Integration of spectral computed tomography in arterial imaging.

Artery imaging, a crucial component in the diagnosis and management of vascular disease, assumes a significant role in the field of medical research. Utilizing advanced imaging modalities such as computed tomography (CT) and magnetic resonance angiography (MRA), artery imaging provides detailed insights into blood flow, detecting conditions such as atherosclerosis, aneurysms, and other vascular abnormalities with high precision. Spectral CT is an innovative imaging technique that goes beyond traditional CT scans, capturing data at multiple energy levels to provide detailed insights into the composition of tissues and materials within the scanned region. Notably, recent studies and clinical applications have underscored the diagnostic advantages offered by spectral CT in the detection and characterization of various arterial diseases. The integration of spectral CT into the realm of arterial imaging presents a promising avenue for improving the diagnosis and management of vascular disease. This comprehensive review aims to provide an extensive overview, delving into the potential benefits, optimization, challenges, and future of spectral CT in arterial imaging.

Spatiotemporal changes of aerosol optical depth and its response to urbanization: a case study of Jinan City, China, 2009-2018.

With the insidiously growing impact of urban development on the environment, the issue of air quality has attracted extensive attention nationally and globally. It is of great significance to study the influence of urbanization on air quality for the rational development of cities. MODIS-MAIAC (Moderate Resolution Imaging Spectroradiometer-Multi-Angle Implementation of Atmospheric Correction) Aerosol optical depth (AOD) product, DMSP/OLS (Defense Meteorological Satellite Program/Operational Linescan System) and NPP/VIIRS (Suomi National Polar-orbiting Partnership/Visible Infrared Imaging Radiometer Suite) night-light were used to explore the spatiotemporal variation and correlation between AOD and urbanization development before and after the promulgation of environmental governance policies in Jinan City from 2009 to 2018. Results show that (1) the spatial distribution of AOD in Jinan had the characteristics of high in the north and low in the south, high in the west and low in the east, and low in some parts of the central region; there was a significant seasonal variation in time, with the highest AOD in summer and the lowest in winter. During 2009-2013, the annual average variation of AOD increased by 20.6%, while during 2014-2018, it decreased by 35.3%; (2) The distribution of night-light in Jinan City has progressively expanded, mirroring the city's ongoing development. The spatial distribution of aerosols in urban areas was relatively low compared to the surrounding areas of the city. (3) From 2009 to 2013, there existed a significant positive correlation between the spatial and temporal distribution of AOD and night-light. However, from 2014 to 2018, with the implementation of environmental governance policies, this relationship shifted to a significant negative correlation between the spatial and temporal distribution of AOD and night-light. Through an analysis of the correlation between urban development and aerosol depth in Jinan City over the past decade, it can be concluded that urban development does not inevitably result in elevated AOD levels. Notably, the Jinan government has achieved remarkable results in controlling the atmospheric environment, as evidenced by recent years' improvements.

Effects of the theory of planned behavior and nudge strategy-based intervention on the adherence to anticoagulation treatment in patients with non-valvular atrial fibrillation.

BACKGROUND: Non-valvular atrial fibrillation is associated with the incidence of thromboembolism. Current guidelines recommend preferential use of novel oral anticoagulants (NOAC) in patients with nonvalvular atrial fibrillation. Oral anticoagulation medication adherence rate was relatively low among discharged patients with non-valvular atrial fibrillation. AIM: To investigate the effects of the anticoagulation programs based on the theory of planned behavior and nudge strategy among patients with non-valvular atrial fibrillation. METHODS: 130 patients with non-valvular atrial fibrillation were randomized to the intervention group or control group, 72 patients in the intervention group, and 58 patients in the control group with a 6-month follow-up. Medication adherence, intention, attitude, perceived behavioral control and subjective norm and quality of life were assessed. RESULTS: There were significantly differences in the intention, attitude and subjective norm between the two groups at one month, three months and six months follow-up (P <0.01). There were significantly differences in the perceived behavioral control between the two groups at three months and six months follow-up (P <0.01). The medication adherence scale score was higher in the intervention group than in the control group at three months and six months follow-up. However, there were no differences in quality of life between the two groups at one month, three months and six months follow-up. CONCLUSIONS: The program based on the theory of planned behavior and nudge strategy can improve medication adherence in patients with non-valvular atrial fibrillation.

A LAMP-Based Toolbox Developed for Detecting the Major Pathogens Affecting the Production and Quality of the Chinese Medicinal Crop Aconitum carmichaelii.

Aconitum carmichaelii Debeaux is a traditional Chinese medicinal herb that has been utilized for approximately 2,000 years. However, as cultivation has increased, there have been more reports of A. carmichaelii infections caused by four major pathogenic fungal species, Fusarium oxysporum, F. solani, Mucor circinelloides, and Sclerotium rolfsii, resulting in increased disease incidences and limited production and quality. To detect these infections, we developed a LAMP-based toolbox in this study. The cytochrome c oxidase subunit 1 (cox1) gene, translation elongation factor-1α (EF-1α), internal transcribed spacer (ITS) regions of rDNA, and alcohol dehydrogenase 1 (ADH1) gene, respectively, were used to design species-specific LAMP primer sets for F. oxysporum, F. solani, S. rolfsii, and M. circinelloides. The results showed that the LAMP-based toolbox was effective at detecting pathogens in soil and plant materials. We also used this toolbox to investigate pathogen infection in the main planting regions of A. carmichaelii. Before harvesting, F. oxysporum, M. circinelloides, and S. rolfsii were commonly found in the planting fields and in infected A. carmichaelii plants. Therefore, the toolbox we developed will be useful for tracking these infections, as well as for disease control in A. carmichaelii.

Sex-specific reference limits of left ventricular ejection fraction and volumes estimated by gated myocardial perfusion imaging for low-risk patients in China: a comparison between three quantitative algorithms.

BACKGROUND: Establishing appropriate reference value limits of left ventricular (LV) functional parameters is fundamental for the assessment of cardiac function. At present, there are no reports aimed at establishing reference limits using gated myocardial perfusion imaging (MPI) in mainland China. METHODS: A total of 175 consecutive patients who were defined as low-risk coronary artery disease patients underwent stress Technetium-99m sestamibi (99mTc-MIBI)-gated myocardial perfusion single-photon emission computed tomography (SPECT) imaging. The LV ejection fraction (EF), end-diastolic volume (EDV), and end-systolic volume (ESV) were obtained by 3 quantitative algorithms: quantitative-gated SPECT, emory cardiac toolbox, and 4-dimensional model SPECT, respectively. The threshold values were obtained using Gaussian distribution or percentiles. The influence of gender, age, and weight on cardiac functional parameters was analyzed by multiple regressions for linear models. RESULTS: For males, the lower reference limits of EF were 52%, 63%, and 58%, respectively; and the upper limits of EDV/ESV were 106/45, 152/55, and 135/55 mL, respectively. For females, the lower reference limits of EF were 58%, 66%, and 65%, respectively; and the upper limits of EDV/ESV were 73/27, 105/31, and 88/29 mL, respectively. Compared to females, males had greater cardiac volume values and lower mean EF values. Bland-Altman plots revealed that the cardiac function parameters calculated by the three quantitative algorithms were in high agreement. CONCLUSIONS: In this study, the reference limits of cardiac parameters calculated by the 3 methods based on single-center data in China were preliminarily established. The threshold values determined by three quantitative algorithms were not interchangeable but were highly correlated.

Diagnostic value of chest computed tomography imaging for COVID-19 based on reverse transcription-polymerase chain reaction: a meta-analysis.

BACKGROUND: The computed tomography (CT) diagnostic value of COVID-19 is controversial. We summarized the value of chest CT in the diagnosis of COVID-19 through a meta-analysis based on the reference standard. METHODS: All Chinese and English studies related to the diagnostic value of CT for COVID-19 across multiple publication platforms, was searched for and collected. Studies quality evaluation and plotting the risk of bias were estimated. A heterogeneity test and meta-analysis, including plotting sensitivity (Sen), specificity (Spe) forest plots, pooled positive likelihood ratio (+LR), negative likelihood ratio (-LR), dignostic odds ratio (DOR) values and 95% confidence interval (CI), were estimated. If there was a threshold effect, summary receiver operating characteristic curves (SROC) was further plotted. Pooled area under the receiver operating characteristic curve (AUROC) and 95% CI were also calculated. RESULTS: Twenty diagnostic studies that represented a total of 9004 patients were included from 20 pieces of literatures after assessing all the aggregated studies. The reason for heterogeneity was caused by the threshold effect, so the AUROC = 0.91 (95% CI: 0.89-0.94) for chest CT of COVID-19. Pooled sensitivity, specificity, +LR, -LR from 20 studies were 0.91 (95% CI: 0.88-0.94), 0.71 (95% CI: 0.59-0.80), 3.1(95% CI: 2.2-4.4), 0.12 (95% CI: 0.09-0.17), separately. The I2 was 85.6% (P = 0.001) by Q-test. CONCLUSIONS: The results of this study showed that CT diagnosis of COVID-19 was close to the reference standard. The diagnostic value of chest CT may be further enhanced if there is a unified COVID-19 diagnostic standard. However, please pay attention to rational use of CT.

Complete Preoperative Evaluation of Pulmonary Atresia with Ventricular Septal Defect with Multi-Detector Computed Tomography.

OBJECTIVE: To compare multi-detector computed tomography (MDCT) with cardiac catheterization and transthoracic echocardiography (TTE) in comprehensive evaluation of the global cardiovascular anatomy in patients with pulmonary atresia with ventricular septal defect (PA-VSD). METHODS: The clinical and imaging data of 116 patients with PA-VSD confirmed by surgery were reviewed. Using findings at surgery as the reference standard, data from MDCT, TTE and catheterization were reviewed for assessment of native pulmonary vasculature and intracardiac defects. RESULTS: MDCT was more accurate than catheterization and TTE in identification of native pulmonary arteries. MDCT is also the most accurate test for delineation of the major aortopulmonary collateral arteries. The inter-modality agreement for evaluation of overriding aorta and VSD were both excellent. In the subgroup with surgical correlation, excellent agreement was found between TTE and surgery, and substantial agreement was also found at MDCT. CONCLUSION: MDCT can correctly delineate the native pulmonary vasculatures and intracardiac defects and may be a reliable method for noninvasive assessment of global cardiovascular abnormalities in patients with PA-VSD.

A preliminary study on the potential of Mycoplasma pneumoniae to induce dyskaryotic change in respiratory epithelium in adult community-acquired pneumonia.

BACKGROUND: This study aimed to explore the cellular morphology of respiratory epithelium in Mycoplasma pneumonia (MpP) patients. MATERIALS AND METHODS: The cast-off cell morphological findings from bronchoscopic brushings in MpP and community-acquired pneumonia (CAP) caused by typical pathogens were reviewed. RESULTS: Compared with the CAP group, cellular dysplasia in respiratory tract epithelial brushings was significantly greater in MpP patients (P = 0.033). CONCLUSION: Unique biological characteristics and mechanisms of pathogenesis of Mycoplasma pneumoniae (Mp) may result in dyskaryotic changes in respiratory epithelium in adult MpP.

Assessment of pulmonary vasculature volume with automated threshold-based 3D quantitative CT volumetry: in vitro and in vivo validation.

OBJECTIVES: To validate the ability of threshold-based 3D CT volumetry to enable measurement of volume of visible pulmonary vessels on CT. MATERIALS AND METHODS: In vivo, 3D CT volumetry was validated in seven phantoms that consisted of silicone tubes embedded in a foam block. With the true volume value as reference standard, the accuracy of CT measurement at various lower thresholds of -600 HU, -500 HU, -300 HU and -200 HU were compared. The volume measurements obtained when filled with varied concentration of iodinated contrast media (1:100, 1:200 and 1:500) were also compared. In vivo validation was performed in sixteen patients (9 men, 7 women; mean age, 52.1 years). Inter-scan and inter-observer agreement and reproducibility for pulmonary vasculature volume measurement were evaluated with Bland-Altman analysis. RESULTS: In vitro, the mean value measured under lower threshold of -300 HU (relative error=1.5%) were the closest to the true values and have no significant difference (P=0.375). There were no significant differences among the phantom measurement values with different filled concentration (1:100, 1:200 and 1:500). In vivo, the inter-scan reproducibility of volume measurements was good, with a correlation coefficient of 0.82 and ICC (intraclass correlation coefficient) of 0.86. Inter-observer agreement was excellent with a correlation coefficient of 0.91 and ICC of 0.95. CONCLUSIONS: The threshold-based 3D quantitative CT volumetry enables accurate and reproducible measurement of pulmonary vessels volume.

Role of MDCT angiography in the preoperative evaluation of anomalous pulmonary venous connection associated with complex cardiac abnormality.

OBJECTIVES: To evaluate the diagnostic accuracy of MDCT in patients with APVC associated with complex cardiac abnormality. MATERIALS AND METHODS: The clinical and imaging data of 39 patients with APVC confirmed by surgery were retrospectively reviewed. According to accompanied cardiac malformations, patients with APVC were classified as isolated and complex group. Using surgical findings as the reference standard, diagnostic agreement of MDCT, TTE (transthoracic echocardiography) and cardiac catheterization for detection of APVC were calculated. RESULTS: At surgery, 27 patients were considered as complex APVCs. MDCT correctly diagnosed APVC in all patients and the diagnostic agreements between MDCT and surgery were both 100% in isolated and complex groups. All 5 APVCs which could not be detected at cardiac catheterization were in complex group, and the diagnostic agreements were 100% and 76.2% in isolated and complex groups, respectively. At TTE, eight of nine disagreed patients were complex cases. The diagnostic agreements of TTE were 91.7% and 66.7% in isolated and complex groups, respectively. The dysmorphic pulmonary veins were identified in 11 patients by MDCT. CONCLUSIONS: MDCT is superior to catheterization and TTE in evaluation of APVC associated with complex cardiac defects.

A case of arrythmogenic right ventricular cardiomyopathy in a middle-aged woman.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a kind of heart muscle disease characterized by the gradual replacement of the right ventricular myocardium with fibrous tissue and fat. It could be the major cause of sudden cardiac death with ventricular tachycardia, and there is a variation in the history of the disease. We reported an unusual case of ARVC in a middle-aged woman with congestive heart failure as her first presentation for a long time.

Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis of ovarian carcinoma.

Our objective was to compare US, CT, and MR imaging in differentiation of malignant from benign ovarian tumors. Through an electronic literature search and manual review of bibliographies (January 1990 to June 2006), relevant studies on the diagnostic performance of US, CT, and MR imaging in the differentiation between benign and malignant ovarian tumours were identified. Sixty-nine articles were included, yielding 143 studies. Data on the accuracy of the different imaging modalities were analyzed and compared by constructing summary receiver-operating characteristic (ROC) curves. Our results suggest that US techniques seems to be similar with CT and MRI in differentiation of malignant from benign ovarian tumors. The results also revealed that color Doppler flow imaging alone is significantly inferior to combined US techniques, morphologic assessment alone and contrast enhanced US in diagnosis of ovarian cancer. In conclusion, US morphologic assessment still is the most important and common modality in detect ovarian cancer.