Myocardial motion-corrected phase-sensitive inversion recovery late gadolinium enhancement in free breathing paediatric patients: a comparison with single-shot coherent gradient echo ("TrueFISP") phase-sensitive inversion recovery.

AIM: To investigate the value of motion-corrected (MOCO) phase-sensitive inversion recovery (PSIR) late gadolinium enhancement (LGE) compared with single-shot balanced steady-state gradient echo ("TrueFISP", Siemens) PSIR in free breathing paediatric patients. MATERIALS AND METHODS: In this retrospective study, 238 paediatric patients underwent clinical contrast-enhanced cardiovascular magnetic resonance imaging (CMRI). Both the single-shot TrueFISP PSIR and MOCO PSIR sequences were performed on each child. The signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Two radiologists rated the quality of the images on a scale of 1-5 (1 = poor, 5 = very good). Bland-Altman, linear regression, and intraclass correlation coefficient were used to compared the extent of LGE of the single-shot TrueFISP PSIR and MOCO PSIR. Imaging artefacts were described and compared. RESULTS: Children ranged in age from 60 days to 17 years with an average age of 8.1 ± 3.8 years. MOCO PSIR had higher SNR and CNR than the single-shot TrueFISP PSIR (p<0.001). Mean quality ratings for short-axis imaging were 4 (interquartile range, 3-4) for single-shot TrueFISP PSIR and 4 (interquartile range, 4-5) for MOCO PSIR (p<0.001). The scan time was faster for single-shot TrueFISP PSIR than for MOCO PSIR. The myocardial LGE results were similar with high agreement between the single-shot TrueFISP PSIR and MOCO PSIR (ICC = 0.955-0.986). CONCLUSION: The MOCO PSIR sequence is feasible in children. MOCO PSIR is robust at high heart rates and can be performed without breath-holding with higher image-quality ratings than the single-shot TrueFISP PSIR.

[Maternal-infant outcome of patients with OSAHS and gestational hypertension treated by CPAP].

Objective:To explore the clinical characteristics of obstructive sleep apnea hypopnea syndrome (OSAHS) diagnosed during pregnancy.To explore the effect on maternal and infant after treated with CPAP.Method:Data of 117 patients with OSAHS diagnosed by nocturnal blood oxygen saturation (SaO2) monitoring and PSG during pregnancy were analyzed retrospectively. All the 117 patients were voluntary and divided into intervention group [received continuous positive airway pressure (CPAP) treatment with good compliance under informed consent and conventional drug] 70 cases and control group(received conventional drug) 47 cases. Record the relevant data during the treatment about maternal and infant.Result:There was no statistical significance on the difference of cesarean delivery and postpartum hemorrhage in the pregnant women with mild OSAHS (P> 0.05), there was no statistical significance on the difference of cesarean delivery and postpartum hemorrhage in the pregnant women with moderate OSAHS (P> 0.05) and there were statistical significance on the difference of cesarean delivery and postpartum hemorrhage in the pregnant women with severe OSAHS (P< 0.05 or P< 0.01). There was no statistical significance on the difference of asphyxia neonatorum, fetal growth restriction and fetal distress in the pregnant women with mild OSAHS (P> 0.05), there were statistical significance on the difference of fetal growth restriction and fetal distress in the pregnant women with moderate OSAHS (P< 0.05), and there were statistical significance on the difference of asphyxia neonatorum, fetal growth restriction and fetal distress in the pregnant women with severe OSAHS (P< 0.05 or P< 0.01).Conclusion:Pregnant women who have OSAHS risk factors should be paid attention to during the perinatal care and nocturnal SaO2 monitoring or PSG should be performed in the suspected OSAHS patients. Strongly advise that those serious OSAHS patients should be treated by CPAP early before delivery. CPAP was a safe and effective treatment to OSAHS patients in pregnancy.

Correlation of plasma soluble cluster of differentiation 40 ligand, alpha fetoprotein A, and pregnancy-associated plasma protein A with carotid plaque in patients with ischemic stroke.

This study investigated the correlation of plama levels of inflammatory biomarkers [soluble cluster of differentiation 40 ligand (sCD40L), alpha fetoprotein A (fetuin-A), and pregnancy-associated protein A (PAPP-A)] with carotid plaque in patients with acute ischemic stroke. After undergoing color Doppler ultrasonography of the bilateral carotid arteries, 200 patients with acute ischemic stroke were grouped into plaque and non-plaque groups. The plaque group was further divided into stable and unstable plaque sub-groups by carotid plaque stability. Inter-group and -subgroup comparisons included demographic characteristics, current condition and medical history, and clinical laboratory and plama inflammatory biomarker data, and logistic regression explored the correlations between plama inflammatory biomarker levels and carotid plaques. Significantly higher sCD40L and fetuin-A levels were found in the plaque group than in the non-plaque group (all P < 0.05), with odds ratios (plaque vs non-plaque) of 6.372 and 4.101, respectively. Increased plama inflammatory biomarker levels were accompanied by a high risk of carotid plaque formation. Similarly, significantly higher plama sCD40L and PAPP-A levels were found in the unstable plaque subgroup than in the stable plaque subgroup (all P < 0.05), and the odds ratios (unstable vs stable) were 5.290 and 4.125, respectively. Increased plama inflammatory biomarker levels were accompanied by a high risk of carotid plaque instability. The study findings showed that plasma sCD40L, fetuin-A, and PAPP-A levels are associated with carotid plaque formation and instability. Fetuin-A and sCD40L might be predictors of carotid plaque formation, while PAPP-A and sCD40L might be predictors of carotid plaque instability.