ABSTRACT
Objective To investigate the voxel-based correlation of mini-mental state examination(MMSE) score with apparent diffusion coefficients(ADC) and fractional anisotropy (FA) derived from diffusion tensor imaging(DTI) in the patients with Alzheimer disease. Methods 12 patients aged (70.0± 10.5) years and 16 normal control aged (66.5±6.7) years were enrolled in this study.DTI was performed based on sequence and 32-channel head coils.ADC and FA images were calculated and normalized to the same space and smoothed with 8 mm Gaussian Kernel. With statistical parameter mapping software SPM5 package,the independent two sample t-test with general linear model were performed to detect ADC and FA differences between AD patients and normal control.Correlation analysis was performed between MMSE score and FA or ADC. Results AD patients showed elevated ADC value and decreased FA value in bilateral temporal lobe and anterior cingulate,which was more pronounced in the left than in the right.There was elevation of ADC value but no FA decrease in bilateral posterior cingulate.The abnormal ADC area was larger than that of FA.There was negative correlation between MMSE score and ADC of the right hippocampus(r=-0.9474,P=0.0232) and a tendency towards positive correlation between MMSE score and FA of the right hippocampus(r=0.5414,P=0.5853). Conclusions ADC value may be more sensitive than FA value in DTI. Right temporal lobe microstructure involvement is less severe,but has a stronger relationship with neuropsyehological abnormality.
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Objective To investigate the clinical application of the distance of biliary duct measured by MRCP in bile duct resection of the donor and biliary reconstruction of recipients in living donor liver transplantation (LDLT) using right lobe graft.Methods Seventy-six living donors received preoperative MRCP after fat meal,who underwent right lobe resection and all had intraoperative cholangiography (IOC) for comparison.The accuracy of preoperative MRCP for biliary types in LDLT donors was analyzed and compared to that of IOC findings.The length of biliary duct between the junction of the right posterior hepatic duct (RPHD) and the junction of the right and left hepatic ducts was measured in MRCP images.The reconstruction of intraoperative data and the length,the diameter were compared,and binary logistic regression and Receiver Operating Characteristic (ROC) curves were calculated.The result included the limitation.Results In comparison to IOC,the accuracy of MRCP after fat meal was 97.4 ％.The length of biliary duct between the junction of RPHD and the junction of the right and left hepatic ducts measured by MRCP and the biliary type were the influencing factor of intraoperative reconstruction of biliary duct; while the diameter of biliary duct had no influence ROC curves showed that when the length of biliary duct of type Ⅰ was smaller or equal to 4.2 mm,or the biliary anatomy had variation,the number of biliary anastomotic stomas was more than one,and plasty was selected in 95 ％ of donors intraoperatively.The corresponding length of biliary duct of type Ⅲ and type Ⅳ was 3.8 mm,which was the limitation whether biliary plasty was done intraoperatively.Conclusion The type of bile duct in MRCP can reflect the biliary anatomy structure accurately.The length of biliary duct between the junction of RPHD and the junction of the right and left hepatic ducts measured by MRCP after fat meal can guide the biliary reconstruction intraoperatively and offer reliable basis for optimizing the clinical operation program in adult LDLT.
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Objective To evaluate the accuracy of multi-detector spiral CT (MSCT) semiautomated volumetric measurement of right lobes and its value in living donor liver transplantation (LDLT). Methods Fifty-six donors underwent four phases MSCT. Pre-operative liver volumes of two measurements [IQQA(R)-liver semi-automated (Vs) and manual volume (Vm) measurements] in portal vein phase were compared with intra-operative measurement (Vio) by means of water displacement. Results Correlation analysis and Bland-Altman tests were used for statistical analysis.Results Pre-operative measurements of grafts resulted in a mean Vs, Vm, Vio of (818. 60 ± 161.43)cm3 , (880. 16 ± 169. 92) cm3 and (669. 84 ± 141.37) cm3 respectively. All corresponding pre-and intra-operative data were correlated significantly with each other. There was a good correlation between Vs and Vio(r= 0. 778, P＜0. 05), so did Vm and Vio(r= 0. 746, P＜0. 05). The equations of linear regression were Vio = Vs × 0. 681 + 112. 26, and Vio = Vm × 0. 620 + 123. 81 respectively. Exact 95 % CIs and the extent of concordance were 121.57-175. 95 cm3, -354. 135-56. 62 cm3 for semiautomated measurements, and 180. 09-240. 56 cm3 , - 438. 66-18. 01 cm3 for manual measurements,respectively. Conclusion Semi-automated method for the volumetric measurements of the right liver lobes in LDLT is more accurate than the manual method.