Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest...Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest-quality images is not known.Methods:Fifteen patients underwent brachial plexus imaging using the 3D T2-NerveView sequence with a scanning duration of 5 min.A consecutive six-phase scan was initiated immediately at the start of contrast agent injection.Subsequently,all patients'images were classified into six groups according to the phases:group A(phase 1,delay 0 min),group B(phase 2,delay 5 min),group C(phase 3,delay 10 min),group D(phase 4,delay 15 min),group E(phase 5,delay 20 min),and group F(phase 6,delay 25 min).The image quality in each group was assessed based on nerve signal(signalnerve),muscle signal(signalmuscle),lymph node signal(signallymph node),background noise(BN),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective score.Results:Signalnerve,signalmuscle,BN,and SNR did not significantly differ among the six groups(p>0.05).However,significant differences(p<0.05)were observed in signallymph node(F=16.067),CNR(F=9.495),and subjective score(χ^(2)=23.586).As the scanning delay increased,signallymph node intensity gradually increased whereas the CNR gradually decreased.The subjective score was significantly higher in groups B(4.830.24),C(4.900.21),D(4.870.30),E(4.830.31),and F(4.830.31)than in group A(4.470.30).Conclusion:We recommend performing brachial plexus ceMRN 5 min after contrast injection.With this delay,the brachial plexus can be visualized optimally with minimal interference from background signals.展开更多
目的应用3.0 T磁共振成像系统探讨扩散张量成像(DTI)诊断前列腺外周带癌的价值。资料与方法搜集在3.0 T MR行前列腺检查并经穿刺活检证实的33例前列腺病变患者资料。扫描序列包括矢、冠、轴位TSET2WI序列及轴位单次激发平面回波成像(SS-...目的应用3.0 T磁共振成像系统探讨扩散张量成像(DTI)诊断前列腺外周带癌的价值。资料与方法搜集在3.0 T MR行前列腺检查并经穿刺活检证实的33例前列腺病变患者资料。扫描序列包括矢、冠、轴位TSET2WI序列及轴位单次激发平面回波成像(SS-EPI)DTI序列,b值采用0和700 s/mm2。扫描图像由两名放射学家进行评估,将前列腺外周带分为六个区域(每侧外周带分为尖部、中部和基底部三部分),根据穿刺结果将每个区域定为癌区或非癌区,测量前列腺外周带癌区和非癌区的表观扩散系数(ADC)值和各向异性分数(FA)值。采用t检验比较两者的ADC和FA值,并对DTI参数建立Logistic回归模型,对ADC、FA值和DTI参数行受试者工作特征(ROC)曲线分析以确定它们区分前列腺外周带癌区和非癌区的效能。结果前列腺外周带癌区及外周带非癌区的ADC值分别为(1.02±0.16)×10-3mm2/s和(1.22±0.14)×10-3mm2/s;FA值分别为0.38±0.09和0.31±0.06,两者差异均具有统计学意义(P<0.0001,P<0.0001)。ADC值、FA值及DTI区分前列腺外周带癌区和非癌区的ROC曲线下面积分别为0.84、0.76和0.86。DTI曲线下面积显著高于FA值(P=0.0009),但DTI和ADC曲线下面积无显著差异(P=0.1595)。结论 DTI有助于诊断前列腺外周带癌。展开更多
20世纪90年代初,随着第一代超高场磁共振成像仪的投入使用,因其诸多的优点,如更高的检测信噪比、更好的对比度、更强的BOLD效应和更宽的波谱,超高场磁共振成像成为国际医学磁共振领域最热门的研究方向之一.该文以最新一代的7.0 T MRI成...20世纪90年代初,随着第一代超高场磁共振成像仪的投入使用,因其诸多的优点,如更高的检测信噪比、更好的对比度、更强的BOLD效应和更宽的波谱,超高场磁共振成像成为国际医学磁共振领域最热门的研究方向之一.该文以最新一代的7.0 T MRI成像仪为例,简述超高场磁共振人体成像仪的系统结构、研究进展,并展望其在神经科学、认知科学和医学的应用前景.展开更多
Objective This study aims to explore the clinical applicability and relevance of giycosaminoglycan Chemical Exchange Saturation Transfer （gagCEST） for intervertebral disc. Methods 25 subjects ranging in age from 24 ...Objective This study aims to explore the clinical applicability and relevance of giycosaminoglycan Chemical Exchange Saturation Transfer （gagCEST） for intervertebral disc. Methods 25 subjects ranging in age from 24 yrs to 74 yrs were enrolled, gagCEST was acquired using a single-slice TSE sequence on a 3T. Saturation used a continuous rectangular RF pulse with B1=0.8 I^T and a fixed duration time =1100 ms. Sagittal image was obtained firstly without saturation pulse, and then saturated images were acquired at 52 offsets ranging from ＋0.i25 to ＋_7 parts per million （ppm）. MR T2 relaxivity map was acquired at the identical location. Six subjects were scanned twice to assess scan-rescan reproducibility. Results GagCEST intraclass correlation coefficient （ICC） of six subjects was 0.759 for nucleus pulposus （NP） and 0.508 for annulus fibrosus （AF）. Bland-Altman plots showed NP had a mean difference of 0.10% （95% limits of agreement： -3.02% to 3.22%）; while that of AF was 0.34% （95% limits of agreement： -2.28% to 2.95%）. For the 25 subjects, gag CEST in NP decreased as disc degeneration increased, with a similar trend to T2 relaxivity. Gag CEST of AF showed a better correlation with disc degeneration than T2 relaxivity. Conclusion GagCEST in NP and AF decreased as disc degeneration increased, while gagCEST in AF showed a better correlation than T2 relaxivity.展开更多
AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A tota...AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A total of 20 patients who underwent 3T magnetic resonance imaging(MRI) without bowel preparation and colonoscopy within 24 h were recruited.Biochemical indexes,including C-reactive protein(CRP),erythrocyte sedimentation rate,hemoglobin,leucocytes,platelets,serum iron and albumin,were determined.Biochemical examinations were then performed within 24 h before or after MR colonography was conducted.DWI was performed at various b values(b = 0,400,600,800,and 1000 s/mm2).Two radiologists independently and blindly reviewed conventional- and contrast-enhanced MR images,DWI and ADC maps; these radiologists also determined ADC in each intestinal segment(rectum,sigmoid,left colon,transverse colon,and right colon).Receiver operating characteristic(ROC) analysis was performed to assess the diagnostic performance of DWI hyperintensity from various b factors,ADC values and different radiological signs to detect endoscopic inflammation in the corresponding bowel segment.Optimal ADC threshold was estimated by maximizing the combination of sensitivity and specificity.MRfindings were correlated with endoscopic results and clinical markers; these findings were then estimated by ROC analysis.RESULTS: A total of 100 segments(71 with endoscopic colonic inflammation; 29 normal) were included.The proposed total magnetic resonance score(MR-score-T) was correlated with the total modified Baron score(Baron-T; r = 0.875,P < 0.0001); the segmental MR score(MR-score-S) was correlated with the segmental modified Baron score(Baron-S; r = 0.761,P < 0.0001).MR-score-T was correlated with clinical and biological markers of disease activity(r = 0.445 to 0.831,P < 0.05).MR-score-S > 1 corresponded to endoscopic colonic inflammation with a sensitivity of 85.9%,a specificity of 82.8% and an area under the curve(AUC) of 0.929(P < 0.0001).The accuracy of DWI hyperintensity was significantly greater at b = 800 than at b = 400,600,or 1000 s/mm2(P < 0.05) when endoscopic colonic inflammation was detected.DWI hyperintensity at b = 800 s/mm2 indicated endoscopic colonic inflammation with a sensitivity of 93.0%,a specificity of 79.3% and an AUC of 0.867(P < 0.0001).Quantitative analysis results revealed that ADC values at b = 800 s/mm2 differed significantly between endoscopic inflamed segment and normal intestinal segment(1.56 ± 0.58 mm2/s vs 2.63 ± 0.46 mm2/s,P < 0.001).The AUC of ADC values was 0.932(95% confidence interval: 0.881-0.983) when endoscopic inflammation was detected.The threshold ADC value of 2.18 × 10-3 mm2/s indicated that endoscopic inflammation differed from normal intestinal segment with a sensitivity of 89.7% and a specificity of 80.3%.CONCLUSION: DWI combined with conventional MRI without bowel preparation provides a quantitative strategy to differentiate actively inflamed intestinal segments from the normal mucosa to detect UC.展开更多
BACKGROUND The level of Ki-67 expression has served as a prognostic factor in gastric cancer.The quantitative parameters based on the novel dual-layer spectral detector computed tomography(DLSDCT)in discriminating the...BACKGROUND The level of Ki-67 expression has served as a prognostic factor in gastric cancer.The quantitative parameters based on the novel dual-layer spectral detector computed tomography(DLSDCT)in discriminating the Ki-67 expression status are unclear.AIM To investigate the diagnostic ability of DLSDCT-derived parameters for Ki-67 expression status in gastric carcinoma(GC).METHODS Dual-phase enhanced abdominal DLSDCT was performed preoperatively in 108 patients with gastric adenocarcinoma.Primary tumor monoenergetic CT attenuation value at 40-100 kilo electron volt(kev),the slope of the spectral curve(λ_(HU)),iodine concentration(IC),normalized IC(nIC),effective atomic number(Z^(eff))and normalized Z^(eff)(nZ^(eff))in the arterial phase(AP)and venous phase(VP)were retrospectively compared between patients with low and high Ki-67 expression in gastric adenocarcinoma.Spearman’s correlation coefficient was used to analyze the association between the above parameters and Ki-67 expression status.Receiver operating characteristic(ROC)curve analysis was performed to compare the diagnostic efficacy of the statistically significant parameters between two groups.RESULTS Thirty-seven and 71 patients were classified as having low and high Ki-67 expression,respectively.CT_(40 kev-VP),CT_(70 kev-VP),CT_(100 kev-VP),and Z^(eff)-related parameters were significantly higher,but IC-related parameters were lower in the group with low Ki-67 expression status than the group with high Ki-67 expression status,and other analyzed parameters showed no statistical difference between the two groups.Spearman’s correlation analysis showed that CT_(40 kev-VP),CT_(70 kev-VP),CT_(100 kev-VP),Z^(eff),and n Z^(eff) exhibited a negative correlation with Ki-67 status,whereas IC and nIC had positive correlation with Ki-67 status.The ROC analysis demonstrated that the multi-variable model of spectral parameters performed well in identifying the Ki-67 status[area under the curve(AUC)=0.967;sensitivity 95.77%;specificity 91.89%)].Nevertheless,the differentiating capabilities of singlevariable model were moderate(AUC value 0.630-0.835).In addition,the nZ_(VP)^(eff) and nIC_(VP)(AUC 0.835 and 0.805)showed better performance than CT_(40 kev-VP),CT_(70 kev-VP) and CT_(100 kev-VP)(AUC 0.630,0.631 and 0.662)in discriminating the Ki-67 status.CONCLUSION Quantitative spectral parameters are feasible to distinguish low and high Ki-67 expression in gastric adenocarcinoma.Z^(eff) and IC may be useful parameters for evaluating the Ki-67 expression.展开更多
Myocardial fiber deformation measurements have been reported to be associated with adverse outcomes in patients with acute heart failure and those with myocardial infarction.However,few studies have addressed the prog...Myocardial fiber deformation measurements have been reported to be associated with adverse outcomes in patients with acute heart failure and those with myocardial infarction.However,few studies have addressed the prognostic value of global circumferential strain(GCS)in dilated cardiomyopathy(DCM)patients with severely impaired systolic function.This study aimed to evaluate the prognostic value of cardiac magnetic resonance(CMR)-derived GCS in DCM patients with severely reduced ejection.Consecutive DCM patients with severely reduced ejection fraction(EF<35%)who underwent CMR were included.GCS was calculated from CMR cine images.The clinical endpoint was a composite of all-cause mortality,heart transplantation,implantable cardioverter defibrillator(ICD)implantation and aborted sudden cardiac death(SCD).A total of 129 patients with a mean EF of 15.33%(11.36%–22.27%)were included.During a median follow-up of 518 days,endpoint events occurred in 50 patients.Patients with GCS≥the median(−5.17%)had significantly reduced event-free survival as compared with those with GCS<the median(P<0.01).GCS was independently associated with adverse events after adjusting for clinical and imaging risk factors including extent of late gadolinium enhancement(LGE)(P<0.05).Adding GCS into the model including the extent of LGE resulted in significant improvements in the C-statistic(from 0.706 to 0.742;P<0.05)with a continuous net reclassification improvement(NRI)of 29.71%.It was concluded that GCS derived from CMR could be useful for risk stratification in DCM patients with severely reduced EF,which may increase common imaging risk factors including LGE.展开更多
Objective To investigate the impact of microvascular obstruction(MVO)on the global and regional myocardial function by cardiac magnetic resonance feature-tracking(CMR-FT)in ST-segment-elevation myocardial infarction(S...Objective To investigate the impact of microvascular obstruction(MVO)on the global and regional myocardial function by cardiac magnetic resonance feature-tracking(CMR-FT)in ST-segment-elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention.Methods Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1-7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study.Based on the presence or absence of MVO on late gadolinium enhancement images,patients were divided into groups with MVO and without MVO.The infarct zone,adjacent zone,and remote zone were determined based on a myocardial 16-segment model.The radial strain(RS),circumferential strain(CS),and longitudinal strain(LS)of the global left ventricle(LV)and the infarct,adjacent,and remote zones were measured by CMRFT from cine images and compared between patients with and without MVO using independent-samples t-test.Logistic regression analysis was used to assess the association of MVO with the impaired LV function.Results A total of 157 STEMI patients(mean age 56.66±11.38 years)were enrolled.MVO was detected in 37.58%(59/157)of STEMI patients,and the mean size of MVO was 3.00±3.76 mL.Compared with patients without MVO(n=98),the MVO group had significantly reduced LV global RS(t=-4.30,P<0.001),global CS(t=4.99,P<0.001),and global LS(t=3.51,P=0.001).The RS and CS of the infarct zone in patients with MVO were significantly reduced(t=-3.38,P=0.001;t=2.64,P=0.01;respectively)and the infarct size was significantly larger(t=8.37,P<0.001)than that of patients without MVO.The presence of LV MVO[OR=4.10,95%CI:2.05-8.19,P<0.001]and its size[OR=1.38,95%CI:1.10-1.72,P=0.01],along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis,while only heart rate(OR=1.08,95%CI:1.03-1.13,P=0.001)and LV infarct size(OR=1.10,95%CI:1.03-1.16,P=0.003)were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.Conclusion The infarct size was larger in STEMI patients with MVO,and MVO deteriorates the global and regional LV myocardial function.展开更多
AIM: To evaluate abdominal and pelvic image characteristics and artifacts on virtual nonenhanced (VNE) images generated from contrast-enhanced dual-energy multidetector computed tomography (MDCT) studies. METHODS: Had...AIM: To evaluate abdominal and pelvic image characteristics and artifacts on virtual nonenhanced (VNE) images generated from contrast-enhanced dual-energy multidetector computed tomography (MDCT) studies. METHODS: Hadassah-Hebrew University Medical Institutional Review Board approval was obtained; 22 patients underwent clinically-indicated abdominal and pelvic single-source dual-energy MDCT (Philips Healthcare, Cleveland, OH, USA), pre- and post-IV administration of Omnipaque 300 contrast (100 cc). Various solid and vascular structures were evaluated. VNE images were generated from the portal contrast-enhanced phase using probabilistic separation. Contrast-enhanced-, regular nonenhanced (RNE)-, and VNE images were evaluated with a total of 1494 density measurements. The ratio of iodine contrast deletion was calculated. Visualization of calcifications, urinary tract stones, and image artifacts in VNE images were assessed. RESULTS: VNE images were successfully generated in all patients. Significant portal-phase iodine contrast deletion was seen in the kidney (61.7%), adrenal gland (55.3%), iliac artery (55.0%), aorta (51.6%), and spleen (34.5%). Contrast deletion was also significant in the right atrium (RA) (51.5%) and portal vein (39.3%), but insignificant in the iliac vein and inferior vena cava (IVC). Average post contrast-to-VNE HU differences were significant (P < 0.05) in the: RA -135.3 (SD 121.8), aorta -114.1 (SD 48.5), iliac artery -104.6 (SD 53.7), kidney -30.3 (SD 34.9), spleen -9.2 (SD 8.8), and portal vein -7.7 (SD 13.2). Average VNE-to-RNE HU differences were significant in all organs but the prostate and subcutaneous fat: aorta 38.0 (SD 9.3), RA 37.8 (SD 16.1), portal vein 21.8 (SD 12.0), IVC 12.2 (SD 11.6), muscle 3.3 (SD 4.9), liver 5.7 (SD 6.4), spleen 22.3 (SD 9.8), kidney 40.5 (SD 6.8), and adrenal 20.7 (SD 13.5). On VNE images, 196/213 calcifications (92%) and 5/6 renal stones (84%) were visualized. Lytic-like artifacts in the vertebral bodies were seen in all studies. CONCLUSION: Iodine deletion in VNE images is most significant in arteries, and less significant in solid organs and veins. Most vascular and intra-abdominal organ calcifications are preserved.展开更多
BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imag...BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.展开更多
Dear Editor,Erectile dysfunction(ED)is a major health problem worldwide that reduces the quality of life of many families.ED is recognized as a consistent or recurrent inability to achieve and/or maintain a penile ere...Dear Editor,Erectile dysfunction(ED)is a major health problem worldwide that reduces the quality of life of many families.ED is recognized as a consistent or recurrent inability to achieve and/or maintain a penile erection sufficient for sexual satisfaction.Epidemiological data have shown that ED is associated with increasing age.?Nevertheless,the prevalence of ED is increasing in younger men(<40 years of age),with previous estimates as high as 30%.More recent studies have also reported organic causes in 5%-72%of ED patients<40 years old,and suggested involvement of the pudendal nerve(PN)as primary cause.3.4 The aim of this study was to evaluate the clinical utility of magnetic resonance neurography(MRN)for visualizing and quantifying PN changes in young men with ED.展开更多
BACKGROUND Previous studies using voxel-based morphometry(VBM)revealed changes in gray matter volume(GMV)of patients with depression,but the differences between patients with bipolar disorder(BD)and unipolar depressio...BACKGROUND Previous studies using voxel-based morphometry(VBM)revealed changes in gray matter volume(GMV)of patients with depression,but the differences between patients with bipolar disorder(BD)and unipolar depression(UD)are less known.AIM To analyze the whole-brain GMV data of patients with untreated UD and BD compared with healthy controls.METHODS Fourteen patients with BD and 20 with UD were recruited from the Mental Health Center of Shantou University between August 2014 and July 2015,and 20 nondepressive controls were recruited.After routine three-plane positioning,axial T2WI scanning was performed.The connecting line between the anterior and posterior commissures was used as the scanning baseline.The scanning range extended from the cranial apex to the foramen magnum.Categorical data are presented as frequencies and were analyzed using the Fisher exact test.RESULTS There were no significant intergroup differences in gender,age,or years of education.Disease course,age at the first episode,and Hamilton depression rating scale scores were similar between patients with UD and those with BD.Compared with the non-depressive controls,patients with BD showed smaller GMVs in the right inferior temporal gyrus,left middle temporal gyrus,right middle occipital gyrus,and right superior parietal gyrus and larger GMVs in the midbrain,left superior frontal gyrus,and right cerebellum.In contrast,UD patients showed smaller GMVs than the controls in the right fusiform gyrus,left inferior occipital gyrus,left paracentral lobule,right superior and inferior temporal gyri,and the right posterior lobe of the cerebellum,and larger GMVs than the controls in the left posterior central gyrus and left middle frontal gyrus.There was no difference in GMV between patients with BD and UD.CONCLUSION Using VBM,the present study revealed that patients with UD and BD have different patterns of changes in GMV when compared with healthy controls.展开更多
We hypothesized that a relationship existed between the mechanical properties and the magnetic resonance imaging (MRI) parameters of muscles, as already demonstrated in cartilaginous tissues. The aim was to develop an...We hypothesized that a relationship existed between the mechanical properties and the magnetic resonance imaging (MRI) parameters of muscles, as already demonstrated in cartilaginous tissues. The aim was to develop an indirect evaluation tool of the mechanical properties of degenerated muscles. Leg and arm muscles of adult rabbits were dissected, and tested 12 hours post mortem, in a state of rigor mortis, or 72 hours post mortem, in a state of post-rigor mortis. The tests consisted of a multi-parametric MRI acquisition followed by a uniaxial tensile test until failure. The statistical analysis consisted of multiple linear regressions and principal component analysis. Significant differences existed between the rigor mortis and post-rigor mortis groups for E but not for the MRI parameters. 78%, 60% or 33% of the Young’s modulus could be explained by the MRI parameters in the post-rigor mortis group, rigor mortis group or both groups respectively. These relationships were confirmed by the principal component analysis. The proposed multi-parametric MRI protocol associated to principal component analysis is a promising tool for the indirect evaluation of muscle mechanical properties and should be useful to find biomarkers and predictive factors of the evolution of the pathologies.展开更多
Background:Left atrioventricular coupling index(LACI)is a promising marker for predicting major adverse cardiac events in individuals with acute ST-segment elevation myocardial infarction(STEMI).However,the relationsh...Background:Left atrioventricular coupling index(LACI)is a promising marker for predicting major adverse cardiac events in individuals with acute ST-segment elevation myocardial infarction(STEMI).However,the relationship between LACI and adverse left ventricular(LV)remodeling(ALVR)in patients with STEMI remains to be fully elucidated.Methods:In this retrospective study,143 patients with STEMI who had undergone primary percutaneous coronary inter-vention(PCI)underwent cardiovascular magnetic resonance(CMR)imaging.The examinations were performed at 5±2 days(baseline)after PCI and at 6 months after STEMI.Left atrial and LV structural and functional indicators were evaluated.ALVR was defined as an increase of≥20%in LV end-diastolic volume(LVEDV)or an increase of≥15%in LV end-systolic volume at 6 months on CMR images.The patients were divided into two groups depending on the presence or absence of ALVR,and the CMR features were compared between the two groups.Results:Overall,51 patients(mean age 57±11 years;42 men)experienced ALVR after 6 months.In the univariable regression analysis,LVEDV index and LACI were significantly correlated with ALVR(odds ratio[OR]:0.989,95%confidence interval[CI]:0.979-0.999,p=0.025;OR:1.046,95%CI:1.012-1.080,p=0.007,respectively).Following adjustment for fundamental clinical variables,multivariate logistic regression analysis showed that baseline LACI was an independent predictor of ALVR at 6 months(OR:1.324,95%CI:1.055-1.662,p=0.016).Conclusions:CMR-derived LACI in patients with acute STEMI was an independent predictor of ALVR.展开更多
Atherosclerosis(AS)is a serious disease that poses a significant threat to the global population.In this review,we analyze the development of AS from multiple perspectives,aiming to elucidate its molecular mechanisms....Atherosclerosis(AS)is a serious disease that poses a significant threat to the global population.In this review,we analyze the development of AS from multiple perspectives,aiming to elucidate its molecular mechanisms.We also focus on imaging techniques and therapeutic approaches,highlighting the crucial role of nanomaterials in both imaging and therapy for AS.By leveraging their compatibility and targeting capabilities,nanomaterials can be integrated with traditional medical imaging and therapeutic agents to achieve targeted drug delivery,controlled release,and precise localization and imaging of atherosclerotic plaques.展开更多
Background The associations among genetic variants,cardiac magnetic resonance(CMR)features,and prognostic factors of pediatric heart failure(HF)remain unknown.This study aimed to explore the relationship between genet...Background The associations among genetic variants,cardiac magnetic resonance(CMR)features,and prognostic factors of pediatric heart failure(HF)remain unknown.This study aimed to explore the relationship between genetic differences in pediatric HF and CMR findings and their impact on prognosis of HF in children.Methods This retrospective study included children with a first-time diagnosis of HF.All patients underwent echocardiogram,CMR and genetic testing.The cohort was divided into three subgroups according to late gadolinium enhancement(LGE)on CMR:the no LGE subgroup,the subendocardial LGE subgroup,and the nonsubendocardial subgroup.The endpoint was defined as a lack of improvement in HF on echocardiography after more than six months of follow-up.Results Ninety-five children with HF were included,of whom 64 underwent genetic testing and 89 had echocardiograms at follow-up.There were 20 patients in the no LGE group,31 in the subendocardial group,and 44 in the nonsubendocardial group.The most common genotype was MYH7(27.0%).RBM20 and LMNA both presented a dilated phenotype,whereas GTPBP3 uniformly presented a hypertrophic phenotype.TNNI3 showed no LGE on CMR(P=0.003)and maintained a restrictive phenotype.The subendocardial group was more likely to have septal LGE(93.5%,P<0.001).Multivariable regression analysis indicated that a family history of cardiomyopathy,hydropericardium,and right ventricular ejection fraction(RVEF)were independent predictors of the endpoint event(P=0.035,P=0.005 and P=0.032,respectively).Notably,nonsubendocardial LGE was associated with a worse prognosis than no LGE was(P=0.030).Conclusions In pediatric non-ischemic HF patients,subendocardial LGE can be observed.A family history of cardiomyopathy,hydropericardium,and RVEF were predictors of HF with no improvement.The prognosis of HF is associated with the presence of LGE,particularly nonsubendocardial LGE,and less so with the genetic phenotype.展开更多
Background：Amide proton transfer （APT） imaging has recently emerged as an important contrast mechanism for magnetic resonance imaging （MRI） in the field of molecular and cellular imaging.The aim of this study was...Background：Amide proton transfer （APT） imaging has recently emerged as an important contrast mechanism for magnetic resonance imaging （MRI） in the field of molecular and cellular imaging.The aim of this study was to evaluate the feasibility of APT imaging to detect cerebral abnormality in patients with Alzheimer＆#39;s disease （AD） at 3.0 Tesla.Methods：Twenty AD patients （9 men and 11 women; age range,67-83 years） and 20 age-matched normal controls （11 men and 9 women; age range,63-82 years） underwent APT and traditional MRI examination on a 3.0 Tesla MRI system.The magnetic resonance ratio asymmetry （MTRasym） values at 3.5 ppm of bilateral hippocampi （Hc）,temporal white matter regions,occipital white matter regions,and cerebral peduncles were measured on oblique axial APT images.MTRasym （3.5 ppm） values of the cerebral structures between AD patients and control subjects were compared with independent samples t-test.Controlling for age,partial correlation analysis was used to investigate the associations between mini-mental state examination （MMSE） and the various MRI measures among AD patients.Results：Compared with normal controls,MTRasym （3.5 ppm） values of bilateral Hc were significantly increased in AD patients （right 1.24% ± 0.21% vs.0.83% ± 0.19%,left 1.18% ± 0.18% vs.0.80%± 0.17%,t =3.039,3.328,P =0.004,0.002,respectively）.MTRasym （3.5 ppm） values of bilateral Hc were significantly negatively correlated with MMSE （right r =-0.559,P =0.013; left r=-0.461,P =0.047）.Conclusions：Increased MTRasym （3.5 ppm） values of bilateral Hc in AD patients and its strong correlations with MMSE suggest that APT imaging could potentially provide imaging biomarkers for the noninvasive molecular diagnosis of AD.展开更多
In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks w...In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks within the brain. Functional MRI(fMRI) was performed on 20 individuals with LBP and 17 age and gender-matched normal controls during the resting state. The severity of the pain in the individuals with LBP ranged from 5 to 8 on a 0–10 scale, with 0 indicating no pain. Network-based statistics were performed to investigate the differences between the brain networks of individuals with LBP and those of normal controls. Several small-world parameters of brain networks were calculated, including the clustering coefficient, characteristic path length, local efficiency, and global efficiency. These criteria reflect the overall network efficiency. The brain networks in the individuals with LBP due to herniation of a lumbar disc demonstrated a significantly longer characteristic path length as well as a lower clustering coefficient, global efficiency, and local efficiency compared to those in control subjects. We found that LBP patients tended to have unstable and inefficient brain networks when compared with healthy controls. In addition, LBP individuals showed significantly decreased functional connectivity in the anterior cingulate cortex, middle cingulate cortex, post cingulate cortex, inferior frontal gyrus, middle temporal gyrus, occipital gyrus, postcentral gyrus, precentral gyrus, supplementary motor area, thalamus, fusiform, caudate, and cerebellum. We believe that these regions may be involved in the pathophysiology of lower back pain.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.82302173).
文摘Background:Contrast-enhanced magnetic resonance neurography(ceMRN)can enhance brachial plexus visualization and quality of imaging.However,the interval between contrast injection and scanning that provides the highest-quality images is not known.Methods:Fifteen patients underwent brachial plexus imaging using the 3D T2-NerveView sequence with a scanning duration of 5 min.A consecutive six-phase scan was initiated immediately at the start of contrast agent injection.Subsequently,all patients'images were classified into six groups according to the phases:group A(phase 1,delay 0 min),group B(phase 2,delay 5 min),group C(phase 3,delay 10 min),group D(phase 4,delay 15 min),group E(phase 5,delay 20 min),and group F(phase 6,delay 25 min).The image quality in each group was assessed based on nerve signal(signalnerve),muscle signal(signalmuscle),lymph node signal(signallymph node),background noise(BN),signal-to-noise ratio(SNR),contrast-to-noise ratio(CNR),and subjective score.Results:Signalnerve,signalmuscle,BN,and SNR did not significantly differ among the six groups(p>0.05).However,significant differences(p<0.05)were observed in signallymph node(F=16.067),CNR(F=9.495),and subjective score(χ^(2)=23.586).As the scanning delay increased,signallymph node intensity gradually increased whereas the CNR gradually decreased.The subjective score was significantly higher in groups B(4.830.24),C(4.900.21),D(4.870.30),E(4.830.31),and F(4.830.31)than in group A(4.470.30).Conclusion:We recommend performing brachial plexus ceMRN 5 min after contrast injection.With this delay,the brachial plexus can be visualized optimally with minimal interference from background signals.
文摘20世纪90年代初,随着第一代超高场磁共振成像仪的投入使用,因其诸多的优点,如更高的检测信噪比、更好的对比度、更强的BOLD效应和更宽的波谱,超高场磁共振成像成为国际医学磁共振领域最热门的研究方向之一.该文以最新一代的7.0 T MRI成像仪为例,简述超高场磁共振人体成像仪的系统结构、研究进展,并展望其在神经科学、认知科学和医学的应用前景.
基金partially by grants from the Research Grants Council of the Hong Kong SAR,China(Project No.SEG_CUHK02)
文摘Objective This study aims to explore the clinical applicability and relevance of giycosaminoglycan Chemical Exchange Saturation Transfer （gagCEST） for intervertebral disc. Methods 25 subjects ranging in age from 24 yrs to 74 yrs were enrolled, gagCEST was acquired using a single-slice TSE sequence on a 3T. Saturation used a continuous rectangular RF pulse with B1=0.8 I^T and a fixed duration time =1100 ms. Sagittal image was obtained firstly without saturation pulse, and then saturated images were acquired at 52 offsets ranging from ＋0.i25 to ＋_7 parts per million （ppm）. MR T2 relaxivity map was acquired at the identical location. Six subjects were scanned twice to assess scan-rescan reproducibility. Results GagCEST intraclass correlation coefficient （ICC） of six subjects was 0.759 for nucleus pulposus （NP） and 0.508 for annulus fibrosus （AF）. Bland-Altman plots showed NP had a mean difference of 0.10% （95% limits of agreement： -3.02% to 3.22%）; while that of AF was 0.34% （95% limits of agreement： -2.28% to 2.95%）. For the 25 subjects, gag CEST in NP decreased as disc degeneration increased, with a similar trend to T2 relaxivity. Gag CEST of AF showed a better correlation with disc degeneration than T2 relaxivity. Conclusion GagCEST in NP and AF decreased as disc degeneration increased, while gagCEST in AF showed a better correlation than T2 relaxivity.
文摘AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A total of 20 patients who underwent 3T magnetic resonance imaging(MRI) without bowel preparation and colonoscopy within 24 h were recruited.Biochemical indexes,including C-reactive protein(CRP),erythrocyte sedimentation rate,hemoglobin,leucocytes,platelets,serum iron and albumin,were determined.Biochemical examinations were then performed within 24 h before or after MR colonography was conducted.DWI was performed at various b values(b = 0,400,600,800,and 1000 s/mm2).Two radiologists independently and blindly reviewed conventional- and contrast-enhanced MR images,DWI and ADC maps; these radiologists also determined ADC in each intestinal segment(rectum,sigmoid,left colon,transverse colon,and right colon).Receiver operating characteristic(ROC) analysis was performed to assess the diagnostic performance of DWI hyperintensity from various b factors,ADC values and different radiological signs to detect endoscopic inflammation in the corresponding bowel segment.Optimal ADC threshold was estimated by maximizing the combination of sensitivity and specificity.MRfindings were correlated with endoscopic results and clinical markers; these findings were then estimated by ROC analysis.RESULTS: A total of 100 segments(71 with endoscopic colonic inflammation; 29 normal) were included.The proposed total magnetic resonance score(MR-score-T) was correlated with the total modified Baron score(Baron-T; r = 0.875,P < 0.0001); the segmental MR score(MR-score-S) was correlated with the segmental modified Baron score(Baron-S; r = 0.761,P < 0.0001).MR-score-T was correlated with clinical and biological markers of disease activity(r = 0.445 to 0.831,P < 0.05).MR-score-S > 1 corresponded to endoscopic colonic inflammation with a sensitivity of 85.9%,a specificity of 82.8% and an area under the curve(AUC) of 0.929(P < 0.0001).The accuracy of DWI hyperintensity was significantly greater at b = 800 than at b = 400,600,or 1000 s/mm2(P < 0.05) when endoscopic colonic inflammation was detected.DWI hyperintensity at b = 800 s/mm2 indicated endoscopic colonic inflammation with a sensitivity of 93.0%,a specificity of 79.3% and an AUC of 0.867(P < 0.0001).Quantitative analysis results revealed that ADC values at b = 800 s/mm2 differed significantly between endoscopic inflamed segment and normal intestinal segment(1.56 ± 0.58 mm2/s vs 2.63 ± 0.46 mm2/s,P < 0.001).The AUC of ADC values was 0.932(95% confidence interval: 0.881-0.983) when endoscopic inflammation was detected.The threshold ADC value of 2.18 × 10-3 mm2/s indicated that endoscopic inflammation differed from normal intestinal segment with a sensitivity of 89.7% and a specificity of 80.3%.CONCLUSION: DWI combined with conventional MRI without bowel preparation provides a quantitative strategy to differentiate actively inflamed intestinal segments from the normal mucosa to detect UC.
基金Supported by Ministerio de Ciencia e Innovación,Nos.FIS PS09/00806FIS PI12/00884 to Montoliu C+3 种基金SAF2011-23051,CSD2008-00005 to Felipo VConsellería de Educación Generalitat Valenciana,Nos.PROMETEO-2009-027,ACOMP/2012/066 to Felipo V,No.ACOMP/2012/056 to Montoliu CSanitat,No.AP-004/11 to Felipo V,AP-087/11 to Montoliu CFundación ERESA to Montoliu C
文摘AIM: To assess whether non invasive blood flow measurement by arterial spin labeling in several brain regions detects minimal hepatic encephalopathy.
文摘BACKGROUND The level of Ki-67 expression has served as a prognostic factor in gastric cancer.The quantitative parameters based on the novel dual-layer spectral detector computed tomography(DLSDCT)in discriminating the Ki-67 expression status are unclear.AIM To investigate the diagnostic ability of DLSDCT-derived parameters for Ki-67 expression status in gastric carcinoma(GC).METHODS Dual-phase enhanced abdominal DLSDCT was performed preoperatively in 108 patients with gastric adenocarcinoma.Primary tumor monoenergetic CT attenuation value at 40-100 kilo electron volt(kev),the slope of the spectral curve(λ_(HU)),iodine concentration(IC),normalized IC(nIC),effective atomic number(Z^(eff))and normalized Z^(eff)(nZ^(eff))in the arterial phase(AP)and venous phase(VP)were retrospectively compared between patients with low and high Ki-67 expression in gastric adenocarcinoma.Spearman’s correlation coefficient was used to analyze the association between the above parameters and Ki-67 expression status.Receiver operating characteristic(ROC)curve analysis was performed to compare the diagnostic efficacy of the statistically significant parameters between two groups.RESULTS Thirty-seven and 71 patients were classified as having low and high Ki-67 expression,respectively.CT_(40 kev-VP),CT_(70 kev-VP),CT_(100 kev-VP),and Z^(eff)-related parameters were significantly higher,but IC-related parameters were lower in the group with low Ki-67 expression status than the group with high Ki-67 expression status,and other analyzed parameters showed no statistical difference between the two groups.Spearman’s correlation analysis showed that CT_(40 kev-VP),CT_(70 kev-VP),CT_(100 kev-VP),Z^(eff),and n Z^(eff) exhibited a negative correlation with Ki-67 status,whereas IC and nIC had positive correlation with Ki-67 status.The ROC analysis demonstrated that the multi-variable model of spectral parameters performed well in identifying the Ki-67 status[area under the curve(AUC)=0.967;sensitivity 95.77%;specificity 91.89%)].Nevertheless,the differentiating capabilities of singlevariable model were moderate(AUC value 0.630-0.835).In addition,the nZ_(VP)^(eff) and nIC_(VP)(AUC 0.835 and 0.805)showed better performance than CT_(40 kev-VP),CT_(70 kev-VP) and CT_(100 kev-VP)(AUC 0.630,0.631 and 0.662)in discriminating the Ki-67 status.CONCLUSION Quantitative spectral parameters are feasible to distinguish low and high Ki-67 expression in gastric adenocarcinoma.Z^(eff) and IC may be useful parameters for evaluating the Ki-67 expression.
基金the National Natural Science Foundation of China(Nos.81701653 and 81570348).
文摘Myocardial fiber deformation measurements have been reported to be associated with adverse outcomes in patients with acute heart failure and those with myocardial infarction.However,few studies have addressed the prognostic value of global circumferential strain(GCS)in dilated cardiomyopathy(DCM)patients with severely impaired systolic function.This study aimed to evaluate the prognostic value of cardiac magnetic resonance(CMR)-derived GCS in DCM patients with severely reduced ejection.Consecutive DCM patients with severely reduced ejection fraction(EF<35%)who underwent CMR were included.GCS was calculated from CMR cine images.The clinical endpoint was a composite of all-cause mortality,heart transplantation,implantable cardioverter defibrillator(ICD)implantation and aborted sudden cardiac death(SCD).A total of 129 patients with a mean EF of 15.33%(11.36%–22.27%)were included.During a median follow-up of 518 days,endpoint events occurred in 50 patients.Patients with GCS≥the median(−5.17%)had significantly reduced event-free survival as compared with those with GCS<the median(P<0.01).GCS was independently associated with adverse events after adjusting for clinical and imaging risk factors including extent of late gadolinium enhancement(LGE)(P<0.05).Adding GCS into the model including the extent of LGE resulted in significant improvements in the C-statistic(from 0.706 to 0.742;P<0.05)with a continuous net reclassification improvement(NRI)of 29.71%.It was concluded that GCS derived from CMR could be useful for risk stratification in DCM patients with severely reduced EF,which may increase common imaging risk factors including LGE.
文摘Objective To investigate the impact of microvascular obstruction(MVO)on the global and regional myocardial function by cardiac magnetic resonance feature-tracking(CMR-FT)in ST-segment-elevation myocardial infarction(STEMI)patients after percutaneous coronary intervention.Methods Consecutive acute STEMI patients who underwent cardiac magnetic resonance imaging 1-7 days after successful reperfusion by percutaneous coronary intervention treatment were included in this retrospective study.Based on the presence or absence of MVO on late gadolinium enhancement images,patients were divided into groups with MVO and without MVO.The infarct zone,adjacent zone,and remote zone were determined based on a myocardial 16-segment model.The radial strain(RS),circumferential strain(CS),and longitudinal strain(LS)of the global left ventricle(LV)and the infarct,adjacent,and remote zones were measured by CMRFT from cine images and compared between patients with and without MVO using independent-samples t-test.Logistic regression analysis was used to assess the association of MVO with the impaired LV function.Results A total of 157 STEMI patients(mean age 56.66±11.38 years)were enrolled.MVO was detected in 37.58%(59/157)of STEMI patients,and the mean size of MVO was 3.00±3.76 mL.Compared with patients without MVO(n=98),the MVO group had significantly reduced LV global RS(t=-4.30,P<0.001),global CS(t=4.99,P<0.001),and global LS(t=3.51,P=0.001).The RS and CS of the infarct zone in patients with MVO were significantly reduced(t=-3.38,P=0.001;t=2.64,P=0.01;respectively)and the infarct size was significantly larger(t=8.37,P<0.001)than that of patients without MVO.The presence of LV MVO[OR=4.10,95%CI:2.05-8.19,P<0.001]and its size[OR=1.38,95%CI:1.10-1.72,P=0.01],along with the heart rate and LV infarct size were significantly associated with impaired LV global CS in univariable Logistic regression analysis,while only heart rate(OR=1.08,95%CI:1.03-1.13,P=0.001)and LV infarct size(OR=1.10,95%CI:1.03-1.16,P=0.003)were independent influencing factors for the impaired LV global CS in multivariable Logistic regression analysis.Conclusion The infarct size was larger in STEMI patients with MVO,and MVO deteriorates the global and regional LV myocardial function.
文摘AIM: To evaluate abdominal and pelvic image characteristics and artifacts on virtual nonenhanced (VNE) images generated from contrast-enhanced dual-energy multidetector computed tomography (MDCT) studies. METHODS: Hadassah-Hebrew University Medical Institutional Review Board approval was obtained; 22 patients underwent clinically-indicated abdominal and pelvic single-source dual-energy MDCT (Philips Healthcare, Cleveland, OH, USA), pre- and post-IV administration of Omnipaque 300 contrast (100 cc). Various solid and vascular structures were evaluated. VNE images were generated from the portal contrast-enhanced phase using probabilistic separation. Contrast-enhanced-, regular nonenhanced (RNE)-, and VNE images were evaluated with a total of 1494 density measurements. The ratio of iodine contrast deletion was calculated. Visualization of calcifications, urinary tract stones, and image artifacts in VNE images were assessed. RESULTS: VNE images were successfully generated in all patients. Significant portal-phase iodine contrast deletion was seen in the kidney (61.7%), adrenal gland (55.3%), iliac artery (55.0%), aorta (51.6%), and spleen (34.5%). Contrast deletion was also significant in the right atrium (RA) (51.5%) and portal vein (39.3%), but insignificant in the iliac vein and inferior vena cava (IVC). Average post contrast-to-VNE HU differences were significant (P < 0.05) in the: RA -135.3 (SD 121.8), aorta -114.1 (SD 48.5), iliac artery -104.6 (SD 53.7), kidney -30.3 (SD 34.9), spleen -9.2 (SD 8.8), and portal vein -7.7 (SD 13.2). Average VNE-to-RNE HU differences were significant in all organs but the prostate and subcutaneous fat: aorta 38.0 (SD 9.3), RA 37.8 (SD 16.1), portal vein 21.8 (SD 12.0), IVC 12.2 (SD 11.6), muscle 3.3 (SD 4.9), liver 5.7 (SD 6.4), spleen 22.3 (SD 9.8), kidney 40.5 (SD 6.8), and adrenal 20.7 (SD 13.5). On VNE images, 196/213 calcifications (92%) and 5/6 renal stones (84%) were visualized. Lytic-like artifacts in the vertebral bodies were seen in all studies. CONCLUSION: Iodine deletion in VNE images is most significant in arteries, and less significant in solid organs and veins. Most vascular and intra-abdominal organ calcifications are preserved.
基金Supported by National Natural Science Foundation of China,No.82071871Guangdong Basic and Applied Basic Research Foundation,No.2021A1515220131+1 种基金Guangdong Medical Science and Technology Research Fund Project,No.2022111520491834Clinical Research Project of Shenzhen Second People's Hospital,No.20223357022。
文摘BACKGROUND Intracranial atherosclerosis,a leading cause of stroke,involves arterial plaque formation.This study explores the link between plaque remodelling patterns and diabetes using high-resolution vessel wall imaging(HR-VWI).AIM To investigate the factors of intracranial atherosclerotic remodelling patterns and the relationship between intracranial atherosclerotic remodelling and diabetes mellitus using HR-VWI.METHODS Ninety-four patients diagnosed with middle cerebral artery or basilar artery INTRODUCTION Intracranial atherosclerotic disease is one of the main causes of ischaemic stroke in the world,accounting for approx-imately 10%of transient ischaemic attacks and 30%-50%of ischaemic strokes[1].It is the most common factor among Asian people[2].The adaptive changes in the structure and function of blood vessels that can adapt to changes in the internal and external environment are called vascular remodelling,which is a common and important pathological mechanism in atherosclerotic diseases,and the remodelling mode of atherosclerotic plaques is closely related to the occurrence of stroke.Positive remodelling(PR)is an outwards compensatory remodelling where the arterial wall grows outwards in an attempt to maintain a constant lumen diameter.For a long time,it was believed that the degree of stenosis can accurately reflect the risk of ischaemic stroke[3-5].Previous studies have revealed that lesions without significant luminal stenosis can also lead to acute events[6,7],as summarized in a recent meta-analysis study in which approximately 50%of acute/subacute ischaemic events were due to this type of lesion[6].Research[8,9]has pointed out that the PR of plaques is more dangerous and more likely to cause acute ischaemic stroke.Previous studies[10-13]have found that there are specific vascular remodelling phenomena in the coronary and carotid arteries of diabetic patients.However,due to the deep location and small lumen of intracranial arteries and limitations of imaging techniques,the relationship between intracranial arterial remodelling and diabetes is still unclear.In recent years,with the development of magnetic resonance technology and the emergence of high-resolution(HR)vascular wall imaging,a clear and multidimensional display of the intracranial vascular wall has been achieved.Therefore,in this study,HR wall imaging(HR-VWI)was used to display the remodelling characteristics of bilateral middle cerebral arteries and basilar arteries and to explore the factors of intracranial vascular remodelling and its relationship with diabetes.
基金the Surface Project of the National Nature Science Foundation of China to GBW(No.81671668)the Natural Science Foundation of Shandong to TG(No.ZR2020QH267).
文摘Dear Editor,Erectile dysfunction(ED)is a major health problem worldwide that reduces the quality of life of many families.ED is recognized as a consistent or recurrent inability to achieve and/or maintain a penile erection sufficient for sexual satisfaction.Epidemiological data have shown that ED is associated with increasing age.?Nevertheless,the prevalence of ED is increasing in younger men(<40 years of age),with previous estimates as high as 30%.More recent studies have also reported organic causes in 5%-72%of ED patients<40 years old,and suggested involvement of the pudendal nerve(PN)as primary cause.3.4 The aim of this study was to evaluate the clinical utility of magnetic resonance neurography(MRN)for visualizing and quantifying PN changes in young men with ED.
基金Supported by the Youth Fund of National Natural Science Foundation of China,No.81701338And the Shantou Medical Science and Technology Plan Project,No.20150406.
文摘BACKGROUND Previous studies using voxel-based morphometry(VBM)revealed changes in gray matter volume(GMV)of patients with depression,but the differences between patients with bipolar disorder(BD)and unipolar depression(UD)are less known.AIM To analyze the whole-brain GMV data of patients with untreated UD and BD compared with healthy controls.METHODS Fourteen patients with BD and 20 with UD were recruited from the Mental Health Center of Shantou University between August 2014 and July 2015,and 20 nondepressive controls were recruited.After routine three-plane positioning,axial T2WI scanning was performed.The connecting line between the anterior and posterior commissures was used as the scanning baseline.The scanning range extended from the cranial apex to the foramen magnum.Categorical data are presented as frequencies and were analyzed using the Fisher exact test.RESULTS There were no significant intergroup differences in gender,age,or years of education.Disease course,age at the first episode,and Hamilton depression rating scale scores were similar between patients with UD and those with BD.Compared with the non-depressive controls,patients with BD showed smaller GMVs in the right inferior temporal gyrus,left middle temporal gyrus,right middle occipital gyrus,and right superior parietal gyrus and larger GMVs in the midbrain,left superior frontal gyrus,and right cerebellum.In contrast,UD patients showed smaller GMVs than the controls in the right fusiform gyrus,left inferior occipital gyrus,left paracentral lobule,right superior and inferior temporal gyri,and the right posterior lobe of the cerebellum,and larger GMVs than the controls in the left posterior central gyrus and left middle frontal gyrus.There was no difference in GMV between patients with BD and UD.CONCLUSION Using VBM,the present study revealed that patients with UD and BD have different patterns of changes in GMV when compared with healthy controls.
文摘We hypothesized that a relationship existed between the mechanical properties and the magnetic resonance imaging (MRI) parameters of muscles, as already demonstrated in cartilaginous tissues. The aim was to develop an indirect evaluation tool of the mechanical properties of degenerated muscles. Leg and arm muscles of adult rabbits were dissected, and tested 12 hours post mortem, in a state of rigor mortis, or 72 hours post mortem, in a state of post-rigor mortis. The tests consisted of a multi-parametric MRI acquisition followed by a uniaxial tensile test until failure. The statistical analysis consisted of multiple linear regressions and principal component analysis. Significant differences existed between the rigor mortis and post-rigor mortis groups for E but not for the MRI parameters. 78%, 60% or 33% of the Young’s modulus could be explained by the MRI parameters in the post-rigor mortis group, rigor mortis group or both groups respectively. These relationships were confirmed by the principal component analysis. The proposed multi-parametric MRI protocol associated to principal component analysis is a promising tool for the indirect evaluation of muscle mechanical properties and should be useful to find biomarkers and predictive factors of the evolution of the pathologies.
基金supported by the National Natural Science Foundation of China(Grant 82471937)Beijing Hospitals Authority Youth Programme(Grant QML20230610).
文摘Background:Left atrioventricular coupling index(LACI)is a promising marker for predicting major adverse cardiac events in individuals with acute ST-segment elevation myocardial infarction(STEMI).However,the relationship between LACI and adverse left ventricular(LV)remodeling(ALVR)in patients with STEMI remains to be fully elucidated.Methods:In this retrospective study,143 patients with STEMI who had undergone primary percutaneous coronary inter-vention(PCI)underwent cardiovascular magnetic resonance(CMR)imaging.The examinations were performed at 5±2 days(baseline)after PCI and at 6 months after STEMI.Left atrial and LV structural and functional indicators were evaluated.ALVR was defined as an increase of≥20%in LV end-diastolic volume(LVEDV)or an increase of≥15%in LV end-systolic volume at 6 months on CMR images.The patients were divided into two groups depending on the presence or absence of ALVR,and the CMR features were compared between the two groups.Results:Overall,51 patients(mean age 57±11 years;42 men)experienced ALVR after 6 months.In the univariable regression analysis,LVEDV index and LACI were significantly correlated with ALVR(odds ratio[OR]:0.989,95%confidence interval[CI]:0.979-0.999,p=0.025;OR:1.046,95%CI:1.012-1.080,p=0.007,respectively).Following adjustment for fundamental clinical variables,multivariate logistic regression analysis showed that baseline LACI was an independent predictor of ALVR at 6 months(OR:1.324,95%CI:1.055-1.662,p=0.016).Conclusions:CMR-derived LACI in patients with acute STEMI was an independent predictor of ALVR.
基金supported by the National Natural Science Foundation of China(82272065)Medical Research Project of Jiangsu Health Commission in 2022(M2022066)+2 种基金The Nanjing Medical Science and technique Development Foundation(ZKX23019)The 15th special supported project of China Postdoctoral Science Foundation(2022T150317)Nanjing Gulou Hospital New Technology Development Fund(XJSFZJJ202026,XJSFZLX202114).
文摘Atherosclerosis(AS)is a serious disease that poses a significant threat to the global population.In this review,we analyze the development of AS from multiple perspectives,aiming to elucidate its molecular mechanisms.We also focus on imaging techniques and therapeutic approaches,highlighting the crucial role of nanomaterials in both imaging and therapy for AS.By leveraging their compatibility and targeting capabilities,nanomaterials can be integrated with traditional medical imaging and therapeutic agents to achieve targeted drug delivery,controlled release,and precise localization and imaging of atherosclerotic plaques.
基金supported by grants from the National Natural Science Foundation of China(82471937)the Beijing Hospitals Authority Youth Programme(QML20230610).
文摘Background The associations among genetic variants,cardiac magnetic resonance(CMR)features,and prognostic factors of pediatric heart failure(HF)remain unknown.This study aimed to explore the relationship between genetic differences in pediatric HF and CMR findings and their impact on prognosis of HF in children.Methods This retrospective study included children with a first-time diagnosis of HF.All patients underwent echocardiogram,CMR and genetic testing.The cohort was divided into three subgroups according to late gadolinium enhancement(LGE)on CMR:the no LGE subgroup,the subendocardial LGE subgroup,and the nonsubendocardial subgroup.The endpoint was defined as a lack of improvement in HF on echocardiography after more than six months of follow-up.Results Ninety-five children with HF were included,of whom 64 underwent genetic testing and 89 had echocardiograms at follow-up.There were 20 patients in the no LGE group,31 in the subendocardial group,and 44 in the nonsubendocardial group.The most common genotype was MYH7(27.0%).RBM20 and LMNA both presented a dilated phenotype,whereas GTPBP3 uniformly presented a hypertrophic phenotype.TNNI3 showed no LGE on CMR(P=0.003)and maintained a restrictive phenotype.The subendocardial group was more likely to have septal LGE(93.5%,P<0.001).Multivariable regression analysis indicated that a family history of cardiomyopathy,hydropericardium,and right ventricular ejection fraction(RVEF)were independent predictors of the endpoint event(P=0.035,P=0.005 and P=0.032,respectively).Notably,nonsubendocardial LGE was associated with a worse prognosis than no LGE was(P=0.030).Conclusions In pediatric non-ischemic HF patients,subendocardial LGE can be observed.A family history of cardiomyopathy,hydropericardium,and RVEF were predictors of HF with no improvement.The prognosis of HF is associated with the presence of LGE,particularly nonsubendocardial LGE,and less so with the genetic phenotype.
文摘Background：Amide proton transfer （APT） imaging has recently emerged as an important contrast mechanism for magnetic resonance imaging （MRI） in the field of molecular and cellular imaging.The aim of this study was to evaluate the feasibility of APT imaging to detect cerebral abnormality in patients with Alzheimer＆#39;s disease （AD） at 3.0 Tesla.Methods：Twenty AD patients （9 men and 11 women; age range,67-83 years） and 20 age-matched normal controls （11 men and 9 women; age range,63-82 years） underwent APT and traditional MRI examination on a 3.0 Tesla MRI system.The magnetic resonance ratio asymmetry （MTRasym） values at 3.5 ppm of bilateral hippocampi （Hc）,temporal white matter regions,occipital white matter regions,and cerebral peduncles were measured on oblique axial APT images.MTRasym （3.5 ppm） values of the cerebral structures between AD patients and control subjects were compared with independent samples t-test.Controlling for age,partial correlation analysis was used to investigate the associations between mini-mental state examination （MMSE） and the various MRI measures among AD patients.Results：Compared with normal controls,MTRasym （3.5 ppm） values of bilateral Hc were significantly increased in AD patients （right 1.24% ± 0.21% vs.0.83% ± 0.19%,left 1.18% ± 0.18% vs.0.80%± 0.17%,t =3.039,3.328,P =0.004,0.002,respectively）.MTRasym （3.5 ppm） values of bilateral Hc were significantly negatively correlated with MMSE （right r =-0.559,P =0.013; left r=-0.461,P =0.047）.Conclusions：Increased MTRasym （3.5 ppm） values of bilateral Hc in AD patients and its strong correlations with MMSE suggest that APT imaging could potentially provide imaging biomarkers for the noninvasive molecular diagnosis of AD.
基金supported by the National Natural Science Foundation of China (81401932)the Beijing Natural Science Foundation (7154246)
文摘In this study, we aimed to investigate the functional network changes that occur in patients with lower back pain(LBP). We also investigated the link between LBP and the small-world properties of functional networks within the brain. Functional MRI(fMRI) was performed on 20 individuals with LBP and 17 age and gender-matched normal controls during the resting state. The severity of the pain in the individuals with LBP ranged from 5 to 8 on a 0–10 scale, with 0 indicating no pain. Network-based statistics were performed to investigate the differences between the brain networks of individuals with LBP and those of normal controls. Several small-world parameters of brain networks were calculated, including the clustering coefficient, characteristic path length, local efficiency, and global efficiency. These criteria reflect the overall network efficiency. The brain networks in the individuals with LBP due to herniation of a lumbar disc demonstrated a significantly longer characteristic path length as well as a lower clustering coefficient, global efficiency, and local efficiency compared to those in control subjects. We found that LBP patients tended to have unstable and inefficient brain networks when compared with healthy controls. In addition, LBP individuals showed significantly decreased functional connectivity in the anterior cingulate cortex, middle cingulate cortex, post cingulate cortex, inferior frontal gyrus, middle temporal gyrus, occipital gyrus, postcentral gyrus, precentral gyrus, supplementary motor area, thalamus, fusiform, caudate, and cerebellum. We believe that these regions may be involved in the pathophysiology of lower back pain.
