1.High-resolution vessel wall imaging combined with computational fluid dynamics in evaluating the spatial distribution of local hemodynamics in internal carotid artery stenosis and its correlation with plaque characteristics
Lei REN ; Shu WANG ; Jihua LIU ; Xiudi LU ; Huiying WANG ; Shuang XIA
Chinese Journal of Radiology 2025;59(8):900-908
Objective:To investigate the local hemodynamic spatial distribution of internal carotid artery stenosis and its correlation with plaque characteristics using high-resolution vessel wall imaging (HR-VWI) combined with computational fluid dynamics.Methods:This was a cross-sectional study. A retrospective analysis was conducted on the clinical and imaging data of 70 patients with moderate to severe stenosis at the initiation of the internal carotid artery in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Tianjin First Central Hospital from March 2018 to June 2020. All patients underwent HR-VWI and CT angiography examinations. The parameters related to plaque characteristics, such as plaque length, maximum wall thickness, plaque volume, wall volume percentage and intraplaque hemorrhage (IPH) were measured and evaluated on HR-VWI images. CT angiography images were used to construct a local hemodynamic vascular model to measure various wall shear stress (WSS) derived parameters, such as time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), and transverse wall shear stress (transWSS), at the narrowest, proximal, and distal parts of the lesion. The Friedman test was used to analyze the difference of hemodynamic parameters in different parts of the lesion. Spearman correlation analysis was performed to assess the correlation between plaque burden and local hemodynamic parameters. Univariate and multivariate logistic regression analyses were used to explore the independent risk factors for predicting IPH.Results:Among the 70 patients, 25 patients with IPH and 45 patients without IPH. The overall differences in TAWSS, OSI, RRT and transWSS at the narrowest, proximal, and distal parts of the lesion in 70 patients were statistically significant ( P<0.05). The TAWSS and transWSS at the narrowest parts were significantly higher than those at the proximal and distal parts ( P<0.05). The OSI at the distal part was significantly higher than that at the narrowest and the proximal parts ( P<0.05). The RRT at the proximal part was significantly lower than that at the narrowest and the distal parts ( P<0.05). Spearman correlation analysis showed RRT at the distal part was correlated with plaque volume ( r s=0.249, P=0.044) and wall volume percentage ( r s=0.286, P=0.016), respectively. In a multivariate logistic regression showed plaque length ( OR=1.315, 95% CI 1.073-1.612, P=0.008) and TAWSS at the narrowest part ( OR=1.631, 95% CI 1.308-1.854, P=0.008) were independent risk factors for predicting IPH. Conclusions:The spatial distribution of local hemodynamics of moderate to severe stenosis at the initiation of the internal carotid artery is different, and the WSS parameters in different parts of the lesion have different effects on plaque volume, wall volume percentage and IPH.
2.CT angiography radiomics for evaluating risk of basilar tip aneurysm rupture
Song LIU ; Chao TIAN ; Tao REN ; Chen CAO ; Song JIN ; Shuang XIA
Chinese Journal of Medical Imaging Technology 2025;41(1):20-24
Objective To observe the value of CT angiography(CTA)radiomics for evaluating the risk of basilar tip aneurysm(BTA)rupture.Methods Totally 133 BTA patients were retrospectively enrolled and divided into ruptured group(n=39)and unruptured group(n=94)based on BT A ruptured or not,also divided into training set(n=93)and test set(n=40)at the ratio of 7∶3.CTA radiomics features of BTA were extracted,the best radiomics features were screened,and the radiomics score(Radscore)was calculated.Then machine learning(ML)models were established with logistic regression(LR),random forest(RF),decision tree(DT)and K-nearest neighbor(KNN)algorithms,respectively.Radscore model was also established,and finally a combined model was constructed based on clinical data,routine imaging findings and Radscore.The efficacy of the above models for evaluating the risk of BTA rupture were comparatively analyzed.Results Finally 4 radiomics features of BTA were obtained.The area under the curve(AUC)of LR,RF,DT and KNN radiomics models for differentiating ruptured and unruptured BTA in training set was 0.770,0.816,0.817 and 0.795,respectively,while that in test set was 0.795,0.793,0.786 and 0.824,respectively,both being not significant different(both P>0.05).Patient's gender,alcohol consumption history,BTA morphology and Radscore were all independent impact factors of BT A rupture(all P<0.05),which were used to establish a clinical-routine imaging model.For all 133 cases,AUC of the combination model for differentiating ruptured and unruptured BTA was 0.877,of Radscore model was 0.775,while that of clinical-routine imaging model was 0.677,of the former was significantly higher than of the last two(both P<0.05).Conclusion CTA radiomics was helpful for evaluating the risk of BTA rupture.Combining with clinical data and routine imaging findings could further improve the value of CTA radiomics.
3.High-resolution vessel wall imaging combined with computational fluid dynamics in evaluating the spatial distribution of local hemodynamics in internal carotid artery stenosis and its correlation with plaque characteristics
Lei REN ; Shu WANG ; Jihua LIU ; Xiudi LU ; Huiying WANG ; Shuang XIA
Chinese Journal of Radiology 2025;59(8):900-908
Objective:To investigate the local hemodynamic spatial distribution of internal carotid artery stenosis and its correlation with plaque characteristics using high-resolution vessel wall imaging (HR-VWI) combined with computational fluid dynamics.Methods:This was a cross-sectional study. A retrospective analysis was conducted on the clinical and imaging data of 70 patients with moderate to severe stenosis at the initiation of the internal carotid artery in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and Tianjin First Central Hospital from March 2018 to June 2020. All patients underwent HR-VWI and CT angiography examinations. The parameters related to plaque characteristics, such as plaque length, maximum wall thickness, plaque volume, wall volume percentage and intraplaque hemorrhage (IPH) were measured and evaluated on HR-VWI images. CT angiography images were used to construct a local hemodynamic vascular model to measure various wall shear stress (WSS) derived parameters, such as time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), relative residence time (RRT), and transverse wall shear stress (transWSS), at the narrowest, proximal, and distal parts of the lesion. The Friedman test was used to analyze the difference of hemodynamic parameters in different parts of the lesion. Spearman correlation analysis was performed to assess the correlation between plaque burden and local hemodynamic parameters. Univariate and multivariate logistic regression analyses were used to explore the independent risk factors for predicting IPH.Results:Among the 70 patients, 25 patients with IPH and 45 patients without IPH. The overall differences in TAWSS, OSI, RRT and transWSS at the narrowest, proximal, and distal parts of the lesion in 70 patients were statistically significant ( P<0.05). The TAWSS and transWSS at the narrowest parts were significantly higher than those at the proximal and distal parts ( P<0.05). The OSI at the distal part was significantly higher than that at the narrowest and the proximal parts ( P<0.05). The RRT at the proximal part was significantly lower than that at the narrowest and the distal parts ( P<0.05). Spearman correlation analysis showed RRT at the distal part was correlated with plaque volume ( r s=0.249, P=0.044) and wall volume percentage ( r s=0.286, P=0.016), respectively. In a multivariate logistic regression showed plaque length ( OR=1.315, 95% CI 1.073-1.612, P=0.008) and TAWSS at the narrowest part ( OR=1.631, 95% CI 1.308-1.854, P=0.008) were independent risk factors for predicting IPH. Conclusions:The spatial distribution of local hemodynamics of moderate to severe stenosis at the initiation of the internal carotid artery is different, and the WSS parameters in different parts of the lesion have different effects on plaque volume, wall volume percentage and IPH.
4.CT angiography radiomics for evaluating risk of basilar tip aneurysm rupture
Song LIU ; Chao TIAN ; Tao REN ; Chen CAO ; Song JIN ; Shuang XIA
Chinese Journal of Medical Imaging Technology 2025;41(1):20-24
Objective To observe the value of CT angiography(CTA)radiomics for evaluating the risk of basilar tip aneurysm(BTA)rupture.Methods Totally 133 BTA patients were retrospectively enrolled and divided into ruptured group(n=39)and unruptured group(n=94)based on BT A ruptured or not,also divided into training set(n=93)and test set(n=40)at the ratio of 7∶3.CTA radiomics features of BTA were extracted,the best radiomics features were screened,and the radiomics score(Radscore)was calculated.Then machine learning(ML)models were established with logistic regression(LR),random forest(RF),decision tree(DT)and K-nearest neighbor(KNN)algorithms,respectively.Radscore model was also established,and finally a combined model was constructed based on clinical data,routine imaging findings and Radscore.The efficacy of the above models for evaluating the risk of BTA rupture were comparatively analyzed.Results Finally 4 radiomics features of BTA were obtained.The area under the curve(AUC)of LR,RF,DT and KNN radiomics models for differentiating ruptured and unruptured BTA in training set was 0.770,0.816,0.817 and 0.795,respectively,while that in test set was 0.795,0.793,0.786 and 0.824,respectively,both being not significant different(both P>0.05).Patient's gender,alcohol consumption history,BTA morphology and Radscore were all independent impact factors of BT A rupture(all P<0.05),which were used to establish a clinical-routine imaging model.For all 133 cases,AUC of the combination model for differentiating ruptured and unruptured BTA was 0.877,of Radscore model was 0.775,while that of clinical-routine imaging model was 0.677,of the former was significantly higher than of the last two(both P<0.05).Conclusion CTA radiomics was helpful for evaluating the risk of BTA rupture.Combining with clinical data and routine imaging findings could further improve the value of CTA radiomics.
5.To construct a CT structural report of laryngeal cancer based on the 8th edition of the American Joint Committee on Cancer TN staging system and evaluate its value
Zhongren TANG ; Pengtao LIU ; Xilong YANG ; Qing LI ; Shuang XIA
Journal of Practical Radiology 2025;41(4):569-573
Objective To evaluate the clinical value of structured report(SR)for CT scans in laryngeal cancer.Methods Accord-ing to the American Joint Committee on Cancer(AJCC)8th edition TN staging,the SR template of CT suitable for initial diagnosis and staging of laryngeal cancer was constructed.It included 5 tumor-related points,4 lymph node-related points,and T and N staging.The differences in the occurrence rate of 11 key points and the accuracy of T and N staging between SR and narrative report(NR)were evaluated and compared.The readability,completeness and overall impression of SR were investigated among radiologists and otolaryngologists with different seniority.Results Finally,208 SR samples and 246 NR samples were included.Except for N0 stage,there were no statistical differences in age,sex ratio,laryngeal cancer classification,or T stage between SR and NR(P>0.05).The occurrence rate of tumor size,extranodal extension(ENE),and T and N staging in early laryngeal cancer(T1-T2 stage)SR was higher than that in NR(P<0.05).The occurrence rate of invasion of intra-and extra-pharyngeal vital structures,tumor size,enhancement degree,ENE,invasion of extranodal soft tissue,and T and N staging was higher in SR than that in NR in advanced laryngeal cancer(T3-T4 stage)(P<0.05).There was no statistical difference in the accuracy of T and N staging between SR and NR(P>0.05).Otolaryngologists rated the difficulty,completeness,and overall impression of SR higher than NR(P<0.05).Radiologists rated the convenience,difficulty,and teaching value of SR higher than NR(P<0.05).Conclusion Building a CT SR based on AJCC 8th edition TN staging suitable for initial diagnosis and staging of laryngeal cancer can improve the clarity and completeness of imaging reports,making it clinically feasible.
7.Association between ABO Blood Types and the Risk of Gestational Diabetes Mellitus: A Prospective Cohort Study.
Shuang Hua XIE ; Shuang Ying LI ; Shao Fei SU ; En Jie ZHANG ; Shen GAO ; Yue ZHANG ; Jian Hui LIU ; Min Hui HU ; Rui Xia LIU ; Wen Tao YUE ; Cheng Hong YIN
Biomedical and Environmental Sciences 2025;38(6):678-692
OBJECTIVE:
To investigate the association between ABO blood types and gestational diabetes mellitus (GDM) risk.
METHODS:
A prospective birth cohort study was conducted. ABO blood types were determined using the slide method. GDM diagnosis was based on a 75-g, 2-h oral glucose tolerance test (OGTT) according to the criteria of the International Association of Diabetes and Pregnancy Study Groups. Logistic regression was applied to calculate the odds ratios ( ORs) and 95% confidence intervals ( CIs) between ABO blood types and GDM risk.
RESULTS:
A total of 30,740 pregnant women with a mean age of 31.81 years were enrolled in this study. The ABO blood types distribution was: type O (30.99%), type A (26.58%), type B (32.20%), and type AB (10.23%). GDM was identified in 14.44% of participants. Using blood type O as a reference, GDM risk was not significantly higher for types A ( OR = 1.05) or B ( OR = 1.04). However, women with type AB had a 19% increased risk of GDM ( OR = 1.19, 95% CI = 1.05-1.34; P < 0.05), even after adjusting for various factors. This increased risk for type AB was consistent across subgroup and sensitivity analyses.
CONCLUSION
The ABO blood types may influence GDM risk, with type AB associated with a higher risk. Incorporating it-either as a single risk factor or in combination with other known factors-could help identify individuals at risk for GDM before or during early pregnancy.
Humans
;
Female
;
Pregnancy
;
Diabetes, Gestational/etiology*
;
ABO Blood-Group System
;
Adult
;
Prospective Studies
;
Risk Factors
;
Young Adult
8.Interpretation of Chinese expert consensus on flow cytometric detection of hematological malignant cells in tissue samples
Liangmei LI ; Shuang CHEN ; Lian LI ; Zailin YANG ; Xia MAO ; Mingxia ZHU ; Hongmei JING ; Min XIAO ; Yao LIU ; Yanrong LIU
International Journal of Laboratory Medicine 2025;46(11):1281-1289
Hematologic malignancies,such as lymphoma,myeloma,and myeloid neoplasms,can occur in extramedullary tissues.Traditional histopathological morphology and immunohistochemical staining have lim-itations,including time-consuming specimen processing,prolonged reporting cycles,and relatively low sensi-tivity in cases of limited cell numbers.Flow cytometry offers significant advantages in detecting tissue sam-ples,such as rapid processing,shorter reporting cycles,and high accuracy and sensitivity,making it an effective complement to histopathological and immunohistochemical methods.However,the application of flow cytome-try in tissue sample detection currently lacks standardized protocols for sample collection and preservation,single-cell suspension preparation,antibody panel design for limited samples,data analysis,and result repor-ting.To promote the standardized application of flow cytometry in detecting hematologic tumor cells in tissue samples,the Cell Analysis Professional Committee of the Chinese Society of Biotechnology organized experts to develop the Chinese Expert Consensus on Flow Cytometry for Detecting Hematologic Tumor Cells in Tis-sue Samples(hereinafter referred to as the Consensus).This Consensus elaborates on the technical aspects of flow cytometry for tissue sample detection,covering sample processing,antibody panel design,data analysis,reporting content,and quality management.It particularly emphasizes recommended antibody panels and data analysis methods for flow cytometry when tissue sample cell counts are low.This article aims to interpret the key points of the Consensus to facilitate its better application in clinical practice.
9.To construct a CT structural report of laryngeal cancer based on the 8th edition of the American Joint Committee on Cancer TN staging system and evaluate its value
Zhongren TANG ; Pengtao LIU ; Xilong YANG ; Qing LI ; Shuang XIA
Journal of Practical Radiology 2025;41(4):569-573
Objective To evaluate the clinical value of structured report(SR)for CT scans in laryngeal cancer.Methods Accord-ing to the American Joint Committee on Cancer(AJCC)8th edition TN staging,the SR template of CT suitable for initial diagnosis and staging of laryngeal cancer was constructed.It included 5 tumor-related points,4 lymph node-related points,and T and N staging.The differences in the occurrence rate of 11 key points and the accuracy of T and N staging between SR and narrative report(NR)were evaluated and compared.The readability,completeness and overall impression of SR were investigated among radiologists and otolaryngologists with different seniority.Results Finally,208 SR samples and 246 NR samples were included.Except for N0 stage,there were no statistical differences in age,sex ratio,laryngeal cancer classification,or T stage between SR and NR(P>0.05).The occurrence rate of tumor size,extranodal extension(ENE),and T and N staging in early laryngeal cancer(T1-T2 stage)SR was higher than that in NR(P<0.05).The occurrence rate of invasion of intra-and extra-pharyngeal vital structures,tumor size,enhancement degree,ENE,invasion of extranodal soft tissue,and T and N staging was higher in SR than that in NR in advanced laryngeal cancer(T3-T4 stage)(P<0.05).There was no statistical difference in the accuracy of T and N staging between SR and NR(P>0.05).Otolaryngologists rated the difficulty,completeness,and overall impression of SR higher than NR(P<0.05).Radiologists rated the convenience,difficulty,and teaching value of SR higher than NR(P<0.05).Conclusion Building a CT SR based on AJCC 8th edition TN staging suitable for initial diagnosis and staging of laryngeal cancer can improve the clarity and completeness of imaging reports,making it clinically feasible.
10.Evaluation of influencing factors for the severity of cerebral microbleed and its relationship with cognitive impairment in end-stage renal disease using MRI semi-automatic quantitative susceptibility imaging
Chao CHAI ; Hongyan LIU ; Huiying WANG ; Jinping LI ; Shuang XIA
Chinese Journal of Radiology 2024;58(1):48-56
Objective:To investigate the influencing factors for total number, total volume, and total iron burden of cerebral microbleeds (CMBs) and the relationship between CMBs with cognitive impairment in end-stage renal disease (ESRD) using semi-automatic quantitative susceptibility mapping (QSM).Methods:The study was a cross-sectional study. Clinical and imaging data of 46 ESRD patients with≥1 CMBs who attended Tianjin First Central Hospital from November 2018 to August 2022 were retrospectively analyzed. There were 26 males and 20 females, aged 42-75 years. All patients underwent susceptibility-weighted imaging (SWI) scanning, then SWI data was post-processed to obtain QSM. The semi-automatic dynamic programming algorithm was used to get the volume and mean susceptibility value of each CMB by sketching the boundary of CMBs. The CMBs iron load total volume were calculated. Stepwise linear regression analysis was used to explore independent influencing factors for the number, total volume, and total iron burden of CMBs in ESRD patients. Partial correlation analysis was used to explore the relationship between CMBs and cognitive impairment with the other signs of cerebral small vessel diseases as covariates.Results:In patients with ESRD, CMBs were located in the frontal lobe in 19 cases, parietal lobe in 9 cases, temporal lobe in 19 cases, occipital lobe in 14 cases, basal ganglia in 27 cases, dorsal thalamus in 15 cases, centrum semiovale in 14 cases, cerebellum in 14 cases, and brainstem in 13 cases. C-reactive protein levels (95% CI 101.81-157.85, r=0.96, P=0.001) and creatinine levels (95% CI 5.32-29.61, r=0.71, P=0.010) were influencing factors for the total iron burden of CMBs. C-reactive protein levels (95% CI 0.72-1.15, r=0.99, P=0.001) and creatinine levels (95% CI 0.03-0.22, r=0.89, P=0.014) were influencing factors for the total volume of CMBs. C-reactive protein levels (95% CI 0.10-0.12, r=0.96, P=0.001) and alkaline phosphatase levels (95% CI 0.16-0.38, r=0.59, P=0.001) were influencing factors for the number of CMBs. The total volume ( r=-0.61, P=0.009) and total iron burden ( r=-0.71, P=0.002) of CMBs in the frontal lobe were negatively correlated with cognitive function. However, although the number of CMBs in the frontal lobe was negatively correlated with cognitive function, the statistics analysis was insignificant ( r=-0.53, P=0.063). Conclusions:C-reactive protein and creatinine are influencing factors for CMBs′ total volume and total iron burden; C-reactive protein levels and alkaline phosphatase are influencing factors for the number of CMBs. The total iron burden and total volume of CMBs in the frontal lobe may be the biomarkers of cognitive impairment in patients with end-stage renal disease.

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