Object: To evaluate the correlation between vertebral bone quality (VBQ) scores and quantitative computer tomography (QCT) based bone mineral density BMD in patients with severe scoliosis, and the correlation between spinal BMD and severity of deformity. Method: We selected patients with severe scoliosis from January 2022 to December 2023 in our hospital. Spinal parameters including main Cobb angle, kyphosis, apical vertebrae evaluated. The BMD was evaluated by QCT technique and VBQ scores was also evaluated. The correlation between the VBQ score and QCT was analyzed. A multivariate logistic regression model was used to analyse factors independently related to osteoporosis. Results: 68 patients were evaluated in this study. The overall mean age was 21.7 f 7.9 years. The mean Cobb angle was 135 f 20 degrees, and the mean angle of kyphosis was 125 f 41 degrees. There was a total of 16 (23.5 %) patients with osteoporosis according to QCT. The statistically differences in QCT and VBQ-score were found between Non-osteoporosis group and osteoporosis group. Although the mean age, Cobb angle degree, and kyphosis degree in osteoporosis group were greater than in Non-osteoporosis group, but there were no statistically differences. The VBQ was significantly related with QCT. The model revealed that the VBQ-score could independently associated with osteoporosis in patients with severe scoliosis. Conclusion: The overall prevalence of osteoporosis in severe scoliosis was 23.5 %. The VBQ-scores had a moderate to strong negative linear correlation with QCT-based BMD. The VBQ scores had a moderate diagnostic ability to verify patients with or without osteoporotic BMD in severe scoliosis.

Background:Tuberculous constrictive pericarditis (TCP) can progress to a chronic, calcific stage, restricting cardiac function. The role of pericardial calcification, best assessed by cardiac computed tomography (CT), in predicting surgical outcomes is unclear. We aimed to evaluate the association of pericardial calcification with clinical features, cardiac structural/functional alterations, and early postoperative outcomes in TCP patients undergoing pericardiectomy. Methods:In this retrospective study, 104 consecutive patients with TCP who underwent pericardiectomy were classified into calcification (n=34) and non-calcification (n=70) groups based on preoperative cardiac CT. Clinical data, laboratory results, echocardiographic parameters, and CT imaging variables were compared between groups. The impact of various pericardial calcification indicators on early postoperative adverse outcomes (a composite of low cardiac output syndrome or in-hospital mortality) was analyzed. Multivariate linear regression was performed to identify factors independently associated with the duration of postoperative intensive care unit (ICU) stay. Results:Patients with pericardial calcification had a longer disease duration, more severe bilateral atrial enlargement, greater dilation of the venae cavae, and a higher peak early diastolic mitral inflow velocity (E), alongside significantly lower C-reactive protein (CRP) levels and less pericardial thickening (all P<0.05). Postoperatively, both groups showed decreases in peak early diastolic mitral annular velocity (e'), ventricular septal bounce incidence, and left atrial (LA) size compared to preoperative values (all P<0.05). There were no significant differences in various pericardial calcification indicators between patients with and without early postoperative adverse outcomes (all P>0.05). Multivariate linear regression analysis identified ejection fraction (EF) (β=-0.278, P=0.004) and the presence of pleural effusion (β=0.205, P=0.037) as independent correlates of postoperative ICU stay, whereas the extent of pericardial calcification [ln(calcium score +1)] (β=-0.062, P=0.558) showed no independent association. Conclusions:Pericardial calcification in TCP signifies a chronic disease state, characterized by attenuated inflammation but more pronounced cardiac remodeling and diastolic dysfunction. However, it is not associated with an increased risk of early adverse outcomes nor with the duration of postoperative ICU stay after pericardiectomy.

Ankylosing spondylitis (AS) is frequently complicated by osteoporosis and progressive sagittal malalignment and may be accompanied by respiratory limitation. However, in radiographically severe AS, the cross-sectional relationships among sagittal alignment, spinal volumetric bone mineral density (vBMD), and imaging-derived pulmonary metrics remain incompletely characterised. We investigated these associations using quantitative computed tomography (QCT) and CT-based lung volumetry. This retrospective, cross-sectional study included 135 patients with radiographically severe AS (modified New York sacroiliitis grade 3–4) evaluated at a single center between 2021 and 2023. Lumbar trabecular vBMD was measured via QCT, sagittal alignment parameters were assessed on standing radiographs, and pulmonary metrics (TLVin, TLVex, ΔTLV) were derived from paired inspiratory/expiratory chest CT scans. Correlations were adjusted using the Benjamini–Hochberg false discovery rate (FDR). Multivariable linear regression examined associations with sagittal vertical axis (SVA) and pelvic tilt (PT), while multivariable logistic regression was employed to identify independent predictors of osteoporosis (defined as vBMD < 80 mg/cm3). Spinal vBMD and SVA differed significantly between radiographic grades (grade 3 vs 4). In FDR-adjusted correlations, vBMD was inversely associated with age (ρ = −0.58, q < 0.001) and BMI (ρ = −0.28, q = 0.007). Height showed robust associations with alignment (PT: ρ = −0.37, q < 0.001; TK: ρ = −0.39, q < 0.001; SS: ρ = 0.34, q < 0.001) and with TLVin (ρ = 0.33, q < 0.001), while BMI was inversely associated with TLVex (ρ = −0.27, q = 0.011). In prespecified multivariable models, the SVA model explained modest variance (R2 = 0.119) with no independent covariate at p < 0.05; PT was independently associated with height (B = −0.33°/cm, p = 0.001; R2 = 0.248). In the prespecified osteoporosis model, age (OR per 10 years 5.37), grade 4 (OR 4.35), and smoking history (OR 3.23) were independently associated with osteoporosis; discrimination within the derivation cohort was good (AUC 0.874). CT-volumetry showed high reproducibility (intra-/inter-observer ICCs 0.95–0.99). In radiographically severe AS, spinal vBMD is strongly influenced by age and radiographic severity. The identification of a high-risk osteoporosis profile, which is characterized by advanced age, grade 4 sacroiliitis, and smoking history, supports targeted bone health surveillance in these subgroups. While CT-derived lung volumetry is technically reproducible, its cross-sectional associations are predominantly anthropometric. Future prospective studies incorporating longitudinal data and standard spirometry are warranted to clarify the clinical utility of these imaging biomarkers.

OBJECTIVE:Low cardiac output syndrome (LCOS) is the leading cause of death after cardiac surgery. Studies have shown that 24% of postoperative mortality in patients undergoing pericardiectomy is attributed to LCOS. It is necessary to explore the risk factors of LCOS after pericardiectomy in patients with tuberculous constrictive pericarditis (CP). METHODS:Patients undergoing pericardiectomy for tuberculous CP were included in the study. The personal and clinical data of these patients with LCOS and without LCOS were collected and compared. Logistic regression analyses were conducted to identify the risk factors of postoperative LCOS. ROC curve analysis was used to check the accuracy of each risk factor to predict LCOS. RESULTS:A total of 175 patients with tuberculous CP were included in this study, of which 35 cases developed LCOS postoperatively, resulting in an incidence rate of 20%. The independent predictors of LCOS were preoperative NYHA class III/IV, decreased left ventricular mass index (LVMI), and hypoalbuminemia in these patients (p < 0.05). When albumin (ALB) < 30.35 g/L, it had the highest diagnostic value in predicting postoperative LCOS, with sensitivity and specificity of 59.4% and 86.9%, respectively (p < 0.01). CONCLUSIONS:For patients with tuberculous CP, preoperative NYHA class III/IV, lower LVMI, and hypoalbuminemia are independent risk factors for LCOS following pericardiectomy. Clinically, these risk factors should be identified as early as possible, and early pericardiectomy should be performed when the patient's cardiac function remains well-preserved to avoid the occurrence of cardiac cachexia, myocardial atrophy and severe hepatic insufficiency.

Perioperative complications following pericardiectomy in patients with constrictive pericarditis can significantly affect cardiac function recovery and postoperative outcomes. The prognostic nutritional index (PNI), a well-established nutritional marker, has been shown to predict outcomes in various diseases. However, its role as a predictive factor in patients with tuberculous constrictive pericarditis undergoing pericardiectomy remains unclear. This study aimed to evaluate the association between preoperative PNI and adverse perioperative outcomes in this patient population. This retrospective cohort study included 158 patients with tuberculous constrictive pericarditis who underwent pericardiectomy between January 2016 and June 2024. Preoperative PNI was calculated using the formula: (10 × serum albumin [g/dL]) + (0.005 × total lymphocyte count [cells/mm³]). The optimal PNI cutoff value was determined via ROC curve analysis, and patients were categorized into two groups: PNI ≥ 36.11 and PNI < 36.11. Univariate and multivariate logistic regression analyses were performed to assess the association between PNI and adverse perioperative outcomes. Of the 158 patients, 67.7

Diabetes mellitus increases the risk of adverse cardiovascular outcomes in hypertrophic cardiomyopathy (HCM) patients. This retrospective study aimed to evaluate myocardial microstructural alterations, particularly fibrosis and subclinical inflammation, in HCM patients across glycemic statuses using multiparametric cardiac magnetic resonance (CMR). Additionally, it explored the correlation between myocardial fibrosis and hemoglobin A1c (HbA1c) levels. 108 HCM patients were stratified by HbA1c levels into non-diabetic (n=38), prediabetic (n=40), and diabetic (n=30) subgroups, along with 30 healthy controls. All participants underwent 3.0-T CMR examination. Compared to non-diabetic HCM patients, prediabetic and diabetic HCM patients exhibited progressively higher mean T1 values and extracellular volume fractions (ECV) (p < 0.001). Similar trends were observed in hypertrophic myocardial regions, with diabetes patients showing pronounced fibrosis. Mean ECV exhibited a strong positive correlation with HbA1c levels (r = 0.634, p < 0.001). In the fully adjusted model, both T1 values and ECV demonstrated significant associations with HbA1c levels. Subclinical myocardial inflammation, as evidenced by elevated T1 and T2 values, was observed in prediabetic and diabetic patients but not in non-diabetic patients. Progression of myocardial fibrosis in HCM is linked to elevated HbA1c, especially in hypertrophied regions, even in prediabetic individuals. Subclinical myocardial inflammation was observed in HCM with glucose metabolism abnormalities. These findings underscore the importance of early glycemic control and the integration of CMR-based tissue characterization into HCM management strategies.

Danon disease is an X-chromosome dominant disorder caused by variants in lysosomal-associated membrane protein-2 (LAMP-2). Patients often present with cardiac lesions as their initial symptom, including hypertrophic cardiomyopathy, arrhythmia, and heart failure. We found a case of a 13-year-old male patient with multimodal imaging suggestive of left ventricular hypertrophy, decreased left ventricular myocardial perfusion, electrocardiographic abnormalities, and abnormal serologic parameters. Genetic testing revealed a variant located in the LAMP2 gene, leading to the diagnosis of Danon disease. Danon disease is a multisystem disorder with a predominance of cardiac lesions, and it should be considered when imaging suggests myocardial hypertrophy or dilatation.

This study aimed to evaluate left ventricular (LV) deformation and tissue characteristics using cardiac magnetic resonance (CMR) in patients with hypertrophic cardiomyopathy (HCM) and heart failure with preserved ejection fraction (HFpEF), to examine their associations with heart failure status, and to explore the correlations between CMR parameters and the H2FPEF score. This retrospective study included 105 patients with HCM who underwent 3.0-T CMR. Participants were classified into HFpEF (n = 46) and non-HF (n = 59) groups according to the 2019 ESC HFA-PEFF algorithm. Global radial strain (GRS), global circumferential strain (GCS), global longitudinal strain (GLS), and corresponding systolic and early-diastolic strain rates were derived using CMR feature tracking. Myocardial tissue characterization included native T1 and T2 mapping, extracellular volume fraction (ECV), and late gadolinium enhancement (LGE). Group differences were assessed with t-tests or chi-square tests. Associations between strain, tissue parameters, and the H2FPEF score were evaluated using Spearman correlations. Multivariable logistic regression was performed to identify independent CMR predictors of HFpEF. Compared with non-HF patients, those with HCM-HFpEF showed significantly reduced LV systolic and early-diastolic strain rates, including sGRSr (P = 0.010), sGCSr (P = 0.044), sGLSr (P = 0.018), and eGLSr (P = 0.006). They also demonstrated a higher prevalence and greater extent of LGE, as well as elevated native T1 and ECV values (all P < 0.05). Strain parameters correlated significantly with tissue characteristics (native T1 and mean ECV), except for GCS and ECV. In multivariable analysis, drinking, atrial fibrillation, lower LV-eGLSr, and higher ECV in segments with maximal wall thickness were independently associated with HCM-HFpEF. The H₂FPEF score showed weak but significantly correlations with native T1, ECV, and T2 values in both global and hypertrophied myocardial segments (r = 0.199–0.252, all P < 0.05). HCM patients with HFpEF exhibit both systolic and diastolic dysfunction, accompanied by increased diffuse and focal fibrosis. Independent predictors of HFpEF include lower LV-eGLSr, higher segmental ECV, atrial fibrillation, and drinking. The H2FPEF score shows significant associations with tissue-level abnormalities, highlighting the complementary role of CMR-derived strain and tissue characterization in the early detection and risk stratification of HFpEF in HCM.

BACKGROUND:Respiratory compromise among ankylosing spondylitis (AS) patients is characterized by restrictive pulmonary function, leading to the need for a meticulous assessment of lung volume. Compared with conventional pulmonary function tests (PFTs), CT-based lung volume measurements have superior accuracy and are crucial for understanding functional limitations in AS. This study investigated the correlation between CT lung volume and PFT parameters in AS patients, with a focus on changes in CT parameters and lung volume in patients with compromised pulmonary function. METHODS:A total of 79 AS patients were included, and their full-length radiographs, thoracic CT scans, and PFT data were analysed. Specialized software was used to estimate the total and lobar lung volumes from the CT scans. The relationship between lung volume and PFT results was examined, and a multiple linear regression model was constructed to determine the influence of radiographic and CT parameters on total lung volume (TLV). Patients were classified into normal or impaired pulmonary function groups based on PFT outcomes, thus facilitating comparative analyses of radiographic and CT parameters and lung volumes between these groups. RESULTS:Among the 79 AS patients, 19 had normal function, 4 had mixed dysfunction, and 56 experienced restrictive dysfunction. PFT parameters, including FVC, FEV1, TLC, FEV1%, and TLC%, showed varying correlations with TLV and individual lobe volume. Patients with compromised pulmonary function exhibited more pronounced spinal kyphosis and experienced a decline in TLV. Multiple regression analysis revealed that lung height and horizontal and vertical lung diameters independently influenced TLV. Notably, a decrease in lung height was observed in patients with impaired pulmonary function, whereas the horizontal and vertical diameters of the lungs remained stable. CONCLUSIONS:In AS patients, TLV was found to be correlated with pulmonary function, particularly parameter such as FVC, FEV1, and TLC. A significant reduction in TLV was observed in those with impaired pulmonary function, with the primary contributing factor being a decrease in lung height.

BACKGROUND:A consensus on normal atrial deformation measurements by feature-tracking cardiac MRI remained absent.PURPOSE:Provide reference ranges for atrial strain parameters in normal subjects, evaluating the influence of field strength and analysis software on the measurements.STUDY TYPE:Meta-analysis.POPULATION:2708 subjects from 42 studies undergoing cardiac MRI.ASSESSMENT:A systematic search was conducted from database (PubMed, Web of Science, ScienceDirect, and EMBASE) inception through August 2023. The random-effects model was used to pool the means of biatrial strain parameters. Heterogeneity and clinical variable effects were assessed. Strain measurements among different field strengths and analysis software were compared.STATISTICAL TESTS:The inverse-variance method, Cochrane Q statistic, and I2 value, meta-regression analysis, and ANOVA were used; P < 0.05 was considered statistically significant.RESULTS:The pooled means of left atrial (LA) total strain (εs), passive strain (εe), and active strain (εa) were 37.46%, 22.73%, and 16.24%, respectively, and the pooled means of LA total strain rate (SRs), passive strain rate (SRe), and active strain rate (SRa) were 1.66, -1.95, and -1.83, indicating significant heterogeneity. The pooled means of right atrial (RA) εs, εe, and εa were 44.87%, 26.05%, and 18.83%. RA SRs, SRe, and SRa were 1.66, -1.95, and -1.83, respectively. The meta-regression identified age as significantly associated with LA εs, εe and SRe, field strength was associated with LA SRa (all P < 0.05). ANOVA revealed differences in LA εa and SRa among different analysis software and in LA εs and all LA strain rates (all P < 0.05) among field strengths. No significant differences were identified in RA strain across analysis software (RA strain: P = 0.145-0.749; RA strain rates: P = 0.073-0.744) and field strengths (RA strain: P = 0.641-0.794; RA strain rates: P = 0.204-0.458).DATA CONCLUSION:This study demonstrated the pooled reference values of biatrial strain. Age, analysis software, and field strength were attributed to differences in LA strain, whereas RA strain showed consistency across different field strengths and analysis software. Limited study subjects may account for the absence of influence on RA strain.LEVEL OF EVIDENCE: 1:TECHNICAL EFFICACY:Stage 5.

Background: Patients diagnosed with severe adolescent idiopathic scoliosis (AIS) often experience reduced pulmonary function and lung volume due to deformities in the spine and ribcage. Presurgical halo-pelvic traction (HPT) has been used to treat severe scoliosis before second-stage surgery. Nevertheless, there is a scarcity of studies utilizing computed tomography (CT) scans to evaluate changes in lung volume post-HPT. Therefore, this study aimed to investigate changes in lung volumes and anatomical parameters using biphasic CT scans following HPT in AIS patients. The hypothesis was that the lung tidal volume, as determined by biphasic CT scans, would exhibit changes in conjunction with pulmonary function. Methods: The study comprised a cohort of 24 patients with AIS scheduled for presurgical HPT intervention. Pre- and post-traction radiographs, biphasic CT scans, and pulmonary function tests (PFTs) were obtained. Then, 3-dimensional (3D) reconstructions were generated from the CT scans obtained at both end inspiration and end expiration to calculate various measurements of lung volumes, particularly the lung tidal volume. Additionally, various thoracic anatomical parameters and clinical parameters, including PFTs, were assessed and compared. Results: Following an average of 91.7 days of HPT, a significant increase in CT total lung volume (TLV) was noted at both end inspiration (P<0.001) and expiration (P=0.020). Conversely, there was no significant change in lung tidal volume (P=0.115). The traction resulted in significant reductions in the thoracic Cobb angle, kyphosis, and hemithoracic symmetry ratio, with average decreases of 32.9%, 33.0%, and 18.8%, respectively, accompanied by notable enhancements in PFTs. Changes in radiographic and CT parameters, excluding TLV at end expiration and hemithoracic symmetry ratio, were not correlated with PFT changes. Significant correlations were found between HPT duration and changes in the Cobb angle (r=-0.688, P<0.001) and left lung volumes at end inspiration (r=0.518, P=0.010) and expiration (r=0.452, P=0.027). Despite the enhancement in pulmonary function after HPT, CT lung tidal volume remained unchanged. This discrepancy contradicts our initial hypothesis, suggesting that CT lung tidal volume is not a reliable indicator of pulmonary function. Conclusions: Preoperative HPT significantly improved spinal deformity, TLV, and pulmonary function. The alteration in CT lung tidal volume did not correlate with PFTs and was deemed an unreliable predictor of pulmonary function. The use of biphasic thoracic CT for calculating lung tidal volume did not demonstrate substantial benefits over monophasic CT and is not recommended for severe AIS.

Background:Adolescent idiopathic scoliosis (AIS) is a prevalent spinal disorder that can potentially influence bone mineral density (BMD), thereby increasing the susceptibility to osteoporosis and fractures. Early identification of reduced bone mass in AIS patients is crucial for clinicians to develop effective preventive strategies against fractures. This study aims to elucidate the correlation between BMD, as measured by quantitative computed tomography (QCT), and various clinical parameters in AIS, including the Cobb angle, vertebral rotation, and the Risser sign. By revealing the potential influences of these factors on BMD, our findings aim to assist clinicians in making informed and timely decisions regarding AIS management, particularly in situations where QCT is unavailable. Methods:A cross-sectional study was conducted on 129 adolescents with AIS who were enrolled at The Third People's Hospital of Chengdu, Sichuan, China, between 2021 and 2023. QCT was employed to assess BMD and vertebral rotation. The Cobb angle and Risser sign were determined through radiographic evaluation, while anthropometric and biochemical data were also collected. Statistical analyses, including Pearson and Spearman rank correlation and regression models, were used to investigate the associations between BMD and clinical measures. Results:A significant negative correlation was found between BMD and Cobb angle (coefficient =-0.663; P<0.001), as well as between BMD and vertebral rotation angle (coefficient =-0.442; P<0.001) in patients with AIS. BMD was positively correlated with increased height (coefficient =0.355; P<0.001) and BMI (coefficient =0.199; P=0.02). A significant association was detected between BMD and the Risser sign (P=0.002). No significant sex-based differences in BMD were observed (P=0.052). No significant correlations were observed between BMD and levels of potassium (K), calcium (Ca), inorganic phosphate (P), and iron (Fe) (P>0.05 all). The binary logistic regression analysis identified Cobb angle as a risk factor of lower BMD presence in AIS patients (coefficient =0.072; OR=1.075; P<0.001). Furthermore, the receiver operating characteristic (ROC) analysis of the combined model for predicting low BMD in AIS patients yielded an area under the curve (AUC) value of 0.900, with an optimal threshold determined as 0.398. The sensitivity and specificity were calculated as 0.816 and 0.900, respectively, indicating a robust predictive capacity. Conclusions:This study highlights the significant inverse correlation observed between BMD measured by QCT and both Cobb angle and vertebral rotation angle in patients with AIS. Furthermore, a notable variation in BMD was found across different Risser sign categories, with BMD values generally increasing as Risser sign levels increased. Additionally, our findings indicate that Cobb angle serves as a risk factor for low BMD presence. Moreover, a combined model was developed to predict the likelihood of low BMD occurrence in AIS patients.

目的 探索不同屏气方法在CT引导下经皮肺穿刺活检中的应用价值.方法 采取前瞻性研究,选取 2021 年 1 月 1 日至 2021 年 11 月 3 日就诊于成都市第三人民医院,患有肺部病变的患者 320 例,采用平静呼吸状态下的吸气末屏气(A组,106 例)、随机屏气(B组,104 例)及呼气末屏气(C组,110 例)三种不同屏气方法,行CT引导下经皮肺穿刺活检.比较三种屏气方法的穿刺成功率、诊断准确率、并发症发生率等差异.结果 三组穿刺成功率均为 100％,诊断准确率三组间差异无统计学意义(P＞0.05);A、B、C三组并发症总体发生率分别为 43.4％、50％、58.2％.三组间肺出血发生率差异无统计学意义(P＞0.05);气胸和咯血发生率差异有统计学意义(P＜0.05),且A组气胸和咯血发生率与B、C两组比较差异有统计学意义(P＜0.05).对于中下叶的病灶,A组气胸发生率较低,与B、C两组比较差异有统计学意义(P＜0.05).结论 CT引导下经皮肺穿刺活检中,采用平静呼吸状态下吸气末屏气相对于其他屏气方法可减少并发症的发生.

目的 明确多层螺旋CT鉴别腹盆腔霍奇金病(HD)和非霍奇金淋巴瘤(NHL)的价值.方法 腹盆腔恶性淋巴瘤66例,其中HD 16例,NHL 50例.通过多层螺旋CT增强检查,观察腹盆腔淋巴结大小、形态、密度及解剖分布.结果 恶性淋巴瘤CT增强,HD中13例为均匀密度,3例为部分坏死;NHL中39例为均匀密度,11例为部分坏死,两者强化类型差异无统计学意义(P＞0.05).HD和NHL均优势累及腹主动脉周围上下部、肠系膜根部、肝十二指肠韧带及肝胃韧带;盆腔淋巴结肿大多发生在髂总动脉,其次为髂内动脉;两者解剖分布差异无统计学意义(P＞0.05).HD和NHL多同时累及2个部位以上的淋巴结.恶性淋巴瘤亦累及肝、脾、肾、胃肠等淋巴结外器官,其中以脾受累最为常见.HD和NHL之间差异有统计学意义(P＜0.05).结论 多层螺旋CT增强扫描可显示HD和NHL累及腹盆腔淋巴结的病理改变及优势解剖分布,有利于两者诊断、分期及治疗.

Study Design: Retrospective review. Objective: To evaluate the effectiveness of halo-pelvic traction and thoracoplasty for pulmonary artery pressure (PAP) and cardiopulmonary function in patients with severe spinal deformity. Summary of Background Data: The effect of severe spinal deformity on pulmonary arterial hypertension, cardiac structure, and function has received little attention before. Patients and Methods: A total of 21 patients with severe spinal deformity were included in our study; all patients were examined by echocardiography and pulmonary function test before and after treatment. The correlations between PAP and pulmonary function were examined using Pearson correlation analysis. Results: The PAP decreased from 58.67 ± 20.24 to 39.00 ± 12.51 mm Hg, and the PAP of 42.86% of the patients returned to normal after treatment. Right cardiac enlargement, left ventricular diastolic function, and pulmonary function were improved at the same time. The ratio of left ventricular to right ventricular diameter returned to normal. Moderate correlations (correlation coefficient: −0.513 to −0.559) between PAP and forced vital capacity and forced expiratory volume in the first second were identified. Conclusions: Pulmonary arterial hypertension, ventricular diastolic function, and pulmonary function were improved after halo-pelvic traction and thoracoplasty. A moderate negative correlation was identified between PAP and pulmonary function: the more pulmonary function improved, the more PAP decreased.

Background Transjugular intrahepatic portosystemic shunt (TIPS) is an important method to alleviate cirrhotic portal hypertension. But the falling and fracture of the stent which detaches into the heart is a potentially fatal threat. Case presentation We present a case of severe tricuspid regurgitation caused by detached stent falling into the right ventricle after transjugular intrahepatic portosystemic shunt. Conclusion Great attention should be paid to the serious complication of stent fracture after TIPS especially when the dual stent technique is used in TIPS.

[目的]分析先天性脊柱侧凸(congenital scoliosis,CS)患者心肺功能特点,探讨Cobb角对心肺功能影响.[方法]回顾性分析2020年10月-2021年10月本院收治的50例胸弯为主的CS患者的临床资料,根据胸弯Cobb角,分为重度组(Cobb角≥90°)30例,中度组(40°≤Cobb角＜90°)20例.比较两组心脏结构、功能及肺功能参数,采用Pearson或Spearman相关性分析Cobb角对其他参数的影响.[结果]两组患者心脏结构及功能测值均在正常范围内,重度组房室腔大小显著小于中度组(P＜0.05),左室舒张功能参数E/A、e'/a'均显著小于中度组(P＜0.05),而E/e'显著大于中度组(P＜0.05).两组患者肺功能均有不同程度的降低,重度组限制性通气功能、小气道功能及换气功能参数均显著低于中度组(P＜0.05).相关分析表明,CS患者Cobb角与左房室腔大小(LA、LVD、LVS)及舒张功能参数(E/A、e/a)呈显著负相关(P＜0.05);CS患者Cobb角与限制性通气功能参数呈显著负相关(P＜0.05).[结论]CS的Cobb角对心脏结构及舒张功能产生影响,Cobb角越大左房室腔内径越小.此外,Cobb角也会影响左室舒张功能.Cobb角与肺功能受损程度相关,Cobb角越大肺功能越差.

目的 评价低管电压、低对比剂浓度及低造影剂流速条件下行冠状动脉、肺动脉、主动脉全段及分支一站式CT血管成像的图像质量和辐射有效剂量的应用价值.方法 回顾性分析不同浓度造影剂下完成一站式血管扫描的60例患者,按不同的扫描条件和造影剂浓度分为A、B两组,每组30例.A组:管电压80 kV,管电流250 mA,碘浓度300 mg/mL,流速3.5 mL/s;B组:管电压100 kV,管电流200 mA,碘浓度320 mg/mL,流速5 mL/s.将两组图像质量进行客观评价,比较两组图像的血管(冠状动脉、肺动脉、主动脉全段主干分支)CT值、对比度噪声比(CNR)、图像噪声(PN)和辐射有效剂量.结果 两组图像质量主客观评价A组与B组冠状动脉各主干CT值及其PN(PN1),肺动脉主干、左右肺动脉CT值及其PN(PN2),主动脉各处CT值差异均有统计学意义(P<0.05);冠状动脉CNR(CNR1)、肺动脉CNR(CNR2)、主动脉PN(PN3)和主动脉CNR(CNR3)无统计学差异(P>0.05).A、B两组血管计算机体层摄影血管造影辐射有效剂量分别为(3.7±0.7)mSv和(6.8±0.9)mSv,A组辐射有效剂量较B组降低约45.6％.结论 采用低管电压结合低对比剂浓度及低造影剂流速行体部大血管一站式扫描时,图像质量在主观评价上满足诊断要求,在客观评价上与常规扫描方法测得结果基本一致,不仅降低患者碘摄入量,还降低约45.6％的辐射有效剂量.

Zhengkai Zhao, Jianlin Li, Yuanyuan Chen, Jian Liu, Qiuyi Cai, Yi Li, Jiayu Zou, Jianshou Zhou, Ya Li, Yong Liang, Hao Yang

目的 探讨肺磨玻璃结节的HRCT定量数据与病理性质的相关性.方法 回顾分析84枚经手术病理证实的肺磨玻璃结节,根据病理结果分为良性组(15枚)、非侵袭性组(38枚)及侵袭性组(31枚).记录各组最大横截面的最大径、面积、平扫CT值、增强CT值,计算强化程度(增强CT值-平扫CT值),绘制风险指数的受试者工作特征曲线(ROC曲线),计算曲线下面积并求得临界值.结果 良性组、非侵袭组及侵袭组病灶逐渐增大,平扫CT值、强化程度逐渐增高.非侵袭性组与良性组比较仅最大横截面面积差异有统计学意义(P＜0.05);侵袭性组分别与良性组、非侵袭组比较,最大径、面积、平扫CT值及强化程度差异均有统计学意义(P＜0.05).鉴别非侵袭性病变与侵袭性病变平扫CT值的最佳临界值为-541.5 HU,诊断侵袭性病变的灵敏度、特异度分别为67.1％、86.8％;鉴别非侵袭性病变与侵袭性病变强化程度的临界值为41.5 HU,诊断侵袭性病变的灵敏度、特异度为74.2％、81.1％.结论 HRCT定量分析对鉴别肺磨玻璃结节的性质具有一定的参考价值.