Sidewall cerebral aneurysms: effect of an outflow angle-assisted approach on diagnosis.

BACKGROUND: The ability to diagnose sidewall cerebral aneurysms (SCAs) on an angle measurement basis may be useful in clinical practice. A study was undertaken to evaluate the effect of an outflow angle (OA)-assisted approach. METHODS: MR angiography (MRA) images of 438 patients with suspected SCAs and other cerebrovascular diseases were separately evaluated using the subjective approach and the OA approach. The approaches were then exchanged for confirmation of unclear cases. An OA of ≥90° was considered to represent SCA positivity. The accuracy, sensitivity, and specificity of the OA-assisted approach were determined using patient-based, aneurysm-based, and size-based evaluations. RESULTS: Digital subtraction angiography (DSA) detected 301 SCAs in 267 patients and no SCAs in 171. An OA of ≥90° was observed for 271 aneurysms in 244 patients (true positives); the OA approach misinterpreted OA as <90° for 29 aneurysms in 29 patients (false negatives) and missed one aneurysm. The subjective approach detected 309 SCAs in 273 patients. This approach misdiagnosed 10 patients (false positives) and missed two aneurysms in two patients (false negatives). The OA-assisted approach detected 300 SCAs in 267 patients and no SCAs in 171, overlooking one aneurysm. Patient-based evaluation yielded high accuracy, sensitivity, specificity, and positive and negative predictive values for the OA-assisted approach. CONCLUSIONS: The OA-assisted approach for SCA diagnosis effectively reduced the false-positive rate obtained with the subjective approach with high accuracy, sensitivity, and specificity, suggesting that MRA based on this approach can be a reliable alternative to DSA in SCA screening and diagnosis.

[Effects of electroacupuncture intervention on changes of quality of ovum and pregnancy out- come in patients with polycystic ovarian syndrome].

OBJECTIVE: To observe the effect of electroacupuncture (EA) treatment on the quality of ovum, stem cell factor(SCF) and the pregnancy outcome in patients with polycystic ovarian syndrome (PCOS), so as to explore its mechanism underlying improving pregnancy rate. METHODS: A total of 200 PCOS patients undergoing in vitro fertilization-embryo transplantation (IVF-ET) were randomly divided into control (medication) group (n = 98) and EA group (n = 102). For patients of the EA group who were undergoing controlled ovarian hyperstimulation, EA stimulation (5 Hz/20 Hz, 15-20 V) was applied to bilateral Shenshu (BL 23), Qihai (CV6), bilateral Zusanli (ST 36)-Sanyinjiao (SP 6), and bilateral Neiguan (PC6)-Zigong (EX-CA 1) for 30 min, once daily till accepting embryo transplant. Patients of the medication group were treated with controlled ovarian hyperstimulation using Diane-35, Decepepty, Gonadotrophin, human Chorionic Gonadotrophin, etc. Serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), estradiol (E2, and progesterone (P) contents were detected using chemiluminescent method. SCF contents in the serum and follicular fluid were assayed by ELISA. The number of retrieved oocytes, fertilization rate, cleavage rate, high quality embryo rate, ovarian hyperstimulation syndrome (OHSS) incidence rate, cycle cancellation rate, clinical pregnancy rate, early abortion rate, Gn dosage and administration duration, and the correlation between the high quality embryo rate and SOF level were determined. RESULTS: Comparison between the two groups showed that the high quality embryo rate, and serum and follicular fluid SCF contents were significantly higher in the EA group than in the medication group (P < 0.05, P < 0.01), while the dosage and administration duration of Gn were significantly lower in the EA group than in the medication group (P < 0.05). A positive correlation was found between the high quality embryo rate and the SCF level in both follicular fluid and serum (P < 0.01). No significant differences were found between the two groups in the number of retrieved oocytes, fertilization rate, cleavage rate, clinical pregnancy rate, OHSS incidence rate, cycle cancellation rate, early abortion rate, serum LH, E2 and P contents (P > 0.05). CONCLUSION: EA can improve the high quality embryo rate, which may be related to its effect in increasing serum and follicular fluid SCF levels.