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Objectives: To explore whether dual-energy computed tomography (DECT) angiography can provide reliable quantitative information on net water uptake (NWU) of ischemic brain to identify stroke patients within 4.5 h. Methods: We retrospectively reviewed 142 patients with stroke occurrence and who underwent DECT angiography between August 2016 and May 2022. DECT angiography manual drawn the ischemic area by referring to the normal area of the contralateral hemisphere and follow-up images. The NWU in the ischemic area was determined using virtual non-contrast and monoenergetic (VNC &VM) images acquired from DECT angiography. The NWU values in the ischemic area were compared between stroke patients within and beyond 4.5 h. The diagnostic performance of the NWU values derived from the VNC and VM images was assessed through receiver operating characteristic curve analysis. Additionally, Furthermore, we examined the correlation between the NWU values and the stroke onset time. Results: Seventy-eight (54.93 %) stroke patients underwent DECT angiography and within 4.5 h. These patients with lower median National Institute of Health stroke scale (NIHSS) scores on admission than those beyond 4.5 h (p < 0.05). Furthermore, the group within 4.5 h had lower NWU values than did the group beyond 4.5 h on all VNC and VM images (p < 0.001). The analysis revealed that the NWU values determined using the VM (60 keV) images had the highest predictive efficiency (AUC, 0.95; sensitivity, 100 %; and specificity, 89.06 %) and showed the strongest positive correlation with stroke onset time (r-value = 0.58, p < 0.001). Conclusions: Our findings showed that DECT angiography-based quantification of NWU helps identify the stroke patients within 4.5 h with high predictive efficiency. Thus, NWU values determined using VM (60 keV) images could serve as a significant biomarker for stroke onset time.
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Objective To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR).Methods Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR,the patients were divided into the pure CHD group (n =32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54,including 20 cases of mild IMR,18 cases of moderate IMR and 16 cases of severe IMR).Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain (GLS),global circumferential strain (GCS),global radial strain(GRS)and LA maximal,minimal and pre-systolic volumes (LAVmax,LAVmin,and LAVp).LA ejection fraction (LAEF),LA passive ejection fraction (LApEF) and LA active ejection fraction (LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed.Results The left ventricular ejection fraction (LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group,and were lower in IMR group than in CHD group(P＜0.05).Compared with the control group,the LAVmin was increased,and the LAaEF was decreased in the IMR group(P＜0.05).Compared with the control group,the GLS,GCS,GRS were declined in the C HD and IMR groups,and were lower in IMR group than in control group(P＜0.05).Along with the increased severity of regurgitation,GLS,GCS,and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD),of time to peak circumferential strains(TCS-SD),and of time to peak radial strain (TRS-SD)rose in the IMR group as compared with the control group(P ＜0.05).The myocardial motion indicators(GLS,GCS,GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group:r=-0.745,-0.718 and 0.627,P=0.006,0.007 and 0.009;IMR group:r=-0.785,-0.781,0.643,P =0.006,0.007 and 0.008).The receiver operating characteristic (ROC)curves analysis showed that the sensitivity and specificity of TLS-SD,TCS-SD and TRS-SD were 89.7％ and 81.8％,78.6％ and 84.8％％,85.7％ and 72.1％,respectively in the evaluation of LA function changes.Conclusions RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.
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Objective@#To assess left atrial(LA)function by evaluating changes of LA wall movement and volume detected by real-time three-dimensional speckle tracking imaging(RT3D-STI)in elderly patients with ischemic mitral regurgitation(IMR).@*Methods@#Eighty-six elderly patients with coronary heart disease(CHD)were enrolled in this study.According to whether or not to have IMR, the patients were divided into the pure CHD group(n=32)and the CHD-induced ischemic mitral regurgitation(IMR)group(n=54, including 20 cases of mild IMR, 18 cases of moderate IMR and 16 cases of severe IMR). Thirty-two healthy elderly volunteers were considered as control group.RT3D-STI was used to evaluate the global atrial longitudinal strain(GLS), global circumferential strain(GCS), global radial strain(GRS)and LA maximal, minimal and pre-systolic volumes(LAVmax, LAVmin, and LAVp). LA ejection fraction(LAEF), LA passive ejection fraction(LApEF)and LA active ejection fraction(LAaEF)were calculated.The relationship of LA volume changes and myocardial strain with LA function was analyzed.@*Results@#The left ventricular ejection fraction(LVEF)and LAEF were reduced in CHD group and IMR group as compared with the control group, and were lower in IMR group than in CHD group(P<0.05). Compared with the control group, the LAVmin was increased, and the LAaEF was decreased in the IMR group(P<0.05). Compared with the control group, the GLS, GCS, GRS were declined in the CHD and IMR groups, and were lower in IMR group than in control group(P<0.05). Along with the increased severity of regurgitation, GLS, GCS, and GRS were decreased in varying degrees.The standard deviations of time to peak longitudinal strains(TLS-SD), of time to peak circumferential strains(TCS-SD), and of time to peak radial strain(TRS-SD)rose in the IMR group as compared with the control group(P<0.05). The myocardial motion indicators(GLS, GCS, GRS)had a quite strong correlation with LAEF in the CHD and IMR groups(CHD group: r=-0.745, -0.718 and 0.627, P=0.006, 0.007 and 0.009; IMR group: r=-0.785, -0.781, 0.643, P=0.006, 0.007 and 0.008). The receiver operating characteristic(ROC)curves analysis showed that the sensitivity and specificity of TLS-SD, TCS-SD and TRS-SD were 89.7% and 81.8%, 78.6% and 84.8%, 85.7% and 72.1%, respectively in the evaluation of LA function changes.@*Conclusions@#RT3D-STI can precisely and objectively assess the LA function changes by measuring the volume changes and tracing the myocardial motion in elderly IMR patients.
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Purpose To detect left atrial volume change and myocardial strain,and to evaluate left atrial (LA) function in coronary heart disease patients with mitral regurgitation (MR) by real-time three-dimensional speckle tracking imaging (RT3D-STI).Materials and Methods Eighty-eight patients with coronary disease were divided into non mitral regurgitation group (NMR group,n=30) and mitral regurgitation group (MR group,n=58),including mild MR (n=20),moderate MR (n=20) and severe MR (n=18).Thirty healthy participants were also included as control group.Using RT3D-STI,the global atrial longitudinal strain (GLS),global radial strain (GRS),global circumferential strain (GCS),LA maximal,minimal and pre-systolic volume (LAVmax,LAVmin and LAVp),LA passive ejection fraction (LApEF) and LA active ejection fraction (LAaEF) were measured,and the relationship between LA myocardial strain and left ventricular function was analyzed.Results ① The LAEF,LVEF,LApEF in NMR group and MR group decreased compared those with the control group (P＜0.05),and the LApEF in MR group were lower than those in NMR group (P＜0.05);② compared with the control group,the GLS and GCS in NMR group and MR group decreased observably (P＜0.05),and the parameters in MR group was lower than those in NMR group (P＜0.05);along with the severity of mitral regurgitation,GLS,GCS and GRS declined in varying degrees.③ The overall strain ability of left atrial myocardium (GLS,GCS,GRS) had a positive correlation with LAEF (NMR group:r=-0.810,-0.760 and 0.851;MR group:r=-0.680,-0.745 and 0.583;P＜0.05).Conclusion RT3D-STI plays an important role in assessing LA myocardial movement change and evaluating left atrial function of mitral regurgitation patients by nvestigating left atrial volume change,calculating LAEF and tracing myocardial motion,which provides valuable references for clinical diagnosis and treatment.
