Assessment of Acute Pulmonary Embolism by Computer-Aided Technique: A Reliability Study.

BACKGROUND Acute pulmonary embolism is one of the most common cardiovascular diseases. Computer-aided technique is widely used in chest imaging, especially for assessing pulmonary embolism. The reliability and quantitative analyses of computer-aided technique are necessary. This study aimed to evaluate the reliability of geometry-based computer-aided detection and quantification for emboli morphology and severity of acute pulmonary embolism. MATERIAL AND METHODS Thirty patients suspected of acute pulmonary embolism were analyzed by both manual and computer-aided interpretation of vascular obstruction index and computer-aided measurements of emboli quantitative parameters. The reliability of Qanadli and Mastora scores was analyzed using computer-aided and manual interpretation. RESULTS The time costs of manual and computer-aided interpretation were statistically different (374.90±150.16 versus 121.07±51.76, P<0.001). The difference between the computer-aided and manual interpretation of Qanadli score was 1.83±2.19, and 96.7% (29 out of 30) of the measurements were within 95% confidence interval (intraclass correlation coefficient, ICC=0.998). The difference between the computer-aided and manual interpretation of Mastora score was 1.46±1.62, and 96.7% (29 out of 30) of the measurements were within 95% confidence interval (ICC=0.997). The emboli quantitative parameters were moderately correlated with the Qanadli and Mastora scores (all P<0.001). CONCLUSIONS Computer-aided technique could reduce the time costs, improve the and reliability of vascular obstruction index and provided additional quantitative parameters for disease assessment.

Large-scale cortical volume correlation networks reveal disrupted small world patterns in Parkinson's disease.

To date, the most frequently reported neuroimaging biomarkers in Parkinson's disease (PD) are direct brain imaging measurements focusing on local disrupted regions. However, the notion that PD is related to abnormal functional and structural connectivity has received support in the past few years. Here, we employed graph theory to analyze the structural co-variance networks derived from 50 PD patients and 48 normal controls (NC). Then, the small world properties of brain networks were assessed in the structural networks that were constructed based on cortical volume data. Our results showed that both the PD and NC groups had a small world architecture in brain structural networks. However, the PD patients had a higher characteristic path length and clustering coefficients compared with the NC group. With regard to the nodal centrality, 11 regions, including 3 association cortices, 5 paralimbic cortices, and 3 subcortical regions were identified as hubs in the PD group. In contrast, 10 regions, including 7 association cortical regions, 2 paralimbic cortical regions, and the primary motor cortex region, were identified as hubs. Moreover, the regional centrality was profoundly affected in PD patients, including decreased nodal centrality in the right inferior occipital gyrus and the middle temporal gyrus and increased nodal centrality in the right amygdala, the left caudate and the superior temporal gyrus. In addition, the structural cortical network of PD showed reduced topological stability for targeted attacks. Together, this study shows that the coordinated patterns of cortical volume network are widely altered in PD patients with a decrease in the efficiency of parallel information processing. These changes provide structural evidence to support the concept that the core pathophysiology of PD is associated with disruptive alterations in the coordination of large-scale brain networks that underlie high-level cognition.

Functional evaluation of normothermic ischemia and reperfusion injury in dog kidney by combining MR diffusion-weighted imaging and Gd-DTPA enhanced first-pass perfusion.

PURPOSE: To evaluate functional alterations of renal ischemia and reperfusion injury using MR diffusion-weighted imaging and dynamic perfusion imaging. MATERIALS AND METHODS: Twelve dogs were randomly divided into four groups. Animal renal ischemia was respectively induced for 30 (group 1), 60 (group 2), 90 (group 3), and 120 (group 4) minutes by left renal artery ligation under anesthesia. Using a 1.5 T MR system, true-FISP, TSE, EPI, and DWI sequences were acquired in five different periods; specifically, pre-ischemia, onset-ischemia, late ischemia, onset-reperfusion, and post-reperfusion. Moreover, a turbo-FLASH sequence (TR/TE/TI/FA = 5.8/3.2/400 msec/10 degrees ) with a temporal resolution of 1.16 seconds was acquired. Signal intensity (SI) was measured in the cortex, outer medulla, and inner medulla of kidney. Apparent diffusion coefficient (ADC) values were calculated, and SI was plotted as a function of time. RESULTS: In all animals, significant SI changes of the left kidney on T2/T2*WI were detected following ischemia-reperfusion insult compared to corresponding values of the right kidney. Following ligation, the ADC values decreased in all layers of the left kidney. Immediately after the release of ligation, ADC values in both outer and inner medulla of the left kidney remained lower than those of the right kidney in those animals which were induced with renal ischemia for 60, 90, and 120 minutes. In all groups, a uniphasic enhancement pattern was observed in the outer and inner medulla of the left kidney, accompanied by a decrease of the area under the curve. CONCLUSION: Our results suggest that MR diffusion-weighted imaging and dynamic perfusion imaging are useful in identifying renal dysfunction following normothermic ischemia and reperfusion injury.