Biomedical subjects
Publications and source records attributed to Zheng-yu Jin.
Multi-slice spiral CT has enabled the real volume data acquisition and opened a brand-new window for non-invasive imaging diagnosis. Its tremendous advantages have gradually been demonstrated in clinical application.
OBJECTIVE: To study the clinical value of multi-slice spiral CT (MSCT) perfusion technique in evaluation of cerebral hemodynamics in patients with severe carotid stenooclusive lesions. METHODS: Twenty-three patients with severe carotid stenosis were enrolled for evaluation of cerebral hemodynamics, including 12 patients with carotid occlusion and 11 with severe carotid stenosis (> 70%). Among them, 16 patients had multiple arterial diseases, including contralateral carotid stenosis, vertebral arteries stenosis, and cerebral arteries stenosis or occlusion. All patients received CT perfusion examination. Ten normal persons received CT perfusion were regarded as the control group. RESULTS: Cerebral perfusion was bilaterally symmetrical in 10 normal persons. While in the patients group, cerebral hemodynamic impairments ipsilateral to the stenosis side were found by CT perfusion in 17 patients, including an delay of time to peak (TTP) (17 patients), increase of cerebral blood volume (CBV) (7 patients), and decrease of cerebral blood flow (CBF) (4 patients). No significant difference was found between occlusion group (n = 8) and stenosis group (n = 9) (P = 0.640), but incidences of hemodynamic impairment were significantly higher in multiple arterial diseases group (n = 14) than single arterial disease group (n = 3) (P = 0.045). CONCLUSION: CT perfusion technique can sensitively reveal the cerebral hemodynamic impairments in patients with severe carotid stenooclusive diseases, and therefore valuable for clinical application.
OBJECTIVE: To explore changes in the carotid arteries in Tarkayasu arteritis (TA) with computed tomographic angiography (CTA). METHODS: The common carotid artery intima-medial thickness (CCA-IMT) in 20 common carotid arteries (CCAs) in 10 controls and 40 CCAs in 20 patients with TA were analyzed and compared. RESULTS: Contrast-enhanced CT scanning combined with the application of 3D reconstruction clearly showed the carotid vascular luminal abnormalities, such as stenosis, occlusion, dilation, and aneurysm formation. CCA-IMT increased in all the patients with TA affecting carotid arteries. CCA-IMT was significantly larger in the patients than in controls [(0.36 +/- 0.13) cm vs. (0.03 +/- 0.02) cm, P < 0.05] , and was significantly larger in patients with active diseases than in those without active diseases [(0.44 +/- 0.09) cm vs. (0.24 +/- 0.10) cm, P < 0.05]. CONCLUSION: CCA-IMT increases in TA affecting carotid arteries, especially in active diseases.
OBJECTIVE: To compare the coronary artery bypass graft (CABG) imaging between 16-slice spiral CT and 64-slice spiral CT. METHODS: Totally 27 patients with CABG received multi-slice spiral CT imaging and the results were retrospectively analyzed. Among them, 8 patients received 16-slice spiral CT scanning, 19 patients received 64-slice spiral CT scanning. RESULTS: The evaluability rates of 64-slice spiral CT in evaluating the proximal anastomosis, bypass graft, distal anastomosis, and distal blood vessel were 100%, 100%, 90.2%, and 93.9%, respectively, while those of 16-slice spiral CT were 92.3%, 95.2%, 90.0%, and 90.0%, respectively. The patency rates of the above four aspects of 64-slice spiral CT were 66.7%, 70.0%, 71.7%, and 70.0%, respectively, while those of 16-slice spiral CT were 83.3%, 85.0%, 83.3%, and 88.9% . CONCLUSIONS: 64-slice spiral CT is superior to 16-slice spiral CT in CABG imaging. It can be used as a non-invasive tool for the post-operative follow-up of CABG.
OBJECTIVE: To compare the image quality and visibility of arteries of 64-slice spiral coronary CT angiography (CTA) with those of 16-slice spiral coronary CTA, and to evaluate the diagnostic accuracy of 64-slice spiral CT for the assessment of coronary artery stenosis. METHODS: Totally 100 patients (Group A) with suspected coronary artery diseases (CAD) were examined by 64-slice spiral CT, 48 of whom also underwent conventional coronary angiography (CAG). Another 100 patients (Group B) with suspected CAD were studied by 16-slice spiral CT. Patients with a heart rate above 70 bpm received oral beta-blockers before the scan. Data were retrospectively analyzed and reviewed by two observers. Image quality was assessed by using a 3-point grading scale from excellent (1) to non-assessable (3) and the rate of displayed coronary branches was calculated. The left main artery (LM), left anterior descending artery (LAD), circumflex artery (CX), and right coronary artery (RCA) were screened for the presence of over 50% stenosis. RESULTS: The mean heart rates of two groups showed no significant difference [(61 +/- 8) bpm vs. (61 +/- 7) bpm, P > 0.05]. The mean scan time of Group A was significantly shorter than that of Group B [(11.9 +/- 0.9) s vs. (22.2 +/- 1.1) s, P < 0.01]. In the evaluation of image quality, better results were obtained in Group A than in Group B (1.20 +/- 0.47 vs. 1.37 +/- 0. 63, P < 0.05). The visibility of proximal arteries was similar between two groups, while the visibility of some distal arteries and small branches was found higher in Group A than in Group B (LAD distal 92% vs. 48%, CX distal 98% vs. 89%, the first obtuse marginal (OMI) 93% vs. 84%, cone branch (CB) 86% vs. 71%, P < 0.05). Compared with CAG, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 64-slice spiral coronary CTA to identify over 50% stenosis were 94.9% (56/59), 93.2% (124/133), 86.2% (56/65), and 97.6% (124/127), respectively. CONCLUSIONS: With higher temporal and spatial resolution, 64-slice spiral CT provides improved image quality and visibility of small branches as compared with 16-slice spiral CT. 64-slice spiral coronary CTA allows reliable non-invasive diagnosis of obvious coronary artery stenosis.
OBJECTIVE: To evaluate the clinical value of assessment of coronary stent patency by 64-slice spiral CT coronary angiography. METHODS: Totally 29 patients (59 stents) were investigated using a retrospective ECG-gated enhanced scan by 64-slice spiral CT at a mean interval of (28.4 +/- 21.2) months after coronary stent implantation. Axial multi-planar reconstruction (MPR) of the stents and curved-planar reconstruction (CPR) through the stents were evaluated for image quality on a 5-point scale (1 = excellent, 5 = uninterpretable) and lumen diameter. Stent lumen diameter was compared with the vessel diameter proximal of the stents to assess the in-stent lumen visibility. Conventional coronary angiography was performed in 5 patients, and 9 stents were evaluated. RESULTS: The image quality was good to excellent on average (scores: 1.94 +/- 0.84), depending on heart rate, breath movement, and stent location. Stent lumen was visible, on average a percentage off (76.1 +/- 11.1)% of the lumen diameter. All the 9 stents were correctly detected as being patent, which was confirmed by conventional coronary angiography. CONCLUSION: 64-slice spiral CT is a useful tool to assess the coronary stent patency.
OBJECTIVE: To investigate the value of multi-slice spiral computed tomography (MSCT) in the determination of global left ventricular function. METHODS: Twenty-nine patients with confirmed or suspected coronary heart diseases were imaged with a contrast-enhanced retrospective electrocardiogram (ECG) -gated technique on a 64-slice spiral CT scanner. The data sets were reconstructed at both end-diastolic and end-systolic phases in order to measure left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular stroke volume (LVSV), and left ventricular ejection fraction (LVEF). The results were compared with corresponding values obtained from conventional left ventriculography (LVG). RESULTS: LVEDV, LVESV, LVSV, and LVEF obtained with 64-slice spiral CT were significantly correlated with the LVG data (r = 0. 887-0.956, P < 0.001). According to the Bland-Altman approach, the mean differences for LVEDV, LVESV, LVSV, and LVEF were -2.3 ml, 4.1 ml, -6.4 ml, and - 3.5%, respectively. The limits of agreement for LVEDV, LVESV, LVSV, and LVEF were -27.2-22.4 ml, -10.2-18.4 ml, -26.4-13.6 ml, and -9.8%-3.0%, respectively. CONCLUSION: MSCT has clinically acceptable agreement with LVG for the quantification of global left ventricular function.
OBJECTIVE: To evaluate the utility of multi-slice spiral CT in the diagnosis of pulmonary hypertension. METHODS: The clinical and multi-slice spiral CT data of 22 patients with pulmonary hypertension were retrospectively analyzed. The diagnoses included chronic thromboembolic pulmonary hypertension (CTEPH) (n = 9), primary pulmonary hypertension (PPH) (n = 7), connective tissue diseases (n = 2), portal-pulmonary hypertension (n = 2), eosinophilia-myalgia syndrome (n = 1), and fibrosing mediastinitis (n = 1). Lung parenchyma, such as ground-glass opacity, mosaic attenuation and septal thickness, mediastinum, pulmonary vascular, right ventricular enlargement and interventricular septum displacement were evaluated on CT. RESULTS: CT pulmonary angiography (CTPA) accurately diagnosed 95% of pulmonary hypertension and the signs of right ventricular dysfunction. Pulmonary embolism was found in 9 patients. The incidence of mosaic attenuation was significantly higher in CTECH than in PPH (P = 0.034). CONCLUSION: CTPA can accurately diagnose pulmonary hypertension and thereby provide useful information for the etiological diagnosis.
OBJECTIVE: To evaluate the difference of the 3D image quality between the low-dose and the standard-dose chest CT. METHODS: Eleven patients were randomly scanned with the standard-dose CT and 9 with the low-dose CT. Quality of the images from both groups was evaluated by different postprocessing techniques. RESULTS: The effective tube current, total tube current, and CT dose index volume were (114.55 +/- 26.20) mAs, (1578.27 +/- 353.09) mAs, and (7.76 +/- 1.77) mGy, respectively, in the standard-dose scanning group, and were 20 mAs, (566.11 +/- 46.23) mAs, and (1.46 +/- 0.07) mGy, respectively, in the low-dose scanning group. All these indicators had significant differences between these two groups (P < 0.001). The image noises were (17.67 +/- 3.24) HU in standard-dose group and (31.61 +/- 9.42) HU in low-dose group (P < 0.001). As shown by different postprocessing techniques, the median score of the standard-dose group and the low-dose group were 4.52 and 4.78, respectively, which was not significantly different (P = 0.92). CONCLUSION: The low-dose CT scanned with 20 mAs effective tube current can remarkably reduce the radiation dose, and provide satisfactory postprocessing images for diagnosis.
OBJECTIVE: To explore the radiological features of cryptogenic organizing pneumonia (COP). METHODS: Five patients with COP were pathologically identified. The chest CT scanning was performed in all patients. The radiological features of COP were classified into four types according to pulmonary consolidation, ground grass opacity (GGO), nodule, and liner or reticular lesion. The distribution of lesions were classified according to the single or double lung fields, upper or lower lung field, or the surrounding bronchovascular bundle or subpleural area. The radiological types and distributions of the lesions were analyzed. RESULTS: Among these 5 patients, pulmonary consolidation was found in 4 patients, ground grass opacity in 3 patients, nodules in 2 patients, and reticulation in one patient. Various radiological features were also observed at the same time. The pulmonary consolidation was distributed along the bronchovascular bundle or subpleural area. The distribution of GGO and pulmonary nodules were nonspecific. CONCLUSIONS: The most common radiological features of COP were pulmonary consolidation and GGO. The distribution of pulmonary consolidation is specific. It extends along the bronchovascular bundle or located in the subpleural area.
OBJECTIVE: To investigate the perfusion characteristics of normal pancreas and insulinoma on multi-slice spiral CT (MSCT). METHODS: Totally 21 subjects with suspected insulinoma were enrolled. Sixteen-slice spiral CT was used for perfusion scan following a standard contrast-enhanced scan. The surgical and pathological outcomes were collected for comparison. Perfusion characteristics, including blood flow (BF), patlak blood volume (pBV), time to peak (TTP), permeability, and peak enhancement (PE) of insulinomas and normal pancreas parenchyma were analyzed based on the MSCT data sets subsequently. RESULTS: Benign insulinoma was pathologically confirmed in 12 out of the 21 subjects, while the remaining 9 subjects were normal. Technical failures were experienced in 2 (9.5%) subjects. In both normal and tumor-suffered subjects (n = 19), perfusion parameters of normal pancreatic parachyma were measured as follows: BF (p) = 104. 9 +/- 28.9, pBV (p) = 166.4 +/- 41.8, TrP (p) = 133.3 +/- 24.4, Permeability (p) = 81.3 +/- 24.4, and peak enhancement (p) = 121.3 +/- 31.1. In subjects with insulinoma (n = 11), perfusion parameters of tumor tissue were measured as follows: F (i) = 206.5 +/- 42.2, BV (i) = 315.9 +/- 79.0, TFP (i) = 123.2 +/- 18.8, Permeability (i) = 102.5 +/- 54. 8, and peak enhancement (i) = 221.3 +/- 48.5. Results of F, BV, and peak enhancement in these two kinds of tissue showed significant differences (P < 0.01), while there were no significant difference (P > 0.05) in TTP and permeability between normal pancreatic parenchyma and insulinoma. CONCLUSIONS: Benign insulinoma has perfusion characteristics of increased blood flow and blood volume, but its TTP is consistent with normal pancreas and has normal permeability. MSCT allows further understanding of the blood flow of the normal pancreas and its benign tumor insulinoma.
OBJECTIVE: To compare the values of multi-slice spiral CT (MSCT) and magnetic resonance imaging (MRI) in evaluating the un-resectability of blood vessels in pancreatic tumor. METHODS: Images obtained from MSCT and MRI of pancreas in 14 patients with pancreatic cancer were retrospectively reviewed. MSCT scanning included arterial phase, pancreatic-portal phase, and delay-phase. MRI scanning included fat-suppressed T2WI, dual-echo T1WI, and fat-suppressed T1WI before and after injection of contrast (arterial phase, pancreatic-portal phase, delay-phase, and late delay phase). Seven patients received operations within two weeks after the examinations. The staging of peripancreatic blood vessels in MSCT and MRI images was evaluated and compared. The veracity of MSCT and MRI in assessing the un-resectability of peripancreatic blood vessels was calculated and compared according to the findings in operation. RESULTS: All the tumors were observed in MSCT and MRI images. Statistical difference existed in staging of peripancreatic blood vessels and in evaluating their un-resectability between MSCT and MR (P < 0.05). The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of the un-resectability assessed by MSCT were 77.8%, 95%, 91.8%, 77.8%, and 95%, respectively, and those assessed by MR were 66.7%, 90%, 85.7%, 60%, and 92.3%, respectively. CONCLUSION: Dynamic MSCT is better than dynamic MR to some extent in evaluating the un-resectability of peripancreatic blood vessels in pancreatic tumor.
OBJECTIVE: To determine the diagnostic accuracy of 16-slice spiral CT in assessing the lower extremity arterial occlusive diseases. METHODS: Thirty patients with suspected peripheral arterial occlusive diseases underwent 16-slice spiral CT angiography (CTA) of lower extremity arteries. All these patients also underwent digital subtraction angiography (DSA) two weeks before or after CTA. CT angiograms were produced using maximal intensity projection, volume rendering technique, and curved planar reconstruction. Using DSA as the standard reference, the diagnostic accuracy of CTA was determined. RESULTS: When detecting segments with > or = 50% stenosis, the sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of CTA were 94.3% (115/122), 98.4% (548/557), 97.6% (663/679), 92.7% (115/124), and 98.7% (548/555), respectively. CONCLUSION: 16-slice spiral CT has high sensitivity, specificity, and accuracy in detecting lower extremity arterial occlusive diseases and may partially substitute DSA examinations.
The emergence of multi-slice spiral computed tomography (MSCT) has a significant influence on cardiovascular imaging. As a noninvasive technique, MSCT is considered suitable for the evaluation of coronary artery stenosis, quantitative and qualitative assessment of plaque, analysis of cardiac function and myocardial perfusion imaging, and determination of the patency of stents or bypass grafts. Recent studies has shown that noninvasive coronary artery imaging with MSCT is a feasible screening test for suspected coronary artery diseases and a valuable follow-up tool for patients who have undergone interventional or surgical therapeutic procedures.
OBJECTIVE: To evaluate the therapeutic effect of percutaneous transluminal angioplasty and stenting for occlusive lesions in supra-arch vessels with brain ischemic symptoms. METHODS: A total of 56 occlusive lesions of the innominate, subclavian, and internal carotid arteries were treated with angioplasty and intravascular stent placement in 52 patients. The degree of stenosis was more than 60% in all patients and the leading symptom was brain ischemia. In 11 patients, the occluded subclavian artery could not be crossed via the femoral route, therefore the brachial route was used and the occlusion was crossed in a retrograde fashion. RESULTS: Technical success was achieved in 54 of 56 procedures (96.4%). Residual stenosis was less than 30% in all cases. The clinical symptoms improved after procedure in all patients. Complications occurred in 3 of 52 (5.8%) procedures, and the 30-day mortality rate was 0. There were no death and severe stroke in the follow-up period (means 24 months). Restenosis was observed in 2 patients after percutaneous transluminal angioplasty treatment. CONCLUSION: Percutaneous transluminal angioplasty with or without stenting is a safe and valid choice for treatment of occlusive lesions of supra-arch vessels in patients with cerebral ischemic symptoms.
OBJECTIVE: To evaluate the value of static pressure-volume (P-V) curve during alveolar recruitment and derecruitment in mechanical ventilated rabbits with acute respiratory distress syndrome (ARDS), and to explore the lung protective ventilation strategies. METHODS: The ARDS rabbit model was duplicated by warm-saline alveolar lavage. Dynamic CT scan was implemented to monitor the intrapulmonary gas volume and distribution during alveolar recruitment and derecruitment gradually. Static P-V curve was measured to reflect the features of alveolar recruitment and derecruitment. RESULTS: Four aeration regions including nonaeration, insufficient aeration, normal aeration and overinflation regions, varied following airway pressure variation (t = 2.477 - 9.794, all P < 0.05). Recruitment of insufficient aeration region was found. Alveolar recruitment was divided two parts, alveolar open at nonaeration region and recruitment at insufficient aeration region. And alveolar derecruitment was divided two parts, alveolar close at nonaeration region and derecruitment at insufficient aeration region. Distribution frequency of alveolar open was different from inspiratory (r = 0.219, P = 0.220). And distribution frequency of alveolar close was different from expiratory (r = 0.094, P = 0.593). The compliance of P-V curve was only positively correlated with the volume of insufficient aeration region (inspiration r = 0.827, P = 0.006; expiration r = 0.792, P = 0.011). The airway pressure with the maximal compliance at inspiratory P-V curve [(16.2 +/- 3.5) cm H2O, 1 cm H2O = 0.098 kPa] was positively correlated with the alveolar opening pressure [(16.4 +/- 3.4) cm H2O, r = 0.900, P = 0.002], and the airway pressure with the maximal compliance at expiratory P-V curve [(11.9 +/- 2.4) cm H2O] was positively correlated with the alveolar closing pressure [(11.3 +/- 2.5) cm H2O, r = 0.887, P = 0.003]. CONCLUSIONS: During inspiration, alveolar recruitment takes place with alveolar overinflation. The compliance of P-V curve is correlated with insufficient region volume, and reflects the potential of lung recruitment, and can predict the alveolar opening pressure and closing pressure.
OBJECTIVE: To describe the magnetic resonance (MR) imaging manifestations in vaginal anomalies, and to discuss the utility and limit of MR imaging in diagnosis of this abnormality. METHODS: Nine female patients with congenital vaginal anomalies who required surgical intervention were studied. MR imaging and ultrasound of the pelvic was performed before surgery. MR imaging features were retrospectively analyzed correlating with surgery. RESULTS: The vaginal anomalies were categorized into three groups: (1) congenital absence of the vagina and uterus, i.e. Mayer-Rokitansky-Küster-Hauser syndrome (MRKH syndrome) (n=3); (2) vaginal atresia (n=2); and (3) transverse vaginal septum (n=2). There was also one case of absence of vaginal with complicated urinogenital abnormality, and 1 case of obstructed hymen. CONCLUSIONS: MRI is a reliable method for evaluating vaginal anomalies. An accurate MRI examination can be helpful for surgical management.
OBJECTIVE: To investigate the feasibility of multi-slice spiral CT (MSCT) for cholangiopancreatography without cholangio-contrast. METHODS: Ten patients without any digestion system diseases and 24 patients with suspected pancreatic malignancy received the 16-slice spiral CT multi-phased contrast-enhanced scanning. The images of patients without any digestion system diseases and cancer-suffered patients were curved reformatted (CR) technique to perform the structure of pancreatic duct, common bile duct, and ampulla. The cholangiopancreatical systems of the cancer suffered patient were reconstructed through volume rendering technique (VRT), minimum intensity projection (MinIP), and indirect minimum intensity projection (IMinIP). The results of patients without any digestion system diseases in curved multiplanar reconstruction were analyzed; meanwhile display rates of the pancreatic duct, common bile duct, and ampulla were evaluated. RESULTS: of the four different cholangiopancreatographies were compared. RESULTS: The display rate of pancreatic duct in the CR images was 90.0 (9/10) with an average diameter of (2.63 +/- 0.51) mm. Sub-pancreatic duct could be seen in 88.9% (8/9) of them. The display rate of common bile duct in the CR images was 100% (10/10) with an average diameter of (7.45 +/- 1.12) mm. The display rate of ampulla was 60.0 (6/10), which was affected by the filling status of duodenum. The cholangiopancreatography using CR, VRT, MinIP, and IMinIP for patients with pancreatic cancer reveal the whole pancreatic and common bile duct, and the modality of distal obstructed bile duct. The result showed that IminIP got the best outcome (98.6%), while VRT got the worst (68.1%). CONCLUSION: The negative CT cholangiopancreatography is a simple and non-invasive examination. It reflects both the 3-dimensional cholangio-pancreatic anatomical structure and its adjacent condition. It has curtain clinical application values, especially for patients with obstructed duct system.