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ObjectiveAfter the brain and heart injuries were simulated by myocardial injury caused by acute cerebral ischemia， this study explored the mechanism of Naoxintong capsules in treating brain and heart injuries under cerebral ischemia state with Toll-like receptor （TLR） 2/TLR4 as the breakthrough point. MethodC57BL/6 male mice were randomly assigned into the sham operation， model， Naoxintong， and Ginaton groups. The middle cerebral artery occlusion （MCAO） method was used to establish a mouse model of cerebral ischemia. The neuroethological score， cerebral infarction area， cell apoptosis， ionized calcium-binding adaptor molecule 1 （IBA-1）-positive microglia proportion， and serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP）， creatine kinase-MB （CK-MB）， and lactic dehydrogenase （LDH） were determined to evaluate the pharmacodynamic effects of Naoxintong capsules on heart and brain injuries after cerebral ischemia in mice. Western blotting was employed to determine the expression of TLR2/TLR4 protein in the brain and heart of mice. ResultCompared with the sham operation group， the model group showed increased cerebral infarction area， neuroethological score， apoptosis rate， IBA-1-positive microglia proportion， and serum levels of NT-proBNP， CK-MB， and LDH （P<0.01）. Naoxintong capsules reduced the cerebral infarction area， neuroethological score， apoptosis rate， IBA-1-positive microglia proportion （P<0.01）， and serum NT-proBNP and CK-MB levels （P<0.05） in mice compared with the model group. Western blotting results showed that Naoxintong Capsules down-regulated the expression levels of TLR2 （P<0.05） in the brain and TLR2 （P<0.01） and TLR4 （P<0.05） in the heart. ConclusionCerebral ischemia can cause myocardial damage， reflecting the pathological process of cardiac injury after cerebral ischemia. Naoxintong capsules can mitigate brain and heart injuries after cerebral ischemia and achieve the simultaneous treatment of the brain and the heart， in which TLR2/TLR4 plays a role.
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Objective To explore the clinical application of material decomposition technique on spectral CT imaging and evaluate hemodynamic changes in different liver lobes with liver cirrhosis.Methods 30 patients with liver cirrhosis diagnosed clinically in our hospital were collected and underwent enhanced scanning of abdomen with spectral CT protocol.The monochromatic energy images and iodine-based material decomposition (MD) images were reconstructed after scanning.The iodine concentration (IC) was measured in five liver lobes (the caudate, left lateral, left inner, right anterior and right posterior lobes) and the abdominal aorta of the same axial slice in both the arterial phase (AP) and portal venous phase (VP) on the iodine-water based material decomposition images.The arterial iodine fraction (AIF) and the portal venous iodine concentration (PVIC) as well as the normalized iodine concentration (NIC) during the AP and VP were calculated.The differences of IC,the NIC,the AIF,and the PVIC in five liver lobes in AP and VP were compared by using single factor analysis of variance.Results The IC,the NIC in both AP and VP and the AIF of the caudate liver lobe were higher than those of other four liver lobes, with statistically significant difference (P0.05).The PVIC of the caudate liver lobe was slightly lower than that of the other four liver lobes, however, the difference was not statistically significant (P=0.929).Conclusion The quantitative iodine concentration measurement of liver lobes on spectral CT material decomposition technique can evaluate the hemodynamic changes in liver lobes with liver cirrhosis,and provide more information about the change of blood flow in liver cirrhosis.
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Objective To explore the application of low dose of radiation combined with low concentration of contrast medium in the energy spectrum CT of the coronary artery angiography.Methods 60 patients with suspected diagnosis of coronary heart disease were randomly divided into A,B two groups,30 cases in each group.Group A with 350 mg I/mL contrast agent,undergoing conventional CT scanning;Group B using 300 mg I/mL contrast agent,the gems energy spectrum CT scanning with low-dose.Two groups both adopted forward-looking heart switch control scanning mode.After scanning,group A reconstructed conventional images of 40% ASiR sequence,group B rebuilded axial surface images of single energy 65 keV and 40% ASiR sequence,all the reconstruction images were introduced to AW4.6 workstations used for analysis.Double-blind subjective rating was done by two experienced doctors to measure CT values and SD of aortic sinus (AS),left main (LMA),the left anterior descending branch proximal (LAD-p),left circumflex branch proximal (LCX-p), right coronary artery proximal (RCA-p)and pericardial fat,AS the noise (SD),to calculate the signal-to-noise ratio (SNR)and contrast to noise ratio (CNR),to calculate the effective doses of radiation(ED)by recording CTDI and DLP,and to record iodine intake.By using two independent samples t test to compare two groups of patients’the effective radiation doses,iodine intake,the average CT value,SD,SNR and CNR.Results The subjective image quality score differences and coronary measuring section CT values between the two groups had no statistical significance.In the aspects of effective radiation dose,group B reduced about 29% compared to group A,the difference was statistically significant.Iodine intake in group B decreased about 16% than in group A.Conclusion In coronary artery CT imaging, spectral scanning with low dose of radiation and reconstruction images with single energy can effectively reduce the radiation dose and iodine intake,at the same time it can obtain the approximate image quality like conventional scanning.
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PurposeTo explore the feasibility of personalized energy spectrum scanning in upper abdomen CT by comparing the image quality and radiation dose of optimizing choice spectrum scanning protocol with conventional 120 kVp scan.Material and Methods Sixty patients undergoing abdominal CT scan with and without contrast enhancement were prospectively collected and randomly assigned into two groups. Group A (30 patients) underwent conventional 120 kVp scan and spectral enhancement scanning; group B (30 patients) underwent spectrum scan and 120 kVp enhancement scanning. Spectral scanning protocol was based on individual choice with conventional 120 kVp NI10-5 mm average mAs scan for every patient. The CT dose index of volume (CTDIvol) and effective dose (ED) during non-contrast phase and portal venous phase were recorded. The CT value, standard deviation (SD), signal noise ratio (SNR) and contrast noise ratio (CNR) were measured in the liver parenchyma, spleen parenchyma and portal venous trunk.Results The CTDIvol and ED of spectrum scanning were less than 120 kVp scan but there was no statistical difference (P>0.05). The SD of group B GSI imaging was less than group A 120 kVp (P<0.05), while the SNR was greater than group A. The SD of group A GSI portal venous phase in the liver, spleen and portal vein was less than group B 120 kVp (P<0.05).ConclusionThe optimized energy spectrum scanning protocol can reduce radiation dose with quality of single energy image from the energy spectrum equal to or better than the conventional 120 kVp scanning protocol. Personalized energy spectrum scan protocol provides multi-parameter diagnosis and multi-application platform and can be used routinely in the upper abdomen scan.
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Objective To compare the virtual non-enhanced chest CT (VNCT)generated from spectral CT with conventional non-enhanced chest CT in patients with lung disease in terms of CT number accuracy and image quality.Methods A total of 30 patients with lung disease proved by pathology underwent the conventional non-enhanced thoracic CT and contrast enhanced CT with spectral imaging mode in arterial phase (AP)and venous phase (VP).The VNCT images were reconstructed based on the enhanced spectral CT imaging data.The mean CT number,signal to noise ratio (SNR)for the lesions and image quality score were obtained and compared between the true non-contrast CT (TNCT)and the VNCT (including AP and VP)with paired t test.Results The mean±standard deviation for CT number were (38.74±5.17)HU,(39.08±5.07)HU and (38.96± 5.18)HU for TNCT,VNCT at AP and VNCT at VP,respectively, with no statistical difference (P>0.05).All 3 sets of images demonstrated acceptable image quality,even though there were statistically significant differences in the SNR value and image quality score.The mean ± standard deviation values for SNR were 4.74±0.42 with TNCT, 3.79 ± 0.5 1 with VNCT at AP and 3.77 ± 0.39 with VNCT at VP (P <0.05),and the image quality scores were 5.00 ±0.00 with TNCT,4.17±0.65 with VNCT at AP and 4.17±0.53 with VNCT at VP (P<0.05).Conclusion In patients with lung disease,the vir-tual non-enhanced CT images generated from spectral CT provide accurate CT numbers for lesions and acceptable image quality com-pared with the true non-contrast CT.VNCT may be used to replace TNCT to improve work flow and reduce radiation dose.
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Objective To evaluate the clinical value of spectral CT monochromatic imaging in improvement of imaging quality of bronchial arteries.Methods We retrospevtively analyzed the chest CT images in 38 patients who underwent the contrast-enhanced spectral CT.These images included a set of 140 kVp polychromatic images and default 70 keV monochromatic images.Using a standard Gemstone Spectral Imaging (GSI)viewer at an advanced workstation (AW4.6),an optimal energy level (in keV)for obtai-ning the best CNR of the bronchial artery could be automatically obtained.The SNR,CNR and objective imaging quality score for these 3 imaging sets (140 kVp,70 keV and optimal energy level)were obtained and compared with one-way ANOVA .Results The optimal energy levels for obtaining the best CNR were (62.58±2.74)keV.The SNR of the 140 kVp polychromatic images,70 keV monochromatic images,and the optimal keV monochromatic images were 1 6.44±5.85,20.96 ±8.32 and 24.91 ±9.91,the CNR were 13.30±5.45,1 7.25±6.97 and 20.67±8.62,and the subjective imaging quality scores were 1.97 ±0.82,3.24±0.75 and 4.47±0.60,respectively,exhibiting significant differences among groups (F =10.1 7,10.1 7 and 1 1 1.12,P <0.00).The optimal monochromatic group was superior to the 70 keV group and the 140 kVp mixed-energy group.Conclusion Monochromatic images at approximately 62 keV in dual-energy spectral CTA yields the best CNR and highest diagnostic confidence for imaging bronchial ar-teries,which may improve imaging quality for imaging bronchial arteries.