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ObjectiveTo explore the application value of CT pulmonary angiography (CTPA) in assessing the severity of acute pulmonary embolism (APE) and right heart function in rehabilitation patients. MethodsFrom January, 2013 to January, 2020, 133 inpatients (94 positive and 39 negative) who underwent CTPA examination in Beijing Bo'ai Hospital were involved. Positive patients were further divided into mild, moderate and severe groups based on the pulmonary artery obstruction index (PAOI). The clinical parameters and right heart function indicators were compared. Spearman correlation analysis was used to analyze the correlation between PAOI, and clinical parameters and right heart function indicators, and Logistic regression analysis was used to predict the risk factors of APE. ResultsThere was significant difference in lower extremity venous thrombosis, D-dimer, oxygen partial pressure, PAOI and left process of interventricular septum among four groups (H ≥ 12.350, P < 0.01). PAOI was moderately positively correlated with D-dimer (r = 0.443, P < 0.001) and left process of interventricular septum (r = 0.520, P < 0.001), and was weakly positively correlated with lower extremity venous thrombosis (r = 0.399, P < 0.001), left pulmonary artery diameter (r = 0.213, P = 0.014) and inferior vena cava regurgitation (r = 0.229, P = 0.008). Lower extremity venous thrombosis (OR = 7.708, P < 0.001) and left process of interventricular septum (OR = 3.641, P = 0.008) were independent risk factors for the onset of APE. The combination of the two indicators was effective for diagnosis of APE, and AUC was 0.795 (95% CI 0.715 to 0.874). ConclusionCTPA may be applied to evaluate the severity of APE and right heart function in rehabilitation patients.
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ObjectiveTo explore the application of Brain and Spinal Injury Center (BASIC) score in evaluation of traumatic cervical spinal cord injury. MethodsFrom January, 2015 to December, 2021, 175 patients with traumatic cervical spinal cord injury in Beijing Bo'ai Hospital were analyzed. Gender, age, cause of injury, injury mechanism and American Spinal Injury Association Impairment Scale (AIS) grade were collected. The sagittal and axial T2 weighted imaging (T2WI) of the patients were evaluated with BASIC score, single/multi-segment injury, and with/without intramedullary hemorrhage. According to the injury mechanism, the patients were divided into two groups: with fracture/fracture dislocation (n = 92) and without fracture and dislocation (n = 83). The baseline demographic indicators and T2WI evaluation indicators were compared between the two groups, and the relationship between AIS grade and BASIC score, intramedullary hemorrhage, single/multi-segment injury were investigated. ResultsThere were significant differences in gender, age and AIS grade, BASIC score, and the rates of inntramedullary hemorrhage and single segment injury of T2WI between two groups (t = -10.276, χ2 > 8.703, P < 0.01); however, no difference was found in the cause of injury (P > 0.05). The AIS grade was significantly correlated with the BASIC score (r = 0.790, P < 0.001). There was significant difference in AIS grade between intramedullary hemorrhage or not, and single/multi-segment injury (χ2 > 5.516, P < 0.05). ConclusionThe BASIC score of T2WI is a predictor of the severity of spinal cord injury after traumatic cervical spinal cord injury, and is different with the injury mechanisms.
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Objective To observe the utility value of MR intravoxel incoherent motion (IVIM) in histological grading and muscle invasion of bladder urothelial carcinoma.Methods According to postoperative histologic grade and T staging,60 patients with bladder urothelial carcinoma confirmed by surgery and pathology were divided into low grade (LG) group and high grade (HG) group,as well as muscle-noninvasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) group.MR IVIM parameters (apparent diffusion coefficient standard [ADCst],true diffusion coefficient [D],pseudodiffusion coefficient [D*] and perfusion fraction [f]) were compared with independent-samples t tests.A binary Logistic regression model was established to evaluate the predicted probability of combined IVIM parameters.ROC curves of IVIM parameters and their combination's predicted probability were drawn,and the diagnostic efficiency was evaluated.Results ADCst,D and f values of HG group were significantly lower than those of LG group (all P＜0.05).Area under ROC curve (AUCs) for ADCst,D and f value to differentiate HG from LG were 0.88,0.86 and 0.72,respectively (all P＜0.01),and AUCs for predicted probability of combined ADCst and D,combined ADCst and f and combined D and f were 0.91,0.90 and 0.88,respectively (all P＜0.0001).ADCst,D and f values of M1BC group were significantly lower than those of NMIBC group (all P＜0.0001).AUCs for ADCst,D and f value to differentiate MIBC from NMIBC were 0.91,0.85 and 0.88,respectively (all P＜0.0001),and all AUCs for predicted probability of combined ADCst and D,combined ADCst and f and combined D and f were both 0.93 (all P＜0.000 1).Conclusion Lower ADCst,D and f values may indicate greater possibility of high grade and muscle invasion of bladder urothelial carcinoma.Combination of IVIM parameters can improve diagnostic efficacy.
