1.The imaging manifestations of spontaneous orbital hemorrhage
Yue HAN ; Mei BAI ; Yang ZHAO ; Lianhai YANG
Chinese Journal of Radiology 2010;44(6):614-618
Objective To study the imaging manifestations of spontaneous orbital hemorrhage and to evaluate the diagnostic values of different imaging techniques.Methods The manifestations of ultrasound,CT and MRI in 30 patients with spontaneous orbital hemorrhage confirmed by surgery or puncture were retrospectively analyzed.Then the imaging data were compared with pathological or clinical results.Results Eighteen of 30 patients were surgically confirmed, including 6 cases of simple blood cysts, 10 cases of venous angioma with hematocysts ( 7 cases in the intraconal space and 3 cases within the extraocular muscle),2 cases of varicosity with hernatocysts ( 1 case in the intraconat space and another case within the extraocular muscle).Twelve patients were proved by puncture.The sonngraphie features of the spontaneous orbital hemorrhage in all 30 cases were inhomogeneons and slightly compressible cysts without blood flow in them.The CT manifestation of the lesions was lack of specificity and showed isodensity or slight hyperdensity,however, the CT value of the lesions had the tendency of decrease over time.The CT values were 82.0 to 89.0 HU in 4 cases with the courses of 1-3 days.And when the hemorrhage courses were 4-20 days,21-60 days, the CT values were 69.0 to 82.0 HU (20 cases) and 30.0 to 37.0 HU (6 cases),respectively.On MRI, the lesions showed typical signal characteristics and evolution of hematomas.For 1-3 days (4 cases), the lesions showed isointensity on T1WI and hypointensity on T2WI; for 4-10 days (10 cases), the lesions appeared hyperintensity in the central zone on T1WI and still showed hypointensity on T2WI; for 11-20 days( 10 cases), the lesions was homogeneous or inhomogeneous hyperintensity on T1WI and homogeneous hyperintensity on T2WI; and for 21-60 days (6 eases), the lesions showed heterogeneous intensity on both T1 WI and T2WI.The coincidence rates with clinical diagnoses were 96.7% (29/30) for ultrasound, 26.7% (8/30)for CT and 100% (30/30) for MRI, but they all showed limited ability in distinguishing simple from secondary orbital hemorrhage.Conclusion MRI is superior to ultrasound and CT in diagnosing spontaneous orbital hemorrhage and evaluating the secondary changes.
2.Control study of anatomy and MRI of male urogenital diaphragm
Bo ZHAO ; Yue HAN ; Yunsheng LI ; Lianhai YANG
Chinese Journal of Urology 2012;33(8):614-617
Objective To investigate the MRI features of male urogenital diaphragm.Methods A total of 4 pelvic specimens of healthy male cadaver and 15 healthy male volunteers underwent pelvic MRI examination.All MRI scan images were analyzed to approach the urogenital diaphragm structure both in corpse and the MRI images.Results The normal urogenital diaphragm of cadavem connected to ramus inferior ossis pubis and ischiadic ramus.There were three layers inside the urogenital diaphragm,including superior fascia of urogenital diaphragm,inferior fascia of urogenital diaphragm and deep transverse muscle of perineum.MRI imaging showed the coronal was the best location to exhibit the urogenital diaphragm,and all of the structure appeared like sandwich.In the images of the diaphragm of the volunteers also exhibited like sandwich,and the three layers are moderate signal in MRI.Ten volunteers were given the fat-depresstion and high resolution scan of T2WI in small ROI,and the structure could be seen much clearly.Fat-depresstion and high resolution scan of T2WI in small ROI was the best sequence to exhibit the urogenital diaphragm.Coronal location of the structure appeared like sandwich.Conclusion MRI is a good way to show urogenital diaphragm,and high resolution scan of T2WI in small ROI can show the structure much clearer.
3.The role of comprehensive geriatric assessment in patients with chronic heart failure and sarcopenia
Yingji ZHOU ; Jiqun CHEN ; Lianhai MIAO ; Zhziyong YANG ; Shitao SONG ; Wenling SONG ; Yunfeng ZHANG ; Defa ZHU
Clinical Medicine of China 2023;39(4):292-298
Objective:To investigate the therapeutic effect of comprehensive geriatric assessment(CGA) in elderly patients with chronic heart failure(CHF) complicated with sarcopenia, and to provide a theoretical reference for clinical application.Methods:This study was a prospective randomized controlled study. 110 elderly CHF patients with myopenia admitted to the Third People's Hospital of Hefei from January 2019 to February 2022 were selected. Using the random number table method, 56 cases were divided into an observation group and 54 cases into a control group. Before treatment, the control group of patients underwent a selective single assessment based on the hospital's requirements and the patient's actual situation, including a fall risk assessment, nutritional risk screening checklist assessment, and routine medication to improve cardiac function and prognosis; Before treatment, the patients in the observation group were assessed with CGA, including the assessment of physical function, mental and psychological status, multiple drug management, pain, Sleep disorder, and social environment. According to the assessment results, individual diagnosis and treatment plans were formulated, implemented, and dynamically adjusted. The two groups were treated for 12 weeks. The general information, treatment compliance, B-type brain natriuretic peptide (BNP) level, left ventricular Ejection fraction (LVEF), 6 min walking distance (6MWD), arm strength of upper limbs and 6 m walking speed, clinical efficacy and prognosis of the two groups were compared before and after treatment. The measurement data is represented by xˉ± s, group t-tests are used for inter group comparison, and paired t-tests are used for intra group comparison before and after treatment; Counting data is represented as an example (%), and inter group comparisons are made using χ 2 test, non parametric rank sum test was used for inter group comparison of hierarchical data. Results:There was no statistically significant difference in gender, age, course of CHF, smoking, alcohol consumption, number of comorbidities, cardiac function grading, and treatment compliance between the two groups of patients (all P>0.05), indicating comparability. Before treatment, there was no statistically significant difference in plasma BNP, LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed between the two groups of patients (all P>0.05); After treatment, the BNP of both groups of patients was lower than before treatment and the observation group was lower than the control group. LVEF, 6MWD, upper limb grip strength, and 6-meter walking speed were all higher than before treatment and the observation group was higher than the control group [(343.45±34.95) ng/L vs (387.09±46.96) ng/L, (49.61±7.11)% vs (42.94±5.72)%, (348.92±37.73) m vs (297.74±43.48) m, (22.64±3.82) kg vs (19.48±3.88) kg, (0.97±0.10) m/s vs (0.83±0.12) m/s], The differences were statistically significant ( t-values were 5.51, -5.40, -6.60, -4.31, -6.60, all P<0.001). After 12 weeks of treatment, there was no statistically significant difference in clinical efficacy between the two groups of patients ( P=0.216), but the overall poor prognosis rate in the follow-up observation group was lower than that in the control group [7.14%(4/56) vs 22.22% (12/54)], and the difference was statistically significant (χ 2=5.03, P=0.025). Conclusions:Developing, implementing, and dynamically adjusting the individualized treatment plan involving CGA can improve the prognosis of elderly CHF patients with sarcopenia, help improve cardiac function, increase grip strength and somatic function, and reduce the risk of major adverse cardiovascular events ,all-cause mortality in elderly patients with CHF combined with sarcopeni and has certain clinical application value.