Evaluating cardiac function with chest computed tomography in acute ischemic stroke: feasibility and correlation with short-term outcome.

Background: The outcomes of patients with acute ischemic stroke (AIS) are related to cardiac function. Cardiac insufficiency can manifest as hydrostatic changes in the lungs. Computed tomography (CT) of the chest is commonly used for screening pulmonary abnormalities and provides an opportunity to assess cardiac function. Purpose: To evaluate the correlation between hydrostatic lung manifestations on chest CT and cardiac function with its potential to predict the short-term outcome of AIS patients. Methods: We retrospectively analyzed AIS patients who had undergone chest CT at admission and echocardiogram within 48 h. Morphological and quantitative hydrostatic changes and left ventricular dimensions were assessed using chest CT. Improvement in the National Institutes of Health Stroke Scale (NIHSS) score on the seventh day determined short-term outcomes. Multivariate analysis examined the correspondence between hydrostatic lung manifestations, left ventricular dimension, and left ventricle ejection fraction (LVEF) on echocardiography, and the correlation between hydrostatic changes and short-term outcomes. Results: We included 204 patients from January to December 2021. With the progression of hydrostatic changes on chest CT, the LVEF on echocardiography gradually decreased (p < 0.05). Of the 204, 53 patients (26%) with varying degrees of hypostatic lung manifestations had less improvement in the NIHSS score (p < 0.05). The density ratio of the anterior/posterior lung on CT showed a significant negative correlation with improvement in the NIHSS score (r = -5.518, p < 0.05). Additionally, patients with a baseline NIHSS ≥4 with left ventricular enlargement had significantly lower LVEF than that of patients with normal NIHSS scores. Conclusion: Hydrostatic lung changes on chest CT can be used as an indicator of cardiac function and as a preliminary reference for short-term outcome in AIS patients.

Modulation of functional activity and connectivity by acupuncture in patients with Alzheimer disease as measured by resting-state fMRI.

Acupuncture has been used in the therapy of Alzheimer disease (AD); however, its neural mechanisms are still unclear. The aim of this study is to examine the effect of acupuncture on the functional connectivity in AD by using resting-state functional magnetic resonance imaging (rs-fMRI). Twenty-eight subjects (14 AD and 14 normal controls) participated in this study. The rs-fMRI data were acquired before and after acupuncture stimulation at the acupoints of Tai chong (Liv3) and Hegu (LI4). During the baseline resting state, by using the amplitude of low-frequency fluctuations (ALFF), we found a significantly decreased or increased ALFF in the AD patients relative to the controls. These regions were located in the right superior frontal gyrus (SFG), left postcentral gyrus, subgenual cingulate cortex (SCC), right middle cingulate cortex (MCC), right inferior frontal gyrus (IFG), right hippocampus and the right inferior temporal gyrus (ITG). Then, we selected these brain regions as seeds to investigate whether regional activity and functional connectivity could be modulated by acupuncture in the AD patients. When compared to the pre-acupuncture stage, several of the above regions showed an increased or decreased ALFF after acupuncture in the AD patients. In addition, the functional connectivity between the hippocampus and the precentral gyrus showed enhancement after acupuncture in the AD patients. Finally, there were close correlations between the functional activity, connectivity and clinical performance in the AD patients. The current study confirmed that acupuncture at Tai chong (Liv3) and He gu (LI4) can modulate functional activity and connectivity of specific cognition-related regions in AD patients.

Effect of a novel motion correction algorithm (SSF) on the image quality of coronary CTA with intermediate heart rates: segment-based and vessel-based analyses.

PURPOSE: To evaluate the effect of SnapShot Freeze (SSF) reconstruction at an intermediate heart-rate (HR) range (65-75bpm) and compare this method with single-sector reconstruction and bi-sector reconstruction on segmental and vessel bases in retrospective coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: Retrospective electrocardiogram-gated CCTA was performed on 37 consecutive patients with HR between 65 and 75bpm using a 64-row CT scanner. Retrospective single-sector reconstruction, bi-sector reconstruction, and SSF were performed for each patient. Multi-phase single-sector reconstruction was performed to select the optimal phase. SSF and bi-sector images were also reconstructed at the optimal phase. The images were interpreted in an intent-to-diagnose fashion by two experienced readers using a 5-point scale, with 3 points as diagnostically acceptable. Image quality among the three reconstruction groups were compared on per-patient, per-vessel, and per-segment bases. RESULTS: The average HR of the enrolled patients was 69.4±2.7bpm. A total of 111 vessels and 481 coronary segments were assessed. SSF provided significantly higher interpretability of the coronary segments than bi-sector reconstructions. The qualified and excellent rates of SSF (97.9% and 82.3%) were significantly higher than those of single-sector (92.9% and 66.3%) and bi-sector (90.9% and 64.7%) reconstructions. The image quality score (IQS) using SSF was also significantly higher than those of single-sector and bi-sector reconstructions both on per-patient and per-vessel bases. On per-segment analysis, IQS was improved in most segments (9/14). CONCLUSION: The SSF algorithm can provide acceptable diagnostic image quality in coronary CTA for patients with intermediate HR.