Background To show the femoral neck better in hip lateral view of X-ray, we design a modified hip lateral view, and then investigate the value in femoral neck fractures. Methods CT images of 10 normal hip joints for 3D reconstruction were selected, the Mimics Medical 21.0 were used, and rotating the proximal femur was to find the most suitable angle for showing the femoral neck well, designed the modified lateral view according to this angle. We collected 25 femoral neck fracture and 25 healthy cases for observation and control group. And two groups were all taken hip anteroposterior, cross-table lateral and modified lateral view, which were analyzed by two radiologists to score the anatomical structures of the articular surface, femoral head, subfemoral head region, femoral neck, basal region and intertrochanteric region. Friedman Test was used to analyze the score of femoral neck at different angles. T test and Wilcoxon signed ranks test were to compare inter-groups. Results The modified lateral view was designed as follows: the subjects were supine, with the sagittal axis biased toward the healthy side at an angle of approximately 20° to the long axis of the examination table, the hip joint flexed at 45°, the lower extremity abducted at 40°, the centerline inclined 45° toward the head, and the centerline aligned with the center of the groin. The modified lateral view showed the femoral head, subfemoral head region and femoral neck more clearly than the lateral cross-table view, but the cross-table lateral showed the femoral neck basal and intertochanteric region better. In addition, the time of taking the modified lateral view was significantly less than the cross-table lateral view (healthy group: 0.752min ± 0.161 vs 0.596min ± 0.151, P < 0.001; fracture group: 1.128min ± 0.404 vs 0.924min ± 0.395, P < 0.001). Conclusions The modified lateral view can obtain a standard sagittal image of femoral neck, which can show the dislocation and angulation of the sagittal femoral neck fracture clearly, and improve the accuracy of diagnosis. And it is more convenient and easier for patients to cooperate, which is worthy promoting and applying in clinical work.

PURPOSE We aimed to establish a liver function evaluation model by combining multiparametric magnetic resonance imaging (MRI) with liver volume (LV) and further verify the effectiveness of the model to evaluate liver function. METHODS This retrospective study included 101 consecutive cirrhosis patients (69 cases for modeling group and 32 cases for validation group) who underwent gadoxetic acid-enhanced MRI. Five signal intensity parameters were obtained by measuring the signal intensities of the liver, spleen, and erector spinae before and 20 minutes after gadoxetic acid disodium enhancement. The diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were obtained from intravoxel incoherent motion diffusion-weighted imaging. The LV parameters (V liver , V spleen , and V liver /V spleen ) were obtained using 3-dimensional image generation software. The most effective parameter was selected from each of the 3 methods, and a multivariate regression model for liver function evaluation was established and validated. RESULTS In the modeling group, relative enhancement (RE), D*, and V liver /V spleen showed significant differences among the different liver function groups ( P < .001). Receiver operating characteristic analysis showed that these parameters had the highest area under the curve (AUC) values for distinguishing Child-Pugh A from Child-Pugh B and C groups (0.917, 0.929, and 0.885, respectively). The following liver function model was obtained by multivariate regression analysis: F(x) = 3.96 − 1.243 (RE) − 0.034 (D*) − 0.080 (V liver /V spleen ) (R 2 = 0.811, P < .001). In the patients with cirrhosis, the F(x) of Child-Pugh A, B, and C were 1.16 ± 0.44, 1.95 ± 0.29, and 2.79 ± 0.38, respectively. In the validation group, the AUC for F(x) to distinguish Child-Pugh A from Child-Pugh B and C was 0.973. CONCLUSION Combining multiparametric MRI with LV effectively distinguished patients with different Child-Pugh grades. This model could hence be useful as a novel radiological marker to estimate the liver function.

Objectives: To reveal the change of renal cortical blood perfusion in primary glomerular disease (PGD) and renal aging by flowsensitive alternating inversion recovery (FAIR) arterial spin labeling (ASL) technique. Patients and Methods: Renal cortical perfusion was estimated in 24 PGD patients and 30 healthy volunteers using FAIR-ASL in this case-control study. MRI examination was repeated after one week in six randomly selected healthy volunteers. In PGD patients, we regard estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m 2 as mild PGD and eGFR < 60 mL/min/1.73 m 2 as moderatelate PGD. The correlations between ASL perfusion values and eGFR in healthy volunteers, mild and moderate-late PGD patients were assessed. Results: In healthy volunteers, the perfusion values between the twice ASL scanning with one week-interval showed an excellent agreement by Bland-Altman analysis. The mean perfusion value of the bilateral kidneys decreased with age increase (25 -72 years) (r = -0.496, P = 0.012). There were significant differences in ASL perfusion values among healthy volunteers, mild and moderate-late PGD patients (P < 0.0001). Perfusion values correlated strongly with eGFR in all PGD patients (r = 0.868, P < 0.0001), but not in healthy volunteers (r = 0.156, P = 0.405). The correlation coefficient of perfusion values with eGFR in mild and moderate-late PGD patients were 0.749 (P = 0.008) and 0.809 (P = 0.010), respectively. Conclusion: FAIR-ASL technique represents a feasible approach to monitor the renal perfusion variations in PGD patients. It is a noninvasive technique to discover the early abnormality of renal function, and assess the degree of renal aging.