Despite the advent and growing availability of magnetic resonance imaging,the imaging modality of choice in the acute care of stroke patients in many institutions remains computed tomography.The hyperdense artery sign...Despite the advent and growing availability of magnetic resonance imaging,the imaging modality of choice in the acute care of stroke patients in many institutions remains computed tomography.The hyperdense artery sign is the earliest marker of acute ischemic stroke.In this short review,we discuss the pathology,incidence,clinical aspects,imaging findings,significance and future questions that need to be addressed concerning this important sign.展开更多
The purpose of this study was to determine whether 5-mm axial CT images can sufficiently depict the hyperdense middle cerebral artery (MCA) sign in patients with acute brain ischemia. Materials and Methods: A retrospe...The purpose of this study was to determine whether 5-mm axial CT images can sufficiently depict the hyperdense middle cerebral artery (MCA) sign in patients with acute brain ischemia. Materials and Methods: A retrospective review of 92 cases of ischemic brain infarction confirmed nine patients showing hyperdense MCA signs. CT images were acquired on a 64-slice helical scanner. Images were reconstructed into contiguous 5-mm axial, coronal and sagittal datasets. The first CT scan images of the patients with hyperdense MCA signs and an equal number of CT scans without hyperdense MCA signs inserted at random were analyzed in a blinded review. The presence of the hyperdense MCA sign in M1 segments was recorded. Round regions of interest (ROI) were placed over the M1 segments of the MCAs and the attenuation values in Hounsfield units (HU) were measured on the sagittal and axial images. Results: Nine patients showed a hyperdense MCA sign. They consisted of 4 male and 5 female (mean age, 74.3 years;age range, 45 - 88 years). On the blinded review, hyperdense MCA signs were detected on axial images in 7 patients. In four of the 7 patients, the hyperdense MCA sign was more conspicuous on sagittal images than that on axial images. Hyperdense MCA sign was detected on sagittal images of all 9 patients and exclusive to the sagittal images in two patients. The ROI study showed higher attenuation for the affected MCA on sagittal images (46 - 65 HU) than that on axial images (36 - 54 HU). Conclusion: In patients with acute brain ischemia, 5-mm axial CT images cannot sufficiently depict the hyperdense MCA sign. Sagittal images may be superior to axial images for identifying the sign.展开更多
Allergic bronchopulmonary aspergillosis(ABPA) is a complex hypersensitivity syndrome triggered against antigens of Aspergillus fumigatus,a fungus that most commonly colonizes the airways of patients with bronchial ast...Allergic bronchopulmonary aspergillosis(ABPA) is a complex hypersensitivity syndrome triggered against antigens of Aspergillus fumigatus,a fungus that most commonly colonizes the airways of patients with bronchial asthma and cystic fibrosis.It presents clinically with refractory asthma,hemoptysis and systemic manifestations including fever,malaise and weight loss.Radiologically,it presents with central bronchiectasis and recurrent episodes of mucus plugging.The mucus plugs in ABPA are generally hypodense but in up to 20% of patients the mucus can be hyperdense on computed tomography.This paper reviews the literature on the clinical significance of hyperattenuated mucus in patients with ABPA.展开更多
目的探索应用简易临床指标早期识别急性前循环大动脉闭塞性卒中的准确性。方法研究回顾性纳入2011年4月~2014年12月期间连续就诊我院并具有完整的发病6 h内血管影像资料的前循环梗死病例。以数字减影血管造影(digital subtraction angio...目的探索应用简易临床指标早期识别急性前循环大动脉闭塞性卒中的准确性。方法研究回顾性纳入2011年4月~2014年12月期间连续就诊我院并具有完整的发病6 h内血管影像资料的前循环梗死病例。以数字减影血管造影(digital subtraction angiography,DSA)或CT血管成像(computed tomography angiography,CTA)判定的有无急性前循环大动脉闭塞结果为参照标准,利用受试者工作特征曲线(Receiver Operator Characteristic Curve,ROC)下的面积(Area Under Curve,AUC)比较大脑中动脉高密度征象(hyperdense sign of MCA,HDS-MCA)、ASPECTS(the Alberta Stroke Program Early CT Score)和国立卫生院神经功能缺损评分(National Institute of Health Stroke Scale,NIHSS)等指标判定急性前循环大动脉闭塞性卒中的准确度。结果研究纳入84例急性前循环缺血性卒中病例(其中49例有大动脉闭塞,占58.3%)。平均年龄为58岁,女性占26.2%(22/84),平均发病至血管影像检查时间为210(141~312)min。有大动脉闭塞组的基线NIHSS(12比8,P=0.008),HDS-MCA阳性率(63.3%比37.1%,P=0.018)及房颤比例(22.4%比5.7%,P=0.037)显著高于无大动脉闭塞组。ROC结果显示单一指标中HDS-MCA(+)的预测准确度最高(AUC=0.631),两项指标联合的复合指标中NIHSS≥12及ASPECTS≤7的预测准确度最高(AUC=0.635),而三项指标联合的复合指标中NIHSS≥12,ASPECTS≤7及HDS-MCA(+)的预测准确度最高(AUC=0.602)。结论本研究结果虽然提示NIHSS、HDS-MCA和ASPECTS在判定卒中严重程度具有一定价值,但其早期识别急性前循环大动脉闭塞性卒中的准确性尚需进一步提高。展开更多
文摘Despite the advent and growing availability of magnetic resonance imaging,the imaging modality of choice in the acute care of stroke patients in many institutions remains computed tomography.The hyperdense artery sign is the earliest marker of acute ischemic stroke.In this short review,we discuss the pathology,incidence,clinical aspects,imaging findings,significance and future questions that need to be addressed concerning this important sign.
文摘The purpose of this study was to determine whether 5-mm axial CT images can sufficiently depict the hyperdense middle cerebral artery (MCA) sign in patients with acute brain ischemia. Materials and Methods: A retrospective review of 92 cases of ischemic brain infarction confirmed nine patients showing hyperdense MCA signs. CT images were acquired on a 64-slice helical scanner. Images were reconstructed into contiguous 5-mm axial, coronal and sagittal datasets. The first CT scan images of the patients with hyperdense MCA signs and an equal number of CT scans without hyperdense MCA signs inserted at random were analyzed in a blinded review. The presence of the hyperdense MCA sign in M1 segments was recorded. Round regions of interest (ROI) were placed over the M1 segments of the MCAs and the attenuation values in Hounsfield units (HU) were measured on the sagittal and axial images. Results: Nine patients showed a hyperdense MCA sign. They consisted of 4 male and 5 female (mean age, 74.3 years;age range, 45 - 88 years). On the blinded review, hyperdense MCA signs were detected on axial images in 7 patients. In four of the 7 patients, the hyperdense MCA sign was more conspicuous on sagittal images than that on axial images. Hyperdense MCA sign was detected on sagittal images of all 9 patients and exclusive to the sagittal images in two patients. The ROI study showed higher attenuation for the affected MCA on sagittal images (46 - 65 HU) than that on axial images (36 - 54 HU). Conclusion: In patients with acute brain ischemia, 5-mm axial CT images cannot sufficiently depict the hyperdense MCA sign. Sagittal images may be superior to axial images for identifying the sign.
文摘Allergic bronchopulmonary aspergillosis(ABPA) is a complex hypersensitivity syndrome triggered against antigens of Aspergillus fumigatus,a fungus that most commonly colonizes the airways of patients with bronchial asthma and cystic fibrosis.It presents clinically with refractory asthma,hemoptysis and systemic manifestations including fever,malaise and weight loss.Radiologically,it presents with central bronchiectasis and recurrent episodes of mucus plugging.The mucus plugs in ABPA are generally hypodense but in up to 20% of patients the mucus can be hyperdense on computed tomography.This paper reviews the literature on the clinical significance of hyperattenuated mucus in patients with ABPA.
文摘目的探索应用简易临床指标早期识别急性前循环大动脉闭塞性卒中的准确性。方法研究回顾性纳入2011年4月~2014年12月期间连续就诊我院并具有完整的发病6 h内血管影像资料的前循环梗死病例。以数字减影血管造影(digital subtraction angiography,DSA)或CT血管成像(computed tomography angiography,CTA)判定的有无急性前循环大动脉闭塞结果为参照标准,利用受试者工作特征曲线(Receiver Operator Characteristic Curve,ROC)下的面积(Area Under Curve,AUC)比较大脑中动脉高密度征象(hyperdense sign of MCA,HDS-MCA)、ASPECTS(the Alberta Stroke Program Early CT Score)和国立卫生院神经功能缺损评分(National Institute of Health Stroke Scale,NIHSS)等指标判定急性前循环大动脉闭塞性卒中的准确度。结果研究纳入84例急性前循环缺血性卒中病例(其中49例有大动脉闭塞,占58.3%)。平均年龄为58岁,女性占26.2%(22/84),平均发病至血管影像检查时间为210(141~312)min。有大动脉闭塞组的基线NIHSS(12比8,P=0.008),HDS-MCA阳性率(63.3%比37.1%,P=0.018)及房颤比例(22.4%比5.7%,P=0.037)显著高于无大动脉闭塞组。ROC结果显示单一指标中HDS-MCA(+)的预测准确度最高(AUC=0.631),两项指标联合的复合指标中NIHSS≥12及ASPECTS≤7的预测准确度最高(AUC=0.635),而三项指标联合的复合指标中NIHSS≥12,ASPECTS≤7及HDS-MCA(+)的预测准确度最高(AUC=0.602)。结论本研究结果虽然提示NIHSS、HDS-MCA和ASPECTS在判定卒中严重程度具有一定价值,但其早期识别急性前循环大动脉闭塞性卒中的准确性尚需进一步提高。
