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Objective:To investigate frailty status of the elderly patients with leukoaraiosis (LA) and to analyze the correlation between white matter hyperintensities and their frailty status.Methods:From June 2019 to September 2020, a total of 162 patients with leukoaraiosis over 65 years old were screened by cranial MRI.The Fried frailty phenotype was used to evaluate their frailty status.The Fazekas scale scoring method was used to independently assess the periventricular white matter hyperintense (PVH) and deep white matter hyperintense (DWMH) by the cranial MRI images.SPSS 22.0 software was used for statistical analysis.ANOVA test was used to compare normal distribution data between groups, and Kruskal-Wallis H test was used to compare non-normal distribution data between groups.Spearman rank correlation analysis was used to analyze the correlation between PVH and DWMH scores and Fried frailty phenotype score. Results:Among 162 elderly patients with leukoaraiosis, 46 patients (28.40%) were non-frailty, 76 patients (46.91%)were pre-frailty and 40 patients (24.69%) were frailty.There were statistically significant differences in age( F=9.382, P<0.01), number of chronic diseases( H=10.736, P<0.01), number of medication ( H=15.927, P<0.01) and mini-nutritional assessment short form (MNA-SF) scores( F=5.263, P<0.01) among older LA patients with different frailty phenotype.There was statistical difference in PVH scores in elderly LA patients with different frailty phenotype (χ 2=108.537, P<0.01), but no significant difference in DWMH scores (χ 2=4.239, P>0.05). Spearman correlation analysis showed significant positive correlation between PVH score and frailty phenotype score in elderly LA patients ( r=0.718, P<0.001). Conclusion:Elderly LA patients have a high incidence of frailty, which may be related to aging, multi-disease coexistence, multiple medication, nutritional risk and other factors.The occurrence of weakness in elderly LA patients is related to periventricular white matter lesions, and the more serious the white matter damage, the more obvious the degree of frailty.
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Objective:To analyze the gait and balance disorder and fall risk in patients with leukoaraiosis (LA) in different degrees and locations.Methods:Seventy-eight patients with LA (LA group) and thirty healthy controls (NC group) were selected.According to Fazekas grading scale, the LA group were subgroups of different degrees(LA1, LA2, LA3)and evaluated independent scores for periventricular white matter hypersignal (PVH) and deep white matter hypersignal (DWMH). All subjects were tested by Tinetti scale, and the gait test, balance test and fall risk assessment were carried out, and the correlation between gait test results and balance test results and PVH and DWMH scores were analyzed.Results:There were significant differences in gait test((11.47±0.51), (10.18±1.29)), balance test((15.63±0.49), (13.96±1.58)) and fall risk((27.10±0.76), (24.15±2.73)) between LA group and NC group ( t=5.310, 5.667, 5.799, all P< 0.01). There were no significant differences in gait test, balance test and fall risk between NC group and LA1 group (all P>0.05). There were significant differences in gait test, balance test and fall risk between NC group and LA2 group and LA3 group ( t=1.110, 1.562, 1.336; 2.592, 3.342, 2.985; all P<0.01). There were significant differences in gait test, balance test and fall risk between LA1 group((11.19±0.85), (15.38±0.75), (26.58±1.47)) and LA2 group((10.36±0.82), (14.07±1.09), (24.43±1.64)) and LA3 group((8.88±0.99), (12.23±1.08), (21.21±1.93)) ( t=0.835, 1.313, 1.039; 2.317, 3.093, 2.756; all P<0.01). There were significant differences in gait test, balance test and fall risk between LA2 group and LA3 group ( t=1.482, 1.780, 1.639, all P<0.01). The analysis showed that the gait test was negatively correlated with the PVH and DWMH scores ( r=-0.810, P<0.01; r=-0.452, P<0.01). The balance test was negatively correlated with the PVH and DWMH scores ( r=-0.502, P<0.01; r=-0.836, P<0.01). Conclusions:There are gait disorder and balance disorder in patients with moderate and severe LA.With the increase of the degree of LA , the damage of gait and balance function is significantly increased, and the risk of fall is also significantly increased.The gait disorder and the balance disorder of LA patients has different correlation with the high-signal score of the white matter in different parts.The correlation between gait disorder and PVH score is more obvious, and the correlation between balance disorder and DWMH score is more obvious.
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Objective To investigate the distribution of femoro-popliteal artery chronic totally occlusions (CTO) and to analyze the influence of different risk factors on the distribution of lesions. Methods A total of 47 patients with CTA and DSA proved femoro-popliteal artery CTO, who were admitted to the Affiliated Beijing Shijitan Hospital of Capital Medical University during the period from January 2013 and May 2015, were enrolled in this study. In order to make a clear description about the distribution characteristics of the lesions, the superficial femoral artery was averagely divided into three segments (F1-F3), and the popliteal artery was also divided into three segments (P1-P3) according to the bony landmarks. Based on the CTA images (including 3D reconstruction images) and DSA images, the distribution of CTO lesions was determined. The factors that might influence the distribution of CTO lesions were collected, and the results were analyzed using multivariable logistic regression analysis. Results A total of 59 femoro-popliteal artery CTO lesions detected in 47 patients were included in this study. The average length of lesion segment was (12.91 ± 10.13) cm. According to the 6-section division method of femoro-popliteal artery, the lesions involved F1 (n=23), F2(n=34), F3(n=48), P1(n=18), P2(n=6) as well as P3(n=5) segments. Multivariable logistic regression analysis reveals that F1 segment was most prone to be affected by CTO lesions in patients with hypertension (RR=3.21) and in patients who had cigarette smoking habit (RR=1.76). In male patients, P1segment was more easil y involved by CTO lesions (RR=1.98). In patients with diabetes mellitus, the RR value was gradually increased from the proximal to the distal end of the blood vessel, indicating that the lesion was more likely to involve distal vessels. Conclusion The distributions of femoro-popliteal artery CTO lesions have certain characteristics, which are closely associated with femoro-popliteal artery hemodynamics and atherosclerosis risk factors.
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Objective To assess the clinical application of iterative reconstruction (IR)in the head and neck CT angiography (CTA).Methods 100 patients who underwent the head and neck CTA examination were divided into Group A and Group B at ran-dom.Each group included 50 patients.Group A was performed the conventional-dose scan method (tube voltage 120 kV,tube cur-rent 300 mAs),and images were reconstructed with filtered back projection (FBP);Group B was performed the low-dose scan method [tube voltage 100 kV,dynamic tube current (1 99-399 mAs)],and images were reconstructed with IR.Two experienced radiology physicians reviewed the results of image quality using double blind method,and compared CT dose index volume (CTDIvol)and dose-length product (DLP).Results There were significant differences between radiation dose and image quality of the two groups (P <0.001).Radiation dose of Group B was significantly lower than that of Group A,while image quality of Group B was significantly better than that of Group A.Conclusion In the head and neck CTA applications,compared with FBP,IR recon-struction can reduce radiation dose and improve image quality.