1.An initial analysis on the status quo of applying diagnosis test in imaging scientific study in China
Rongbo LIU ; Yan LIU ; Zhihan YAN
Chinese Journal of Radiology 2001;0(08):-
Objective To analyze the status quo of applying diagnosis test in imaging scientific study in China, and to see whether reliable diagnosis can be provided to clinicians for accurate guidance of clinical management. Method We manually looked up diagnosis tests published in 1979~1999 "Chinese Journal of Radiology" that is quite influential in our country. Then we evaluated each of these diagnosis tests according to the International Standards. Results We totally searched 2 888 articles in which only 9% were diagnosis tests. Of these diagnosis tests, only 8.9% applied blind comparison with Gold Standard, 24% calculated sensitivity, specificity and accuracy in the same time. And only 0.5%?6% and 5.7% respectively calculated likelihood ratios, negative predictive value and positive predictive value. Conclusion In China, the quality and quantity of the diagnosis tests applied in the specialty of imaging scientific study is far from meeting the clinical demand. Improving methods of scientific study and carrying on more diagnosis tests of high quality are of important significance to improving the diagnostic level of imaging.
2.Cross-sectional study on health care seeking behavior and financial burden of patients with rheumatic diseases in Fujian Province
Yijun DAI ; Fei GAO ; Zhihan CHEN ; Qing YAN ; He LIN
Chinese Journal of Rheumatology 2014;18(7):485-488
Objective To investigate and analyze the health care seeking behavior,financial burden and relative factors of patients with rheumatic diseases in Fujian Province.Methods Patients diagnosed with rheumatic diseases were investigated in Fujian Provincial Hospital from December 2013 to February 2014,including demographic data,health care seeking behavior and financial burden.Relevant factors were analyzed by Logistic regression.Results ① In this study,474 patients were enrolled.The ratio of male to female was 1∶2.38.② At the onset of symptoms,51.9%(246 cases) of patients visited a doctor as soon as possible,and 36.1%(171 cases) of them went to hospital within a month after disease onset.③ 74.1%(351 cases) of patients could adhere to medication regimen prescribed by doctors,and the most common reason for stopping medication was symptoms relieved (33.3%,41 cases).④ 63.1%(299 cases) of patients learned about the knowledge of rheumatic diseases from hospitals and doctors.⑤ 34.2%(162 cases) of patients spent 1 000-5 000 yuan every month on treatment.⑥ Insurance type could affect the time of first visit to hospital (P=0.004),while income and cost of therapy might impact patients' compliance (P=0.013,P=0.004).Conclusion Most patients will go to hospital as soon as possible and adhere to treatment.Economic situation is the main factor influencing health care seeking behavior of patients with rheumatic diseases.
3.Lumbosacral MR Study in the Neurogenic Bladder
Zhisheng CAI ; Jiangxi XIAO ; Zhihan YAN ; Zhongjie ZHOU
Journal of Practical Radiology 2001;0(08):-
Objective To evaluate the lumbosacral features and diagnostic value of MRI in the neurogenic bladder .Methods Lumbosarcral MR scans were performed in 90 patients with neurogenic bladder.MRI images were reviewed and the abnormal appearances of lumbosacrum on MRI were analysed.Results Of 90 cases,61 cases showed abnormal appearances,the positive rate was 68% and 60 cases were accurately diagnosed by MRI(98.5%).These positive cases were mostly composed of follow three kinds of diseases:spinal deformations,tumors of spinal canal and lumber disc herniations.Conclusion MRI has significant value in lumbosacral examination of patients with neurogenic bladder.
4.Role of dynamic magnetic resonance imaging in the diagnosis of female stress urinary incontinence
Zhikang YU ; Zhihan YAN ; Lei HUANG ; Chuanwan MAO ; Yunxin ZHOU ; Jiayu LIN
Chinese Journal of Urology 2008;29(8):560-563
Objective To evaluate the application of dynamic magnetic resonance imaging in the diagnosis of female stress urinary incontinence(SUI). Methods Dynamic magnetic resonance imaging(DMRI)were performed on 30 healthy female volunteers and 35 female SUI patients.DMRI of the pelvic floor at rest and OR maximal strain were performed by using sagittal T2-weighted fast gradient sequences.The distance of Urethra-vesical junction to the pubococcygeal line,the posterior vesicourethral angle and angle of inclination of the urethral axis were measured at rest and on maximal strain position.The t-value exact test were used to analyze the data. Results At rest the Urethravesical junction laid above pubococcygeal line on both control and SUI groups.Mean distance from the Urethra-vesical junction to pubococcygeal line at rest had no difference between the two groups.On straining,the mean Urethra-vesical junction descent distance in the SUI group(-0.9±1.1cm)was significantly higher than in control group(-0.14±0.3 cm),(P<0.001).On straining,the mean angle of urethral inclination in the SUI group(65±37°)was significantly bigger than in control groups (17±21°),(P<0.05).The posterior vesicourethral angle in the SUI groups(156±36°)was significantly bigger than in control groups(113±28°),(P<0.05). Conclusion Dynamic magnetic resonance imaging is a non-invasive.easily applied method in the diagnosis of SUI.
5.MRI Features in Children Surviving Premature Delivery with Cerebral Palsy
Xinglu TANG ; Zhiyong DING ; Lidan LIANG ; Zhihan YAN ; Wei CHEN ; Xiang CHEN
Chinese Journal of Rehabilitation Theory and Practice 2010;16(4):352-355
ObjectiveTo study the characteristic findings on MRI in children surviving premature delivery with cerebral palsy.MethodsThe clinical data and MR imaging in 16 cases surviving premature delivery with cerebral palsy was retrospectively analyzed, compared with 16 healthy and age-matched controls.Results16 cases were final diagnosed as cerebral palsy with spstic diplegia. MRI features of children surviving premature delivery with cerebral palsy included abnormally high signal intensity in the periventricula white matter on T2WI, marked loss of periventricular deep white matter, ventriculomegaly with or without irregular ventricular outline and atrophy of the corpus callossum. These features were consistent with periventricular leukomalacia(PVL).ConclusionPVL was the characteristic findings on MRI in children surviving premature delivery with cerebral palsy. The characteristic findings of PVL was useful in determining the etiology and type of cerebral palsy in children.
6.Sodium pyruvate protect occipital cortex of rats with repetitive and severe neonatal hypoglycemia detected by high resolution 1H nuclear magnetic resonance spectroscopy
Kun LIU ; Yuchuan FU ; Meimei DU ; Xinjian YE ; Xiaoyan HUANG ; Yongjin ZHOU ; Liangcai ZHAO ; Hongchang GAO ; Zhihan YAN
Chinese Journal of Perinatal Medicine 2017;20(3):228-233
Objectives To investigate the occipital cortex metabolite alterations in repetitive and severe neonatal hypoglycemia rats treated with sodium pyruvate and to reveal the protective role of sodium pyruvate using high resolution 1H nuclear magnetic resonance spectroscopy.Methods Thirty-six 2-dayold Sprague-Dawley rats were randomly divided into hypoglycemia group and pyruvate group with 18 rats in each group.Rats in both groups received intraperitoneal injections of insulin (40 U/kg body weight) at 2,4 and 6 days of age to induce severe hypoglycemia (blood glucose value ≤ 1.4 mmol/L).In the hypoglycemia group,2.5 hours after insulin injection,intraperitoneal injection of 50% glucose (2 ml/kg) was administered to terminate hypoglycemia,while in the pyruvate group,50% glucose (2 ml/kg) and sodium pyruvate solution 2.5 ml/kg (500 mg/kg) were injected.Terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay was used to observe the status of injured neurons in six neonatal rats,and metabolite changes in occipital cortex of the other 12 rats were detected by 1H nuclear magnetic resonance spectroscopy.The difference between the two groups was compared by independent-samples t test.Results Neonatal rats of both groups reached severe hypoglycemia level 2.5 hours after insulin injection.Compared with hypoglycemia group,pyruvate group had fewer injured neurons (45±5 vs 113 ± 12,t=0.782,P=0.013) and lower injured index in the occipital cortex (0.15 ± 0.03 vs 0.36 ± 0.06,t=l.143,P=0.020).Pyruvate group showed significant decreases in the concentration of taurine [(13.31 ± 2.06) vs (18.44 ± 3.86) mol/kg,t=8.231],glutamine[(1.50 ± 0.24) vs (2.02 ± 0.40) mol/kg,t=3.137],glutamate[(7.04 ± 0.95) vs (9.40 ± 1.73) mol/kg,t=6.449],aspartate[(1.51 ± 0.28) vs (2.15 ± 0.58) mol/kg,t=2.561] and creatine [(6.37±0.99) vs (8.46± 1.77) mol/kg,t =4.226] in the occipital cortex (all P'<0.017).Conclusions Simultaneous use of glucose and sodium pyruvate to terminate hypoglycemia in repetitive and severe neonatal hypoglycemia rats can effectively alleviate severe hypoglycemia-induced occipital lobe damage via regulating excitatory amino acid neurotransmitters,energy metabolism and other metabolic pathways.
7.One case of adult Kawasaki disease.
Yajuan ZHOU ; Lu SUN ; Xianyi YU ; Zhihan YAN ; Fen HUANG
Journal of Central South University(Medical Sciences) 2012;37(4):431-432
Kawasaki disease is far more frequent in children than in adults. The pathogenesis of Kawasaki disease is unknown, but it involves changes to the coronary artery and other diverse clinical manifestations. There are currently no specific laboratory diagnostic indexes, and especially since the disease is rare in adults, so it is extremely easy to misdiagnose or to overlook entirely. Our retrospective analysis of an diagnosis of and treatment for Kawasaki disease in an adult provides a guide to clinical doctors in terms of understanding Kawasaki disease, early diagnosis of it, and improved prognosis.
Adult
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Aspirin
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therapeutic use
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Humans
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Male
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Mucocutaneous Lymph Node Syndrome
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diagnosis
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therapy
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gamma-Globulins
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therapeutic use
8.MRI Features in Children with Cerebral Palsy Induced by Chronic Kernicterus
Xinglu TANG ; Xiang CHEN ; Wei CHEN ; Lidan LIANG ; Ziying ZHANG ; Shan LIU ; Fengxia TU ; Xiaotong WANG ; Zhihan YAN
Chinese Journal of Rehabilitation Theory and Practice 2009;15(4):357-359
Objective To study the characteristic findings on magnetic resonance imaging (MRI) in children with cerebral palsy (CP) induced by chronic kernicterus.Methods The MR imagings in 13 CP cases induced by chronic kernicterus were retrospectively studied, which were compared with 6 healthy and age-matched controls. 13 cases were finally diagnosed as dyskinetic cerebral palsy (athetoid subtype).Results In 13 cases, all showed symmetric high signals in the the globus pallidus on T2-weighted imaging. There were not apparent abnormality on T1-weighted imaging.Conclusion The bilateral high intensity signals in the globus pallidus on T2-weighted imaging are the characteristic findings on MRI in CP children induced by chronic kernicterus. Paying attention to the globus pallidus on MRI may be useful in determining the type of cerebral palsy.
9.The establishment and meaning of the three-dimensional finite element model of pelvic floor levator ani muscle in an old healthy woman.
Wei CHEN ; Lijun WN ; Zhihan YAN ; Jusong WANG ; Yalan FU ; Xiongfei CHEN ; Kun LIU ; Zhipeng WU
Journal of Biomedical Engineering 2011;28(5):927-931
This paper is to establish a three-dimensional finite element model (3D-FEM) of pelvic floor levator ani muscles in an old healthy women. We acquired the image data of the pelvic bones and pelvic floor muscles from CT and MRI scanning in a non-pregnant old healthy female volunteers. The 3-D reconstruction and mesh optimization of the whole pelvic bones and muscles with application of image processing software Mimics12.0 and Geomagic9.0 were obtained. Then we built the 3D-FEM of the musculoskeletal system of the pelvic bones and levator ani muscles with Ansys11.0 software. We obtained an accurate 3D-FEM of pelvic bones and levator ani muscles in the older healthy woman. The results showed that it was reliable to build 3D-FEM with CT and MRI scanning data and this model could vividly reflect the huge space anatomy of the real pelvic floor levator ani muscles. It avoids the defects to gain the model from the body of anatomical specimens in the past. The image data of model are closer to vivisection, and the model is more conducive to the latter finite element analysis.
Female
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Finite Element Analysis
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Humans
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Imaging, Three-Dimensional
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Magnetic Resonance Imaging
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Middle Aged
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Muscle, Skeletal
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anatomy & histology
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diagnostic imaging
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Pelvic Floor
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anatomy & histology
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diagnostic imaging
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Tomography, X-Ray Computed
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methods
10.Value of dynamic enhanced multi-slice spiral computed tomography in the differentiation of benign and malignant intraductal papillary mucinous neoplasm of pancreas
Quelu CHEN ; Yu CHEN ; Wenchao HU ; Yi JIANG ; Jicheng DU ; Xiaolong MA ; Zhihan YAN
Chinese Journal of Pancreatology 2018;18(2):85-89
Objective To analyze the value of dynamic enhanced multi-slice spiral computed tomography (MSCT) combined with two-dimensional (2D) curved reconstruction technique in the differentiation of benign and malignant intraductal papillary mucinous neoplasm (IPMN) of pancreas,and compare with magnetic resonance cholangiopancreatography(MRCP).Methods MSCT and MRCP data of a total of 50 patients with IPMNs confirmed by pathology after surgery was retrospectively reviewed.The benign and malignant IPMNs were differentiated based on the presence of mural nodules,main pancreatic duct (MPD) ≥ 10 mm,septum thickness ≥2 mm,calcification,surrounding vascular infiltration,enlarged peripancreatic lymph nodules,distant metastatic lesions and maximal branch duct type IPMN lesions ≥30 mm shown in the images.The sensitivity,specificity and accuracy were calculated and the receiver-operating-characteristics (ROC) analysis were drawn.Area under the curve (AUC) was calculated.Results Mural nodules in MSCT had a sensitivity,specificity,and accuracy of 77.1% (27/35),80.0% (12/15) and 78.0% (39/50) for diagnosing malignant IPMN,respectively;which in MRCP were 77.1% (27/35),86.7% (13/15),and 80.0% (40/50) in comparison.When MPD diameter ≥10 mm was used for diagnose malignancy,MSCT and MRCP had the sensitivity,specificity,and accuracy of 96.3% (26/27),81.8% (9/11),92.1% (35/38),and 96.3% (26/27),90.9% (10/11),94.7% (36/38),respectively.For thick septum ≥2 mm,MSCT and MRCP had the sensitivity,specificity,and accuracy of 4.8.6% (17/35),93.3% (14/15),62.0%(31/50),and 51.4% (18/35),93.3% (14/15),64.0% (32/50),respectively.Out of 50 cases,calcifications were detected on MSCT in 6 patients,and 5 of them were pathologically diagnosed as malignant IPMN.MRCP failed to identify calcifications in any of these lesions.For MSCT,the AUC of MPD diameter ≥ 10 mm,mural nodules and thick septum ≥ 2 mm were 0.973 (P =0.000),0.825 (P =0.002) and 0.704(P =0.051),respectively.For MRCP,the AUC of the three factors above were 0.976(P =0.000),0.825(P =0.002),0.722 (P =0.034),respectively.For the predicting of IPMN malignancy,MSCT had an overall sensitivity,specificity,and accuracy of 94.3% (33/35),73.3% (11/15) and 88.0% (44/50),respectively;in comparison,MRCP had values of 94.3% (33/35),80.0% (12/15) and 90.0% (45/50),respectively.Conclusions Presence of mural nodules,MPD ≥10 mm and thick septum ≥2 mm on MSCT combined with 2D curved reconstruction or MRCP have a high value for predicting the malignancy of IPMN.The values of MSCT and MRCP were basically consistent in the differentiation of benign and malignant IPMN.MSCT can be used as the preferred examination for diagnosing IPMN in the primary hospitals without MR equipment.