Background/Objectives: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is an established heart failure biomarker, but its associations with cardiac magnetic resonance (CMR) parameters in patients with reduced ejection fraction remain unclear. This study examined the associations between serum NT-proBNP concentrations and CMR-derived functional, structural, and tissue characterization parameters in patients with HFrEF and evaluated which imaging parameters remained associated with NT-proBNP after multivariable adjustment. Methods: This retrospective single-center study included 92 consecutive patients with HFrEF who underwent CMR and NT-proBNP measurement within a 24 h window, with a median absolute interval of 6 h (range, 1–15 h) between the two assessments. CMR analysis included left ventricular ejection fraction (LVEF), left ventricular and left atrial (LA) cavity diameters, myocardial mass, extracellular volume fraction (ECV), the late gadolinium enhancement (LGE) burden, and the T2 signal intensity (T2-SI) ratio. Spearman correlation, univariate linear regression, and multivariable linear regression analyses were performed using log-transformed NT-proBNP values. Results: Log NT-proBNP demonstrated significant correlations with LVEF (rs = −0.359, p < 0.001), T2-SI ratio (rs = −0.332, p = 0.001), ECV (rs = 0.383, p < 0.001), and LA diameter (rs = 0.347, p < 0.001). No statistically significant correlations were observed between log-transformed NT-proBNP and LGE burden, LV cavity diameter, myocardial mass, LV wall thickness, age, or the recorded comorbidities. In multivariable analysis, LVEF, T2-SI ratio, and LA diameter remained associated with NT-proBNP after adjustment for the available covariates. Conclusions: Lower LVEF, a lower T2-SI ratio, and a larger LA diameter were associated with higher NT-proBNP levels in patients with HFrEF. The T2-SI ratio and LA diameter should be considered exploratory imaging markers requiring prospective validation.
K. Memiş, İffet Doğan, D. Şahin et al.· Tomography· 0 citations
To evaluate the diagnostic performance of dual-energy computed tomography (DECT) in acute appendicitis by comparing attenuation characteristics across different virtual monoenergetic energy levels, virtual non-contrast, overlay, and mixed image reconstructions.
All participants underwent DECT using a dual-source scanner. Appendiceal diameter, periappendiceal findings, and attenuation values obtained from iodine maps, virtual non-contrast, overlay, mixed images, and 40, 80, and 190 keV virtual monoenergetic images were recorded. Diagnostic performance was evaluated using receiver operating characteristic analysis, and interobserver agreement was assessed using a two-way random intraclass correlation coefficient.
In this prospective observational case-control study, 20 patients with surgically or clinically confirmed acute appendicitis and 20 control subjects without appendicitis were included. Appendiceal diameter and all DECT-derived attenuation parameters were significantly higher in patients with acute appendicitis compared with controls (
P
< .001). The highest diagnostic accuracy was achieved with 40 keV virtual monoenergetic images (AUC = 0.998), followed by appendiceal diameter (AUC = 0.994) and mixed images (AUC = 0.973). Low-keV reconstructions provided markedly improved lesion conspicuity. Periappendiceal fat stranding demonstrated high diagnostic performance (sensitivity 0.95, specificity 1.0). Interobserver agreement for attenuation measurements was excellent (intraclass correlation coefficient = 0.887).
Low-keV (40 keV) virtual monoenergetic DECT imaging provides very high diagnostic accuracy for the detection of acute appendicitis and outperforms higher-keV reconstructions and other DECT image types. When combined with conventional CT findings such as appendiceal diameter and periappendiceal inflammatory changes, DECT-derived attenuation analysis represents a reliable and reproducible tool that may enhance diagnostic confidence in emergency imaging.
Mustafa Yeşilyurt, M. Kantarcı· Journal of Acute Disease· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
