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1.
Chinese Journal of Microsurgery ; (6): 167-170, 2022.
Article in Chinese | WPRIM | ID: wpr-934189

ABSTRACT

Objective:To investigate the clinical value of digital technology in repair of soft tissue defect in hand by anterior tibial artery perforator flap.Methods:From January 2015 to February 2021, 9 patients with soft tissue defects in hand were repaired with anterior tibial artery perforator flap assisted by digital technology in flap design, including 6 males and 3 females aged from 19 to 63 years with a mean age of 33 years. The size of defects varied from 2.0 cm×1.5 cm to 4.0 cm×3.0 cm, with exposed bones or tendons. Preoperative CTA scan of lower limb was performed and three-dimensional image was reconstructed with Mimics 20.0. The anterior tibial artery perforator flap was designed according to the shape and size of the defect, then the resection of flap was digitally simulated. The flap based on the digital design was harvested and the defect was repaired in the operation. The size of flap was 2.5 cm×2.0 cm~4.5 cm×3.5 cm. Outpatient clinic follow-up was performed to evaluate the survival of flaps. Disability of Arm, Shoulder and Hand(DASH) was used for function evaluation.Results:All flaps were harvested successfully and all donor sites were closed directly. After surgery, 8 flaps survived completely. One flap developed venous occlusion that showed partial necrosis of the flap, and it was rescued after exploration and re-anastomosis. The follow-up period ranged from 6 to 21 months, with an average of 13 months. The DASH scores of the affected limb were 2 to 15 points at the last follow-up, with an average of 6.4 points. Mild scar hyperplasia occurred at donor site in 1 case without sensory abnormality.Conclusion:The digital technology is able to accurately locate the perforators by allowing an individualised design of the anterior tibial artery perforator flap. The flap is suitable for repair of small and medium-sized soft tissue defect in hand, and the digital technology has certain value in clinical application.

2.
Article in Chinese | WPRIM | ID: wpr-932938

ABSTRACT

Objective:To investigate differences in cardiac function and perfusion parameters measured by IQ-SPECT and low energy high-resolution (LEHR)-SPECT, as well as effects of scattering correction (SC) and CT attenuation correction (AC) on myocardial perfusion imaging.Methods:From May 2020 to September 2020, 80 patients (58 males, 22 females, age (57±10) years) who underwent SPECT myocardial perfusion imaging were retrospectively enrolled in Fuwai Hospital. According to the standardized left ventricular end-diastolic diameter of body surface measured by two-dimensional echocardiography, patients were divided into 2 groups: A group ( n=34) with significantly enlarged left ventricle and B group ( n=46) with no significant enlargement of left ventricle. LEHR-SPECT and IQ-SPECT gated myocardial perfusion imaging were performed in all patients. Left ventricular end-diastolic volume (EDV), end-systolic volume (ESV), ejection fraction (EF), summed rest score (SRS) and total perfusion defect (TPD) were measured. Parameters measured by two methods and differences before and after SC and AC were compared by using paired t test and Wilcoxon signed rank test. The correlation was analyzed by Pearson correlation or Spearman rank correlation analyses, and the consistency was analyzed by Bland-Altman analysis. Results:In A group, EDV, EF and SRS measured by IQ-SPECT were significantly lower than those assessed by LEHR-SPECT after SC and AC (EDV: (257±137) vs (276±154) ml, EF: (21±11)% vs (26±13)%, SRS: 17(6, 25) vs 18(8, 28); t values: -2.63, -7.46, z=-2.14, all P<0.05); all parameters measured by LEHR-SPECT and IQ-SPECT had well correlation ( r values: 0.965, 0.969, 0.967, rs values: 0.920, 0.960, all P<0.001) and consistency. In B group, EDV and EF measured by IQ-SPECT were significantly lower than those assessed by LEHR-SPECT after SC and AC (EDV: (96±40) vs (107±39) ml, EF: (46±15)% vs (54±16)%; t values: -6.23, -10.71, both P=0.001); SRS and TPD measured by IQ-SPECT after SC and AC were significantly lower than non-SC and non-AC (SRS: 2(1, 4) vs 5(3, 11), TPD: (3%(1%, 5%) vs 7%(3%, 12%); z values: -4.11, -4.16, both P<0.001); all parameters measured by LEHR-SPECT and IQ-SPECT had well correlation ( r values: 0.956, 0.978, 0.958, rs values: 0.926, 0.944, all P<0.001) and consistency. Conclusions:There are good correlation and consistency of left ventricular function and myocardial perfusion parameters acquired by IQ-SPECT and LEHR-SPECT. Moreover, IQ-SPECT is able to shorten acquisition time, resulting in great potential in clinical application.

3.
Article in Chinese | WPRIM | ID: wpr-932927

ABSTRACT

Objective:To investigate the effect of motion correction (MC) on the calculated values of myocardial blood flow (MBF) and myocardial flow reserve (MFR) based on cadmium-zinc-telluride SPECT (CZT SPECT) images.Methods:Twenty-eight consecutive patients (10 males, 18 females, age: (60.75±11.62) years) with suspected or known coronary artery disease who underwent myocardial perfusion imaging (MPI) with dynamic CZT SPECT between June 2019 and August 2019 in TEDA International Cardiovascular Hospital were retrospectively analyzed. The MBF and MFR during rest imaging and stress imaging were quantitatively analyzed. Corridor 4DM software was used to calculate the stress MBF (sMBF) and MFR of the coronary artery branches and left ventricular (LV) before and after MC. The paired t test and Pearson correlation were used for data analysis. Results:The sMBF and MFR of LV before MC were (0.82±0.49) ml·min -1·g -1 and 1.69±0.68 respectively. After MC the two parameters increased to (1.05±0.64) ml·min -1·g -1 and 2.12±0.77 respectively ( t values: -4.87, -6.01, both P<0.001). The sMBF and MFR in left anterior descending (LAD), left circumflex (LCX), right coronary artery (RCA) and LV before MC were correlated with those after MC ( r values: 0.69-0.96, all P<0.001). If MFR <2.0 was used as the reference of impaired MFR, data before MC showed 19 patients (67.9%, 19/28) had impaired MFR, while 13 patients (46.4%, 13/28) had impaired MFR based on MFR values after MC. Conclusion:For MPI quantitative imaging with CZT SPECT, the calculated values of sMBF and MFR after MC is higher than those before MC, suggesting that MC is helpful to reduce the false positive results which may be caused by the " creep" effect of the heart.

4.
Article in Chinese | WPRIM | ID: wpr-932328

ABSTRACT

Objective:To study the morphology of dorsal medial talar neck osteophyte (DMTNO) and its association with anteromedial ankle impingement syndrome (AAIS) using CT 3D reconstruction images.Methods:The present retrospective study included 23 patients with AAIS due to DMTNO (case group) and 23 patients with DMTNO but without AAIS (control group) who had been admitted from February 2019 to June 2021. Multi-slice CT data (DICOM) of DMTNO in both groups were collected and imported into Arigin 3D Pro 3D reconstruction software to reconstruct and observe the 3D morphology of DMTNO. The dorsal convex distance, medial convex distance and anterior convex distance of DMTNO were measured to find their association with AAIS.Results:In the case group, DMTNO clearly showed a flat polyhedral shape with a large base and a small top; in the control group, DMTNO showed various shapes that were different mainly in an irregular top but similar in a large, long and narrow base. The dorsal convex distance [(8.07±2.30) mm] and medial convex distance [(6.70±2.62) mm] in the case group were significantly larger than those in the control group [(3.59±1.10) mm and (1.98±0.93) mm] ( P<0.05), but there was no significant difference between the 2 groups in the anterior convex distance ( P>0.05). Conclusions:The DMTNO leading to AAIS shows a flat polyhedral shape with a large base and a small top. No correlation is found between the anterior convex and AAIS whereas the dorsal convex and medial convex of DMTNO may be closely associated with AAIS.

5.
Article in Chinese | WPRIM | ID: wpr-931041

ABSTRACT

Objective:To investigate a rapid protocol for the acquisition of a three-dimensional (3D) image of corneal nerve distribution and its various parameters.Methods:Four SPF female C57BL/6 mice were selected and four corneal samples with complete limbi were obtained using a dissecting microscope after the sacrifice of mice euthanized by ether.After conventional fixation, permeabilization, and immunostaining by an anti-β-Ⅲ tubulin fluorescent-conjugated antibody, a whole-nerve image of the whole-mount cornea was captured under a 60X oil lens using a scientific complementary metal-oxide-semiconductor detector and a high-resolution deconvolution microscope.The 3D image of the corneal nerve fiber was obtained after 3D deconvolution processing, Z-axis data projection, and automatic stitching using the self-contained image processing software of the microscope system.The corneal nerve density in different areas was analyzed using the automatic detection mode in the Filament Tracer module and the manual Autopath module of the interactive microscopic image analysis software Imaris.The use and care of animals complied with the statement of the Association for Research in Visual and Ophthalmology, and the study protocol was approved by an Experimental Animal Welfare Committee of Jinan University (No.JN-A-2002-01).Results:It was found that stromal nerve fibers in a dense network entered the Bowman membrane near the limbus, and branches of stromal nerve fibers formed subbasal nerve plexus, which stretched toward the center of the cornea to form a dense neural network-like structure and converged into a vortex-like structure at the apex of the cornea.Some subbasal nerves entered the epithelial layer vertically and some branches of nerve endings were found.Through the automatic detection mode of Imaris software, a gradual increase of the density from (2 488.88±282.84)μm/μm 2 at the limbus to (5 766.66±298.55)μm/μm 2 at the center of the cornea of the subbasal nerve branches, and a decrease of the density from (40.99±0.99)μm/μm 2 at the limbus to (34.57±1.28)μm/μm 2 at the center of the stromal nerves were found.It was also found that the stromal nerves at the limbus entered the Bowman membrane for about 151 μm and then began to branch to form subbasal nerves. Conclusions:The high-resolution deconvolution microscope system can be used to study the 3D distribution of the whole corneal nerve.Additionally, Imaris can be used for obtaining various parameters of the corneal nerves automatically and quickly.

6.
Radiol. bras ; 54(3): 155-164, May-June 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1250656

ABSTRACT

Abstract Objective: To evaluate the degree of similarity between manual and semiautomatic segmentation of soft-tissue sarcomas on magnetic resonance imaging (MRI). Materials and Methods: This was a retrospective study of 15 MRI examinations of patients with histopathologically confirmed soft-tissue sarcomas acquired before therapeutic intervention. Manual and semiautomatic segmentations were performed by three radiologists, working independently, using the software 3D Slicer. The Dice similarity coefficient (DSC) and the Hausdorff distance were calculated in order to evaluate the similarity between manual and semiautomatic segmentation. To compare the two modalities in terms of the tumor volumes obtained, we also calculated descriptive statistics and intraclass correlation coefficients (ICCs). Results: In the comparison between manual and semiautomatic segmentation, the DSC values ranged from 0.871 to 0.973. The comparison of the volumes segmented by the two modalities resulted in ICCs between 0.9927 and 0.9990. The DSC values ranged from 0.849 to 0.979 for intraobserver variability and from 0.741 to 0.972 for interobserver variability. There was no significant difference between the semiautomatic and manual modalities in terms of the segmentation times (p > 0.05). Conclusion: There appears to be a high degree of similarity between manual and semiautomatic segmentation, with no significant difference between the two modalities in terms of the time required for segmentation.


Resumo Objetivo: Verificar a similaridade entre as segmentações manual e semiautomática de sarcomas de tecidos moles na ressonância magnética (RM) e a similaridade interobservador e intraobservador entre as segmentações manuais. Materiais e Métodos: Estudo retrospectivo que incluiu 15 exames de RM de pacientes com diagnóstico de sarcoma de tecidos moles realizados antes de intervenções terapêuticas. As segmentações manual e semiautomática foram realizadas por três radiologistas utilizando o software 3D Slicer. O coeficiente de similaridade Dice (CSD) e a distância de Hausdorff foram utilizados para avaliar a similaridade das segmentações. Análise estatística descritiva e coeficiente de correlação intraclasse (CCI) foram realizados para comparar volumes tumorais. Resultados: A comparação dos métodos manual e semiautomático obteve valores de CSD entre 0,871 e 0,973. A comparação dos volumes segmentados pelos dois métodos de segmentação mostrou CCI entre 0,9927 e 0,9990. As análises intraobservador e interobservador obtiveram valores de CSD, respectivamente, de 0,849 a 0,979 e de 0,741 a 0,972. Não houve diferença significativa entre os tempos de segmentação dos métodos semiautomático e manual (p > 0,05). Conclusão: Houve alta similaridade entre as segmentações de sarcomas de tecidos moles obtidas pelos métodos manual e semiautomático, sem diferença significativa para o tempo despendido para as segmentações.

7.
Radiol. bras ; 54(1): 27-32, Jan.-Feb. 2021. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1155222

ABSTRACT

Abstract Objective: To compare ultrasound images of the kidney obtained, randomly or in a controlled manner (standardizing the physical aspects of the ultrasound system), by various professionals and with different devices. Materials and Methods: We evaluated a total of 919 images of kidneys, obtained by five professionals using two types of ultrasound systems, in 24 patients. The images were categorized into four types, by how they were acquired and processed. We compared the gray-scale median and different gray-scale ranges representative of virtual histological tissues. Results: There were statistically significant differences among the five professionals, regardless of the type of ultrasound system employed, in terms of the gray-scale medians for the images obtained (p < 2.2e-16). Analyzing the four categories of images-a totally random image (without any standardization); a standardized image (with fixed values for gain, time gain control, and dynamic range); a normalized version of the random image; and a normalized version of the standardized image-we determined that the random image, even after normalization, differed quite significantly among the professionals (p = 0.006098). The analysis of the normalized version of the standardized image did not differ significantly among the professionals (p = 0.7319). Conclusion: Our findings indicate that a gray-scale analysis of ultrasound images of the kidney performs better when the image acquisition process is standardized and the images undergo a process of normalization.


Resumo Objetivo: Comparar imagens renais ultrassonográficas obtidas de maneira aleatória e controlada (padronizando fatores físicos do aparelho de ultrassom) por diferentes profissionais e aparelhos. Materiais e Métodos: Foram obtidos quatro tipos de imagens, de acordo com sua aquisição e processamento por cinco profissionais e dois tipos de aparelhos de ultrassonografia, em 24 pacientes, totalizando 919 imagens. Comparamos a mediana de escala de cinza e diferentes intervalos de tons de cinza representantes de tecidos histológicos virtuais. Resultados: As medianas de escala de cinza de imagens renais obtidas por dois tipos de aparelhos foram estatisticamente diferentes (p < 2.2e-16). Analisando os quatro tipos de imagens, partindo de uma totalmente aleatória (sem qualquer padronização), uma padronizada (fixado o ganho, time gain control e dynamic range), e essas duas passando por um processo de normatização, obteve-se que a imagem aleatória é totalmente diversa entre os profissionais (p = 0,006098), mesmo passando pelo processo de normatização. A imagem padronizada, após passar pelo processo de normatização, apresentou resultados equivalentes, não possuindo diferença estatística (p = 0,7319). Conclusão: Constatou-se que na análise de tons de cinza deve-se usar um mesmo tipo de máquina e uma imagem em que sejam padronizados aspectos físicos, passando por um processo de normatização/padronização.

8.
Chinese Journal of Dermatology ; (12): 586-589, 2021.
Article in Chinese | WPRIM | ID: wpr-911493

ABSTRACT

Objective:To construct an artificial intelligence model for the diagnosis of facial vitiligo, so as to realize artificial intelligence-assisted diagnosis of facial vitiligo.Methods:Based on digital single-lens reflex (SLR) camera images of vitiligo skin lesions and YOLO (You Only Look Once) v3 algorithm, a skin lesion detection model Vit3 was established, and its performance was evaluated by comparing its detection results and labeling results of dermatologists. On the basis of the Vit3 model, both optical and ultraviolet images of vitiligo and non-vitiligo skin lesions were taken by using an artificial intelligence-based facial skin image collector, and the gray values of vitiligo and non-vitiligo skin lesion areas on the ultraviolet images were measured by using an image processing technique. According to the gray-value threshold between vitiligo and non-vitiligo skin lesions, a facial vitiligo diagnosis model Vit4 was established. Cochran′s Q test was used to compare the diagnostic results of the Vit4 model and dermatologists, and the diagnostic performance of the Vit4 model was evaluated. Results:For 100 SLR camera images of vitiligo skin lesions (167 lesional sites) and 100 SLR camera images of normal skin, the diagnostic sensitivity of the Vit3 model was 92.81% (155/167) . For 97 pairs of facial skin images (including 50 vitiligo lesions, 30 pityriasis alba lesions, 7 amelanotic nevus leisons, and 10 normal skin tissues) , the diagnostic accuracy rate, sensitivity and specificity of the Vit4 model were 88.66% (86/97) , 88.00% (44/50) and 89.36% (42/47) respectively, and there was no significant difference in the diagnostic accuracy rate between the Vit4 model and dermatologists (92.78%[90/97], χ2=2.323, P > 0.05) . Conclusion:The artificial intelligence model Vit4 was established for the diagnosis of facial vitiligo with favorable diagnostic performance, and could serve as an objective and convenient method for the auxiliary diagnosis of facial vitiligo.

9.
Article in Chinese | WPRIM | ID: wpr-910805

ABSTRACT

Objective:To improve the quality of 18F-fluorodeoxyglucose (FDG) PET images at different acquisition times through deep learning (DL) PET image reconstruction methods. Methods:A total of 45 patients (20 males, 25 females; age (52.0±13.6) years) with malignant tumors and PET/CT scans from September 2020 to October 2020 in the Department of Nuclear Medicine of the First Hospital of Shanxi Medical University were included in this retrospective study. The short acquisition time 30 s/bed PET images from the raw list mode were selected as the input of DL model. DL image reconstruction model, based on the Unet algorithm, was trained to output imitated PET images with full dose standard acquisition time (3 min). The image quality evaluation and quantitative analysis were carried out for four groups of images: DL images, 30 s, 90 s, and 120 s images, respectively. The quality of PET images in four groups was evaluated using the five-point method. Liver background activities, lesions quantification parameters (maximum standardized uptake value (SUV max), mean standardized uptake value (SUV mean), standard deviation (SD), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR)), and first-order texture features (skewness, kurtosis, uniformity, entropy) were measured. Kappa test, χ2 test and one-way analysis of variance (least significant difference t test) were used for data analysis. Results:The image quality scores between four groups were highly consistent ( Kappa=0.799, P<0.001). The number of patients with scores≥3 in DL, 30 s, 90 s and 120 s groups were 6, 4, 7 and 8, respectively ( χ2=125.47, P<0.001). The liver SD of DL group was significantly lower than that of 30 s group (0.26±0.07 vs 0.43±0.11; F=3.58, t=-7.91, P<0.05). The liver SNR of DL group was higher than that of 30 s group (11.04±4.36 vs 5.41±1.41; F=10.22, t=5.40, P<0.05). The liver SD and SNR of DL group were similar to those of 90 s group (0.39±0.16, 8.46±3.34; t values: -0.87 and 2.17, both P>0.05). In 18 tumor lesions with high uptake, SNR and CNR of DL group were significantly higher than those of 30 s group (60.21±29.26 vs 38.38±16.54, 22.26±15.85 vs 15.41±9.51; F values: 13.09 and 7.05; t values: 5.20 and 4.04, both P<0.001). There were statistically significant differences among four groups in the first-order texture features ( F values: 4.30-9.65, all P<0.05), but there was no significant difference between DL group and 120 s group ( t values: from -1.25 to 0.15, all P>0.05). Conclusion:DL reconstruction model can improve the quality of short-frame PET images, which meets the needs of clinical diagnosis, efficacy evaluation and radiomics research.

10.
Article in Chinese | WPRIM | ID: wpr-910785

ABSTRACT

Objective:To investigate the segmentation methods of pancreatic ductal adenocarcinoma (PDAC) tumor regions in 18F-fluorodeoxyglucose (FDG) PET/CT images, as well as their impact on radiomic features-based pathological grade prediction. Methods:A total of 72 patients (46 males, 26 females, age range: 25-87 years) with pathologically confirmed PDAC and a preoperative 18F-FDG PET/CT scan in Peking Union Medical College Hospital between September 2010 and January 2016 were enrolled retrospectively. The cohort of patients was classified as well differentiated group and non-well differentiated group based on the pathological grade of PDAC, and patients were divided into training set and validation set in the ratio of 3∶1 randomly. Two physicians performed manual contours in the tumor region (referred as region of interest (ROI)_M1 and ROI_M2) and semi-automatic ROIs based on standardized uptake value (SUV) gradient edge search (referred as ROI_G) and 40% threshold applied to the maximum SUV (SUV max; referred as ROI_S) were drawn. The four types of segmentation results were compared in terms of volume and Dice similarity coefficient (DSC). Shape, first-order, and texture features were extracted from PET/CT original and preprocessed images, and the interclass correlation coefficient (ICC) was used to assess each feature′s consistency across all segmentations. Kruskal-Wallis rank sum test, independent-sample t test or z test were used to analyze the data. The area under the receiver operating characteristic curve was used to assess model accuracy, and cross validation was used to assess generalization ability. Results:There were 55 patients in the training set (14 well differentiated cases and 41 non-well differentiated cases) and 17 patients in the validation set (4 well differentiated cases and 13 non-well differentiated cases). A total of 44 selected features were predictive of the pathological grade of PDAC among 20 feature groups. There was significant difference among the volumes of ROI_M1, ROI_M2, ROI_G and ROI_S (10.29(4.01, 19.43), 9.34(4.26, 17.27), 11.86(5.52, 19.74) and 15.08(9.62, 27.44) cm 3; H=18.641, P<0.05). The degree of contour coincidence and feature consistency between ROI_M1 and ROI_M2 were both higher (DSC=0.86 (0.76, 0.90), ICC=0.86 (0.74, 0.94)). Compared to manual contours, the degree of contour coincidence and feature consistency of ROI_G (DSC: 0.86(0.75, 0.91), 0.91(0.85, 0.96); ICC: 0.87(0.72, 0.94), 0.94(0.88, 0.98)) were better. There was no statistically significant difference in model accuracy or generalization ability between ROI_M1 and ROI_G ( z=1.052, t=0.712, both P>0.05). The accuracy of ROI_M2 was better than ROI_G ( z=3.031, P=0.002), but the generalization ability of ROI_M2 was insufficient ( t=3.086, P=0.012). Conclusions:Although the manual contour prediction models are highly accurate, their performance are unstable. Semi-automatic contouring based on gradient can achieve comparable accuracy to manual contouring, and the model′s generalization ability is stronger.

11.
Article in Chinese | WPRIM | ID: wpr-910782

ABSTRACT

Objective:To explore the influence of time of flight (TOF) and point spread function (PSF) on PET/CT image quality and standardized uptake value (SUV) based on a phantom study.Methods:PET/CT imaging were performed using Jaszczak phantom and International Electrotechnical Commission (IEC) body phantom respectively, and conventional clinical imaging protocol (3 min/bed) was used for three consecutive imaging. The ordered subsets expectation maximization (OSEM), OSEM+ TOF, OSEM+ PSF and OSEM+ TOF+ PSF were used to reconstruct the raw data respectively. The differences of image resolution, image uniformity, contrast, signal to noise ratio (SNR) and SUV among different reconstruction algorithms were compared by using one-way analysis of variance and the least significant difference (LSD) t test. The correlations between SNR, mean SUV (SUV mean), maximum SUV (SUV max) and the sphere diameter were analyzed by Pearson correlation analysis. Results:The minimum image resolution for the hot column was 6.4 mm by OSEM and OSEM+ PSF reconstruction, while it was 4.8 mm by OSEM+ TOF and OSEM+ TOF+ PSF reconstruction. The contrast was significantly better by OSEM+ TOF ((78.56±1.21)%) and OSEM+ TOF+ PSF ((78.85±1.17)%) reconstruction than that by OSEM reconstruction ((73.44±1.47)%; F=61.068, t values: 9.503, 10.018, both P<0.001). The maximum and minimum nonuniformity percentages were significantly better for images reconstructed with OSEM+ PSF than those reconstructed with OSEM ( F values: 10.286, 27.630, t values: -2.599, 7.698, both P<0.05). In IEC phantom imaging, the SNR and SUV max of hot sphere were higher by OSEM+ PSF and OSEM+ TOF+ PSF reconstruction than those by OSEM reconstruction (SNR: (98.99±34.76)%, (98.29±28.66)%, (73.64±26.05)%; F=5.712, t values: 3.209, 3.412, both P<0.05; SUV max: 8.96±2.72, 9.28±2.17, 8.01±2.21; F=3.931, t values: 2.154, 2.863, both P<0.05), but there was no significant difference between OSEM+ TOF and OSEM reconstruction ( t values: 0.297, 0.272, both P>0.05). Among the four reconstruction methods, the SNR and SUV mean increased with the increase of the sphere diameter ( r values: 0.913-0.963, all P<0.05), but SUV max in images reconstructed with OSEM+ PSF and OSEM+ TOF+ PSF had no significant correlations with the sphere diameter ( r values: 0.496, 0.614, both P>0.05). Conclusions:Under specific acquisition and reconstruction conditions, TOF mainly improves image resolution and contrast, while PSF mainly improves image uniformity and SNR. The combination of the two method can obtain better image quality and significantly improve the SUV of hot lesions.

12.
Chinese Journal of Orthopaedics ; (12): 1209-1216, 2021.
Article in Chinese | WPRIM | ID: wpr-910709

ABSTRACT

Objective:To compare the effects of Dynesys dynamic fixation and fusion fixation on the sagittal parameters of lumbar degenerative diseases of 2-4 segments.Methods:A total of 45 patients with 2-4 segments lumbar degenerative diseases, who underwent decompression and internal fixation in our hospital from March 2014 to July 2019, were retrospectively analyzed. There were 23 males and 22 females with an average age of 55±18 years (range 15-86 years). Dynesys dynamic fixation was performed in 22 cases and fusion fixation in 23 cases. Lumbar anteroposterior, flexion and extension lateral and standing full-length spine radiographs were taken before surgery, 2 weeks postoperatively, 3 months postoperatively and at the last follow-up. Sagittal alignment parameters were measured on those radiographs and compared between two groups. Lumbar parameters included lumbar lordosis (LL), lordosis of the fixed segments (LFx), lordosis of the adjacent level to fixed segment (LAdj) and lumbar range of motion (ROM). Pelvic parameters included pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS).Results:All cases were followed up for 12-50 months with an average of 18.5 months. There was no significant intra- and inter-group difference of LL value between Dynesys dynamic fixation and fusion fixation group before and after surgery ( P>0.05). The overall difference of LFx between groups was not statistically significant ( F=0.700, P=0.406). There was statistically significant variance between time points ( F=7.960, P<0.001) and an interaction effect between group and time ( F=3.940, P=0.006). The LFx of the fusion fixation group was more than that of the dynamic fixation group at 3 months postoperatively and at the last follow-up ( P<0.05). The difference of LAdj value between the two groups was not statistically significant ( F=0.520, P=0.476), while the difference between time points was significant ( F=4.810, P=0.002) with interaction effect between group and time ( F=3.560, P=0.010). Postoperative ROM values of the two groups showed statistically significant differences in group effect, time effect and interaction effect, respectively ( F=4.770, P=0.034; F=18.510, P<0.001; F=5.940, P=0.002). Dynamic fixation group's ROM was more than that of the fusion fixation group at 3 months postoperatively and at the last follow-up ( P<0.05). There was no significant difference of PI between groups and between different time points ( F=0.580, P=0.451; F=0.750; P=0.477). There was no interaction effect in PI between group and time ( F=0.120, P=0.886). There was no significant difference of PT and SS between two groups ( F=0.320, P=0.576; F=0.020, P=0.901). Both time effect and interaction effect were statistically significant ( P<0.05). One complication of unilateral S 1 screw loosening happened in one patient with dynamic fixed at 2 years after surgery. There was no complication in the fusion fixation group during the follow-up. Conclusion:Both Dynesys dynamic fixation and fusion fixation can effectively reconstruct the lumbar lordosis. The fixed segments' lordosis of Dynesys was less than that of fusion fixation from 3 months after operation. Theoretically, the similar increasing trends of LAdj after fixation implied that the degeneration of adjacent segments may occur in both fixation systems. The dynamic fixation can retain more ROM than the fusion fixation. Both two fixation systems have similar influence on the pelvic parameters.

13.
Chinese Journal of Trauma ; (12): 501-507, 2021.
Article in Chinese | WPRIM | ID: wpr-909897

ABSTRACT

Objective:To investigate the effectiveness of CT angiography (CTA) combined with three-dimensional modeling-assisted design of superficial peroneal artery perforator flap for reconstruction of traumatic hand wound.Methods:A retrospective case series study was conducted to analyze the clinical data of 15 patients with hand injury admitted to 920th Hospital of Joint Logistic Support Force of PLA from January 2016 to December 2019. There were 11 males and 4 females, aged 19-51 years [(27.8±8.1)years]. All patients had soft tissue defect of the hand with exposed bone or tendon, and the defect area ranged from 2.0 cm×1.0 cm to 6.0 cm×4.0 cm. All patients underwent CTA of the abdominal aorta to dorsalis pedis artery before surgery. The three-dimensional models of bones, blood vessels, skin and other tissues were reconstructed by Mimics 20.0 software. The location, diameter and length of the superficial peroneal artery perforator vessels were accurately measured, and the perforator flap was designed according to the shape and size of the defect, then the resection of flap was simulated. During the operation, the superficial peroneal artery perforator flap was removed and transplanted to repair the defect according to the design. The location, diameter and length of perforator vessels were measured intraoperatively and compared with the preoperative modeling measurement. The operation time and intraoperative blood loss were recorded. The survival of the flap and healing of the donor site were observed after operation. The function of the affected limb was evaluated according to the upper limb function evaluation standard of Chinese Medical Association before and 3 months after surgery. The appearance, sensation and motion of the donor site were observed 3 months after surgery.Results:The origin and course of superficial peroneal artery perforator vessels could be clarified preoperatively based on the three-dimensional model. There was no significant difference in the location, diameter and length of perforator vessels between the pre- and intra-operative measurements ( P>0.05). All patients were followed up for 6-20 months [(12.2±3.8)months]. The operation duration was 50-125 minutes [(91.2±10.4)minutes], with blood loss of 150-450 ml [(364.1±44.7)ml]. The partial epidermal necrosis occurred in 2 patients after surgery, which gradually healed after dressing change, and other flaps survived smoothly. All donor sites could be sutured directly, and all incisions healed by first intention. According to the upper limb function evaluation standard of the Chinese Medical Association, the affected limb scored (76.4±9.7)points 3 months after surgery, higher than the preoperative score of (48.2±10.1)points ( P<0.05). The results were excellent in 8 patients, good in 6 and fair in 1, with the excellent and good rate of 93%. All patients had slight scar growth in donor sites and showed no obvious abnormalities in the sensation of foot dorsum and donor sites, with normal walking gait. Conclusion:CT angiography combined with three-dimensional modeling can accurately locate the perforating vessels, realize the individualized and precise design of the superficial peroneal artery perforator flap, and assist in the rapid and accurate flap resection, and hence promote wound healing and functional recovery of the hand.

14.
Article in Chinese | WPRIM | ID: wpr-909271

ABSTRACT

Objective:To investigate the image quality of digital radiography (DR) versus neoimaging (NE) technique in imaging of the spine and lower extremities in a standing position. Methods:The clinical data of 163 patients who underwent DR of the thoracolumbar spine and full-length lower extremities in a staining position in June to December 2019 in Taizhou Hospital of Zhejiang Province were retrospectively analyzed. Conventional DR images were designated as pre-processing images. NE software technique-processed images were designated as post-processing images. The image quality between the two techniques were compared.Results:Grade I image quality was observed in 91.41% (149/163) of DR images, and grade II image quality in 8.59% (14/163) of DR images. Grade I image quality was found in 93.87% (153/163) of NE software-treated images, and grade II image quality in 6.14% (10/163) NE software-treated images. There was significant difference in image quality between before and after NE software processing ( χ2 = 10.220, P = 0.001). Conclusion:NE software technique can seamlessly splice conventional DR images of the spine and low extremities in a standing position without being limited by equipment. Thus, high-quality images can be obtained to meet the requirement of clinical diagnosis. This study is innovative.

15.
ABCD arq. bras. cir. dig ; 34(4): e1630, 2021. graf
Article in English, Portuguese | LILACS | ID: biblio-1360001

ABSTRACT

RESUMO - RACIONAL: O estresse oxidativo é um dos principais mecanismos associados à ruptura dos mecanismos de defesa que formam a barreira epitelial cólica e reduz o conteúdo tecidual das proteínas claudina-3 e ocludina principais constituintes das junções de oclusão intercelulares. O sucralfato, possui atividade antioxidante e tem sido usado para tratar diferentes formas de colite. OBJETIVO: Mensurar o conteúdo tecidual de claudina-3 e ocludina da mucosa do cólon sem trânsito fecal, submetido à intervenção com sucralfato. MÉTODO: Trinta e seis ratos foram submetidos à colostomia do cólon esquerdo e fístula mucosa distal. Os animais foram divididos em dois grupos de acordo com a eutanásia ser realizada duas ou quatro semanas após a intervenção. Cada grupo foi dividido em três subgrupos de acordo com o tipo de intervenção realizada diariamente: solução salina isolada; sucralfato a 1 g/kg/dia ou sucralfato a 2g/kg/dia. A colite foi diagnosticada por análise histológica adotando escala de validação prévia. A expressão tecidual de ambas as proteínas foi identificada por imunoistoquímica. O conteúdo das proteínas foi quantificado por análise de imagem assistida por computador. RESULTADOS: O escore inflamatório foi maior nos segmentos cólicos sem trânsito fecal e os enemas com sucralfato reduziram o escore inflamatório nesses segmentos, principalmente nos animais submetidos à intervenção com sucralfato em maior concentração e por período mais longo de intervenção. Houve aumento no conteúdo tecidual das proteínas claudina-3 e ocludina, relacionado com a concentração de sucralfato. O conteúdo tecidual de ambas as proteínas não se modificou com a duração da intervenção. CONCLUSÃO: Enemas com sucralfato reduzem a inflamação e aumentam o conteúdo tecidual de claudina-3 e ocludina na mucosa cólica sem trânsito intestinal.


ABSTRACT - BACKGROUND: Oxidative stress is one of the main mechanisms associated with the rupture of the defense mechanisms of the colonic epithelial barrier; it reduces the tissue content of the claudin-3 and occludin proteins, which are the main constituents of intercellular tight junctions. Sucralfate (SCF) has antioxidant activity and has been used to treat different forms of colitis. AIM: This study aimed to measure the tissue claudin-3 and occludin content of the colon mucosa without fecal transit, subjected to intervention with SCF. METHODS: Thirty-six rats were subjected to left colon colostomy and distal mucous fistula. They were divided into two groups according to euthanasia that was performed 2 or 4 weeks after the intervention. Each group was divided into three subgroups according to the enema applied daily: saline alone, SCF at 1 g/kg/day, or SCF at 2 g/kg/day. Colitis was diagnosed by the histological analysis adopting the previous validate scale. The tissue expression of both proteins was identified by immunohistochemical technique. The content of proteins was quantified by computer-assisted image analysis. RESULTS: The inflammatory score was high in colonic segments without fecal transit, and enemas with SCF reduced the inflammatory score in these segments, mainly in those animals submitted to intervention with SCF in greater concentration and for a longer period of intervention. There was an increase in tissue content of claudin-3 and occludin, related to SCF concentration. The tissue content of both proteins was not related to the intervention time. CONCLUSION: Enemas with SCF reduced the inflammation and increased the tissue content of claudin-3 and occludin in colonic mucosa without fecal stream.


Subject(s)
Animals , Rats , Sucralfate/therapeutic use , Colitis/prevention & control , Colitis/drug therapy , Rats, Wistar , Enema
16.
ABCD arq. bras. cir. dig ; 34(2): e1608, 2021. graf
Article in English, Portuguese | LILACS | ID: biblio-1345008

ABSTRACT

ABSTRACT Background: Heart dysfunction and liver disease often coexist because of systemic disorders. Any cause of right ventricular failure may precipitate hepatic congestion and fibrosis. Digital image technologies have been introduced to pathology diagnosis, allowing an objective quantitative assessment. The quantification of fibrous tissue in liver biopsy sections is extremely important in the classification, diagnosis and grading of chronic liver disease. Aim: To create a semi-automatic computerized protocol to quantify any amount of centrilobular fibrosis and sinusoidal dilatation in liver Masson's Trichrome-stained specimen. Method: Once fibrosis had been established, liver samples were collected, histologically processed, stained with Masson's trichrome, and whole-slide images were captured with an appropriated digital pathology slide scanner. After, a random selection of the regions of interest (ROI's) was conducted. The data were subjected to software-assisted image analysis (ImageJ®). Results: The analysis of 250 ROI's allowed to empirically obtain the best application settings to identify the centrilobular fibrosis (CF) and sinusoidal lumen (SL). After the establishment of the colour threshold application settings, an in-house Macro was recorded to set the measurements (fraction area and total area) and calculate the CF and SL ratios by an automatic batch processing. Conclusion: Was possible to create a more detailed method that identifies and quantifies the area occupied by fibrous tissue and sinusoidal lumen in Masson's trichrome-stained livers specimens.


Resumo Racional: Tecnologias de imagem digital têm sido introduzidas ao diagnóstico patológico, permitindo avaliações quantitativas objetivas. A quantificação de tecido fibroso em biópsias de fígado é extremamente importante para a classificação, diagnóstico e graduação de doenças crônicas hepáticas. Objetivo: Criar um protocolo computadorizado semi-automático para quantificação de fibrose centrolobular e dilatação sinusoidal em amostras de fígado coradas por Tricrômico de Masson. Método: Uma vez instaurada a fibrose, amostras de fígado foram coletadas, processadas histologicamente, coradas por Tricrômico de Masson e WSI (Whole Slide Images) foram capturadas por scanner digital patológico apropriado. Uma seleção aleatória das regiões de interesse (ROI) foi realizada. Os dados foram submetidos a uma análise de imagem assistida por software (ImageJ®). Resultados: A análise de 250 ROIs permitiu obter-se empiricamente as melhores configurações capazes de identificar fibrose centrolobular (FC) e lúmen sinusoidal (LS). Após o estabelecimento das configurações de padrão de cor, uma Macro de autoria própria foi gravada para definir as medidas (área da fração e área total) e calcular as razões de FC e LS por processamento em grupo/lote (batch mode). Conclusão: Foi possível criar um método detalhado capaz de identificar e quantificar a área ocupada por tecido fibroso e lúmen sinusoidal em espécimes de fígado coradas por Tricrômico de Masson.


Subject(s)
Humans , Image Processing, Computer-Assisted , Software , Fibrosis , Dilatation , Liver/pathology , Liver/diagnostic imaging , Liver Cirrhosis
17.
Article in Chinese | WPRIM | ID: wpr-942197

ABSTRACT

Cryo-electron microscopy (cryo-EM) imaging has the unique potential to bridge the gap between cellular and molecular biology. Therefore, cryo-EM three-dimensional (3D) reconstruction has been rapidly developed in recent several years and applied widely in life science research to reveal the structures of large macromolecular assemblies and cellular complexes, which is critical to understanding their functions at all scales. Although the technical breakthrough in recent years, for example, the introduction of the direct detection device (DDD) camera and the development of cryo-EM software tools, made the three cryo-EM pioneers share the 2017 Nobel Prize, several bottleneck problems still exist that hamper the further increase of the resolution of single-particle reconstruction and hold back the application of in situ subnanometer structure determination by cryo-tomography. Radiation damage is still the key limiting factor in cryo-EM. In order to minimize the radiation damage and preserve as much resolution as possible, the imaging conditions of a low dose and weak contrast make cryo-EM images extremely noisy with very low signal-to-noise ratios (SNR), generally about 0.1. The high noise will obscure the fine details in cryo-EM images or reconstructed maps. Thus, a method to reduce the level of noise and improve the resolution has become an important issue. In this paper, we systematically reviewed and compared some robust filters in the cryo-EM field of two aspects, single-particle analysis (SPA) and cryo-electron tomography (cryo-ET), and especially studied their applications, such as, 3D reconstruction, visualization, structural analysis, and interpretation. Conventional approaches to noise reduction in cryo-EM imaging include the use of Gaussian, median, and bilateral filters, among other means. A Gaussian filter selects an appropriate filter kernel to conduct spatial convolution with a noisy image. Although noise with larger standard deviations in cryo-EM images can be suppressed and satisfactory performance is achieved in certain cases, this filter also blurs the images and over-smooths small-scale image features. This is especially detrimental when precise quantitative information needs to be extracted. Unlike a Gaussian filter, a median filter is based on the order statistics of the image and selects the median intensity in a window of the adjacent pixels to denoise the image. Although this filter is robust to outliers, it suffers from aliasing problems that possibly result in incorrect information for cryo-EM structure interpretation. A bilateral filter is a nonlinear filter that performs spatial weighted averaging and is more selective in the pixels allowing to contribute to the weighted sum, excluding the high frequency noise from the smoothing process. Thus, this filter can be used to smooth out noise while maintaining the edge details, which is similar to an anisotropic diffusion filter, and distinct from a Gaussian filter but its utility will be limited when the SNR of a cryo-EM image is very low. Generally, spatial filtering methods have the disadvantage of losing image resolution when reducing noise. A wavelet transform can exploit the wavelet's natural ability to separate a signal from noise at multiple image scales to allow for joint resolution in both the spatial and frequency domains, and thus has the potential to outperform existing methods. The modified wavelet shrinkage filter we developed can offer a remarkable improvement in image quality with a good compromise between detail preservation and noise smoothing. We expect that our review study on different filters can provide benefits to cryo-EM applications and the interpretation of biological structures.


Subject(s)
Algorithms , Cryoelectron Microscopy , Image Processing, Computer-Assisted , Normal Distribution , Signal-To-Noise Ratio , Tomography, X-Ray Computed
18.
Journal of Chinese Physician ; (12): 1842-1846, 2021.
Article in Chinese | WPRIM | ID: wpr-932008

ABSTRACT

Objective:To investigate the application effect of intensity-modulated radiotherapy guided by computed tomography/magnetic resonance imaging (CT/MRI) fusion technology in patients with nasopharyngeal carcinoma.Methods:The case data of 112 patients with nasopharyngeal carcinoma in 904 Hospital from June 2013 to January 2018 were retrospectively analyzed. They were divided into control group (three-dimensional conformal radiotherapy guided by CT/MRI image fusion technology) and observation group (intensity-modulated radiotherapy guided by CT/MRI image fusion technology), with 56 cases in each group. The average target volume, short-term efficacy, incidence of toxic and side effects of radiotherapy, 1, 2 and 3-year survival rate and recurrence rate were compared between the two groups.Results:The target volume in the observation group was larger than that in the control group ( P<0.05), and the total effective rate (78.57%) was higher than that in the control group (60.71%, P<0.05); There was no significant difference in the incidence of dry mouth, temporomandibular joint injury, hearing loss and skin injury between the two groups ( P>0.05), but there was significant difference in the total incidence of toxic and side effects ( P<0.05); There was no significant difference in 1-year and 2-year survival rate and recurrence rate between the two groups ( P>0.05); The 3-year survival rate (82.14%) in the observation group was higher than that in the control group (64.29%), and the recurrence rate (8.93%) was lower than that in the control group (23.21%, P<0.05). Conclusions:CT/MRI image fusion technology can guide the intensity-modulated radiotherapy in patients with nasopharyngeal carcinoma, which can improve the accuracy of radiotherapy target volume delineation and the total effective rate of treatment and 3-year survival rate, and reduce the 3-year recurrence rate. It is worthy of clinical promotion and application.

19.
Rev. Assoc. Med. Bras. (1992) ; 66(6): 818-823, June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136279

ABSTRACT

SUMMARY INTRODUCTION Celiac disease (CeD) is an autoimmune disease that can be delayed in diagnosis due to the presence of atypical and asymptomatic cases in adulthood. Herein we aimed to study the frequency of CeD and evaluate whether magnified endoscopy and magnified/FICE (flexible spectral imaging color enhancement) techniques contribute to the diagnosis in patients with serum iron and vitamin B12 deficiency. METHODS We evaluated 50 adult patients (10 males and 40 females) who had serum iron and vitamin B12 deficiency, prospectively. All the patients had undergone upper gastrointestinal system endoscopy by the same endoscopist. The second part of the duodenum was evaluated with white light, magnified, and magnified/FICE endoscopy. Biopsy specimens were evaluated by the same pathologist. The specimens diagnosed as CeD were classified according to the Modified Marsh-Oberhuber criteria. RESULTS 10 of 50 patients (20%) were diagnosed as CeD. The average age was 41±11 years (20-67 years). Thirty percent of CeD diagnosed patients had typical CeD symptoms. Six of 10 patients (60%) who were diagnosed as CeD had typical endoscopic images under white lighted endoscopy. All of these 10 patients (100%) showed villous irregularity, partial villous atrophy, or total villous atrophy consistent with CeD with magnified and magnified/FICE endoscopy. CONCLUSION The practical use of magnified/FICE endoscopy allows us to differentiate mucosal abnormalities of the duodenum and minimize false-negative results that indicate normal mucosal findings with conventional endoscopy.


RESUMO INTRODUÇÃO A doença celíaca (DC) é uma doença autoimune que pode ter seu diagnóstico atrasado devido à presença de casos atípicos e assintomáticos na idade adulta. Neste trabalho, objetivamos estudar a frequência de DC e avaliar se as técnicas de endoscopia magnificada e magnificada/Fice (flexible spectral imaging color enhancement) contribuem para o diagnóstico em pacientes com deficiência sérica de ferro e vitamina B12. MÉTODO Foram avaliados prospectivamente 50 pacientes adultos (10 homens e 40 mulheres) com deficiência sérica de ferro e vitamina B12. Todos os pacientes foram submetidos a endoscopia digestiva alta pelo mesmo endoscopista. A segunda parte do duodeno foi avaliada com endoscopia com luz branca, magnificada e magnificada/Fice. As amostras de biópsia foram avaliadas pelo mesmo patologista. Os espécimes diagnosticados como DC foram classificados de acordo com os critérios de Marsh-Oberhuber modificado. RESULTADOS Dez dos 50 pacientes (% 20) foram diagnosticados como DC. A idade média foi de 41±11 anos (20-67 anos). Trinta por cento dos pacientes diagnosticados com DC apresentaram sintomas típicos de DC. Seis dos dez pacientes (60%) diagnosticados com DC tinham imagens endoscópicas típicas sob endoscopia de luz branca. Todos esses dez pacientes (% 100) apresentaram irregularidade das vilosidades, atrofia das vilosidades parciais ou atrofia das vilosidades totais consistentes com a DC com endoscopia magnificada e magnificada/Fice. CONCLUSÃO O uso prático da endoscopia magnificada/Fice permite diferenciar anormalidades mucosas do duodeno e minimizar os resultados falso-negativos que apresentam achados mucosais normais com a endoscopia convencional.


Subject(s)
Humans , Male , Female , Adult , Vitamin B 12 Deficiency , Celiac Disease , Image Enhancement , Endoscopy, Digestive System , Endoscopy , Iron , Middle Aged
20.
An. bras. dermatol ; 95(3): 379-382, May-June 2020. graf
Article in English | LILACS, ColecionaSUS | ID: biblio-1130887

ABSTRACT

Abstract In situations in when a dermoscopic record of a large lesion is desirable, the resulting images are usually restricted to a small field of view due to the limited diameter of dermatoscope lenses. This limitation often produces several photographs separately, thus losing the possibility of a single-image global evaluation. In these case reports, we show examples of a recently published image montage technique called Wide Area Digital Dermoscopy, in this case, applied to basal cell carcinomas.


Subject(s)
Humans , Male , Skin Neoplasms/diagnostic imaging , Image Processing, Computer-Assisted/methods , Carcinoma, Basal Cell/diagnostic imaging , Dermoscopy/methods , Skin Neoplasms/pathology , Software , Carcinoma, Basal Cell/pathology , Reproducibility of Results , Middle Aged
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