Objective To explore the role of PDSA quality management tool in promoting the construction of hospital medical record quality control audit system,and the path to continuously improve the quality of intelligent audit of medical record first page data.Methods Analyzing the current state of medical record quality management using root cause verification meth-ods,we followed the PDSA quality management theory and process,implementing planning,execution,evaluation,and handling procedures.Special pilot programs,effectiveness validation,and iterative improvement measures were undertaken to enhance the entire process of intelligent medical record quality control review.Results After implementing PDSA cycle management meas-ures,the completion rates for admission records,surgical records,discharge records,and medical record cover pages within 24 hours all reached the preset target values.The accuracy of the main diagnosis selection by physicians significantly improved,re-sulting in a standardized and visualized work mechanism for intelligent medical record quality control.Conclusion The applica-tion of PDSA cycle management can effectively improve and enhance the quality of intelligent review of medical record cover pa-ges,facilitating the construction of a scientific system for intelligent medical record quality control review.

Objective:To explore the application value of guide tube fenestration and drainage technology in intracranial artery stenting surgery.Methods:A total of 120 patients with symptomatic intracranial atherosclerotic stenosis admitted to the Xingtai Third Hospital from January 2021 to December 2022 were selected and randomly divided into an observation group ( n=60) and a control group ( n=60). Both groups were treated with intracranial artery stenting, with the observation group receiving guidance catheterization and window opening technique during the surgery. Two groups of surgeries were observed and compared: the degree of vascular stenosis before and after surgery, the Montreal Cognitive Assessment Scale (MoCA) scores before and one month after surgery, intraoperative complications, and prognosis. Results:The surgical time and catheter placement time in the observation group were (110.20±23.32)minutes and (11.32±2.01)minutes, respectively, which were significantly shorter than those in the control group (all P<0.05). The stent placement rate and operation success rate in the observation group were 95.00% and 96.67%, respectively, significantly higher than those in the control group (all P<0.05). The degree of postoperative vascular stenosis in the observation group was (32.29±7.11)%, significantly milder than that in the control group [(44.43±8.15)%, P<0.05]. One month after surgery, the MoCA scores of both groups improved significantly compared to before surgery (all P<0.05), and there was no statistically significant difference between the groups ( P>0.05). There was no statistically significant difference in the incidence of collateral circulation occlusion and vascular rupture between the two groups (all P>0.05). During the follow-up period, there was no statistically significant difference in the incidence of restenosis, intracranial hemorrhage, and recurrent ischemic stroke between the observation group and the control group (all P>0.05); The good prognosis rate of the observation group was 73.33%, significantly higher than that of the control group (53.33%, P<0.05). Conclusions:The application of guided catheter fenestration technique in intracranial artery stenting has good value, which is beneficial for improving the stent placement rate and operation success rate, and improving the degree of vascular stenosis.

Objective:To investigate the preoperative nutritional status of cardiac surgery patients in southwest China, analyze the incidence and characteristics of nutritional risk, and provide basis for establishing a standardized individualized nutritional intervention program for cardiac surgery patients.Methods:A cross-sectional survey was conducted on the nutritional status and intervention status of preoperative patients in cardiac surgery department of 23 general hospitals in Yunnan, Guizhou, Sichuan and Chongqing districts. At 00: 00 on July 7, 2022, the patients aged > 18 years old in cardiac surgery departments of the above hospitals who planned to undergo surgical treatment were enrolled as the survey objects to investigate the nutritional status on July 6, 2022 (the survey date), including basic information (general information, nutrition indicators, etc.), nutrition screening and evaluation (nutrition risk screening and organ support, etc.), nutrition treatment (nutrition supplement methods and prescriptions, etc.) and nutrition awareness of medical staff.Results:The 126 questionnaires were collected, of which 125 were valid (99.2%). ① Basic information: of the 125 patients, 67 patients were male (53.6%) and 58 patients were female (46.4%). The age ranged from 19 years old to 86 years old, with an average of (53.13±14.74) years old. Body mass index (BMI) was (22.21±3.78) kg/m 2. The age and BMI of men were significantly higher than those of women [age (years old): 56.63±13.34 vs. 49.09±15.35, BMI (kg/m 2): 22.74±3.86 vs. 21.59±3.61, both P < 0.05]. Of the 125 patients, 75 had valvular disease and 50 were with non-valvular diseases, which mainly included congenital heart disease [19 cases (15.2%)], aortic dissection [13 cases (10.4%)], coronary heart disease [12 cases (9.6%)], etc. The course of disease was 0.5 hour to 36 years, of which 93 patients (74.4%) were more than 6 months and 32 patients (25.6%) were equal to or less than 6 months. The proportion of female patients with disease duration > 6 months was significantly higher than that of male patients [87.9% (51/58) vs. 62.7% (42/67), P < 0.01]. The basic diseases mainly included hypertension [38 cases (30.4%)], coronary heart disease [12 cases (9.6%)], diabetes [7 cases (5.6%)], chronic obstructive pulmonary disease [COPD, 6 cases (4.8%)], etc. Among 125 patients, total protein (TP) < 60 g/L in 24 cases (19.2%), albumin (Alb) < 40 g/L in 64 cases (51.2%), anemia [male hemoglobin (Hb) < 120 g/L, female Hb < 110 g/L] in 33 cases (26.4%). A total of 60 cases of prealbumin data were collected, of which 23 cases (38.3%) were less than 200 mg/L.② Nutrition screening and assessment: 33.6% of the 125 patients did not undergo routine nutrition screening after admission, including the provincial and municipal tertiary hospitals. Among the 83 patients undergoing nutritional screening, 41 (32.8%) were at nutritional risk. Further analysis of patients with nutritional risk showed that of the 41 patients, 20 were male (48.8%) and 21 were female (51.2%); 27 cases (65.9%) was with valvular diseases and 14 cases (34.1%) was with non-valvular diseases; the course of disease was more than 6 months in 30 cases (73.2%), and ≤ 6 months in 11 cases (26.7%). Statistical comparison of the above 83 patients showed that women, basic disease, long term-valvular disease, anemia, low TP, and low Alb before operation were more prone to innutrition. ③ Nutritional therapy: of the 125 patients, 5 were receiving mechanical ventilation (4.0%) and 2 were using vasoactive drugs (1.6%); there were 5 cases with gastrointestinal dysfunction (4.0%), mainly manifested as abdominal distension, abdominal pain, constipation and diarrhea. One patient was treated with enteral nutrition through gastric tube combined with parenteral nutrition support, 124 patients were fed orally, and an irregular phenomenon of injecting amino acid fat emulsion through peripheral vein in 2 patients. ④ Nutrition awareness of medical staff: 124 (99.2%) of the 125 patients had a nutrition department in their hospital; 71 cases (56.8%) received nutrition education, of which 37 cases (52.1%) were consulted by the nutrition department. Of all the cases, only 38 (30.4%) were consulted by the nutrition department, of which 1 (2.6%) did not receive nutrition education after consultation. Conclusions:At present, the incidence of preoperative malnutrition in patients undergoing cardiac surgery is high in southwest China. The incidence of malnutrition in patients with basic diseases, long term-valvular disease, low TP, low Alb and anemia before operation is higher, and the incidence of malnutrition is hidden in women. The course of disease of women is longer than that of men at the time of treatment, and malnutrition is more likely to occur. The attending physicians should pay attention to the above groups. It is necessary to establish a standardized individualized nutritional intervention program and apply it to actual clinical diagnosis and treatment, so as to ultimately improve the prognosis of patients undergoing cardiac surgery and increase the benefits of patients in treatment.

Objective:To investigate the application value of contrast-enhanced ultra-sound, enhanced computed tomography (CT) and enhanced magnetic resonance imaging (MRI) in the diagnosis of small hepatocellular carcinoma.Methods:The clinical diagnositic trial was con-ducted. The clinicopathological data of 145 patients with small hepatocellular carcinoma who were admitted to the First Affiliated Hospital of Amy Medical University from January 2019 to June 2021 were collected. There were 121 males and 24 females, aged from 26 to 78 years, with a median age of 54 years. All patients were examined with contrast-enhanced ultrasound, enhanced CT and enhanced MRI, and underwent surgical resection of liver lesions within one month. Observation indicators: (1) postoperative histopathological examinations of patients with small hepatocellular carcinoma; (2) examination of small hepatocellular carcinoma by contrast-enhanced ultrasound, enhanced CT and enhanced MRI; (3) imaging features of small hepatocellular carcinoma in the contrast-enhanced ultrasound, enhanced CT and enhanced MRI; (4) enhancement mode distribution of small hepatocellular carcinoma in the arterial, portal and delayed phases of contrast-enhanced ultrasound, enhanced CT and enhanced MRI; (5) the efficacy of contrast-enhanced ultrasound, enhanced CT and enhanced MRI in the diagnosis of small hepatocellular carcinoma. Measurement data with normal distribution were represented as Mean± SD, and measurement data with skewed distribution were represented as M(range). Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the Cochran′s Q test or the chi-square test. The sensitivity, specificity and accuracy were used to analyze the efficacy of contrast-enhanced ultrasound, enhanced CT and enhanced MRI in the diagnosis of small hepatocellular carcinoma. Results:(1) Postoperative histopathological examinations of patients with small hepatocellular carcinoma. There were 154 lesions detected in the postoperative histopathological examinations for the 145 small hepatocellular carcinoma patients, with the tumor diameter as (2.2±0.6)cm. (2) Examination of small hepatocellular carcinoma by contrast-enhanced ultrasound, enhanced CT and enhanced MRI. There were 153, 154 and 154 lesions detected in contrast-enhanced ultrasound, enhanced CT and enhanced MRI for the 145 patients with small hepatocellular carcinoma, respectively, with the detection rate as 99.35%(153/154), 100.00%(154/154) and 100.00%(154/154), showing no significant difference among the 3 imaging examination methods ( Q=2.00, P>0.05). (3) Imaging features of small hepatocellular carcinoma in the contrast-enhanced ultrasound, enhanced CT and enhanced MRI. Of the 153 lesions reported in contrast-enhanced ultrasound for patients with small hepatocellular carcinoma, 140 lesions showed "fast-in and fast-out" enhancement, 12 lesions showed "fast-in and slow-out" enhancement and 1 lesion showed isoenhancement in arterial phases and hypoenhancement in portal and delayed phase. Of the 154 lesions reported in enhanced CT for patients with small hepatocellular carcinoma, 112 lesions showed "fast-in and fast-out" enhancement, 13 lesions showed "fast-in and slow-out" enhancement, 14 lesions showed isoenhancement in arterial phase and hypoenhancement in portal and delayed phases, 5 lesions showed rim-like hyperenhancement in arterial phase and hypoenhancement in portal and delayed phases, 5 lesions showed hypoenhancement in the three phases, 3 lesions showed hyperenhancement in the three phases, 1 lesion showed isoenhancement in the three phases and 1 lesion showed isoenhancement in arterial and portal phases and hypoenhancement in delayed phase. Of the 154 lesions reported in enhanced MRI for patients with small hepatocellular carcinoma, 134 lesions showed "fast-in and fast-out" enhancement, 1 lesion showed "fast-in and slow-out" enhancement, 8 lesions showed isoenhancement in arterial phase and hypoenhance-ment in portal and delayed phases, 5 lesions showed rim-like hyperenhancement in arterial phase and hypoenhancement in portal and delay phases, 2 lesions showed rim-like hyperenhancement in the three phases, 1 lesion showed hyperenhancement in the three phases, 1 lesion showed hypoenhancement in the three phases, 1 lesion showed isoenhancement in arterial and portal phases and hypoenhancement in delayed late phase, 1 lesion showed edge delay enhancement in the three phases. (4) Enhancement mode distribution of small hepatocellular carcinoma in the arterial, portal and delayed phases of contrast-enhanced ultrasound, enhanced CT and enhanced MRI. Of the 153 lesions reported in contrast-enhanced ultrasound for patients with small hepatocellular carcinoma, there were 152 lesions with hyperenhancement and 1 lesion with iso or hypoenhance-ment in the arterial phase, there were 55 lesions with hyper or isoenhancement and 98 lesions with hypoenhancement in the portal venous phase, there were 12 lesions with hyper or isoenhancement and 141 lesions with hypoenhancement in the delayed phase. Of the 154 lesions reported in enhanced CT for patients with small hepatocellular carcinoma, there were 133 lesions with hyperen-hancement signal and 21 lesions with iso or hypoenhancement in the arterial phase, there were 53 lesions with hyper or isoenhancement and 101 lesions with hypoenhancement in the portal phase, there were 17 lesions with hyper or isoenhancement and 137 lesions with hypoenhancement in the delayed phase. Of the 154 lesions reported in enhanced MRI for patients with small hepatocellular carcinoma, there were 143 lesions with hyperenhancement and 11 lesions with iso or hypoenhance-ment in the arterial phase, there were 29 lesions with hyper or isoenhancement and 125 lesions with hypoenhancement in the portal phase, there were 5 lesions with hyper or isoenhancement and 149 lesions with hypoenhancement in the delayed phase. There were significant differences in the enhancement mode distribution of lesions in the arterial, portal and delayed phases among contrast-enhanced ultrasound, enhanced CT and enhanced MRI ( χ2=19.47, 13.21, 6.92, P<0.05). (5) The efficacy of contrast-enhanced ultrasound, enhanced CT and enhanced MRI in the diagnosis of small hepatocellular carcinoma. Of the 153 lesions reported in contrast-enhanced ultrasound for patients with small hepatocellular carcinoma, there were 3 lesions misdiagnosed according to the postoperative histopathological examinations. Of the 154 lesions reported in enhanced CT and enhanced MRI for patients with small hepatocellular carcinoma, there were 7 lesions and 2 lesions misdiagnosed according to the postoperative histopathological examinations, respectively. Lesions misdiagnosed in one imaging examination method were correctly diagnosed in the other two imaging examination methods. The sensitivity, specificity, accuracy were 97.4%, 63.0%, 92.3% for contrast-enhanced ultrasound in the diagnosis of small hepatocellular carcinoma. The above indica-tors were 95.5%, 63.0%, 90.6% for enhanced CT and 98.7%, 63.0%, 93.4% for enhanced MRI in the diagnosis of small hepatocellular carcinoma. There was no significant difference in the sensitivity and accuracy among the 3 imaging examination methods ( Q=2.92, 0.00, 1.81, P>0.05). Conclusion:Contrast-enhanced ultrasound, enhanced CT and enhanced MRI all have good diagnostic value in diagnosis of small hepatocellular carcinoma, and they complement each other.

Objective:To compare the influence of single and staged percutaneous coronary intervention (PCI) on long-term prognosis in patients with multi-vessel coronary artery disease.Methods:Using prospective research methods, 1 832 patients with multi-vessel coronary artery disease from January to December 2013 in Fuwai Hospital, Chinese Academy of Medical Sciences were selected. According to the time of PCI, the patients were divided into single PCI group (1 218 cases) and staged PCI group (614 cases). The patients were followed up for 2 years, the primary endpoint was major cardiovascular and cerebrovascular event (MACCE), including target vessel-related myocardial infarction (TV-MI), target vessel-related revascularization (TVR), cardiogenic death and stroke, and the secondary endpoint was stent thrombosis. The propensity score matching (PSM) was applied to balance the discrepancies between 2 groups, and the baseline and follow-up data were compared. The Kaplan-Meier survival curves were drawn to evaluate the survival rates events; multifactor Cox proportional risk regression was used to analyze whether staged PCI was an independent risk factor for the endpoint events.Results:The in-hospital stay, duration of procedure and synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score in single PCI group were significantly lower than those in staged PCI group: (5.54±3.09) d vs. (9.50±4.06) d, (43.12±28.55) min vs. (79.54±44.35) min, (14.04±7.63) scores vs. (18.51±7.79) scores, and there were statistical differences ( P<0.01); there were no statistical difference in complete revascularization rate and SYNTAX score after PCI between 2 groups ( P>0.05). Based on 2-year follow-up, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.5% (6/1 218) and 2.0% (12/614) vs. 0.4% (5/1 218), and there were statistical differences ( P<0.01). Kaplan-Meier survival curves analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were better than those in staged PCI group (99.5% vs. 97.9% and 99.6% vs. 98.0%, P<0.01). Multifactor Cox proportional risk regression analysis results showed that staged PCI was an independent risk factor for stent thrombosis ( HR = 3.91, 95% CI 1.25 to 12.18, P = 0.019). After PSM, the incidences of TV-MI and stent thrombosis in staged PCI group were significantly higher than those in single PCI group: 2.1% (13/614) vs. 0.7% (4/614) and 2.0% (12/614) vs. 0.5% (3/614), and there were statistical differences ( P<0.05); Kaplan-Meier survival curve analysis results showed that the event-free survival rates of TV-MI and stent thrombosis in single PCI group were significantly higher than those in staged PCI group: (99.3% vs. 97.9% and 99.5% vs. 98.0%, P<0.05); multifactor Cox proportional risk regression analysis results showed that staged PCI was not an independent risk factor of stent thrombosis ( HR = 2.29, 95% CI 0.58 to 9.00, P = 0.234). Both before and after PSM, there were no evidences for interaction between the type of angina pectoris and staged PCI ( P>0.05). Conclusions:Although a seemingly increase exists in the incidence of TV-MI and stent thrombosis in the staged PCI group, staged PCI is an independent risk factor neither for MACCE and its components, nor for stent thrombosis. In addition single PCI reduces the in-hospital days and duration of PCI procedure, which may be a relatively reasonable approach to clinical practice.

Objective     To investigate short-term outcomes of robot-assisted Heller-Dor myotomy (RAHM-Dor) for achalasia of cardia and our learning curve experience. Methods     The clinical data and recent follow-up results of 42 patients who received RAHM-Dor from November 2015 to January 2020 in the Department of Thoracic Surgery of the First Affiliated Hospital of Nanchang University were retrospectively analyzed, including 20 males and 22 females with a mean age of 40.8±18.4 years. Results    Dysphagia was the most common symptom, followed by heartburn and regurgitation. The mean operation time was 122.8±23.9 min. The mean blood loss was 47.5±32.7 mL. Two patients suffered mucosal injury, and successfully repaired by suturing during surgery. There was no esophageal fistula, conversion to an open operation or perioperative death in this series. The median length of hospital stay was 8 (6, 9) d. In all patients, the Stooler and Eckardt scores of postoperative 1, 6 and 12 months decreased compared to those of pre-operation (P<0.001). Conclusion     RAHM-Dor is a safe and feasible avenue for the treatment of achalasia of cardia, and can achieve a satisfying short-term results. The learning curve shows a transition to the standard stage from the learning stage after 16-18 operations.

Liver transplantation is one of the main treatments of early hepatocellular carcinoma (HCC). The recurrence of HCC after liver transplantation severely affects the long-term survival rate of the recipients. Targeted therapy and immunotherapy play a critical role in HCC downstaging, preventing disease progression, reducing recurrence rate, prolonging the survival and improving the quality of life. However, no consensus has been reached on the application of targeted therapy and immunotherapy in recipients undergoing liver transplantation for HCC, including indications, timing and dosage. In this article, clinical research progresses on the indications and timing of targeted therapy and immunotherapy before and after liver transplantation for HCC were reviewed, aiming to provide reference for prolonging the survival of recipients after liver transplantation for HCC.

Objective:To investigate the clinical value of contrast-enhanced ultrasound and gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA MRI) in the diagnosis of hepatocellular carcinoma (HCC).Methods:The clinically diagnostic test was conducted. The clinicopathological data of 274 lesions in 250 patients with liver neoplasms who were admitted to the First Hospital Affiliated to Army Medical University from January 2017 to December 2018 were collected. There were 204 males and 46 females, aged (52±11)years, with a range from 22 to 78 years. Patients underwent contrast-enhanced ultrasound and Gd-EOB-DTPA MRI, and they received surgical resection or biopsy within one month. Images was read and analyzed by two senior radiologists for diagnosis. Observation indicators: (1) imaging features of contrast-enhanced ultrasound and Gd-EOB-DTPA MRI, including ① imaging features of contrast-enhanced ultrasound, ② imaging features of Gd-EOB-DTPA MRI, ③ enhanced imaging manifestation in different phases of 223 HCC lesions; (2) dignostic performance of contrast-enhanced ultrasound, Gd-EOB-DTPA MRI, or the combined examinations for HCC diagnosis, including ① sensitivity, specificity and accuracy rate of the three methods for HCC diagnosis and ② sensitivity, specificity and accuracy rate of the three methods for HCC diagnosis in lesions with different diameters. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. With the pathological examination as the golden criteria of diagnosis, the sensitivity, specificity and accuracy rate of the contrast-enhanced ultrasound, Gd-EOB-DTPA MRI, or the combined examinations for HCC diagnosis were calculated.Results:(1) Imaging features of contrast-enhanced ultrasound and Gd-EOB-DTPA MRI. ① Imaging features of contrast-enhanced ultrasound: of the 223 HCC lesions on contrast-enhanced ultrasound, 167 lesions were accorded with fast in fast out of HCC, 7 were missed diagnosed and 49 were misdiagnosed. Of the 51 non-HCC lesions on contrast-enhanced ultrasound, 7 lesions were accorded with fast in fast out, including 3 of combined hepatocellular-cholangiocarcinoma, 2 of intrahepatic cholangiocarcinoma, 1 of neuroendocrine tumor, 1 of inflammatory granuloma, 44 lesions were no fast in fast out. ② Imaging features of Gd-EOB-DTPA MRI: of the 223 HCC lesions on Gd-EOB-DTPA MRI, 178 lesions were accorded with fast in fast out of HCC, 1 was missed diagnosed and 44 were misdiagnosed. Of the 51 non-HCC lesions on Gd-EOB-DTPA MRI, 5 lesions were accorded with fast in fast out, inlcuding 2 of intrahepatic cholangiocarcinoma, 1 of combined hepatocellular-cholangiocarcinoma, 1 of neuroendocrine tumor, 1 of inflammatory granuloma, 46 lesions were no fast in fast out. ③ Enhanced imaging manifestation in different phases of 223 HCC lesions. In arterial phase, 92.83%(207/223) of the lesions displayed hyper-enhanced on contrast-enhanced ultrasound, and 80.72%(180/223) of the lesions displayed hyper-enhanced on Gd-EOB-DTPA MRI, showing a significant difference ( χ2=14.240, P<0.05). In portal vein phase or late phase, 78.48%(175/223) of the lesions displayed hypo-enhanced on contrast-enhanced ultrasound, and 96.41%(215/223) of the lesions displayed hypo-enhanced on Gd-EOB-DTPA MRI, showing a significant difference ( χ2=32.674, P<0.05). On Gd-EOB-DTPA MRI, 96.41%(215/223) of the lesions displayed low signals in portal-vein phase or late phase, and 98.21%(219/223) of the lesions displayed low signals in hepatobiliary phase, showing no significant difference ( χ2=1.370, P>0.05). (2) Dignostic performance of contrast-enhanced ultrasound, Gd-EOB-DTPA MRI, or the combined examinations for HCC diagnosis. ① Sensitivity, specificity and accuracy rate of the three methods for HCC diagnosis: the sensitivities of contrast-enhanced ultrasound, Gd-EOB-DTPA MRI, or the combined examinations for HCC diagnosis were 74.89%(167/223), 79.82%(178/223), 94.62%(211/223), respectively. The specificities of contrast-enhanced ultrasound, Gd-EOB-DTPA MRI, or the combined examinations for HCC diagnosis were 86.27%(44/51), 90.20%(46/51), 80.39%(41/51). The accuracy rates of contrast-enhanced ultrasound, Gd-EOB-DTPA MRI, or the combined examinations for HCC diagnosis were 77.01%(211/274), 81.75%(224/274), 91.97%(252/274). There were significant differences in the sensitivity and accuracy rate among the three methods ( χ2=33.499, 23.345, P<0.05). There was no significant difference in the specificity among the three methods ( χ2=2.017, P>0.05). ② Sensitivity, specificity and accuracy rate of the three methods for HCC diagnosis in lesions with different diameters: 128 of 274 lesions had the maximun diameter>3 cm and ≤5 cm, 92 lesions had the maximun diameter >2 cm and ≤3 cm, 54 lesions had the maximun diameter≤ 2 cm. The sensitivities of contrast-enhanced ultrasound for HCC diagnosis in lesions with the maximun diameter>3 cm and ≤5 cm, >2 cm and ≤3 cm, ≤2 cm were 81.19%(82/101), 76.92%(60/78), 56.82%(25/44), the specificities were 92.59%(25/27), 71.43%(10/14), 90.00%(9/10), and the accuracy rates were 83.59%(107/128), 76.09%(70/92), 62.96%(34/54), respectively. The sensitivities of Gd-EOB-DTPA MRI for HCC diagnosis in lesions with the maximun diameter>3 cm and ≤5 cm, >2 cm and ≤3 cm, ≤2 cm were 83.17%(84/101), 79.49%(62/78), 72.73%(32/44), the specificities were 96.30%(26/27), 85.71%(12/14), 80.00%(8/10), and the accuracy rates were 85.94%(110/128), 80.43%(74/92), 74.07%(40/54), respectively. The sensitivities of contrast-enhanced ultrasound combined with Gd-EOB-DTPA MRI for HCC diagnosis in lesions with the maximun diameter>3 cm and ≤5 cm, >2 cm and ≤3 cm, ≤2 cm were 95.05%(96/101), 96.15%(75/78), 90.91%(40/44), the specificities were 92.59%(25/27), 57.14%(8/14), 80.00%(8/10), and the accuracy rates were 94.53%(121/128), 90.22%(83/92), 88.89%(48/54), respectively. There were significant differences in the sensitivities for HCC diagnosis in lesions with the maximun diameter>3 cm and ≤5 cm, >2 cm and ≤3 cm, ≤2 cm among the three methods ( χ2=9.703, 12.777, 13.142, P<0.05). There were also significant differences in the accuracy rates ( χ2=8.051, 6.600, 9.826, P<0.05). There was no significant difference in the specificies ( P>0.05). Conclusions:There was no significant difference in the dignostic performance for HCC diagnosis between contrast-enhanced ultrasound and Gd-EOB-DTPA MRI, and the combination of contrast-enhanced ultrasound and Gd-EOB-DTPA MRI can improve the diagnostic sensitivity and accuracy rate of HCC.

OBJECTIVE: To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data. METHODS: MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model. RESULTS: The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm). CONCLUSIONS Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.
Female ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; Models, Anatomic ; Muscle, Skeletal ; Tomography, X-Ray Computed ; Urethra ; diagnostic imaging ; Urinary Bladder ; diagnostic imaging

OBJECTIVE: To reconstruct a three-dimensional model of female urinary system based on magnetic resonance imaging (MRI) and tomography angiography (CTA) data. METHODS: MRI and CTA datasets were collected from 20 patients in our department in 2018 for reconstructing 3D models of the bladder urethra in resting state using Mimics19.0 software combined with engineering software. The metric parameters of the bladder urethra were analyzed in the reconstructed 3D model. RESULTS: The bladder and urethra were successfully reconstructed using 10 MRI datasets, and the kidney, ureter and bladder were reconstructed using 10 CTA datasets. Using engineering software, we measured a number of cysto-urethral geometric parameters, including the cysto-urethral posterior angle (151.1±17.9°), beta angle (137.3±14.0°), urethral pubic angle (47.8± 12.1°), urethral tilt angle (21.5±7.3°), alpha angle (83.8±13.8°), the posterior pubic space (15.3±3.0 mm), and the urethral striated muscle thickness (2.6±0.6 mm). CONCLUSIONS Three-dimensional reconstruction of the anatomical model of the human urinary system provides a platform for studying the fine anatomy of the female urinary system and allows measurement of multiple parameters to better understand the functional differences of the bladder and urethra in different populations.
Female ; Humans ; Magnetic Resonance Imaging ; Models, Anatomic ; Tomography, X-Ray Computed ; Urethra ; Urinary Bladder