ABSTRACT
BACKGROUND: Orthostatic dizziness/vertigo (ODV) is characterized by lightheadedness owing to postural changes. AIMS/OBJECTIVES: To measure the endolymphatic space (ELS)/total fluid space (TFS) volume ratio and the distribution rate of endolymphatic fluid (ELF) of patients with ODV and compare them with those of control subjects (CS). MATERIALS AND METHODS: This study included 22 patients (44 ears) with ODV and 52 controls (104 ears, CS). The ELS/TFS volume ratio (%) and distribution rate (%) of the inner ear components were measured using 3-dimensional magnetic resonance imaging. RESULTS: In the ODV group, the mean ELS/TFS volume ratios of the cochlea, vestibule, and semi-circular canals (SCCs) were 12.1%, 18.6%, and 18.1%, respectively; the mean ELS distribution rates for the cochlea, vestibule, and SCCs were 27.3%, 26.2%, and 46.6%, respectively. The ELS distribution rate of the vestibule was significantly lower (p < .01) and the ELS distribution rate of the SCCs was significantly higher in the ODV than in the CS group (p < .01). CONCLUSIONS AND SIGNIFICANCE: The ELS distribution rate in the vestibule + SCCs among patients with ODV did not differ from that in the CS; ELF in the vestibule moved to the SCCs, and a large amount of ELF was distributed only in the SCCs.
Subject(s)
Endolymphatic Hydrops , Meniere Disease , Vestibule, Labyrinth , Humans , Dizziness , Endolymphatic Hydrops/pathology , Meniere Disease/complications , Meniere Disease/diagnostic imaging , Meniere Disease/pathology , Vertigo/diagnostic imaging , Vestibule, Labyrinth/pathology , Magnetic Resonance Imaging/methodsABSTRACT
OBJECTIVES: To establish a novel quantitative method that automatically excludes the red bone marrow and accurately quantifies the tumor volume on whole-body magnetic resonance imaging using updated imaging software. To also evaluate the association between the quantified tumor volume and the prognosis of patients with metastatic prostate cancer. METHODS: This prospective analysis included patients diagnosed with metastatic hormone-sensitive or metastatic castration-resistant prostate cancer between 2017 and 2022. We developed an imaging software (Attractive BD_Score) that analyzed whole-body diffusion-weighted and in-phase and opposed-phase T1-weighted images to automatically exclude the red bone marrow. The quantified tumor volume was compared with that quantified by traditional whole-body diffusion-weighted imaging without red bone marrow exclusion. Prostate-specific antigen progression-free survival, time-to-pain progression, and overall survival were evaluated to assess the prognostic value of the quantified tumor volume. RESULTS: The quantified tumor volume was significantly smaller than that quantified by the traditional method in metastatic hormone-sensitive (median: 81.0 ml vs. 149.4 ml) and metastatic castration-resistant (median: 29.4 ml vs. 63.5 ml) prostate cancer. A highly quantified tumor volume was associated with prostate-specific antigen progression-free survival (p = 0.030), time-to-pain progression (p = 0.003), and overall survival (p = 0.005) in patients with metastatic hormone-sensitive prostate cancer and with poor prostate-specific antigen progression-free survival (p = 0.001) and time-to-pain progression (p = 0.005) in patients with metastatic castration-resistant prostate cancer. CONCLUSIONS: Our imaging method could accurately quantify the tumor volume in patients with metastatic prostate cancer. The quantified tumor volume can be clinically applied as a new prognostic biomarker for metastatic prostate cancer.
Subject(s)
Magnetic Resonance Imaging , Prostatic Neoplasms, Castration-Resistant , Male , Humans , Prostate-Specific Antigen , Prostatic Neoplasms, Castration-Resistant/diagnostic imaging , Prostatic Neoplasms, Castration-Resistant/pathology , Pilot Projects , Bone Marrow/diagnostic imaging , Bone Marrow/pathology , Whole Body Imaging , Pain , HormonesABSTRACT
BACKGROUND: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disease. It is characterised by sudden onset short lived vertigo triggered by sudden changes in head position relative to gravity. AIMS/OBJECTIVES: We aimed to perform a quantitative volumetric analysis of the inner ear endolymphatic space in patients with BPPV. MATERIAL AND METHODS: This study included 67 patients with BPPV and 50 control subjects (CS). The endolymphatic space/total fluid space volume ratio (%) and the distribution rate of the inner ear components in the endolymphatic space (%) were measured using three-dimensional magnetic resonance imaging. RESULTS: Differences in the endolymphatic space/total fluid space volume ratio of the inner ear, cochlea, vestibule, and semi-circular canals (SCCs) between the CS and BPPV groups were not significant. The endolymphatic space distribution rate of the vestibule in the BPPV group was significantly lower than that in the CS group, and the endolymphatic space distribution rate of SCCs in the BPPV group was significantly higher than that in the CS group. CONCLUSIONS AND SIGNIFICANCE: Extended endolymphatic space in patients with BPPV did not exist. The otoconia released from the damaged utricles were considered to move with the endolymphatic flow toward SCCs.
Subject(s)
Vestibular Diseases , Vestibule, Labyrinth , Benign Paroxysmal Positional Vertigo/diagnostic imaging , Humans , Magnetic Resonance Imaging , Saccule and Utricle , Semicircular CanalsABSTRACT
BACKGROUND: Endolymphatic hydrops (ELH), which is a pathological feature of Meniere's disease (MD), is characterized by an extended endolymphatic space (ELS). AIMS/OBJECTIVES: We aimed to perform a quantitative volumetric analysis of inner-ear ELH in patients with unilateral MD (uMD). MATERIAL AND METHODS: This study included 97 patients with definite uMD and 49 control subjects (CS). The ELS/total fluid space (TFS) volume ratio (%) and the distribution rate of the inner-ear components in the ELS (%) were measured using 3D magnetic resonance imaging and compared between patients with uMD and CS. RESULTS: Compared to CS, patients with uMD had significantly higher mean ELS/TFS volume ratios for inner-ear components. The mean distribution rate of the inner-ear components in the ELS was not significantly different between the two groups. CONCLUSIONS AND SIGNIFICANCE: In patients with uMD, ELH was noted to be spread throughout the entire inner ear and the endolymph was evenly distributed in the total ELS. These findings should be useful as a standard reference for further research.
Subject(s)
Ear, Inner/diagnostic imaging , Endolymphatic Hydrops/diagnostic imaging , Magnetic Resonance Imaging , Meniere Disease/diagnostic imaging , Adult , Aged , Aged, 80 and over , Case-Control Studies , Ear, Inner/anatomy & histology , Ear, Inner/pathology , Endolymphatic Hydrops/complications , Female , Humans , Image Processing, Computer-Assisted , Male , Meniere Disease/complications , Meniere Disease/pathology , Middle AgedABSTRACT
BACKGROUND: The presence of endolymphatic hydrops (ELH) in patients with Meniere's disease (MD) is considered a pathological hallmark. AIMS/OBJECTIVES: We aimed to conduct a quantitative volumetric measurement of inner ear ELH in patients with unilateral MD (uMD). The values of uMD with and without herniation into the posterior semi-circular canal (h-PSC) and the lateral semi-circular canal (h-LSC) were compared using 3 D magnetic resonance imaging. MATERIAL AND METHODS: This study included 130 individuals (47 controls and 83 patients with uMD). We measured the total fluid space (TFS) and endolymphatic space (ELS) volumes. We also evaluated the ELS/TFS volume ratios (%). RESULTS: The ELS/TFS volume ratios in the inner ear, cochlea, and vestibule were significantly different between the affected and contralateral sides in patients with h-PSC. Moreover, the ELS/TFS volume ratios of the inner ear, vestibule, and semi-circular canals in the affected ear were significantly higher in patients with h-PSC than in those without h-PSC. The vestibular ELS/TFS volume ratio in the affected ear was significantly higher in patients with h-LSC than in those without h-LSC. CONCLUSIONS AND SIGNIFICANCE: H-LSC is present in extended vestibular ELH. However, this is a result of ELH progression in the inner ear.
Subject(s)
Ear, Inner/pathology , Endolymphatic Hydrops/diagnostic imaging , Magnetic Resonance Imaging , Meniere Disease/complications , Adult , Aged , Aged, 80 and over , Audiometry, Pure-Tone , Ear, Inner/diagnostic imaging , Endolymphatic Hydrops/etiology , Endolymphatic Hydrops/pathology , Female , Hernia/diagnostic imaging , Hernia/etiology , Humans , Imaging, Three-Dimensional , Labyrinth Diseases/diagnostic imaging , Labyrinth Diseases/etiology , Male , Meniere Disease/diagnostic imaging , Middle Aged , Semicircular Canals/diagnostic imaging , Semicircular Canals/pathology , Young AdultABSTRACT
INTRODUCTION: The diffusion-weighted imaging (DWI) technique with intravoxel incoherent motion model enables the estimation of capillary blood volume as a perfusion-related parameter- (PP-) value. Therefore, the PP-value of the kidney theoretically reflects renal capillary blood volume. We analyzed the usefulness of the PP-value in estimating postoperative renal function in upper-tract urothelial carcinoma (UTUC) patients. METHODS: Forty-eight consecutive patients who underwent magnetic resonance imaging before radical nephroureterectomy from 2011 to 2018 were analyzed. A PP-map displaying PP-values on a pixel-by-pixel basis was created from DWI signals (b-values of 0, 500, and 1,000 s/mm2). Two readers independently analyzed the renal PP-value. DWI-based split renal function (SRF) of the intact kidney was calculated by splitting serum Cr-based preoperative estimated glomerular filtration rates (eGFRs). The predictive accuracy of the method was evaluated using renography as the reference standard. RESULTS: Interobserver analysis revealed an excellent correlation value of 0.97. The SRF value showed a good linear correlation with the observed postoperative eGFR (r = 0.76, p < 0.001). The predictive accuracy of the DWI-based method was similar to that of the nuclear-based method. CONCLUSION: This DWI-based evaluation of capillary blood volume provides a noninvasive tool for predicting the postoperative renal function, thereby facilitating the management of UTUC patients.
Subject(s)
Carcinoma, Transitional Cell/diagnostic imaging , Carcinoma, Transitional Cell/surgery , Diffusion Magnetic Resonance Imaging , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/surgery , Kidney/physiology , Nephroureterectomy , Ureteral Neoplasms/diagnostic imaging , Ureteral Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Blood Volume , Carcinoma, Transitional Cell/physiopathology , Female , Humans , Kidney Neoplasms/physiopathology , Male , Middle Aged , Nephroureterectomy/methods , Predictive Value of Tests , Retrospective Studies , Ureteral Neoplasms/physiopathologyABSTRACT
Three Dimensional-magnetic resonance imaging of the inner ear endolymphatic space was performed in 100 control human subjects. Ear endolymphatic space was visualized using contrast-enhanced magnetic resonance imaging with intravenous gadolinium injection. The images were acquired on a 3-tesla magnetic resonance scanner using a 32-channel array head coil for all patients. The ear endolymphatic space and total fluid space volumes of the inner ear, cochlea, and vestibule were measured, and the ear endolymphatic space in the cochlea and vestibule was classified into four categories. The cochlea categories were: c-1, no ear endolymphatic space; c-2, ear endolymphatic space visualized only until the upper turn; c-3, ear endolymphatic space visualized from the upper turn to the second turn; and c-4, ear endolymphatic space visualized up to the basal turn. The vestibule categories were: v-1, no ear endolymphatic space; v-2, ear endolymphatic space visualized only in the utriculus; v-3, ear endolymphatic space visualized in the utriculus and sacculus separately; and v-4, ear endolymphatic space visualized in the utriculus and sacculus together. The mean TFS volumes of the inner ear, cochlea, and vestibule were 282.1 ± 33.2 µL, 112.9 ± 15.9 µL, and 69.1 ± 9.9 µL, respectively, and that of the ampulla of the posterior semicircular canal was 7.8 ± 1.7 µL. The mean ear endolymphatic space/total fluid space volume ratio in the cochlea was 10.3 ± 6.7% and that in the vestibule was 17.3 ± 12.2%. This ratio in the cochlea was between the results of categories c-1 and c-2 and that in the vestibule between those of categories v-2 and v-3. Two subjects had ear endolymphatic space extending from the vestibule to the posterior non-ampullated crus of the lateral semicircular canal. These findings can be applied as standard reference values for further research.
Subject(s)
Endolymphatic Hydrops , Meniere Disease , Vestibule, Labyrinth , Contrast Media , Humans , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy , Research Subjects , Vestibule, Labyrinth/diagnostic imaging , Vestibule, Labyrinth/pathologyABSTRACT
Background: Recently, 3-Tesla magnetic resonance imaging (MRI) after an intravenous gadolinium injection has been used to describe the endolymphatic space (ELS).Objectives: This study described the histopathological differences between idiopathic sudden sensorineural hearing loss (ISSNHL) and fluctuating sensorineural hearing loss (FSNHL) by examining the ELS. Additionally, the relationship between the affected cochlear and vestibular ELS/total fluid space (TFS) volume ratio and the duration from the onset to MRI in patients with FSNHL were evaluated.Material and methods: This study included 205 individuals without vertigo: 47 controls, 94 with ISSNHL, and 64 with FSNHL. The TFS and ELS volumes were measured and the ELS/TFS volume ratios (%) were evaluated.Results: The cochlear and vestibular ELS/TFS volume ratios of the affected ear in patients with FSNHL were significantly higher than that in those with ISSNHL. There was no correlation between the duration from FSNHL onset to the MRI scan in the affected cochlea and vestibule.Conclusion and significance: There were differences in the form of hearing fluctuation and the extended ELS volume between ISSNHL and FSNHL. ISSNHL cases with severe ELS extension were likely to change to FSNHL.
Subject(s)
Endolymphatic Duct/diagnostic imaging , Endolymphatic Hydrops/diagnostic imaging , Hearing Loss, Sensorineural/diagnostic imaging , Hearing Loss, Sudden/diagnostic imaging , Magnetic Resonance Imaging , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
PURPOSE: Locoregional therapy for oligometastatic prostate cancer has generated great interest. However, its benefit for castration-resistant prostate cancer (CRPC) has not been fully demonstrated. Our objective was to evaluate the treatment outcome of progressive site-directed therapy (PSDT) for oligoprogressive CRPC (OP-CRPC). METHODS AND MATERIALS: This study cohort consisted of 101 patients with CRPC who underwent whole-body diffusion-weighted magnetic resonance imaging between 2014 and 2018, when a new line of anticancer therapy was being considered. For OP-CRPC, PSDT with radiation therapy and unchanged continuation of systemic therapy were recommended. RESULTS: Thirty-eight patients received a diagnosis of OP-CRPC, and 23 (61%) underwent PSDT at a median prostate-specific antigen (PSA) level of 7.8 ng/mL. The regional radiation therapy targets were the prostate/pelvic lymph nodes (n = 7), bone (n = 15), or both (n = 1). A decrease in PSA levels of at least 50% in response to PSDT (50% PSA decline) was observed in 16 cases (70%); the median time to PSA progression was 8.7 months. Intrapelvic localization of progressive lesions was a significant predictor of time to PSA progression (hazard ratio, 6.6; P = .007) as well as volumes of abnormal signal intensity on whole-body diffusion-weighted magnetic resonance imaging (hazard ratio, 0.5; P = .045). A 50% PSA decline was achieved in 16 of the 18 patients with intrapelvic OP-CRPC (89%) and in none of the 5 patients with non-intrapelvic OP-CRPC (P < .001). Intrapelvic OP-CRPC had a significantly longer time to PSA progression than non-intrapelvic OP-CRPC (10.1 vs 4.8 months, P = .0014). CONCLUSIONS: PSDT can be an effective treatment option for OP-CRPC. Progressive site localization was an important factor in good PSA response.
Subject(s)
Diffusion Magnetic Resonance Imaging , Kallikreins/blood , Prostate-Specific Antigen/blood , Prostatic Neoplasms, Castration-Resistant/diagnostic imaging , Prostatic Neoplasms, Castration-Resistant/therapy , Aged , Aged, 80 and over , Disease Progression , Dose Fractionation, Radiation , Humans , Lymphatic Irradiation/methods , Male , Pelvis , Prognosis , Prostate , Prostatic Neoplasms, Castration-Resistant/blood , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: The aim of this study was to measure the volume of the endolymphatic space (ELS) and to investigate prognosis in patients with acute low-tone sensorineural hearing loss (ALHL). METHODS: A total of 61 ALHL patients participated; 47 were definite while 14 were probable ALHL cases. The definite ALHL patients were classified into three groups: A, "Cure"; B, "No cure"; and C, "Recurrence." Also, nine patients for whom diagnosis changed from ALHL to cochlear Meniere's disease (cMD) without vertigo (ALHL-cMD group). Images of the inner ear fluid space, positive perilymph, and positive endolymph were acquired using a 3T magnetic resonance scanner. Three-dimensional (3D) images were semi-automatically reconstructed using anatomical and tissue information to fuse the 3D images of the inner ear fluid space with the 3D ELS images. RESULTS: Patients in the no cure group showed a significantly higher ELS/total fluid space (TFS) volume ratio in the affected cochlear region than the patients of the other groups. Additionally, the affected vestibular ELS/TFS volume ratio in the cure group was significantly lower than that in the recurrence group. There were significantly higher cochlear and vestibular ELS/TFS ratios in ALHL-cMD patients than in control subjects. CONCLUSIONS: These results indicate that the cochlear ELS/TFS volume ratio should be considered when investigating the extent of recovery, while the extended ELS in the vestibule should be considered when investigating cases of recurrence. Thus, our study suggests that the severe extended ELS appeared likely to change to cMD and that the prognostic determination of ALHL is possible.
Subject(s)
Ear, Inner/diagnostic imaging , Hearing Loss, Sensorineural/diagnostic imaging , Hearing Loss, Sudden/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Endolymph/diagnostic imaging , Endolymphatic Hydrops/diagnostic imaging , Endolymphatic Hydrops/physiopathology , Female , Glucocorticoids/therapeutic use , Hearing Loss, Sensorineural/drug therapy , Hearing Loss, Sensorineural/physiopathology , Hearing Loss, Sudden/drug therapy , Hearing Loss, Sudden/physiopathology , Humans , Magnetic Resonance Imaging , Male , Meniere Disease/diagnostic imaging , Meniere Disease/physiopathology , Middle Aged , Perilymph/diagnostic imaging , Prognosis , Recurrence , Young AdultABSTRACT
OBJECTIVE: To employ magnetic resonance imaging (MRI) to measure the volume of the inner ear endolymphatic space (ELS) in patients with acute low-tone sensorineural hearing loss (ALHL), sudden deafness (SD), cochlear Meniere's disease (cMD), and unilateral MD (uMD) compared with control subjects (CS) with chronic rhinosinusitis. METHODS: Forty-one patients with ALHL, 82 with SD, 48 with cMD, 72 with uMD, and 47 CS participated in the study. With the exception of all uMD patients, none of the subjects had vertigo. Images of the inner ear fluid space, positive perilymph signal, and positive endolymph signal were acquired using a 3-T MRI scanner. Three-dimensional images were reconstructed semi-automatically by using anatomical and tissue information to fuse the inner ear fluid space images and the ELS images. RESULTS: The cochlear ELS/total fluid space (TFS) volume ratio was 10.2±6.7% (mean±standard deviation) in the CS group, 12.1±5.7% in ALHL patients, 15.2±8.7% in SD patients, 18.1±8.2% in cMD patients, and 21.9±16.4% in uMD patients. The vestibular ELS/TFS volume ratio was 17.7±10.2% in the CS group, 18.9±8.3% in ALHL patients, 19.9±11.3% in SD patients, 22.5±13.7% in cMD patients, and 35.7±24.1% in uMD patients. The cochlear ELS/TFS volume ratio in patients with uMD was similar to that in the cMD group and significantly higher than that in the CS, ALHL, and SD groups (CS=ALHLSubject(s)
Endolymphatic Sac/diagnostic imaging
, Hearing Loss, Sensorineural/diagnostic imaging
, Hearing Loss, Sudden/diagnostic imaging
, Meniere Disease/diagnostic imaging
, Adolescent
, Adult
, Aged
, Aged, 80 and over
, Case-Control Studies
, Chronic Disease
, Endolymphatic Duct/diagnostic imaging
, Endolymphatic Hydrops/diagnostic imaging
, Female
, Humans
, Imaging, Three-Dimensional
, Magnetic Resonance Imaging
, Male
, Middle Aged
, Rhinitis
, Sinusitis
, Young Adult
ABSTRACT
CONCLUSION: Magnetic resonance volumetric measurement of inner ear endolymphatic space (ELS) was performed in patients without vertiginous or cochlear symptoms. The existence of the ELS in patients with chronic rhinosinusitis (CRS) was shown. The ELS in the cochlea and vestibule was classified into four categories. These findings could be useful as a standard reference for further research. OBJECTIVES: To identify normal values of the ELS in the cochlea and vestibule. METHODS: Twenty-four patients with CRS were enrolled. Inner ear fluid space images and positive perilymph/positive endolymph images were acquired using a 3.0-tesla unit. Three-dimensional (3-D) images were constructed semi-automatically using both anatomical and tissue information by fusing the 3-D images of the inner ear fluid space and the ELS. RESULTS: Among all patients, the mean ELS/the total fluid space (TFS) ratio in the cochlea was 8.8% and that in the vestibule was 16.2%. The ELS in the cochlea and vestibule was classified into four categories. Age-related differences were found in the TFS, ELS, and ELS/TFS ratio in the inner ear and the ELS and ELS/TFS ratio in the vestibule.
Subject(s)
Ear, Inner/diagnostic imaging , Magnetic Resonance Imaging/methods , Adult , Aged , Aged, 80 and over , Female , Humans , Imaging, Three-Dimensional , Male , Middle Aged , Young AdultABSTRACT
CONCLUSION: This study described the lateralities of axial length of inner ear (ALIE), of the volume of inner ear (VIE) and age-related differences of the volume of inner ear components in patients with chronic rhinosinusitis (CRS). Age-related differences were found in ALIE and the positive correlation in ALIE and the volume of the cochlea (VC) of the affected ear in patients with Meniere's disease (MD). OBJECTIVE: To identify side or sex-related differences in the ALIE, the length of the spiral canal of cochlea (LSCC), and the volume of components of the inner ear in MD and CRS. METHODS: Thirty-two with unilateral MD and 14 with CRS were included. Images were acquired with a 3.0-tesla unit using SPACE sequences. The ALIE was measured and the VIE, VC, the volume of the vestibule (VV), and of the semi-circular canals (VSC) were also measured. RESULTS: In CRS, ALIE of the right ear in males was significantly longer than in females. Patients younger than 60 years old with CRS had a significantly larger VIE, VC, and VSC than older than 60. In MD, the ALIE in older than 60 was longer than below 60.
Subject(s)
Ear, Inner/diagnostic imaging , Imaging, Three-Dimensional , Magnetic Resonance Imaging , Meniere Disease/diagnostic imaging , Adult , Aged , Female , Humans , Male , Middle Aged , Nose Diseases/diagnostic imaging , Young AdultABSTRACT
It has been than 15 years since medical image analysis is used clinical scene. We provide 3D image for doctors to recognize easily by reconstructed CT or MRI images. It is introduced a recently technique for 3D medical image, for example, volume rendering, CPR, colon analysis, CT-SPECT fusion image.
Subject(s)
Imaging, Three-Dimensional/methods , Tomography, X-Ray Computed/methods , Coronary Vessels/diagnostic imaging , Heart , Humans , Imaging, Three-Dimensional/trends , Intestine, Large/diagnostic imaging , Radionuclide Imaging , SoftwareABSTRACT
OBJECTIVES: The purpose of this study was to estimate the myocardial area at risk (MAAR) using coronary computed tomography angiography (CTA) and Voronoi algorithm-based myocardial segmentation in comparison with single-photon emission computed tomography (SPECT). METHODS: Thirty-four patients with coronary artery disease underwent 128-slice coronary CTA, stress/rest thallium-201 SPECT, and coronary angiography (CAG). CTA-based MAAR was defined as the sum of all CAG stenosis (>50%) related territories (the ratio of the left ventricular volume). Using automated quantification software (17-segment model, 5-point scale), SPECT-based MAAR was defined as the number of segments with a score above zero as compared to the total 17 segments by summed stress score (SSS), difference (SDS) score map, and comprehensive SPECT interpretation with either SSS or SDS best correlating CAG findings (SSS/SDS). Results were compared using Pearson's correlation coefficient. RESULTS: Forty-nine stenoses were observed in 102 major coronary territories. Mean value of CTA-based MAAR was 28.3 ± 14.0%. SSS-based, SDS-based, and SSS/SDS-based MAAR was 30.1 ± 6.1%, 20.1 ± 15.8%, and 26.8 ± 15.7%, respectively. CTA-based MAAR was significantly related to SPECT-based MAAR (r = 0.531 for SSS; r = 0.494 for SDS; r = 0.814 for SSS/SDS; P < 0.05 in each). CONCLUSIONS: CTA-based Voronoi algorithm myocardial segmentation reliably quantifies SPECT-based MAAR. KEY POINTS: ⢠Voronoi algorithm allows for three-dimensional myocardial segmentation of coronary CT angiography ⢠Stenosis-related CT myocardial territories correlate to SPECT based area at risk ⢠CT angiography myocardial segmentation may assist in clinical decision-making.
Subject(s)
Algorithms , Coronary Angiography/methods , Coronary Artery Disease/diagnostic imaging , Multidetector Computed Tomography/methods , Radiographic Image Interpretation, Computer-Assisted/methods , Software , Aged , Female , Humans , Male , Retrospective Studies , Tomography, Emission-Computed, Single-Photon/methodsABSTRACT
The circumstances surrounding medical image analysis have undergone rapid evolution. In such a situation, it can be said that "imaging" obtained through medical imaging modality and the "analysis" that we employ have become amalgamated. Recently, we feel the distance between "imaging" and "analysis" has become closer regarding the imaging analysis of any organ system, as if both terms mentioned above have become integrated. The history of medical image analysis started with the appearance of the computer. The invention of multi-planar reconstruction (MPR) used in the helical scan had a significant impact and became the basis for recent image analysis. Subsequently, curbed MPR (CPR) and other methods were developed, and the 3D diagnostic imaging and image analysis of the human body have started on a full scale. Volume rendering: the development of a new rendering algorithm and the significant improvement of memory and CPUs contributed to the development of "volume rendering," which allows 3D views with retained internal information. A new value was created by this development; computed tomography (CT) images that used to be for "diagnosis" before that time have become "applicable to treatment." In the past, before the development of volume rendering, a clinician had to mentally reconstruct an image reconfigured for diagnosis into a 3D image, but these developments have allowed the depiction of a 3D image on a monitor. Current technology: Currently, in Japan, the estimation of the liver volume and the perfusion area of the portal vein and hepatic vein are vigorously being adopted during preoperative planning for hepatectomy. Such a circumstance seems to be brought by the substantial improvement of said basic techniques and by upgrading the user interface, allowing doctors easy manipulation by themselves. The following describes the specific techniques. Future of post-processing technology: It is expected, in terms of the role of image analysis, for better or worse, that computer-aided diagnosis (CAD) will develop to a highly advanced level in every diagnostic field. Further, it is also expected in the treatment field that a technique coordinating various devices will be strongly required as a surgery navigator. Actually, surgery using an image navigator is being widely studied, and coordination with hardware, including robots, will also be developed.
Subject(s)
Diagnostic Imaging/methods , Hepatectomy/methods , Imaging, Three-Dimensional , Surgery, Computer-Assisted/methods , Humans , Magnetic Resonance Imaging/methods , Reproducibility of Results , Tomography, X-Ray Computed/methodsABSTRACT
We describe the pathological features of a spinal cord biopsy from a 69-year-old woman with anti-aquaporin-4 antibody-negative recurrent longitudinal myelitis. Spinal cord MRI showed T2 high-intensity lesions with strong gadolinium enhancement, when episodes of sensory-motor impairment were repeated. The radiological abnormality was corrected by corticosteroid administration, but improvement of the symptoms was minimal. Although the patient had sicca symptoms and fulfilled four of the diagnostic criteria for Sjögren syndrome, the diagnosis was excluded, because of infection with hepatitis C virus, an exclusion criterion of Sjögren syndrome. In the spinal cord lesions, necrotic changes affected both myelin and axons. Infiltrating lymphocytes were predominantly T-cells. The proliferation of small vessels with hyalinization and concomitant occlusive change was remarkable. These pathological findings resembled those previously reported in Sjögren syndrome. Ultrastructurally, the endothelial cells of the small vessels showed features of activated cells and contained vesiculo-tubular structures in the cytoplasm, indicating that increased blood-brain barrier (BBB) permeability might contribute to pathogenesis. We speculated that increased BBB permeability and T-cell entry in the spinal parenchyma triggered pathological reactions resulting in necrotic changes in the spinal cord. Obstruction of small vessels might add ischemic damage to the lesions. The clinical course and pathological findings indicated that damage progressed rapidly in the spinal cord and was irreversible. The lesions apparently differed from typical demyelination plaques. Faced with such spinal cord lesions, a preventive therapeutic approach is necessary to avoid attack-associated disability.
Subject(s)
Antibodies , Aquaporin 4/immunology , Hepatitis C/blood , Myelitis/blood , Sjogren's Syndrome/blood , Spinal Cord/pathology , Aged , Antibodies/blood , Aquaporin 4/blood , Female , Hepacivirus , Hepatitis C/pathology , Humans , Myelitis/pathology , Myelitis/virology , Recurrence , Sjogren's Syndrome/pathology , Sjogren's Syndrome/virology , Spinal Cord/virologyABSTRACT
We report a patient with uncontrolled Crohn's disease who presented with progressive weakness of proximal muscles and a marked elevation of serum creatine kinase. Muscle biopsy from the left deltoid exhibited myositic changes with inflammatory infiltrates in the perimysium, endomysium, and perivascular locations. Most were stained as CD68-positive macrophages, whereas some were CD4- and CD8-positive T lymphocytes. Due to uncontrolled bowel inflammation, several fistulae were found in the descending colon, and partial colectomy was performed. An examination of the resected colon exhibited inflammation of the bowel structure surrounded mainly by CD68-positive macrophages. The histopathological findings of the descending colon were analogous to those of the muscle. After an increased dose of mesalazine and partial colectomy, her muscle symptoms improved. These findings suggest that the myositis in Crohn's disease is immune-mediated and that treatment of bowel inflammation should be emphasized as opposed to steroid or other immunosuppressive therapy.
Subject(s)
Crohn Disease/complications , Crohn Disease/pathology , Muscle, Skeletal/pathology , Muscle, Skeletal/physiopathology , Myositis/pathology , Myositis/physiopathology , Adult , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Antigens, CD/immunology , Antigens, Differentiation, Myelomonocytic/immunology , Biopsy , CD4-Positive T-Lymphocytes/cytology , CD4-Positive T-Lymphocytes/immunology , Colectomy , Colon/immunology , Colon/pathology , Colon/physiopathology , Creatine Kinase/analysis , Creatine Kinase/blood , Crohn Disease/surgery , Electromyography , Female , Humans , Lymphocyte Activation/immunology , Macrophages/cytology , Macrophages/immunology , Magnetic Resonance Imaging , Mesalamine/administration & dosage , Muscle Weakness/immunology , Muscle Weakness/pathology , Muscle Weakness/physiopathology , Muscle, Skeletal/immunology , Myositis/immunology , Neck Muscles/immunology , Neck Muscles/pathology , Neck Muscles/physiopathology , Treatment OutcomeABSTRACT
We report a case of antecollis, or dropped head with Parkinson's disease (PD) induced by pramipexole, a nonergot dopamine agonist. An 80-year-old woman presented with progressively severe neck flexion, which developed within a few weeks of taking pramipexole at 3 mg/day. She had a disturbed gait and complained of difficulty in daily activity because of restricted visual field and severe stooped posture. Surface EMG showed disproportionate tonus of the neck muscles but needle EMG of the neck muscles was normal. Withdrawal of pramipexole resulted in immediate improvement; the patient could keep the head in natural position and walk normally. Pramipexole-induced antecollis may be serious, but is a reversible dystonia in patients with PD. Clinicians should be aware of such complication.
Subject(s)
Benzothiazoles/adverse effects , Dopamine Agonists/adverse effects , Dyskinesia, Drug-Induced/physiopathology , Dystonic Disorders/chemically induced , Dystonic Disorders/physiopathology , Parkinson Disease/drug therapy , Aged, 80 and over , Dopamine/metabolism , Electromyography , Female , Head Movements/drug effects , Head Movements/physiology , Humans , Japan , Muscle Tonus/drug effects , Muscle Tonus/physiology , Neck Muscles/drug effects , Neck Muscles/physiopathology , Posture/physiology , PramipexoleABSTRACT
Hepatocyte growth factor (HGF) exhibits strong neurotrophic activities on motoneurons both in vitro and in vivo. We examined survival-promoting effects of an adenoviral vector encoding human HGF (AxCAhHGF) on injured adult rat motoneurons after peripheral nerve avulsion. The production of HGF in COS1 cells infected with AxCAhHGF and its bioactivity were confirmed by ELISA, Western blot and Madin-Darby canine kidney (MDCK) cell scatter assay. The facial nerve or the seventh cervical segment (C7) ventral and dorsal roots of 3-month-old Fischer 344 male rats were then avulsed and removed from the stylomastoid or vertebral foramen, respectively, and AxCAhHGF, AxCALacZ (adenovirus encoding beta-galactosidase gene) or phosphate-buffered saline (PBS) was inoculated in the lesioned foramen. Treatment with AxCAhHGF after avulsion significantly prevented the loss of injured facial and C7 ventral motoneurons as compared to AxCALacZ or PBS treatment and ameliorated choline acetyltransferase immunoreactivity in these neurons. These results indicate that HGF may prevent the degeneration of motoneurons in adult humans with motoneuron injury and motor neuron diseases.