AIM To evaluate the diagnostic performance of computed tomography(CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease(NAFLD).METHODS A total of 38 NAFLD patients were ...AIM To evaluate the diagnostic performance of computed tomography(CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease(NAFLD).METHODS A total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment(LLS), left medial segment, caudate lobe, and right lobe(RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman's rank correlation coefficient. A receiver operating characteristic(ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.RESULTS The volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage(r = 0.815, P < 0.001; and r = 0.465, P = 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage(r =-0.563, P < 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis(F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.CONCLUSION The volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.展开更多
BACKGROUND Several studies found that early pancreatic atrophy detected by computed tomo-graphy(CT)within 6 months was associated with a high incidence of diabetes in patients with type-1 autoimmune pancreatitis(AIP)r...BACKGROUND Several studies found that early pancreatic atrophy detected by computed tomo-graphy(CT)within 6 months was associated with a high incidence of diabetes in patients with type-1 autoimmune pancreatitis(AIP)receiving steroid therapy;however,no long-term follow-up studies have been performed.AIM To investigate pancreatic volume(PV)changes using three dimensional(3D)-CT volumetry and their relationship with IgG4 and diabetes in patients with AIP.METHODS This retrospective study included 33 patients with type-1 AIP receiving steroid therapy.Patients were divided into diffuse(D-type)and mass-forming type(M-type)AIP.PV was determined by semi-automated 3D-CT volumetry,and changes between initial and follow-up values were calculated.The relationship between PV and serum IgG4 levels was analyzed by Spearman’s rank correlation.The PV atrophy ratio compared with the presumed normal PV at the time of last follow-up CT and its relationship with diabetes were investigated.RESULTS There were 16 D-type and 17 M-type patients with long-term follow-up(mean,95.8 months).The regression curve of mean relative PV change reduced exponentially and rapidly during the first 25 months and then more slowly in both groups.The overall cumulative pancreas re-enlargement rates at 1,3,5,7 and 10 years were 6.1%,12.2%,29.2%,47.5%and 55.0%,respectively.There was a moderate-to-very strong positive correlation(ρ≥0.4)between PV and serum IgG4 levels in nine(9/13,69.2%)patients.All 33 patients showed pancreatic atrophy(mean 59.3%)after long-term follow-up.Patients with D-type AIP had a significantly higher atrophy rate and higher incidence of diabetes than M-type patients(P<0.05).CONCLUSION PV change initially reduced exponentially and then more slowly and is considered an important factor associated with diabetes.Serum IgG4 levels were positively correlated with PV during follow-up.展开更多
BACKGROUND: Convenient way to clarify liver volum or tumor volume in the liver is eagerly demanded by hepa tobiliary surgeons, for so many aspects of clinical wor need to know the liver volumetry. At present, some me ...BACKGROUND: Convenient way to clarify liver volum or tumor volume in the liver is eagerly demanded by hepa tobiliary surgeons, for so many aspects of clinical wor need to know the liver volumetry. At present, some me thods have been used to measure the liver volumetry, suc as computed tomography (CT) scans, three-dimensiona ultrasound volumetric system [1] and 3-dimensional sono graphy[2,3] et al. But enough volumetric information wa failed to obtain by surgeons and a new way of measurin the liver volumetry that can be operated by themselves i exigent. Whereas we devise a new method of using Photo Shop in personal computer to measure the liver volumetry METHODS: A piece of whole CT film was transformed t a high quality digitized image by digital camera or scanne and then the digitized image was conducted as JPEG file in to personal computer. The JPEG image file of CT film wa opened by PhotoShop. Determining the edge of interested areas, and the data of pixel values of the interested areas di vided by 1 cm2 pixel value will produce the actual area with the unit of square centimeter. If section thickness of CT scan is 1 cm, the sum of the areas of the liver or tumor in all sections naturally is the volume of the liver or tumor. RESULTS: Comparison of 10 hepatic volumes gained by this method and those gained by the GE Prospeed CT se showed a good relativity between the two groups. The vo lumes of three right lobes were calculated by this method before lobectomy and their real volumes were obtained postoperatively by a volumenometer. Their variation wa limited to 5%. CONCLUSIONS: Hepatic volume obtained by PhotoShop is reliable. This method can be used to measure hepati volume perfectly to meet clinical demand, and many pa rameters such as liver resection rate, graft volume can be achieved. The disadvantage of this method is the step o copying the pixel value from PhotoShop to Microsoft Ex cel.展开更多
Objective To detect for hippocampal sclerosis presurgically in a group of patients with refractory temporal lobe epilepsy Methods Eighty four consecutive patients with refractory temporal lobe epilepsy were subjec...Objective To detect for hippocampal sclerosis presurgically in a group of patients with refractory temporal lobe epilepsy Methods Eighty four consecutive patients with refractory temporal lobe epilepsy were subjected to brain MRI of hippocampal volumetry A ratio of smaller to larger hippocampal volume was determined and unilateral hippocampal atrophy (HA) was diagnosed if the ratio is less than 0 91 Results Unilateral HA was diagnosed in 42 patients (50%) and bilateral HA in 1 patient Other MRI abnormalities were detected in 18 patients with or without coexisting HA Conclusions Hippocampal sclerosis can be detected presurgically in many patients by brain MRI Additional abnormalities not detected by brain CT can also be demonstrated展开更多
Aim:The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin(99mTc-GSA)scin...Aim:The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin(99mTc-GSA)scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry.Methods:The study group comprised 15 patients who underwent preoperative 3-dimensional(3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015.The diagnosis was hepatocellular carcinoma(n=4),metastatic liver tumor(n=10),or intrahepatic cholangiocarcinoma(n=1).Right hepatectomy was performed in 2 patients,left hepatectomy in 3 patients,right posterior sectionectomy in 3 patients,segmentectomy in 2 patients,and partial hepatectomy in 4 patients.99mTc-GSA scintigraphy and computed tomography(CT)were performed to construct 3D-99mTc-GSA scintigraphy/vascular fused images.The conventional volume ratio of the planned resection region without tumor(%CT),and the functional volume ratio of the planned resection region without tumor(%GSA)were calculated.The discrepancy ratio was calculated as follows:discrepancy ratio=100-%GSA/%CT×100(%).Results:The%GSA(17.9±16.7%)was significantly lower than the%CT(21.5±17.6%)(P<0.036).In all except 2 patients,the%GSA was lower than the%CT.The discrepancy ratio ranged from-4%to 75%(median,20.7%).Conclusion:3D-99mTc-GSA scintigraphy/vascular fused images constructed using SYNAPSE VINCENT were useful for noninvasively performing functional liver volumetry in patients scheduled to undergo various patterns of hepatectomy.In planned resection regions without tumor,the functional volume ratio was about 20%lower than the conventional volume ratio.展开更多
Background: An accurate preoperative volumetric assessment of donor liver is essential for successful living donor liver transplant by ensuring adequate remnant and graft recipient weight ratio (GRWR). Methods: The st...Background: An accurate preoperative volumetric assessment of donor liver is essential for successful living donor liver transplant by ensuring adequate remnant and graft recipient weight ratio (GRWR). Methods: The study cohort consisted of 744 right lobe (RL), 65 left lobe (LL) and 33 left lateral sector (LLS) grafts from July 2010 to January 2014. A semi-automated interactive commercial software called AW Volume share 6 was used for volumetry. Bland Altman plot was used for assessing the agreement between estimated graft weight (EGW) and actual graft weight (AGW). Results: There was no statistically significant difference between EGW and AGW for RL graft weight (722±134 vs. 717±126 gm;P=0.06). Although Bland Altman graph showed that 95% limits of agreement was more in LL (?164 to +110) than RL (?156 to +147) and LLS grafts (?137 to +239), CT scan significantly overestimated LL graft weight (EGW =460±118 gm vs. AGW =433±102 gm;P=0.003) and underestimated LLS graft weight (EGW =203±48 gm vs. AGW =254±49 gm;P<0.001). Conclusions: CT volumetry overestimate LL graft and underestimate LLS graft weight. This should be factored in when selecting LL graft by taking higher GRWR.展开更多
Transplantation of the left lateral section(LLS)of the liver is now an established practice for treating advanced diffuse and unresectable focal liver diseases in children,with variants of the LLS primarily used in in...Transplantation of the left lateral section(LLS)of the liver is now an established practice for treating advanced diffuse and unresectable focal liver diseases in children,with variants of the LLS primarily used in infants.However,the surgical challenge of matching the size of an adult donor's graft to the volume of a child's abdomen remains significant.This review explores historical developments,various approaches to measuring the required functional liver mass,and techniques to prevent complications associated with large-for-size grafts in infants.展开更多
Background Ongoing debates question the harm of internet use with the evolving technology,as many individuals transition from regular to problematic internet use(PIU).The habenula(Hb),located between the thalamus and ...Background Ongoing debates question the harm of internet use with the evolving technology,as many individuals transition from regular to problematic internet use(PIU).The habenula(Hb),located between the thalamus and the third ventricle,is implicated in various psychiatric disorders.In addition,personality features have been suggested to play a role in the pathophysiology of PIU.Aims This study aimed to investigate Hb volumetry in individuals with subclinical PIU and the mediating effect of personality traits on this relationship.Methods 110 healthy adults in this cross-sectional study underwent structural magnetic resonance imaging.Hb segmentation was performed using a deep learning technique.The Internet Addiction Test(IAT)and the NEO Five-Factor Inventory were used to assess the PIU level and personality,respectively.Partial Spearman's correlation analyses were performed to explore the reiationships between Hb volumetry,IAT and NEO.Multiple regression analysis was applied to identify personality traits that predict IAT scores.The significant trait was then treated as a mediator between Hb volume and IAT correlation in mediation analysis with a bootstrap value of 5000.Results Relative Hb volume was negatively correlated with IAT scores(partial rho=-0.142,p=0.009).The IAT score was positively correlated with neuroticism(partial rho=0.430,p<0.001)and negatively correlated with extraversion,agreeableness and conscientiousness(partial rho=-0.213,p<0.001;partial rho=-0.279,p<0.001;and partial rho=-0.327,p<0.001).There was a significant indirect effect of Hb volume on this model(β=-0.061,p=0.048,boot 95%confidence interval:-0.149 to-0.001).Conclusions This study uncovered a crucial link between reduced Hb volume and heightened PIU.Our findings highlight neuroticism as a key risk factor for developing PIU.Moreover,neuroticism was shown to mediate the relationship between Hb volume and PIU tendency,offering valuable insight into the complexities of this interaction.展开更多
The development of digital intelligent diagnostic and treatment technology has opened countless new opportunities for liver surgery from the era of digital anatomy to a new era of digital diagnostics,virtual surgery s...The development of digital intelligent diagnostic and treatment technology has opened countless new opportunities for liver surgery from the era of digital anatomy to a new era of digital diagnostics,virtual surgery simulation and using the created scenarios in real-time surgery using mixed reality.In this article,we described our experience on developing a dedicated 3 dimensional visualization and reconstruction software for surgeons to be used in advanced liver surgery and living donor liver transplantation.Furthermore,we shared the recent developments in the field by explaining the outreach of the software from virtual reality to augmented reality and mixed reality.展开更多
The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases.While conventional magnetic resonance imaging(MRI) is widely used for ...The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases.While conventional magnetic resonance imaging(MRI) is widely used for brain and cerebellar morphologic evaluation,advanced MRI techniques allow the investigation of cerebellar microstructural and functional characteristics.Volumetry,voxel-based morphometry,diffusion MRI based fiber tractography,resting state and task related functional MRI,perfusion,and proton MR spectroscopy are among the most common techniques applied to the study of cerebellum.In the present review,after providing a brief description of each technique's advantages and limitations,we focus on their application to the study of cerebellar injury in major neurodegenerative diseases,such as multiple sclerosis,Parkinson's and Alzheimer's disease and hereditary ataxia.A brief introduction to the pathological substrate of cerebellar involvement is provided for each disease,followed by the review of MRI studies exploring structural and functional cerebellar abnormalities and by a discussion of the clinical relevance of MRI measures of cerebellar damage in terms of both clinical status and cognitive performance.展开更多
Objective To measure volume and other parameters of normal adrenal glands in Chinese adults with 64-slice multidetector CT, to evaluate the relationship of volume result with age, sex and body size, and to explore the...Objective To measure volume and other parameters of normal adrenal glands in Chinese adults with 64-slice multidetector CT, to evaluate the relationship of volume result with age, sex and body size, and to explore the correlations between adrenal volume and other measurements. Methods This study was based on 125 acquired contrast-enhanced upper abdominal CT scans performed with a 64-slice CT. The final study group consisted of 81 patients (49 males, 32 females). Portal venous phase images were studied for the measurements. Both the reconstruction interval and thickness were 1.5 mm. Each adrenal gland was outlined manually with computer-assistant technology to calculate its volume. The maximal sectional area, length, width and thickness of each adrenal gland were also measured. Results The mean age of total population was 47.9±13.0 (range: 20-76) years. The left, right, and total adrenal gland volumes were 4.23±0.74 (range: 2.85-5.83) cm 3 , 4.26±0.86 (2.59-6.56) cm 3 , and 8.50±1.40 (5.80-11.39) cm 3 , respectively. These volumes increased with weight (r=0.381, 0.389, and 0.437 respectively, all P<0.001), height (r=0.386, P<0.001; r=0.297, P=0.007; r=0.384, P<0.001) and body surface area (r=0.406, 0.392, and 0.452, all P<0.001). There was no significant difference in left, right or total adrenal volume with regard to sex after applying General Linear Model procedure to reduce the impact of weight (F=1.304, 0.064, and 0.597, all P>0.05), nor did volume change significantly with age (r=-0.033, -0.014, and -0.026, all P>0.05). Nearly all descriptors of bilateral adrenal glands correlated with ipsilateral volume except thickness (r=-0.027, P=0.814) and width (r=0.166, P=0.138) in the left side. Among these parameters, length had a stronger correlation with volume than others in the both left (r=0.412, P<0.001) and right (r=0.516, P<0.001) adrenal glands. Conclusion Our study has defined the volume distribution and other parameters of normal adrenal glands in Chinese adults, which provide a baseline for future studies.展开更多
BACKGROUND Liver transplantation has evolved into a safe life-saving operation and remains the golden standard in the treatment of end stage liver disease.The main limiting factor in the application of liver transplan...BACKGROUND Liver transplantation has evolved into a safe life-saving operation and remains the golden standard in the treatment of end stage liver disease.The main limiting factor in the application of liver transplantation is graft shortage.Many strategies have been developed in order to alleviate graft shortage,such as living donor partial liver transplantation and split liver transplantation for adult and pediatric patients.In these strategies,liver volume assessment is of paramount importance,as size mismatch can have severe consequences in the success of liver transplantation.AIM To evaluate the safety,feasibility,and accuracy of light detection and ranging(LIDAR)3D photography in the prediction of whole liver graft volume and mass.METHODS Seven liver grafts procured for orthotopic liver transplantation from brain deceased donors were prospectively measured with an LIDAR handheld camera and their mass was calculated and compared to their actual weight.RESULTS The mean error of all measurements was 17.03 g(range 3.56-59.33 g).Statistical analysis of the data yielded a Pearson correlation coefficient index of 0.9968,indicating a strong correlation between the values and a Student’s t-test P value of 0.26.Mean accuracy of the measurements was calculated at 97.88%.CONCLUSION Our preliminary data indicate that LIDAR scanning of liver grafts is a safe,cost-effective,and feasible method of ex vivo determination of whole liver volume and mass.More data are needed to determine the precision and accuracy of this method.展开更多
To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal vo...To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal volumes were measured on CT. The aortic contrast enhancement was inversely correlated with renal medullary volume (r = -0.52, p 0.0001), and renal cortical volume (r = -0.3, p = 0.02). Renal volume may have inverse correlation with aortic contrast enhancement on the hepatic arterial phase of dynamic CT. This might call for adjustment of contrast material dose based in part on renal volume in the future.展开更多
Background:The presence and extent of structural changes in the brain as a consequence of Parkinson’s disease(PD)is still poorly understood.Methods:High-resolution 3-tesla T1-weighted structural magnetic resonance im...Background:The presence and extent of structural changes in the brain as a consequence of Parkinson’s disease(PD)is still poorly understood.Methods:High-resolution 3-tesla T1-weighted structural magnetic resonance images in sixty-five PD and 27 age-matched healthy control participants were examined.Putamen,caudate,and intracranial volumes were manually traced in the axial plane of 3D reconstructed images.Striatal nuclei volumes were normalized to intracranial volume for statistical comparison.Disease status was assessed using the Unified Parkinson’s Disease Rating Scale and Hoehn and Yahr scale.Cognitive status was assessed using global status tests and detailed neuropsychological testing.Results:Both caudate and putamen volumes were smaller in PD brains compared to controls after adjusting for age and gender.Caudate volumes were reduced by 11%(p=0.001)and putamen volumes by 8.1%(p=0.025).PD striatal volumes were not found to be significantly correlated with cognitive or motor decline.Conclusion:Small,but significant reductions in the volume of both the caudate and putamen occur in PD brains.These reductions are independent of the effects of age and gender,however the relation of these reductions to the functional loss of dopamine,which is characteristic of PD,remains unclear.展开更多
基金Supported by a Grant-in-in-Aid for Scientific Research(C)(No26461796) from the Japanese Ministry of Education,Culture,Sports,Science,and Technology
文摘AIM To evaluate the diagnostic performance of computed tomography(CT) volumetry for discriminating the fibrosis stage in patients with nonalcoholic fatty liver disease(NAFLD).METHODS A total of 38 NAFLD patients were enrolled. On the basis of CT imaging, the volumes of total, left lateral segment(LLS), left medial segment, caudate lobe, and right lobe(RL) of the liver were calculated with a dedicated liver application. The relationship between the volume percentage of each area and fibrosis stage was analyzed using Spearman's rank correlation coefficient. A receiver operating characteristic(ROC) curve analysis was performed to determine the accuracy of CT volumetry for discriminating fibrosis stage.RESULTS The volume percentages of the caudate lobe and the LLS significantly increased with the fibrosis stage(r = 0.815, P < 0.001; and r = 0.465, P = 0.003, respectively). Contrarily, the volume percentage of the RL significantly decreased with fibrosis stage(r =-0.563, P < 0.001). The volume percentage of the caudate lobe had the best diagnostic accuracy for staging fibrosis, and the area under the ROC curve values for discriminating fibrosis stage were as follows: ≥ F1, 0.896; ≥ F2, 0.929; ≥ F3, 0.955; and ≥ F4, 0.923. The best cut-off for advanced fibrosis(F3-F4) was 4.789%, 85.7% sensitivity and 94.1% specificity.CONCLUSION The volume percentage of the caudate lobe calculated by CT volumetry is a useful diagnostic parameter for staging fibrosis in NAFLD patients.
文摘BACKGROUND Several studies found that early pancreatic atrophy detected by computed tomo-graphy(CT)within 6 months was associated with a high incidence of diabetes in patients with type-1 autoimmune pancreatitis(AIP)receiving steroid therapy;however,no long-term follow-up studies have been performed.AIM To investigate pancreatic volume(PV)changes using three dimensional(3D)-CT volumetry and their relationship with IgG4 and diabetes in patients with AIP.METHODS This retrospective study included 33 patients with type-1 AIP receiving steroid therapy.Patients were divided into diffuse(D-type)and mass-forming type(M-type)AIP.PV was determined by semi-automated 3D-CT volumetry,and changes between initial and follow-up values were calculated.The relationship between PV and serum IgG4 levels was analyzed by Spearman’s rank correlation.The PV atrophy ratio compared with the presumed normal PV at the time of last follow-up CT and its relationship with diabetes were investigated.RESULTS There were 16 D-type and 17 M-type patients with long-term follow-up(mean,95.8 months).The regression curve of mean relative PV change reduced exponentially and rapidly during the first 25 months and then more slowly in both groups.The overall cumulative pancreas re-enlargement rates at 1,3,5,7 and 10 years were 6.1%,12.2%,29.2%,47.5%and 55.0%,respectively.There was a moderate-to-very strong positive correlation(ρ≥0.4)between PV and serum IgG4 levels in nine(9/13,69.2%)patients.All 33 patients showed pancreatic atrophy(mean 59.3%)after long-term follow-up.Patients with D-type AIP had a significantly higher atrophy rate and higher incidence of diabetes than M-type patients(P<0.05).CONCLUSION PV change initially reduced exponentially and then more slowly and is considered an important factor associated with diabetes.Serum IgG4 levels were positively correlated with PV during follow-up.
文摘BACKGROUND: Convenient way to clarify liver volum or tumor volume in the liver is eagerly demanded by hepa tobiliary surgeons, for so many aspects of clinical wor need to know the liver volumetry. At present, some me thods have been used to measure the liver volumetry, suc as computed tomography (CT) scans, three-dimensiona ultrasound volumetric system [1] and 3-dimensional sono graphy[2,3] et al. But enough volumetric information wa failed to obtain by surgeons and a new way of measurin the liver volumetry that can be operated by themselves i exigent. Whereas we devise a new method of using Photo Shop in personal computer to measure the liver volumetry METHODS: A piece of whole CT film was transformed t a high quality digitized image by digital camera or scanne and then the digitized image was conducted as JPEG file in to personal computer. The JPEG image file of CT film wa opened by PhotoShop. Determining the edge of interested areas, and the data of pixel values of the interested areas di vided by 1 cm2 pixel value will produce the actual area with the unit of square centimeter. If section thickness of CT scan is 1 cm, the sum of the areas of the liver or tumor in all sections naturally is the volume of the liver or tumor. RESULTS: Comparison of 10 hepatic volumes gained by this method and those gained by the GE Prospeed CT se showed a good relativity between the two groups. The vo lumes of three right lobes were calculated by this method before lobectomy and their real volumes were obtained postoperatively by a volumenometer. Their variation wa limited to 5%. CONCLUSIONS: Hepatic volume obtained by PhotoShop is reliable. This method can be used to measure hepati volume perfectly to meet clinical demand, and many pa rameters such as liver resection rate, graft volume can be achieved. The disadvantage of this method is the step o copying the pixel value from PhotoShop to Microsoft Ex cel.
文摘Objective To detect for hippocampal sclerosis presurgically in a group of patients with refractory temporal lobe epilepsy Methods Eighty four consecutive patients with refractory temporal lobe epilepsy were subjected to brain MRI of hippocampal volumetry A ratio of smaller to larger hippocampal volume was determined and unilateral hippocampal atrophy (HA) was diagnosed if the ratio is less than 0 91 Results Unilateral HA was diagnosed in 42 patients (50%) and bilateral HA in 1 patient Other MRI abnormalities were detected in 18 patients with or without coexisting HA Conclusions Hippocampal sclerosis can be detected presurgically in many patients by brain MRI Additional abnormalities not detected by brain CT can also be demonstrated
文摘Aim:The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin(99mTc-GSA)scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry.Methods:The study group comprised 15 patients who underwent preoperative 3-dimensional(3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015.The diagnosis was hepatocellular carcinoma(n=4),metastatic liver tumor(n=10),or intrahepatic cholangiocarcinoma(n=1).Right hepatectomy was performed in 2 patients,left hepatectomy in 3 patients,right posterior sectionectomy in 3 patients,segmentectomy in 2 patients,and partial hepatectomy in 4 patients.99mTc-GSA scintigraphy and computed tomography(CT)were performed to construct 3D-99mTc-GSA scintigraphy/vascular fused images.The conventional volume ratio of the planned resection region without tumor(%CT),and the functional volume ratio of the planned resection region without tumor(%GSA)were calculated.The discrepancy ratio was calculated as follows:discrepancy ratio=100-%GSA/%CT×100(%).Results:The%GSA(17.9±16.7%)was significantly lower than the%CT(21.5±17.6%)(P<0.036).In all except 2 patients,the%GSA was lower than the%CT.The discrepancy ratio ranged from-4%to 75%(median,20.7%).Conclusion:3D-99mTc-GSA scintigraphy/vascular fused images constructed using SYNAPSE VINCENT were useful for noninvasively performing functional liver volumetry in patients scheduled to undergo various patterns of hepatectomy.In planned resection regions without tumor,the functional volume ratio was about 20%lower than the conventional volume ratio.
文摘Background: An accurate preoperative volumetric assessment of donor liver is essential for successful living donor liver transplant by ensuring adequate remnant and graft recipient weight ratio (GRWR). Methods: The study cohort consisted of 744 right lobe (RL), 65 left lobe (LL) and 33 left lateral sector (LLS) grafts from July 2010 to January 2014. A semi-automated interactive commercial software called AW Volume share 6 was used for volumetry. Bland Altman plot was used for assessing the agreement between estimated graft weight (EGW) and actual graft weight (AGW). Results: There was no statistically significant difference between EGW and AGW for RL graft weight (722±134 vs. 717±126 gm;P=0.06). Although Bland Altman graph showed that 95% limits of agreement was more in LL (?164 to +110) than RL (?156 to +147) and LLS grafts (?137 to +239), CT scan significantly overestimated LL graft weight (EGW =460±118 gm vs. AGW =433±102 gm;P=0.003) and underestimated LLS graft weight (EGW =203±48 gm vs. AGW =254±49 gm;P<0.001). Conclusions: CT volumetry overestimate LL graft and underestimate LLS graft weight. This should be factored in when selecting LL graft by taking higher GRWR.
文摘Transplantation of the left lateral section(LLS)of the liver is now an established practice for treating advanced diffuse and unresectable focal liver diseases in children,with variants of the LLS primarily used in infants.However,the surgical challenge of matching the size of an adult donor's graft to the volume of a child's abdomen remains significant.This review explores historical developments,various approaches to measuring the required functional liver mass,and techniques to prevent complications associated with large-for-size grafts in infants.
基金funded by a Grant-in-Aid for Scientific Research(B)(Japan Society for The Promotion of Science,21H02849)Grant-in-Aid for Scientific Research(C)(Japan Society for The Promotion of Science,23K07013)+2 种基金Grant-in-Aid for Transformative Research Areas(A)(Japan Society for The Promotion of Science,JP21H05173)Grant-in-Aid by the Smoking Research FoundationGrant-in-Aid by the Telecommunications Advancement Foundation.
文摘Background Ongoing debates question the harm of internet use with the evolving technology,as many individuals transition from regular to problematic internet use(PIU).The habenula(Hb),located between the thalamus and the third ventricle,is implicated in various psychiatric disorders.In addition,personality features have been suggested to play a role in the pathophysiology of PIU.Aims This study aimed to investigate Hb volumetry in individuals with subclinical PIU and the mediating effect of personality traits on this relationship.Methods 110 healthy adults in this cross-sectional study underwent structural magnetic resonance imaging.Hb segmentation was performed using a deep learning technique.The Internet Addiction Test(IAT)and the NEO Five-Factor Inventory were used to assess the PIU level and personality,respectively.Partial Spearman's correlation analyses were performed to explore the reiationships between Hb volumetry,IAT and NEO.Multiple regression analysis was applied to identify personality traits that predict IAT scores.The significant trait was then treated as a mediator between Hb volume and IAT correlation in mediation analysis with a bootstrap value of 5000.Results Relative Hb volume was negatively correlated with IAT scores(partial rho=-0.142,p=0.009).The IAT score was positively correlated with neuroticism(partial rho=0.430,p<0.001)and negatively correlated with extraversion,agreeableness and conscientiousness(partial rho=-0.213,p<0.001;partial rho=-0.279,p<0.001;and partial rho=-0.327,p<0.001).There was a significant indirect effect of Hb volume on this model(β=-0.061,p=0.048,boot 95%confidence interval:-0.149 to-0.001).Conclusions This study uncovered a crucial link between reduced Hb volume and heightened PIU.Our findings highlight neuroticism as a key risk factor for developing PIU.Moreover,neuroticism was shown to mediate the relationship between Hb volume and PIU tendency,offering valuable insight into the complexities of this interaction.
文摘The development of digital intelligent diagnostic and treatment technology has opened countless new opportunities for liver surgery from the era of digital anatomy to a new era of digital diagnostics,virtual surgery simulation and using the created scenarios in real-time surgery using mixed reality.In this article,we described our experience on developing a dedicated 3 dimensional visualization and reconstruction software for surgeons to be used in advanced liver surgery and living donor liver transplantation.Furthermore,we shared the recent developments in the field by explaining the outreach of the software from virtual reality to augmented reality and mixed reality.
文摘The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases.While conventional magnetic resonance imaging(MRI) is widely used for brain and cerebellar morphologic evaluation,advanced MRI techniques allow the investigation of cerebellar microstructural and functional characteristics.Volumetry,voxel-based morphometry,diffusion MRI based fiber tractography,resting state and task related functional MRI,perfusion,and proton MR spectroscopy are among the most common techniques applied to the study of cerebellum.In the present review,after providing a brief description of each technique's advantages and limitations,we focus on their application to the study of cerebellar injury in major neurodegenerative diseases,such as multiple sclerosis,Parkinson's and Alzheimer's disease and hereditary ataxia.A brief introduction to the pathological substrate of cerebellar involvement is provided for each disease,followed by the review of MRI studies exploring structural and functional cerebellar abnormalities and by a discussion of the clinical relevance of MRI measures of cerebellar damage in terms of both clinical status and cognitive performance.
文摘Objective To measure volume and other parameters of normal adrenal glands in Chinese adults with 64-slice multidetector CT, to evaluate the relationship of volume result with age, sex and body size, and to explore the correlations between adrenal volume and other measurements. Methods This study was based on 125 acquired contrast-enhanced upper abdominal CT scans performed with a 64-slice CT. The final study group consisted of 81 patients (49 males, 32 females). Portal venous phase images were studied for the measurements. Both the reconstruction interval and thickness were 1.5 mm. Each adrenal gland was outlined manually with computer-assistant technology to calculate its volume. The maximal sectional area, length, width and thickness of each adrenal gland were also measured. Results The mean age of total population was 47.9±13.0 (range: 20-76) years. The left, right, and total adrenal gland volumes were 4.23±0.74 (range: 2.85-5.83) cm 3 , 4.26±0.86 (2.59-6.56) cm 3 , and 8.50±1.40 (5.80-11.39) cm 3 , respectively. These volumes increased with weight (r=0.381, 0.389, and 0.437 respectively, all P<0.001), height (r=0.386, P<0.001; r=0.297, P=0.007; r=0.384, P<0.001) and body surface area (r=0.406, 0.392, and 0.452, all P<0.001). There was no significant difference in left, right or total adrenal volume with regard to sex after applying General Linear Model procedure to reduce the impact of weight (F=1.304, 0.064, and 0.597, all P>0.05), nor did volume change significantly with age (r=-0.033, -0.014, and -0.026, all P>0.05). Nearly all descriptors of bilateral adrenal glands correlated with ipsilateral volume except thickness (r=-0.027, P=0.814) and width (r=0.166, P=0.138) in the left side. Among these parameters, length had a stronger correlation with volume than others in the both left (r=0.412, P<0.001) and right (r=0.516, P<0.001) adrenal glands. Conclusion Our study has defined the volume distribution and other parameters of normal adrenal glands in Chinese adults, which provide a baseline for future studies.
基金the European Union and Greek national funds through the Operational Program Competitiveness,Entrepreneurship and Innovation,No.T1EDK-03599.
文摘BACKGROUND Liver transplantation has evolved into a safe life-saving operation and remains the golden standard in the treatment of end stage liver disease.The main limiting factor in the application of liver transplantation is graft shortage.Many strategies have been developed in order to alleviate graft shortage,such as living donor partial liver transplantation and split liver transplantation for adult and pediatric patients.In these strategies,liver volume assessment is of paramount importance,as size mismatch can have severe consequences in the success of liver transplantation.AIM To evaluate the safety,feasibility,and accuracy of light detection and ranging(LIDAR)3D photography in the prediction of whole liver graft volume and mass.METHODS Seven liver grafts procured for orthotopic liver transplantation from brain deceased donors were prospectively measured with an LIDAR handheld camera and their mass was calculated and compared to their actual weight.RESULTS The mean error of all measurements was 17.03 g(range 3.56-59.33 g).Statistical analysis of the data yielded a Pearson correlation coefficient index of 0.9968,indicating a strong correlation between the values and a Student’s t-test P value of 0.26.Mean accuracy of the measurements was calculated at 97.88%.CONCLUSION Our preliminary data indicate that LIDAR scanning of liver grafts is a safe,cost-effective,and feasible method of ex vivo determination of whole liver volume and mass.More data are needed to determine the precision and accuracy of this method.
文摘To assess the correlation of renal volume measured on CT with aortic contrast enhancement on the hepatic arterial phase of dynamic CT, 64 consecutive patients (34 men, 30 women) were retrospectively examined. Renal volumes were measured on CT. The aortic contrast enhancement was inversely correlated with renal medullary volume (r = -0.52, p 0.0001), and renal cortical volume (r = -0.3, p = 0.02). Renal volume may have inverse correlation with aortic contrast enhancement on the hepatic arterial phase of dynamic CT. This might call for adjustment of contrast material dose based in part on renal volume in the future.
基金Funding was received from Lottery Health Research,The Neurological Foundation,Canterbury Research Foundation and The Neurology Trust.
文摘Background:The presence and extent of structural changes in the brain as a consequence of Parkinson’s disease(PD)is still poorly understood.Methods:High-resolution 3-tesla T1-weighted structural magnetic resonance images in sixty-five PD and 27 age-matched healthy control participants were examined.Putamen,caudate,and intracranial volumes were manually traced in the axial plane of 3D reconstructed images.Striatal nuclei volumes were normalized to intracranial volume for statistical comparison.Disease status was assessed using the Unified Parkinson’s Disease Rating Scale and Hoehn and Yahr scale.Cognitive status was assessed using global status tests and detailed neuropsychological testing.Results:Both caudate and putamen volumes were smaller in PD brains compared to controls after adjusting for age and gender.Caudate volumes were reduced by 11%(p=0.001)and putamen volumes by 8.1%(p=0.025).PD striatal volumes were not found to be significantly correlated with cognitive or motor decline.Conclusion:Small,but significant reductions in the volume of both the caudate and putamen occur in PD brains.These reductions are independent of the effects of age and gender,however the relation of these reductions to the functional loss of dopamine,which is characteristic of PD,remains unclear.
