Predictive value of chronic total occlusion score based on coronary CT angiography in interventional treatment of chronic total occlusion of coronary artery / 中华放射学杂志

Objective@#To explore the predictive value of modified chronic total occlusion (CTO) scores based on coronary computed tomography angiography (CCTA) for the outcome of CTO lesions after percutaneous coronary intervention (PCI).@*Methods@#A total of sixty-six patients who had undergone CCTA examinations were retrospectively enrolled and divided into PCI-success group (n=48) and PCI-failure group (n=18). Age, body mass index (BMI), calcium score (CACS), location and extent of CTO occlusive segments were recorded and compared between the two groups using paired-samples t test. In addition, the differences of gender, hypertension, hyperlipidemia, hyperuricemia, diabetes mellitus, myocardial infarction and angina pectoris were analyzed by using chi-square test and Fisher exact test. J-CTO score based on CCTA images (J-CTOCT) was calculated. Furthermore, modified-CTO score (m-CTOCT) was measured by redefining the calcification degree (mild, severe) and range (full segment, part) in the J-CTO scoring system. Predictive value of J-CTOCT and m-CTOCT on recanalization success was evaluated by the receiver operating curve (ROC) analysis.@*Results@#There were no significant differences in patients′ clinical indices between the two groups (all P>0.05). Compared to PCI-success group, blunt cap, blending>45 degrees, lesion length>20 mm, full calcification segment of lesion (χ2=5.012, 3.999 and 4.103, respectively; P<0.05) occurred more frequently in the PCI-failure group. In addition, the incidence of occlusive calcification was significantly increased in the PCI-failure group (P<0.05), as well as the total occlusive calcification (P=0.001) and severe occlusive calcification (P=0.000). Nevertheless, the rate of mild occlusive calcification was significantly higher in the PCI-success group (P=0.037). There were no significant differences in calcification location, calcification score and extent of calcification (P>0.05) between the two groups. The area under ROC (AUC) of m-CTOCT (0.921) was significantly higher than that of J-CTOCT (0.847, P<0.001).@*Conclusions@#Morphological evaluation of CCTA is helpful to predict the surgical success in patients with PCI. m-CTOCT scoring shows higher predictive value compared to traditional J-CTOCT score.

Predictive value of chronic total occlusion score based on coronary CT angiography in interventional treatment of chronic total occlusion of coronary artery / 中华放射学杂志

Objective:To explore the predictive value of modified chronic total occlusion (CTO) scores based on coronary computed tomography angiography (CCTA) for the outcome of CTO lesions after percutaneous coronary intervention (PCI).Methods:A total of sixty-six patients who had undergone CCTA examinations were retrospectively enrolled and divided into PCI-success group ( n=48) and PCI-failure group ( n=18). Age, body mass index (BMI), calcium score (CACS), location and extent of CTO occlusive segments were recorded and compared between the two groups using paired-samples t test. In addition, the differences of gender, hypertension, hyperlipidemia, hyperuricemia, diabetes mellitus, myocardial infarction and angina pectoris were analyzed by using chi-square test and Fisher exact test. J-CTO score based on CCTA images (J-CTO CT) was calculated. Furthermore, modified-CTO score (m-CTO CT) was measured by redefining the calcification degree (mild, severe) and range (full segment, part) in the J-CTO scoring system. Predictive value of J-CTO CT and m-CTO CT on recanalization success was evaluated by the receiver operating curve (ROC) analysis. Results:There were no significant differences in patients′ clinical indices between the two groups (all P>0.05). Compared to PCI-success group, blunt cap, blending>45 degrees, lesion length>20 mm, full calcification segment of lesion (χ 2=5.012, 3.999 and 4.103, respectively; P<0.05) occurred more frequently in the PCI-failure group. In addition, the incidence of occlusive calcification was significantly increased in the PCI-failure group ( P<0.05), as well as the total occlusive calcification ( P=0.001) and severe occlusive calcification ( P=0.000). Nevertheless, the rate of mild occlusive calcification was significantly higher in the PCI-success group ( P=0.037). There were no significant differences in calcification location, calcification score and extent of calcification ( P>0.05) between the two groups. The area under ROC (AUC) of m-CTO CT (0.921) was significantly higher than that of J-CTO CT (0.847, P<0.001). Conclusions:Morphological evaluation of CCTA is helpful to predict the surgical success in patients with PCI. m-CTO CT scoring shows higher predictive value compared to traditional J-CTO CT score.

The comparative study of CT angiography with DSA in vertebral artery dissection / 中华放射学杂志

Objective To explore the diagnostic value of CT angiography (CTA) of vertebral artery dissection (VAD) value. Methods We retrospectively analysed vertebral artery dissection in 30 patients (32 branches) according to the results of DSA. Tow radiologists independently analyzed the CTA images, and the sensitivity, specificity and accuracy of CTA in VAD patients were determined. The consistency of DSA and CTA results were evaluated by Kappa test. Results Thirty two branches of 60 vertebral arteries were diagnosed as VAD by DSA, 31 branches were diagnosed as VAD by CTA, 1 branch was misdiagnosis. Eight branches with dissection aneurysm were all displayed by CTA and DSA. Eleven branches of 12 branches withstring of beads signwere diagnosed by CTA. Five branches of 6 branches withstring and pearl signwere diagnosed by CTA;CTA and DSA of 1 branch withdouble-lumen signwere all displayed. Six branches of 5 branch withlinear signwere diagnosed by CTA. One branch showedlinear sign, but was diagnosed thrombosis by CTA. Two branches were showedlinear sign, but were diagnosedstring of beads signandstring and pearl sign. The sensitivity, specificity, accuracy of CT angiography in diagnosing VA dissection were 96.8％(31/32), 100％(28/28), 98.3％(59/60), respectively. The results made good agreement with DSA(Kappa=0.967,P<0.01). Conclusion Dual source CTA was a sensitive and accurate technique for the diagnosis of VAD.

Apparent Diffusion Coefficient in Assessing Early Response to Tyrosine Kinase Inhibitors in Non-small Cell Lung Cancer / 中国医学影像学杂志

[Abstact] Purpose To investigate the value of apparent diffusion coefficient (ADC) of diffusion weighted imaging (DW1) in the evaluation of the efficacy of treatment of nonsmall cell lung cancer (NSCLC) with tyrosine kinase inhibitor (TKI).Materials and Methods Nineteen patients with advanced NSCLC who treated with TKIs from May 2014 to December 2015 were recruited prospectively.All patients underwent CT and MRI scans three times before targeted therapy,after 1 week and 4 weeks of treatment.The tumor maximal diameter and mean ADC value at different time points were compared.The correlations between mean ADC value and tumor maximal diameter and maximum diameter change rate at different time points were analyzed.Bland-Altman analysis was performed to confirm the reproducibility of measurements.Results The ADC value after 1 week of treatment was significantly increased compared with that before treatment (t=-6.329,P＜0.05),but the change of tumor maximal diameter was not significant (P＞0.05).The ADC value was significantly increased after 4 weeks of treatment compared with that before treatment (t=-4.878,P＜0.05),and the change of tumor maximal diameter was also significant (t=7.054,P＜0.05).The negative correlation was detected between the ADC before treatment and the maximal diameter change ratio after 4 weeks of treatment (r2=-0.474,P＜0.05).In the group of responders,there was significant difference between the ADC value before treatment and 1 week after treatment (P＜0.05).There was significant difference in ADC value between the groups of responders and non-responders after 4 weeks of treatment (P＜0.05).The Bland-Altman analysis showed good reproducibility among the operators.Conclusion The ADC value after 1 week of targeted therapy is more sensitive to the change of tumor than the maximal diameter,and the ADC value before treatment has a certain value in predicting the maximum diameters of the target after 4 weeks of targeted therapy with repeatability.

MRI and Pathological Features of Ovarian Endometrioid Adenocarcinoma / 中国医学影像学杂志

PurposeTo study the MRI and pathological features of ovarian endometrioid adenocarcinoma (OEC) in order to evaluate the value of MRI in diagnosing OEC. Materials and Methods The MRI imaging features of 8 patients confirmed by surgery and pathology were analyzed retrospectively and were compared with the results of surgery and pathology. The MRI outcome and the related histological findings were further analyzed.Results Six out of the eight patients had unilateral tumor, 3 tumors in the left and the other 3 in the right; 2 patients had masses in the both ovaries. The total number of masses was ten.The diameters of the tumors ranged from 3.5 to 16.5 cm, with the average size of (10.5±4.1) cm. The border of 2 tumors was partially fuzzy and that of the other 6 was clear. The MRI scans showed that 8 tumors were cystic-solid and the other 2 were solid with heterogeneous signals. The solid components mainly presented slightly short T1 signals and long T2 signals; the cystic ones revealed long T1 and T2 signals. The enhanced scanning showed that the solid components of 8 tumors were patchy and obviously enhanced and the other 2 had mild or moderate enhancement. The cystic components were not hyper-intense. The enhanced MRI scans of two cases of primary endometrial carcinoma with metastases to the ovaries showed thickened endometrium and mild hyper-intense.Conclusion MRI can reveal the pathological features of OEC and clearly presents the forms, components and the relationship with its surroundings of tumors. Therefore, MRI is of great importance to the clinical diagnosis of OEC.