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Censi, S.

Publications and source records attributed to Censi, S..

2 recordsLinked to original sources

Three-dimensional T1 mapping demonstrates the transfer of oxygen into cerebrospinal fluid during hyperoxia

BackgroundThis study optimised a non-invasive magnetic resonance imaging technique to investigate the transfer of oxygen into cerebrospinal fluid (CSF) across the whole brain of healthy subjects. MethodsA shortening of the T1 (longitudinal relaxation time) of CSF was induced by 100% hyperoxia and measured using a 3D SPACE sequence at 3T in 29 subjects, thereby demonstrating the diffusion of oxygen from blood to CSF. T1 mapping was performed at high resolution (0.9-mm isotropic, taking approximately 16 minutes) to capture anatomical details of the CSF spaces and was also repeated more rapidly at a lower resolution (3-mm isotropic, taking approximately 3.5 minutes) to capture the temporal dynamics of T1 changes. ResultsSignificant region-dependent reductions in T1 were observed, indicating increased oxygen concentration in CSF. These occurred most prominently and rapidly in the cortical subarachnoid space and basilar cisterns, stabilising between 7 and 10 minutes after initiating hyperoxia, suggesting that oxygen diffusion primarily occurs via pial arteries and arteries at the base of the skull, both of which are in proximity to CSF-filled spaces. Over a timescale of 16 minutes, smaller T1 changes, only observed on the high-resolution T1 maps, occurred in the posterior lateral ventricles, where the choroid plexus is found, and the cisterna magna, possibly because of mixing effects with the adjacent basilar cisterns. ConclusionsThis study provides insights into the structure of CSF and dynamics of blood-CSF oxygen exchange, including their regional dependence. Moreover, the methodology presented here could, in the future, offer a valuable tool for characterising the passive diffusion of oxygen across cerebral blood vessel walls (i.e., their oxygen permeability), thereby providing a potential marker of cerebrovascular integrity.

physiology↗

Postural test to differentiate primary aldosteronism from low-renin hypertension

BackgroundThe diagnostic accuracy of screening and confirmatory tests to differentiate primary aldosteronism (PA) among patients with low-renin hypertension (HTN) is suboptimal. We aimed to assess the role of postural stimulation test (PST, previously used for PA subtyping) in differentiating PA from low-renin HTN. Patients and methodsClinical and endocrine data in clinostatic position (CP) and orthostatic position (OP) during PST were evaluated in 190 hypertensive patients: 80 PA and 110 low-renin HTN. Multivariate techniques were computed: Principal Component Analysis (PCA), Partial Least Square-Discriminant Analysis (PLS-DA) and k-means clustering. ResultsPST response differentiated our cohort: 96% of PA were detected in the 56/190 patients with always suppressed renin levels, 80% of patients with low-renin HTN were identified among 56/190 subjects with de-suppression of renin from CP to OP and 78/190 with always measurable renin. Increased potassium and measurable renin in OP were predictors of low-renin HTN. Cluster analysis distinguished PA from low-renin HTN: Cluster 2 included 104/110 low-renin HTN; Cluster 1 PA patients showed a higher frequency of suppressed renin levels at baseline and during PST (100% in CP and 95% in OP, respectively). Cluster 1 low-renin HTN patients had lower potassium and a higher frequency of suppressed renin levels at diagnosis and during PST, compared to Cluster 2. PLS-DA and PCA confirmed that renin in OP, renin response to PST and presence of hypokalemia were the most relevant parameters for distinguishing PA from low-renin HTN. ConclusionRenin response during PST can be used to differentiate PA from low-renin HTN.

physiology↗