ABSTRACT
Objective:To investigate predictive value of model based on pre-surgical 18F-FDG PET/CT metabolic parameters for mediastinal lymph node metastasis (LNM) in lung adenocarcinoma. Methods:A total of 288 patients with lung adenocarcinoma (135 males, 153 females, age (61.6±8.5) years) who diagnosed and treated in the Fourth Hospital of Hebei Medical University from January 2016 to February 2021 were enrolled retrospectively. All patients underwent 18F-FDG PET/CT examination within 1 month before operation, and underwent complete resection of primary lung tumor and standard lymph node dissection. PET/CT parameters were extracted (PET metabolic parameters: minimum SUV(SUV min), SUV max, SUV mean, SUV standard deviation (SUV std), metabolic tumor volume (MTV) and total lesion glycolysis (TLG); CT parameters: minimum CT value (HU min), maximum CT value (HU max), mean CT value (HU mean), CT value standard deviation (HU std)). Multivariate logistic regression analysis was used for screening parameters and establishing model to predict LNM. ROC curves analyses were used to evaluate the predictive performance of models. Results:Among 288 patients, 90 had LNM, and 361 metastatic lymph nodes (N1: 186, N2: 175) were reported by pathology. SUV min (odds ratio ( OR)=1.859, 95% CI: 1.074-3.220, P=0.027), SUV max ( OR=2.255, 95% CI: 1.306-3.893, P=0.004), SUV mean ( OR=0.277, 95% CI: 0.115-0.665, P=0.004) were predictors of LNM. The AUC of PET/CT model was 0.849 (95% CI: 0.804-0.893), and the sensitivity, specificity, accuracy, and positive and negative predictive values were 87.8%(79/90), 72.2%(143/198), 77.1%(222/288), 59.0%(79/134) and 92.9%(143/154), respectively. Conclusion:The model based on 18F-FDG PET/CT metabolic parameters can improve the accuracy of pre-surgical N-staging in patients with lung adenocarcinoma.
ABSTRACT
Objective:To investigate the value of pre-therapy 18F-FDG PET/CT radiomic models in differentiating epidermal growth factor receptor (EGFR) exon 19 deletion from exon 21 L858R missense in patients with non-small cell lung cancer (NSCLC). Methods:A total of 172 patients with EGFR mutant NSCLC (54 males, 118 females, age: (56.2±12.5) years) in the Fourth Hospital of Hebei Medical University between January 2015 and November 2019 were retrospectively included. Exon 19 mutation was found in 75 patients and exon 21 mutation was identified in 97 patients. The patients were divided into training set ( n=121) and validation set ( n=51) in a 7∶3 ratio by using random number table. The LIFEx 4.00 package was used to extract texture features of PET/CT images of lesions. The least absolute shrinkage and selection operator (LASSO) algorithm was used for feature screening. Three machine learning models, namely logistic regression (LR), random forest (RF), and support vector machine (SVM) models, were constructed based on the selected optimal feature subsets. The ROC curve analysis was performed to assess the predictive performance of those models. Finally, decision curve analysis (DCA) was used to evaluate the clinical value of the models. Results:Nine radiomics features, including 6 PET features (histogram (HISTO)_Kurtosis, SHAPE_Sphericity, gray level run length matrix (GLRLM)_ low gray-level run emphasis (LGRE), GLRLM_ run length non-uniformity (RLNU), neighborhood grey level different matrix (NGLDM)_Contrast, gray level zone length matrix (GLZLM)_ short-zone low gray-level emphasis (SZLGE)), and 3 CT features (gray level co-occurrence matrix (GLCM)_Correlation, GLRLM_ run percentage (RP), NGLDM_Contrast), were screened by LASSO algorithm. Three machine learning models had similar predictive performance in the training and validation sets: AUCs for the RF model were 0.79, 0.77, and those for the SVM model were 0.76, 0.75, for the LR model were 0.77, 0.75. The DCA showed that the 3 machine learning models had good net benefits and clinical values in predicting EGFR mutation subtypes.Conclusion:18F-FDG PET/CT radiomics provide a non-invasive method for the identification of EGFR exon 19 deletion and exon 21 L858R missense mutations in patients with NSCLC, which may help the clinical decision-making and the formulation of individualized treatment plan.
ABSTRACT
Objective:To investigate the relationship between 18F-FDG PET/CT Lugano lymphoma response evaluation criteria and prognosis of patients with diffuse large B-cell lymphoma (DLBCL) at the end of chemotherapy. Methods:A total of 131 patients with DLBCL (63 males, 68 females, age (50.3±17.0) years) who underwent 18F-FDG PET/CT at the end of chemotherapy in the Fourth Hospital of Hebei Medical University from July 2013 to January 2021 were analyzed retrospectively. 18F-FDG PET/CT Lugano lymphoma response evaluation criteria was used to evaluate the response (complete remission (CR), partial remission (PR), stable disease (SD) and progressive disease (PD)). Progression-free survival (PFS) and overall survival (OS) were followed up. Kaplan-Meier survival analysis was used for univariate analysis of clinical parameters and imaging parameters, and Cox proportional hazards regression model was used for multivariate analysis to explore related factors affecting the prognosis of patients with DLBCL. Results:The median follow-up time was 35.47 months for 131 patients with DLBCL. The 5-year PFS rate was 57.3%(75/131), and the 5-year OS rate was 84.0%(110/131). There were 74 cases of CR, 37 cases of PR and 20 cases of PD. Univariate analysis showed that the Lugano lymphoma response evaluation criteria was the influencing factor of PFS and OS (PFS, χ2=72.25, P<0.001; OS, χ2=11.97, P=0.003). Deauville score (DS) of patients with DLBCL was also the influencing factor for PFS ( χ2=62.46, P<0.001) and OS ( χ2=19.95, P<0.001). Ann Arbor stage, Eastern Cooperative Oncology Group physical state (ECOG PS) score and international prognostic index (IPI) were the influencing factors for PFS ( χ2 values: 10.31-15.80, all P<0.05). Ann Arbor stage, ECOG PS score, number of extranodal organ involved, β 2 microglobulin, and IPI were the influencing factors for OS ( χ2 values: 4.97-30.57, all P<0.05). Cox multivariate analysis showed that Lugano lymphoma response evaluation criteria, Ann Arbor stage and ECOG PS score were independent prognostic factors for PFS (relative risk ( RR) and 95% CI: 8.841(4.764-16.405), 1.434(1.111-1.852), 2.125(1.205-3.746), P values: <0.001, 0.006, 0.009) and OS ( RR(95% CI): 3.276(1.304-8.235), 9.728(2.216-42.669), 2.506(1.040-6.039), P values: 0.012, 0.003, 0.041). Conclusion:18F-FDG PET/CT Lugano lymphoma response evaluation criteria can precisely evaluate the prognosis of patients with DLBCL at the end of chemotherapy.
ABSTRACT
Objective To explore the feasibility of delineation of the atherosclerotic plaque in carotid artery using compressed sensing three dimensional motion-sensitized driven equilibrium prepared rapid gradient echo (CS-3D MERGE) technique. Methods Twenty-three patients who underwent carotid endarterectomy (CEA) were enrolled prospectively. In all patients, bilateral carotid arteries were scanned by CS-3D MERGE and contrast-enhanced MR angiography (MRA) simultaneously. Image quality of CS-3D MERGE images was scored. Images from the CS-3D MERGE sequence and contrast-enhanced MRA were used to measure the carotid stenosis, which were divided into four groups:normal group, mild stenosis group, moderate stenosis group, and severe stenosis group. The results were compared between the two methods. And images from the CS-3D MERGE sequence were compared with corresponding histology in identifying major plaque components including lipid rich necrotic core (LRNC), intraplaque hemorrhage (IPH), and calcification (CA). Spearman rank correlation coefficient was used to compare the correlation between the CS-3D MERGE sequence and contrast-enhanced MRA in measuring the carotid stenosis. Agreement was tested comparing images from the CS-3D MERGE sequence with corresponding histology in identifying major plaque components including lipid-rich necrotic core, intraplaque hemorrhage, and calcification. Results Twenty-three CEA patients finished bilateral CS-3D MERGE scanning successfully. Image quality was 3.16±0.25. There was an excellent correlation between CS-3D MERGE and MRA in measuring stenosis (r=0.95, P<0.01). The agreement between CS-3D MERGE and histological results for LRNC detection was 76.2% (16/21). It was less sensitive for IPH detection (71.4%, 15/21). CS-3D MERGE identified all CA accurately (100.0%, 21/21). Sensitivity and specificity were 86.6% (13/15) and 50.0% (3/6) for LRNC, 73.3% (11/15) and 66.6% (4/6) for IPH, 100.0% for CA respectively(16/16, 5/5). Conclusion CS-3D MERGE, a single sequence, can be used to quantify carotid stenosis and plaque components conveniently.
ABSTRACT
Objective Explore the change of IL-1β and IL-18 expression in pulmonary hypertension induced by monocrotaline.Methods Divide the mouses into two groups, control group and experimental group (n=10).Establish rats pulmonary hypertension model induced by monocrotaline.Detect the model by ultrasound, myocardial cells HE dyeing and tunnel test;ELISA was used to detect the serum biological markers NF-κB, COX2, IL-6, IL-1β, TNF-α and NO;Immunohistochemical was used to detect the expression level of IL-1β and IL-18 in the lung tissue;the protein change of NLRP3 in the lung tissue was detected by Western blot.Results Serum biological markers of NF-κB, COX2, IL-6, IL-1β, TNF-α and NO are significantly increased in PAH rats(P<0.05);The expression of IL-1β, IL-18 in the lung tissue increased obviously(P<0.05);The NLRP3 protein expression was significantly higher in experimental group.Conclusions Changes of NLRP3 effect increase expression of IL-1β and IL-18and which may play an important role in pulmonary hypertension induced by monocrotaline.
ABSTRACT
In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios. Ninety-five clinical scenarios were developed from eight selected pre-existing guidelines and classified into four sections as follows: 1) detection of coronary artery disease, symptomatic or asymptomatic; 2) cardiac evaluation in various clinical scenarios; 3) use of imaging modality according to prior testing; and 4) evaluation of cardiac structure and function. The clinical scenarios were scored by a separate rating committee on a scale of 1–9 to designate appropriate use, uncertain use, or inappropriate use according to a modified Delphi method. Overall, the AUC ratings for CT were higher than those of previous guidelines. These new AUC provide guidance for clinicians choosing among available testing modalities for various cardiac diseases and are also unique, given that most previous AUC for noninvasive imaging include only one imaging technique. As cardiac imaging is multimodal in nature, we believe that these AUC will be more useful for clinical decision making.
Subject(s)
Humans , Area Under Curve , Asian People , Clinical Decision-Making , Consensus , Coronary Artery Disease , Echocardiography , Electrocardiography , Heart Diseases , Magnetic Resonance Imaging , Methods , Positron-Emission Tomography , Radionuclide Imaging , Tomography, Emission-ComputedABSTRACT
Objective To evaluate the clinical value of 18F-FDG PET/CT in the detection of residual,recurrent and metastatic diseases in post-treatment uterine cervical cancer patients presenting with elevated serum squamous cell carcinoma (SCC) antigen levels.Methods Between March 2009 and October 2012,18F-FDG PET/CT was performed in 48 patients(average age (47.5±11.2) years) with suspected residual,recurrent or metastatic uterine cervical cancer because of increased serum SCC antigen level (＞1.5 tμg/L).The final diagnosis was established by pathology or more than 1 year of clinical follow-up.The diagnostic efficiency of 18F-FDG PET/CT was calculated.Two-sample t test was used for data analysis.Results The serum SCC levels were 1.6-42.5(mean:8.6±9.4) μg/L.Among the 48 patients,45 (93.75％) were confirmed of having malignant lesions.18F-FDG PET/CT along with other imaging detected 174 lesions,of which 169 were proven as residual,recurrent or metastatic diseases.18F-FDG PET/CT correctly identified 159 lesions,yielding a diagnostic sensitivity and accuracy of 94.08％(159/169) and 91.38％(159/174),respectively.The diagnostic sensitivity and accuracy for residual and recurrent diseases were both 9/10;for lymph node metastasis were 94.59％ (105/111) and 92.92％ (105/113),respectively;and for other sites of metastasis were 93.75％ (45/48) and 88.24％ (45/51),respectively.There was no significant difference of SUVmax between the patients with residual/recurrent disease (mean:6.9±3.8,range:2.0-13.7) and those with metastasis (mean:6.3±2.7,range:2.0-14.4,t=0.629,P＞0.05).Conclusion 18F-FDG PET/CT is valuable for the detection of residual,recurrent and metastatic diseases in the uterine cervical cancer patients pr esenting with elevated serum squamous cell carcinoma antigen after conventional treatment.
ABSTRACT
Objective To evaluate the in vitro effect on tumor cell uptake,tumor imaging and in vivo biodistribution of 99Tcm-epidermal growth factor receptor (EGFR) mRNA antisense PNA probe mediated by cationic liposome.Methods The oligonucleotide with sequence complementary to part of the EGFR mRNA antisense PNA was hybridized in an anti-parallel orientation targeted PNA.PNA hybridization complexes were labeled with 99Tcm by ligand exchange.The assembly of lipofectamine and 99Tcm-labeled heteroduplex was achieved by electrostatic interactions,and the radiolabeled purity was determined by reversedphase HPLC (RP-HPLC).The disparities of cell uptake in SKOV3 cells and the differences of biodistribution and molecular imaging in BALB/c nude mice bearing SKOV3 xenografts between lipofectanine-mediated 99Tcm-EGFR mRNA antisense PNA (group 1) and 99Tcm-EGFR mRNA antisense PNA (group 2) were analyzed.Two-sample t (or t') test and Wilcoxon rank sum test were used for statistical analysis.Results The labeling rates of both group 1 and group 2 were more than 95％ within 6 h.The cell uptake at 1,2,4,6,12,24 h after injection was (28.90±1.12)％,(32.76±1.20)％,(38.20±3.11)％,(41.23±1.60)％,(46.63±1.55)％ and (46.78±2.14)％ in group 1,and was (3.51±0.39)％,(3.90±0.40)％,(4.69±0.18)％,(5.91±0.26)％,(5.30±0.22)％ and (5.39±0.17)％ in group 2 respectively (t'=47.11-58.67,Z=2.80,all P＜0.05).The retention ratios showed significant difference between the two groups (t'=7.25-11.55,Z=2.80,all P＜0.05).The SKOV3 tumor could be visualized in both groups at 1 h post injection but much better visualized in group 1.The T/NT ratios were higher in group 1 at all time points (t =3.96,t'=12.65-14.69,Z=2.83-5.29,all P＜0.05).The T/NT ratios at uptake peak were 5.02 and 3.95,respectively.The probe accumulated mainly in tumor,kidneys and liver.Tumor uptake increased with time ((1.49±0.09) ％ID/g and (2.15±0.21) ％ID/g at 1 h,(3.90±0.65) ％ID/g and (5.00±0.10) ％ID/g at 6 h) after lipofectamine treatment.The ratios of tumor to contralateral muscle were also higher in group 1 (t =11.24,t' =3.96-11.94,all P＜0.05).Conclusions Lipofectamine-mediation can significantly improve the intracellular delivery of radionuclide molecular probe.Lipofectamine-mediated 99Tcm-EGFR mRNA antisense PNA can greatly improve imaging contrast and visualization of EGFR-over-expressing tumors.
ABSTRACT
Objective The study was to investigate the feasibility of using an intravascular Loopless Monopole Antenna (ILMA) for 3.0 T MR imaging of water bath and deep-seated arterial walls of experimental animal.Methods A novel intravascular loopless monopole antenna (ILMA) was developed,including a non-shield loach guide-wire and a matching circuit.The non-shield loach guide-wire is used as a receive antenna,with the diameter of 0.019 in( 1 in =2.54 cm) and length of 23.11 in.During the MR scanning,the ILMA was used as a receive-only probe,while body coil was used to transmit the RF pulses.Utilizing the coil in water bath and in-vivo animal experiment,we measured signal-to-noise ratio (SNR) and contrast-to-noise ratio(CNR) of artery wall using the same scanning parameter compared with phased-array coil.Results In the study,the developed novel ILMA conduced to improved SNR of imaging and much higher space resolution( 313 μm).First,the feasibility of acquiring the wall images was demonstrated on phantoms.The SNRs map generated by the matlab software showed that in comparison with the phased-array coil,ILMA generated higher SNR of the phantom wall when using the same sequences,parameters,and slices (86.8 ±0.8 vs.9.9 ±0.1,P ＜0.01 ).When imaging the aorta wall with the ILMA and phased-array coil,the SNRs of the arterial wall with the ILMA is 60.4 ±20.9,61.3 ±22.5,59.8 ±20.4,32.3 ±22.6 (T1WI),51.2 ±21.6,49.8 ± 15.5,50.4 ± 17.2,22.4 ± 18.3 (T2WI),the CNRs of the aorta wall with theILMA is 19.8±8.1,18.9±9.2,19.6±11.8,20.7 ± 13.3(T1WI),17.7±6.4,18.6±6.9,17.2 ± 6.4,17.2 ± 6.4 ( T2 WI),compared with phased-array coil,t values SNR:6.36,3.84,3.51,6.92(T1 WI),3.47,4.89,6.35,4.21 (T2WI),CNR:3.56,3.97,-0.71,4.74 (T1WI),3.99,3.01,4.27,5.03(T2 WI,P ＜ 0.05 ),respectively.Conclusion The study demonstrates the capability of using an MR ILMA to generate 3.0 T MR in-vivo experiments,the developed novel ILMA conduces to increased SNR compared with the conventional phased-array coil.
ABSTRACT
Objective To evaluate the feasibility of 320-row volume CT myocardial perfusion imaging (CT-MPI) in detecting myocardial perfusion defect.MethodsFourteen patients with positive single-positron emission computed tomography myocardial perfusion imaging (SPECT-MPI)findings underwent both rest and adenosine stress 320-row volume CT-MPI.Rest and stress CT perfusion images were analyzed by employing dedicated software in 320-row CT workstation.Both SPECT-MPI and CT-MPI were evaluated for fixed and reversible perfusion defects using a 16-segment model (apex was excluded).The sensitivity,specificity of 320-row volume CT-MPI in detecting myocardial perfusion defect were evaluated by taking SPECT-MPI as a reference standard.ResultsBoth rest and stress 320-row volume CT-MPI were successfully performed in all patients.Thirty nine segments with fixed or reversible perfusion defects in all patients were depicted by SPECT-MPI,while 34 perfusion defects in 12 patients were identified by CT-MPI.The sensitivity,specificity of 320-row volume CT-MPI for detection of perfusion defects were 87.2％(34/39),91.4％ ( 169/185 ),respectively.Conclusion320-row volume CT-MPI has high sensitivity and specificity for detection of myocardial perfusion defects.
ABSTRACT
ObjectiveTo evaluate the feasibility of CT coronary angiography (CTCA) in patients with arrhythmia using 320-detector row CT.MethodsThirty-one patients with persistent atrial fibrillation and 8 patients with premature ventricular contraction were enrolled in this study.All patients underwent 320-detector row CTCA.CT image quality was evaluated with 4-point grading scale by two radiologists.Interobserver agreement was evaluated by Kappa statistics.The radiation dose was calculated.ResultsIn total510 coronary segments,496 (97.2％) segments met diagnostic standard.The mean effective dose was (12.7 ± 4.8) mSv in this study.There was a good agreement in image quality scoring between the two reviewers (Kappa =0.72 ).Conclusion 320-detector row CTCA is feasible in patients with atrial fibrillation and premature ventricular contraction.Arrhythmia may not be considered as a contraindication to CTCA.
ABSTRACT
Objective To evaluate the combination of dual-energy CT angiography (DE-CTA) and dual-energy CT peffusion (DE-CTP) in the diagnosis of coronary artery disease. Methods Thirty-one patients with angina pectoris were examined using dual-source dual energy CT and conventional coronary angiography. For DE-CTA, we used a contrast-enhanced ECG-gated coronary scan protocol with energy levels of two tube detector arrays at 140 and 100 kVp. Two kinds of acquired images were fused for the CT angiogram and further calculated to construct a perfusion map (Siemens DE Heart PBV). The compared the following results: DE-CTA vs. CA, DE-CTP vs. CA to assess the sensitivity and specificity, and further compared DE-CTA plus DE-CTP with CA. Results DECT obtained diagnostic image quality in 28 patients.DE-CTA detected 41/112 arterial stenosis. Using CA as a reference, the sensitivity of DE-CTA was 81%(38/47), specificity was 95% (62/65), positive predictive value was 92% (38/41), negative predictive value was 87% (62/71), and accuracy was 89% (100/112). DE-CTP detected 46 perfusion defects in artery territories. Using CA as a reference, the sensitivity of DE-CTP was 76% ( 36/47), specificity was 85% (55/65), positive predictive value was 78% (36/46), negative predictive value was 83% (55/66),and accuracy was 81% (91/112). DE-CTA plus DE-CTP diagnosed 52 arteries stenosis. Using CA as a reference, combination of DE-CTA and DE-CTP gave sensitivity of 95% ( 45/47 ), specificity of 89%(58/65) , NPV of 97% (58/60), and accuracy of 92% (103/112). Conclusions DECT can provide perfusion blood volume information as well as vessel pathology in one scan. DECT can provide comprehensive diagnosis and improve diagnosis of CAD.
ABSTRACT
Objective To explore the feasibility of evaluating cardiac structure, coronary artery,pulmonary artery and cardiac function in one single scan by 320-row CT ECG-gated double phase cardiac function scan mode. MethodsForty patients underwent the 320-detector row CT double phase cardiovascular angiography. The pulmonary phase and aortic phase were reconstructed in order to evaluate the pulmonary and coronary artery. MPR reconstructions of both pulmonary and aortic phase were used to analyze the function of the two ventricles. And the results of the cardiac function were compared with those of transthoracic echocardiography. Thirty-five cases could be analyzed and diagnosed, while the other 5 cases had to be given up because of the poor imaging quality. The mean heart rate was (71.2 ± 11.2) beat per min (bpm). No arrhythmia case included. Results ( 1 ) Pulmonary embolism were diagnosed in 11 cases,coronary artery disease (CAD) were found in 5 cases, while post-stent implantation were observed in 7 cases. Six cases of congenital heart disease were diagnosed with 3 ASD and 3 primary pulmonary hypertension. Another one was diagnosed with left atrial myxoma, and 5 cases were pulmonary embolism associated with CAD. All of above cases were verified by final clinical diagnosis. (2) The heart function parameters including LVEDd , RVEDd, LVESd, RVESd and LVEF were (36.7 ±3.3), (43.3 ± 3.4) mm,(31.6±5.1), (41.3 ±5.1) mm and (47.1 ±15.1) for CT, while those were (40.3 ±3.1), (47.3 ±4.2) mm,(37.3 ±5.6), (45.3 ±3.3) mm,and (46.0 ± 14.8) for ultrasound, respectively. The CT results were correlated with the ultrasound ( n = 35, r = 0.886-0.988, P ＜ 0.01 ). (3) The average radiation exposure was ( 5.4 ± 0.5 ) mSv. Conclusions 320-row CT ECG-gated double phase cardiac function scan mode is feasible for the "one-stop-shop" examination of the cardiovascular disease. This noninvasive method is recommended for the diagnosis, differential diagnosis, treatment and prognosis of cardiovascular disease.
ABSTRACT
ObjectiveTo assess the performance of dual-source CT (DSCT) for left atrial volume and function evaluation and compare this performance to that of cardiac cine MR ( CMR ),which was considered as the standard reference technique.Methods Forty-nine patients referred for CT coronary angiography were enrolled in this study.DSCT data sets and FIESTA cines of the vertical long axis covering the left atrium and the short axis covering the left ventricle were obtained on the same day without additional medicine.All images were analyzed to obtain left atrial volume at different time and its function values.All the parameters were corrected by body surface area.Inter-modality agreement was tested through linear regression and Bland-Altman analyses.Repeated measurements were performed to determine inter-observer variation.ResultsThe indexed measurements of DSCT and CMR were (47.4 ± 11.1 ) and (46.2 ± 9.7 )ml/m2 for LAVmax,( 22.2 ± 6.9) and ( 21.3 ± 5.8 ) ml/m2 for LAVmin,( 34.8 ± 8.8 ) and ( 33.6 ± 7.8 )ml/m2 for LAVp,(24.0 ±5.7)and(21.5 ±5.0) ml/m2 for LARV,(11.6 ±3.9)and(10.9 ±3.9) ml/m2 for LAPV,(12.4 ±3.9)and(10.7 ±3.6) ml/m2 for LAAV,(22.6 ±8.4)and(21.0 ±6.4) ml/m2 for LACV,(52.8 ± 7.4) ％ and ( 54.5 ± 6.3 ) ％ for LAEF,respectively.The correlation coefficients between DSCT and CMR measurements for LAVmax,LAVmin,LAVp,LARV,LAPV,LAAV,LACV and LAEF were 0.89,0.90,0.90,0.80,0.82,0.80,0.76 and 0.78,respectively.However,DSCT slightly overestimated LAVmax,LAVmin,LAVp,LARV,LAPV,LAAV and LACV,and the deviation was 1.2,0.9,1.1,0.3,0.1,0.2 and 0.4 ml/m2,respectively.Compared with CMR,DSCT slightly underestimated LAEF of about 0.6％.Interobserver variation was lower in DSCT examination than CMR for the measurements of left atrial function.ConclusionDSCT provided accurateand reproducible measurements of left atrial volume and function.
ABSTRACT
ObjectiveTo explore the imaging of the thrombosis after pharmacological triggering of plaque rupture in atherosclerotic rabbit model by using 3.0 T high-resolution magnetic resonance imaging.MethodsTwenty male New Zealand white rabbits were divided into an experimental group (n = 16) and a control group (n = 4).The aortic wall injuries were induced by an intravascular balloon in experimental group rabbits after high cholesterol diet.The pharmacological triggering with Russell's viper venom and histamine was performed after 3 months of establishment of model.All of the animals underwent pre-trigger and post-trigger MR examinations including 3D time of fight (3D TOF),T1 WI,T2WI and post contrast T1 WI.Euthanasia was performed in all rabbits and gross anatomy and histological specimen of aorta were obtained.Comparing the location and length of the thrombus between MRI images and histopathology was used Pearson test.Comparing the calculated indexes of abdominal aorta between rabbits with and without thrombosis was used AVONA test and LSD-t test.Results After triggering,8 in 14 survived rabbits developed thrombosis in experimental group,meanwhile,no thrombus was found in control group.The accuracy of multi-sequences MRI for detecting of thrombus was 87.1％ (27/31).MRI data correlated with the histopathology regarding thrombus length ( r = 0.85,P ＜ 0.01 ) and thrombus location ( r = 0.94,P＜0.01 ).Compared with rabbits without thrombosis,the rabbits with thrombosis had narrower lumen of abdominal aorta in the pre-triggered MR images [ ( 5.71 ± 2.38 )mm2 vs.( 8.93 ± 5.36) mm2,P ＜ 0.01 ].ConclusionMRI is useful tool to determine the thrombosis and plaque rupture in atherosclerotic rabbit model.
ABSTRACT
Objective To evaluate the diagnostic accuracy of coronary artery stenosis caused by calcified coronary artery plaques with 64-detector row CT under different conditions. Methods Totally 165 patients with coronary artery calcification accompanied by one or more branches stenosis more than 50% detected with computed tomography coronary angiography (CTCA) were collected. The Agatston calcium score (ACS) and stenosis rate were calculated based on per-patient, per-vessel, per-segment, various stenosis degree and different morphology of calcification as the analysis object, respectively. The measurement results of coronary angiography (CAG) were taken as the gold standard. The diagnostic accuracy was evaluated with receiver operating characteristic (ROC) curves which were created to assess the diagnostic value and to determine the diagnostic cutoff level (threshold). Results When per-patient analyzed, the greatest diagnostic accuracy rate was obtained with ACS threshold of 113.5, and the area under curve (AUC) value of ROC was 0.791. With the analysis object of per-vessel, the greatest diagnostic accuracy rate was found in right coronary artery and its sub-branches, and the AUC value was 0.897. Per-segment analyzed, the highest accuracy rate was obtained in RCA1 segment, and the AUC value was 0.894. When the analysis object was the morphology of calcification, the range of AUC value was merely 0.601-0.667, while the diagnostic value was rather low. The highest accuracy of CTCA was obtained in stenosis less than 50%, and the AUC value was 0.856. Conclusion Coronary artery calcification has different influence on the diagnostic accuracy rate of coronary artery stenosis with CTCA in various situations. Moreover, the morphology of the calcification may not be the main impact factors of the diagnostic accuracy.
ABSTRACT
Objective To evaluate the morphological characteristics of large and small infrarenal abdominal aortic aneurysm (AAA) with 64-slice spiral CT angiography (CTA). Methods Forty-five patients with infrarenal true AAA underwent CTA. The morphological characteristics of AAA were evaluated. The patients were divided into two groups: small AAA (diameter<5 cm, n=20) and large AAA (diameter≥5.0 cm, n=25). The clinical risk factors and morphological characteristics between small and large AAA were compared. The correlation between the size of AAA and the other morphological characteristics was analyzed. Results Compared to patients with small AAA, those with large AAA showed lower systolic blood pressure and larger prevalence of smoking (P＜0.05). The length of aneurysms body, diameter of proximal and distal neck, the prevalence of thrombus in posterior wall, and aneurysm wall calcification score in large AAA were significantly larger than those of small AAA (P＜0.05). The length of AAA was positively correlated with proximal neck angle (r=0.418, P＜0.01) and diameter (r=0.411, P＜0.01), whereas negatively correlated with entry angle (r=-0.478, P＜0.01)and proximal neck length (r=-0.562, P＜0.01). Conclusion The size of infrarenal AAA is associated with the other morphological characteristics.
ABSTRACT
Objective To establish the method and cardiovascular imaging in mice using ultrasound biomicroscopy(UBM) with anatomical confirmation by magnetic resonance (MR) imaging, and to evaluate the feasibility and value of UBM in mice cardiovascular imaging.Methods The mouse thoracic anatomy was elucidated using Signo 3.0T MR imaging on 2 healthy C57BL/6 adult male mice.The structures and flow of mice heart and great vessels in 16 healthy C57BL/6 adult male mice were showed and analyzed by Visualsonics Vevo 770 UBM through several acoustic windows, including left parasternal, right parasternal, apical regions, and suprasternalis.The systolic and diastolic function of mice heart were also evaluated.ResultsAnatomic characteristic of mice could be displayed by MR imaging.The heart was mostly located in left thoracic cavity.The angle between long axis of the heart and the midline of the chest was about 45 degrees.Left atrium,left ventricle, mitral valve and right ventricle were located on the left side of the midline of the chest.Aortic valve orifice, ascending aorta,right atrium and tricuspid valve were located on the right side of the midline of the chest.Left heart long axis view,left ventricular short axis view,ascending aorta long axis view,long axis view of aortic arch, aortic short axis view, right ventricular inflow tract long axis view, pulmonary artery long axis view and so on were obtained clearly using UBM.The structures of heart and great vessels were displayed and the cardiovascular parameters could be measured accurately,including left atrium,left ventricle,aorta and aortic arch,interventricular septum,right atrium, right ventricle, pulmonary artery, innominate artery, right internal carotid artery and the velocity in each valve orifices from Doppler flow spectrum.No significant difference was found in the measurements between different age groups.Conclusions The cardiovascular structures and hemodynamics could be displayed by UBM in mice when appropriate acoustic windows and sections were selected.This novel imaging protocol provides us a non-invasive way to follow atherosclerosis in genes knockout mice.
ABSTRACT
Objective To investigate the application of low-dose adaptive sequence scan of dual-source CT coronary angiography in patients with high heart rate and evaluate the image quality.Methods Seventy-two patients who underwent coronary CT angiography with heart rate> 70 bpm were divided into 2 groups.Group A was adaptive sequence scan, and Group B was retrospective ECG-gating helical scan.Examinations were performed on a dual-source CT scanner (Somatom Definition) .All images were transferred to a workstation for further processing and analysis.The image quality was evaluated using same criteria.The image quality of coronary artery segments was compared in two groups using rank sum test, and the radiation dose was compared using t test Results A total of 501 coronary artery segments were evaluated in group A and 400 segments in group B.The mean ranks in image quality of coronary artery segments in group A was 475.42, whereas 420.41 in group B.There was a statistical difference in image quality between the two groups (Z= - 3.509,P=0.000).The effective dose was on average (6.2±0.9) mSv in group A, whereas on average (14.7±1.9) mSv in group B, there was a statistical difference between the two groups(t= - 27.011, P=0.000).Conclusions Adaptive sequence scan in dual-source CT coronary angiography is feasible in patients with high heart rates.This scan mode can substantially reduce radiation dose and maintain the diagnostic image quality.
ABSTRACT
Objective To prospectively evaluate the influence of average heart rate,heart rate variability and ECG editing on image quality of 64-slice CT coronary angiography(CTCA)in patients with atrial fibrillation(AF).Methods Fifty patients who were diagnosed with AF underwent respective ECG-gating 64-slice CTCA Image quality(good,moderate,poor)were evaluated on vessel segment level pre-and post ECG editing.Chi-square test was performed to compare the image quality in patients with various average heart rate,heart rate variability,and pre-and post ECC editing.Pearson correlation analysis was performed to test the relationship between the image quality and average heart rate and heart rate variability.Sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)were calculated by using the conventional angiography as the standard reference.Results The average heart rate of the fifty AF patients was(89±23)beat/min,with variability of(18.2±6.1)beat/min.Finally,24(3.4%)segments were considered to have poor image quality in 6(12.0%)patients.Image quality decreased significantly(P＜0.05)at the average heart rate of over 100 beats per minute(11 segments)or the standard deviation of heart rate of over 24 beats per minute(11 segments).There was significant correlation between the mean heart rate and the image quality for all segments,the RCA,and distal section of coronary artery(r=0.50,0.55,0.53,0.49,0.42,0.44;P＜0.05).Heart rate variability was also significant correlated with the image quality.There was significant difference on image quality pre-and post ECG editing(P=0.013).The respective overall sensitivity,specificity,NPV,PPV values were 100%(6/6),93.2%(41/44),100%(41/41),and 66.7%(6/9).Conclusion ECG editing can improve the success rate and the image quality of 64-slice CTCA effectively in patients with AF within a certain range of average heart rates and heart rate variability.