1.Analyses of risk factors for basilar tip aneurysms rupture using CT angiography
Tao REN ; Song LIU ; Chao TIAN ; Yu SUN ; Song JIN
Chinese Journal of Radiology 2021;55(4):397-402
Objective:To analyze risk factors for the rupture of basilar tip aneurysms (BTA) using morphological parameters assessed on CTA.Methods:The clinical data and CTA imaging characteristics of 62 patients with BTA from March 2016 to November 2020 in Huanhu Hospital of Tianjin were analyzed retrospectively. The patients were divided into un-rupture ( n=44) and rupture ( n=18) groups according to whether the BTA ruptured. The morphological parameters of aneurysms were measured and recorded. The number, shape and orientation of aneurysms were analyzed by χ 2 test between the two groups. The length (H max), height (H p), neck width (N D), aspect ratio (AR), size ratio (SR), angle of aneurysms (AA), flow angle (FA), basilar vessel angle (BVA), the angle between the proximal long axis of bilateral posterior cerebral artery P1 segment (P1-P1 angle), the angle between the proximal long axis of bilateral superior cerebellar arteries and bifurcation angle (the sum of the angle between the basilar artery and the bilateral posterior cerebral arteries) were analyzed by independent-sample t test between the two groups. On the basis of univariate analysis, logistic regression was used to identify the independent risk factors for BTA rupture. ROC curve analysis was further performed. Results:BTA with irregular shape was more likely to break (χ 2=5.412, P<0.05). The H max[(4.18±2.11)mm], N D [(3.06±1.75)mm], P1-P1 angle (148°±18°) in the rupture group were smaller than those in the un-rupture group [(6.38±2.21)mm, (5.20±1.59)mm, 178°±25°], with statistically significant difference ( P<0.05). While AR (1.19±0.13), BVA (82°±11°), and bifurcation angle (212°±18°) in the rupture group were larger than those in the un-rupture group (1.05±0.18, 70°±10°, 181°±27°), with statistically significant difference ( P<0.05). The logistic regression analysis showed that the shape of aneurysms (β=4.878, OR=11.418, P=0.019), BVA (β=0.165, OR=1.177, P=0.043), and P1-P1 angle (β=-0.223, OR=1.080, P=0.029) were independent risk factors for BTA rupture. The ROC curve analysis showed that the cut-off value of BVA and P1-P1 angle to predict the BTA rupture were 76.7° and 158.5°, and area under curve (AUC) were 0.79 and 0.86, respectively. The AUC of combined BVA with P1-P1 angle was 0.89. Conclusion:The shape of aneurysms, BVA and P1-P1 angle are independent risk factors for BTA rupture. BTA are prone to rupture when the shape of aneurysm is irregular, BVA>76.7 ° and P1-P1 angle<158.5 °.
3.The overcrowding of osteal posterior cranial fossa in adults: multi-slice CT measurements and clinical significance
Zhongfu XIE ; Chao TIAN ; Song JIN ; Tong HAN ; Shimin CUI
Chinese Journal of Radiology 2010;44(3):260-264
Objective To assess the clinical value of MSCT in diagnosing the overcrowding of osteal posterior cranial fossa (PCF) in adults.Methods MSCT images of a cohort of 52 adult patients with foramen magnum osteal malformation confirmed by surgery (diseased group), and 100 healthy adults (control group) were retrospectively reviewed.Images post-processing techniques included multi-planer reformation (MPR) and volume rendering (VR).The posterior cranial fossa volume (PCFV), posterior cranial fossa height (PCFH), clivus length (CL), clivus gradient (CG), supraocciput length (SL), and anteroposterior diameter of the foramen magnum (FMD) were measured on sagittal images in 52 patients and 100 normal adults.Independent-sample student's t test was used to compare the differences between patients and normal adults.Results The results of PCFV, PCFH, CL, SL,FMD and CG, male of control group were (168.2 ±12.3) cm~3, (38.2 ±1.2), (47.1 ±2.8), (41.1 ±1.8), (36.6 ±4.9) mm, (51.5±3.6)°, female of control group were (157.5 ±10.2) cm~3, (36.5 ±1.4), (46.2 ±2.2), (39.7 ±1.3), (35.2 ±3.8), (49.6±3.1)° ;diseased group were (128.7 ±11.7) cm~3, (30.6 ±1.9), (36.2 ±1.4), (37.3 ±0.9), (33.9 ±3.5)mm, (44.5 ±2.8)° .There was significant sex difference in PCFV, PCFH, CL, SL and CG in control group (t =4.70, 6.44, 4.84, 4.43 and 2.81 respectively, P<0.01), but FMD was not significant(t=1.97,P>0.05); the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and male of control group (t=16.62, 24.04, 25.01, 14.17 and 10.99 respectively,P<0.01) ; the results of PCFV, PCFH, CL, CG and SL were significant different between diseased group and female of control group (t=13.23, 17.80, 27.50, 11.67 and 8.73 respectively,P<0.01) ;but there were no significant differences of FMD between diseased group and control group, both male and female (t=2.96,2.07, P> 0.05).Conclusions The overcrowding of PCF can be accurately measured by MCST.As a routine preoperative examination, MSCT is helpful in the therapeutic selection and the anatomic and pathologic study of PCF.
5.Rectal and perianal inflammatory myofibroblastic tumor: report of 3 cases
Bo SONG ; Yangchun ZHENG ; Jin YAN ; Hai HU ; Lin XU ; Chao LIU ; Baoshan LIU
Chinese Journal of General Surgery 2011;26(12):1016-1018
Objective To analyze the clinical features of rectal and perianal inflammatory myofibroblastic tumor and evaluate its diagnosis and treatment.Method Clinicopathological data of 3 cases diagnosed as inflammatory myofibroblastic tumor from January,2005 to June,2011 were retrospectively reviewed.Results Inflammatory myofibroblastic tumor presents as infiltrative growth mass with rich vascularization on CT or MRI,and is difficult to distinguish from hemangioma and other rectal tumors.Preoperative biopsy usually fails to ascertain the entity of mass,and pathological examination of the whole resected specimen with immunohistochemical staining is needed to make final diagnosis.All 3 cases underwent sphincter preserving surgery.One case received a second radical operation 16 months after primary resection because of local recurrence.All patients are followed up to now,with a survival time of 67 months,55 months,and 35 months respectively.Conclusions Rectal and perianal inflammatory myofibroblastic tumor is difficult to diagnose on preoperative imaging examinations or biopsy.Immunohistochemical staining is needed to make final diagnosis.Sphincter preserving surgery with complete tumor removal could achieve long term survival.
6.The effects of renal denervation on hypothalamus angiotensinⅡand oxidative stress in myocardial infarction dogs
Yijie MA ; Chengzhi LU ; Chao LI ; Jin ZHANG ; Li WANG ; Lijun SONG
Tianjin Medical Journal 2016;44(3):327-329,330
Objective To explore the effects of renal denervation (RDN) on hypothalamus angiotensinⅡ(AngⅡ) and oxidative stress in myocardial infarction (MI) dogs. Methods Eighteen mongrel dogs were randomly divided into MI group (n=6), RDN group (n=6) and sham operation group (n=6). Myocardial infarction model was made in the former two groups by gelatin sponge embolization of the left anterior descending artery. One week after MI, RDN was given to dogs in RDN group. Levels of AngⅡ, malondialdehyde (MDA), superoxide dismutase (SOD) and expression of gp91phox protein were detected four weeks after MI. Results Compared with control group, hypothalamus AngⅡ, MDA and expression of gp91phox protein were increased in MI group (P<0.01), but SOD was decreased (P<0.01). There was a negative correlation between AngⅡand SOD activity in MI group (r=-0.849, P < 0.01). There was a positive correlation between AngⅡ and expression of gp91phox protein in MI group (r=0.950, P<0.01). Compared with MI group, hypothalamus AngⅡ, MDA and expression of gp91phox protein were decreased in RDN group (P<0.01), but SOD was increased (P<0.01). Conclusion RDN can de?crease the level of hypothalamus AngⅡand the level of hypothalamus oxidative stress, and improve heart function of MI dogs.
7.Evaluation of osteal posterior cranial fossa in adults by multi-slice CT measurements before and after operation in basilar invagination patients
Zhongfu XIE ; Chao TIAN ; Song JIN ; Yi WANG ; Tong HAN ; Shimin CUI
Chinese Journal of Radiology 2011;45(12):1151-1154
ObjectiveTo evaluate the clinical effect of MSCT measurements in the pre- and postoperational osteal posterior cranial fossa for the adult patients of basilar invagination.Methods We reviewed the images of a cohort of 31 adult patients with basilar invagination,which were treated by surgical operation.According to the presence of atlantoaxial dislocation,the patients were divided into groups A and B.The basion-dens interval (BDI),atlanto-dental interval (ADI),space available of the spinal cord ( SAC),clivus-canal angle( CCA),Highly index( HI),and Chamberlian line(CBL) of the posterior cranial fossa were obtained in all the patients.Independent-sample Student's t test was used to compare the differences between groups A and groups B.Spearman correlations were analyzed between CT measurement data and effects of operations.ResultsIn Group A,the BDI,ADI,SAC,CCA,HI,CBL before and after surgery were 12.6 mm,8.3 mm,4.5 mm,3.3 mm;18.2 mm,20.8 mm,138.3°,150.4°,28.7 mm,43.4 mm,6.3 mm,3.3 mm respectively.There were significant differences ( t = 5.603,2.323,3.124,5.531,4.278 and 2.375,respectively,P <0.05 ).Preoperative JOA score in groups A was 10 points,and was 14 points after surgery.There was significant difference between the JOA scores before and after surgery ( t = 3.526,P < 0.05 ).There were 7 effective cases and 4 stable cases after surgery in group A.Before and after surgery,JOA score and BDI,ADI,SAC,CCA,HI,CBL were significantly correlated( r = -0.667,- 0.673 ; - 0.571,- 0.619 ; 0.642,0.513 ; 0.525,0.558 ; 0.587,0.511 ; - 0.532,- 0.596,respectively,P<0.05).The SAC,CCA,and CBL before and after surgery in group B were 18.3 mm,19.6 mm,146.8°,150.2°,2.7 mm,1.8 mm.The difference was statistically significant after operation ( t = 5.359,4.126,0.769,P <0.05).The BDI,ADI,and HI before and after surgery in group B were 7.2 mm,6.6 mm,2.4 mm,2.1 mm,39.3 mm,41.5 mm.And there were no significant differences (t = 1.482,2.374,0.153,P>0.05).The preoperative JOA score in groups B was 11 points,and the postoperative score was 16 points.JOA scores before and after surgery were significantly different (t =2.874,P <0.05).There were 14 effective cases and 6 stable cases after operation in group B.The JOA score before and after surgery and BDI,ADI,and HI had no correlation (r =0.341,0.387;0.154,0.182; 0.192,0.167,P >0.05),and CBL,SAC and CCA were correlated (r = -0.756,-0.728;0.651,0.672; 0.726,0.695,P <0.05).ConclusionMSCT measurements for basilar invagination before and after surgery are helpful for understanding changes of osteal posterior fossa anatomy and comprehensive evaluation of surgical treatment.
8.Effect of renal denervation on cardiac oxidative stress and sympathetic nerve remodeling after myocardial infarction in canine
Lijun SONG ; Chengzhi LU ; Chao LI ; Jin ZHANG ; Li WANG ; Yijie MA
Tianjin Medical Journal 2015;(8):864-866,867
Objective To observe the effect of renal denervation (RDN) on the cardiac oxidative stress and sympathetic nerve remodeling after myocardial infarction (MI) in canine. Methods Canine (n=18) were randomly divided into three groups: Sham operation group (SHAM group, n=6), MI group (n=6), MI+RDN group (n=6). Anterior myocardial infarction was gained by gelatin sponge embolization of the left anterior descending artery. At four weeks post-MI, left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF) were examined using echocardiography. Immunohistochemical assay was used to analyze the distribution and density of tyrosine hydroxylase (TH) stained nerve fibers at peri-infarct zone. Myocardial superoxide dismutase (SOD) activity and malondialde?hyde (MDA) were also assessed. Results Compared with dogs in SHAM group, LVEF and SOD expression were decreased in MI group and MI+RDN group (P<0.05), but Left ventricular end diastolic pressure (LVEDP), LVEDV, LVESV, MDA and rate of TH positive staining nerve fibers were increased (P<0.05). There was a negative correlation between the rate of TH positive staining nerve fibers and SOD level (rs=-0.818,P<0.05) and a positive correlation between rate of TH positive stain?ing nerve fibers with MDA level (rs=0.900,P<0.05). By contract, compared with MI group, LVEF and SOD in MI +RDN group were increased (P<0.05), while LVEDV, LVESV, MDA and rate of TH positive staining nerve fibers were significant?ly lowered (P<0.05). Conclusion RDN is effective to decrease the level of cardiac oxidative stress and improve cardiac sympathetic nerve remodeling and heart function after myocardial infarction in canine.
9. Study of CT perfusion in posterior circulation cerebral ischemia and hyperacute phase of cerebral infarction
Chao TIAN ; Tianhao YANG ; Lejun FU ; Song JIN
Chinese Journal of Neurology 2019;52(12):1039-1046
Objective:
To evaluate the diagnostic value of CT perfusion (CTP) for posterior circulation cerebral ischemia and hyperacute phase of cerebral infarction.
Methods:
CTP was performed in 184 patients with suspected posterior circulation acute ischemic stroke, and diffusion weighted imaging (DWI) of MRI was performed 24-72 hours after onset. According to the characteristics of various perfusion parameters, the perfusion defect area in CTP was divided into group Ⅰ (compensatory phase of cerebral circulation reserve), group Ⅱ (compensatory phase of cerebral metabolism reserve), group Ⅲ (hyperacute phase of cerebral infarction). The region of interest (ROI) in each perfusion defect area and the contralateral mirror perfusion normal area was delineated, and the mean values of regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), mean transit time (MTT), and time to peak (TTP) in the ROI were recorded. The perfusion parameters of normal brain tissue were included in group Ⅳ (normal control group). One-way analysis of variance was used to compare the overall differences in CTP parameters measured in each group in each region, and the multiple comparisons were performed to assess statistical differences between the perfusion parameters of groups in all parts of the posterior circulation. The sensitivity, specificity and accuracy of CTP in evaluating the hyperacute phase of cerebral infarction in various parts of the posterior circulation were calculated by using DWI as a standard.
Results:
A total of 271 cerebral ischemia or cerebral infarction lesions were detected in 184 patients, 107 in group Ⅰ, 75 in group Ⅱ, and 89 in group Ⅲ. There were statistically significant differences in the perfusion parameters of each group and each part of the posterior circulation (
10.Activity of lysozyme from Oncomelania hupensis and its role in inhibiting bacteria: a preliminary study
Shu-lin, ZHOU ; Chun-lan, HUANG ; Jin-song, ZHAO ; Chao-pin, LI
Chinese Journal of Endemiology 2013;32(6):616-618
Objective To study the lysozyme activity in Oncomelania hupensis and observe its inhibitory effect on bacterial growth.Methods Soft tissues of Oncomelania hupensis were initially homogenized and immersed in Tris-HCl-TritonX-114 buffer solution for 24 hours then the supernatant was collected after centrifugation at 10 000 × g for 10 minutes.The supernatant was incubated in a 37 ℃ water bath for 15 minutes and centrifuged again at 2000 × g for 10 minutes.The precipitate was put into ultrafiltration tube (relative retention molecular mass =3000) and centrifuged at 4 ℃,5 000 × g for 30 minute to obtain concentrated enzyme.The protein content,lysozyme activity and the antibacterial effect on Micrococcus lysodeikticus,Shigella dysenteriae,Staphylococcus aureus,Escherichia coli and Candida albicans were measured with bicinchonininc acid(BCA) method,turbidimetric method and agar diffusion (K-B) method,respectively.Results The antibacterial protein lysozyme was identified in gastropod protein concentration of the concentrated enzyme was 3.428 g/L.Average activity,total activity,and specific activity were (760 ± 120) × 103 U/L,(1520 ± 240) × 103 U/L and (221.70 ± 35.00)U/mg,respectively.The enzyme had produced exclusive inhibitory effects on growth of Micrococcus lysodeikticus and Shigella dysenteriae.Average inhibitory diameters were 10-12 and 12-15 mm,respectively.No inhibition zone was observed in saline control,Staphylococcus aureus,Escherichia coli and Candida albicans.Conclusions Lysozyme can be extracted from soft tissues of Oncomelania hupensis with Tris-HCl-TritonX-114 buffer solution,and the enzyme has inhibitory effect on growth of Micrococcus lysodeikticus and Shigella dysenteriae but has no antibacterial effect on Staphylococcus aureus,Escherichia coli and Candida albicans.