Dual-energy CT angiography-derived virtual non-contrast images for follow-up of patients with surgically clipped aneurysms: a retrospective study

Abstract

Purpose

To evaluate the diagnostic performance, image quality, artifacts, and radiation doses of virtual non-contrast (VNC) images, relative to true non-contrast (TNC) images, in patients with surgically clipped aneurysms.

Methods

Seventy-six patients who underwent unenhanced computed tomography (CT) and dual-energy (DE)-CT angiography after surgical clipping of 85 intracranial aneurysms were included in the study. Diagnostic performances of VNC and TNC images were compared with respect to sensitivity, specificity, and positive and negative predictive values. The results of quantitative and qualitative analyses were compared between VNC and TNC images. Radiation doses were also compared between VNC and TNC images.

Results

Diagnostic performance of VNC images was lower than that of TNC images; however, addition of contrast-enhanced images improved diagnostic performance. Image noise and mean attenuation of VNC images were significantly higher than those of TNC images in the centrum semiovale, cerebellum, and pons. The quality of VNC images was excellent or sufficient (85.5% for observer 1, 85.5% for observer 2), and complete acceptance of VNC images was achieved in 64.5% for observer 1 and in 71.0% for observer 2; however, the addition of contrast-enhanced images increased the level of acceptance (92.0% for observer 1, 90.9% for observer 2). Clip artifacts were significantly lower in VNC images than in TNC images. CT dose index, dose-length product, and effective dose were significantly lower without TNC images.

Conclusion

VNC images showed lower diagnostic performance and image quality, and higher image noise than TNC images; however, VNC images could reduce clip artifacts and radiation doses.

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Maternal allergen-specific IgG may protect the child against allergic sensitization

Publication date: Available online 25 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Christian Lupinek, Heidrun Hochwallner, Catharina Johansson, Axel Mie, Eva Rigler, Annika Scheynius, Johan Alm, Rudolf Valenta

Abstract

Background

The analysis of allergen-specific IgE responses in birth cohorts with micro-arrayed allergens has provided detailed information regarding the evolution of specific IgE responses in children. High resolution data regarding early development of allergen-specific IgG are needed.

Objective

To analyze IgG reactivity to micro-arrayed allergens in mothers during pregnancy, in cord blood samples, breast milk and in infants in the first years of life with the aim to investigate if maternal allergen-specific IgG may protect against IgE sensitization in the offspring.

Methods

Plasma samples from mothers during third trimester, cord blood, breast milk collected at 2 months after delivery, and plasma samples from children at 6, 12 and 60 months of age were analyzed for IgG reactivity to 164 micro-arrayed allergens (ImmunoCAP ISAC technology) in 99 families in the Swedish birth cohort ALADDIN. IgE sensitizations to micro-arrayed allergens were determined at 5 years of age in the children.

Results

Allergen-specific IgG reactivity profiles in mothers, cord blood and breast milk were highly correlated. Maternal allergen-specific IgG persisted in some children at 6 months. Children´s allergen-specific IgG production occurred at 6 months and reflected allergen exposure. Children who were IgE-sensitized against an allergen at 5 years of age had significantly higher allergen-specific IgG levels than non-sensitized children. For all 164 tested allergens, children from mothers with elevated (>30 ISU) specific plasma IgG against an allergen had no IgE sensitizations against that allergen at 5 years of age.

Conclusion

This is the first detailed analysis of the molecular IgG recognition profile in mothers and their children in early life. High allergen-specific IgG reactivity in mother´s plasma and breast milk and in cord blood seemed to protect against allergic sensitization at 5 years of age.

Clinical implication

High levels of allergen-specific IgG in mothers during third trimester and in cord blood seem to protect against allergic sensitization in the offsprings. This finding has implications for the prevention of allergy.

Graphical abstract

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Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis

Publication date: Available online 24 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Lisa Zhou, Alexandra Leonard, Ana B. Pavel, Kunal Malik, Aishwarya Raja, Jacob Glickman, Yeriel D. Estrada, Xiangyu Peng, Ester del Duca, Juan Sanz-Cabanillas, Juan Ruano, Hui Xu, Ning Zhang, Huei-Chi Wen, Juana Gonzalez, Sandra Garcet, James G. Krueger, Emma Guttman-Yassky

Abstract

Background

Atopic dermatitis/AD shows differential clinical presentation in older compared to younger patients. Nevertheless, changes in the AD molecular profile with age are unknown.

Objective

To characterize age-related changes in the AD profile.

Methods

We evaluated age-specific changes in lesional and non-lesional tissues and blood from moderate-to-severe AD patients (n=246) and age-matched controls (n=72) using immunohistochemistry, qRT-PCR, and Singulex in a cross-sectional study. Patients were analyzed using age-groups (18-40, 41-60, and 61+ years old).

Results

While disease severity/SCORAD was similar across AD age-groups (mean:∼60; P=0.873), dendritic cell infiltrates (CD1b⁺, FcεRI⁺; P<0.05) decreased with age. T_H2 measures (IL-5, IL-13, CCL13, CCL18, CCL26) significantly decreased with age in AD, despite increasing with age in controls. Consistent with T_H2 axis decreases, serum IgE and eosinophils negatively correlated with age in AD (r=-0.24, r=-0.23, P<0.05). T_H22-secreted IL-22 also decreased with age uniquely in AD (P<0.05). T_H1- (IFN-γ, IL-12/23p40, STAT1, CXCL9; P<0.05 for CXCL9) and T_H17-related markers (IL-17A, IL-20; P<0.05 for IL-20) increased with age in both AD and controls. Terminal differentiation measures significantly increased in older AD patients (LOR, FLG; P<0.05), while S100As (S100A8; P<0.01) and hyperplasia markers (epidermal thickness/ET, K16, Ki67; P<0.05 for K16) decreased. Serum trends in AD mimicked skin findings, with T_H2 downregulation (CCL26; r=-0.32, P<0.1) and T_H1 upregulation (IFN-γ; r=0.48, P<0.01) with age.

Conclusion

The adult AD profile varies with age. While T_H1/T_H17-skewing decreases in both AD and controls, AD shows unique decreases in T_H2/T_H22 polarization, and normalization of epithelial abnormalities. Thus, age-specific treatment approaches may be beneficial for AD.

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Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

Conclusions The majority of patients undergoing translabyrinthine excision of vestibular schwannoma with concurrent CI achieve open set speech perception, with 75% of these patients meeting criteria for being intermediate to high performers. Additional benefits include improved subjective hearing measures, decreased tinnitus, and improved sound localization. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Dual-energy CT angiography-derived virtual non-contrast images for follow-up of patients with surgically clipped aneurysms: a retrospective study

Abstract

Purpose

To evaluate the diagnostic performance, image quality, artifacts, and radiation doses of virtual non-contrast (VNC) images, relative to true non-contrast (TNC) images, in patients with surgically clipped aneurysms.

Methods

Seventy-six patients who underwent unenhanced computed tomography (CT) and dual-energy (DE)-CT angiography after surgical clipping of 85 intracranial aneurysms were included in the study. Diagnostic performances of VNC and TNC images were compared with respect to sensitivity, specificity, and positive and negative predictive values. The results of quantitative and qualitative analyses were compared between VNC and TNC images. Radiation doses were also compared between VNC and TNC images.

Results

Diagnostic performance of VNC images was lower than that of TNC images; however, addition of contrast-enhanced images improved diagnostic performance. Image noise and mean attenuation of VNC images were significantly higher than those of TNC images in the centrum semiovale, cerebellum, and pons. The quality of VNC images was excellent or sufficient (85.5% for observer 1, 85.5% for observer 2), and complete acceptance of VNC images was achieved in 64.5% for observer 1 and in 71.0% for observer 2; however, the addition of contrast-enhanced images increased the level of acceptance (92.0% for observer 1, 90.9% for observer 2). Clip artifacts were significantly lower in VNC images than in TNC images. CT dose index, dose-length product, and effective dose were significantly lower without TNC images.

Conclusion

VNC images showed lower diagnostic performance and image quality, and higher image noise than TNC images; however, VNC images could reduce clip artifacts and radiation doses.

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Maternal allergen-specific IgG may protect the child against allergic sensitization

Publication date: Available online 25 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Christian Lupinek, Heidrun Hochwallner, Catharina Johansson, Axel Mie, Eva Rigler, Annika Scheynius, Johan Alm, Rudolf Valenta

Abstract

Background

The analysis of allergen-specific IgE responses in birth cohorts with micro-arrayed allergens has provided detailed information regarding the evolution of specific IgE responses in children. High resolution data regarding early development of allergen-specific IgG are needed.

Objective

To analyze IgG reactivity to micro-arrayed allergens in mothers during pregnancy, in cord blood samples, breast milk and in infants in the first years of life with the aim to investigate if maternal allergen-specific IgG may protect against IgE sensitization in the offspring.

Methods

Plasma samples from mothers during third trimester, cord blood, breast milk collected at 2 months after delivery, and plasma samples from children at 6, 12 and 60 months of age were analyzed for IgG reactivity to 164 micro-arrayed allergens (ImmunoCAP ISAC technology) in 99 families in the Swedish birth cohort ALADDIN. IgE sensitizations to micro-arrayed allergens were determined at 5 years of age in the children.

Results

Allergen-specific IgG reactivity profiles in mothers, cord blood and breast milk were highly correlated. Maternal allergen-specific IgG persisted in some children at 6 months. Children´s allergen-specific IgG production occurred at 6 months and reflected allergen exposure. Children who were IgE-sensitized against an allergen at 5 years of age had significantly higher allergen-specific IgG levels than non-sensitized children. For all 164 tested allergens, children from mothers with elevated (>30 ISU) specific plasma IgG against an allergen had no IgE sensitizations against that allergen at 5 years of age.

Conclusion

This is the first detailed analysis of the molecular IgG recognition profile in mothers and their children in early life. High allergen-specific IgG reactivity in mother´s plasma and breast milk and in cord blood seemed to protect against allergic sensitization at 5 years of age.

Clinical implication

High levels of allergen-specific IgG in mothers during third trimester and in cord blood seem to protect against allergic sensitization in the offsprings. This finding has implications for the prevention of allergy.

Graphical abstract

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Age-specific changes in the molecular phenotype of patients with moderate-to-severe atopic dermatitis

Publication date: Available online 24 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): Lisa Zhou, Alexandra Leonard, Ana B. Pavel, Kunal Malik, Aishwarya Raja, Jacob Glickman, Yeriel D. Estrada, Xiangyu Peng, Ester del Duca, Juan Sanz-Cabanillas, Juan Ruano, Hui Xu, Ning Zhang, Huei-Chi Wen, Juana Gonzalez, Sandra Garcet, James G. Krueger, Emma Guttman-Yassky

Abstract

Background

Atopic dermatitis/AD shows differential clinical presentation in older compared to younger patients. Nevertheless, changes in the AD molecular profile with age are unknown.

Objective

To characterize age-related changes in the AD profile.

Methods

We evaluated age-specific changes in lesional and non-lesional tissues and blood from moderate-to-severe AD patients (n=246) and age-matched controls (n=72) using immunohistochemistry, qRT-PCR, and Singulex in a cross-sectional study. Patients were analyzed using age-groups (18-40, 41-60, and 61+ years old).

Results

While disease severity/SCORAD was similar across AD age-groups (mean:∼60; P=0.873), dendritic cell infiltrates (CD1b⁺, FcεRI⁺; P<0.05) decreased with age. T_H2 measures (IL-5, IL-13, CCL13, CCL18, CCL26) significantly decreased with age in AD, despite increasing with age in controls. Consistent with T_H2 axis decreases, serum IgE and eosinophils negatively correlated with age in AD (r=-0.24, r=-0.23, P<0.05). T_H22-secreted IL-22 also decreased with age uniquely in AD (P<0.05). T_H1- (IFN-γ, IL-12/23p40, STAT1, CXCL9; P<0.05 for CXCL9) and T_H17-related markers (IL-17A, IL-20; P<0.05 for IL-20) increased with age in both AD and controls. Terminal differentiation measures significantly increased in older AD patients (LOR, FLG; P<0.05), while S100As (S100A8; P<0.01) and hyperplasia markers (epidermal thickness/ET, K16, Ki67; P<0.05 for K16) decreased. Serum trends in AD mimicked skin findings, with T_H2 downregulation (CCL26; r=-0.32, P<0.1) and T_H1 upregulation (IFN-γ; r=0.48, P<0.01) with age.

Conclusion

The adult AD profile varies with age. While T_H1/T_H17-skewing decreases in both AD and controls, AD shows unique decreases in T_H2/T_H22 polarization, and normalization of epithelial abnormalities. Thus, age-specific treatment approaches may be beneficial for AD.

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Translabyrinthine Excision of Vestibular Schwannoma with Concurrent Cochlear Implantation: Systematic Review

Conclusions The majority of patients undergoing translabyrinthine excision of vestibular schwannoma with concurrent CI achieve open set speech perception, with 75% of these patients meeting criteria for being intermediate to high performers. Additional benefits include improved subjective hearing measures, decreased tinnitus, and improved sound localization. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Journal of Neurological Surgery Part B: Skull Base)

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Role of a two-step suture in the prevention of postoperative transoral salivary fistulas during reconstruction of the oral cavity

Publication date: Available online 24 January 2019

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Z.-H. Ren, K. Wu, Y. Wang, Z.-W. Tian, J.-Z. Hu

Abstract

Transoral salivary fistulas are one of the most serious postoperative complications after operations for oral cancer, and we propose a new, two-step suture method to avoid them. From January 2005 to September 2017, 240 patients were recruited at the Shanghai Ninth People's Hospital and divided into experimental (n = 89) or control (n = 151) groups. The experimental group was treated by a two-step suture technique, while the control group had conventional sutures. Statistical differences were assessed using the chi squared and t tests, as appropriate. Only two patients developed transoral salivary fistulas in the experimental group, while in the control group there were 14 (9%). The incidence of fistulas in the experimental group was significantly lower than that in the control group (p = 0.035). Regression analysis showed that there was a significant correlation between the groups and the incidence of salivary fistulas (p = 0.032). The two-step suture technique is safe, effective, and easy to learn, and could reduce the incidence of postoperative salivary fistulas.

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Automated CT Quantification Methods for the Assessment of Interstitial Lung Disease in Collagen Vascular Diseases: A Systematic Review

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Florien S. van Royen, Sofia A. Moll, Jacob M. van Laar, Joris M. van Montfrans, Pim A. de Jong, Firdaus A.A. Mohamed Hoesein

Abstract

Interstitial lung disease (ILD) is highly prevalent in collagen vascular diseases and reduction of ILD is an important therapeutic target. To that end, reliable quantification of pulmonary disease severity is of great significance. This study systematically reviewed the literature on automated computed tomography (CT) quantification methods for assessing ILD in collagen vascular diseases. PRISMA-DTA guidelines for systematic reviews were used and 19 original research articles up to January 2018 were included based on a MEDLINE/Pubmed and Embase search. Quantitative CT methods were categorized as histogram assessment (12 studies) or pattern/texture recognition (7 studies). R² for correlation with visual ILD scoring ranged from 0.143 (p < 0.01) to 0.687 (p < 0.0001), for FVC from 0.048 (p < 0.0001) to 0.504 (p < 0.0001) and for DLCO from 0.015 (p = 0.61) to 0.449 (p < 0.0001). Automated CT methods are independent of reader's expertise and are a promising tool in the quantification of ILD in collagen vascular disease patients.

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Automated CT Quantification Methods for the Assessment of Interstitial Lung Disease in Collagen Vascular Diseases: A Systematic Review

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Florien S. van Royen, Sofia A. Moll, Jacob M. van Laar, Joris M. van Montfrans, Pim A. de Jong, Firdaus A.A. Mohamed Hoesein

Abstract

Interstitial lung disease (ILD) is highly prevalent in collagen vascular diseases and reduction of ILD is an important therapeutic target. To that end, reliable quantification of pulmonary disease severity is of great significance. This study systematically reviewed the literature on automated computed tomography (CT) quantification methods for assessing ILD in collagen vascular diseases. PRISMA-DTA guidelines for systematic reviews were used and 19 original research articles up to January 2018 were included based on a MEDLINE/Pubmed and Embase search. Quantitative CT methods were categorized as histogram assessment (12 studies) or pattern/texture recognition (7 studies). R² for correlation with visual ILD scoring ranged from 0.143 (p < 0.01) to 0.687 (p < 0.0001), for FVC from 0.048 (p < 0.0001) to 0.504 (p < 0.0001) and for DLCO from 0.015 (p = 0.61) to 0.449 (p < 0.0001). Automated CT methods are independent of reader's expertise and are a promising tool in the quantification of ILD in collagen vascular disease patients.

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MRI Texture Analysis based on 3D tumor measurement Reflects the IDH1 Mutations in Gliomas - A Preliminary Study

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Liang Han, Siyu Wang, Yanwei Miao, Huicong Shen, Yan Guo, Lizhi Xie, Yuqing Shang, Junyi Dong, Xiaoxin Li, Weiwei Wang, Qingwei Song

Abstract

Objective

To evaluate the differentiation efficiency of texture analysis of T1WI, T2WI and contrasted-enhanced T1WI MRI sequences in gliomas with and without IDH1 mutation based on entire tumor region.

Materials and methods

A total of 42 patients with histopathologically confirmed gliomas, including 21 patients carrying IDH1 mutation (IDH1^mutation group) and 21 with wild-type IDH1 (IDH1^wt group) were included in this study. The preoperative MRI and clinical data were collected. The regions of interest (ROIs) covering the entire tumor and edema were manually delineated on axial slices using O.K. (Omni Kinetics, GE Healthcare, China) software; and the histogram and GLCM features based on T1WI, T2WI and contrasted-enhanced T1WI sequences were automatically generated.

Results

Based on contrasted-enhanced T1WI features, the inertia resulted as the best feature for diagnosis, with the AUC of 0.844. Furthermore, the AUC for gliomas prediction with IDH1^mutation was 0.800 for cluster prominence. IDH1-mutation was differentiated on T2WI with the highest AUC of 0.848, which corresponded to GLCM Entropy. After modeling, the accuracy of the contrasted-enhanced T1WI, T1WI, and T2WI features model was 0.952, 0.857, and 0.738, respectively. The AUC of Joint Variable_T1WI+C for predicting IDH1^mutation was 0.984, while the AUC of Joint Variable_T1WI for predicting the same mutation was 0.927. The diagnostic efficiency of Joint Variable_T2WI was also desirable.

Conclusion

MRI texture analysis could be used as a new noninvasive method for identification of gliomas with IDH1 mutation. The present results show that the Joint Variable derived from conventional MR imaging histogram and GLCM features is suitable for precise detection of IDH1-mutated gliomas.

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MRI Texture Analysis based on 3D tumor measurement Reflects the IDH1 Mutations in Gliomas - A Preliminary Study

Publication date: Available online 24 January 2019

Source: European Journal of Radiology

Author(s): Liang Han, Siyu Wang, Yanwei Miao, Huicong Shen, Yan Guo, Lizhi Xie, Yuqing Shang, Junyi Dong, Xiaoxin Li, Weiwei Wang, Qingwei Song

Abstract

Objective

To evaluate the differentiation efficiency of texture analysis of T1WI, T2WI and contrasted-enhanced T1WI MRI sequences in gliomas with and without IDH1 mutation based on entire tumor region.

Materials and methods

A total of 42 patients with histopathologically confirmed gliomas, including 21 patients carrying IDH1 mutation (IDH1^mutation group) and 21 with wild-type IDH1 (IDH1^wt group) were included in this study. The preoperative MRI and clinical data were collected. The regions of interest (ROIs) covering the entire tumor and edema were manually delineated on axial slices using O.K. (Omni Kinetics, GE Healthcare, China) software; and the histogram and GLCM features based on T1WI, T2WI and contrasted-enhanced T1WI sequences were automatically generated.

Results

Based on contrasted-enhanced T1WI features, the inertia resulted as the best feature for diagnosis, with the AUC of 0.844. Furthermore, the AUC for gliomas prediction with IDH1^mutation was 0.800 for cluster prominence. IDH1-mutation was differentiated on T2WI with the highest AUC of 0.848, which corresponded to GLCM Entropy. After modeling, the accuracy of the contrasted-enhanced T1WI, T1WI, and T2WI features model was 0.952, 0.857, and 0.738, respectively. The AUC of Joint Variable_T1WI+C for predicting IDH1^mutation was 0.984, while the AUC of Joint Variable_T1WI for predicting the same mutation was 0.927. The diagnostic efficiency of Joint Variable_T2WI was also desirable.

Conclusion

MRI texture analysis could be used as a new noninvasive method for identification of gliomas with IDH1 mutation. The present results show that the Joint Variable derived from conventional MR imaging histogram and GLCM features is suitable for precise detection of IDH1-mutated gliomas.

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Absence of dentate nucleus resting‐state functional connectivity changes in nonneurological patients with gadolinium‐related hyperintensity on T1‐weighted images

Background

The dentate nuclei of the cerebellum are the areas where gadolinium predominantly accumulates. It is not yet known whether gadolinium deposition affects brain functions.

Purpose/Hypothesis

To assess whether gadolinium‐dependent high signal intensity of the cerebellum on T₁‐weighted images of nonneurological adult patients with Crohn's disease is associated with modifications of resting‐state functional connectivity (RSFC) of the cerebellum and dentate nucleus.

Study Type

Observational, cross‐sectional.

Population

Fifteen patients affected by Crohn's disease were compared with 16 healthy age‐ and gender‐matched control subjects. All participants underwent neurological, neurocognitive‐psychological assessment, and blood sampling.

Field Strength/Sequence

1.5‐T magnet blood oxygenation level‐dependent (BOLD) functional MRI.

Assessment

High signal intensity on T₁‐weighted images, cerebellum functional connectivity, neurocognitive performance, and blood circulating gadolinium levels.

Statistical Tests

An unpaired two‐sample t‐test (age and sex were nuisance variables) was used to investigate between‐group differences in cerebellar and dentate nucleus functional connectivity. Z‐statistical images were set using clusters determined by Z > 2.3 and a familywise error (FWE)‐corrected cluster significance threshold of P = 0.05.

Results

Dentate nuclei RSFC was not different (P = n.s.) between patients with gadolinium‐dependent high signal intensity on T₁‐weighted images and controls. Pre‐ and postcentral gyrus bilaterally and the right supplementary motor cortex showed a decrease of RSFC with the cerebellum hemispheres (P < 0.05 FWE‐corrected) and was related to disease duration but not to gadodiamide cumulative doses (P = n.s.).

Data Conclusion

Crohn's disease patients with gadolinium‐dependent hyperintense dentate nuclei on unenhanced T₁‐weighted images do not show dentate nucleus RSFC changes.

Level of Evidence: 2

Technical Efficacy Stage: 5

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Absence of dentate nucleus resting‐state functional connectivity changes in nonneurological patients with gadolinium‐related hyperintensity on T1‐weighted images

Background

The dentate nuclei of the cerebellum are the areas where gadolinium predominantly accumulates. It is not yet known whether gadolinium deposition affects brain functions.

Purpose/Hypothesis

To assess whether gadolinium‐dependent high signal intensity of the cerebellum on T₁‐weighted images of nonneurological adult patients with Crohn's disease is associated with modifications of resting‐state functional connectivity (RSFC) of the cerebellum and dentate nucleus.

Study Type

Observational, cross‐sectional.

Population

Fifteen patients affected by Crohn's disease were compared with 16 healthy age‐ and gender‐matched control subjects. All participants underwent neurological, neurocognitive‐psychological assessment, and blood sampling.

Field Strength/Sequence

1.5‐T magnet blood oxygenation level‐dependent (BOLD) functional MRI.

Assessment

High signal intensity on T₁‐weighted images, cerebellum functional connectivity, neurocognitive performance, and blood circulating gadolinium levels.

Statistical Tests

An unpaired two‐sample t‐test (age and sex were nuisance variables) was used to investigate between‐group differences in cerebellar and dentate nucleus functional connectivity. Z‐statistical images were set using clusters determined by Z > 2.3 and a familywise error (FWE)‐corrected cluster significance threshold of P = 0.05.

Results

Dentate nuclei RSFC was not different (P = n.s.) between patients with gadolinium‐dependent high signal intensity on T₁‐weighted images and controls. Pre‐ and postcentral gyrus bilaterally and the right supplementary motor cortex showed a decrease of RSFC with the cerebellum hemispheres (P < 0.05 FWE‐corrected) and was related to disease duration but not to gadodiamide cumulative doses (P = n.s.).

Data Conclusion

Crohn's disease patients with gadolinium‐dependent hyperintense dentate nuclei on unenhanced T₁‐weighted images do not show dentate nucleus RSFC changes.

Level of Evidence: 2

Technical Efficacy Stage: 5

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23Na Triple‐quantum signal of in vitro human liver cells, liposomes, and nanoparticles: Cell viability assessment vs. separation of intra‐ and extracellular signal

Background

Triple‐quantum (TQ) filtered sequences have become more popular in sodium MR due to the increased usage of scanners with field strengths exceeding 3T. Disagreement as to whether TQ signal can provide separation of intra‐ and extracellular compartments persists.

Purpose

To provide insight into TQ signal behavior on a cellular level.

Study Type

Prospective.

Phantom/Specimen

Cell‐phantoms in the form of liposomes, encapsulated 0 mM, 145 mM, 154 mM Na+ in a double‐lipid membrane similar to cells. Poly(lactic‐co‐glycolic acid) nanoparticles encapsulated 154 mM Na+ within a single‐layer membrane structure. Two microcavity chips with each 6 × 10⁶ human HEP G2 liver cells were measured in an MR‐compatible bioreactor.

Field Strength/Sequence

Spectroscopic TQ sequence with time proportional phase‐increments at 9.4T.

Assessment

The TQ signal of viable, dead cells, and cell‐phantoms was assessed by a fit in the time domain and by the amplitude in the frequency domain.

Statistical Tests

The noise variance (σ) was evaluated to express the deviation of the measured TQ signal amplitude from noise.

Results

TQ signal >20σ was found for liposomes encapsulating sodium ions. Liposomal encapsulation of 0 mM Na+ and 154 mM Na+ encapsulation in the nanoparticles resulted in <2σ TQ signal. Cells under normal perfusion resulted in >9σ TQ signal. Compared with TQ signal under normal perfusion, a 56% lower TQ signal of was observed (25σ) during perfusion stop. TQ signal returned to 92% of the initial signal after reperfusion.

Data Conclusion

Our measurements indicate that TQ signal in liposomes was observed due to the trapping of ions within the double‐lipid membrane rather than from the intraliposomal space. Transfer to the cell results suggests that TQ signal was observed from motion restriction equivalent to trapping.

Level of Evidence: 1

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2019.

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23Na Triple‐quantum signal of in vitro human liver cells, liposomes, and nanoparticles: Cell viability assessment vs. separation of intra‐ and extracellular signal

Background

Triple‐quantum (TQ) filtered sequences have become more popular in sodium MR due to the increased usage of scanners with field strengths exceeding 3T. Disagreement as to whether TQ signal can provide separation of intra‐ and extracellular compartments persists.

Purpose

To provide insight into TQ signal behavior on a cellular level.

Study Type

Prospective.

Phantom/Specimen

Cell‐phantoms in the form of liposomes, encapsulated 0 mM, 145 mM, 154 mM Na+ in a double‐lipid membrane similar to cells. Poly(lactic‐co‐glycolic acid) nanoparticles encapsulated 154 mM Na+ within a single‐layer membrane structure. Two microcavity chips with each 6 × 10⁶ human HEP G2 liver cells were measured in an MR‐compatible bioreactor.

Field Strength/Sequence

Spectroscopic TQ sequence with time proportional phase‐increments at 9.4T.

Assessment

The TQ signal of viable, dead cells, and cell‐phantoms was assessed by a fit in the time domain and by the amplitude in the frequency domain.

Statistical Tests

The noise variance (σ) was evaluated to express the deviation of the measured TQ signal amplitude from noise.

Results

TQ signal >20σ was found for liposomes encapsulating sodium ions. Liposomal encapsulation of 0 mM Na+ and 154 mM Na+ encapsulation in the nanoparticles resulted in <2σ TQ signal. Cells under normal perfusion resulted in >9σ TQ signal. Compared with TQ signal under normal perfusion, a 56% lower TQ signal of was observed (25σ) during perfusion stop. TQ signal returned to 92% of the initial signal after reperfusion.

Data Conclusion

Our measurements indicate that TQ signal in liposomes was observed due to the trapping of ions within the double‐lipid membrane rather than from the intraliposomal space. Transfer to the cell results suggests that TQ signal was observed from motion restriction equivalent to trapping.

Level of Evidence: 1

Technical Efficacy: Stage 3

J. Magn. Reson. Imaging 2019.

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Recommendations towards standards for quantitative MRI (qMRI) and outstanding needs

Level of Evidence: 5

Technical Efficacy: Stage 5

J. Magn. Reson. Imaging 2019.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tcn8M1

Recommendations towards standards for quantitative MRI (qMRI) and outstanding needs

Level of Evidence: 5

Technical Efficacy: Stage 5

J. Magn. Reson. Imaging 2019.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Tcn8M1

Role of a two-step suture in the prevention of postoperative transoral salivary fistulas during reconstruction of the oral cavity

Publication date: Available online 24 January 2019

Source: British Journal of Oral and Maxillofacial Surgery

Author(s): Z.-H. Ren, K. Wu, Y. Wang, Z.-W. Tian, J.-Z. Hu

Abstract

Transoral salivary fistulas are one of the most serious postoperative complications after operations for oral cancer, and we propose a new, two-step suture method to avoid them. From January 2005 to September 2017, 240 patients were recruited at the Shanghai Ninth People's Hospital and divided into experimental (n = 89) or control (n = 151) groups. The experimental group was treated by a two-step suture technique, while the control group had conventional sutures. Statistical differences were assessed using the chi squared and t tests, as appropriate. Only two patients developed transoral salivary fistulas in the experimental group, while in the control group there were 14 (9%). The incidence of fistulas in the experimental group was significantly lower than that in the control group (p = 0.035). Regression analysis showed that there was a significant correlation between the groups and the incidence of salivary fistulas (p = 0.032). The two-step suture technique is safe, effective, and easy to learn, and could reduce the incidence of postoperative salivary fistulas.

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