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【Objective】 To evaluate the application value of the three-point localization method in improving the quality and efficiency of four-chamber view acquisition in cardiac magnetic resonance (CMR) imaging. 【Methods】 A total of 215 patients who underwent four-chamber view in CMR imaging from January 2022 to October 2023 were retrospectively enrolled and divided into two groups. The control group (n=109) received traditional localization method while the study group (n=106) received three-point localization method. The image quality of mitral valve, tricuspid valve and cruciform structure in four-chamber view images were assessed by two radiologists using a Likert 4-piont scale. The time-consumption from scout imaging to the finish of four-chamber view imaging was recorded. Constituent data and numeral data were compared by Chi-square test and two-sample t test, respectively. Kappa test was used to analyze the inter-observer consistency. 【Results】 There were no significant inter-group differences in gender, age, disease profile, or the radiographers’ experience. The mean quality scores of the mitral valve, tricuspid valve and cruciform structure in the control group and the study group were 3.44±0.64 and 3.63±0.49 (P=0.023), 3.43±0.67 and 3.53±0.60(P=0.202), 3.71±0.49 and 3.83±0.35 (P=0.047), respectively. The image quality score was higher in the study group than in the control group, with the differences in mitral valve and cruciform structure reaching statistical significance. The time-consumption for obtaining four-chamber view for the control group and the study group was 11.67±3.49 minutes and 7.212±1.83 minutes, respectively, with statistically significant differences (P<0.001). 【Conclusion】 Compared with the traditional localization method, the three-point localization method provides better image quality in four-chamber view imaging with shortened imaging time.
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【Objective】 To explore the correlation between the percentage of epicardial adipose tissue（EAT） and cardiac function in type 2 diabetes mellitus without heart failure. 【Methods】 We recruited diabetic inpatients and random non-diabetic inpatients who underwent CTA examinations in the Imaging Department of The First Affiliated Hospital， Xi’an Jiaotong University， from 2012 to 2014 as the research subjects. Their clinical data， laboratory examinations， echocardiography， and EAT quantification based on cardiac CTA were analyzed retrospectively. The parameters were compared between the two groups. Then the correlation between cardiac function parameters and EAT parameters was analyzed. 【Results】 Compared with those in control group， type 2 diabetic patients without heart failure had lower left ventricular stroke volume （61.41±15.95 vs. 79.41±15.19， P=0.047）， and the percentage of EAT in the pericardium， plasma total cholesterol， and low-density lipoprotein cholesterol were all related to it. The correlation coefficients were -0.501， -0.136， and -0.377. The percentage of EAT in the pericardium still had a moderately linear negative correlation with SV when the other factors were under control （r=-0.470， P<0.001）. 【Conclusion】 The percentage of EAT is asseated with early decreased left ventricular SV in patients with type 2 diabetes. It can be used as a sensitive index to quantify cardiac function abnormalities in type 2 diabetes.
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ObjectiveAs a pandemic, a most-common pattern resembled organizing pneumonia (OP) has been identified by CT findings in novel coronavirus disease (COVID-19). We aimed to delineate the evolution of CT findings and outcome in OP of COVID-19. Materials and Methods106 COVID-19 patients with OP based on CT findings were retrospectively included and categorized into non-severe (mild/common) and severe (severe/critical) groups. CT features including lobar distribution, presence of ground glass opacities (GGO), consolidation, linear opacities and total severity CT score were evaluated at three time intervals from symptom-onset to CT scan (day 0-7, day 8-14, day>14). Discharge or adverse outcome (admission to ICU or death), and pulmonary sequelae (complete absorption or lesion residuals) on CT after discharge were analyzed based on the CT features at different time interval. Results79(74.5%) patients were non-severe and 103(97.2%) were discharged at median day 25 (range, day 8-50) after symptom-onset. Of 67 patients with revisit CT at 2-4 weeks after discharge, 20(29.9%) had complete absorption of lesions at median day 38 (range, day 30-53) after symptom-onset. Significant differences between complete absorption and residuals groups were found in percentages of consolidation (1.5% vs. 13.8%, P=0.010), number of involved lobe >3 (40.0% vs. 72.5%, P=0.030), CT score >4 (20.0% vs. 65.0%, P=0.010) at day 8-14. ConclusionsMost OP cases had good prognosis. Approximately one-third of cases had complete absorption of lesions during 1-2 months after symptom-onset while those with increased frequency of consolidation, number of involved lobe>3, and CT score >4 at week 2 after symptom-onset may indicate lesion residuals on CT.
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AbstractsO_ST_ABSPurposeC_ST_ABSAs global healthcare system is overwhelmed by novel coronavirus disease (COVID-19), early identification of risks of adverse outcomes becomes the key to optimize management and improve survival. This study aimed to provide a CT-based pattern categorization to predict outcome of COVID-19 pneumonia. Methods165 patients with COVID-19 (91 men, 4-89 years) underwent chest CT were retrospectively enrolled. CT findings were categorized as Pattern0 (negative), Pattern1 (bronchopneumonia), Pattern2 (organizing pneumonia), Pattern3 (progressive organizing pneumonia) and Pattern4 (diffuse alveolar damage). Clinical findings were compared across different categories. Time-dependent progression of CT patterns and correlations with clinical outcomes, i.e. discharge or adverse outcome (admission to ICU, requiring mechanical ventilation, or death), with pulmonary sequelae (complete absorption or residuals) on CT after discharge were analyzed. ResultsOf 94 patients with outcome, 81(86.2%) were discharged, 3(3.2%) were admitted to ICU, 4(4.3%) required mechanical ventilation, 6(6.4%) died. 31(38.3%) had complete absorption at median day 37 after symptom-onset. Significant differences between pattern-categories were found in age, disease-severity, comorbidity and laboratory results (all P<0.05). Remarkable evolution was observed in Pattern0-2 and Pattern3-4 within 3 and 2 weeks after symptom-onset, respectively; most of patterns remained thereafter. After controlling for age, CT pattern significantly correlated with adverse outcomes (Pattern4 vs. Pattern0-3 [reference]; hazard-ratio[95%CI], 18.90[1.91-186.60], P=0.012). CT pattern (Pattern3-4 vs. Pattern0-2 [reference]; 0.26[0.08-0.88], P=0.030) and C-reactive protein (>10 vs. [≤]10mg/L [reference]; 0.31[0.13-0.72], P=0.006) were risk-factors associated with pulmonary residuals. ConclusionCT pattern categorization allied with clinical characteristics within 2 weeks after symptom-onset would facilitate early prognostic stratification in COVID-19 pneumonia.
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PURPOSEIn the global presence of secondary infections with the coronavirus disease 2019 (COVID-19), little is known about the transmission characteristics of COVID-19 outside Wuhan, China. We evaluated differences in clinic and radiologic findings of multiple generations of COVID-19 infection in Xian (Shaanxi, China) to provide more clues for the correct estimate of the disease. METHODSAll COVID-19 infected patients reported in Xian up to 10 February 2020 were included for this analysis. Among these cases, clinical and chest CT data of 62 cases were obtained from three hospital in Xian. With this information, patients were grouped on basis of exposure history and transmission chains as first-generation, second-generation and third-generation patients. We described clinical characteristics and evaluated CT score/patterns in these COVID-19 cases. RESULTSThere was a clear age differences in multiple generations with COVID-19 infection. Above two thirds of the second-generation (75.0%) and third-generation patients (77.8%) were aged [≥]45 years while 40.0% of first-generation cases at this age (p=0.001). More than half of second-generation patients (52.8%) and third-generation patients (55.6%) have comorbidities and is predominantly hypertensive (22.8% of second-generation vs. 27.8% of third-generation infections). The main exposure of second- and third-generation patients in Xian is family exposure (35.2%). For evaluation of CT findings of pulmonary involvement, the total CT score were 4.22{+/-}3.00 in first-generation group, 4.35{+/-}3.03 in second-generation group and 7.62{+/-}3.56 in third-generation group (p<0.001). In all of three generations, the predominant pattern of abnormality observed was organizing pneumonia (65.5% in first-generation group, 61.5% in second-generation group and 71.4% in third-generation group). The average courses of the disease in third-generation infections has obviously extension (22.93{+/-}7.22 days of first-generation, 21.53{+/-}8.31 days of second-generation vs. 31.00{+/-}8.12 days of third-generation group, p=0.004). There were no significant differences of the pulmonary sequelae among three generation patients. CONCLUSIONThere is more serious pulmonary infection of COVID-19 pneumonia in second- and third-generation patients, which might be attribute to the elder age and comorbidity of these patients.
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Objective To study the MR features and differential diagnosis of oligodendroglioma.Methods Clinical and MR data of 34 pathology-diagnosed oligodendroglioma cases were analyzed retrospectively, which included tumor location,signal,size,enhanced and MRS features.Results 22 cases were diagnosed as WHOⅡoligodendroglioma and 12 cases WHOⅢ anaplastic oligodendroglioma.22 tumors located in the frontal lobes,4 tumors in the temporal lobes, 7 tumors in both frontal and temporal lobes,1 tumor located at the optic chiasma.25 tumors located in the superficial areas of the brain.For anaplastic oligodendrogliomas,tumor necrosis and cystic degenerations were showed in 11 cases,and hemorrhage or calcification in 6 cases.For oligodendroglioma,tumor necrosis and cystic degenerations were showed in 6 cases,hemorrhage in 2 cases,calcification in 8 cases.The average tumor diameter was 35 mm for oligodendroglioma and 58 mm for anaplastic oligodendroglioma.For anaplastic oligodendroglioma,obvious irregular or ring enhancements were showed in 11 cases.For oligodendroglioma, mild enhancement was showed in 6 cases,no enhancement in 6 cases and mild or moderate irregular ring-type enhancements in 4 cases.MRS was performed in 6 anaplastic oligodendrogliomas the Cho/Cr ratio was over 4 in 5 cases.MRS was performed in 12 oligodendrogliomas the Cho/Cr ratio was between 2.3 to 3.3 in 10 cases and below 2 in 2 cases.Conclusion The main MR feature of anaplastic oligodendroglioma is that tumor is located in the frontal lobe and superficial area of the brainwith irregular or ring-type enhancement,and the Cho/Cr ratio over 4.
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Objective To investigate the clinical and MR features of fungal encephalopyosis and fungal granuloma.Methods The clinical and MR data of 10 cases with fungal encephalopyosis and fungal granuloma confirmed by surgical pathology or clinical serum were analyzed retrospectively.Then we analyzed the clinical conditions,MR signals,lesion enhancement,DWI and MRS performance characteristics of the 10 cases.Results Six cases were fungal encephalopyosis,among which 2 cases occurred in the sella turcica after surgery which located in and above the sella turcica.2 cases occurred in the frontal lobe after frontal surgery and 1 case of them was multiple encephalopyosis.2 cases of encephalopyosis without operation history were located in the left frontal lobe and right cerebellum respectively.The abscess walls of these cases were thin and showed high tension.Furthermore,it had annular significant signal enhancement and high signal in DWI scan.One case of huge fungal granuloma located in the frontal lobe and into the sinuses which showed uneven signal enhancement. The Cho level was significantly increased.Three cases of cryptococcal granuloma showed multiple lesions located in the bilateral basal ganglia region and 2 out of them accompanied with cephalomeningitis.Conclusion The MR performance of fungal encephalopyosis was quite similar with bacterial brain abscesses,which makes the differential diagnosis difficult.The brain fungal granuloma MRS may display a significant increase of Cho level which might be related with gliosis.It shows certain characteristics of brain MR performance of cryptococcal granuloma which are multiple lesions,preferential distribution of basal ganglia region and accompanying cephalomeningitis.