OBJECTIVETo reduce the acquisition time of carotid high-resolution contrast-enhanced magnetic resonance imaging (CEMRI), we designed a small field-of-view (FOV) quadruple-inversion-recovery (SF-QIR) T1WI and evaluated the image quality.

METHODSTwenty-four subjects with carotid plaque were enrolled in our study. All the subjects were imaged using the same 3.0T MRI by SF-QIR and standard rectangular FOV QIR (SrF-QIR) with identical parameters except for the phase-encoding step numbers and the RF excitation methods. Three independent readers qualitatively evaluated the differences between the two sequences in regard of the carotid outer wall border delineation, fibrous cap and lipid-rich necrotic core (LR-NC) border delineation, and diagnostic confidence. The quantitative measurements included maximal stenosis, wall area, LR-NC area, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The inter-reader variability was assessed.

RESULTSThe application of SF-QIR combined with orthogonal radio frequency excitation resulted in nearly half of the scan time with the SrF-QIR. Both qualitative and quantitative assessment by the readers revealed no significant differences between the two sequences except for SNR and CNR (Pgt;0.05). Since the mean loss of SNR with SF-QIR was 37.7%, SrF-QIR demonstrated a superior performance in SNR (P<0.001).

CONCLUSIONThe small FOV QIR sequence is effective in high-resolution CEMRI for evaluating carotid plaques and can effectively reduce the scan time and eliminate motion artifacts.

Adult ; Aged ; Aged, 80 and over ; Carotid Artery Diseases ; diagnosis ; pathology ; Female ; Humans ; Image Enhancement ; methods ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged

OBJECTIVETo explore the relationship of continuous positive airway pressure and pulmonary function in patients with obstructive sleep apnea hypopnea syndrome (OSAHS), and formulate the prediction equation for the effective therapeutic pressure.

METHODSIn a retrospective cross-sectional study of 48 patients with established OSAHS, all the patients were carefully examined for their medical history, and overnight sleep monitoring was carried out to measure the sleep apnea-hypopnea index, mean oxygen saturation, minimum oxygen saturation, and oxygen drop index. The data of manual pressure titration (effective pressure) and pulmonary function tests (tidal volume, one second forced expiratory volume, central airway resistance, and peripheral airway resistance were collected for multiple linear regression analysis.

RESULTSThe effective therapeutic pressure was not correlated with the indices of the pulmonary functions in the patients, but showed correlations with the neck circumference, abdominal circumference, apnea-hypopnea index, mean oxygen saturation, least oxygen saturation, and oxygen desaturation index. Multiple linear regression (α=0.05 test level) identified only oxygen desaturation index (P=0.012) and mean oxygen saturation (P=0.036) as the dependent variables of the effective therapeutic pressure. Linear regression analysis showed that the effective therapeutic pressure had a linear relationship with the oxygen drop index and mean oxygen saturation, and was inversely correlated with the mean oxygen saturation.

CONCLUSIONSIn patients with OSAHS, the pulmonary function indices are not correlated with the effective therapeutic pressure. In the absence of manual pressure titration, the effective therapeutic pressure can be predicted using the prediction equation: effective therapy pressure = 24.262+0.044×oxygen desaturation index -0.19×average oxygen saturation.

Adult ; Aged ; Continuous Positive Airway Pressure ; Forced Expiratory Volume ; Humans ; Middle Aged ; Polysomnography ; Respiratory Function Tests ; Retrospective Studies ; Sleep Apnea, Obstructive ; physiopathology ; therapy

OBJECTIVETo assess the value of high-resolution three-dimensional black-blood magnetic resonance imaging (3D-BB-MRI) in quantitative measurement of carotid atherosclerotic plaque by comparison with two-dimensional black-blood magnetic resonance imaging (2D-BB-MRI).

METHODSForty patients were scanned with routine 2D and oblique-sagittal 3D-BB-MRI. The original oblique-sagittal 3D images were reformatted to an axial 2D-like dataset. Two experienced radiologists identified the interested slice in consensus for every patient (unilateral carotid artery) in 2D-BB-MRI images and matched the axial reformatted 3D images with 2D black-blood images. Plaque thickness (PT), lumen area (LA) and total vessel area (TVA) were measured, and lumen stenosis (LS) and normalized wall index (NWI) were calculated.

RESULTSThere was no measurement difference between 2D-BB-MRI and reformatted 3D-BB-MRI (P>0.05), and these two methods had a good correlation (r<0.9). The Bland-Altman chart showed that 2D-BB-MRI and 3D-BB-MRI were in good agreement in the measurement of PT, LA and TVA.

CONCLUSION3D-BB-MRI and 2D-BB-MRI have no obvious difference in quantitative measurement of the carotid plaques. 3D-BB-MRI can demonstrate the vessels and plaques by multiplanar reconstruction and thus have better performance in evaluating carotid atherosclerosis compared with 2D-BB-MRI.

Adult ; Aged ; Aged, 80 and over ; Carotid Artery Diseases ; pathology ; Female ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged

OBJECTIVETo evaluate the feasibility by oblique sagittal T(1)-weighted (QIR-FSE) black-blood sequence for measurement of the carotid bifurcation angle.

METHODSTwenty-three patients undergoing carotid magnetic resonance imaging (MRI) were divided in normal group and plaque group. Carotid bifurcation angle was measured by both 2D-TOF and oblique sagittal T(1)W (QIR-FSE) black-blood sequence, and the measurement was repeated after 3 months to evaluate the reproducibility. The measurement results using 2D-TOF and oblique sagittal T(1)W (QIR-FSE) black-blood sequence were compared to assess the consistency of the two sequences. Four different angles of each carotid artery were measured from different locations on oblique sagittal T(1)W. The ratio of the bilateral carotid bifurcation angle (Right/Left) was compared.

RESULTSTen patients in each group were enrolled after excluding 3 patients. Strong correlations were found between the results of the first and the second measurements for both 2D-TOF and oblique sagittal T(1)W sequences. No significant difference was found between the two sequences in the ratio of bilateral carotid bifurcation angle (right/left), nor in the 4 angles from different locations.

CONCLUSIONOblique sagittal T(1)-weighted (QIR-FSE) black-blood sequence can be used to measure the carotid bifurcation angle.

Adult ; Aged ; Aged, 80 and over ; Carotid Arteries ; pathology ; Carotid Artery Diseases ; pathology ; Feasibility Studies ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Reproducibility of Results

Objective:To investigate the prevalence and risk factors of stroke in residents of Hanzhong community, Wuhan city, Hubei province, and develop subsequent prevention and treatment measures.Methods:A questionnaire survey, physical examination, and laboratory tests were conducted from May 1 to July 31, 2023, among a population of 801 residents aged 40 years and older in Hanzhong community, Wuhan city, Hubei province, using multi-stage whole cluster random sampling.Results:Among the 801 residents surveyed, 28 were found to have suffered from stroke, yielding a prevalence rate of 3.5%. Additionally, there were 255 individuals identified as high-risk, accounting for 31.8% of the population. The risk factors for stroke, ranked from highest to lowest in prevalence, were as follows: hypertension (24.3%), dyslipidemia (23.6%), lack of exercise (17.6%), smoking (13.1%), diabetes (12.0%), family history of stroke (9.0%), obesity or overweight (8.6%), and atrial fibrillation or valvular heart disease (3.0%). The prevalence of stroke is higher in men than in women, and it continues to increase with advancing age (χ 2 = 33.95, P < 0.001). Homocysteine is likely to contribute to the occurrence of stroke through its association with hypertension (χ2 = 42.63, P < 0.001). Additionally, homocysteine levels have emerged as another significant risk factor for stroke among individuals who are at high risk (χ2 = 5.74, P < 0.05). Conclusion:In Hanzhong community, Wuhan city, Hubei province, smoking, hypertension, overweight, and obesity are the major risk factors for stroke among residents aged 40 years and older. Homocysteinemia is closely related to these high-risk factors for stroke. Therefore, screening and prevention of elevated homocysteine levels will be one of the critical indicators for the subsequent screening and prevention of stroke.

Objective:Early death (ED) characteristics and predictive factors analysis in patients with severe/very severe aplastic anemia (SAA/VSAA) treated with intensive immunosuppression therapy and establish an ED prediction model.Methods:The clinical data of 232 patients with SAA/VSAA treated with Antithymocyte immunoglobulin (ATG) at the Peking Union Medical College Hospital from August 2003 to August 2021 were collected. The characteristics and causes of ED within 90 days were analyzed retrospectively. Cox proportional hazards model was used to screen the ED risk factors and build a prediction model.Results:Only 19 patients (8.2% ) developed ED with a median time of 24 (3-85) days among the 232 patients with SAA/VSAA who received ATG treatment. The main cause of ED was infection (84.2% ) , followed by cerebral hemorrhage (10.5% ) . Multivariate analysis showed that VSAA ( HR=15.359, 95% CI 1.935-121.899, P=0.010) , fungal infection prevention by posaconazole ( HR=0.147, 95% CI 0.019-1.133, P=0.066) , lymphocyte count (LYM) ≤ 0.5×10 9/L ( HR=3.386, 95% CI 1.123-10.206, P=0.030) , and PLT ≤ 5×10 9/L ( HR=8.939, 95% CI 1.948-41.019, P=0.005) were ED’s independent influencing factors. To build a clinical prediction model, VSAA, fungal infection prevention by posaconazole, LYM ≤ 0.5×10 9/L, and PLT ≤ 5×10 9/L were scored with 3, -2, 1, and 2, respectively. The integral model AUC=89.324 (95% CI 80.859-97.789) . The ED risk in patients with a score ≥ 3 was 23.1 (95% CI 5.3-100.2) times that in patients with a score<3. Conclusion:ED caused by infection and cerebral hemorrhage is an important challenge for SAA/VSAA to be treated with ATG. VSAA, LYM ≤ 0.5×10 9/L, and PLT ≤ 5×10 9/L patients who did not use posaconazole to prevent fungal infection had a high ED risk.