Contrast-enhancement cardiac magnetic resonance imaging beyond the scope of viability

The clinical applications of cardiovascular magnetic resonance imaging with contrast enhancement are expanding. Besides the direct visualisation of viable and non-viable myocardium, this technique is increasingly used in a variety of cardiac disorders to determine the exact aetiology, guide proper treatment, and predict outcome and prognosis. In this review, we discuss the value of cardiovascular magnetic resonance imaging with contrast enhancement in a range of cardiac disorders, in which this technique may provide insights beyond the scope of myocardial viability.     

Structure of antimicrobial peptides and lipid membranes probed by interface-sensitive X-ray scattering

The conformation and correlations of amphiphilic and antimicrobial peptides and the associated changes of lipid bilayers can be studied in oriented lipid membranes deposited on solid substrates. Here we review recent work on these systems, as studied by modern interface-sensitive X-ray and neutron scattering methods. Density profile, short range order of acyl chains and molecular conformations of peptides and lipids are probed in the fluid state of the bilayer. With an emphasis on technical aspects, we review recent work illustrating the potential of the methods and discuss its potential in the field.     

两种碘浓度对比剂对肾脏CT增强扫描的对比研究

目的：对比300 mgI.ml-1对比剂与400 mgI.ml-1对比剂对肾脏多层面CT（multislice CT,MSCT）多期增强扫描的强化作用及不良反应。材料与方法：68例腹部CT受检者随机分成两组各34例,分别给予肾脏平扫和典比乐300（300 mgI.ml-1）与碘迈伦400（400 mgI.ml-1）的多期增强MSCT扫描（在对比剂开始注射后18s、30 s、80 s、3 min~5 min）,测量各期增强扫描腹主动脉、双肾动脉、双肾静脉、双肾皮质、双肾髓质、双肾盂的CT强化值。观察对比剂的不良反应。结果：使用400 mgI.ml-1对比剂在18s与30s采集,所检测的血管与肾各结构强化均值有意义高于300 mgI.ml-1对比剂（p〈0.01）,80 s采集,肾动脉、肾静脉、肾髓质强化均值有意义高于300 mgI.ml-1对比剂（p〈0.01）,3 min~5 min采集,肾静脉与肾盂强化均值有意义高于300 mgI.ml-1对比剂（p〈0.01）。结论：高碘浓度对比剂对肾脏各解剖结构的显示优于标准碘浓度对比剂,并可降低对比剂用量,而不良反应并无增加。     

Study of non-covalent interactions between MRI contrast agents and human serum albumin by NMR diffusometry

The NMR diffusometry technique, based on the measurement of the diffusion coefficient of a ligand in the absence and in the presence of its macromolecular partner, was used to study the affinity for human serum albumin (HSA) of four gadolinium complexes, potential or already used magnetic resonance imaging contrast agents. Diamagnetic lanthanum(III) ion or europium(III) ion, which has the advantage of shifting the NMR signals far away from those of the macromolecule, was used to avoid the excessive broadening of the NMR signals induced by the gadolinium(III) ion. Titration experiments, in which the HSA concentration was kept constant and the concentration of the europium or lanthanum chelate was varied, were performed to evaluate the association constant and the number of binding sites. Some additional information about the kinetics of the exchange between the free and the bound chelate was also obtained. Competition experiments with ibuprofen and salicylate, which are ligands with a known affinity for the macromolecule and for which the binding site is known, were also performed to get information about the binding site of the contrast agents.     

Solvent H NMRD study of biotinylated paramagnetic liposomes containing Gd-bis-SDA-DTPA or Gd-DMPE-DTPA

The relaxometric properties of two biotinylated paramagnetic liposomes with different lipophilic complexes have been investigated by water proton nuclear magnetic resonance dispersion. The proton relaxivity was found to have a peak at the proton Larmor frequencies generally used in MRI, and to be largely affected by the residence lifetime of the water molecule in the coordination site of the metal chelate. The measurements also indicate that a local motion in the nanosecond time scale, i.e. much faster than the rotational time of the whole liposome, is effective. Possible explanations for this behavior are discussed, that may provide guidelines for the design of second-generation paramagnetic liposomes as contrast agents.     

Decreased solute adsorption onto cracked surfaces of mechanically injured articular cartilage: Towards the design of cartilage-specific functional contrast agents

Background

Currently available methods for contrast agent-based magnetic resonance imaging (MRI) and computed tomography (CT) of articular cartilage can only detect cartilage degradation after biochemical changes have occurred within the tissue volume. Differential adsorption of solutes to damaged and intact surfaces of cartilage may be used as a potential mechanism for detection of injuries before biochemical changes in the tissue volume occur.

Methods

Adsorption of four fluorescent macromolecules to surfaces of injured and sliced cartilage explants was studied. Solutes included native dextran, dextrans modified with aldehyde groups or a chondroitin sulfate (CS)-binding peptide and the peptide alone.

Results

Adsorption of solutes to fissures was significantly less than to intact surfaces of injured and sliced explants. Moreover, solute adsorption at intact surfaces of injured and sliced explants was less reversible than at surfaces of uninjured explants. Modification of dextrans with aldehyde or the peptide enhanced adsorption with the same level of differential adsorption to cracked and intact surfaces. However, aldehyde–dextran exhibited irreversible adsorption. Equilibration of explants in solutes did not decrease the viability of chondrocytes.

Conclusions and general significance

Studied solutes showed promising potential for detection of surface injuries based on differential interactions with cracked and intact surfaces. Additionally, altered adsorption properties at surfaces of damaged cartilage which visually look healthy can be used to detect micro-damage or biochemical changes in these regions. Studied solutes can be used in in vivo fluorescence imaging methods or conjugated with MRI or CT contrast agents to develop functional imaging agents.     

超声分子成像的研究进展

超声成像无创、无放射性、低成本、实时成像的优点,使其成为目前世界上应用最广的成像手段之一。特别是超声造影剂引入之后,超声成像的图像分辨率和灵敏度得到了大大提高,使超声成像在临床上得到了进一步应用。近年来,随着分子生物学和超声成像技术的不断发展,人们提出了"超声分子成像"的概念。它是一项结合了分子靶向造影剂和超声影像技术的能在分子水平下观察病理变化的新兴技术,目前这一技术还处于研究初期阶段。但大量临床前的研究成果已表明超声分子成像在诊断血管生成、炎症和血栓三种疾病具有很大应用前景。本文主要综述了目前常用超声造影剂的种类以及超声分子成像技术的研究现状,并对该技术进行了讨论和展望。     

不同粘度对比剂对冠状动脉造影患者肾功能的影响*

摘要目的：对比剂肾病（CIN）是介入治疗中常见并发症之一。由于对比剂肾病发病机制复杂,其确切的机制尚不明确,有研究认 为应用渗透压相似的对比剂,高粘度组对比剂引起CIN 的几率明显高于低粘度组。本研究探讨接受不同粘度对比剂冠状动脉造 影检查的患者术后引起肾功能损害的差异及其可能的机制。方法：80 例接受冠状动脉造影检查的患者随机分为两组,分别为20 ℃碘海醇组、37 ℃碘海醇组,每组各40 例。分别于冠脉造影前8h、冠脉造影后48 h采集同一患者肘正中静脉血进行血清肌酐 （Scr）、血清胱抑素C（CysC）检测,并对数据进行统计学分析。结果：两组患者组间比较基本资料无明显差异,两组患者术后Scr、 CysC 较术前均升高,差异均有统计学意义（P<0.05）;20 ℃碘海醇组术后Scr较37 ℃碘海醇组升高不明显,差异无统计学意义 （P>0.05）;20 ℃碘海醇组术后CysC 较37 ℃碘海醇组升高明显,差异有统计学意义（P<0.05）。结论：冠脉造影检查时,对比剂对患 者的肾功能有损害;选择低粘度对比剂可能减少其对冠状动脉造影患者的肾功能的不良影响;其作用机制可能与对比剂改变血 液粘滞性,从而影响肾血流有关。     

CT检查中造影剂不良反应的预防、处理及对影像学检查的影响分析

目的：在CT等医学影像检查过程中,常需要应用造影剂。在造影剂的使用常常发生不良反应,掌握不良反应的发生率,减少或减轻患者的不良反应,能够使CT增强扫描顺利进行,提高检查安全性。方法：搜集我院2011年10月至2012年9月间的1500例CT造影增强检查患者,包括冠状动脉CT血管成像（冠脉CTA）、头部CT血管成像（头CTA）、肝脏增强、泌尿系三维成像（CTU）以及双下肢血管成像（双下肢CTA）,进行造影剂的不良反应类型、造影剂药物剂量、注射速度等统计分析,总结造成不良反应发生的因素及处理方法。结果：不良反应的类型包括发热、呕吐、荨麻疹、面色潮红、局部疼痛、流泪、血压下降、喉头水肿、休克等。使用非离子型造影剂出现不良反应者85例,占5．67％。其中轻度反应65例,占4．33％;中度反应16例,占1．06％;重度4例,占0．27％。结论：在CT增强扫描过程中,造影剂的用量及注射速度与不良反应的发生有相关性。cT检查过程总应该认真执行操作流程,密切观察病人情况,积极防治,正确处理,将造影剂不良反应降低到最低程度,使患者更加安全。