Intra- and inter-observer variability in intracranial aneurysm segmentation: comparison between CT angiography (semi-automated segmentation software stroke VCAR) and digital subtraction angiography (3D rotational angiography).

PURPOSE: To compare size and morphologic features of three-dimensional aneurysm models, obtained with a semi-automated segmentation software (Stroke VCAR, GE, USA) from cerebral CT angiography (CTA) data, to three-dimensional aneurysm models obtained with digital subtraction angiography (DSA, with 3D rotational angiography acquisition-3DRA), considered as the reference standard. METHODS: In this retrospective study, we reviewed 132 patients, with a total number of 137 intracranial aneurysm, who underwent CTA and subsequent DSA examination, supplemented with 3DRA. We compared neck length, short axis and long axis measured on 3DRA model to the same variables measured on 3D-CTA model by two blinded readers and to the automatic software dimensions. Therefore, statistics analysis assessed intra-observer and inter-observer variability and differences between patients with or without subarachnoid hemorrhage (SAH). RESULTS: There were no significant differences in short-axis and long-axis measurements between 3D angiographic and 3D-CTA models, while comparison of neck lengths revealed a statistically significant difference, which tended to be greater for smaller neck lengths (partial volume effect and "kissing vessels" artifact). There were significant differences between manual and automatic data measured for the same three variables, and the presence of SAH did not affect aneurysm 3D reconstruction. Inter-observer agreement resulted moderate for neck length and substantial for short axis and long axis. CONCLUSION: The examined 3D-CTA segmentation system is a reproducible procedure for aneurysm morphologic characterization and, in particular, for assessment of aneurysm sac dimensions, but considerable carefulness is required in neck length interpretation.

Ganglionic Eminence Anomalies and Coexisting Cerebral Developmental Anomalies on Fetal MR Imaging: Multicenter-Based Review of 60 Cases.

BACKGROUND AND PURPOSE: The ganglionic eminences are transient fetal brain structures that produce a range of neuron types. Ganglionic eminence anomalies have been recognized on fetal MR imaging and anecdotally found in association with a number of neurodevelopmental anomalies. The aim of this exploratory study was to describe and analyze the associations between ganglionic eminence anomalies and coexisting neurodevelopmental anomalies. MATERIALS AND METHODS: This retrospective study includes cases of ganglionic eminence anomalies diagnosed on fetal MR imaging during a 20-year period from 7 centers in Italy and England. Inclusion criteria were cavitation or increased volume of ganglionic eminences on fetal MR imaging. The studies were analyzed for associated cerebral developmental anomalies: abnormal head size and ventriculomegaly, reduced opercularization or gyration, and abnormal transient layering of the developing brain mantle. The results were analyzed using χ2 and Fisher exact tests. RESULTS: Sixty fetuses met the inclusion criteria (21 females, 24 males, 15 sex unknown). Thirty-four had ganglionic eminence cavitations (29 bilateral and 5 unilateral), and 26 had increased volume of the ganglionic eminences (19 bilateral, 7 unilateral). Bilateral ganglionic eminence cavitations were associated with microcephaly (P = .01), reduced opercularization, (P < .001), reduced gyration (P < .001), and cerebellar anomalies (P = .01). Unilateral ganglionic eminence cavitations were not significantly associated with any particular feature. Bilateral increased volume of the ganglionic eminences showed an association with macrocephaly (P = .03). Unilateral increased volume was associated with macrocephaly (P = .002), abnormal transient layering (P = .001), unilateral polymicrogyria (P = .001), and hemimegalencephaly (P < .001). CONCLUSIONS: Ganglionic eminence anomalies are associated with specific neurodevelopmental anomalies with ganglionic eminence cavitations and increased ganglionic eminence volume apparently having different associated abnormalities.

Temporal variations in the diet of pearly razorfish Xyrichtys novacula (Osteichthyes: Labridae).

The diet of pearly razorfish Xyrichtys novacula, caught monthly along the shores of the Island of Lampedusa, appeared to be mainly composed of crustaceans, followed by colonial ascidians, molluscs and polychaetes. Among prey, sand dwellers and phanerogam-associated species were recorded. In winter months, the diet was characterized by a small number of prey items, dominated by colonial ascidians, while in spring and summer a wider prey array was recorded. Dietary indices show that X. novacula do not strictly exploit benthic prey but also pelagic organisms, such as copepods. This feeding behaviour reached its peak in March and October, when the abundance of primary consumers was at its highest after phytoplankton blooms. Furthermore, X. novacula caught prey organisms according to their availability and seasonal patterns during their life cycles, irrespective of fish size.

Prognostic value of CT myocardial perfusion imaging and CT-derived fractional flow reserve for major adverse cardiac events in patients with coronary artery disease.

OBJECTIVES: The purpose of this study was to analyze the prognostic value of dynamic CT perfusion imaging (CTP) and CT derived fractional flow reserve (CT-FFR) for major adverse cardiac events (MACE). METHODS: 81 patients from 4 institutions underwent coronary computed tomography angiography (CCTA) with dynamic CTP imaging and CT-FFR analysis. Patients were followed-up at 6, 12, and 18 months after imaging. MACE were defined as cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or revascularization. CT-FFR was computed for each major coronary artery using an artificial intelligence-based application. CTP studies were analyzed per vessel territory using an index myocardial blood flow, the ratio between territory and global MBF. The prognostic value of CCTA, CT-FFR, and CTP was investigated with a univariate and multivariate Cox proportional hazards regression model. RESULTS: 243 vessels in 81 patients were interrogated by CCTA with CT-FFR and 243 vessel territories (1296 segments) were evaluated with dynamic CTP imaging. Of the 81 patients, 25 (31%) experienced MACE during follow-up. In univariate analysis, a positive index-MBF resulted in the largest risk for MACE (HR 11.4) compared to CCTA (HR 2.6) and CT-FFR (HR 4.6). In multivariate analysis, including clinical factors, CCTA, CT-FFR, and index-MBF, only index-MBF significantly contributed to the risk of MACE (HR 10.1), unlike CCTA (HR 1.2) and CT-FFR (HR 2.2). CONCLUSION: Our study provides initial evidence that dynamic CTP alone has the highest prognostic value for MACE compared to CCTA and CT-FFR individually or a combination of the three, independent of clinical risk factors.

Gas exchange, metabolite status and excess post-exercise oxygen consumption after repetitive bouts of exhaustive exercise in juvenile rainbow trout.

Juvenile rainbow trout (approximately 6 g) were exercised to exhaustion in two 5 min bouts given 6 h apart. Resting levels of whole-body lactate and glycogen were restored prior to the second bout. The rate of O2 consumption increased about threefold 5 min after each bout of exercise, while recovery time decreased from 4 h after the first bout to 2-3 h after the second. The excess post-exercise oxygen consumption, i.e. 'oxygen debt', was significantly reduced by 40% after the second exercise bout, despite almost identical rates of lactate clearance and glycogen resynthesis. The rates of CO2 and ammonia excretion increased sixfold and threefold, and recovery times decreased from 4-6 h to 3 h and from 3 h to 1.5 h, respectively. After the first bout, whole-body lactate levels peaked at 5 min post-exercise at about 8.5 times pre-exercise levels. After the second bout, lactate levels peaked at 0 min post-exercise and fell more rapidly during recovery. Whole-body glycogen levels decreased by 70% and 80% and ATP levels decreased by 75% and 65% after the first and second bouts, respectively, while glucose levels increased about 1.5-fold immediately after both bouts. Creatine phosphate levels decreased by 70% and 80% after the first and second bouts, respectively. After 6 h of recovery, creatine phosphate levels were higher after the second bout than after the first. These findings suggest that exhaustive exercise may cause a 'non-specific' increase in metabolic rate not directly related to the processing of metabolites, which is reduced upon a subsequent exercise bout. This is in contrast with the classical 'oxygen debt hypothesis', which states that the oxygen debt and lactate clearance are linked. Furthermore, it appears that two sequential exercise bouts are sufficient to induce a 'training effect', i.e. improved rates of metabolic recovery.

The oxygen debt hypothesis in juvenile rainbow trout after exhaustive exercise.

A 5 min bout of exhaustive exercise in 2-3 g rainbow trout resulted in a 2.0-2.5 fold increase in oxygen consumption (MO2), a 5-fold increase in whole-body lactate (LAC) levels and a near depletion in whole-body glycogen (GLY), ATP and creatine phosphate (CP) stores; glucose, ADP and AMP did not change. Recovery of MO2 and LAC was complete by 6 h, by which time GLY had stabilized at about 65% resting levels without further recovery through 24 h. Complete recovery of ATP required 1.0-1.5 h, whereas restoration of CP required only 5 min. The MO2 recovery curve was resolved into an initial fast component (t1/2 = 0.23 h) and a second slower component (t1/2 = 2.1 h), comprising approximately 20% and 80% respectively of the excess post-exercise oxygen consumption (EPOC). The fast component was satisfactorily accounted for by the standard components of the 'alactacid O2 debt'. However, the slow component could not be completely explained by changes in whole body LAC and GLY during recovery based on scenarios of either oxidation or GLY resynthesis as the primary fate of LAC. The classical 'O2 dept hypothesis' (Hill and Lupton, Quart, J. Med. 16: 135-171, 1923; Margaria et al., Am. J. Physiol. 106: 689-715, 1933) cannot be the complete explanation of EPOC in the trout.