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1.
Ann Otol Rhinol Laryngol ; 129(8): 741-747, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32126808

RESUMEN

OBJECTIVES: To evaluate volume changes within the tongue post chemoradiation therapy (CRT). STUDY DESIGN: Retrospective review. SETTING: Academic Medical Center. SUBJECTS AND METHODS: Subjects included 19 patients that received CRT as the primary treatment for tonsillar or hypopharynx squamous cell carcinoma. Tongue volumes were calculated by three raters from thin slice computed tomography images collected before treatment and up to 29 months post-CRT. Body mass index (BMI) was also collected at each time point. RESULTS: Inter-rater reliability was high with an ICC of 0.849 (95% CI = 0.773, 0.905). Linear mixed effects modeling showed a mean decrease of 0.45 cm3 (standard error of the mean [SEM] = 0.11) in tongue volume per month post-CRT (P < .001). However, the addition of BMI to the model was significant (χ2 (4) = 25.0, P < .001), indicating that BMI was a strong predictor of tongue volume, with a mean decrease of 1.75 cm3 (SEM = 0.49) in tongue volume per unit decrease in BMI (P < .001) and reducing the post-CRT effect on tongue volume decrease per month to 0.23 cm3 (P = .02). BMI significantly (P < .001) decreased by 0.11 units (SEM = 0.02) per month post radiation. CONCLUSION: Tongue dysfunction and decreased tongue strength are significant contributors to the dysphagia that patients experience after receiving CRT. In this study, both tongue volume and BMI decreased post-CRT; therefore, BMI could potentially be used as a predictor of tongue volume post-CRT.


Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Neoplasias Hipofaríngeas/radioterapia , Tomografía Computarizada por Rayos X/métodos , Lengua/diagnóstico por imagen , Adulto , Anciano , Carcinoma de Células Escamosas/diagnóstico , Quimioradioterapia , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Hipofaríngeas/diagnóstico , Masculino , Persona de Mediana Edad , Tamaño de los Órganos/efectos de la radiación , Estudios Retrospectivos , Lengua/efectos de la radiación
2.
Medicine (Baltimore) ; 99(3): e18305, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32011432

RESUMEN

BACKGROUND: Ultrasonic measurements of tongue thickness and condylar translation were recently introduced to predict difficult laryngoscopy in non-obstetric patients. We designed the present study to evaluate the performance of these two ultrasonic indicators in predicting difficult laryngoscopy in healthy parturients. METHODS: The 119 parturients undergoing elective cesarean delivery were enrolled. Tongue thickness and condylar translation measured by ultrasonography, and Modified Mallampati test (MMT) score, inter-incisor distance (IID) and modified Cormack-Lehane grading system (MCLS) were measured and recorded before anesthesia. The primary outcome was difficult laryngoscopy defined as MCLS 3 or 4. The association between these variables and difficult laryngoscopy were analyzed by using multivariable logistic regression and receiver operating characteristic (ROC) curve. RESULTS: Compared to the Easy Laryngoscopy Group, the tongue thickness was significantly higher and the condylar translation and IID were significantly lower in the Difficult Laryngoscopy Group. Tongue thickness and condylar translation but not MMT score and IID were proved to be two independent predictors for difficult laryngoscopy by multivariate logistic regression, with the odds ratios of 2.554 (95% confidence interval (CI), 1.715 to 3.802) and 0.457 (95% CI, 0.304 to 0.686). The area under the ROC curve to predict difficult laryngoscopy for tongue thickness was 0.93 (95% CI, 0.88-0.98) and for condylar translation was 0.77 (95% CI, 0.67-0.86), which were significantly higher than those for MMT score (0.67, 95% CI, 0.56-0.77) and IID (0.65, 95% CI, 0.55-0.76). CONCLUSIONS: Compared with MMT and IID, tongue thickness and condylar translation measured by ultrasonography appear to be better indicators for predicting difficult laryngoscopy in parturients.The trial was registered at the Chinese Clinical Trial Registry (ChiCTR)(www.chictr.org), registration number ChiCTR-ICR-1800019991.


Asunto(s)
Laringoscopía/métodos , Cóndilo Mandibular/diagnóstico por imagen , Lengua/diagnóstico por imagen , Ultrasonografía/métodos , Adulto , Anestesia , Cesárea , Método Doble Ciego , Femenino , Humanos , Cóndilo Mandibular/anatomía & histología , Valor Predictivo de las Pruebas , Embarazo , Estudios Prospectivos , Lengua/anatomía & histología
3.
Ultrasonics ; 103: 106095, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32044566

RESUMEN

We measured the apparent reflection coefficient of a 1-MHz ultrasound compressional wave at the interface between rough and lubricated tongue mimicking surfaces and various food gels, composed of agar or gelatin. For the smoothest mimicking surface, when a lubricating layer was present, the apparent reflection coefficient was fairly similar for the different food gels (33.6% on average). The apparent reflection coefficient was significantly larger in the following situations: (i) tongue asperities were high and dense; (ii) lubrication levels were low; and (iii) gels were less rigid (range for the different gels-45.9-84.3%). The apparent reflection coefficient conveys the ability of food gels to mold themselves to surface asperities or to form a coupling film of liquid at the interface. This study demonstrates that ultrasound methods can and should be used to explore the physical phenomena that underlie the texture perceptions resulting from tongue-palate interactions.


Asunto(s)
Alimentos , Lengua/diagnóstico por imagen , Ultrasonografía/métodos , Agar , Módulo de Elasticidad , Gelatina , Geles , Técnicas In Vitro , Lubrificación , Propiedades de Superficie
5.
J Clin Ultrasound ; 48(1): 48-51, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31638729

RESUMEN

Cleft lip and cleft palate (CP) are the most common facial malformations. Two-dimensional (2D) ultrasound (US) is the first-line examination in the prenatal diagnosis of CP. Three-dimensional, four-dimensional US and MRI provide a better detection of facial clefts. We present two fetuses with micrognathia and suspected secondary CP on 2D US: fetal tongue appeared in an unusual position (low tip and high dorsum position) and showed uncoordinated movements. MRI did not confirm the US suspicion, but at birth the two fetuses were affected by Pierre Robin sequence.


Asunto(s)
Fisura del Paladar/diagnóstico por imagen , Micrognatismo/diagnóstico por imagen , Síndrome de Pierre Robin/diagnóstico por imagen , Lengua/diagnóstico por imagen , Ultrasonografía Prenatal/métodos , Adulto , Femenino , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Embarazo , Lengua/embriología
6.
PLoS One ; 14(9): e0223072, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31557235

RESUMEN

AIM: To investigate the correlation between the dorsal tongue porphyrin autofluorescence, revealed using VELscope, and Candida saprophytism. MATERIAL AND METHODS: Consecutive patients underwent an autofluorescence examination by the VELscope device to establish the presence or absence of porphyrin fluorescence. A tongue swab was collected for the Candida cultural test. Sensitivity, specificity, accuracy, negative predictive value and positive predictive value were calculated considering the oral swab as the gold standard. The degree of agreement between the two tests was calculated using Cohen's K coefficient. RESULTS: One hundred twenty-six patients were enrolled. Porphyrin fluorescence method showed a sensitivity of 78%, specificity of 76% and an accuracy of 78%. Negative predictive value and positive predictive value were respectively 90% and 59%. The strength of agreement between the two methods resulted to be moderate (k = 0.551). CONCLUSIONS: Off-label use of tongue autofluorescence examination to detect the presence of Candida species is characterized by a loss of porphyrin fluorescence. The high negative predictive value of porphyrin fluorescence loss suggests its use in preliminary selection of Candida carriers, in order to plan preventive and therapeutic strategies.


Asunto(s)
Candida/aislamiento & purificación , Candidiasis Bucal/diagnóstico , Imagen Molecular/métodos , Imagen Óptica/métodos , Porfirinas/química , Lengua/diagnóstico por imagen , Adulto , Anciano , Biopsia , Candida/metabolismo , Candidiasis Bucal/microbiología , Femenino , Fluorescencia , Humanos , Masculino , Persona de Mediana Edad , Porfirinas/metabolismo , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y Especificidad , Lengua/microbiología
7.
Eur J Radiol ; 118: 19-24, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31439241

RESUMEN

PURPOSE: By comparing styloglossus and hyoglossus muscle invasion (SHMI) of oral tongue squamous cell cancer (OTSCC) on MR imaging to pathological depth of invasion (DOI) and prognosis, we aimed to evaluate the clinical significance of MR imaging findings of SHMI. METHOD: Forty-five, early stages and clinically N0 OTSCCs were retrospectively reviewed. Data included pathological DOI, DOI on MR imagings, two-year potential cervical lymph node positive, locoregional control, disease-free survival, and overall survival. Data were statistically compared between the groups with MR evidence of SHMI (SHMI+) and without MR evidence of SHMI (SHMI-). RESULTS: There were 17 SHMI + and 28 SHMI-. Elective neck dissections performed on 13 cases revealed five node positive cases, all of which were SHMI + . Pathological DOI in SHMI + was significantly larger than SHMI- (average 9.0 vs 4.6 mm, p < 0.001). All SHMI + revealed pathological DOI larger than 4 mm. The two-year potential cervical lymph node positive rate of SHMI + was significantly higher than SHMI- (p =  0.01). Locoregional control rate and disease-free survival of SHMI+ were significantly lower than in SHMI- (p =  0.02). There was no significant difference in overall survival. Interobserver agreement in evaluation of SHMI on MR imaging was good (kappa value = 0.72, p <  0.001). CONCLUSIONS: Pathological DOIs of SHMI + were all larger than 4 mm, which is the cut-off point that National Comprehensive Cancer Network recommends for neck dissection, and SHMI + had a worse prognosis than SHMI-. SHMI + can be used as a criterion for elective neck dissection.


Asunto(s)
Carcinoma de Células Escamosas/patología , Imagen por Resonancia Magnética/métodos , Disección del Cuello , Músculos del Cuello/diagnóstico por imagen , Neoplasias de la Lengua/patología , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/diagnóstico por imagen , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculos , Músculos del Cuello/patología , Invasividad Neoplásica/patología , Valor Predictivo de las Pruebas , Pronóstico , Estudios Retrospectivos , Lengua/diagnóstico por imagen , Lengua/patología , Neoplasias de la Lengua/diagnóstico por imagen
8.
J Bras Pneumol ; 45(4): e20180264, 2019 Aug 15.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31432889

RESUMEN

OBJECTIVE: To determine whether airway narrowing during obstructive events occurs predominantly at the retropalatal level and results from dynamic changes in the lateral pharyngeal walls and in tongue position. METHODS: We evaluated 11 patients with severe obstructive sleep apnea (OSA) and 7 healthy controls without OSA during wakefulness and during natural sleep (documented by full polysomnography). Using fast multidetector CT, we obtained images of the upper airway in the waking and sleep states. RESULTS: Upper airway narrowing during sleep was significantly greater at the retropalatal level than at the retroglossal level in the OSA group (p < 0.001) and in the control group (p < 0.05). The retropalatal airway volume was smaller in the OSA group than in the control group during wakefulness (p < 0.05) and decreased significantly from wakefulness to sleep only among the OSA group subjects. Retropalatal pharyngeal narrowing was attributed to reductions in the anteroposterior diameter (p = 0.001) and lateral diameter (p = 0.006), which correlated with an increase in lateral pharyngeal wall volume (p = 0.001) and posterior displacement of the tongue (p = 0.001), respectively. Retroglossal pharyngeal narrowing during sleep did not occur in the OSA group subjects. CONCLUSIONS: In patients with OSA, upper airway narrowing during sleep occurs predominantly at the retropalatal level, affecting the anteroposterior and lateral dimensions, being associated with lateral pharyngeal wall enlargement and posterior tongue displacement.


Asunto(s)
Tomografía Computarizada Multidetector/métodos , Enfermedades Faríngeas/diagnóstico por imagen , Enfermedades Respiratorias/diagnóstico por imagen , Apnea Obstructiva del Sueño/diagnóstico por imagen , Lengua/diagnóstico por imagen , Adulto , Anciano , Estudios de Casos y Controles , Humanos , Masculino , Persona de Mediana Edad , Paladar (Hueso)/diagnóstico por imagen , Paladar (Hueso)/patología , Paladar (Hueso)/fisiopatología , Enfermedades Faríngeas/patología , Enfermedades Faríngeas/fisiopatología , Faringe/diagnóstico por imagen , Faringe/patología , Faringe/fisiopatología , Polisomnografía , Valores de Referencia , Enfermedades Respiratorias/patología , Enfermedades Respiratorias/fisiopatología , Apnea Obstructiva del Sueño/patología , Apnea Obstructiva del Sueño/fisiopatología , Lengua/patología , Lengua/fisiopatología , Vigilia/fisiología
9.
PLoS One ; 14(8): e0221593, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31454385

RESUMEN

PURPOSE: Tongue mobility has shown to be a clinically interesting parameter on functional results after tongue cancer treatment which can be objectified by measuring the Range Of Motion (ROM). Reliable measurements of ROM would enable us to quantify the severity of functional impairments and use these for shared decision making in treatment choices, rehabilitation of speech and swallowing disturbances after treatment. METHOD: Nineteen healthy participants, eighteen post-chemotherapy patients and seventeen post-surgery patients were asked to perform standardized tongue maneuvers in front of a 3D camera system, which were subsequently tracked and corrected for head and jaw motion. Indicators, such as the left-right tongue range and the deflection angle with the horizontal axis were extracted from the tongue trajectory to serve as a quantitative measure for the impaired tongue mobility. RESULTS: The range and deflection angle showed an excellent intra- and interrater reliability (ICC 0.9) The repeatability experiment showed an average standard deviation of 2.5 mm to 3.5 mm for every movement, except the upward movement. The post-surgery patient group showed a smaller tongue range and higher deflection angle overall than the healthy participants. Post-chemoradiation patients showed less difference in tongue ROM compared with healthy participants. Only a few patients showed asymmetrical movement after treatment, which could not always be explained by T-stage or the side of treatment alone. CONCLUSION: We introduced a reliable and reproducible method for measuring the ROM and to quantify for motion impairments, that was able to show differences in tongue ROM between healthy subjects and patients after chemoradiation or surgery. Future research should focus on measuring patients with oral cancer pre- and post-treatment in combination with the collection of detailed information about the individual tongue anatomy, so that the full ROM trajectory can be used to identify changes over time and to quantify functional impairment.


Asunto(s)
Quimioradioterapia , Movimiento , Imagen Óptica , Lengua/diagnóstico por imagen , Lengua/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Puntos Anatómicos de Referencia , Humanos , Imagenología Tridimensional , Persona de Mediana Edad , Variaciones Dependientes del Observador , Rango del Movimiento Articular , Reproducibilidad de los Resultados , Adulto Joven
11.
Artículo en Chino | MEDLINE | ID: mdl-31262106

RESUMEN

Objective: To investigate the effect of genioglossus (GG) activation at sleep onset on the outcome of velopharyngeal surgery in obstructive sleep apnea hypopnea syndrome (OSAHS) patients. Methods: Thirty-five patients between April 2014 and February 2015 in Beijing Tongren Hospital with OSAHS underwent overnight polysomnography with synchronous genioglossus electromyography (GGEMG) using intraoral electrodes. The upper airway (UA) anatomy was evaluated by three-dimensional computer tomography (3D-CT) in OSAHS patients. Then, all of the patients received velopharyngeal surgery, including revised uvulopalatopharyngoplasty (UPPP) with uvula preservation or UPPP combined transpalatal advancement pharyngoplasty. All patients were followed-up using polysomnography 3-6 months after surgery. T-test or Wilcoxon test were used to compare the variables between groups, and Spearman correlation analysis was used to test the correlation between parameters. Results: Thirty-five patients received velopharyngeal surgery. Twenty-two patients (62.86%) were responders, and 13 patients (37.14%) were non-responders. Responders had a higher mean GGEMG during sleep onset (15.31±3.74 vs. 9.92±2.93, t=4.504, P=0.001). The decreased AHI was significantly positively related to the sleep onset mean GGEMG (r=0.541, P=0.004) and the change in GGEMG (r=0.422, P=0.028). The decreased AHI was significantly negatively related to the minimal cross sectional airway area (mCSA,ρ=0.629,P=0.000) and the minimal lateral airway dimension (mLAT, ρ=0.484, P=0.009) at velopharynx. Conclusions: The outcome of velopharyngeal surgery was affected by the mean GGEMG during sleep onset. We speculated that the patient with higher GGEMG at sleep onset and narrower velopharynx were more suitable candidates for velopharyngeal surgery.


Asunto(s)
Procedimientos Quirúrgicos Reconstructivos/métodos , Apnea Obstructiva del Sueño/fisiopatología , Apnea Obstructiva del Sueño/cirugía , Lengua/fisiopatología , Electromiografía , Humanos , Imagenología Tridimensional , Paladar (Hueso)/diagnóstico por imagen , Paladar (Hueso)/cirugía , Faringe/diagnóstico por imagen , Faringe/cirugía , Polisomnografía , Apnea Obstructiva del Sueño/diagnóstico , Tomografía Computarizada por Rayos X , Lengua/diagnóstico por imagen , Resultado del Tratamiento , Úvula/diagnóstico por imagen , Úvula/cirugía
12.
Medicine (Baltimore) ; 98(28): e16106, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31305393

RESUMEN

The aim of this study was to examine the correlation between the tongue coating thickness (TCT) and ultraviolet (UV) fluorescence and propose a new method for the estimation of TCT using a computerized tongue image acquisition system (CTIS).In this prospective and observational single-center study, we acquired tongue images under visible light and near-UV light for 60 patients with functional dyspepsia. Tongue images were acquired twice within a 30-minute interval to assess the reliability of CTIS. Then, the tongue coating was scraped and weighed to derive the wet weight of the tongue coating (WWTC). The percentage of the tongue coating area was calculated from the tongue images acquired under visible light. Mean color values (mCVs) for the UV fluorescence of the dorsal surface of the tongue were also computed.The reliabilities of the derived mCVs and percentage of the tongue coating area were acceptable (intraclass correlation coefficients, 0.907-0.947). The mCVs were more strongly correlated with WWTC than with the area, with mCV of modified lightness showing the strongest association (r = 0.785, P < .01). Finally, we suggested an estimation model for TCT based on the results.The results of this study suggest that both UV fluorescence of the dorsal tongue and the distribution area of tongue coating are useful parameters for the quantitative assessment of tongue coating. We believe that these findings will contribute to the development of a clinically useful CTIS.


Asunto(s)
Dispepsia/diagnóstico por imagen , Imagen Óptica , Lengua/diagnóstico por imagen , Dispepsia/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Reproducibilidad de los Resultados , Lengua/patología , Rayos Ultravioleta
13.
Int J Radiat Oncol Biol Phys ; 105(3): 514-524, 2019 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-31306734

RESUMEN

PURPOSE: To benchmark and improve, through means of a targeted intervention, the quality of intensity modulated radiation therapy treatment planning for locally advanced head and neck cancer (HNC) in the Netherlands. The short and long-term impact of this intervention was assessed. METHODS AND MATERIALS: A delineated computed tomography-scan of an oropharynx HNC case was sent to all 15 Dutch radiation therapy centers treating HNC. Aims for planning target volume and organ-at-risk (OAR) dosimetry were established by consensus. Each center generated a treatment plan. In a targeted intervention, OAR sparing of all plans was discussed, and centers with the best OAR sparing shared their planning strategies. Impact of the intervention was assessed by (1) short-term (half a year after intervention) replanning of the original case and (2) long-term (1 and 3 years after intervention) planning of new cases. RESULTS: Benchmarking revealed substantial difference in OAR doses. Initial mean doses were 22 Gy (range, 15-31 Gy), 35 Gy (18-49 Gy), and 37 Gy (20-46 Gy) for the contralateral parotid gland, contralateral submandibular gland, and combined swallowing structures, respectively. Replanning after targeted intervention significantly reduced mean doses and variation, but clinically relevant differences still remained: 18 Gy (14-22 Gy), 28 Gy (17-45 Gy), and 29 Gy (18-39 Gy), respectively. One and 3 years later the variation remained stable. CONCLUSIONS: Despite many years of HNC intensity modulated radiation therapy experience, initial treatment plans showed surprisingly large variations. The simple targeted intervention used in this analysis improved OAR sparing, and its impact was durable; however, fairly large dose differences still continue to exist. Additional work is needed to understand these variations and to minimize them. A national radiation oncology platform can be instrumental for developing and maintaining high-quality planning protocols.


Asunto(s)
Benchmarking/métodos , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Neoplasias de Cabeza y Cuello/radioterapia , Tratamientos Conservadores del Órgano/métodos , Órganos en Riesgo/efectos de la radiación , Planificación de la Radioterapia Asistida por Computador/normas , Radioterapia de Intensidad Modulada/normas , Benchmarking/normas , Encuestas de Atención de la Salud , Humanos , Países Bajos , Tratamientos Conservadores del Órgano/normas , Órganos en Riesgo/diagnóstico por imagen , Glándula Parótida/diagnóstico por imagen , Glándula Parótida/efectos de la radiación , Músculos Faríngeos/diagnóstico por imagen , Músculos Faríngeos/efectos de la radiación , Mejoramiento de la Calidad , Dosis de Radiación , Planificación de la Radioterapia Asistida por Computador/métodos , Radioterapia de Intensidad Modulada/métodos , Glándula Submandibular/diagnóstico por imagen , Glándula Submandibular/efectos de la radiación , Factores de Tiempo , Lengua/diagnóstico por imagen , Lengua/efectos de la radiación , Neoplasias Tonsilares/diagnóstico por imagen , Neoplasias Tonsilares/radioterapia
14.
J Neurol ; 266(10): 2518-2523, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31256280

RESUMEN

BACKGROUND: Late-onset Pompe disease (LOPD) is an often misdiagnosed inherited myopathy for which treatment exists. We noticed a bright tongue sign on brain MRIs of two patients who were admitted to the ICU for respiratory failure of unclear origin, and who were eventually diagnosed with LOPD. This led us to systematically review brain MRIs of patients with LOPD and various other neuromuscular disorders (NMD). MATERIALS AND METHODS: Chart and brain MRI review of patients with LOPD and other NMD. RESULTS: Abnormalities of the tongue were observed in 11/33 of the patients studied. In 10/11 patients, no comments were made with regard to the tongue abnormalities in the radiology report. Bright tongue sign was seen in 4/6 patients with LOPD and 4/28 patients with other NMD. Tongue atrophy was seen in 3/6 patients with LOPD and 6/28 patients with other NMD. CONCLUSION: Tongue abnormalities on brain MRI are common in LOPD compared to other NMD. These abnormalities are not usually reported by the radiologist. Particular attention to the tongue when reviewing brain MRIs may be an important clue for diagnosis of a patient's muscle weakness. A larger study is suggested to evaluate the sensitivity and specificity of tongue abnormalities in patients with LOPD.


Asunto(s)
Enfermedad del Almacenamiento de Glucógeno Tipo II/diagnóstico por imagen , Enfermedades Neuromusculares/diagnóstico por imagen , Lengua/diagnóstico por imagen , Edad de Inicio , Femenino , Enfermedad del Almacenamiento de Glucógeno Tipo II/fisiopatología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades Neuromusculares/fisiopatología , Estudios Retrospectivos , Lengua/patología , Lengua/fisiopatología
15.
Magn Reson Imaging ; 64: 132-141, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31247254

RESUMEN

Magnetic resonance (MR) images with both high resolutions and high signal-to-noise ratios (SNRs) are desired in many clinical and research applications. However, acquiring such images takes a long time, which is both costly and susceptible to motion artifacts. Acquiring MR images with good in-plane resolution and poor through-plane resolution is a common strategy that saves imaging time, preserves SNR, and provides one viewpoint with good resolution in two directions. Unfortunately, this strategy also creates orthogonal viewpoints that have poor resolution in one direction and, for 2D MR acquisition protocols, also creates aliasing artifacts. A deep learning approach called SMORE that carries out both anti-aliasing and super-resolution on these types of acquisitions using no external atlas or exemplars has been previously reported but not extensively validated. This paper reviews the SMORE algorithm and then demonstrates its performance in four applications with the goal to demonstrate its potential for use in both research and clinical scenarios. It is first shown to improve the visualization of brain white matter lesions in FLAIR images acquired from multiple sclerosis patients. Then it is shown to improve the visualization of scarring in cardiac left ventricular remodeling after myocardial infarction. Third, its performance on multi-view images of the tongue is demonstrated and finally it is shown to improve performance in parcellation of the brain ventricular system. Both visual and selected quantitative metrics of resolution enhancement are demonstrated.


Asunto(s)
Hidrocéfalo Normotenso/diagnóstico por imagen , Interpretación de Imagen Asistida por Computador/métodos , Imagen por Resonancia Magnética/métodos , Esclerosis Múltiple/diagnóstico por imagen , Infarto del Miocardio/diagnóstico por imagen , Neoplasias de la Lengua/diagnóstico por imagen , Algoritmos , Artefactos , Encéfalo/diagnóstico por imagen , Aprendizaje Profundo , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Movimiento (Física) , Relación Señal-Ruido , Lengua/diagnóstico por imagen
16.
Artif Intell Med ; 96: 123-133, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31164206

RESUMEN

The body constitution is much related to the diseases and the corresponding treatment programs in Traditional Chinese Medicine. It can be recognized by the tongue image diagnosis, so that it is essentially regarded as a problem of tongue image classification, where each tongue image is classified into one of nine constitution types. This paper first presents a system framework to automatically identify the constitution through natural tongue images, where deep convolutional neural networks are carefully designed for tongue coating detection, tongue coating calibration, and constitution recognition. Under the system framework, a novel complexity perception (CP) classification method is proposed to nicely perform the constitution recognition, which can better deal with the bad influence of the variation of environmental condition and the uneven distribution of the tongue images on constitution recognition performance. CP performs the constitution recognition based on the complexity of individual tongue images by selecting the classifier with the corresponding complexity. To evaluate the performance of the proposed method, experiments are conducted on three sizes of clinic tongue images from hospitals. The experimental results illustrate that CP is effective to improve the accuracy of body constitution recognition.


Asunto(s)
Aprendizaje Profundo , Procesamiento de Imagen Asistido por Computador/métodos , Lengua/diagnóstico por imagen , Humanos , Medicina China Tradicional , Redes Neurales de la Computación
17.
J Craniofac Surg ; 30(4): e301-e303, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31166273

RESUMEN

The Stafne bone defect (SBD) classically presents as a well-defined, radiolucent lesion in the molar-mandibular angle region beneath the level of the mandibular canal. Due in large part to this prototypical appearance, most cases of SBDs are radiographically diagnostic without the need for tissue biopsy. A diagnostic challenge may arise, however, when the SBD occurs in other locations in the mandible. The authors report a case of a 57-year-old male who presented with a SBD of the left ascending ramus. The lesion was found incidentally on a panoramic radiograph. Additional imaging studies confirmed a lingual concavity of the mandibular bone consistent with a SBD, and a retrospective study of the patient's records revealed the presence of the lesion 5 years prior without any radiographic alterations. To date, only 10 documented cases of an SBD involving the ascending ramus have been reported. The rarity of such a presentation may obscure the diagnosis and lead to unwarranted surgical procedures. It is important to recognize atypically located SBDs, because unlike other radiolucent lesions, imaging studies are diagnostic. With proper diagnosis, additional surgical procedures and any associated morbidities can be avoided.


Asunto(s)
Quistes Maxilomandibulares/diagnóstico por imagen , Enfermedades Mandibulares/diagnóstico por imagen , Biopsia , Humanos , Hallazgos Incidentales , Masculino , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Diente Molar/diagnóstico por imagen , Radiografía Panorámica , Estudios Retrospectivos , Lengua/diagnóstico por imagen
18.
Strahlenther Onkol ; 195(9): 780-791, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31214735

RESUMEN

PURPOSE: The aim of the study was to evaluate the usefulness and accuracy of 18-fluorine-labeled fluorodeoxyglucose (PET) and magnetic resonance imaging (MRI) hybrid in gross tumor volume (GTV) delineation during radiotherapy planning in patients with carcinoma of the tongue. METHODS: Ten patients with squamous cell carcinoma (SCC) of the tongue underwent computed tomography (CT) and PET/MRI examination. The GTV for primary tumor and lymph nodes (nGTV) were defined on CT (GTV-CT) and compared to GTVs obtained from PET (GTV-PET) and MRI (GTV-MRI) images. Two methods of GTV determination were used: visual interpretation of CT, PET (GTV-PETvis) and MRI images and quantitative automatic method (Syngovia, Siemens) based on a chosen threshold value (20%, 30%, 40%, 50%) of standardized uptake values (SUVmax) from PET examination (GTV-PET20%, GTV-PET30%, etc.). Statistical analysis of differences in GTV values obtained from CT, PET and MRI studies was performed. GTV-CT was used as a reference. RESULTS: In all, 80% of GTV-MRI and 40% of GTV-PETvis were larger than GTV-CT. Respectively, 20% of GTV-MRI and 60% of GTV-PETvis were smaller than GTV-CT. Taking into account all threshold measurements, 70% of volumes were smaller than GTV-CT. GTV-PET30% were the most closely related volumes to GTV-CT from all threshold methods in 50% of patients. GTV-PETvis generated the most similar volumes in relation to GTV-CT from all PET measurements. Statistical analysis confirmed those results. Compared to nGTV-CT, 70% of nGTV-MRI and 20% of nGTV-PETvis were larger. The remaining nGTV-MRI and nGTV-PETvis measurements were smaller than nGTV-CT. Measurements of all thresholds nGTVs were smaller than nGTV-CTV in 52.5% of cases. nGTV-PET20% were the most closely related volumes to nGTV-CT in 40% of the cases. Statistical analysis showed that nGTV-PET20% (p = 0.0468), nGTV-PETvis (p = 0.0166), and nGTV-PET50% (p = 0.0166) diverge significantly from nGTV-CT results. nGTV-MRI (p = 0.1141), nGTV-PET30% (p = 0.2845), and nGTV-PET40% (p = 0.5076) were significantly related with nGTV-CT. CONCLUSION: Combination of PET/MRI provides more information during target tumor mass delineation in radiotherapy planning of patients with SCC of the tongue than other standard imaging methods. The most frequently matching threshold value was 30% of SUVmax for primary tumor delineation and 30-40% of SUVmax for nGTV determination.


Asunto(s)
Carcinoma de Células Escamosas/radioterapia , Imagen por Resonancia Magnética , Imagen Multimodal/métodos , Tomografía de Emisión de Positrones/métodos , Planificación de la Radioterapia Asistida por Computador , Radioterapia Guiada por Imagen/métodos , Neoplasias de la Lengua/radioterapia , Adulto , Anciano , Biopsia , Carcinoma de Células Escamosas/patología , Femenino , Fluorodesoxiglucosa F18 , Humanos , Metástasis Linfática/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Lengua/diagnóstico por imagen , Lengua/patología , Neoplasias de la Lengua/patología , Carga Tumoral
20.
Ear Nose Throat J ; 98(5): E21-E23, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30943808

RESUMEN

OBJECTIVE: We report a rare case of an intralingual ranula. The differential diagnosis, etiology, diagnostic features, and management are discussed. CASE REPORT: An 18-year-old man presented with a mass that extended along the ventral surface of the tongue and up to the tip. The computed tomography scan clearly defined the extent of a cystic lesion. The pathologic diagnosis of an intralingual ranula was made. CONCLUSION: Lingual cysts have a varied etiology. Diagnosis hinges on histological examination of the cyst wall. Conservative resection and histological examination is the standard of care.


Asunto(s)
Disección/métodos , Ránula , Glándulas Salivales/diagnóstico por imagen , Enfermedades de la Lengua , Lengua , Adolescente , Biopsia/métodos , Diagnóstico Diferencial , Humanos , Masculino , Ránula/patología , Ránula/fisiopatología , Ránula/cirugía , Tomografía Computarizada por Rayos X/métodos , Lengua/diagnóstico por imagen , Lengua/patología , Lengua/cirugía , Enfermedades de la Lengua/patología , Enfermedades de la Lengua/fisiopatología , Enfermedades de la Lengua/cirugía , Resultado del Tratamiento
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