scholarly journals Detection and Prediction of Peripheral Arterial Plaque Using Vessel Wall MR in Patients with Diabetes

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Li Wang ◽  
Wei Deng ◽  
Jianke Liang ◽  
Weizhao Zhuang ◽  
Huigang Feng ◽  
...  

Objectives. To evaluate the predictive performance of a newly developed delay alternating with nutation for tailored excitation (DANTE) pulse sequence for detecting lower extremity artery wall morphology and distribution in patients with peripheral artery disease (PAD) with diabetes. Methods. Seventy-four PAD patients diagnosed according to 2011 WHO criteria were enrolled, who has diabetic diagnosis by 1999 WHO diabetes criteria. All patients received sequential DANTE, T2WI, DANTE-enhance, and CE-MRA scans. The images consisted of three parts: the iliac artery (segment 1), femoral artery (segment 2), and popliteal artery (segment 3). Regions of interest (ROIs) were drawn on vessels, muscle, and background, and multiple imaging metrics compared between modalities, including image quality score, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). In the images with a score greater than 2, the lumen area (LA), total vessel area (TVA), and vessel thickness (VT) can be identified using semiautomatic image analysis vessel morphology parameters. Results. All 222 arterial segments were successfully analyzed from 71 patients, after exclusion of three subjects with poor image quality ( IQ < 2 ) in segment 3. There were 54 diabetic and 17 nondiabetic patients. Quantitative analysis shows that the CNR difference between diabetic patients and nondiabetic patients was statistically significant for the same segment, while there was no significant difference among the three segments of SNR and CNR. There were a total of 54 diabetics with plaque distribution data, which showed that LA of segments 1 and 2 was higher than that of segment 3. The VWI of segments 1 and 2 was lower than segment 3. Diabetic was associated with vascular WT 3 and WA3, which increased by 0.23 and 0.83 units on average compared without diabetic foot, respectively. Diabetic foot was associated with vascular WT 3, which increased by 0.37 units on average compared without diabetic foot. The incidence of segment 3 plaques was higher than that of segment 1. The incidence of the left and right plaques was different. Conclusions. MR imaging using the DANTE and multicontrast sequence could evaluate plaque morphology, and distribution of lower extremities and the occurrence of diabetic foot development are closely related; it may predict occurrence of PAD with diabetic foot.

2021 ◽  
Vol 11 (5) ◽  
pp. 2047
Author(s):  
Nor Azura Muhammad ◽  
Zunaide Kayun ◽  
Hasyma Abu Hassan ◽  
Jeannie Hsiu Ding Wong ◽  
Kwan Hoong Ng ◽  
...  

The aim of this study is to investigate the impact of CT acquisition parameter setting on organ dose and its influence on image quality metrics in pediatric phantom during CT examination. The study was performed on 64-slice multidetector CT scanner (MDCT) Siemens Definition AS (Siemens Sector Healthcare, Forchheim, Germany) using various CT CAP protocols (P1–P9). Tube potential for P1, P2, and P3 protocols were fixed at 100 kVp while P4, P5, and P6 were fixed at 80 kVp with used of various reference noise values. P7, P8, and P9 were the modification of P1 with changes on slice collimation, pitch factor, and tube current modulation (TCM), respectively. TLD-100 chips were inserted into the phantom slab number 7, 9, 10, 12, 13, and 14 to represent thyroid, lung, liver, stomach, gonads, and skin, respectively. The image quality metrics, signal to noise ratio (SNR) and contrast to noise ratio (CNR) values were obtained from the CT console. As a result, this study indicates a potential reduction in the absorbed dose up to 20% to 50% along with reducing tube voltage, tube current, and increasing the slice collimation. There is no significant difference (p > 0.05) observed between the protocols and image metrics.


2021 ◽  
Vol 94 (1125) ◽  
pp. 20210430
Author(s):  
Puja Shahrouki ◽  
Kim-Lien Nguyen ◽  
John M. Moriarty ◽  
Adam N. Plotnik ◽  
Takegawa Yoshida ◽  
...  

Objectives: To assess the feasibility of a rapid, focused ferumoxytol-enhanced MR angiography (f-FEMRA) protocol in patients with claustrophobia. Methods: In this retrospective study, 13 patients with claustrophobia expressed reluctance to undergo conventional MR angiography, but agreed to a trial of up to 10 min in the scanner bore and underwent f-FEMRA. Thirteen matched control patients who underwent gadolinium-enhanced MR angiography (GEMRA) were identified for comparison of diagnostic image quality. For f-FEMRA, the time from localizer image acquisition to completion of the angiographic acquisition was measured. Two radiologists independently scored images on both f-FEMRA and GEMRA for arterial and venous image quality, motion artefact and diagnostic confidence using a 5-point scale, five being best. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) in the aorta and IVC were measured. The Wilcoxon rank-sum test, one-way ANOVA with Tukey correction and two-tailed t tests were utilized for statistical analyses. Results: All scans were diagnostic and assessed with high confidence (scores ≥ 4). Average scan time for f-FEMRA was 6.27 min (range 3.56 to 10.12 min), with no significant difference between f-FEMRA and GEMRA in diagnostic confidence (4.86 ± 0.24 vs 4.69 ± 0.25, p = 0.13), arterial image quality (4.62 ± 0.57 vs 4.65 ± 0.49, p = 0.78) and motion artefact score (4.58 ± 0.49 vs 4.58 ± 0.28, p > 0.99). f-FEMRA scored significantly better for venous image quality than GEMRA (4.62 ± 0.42 vs 4.19 ± 0.56, p = 0.04). CNR in the IVC was significantly higher for steady-state f-FEMRA than GEMRA regardless of the enhancement phase (p < 0.05). Conclusions: Comprehensive vascular MR imaging of the thorax, abdomen and pelvis can be completed in as little as 5 min within the magnet bore using f-FEMRA, facilitating acceptance by patients with claustrophobia and streamlining workflow. Advances in knowledge: A focused approach to vascular imaging with ferumoxytol can be performed in patients with claustrophobia, limiting time in the magnet bore to 10 min or less, while acquiring fully diagnostic images of the thorax, abdomen and pelvis.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Chinedum Ogbonnaya Eleazu ◽  
Aniza Abd Aziz ◽  
Tay Chuu Suen ◽  
Lam Chun-Hau ◽  
Chin Elynn ◽  
...  

Purpose This study aims to design to assess the traditional, complementary and alternate medicine (TCAM) usage and its association with the quality of life (QOL) of Type 2 diabetic patients in a tertiary hospital (Hospital Universiti Sains Malaysia) in Malaysia. Design/methodology/approach A total of 300 respondents included in this study were divided into the following two major categories: TCAM (34.33% of respondents) and non-TCAM users (65.67% of the respondents), respectively. The mean ages of the respondents were 59.3 ± 10.2 for the TCAM users and 57.7 ± 12.0 for the non-TCAM users. Findings A greater percentage of non-TCAM users reported poor control of diabetes (14.7%) and blood glucose (55.8%) compared with the TCAM users (9.7% and 48.5%, respectively). Further, the diabetic patients on TCAM reported lower rates of coma, stroke and kidney problems but higher rates of diabetic foot ulcers, heart diseases and retinopathy than the non-TCAM users. Additionally, the diabetic patients with TCAM usage had a significantly better physical (p = 0.02) and overall (p = 0.03) qualities of life compared to the non-TCAM users. However, psychological, social and environmental health did not show any significant difference. Originality/value The prevalence of TCAM usage among diabetic patients was lower than in other comparable studies. Diabetic patients on TCAM reported lower rates of coma, stroke and kidney problems but higher rates of diabetic foot ulcers, heart diseases and retinopathy than the non-TCAM users. Further, diabetes patients on TCAM reported better QOL compared to non-TCAM users especially in terms of physical health.


2019 ◽  
Vol 829 ◽  
pp. 252-257
Author(s):  
Azhari ◽  
Yohanes Hutasoit ◽  
Freddy Haryanto

CBCT is a modernized technology in producing radiograph image on dentistry. The image quality excellence is very important for clinicians to interpret the image, so the result of diagnosis produced becoming more accurate, appropriate, thus minimizing the working time. This research was aimed to assess the image quality using the blank acrylic phantom polymethylmethacrylate (PMMA) (C­5H8O2)n in the density of 1.185 g/cm3 for evaluating the homogeneity and uniformity of the image produced. Acrylic phantom was supported with a tripod and laid down on the chin rest of the CBCT device, then the phantom was fixed, and the edge of the phantom was touched by the bite block. Furthermore, the exposure of the X-ray was executed toward the acrylic phantom with various kVp and mAs, from 80 until 90, with the range of 5 kV and the variation of mA was 3, 5, and 7 mA respectively. The time exposure was kept constant for 25 seconds. The samples were taken from CBCT acrylic images, then as much as 5 ROIs (Region of Interest) was chosen to be analyzed. The ROIs determination was analyzed by using the ImageJ® software for recognizing the influence of kVp and mAs towards the image uniformity, noise and SNR. The lowest kVp and mAs had the result of uniformity value, homogeneity and signal to noise ratio of 11.22; 40.35; and 5.96 respectively. Meanwhile, the highest kVp and mAs had uniformity value, homogeneity and signal to noise ratio of 16.96; 26.20; and 5.95 respectively. There were significant differences between the image uniformity and homogeneity on the lowest kVp and mAs compared to the highest kVp and mAs, as analyzed with the ANOVA statistics analysis continued with the t-student post-hoc test with α = 0.05. However, there was no significant difference in SNR as analyzed with the ANOVA statistic analysis. The usage of the higher kVp and mAs caused the improvement of the image homogeneity and uniformity compared to the lower kVp and mAs.


2020 ◽  
Author(s):  
Jia-Suo Jiang ◽  
Liu-Ning Zhu ◽  
Qian Wu ◽  
Yi Sun ◽  
Wei Liu ◽  
...  

Abstract Background To evaluate the feasibility of using simultaneous multi-slice (SMS) readout segmentation of long variable echo-trains (RESOLVE) diffusion-weighted imaging (DWI) to assess parotid gland tumors, compared with conventional RESOLVE DWI Methods From September 2018 to December 2018, 20 consecutive patients with parotid tumors who underwent MRI scan for pre-surgery evaluation were enrolled. SMS-RESOLVE DWI and conventional RESOLVE DWI were scanned with matched imaging parameters, respectively. The scan time of two DWI sequences was recorded. Qualitative (anatomical structure differentiation, lesion display, artifact, and overall image quality) and quantitative (apparent diffusion coefficient, ADC; ratio of signal-to-noise ratio, SNR ratio; ratio of contrast-to-noise ratio, CNR ratio) assessments of image quality were performed, and compared between SMS-RESOLVE DWI and conventional RESOLVE DWI. Paired t-test was used for statistical analyses. Results The scan time was 3 minutes and 41 seconds for SMS-RESOLVE DWI, and 5 minutes and 46 seconds for conventional RESOLVE DWI. SMS-RESOLVE DWI produced similar qualitative image quality with RESOLVE DWI (anatomical structure differentiation, P = 0.164; lesion display, P = 0.193; artifact, P = 0.330; overall image quality, P = 0.083). Meanwhile, there were no significant difference on ADCLesion (P = 0.298), ADCMasseter (P = 0.122), SNR ratio (P = 0.584) and CNR ratio (P = 0.217) between two DWI sequences. Conclusion Compared with conventional RESOLVE DWI, SMS-RESOLVE DWI could provide comparable image quality using markedly reduced scan time. SMS could increase the clinical usability of RESOLVE technique for DWI of parotid gland.


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Gholam Hosein Kazemzadeh ◽  
Hasan Ravari ◽  
Masomeh Nabavizadeh ◽  
Saeid Pasban Noghabi

Background: Diabetic foot ulcers (DFUs) can be created due to neuropathy and peripheral vascular disease in the lower limbs. Objectives: This study aimed to evaluate the effects of spraying oxytetracycline on DFU. Methods: This randomized clinical trial was conducted on 60 diabetic patients suffering from DFU. The patients were randomly assigned into two equal groups of intervention and control (n = 30 each). While all subjects received antibiotic therapy, blood sugar control, and, if necessary debridement, the intervention group received oxytetracycline spraying on the DFUs twice a day. After the intervention, the patients were visited every week (for three weeks), photos were taken of the DFUs by special software, and the size of the DFUs was checked. The DFUs were also studied in terms of purulent discharge, the smell, and erythema, and edema around the ulcer. After three weeks, the healing of ulcers were compared in the two groups. Data were gathered and analyzed using the SPSS software version 11.5, descriptive statistical test, chi-square, and t-test. Results: Before the study, the size of the DFUs in the intervention and control groups was 110.87 ± 38.3 and 127.12 ± 40 mm2, respectively. After the treatment, the alterations in the intervention group in the first, second, and third weeks were 14.90 ± 14.41, 26.93 ± 18.86, and 41.25 ± 19.51, respectively. Also, in the control group, the alterations were 19.45 ± 1.35, 23.78 ± 5.31, and 13.29 ± 8.75, respectively. There was a statistically significant difference in the size of DFUs between the two groups (P < 0.05). Conclusions: According to the results, spraying oxytetracycline on DFUs facilitated the process of healing. Thus, it can be used as an affordable, available, and effective method.


Author(s):  
Vasavi Gedela ◽  
Sree Lakshmi Gosala

Background: Diabetic foot infections can cause substantial morbidity. The role of Diabetes mellitus in the antimicrobial resistance of pathogens in patients with foot infections is not well clarified. So, we compared the profile of antibiotic resistance in diabetic and non-diabetic foot ulcer infections. Objectives were to compare the antimicrobial resistance pattern in diabetic and non-diabetic lower limb infections.Methods: T Pus was isolated in 50 Diabetic and 50 non-diabetic foot ulcer infections. The organisms were isolated on specific media and antibiotic susceptibility was done by using Kirby-Bauer disc diffusion method.Results: The most frequent causative organism in diabetic and non-diabetics is Pseudomonas 27.5% vs 27.1%, Staphylococcus 24.1% vs 27.1%, Klebsiella 24.1% vs 22.03%, E. coli 10.3% vs 10.16%, Proteus 5.17% vs 5.08%. No significant differences in resistance rates to Amikacin, Penicillin, Ofloxacin, Vancomycin, Piperacillin + Tazobactum were observed between diabetic and non-diabetic patients. There is significant difference in resistance to Ampicillin (p=0.017).Conclusions: Diabetes per se does not seem to influence the susceptibility pattern to antimicrobials in our group of patients with foot ulcer infections.


Author(s):  
Ghazala Usman

Background: Recent evidence states that about a quarter of all diabetic patients will experience an ulcer on foot at some point in their lifetime and 15-25% of these will require foot amputation. In the present study, we aimed to evaluate the incidence of chronic kidney disease (CKD) in Type 2 diabetes mellitus (T2DM) patients presenting with Diabetic foot ulcer. Methods: The present study was carried out at Jinnah Postgraduate Medical Center (JPMC), Sindh from February-August 2017. Over 100 Type 2 - DM patients, aged between 35-60 years who presented with diabetic foot ulcer took part in this study. Data was collected and documented in pre-approved pro-forma, subsequently, entered and analyzed via SPSS version 19. Chi-square was applied to test any significant difference between the categories with a p-value of ≤0.05 considered as significant. Results: The mean serum creatinine (mg/dl) value was reported to be 1.17 ± 0.45. Frequency of CKD in Type 2 - DM patients presenting with diabetic foot ulcer was 31%. Male gender was affected more from CKD. Frequency distribution of chronic kidney disease among duration of DM groups 10-15 years = 35.5% and >15 years = 64.5%. The characteristics of HbA1c (g/dl) of study population was 8.34 ± 0.59. Conclusion: Occurrence of CKD in Type 2 - DM patients presenting with diabetic foot ulcer was much higher as compared to national and international studies. Therefore, special attention should be given on regular screening of diabetic patients with a complaint of a foot ulcer.


2020 ◽  
Author(s):  
Yaru Sheng ◽  
Rujian Hong ◽  
Yan Sha ◽  
Zhongshuai Zhang ◽  
Kun Zhou ◽  
...  

Abstract Background: Based on the high resolution of soft tissue, MRI has gained increasing importance in the evaluation of cholesteatoma, especially diffusion-weighted imaging(DWI). The purpose of this study was to evaluate the role of 2D turbo gradient- and spin-echo (TGSE) diffusion-weighted (DW) pulse sequence with BLADE trajectory technique in the diagnosis of cholesteatoma at 3T and to qualitatively and quantitatively compare the image quality between the TGSE BLADE and RESOLVE methods.Method: A total of 42 patients (23 males, 19 females; age range, 7-65 years; mean, 40.1 years) with surgically confirmed cholesteatoma in the middle ear were enrolled in this study. All patients underwent DWI (both the prototype TGSE BLADE DWI sequence and RESOLVE DWI sequence) using a 3-T scanner with a 64-channel brain coil.Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR] for the two diffusion acquisition techniques were assessed by two independent radiologists. Result: Comparison of the qualitative scores indicated that TGSE BLADE DWI produced less geometric distortion and ghosting artifacts (P<0.001) and higher image quality (P<0.001) than RESOLVE DWI. Comparison of the evaluated quantitative image parameters between TGSE and RESOLVE showed that TGSE BLADE DWI produced a significantly lower SNR (P<0.001) and higher parameter values (both contrast and CNR (P < 0.001)) than RESOLVE DWI.The ADC (P<0.001) measured by TGSE BLADE DWI (0.763×10-3 s/mm2) is significantly lower than that measured by RESOLVE DWI (0.928×10-3 s/mm2). Conclusion: Comparing with RESOLVE DWI, TGSE BLADE DWI can significantly improve the image quality of cholesteatoma by reducing magnetic sensitive artifacts, distortion, and blurring. TGSE BLADE DWI is more valuable for the diagnosis of small-sized (2mm) cholesteatoma lesions compare with RESOLVE DWI image. However, TGSE BLADE DWI also has some disadvantages: the whole image intensity is slightly low, so that the anatomical details of the air-bone interface are not well shown, which is the place to be improved in the future.


2021 ◽  
Vol 10 (10) ◽  
pp. 205846012110553
Author(s):  
Johannes Clemens Godt ◽  
Cathrine K Johansen ◽  
Anne Catrine T Martinsen ◽  
Anselm Schulz ◽  
Helga M Brøgger ◽  
...  

Background Radiation-related cancer risk is an object of concern in CT of trauma patients, as these represent a young population. Different radiation reducing methods, including iterative reconstruction (IR), and spilt bolus techniques have been introduced in the recent years in different large scale trauma centers. Purpose To compare image quality in human cadaver exposed to thoracoabdominal computed tomography using IR and standard filtered back-projection (FBP) at different dose levels. Material and methods Ten cadavers were scanned at full dose and a dose reduction in CTDIvol of 5 mGy (low dose 1) and 7.5 mGy (low dose 2) on a Siemens Definition Flash 128-slice computed tomography scanner. Low dose images were reconstructed with FBP and Sinogram affirmed iterative reconstruction (SAFIRE) level 2 and 4. Quantitative image quality was analyzed by comparison of contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR). Qualitative image quality was evaluated by use of visual grading regression (VGR) by four radiologists. Results Readers preferred SAFIRE reconstructed images over FBP at a dose reduction of 40% (low dose 1) and 56% (low dose 2), with significant difference in overall impression of image quality. CNR and SNR showed significant improvement for images reconstructed with SAFIRE 2 and 4 compared to FBP at both low dose levels. Conclusions Iterative image reconstruction, SAFIRE 2 and 4, resulted in equal or improved image quality at a dose reduction of up to 56% compared to full dose FBP and may be used a strong radiation reduction tool in the young trauma population.


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