The feasibility and preliminary application of deltoid muscle volume measurement using MR volume of interest method / 中华放射学杂志

Objective To explore the feasibility and repeatability of deltoid muscle volume measurement using MR volume of interest method, and discuss the clinical significance. Methods Seventy-eight subjects'' MR images were retrospectively reviewed including 33 normal shoulders, 22 rotator cuff tear (7 male, 15 female), 12 cases with labrum lesions (11 male, 1 female), and 2 long head of biceps tendon lesions. Routine axial 2D MR images of deltoid muscle were transported into post-processing work station, the matrix of all images were higher than 275 × 336, and the imaging field included the upper and lower margin of the deltoid muscle, and the three dimension shape of muscle was reconstructed by software based on MR volume of interest, then the muscle volume was calculated automatically. This process was independently performed by 2 operators, and operator 1 repeated this process 1 week later. Intra-class correlation coefficient and 95％confidence interval were used to analyze the reliability and repeatability of the measurement. Deltoid muscle volumes of different ages and different pathological processes were compared using stratified sampling method, one-way analysis of variance (ANOVA), least significant difference (LSD) multiple comparison method, and independent-samples t test. Results Three-dimensional shape of deltoid muscle were well demonstrated and corresponded well to the known anatomy. The measurement showed very good inter-and intra-observer consistency (ICC: 0.983 and 0.995, respectively). There were statistical differences in deltoid muscle volume between group A and C [volume:(382.39 ± 38.87) cm3 and (279.15 ± 63.65) cm3;P=0.000], group B and C [volume:(358.49 ± 44.50) cm3 and (279.15 ± 63.65) cm3; P=0.000]. The normal participants were divided by gender into normal group 1 (9 males and 15 females) and normal group 2 (13 males and 1 female) using stratified random sampling method. The deltoid muscle volume of patients with rotator cuff tear was lower than the normal group 1 [volume:(313.21±63.48) cm3 versus (359.08±57.98) cm3;t=-2.562, P<0.05], and there was no statistical difference in deltoid muscle volume between labrum-ligament complex lesions patients and the normal group 2 [volume: (394.28 ± 33.67) cm3 versus (389.30 ± 22.14) cm3; t=0.385, P=0.704]. Conclusions Volume of interest measurement based on routine MR images could evaluate the deltoid muscle volume conveniently and directly, and which could be used as a preferred choice for muscle volume evaluation.

Longitudinal Study of Cerebral Blood Perfusion Deficits in 12 Cases of Dementia of Alzheimer's Typer / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the pattern of longitudinal changes in cerebral blood perfusion defects using SPECT in patients with dementia of Alzheimer's type . METHOD: Twelve patients with dementia of Alzheimer's type(10 male, 2 female; mean age 73.25+/- 10.62 years), diagnosed by the criteria of the DSM IV and the NINCDS-ADRDA, and ten normal comparison subjects(7 male, 3 female; mean age 75.10+/-5.76 years) were recruited. They were rated by Mini-Mental Status Examination, Mattis dementia Rating Scale, and Hamilton Depression Rating Scale. rCBF(regional cerebral blood flow) was measured using 99mTc-HMPAO SPECT at the initial study in all subjects, but rCBF was remeasured only in the patients after the follow-up period of average 2 years. SPECT scans of dementia patients and comparison subjects were analyzed by three- dimensional volume of interest method. RESULTS: Results were as follows. 1) There were significant perfusion defects in the bilateral frontal and temporoparietal areas in patients with dementia compared with normal comparison subjects at the baseline evaluation. More extensive perfusion defects including left superior frontal and medial temporal areas were observed in the follow-up SPECT scan compared with baseline scan. 2) There was significant negative correlation between rCBF of bilateral temporal lobe at the baseline scan and the rate of decline of scores of MMSE-K and Mattis dementia rating scale. 3) Various areas of the brain showed correlations between rCBF at the baseline scan and the rate of decline of scores of five subscales of Mattis dementia rating scale. CONCLUSIONS: Three-dimensional VOI approach using SPM analysis showed the characteristic perfusion defects and pattern of longitudinal changes in the patients of dementia of Alzheimer's type, which may be overlooked by the conventional region-of-interest technique. This alteration in rCBF may be closely related to the pathophysiological process of dementia of Alzheimer's type.

Cerebrovascular Reactivity in Dementia of Alzheimer's Type Assessed by Acetaxolamide Brain SPECT / 신경정신의학

OBJECTIVES: The purpose of this study was to investigate the abnormality of cerebrovascular reactivity in patients with dementia of Alzheimer's type by the acetazolamide brain SPECT, which has been used in the assessment of cerebrovascular diseases. METHODS: Eighteen patients with dementia of Alzheimer's type, as diagnosed by the criteria of DSM-IV and NINCDS-ADRDA, and ten normal comparison subjects were recruited. They were rated by Mini-Mental Status Examination, Mattis Ddementia Rating Scale, and Hamilton Depression Rating Scale. Acetazolamide brain SPECT scans of dementia patients and comparison subjects were analyzed by 3-dimensional volume of interest method. RESULTS: The results were as follows. There were significant differences in the values of cerebrovascular reactivity between the two groups. The cerebrovascular reactivity of dementia patients was significantly decreased in the right frontal lobes, and increased in left temporal lobe, compared to comparison subjects(p<0.05). CONCLUSION: These results imply the possible role of the abnormality of cerebrovascular reactivity in the pathophysiology of dementia of Alzheimer's type.