Retinol-Binding Protein 4 Predicts Lesion Volume (Determined by MRI) and Severity of Acute Ischemic Stroke.

Retinol-binding protein 4 (RBP4) is an adipocyte-secreted molecule and is associated with cardiovascular risk factors. The aim of this study was to assess the clinical significance of serum levels of RBP4 in Chinese patients with acute ischemic stroke (AIS). We sequentially screened patients with first-ever AIS who were admitted to our Hospital between September 2016 and October 2017. Serum levels of RBP4 were assayed with solid-phase sandwich ELISA, and severity of stroke was evaluated with the National Institutes of Health Stroke Scale (NIHSS) score on admission. We used logistic regression models to assess the relationship between RBP4 levels and stroke risk and severity. During the inclusion period, 323 patients completed the study. Our results indicated that the median serum RBP4 levels were significantly (P < 0.001) higher in patients with AIS than in those normal cases [28.9 (IQR, 17.3-39.6) µg/ml vs. 23.7 (14.6-32.3) µg/ml]. In logistic regression analysis, for each 1 unit increase of serum level of RBP4, the unadjusted and adjusted risks of AIS increased by 4% (OR 1.04 [95% CI 1.02-1.05], P < 0.001) and 3% (1.03 [1.01-1.04], P < 0.001), respectively. At admission, 116 patients (35.9%) had a minor stroke (NIHSS < 6). In logistic regression analysis, for each 1 unit increase of serum level of RBP4, the unadjusted and adjusted risks of moderate-to-high stroke increased by 7% (OR 1.07 [95% CI 1.05-1.09], P < 0.001) and 5% (1.05 [1.02-1.07], P < 0.001), respectively. Elevated levels of RBP4 could be considered an independent diagnosis marker of AIS. Elevated levels of RBP4 were significantly associated with higher stroke severity in Chinese sample.

The impact of adaptive iterative dose reduction 3D on the improvement of shoulder image quality in head and neck CTA.

OBJECTIVE: The aim of this study was to determine the impact of adaptive iterative dose reduction 3 D (AIDR3D) on the improvement of shoulder image quality in low-radiographic dose head and neck CT angiography (CTA). MATERIALS AND METHODS: Ninety patients who underwent CTA examination were randomly divided into two groups, namely group A (n = 45) and B (n = 45). Patients in group A were scanned under 120 kV and 300 mA, with images reconstructed by filtered back projection (FBP), and patients in group B were scanned under 80 kV and auto mA with images reconstructed by AIDR3D. Image quality was accessed by two experienced radiologists. The noise, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of common carotid artery (CCA) at C7 level, and radiation dosage were compared between the two groups. RESULTS: The score of CCA in group B was significantly higher than group A (p < 0.05), and there were no significant differences in the scores of carotid sinus and internal carotid artery between the two groups (p > 0.05). The score of intracranial artery in group B was lower than that of group A, however, the image quality in group B can meet the requirement of clinical diagnosis. The noise value of CCA at C7 level in group B was significantly lower than that of group A (p < 0.05). SNR and CNR values of CCA at C7 level in group B were significantly higher than those of group A (p < 0.05). Effective radiation dose in group B was significantly decreased compared with group A (p < 0.05). CONCLUSION: AIDR3D remarkably improved image quality in low-radiographic dose head and neck CTA over FBP, which made the low-dose CTA images meet the requirement of clinical diagnosis.

Application value of iterative reconstruction with CTA to intractable headache patients.

Application value of iterative reconstruction with computed tomographic angiography (CTA) in the patients with intractable headache was investigated. One hundred and eighty patients with headache, who were admitted and treated in Cangzhou Central Hospital, were selected to undergo CTA scan. The patients were divided into group A, B and C according to different scanning conditions and data reconstruction techniques. In group A, the scanning parameters were 120 kV and 300 mA, and filtered back projection (FBP) algorithm was used for data reconstruction. In group B, the scan parameters were 100 kV and automatic milliamperes. Further, adaptive iterative dose reduction via three-dimensional processing (AIDR-3D) was used for data reconstruction. In group C, the scan parameters were 80 kV with automatic milliamperes, and AIDR-3D technique was utilized for data reconstruction. The CT value, noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), subjective assessment score of image quality and radiation dose of the three groups of images were compared. There were significant differences in CT values, standard deviation (SD) values, SNRs and CNRs of different vessel segments and muscles among the three groups (P<0.05). The image assessment scores at the levels of the atlas and C7 vertebra as well as those of the brain parenchyma in the three groups had notable differences (P<0.05). However, they showed no differences at the level of the C4 vertebra (P>0.05). Further, significant differences were observed in volume computed tomography dose index (CTDIvol), dose-length product (DLP) and effective dose (ED) (P<0.05). In conclusion, for patients with intractable headache, the image quality of the CTA scan using AIDR-3D reconstruction method showed better results over FBP reconstruction method. Further, best results were observed when the scan parameters were 100 kV, automatic milliamperes and the data reconstruction was performed by AIDR-3D.

Reliability of temporal bone high-resolution CT in patients with facial paralysis in temporal bone fracture.

OBJECTIVE: This study aimed to investigate the reliability of temporal bone high-resolution CT (HRCT) in patients with traumatic facial paralysis. METHODS: HRCT with cross-sectional scanning and multi-planar reformation (MPR) was performed on 26 cases with traumatic facial paralysis, and the preoperative imaging manifestations were compared with surgical findings. RESULTS: Preoperative HRCT revealed fallopian canal damage at the posterior genu in 1 case, geniculate ganglion in 22 cases, labyrinthine segment in 4 cases, tympanic segment in 13 cases and mastoid segment in 0 case, while surgical findings confirmed fallopian canal damage at the posterior genu in 7 cases, geniculate ganglion in 23 cases, labyrinthine segment in 4 cases, tympanic segment in 17 cases and mastoid segment in 7 cases. The accuracy of temporal bone HRCT in revealing damage at those segments of fallopian canal was 14.3%, 95.7%, 100%, 76.5, and 0%, respectively. CONCLUSION: Temporal bone HRCT can generally estimate the extent of damage and provide important information for traumatic facial paralysis before surgery. However, it is unreliable in revealing the damage of fallopian canal at the posterior genu and mastoid segment.