Vascular Features Research Articles

Anatomical features of venous and arterial corona mortis in fresh cadavers in the Turkish population and anatomical landmarks to be used during surgical procedures

Objectives: The aim of this study is to determine the topographic position of the corona mortis on fresh cadavers and also to determine anatomical landmarks that will facilitate surgeons to consider to this structure during operations by clarifying the relationship of the corona mortis with the surrounding anatomical structures. Methods: A total of 50 autopsy cases of 31 men and 19 women, all examined within 24 hours post-mortem, were evaluated bilaterally for the presence of corona mortis. When identified, the vascular characteristics (arterial/venous) of the corona mortis were documented. The topographic position of the corona mortis was determined by measuring the distances to the pubic symphysis, promontory, obturator nerve and anterior superior iliac spine. The study also investigated whether some anthropometric measurements affect these distances. Results: Out of the 100 hemipelves examined, corona mortis were observed in 50 cases. Among these, 34% were arterial (n=17), and 66% were venous (n=33). Anastomoses were identified in the hemipelves of 22 women and 28 men, with no significant gender difference (p>0.05). The average distances to anatomical landmarks were as follows: 5.43 cm to the pubic symphysis, 1.77 cm to the obturator nerve, 9.87 cm to the promontory, and 10.56 cm to the anterior superior iliac spine. Conclusion: Corona mortis poses a significant risk in surgical procedures. Knowing the vascular anatomy of the pelvis is vital for gynecological, urological and orthopedic interventions, while investigating deaths caused by pelvic trauma is important for forensic practice. This anatomical study contributes to a better understanding of the complex and intricate pelvic structure.

The Surgical Histopathology of the Filum Terminale: Findings from a Large Series of Patients with Tethered Cord Syndrome.

This study investigated the prevalence of embryonic and connective tissue elements in the filum terminale (FT) of patients with tethered cord syndrome (TCS), examining both typical and pathological histology. The FT specimens from 288 patients who underwent spinal cord detethering from 2013 to 2021 were analyzed. The histopathological examination involved routine hematoxylin and eosin staining and specific immunohistochemistry when needed. The patient details were extracted from electronic medical records. The study found that 97.6% of the FT specimens had peripheral nerves, and 70.8% had regular ependymal cell linings. Other findings included ependymal cysts and canals, ganglion cells, neuropil, and prominent vascular features. Notably, 41% showed fatty infiltration, and 7.6% had dystrophic calcification. Inflammatory infiltrates, an underreported finding, were observed in 3.8% of the specimens. The research highlights peripheral nerves and ganglion cells as natural components of the FT, with ependymal cell overgrowth and other tissues potentially linked to TCS. Enlarged vessels may suggest venous congestion due to altered FT mechanics. The presence of lymphocytic infiltrations and calcifications provides new insights into structural changes and mechanical stress in the FT, contributing to our understanding of TCS pathology.

Comparison of microvascular flow imaging and contrast-enhanced ultrasound for blood flow analysis of cervical lymph node lesions.

To compare the diagnostic value of microvascular flow imaging (MVFI) with that of contrast-enhanced ultrasound (CEUS) for the analysis of blood flow in benign and malignant cervical lymph nodes. As a prospective study, 95 cervical enlarged lymph nodes (43 benign and 52 malignant) were observed in 95 patients using conventional ultrasonography (including gray and Color Doppler Flow Imaging), CEUS, and MVFI. Two researchers evaluated vascular parameters of MVFI (vascular distribution, internal vascular features, vascular index) and CEUS (enhancement mode, enhancement type) and compared the diagnostic effects of MVFI and CEUS.All results were compared with pathological findings. There were significant differences in the vascular distribution and internal vascular features of benign and malignant lymph nodes on MVFI (P < 0.05). The vascular distribution of benign lymph nodes was mainly of the central and avascular types, the internal blood vessels were mostly normal, the vascular distribution of malignant lymph nodes was mainly mixed, the internal vessels were mainly tortuous and displaced. The optimal cut-off value of the benign and malignant lymph node vascular index (VI) was 15.55%, and the area under the receiver operating characteristic curve (AUC) of the VI was 0.876. There were also significant differences in the enhancement mode and types of benign and malignant lymph nodes in CEUS (P < 0.05). The benign lymph nodes showed centrifugal perfusion, and the enhancement types were mostly type I and type II. Most malignant lymph nodes showed centripetal or mixed perfusion, and the enhancement types were usually type III and type IV. The accuracy, sensitivity, and specificity of CEUS in the diagnosis of lymph node lesions were 84.2%, 84.6% and 83.7%, respectively, and the AUC was 0.845. The accuracy, sensitivity, and specificity of MVFI in the diagnosis of lymph node lesions were 85.3%, 84.6%, and 86.0%, respectively, and the AUC was 0.886. Both CEUS and MVFI are valuable in differentiating benign and malignant lesions of lymph nodes and have a similar diagnostic performance; however, MVFI is less invasive and simpler than CEUS. Therefore it is preferred for auxiliary examination of enlarged lymph nodes that are difficult to diagnose by conventional ultrasound.

Development and Validation of a Prediction Model for Failure of the Transfemoral Approach of Endovascular Treatment for Large Vessel Occlusion Acute Ischemic Stroke

Introduction: Extracranial vascular characteristics determine the accessibility of the large vessel intracranial occlusion for endovascular treatment (EVT) in acute ischemic stroke. We developed and validated a prediction model for failure of the transfemoral approach to aid clinical decision-making regarding EVT. Methods: A prediction model was developed from data of patients included in the Dutch multicenter MR CLEAN Registry (March 18, 2014, until June 15, 2016) with penalized logistic regression. Predictor variables were available prior to the EVT procedure and included age, hypertension, and extracranial vascular characteristics assessed on baseline CTA. The prediction model was internally validated, temporally validated within a second MR CLEAN Registry cohort (June 15, 2016, until November 1, 2017), and updated by re-estimating the coefficients using the combined cohort. Results: Failure of the transfemoral approach occurred in 7% of patients, in both cohorts (derivation cohort: n = 887, median age 71 years, interquartile range [IQR] 60–80, 52% men; validation cohort: n = 1,111, median age 73 years, IQR: 62–81, 51% men). The prediction model had a c-statistic of 0.81 (95% CI: 0.76–0.86) in the derivation cohort, 0.69 (95% CI: 0.62–0.75) at temporal validation, and 0.75 (95% CI: 0.71–0.79) in the final prediction model, with the following penalized β-coefficients for predictor age (per decade): 0.26, hypertension: −0.16, severe aortic arch elongation: 1.45, bovine aortic arch: 0.44, elongation of the supra-aortic arteries: 0.72, cervical ICA elongation: 0.44, and high-grade stenosis of the cervical ICA: 0.78. Conclusion: Our prediction model showed good performance for prediction of failure to reach the intracranial occlusion by the transfemoral approach.

Plasma levels of PRO-C3, a type III collagen synthesis marker, are associated with arterial stiffness and increased risk of cardiovascular death

Background and aimsThe N-terminal propeptide of type III collagen (PRO-C3) assay measures a pro-peptide released during type III collagen synthesis, an important feature of arterial stiffening and atherogenesis. There is a clinical need for improved non-invasive, cheap and easily accessible methods for evaluating individuals at risk of cardiovascular disease (CVD). In this study, we investigate the potential of using circulating levels of PRO-C3 to mark the degree of vascular stenosis and risk of cardiovascular events. MethodsBaseline plasma levels of PRO-C3 were measured by ELISA in subjects belonging to the SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools (SUMMIT) cohort (N = 1354). Associations between PRO-C3 levels with vascular characteristics, namely stiffness and stenosis, and risk of future cardiovascular events were explored. Subjects were followed up after a median of 35 months (interquartile range 34–36 months), with recorded outcomes cardiovascular death and all-cause mortality. ResultsWe found a correlation between PRO-C3 levels and pulse wave velocity (rho 0.13, p = 0.000009), a measurement of arterial stiffness. Higher PRO-C3 levels were also associated with elevated blood pressure (rho 0.07, p = 0.014), as well as risk of cardiovascular mortality over a three-year follow-up period (OR 1.56, confidence interval 1.008–2.43, p = 0.046). ConclusionsElevated circulating PRO-C3 levels are associated with arterial stiffness and future cardiovascular death, in the SUMMIT cohort, suggesting a potential value of PRO-C3 as a novel marker for declining vascular health.

Semi-supervised contrast learning-based segmentation of choroidal vessel in optical coherence tomography images

Objective. Choroidal vessels account for 85% of all blood vessels in the eye, and the accurate segmentation of choroidal vessels from optical coherence tomography (OCT) images provides important support for the quantitative analysis of choroid-related diseases and the development of treatment plans. Although deep learning-based methods have great potential for segmentation, these methods rely on large amounts of well-labeled data, and the data collection process is both time-consuming and laborious. Approach. In this paper, we propose a novel asymmetric semi-supervised segmentation framework called SSCR, based on a student-teacher model, to segment choroidal vessels in OCT images. The proposed framework enhances the segmentation results with uncertainty-aware self-integration and transformation consistency techniques. Meanwhile, we designed an asymmetric encoder–decoder network called Pyramid Pooling SegFormer (APP-SFR) for choroidal vascular segmentation. The network combines local attention and global attention information to improve the model’s ability to learn complex vascular features. Additionally, we proposed a boundary repair module that enhances boundary confidence by utilizing a repair head to re-predict selected fuzzy points and further refines the segmentation boundary. Main results. We conducted extensive experiments on three different datasets: the ChorVessel dataset with 400 OCT images, the Meibomian Glands (MG) dataset with 400 images, and the U2OS Cell Nucleus Dataset with 200 images. The proposed method achieved an average Dice score of 74.23% on the ChorVessel dataset, which is 2.95% higher than the fully supervised network (U-Net) and outperformed other comparison methods. In both the MG dataset and the U2OS cell nucleus dataset, our proposed SSCR method achieved average Dice scores of 80.10% and 87.26%, respectively. Significance. The experimental results show that our proposed methods achieve better segmentation accuracy than other state-of-the-art methods. The method is designed to help clinicians make rapid diagnoses of ophthalmic diseases and has potential for clinical application.

Hemorheological changes in arterial hypertension in persons with and without COVID-19

BACKGROUND: Vascular resistance, and therefore blood pressure (BP), depends on vascular and rheological factors. Microrheological characteristics of red blood cells (RBCs) can affect blood viscosity (BV) and thus be included in the pathogenesis of increased blood pressure in arterial hypertension (AH). Signaling molecules such as gasotransmitters (NO, CO and H2S) regulate vascular tone and RBC microrheological characteristics and thus affect blood pressure and tissue perfusion. OBJECTIVE: It was evaluated the changes in the macro- and microrheological characteristics of blood and red blood cells (RBCs) under arterial hypertension in persons with and without COVID-19, as well as the protective effect of NO and H2S donors on the RBC microrheological properties. METHODS: Hemorheological profile parameters were recorded in group 1 individuals (n = 18, 9 women and 9 men) without a history of COVID-19; group 2 (n = 16; 11 females and 5 males), hypertensive patients who had COVID-19. As a control, there was a group of healthy individuals (group 3 n = 22). In experiments with red blood cells (RBCs) and their recovered ghosts (filled with an isotonic solution of known viscosity), deformability (RBCD) and aggregation (RBCA) were recorded after incubation of cells with sodium nitroprusside (SNP, 100μM) and sodium hydrosulfide (NaHS, 100μM). RESULTS: In patients with AH in both groups, the main parameters of the hemorheological profile were negatively changed, including a decrease in RBCD and an increase in BV, plasma viscosity (PV) and RBCA. SNP and NaHS significantly increased deformability and reduced their aggregation (p &lt; 0.01). However, in healthy individuals, microrheological responses to GT donors (100μM) were more pronounced than in patients with AH, especially in the AH+COVID-19 group (p &lt; 0.05). CONCLUSION: Both gasotransmitter donors (NO and H2S) have a positive effect on the RBC microrheological characteristics in healthy and sick individuals. However in hypertensive patients, especially those who had COVID-19, microrheological responses to GT donors were significantly lower. Therefore, on the model of red cell microrheological responses, as on a test object, it is possible to determine the decrease in the sensitivity of cells and tissues to the regulatory action of gasotransmitters.

Breath-hold BOLD fMRI without CO2 sampling enables estimation of venous cerebral blood volume: potential use in normalization of stimulus-evoked BOLD fMRI data

BOLD fMRI signal has been used in conjunction with vasodilatory stimulation as a marker of cerebrovascular reactivity (CVR): the relative change in cerebral blood flow (CBF) arising from a unit change in the vasodilatory stimulus. Using numerical simulations, we demonstrate that the variability in the relative BOLD signal change induced by vasodilation is strongly influenced by the variability in deoxyhemoglobin-containing cerebral blood volume (CBV), as this source of variability is likely to be more prominent than that of CVR. It may, therefore, be more appropriate to describe the relative BOLD signal change induced by an isometabolic vasodilation as a proxy of deoxygenated CBV (CBVdHb) rather than CVR. With this in mind, a new method was implemented to map a marker of CBVdHb, termed BOLD-CBV, based on the normalization of voxel-wise BOLD signal variation by an estimate of the intravascular venous BOLD signal from voxels filled with venous blood. The intravascular venous BOLD signal variation, recorded during repeated breath-holding, was extracted from the superior sagittal sinus in a cohort of 27 healthy volunteers and used as a regressor across the whole brain, yielding maps of BOLD-CBV. In the same cohort, we demonstrated the potential use of BOLD-CBV for the normalization of stimulus-evoked BOLD fMRI by comparing group-level BOLD fMRI responses to a visuomotor learning task with and without the inclusion of voxel-wise vascular covariates of BOLD-CBV and the BOLD signal change per mmHg variation in end-tidal carbon dioxide (BOLD-CVR). The empirical measure of BOLD-CBV accounted for more between-subject variability in the motor task-induced BOLD responses than BOLD-CVR estimated from end-tidal carbon dioxide recordings. The new method can potentially increase the power of group fMRI studies by including a measure of vascular characteristics and has the strong practical advantage of not requiring experimental measurement of end-tidal carbon dioxide, unlike traditional methods to estimate BOLD-CVR. It also more closely represents a specific physiological characteristic of brain vasculature than BOLD-CVR, namely blood volume.

Parapapillary choroidal microvasculature in retrobulbar optic neuritis: An optical coherence tomography angiography study

PurposeTo compare superficial and deep vascular characteristics of the optic disc in retrobulbar optic neuritis using optical coherence tomography angiography (OCT-A). MethodsNineteen patients with unilateral non-infectious retrobulbar neuritis were included in the study. The contralateral eyes of each patient were served as controls. OCT-A scans of the optic discs were performed in a 4.5 × 4.5 mm rectangular area, while macular OCT-A scans were performed in a 6 × 6 mm rectangular area. Various parameters, including radial peripapillary capillary (RPC) density, peripapillary retinal nerve fibre layer (pRNFL) thickness, cup volume, rim area, disc area, cup-to-disc (c/d) area ratio, and vertical and horizontal c/d ratios were automatically obtained using the instrument software. The density for superficial capillary plexus (SCP) and deep capillary plexus (DCP) were assessed using macular OCT-A. Parapapillary choroidal microvascular (PPCMv) density was calculated using MATLAB software. ResultsParafoveal inferior, perifoveal total and inferior SCP densities were significantly decreased in eyes with optic neuritis when compared with contralateral control eyes in OCT-A measurements (respectively, p = 0.027, p = 0.041, p = 0.045). The axial lengths, (p = 0.72), vertical and horizontal cup-disc ratios, and disc area, cup-disc areas, cup volumes, and pRNFL thicknesses between the groups were similar (for each, p>0.05). ConclusionsThis study demonstrated for the first time that patients with retrobulbar optic neuritis had decreased SCP densities, though it did not cause any changes in PPCMv density.

Neuropathological correlates of neuropsychiatric symptoms in the Brains for Dementia Research study

AbstractBackgroundNeuropsychiatric symptoms are a common feature of many dementia syndromes, and are frequently associated with poor clinical prognosis, reduction in quality of life, earlier institutionalisation, greater disability, and increased caregiver distress, particularly during later stages of disease. It has also been postulated that NPS may occur during prodromal stages of dementia, preceding or alongside early cognitive symptoms. Clinical profiles of dementia are both heterogenous and intersecting, which may reflect that up to 90% of cases have multiple pathologies post‐mortem. Comprehensive clinicopathological studies of neuropsychiatric symptoms in dementia are lacking, thus this study sought to investigate potential neuropsychiatric profiles resulting from mixed underlying pathology.MethodThis analysis aimed to identify pathological correlations of neuropsychiatric symptoms and included 840 post‐mortem brains donated to the Brains for Dementia Research project, a longitudinal study with post‐mortem neuropathological assessment across several brain banks, between 2008 and 2020. Patterns of neuropsychiatric symptoms were compared between pathology subtypes using clinical data including the Neuropsychiatric Inventory (NPI‐Q) and Clinical Dementia Rating scale, and neuropathological assessment of degenerative pathologies and vascular features. Confirmatory factor analysis was used to identify latent variables for psychosis, mood, and behaviour. Associations between pathological variables assessed at autopsy and neuropsychiatric features during life were explored using bivariate and multivariate statistical methods.ResultAlmost 80% of the 494 dementia cases included had at least one neuropsychiatric symptom across the course of disease. Apathy (51.2%) and aggression (41.7%) were the most prevalent neuropsychiatric features across all dementia subtypes. Preliminary results indicate that different underlying pathologies, including neurodegenerative pathologies (amyloid, neurofibrillary tangles, Lewy bodies, TDP‐43 inclusions) and vascular features may be associated with increased likelihood of specific neuropsychiatric symptoms, such as psychosis, mood and behaviour, during life. Co‐occurring substantial AD and Lewy body pathology was associated with the presence of anxiety, depression, and aberrant motor activity during life. AD in the absence of substantial Lewy body pathology, was associated with agitation, apathy, and disinhibition. Lewy body pathology, in the absence of substantial AD pathology, was associated with hallucinations, depression and sleep disturbances.ConclusionThe interaction of multiple pathologies may contribute to differing neuropsychiatric profiles during life.

Retinal microvasculature and risk of incident dementia over a 10‐year period: results from the 3C‐Alienor population‐based study

AbstractBackgroundThe retina and the brain microvasculatures share many anatomical and physiological similarities; thus, retinal microvasculature could represent a potential screening tool for cerebrovascular and neurodegenerative diseases. Changes in retinal microvasculature have been associated with dementia in previous studies. However, all the previous studies analyzing retinal vascular network features in relation to dementia or Alzheimer Disease (AD) were cross‐sectional. This study aimed to explore the longitudinal relationship between retinal microvascular features and dementia incidence over a 10‐year follow‐up period.MethodWe included 617 participants from the Three‐City (3C) population‐based cohort and its ancillary ophthalmological study, the Alienor study. Quantitative retinal vascular features (caliber, tortuosity, fractal dimension) were assessed at baseline in the Alienor study using the semi‐automated Singapore I Vessel Assessment (SIVA) software; dementia was actively screened and diagnosed over a 10‐year period. Cox proportional‐hazards models were used to estimate the risk of incident dementia and its main etiologies (i.e., probable or possible AD and mixed or vascular dementia) associated with retinal vascular features.ResultThe mean age of the participants was 79.5 years (SD 4.4) and 66.6% were women. During the follow‐up (median of 7.2 years), 134 participants developed dementia (87 probable or possible AD and 38 mixed or vascular dementia). In multivariate models adjusted for the main potential confounders (socio‐demographic factors, vascular co‐morbidities and Apolipoprotein ε4 allele), increased arteriolar tortuosity was associated with increased risk of dementia (HR per SD increase = 1.26, 95%CI: 1.07; 1.50). Despite some trends, retinal calibers were not significantly associated with dementia all‐cause. When considering the different etiologies of dementia, wider retinal venular calibers were associated with mixed or vascular dementia, but not with Alzheimer’s disease. Fractal dimensions were not associated with dementia.ConclusionChanges in retinal microvasculature were associated with risk of incident dementia. More works are needed to replicate and determine which features could help identifying persons at risk of future dementia at an early stage, and to examine the specific processes that might be involved according to dementia etiology.

Characterization of brain metabolism, volume, and vasculature of the 5xFAD mouse model of Alzheimer’s Disease across lifespan.

AbstractBackgroundThe MODEL‐AD Consortium seeks to develop the next generation of Alzheimer’s Disease models based on human data. A popular model of familial AD is the 5xFAD mouse, characterized by early amyloid‐β deposition and cognitive decrements. Despite numerous studies, the 5xFAD mouse has not been comprehensively phenotyped for vascular and metabolic features over its lifespan.MethodMale and female 5xFAD and WT littermates underwent in vivo 18F‐FDG‐PET imaging at 4, 6, and 12 months of age to evaluate regional glucose metabolism. A separate cohort of mice (4, 8, 12 months) underwent “vessel painting” that labels all cerebral vessels with a fluorescent dye. “Vessel painted” brains were analyzed for vascular characteristics such as vessel density, junction density, vessel length, network complexity, number of collaterals and vessel diameter.ResultsOur analyses revealed that vessel length, vessel and junction densities increased from 4 to 12 months on the cortical surface in both 5xFAD and WT mice. The number of collateral vessels between the middle cerebral artery (MCA) and the anterior and posterior cerebral arteries decreased with age but their diameters were significantly increased only in 5xFAD mice. MCA average vessel length was decreased in 5xFAD mice compared to WT. Analysis of 18F‐FDG cortical uptake found significant interactions between WT and 5xFAD mice spanning 4‐12 months of age in retrosplenial, somatosensory and visual cortices. Broadly, 5xFAD males had increased 18F‐FDG uptake at 12 months of age compared to WT mice. In most cortical regions, female 5xFAD mice had reduced FDG uptake compared to WT across the lifespan. In males these metabolic increases coincided with decreased vessel characteristics.ConclusionThe 5xFAD mouse exhibits AD‐like cognitive deficits with age that are associated with increasing amyloid‐β deposition. No significant differences were found in cortical vascular features although males and females exhibited opposite effects in 18F‐FDG uptake. The MCA supplies blood to large portions of the motor cortex and increased vessel lengths and decreased collaterals along with higher metabolic rates in 5xFAD mice may be related to increasing behavioral deficits via metabolic insufficiency or other mechanisms.

Characterization of brain metabolism, volume, and vasculature of the 5xFAD mouse model of Alzheimer’s Disease across lifespan

AbstractBackgroundThe MODEL‐AD Consortium seeks to develop the next generation of Alzheimer’s Disease models based on human data. A popular model of familial AD is the 5xFAD mouse, characterized by early amyloid‐ß deposition and cognitive decrements. Despite numerous studies, the 5xFAD mouse has not been comprehensively phenotyped for vascular and metabolic features over its lifespan.MethodMale and female 5xFAD and WT littermates underwent in vivo 18F‐FDG‐PET imaging at 4, 6, and 12 months of age to evaluate regional glucose metabolism. A separate cohort of mice (4, 8, 12 months) underwent “vessel painting” that labels all cerebral vessels with a fluorescent dye. “Vessel painted” brains were analyzed for vascular characteristics such as vessel density, junction density, vessel length, network complexity, number of collaterals and vessel diameter.ResultOur analyses revealed that vessel length, vessel and junction densities increased from 4 to 12 months on the cortical surface in both 5xFAD and WT mice. The number of collateral vessels between the middle cerebral artery (MCA) and the anterior and posterior cerebral arteries decreased with age but their diameters were significantly increased only in 5xFAD mice. MCA average vessel length was decreased in 5xFAD mice compared to WT. Analysis of 18F‐FDG cortical uptake found significant interactions between WT and 5xFAD mice spanning 4‐12 months of age in retrosplenial, somatosensory and visual cortices. Broadly, 5xFAD males had increased 18F‐FDG uptake at 12 months of age compared to WT mice. In most cortical regions, female 5xFAD mice had reduced FDG uptake compared to WT across the lifespan. In males these metabolic increases coincided with decreased vessel characteristics.ConclusionThe 5xFAD mouse exhibits AD‐like cognitive deficits with age that are associated with increasing amyloid‐ß deposition. No significant differences were found in cortical vascular features although males and females exhibited opposite effects in 18F‐FDG uptake. The MCA supplies blood to large portions of the motor cortex and increased vessel lengths and decreased collaterals along with higher metabolic rates in 5xFAD mice may be related to increasing behavioral deficits via metabolic insufficiency or other mechanisms.

Vascular, Imaging and Cognition Association of China (VICA) Study: Rationale and Design

AbstractBackgroundChina has the highest number of patients with dementia in the world, and about 15‐30% of these cases are caused by vascular disease. Currently, the pathophysiological mechanism that cause vascular cognitive impairment (VCI) remain insufficiently understood. Therefore, early diagnosis and prognostic indicators of VCI are critically important for managing its onset and development To this end, several Chinese institutions have joined forces to establish “Vascular, Imaging and Cognition Association of China” (VICA) (Figure 1). The objective of VICA is to identify new targets for intervention and prompting intelligent graded and stratified treatment.MethodVICA is the first large‐scale multi‐center VCI consortium in China. It consists of seven advanced centers and over two hundred primary hospitals across the country. Included VICA are three different populations at risk for VCI: (a) high vascular risk factors for dementia, (b) cerebral small vessel disease, and (c) acute ischemic stroke or transient ischemic attacks (TIA).ResultAll individuals will be enrolled and monitored for at least 1 year using serial neuropsychological assessment, neuroimaging and collection of multi‐omics data from biospecimens (e.g., blood, urine, feces). In addition, a small sample of patients will undergo PET scans to determine whether neurodegenerative pathology (such as amyloid or tau accumulation) contributes to the course of vascular dementia. The enrollment procedure of patients with stroke or TIA is shown in Figure 2.ConclusionThe overall scientific aim of VICA is to guide early clinical diagnosis and early intervention of VCI based on the integration of multiple vascular risk factors, neuroimaging features and biomarkers. VICA represents a unique scientific resource that will help better understand the dynamics of cognitive change in different populations and identify new potential therapeutic targets for this condition.

The Role of Superb Microvascular Imaging and Shear Wave Elastography in the Prediction of Hemorrhage Complications After Renal Parenchyma Biopsy.

The aim of study was to evaluate the diagnostic utility of the renal parenchyma elasticity with the shear wave elastography (SWE) and microvascularization with the superb microvascular imaging (SMI) technique before kidney biopsy and to predict the complication of hemorrhage before kidney biopsy. A total of 75 patients were included in the prospective study. Before the biopsy, vascularity features of the kidney parenchyma in the area to be biopsied were assessed by SMI and parenchymal stiffness by SWE and were examined by 2 independent radiologists. A statistically significant difference was found in the SMI and SWE values between the groups with and without hematoma and hematuria when compared with the Student t test and Mann-Whitney U test ( P < 0.05). The SWE hardness cutoff value, which maximizes the prediction of the development of hematuria, was found to be 18.40 kPa, and the sensitivity and specificity values were 84.4% and 62.8%, respectively. In SMI vascularity index values, the cutoff value was found to be 0.247410800 kPa, and sensitivity and specificity values were 81.3% and 83.7%, respectively. The cutoff value of the SMI vascularity index values that maximized the prediction of hematoma development was 0.297009650, and the sensitivity and specificity values were 87% and 87%, respectively. We believe that evaluating and standardizing the microvascularization and elasticity of the kidney parenchyma before a percutaneous kidney biopsy will be potentially useful as a guiding method in the prediction of postbiopsy hemorrhage development.

A High‐Resolution Prediction Network for Predicting Intratumoral Distribution of Nanoprobes by Tumor Vascular and Nuclear Feature

In this study, the critical need for precise and accurate prediction of intra‐tumor heterogeneity related to the enhanced permeability and retention effect and spatial distribution of nanoprobes is addressed for the development of effective nanodrug delivery strategies. Current predictive models are limited in terms of resolution and accuracy, prompting the construction of a high‐resolution prediction network (HRPN) that estimates the microdistribution of quantum dots, factoring in tumor vascular and nuclear features. The HRPN algorithm is trained using 27 780 patches and validated on 4920 patches derived from 4T1 breast cancer whole‐slide images, demonstrating its reliability. The HRPN model exhibits minimal error (mean square error = 1.434, root mean square error = 1.198), satisfactory goodness of fit (R2 = 0.891), and superior image quality (peak signal‐to‐noise ratio = 44.548) when compared to a generative‐adversarial‐network‐structured model. Furthermore, the HRPN model offers improved prediction accuracy, broader prediction intervals, and reduced computational resource requirements. Consequently, the proposed model yields high‐resolution predictions that more closely resemble actual tumor microdistributions, potentially serving as a powerful analytical tool for investigating the spatial relationship between the tumor microenvironment and nanoprobes.

Photobiomodulation for melasma treatment: Integrative review and state of the art.

Photobiomodulation therapy (PBM) is a versatile technique for treating skin diseases. Melasma, a chronic hyperpigmentation condition, has recently been associated with vascular features and dermal photoaging and poses significant management challenges. We review the recent literature on melasma etiology and the evidence supporting PBM as a therapeutic modality for melasma treatment. We conducted a comprehensive literature search in three different databases from May to August 2023, focusing on studies published in the past 10 years. The inclusion criteria comprised full-text studies investigating low-power lasers and/or light-emitting diodes (LEDs) in invitro or invivo models, as well as clinical trials. We excluded studies discussing alternative melasma therapies or lacking experimental data. We identified additional studies by searching the reference lists of the selected articles. We identified nine relevant studies. Clinical studies, in agreement with invitro experiments and animal models, suggest that PBM effectively reduces melasma-associated hyperpigmentation. Specific wavelengths (red: 630 nm; amber: 585 and 590 nm; infrared: 830 and 850 nm) at radiant exposures between 1 and 20 J/cm2 exert modulatory effects on tyrosinase activity, gene expression, and protein synthesis of melanocytic pathway components, and thus significantly reduce the melanin content. Additionally, PBM is effective in improving the dermal structure and reducing erythema and neovascularization, features recently identified as pathological components of melasma. PBM emerges as a promising, contemporary, and non-invasive procedure for treating melasma. Beyond its role in inhibiting melanogenesis, PBM shows potential in reducing erythema and vascularization and improving dermal conditions. However, robust and well-designed clinical trials are needed to determine optimal light parameters and to evaluate the effects of PBM on melasma thoroughly.

Contrast-Enhanced Ultrasound and Conventional Ultrasound Characteristics of Breast Cancer With Different Molecular Subtypes

BackgroundIdentifying molecular subtypes of breast cancer (BC) is of great significance in selecting optimal treatment strategy. Different molecular subtypes of BC have various vascular distribution characteristics. Contrast-enhanced ultrasound (CEUS) can dynamically display the microcirculation of tumor. This study intends to explore the conventional ultrasound and CEUS characteristics of different molecular subtypes of BC. MethodsDuring this prospective study, 86 patients with BC who were divided into Luminal A (LA), Luminal B (LB), HER2 over-expression (H2), and triple-negative (TN). The CEUS qualitative and quantitative characteristics of BC with different molecular subtypes was explored, as well as the conventional ultrasound features. In addition, the diagnostic efficiency of CEUS quantitative parameters in differentiating molecular subtypes of BC was analyzed. ResultsOur study found that the Adler grade differed significantly among 4 molecular subtypes (P < .05). The enhancement speed, enhancement degree and size after enhancement of 4 molecular subtypes were statistically different (P < .05). The wash in slope (WIS), peak intensity (PI), and wash-in area under the curve (WiAUC) differed significantly among 4 subtypes (P < .05). The diagnostic efficiency of PI was better for detecting LA and H2 subtype with the areas under the receiver operating characteristic curve was 0.778 and 0.734, respectively. ConclusionDifferent molecular subtypes of BC have different CEUS and conventional ultrasound characteristics. CEUS can provide valuable imaging basis for precise clinical diagnosis and individualized therapy of BC with different molecular subtypes.

Perception-oriented generative adversarial network for retinal fundus image super-resolution

Retinal fundus imaging is a crucial diagnostic tool in ophthalmology, enabling the early detection and monitoring of various ocular diseases. However, capturing high-resolution fundus images often presents challenges due to factors such as defocusing and diffraction in the digital imaging process, limited shutter speed, sensor unit density, and random noise in the image sensor or during image transmission. Super-resolution techniques offer a promising solution to overcome these limitations and enhance the visual details in retinal fundus images. Since the retina has rich texture details, the super-resolution images often introduce artifacts into texture details and lose some fine retinal vessel structures. To improve the perceptual quality of the retinal fundus image, a generative adversarial network that consists of a generator and a discriminator is proposed. The proposed generator mainly comprises 23 multi-scale feature extraction blocks, an image segmentation network, and 23 residual-in-residual dense blocks. These components are employed to extract features at different scales, acquire the retinal vessel grayscale image, and extract retinal vascular features, respectively. The generator has two branches that are mainly responsible for extracting global features and vascular features, respectively. The extracted features from the two branches are fused to better restore the super-resolution image. The proposed generator can restore more details and more accurate fine vessel structures in retinal images. The improved discriminator is proposed by introducing our designed attention modules to help the generator yield clearer super-resolution images. Additionally, an artifact loss function is also introduced to enhance the generative adversarial network, enabling more accurate measurement of the disparity between the high-resolution image and the restored image. Experimental results show that the generated images obtained by our proposed method have a better perceptual quality than the state-of-the-art image super-resolution methods.

How network structures affect the 2D-3D registration of cardiovascular images

Pre-operative and intra-operative vascular image registration plays an important role in the navigation of minimally invasive vascular interventional surgery (MIVI). Deep learning methods perform excellently in the balance of time consumption and registration accuracy. Optimal network structure is hard to construct due to the indirect correlation between convolution operation and vascular characteristics. In this paper, we compare the performance of various CNN models to find the most suitable network structure for vascular image registration. The effects of different convolution submodules are also discussed to optimize the network structures. Experiments on patients suffering from different cardiovascular diseases are conducted to evaluate the robustness of CNN models. Networks covered in this paper are all suitable for vascular image registration with the registration error within 1 mm or 1 degree, while Alex-reg outperforms the others and achieves the best registration result.