UNASSIGNED: Large-scale investigations on ascending aortic diameter, especially in the Asian population, are lacking. Furthermore, relevant evidence regarding the distribution of hypertension (HP), bicuspid aortic valve (BAV), and Marfan syndrome (MFS) is scarce. We aimed to examine the distribution of ascending aortic diameter in these populations in China.
UNASSIGNED: The data of a total number of 698 795 individuals who underwent cardiac ultrasound were subjected to retrospective analysis. After screening, 647 087 individuals were included in the final analysis. In the normal population, the mean ascending aortic diameter was 28.1 ± 3.2 mm (27.2 ± 3.1 mm in women vs. 29.0 ± 3.1 mm in men) (P < 0.001). Aortic diameter increased gradually with age (P < 0.001). The prevalence of aortic dilation, aneurysm, and dissection in individuals with HP was 12.83%, 2.70%, and 4.77%, respectively. In individuals with MFS, the corresponding rates were 43.92%, 35.31%, and 26.11%. Notably, although BAV patients had high incidences of aortic dilation (37.00%) and aortic aneurysm (16.46%), the incidence of aortic dissection was relatively low (0.74%). Most cases of aortic dissection occurred at an aortic diameter of less than 55 mm. However, in the overall population, the incidence of aortic dissection significantly increased with the increase in the aortic diameter, revealing the existence of an \'aortic paradox\'.
UNASSIGNED: (i) The ascending diameter increases with age and is larger in men than in women; (ii) \'Aortic paradox\' is explained; (iii) BAV bears a high rate of aortic dilation, but a low incidence of aortic dissection.

暂无摘要。

OBJECTIVE: To evaluate the occurrence of aortic dilatation and its associated predictors with coarctation of the aorta (CoA) in infants using multi-slice computed tomography (MSCT).
METHODS: The clinical data of 47 infantile patients with CoA diagnosed by MSCT and 28 infantile patients with simple ventricular septal defect were analyzed retrospectively. Aortic diameters were measured at six different levels, and aortic sizes were compared by z score. The coarctation site-diaphragm ratio was used to describe the degree of narrowing. Relevant clinical data were collated and analyzed.
RESULTS: The dilation rate and z score of the ascending aorta in the severe CoA group were significantly higher than those in the mild CoA group (11 [52.38%] vs. 21 [80.77%], P=0.038 and 2.00 ± 0.48 vs. 2.36 ± 0.43, P=0.010). Pearson\'s correlation analysis found that the z score of the ascending aorta was negatively correlated with the coarctation site-diaphragm ratio value (r=-0.410, P=0.004). A logistic retrospective analysis found that an increased degree of coarctation was an independent predictor of aortic dilatation (adjusted odds ratio 0.002; 95% confidence interval 0.00-0.819; P=0.043). The z score of the ascending aorta in the severe CoA group was significantly higher than that in the ventricular septal defect group (P<0.05).
CONCLUSIONS: Most infants with CoA can also have significant dilatation of the ascending aorta, and the degree of this dilatation is related to the degree of coarctation. Assessment of aortic diameter and related malformations by MSCT can predict the risk of aortic dilatation in infants with CoA.

OBJECTIVE: To improve the scan efficiency of thoracic aorta vessel wall imaging using a self-gating (SG)-based motion correction scheme.
METHODS: A slab-selective variable-flip-angle 3D turbo spin-echo (SPACE) sequence was modified to acquire SG signals and imaging data. Cartesian sampling with a tiny golden-step spiral profile ordering was used to obtain the imaging data during the systolic period, and then the image data were subsequently corrected based on the SG signals and binned to different respiratory cycles. Finally, respiratory artifacts were estimated from image-based registration of 3D undersampled respiratory bins that were reconstructed with L1 iterative self-consistent parallel imaging reconstruction (SPIRiT). This method was evaluated in 11 healthy volunteers and compared against conventional diaphragmatic navigator-gated acquisition to assess the feasibility of the proposed framework.
RESULTS: Results showed that the proposed method achieved image quality comparable to that of conventional diaphragmatic navigator-gated acquisition with an average scan time of 4 min. The sharpness of the vessel wall and the definition of the liver boundary were in good agreement with the navigator-gated acquisition, which took approximately above 8.5 min depend on the respiratory rate. Further valuation of this technique in patients will be conducted to determine its clinical use.

暂无摘要。

UNASSIGNED: Three-dimensional (3D) black-blood (BB) vessel wall imaging is a promising noninvasive imaging technique for assessing thoracic aortic diseases. We aimed to develop and evaluate a fast thoracic aorta vessel wall imaging method with patch-based low-rank tensor (Pt-LRT) reconstruction using the 3D-modulated variable flip angle fast-spin echo (vFA-FSE) sequence.
UNASSIGNED: The Pt-LRT technique adopts a low-rank tensor image model with regularization to explore the local low-rankness and nonlocal redundancies of the images to assess the thoracic aorta vessel wall. It uses high-order tensors to capture correlations between data in multiple dimensions and reconstructs images from highly undersampled data. For this study, 12 healthy participants and 2 patients with thoracic aortic diseases were evaluated at 3T magnetic resonance (MR). The reconstruction results were compared to the traditional generalized autocalibrating partially parallel acquisitions (GRAPPA) and ℓ1-SPIRiT reconstruction to assess the feasibility of the proposed framework. Quantitative analyses of the vessel wall thickness (VWT), internal diameter (ID), lumen area (LA), and contrast-to-noise ratio (CNR) between the lumen and vessel wall were performed on all healthy participants.
UNASSIGNED: Results demonstrated no significant differences between the GRAPPA and the proposed Pt-LRT in VWT, ID, or LA of the aorta (P<0.05). A higher mean CNR was attained with 3D patch-based low-rank tensor reconstruction than with ℓ1-SPIRiT reconstruction (49.4±10.8 vs. 38.9±8.2).
UNASSIGNED: The proposed 3D BB thoracic aorta vessel wall imaging method can reduce the scan time and produce an image quality that is in good agreement with the conventional GRAPPA acquisition, which takes approximately more than 8 min. This study also shows that the proposed Pt-LRT method substantially improves the visualization and sharpness of the vessel wall and the definition of the tissue boundary compared to the imaging obtained with ℓ1-SPIRiT.

Thoracic aortic pseudoaneurysm caused by Brucella melitensis is extremely rare with extremely few cases reported to date. Herein, we present the case of a 65 year-old man with a huge pseudoaneurysm of the proximal descending thoracic aorta, involving the left subclavian artery and distal arch. Surgery was performed to replace the proximal descending aorta with a self-made bovine pericardial duct and the left subclavian artery with a 10 mm artificial vessel under deep hypothermic circulatory arrest; the patient recovered uneventfully. However, continued follow-up is required for long-term results.

OBJECTIVE: To compare between the diagnostic performance of 3.0-T MRI and CT for aorta and tracheobronchial invasion in patients with esophageal cancer (EC).
METHODS: We prospectively included patients with pathologically confirmed EC from November 2018 to June 2021, who had baseline stage of T3-4N0-2M0 and restaging after neoadjuvant chemotherapy. All patients underwent contrast-enhanced CT and MRI of the thorax. Two independent blinded radiologists scored image quality and the presence of invasion. Agreements between the two readers were calculated using kappa test. The sensitivity, specificity, accuracy, positive predict value (PPV), and negative predict value (NPV) of MRI and CT in evaluating invasion were calculated. The net reclassification index (NRI) was used to evaluate the change in the number of patients correctly classified by MRI and CT.
RESULTS: A total of 70 patients (64.8 ± 9.0 years; 53 men) were enrolled. Inter-reader agreements of image quality scores and presence of invasion by MRI and CT between the two readers were almost perfect (kappa > 0.80). The accuracy of MRI in evaluating thoracic aorta invasion was significantly higher than that of CT (reader 1: 90.0% vs. 71.4%; reader 2: 92.9% vs. 70.0%, respectively), and the accuracy of MRI in evaluating tracheobronchial invasion also was significantly higher than that of CT (reader 1: 92.9% vs. 72.9%; reader 2: 95.7% vs. 70.0%, respectively). NRI values were positive in both the evaluation of aorta and tracheobronchial invasion.
CONCLUSIONS: The accuracy of 3-T MRI in determining thoracic aorta and tracheobronchial invasion is significantly higher than that of CT.
CONCLUSIONS: • 3.0-T MRI was significantly more accurate than CT in assessing invasion of the thoracic aorta in patients with esophageal cancer. • 3.0-T MRI was also significantly more accurate than CT in assessing tracheobronchial invasion in patients with esophageal cancer. • 3.0-T MRI has a higher diagnostic performance than CT in evaluating patients with suspected aortic or tracheobronchial invasion in esophageal cancer.

Lotus (Nelumbo nucifera) leaves are widely used for both edible and medicinal applications. For its further utilization, we studied the vasodilatory activity of lotus leaf extract for the first time. In this study, we obtained the extracts using different ratios of water and ethanol, which was followed by polarity-dependent extraction. We found that the CH2Cl2 layer exhibited better vasodilatory activity (EC50 = 1.21 ± 0.10 μg/ml). HPLC and ESI-HRMS analysis of the CH2Cl2 layer using the standard product as a control revealed that nuciferine (Emax = 97.95 ± 0.76%, EC50 = 0.36 ± 0.02 μM) was the main component in this layer. Further research revealed that nuciferine exerts a multi-target synergistic effect to promote vasodilation, via the NO signaling pathway, K+ channel, Ca2+ channel, intracellular Ca2+ release, α and β receptors, etc. Nuciferine exhibits good vasodilatory activity, and it exhibits the potential to be utilized as a lead compound.

BACKGROUND: Massive upper gastrointestinal (GI) bleeding is usually urgent and severe, and is mostly caused by GI diseases. Aortoesophageal fistula (AEF) after thoracic aortic stent grafting is a rare cause of this condition, and has a poor prognosis with a high mortality rate. The clinical symptoms of AEF are usually nonspecific, and the diagnosis is often difficult, especially when upper GI bleeding is absent. Early identification, early diagnosis, and early treatment are very important for improving prognosis.
METHODS: A 74-year-old man was admitted to the infectious disease department with > 10-d fever and 10-mo prior history of thoracic aortic stent grafting for thoracic aortic penetrating ulcers. Blood tests revealed elevated inflammatory indicators and anemia. Chest computed tomography (CT) showed postoperative changes of the aorta after endovascular stent graft implantation, pulmonary infection and pleural effusion. Pleural effusion tests showed empyema. After 1 wk of anti-infective treatment, temperature returned to normal and chest CT indicated improvement in pulmonary infection and reduction of pleural effusion. Esophageal endoscopy was performed because of epigastric discomfort, and showed a large ulcer with blood clot in the middle esophagus. However, on day 11, hematemesis and melena developed suddenly. Bleeding stopped temporarily after hemostatic treatment and bedside endoscopic hemostasis. Thoracic and abdominal aortic CT angiography confirmed AEF. Later that day, he suffered massive hemorrhage and hemorrhagic shock. Eventually, his family elected to discontinue treatment.
CONCLUSIONS: AEF should be strongly considered in patients with a history of aortic intervention who present with fever, especially with empyema.