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Objective:To investigate the clinical characteristics and pregnancy outcomes in pregnant women with left ventricular non-compaction (LVNC).Methods:The clinical data of seven pregnant women with LVNC from January 2011 to December 2021 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed, including age, gestational age of symptom first occured, LVNC history, clinical symptoms, New York Heart Association (NYHA) cardiac function class, echocardiography, blood brain natriuretic peptide (BNP), treatment and the maternal and fetal outcomes.Results:Five cases were diagnosed before pregnancy, of which there were three women with medication; one case diagnosed in the month of pregnancy; one case diagnosed at 36 weeks of gestation. NYHA cardiac function was grade Ⅰ in four cases and grade Ⅱ in three cases before or during the first trimester of pregnancy. Of the five pregnant women who underwent echocardiography, there were one case of left ventricular insufficiency, three cases of mild left ventricular dysfunction and one case of normal left ventricular function before or during the first trimester of pregnancy. Of the five pregnant women to the second and third trimester of pregnancy, there were one case of grade Ⅳ, one case of grade Ⅲ, two cases of grade Ⅱ-Ⅲ and one case of grade Ⅱ in NYHA class ; three cases of left ventricular insufficiency, two cases of normal left ventricular function by echocardiography four cases had cardiac symptoms at 15-24 weeks of gestation and were treated with medication. In four cases, blood BNP increased to 214-1 197 ng/L during pregnancy, and were 89-106 ng/L after termination of pregnancy. There were 4 cases with arrhythmia. Indications for termination of pregnancy: LVNC complicated with heart failure in two cases, LVNC complicated with decreased cardiac function and threatened preterm birth in one case, complicated with pregnancy at full term in two cases, LVNC complicated with severe pulmonary hypertension in one case, and left ventricular dysfunction in one case. Cesarean section in four cases in the third-trimester, in one case in the second-trimester, and forceps curettage in two cases were taken. Two full-term infants,two preterm infants were born without LVNC.Conclusions:Women diagnosed with LVNC and low left ventricular ejection fraction before pregnancy are more prone to decreased cardiac function during pregnancy. Carrying out pregnancy risk assessment and strengthening the multi-disciplinary team management of high risk factors in pregnancy are conducive to achieve good pregnancy outcomes.
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Objective:To investigate the short-term and medium-term changes of the left ventricular ejection fraction (LVEF) and the predictive value of relevant electrocardiogram (ECG) indexes in children with dilated cardiomyopathy (DCM) complicated with complete left bundle branch block (CLBBB).Methods:Children clinically diagnosed with DCM in the Department of Heart Center, Women and Children′s Hospital, Qingdao University and Beijing Anzhen Hospital, Capital Medical University between November 2011 and August 2020 were retrospectively recruited.According to the combination of CLBBB, they were divided into CLBBB group and non-CLBBB group.Echocardiogram and ECG were regularly performed.Short-term and medium-term changes of LVEF based on the 1-5-year follow-up data were compared between groups.COX proportional hazards model and Kaplan-Meier multiplicative limit method were used to analyze the predictive value of ECG indexes of LVEF changes in children with DCM combined with CLBBB.Results:Ninety-four children with DCM were enrolled, including 35 cases in CLBBB group and 59 cases in non-CLBBB group.There was no difference in baseline LVEF between groups.However, significant differences were found in QRS duration, corre-cted QT interval(QTc), R peak time in lead V 5 (T V5R) and QRS notching or slurring between groups ( P<0.05). LVEF of all children showed an upward trend within one year after onset, while the Z value of eft ventricular end diastolic diameter(LVEDd) showed a downward trend, and the two indexes tended to be stable within 1 - 5 years.The Z value of LVEDd in CLBBB group was significantly higher than that of non-CLBBB group, while LVEF was significantly lower (all P<0.05). The mean LVEF of CLBBB group slightly fluctuated around 50%, that of LVEF in non-CLBBB group was 60%.The multivariate COX regression analysis showed that QRS duration ( HR=0.979; 95% CI: 0.960-0.999, P<0.05) and QTc ( HR=0.988; 95% CI: 0.979-0.998, P<0.05) were independent predictors of LVEF recovery in children with DCM.Kaplan-Meier method showed a significant difference of LVEF normalization between DCM children with different QRS durations ( P<0.05), which was also detected in those with QTc interval ( P<0.05). Conclusions:LVEF of children with DCM combined with CLBBB increases in the short term after standard treatment, and then being stable.CLBBB can affect the recovery of left ventricular systolic function in children with DCM.Moreover, QRS duration and QTc interval are independent predictors of LVEF recovery in DCM children.
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Objective:To investigate the levels of periphreal blood free carnitine and amino acids in healthy pregnant women in the third trimester and their association with maternal, fetal, and neonatal cardiac function and structure.Methods:This prospective descriptive study included healthy singleton pregnancies who underwent routine obstetric examination and delivered in two district maternal and child health hospitals (one in the urban and one in the suburb an area) in Beijing from June 2017 to February 2018. All recruiters had serology Down's syndrome screening test at (18±1) gestational weeks. Besides measurement of amino acids and free carnitine levels in whole blood and urine samples by liquid chromatography-tandem mass spectrometry, all cases underwent maternal and fetal echocardiography at (35±1) weeks of gestation. And neonatal echocardiography was performed after delivery to assess the heart function and structure. Antenatal factors were also collected, including maternal education background, age at first marriage and conception, gravidity, and folic acid supplement in early pregnancy. Statistical analysis was performed using t-test, ANOVA, Chi-square test, Pearson correlation coefficient, and Kappa test. Results:A total of 493 mother-neonate dyads were enrolled in this study. Blood free carnitine levels in the healthy pregnant women in the third trimester ranged from 5.09 to 59.17 μmol/L (reference value: 10.00-50.00 μmol/L) with an average value of (13.03±3.87) μmol/L. None was found with structural abnormalities by cardiac ultrasound, showing an average left ventricular end diastolic diameter (LVEDD) and end systolic diameter (LVESD) of (45.70±3.08) mm and (29.17±3.12) mm, respectively, and left ventricular ejection fraction (LVEF) of all cases were over 55%. No cardiac malformation was detected by the third-trimester fetal echocardiography. The average birth weight of the 493 newborns was (3 340±313) g. Those whose birth weight <2 500 g and >4 000 g were accounted for 1.0% (5 cases) and 3.0% (15 cases) with the average maternal blood free carnitine level of (13.25±2.17) μmol/L (10.46-19.21 μmol/L) and (12.64±2.50) μmol/L (8.78-17.73 μmol/L) ( t=0.42, P>0.05). The average LVEDD and LVESD of the 493 newborns were (17.21±1.27) mm and (11.03±1.30) mm, respectively. For the 64 newborns (13.0%) whose LVEF<60%, the maternal blood free carnitine level was (12.93±2.78) μmol/L (7.34-22.13 μmol/L), showing no statistical difference ( t=-0.29, P>0.05) with those 59 neonates (12.0%) whose LVEF over 75% and maternal carnitine level of (13.09±3.24) μmol/L (8.66-27.49 μmol/L). All cases were divided into four groups based on the quartiles of maternal blood free carnitine level and no significant difference in maternal or neonatal LVEDD or LVEF was observed among these groups (all P>0.05). Conclusions:Blood free carnitine concentration in healthy pregnant women in the third trimester is at the lower limit of normal range, and no significant effect on maternal cardiac function and fetal cardiac structure is seen. However, the effect of low maternal carnitine level in the third trimester on children's myocardial function and whether carnitine should be supplemented in the third trimester are worthy of further investigation with larger sample size.
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Objective:To explore the clinical characteristics, treatment and prognosis of primary cardiac tumors in infants and children.Methods:The clinical information for 21 patients with primary cardiac tumor in the Department of Pediatric Cardiology, Beijing Anzhen Hospital Affiliated to Capital Medical University from May 2010 to August 2018 were analyzed retrospectively.Their median age was 7 months (gestational age 26 weeks-15 years old, and 6 cases were found in fetal phase) and 10 cases of them were male, 11 cases were girl.The clinical features, treatment methods and prognosis were summarized.Results:Among the 21 patients, 8 cases had an atypical heart murmur, 2 cases with chest tightness and chest pain, 2 cases with congestive heart failure, 1 case with dizziness and amaurosis, 1 case with cerebral artery embolism, 1 case with higher inflammatory index, and 9 cases were asymptomatic.Totally, 13 cases underwent surgical resection.All of them were confirmed as benign tumors, including 4 cases of rhabdomyoma, 3 cases of myxoma, 3 cases of fibroma and 2 cases of inflammatory myofibroblastic tumor (IMT) and 1 case of teratomas.There was no death during perioperative period.Follow-ups were performed from 3 months to 7 years, and 3 cases had recu-rrence (2 cases with myxomas and 1 cases with IMT). There were 8 cases without treatment, of which 7 cases were clinically diagnosed as transverse leiomyoma.During the follow-up, 3 cases disappeared, 1 case became small, 2 cases had no obvious change, and 1 case was lost to follow-up.One case was considered to be malignant tumor, and died within half a year.Conclusions:Primary cardiac tumors in children are mostly benign, especially transverse leiomyoma, and their clinical manifestations are diverse.Pathological examination is the golden standard for diagnosis.Surgical treatment is a radical method for most cardiac tumors, some benign tumors can be treated with drug adjuvant therapy, while the prognosis is poor for malignant cardiac tumor patients.
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Objective:To optimize the scheme and process of chest CT scanning and control the dose level to the examined individuals by establishing the diagnostic reference level (DRL) and warning dose value from chest CT examinations in our hospital.Methods:The medical records for 205 511 examined individuals, who had undergone chest CT scans in the Second Affiliated Hospital of Zhejiang University Medical College from January 1, 2018 to December 31, 2019, were reviewed consecutively. For the two-year examination periods, these examined individuals were divided into two groups, one for 2018 totalling 90 507 and another for 2019 with a total of 115 004. The mean value of doses from chest CT scans in 2018 was set as the DRL for the hospital, with the 75th and 25th percentiles as the upper and lower limits of diagnostic reference range (DRR) and the 97.5th percentiles as the warning dose values. The doses above the upper limit of DRR were considered to be relatively-high whearas the ones exceeding the warning dose value to be over-high. Based on the analysis of the over high dose in 2018, the scanning scheme and inspection process of the chest CT scans were improved in 2019. The number of examinations were estimated for the 2018 period for chest plain CT scans, chest enhancement CT scans, lung cancer screening low-dose CT scans, and relatively-high and over-high dose CT scans, as well as the single scanning doses to the examined in the two groups. The number of examinations resulting in high dose to the examined due to different reasons before and after the improvement were studied. The various parameters on the examined in the two groups were compared statistically.Results:After the improvement, the average dose from chest plain CT scans decreased by 8.67 %, with the statistically significant difference as compared with before improvement ( t=55.71, P<0.05). The average dose from low-dose chest CT scans fell by 20.13% with statistically significant difference ( t=81.99, P<0.05). The fraction of the examinations with slightly-high doses arising from chest plain CT scans and low dose chest CT scans dropped by 3.66% and 17.15%, respectively. The fraction of the examinations with slightly-high dose from chest enhanced CT increased by 1.7%. The fraction of the examinations with over-high dose from chest plain CT scans, enhanced CT scans and low-dose CT scans decreased by 0.55%, 1.06% and 1.74%, respectively. After improvement, the optimized fraction of the examinations with over-high dose, dropped by 4.72%, 31.49% and 19.18% respectively. Conclusions:The establishment of the DRL and the warming dose value of for chest CT examinations in our hospital is helpful to find out the cause of high dose scanning, promote the optimization of dose, reduce the average dose to the examinedes, and avoid using excessive dose during scanning.
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Objective@#To characterize the clinical features and outcomes of scimitar syndrome (SS) to aid the understanding of this syndrome.@*Methods@#This retrospective study included 6 children who were diagnosed with SS at the pediatric cardiovascular center of Beijing Anzhen Hospital from January 2012 to September 2018. SS was diagnosed by echocardiography and confirmed by cardiac computed tomography angiography(CTA) or surgery. All data were collected to analyze the clinical and imaging characteristics and prognosis.@*Results@#Among the 6 SS children (aged 2 months to 15 years; 5 males) weighed 5.6-17.1 kg. Three cases were infant type, the clinical manifestations were recurrent respiratory tract infection with growth retardation, including 2 cases with severe pulmonary hypertension, while 3 cases with adult type, were asymptomatic. Cardiac CTA imaging showed that the right single or all pulmonary veins descended through the diaphragm and converged into the inferior vena cava. One case was isolated infracardiac partial anomalous pulmonary venous connection (PAPVC) without other malformations. The remaining 5 cases complicated with atrial septal defect, different vascular and trachea malformations as well as spinal malformations. Vascular malformations included pulmonary veins stenosis, abnormal origin of pulmonary artery branches, collateral branches of systemic artery supplying local lung tissue, and persistent left superior vena cava. The treatment varied according to the specific location of anomalous pulmonary venous connection, the degree of pulmonary hypertension and the severity of clinical symptoms. Four cases underwent one-stage radical surgery, one case accepted intervention to occlude the collateral artery which was supplying the right lower lung and received stage Ⅱ radical surgery half a year later, and the remaining one case died from pulmonary hypertension crisis preoperation.@*Conclusions@#Isolated SS can easily miss diagnosis due to mild clinical symptoms. Patients with complicated malformations can benefit from combination therapy. SS associated with severe pulmonary hypertension can lead to early death. Therefore, early diagnosis and appropriate treatment can improve the prognosis of patients.
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Objective To evaluate and compare the radiation dose and image quality of the new generation of whole body mobile CT (BodyTom CT) with commonly used fixed CT.Methods The image quality was evaluated with CATPHAN 500 performance test body model.The radiation dose was measured by conventional 100 mm pen ionization chamber and PMMA body phantom and head phantom (head diameter 160 mm,phantom diameter 320 rm and width 140 mm).Results The spatial and contrast resolution of BodyTom CT images were similar to two kinds of fixed CT(P ＞ 0.05).The CNR of image with BodyTom CT decreased by about 20％:In head scan mode,significantly lower than that with Philps 64 slice CT and Toshiba 320 slice CT (with soft,t =-4.82,-6.98,P ＜ 0.05;with standard,t =-20.60,-20.09,P ＜0.05);in body scan mode,significantly lower than that with Philps 64 slice CT and Toshiba 320 slice CT (with soft,t =-5.67,-12.82,P ＜ 0.05;with standard,t =-3.39,-9.18,P ＜ 0.05;with sharp,t =-3.88,-3.21,P ＜0.05).The radiation dose with BodyTom CT was significantly higher than that with fixed CT:in body model,22.97％ than that with Philps 64(t=9.48,P＜0.05),29.6％ than that with Toshiba 320 slice CT(t =11.66,P ＜0.05);in head model,29.76％ than that with Philps 64 slice CT(t=23.44,P＜0.05),33.22％ than that with Toshiba 320 slice CT(t=23.11,P＜0.05).Conclusions The radiation dose with mobile CT was over 20％ higher than that with routine multi-row CT while with the similar image quality.
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Objective To analyze the sites of CT scan and radiation dose to children, and to compare the dose difference between children and others aged above 14 years with the dose-monitoring software in a single scan. Methods A total of 125147 cases undergoing CT scans were selected from Jan 1 to Dec 31, 2016, including 542 in children group and 124605 in patients group aged above 14 years. Based on the self-designed CT dose of real-time detection and management software, the scan sites and the composition of the scanning dose were recorded and compared between children and patients aged above 14 years in a single scan. Results Head (39. 67%) and extremities (36. 90%) were the primary CT scan sites in children. Abdominal (20. 77%) and limbs (48. 87%) constituted the main part of effective dose to children. In children group, the average single DLP gradually increased with age ( Z =21. 42, P <0. 05). The mean DLP was (567. 38 ± 433. 03) mGy·cm and average effective dose (5. 58 ± 5. 45) mSv in children group, significantly lower than that in patients aged above[14 years (737. 75 ± 172. 40) mGy· cm and (11. 07 ± 2. 59) mSv, Z= -3. 74,-4. 12, P<0. 05]. DLPs in patients aged above 14 years were higher than or equal to those in children group, with a few exceptions of neck and limbs with higher values(Z= -2. 04、 -3. 97, P<0. 05). Effective doses in children were higher than or equal to those in the group aged above 14 years(Z= -3. 03, -3. 11, -4. 12,P<0. 05), with an exception of chest with higher value. Conclusions Although the parameters of CT scan and dose control were optimized to some extent in children, radiation protection on children still needs to be paid attention for due to the radiosensitivity of children. CT scanning on children should be more careful.
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Objective@#To analyze the gene mutations and clinical features of patients with Noonan syndrome and hypertrophic cardiomyopathy.@*Method@#Determined the mutation domain in five cases diagnosed with Noonan syndrome and hypertrophic cardiomyopathy and identified the relationship between the mutant domain and hypertrophic cardiomyopathy by searching relevant articles in pubmed database.@*Result@#Three mutant genes (PTPN11 gene in chromosome 12, RIT1 gene in chromosome 1 and RAF1 gene in chromosome 3) in five cases all had been reported to be related to hypertrophic cardiomyopathy. The reported hypertrophic cardiomyopathy relevant genes MYPN, MYH6 and MYBP3 had also been found in case 1 and 2. Patients with same gene mutation had different clinical manifestations. Both case 4 and 5 had RAF1 mutation (c.770C>T). However, case 4 had special face, low IQ, mild pulmonary artery stenosis, and only mild ventricular hypertrophy.@*Conclusion@#Noonan syndrome is a genetic heterogeneity disease. Our study identified specific gene mutations that could result in Noonan syndrome with hypertrophic cardiomyopathy through molecular biology methods. The results emphasize the importance of gene detection in the management of Noonan syndrome.
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<p><b>BACKGROUND</b>The anomalous origin of the left coronary artery (LCA) from the pulmonary artery (ALCAPA) and congenital left main coronary artery atresia (CLMCA-A) are two kinds of very rare coronary heart diseases which affect heart function profoundly. This study aimed to retrospectively illustrate the clinical features and therapy experience of ALCAPA and CLMCA-A patients.</p><p><b>METHODS</b>From April 1984 to July 2012, in Beijing Anzhen Hospital, 23 patients were diagnosed with ALCAPA and 4 patients with CLMCA-A. We summarized the clinical data of the 27 cases and retrospectively analyzed the clinical manifestation, diagnosis, and treatments of these two kinds of congenital coronary abnormalities.</p><p><b>RESULTS</b>The 23 patients (13 males and 10 females, aged ranging from 2.5 months to 65 years) identified with ALCAPA were classified into infantile type (age of onset younger than 12 months, 16 cases) and adult type (age of onset older than 12 months, 7 cases). Four patients were diagnosed with CLMCA-A (three males and one female, aged ranging from 3 months to 2 years). The main clinical manifestations of infantile-type ALCAPA and CLMCA-A include repeated respiratory tract infection, heart failure, dyspnea, feeding intolerance, diaphoresis, and failure to thrive. And these two congenital coronary abnormalities might be misdiagnosed as endocardial fibroelastosis, dilated cardiomyopathy, and acute myocardial infarction. As for the adult-type ALCAPA, cardiac murmurs and discomfort of the precordial area are the most common presentations and might be misdiagnosed as coronary heart disease, myocarditis, or patent ductus arteriosus. In ECG examination: Infantile-type ALCAPA and CLMCA-A showed abnormal Q waves with T wave inversion in leads I, avL, and V4-V6, especially in lead avL. However, ECG of adult-type ALCAPA lacked distinct features. In chest radiography: pulmonary congestion and cardiomegaly were the most common findings in infantile-type ALCAPA and CLMCA-A, while pulmonary artery segment dilation was more common in adult type. In echocardiography, the common features of infantile-type ALCAPA and CLMCA-A included left ventricular enlargement, left ventricular systolic function normal or mildly reduced in CLMCA-A or significantly reduced in ALCAPA, and moderate to large mitral valve. It was performed in 9 of 23 cases of ALCAPA and showed the origin of the dilated right coronary artery (RCA) from the right sinus of the aortic root and absence of LCA origin in angiography. After opacification of RCA, reverse flow in the LCA and pulmonary artery was visualized through coronary artery collateral circulation. Angio was performed in three of the four cases of CLMCA-A and showed left main coronary artery was a blind end, with diameter of only 1.1-2.0 mm. Treatment and prognosis: 21 patients with ALCAPA had cardiac surgery and 6 of them died postoperatively. Fifteen postoperative patients survived without overt symptoms within the follow-up period of 6-166 months (median 17 months). As for treatment of CLMCA-A, four patients took digoxin and diuretics without undergoing cardiac surgery. Their clinical symptoms improved during the close follow-ups.</p><p><b>CONCLUSIONS</b>ALCAPA and CLMCA-A are two rare coronary artery abnormalities that affect cardiac function in infants and children. In younger patients with cardiomegaly and heart dysfunction these two congenital coronary diseases should be noticed.</p>
Subject(s)
Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Bland White Garland Syndrome , Diagnosis , Pathology , General Surgery , Cardiac Surgical Procedures , Coronary Vessel Anomalies , Pathology , General Surgery , Coronary Vessels , Pathology , General Surgery , Echocardiography , Electrocardiography , Pulmonary Artery , Pathology , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the clinical manifestations and treatment of congenital atresia of the left main coronary artery (CLMCA-A).</p><p><b>METHOD</b>Four patients were diagnosed to have CLMCA-A from June 2010 to June 2012 in Beijing Anzhen Hospital. Clinical manifestations, ultrasound, ECG and angiographic characteristics were analyzed and summarized.</p><p><b>RESULT</b>Of the 4 cases, age of onset was 3 months to 2 yrs. Three cases were diagnosed by angiography, and 1 case by CTA . All 4 cases had chronic heart failure symptoms and signs, such as sweating, shortness of breath, easily choked by milk, predispose to pneumonia, activity intolerance. ECG showed abnormal Q wave and other ischemic signs such as ST-T segment depression. Ultrasonography showed left ventricular enlargement, left ventricular systolic function was normal or slightly reduced, and there was moderate to large amount of mitral valve regurgitation. Left ventricular trabeculations increased. Coronary collateral circulation increased. Left coronary artery appeared to be slender and disconnected with left coronary artery sinus. Aortic root angiography was the golden diagnostic standard. Angiography was performed in 3 patients and showed that left main coronary artery had a blind end, diameter 1.1-2.0 mm. The right coronary artery was found rising from the right coronary sinus and visible on coronary collateral circulation. Contrast agent developing sequence: right coronary artery-collateral vessels-left coronary artery distal branches-left main coronary artery. CTA exam was performed in 2 cases and in 1 case the diagnoses was confirmed. All the 4 patients are currently in the close follow-up, digoxin and diuretics were taken everyday and clinical symptoms were improved.</p><p><b>CONCLUSION</b>CLMCA-A is not rare, its clinical manifestations should be differentiated from those of cardiomyopathy, endocardial fibroelastosis, congenital valvular disease and abnormal left coronary artery originating from pulmonary artery etc. For pediatric patients with cardiac enlargement, abnormal heart function, mitral valve regurgitation etc, attention must be paid to consider the developmental abnormality of coronary artery, particularly the CLMCA-A diagnosis.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Coronary Angiography , Methods , Coronary Vessel Anomalies , Diagnosis , Pathology , Coronary Vessels , Diagnostic Imaging , Pathology , Diagnosis, Differential , Echocardiography , Electrocardiography , Endocardial Fibroelastosis , Diagnosis , Pathology , Heart Defects, Congenital , Diagnosis , Pathology , Mitral Valve Insufficiency , Diagnosis , Pathology , Pulmonary Artery , Congenital Abnormalities , Diagnostic Imaging , Tomography, X-Ray Computed , MethodsABSTRACT
Objective To investigate the reproducibility and influencing factors of relative quantification of phosphorus metabolites with two-dimensional chemical shift imaging (2D CSI) in rabbit liver. Methods Using 2D CSI MRS, 500 ml phosphate (NaH2PO4) solution phantom with 0. 05 mol/E concentration and one healthy rabbit were scanned 30 times respectively in one day and rescanned 30 times in the next day, and the stability of MR scanner and reproducibility of within-run and between-days in the same individual were analyzed. Each of thirty rabbits was scanned and rescanned one time respectively in different days, and the reproducibility of between-days in one group was analyzed. The data were statistically analyzed with t tests. Results (1) Phosphate solution phantom had a good reproducibility of within-run with the coefficient variation (CV) of 4. 92% and 5. 12% respectively in different two days. No significant change of phosphorus metabolites was detected in between-days, which was 16. 68 ± 0. 82 and 16. 56 ± 0. 85 respectively(t = 0. 665, P > 0. 05 ). (2) The CV of metabolites in one healthy rabbit ranged from 8. 04% to 34. 13%. Among the metabolites, β-ATP had the best reproducibility with the CV less than 10%. PME was 0. 88 ± 0. 28 and 0. 88 ± 0. 30, PDE was 4. 35 ± 0. 66 and 4. 35 ± 0, 66, Pi was 0. 95 ± 0.30 and 0.97±0.28, α-ATP was 5.58±0.60 and 5.61±0.61, β-ATP was 2.70±0.22 and 2.71± 0. 22, γ-ATP was 2. 20±0. 63 and 2. 18±0.44 respectively, no significant changes of metabolites were detected in between-days( P >0. 05 ). (3) The CV of metabolites in 30 healthy rabbits ranged from 8.48% to 36. 21%. Among the metabelites, β-ATP had the best reproducibility with CV less than 10%. PME was 0. 84 ± 0. 30 and 0. 79 ± 0. 28, PDE was 4. 29 ± 0.72 and 3.94 ± 0. 84, Pi was 0. 91 ± 0. 28 and 0. 92 ± 0. 31, α-ATP was 5.65±0. 66 and 5. 36±0. 60, β-ATP was 2. 71±0. 23 and 2. 66±0. 25, γ-ATP was 2. 07±0. 29 and 1.99±0. 37 respectively, no significant changes of metabolites were detected in between-days (P > 0. 05). Conclusions The relative quantification of hepatic β-ATP may be most reliable among the phosphorus metabolites for rabbit liver because of its good reproducibility and small CV. The quantification of phosphorus metabolites by 31p MRS with 2D CSI in rabbit liver is affected by many factors.
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Objective To compare image quality and radiation dose of the new imaging plate (IP) with the used IP on computed radiography (CR),and to investigate the using principle in the two kinds of IP. Methods The dark noise, uniformity and erasure thoroughness of the new and the used IP were measured respectively.Based on threshold contrast-detail detectability(TCCD) technique,the phantom T0.16 photography was done at 75 kV,and with the two kinds of IP respectively.Three observers scored each image sequence using double blind method,calculated the threshold detection index (HT).The volunteers were randomly divided into three groups:the knee joint group,the chest group and the lumbar group.Each group had 50 cases and checked with the same condition as the phantom.Three radiologists using double blind method evaluated the imaging quality of knee joint,chest and lumbar.Results The physical characteristic indexes of the new and the used IP were similar to each other.Under the same condition,the detection ability of the new IP was better than that of the used one.When the dose of exposure was raised about 20%,the detection ability of the used IP was close to that of the new one.Conclusions The dose of exposure can be raised to keep the same imaging quality with the increase times of IP used.The detection ability of IP can decrease with the same dose as before,and the image quality decreases too.
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Objective To investigate acute CT radiation injury on rabbit liver after the whole body CT scans with high-dose abdominal CT scan model.Methods The forty-six New Zealand white rabbits were randomly assigned into 3 groups.High-dose CT scanning groups included one-off CT scanning group(group 1)and repeated CT scanning group (group 2)with high-dose abdominal CT scan modes,and 18 rabbits in each group.The other two groups were routine-dose CT scanning group(n=5)and control group(n=5).Rats in both group 1 and 2 were divided into 6 subgroups(n= 3).Four to twenty-four times of continuous or discontinuous CT scans with 240 mAs and 140 Kv were performed on every rabbit.The liver samples of every animal were eoUected at 48 h or 24 h after CT scans and pathological examination and immunohistochemistry assay of Cpp32 and Bax expression were performed.Results(1)Light microscope showed①in group 1,slight hepatic injury occurred at 6 times of continuous CT scanning;after 6～18 times of continuous CT scanning,hepatocytes were slight swelling at first,followed by hydropic or fatty degeneration,constriction or emphraxis of hepatic sinuses,puncture necrosis of hepatocytes,and local hepatic hemorrhage;②in group 2:slight hepatic injury occurred at 8 times of CT scanning,and after 8～24 times of CT scanning,hepatocytes were slight or mild swelling at first,followed by moderate or diffuse swelling,hydropic degeneration,and dispersed karyopyknosis of hepatocytes near central vein.(2)Immunohistochemistry assay showed:①in group 1,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were observed in part of liver samples,the expressions of Bax and Cpp32 were correlated with CT radiation dose;②in group 2,positive expressions of the apoptosis-inducing protein Bax and Cpp32 were found in every subgroup,but the expression was not correlated with CT scan times.(3)The hepatic tissues of routine-dose CT scanning group were normal under the light microscope and immunohistochemistry assay.Conclusion Routine-dose CT scanning on liver is very safe,but high-dose CT scanning with non-routine scan times may cause acute pathological hepatic injury and hepatocyte apoptosis.