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Applications of Stomach Full Acoustic Imaging in the Diagnosis of Congenital Hypertrophic Pyloric Stenosis

Suihong MA ; Jianhua LIU ; Xiaomei MA ; Huanqian LUO ; Shuyi XIAO ; Wencai OU

Chinese Journal of Medical Imaging.2013;(10):758-760,764. doi:10.3969/j.issn.1005-5185.2013.10.011

Purpose To explore the significance of stomach full acoustic imaging in the diagnosis of congenital hypertrophic pyloric stenosis (CHPS). Materials and Methods 44 cases of CHPS children underwent gastrointestinal filling acoustic contrast imaging, diameter and mucous layer thickness of the front and rear walls of the pyloric tube were measured, the contrast agent flow between the pyloric lumen gaps was observed. Results With the backdrop of the ultrasound contrast agent, delicate structure of the stomach and pyloric mucosa could be more clearly observed, it was shown that muscular layer in the middle of pyloric tube was thickest and mucosal layer edema and thickening was more obvious near the antrum;internal diameter of pyloric tube was (1.95±0.35) mm;first pass time of the contrast agent through the pyloric tube:within 5 min in 16 cases, 5-10 min in 19 cases, while clear pass through still could not be observed by 20 minutes in 9 cases;during the 20 minutes observation, contrast agent passed through the pyloric tube for 5 times or more in 13 cases, 1 to 5 times in 22 cases, while 9 cases showed no obvious pass. Conclusion Stomach full acoustic imaging enables clearly and detailed observation of the structural characteristics of the pyloric tube and hydrodynamic manifestation of the stomach liquid when passing through the tube, thus is significantly important for surgical treatment and efficacy evaluation.

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Ultrasound in Early Diagnosis of Periventricular-intraventricular Hemorrhage in Premature Infants

Xiao LI ; Jiangfeng XIAN

Chinese Journal of Medical Imaging.2013;(10):749-751,753. doi:10.3969/j.issn.1005-5185.2013.10.008

Purpose To observe the ultrasonographic features of periventricular-intraventricular hemorrhage (PIVH) in preterm infants, to evaluate the value of cranial ultrasound for early diagnosis of PIVH. Materials and Methods 555 cases of premature children underwent bedside cranial ultrasound examination, characteristics of their ultrasound images were retrospectively analyzed and categorized with Papile grading, gradeⅢandⅣPIVH were defined as severe bleeding. Results 125 PIVH cases (22.52%) were detected by ultrasound, of which 111 cases (88.8%) were Papile gradeⅠ, manifested as hyperechoic group localized in the rear and below lateral ventricle anterior horn and in the sulcus of hypothalamic caudate nucleuscaudate;7 cases (5.6%) were Papile gradeⅡ, manifested as increased echogenicity, irregular widen or isolated mass shadow of the choroid plexus within the triangle zone and posterior horn of the lateral ventricle;7 cases (5.6%) were Papile gradeⅢ, manifested as hyperechoic group within the lateral ventricle with ventricular dilatation. 7 cases (1.26%) were severe PIVH. Overall incidence rates of PIVH in premature children whose gestational age was <32 weeks and ≥ 32 weeks were 45.05% and 16.89% respectively; overall incidence rates of PIVH for preterm infants whose birth weight were <1500 g and ≥ 1500 g were 44.16% and 19.04%, overall incidence of PIVH of preterm infants with gestational age<32 weeks and birth weight<1500 g was significantly higher than their contemporaries with gestational age≥32 weeks and birth weight ≥1500 g, and the differences were statistically significant (χ2=40.334, 23.978; P<0.01). Conclusion Incidence of PIVH becomes higher when the gestational age of preterm child is smaller and the birth weight is lower. Performing routine cranial ultrasound examination for preterm infants is important for early diagnosis of PIVH and Papile grading, thus will instruct the clinical intervention in early stage.

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Clinical Application of Wireless Flat-panel Detector in X-ray Photography in the Small Joints of the Limbs

Huizhao WU ; Zekun ZHANG ; Wenjuan WU

Chinese Journal of Medical Imaging.2013;(6):411-413,416. doi:10.3969/j.issn.1005-5185.2013.06.003

Purpose To compare the wireless flat-panel detector with gadolinium oxide coating in X-ray photography in the small joints of the limbs compared with conventional flat panel detector with cesium iodide coating. Materials and Methods Comparison was randomly performed between gadolinium oxide coated sulfur wireless flat-panel detector and cesium iodide coated conventional flat-panel detector for 80 patients who received routine X-ray photography, and scoring data were applied with statistical analysis. Results There was no significant difference between the scoring data from two film-reading people (P>0.05). The resolution of anatomical structure of small joint of limbs and tube current showed no significant difference for two types of imaging systems (P>0.05). Conclusion Wireless flat panel detector sulfur with gadolinium oxide coatings can obtain satisfactory image quality at a reasonable inspection doses in the X-ray photography of small joint of limbs. The imaging quality and inspection doses are similar to conventional flat panel detector device with cesium iodide coating, but the posture is more convenient.

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CT Manifestations and Drainage Characteristics of Klebsiella Pneumoniae Induced Liver Abscess

Zhihui CHANG ; Jian ZHAO ; Jiahe ZHENG ; Zhaoyu LIU

Chinese Journal of Medical Imaging.2013;(6):436-438,442. doi:10.3969/j.issn.1005-5185.2013.06.010

Purpose To analyze the differences of CT manifestations, and to explore the disparity of drainage volume in early drainage between Klebsiella pneumoniae induced liver abscess and non-Klebsiella pneumoniae induced liver abscess. Materials and Methods 337 cases of patients whose blood culture or drainage fluid culture results were positive were divided into Klebsiella pneumoniae group (219 cases) and non-Klebsiella pneumoniae group (118 cases). CT characteristics of the two groups were analyzed, including lesion distribution, quantity, structure, texture, abscess wall thickness, enhancement character around the lesion, whether or not concurrent with thrombophlebitis or migratory infection and so on. Early drainage volume in interventional puncture drainage was observed in both groups. Results Chest CT showed that solitary, multi-room, solid, thin-walled abscesses with concurrent thrombophlebitis, migratory infection and no enhancement around tend to occur in Klebsiella pneumoniae group (χ2=4.065, 3.834, 4.682, 5.689, 5.215, 8.362, 8.407, P<0.01). Early drainage volume of Klebsiella pneumoniae group was significantly lower than that of non-Klebsiella pneumoniae group (χ2=5.863, P<0.01). Conclusion CT manifestations of Klebsiella pneumoniae induced liver abscess are solitary, multi-room, solid, thin-walled abscesses without enhancement around them, thrombophlebitis and migratory infection are common seen and drainage volume is less in early stage after interventional operation.

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Whole Body Diffusion-weighted MR Imaging Study of Bone Marrow in Healthy Adults

Xian XU ; Lin MA ; Ningyu AN ; Youquan CAI ; Xinqiu LIU

Chinese Journal of Medical Imaging.2013;(6):401-405,410. doi:10.3969/j.issn.1005-5185.2013.06.001

Purpose To explore the correlation between whole body magnetic resonance diffusion-weighted imaging (WB-DWI) quantitative parameters of healthy adults' bone marrow with gender, age, height, weight, body mass index, and sex hormone levels. Materials and Methods 108 healthy adult subjects in different age groups underwent WB-DWI scan using GE 1.5T MR scanner, among them estradiol and progesterone levels were measured in 60 subjects within 48 hours before or after the scan. Apparent diffusion coefficient (ADC) values of bone marrow and the signal to noise ratio (SNR) were compared among different gender and age groups. Partial correlation analysis was used to evaluate the correlation of skeletal system ADC values and SNR with sex, age, height, weight, body mass index, estradiol and progesterone levels in 60 subjects. Results ADC values and SNR of the female subjects were significantly higher than males (P<0.01);there were significantly differences for skeletal system ADC values and SNR in different age groups (P<0.01). Skeletal system ADC values was significantly negatively correlated (r=-0.642, P<0.01) with age, and were mildly positively correlated (r=0.278, 0.271, P<0.05) with estradiol and progesterone levels;SNR was significantly negatively correlated (r=-0.709, P<0.01) with age, and was mildly positively correlated (r=0.293, P<0.05) with estradiol levels;ADC values and SNR had no significant correlation with height, weight and body mass index. Conclusion Skeletal system ADC values are effected by gender, age and sex hormone levels, the skeletal system WB-DWI manifestations are different in different gender and age groups.

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Correlation Between Fetal Cardiac Function and Interventricular Septal Thickness in Fetuses of Diabetic Mothers

Ping HE ; Yuqi ZHANG ; Yu LU ; Huiying XU ; Xiangli HONG

Chinese Journal of Medical Imaging.2013;(10):771-774,779. doi:10.3969/j.issn.1005-5185.2013.10.015

Purpose To explore the correlation between fetal cardiac function and interventricular septal thickness in fetuses of gestational diabetes mellitus (GDM) mothers. Materials and Methods Thirty-nine GDM mothers were involved in the study and divided into group MH (fetuses of GDM mothers with interventricular septal hypertrophy) and group NMH (fetuses of GDM mothers with normal interventricular septal thickness). Ultrasonic cardiogram was performed for both groups to assess such variables as interventricular septum thickness at end diastole (IVSd), left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS), right ventricular fraction shortening (RVFS), the ratio of E and A of mitral flow (E/AMV), the ratio of E and A of tricuspid flow (E/ATV), peak velocity of aortic valve (VPAO), peak velocity of pulmonary valve (VPPA) and myocardial performance index (MPI). The results were further compared with those of control group. Results The VPAO, VPPA, LVEF and LVFS in group NMH were significantly higher than those in control group (P<0.05). The VPAO, VPPA, LVEF, LVFS and RVFS in group MH were significantly higher than those in control group whilst the E/AMV and E/ATV significantly lower than those in control group (P<0.05). The LVEF, LVFS and RVFS in group MH were significantly higher than those in group NMH whilst the E/AMV and E/ATV significantly lower (P<0.05). MPI in group MH was significantly higher than that in group NMH (P<0.05), whilst both were significantly higher than that in control group (P<0.05). The LVEF, LVFS, RVFS, VPAO and VPPA were positively correlated with IVSd (r=0.48, 0.51, 0.45, 0.30, 0.30;P<0.05). Conclusion Cardiac function in fetuses of GDM mothers may be associated with interventricular septal thickness.

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Application of Low Pressure Contrast Injection in Transvaginal Ultrasound Three-dimensional Hysterosalpingo-contrast Sonography

Shufang GU ; Qi CHENG ; Xiansheng ZHU ; Hong WANG ; Shasha WANG

Chinese Journal of Medical Imaging.2017;25(1):34-36. doi:10.3969/j.issn.1005-5185.2017.01.009

Purpose To explore the clinical value of reducing the incidence of reflux and improving patients' comfort by low pressure contrast injection during transvaginal ultrasound real time three-dimensional hysterosalpingo-contrast sonography (TVS RT-3D-HyCoSy).Materials and Methods Data ofTVS RT-3D HyCoSy using low pressure contrast injection of 498 infertile women were analyzed.The peak pressure,the incidence of reflux and adverse reactions were recorded.Compared these parameters between bilateral tubals.Results The peak pressure in patency,partially patency and fully obstructed of bilateral tubals were (22.47±5.96) kPa,(37.24±8.83) kPa and (44.64±7.73) kPa.There was significant difference among the three groups (F=70.35,P＜0.05).Among all 498 patients,the incidence of reflux was 26.31％.The incidence in patency,partially patency and fully obstructed of bilateral tubals were 18.00％,30.21％ and 43.59％.There was significant difference among the three groups (x2=15.59,P＜0.05).Different degrees of adverse reactions were 88.96％,10.64％ and 0.4％.Conclusion By using low pressure contrast injection during HyCoSy,the incidence of reflux can be reduced and examination comfort can be improved.

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Application of Individualized Optimal Monochromatic Energy Images in Low Radiation Dose and Contrast Dose Spectral Coronary CT Angiography

Xiaoxia CHEN ; Taiping HE ; Yong YU ; Zhanli REN ; Chunling MA ; Dong HAN

Chinese Journal of Medical Imaging.2017;25(1):30-33. doi:10.3969/j.issn.1005-5185.2017.01.008

Purpose To explore the value of spectral coronary CT angiography (CCTA) in reducing radiation dose and contrast dose using individualized optimal monochromatic imaging.Materials and Methods Sixty patients with suspected coronary disease were recruited in the study,who were randomly divided into two groups:group A (n=30) using conventional CT protocol with 350 mgI/ml contrast agent;group B (n=30) using low dose spectral CT imaging mode with 300 mgI/ml contrast agent.The images of group A were reconstructed with conventional process,and the images of group B were reconstructed with Optimal CNR to obtain the optimal monochromatic energy images.The images of both groups were transferred to an Advanced Workstation for analysis.Double-blinded method was carried out to qualify the images.CT values of coronary artery segments,as well as standard deviations (SD),the signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR) of aortic sinus were measured.Radiation doses and iodine intake were compared between the two groups.The optimal keV distribution in group B was analyzed.Results There was no significant difference for the subjective scoring of image quality,CT value of each coronary artery segment,SD,SNR,and CNR values between the two groups (P＞0.05).The effective radiation dose and total iodine load in group B were less than that in group A (P＜0.05).The optimal energy distribution for group B was 60-75 keV,average at (66.50+3.91) keV.Conclusion Compared with the conventional CT protocol,spectral CT imaging at optimal energy levels combined with iterative reconstruction can effectively reduce the radiation dose and iodine load,and obtain better images than usual protocol.

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Speckle Tracking Imaging Technique in Detection of Coronary Artery Disease in Patients with Hypertension

Yanjun LI ; Donghong LIU ; Yanqiu LIU

Chinese Journal of Medical Imaging.2017;25(1):21-25. doi:10.3969/j.issn.1005-5185.2017.01.006

Purpose To explore the effect of speckle tracking imaging (STI) in early detection of coronary artery disease (CAD) in patients with hypertension (HT),and to intervene early to alleviate or delay the progression of CAD.This would provide theoretical evidence in controlling the development and improving the prognosis of CAD.Materials and Methods From January 2013 to April 2015,a total of 166 cases of hospitalized patients from the First Affiliated Hospital of Sun Yat-sen and Jiangmen Central Hospital were retrospectively analyzed,including HT group (n=42),CAD group (n=35),HT+CAD group (n=49) and control group (n=40).Conventional measurement and STI were used to analyze the conventional values and the 17 section peak strain value of the left ventricle.Results The total mean strain,average peak strain of lesion segment and minimum peak strain in CAD group and HT+CAD group were significantly lower (P＜0.05) compared to the control group.ROC analyses showed that the AUC for total mean strain,average peak strain of lesion segment and minimum peak strain value were 0.71,0.76,and 0.70,respectively.Using a combined cut-off of ≥-18％ of average peak strain of lesion segment,≥-19％ of total mean strain and ≥-6％ of minimum peak strain value,the performance of CHD diagnosis had a sensitivity of 91.3％ and a specificity of 83.5％.Conclusion Speckle tracking automatic function imaging can be used to quantitatively analyze abnormal left ventricular segmental wall movement.It improves the detection in hypertension patients with coronary artery disease.

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Effect of Subclinical Left Ventricular Systolic Dysfunction on Prognosis of Prediabetic Patients

Shengjun TA ; Dandan LIANG ; Haijun WANG ; Hongxing BAI

Chinese Journal of Medical Imaging.2017;25(1):17-20. doi:10.3969/j.issn.1005-5185.2017.01.005

Purpose Many studies have shown that subclinical left ventricular systolic dysfunction is seen in prediabetic patients.However,its relationship with prognosis is unclear.The purpose of this study is to investigate the prognostic value of subclinical left ventricular systolic dysfunction with prediabetes.Materials and Methods This was a prospective clinical cohort study.A total of 98 prediabetes patients with complete medical record and follow up data in the physical exam center and the clinic of Yan'an People's Hospital were chosen between January 2013 and January 2014.The biochemical data,echocardiography and left ventricular global longitudinal strain (GLS) in 2 years of follow up were collected.The subjects were grouped into diabetes if the diagnosis was confirmed during follow up,or non-diabetes group if not diagnosed.After follow up,the baseline parameters were compared to screen for risk factors to develop clinical diabetes.Results During the study,38 participants were diagnosed as clinical diabetes.Cox proportional hazard regression models show that obesity [hazard ratio (HR):2.662,95％ CI 1.374-5.159,P=0.004],waist-hip ratio (HR:1.917,95％ CI:1.012-3.492,P=0.001),mitral E/e'ratio (HR:1.661,95％ CI:1.336-2.065,P＜0.001),HbAlc (HR:2.029,95％ CI:1.047-3.932,P＜0.001),global longitudinal strain (HR:0.786,95％ CI:0.728-0.848,P＜0.001) were significant independent predictors for developing diabetes.Using GLS＜18％ as cutoff value,the area under receiver operating characteristic (ROC) curve to predict development of diabetes was 0.796 (95％ CI:0.704-0.888,P＜0.001),with sensitivity and specificity of 46.7％ and 89.5％,respectively.Conclusion Among modifiable risk factors in patients with prediabetes,subclinical left ventricular systolic dysfunction is an early indicator of progressing to diabetes.Early detection of left ventricular systolic dysfunction in prediabetes can provide the basis for early clinical intervention.

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