1.Value of MRI in predicting intradiscal cemment leakage during percutaneous vertebral augmentation
Jinhui CAI ; Qingyu LIU ; Yurong ZENG ; Zhifeng LIU ; Yaoqin RUAN ; Donghua GUO ; Zhen WANG
Chinese Journal of Medical Imaging Technology 2017;33(7):1061-1065
Objective To assess the value of preoperative MRI in predicting the incidence of cement leakage into adjacent discs during percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fracture (OVCF).Methods Clinical and radiological characteristics of 127 patients who were treated with PVA for OVCF were analyzed retrospec tively.The following clinical data of these patients were analyzed,including gender,age,location of treated vertebral body and surgical approach.The image features of endplate injury,fracture line extended to the endplate,adjacent intervertebral dick injury and intravertebral cleft were evaluated on the preoperative MRI.The incidence of cement leakage into the adjacent disc were compared for the above factors with statistical methods.Results Totally 127 patients were enrolled in our study,including 179 treated vertebral bodies,358 endplates and 341 adjacent intervertebral discs.The incidence of intradiscal cement leakage was 57.73% (56/97) in endplate injury sign,60.98% (25/41) in fracture line extended to endplate sign,35.91%(51/142) in adjacent discs injury sign and 55.56%(20/36) inintravertebral cleft sign.The differences were statistically significant on preoperative MRI in patients with the above signs compared to those who had not (P<0.05).The incidence of intradiscal cement leakage in percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) were 26.67%(16/60) and 42.86%(51/119),respectively,which was significant different (P=0.035).For bone cement volume ≤ 5 ml vertebral bodies,the incidence of intradiscal cement leakage was 31.19 % (34/109),lower than bone cement volume > 5 ml vertebral bodies (47.14% [33/70],P=0.031).There was no statistically significant association between intradiscal cement leakage and age,gender and location of treated vertebral body (P>0.05).Conclusion Preoperative MRI can predict the leakage of bone cement into adjacent discs effectively during PVA.The PKP and the lower volume of bone cement injection can reduce the risk of intradiscal cement leakage.
2.Evaluation of brain injury after cardiopulmonary resuscitation onby T2W images texture analysis: A preliminary study
Zhifeng LIU ; Qingyu LIU ; Haoyi YE ; Yaoqin RUAN ; Jinhui CAI ; Zhihua WU ; Zhengfei YANG
Chinese Journal of Emergency Medicine 2021;30(12):1438-1443
Objective:To evaluate the feasibility of brain injury after cardiopulmonary resuscitation (CPR) in rats based on T2WI image texture analysis.Methods:Eighteen SD rats were randomly divided into the sham group ( n=8) and model group ( n=10). The rats in the model group underwent MRI scanning at 6 h after return of spontaneous circulation (ROSC), and the rats in the sham group received MRI scanning at 6 h after the operation. The differences in the texture features of T2WI images and the expressions of AQP4 and NSE between the two groups were analyzed. The receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficacy of statistically different texture features between the two groups for brain injury. The associations between texture features and AQP4 and NSE expressions in the sham group and model group were analyzed using Spearman correlation coefficients. Results:The minimum intensity, standard deviation, and inverse difference moment of the whole brain T2WI texture features of the model group were significantly lower than those of the sham group ( P<0.05), while the difference entropy and characteristics of high gray in homogeneity were significantly higher than those of the sham group ( P<0.05). The difference entropy was the best with an area under curve (AUC) of 0.922, a sensitivity of 100% and a specificity of 75%. The AQP4 and NSE expressions in the model group were significantly higher than those in the sham group ( P<0.05). The minimum intensity value was positively correlated with AQP4 and NSE expressions ( r=0.501, 0.568, P=0.048, 0.022). The standard deviation was positively correlated with AQP4 and NSE expressions ( r=0.620, 0.530, P=0.010, 0.035). The difference entropy was negatively correlated with AQP4 expression ( r=-0.535, P=0.033). Conclusions:Texture analysis on T2WI images can evaluate the degree of brain edema and neuronal damage. The minimum intensity, standard deviation, and difference entropy are sensitive indicators to evaluate brain injury after CPR, and difference entropy has the highest sensitivity and specificity.
3.The feasibleness study of forecasting the prognostic of sick person acute ischemic stroke by intravenous thrombolysis based on multi-phase CTA
Haoyi YE ; Zhifeng LIU ; Yaoqin RUAN
Journal of Apoplexy and Nervous Diseases 2022;39(7):605-608
Evaluate the feasibleness of forecast the prognostic of sick person acute ischemic stroke Intravenous thrombolysis based on multi-phase CT angiography(mCTA)united with medical message. MethodsThe sufferer acute ischemic stroke accomplished mCTA scan were choose. The multi-phase ASPECTS collateral circulation,blood glucose results red blood cell distribution width(RDW)and neutrophil to lymphocyte ratio(NLR)were record. Pursuant to the modified Rankin Scale(mRS)as the criterion,90 daytime after therapy,sufferer mRS score≤2 were specified as set A(n=18),and sufferer mRS score≥3 were specified as set B(n=33). The information with statistics discrepancies in univariate analysis were contained in binary Logistics regression analysis. The standalone risk elements for forecast the prognostic of sick person acute ischemic stroke were sifted out and the prognostic modeling was effected. The ROC curvature of all the variable with statistics meaning and the binary Logistics regression analysis was used to assess the diagnosis effectivity,Delong test was used to evaluate the discrepancies in between the ROC curvature. ResultsThe blood glucose results,RDW and NLR of set A were higher than those of set B,and the multi-phase score of set A was lower Compare of set B(P<0.05). Binary Logistics regression analysis showed multi-phase score and NLR were standalone risk factor for 90 daytime prognostic of sick person acute ischemic stroke. The prediction model was logit(P)=-4.877+aspects score×-0.624+NLR×When the threshhold was 0.5288,the sensitivities and specificity were 77.8% and 93.9%,respectively. ConclusionAspects score and NLR are independent risk factors for predicting 90 daytime prognosis of patients with AIS. multi-phase CTA combined with laboratory examination can forecast the prognostic of sick person acute ischemic stroke and bestow precise forecast information for clinical sick person acute ischemic stroke.