First Nerve-Related Immunoprobe for Guidance of Renal Denervation through Colocalization of NIR-II and Photoacoustic Bioimaging.

Nerve-related fluorophores generally locate in the visible or near-infrared region with shallow penetration depth and easy uptake by surrounding tissues. Prolonging the optical window promotes resolution by minimizing photoscattering and eliminating autofluorescence for NIR-II (second near infrared; 1000-1700 nm) and photoacoustic bioimaging. In addition, combination of the two could help in colocalization of targets at the 3D level. Catheter-based renal sympathetic denervation (RDN), an alternative treatment recently finishing its clinical evaluation for treating resistant hypertension, is highly dependent on experience and in urgent demand for in vivo guidance in locating the nerve over the renal artery. Here, an NIR-II and photoacoustic bioimaging system based on a dye-modified anti-tyrosine-hydroxylase antibody (TH-ICGM) to illustrate the peritoneal sympathetic nerve-related region are combined. With high resolution (0.15 mm) in NIR-II region for both absorbance (λex = 925 nm) and fluorescence (bioimaging in λem ≥ 1300 nm), TH-ICGM succeeds in providing 3D coordinates of procedure position with a precision in 0.1 mm. As the first nerve-related NIR-II immunoprobe, TH-ICGM has great clinical potential as assistance for nerve-related interventions.

Diagnostic efficacy of CCTA and CT-FFR based on risk factors for myocardial ischemia.

BACKGROUND: Coronary artery coronary computed tomography angiography (CCTA) can observe the degree of coronary artery stenosis and fractional flow reserve (FFR) can diagnose hemodynamic abnormalities caused by coronary artery stenosis. However, noninvasive imaging examination that can both observe the above two methods at the same time has not yet been elucidated. OBJECTIVE: To investigate the diagnostic efficacy of CCTA and computed tomography-derived fractional flow reserve (CT-FFR) based on different risk factors for myocardial ischemia. METHODS: Patients undergoing CCTA in our hospital from August 18, 2020 to April 28, 2021 were randomly selected, and the data were subjected to CT-FFR analysis. Vascular characteristics were measured, including total plaque volume, calcified plaque volume, non-calcified plaque volume, plaque length, and lumen stenosis, and the patients were categorized into a non-ischemia group (FFR > 0.8) and an ischemia group (FFR ≤ 0.8). Plaque characteristics were compared between the two groups, and logistic regression analysis was employed to explore the correlations between plaque characteristics and ischemic lesions. RESULTS: From a total of 122 patients enrolled in the study, there were 218 vascular branches with FFR > 0.8 and 174 vascular branches with FFR ≤ 0.8. There were significant group differences in total plaque volume, calcified plaque volume, plaque length, and lumen stenosis > 50% (n). The obtained data were as follows: non-ischemic group 10.57 (4.80, 259.65), ischemic group 14.87 (3.39, 424.45), Z = 9.772, p = 0.002, non-ischemic group 10.57 (0, 168.77), ischemic group 14.87 (0, 191.00), Z = 2.503, p ≤ 0.001), non-ischemic group 8.17 (37.05, 40.53), ischemic group 8.38 (56.66, 86.47), Z = 5.923, p = 0.016, and lumen stenosis > 50%, non-ischemic group 46, ischemic group 90, x2 = 14.77, p ≤ 0.001. The regression analysis results indicated that total plaque volume, calcified plaque volume, plaque length and lumen stenosis > 50% were risk factors for myocardial ischemia, with ORs and p values of (2.311, p = 0.002), (1.021, p = 0.004), (2.159, p < 0.001), and (0.181, p < 0.001), respectively. CONCLUSION: Total plaque volume, calcified plaque volume, plaque length and lumen stenosis > 50% are predictors for myocardial ischemia. Coronary artery CCTA combined with CT-FFR could simultaneously observe the anatomical stenosis and evaluate myocardial blood supply at the functional level. Thus, myocardial ischemia could be better diagnosed.

The assessment of the left atrial myocardial fibrosis of atrial fibrillation with late Gadolinium enhancementMRI / 中华放射学杂志

Objective To investigate the clinical value of 2 dimension late Gadolinium enhancement MRI (LGE-MRI) technique for the evaluation of atrial myocardial fibrosis in patients with atrial fibrillation. Methods Forty-nine cases of atrial fibrillation in our hospital from March 2015 to December 2016 were retrospectively collected. The LGE-MR was acquired by the Siemens 3.0 T MR machine before the catheter ablation.The findings of LGE-MR were evaluated by two experienced doctors. The left atrium(LA)were manually segmented into 8 regions in axial view.All patients were classified into 4 stages based on the extent of enhancement, stage 0: absence of enhancement, stage Ⅰ: enhancement appeared in minimal two consecutive slices in single region,stageⅡ:enhancement in two regions,stageⅢ:enhancement in three or more regions. All electroanatomic maps were obtained after electrical conversion during catheter ablation. The Kappa test was used to assess the consistency of LGE-MRI left atrial myocardial fibrosis and CARTO system of the left atrial endocardial voltage reconstruction. Results Forty-nine cases of atrial fibrillation with LGE-MRI and CARTO were included. There were 17 cases of atrial fibrosis stage 0,10 cases of stageⅠ,11 cases of stageⅡ,11 cases of stageⅢaccording to LGE-MRI findings;There were 17 cases of atrial fibrosis stage 0,19 cases of stageⅠ,12 cases of stageⅡ,11 cases of stage Ⅲ with reference to CARTO findings. The diagnostic accuracy of the LGE-MRI atrial fibrosis was 81.6%(40/49),of which the correlation was good(Kappa= 0.751,P<0.001). Conclusions LGE-MRI can accurately assess the degree of left atrial myocardial fibrosis in patients with atrial fibrillation,help to select the proper candidate and strategy in catheter ablation.