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Bhatia H, Bhatia A, Mathew JL, Saxena AK, Kumar P, Nallasamy K, Tao T, Sodhi KS. Tracheobronchial abnormalities on computed tomography angiography in children with congenital heart disease. Pediatr Pulmonol 2024; 59:1438-1448. [PMID: 38376264 DOI: 10.1002/ppul.26934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/17/2024] [Accepted: 02/12/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES To evaluate the assortment of tracheobronchial abnormalities on computed tomography angiography (CTA) in children with congenital heart disease (CHD). METHODS In this study approved by the Institute ethics committee, CTA studies of 182 children (age range: 2 days-8 years) with CHD, performed from July 2021 to March 2023 were analyzed. Two pediatric radiologists independently assessed the tracheobronchial airways (from the trachea to lobar bronchi) for developmental and branching anomalies and airway compromise (narrowing). In cases which demonstrated airway compromise, the extent and the cause of airway narrowing were evaluated, and the etiology were divided into extrinsic and intrinsic causes. Interobserver agreement between the two radiologists was calculated using kappa statistics. RESULTS One hundred children demonstrated normal airway anatomy and no luminal narrowing. Airway narrowing was observed in 63 (34.6%) children (κ: 0.954), and developmental airway anomalies were seen in 32 (17.5%) children (κ: 0.935). Of the 63 children with airway narrowing, 47 (25.8%) children had extrinsic cause for narrowing, 11 (6%) children had intrinsic causes for narrowing, and 5 (2.7%) children had both intrinsic and extrinsic causes attributing to airway compromise. Significant airway narrowing (>50% reduction) was seen in 35 (19.2%) children (κ: 0.945). CONCLUSION Tracheobronchial airway abnormalities are frequently associated in children with CHD and need to be appraised preoperatively. Cross-sectional imaging with CTA provides excellent information on tracheobronchial airway anatomy and caliber as well as delineates the possible etiology of airway narrowing, thus accurately diagnosing airway anomalies.
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Affiliation(s)
- Harsimran Bhatia
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Anmol Bhatia
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Joseph L Mathew
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Akshay K Saxena
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Praveen Kumar
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Karthi Nallasamy
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ting Tao
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kushaljit S Sodhi
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Liu Y, Niu H, Zhang T, Cai L, Liu D, Zhao E, Zhu L, Qiao P, Zheng W, Ren P, Wang Z. Altered spontaneous brain activity during dobutamine challenge in healthy young adults: A resting-state functional magnetic resonance imaging study. Front Neurosci 2023; 16:1033569. [PMID: 36685245 PMCID: PMC9853379 DOI: 10.3389/fnins.2022.1033569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023] Open
Abstract
Introduction There is a growing interest in exploring brain-heart interactions. However, few studies have investigated the brain-heart interactions in healthy populations, especially in healthy young adults. The aim of this study was to explore the association between cardiovascular and spontaneous brain activities during dobutamine infusion in healthy young adults. Methods Forty-eight right-handed healthy participants (43 males and 5 females, range: 22-34 years) underwent vital signs monitoring, cognitive function assessment and brain MRI scans. Cardiovascular function was evaluated using blood pressure and heart rate, while two resting-state functional magnetic resonance imaging (rs-fMRI) methods-regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF)-were used together to reflect the local neural activity of the brain. Logistic regression was used to model the association between brain and heart. Results Results showed that blood pressure and heart rate significantly increased after dobutamine infusion, and the performance in brain functional activity was the decrease in ReHo in the left gyrus rectus and in ALFF in the left frontal superior orbital. The results of logistic regression showed that the difference of diastolic blood pressure (DBP) had significant positive relationship with the degree of change of ReHo, while the difference of systolic blood pressure (SBP) had significant negative impact on the degree of change in ALFF. Discussion These findings suggest that the brain-heart interactions exist in healthy young adults under acute cardiovascular alterations, and more attention should be paid to blood pressure changes in young adults and assessment of frontal lobe function to provide them with more effective health protection management.
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Affiliation(s)
- Yawen Liu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Haijun Niu
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Tingting Zhang
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China,Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Linkun Cai
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Dong Liu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Erwei Zhao
- National Space Science Center, Chinese Academy of Sciences (CAS), Beijing, China
| | - Liang Zhu
- National Research Center for Rehabilitation Technical Aids, Beijing, China
| | - PengGang Qiao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wei Zheng
- National Space Science Center, Chinese Academy of Sciences (CAS), Beijing, China
| | - Pengling Ren
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China,Pengling Ren,
| | - Zhenchang Wang
- School of Biological Science and Medical Engineering, Beihang University, Beijing, China,Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China,*Correspondence: Zhenchang Wang,
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Tan S, Xu Z. Intelligent Algorithm-Based Multislice Spiral Computed Tomography to Diagnose Coronary Heart Disease. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4900803. [PMID: 35069783 PMCID: PMC8776441 DOI: 10.1155/2022/4900803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/11/2021] [Accepted: 12/22/2021] [Indexed: 11/18/2022]
Abstract
In this study, dictionary learning and expectation maximization reconstruction (DLEM) was combined to denoise 64-slice spiral CT images, and results of coronary angiography (CAG) were used as standard to evaluate its clinical value in diagnosing coronary artery diseases. 120 patients with coronary heart disease (CHD) confirmed by CAG examination were retrospectively selected as the research subjects. According to the random number table method, the patients were divided into two groups: the control group was diagnosed by conventional 64-slice spiral CT images, and the observation group was diagnosed by 64-slice spiral CT images based on the DLEM algorithm, with 60 cases in both groups. With CAG examination results as the standard, the diagnostic effects of the two CT examination methods were compared. The results showed that when the number of iterations of maximum likelihood expectation maximization (MLEM) algorithm reached 50, the root mean square error (RMSE) and peak signal to noise ratio (PSNR) values were similar to the results obtained by the DLEM algorithm under a number of iterations of 10 when the RMSE and PSNR values were 18.9121 dB and 74.9911 dB, respectively. In the observation group, 28.33% (17/60) images were of grade 4 or above before processing; after processing, it was 70% (42/60), significantly higher than the proportion of high image quality before processing. The overall diagnostic consistency, sensitivity, specificity, and accuracy (88.33%, 86.67%, 80%, and 85%) of the observation group were better than those in the control group (60.46%, 62.5%, 58.33%, and 61.66%). In conclusion, the DLEM algorithm has good denoising effect on 64-slice spiral CT images, which significantly improves the accuracy in the diagnosis of coronary artery stenosis and has good clinical diagnostic value and is worth promoting.
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Affiliation(s)
- Shaowen Tan
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
| | - Zili Xu
- Department of Cardiovascular Medicine, The Third Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang, Hunan 421001, China
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Houska N, Twite MD, Ing RJ. The Importance of the Airway in Children Undergoing Surgery for Congenital Heart Disease. J Cardiothorac Vasc Anesth 2020; 35:145-147. [PMID: 33004270 DOI: 10.1053/j.jvca.2020.09.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 09/05/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Nicholas Houska
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Mark D Twite
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
| | - Richard J Ing
- Department of Anesthesiology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO
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Kylat RI. Tracheal Stenosis and Congenital Heart Disease in Trisomy 21. CHILDREN-BASEL 2019; 6:children6090098. [PMID: 31487969 PMCID: PMC6769800 DOI: 10.3390/children6090098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/28/2019] [Accepted: 09/02/2019] [Indexed: 01/13/2023]
Abstract
Tracheal rings (TR) are rare, congenital cartilaginous defect of the upper airway and are usually due to complete or near complete circumferential cartilaginous tracheal rings, with variable degrees of tracheal stenosis (TS) and shortening. Chromosomal anomalies like trisomy 21 are characteristically associated with a wide range of upper airway anomalies including TS and congenital heart disease (CHD). However, the overall prevalence of severe forms of TS is rare and reported in 1.2% of all CHD patients. Herein, we present a rare association of severe TS due to complete tracheal rings in a trisomy 21 patient with CHD and the challenges in the management.
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Affiliation(s)
- Ranjit I Kylat
- Department of Pediatrics, University of Arizona, College of Medicine, Tucson, AZ 85724, USA.
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