Plasma D-dimer as a predictor of intraluminal thrombus burden and progression of abdominal aortic aneurysm.

AIM: Intraluminal thrombus (ILT) is presented in most abdominal aortic aneurysms (AAAs) and is suggested to promote AAA expansion. D-dimer, a breakdown product in the thrombus remodeling, may have prognostic value for AAA. This study investigated the interrelation between plasma D-dimer level, ILT volume, AAA size and progression. MAIN METHODS: This was a retrospective observational study that involved 181 patients with infra-renal AAA. They were divided into small and large AAA groups according to AAA diameter. 24 of them had repeated abdominal computed tomography angiography (CTA) scan and were divided into slow-growing and fast-growing AAA groups according to the median value of AAA growth rate. Baseline and follow-up plasma D-dimer level, maximum diameter of AAA, total infra-renal aortic volume and ILT volume were analyzed. KEY FINDINGS: Plasma D-dimer level was positively correlated with ILT volume (R = 0.382, P < 0.001) and maximum diameter of AAA (R = 0.442, P < 0.001). Increasing value of plasma D-dimer was positively associated with the accelerated growth rate of AAA (R = 0.720, P < 0.01). ILT volume showed positive correlation with maximum diameter (R = 0.859, P < 0.001) and growth rate of AAA (R = 0.490, P < 0.05). After adjusting the baseline ILT volume, the positive correlations remained to be statistically significant between plasma D-dimer level and AAA size (R = 0.200, P < 0.05), as well as increasing value of plasma D-dimer and growth rate of AAA (R = 0.642, P < 0.05). SIGNIFICANCE: Plasma D-dimer level reflected ILT burden in AAAs. Plasma D-dimer level and ILT volume were positively correlated with AAA size. Increasing value of plasma D-dimer and baseline ILT volume could be predictors of AAA progression.

Assessment of Nonalcoholic Fatty Liver Disease in Rats Using Quantitative Dynamic Contrast-Enhanced MRI.

PURPOSE: To evaluate the usefulness of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the assessment of nonalcoholic fatty liver disease (NAFLD) severity. MATERIALS AND METHODS: Liver DCE-MRI at 3.0T was performed in 36 adult Sprague-Dawley rats with methionine choline-deficient diet-induced NAFLD and 10 untreated control rats. Pharmacokinetic parameters of DCE-MRI including Ktrans , Kep , Ve , Vp , and hepatic portal index (HPoI) were measured using the dual-input extended Tofts model. Animals were categorized as normal (n = 10), simple steatosis (SS, n = 11), borderline nonalcoholic steatohepatitis (bNASH, n = 20), and NASH (n = 5) subgroups according to the NAFLD activity score system, and classified into F0 (n = 24), F1 (n = 11), F2 (n = 7), and F3 (n = 4) subgroups according to an established scoring system. DCE-MRI parameters were compared. Receiver operating characteristic analyses were performed to assess the diagnostic performance of various DCE-MRI parameters in grading NAFLD activity and staging liver fibrosis. RESULTS: Ktrans and HPoI were elevated with increasing severity of NAFLD activity and increased fibrosis stage. The areas under the receiver operating characteristic curve (AUROCs) of HPoI ranged from 0.895-0.951 for discriminating between different grades of NAFLD activity, and the AUROC was 0.852 for discriminating F0 stage from overall F1-F3 stages. The AUROC of Ktrans for discriminating non-NASH from bNASH and NASH groups was 0.968, and 0.898 for discriminating between normal and overall fibrosis groups. CONCLUSION: DCE-MRI may play a role in assessing NAFLD severity. LEVEL OF EVIDENCE: 1 J. MAGN. RESON. IMAGING 2017;45:1485-1493.