ADDED UTILITY OF COMPUTED TOMOGRAPHY PERFUSION STUDY IN THE ASSESSMENT OF EARLY ISCHEMIC STROKE IN COMPARISON WITH NON- CONTRAST COMPUTED TOMOGRAPHY - A PROSPECTIVE OBSERVATIONAL STUDY

Objective: 1. T o study the added utility of computed tomography perfusion study in the assessment of early ischemic stroke in comparison with non-contrast computed tomography. 2. To study the role of computed tomography perfusion study in deciding thrombolytic treatment/ therapeutic protocols aimed at reversing the cerebral ischemic insult. Conclusions and Results: It was observed that 15 (46.68%) patients were in the 61-70 years of age group followed by 8 (25%) in the age group of 51-60 years. The mean age of the patients was 58.87 ±12.14 years. Ÿ Females were affected more i.e. 18 (56.25%) compared to the male patients 14 (43.75%). Ÿ Most observed co-morbid condition was hypertension in 9 (28.13%) patients followed by hypertension and diabetes in 7 (21.87%) patients and diabetes in 6 (18.75%) patients. Ÿ Among the study participants 4 (12.50%) were smokers followed by 6 (18.75%) were alcoholic and smokers & alcoholic (15.62%) respectively. Ÿ It was observed that the symptoms of palsy were present among 23 (71.88%) patients Ÿ The most commonly observed time of onset of symptoms was 3-5 hours in 23 (71.88%) patients followed by 1-3 hours (21.87%) and >5 hours in 2 (6.25%) patients. Ÿ NCCT ?ndings observed was de?nite signs of stroke in 12 (37.5%) patients followed by suspected signs of stroke on NCCT (25%) Ÿ It was observed that no sign of stroke was observed in 12 (37.5%) patients. Ÿ CT perfusion ?ndings observed was increased mean transient time (MTT) in all (100%) patients followed by decreased blood ?ow in all (100%) patients. It was observed that cerebral blood volume decreased in 12 (37.5%) patients, increased in 8 (25%) and normal in 12 (37.5%) patients. Ÿ The correlation of NCCT and CT perfusion ?ndings observed that out of total 32 patients NCCT study identi?es 20 patients while all 32 patients were identi?ed by CT perfusion study with sensitivity of 100%. Ÿ CT perfusion provides early diagnosis of ischemic stroke thus helps in management of stroke patients. Inference : The present study concludes that CT-perfusion had more sensitivity compared to NCCT in identifying early ischemic stroke. CT perfusion has additional utility in management of early ischemic stroke. CT Perfusion study provides important information to the neurologist and neuro-interventionalist when evaluating patients for endovascular reperfusion therapy by identifying the size of core infarction and penumbra

Diagnostic value of multi-slice spiral CT perfusion imaging combined with serum CYFRA21-1, CEA and NSE for peripheral non-small cell lung cancer / 解放军医学杂志

Objective To investigate the diagnostic value of multi-slice spiral CT (MSCT) perfusion imaging combined with serum cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA) and neuron specific enolase (NSE) for peripheral non-small cell lung cancer (NSCLC). Methods Based on diagnosis, 109 patients with suspected peripheral NSCLC admitted from Aug. 2017 to Aug. 2019 in the Xinxiang Central Hospital were divided into peripheral NSCLC group (n=65) and benign pulmonary nodule group (n=44). Another 56 healthy subjects undergone physical examination during the same period were selected as control group. The parameters of MSCT perfusion imaging and serum levels of CYFRA21-1, CEA and NSE in the 3 groups were compared. The receiver operating curve (ROC) was used to analyze the diagnostic value of MSCT perfusion imaging combined with serous levels of CYFRA21-1, CEA and NSE for peripheral NSCLC. Results The blood volume (BV) was larger in peripheral NSCLC group than those in benign pulmonary nodule group and control group [(10.76±1.26) ml/100 mg vs. (4.01±0.59) ml/100 mg and (2.32±0.42) ml/100 mg]; the same was for surface permeability (PS) [(42.56±5.60) ml/ (100 mg·min) vs. (16.13±1.88) ml/(100 mg·min) and (8.49±0.91) ml/(100 mg·min)]; and for the mean transit time (MTT) of contrast medium [(20.14±3.67) s vs. (12.85±1.49) s and (7.21±0.95) s]. All the BV, PS and contrast medium MTT were higher (larger) in benign pulmonary nodule group than those in control group (P<0.05). The serum level of CYFRA21-1 was higher in peripheral NSCLC group than that in benign pulmonary nodule group and control group [(8.94±1.67) ng/ml vs. (4.73±0.51) ng/ ml and (1.93±0.26) ng/ml]; the same was for the CEA level [(27.91±3.25) ng/ml vs. (7.88±0.92) ng/ml and (2.06±0.47) ng/ml]; and for the NSE level [(19.53±2.16) ng/ml vs. (15.02±1.74) ng/ml and (11.96±1.22) ng/ml]. All the serum levels of CYFRA21-1, CEA and NSE were higher in benign pulmonary nodule group than those in control group (P<0.05). The ROC results showed that the diagnosis of peripheral NSCLC alone and combined with MSCT perfusion imaging, serum levels of CYFRA21-1, CEA and NSE were 0.802, 0.794, 0.698, 0.712 and 0.841, respectively. The diagnostic value of combined detection of the four methods was higher than that of individual detection. Conclusion MSCT perfusion imaging combined with serum levels of CYFRA21-1, CEA and NSE have high diagnostic value for peripheral NSCLC.

Correlation of memory impairment and cerebral perfusion in patients with vertebral-basilar artery stenosis / 中华行为医学与脑科学杂志

Objective To evaluate the correlation between cerebral blood flow perfusion and memory impairment in patients with severe stenosis of vertebral basilar artery (VBA).Methods 62 cases of patients with VBA stenosis diagnosed by digital subtraction angiography(DSA) in Beijing Tiantan Hospital from September 2016 to March 2017 were enrolled.Mental State Examination (MMSE),Clinical Memory Scale (CMS) test and CT perfusion(CTP) was performed.All patients were divided into memory normal group(n=24,including 1 excellent case,6 above normal cases,and 14 normal cases) and memory impairment group(n =38,including 18 below normal cases,12 periphery cases,8 impaired cases) according to CMS.The ratios of side-to-side period were compared between bilateral mesial temporal lobe and anterior circulation area.The relative time to peak (rTTP),relative mean transit time(rMTY),relative cerebral blood flow(rCBF) and relative cerebral blood volume (rCBV) were calculate.Results The incidence of CTP decompensation in the medial temporal lobe was higher than that in the patients with memory impairment(P＜0.05).The difference of rTTP and rMTT value between the two groups in the bilateral medial temporal lobes was statistically significant (rTFP:(1.131 ±0.037),(1.437±0.139),t=10.520,P＜ 0.05);rMTT:(1.081 ±0.059),(1.281 ±0.174),t=5.423,P＜0.05).Conclusion The patients with VBA severe stenosis are more likely to get memory impairment due to cerebral hypoperfusion.

Correlation between 320 row volume CT perfusion parameters of primary liver cancer and liver tumor volume and liver function Child-Pugh classification / 新乡医学院学报

Objective To explore the relationship between the values of total tumor perfusion parameters in primary hepatocellular carcinoma and tumor volume and peritumoral perfusion parameters,and analyze its correlation with liver ChildPugh classification.Methods Forty-seven patients with primary liver cancer in the First Affiliated Hospital of Zhengzhou University from January 2013 to January 2015 were selected to perform 320 row volume CT perfusion imaging.The parameters of hepatic artery perfusion(HAP),portal vein perfusion(PVP) and hepatic perfusion index(HAPI) in tumor and peritumoral liver tissues were calculated based on total tumor measurement.The relationship between tumor perfusion parameters and ChildPugh classification of liver function,tumor volume and total tumor perfusion parameters,total tumor perfusion parameters and peritumoral perfusion parameters were analyzed.Results There was no correlation between tumor volume and total tumor perfusion parameters,peritumoral perfusion parameters (P ＞ 0.05),and there was no correlation between total tumor perfusion parameters and peritumoral perfusion parameters(P ＞0.05).There were significant differences between HAP,PVP and HAP of total tumor perfusion in different liver Child-Pugh classifications(P ＜ 0.05).With the increase of Child-Pugh classification of liver function,the HAP and HAPI of tumor gradually increased while PVP gradually decreased (P ＜ 0.05).Conclusions There is no correlation between tumor volume,total tumor perfusion parameters and peritumoral perfusion parameters.There is also no correlation between total tumor perfusion parameters and peritumoral perfusion parameters.There are significant differences in perfusion parameters between different Child-Pugh classifications of liver function,and the perfusion parameters obtained by the total tumor measurement can be used as the imaging indexes to reflect liver reserve function.

Effects of cranioplasty on neurological function:a CT perfusion study / 实用医学杂志

Objective To explore the effects of cranioplasty onneurological functionin patients based on the cerebral CT perfusion technique. Methods Twenty cases of patients receiving cranioplasty were rerecorded during the study period,and they wererespectively scanned by CT perfusion within 72 hours before and 2 weeks after the cranioplasty. Meanwhile,the neurological function was evaluated by neurological function scale. Results The difference of cerebral blood flow before and after cranioplasty was statistically significant(P<0.05), whereas the difference of cerebral blood volume,transit time to the peak and mean transit time was not statistically significant(P>0.05).Correlation analysis showed that the preoperativedifference ratio of thecerebral blood infusio-nis not correlated with the neurological function score(P > 0.05). The changes of preoperative and postoperative difference rateof the cerebral blood infusionwas correlated with the functional independence measure(P < 0.05), whereas not with mini-mental state examination(P > 0.05). Conclusions The neurological function of the patients after cranioplasty may be improved.This improvement may benefit from the improvement of cerebral blood flow after cranioplasty.

Application of a deep machine learning technique for low dose renal CT perfusion / 中华放射医学与防护杂志

Objective To assess the ability of a deep machine learning technique for improving the quality of one-stop renal low dose CTP images.Methods Twenty-one cases who underwent renal noncontrast CT,triple-phase contrast enhanced CT,and CT perfusion (CTP) were collected prospectively.Revolution CT scanner was used with the scan protocol as followed:120 kVp,20 mA for CTP and 100 mA for triple-phase conctrast enhancement,axial scan,ASIR-V80％,rotation 0.5 s,coverage area for z-axial 160 mm,thickness 5 mm.A total of 15 phases were obtained for the first 28 s and then scanned once at 39,43,47,51,63,83,113,213,353,593 s for CTP,which the phases at the 22,51 and 153 s were the cortical phase,medullary phase and excretory phase,respectively.All CTP data was reconstructed with a deep machine learning technique pixel shine A7 model.The data before and after reconstruction was in group A and in group B,respectively.Compared the all data of cortex in the cortical phase and CTP parameters between the two groups.Results There were significant differences of CT values of SD of cortex (9.04 ± 1.77 and 5.75 ± 1.00,respectively),CT values of SD of elector spinae (8.52 ±2.28 and 5.67 ±0.98,respectively),CNR(16.28 ±6.61 and 28.90 ±1.50,respectively) and SNR (21.41 ± 6.67 and 30.65 ± 7.67,respectively) between the two groups (t=1.562,6.286,5.925,-5.892,-17.274,P＜0.05).The SD of images after PS-B was lower than that before PS-B significantly and SNR was improved obviously.There were no differences of cortical blood flow (BF),blood volume (BV),time to peak (TP) and medullary permeability of surface (PS) between the two groups (P ＞ 0.05).Conclusions The reconstruction of deep machine learning PixelShine technique PS-A7 can reduce the noise of images obtained with low tube current,improve the SNR and can not effect the CTP parameters.

Fluid-attenuated inversion recovery vascular hyperintensity: Correlation with other radiologic findings in acute ischemic stroke with middle cerebral artery occlusion

Objective: To assess fluid-attenuated inversion recovery (FLAIR) vascular hyper-intensity (FVH) and explore its relationship with CT perfusion (CTP) penumbral/infarct core mismatch ratio and diffusion weighted imaging (DWI) final infarct volume in acute ischemic stroke (AIS) patients with middle cerebral artery occlusion (MCAO). Methods: The CTP and MRI images of 38 AIS patients with MCAO were reviewed. The FVH score (longitudinal direction) [FVH score (L)] and FVH score (transverse direction) [FVH score (T)] were quantified on the FLAIR images. The FVH score (L) (range, 0-16) was based on a rostrocaudal extension of FVH and the FVH score (T) (range, 0-3) was based on FVH supply of the occluded MCA territory. The mismatch ratio was calculated from the ratio of the [mean transit time - cerebral blood volume (CBV)] lesion/CBV lesion on the CTP images. The DWI infarct volume was measured on the DWI images. Results: The mismatch ratio was larger for the group of FVH score (L)=7~8 than those of FVH score (L)=5~6 and FVH score (L)=3~4 (p=0.03), whereas the DWI infarct volume was smaller (p=0.04). Similarly, the mismatch ratio of FVH score (T)=2~3 group was larger than FVH score (T)=1 group (p=0.01), whereas the DWI infarct volume was smaller (p=0.02). Both FVH score (L) and FVH score (T) correlated positively with mismatch ratio (P=0.02, P=0.001, respectively), but negatively with DWI infarct volume (P=0.03, P=0.004, respectively). Conclusions: Higher FVH score is associated with larger mismatch ratio and smaller DWI infarct volume in AIS patients with MCAO. FLAIR vascular hyperintensity may represent collateral arterial circulation, and may play a role in protecting the ischemic penumbra.

Diagnostic Performance of Coronary CT Angiography, Stress Dual-Energy CT Perfusion, and Stress Perfusion Single-Photon Emission Computed Tomography for Coronary Artery Disease: Comparison with Combined Invasive Coronary Angiography and Stress Perfusion Ca

OBJECTIVE: To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. MATERIALS AND METHODS: We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. RESULTS: For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. CONCLUSION: The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.

Geographic and demographic variabilities of quantitative parameters in stress myocardial computed tomography perfusion

BACKGROUND/AIMS: To evaluate the geographic and demographic variabilities of the quantitative parameters of computed tomography perfusion (CTP) of the left ventricular (LV) myocardium in patients with normal coronary artery on computed tomography angiography (CTA). METHODS: From a multicenter CTP registry of stress and static computed tomography, we retrospectively recruited 113 patients (mean age, 60 years; 57 men) without perfusion defect on visual assessment and minimal (< 20% of diameter stenosis) or no coronary artery disease on CTA. Using semiautomatic analysis software, quantitative parameters of the LV myocardium, including the myocardial attenuation in stress and rest phases, transmural perfusion ratio (TPR), and myocardial perfusion reserve index (MPRI), were evaluated in 16 myocardial segments. RESULTS: In the lateral wall of the LV myocardium, all quantitative parameters except for MPRI were significantly higher compared with those in the other walls. The MPRI showed consistent values in all myocardial walls (anterior to lateral wall: range, 25% to 27%; p = 0.401). At the basal level of the myocardium, all quantitative parameters were significantly lower than those at the mid- and apical levels. Compared with men, women had significantly higher values of myocardial attenuation and TPR. Age, body mass index, and Framingham risk score were significantly associated with the difference in myocardial attenuation. CONCLUSIONS: Geographic and demographic variabilities of quantitative parameters in stress myocardial CTP exist in healthy subjects without significant coronary artery disease. This information may be helpful when assessing myocardial perfusion defects in CTP.

Application of quantitative arterial enhancement fraction of multiphase perfusion CT imaging in evaluating the curative effect of transcatheter arterial chemoembolization for hepatocellular carcinoma / 介入放射学杂志

Objective To discuss the application of routine CT three-phase perfusion parameter,that is arterial enhancement fraction (AEF) value,in evaluating the curative effect of transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods The clinical data of a total of 30 patients with pathologically proved HCC were enrolled in this study.Routine CT three-phase perfusion scan was performed 1-3 days before as well as 30-40 days after TACE in all patients.AEF value was calculated by using CT Kinetics software (GE Healthcare).The formula for calculating AEF value was as follows:AEF value=(arterial phase CT value-plain scan CT value)÷(portal phase CT value-plain scan CT value).The results were statistically analyzed.Results Effective treatment group had 17 patients,and ineffective treatment group had 13 patients.The postoperative AEF values in the effective treatment group and the ineffective treatment group were (0.351±0.090) and (0.438±0.050) respectively,the difference between the two groups was statistically significant (P＜0.05).Taking postoperative AEF value of 0.392 as the critical value to predict the postoperative effect of TACE,the sensitivity and specificity were 86.7％ and 73.2％ respectively,and the area under the curve was 0.876 (P＜0.001).Conclusion The routine CT three-phase perfusion parameter (AEF) can quantitatively reflect the hemodynamic changes of HCC after TACE,which is helpful for making early evaluation of TACE effect,meanwhile,no additional radiation dose will be added.

Application value of CT perfusion imaging combined with CT angiography for pathogenesis determination and diagnosis of transient ischemic attack / 医疗卫生装备

Objective To investigate the application value of CT perfusion imaging (CTPI) combined with CT angiography (CTA) for determination and diagnosis of transient ischemic attack (TIA).Methods Totally 50 TIA patients from April 2014 to April 2016 in the neurology department of some hospital underwent examinations by CT scan,CTPI and CTA in time,and the values of cerebral blood volume (CBV),cerebral blood flow (CBF),mean transit time (MTT) and time to peak (TTP) were calculated at the uninjured and injured sides of the areas of interest.The relationship between cerebral blood perfusion and cerebral angiostenosis of the TIA patient was analyzed.Results The 50 patients had the values of CBF and CBV at the injured sides lower while the ones of MTI and TTP higher than those at the uninjured sides (P＜0.05).The numbers of the abnormal cerebral blood perfusion patients found by CT scan,CTPI and CTA were 28 (56.00％),45 (90.00％) and 38 (76.00％) respectively,who were confirmed clinically simultaneously.There were significant differences between the TIA positive result rates by CT scan,CTPI and CTA (P＜0.05).Conclusion Carotid artery hypoperfusion is one of the pathogeneses of TIA,and positive rate by CTPI is closely related to the conditions of TIA.CTPI combined with CTA contributes to the diagnosis of TIA,and can be used for its individualized treatment.

Application of CTP in STA-MAC Treat Moyamoya Disease / 医学研究杂志

Objective To investigate the application of Computed tomography perfusion imaging (CTP) in superficial temporal artery-middle cerebral artery bypass(STA-MAC) treated moyamoya disease (MMD).Methods The clinical data of 21 patients with MMD who received STA-MAC surgery were collected.CTP was performed before and after the surgery for all the patients included.We routinely delimited the corresponding position as regions of interest (ROI) and obtained value of the cerebral blood flow(CBF),cerebral blood volume(CBV),the mean transittime(MTT),time to peak(TTP).The deviations of rCBF,rCBV,rMTT,rTTP between the affected side and corresponding area were analysed and the paired t test was performed.Results Unobstructed blood flow was observed in all patients received STA-MAC surgery after DSA examination.Increased CBF was observed in 100％ patients and increased CBV in 80.95％ patients,shortened MMT in 80.95 ％ patients,shortened TTP in 85.71％ patients.Difference of CBF,CBV,MTT,r-CBF,rMTT between pre-and post-Operation had statistical significance (P ＜ 0.05).Conclusion CTP is important in elucidating the hemodynamic changes before and after STA-MCA bypass,which indicts a crucial role in evaluating therapeutic effect of surgical treatment for MMD.

Association of CT perfusion imaging with plasma levels of TGF-β1 and VEGF in patients with NSCLC

OBJECTIVE@#To study the association of CT perfusion imaging parameters with plasma level of transforming growth factor-β1 (TGF-β1) and vascular endothelial growth (VEGF) in patients with non small cell lung cancer (NSCLC).@*METHODS@#A total of 67 patients with NSCLC (NSCLC group) and 64 patients with benign lesion (control group) were given with CT perfusion imaging to obtain blood flow, blood volume, mean transit time, time to peal and permeability surface through CT perfusion software. The plasma levels of TGF-β1 and VEGF were tested by ELISA. The relationship between plasma levels of TGF-β1, VEGF and CT perfusion imaging parameters were analyzed.@*RESULTS@#CT perfusion imaging parameters and the plasma levels of TGF-β1 and VEGF of NSCLC group were significantly higher than the control group (P < 0.05), while CT perfusion parameters and the levels of TGF-β1 and VEGF in NSCLC group showed significant difference in different tumor node metastasis stages (P < 0.05). Correlation analysis showed that the level of plasma TGF-β1 and VEGF were positively correlated with blood flow, blood volume, and mean transit time (P < 0.05), and negatively correlated with time to peal (P < 0.05). There was no significant correlation between TGF-β1 and VEGF with the permeability surface.@*CONCLUSIONS@#CT perfusion imaging parameters in patients with NSCLC is closely associated with plasma TGF-β1, VEGF and its biological characteristics. CT perfusion imaging is a convenient method to detect tumor blood perfusion.

Influence of 256-slice Spiral CT Perfusion Imaging on the Cerebral Blood Flow before and after Cranioplasty / 昆明医科大学学报

Objective To evaluate changes in cerebral blood flow before and after cranioplasty by 256-slice Spiral CT perfusion imaging,and evaluate the effect of cranioplasty on the cerebral blood flow in patients with skull defect.Methods 256-slice spiral CT scan was performed in 20 cases with early cranioplasty surgery,CTP check time points were 1 to 2 days before and 10 to 14 days after cranioplasty surgery.We recorded the the CBF and CBV of the cortex,basal ganglia,and thalamus and other parts,MTT on rCBV,parameter values rCBF,MTT and 1TrP etc.and analyzed and compared.(RCBF,rCBV,MTT and TTP) Results The CBF of cortex after cranioplasty at injured side had statistically significant increase (P＜0.05).The CBF of cortex,basic nuclei,thalamus on contrateral had no statistically significant difference.The cerebral blood flow on both sides of the basal ganglia and the thalamus was increased after surgery,but there was no significant difference between before and after surgery (P＞0.05) Conclusion Cranioplasty can significantly improve the ipsilateral cortex cerebral blood flow,and CT brain perfusion can accurately assess changes in brain tissue blood flow before and after cranioplasty.

Applied Research of CT Perfusion Imaging on the Diagnosis of Splenic Diseases / 昆明医科大学学报

Objective To discuss the applied research of CT perfusion imaging on the diagnosis of splenic diseases. Methods 20 patients with splenic diseases which accepted treatment in our hospital from January 2012 to December 2014 were assigned into group A,including 7 cases of splenic lymphoma patients(group A1),8 cases of leukemia patients with spleen infiltration(group A2)and 5 cases of splenic metastasis(group A3). At the same time,20 healthy persons were selected as the control(group B). Results The result of CT scan was normal in group B,but that showed a variety of lesions in the spleen in group A. The spleen perfusion volume in the group A was significantly higher than that in the control group(P<0.05). The detection rate of CT perfusion imaging was significantly higher than that of CT scan(P<0.05). TIP and MTT in group A were significantly higher than those in group B,while BF,PEI and BV were significantly lower(P<0.05). Conclusion CT perfusion imaging has advantage of simple,short imaging time,less trauma,and a high diagnostic value for the spleen disease,which is an ideal detection means and can be used in clinic.

Assessment value of multimodal CT for cerebral collateral circulation in ischemic stroke / 中国脑血管病杂志

Objective To investigate the assessment value of multimodal CT examination for collateral circulation after cerebral ischemia. Methods Within 3 days of admission,39 patients with ischemic stroke received multimodal CT examinations,including CT scan,CT perfusion (CTP)imaging,and CT angiography (CTA). The postprocessing software of the German SIEMENS 64-slice spiral CT system was used to evaluate the state of brain tissue perfusion and the conditions of head blood vessels of the subjects. The cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP) and the score of the modified Rankin scale (mRS)in the 90 d after discharge were compared between the patients with good collateral circulation and poor collateral circulation. Results Among 39 patients, multimodal CT examination revealed that 2 patients were negative,one of them was followed up by head MR and was clinically proven as transient ischemic attack,and the other was lacunar infarction. Thirty-seven patients were positive. Multimodal CT examination found 24 patients had offending vessels occlusion and/or stenosis on the lesion sides,the collateral circulation formation in 11 of them was observed on the lesion sides;another 13 patients had poor collateral circulation on the lesion sides. The comparison of lesion sides and contralateral sides,the patients with good collateral circulation showed the CBF decreased (t= -5. 92),the MTT and TTP prolonged (t=4. 27 and 3. 17 respectively). There were significant differences (all P<0. 01). The CBV and CBF in patients with poor collateral circulation were decreased significantly (t= -14.27 and-14.82 respectively),MTT and TTP prolonged (t=7. 26 and 7. 54 respectively). There were significant differences (all P <0. 01). There were significant differences in CBF,CBV,and TTP on the lesion sides between the two groups of patients (t=3. 24,4. 11,and -2. 34,respectively;all P<0. 05). The 90 d mRS scores for patients with good collateral circulation and poor collateral circulation were 1. 3 ± 0.6 and 4. 0 ± 0. 9 respectively. There was significant difference (t = -8. 29,P <0. 01). The patients of having collateral circulation formation had good prognosis. Conclusion Multimodal CT examination has certain clinical significance for evaluation of cerebral perfusion state,understanding the establishment or patency of cerebral collateral circulation,and determining the clinical prognosis.

Association of CT perfusion imaging with plasma levels of TGF-β1 and VEGF in patients with NSCLC

Objective: To study the association of CT perfusion imaging parameters with plasma level of transforming growth factor-β1 (TGF-β1) and vascular endothelial growth (VEGF) in patients with non small cell lung cancer (NSCLC). Methods: A total of 67 patients with NSCLC (NSCLC group) and 64 patients with benign lesion (control group) were given with CT perfusion imaging to obtain blood flow, blood volume, mean transit time, time to peal and permeability surface through CT perfusion software. The plasma levels of TGF-β1 and VEGF were tested by ELISA. The relationship between plasma levels of TGF-β1, VEGF and CT perfusion imaging parameters were analyzed. Results: CT perfusion imaging parameters and the plasma levels of TGF-β1 and VEGF of NSCLC group were significantly higher than the control group (P < 0.05), while CT perfusion parameters and the levels of TGF-β1 and VEGF in NSCLC group showed significant difference in different tumor node metastasis stages (P < 0.05). Correlation analysis showed that the level of plasma TGF-β1 and VEGF were positively correlated with blood flow, blood volume, and mean transit time (P < 0.05), and negatively correlated with time to peal (P < 0.05). There was no significant correlation between TGF-β1 and VEGF with the permeability surface. Conclusions: CT perfusion imaging parameters in patients with NSCLC is closely associated with plasma TGF-β1, VEGF and its biological characteristics. CT perfusion imaging is a convenient method to detect tumor blood perfusion.

Changes of cognitive impairment and cerebral perfusion in patients with asymptomatic severe unilateral internal carotid stenosis / 中国脑血管病杂志

Objective To investigate the relationship between the evaluation of cerebral perfusion with CT perfusion (CTP)imaging and cognitive impairment in patients with asymptomatic severe internal carotid stenosis. Methods A total of 104 patients with asymptomatic severe unilateral internal carotid artery origin stenosis (the unilateral stenosis rate ≥70% and the contralateral stenosis rate 0. 05). The CTP parameters rMTT,rTTP,rCBV,and rCBF in the non-cognitive impairment group were 1. 074 ± 0. 066,1. 103 ± 0. 032,1. 045 ± 0. 021 and 1. 066 ± 0. 040,respectively;the CTP parameters rMTT,rTTP,rCBV,and rCBF in the cognitive impairment group were 1. 241 ± 0. 169, 1. 328 ± 0. 248,1. 046 ± 0. 030,and 1. 093 ± 0. 058,respectively. The rTTP and rMTT of the cognitive impairment were longer than those of the non-cognitive impairment group. There were significant differences in rTTP and rMTT between the 2 groups (P 0.05). Conclusion Most of the patients with asymptomatic severe internal carotid stenosis has cognitive impairment,and cerebral perfusion caused by stenosis is significantly slower in patients with cognitive impairment than in those with noncognitive impairment.

Effect of CTP guided thrombolytic therapy in the treatment of acute cerebral infarction / 天津医药

Objective To investigate the effect of CT perfusion (CTP) imaging guidance in the treatment of acute cere?bral infarction. Methods Patients (n=200) with acute cerebral infarction who visited our clinic within 6 hours underwent CTP examination and were divided into two groups:penumbra group and non-penumbra group according to their CTP imag?ing (presence of penumbra or not). Recombinant tissue plasminogen activator (rt- PA) was administrated for intravenous thrombolysis in both groups. NIHSS (The NIH Stroke Scale), BI (Barthel Index), mRS (modified Rankin Scores) and hemor?rhagic transformation events of two groups were determined before and after thrombolysis to evaluate its effect and prognosis in these two group. Results Compared with non penumbra group, NIHSS was reduced in penumbra group from 7 days after rt-PA (6.67±3.46 vs 4.76±2.04), and this decrease became obvious at 4 weeks after rt-PA (6.67±3.46 vs 3.68±1.93). Effi?ciency rate at 4 week (60.3%) and good prognosis rate at 3 months(71.7%)were both significantly improved in penumbra group than those in non penumbra group(34.7%,56.8%). Conclusion rt-PA under CTP guidance is effective and safe in the treatment of acute cerebral infarction. The thrombolytic therapy window can be enlarged according to the presence of pen?umbra or not and the bleeding conversion rate remains at low level.

Microenvironment changes induced by Endostar monotherapy in patients with non-small cell lung cancer：a pilot study / 中国癌症杂志

Background and purpose:Clinical data show that Endostar, a recombinant human endostatin, has the therapeutic beneift for patients with non-small cell lung cancer (NSCLC) while combined with chemotherapy or ra-diotherapy. However, the microenvironment changes induced by Endostar monotherapy in NSCLC is not yet clear. The purpose of this study was to prospectively study tumor vascular effects of Endostar monotherapy in patients with locally advanced or advanced NSCLC by dynamic contrast-enhanced perfusion computed tomography (CT perfusion, CT-p). Methods:Previously untreated patients with histologically or cytologically conifrmed locally advanced or advanced NSCLC were eligible. All patients received daily Endostar (7.5 mg?m2) for 14 days. CT-p scans were acquired at the baseline and post-treatment. CT-p parameters, such as blood lfow (BF), blood volume (BV) and permeability surface PS (area product), were measured in all patients.Results:Of all 7 patients enrolled, four were staged asⅢB and three as stageⅣ (2 with malignant pleural effusion, 1 with brain metastasis). The median BF, BV and PS values of baseline and post-treatment were 27.1/48.9 mL/100 mL/min, 86.8/84.8 mL/100 mL and 45.0/54.0 mL/100 mL/min, respectively. After administration of Endostar for 14 days , BF showed a signiifcant increase compared with that at baseline (P=0.028), whereas no signiifcant changes were found in BV (P=0.398) and PS (P=0.237) values.Conclusion:Our results suggest that Endostar monotherapy induces a signiifcant increase in BF whereas no signiifcant difference in BV and PS.