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1.
Int J Hyperthermia ; 39(1): 8-14, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34936851

RESUMO

PURPOSE: To assess the absorption rate and factors related to the development of benign thyroid nodules (BTNs) following image-guided microwave ablation (MWA). MATERIALS AND METHODS: This retrospective study reviewed nodule efficacy in patients who underwent MWA of BTNs between January 2016 and January 2018. The endpoint was a third-year follow-up. Nodules were categorized into those showing complete absorption (volumes with less than 100% volume reduction ratio (VRR) and those showing partial absorption (100% VRR)). Univariable and multivariable regression analyses were carried out to identify variables that were associated with nodule absorption rates. RESULTS: A total of 173 BTNs (median volume= 4.23 ml; 25-75 percentiles= 2.27-9.00 ml) from 173 patients were evaluated. 49.7% (86/173) of patients had nodules that became completely absorbed. The mean VRRs of all BTNs were 18.0%, 78.7%, 89.0%, 94.5%, and 97.1% at the 1-, 6-,12-, 24- and 36- month follow-ups. At the 3-year follow-up time point, nodule characteristics related to nodule VRR included nodule volume (adjusted odds ratio [AOR], 1.1 [95% CI: 1.0, 1.2]; p = 0.03) and nodule margin (AOR, 5.3 [95% CI: 1.8, 16.0]; p < 0.01). Treatment-related characteristics included energy per ml in nodular volume (AOR, 1.0 [95% CI: 1.0, 1.0]; p < 0.01) and blockage of peripheral flow (AOR, 3.3 [95% CI: 1.3 8.3]; p = 0.01). CONCLUSIONS: US-guided image-guided MWA results in satisfactory long-term outcomes for the patients with BTNs. Factors related to nodule absorption rate were the volume and margin of the nodule, energy per ml in nodular volume and blockage of peripheral flow.


Assuntos
Ablação por Cateter , Nódulo da Glândula Tireoide , Ablação por Cateter/métodos , Seguimentos , Humanos , Micro-Ondas/uso terapêutico , Estudos Retrospectivos , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/cirurgia , Resultado do Tratamento
2.
Knee Surg Sports Traumatol Arthrosc ; 27(1): 197-205, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30008056

RESUMO

PURPOSE: To examine the predictors of the second-time lateral patellar dislocation (LPD) in patients after acute first-time LPD in a 5-year follow-up. METHODS: Data were collected prospectively from patients after acute first-time LPD with conservative treatment. Factors included sex, age at the first-time LPD, anatomical variants [trochlear dysplasia, patellar height, tibial tuberosity-trochlear groove (TT-TG) distance], and injury patterns of medial patellofemoral ligament (MPFL) in acute first-time LPD. Logistic regression was carried out to identify the independent risk factors for the incidence of the second-time LPD. RESULTS: The incidence rate of a second-time LPD was 35.5% (59 of 166) in the 5-year follow-up. Univariate analysis revealed significant differences in the incidence rate of the second-time LPD among age at the first-time LPD (P = 0.04), trochlear dysplasia (P = 0.003), patella height (P = 0.017) and the TT-TG distance (P = 0.027). Risk factors for the second-time LPD were age < 18 years at the first-time LPD [odds ratio (OR) 4.088], low-grade trochlear dysplasia (OR 7.214), high-grade trochlear dysplasia (OR 18.945), patella alta (OR 8.416), elevated TT-TG distance (OR 12.742), complete MPFL tear at its isolated femoral-side (OR 6.04) and complete combined MPFL tear (OR 5.851). CONCLUSIONS: Trochlear dysplasia, elevated TT-TG distance, patella alta, age < 18 years at the first-time LPD, complete MPFL tear at its isolated femoral-side and complete combined MPFL tear in the first-time LPD are independently associated with a higher incidence rate of the second-time LPD. LEVEL OF EVIDENCE: III.


Assuntos
Ligamentos Articulares/lesões , Luxação Patelar/epidemiologia , Luxação Patelar/patologia , Adolescente , Adulto , Fatores Etários , Variação Anatômica , Tratamento Conservador , Feminino , Fêmur/diagnóstico por imagem , Fêmur/patologia , Seguimentos , Humanos , Incidência , Ligamentos Articulares/diagnóstico por imagem , Modelos Logísticos , Imageamento por Ressonância Magnética , Masculino , Razão de Chances , Luxação Patelar/diagnóstico por imagem , Articulação Patelofemoral/diagnóstico por imagem , Estudos Prospectivos , Fatores de Risco , Ruptura , Tíbia/diagnóstico por imagem , Tíbia/patologia , Adulto Jovem
3.
Knee Surg Sports Traumatol Arthrosc ; 26(3): 719-726, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28028571

RESUMO

PURPOSE: To evaluate the correlation between injury patterns of the medial patellofemoral ligament (MPFL) and vastus medialis obliquus (VMO) after acute first-time lateral patellar dislocation (LPD) in adults. METHODS: Magnetic resonance imaging (MRI) was prospectively performed in 132 consecutive adults with acute first-time LPD. Images were acquired and evaluated using standardized protocols. Injury patterns of MPFL were grouped by location and severity for analysis of the prevalence of VMO injury. RESULTS: MRI demonstrated VMO injury in 63 (47.7%) patients. Twenty (38.5%) and 43 cases (56.6%) were present in partial and complete MPFL tear subgroups, respectively. Compared with partial MPFL tears, complete tears showed a higher prevalence of VMO injury (P = 0.044). The mean coronal (28.5 mm) and mean sagittal VMO elevations (20.7 mm) were higher in the complete MPFL tear subgroup than in the partial tear subgroup (19.8 mm, P = 0.005; 11.9 mm, P < 0.001). No correlations were identified between the prevalence of VMO injury and location subgroups of MPFL injury (n.s.). Mean VMO elevations were higher in isolated femoral-side (FEM) and combined MPFL tear (COM) subgroups (mean coronal VMO elevation of 29 mm and mean sagittal VMO elevation of 20.8 mm in the FEM subgroup; mean coronal VMO elevation of 29.6 mm and mean sagittal VMO elevation of 23.1 mm in the COM subgroup) than in the isolated patellar-side MPFL tear (PAT) subgroup (P = 0.022, P < 0.001) (mean coronal VMO elevation of 20.7 mm and mean sagittal VMO elevation of 10.6 mm). CONCLUSIONS: Complete MPFL tear predisposes to VMO injury and has a higher elevation of torn VMO after acute first-time LPD in adults. Isolated femoral-side and combined MPFL tears predispose to higher elevation of torn VMO. LEVEL OF EVIDENCE: IV.


Assuntos
Imageamento por Ressonância Magnética/métodos , Luxação Patelar/diagnóstico por imagem , Ligamento Patelar/lesões , Articulação Patelofemoral/lesões , Músculo Quadríceps/lesões , Adulto , Feminino , Humanos , Masculino , Procedimentos Ortopédicos , Luxação Patelar/cirurgia , Ligamento Patelar/diagnóstico por imagem , Ligamento Patelar/cirurgia , Articulação Patelofemoral/diagnóstico por imagem , Articulação Patelofemoral/cirurgia , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/cirurgia , Ruptura/patologia , Adulto Jovem
4.
Eur Radiol ; 27(3): 1322-1330, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27352088

RESUMO

OBJECTIVES: To assess the relationship between injury patterns of medial patellofemoral ligament (MPFL) and anatomical variants and patellar cartilage lesions after acute lateral patellar dislocation (LPD) in children. METHODS: MR images were obtained in 140 children with acute LPD. Images were acquired and evaluated using standardised protocols. RESULTS: Fifty-eight cases of partial MPFL tear and 75 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 52 cases, an isolated femoral attachment (FEM) in 42 cases and an isolated mid-substance (MID) in five cases. More than one site of injury was identified in 34 cases. Compared with Wiberg patellar type C, Wiberg patellar type B predisposed to complete MPFL tear (P = 0.042). No correlations were identified between injury patterns of MPFL and trochlear dysplasia, patellar height and tibial tuberosity-trochlear groove distance (P > 0.05). Compared with partial MPFL tear, complete MPFL tear predisposed to Grade-IV and Grade-V patellar chondral lesion (P = 0.02). There were no correlations between incidence of patellar cartilage lesion and injury locational-subgroups of MPFL (P = 0.543). CONCLUSIONS: MPFL is most easily injured at the PAT in children. Wiberg patellar type B predisposes to complete MPFL tear. Complete MPFL tear predisposes to a higher grade of patellar chondral lesion. KEY POINTS: • MPFL is most easily injured at its patellar insertion in children. • Wiberg patellar type B predisposes to complete MPFL tear. • No correlations between injury patterns of MPFL and other three anatomical variants. • Complete MPFL tear predisposes to higher grade patellar chondral lesion. • No correlations between injury locations of MPFL and patellar cartilage lesion.


Assuntos
Ligamentos Articulares/anatomia & histologia , Ligamentos Articulares/lesões , Luxação Patelar/complicações , Articulação Patelofemoral/anatomia & histologia , Articulação Patelofemoral/lesões , Adolescente , Criança , Feminino , Humanos , Ligamentos Articulares/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Masculino , Luxação Patelar/diagnóstico por imagem , Articulação Patelofemoral/diagnóstico por imagem , Ruptura
5.
Eur Radiol ; 25(1): 274-81, 2015 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25187383

RESUMO

OBJECTIVES: The purpose of this study was to compare the diagnostic performance of high-frequency ultrasound with MR in the evaluation of medial patellofemoral ligament (MPFL) lesions after acute lateral patellar dislocation (LPD). METHODS: High-frequency ultrasound and MR images were prospectively obtained in 97 consecutive patients with acute LPD. Images were acquired using standardised protocols and were independently evaluated by two radiologists. The MPFL was assessed at three sites (patellar insertion, femoral attachment, and mid-substance) for signs of injury. RESULTS: Of a total of 291 sites in 97 MPFLs, 127 showed proven MPFL tear at surgery, including 51 sites of complete tear and 76 sites of partial tear. In a site-based analysis, the sensitivity, specificity, and accuracy of high-frequency ultrasound was 90.8%, 96.3%, and 94.6%, respectively, for partial MPFL tear and 86.3%, 96.3%, and 94%, respectively, for complete tear. For MR, the sensitivity, specificity, and accuracy was 81.6%, 95.7%, and 91.3%, respectively, for partial MPFL tear and 80.4%, 95.7%, and 92.1%, respectively, for complete tear. There was no statistical difference between high-frequency ultrasound and MR in the assessment of partial (P = 0.1, 0.777, 0.155) or complete (P = 0.425, 0.777, 0.449) MPFL lesions. Interobserver agreement was very good for high-frequency ultrasound and good for MR. CONCLUSIONS: Data suggest that high-frequency ultrasound and MR have similar diagnostic performance in the evaluation of MPFL lesions after acute LPD. KEY POINTS: • High-frequency ultrasound and MR were able to detect MPFL lesions after acute lateral patellar dislocation. • High-frequency ultrasound and MR showed similarly high accuracy in diagnosing MPFL lesions. • Interobserver agreement was very good for high-frequency ultrasound and good for MR.


Assuntos
Traumatismos do Joelho/diagnóstico , Ligamentos Articulares/lesões , Imageamento por Ressonância Magnética/métodos , Patela/lesões , Luxação Patelar/diagnóstico , Doença Aguda , Adolescente , Adulto , Criança , Feminino , Humanos , Traumatismos do Joelho/complicações , Ligamentos Articulares/diagnóstico por imagem , Ligamentos Articulares/patologia , Masculino , Patela/diagnóstico por imagem , Patela/patologia , Luxação Patelar/etiologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Ruptura , Ultrassonografia , Adulto Jovem
6.
Injury ; 52(6): 1549-1555, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33097203

RESUMO

OBJECTIVES: To explore the gender differences in the concomitant articular injuries after acute lateral patellar dislocation (LPD). METHODS: Magnetic resonance images were prospectively analyzed in 166 patients after an acute LPD. Concomitant articular injuries included bone contusion, medial patellofemoral ligament (MPFL) injury, articular cartilage lesion, and vastus medialis obliquus (VMO) lesion. Statistical analyses were performed between the patient's gender and the incidence of concomitant articular injuries in adolescent and adult subgroups. RESULTS: The incidence of partial and complete MPFL tear in adolescent males and females were (45%, 50%) and (63.2%, 29.8%), respectively. Compared with adolescent females, adolescent males showed higher incidence of complete MPFL tear (P = 0.049). The incidence of articular cartilage lesion of patella in adolescent males and females were 40% and 21.1%, respectively. Compared with adolescent females, adolescent males showed higher incidence of articular cartilage lesion of the patella (P = 0.043). No correlations were identified in other injuries in the adolescent group. The incidence of partial and complete MPFL tear in adult males and females were (34.4%, 65.6%) and (56.8%, 37.8%), respectively. Compared with adult females, adult males showed higher incidence of complete MPFL tear (P = 0.036). The incidence of articular cartilage lesion of patella in adult males and females were 56.3% and 32.4%, respectively. Compared with adult females, adult males showed higher incidence of articular cartilage lesion of patella (P = 0.047). The incidence of VMO injury in adult males and females were 59.4% and 35.1%, respectively. Compared with adult females, adult males showed higher incidence of VMO injury (P = 0.044). No correlations were identified in other injuries in the adult group. CONCLUSIONS: Compared with females, males predispose to complete MPFL tear and articular cartilage lesion of patella after acute LPD. Compared with female adults, male adults predispose to VMO injury.


Assuntos
Cartilagem Articular , Luxação Patelar , Articulação Patelofemoral , Adolescente , Adulto , Cartilagem Articular/diagnóstico por imagem , Feminino , Humanos , Articulação do Joelho , Ligamentos Articulares/diagnóstico por imagem , Masculino , Patela/diagnóstico por imagem , Luxação Patelar/diagnóstico por imagem , Luxação Patelar/epidemiologia
7.
J Cancer ; 11(13): 3903-3909, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32328194

RESUMO

Objectives: To assess the performance of elastography (ES) and ultrasound (US) in predicting the malignancy of breast lesions and to compare their combined diagnostic value with that of magnetic resonance imaging (MRI). Materials and Methods: The study prospectively enrolled 242 female patients with dense breasts treated in 35 heath care facilities in China between November 2018 and October 2019. Based on conventional US and elastography, radiologists classified the degree of suspicion of breast lesions according to the US Breast Imaging Reporting and Data System (BI-RADS) criteria. The diagnostic value was compared between US BI-RADS and MRI BI-RADS, with pathological results used as the reference standard. Results: The results demonstrated that irregular tumor shape, a nonparallel growth orientation, indistinct margins, angular contours, microcalcifications, color Doppler flow and ES score on US imaging were significantly related to breast cancer in dense breasts (P=0.001; P=0.001; P=0.008; P<0.001; P=0.019; P=0.008; P=0.002, respectively). The sensitivity, specificity, PPV, NPV, accuracy and AUC of US BI-RADS category were 94.7%, 90.7%, 95.8%, 88.0%, 93.4% and 0.93 (95%CI, 0.88-0.97), respectively, while those of MRI BI-RADS category were 98.2%, 57.5%, 84.3%, 83.3%, 86.0% and 0.78 (95%CI, 0.71-0.85), respectively. MRI BI-RADS showed a significantly higher sensitivity than US BI-RADS (98.2% vs 94.7%, P=0.043), whereas US BI-RADS showed significantly higher specificity (90.7% vs 57.5%, P<0.001). US BI-RADS showed better diagnostic efficiency in differentiating nodules in dense breasts than MRI BI-RADS (AUC 0.93 vs 0.78, P<0.001). Conclusion: By combining the use of ES and conventional US, US BI-RADS had better diagnostic efficiency in differentiating nodules in dense breasts than MRI. For the diagnosis of malignant tumors in patients with dense breasts, MRI and US BI-RADS can be used as supplemental diagnostic tools to detect lesions, with US BI-RADS considered the preferred adjunctive resource.

8.
Korean J Radiol ; 19(2): 292-300, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29520187

RESUMO

Objective: To evaluate the correlation between the injury patterns of the medial patellofemoral ligament (MPFL) on magnetic resonance imaging in an acute first-time lateral patellar dislocation (LPD) and incidence of a second-time LPD. Materials and Methods: Magnetic resonance images were prospectively analyzed in 147 patients after an acute first-time LPD with identical nonoperative management. The injury patterns of MPFL in acute first-time LPDs were grouped by location and severity for the analysis of the incidence of second-time LPD in a 5-year follow-up. Independent t tests, chi-square tests and Kruskal-Wallis tests were performed as appropriate. Results: Forty-six cases (46/147, 31.3%) of second-time LPD were present at the 5-year follow-up. Fourteen (14/62, 22.6%) and 31 cases (31/80, 38.8%) were present in the partial and complete MPFL tear subgroups, respectively. Twenty-five cases (25/65, 38.5%), 11 cases (11/26, 42.3%), and 8 cases (8/47, 17%) were present in the isolated femoral-side MPFL tear (FEM), combined MPFL tear (COM), and isolated patellar-side MPFL tear (PAT) subgroups, respectively. Compared with the partial MPFL tears, complete tears showed higher incidence of a second-time LPD (p = 0.04). The time interval between the two LPDs was shorter in the complete MPFL tear subgroup (24.2 months) than in the partial tear subgroup (36.9 months, p = 0.001). Compared with the PAT subgroup, the FEM and COM subgroups showed a higher incidence of a second-time LPD (p = 0.025). The time intervals between the two LPDs were shorter in the FEM and COM subgroups (20.8 months and 19.2 months) than in the PAT subgroup (32.5 months, p = 0.049). Conclusion: A complete MPFL tear, isolated femoral-side tear and combined tear in a first-time LPD predispose a second-time LPD.


Assuntos
Imageamento por Ressonância Magnética , Luxação Patelar/diagnóstico por imagem , Doença Aguda , Adolescente , Adulto , Criança , Feminino , Seguimentos , Humanos , Incidência , Articulação do Joelho/diagnóstico por imagem , Ligamentos Articulares/diagnóstico por imagem , Masculino , Patela/diagnóstico por imagem , Luxação Patelar/diagnóstico , Luxação Patelar/epidemiologia , Adulto Jovem
9.
Zhonghua Nan Ke Xue ; 13(7): 605-9, 2007 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-17725302

RESUMO

OBJECTIVE: To explore the diagnostic and differential value of diffusion weighted imaging (DWI) for prostate cancer. METHODS: Included in the study were 50 patients with prostatic diseases, including 19 cases of prostate cancer (PCa) and 31 cases of benign prostatic hyperplasia (BPH), and another 16 healthy volunteers were recruited as controls. All underwent DWI sequence on a 1.5T superconducting MRI system with an endorectal coil. The results from DWIs and apparent diffusion coefficient (ADC) maps were treated statistically. RESULTS: The mean ADC value of the prostatic peripheral zone and the prostatic central gland of the 16 healthy volunteers were (170.23 +/- 37.39) x 10(-5) mm2/s and (127.84 +/- 17.93) x 10(-5) mm2/s, while those of the 31 BPH cases and 19 PCa cases were (175.21 +/- 64.86) x 10(-5) mm2/s and (104.23 +/- 26.15) x 10(-5) mm2/s, respectively. There were significant differences in the tissue types between any two groups after the treatment of one-way ANOVA, except between the groups of the peripheral zone and. BPH. CONCLUSION: PCa shows specific DWI features that could be distinguished from those of the normal prostatic tissues and BPH. Therefore, DWI has an important clinical application value in the diagnosis and differentiation of PCa.


Assuntos
Imagem de Difusão por Ressonância Magnética/métodos , Próstata/patologia , Neoplasias da Próstata/diagnóstico , Adulto , Idoso , Diagnóstico Diferencial , Imagem de Difusão por Ressonância Magnética/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
10.
Injury ; 46(6): 1137-44, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25724397

RESUMO

OBJECTIVES: The purpose of this study was to investigate the injury characteristics of medial patellofemoral ligament (MPFL), and to analyse the correlations between the injury patterns of MPFL and articular cartilage lesions of the lateral femoral condyle in children and adolescents with acute lateral patellar dislocation (LPD). METHODS: Magnetic resonance (MR) images were prospectively obtained in 127 consecutive children and adolescents with acute LPD. Images were acquired using standardised protocols and these were independently evaluated by two radiologists. RESULTS: Fifty-four cases of partial MPFL tear and 69 cases of complete MPFL tear were identified. Injuries occurred at an isolated patellar insertion (PAT) in 47 cases, an isolated femoral attachment (FEM) in 41 cases and an isolated mid-substance (MID) in four cases. More than one site of injury to the MPFL (COM) was identified in 31 cases. The prevalence rate of chondral and osteochondral lesions of the lateral femoral condyle were 23.4% (11/47) and 29.8% (14/47) in the PAT subgroup, 7.3% (3/41) and 9.8% (4/41) in the FEM subgroup and 25.8% (8/31) and 32.3% (10/31) in the COM subgroup, respectively. The PAT and COM subgroups showed significantly higher prevalence rate of chondral and osteochondral lesions in the lateral femoral condyle when compared with the FEM subgroup. The prevalence rate of chondral and osteochondral lesions of the lateral femoral condyle were 17.4% (12/69) and 30.4% (21/69) in the complete MPFL tear subgroup and 20.4% (11/54) and 13% (7/54) in the partial MPFL tear subgroup, respectively. The subgroup of the complete MPFL tear showed significantly higher prevalence rate of osteochondral lesions in the lateral femoral condyle when compared with the subgroup of the partial MPFL tear. CONCLUSIONS: Firstly, the MPFL is most easily injured at the PAT, and secondly at the FEM in children and adolescents after acute LPD. The complete MPFL tear is more often concomitant with osteochondral lesions of the lateral femoral condyle than the partial MPFL tear. The isolated patellar-sided MPFL tear and the combined MPFL tear are more easily concomitant with chondral lesions and osteochondral lesions of the lateral femoral condyle than the isolated femoral-sided MPFL tear.


Assuntos
Cartilagem Articular/lesões , Traumatismos do Joelho/diagnóstico , Ligamentos Articulares/lesões , Imageamento por Ressonância Magnética , Patela/lesões , Luxação Patelar/diagnóstico , Doença Aguda , Adolescente , Cartilagem Articular/patologia , Criança , China/epidemiologia , Feminino , Humanos , Traumatismos do Joelho/complicações , Traumatismos do Joelho/patologia , Ligamentos Articulares/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Patela/patologia , Luxação Patelar/etiologia , Prevalência , Estudos Prospectivos , Reprodutibilidade dos Testes , Ruptura
11.
Injury ; 46(12): 2413-21, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26462959

RESUMO

OBJECTIVES: The purpose of this study was to investigate the injury characteristics of medial patellofemoral ligament (MPFL), and to analyse the correlations between the injury patterns of MPFL and articular cartilage lesions of the lateral femoral condyle in adults with acute lateral patellar dislocation (LPD). METHODS: Magnetic resonance (MR) images were prospectively obtained in 121 consecutive adults with acute LPD. Images were acquired using standardised protocols and these were independently evaluated by two radiologists. RESULTS: Forty-eight cases of partial MPFL tear and 71 cases of complete MPFL tear were identified. Injuries occurred at an isolated femoral attachment (FEM) in 48 cases, an isolated patellar insertion (PAT) in 36 cases and an isolated mid-substance (MID) in five cases. More than one site of injury to the MPFL (COM) was identified in 30 cases. The prevalence rate of chondral and osteochondral lesions of the lateral femoral condyle were 4.2% (2/48) and 6.3% (3/48) in the FEM subgroup, 19.4% (7/36) and 22.2% (8/36) in the PAT subgroup and 6.7% (2/30) and 13.3% (4/30) in the COM subgroup, respectively. The PAT subgroup showed significantly higher prevalence rate of chondral and osteochondral lesions in the lateral femoral condyle when compared with the FEM subgroup. The prevalence rate of chondral and osteochondral lesions of the lateral femoral condyle were 8.5% (6/71) and 19.7% (14/71) in the complete MPFL tear subgroup and 10.4% (5/48) and 4.2% (2/58) in the partial MPFL tear subgroup, respectively. The subgroup of the complete MPFL tear showed significantly higher prevalence rate of osteochondral lesions in the lateral femoral condyle when compared with the subgroup of the partial MPFL tear. CONCLUSIONS: Firstly, the MPFL is most easily injured at the FEM, and secondly at the PAT in adults after acute LPD. The complete MPFL tear is more often concomitant with osteochondral lesions of the lateral femoral condyle than the partial MPFL tear. The isolated patellar-sided MPFL tear is more easily concomitant with chondral lesions and osteochondral lesions of the lateral femoral condyle than the isolated femoral-sided MPFL tear.


Assuntos
Cartilagem Articular/diagnóstico por imagem , Traumatismos do Joelho/diagnóstico por imagem , Ligamentos Articulares/diagnóstico por imagem , Imageamento por Ressonância Magnética , Patela/diagnóstico por imagem , Luxação Patelar/diagnóstico por imagem , Cartilagem Articular/lesões , Cartilagem Articular/patologia , Feminino , Humanos , Instabilidade Articular , Traumatismos do Joelho/complicações , Traumatismos do Joelho/patologia , Ligamentos Articulares/lesões , Ligamentos Articulares/patologia , Imageamento por Ressonância Magnética/métodos , Masculino , Patela/lesões , Patela/patologia , Luxação Patelar/diagnóstico , Prevalência , Estudos Prospectivos , Reprodutibilidade dos Testes
12.
Injury ; 44(12): 1892-8, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24074831

RESUMO

OBJECTIVE: The purpose of this study was to investigate the accuracy of high-frequency ultrasonography in the diagnosis of injuries of medial patellofemoral ligaments (MPFLs), analyse the characteristics of MPFL injury and correlations between injury of the MPFL and articular cartilage of the inferomedial patella in patients with acute traumatic lateral patellar dislocation. METHODS: High-frequency sonographic images of 49 patients with acute traumatic lateral patellar dislocations treated surgically were reviewed. The χ(2) tests were performed for statistical analysis. RESULTS: Twenty-eight cases of complete MPFL tear and 21 cases of partial MPFL tear were identified in operation, with 27 cases of MPFL tear located at their femoral attachment, 21 cases of tear at the patellar attachment and one case of midsubstance tear. The diagnostic accuracy of sonography regarding partial MPFL tear and complete MPFL tear was 89.8% and 89.8%. Among the patients with MPFL tear at the patellar attachment, eight and six cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, in contrast to nine and six cases in patients with MPFL tear at the femoral attachment, respectively. There was no significant difference between the two locations described above regarding the prevalence rates of chondral or osteochondral lesions of the inferomedial patella (P=0.732, P=0.614). Among the patients with complete MPFL tear, 12 and 10 cases were concomitant with chondral and osteochondral lesions in the inferomedial patella, respectively, while six and two cases were concomitant with partial MPFL tear. There was no significant difference between the two types of injuries discussed above on the prevalence rates of chondral lesions of the inferomedial patella (P=0.305), but the prevalence rate of osteochondral lesions between the two types of injuries discussed above was statistically different (P=0.035). CONCLUSIONS: The MPFL is most easily injured at the femoral attachment, secondly at the patellar attachment. High-frequency ultrasonography is an accurate method in the diagnosis of an MPFL tear. There are neither significant differences on the prevalence rates of chondral or osteochondral lesions of the inferomedial patella between locations of MPFL injuries, nor significant difference on the prevalence rates of chondral lesions between MPFL injury types; but the complete MPFL tear is more often concomitant with inferomedial patellar osteochondral lesions than the partial MPFL tear.


Assuntos
Cartilagem Articular/diagnóstico por imagem , Instabilidade Articular/diagnóstico por imagem , Ligamento Colateral Médio do Joelho/diagnóstico por imagem , Patela/diagnóstico por imagem , Patela/lesões , Luxação Patelar/diagnóstico por imagem , Adolescente , Adulto , Cartilagem Articular/lesões , Feminino , Humanos , Masculino , Ligamento Colateral Médio do Joelho/lesões , Patela/fisiopatologia , Luxação Patelar/fisiopatologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Índices de Gravidade do Trauma , Ultrassonografia
13.
Eur J Radiol ; 81(3): e370-5, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22197089

RESUMO

BACKGROUND: To explore the use of magnesium sulfate (MgSO4) as an oral contrast medium (CM) in MRI of the small intestine. METHODS: By comparing MgSO4 SNRs at different concentrations, we determined that 2.5% MgSO4 is the ideal concentration for small bowel MRI. Twenty volunteers underwent MRI after drinking 2.5% MgSO4. Thirty-one patients with clinical suspicion of small intestinal pathology underwent both MRI and the air-barium contrast examination. The patient's tolerance, side effects and complications were noted. RESULTS: 2.5% MgSO4 can decrease the absorption of water and fully fill the enteric cavity, thereby increasing the contrast between the intestinal wall and lumen and facilitating radiographic examination of the small bowel. The mean diameter of the small intestine was 19.8±1.21 mm in the 20 volunteers consuming 2.5% MgSO4 and 12.7±0.84 mm in the 20 volunteers given water. There was a significant difference (P<0.05) between the diameters of the small intestine of the two groups. But there were no significant differences (P>0.05) in side effects between MgSO4 and water groups. Small intestinal MRI was successfully performed in all 31 patients, who were also examined by the double contrast barium, which gave almost identical diagnoses to MRI in all cases except for 1 patient with small intestinal hemorrhage. CONCLUSIONS: MRI with 2.5% MgSO4 can demonstrate intestinal abnormalities. Therefore, 2.5% MgSO4 solution is an ideal oral CM for small bowel MRI.


Assuntos
Meios de Contraste/administração & dosagem , Enteropatias/diagnóstico , Intestino Delgado , Sulfato de Magnésio/administração & dosagem , Imageamento por Ressonância Magnética/métodos , Administração Oral , Adolescente , Adulto , Sulfato de Bário/administração & dosagem , Sulfato de Bário/farmacocinética , Meios de Contraste/farmacocinética , Feminino , Humanos , Sulfato de Magnésio/farmacocinética , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade , Estatísticas não Paramétricas
14.
Zhonghua Er Ke Za Zhi ; 50(2): 131-5, 2012 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-22455638

RESUMO

OBJECTIVES: To evaluate the diagnostic value of arterial spin labeling (ASL) technology in newborns with hypoxic ischemic encephalopathy (HIE). METHOD: Seven full-term newborn infants without any history of asphyxia and other nervous system diseases were selected as the control and 33 full-term newborn infants were assigned into HIE group. The patients in HIE group were further divided into three subgroups (19 cases of mild, 6 cases of moderate and 8 cases of severe HIE) based on their clinical diagnosis. The control group and HIE group were examined with GE Signa EXCITE HD 3.0T superconducting MRI scanner with a head phase array coil. Both groups were scanned with conventional axial MRI (T1FLAIR, T2WI and T2FLAIR), 1HMRS (PRESS sequence) and ASL (FAIR). Original images of 1HMRS and ASL were processed by Functool software of ADW 4.3 workstation. ASL perfusion images were observed and the signal intensity values of the region of interest (bilateral gray, white matter and basal ganglia) of the two groups were quantitatively measured, and mean value were calculated and compared between groups. Statistical analysis was performed with SPSS 13.0 software, and statistically significant difference was set at P < 0.05. RESULT: The perfusion images of two groups were obtained perfectly. The signal intensity values of bilateral gray, white matter and basal ganglia of control group were 125.34 ± 11.76, 73.42 ± 11.67 and 173.65 ± 15.49, respectively and there was a statistically significant difference between the different areas. The signal intensity values of bilateral gray, white matter and basal ganglia of HIE group were 153.47 ± 11.72, 71.35 ± 10.37 and 217.13 ± 12.51, respectively. There was a statistically significant difference (P < 0.05) in the average signal intensity value of gray matter and basal ganglia, but there were no statistically significant difference (P > 0.05) in white matter between the two groups. CONCLUSION: ASL Perfusion technique can assess HIE comprehensively and accurately. Furthermore, it can evaluate the brain damage of hypoxic ischemia. The results provide a strong basis for clinical treatment.


Assuntos
Espectroscopia de Ressonância de Spin Eletrônica , Hipóxia-Isquemia Encefálica/diagnóstico , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Masculino , Marcadores de Spin
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