散发性主动脉瘤和夹层的纳米颗粒对比增强计算机断层扫描:纳米颗粒大小和造影剂剂量的影响。

Nanoparticle contrast-enhanced computed tomography of sporadic aortic aneurysm and dissection: Effect of nanoparticle size and contrast agent dose.

作者信息

Devkota Laxman, Zhang Chen, Vela Deborah, Sarkar Poonam, Bhandari Prajwal, Starosolski Zbigniew, Menon Renuka, Milewicz Dianna M, Shen Ying H, LeMaire Scott A, Ghaghada Ketan B

机构信息

Department of Radiology, Baylor College of Medicine, Houston, TX.

Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX.

出版信息

Theranostics. 2025 Feb 24;15(8):3462-3473. doi: 10.7150/thno.109325. eCollection 2025.

Abstract

: Aortopathies, such as aortic aneurysm and dissection (AAD), are associated with enhanced aortic wall permeability and endothelial dysfunction. We previously demonstrated that nanoparticle contrast-enhanced computed tomography (nCECT), which detects enhanced aortic wall permeability, could enable non-invasive detection of early AAD before its progresses to fatal aortic rupture. This study investigated the effect of nanoparticle contrast agent (NPCA) size and dose on detection of aortopathy by nCECT. studies were performed in a mouse model of sporadic AAD induced by challenging animals with high fat diet (5 weeks) and angiotensin II infusion (last one week). The effects of NPCA size (80, 150, and 240 nm) and NPCA dose (300, 600, and 1200 mg I/kg) on detection of aortopathy were studied. To examine temporal changes in aortic wall NPCA signal at sites of AAD, mice underwent longitudinal CT. To investigate changes in aortic wall integrity, mice underwent follow-up nCECT at 6 months after initial challenge. Imaging findings were compared with gross and histologic examination of the aorta. Fluorescence microscopy was used to confirm presence or absence of intramural NPCA. : nCECT using all three sizes of NPCAs demonstrated significantly higher sensitivity (p< 0.05) for the detection of aortopathy compared to gross examination. Histologic analysis showed excellent correlation between the nCECT finding of intramural signal and the presence of aortopathy. The absolute improvements in detection rates were 16%, 20%, and 17% for 80 nm, 150 nm, 250 nm NPCA respectively. Sensitivity of nCECT for detection of aortic injury improved with increasing NPCA dose compared to gross exam (-17% at 300 mg I/kg to 14% at 1200 mg I/kg). Temporal analysis of aortic wall NPCA signal at sites of AAD demonstrated a peak in aortic wall CT attenuation at day 3-5 post-contrast followed by gradual return to baseline by day 120. Follow-up nCECT at 6 months demonstrated absence of wall signal enhancement compared to baseline, suggesting resolution of the altered aortic wall permeability and injury. Histologic analysis demonstrated remodeling and healing of the aortic wall. : Nanoparticle contrast-enhanced CT using all three studied nanoparticle sizes demonstrated higher sensitivity than gross examination for the detection of aortopathy. A dose-dependent effect on sensitivity was observed with only high NPCA dose (1200 mg I/kg) demonstrating superior performance compared to gross examination for detecting early stages of aortic injury. Nanoparticle contrast-enhanced CT enabled interrogation of changes in aortic wall integrity.

摘要

主动脉病变,如主动脉瘤和主动脉夹层(AAD),与主动脉壁通透性增强和内皮功能障碍有关。我们之前证明,检测主动脉壁通透性增强的纳米颗粒对比增强计算机断层扫描(nCECT)能够在早期AAD进展为致命的主动脉破裂之前进行无创检测。本研究调查了纳米颗粒造影剂(NPCA)的大小和剂量对nCECT检测主动脉病变的影响。研究在通过高脂饮食(5周)和输注血管紧张素II(最后一周)诱导的散发性AAD小鼠模型中进行。研究了NPCA大小(80、150和240纳米)和NPCA剂量(300、600和1200毫克碘/千克)对主动脉病变检测的影响。为了检查AAD部位主动脉壁NPCA信号的时间变化,对小鼠进行了纵向CT检查。为了研究主动脉壁完整性的变化,在初次激发后6个月对小鼠进行了随访nCECT检查。将影像学结果与主动脉的大体和组织学检查结果进行比较。使用荧光显微镜确认壁内NPCA的存在与否。与大体检查相比,使用所有三种大小的NPCA进行的nCECT在检测主动脉病变方面显示出显著更高的敏感性(p<0.05)。组织学分析表明壁内信号的nCECT结果与主动脉病变的存在之间具有良好的相关性。80纳米、150纳米、250纳米NPCA的检测率绝对提高分别为16%、20%和17%。与大体检查相比,nCECT检测主动脉损伤的敏感性随着NPCA剂量的增加而提高(300毫克碘/千克时为-17%,1200毫克碘/千克时为14%)。对AAD部位主动脉壁NPCA信号的时间分析表明,造影剂注射后第3 - 5天主动脉壁CT衰减达到峰值,随后在第120天逐渐恢复到基线水平。6个月时的随访nCECT显示与基线相比壁信号增强消失,提示主动脉壁通透性改变和损伤得到缓解。组织学分析表明主动脉壁发生了重塑和愈合。使用所有三种研究的纳米颗粒大小进行的纳米颗粒对比增强CT在检测主动脉病变方面显示出比大体检查更高的敏感性。观察到对敏感性有剂量依赖性影响,只有高NPCA剂量(1200毫克碘/千克)在检测主动脉损伤早期阶段时表现出优于大体检查的性能。纳米颗粒对比增强CT能够检测主动脉壁完整性的变化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/986f/11905125/3e8a0bc0a909/thnov15p3462g001.jpg

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