP2C19 and CYP2D6 in mainland Chinese Mongolian, Hui and Han populations.

WHAT IS KNOWN AND OBJECTIVE: Cytochrome P450 2C19 (CYP2C19) and CYP2D6 are important xenobiotic metabolic enzymes and both show considerable genetic variability between Orientals and Caucasians. There are known marked heterogeneity in susceptibility to various cancers and hypertension among Chinese Mongolian, Hui and Han ethnic groups, but the molecular mechanisms are unknown. Our objective was to investigate the patterns of distribution of CYP2C19 and CYP2D6 polymorphisms among healthy Chinese subjects to determine whether any observed inter-ethnic variability might be worth further investigation as possible contributors to the known differences in disease prevalence. METHODS: Blood samples were collected from 454 unrelated Chinese healthy subjects (214 Han, 111 Hui, 129 Mongolian) for genotyping analysis. The single nucleotide polymorphisms (SNPs) CYP2C19*2 (681G>A in exon 5), CYP2C19*3 (636G>A in exon 4) and CYP2D6*10 (188C>T in exon 1) were determined by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. RESULTS AND DISCUSSION: Significantly higher frequencies of the CYP2C19 poor metabolic genotypes were observed in Chinese Han (18·7%), Chinese Hui (25·0%) and Chinese Mongolian (10·9%) subjects than has been reported for Caucasians (1·7-3·0%, P < 0·01). The prevalent defective allele CYP2C19*2 occurred more frequently in both Chinese Hui (32·4%) and Han (29·7%) than in Chinese Mongolian (18·2%, P < 0·01) subjects. The CYP2C19*2 and CYP2C19*3 defective alleles were significantly more frequent in Chinese Han and Chinese Hui ethnic groups than have been reported for Caucasians (11·1-16·3% and 0-0·2%, P < 0·01). CYP2D6*1/*10 heterozygotes and CYP2D6*10/*10 homozygotes were observed more frequently in Chinese Han (43·1% and 27·2%), Hui (40·6% and 30·7%) and Mongolian subjects (31·3% and 9·6%, both P < 0·01) than have been reported for Caucasians (5·5% and 0·3%, P < 0·01). In Chinese Mongolians, the CYP2D6*10 allele occurred at a frequency (25·2%, P < 0·01) intermediate between those reported for Caucasians and the other two Chinese ethnic populations. WHAT IS NEW AND CONCLUSIONS: This is first report of interethnic differences in frequencies of functional CYP2C19 and CYP2D6 genes among Chinese Mongolian, Hui and Han populations. These differences may be important in explaining reported inter-ethnic differences in disease prevalence and response to drugs.

Solitary olfactory schwannoma without olfactory dysfunction: a new case report and literature review.

Schwannomas are rare and seldom extend into the anterior cranial fossa. Herein, we report a case of schwannoma arising from the olfactory groove in a 16-year-old girl who presented with generalized seizures without olfactory dysfunction or other neurologic deficits. Computerized tomography (CT) scan showed a large mass with abundant calcification located in the olfactory groove, which was confirmed as a schwannoma by histology and totally resected via basal subfrontal approach. The presentation, imaging findings and histogenesis of the tumor are discussed along with a review of the pertinent literature.