Clinical Physiology and Functional Imaging最新文献_第2页

Palpation versus hand‑held Doppler for identifying lower‑limb peripheral arteries: Time‑efficiency and reliability in healthy adults 触诊与手持式多普勒鉴别下肢外周动脉：健康成人的时效性和可靠性

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-12-03 DOI: 10.1111/cpf.70039

Rio Nakamine, Ryoga Matsumoto, Misaki Matsumoto, Yoshiyuki Yoshikawa, Noriaki Maeshige

Background

Bedside lower‑limb vascular assessment commonly relies on pedal pulse palpation or hand‑held Doppler, yet their relative time‑efficiency and the reliability of Doppler measurements in novices are unclear.

Methods

Twenty healthy adults were examined by three undergraduate raters without prior Doppler experience. For dorsalis pedis, anterior tibial, and posterior tibial arteries, each rater performed three trials with palpation and with a hand‑held continuous‑wave Doppler. Primary outcomes were time‑to‑identification and identification success; for Doppler, peak systolic velocity (PSV) reliability was evaluated (intra‑ and inter‑rater intraclass correlation coefficients [ICC] and Bland–Altman).

Results

Differences were defined as Doppler—palpation (positive values indicate longer time for Doppler). Palpation was faster than Doppler for dorsalis pedis (Hodges–Lehmann +6.47 s, 95% confidence interval [CI]: 2.40–8.00; p = 0.004) and posterior tibial arteries (+6.38 s, 1.10–13.61; p = 0.012). The anterior tibial artery was never identified by palpation but was identified by Doppler in all participants (exact McNemar p = 1.91 × 10⁻⁶). Doppler reliability for dorsalis pedis PSV was excellent within raters (ICC [3.1]: 0.926–0.971) and between raters (ICC [2.1]: 0.966), with small mean biases and narrow limits of agreement.

Conclusions

In healthy adults, palpation enables faster identification of dorsalis pedis and posterior tibial pulses, whereas the deeper anterior tibial artery is consistently detected only with Doppler. Doppler‑derived PSV shows excellent reproducibility even among novice examiners. These findings provide methods-level evidence to inform protocol design and training; validation in patient populations is required before any workflow recommendations.

床边下肢血管评估通常依赖于脚脉冲触诊或手持式多普勒，但其在新手中的相对时间效率和多普勒测量的可靠性尚不清楚。方法由3名没有多普勒经验的大学生评判员对20名健康成人进行检查。对于足背动脉、胫骨前动脉和胫骨后动脉，每位受试者用触诊和手持式连续波多普勒进行三次试验。主要结果为识别时间和识别成功；对于多普勒，评估峰值收缩速度（PSV）的可靠性（组内和组间组内相关系数[ICC]和Bland-Altman）。结果差异定义为多普勒触诊（阳性值表明多普勒时间较长）。触诊对足背部（hoges - lehmann +6.47 s， 95%可信区间[CI]: 2.40-8.00; p = 0.004）和胫骨后动脉（+6.38 s, 1.10-13.61; p = 0.012）均快于多普勒。胫骨前动脉从未被触诊发现，但在所有参与者中都被多普勒发现（确切的McNemar p = 1.91 × 10⁻26）。足背虫PSV的多普勒信度在评分者内（ICC[3.1]: 0.926-0.971）和评分者间（ICC[2.1]: 0.966）均极好，平均偏倚小，一致性限窄。结论：在健康成人中，触诊可以更快地识别足背和胫骨后脉，而只有多普勒才能检测到更深的胫骨前动脉。多普勒衍生的PSV显示出出色的再现性，即使在新手检查。这些发现为方案设计和培训提供了方法层面的证据；在提出任何工作流程建议之前，需要在患者群体中进行验证。

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引用次数: 0

Characterization of sympathicotonia in post-covid condition (long covid) and healthy controls using long-term electrodermal activity (EDA) follow-up 通过长期皮电活动（EDA）随访，了解新冠肺炎后（长新冠）和健康对照组交感神经张力的特征。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-11-23 DOI: 10.1111/cpf.70037

Timo Mustonen, Pasi Kytölä, Hanna Lantto, Erika Lager, Velina Vangelova-Korpinen, Hélène Virrantaus, Aleksandra Sulg, Sanna Stålnacke, Tatiana Posharina, Ritva Luukkonen, Arja Uusitalo, Päivi Piirilä, Mari Kanerva

Purpose

After SARS-CoV-2 infection, some patients develop post-COVID condition (PCC), often associated with sympathicotonia. This study aimed to characterize sympathicotonia in PCC patients using a novel long-term electrodermal activity (EDA) analysis via a smart ring and evaluate its clinical applicability.

Methods

Seventeen PCC patients were recruited from a Long Covid outpatient clinic, and 18 healthy controls volunteered. PCC patients were divided based on self-reported symptoms into those with or without sympathicotonia. A 14-day EDA monitoring was conducted. Sympathetic nervous system (SNS) activity was expressed as a double normalized index of electrodermal activity (DNE), with higher levels indicating higher SNS activity. Orthostatic tests were performed to identify orthostatic sympathicotonia. DNE levels, representing EDA, were compared to self-reported and orthostatic sympathicotonia.

Results

DNE levels did not differ between PCC patients with (N = 12) or without (N = 5) self-reported sympathicotonia or compared with nonsympathetic controls. When dividing all participants by orthostatic test results, DNE levels were lower during day (08:00–14:00; p < 0.05) but higher during late night (00:00–02:00; p < 0.05) in those with orthostatic sympathicotonia (N = 21) compared to those without (N = 14), with the 24-h comparison significant (p = 0.022). Among PCC patients, DNE levels were higher in orthostatic nonsympathicotonic (N = 7) than orthostatic sympathicotonic (N = 10) during morning (09:00–12:00; p < 0.05), with the 24-h comparison significant (p = 0.044).

Conclusion

Self-reported symptoms did not distinguish sympathicotonia. However, individuals with orthostatic test-identified sympathicotonia had heightened EDA, indicating increased sympathetic activity, particularly during late night. PCC was not identifiable by EDA. Long-term EDA monitoring may provide an objective tool for detecting sympathicotonia independently of self-reported symptoms.

目的：SARS-CoV-2感染后，部分患者出现新冠后症状（PCC），常伴有交感神经张力。本研究旨在通过智能环使用一种新颖的长期皮肤电活动（EDA）分析来表征PCC患者的交感张力，并评估其临床适用性。方法：从长冠门诊招募17例PCC患者，并自愿招募18例健康对照。根据自我报告的症状将PCC患者分为有或无交感张力。进行了为期14天的EDA监测。交感神经系统（SNS）活动以双归一化指数表示，水平越高表明SNS活动越活跃。进行直立性试验以确定直立性交感强直。将代表EDA的DNE水平与自我报告和直立性交感神经张力进行比较。结果：DNE水平在有（N = 12）或没有（N = 5）自述交感神经张力的PCC患者之间，与非交感神经张力对照组相比，没有差异。根据直立测试结果对所有参与者进行分组时，DNE水平在白天（08:00-14:00）较低；p结论：自述症状不能区分交感张力。然而，体位测试确定的交感张力个体的EDA升高，表明交感活动增加，特别是在深夜。PCC未被EDA识别。长期的EDA监测可以提供客观的工具来检测交感张力独立于自我报告的症状。

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引用次数: 0

Exercise intensity affects circulating C1q/TNF-related proteins and follistatin-like 1 concentrations 运动强度影响循环C1q/ tnf相关蛋白和卵泡抑素样1浓度。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-11-14 DOI: 10.1111/cpf.70036

Michihiro Kon, Koichi Watanabe

Background

Individuals who engage in high-intensity endurance exercise reportedly have a lower rate of mortality from metabolic diseases than do those who engage in moderate-intensity endurance exercise. However, the mechanisms underlying this association remain unclear. The cytokines C1q/tumour necrosis factor-related protein (CTRP) 3, CTRP9, and follistatin-like 1 (FSTL1) improve metabolic diseases. The secretion of these circulating cytokines is enhanced through acute endurance exercise; however, the effects of exercise intensity on this secretion have not been elucidated. We investigated the effect of exercise intensity on the circulating CTRP3, CTRP9, and FSTL1 concentrations.

Methods

Ten healthy men performed three experimental trials—moderate-intensity cycling (MIE; 50% maximal oxygen uptake), high-intensity cycling (HIE; 75% maximal oxygen uptake), and control (Con; rest)—in a crossover design. The duration of the exercise trials was varied to match the total energy expenditure between the trials. Blood samples were collected before exercise and at 0 (immediately after exercise) and 120 min after exercise. Circulating CTRP3, CTRP9, and FSTL1 concentrations were measured.

Results

In the HIE trial, significant increases in the circulating concentrations of CTRP3, CTRP9, and FSTL1 were observed after exercise compared to before exercise; however, no significant increases in these cytokines were observed in the MIE trial. Moreover, the increased ratios of the CTRP3, CTRP9, and FSTL concentrations after exercise compared to those before exercise were higher only in the HIE trial compared to the Con trial.

Conclusion

These findings indicate that circulating CTRP3, CTRP9, and FSTL1 concentrations are affected by exercise intensity during endurance exercise, increasing only after high-intensity exercise.

背景：据报道，从事高强度耐力运动的人比从事中等强度耐力运动的人死于代谢性疾病的几率要低。然而，这种关联背后的机制尚不清楚。细胞因子C1q/肿瘤坏死因子相关蛋白（CTRP） 3、CTRP9和卵泡抑素样1 （FSTL1）改善代谢性疾病。这些循环细胞因子的分泌通过急性耐力运动增强；然而，运动强度对这种分泌的影响尚未阐明。我们研究了运动强度对循环CTRP3、CTRP9和FSTL1浓度的影响。方法：10名健康男性进行了3项交叉设计试验：中强度自行车（MIE；最大摄氧量50%）、高强度自行车（HIE；最大摄氧量75%）和对照组（Con；休息）。运动试验的持续时间不同，以匹配试验之间的总能量消耗。在运动前、运动后0点和运动后120分钟采集血样。检测循环中CTRP3、CTRP9和FSTL1的浓度。结果：在HIE试验中，与运动前相比，运动后CTRP3、CTRP9和FSTL1的循环浓度显著升高；然而，在MIE试验中没有观察到这些细胞因子的显著增加。此外，运动后CTRP3、CTRP9和FSTL浓度比运动前升高的比例仅在HIE试验中高于对照组。结论：耐力运动时循环CTRP3、CTRP9和FSTL1浓度受运动强度影响，仅在高强度运动后升高。

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引用次数: 0

Echocardiographic assessment of peak atrial longitudinal strain in paroxysmal atrial fibrillation patients compared to age-matched controls 超声心动图评价阵发性心房颤动患者与年龄匹配对照的心房纵向应变峰值。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-11-05 DOI: 10.1111/cpf.70035

Larissa Bastos, Faris Al-Khalili, Magnus Bäck, Aristomenis Manouras, Johan Engdahl, Kambiz Shahgaldi

Aim

To investigate left atrial (LA) function assessed by peak atrial longitudinal strain (PALS) in an elderly population with silent paroxysmal atrial fibrillation (PAF) compared to age-matched control group.

Methods

From the STROKESTOP2-study, patients with newly diagnosed silent PAF were enrolled together in a randomly selected age-matched control group. All patients had NT-proBNP levels between 125 and 900 ng/L. Echocardiographic examinations were performed and analyzed offline using dedicated software. In addition to conventional echocardiographic variables, PALS was measured using a two-dimensional speckle tracking (2D-ST) biplane.

Results

The study population (mean age 76 ± 0.3) demonstrated significantly reduced PALS in patients with PAF (N = 69) compared to controls (N = 94) (23.9% ± 6.5% vs 30.7% ± 7.6%, p < 0.001). In the PAF group, 29 (42%) patients had normal LA volume index (LAVI) defined as $� � � � � \leq � � � �$ 34 mL/m². When subgroups with normal LAVI were compared, PALS was reduced in PAF compared to controls (25.1 ± 8.0 vs 31.1 ± 7.8, p = 0.001). NT-proBNP levels did not differ between the PAF group (median 228 ng/L) and the control group (median: 217 ng/L) (p = 0.16). In multiple linear regression analysis, left ventricular global longitudinal strain, stroke volume index and LAVI were independent predictors of PALS. Receiver operating characteristic curve identified PALS threshold <22% for predicting risk of silent PAF.

Conclusion

PALS was significantly reduced in PAF patients even in the absence of significant LA remodeling. PALS <22% predicts risk for silent PAF in general elderly population. In high-risk patients PALS could be used for AF screening enrichment.

目的：探讨老年无症状阵发性心房颤动（PAF）患者左心房（LA）功能的峰心房纵应变（PALS）评估，并与年龄匹配的对照组进行比较。方法：从strokestop2研究中，新诊断的无症状PAF患者被纳入随机选择的年龄匹配的对照组。所有患者的NT-proBNP水平均在125 - 900 ng/L之间。使用专用软件进行超声心动图检查和离线分析。除了常规超声心动图变量外，PALS还使用二维散斑跟踪（2D-ST）双翼飞机进行测量。结果：研究人群（平均年龄76±0.3岁）显示，与对照组（N = 94）相比，PAF患者（N = 69）的PALS显著降低(23.9%±6.5% vs 30.7%±7.6%,p≤$ $ 34 mL/m2。与LAVI正常的亚组相比，PAF的PALS比对照组减少（25.1±8.0 vs 31.1±7.8,p = 0.001）。NT-proBNP水平在PAF组（中位数：228 ng/L）和对照组（中位数：217 ng/L）之间没有差异（p = 0.16）。在多元线性回归分析中，左室整体纵向应变、脑卒中容积指数和LAVI是PALS的独立预测因子。结论：即使在没有明显LA重塑的情况下，PAF患者的PALS也显著降低。朋友

{"title":"Echocardiographic assessment of peak atrial longitudinal strain in paroxysmal atrial fibrillation patients compared to age-matched controls","authors":"Larissa Bastos, Faris Al-Khalili, Magnus Bäck, Aristomenis Manouras, Johan Engdahl, Kambiz Shahgaldi","doi":"10.1111/cpf.70035","DOIUrl":"10.1111/cpf.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To investigate left atrial (LA) function assessed by peak atrial longitudinal strain (PALS) in an elderly population with silent paroxysmal atrial fibrillation (PAF) compared to age-matched control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>From the STROKESTOP2-study, patients with newly diagnosed silent PAF were enrolled together in a randomly selected age-matched control group. All patients had NT-proBNP levels between 125 and 900 ng/L. Echocardiographic examinations were performed and analyzed offline using dedicated software. In addition to conventional echocardiographic variables, PALS was measured using a two-dimensional speckle tracking (2D-ST) biplane.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population (mean age 76 ± 0.3) demonstrated significantly reduced PALS in patients with PAF (<i>N</i> = 69) compared to controls (<i>N</i> = 94) (23.9% ± 6.5% vs 30.7% ± 7.6%, <i>p</i> < 0.001). In the PAF group, 29 (42%) patients had normal LA volume index (LAVI) defined as <span></span><math>\u0000 <semantics>\u0000 <mrow>\u0000 \u0000 <mrow>\u0000 <mo>≤</mo>\u0000 </mrow>\u0000 </mrow>\u0000 <annotation> $le $</annotation>\u0000 </semantics></math>34 mL/m<sup>2</sup>. When subgroups with normal LAVI were compared, PALS was reduced in PAF compared to controls (25.1 ± 8.0 vs 31.1 ± 7.8, <i>p</i> = 0.001). NT-proBNP levels did not differ between the PAF group (median 228 ng/L) and the control group (median: 217 ng/L) (<i>p</i> = 0.16). In multiple linear regression analysis, left ventricular global longitudinal strain, stroke volume index and LAVI were independent predictors of PALS. Receiver operating characteristic curve identified PALS threshold <22% for predicting risk of silent PAF.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PALS was significantly reduced in PAF patients even in the absence of significant LA remodeling. PALS <22% predicts risk for silent PAF in general elderly population. In high-risk patients PALS could be used for AF screening enrichment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The impact of epicardial adiposity on STEMI outcomes: Insights from a prospective cohort 心外膜肥胖对STEMI结果的影响：来自前瞻性队列的见解。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-10-21 DOI: 10.1111/cpf.70034

Ahmet Murat, Gürkan Karaca, Nijad Bakhshaliyev, Ahmet Ekmekci, Ali Kimiaei, Seyedehtina Safaei, Mehmet Eren

Purpose

Cardiovascular diseases, primarily driven by atherosclerosis, remain the leading cause of death worldwide. Key risk factors include diabetes, hyperlipidemia, hypertension, smoking, genetic predispositions and notably, obesity-related visceral adipose tissue (VAT). Like VAT, epicardial adipose tissue (EAT) influences heart function by releasing inflammatory cytokines. This study evaluated the relationship between EAT thickness and coronary artery disease severity, its interaction with risk factors, and its prognostic value for major cardiac and cerebrovascular events in ST-segment elevation myocardial infarction (STEMI) patients after percutaneous intervention (PCI).

Methods

We analyzed 138 STEMI patients (124 males and 14 females) treated with primary PCI at our centre, documenting medical and demographic data, cardiovascular history, risk factors, time metrics, physical and clinical examinations, EAT thickness, and biochemical parameters. Follow-ups at 1 and 6 months post-discharge tracked major cardiovascular events.

Results

The average age of the patients was 55.14 ± 12.83 years, predominantly male (89.9%), with varying prevalences of diabetes (22.5%), hypertension (38.4%), hyperlipidemia (37%), metabolic syndrome (32.6%), and family history of cardiovascular disease (47.1%). EAT thickness ranged from 1.5 to 11 mm, averaging 3.91 ± 1.42. Patients were divided into tertiles by EAT thickness, showing significant differences in age, weight, body mass index (BMI), thrombolysis in myocardial infarction (TIMI) scores, and number of affected vessels but not in mortality (7.2%), Major adverse cardiac and cerebrovascular events (MACCE) (13.8%), or combined endpoint outcomes across tertiles.

Conclusion

No correlation was found between EAT thickness and mortality or MACCE in STEMI patients, highlighting the need for validation in long-term studies.

目的：主要由动脉粥样硬化引起的心血管疾病仍然是世界范围内死亡的主要原因。主要的危险因素包括糖尿病、高脂血症、高血压、吸烟、遗传易感性，尤其是与肥胖相关的内脏脂肪组织（VAT）。像VAT一样，心外膜脂肪组织（EAT）通过释放炎症细胞因子影响心脏功能。本研究评估了st段抬高型心肌梗死（STEMI）患者经皮介入治疗（PCI）后EAT厚度与冠状动脉疾病严重程度的关系、与危险因素的相互作用以及对主要心脑血管事件的预后价值。方法：我们分析了138例STEMI患者（124例男性，14例女性）在我们的中心接受了初级PCI治疗，记录了医学和人口统计学资料、心血管病史、危险因素、时间指标、身体和临床检查、EAT厚度和生化参数。出院后1个月和6个月随访主要心血管事件。结果：患者平均年龄55.14±12.83岁，以男性为主（89.9%），糖尿病（22.5%）、高血压（38.4%）、高脂血症（37%）、代谢综合征（32.6%）、心血管疾病家族史（47.1%）的患病率各不相同。EAT厚度范围为1.5 ~ 11 mm，平均3.91±1.42。患者按EAT厚度分为各组，年龄、体重、体重指数（BMI）、心肌梗死溶栓（TIMI）评分和受影响血管数量均有显著差异，但死亡率（7.2%）、主要心脑血管不良事件（MACCE）（13.8%）或各各组的综合终点结果均无显著差异。结论：在STEMI患者中未发现EAT厚度与死亡率或MACCE之间的相关性，强调需要在长期研究中进行验证。

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引用次数: 0

Nuclear medicine in hematology: Bridging diagnostics and therapy 血液学中的核医学：连接诊断和治疗。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-10-15 DOI: 10.1111/cpf.70031

Julius Jungnitsch, Kirsten Korsholm, Fazila Asmar, Søren Møller

The investigation and therapeutic trials of hematological and hemato-oncological diseases using nuclear medicine methods dates back to the 1930s. At that time, ³²P was used as the isotope for various experimental procedures. Over the years, a wide variety of isotopes and techniques have been developed, some of which have established themselves as the gold standard in certain clinical indications, such as in the management of patients with lymphoma. Other nuclear medicine procedures are used as complementary techniques in more specific clinical scenarios. In recent years, the concept of theranostics has gained popularity in nuclear medicine. Radioendotherapies have been developed and some of them have already been FDA approved. Their promising results could potentially have a major impact on the treatment of patients with hemato-oncologic diseases. In this article we review some of the contemporary techniques used in nuclear medicine and recent developments of clinical indications in the field of hematology and oncology.

利用核医学方法对血液学和血液肿瘤学疾病的研究和治疗试验可以追溯到20世纪30年代。当时，32P被用作各种实验程序的同位素。多年来，已经开发了各种各样的同位素和技术，其中一些已成为某些临床适应症的金标准，例如淋巴瘤患者的管理。其他核医学程序在更具体的临床情况下用作补充技术。近年来，治疗学的概念在核医学中得到了普及。放射疗法已经被开发出来，其中一些已经获得了FDA的批准。他们有希望的结果可能会对血液肿瘤疾病患者的治疗产生重大影响。在这篇文章中，我们回顾了一些用于核医学的当代技术和血液学和肿瘤学领域临床适应症的最新发展。

引用次数: 0

Detection of upper airway obstruction by diaphragm ultrasound combined with inspired volume measurement 膈超声联合吸入容积检测上气道阻塞

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-10-02 DOI: 10.1111/cpf.70033

Alain Boussuges, Manon Leveque, Ralph Haddad, Camille Martinez, Eric Nussbaum, Fabienne Brégeon

Background

Upper airway stenosis may remain undiagnosed for extended periods. Ultrasound allows for the evaluation of the impact of respiratory diseases on diaphragmatic function.

Methods

Three patients presenting with symptoms suggestive of upper airway obstruction were assessed using diaphragmatic ultrasound. Simultaneously, inspired volumes were measured on a breath-by-breath basis. Inspiratory flow was calculated during both quiet and deep breathing by dividing inspired volume by excursion duration.

Results

Diaphragmatic function, studied by the measurement of excursion and thickening fraction, was preserved in all cases. However, the temporal profile of diaphragmatic excursion differed from that observed in healthy individuals. A reduction in inspiratory flow was observed and appeared to be related to the severity of obstruction, as determined by clinical presentation and flow-volume loop analysis.

Conclusion

Based on these preliminary findings, the combination of diaphragmatic ultrasound and inspired volume measurement should be able to provide valuable information in the assessment of upper airway stenosis. Further prospective studies are warranted to confirm its clinical utility.

背景：上呼吸道狭窄可能长时间未被诊断。超声允许评估呼吸系统疾病对膈功能的影响。方法对3例有上呼吸道梗阻症状的患者进行横膈膜超声检查。同时，吸气量是在每次呼吸的基础上测量的。通过吸气量除以漂移时间计算静呼吸和深呼吸时的吸气流量。结果通过测量偏移和增厚分数，所有病例的膈功能均得以保留。然而，横膈膜漂移的时间分布与健康人不同。通过临床表现和流量-容量循环分析，观察到吸气流量减少，似乎与梗阻的严重程度有关。结论基于这些初步发现，膈超声和吸入容积测量相结合可以为评估上气道狭窄提供有价值的信息。需要进一步的前瞻性研究来证实其临床应用。

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引用次数: 0

Deep learning-based 3D classification of head and neck cancer PET/MRI: Radiologist comparison and Grad-CAM interpretability 基于深度学习的头颈癌PET/MRI三维分类：放射科医师比较和Grad-CAM可解释性。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-09-25 DOI: 10.1111/cpf.70030

Joonas Liedes, Jussi Hirvonen, Oona Rainio, Sarita Murtojärvi, Simona Malaspina, Riku Klén, Jukka Kemppainen

Purpose

To develop and evaluate a three-dimensional convolutional neural network for automated classification of PET/MRI images in head and neck cancer (HNC) patients, assessing its performance against radiologist interpretation and its potential as a diagnostic aid.

Methods

Data from 202 patients with HNC who underwent ¹⁸F-FDG PET/MRI were used to train and validate PET-, MRI-, and PET/MRI-based models. Of these data, 101 patients were labelled as positive in terms of having HNC, and 101 patients as negative. An additional test set of 20 patients was also evaluated, where 10 patients were labelled as positive and 10 as negative. The model performance was assessed using sensitivity, specificity, accuracy, and AUC. Grad-CAM was utilised to improve interpretability and classification results on the test set were compared with a radiologist.

Results

The PET-based model achieved an AUC of 0.92 on the test set, with an accuracy of 90%, a sensitivity of 100% and a specificity of 80%. PET/MRI and MRI-based models underperformed relative to the PET-based model. The radiologist achieved perfect classification accuracy. Analysis of Grad-CAM showed that the model classifications are based on real areas of interest. In addition, it gave valuable insight into using similar systems in identifying false positive findings.

Conclusion

The PET-based model demonstrated high sensitivity, indicating its potential as a pre-screening tool for HNC. However, specificity requires improvement to reduce false-positive rates. Enhanced datasets and refinement of model architecture will be crucial before clinical adoption. Grad-CAM provides valuable insights into model decisions, aiding clinical integration.

目的：开发和评估用于头颈癌（HNC）患者PET/MRI图像自动分类的三维卷积神经网络，评估其对放射科医生解释的表现及其作为诊断辅助的潜力。方法：使用202例接受18F-FDG PET/MRI检查的HNC患者的数据来训练和验证基于PET、MRI和PET/MRI的模型。在这些数据中，101例患者被标记为HNC阳性，101例患者被标记为阴性。另外还对20名患者进行了评估，其中10名患者被标记为阳性，10名患者被标记为阴性。通过敏感性、特异性、准确性和AUC评估模型的性能。使用Grad-CAM来提高可解释性，并将测试集上的分类结果与放射科医生进行比较。结果：基于pet的模型在测试集上的AUC为0.92，准确率为90%，灵敏度为100%，特异性为80%。PET/MRI和基于MRI的模型相对于基于PET的模型表现不佳。放射科医生达到了完美的分类准确度。对Grad-CAM的分析表明，模型分类是基于真实感兴趣的领域。此外，它还为使用类似系统识别假阳性结果提供了宝贵的见解。结论：基于pet的模型具有较高的敏感性，表明其具有作为HNC预筛选工具的潜力。然而，特异性需要改进以减少假阳性率。在临床应用之前，增强数据集和改进模型架构将是至关重要的。Grad-CAM为模型决策提供了有价值的见解，有助于临床整合。

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引用次数: 0

Reproducibility of diastolic function parameters in repeated ECG-gated SPECT myocardial perfusion imaging and echocardiography 重复心电图门控SPECT心肌灌注成像和超声心动图舒张功能参数的可重复性。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-09-24 DOI: 10.1111/cpf.70032

Aaro Krohns, Tomi P. Laitinen, Tiina M. Laitinen, Saara Sillanmäki

Objective

To study the reproducibility of diastolic function parameters from myocardial perfusion imaging (MPI) using ECG-gated single photon emission computed tomography (SPECT), and echocardiography in repeated imaging.

Methods

We studied the reproducibility of MPI diastolic function parameters peak-filling rate (PFR) and time to peak filling (TTPF) as well as echocardiographic parameters E/A, E/e', and E-wave deceleration time (DT). The study population consisted of 21 patients who underwent routine MPI with repeated rest acquisition and echocardiography. In a test–retest setting, appropriate diastolic measures were successfully obtained using SPECT in 20 patients, with E/A measured in 18, E/e' in 17, and DT in 16 patients.

Results

We found that PFR was well reproducible with the intraclass correlation coefficient (ICC) 0.887, and coefficient of variation (CV%) 10.5. However, TTPF was poorly reproducible (ICC 0.012, and CV% 17.5). E/A was highly reproducible (ICC 0.963, and CV% 12.5). Decent reproducibility was observed for E/e' (ICC 0.809, and CV% 18.6) and DT (ICC 0.833, and CV% 12.0). We further studied the correlation between these parameters. PFR (EDV/s) had negative correlation with DT (r = −0.538, p = 0.039) and E/A had positive with E/é (r = 0.689, p = 0.002). No other significant correlations were observed (p > 0.05 for all). We also examined how parameters classified patients as normal or abnormal regarding the diastolic function. E/A and E/e´, as well as E/A and PFR showed similar classifications in 88% of cases, with a Kappa value of 0.433, p = 0.074 for both.

Conclusions

PFR obtained from repeated SPECT studies, along with the E/A ratio, is highly reproducible.

目的：探讨心电图门控单光子发射计算机断层扫描（SPECT）和超声心动图重复成像心肌灌注成像（MPI）舒张功能参数的可重复性。方法：研究MPI舒张功能参数峰充盈率（PFR）、峰充盈时间（TTPF）以及超声心动图参数E/A、E/ E′、E波减速时间（DT）的可重复性。研究人群包括21名接受常规MPI、反复休息获取和超声心动图检查的患者。在测试-重测设置中，20例患者使用SPECT成功获得适当的舒张测量，18例患者测量E/ a， 17例患者测量E/ E′，16例患者测量DT。结果：PFR重复性好，类内相关系数（ICC） 0.887，变异系数（CV%） 10.5。然而，TTPF的重复性很差（ICC 0.012, CV% 17.5）。E/A重现性高（ICC 0.963, CV% 12.5）。E/ E′（ICC 0.809, CV% 18.6）和DT （ICC 0.833, CV% 12.0）的重现性良好。我们进一步研究了这些参数之间的相关性。PFR （EDV/s）与DT呈负相关（r = -0.538, p = 0.039）， E/A与E/ 呈正相关（r = 0.689, p = 0.002）。未观察到其他显著相关性（p < 0.05）。我们还检查了参数如何将患者分类为舒张功能正常或异常。E/A和E/ E´以及E/A和PFR在88%的病例中表现出相似的分类，Kappa值为0.433，两者的p = 0.074。结论：从重复SPECT研究中获得的PFR以及E/A比具有高度可重复性。

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引用次数: 0

Hemodynamic and autonomic dysfunction in symptomatic carotid artery stenosis 症状性颈动脉狭窄的血流动力学和自主神经功能障碍

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2025-09-21 DOI: 10.1111/cpf.70029

Kristine Wichmann Madsen, Rasmus Primholdt Haahr, Tatevik Mkhitarjan, Niels Wiinberg, Jacob Rørbech Marstrand, Sverre Rosenbaum, Alexander Cuculiza Henriksen, Lisbeth Marner

Background

Hemodynamic failure in patients with steno-occlusive arterial disease is a major risk factor for stroke. Previous studies have identified impaired autonomic function in patients with carotid artery stenosis. Our study explores autonomic dysfunction and altered cerebrovascular hemodynamics in patients with stenosis and suspected hemodynamic failure.

Methods

To assess autonomic nervous system dysfunction, patients underwent heart rate variability (HRV) testing, an active stand test, and the Valsalva maneuver with simultaneous monitoring of heart rate, blood pressure, and cardiac output. Transcranial Doppler was used to measure relative changes in cerebral blood flow during Valsalva.

Results

Analysis of 13 patients and 19 controls revealed a significantly greater decrease in cerebral blood flow in the patient group during Valsalva, as evidenced by mean relative changes in time-averaged peak velocities ±SE of 0.80 ± 0.04 in patients compared to 0.96 ± 0.05 in controls (p < 0.05). There were no significant differences in mean arterial blood pressure or heart rate during the Valsalva maneuver. HRV analysis and the active stand test did not reveal autonomic dysfunction or orthostatic intolerance.

Conclusion

Patients with steno-occlusive carotid artery disease exhibit impaired intracranial flow during Valsalva-induced blood pressure reduction. However, our results do not support the presence of significant autonomic dysfunction in patients with symptomatic large-vessel cerebrovascular disease as measured by HRV and blood pressure reduction during active stand.

背景：狭窄闭塞性动脉疾病患者的血流动力学衰竭是卒中的主要危险因素。先前的研究已经发现颈动脉狭窄患者的自主神经功能受损。我们的研究探讨了血管狭窄和疑似血流动力学衰竭患者的自主神经功能障碍和脑血管血流动力学改变。方法：为了评估自主神经系统功能障碍，患者接受心率变异性（HRV）测试、主动站立试验和Valsalva动作，同时监测心率、血压和心输出量。经颅多普勒测量Valsalva期间脑血流的相对变化。结果对13例患者和19例对照组的分析显示，在Valsalva期间，患者组脑血流量明显减少，时间平均峰值速度±SE的平均相对变化为0.80±0.04，而对照组为0.96±0.05 （p < 0.05）。在Valsalva操作期间，平均动脉血压和心率没有显著差异。HRV分析和主动站立试验未发现自主神经功能障碍或直立不耐受。结论颈动脉狭窄闭塞性疾病患者在缬草碱降压过程中表现为颅内血流受损。然而，我们的研究结果不支持在有症状的大血管脑血管疾病患者中存在显著的自主神经功能障碍，通过HRV和活动站立期间的血压降低来测量。

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引用次数: 0