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This study aimed to investigate the relationship between white matter hyperintensity (WMH) and cerebral microbleeds (CMBs) using susceptibility-weighted imaging (SWI) with high resolution. Additionally, it sought to analyze the clinical significance of SWI with high resolution and its potential to guide intravenous thrombolysis in stroke patients. In this retrospective analysis, we examined 96 patients with hypertension after acute stroke in our hospital using SWI. Demographic and medical data of these 96 patients were collected. Spearman correlation analysis was performed to investigate the relationship between CMBs and the grading of WMH. A significant positive correlation was observed between CMBs and the grade of WMH (R = 0.593, P < .05). The data also revealed a superior ROC area under the curve for the modified Fazekas grading of WMH, which was 0.814 (P < .05). There is a positive correlation between CMBs and the grading of leukoaraiosis in patients with acute stroke and hypertension. The higher the degree of WMH, the more severe the microvascular lesions, increasing the likelihood of intracranial hemorrhage. SWI can provide valuable guidance for administering intravenous thrombolysis in patients with acute stroke.

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INTRODUCTION: The clinical symptoms of Chlamydia psittaci pneumonia are still poorly understood. This study was designed to summarize the clinical features and outcome of eight C. psittaci pneumonia patients diagnosed by targeted next generation sequencing (tNGS). METHODS: We included eight C. psittaci pneumonia patients admitted to our hospital from January 2021 to July 2022. The tNGS was performed to the samples collected from bronchoalveolar lavage fluid of each patient. Their clinical data were analysed, including baseline features, clinical symptoms, chest radiographic findings and laboratory examinations. RESULTS: The tNGS sequence number for C. psittaci was in a range of 10 to 1722. The radiographic characteristics were mainly featured by patchy consolidation shadows, ground-glass density shadows, air bronchogram and slight pleural effusion. Within 1-3 days after hospitalization, most patients showed increased neutrophil ratio, C-reactive protein and erythrocyte sedimentation rate, and decreased lymphocyte count, total protein, albumin and prealbumin. Some patients showed increased glutamic-pyruvic transaminase, glutamic-oxaloacetic transaminase and lactate dehydrogenase levels. Three critically ill patients showed increased creatine kinase, creatine kinase isoenzyme and high-sensitivity troponin T (hs-TnT) levels. CONCLUSIONS: A poultry or bird contact history, typical flu-like symptoms, patchy consolidation, ground-glass density shadow and air bronchogram may contribute to the diagnosis and treatment of C. psittaci pneumonia. Increase in creatine kinase, creatine kinase isoenzyme and hs-TnT may indicate a severe condition. Moxifloxacin and minocycline were effective in the management of C. psittaci pneumonia.

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OBJECTIVE: We aimed to investigate risk factors related to remnant gallbladder (RGB) stones. METHODS: This retrospective study included 73 patients with RGB, in groups with and without RGB calculi. Univariate analyses were used to identify nine variables associated with RGB calculi: sex, age, body mass index (BMI), time to detection, surgical method, length of RGB, angle of RGB and common hepatic duct (CHD), choledocholithiasis, and remnant cholecystitis. Multivariate logistic regression was performed to assess independent predictors of RGB stones. A receiver operating characteristic (ROC) curve was used to estimate model accuracy and determine cut-off values of independent predictors. RESULTS: We enrolled 73 patients, 33 with and 40 without RGB stones. Univariate analyses showed that age, BMI, time to detection, length of RGB, angle of RGB and CHD were predictors for RGB calculi. Multivariate analyses indicated that time to detection, length of RGB, and angle of RGB and CHD were independent predictors for RGB calculi. The area under the ROC curve of the model was 0.940. Cut-off values of the three indicators were 1.5 years, 2.25 cm, and 22.5°, respectively. CONCLUSION: Time to detection, length of RGB, and angle of RGB and CHD were independent predictors of RGB calculi.

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BACKGROUND Chest CT has an essential role in the detection and evaluation of novel coronary pneumonia (COVID-19) and has be regarded as a critical supplement for RT-PCR. This study explored the dynamic CT manifestations of COVID-19 at different times and the value of some laboratory indicators for clinical guidance. MATERIAL AND METHODS This retrospective review included 44 patients who were infected with COVID-19. The dynamic chest CT and laboratory findings were obtained from electronic medical records. The intervals between onset and CT scans and the dynamic changes of the lesions were recorded. The above data were reviewed, sorted, and analyzed by using SPSS 21.0 software. RESULTS From the time of onset, the dynamic image of the lungs became more complete. Fibrous cord shadow absorption in the lungs were observed. Experimental indicators, biochemical indicators of lymphocytes, and protein series were decreased to varying degrees, while erythrocyte sedimentation, fibrinogen, and D-dimer were increased to varying degrees. CONCLUSIONS The dynamic changes of CT images of lungs of COVID-19 patients, combined with the clinical manifestations and laboratory indicators of patients, can help guide clinical diagnosis and treatment.

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The present study aimed to investigate the correlation between the parameters of non-contrast helical computed tomography (NCHCT) and the total energy of holmium laser lithotripsy, and establish a correlative mathematical model. From March 2016 to February 2017, 120 patients with a single urinary calculus were examined by NCHCT prior to holmium laser lithotripsy. The calculus location was confirmed, the CT value was measured and the volume of the calculus in the established three-dimensional reconstruction model was calculated. The total energy of lithotripsy (TEL) was recorded post-operatively. A significant difference in the TEL between renal calculi and ureteral calculi was identified (P<0.001) and a high and significant correlation between the volume of the calculus and the TEL was determined (Spearman r=0.827, P<0.001). A moderate correlation was identified between the CT value of the calculus and the TEL (Spearman r=0.468, P<0.001). Multivariate linear regression analysis revealed that the location, the volume and the CT value of the calculus were independently associated with the TEL (F=288.858, adjusted R2=0.879, P<0.01). A mathematical model correlating the parameters of NCHCT with the TEL was established, which may provide a foundation to guide the use of energy in holmium laser lithotripsy, and it was possible to estimate the TEL by the location, the volume and the CT value of the calculus.

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RATIONALE AND OBJECTIVES: The aims of this study were to assess the prevalence of noncalcified coronary plaques in asymptomatic patients and to investigate the risk factors. MATERIALS AND METHODS: In this study, 584 patients were recruited prospectively. Patients were classified as having low, intermediate, or high pretest likelihoods of coronary artery disease according to the Morise score. Coronary computed tomographic angiography was performed in all patients using a 320-detector row dynamic-volume computed tomographic scanner. Imaging reconstruction was performed, and the postprocessed data were analyzed. Logistic regression analysis was used to evaluate the relationship between risk factors and the presence of noncalcified plaque. RESULTS: Coronary computed tomographic angiography revealed noncalcified plaques in 38.3% of all patients (224 of 584). The prevalence of noncalcified plaques was significantly higher in patients with calcium scores > 0 (P < .001). Significant differences were found between the degrees of luminal stenosis among patients with low, intermediate, and high pretest likelihoods of coronary artery disease (P = .001), while the prevalence of noncalcified plaques did not differ with the Morise score (P = .08). Noncalcified plaque was associated with hypercholesterolemia (P = .02) and diabetes mellitus (P = .002). Age (P = .47), gender (P = .58), estrogen status (P = .55), smoking (P = .22), hypertension (P = .27), and family history (P = .09) did not differ between patients with and those without noncalcified plaques. CONCLUSIONS: Hypercholesterolemia and diabetes mellitus are high risk factors for the prevalence of noncalcified plaques for asymptomatic patients.

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RATIONALE AND OBJECTIVE: To evaluate the feasibility of transthoracic Doppler echocardiography to determine the optimal pulsing windows for CT coronary angiography to narrow the pulsing windows further, especially in higher heart rate. MATERIALS AND METHODS: Doppler was performed on 135 patients before CT scanning. For Doppler, the intervals with minimal motion were evaluated during both systole and diastole integrating electrocardiogram (ECG) intervals. For CT scanning, the retrospective ECG-gating was applied and the optimal reconstruction intervals were determined. The accuracy of Doppler analysis to predict the optimal reconstruction intervals was tested. The predicted length of pulsing windows was compared between Doppler analysis and traditional prospective ECG-gating protocol (heart rate≦65 bpm, 60-76%; 66-79 bpm, 30-77%; ≧80 bpm, 31-47%). RESULTS: According to Doppler analysis, the mean length of intervals with minimal motion in systole was 106.4±39.2 ms and 125.2±92.0 ms in diastole. When the intervals with minimal motion during diastole>90 ms, the optimal reconstruction intervals were located at diastole; otherwise, at systole (P<0.001). The optimal reconstruction intervals in 93.8% (132/135) patients could be predicted accurately by Doppler analysis. If the optimal reconstruction intervals predicted by Doppler were applied as the exposure windows, the mean length of pulsing windows should has been 105.2±69.4 ms (range: 26.9-510.3 ms), which was significantly shorter than that of traditional prospective ECG-gating protocol (232.0±120.2 ms, range: 93.2-427.3 ms, P<0.001). CONCLUSION: Doppler can help detecting the optimal pulsing windows accurately. Prospective ECG-gating incorporating Doppler analysis may narrow pulsing windows significantly while maintaining image quality.

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