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Wenjing Li,
Jianhong Li,
Junfang Xian, Bin Lv,
Meng Li,
Chunheng Wang,
Yong Li,
Zhaohui Liu,
Sha Liu,
Zhenchang Wang,
Huiguang He,
Bernhard A Sabel
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ABSTRACT: Purpose: Prelingual deafness has been shown to lead to brain reorganization as demonstrated by functional parameters, but anatomical evidences still remain controversial. The present study investigated hemispheric asymmetry changes in deaf subjects using MRI, hypothesizing auditory-, language- or visual-related regions after early deafness. Methods: Prelingually deaf adolescents (n = 16) and age- and gender-matched normal controls (n = 16) were recruited and hemispheric asymmetry was evaluated with voxel-based morphometry (VBM) from MRI combined with analysis of cortical thickness (CTh). Results: Deaf adolescents showed more rightward asymmetries (L < R) of grey matter volume (GMV) in the cerebellum and more leftward CTh asymmetries (L > R) in the posterior cingulate gyrus and gyrus rectus. More rightward CTh asymmetries were observed in the precuneus, middle and superior frontal gyri, and middle occipital gyrus. The duration of hearing aid use was correlated with asymmetry of GMV in the cerebellum and CTh in the gyrus rectus. Interestingly, the asymmetry of the auditory cortex was preserved in deaf subjects. Conclusions: When the brain is deprived of auditory input early in life there are signs of both irreversible morphological asymmetry changes in different brain regions but also signs of reorganization and plasticity which are dependent on hearing aid use, i.e. use-dependent.
Restorative neurology and neuroscience 10/2012; · 2.51 Impact Factor
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ABSTRACT: The correct and prompt diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) plays a pivotal role in determining appropriate therapy. This study aimed to compare the diagnostic efficacy of pulmonary ventilation/perfusion (V/Q) scanning and computed tomography pulmonary angiography (CTPA) using pulmonary angiography as the golden standard.
A total of 114 consecutive patients (49 men and 65 women, age 43.3 ± 15.3 years) suspected of having CTEPH were prospectively enrolled. All patients underwent V/Q scanning, CTPA, and pulmonary angiography within an interval of 7 days from one another. Interpretation of V/Q images was based on the refined Pulmonary Embolism Diagnosis criteria. For threshold 1, high-probability and intermediate-probability V/Q scan findings were considered to be positive, and low-probability/normal V/Q scan findings were negative. For threshold 2, only a high-probability V/Q scan finding was considered to be positive, and intermediate-probability and low-probability/normal V/Q scan findings were considered to be negative.
Fifty-one patients (44.7%) had a final diagnosis of CTEPH. V/Q scan showed high probability, intermediate probability, and low probability/normal scan in 52, three, and 59 patients, respectively. CTPA revealed 50 patients with CTEPH and 64 patients without CTEPH. The sensitivity, specificity, and accuracy of the V/Q scan were 100, 93.7, and 96.5%, respectively, with threshold 1, and 96.1, 95.2, and 95.6%, respectively, with threshold 2; similarly, the sensitivity, specificity, and accuracy of CTPA were 92.2, 95.2, and 93.9%, respectively.
In conclusion, both V/Q scanning and CTPA are accurate methods for the detection of CTEPH with excellent diagnostic efficacy.
Nuclear Medicine Communications 01/2012; 33(5):459-63. · 1.40 Impact Factor
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Jia He,
Feng Wang,
Hao-Jie Dai,
Mei Li,
Qian Wang,
Zhiming Yao, Bin Lv,
Chang-Ming Xiong,
Jian-Guo He,
Zhi-Hong Liu,
Zuo-Xiang He,
Wei Fang
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ABSTRACT: To evaluate diagnostic value of the PISA-PED and PIOPED II criteria for lung scintigraphy and compare it with CT pulmonary angiography (CTPA) for the detection of pulmonary embolism (PE). Five hundred and forty-four consecutive patients with suspected PE were enrolled. All patients underwent lung ventilation/perfusion (V/P) scan, chest radiography, and CTPA. Two readers used the PIOPED II criteria, and 2 used the PISA-PED criteria for the interpretation of lung scintigraphy. CTPA scans were interpreted by two experienced radiologists. Lung scintigraphy and CTPA were categorized as PE present, absent or non-diagnostic. PE was present in 321 of 544 patients. Using PIOPED II criteria, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 85.1, 82.5, 88.1, and 78.4% respectively for V/P scan. Using PISA-PED criteria, sensitivity, specificity, PPV, and NPV were 86.0, 81.2, 86.8, and 80.1% respectively, and none was non-diagnostic. Sensitivity, specificity, PPV, and NPV were 81.7, 93.4, 94.9, and 77.3%, respectively for CTPA. PISA-PED interpretation has similar diagnostic accuracy to PIOPED II interpretation, does not have non-diagnostic scan, with lower cost and radiation, thus should be considered as a choice for patients with suspected PE.
The international journal of cardiovascular imaging 01/2012; 28(7):1799-805. · 2.15 Impact Factor
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ABSTRACT: Applying a dynamic Bayesian network model can help detect neural interactions and analyze the characteristics of a monkey's motor cortex during reach-to-grasp tasks.
Intelligent Systems, IEEE 11/2011; · 2.15 Impact Factor
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4th International Conference on Biomedical Engineering and Informatics, BMEI 2011, Shanghai, China, October 15-17, 2011; 01/2011
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IEEE Intelligent Systems. 01/2011; 26:64-71.
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ABSTRACT: Many previous studies have shown that there exists the gender effect on the structural and functional organization in the human brain. Although the reported functional differences are generally consistent, the structural differences are controversial among the various studies. In this study, we particularly focused on the gender-related effect in the gray matter (GM). We performed a structural magnetic resonance imaging (MRI) study in 184 healthy adults (90 males and 94 females) with ages ranging from 18 to 70 years. Cortical thickness was measured using an automated surface-based method. Based on this surface morphological feature of GM, we first compared their regional differences between males and females. We then constructed the morphometry-based anatomical networks derived from cortical thickness measurement, while the anatomical connection between two cortical areas depended upon the statistical dependence of their cortical thickness across subjects. Subsequently, we applied graph theoretical approaches to investigate the properties of the resultant anatomical networks. The results showed that the significant gender-related differences of cortical thickness appeared extensively in the frontal, parietal and occipital lobes. And there were also some between-group differences in the interregional correlation. Additional graph theoretical analysis on the morphological networks revealed both networks exhibited the small-world efficiency and their patterns of topological vulnerability had no statistical differences. The findings on the large sample may provide the evidences to study the gender consistency and difference in the human brain structures.
NeuroImage 11/2010; 53(2):373-82. · 5.89 Impact Factor
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ABSTRACT: The impact of spinal cord injury (SCI) on potential functional reorganization in neuronal populations in motor cortical areas remains unknown, though its influence on functional recovery may be significant. The cortical neuronal data was recorded from a monkey while it was trained to walk bipedally on a treadmill both before and after spinal cord injury. By using the correlation coefficients between different neurons, we constructed graphs for multiple steps in different sessions. The global efficiency of the graph was then calculated to investigate the effect of SCI on the neuronal activity patterns and how the correlation between the neurons changes as the functional recovery continued. Our results indicate that the observed significant changes in neuronal activity patterns in the motor cortex, although preliminary, suggest that the patterns of functional reorganization (neural plasticity) in motor areas of the cortex correlate and contribute to the functional recovery.
Engineering in Medicine and Biology Society (EMBC), 2010 Annual International Conference of the IEEE; 10/2010
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ABSTRACT: In this work, we took the analysis of neural interaction based on the data recorded from the motor cortex of a monkey, when it was trained to complete multi-targets reach-to-grasp tasks. As a recently proved effective tool, Dynamic Bayesian Network (DBN) was applied to model and infer interactions of dependence between neurons. In the results, the gained networks of neural interactions, which correspond to different tasks with different directions and orientations, indicated that the target information was not encoded in simple ways by neuronal networks. We also explored the difference of neural interactions between delayed period and peri-movement period during reach-to-grasp task. We found that the motor control process always led to relatively more complex neural interaction networks than the plan thinking process.
Engineering in Medicine and Biology Society (EMBC), 2010 Annual International Conference of the IEEE; 10/2010
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ABSTRACT: A conventional single-stage procedure, staged procedures, or debranching of the supraaortic vessels, followed by immediate transfemoral stenting of the aortic arch, have been introduced to treat chronic type B dissection with aortic arch involvement. The best method for surgical repair of chronic type B dissection with aortic arch involvement alone or concomitant with proximal aortic lesions is not known.
Between October 2003 and December 2008, 19 patients underwent total arch replacement combined with stented elephant trunk implantation under hypothermic cardiopulmonary bypass and selective cerebral perfusion through a median sternotomy. Thirteen patients had proximal aortic lesions. Postoperative computed tomography was used to evaluate thrombosis and absorption of the false lumen.
Concomitant proximal aortic lesions were repaired in all patients. Thirty-day mortality was 5.26% (1/19). There was one late death at a mean follow-up of 36 +/- 12 months. There was no spinal cord injury or visceral malperfusion. One patient with Marfan syndrome with chronic dissection underwent thoracoabdominal aortic replacement 6 months later. Obliteration of the false lumen around the stented elephant trunk was observed in 16 patients (94.1%, 16/17) during follow-up.
This technique is safe, effective, and economical. Replacement of aortic arch dissection and thrombosis of the dissected descending aorta was achieved simultaneously. Concomitant proximal aortic lesions were repaired. Favorable surgical outcomes and postoperative results using this technique were obtained in patients with chronic type B dissection with aortic arch involvement alone or concomitant with proximal aortic lesions.
The Annals of thoracic surgery 07/2010; 90(1):95-100. · 3.74 Impact Factor
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[show abstract]
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ABSTRACT: In this work, we took the analysis of neural interaction based on the data recorded from the motor cortex of a monkey, when it was trained to complete multi-targets reach-to-grasp tasks. As a recently proved effective tool, Dynamic Bayesian Network (DBN) was applied to model and infer interactions of dependence between neurons. In the results, the gained networks of neural interactions, which correspond to different tasks with different directions and orientations, indicated that the target information was not encoded in simple ways by neuronal networks. We also explored the difference of neural interactions between delayed period and peri-movement period during reach-to-grasp task. We found that the motor control process always led to relatively more complex neural interaction networks than the plan thinking process.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2010; 2010:4140-3.
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[show abstract]
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ABSTRACT: The impact of spinal cord injury (SCI) on potential functional reorganization in neuronal populations in motor cortical areas remains unknown, though its influence on functional recovery may be significant. The cortical neuronal data was recorded from a monkey while it was trained to walk bipedally on a treadmill both before and after spinal cord injury. By using the correlation coefficients between different neurons, we constructed graphs for multiple steps in different sessions. The global efficiency of the graph was then calculated to investigate the effect of SCI on the neuronal activity patterns and how the correlation between the neurons changes as the functional recovery continued. Our results indicate that the observed significant changes in neuronal activity patterns in the motor cortex, although preliminary, suggest that the patterns of functional reorganization (neural plasticity) in motor areas of the cortex correlate and contribute to the functional recovery.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2010; 2010:5468-71.
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ABSTRACT: To compare the diagnostic efficacy of lung perfusion scans combined with ventilation (V/Q) scans and/or chest radiography (CR) with contrast-enhanced multislice spiral CT pulmonary angiography (CTPA) in diagnosing pulmonary embolism (PE).
Eighty-two consecutive patients with suspected PE underwent CTPA, lung perfusion scan, and CR. Of them, 28 patients underwent V/Q scans. The final diagnosis was made using a composite reference test.
The overall sensitivity and specificity were 89.2% and 92.1% for V/Q scan or perfusion scan combined with CR, and 97.3% and 97.4% for CTPA. For the 28 patients with V/Q scan, the sensitivity and specificity were 91.7% and 92.9% for V/Q scan, and 91.7% and 100.0% for CTPA. The segmental agreement rate between perfusion scan and CTPA was 69.5% (kappa = 0.30, P < 0.05). The perfusion scan revealed significantly more subsegmental abnormalities than CTPA (59 vs. 10, chi2 test, P < 0.05).
V/Q scan, perfusion scan combined with CR and CTPA all show high efficacy in diagnosing PE. V/Q scan or perfusion scan combined with CR is as accurate as CTPA.
Clinical nuclear medicine 07/2009; 34(7):424-7. · 3.92 Impact Factor
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ABSTRACT: In patients with acute type A dissection, it is controversial whether to use a more aggressive strategy with extended aortic replacement to improve long-term outcome or to use a conventional strategy with limited ascending aortic or hemiarch replacement to circumvent a life-threatening situation.
Between April 2003 and June 2007, 107 patients (17 women, 90 men; mean age, 45 +/- 11 years; range, 17-78 years) with acute type A dissection underwent total arch replacement combined with stented elephant trunk implantation under hypothermic cardiopulmonary bypass and selective cerebral perfusion. Computed tomography was performed to evaluate the residual false lumen in the descending aorta during follow-up.
Thirty-day mortality was 3.74% (4/107 patients), and in-hospital mortality was 4.67% (5/107 patients). Spinal cord injury was observed in 3 patients (1 patient with left lower-extremity paraparesis and 2 patients with paraplegia). Cerebral infarction was observed in 3 patients, ventilator support exceeding 5 days was required in 9 patients, and rebleeding was observed in 4 patients. During a mean follow-up of 35 +/- 14 months, 3 patients died and 3 patients were lost to follow-up. On postoperative computed tomography, complete thrombus formation was observed around the stented elephant trunk in 95% of patients (95/100) and at the diaphragmatic level in 69% of patients (69/100).
Low morbidity and mortality were achieved using total arch replacement combined with stented elephant trunk implantation. These encouraging surgical results and postoperative outcomes favor this more aggressive procedure for acute type A dissection.
The Journal of thoracic and cardiovascular surgery 06/2009; 138(6):1358-62. · 3.41 Impact Factor
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ABSTRACT: Surgical treatment of chronic Stanford type A aortic dissection using total arch replacement combined with stented elephant trunk implantation is controversial owing to the visceral arteries and intercostal arteries originating from the false lumen.
Eighty-nine patients (mean age, 45.67 +/- 10.18 years; range, 21-68 years) with chronic type A dissection underwent total arch replacement combined with stented elephant trunk implantation between April 2003 and March 2007. Careful assessment of the visceral arteries and location of entry and re-entry was done before surgery. Postoperative patency of the visceral arteries and diameter of the aortic artery and the residual false lumen were evaluated by computed tomography.
One (1.12%) hospital death and 2 (2.25%) late deaths occurred at a mean follow-up of 28.5 months (range, 8-52 months). Visceral malperfusion was not observed. Two patients had spinal cord injury and recovered during follow-up. One patient had a transient neurologic deficit and recovered completely before discharge. One patient underwent thoracoabdominal aortic replacement for aneurysmal dilatation of the residual descending aorta 3 months after the operation. Thrombus obliteration of the false lumen at the distal edge of the stented elephant trunk and at the diaphragmatic level was 94.2% (81/86) and 61.6% (53/86), respectively.
Satisfactory results with low morbidity and mortality were obtained. No visceral malperfusion and a low risk of postoperative spinal cord injury favor this technique in patients with chronic type A dissection.
The Journal of thoracic and cardiovascular surgery 05/2009; 138(4):892-6. · 3.41 Impact Factor
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LiZhong Sun,
RuiDong Qi,
Qian Chang,
JunMing Zhu,
YongMin Liu,
ChunTao Yu,
HaiTao Zhang, Bin Lv,
Jun Zheng,
LiangXin Tian,
JinGuo Lu
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ABSTRACT: Surgical management of acute type A dissection with the tear in the descending aorta is challenging because of the technical difficulty in managing proximal and distal aortic lesions through a median sternotomy or lateral thoracotomy using a single-stage procedure.
Thirty-three patients with acute type A dissection with the tear in the descending aorta underwent total arch replacement combined with stented elephant trunk implantation through a median sternotomy from April 2003 to June 2007. Preoperative complications included acute cardiac tamponade (n = 1), acute left heart failure (n = 1), acute myocardial infarction (n = 1), cerebral ischemia (n = 1), acute renal failure (n = 2), chronic renal dysfunction (n = 2), and acute mesenteric ischemia (n = 1) and lower extremity ischemia (n = 3). The residual false lumen was evaluated using postoperative computed tomography.
Death at 30 days was 6.06% (2 of 33 patients). One patient with preoperative mesenteric ischemia died of postoperative multiple-organ failure. One patient with preoperative acute renal failure ceased treatment after three reoperations owing to uncontrollable bleeding. Left lower-extremity paraparesis occurred in 1 patient, and transient neurologic dysfunction occurred in 1 patient. Severe complications were not observed at a mean follow-up of 25 +/- 11 months. Thrombus obliteration of the false lumen was observed at the distal end of the stented graft in 29 patients (96.7%) and at the diaphragmatic level in 20 patients (66.7%) during follow-up.
Encouraging outcomes favor this technique in patients with acute type A dissection with the tear in the descending aorta. Simultaneous repair of proximal aortic lesions and thrombosis of the false lumen in the descending aorta could be obtained.
The Annals of thoracic surgery 05/2009; 87(4):1177-80. · 3.74 Impact Factor
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ABSTRACT: To determine the optimal contrast injection protocol for 64-MDCT coronary angiography.
One hundred and fifty consecutive patients scheduled to undergo retrospectively electrocardiographically gated 64-MDCT. Each 30 patients were assigned to use a different contrast protocol: group 1: uniphasic protocol (contrast injection without saline flush); group 2: biphasic protocol (contrast injection with saline flush); group 3A, 3B and 3C: triphasic protocol (contrast media+different saline diluted contrast media+saline flush). Image quality scores and artifacts were compared and evaluated on both transaxial and three-dimensional coronary artery images among each contrast protocol.
Among the triphasic protocol groups, group 3A (30%:70% contrast media-saline mixture was used in second phase) used the least contrast media and had the least frequency of streak artifacts, but there were no significant differences in coronary artery attenuation, image quality, visualization right and left heart structures. Among the uniphasic protocol group (group 1), biphasic protocol group (group 2) and triphasic protocol subgroup (group 3A), there were no significant differences in image quality scores of coronary artery (P=0.18); uniphasic protocol group had the highest frequency of streak artifacts (20 cases) (P<0.05) and had the most amount contrast media (67.0+/-5.3 ml); biphasic protocol group had the least amount of contrast media (59.9+/-4.9 ml) (P<0.05) and had the highest attenuation of left main coronary artery and right coronary artery (P<0.01), but had the least amount of clear visualization right heart structure (6 cases); triphasic protocol group (group 3A) had the most amount of clear visualization right heart structures (29 cases) were the most among the three groups (P<0.05).
Biphasic protocol are superior to the traditional uniphasic protocols for using the least total contrast media, having the least Streak artifacts and without image quality degradation. However, it is also important to visualize the right atrium and ventricle, so triphasic protocol (30%:70% contrast media-saline mixture was used in second phase) should be used for 64-MDCT coronary CT angiography.
European journal of radiology 05/2009; 75(2):159-65. · 2.65 Impact Factor
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Lizhong Sun,
Ruidong Qi,
Qian Chang,
Junming Zhu,
Yongmin Liu,
Chuntao Yu,
Haitao Zhang, Bin Lv,
Jun Zheng,
Liangxin Tian,
Jinguo Lu
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ABSTRACT: The purpose of the study was to assess the efficacy of total arch replacement combined with stented elephant trunk implantation for Marfan patients with acute Stanford type A aortic dissection involving the aortic arch.
Between January 2004 and April 2006, 13 consecutive Marfan patients (4 female, 9 male) with acute type A aortic dissection involving the aortic arch underwent total arch replacement combined with implantation of a stented elephant trunk. Aortic dissection extending to the iliac artery was seen in 10 patients, and to the abdominal aorta in 3 patients. Ages ranged from 17 to 65 years (mean, 39 +/- 13). Computed tomography was done to evaluate the residual false lumen in the descending aorta.
All patients survived and were discharged from hospital. One patient with thrombosis of the innominate artery suffered cerebral infarction and recovered during follow-up. One patient had ischemia of the left upper limb postoperatively, but recovered after axillary to axillary artery bypass. There was 1 death during the mean follow-up period of 27 +/- 10 months. Complete thrombus formation was observed in 84.6% of patients (11 of 13) around the stented elephant trunk, and in 69.2% of patients (9 of 13) at the diaphragmatic level.
Total arch replacement combined with stented elephant trunk implantation for Marfan patients with acute type A aortic dissection involving the aortic arch results in less late dilatation of the dissected descending aorta. That prolongs the reoperation interval or reduces the number of late thoracoabdominal aortic replacements, unless there is a patent false lumen around the stented elephant trunk.
The Annals of thoracic surgery 01/2009; 86(6):1821-5. · 3.74 Impact Factor
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Proceedings of the 2nd International Conference on BioMedical Engineering and Informatics, BMEI 2009, October 17-19, 2009, Tianjin, China; 01/2009
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Proceedings of the 2nd International Conference on BioMedical Engineering and Informatics, BMEI 2009, October 17-19, 2009, Tianjin, China; 01/2009
