1.Influence of noninvasive mechanical ventilation therapy on BNP and prognosis in patients with AAMI complicated hypoxemia
Chulin WANG ; Yupeng LIN ; Qiang WU ; Xiaoying CHEN ; Mingwei XU
Chinese Journal of cardiovascular Rehabilitation Medicine 2014;23(3):300-303
Objective:To study dynamic change of brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF)and prognosis improvement in patients with acute anterior myocardial infarction (AAMI)complicated hy-poxemia after noninvasive mechanical ventilation therapy.Methods:A total of 60 patients with AAMI complicated hypoxemia,who were hospitalized in our hospital from Mar 2011 to Oct 2013,were divided into noninvasive venti-lation group (n=28)and routine treatment group (n=32)according to number table.Dynamic change of BNP, LVEF and prognosis were observed and compared between two groups.Results:After treatment,BNP level and LVEF significantly improved in both groups (P<0.05 all),compared with routine treatment group,there was more significant reduction in BNP level [24h:(263.6±23.3)μmol/L vs.(126.2±21.9)μmol/L]and significant rise in LVEF [(40.6±13.1)% vs.(47.3±14.7)%]in noninvasive ventilation group after treatment (P<0.01 both);af-ter 30d follow-up,there were significant rise in 6min walking distance (percentage of 426~550m,59.3% vs. 75.0%),LVEF [(41.1±11.7)% vs.(49.4±12.5)%]and survival rate (90.6% vs.96.4%),and significant re-duction in rehospitalization rate (12.5% vs.7.1%)in noninvasive ventilation group,P<0.01 all.Conclusion:Ear-ly noninvasive mechanical ventilation therapy can significantly improve cardiac function,exercise tolerance and short-term prognosis in patients with acute anterior myocardial infarction complicated hypoxemia.
2.A controlled study on the impacts of different scanning protocols on image quality and radiation dose in chest CT
Chulin XU ; Wentao MA ; Yongxian ZHANG ; Yunfu LIU ; Tianliang KANG ; Senlin GUO ; Yantao NIU
Chinese Journal of Radiological Medicine and Protection 2024;44(9):789-796
Objective:To explore and compare the impacts of different scanning protocols on image quality and radiation dose in chest computed tomography (CT) scans.Methods:A retrospective analysis was conducted for the data of 65 randomly selected patients who underwent chest CT scans using a tube voltage of 120 kV, the automatic modulation technique for tube current, and z-axis radiation dose modulation at the Emergency Department of our hospital from June to July 2023. The enrolled cases were divided into two groups: the high-resolution group ( n = 34) and the conventional group ( n = 31), with the settings for scanning protocols identical to those for phantom scans. For patients in both groups, thin-layer images of the cross-sections in the lung and mediastinal windows were reconstructed using thickness/intervals of 1 mm/1 mm and 2 mm/1 mm, respectively. Meanwhile, high-resolution and conventional CT scans were conducted using a Catphan500 phantom under a tube voltage of 120 kV and a tube current of 150 mAs. Of both scanning protocols, the high-resolution CT scan utilized the lung nodule-orientated scanning mode, pitch of 1.5, and a detector combination providing a collimation of 16 × 0.75 mm. In contrast, the conventional CT scan was performed using the body-orientated scanning mode, pitch of 0.813, and a detector combination providing a collimation of 16 × 1.5 mm. Then, the high-contrast resolutions of the phantom images obtained using the two scanning protocols were objectively evaluated. Both coronal chest images in the lung window and cross-sectional images in the mediastinal window were reconstructed with a thickness/interval of 5 mm/5 mm for both groups. Then, the obtained images were imported into the Radimetrics system to compare the body size-specific dose estimation (SSDE), doses to sensitive organs on the body surface, and scanning time of both groups. For the cross-sectional images in the mediastinal window, the contrast-noise-ratio (CNR), signal-to-noise ratio (SNR), and figure-of-merit (FOM) were measured and calculated at the fixed anatomical parts. For the cross-sectional images in the lung window, their quality was subjectively evaluated by two senior diagnostic radiologists. Results:The result of phantom scans indicated that high-resolution CT scans yielded images with an approximately 5% increase in the spatial resolution in the xy-plane and a nearly 20% increase in the spatial resolution along the z-axis compared to conventional CT scans. The result of clinical data demonstrated that the conventional group exhibited significantly higher doses to the thyroid and the female breast ( t = 2.8, 2.3, P < 0.05), along with notably elevated SNR, CNR, and FOM values of the right trapezius, compared to the high-resolution group ( t = 4.1, 5.8, z=4.4, P < 0.001). However, the high-resolution group manifested significantly higher SNR, CNR, and FOM values of the thoracic aorta compared to the conventional group ( t = 3.4, 4.4, z=3.4, P < 0.001). In addition, the cross-sectional and coronal images in the lung window of the clinical cases in the high-resolution group exhibited more stable quality, with subjective scores exceeding 4 and the average scores of both groups not statistically significantly different. Conclusions:For chest CT examination, high-resolution CT scans are more suitable for observations focusing on the details of the lungs and mediastinum, while conventional CT is more suitable for those centering on soft tissues on the body surface.