Jianxun Qu - Academia.edu (original) (raw)

Papers by Jianxun Qu

European Radiology

To investigate whether preoperative arterial spin labeling (ASL) MRI can predict cerebral hyperpe... more To investigate whether preoperative arterial spin labeling (ASL) MRI can predict cerebral hyperperfusion after carotid endarterectomy (CEA) in patients with carotid stenosis. Consecutive patients with carotid stenosis who underwent CEA between May 2015 and July 2021 were included. For each patient, a cerebral blood flow ratio (rCBF) map was obtained by dividing postoperative CBF with preoperative CBF images from two pseudo-continuous ASL scans. Hyperperfusion regions with rCBF > 2 were extracted and weighted with rCBF to calculate the hyperperfusion index. According to the distribution of the hyperperfusion index, patients were divided into hyperperfusion and non-hyperperfusion groups. Preoperative ASL images were scored based on the presence of arterial transit artifacts (ATAs) in 10 regions of interest corresponding to the Alberta Stroke Programme Early Computed Tomography Score methodology. The degree of stenosis and primary and secondary collaterals were evaluated to correlate with the ASL score. Logistic regression and receiver operating characteristic curve analyses were performed to assess the predictive ability of the ASL score for cerebral hyperperfusion. Of 86 patients included, cerebral hyperperfusion was present in 17 (19.8%) patients. Carotid near occlusion, opening of posterior communicating arteries with incomplete anterior semicircle, and leptomeningeal collaterals were associated with lower ASL scores (p < 0.05). The preoperative ASL score was an independent predictor of cerebral hyperperfusion (OR = 0.48 [95% CI [0.33–0.71]], p < 0.001) with the optimal cutoff value of 25 points (AUC = 0.98, 94.1% sensitivity, 88.4% specificity). Based on the presence of ATAs, ASL can non-invasively predict cerebral hyperperfusion after CEA in patients with carotid stenosis. • Carotid near occlusion, opening of posterior communicating arteries with incomplete anterior semicircle, and leptomeningeal collaterals were associated with lower ASL scores. • The ASL score performed better than the degree of stenosis, type of CoW, and leptomeningeal collaterals, as well as the combination of the three factors for the prediction of cerebral hyperperfusion. • For patients with carotid stenosis, preoperative ASL can non-invasively identify patients at high risk of cerebral hyperperfusion after carotid endarterectomy without complex post-processing steps.

Table S2. Comparison of functional imaging parameters between affected and contralateral lower ex... more Table S2. Comparison of functional imaging parameters between affected and contralateral lower extremities in PAD patients. (DOCX 18 kb)

Figure S2. Graphs depicting serial measurements of imaging parameters from ASL, BOLD, and IVIM fo... more Figure S2. Graphs depicting serial measurements of imaging parameters from ASL, BOLD, and IVIM for the anterior, lateral, soleus, and gastrocnemius muscle groups in the control side in healthy young subjects. (PPTX 727 kb)

Figure S1. Example of source images and processed maps for arterial spin labeling (ASL), blood-ox... more Figure S1. Example of source images and processed maps for arterial spin labeling (ASL), blood-oxygenÂ level dependent (BOLD), and intravoxel incoherent motion (IVIM) cardiovascular magnetic resonance (CMR). (PPTX 11134 kb)

Chinese Journal of Academic Radiology, 2021

Arterial spin labeling (ASL) is a technique used to measure blood flow quantitatively and non-inv... more Arterial spin labeling (ASL) is a technique used to measure blood flow quantitatively and non-invasively. It has been successfully practiced assessing cerebral perfusion and became widely available for research and clinical practices. In 2015, a consensus document standardized the implementation and operation of brain ASL and paved the way for the subsequent clinical translation. The success of ASL in the brain also encouraged the practice of ASL in regions outside, like kidney, placenta, pancreas, liver, and myocardium. These attempts faced distinctive technique and physiological problems, like markedly increased influence from motion and prolonged transit time. This review aims to provide a summary of the technique advances and the recent progress of body ASL.

Acta Radiologica, 2021

Background Leukoaraiosis is a type of lesion characterized by tissue rarefaction or myelin pallor... more Background Leukoaraiosis is a type of lesion characterized by tissue rarefaction or myelin pallor resulting from axons loss and gliosis. Synthetic magnetic resonance imaging (MRI) could yield quantitative T1, T2, proton density (PD) values of leukoaraiosis in addition to information on the volume of the lesion. Purpose To investigate the feasibility of quantifying leukoaraiosis using synthetic MRI and to explore the association between leukoaraiosis and cerebral small vascular diseases and cerebral atherosclerosis. Material and Methods Patients with acute ischemic stroke were enrolled in this study. All participants underwent a conventional T2-weighted image, brain volume, CUBE fluid attenuated inversion recovery, and synthetic MRI acquisition using a 3.0-T MR system. A time-of-flight magnetic resonance angiography was also obtained. We evaluated the T1, T2, PD values and leukoaraiosis volume. Results Analysis of the leukoaraiosis volume ratios demonstrated a positive association wi...

European Radiology, 2021

To evaluate the diagnostic accuracy of super-selective pseudo-continuous arterial spin labeling (... more To evaluate the diagnostic accuracy of super-selective pseudo-continuous arterial spin labeling (ss-pCASL) at depicting external carotid artery (ECA) perfusion territory in moyamoya disease (MMD). In total, 103 patients with MMD who underwent both ss-pCASL and digital subtraction angiography (DSA, the reference standard) were included. There were 3, 184, and 19 normal, preoperative, and postoperative MMD hemispheres, respectively. The ss-pCASL results were interpreted by two different visual inspection criteria: presence or absence and definite or indefinite ECA perfusion territory. The performance of ss-pCASL at depiction of ECA perfusion territory was compared to that of DSA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. The κ statistic was used to assess intermodality and inter-reader agreement. When interpreted as presence or absence, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ss-pCASL for depicting ECA perfusion territory were 78.3 %, 79.6 %, 92.5 %, 53.4 %, and 78.6 %, respectively, and the intermodality and inter-reader agreement were κ = 0.49 (CI: 0.43 – 0.55, p < 0.01) and 0.71 (CI: 0.66 – 0.76, p < 0.01), respectively. When interpreted as definite or indefinite, the respective values were 61.1%, 100%, 100%, 44.5%, 70.4%, κ = 0.42 (CI: 0.37 – 0.47, p < 0.01), and 0.90 (CI: 0.87 – 0.93, p < 0.01). ss-pCASL has substantial sensitivity and specificity compared with DSA for depicting the presence versus absence of ECA perfusion territory in MMD. As a noninvasive method in which no ion radiation or contrast medium is needed, ss-pCASL may potentially reduce the need for repeated DSA examination. • Super-selective pseudo-continuous arterial spin labeling (ss-pCASL) is a noninvasive vessel-selective MR technique to demonstrate perfusion territory of a single cerebral artery. • Compared with digital subtraction angiography, ss-pCASL has substantial sensitivity and specificity for depicting the perfusion territory of the external carotid artery in brain parenchyma in moyamoya disease. • ss-pCASL may potentially reduce the need for repeated DSA examination.

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European Journal of Radiology, 2018

Highlight  Crossed cerebellar diaschisis (CCD) was observed in glioma patients after treatment. ... more Highlight  Crossed cerebellar diaschisis (CCD) was observed in glioma patients after treatment.  ASL-CBF and DSC-rCBF maps are better at diagnosing CCD than DSC-rCBV or DSC-Tmax maps.  Presence of CCD is associated with supratentorial lesions involving the corona radiata, basal ganglia, and insula.

Journal of Magnetic Resonance Imaging, 2020

BACKGROUND Despite the growing concern about the safety of gadolinium-based contrast agents (GBCA... more BACKGROUND Despite the growing concern about the safety of gadolinium-based contrast agents (GBCAs), they are still the most commonly used. Ferumoxytol, as an off-label alternative MRI contrast agent, cannot be administered by a rapid bolus for dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI). PURPOSE To assess the feasibility of iron sucrose (IS) as a contrast agent for MR angiography (MRA) and DSC-PWI. STUDY TYPE Prospective animal model. ANIMAL MODEL Thirty-six normal rats (16 for MRA, 20 for biocompability tests) and 36 occlusion of the middle cerebral artery (MCAO) model rats. FIELD STRENGTH/SEQUENCE 3.0T; head and neck angiography, using a fast spoiled gradient-recalled-echo (FSPGR) sequence and DSC-MRI using echo planar imaging(EPI) sequence. ASSESSMENT MRA was performed on normal rats to examine the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of different doses of IS. DSC-PWI was performed on MCAO rats at 0, 24, 48, and 72 hours postreperfusion to investigate the lesion detectability of IS. Arterial spin labeling (ASL) and DSC-PWI enhanced by GBCAs were conducted on MCAO rats as controls. STATISTICAL TESTS Kruskal-Wallis test was used to compare qualitative assessment. One-way analysis of variance (ANOVA) was used to compare the parametric data. Pearson's r values were evaluated between relative cerebral blood flow(rCBF)-ASL, rCBF-DSCIS , and rCBF obtained from DSC-PWI enhanced by GBCA. RESULTS The mean SNR and CNR of the common carotid artery at doses of 10 mg Fe/kg of IS were comparable with the standard dose of GBCAs (SNR: 68.04 ± 12.55 vs. 67.72 ± 14.66; CNR: 23.78 ± 7.21vs. 21.63 ± 6.83). In MCAO rat models, rCBF and relative cerebral blood volume (rCBV) of ipsilateral striatum declined (0.72 ± 0.14, 0.86 ± 0.11) with prolonged relative mean transit time (rMTT) and relative time-to-peak (rTTP) (1.27 ± 0.24, 1.07 ± 0.03) following occlusion. Hyperperfusion was observed in all rats at 48 and 72 hours postreperfusion, in 4/6 rats at 24 hours postreperfusion for IS-mediated DSC-PWI. DATA CONCLUSION IS may be an effective contrast agent for both MRA and DSC-PWI in ischemic stroke models. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 1.

European Journal of Radiology, 2020

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Clinical Otolaryngology, 2019

Recently, a few studies that evaluated sudden deafness caused by intralabyrinthine hemorrhage (IL... more Recently, a few studies that evaluated sudden deafness caused by intralabyrinthine hemorrhage (ILH) on three-dimensional fluid-attenuated inversion recovery (3D FLAIR) images. But, there has been no report yet about the volume of ILH on living body, especially the relationship between the relative volume of ILH and the degree of hearing loss as well as the prognosis. We found that there was a positive correlation between the relative volume of ILH and the degree of hearing loss (r =0.476, P = 0.003) as well as the prognosis (r = 0.628, P = 0.000). Therefore, the relative volume of ILH is suggested to serve as a novel objective prognostic factor in SSNHL. This article is protected by copyright. All rights reserved.

Acta Biomaterialia, 2019

Myocardial infarction (MI) is a primary cardiovascular disease threatening human health and quali... more Myocardial infarction (MI) is a primary cardiovascular disease threatening human health and quality of life worldwide. The development of engineered heart tissues (EHTs) as a transplantable artificial myocardium provides a promising therapy for MI. Since most MIs occur at the ventricle, engineering ventricular-specific myocardium is therefore more desirable for future applications. Here, by combining a new macroporous 3D iron oxide scaffold (IOS) with a fixed ratio of human pluripotent stem cell (hPSC)-derived ventricular-specific cardiomyocytes and human umbilical cord-derived mesenchymal stem cells, we constructed a new type of engineered human ventricular-specific heart tissue (EhVHT). The EhVHT promoted expression of cardiac-specific genes, ion exchange, and exhibited a better Ca 2+ handling behaviors and normal electrophysiological activity in vitro. Furthermore, when patched on the infarcted area, the EhVHT effectively promoted repair of heart tissues in vivo and facilitated the restoration of damaged heart function of rats with acute MI. Our results show that it is feasible to generate functional human ventricular heart tissue based on hPSC-derived ventricular myocytes for the treatment of ventricular-specific myocardium damage.

European Radiology, 2018

Objectives Cerebral hyperperfusion (CH) could be a disastrous outcome causing complication after ... more Objectives Cerebral hyperperfusion (CH) could be a disastrous outcome causing complication after carotid revascularization if not managed properly and timely. The aim of this study was to investigate the association between preoperative arterial spin labelling (ASL) perfusion features and circle of Willis (CoW) pattern with CH. Methods Forty-eight consecutive carotid stenosis patients who underwent carotid endarterectomy (CEA) or carotid artery stenting (CAS) were enrolled. All patients had single post-labelling delay (PLD) ASL, territory-ASL, and 3-dimensional timeof-flight MR angiography (3D TOF MRA) within 2 weeks before surgery and within 3 days after surgery. Spatial coefficient of variation (CoV) of cerebral blood flow (CBF), whole brain, and territory perfusion volume ratio were calculated from ASL and territory-ASL. Postoperative CoW was classified into two groups based on patency of the first segment of the anterior cerebral arteries (A1) and anterior communicating artery (AcomA). ASL perfusion features, type of CoW, and clinical characteristics were analyzed between CH group and non-CH group to identify CH risk factors. Results Higher CoV (p = 0.005) of CBF, lower whole brain perfusion volume ratio (p = 0.012), missing any of A1 or AcomA in CoW (p = 0.002 for postoperative MRA and p = 0.004 for preoperative MRA), and large artery stroke history (p = 0.028) were significantly associated with higher risk of CH. Two cases with cerebral hyperperfusion syndrome (CHS) were also discussed, and their perfusion and angiographic features were shown. Conclusions Single-PLD ASL and MRA might be useful and non-invasive imaging tools to identify patients with higher risk of CH after carotid revascularization. Key Points • Cerebral hyperperfusion is a critical complication after carotid endarterectomy or carotid artery stenting. • ASL and MRA can be used to identify patients at higher risk of cerebral hyperperfusion • Pattern of circle of Willis, ASL perfusion features, and whole brain perfusion volume ratio are potential predicting markers for hyperperfusion after carotid revascularization.

World Neurosurgery, 2018

To use territory arterial spin labeling (T-ASL) in the early postoperative period to evaluate the... more To use territory arterial spin labeling (T-ASL) in the early postoperative period to evaluate the revascularization area (RA) obtained by superficial temporal artery-to-middle cerebral artery bypass and to evaluate subsequent perfusion territory changes of the major cerebral arteries.-METHODS: Thirty patients with moyamoya disease treated via unilateral superficial temporal artery-to-middle cerebral artery bypass were included. T-ASL was performed preoperatively and within 1 week postoperatively. The RA was examined by labeling the superficial temporal artery-to-middle cerebral artery bypass postoperatively. Preoperative and postoperative perfusion territories of the bilateral internal carotid arteries, bilateral external carotid arteries, and basilar artery were also examined and compared. Postoperative computed tomography angiography was performed and compared with T-ASL results.-RESULTS: In 14 of 30 patients (46.7%), T-ASL demonstrated the presence of an RA (RA-positive), whereas 16 patients (53.3%) had no RA (RA-negative). In the RA-positive group, mean volume of the RA was 80.32 AE 8.13 mL (range, 34.95e142.50 mL). Postoperative perfusion territory changes of the major cerebral arteries differed between the RA-positive group and the RA-negative group. The incidence of preoperative external carotid artery compensation was significantly higher in the RA-negative group than the RA-positive group (F [ 0.011, df [ 1, P < 0.05). There was good intermodality agreement between T-ASL and computed tomography angiography (k [ 0.780).-CONCLUSIONS: T-ASL can demonstrate the RA obtained by direct revascularization and postoperative perfusion territory changes of the major cerebral arteries. T-ASL is a promising technique in postoperative evaluation of patients with moyamoya disease.

Journal of Neuro-Oncology, 2018

Introduction The longitudinal relaxation time in the rotating frame (T1ρ) has proved to be sensit... more Introduction The longitudinal relaxation time in the rotating frame (T1ρ) has proved to be sensitive to metabolism and useful in application to neurodegenerative diseases. However, few literature exists on its utility in gliomas. Thus, this study was conducted to explore the performance of T1ρ mapping in tumor grading and characterization of isocitrate dehydrogenase 1 (IDH1) gene mutation status of gliomas. Methods Fifty-seven patients with gliomas underwent brain MRI and quantitative measurements of T1ρ and apparent diffusion coefficient (ADC) were recorded. Parameters were compared between high-grade gliomas (HGG) and low-grade gliomas (LGG) and between IDH1 mutant and wildtype groups. Results HGG showed significantly higher T1ρ values in both the solid and peritumoral edema areas compared with LGG (P < 0.001 and P = 0.005, respectively), whereas no significant differences in the two areas were found for ADC (both P > 0.05). Receiver operating characteristic (ROC) curve analysis showed that T1ρ value in the solid area achieved the highest area under the ROC curve (AUC, 0.841) in grading with a sensitivity of 80.6% and a specificity of 81.0%. In the grade II/III glioma group, multivariate logistic regression showed that both tumor frontal lobe location (odds ratio [OR] 526.608; P = 0.045) and T1ρ value of the peritumoral edema area (OR 0.863; P = 0.037) were significant predictors of IDH1 mutation. Using the combination, the diagnostic sensitivity and specificity for IDH1 mutated gliomas were 93.3% and 88.9%, respectively. Conclusions Our study shows the feasibility of applying T1ρ mapping in assessing the histologic grade and IDH1 mutation status of gliomas.

Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance, Jan 19, 2018

Noninvasive cardiovascular magnetic resonance (CMR) techniques including arterial spin labeling (... more Noninvasive cardiovascular magnetic resonance (CMR) techniques including arterial spin labeling (ASL), blood oxygenation level-dependent (BOLD), and intravoxel incoherent motion (IVIM), are capable of measuring tissue perfusion-related parameters. We sought to evaluate and compare these three CMR techniques in characterizing skeletal muscle perfusion in lower extremities and to investigate their abilities to diagnose and assess the severity of peripheral arterial disease (PAD). Fifteen healthy young subjects, 14 patients with PAD, and 10 age-matched healthy old subjects underwent ASL, BOLD, and IVIM CMR perfusion imaging. Healthy young and healthy old participants were subjected to a cuff-induced ischemia experiment with pressures of 20 mmHg and 40 mmHg above systolic pressure during imaging. Perfusion-related metrics, including blood flow, T2* relaxation time, perfusion fraction f, diffusion coefficient D, and pseudodiffusion coefficient D*, were measured in the anterior, lateral, ...

Medicine, 2017

Gliomas constitute over 90% of primary brain tumors. Accurate identification of glioma recurrence... more Gliomas constitute over 90% of primary brain tumors. Accurate identification of glioma recurrence and treatment effects is important, as it can help determine whether to continue with standard adjuvant chemotherapy or to switch to a second-line therapy for recurrence. Our purpose is to compare three dimensional pseudo-continuous arterial spin labeling (3D-pcASL) technique and dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC-MRI) for differentiation tumor recurrence from treatment-related effects in gliomas. Twenty-nine patients with gliomas previously who showed enlarged, contrast-enhancing lesions within the radiation field after surgery and concurrent chemoradiotherapy (CCRT) were assessed with 3D-pcASL and DSC-MRI. These patients were classified into 2 groups, tumor recurrence group (n = 17) and treatment effects group (n = 12), based on pathologic analysis or clinical-radiologic follow-up. The perfusion imaging quality was assessed using a 3-point scale ...

Frontiers in aging neuroscience, 2017

To evaluate the feasibility of a simplified method based on diffusion-weighted imaging (DWI) acqu... more To evaluate the feasibility of a simplified method based on diffusion-weighted imaging (DWI) acquired with three b-values to measure tissue perfusion linked to microcirculation, to validate it against from perfusion-related parameters derived from intravoxel incoherent motion (IVIM) and dynamic contrast-enhanced (DCE) magnetic resonance (MR) imaging, and to investigate its utility to differentiate low-from high-grade gliomas. Materials and Methods: The prospective study was approved by the local institutional review board and written informed consent was obtained from all patients. From May 2016 and May 2017, 50 patients confirmed with glioma were assessed with multib-value DWI and DCE MR imaging at 3.0 T. Besides conventional apparent diffusion coefficient (ADC 0,1000) map, perfusion-related parametric maps for IVIM-derived perfusion fraction (f) and pseudodiffusion coefficient (D *), DCE MR imaging-derived pharmacokinetic metrics, including K trans , v e and v p , as well as a metric named simplified perfusion fraction (SPF), were generated. Correlation between perfusionrelated parameters was analyzed by using the Spearman rank correlation. All imaging parameters were compared between the low-grade (n = 19) and high-grade (n = 31) groups by using the Mann-Whitney U test. The diagnostic performance for tumor grading was evaluated with receiver operating characteristic (ROC) analysis. Results: SPF showed strong correlation with IVIM-derived f and D * (ρ = 0.732 and 0.716, respectively; both P < 0.001). Compared with f, SPF was more correlated with DCE MR imaging-derived K trans (ρ = 0.607; P < 0.001) and v p (ρ = 0.397; P = 0.004). Among all parameters, SPF achieved the highest accuracy for differentiating low-from high-grade gliomas, with an area under the ROC curve value of 0.942, which was significantly higher than that of ADC 0,1000 (P = 0.004). By using SPF as a discriminative index, the diagnostic sensitivity and specificity were 87.1% and 94.7%, respectively, at the optimal cutoff value of 19.26%. Conclusion: The simplified method to measure tissue perfusion based on DWI by using three b-values may be helpful to differentiate low-from high-grade gliomas. SPF may