Publications by authors named "Wenzhen Zhu"

122 Publications

Cortical and Subcortical Grey Matter Abnormalities in White Matter Hyperintensities and Subsequent Cognitive Impairment.

Neurosci Bull 2021 Apr 7. Epub 2021 Apr 7.

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.

Grey matter (GM) alterations may contribute to cognitive decline in individuals with white matter hyperintensities (WMH) but no consensus has yet emerged. Here, we investigated cortical thickness and grey matter volume in 23 WMH patients with mild cognitive impairment (WMH-MCI), 43 WMH patients without cognitive impairment, and 55 healthy controls. Both WMH groups showed GM atrophy in the bilateral thalamus, fronto-insular cortices, and several parietal-temporal regions, and the WMH-MCI group showed more extensive and severe GM atrophy. The GM atrophy in the thalamus and fronto-insular cortices was associated with cognitive decline in the WMH-MCI patients and may mediate the relationship between WMH and cognition in WMH patients. Furthermore, the main results were well replicated in an independent dataset from the Alzheimer's Disease Neuroimaging Initiative database and in other control analyses. These comprehensive results provide robust evidence of specific GM alterations underlying WMH and subsequent cognitive impairment.
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http://dx.doi.org/10.1007/s12264-021-00657-0DOI Listing
April 2021

Brain Development From Newborn to Adolescence: Evaluation by Neurite Orientation Dispersion and Density Imaging.

Front Hum Neurosci 2021 15;15:616132. Epub 2021 Mar 15.

Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.

Neurite orientation dispersion and density imaging (NODDI) is a diffusion model specifically designed for brain magnetic resonance imaging. Despite recent studies suggesting that NODDI modeling might be more sensitive to brain development than diffusion tensor imaging (DTI), these studies were limited to a relatively small age range and mainly based on the manually operated region of interest analysis. Therefore, this study applied NODDI to investigate brain development in a large sample size of 214 subjects ranging in ages from 0 to 14. The whole brain was automatically segmented into 122 regions. The maturation trajectory of each region was characterized by the time course of diffusion metrics and further quantified using nonlinear regression. The NODDI-derived metrics, neurite density index (NDI) and orientation dispersion index (ODI), increased with age. And these two metrics were superior to the DTI-derived metrics in SVM regression models of age. The NDI in white matter exhibited a more rapid growth than that in gray matter (including the cortex and deep nucleus). These diffusion indicators experienced conspicuous increases during early childhood and the growth speed slowed down in adolescence. Region-specific maturation patterns were described throughout the brain, including white matter, cortical and deep gray matter. These development patterns were evaluated and discussed on the basis of NODDI's model assumptions. To summarize, this study verified the high sensitivity of NODDI to age over a crucial developmental period from newborn to adolescence. Moreover, the existing knowledge of brain development has been complemented, suggesting that NODDI has a potential capability in the investigation of brain development.
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http://dx.doi.org/10.3389/fnhum.2021.616132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005551PMC
March 2021

Correlation of autopsy pathological findings and imaging features from 9 fatal cases of COVID-19 pneumonia.

Medicine (Baltimore) 2021 Mar;100(12):e25232

Department of Radiology.

Abstract: We aimed to investigate the relationship of radiological features and the corresponding pulmonary pathology of patients with Coronavirus Disease (COVID-19) pneumonia.In this multicenter study, serial chest CT and radiographic images from 9 patients (51-85 years old, 56% male) were reviewed and analyzed. Postmortem lungs were sampled and studied from these autopsies, with a special focus on several corresponding sites based on imaging features.The predominant pattern of pulmonary injury in these 9 cases was diffuse alveolar damage (DAD) and interstitial inflammation. Moreover, acute fibrinous exudates, organization, inflammatory cell infiltration, hyaline membranes, pulmonary edema, pneumocyte hyperplasia, and fibrosis were all observed. The histopathology features varied according to the site and severity of each lesion. In most of the 9 cases, opacities started from a subpleural area and peripheral structures were more severely damaged based on gross views and pathological examinations. Fibrosis could occur in early stages of infection and this was supported by radiological and pathological findings. The radiological features of COVID-19 pneumonia, at the critically ill stage, were diffuse ground-glass opacities with consolidation, interstitial thickening, and fibrous stripes, which was based in the fibrous tissue proliferation in the alveolar and interlobular septa, and filled alveoli with organizing exudation. Fungal and bacterial co-infections were also observed in 6 cases.Typical imaging features can be correlated with underlying pathological findings. Combining assessments of imaging features with pathological findings therefore can enhance our understanding of the histopathological mechanism of COVID-19 pneumonia, and facilitate early radiological diagnosis and prognosis estimation of COVID-19 pneumonia, which has important implications for the development of clinical targeted treatments and research related to COVID-19 pneumonia.
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http://dx.doi.org/10.1097/MD.0000000000025232DOI Listing
March 2021

Long-term micro-structure and cerebral blood flow changes in patients recovered from COVID-19 without neurological manifestations.

J Clin Invest 2021 Feb 25. Epub 2021 Feb 25.

Department of Radiology, Tongi Medical College, Huazhong University of Science and Technology, Wuhan, China.

The coronavirus disease 2019 (COVID-19) rapidly progressed to a global pandemic. Although patients totally recover from COVID-19 pneumonia, long-term effects on the brain still need to be explored. Here, two subtypes (mild type-MG and severe type-SG) with no specific neurological manifestations at the acute stage and no obvious lesions on the conventional MRI three months after discharge were recruited. Changes in gray matter morphometry, cerebral blood flow (CBF) and white matter (WM) microstructure were investigated using MRI. The relationship between brain imaging measurements and inflammation markers were further analyzed. Compared with healthy controls, the decrease in cortical thickness/CBF, and the changes in WM microstructure were observed to be more severe in the SG than MG, especially in the frontal and limbic systems. Furthermore, changes in brain microstructure, CBF and tracts parameters were significantly correlated with inflammatory markers. The indirect injury related to inflammatory storm may damage the brain, that led to these interesting observations. There are also other likely potential causes, such as hypoxemia and dysfunction of vascular endothelium, et al. The abnormalities in these brain areas need to be monitored in the process of complete recovery, which could help clinicians to understand the potential neurological sequelae of COVID-19.
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http://dx.doi.org/10.1172/JCI147329DOI Listing
February 2021

Very fast-progressive pulmonary opacities and high inflammatory factors levels are associated with decease of young Coronavirus Disease 2019 patients.

Medicine (Baltimore) 2021 Feb;100(7):e24668

Department of Radiology.

Abstract: We aimed to retrospectively analyze the clinical and computed tomography (CT) characteristics of young adults with Coronavirus Disease 2019 (COVID-19) pneumonia who were critically ill and to identify the features associated with non-survival.Thirty-eight COVID-19 patients (20-45 years old, 28 men) who had been admitted in the intensive care unit were included, including 18 non-survivors (group 1) and 20 survivors (group 2). Their clinical characteristics and initial and follow-up CT were compared between groups.In group 1, the days from illness onset to death were 21.1 ± 10.3 days; 7 patients had underlying comorbidities. At admission, group 1 exhibited higher serum ferritin and interleukin-6 (IL-6) levels (1142.6 ± 242.4 mg/L and 33.8 ± 18.6 mmol/L) compared with group 2 (728.3 ± 150.9 mg/L and 15.2 ± 6.9 mmol/L, P < .01). Group 1 exhibited more rapidly progressive opacities and consolidation in follow-up CT (16.7 ± 3.1 scores, 15.7 ± 3.1 segments) than group 2 (11.4 ± 4.0 scores, 10.3 ± 4.6 segments, P < .01). The oxygenation index was lower (87.6 ± 19.2 vs 99.1 ± 20.4 mm Hg) and the mechanical ventilation duration was longer (14.7 ± 6.9 vs 9.7 ± 3.7 days) in group 1 compare with group 2 (P < .01).Compared with the survivors, the non-survivors showed higher serum ferritin and IL-6 levels, more rapidly progressive opacities in CT, lower oxygenation index, and longer mechanical ventilation durations. Special attention to ferritin/IL-6 levels and oxygenation index as well as early CT application and timely reexaminations are important to identify the individuals who may be at risk of becoming critically ill.
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http://dx.doi.org/10.1097/MD.0000000000024668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7899904PMC
February 2021

Quartile histogram assessment of glioma malignancy using high b-value diffusion MRI with a continuous-time random-walk model.

NMR Biomed 2021 Apr 4;34(4):e4485. Epub 2021 Feb 4.

Center for MR Research, University of Illinois at Chicago, Chicago, Illinois, USA.

The purpose of this study is to investigate the feasibility of using a continuous-time random-walk (CTRW) diffusion model, together with a quartile histogram analysis, for assessing glioma malignancy by probing tissue heterogeneity as well as cellularity. In this prospective study, 91 patients (40 females, 51 males) with histopathologically proven gliomas underwent MRI at 3 T. The cohort included 42 grade II (GrII), 19 grade III (GrIII) and 29 grade IV (GrIV) gliomas. Echo-planar diffusion-weighted imaging was conducted using 17 b-values (0-4000 s/mm ). Three CTRW model parameters, including an anomalous diffusion coefficient D , and two parameters related to temporal and spatial diffusion heterogeneity α and β, respectively, were obtained. The mean parameter values within the tumor regions of interest (ROIs) were computed by utilizing the first quartile of the histograms as well as the full ROI for comparison. A Bonferroni-Holm-corrected Mann-Whitney U-test was used for the group comparisons. Individual and combinations of the CTRW parameters were evaluated for the characterization of gliomas with a receiver operating characteristic analysis. All first-quartile mean CTRW parameters yielded significant differences (p-values < 0.05) between pair-wise comparisons of GrII (D : 1.14 ± 0.37 μm /ms; α: 0.904 ± 0.03, β: 0.913 ± 0.06), GrIII (D : 0.88 ± 0.21 μm /ms; α: 0.888 ± 0.01, β: 0.857 ± 0.06) and GrIV gliomas (D : 0.73 ± 0.22 μm /ms; α: 0.878 ± 0.01; β: 0.791 ± 0.07). The highest sensitivity, specificity, accuracy and area-under-the-curve of using the combinations of the first-quartile parameters were 84.2%, 78.5%, 75.4% and 0.76 for GrII and GrIII classification; 86.2%, 89.4%, 75% and 0.76 for GrIII and GrIV classification; and 86.2%, 85.7%, 84.5% and 0.90 for GrII and GrIV classification, respectively. Quartile-based analysis produced higher accuracy and area-under-the-curve than the full ROI-based analysis in all classifications. The CTRW diffusion model, together with a quartile-based histogram analysis, offers a new way for probing tumor structural heterogeneity at a subvoxel level, and has potential for in vivo assessment of glioma malignancy to complement histopathology.
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http://dx.doi.org/10.1002/nbm.4485DOI Listing
April 2021

Characterization of microenvironmental changes in the intervertebral discs of patients with chronic low back pain using multiparametric MRI contrasts extracted from Z-spectrum.

Eur Spine J 2021 Apr 21;30(4):1063-1071. Epub 2021 Jan 21.

Departments of Radiology, Department of Bioengineering, and the Center for MR Research, University of Illinois at Chicago, Chicago, IL, USA.

Purpose: Z-spectral MRI data were analyzed to produce multiparametric metabolic and microenvironmental contrasts for identifying intervertebral discs with/without pain symptom and sore pain.

Methods: Z-spectra data were collected from the lumbar discs of 26 patients with non-specific chronic low bck pain (CLBP) and 21 asymptomatic controls (AC) with a chemical exchange saturation transfer (CEST). Data were fitted to quantify the CEST effects from glycosaminoglycan, amide proton transfer (APT), nuclear Overhauser enhancement (NOE), semi-solid magnetization transfer contrast effects, and the direct saturation of water. Multiparametric maps were computed from the fitted peak amplitudes, and the average values were calculated from all five lumber discs. Those parameters were compared between the CLBP and AC groups and between the subgroups with and without (Nsore) sore pain.

Results: The discs in symptomatic patients have lower water content, collagen-bound water and collagen than the discs in AC (P < 0.05). Additionally, Z-sepctral MRI indicated that the discs in the sore subgroup had less water, collagen-bound water and collagen, and likely lower pH compared to the Nsore subgroup (P < 0.05). Lower pH as measured with reduced APT and NOE effects may be an important pathological factor causing sore pain of the back.

Conclusion: Z-spectral MRI with its multiparametric metabolic and microenvironmental contrasts has been demonstrated to identify discs with and without pain symptom or sore pain, providing more important information of CLBP.
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http://dx.doi.org/10.1007/s00586-021-06733-3DOI Listing
April 2021

Altered regional homogeneity and functional brain networks in Type 2 diabetes with and without mild cognitive impairment.

Sci Rep 2020 12 4;10(1):21254. Epub 2020 Dec 4.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, Wuhan, 430030, China.

Patients with Type-2 Diabetes Mellitus (T2DM) have a considerably higher risk of developing mild cognitive impairment (MCI) and dementia. The initial symptoms are very insidious at onset. We investigated the alterations in spontaneous brain activity and network connectivity through regional homogeneity (ReHo) and graph theoretical network analyses, respectively, of resting-state functional Magnetic Resonance Imaging (rs-fMRI) in T2DM patients with and without MCI, so as to facilitate early diagnose. Twenty-five T2DM patients with MCI (DM-MCI), 25 T2DM patients with normal cognition (DM-NC), 27 healthy controls were enrolled. Whole-brain ReHo values were calculated and topological properties of functional networks were analyzed. The DM-MCI group exhibited decreased ReHo in the left inferior/middle occipital gyrus and right inferior temporal gyrus, and increased ReHo in frontal gyrus compared to the DM-NCs. Significant correlations were found between ReHo values and clinical measurements. The DM-MCI group illustrated greater clustering coefficient/local efficiency and altered nodal characteristics (efficiency, degree and betweenness), which increased in certain occipital, temporal and parietal regions but decreased in the right inferior temporal gyrus, compared to the DM-NCs. The altered ReHo and impaired network organization may underlie the impaired cognitive functions in T2DM and suggesting a compensation mechanism. These rs-fMRI measures have the potential as biomarkers of disease progression in diabetic encephalopathy.
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http://dx.doi.org/10.1038/s41598-020-76495-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7718881PMC
December 2020

Polysaccharide-Based Biomaterials in Tissue Engineering: A Review.

Tissue Eng Part B Rev 2021 Feb 26. Epub 2021 Feb 26.

Department of Biomedical Engineering, City University of Hong Kong, Kowloon, Hong Kong SAR.

In addition to proteins and nucleic acids, polysaccharides are an important type of biomacromolecule widely distributed in plants, animals, and microorganisms. Polysaccharides are considered as promising biomaterials due to their significant bioactivities, natural abundance, immunoactivity, and chemical modifiability for tissue engineering (TE) applications. Due to the similarities of the biochemical properties of polysaccharides and the extracellular matrix of human bodies, polysaccharides are increasingly recognized and accepted. Furthermore, the degradation behavior of these macromolecules is generally nontoxic. Certain delicate properties, such as remarkable mechanical properties and tunable tissue response, can be obtained by modifying the functional groups on the surface of polysaccharide molecules. The applications of polysaccharide-based biomaterials in the TE field have been growing intensively in recent decades, for example, bone/cartilage regeneration, cardiac regeneration, neural regeneration, and skin regeneration. This review summarizes the main essential properties of polysaccharides, including their chemical properties, crosslinking mechanisms, and biological properties, and focuses on the association between their structures and properties. The recent progress in polysaccharide-based biomaterials in various TE applications is reviewed, and the prospects for future studies are addressed as well. We intend this review to offer a comprehensive understanding of and inspiration for the research and development of polysaccharide-based materials in TE.
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http://dx.doi.org/10.1089/ten.TEB.2020.0208DOI Listing
February 2021

Durable clinical benefit from pyrotinib combined with carboplatin in HER2-positive relapsed breast cancer previously treated with taxanes, anthracyclines, and trastuzumab.

Ann Palliat Med 2020 Sep;9(5):3684-3689

Zhuhai People's Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, China.

Patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer inevitably progressed after a short response to initial trastuzumab treatment, suggesting a possibility of acquired-resistance to trastuzumab. Pyrotinib, an irreversible pan-ErbB receptor tyrosine kinase inhibitor (TKI), has been reported as an effective and safe drug for the treatment of HER2-positive relapsed or metastatic breast cancer. Pyrotinib combined with capecitabine is widely used to treat HER2-positive metastatic breast cancer in patients who have been previously treated with anthracyclines, taxanes, and trastuzumab. However, the efficacy of pyrotinib combined with other chemotherapy drugs is still unclear. Here we report pyrotinib combined with carboplatin in treating a patient with HER2-positive relapsed breast cancer who had acquired resistance to trastuzumab. The patient received three cycles of treatments of pyrotinib (400 mg, orally once per day, days 1-21) combined with carboplatin (600 mg, iv drip, day 1, cycled every 21 days). The patient showed an excellent response to the therapy, including faded rashes on the skin of her breast, no obvious signs of recurrence from the breast magnetic resonance imaging (MRI), decreased skin thickness and cord shadow of the right breast, unchanged degree of right pleural effusion, and no enlarged LN. The patient had a stable disease time of more than four months. Our case provides evidence for the feasibility and efficacy of pyrotinib with carboplatin in treating patients with HER2-positive relapsed or metastatic breast cancer who may develop resistance to trastuzumab.
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http://dx.doi.org/10.21037/apm-20-1363DOI Listing
September 2020

Effects of childhood trauma experience and BDNF Val66Met polymorphism on brain plasticity relate to emotion regulation.

Behav Brain Res 2021 02 11;398:112949. Epub 2020 Oct 11.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, PR China. Electronic address:

Brain-derived neurotrophic factor (BDNF) Val66Met polymorphism may modulate the link between childhood trauma experience and psychopathology by altering trophic signaling on neuroplasticity. However, few multimodal magnetic resonance imaging (MRI) researches have investigated this gene-environment interaction on both structural and functional plasticity, thereby advancing knowledge about the etiology, prevention, and customized therapeutic directions of mental disease in individuals with childhood trauma experience. We recruited a large non-clinical sample of young adults that completed Childhood Trauma Questionnaire (CTQ), behavioral scores, multimodal MRI scans, and genotyping. Morphometric similarity network (MSN) and independent component analysis were adopted to quantify brain structural and functional changes. Gene-environment-brain-behavior relationships were identified by multiple regression and mediation effect analysis. CTQ score was positively associated with depression and anxiety scores. We found interactions on MSN in sensorimotor, temporal, and orbitofrontal cortex. For intra-network connectivity, significant interaction was noted in clusters within sensorimotor network. For inter-network connectivity, connectivity between dorsal attention network and salience network showed an interactive effect. For mean connectivity strength of each network, we found a main effect of CTQ score on self-reference network that was an outstanding mediator supporting the relationship between CTQ score and anxiety. Our findings demonstrate that childhood trauma and the BDNF Val66Met polymorphism are associated with brain plasticity involving emotion regulation, structurally and functionally, which may contribute to understanding psychotic mechanisms and predicting differential susceptibility. Imaging genetics may be useful as biomarkers to provide early assessment and guide cognitive interventions to avoid or decrease the risk of developing psychopathology.
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http://dx.doi.org/10.1016/j.bbr.2020.112949DOI Listing
February 2021

Initial Experience of Challenge-Free MRI-Based Oxygen Extraction Fraction Mapping of Ischemic Stroke at Various Stages: Comparison With Perfusion and Diffusion Mapping.

Front Neurosci 2020 16;14:535441. Epub 2020 Sep 16.

Department of Radiology, Weill Cornell Medicine, New York, NY, United States.

MRI-based oxygen extraction fraction imaging has a great potential benefit in the selection of clinical strategies for ischemic stroke patients. This study aimed to evaluate the performance of a challenge-free oxygen extraction fraction (OEF) mapping in a cohort of acute and subacute ischemic stroke patients. Consecutive ischemic stroke patients (a total of 30 with 5 in the acute stage, 19 in the early subacute stage, and 6 in the late subacute stage) were recruited. All subjects underwent MRI including multi-echo gradient echo (mGRE), diffusion weighted imaging (DWI), and 3D-arterial spin labeling (ASL). OEF maps were generated from mGRE phase + magnitude data, which were processed using quantitative susceptibility mapping (QSM) + quantitative blood oxygen level-dependent (qBOLD) imaging with cluster analysis of time evolution. Cerebral blood flow (CBF) and apparent diffusion coefficient (ADC) maps were reconstructed from 3D-ASL and DWI, respectively. Further, cerebral metabolic rate of oxygen (CMRO) was calculated as the product of CBF and OEF. OEF, CMRO, CBF, and ADC values in the ischemic cores (absolute values) and their contrasts to the contralateral regions (relative values) were evaluated. One-way analysis of variance (ANOVA) was used to compare OEF, CMRO, CBF, and ADC values and their relative values among different stroke stages. The OEF value of infarct core showed a trend of decrease from acute, to early subacute, and to late subacute stages of ischemic stroke. Significant differences among the three stroke stages were only observed in the absolute OEF ( = 6.046, = 0.005) and relative OEF ( = 5.699, = 0.009) values of the ischemic core, but not in other measurements (absolute and relative CMRO, CBF, ADC values, all values of > 0.05). In conclusion, the challenge-free QSM + qBOLD-generated OEF mapping can be performed on stroke patients. It can provide more information on tissue viability that was not available with CBF and ADC and, thus, may help to better manage ischemic stroke patients.
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http://dx.doi.org/10.3389/fnins.2020.535441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525031PMC
September 2020

Effects of childhood trauma experience and COMT Val158Met polymorphism on brain connectivity in a multimodal MRI study.

Brain Behav 2020 12 30;10(12):e01858. Epub 2020 Sep 30.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Childhood adversity may act as a stressor to produce a cascade of neurobiological effects that irreversibly alter neural development, setting the stage for developing psychopathology in adulthood. The catechol-O-methyltransferase (COMT) Val158Met polymorphism has received much attention as a candidate gene associated with environmental adversity, modifying risk for psychopathology. In this study, we aim to see how gene × brain × environment models give a more integrative understanding of brain modifications that contribute to predicting psychopathology related to childhood adversity. A large nonclinical sample of young adults completed Childhood Trauma Questionnaire (CTQ), behavioral scores, multimodal magnetic resonance imaging (MRI) scans, and genotyping. We utilized graph-based connectivity analysis in morphometric similarity mapping and resting-state functional MRI to investigate brain alterations. Relationships among COMT genotypes, CTQ score, imaging phenotypes, and behavioral scores were identified by multiple regression and mediation effect analysis. Significant main effect of CTQ score was found in anatomic connectivity of orbitofrontal cortex that was an outstanding mediator supporting the relationship between CTQ score and anxiety/harm-avoiding personality. We also noted the main effect of childhood trauma on reorganization of functional connectivity within the language network. Additionally, we found genotype × CTQ score interactions on functional connectivity of the right frontoparietal network as well as anatomic connectivity of motor and limbic regions. Our data demonstrate childhood adversity and COMT genotypes are associated with abnormal brain connectivity, structurally and functionally. Early identification of individuals at risk, assessment of brain abnormality, and cognitive interventions may help to prevent or limit negative outcomes.
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http://dx.doi.org/10.1002/brb3.1858DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749512PMC
December 2020

Intracerebral hemorrhage as initial presentation of metastatic choriocarcinoma: A case report.

Radiol Case Rep 2020 Nov 15;15(11):2335-2338. Epub 2020 Sep 15.

Department of radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

Metastatic brain tumors are the rare cause of intracerebral hemorrhage in the young. In this study, we present a case of a 24-year-old woman who suffered from brain and lung metastatic choriocarcinoma with intracerebral hemorrhage as initial presentation. Head computed tomography showed an irregular hematoma of the right frontal lobe and enlarged within 1 month. Chest X ray showed a mass in the right lung. This patient responded well with combined treatment with craniotomy for evacuation of hematoma, multidrug chemotherapy and lobectomy. This case report discusses a rare phenomenon of hemorrhage metastasis in the brain from choriocarcinoma. The better knowledge of this entity would facilitate earlier diagnosis and improve the outcome.
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http://dx.doi.org/10.1016/j.radcr.2020.09.012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7501481PMC
November 2020

Novel proton exchange rate MRI presents unique contrast in brains of ischemic stroke patients.

J Neurosci Methods 2020 12 5;346:108926. Epub 2020 Sep 5.

Departments of Radiology, Department of Bioengineering, the Center for MR Research, University of Illinois at Chicago, Chicago, USA. Electronic address:

Background: To map and quantify the proton exchange rate (k) of brain tissues using improved omega plots in ischemic stroke patients and to investigate whether k can serve as a potential endogenous surrogate imaging biomarker for detecting the metabolic state and the pathologic changes due to ischemic stroke.

New Method: Three sets of Z-spectra were acquired from seventeen ischemic stroke patients using a spin echo-echo planar imaging sequence with pre-saturation chemical exchange saturation transfer (CEST) pulse at B of 1.5, 2.5, and 3.5 μT, respectively. Pixel-wise k was calculated from improved omega plot of water direct saturation (DS)-removed Z-spectral signals.

Results: The derived k maps can differentiate infarcts from contralateral normal brain tissues with significantly increased signal (893 ± 52 svs. 739 ± 34 s, P < 0.001).

Comparison With Existing Method(s): The k maps were found to be different from conventional contrasts from diffusion-weighted imaging (DWI), CEST, and semi-solid magnetization transfer (MT) MRI. In brief, k MRI showed larger lesion areas than DWI with different degrees and different lesion contrast compared to CEST and MT.

Conclusions: In this preliminary translational research, the k MRI based on DS-removed omega plots has been demonstrated for in vivo imaging of clinical ischemic stroke patients. As a noninvasive and unique MRI contrast, k MRI at 3 T may serve as a potential surrogate imaging biomarker for the metabolic changes of stroke and help for monitoring the evolution and the treatment of stroke.
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http://dx.doi.org/10.1016/j.jneumeth.2020.108926DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606776PMC
December 2020

Interactions at engineered graft-tissue interfaces: A review.

APL Bioeng 2020 Sep 21;4(3):031502. Epub 2020 Aug 21.

School of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225009, Jiangsu, People's Republic of China.

The interactions at the graft-tissue interfaces are critical for the results of engraftments post-implantation. To improve the success rate of the implantations, as well as the quality of the patients' life, understanding the possible reactions between artificial materials and the host tissues is helpful in designing new generations of material-based grafts aiming at inducing specific responses from surrounding tissues for their own reparation and regeneration. To help researchers understand the complicated interactions that occur after implantations and to promote the development of better-designed grafts with improved biocompatibility and patient responses, in this review, the topics will be discussed from the basic reactions that occur chronologically at the graft-tissue interfaces after implantations to the existing and potential applications of the mechanisms of such reactions in designing of grafts. It offers a chance to bring up-to-date advances in the field and new strategies of controlling the graft-tissue interfaces.
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http://dx.doi.org/10.1063/5.0014519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443169PMC
September 2020

Autologous cell membrane coatings on tissue engineering xenografts for suppression and alleviation of acute host immune responses.

Biomaterials 2020 11 11;258:120310. Epub 2020 Aug 11.

Department of Biomedical Engineering, City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong. Electronic address:

Xenogeneic extracellular matrix (ECM) based tissue engineering graft is one of the most promising products for transplantation therapies, which could alleviate the pain of patients and reduce surgery cost. However, in order to put ECM based xenografts into clinical use, the induced inflammatory and immune responses have yet to be resolved. Cell membrane is embedded with membrane proteins for regulation of cell interactions including self-recognition and potent in reducing foreign body rejections. In this study, a novel and facile method for evasion from immune system was developed by coating autologous red blood cell membrane as a disguise on xenogeneic ECM based tissue engineering graft surface. Porcine source Living Hyaline Cartilage Graft (LhCG) and decellularized LhCG (dLhCG) established by our group for cartilage tissue engineering were chosen as model grafts. The cell membrane coating was quite stable on xenografts with no obvious decrease in amount for 4 weeks. The autologous cell membrane coated xenograft has been proved to be recognized as "self" by immune system on cell, protein and gene levels according to the 14-day lasting in vivo study on rats with less inflammatory cells infiltrated and low inflammation-related cytokines gene expression, showing alleviated acute immune and inflammatory responses.
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http://dx.doi.org/10.1016/j.biomaterials.2020.120310DOI Listing
November 2020

Clinical and CT characteristics of healthcare workers with COVID-19: A single-centered, retrospective study.

Medicine (Baltimore) 2020 Jul;99(30):e21396

Department of Radiology.

A large number of healthcare workers have been infected with coronavirus disease-2019 (COVID-19). We aimed to investigate their clinical and chest computed tomography (CT) characteristics.The clinical, laboratory test and CT features of 43 medical and hospital staff with confirmed COVID-19 (MP group, 26-70 years old) were retrospectively analyzed, and compared to 43 non-medical related patients (non-MP group, 26-71 years old). Follow-up CT characteristics were analyzed to assess the disease progression in the period of hospitalization.At admission, the main complaints of the MP group, including fever (81.4%), fatigue (48.8%) and cough (41.9%), were similar to the non-MP group. The C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase levels were higher in the non-MP group than the MP group (17.5 ± 22.4 mg/L, 20.2 ± 23.4 mm/H and 219 ± 66U/L, respectively, P < .05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The severity of opacities on initial CT were less in the MP group (5.3 ± 3.9 scores) than in the non-MP group (9.1 ± 4.8 scores, P < .05). Before regular treatments, the sum score of the opacities showed weak to moderate correlations with duration, C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels (R ranged from 0.341-0.651, P < .05). In the study time window, the duration from illness onset to when the most obvious pulmonary opacities were observed, according to CT findings, were similar in the MP group (13.3 ± 6.6 days) and the non-MP group (13.8 ± 5.1 days, P = .69). Mild to moderate anxiety and depression were observed in both groups.Despite greater knowledge of how to protect themselves than the general population, healthcare workers are also susceptible to COVID-19 infection. Occupational exposure is a very important factor. Healthcare workers have a higher vigilance about the infection in the early stage of the disease.
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http://dx.doi.org/10.1097/MD.0000000000021396DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7386973PMC
July 2020

Effects of Mrp8/14 on mice with IgA nephropathy via regulating NF-κB p65/p38-MAPK signaling pathway.

Minerva Med 2020 Jul 21. Epub 2020 Jul 21.

Department of Pediatric Rheumatology Immunology, Provincial Hospital Affiliated to Shandong University, Jinan, China -

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http://dx.doi.org/10.23736/S0026-4806.20.06709-9DOI Listing
July 2020

Clinical and Imaging Features of COVID-19 in a Neonate.

Chest 2020 07 2;158(1):e5-e7. Epub 2020 Jul 2.

Department of Radiology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology (Ringgold standard institution), Wuhan, Hubei, China. Electronic address:

We report the clinical history, laboratory findings, and imaging features of coronavirus disease 2019 (COVID-19) in a neonate whose mother was also a patient. The newborn was the youngest patient with COVID-19 in the world at the time he was diagnosed. This case has brought more attention and understanding to the epidemic and mode of transmission of the disease.
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http://dx.doi.org/10.1016/j.chest.2020.03.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7330548PMC
July 2020

Stabilized albumin coatings on engineered xenografts for attenuation of acute immune and inflammatory responses.

J Mater Chem B 2020 07;8(28):6080-6091

City University of Hong Kong, Tat Chee Avenue, Kowloon, Hong Kong.

Xenogeneic grafts are promising candidates for transplantation therapy due to their easily accessible sources. Nevertheless, the immune and inflammatory responses induced by xenografts need to be addressed for clinical use. A novel and facile method was introduced for the attenuation of immune and inflammatory responses by extending the immune evasion potential of albumin to the tissue engineering field and coating albumin, which could passivate biomaterial surfaces, onto xenografts. Albumin was first modified by dopamine to enhance its adhesion on graft surfaces. Porcine chondrocytes derived living hyaline cartilage graft (LhCG) and decellularized LhCG (dLhCG) were applied as xenograft models implanted in the omentum of rats. Both LhCG which contained porcine chondrocytes as well as secreted ECM and dLhCG which was mainly composed of the porcine source ECM showed alleviated immune and inflammatory responses after being coated with albumin at cell, protein and gene levels, respectively. Significantly less inflammatory cells including neutrophils, macrophages and lymphocytes were recruited according to pathological analysis and immunohistochemistry staining with lower gene expression encoding inflammation-related cytokines including MCP-1, IL-6 and IL-1β after employing LhCG and dLhCG with albumin passivation coating.
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http://dx.doi.org/10.1039/d0tb01111hDOI Listing
July 2020

The delineation of largely deformed brain midline using regression-based line detection network.

Med Phys 2020 Nov 15;47(11):5531-5542. Epub 2020 Oct 15.

Shanghai United Imaging Intelligence Co., Ltd., Shanghai, 201807, China.

Purpose: The human brain has two cerebral hemispheres that are roughly symmetric and separated by a midline, which is nearly a straight line shown in axial computed tomography (CT) images in healthy subjects. However, brain diseases such as hematoma and tumors often cause midline shift, where the degree of shift can be regarded as a quantitative indication in clinical practice. To facilitate clinical evaluation, we need computer-aided methods to automate this quantification. Nevertheless, most existing studies focused on the landmark- or symmetry-based methods that provide only the existence of shift or its maximum distance, which could be easily affected by anatomical variability and large brain deformations. Intuitive results such as midline delineation or measurement are lacking. In this study, we focus on developing an automated and robust method based on the fully convolutional neural network for the delineation of midline in largely deformed brains.

Methods: We propose a novel regression-based line detection network (RLDN) for the robust midline delineation, especially in largely deformed brains. Specifically, to improve the robustness of delineation in largely deformed brains, we regard the delineation of the midline as the skeleton extraction task and then use the multiscale bidirectional integration module to acquire more representative features. Based on the skeleton extraction, we incorporate the regression task into it to delineate more accurate and continuous midline, especially in largely deformed brains. Our study utilized the public CQ 500 dataset (128 subjects) for training with hold-out validation on 61 subjects from a private cohort accrued from a local hospital.

Results: The mean line distance error and F1-score were 1.17 ± 0.72 mm with 0.78 on CQ 500 test set, and 4.15 ± 3.97 mm with 0.61 on the private dataset. Besides, significant differences (P < 0.05) were observed between our method and other comparative ones on these two datasets.

Conclusions: This work provides a novel solution to acquire robust delineation of the midline, especially in largely deformed brains, and achieves state-of-the-art performance on the public and our private dataset, which makes it possible for automated diagnosis of relevant brain diseases in the future.
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http://dx.doi.org/10.1002/mp.14302DOI Listing
November 2020

Obesity predisposes to the risk of higher mortality in young COVID-19 patients.

J Med Virol 2020 11 19;92(11):2536-2542. Epub 2020 Jun 19.

Department of Radiology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China.

Although emerging data demonstrated mortality of young COVID-19 patients, no data have reported the risk factors of mortality for these young patients, and whether obesity is a risk for young COVID-19 patients remains unknown. We conducted a retrospective study including 13 young patients who died of COVID-19 and 40 matched survivors. Logistic regression was employed to characterize the risk factors of mortality in young obese COVID-19 patients. Most of the young deceased COVID-19 patients were mild cases at the time of admission, but the disease progressed rapidly featured by a higher severity of patchy shadows (100.00% vs 48.70%; P = .006), pleural thickening (61.50% vs 12.80%; P = .012), and mild pericardial effusion (76.90% vs 0.00%; P < .001). Most importantly, the deceased patients manifested higher body mass index (odds ratio [OR] = 1.354; 95% confidence interval [CI] = 1.075-1.704; P = .010), inflammation-related index C-reactive protein (OR = 1.014; 95% CI = 1.003-1.025; P = .014), cardiac injury biomarker hs-cTnI (OR = 1.420; 95% CI = 1.112-1.814; P = .005), and increased coagulation activity biomarker D-dimer (OR = 418.7; P = .047), as compared with that of survivors. Our data support that obesity could be a risk factor associated with high mortality in young COVID-19 patients, whereas aggravated inflammatory response, enhanced cardiac injury, and increased coagulation activity are likely to be the mechanisms contributing to the high mortality.
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http://dx.doi.org/10.1002/jmv.26039DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280697PMC
November 2020

Age and anatomical location related hemodynamic changes assessed by 4D flow MRI in the carotid arteries of healthy adults.

Eur J Radiol 2020 Jul 4;128:109035. Epub 2020 May 4.

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. Electronic address:

Purpose: To evaluate hemodynamic changes (volume, velocity, wall shear stress, pressure gradient, and energy loss) in the common carotid artery (CCA) and internal carotid artery (ICA) of healthy adults among different ages and anatomical locations using 4D flow MRI.

Methods: Sixty-two healthy volunteers aged 20-75 years were enrolled in this study. 4D flow MRI examinations were performed for each subject and were analyzed using the CVI42 platform to generate hemodynamic parameters. Hemodynamic parameters were compared among different age groups and anatomical locations (proximal CCA, distal CCA, proximal ICA and distal CCA) using one-way ANOVA. The paired t-test was used to estimate the differences between left and right vessels. The relationship between age and hemodynamic parameters was quantified by Pearson's correlation coefficient.

Results: There were no differences between the left and right carotid arteries for any of the hemodynamic parameters (all p values > 0.05), so we set each vessel as an independent sample. The proximal ICA had significantly lower volume, velocity, wall shear stress, and pressure gradient values than the values determined for other locations (p < 0.05), and energy loss was similar among different locations. Wall shear stress (except in the distal ICA), velocity, pressure gradient, and energy loss decreased with age (p < 0.05).

Conclusions: The multiparameter analysis of 4D flow MRI can identify age and anatomical location changes in hemodynamic parameters in the carotid arteries of healthy adults. The lower velocity, wall shear stress, and pressure gradient in the proximal ICA and the reduced trend with age may be associated with disease occurrence.
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http://dx.doi.org/10.1016/j.ejrad.2020.109035DOI Listing
July 2020

Mitochondria determine the sequential propagation of the calcium macrodomains revealed by the super-resolution calcium lantern imaging.

Sci China Life Sci 2020 Oct 8;63(10):1543-1551. Epub 2020 Apr 8.

State Key Laboratory of Membrane Biology, Beijing Key Laboratory of Cardiometabolic Molecular Medicine, Institute of Molecular Medicine, Peking University, Beijing, 100871, China.

Despite the wide application of super-resolution (SR) microscopy in biological studies of cells, the technology is rarely used to monitor functional changes in live cells. By combining fast spinning disc-confocal structured illumination microscopy (SD-SIM) with loading of cytosolic fluorescent Ca indicators, we have developed an SR method for visualization of regional Ca dynamics and related cellular organelle morphology and dynamics, termed SR calcium lantern imaging. In COS-7 cells stimulated with ATP, we have identified various calcium macrodomains characterized by different types of Ca+ release from endoplasmic reticulum (ER) stores. Finally, we demonstrated various roles of mitochondria in mediating calcium signals from different sources; while mitochondria can globally potentiate the Ca+ entry associated with store release, mitochondria also locally control Ca release from the neighboring ER stores and assist in their refilling processes.
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http://dx.doi.org/10.1007/s11427-019-1659-4DOI Listing
October 2020

Structural changes in the lobar regions of brain in cerebral small-vessel disease patients with and without cognitive impairment: An MRI-based study with automated brain volumetry.

Eur J Radiol 2020 May 19;126:108967. Epub 2020 Mar 19.

BrainNow Research Institute, Shenzhen, Guangdong Province, 518000, China; Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.

Purpose: This study aims to investigate the alterations of brain volumetry and associated structural covariance at lobar level in cerebral small-vessel disease (CSVD) with and without cognitive impairment.

Method: Twenty-seven CSVD patients with mild cognitive impairment (CSVD-MCI), 37 CSVD patients with normal cognition (CSVD-NC), and 35 controls, underwent T1-weighted imaging of magnetic resonance. Volume of gray matter (GM) and white matter (WM) and a lobar atrophy index that measures the ratio of cerebrospinal fluid to brain parenchyma were quantified for each lobe. One-way ANOVA with multiple comparison corrections was performed to compare these volumetric measures. Volumetric structural covariance analyses were performed with lobar atrophy indexes to investigate the alterations of anatomical covariance within each pair of lobar regions in CSVD-NC and CSVD-MCI subjects compared with controls.

Results: CSVD-NC subjects presented no significant volumetric differences with controls in any of the lobar regions. Compared with controls, CSVD-MCI patients presented significantly smaller volume of GM in bilateral frontal and parietal lobes, significantly smaller volume of WM in right cingulate lobe, and significantly larger lobar atrophy indexes of bilateral temporal, insular lobes and left cingulate lobe (P < 0.05). Both CSVD-NC group and CSVD-MCI group showed significant differences of structural covariance as measured by lobar atrophy index compared with controls. In particular, CSVD-MCI group showed even more extensive alterations of structural covariance, especially in bilateral cingulate and temporal lobes.

Conclusions: There are alterations of brain volumetry and associated structural covariance within lobar regions in CSVD, which indicates the potential brain structural reorganization in CSVD.
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http://dx.doi.org/10.1016/j.ejrad.2020.108967DOI Listing
May 2020

A DOPA-functionalized chondroitin sulfate-based adhesive hydrogel as a promising multi-functional bioadhesive.

J Mater Chem B 2019 03 20;7(10):1741-1752. Epub 2018 Dec 20.

Division of Bioengineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, 70 Nanyang Drive, N1.3-B2-13, Singapore 637457, Singapore.

Great progress has been achieved on the study of hydrogels, which were presented for the first time in 1960 by Otto Wichterle and Drahoslav Lím. The two crucial properties of hydrogels, namely high water content and biocompatibility, have made hydrogels ideal compositions in the development of bioadhesives in recent years. Chondroitin sulfate (CS), a sulfated glycosaminoglycan (GAG), is distributed throughout animal bodies, including cartilage and the extracellular matrix (ECM), and it has been widely utilized in the dietary supplement and pharmaceutical industries. Besides, CS has been reported to have excellent pain-relief and anti-inflammation properties. Some studies have even reported CS's wound healing promoting ability. In this study, taking advantage of CS's excellent physical and chemical properties, DOPA groups were functionalized onto CS backbones. After that, the potential of the newly established CS-DOPA (CSD) hydrogel to work as a bioadhesive in multiple internal medical conditions was evaluated through in vitro and in vivo means. The outcomes of the in vivo assessments demonstrated CSD's promising potential to be further commercialized into an adhesive hydrogel product, and to be utilized in diverse clinical medications in the future.
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http://dx.doi.org/10.1039/c8tb01990hDOI Listing
March 2019

Sub-regional anterior cingulate cortex functional connectivity revealed default network subsystem dysfunction in patients with major depressive disorder.

Psychol Med 2020 Mar 10:1-9. Epub 2020 Mar 10.

Department of Psychology, Hunan Normal University, Changsha, China.

Background: Major depressive disorder (MDD) is a prevalent mental disorder characterized by impairments in affect, behaviour and cognition. Previous studies have indicated that the anterior cingulate cortex (ACC) may play an essential role in the pathophysiology of depression. In this study, we systematically identified changes in functional connectivity (FC) for ACC subdivisions that manifest in MDD and further investigated the relationship between these changes and the clinical symptoms of depression.

Methods: Sub-regional ACC FC was estimated in 41 first-episode medication-naïve MDD patients compared to 43 healthy controls. The relationships between depressive symptom severity and aberrant FC of ACC subdivisions were investigated. In addition, we conducted a meta-analysis to generate the distributions of MDD-related abnormal regions from previously reported results and compared them to FC deficits revealed in this study.

Results: In MDD patients, the subgenual and perigenual ACC demonstrated decreased FC with the posterior regions of the default network (DN), including the posterior inferior parietal lobule and posterior cingulate cortex. FC of these regions was negatively associated with the Automatic Thoughts Questionnaire scores and largely overlapped with previously reported abnormal regions. In addition, reduced FC between the caudal ACC and precuneus was negatively correlated with the Hamilton Anxiety Scale scores. We also found increased FC between the rostral ACC and dorsal medial prefrontal cortex.

Conclusions: Our findings confirmed that functional interaction changes in different ACC sub-regions are specific and associated with distinct symptoms of depression. Our findings provide new insights into the role of ACC sub-regions and DN in the pathophysiology of MDD.
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http://dx.doi.org/10.1017/S0033291720000434DOI Listing
March 2020

Clinical and High-Resolution CT Features of the COVID-19 Infection: Comparison of the Initial and Follow-up Changes.

Invest Radiol 2020 06;55(6):332-339

From the Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

Objectives: In late December 2019, an outbreak of coronavirus disease (COVID-19) in Wuhan, China was caused by a novel coronavirus, newly named severe acute respiratory syndrome coronavirus 2. We aimed to quantify the severity of COVID-19 infection on high-resolution chest computed tomography (CT) and to determine its relationship with clinical parameters.

Materials And Methods: From January 11, 2020, to February 5, 2020, the clinical, laboratory, and high-resolution CT features of 42 patients (26-75 years, 25 males) with COVID-19 were analyzed. The initial and follow-up CT, obtained a mean of 4.5 days and 11.6 days from the illness onset were retrospectively assessed for the severity and progression of pneumonia. Correlations among clinical parameters, initial CT features, and progression of opacifications were evaluated with Spearman correlation and linear regression analysis.

Results: Thirty-five patients (83%) exhibited a progressive process according to CT features during the early stage from onset. Follow-up CT findings showed progressive opacifications, consolidation, interstitial thickening, fibrous strips, and air bronchograms, compared with initial CT (all P < 0.05). Before regular treatments, there was a moderate correlation between the days from onset and sum score of opacifications (R = 0.68, P < 0.01). The C-reactive protein, erythrocyte sedimentation rate, and lactate dehydrogenase showed significantly positive correlation with the severity of pneumonia assessed on initial CT (Rrange, 0.36-0.75; P < 0.05). The highest temperature and the severity of opacifications assessed on initial CT were significantly related to the progression of opacifications on follow-up CT (P = 0.001-0.04).

Conclusions: Patients with the COVID-19 infection usually presented with typical ground glass opacities and other CT features, which showed significant correlations with some clinical and laboratory measurements. Follow-up CT images often demonstrated progressions during the early stage from illness onset.
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http://dx.doi.org/10.1097/RLI.0000000000000674DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147282PMC
June 2020

Fiber Connectivity Density in Cerebral Small-Vessel Disease Patients With Mild Cognitive Impairment and Cerebral Small-Vessel Disease Patients With Normal Cognition.

Front Neurosci 2020 12;14:83. Epub 2020 Feb 12.

Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Hong Kong, China.

Abnormal structural connectivity of cerebral small-vessel disease (CSVD) is associated with cognitive impairment. But the different characteristics of structural connectivity have not been elucidated in early CSVD patients. The current study aimed to investigate the potential differences of structural connectivity in CSVD patients with mild cognitive impairment (MCI) and CSVD patients with normal cognition. Twenty-two CSVD patients with MCI, 34 CSVD patients with normal cognition, and 35 controls, who were age, sex, and education matched underwent diffusion tensor imaging and high resolution T1-weighted imaging. Clinical characteristics, lacunar infarct volume, white matter hyperintensity (WMH) volume, and global atrophy were quantitatively evaluated. Maps of fiber connectivity density (FiCD) were constructed and compared across groups in vertex levels. Pearson correlation was used to estimate the imaging-clinical relationships with control of general characteristics. CSVD patients with MCI had higher lesion load of WMH and lacunar infarcts, and correspondingly lower global FiCD value than CSVD patients with normal cognition ( < 0.01). Lacunar infarct ( = -0.318, < 0.01) and WMH ( = -0.400, < 0.01), but not global atrophy, age, or sex, were significantly correlated with the global FiCD value. CSVD patients with normal cognition showed decreased FiCD value mainly in the prefrontal areas ( < 0.01 with Monte Carlo correction). Compared with CSVD patients with normal cognition, CSVD patients with MCI showed significantly decreased FiCD value in enlarged frontal and parietal areas ( < 0.01 with Monte Carlo correction). Inter-group comparisons showed regional enhanced impairment of connectivity density in CSVD patients with MCI in the left superior frontal gyrus, the left precuneus, and the orbital part of the right inferior frontal gyrus ( < 0.01 with Monte Carlo correction). Regional FiCD value of frontal and parietal areas was associated with the cognitive function ( < 0.01). In conclusion, cognitively normal CSVD patients already have disruptions of structural connectivity. The extent and intensity of connectivity disruptions in frontal and parietal areas may underlie the mechanism of cognitive impairment in CSVD. Fiber connectivity density measurements may be helpful for quantitative description of structural cortical connectivity.
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http://dx.doi.org/10.3389/fnins.2020.00083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7028684PMC
February 2020