Biomedical subjects

Cheng Hong

Publications and source records attributed to Cheng Hong.

At least 19 recordsLinked to original sources

PubMed2007

Comparison of standard- and low-radiation-dose CT for quantification of emphysema.

OBJECTIVE: This study was performed to compare standard- and low-radiation-dose techniques in the CT quantification of emphysema. MATERIALS AND METHODS: The study population consisted of 36 men and 20 women who were current or former heavy smokers and underwent standard-dose (effective tube current, 100-250 mAs) chest CT at our institution within 6 months of having undergone low-dose (effective tube current, 30-60 mAs) chest CT. All CT scans were reconstructed at 5-mm slice thickness with a smooth filter. CT-measured lung volume, mean and median lung attenuation, and percentage of lung volume with attenuation lower than multiple thresholds (emphysema index values) were compared by Pearson correlation, two-tailed and paired Student's t tests, and regression analysis. RESULTS: There were no significant differences in mean attenuation (-848 vs -846 H, p > 0.35) for the low dose and the standard dose or in median lung attenuation (-879 vs -878 H, p > 0.66). Low- and standard-dose emphysema indexes were correlated at all attenuation thresholds (r = 0.86-0.97). Mean emphysema indexes were higher on the low-dose scans, but the mean difference at all thresholds was less than 3%. The differences were significant (p < 0.05) only at the lower index thresholds, correlated with differences in lung volume (r < or = 0.86), and increased with greater differences in dose. CONCLUSION: Low-dose technique has minimal effect on CT quantification of emphysema.

Aged↗

PubMed2005

Coronary artery calcification and risk factors for atherosclerosis in patients with venous thromboembolism.

BACKGROUND: Venous thromboembolism (VTE) and atherosclerosis may be associated and may share common risk factors. We conducted a retrospective case-control study to investigate the association between VTE and coronary atherosclerotic disease (CAD) by means of measuring coronary artery calcification and evaluating clinical risk factors. METHODS: From 385 consecutive patients suspected of VTE, we randomly selected 89 cases with idiopathic VTE and 89 controls without VTE, frequency matched on gender and age. Risk factors for atherosclerosis were noted for both groups. Coronary artery calcification was quantified on pulmonary computed tomography (CT) angiographic images. The coronary artery calcification and risk factors were compared between the case and control groups. The associations between VTE and the presence of coronary artery calcium and risk factors were assessed with logistic regression analysis. RESULTS: A higher prevalence of coronary artery calcium was found in the case group (51.7%) than in the control group (28.1%) (p=0.001). The presence of coronary artery calcium was significantly associated with VTE with an odds ratio of 4.3 (95% confidence interval, 1.9-10.1) in a multivariable model. Diabetes mellitus and hypertension were also significantly associated with VTE. CONCLUSION: A significant association between VTE and CAD suggests that CAD is an independent risk factor for VTE. Diabetes and hypertension are also independent risk factors for VTE.

Adult↗

PubMed2005

Feasibility of combining MR perfusion, angiography, and 3He ventilation imaging for evaluation of lung function in a porcine model.

RATIONALE AND OBJECTIVE: To assess the feasibility of combining magnetic resonance (MR) perfusion, angiography, and 3He ventilation imaging for the evaluation of lung function in a porcine model. MATERIALS AND METHODS: Fourteen consecutive porcine models with externally delivered pulmonary emboli and/or airway occlusions were examined with MR perfusion, angiography, and 3He ventilation imaging. Ultrafast gradient-echo sequences were used for 3D perfusion and angiographic imaging, in conjunction with the use of contrast-agent injections. 2D multiple-section 3He imaging was performed subsequently via the inhalation of hyperpolarized 3He gas. The diagnostic accuracy of MR angiography for detecting pulmonary emboli was determined by two reviewers. The diagnostic confidence for different combinations of MR techniques was rated on the basis of a 5-point grading scale (5 = definite). RESULTS: The sensitivity, specificity, and accuracy of MR angiography for detecting pulmonary emboli were approximately 85.7%, 90.5%, and 88.1%, respectively. The interobserver agreement was very strong (k = 0.82). There was a clear tendency for confidence to increase when first perfusion and then ventilation imaging were added to the angiographic image (Wilcoxon signed ranks test, P = 0.03). CONCLUSION: The combination of the three methods of MR perfusion, angiography, and 3H ventilation imaging may provide complementary information on abnormal lung anatomy and function.

Administration, Inhalation↗

PubMed2005

[Evaluation of quality of life of hypertensive patients].

OBJECTIVE: To evaluate the quality of life (QOL) of patients with hypertension. METHODS: Totally 319 patients with hypertension were investigated for their QOL in comparison with 319 healthy controls using the World Health Organization Quality of Life assessment instrument (WHOQOL-100). RESULTS: The scores of physical functions, psychological condition, independent ability, social relation, living environment, and personal faith and the total score of QOL-100 were significantly lower in the hypertensive patients than in the normal subjects (P<0.01). After adjusting the confounding factors of other diseases, the scores of all the items with the exception of personal faith and the total score of QOL-100 were all lower in the patients than in the controls (P<0.01). Hostelling T2 test and multivariate analysis of variance showed significant differences in the QOL between the hypertensive patients and the controls in the 6 domains synthesized (P<0.01), further demonstrating lowered QOL of hypertensive patients in comparison with the healthy population. CONCLUSION: Improvement of the hypertensive patients' QOL in addition to effective blood pressure control is a basic target in clinical therapy of hypertension.

Adult↗

PubMed2004

Coronary artery calcification: effect of size of field of view on multi-detector row CT measurements.

The effect of the size of the field of view (FOV) on coronary artery calcium measurements at multi-detector row computed tomography (CT) was assessed. Coronary multi-detector row CT was performed with an identical protocol in 100 consecutive subjects. CT images were reconstructed at different FOV sizes (210, 260, and 310 mm). Calcified coronary lesions were detected in all three image sets in 52 subjects. The FOV sizes tested for multi-detector row CT coronary screening had a negligible effect on coronary artery calcium measurements (P >/=.06). However, risk stratification decreased by one level in seven of 52 subjects when the FOV increased from 210 or 260 to 310 mm.

Adult↗

PubMed2004

Coronary artery stent patency assessed with in-stent contrast enhancement measured at multi-detector row CT angiography: initial experience.

The authors investigated the contrast enhancement characteristics of the coronary artery stent lumen to assess patency and then evaluated the accuracy of computed tomographic (CT) measurement of the in-stent luminal diameter. Nineteen patients (16 men and three women; mean age, 58.7 years) with 26 stents underwent cardiac-gated CT angiography with a 16-detector row scanner 1-3 weeks after stent placement. CT images depicted the lumina of 20 stents in 14 patients. CT attenuation measured in the treated lumen was higher than, and correlated highly (r >/= 0.87) with, attenuation in the proximal and distal untreated lumen. Estimated values for in-stent luminal diameter were lower with CT than with conventional angiography (P <.001), and the mean error (16.1%) that resulted from estimation based on sharp-kernel CT images was significantly smaller than that (27.3%) from estimation based on medium-smooth-kernel CT images (P <.001). Visualization of the in-stent lumen at CT angiography with a 16-detector row scanner allows assessment of coronary artery stent patency on the basis of measured contrast enhancement.

Adult↗

PubMed2004

Multi-detector row computed tomographic angiography in pediatric heart transplant recipients: Initial observations.

BACKGROUND: The purpose of this study was to assess the feasibility and limitation of multi-detector row computed tomographic (MDCT) imaging for evaluating coronary arteries in pediatric heart transplant patients. METHODS: Coronary MDCT angiography was performed in eight pediatric heart transplant recipients. The presence of coronary calcification was evaluated. Luminal changes of the visualized coronary segments on MDCT images were compared with catheter angiographic findings and intravascular ultrasound. RESULTS: Coronary calcification was present in one patient who had severe coronary arteriopathy documented by intravascular ultrasound. In 48 coronary segments visualized on MDCT images, 33, 7, and 4 segments each had normal, luminal irregularities, and moderate stenoses, respectively, which were confirmed by catheter angiography. Twelve coronary segments could not be assessed because of severe motion artifacts. Image quality degradation was more pronounced in patients with higher heart rates. CONCLUSIONS: Noninvasive MDCT angiography is promising but requires further technical improvement to evaluate coronary arteries in pediatric heart transplant patients.

Adolescent↗

PubMed2004

Radiation dose in multidetector row computed tomography cardiac imaging.

Multidetector row computed tomography (MDCT) with its markedly improved temporal and spatial resolution has opened up a new opportunity in cardiac CT imaging. MDCT scanners are increasingly available and have become the preferred CT scanners for the entire spectrum of clinical CT examinations. As a consequence, the number of cardiac CT studies is continuously growing. Because cardiac CT studies involve considerable radiation doses, it is compelling for us to understand the radiation dose estimates associated with cardiac CT imaging. In this article, we review the concepts of radiation dose measurement in CT, discuss MDCT scan parameters affecting radiation exposure, and provide a reference summary of radiation dose estimates associated with MDCT cardiac imaging.

Heart↗

PubMed2004

Gadolinium-enhanced computed tomography angiography in multi-detector row computed tomography: initial observations.

RATIONALE AND OBJECTIVES: The feasibility of using gadolinium contrast medium for computed tomography angiography (CTA) in multi-detector row computed tomography and the effect of contrast medium dilution was investigated. MATERIALS AND METHODS: Three pigs were each scanned in multiple sessions with injections of non-dilute and dilute contrast medium at a dose of 0.3 mmol/kg body weight. Non-spiral dynamic scanning at a fixed mid-abdominal aortic level and thoracoabdominal CTA were performed. RESULTS: The magnitude of peak aortic enhancement was not significantly different between dilute and non-dilute contrast medium injections (P = .88), but the former showed earlier enhancement (mean of 2.3 seconds sooner, P < .01) than the latter. CT angiography with gadolinium contrast medium showed much lower enhancement than iodine contrast medium, but small vessels were readily identifiable. CONCLUSION: Gadolinium contrast medium combined with multi-detector row computed tomography may provide clinically useful CTA. Dilution of contrast medium shortens the enhancement time but has little effect on the magnitude.

Angiography↗

PubMed2004

Is coronary artery calcium mass related to Agatston score?

RATIONALE AND OBJECTIVES: The objective of this study was to investigate the relationship between the coronary calcium mass and Agatston score measured on multidetector row computed tomography. MATERIALS AND METHODS: Eighty-three consecutive subjects (60 men and 23 women) referred for coronary screening were examined prospectively by electrocardiogram-triggered sequential multidetector row computed tomography scan (4 x 2.5-mm collimation). Their coronary calcium was quantitated by means of the Agatston scoring and mass method. The values of score and mass were transformed by taking the natural logarithm (ln(value + 1)) to reduce skewness. The relationship between the mass and score was analyzed with multiple regression analysis. RESULTS: Fifty-one subjects had a total of 328 calcified lesions detected and measured. The relationship between the calcium mass and score in 51 subjects conformed well to a linear relationship (r2 = 0.96). When analyzed in the total of 328 lesions, the relationship had a good empiric fit with a nonlinear (quadratic) model (r2 = 0.96). The best-fit equation was ln(lesion mass + 1) = -0.87 + 0.67 x ln(lesion score + 1) + 0.10 x (ln(lesion score + 1) - 2.86)2. This relationship was consistent in different coronary vessels and at different heart levels (r2 = 0.96 - 0.99), although there was a higher image noise at lower heart levels (paired t-tests, P < .0001). CONCLUSION: A nonlinear (quadratic) relationship existed strongly and consistently between coronary calcium mass and score, demonstrating a possible cross-sectional conversion between the two measurements.

Aged↗

PubMed2003

Coronary artery calcium: accuracy and reproducibility of measurements with multi-detector row CT--assessment of effects of different thresholds and quantification methods.

PURPOSE: To evaluate the effects of different thresholds and quantification methods on the accuracy and reproducibility of coronary calcium measurements with multi-detector row computed tomography (CT). MATERIALS AND METHODS: A cardiac CT phantom containing predetermined calcified cylinders was scanned. Calcium volume and mass were measured at various threshold values ranging from 80 to 230 HU. In 32 patients, two consecutive CT scans were obtained, and the coronary artery calcium score, volume, and mass were measured by one observer at 130- and 90-HU thresholds. Correlation analysis and analysis of variance were performed to evaluate the measurement errors in the phantom study and the interscan variability in the clinical study. RESULTS: In the phantom, mass measurement error varied with threshold and calcium density (P <.01). Mass error was strongly correlated with volume error (r = 0.91, P <.01) but with a much smaller range. In the clinical study, interscan variability of mass measurements was significantly lower than that with other measurement methods for both patients and individual vessels. For the patients, the mean interscan variability of calcium score, volume, and mass at the 130-HU threshold was 20.4%, 13.9%, and 9.3%, respectively. For all methods, interscan variability was not significantly different between the 130- and 90-HU thresholds (P >.05). CONCLUSION: The mass measurement is more accurate, less variable, and more reproducible in coronary calcium quantification than are measurements with other algorithms. Accurate quantification of calcium in each calcified plaque may require that the threshold be set individually, depending on the calcium density.

Algorithms↗

PubMed2003

Improving mass measurement of coronary artery calcification using threshold correction and thin collimation in multi-detector row computed tomography: in vitro experiment.

RATIONALE AND OBJECTIVES: This in vitro study was designed to improve the accuracy of coronary calcium mass measurement from computed tomography (CT) images by developing threshold-based calcium CT number correction and thin-slice spiral techniques. MATERIALS AND METHODS: A cardiac CT phantom containing simulated calcified cylinders of known calcium density was scanned with sequential 4 x 2.5-, spiral 16 x 1.5-, and spiral 16 x 0.75-mm collimation on 4- and 16-detector row CT scanners. The images obtained from the spiral scans were reconstructed in various slice widths. The calcified cylinders were imaged and their mean CT number and size were measured at thresholds ranging from 50 to 390 Hounsfield unit. The calcium mass measured was compared with the actual value to determine errors, and threshold-based correction factors were derived to minimize the errors. RESULTS: The minimum amount of measurable calcium in 1-mm cylinder was 0.3 mg at the 16 X 1.5-mm protocol and 0.2 mg at the 16 x 0.75-mm protocol. Compared with 2.5-mm sequential protocol, thin-slice spiral protocols yielded a higher radiation exposure and lower or similar image noise levels. The error in calcium mass after correction was significantly smaller than that in measured mass (P < .0001) and was consistent between the imaging protocols (P = .49). The accuracy of mass measurements was clearly improved by using thin-slice imaging protocols especially in 200-mg/cm3 calcium density (P < .0001). CONCLUSION: The accuracy of calcium mass CT measurement can be improved by threshold-based calcium CT number correction and thin collimation spiral techniques.

Calcinosis↗

PubMed2003

CO2-enhanced CT imaging for the detection of pulmonary emboli: feasibility study in a porcine model.

RATIONALE AND OBJECTIVES: The authors investigated the feasibility of using computed tomography (CT) with CO2 gas as a negative contrast agent for detecting pulmonary emboli in a porcine model. MATERIALS AND METHODS: Seven pigs with or without pulmonary emboli underwent thoracic imaging with multi-detector row spiral CT. To identify optimal injection and scanning protocols, the first four pigs were scanned repeatedly in the supine and prone positions with different scan delays (10, 15, and 20 seconds) and different volumes of CO2 (60, 120, 180, and 240 mL), which were hand infused (each infusion took 10-15 seconds). The last five pigs with emboli were scanned with iodinated contrast medium and then rescanned with 120 or 180 mL of CO2. The CO2 volumes and scan delays were qualitatively assessed. The supine and prone CT scans and the number and location of thrombi depicted in the CO2- and contrast material-enhanced CT scans were compared. RESULTS: Because the pulmonary artery in pigs is in the posterior anatomy, the prone position was more effective than the supine position with CO2 enhancement. An infusion of 120 mL of CO2 was sufficient to enhance the entire pulmonary artery, and scanning timed to coincide with the completion of infusion was the most effective. Both the CO2- and contrast-enhanced CT scans demonstrated all thrombi. Thrombi were more apparent on the CO2-enhanced CT scans than on the contrast-enhanced scans because of the high contrast interface between soft tissue and gas. However, two of the seven pigs with thrombi experienced abrupt cardiac arrest after CO2-enhanced scanning and could not be resuscitated. The cause of these events was not determined in the current study. CONCLUSION: The CT depiction of pulmonary emboli is feasible with CO2 gas as a negative contrast agent and may even be superior to that with iodinated contrast media. Further studies are required to evaluate the safety of this method and to develop an improved delivery of CO2 gas for this application.

Animals↗

PubMed2003

Optimal contrast application for cardiac 4-detector-row computed tomography.

RATIONALE AND OBJECTIVES: This study was designed to determine the optimal contrast protocol for 4-detector-row computed tomography angiography of the heart. METHODS: Sixty patients were randomly assigned to 1 of 4 groups with 300 and 400 mg/mL iodine concentrations and 2.5 and 3.5 mL/s flow rates. Contrast density was measured in the left ventricular cavity and coronary arteries. RESULTS: Low iodine concentration injected at slow flow rate (0.75 g iodine/s) resulted in acceptable contrast enhancement in only 53.8% of the patients. There was no significant difference between low contrast concentration injected at high flow rate and high contrast concentration injected at slow flow rate ( approximately 1 g iodine/s). High contrast concentration administered with high flow rates (1.4 g iodine/s) may result in an enhancement above 350 Hounsfield units (HU) and interfere with coronary calcifications. CONCLUSIONS: The injection of approximately 1 g iodine/s resulted in an optimal (250-300 HU) contrast enhancement for cardiac 4-detector-row computed tomography.

Adult↗

PubMed2003

Coronary artery calcium quantification at multi-detector row CT: influence of heart rate and measurement methods on interacquisition variability initial experience.

PURPOSE: To assess the effect of heart rate on interacquisition variability in different coronary calcium quantification methods at multi-detector row computed tomography (CT). MATERIALS AND METHODS: Fifty consecutive adults (39 men and 11 women; mean age, 57 years +/- 13 [SD]) with various heart rates were examined with two prospectively electrocardiographically triggered multi-detector row CT acquisitions in succession for detection and quantification of coronary artery calcification. Calcium score, volume, and mass were measured for each acquisition. Interacquisition variability was evaluated in association with heart rate and quantification method in subjects and individual coronary vessels by using t tests and analysis of variance. RESULTS: In 37 subjects with detected calcium, interacquisition variability in mass measurement (10.4%) was significantly lower than that in score (23.9%) and volume (15.7%) measurements (P <.02). The interacquisition variability in all quantification methods was well correlated with heart rate and was considerably greater when heart rates were higher than 70 beats per minute (bpm) than when heart rates were 70 bpm or lower (P <.002). There was a clear tendency for interacquisition variability to vary by vessel (P <.01). The correlation of interacquisition variability with heart rate and a significant difference in interacquisition variability between the group with heart rates of 70 bpm or lower and the group with rates higher than 70 bpm (P <.02) were found for the left main and left anterior descending arteries but not for the circumflex and right coronary arteries. CONCLUSION: Interacquisition variability in coronary calcium measurements at multi-detector row CT is significantly less at lower heart rates. The coronary calcium mass measurement is more reproducible than are score and volume measurements.

Adult↗

PubMed2002

Association between high initial tissue levels of cyclin d1 and recurrence of nasopharyngeal carcinoma.

OBJECTIVES/HYPOTHESIS: Cyclin D1 expression and the rate of apoptosis have been reported to serve as important prognostic indicators in human cancers. The purpose of the present study was to determine the prognostic significance of both initial cyclin D1 expression and the apoptotic index in nasopharyngeal carcinoma. STUDY DESIGN: Cohort study. METHODS: Cyclin D1 protein levels and apoptosis in tumors and their corresponding adjacent, histologically normal tissues were determined at the time of initial diagnosis using immunohistochemical staining, Western blot analysis, and in situ end labeling, respectively, in 64 patients with T1-T4/N0-N2, poorly differentiated squamous cell carcinoma of the nasopharynx. All cases were treated by routine radiation therapy with a total median dose of 70 Gy and followed up for 10 years. RESULTS: High levels of cyclin D1 were found in 35 of 64 tumor specimens (54.7%); no cyclin D1--positive cells were determinable in normal epithelium of the nasopharynx. Rates of early local recurrence (within 5 y) were significantly higher (P <.01) for patients with high levels of cyclin D1 before radiation therapy (24 of 35 patients [68.6%]) as compared with patients with low or no expression (3 of 29 [10.3%]). Furthermore, patients bearing high levels of cyclin D1 had a poorer prognosis concerning 10-year survival than the others (P <.001), whereas overexpression of cyclin D1 did not correlate with the initial TMN classification (P >.05). According to the rate of spontaneous apoptosis in tumors below or above the median, patients were divided into two groups. There was no statistically significant difference for the overall survival between the two groups (P >.05). CONCLUSIONS: The present study demonstrates that cyclin D1 can be used as an indicator of recurrence and subsequent prognosis in nasopharyngeal carcinoma after radiation therapy. At the same time, the apoptotic state before radiation therapy is of no value in predicting the prognosis of patients with nasopharyngeal carcinoma.

Adult↗

PubMed2002

Subsegmental pulmonary emboli: improved detection with thin-collimation multi-detector row spiral CT.

PURPOSE: To compare different reconstruction thicknesses of thin-collimation multi-detector row spiral computed tomographic (CT) data sets of the chest for the detection of subsegmental pulmonary emboli. MATERIALS AND METHODS: A multi-detector row spiral CT protocol for the diagnosis of pulmonary embolism was used that consisted of scanning the entire chest with 1-mm collimation within one breath hold. In 17 patients with central pulmonary embolism, the raw data were used to perform reconstructions with 1-mm, 2-mm, and 3-mm section thicknesses. For each set of images, each subsegmental artery was independently graded by three radiologists as open, containing emboli, or indeterminate. RESULTS: For the rate of detection of emboli in subsegmental pulmonary arteries, use of the 1-mm section width yielded an average increase of 40% when compared with the use of 3-mm-thick sections (P <.001) and of 14% when compared with the use of 2-mm-thick sections (P =.001). With the use of 1-mm sections versus 3-mm sections, the number of indeterminate cases decreased by 70% (P =.001). Interrater agreement was substantially better with the use of 1-mm and 2-mm sections than with the use of 3-mm sections. CONCLUSION: For the diagnosis of subsegmental pulmonary emboli at multi-detector row CT, the use of 1-mm section widths results in substantially higher detection rates and greater agreement between different readers than the use of thicker sections.

Adult↗

PubMed2002

Coronary artery calcium: absolute quantification in nonenhanced and contrast-enhanced multi-detector row CT studies.

PURPOSE: (a) To determine the accuracy of multi-detector row computed tomography (CT) in the measurement of the calcium concentration in a cardiac CT calibration phantom and (b) to assess the correlation of a traditional 3-mm section width CT coronary screening protocol and a 1.25-mm section width CT angiography imaging protocol in the quantification of the absolute mass of coronary calcium in patients who underwent both coronary screening and CT angiography with a multi-detector row CT scanner. MATERIALS AND METHODS: A heart phantom containing calcified cylinders was scanned to determine calibration factors and absolute calcium mass. In 50 patients, the variability (value 1 - value 2/mean value 1 - value 2), limit of agreement (+/-2SD value 1 - value 2), and systematic error (mean value 1 - value 2) of the total amount of coronary calcium calculated at traditional 3-mm section width CT and at 1.25-mm section width CT angiography were determined. RESULTS: The correlation coefficient between the 3-mm section width, nonenhanced protocol and the 1.25-mm section width CT angiography protocol was very high (r = 0.977) and the mean variability was low (19.7%) for the absolute mass. There was a systematic error of -6.7 mg and a limit of agreement between 45.0 mg and -58.5 mg. CONCLUSION: Use of the mass quantification algorithm in combination with a calibration phantom allows accurate quantification of coronary calcium. Measurements of calcium mass obtained at 1.25-mm section width CT angiography have the best agreement with those obtained at the traditional 3-mm section width imaging protocol.

Algorithms↗