Objective:Magnetic resonance imaging (MRI) was used to perform multi-plane quantitative analysis of temporal soft tissue thickness, and the measurement data set of temporal soft tissue thickness was initially established to provide clinical reference for the diagnosis and treatment of temporal rejuvenation.Methods:High definition images of Han population in Southwest China who underwent head MRI in the First Affiliated Hospital of Chongqing Medical University from December 2016 to December 2021 were randomly collected in this study. A total of 12 measuring points were set, which were evenly distributed in the upper, middle, lower, anterior and posterior regions of the temporal, including the thickness of the whole temporal soft tissue (NA, Na, MA, Ma, GA, Ga) and the thickness of the temporal muscle (NB, Nb, MB, Mb, GB, Gb). They were divided into different groups according to sex, age (≤30 years old, 31-40 years old, 41-50 years old, 51-60 years old, >60 years old) and body mass index (BMI < 21 kg/m 2, 21-26 kg/m 2, > 26 kg/m 2). The differences of temporal soft tissue thickness under different gender, age and BMI were compared. Independent sample t-test was used for comparison of normal distribution measurement data between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:(1) A total of 278 patients were included, including 140 males and 138 females, ranging in age from 12 to 82 years, with an average age of 44.5 years, and BMI of 18.4 to 33.4 kg/m 2. According to age group: ≤30 years old, 56 cases; 31-40 years old, 64 cases; 41-50 years old, 56 cases; 51- 60 years old, 56 cases; >60 years old, 46 cases. According to BMI, males (< 21 kg/m 2, 38 cases; 21-26 kg/m 2, 56 cases; > 26 kg/m 2, 46 cases) and females(< 21 kg/m 2, 48 cases; 21-26 kg/m 2, 50 cases; >26 kg/m 2, 40 cases) were grouped. (2) Male temporal soft tissue was thicker than female, especially temporalis muscle, and the difference in 6 temporal muscle thickness measurements were statistically significant ( P<0.05). (3) In general, the temporalis muscle in males at 31-40 years old and in females at ≤30 years old tend to be thicker than that in other age groups. In both sexes, the temporalis muscle became thinner with age after reaching the peak. (4) The whole layer of soft tissue in the temporal region thickened with the increase of BMI in both sexes, and the whole layer of soft tissue in the lower temporal region was thicker than that in the middle and upper temporal region. Conclusion:Temporal soft tissue thickness is associated with gender, age and BMI. The temporal muscle thickness of both sexes was gradually thinning with age, while the whole temporal soft tissue was thickening with the increase of BMI.

Objective:Magnetic resonance imaging (MRI) was used to perform multi-plane quantitative analysis of temporal soft tissue thickness, and the measurement data set of temporal soft tissue thickness was initially established to provide clinical reference for the diagnosis and treatment of temporal rejuvenation.Methods:High definition images of Han population in Southwest China who underwent head MRI in the First Affiliated Hospital of Chongqing Medical University from December 2016 to December 2021 were randomly collected in this study. A total of 12 measuring points were set, which were evenly distributed in the upper, middle, lower, anterior and posterior regions of the temporal, including the thickness of the whole temporal soft tissue (NA, Na, MA, Ma, GA, Ga) and the thickness of the temporal muscle (NB, Nb, MB, Mb, GB, Gb). They were divided into different groups according to sex, age (≤30 years old, 31-40 years old, 41-50 years old, 51-60 years old, >60 years old) and body mass index (BMI < 21 kg/m 2, 21-26 kg/m 2, > 26 kg/m 2). The differences of temporal soft tissue thickness under different gender, age and BMI were compared. Independent sample t-test was used for comparison of normal distribution measurement data between two groups, and one-way analysis of variance was used for comparison between multiple groups. Results:(1) A total of 278 patients were included, including 140 males and 138 females, ranging in age from 12 to 82 years, with an average age of 44.5 years, and BMI of 18.4 to 33.4 kg/m 2. According to age group: ≤30 years old, 56 cases; 31-40 years old, 64 cases; 41-50 years old, 56 cases; 51- 60 years old, 56 cases; >60 years old, 46 cases. According to BMI, males (< 21 kg/m 2, 38 cases; 21-26 kg/m 2, 56 cases; > 26 kg/m 2, 46 cases) and females(< 21 kg/m 2, 48 cases; 21-26 kg/m 2, 50 cases; >26 kg/m 2, 40 cases) were grouped. (2) Male temporal soft tissue was thicker than female, especially temporalis muscle, and the difference in 6 temporal muscle thickness measurements were statistically significant ( P<0.05). (3) In general, the temporalis muscle in males at 31-40 years old and in females at ≤30 years old tend to be thicker than that in other age groups. In both sexes, the temporalis muscle became thinner with age after reaching the peak. (4) The whole layer of soft tissue in the temporal region thickened with the increase of BMI in both sexes, and the whole layer of soft tissue in the lower temporal region was thicker than that in the middle and upper temporal region. Conclusion:Temporal soft tissue thickness is associated with gender, age and BMI. The temporal muscle thickness of both sexes was gradually thinning with age, while the whole temporal soft tissue was thickening with the increase of BMI.

Objective:To investgate the effect of endovascular therapy (EVT) on the requirement for decompressive craniectomy (DC) and functional outcomes in patients with large anterior circulation ischemic stroke.Methods:Patients with large anterior circulation ischemic stroke within 24 hours of onset admitted to the Department of Neurology, West China Hospital, Sichuan University between September 2017 and December 2019 were included. Outcome indicators included DC demand and poor outcome at 3 months. The latter was defined as a modified Rankin Scale score >2. Multivariate logistic regression analysis was used to determine independent factors of DC requirement and functional outcomes at 3 months. Results:A total of 381 patients with large anterior circulation ischemic stroke were enrolled, including 203 males (53.3%), and the mean age was 70.7±14.3 years. The median time from onset to admission was 4.5 hours. The median baseline National Institutes of Health Stroke Scale score was 17 and median baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS) was 7. Totally 139 patients (36.5%) received EVT, and 64 (16.8%) required DC; 376 patients (98.7%) completed a 3-month follow-up (5 who did not complete follow-up did not require DC, of which 2 received EVT), 312 (83.0%) had poor outcome at 3 months, and 146 (38.8%) died. Multivariate logistic regression analysis showed that EVT was an independent predictor for the requiremet of DC (odds ratio [ OR] 4.42, 95% confidence interval [ CI] 1.81-10.81; P=0.001), higher baseline ASPECTS ( OR 0.80, 95% CI 0.71-0.89; P<0.001) and successful recanalization ( OR 0.37, 95% CI 0.15-0.90; P=0.028) were independent protective factors of reducing the requirement of DC. Successful recanalization ( OR 0.09, 95% CI 0.01-0.72; P=0.023) and antiplatelet therapy ( OR 0.29, 95% CI 0.11-0.76; P=0.012) were independent predictors for reduced risk of poor outcome. In 139 patients who received EVT, 27 (19.4%) received intravenous thrombolysis, 96 (69.1%) achieved successful recanalization, 88 (63.3%) had hemorrhagic transformation, 61 (43.9%) had symptomatic hemorrhagic transformation, and 34 (24.5%) required DC; 137 (98.6%) completed a 3-month follow-up, 116 (84.7%) had poor outcome at 3 months, and 67 (48.9%) died. For patients receiving EVT, a higher baseline ASPECTS ( OR 0.72, 95% CI 0.60-0.88; P=0.001) and successful recanalization ( OR 0.35, 95% CI 0.14-0.90; P=0.029) were independent predictors of reducing the requirement of DC, while successful recanalization ( OR 0.09, 95% CI 0.01-0.71; P=0.022) was an independent predictor for reduced risk of poor outcome. Among 64 patients who required DC, 22 (34.4%) received DC. Receiving DC significantly reduced the mortality within 3 months ( OR 0.25, 95% CI 0.07-0.86; P=0.028), but had no significant effect on functional outcome at 3 months ( OR 0.35, 95% CI 0.03-4.38; P=0.412). There was no significant interaction of either EVT or successful recanalization in the effect of DC on 3-month death ( P for interaction > 0.05). Conclusions:Successful recanalization after EVT reduces requirement for DC in patients with large anterior circulation ischemic stroke and improves functional outcome at 3 months. DC can reduce the mortality in patients required DC, and have no interactive effect with EVT or successful recanalization.