Background In the chronic stage of cerebral venous sinus thrombosis （CVST）, recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance ...Background In the chronic stage of cerebral venous sinus thrombosis （CVST）, recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance venography （MRV） in the evaluation of the recanalization of CVST. Methods This study prospectively evaluated the diagnostic performance of 2-dimensional time-of-flight （2D-TOF） MRV in thirty-two consecutive patients during a threeto six-month follow-up for CVST. Both 2D-TOF MRV and digital substraction angiography （DSA） were undertaken. Diagnostic accuracy of 2D-TOF MRV in the detection of recanalized thrombus was evaluated using DSA as the reference standard. Results MRV and DSA were completed without complications in all 32 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of 2D-TOF MRV for the detection of recanalization on a segmental basis were 91% （62/68）, 93% （37/40）, 95% （62/65）, and 86% （37/43） respectively. Conclusion 2D-TOF MRV provides high sensitivity and specificity for the diagnosis of recanalized CVST segments.展开更多
Background Local hypothermia induced by intravascular infusion of cold saline solution effectively reduces brain damage in stroke. We further determined the optimal temperature of local hypothermia in our study. Metho...Background Local hypothermia induced by intravascular infusion of cold saline solution effectively reduces brain damage in stroke. We further determined the optimal temperature of local hypothermia in our study. Methods Seventy-eight adult male Sprague Dawley rats （260-300 g） were randomly divided into 3 groups： group A, ischemia/reperfusion without cold saline infusion （n=26） （control group）; group B, infusion with 20℃ saline before reperfusion （n=26）; group C： infusion with 10℃ saline before reperfusion （n=26）. In each group, we chose 15 rats for monitoring physical indexes and the temperature of the brain （cortex and striatum） and body （anus）, measurement of brain infarction volume, assessment of neurological deficits and the survival rate of reperfusion at 48 hours. Another 8 rats from each group was chosen for examining brain edema, another 3 from each group for histological observation by electron microscopy （EM） and light microscopy （LM） at 48 hours after reperfusion. Results There was no significant difference among the 3 groups for physical indexes during the examination （F（2. 45）= 0.577, P=0.568; F（2.45）= 0.42, P=0.78 for blood pressure and blood gas analysis, respectively）. The brain temperature was significantly reduced in the group C compared to the other groups （F（2.45）=37.074, P=0.000; F（2.45）=32.983, P=0.000, for cortex and striatum temperature respectively）, while the difference in rectal temperature between group A and B or C after reperfusion was not significant （F（2.45）= 0.17115,P=0.637）. And the brain infarct volume was significantly reduced in group C （from 40%±10% in group A, 26%±8% in group B, to 12%±6% in group C, F（2.45）=43.465, P=0.000） with the neurological deficits improving in group C （Х^2=27.626, P=0.000）. The survival rate at 48 hours after 10℃ and 20℃ saline reperfusion was increased by 132.5% and 150%, respectively, as compared to the control group （Х^2=10.489, P=0.005）. The extent of the brain edema showed no significant difference （F（2.21）=0.547, P=0.587） after cold saline infusion compared to the control group. No obvious vascular injury was found by electron or light microscopy in either infusion group. Conclusions Regional hypothermia with 10℃ cold saline infusion can significantly decrease the infarction volume, improve the neurological deficits, and 10℃ seems to be the optimal temperature in inducing a cerebral protection effect during stroke. This procedure could be adopted as a further treatment for acute stroke patients.展开更多
Background Cerebral venous sinus thrombosis （CVST） is a special form of stroke with multiple causes and risk factors. However, there are still a portion of cases with unknown reasons. The aim of this study was to in...Background Cerebral venous sinus thrombosis （CVST） is a special form of stroke with multiple causes and risk factors. However, there are still a portion of cases with unknown reasons. The aim of this study was to investigate the relationship between internal jugular vein （IJV） abnormalities and the development of CVST. Methods A total of 51 CVST patients and 30 healthy controls were enrolled. The diameter, the maximum velocity （Vmax） and the reflux time in bilateral IJVs were measured by color Doppler flow imaging （CDFI）. The paired t test was used to compare the numeric values between the bilateral IJVs. The Pearson chi-square test was used to evaluate the relationship between IJV abnormality and CVST, IJV abnormality and IJV reflux, respectively. Results Among the 51 CVST patients, 20 （39%） patients were with normal IJV and 31 （61%） patients were with abnormal IJV. The types of IJV abnormality included annulus stenosis 19 cases （61%）, hypoplasia 9 cases （29%）, thrombosis 2 cases （7%） and anomalous valve 1 case （3%）. In patients with unilateral IJV abnormality, the minimum diameter of the IJV on the lesion side was significantly smaller than that of the contralateral side （P 〈0.0001）. When compared with contralateral side, the Vmax of the lesion side with unilateral annulus stenosis was significant higher, however, it was obvious lower in patients with unilateral hypoplasia （P 〈0.05）. Furthermore, among 27 cases with unilateral IJV abnormality, all the CYST occurred on the same side as the IJV lesions.展开更多
Background Carotid artery stenting （CAS） as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies. This study analyzed the clinical data of 1700 consecutive patient...Background Carotid artery stenting （CAS） as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies. This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population. Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed. Postoperative 30-day complication rates were analyzed and compared with those of other studies. Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction （MI）, stroke, and death.展开更多
文摘Background In the chronic stage of cerebral venous sinus thrombosis （CVST）, recanalization can result in disparate MR appearances. We aimed to prospectively investigate the diagnostic accuracy of magnetic resonance venography （MRV） in the evaluation of the recanalization of CVST. Methods This study prospectively evaluated the diagnostic performance of 2-dimensional time-of-flight （2D-TOF） MRV in thirty-two consecutive patients during a threeto six-month follow-up for CVST. Both 2D-TOF MRV and digital substraction angiography （DSA） were undertaken. Diagnostic accuracy of 2D-TOF MRV in the detection of recanalized thrombus was evaluated using DSA as the reference standard. Results MRV and DSA were completed without complications in all 32 patients. The sensitivity, specificity, positive predictive value, and negative predictive value of 2D-TOF MRV for the detection of recanalization on a segmental basis were 91% （62/68）, 93% （37/40）, 95% （62/65）, and 86% （37/43） respectively. Conclusion 2D-TOF MRV provides high sensitivity and specificity for the diagnosis of recanalized CVST segments.
基金This research was suported by a grant from the National Natural Science Foundation of China （No. 30471780）.
文摘Background Local hypothermia induced by intravascular infusion of cold saline solution effectively reduces brain damage in stroke. We further determined the optimal temperature of local hypothermia in our study. Methods Seventy-eight adult male Sprague Dawley rats （260-300 g） were randomly divided into 3 groups： group A, ischemia/reperfusion without cold saline infusion （n=26） （control group）; group B, infusion with 20℃ saline before reperfusion （n=26）; group C： infusion with 10℃ saline before reperfusion （n=26）. In each group, we chose 15 rats for monitoring physical indexes and the temperature of the brain （cortex and striatum） and body （anus）, measurement of brain infarction volume, assessment of neurological deficits and the survival rate of reperfusion at 48 hours. Another 8 rats from each group was chosen for examining brain edema, another 3 from each group for histological observation by electron microscopy （EM） and light microscopy （LM） at 48 hours after reperfusion. Results There was no significant difference among the 3 groups for physical indexes during the examination （F（2. 45）= 0.577, P=0.568; F（2.45）= 0.42, P=0.78 for blood pressure and blood gas analysis, respectively）. The brain temperature was significantly reduced in the group C compared to the other groups （F（2.45）=37.074, P=0.000; F（2.45）=32.983, P=0.000, for cortex and striatum temperature respectively）, while the difference in rectal temperature between group A and B or C after reperfusion was not significant （F（2.45）= 0.17115,P=0.637）. And the brain infarct volume was significantly reduced in group C （from 40%±10% in group A, 26%±8% in group B, to 12%±6% in group C, F（2.45）=43.465, P=0.000） with the neurological deficits improving in group C （Х^2=27.626, P=0.000）. The survival rate at 48 hours after 10℃ and 20℃ saline reperfusion was increased by 132.5% and 150%, respectively, as compared to the control group （Х^2=10.489, P=0.005）. The extent of the brain edema showed no significant difference （F（2.21）=0.547, P=0.587） after cold saline infusion compared to the control group. No obvious vascular injury was found by electron or light microscopy in either infusion group. Conclusions Regional hypothermia with 10℃ cold saline infusion can significantly decrease the infarction volume, improve the neurological deficits, and 10℃ seems to be the optimal temperature in inducing a cerebral protection effect during stroke. This procedure could be adopted as a further treatment for acute stroke patients.
基金This research was supported by grants from Research Fund for the Doctoral Program of Higher Education of China （No. 20111107120001） and National Natural Science Foundation of China （No. 81200912）.
文摘Background Cerebral venous sinus thrombosis （CVST） is a special form of stroke with multiple causes and risk factors. However, there are still a portion of cases with unknown reasons. The aim of this study was to investigate the relationship between internal jugular vein （IJV） abnormalities and the development of CVST. Methods A total of 51 CVST patients and 30 healthy controls were enrolled. The diameter, the maximum velocity （Vmax） and the reflux time in bilateral IJVs were measured by color Doppler flow imaging （CDFI）. The paired t test was used to compare the numeric values between the bilateral IJVs. The Pearson chi-square test was used to evaluate the relationship between IJV abnormality and CVST, IJV abnormality and IJV reflux, respectively. Results Among the 51 CVST patients, 20 （39%） patients were with normal IJV and 31 （61%） patients were with abnormal IJV. The types of IJV abnormality included annulus stenosis 19 cases （61%）, hypoplasia 9 cases （29%）, thrombosis 2 cases （7%） and anomalous valve 1 case （3%）. In patients with unilateral IJV abnormality, the minimum diameter of the IJV on the lesion side was significantly smaller than that of the contralateral side （P 〈0.0001）. When compared with contralateral side, the Vmax of the lesion side with unilateral annulus stenosis was significant higher, however, it was obvious lower in patients with unilateral hypoplasia （P 〈0.05）. Furthermore, among 27 cases with unilateral IJV abnormality, all the CYST occurred on the same side as the IJV lesions.
文摘Background Carotid artery stenting （CAS） as a competing treatment modality has had to adhere to limits to gain widespread acceptance in some studies. This study analyzed the clinical data of 1700 consecutive patients after CAS to retrospectively evaluate the 30-day outcome of CAS for internal carotid artery stenosis in a Chinese population. Methods Medical records of 1700 patients who underwent CAS at Xuanwu Hospital affiliated to Capital Medical University between January 2001 and August 2012 were reviewed. Postoperative 30-day complication rates were analyzed and compared with those of other studies. Univariate and multivariate Logistic regression analyses were used to identify factors associated with perioperation myocardial infarction （MI）, stroke, and death.
