目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)联合MRI总负荷评分对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入178例CSVD患者并根据蒙特利尔认知评估量表(MoCA)将其分为认知正常组(MoCA≥26分)89例和认知障碍组(MoCA<26分)89例,采用3...目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)联合MRI总负荷评分对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入178例CSVD患者并根据蒙特利尔认知评估量表(MoCA)将其分为认知正常组(MoCA≥26分)89例和认知障碍组(MoCA<26分)89例,采用3.0 T MRI评价CSVD影像学总负荷评分。比较2组患者基线资料、Lp-PLA2水平、MRI总负荷,Logistic回归分析CSVD患者认知障碍的影响因素,受试者工作特征(ROC)曲线评估Lp-PLA2水平联合MRI总负荷评分对CSVD患者认知障碍的预测价值。结果与认知正常组相比,认知障碍组Lp-PLA2水平、MRI总负荷评分、白细胞介素(IL)-6水平均升高(P<0.05),多因素Logistic回归分析结果显示,Lp-PLA2水平、MRI总负荷升高为CSVD患者认知障碍的危险因素(P<0.05),ROC曲线分析结果显示,Lp-PLA2水平联合MRI总负荷评分预测CSVD患者认知障碍的曲线下面积为0.905(95%CI:0.861~0.948),敏感度为86.5%,特异度为79.8%。结论认知障碍患者的Lp-PLA2水平、MRI总负荷评分升高,两者联合可作为CSVD患者认知障碍的早期预测指标。展开更多
Interbody disc spacers for anterior spine fusion are made of different materials, such as titanium alloys or carbon fiber reinforced polymers (CFRP). Implant-related susceptibility artifacts can decrease the quality o...Interbody disc spacers for anterior spine fusion are made of different materials, such as titanium alloys or carbon fiber reinforced polymers (CFRP). Implant-related susceptibility artifacts can decrease the quality of MRI scans. This cadaveric study aimed to demonstrate the extent that implant-related MRI artifacting affects the post fusion differentiation of the spinal canal (SC) and intervertebral disc space (IDS). In 6 cadaveric porcine spines, we evaluated the post-im- plantation MRI scans of a titanium and CFRP spacer that differed in shape and surface qualities. A spacer made of human cortical bone was used as a control. A defined evaluation unit was divided into regions of interest (ROI) to characterize the SC and IDS. Considering 15 different MRI sequences read independently by an interobserver-validated team of specialists artifact-affected image quality of the median MRI slice was rated on a modified score of 0-1-2-3. A maximum score of 15 points for the SC and 9 points for the IDS (100%) was possible. Turbo spin echo sequences produced the best scores for both spacers and the control. Only the control achieved a score of 100%. For the IDS the titanium and CFRP spacer maximally scored 0% and 74%, for the SC 80% and 99%, respectively. By using favored T1 TSE sequences the CFRP-spacer represented clear advantages in post fusion spinal imaging. Independent of artifact dimensions the used scoring system allowed us to create an implant-related ranking of MRI scan quality in reference to the bone control.展开更多
Introduction: According to anterior spine fusion intervertebral disc spacers made of titanium or cobalt-chromium al-loys are of special interest. With regard to postoperative problems implant related artifacts can lea...Introduction: According to anterior spine fusion intervertebral disc spacers made of titanium or cobalt-chromium al-loys are of special interest. With regard to postoperative problems implant related artifacts can lead to a decreased MRI evaluation. The focus of this study was to compare the respective implant artifact artifact range dependend on different MRI sequences. To simplify artifact evaluation we introduced in this study a new developed 0-1-2 score. Material and Methods: We performed an MRI artifact evaluation of 2 different metallic intervertebral disc spacers (cobalt-chromium and titanium alloy). A carcass porcine spine was employed. Considering 12 defined spinal regions of interest we evaluated the respective implant artifact properties independent from the total artifact volume by using a new developed 0-1-2 score. The artifact range was documented for 15 different MRI-sequences. Results: For the titanium spacer as well as the cobalt-chromium-spacer an MRI evaluation of the implant/disc space situation could not be carried out. In contrast to the cobalt chromium spacer the titanium spacer allowed a good differentiation of the spinal canal opposite to the implant. Optimal MRI imaging results for both metallic intervertebral disc spacers could be achieved considering TSE sequences. Conclusion: A comparison of these two metallic spacers showed in all examined sequences clear advantages in favour of the titanium spacer. The best MRI representation of both tested implants by reducing implant related artifacts could be achieved with fast spin echo (TSE-) sequences. In spite of the use of TSE sequences a variability of susceptibility artifacts has to be included with regard to implant shape and material. With regard to the results of this study the easy use of a new developed artifact score represented a useful help to compare implant related MRI artifact properties independent from the actual implant related total artifact volume.展开更多
目的:探讨核磁共振成像(MRI)对膝骨性关节炎患者合并滑膜炎的严重度评估的方法及临床意义。方法:23例膝骨性关节炎患者行MRI检查。应用MRI的T2加权像检查膝关节内滑液含量和用梯度回波(GRE)检查滑膜厚度,应用ROI体积测量方法测量滑膜厚...目的:探讨核磁共振成像(MRI)对膝骨性关节炎患者合并滑膜炎的严重度评估的方法及临床意义。方法:23例膝骨性关节炎患者行MRI检查。应用MRI的T2加权像检查膝关节内滑液含量和用梯度回波(GRE)检查滑膜厚度,应用ROI体积测量方法测量滑膜厚度,包括内外侧间沟和内外侧髌上囊4个区域,每个区域分0～3级,总计最大12级。其中随机选择12例患者在60d后行MRI检查并对膝关节症状进行评估,膝关节症状的评估应用Western Ontario大学和McMaster大学骨关节炎指数(WOMAC OA in-dex)和视觉模拟评分(VAS),并用三维抑脂扰相梯度回波(SPGR)序列来测量软骨体积。结果:滑膜的厚度为(1.82±0.52)级,内侧室的测量等级是(1.77±0.58)级,外侧室为(1.88±0.67)级,髌上囊和隐窝的测量等级分别是(1.95±0.50)级、(1.70±0.68)级。滑膜炎的严重程度和软骨体积的缺失有相关性(P<0.05)。结论:通过MRI可以准确和有效地测量膝骨性关节滑膜炎的严重程度。展开更多
文摘目的探讨脂蛋白相关磷脂酶A2(Lp-PLA2)联合MRI总负荷评分对脑小血管病(CSVD)患者认知障碍的预测价值。方法纳入178例CSVD患者并根据蒙特利尔认知评估量表(MoCA)将其分为认知正常组(MoCA≥26分)89例和认知障碍组(MoCA<26分)89例,采用3.0 T MRI评价CSVD影像学总负荷评分。比较2组患者基线资料、Lp-PLA2水平、MRI总负荷,Logistic回归分析CSVD患者认知障碍的影响因素,受试者工作特征(ROC)曲线评估Lp-PLA2水平联合MRI总负荷评分对CSVD患者认知障碍的预测价值。结果与认知正常组相比,认知障碍组Lp-PLA2水平、MRI总负荷评分、白细胞介素(IL)-6水平均升高(P<0.05),多因素Logistic回归分析结果显示,Lp-PLA2水平、MRI总负荷升高为CSVD患者认知障碍的危险因素(P<0.05),ROC曲线分析结果显示,Lp-PLA2水平联合MRI总负荷评分预测CSVD患者认知障碍的曲线下面积为0.905(95%CI:0.861~0.948),敏感度为86.5%,特异度为79.8%。结论认知障碍患者的Lp-PLA2水平、MRI总负荷评分升高,两者联合可作为CSVD患者认知障碍的早期预测指标。
文摘Interbody disc spacers for anterior spine fusion are made of different materials, such as titanium alloys or carbon fiber reinforced polymers (CFRP). Implant-related susceptibility artifacts can decrease the quality of MRI scans. This cadaveric study aimed to demonstrate the extent that implant-related MRI artifacting affects the post fusion differentiation of the spinal canal (SC) and intervertebral disc space (IDS). In 6 cadaveric porcine spines, we evaluated the post-im- plantation MRI scans of a titanium and CFRP spacer that differed in shape and surface qualities. A spacer made of human cortical bone was used as a control. A defined evaluation unit was divided into regions of interest (ROI) to characterize the SC and IDS. Considering 15 different MRI sequences read independently by an interobserver-validated team of specialists artifact-affected image quality of the median MRI slice was rated on a modified score of 0-1-2-3. A maximum score of 15 points for the SC and 9 points for the IDS (100%) was possible. Turbo spin echo sequences produced the best scores for both spacers and the control. Only the control achieved a score of 100%. For the IDS the titanium and CFRP spacer maximally scored 0% and 74%, for the SC 80% and 99%, respectively. By using favored T1 TSE sequences the CFRP-spacer represented clear advantages in post fusion spinal imaging. Independent of artifact dimensions the used scoring system allowed us to create an implant-related ranking of MRI scan quality in reference to the bone control.
文摘Introduction: According to anterior spine fusion intervertebral disc spacers made of titanium or cobalt-chromium al-loys are of special interest. With regard to postoperative problems implant related artifacts can lead to a decreased MRI evaluation. The focus of this study was to compare the respective implant artifact artifact range dependend on different MRI sequences. To simplify artifact evaluation we introduced in this study a new developed 0-1-2 score. Material and Methods: We performed an MRI artifact evaluation of 2 different metallic intervertebral disc spacers (cobalt-chromium and titanium alloy). A carcass porcine spine was employed. Considering 12 defined spinal regions of interest we evaluated the respective implant artifact properties independent from the total artifact volume by using a new developed 0-1-2 score. The artifact range was documented for 15 different MRI-sequences. Results: For the titanium spacer as well as the cobalt-chromium-spacer an MRI evaluation of the implant/disc space situation could not be carried out. In contrast to the cobalt chromium spacer the titanium spacer allowed a good differentiation of the spinal canal opposite to the implant. Optimal MRI imaging results for both metallic intervertebral disc spacers could be achieved considering TSE sequences. Conclusion: A comparison of these two metallic spacers showed in all examined sequences clear advantages in favour of the titanium spacer. The best MRI representation of both tested implants by reducing implant related artifacts could be achieved with fast spin echo (TSE-) sequences. In spite of the use of TSE sequences a variability of susceptibility artifacts has to be included with regard to implant shape and material. With regard to the results of this study the easy use of a new developed artifact score represented a useful help to compare implant related MRI artifact properties independent from the actual implant related total artifact volume.
文摘目的:探讨核磁共振成像(MRI)对膝骨性关节炎患者合并滑膜炎的严重度评估的方法及临床意义。方法:23例膝骨性关节炎患者行MRI检查。应用MRI的T2加权像检查膝关节内滑液含量和用梯度回波(GRE)检查滑膜厚度,应用ROI体积测量方法测量滑膜厚度,包括内外侧间沟和内外侧髌上囊4个区域,每个区域分0～3级,总计最大12级。其中随机选择12例患者在60d后行MRI检查并对膝关节症状进行评估,膝关节症状的评估应用Western Ontario大学和McMaster大学骨关节炎指数(WOMAC OA in-dex)和视觉模拟评分(VAS),并用三维抑脂扰相梯度回波(SPGR)序列来测量软骨体积。结果:滑膜的厚度为(1.82±0.52)级,内侧室的测量等级是(1.77±0.58)级,外侧室为(1.88±0.67)级,髌上囊和隐窝的测量等级分别是(1.95±0.50)级、(1.70±0.68)级。滑膜炎的严重程度和软骨体积的缺失有相关性(P<0.05)。结论:通过MRI可以准确和有效地测量膝骨性关节滑膜炎的严重程度。
