Publications by authors named "Andrzej Urbanik"

167 Publications

Use of artificial intelligence in the imaging of sarcopenia: A narrative review of current status and perspectives.

Nutrition 2021 Mar 3;89:111227. Epub 2021 Mar 3.

Jagiellonian University Medical College, Department of Radiology, Krakow, Poland. Electronic address:

Sarcopenia is a muscle disease which previously was associated only with aging, but in recent days it has been gaining more attention for its predictive value in a vast range of conditions and its potential link with overall health. Up to this point, evaluating sarcopenia with imaging methods has been time-consuming and dependent on the skills of the physician. The solution for this problem may be found in artificial intelligence, which may assist radiologists in repetitive tasks such as muscle segmentation and body-composition analysis. The major aim of this review was to find and present the current status and future perspectives of artificial intelligence in the imaging of sarcopenia. We searched the PubMed database to find articles concerning the use of artificial intelligence in diagnostic imaging and especially in body-composition analysis in the context of sarcopenia. We found that artificial-intelligence systems could potentially help with evaluating sarcopenia and better predicting outcomes in a vast range of clinical situations, which could get us closer to the true era of precision medicine.
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http://dx.doi.org/10.1016/j.nut.2021.111227DOI Listing
March 2021

Iatrogenic pericallosal artery aneurysm after endovascular procedure.

Pol J Radiol 2021 18;86:e50-e52. Epub 2021 Jan 18.

Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland.

Iatrogenic brain aneurysms are rare and are usually a result of direct trauma to the arterial wall during various neurosurgical or endovascular procedures. Single cases of pericallosal posttraumatic and postsurgical aneurysms were previously reported. Herein, we report the first confirmed case of iatrogenic pericallosal artery aneurysm caused by an arterial wall injury during the endovascular treatment of another aneurysm. A 50-year-old woman with ruptured anterior communicating artery aneurysm was initially treated with balloon-assisted coiling. During the procedure the tip of a microwire inserted into balloon catheter placed in the pericallosal artery caused a local injury of the inner layer of the vessel wall and vasoconstriction, without bleeding, dissection, or flow disturbances visible in digital subtraction angiography (DSA). Control examination revealed dissecting pericallosal aneurysm. After standard dual-antiplatelet oral preparation, stent-assisted coiling of the pericallosal artery aneurysm was performed with residual contrast filling of the base of the aneurysm sac in control angiography (RROC III). After 6 months the control DSA examination showed entirely cured pericallosal aneurysm (RROC I) and reconstruction of the parent artery. Successful endovascular treatment of an iatrogenic pericallosal aneurysm was previously reported, and this method seems to be the first-choice treatment. In our case, endovascular stent-assisted coiling also allowed for safe exclusion from circulation of pericallosal dissecting aneurysm, and the implanted stent caused reconstruction of the parent artery, restoring the normal lumen diameter. The second endovascular treatment option considered was implantation of a flow-diverted stent into the pericallosal artery.
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http://dx.doi.org/10.5114/pjr.2021.103238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7934731PMC
January 2021

Coexistence of posterior cerebral circulation anatomical variations and basilar artery aneurysms: Case-control study.

Folia Med Cracov 2020 11;60(3):75-84

Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

B a c k g r o u n d: The anatomy of arteries supplying blood to the brain often varies among the population. It applies particularly to posterior cerebral circulation. The impact of its anatomy variabilities on the formation of intracranial aneurysms has not been determined yet. The aim was to find out if posterior cerebral circulation anatomy variations coexist with basilar artery aneurysms (BAAs). We retrospectively analyzed 27 patients with BAA and a group of 30 patients matched by gender and age but without BAA. In both groups together most (66.67%) of patients were female and the average age was 59.75 ± 10.91. All of the patients had Computed Tomography performed. We assessed the occurrence of BAA, basilar artery (BA) diameter, vertebral artery (VA) diameter, posterior cerebral artery (PCA) diameter, and if patients had hypoplastic VA or PCA. Results: The presence of right VA hypoplasia significantly increased the risk of BAA occurrence (48.15% vs. 16.67%; p = 0.011). The occurrence of hypoplastic VA on either side was significantly associated with the risk of BAA formation (59.26% vs. 26.67%; p = 0.013). Patients with BAA had slightly larger left PCA diameter 1cm after division (1.96 ± 0.51 vs. 1.64 ± 0.42; p = 0.014) in comparison to those without BAA. Additionally, hypoplastic right PCA occurred more often in patients with BAA (22.22% vs. 0%; p = 0.022). Conclusions: We can conclude that the anatomy of PCA and VA affects the occurrence of BAA. Hypoplastic VA, the presence of wider left PCA and hypoplastic right PCA may be factors that coexist with BAA occurrence.
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http://dx.doi.org/10.24425/fmc.2020.135797DOI Listing
November 2020

The height and type of the main septum in the sphenoid sinuses - evaluation before the fess.

Folia Med Cracov 2020 11;60(3):65-74

Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

The purpose of this study was to examine the height of the main septum (MS) in the sphenoid sinuses and its type, depending on the percentage prevalence of its tissue composition (osseous and membranous) in the adult population. Materials and Methods: A retrospective analysis of 296 computed tomography (CT) scans (147 females, 149 males) of the paranasal sinuses was conducted. The patients did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were carried out with a spiral CT scanner (Siemens Somatom Sensation 16) in a standard procedure, in the option Siemens CARE Dose 4D. No contrast medium was used. Having obtained the transversal planes, a secondary reconstruction tool (multiplans reconstruction - MPR) was used in furtherance of gleaning sagittal and frontal planes. R e s u l t s: In all cases, the height of the MS was measured by using a straight line running parallel to the course of the septum (when the MS was regarded as straight) or curved (when the MS was regarded as irregularly shaped). The average height of the MS was 2.1 ± 0.41 cm in the whole research group. Completely osseous MS was found in 32.77% of the patients. In 63.85% of them, the MS was partially membranous. The rarest was the MS which was not even partially ossified - a membranous type, that was observed in 3.38% of the patients. C o n c l u s i o n s: Variant anatomy of the paranasal sinuses may lead to complications encountered during a surgery, hence a CT scan is advised before the planned treatment.
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http://dx.doi.org/10.24425/fmc.2020.135796DOI Listing
November 2020

Endovascular treatment of middle cerebral artery aneurysms - single-centre results.

Pol J Radiol 2020 20;85:e650-e656. Epub 2020 Dec 20.

Chair of Radiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland.

Purpose: The middle cerebral artery (MCA) is the second most common location of intracerebral aneurysms. Traditionally, they are treated by microsurgical clipping, but with the development of new techniques and devices endovascular embolisation is gaining more importance. The aim of this study was to summarise six years of experience of our department in endovascular treatment of MCA aneurysms.

Material And Methods: Forty patients with 41 MCA aneurysms treated in a single centre were included in this study. Data on patients' comorbidities, aneurysm morphology, and treatment course were collected, with special emphasis on complications.

Results: There were no statistically significant differences in terms of aneurysm morphology between males and females and between ruptured and unruptured aneurysms. None of the diseases analysed in the current study were linked with significantly increased risk of SAH. Unruptured aneurysms were significantly more frequently treated by stent-assisted coiling (30.4% vs. 5.6%, = 0.0388) than were ruptured aneurysms, while ruptured aneurysms were treated more frequently by coiling alone (77.8% vs. 34.8%, = 0.0062). After an initial course of treatment 63.4% ( = 26) of patients had class I in Raymond-Roy occlusion classification, 22% ( = 9) had class II, and 14.6% ( = 6) had class III. Complications of the procedure were observed in 17.5% ( = 7) of patients: 22.2% ( = 4) with ruptured and 13.6% ( = 3) with unruptured aneurysms.

Conclusions: Endovascular treatment of MCA aneurysms is feasible, and our results are convergent with other studies. Ruptured MCA aneurysms may be treated endovascularly with similar effects as unruptured MCA aneurysms. The complication rate of such treatment is low.
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http://dx.doi.org/10.5114/pjr.2020.103204DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7857335PMC
December 2020

Ultrasound methods of imaging atherosclerotic plaque in carotid arteries: examinations using contrast agents.

J Ultrason 2020 Nov 28;20(82):e191-e200. Epub 2020 Sep 28.

Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

The primary technique for detecting the presence and monitoring the development of carotid atherosclerotic plaque is ultrasound. The development of ultrasound techniques has made it possible to precisely visualise not only blood flow, but also vessel walls, including atherosclerotic plaque. Contrast-enhanced ultrasound examination enables one to make an objective observation of atherosclerotic plaque neovascularisation, clearly indicating active inflammation, which is an inherent feature of vulnerable (unstable) plaque. Depending on the examination method used, it is possible to precisely visualise different components of the plaque and its behaviour during blood flow through the vessel lumen or through the neovessels of the plaque, and, consequently, determine the possible presence of inflammation, which is a defining feature of plaque stability. The full utilisation of physical phenomena that underlie contrast-enhanced ultrasound will bring further enormous progress of diagnostic and probably also therapeutic methods for carotid atherosclerosis. The selection of the right examination method significantly accelerates diagnosis and adequate classification of plaque, and makes it possible to monitor the progression of atherosclerosis. However, one needs to bear in mind that ultrasound remains a very subjective method. The success of contrast-enhanced ultrasound also depends on the skills and experience of the examiner. Current attempts at increasing the objectivity of contrast-enhanced ultrasound examination using artificial intelligence will make it possible in the future to make a definitive evaluation of atherosclerotic plaque stability. This will allow one to assess the risk of ischaemic stroke adequately.
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http://dx.doi.org/10.15557/JoU.2020.0032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705485PMC
November 2020

Changes in the brain directly following alcohol consumption-a study of healthy male individuals, with the use of proton magnetic resonance spectroscopy (1HMRS) and diffusion (DWI).

Alcohol Alcohol 2020 Nov 12. Epub 2020 Nov 12.

Department of Radiology, Collegium Medicum, Jagiellonian University, Krakow, Poland.

Aims: To use proton magnetic resonance spectroscopy (1HMRS) and diffusion weighted imaging (DWI) to identify ethanol in the brain directly after consumption, and examine changes in brain metabolite levels and brain microstructure relative to the duration of time following exposure to alcohol.

Methods: The study involved 44 male volunteers (18-55 years). All brain changes were assessed in the frontal lobes, occipital lobes, basal ganglia and cerebellum, however the detailed analyses focused on the frontal lobes. All participants were examined four times, i.e. before and 0.5-hour, 1 hour and 2 hours after consumption of 150 mL pure vodka (60 g of ethanol).

Results: The highest ethanol levels were identified between 0.5 and 1 hour following alcohol intake. There were significant increases in the concentrations of lipids and lactates approximately one hour after alcohol consumption, and the concentration levels were found to normalise during the following two hours. Some statistically insignificant trends of changes were found for tCr, tCho, mI, GABA, Glc, Glx and tNAA. For the DWI and ADC (Apparent Diffusion Coefficient of water) values, the findings showed statistically insignificant decrease and increase, followed by a tendency towards normalisation. Similar associations in changes of metabolite concentrations and DWI and ADC values were found in the other locations investigated in the study.

Conclusion: A single dose of alcohol as used in this experiment produces increases in lipids and lactates in brain tissues that appear reversible.
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http://dx.doi.org/10.1093/alcalc/agaa119DOI Listing
November 2020

Endovascular embolization of wide-necked bifurcation aneurysms with the use of pCONus device: A systematic review and meta-analysis.

Clin Imaging 2021 Feb 24;70:81-88. Epub 2020 Oct 24.

Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501 Krakow, Poland.

Background: The following study aimed to summarize the overall safety and efficacy of the pCONus device in the treatment of wide-necked bifurcation aneurysms.

Material And Methods: Major electronic medical databases were thoroughly searched to identify relevant studies. Data regarding the type of included studies, type of aneurysm and its location, treatment results measured in Raymond-Roy Occlusion Class (RROC) and its complications, as well as patients' neurological outcome at the discharge were extracted from the eligible studies and included in the meta-analysis. The subgroup analyses dependent on the aneurysm rupture status were also conducted.

Results: A total of 8 studies (198 patients with 200 aneurysms) were included in this meta-analysis. The most common localization of the treated aneurysms was the middle cerebral artery with its pooled prevalence estimate (PPE) of 44.5%. Immediately after the procedure, RROC I (complete obliteration of the aneurysm) was observed in 46.8%, RROC II in 32.9%, while RROC III (residual aneurysm) in 20.3% of the patients. In a short-term follow-up, PPE of RROC I was 55.0%, RROC II 29.0%, and RROC III 16.1%. The PPE of intraprocedural complications was 17.3%, the most frequent were thromboembolic events, which were observed in 12.1% of all procedures. Poor neurological outcome at the discharge was noted with PPE of 9.6%.

Conclusions: The effectiveness and safety of wide-necked bifurcation aneurysm treatment utilizing the pCONus device is moderate. There is still a need for a consensus regarding the effective antiplatelet regimen in furtherance of diminishing the rate of thromboembolic events.
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http://dx.doi.org/10.1016/j.clinimag.2020.10.025DOI Listing
February 2021

Ineffective endovascular treatment of a giant internal carotid artery aneurysm.

Pol J Radiol 2020 27;85:e323-e327. Epub 2020 Jun 27.

Department of Imaging Studies, Emergency and Mass-Event Medicine Trauma Centre, University Hospital, Krakow, Poland.

Purpose: Despite a growing range of therapeutic possibilities, including various intravascular methods, treating cerebral aneurysms can be still a therapeutic challenge. A growing number of patients previously treated with older techniques require additional therapy. Treatment options as well as their efficiency may be influenced by previous procedures.

Case Report: We report a rare case of a giant treatment-resistant aneurysm in a 65-year-old woman. The aneurysm was first diagnosed due to visual disturbances in the right eye. Computed tomography angiography showed large (20 × 18 mm) wide neck aneurysm of the right internal carotid artery. The patient was subsequently treated with several methods including coiling with regular stent implantation, two flow diverter stent implantations, and hybrid neurosurgery. Full occlusion was not achieved after any of those procedures. After the last procedure (hybrid neurosurgery) the patient, in vegetative state, was transferred to the intensive care unit and then to the Health and Care Centre.

Conclusions: Discussion focuses on endovascular treatment options after failure of previous treatment such as "stent in stent" technique. We conclude that three subsequent stent implantations are technically possible; however, subsequent procedures are associated with technical difficulties and their effectiveness is questionable. Ventriculoperitoneal shunt may influence the outcome of flow diversion therapy.
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http://dx.doi.org/10.5114/pjr.2020.96979DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361365PMC
June 2020

Effects of using different software packages for BOLD analysis in planning a neurosurgical treatment in patients with brain tumours.

Clin Imaging 2020 Dec 20;68:148-157. Epub 2020 Jun 20.

Collegium Medicum, Jagiellonian University, Krakow, Poland. Electronic address:

Background: The authors of the present thesis carried out a comparative analysis of three different computer software packages - FSL, SPM and FuncTool - for the processing of fMRI scans.

Purpose: The aim of the thesis was the analysis of the volume of regions functionally active during the stimulation of the centres evaluated as well as the location of those regions in relation to the tumour boundaries, and then the comparison of the results.

Material And Methods: Thirty eight patients with a diagnosed tumour of the left hemisphere, qualified for a neurosurgical operation, underwent fMRI. The functions of speech, motion and sensation were evaluated. Imaging data were processed for all the acquired scans with the use of each of the three software packages assessed.

Results: For the FuncTool software package the calculated differences in the distances were several times greater than those calculated using FSL and SPM. The differences in the volume of the functionally active regions derived from the calculations with the use of the FSL and SPM software packages were statistically different for four out of the six functions evaluated.

Conclusions: The conclusions of the analysis in question showed that the FSL and SPM packages could be used interchangeably in the functional mapping of the brain with the purpose of the planning of neurosurgical operations. The FuncTool software package is less precise than FSL and SPM.
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http://dx.doi.org/10.1016/j.clinimag.2020.06.034DOI Listing
December 2020

Ultrasonography of vulnerable atherosclerotic plaque in the carotid arteries: B-mode imaging.

J Ultrason 2020 15;20(81):e135-e145. Epub 2020 Jun 15.

Department of Radiology, Jagiellonian University Medical College , Krakow , Poland.

The most common type of stroke, i.e. ischemic stroke, is a great challenge for contemporary medicine as it poses both diagnostic and therapeutic difficulties. Atherosclerosis, which is rapidly beginning to affect more and more social groups, is the main cause of cerebrovascular accidents. Atherosclerosis is currently defined as a generalized, dynamic and heterogeneous inflammatory and immune process affecting arterial walls. Atherosclerotic plaque is the emanation of this disease. As the paradigm of the diagnosis of atherosclerosis has changed, it has become crucial to properly identify plaque instability within the carotid arteries by evaluating parameters and phenomena that signify a developing cascade of complications, eventually leading to stroke. Irrespective of the ultrasound technique employed, proper morphological evaluation of atherosclerotic plaque, involving observation of its echogenicity, i.e. subjective analysis of its structure, with the classification to Gray-Weale-Nicolaides types as well as assessment of the integrity of its surface, makes it possible to roughly evaluate plaque morphology and thereby its stability. This enables treatment planning and therapy monitoring. This evaluation should be a prelude to further diagnostic work-up, which involves non-invasive examinations that enable unambiguous assessment of plaque stability. These examinations include contrast-enhanced ultrasound to assess progression or recession of inflammation, which presents as plaque neovascularization, or shear wave elastography to objectively define tissue stiffness, and thereby its mineralization.

The most common type of stroke, i.e. ischemic stroke, is a great challenge for contemporary medicine as it poses both diagnostic and therapeutic difficulties. Atherosclerosis, which is rapidly beginning to affect more and more social groups, is the main cause of cerebrovascular accidents. Atherosclerosis is currently defined as a generalized, dynamic and heterogeneous inflammatory and immune process affecting arterial walls. Atherosclerotic plaque is the emanation of this disease. As the paradigm of the diagnosis of atherosclerosis has changed, it has become crucial to properly identify plaque instability within the carotid arteries by evaluating parameters and phenomena that signify a developing cascade of complications, eventually leading to stroke. Irrespective of the ultrasound technique employed, proper morphological evaluation of atherosclerotic plaque, involving observation of its echogenicity, i.e. subjective analysis of its structure, with the classification to Gray-Weale–Nicolaides types as well as assessment of the integrity of its surface, makes it possible to roughly evaluate plaque morphology and thereby its stability. This enables treatment planning and therapy monitoring. This evaluation should be a prelude to further diagnostic work-up, which involves non-invasive examinations that enable unambiguous assessment of plaque stability. These examinations include contrast-enhanced ultrasound to assess progression or recession of inflammation, which presents as plaque neovascularization, or shear wave elastography to objectively define tissue stiffness, and thereby its mineralization.
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http://dx.doi.org/10.15557/JoU.2020.0022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7418858PMC
June 2020

Effect of Thermal Insulation on Image Quality and Radiation Dose in Polytrauma Computed Tomography.

Can Assoc Radiol J 2020 May 5;71(2):238-243. Epub 2020 Feb 5.

Department of Anesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland.

Purpose: Unintentional drop in body temperature in trauma victims is an independent risk factor for mortality. We aimed to assess the impact of thermal insulation on image quality and radiation dose in polytrauma computed tomography (CT).

Methods: Thirteen different insulating covers were used to wrap CT phantoms. Images were assessed subjectively at a radiological workstation and analyzed digitally with dedicated software evaluating the noise intensity, spatial resolution, and image homogeneity. The radiation dose was measured using a dosimeter.

Results: Most materials did not cause significant artifacts apart from 2 heating pads. Although the radiation dose was increased by the majority of insulating covers (up to 64.66%), certain covers decreased the absorbed radiation (up to -7.35%).

Conclusions: The majority of insulating systems do not cause artifacts in CT scans. When using covers with self-heating warmers, removing the heating pad is suggested due to the risk of considerable artifacts appearing. Certain insulating covers may increase or decrease the radiation dose.
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http://dx.doi.org/10.1177/0846537119894250DOI Listing
May 2020

The semi-automated algorithm for the detection of bone marrow oedema lesions in patients with axial spondyloarthritis.

Rheumatol Int 2020 Apr 18;40(4):625-633. Epub 2020 Jan 18.

Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501, Kraków, Poland.

The aim of the study was to create the efficient tool for semi-automated detection of bone marrow oedema lesions in patients with axial spondyloarthritis (axSpA). MRI examinations of 22 sacroiliac joints of patients with confirmed axSpA-related sacroiliitis (median SPARCC score: 14 points) were included into the study. Design of our algorithm is based on Maksymowych et al. evaluation method and consists of the following steps: manual segmentation of bones (T1W sequence), automated detection of reference signal region, sacroiliac joint central lines and ROIs, a division of ROIs into quadrants, automated detection of inflammatory changes (STIR sequence). As a gold standard, two sets of manual lesion delineations were created. Two approaches to the performance assessment of lesion detection were considered: pixel-wise (detections compared pixel by pixel) and quadrant-wise (quadrant to quadrant). Statistical analysis was performed using Spearman's correlation coefficient. Correlation coefficient obtained for pixel-wise comparison of semi-automated and manual detections was 0.87 (p = 0.001), while for quadrant-wise analysis was 0.83 (p = 0.001). The correlation between two sets of manual detections was 0.91 for pixel-wise comparison (p = 0.001) and 0.88 (p = 0.001) for quadrant-wise approach. Spearman's correlation between two manual assessments was not statistically different from the correlation between semi-automated and manual evaluations, both for pixel- (p = 0.14) and quadrant-wise (p = 0.17) analysis. Average single slice processing time: 0.64 ± 0.30 s. Our method allows for objective detection of bone marrow oedema lesions in patients with axSpA. The quantification of affected pixels and quadrants has comparable reliability to manual assessment.
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http://dx.doi.org/10.1007/s00296-020-04511-wDOI Listing
April 2020

Incorporation of the sphenoid sinuses' septum / septa in the carotid canal - evaluation before the FESS.

Folia Med Cracov 2020 ;60(4):65-78

Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

The purpose of the research was to define the frequency prevalence of the incorporation of sphenoid sinuses' septum / septa in the carotid canal of the adult population.

Materials And Methods: 296 computed tomography (CT) scans of the patients (147 females, 149 males), who did not present any pathology in the sphenoid sinuses, were evaluated in this retrospective analysis. Spiral CT scanner - Siemens Somatom Sensation 16 - was used to glean the medical images. Standard procedure applied in the option Siemens CARE Dose 4D. No contrast medium was administered. Multiplans reconstruction (MPR) tool was used in order to obtain frontal and sagittal planes from the transverse planes previously received.

Results: Bilateral incorporation of the main septum (MS) in the carotid canal was not present in any of the patients, whereas unilateral incorporation was noticed in 21.96% of the patients (17.68% females, 26.17% males). On the right side it occurred in 11.82% of cases (10.88% females, 12.75% males), and on the left side in 10.14% of cases (6.8% females, 13.42% males). Bilateral incorporation of the additional septum (AS) was found in 8.45% of the patients (4.08% females, 12.75% males), whereas unilateral incorporation was noted in 28.37% of the patients. It was seen on the right side in 11.82% of cases (12.93% females, 10.74% males), and on the left side in 16.55% cases (15.65% females, 17.45% males). The most common variant was the incorporation of only one of the septa (either the MS or the AS) in the wall of the carotid canal unilaterally. Such situation took place in 30.07% of the patients (29.25% females, 30.87% males). Incorporation of two septa on the same side was noticed in 4.39% of cases (4.08% females, 4.7% males), and incorporation of three septa in 0.34% of cases (0.7% males).

Conclusions: The anatomy of the paranasal sinuses is varied to a great extent, hence performing a CT scan is crucial before the scheduled surgery, as it may lessen the unforeseeable surgical complications, that may result from the high prevalence of variants in the sinuses.
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January 2020

Influence of Acquisition Time on MR Image Quality Estimated with Nonparametric Measures Based on Texture Features.

Biomed Res Int 2019 20;2019:3706581. Epub 2019 Nov 20.

Institute of Electronics, Łódź University of Technology, Łódź 90-924, Poland.

Correlation of parametrized image texture features (ITF) analyses conducted in different regions of interest (ROIs) overcomes limitations and reliably reflects image quality. The aim of this study is to propose a nonparametrical method and classify the quality of a magnetic resonance (MR) image that has undergone controlled degradation by using textural features in the image. Images of 41 patients, 17 women and 24 men, aged between 23 and 56 years were analyzed. T2-weighted sagittal sequences of the lumbar spine, cervical spine, and knee and T2-weighted coronal sequences of the shoulder and wrist were generated. The implementation of parallel imaging with the use of GRAPPA2, GRAPPA3, and GRAPPA4 led to a substantial reduction in the scanning time but also degraded image quality. The number of degraded image textural features was correlated with the scanning time. Longer scan times correlated with markedly higher ITF image persistence in comparison with images computed with reduced scan times. Higher ITF preservation was observed in images of bones in the spine and femur as compared to images of soft tissues, i.e., tendons and muscles. Finally, a nonparametrized image quality assessment based on an analysis of the ITF, computed for different tissues, correlating with the changes in acquisition time of the MR images, was successfully developed. The correlation between acquisition time and the number of reproducible features present in an MR image was found to yield the necessary assumptions to calculate the quality index.
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http://dx.doi.org/10.1155/2019/3706581DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886329PMC
April 2020

Computed Tomography Assessment of Brain Atrophy in Centenarians.

Int J Environ Res Public Health 2019 09 29;16(19). Epub 2019 Sep 29.

Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland.

The aim of our study was to compare the degree of brain atrophy in centenarians and in seniors 70-99 years old. The study group consisted of 23 patients aged 100-106 years. The control group consisted of 90 patients, 30 in each age subgroup 90-99, 80-89, 70-79. In all the patients, the brain atrophy linear parameters were measured on computed tomography scans, in relation to both "subcortical atrophy", evaluated as progressive widening of the ventricular system, and "cortical atrophy", defined as widening of subarachnoid space. Secondary indices based on the parameters were calculated. Correlations between the above parameters/indices and age were tested. Significantly different values between the centenarians and the control group were found in the brain atrophy parameters: A, B, C, E, FI, ICR, ICL, SW, CFW, F/A 'frontal horn index', A/G 'Evans index', D/A 'ventricular index', H/E 'cella media Schiersmann index', A+B 'Huckman number'. Correlations between parameter/index and age were found for: A, B, C, FI, ICR, ICL, SW, F/A 'frontal horn index', A/G 'Evans index', D/A 'ventricular index', H/E 'cella media Schiersmann index', A+B 'Huckman number'. Brain atrophy associated with aging is a continuously advancing process, affecting centenarians even more than people before the "magic" threshold of 100 years.
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http://dx.doi.org/10.3390/ijerph16193659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801833PMC
September 2019

Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment.

Wideochir Inne Tech Maloinwazyjne 2019 Sep 21;14(3):451-460. Epub 2019 Jan 21.

Chair of Radiology, Jagiellonian University Medical College, Krakow, Poland.

Introduction: The anterior communicating artery (ACoA) is the most common location of intracranial aneurysms, observed in 35% of cases. Endovascular treatment has become an alternative to surgical clipping and the primary method of choice.

Aim: To assess the treatment results of ruptured and unruptured ACoA aneurysms and to assess the incidence of intraprocedural complications and various factors influencing these aspects.

Material And Methods: One hundred and eleven embolizations of ACoA aneurysms (80.7% ruptured and 19.3% unruptured) were retrospectively analysed. The methods of embolization were: coiling, balloon-assisted coiling, stent-assisted coiling. Morphology and dimensions of aneurysms were assessed on 3D digital subtraction angiography (DSA) images. Medical records were analysed for patient's clinical status at admission, intraprocedural complications, follow-up examination and modified Rankin Scale (mRS) score 1 month after discharge.

Results: Immediately after the procedure 56.9% of patients had Raymond-Roy Occlusion Classification (RROC) class I, 37.6% class II and 5.5% class III. The overall intraprocedural complication rate was 6.6%. There were significantly more cases of bleeding (p = 0.012) and coil prolapse (p = 0.012) during the procedures ending with higher packing density. Twenty-eight (25.7%) patients died during hospital stay, 27 (96.4%) with ruptured aneurysm. In the follow-up of 41 patients, RROC was the same or improved in 73.2% of cases and recanalization occurred in 26.8%. Six patients with aneurysm recanalization underwent repeat embolization.

Conclusions: Endovascular embolization of ACoA aneurysms is an effective and safe treatment method. The most powerful factor influencing the incidence of complications is packing density. Superior orientation of the dome, initial incomplete embolization and poor outcome in mRS scale are factors predisposing to ACoA aneurysm recurrence.
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http://dx.doi.org/10.5114/wiitm.2019.81406DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6748064PMC
September 2019

Novel Technique for Growth Plate Analysis Based on the Superposition of T- and T-weighted MR Imaging of Adolescent Wrists.

Magn Reson Med Sci 2020 Aug 2;19(3):259-267. Epub 2019 Aug 2.

Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology.

In this article, a new method of information extraction on the basis of the differentiation of T- and T-weighted MR images is proposed. It relies on a technique of superposition of T- and T-weighted MR images with use of statistical dominance algorithm. On the basis of implemented image analysis, a reproducible extraction of growth zone of adolescent boys' wrists is possible.
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http://dx.doi.org/10.2463/mrms.tn.2019-0052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553804PMC
August 2020

The usefulness of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) sequences visual assessment in the early diagnosis of axial spondyloarthritis.

Rheumatol Int 2019 Sep 10;39(9):1559-1565. Epub 2019 Jul 10.

Department of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501, Krakow, Poland.

The aim of the study was to compare the diagnostic efficacy of the visual assessment of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced (DCE) sequences compared to the STIR sequence in the diagnostics of active sacroiliitis in the course of axial spondyloarthritis (axSpA). The study group consisted of 49 patients who had undergone multiparametric magnetic resonance imaging of the sacroiliac joints (SIJs) due to clinical suspicion of axSpA. Two independent observers retrospectively assessed four quadrants of the SIJs for the presence of subchondral bone marrow oedema/osteitis with the use of modified SPARCC score in sequences: STIR, DWI (with ADC map) and DCE. Diagnostic efficiency parameters were calculated for DWI and DCE sequence separately, using STIR sequence as a reference. Inter-observer agreement was evaluated with the use of κ coefficient. Patients' clinical symptoms were analysed to identify the group fulfilling the imaging arm of the ASAS criteria for axSpA. Overall, 46.9% (n = 23) of patients fulfilled the imaging arm of ASAS criteria for axial spondyloarthritis. DWI with ADC map: accuracy 95.6%, sensitivity 99.4%, specificity 54.0%. DCE sequence: accuracy 96.8%, sensitivity 98.4%, specificity 79.5%. The highest level of inter-observer agreement was achieved for STIR sequence (κ = 0.888), slightly lower for DCE sequence (κ = 0.773) and the lowest for DWI with ADC (κ = 0.674). Visual assessment of the DWI and DCE sequences has high accuracy and sensitivity of bone marrow oedema/osteitis detection, but the specificity and inter-observer agreement are poor, especially for the DWI sequence with ADC maps.
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http://dx.doi.org/10.1007/s00296-019-04373-xDOI Listing
September 2019

Changes in the Selected Antioxidant Defense Parameters in the Blood of Patients after High Resolution Computed Tomography.

Int J Environ Res Public Health 2019 04 26;16(9). Epub 2019 Apr 26.

Department of Radiology, Jagiellonian University Medical College, Kopernika 19, 31-501 Krakow, Poland.

Ionizing radiation generated during high resolution computed tomography (HRCT) scanning may have an indirect effect on the mechanisms regulating the oxidative-antioxidant balance in the human body, which is one of the necessary factors ensuring the maintenance of its homeostasis. The aim of the study was to analyze the response of antioxidant systems through the determination of the antioxidant markers in the blood of patients exposed to oxidative stress resulting from the routine HRCT examination of the chest. Blood of 35 people aged 60.77 ± 10.81 taken before and at four time points after the examination constituted the test material. The determination of the total antioxidant capacity expressed as ferric reducing ability of plasma (FRAP) and ferric reducing antioxidant activity and ascorbic acid concentration (FRASC) were performed together with an examination of catalase activity and the concentration of the reduced glutathione. The organism's response to ionizing radiation was associated with a significant decrease in the antioxidant markers' levels at all time-points and showed a significant negative correlation depending on the radiation dose. Visible down-regulation of these markers is a response to increased oxidative stress. In light of the obtained results, the measurement of the selected markers of antioxidant defense may be a useful parameter of oxidative stress caused by ionizing radiation.
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http://dx.doi.org/10.3390/ijerph16091476DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6539922PMC
April 2019

The effect of software post-processing applications on identification of the penumbra and core within the ischaemic region in perfusion computed tomography.

Pol J Radiol 2019 15;84:e118-e125. Epub 2019 Feb 15.

Department of Radiology, Jagiellonian University Medical College, Krakow, Poland.

Purpose: Assessment of software applications designed for post-processing of CT imaging data and perfusion maps in terms of their ability to consistently define the penumbra and core in an ischemic area.

Material And Methods: This study is based on measurements conducted in a group of 65 patients with neurological symptoms suggestive of ischaemia in the area of the MCA within 12 hours following onset of the first symptoms. Non-contrast and perfusion CT were performed during an emergency duty. The acquired data were processed using various programs to obtain defined ischaemic areas and parameters. Finally, the results obtained were compared to the distribution of penumbra and core within the ischaemic area received from different perfusion mapping programs.

Results: The programs designed to convert the acquired data and to map the distribution of perfusion were also assessed for their viability in dividing the ischaemic zone into penumbra and core. There was a statistically strong correlation (0.784-0.846) between results obtained by processing of imaging data with two different packages, and then by post-processing with one package, and a poor correlation (0.315-0.554) between results obtained by processing of data with the same package, and post-processing with two different packages designed for measuring penumbra and core areas.

Conclusions: The results obtained by processing of imaging data with different software applications and by post-processing with one program developed for identifying penumbra and core areas show a strong correlation. However, the results obtained by processing imaging data with the same software application and by post-processing with different programs measuring penumbra and core areas reveal poor correlation.
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http://dx.doi.org/10.5114/pjr.2019.83182DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6479142PMC
February 2019

Association of Apolipoprotein E With Intracerebral Hemorrhage Risk by Race/Ethnicity: A Meta-analysis.

JAMA Neurol 2019 04;76(4):480-491

Department of Neurology, Baltimore Veterans Administration Medical Center and University of Maryland School of Medicine, Baltimore.

Importance: Genetic studies of intracerebral hemorrhage (ICH) have focused mainly on white participants, but genetic risk may vary or could be concealed by differing nongenetic coexposures in nonwhite populations. Transethnic analysis of risk may clarify the role of genetics in ICH risk across populations.

Objective: To evaluate associations between established differences in ICH risk by race/ethnicity and the variability in the risks of apolipoprotein E (APOE) ε4 alleles, the most potent genetic risk factor for ICH.

Design, Setting, And Participants: This case-control study of primary ICH meta-analyzed the association of APOE allele status on ICH risk, applying a 2-stage clustering approach based on race/ethnicity and stratified by a contributing study. A propensity score analysis was used to model the association of APOE with the burden of hypertension across race/ethnic groups. Primary ICH cases and controls were collected from 3 hospital- and population-based studies in the United States and 8 in European sites in the International Stroke Genetic Consortium. Participants were enrolled from January 1, 1999, to December 31, 2017. Participants with secondary causes of ICH were excluded from enrollment. Controls were regionally matched within each participating study.

Main Outcomes And Measures: Clinical variables were systematically obtained from structured interviews within each site. APOE genotype was centrally determined for all studies.

Results: In total, 13 124 participants (7153 [54.5%] male with a median [interquartile range] age of 66 [56-76] years) were included. In white participants, APOE ε2 (odds ratio [OR], 1.49; 95% CI, 1.24-1.80; P < .001) and APOE ε4 (OR, 1.51; 95% CI, 1.23-1.85; P < .001) were associated with lobar ICH risk; however, within self-identified Hispanic and black participants, no associations were found. After propensity score matching for hypertension burden, APOE ε4 was associated with lobar ICH risk among Hispanic (OR, 1.14; 95% CI, 1.03-1.28; P = .01) but not in black (OR, 1.02; 95% CI, 0.98-1.07; P = .25) participants. APOE ε2 and ε4 did not show an association with nonlobar ICH risk in any race/ethnicity.

Conclusions And Relevance: APOE ε4 and ε2 alleles appear to affect lobar ICH risk variably by race/ethnicity, associations that are confirmed in white individuals but can be shown in Hispanic individuals only when the excess burden of hypertension is propensity score-matched; further studies are needed to explore the interactions between APOE alleles and environmental exposures that vary by race/ethnicity in representative populations at risk for ICH.
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http://dx.doi.org/10.1001/jamaneurol.2018.4519DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459133PMC
April 2019

Cerebral Aneurysms: Are They Associated with Anatomic Variations of Carotid and Main Cerebral Arteries?

World Neurosurg 2019 Jan 10. Epub 2019 Jan 10.

Department of Radiology, Jagiellonian University Medical College, Kraków, Poland.

Objective: Vascular anatomic variations are very common in the population, but their coexistence with life-threating vascular malformations remains unclear. The objective of the study was to assess the correlation between the presence of anatomic variants of both carotid and main cerebral arteries and the occurrence of cerebral aneurysms.

Methods: We analyzed examinations of 194 patients who underwent computed tomography angiography of the head and neck between September of 2016 and November of 2017. The assessed parameters were: the variation of the common carotid arteries origin, hypoplasia or duplication of any of the main cerebral arteries, carotid artery kinking, and the presence of cerebral aneurysms.

Results: We found 5.7% of patients had a cerebral aneurysm. Hypoplasia of at least 1 main cerebral artery occurred in 34.5% of patients, with the most frequent being the vertebral artery (21.6%). Duplication of at least 1 main cerebral artery was detected in 2.6%. Cerebral aneurysms occurred more often together with hypoplasia (P = 0.041; OR = 3.175) or duplication (P < 0.001; OR = 18.500) of at least 1 main cerebral artery. In 7.2% of cases, the origin of common carotid arteries created a true bovine arch, and in 4.1% the so-called bovine arch. Patients with alternative variants of aortic arch branching were more likely to have cerebral aneurysms (P = 0.002; OR = 5.903). We found 27.3% of patients had internal carotid arteries affected by kinking. Carotid kinking did not predispose the patient to the formation of a cerebral aneurysm (P = 0.378).

Conclusions: There is an evident correspondence between the presence of vascular anatomic variants (abnormal origin of the carotid arteries, hypoplasia, or duplication of the main cerebral artery) and the occurrence of cerebral aneurysms.
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http://dx.doi.org/10.1016/j.wneu.2018.12.161DOI Listing
January 2019

Caries detection enhancement using texture feature maps of intraoral radiographs.

Oral Radiol 2020 07 9;36(3):275-287. Epub 2018 Nov 9.

Department of Geoinformatics and Applied Computer Science, AGH University of Science and Technology, Mickiewicza 30, 30-059, Cracow, Poland.

Objectives: Dental caries are caused by tooth demineralization due to bacterial plaque formation. However, the resulting lesions are often discrete and thus barely recognizable in intraoral radiography images. Therefore, more advanced detection techniques are in great demand among dentists and radiographers. This study was performed to evaluate the performance of texture feature maps in the recognition of discrete demineralization related to caries plaque formation.

Methods: Digital intraoral radiology image analysis protocols incorporating first-order features (FOF), co-occurrence matrices, gray tone difference matrices, run-length matrices (RLM), local binary patterns (LBP), and k-means clustering (CLU) were used to transform the digital intraoral radiology images of 10 patients with confirmed caries, which were retrospectively reviewed in a dental clinic. The performance of the resulting texture feature maps was compared with that of radiographic images by radiologists and dental specialists.

Results: Significantly improved detection of caries spots was achieved by employing the CLU and FOF texture feature maps. The caries-affected area with sharp margins was well defined using the CLU approach. A pseudo-three-dimensional effect was observed in outlining the demineralization zones inside the cavity with the FOF 5 protocol. In contrast, the LBP and RLM techniques produced less satisfactory results with unsharp edges and less detailed depiction of the lesions.

Conclusions: This study illustrated the applicability of texture feature maps to the recognition of demineralized spots on the tooth surface debilitated by caries and identified the best performing techniques.
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http://dx.doi.org/10.1007/s11282-018-0354-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7280345PMC
July 2020

Radiologic approach to axial spondyloarthritis: where are we now and where are we heading?

Rheumatol Int 2018 Oct 21;38(10):1753-1762. Epub 2018 Aug 21.

Chair of Radiology, Jagiellonian University Medical College, 19 Kopernika Street, 31-501, Krakόw, Poland.

Current emphasis on diagnosing axial spondyloarthritis (axSpA) in early stage enforced the search for sensitive and specific diagnostic algorithms with the use of imaging methods. The aim of this review was to summarise current recommendations concerning the use of imaging techniques in diagnostics and monitoring of axSpA as well as to outline possible future directions of the development in this field. MEDLINE database was searched between March and April 2018. In the first phase, such keywords were applied: 'ASAS', 'EULAR', 'ASAS-EULAR', 'ASAS/OMERACT', 'axial spondyloarthritis', while in the second step: 'axial spondyloarthritis', 'ankylosing spondylitis', 'magnetic resonance imaging', 'computed tomography', and 'radiography', 'imaging'. An up-to-date summary of European League Against Rheumatism (EULAR) recommendations enriched with recent updates of Assessment of Spondyloarthritis International Society (ASAS) diagnostic criteria regarding imaging in axSpA course was created. Moreover, we outlined the role of new in this field, promising imaging techniques, such as diffusion-weighted imaging and dynamic contrast-enhanced sequences in magnetic resonance imaging (MRI) or low-dose computed tomography (CT). As precise monitoring of axSpA activity is vital, we reviewed the most precise methods: semiquantitative scores (e.g., Spondyloarthritis Research Consortium of Canada scores or CT Syndesmophyte Score) and quantitative analysis of MRI-based apparent diffusion coefficient or perfusion maps and enhancement curves. According to EULAR and ASAS recommendations, radiography and MRI still remain basic methods of axSpA diagnostics and monitoring. However, the knowledge of state-of-the-art international guidelines combined with the awareness of emerging imaging methods is the key to effective management of axSpA.
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http://dx.doi.org/10.1007/s00296-018-4130-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132717PMC
October 2018

The assessment of diagnostic medical images using 10-bit grayscale - fact or myth?

Pol J Radiol 2018 5;83:e127-e132. Epub 2018 Apr 5.

Department of Radiology, Jagiellonian University Medical College, Cracow, Poland.

Purpose: The aim of the study was to find tests for verification of 10-bit grayscale support for radiological workstation hardware/operating system and for DICOM viewer. Also, we wanted to perform the tests on available workstations.

Material And Methods: The following tests were selected to verify 10-bit grayscale support: workstation hardware and operating system tests using DirectX SDK 10BitScanout10.exe and NEC 10bitdemo.exe programs, DICOM viewer tests using TG18-MP and TG18-QC patterns. The tests were performed on 14 radiological workstations in a local department of radiology and on 4 radiological workstations during the technical exhibition at the ECR (European Congress of Radiology) in 2017.

Results: Only 3 out of 14 local workstations passed the hardware and operating system 10-bit grayscale support test. Only one workstation passed the DICOM viewer 10-bit grayscale support test.

Conclusions: Hardware/operating system and DICOM viewer 10-bit grayscale support should be tested on every radiological workstation even if compatibility is stated by the manufacturer. Existing medical diagnostic display quality requirements should be adjusted so that 10-bit support for DICOM viewers is only a desirable option.
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http://dx.doi.org/10.5114/pjr.2018.75877DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047087PMC
April 2018

Sex differences in brain metabolite concentrations in healthy children - proton magnetic resonance spectroscopy study (HMRS).

Pol J Radiol 2018 4;83:e24-e31. Epub 2018 Feb 4.

Department of Radiology, Jagiellonian University Medical College, Krakow, Poland.

Purpose: The aim of this HMRS study was to define sex-related differences in metabolic spectrum between healthy children. Forty-nine girls and boys aged 6-15 years were examined.

Material And Methods: Volume of interest was located in seven brain regions: frontal lobes, basal ganglia, hippocampi, and cerebellum.

Results: Statistical analysis of the results showed significantly higher ( < 0.05) myo-inositol concentrations relative to the total concentrations in the boys than the girls, as well as higher absolute -acetyl aspartate concentrations in the left frontal lobes in girls. No other significant differences were shown, except for trends in differences.

Conclusions: In clinical practice the diagnostic process first of all focuses on assessing concentrations of metabolites to relative cerebellum concentration. Thus, the findings of the present study allow the conclusion that when analysing the results of HMRS studies in children it is not necessary to take into account the child's gender.
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http://dx.doi.org/10.5114/pjr.2018.74536DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6047095PMC
February 2018

Evaluation of Alterations in Tumor Tissue of Gastrointestinal Stromal Tumor (GIST) in Computed Tomography Following Treatment with Imatinib.

Pol J Radiol 2017 15;82:817-826. Epub 2017 Dec 15.

Department of Radiology, Jagiellonian University Medical College, Cracow, Poland.

Background: The aim of this study was to evaluate the alterations in the neoplastic tissue of GIST following Imatinib treatment.

Material/methods: CT studies of 14 patients with inoperable primary tumors and 56 patients with metastatic and recurrent disease after chemotherapy were analyzed retrospectively. The following alterations in features of primary and secondary tumors were analyzed: dimension, degree and type of contrast enhancement, outlines of lesions, presence of intratumoral bleeding, presence of calcifications.

Results: In the analyzed group of primary, metastatic and recurrent tumors after treatment with Imatinib in most cases a decrease in size and contrast enhancement were observed; the outlines of lesions became well circumscribed. Following the treatment, the number of tumors enhancing inhomogeneously decreased. In primary tumors the percentage of calcifications increased, whereas in metastatic tumors calcifications were observed only after treatment. There was no bleeding found within primary tumors after treatment. In metastatic disease, increased percentage of tumors with transient intratumoral bleeding was observed. There were also some unconventional CT images following treatment, such as: cystic transformation of lesions, enlargement of lesions, appearing of new lesions suggesting progression of the disease, stationary dimensions of lesions during local progression of the disease, simultaneous decrease and increase in size of metastatic lesions or appearance of new ones.

Conclusions: Right from the start of Imatinib therapy in inoperable and disseminated GIST patients, specific CT images, not seen during conventional cytotoxic chemotherapy, were observed.
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http://dx.doi.org/10.12659/PJR.902944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894004PMC
December 2017

Evaluation of changes in biochemical composition of fetal brain between 18th and 40th gestational week in proton magnetic resonance spectroscopy.

J Matern Fetal Neonatal Med 2019 Aug 20;32(15):2493-2499. Epub 2018 Feb 20.

b Department of Electroradiology , Collegium Medicum of the Jagiellonian University , Kraków , Poland.

Introduction: The aim of this study is to determine the right H MRS spectra of the brain in fetuses of different age, and then to define what metabolic changes occur between 18th and 40th weeks of pregnancy.

Methods: H MRS studies of 32 fetuses aged 18-40 gestational weeks were performed, in which the MRI excluded central nervous system malformations. The studied group included 11 fetuses aged 18-25 weeks (the second half of the second trimester), 14 fetuses aged 26-33 weeks (the first half of the third trimester), and seven fetuses aged 34-40 weeks (the second half of the third trimester). The relative ratios of metabolites concentrations to the sum of all metabolites were calculated.

Results: Increase in the concentrations of N-acetylaspartate (NAA), Cr, Cho, and myo-inositol (mI) with gestational age is statistically significant. Only increase in Glx is statistically insignificant. In the analyzed period of pregnancy also, an insignificant increase of NAA/Σ and Cr/Σ ratios and a decrease of mI/Σ, Cho/Σ and Glx/Σ ratios were noticed.

Conclusions: Changes in the H MRS spectrum are visible with increasing age of the fetus. All studied substances in fetal brain change their concentrations during pregnancy, which may be associated with the synaptic and dendritic development as well as myelination. Knowledge about the chemical changes in the fetal brain can provide valuable information in studies of the mechanisms of pregnancy and fetal development, define steps of brain metabolic development and explain reasons of pathologies.
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http://dx.doi.org/10.1080/14767058.2018.1439009DOI Listing
August 2019