1
|
Agrawal I, Bano S, Chaudhary A, Ahuja A. Role of Permeability Surface Area Product in Grading of Brain Gliomas using CT Perfusion. Asian J Neurosurg 2023; 18:751-760. [PMID: 38161609 PMCID: PMC10756843 DOI: 10.1055/s-0043-1774820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Purpose The aim of this study was to evaluate the role of permeability surface area product in grading brain gliomas using computed tomography (CT) perfusion Materials and Methods CT perfusion was performed on 33 patients with brain glioma diagnosed on magnetic resonance imaging. Of these, 19 had high-grade glioma and 14 had low-grade glioma on histopathological follow-up. CT perfusion values were obtained and first compared between the tumor region and normal brain parenchyma. Then the relative values of perfusion parameters were compared between high- and low-grade gliomas. Cut-off values, sensitivity, specificity, and strength of agreement for each parameter were calculated and compared subsequently. A conjoint factor (permeability surface area product + cerebral blood volume) was also evaluated since permeability surface area product and cerebral blood volume are considered complimentary factors for tumor vascularity. Results All five perfusion parameters namely permeability surface area product, cerebral blood volume, cerebral blood flow, mean transit time, and time to peak were found significantly higher in the tumor region than normal brain parenchyma. Among these perfusion parameters, only relative permeability surface area product and relative cerebral blood volume were found significant in differentiating high- and low-grade glioma. Moreover, relative permeability surface area product was significantly better than all other perfusion parameters with highest sensitivity and specificity (97.74 and 100%, respectively, at a cut-off of 9.0065). Relative permeability surface area product had a very good agreement with the histopathology grade. The conjoint factor did not yield any significant diagnostic advantage over permeability surface area product. Conclusion Relative permeability surface area product and relative cerebral blood volume were helpful in differentiating high- and low-grade glioma; however, relative permeability surface area product was significantly better than all other perfusion parameters. Grading brain gliomas using relative permeability surface area product can add crucial value in their management and prognostication; hence, it should be evaluated in the routine CT perfusion imaging protocol.
Collapse
Affiliation(s)
- Ira Agrawal
- Department of Radiodiagnosis, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Shahina Bano
- Department of Radiodiagnosis, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Ajay Chaudhary
- Department of Neurosurgery, PGIMER, Dr. RML Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, PGIMER, Dr. RML Hospital, New Delhi, India
| |
Collapse
|
2
|
Chandola S, Dhamija E, Paul SB, Hari S, Batra A, Mathur S, Deo SVS. Imaging features of breast cancer subtypes on contrast enhanced ultrasound: a feasibility study. Ecancermedicalscience 2023; 17:1619. [PMID: 38414960 PMCID: PMC10898897 DOI: 10.3332/ecancer.2023.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Indexed: 02/29/2024] Open
Abstract
The objective of this research was to study the contrast enhancement patterns of the different molecular subtypes of breast cancer on contrast-enhanced ultrasound (CEUS) using both qualitative and quantitative parameters. This prospective study included females with a single breast mass which was histopathologically proven carcinoma. B mode ultrasound (USG) and CEUS were performed in all patients during baseline assessment. Qualitative CEUS assessment encompassed enhancement pattern, presence of fill-in and washout. Quantitative assessment included measurement of peak enhancement, time to peak; area under the curve and mean transit time. A p-value < 0.05 was considered statistically significant for differentiating the subtypes. The included thirty masses were categorised into two subtypes-triple negative breast cancer (TNBC) (36.7%) and non-TNBC (63.3%) subtypes. With B-mode USG, a statistically significant difference was observed between the two groups with respect to their shape and margins. TNBC lesions showed an oval shape, circumscribed margins and peripheral nodular enhancement on CEUS with the absence of fill-in even in the delayed phase (p-value - 0.04). The two subtypes did not significantly differ in terms of quantitative perfusion parameters. The various subtypes of breast cancer therefore possess distinct contrast enhancement patterns. CEUS potentially allows differentiation amongst these molecular subtypes that may aid in radiology-pathology (rad-path) correlation and follow up of the patients.
Collapse
Affiliation(s)
- Stuti Chandola
- Department of Radiodiagnosis and Interventional Radiology, IRCH, AIIMS, New Delhi 110029, India
| | - Ekta Dhamija
- Department of Radiodiagnosis and Interventional Radiology, IRCH, AIIMS, New Delhi 110029, India
| | - Shashi B Paul
- Department of Radiodiagnosis and Interventional Radiology, IRCH, AIIMS, New Delhi 110029, India
| | - Smriti Hari
- Department of Radiodiagnosis and Interventional Radiology, IRCH, AIIMS, New Delhi 110029, India
| | - Atul Batra
- Department of Medical Oncology, IRCH, AIIMS, New Delhi 110029, India
| | - Sandeep Mathur
- Department of Pathology, IRCH, AIIMS, New Delhi 110029, India
| | - S V S Deo
- Department of Surgical Oncology, IRCH, AIIMS, New Delhi 110029, India
| |
Collapse
|
3
|
Tong CY, Zhu RTL, Ling YT, Scheeren EM, Lam FMH, Fu H, Ma CZH. Muscular and Kinematic Responses to Unexpected Translational Balance Perturbation: A Pilot Study in Healthy Young Adults. Bioengineering (Basel) 2023; 10:831. [PMID: 37508858 PMCID: PMC10376184 DOI: 10.3390/bioengineering10070831] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
Falls and fall-related injuries are significant public health problems in older adults. While balance-controlling strategies have been extensively researched, there is still a lack of understanding regarding how fast the lower-limb muscles contract and coordinate in response to a sudden loss of standing balance. Therefore, this pilot study aims to investigate the speed and timing patterns of multiple joint/muscles' activities among the different challenges in standing balance. Twelve healthy young subjects were recruited, and they received unexpected translational balance perturbations with randomized intensities and directions. Electromyographical (EMG) and mechanomyographical (MMG) signals of eight dominant-leg's muscles, dominant-leg's three-dimensional (3D) hip/knee/ankle joint angles, and 3D postural sways were concurrently collected. Two-way ANOVAs were used to examine the difference in timing and speed of the collected signals among muscles/joint motions and among perturbation intensities. This study has found that (1) agonist muscles resisting the induced postural sway tended to activate more rapidly than the antagonist muscles, and ankle muscles contributed the most with the fastest rate of response; (2) voluntary corrective lower-limb joint motions and postural sways could occur as early as the perturbation-induced passive ones; (3) muscles reacted more rapidly under a larger perturbation intensity, while the joint motions or postural sways did not. These findings expand the current knowledge on standing-balance-controlling mechanisms and may potentially provide more insights for developing future fall-prevention strategies in daily life.
Collapse
Affiliation(s)
- Cheuk Ying Tong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Ringo Tang-Long Zhu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Yan To Ling
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Centre for Developmental Neurobiology, King's College London, London SE1 1UL, UK
| | - Eduardo Mendonça Scheeren
- Graduate Program in Health Technology, Pontifícia Universidade Católica do Paraná, Curitiba 80215-901, Brazil
| | - Freddy Man Hin Lam
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Hong Fu
- Department of Mathematics and Information Technology, The Education University of Hong Kong, Hong Kong SAR 999077, China
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| |
Collapse
|
4
|
Berczeli M, Chinnadurai P, Legeza P, Peden EK, Bavare CS, Chang SM, Lumsden AB. Dynamic, Time-Resolved CT Angiography After EVAR: A Quantitative Approach to Accurately Characterize Aortic Endoleak Type and Identify Inflow Vessels. J Endovasc Ther 2023; 30:123-131. [PMID: 35068202 DOI: 10.1177/15266028211070970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE Our purpose was to study the accuracy of dynamic computed tomography angiography (d-CTA) in characterizing endoleak type, inflow vessels as compared with digital subtraction angiography (DSA) using qualitative and quantitative analysis. METHODS Between March 2019 and January 2021, all patients who underwent d-CTA imaging after EVAR were retrospectively reviewed. Two blinded independent reviewers qualitatively reviewed d-CTA and DSA images. Quantitative region of interest (ROI) analysis was performed by measuring time-resolved contrast enhancement within the aorta and endoleak lesion(s) in the aneurysm sac. Differences between time-to-peak enhancement (Δ TTP) across different ROIs were quantified. RESULTS A total of 48 patients underwent d-CTA during the study period, of whom 24 patients had abdominal EVAR and DSA imaging for comparison. Qualitative review of DSA imaging showed type I (n=4), type II (n=16), and type III (n=2) and no endoleak (n=2). In 23 of 24 patients (95.8%), d-CTA findings correlated with DSA findings for endoleak type. One patient had a type III endoleak that was demonstrated only in d-CTA (arising from defect in polymer sealing ring of Ovation stent graft) imaging. In type II endoleak cases, d-CTA identified more inflow vessels than DSA imaging (33 vs 21 vessels, p=0.010). Quantitative analysis showed mean (±SD) Δ TTP values for type I endoleak as 1.8 (±1.8) seconds, type II as 9.6 (±3.5) seconds, and for type III endoleak as 5.6 (±1.3) seconds. CONCLUSION Dynamic CTA can accurately characterize aortic endoleak type, inflow vessels as compared with DSA imaging. Quantitative parameters such as Δ TTP enhancement can help better differentiate endoleak types and provide an objective approach to endoleak diagnosis.
Collapse
Affiliation(s)
- Marton Berczeli
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA.,Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Ponraj Chinnadurai
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA.,Advanced Therapies, Siemens Medical Solutions USA Inc, Malvern, PA, USA
| | - Peter Legeza
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA.,Department of Vascular and Endovascular Surgery, Semmelweis University, Budapest, Hungary
| | - Eric K Peden
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Charudatta S Bavare
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA
| | - Su Min Chang
- Department of Cardiology, Houston Methodist Hospital, Houston, TX, USA
| | - Alan B Lumsden
- Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX, USA
| |
Collapse
|
5
|
An P, Lin Y, Hu Y, Qin P, Ye Y, Gu W, Li X, Song P, Feng G. Predicting Model of Biochemical Recurrence of Prostate Carcinoma (PCa-BCR) Using MR Perfusion-Weighted Imaging-Based Radiomics. Technol Cancer Res Treat 2023; 22:15330338231166766. [PMID: 37016971 PMCID: PMC10084547 DOI: 10.1177/15330338231166766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVE To build a combined model that integrates clinical data, contrast-enhanced ultrasound, and magnetic resonance perfusion-weighted imaging-based radiomics for predicting the possibility of biochemical recurrence of prostate carcinoma and develop a nomogram tool. METHOD We retrospectively analyzed the clinical, ultrasound, and magnetic resonance imaging data of 206 patients pathologically confirmed with prostate carcinoma and receiving radical prostatectomy at Xiangyang No. 1 People's Hospital from February 2015 to August 2021. Based on one to 7 years of follow-up (prostate specific antigen [PSA] level≥0.2 ng/mL, indicative of prostate carcinoma-biochemical recurrence), the patients were divided into biochemical recurrence group (n = 77) and normal group (n = 129). The training and testing sets were formed by dividing the patients at a 7:3 ratio. In training set, The magnetic resonance perfusion-weighted imaging-based radiomics radscore was generated using lasso regression. Several predictive models were built based on the patients' clinical imaging data. The predictive efficacy (area under the curve) of these models was compared using the MedCalc software. The decision curve analysis was conducted using the R to compare the net benefit. Finally, an external validation was carried out on the testing set, and the nomogram tool was developed for predicting prostate carcinoma-biochemical recurrence. RESULT The univariate analysis confirmed that Tumor diameter, tumor node metastasis classification stage of tumor, lymph node metastasis or distance metastasis, Gleason grade, preoperative PSA, ultrasound (peak intensity, arrival time, and elastography grade), and magnetic resonance imaging-radscore1/2 were predictors of prostate carcinoma-biochemical recurrence. On the training set, the combined model based on the above factors had the highest predictive efficacy for prostate carcinoma-biochemical recurrence (area under the curve: 0.91; odds ratio 0.02, 95% confidence interval: 0.85-0.95). The predictive performance of the combined model was significantly higher than that of the model based on general clinical data (area under the curve: 0.74; odds ratio 0.04, 95% confidence interval: 0.67-0.81, P < .05), contrast-enhanced ultrasound (area under the curve: 0.61; odds ratio 0.05 95% confidence interval: 0.53-0.69, P < .05), and the magnetic resonance imaging-based radiomics model (area under the curve: 0.85; odds ratio 0.03, 95% confidence interval: 0.78-0.91, P = .01). The decision curve analysis also indicated the maximum net benefit derived from the combined model, which agreed with the validation results on the testing set. The nomogram tool developed based on the combined model achieved a good performance in clinical applications. CONCLUSION The magnetic resonance imaging texture parameters extracted by magnetic resonance perfusion-weighted imaging Lasso regression could help increase the accuracy of the predictive model. The combined model and the nomogram tool provide support for the clinical screening of the populations at a risk for biochemical recurrence.
Collapse
Affiliation(s)
- Peng An
- Department of Radiology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Urology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Yong Lin
- Department of Gynaecology and Reproductive medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of internal medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Yan Hu
- Department of Urology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Gynaecology and Reproductive medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Pharmacy and Laboratory, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Ping Qin
- Department of Gynaecology and Reproductive medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - YingJian Ye
- Department of Urology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of internal medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Weiping Gu
- Department of Urology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Gynaecology and Reproductive medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Xiumei Li
- Department of Radiology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of internal medicine, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Ping Song
- Department of Radiology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Pharmacy and Laboratory, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| | - Guoyan Feng
- Department of Radiology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
- Department of Urology, 584878Xiangyang No. 1 People's Hospital, Hubei University of Medicine, Xiangyang, China
| |
Collapse
|
6
|
Rai BB, Essex RW, Sabeti F, Maddess T, Rohan EMF, van Kleef JP, Carle CF. An Objective Perimetry Study of Central Versus Peripheral Sensitivities and Delays in Age-Related Macular Degeneration. Transl Vis Sci Technol 2021; 10:24. [PMID: 34932115 PMCID: PMC8711003 DOI: 10.1167/tvst.10.14.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/18/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to compare central versus peripheral retinal sensitivities and delays in neovascular age-related macular degeneration (nAMD) using US Food and Drug Administration (FDA)-cleared multifocal pupillographic objective perimetry (mfPOP). Methods We recruited 18 patients with nAMD and commenced Pro re nata intravitreal anti- vascular endothelial growth factor (VEGF) injection. We compared macular (±15 degrees) and wide-field (±30 degrees) mfPOP variants. We examined temporal correlations between treated and untreated fellow eyes. We fitted linear models to selected treatment patterns, and compared the ability of central versus peripheral responses to predict the need for treatment. Results Central sensitivity decreased by -2.23 ± 0.051 dB/month (P < 0.0002) in treated eyes, and -0.17 ± 0.07 dB/month (P = 0.033) in untreated eyes. Treated eyes showed quicker central responses by 13.08 ± 3.77 ms than untreated eyes (P = 0.001). Based on peripheral responses, we identified two eye-types. Among positive-eyes peripheral sensitivity increased by 9.88 ± 4.41 dB (P = 0.042) before treatment; delays increased by 3.49 ± 1.75 ms/month (P = 0.049). For negative-eyes peripheral delays were shorter a month before treatment by 9.38 ± 3.59 ms (P = 0.013). Correlations between treatment and peripheral sensitivities or delays peaked at 1 to 2 months post-treatment. Peripheral data significantly determined treatment frequency and final acuity (all P < 0.044). Conclusions Peripheral macular function of treated and untreated eyes divided eyes into positive and negative groups. Those peripheral responses determined outcomes; changes preceding active disease by 1 to 3 months. Overall, mfPOP may provide potential biomarkers to assist nAMD management. Translational Relevance Objective perimetry may identify the requirement for treatment in nAMD that accords with the decision of a skilled clinician based on optical coherence tomography (OCT) and clinical findings.
Collapse
Affiliation(s)
- Bhim B Rai
- John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia
| | - Rohan W Essex
- Academic Unit, ANU Medical School, ANU, Canberra, Australia Capital Territory, Australia
- Department of Ophthalmology, The Canberra Hospital, ACT Health, Canberra, ACT, Australia
| | - Faran Sabeti
- John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia
- School of Optometry, University of Canberra, Bruce, Canberra, Australia Capital Territory, Australia
| | - Ted Maddess
- John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia
| | - Emilie M F Rohan
- John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia
| | - Joshua P van Kleef
- John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia
| | - Corinne F Carle
- John Curtin School of Medical Research, Australian National University, Australia Capital Territory, Australia
| |
Collapse
|
7
|
Bell E, Binkowski S, Sanderson E, Keating B, Smith G, Harray AJ, Davis EA. Substantial Intra-Individual Variability in Post-Prandial Time to Peak in Controlled and Free-Living Conditions in Children with Type 1 Diabetes. Nutrients 2021; 13:4154. [PMID: 34836409 DOI: 10.3390/nu13114154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/10/2021] [Accepted: 11/16/2021] [Indexed: 12/04/2022] Open
Abstract
The optimal time to bolus insulin for meals is challenging for children and adolescents with type 1 diabetes (T1D). Current guidelines to control glucose excursions do not account for individual differences in glycaemic responses to meals. This study aimed to examine the within- and between-person variability in time to peak (TTP) glycaemic responses after consuming meals under controlled and free-living conditions. Participants aged 8–15 years with T1D ≥ 1 year and using a continuous glucose monitor (CGM) were recruited. Participants consumed a standardised breakfast for six controlled days and maintained their usual daily routine for 14 free-living days. CGM traces were collected after eating. Linear mixed models were used to identify within- and between-person variability in the TTP after each of the controlled breakfasts, free-living breakfasts (FLB), and free-living dinners (FLD) conditions. Thirty participants completed the study (16 females; mean age and standard deviation (SD) 10.5 (1.9)). The TTP variability was greater within a person than the variability between people for all three meal types (between-person vs. within-person SD; controlled breakfast 18.5 vs. 38.9 min; FLB 14.1 vs. 49.6 min; FLD 5.7 vs. 64.5 min). For the first time, the study showed that within-person variability in TTP glycaemic responses is even greater than between-person variability.
Collapse
|
8
|
Zeng YN, Zhang BT, Song T, Peng JF, Wang JT, Yuan Q, Tan MY. The clinical value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) semi-quantitative parameters in monitoring neoadjuvant chemotherapy response of osteosarcoma. Acta Radiol 2021; 63:1077-1085. [PMID: 34247514 DOI: 10.1177/02841851211030768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a non-invasive technique which could monitor tumor morphology, blood vessel dynamics, and micro-environmental changes. PURPOSE To evaluate the value of DCE-MRI semi-quantitative parameters in monitoring the neoadjuvant chemotherapy (NAC) response of osteosarcoma. MATERIAL AND METHODS Twenty-five patients pathologically confirmed as osteosarcoma received four cycles of NAC followed by surgery. All patients underwent conventional and dynamic MRI twice, before starting chemotherapy and before surgical treatment. With a reference standard of histological response (tumor necrosis rate), semi-quantitative parameters were compared between good response group (TNR ≥ 90%) and non-response group (TNR < 90%). The differences between intra- and inter-group parameters before and after NAC were analyzed by Mann-Whitney U test. Receiver operating characteristic (ROC) analysis was generated to assess the parameters' efficacy in predicting the outcome of NAC. RESULTS The changes were statistically significant on slope, maximum signal intensity (SImax), time to peak (TTP), signal enhanced extent (SEE), peak percent enhancement (PPE), washout rate (WOR), and enhancement rate (ER) in the good response group (P < 0.05), while only SImax and SEE were different in the non-response group after NAC. The changes in Slope, SImax, TTP, SEE, WOR, and ER were markedly different (P < 0.05) between the two groups after NAC. Also, at the threshold values of 3.2%/s, 175 s, and 5.4% (slope, TTP, and ER), the sensitivity and specificity for predicting good response to chemotherapy were 83.3% and 92.3%, 91.7% and 69.2%, 84.6% and 75.0%, respectively. CONCLUSION Slope, TTP, and ER values could be used to evaluate and predict the response to NAC in osteosarcoma.
Collapse
Affiliation(s)
- Yan-ni Zeng
- Department of Radiology, Huadu Distinct People’s Hospital of Guangzhou, Guangzhou, PR China
| | - Bu-tian Zhang
- Department of Radiology, China-Japan Union Hospital of Jilin University, ChangChun, PR China
| | - Ting Song
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, PR China
| | - Jian-feng Peng
- Department of Radiology, Huadu Distinct People’s Hospital of Guangzhou, Guangzhou, PR China
| | - Juan-ting Wang
- Department of Radiology, Huadu Distinct People’s Hospital of Guangzhou, Guangzhou, PR China
| | - Qiang Yuan
- Department of Radiology, Huadu Distinct People’s Hospital of Guangzhou, Guangzhou, PR China
| | - Min-yi Tan
- Department of Radiology, Huadu Distinct People’s Hospital of Guangzhou, Guangzhou, PR China
| |
Collapse
|
9
|
Zhao J, Kader A, Mangarova DB, Brangsch J, Brenner W, Hamm B, Makowski MR. Dynamic Contrast-Enhanced MRI of Prostate Lesions of Simultaneous [ 68Ga]Ga-PSMA-11 PET/MRI: Comparison between Intraprostatic Lesions and Correlation between Perfusion Parameters. Cancers (Basel) 2021; 13:1404. [PMID: 33808685 PMCID: PMC8003484 DOI: 10.3390/cancers13061404] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/25/2021] [Accepted: 03/16/2021] [Indexed: 11/29/2022] Open
Abstract
We aimed to retrospectively compare the perfusion parameters measured from dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) of prostate benign lesions and malignant lesions to determine the relationship between perfusion parameters. DCE-MRI was performed in patients with PCa who underwent simultaneous [68Ga]Ga-prostate-specific membrane antigen (PSMA)-11 positron emission tomography (PET)/MRI. Six perfusion parameters (arrival time (AT), time to peak (TTP), wash-in slope (W-in), wash-out slope (W-out), peak enhancement intensity (PEI), and initial area under the 60-s curve (iAUC)), and a semi-quantitative parameter, standardized uptake values maximum (SUVmax) were calculated by placing regions of interest in the largest area of the lesions. The DCE-MRI parameters between prostate benign and malignant lesions were compared. The DCE-MRI parameters in both the benign and malignant lesions subgroup with SUVmax ≤ 3.0 and SUVmax > 3.0 were compared. The correlation of DCE-MRI parameters was investigated. Malignant lesions demonstrated significantly shorter TTP and higher SUVmax than did benign lesions. In the benign and malignant lesions subgroup, perfusion parameters of lesions with SUVmax ≤ 3.0 show no significant difference to those with SUVmax > 3.0. DCE-MRI perfusion parameters show a close correlation with each other. DCE-MRI parameters reflect the perfusion characteristics of intraprostatic lesions with malignant lesions, demonstrating significantly shorter TTP. There is a moderate to strong correlation between DCE-MRI parameters. Semi-quantitative analysis reflects that malignant lesions show a significantly higher SUVmax than benign lesions.
Collapse
Affiliation(s)
- Jing Zhao
- Institute of Radiology and Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (A.K.); (D.B.M.); (J.B.); (B.H.); (M.R.M.)
| | - Avan Kader
- Institute of Radiology and Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (A.K.); (D.B.M.); (J.B.); (B.H.); (M.R.M.)
- Department of Biology, Chemistry and Pharmacy, Institute of Biology, Freie Universität Berlin, Königin-Luise-Str. 1-3, 14195 Berlin, Germany
| | - Dilyana B. Mangarova
- Institute of Radiology and Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (A.K.); (D.B.M.); (J.B.); (B.H.); (M.R.M.)
- Department of Veterinary Medicine, Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, Building 12, 14163 Berlin, Germany
| | - Julia Brangsch
- Institute of Radiology and Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (A.K.); (D.B.M.); (J.B.); (B.H.); (M.R.M.)
| | - Winfried Brenner
- Department of Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany;
| | - Bernd Hamm
- Institute of Radiology and Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (A.K.); (D.B.M.); (J.B.); (B.H.); (M.R.M.)
| | - Marcus R. Makowski
- Institute of Radiology and Nuclear Medicine, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117 Berlin, Germany; (A.K.); (D.B.M.); (J.B.); (B.H.); (M.R.M.)
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany
| |
Collapse
|
10
|
Cindil E, Erbas G, Akkan K, Cerit MN, Sendur HN, Zor MH, Ilgıt E. Dynamic Volume Perfusion CT of the Foot in Critical Limb Ischemia: Response to Percutaneous Revascularization. AJR Am J Roentgenol 2020; 214:1398-408. [PMID: 32097028 DOI: 10.2214/AJR.19.21520] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE. The purpose of this study was to assess the reproducibility and validity of quantitative perfusion parameters derived from dynamic volume perfusion CT in patients with critical limb ischemia (CLI) and to evaluate perfusion parameter changes before and after endovascular revascularization. SUBJECTS AND METHODS. Patients with CLI referred for unilateral extremity endovascular arterial recanalization were enrolled in this study. CT examinations obtained 1-3 days before the procedure and then within 1 week after the treatment were evaluated at two reading sessions. Blood flow (BF), blood volume (BV), and time to peak (TTP) were measured on color-coded maps and compared statistically. Intraobserver agreement was assessed using intraclass correlation coefficient (ICC) and Bland-Altman analysis. RESULTS. Endovascular treatment was technically successful for all 16 patients. The posttreatment BF and BV showed a statistically significant increase in both dermal and muscle areas (p < 0.05). The posttreatment TTP shortened at a statistically significant level (p < 0.05). In the 3-month clinical follow-up period, the limb salvage rate was 81% and the percentage change in BF and BV of patients with poor response to treatment had no statistically significant increase after treatment, consistent with the clinical assessment. The percentage change in BF and BV correlated well with the improvement of the clinical condition (r = 0.673-0.901). ICC values showed excellent agreement in the range of 0.95-0.98. CONCLUSION. As a reproducible method, dynamic volume perfusion CT of the foot may enable quantitative evaluation of the perfusion of soft tissues and also provide a novel approach to assessing response to endovascular recanalization in CLI.
Collapse
|
11
|
Ravindra VM, Kralik SF, Griauzde J, Gadgil N, LoPresti MA, Lam S. Preoperative computed tomography perfusion in pediatric moyamoya disease: a single-institution experience. J Neurosurg Pediatr 2020; 25:1-8. [PMID: 31978885 DOI: 10.3171/2019.10.peds19450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 10/25/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Moyamoya disease is a progressive occlusive arteriopathy for which surgical revascularization is indicated. In this retrospective study, the authors investigated the use of preoperative CT perfusion with the aim of establishing pathological data references. METHODS The authors reviewed the medical records of children with moyamoya disease treated surgically at one institution between 2016 and 2019. Preoperative CT perfusion studies were used to quantify mean transit time (MTT), cerebral blood volume (CBV), cerebral blood flow (CBF), and time to peak (TTP) for the anterior, middle, and posterior cerebral artery vascular territories for each patient. CT perfusion parameter ratios (diseased/healthy hemispheres) and absolute differences were compared between diseased and normal vascular territories (defined by catheter angiography studies). Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values for CT perfusion parameters for severe angiographic moyamoya were calculated. RESULTS Nine children (89% female) had preoperative CT perfusion data; 5 of them had evidence of unilateral hemispheric disease and 4 had bilateral disease. The mean age at revascularization was 77 months (range 40-144 months). The etiology of disease was neurofibromatosis type 1 (3 patients), Down syndrome (2), primary moyamoya disease (2), cerebral proliferative angiopathy (1), and sickle cell disease (1). Five patients had undergone unilateral revascularization. Among these patients, pathological vascular territories demonstrated increased MTT in 66% of samples, increased TTP in 66%, decreased CBF in 47%, and increased CBV in 87%. Severe moyamoya (Suzuki stage ≥ 4) had diseased/healthy ratios ≥ 1 for MTT in 78% of cases, for TTP in 89%, for CBF in 67%, and for CBV in 89%. The MTT and TTP region of interest ratio ≥ 1 demonstrated 89% sensitivity, 67% specificity, 80% PPV, and 80% NPV for the prediction of severe angiographic moyamoya disease. CONCLUSIONS Pathological hemispheres in these children with moyamoya disease demonstrated increased MTT, TTP, and CBV and decreased CBF. The authors' results suggest that preoperative CT perfusion may, with high sensitivity, be useful in deciphering perfusion mismatch in brain tissue in children with moyamoya disease. More severe angiographic disease displays a more distinct correlation, allowing surgeons to recognize when to intervene in these patients.
Collapse
Affiliation(s)
| | - Stephen F Kralik
- 2Department of Pediatric Radiology, Baylor College of Medicine, Houston, Texas
| | - Julius Griauzde
- 3Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | | | | | - Sandi Lam
- 4Department of Neurosurgery, Northwestern University Feinberg School of Medicine; and
- 5Division of Pediatric Neurosurgery, Ann and Robert H Lurie Children's Hospital, Chicago, Illinois
| |
Collapse
|
12
|
Jalalvand A, Anbarian M. Effect of Lower Limb Muscle Fatigue on Ground Reaction Force Components During Landing in People With Nonspecific Chronic Low Back Pain. J Sport Rehabil 2019; 28:847-53. [PMID: 30222491 DOI: 10.1123/jsr.2018-0153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/09/2018] [Accepted: 08/10/2018] [Indexed: 11/18/2022]
Abstract
CONTEXT The link between landing parameters and lower limb muscle fatigue in association with chronic low back pain (CLBP) is not well understood. OBJECTIVE To examine the effects of fatigue on the ground reaction force components during landing in people with nonspecific CLBP. DESIGN Quasi-experimental study. SETTING Clinical biomechanics laboratory. PARTICIPANTS A total of 44 subjects were equally divided into a healthy group and a group with CLBP. MAIN OUTCOME MEASURES The ground reaction force along anterior-posterior (y) and medial-lateral (x) and vertical (z) axes, time to peak (TTP), the rate of force development, and impulses for all axes were calculated. A repeated-measures analysis of variance (group × fatigue) was used to compare the data among groups. RESULTS In the unfatigued conditions, the amplitudes of Fy3, Fz2, and TTP of Fy1, Fy2, Fz1, Fz2, Fz3, Fz4, rate of force development in Y in the CLBP subjects are significantly different than those in the healthy subjects (P < .05). In the fatigued conditions, the amplitudes of Fz2, Fz3, Fz4, and TTP of Fy2, Fy3, Fy4, Fz2, impulses of X2, Z in the CLBP group were significantly different than those in the healthy subjects (P < .05). Within-group comparisons of measured Fx1, Fy1, Fy2, Fz2, Fz4 and TTP of Fx1, Fy1, Fy2, Fz2, Fz3, Fz4, impulses of X2, z were significantly different from prefatigue to postfatigue in the healthy group (P < .05). Within-group comparisons of measured Fx1, Fy1, Fz1, Fz2 and TTP of Fx5, Fz1, impulses of X2 were significantly differed from prefatigue to postfatigue in the CLBP group (P < .05). CONCLUSIONS It seems that TTP of ground reaction force variables in CLBP may have clinical values for rehabilitation. Muscle fatigue altered landing performance. However, patients with CLBP will respond differently to lower-extremity fatigue. These altered variables in patients with low back pain are the cause of future injuries or lower-extremity injuries that need to be addressed in further studies.
Collapse
|
13
|
Szarmach A, Kaszubowski M, Sabisz A, Frydrychowski AF, Halena G, Piskunowicz M, Dzierzanowski J, Studniarek M, Szurowska E, Winklewski PJ. Regional resting state perfusion variability and delayed cerebrovascular uniform reactivity in subjects with chronic carotid artery stenosis. Acta Biochim Pol 2018. [PMID: 29529102 DOI: 10.18388/abp.2018_2581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The aim of this study was to assess regional perfusion at baseline and regional cerebrovascular resistance (CVR) to delayed acetazolamide challenge in subjects with chronic carotid artery stenosis. Sixteen patients (ten males) aged 70.94±7.71 with carotid artery stenosis ≥ 90% on the ipsilateral side and ≤ 50% on the contralateral side were enrolled into the study. In all patients, two computed tomography perfusion examinations were carried out; the first was performed before acetazolamide administration and the second 60 minutes after injection. The differences between mean values were examined by paired two-sample t-test and alternative nonparametric Wilcoxon's test. Normality assumption was examined using W Shapiro-Wilk test. The lowest resting-state cerebral blood flow (CBF) was observed in white matter (ipsilateral side: 18.4±6.2; contralateral side: 19.3±6.6) and brainstem (ipsilateral side: 27.8±8.5; contralateral side: 29.1±10.8). Grey matter (cerebral cortex) resting state CBF was below the normal value for subjects of this age: frontal lobe - ipsilateral side: 30.4±7.0, contralateral side: 33.7±7.1; parietal lobe - ipsilateral side: 36.4±11.3, contralateral side: 42.7±9.9; temporal lobe - ipsilateral side: 32.5±8.6, contralateral side: 39.4±10.8; occipital lobe - ipsilateral side: 24.0±6.0, contralateral side: 26.4±6.6). The highest resting state CBF was observed in the insula (ipsilateral side: 49.2±17.4; contralateral side: 55.3±18.4). A relatively high resting state CBF was also recorded in the thalamus (ipsilateral side: 39.7±16.9; contralateral side: 41.7±14.1) and cerebellum (ipsilateral side: 41.4±12.2; contralateral side: 38.1±11.3). The highest CVR was observed in temporal lobe cortex (ipsilateral side: +27.1%; contralateral side: +26.1%) and cerebellum (ipsilateral side: +27.0%; contralateral side: +34.6%). The lowest CVR was recorded in brain stem (ipsilateral side: +20.2%; contralateral side: +22.2%) and white matter (ipsilateral side: +18.1%; contralateral side: +18.3%). All CBF values were provided in milliliters of blood per minute per 100 g of brain tissue (ml/100g/min). Resting state circulation in subjects with carotid artery stenosis is low in all analysed structures with the exception of insula and cerebellum. Acetazolamide challenge yields relatively uniform response in both hemispheres in the investigated population. Grey matter is more reactive to acetazolamide challenge than white matter or brainstem.
Collapse
Affiliation(s)
- Arkadiusz Szarmach
- 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | - Mariusz Kaszubowski
- Department of Economic Sciences, Faculty of Management and Economics, Gdansk University of Technology, Gdańsk, Poland
| | - Agnieszka Sabisz
- 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | | | - Grzegorz Halena
- Department of Cardiovascular Surgery, Medical University of Gdansk, Gdańsk, Poland
| | - Maciej Piskunowicz
- 1-st Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | | | - Michał Studniarek
- 1-st Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
- Department of Diagnostic Imaging, Medical University of Warsaw, Warsaw, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
| | - Pawel J Winklewski
- 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
- Department of Human Physiology, Medical University of Gdansk, Gdańsk, Poland
- Faculty of Health Sciences, Pomeranian University of Slupsk, Słupsk, Poland
| |
Collapse
|
14
|
Szarmach A, Halena G, Kaszubowski M, Piskunowicz M, Studniarek M, Lass P, Szurowska E, Winklewski PJ. Carotid Artery Stenting and Blood-Brain Barrier Permeability in Subjects with Chronic Carotid Artery Stenosis. Int J Mol Sci 2017; 18:ijms18051008. [PMID: 28481312 PMCID: PMC5454921 DOI: 10.3390/ijms18051008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/23/2017] [Accepted: 05/03/2017] [Indexed: 01/28/2023] Open
Abstract
Failure of the blood-brain barrier (BBB) is a critical event in the development and progression of diseases such as acute ischemic stroke, chronic ischemia or small vessels disease that affect the central nervous system. It is not known whether BBB breakdown in subjects with chronic carotid artery stenosis can be restrained with postoperative recovery of cerebral perfusion. The aim of the study was to assess the short-term effect of internal carotid artery stenting on basic perfusion parameters and permeability surface area-product (PS) in such a population. Forty subjects (23 males) with stenosis of >70% within a single internal carotid artery and neurological symptoms who underwent a carotid artery stenting procedure were investigated. Differences in the following computed tomography perfusion (CTP) parameters were compared before and after surgery: global cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP) and PS. PS acquired by CTP is used to measure the permeability of the BBB to contrast material. In all baseline cases, the CBF and CBV values were low, while MTT and TTP were high on both the ipsi- and contralateral sides compared to reference values. PS was approximately twice the normal value. CBF was higher (+6.14%), while MTT was lower (−9.34%) on the contralateral than on the ipsilateral side. All perfusion parameters improved after stenting on both the ipsilateral (CBF +22.66%; CBV +18.98%; MTT −16.09%, TTP −7.62%) and contralateral (CBF +22.27%, CBV +19.72%, MTT −14.65%, TTP −7.46%) sides. PS decreased by almost half: ipsilateral −48.11%, contralateral −45.19%. The decline in BBB permeability was symmetrical on the ipsi- and contralateral sides to the stenosis. Augmented BBB permeability can be controlled by surgical intervention in humans.
Collapse
Affiliation(s)
- Arkadiusz Szarmach
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk 80-210, Poland.
| | - Grzegorz Halena
- Department of Cardiovascular Surgery, Medical University of Gdansk, Gdansk 80-210, Poland.
| | - Mariusz Kaszubowski
- Department of Economic Sciences, Faculty of Management and Economics, Gdansk University of Technology, Gdansk 80-210, Poland.
| | - Maciej Piskunowicz
- 1st Department of Radiology, Medical University of Gdansk, Gdansk 80-210, Poland.
| | - Michal Studniarek
- 1st Department of Radiology, Medical University of Gdansk, Gdansk 80-210, Poland.
- Department of Diagnostic Imaging, Medical University of Warsaw, Warsaw 03-242, Poland.
| | - Piotr Lass
- Department of Nuclear Medicine, Medical University of Gdansk, Gdansk 80-210, Poland.
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdansk, Gdansk 80-210, Poland.
| | - Pawel J Winklewski
- Institute of Human Physiology, Medical University of Gdansk, Gdansk 80-210, Poland.
- Department of Clinical Sciences, Institute of Health Sciences, Pomeranian University of Slupsk, Slupsk 76-200, Poland.
| |
Collapse
|
15
|
Ma L, Li Y, Wu Z, Mu Y. Relationship between R-R interval and left ventricular systolic synchrony in subjects with coronary artery disease determined using angiography. Am J Cardiovasc Dis 2016; 6:175-184. [PMID: 28078178 PMCID: PMC5218850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 11/24/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to assess the relationship between R-R interval and left ventricular systolic synchrony in subjects with coronary artery disease determined using angiography. A total of 277 subjects who underwent coronary angiography for suspected CAD were recruited in this study. For all subjects, the R-R interval was quantified using simultaneous ECG, and the times to peak systolic longitudinal strain (Tssl) on 17 LV segments were quantified using four-dimensional (4D) speckle tracking echocardiography (STE) and manually measured. The independent predictors of R-R interval using multiple linear regression analyses were the time to peak systolic longitudinal strain in the apical-septal segment (Tssl-Apical-S) (β=0.325, P=0.000), smoking status (β=0.141, P=0.013), and the time to peak systolic longitudinal strain in the basal-anterolateral segment (Tssl-Basal-AL) (β=0.151, P=0.014), which were significantly independently associated with the R-R interval. In multiple regression analyses, smoking status (OR, 1.943; 95% CI, 1.119-3.375, P=0.018), Tssl-Basal-AL (OR, 1.002; 95% CI, 1.000-1.004, P=0.043), the time to peak systolic longitudinal strain in the mid-inferoseptal segment (Tssl-Mid-IS) (OR, 1.008; 95% CI, 1.003-1.013, P=0.004), and Tssl-Apical-S (OR, 1.010; 95% CI, 1.004-1.016, P=0.002) remained independently associated with the risk of a longer R-R interval (the median 849.49 ms was set as the cutoff value) in the population. Our findings may provide the basis for future investigations of LV systolic synchrony and cardiac resynchronization therapy.
Collapse
Affiliation(s)
- Li Ma
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University Urmuqi, China
| | - Yanhong Li
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University Urmuqi, China
| | - Zhisheng Wu
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University Urmuqi, China
| | - Yuming Mu
- Department of Echocardiography, First Affiliated Hospital, Xinjiang Medical University Urmuqi, China
| |
Collapse
|
16
|
Meagher R, Shankar JJS. CT Perfusion in Acute Stroke: "Black Holes" on Time-to-Peak Image Maps Indicate Unsalvageable Brain. J Neuroimaging 2016; 26:605-611. [PMID: 27171598 DOI: 10.1111/jon.12352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 03/16/2016] [Accepted: 03/23/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND PURPOSE CT perfusion is becoming important in acute stroke imaging to determine optimal patient-management strategies. The purpose of this study was to examine the predictive value of time-to-peak image maps and, specifically, a phenomenon coined a "black hole" for assessing infarcted brain tissue at the time of scan. METHODS Acute stroke patients were screened for the presence of black holes and their follow-up imaging (noncontrast CT or MR) was reviewed to assess for infarcted brain tissue. RESULTS Of the 23 patients with signs of acute ischemia on CT perfusion, all had black holes. The black holes corresponded with areas of infarcted brain on follow-up imaging (specificity 100%). Black holes demonstrated significantly lower cerebral blood volumes (P < .001) and cerebral blood flow (P < .001) compared to immediately adjacent tissue. CONCLUSIONS Black holes on time-to-peak image maps represent areas of unsalvageable brain.
Collapse
Affiliation(s)
- Ruairi Meagher
- QEII Health Sciences Centre, Victoria General Hospital, NS, B3H 2Y9, Canada
| | - Jai Jai Shiva Shankar
- Department of Diagnostic Radiology, QEII Health Sciences Centre, NS B3H 3A7, Canada.
| |
Collapse
|
17
|
Evanoff NG, Kelly AS, Steinberger J, Dengel DR. Peak shear and peak flow mediated dilation: a time-course relationship. J Clin Ultrasound 2016; 44:182-187. [PMID: 26689837 PMCID: PMC5884966 DOI: 10.1002/jcu.22324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 09/23/2015] [Accepted: 11/16/2015] [Indexed: 06/05/2023]
Abstract
PURPOSE To explore the temporal relationship between brachial artery peak shear stress (Shear) and flow-mediated dilation (FMD) in children and adults. METHODS Shear and brachial artery diameter were tracked following reactive hyperemia in 122 children and 350 adults using sonographic imaging. RESULTS Peak Shear, Shear area under the curve (Shear(AUC)), and Peak FMD were significantly larger in children than in adults. The time to peak Shear (Shear(TTP)) and time to peak FMD (FMD(TTP)) were significantly lower in children, while there was no significant difference in time from Shear(TTP) to FMD(TTP) between children and adults. CONCLUSIONS Children have a lower shear stimulus and FMD response than adults, but the time interval separating these events is similar. These differences could be due to changes in vascular dynamics with age, including reduced smooth muscle cell responsiveness and other factors. Despite differences in timing, the interval from peak Shear to peak FMD was similar in children and adults.
Collapse
Affiliation(s)
- Nicholas G. Evanoff
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, 55455
| | - Aaron S. Kelly
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, 55455
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, 55455
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, 55455
| | - Donald R. Dengel
- Laboratory of Integrative Human Physiology, School of Kinesiology, University of Minnesota, Minneapolis, Minnesota, 55455
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota, 55455
| |
Collapse
|
18
|
Cheng XQ, Tian JM, Zuo CJ, Zhang LJ, Zhou CS, Zhao YE, Luo S, Zhang Q, Lu GM. Hemodynamic alterations in unilateral chronic middle cerebral artery stenosis patients and the effect of percutaneous transluminal angioplasty and stenting: a perfusion-computed tomography study. Acta Radiol 2015; 56:754-60. [PMID: 25009278 DOI: 10.1177/0284185114538793] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 05/13/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND The Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial indicated that most patients with symptomatic intracranial atherosclerosis are not good candidates for percutaneous transluminal angioplasty and stenting (PTAS) because of a higher complication risk than with conservative treatment. However, enrollment of SAMMPRIS patients was based on lesion severity only, without functional imaging. PURPOSE To determine whether perfusion computed tomography (PCT) can effectively evaluate hemodynamic compromise in unilateral chronic middle cerebral artery stenosis and the alterations of hemodynamics after PTAS. MATERIAL AND METHODS In this prospective study, 89 patients with unilateral middle cerebral artery (MCA) stenosis/occlusion were enrolled and classified into four groups according to the degree of stenosis. Cerebral hemodynamics was evaluated by measuring cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) in the ipsilateral and contralateral hemispheres by PCT before and after intervention with PTAS. Differences in hemodynamic parameters before and after intervention were analyzed. RESULTS Three different hemodynamic patterns were observed in these patients. Patients with severe MCA stenosis (70-99%) or MCA occlusion demonstrated a significant increase of ipsilateral CBV and TTP, indicating hemodynamic compromise. Ten severe stenosis patients with recurrent ischemic symptoms despite of maximal conservative therapy were selected for PTAS. PTAS induced a rapid recovery of cerebral hemodynamics (especially TTP) at 1 week post intervention. CONCLUSION PCT appears to be a valuable noninvasive technique to evaluate hemodynamic compromise in unilateral chronic MCA stenosis and the improvements after PTAS.
Collapse
Affiliation(s)
- Xiao Qing Cheng
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu Province, PR China
| | - Jian Ming Tian
- Department of Medical Imaging, Changhai Hospital, The 2nd Military Medical University, Shanghai, PR China
| | - Chang Jing Zuo
- Department of Nuclear Medicine, Changhai Hospital, The 2nd Military Medical University, Shanghai, PR China
| | - Long Jiang Zhang
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu Province, PR China
| | - Chang Sheng Zhou
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu Province, PR China
| | - Yan E Zhao
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu Province, PR China
| | - Song Luo
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu Province, PR China
| | - Qi Zhang
- Department of Neurosurgery, Changhai Hospital, The 2nd Military Medical University, Shanghai, PR China
| | - Guang Ming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, Jiangsu Province, PR China
| |
Collapse
|
19
|
Peng SL, Wang FN, Wang CH, Peng HH, Lu CT, Yeh CK. Using microbubbles as an MRI contrast agent for the measurement of cerebral blood volume. NMR Biomed 2013; 26:1540-1546. [PMID: 23794141 DOI: 10.1002/nbm.2988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 05/17/2013] [Accepted: 05/17/2013] [Indexed: 06/02/2023]
Abstract
The susceptibility differences at the gas-liquid interface of microbubbles (MBs) allow their use as an intravascular susceptibility contrast agent for in vivo MRI. However, the characteristics of MBs are very different from those of the standard gadolinium-diethylenetriaminepentaacetic acid (Gd-DPTA) contrast agent, including the size distribution and hemodynamic properties, which could influence MRI outcomes. Here, we investigate quantitatively the correlation between the relative cerebral blood volume (rCBV) derived from Gd-DTPA (rCBV(Gd)) and the MB-induced susceptibility effect (ΔR(2*MB)) by conventional dynamic susceptibility contrast MRI (DSC-MRI). Custom-made MBs had a mean diameter of 0.92 µm and were capable of inducing 4.68 ± 3.02% of the maximum signal change (MSC). The MB-associated ΔR(2*MB) was compared with rCBV(Gd) in 16 rats on 4.7-T MRI. We observed a significant effect of the time to peak (TTP) on the correlation between ΔR(2*MB) and rCBV(Gd), and also found a noticeable dependence between TTP and MSC. Our findings suggest that MBs with longer TTPs can be used for the estimation of rCBV by DSC-MRI, and emphasize the critical effect of TTP on MB-based contrast MRI.
Collapse
Affiliation(s)
- Shin-Lei Peng
- Department of Biomedical Engineering and Environmental Sciences, National Tsing Hua University, Hsinchu, Taiwan
| | | | | | | | | | | |
Collapse
|
20
|
Galldiks N, Stoffels G, Ruge MI, Rapp M, Sabel M, Reifenberger G, Erdem Z, Shah NJ, Fink GR, Coenen HH, Langen KJ. Role of O-(2-18F-fluoroethyl)-L-tyrosine PET as a diagnostic tool for detection of malignant progression in patients with low-grade glioma. J Nucl Med 2013; 54:2046-54. [PMID: 24159047 DOI: 10.2967/jnumed.113.123836] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
UNLABELLED In patients with low-grade glioma (LGG) of World Health Organization (WHO) grade II, early detection of progression to WHO grade III or IV is of high clinical importance because the initiation of a specific treatment depends mainly on the WHO grade. In a significant number of patients with LGG, however, information on tumor activity and malignant progression cannot be obtained on the basis of clinical or conventional MR imaging findings only. We here investigated the potential of O-(2-(18)F-fluoroethyl)-L-tyrosine ((18)F-FET) PET to noninvasively detect malignant progression in patients with LGG. METHODS Twenty-seven patients (mean age ± SD, 44 ± 15 y) with histologically proven LGG (WHO grade II) were investigated longitudinally twice using dynamic (18)F-FET PET and routine MR imaging. Initially, MR imaging and PET scans were performed, and diagnosis was confirmed on the basis of biopsy. Subsequently, PET scans were obtained when clinical findings or contrast-enhanced MR imaging suggested malignant progression. Maximum and mean tumor-to-brain ratios (20-40 min after injection) (TBRmax and TBRmean, respectively) of (18)F-FET uptake as well as tracer uptake kinetics (i.e., time to peak [TTP] and patterns of the time-activity curves) were determined. The diagnostic accuracy of imaging parameters for the detection of malignant progression was evaluated by receiver-operating-characteristic analyses and by Fisher exact test for 2 × 2 contingency tables. RESULTS In patients with histologically proven malignant progression toward WHO grade III or IV (n = 18), TBRmax and TBRmean increased significantly, compared with baseline (TBRmax, 3.8 ± 1.0 vs. 2.4 ± 1.0; TBRmean, 2.2 ± 0.3 vs. 1.6 ± 0.6; both P < 0.001), whereas TTP decreased significantly (median TTP, 35 vs. 23 min; P < 0.001). Furthermore, time-activity curve patterns changed significantly in 10 of 18 patients (P < 0.001). The combined analysis of (18)F-FET PET parameters (i.e., changes of TBRmax, TTP, or time-activity curve pattern) yielded a significantly higher diagnostic accuracy for the detection of malignant progression than changes of contrast enhancement in MR imaging (accuracy, 81% vs. 63%; P = 0.003). CONCLUSION Both tumor-to-brain ratio and kinetic parameters of (18)F-FET PET uptake provide valuable diagnostic information for the noninvasive detection of malignant progression of LGG. Thus, repeated (18)F-FET PET may be helpful for further treatment decisions.
Collapse
Affiliation(s)
- Norbert Galldiks
- Institute of Neuroscience and Medicine (INM-3,-4,-5), Forschungszentrum Jülich, Jülich, Germany
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Kheradmand A, Fisher M, Paydarfar D. Ischemic stroke in evolution: predictive value of perfusion computed tomography. J Stroke Cerebrovasc Dis 2013; 23:836-43. [PMID: 23954606 DOI: 10.1016/j.jstrokecerebrovasdis.2013.07.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 07/07/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Various perfusion computed tomography (PCT) parameters have been used to identify tissue at risk of infarction in the setting of acute stroke. The purpose of this study was to examine predictive value of the PCT parameters commonly used in clinical practice to define ischemic penumbra. The patient selection criterion aimed to exclude the effect of thrombolysis from the imaging data. METHODS Consecutive acute stroke patients were screened and a total of 18 patients who initially underwent PCT and CT angiogram (CTA) on presentation but did not qualify to receive thrombolytic therapy were selected. The PCT images were postprocessed using a delay-sensitive deconvolution algorithm. All the patients had follow-up noncontrast CT or magnetic resonance imaging to delineate the extent of their infarction. The extent of lesions on PCT maps calculated from mean transit time (MTT), time to peak (TTP), cerebral blood flow, and cerebral blood volume were compared and correlated with the final infarct size. A collateral grading score was used to measure collateral blood supply on the CTA studies. RESULTS The average size of MTT lesions was larger than infarct lesions (P < .05). The correlation coefficient of TTP/infarct lesions (r = .95) was better than MTT/infarct lesions (r = .66) (P = .004). CONCLUSIONS A widely accepted threshold to define MTT lesions overestimates the ischemic penumbra. In this setting, TTP with appropriate threshold is a better predictor of infarct in acute stroke patients. The MTT/TTP mismatch correlates with the status of collateral blood supply to the tissue at risk of infarction.
Collapse
Affiliation(s)
- Amir Kheradmand
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
| | - Marc Fisher
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - David Paydarfar
- Department of Neurology, University of Massachusetts Medical School, Worcester, Massachusetts
| |
Collapse
|
22
|
Woodle SA, Shibeko AM, Lee TK, Ovanesov MV. Determining the impact of instrument variation and automated software algorithms on the TGT in hemophilia and normalized plasma. Thromb Res 2013; 132:374-80. [PMID: 23953593 DOI: 10.1016/j.thromres.2013.07.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 07/07/2013] [Accepted: 07/23/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Despite increasing recognition as a more precise test of in vivo hemostatic conditions, standardization of the thrombin generation test (TGT) continues to hinder its development as routine clinical practice. Prior efforts largely focused on comparing the effects of experimental conditions and different reagents. Commercialized kits, instruments and software have been introduced to calculate the TG curve and its parameters. However, modified versions of the TGT continue to be used worldwide on a variety of microplate reader instruments and processed using individualized algorithms. No prior study has compared the effect of instrument choice and its inherent noise profile on the processing of the TG curve and its common endpoint parameters. MATERIALS AND METHODS Hemophilia A plasma supplemented with buffer or Factor VIII, mimicking hemophilic or normalized samples respectively, was monitored for thrombin generation after activation with TF on six different fluorescent microplate readers. Each instrument was optimized for TGT signal recording prior to testing. An automated software package containing various mathematical algorithms was utilized to compute the TG curves and parameters, and compare different TG processing approaches. RESULTS Instruments produced unique noise profiles and end-point parameters that were incomparable in absolute signal terms. Similar relative hemophilic responses were obtained across various instruments when the normalized plasma sample was used as an internal standard. Smoothing algorithms corrected destructive instrument noise. CONCLUSIONS Instrument-induced errors from numerical differentiation during TG curve processing cannot be eliminated by external calibrators, and require careful qualification of the instrument and implementation of noise-reducing software algorithms.
Collapse
Affiliation(s)
- S A Woodle
- Office of Blood Research and Review, Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, Bethesda, MD, USA
| | | | | | | |
Collapse
|
23
|
Promjunyakul NO, Schmit BD, Schindler-Ivens S. Changes in hemodynamic responses in chronic stroke survivors do not affect fMRI signal detection in a block experimental design. Magn Reson Imaging 2013; 31:1119-28. [PMID: 23642802 DOI: 10.1016/j.mri.2013.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/22/2013] [Accepted: 02/20/2013] [Indexed: 10/26/2022]
Abstract
The use of canonical functions to model BOLD-fMRI data in people post-stroke may lead to inaccurate descriptions of task-related brain activity. The purpose of this study was to determine whether the spatiotemporal profile of hemodynamic responses (HDRs) obtained from stroke survivors during an event-related experiment could be used to develop individualized HDR functions that would enhance BOLD-fMRI signal detection in block experiments. Our long term goal was to use this information to develop individualized HDR functions for stroke survivors that could be used to analyze brain activity associated with locomotor-like movements. We also aimed to examine the reproducibility of HDRs obtained across two scan sessions in order to determine whether data from a single event-related session could be used to analyze block data obtained in subsequent sessions. Results indicate that the spatiotemporal profile of HDRs measured with BOLD-fMRI in stroke survivors was not the same as that observed in individuals without stroke. We observed small between-group differences in the rates of rise and decline of HDRs that were more apparent in individuals with cortical as compared to subcortical stroke. There were no differences in the peak or time to peak of HDRs in people with and without stroke. Of interest, differences in HDRs were not as substantial as expected from previous reports and were not large enough to necessitate the use of individualized HDR functions to obtain valid measures of movement-related brain activity. We conclude that all strokes do not affect the spatiotemporal characteristics of HDRs in such a way as to produce inaccurate representations of brain activity as measured by BOLD-fMRI. However, care should be taken to identify individuals whose BOLD-fMRI data may not provide an accurate representation of underlying brain activation when canonical models are used. Examination of HDRs need not be done for each scan session, as our data suggest that the characteristics of HDRs in stroke survivors are reproducible across days.
Collapse
Affiliation(s)
- Nutta-On Promjunyakul
- Department of Physical Therapy, Marquette University, P.O. Box 1881, Milwaukee, WI 53201-1881, USA.
| | | | | |
Collapse
|
24
|
Qu H, Li J, Zhao X, Dong K. Factors affecting pre- and post-stenting computed tomography perfusion in patients with middle cerebral artery stenosis. Exp Ther Med 2012; 5:471-474. [PMID: 23404087 PMCID: PMC3570112 DOI: 10.3892/etm.2012.805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 10/22/2012] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to investigate the factors affecting pre- and post-stenting head computed tomography perfusion (CTP) in patients with middle cerebral artery stenosis. A total of 25 patients with severe middle cerebral artery stenosis were enrolled. CTP was performed prior to and following stenting. Scores were allocated to the time-to-peak (TTP) parameter of CTP using the Alberta stroke program early computed tomography scoring (ASPECTS) scale. The factors possibly affecting pre- and post-stenting CTP were analyzed. All the patients exhibited markedly prolonged TTP on the affected side prior to stenting, compared with the healthy side. Following surgery, the TTP was improved in all patients. The preoperative ASPECTS score was negatively correlated with the degree of middle cerebral artery stenosis with a correlation coefficient of −5.78. The preoperative vascular stenosis rate was positively correlated with the improvement degree of the ASPECTS score with a correlation coefficient of 1.137 (P=0.001). TTP is a sensitive parameter for evaluating the effect of stenting on middle cerebral artery stenosis. TTP prior to and following stenting may be quantitatively assessed using the ASPECTS scale. Patients with serious stenosis and/or good collateral circulation are able to benefit more from stenting.
Collapse
Affiliation(s)
- Hui Qu
- Department of Neurology, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing 100050, P.R. China
| | | | | | | |
Collapse
|