Quantitative CT assessment by histogram and volume ratio in pyrrolizidines alkaloids-induced hepatic sinusoidal obstruction syndrome.

OBJECTIVE: To quantitatively assess hypoattenuation volume ratio and hepatic parenchymal hypoattenuation on contrast enhanced computed tomography (CECT) in patients with pyrrolizidines alkaloids (PAs)-induced hepatic sinusoidal obstruction syndrome (HSOS), and evaluate the correlations of the CT-based quantitative values with clinical factors. METHODS: Thirty-five patients with PAs-induced HSOS who underwent CECT were retrospectively enrolled. The ratio of hypoattenuation volume to total liver volume, and changes in damaged area-to-normal liver density ratio (ΔDR) derived from histogram on portal venous phase were quantitatively measured. Heterogeneous hypoattenuation (CT score) scored by hypoattenuation volume ratio and ΔDR were calculated. The correlation between imaging findings and clinical factors was analyzed using Pearson correlation test. RESULTS: Liver function tests were abnormal in most patients, the mean Hounsfield unit (HU) of damaged area (58.68 ± 17.3) was significantly lower (P < 0.001) than the corresponding normal liver (82.27 ± 23.97). Heterogeneous hypoattenuation were mild in 13 patients (37 %), moderate in 16 patients (46 %), and severe in 6 patients (17 %). ΔDR derived from histogram was positively correlated (weakly to moderately) with total bilirubin (r = 0.341, P = 0.045), direct bilirubin (r = 0.385, P = 0.022), and alkaline phosphatase (r = 0.491, P = 0.003), while such correlation was not observed in hypoattenuation volume ratio. The severity of heterogeneous hypoattenuation scored by hypoattenuation volume ratio and ΔDR was positively correlated (weakly) with prothrombin time (r = 0.357, P = 0.035), international normalized ratio (r = 0.363, P = 0.032), alkaline phosphatase (r = 0.359, P = 0.034), and model for end-stage liver disease (MELD) score (r = 0.347, P = 0.041). CONCLUSION: Heterogeneous hypoattenuation scored by volume ratio and ΔDR on CECT provides a non-invasive approach in evaluating the severity of PAs-induced HSOS.

Assessment of liver metastases radiomic feature reproducibility with deep-learning-based semi-automatic segmentation software.

BACKGROUND: Good feature reproducibility enhances model reliability. The manual segmentation of gastric cancer with liver metastasis (GCLM) can be time-consuming and unstable. PURPOSE: To assess the value of a semi-automatic segmentation tool in improving the reproducibility of the radiomic features of GCLM. MATERIAL AND METHODS: Patients who underwent dual-source computed tomography were retrospectively reviewed. As an intra-observer analysis, one radiologist segmented metastatic liver lesions manually and semi-automatically twice. Another radiologist re-segmented the lesions once as an inter-observer analysis. A total of 1691 features were extracted. Spearman rank correlation was used for feature reproducibility analysis. The times for manual and semi-automatic segmentation were recorded and analyzed. RESULTS: Seventy-two patients with 168 lesions were included. Most of the GCLM radiomic features became more reliable with the tool than the manual method. For the intra-observer feature reproducibility analysis of manual and semi-automatic segmentation, the rates of features with good reliability were 45.5% and 62.3% (P < 0.02), respectively; for the inter-observer analysis, the rates were 29.3% and 46.0% (P < 0.05), respectively. For feature types, the semi-automatic method increased reliability in 6/7 types in the intra-observer analysis and 5/7 types in the inter-observer analysis. For image types, the reliability of the square and exponential types was significantly increased. The mean time of semi-automatic segmentation was significantly shorter than that of the manual method (P < 0.05). CONCLUSION: The application of semi-automated software increased feature reliability in the intra- and inter-observer analyses. The semi-automatic process took less time than the manual process.

[Assessment and explorations on the mechanism of neuroprotection of patients in ischemic stroke by traditional Chinese medicine].

Ischemic stroke is a common clinical emergency, with thrombolysis and neuroprotection as its cardinal treatment, and nowadays the latter is more and more stressed by stroke researchers. On the basis of pathophysiology and ischemic cascade of ischemic stroke, we now try to analyze the conceivable mechanism of intervention by tradition Chinese medicine (TCM) and hopefully provide experience for experimental and clinical research in the future.