【摘要】 目的 在实验性自身免疫性脑脊髓炎(experimental autoimmune encephalomyelitis,EAE)模型中,比较常规T2加权成像(T2weighted imaging,T2WI)、钆二乙三胺五醋酸(gadoliniumdiethylenetriamine pentaacetic acid,GdDTPA)和超顺磁性氧化铁(superparamagnetic iron oxide,SPIO)增强图像之间的差异,探讨巨噬细胞在多发性硬化(multiple sclerosis,MS)炎性活动病灶中的细胞学标志。方法 在EAE模型临床症状的亚临床期、初发期、高峰期,13只复发缓解(relapsingremitting,RR)EAE大鼠模型组和13只正常对照组大鼠在注入对比剂之前均行常规T2WI扫描,接着分别在其尾静脉注入GdDTPA后5 min行T1加权成像(T1weighted imaging,T1WI),再注入SPIO,24 h后行T2WI扫描。扫描完毕后立即处死大鼠取脑,行脑组织切片的ED1免疫组织化学染色和Prussian blue染色。结果 EAE模型组大鼠在第11天出现临床症状(初发期),第14天达到高峰期;MRI检查:SPIO增强图像对EAE病灶的显示较常规T2WI和GdDTPA增强图像好。病理学检查:ED1染色,在SPIO显示为低信号的区域内出现了炎症细胞(以巨噬细胞为主)浸润;Prussian blue染色示病灶内巨噬细胞胞质内出现了蓝染颗粒,沉积部位与T2WI上低信号区对应。对照组大鼠均无异常。结论 SPIO较GdDTPA更好地显示EAE模型中炎性活动性病灶内血管周围以巨噬细胞为主的浸润。
ObjectiveTo analyze systematic reviews (SRs) and meta-analyses on the efficacy of pharmacological interventions in the prevention of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI). MethodsWe searched the PubMed, The Cochrane Library, EMbase, CNKI, CBM, WanFang Data, and VIP databases to identify SRs and meta-analyses on the pharmacological interventions aimed at preventing CI-AKI after PCI from inception of the databases to February 2022. Two researchers independently screened the literature and extracted data. The PRISMA statement, AMSTAR 2 tool, and GRADE system were adopted to evaluate the reporting quality, methodological quality, and evidence quality of the findings of the included SRs and meta-analyses. ResultsA total of 14 SRs and meta-analyses were identified. Among the drugs used were statins, N-acetylcysteine, sodium bicarbonate, Dan-hong injection, vitamins, salvianolate, adenosine antagonists, nicorandil, allopurinol, alprostadil, furosemide, trimetazidine, probucol, and brain natriuretic peptide. Most of the studies had relatively comprehensive coverage of the items, with the PRISMA scores ranging from 18 to 24.5. The main issues of reporting quality were protocol and registration, search, and funding. The methodological quality of the SRs and meta-analyses was generally low. Items 2 and 7 were the key items with poor scores, and the non-critical items with poor scores were items 3, 10, and 16. All drugs, except furosemide, decreased the incidence of CI-AKI. The quality of evidence ranged from medium to very low according to GRADE. Conclusion Most of the single drugs or drugs combined with hydration show the potential to prevent CI-AKI, however, the overall methodological quality of the included studies is relatively low, and the strength of evidence is generally low.
目的:探讨64层螺旋CT冠状动脉成像(64-slice CTA)检查中护理工作的重要性及获得最佳图像的影响因素。材料与方法:对462例行64-slice CTA检查的患者进行有效的护理措施和细致的前期准备工作。结果:462例检查者中96%的病例达到诊断标准。结论:经过细致准备和护理,可以提高图像质量和冠脉疾病的诊断率。
Objective To systematically evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rhBNP) in preventing contrast induced nephronpathy (CIN). Methods Randomized controlled trials using rhBNP for the prevention of CIN were retrieved from China National Knowledge Infrastructure, Chongqing VIP, Wanfang, SinoMed, PubMed, Embase, Web of Science, and Cochrane Library between the establishment of databases and December 31, 2024. RevMan 5.3 software was used for meta-analysis. Results A total of 12 articles were included. The meta-analysis results showed that compared with the saline group, the rhBNP group had a lower incidence of CIN [relative risk (RR)=0.39], blood creatinine levels at 48 hours [(standardized mean difference (SMD)=−0.79] and 72 hours (SMD=−0.68), cystatin C levels at 48 hours (SMD=−0.44) and 72 hours (SMD=−0.72), incidence of adverse events (RR=0.53), and higher eGFR at 48 hours [mean difference (MD)=4.62] and 72 hours (MD=7.11) after angiography. Conclusion The rhBNP may reduce the incidence and adverse events of CIN, and alleviate renal function damage after angiography.
ObjectivesTo evaluate the association between high homocysteine (Hcy) levels and risk of contrast-induced nephropathy (CIN).MethodsCNKI, VIP, WanFang Data, PubMed, The Cochrane Library and Web of Science databases were electronically searched to collect the case-control studies on the association between Hcy and risk of CIN from inception to November 30th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was performed by using Stata 12.0 software.ResultsTen case-control studies involving 6 124 subjects were included. Meta-analysis showed that the high Hcy level was associated with an increased risk of CIN (OR=1.59, 95%CI 1.33 to 1.89, P<0.001), and the homocysteine level in CIN group was higher than that in non-CIN group (WMD=8.74, 95%CI 6.18 to 11.31,P<0.001).ConclusionsAccording to the current evidence, the high Hcy level is a risk factor for CIN. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.
目的 探讨常规注射速率下单倍剂量对比剂在颈部三维对比增强磁共振血管成像（3D-CEMRA）中的可行性及临床应用价值。 方法 2011年8月－11月，连续纳入30例临床怀疑颈动脉或椎动脉狭窄并要求颈部磁共振血管成像检查的患者，随机分成A、B两组（每组各15例）。使用西门子Magnetom Avanto 1.5 T磁共振成像仪及其配备的颈部线圈和头部线圈进行CEMRA成像。A组使用双倍剂量对比剂（0.2 mmol/kg），B组使用单倍剂量对比剂（0.1 mmol/kg）。用三维快速小角度激发序列进行颈部血管成像。由2位有丰富经验的高年资医生对两组原始图像的信噪比以及最大密度投影（MIP）图像的质量进行评价，并对结果进行统计学分析和处理。 结果 A、B两组的所颈动脉信噪比分别为189.95 ± 71.31、175.07 ± 68.61，差异无统计学意义（t=?0.566，P=0.576）；所得的MIP图像质量均达到优良，差异无统计意义（χ2=0.180，P=0.671）。 结论 与双倍剂量相比，单倍剂量对比剂获得颈部血管的图像清晰，能够满足临床诊断要求。
ObjectiveTo assess the image quality and radiation dose of gemstone CT coronary angiography (CCTA) with low tube voltage and low concentration contrast medium. MethodsSixty-nine patients who underwent CCTA from January to March 2014 were randomly divided into group A and B. CCTA was performed in thirty-four patients in group A with tube voltage of 100 kV and concentration of contrast medium of 300 mgI/mL. And thirty-five patients in group B underwent CCTA with 120 kV and 370 mgI/mL. According to upgrading American Heart Association standard all segments and all vessels were evaluated. We measured the CT value of ascending aortic root, left main coronary artery, and the initial segment of left anterior descending branch, left circumflex, right coronary artery, and also adjacent tissues. Besides, we recorded CT dose volume index (CTDIvol) and the dose length product (DLP) and calculated effective radiation dose. ResultsThe image quality scores were not significantly different between two groups (P>0.05). The density in the contrast enhanced vessel lumens in group A were signifcantly higher than that in group B (P<0.05). There was no significant difference in signal to noise ratio and carrier to noise ratio between the two groups (P>0.05). Noise in group A was higher than that in group B (P<0.05). The CTDIvol and effective radiation dose in group A were significantly lower than those in group B (P<0.05). ConclusionThe combination of 100 kV with low concentration contrast medium (300 mgI/mL) still maintains the image quality, as well as significantly lowers the radiation dose and the dose of iodine.
Magneticaly labeled stem cells and magnetic resonance imaging(MRI) technology is an effective tracking method in vivo study, which has high spatial-temporal resolution. Gadolinium, which shows positive T1 signals and iron oxide showing negative T2 signals are the two often used contrast agents. The latter also include superparamagnetic iron oxide particle and ultrasmall superparamagnetic iron oxide particle. Transfection agents, e.g. poly-L-lysine and protamine sulfate，can enhance magnetical nanoparticles labeling stem cells. The biological characteristics of labeled stem cells did not seem to be altered. MRI can detect the labeled stem cells’ signals and also can track changes of signal in intensity and size with time past. In conclusion, MRI tracking magneticaly labeled stem cells represents a method for noninvasivly monitoring the existence and migration of engrafts.
ObjectiveTo explore the influence of different concentrations of iodinated contrast agent on image quality of galactography. MethodsBetween June 2008 and October 2009, 50 non-pregnancy and non-lactation patients with mammary papilla discharge underwent breast galactography with digital mammography. All the patients' left breasts were in group L, and right breasts were in group R. The iohexol concentration of iopamidol injection was 370 mg/mL in group L and 300 mg/mL in group R. The image quality and the evaluation of average density of the two groups was analyzed and compared. ResultsThe image quality score of group L and R was 2.8±0.2 (P>0.05). The mean density of main duct of breast axial view in two groups was (4 020.25±96.26) and (3 984.75±117.67) HU, respectively; the mean density of the lateral oblique view was (4 067.13±24.69) and (3 971.25±167.32) HU, respectively; the mean density of the lateral view was (4 058.88±52.07) and (4 034.75±67.54) HU, respectively. There was no significant difference between the two groups (P>0.05). ConclusionNo obvious difference between the two concentrations of non-ionic iodinated contrast agents (300 and 370 mg/mL) in galactography diagnosis is found.