MSCT和MRI对浆液性卵巢囊腺癌和黏液性卵巢囊腺癌的临床诊断价值探讨

目的:探讨MSCT和MRI对卵巢囊腺癌的临床诊断价值,为该类疾病临床诊断提供方法参考。方法:以我院2010年2月至2014年1月间收治的53例卵巢囊腺癌患者为研究对象,回顾其临床诊治资料,对比MSCT和MRI对不同类型卵巢囊腺癌的诊断率。结果:MRI和MSCT对浆液性卵巢囊性腺癌的诊断率分别为89.19%和94.59%,差异无统计学意义(P>0.05)。在黏液性卵巢囊性腺癌的诊断率方面,MRI和MSCT分别为68.75%和87.50%,差异具有统计学意义(P<0.05)。结论:MSCT对浆液性卵巢囊性腺癌的诊断率与MRI相似,但对黏液性卵巢囊性腺癌的诊断率高于MRI,必要时应考虑联合应用。     

MRI检测在腰间盘突出症术前诊断及术后效用评估中的价值分析

目的:探讨核磁共振成像(MRI)在腰椎间盘突出症术前诊断及术后效用评估中的价值。方法:选取2018年1月至2020年10月在我院就诊的疑似腰椎间盘突出症患者91例,给予MRI、CT检查,比较两者诊断价值。结果:MRI腰椎间盘突出症阳性征象钙化、积气检出率为9.89%和12.09%,明显低于CT(P<0.05),而脊髓变形、硬膜囊受压检出率分别为15.38%和58.24%,明显高于CT(P<0.05)。结论:MRI诊断腰椎间盘突出症、预测治疗疗效方面有一定应用价值。     

多层螺旋CT及多维重建技术对隐匿性肋骨骨折的诊断价值探讨

目的 :考察多层螺旋CT(MSCT)联合多维重建技术对隐匿性肋骨骨折的临床诊断价值,为该类疾病临床诊断提供参考。方法 :以我院2012年7月至2014年2月间收治的73例隐匿性肋骨骨折患者为研究对象,使用MSCT联合VR、SSD、CRP等多种重建技术对患者进行检查,统计并分析影像学检查结果。结果:73例患者经MSCT检查确诊隐匿性肋骨骨折107处,骨折多发于肋骨角(59.81%)且以非完全线性骨折为主(91.59%)。所用多维重建技术的诊断精度依次为:CRP(100.0%)>MPR(97.19%)>SSD(85.89%)>VR(78.50%)>MIP(27.88%)。结论 :MSCT联合多维重建技术对隐匿性肋骨骨折具有较为明确的诊断价值,MSCT与CRP/MPR及VR等联用可获得较为理想的诊断率。     

MSCT和MRI对胫骨平台骨折的临床诊断价值

目的 :考察MRI和MSCT对胫骨平台骨折的临床诊断价值,以及其在胫骨平台骨折AO分型方面的指导价值。方法 :以我院2009年5月至2013年11月间收治的183例胫骨平台骨折患者为研究对象,对其MSCT和MRI检查结果进行汇总分析。对比分析两种影像手段对不同AO分型的胫骨平台骨折的诊断情况。结果 :经手术和联用其它检查手段,最终确诊AO分型中B型骨折患者96例(B1型46例、B2型31例、B3型19例),C型患者87例(C1型50例、C2型22例、C3型15例)。MSCT和MRI的诊断结果显示,MRI和CT在B1型、B2型、B3型、C2型的检出比例和确诊精度均相似,且差异无统计学意义(P>0.05)。但在C1和C3型骨折的检出比例和确诊精度方面,则以MRI较为理想,且差异具有统计学意义(P<0.05)。在合并伤方面,MSCT和MRI的检出情况接近,差异无统计学意义(P>0.05)。治疗效果显示,参考MSCT和MRI诊断结果制定的治疗方案合理、可靠,表明MSCT和MRI在对胫骨平台骨折的诊治具有明确的临床指导价值。结论 :MSCT和MRI对不同AO分型的胫骨平台骨折和其合并伤均有较好的诊断能力。     

强直性脊柱炎伴有脊柱骨折患者的临床影像学表现及损伤特征分析

目的 :探讨强直性脊柱炎伴有脊柱骨折胡临床影像学表现和损伤特征。方法 :回顾我院2008年4月至2013年9月间收治的60例AS伴有脊柱骨折患者的临床资料,对其影像学表现和损伤特征进行汇总分析。结果 :60例患者中剪力性骨折、应力性骨折、压缩性骨折患者分别为24例(40.0%)、19例(36.67%)和17例(28.33%),即以累及三柱的贯通性骨折为主要表现。MRI、X线平片和MSCT的检出病变数分别为286、120、251。结论 :AS伴脊柱骨折以累及三柱的贯通性骨折如剪力性骨折和应力性骨折为主要损伤特点,并伴有脊柱韧带损伤、脊柱隐匿性骨折、Andersson病变等。MRI和MSCT对脊柱骨折的早期诊断价值高于X线平片,且MRI对脊柱隐匿性骨折、脊柱韧带损伤等的诊断精度较高,可作为临床诊断首选手段。     

成人髋臼发育不良继发骨关节炎的影像学分析

目的 :分析成人髋臼发育不良(Acetabular dysplasia,AD)继发骨关节炎的影像学特点。方法 :分析217例AD患者影像资料,比较继发与未继发组患者影像学参数,并探讨X线片、CT、MRI的诊断价值。结果:217例患者中,共确诊继发骨关节炎者59例,占27.19%。继发关节炎组平均年龄为(51.43±6.98)岁,大于未继发组的(39.62±7.15)岁,差异有统计学意义。继发关节炎组CE角、髋顶切线角、髋臼指数、股骨头覆盖率、髋关节上间隙小于未继发组,其Sharp角、髋关节内侧间隙大于后者,差异有统计学意义。X线对继发性骨关节炎的检出率为50.84%,低于CT的69.49%,亦低于MRI的100.00%,差异有统计学意义。CT轴位图像可检出X线无法检出的髋关节脱位;MRI可检出CT图像无法显示的软骨下小囊变与关节软骨退变。结论:X线平片可为成人AD继发骨关节炎的诊断提供一定依据但检出率较低,在此基础上结合CT、MRI图像能够进一步明确髋关节脱位情况、发现软骨下小囊变,从而提高诊断准确率。     

磁共振显微线圈高分辨成像技术在腕关节病变中的临床应用

目的探讨磁共振显微线圈高分辨成像技术在腕关节病变中的临床应用。方法收集2018年12月至2019年12月45例腕关节类风湿关节炎患者、30例手腕关节骨性关节炎患者、40例腕部撞击综合症损伤患者作为研究对象,分别使用磁共振常规线圈及显微线圈技术对其部位进行扫描。比较分析两种诊断方式的诊断准确率及对软骨侵蚀、关节积液和滑膜增厚的诊出情况。结果显微线圈技术对腕关节类风湿关节炎、手腕关节骨性关节炎、腕部撞击综合症损伤的诊断准确率分别为97.78%、96.67%、97.50%,均显著高于常规线圈技术的60.00%、50.00%、60.00%,差异有统计学意义(P<0.05)。显微线圈技术对软骨侵蚀、关节积液和滑膜增厚的诊出情况显著优于常规线圈技术,差异有统计学意义(P<0.05)。经显微线圈技术MRI增强扫描检测:腕关节类风湿关节炎患者右手近端指间关节周围软组织增厚,关节周围可见少量积液,增强扫描指间关节滑膜呈明显增厚并强化。骨性关节炎患者可见关节面下骨质异常信号,表现为“虫蚀状”或小斑片状软骨下骨质缺损区。结论磁共振显微线圈高分辨成像技术能够显著提高腕关节病变的诊断准确率,提高对软骨侵蚀、关节积液和滑膜增厚的诊出情况,值得广泛推广。     

三维超声成像在乳腺肿块诊断中应用价值

目的探讨三维超声成像技术对乳腺肿块的诊断价值。方法以我院2010年1月~2012年6月收治的60例女性患者为研究对象,所有患者均行二维、三维超声检查,对比2种检查方式的诊断准确率及检出率。结果超声诊断结果与手术及穿刺病理结果进行对照,60例患者共71个肿块。二维超声对59个乳腺肿块诊断正确,诊断准确率为83.1%(59/71),三维超声对68个乳腺肿块诊断正确,诊断准确率为95.8%(68/71),三维超声诊断准确率率高于二维超声,差异有统计学意义(P<0.05)。二维超声血流检出率63.41%(26/41),三维超声血流检出率97.56%(40/41),三维超声血流检出率高于二维超声血流检出率,差异有统计学意义(P<0.05)。结论三维超声诊断乳腺肿块准确率和血流检出率高于二维超声,使用三维超声可提高乳腺肿块鉴别诊断水平。     

256螺旋CT冠脉成像与DSA血管造影的对比研究

目的:对比256层螺旋计算机断层扫描(MSCT)与数字减影血管造影(DSA)在临床冠脉疾病诊断中的应用。方法:回顾性分析80例疑似冠脉疾病并在1周内分别采用256层MSCT、DSA诊断者的临床资料。对比二者对不同冠脉分段狭窄程度的评估结果;将DSA结果记为“金标准”,分析256层MSCT诊断冠脉狭窄的效能;统计256层MSCT对不同冠脉分段斑块形成的诊断结果。结果:冠脉血管节段可评价率为96.14%;256层MSCT、DSA对不同冠脉分段及总狭窄程度分布、狭窄检出率对比差异均无统计学意义(P>0.05);256层MSCT诊断冠脉狭窄的灵敏度、特异度、准确度、约登指数分别为97.92%、99.45%、98.57%、0.974;256层MSCT检出的568个冠脉狭窄段中共检出1036个斑块,其中钙化斑块、非钙化斑块、混合斑块分别有429个、200个、407个,占比分别为41.41%、19.31%、39.29%。结论:256层MSCT可诊断冠脉疾病,其诊断价值与DSA相当,且还可检出冠脉斑块形成情况及斑块性质。     

BI-RADS联合UE技术对小乳腺癌的诊断价值分析

目的分析乳腺影像报告与数据系统(BI-RADS)联合超声弹性成像(UE)技术对小乳腺癌的诊断价值。方法以我院乳腺科2018年1月~2020年2月收治的274例乳腺肿块患者为研究对象,所有患者均进行病理检查,根据病理检查结果分为乳腺增生患者(165例)和小乳腺癌(109例)患者,比较乳腺增生患者和小乳腺癌患者BI-RADS和UE评分;根据病理结果,比较UE、BI-RADS单独检查和联合检查对小乳腺癌的检出情况,并分析UE、BI-RADS单独检查和联合检查对小乳腺癌的诊断价值。结果经病理检查结果显示,本研究纳入的274例乳腺肿块患者中乳腺增生患者占比为60.22%,小乳腺癌患者占比为39.78%。小乳腺癌患者UE、BI-RADS评分均显著高于乳腺增生患者(P<0.05)。UE、BI-RADS联合检查对小乳腺癌的检出率为91.74%,显著高于UE(76.15%)和BI-RADS(79.90%,P<0.05)。UE、BI-RADS联合检查诊断小乳腺癌的灵敏度(91.74%)、特异度(95.15%)、阳性预测值(92.59%)、阴性预测值(94.58%)和准确度(93.80%)均高于UE和BI-RADS单独检查(76.15%、78.18%、69.75%、83.23%、77.37%和78.90%、81.82%、74.14%、85.44%、80.66%,P<0.05)。结论小乳腺癌患者UE、BI-RADS评分均显著高于乳腺增生患者,BI-RADS联合UE技术对小乳腺癌的检出率高于两者单独检查,同时其对小乳腺癌的诊断价值高于两者单独检查,因此临床可联合两者对乳腺肿块患者进行检查,提高小乳腺癌的检出率,进而及时治疗以改善患者预后。     

Influence of alumina dispersoid and test parameters on erosive wear behaviour of a cast zinc–aluminium alloy

Observations made pertaining to the erosive wear characteristics of a cast zinc-based alloy and its composite containing 10 wt.% (corresponding to 11.2 vol.%) alumina particles have been presented in this study. Matrix alloy has also been tested under identical test conditions in order to examine the role played by second phase alumina particles on the erosive wear resistance of the matrix alloy. Eroded surfaces and subsurface regions of the specimens were also characterized to understand the operating wear mechanisms.The composite exhibited higher erosive wear resistance (inverse of erosive wear rate) than the unreinforced matrix alloy in general. Further, the wear rate increased with increasing impingement velocity as also evident from higher surface damage. Increasing angle of impingement at lower impinging velocity led to reduced erosive wear rate. On the contrary, the erosive wear rate increased initially with impingement angle, attained the peak and then decreased at still higher angles at the higher impingement velocity. The eroded surfaces showed more abrasion grooves at lower impingement angle and greater tendency of crater formation at higher angles of attack. In case of the composite, protrusion and fracture of the dispersoid phase was also noted. The composite also revealed less severe surface and subsurface damage than the matrix alloy.     

Solid particle erosion of CFRP composite with different laminate orientations

The solid particle erosion behavior of epoxy base unidirectional and multidirectional carbon fiber reinforced plastic composites was investigated. The erosion rates of these composites were evaluated at various impingement angles (15–90°) with a particle velocity of 70 m/s. Irregular SiC particles with an average diameter of 80 μm was used. The dependence of impingement angle on the erosive wear resembled the conventional ductile behavior with maximum erosion rate at 15–30° impingement angle. The erosion rate of unidirectional composites at acute impingement angle was higher for [90] than for [45] and [0] while the difference disappeared at normal impingement angle (90°). On the other hand, the erosion rates of multidirectional laminated composites ([0/90], [45/−45], [90/30/−30] and [0/60/−60]) were not much influenced by the fiber orientation except for 15° impingement angle.     

Theoretical relationships between component design, patient bone geometry and range-of-motion post hip resurfacing

Clinical studies indicate that range of motion until prosthetic impingement is important in understanding unexplained failures of hip resurfacings, yet the underlying biomechanical principles have received little attention. This study investigates the mathematical relationships between component design, position, patient bone geometry and range of motion in hip resurfaced prostheses. Variations in range of motion and impingement-free safe-zones for cup position were calculated using an established method of vector analysis that facilitated parametric analysis in a time efficient manner. The alpha angle, defined as the angle between the centreline of the femoral neck and the waist of the femoral head/neck junction, was used to represent the natural femoral neck. Range of motion and impingement-free safe-zones were inversely proportional to the alpha angle and cup inclusion angle. The size of the safe-zone was most sensitive to the alpha angle with a 6 degrees reduction, decreasing the range of cup positions without impingement by 80-100%. Lowering the upper limit of cup inclination from 55 degrees to 45 degrees reduced the range of cup positions that allow impingement-free motion by 47-94%. No common safe-zone was observed for the range of component sizes and positions investigated. This offers an explanation to why clinic studies have failed to associate outcome with standardised positioning criteria.     

Slurry wear properties of pump lining materials

In order to study the slurry wear properties of elastomeric lining materials for sand, sludge and sewage pumps, several tests were carried out under various test conditions with a slurry jet device and prototype pump. Preliminary tests were done with 13 materials including polymers, metals and ceramic coatings. Polyurethane, fluid elastomer and rubber showed good wear resistance compared with the hard metals, and were examined in detail. The test conditions were as follows: jet velocity v (8–25 m s⁻¹), impingement angle (10°−90°), mean diameter of silica sand d (42–415 μm), and sand concentration by weight c (0.1–7 wt.%). The slurry wear rates of the polyurethane and the fluid elastomer were maximum at the impingement angle of approximately 30°. The rubber showed almost the same wear rate regardless of impingement angle. The slurry were rate increased according to a power law of the jet velocity above a critical velocity and sand concentration. As the particle size increased above a critical size at the same weight concentration, the wear rate first increased but then decreased. The influence of impingement variables and particle variables observed using both test methods shows a similar tendency for each lining material, so the slurry wear loss can be described with a single empirical equation. Comparing the slurry wear resistance of three lining materials, the polyurethane showed the lowest resistance because it contained many pores which were produced during the lining process. The rubber showed the highest slurry wear resistance which is probably related to its high tear strength.     

Quantitative zonal differentiation of articular cartilage by microscopic magnetic resonance imaging,polarized light microscopy,and Fourier‐transform infrared imaging

This study aimed to synchronize the zonal differentiation of the full‐thickness articular cartilage by three micro‐imaging techniques, namely microscopic magnetic resonance imaging (µMRI), polarized light microscopy (PLM), and Fourier‐transform infrared imaging (FTIRI). Eighteen cartilage‐bone blocks from three canine humeral joints were imaged by: (a) µMRI T₂ relaxation at 0° and 55° orientations in a 7 T magnetic field, (b) PLM optical retardation and azimuthal angle, and (c) FTIRI amide I and amide II anisotropies at 0° and 90° polarizations relative to the articular surface. In addition, µMRI T₁ relaxation was imaged before and after the tissue being immersed in gadolinium (contrast agent) solution, to calculate the proteoglycan concentration. A set of previously established criteria in cartilage imaging was revised. The new criteria could simultaneously correlate the thicknesses of the three consecutive subtissue zones in articular cartilage among these imaging techniques. Microsc. Res. Tech. 76:625–632, 2013. © 2013 Wiley Periodicals, Inc.