Medical imaging is essential in modern health care,allowing accurate diagnosis and effective treatment planning.These images,however,often demonstrate low contrast,noise,and brightness distortion that reduce their dia...Medical imaging is essential in modern health care,allowing accurate diagnosis and effective treatment planning.These images,however,often demonstrate low contrast,noise,and brightness distortion that reduce their diagnostic reliability.This review presents a structured and comprehensive analysis of advanced histogram equalization(HE)-based techniques for medical image enhancement.Our review methodology encompasses:(1)classical HE approaches and related limitations in medical domains;(2)adaptive schemes like Adaptive Histogram Equalization(AHE)and Contrast Limited Adaptive Histogrma Equalization(CLAHE)and their advance variants;(3)brightnesspreserving schemes like BBHE and MMBEBHE and related algorithms;(4)dynamic and recursive histogram equalization methods incorporating DHE and RMSHE;(5)fuzzy logic-based enhancement methodologies addressing uncertainty and noise in medical images;and(6)hybrid optimization methodologies through the application of metaheuristic algorithms(World Cup Optimization,Particle Swarm Optimization,Genetic Algorithms,along with histogram-based methodologies.)There is also a comparative discussion given based on contrast improvement,image brightness preservation,noise management,and computational efficiency.Such advancements have better capabilities of improving image quality,which is more important for improved diagnosis and image analysis.展开更多
Synaptic pruning is a crucial process in synaptic refinement,eliminating unstable synaptic connections in neural circuits.This process is triggered and regulated primarily by spontaneous neural activity and experience...Synaptic pruning is a crucial process in synaptic refinement,eliminating unstable synaptic connections in neural circuits.This process is triggered and regulated primarily by spontaneous neural activity and experience-dependent mechanisms.The pruning process involves multiple molecular signals and a series of regulatory activities governing the“eat me”and“don't eat me”states.Under physiological conditions,the interaction between glial cells and neurons results in the clearance of unnecessary synapses,maintaining normal neural circuit functionality via synaptic pruning.Alterations in genetic and environmental factors can lead to imbalanced synaptic pruning,thus promoting the occurrence and development of autism spectrum disorder,schizophrenia,Alzheimer's disease,and other neurological disorders.In this review,we investigated the molecular mechanisms responsible for synaptic pruning during neural development.We focus on how synaptic pruning can regulate neural circuits and its association with neurological disorders.Furthermore,we discuss the application of emerging optical and imaging technologies to observe synaptic structure and function,as well as their potential for clinical translation.Our aim was to enhance our understanding of synaptic pruning during neural development,including the molecular basis underlying the regulation of synaptic function and the dynamic changes in synaptic density,and to investigate the potential role of these mechanisms in the pathophysiology of neurological diseases,thus providing a theoretical foundation for the treatment of neurological disorders.展开更多
BACKGROUND Congenital renal arteriovenous fistula(RAVF)is a clinically rare condition and frequently missed and misdiagnosed.Multimodal imaging techniques can pro-vide more detailed diagnostic information to help phys...BACKGROUND Congenital renal arteriovenous fistula(RAVF)is a clinically rare condition and frequently missed and misdiagnosed.Multimodal imaging techniques can pro-vide more detailed diagnostic information to help physicians more accurately diagnose and treat diseases.Combining imaging methods to diagnose RAVF has rarely been reported.CASE SUMMARY A 69-year-old female patient presented with gross hematuria that had persisted for 10 days.The patient underwent ultrasound examinations of the kidneys and renal blood vessels,enhanced computed tomography,three-dimensional com-puted tomography angiography,and digital subtraction angiography of the renal arteries.These revealed dilatation of the left renal vein and abnormal shunting between the left renal artery and vein.The patient was diagnosed with a left RAVF using combined multimodal imaging techniques.The patient was treated with left renal artery embolization immediately after renal arteriography.Hema-turia resolved following the left renal artery embolization without serious bleeding or other complications.The patient made a full recovery after one year of postoperative follow-up.CONCLUSION Multimodal imaging techniques complement each other when diagnosing RAVF,providing detailed diagnostic information that can aid in accurate diagnosis and treatment.In addition,this case reminds the sonographer to pay more attention to the color doppler flow imaging and blood flow spectrum when examining the kidney,so as to avoid misdiagnosis of renal cystic lesions as renal cysts and missed diagnosis of RAVF.展开更多
Optical imaging has been pivotal in biological research(e.g.,cellular/developmental biology)for over two centuries.Recent advances like super-resolution fluorescence and nonlinear optical microscopy enable nanoscale s...Optical imaging has been pivotal in biological research(e.g.,cellular/developmental biology)for over two centuries.Recent advances like super-resolution fluorescence and nonlinear optical microscopy enable nanoscale studies of live cells and animals,yet their application to marine mollusks-key marine ecosystem species,remains underexplored.This review summarizes optical imaging techniques and their use in investigating marine mollusks across molecular,cellular,tissue,and individual levels.It highlights promising avenues for novel imaging methods to unravel the structures and functions of these organisms in future research,with a focus on advancements in applying cutting-edge optical techniques across these hierarchical levels.Given optical imaging's significance in elucidating marine mollusks'ecological and genetic information,this field deserves substantial attention and support.The review aims to address existing gaps,providing researchers and practitioners with comprehensive insights to foster further progress in this domain.展开更多
Water electrolysis is pivotal for converting renewable energy into clean hydrogen fuel,addressing global energy demand sustainably.However,the development of highly efficient and cost-effective catalysts for the oxyge...Water electrolysis is pivotal for converting renewable energy into clean hydrogen fuel,addressing global energy demand sustainably.However,the development of highly efficient and cost-effective catalysts for the oxygen evolution reaction(OER)remains a significant challenge,particularly at the industrial scale.This report explores a newly discovered pathway,the oxide path mechanism(OPM) for OER-mechanism involving the oxide formation and evolution during the reaction,emphasizing its potential to overcome existing limitations.OPM enables direct O-O coupling without oxygen vacancies,offering superior stability.We detail both classical and innovative in-situ characterization techniques that are central to unraveling the OER mechanism.The advanced in-situ electrochemical techniques,such as inductively coupled plasma mass spectroscopy,X-ray photoelectron spectroscopy,and Mössbauer spectroscopy,coupled with in-situ structural analyses,provide crucial insights into the catalyst surface,the electrode-electrolyte interface and the kinetics of OER.This review provides a systematic analysis integrating classical electrochemical methods with advanced in-situ/operando techniques,specifically focusing on understanding OPM.While numerous studies have examined individual characterization methods,this study systematically integrates traditional electrochemical approaches with in-situ and operando techniques,offering critical insights into their complementary roles in elucidating reaction pathways.The integration of these methodologies provides unprecedented understanding of catalyst behavior under operational conditions,guiding the rational design of next-generation OER catalysts.Furthermore,we discuss essential standardized test toolkits and protocols,such as those for rotating disk electrode and membrane electrode assembly,which are vital for ensuring reproducibility and scalability in OER catalyst research.展开更多
Objective： To evaluate retrospectively the MRI and MRS features of gliomatosis cerebri for investigating the clinical value of MR imaging and MR spectroscopy in the diagnosis of gliomatosis cerebri. Methods： Seven p...Objective： To evaluate retrospectively the MRI and MRS features of gliomatosis cerebri for investigating the clinical value of MR imaging and MR spectroscopy in the diagnosis of gliomatosis cerebri. Methods： Seven patients with gliomatosis cerebri proved clinically and histopathologically were analyzed retrospectively. All patients underwent MRI and three of them underwent MRS. Results： The tumors involved at least 2 cerebral lobes in all patients, with low signal intensity on TlWI and high intensity on T2WI. The area invaded by tumor showed cortex swelling and no obvious mass effect. The tumors presented small nodules or plaque lesions on enhance-MRI in 3 cases, and no contrast enhancement was shown in the rest 4 cases. All patients with MRS showed elevated Cho, Cho/Cr and Cho/NAA levels as well as varying degrees of decreased NAA. Conclusion： MRI is the method of first choice to detect gliomatosis cerebri so far, MR spectroscopy might be helpful in its differential diagnosis.展开更多
Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fatcon...Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fatcontaining vacuoles within their cytoplasm, which is the key histological feature. In contrast to ALD, NAFLD is commonly associated with metabolic syndrome, obesity and insulin resistance. To determine increased liver fat content, liver biopsy is currently considered the gold standard. Besides the invasive technique, various other non-invasive techniques have been developed, such as ultrasound, computed tomography (CT), magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) based methods. Among these techniques, ultrasound and CT provide only qualitative information about hepatic steatosis, whereas MRS-or MRI-based methods are able to determine even small amounts of fat accurately. These non-invasive magnetic resonance techniques have already proven their great potential, especially in longitudinal and cross-sectional studies regarding various metabolic conditions and medical treatment regimens. In this review, the most common, non-invasive MRS/MRI techniques for assessment of intrahepatic lipid content are described with their inherent advantages and limitations.展开更多
The terahertz band lies between the microwave and infrared regions of the electromagnetic spectrum.This radiation has very low photon energy and thus it does not pose any ionization hazard for biological tissues.It is...The terahertz band lies between the microwave and infrared regions of the electromagnetic spectrum.This radiation has very low photon energy and thus it does not pose any ionization hazard for biological tissues.It is strongly attenuated by water and very sensitive to water content.Unique absorption spectra due to intermolecular vibrations in this region have been found in different biological materials.These unique features make tera-hertz imaging very attractive for medical applications in order to provide complimentary information to existing imaging techniques.There has been an increasing interest in terahertz imaging and spectroscopy of biologically related applications within the last few years and more and more terahertz spectra are being reported.This paper introduces terahertz technology and provides a short review of recent advances in terahertz imaging and spectroscopy techniques,and a number of applications such as molecular spectroscopy,tissue characterization and skin imaging are discussed.展开更多
Hepatocellular carcinoma(HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization(TACE) can significantly improve the survival rate of patients...Hepatocellular carcinoma(HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization(TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusionweighted magnetic resonance imaging(MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusionweighted imaging, blood oxygen level-dependent MRI, positron emission tomography(PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.展开更多
Benign gallbladder diseases usually present with intraluminal lesions and localized or diffuse wall thickening.Intraluminal lesions of the gallbladder include gallstones,cholesterol polyps,adenomas,or sludge and polyp...Benign gallbladder diseases usually present with intraluminal lesions and localized or diffuse wall thickening.Intraluminal lesions of the gallbladder include gallstones,cholesterol polyps,adenomas,or sludge and polypoid type of gallbladder cancer must subsequently be excluded.Polyp size,stalk width,and enhancement intensity on contrast-enhanced ultrasound and degree of diffusion restriction may help differentiate cholesterol polyps and adenomas from gallbladder cancer.Localized gallbladder wall thickening is largely due to segmental or focal gallbladder adenomyomatosis,although infiltrative cancer may present similarly.Identification of Rokitansky-Aschoff sinuses is pivotal in diagnosing adenomyomatosis.The layered pattern,degree of enhancement,and integrity of the wall are imaging clues that help discriminate innocuous thickening from gallbladder cancer.High-resolution ultrasound is especially useful for analyzing the layering of gallbladder wall.A diffusely thickened wall is frequently seen in inflammatory processes of the gallbladder.Nevertheless,it is important to check for coexistent cancer in instances of acute cholecystitis.Ultrasound used alone is limited in evaluating complicated cholecystitis and often requires complementary computed tomography.In chronic cholecystitis,preservation of a two-layered wall and weak wall enhancement are diagnostic clues for excluding malignancy.Magnetic resonance imaging in conjunction with diffusion-weighted imaging helps to differentiate xathogranulomatous cholecystitis from gallbladder cancer by identifying the presence of fat and degree of diffusion restriction.Such distinctions require a familiarity with typical imaging features of various gallbladder diseases and an understanding of the roles that assorted imaging modalities play in gallbladder evaluations.展开更多
Hepatic encephalopathy （HE） is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease and results from hepatocellular failure and/or portosystemic shunting. The manifestat...Hepatic encephalopathy （HE） is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease and results from hepatocellular failure and/or portosystemic shunting. The manifestations of HE are widely variable and involve a spectrum from mild subclinical disturbance to deep coma. Research interest has focused on the role of circulating gut-derived toxins, particularly ammonia, the development of brain swelling and changes in cerebral neurotransmitter systems that lead to global CNS depression and disordered function. Until recently the direct investigation of cerebral function has been difficult in man. However, new magnetic resonance imaging （MRI） techniques provide a non-invasive means of assessment of changes in brain volume （coregistered MRI） and impaired brain function （fMRI）, while proton magnetic resonance spectroscopy （^1H MRS） detects changes in brain biochemistry, including direct measurement of cerebral osmolytes, such as myoinositol, glutamate and glutamine which govern processes intrinsic to cellular homeostasis, including the accumulation of intracellular water. The concentrations of these intracellular osmolytes alter with hyperammonaemia. MRS-detected metabolite abnormalities correlate with the severity of neuropsychiatric impairment and since MR spectra return towards normal after treatment, the technique may be of use in objective patient monitoring and in assessing the effectiveness of various treatment regimens.展开更多
In recent years, advanced magnetic resonance imaging(MRI) techniques, such as magnetic resonance spec-troscopy, diffusion weighted imaging, diffusion tensor imaging and perfusion weighted imaging have been used in ord...In recent years, advanced magnetic resonance imaging(MRI) techniques, such as magnetic resonance spec-troscopy, diffusion weighted imaging, diffusion tensor imaging and perfusion weighted imaging have been used in order to resolve demanding diagnostic prob-lems such as brain tumor characterization and grading, as these techniques offer a more detailed and non-invasive evaluation of the area under study. In the last decade a great effort has been made to import and utilize intelligent systems in the so-called clinical deci-sion support systems(CDSS) for automatic processing, classification, evaluation and representation of MRI data in order for advanced MRI techniques to become a part of the clinical routine, since the amount of data from the aforementioned techniques has gradually inticle is two-fold. The first is to review and evaluate the progress that has been made towards the utilization of CDSS based on data from advanced MRI techniques. The second is to analyze and propose the future work that has to be done, based on the existing problems and challenges, especially taking into account the new imaging techniques and parameters that can be intro-duced into intelligent systems to significantly improve their diagnostic specificity and clinical application.展开更多
Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal d...Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.展开更多
In the world,nonalcoholic fatty liver disease(NAFLD)accounts for majority of diffuse hepatic diseases.Notably,substantial liver fat accumulation can trigger and accelerate hepatic fibrosis,thus contributing to disease...In the world,nonalcoholic fatty liver disease(NAFLD)accounts for majority of diffuse hepatic diseases.Notably,substantial liver fat accumulation can trigger and accelerate hepatic fibrosis,thus contributing to disease progression.Moreover,the presence of NAFLD not only puts adverse influences for liver but is also associated with an increased risk of type 2 diabetes and cardiovascular diseases.Therefore,early detection and quantified measurement of hepatic fat content are of great importance.Liver biopsy is currently the most accurate method for the evaluation of hepatic steatosis.However,liver biopsy has several limitations,namely,its invasiveness,sampling error,high cost and moderate intraobserver and interobserver reproducibility.Recently,various quantitative imaging techniques have been developed for the diagnosis and quantified measurement of hepatic fat content,including ultrasound-or magnetic resonancebased methods.These quantitative imaging techniques can provide objective continuous metrics associated with liver fat content and be recorded for comparison when patients receive check-ups to evaluate changes in liver fat content,which is useful for longitudinal follow-up.In this review,we introduce several imaging techniques and describe their diagnostic performance for the diagnosis and quantified measurement of hepatic fat content.展开更多
1 H-magnetic resonance spectroscopy imaging and diffusion tensor imaging were performed in 19 patients with mild depression and in 13 controls.The mean age of the patients was 31 years.The mean Hamilton depression sco...1 H-magnetic resonance spectroscopy imaging and diffusion tensor imaging were performed in 19 patients with mild depression and in 13 controls.The mean age of the patients was 31 years.The mean Hamilton depression score of the patients was 22.5±13.2.N-acetylaspartate,choline and creatine concentrations and the average diffusion coefficient and fractional anisotropy values were measured in the bilateral hippocampus,striatum,thalamus and prefrontal deep white matter. Compared with the control group,the mild depressed patients had：（1）a higher choline/creatine ratio and a negative correlation between the choline/creatine ratio and the average diffusion coefficient in the hippocampus;（2）a lower choline/creatine ratio and a higher fractional anisotropy in the striatum;（3）a lower fractional anisotropy and a positive correlation between the fractional anisotropy and the choline/creatine ratio in the prefrontal deep white matter;and（4）a higher average diffusion coefficient and a positive correlation between the choline/creatine ratio and the N-acetylaspartate/creatine ratio in the thalamus,as well as positive correlation between the choline/creatine ratio and Hamilton depression scores.These data suggest evidence of abnormal connectivity in neurofibrotic microstructures and abnormal metabolic alterations in the limbic-cortical-striatal-pallidal-thalamic neural circuit in patients with mild depression.展开更多
Traditional Chinese medicine(TCM)is a treasure of the Chinese nation,providing effective solutions to current medical requisites.Various spectral techniques are undergoing continuous development and provide new and re...Traditional Chinese medicine(TCM)is a treasure of the Chinese nation,providing effective solutions to current medical requisites.Various spectral techniques are undergoing continuous development and provide new and reliable means for evaluating the efficacy and quality of TCM.Because spectral techniques are noninvasive,convenient,and sensitive,they have been widely applied to in vitro and in vivo TCM evaluation systems.In this paper,previous achievements and current progress in the research on spectral technologies(including fluorescence spectroscopy,photoacoustic imaging,infrared thermal imaging,laser-induced breakdown spectroscopy,hyperspectral imaging,and surface enhanced Raman spectroscopy)are discussed.The advantages and disadvantages of each technology are also presented.Moreover,the future applications of spectral imaging to identify the origins,components,and pesticide residues of TCM in vitro are elucidated.Subsequently,the evaluation of the efficacy of TCM in vivo is presented.Identifying future applications of spectral imaging is anticipated to promote medical research as well as scientific and technological explorations.展开更多
The investigation of small bowel morphology is often mandatory in many patients with Crohn's disease. Traditional radiological techniques (small bowel enteroclysis and small bowel follow-through) have long been th...The investigation of small bowel morphology is often mandatory in many patients with Crohn's disease. Traditional radiological techniques (small bowel enteroclysis and small bowel follow-through) have long been the only suitable methods for this purpose. In recent years, several alternative imaging techniques have been proposed. To review the most recent advances in imaging studies of the small bowel, with particular reference to their possible application in Crohn's disease, we conducted a complete review of the most important studies in which traditional and newer imaging methods were performed and compared in patients with Crohn's disease. Several radiological and endoscopic techniques are now available for the study of the small bowel; each of them is characterized by a distinct profile of favourable and unfavourable features. In some cases, they may also be used as complementary rather than alternative techniques. In everyday practice, the choice of the technique to be used stands upon its availability and a careful evaluation of diagnostic accuracy, clinical usefulness, safety and cost. The recent development ofinnovative imaging techniques has opened a new and exciting area in the exploration of the small bowel in Crohn's disease patients.展开更多
Crohn’s disease(CD)is a chronic,non-specific granulomatous inflammatory disorder that commonly affects the small intestine and is a phenotype of inflammatory bowel disease(IBD).CD is prone to relapse,and its incidenc...Crohn’s disease(CD)is a chronic,non-specific granulomatous inflammatory disorder that commonly affects the small intestine and is a phenotype of inflammatory bowel disease(IBD).CD is prone to relapse,and its incidence displays a persistent increase in developing countries.However,the pathogenesis of CD is poorly understood,with some studies emphasizing the link between CD and the intestinal microbiota.Specifically,studies point to the brain-gut-enteric microbiota axis as a key player in the occurrence and development of CD.Furthermore,investigations have shown whitematter lesions and neurologic deficits in patients with IBD.Based on these findings,brain activity changes in CD patients have been detected by blood oxygenation level dependent functional magnetic resonance imaging(BOLD-f MRI).BOLD-f MRI functions by detecting a local increase in relative blood oxygenation that results from neurotransmitter activity and thus reflects local neuronal firing rates.Therefore,biochemical concentrations of neurotransmitters or metabolites may change in corresponding brain regions of CD patients.To further study this phenomenon,brain changes of CD patients can be detected non-invasively,effectively and accurately by BOLD-f MRI combined with magnetic resonance spectroscopy(MRS).This approach can further shed light on the mechanisms of the occurrence and development of neurological CD.Overall,this paper reviews the current status and prospects on fMRI and MRS for evaluation of patients with CD based on the brain-gut-enteric microbiota axis.展开更多
1H magnetic resonance spectroscopy and diffusion weighted imaging features of the cerebellar vermis in 17 medulloblastoma patients were retrospectively analyzed, and 17 healthy volunteers were selected as controls. 1H...1H magnetic resonance spectroscopy and diffusion weighted imaging features of the cerebellar vermis in 17 medulloblastoma patients were retrospectively analyzed, and 17 healthy volunteers were selected as controls. 1H magnetic resonance spectroscopy showed that in all 17 medulloblastoma patients, N-acetyl aspartate and creatine peaks were significantly decreased, the choline peak was significantly increased, and there was evidence of a myo-inositol peak. Further, 11 patients showed a low taurine peak at 3.4 ppm, five patients showed a lipid peak at 0.9-1.3 ppm, and three patients showed a negative lactic acid peak at 1.33 ppm. Compared with the control group, the ratios of N-acetyl aspartate/choline and N-acetyl aspartate/creatine were significantly decreased, and the ratio of choline/creatine was increased, in medulloblastoma patients. Diffusion weighted imaging displayed hyperintensity and decreased apparent diffusion coefficient in medulloblastoma patients. These findings indicate that 1H magnetic resonance spectroscopy and diffusion weighted imaging are useful for qualitative diagnosis of medulloblastoma.展开更多
AIM： To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid （CSF） volume and clinical signs in controls and in pa...AIM： To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid （CSF） volume and clinical signs in controls and in patients with acute liver failure （ALF） and acute- on-chronic liver failure （ACLF）, by comparing changes in conventional magnetic resonance imaging （MRI）, in vivo proton magnetic resonance spectroscopy （PMRS） and diffusion tensor imaging （DTI） before and after its infusion.METHODS： Five patients each with ALF and ACLF in grade 3 or 4 hepatic encephalopathy and with clinical signs of raised intracranial pressure were studied along with five healthy volunteers. After baseline MRI, an intravenous bolus of 20% mannitol solution was given over 10 min in controls as well as in patients with ALF and ACLE Repeat MRI for the same position was acquired 30 rnin after completing the rnannitol injection. RESULTS： No statistically significant difference was observed between controls and patients with ALF and ACLF in metabolite ratios, DTI metrics and brain volume or CSF volume following 45 rain of mannitol infusion. There was no change in clinical status at the end of post-mannitol imaging. CONCLUSION： The osmotic effect of mannitol did not result in significant reduction of brain water content, alteration in metabolite ratios or any change in the clinical status of these patients during or within 45 min of mannitol infusion.展开更多
基金funded by the Deanship of Scientific Research(DSR)at King Abdulaziz University,Jeddah,under grant No.(IFPDP-261-22).
文摘Medical imaging is essential in modern health care,allowing accurate diagnosis and effective treatment planning.These images,however,often demonstrate low contrast,noise,and brightness distortion that reduce their diagnostic reliability.This review presents a structured and comprehensive analysis of advanced histogram equalization(HE)-based techniques for medical image enhancement.Our review methodology encompasses:(1)classical HE approaches and related limitations in medical domains;(2)adaptive schemes like Adaptive Histogram Equalization(AHE)and Contrast Limited Adaptive Histogrma Equalization(CLAHE)and their advance variants;(3)brightnesspreserving schemes like BBHE and MMBEBHE and related algorithms;(4)dynamic and recursive histogram equalization methods incorporating DHE and RMSHE;(5)fuzzy logic-based enhancement methodologies addressing uncertainty and noise in medical images;and(6)hybrid optimization methodologies through the application of metaheuristic algorithms(World Cup Optimization,Particle Swarm Optimization,Genetic Algorithms,along with histogram-based methodologies.)There is also a comparative discussion given based on contrast improvement,image brightness preservation,noise management,and computational efficiency.Such advancements have better capabilities of improving image quality,which is more important for improved diagnosis and image analysis.
基金supported by the National Natural Science Foundation of China,No.31760290,82160688the Key Development Areas Project of Ganzhou Science and Technology,No.2022B-SF9554(all to XL)。
文摘Synaptic pruning is a crucial process in synaptic refinement,eliminating unstable synaptic connections in neural circuits.This process is triggered and regulated primarily by spontaneous neural activity and experience-dependent mechanisms.The pruning process involves multiple molecular signals and a series of regulatory activities governing the“eat me”and“don't eat me”states.Under physiological conditions,the interaction between glial cells and neurons results in the clearance of unnecessary synapses,maintaining normal neural circuit functionality via synaptic pruning.Alterations in genetic and environmental factors can lead to imbalanced synaptic pruning,thus promoting the occurrence and development of autism spectrum disorder,schizophrenia,Alzheimer's disease,and other neurological disorders.In this review,we investigated the molecular mechanisms responsible for synaptic pruning during neural development.We focus on how synaptic pruning can regulate neural circuits and its association with neurological disorders.Furthermore,we discuss the application of emerging optical and imaging technologies to observe synaptic structure and function,as well as their potential for clinical translation.Our aim was to enhance our understanding of synaptic pruning during neural development,including the molecular basis underlying the regulation of synaptic function and the dynamic changes in synaptic density,and to investigate the potential role of these mechanisms in the pathophysiology of neurological diseases,thus providing a theoretical foundation for the treatment of neurological disorders.
文摘BACKGROUND Congenital renal arteriovenous fistula(RAVF)is a clinically rare condition and frequently missed and misdiagnosed.Multimodal imaging techniques can pro-vide more detailed diagnostic information to help physicians more accurately diagnose and treat diseases.Combining imaging methods to diagnose RAVF has rarely been reported.CASE SUMMARY A 69-year-old female patient presented with gross hematuria that had persisted for 10 days.The patient underwent ultrasound examinations of the kidneys and renal blood vessels,enhanced computed tomography,three-dimensional com-puted tomography angiography,and digital subtraction angiography of the renal arteries.These revealed dilatation of the left renal vein and abnormal shunting between the left renal artery and vein.The patient was diagnosed with a left RAVF using combined multimodal imaging techniques.The patient was treated with left renal artery embolization immediately after renal arteriography.Hema-turia resolved following the left renal artery embolization without serious bleeding or other complications.The patient made a full recovery after one year of postoperative follow-up.CONCLUSION Multimodal imaging techniques complement each other when diagnosing RAVF,providing detailed diagnostic information that can aid in accurate diagnosis and treatment.In addition,this case reminds the sonographer to pay more attention to the color doppler flow imaging and blood flow spectrum when examining the kidney,so as to avoid misdiagnosis of renal cystic lesions as renal cysts and missed diagnosis of RAVF.
基金supported by the National Natural Science Foundation of China(T2421003/22327802/41806142)Guangdong Basic and Applied Basic Foundation(2025A1515011484/2022A1515011845)+1 种基金Shenzhen Key Laboratory of Photonics and Biophotonics(ZDSYS20210623092006020)Medical-Engineering Interdisciplinary Research Foundation of Shenzhen University(2023YG033).
文摘Optical imaging has been pivotal in biological research(e.g.,cellular/developmental biology)for over two centuries.Recent advances like super-resolution fluorescence and nonlinear optical microscopy enable nanoscale studies of live cells and animals,yet their application to marine mollusks-key marine ecosystem species,remains underexplored.This review summarizes optical imaging techniques and their use in investigating marine mollusks across molecular,cellular,tissue,and individual levels.It highlights promising avenues for novel imaging methods to unravel the structures and functions of these organisms in future research,with a focus on advancements in applying cutting-edge optical techniques across these hierarchical levels.Given optical imaging's significance in elucidating marine mollusks'ecological and genetic information,this field deserves substantial attention and support.The review aims to address existing gaps,providing researchers and practitioners with comprehensive insights to foster further progress in this domain.
基金funded by the EU H2020 Marie Skłodowska-Curie Fellowship (1439425)the National Natural Science Foundation of China (No. 52171199 and 22479011)
文摘Water electrolysis is pivotal for converting renewable energy into clean hydrogen fuel,addressing global energy demand sustainably.However,the development of highly efficient and cost-effective catalysts for the oxygen evolution reaction(OER)remains a significant challenge,particularly at the industrial scale.This report explores a newly discovered pathway,the oxide path mechanism(OPM) for OER-mechanism involving the oxide formation and evolution during the reaction,emphasizing its potential to overcome existing limitations.OPM enables direct O-O coupling without oxygen vacancies,offering superior stability.We detail both classical and innovative in-situ characterization techniques that are central to unraveling the OER mechanism.The advanced in-situ electrochemical techniques,such as inductively coupled plasma mass spectroscopy,X-ray photoelectron spectroscopy,and Mössbauer spectroscopy,coupled with in-situ structural analyses,provide crucial insights into the catalyst surface,the electrode-electrolyte interface and the kinetics of OER.This review provides a systematic analysis integrating classical electrochemical methods with advanced in-situ/operando techniques,specifically focusing on understanding OPM.While numerous studies have examined individual characterization methods,this study systematically integrates traditional electrochemical approaches with in-situ and operando techniques,offering critical insights into their complementary roles in elucidating reaction pathways.The integration of these methodologies provides unprecedented understanding of catalyst behavior under operational conditions,guiding the rational design of next-generation OER catalysts.Furthermore,we discuss essential standardized test toolkits and protocols,such as those for rotating disk electrode and membrane electrode assembly,which are vital for ensuring reproducibility and scalability in OER catalyst research.
文摘Objective： To evaluate retrospectively the MRI and MRS features of gliomatosis cerebri for investigating the clinical value of MR imaging and MR spectroscopy in the diagnosis of gliomatosis cerebri. Methods： Seven patients with gliomatosis cerebri proved clinically and histopathologically were analyzed retrospectively. All patients underwent MRI and three of them underwent MRS. Results： The tumors involved at least 2 cerebral lobes in all patients, with low signal intensity on TlWI and high intensity on T2WI. The area invaded by tumor showed cortex swelling and no obvious mass effect. The tumors presented small nodules or plaque lesions on enhance-MRI in 3 cases, and no contrast enhancement was shown in the rest 4 cases. All patients with MRS showed elevated Cho, Cho/Cr and Cho/NAA levels as well as varying degrees of decreased NAA. Conclusion： MRI is the method of first choice to detect gliomatosis cerebri so far, MR spectroscopy might be helpful in its differential diagnosis.
文摘Hepatic steatosis as the most prevalent liver disorder can either be related to alcoholic liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD). In both conditions, hepatocytes excessively accumulate fatcontaining vacuoles within their cytoplasm, which is the key histological feature. In contrast to ALD, NAFLD is commonly associated with metabolic syndrome, obesity and insulin resistance. To determine increased liver fat content, liver biopsy is currently considered the gold standard. Besides the invasive technique, various other non-invasive techniques have been developed, such as ultrasound, computed tomography (CT), magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) based methods. Among these techniques, ultrasound and CT provide only qualitative information about hepatic steatosis, whereas MRS-or MRI-based methods are able to determine even small amounts of fat accurately. These non-invasive magnetic resonance techniques have already proven their great potential, especially in longitudinal and cross-sectional studies regarding various metabolic conditions and medical treatment regimens. In this review, the most common, non-invasive MRS/MRI techniques for assessment of intrahepatic lipid content are described with their inherent advantages and limitations.
基金Supported by in part for this work from the Research Grants Council of the Hong Kong Government and the Shun Hing Institute of Advanced Engineering, Hong Kong
文摘The terahertz band lies between the microwave and infrared regions of the electromagnetic spectrum.This radiation has very low photon energy and thus it does not pose any ionization hazard for biological tissues.It is strongly attenuated by water and very sensitive to water content.Unique absorption spectra due to intermolecular vibrations in this region have been found in different biological materials.These unique features make tera-hertz imaging very attractive for medical applications in order to provide complimentary information to existing imaging techniques.There has been an increasing interest in terahertz imaging and spectroscopy of biologically related applications within the last few years and more and more terahertz spectra are being reported.This paper introduces terahertz technology and provides a short review of recent advances in terahertz imaging and spectroscopy techniques,and a number of applications such as molecular spectroscopy,tissue characterization and skin imaging are discussed.
基金Supported by Projects of Department of Science and Technology of Sichuan Province,No.2016JY0105
文摘Hepatocellular carcinoma(HCC) is one of the major causes of morbidity and mortality in patients with chronic liver disease. Transarterial chemoembolization(TACE) can significantly improve the survival rate of patients with HCC and is the first treatment choice for patients who are not suitable for surgical resections. The evaluation of the response to TACE treatment affects not only the assessment of the therapy efficacy but also the development of the next step in the treatment plan. The use of imaging to examine changes in tumor volume to assess the response of solid tumors to treatment has been controversial. In recent years, the emergence of new imaging technology has made it possible to observe the response of tumors to treatment prior to any morphological changes. In this article, the advances in studies reporting the use of computed tomography perfusion imaging, diffusionweighted magnetic resonance imaging(MRI), intravoxel incoherent motion, diffusion kurtosis imaging, magnetic resonance spectroscopy, magnetic resonance perfusionweighted imaging, blood oxygen level-dependent MRI, positron emission tomography(PET)/computed tomography and PET/MRI to assess the TACE treatment response are reviewed.
文摘Benign gallbladder diseases usually present with intraluminal lesions and localized or diffuse wall thickening.Intraluminal lesions of the gallbladder include gallstones,cholesterol polyps,adenomas,or sludge and polypoid type of gallbladder cancer must subsequently be excluded.Polyp size,stalk width,and enhancement intensity on contrast-enhanced ultrasound and degree of diffusion restriction may help differentiate cholesterol polyps and adenomas from gallbladder cancer.Localized gallbladder wall thickening is largely due to segmental or focal gallbladder adenomyomatosis,although infiltrative cancer may present similarly.Identification of Rokitansky-Aschoff sinuses is pivotal in diagnosing adenomyomatosis.The layered pattern,degree of enhancement,and integrity of the wall are imaging clues that help discriminate innocuous thickening from gallbladder cancer.High-resolution ultrasound is especially useful for analyzing the layering of gallbladder wall.A diffusely thickened wall is frequently seen in inflammatory processes of the gallbladder.Nevertheless,it is important to check for coexistent cancer in instances of acute cholecystitis.Ultrasound used alone is limited in evaluating complicated cholecystitis and often requires complementary computed tomography.In chronic cholecystitis,preservation of a two-layered wall and weak wall enhancement are diagnostic clues for excluding malignancy.Magnetic resonance imaging in conjunction with diffusion-weighted imaging helps to differentiate xathogranulomatous cholecystitis from gallbladder cancer by identifying the presence of fat and degree of diffusion restriction.Such distinctions require a familiarity with typical imaging features of various gallbladder diseases and an understanding of the roles that assorted imaging modalities play in gallbladder evaluations.
基金Supported by grants from BUPA, the Royal College of Physicians of London and Paddington Charitable Trust, St Mary's,London. The European Association for the Study of the Liver, the British Medical Research Council (G9900178)Philips Medical Systems (Cleveland, Ohio, USA) and the United Kingdom Department of Health provided support for some of the studies outlined
文摘Hepatic encephalopathy （HE） is a common neuropsychiatric abnormality, which complicates the course of patients with liver disease and results from hepatocellular failure and/or portosystemic shunting. The manifestations of HE are widely variable and involve a spectrum from mild subclinical disturbance to deep coma. Research interest has focused on the role of circulating gut-derived toxins, particularly ammonia, the development of brain swelling and changes in cerebral neurotransmitter systems that lead to global CNS depression and disordered function. Until recently the direct investigation of cerebral function has been difficult in man. However, new magnetic resonance imaging （MRI） techniques provide a non-invasive means of assessment of changes in brain volume （coregistered MRI） and impaired brain function （fMRI）, while proton magnetic resonance spectroscopy （^1H MRS） detects changes in brain biochemistry, including direct measurement of cerebral osmolytes, such as myoinositol, glutamate and glutamine which govern processes intrinsic to cellular homeostasis, including the accumulation of intracellular water. The concentrations of these intracellular osmolytes alter with hyperammonaemia. MRS-detected metabolite abnormalities correlate with the severity of neuropsychiatric impairment and since MR spectra return towards normal after treatment, the technique may be of use in objective patient monitoring and in assessing the effectiveness of various treatment regimens.
文摘In recent years, advanced magnetic resonance imaging(MRI) techniques, such as magnetic resonance spec-troscopy, diffusion weighted imaging, diffusion tensor imaging and perfusion weighted imaging have been used in order to resolve demanding diagnostic prob-lems such as brain tumor characterization and grading, as these techniques offer a more detailed and non-invasive evaluation of the area under study. In the last decade a great effort has been made to import and utilize intelligent systems in the so-called clinical deci-sion support systems(CDSS) for automatic processing, classification, evaluation and representation of MRI data in order for advanced MRI techniques to become a part of the clinical routine, since the amount of data from the aforementioned techniques has gradually inticle is two-fold. The first is to review and evaluate the progress that has been made towards the utilization of CDSS based on data from advanced MRI techniques. The second is to analyze and propose the future work that has to be done, based on the existing problems and challenges, especially taking into account the new imaging techniques and parameters that can be intro-duced into intelligent systems to significantly improve their diagnostic specificity and clinical application.
基金supported by the Natural Science Foundation of Sichuan Province of China,Nos.2022NSFSC1545 (to YG),2022NSFSC1387 (to ZF)the Natural Science Foundation of Chongqing of China,Nos.CSTB2022NSCQ-LZX0038,cstc2021ycjh-bgzxm0035 (both to XT)+3 种基金the National Natural Science Foundation of China,No.82001378 (to XT)the Joint Project of Chongqing Health Commission and Science and Technology Bureau,No.2023QNXM009 (to XT)the Science and Technology Research Program of Chongqing Education Commission of China,No.KJQN202200435 (to XT)the Chongqing Talents:Exceptional Young Talents Project,No.CQYC202005014 (to XT)。
文摘Epilepsy can be defined as a dysfunction of the brain network,and each type of epilepsy involves different brain-network changes that are implicated diffe rently in the control and propagation of interictal or ictal discharges.Gaining more detailed information on brain network alterations can help us to further understand the mechanisms of epilepsy and pave the way for brain network-based precise therapeutic approaches in clinical practice.An increasing number of advanced neuroimaging techniques and electrophysiological techniques such as diffusion tensor imaging-based fiber tra ctography,diffusion kurtosis imaging-based fiber tractography,fiber ball imagingbased tra ctography,electroencephalography,functional magnetic resonance imaging,magnetoencephalography,positron emission tomography,molecular imaging,and functional ultrasound imaging have been extensively used to delineate epileptic networks.In this review,we summarize the relevant neuroimaging and neuroelectrophysiological techniques for assessing structural and functional brain networks in patients with epilepsy,and extensively analyze the imaging mechanisms,advantages,limitations,and clinical application ranges of each technique.A greater focus on emerging advanced technologies,new data analysis software,a combination of multiple techniques,and the construction of personalized virtual epilepsy models can provide a theoretical basis to better understand the brain network mechanisms of epilepsy and make surgical decisions.
文摘In the world,nonalcoholic fatty liver disease(NAFLD)accounts for majority of diffuse hepatic diseases.Notably,substantial liver fat accumulation can trigger and accelerate hepatic fibrosis,thus contributing to disease progression.Moreover,the presence of NAFLD not only puts adverse influences for liver but is also associated with an increased risk of type 2 diabetes and cardiovascular diseases.Therefore,early detection and quantified measurement of hepatic fat content are of great importance.Liver biopsy is currently the most accurate method for the evaluation of hepatic steatosis.However,liver biopsy has several limitations,namely,its invasiveness,sampling error,high cost and moderate intraobserver and interobserver reproducibility.Recently,various quantitative imaging techniques have been developed for the diagnosis and quantified measurement of hepatic fat content,including ultrasound-or magnetic resonancebased methods.These quantitative imaging techniques can provide objective continuous metrics associated with liver fat content and be recorded for comparison when patients receive check-ups to evaluate changes in liver fat content,which is useful for longitudinal follow-up.In this review,we introduce several imaging techniques and describe their diagnostic performance for the diagnosis and quantified measurement of hepatic fat content.
文摘1 H-magnetic resonance spectroscopy imaging and diffusion tensor imaging were performed in 19 patients with mild depression and in 13 controls.The mean age of the patients was 31 years.The mean Hamilton depression score of the patients was 22.5±13.2.N-acetylaspartate,choline and creatine concentrations and the average diffusion coefficient and fractional anisotropy values were measured in the bilateral hippocampus,striatum,thalamus and prefrontal deep white matter. Compared with the control group,the mild depressed patients had：（1）a higher choline/creatine ratio and a negative correlation between the choline/creatine ratio and the average diffusion coefficient in the hippocampus;（2）a lower choline/creatine ratio and a higher fractional anisotropy in the striatum;（3）a lower fractional anisotropy and a positive correlation between the fractional anisotropy and the choline/creatine ratio in the prefrontal deep white matter;and（4）a higher average diffusion coefficient and a positive correlation between the choline/creatine ratio and the N-acetylaspartate/creatine ratio in the thalamus,as well as positive correlation between the choline/creatine ratio and Hamilton depression scores.These data suggest evidence of abnormal connectivity in neurofibrotic microstructures and abnormal metabolic alterations in the limbic-cortical-striatal-pallidal-thalamic neural circuit in patients with mild depression.
基金supported by the National Key R&D Program of China(Grant No.:2017YFC1702003)the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(Grant No.:2019e12M-5-078).
文摘Traditional Chinese medicine(TCM)is a treasure of the Chinese nation,providing effective solutions to current medical requisites.Various spectral techniques are undergoing continuous development and provide new and reliable means for evaluating the efficacy and quality of TCM.Because spectral techniques are noninvasive,convenient,and sensitive,they have been widely applied to in vitro and in vivo TCM evaluation systems.In this paper,previous achievements and current progress in the research on spectral technologies(including fluorescence spectroscopy,photoacoustic imaging,infrared thermal imaging,laser-induced breakdown spectroscopy,hyperspectral imaging,and surface enhanced Raman spectroscopy)are discussed.The advantages and disadvantages of each technology are also presented.Moreover,the future applications of spectral imaging to identify the origins,components,and pesticide residues of TCM in vitro are elucidated.Subsequently,the evaluation of the efficacy of TCM in vivo is presented.Identifying future applications of spectral imaging is anticipated to promote medical research as well as scientific and technological explorations.
文摘The investigation of small bowel morphology is often mandatory in many patients with Crohn's disease. Traditional radiological techniques (small bowel enteroclysis and small bowel follow-through) have long been the only suitable methods for this purpose. In recent years, several alternative imaging techniques have been proposed. To review the most recent advances in imaging studies of the small bowel, with particular reference to their possible application in Crohn's disease, we conducted a complete review of the most important studies in which traditional and newer imaging methods were performed and compared in patients with Crohn's disease. Several radiological and endoscopic techniques are now available for the study of the small bowel; each of them is characterized by a distinct profile of favourable and unfavourable features. In some cases, they may also be used as complementary rather than alternative techniques. In everyday practice, the choice of the technique to be used stands upon its availability and a careful evaluation of diagnostic accuracy, clinical usefulness, safety and cost. The recent development ofinnovative imaging techniques has opened a new and exciting area in the exploration of the small bowel in Crohn's disease patients.
基金the National Natural Science Foundation of China,No.81473506the Natural Science Foundation of Zhejiang Province,No.LY17H290009the Ministry of Construction,Zhejiang Province,No.WKJ-ZJ-1531
文摘Crohn’s disease(CD)is a chronic,non-specific granulomatous inflammatory disorder that commonly affects the small intestine and is a phenotype of inflammatory bowel disease(IBD).CD is prone to relapse,and its incidence displays a persistent increase in developing countries.However,the pathogenesis of CD is poorly understood,with some studies emphasizing the link between CD and the intestinal microbiota.Specifically,studies point to the brain-gut-enteric microbiota axis as a key player in the occurrence and development of CD.Furthermore,investigations have shown whitematter lesions and neurologic deficits in patients with IBD.Based on these findings,brain activity changes in CD patients have been detected by blood oxygenation level dependent functional magnetic resonance imaging(BOLD-f MRI).BOLD-f MRI functions by detecting a local increase in relative blood oxygenation that results from neurotransmitter activity and thus reflects local neuronal firing rates.Therefore,biochemical concentrations of neurotransmitters or metabolites may change in corresponding brain regions of CD patients.To further study this phenomenon,brain changes of CD patients can be detected non-invasively,effectively and accurately by BOLD-f MRI combined with magnetic resonance spectroscopy(MRS).This approach can further shed light on the mechanisms of the occurrence and development of neurological CD.Overall,this paper reviews the current status and prospects on fMRI and MRS for evaluation of patients with CD based on the brain-gut-enteric microbiota axis.
基金supported by the National Natural Science Foundation of China, No. 81171315the Fundamental Research Funds of the Central Universities, No. 303275894the Natural Science Foundation of Hubei Province, No.2009CDA071
文摘1H magnetic resonance spectroscopy and diffusion weighted imaging features of the cerebellar vermis in 17 medulloblastoma patients were retrospectively analyzed, and 17 healthy volunteers were selected as controls. 1H magnetic resonance spectroscopy showed that in all 17 medulloblastoma patients, N-acetyl aspartate and creatine peaks were significantly decreased, the choline peak was significantly increased, and there was evidence of a myo-inositol peak. Further, 11 patients showed a low taurine peak at 3.4 ppm, five patients showed a lipid peak at 0.9-1.3 ppm, and three patients showed a negative lactic acid peak at 1.33 ppm. Compared with the control group, the ratios of N-acetyl aspartate/choline and N-acetyl aspartate/creatine were significantly decreased, and the ratio of choline/creatine was increased, in medulloblastoma patients. Diffusion weighted imaging displayed hyperintensity and decreased apparent diffusion coefficient in medulloblastoma patients. These findings indicate that 1H magnetic resonance spectroscopy and diffusion weighted imaging are useful for qualitative diagnosis of medulloblastoma.
基金The Indian Council of Medical Research (Saksena S), IndiaNew Delhi (Nath K), IndiaThe National Institute of Mental Health,MH58284 and MH06595 (Thomas MA)
文摘AIM： To evaluate the effect of an intravenous bolus of mannitol in altering brain metabolites, brain water content, brain parenchyma volume, cerebrospinal fluid （CSF） volume and clinical signs in controls and in patients with acute liver failure （ALF） and acute- on-chronic liver failure （ACLF）, by comparing changes in conventional magnetic resonance imaging （MRI）, in vivo proton magnetic resonance spectroscopy （PMRS） and diffusion tensor imaging （DTI） before and after its infusion.METHODS： Five patients each with ALF and ACLF in grade 3 or 4 hepatic encephalopathy and with clinical signs of raised intracranial pressure were studied along with five healthy volunteers. After baseline MRI, an intravenous bolus of 20% mannitol solution was given over 10 min in controls as well as in patients with ALF and ACLE Repeat MRI for the same position was acquired 30 rnin after completing the rnannitol injection. RESULTS： No statistically significant difference was observed between controls and patients with ALF and ACLF in metabolite ratios, DTI metrics and brain volume or CSF volume following 45 rain of mannitol infusion. There was no change in clinical status at the end of post-mannitol imaging. CONCLUSION： The osmotic effect of mannitol did not result in significant reduction of brain water content, alteration in metabolite ratios or any change in the clinical status of these patients during or within 45 min of mannitol infusion.
