Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

Objective To assess the value of cardiac magnetic resonance(CMR)imaging for predicting adverse left ventricular remodeling in patients with ST-segment elevation myocardial infarction(STEMI).Methods We retrospectively analyzed the clinical data and serial CMR(cine and LGE sequences)images of 86 STEMI patients within 1 week and 5 months after percutaneous coronary intervention(PCI),including 25 patients with adverse LV remodeling and 61 without adverse LV remodeling,defined as an increase of left ventricular end-systolic volume(LVESV)over 15%at the second CMR compared to the initial CMR.The CMR images were analyzed for LV volume,infarct characteristics,and global and infarct zone myocardial function.The independent predictors of adverse LV remodeling following STEMI were analyzed using univariate and multivariate Logistic regression methods.Results The initial CMR showed no significant differences in LV volume or LV ejection fraction(LVEF)between the two groups,but the infarct mass and microvascular obstructive(MVO)mass were significantly greater in adverse LV remodeling group(P<0.05).Myocardial injury and cardiac function of the patients recovered over time in both groups.At the second CMR,the patients with adverse LV remodeling showed a significantly lower LVEF,a larger left ventricular end-systolic volume index(LVESVI)and a greater extent of infarct mass(P<0.001)with lower global peak strains and strain rates in the radial,circumferential,and longitudinal directions(P<0.05),infarct zone peak strains in the 3 directions,and infarct zone peak radial and circumferential strain rates(P<0.05).The independent predictors for adverse LV remodeling following STEMI included the extent of infarct mass(AUC=0.793,95%CI:0.693-0.873;cut-off value:30.67%),radial diastolic peak strain rate(AUC=0.645,95%CI:0.534-0.745;cut-off value:0.58%),and RAAS inhibitor(AUC= 0.699,95%CI:0.590-0.793).Conclusion The extent of infarct mass,peak radial diastolic strain rate,and RAAS inhibitor are independent predictors of adverse LV remodeling following STEMI.

Infective endocarditis is a microbial infection of the endocardium and can easily affect heart valve.Its characteristic lesion is vegetation formation,and the shedding of vegetation results in arterial embolism and ischemic necrosis of corresponding tissues and organs.A case of infective endocarditis with multiple extracardiac complications was described in this article.The characteristic ultrasound finding was the vegetation formation in anterior mitral valve.CT and MRI scans revealed involvements in multiple organs and blood vessels,which were manifested as splenic infarction,renal infarction,cerebral infarction,splenic aneurysm,superior mesenteric artery aneurysms,renal artery aneurysms,and distal segment stenosis and occlusion of right middle cerebral artery.
Embolism ; Endocarditis ; Endocarditis, Bacterial ; Humans ; Infarction ; Mitral Valve

To evaluate the effect of monochromatic energy image on inferior vena cava imaging quality on dual-layer detector spectral CT. Totally 39 patients who were clinically suspected of abdominal disease and referred to perform contrast-enhanced computed tomography(CT)were prospectively enrolled and underwent abdominal examination using a single-source,dual-detector spectral CT.The delayed phase scan was performed 3 minutes after injection of 60 ml of iopamidol(320 mg/ml)at a rate of 3 ml/s.The raw images were reconstructed to obtain conventional mixed energy images and spectral based images(SBI).The 40,50,60,and 70 keV single energy images were obtained.The CT value,noise,and signal-to-noise(SNR)of inferior vena cava and the contrast-to-noise(CNR)of inferior vena cava relative to psoas major on conventional mixed energy images and the 40,50,60,70 keV single energy images were measured.The SNRs and CNRs on monoenergetic 40-70 keV images were compared with polychromatic 120 kVp images.ANOVA was used to compare the CT value,noise,SNR,and CNR among these five groups.The optimal monoenergetic image set was chosen. The differences in CT value,noise,SNR,CNR of inferior vena cava were statistically significant among five groups(all <0.05).The SNR and CNR in 40 keV group and 50 keV group were significantly higher than those in other groups(all <0.05).The SNR of 40 keV group was significantly higher than that of 50 keV group(=0.002).The CNR of 40 keV group was not statistical different compared with that of 50 keV group(=0.630). 40 keV is the optimal monoenergetic energy level for the inferior vena cava on dual-layer detector spectral CT and may be valuable for the diagnosis of inferior vena cava disease.
Abdomen ; Humans ; Radiographic Image Interpretation, Computer-Assisted ; Signal-To-Noise Ratio ; Tomography, X-Ray Computed ; Vena Cava, Inferior

Internal fixator is usually adopted in the treatment of bone fractures. In order to achieve anatomical reduction and effective fixation of fractures, the placement of internal fixators should comply with the biology force line of the bone and adapt to the specific anatomical morphological characteristics of the cortical bone. In order to investigate the distribution characteristics and formation regularity of biology force line and cortical thickness of human bone, three-dimensional model of proximal femur is established by using three-dimensional reconstruction technique in this paper. The normal physiological stress distribution of proximal femur is obtained by finite element analysis under three kinds of behavior conditions: one-legged stance, abduction and adduction. The structural topology optimization method is applied to simulate the cortex of the proximal femur under the combined action of three kinds of behavior conditions, and the anatomic morphological characteristics of the proximal femur are compared. The distribution trend of biology force line of proximal femur and the characteristics of cortex are analyzed. The results show that the biology force lines of bone structure and the morphological characteristics of cortex depend on the load of human activities. The distribution trend of biology force line is related to the direction of trabecular bone and the ridge trend and firmness of cortex when bone is loaded physiologically. The proposed analytical method provides a solution to determine the biology force line of bone and the distribution characteristics of cortex. The conclusions obtained may guide the reasonable placement of internal fixator components of fracture.

OBJECTIVE: To assess the effects of iterative model reconstruction (IMR) on image quality for demonstrating non-calcific high-risk plaque characteristics of coronary arteries. MATERIALS AND METHODS: This study included 66 patients (53 men and 13 women; aged 39–76 years; mean age, 55 ± 13 years) having single-vessel disease with predominantly non-calcified plaques evaluated using prospective electrocardiogram-gated 256-slice CT angiography. Paired image sets were created using two types of reconstruction: hybrid iterative reconstruction (HIR) and IMR. Plaque characteristics were compared using the two algorithms. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of the images and the CNR between the plaque and adjacent adipose tissue were also compared between the two reformatted methods. RESULTS: Seventy-seven predominantly non-calcified plaques were detected. Forty plaques showed napkin-ring sign with the IMR reformatted method, while nineteen plaques demonstrated napkin-ring sign with HIR. There was no statistically significant difference in the presentation of positive remodeling, low attenuation plaque, and spotty calcification between the HIR and IMR reconstructed methods (all p > 0.5); however, there was a statistically significant difference in the ability to discern the napkin-ring sign between the two algorithms (χ2 = 12.12, p < 0.001). The image noise of IMR was lower than that of HIR (10 ± 2 HU versus 12 ± 2 HU; p < 0.01), and the SNR and CNR of the images and the CNR between plaques and surrounding adipose tissues on IMR were better than those on HIR (p < 0.01). CONCLUSION: IMR can significantly improve image quality compared with HIR for the demonstration of coronary artery and atherosclerotic plaques using a 256-slice CT.
Adipose Tissue ; Angiography ; Atherosclerosis ; Coronary Artery Disease ; Coronary Vessels ; Female ; Humans ; Image Processing, Computer-Assisted ; Male ; Methods ; Multidetector Computed Tomography ; Noise ; Plaque, Atherosclerotic ; Prospective Studies ; Signal-To-Noise Ratio

Objective To explore the clinical effect of treatment on facial soft tissue depression by autologous fat granule mixed with adipose-derived stem ceils.Methods A lof of 36 patients with facial soft tissue depression from September 2011 to March 2013 in this clinic were as the research objects.The autologous fat granules were harvested from patients' lateral thigh.The autologous fat granules mixed with adipose-derived stem cells (ADSCs) which were harvested by separating and cleaning were injected into facial soft tissue depression.The standard was based on the subjective satisfaction of patients and the physicians' objective assessment;there were two unrelated doctors to reach an objective assessment of the clinical efficacy based on the comparison of preoperative and postoperative photographs.Results A lof of 36 patients were followed up for 5 16 months,low absorption rate of injec ted fat and significant improvement in shape filling areas were observed,and skin texture,pores,spots and wrinkles were significantly improved.Conclusions Autologous fat granule mixed with AD SCs in the treatment of facial soft tissue depression is a minimally injuried,easily-handled,cheap and safe procedure.It is an ideal treatment of facial soft tissue depression.All the patients have no complications such as infection,induration and fat liquefaction.

Objective To study the efficacy and complications of total hip arthroplasty (THA) with rivet system for reconstruction of joint capsule and external rotator muscles.Methods Data of 170 patients managed with THA of femoral neck fracture between January 2009 and January 2012 were reviewed retrospectively.Hip fracture was the result of a fall and all were subcapital fractures.The fracture patterns were classified as Garden Ⅳ in 139 patients and Garden Ⅱ in 31 patients according to the degree of displacement.In all,85 patients (37 males and 48 females;age between 61 and 84 years,mean 73 years) underwent joint capsule as well as external rotator muscle reconstruction by rivet system (study group).The remaining 85 patients (36 males and 49 females;age between 64-87 years,mean 74 years) were served as control group.The MOS 36-item short form health survey (SF-36),dislocation rate and complications were evaluated at postoperative follow-up.Results Duration of follow-up was 36 to 60 months (mean,46 months).SF-36 questionnaire scale was (45.95 ±4.27)points in study group and (45.38 ± 4.67) points in control group before operation (P ＞ 0.05),while (83.67 ± 3.93) points in study group and (82.16 ± 3.21) points in control group at postoperative follow-up (P ＜ 0.05).Six patients in control group suffered from early prosthetic dislocation,but none in study control.Perioperative incidence of complications was comparable between the two groups (P ＞0.05).Conclusions Application of rivet system for reconstruction of joint capsule and external rotator muscles in THA of patients with femoral neck fracture can reduce incidence of prosthetic dislocation after operation.The operation is simple and will not increase the rate of perioperative complications.

10.3969/j.issn.2095-4344.2013.26.001

ObjectiveTo investigate the plasma endothelin(ET),angiotensin (Ang) Ⅱ levels on middle cerebral artery resistance in hypertension patients.MethodsThe plasma ET and Ang Ⅱ levels were determined in hypertension grade 1 (grade 1 group,40 cases),grade 2 (grade 2 group,40 cases ),grade 3(grade 3 group,40 cases) and healthy adults (control group,50 cases).The systolic velocity and pulsatility index of middle cerebral artery were determined by transcranial Doppler,and 24 h ambulatory blood pressure was monitored.ResultsThe pulsatility index in grade 2 group and grade 3 group was higher than that in control group and grade 1 group (1.23 ±0.22,1.31 ±0.21 vs.0.76 ±0.18,0.78 +0.13)(P＜0.05).The systolic velocity in grade 2 group was higher than that in control group,grade 1 group and grade 3 group [(87.8 ± 11.7) cm/s vs.(60.8 ± 10.6),(63.8 ± 11.8),(49.9 ± 10.8) cm/s](P ＜ 0.05),and in grade 3 group was lower than that in control group,grade 1 group and grade 2 group(P ＜ 0.05 ).The plasma ET,Ang Ⅱ in grade 1,2,3 group was higher than that in control group[(46.83 ± 8.83 ),(55.63 ± 10.28 ),(67.19 ± 10.73)ng/L vs.( 38.94 ± 7.83 ) ng/L and ( 50.23 ± 9.23 ),(64.34 ± 12.23 ),( 79.83 ± 13.43 ) ng/L vs.(41.63 ± 8.76 )ng/L] (P ＜0.05).A increasing trend in the plasma ET and Ang Ⅱ was present with increasing the hypertension grade(P ＜ 0.05 ).The night average systolic pressure,night average diastolic pressure and plasma ET,Ang Ⅱ levels in dipper hypertension patients (60 cases) were lower than those in non-dipper hypertension patients(60 cases) [(121.83 ± 11.83) mm Hg(1 mm Hg =0.133 kPa) vs.(138.84 ± 13.29)mm Hg,(77.23 ± 8.54) mm Hg vs.(86.93 ± 10.34) mm Hg,(48.83 ± 10.14) ng/L vs.(59.83 ± 11.29)ng/L,(55.84 ± 10.83 ) ng/L vs.(72.83 ± 20.29) ng/L,P ＜ 0.05].ConclusionMonitoring plasma ET,Ang Ⅱ levels and ambulatory blood pressure in hypertension patients is helpful in using medicine to improve endothelial function and to promote its dynamic type into a dipper blood pressure in the treatment of patients,thereby to reduce the incidence of hypertension adverse events.