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Objective To investigate the correlation between 24-h ambulatory blood pressure variability and the overall burden of cerebral small vessel disease (CSVD) in patients with acute ischemic stroke. Methods From March 2016 to December 2017, consecutive patients with acute ischemic stroke admitted to the Department of Neurology, the Affiliated Changshu Hospital of Soochow University were enrolled. The 3. 0 T-MRI was used to assess asymptomatic lacunar infarction, white matter hyperintensities, cerebral microbleeds, and enlarged perivascular spaces within 24 h after admission, and the total CSVD score (0-4) was calculated. 24-h ambulatory blood pressure monitoring was performed 24 to 72 h after admission. Ordinal logistic regression analysis was used to determine the independent correlation between the 24-h ambulatory blood pressure-related index and the total CSVD score. Results A total of 220 patients with acute ischemic stroke were enrolled. The patients were divided into five groups according to the total CSVD score. Univariate analysis showed that there were significant differences in age, homocysteine, the proportion of hypertension, as well as 24 h, daytime and nighttime mean systolic blood pressure (SBP), and coefficient of variation of daytime SBP among the 5 groups (all P < 0. 05). Ordinal logistic regression analysis showed that age (odds ratio [OR] 1. 078, 95％ confidence interval [CI] 1. 051-1. 106; P < 0. 001), 24-h mean SBP (OR 1. 043, 95％ CI 1. 026-1. 060; P < 0. 001), daytime mean SBP (OR 1. 042, 95％ CI 1. 025-1. 059; P < 0. 001), nighttime mean SBP (OR 1. 034, 95％ CI 1. 019-1. 049; P < 0. 001), and coefficient of variation of daytime SBP (OR 1. 129, 95％ CI 1. 052-1. 210; P = 0. 003) were independently correlated with the total CSVD score. Conclusions The elevated 24 h, daytime and nighttime mean SBP levels and coefficient of variation of daytime SBP are independently correlated with the severity of overall CSVD burden in patients with acute ischemic stroke.
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Objective To investigate the correlation between 24-h ambulatory blood pressure (BP) variability and cerebral microbleeds (CMBs) in patients with acute ischemic stroke. Methods Consecutive inpatients with acute ischemic stroke were prospectively enrolled. 24-h ambulatory BP was monitored. Magnetic susceptibility-weighted imaging was used to evaluate CMBs and their locations. Univariate analysis was used to compare the baseline data between the CMBs group and the non-CMBs group. Multivariate logistic regression analysis was used to determine the independent correlation between ambulatory BP related indexes and CMBs. Results A total of 178 patients with acute ischemic stroke were enrolled, including 114 males, aged 67.6 ±10.8 years, and 90 (50.6%) with CMBs. The proportion of hypertension and asymptomatic lacunar infarction, periventricular and deep white matter high signal score, 24-h, daytime, nighttime mean systolic and diastolic BP, 24-h, and daytime systolic BP variability in the CMBs group were significantly higher than those in the non-CMB group (all P<0.05). Multivariate logistic regression analysis showed that 24-h systolic BP variability (odds ratio 1.133, 95% confidence interval 1.023-1.255; P=0.016) and daytime mean systolic BP (odds ratio 1.045, 95% confidence interval 1.022-1.069; P<0.001) had significant independent correlation with CMBs. Conclusion 24-h systolic BP variability and daytime mean systolic BP were the independent risk factors for CMBs in patients with acute ischemic stroke.
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Objective To investigate the value of evaluating vertebrobasilar artery atherosclerosis with 3.0 T high-resolution magnetic resonance imaging (HR-MRI) in the progress of posterior circulation transient cerebral ischemia (TIA).Methods From July 2013 to July 2014,30 consecutive patients (outpatients and inpatients) with posterior circulation TIA at the Department of Neurology,the First People's Hospital of Changshu were enrolled respectively.They were all confirmed as the presence of vertebrobasilar atherosclerotic plaques by the head magnetic resonance angiography.The vertebrobasilar artery plaques were examined with 3 T HR-MRI to assess the nature and stability of the plaques.They were randomly divided into either a stable plaque group (n =16) or an unstable plaque group (n =14) according to the results of plaque stability.They were followed up for 24 months.The time and proportion from the first visit to the posterior circulation infarction were recorded and compared between the two groups of patients.Results At the end of follow-up,the time of posterior circulation infarction in the unstable group was significantly shorter than that in the stable group,and the difference was statistically significant (11.5 [7.0,20.0] months vs.24.0[22.5,24.0] months,Z =-2.755,P ＜ 0.05).The ratios of posterior circulation infarction in the stable group and the unstable group were 5/16 and 8/14 respectively.The difference was not statistically significant between the two groups (P ＞ 0.05).Conclusion Evaluating the results of vertebrobasilar artery atherosclerosis plaque with HR-MRI has a certain value for the progression of posterior circulation ischemia disease.
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<p><b>OBJECTIVE</b>To examine the associations of apparent diffusion coefficient (ADC) value from MR diffusion-weighted imaging (DWI) with Ki-67 expression and differentiation grade in gastric cancer.</p><p><b>METHODS</b>Images and pathologic data of 68 gastric cancer patients between September 2013 and February 2015 in Affiliated Changshu Hospital of Soochow University were analyzed retrospectively. The expression of Ki-67 antigen in cancer tissue sample was determined by immunohistochemistry. Ki-67 labeling index(LI) was calculated to divide the cases into low Ki-67 group(Ki-67 LI <50%) and high Ki-67 group (Ki-67 LI ≥ 50%). Associations of ADC value with differentiation grade and Ki-67 LI were examined.</p><p><b>RESULTS</b>Mean ADC value of low Ki-67 LI group was significantly higher than that of high Ki-67 LI group [(0.977 ± 0.100) × 10(-3) mm(2)/s vs. (0.859 ± 0.064) × 10(-3) mm(2)/s, P=0.000]. The ADC value was negatively correlated with Ki-67 LI (r=-0.685, P=0.000). Mean ADC value of well differentiated adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated adenocarcinoma, and signet-ring cell carcinoma was (1.124 ± 0.080) × 10(-3) mm(2)/s, (0.950 ± 0.064) × 10(-3) mm(2)/s, (0.899 ± 0.091) × 10(-3) mm(2)/s, and (0.894 ± 0.081) × 10(-3) mm(2)/s respectively. Difference of ADC value among differentiation grades was significantly different (F=11.405, P=0.000). Difference of ADC value between well differentiated adenocarcinoma and non-well differentiated adenocarcinoma was significantly different(P=0.000).</p><p><b>CONCLUSION</b>ADC value is associated with differentiation grade and Ki-67 LI of gastric cancer, which may be used as a noninvasive predictor for evaluating the proliferation and differentiation grade of gastric cancer.</p>
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Humans , Adenocarcinoma , Diagnosis , Diffusion Magnetic Resonance Imaging , Ki-67 Antigen , Metabolism , Retrospective Studies , Stomach Neoplasms , DiagnosisABSTRACT
Objective To investigate the morphologic characteristics of gonococcal inflammation of paraurethral glands in males. Methods Eleven male patients with gonococcal inflammation of paraurethral glands were examined by both real-time ultrasound imaging (Siemens Acuson X300) and 3.0 T magnetic resonance imaging (MRI, Philips Achieva). Results High-frequency ultrasound imaging revealed tubular echoic areas with well-defined borders and smooth margins in all the patients. The inside of these tubular areas was weak-echoic. These tubular echoic areas were blind in one end, but open in the other end, and ran in parallel with the urethra. The mean lumen diameter was 1.1 ± 0.2 mm (range, 0.7 - 1.3 mm) , and the mean lumen length was 8.4 ± 0.6 mm (range, 7.0 - 12.0 mm). Anechoic liquid-filled areas were seen in the tubular echoic areas in two patients. Paraurethral ducts were not detected by 3.0 T MRI in these patients. Conclusions High-frequency ultrasound imaging can clearly show the morphologic characteristics of gonococcal inflammation of paraurethral glands in males, and provide valuable ultrasound images for surgery.
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Objective To investigate the suitable injection rate and dose in multi-slice CT perfusion imaging.Methods Randomized block design was adopted in this study.The treatment factor-contrast medium injection rate was classified into 3,4,5,6 and 8 ml/s;thesubjects were divided into 5 blocks grouped by contrast medium injection dose: 0.5,0.75,1,1.25 and 1.5 ml/kg.25 Beagles wererandomly enrolled to undergo cerebral CT perfusion imaging.After post processing,time to peak(TTP) and rise value(RV) were measured in superior sagital venous.Results Injection rate had a significant effect on TTP of superior sagital venous.There was no significant difference among group 5,6 and 8 ml/s.Compared with 8 ml/s,TTP of superior sagital venous was prolonged when injection rate 3,4 ml/swere adopted.Injection dose had a significant effect on RV of superior sagital venous.There was no significant difference among group 1,1.25 and 1.5 ml/kg.In comparison with 1 ml/kg,RV of superior sagital venous was prolonged when injection dose 0.5 and 0.75 ml/kg were adopted.Conclusion The quality of cerebral CT perfusion imaging is well enough even injection rate as low as 5 ml/s or injection dose as few as 1 ml/kg.