Risk factors and the CCTA application in patients with vulnerable coronary plaque in type 2 diabetes: a retrospective study.

BACKGROUND: Diabetes is an independent risk factor for cardiovascular disease. The purpose of this study was to identify the risk factors for vulnerable coronary plaques (VCPs), which are associated with adverse cardiovascular events, and to determine the value of coronary CT angiography (CCTA) in patients with type 2 diabetes mellitus (T2DM) and VCPs. METHODS: Ninety-eight T2DM patients who underwent CCTA and intravascular ultrasound (IVUS) were retrospectively included and analyzed. The patients were grouped and analyzed according to the presence or absence of VCPs. RESULTS: Among the patients with T2DM, time in range [TIR {the percentage of time blood glucose levels were in the target range}] (OR = 0.93, 95% CI = 0.89-0.96; P < 0.001) and the high-density lipoprotein-cholesterol (HDL-C) concentration (OR = 0.24, 95% CI = 0.09-0.63; P = 0.04) were correlated with a lower risk of VCP, but the triglycerides (TG) concentration was correlated with a higher risk of VCP (OR = 1.79, 95% CI = 1.01-3.18; P = 0.045). The area under the receiver operator characteristic curve (AUC) of TIR, and HDL-C and TG concentrations were 0.76, 0.73, and 0.65, respectively. The combined predicted AUC of TIR, and HDL-C and TG concentrations was 0.83 (P < 0.05). The CCTA sensitivity, specificity, false-negative, and false-positive values for the diagnosis of VCP were 95.74%, 94.12%, 4.26%, and 5.88%, respectively. The identification of VCP by CCTA was positively correlated with IVUS (intraclass correlation coefficient [ICC] = 0.90). CONCLUSIONS: The TIR and HDL-C concentration are related with lower risk of VCP and the TG concentration was related with higher risk of VCP in patients with T2DM. In clinical practice, TIR, HDL-C and TG need special attention in patients with T2DM. The ability of CCTA to identify VCP is highly related to IVUS findings.

Imaging algorithm and multimodality evaluation of spinal osteoblastoma.

BACKGROUND: To analyze the features of CT, MRI and PET/CT and their diagnostic value for spinal osteoblastomas (OBs). METHODS: The radiological and clinical data of 21 patients with histopathologically-confirmed spinal OBs were analyzed retrospectively. RESULTS: Sixteen of the 21 cases were benign and 5 were aggressive OBs. Tumors were located in the lumbar (n = 11), cervical (n = 4), thoracic (n = 5), and sacral (n = 1) spinal regions. Nineteen cases were centered in the posterior elements of the spine, 13 of which extended into the vertebral body. Punctate or nodular calcifications were found in all cases on CT with a complete sclerotic rim (n = 12) or incomplete sclerotic rim (n = 8). The flare phenomenon (indicative of surrounding tissue inflammation) was found in 17/21 cases on CT, thin in 11 cases and thick in 6 cases, and in 19/19 cases on MRI, thin in 1 case and thick in 18 cases. On 18F-FDG PET/CT, all cases (8/8) were metabolically active with the SUVmax of 12.3-16.0; the flare sign was observed in 8 cases, including 7 cases of hypometabolism and 1 case of coexistence of hypermetabolism and hypometabolism. Based on CT, 3, 12, and 6 cases were classified as Enneking stage 1, 2 and 3, respectively. Of 19 cases with MRI, 1 and 18 cases were classified as Enneking stage 2 and 3, respectively. CONCLUSIONS: Spinal OB has multiple unique characteristic radiological features. Although a larger sample size is needed, combining CT, MRI and PET may be beneficial to optimize preoperative diagnosis and care of patients with OBs.

[Imaging diagnosis of osteopoiknosis: a report of 6 cases in four generations of one family and 3 sporadic cases].

OBJECTIVE: To analyze the imaging features of osteopoikilosis and its diagnosis knowledge. METHODS: The imaging data of 9 patients with osteopoikilosis were analyzed retrospectively, including 6 familial cases and 3 sporadic cases. In 6 familial cases,there were 4 males and 2 females with an average age of 28 years old ranging from 10 to 63 years. Clinical manifestations of 1 familial case were left knee pain and limitation of activity for 3 years, and other 5 cases without clinical manifestation. In 3 sporadic cases, there were 2 males and 1 female with an average age of 33.7 years old ranging from 25 to 44 years. Three sporadic cases had obvious injury history with following up from 6 to 12 months. All imaging results of 9 cases were observed. RESULTS: The imaging data of 6 familial osteopoikilosis showed the multiple round or oval nodes within bone with clear margins, uniform density, different size. The occurrence of the hyperostotic spots preferentially localized in the epiphyses and metaphyses of the long bones, and carpus and tarus. X-ray features of 3 sporadic osteopoikilosis were similar to that of 6 familial cases and for 6 to 12 months follow-up X-ray features were unchanged. CONCLUSION: The imaging features of osteopoikilosis are relatively specific such as the multiple mottling dense focal within bone with clear border and bilateral symmetry, and the focus located on cancellous bone and the diaphyses usually is unaffected. The imaging is a valuable examination for the accurate diagnosis of osteopoikilosis.

[Role of computed tomographic dacryocystography in lacrimal path damage].

OBJECTIVE: To explore the diagnostic role of computed tomographic dacryocystography (CTDCG) in lacrimal path damage and provide operative approach guidance for the endoscopic transnasal dacryocystorhinostomy (DCR). METHOD: Twenty-eight cases with lacrimal path damage underwent CTDCG. The following reconstruction techniques including volume rendering (VR), multiple planar reconstruction (MPR), maximum intensity projection (MIP) and three-dimensional reconstruction (3-d R) were done on the real-time workstation. The morphology of dacryocyst, displacement fracture of the lacrimal fossa (FS) and the relationship between the uncinate process (UP) and the FS were observed. The thickness of inner walls of anterosuperior and posteroinferior aspects of lacrimal fossa was measured. RESULT: The morphology of dacryocyst, the displacement fracture of the lacrimal fossa and the block site of the lacrimal passage could be displayed clearly by CTDCG with the following reconstruction techniques including VR, MPR, MIP and 3-d R, 6 cases of canaliculus obstruction, 14 cases of lacrimal sac obstruction, 8 cases of lacrimonasal duct obstruction were showed. Meanwhile the relationship between the UP and the FS could also be showed clear. The average bony thickness of the anterosuperior part of FS was (2.96 +/- 0.30) mm, while the bony thickness of the posteroinferior half was (0.02 +/- 0.005) mm, and the distance between the top and bottom of dacryocyst to the operculum of the middle turbinated (OMT) are (6.80 +/- 1.50) mm, (4.00 +/- 1.80) mm respectively (P < 0.05). CONCLUSION: The morphology of dacryocyst, the displacement fracture of the lacrimal fossa, block site of the lacrimal passage and the relationship between the UP and FS can be clearly displayed by CTDCG, which provide operative approach guidance for the endoscopic transnasal dacryocystorhinostomy.

[A comparative study of Gd-DTPA and HSA-Gd-DTPA in magnetic resonance lymphography].

OBJECTIVE: To compare the effects of two contrast agents, Gd-DTPA and HSA-Gd-DTPA, in magnetic resonance (MR) lymphography. METHODS: Twelve New-Zealand rabbits were randomized into Gd-DTPA and HSA-Gd-DTPA groups with subcutaneous (interdigital skin fold) injection of the two contrast agents (0.2 ml of 0.5 mmol/L Gd(3+)) for MR lymphography of the popliteal lymph nodes examined in the axial and sagital orientation. T(1)-weighted, T1-weighted fat suppressed, and T(2)-weighted spin-echo (SE) images of the lymph nodes were obtained in plain scans. The post-contrast scanning started at 30 min, 1 h and 3 h after Gd-DTPA administration and at 10 min, 30 min and 60 min after HSA-Gd-DTPA injection to obtain T(1)-weighted images with identical imaging parameters. The signal intensity of popliteal lymph node was measured and the enhancement rate calculated. RESULTS: After subcutaneous injection, Gd-DTPA quickly entered blood circulation to result in obvious enhancement of the anterior-tibial vein and the urine and also in heterogeneous enhancement of the popliteal lymph nodes. HSA-Gd-DTPA did not enter the blood, causing obvious homogeneous enhancement of the lymphatic vessels and lymph nodes. HSA-Gd-DTPA resulted in higher enhancement rate than Gd-DTPA, and the enhancement rate in Gd-DTPA group decreased with time as opposed to that of the HSA-Gd-DTPA group. CONCLUSION: HSA-Gd-DTPA has better performance than Gd-DTPA in MR lymphography after subcutaneous administration.