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.
{"title":"Detection of upper airway obstruction by diaphragm ultrasound combined with inspired volume measurement","authors":"Alain Boussuges, Manon Leveque, Ralph Haddad, Camille Martinez, Eric Nussbaum, Fabienne Brégeon","doi":"10.1111/cpf.70033","DOIUrl":"https://doi.org/10.1111/cpf.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Upper airway stenosis may remain undiagnosed for extended periods. Ultrasound allows for the evaluation of the impact of respiratory diseases on diaphragmatic function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145204799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Deep learning-based 3D classification of head and neck cancer PET/MRI: Radiologist comparison and Grad-CAM interpretability","authors":"Joonas Liedes, Jussi Hirvonen, Oona Rainio, Sarita Murtojärvi, Simona Malaspina, Riku Klén, Jukka Kemppainen","doi":"10.1111/cpf.70030","DOIUrl":"10.1111/cpf.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from 202 patients with HNC who underwent <sup>18</sup>F-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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136676","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}
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.
{"title":"Reproducibility of diastolic function parameters in repeated ECG-gated SPECT myocardial perfusion imaging and echocardiography","authors":"Aaro Krohns, Tomi P. Laitinen, Tiina M. Laitinen, Saara Sillanmäki","doi":"10.1111/cpf.70032","DOIUrl":"10.1111/cpf.70032","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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, <i>p</i> = 0.039) and E/A had positive with E/é (<i>r</i> = 0.689, <i>p</i> = 0.002). No other significant correlations were observed (<i>p</i> > 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, <i>p</i> = 0.074 for both.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PFR obtained from repeated SPECT studies, along with the E/A ratio, is highly reproducible.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130352","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}
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.
{"title":"Hemodynamic and autonomic dysfunction in symptomatic carotid artery stenosis","authors":"Kristine Wichmann Madsen, Rasmus Primholdt Haahr, Tatevik Mkhitarjan, Niels Wiinberg, Jacob Rørbech Marstrand, Sverre Rosenbaum, Alexander Cuculiza Henriksen, Lisbeth Marner","doi":"10.1111/cpf.70029","DOIUrl":"https://doi.org/10.1111/cpf.70029","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> < 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102294","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}
The present study investigates the relationship between obesity and metabolic, hormonal, and clinical indicators in adolescent girls. A total of 75 girls aged 15–19 years (mean age: 17.53 ± 1.29 years) were enrolled, including 58 with excess weight or obesity and 17 with normal weight. Anthropometric parameters related to obesity, various clinical scores, fasting glucose, fasting insulin, insulin resistance indices, lipid profile, blood pressure, and thyroid-stimulating hormone (TSH) were assessed. Mann-Whitney U test compared differences between the groups, while Spearman's rho correlation analysed the associations among adiposity, metabolic, and clinical parameters. Simple linear regression predicted insulin resistance indices using BMI, WHR, and WHtR. Receiver operating characteristic (ROC) analysis evaluated the predictive ability of BMI, WHR, and WHtR for insulin resistance. Girls with obesity exhibited significantly higher weight, BMI, WC, WHR, and WHtR (p < 0.05). Acanthosis scores and insulin resistance indices strongly correlated with BMI, WHR, and WHtR, while lipid profile parameters showed no significant association with adiposity. Regression analysis identified BMI and WHtR as strong predictors of HOMA-IR, while WHR and WHtR inversely correlated with QUICKI and GIR. The McAuley Index moderately correlated with BMI and WHtR. ROC analysis confirmed BMI (AUC = 0.779, p = 0.000) and WHtR (AUC = 0.776, p = 0.000) as strong predictors of insulin resistance. Concluding that, obesity in adolescent girls is strongly linked to insulin resistance but not lipid profile parameters. BMI and WHtR emerge as reliable predictors, with acanthosis as a potential clinical marker.
本研究旨在探讨青春期少女肥胖与代谢、激素及临床指标的关系。共纳入75名15-19岁的女孩（平均年龄：17.53±1.29岁），其中超重或肥胖58名，体重正常17名。评估与肥胖相关的人体测量参数、各种临床评分、空腹血糖、空腹胰岛素、胰岛素抵抗指数、血脂、血压和促甲状腺激素（TSH）。Mann-Whitney U检验比较了两组之间的差异，而Spearman的rho相关性分析了肥胖、代谢和临床参数之间的关系。简单线性回归用BMI、WHR和WHtR预测胰岛素抵抗指数。受试者工作特征（ROC）分析评估BMI、WHR和WHtR对胰岛素抵抗的预测能力。肥胖女生的体重、BMI、腰围、腰宽比和腰宽比均显著高于肥胖女生（p < 0.05）。棘层评分和胰岛素抵抗指数与BMI、WHR和WHtR密切相关，而脂质参数与肥胖无显著相关性。回归分析发现BMI和WHtR是HOMA-IR的强预测因子，而WHR和WHtR与QUICKI和GIR呈负相关。McAuley指数与BMI和WHtR呈正相关。ROC分析证实BMI （AUC = 0.779, p = 0.000）和WHtR （AUC = 0.776, p = 0.000）是胰岛素抵抗的有力预测因子。综上所述，青春期女孩的肥胖与胰岛素抵抗密切相关，而与血脂参数无关。BMI和WHtR是可靠的预测指标，棘层增生是潜在的临床标志。
{"title":"Adolescent obesity and insulin resistance: The role of anthropometric indicators in metabolic health","authors":"Prasenjit Chaudhuri, Debanjana Sen, Jhuma Saha, Suparna Parua, Koushik Bhattacharya, Alak Kumar Syamal","doi":"10.1111/cpf.70028","DOIUrl":"https://doi.org/10.1111/cpf.70028","url":null,"abstract":"<p>The present study investigates the relationship between obesity and metabolic, hormonal, and clinical indicators in adolescent girls. A total of 75 girls aged 15–19 years (mean age: 17.53 ± 1.29 years) were enrolled, including 58 with excess weight or obesity and 17 with normal weight. Anthropometric parameters related to obesity, various clinical scores, fasting glucose, fasting insulin, insulin resistance indices, lipid profile, blood pressure, and thyroid-stimulating hormone (TSH) were assessed. Mann-Whitney U test compared differences between the groups, while Spearman's rho correlation analysed the associations among adiposity, metabolic, and clinical parameters. Simple linear regression predicted insulin resistance indices using BMI, WHR, and WHtR. Receiver operating characteristic (ROC) analysis evaluated the predictive ability of BMI, WHR, and WHtR for insulin resistance. Girls with obesity exhibited significantly higher weight, BMI, WC, WHR, and WHtR (<i>p</i> < 0.05). Acanthosis scores and insulin resistance indices strongly correlated with BMI, WHR, and WHtR, while lipid profile parameters showed no significant association with adiposity. Regression analysis identified BMI and WHtR as strong predictors of HOMA-IR, while WHR and WHtR inversely correlated with QUICKI and GIR. The McAuley Index moderately correlated with BMI and WHtR. ROC analysis confirmed BMI (AUC = 0.779, <i>p</i> = 0.000) and WHtR (AUC = 0.776, <i>p</i> = 0.000) as strong predictors of insulin resistance. Concluding that, obesity in adolescent girls is strongly linked to insulin resistance but not lipid profile parameters. BMI and WHtR emerge as reliable predictors, with acanthosis as a potential clinical marker.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144998624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Julius Åkesson, Jonathan Edlund, Katarina Steding-Ehrenborg, Einar Heiberg
Breath-hold ECG-gated cardiovascular magnetic resonance (CMR) imaging is challenging during exercise due to motion, ECG-problems, and lengthy scans. To facilitate time-resolved volumetric measures from exercise-CMR, we aimed to develop a method for constructing time-resolved ventricular cines from real-time free-breathing exercise-CMR. Time-resolved ventricular cines were semi-automatically constructed from real-time exercise-CMR by identifying end-expiratory timeframes, identifying one R-R interval within these timeframes, and synchronizing R-R intervals across slice positions. To investigate utility, ECG-gated rest CMR and real-time exercise-CMR images were collected from ten healthy volunteers and ten heart failure patients. The consistency of the left ventricular mass (LVM) was assessed between rest and exercise at end diastole (ED), mid systole (MS), end systole (ES), and early rapid filling (ERF). When comparing LVM between rest and exercise for healthy volunteers, bias ± SD was 1.5 ± 2.7 g at ED, 0.9 ± 3.3 g at MS, 1.3 ± 3.3 g at ES, and 1.2 ± 3.3 g at ERF. When comparing LVM between rest and exercise for heart failure patients, bias ± SD was 1.6 ± 2.8 g at ED, 1.0 ± 2.7 g at MS, 1.5 ± 2.6 g at ES, and 1.6 ± 2.5 g at ERF. The bias ± SD between ED and ES in standard rest images was 0.0 ± 0.7 g for healthy volunteers, and 0.0 ± 0.5 g for heart failure patients. The method for constructing time-resolved ventricular cines from real-time exercise-CMR demonstrated utility for time-resolved volumetric measurements in healthy volunteers and heart failure patients.
{"title":"Retrospectively synchronized time-resolved ventricular cine images from 2D real-time exercise cardiac magnetic resonance imaging","authors":"Julius Åkesson, Jonathan Edlund, Katarina Steding-Ehrenborg, Einar Heiberg","doi":"10.1111/cpf.70027","DOIUrl":"https://doi.org/10.1111/cpf.70027","url":null,"abstract":"<p>Breath-hold ECG-gated cardiovascular magnetic resonance (CMR) imaging is challenging during exercise due to motion, ECG-problems, and lengthy scans. To facilitate time-resolved volumetric measures from exercise-CMR, we aimed to develop a method for constructing time-resolved ventricular cines from real-time free-breathing exercise-CMR. Time-resolved ventricular cines were semi-automatically constructed from real-time exercise-CMR by identifying end-expiratory timeframes, identifying one R-R interval within these timeframes, and synchronizing R-R intervals across slice positions. To investigate utility, ECG-gated rest CMR and real-time exercise-CMR images were collected from ten healthy volunteers and ten heart failure patients. The consistency of the left ventricular mass (LVM) was assessed between rest and exercise at end diastole (ED), mid systole (MS), end systole (ES), and early rapid filling (ERF). When comparing LVM between rest and exercise for healthy volunteers, bias ± SD was 1.5 ± 2.7 g at ED, 0.9 ± 3.3 g at MS, 1.3 ± 3.3 g at ES, and 1.2 ± 3.3 g at ERF. When comparing LVM between rest and exercise for heart failure patients, bias ± SD was 1.6 ± 2.8 g at ED, 1.0 ± 2.7 g at MS, 1.5 ± 2.6 g at ES, and 1.6 ± 2.5 g at ERF. The bias ± SD between ED and ES in standard rest images was 0.0 ± 0.7 g for healthy volunteers, and 0.0 ± 0.5 g for heart failure patients. The method for constructing time-resolved ventricular cines from real-time exercise-CMR demonstrated utility for time-resolved volumetric measurements in healthy volunteers and heart failure patients.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70027","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144929906","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}
Although force transfer during elongation occurs longitudinally and transversely, the influence of transverse force transfer between the biceps femoris long head and short head remains unclear. This study aimed to investigate whether separating the intermuscular connections between the biceps femoris long head and short head alters tension in the biceps femoris long head. Eight human cadaver legs were used, and ultrasonic shear wave elastography measurements were performed under four conditions: (1) intact, (2) removal of all tissues from the skin to the deep fascia, (3) intermuscular dissection, and (4) biceps femoris short head detachment. Measurements were taken in four limb positions, defined by hip and knee joint angles, under each tissue condition. The shear modulus of the biceps femoris long head significantly increased by 62.2% after intermuscular dissection compared to fascia removal, and further increased by 174.7% after biceps femoris short head detachment. In contrast, the shear modulus of the biceps femoris short head significantly decreased by 36.0% following intermuscular dissection and by 75.1% after detachment. In conclusion, reducing biceps femoris short head tension while increasing biceps femoris long head tension may influence muscle stress distribution, particularly during movement.
{"title":"Mechanical interactions between the biceps femoris long and short heads: Implications for T-junction hamstring injuries","authors":"Gakuto Nakao, Ginji Nara, Risa Adachi, Koki Ishiyama, Kazuyoshi Kozawa, Keita Sekiguchi, Kanna Nagaishi, Kousuke Shiwaku, Norio Hayashi, Jurdan Mendiguchia, Raki Kawama, Nobuhiro Aoki, Masaki Katayose, Keigo Taniguchi","doi":"10.1111/cpf.70026","DOIUrl":"https://doi.org/10.1111/cpf.70026","url":null,"abstract":"<p>Although force transfer during elongation occurs longitudinally and transversely, the influence of transverse force transfer between the biceps femoris long head and short head remains unclear. This study aimed to investigate whether separating the intermuscular connections between the biceps femoris long head and short head alters tension in the biceps femoris long head. Eight human cadaver legs were used, and ultrasonic shear wave elastography measurements were performed under four conditions: (1) intact, (2) removal of all tissues from the skin to the deep fascia, (3) intermuscular dissection, and (4) biceps femoris short head detachment. Measurements were taken in four limb positions, defined by hip and knee joint angles, under each tissue condition. The shear modulus of the biceps femoris long head significantly increased by 62.2% after intermuscular dissection compared to fascia removal, and further increased by 174.7% after biceps femoris short head detachment. In contrast, the shear modulus of the biceps femoris short head significantly decreased by 36.0% following intermuscular dissection and by 75.1% after detachment. In conclusion, reducing biceps femoris short head tension while increasing biceps femoris long head tension may influence muscle stress distribution, particularly during movement.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144914961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To compare measurements of skin perfusion pressure (SPP) and transcutaneous oxygen pressure (TcPO2) to predict postamputation wound healing according to amputation level.
Methods
This study was conducted as a prospective two-centre, head-to-head study.
Results
Fifty-two patients had SPP, TcPO2 measured (below and above the knee), and toe and ankle blood pressure measurements taken before major amputation. Paired measurements of SPP and TcPO2 were used to compare the methods. We found overall poor agreement between SPP and TcPO2 measurements, with crude agreement below the knee in 32 of 45 limbs (71%) and above the knee in 17 of 23 limbs (74%), with κ values of 0.32 and 0.13, respectively. Among the 29 patients whose SPP measurements below the knee indicated healing potential, seven were amputated above the knee. Blood pressure measurements above the cut-off values (30 mmHg for the toe and 80 mmHg for the ankle, above 40 mmHg SPP and TcPO2 values), were seen as an indicator of high healing potential.
Conclusion
We found poor (71%–74%) crude agreement between SPP and TcPO2, concerning measurements above and below the knee, using the established diagnostic cut-offs for predicting a high probability of postamputation wound healing. We determined that SPP and TcPO2 evaluate different physiological properties of the microcirculation and cannot be interchanged. Additionally, we found that the actual amputation level is often chosen at another level than that suggested by SPP and TcPO2, indicating that the choice is based on a multitude of factors, including clinical, paraclinical and patient-related parameters.
{"title":"Skin perfusion pressure, distal blood pressure vs. trans cutaneous oxygen pressure for predicting wound healing after major amputation","authors":"J. P. Paludan, C. Høyer, A. Høgh, H. D. Zacho","doi":"10.1111/cpf.70025","DOIUrl":"https://doi.org/10.1111/cpf.70025","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare measurements of skin perfusion pressure (SPP) and transcutaneous oxygen pressure (TcPO<sub>2</sub>) to predict postamputation wound healing according to amputation level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted as a prospective two-centre, head-to-head study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-two patients had SPP, TcPO<sub>2</sub> measured (below and above the knee), and toe and ankle blood pressure measurements taken before major amputation. Paired measurements of SPP and TcPO<sub>2</sub> were used to compare the methods. We found overall poor agreement between SPP and TcPO<sub>2</sub> measurements, with crude agreement below the knee in 32 of 45 limbs (71%) and above the knee in 17 of 23 limbs (74%), with κ values of 0.32 and 0.13, respectively. Among the 29 patients whose SPP measurements below the knee indicated healing potential, seven were amputated above the knee. Blood pressure measurements above the cut-off values (30 mmHg for the toe and 80 mmHg for the ankle, above 40 mmHg SPP and TcPO<sub>2</sub> values), were seen as an indicator of high healing potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found poor (71%–74%) crude agreement between SPP and TcPO<sub>2</sub>, concerning measurements above and below the knee, using the established diagnostic cut-offs for predicting a high probability of postamputation wound healing. We determined that SPP and TcPO<sub>2</sub> evaluate different physiological properties of the microcirculation and cannot be interchanged. Additionally, we found that the actual amputation level is often chosen at another level than that suggested by SPP and TcPO<sub>2</sub>, indicating that the choice is based on a multitude of factors, including clinical, paraclinical and patient-related parameters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cpf.70025","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869483","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}
Olli-Pekka Nuuttila, Pauliina Husu, Kari Tokola, Henri Vähä-Ypyä, Tommi Vasankari, Harri Sievänen
Background
This study aimed to examine the adherence to selected health-related fitness (HRF) tests in adults. In addition, we investigated how excluded participants or those who did not attend HRF tests differed in their background characteristics from those who attended.
Methods
Two population study samples comprising 3867 (1594 males) 20─69-year-old participants performing HRF tests, or 1249 (456 males) participants answering only the study questionnaire, were pooled for the analyses. The selected HRF tests were: one-leg stand, neck-shoulder mobility, jump-and-reach, modified push-ups, and 6-min walking test. The exclusion rate was analyzed separately for each test.
Results
In total, 14.9% of the participants were excluded from at least one test. Failure to meet the health criteria and unwillingness to perform the test were the most typical reasons for the exclusion. The exclusion rate was highest in the modified push-up test (13.2%), while in all other tests, the rate was less than 5%. Excluded participants were more likely (p < 0.001) older (46–69 years) (OR = 4.59), not meeting physical activity recommendations for endurance (OR = 2.28) and perceiving their health (OR = 3.69) and fitness (OR = 3.26) as poor. Similarly, participants who answered only the questionnaire were more likely (p < 0.01) to perceive their health (OR = 1.56) and fitness (OR = 1.41) as poor and not meeting physical activity recommendations for endurance (OR = 1.48).
Conclusions
The assessed HRF tests were feasible in terms of low exclusion rates. Individuals that were excluded or not participating the tests differed in their background characteristics from those who attended highlighting the importance of feasible testing methods to achieve a representative population sample of participants.
{"title":"Adherence to health-related fitness tests in working-aged adults—who are we (not) measuring?","authors":"Olli-Pekka Nuuttila, Pauliina Husu, Kari Tokola, Henri Vähä-Ypyä, Tommi Vasankari, Harri Sievänen","doi":"10.1111/cpf.70020","DOIUrl":"https://doi.org/10.1111/cpf.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to examine the adherence to selected health-related fitness (HRF) tests in adults. In addition, we investigated how excluded participants or those who did not attend HRF tests differed in their background characteristics from those who attended.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two population study samples comprising 3867 (1594 males) 20─69-year-old participants performing HRF tests, or 1249 (456 males) participants answering only the study questionnaire, were pooled for the analyses. The selected HRF tests were: one-leg stand, neck-shoulder mobility, jump-and-reach, modified push-ups, and 6-min walking test. The exclusion rate was analyzed separately for each test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 14.9% of the participants were excluded from at least one test. Failure to meet the health criteria and unwillingness to perform the test were the most typical reasons for the exclusion. The exclusion rate was highest in the modified push-up test (13.2%), while in all other tests, the rate was less than 5%. Excluded participants were more likely (<i>p</i> < 0.001) older (46–69 years) (OR = 4.59), not meeting physical activity recommendations for endurance (OR = 2.28) and perceiving their health (OR = 3.69) and fitness (OR = 3.26) as poor. Similarly, participants who answered only the questionnaire were more likely (<i>p</i> < 0.01) to perceive their health (OR = 1.56) and fitness (OR = 1.41) as poor and not meeting physical activity recommendations for endurance (OR = 1.48).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The assessed HRF tests were feasible in terms of low exclusion rates. Individuals that were excluded or not participating the tests differed in their background characteristics from those who attended highlighting the importance of feasible testing methods to achieve a representative population sample of participants.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 5","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lehel-Barna Lakatos, Martin Müller, Laura Weichsel, Mareike Österreich, Manuel Bolognese
Blood pressure (BP) management in acute ischaemic stroke presents uncertainties regarding whether systolic BP (sys), mean BP (mean), or diastolic BP (dia) should be used for therapeutic guidance. Repeated assessments of BP-dependent cerebral autoregulation (CA) could help identify a suitable BP modality for this purpose. Forty-nine patients (median age 75 [62–81] years; 13 women) with unilateral acute ischemic stroke (NIHSS 5 [1.75–15.0]), underwent stroke center care and dynamic cerebral autoregulation (dCA) assessments on days 1 to 3 after the stroke event. Using frequency-dependent transfer function analysis between BP and cerebral blood flow velocity (CBFV), gain indicates the amplitude transmission, and phase shift represents the phase difference between the two. CA failure is typically indicated by a low or absent phase shift in the very low (0.02–0.07 Hz) or low frequencies (0.07–0.20 Hz) ranges, leading to a direct transmission of BP changes to CBFV changes. BP values were averaged, with their standard deviation indicating BP variability (BPV). Averaged sys, mean, or dia BP did not predict gain or phase, but BPV did. In the stroke-affected hemisphere (AH), sys, mean and dia BPV on day 1 predicted low frequency gain on days 1 and 2 (p < 0.02 - p < 0.001). On day 2, dia more than mean BPV predicted linearly (p < 0.001) very low frequency phase with small phase values associated with a low BPV and large phase values with high BPV values. In acute stroke, dia BPV predicts best phase shift, and could be a promising candidate for BP guidance.
{"title":"Short-term blood pressure variability and predictability of dynamic cerebral autoregulation in acute stroke patients","authors":"Lehel-Barna Lakatos, Martin Müller, Laura Weichsel, Mareike Österreich, Manuel Bolognese","doi":"10.1111/cpf.70024","DOIUrl":"https://doi.org/10.1111/cpf.70024","url":null,"abstract":"<p>Blood pressure (BP) management in acute ischaemic stroke presents uncertainties regarding whether systolic BP (sys), mean BP (mean), or diastolic BP (dia) should be used for therapeutic guidance. Repeated assessments of BP-dependent cerebral autoregulation (CA) could help identify a suitable BP modality for this purpose. Forty-nine patients (median age 75 [62–81] years; 13 women) with unilateral acute ischemic stroke (NIHSS 5 [1.75–15.0]), underwent stroke center care and dynamic cerebral autoregulation (dCA) assessments on days 1 to 3 after the stroke event. Using frequency-dependent transfer function analysis between BP and cerebral blood flow velocity (CBFV), gain indicates the amplitude transmission, and phase shift represents the phase difference between the two. CA failure is typically indicated by a low or absent phase shift in the very low (0.02–0.07 Hz) or low frequencies (0.07–0.20 Hz) ranges, leading to a direct transmission of BP changes to CBFV changes. BP values were averaged, with their standard deviation indicating BP variability (BPV). Averaged sys, mean, or dia BP did not predict gain or phase, but BPV did. In the stroke-affected hemisphere (AH), sys, mean and dia BPV on day 1 predicted low frequency gain on days 1 and 2 (<i>p</i> < 0.02 - <i>p</i> < 0.001). On day 2, dia more than mean BPV predicted linearly (<i>p</i> < 0.001) very low frequency phase with small phase values associated with a low BPV and large phase values with high BPV values. In acute stroke, dia BPV predicts best phase shift, and could be a promising candidate for BP guidance.</p>","PeriodicalId":10504,"journal":{"name":"Clinical Physiology and Functional Imaging","volume":"45 4","pages":""},"PeriodicalIF":1.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144716674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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