Clinical Physiology and Functional Imaging最新文献_第3页

Relationship between heart rate variability and echocardiography indices of cardiac function in healthy individuals 健康人的心率变异性与心脏功能超声心动图指数之间的关系。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-11-05 DOI: 10.1111/cpf.12910

Mushidur Rahman, Sophie L. Russell, Nduka C. Okwose, Charles J. Steward, Helen Maddock, Prithwish Banerjee, Djordje G. Jakovljevic

Purpose

This study evaluated the relationship between HRV and echocardiography indices of cardiac function.

Methods

Healthy individuals (N = 30) aged 33 ± 10 years old, underwent short-term resting HRV assessment and transthoracic echocardiography with speckle tracking analysis. Time domain - (i.e. R-R interval, root mean square of successive RR interval difference (RMSSD), standard deviation of normal RR intervals (SDNN) and frequency domain-measures of HRV (i.e. high-frequency power (HF), low-frequency power (LF), high-frequency normalised (HFnorm) and low-frequency normalised (LFnorm)). Echocardiography indices of cardiac function included; Left ventricular ejection fraction (LVEF), left- and right-ventricular global longitudinal strain (LV-GLS, and RV GLS), left atrial strain: left atrial reservoir (LA_res), left atrial conduit (LA_con) and left atrial contraction (LA_CT).

Results

The mean values for HRV time-domain measures were: R-R (991 ± 176 ms), SDNN (50.9 ± 21.5 ms), and RMSSD (46.8 ± 29.4 ms); and frequency-domain: LF (727 ± 606 ms²), HF (415 ± 35 ms²), LFnorm (56 ± 19.4) and HFnorm (36.5 ± 18.8). Mean values for indices of cardiac function were LVEF (59.9% ± 2.8%), LV-GLS (19.2% ± 1.4%), RV-GLS (21.7% ± 2.7%), LA_res (36.8% ± 6.99%), LA_con (26.2% ± 6.95%) and LA_CT (12.3% ± 3.56%). There was a significant negative relationship between HF and LV-GLS (r = −0.47, p = 0.01) and RMSSD and LVEF (r = −0.39, p = 0.03) respectively.

Conclusion

Heart rate variability measures such as high frequency power and RMSSD are associated with left ventricle systolic function in healthy individuals.

目的：本研究评估了心率变异与心脏功能超声心动图指标之间的关系。方法：年龄在 33 ± 10 岁之间的健康人（N = 30）接受了短期静息心率变异评估和带有斑点追踪分析的经胸超声心动图检查。心率变异的时域测量（即 R-R 间期、连续 RR 间期差的均方根（RMSSD）、正常 RR 间期的标准偏差（SDNN））和频域测量（即高频功率（HF）、低频功率（LF）、高频归一化（HFnorm）和低频归一化（LFnorm））。心脏功能的超声心动图指标包括：左室射血分数（LVEF）、左室和右室整体纵向应变（LV-GLS 和 RV GLS）、左房应变：左房蓄积（LAres）、左房导管（LAcon）和左房收缩（LACT）：心率变异时域测量的平均值为R-R (991 ± 176 ms)、SDNN (50.9 ± 21.5 ms) 和 RMSSD (46.8 ± 29.4 ms)；频域测量值为低频（727 ± 606 ms2）、高频（415 ± 35 ms2）、低频标准（56 ± 19.4）和高频标准（36.5 ± 18.8）。心功能指数的平均值为 LVEF（59.9% ± 2.8%）、LV-GLS（19.2% ± 1.4%）、RV-GLS（21.7% ± 2.7%）、LAres（36.8% ± 6.99%）、LAcon（26.2% ± 6.95%）和 LACT（12.3% ± 3.56%）。HF与LV-GLS（r = -0.47，p = 0.01）、RMSSD与LVEF（r = -0.39，p = 0.03）之间分别存在明显的负相关：结论：高频功率和 RMSSD 等心率变异性指标与健康人的左心室收缩功能有关。

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引用次数: 0

Plantar flexor strength and size decrease following single-leg disuse in uninjured adults: A meta-analysis 未受伤的成年人单腿废用后跖屈肌力量和大小下降：荟萃分析

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-11-04 DOI: 10.1111/cpf.12912

Nicholas Preobrazenski, Joel Seigel, Ian Janssen, Sandra Halliday, Chris McGlory

Introduction

Plantar flexors play a pivotal role in human locomotion and balance. Several original research studies and systematic reviews have characterised the impact of single-leg disuse on plantar flexor strength and size. However, no meta-analysis has quantified the effects of single-leg disuse on changes in plantar flexor strength and size in uninjured adults.

Aim

To quantify changes in plantar flexor strength and size in response to single-leg disuse.

Methods

Data were extracted from 19 studies captured in our previous systematic review on studies that employed a unilateral lower limb immobilisation model (cast or brace) and were published up to January 30, 2022. Random-effects meta-analyses were performed on original research studies reporting measures of plantar flexor strength (isometric, isokinetic, or repetition maximum) and size (magnetic resonance imaging or computed tomography) in uninjured adults.

Results

Single-leg disuse decreased plantar flexor strength (Hedges g_av = −0.71 [95% confidence interval: −0.93, −0.48], p < 0.001, 7−28 days, N = 16 studies, n = 121 participants including ≥13 females, ages 19−29) and plantar flexor size (−0.33 [−0.50, −0.15], p < 0.001, 14−35 days, N = 6, n = 49, 10 females, ages 22−27) across all durations of disuse.

Discussion

Single-leg disuse decreases plantar flexor strength and size in uninjured adults. This work adds to recent meta-analytic findings demonstrating the declines in knee extensors strength and size following single-leg disuse. The paucity of female and participants >30 years old in the single-leg disuse literature examining plantar flexors represents a priority of future work.

导言跖屈肌在人体运动和平衡中发挥着关键作用。一些原创性研究和系统性综述描述了单腿废用对跖屈肌力量和大小的影响。目的：量化单腿废用对跖屈肌力量和大小变化的影响：从我们之前的系统综述中捕获的 19 项研究中提取数据，这些研究采用了单侧下肢固定模式（石膏或支架），发表时间截至 2022 年 1 月 30 日。随机效应荟萃分析对报告未受伤成年人跖屈肌力量（等长、等动或重复最大值）和大小（磁共振成像或计算机断层扫描）测量结果的原始研究进行了分析：结果：单腿废用会降低跖屈肌的力量（海德斯伽夫=-0.71 [95%置信区间：-0.93，-0.48]，P单腿废用会降低未受伤成年人的跖屈肌力量和大小。最近的荟萃分析结果表明，单腿废用后，膝关节伸肌的力量和大小都会下降。在单腿废用的文献中，很少有女性和年龄大于 30 岁的参与者对跖屈肌进行研究，这也是未来工作的重点。

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引用次数: 0

The effect of eccentric arm cycling on muscle damage and injury-related biomarkers 手臂偏心骑行对肌肉损伤和损伤相关生物标志物的影响

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-10-13 DOI: 10.1111/cpf.12911

Frode Gottschalk, Mikael Gennser, Ola Eiken, Antonis Elia

Purpose

There is a scarcity of information regarding the effect of upper-body eccentric exercise on biomarkers of muscle damage. This study sought to investigate the effect of eccentric arm cycling on muscle damage [exercise-induced muscle damage (EIMD)].

Method

Ten subjects performed a 15 min eccentric arm cycling protocol (cadence 49 ± 7 rpm, power absorbed 248 ± 34 W). Maximal voluntary contraction (MVC) of the elbow flexors was evaluated at rest and at 5 min, 24 h, and 48 h post-exercise. In addition, blood samples were drawn at rest and thereafter at 30 min, 24 h, and 48 h intervals after exercise for quantification of creatine kinase (CK), myoglobin, lactate dehydrogenase (LDH) and endothelin (ET-1) concentrations. Delayed onset muscle soreness (DOMS) was assessed using a category ratio scale (0–10).

Results

Myoglobin was increased from baseline at 30 min post-exercise (+114%, 46.08 ± 22.17 µg/L, p = 0.018). Individual peak values were higher than baseline values for CK (+72.8%, 204 ± 138 U/L, p = 0.046) and LDH (+17%, 3.3 ± 0.88 nmole/min/mL, p = 0.017), but not for ET-1 (+9%, 1.4 ± 0.48 pg/mL, p = 0.45). DOMS was reported at 24 h (median 4) and 48 h (median 4) post-exercise and MVC of the elbow flexors were reduced from baseline (216 ± 44 N) at 5 min (−34%, 147 ± 61 N, p < 0.001), 24 h (−17%, 181 ± 56 N, p = 0.005) and 48 h (−9%, 191 ± 54 N, p = 0.003).

Conclusion

Eccentric arm cycling incites EIMD with reduced MVC and elevation of myoglobin, CK and LDH.

目的：有关上半身偏心运动对肌肉损伤生物标志物的影响的信息很少。本研究旨在调查偏心臂骑行对肌肉损伤[运动诱发的肌肉损伤（EIMD）]的影响：方法：10 名受试者进行了 15 分钟的偏心手臂骑行（速度为 49 ± 7 rpm，吸收功率为 248 ± 34 W）。分别在休息时、运动后 5 分钟、24 小时和 48 小时评估肘部屈肌的最大自主收缩力（MVC）。此外，还在休息时和运动后 30 分钟、24 小时和 48 小时抽取血液样本，以量化肌酸激酶（CK）、肌红蛋白、乳酸脱氢酶（LDH）和内皮素（ET-1）的浓度。延迟性肌肉酸痛（DOMS）采用类别比率表（0-10）进行评估：结果：运动后 30 分钟肌红蛋白比基线高（+114%，46.08 ± 22.17 µg/L，p = 0.018）。CK（+72.8%，204 ± 138 U/L，p = 0.046）和 LDH（+17%，3.3 ± 0.88 nmole/min/mL，p = 0.017）的单项峰值高于基线值，但 ET-1（+9%，1.4 ± 0.48 pg/mL，p = 0.45）的单项峰值低于基线值。运动后 24 小时（中位数为 4）和 48 小时（中位数为 4）出现 DOMS，5 分钟时肘屈肌的 MVC 从基线（216 ± 44 N）降低（-34%，147 ± 61 N，p 结论：运动后 24 小时和 48 小时，肘屈肌的 MVC 从基线（216 ± 44 N）降低（-34%，147 ± 61 N，p）：偏心臂力自行车运动会诱发 EIMD，导致肌收缩力降低以及肌红蛋白、肌酸激酶和低密度脂蛋白胆固醇升高。

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引用次数: 0

COVID-19 is associated with cardiac structural and functional remodelling in healthy middle-aged and older individuals COVID-19 与健康中老年人的心脏结构和功能重塑有关。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-10-08 DOI: 10.1111/cpf.12909

Mushidur Rahman, Sophie L. Russell, Nduka C. Okwose, Gordon McGregor, Helen Maddock, Prithwish Banerjee, Djordje G. Jakovljevic

Background

Coronavirus disease 2019 (COVID-19) was declared a global pandemic in 2019. It remains uncertain to what extent COVID-19 effects the heart in heathy individuals. To evaluate the effect of the COVID-19 on cardiac structure and function in middle-aged and older individuals.

Methods

A single-centre prospective observational study enroled a total of 124 participants (84 with history of COVID-19 [COVID-19 group] and 40 without a history of COVID-19 [non-COVID group]). All participants underwent echocardiography with speckle tracking to assess cardiac structure and function at rest and during peak exercise.

Results

There were no differences in left and right ventricular diastolic function (p ≥ 0.05) between the COVID-19 and non-COVID-19 groups. Participants in COVID-19 group demonstrated higher left ventricular mass (130 ± 39.8 vs. 113 ± 27.2 g, p = 0.008) and relative wall thickness (0.38 ± 0.07 vs. 0.36 ± 0.13, p = 0.049). Left ventricular global longitudinal strain was reduced in the COVID-19 group at rest and at peak-exercise (rest: 18.3 ± 2.01 vs. 19.3 ± 1.53%, p = 0.004; peak exercise: 19.1 ± 2.20 vs. 21.0 ± 1.58%, p ≤ 0.001). However, no difference was seen in resting left ventricular ejection fraction (58 ± 2.89 vs. 59 ± 2.51%, p = 0.565) between groups. Right ventricular fractional area change was reduced in the COVID-19 group (p = 0.012).

Conclusion

Cardiac structural and functional remodelling was observed in middle-aged and older otherwise healthy individuals with a history of COVID-19.

背景：2019年冠状病毒病（COVID-19）被宣布为2019年全球大流行病。目前仍不确定COVID-19对健康人心脏的影响程度。评估 COVID-19 对中老年人心脏结构和功能的影响：一项单中心前瞻性观察研究共招募了 124 名参与者（其中 84 人有 COVID-19 病史 [COVID-19 组]，40 人无 COVID-19 病史 [非 COVID 组]）。所有参与者都接受了斑点追踪超声心动图检查，以评估静息状态和运动高峰期的心脏结构和功能：结果：COVID-19 组和非 COVID-19 组的左心室和右心室舒张功能没有差异（P ≥ 0.05）。COVID-19 组参与者的左心室质量（130 ± 39.8 vs. 113 ± 27.2 g，p = 0.008）和相对室壁厚度（0.38 ± 0.07 vs. 0.36 ± 0.13，p = 0.049）较高。COVID-19 组的左心室整体纵向应变在静息和运动峰值时均有所降低（静息：18.3 ± 2.01 vs 0.36 ± 0.13，p = 0.049）：18.3 ± 2.01 vs. 19.3 ± 1.53%，p = 0.004；运动峰值：19.1 ± 2.20 vs. 21.0 ± 1.58%，p ≤ 0.001）。然而，各组间静息左心室射血分数（58 ± 2.89 vs. 59 ± 2.51%，p = 0.565）无差异。COVID-19组的右心室射血分数面积变化减少（p = 0.012）：结论：在有 COVID-19 病史的中老年健康人群中观察到心脏结构和功能重塑。

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引用次数: 0

The prognostic value of [18F]FDG PET/CT texture analysis prior to transplantation for unresectable colorectal liver metastases 无法切除的结直肠肝转移瘤移植前[18F]FDG PET/CT 纹理分析的预后价值。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-10-02 DOI: 10.1111/cpf.12908

Nadide Mutlukoca Stern, Lars Tore Gyland Mikalsen, Svein Dueland, Anselm Schulz, Pål-Dag Line, Caroline Stokke, Harald Grut

Introduction

To determine whether heterogeneity in colorectal liver metastases (CRLM) ¹⁸F fluorodeoxyglucose [¹⁸F]FDG distribution is predictive of disease-free survival (DFS) and overall survival (OS) following liver transplantation (LT) for unresectable CRLM.

Methods

The preoperative [¹⁸F]FDG positron emission tomography/computed tomography examinations of all patients in the secondary cancer 1 and 2 studies were retrospectively assessed. Maximum standardized uptake value (SUV_max), metabolic tumour volume (MTV), and six texture heterogeneity parameters (joint entropy_GLCM, dissimilarity_GLCM, grey level variance_SZM, size zone variance_SZM, and zone percentage_SZM, and morphological feature convex deficiency) were obtained. DFS and OS for patients over and under the median value for each of these parameters were compared by using the Kaplan Meier method and log rank test.

Results

Twenty-eight out of 40 patients who underwent LT for unresectable CRLM had liver metastases with uptake above liver background and were eligible for inclusion. Low MTV (p < 0.001) and dissimilarity_GLCM (p = 0.016) were correlated to longer DFS. Low MTV (p < 0.001) and low values of the texture parameters dissimilarity_GLCM (p = 0.038), joint entropy_GLCM (p = 0.015) and zone percentage_SZM (p = 0.037) were significantly correlated to longer OS. SUV_max was not correlated to DFS and OS.

Conclusion

Although some texture parameters were able to significantly predict DFS and OS, MTV seems to be superior to predict both DFS and OS following LT for unresectable CRLM.

导言：目的：确定结直肠肝转移瘤（CRLM）18F氟脱氧葡萄糖[18F]FDG分布的异质性是否可预测不可切除CRLM肝移植术后的无病生存期（DFS）和总生存期（OS）：方法：对二次癌症1和2研究中所有患者的术前[18F]FDG正电子发射断层扫描/计算机断层扫描检查进行了回顾性评估。获得了最大标准化摄取值（SUVmax）、代谢肿瘤体积（MTV）和六个纹理异质性参数（联合熵GLCM、异质性GLCM、灰度方差SZM、大小区方差SZM、大小区百分比SZM和形态特征凸缺）。采用 Kaplan Meier 法和对数秩检验比较了超过和低于上述各项参数中位值的患者的 DFS 和 OS：40例因无法切除的CRLM而接受LT治疗的患者中，有28例患者的肝脏转移灶摄取量高于肝脏本底，符合纳入条件。低 MTV (p GLCM (p = 0.016) 与较长的 DFS 相关。低MTV（p GLCM（p = 0.038）、联合熵GLCM（p = 0.015）和区域百分比SZM（p = 0.037）与较长的OS显著相关。SUVmax与DFS和OS无关：结论：虽然一些纹理参数能显著预测DFS和OS，但MTV似乎更能预测不可切除CRLM经LT治疗后的DFS和OS。

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引用次数: 0

Assessing body composition through anthropometry: Implications for diagnosing and managing polycystic ovary syndrome (PCOS) 通过人体测量评估身体成分：多囊卵巢综合征 (PCOS) 诊断和管理的意义。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-09-25 DOI: 10.1111/cpf.12905

Suparna Parua, Arnab Das, Anukona Hazra, Prasenjit Chaudhuri, Koushik Bhattacharya, Sulagna Dutta, Pallav Sengupta

Polycystic ovary syndrome (PCOS) is a multifaceted endocrine disorder with profound implications for the reproductive and metabolic health of women. The utilization of anthropometric measures in the diagnosis and management of PCOS has gained increasing attention due to their practicality and predictive capacity for associated conditions such as obesity and insulin resistance. This review rigorously explores the application of various anthropometric indices, including body mass index, waist-to-hip ratio, and advanced metrics such as the body shape index and body roundness index, wrist circumference, neck circumference. These indices offer critical insights into body fat distribution and its association with the metabolic and hormonal perturbations characteristic of PCOS. The review underscores the necessity of addressing obesity, a prevalent comorbidity in PCOS, through lifestyle modifications and personalized therapeutic approaches. By incorporating anthropometric evaluations into routine clinical practice, healthcare professionals can enhance diagnostic precision, optimize treatment strategies, and ultimately improve patient outcomes. This integrative approach not only facilitates the management of the metabolic challenges inherent in PCOS but also contributes to the development of more individualized therapeutic interventions, thereby enhancing the overall quality of life for women affected by PCOS.

多囊卵巢综合征（PCOS）是一种多方面的内分泌失调症，对妇女的生殖和代谢健康有着深远的影响。由于其实用性以及对肥胖和胰岛素抵抗等相关疾病的预测能力，在多囊卵巢综合征的诊断和管理中使用人体测量指标的做法日益受到关注。本综述严格探讨了各种人体测量指数的应用，包括体重指数、腰臀比、体形指数和体圆指数、腕围、颈围等高级指标。这些指数为了解体脂分布及其与多囊卵巢综合症特有的代谢和激素紊乱之间的关系提供了重要依据。该综述强调了通过改变生活方式和个性化治疗方法来解决肥胖这一多囊卵巢综合症常见合并症的必要性。通过将人体测量评估纳入常规临床实践，医护人员可以提高诊断的准确性，优化治疗策略，并最终改善患者的预后。这种综合方法不仅有助于应对多囊卵巢综合症固有的代谢挑战，还有助于开发更加个性化的治疗干预措施，从而提高受多囊卵巢综合症影响的女性的整体生活质量。

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引用次数: 0

Limb dominance does not have a meaningful impact on arterial occlusion pressure 肢体优势对动脉闭塞压的影响不大。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-09-24 DOI: 10.1111/cpf.12906

Yujiro Yamada, William B. Hammert, Ryo Kataoka, Jun Seob Song, Anna Kang, Jeremy P. Loenneke

Introduction

Limb dominancy has been suggested, by some, to influence arterial occlusion pressure (AOP). However, we hypothesized that the differences in AOP between the dominant and nondominant legs were more likely explained by differences in cuff position.

Aims

To determine the impact of limb dominance, composition, and cuff position on AOP in the context of error associated with measuring AOP twice on the same leg.

Methods

Fifty-eight adults (30 males) volunteered to have AOP measured on their dominant legs with the cuff bladder covering their inner thighs and on their nondominant legs with the bladder covering their inner and outer thighs (in random order). Thigh circumference and muscle and fat thicknesses were also measured on each leg.

Results

We found evidence for differences in AOP between legs [median δ of −0.222, 95% credible interval: (−0.429, −0.016)] when the cuff position was matched. The mean difference was −2.8 mmHg, and the 95% limit of agreement in a Bland–Altman plot was −24.8 to 19.0 mmHg. When plotting this alongside an error range (i.e., 95% limits of agreement) of taking the same measurement twice from our previous study (Spitz et al., 2020), 52 out of 58 measurements were within the error range. This difference was not due to the cuff position. Additionally, there was no evidence that thigh circumference or composition (muscle/fat thickness) moderated any difference between limbs.

Conclusion

The difference in AOP between limbs is small and is mostly indistinguishable from the difference observed from taking the measurement twice on the same limb.

简介：有些人认为肢体优势会影响动脉闭塞压（AOP）。然而，我们假设优势腿和非优势腿之间 AOP 的差异更可能是由袖带位置的差异造成的。目的：确定肢体优势、组成和袖带位置对 AOP 的影响，同时考虑到在同一条腿上测量两次 AOP 所产生的误差：58 名成年人（30 名男性）自愿接受 AOP 测量，其中优势腿的袖带膀胱覆盖大腿内侧，非优势腿的袖带膀胱覆盖大腿内侧和外侧（随机顺序）。同时还测量了每条腿的大腿围、肌肉和脂肪厚度：我们发现，当袖带位置匹配时，两条腿之间的 AOP 存在差异[中位数 δ 为 -0.222，95% 可信区间：(-0.429, -0.016)]。平均差为-2.8 mmHg，在布兰-阿尔特曼图中，95% 的一致限度为-24.8 至 19.0 mmHg。将这一结果与我们之前的研究（Spitz 等人，2020 年）中两次测量同一数据的误差范围（即 95% 的一致性界限）相比较，58 次测量中有 52 次在误差范围内。这种差异不是袖带位置造成的。此外，没有证据表明大腿围度或组成（肌肉/脂肪厚度）会调节肢体间的任何差异：结论：肢体间 AOP 的差异很小，与在同一肢体上测量两次所观察到的差异基本没有区别。

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引用次数: 0

PET/MRI in paediatric inflammatory bowel disease – a prospective accuracy study PET/MRI 在儿科炎症性肠病中的应用--前瞻性准确性研究。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-09-23 DOI: 10.1111/cpf.12903

Sina Dalby, Reza Piri, Ole Graumann, Oke Gerke, Thomas Lund Andersen, Anne-Mette Walsted, Kirsten Risby, Rasmus Gaardskær Nielsen, Anders Linnemann, Poul Flemming Høilund-Carlsen, Steffen Husby

Cross-sectional imaging supplements endoscopy in detecting disease manifestations in inflammatory bowel diseases (IBD). This study aimed to evaluate the accuracy of PET/MRI in a paediatric population suspected of IBD. This prospective study consecutively included patients aged 8–17 years under diagnostic evaluation for IBD. Forty-three patients underwent a PET/MRI scan and subsequent ileocolonoscopy, of whom 26 patients diagnosed with IBD participated in a follow-up scan, hereof 19 with Crohn's disease (CD), five with Ulcerative colitis and two with unclassified IBD. The results of PET alone, MRI alone, and PET/MRI combined were compared to a reference standard of endoscopy and histopathology. Of the 208 intestinal segments analysed, 109 showed inflammation, and 99 had no inflammation. In the per-segment analysis PET had a sensitivity of 0.83 (95% CI 0.73–0.93), specificity of 0.59 (95% CI 0.47–0.71), and area under the receiver operating characteristic curve (AUROC) of 0.73 (95% CI 0.67–0.80). MRI had a sensitivity of 0.52 (95% CI 0.41–0.64), specificity 0.89 (95% CI 0.82–0.96), and AUROC of 0.72 (95% CI 0.66–0.77). PET/MRI had a sensitivity of 0.83 (95% CI 0.74–0.94), specificity of 0.57 (95% CI 0.44–0.69), and AUROC of 0.77 (95% CI 0.71–0.84). At follow-up, PET and MRI scores decreased, and the change in MRI was able to identify patients with a clinical response. The accuracy of the PET/MRI scan in detecting inflammation in the terminal ileum and colon was moderate and not superior to either modality alone. With technological advances and combined reading, PET/MRI may still be valuable in selected cases.

在检测炎症性肠病（IBD）的疾病表现方面，横断面成像是内窥镜检查的补充。本研究旨在评估 PET/MRI 在疑似 IBD 儿童人群中的准确性。这项前瞻性研究连续纳入了 8-17 岁接受 IBD 诊断评估的患者。43名患者接受了PET/MRI扫描和随后的回肠结肠镜检查，其中26名确诊为IBD的患者参加了后续扫描，其中19人患有克罗恩病（CD），5人患有溃疡性结肠炎，2人患有未分类的IBD。将单独 PET、单独 MRI 和 PET/MRI 联合扫描的结果与内窥镜检查和组织病理学检查的参考标准进行了比较。在分析的 208 个肠段中，109 个出现炎症，99 个没有炎症。在每段分析中，PET 的灵敏度为 0.83（95% CI 0.73-0.93），特异性为 0.59（95% CI 0.47-0.71），接收者操作特征曲线下面积 (AUROC) 为 0.73（95% CI 0.67-0.80）。MRI 的灵敏度为 0.52（95% CI 0.41-0.64），特异性为 0.89（95% CI 0.82-0.96），接收器操作特征曲线下面积为 0.72（95% CI 0.66-0.77）。PET/MRI 的灵敏度为 0.83（95% CI 0.74-0.94），特异性为 0.57（95% CI 0.44-0.69），AUROC 为 0.77（95% CI 0.71-0.84）。随访时，PET 和 MRI 评分均有所下降，MRI 的变化能够识别出有临床反应的患者。PET/MRI 扫描在检测回肠末端和结肠炎症方面的准确性适中，并不优于单独使用其中一种方式。随着技术的进步和联合阅片，PET/MRI 在特定病例中可能仍有价值。

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引用次数: 0

Microvascular effects of a mixed meal tolerance test: a model validation study 混合餐耐受性测试对微血管的影响：模型验证研究。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-09-23 DOI: 10.1111/cpf.12904

Sebastiaan J. W. van Kraaij, Boukje Charlotte Eveleens Maarse, Femke P. M. Hoevenaars, Ines Warnke, Marieke L. de Kam, Matthijs Moerland, Pim Gal

Purpose

Endothelial dysfunction is a pathophysiological change preceding many cardiovascular events. Measuring improvements of endothelial function is challenging when function is already optimal, which may be remediated using a physiological challenge. This study aimed to determine whether imaging assessments can detect microvascular effects of a mixed meal tolerance test (MMTT).

Methods

Twenty healthy volunteers (age ≥45 and ≤70 years) underwent two MMTTs at the beginning (Day 1) and end (Day 84) of a twelve-week period. Imaging methods included laser speckle contrast imaging (LSCI) combined with post-occlusive reactive hyperaemia (PORH) and local thermal hyperaemia (LTH) challenges, passive leg movement ultrasonography (PLM), and sidestream dark field microscopy (SDFM). Measurements were conducted pre-MMTT and at 5 timepoints post-MMTT for PLM and SDFM and 3 timepoints post-MMTT for PORH and LTH.

Results

No consistent effects of the MMTT were detected on LSCI LTH, PLM and SDFM endpoints. LSCI PORH maximum perfusion was significantly suppressed 46, 136, and 300 min post-MMTT administration on Day 1, while residual perfusion decreased significantly 46 and 136 min post-MMTT on Day 1. However, when repeated on Day 84, PORH endpoints were not significantly affected by the MMTT.

Conclusion

SDFM, PLM and LSCI LTH endpoints displayed high intra-subject variability and did not detect consistent effects of MMTT. LSCI PORH endpoints displayed the lowest intra-subject variability of all assessed endpoints and were affected by the MMTT on Day 1, but not on Day 84. Further standardization of methods or more robust challenges to affect vascular endpoints may be needed.

目的：内皮功能障碍是许多心血管事件发生前的一种病理生理变化。当内皮功能已经达到最佳状态时，测量内皮功能的改善情况具有挑战性，而生理挑战可能会对内皮功能进行补救。本研究旨在确定成像评估是否能检测混合膳食耐受试验（MMTT）对微血管的影响：方法：20 名健康志愿者（年龄≥45 岁和≤70 岁）在为期 12 周的开始（第 1 天）和结束（第 84 天）时接受了两次 MMTT。成像方法包括激光斑点对比成像（LSCI）结合闭塞后反应性高血症（PORH）和局部热高血症（LTH）挑战、被动腿部运动超声波成像（PLM）和侧流暗视野显微镜（SDFM）。PLM和SDFM的测量在MMTT前和MMTT后的5个时间点进行，PORH和LTH的测量在MMTT后的3个时间点进行：结果：未发现 MMTT 对 LSCI LTH、PLM 和 SDFM 终点有一致的影响。第 1 天服用 MMTT 后 46、136 和 300 分钟，LSCI PORH 最大灌注量明显受到抑制，而第 1 天服用 MMTT 后 46 和 136 分钟，残余灌注量明显下降。然而，在第 84 天重复使用时，PORH 终点没有受到 MMTT 的明显影响：结论：SDFM、PLM 和 LSCI LTH 终点显示出很高的受试者内变异性，并没有检测到 MMTT 的一致影响。LSCI PORH终点在所有评估终点中显示出最低的受试者内变异性，在第1天受到MMTT的影响，但在第84天没有受到影响。可能需要进一步规范方法或进行更有力的挑战来影响血管终点。

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引用次数: 0

High concordance of PET-CT treatment response evaluation according to PERCIST 1.0 when comparing images reconstructed with OSEM vs. BSREM 对比OSEM和BSREM重建的图像，根据PERCIST 1.0评价PET-CT治疗反应的一致性高。

IF 1.3 4区医学 Q4 PHYSIOLOGY

Clinical Physiology and Functional Imaging

Pub Date : 2024-09-20 DOI: 10.1111/cpf.12907

Tilda Skoglund, David Minarik, Lars Edenbrandt, Elin Trägårdh

Background

Positron emission tomography (PET) response criteria in solid tumours (PERCIST 1.0) is a systematic assessment of therapy response with fluorine 18 fluorodeoxyglucose ([¹⁸F]FDG) PET. The ordered subset expectation maximization (OSEM) and block sequential regularized expectation maximization (BSREM) reconstruction algorithms are both commonly used. The impact of using OSEM or BSREM on PERCIST 1.0 is not fully determined. This study aimed to compare treatment response evaluation between the reconstructions OSEM and BSREM according to PERCIST 1.0.

Methods

The highest peak standardized uptake value corrected for lean body mass (SUL_peak) in a lesion were measured in PET-CT scans from 90 patients with metastatic breast cancer or malignant melanoma, who had undergone two [¹⁸F]FDG PET with computer tomography (CT) scans for treatment evaluation purpose. SUL measurements in the reference organ were also calculated. All scans were reconstructed with OSEM and BSREM. Bland Altman plots and Spearman correlation coefficient were used for comparing measurements obtained from OSEM and BSREM images. Patients were categorized as a complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), or progressive metabolic disease (PMD).

Results

The mean standard deviation (SD) of SUL_mean in the reference organ was slightly lower for BSREM images, resulting in a slightly lower threshold. Lesion SUL_peak was slightly higher for BSREM images compared with OSEM images. Only 5 out of 90 patients had different response evaluations for the different reconstructions.

Conclusion

PERCIST 1.0 serves as a robust response evaluation criterion and is only marginally dependent on the reconstruction used.

背景：实体肿瘤正电子发射断层扫描（PET）反应标准（PERCIST 1.0）是对氟- 18氟脱氧葡萄糖（[18F]FDG） PET治疗反应的系统评估。有序子集期望最大化重构算法（OSEM）和块顺序正则化期望最大化重构算法（BSREM）都是常用的重构算法。使用OSEM或BSREM对PERCIST 1.0的影响尚未完全确定。本研究旨在比较重建OSEM和重建BSREM的治疗反应评价。方法：对90例转移性乳腺癌或恶性黑色素瘤患者进行了两次[18F]FDG PET和计算机断层扫描（CT），以评估治疗效果，并在PET-CT扫描中测量病变中经瘦体重校正的最高标准化摄取值（SULpeak）。还计算了参考器官的SUL测量值。所有扫描都用OSEM和BSREM重建。使用Bland Altman图和Spearman相关系数比较OSEM和BSREM图像的测量结果。患者被分类为完全代谢反应（CMR）、部分代谢反应（PMR）、稳定代谢疾病（SMD）或进行性代谢疾病（PMD）。结果：BSREM图像的参比器官SULmean的平均标准偏差（SD）略低，导致阈值略低。与OSEM图像相比，BSREM图像的病变SULpeak略高。90例患者中只有5例对不同的重建有不同的反应评价。结论：PERCIST 1.0可作为一个可靠的反应评价标准，仅与所使用的重建有轻微的关系。

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引用次数: 0