Prognostic Value of Different Imaging Scores Based on CTA in Endovascular Treatment of Acute Basilar Artery Occlusion.

OBJECTIVE: To investigate the prognostic factors of intravascular therapy for acute basilar artery occlusion (aABO), and to evaluate the prognostic value of various imaging scores based on CTA. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, China, from January 2018 to January 2022. METHODOLOGY: Clinical data of 120 patients who underwent intravascular therapy for aABO were analysed retrospectively. The patients were divided into the poor prognosis group (n=54) and the good prognosis group (n=66) according to the score of the modified rankin scale (mRS) 90 days after the intervention. General clinical parameters of patients and the results of three imaging scores based on CTA i.e. basilar artery CT angiography (BATMAN) score, posterior circulation collateral circulation score (pc-CS), and posterior circulation CT angiography (pc-CTA) score, were taken as independent variables. Prognosis was taken as dependent variable. Univariate and unconditional binary logistic regression analyses were carried out respectively. RESULTS: Multivariate logistic regression analysis showed that preoperative National Institutes of Health Stroke Scale (NIHSS) score (OR=1.063, 95%CI: 1.014~1.114, p=0.011), pc-CTA score (OR=17.183, 95%CI: I3.515~84.010, p <0.001), BATMAN score (OR=0.393, 95%CI: 0.229~0.675, p=0.001), and pc-CS score (OR=0.374, 95%CI: 0.206~0.682, p=0.001) were independent factors affecting the short-term prognosis of patients with aABO. ROC curve analysis showed that the area under the curve (AUC) of the Batman score, pc-CS score and pc-CTA score were 0.900, 0.864 and 0.842 respectively, and the cut-off values were 4.5, 4.5 and 1.5 respectively. CONCLUSION: Preoperative high NIHSS score and high pc-CTA score were independent risk factors for poor prognosis of patients with aABO after intravascular therapy, while high BATMAN score and high pc-CS score were protective factors for prognosis. KEY WORDS: Acute basilar artery occlusion, Intravascular therapy, Basilar artery CT angiography score, Posterior circulation collateral circulation score, Posterior circulation CT angiography.

Usefulness of Noncontrast MRI-Based Radiomics Combined Clinic Biomarkers in Stratification of Liver Fibrosis.

Purpose: To develop and validate a radiomic nomogram based on texture features from out-of-phase T1W images and clinical biomarkers in prediction of liver fibrosis. Materials and Methods: Patients clinically diagnosed with chronic liver fibrosis who underwent liver biopsy and noncontrast MRI were enrolled. All patients were assigned to the nonsignificant fibrosis group with fibrosis stage <2 and the significant fibrosis group with stage ≥2. Texture parameters were extracted from out-of-phase T1-weighted (T1W) images and calculated using the Artificial Intelligent Kit (AK). Boruta and LASSO regressions were used for feature selection and a multivariable logistic regression was used for construction of a combinational model integrating radiomics and clinical biomarkers. The performance of the models was assessed by using the receiver operator curve (ROC) and decision curve. Results: ROC analysis of the radiomics model that included the most discriminative features showed AUCs of the training and test groups were 0.80 and 0.78. A combinational model integrating RADscore and fibrosis 4 index was established. ROC analysis of the training and test groups showed good to excellent performance with AUC of 0.93 and 0.86. Decision curves showed the combinational model added more net benefit than radiomic and clinical models alone. Conclusions: The study presents a combinational model that incorporates RADscore and clinical biomarkers, which is promising in classification of liver fibrosis.

Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Imaging for the Analysis of Microvascular Permeability in Peritumor Brain Edema of Fibrous Meningiomas.

INTRODUCTION: This study aims to analyze the permeability of intra- and peri-meningiomas regions and compare the microvascular permeability between peritumoral brain edema (PTBE) and non-PTBE using DCE-MRI. METHODS: This was a retrospective of patients with meningioma who underwent surgery. The patients were grouped as PTBE and non-PTBE. The DCE-MRI quantitative parameters, including volume transfer constant (Ktrans), rate constant (Kep), extracellular volume (Ve), and mean plasma volume (Vp), obtained using the extended Tofts-Kety 2-compartment model. Logistic regression analysis was conducted to explore the risk factor of PTBE. RESULTS: Sixty-three patients, diagnosed as fibrous meningioma, were included in this study. They were 17 males and 46 females, aged from 32 to 88 years old. Kep and Vp were significantly lower in patients with PTBE compared with those without (Kep: 0.1852 ± 0.0369 vs. 0.5087 ± 0.1590, p = 0.010; Vp: 0.0090 ± 0.0020 vs. 0.0521 ± 0.0262, p = 0.007), while there were no differences regarding Ktrans and Ve (both p > 0.05). The multivariable analysis showed that tumor size ≥10 cm3 (OR = 4.457, 95% CI: 1.322-15.031, p = 0.016) and Vp (OR = 0.572, 95%CI: 0.333-0.981, p = 0.044) were independently associated with PTBE in patients with meningiomas. CONCLUSION: DCE-magnetic resonance imaging·Meningioma·Blood vessel MRI can be used to quantify the microvascular permeability of PTBE in patients with meningioma.

Use of Texture Analysis on Noncontrast MRI in Classification of Early Stage of Liver Fibrosis.

Purpose. To compare the diagnostic value of texture analysis- (TA-) derived parameters from out-of-phase T1W, in-phase T1W, and T2W images in the classification of the early stage of liver fibrosis. Methods. Patients clinically diagnosed with hepatitis B infection, who underwent liver biopsy and noncontrast MRI scans, were enrolled. TA parameters were extracted from out-of-phase T1-weighted (T1W), in-phase T1W, and T2-weighted (T2W) images and calculated using Artificial Intelligent Kit (AK). Features were extracted including first-order, shape, gray-level cooccurrence matrix, gray-level run-length matrix, neighboring gray one tone difference matrix, and gray-level differential matrix. After statistical analyses, final diagnostic models were constructed. Receiver operating curves (ROCs) and areas under the ROC (AUCs) were used to assess the diagnostic value of each final model and 100-time repeated cross-validation was applied to assess the stability of the logistic regression models. Results. A total of 57 patients were enrolled in this study, with 27 in the fibrosis stage < 2 and 30 in stages ≥ 2. Overall, 851 features were extracted per ROI. Eight features with high correlation were selected by the maximum relevance method in each sequence, and all had a good diagnostic performance. ROC analysis of the final models showed that all sequences had a preferable performance with AUCs of 0.87, 0.90, and 0.96 in T2W and in-phase and out-of-phase T1W, respectively. Cross-validation results reported the following values of mean accuracy, specificity, and sensitivity: 0.98 each for out-of-phase T1W; 0.90, 0.89, and 0.90 for in-phase T1W; and 0.86, 0.88, 0.84 for T2W in the training set, and 0.76, 0.81, and 0.72 for out-of-phase T1W; 0.74, 0.72, and 0.75 for in-phase T1W; and 0.63, 0.64, and 0.63 for T2W for the test group, respectively. Conclusion. Noncontrast MRI scans with texture analysis are viable for classifying the early stages of liver fibrosis, exhibiting excellent diagnostic performance.

Liver microRNA-29b-3p positively correlates with relative enhancement values of magnetic resonance imaging and represses liver fibrosis.

This study aims to identify potential microRNAs (miRNAs) contribute to liver fibrosis progression and investigate how the miRNA is involved. We recruited totally 58 patients. Magnetic resonance imaging was employed to detect fibrosis. Classification of liver fibrosis was carried out by Ishak scoring system. Cell viability was tested using cell counting kit-8. Measurements of mRNA and protein expressions were conducted using real-time quantitative polymerase chain reaction and western blotting. Luciferase reporter assay was recruited for determination of miR-29b-3p targets. We found that relative enhancement (RE) values were reduced with the increases in fibrosis stages and was negatively associated with Ishak scores. In comparison with patients without liver fibrosis, miR-29b-3p level was remarkably reduced in those with liver fibrosis. Its level was found to be positively associated with RE values. Transforming growth factor beta 1 (TGF-ß1)-induced hepatic stellate cell (HSC) activation significantly decreased miR-29b-3p expression. However, miR-29b-3p overexpression repressed TGF-ß1-induced collagen I protein and alpha-smooth muscle actin (α-SMA) expression. As expected, its overexpression also reduced cell viability. We found that miR-29b-3p directly bind to signal transducer and activator of transcription 3 (STAT3) and suppressed its expression. Our study demonstrates that low expression of miR-29b-3p may contribute to the progression of liver fibrosis by suppressing STAT3.

Gray Matter Structural Network Disruptions in Survivors of Acute Lymphoblastic Leukemia with Chemotherapy Treatment.

OBJECTIVES: Neuroimaging studies of acute lymphoblastic leukemia (ALL) during chemotherapy treatment have shown alterations in structure, function, and connectivity in several brain regions, suggesting neurobiological impairment that might influence the large-scale brain network. This study aimed to detect the alterations in the topological organization of structural covariance networks of ALL patients. METHODS: This study included 28 ALL patients undergoing chemotherapy and 20 matched healthy controls. We calculated the gray matter volume of 90 brain regions based on an automated anatomical labeling template and applied graph theoretical analysis to compare the topological parameters of the gray matter structural networks between the two groups. RESULTS: The results demonstrated that both the ALL and healthy control groups exhibited a small-world topology across the range of densities. Compared to healthy controls, ALL patients had less highly interactive nodes and a reduced degree/betweenness in temporal regions, which may contribute to impaired memory and executive functions in these patients. CONCLUSION: These results reveal that ALL patients undergoing chemotherapy treatment may have decreased regional connectivity and reduced efficiency of their structural covariance network. This is the first report of anomalous large-scale gray matter structural networks in ALL patients undergoing chemotherapy treatment and provides new insights regarding the neurobiological mechanisms underlying the chemo-brain network.

Clinical value of MRI T2-mapping quantitative assessment of carotid plaque.

BACKGROUND: Stroke is a severe health problem, and magnetic resonance imaging (MRI) plays a significant role in stroke. PURPOSE: To investigate the clinical value of MRI T2-mapping in carotid artery plaque. MATERIAL AND METHODS: To locate the plaque in the carotid artery, 25 patients with carotid atherosclerosis were examined by 3.0-T MRI with three-dimensional (3D) time-of-flight and 3D fast spin-echo (FSE) T1-weighted scanning. The original images were obtained after T2-mapping (multi-spin-echo sequence) scanning. The T2 values of the plaque in the narrowest lumen were measured on T2 maps after postprocessing of the original images. Based on the symptoms, the patients were divided into two sub-groups; independent sample t-test was employed to compare the difference between the T2 values of the plaque in the two groups. We evaluated the optimal threshold and diagnostic efficacy of T2 values in predicting cerebrovascular symptoms by the receiver operating characteristic (ROC) curve. RESULTS: The T2 values of the carotid artery plaque in symptomatic and asymptomatic patients were 111.43 ± 46.54 ms and 59.25 ± 39.77 ms, respectively (t = -3.421, P < 0.01). ROC analysis showed that the T2 value of 65.38 ms was the optimal threshold to predict cerebrovascular symptoms. The specificity, sensitivity, and accuracy attained were 94.1% (16/17), 93.3% (14/15), and 93.8% (30/32), respectively. CONCLUSION: We quantitatively assessed carotid plaque components by MRI T2-mapping technology. The T2 values of the carotid plaque were associated with cerebrovascular symptoms. The T2 values of the symptomatic plaque group were significantly higher than those of the asymptomatic group.

Altered brain structural and cognitive impairment in end-stage renal disease patients with secondary hyperparathyroidism.

BACKGROUND: Cognitive impairment has received attention as an important problem in patients with end-stage renal disease, although end-stage renal disease patients with secondary hyperparathyroidism have not been studied. PURPOSE: To assess the pattern of brain volume changes in end-stage renal disease patients with secondary hyperparathyroidism by using voxel-based morphometry and correlating these measures with clinical markers and the Montreal Cognitive Assessment scores. MATERIAL AND METHODS: Fifty end-stage renal disease patients with no anatomical abnormalities in conventional MRI (25 patients with secondary hyperparathyroidism, 14 men, mean age 42.20 ± 7.53 years; 25 patients without secondary hyperparathyroidism, 15 men, mean age 41.96 ± 6.17 years) were selected in this study. All patients underwent laboratory tests, neuropsychological tests, and MRI. Voxel-based morphometry analysis was performed to detect regional gray matter volume differences between the two groups. The relationships between abnormal gray matter volume and clinical markers and Montreal Cognitive Assessment scores were investigated. RESULTS: Voxel-based morphometry revealed increased gray matter volume in end-stage renal disease patients with secondary hyperparathyroidism in the bilateral caudate and bilateral thalamus compared with non- secondary hyperparathyroidism end-stage renal disease patients (P < 0.05, FWE corrected). Regarding the laboratory and neuropsychological tests, we found significant correlations between volume in these brain regions and intact parathyroid hormone levels and negative correlations with the Montreal Cognitive Assessment scores. There were no significant associations between brain volume changes and other clinical data (disease duration, urea, creatinine, and uric acid levels). CONCLUSION: Our results showed significantly increased gray matter volume in end-stage renal disease patients with secondary hyperparathyroidism, which was associated with intact parathyroid hormone levels and cognitive impairment. Serum intact parathyroid hormone levels may be a risk factor for cognitive impairment in end-stage renal disease patients with secondary hyperparathyroidism.

Functional magnetic resonance imaging-based assessment of terlipressin vs. octreotide on renal function in cirrhotic patients with acute variceal bleeding (CHESS1903): study protocol of a multicenter randomized controlled trial.

BACKGROUND: Acute variceal bleeding is one of the critical complications in patients with liver cirrhosis. Severe renal vasoconstriction in consequence of low peripheral vascular resistance triggers the reduction of glomerular filtration rate (GFR), and thus induces acute kidney injury (AKI)/hepato-renal syndrome (HRS). Terlipressin and octreotide have been used in the management of cirrhotic patients with variceal bleeding. Also, terlipressin has been recommended as the international first-line pharmacological therapy for the treatment of HRS. In addition, the use of renal functional magnetic resonance imaging (fMRI) has become increasingly prevalent in research and clinical applications. However, the renal function-protective effect of terlipressin and octreotide and the value of fMRI in monitoring renal function remains unclear in patients with cirrhosis undergoing acute variceal bleeding. METHODS: This is a multicenter, randomized controlled trial (RCT). Participants will be 1:1 assigned randomly into either terlipressin or octreotide groups. Sixty participants with clinically and/or pathologically diagnosed cirrhosis and active gastroesophageal variceal bleeding (GVB) will be recruited in several sites in China. Participants will receive either the treatment of terlipressin or octreotide after assigned into each group. The primary end point for the trial is the renal function. The secondary end points are (I) renal perfusion; (II) renal blood oxygenation; (III) failure to control bleeding; (IV) intra-hospital rebleeding; (V) intra-hospital mortality; (VI) adverse events (AE); (VII) overall survival. Statistical analysis including multivariate Cox regression, Kaplan-Meier analysis with log-rank test, etc. will be conducted. DISCUSSION: The study will provide new insight into the protection of renal function in the process of the treatment of variceal bleeding in patients with cirrhosis. TRIAL REGISTRATION NUMBER: NCT04028323.

The association between three promoter polymorphisms of IL-1 and stroke: a meta-analysis.

AIM: The association between Interleukin-1 (IL-1) gene polymorphism and stroke remains controversial. The present study was designed to clarify this relationship through a pooled analysis of the numerous epidemiological studies focusing on this association. METHODS: Published data addressing the association between polymorphism of the IL-1 gene and stroke were selected from electronic databases. A total of 21 studies from 19 publications including 5280 stroke patients and 5699 controls were included in this meta-analysis which detect whether IL-1α-889C/T, IL-1ß-511C/T and IL-1 RN polymorphism were associated with stroke susceptibility. RESULT: The combined results of overall analysis revealed that there was a significant association between IL-1α-889C/T polymorphism and stroke (allele model: OR = 1.39, 95% CI = 1.14-1.68, P < 0.001; recessive model: OR = 1.56, 95% CI = 1.27-1.90, P < 0.001; dominant model: OR = 1.45, 95% CI = 1.13-1.87, P = 0.004; additive model: OR = 1.70, 95% CI = 1.37-2.10, P < 0.001). On a subgroup analysis by ethnicity of study population, significant association was found in Asians (allele model: OR = 1.25 95% CI = 1.12-1.39, P < 0.001; recessive model: OR = 1.36, 95% CI = 1.09-1.69, P = 0.007; dominant model: OR = 1.29, 95% CI = 1.12-1.48, P < 0.001; additive model: OR = 1.42, 95% CI = 1.13-1.80, P = 0.003). There are no associations of IL-1ß-511C/T and IL-RN polymorphisms on stroke risk were identified. CONCLUSION: In conclusion, our results suggested that IL-1α-889C/T polymorphism is associated with stroke risk, especially in Asians. However, no associations of IL-1ß-511C/T and IL-RN polymorphisms on stroke risk in overall analysis or subgroup analysis.

The association between three promoter polymorphisms of IL-10 and inflammatory bowel diseases (IBD): a meta-analysis.

AIM: To assess the relationship of the Interleukin-10 (IL-10) -1082G/A (rs1800896), -819C/T (rs1800871) and -592C/A (rs1800872) polymorphism with inflammatory bowel disease (IBD) by means of meta-analysis. METHODS: Published data addressing the association between polymorphism of the IL-10 with Crohn's disease (CD) and Ulcerative colitis (UC) were selected from electronic databases. A total of 17 studies including 4132 cases and 5109 controls were included in this meta-analysis which detected whether -1082G/A, -819C/T and -592C/A polymorphism were associated with CD or UC susceptibility. RESULT: The IL-10 -819C/T and -519C/A variant allele observed a significant association with UC (OR 1.16, 95%CI 1.03-1.31 and OR 1.19, 95%CI 1.03-1.38) not CD while there is no significant association between -1082G/A and UC or CD. CONCLUSION: The IL-10 -819C/T and -592C/A polymorphisms contribute to susceptibility to UC, but IL-10 -1082G/A polymorphism neither associated with CD nor UC.