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Self-assembly of nanoparticles (NPs) in drying emulsion droplets paves the way for intricate three-dimensional (3D) superstructures, given the myriad of control parameters for fine-tuning assembly conditions. With their substantial energetic dynamics that are acutely responsive to emulsion confinements, polymeric ligands incorporated into a system can enrich its structural diversity. Here, we demonstrate the assembly of soft polymer-grafted NPs into Mackay icosahedrons beyond spherical body-centered cubic (BCC) packing structures commonly observed for these soft spheres. This behavior is governed by the free energy minimization within emulsions through the interplay of the oil-water interfacial energy and confinement effect as demonstrated by the experimental observations of structural transitions between icosahedrons and BCC crystals and by corresponding free energy calculations. The anisotropic surface of the icosahedral supracrystals provides the capability of guiding the position of a secondary constituent, creating unique hybrid patchy icosahedrons with the potential to develop into multifunctional 3D clusters that combine the benefits of both polymers and conventional colloids.
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RATIONALE AND OBJECTIVES: MRI reconstruction of undersampled data using a deep learning (DL) network has been recently performed as part of accelerated imaging. Herein, we compared DL-reconstructed T2-weighted image (T2-WI) to conventional T2-WI regarding image quality and degenerative lesion detection. MATERIALS AND METHODS: Sixty-two patients underwent C-spine (n = 27) or L-spine (n = 35) MRIs, including conventional and DL-reconstructed T2-WI. Image quality was assessed with non-uniformity measurement and 4-scale grading of structural visibility. Three readers (R1, R2, R3) independently assessed the presence and types of degenerative lesions. Student t-test was used to compare non-uniformity measurements. Interprotocol and interobserver agreement of structural visibility was analyzed with Wilcoxon signed-rank test and weighted-κ values, respectively. The diagnostic equivalence of degenerative lesion detection between two protocols was assessed with interchangeability test. RESULTS: The acquisition time of DL-reconstructed images was reduced to about 21-58% compared to conventional images. Non-uniformity measurement was insignificantly different between the two images (p-value = 0.17). All readers rated DL-reconstructed images as showing the same or superior structural visibility compared to conventional images. Significantly improved visibility was observed at disk margin of C-spine (R1, p < 0.001; R2, p = 0.04) and dorsal root ganglia (R1, p = 0.03; R3, p = 0.02) and facet joint (R1, p = 0.04; R2, p < 0.001; R3, p = 0.03) of L-spine. Interobserver agreements of image quality were variable in each structure. Clinical interchangeability between two protocols for degenerative lesion detection was verified showing <5% in the upper bounds of 95% confidence intervals of agreement rate differences. CONCLUSIONS: DL-reconstructed T2-WI demonstrates comparable image quality and diagnostic performance with conventional T2-WI in spine imaging, with reduced acquisition time.
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Aprendizaje Profundo , Humanos , Imagen por Resonancia Magnética/métodosRESUMEN
Health implications of indoor air quality (IAQ) have drawn more attention since the COVID epidemic. There are many different kinds of studies done on how IAQ affects people's well-being. There hasn't been much research that looks at the microbiological composition of the aerosol in subway transit systems. In this work, for the first time, we examined the aerosol bacterial abundance, diversity, and composition in the microbiome of the Seoul subway and train stations using DNA isolated from the PM10 samples from each station (three subway and two KTX stations). The average PM10 mass concentration collected on the respective platform was 41.862 µg/m3, with the highest average value of 45.95 µg/m3 and the lowest of 39.25 µg/m3. The bacterial microbiomes mainly constituted bacterial species of soil and environmental origin (e.g., Acinetobacter, Brevundimonas, Lysinibacillus, Clostridiodes) with fewer from human sources (Flaviflexus, Staphylococcus). This study highlights the relationship between microbiome diversity and PM10 mass concentration contributed by outdoor air and commuters in South Korea's subway and train stations. This study gives insights into the microbiome diversity, the source, and the susceptibility of public transports in disease spreading.
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Contaminantes Atmosféricos , Vías Férreas , Humanos , Material Particulado/análisis , Contaminantes Atmosféricos/análisis , Seúl , Monitoreo del Ambiente , AerosolesRESUMEN
PURPOSE: This retrospective study aimed to evaluate the validity of an automated screening Dixon (e-DIXON) technique for quantifying hepatic steatosis in living liver-donor patients by comparison with magnetic resonance spectroscopy (MRS) as a reference standard. METHODS: A total of 285 living liver-donor candidates were examined with the e-DIXON technique and single-voxel MRS to assess hepatic steatosis and iron deposition between January 2014 and February 2019. The sensitivity, specificity, and positive and negative predictive values (PPV and NPV) of the e-DIXON technique for hepatic steatosis were calculated. The mean fat signal fractions obtained in MRS were compared between the donors diagnosed with hepatic steatosis and the normal group. The mean R2 values of donors with or without hepatic siderosis also were compared. RESULTS: The e-DIXON technique diagnosed normal in 133 (47%), fat in 124 (44%), iron in one (0.4%), and a combination of both fat and iron in 27 (10%) donors. The sensitivity, specificity, PPV, and NPV ââfor diagnosing hepatic steatosis were 94%, 70%, 64%, and 96%, respectively. There was a significant difference in the mean fat signal fraction obtained in MRS between the steatosis and normal groups (p < 0.001), but R2 values were not significantly different between siderosis and normal groups (p = 0.11). The e-DIXON technique showed a strong correlation with MRS in fat measurement (r2 = 0.92, p < 0.001). CONCLUSION: The e-DIXON technique reliably screens for hepatic steatosis but may not accurate for detecting hepatic iron deposition.
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Hígado Graso , Siderosis , Humanos , Imagen por Resonancia Magnética/métodos , Estudios Retrospectivos , Hígado Graso/diagnóstico por imagen , Hígado/diagnóstico por imagen , HierroRESUMEN
PURPOSE: To assess the feasibility of deep learning (DL)-based k-space-to-image reconstruction and super resolution for whole-spine diffusion-weighted imaging (DWI). METHOD: This retrospective study included 97 consecutive patients with hematologic and/or oncologic diseases who underwent DL-processed whole-spine MRI from July 2022 to March 2023. For each patient, conventional (CONV) axial single-shot echo-planar DWI (b = 50, 800 s/mm2) was performed, followed by DL reconstruction and super resolution processing. The presence of malignant lesions and qualitative (overall image quality and diagnostic confidence) and quantitative (nonuniformity [NU], lesion contrast, signal-to-noise ratio [SNR], contrast-to-noise ratio [CNR], and ADC values) parameters were assessed for DL and CONV DWI. RESULTS: Ultimately, 67 patients (mean age, 63.0 years; 35 females) were analyzed. The proportions of vertebrae with malignant lesions for both protocols were not significantly different (P: [0.55-0.99]). The overall image quality and diagnostic confidence scores were higher for DL DWI (all P ≤ 0.002) than CONV DWI. The NU, lesion contrast, SNR, and CNR of each vertebral segment (P ≤ 0.04) but not the NU of the sacral segment (P = 0.51) showed significant differences between protocols. For DL DWI, the NU was lower, and lesion contrast, SNR, and CNR were higher than those of CONV DWI (median values of all segments; 19.8 vs. 22.2, 5.4 vs. 4.3, 7.3 vs. 5.5, and 0.8 vs. 0.7). Mean ADC values of the lesions did not significantly differ between the protocols (P: [0.16-0.89]). CONCLUSIONS: DL reconstruction can improve the image quality of whole-spine diffusion imaging.
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Aprendizaje Profundo , Femenino , Humanos , Persona de Mediana Edad , Estudios Retrospectivos , Imagen de Difusión por Resonancia Magnética/métodos , Imagen Eco-Planar/métodos , Columna Vertebral , Procesamiento de Imagen Asistido por Computador , Reproducibilidad de los ResultadosRESUMEN
Mesoporous carbon particles have great potential due to their unique structural properties as support materials for catalytic applications. Particle shapes and channel nanostructures of mesoporous carbon particles can determine the reactant/product transport efficiency. However, the role of the channel nanostructure in the catalytic reaction has not been much explored. Herein, we introduce a facile method to fabricate a series of porous carbon particles (PCPs) with controlled channel exposure on the carbon surface and investigate the impact of the channel nanostructure of the PCPs on the catalytic activity. By employing a membrane emulsification method with a controlled solvent evaporation rate, we fabricate block copolymer (BCP) particles with uniform size and regulated degrees of cylindrical channel exposed to the particle surface. Followed by the carbonization of the BCP particles, a low amount (1.3 wt%) of Pt is incorporated into the PCP series to investigate the impact of channel nanostructures on the catalytic oxidation reaction of o-phenylenediamine (OPD). Specifically, PCP featuring highly open channel nanostructures shows a high reaction rate constant of 0.154 mM-1 s-1 for OPD oxidation, showing 5.5 times higher catalytic activity than those of closed channel nanostructures (0.028 mM-1 s-1). This study provides a deeper understanding of the impact of channel nanostructure within mesoporous carbon particles on catalytic activity.
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PURPOSE: This study aims to compare the image quality, apparent diffusion coefficient (ADC), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) values, and scan time between readout-segmented echo planar imaging (rs-EPI) and simultaneous multislice (SMS) rs-EPI sequences. METHODS: A total of 80 consecutive women who underwent breast diffusion-weighted imaging (DWI) were included, and two rs-EPI DWI sequences with and without SMS were acquired and compared. Qualitative analysis involved three radiologists independently scoring image quality and radiologist preference. For quantitative comparison, the radiologists independently measured the ADC values in patients, while SNR, CNR, and ADC values were measured on a phantom. RESULTS: The acquisition time was 5:47 min for rs-EPI and 3:20 min for SMS rs-EPI. In terms of image quality, scores were similar between rs-EPI and SMS rs-EPI sequences in the pooled data set, with the exception of skin-line distinction (p = 0.001) and background noise (p < 0.001). All radiologists considered SMS rs-EPI as equal or superior to rs-EPI in more than 70 % of cases. SMS rs-EPI demonstrated significantly higher ADC values than rs-EPI by all radiologists (p ≤ 0.002). For the phantom measurement, ADC (SMS: 1.26 ± 0.68 and RS: 1.26 ± 0.68, p = 0.198), SNR (SMS: 540.6 ± 342.1 and RS: 558.8 ± 523.2, p = 0.927), and CNR (SMS: 235.5 ± 38.9 and RS: 252.8 ± 108.0, p = 0.784) values did not significantly differ between the two sequences. CONCLUSION: SMS rs-EPI exhibited comparable image quality and similar ADC, SNR, and CNR values to rs-EPI while reducing the scan time by 42%.
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Mama , Imagen Eco-Planar , Humanos , Femenino , Imagen Eco-Planar/métodos , Mama/diagnóstico por imagen , Relación Señal-Ruido , Imagen de Difusión por Resonancia Magnética/métodos , Fantasmas de Imagen , Reproducibilidad de los ResultadosRESUMEN
PURPOSE: In the present study, we determined the prevalence of obstructive meibomian gland dysfunction (MGD), hyposecretory MGD, grossly normal MG, and hypersecretory MGD in patients with dry eye syndrome using lipid layer thickness (LLT) and MG dropout. METHODS: Eighty-eight patients with dry eye syndrome were included in the study. Patients were categorized into four groups according to the LLT and weighted total meiboscore. The proportion of patients in each group was calculated. The age, sex, Ocular Surface Disease Index, LLT, Schirmer, tear film breakup time, cornea stain, weighted total meiboscore, expressibility, and quality of meibum were compared between the four groups. RESULTS: Fifteen eyes (17.0%) had obstructive MGD, two eyes (2.3%) had hyposecretory MGD, 40 eyes (45.5%) had grossly normal MG, and 17 eyes (19.3%) had hypersecretory MGD. The obstructive MGD group was younger than the grossly normal MG group. In obstructive MGD, the ratio of men to women was higher than that of the other groups. However, Ocular Surface Disease Index, Schirmer, tear film breakup time, and corneal stain did not show statistically significant differences between the four groups. The meibum expressibility of the hyposecretoy MGD group was worse than those of the other groups. The meibum expressibility of the hyposecretoy MGD group was poor than those of the obstructive and hypersecretory MGD group. CONCLUSIONS: This categorization was expected to help determine the best treatment method for dry eye syndrome, according to the MG status.
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Síndromes de Ojo Seco , Disfunción de la Glándula de Meibomio , Masculino , Humanos , Femenino , Disfunción de la Glándula de Meibomio/diagnóstico , Glándulas Tarsales/diagnóstico por imagen , Estudios Retrospectivos , Síndromes de Ojo Seco/diagnóstico , Lágrimas , LípidosRESUMEN
Public transportation facilities, especially road crossings, which raise the pathogenic potential of urban environments, are the most conducive places for the transfer of germs between people and the environment. It is necessary to study the variety of the microbiome and describe its unique characteristics to comprehend these relationships. In this investigation, we used 16 S rRNA gene sample sequencing to examine the biological constituents and inhalable, thoracic, and alveolar particles in aerosol samples collected from busy areas in the Gangnam-gu district of the Seoul metropolitan area using a mobile vehicle. We also conducted a comparison analysis of these findings with the previously published data and tested for antibiotic resistance to determine the distribution of bacteria related to the human microbiome and the environment. Actinobacteria, Cyanobacteria, Bacteriodetes, Proteobacteria, and Firmicutes were the top five phyla in the bacterial 16 S rRNA libraries, accounting for >90 % of all readings across all examined locations. The most prevalent classes among the 12 found bacterial classes were Bacilli (45.812 %), Gammaproteobacteria (25.238 %), Tissierellia (13.078 %), Clostridia (5.697 %), and Alphaproteobacteria (5.142 %). The data acquired offer useful information on the variety of bacterial communities and their resistance to antibiotic drugs on the streets of Gangnam-gu, one of the most significant social centers in the Seoul metropolitan area. This work emphasizes the relevance of biological particles and particulate matter in the air, and it suggests more research is needed to perform biological characterization of the ambient particulate matter.
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Distortion of echo planar imaging (EPI) can be corrected using B0 field maps, which can be estimated with the topup algorithm that requires two EPI images with opposite distortions. In this study, we propose a new algorithm, termed topup algorithm by single K-space (TASK), to generate two input images from a single k-space for the topup algorithm to correct EPI distortions. The centric EPI contains the opposite phase-encoding polarities in one k-space, which can be divided into two halves with opposite distortions. Therefore, two inputs could be extracted by dividing the k-space into halves and processing them using the proposed procedure including an iterative procedure of automatic brain masking and uniformity correction. The efficiency of TASK was evaluated using 3D EPI. Quantitative evaluations showed that TASK corrected EPI distortion at a similar level to the traditional methods. The estimated field maps from the conventional topup and TASK showed a high correlation ([Formula: see text]). An ablation study showed the validity of every suggested step. Furthermore, it was confirmed that TASK was effective for distortion correction of two-shot centric EPI as well, demonstrating its wider applicability. In conclusion, TASK can correct EPI distortions by its own single k-space information with no additional scan.
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This paper deals with the practical application of Radar Cross Section (RCS) reduction technology using plasma. Although various plasma application technologies for RCS reduction have been studied, there are still many issues to be addressed for practical implementation. In order to achieve actual application, the discharge should be sustained regardless of the external environment of the aircraft. It is also important to investigate the actual plasma parameters to determine the expected RCS reduction effect. Building upon previous studies that optimized the electrodes for RCS reduction, this study fabricates a Dielectric Barrier Discharge (DBD) source suitable for dynamic environments and verifies the power consumption during one cycle of plasma generation. The obtained results are expected to contribute to the optimization of DBD electrodes for plasma RCS reduction.
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In this study, the problems encountered in radar cross-section (RCS) measurement experiments utilizing a dielectric barrier discharge (DBD) plasma system are examined and an effective solution is proposed. A DBD plasma system generates heat due to the high bias voltage required for plasma generation. The thermal-induced structural deformation of the DBD structure caused by this high voltage and its impact on RCS measurements are analyzed. In addition, techniques for minimizing the thermal-induced deformation and compensation methods for addressing the minimized deformation are proposed. Furthermore, RCS measurements are conducted on two kinds of DBD structures using the proposed method to experimentally demonstrate the improved agreement between the simulation and measurement results. For both structures, the RCS experimental results are in very good agreement with the simulation results, which enables accurate plasma characterization. In conclusion, it can be expected that the proposed method can be used to provide more accurate RCS measurements on various DBD structures that generate high heat.
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The fundamental aspects of energy dissipation on 2-dimensional (2D) atomic layers are extensively studied. Among various atomic layers, transition metal dichalcogenides (TMDs) exists in several phases based on their lattice structure, which give rise to the different phononic and electronic contributions in energy dissipation. 2H and 1T' (distorted 1T) phase MoS2 and MoTe2 atomic layers exfoliated on mica substrate are obtained and investigated their nanotribological properties with atomic force microscopy (AFM)/ friction force microscopy (FFM). Surprisingly, 1T' phase of both MoS2 and MoTe2 exhibits ≈10 times higher friction compared to 2H phase. With density functional theory analyses, the friction increase is attributed to enhanced electronic excitation, efficient phonon dissipation, and increased potential energy surface barrier at the tip-sample interface. This study suggests the intriguing possibility of tuning the friction of TMDs through phase transition, which can lead to potential application in tunable tribological devices.
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During rigid ureteroscopic lithotripsy, it is often encountered that the ureter is difficult to access. Attempts to advance the ureteroscope make the surgery more difficult. This study evaluated the preoperative predictive factors associated with difficult ureteral access (difficult ureter (DU)) during URS and assessed if clinical outcomes differed according to the degree of DU. This study identified 217 patients who underwent rigid ureteroscopic (URS) lithotripsy for the management of ureter stones between June 2017 and July 2021 in a tertiary hospital in Korea. In this group, preoperative factors were identified using univariate and multiple logistic regression analyses that could predict the degree of DU. Additionally, we also evaluated differences in treatment outcomes depending on the degree of DU. In 50 URS cases (22.0%), ureteral access using a ureteroscope was difficult. In the univariate and multivariate analyses, the degree of hydronephrosis was associated with the degree of DU. Treatment outcomes, extended operation times, low stone-free rate, postoperative pain, and secondary treatment were also significantly associated with the degree of DU. Clinicians can counsel patients with a lesser degree of hydronephrosis and approach their management accordingly.
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OBJECTIVES: Deep learning-reconstructed diffusion-weighted imaging (DL-DWI) is an emerging promising time-efficient method for liver evaluation, but analyses regarding different motion compensation strategies are lacking. This study evaluated the qualitative and quantitative features, sensitivity for focal lesion detection, and scan time of free-breathing (FB) DL-DWI and respiratory-triggered (RT) DL-DWI compared with RT conventional DWI (C-DWI) in the liver and a phantom. MATERIALS AND METHODS: Eighty-six patients indicated for liver MRI underwent RT C-DWI, FB DL-DWI, and RT DL-DWI with matching imaging parameters other than the parallel imaging factor and number of averages. Two abdominal radiologists independently assessed qualitative features (structural sharpness, image noise, artifacts, and overall image quality) using a 5-point scale. The signal-to-noise ratio (SNR) along with the apparent diffusion coefficient (ADC) value and its standard deviation (SD) were measured in the liver parenchyma and a dedicated diffusion phantom. For focal lesions, per-lesion sensitivity, conspicuity score, SNR, and ADC value were evaluated. Wilcoxon signed rank test and repeated-measures analysis of variance with post hoc test revealed the difference in DWI sequences. RESULTS: Compared with RT C-DWI, the scan times for FB DL-DWI and RT DL-DWI were reduced by 61.5% and 23.9%, respectively, with statistically significant differences between all 3 pairs (all P 's < 0.001). Respiratory-triggered DL-DWI showed a significantly sharper liver margin, less image noise, and more minor cardiac motion artifact compared with RT C-DWI (all P 's < 0.001), whereas FB DL-DWI showed more blurred liver margins and poorer intrahepatic vessels demarcation than RT C-DWI. Both FB- and RT DL-DWI showed significantly higher SNRs than RT C-DWI in all liver segments (all P 's < 0.001). There was no significant difference in overall ADC values across DWI sequences in the patient or phantom, with the highest value recorded in the left liver dome by RT C-DWI. The overall SD was significantly lower with FB DL-DWI and RT DL-DWI than RT C-DWI (all P 's ≤ 0.003). Respiratory-triggered DL-DWI showed a similar per-lesion sensitivity (0.96; 95% confidence interval, 0.90-0.99) and conspicuity score to those of RT C-DWI and significantly higher SNR and contrast-to-noise ratio values ( P ≤ 0.006). The per-lesion sensitivity of FB DL-DWI (0.91; 95% confidence interval, 0.85-0.95) was significantly lower than that of RT C-DWI ( P = 0.001), with a significantly lower conspicuity score. CONCLUSIONS: Compared with RT C-DWI, RT DL-DWI demonstrated superior SNR, comparable sensitivity for focal hepatic lesions, and reduced acquisition time, making it a suitable alternative to RT C-DWI. Despite FB DL-DWI's weakness in motion-related challenges, further refinement could potentiate FB DL-DWI in the context of abbreviated screening protocols, where time efficiency is a high priority.
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Aprendizaje Profundo , Humanos , Hígado/diagnóstico por imagen , Respiración , Abdomen , Relación Señal-Ruido , Imagen de Difusión por Resonancia Magnética/métodos , Reproducibilidad de los ResultadosRESUMEN
This study investigated the optimal strategy for the treatment of chronic recurrent urethral strictures longer than 3 cm, using a temporary urethral stent. Between September 2011 and June 2021, 36 patients with chronic bulbomembranous urethral strictures underwent temporary urethral stent placement. Retrievable self-expandable polymer-coated bulbar urethral stents (BUSs) were placed in 21 patients (group A), and thermo-expandable nickel-titanium alloy urethral stents were placed in 15 patients (group M). Each group was subdivided into those with and without transurethral resection (TUR) of fibrotic scar tissue. The urethral patency rates at 1 year after stent removal were compared between the groups. The patients in group A showed a higher urethral patency maintenance rate at 1 year after stent removal than those in group M (81.0% vs. 40.0%, log rank test p = 0.012). Analysis of subgroups in which TUR was performed due to severe fibrotic scar, showed that the patients in group A showed a significantly higher patency rate than patients in group M (90.9% vs. 44.4%, log rank test p = 0.028). In the treatment of chronic urethral strictures with a long fibrotic scar, temporary BUS combined with TUR of fibrotic tissue seems to be the optimal minimally invasive treatment strategy.
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Tumor progression is intimately associated with the vasculature, as tumor proliferation induces angiogenesis and tumor cells metastasize to distant organs via blood vessels. However, whether tumor invasion is associated with blood vessels remains unknown. As glioblastoma (GBM) is featured by aggressive invasion and vascular abnormalities, we characterized the onset of vascular remodeling in the diffuse tumor infiltrating zone by establishing new spontaneous GBM models with robust invasion capacity. Normal brain vessels underwent a gradual transition to severely impaired tumor vessels at the GBM periphery over several days. Increasing vasodilation from the tumor periphery to the tumor core was also found in human GBM. The levels of vascular endothelial growth factor (VEGF) and VEGF receptor 2 (VEGFR2) showed a spatial correlation with the extent of vascular abnormalities spanning the tumor-invading zone. Blockade of VEGFR2 suppressed vascular remodeling at the tumor periphery, confirming the role of VEGF-VEGFR2 signaling in the invasion-associated vascular transition. As angiopoietin-2 (ANGPT2) was expressed in only a portion of the central tumor vessels, we developed a ligand-independent tunica interna endothelial cell kinase 2 (Tie2)-activating antibody that can result in Tie2 phosphorylation in vivo. This agonistic anti-Tie2 antibody effectively normalized the vasculature in both the tumor periphery and tumor center, similar to the effects of VEGFR2 blockade. Mechanistically, this antibody-based Tie2 activation induced VE-PTP-mediated VEGFR2 dephosphorylation in vivo. Thus, our study reveals that the normal-to-tumor vascular transition is spatiotemporally associated with GBM invasion and may be controlled by Tie2 activation via a novel mechanism of action.
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Glioblastoma , Humanos , Glioblastoma/patología , Factor A de Crecimiento Endotelial Vascular/metabolismo , Remodelación Vascular , Transducción de Señal , Factores de Crecimiento Endotelial VascularRESUMEN
PURPOSE: Pulmonary thromboembolism is a potentially life-threatening condition in patients with heart disease; however, limited studies discussing long-term outcomes exist. This study aimed to investigate the long-term outcomes of pulmonary endarterectomy (PEA) in patients with chronic thromboembolic pulmonary hypertension (CTEPH), focusing on the improvement of functional class and right ventricular (RV) pressure. MATERIALS AND METHODS: Clinical data of patients with CTEPH were obtained from Yonsei Hospital between May 2012 and December 2021, and reviewed retrospectively. Twenty-six patients underwent endoscope-guided PEA during the study period, and the mean follow-up duration was 24.8±23.4 months. RESULTS: After PEA, most patients (88.5%) were weaned from inotropes without extracorporeal membrane oxygenation support during the first few days. Two patients (7.6%) had cerebrovascular accidents without neurological deficits. On echocardiography, the RV systolic pressure and tricuspid regurgitation grades significantly improved (p<0.001). Furthermore, the mean left ventricle end-diastolic diameter was significant increased (p=0.003), and the left ventricular end-systolic diameter increased (p<0.001). The median intensive care unit stay was 3.0±9.4 days, and median hospital stay 16.0±26.5 days. The 5-year survival rate was 95.5%, and the 5-year freedom rate of cardiac death was 100%. There was a marked improvement in New York Heart Association (NYHA) status (p<0.001). Cox regression suggested that the main pulmonary artery (MPA) involvement is a significant predictor of non-improvement in functional class post-PEA. CONCLUSION: Mortality rates are low and patients experience a marked improvement in NYHA class and health status after PEA. Moreover, MPA involvement may affect functional outcomes.
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Hipertensión Pulmonar , Embolia Pulmonar , Humanos , Hipertensión Pulmonar/cirugía , Hipertensión Pulmonar/etiología , Estudios Retrospectivos , Resultado del Tratamiento , Embolia Pulmonar/cirugía , Arteria Pulmonar/cirugía , Endarterectomía/efectos adversos , Enfermedad CrónicaRESUMEN
The purpose of the current study was to develop spatially and velocity-selective (SVS) magnetization preparation pulses for noncontrast-enhanced peripheral MR angiography (MRA) to provide comparisons with velocity-selective (VS) MRA with comparison to velocity-selective (VS). VS preparation pulses were designed by concatenating multiple excitation steps, each of which was a combination of a hard RF pulse, VS unipolar gradient pulses, and refocusing RF pulses. SVS preparation pulses were designed by replacing the hard RF pulse with a sinc-shaped RF pulse combined with a symmetric tripolar gradient pulse (which does not perturb the velocity encoding by the VS unipolar gradient pulses). Numerical simulations were performed to verify the intended hybrid excitation selectivity of SVS pulses taking account of tissue relaxation, magnetic field errors, and eddy currents. In vivo experiments were performed in healthy subjects to verify the hybrid excitation selectivity, as well as to demonstrate the visualization of the entire peripheral arteries using six-station protocols. As demonstrated by numerical simulations, SVS preparation yielded a notch-shaped longitudinal magnetization (Mz )-velocity response within the spatial stopband (the same as VS preparation) and preserved the Mz of spins outside the stopband, regardless of its velocity. We confirmed these observations also through in vivo tests with good agreement in normalized arterial and muscle signal intensities. In six-station peripheral MRA experiments, the proposed SVS-MRA yielded significantly higher arterial signal-to-noise ratio (SNR) (51.6 ± 14.3 vs. 38.9 ± 10.9; p < 0.001) and contrast-to-noise ratio (CNR) (41.2 ± 13.0 vs. 31.3 ± 10.5; p < 0.001) compared with VS-MRA. The proposed SVS-MRA improves arterial SNR and CNR compared with VS-MRA by mitigating undesired presaturation of arterial blood upstream the imaging field of view.
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Arterias , Angiografía por Resonancia Magnética , Humanos , Angiografía por Resonancia Magnética/métodos , Relación Señal-RuidoRESUMEN
OBJECTIVES: The study aimed to develop a deep neural network (DNN)-based noise reduction and image quality improvement by only using routine clinical scans and evaluate its performance in 3D high-resolution MRI. METHODS: This retrospective study included T1-weighted magnetization-prepared rapid gradient-echo (MP-RAGE) images from 185 clinical scans: 135 for DNN training, 11 for DNN validation, 20 for qualitative evaluation, and 19 for quantitative evaluation. Additionally, 18 vessel wall imaging (VWI) data were included to evaluate generalization. In each scan of the DNN training set, two noise-independent images were generated from the k-space data, resulting in an input-label pair. 2.5D U-net architecture was utilized for the DNN model. Qualitative evaluation between conventional MP-RAGE and DNN-based MP-RAGE was performed by two radiologists in image quality, fine structure delineation, and lesion conspicuity. Quantitative evaluation was performed with full sampled data as a reference by measuring quantitative error metrics and volumetry at 7 different simulated noise levels. DNN application on VWI was evaluated by two radiologists in image quality. RESULTS: Our DNN-based MP-RAGE outperformed conventional MP-RAGE in all image quality parameters (average scores = 3.7 vs. 4.9, p < 0.001). In the quantitative evaluation, DNN showed better error metrics (p < 0.001) and comparable (p > 0.09) or better (p < 0.02) volumetry results than conventional MP-RAGE. DNN application to VWI also revealed improved image quality (3.5 vs. 4.6, p < 0.001). CONCLUSION: The proposed DNN model successfully denoises 3D MR image and improves its image quality by using routine clinical scans only. KEY POINTS: ⢠Our deep learning framework successfully improved conventional 3D high-resolution MRI in all image quality parameters, fine structure delineation, and lesion conspicuity. ⢠Compared to conventional MRI, the proposed deep neural network-based MRI revealed better quantitative error metrics and comparable or better volumetry results. ⢠Deep neural network application to 3D MRI whose pulse sequences and parameters were different from the training data showed improvement in image quality, revealing the potential to generalize on various clinical MRI.