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1.
Hum Brain Mapp ; 45(11): e26790, 2024 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-39037119

RESUMO

Brain glymphatic dysfunction is critical in neurodegenerative processes. While animal studies have provided substantial insights, understandings in humans remains limited. Recent attention has focused on the non-invasive evaluation of brain glymphatic function. However, its association with brain parenchymal lesions in large-scale population remains under-investigated. In this cross-sectional analysis of 1030 participants (57.14 ± 9.34 years, 37.18% males) from the Shunyi cohort, we developed an automated pipeline to calculate diffusion-weighted image analysis along the perivascular space (ALPS), with a lower ALPS value indicating worse glymphatic function. The automated ALPS showed high consistency with the manual calculation of this index (ICC = 0.81, 95% CI: 0.662-0.898). We found that those with older age and male sex had lower automated ALPS values (ß = -0.051, SE = 0.004, p < .001, per 10 years, and ß = -0.036, SE = 0.008, p < .001, respectively). White matter hyperintensity (ß = -2.458, SE = 0.175, p < .001) and presence of lacunes (OR = 0.004, 95% CI < 0.002-0.016, p < .001) were significantly correlated with decreased ALPS. The brain parenchymal and hippocampal fractions were significantly associated with decreased ALPS (ß = 0.067, SE = 0.007, p < .001 and ß = 0.040, SE = 0.014, p = .006, respectively) independent of white matter hyperintensity. Our research implies that the automated ALPS index is potentially a valuable imaging marker for the glymphatic system, deepening our understanding of glymphatic dysfunction.


Assuntos
Imagem de Difusão por Ressonância Magnética , Sistema Glinfático , Humanos , Masculino , Feminino , Sistema Glinfático/diagnóstico por imagem , Sistema Glinfático/patologia , Sistema Glinfático/fisiopatologia , Pessoa de Meia-Idade , Estudos Transversais , Idoso , Imagem de Difusão por Ressonância Magnética/métodos , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Processamento de Imagem Assistida por Computador/métodos , Adulto , Estudos de Coortes
2.
Cerebrovasc Dis ; 52(4): 480-486, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36446342

RESUMO

BACKGROUND AND PURPOSE: The circle of Willis (COW) is a circulatory anastomosis located at the base of the brain. Little is known about the association between covert vascular brain injury and COW configurations in the general population. We explored this relationship in a community-based Chinese sample. METHODS: A total of 1,055 patients (mean age, 54.8 ± 8.9 years; 36.0% men) without intracranial arterial stenosis were included in the analysis. Magnetic resonance imaging was performed to evaluate the presence of imaging markers of covert vascular brain injury, including white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), enlarged perivascular spaces, and brain atrophy. Magnetic resonance angiography was used to classify the COW configurations according to the completeness, symmetry, and presence of the fetal posterior cerebral artery (FTP). The association between vascular lesions and variations in COW was analyzed. RESULTS: Among the 1,055 patients, 104 (9.9%) had a complete COW. Completeness correlated with age (p = 0.001). Incomplete COW was positively associated with WMH severity (OR = 2.071; 95% CI, 1.004-4.270) and CMB presence (OR = 1.542; 95% CI, 1.012-2.348), independent of age and sex. The presence of FTP was associated with lacunes (OR = 1.878; 95% CI, 1.069-3.298), more severe WMHs (OR = 1.739; 95% CI, 1.064-2.842), and less severe enlarged perivascular spaces (OR = 0.562; 95% CI, 0.346-0.915). CONCLUSIONS: COW configuration was significantly related to various covert vascular brain injuries.


Assuntos
Traumatismo Cerebrovascular , Círculo Arterial do Cérebro , Humanos , Círculo Arterial do Cérebro/diagnóstico por imagem , Círculo Arterial do Cérebro/patologia , Encéfalo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Angiografia por Ressonância Magnética , Traumatismo Cerebrovascular/patologia
3.
Cerebrovasc Dis ; 51(5): 655-662, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35259750

RESUMO

BACKGROUND: Although inflammation is found to be related to arteriopathy pathogenesis, it is yet to be determined the distinct correlations of specific inflammatory biomarker types contributing to different cerebral large vessel diseases. We aimed to investigate the association between multiple inflammatory biomarkers and cerebral atherosclerosis and dolichoectasia in a community-based sample. METHODS: A total of 960 participants of the Shunyi study were included. A panel of 14 circulatory inflammatory biomarkers was assessed and then grouped in three sets as systemic, endothelial-related, and media-related inflammation, based on underlying different inflammatory cascades. Intracranial atherosclerotic stenosis (ICAS), dolichoectasia estimated by magnetic resonance angiography, and carotid plaques estimated by ultrasound were also performed. RESULTS: Endothelial-related inflammatory group was related to the presence of ICAS (R2 = 0.215, p = 0.024) and carotid plaques (R2 = 0.342, p = 0.013). Backward stepwise elimination showed that E-selectin was prominent (ß = 0.67, 95% CI: 0.54-0.85, p = 0.001; ß = 0.79, 95% CI: 0.68-0.93, p = 0.005). Systemic inflammatory group was associated with an increased basilar artery diameter (R2 = 0.051, p < 0.001), and backward stepwise elimination showed that IL-6 was prominent (ß = 0.07, 95% CI: 0.03-0.11, p < 0.001). CONCLUSION: Different types of inflammatory biomarkers were associated with atherosclerosis and dolichoectasia, respectively, implying dissimilar inflammatory processes. Further confirming of their distinct anti-inflammatory roles as potential therapeutic targets is warrant.


Assuntos
Aterosclerose , Arteriosclerose Intracraniana , Aterosclerose/complicações , Aterosclerose/diagnóstico por imagem , Aterosclerose/patologia , Artéria Basilar , Biomarcadores , Humanos , Inflamação/complicações , Inflamação/diagnóstico por imagem , Inflamação/patologia , Arteriosclerose Intracraniana/complicações , Arteriosclerose Intracraniana/diagnóstico por imagem
4.
BMC Neurol ; 22(1): 401, 2022 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-36324076

RESUMO

BACKGROUND: Neuronal intranuclear inclusion disease (NIID) is a progressive neurodegenerative disease. Patients with NIID may present with heterogeneous clinical symptoms, including episodic encephalopathy, dementia, limb weakness, cerebellar ataxia, and autonomic dysfunction. Among the NIID cases reported in China, patients often have complicated and severe manifestations. Therefore, many clinicians do not consider the disease when the patient presents with relatively minor complaints. CASE PRESENTATION: We present the case of a 39-year-old man showing migraine-aura-like symptoms for the past 3 years. Brain magnetic resonance imaging (MRI) revealed hyperintense signals in the splenium of the corpus callosum and corticomedullary junction on diffusion-weighted imaging (DWI) over time. In addition, brain atrophy that was not concomitant with the patient's age was detected while retrospectively reviewing the patient's imaging results. Genetic analysis and skin biopsy confirmed a diagnosis of NIID. The patient was treated with sibelium, and the symptoms did not recur. DISCUSSION AND CONCLUSIONS: Migraine-aura-like symptoms may be the predominant clinical presentation in young patients with NIID. Persistent high-intensity signals on DWI in the brain and early-onset brain atrophy might be clues for the diagnosis of NIID.


Assuntos
Epilepsia , Transtornos de Enxaqueca , Doenças Neurodegenerativas , Masculino , Humanos , Adulto , Doenças Neurodegenerativas/diagnóstico , Doenças Neurodegenerativas/diagnóstico por imagem , Estudos Retrospectivos , Atrofia/complicações , Cefaleia/complicações , Transtornos de Enxaqueca/complicações , Epilepsia/complicações
5.
J Ultrasound Med ; 41(8): 1961-1974, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34751458

RESUMO

BACKGROUND: This pilot study aims at exploiting machine learning techniques to extract color Doppler ultrasound (CDUS) features and to build an artificial neural network (ANN) model based on these CDUS features for improving the diagnostic performance of thyroid cancer classification. METHODS: A total of 674 patients with 712 thyroid nodules (TNs) (512 from internal dataset and 200 from external dataset) were randomly selected in this retrospective study. We used ANN to build a model (TDUS-Net) for classifying malignant and benign TNs using both the automatically extracted quantitative CDUS features (whole ratio, intranodular ratio, peripheral ratio, and number of vessels) and gray-scale ultrasound (US) features defined by the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TI-RADS). Then, we compared the diagnostic performance of the model, the performance of another ANN model based on the gray-scale US features alone (TUS-Net), and that of radiologists. RESULTS: The TDUS-Net (0.898, 95% CI: 0.868-0.922) achieved a higher area under the curve (AUC) than that of TUS-Net (0.881, 95% CI: 0.850-0.908) in the internal tests. Compared with radiologists, TDUS-Net (AUC: 0.925, 95% CI: 0.880-0.958) performed better than radiologists (AUC: 0.810, 95% CI: 0.749-0.862) in the external tests. CONCLUSIONS: Applying a machine learning model by combining both gray-scale US features and CDUS features can achieve comparable or even higher performance than radiologists in classifying TNs.


Assuntos
Neoplasias da Glândula Tireoide , Nódulo da Glândula Tireoide , Estudos de Coortes , Humanos , Aprendizado de Máquina , Projetos Piloto , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/patologia , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia , Ultrassonografia/métodos
6.
Stroke ; 52(12): 3918-3925, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34404235

RESUMO

BACKGROUND AND PURPOSE: Researches on rare variants of NOTCH3 in the general Chinese population are lacking. This study aims to describe the spectrum of rare NOTCH3 variants by whole-exome sequencing in a Chinese community-based cohort and to investigate the association between rare NOTCH3 variants and age-related cerebral small vessel disease. METHODS: The cross-sectional study comprised 1065 participants who underwent whole-exome sequencing and brain magnetic resonance imaging. NOTCH3 variants with minor allele frequency<1% in all 4 public population databases (1000 Genomes, ESP6500siv2_ALL, GnomAD_ALL, and GnomAD_EAS) were defined as rare variants. Multivariable linear and logistic regressions were used to investigate the associations between rare NOTCH3 variants and volume of white matter hyperintensities and cerebral small vessel disease burden. Clinical and imaging characteristics of rare NOTCH3 variant carriers were summarized. RESULTS: Sixty-five rare NOTCH3 variants were identified in 147 of 1065 (13.8%) participants, including 57 missense single nucleotide polymorphisms (SNPs), 5 SNPs in splice branching sites, and 3 frameshift deletions. A significantly higher volume of white matter hyperintensities and heavier burden of cerebral small vessel disease was found in carriers of rare NOTCH3 EGFr (epidermal growth factor-like repeats)-involving variants, but not in carriers of EGFr-sparing variants. The carrying rate of rare EGFr-involving NOTCH3 variants in participants with dementia or stroke was significantly higher than those without dementia or stroke (12.4% versus 6.6%, P=0.041). Magnetic resonance imaging signs suggestive of CADASIL were found in 3.4% (5/145) rare EGFr cysteine-sparing NOTCH3 variant carriers but not in 2 cysteine-altering NOTCH3 variant carriers. CONCLUSIONS: Carriers of rare NOTCH3 variants involving the EGFr domain may be genetically predisposed to age-related cerebral small vessel disease in the general Chinese population.


Assuntos
Doenças de Pequenos Vasos Cerebrais/genética , Predisposição Genética para Doença/genética , Receptor Notch3/genética , Idoso , Povo Asiático/genética , Estudos de Coortes , Estudos Transversais , Feminino , Variação Genética , Humanos , Masculino , Pessoa de Meia-Idade
7.
J Nanobiotechnology ; 19(1): 386, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34819078

RESUMO

BACKGROUND: The ratio of fPSA/tPSA in the "grey zone" of tPSA with the concentration range between 4 ng/ml and 10 ng/ml is significant for diagnosis of prostate cancer, and highly efficiency quantification of the ratio of fPSA/tPSA remain elusive mainly because of their extremely low concentration in patients' peripheral blood with high biosample complexity. METHODS: We presented an interdigitated spiral-based MXene-assisted organic electrochemical transistors (isMOECTs) biosensor for highly sensitive determination of fPSA/tPSA. The combination of MXene and the interdigitated multiple spiral architecture synergistically assisted the amplification of amperometric signal of biosensor with dual functionalizations of anti-tPSA and anti-fPSA. RESULTS: The ultrasensitivity of the biosensor was enhanced by tunable multiple spiral architecture and MXene nanomaterials; and the sensor exhibited improved detection limit of tPSA and fPSA down to 0.01 pg/ml and acceptable performance of selectivity, repeatability and stability. Moreover, the isMOECTs displayed area under the curve (AUC) value of 0.8138, confirming the potential applications of isMOECTs in clinics. CONCLUSIONS: The merits of isMOECTs biosensor demonstrated the reliability of MXene-assisted organic electrochemical transistor biosensor with multiple interdigitated spiral for ultrasensitive quantification of fPSA/tPSA, suggesting potential current and future point-of-care testing applications.


Assuntos
Técnicas Biossensoriais/métodos , Técnicas Eletroquímicas/métodos , Antígeno Prostático Específico/sangue , Biomarcadores/sangue , Técnicas Biossensoriais/instrumentação , Técnicas Eletroquímicas/instrumentação , Eletrodos , Desenho de Equipamento , Humanos , Masculino , Neoplasias da Próstata/diagnóstico
8.
Cerebrovasc Dis ; 49(5): 522-530, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33091907

RESUMO

BACKGROUND AND PURPOSE: To compare the risk factors and risk of stroke between lacune and large perivascular spaces (PVSs) in a community-based sample. METHODS: Large PVSs were assessed using 3.0T MRI in a population-based cohort consisting of 1,204 participants. The relationship between cardiovascular risk factors, neuroimaging changes, and incidental stroke risk and the presence of lacune or large PVSs was assessed with univariate and multivariable ordinal logistic regression analysis. RESULTS: Of the 1,204 study participants (55.7 ± 9.3 years, 37.0% men), a total of 347 large PVSs were detected in 235 (19.5%) subjects, while a total of 219 lacunes were detected in 183 subjects (15.2%). The presence of lacunes was found to be significantly associated with age, male gender, hypertension, and diabetes, whereas only age (p < 0.01) and ApoEε4 carrier status (p < 0.01) were related to the presence of large PVSs. Those who had lacunes detected on MRI at baseline had a significant increased risk of stroke (hazard ratio [HR] 4.68; 95% confidence interval [CI], 1.15-19.07) during the 3-year follow-up independent of age, gender, and other vascular risk factors. However, there was no significant relationship between the presence of large PVSs and incident stroke (HR 3.84; 95% CI, 0.82-18.04). CONCLUSIONS: The lack of association between large PVSs and cardiovascular risk factors or risk of stroke indicated a nonvascular pathogenic mechanism underlying large PVSs, suggesting the importance of distinguishing large PVSs from lacunes in clinical practice.


Assuntos
Artérias Cerebrais/diagnóstico por imagem , Sistema Glinfático/diagnóstico por imagem , Imageamento por Ressonância Magnética , Acidente Vascular Cerebral Lacunar/diagnóstico por imagem , Acidente Vascular Cerebral/diagnóstico por imagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral Lacunar/etiologia
9.
Eur Heart J ; 40(48): 3924-3933, 2019 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-31365073

RESUMO

AIMS: A persistent cardiac T-cell response initiated by myocardial infarction is linked to subsequent adverse ventricular remodelling and progression of heart failure. No data exist on T-cell receptor (TCR) repertoire changes in combination with phenotypic characterization of T cells in ischaemic failing human hearts. METHODS AND RESULTS: Analysis of TCR repertoire with high-throughput sequencing revealed that compared with T cells in control hearts, those in ischaemic failing hearts showed a clonally expanded TCR repertoire but similar usage patterns of TRBV-J rearrangements and V gene segments; compared with T cells in peripheral blood, those in ischaemic failing hearts exhibited a restricted and clonally expanded TCR repertoire and different usage patterns of TRBV-J rearrangements and V gene segments, suggesting the occurrence of tissue-specific T-cell expansion in ischaemic failing hearts. Consistently, TCR clonotype sharing was prominent in ischaemic failing hearts, especially in hearts of patients who shared human leucocyte antigen (HLA) alleles. Furthermore, ischaemia heart failure (IHF) heart-associated clonotypes were more frequent in peripheral blood of IHF patients than in that of controls. Heart-infiltrating T cells displayed memory- and effector-like characteristics. Th1 cells were the predominant phenotype among CD4+ T cells; CD8+ T cells were equally as abundant as CD4+ T cells and produced high levels of interferon-γ, granzyme B, and perforin. CONCLUSION: We provide novel evidence for a tissue-specific T-cell response predominated by Th1 cells and cytotoxic CD8+ T cells in ischaemic failing human hearts that may contribute to the progression of heart failure.


Assuntos
Insuficiência Cardíaca/patologia , Infarto do Miocárdio/patologia , Receptores de Antígenos de Linfócitos T/genética , Linfócitos T/patologia , Linfócitos T CD4-Positivos/metabolismo , Linfócitos T CD8-Positivos/metabolismo , Estudos de Casos e Controles , Células Clonais/metabolismo , Progressão da Doença , Granzimas/metabolismo , Insuficiência Cardíaca/metabolismo , Humanos , Memória Imunológica/genética , Interferon gama/metabolismo , Isquemia , Infarto do Miocárdio/metabolismo , Perforina/metabolismo , Fenótipo , Remodelação Ventricular
10.
J Stroke Cerebrovasc Dis ; 29(11): 105274, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33066887

RESUMO

BACKGROUND AND OBJECTIVE: Cerebral venous thrombosis (CVT) is not rare in women of childbearing age. Chinese couples have been encouraged to have two children by the new family-planning policy. Concerns have been raised about the effect of CVT on subsequent pregnancies, but few studies have focused on the Chinese population. We aimed to analyze the clinical features of Chinese female CVT patients of childbearing age and study the outcome of their subsequent pregnancies after CVT. METHODS: We retrospectively analyzed the clinical data of female patients at fertile age (15-45 years) diagnosed with CVT in our hospital between January 2009 and January 2019. Information on recurrence of venous thrombotic events as well as obstetrical outcomes of subsequent pregnancies was obtained and evaluated during follow-up. RESULTS: A total of 72 patients were enrolled, mean age at CVT onset was 29.4 ± 7.9 years. The main risk factors included autoimmune system disease (27.8%), pregnancy or puerperium (12.5%), and inherited thrombophilia (11.1%). Furthermore, 58 patients were followed up for a mean time of 63.1 ± 31.4 months and 17 new pregnancies occurred in 13 women. Among the 17 pregnancies, one CVT (5.9%) recurred in a patient with antiphospholipid syndrome. Overall, 10 (58.8%) pregnancies resulted in the birth of healthy children, including 8 full-term and 2 preterm births; 7 were terminated, including 3 (17.6%) spontaneous abortions. All patients with spontaneous abortions had antiphospholipid syndrome or Behcet's disease. CONCLUSIONS: Autoimmune system disease was the most common risk factor in Chinese female CVT patients. Recurrent pregnancy-associated CVT was infrequent in women with prior CVT, but attention should be paid during subsequent pregnancies.


Assuntos
Doenças Autoimunes/complicações , Trombose Intracraniana/etiologia , Complicações Cardiovasculares na Gravidez/etiologia , Resultado da Gravidez , Trombose Venosa/etiologia , Aborto Induzido , Aborto Espontâneo , Adolescente , Adulto , Doenças Autoimunes/diagnóstico , Doenças Autoimunes/terapia , China , Feminino , Humanos , Trombose Intracraniana/diagnóstico , Trombose Intracraniana/terapia , Nascido Vivo , Pessoa de Meia-Idade , Gravidez , Complicações Cardiovasculares na Gravidez/diagnóstico , Complicações Cardiovasculares na Gravidez/terapia , Recidiva , Estudos Retrospectivos , Fatores de Risco , Trombose Venosa/diagnóstico , Trombose Venosa/terapia , Adulto Jovem
11.
Med Sci Monit ; 25: 5336-5342, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31318849

RESUMO

BACKGROUND This study aimed to evaluate superb microvascular imaging (SMI) as an adjunctive imaging method to evaluate mesenteric lymph nodes in children with mesenteric lymphadenitis compared with healthy children. MATERIAL AND METHODS A retrospective study compared children with mesenteric lymphadenitis (n=27) and healthy children (n=30). Lymph node size was determined using grayscale ultrasonography and parameters of lymph node vascularity were compared using color Doppler flow imaging (CDFI) and SMI. The diagnostic performance of ultrasound (US), US combined with SMI, and US combined with CDFI were compared. RESULTS Lymph nodes from children with mesenteric lymphadenitis (n=77) and normal lymph nodes (n=84) were evaluated by SMI, which showed that the least diameter of lymph nodes in cases of mesenteric lymphadenitis was 0.58±0.15 mm and of normal mesenteric lymph nodes was 0.47±0.08 mm (p<0.001). SMI identified 92.6% of abnormal mesenteric lymph nodes while CDFI detected 85.2%. US combined with SMI had the highest sensitivity (81.5%), and specificity (78.9%) compared with US alone (sensitivity, 63.0%; specificity, 64.9%), and compared with US combined with CDFI (sensitivity, 74.1%; specificity, 75.4%). US combined with SMI and US combined with CDFI achieved the same specificity (76.7%), which was higher than that of US alone (66.7%). CONCLUSIONS SMI was superior to color Doppler flow imaging in evaluating the microvasculature in lymphadenopathy in mesenteric lymphadenitis. SMI may be used as an adjunct to grayscale ultrasonography to assist in identifying mesenteric lymphadenopathy in pediatric patients.


Assuntos
Linfadenite Mesentérica/diagnóstico por imagem , Linfadenite Mesentérica/fisiopatologia , Microvasos/diagnóstico por imagem , Criança , Pré-Escolar , China , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/efeitos dos fármacos , Linfonodos/fisiopatologia , Masculino , Linfadenite Mesentérica/metabolismo , Mesentério/metabolismo , Estudos Retrospectivos , Sensibilidade e Especificidade , Ultrassonografia/métodos , Ultrassonografia Doppler em Cores/métodos
12.
Med Sci Monit ; 25: 8571-8578, 2019 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-31723116

RESUMO

BACKGROUND The aim of this study was to evaluate the association between prostate cancer (PCa) vascularity detected by superb microvascular imaging (SMI) and Gleason score in biopsy specimens. MATERIAL AND METHODS A total of 119 patients with suspected PCa before biopsy underwent gray-scale ultrasound (US), color Doppler ultrasound (CDUS), and SMI imaging between June 2018 and March 2019. Vascularity quantity was assessed by SMI and compared with that of CDUS. The vessel parameter was also compared with the Gleason score. The sensitivity of PCa was compared between transrectal ultrasound guided systematic biopsy (SB) and SMI-guided targeted biopsy (SMI-guided TB). RESULTS Pathology confirmed 74 of 119 patients had PCa. The microvascular quantity of PCa patients was significantly higher than that of non-malignant patients. SMI detected blood vessels in 97.3% (72/74) in the malignant group, while CDUS identified blood flow signals in 90.5% (67/74) of the PCa group. SMI visualized enriched microvascular in PCa of Gleason 8 (54.5%) and Gleason 9 (92.3%). There was a positive correlation between microvascular quantity detected by SMI and Gleason score, with a correlation coefficient of 0.373 (P<0.001). SMI-guided TB cores were significantly more likely than SB cores to detect PCa (OR=12.83, P<0.001). CONCLUSIONS SMI could be promising as a useful imaging technique in the detection and characterization of PCa. There was a positive correlation between microvascular quantity detected by SMI and Gleason score.


Assuntos
Microvasos/diagnóstico por imagem , Neoplasias da Próstata/irrigação sanguínea , Ultrassonografia/métodos , Idoso , Idoso de 80 Anos ou mais , Biópsia com Agulha de Grande Calibre/métodos , China , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Pessoa de Meia-Idade , Imagem Multimodal/métodos , Gradação de Tumores , Estudos Prospectivos , Próstata/patologia , Neoplasias da Próstata/patologia , Ultrassonografia de Intervenção/métodos
13.
Med Sci Monit ; 25: 8836-8842, 2019 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-31754091

RESUMO

BACKGROUND The present study aimed to assess the correlation between prostate volume and prostate cancer (PCa) detection by strain elastography (SE)-guided targeted biopsy (TB) compared with conventional transrectal ultrasound (TRUS)-guided systematic biopsy (SB). MATERIAL AND METHODS This retrospective study enrolled 357 patients suspected to have PCa. All patients received TRUS-guided 10-core SB and SE-guided TB. The sensitivity for PCa detected by SE-guided TB was compared with that by TRUS-guided SB, in combination with prostate biopsy pathology. The correlation between the prostate volume and the detection rate of SE-guided TB was investigated. RESULTS PCa was pathologically confirmed in 151 out of 357 patients. The by-patient detection rate of TRUS-guided SB was 72.8% (110/151). Subsequently, a further increase of 6.6% (10/151) in PCa determination was obtained by the SE-guided TB. The sensitivity of SE-guided TB for patients with prostate volume <30 ml, 30-50 ml, 51-80 ml, and >80 ml was 91.7% (44/48), 80.3% (53/66), 70.4% (19/27), and 40.0% (4/10), respectively (p=0.002). For patients with a prostate volume less than 30 ml, SE-guided TB (91.7%) had a higher sensitivity than SB (62.5%) (p<0.007). CONCLUSIONS SE-guided TB has a higher detection rate of PCa in comparison with TRUS-guided SB. There was also a negative correlation between prostate volume and SE-guided TB. Therefore, use of SE-guided TB may complement use of conventional SB, especially for patients with smaller prostate volume.


Assuntos
Técnicas de Imagem por Elasticidade/métodos , Biópsia Guiada por Imagem/métodos , Neoplasias da Próstata/patologia , Idoso , Idoso de 80 Anos ou mais , Biópsia com Agulha de Grande Calibre/métodos , China , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Próstata/diagnóstico por imagem , Próstata/patologia , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Estudos Retrospectivos , Ultrassonografia de Intervenção/métodos
14.
J Stroke Cerebrovasc Dis ; 28(3): 830-837, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30563776

RESUMO

BACKGROUND: The present study aimed to explore the efficacy of atorvastatin on patients with carotid plaque, applying superb microvascular imaging (SMI), and contrast-enhanced ultrasound (CEUS) for evaluating carotid intraplaque neovascularization. METHODS: A total of 82 patients (82 carotid plaques) who were randomized into treatment group and control group underwent conventional ultrasound, CEUS, and SMI examinations. Patients in treatment group received a dose of 20 mg atorvastatin per day for 6 months while those in control group received placebo instead. Lipid parameters were assessed and intraplaque neovascularization were evaluated by CEUS and SMI before and 6 months after atorvastatin treatment. RESULTS: No significant differences were found between the 2 groups at the study entry. Patients with atorvastatin treatment received marked improvement in total cholesterol, triglyceride, and LDL-cholesterol compared with those in control group (P < .001). In treatment group, SMI-detected intraplaque neovascularization reduced from 69.23% to 48.72% while CEUS-detected ones reduced from 76.92% to 69.23%. By contrast, the percentage of intraplaque neovascularization in control group did not change too much either by SMI (65.12%, 67.44%) or CEUS (74.41%, 74.41%). The consistency between CEUS and SMI was above .75 at all assessments (P < .001). CONCLUSIONS: Atorvastatin treatment works for patients with carotid plaque by reducing LDL-cholesterol and improving plaque regression. Second, the consistency between SMI and CEUS in visualizing intraplaque neovascularization is good. That indicates a high possibility to identify carotid plaque instability by a safer and cheaper ultrasonography without contrast agent.


Assuntos
Atorvastatina/uso terapêutico , Artérias Carótidas/efeitos dos fármacos , Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/diagnóstico por imagem , Doenças das Artérias Carótidas/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Ultrassonografia Doppler em Cores/métodos , Idoso , Idoso de 80 Anos ou mais , Atorvastatina/efeitos adversos , Biomarcadores/sangue , Artérias Carótidas/patologia , Doenças das Artérias Carótidas/sangue , Doenças das Artérias Carótidas/patologia , China , LDL-Colesterol/sangue , Meios de Contraste/administração & dosagem , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica , Fosfolipídeos/administração & dosagem , Placa Aterosclerótica , Valor Preditivo dos Testes , Estudos Prospectivos , Hexafluoreto de Enxofre/administração & dosagem , Fatores de Tempo , Resultado do Tratamento
15.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(3): 344-350, 2019 Jun 30.
Artigo em Zh | MEDLINE | ID: mdl-31282328

RESUMO

Objective To explore the clinical characteristics of autoimmune disease with dual seropositive antibodies of leucine-rich glioma inactivated 1(LGI1)and contactin-associated protein 2(Caspr2).Methods The clinical data of seven patients with dual seropositive LGI1 and Caspr2 antibodies who were admitted to the Neurology Department of Peking Union Medical College Hospital from July 2014 to December 2017 were retrospectively analyzed.Results Central,peripheral and autonomic nervous systems were all involved in the seven cases;100%(7/7)presented with insomnia,myokymia,neuropahic pain and hyperhydrosis;71%(5/7)showed memory decline or psychiatric and behavioral symptoms;57%(4/7)had urinary hesitation or constipation;and 43%(3/7)had seizure.Electromyography showed 100%(6/6) of the patients had prolonged afterdischarges following normal M waves and/or abnormal spontaneous firing.Electroencephalography revealed slow waves or basic rhythm slowing in 71%(5/7)of patients.Electrocardiography showed sinus tachycardia,axis deviation,and prolonged QT intervals in 71%(5/7)of patients.One patient died from arrhythmia before immunotherapy.One died from pulmonary infection after immunotherapy.Improvement with immunotherapy was documented in the other five cases.No relapse was noted during the 1-2-year follow-up.Conclusions Autoimmune disease with dual seropositive antibodies of LGI1 and Caspr2 can diffusely affect the central,peripheral,and autonomic nervous systems.The possibility of this disease should be considered in patients with acute and subacute onset of neuropsychiatric symptoms,especially in patients with accompanying insomnia,myokymia,and hyperhydrosis.


Assuntos
Autoanticorpos/sangue , Doenças Autoimunes/imunologia , Proteínas de Membrana/imunologia , Proteínas do Tecido Nervoso/imunologia , Proteínas/imunologia , Humanos , Peptídeos e Proteínas de Sinalização Intracelular , Estudos Retrospectivos
16.
Stroke ; 49(2): 282-287, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29311265

RESUMO

BACKGROUND AND PURPOSE: The genetic contribution to dilated perivascular space (dPVS) burden-an emerging MRI marker of cerebral small vessel disease-is unknown. We measured the heritability of dPVS burden and its shared heritability with other MRI markers of cerebral small vessel disease. METHODS: The study sample comprised 1597 participants from the population-based Three City (3C) Dijon Study, with brain MRI and genome-wide genotyping (mean age, 72.8±4.1 years; 61% women). dPVS burden and lacunar brain infarcts were rated on a semiquantitative scale, whereas an automated algorithm generated white matter hyperintensity volume (WMHV). We estimated dPVS burden heritability and shared heritability with WMHV and lacunar brain infarcts using the genome-wide complex trait analysis tool, on unrelated participants, adjusting for age, sex, intracranial volume, and principal components of population stratification. RESULTS: dPVS burden was significantly correlated with WMHV and lacunar brain infarcts, the strongest correlation being found between WMHV and dPVS in basal ganglia. Heritability estimates were h2=0.59±0.24 (P=0.007) for dPVS burden, h2=0.54±0.24 (P=0.010) for WMHV, and h2=0.48±0.81 (P=0.278) for lacunar brain infarcts. We found a nonsignificant trend toward shared heritability between dPVS and WMHV (rg=0.41±0.28; P=0.096), which seemed driven by dPVS in basal ganglia (rg=0.72±0.61; P=0.126) and not dPVS in white matter (rg=-0.10±0.36; P=0.393). A genetic risk score for WMHV based on published loci was associated with increased dPVS burden in basal ganglia (P=0.031). CONCLUSIONS: We provide evidence for important genetic contribution to dPVS burden in older community-dwelling people, some of which may be shared with WMHV. Differential heritability patterns for dPVS in white matter and basal ganglia suggest at least partly distinct underlying biological processes.


Assuntos
Encéfalo/irrigação sanguínea , Doenças de Pequenos Vasos Cerebrais/genética , Acidente Vascular Cerebral Lacunar/genética , Idoso , Idoso de 80 Anos ou mais , Doenças de Pequenos Vasos Cerebrais/complicações , Feminino , Genótipo , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Fatores de Risco , Acidente Vascular Cerebral Lacunar/complicações
17.
Stroke ; 49(5): 1135-1140, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29581240

RESUMO

BACKGROUND AND PURPOSE: Intracranial arterial dolichoectasia (IADE) is a poorly understood arteriopathy compared with intracranial atherosclerotic stenosis (ICAS). We aimed to investigate the risk factors of IADE and ICAS and their relationship with neuroimaging markers of cerebral small vessel disease in a population-based study. METHODS: This study comprised 1237 participants (aged 57.2±9.4 years, 37.6% men) who underwent brain magnetic resonance imaging and magnetic resonance angiography. IADE was assessed based on basilar artery dolichoectasia (diameter, height of bifurcation, and laterality of basilar artery) and dilation of basilar artery and internal carotid artery (intracranial volume-adjusted diameter ≥2 SD). ICAS was defined as any degree of stenosis in at least 1 intracranial artery. The neuroimaging markers of cerebral small vessel disease, including lacunes, white matter hyperintensities, microbleeds, dilated perivascular spaces, and brain atrophy, were evaluated. RESULTS: Basilar arterial dolichoectasia was observed in 3.6% (45/1237); intracranial arterial dilation in 5.9% (67/1142); and ICAS in 15.7% (194/1237). Older age, higher systolic blood pressure, diabetes mellitus, higher LDL-C (low-density lipoprotein cholesterol) and lower HDL-C (high-density lipoprotein cholesterol) were associated with the presence of ICAS (all P<0.001), whereas only older age was associated with IADE. ICAS was associated with lacunes (odds ratio, 2.91; 95% confidence interval, 1.96-4.34; P<0.001), increased white matter hyperintensities volume (ß±SE, 0.54±0.13; P<0.001), and brain atrophy (ß±SE, -1.16±0.21; P<0.001), whereas basilar arterial dolichoectasia was mainly associated with dilated perivascular spaces in basal ganglia (odds ratio, 2.20; 95% confidence interval, 1.20-4.02; P=0.01) and, to a lesser extent, associated with lacunes and microbleeds. CONCLUSIONS: IADE and ICAS had different risk factor profiles and associated with different imaging phenotypes of cerebral small vessel disease, suggesting different underlying mechanisms.


Assuntos
Artéria Basilar/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Doenças de Pequenos Vasos Cerebrais/epidemiologia , Arteriosclerose Intracraniana/epidemiologia , Insuficiência Vertebrobasilar/epidemiologia , Fatores Etários , Idoso , Atrofia , Pressão Sanguínea , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Constrição Patológica , Diabetes Mellitus/epidemiologia , Dilatação Patológica , Feminino , Humanos , Arteriosclerose Intracraniana/diagnóstico por imagem , Leucoaraiose/diagnóstico por imagem , Leucoaraiose/epidemiologia , Angiografia por Ressonância Magnética , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem , Fenótipo , Fatores de Risco , Insuficiência Vertebrobasilar/diagnóstico por imagem , Substância Branca/diagnóstico por imagem
18.
Hum Brain Mapp ; 39(11): 4452-4461, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29956412

RESUMO

In the elderly, brain structural deficits and gait disturbances due to cerebral small vessel disease (CSVD) have been well demonstrated. The relationships among CSVD, brain atrophy, and motor impairment, however, are far from conclusive. Particularly, the effect of CSVD on subcortical nuclear atrophy, motor performance of upper extremities, and associating patterns between brain atrophy and motor impairment remains largely unknown. To address these gaps, this study recruited 770 community-dwelling subjects (35-82 years of age), including both CSVD and non-CSVD individuals. For each subject, four motor tests involving upper and lower extremities were completed. High-resolution structural MRI was applied to extract gray matter (GM) volume, white matter volume, cortical thickness, surface area, and subcortical nuclear (caudate, putamen, pallidum, and thalamus) volumes. The results showed worse motor performance of lower extremities but relatively preserved performance of upper extremities in the CSVD group. Intriguingly, there was a significant association between the worse performance of upper extremities and atrophy of whole-brain GM and pallidum in the CSVD group but not in the non-CSVD group. In addition, mediation analysis confirmed a functional CSVD-to-"brain atrophy"-to-"motor impairment" pathway, that is, a mediating role of thalamic atrophy in the CSVD effect on walking speed in the elderly, indicating that CSVD impairs walking performance through damaging the integrity of the thalamus in aging populations. These findings provide important insight into the functional consequences of CSVD and highlight the importance of evaluating upper extremities functions and exploring their brain mechanisms in CSVD populations during aging.


Assuntos
Encéfalo/diagnóstico por imagem , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Transtornos dos Movimentos/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Atrofia , Encéfalo/patologia , Doenças de Pequenos Vasos Cerebrais/complicações , Doenças de Pequenos Vasos Cerebrais/patologia , Estudos de Coortes , Feminino , Substância Cinzenta/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos dos Movimentos/etiologia , Transtornos dos Movimentos/patologia , Tamanho do Órgão , Substância Branca/patologia
19.
Med Sci Monit ; 24: 7891-7897, 2018 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-30391992

RESUMO

BACKGROUND This study explored symptoms and signs of pelvic organ prolapse (POP) evaluated by 4-dimensional pelvic floor ultrasonography and analyzed the relationship between delivery mode and POP. MATERIAL AND METHODS A total of 578 women who underwent 4-dimensional transperineal ultrasound were enrolled in this study. Obstetric history together with other clinical information were gathered from clinical questionnaires and gynecologists. Patients were thereafter classified into 4 groups: women with normal vaginal delivery, women with forceps delivery, women with cesarean, and nullipara women. We assessed symptoms and signs of POP among these 4 groups by use of 2 evaluation methods. The first method was clinical assessment applying International Continence Society (ICS) pelvic organ prolapse quantification (POP-Q). The second method was the use of ultrasonography in the quantification of anterior, middle, and posterior compartment prolapse. RESULTS Nulliparae women exhibited the lowest probability of POP (POP-Q: cystocele of 15.6%, uterine prolapse of 11.1%, rectocele of 20.0%; ultrasound exam: 6.7%, 8.9%, 13.3% in sequence), while women with forceps delivery had the highest probability of POP (POP-Q: 59.6%, 50.8%, 63.2% in sequence; ultrasound exam: 45.6%, 52.6%, 42.1% in sequence). Regarding the correlation between POP and delivery mode, the adjusted odds ratio was 2.40 (95%CI: 1.301~4.590) and 3.20 (95%CI: 1.651~6.121) in the normal vaginal delivery group and forceps group, respectively, compared with the cesarean group. CONCLUSIONS Four-dimensional pelvic floor ultrasonography can be used as a preferred method in evaluating POP. Regarding the relationship between delivery mode and POP, there is a significant correlation between vaginal delivery and POP.


Assuntos
Diafragma da Pelve/diagnóstico por imagem , Prolapso de Órgão Pélvico/diagnóstico por imagem , Ultrassonografia/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Cesárea/métodos , Parto Obstétrico/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Paridade , Gravidez , Vagina/diagnóstico por imagem
20.
Med Sci Monit ; 24: 5935-5942, 2018 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-30145602

RESUMO

BACKGROUND This study explored the diagnostic value of a combined modality of Superb Microvascular Imaging (SMI) and shear-wave elastography in differentiating malignant and benign breast lesions. MATERIAL AND METHODS A total of 121 patients with 123 breast lesions enrolled underwent conventional ultrasound exam (US), Color Doppler Flow Imaging (CDFI), SMI examination, and Virtual Touch Tissue Quantification (VTQ) measurement between May 2016 and October 2017. Vessels were detected by both CDFI and SMI in a quantitative manner. The stiffness of all the breast tissues was evaluated by VTQ method. We further assessed the diagnostic performances of CDFI, SMI, VTQ, CDFI+VTQ, and SMI+VTQ. RESULTS Both CDFI and SMI exhibited significant differences between malignant and benign masses (p<0.001) in terms of Adler classification. The mean shear-wave velocity (SWV) of malignant neoplasms was 5.28 m/s, with interquartile range (IQR) 4.01-6.39 m/s (p<0.001). The mean SWV of benign lesions was 2.64 m/s, with IQR 2.30-5.01 m/s (p<0.001). No significant difference was found for the area under the receiver operating characteristic curve (AUC) for CDFI, SMI, and VTQ (c2=2.29, P=0.3715). The sensitivity was the highest on SMI+VTQ (85.42%) and the lowest on CDFI (58.33%). CDFI+VTQ (85.33%) had a slightly higher specificity than SMI+VTQ (84.00%). The accuracy rate of these 2 modalities remained the same (84.55%). CONCLUSIONS Superb Microvascular Imaging yields more detailed vascular information in the bloodstream in benign and malignant breast masses compared with conventional ultrasonography. VTQ provides standardized quantified results in assessing tissue stiffness. The combined modality of SMI+VTQ added to conventional ultrasonography presented a better diagnostic performance in differentiating malignant breast neoplasms.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Técnicas de Imagem por Elasticidade/métodos , Microvasos/diagnóstico por imagem , Adolescente , Adulto , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/patologia , China , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Ultrassonografia Doppler em Cores/métodos
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