[Increased risk of cardiovascular disease in elderly population with carotid plaque and low ankle brachial index].

Objective: To investigate whether the co-presence of carotid plaques and low ankle-brachial index (ABI) might increase the risks of ischemic cardiovascular and cerebrovascular event in elderly population. Methods: It was a prospective study. Participants from the elderly cohort of the Kailuan Study, who completed a carotid sonography and ABI examination, were included in this study. Participants underwent physical examinations between 2010 and 2011 and were divided into 3 groups: no carotid plaque and ABI>0.9 group (n=526), carotid plaque and ABI>0.9 group (n=1 067), and carotid plaques and ABI≤0.9 group (n=49). Follow up ended on the 31 December 2016. The incidence of ischemic cardiovascular and cerebrovascular event was compared between the 3 groups, the relationship between carotid plaque and low ABI with ischemic cardiovascular and cerebrovascular event was analyzed. Results: A total of 1 642 participants were included (age, (67.1±6.4) years). There were 1 028 males (62.6%) and 1 028 females(37.4%). The average follow-up time was 5.41 years, the incidence of ischemic cardiovascular and cerebrovascular event in the 3 group was 2.1%(11/526), 5.5%(59/1 067), and 12.2%(6/49),respectively; the incidence of myocardial infarction in the 3 group was 0.2%(1/526), 1.6%(17/1 067), 10.2%(5/49), respectively; the incidence of cerebral infarction in the 3 group was 1.9%(10/526), 3.9%(42/1 067) and 2.0%(1/49), respectively. Multivariate Cox risk proportional regression analysis showed that compared with the group without carotid plaque and ABI>0.9, the HR values (95%CI) of ischemic cardiovascular and cerebrovascular event in the group with carotid plaque and ABI>0.9, carotid plaques and ABI≤0.9 group were 3.52 (1.49-8.35), 7.16(2.11-24.26) respectively, after adjusting for sex,age,systolic blood pressure,fast blood glucose,body mass index,total cholesterol,smoke,alcohol consumption and lipid-lowering medication and antihypertensive medication. Conclusions: Co-presence of carotid plaques and low ankle-brachial index may further increase the risk of ischemic cardiovascular and cerebrovascular event among elderly population in this cohort.

Application of Gd-DTPA in diseases of the central nervous system.

Patients whose routine MRI were negative but were clinically highly suspected of having intra-cranial or intra-spinal canal space-occupying lesions, and those whose routine MRI were positive but presented difficulties in defining the contour or the nature of the lesion, or difficulty in distinguishing the lesion from the surrounding edema were selected for Gd-DTPA enhancement. Altogether there were 80 cases, in which 51 had intracranial lesions and 29 intraspinal canal lesions. In each patient, Gd-DTPA 0.06-0.1 mmol/kg was injected intravenously 5 minutes before imaging (pituitary microadenoma images were taken immediately and 10 minutes after injection). No patient had contrast media reaction or complications. In cases with hemorrhage, hematoma, edema, cyst and arteriovenous malformation, no marked enhancement was observed after contrast media injection. When difficulty in differential diagnosis between these lesions and tumors occurs, injection of Gd-DTPA is very helpful. Gd-DTPA enhancement is of great benefit in diagnosis of intracranial or intraspinal canal tumors in four ways. 1) It reveals lesions which can not be demonstrated or can not be demonstrated clearly before enhancement, including iso-intensity lesions and small lesions which comprised 13.7% of our cases. 11 cases with equivocal diagnoses before enhancement obtained unequivocal diagnoses after enhancement. 2) It differentiates the tumor from edema more definitely. 3) It helps to distinguish the nature of lesions. 4) It shortens examination time when the T2 weighted image procedure is omitted.

Computed tomography in hepatolenticular degeneration (Wilson's disease).

Fifteen cases of hepatolenticular degeneration have been studied by means of computerized cranial tomography (CT). The common abnormalities were hypodense areas in the regions of the basal ganglia, in 9 cases; ventricular dilatation, in 7 cases; cortical atrophy, in 5 cases and brain-stem atrophy, in 4 cases. CT abnormalities were most common and most marked in patients with neurological presentations, but 1 of 3 asymptomatic patients discovered by the genetic screening of the affected family had hypodense areas in bilateral lenticular nuclei.