Objective To systematically review the value of the perfusion paramenters of Ktrans and Kep of dynamic contrast enhanced MRI(DCE-MRI) in distinguishing different histological grades of rectal cancer. Methods Databases such as PubMed, EMbase, Web of Science, The Cochrane Library (Issue 1, 2017), CBM, CNKI, WanFang Data and VIP were searched from 1990 to Feb 6th, 2017 to collect the studies according to the criteria. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies and then meta-analysis was performed by using STATA 12.0 software. Results A total of 11 studies involving 618 patients were included. The results of meta-analysis showed that there was significant difference of Ktrans between poorly differentiated grade and moderately-well differentiated grade (SMD=1.123, 95% CI 0.334 to 1.911,P=0.005), but there was no significant difference of Kep between these two groups (SMD=0.233, 95% CI –0.173 to 0.639,P=0.260). Conclusion Current evidence shows that Ktrans can be used to distinguish different histological grades of rectal cancer. The clinical application value of Kep still needs large sample original studies to further verify.
Six patients with moderate to advanced primary carcinoma of the liver were treated in this hospital with perfusion chemotherapy and embolization through the regional portal vein under the guidance of B-ultrasongraph rather than (with) operatie catheteization of the portal vein. The results show that all the tumor masses were reduced in size after the treatment (1.2-3.2cm, average value 1.9cm). It might be a new way for treating the primary carcinom of liver. The detailed procedure is descibed and the effects are also discussed in this article.
ObjectiveTo explore the application of pulmonary ventilation and perfusion imaging (V/P SPECT/CT) in quantitative evaluation of ventilation and perfusion function and its potential value in guiding local treatment of lung in patients with asthma.MethodsA total of 20 patients with asthma were included in this study. All patients underwent V/P SPECT/CT and pulmonary function test, and symptoms were assessed by the ACT questionnaire. Patients were graded for degree of airway obstruction according to V/ P SPECT/CT image visual scoring criteria. The comprehensive lung function (%) of the patients was quantitatively evaluated by combining the ventilation and perfusion defect of each lung segment in V/P imaging. The correlation between the degree of airway obstruction, comprehensive lung function, pulmonary function test and ACT score was analyzed.ResultsV/P SPECT/CT imaging can be used to grade the degree of airway obstruction in asthma patients (0-3 grade). Airway obstruction grading by V/P SPECT/CT visual score was associated with predictive forced expiratory volume in one second (FEV1%pred) of patients (r=–0.74, P<0.001). V/P SPECT/CT can also comprehensively evaluate ventilation and perfusion function in patients with asthma, and comprehensive lung function measured by this method was also correlated with FEV1%pred (r=0.629, P=0.003). V/P SPECT/CT can be used to quantitatively analyze the percentage of ventilation and perfusion function in each lung lobe. Compared with V/P SPECT/CT results, the CT volume overestimates the contribution in the upper lobes, and underestimates the lower lobes contribution to overall function.ConclusionsV/P SPECT/CT can be used as a new method to directly reflect the degree of airway obstruction in patients with asthma. Moreover, it can comprehensively and quantitatively evaluate the ventilation and perfusion function of asthma patients. V/P SPECT/CT can also be used to evaluate lobe function in patients with asthma, helping to identify the heterogeneity of changes in pulmonary function in patients with asthma, and has potential value for future treatment targeting specific areas of the lung.
Objective To investigate perfusion features of gastric antrum cancer by 64-multidetector CT and to assess the correlation between perfusion CT parameters and immunohistochemical markers of angiogenesis in gastric cancer. Methods Perfusion CT was performed in 30 patients with gastric antrum cancer （gastric antrum cancer group） and 24 patients with normal stomach (control group), and postoperative specimens were stained using a polyclonal antibody to VEGF and CD34. The correlation between perfusion parameters and microvessel density (MVD), and VEGF were analyzed. Results Blood volume (BV) increased in the gastric antrum cancer group (Plt;0.01). There was no significant difference in perfusion (PF), peak enhancement (PE), or time to peak (TTP) between the gastric antrum cancer and the normal groups (Pgt;0.05). BV was positively significantly correlated with MVD （r=0.522, P=0.02), but no significant correlation was found between PF （r=0.072, P=0.78), PE （r=0.253, P=0.31), or TTP （r=0.235, P=0.35) and MVD. No correlation was found between PF （r=-0.208, P=0.45), PE （r=-0.251, P=0.37), TTP（r=-0.284, P=0.31), or BV（r=-0.472, P=0.09) and VEGF.Conclusion Blood volume can evaluate the angiogenesis of tumor and perfusion CT can be a tool to assess microvessel status in gastric antrum cancer.
Objective To compare the perfusion pressure between cardiopulmonary bypass (CPB) through improved intubations of femoral artery-vein and routine identical flow on organic perfusion such as brain, lung, liver, kidney, intestines, etc.. Methods Twenty dogs with body weight from 10-15kg were randomly divided into two groups: thoracoscope group(n=10): CPB was set up by the right femoral artery-vein for completely video assisted cardiac operations; routine thoracotomy group(n=10): CPB was set up by the aorta-caval vein. The perfusion pressure of innominate artery, left common carotid artery, superior mesenteric artery, renal artery, homonymic and opposite side popliteal artery and the pressure of concomitant vein were measured at the following time points: instantly after induction of anesthesia (T1) , before aortic clamping (T2) , fifteen minutes after aortic clamping (T3) , fifteen minutes after aortic opening (T4) , twenty minutes after stop (T5) . The venous blood samples were collected at the preceding time points and venous oxygen saturation (SvO2) were measured. Results There were no significant difference between both groups in arterial perfusion pressure, besides perfusion pressure of homonymic popliteal artery in thoracoscope group was lower than that in routine thoracotomy group (Plt;0. 01) . Before aortic clamping, fifteen minutes after aortic clamping and fifteen minutes after aortic opening, venous pressure of renal vein, superior mesenteric vein, homonymic and opposite side popliteal vein in thoracoscope group were higher than those in routine thoracotomy group (Plt;0. 05) . SvO2 of renal vein, superior mesenteric vein, homonymic and opposite side popliteal vein in thoracoscope group were lower than those in routine thoracotomy group (Plt;0. 05) . Conclusion The improved femoral CPB has a similar perfusion pressure with routine CPB and a higher vein pressure than routine CPB below inferior vena cava after aortic intubations. So this experiment provides theoretical evidence for the organic protection of infants’ thoracoscopic extracorporeal circulation.
ObjectiveTo explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. MethodsThirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. ResultsIn the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). ConclusionCTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.
Objective To compare the difference of preparing the acellular larynx scaffold between perfusion method and immersion method, and find better way to make acellular larynx scaffold for tissue engineering. Methods Twenty 6-month-old male New Zealand rabbits, weighing 2.0-2.5 kg, were divided into perfusion group (n=10) and immersion group (n=10) at random. All the larynxes were excised in a sterile fashion. The acellular larynx scaffold was obtained by perfusionmethod and immersion method respectively, and then comparative examinations were performed by the macroscopicview, histological view, scanning electron microscope (SEM), cartilage vital ity assay and toluidine blue staining. ResultsMacroscopic view showed that the larynxes perfused by sodium dodecyl sulphate (SDS) became transparent after 2 hoursof perfusion, but the larynxes immersed by SDS over 16 hours still appeared pink-white. Histology and SEM indicated thatcompared with immersion group, perfusion group showed better acellular effect, more ventages and collagen fibers wereretained, no intact cell or nuclei remained in acellular matrix and chondrocytes were still survival. The porosity was 85.39% ± 3.16% in perfusion group and 34.72% ± 4.51% in immersion group, showing significant difference (P lt; 0.01). The chondrocyte vital ity rate of perfusion group (86.93% ± 1.52%) was higher than that of immersion group (77.73% ± 1.66%), showing significant difference (P lt; 0.01). Toluidine blue staining showed that the chondrocyte heterochromaty was ber in perfusion group than that in immersion group. Conclusion Compared with immersion method, perfusion method is a better way to construct acellular larynx scaffold because it can achieve better acellular effect and retain chondrocyte vital ity at the greatest extent in the acellular larynx scaffold.
ObjectiveTo summarize the research progress of severed limb preservation by perfusion and to analyze difference in effect of severed limb preservation by different perfusate. MethodsThe domestic and foreign related literature about severed limb preservation by perfusion was extensively reviewed and analyzed. ResultsCurrently the main perfusate includes organ perfusate,free radical scavengers,energy mixture,blood substitutes,and whole blood.They can reduce the skeletal muscle's ischemia-reperfusion injury in different degrees. ConclusionDifferent perfusate can reduce the skeletal muscle's ischemia-reperfusion injury in different degrees,but the best effect of perfusate and personalized preservation method need further study.
To evaluate the effects of different pressure and duration of autologous bile perfusion into dog’s pancreatic duct on the severity of induced acute pancreatitis. Thirty mongrel dogs were divided into five groups, with each group consisting of six dogs. Histological changes of pancreas were observed. Results: Histological changes of pancreas were correlated with the pressure and duration of autologous bile perfusion into pancreatic duct. It was easier to produce acute hemorrhagic necrotizing pancreatitis in the groups with a higher pressure and a longer duration of perfusion than in the groups with a lower pressure and a shorter duration. The results indicated that there was a significant effect of higher pressure and longer duration bile perfusion into pancreatic duct on the severity of induced acute pancreatitis.
Objective To assess the predictive value of alveolar dead space fraction ( ADSF) for severity and reperfusion of acute pulmonary embolism( APE) . Methods 39 consecutive patients with APE were enrolled in a perspective study from July 2004 to March 2007. All patients were divided into a large pulmonary embolism group ( LPE) and a small pulmonary embolism group ( SPE) based to the mass and location of the embolus. The patients of the LPE group received thrombolytic therapy and anticoagulation,while the patients of the SPE group received anticoagulation only. CTPA or lung scintigraphy was performed before and after treatment to confirm the resolve condition of the embolism after treatment. Pressure of endexpired carbon dioxide ( PETCO2 ) and blood gas analysis ( including PaCO2 ) were measured at the time of run-in and 30 days after treatment by bedside. ADSF was calculated by PET CO2 and PaCO2 . Results Among 39 APE patients, there were 18 patients in the LPE group, while 21 in the SPE group. The ADSF of the LPE group before treatment were higher than that of the SPE group ( 0. 34 ±0. 078 vs. 0. 18 ±0. 027,P lt;0. 05) . The ADSF decreased significantly after treatment in the patients with full reperfusion ( 0. 09 ±0. 04 vs. 0. 28 ±0. 11, P lt;0. 01) . Conclusion As a bedside test, ADSF can reflect the mass of embolism and the reperfusion condition, and is useful in monitoring the disease.