The value of quantitative dual-energy CT parameters in predicting delayed haemorrhage after thrombectomy in acute ischaemic stroke.

OBJECTIVE: This study investigates the predictive value of dual-energy CT Rho/Z quantitative parameters for delayed hemorrhage post-thrombectomy in patients with acute ischemic stroke MATERIALS AND METHODS: A retrospective analysis was conducted on 80 patients who underwent dual-energy CT after thrombectomy for acute ischemic stroke. Patients were divided into delayed hemorrhage/no delayed hemorrhage, symptomatic intracranial hemorrhage/asymptomatic intracranial hemorrhage and cerebral parenchymal hematoma/no cerebral parenchymal hematoma groups RESULTS: The quantitative parameters significantly associated with delayed hemorrhage are DEI and Zeff (p < 0.001), with the optimal cutoff values for DEI and Zeff being 0.045 and 9.355, respectively. The quantitative parameters significantly associated with symptomatic intracranial hemorrhage are DEI and Zeff (p < 0.001), with the optimal cutoff values being 0.064 and 9.422, respectively. The parameters significantly associated with cerebral parenchymal hematoma are DEI and Zeff (p < 0.001), with the optimal cutoff values for DEI and Zeff being 0.058 and 9.09, respectively CONCLUSION: The DEI and Zeff parameters derived from dual-energy CT Rho/Z analysis are valuable in predicting delayed hemorrhage, symptomatic intracranial hemorrhage, and cerebral parenchymal hematoma in patients with acute ischemic stroke following thrombectomy.

Demographic characteristics, clinical manifestations, and treatment outcomes of May-Thurner Syndrome: a five-year retrospective analysis using computed tomography venography in a Chinese population.

OBJECTIVE: This study aimed to analyze the demographic characteristics, symptoms, and treatment outcomes of patients diagnosed with May-Thurner syndrome (MTS) using computed tomography venography (CTV). METHODS: Medical records of patients diagnosed with MTS through CTV at Hebei General Hospital of China between April 1, 2017, and May 31, 2022, were reviewed. The data collected included: (1) gender, age, body mass index (BMI), and smoking and drinking habits; (2) time of onset and symptoms of MTS, as well as other accompanying symptoms; (3) additional diagnoses, length of hospital stay (days), treatment methods, treatment success, and the occurrence of post-treatment bleeding or recurrence. Descriptive statistics were used, with mean ± standard deviation and median values reported. The t-test/u-test and Chi-square test (including the exact probability method) were used to compare means and rates, respectively, with a significance level set at α = 0.05. RESULTS: Out of 402 patients (233 males, 169 females), 118 (29.4%) were diagnosed with MTS, with 47 (21.1%) males and 71 (39.7%) females. The incidence of MTS was significantly higher in females than males (χ2 proportion = 16.545, χ2 composition = 9.763, P < 0.05). The average ages of male and female MTS patients were 56.4 and 59.9 years, respectively, with mean BMIs of 27.05 and 27.09 kg/m2. Among male patients, 27.7% (13) were smokers, and 17.0% (8) consumed alcohol. Inferior vena cava (IVC) thrombosis was notable in 59.3% of MTS patients, with a significantly higher proportion in females (70.4%) than in males (42.6%) (χ2 = 9.102, P < 0.05). Lower limb swelling without pain was reported by 70.3% of patients, with 53.4% (44.7% male, 59.2% female) experiencing swelling on the left side only, which was significantly more common than swelling on the right side only or both sides (χ2 = 44.554, P < 0.05). Additionally, 12.7% of patients reported both swelling and pain, with left-side symptoms being more prevalent than right-side or both sides. The average ages at symptom onset were 51.3 ± 17.1 years in males and 57.1 ± 13.2 years in females. All treatments for MTS were successful without bleeding or recurrence. The most common treatment method was balloon dilation combined with stent placement (57.6%). CONCLUSION: CTV is highly effective in detecting and facilitating the successful treatment of MTS. It should be fully utilized to promote early diagnosis and treatment of MTS. Female MTS patients need more medical resources for diagnosis and treatment.

Added value of computed tomography venography in the identification of abnormities in veins of lower extremities.

OBJECTIVE: To investigate the efficacy of direct computed tomography venography (CTV) in early and accurate detection of lower extremity venous (LEV) abnormalities. METHODS: Cross-sectional research was conducted in Hebei General Hospital of China. A total of 211 CTV reports of both lower extremities from January 2017 to September 2019, 75 color Doppler ultrasound (DUS) examinations, and eight intravascular angiography records of these patients over the same period were collected from the hospital. Comparisons were made for the reported number and percentage of LEV abnormalities (thrombosis, stenosis including severe stenosis, and varicosities). Chi-square test and t-test were applied to compare the rates and means, respectively. Significance level α was 0.05. Individual interviews were performed to understand the perceptions of medical staff and patients on the application of CTV, and the interview results were analyzed. RESULTS: Of the 75 cases with both CTV and DUS reports, 159 abnormalities occurring in the lower extremity deep veins (LEDV) were reported, among which 125 (79%) and 18 (11%) were reported by CTV and DUS on a single basis, respectively, whereas 16 (10%) were reported by CTV and DUS simultaneously. A statistically significant greater number of abnormalities in LEDV were identified by CTV than DUS in both males and females (χ2males = 78.449, χ2females = 27.574, χ2total = 104.164, p < .05). In the 211 CTV reports, among the 383 abnormalities reported in total, the common iliac vein (CIV) had the highest number of reported abnormalities (132, 34.5%), followed by the femoral vein (93, 24.3%). The ratios between LEDV abnormality and patient numbers were 1.055 and 0.688 for left and right sides in males, and 0.892 and 0.461 for left and right sides in females, respectively, with that for the left side statistically significantly higher than the right one (tmale = 2.896, tfemale = 4.347, p < .05). The incidence of thrombosis was 10.9% (95% CI = 6.7 ∼ 15.1%). Reported abnormities in CIV by CTV were in agreement with those by intravascular angiography. The medical staff believed that CTV could guide the performance of surgeries for LEV and the patients perceived CTV acceptable. CONCLUSIONS: Application of CTV for early and accurate detection of LEDV abnormalities including thrombosis has been proven to be efficient. Corresponding benefit in early intervention and reduction of severe complications of such abnormalities is of important value. CTV earned good recognition from medical staff and patients. Hence, it could be considered as part of global health assistance cooperation with developing countries to facilitate enhanced medical services.

Blood-oxygenation-level-dependent-(BOLD-) based R2' MRI study in monkey model of reversible middle cerebral artery occlusion.

OBJECTIVE: To investigate the value of BOLD-based reversible transverse relaxation rate (R2') MRI in detecting ischemic penumbra (IP) in a monkey model of reversible middle cerebral artery occlusion (MCAO) and time evolution of relative R2' (rR2') in infarcted core, IP, and oligemia. MATERIALS AND METHODS: 6 monkeys were used to make MCAO by the microcatheter method. MR scans were performed at 0 h (1 h after MCAO), 1 h, 3 h, 6 h, 12 h, 24 h, and 48 h after reperfusion. R2' was calculated using quantitative T2 and T2* maps. Ischemic area was subdivided into infracted core, IP and oligemia. rR2' was calculated respectively. RESULTS: Reversible MCAO model for 4/6 monkeys was made successfully. rR2' values were significantly different at each time point, being highest in oligemia followed by IP and infarcted core (P < .05). With reperfusion time evolution, rR2' in infarcted core showed a decreased trend: sharply decreased within 6 hours and maintained at 0 during 6-48 hours (P < .05). rR2' values in IP and oligemia showed similar increased trend: sharply increased within 6 hours, maintained a plateau during 6-24 hours, and slightly increased until 48 hours. CONCLUSION: BOLD-based R2' MRI can be used to describe changes of cerebral oxygen extract in acute ischemic stroke, and it can provide additional information in detecting IP. The time evolution rR2' in infarcted core, IP, and oligemia is in accordance with the underlying pathophysiology.

Electrophysiological mechanisms of sophocarpine as a potential antiarrhythmic agent.

AIM: To examine the electrophysiological effects of sophocarpine on action potentials (AP) and ionic currents of cardiac myocytes and to compare some of these effects with those of amiodarone. METHODS: Langendorff perfusion set-up was used in isolated guinea pig heart, and responses to sophocarpine were monitored using electrocardiograph. Conventional microelectrode, voltage clamp technique and perforated patch were employed to record fast response AP (fAP), slow response AP (sAP) and ionic currents in guinea pig papillary muscle or rabbit sinus node cells. RESULTS: Tachyarrhythmia produced by isoprenaline (15 µmol/L) could be reversed by sophocarpine (300 µmol/L). Sophocarpine (10 µmol/L) decreased the amplitude by 4.0%, maximal depolarization velocity (V(max)) of the fAP by 24.4%, and Na(+) current (I(Na)) by 18.0%, while it prolonged the effective refractory period (ERP) by 21.1%. The same concentration of sophocarpine could also decrease the amplitude and V(max) of the sAP, by 26.8% and 25.7%, respectively, and attenuated the Ca(2+) current (I(CaL)) and the K(+) tail current substantially. Comparison of sophocarpine with amiodarone demonstrated that both prolonged the duration and the ERP of fAP and sAP, both decreased the amplitude and V(max) of the fAP and sAP, and both slowed the automatic heart rate. CONCLUSION: Sophocarpine could reverse isoprenaline-induced arrhythmia and inhibit I(Na), I(CaL), and I(Kr) currents. The electrophysiological effects of sophocarpine are similar to those of amiodarone, which might be regarded as a prospective antiarrhythmic agent.

Sensitivity analysis of heat and mass transfer characteristics during forced-air cooling process of peaches on different air-inflow velocities.

Peach is one of the most perishable fruits. During forced-convection cooling, the heat sources (respiratory and evaporative latent heat) internal to freshly harvested peaches have a remarkable influence on its evaluation of cooling characteristics with respect to various cooling strategies. Therefore, to improve the accuracy of simulation results in peaches cooling, the term of heat source was coded as detailed procedures and included into a computational fluid dynamics (CFD) model. By comparing the temperature simulated with and without considering these heat sources, it is found that a reasonable decrease in variations of cooling performances is obtained with sustained increase in air-inflow velocities. A maximum discrepancy in peaches volume-weighted average temperature (∆T vwa-max) is mainly concentrated in 0.1-0.3°C when the air-inflow velocity not exceeds 1.7 m/s, and its corresponded 7/8ths cooling time (SECT) is also prolonged by 1-6 min. This means that, below 1.7 m/s, these heat sources should be added as a term into the heat transfer equations for modifying the mathematical model inside peaches computational domain. Furthermore, the feasibility of this modeling method is confirmed by a great agreement with experiments, and its modified model has a higher accuracy with the decreased RMSE and MAPE values of 6.90%-11.26% and 7.28%-12.95%, respectively.

Radiologic features of Castleman's disease involving the renal sinus: A case report and review of the literature.

BACKGROUND: We present a rare case of plasma cell type of Castleman's disease (CD) involving only the right renal sinus in a 65-year-old woman with a duplex collecting system (DCS). CASE SUMMARY: The patient presented with a right renal sinus lesion after renal ultrasonography. Subsequent abdominal enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the kidneys showed DCS and a soft tissue mass with mild enhancement at the lower right renal sinus. The lesion was suspected to be a malignant renal pelvic carcinoma. Hence, the patient underwent a right radical nephrectomy. Histological examination revealed hyperplastic lymphoid follicles in the renal sinus. A detailed review of the patient's CT and MRI images and a literature review suggested that the lesion was hypointense on T2-weighted images and hyperintense on diffusion-weighted image manifestations, and showed mild enhancement, which distinguished the plasma cell type of CD from many other renal sinus lesions. Furthermore, peripelvic soft tissue masses with a smooth internal surface of the renal pelvis were on imaging findings, which suggests that the urinary tract epithelial system is invulnerable and can be used to differentiate the plasma cell type of CD from malignant lymphoma with a focally growth pattern to some extent. CONCLUSION: Preoperative diagnosis is often difficult in such cases, as plasma cell type of CD involving only the right kidney is exceedingly rare. However, heightened awareness of this disease entity and its radiographic presentations may alert one to consider this diagnosis.