The Effect Evaluation And Sequence Optimization Study Of MRI On Ankle Joint Injury With Traditional Chinese Medicine Fumigation And Washing

Objective 1.To optimize the scanning sequence of ankle joint by comparing the detection rate of ankle joint injuries with different scanning sequence combinations and reasonable optimized scanning parameters,calculating the scanning time before and after sequence optimization,and comparing the image quality before and after parameter optimization.2.To explore the clinical value of magnetic resonance imaging in the treatment of ankle joint injury by observing and comparing the injury of ankle joint before and after fumigation and washing with traditional Chinese medicine.Methods 1.Study subjects:30 patients with ankle sprain in the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine from March 2016 to September 2018 were collected.All patients met the inclusion criteria and received conservative treatment.They were fumigated and washed with traditional Chinese medicine(Chen’s Suhong Decoction)according to the criteria,and were reexamined after 1-2 months of continuous use.There were 9 males,21 females,12 left ankle injuries and 18 right ankle injuries,aged 13-69 years,with an average age of(44.8±15.0)years.2.Methods:Philips Achieval 1.5T Achieva SE was selected to perform the scanning.The scanning sequence was PDW-SPAIR,T2WI,sagittal TIWI,sagittal T2WI,sagittal STIR,coronal STIR and sagittal 3D-WATSc.The detection rate and scanning time of different scanning sequence combinations were compared,and the best sequence combination was obtained.The parameters of NSA,FOV and matrix were optimized,and the image quality was evaluated comprehensively by observing the artifacts,noise range and degree,and the ability of displaying bone,tendon,ligament,cartilage and surrounding soft tissue.The injuries of bone,surrounding ligament,talus cartilage and tendon in ankle joint were observed and recorded.The imaging manifestations of ankle joint injuries before and after fumigation with traditional Chinese medicine were analyzed and compared to evaluate the value of traditional Chinese medicine fumigation with magnetic resonance imaging in evaluating ankle joint injuries.3.Statistical analysis:SPSS22.0 statistical software was used to collect and analyze the relevant data,and descriptive analysis of the characteristics of the subjects was carried out.The numerical variables were expressed by mean and standard deviation(x+s),while the classification variables were described by percentage.Two samples of frequency table and grade data were used to evaluate the image quality before and after optimization of sequence parameters;Wilcoxon rank test(non-parametric test)was used to compare the detection rate of lesions with paired samples in each sequence optimization combination;Wilcoxon rank test was used to compare the location and number of bone contusion,ligament and tendon injury of ankle joint before and after fumigation of traditional Chinese medicine.Rank test(non-parametric test);comparison of cartilage injury classification before and after fumigation and washing with frequency table data and grade data of two samples;P<0.05 showed significant difference.Result:The image quality was comprehensively evaluated by artifacts,the range and extent of noise,and the ability to display bone,tendon,ligament and cartilage.Statistical analysis results showed that Z=-0.740,P=0.459.The image quality before and after optimization of sequence parameters could not be considered to be different.To observe the diagnostic ability of three sequence combinations for bone contusion,ligament and tendon injury and talus cartilage injury in all patients.Combination 1(cross-sectional PDW-SPAIR sequence,coronal STIR sequence,sagittal T1WI sequence,sagittal 3D sequence)had the highest detection rate of lesions,P＝0.059(P>0.05),with no significant difference.The scanning parameters were optimized by NSA,FOV and matrix size.The scanning time was only 8:56.9.Statistical analysis showed that Z=-1.826,P=0.068.There was no significant difference between the optimized parameters and the conventional sequence combination.Before fumigation,83.3%(25/30)of the patients had different amounts and forms of bone damage.After fumigation,80%(24/30)of the patients had bone damage.Statistical results Z=2.867,P=0.004 showed that the degree of bone contusion of ankle joint was reduced before and after fumigation with traditional Chinese medicine.29 patients had ligament injury,and there were ligaments before fumigation with traditional Chinese medicine.There were 97 ligament injuries and 56 ligament injuries after fumigation and washing with traditional Chinese medicine.Statistical results showed that Z=-4.396,P=0.000,the difference was statistically significant,indicating that the number of injured ligaments after fumigation and washing with traditional Chinese medicine was less than that before fumigation and washing with traditional Chinese medicine.Among the 30 patients,23 patients had different grades of local osteochondral injury,including stage Ⅰ(n=7),stage Ⅱ(n=8),stage Ⅲ(n=7),stage IV(n＝1),and 19 cases of cartilage injury after fumigation and washing with traditional Chinese medicine,including stage Ⅰ(n=10),stage Ⅱ(n=4),stage Ⅲ(n=4),and stage Ⅳ(n=1).Statistical results:Z=-1.150,P=0.250,the difference was not significant,and it could not be considered that traditional Chinese medicine was still used.The degree of cartilage injury of ankle joint changed before and after fumigation.Among 30 patients with ankle injury,29 patients(96.7%)had 75 tendon injuries.After fumigation and washing with Chinese herbs,29 patients had 54 tendon injuries.The statistical results showed that Z=-3.063,P=0.002<0.05.The difference was statistically significant.It can be concluded that the degree of injury of ankle tendon was reduced after fumigation and washing with Chinese herbs.Conclusion 1.By optimizing the sequence combination and adjusting the scanning parameters reasonably,we think that the best sequence combination is PDW-SPAIR sequence of cross-section,STIR sequence of coronal plane,T1WI sequence of sagittal plane and 3D sequence of sagittal plane.The best sequence combination can be further optimized.The image quality and detection rate of lesions have no obvious difference,and the imaging time is more obvious than that of conventional sequence.The reduction not only meets the basic needs of clinical examination,but also ensures the image quality.2.Magnetic resonance imaging(MRI)can clearly show the number,location and degree of lesions in the evaluation of the efficacy of traditional Chinese medicine fumigation and washing for ankle joint injury.It has a high clinical diagnostic value,which is helpful for clinical evaluation of curative effect and provides a more accurate imaging basis for clinical selection of the best treatment.