2.Multidisciplinary classification of magnetic resonance imaging features of neuropsychiatric lupus.
Jun Ying CHANG ; Mei ZHENG ; Ying LIU ; Rui LIU ; Jing Feng ZHANG ; Xiao Li DENG
Journal of Peking University(Health Sciences) 2018;50(6):1009-1013
OBJECTIVE:
To investigate the clinical correlation between the manifestations of neuropsychiatric lupus (NPSLE) and brain magnetic resonance imaging (MRI).
METHODS:
Retrospective analysis of 65 neuropsychiatric lupus patients with brain MRI and clinical data from Peking University Third Hospital from January 2006 to October 2016, which was classified by rheumatologist, neurologists, and radiologists based on their brain MRI findings. The correlation between brain MRI findings and clinical manifestations was analyzed.
RESULTS:
The characteristics of the brain MRI of the 65 patients were divided into 6 categories: 16 cases (25%) with demyelination in the white matter, 15 cases (23%) with cerebrovascular disease, including 4 cases (6%) with large vascular disease and 11 cases (17%) with small vessel disease, 4 cases (6%) with inflammation, 4 cases (6%) with edema, 13 cases (20%) with multiple manifestation coexistence, and 13 cases (20%) without any abnormality. Except for 4 cases of brain MRI with edema, the clinical manifestations were only epileptic seizures, other patients had complex and diverse clinical manifestations, including epileptic seizures, lupus-like headaches, mental symptoms, blurred vision, peripheral neuropathy and disturbance of consciousness. The incidence of epileptic seizures in patients with edema of MRI is significantly higher than that of other patients, and the therapeutic response time is the shortest.
CONCLUSION
Multidisciplinary collaboration divides the MRI findings of neuropsychiatric lupus patients into six categories. This classification method helps clinicians to predict and intervene early possible neuropsychiatric symptoms to guide clinical treatment.
Brain/diagnostic imaging*
;
Cerebrovascular Disorders/diagnostic imaging*
;
Humans
;
Lupus Vasculitis, Central Nervous System/diagnostic imaging*
;
Magnetic Resonance Imaging
;
Retrospective Studies
3.Limb-shaking transient ischemic attack with distal micro-embolic signals and impaired cerebrovascular reactivity using transcranial Doppler.
Deidre Anne De SILVA ; Moi-Pin LEE ; Meng-Cheong WONG ; Hui-Meng CHANG ; Christopher L H CHEN
Annals of the Academy of Medicine, Singapore 2008;37(7):619-620
Carotid Artery, Internal
;
diagnostic imaging
;
Cerebrovascular Disorders
;
diagnostic imaging
;
physiopathology
;
Extremities
;
physiopathology
;
Humans
;
Ischemic Attack, Transient
;
complications
;
diagnostic imaging
;
drug therapy
;
Male
;
Middle Aged
;
Middle Cerebral Artery
;
diagnostic imaging
;
Thromboembolism
;
diagnostic imaging
;
physiopathology
;
Ultrasonography, Doppler, Transcranial
4.Clinical screening of patients with cerebral arteriosclerosis combined with vertebral artery abnormalies.
Ju-Kun CHEN ; Hong-Lin TENG ; Lei CHEN ; Jing WANG ; Qiang YE ; Xiao-Bo WANG
China Journal of Orthopaedics and Traumatology 2012;25(3):212-215
OBJECTIVETo explore the clinical screening and value of vertebral artery ultrasound, Transcranial doppler (TCD), Magnetic resonance angiography (MRA) and Computed tomography angiography (CTA) in the diagnosis of cerebral arteriosclerosis combined with vertebral artery abnormalies according to vertebral artery digital subtraction angiography (DSA).
METHODSFrom January 2006 to September 2010, 186 patients with cerebral arteriosclerosis were retrospectively analyzed. Among the patients, 133 cases were males and 53 cases were females,ranged from 30 to 84 years (with a mean of 63.8 years). All the patients were estimated by DSA; 172 cases were estimated vertebral artery ultrasound and TCD; 53 cases were estimated by MRA; 25 cases were estimated by CTA. The positive results by DSA were seen as case group, while the negative results were seen as control group. The sensitivity, specificity and concordance rate among four groups were calculated.
RESULTSThe abnormality rate of vertebral artery with DSA, vertebral artery ultrasound, TCD, MRA and CTA separately was 50.00% (93/186), 30.81% (53/172), 49.42% (85/172),15.10% (8/53) and 40.00% (10/25). According to DSA standard, the sensitivity of vertebral artery ultrasound in diagnosing was 50.57%, the specificity was 89.41%, and concordance rate was 69.77%; while the sensitivity of TCD was 68.48%, the specificity was 72.50%, and concordance rate was 70.35%; the sensitivity of MRA was 21.43%, specificity was 92.00%, and concordance rate was 54.72%; the sensitivity of CTA was 63.64%,the specificity was 78.57%, and concordance rate was 72.00%.
CONCLUSIONThe reasonable and combined application of vertebral artery ultrasound, TCD, MRA and CTA is helpful for diagnosing cerebral arteriosclerosis combined with vertebral artery abnormalies. For the patients with cerebrovascular disease, cervical massage technique should be paid highly attention, which may cause vertebral artery injury and other complications.
Adult ; Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; Arteriosclerosis ; diagnosis ; Cerebral Arteries ; diagnostic imaging ; Cerebrovascular Disorders ; diagnosis ; diagnostic imaging ; Female ; Humans ; Intracranial Arteriosclerosis ; diagnosis ; diagnostic imaging ; Male ; Middle Aged ; Ultrasonography ; Vertebral Artery ; abnormalities ; diagnostic imaging
5.Correlative study of carotid transient ischemic attacks and intracranial or extracranial angiostenosis.
Yi YUAN ; Shen-mao LI ; Feng-shui ZHU ; Xing-long ZHI ; Xun-min JI
Journal of Central South University(Medical Sciences) 2008;33(8):751-754
OBJECTIVE:
To investigate the relationship between the clinical features of carotid transient ischemic attacks (TIA) and the intracranial or extracranial angiostenosis.
METHODS:
Location and degree of stenosis of involved arteries were examined by the digital subtraction angiography in 52 patients with carotid TIA.
RESULTS:
Intracranial or extracranial vascular lesions of different degrees were revealed in 45 patients (86.5%), and 29 out of 45 (64.4%) had more than one site. Severe stenosis and occlusion occurred more frequently in TIA patients with short duration (less than 1 hour) and multiple attacks (more than twice).
CONCLUSION
Most patients with TIA of carotid systems have stenosis in intracranial or extracranial arteries. TIA with short duration and multiple attacks always accompany with severe stenosis or occlusion in intracranial or extracranial arteries. Digital subtraction angiography helps to identify the vascular etiology of TIA and provides the instruction of therapeutic regimen.
Adult
;
Aged
;
Angiography, Digital Subtraction
;
Carotid Stenosis
;
complications
;
diagnostic imaging
;
pathology
;
Cerebral Angiography
;
Cerebrovascular Disorders
;
complications
;
diagnostic imaging
;
pathology
;
Female
;
Humans
;
Ischemic Attack, Transient
;
diagnostic imaging
;
pathology
;
Male
;
Middle Aged
6.The application of cerebral angiography in the forensic postmortem examination.
Tong-Li XU ; Xu-Fu YI ; Xiao-Gang CHEN
Journal of Forensic Medicine 2007;23(6):450-452
As a "Gold Standard" in clinical diagnosis of cerebrovascular disease, cerebral angiography also plays an important role in forensic postmortem examination. The key roles of identifying the site of cerebrovascular disease and the cause of death as well as providing guidance for autopsy and postmortem sampling and the broad future application of cerebral angiography in forensic practice are reviewed.
Autopsy
;
Cause of Death
;
Cerebral Angiography
;
Cerebrovascular Disorders/diagnostic imaging*
;
Forensic Pathology/methods*
;
Humans
;
Intracranial Hemorrhages/etiology*
;
Postmortem Changes
;
Wounds and Injuries/pathology*
7.Predictive value of CHADS2 score for cardiovascular events in patients with acute coronary syndrome and documented coronary artery disease.
In Sook KANG ; Wook Bum PYUN ; Gil Ja SHIN
The Korean Journal of Internal Medicine 2016;31(1):73-81
BACKGROUND/AIMS: The CHADS2 score, used to predict the risk of ischemic stroke in atrial fibrillation (AF) patients, has been reported recently to predict ischemic stroke in patients with coronary heart disease, regardless of the presence of AF. However, little data are available regarding the relationship between the CHADS2 score and cardiovascular outcomes. METHODS: This was a retrospective study on 104 patients admitted for acute coronary syndrome (ACS) who underwent coronary angiography, carotid ultrasound, and transthoracic echocardiography. RESULTS: The mean age of the subjects was 60.1 +/- 12.6 years. The CHADS2 score was as follows: 0 in 46 patients (44.2%), 1 in 31 (29.8%), 2 in 18 (17.3%), and > or = 3 in 9 patients (8.7%). The left atrial volume index (LAVi) showed a positive correlation with the CHADS2 score (20.8 +/- 5.9 for 0; 23.2 +/- 6.7 for 1; 26.6 +/- 10.8 for 2; and 30.3 +/- 8.3 mL/m2 for > or =3; p = 0.001). The average carotid total plaque area was significantly increased with CHADS2 scores > or = 2 (4.97 +/- 7.17 mm2 vs. 15.52 +/- 14.61 mm2; p = 0.002). Eight patients experienced cardiovascular or cerebrovascular (CCV) events during a mean evaluation period of 662 days. A CHADS2 score > or = 3 was related to an increase in the risk of CCV events (hazard ratio, 14.31; 95% confidence interval, 3.53 to 58.06). Furthermore, LAVi and the severity of coronary artery obstructive disease were also associated with an increased risk of CCV events. CONCLUSIONS: The CHADS2 score may be a useful prognostic tool for predicting CCV events in ACS patients with documented coronary artery disease.
Acute Coronary Syndrome/complications/*diagnostic imaging
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Aged
;
Carotid Arteries/*diagnostic imaging
;
Carotid Artery Diseases/complications/*diagnostic imaging
;
Cerebrovascular Disorders/diagnosis/*etiology
;
*Coronary Angiography
;
Coronary Artery Disease/complications/*diagnostic imaging
;
*Decision Support Techniques
;
*Echocardiography
;
Female
;
Humans
;
Male
;
Middle Aged
;
Plaque, Atherosclerotic
;
Predictive Value of Tests
;
Prognosis
;
Republic of Korea
;
Retrospective Studies
;
Risk Assessment
;
Risk Factors
;
Severity of Illness Index
;
Time Factors
8.Effection of observation Xinnaoxin capsules in treatment of chronic cerebral circulatory insufficiency.
Lan-qing MENG ; Rui-ya HUANG ; Ye-sheng WEI ; Shi-ge WEI ; Xue-bin LI ; Jian-min HUANG
China Journal of Chinese Materia Medica 2007;32(17):1798-1800
OBJECTIVETo observe the therapeutic effect of Xinnaoxin capsules in patients with chronic cerebral circulatory insufficiency.
METHODPatients with chronic cerebral circulatory insufficiency were divided randomly into two groups: a Xinnaoxin capsules group (n = 60, treated by Xinnaoxin capsules for four 4 weeks), a control group (n = 58, treated by Nimodiping for four weeks). The transcranial doppler (TCD) was used to determined mean velocity (Vm) and auto-viscometer measured hemorheological indices before and after being treated.
RESULTAfter 4 weeks treatment, the hemorheological indices and mean velocity were obviously improve in Xinnaoxin capsules group (P <0.05), there is significant difference between the effective rate of two groups (88.3%, 70.7%).
CONCLUSIONOur study suggest that Xinnaoxin capsules have therapeutic function on chronic cerebral circulatory insufficiency.
Blood Flow Velocity ; drug effects ; Capsules ; Cerebrovascular Circulation ; drug effects ; Cerebrovascular Disorders ; diagnostic imaging ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; therapeutic use ; Female ; Hippophae ; chemistry ; Humans ; Lycium ; chemistry ; Male ; Middle Aged ; Phytotherapy ; Plants, Medicinal ; chemistry ; Rhodiola ; chemistry ; Treatment Outcome ; Ultrasonography, Doppler, Transcranial