ABSTRACT
Objective:To explore the detection rate, missed diagnosis rate, and clinical significance of incidental extra-hip findings (IEHFs) in hip joint MRI.Methods:The data of 1 734 cases who underwent MRI examination of hip joint from September 2014 to September 2018 at the First Central Hospital of Baoding City were retrospectively analyzed. According to the revised CT colonography reporting and data system (C-RADS), the IEHFs were divided into 4 types using structural imaging reading method. E1 type was anatomical variation; E2 type was sign without clinical significance; E3 type was sign with little clinical significance; E4 type was sign with important clinical significance. The types and distributions of IEHFs were analyzed, and the results of structural imaging reading were compared with those of the initial MRI reports. The missed diagnosis rate was calculated in this group.Results:Among the 1 734 patients, 1 651 of IEHFs were found in 1 064 patients. There were 1 080 E2 type IEHFs (65.4%, 1 080/1 651), with cervical cysts (26.0%, 281/1 080) accounting for the largest number. There were 354 IEHFs of E3 type (21.4%, 354/1 651), with most cases were prostatic hyperplasia (47.2%, 167/354). There were 217 IEHFs of E4 type (13.1%, 217/1 651), most of which were the enlarged lymph nodes in the inguinal region (30.9%, 67/217). E2 and E3 IEHFs accounted for a great proportion in male patients. The proportion of E2 IEHFs was the largest in female patients. There was significant difference in IEHFs composition between male and female patients (χ2=294.080, P<0.001). The IEHFs of patients under 60 years old were mainly E2 type, while those of over 60 years old patients were mainly E3 type. There was significant difference in IEHFs composition among different age groups (χ2=206.702, P<0.001). The overall missed diagnosis rate of IEHFs was 85.2% (1 406/1 651). The missed diagnosis rate of E2 was the highest (91.1%, 984/1 080), and that of E4 was the lowest (63.1%, 137/217). Conclusion:The incidence of IEHFs in patients undergoing hip joint MRI are prevalent. The structural imaging reading method can increase the detection of IEHFs. Therefore, it is suggested that revised C-RADS be used to grade IEHFs to reduce the rate of missed diagnosis.
ABSTRACT
Objective To estimate cervical stiffness during late pregnancy with virtual touch tissue quantification technique(VTQ) and investigate the value of predicting the outcome of labor induction. Methods Cervical length in pregnancy women at 35 -41 weeks′gestation was measured through perineum ultrasound examination before labor induction,and then VTQ was applied to measure shear wave velocity (SWV)values in region of interest(ROI),the maximum,minimum and average of SWV values were obtained from multiple SWV measurement under the VTQ mode. The outcomes of labor induction were tracked and Bishop scores were recorded,vaginal delivery and cesarean delivery groups were compared using Student′s t-test for continuous variables. ROC curve was plotted to analyze the correlation between parameters and the outcome of labor induction and to determine the most accurate SWV value and cut-off value for diagnosis.Univariate and multivariate logistic regression analysis were used to determine which of the following parameters were significant predictors of the outcome of labor induction. Results The SWV mix,SWV max and SWV mean of vaginal delivery and cesarean section were (0.92 ± 0.13)m/s,(1.37 ± 0.14)m/s,(1.13 ± 0.10)m/s and (1.03 ± 0.13)m/s,(1.74 ± 0.42)m/s,(1.36 ± 0.11)m/s,respectively, there were significant differences between vaginal delivery and cesarean section(all P < 0.05).Based on ROC curve analysis,the SWV mean value in cervix was the best value for predicting the outcome of labor induction.The cut-off value of SWV mean value was 1.23 m/s,the sensitivity,specificity and Youden index were 93.8%,83.4%,0.77,respectively.The SWV value and cervical length were closely correlated to the outcome of labor induction,especially the SWV value according to multivariate logistic analysis. Conclusions VTQ can assess the cervical stiffness with SWV values during pregnancy,and it may have an application value of predicting the outcome of labor induction.