Rapid detection of colored and colorless macro- and micro-plastics in complex environment via near-infrared spectroscopy and machine learning.

To better understand the migration behavior of plastic fragments in the environment, development of rapid non-destructive methods for in-situ identification and characterization of plastic fragments is necessary. However, most of the studies had focused only on colored plastic fragments, ignoring colorless plastic fragments and the effects of different environmental media (backgrounds), thus underestimating their abundance. To address this issue, the present study used near-infrared spectroscopy to compare the identification of colored and colorless plastic fragments based on partial least squares-discriminant analysis (PLS-DA), extreme gradient boost, support vector machine and random forest classifier. The effects of polymer color, type, thickness, and background on the plastic fragments classification were evaluated. PLS-DA presented the best and most stable outcome, with higher robustness and lower misclassification rate. All models frequently misinterpreted colorless plastic fragments and its background when the fragment thickness was less than 0.1mm. A two-stage modeling method, which first distinguishes the plastic types and then identifies colorless plastic fragments that had been misclassified as background, was proposed. The method presented an accuracy higher than 99% in different backgrounds. In summary, this study developed a novel method for rapid and synchronous identification of colored and colorless plastic fragments under complex environmental backgrounds.

Physicochemical characteristics of airborne microplastics of a typical coastal city in the Yangtze River Delta Region, China.

Airborne microplastics (MPs) are important pollutants that have been present in the environment for many years and are characterized by their universality, persistence, and potential toxicity. This study investigated the effects of terrestrial and marine transport of MPs in the atmosphere of a coastal city and compared the difference between daytime and nighttime. Laser direct infrared imaging (LDIR) and polarized light microscopy were used to characterize the physical and chemical properties of MPs, including number concentration, chemical types, shape, and size. Backward trajectories were used to distinguish the air masses from marine and terrestrial transport. Twenty chemical types were detected by LDIR, with rubber (16.7%) and phenol-formaldehyde resin (PFR; 14.8%) being major components. Three main morphological types of MPs were identified, and fragments (78.1%) are the dominant type. MPs in the atmosphere were concentrated in the small particle size segment (20-50 µm). The concentration of MPs in the air mass from marine transport was 14.7 items/m3 - lower than that from terrestrial transport (32.0 items/m3). The number concentration of airborne MPs was negatively correlated with relative humidity. MPs from terrestrial transport were mainly rubber (20.2%), while those from marine transport were mainly PFR (18%). MPs in the marine transport air mass were more aged and had a lower number concentration than those in the terrestrial transport air mass. The number concentration of airborne MPs is higher during the day than at night. These findings could contribute to the development of targeted control measures and methods to reduce MP pollution.

Impact of signal-to-noise ratio and contrast definition on the sensitivity assessment and benchmarking of fluorescence molecular imaging systems.

Significance: Standardization of fluorescence molecular imaging (FMI) is critical for ensuring quality control in guiding surgical procedures. To accurately evaluate system performance, two metrics, the signal-to-noise ratio (SNR) and contrast, are widely employed. However, there is currently no consensus on how these metrics can be computed. Aim: We aim to examine the impact of SNR and contrast definitions on the performance assessment of FMI systems. Approach: We quantified the SNR and contrast of six near-infrared FMI systems by imaging a multi-parametric phantom. Based on approaches commonly used in the literature, we quantified seven SNRs and four contrast values considering different background regions and/or formulas. Then, we calculated benchmarking (BM) scores and respective rank values for each system. Results: We show that the performance assessment of an FMI system changes depending on the background locations and the applied quantification method. For a single system, the different metrics can vary up to ∼ 35 dB (SNR), ∼ 8.65 a . u . (contrast), and ∼ 0.67 a . u . (BM score). Conclusions: The definition of precise guidelines for FMI performance assessment is imperative to ensure successful clinical translation of the technology. Such guidelines can also enable quality control for the already clinically approved indocyanine green-based fluorescence image-guided surgery.

Estimation of the absorbed dose in simultaneous digital breast tomosynthesis and mechanical imaging.

Purpose: Use of mechanical imaging (MI) as complementary to digital mammography (DM), or in simultaneous digital breast tomosynthesis (DBT) and MI - DBTMI, has demonstrated the potential to increase the specificity of breast cancer screening and reduce unnecessary biopsies compared with DM. The aim of this study is to investigate the increase in the radiation dose due to the presence of an MI sensor during simultaneous image acquisition when automatic exposure control is used. Approach: A radiation dose study was conducted on clinically available breast imaging systems with and without an MI sensor present. Our estimations were based on three approaches. In the first approach, exposure values were compared in paired clinical DBT and DBTMI acquisitions in 97 women. In the second approach polymethyl methacrylate (PMMA) phantoms of various thicknesses were used, and the average glandular dose (AGD) values were compared. Finally, a rectangular PMMA phantom with a 45 mm thickness was used, and the AGD values were estimated based on air kerma measurements with an electronic dosemeter. Results: The relative increase in exposure estimated from digital imaging and communications in medicine headers when using an MI sensor in clinical DBTMI was 11.9 % ± 10.4 . For the phantom measurements of various thicknesses of PMMA, the relative increases in the AGD for DM and DBT measurements were, on average, 10.7 % ± 3.1 and 11.4 % ± 3.0 , respectively. The relative increase in the AGD using the electronic dosemeter was 11.2 % ± < 0.001 in DM and 12.2 % ± < 0.001 in DBT. The average difference in dose between the methods was 11.5 % ± 3.3 . Conclusions: Our measurements suggest that the use of simultaneous breast radiography and MI increases the AGD by an average of 11.5 % ± 3.3 . The increase in dose is within the acceptable values for mammography screening recommended by European guidelines.

Recent advancements in image-enhanced endoscopy in the pancreatobiliary field.

Image-enhanced endoscopy (IEE) has advanced gastrointestinal disease diagnosis and treatment. Traditional white-light imaging has limitations in detecting all gastrointestinal diseases, prompting the development of IEE. In this review, we explore the utility of IEE, including texture and color enhancement imaging and red dichromatic imaging, in pancreatobiliary (PB) diseases. IEE includes methods such as chromoendoscopy, optical-digital, and digital methods. Chromoendoscopy, using dyes such as indigo carmine, aids in delineating lesions and structures, including pancreato-/cholangio-jejunal anastomoses. Optical-digital methods such as narrow-band imaging enhance mucosal details and vessel patterns, aiding in ampullary tumor evaluation and peroral cholangioscopy. Moreover, red dichromatic imaging with its specific color allocation, improves the visibility of thick blood vessels in deeper tissues and enhances bleeding points with different colors and see-through effects, proving beneficial in managing bleeding complications post-endoscopic sphincterotomy. Color enhancement imaging, a novel digital method, enhances tissue texture, brightness, and color, improving visualization of PB structures, such as PB orifices, anastomotic sites, ampullary tumors, and intraductal PB lesions. Advancements in IEE hold substantial potential in improving the accuracy of PB disease diagnosis and treatment. These innovative techniques offer advantages paving the way for enhanced clinical management of PB diseases. Further research is warranted to establish their standard clinical utility and explore new frontiers in PB disease management.

Visibility of esophageal squamous cell carcinoma under iodine staining on texture and color enhancement imaging.

Objective: Iodine staining on white light imaging (WLI) is the gold standard for detecting and demarcating esophageal squamous cell carcinoma (ESCC). We examined the effects of texture and color enhancement imaging (TXI) on improving the endoscopic visibility of ESCC under iodine staining. Methods: Twenty ESCC lesions that underwent endoscopic submucosal dissection were retrospectively included. The color difference between ESCC and the surrounding mucosa (ΔEe) on WLI, TXI, and narrow-band imaging was assessed, and ΔEe under 1% iodine staining on WLI and TXI. Furthermore, the visibility grade determined by endoscopists was evaluated on each imaging. Result: The median ΔEe was greater on TXI than on WLI (14.53 vs. 10.71, respectively; p < 0.005). Moreover, the median ΔEe on TXI under iodine staining was greater than the median ΔEe on TXI and narrow-band imaging (39.20 vs. 14.53 vs. 16.42, respectively; p < 0.005 for both). A positive correlation in ΔEe under iodine staining was found between TXI and WLI (correlation coefficient = 0.61, p < 0.01). Moreover, ΔEe under iodine staining on TXI in each lesion was greater than the corresponding ΔEe on WLI. The visibility grade assessed by endoscopists on TXI was also significantly greater than that on WLI under iodine staining (p < 0.01). Conclusions: The visibility of ESCC after iodine staining was greater on TXI than on WLI.

Exploratory investigation of virtual lesions in gastrointestinal endoscopy using a novel phase-shift method for three-dimensional shape measurement.

Accurate measurement of the size of lesions or distances between any two points during endoscopic examination of the gastrointestinal tract is difficult owing to the fisheye lens used in endoscopy. To overcome this issue, we developed a phase-shift method to measure three-dimensional (3D) data on a curved surface, which we present herein. Our system allows the creation of 3D shapes on a curved surface by the phase-shift method using a stripe pattern projected from a small projecting device to an object. For evaluation, 88 measurement points were inserted in porcine stomach tissue, attached to a half-pipe jig, with an inner radius of 21 mm. The accuracy and precision of the measurement data for our shape measurement system were compared with the data obtained using an Olympus STM6 measurement microscope. The accuracy of the path length of a simulated protruded lesion was evaluated using a plaster model of the curved stomach and graph paper. The difference in height measures between the measurement microscope and measurement system data was 0.24 mm for the 88 measurement points on the curved surface of the porcine stomach. The error in the path length measurement for a lesion on an underlying curved surface was <1% for a 10-mm lesion. The software was developed for the automated calculation of the major and minor diameters of each lesion. The accuracy of our measurement system could improve the accuracy of determining the size of lesions, whether protruded or depressed, regardless of the curvature of the underlying surface.

Efficacy of texture and color enhancement imaging for the visibility and diagnostic accuracy of non-polypoid colorectal lesions.

Objective: A newly launched endoscopy system (EVIS X1, CV-1500; Olympus) is equipped with texture and color enhancement imaging (TXI). We aimed to investigate the efficacy of TXI for the visibility and diagnostic accuracy of non-polypoid colorectal lesions. Methods: We examined 100 non-polypoid lesions in 42 patients from the same position, angle, and distance of the view in three modes: white light imaging (WLI), narrow-band imaging (NBI), and TXI. The primary outcome was to compare polyp visibility in the three modes using subjective polyp visibility score and objective color difference values. The secondary outcome was to compare the diagnostic accuracy without magnification. Results: Overall, the visibility score of TXI was significantly higher than that of WLI (3.7 ± 1.1 vs. 3.6 ± 1.1; p = 0.008) and lower than that of NBI (3.7 ± 1.1 vs. 3.8 ± 1.1; p = 0.013). Color difference values of TXI were higher than those of WLI (11.5 ± 6.9 vs. 9.1 ± 5.4; p < 0.001) and lower than those of NBI (11.5 ± 6.9 vs. 13.1 ± 7.7; p = 0.002). No significant differences in TXI and NBI (visibility score: 3.7 ± 1.0 vs. 3.8 ± 1.1; p = 0.833, color difference values: 11.6 ± 7.1 vs. 12.9 ± 8.3; p = 0.099) were observed for neoplastic lesions. Moreover, the diagnostic accuracy of TXI was significantly higher than that of NBI (65.5% vs. 57.6%, p = 0.012) for neoplastic lesions. Conclusions: TXI demonstrated higher visibility than that of WLI and lower than that of NBI. Further investigations are warranted to validate the performance of the TXI mode comprehensively.

Evaluation of the relationship between Knee Osteoarthritis and Meniscus Pathologies.

Background: Knee osteoarthritis is a common, degenerative joint disease that causes chronic pain that affects daily life. Our study aims to evaluate geriatric patients aged 65 and over with knee pain in terms of osteoarthritis with radiography and magnetic resonance imaging and to investigate its relationship with meniscal pathologies. Methods: Radiography and magnetic resonance imaging of patients aged 65-88 years with knee pain were evaluated in terms of knee osteoarthritis and staging was performed. Meniscal pathologies were evaluated in magnetic resonance imaging, and the prevalence of different meniscal lesion types was calculated. In addition, the relationship between knee osteoarthritis and meniscal pathologies was analyzed. Results: Radiographic evidence of knee osteoarthritis was found in 182 (84.2%) of the 216 cases in our study group. A strong correlation was found between the degrees of knee osteoarthritis on magnetic resonance imaging and radiography. At least one meniscus pathology was observed in all 182 radiography cases with knee osteoarthritis findings. At least one meniscus pathology was observed in 29 (85.3%) of those without osteoarthritis signs. It was determined that meniscus degeneration, tear, and extrusion were observed more frequently in patients with knee osteoarthritis than in patients without osteoarthritis. Meniscal extrusion and complex and horizontaltype tears were the most common lesions. Conclusions: Osteoarthritis was found to be common in geriatric patients with knee pain. A correlation was found between radiography and magnetic resonance imaging regarding knee osteoarthritis. It was observed that meniscal pathologies were detected more frequently in patients with knee osteoarthritis.

Advantages of the intradermal lymphoscintigraphy.

Lymphoscintigraphy is a nuclear medicine procedure that uses a small quantity of radioactive particles for visualizing the lymphatic system. Traditionally, the radiotracer was injected subcutaneously, but the quality of lymphatic path imaging was scarce due to high background. Intradermal radiotracer injection is considered the modern-day intralymphatic injection. We propose rest/stress intradermal lymphoscintigraphy for the diagnosis, staging and surgical planning of lymphedema. Major and minor findings were described in primary and secondary lymphedema. Based on the in-depth information of the lymphatic pathways, physiotherapists and microsurgeons can obtain important functional information in patients' selection to treat with physical treatments and/or undergo microsurgery.

Evaluating the role of 7-Tesla magnetic resonance imaging in neurosurgery: Trends in literature since clinical approval.

BACKGROUND: After approval for clinical use in 2017, early investigations of ultra-high-field abdominal magnetic resonance imaging (MRI) have demonstrated its feasibility as well as diagnostic capabilities in neuroimaging. However, there are no to few systematic reviews covering the entirety of its neurosurgical applications as well as the trends in the literature with regard to the aforementioned application. AIM: To assess the impact of 7-Tesla MRI (7T MRI) on neurosurgery, focusing on its applications in diagnosis, treatment planning, and postoperative assessment, and to systematically analyze and identify patterns and trends in the existing literature related to the utilization of 7T MRI in neurosurgical contexts. METHODS: A systematic search of PubMed was conducted for studies published between January 1, 2017, and December 31, 2023, using MeSH terms related to 7T MRI and neurosurgery. The inclusion criteria were: Studies involving patients of all ages, meta-analyses, systematic reviews, and original research. The exclusion criteria were: Pre-prints, studies with insufficient data (e.g., case reports and letters), non-English publications, and studies involving animal subjects. Data synthesis involved standardized extraction forms, and a narrative synthesis was performed. RESULTS: We identified 219 records from PubMed within our defined period, with no duplicates or exclusions before screening. After screening, 125 articles were excluded for not meeting inclusion criteria, leaving 94 reports. Of these, 2 were irrelevant to neurosurgery and 7 were animal studies, resulting in 85 studies included in our systematic review. Data were categorized by neurosurgical procedures and diseases treated using 7T MRI. We also analyzed publications by country and the number of 7T MRI facilities per country was also presented. Experimental studies were classified into comparison and non-comparison studies based on whether 7T MRI was compared to lower field strengths. CONCLUSION: 7T MRI holds great potential in improving the characterization and understanding of various neurological and psychiatric conditions that may be neurosurgically treated. These include epilepsy, pituitary adenoma, Parkinson's disease, cerebrovascular diseases, trigeminal neuralgia, traumatic head injury, multiple sclerosis, glioma, and psychiatric disorders. Superiority of 7T MRI over lower field strengths was demonstrated in terms of image quality, lesion detection, and tissue characterization. Findings suggest the need for accelerated global distribution of 7T magnetic resonance systems and increased training for radiologists to ensure safe and effective integration into routine clinical practice.

Caseous Calcification of the Mitral Annulus Associated with Severe Mitral Regurgitation: A Multimodality Diagnostic Approach.

Caseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification, and a multimodality approach is advised to ensure an accurate diagnosis. We report a case of a patient with CCMA, associated with severe mitral regurgitation. An 82-year-old woman was admitted due to worsening heart failure. Transthoracic echocardiography revealed a fixed, hyperechogenic mass, accompanied by restriction of the posterior mitral leaflet, and subsequent severe mitral regurgitation. Transesophageal echocardiography demonstrated a restricted motion of the posterior mitral leaflet, because of a large, echogenic mass (15 mm × 11 mm), attached to the mitral annulus, vacuolated with a central echolucent aspect, lacking acoustic shadowing. Contrast-enhanced cardiac computed tomography identified a distinct oval mass (18 mm × 11 mm × 19 mm) presenting a central hypodense content and peripheral calcification, strongly suggestive of CCMA. Considering the patient's profile, surgical valvular replacement was considered unsuitable. Therefore, a transcatheter edge-to-edge repair was performed, resulting in mild residual regurgitation.

A Case Report of Aortic Intramural Hematoma: From Diagnosis to Endovascular Treatment Guided by Transesophageal Echocardiography.

Aortic intramural hematoma (IMH) accounts for approximately 10%-25% of acute aortic syndromes (AAS), and multi-slice computed tomography and magnetic resonance imaging are the leading techniques for diagnosis and classification. In this context, endovascular strategies provide a valid alternative to traditional open surgery and transesophageal echocardiography (TEE) could play a role in therapeutic decision-making and in endovascular repair procedure guidance. A 57-year-old female patient with IMH extending from the left subclavian artery to the upper tract of the abdominal aorta, underwent endovascular aortic repair using an unibody single-branched stent grafting in the aortic arch and descending aorta with a side branch inserted in the left common carotid artery. To restore proper flow in the left axillary artery, a carotid-subclavian bypass graft was performed. The procedure was guided by angiography and TEE. Intraoperative TEE revealed aortic IMH with a significant fluid component in the middle tunic of the aorta with a wall thickness of over 13 mm. TEE was useful in monitoring of all steps of the procedure, showing the presence of the guidewires into the true lumen, the advancement of the prosthesis, and the phases of release and anchoring. This case highlights the importance of using multimodality imaging techniques to evaluate AAS and demonstrates the growing potential of TEE in guiding endovascular repairs.

Dynamic functional network connectivity in patients with a mismatch between white matter hyperintensity and cognitive function.

Objective: White matter hyperintensity (WMH) in patients with cerebral small vessel disease (CSVD) is strongly associated with cognitive impairment. However, the severity of WMH does not coincide fully with cognitive impairment. This study aims to explore the differences in the dynamic functional network connectivity (dFNC) of WMH with cognitively matched and mismatched patients, to better understand the underlying mechanisms from a quantitative perspective. Methods: The resting-state functional magnetic resonance imaging (rs-fMRI) and cognitive function scale assessment of the patients were acquired. Preprocessing of the rs-fMRI data was performed, and this was followed by dFNC analysis to obtain the dFNC metrics. Compared the dFNC and dFNC metrics within different states between mismatch and match group, we analyzed the correlation between dFNC metrics and cognitive function. Finally, to analyze the reasons for the differences between the mismatch and match groups, the CSVD imaging features of each patient were quantified with the assistance of the uAI Discover system. Results: The 149 CSVD patients included 20 cases of "Type I mismatch," 51 cases of Type I match, 38 cases of "Type II mismatch," and 40 cases of "Type II match." Using dFNC analysis, we found that the fraction time (FT) and mean dwell time (MDT) of State 2 differed significantly between "Type I match" and "Type I mismatch"; the FT of States 1 and 4 differed significantly between "Type II match" and "Type II mismatch." Correlation analysis revealed that dFNC metrics in CSVD patients correlated with executive function and information processing speed among the various cognitive functions. Through quantitative analysis, we found that the number of perivascular spaces and bilateral medial temporal lobe atrophy (MTA) scores differed significantly between "Type I match" and "Type I mismatch," while the left MTA score differed between "Type II match" and "Type II mismatch." Conclusion: Different mechanisms were implicated in these two types of mismatch: Type I affected higher-order networks, and may be related to the number of perivascular spaces and brain atrophy, whereas Type II affected the primary networks, and may be related to brain atrophy and the years of education.

Rapid species discrimination of similar insects using hyperspectral imaging and lightweight edge artificial intelligence.

Species discrimination of insects is an important aspect of ecology and biodiversity research. The traditional methods based on human visual experience and biochemical analysis cannot strike a balance between accuracy and timeliness. Morphological identification using computer vision and machine learning is expected to solve this problem, but image features have poor accuracy for very similar species and usually require complicated networks that are unfriendly to portable edge devices. In this work, we propose a fast and accurate species discrimination method of similar insects using hyperspectral features and lightweight machine learning algorithm. Feature regions selection, feature spectra selection and model quantification are used for the optimization of discriminating network. The experimental results of six similar butterfly species in the genus of Graphium show that, compared with morphological recognition with machine vision, our work achieves a higher accuracy of 92.36 ± 3.04% and a shorter inference time of 0.6 ms, with the tiny-size convolutional neural network deployed on a neural network chip. This study provides a rapid and high-accuracy species discrimination method for insects with high appearance similarity and paves the way for field discriminations using intelligent micro-spectrometer based on on-chip microstructure and artificial intelligence chip.

Non-polypoid Colorectal Lesions Detection and False Positive Detection by Artificial Intelligence under Blue Laser Imaging and Linked Color Imaging.

Objectives: Artificial intelligence (AI) with white light imaging (WLI) is not enough for detecting non-polypoid colorectal polyps and it still has high false positive rate (FPR). We developed AIs using blue laser imaging (BLI) and linked color imaging (LCI) to detect them with specific learning sets (LS). Methods: The contents of LS were as follows, LS (WLI): 1991 WLI images of lesion of 2-10 mm, LS (IEE): 5920 WLI, BLI, and LCI images of non-polypoid and small lesions of 2-20 mm. LS (IEE) was extracted from videos and included both in-focus and out-of-focus images. We designed three AIs as follows: AI (WLI) finetuned by LS (WLI), AI (IEE) finetuned by LS (WLI)+LS (IEE), and AI (HQ) finetuned by LS (WLI)+LS (IEE) only with images in focus. Polyp detection using a test set of WLI, BLI, and LCI videos of 100 non-polypoid or non-reddish lesions of 2-20 mm and FPR using movies of 15 total colonoscopy were analyzed, compared to 2 experts and 2 trainees. Results: The sensitivity for LCI in AI (IEE) (83%) was compared to that for WLI in AI (IEE) (76%: p=0.02), WLI in AI (WLI) (57%: p<0.01), BLI in AI (IEE) (78%: p=0.14), and LCI in trainees (74%: p<0.01). The sensitivity for LCI in AI (IEE) (83%) was significantly higher than that in AI (HQ) (78%: p<0.01). The FPR for LCI (6.5%) in AI (IEE) were significantly lower than that in AI (HQ) (17.3%: p<0.01). Conclusions: AI finetuned by appropriate LS detected non-reddish and non-polypoid polyps under LCI.

Aberrant functional connectivity in anterior cingulate gyrus subregions in migraine without aura patients.

Background: The anterior cingulate gyrus (ACG) is an important regulatory region for pain-related information. However, the ACG is composed of subregions with different functions. The mechanisms underlying the brain networks of different subregions of the ACG in patients with migraine without aura (MwoA) are currently unclear. Methods: In the current study, resting-state functional magnetic resonance imaging (rsfMRI) and functional connectivity (FC) were used to investigate the functional characteristics of ACG subregions in MwoA patients. The study included 17 healthy volunteers and 28 MwoA patients. The FC calculation was based on rsfMRI data from a 3 T MRI scanner. The brain networks of the ACG subregions were compared using a general linear model to see if there were any differences between the two groups. Spearman correlation analysis was used to examine the correlation between FC values in abnormal brain regions and clinical variables. Results: Compared with healthy subjects, MwoA patients showed decreased FC between left subgenual ACG and left middle cingulate gyrus and right middle temporal gyrus. Meanwhile, MwoA patients also showed increased FC between pregenual ACG and right angular gyrus and increased FC between right pregenual ACG and right superior occipital gyrus. The FC values between pregenual ACG and right superior occipital gyrus were significantly positively correlated with the visual analogue scale. Conclusion: Disturbances of FC between ACG subregions and default model network and visual cortex may play a key role in neuropathological features, perception and affection of MwoA. The current study provides further insights into the complex scenario of MwoA mechanisms.

Effectiveness of magnetic resonance imaging and spiral computed tomography in the staging and treatment prognosis of colorectal cancer.

BACKGROUND: Colorectal cancer (CRC) is a prevalent cancer type in clinical settings; its early signs can be difficult to detect, which often results in late-stage diagnoses in many patients. The early detection and diagnosis of CRC are crucial for improving treatment success and patient survival rates. Recently, imaging techniques have been hypothesized to be essential in managing CRC, with magnetic resonance imaging (MRI) and spiral computed tomography (SCT) playing a significant role in enhancing diagnostic and treatment approaches. AIM: To explore the effectiveness of MRI and SCT in the preoperative staging of CRC and the prognosis of laparoscopic treatment. METHODS: Ninety-five individuals admitted to Zhongshan Hospital Xiamen University underwent MRI and SCT and were diagnosed with CRC. The precision of MRI and SCT for the presurgical classification of CRC was assessed, and pathological staging was used as a reference. Receiver operating characteristic curves were used to evaluate the diagnostic efficacy of blood volume, blood flow, time to peak, permeability surface, blood reflux constant, volume transfer constant, and extracellular extravascular space volume fraction on the prognosis of patients with CRC. RESULTS: Pathological biopsies confirmed the following CRC stages: 23, 23, 32, and 17 at T1, T2, T3, and T4, respectively. There were 39 cases at the N0 stage, 22 at N1, 34 at N2, 44 at M0 stage, and 51 at M1. Using pathological findings as the benchmark, the combined use of MRI and SCT for preoperative TNM staging in patients with CRC demonstrated superior sensitivity, specificity, and accuracy compared with either modality alone, with a statistically significant difference in accuracy (P < 0.05). Receiver operating characteristic curve analysis revealed the predictive values for laparoscopic treatment prognosis, as indicated by the areas under the curve for blood volume, blood flow, time to peak, and permeability surface, blood reflux constant, volume transfer constant, and extracellular extravascular space volume fraction were 0.750, 0.683, 0.772, 0.761, 0.709, 0.719, and 0.910, respectively. The corresponding sensitivity and specificity values were also obtained (P < 0.05). CONCLUSION: MRI with SCT is effective in the clinical diagnosis of patients with CRC and is worthy of clinical promotion.

Stroke-Like Migraine Attacks After Radiation Therapy (SMART) Syndrome: A Case Report.

Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a rare and delayed complication of brain irradiation involving impaired cerebrovascular autoregulation, and diagnosis is based on distinct clinic-radiographic findings and exclusion of differentials. We report a 38-year-old man, who received cranial irradiation 28 years before and developed episodes of headache and visual aura, followed by left hemianopia, aphasia, behavioral disturbances, and focal seizures. An MRI of the brain revealed gyral swelling with restricted diffusion and mild contrast enhancement over the right temporoparietal and occipital region, and fludeoxyglucose-FDG PET scan showed hyperperfusion in the corresponding brain region. He improved completely with pulse steroids and antiseizure medications. The recognition of this syndrome is important as we can reassure patients and their families and help avoid unnecessary and invasive diagnostic tests.

An Uncommon Culprit: Dural Arteriovenous Fistula Presenting as Otodynia and Dizziness.

Dural arteriovenous fistulas (DAVFs) are rare vascular abnormalities that can present with diverse neurological symptoms. We report a case of a woman in her early 60s who presented with pain in the left ear and dizziness. Neurological evaluation and imaging studies revealed a DAVF in the left cerebellopontine angle. This case underscores the importance of considering DAVF as a potential etiology in patients presenting with atypical otological symptoms.