1.Relationship between the cerebral blood flow filling condition and prognosis of patients with acute severe cerebral infarction
Xiaolin LOU ; Xiaohai MA ; Yining QIAN
Journal of Clinical Neurology 1988;0(02):-
Objective To investigate the relationship between the cerebral blood flow filling condition and prognosis of patients with acute severe cerebral infarction.Methods The clinical data and MR features of 10 cases of acute severe cerebral infarction were retrospectively analyzed.Results The regional cerebral blood flow(rCBF) and regional cerebral blood volume(rCBV) of 9 cases(90%) in the infarcted side decreased significantly.The reduced percents of the infarcted side reached 64.1% and 49.7% respectively.There were significant differences between two opposite sides(P=0.001,P=0.01).The MRA results showed great vessels(arteria carotis interna or arteria cerebri media) in the infarcted side were all obliterated in the all patients,and simultaneous great vessels in opposite side were narrow or occlusion in 7 cases(70%).2 cases died;and 8 cases were serious disability.Conclusions The cerebral blood flow filling of the acute severe cerebral infarction patients decrease significantly.The prognosis of the patients is quite bad.
2.A study of neurological complications after coronary artery bypass grafting
Qi BI ; Qin LI ; Zhaoqi ZHANG ; Chengxiong GU ; Xiaohai MA
Chinese Journal of Internal Medicine 2008;47(3):202-205
Objective To prospectively investigate the neurological complications(NC)after offpump coronary artery bypass grafting(OPCABG),including the kinds of NC and their mobility,risk factors.prevetion and treatment.Methods A total of 55 consecutive patients with undergoing OPCABG were evaluated from March to June 2006 at the Department of Cardiosurgery in Beijing Anzhen Hospital.Risk factors of NC were collected before operation.Nervous system physical examination,The NIH Stroke Scale(NIHSS)score evaluation,cognitive tests,imaging examination(MRI,MRA and f-MRI),anxious and depression scale were performed before and after OPCABG.NC and their kinds were identified after surgery.According to the presence or absence of NC after the operation,the patients were divided into two groups,and univariate analysis was used between the two groups.P<0.05 was considered of statistically significant difference.Results (1)2 cases of ischemic stroke developed after surgery(2/55),but there no case of mortality.The risk factors were not statistically different between the two groups(P>0.05):(2)For all the patients,cognitive evaluation was normal and unchanged before and after surgery(P>0.05),including Mini-Mental State Examination(MMSE),Clinical dementia rating(CDR)and Global Deterioration Scale (GDS);(3)Except the 2 cases of stroke,the others were normal and had no change on MRI,MRA,and f-MRI(P>0.05)before and after surgery;(4)7 patients with slight anxiety and one with sight depression before operation recovered completely after surerty without treatment.Both the Self-rating Anxiety Scale (SAS)and Self-rating Depression Scale(SDS)were normal and unchanged before and after surgery (P>0.05).Conclusions 2 cases of ischemic stroke were found among 55 patients undergoing OPCABG (2/55)and there was no mortality.There was no obvious change of cognitive function,imaging finding,anxiety and depression before and after the operation(P>0.05).OPCABG is relatively safe for nervous system,but more exploratory work andclinical data are needed.
3.Effect of adipose-derived mesenchymal stem cell transplantation on inflammatory response and ventricular remodeling after myocardial infarction
Yan FAN ; Jianjun WANG ; Feng WEI ; Xiaohai FAN ; Aiqun MA
Chinese Journal of Tissue Engineering Research 2014;(6):900-905
BACKGROUND:Whether adipose-derived mesenchymal stem cells are able to exert immunomodulatory effects in the treatment of myocardial infarction, as wel as the best time, is less reported.
OBJECTIVE:To observe the effect of adipose-derived mesenchymal stem cells on inflammatory reaction and ventricular remodeling after myocardial infarction, and to explore the possible mechanisms of adipose-derived mesenchymal stem cells for the treatment of myocardial infarction.
METHODS:Enzyme digestion method was employed to isolate and culture rat adipose-derived mesenchymal stem cells. By ligation of the left anterior descending coronary artery, we established animal models of myocardial infarction in 40 rats. The rats were randomly divided into four groups:sham group, control group (injected high-glucose Dulbecco’s modified Eagle’s medium), 3-hour transplantation group (transplanted adipose-derived mesenchymal stem cells after 3 hours of myocardial infarction), 7-day transplantation group (transplanted adipose-derived mesenchymal stem cells after 7 days of myocardial infarction). After 14 days of operation, the levels of tumor necrosis factor-αand interleukin-10 in the plasma were detected by enzyme linked immunosorbent assay. After 28 days of operation, the left ventricular end diastolic diameter, left ventricular end systolic diameter, left ventricular ejection fraction and left ventricular fractional shortening were measured by echocardiography.
RESULTS AND CONCLUSION:Compared with the control group, in the 3-hour transplantation group and 7-day transplantation group, the levels of tumor necrosis factor-αwere significantly lower (P<0.01), and the levels of interleukin-10 were significantly higher (P<0.01) at postoperative 14 days;the left ventricular end diastolic diameter and left ventricular end systolic diameter in the two transplantation groups were also significantly smal er (P<0.05), but left ventricular ejection fraction and left ventricular fractional shortening were significantly elevated (P<0.05), which was more apparent in the 3-hour transplantation group than the 7-day transplantation group. Adipose-derived mesenchymal stem cells transplantation in acute phase of myocardial infarction can suppress the inflammatory response, regulate the cytokine network equilibrium, and thus delay ventricular remodeling and improve cardiac function.
4.Evaluation of diffuse myocardial fibrosis of cardiomyopathy by using T1 mapping:initial study
Xiaohai MA ; Lei ZHAO ; Songnan LI ; Jianzeng DONG ; Zhanhong WANG ; Zhanming FAN
Chinese Journal of Radiology 2016;(1):13-17
Objective To investigate the value of contrast enhancement T1 mapping in detection of diffuse myocardial fibrosis in cardiomyopathy, and the relationship between myocardial fibrosis and cardiac function. Methods From September 2013 to September 2014, 76 cases of cardiomyopathy patients (including myocarditis) and 33 cases of healthy controls were enrolled in our study. All the subjects underwent cardiac MR (CMR) examination. Scan sequences included cine MR, pre-contrast and post-contrast T1 mapping and late gadolinium enhancement (LGE) imaging. The pre-/post-contrast left ventricle average T1 value and cardiac function of patients and controls were measured and compared by using independent-samples t test. According to the LGE imaging, all the subjects were subsequently divided into LGE positive group, LGE negative group and control group. The myocardial average T1 value and cardiac function among the three sub-groups were compared by using one-way ANOVA, and the relationship among them were analyzed by using Pearson correlation. Results Among the 76 cases of non-ischemia cardiomyopathy patients, 51 cases (67.1%) had LGE. Compared with controls, cardiomyopathy patients presented with higher pre-contrast T1 value [(1 306.4 ± 84.6)ms vs. (1 266.6 ± 57.3)ms, t=2.10, P<0.05] and lower post-contrast T1 value [(483.6 ± 112.0)ms vs. (534.1 ± 92.7)ms,t=-0.27, P<0.05]. Pre-contrast and post-contrast average T1 value of LGE positive patients were (1 322.2 ± 85.8) and (459.7 ± 132.2)ms respectively;pre-contrast and post-contrast average T1 value of LGE negative patients were (1 267.0 ± 68.5) ms and (521.0±95.2)ms, there were statistical significant differences of T1 value between LGE positive and LGE negative patients (P<0.01), however, there were no statistical significant differences of T1 value between LGE negative patients and controls (P>0.05). There were correlation between pre-/post-contrast left ventricle T1 value and ejection fraction (EF) in cardiomyopathy patients (r=-0.252,-0.217, P<0.01), however no statistical correlation with other cardiac function parameters (P>0.05). Conclusions The average pre-/post-contrast T1 value in left ventricle myocardium are helpful for detection of diffuse fibrosis in cardiomyopathy patients. The LGE positive is a sign that can greatly change the T1 value of the myocardial tissue, meanwhile, myocardial fibrosis is negative correlated with ejection fraction in cardiomyopathy patients.
5.A feasibility study in 3.0 T MR imaging using an improved intravascular coil
Chen ZHANG ; Lei ZHAO ; Xiaohai MA ; Hongyang YUAN ; Jue ZHANG ; Zhaoqi ZHANG
Chinese Journal of Radiology 2012;46(9):846-850
Objective The study was to investigate the feasibility of using an intravascular Loopless Monopole Antenna (ILMA) for 3.0 T MR imaging of water bath and deep-seated arterial walls of experimental animal.Methods A novel intravascular loopless monopole antenna (ILMA) was developed,including a non-shield loach guide-wire and a matching circuit.The non-shield loach guide-wire is used as a receive antenna,with the diameter of 0.019 in( 1 in =2.54 cm) and length of 23.11 in.During the MR scanning,the ILMA was used as a receive-only probe,while body coil was used to transmit the RF pulses.Utilizing the coil in water bath and in-vivo animal experiment,we measured signal-to-noise ratio (SNR) and contrast-to-noise ratio(CNR) of artery wall using the same scanning parameter compared with phased-array coil.Results In the study,the developed novel ILMA conduced to improved SNR of imaging and much higher space resolution( 313 μm).First,the feasibility of acquiring the wall images was demonstrated on phantoms.The SNRs map generated by the matlab software showed that in comparison with the phased-array coil,ILMA generated higher SNR of the phantom wall when using the same sequences,parameters,and slices (86.8 ±0.8 vs.9.9 ±0.1,P <0.01 ).When imaging the aorta wall with the ILMA and phased-array coil,the SNRs of the arterial wall with the ILMA is 60.4 ±20.9,61.3 ±22.5,59.8 ±20.4,32.3 ±22.6 (T1WI),51.2 ±21.6,49.8 ± 15.5,50.4 ± 17.2,22.4 ± 18.3 (T2WI),the CNRs of the aorta wall with theILMA is 19.8±8.1,18.9±9.2,19.6±11.8,20.7 ± 13.3(T1WI),17.7±6.4,18.6±6.9,17.2 ± 6.4,17.2 ± 6.4 ( T2 WI),compared with phased-array coil,t values SNR:6.36,3.84,3.51,6.92(T1 WI),3.47,4.89,6.35,4.21 (T2WI),CNR:3.56,3.97,-0.71,4.74 (T1WI),3.99,3.01,4.27,5.03(T2 WI,P < 0.05 ),respectively.Conclusion The study demonstrates the capability of using an MR ILMA to generate 3.0 T MR in-vivo experiments,the developed novel ILMA conduces to increased SNR compared with the conventional phased-array coil.
6.Detection of thrombosis and plaque rupture in atherosclerotic rabbit model by using 3.0 T MR imaging
Xiaohai MA ; Zhaoqi ZHANG ; Lei ZHAO ; Quanming ZHAO ; Jianfeng SHANG ; Tingting FENG ; Conghe ZENG
Chinese Journal of Radiology 2011;45(12):1211-1215
ObjectiveTo explore the imaging of the thrombosis after pharmacological triggering of plaque rupture in atherosclerotic rabbit model by using 3.0 T high-resolution magnetic resonance imaging.MethodsTwenty male New Zealand white rabbits were divided into an experimental group (n = 16) and a control group (n = 4).The aortic wall injuries were induced by an intravascular balloon in experimental group rabbits after high cholesterol diet.The pharmacological triggering with Russell's viper venom and histamine was performed after 3 months of establishment of model.All of the animals underwent pre-trigger and post-trigger MR examinations including 3D time of fight (3D TOF),T1 WI,T2WI and post contrast T1 WI.Euthanasia was performed in all rabbits and gross anatomy and histological specimen of aorta were obtained.Comparing the location and length of the thrombus between MRI images and histopathology was used Pearson test.Comparing the calculated indexes of abdominal aorta between rabbits with and without thrombosis was used AVONA test and LSD-t test.Results After triggering,8 in 14 survived rabbits developed thrombosis in experimental group,meanwhile,no thrombus was found in control group.The accuracy of multi-sequences MRI for detecting of thrombus was 87.1% (27/31).MRI data correlated with the histopathology regarding thrombus length ( r = 0.85,P < 0.01 ) and thrombus location ( r = 0.94,P<0.01 ).Compared with rabbits without thrombosis,the rabbits with thrombosis had narrower lumen of abdominal aorta in the pre-triggered MR images [ ( 5.71 ± 2.38 )mm2 vs.( 8.93 ± 5.36) mm2,P < 0.01 ].ConclusionMRI is useful tool to determine the thrombosis and plaque rupture in atherosclerotic rabbit model.
7.Low-dose adaptive sequence scan of dual-source CT coronary angiography in patients with high heart rate: an initial study
Lei XU ; Zixu YAN ; Zhaoqi ZHANG ; Zhanming FAN ; Xiaohai MA ; Yu LI ; Lin YANG ; Lei ZHAO
Chinese Journal of Radiology 2010;44(3):265-268
Objective To investigate the application of low-dose adaptive sequence scan of dual-source CT coronary angiography in patients with high heart rate and evaluate the image quality.Methods Seventy-two patients who underwent coronary CT angiography with heart rate> 70 bpm were divided into 2 groups.Group A was adaptive sequence scan, and Group B was retrospective ECG-gating helical scan.Examinations were performed on a dual-source CT scanner (Somatom Definition) .All images were transferred to a workstation for further processing and analysis.The image quality was evaluated using same criteria.The image quality of coronary artery segments was compared in two groups using rank sum test, and the radiation dose was compared using t test Results A total of 501 coronary artery segments were evaluated in group A and 400 segments in group B.The mean ranks in image quality of coronary artery segments in group A was 475.42, whereas 420.41 in group B.There was a statistical difference in image quality between the two groups (Z= - 3.509,P=0.000).The effective dose was on average (6.2±0.9) mSv in group A, whereas on average (14.7±1.9) mSv in group B, there was a statistical difference between the two groups(t= - 27.011, P=0.000).Conclusions Adaptive sequence scan in dual-source CT coronary angiography is feasible in patients with high heart rates.This scan mode can substantially reduce radiation dose and maintain the diagnostic image quality.
8.Effects of nail polish on measurement of pulse oxygen saturation by different brands of monitors in healthy volunteers
Jie CHEN ; Xin XU ; Xiaohai WANG ; Zhengliang MA ; Xiaoping GU ; Wenliang JI
Chinese Journal of Anesthesiology 2013;33(11):1372-1375
Objective To evaluate the effects of nail polish on measurement of pulse oxygen saturation (SpO2) by different brands of monitors in healthy volunteers.Methods Twenty healthy female volunteers were enrolled in the study.Nine fingers of each volunteer were chosen randomly,8 nails were painted 8 different colors (transparent color,red,yellow,green,blue,purple,black,white),respectively,and the left 1 nail served as blank control.SpO2 and pulse rate (PR) were measured using TuffSat Handheld Oximeter (GE) and MP70 (Philip) and PM-9800 (Mindray) monitors.SpO2 of the 9 nails monitored and the response time for SpO2 and PR were recorded.Results (1) Compared with blank control,when MP70 monitor was used,no significant change was found in each color-induced effect on the value of SpO2 obtained (P > 0.05),and blue prolonged the response time for PR and SpO2 (P < 0.05) ;When PM-9800 monitor was used,black could decrease the value of SpO2 measured (P < 0.05),and no significant change was found in each color-induced effect on the response time for SpO2 and PR (P > 0.05) ; when TuffSat Handheld Oximeter was used,green and blue could decrease the value of SpO2 monitored,and the value of SpO2 obtained was significantly lower when blue was used (P < 0.05).Black,blue,purple and white could sequentially prolong the response time for PR (P < 0.05),and no significant change was found in each color-induced effect on the response time for SpO2 (P > 0.05).(2) For green and blue nail polish,the value of SpO2 measured with TuffSat Handheld Oximeter was significantly lower than that measured with MP70 and PM-9800 monitors(P < 0.05) ; for red,yellow and green nail polish,the response time for PR obtained with TuffSat Handheld Oximeter was significantly shorter than that obtained with MP70 and PM-9800 monitors (P <0.05) ; for blank control group and 8 colors of nail polish,the response time for SpO2 measured with TuffSat Handheld Oximeter was significantly shorter than that measured with MP70 and PM-9800 monitors (P < 0.05).For black nail polish,the value of SpO2 measured with PM-9800 monitors was significantly lower than that measured with MP70 and TuffSat Handheld Oximeter(P < 0.05).Conclusion The ability for nail polish recognition and identification is different for each monitor and the color of nail polish can exert obvious effect on the value and response time for SpO2 obtained.The results of this study shows that blue nail polish-induced effect on the value of SpO2 obtained with TuffSat Handheld Oximeter is obvious,and MP70 monitor is the most stable instrument and TuffSat Handheld Oximeter is the most sensitive instrument in obtaining the value of SpO2.
9.Myocardial Fibrosis in Hypertrophic Cardiomyopathy:Assessed by Delayed-enhanced CT
Xiaohai MA ; Lei ZHAO ; Hailong GE ; Chen ZHANG ; Dongxu LU ; Zhanming FAN
Chinese Journal of Medical Imaging 2015;(2):100-104,113
PurposeTo determine the feasibility and accuracy of dual source CT (DSCT) in assessing myocardial delayed-enhancement and left ventricular wall thickness of hypertrophic cardiomyopathy (HCM) in comparison with cardiac magnetic resonance (CMR).Materials and MethodsEighty patients with HCM confirmed by clinical diagnosis were enrolled in the study. DSCT images and CMR images were acquired at the arterial and lag phases. According to 17-segment model provided by American Heart Association, the left ventricular wall thickness and location of delayed-enhancement were verified, and the correlation of these two methods were analyzed in terms of the diagnosis of myocardial delayed enhancement (MDE).Results1360 myocardial segments for 80 patients were assessed. The left ventricular wall thickness determined by DSCT was significantly correlated with MR results (r=0.88,P<0.01). DSCT and MDE showed substantial agreement on per-patient (n=74,Kappa=0.751,P<0.05) and per-segment (n=1238, Kappa=0.746,P<0.01) levels. For dense myocardial delayed enhancement, CT findings were significantly correlated with those of CMR (r=0.89, P<0.01), but CT scan slightly underestimated the lesion scope of fibrosis. Bland-Altman analysis showed that CT and MRI were different in measuring the lesion volume of myocardial delayed enhancement (mean standard deviation was 2.71%).ConclusionThe cardiac CT examination provides comprehensive information in coronary artery and myocardial assessment, and MDE-DSCT is also effective in the diagnosis of myocardial fibrosis in HCM since it can be used in assessing myocardial fibrosis.
10.A study on the relationship between biomarkers and left ventricular myocardial native T 1 value in patients with lone atrial fibrillation
Lei ZHAO ; Chen ZHANG ; Jie TIAN ; Aijia LU ; Songnan LI ; Rong BAI ; Hailong GE ; Xiaohai MA
Chinese Journal of Radiology 2021;55(3):264-268
Objective:To investigate the relationship between serum procollagen Ⅲ amino terminal peptide (PIIINP), collagen I carboxyl terminal cross-linking peptide (CTXI), high-sensitivity C-reactive protein (hs-CRP) and cardiac magnetic resonance (CMR) T 1 mapping value in patients with lone atrial fibrillation (AF). Methods:Fifty-five patients with lone AF in Beijing Anzhen Hospital from July 2017 to June 2018 were prospectively enrolled. Another 20 healthy volunteers were examined at the same time to provide normal reference range. All patients completed PIIINP, CTXI, hs-CRP and CMR examination within one week. CMR examination including cine, pre-contrast T 1 mapping, and late gadolinium enhancement sequences. We used t test, Mann-Whitney U test or chi square test to compare the difference of the above indexes between AF patients and the control group. Spearman correlation analysis was used to determine the associations between left ventricular native T 1 value and blood biomarker in AF patients. Results:All the patients were paroxysmal AF with an average age of (48±10) years, of which 46 (83.6%) were male. The PIIINP, CTXI, hs-CRP, left ventricular native T 1 value of AF patients were 5.83 (3.52, 12.40) ng/ml, 4.63 (3.31, 6.82) μg/ml, 3.41 (1.72, 6.61) mg/L and (1 261±23) ms, respectively, which all significant higher than those in healthy subjects (all P<0.05). The native T 1 value of left ventricular myocardium was positively correlated with PIIINP ( r=0.492, P<0.05) and hs-CRP ( r=0.516, P<0.05), but not with CTXI ( r=0.021, P>0.05). Conclusions:The PIIINP, CTXI and hs-CRP increased in patients with lone AF, PIIINP and hs-CRP were correlated with elevated native T 1 value of left ventricular myocardium.