Characterisation of carotid plaques with ultrasound elastography: feasibility and correlation with high-resolution magnetic resonance imaging

Objectives

To evaluate the ability of ultrasound non-invasive vascular elastography (NIVE) strain analysis to characterise carotid plaque composition and vulnerability as determined by high-resolution magnetic resonance imaging (MRI).

Methods

Thirty-one subjects with 50 % or greater carotid stenosis underwent NIVE and high-resolution MRI of internal carotid arteries. Time-varying strain images (elastograms) of segmented plaques were generated from ultrasonic raw radiofrequency sequences. On MRI, corresponding plaques and components were segmented and quantified. Associations between strain parameters, plaque composition and symptomatology were estimated with curve-fitting regressions and Mann–Whitney tests.

Results

Mean stenosis and age were 72.7 % and 69.3 years, respectively. Of 31 plaques, 9 were symptomatic, 17 contained lipid and 7 were vulnerable on MRI. Strains were significantly lower in plaques containing a lipid core compared with those without lipid, with 77–100 % sensitivity and 57–79 % specificity (P?<?0.032). A statistically significant quadratic fit was found between strain and lipid content (P?<?0.03). Strains did not discriminate symptomatic patients or vulnerable plaques.

Conclusions

Ultrasound NIVE is feasible in patients with significant carotid stenosis and can detect the presence of a lipid core with high sensitivity and moderate specificity. Studies of plaque progression with NIVE are required to identify vulnerable plaques.

Key points

? Non-invasive vascular elastography (NIVE) provides additional information in vascular ultrasound ? Ultrasound NIVE is feasible in patients with significant carotid stenosis ? Ultrasound NIVE detects a lipid core with high sensitivity and moderate specificity ? Studies on plaque progression with NIVE are required to identify vulnerable plaques     

休克大鼠微循环中白细胞流动分布的变化及虎杖4号的治疗作用

应用微循环图像多参数计算机分析系统，测量了大鼠失血性休克过程中骨骼肌微循环中白细胞流动分布的变化，发现第三级细静脉内中央轴流白细胞的流速减慢，移边并开始敞因管内皮滚动，最后粘着于血管内皮。输血时，血流加快，粘着白细胞开始沿管壁滚动，并加速进入中央血流。计算了反映白细胞和内皮细胞作用程度的指标：总体白细胞２－内皮细胞接触时间（ＴＬＥＣＴ），发现休克时ＴＬＥＣＴ明显延长。查明在失血性休克晚期，要解除白     

螺旋CT在腔内隔绝术治疗腹主动脉瘤术前评估中的价值

目的探讨螺旋ＣＴ（ｓｐｉｒａｌＣＴ，ＳＣＴ）在腔内隔绝术（ＥＶＧＥ）治疗腹主动脉瘤（ＡＡＡ）术前评估中的价值。方法以ＳＣＴ扫描了４１例ＡＡＡ患者，资料经计算机处理进行ＳＣＴ图像重建（ＣＴＡ），所用技术主要为表面阴影遮盖技术（ＳＳＤ）、最大信号强度投影（ＭＩＰ）、多平面重建（ＭＰＲ）及曲面重建（ＣＰＲ）技术，少数夹层动脉瘤应用模拟的内窥镜技术。测量远近端瘤颈长度及直径，瘤体的大小、形态及与分支动脉的关系，双髂动脉形态、口径及肾动脉开口到髂动脉分叉水平的自然长度。根据ＥＶＧＥ手术适应证的要求，选择９例患者行ＥＶＧＥ。结果据上述参数选定移植物的规格、型号，经术中证实与需求相符。结论ＣＴＡ图像质量高，无创、快速、准确，可获得ＥＶＧＥ术前评估所需全部参数，具有良好的应用价值     

X线照片影像颗粒度及其相关影响因素的探讨

目的评价不同屏片组合下Ｘ线照片影像的颗粒性，以期掌握照片颗粒性的客观评价方法，并获得影响影像颗粒度的相关因素。方法利用显微密度计对测试样本进行扫描，通过均方根（ｒｏｏｔｍｅａｎｓｑｕａｒｅ，ＲＭＳ）值的计算，对不同屏片组合的Ｘ线影像进行颗粒度的物理评价。结果通过测试和数据整理，得出颗粒度与管电压、密度、对比度及清晰度的关系。结论Ｘ线照片影像颗粒度随着管电压、清晰度和对比度的升高而升高，随密度的升高而降低     

下体负压作用下心率变异性的线性和非线性动力学分析

为了评估下体负压作用下心率变异性的变化，本文应用了时域，频域分析和复杂度分析了ＨＲＶ。受试者为１５名健康男性。下体负压作用的强度和时间分别为－２．７ｋＰａ，２ｍｉｎ；－４．０ｋＰａ，３ｍｉｎ；－５．３ｋＰａ，５ｍｉｎ；－６．７ｋＰａ，１０ｍｉｎ。     

双侧颈动脉体瘤的CT和MRI诊断

目的:探讨双侧颈动脉体瘤CT、MRl影像表现.材料和方法:回顾性分析9例双侧颈动脉体瘤的CT和MRI影像表现及其临床资料.结果:9例双侧颈动脉体瘤影像表现为双侧舌骨水平颈动脉鞘区肿块,平扫呈较均匀的等密度或中等信号,增强扫描肿块明显增强.螺旋CT薄层图像可见肿块周边迂曲扩张的供血动脉(5/6),颈内、外动脉间距增宽.MRI最为特征表现是肿块内或周边迂曲条状的血管流空影(10/13).结论:双侧颈动脉体瘤的CT和MRI表现具有特征性,术前可以做出定性诊断.     

Early uptake of 99mTc-C2A in the acute phase of myocardial infarction as a prognostic indicator for follow-up cardiac dysfunction

OBJECTIVE: The C2A domain of Synaptotagmin I is a molecular probe for the specific imaging of cell death. Here we test the hypothesis that the uptake of 99mTc-C2A in the acute phase of an infarction is associated with cardiac dysfunction in follow-ups. METHODS: The left coronary artery was occluded in Sprague-Dawley rats for 0, 10, 20, and 30 min. 99mTc-C2A was injected intravenously at 2 h of reperfusion. Anterior planar images were acquired with one million counts on a gamma camera 3 h after injection. 99mTc-C2A uptake was calculated as the total counts in the left ventricle region minus blood pool signal. The in-vivo signal detected was correlated with wall motion score index at 1 and 3 weeks follow-ups measured by echocardiography. RESULTS: 99mTc-C2A uptake was higher with increased ischemic time (2244+/-852, 4054+/-1223, and 6178+/-1451 for 10, 20, and 30 min ischemia, analysis of variance P<0.001). A significant correlation was found between 99mTc-C2A uptake and wall motion score index at 1 week (R=0.800, P=0.0006) and 3 weeks (R=0.810, P=0.0008). CONCLUSION: In this ischemia/reperfusion model, 99mTc-C2A uptake in the acute phase was associated with functional abnormality at 1 and 3 weeks. This demonstrates the potential diagnostic and prognostic value of 99mTc-C2A as a novel imaging agent.     

多层CT尿路造影在上尿路梗阻性疾病中的应用价值

目的探讨多层CT尿路造影(MSCTU)在上尿路梗阻性病变中的诊断价值。方法回顾分析103例因上尿路梗阻就诊患者的MSCT和CT尿路造影(CTU)后处理图像资料。结果本组93例上尿路梗阻患者中,结石嵌顿致上尿路梗阻者32例,尿路先天畸形引起上尿路梗阻积水12例,肾盂囊肿或泌尿系肿瘤引起上尿路梗阻者28例,炎性病变、结核致肾盂、输尿管狭窄者14例,非泌尿系肿瘤包埋或压迫上尿路致梗阻积水者7例。结论多层螺旋CT具有快速扫描、图像分辨率优良和强大的图像后处理功能,MSCTU对上尿路梗阻定位、定性诊断具有很高价值。     

抗中性粒细胞胞质抗体和抗酿酒酵母抗体表达在炎症性肠病诊断中的意义

目的 回顾性分析血清核周型抗中性粒细胞胞质抗体(pANCA)和抗酿酒酵母抗体(AScA)的表达在炎症性肠病(IBD)诊断中的意义.方法 间接免疫荧光生物薄片(IIFT)法检测97例IBD患者血清pANCA、ASCA表达,其中86例溃疡性结直肠炎(UC)列入UC组,11例克罗恩病(CD)列入CD组,另设36例结肠镜检查正常者为对照组.结果 pANCA在UC、CD和对照组的阳性率分别为27.9%、0%和0%,UC组显著高于其他两组(P<0.01);ASCA在CD、UC和对照组的阳性率分别为36.4%、4.7%和0%,CD组显著高于其他两组(P<0.01).86例UC患者中,重度UC 23例(26.7%),其中pANCA 6例(26.1%),ASCA 2例(8.7%),pANCA /ASCA 1例(4.4%),轻、中度UC 63例(73.3%),其中pANCA 18例(28.6%).重度与轻、中度UC患者pAN-CA表达情况无显著差异(P>0.05).11例CD患者中,重度CD 4例(36.4%),其中ASCA 3例(75.0%),轻、中度CD 7例(63.6%),其中ASCA 1例(14.3%).重度CD患者ASCA阳性率明显高于轻、中度CD患者(P<0.05).结论 ASCA、pANCA两种血清标志物对诊断UC和CD具有一定临床参考价值.     

HPLC法测酸枣仁合剂中阿魏酸的含量

目的建立酸枣仁合剂中阿魏酸的含量测定方法。方法采用HPLC法Hypersil-C18色谱柱，流动相分别为：乙腈-水（30：70）和甲醇．1％冰醋酸（28：72），检测波长分别为：204nm和322nm。结果HPLC法测定阿魏酸的含量，阿魏酸在0．2-0．6mg／ml范围内线形良好（r=0．9999），平均加样回收率为99．95％，RSD％为2．35％。结论方法简便，准确。