Quantifying calcium changes in the fetal spine using quantitative susceptibility mapping as extracted from STAGE imaging.

OBJECTIVES: To evaluate calcium deposition in the fetal spine in vivo during the second and third trimesters using quantitative susceptibility mapping (QSM). METHODS: Fifty-four pregnant women in their second and third trimesters underwent a 2D multi-echo STrategically Acquired Gradient Echo (STAGE) MR imaging protocol at 3T covering the fetal spine. The first echo data was used for QSM processing. A linear regression model was used to assess the correlation between magnetic susceptibility and gestational age (GA). A paired sample t-test was used to compare the consistency of QSM measurements from each sequence. RESULTS: The magnetic susceptibility of the fetal spine decreased linearly with advancing GA, with a slope of -52.3 parts per billion (ppb)/week and a Pearson correlation coefficient (r) of 0.83 (p < 0.001). In 37 subjects for whom the STAGE local QSM data were available from both flip angles, the average magnetic susceptibility values were -1111 ± 278 ppb and -1081 ± 262 ppb for FA = 8° and FA = 40°, respectively. These means were not statistically different according to a paired sample t-test (p = 0.156). CONCLUSIONS: QSM is a reliable technique for evaluating calcium deposition and bone mineral density of fetal vertebrae. Our results demonstrate an increase in fetal calcium levels as a function of GA. These measures might be able to provide reference values for calcium content in the fetal spine during the second and third trimesters. KEY POINTS: • Calcium deposition and mineralization in the fetal spine, evaluated by vertebral magnetic susceptibility, increased with advancing gestational age. • Our results provide reference values for calcium content in the fetal spine during the second and third trimesters.

Leptin promotes endothelial dysfunction in chronic kidney disease through AKT/GSK3ß and ß-catenin signals.

Endothelial dysfunction (ED) is a well-recognized instigator of cardiovascular diseases and develops in chronic kidney disease (CKD) with high rate. Recent studies have implicated that leptin is associated with endothelial dysfunction. We investigated the relationship between leptin and markers of ED in CKD patients and how leptin contributed to endothelial damage. 140 CKD patients and 140 healthy subjects were studied. Serum leptin levels were significantly higher in CKD than in controls and displayed significantly positive association with the increase levels of sICAM-1 and sVCAM-1 but negative correlation with flow-mediated dilatation (FMD) reduction in patients. Our in vitro study demonstrated that leptin induced overexpression of ICAM-1 and VCAM-1, led to f-actin reorganization and vinculin assembly, increased endothelial monolayer permeability for FITC-dextran, and accelerated endothelial cell migration; these changes were markedly reversed when the cells were transfected with AKT or ß-catenin shRNA vectors. Notably, high leptin resulted in hyper-phosphorylation of AKT and GSK3ß, along with nuclear accumulation of ß-catenin. In conclusion, serum leptin was elevated in CKD patients and it might contribute to endothelial dysfunction by disarrangement of f-actin cytoskeleton via a mechanism involving the AKT/GSK3ß and ß-catenin pathway.

Pediatric Mycotic Pseudoaneurysm of the Ascending Aorta: A Case Report.

Mycotic pseudoaneurysm of the ascending aorta is extremely uncommon, particularly in children with no prior cardiac surgery or trauma. We report a rare case of a mycotic pseudoaneurysm of the ascending aorta in a 2-year-old girl with no history of cardiac surgery. Investigations revealed a methicillin-resistant Staphylococcus aureus infection and significant pericardial effusion in the child who presented with persistent fever and altered mental state. Cardiac ultrasound revealed a disruption in the aortic wall and a tumor-like structure. Contrast-enhanced computed tomography confirmed an ascending aortic pseudoaneurysm with thrombus. The child underwent successful surgical treatment without implants. This case emphasizes the diagnostic significance of imaging, particularly the advantages of ultrasound in pediatric settings, and the need for timely and accurate diagnosis using appropriate imaging modalities in children.

Regional changes in brain apparent diffusion coefficient in fetuses with complex congenital heart disease and normal pregnancy assessed using diffusion-weighted imaging.

Objectives: To explore changes in brain apparent diffusion coefficient (ADC) in normal fetuses and fetuses with complex congenital heart disease (CHD) during the second and early third trimesters. Methods: This single-center prospective study was conducted from May 2019 through October 2021. We measured and compared the mean ADC values between 23 fetuses with CHD and 27 gestational age (GA)-matched controls using covariance analyses. ADC density plots and histograms were used to compare brain characteristics. False-discovery rates (FDR, α = 0.05) correction was used for multiple testing. Results: The mean ADC in the frontal white matter, temporal white matter, parietal white matter, occipital white matter, cerebellar hemisphere, central area of the centrum semiovale, basal ganglia region, thalamus, and pons were not significantly different (all p > 0.05). Based on histogram analysis, there were no significant differences between the controls and fetuses with CHD after FDR correction. However, the ADC density plots showed significant heterogeneity between the controls and fetuses with CHD. Conclusion: The mean ADC values and ADC histogram analysis did not differ between the CHD and normal groups. The ADC density plots may provide supplementary information and improve the sensitivity for detecting early brain changes in fetuses with CHD.

Rare cardiac metastasis of soft tissue sarcoma: A case report and literature review.

RATIONALE: Owing to the unique structure and function of the heart, tumor metastasis in the heart is rare. Accordingly, no unique symptoms have yet been identified for cardiac metastasis. PATIENT AND CONCERNS: A patient presented with cardiac metastasis 3 years after surgical resection of alveolar soft tissue sarcomas in their late stage. DIAGNOSIS: Ultrasonography showed a middle-high echo clump on the left surface of the mid-upper interventricular septum, which had an unclear boundary with the myocardium. Meanwhile, blood flow was found in the clump, with no blockage of blood flow having been observed. LESSONS: Although cardiac metastasis in terminal cancer patients always carries a poor prognosis, there is still no effective treatment for cardiac metastasis. In the clinic, it is important to improve the patient's quality of life, reduce symptoms and signs, and extend the duration of survival.