Role of endogenous T1ρ and its dispersion imaging in differential diagnosis of cardiac amyloidosis.

BACKGROUND: Cardiovascular magnetic resonance (CMR) has demonstrated excellent performance in the diagnosis of cardiac amyloidosis (CA). However, misdiagnosis occasionally occurs because the morphological and functional features of CA are non-specific. This study was performed to determine the value of non-contrast CMR T1ρ in the diagnosis of CA. METHODS: This prospective study included 45 patients with CA, 30 patients with hypertrophic cardiomyopathy (HCM), and 10 healthy controls (HCs). All participants underwent cine (whole heart), T1ρ mapping, pre- and post-contrast T1 mapping imaging (three slices), and late gadolinium enhancement using a 3T whole-body magnetic resonance imaging system. All participants underwent T1ρ at two spin-locking frequencies: 0 and 298 Hz. Extracellular volume (ECV) maps were obtained using pre- and post-contrast T1 maps. The myocardial T1ρ dispersion map, termed myocardial dispersion index (MDI), was also calculated. All parameters were measured in the left ventricular myocardial wall. Participants in the HC group were scanned twice on different days to assess the reproducibility of T1ρ measurements. RESULTS: Excellent reproducibility was observed upon evaluation of the coefficient of variation between two scans (T1ρ [298 Hz]: 3.1%; T1ρ [0 Hz], 2.5%). The ECV (HC: 27.4 ± 2.8% vs HCM: 32.6 ± 5.8% vs CA: 46 ± 8.9%; p < 0.0001), T1ρ [0 Hz] (HC: 35.8 ± 1.7 ms vs HCM: 40.0 ± 4.5 ms vs CA: 51.4 ± 4.4 ms; p < 0.0001) and T1ρ [298 Hz] (HC: 41.9 ± 1.6 ms vs HCM: 48.8 ± 6.2 ms vs CA: 54.4 ± 5.2 ms; p < 0.0001) progressively increased from the HC group to the HCM group, and then the CA group. The MDI progressively decreased from the HCM group to the HC group, and then the CA group (HCM: 8.8 ± 2.8 ms vs HC: 6.1 ± 0.9 ms vs CA: 3.4 ± 2.1 ms; p < 0.0001). For differential diagnosis, the combination of MDI and T1ρ [298 Hz] showed the greatest sensitivity (98.3%) and specificity (95.5%) between CA and HCM, compared with the native T1 and ECV. CONCLUSION: The T1ρ and MDI approaches can be used as non-contrast CMR imaging biomarkers to improve the differential diagnosis of patients with CA.

T1 mapping in evaluation of clinicopathologic factors for rectal adenocarcinoma.

OBJECTIVE: T1 mapping has been increasingly applied in the study of tumor. The purpose of this study was to evaluate the value of T1 mapping in evaluating clinicopathologic factors for rectal adenocarcinoma. MATERIALS AND METHODS: Eighty-six patients with rectal adenocarcinoma confirmed by surgical pathology who underwent preoperative pelvic MRI were retrospectively analyzed. High-resolution T2-weighted imaging (T2WI), T1 mapping, and diffusion-weighted imaging (DWI) were performed. T1 and apparent diffusion coefficient (ADC) parameters were compared among different associated tumor markers, tumor grades, stages, and structure invasion statuses. A receiver operating characteristic (ROC) analysis was estimated. RESULTS: T1 value showed significant difference between high- and low-grade tumors ([1531.5 ± 84.7 ms] vs. [1437.1 ± 80.3 ms], P < 0.001). T1 value was significant higher in positive than in negative perineural invasion ([1495.7 ± 89.2 ms] vs. [1449.4 ± 88.8 ms], P < 0.05). No significant difference of T1 or ADC was observed in different CEA, CA199, T stage, N stage, lymphovascular invasions, extramural vascular invasion (EMVI), and circumferential resection margin (CRM) (P > 0.05). The AUC under ROC curve of T1 value were 0.796 in distinguishing high- from low-grade rectal adenocarcinoma. The AUC of T1 value in distinguishing perineural invasion was 0.637. CONCLUSION: T1 value was helpful in assessing pathologic grade and perineural invasion correlated with rectal cancer.

Multimodal imaging features of primary pericardial synovial sarcoma: a case report.

Background: Primary pericardial synovial sarcoma is an extremely rare malignant tumor, and affected patients have a poor prognosis. Only a few cases have been reported in the literature. Case summary: A 34-year-old man was admitted to our hospital with chest tightness and a cough. An echocardiogram revealed a heterogeneous mass with a large pericardial effusion. Further computed tomography (CT) of the chest and cardiac magnetic resonance imaging (CMRI) demonstrated an irregular pericardial mass abutting the left atrium and left ventricle and invading the mediastinal structures. Pathology results showed that the tumor was a monophasic synovial sarcoma. The patient underwent chemotherapy and survived for 17 months. Discussion: Many cardiac tumors are clinically asymptomatic or nonspecific, and they are frequently detected or diagnosed at an advanced stage of the disease. Multimodal cardiac imaging facilitates the detection and assessment of cardiac tumors. In particular, CMRI is considered as a superior imaging tool, because it provides high tissue contrast and can detect invasion of the myocardium. We describe the clinical details and multimodal imaging features of a rare primary pericardial synovial sarcoma, hoping to provide guidance for the diagnosis of similar cases in the future.

Diagnostic Performance of Diffusion-Weighted Imaging for Colorectal Cancer Detection: An Updated Systematic Review and Meta-Analysis.

Background: Magnetic resonance imaging (MRI), which uses strong magnetic fields and radio waves (radiofrequency energy) to make images, is one of the best imaging methods for soft tissues and can clearly display unique anatomical structures. Diffusion-weighted imaging (DWI) has been developed for identifying various malignant tumors. Aim: To investigate the diagnostic value of DWI-MRI quantitative analysis in colorectal cancer detection. Methods: The PubMed, Cochrane Library, and Embase databases were searched from inception to May 29, 2020. Studies published in English that used DWI-MRI for diagnosing colorectal cancer were included. Case reports, letters, reviews, and studies conducted in non-humans or in-vitro experiments were excluded. The pooled diagnostic odds ratio (DOR) and hierarchical summary receiver operating characteristic (HSROC) curves were computed for DWI, and the area under the curve (AUC) and associated standard error (SE) and 95% confidence intervals (CIs) were also used. Results: In total, 15 studies with 1,655 participants were finally included in this meta-analysis. There were four prospective studies and 11 retrospective studies. Eight studies focused on rectal cancer, six on colorectal cancer, and one on colonic cancer. The performance of DWI-MRI for diagnosing colorectal cancer was accurate, with pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio of 0.88 (95% CI = 0.85-0.91), 0.92 (95% CI = 0.91-0.94), 30.36 (95% CI = 11.05-83.43), and 0.44 (95% CI = 0.30-0.64), respectively. The DOR and HSROC curves were 121 (95% CI = 56-261) and 0.92 (λ: 4.79), respectively. Conclusion: DWI showed high diagnostic accuracy for colorectal cancer detection. Further studies with large sample sizes and prospective design are needed to confirm these results.

Noncontrast T1ρ dispersion imaging is sensitive to diffuse fibrosis: A cardiovascular magnetic resonance study at 3T in hypertrophic cardiomyopathy.

PURPOSE: To determine the sensitivity of a noncontrast T1 dispersion cardiovascular magnetic resonance technique for detecting diffuse fibrosis in hypertrophic cardiomyopathy (HCM). METHODS: Thirty-two adult HCM patients and ten age- and gender-matched healthy volunteers were prospectively included in this study. Patients and controls underwent cine, T1ρ-mapping, and pre- and post-contrast T1-mapping imaging using a 3-T magnetic resonance system. Myocardial extracellular volume fraction (ECV) maps were obtained using pre- and post-contrast T1 maps to determine reference values for diffuse fibrosis. Myocardial T1ρ and T1ρ dispersion maps called myocardial fibrosis index (mFI) maps provided 570 myocardial segments for Pearson or Spearman correlation analysis. The left ventricle myocardia of the HCM patients were divided into 16 segments that were further classified as either normal-thickness myocardium (<15 mm) (HCM-N) or hypertrophic myocardium (≥15 mm) (HCM-H). RESULTS: ECV and mFI values increased progressively on a per-segment basis from healthy controls to the HCM-N group and then to the HCM-H group (ECV: 27.4 ± 2.8% vs. 31.1 ± 4.2% vs. 37.6 ± 6.9%, respectively [P < 0.0001]; mFI: 6.1 ± 0.9 ms vs. 8 ± 1.9 ms vs. 11 ± 3.3 ms, respectively [P < 0.0001]). There was a strong positive correlation between the segmented ECV and the mFI (r = 0.878). The mFI was equally or significantly better than the ECV for differentiating fibrosis content in HCM-N and HCM-H according to their receiver operating characteristic curves. CONCLUSION: A T1ρ dispersion imaging mFI can sensitively detect diffuse myocardial fibrosis in HCM, even in HCM-N.

Improved Outcomes of Combined Main Branch Stenting and Side Branch Drug-Coated Balloon versus Two-Stent Strategy in Patients with Left Main Bifurcation Lesions.

BACKGROUND: Drug-eluting stent (DES) plus drug-coated balloon (DCB) is a safe and effective treatment strategy for coronary artery bifurcation lesions, but there is no report about this strategy being used for left main (LM) bifurcation lesions. We aim to explore the efficacy and safety of DES plus DCB in the treatment of LM bifurcation lesions. METHODS: A total of 100 patients diagnosed with LM bifurcation lesions by coronary angiography were retrospectively enrolled at our center from January 2018 to December 2019. They received either a two-stent strategy or a main branch (MB) stenting plus side branch (SB) DCB strategy and were accordingly divided into the 2-DES group and the DES + DCB group. Patients treated with DES + DCB were compared with a cohort of matched patients treated with a 2-DES strategy. Clinical data was collected and quantitative coronary analysis was performed. RESULTS: For immediate postoperative angiography, though the two groups had no differences in the minimal luminal diameter (MLD) and luminal stenosis of MB, the DES + DCB group had significantly lower SB ostial MLD and a higher degree of residual lumen stenosis than the 2-DES group (P < 0.05). At the time of follow-up, the SB ostial MLD of the DES + DCB group was higher than that of the 2-DES group, but lumen stenosis, late lumen loss (LLL), and LLL at the distal end of the left MB were all smaller than those of the 2-DES group (Ps < 0.05). Furthermore, the incidence of lumen restenosis and MACE between the two groups had no significance. CONCLUSION: The combination of DES and DCB is relatively safe and effective for the treatment of LM bifurcation lesions, and this strategy seems to have advantages in reducing LLL at the SB ostium.

Tumor-specific design of PEGylated gadolinium-based nanoscale particles: Facile synthesis, characterization, and improved magnetic resonance imaging of metastasis lung cancer.

Herein we report the synthesis and characterization of the antifouling Gadolinium oxide (Gd2O3) nanoparticles (NPs) modified with PEG with improved biocompatibility for MR imaging purposes. In this report, using the solvothermal decomposition of Gadolinium (III) in the presence of Na3cit, monitored by surface modification with PEG and L-Cys. The synthesized nanoparticles were confirmed by the TEM, DLS and UV-Visible spectroscopy. The morphological results show normal distance across of the flawless Gd2O3-PEG-Cys-NPs show 7.9 ±â€¯0.4 nm, discretely, with a thin size exchange. This infers the surface adjustment does not obviously alteration the center size of the Gd2O3-NPs when contrasted with the perfect sodium citrate-balanced out Gd2O3-NPs. The Gd2O3-PEG-L-Cys-NPs are highly stable at room temperature, water dispersible and importantly less cytotoxic at high concentration of the NPs. The T1-weighted MR phantasm readings evidentially displayed that the formed PEG coated Gd2O3-PEG and Gd2O3-PEG-Cys-NPs with and without Cys may be performed as the promising T1-weighted MR imaging. The NPs displays no signs of toxicity against the human blood, which represents the biocompatibility for the human medicine applications. The Gd2O3-PEG-Cys-NPs shows relatively, high r1 acceptable cytocompatibility, target specific cancer cells and activate the dual mode MR imaging of lung metastasis cancer model in vitro. The development of versatile zwitterion functionalized Gd2O3 may be promising as an active nanoparticle probe for improved multi-model of MR imaging agents for various cancer diseases.

Analysis of CT and MRI Combined Examination for the Diagnosis of Acute Cerebral Infarction.

The aim of this study was to analyse the application value of CT and MRI combined examination for the diagnosis of acute cerebral infarction. It was an observational study carried out from March 2017 to April 2018. All the patients of acute cerebral infarction, diagnosed on the basis of clinical and laboratory findings and underwent brain CT and MRI examination within 6 hours after the onset of the disease, were included in the study. A total of 70 patients were diagnosed, which included 40 (57.14%) males and 30 (42.86%) females. Median age was 64 years. The confirmed diagnosis rate of acute cerebral infarction by CT combined with MRI was higher than that by CT examination alone (p<0.001). The positive rates of the brainstem were statistically different between the two methods (p=0.007). The diameter of infarct lesion in CT combined with MRI was longer than that in CT examination alone (p<0.001). CT combined with MRI can be used as the first choice for early diagnosis of acute cerebral infarction, particularly of brain stem.

Facile synthesis of cerium-doped carbon quantum dots as a highly efficient antioxidant for free radical scavenging.

Excessive reactive oxygen species (ROS) can lead to irreversible damage to the human body in vivo, therefore it is highly desirable to exploit an efficient antioxidant. Recently, cerium oxide nanoparticles have attracted extensive attention in the field of biomedicine due to their excellent antioxidant properties. In this study, cerium-doped carbon quantum dots (Ce-doped CQDs) with hydroxyl radical scavenging capacity were synthesized for first time by one-step hydrothermal carbonization method. The resultant Ce-doped CQDs with the average particle size of 2.5 nm possessed the properties of good water solubility, colloid stability, and strong fluorescence, which are similar to traditional CQDs. Meanwhile, the Ce-doped CQDs had good biocompatibility and negligible cytotoxicity. Taking advantage of inherent ultra-small size, the Ce-doped CQDs exhibited a high Ce3+/Ce4+ ratio at the surface of particles. The radical scavenging capability of the Ce-doped CQDs was proved by a simple photometric system in vitro, which provided direct evidence for its antioxidant potency. Furthermore, the Ce-doped CQDs had a high ability to protect cells from hydrogen peroxide-induced damage by scavenging hydroxyl radicals. These results suggest that Ce-doped CQDs as a new ROS scavenger may provide potential prospects for the treatment of oxidative stress-related diseases.

Magnetic resonance imaging in interventional therapy of patients with acute myocardial infarction prior to and after treatment.

The aim of the study was to investigate the cardiac magnetic resonance (CMR) imaging in interventional therapy of patients with acute myocardial infarction prior to and after treatment. Fifty-six cases of AMI patients with elective treatment by percutaneous coronary intervention (PCI) were continuously selected. Patients with an incidence of 7-10 days were treated with CMR and echocardiography to evaluate the quality of myocardial infarction, visual score method (VSM), wall motion score abnormality, left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF). Patients with an incidence of 10-14 days were treated with PCI, and CMR and echocardiography were evaluated after 6 months, after which the occurrence of major adverse cardiac events (MACE) were compared. The infarction quality, VSM score and wall motion abnormality (WMA) score were significantly reduced following surgery, and the difference was statistically significant (P<0.05). Ultrasound evaluation of LVEDD, LVESD, and LVEF prior to and after surgery was compared, and the difference was not statistically significant (P>0.05). Evaluation of the magnetic resonance imaging (MRI) in LVEDD prior to surgery was increased compared with that of the ultrasound in LVEDD, whereas MRI in LVESD and LVEF was decreased compared to that of the ultrasound obtained for LVESD and LVEF. Additionally, postoperative LVEDD was reduced compared with preoperative LVEDD, whereas LVEF was increased, and the difference was statistically significant (P<0.05). However, the evaluation of LVESD using the two methods exhibited no significant change. MACE occurred in 7 (12.5%) of 56 cases. The infarction quality of patients in the MACE group following surgery indicated that VSM and WMA scores were significantly higher than the group without MACE, while LVEF was lower than the MACE group following surgery, and the difference was statistically significant (P<0.05), albeit the ultrasound results of LVEF indicated no difference. In conclusion, CMR evaluation of AMI patients with elective PCI treatment in myocardial remodeling and cardiac function were more sensitive and accurate than with cardiac ultrasound.