Objective To introduce the imaging modalities used for the evaluation of postoperative complications of orthotopic liver transplantation (OLT) and to present the imaging findings of these complications. Methods The literatures related to the imaging methods and imaging manifestations of OLT complications were reviewed. Results Ultrasound was the initial imaging technique used for the detection of complications in the early postoperative period. Spiral CT and MRI yielded more accurate and comprehensive evaluation of postoperative complications in later stage. So far, there had been no specific imaging findings to suggest rejection reaction. The spectrum of imaging manifestations of OLT complications, such as vascular complications, biliary complications, liver parenchymal complications, and so on, were summarized and illustrated. Conclusion Imaging examination (especially ultrasound, spiral CT and MRI ) plays an important role in the evaluation of postoperative complications of OLT.
ObjectiveTo observe multimodal imaging characteristics in eyes with focal choroidal excavation (FCE) and preliminarily analyze the risk factors in FCE with complications correlated with RPE.MethodsA retrospective case series. Thirty-one patients (31 eyes) with monocular FCE, first identified by spectral-domain (SD)-OCT in the Eye Center of The Second People’s Hospital of Foshan from December 2014 to December 2018, were involved in this study. There were 14 males and 17 females, with the mean age of 45.84±13.57 years. All patients underwent BCVA, optometry, and SD-OCT examinations. FFA and ICGA were simultaneously performed in 3 FCE patients with RPE complications. The subfoveal choroidal thickness (SFCT) and excavation width were measured with enhanced depth imaging OCT (EDI-OCT). The eyes with FCE were divided into two groups (FCE alone group 17 eyes vs. FCE complication group 14 eyes), based on whether complicated by RPE dysfunction. Among 14 eyes of FCE complication group, 7 (22.6%) with choroidal neovascularization, 4 (12.9%) with central serous chorioretinopathy, 1 (3.2%) with polypoidal choroidal vasculopathy, and 2 (6.5%) with RPE detachment. No significant difference was found in the mean age (t=0.87), gender composition (χ2=0.06), ocular laterality (χ2=2.58), and spherical equivalent (t=?0.81) between two groups, respectively (P＞0.05), except that the BCVA was significantly different (t=?2.11, P＜0.05). The SFCT and excavation width of eyes in both groups and the ICGA imaging characteristics of eyes in FCE complication group were analyzed. Risk factors of FCE with RPE complications were analyzed by logistic regression analysis.ResultsThirty-three excavations were identified in 31 eyes with FCE. The mean SFCT was 167.00±85.18 μm in FCE alone group vs. 228.36±67.95 μm in FCE complication group, while the excavation width was 645.00±231.93 μm vs. 901.00±420.55 μm and they were both significantly different (P＜0.05). Logistic regression analysis showed the SFCT (OR=1.016, P=0.026) and excavation width (OR=1.004, P=0.034) were risk factors for RPE complications of FCE. EDI-OCT showed the RPE at the excavation was impaired or vulnerable in all eyes of the FCE alone group, especially at the boundary area of excavation. The RPE damages were located at the boundary area of excavation in 10 eyes (71.4%) of FCE complication group. Constant choroidal hypofluorescence and filling defect were observed under the excavation in 3 eyes with ICGA imaging.ConclusionsSFCT and excavation width may be risk factors for RPE complications of FCE. Impairment of RPE at boundary area of excavation and focal choroidal ischemia or aberrant circulation under the excavation may correlate with the development of FCE complications.
ObjectiveTo establish the degenerative disc animal model in rhesus macaques and to verify its reliability with T1ρ, spin-lock imaging and T2-mapping MRI and histological observation. MethodsTwelve female rhesus macaques (aged 4-6 years, weighing 4.4-6.1 kg) were enrolled in the study. The L5, 6 intervertebral disk was used for the experimental group by injecting 1 mL bleomycin A5 (2 mg/mL) to its adjacent endplates to induce degeneration, and the L4,5 intervertebral disk for the control group by injecting 1 mL normal sodium to its adjacent endplates. T1ρ and T2-mapping relaxation time was examined by using MRI, and the histological observation was performed to evaluate the process of degeneration at 1, 4, and 12 weeks after operation. ResultsThere was no significant change of T1ρ, T2 map relaxation time in the control group at different time points before and after operation (P>0.05). In the experimental group, there was a significant decrease of T1ρ relaxation time from 4 weeks after operation, showing significant difference when compared with the values at pre-operation and 1 week after operation (P<0.05). The T2 map relaxation time decreased significantly at 12 weeks after operation, showing significant difference when compared with the values at the other time points (P<0.05). There was no significant difference between 2 groups at the other time points (P>0.05) except T1ρ relaxation time at 4 and 12 weeks and T2 map relaxation time at 12 weeks (P<0.05). No significant change of the percentage of the high intensity area of the operated discs was observed on T2WI of MRI after operation in 2 groups (P>0.05). The histological results showed that the number of nucleus pulposus decreased and arranged irregularly at 4 weeks, and there were fibrosis changes of nucleus pulposus and cleft of the inner annulus fibrosus at 12 weeks after operation in the experimental group. ConclusionDegeneration of lumbar intervertebral disc in rhesus macaques can be induced by injecting bleomycin A5. T1ρ-MRI may be an effective method to evaluate early degeneration of intervertebral disc.
Objective To summarize the development, clinical application, advantages and disadvantages, and future prospects of parathyroid autofluorescence in recent years. MethodThe literatures related to the research progress of parathyroid autofluorescence in recent years were searched, and launched a specific discussion. Results Autofluorescence of parathyroid gland was still in its infancy at home and abroad. The existing studies had shown that this technique was superior to visual recognition and could reduce the incidence of postoperative complications. Autofluorescence technology had shown some advantages in identifying parathyroid gland during operation, and its mechanism research and related equipment improvement should be focused in the future. ConclusionAutofluorescence technique is of great value in the identification of parathyroid glands in patients undergoing thyroidectomy or parathyroidectomy.
Primary liver cancer is the sixth most common malignancy and the third leading cause of cancer-related death worldwide, and hepatocellular carcinoma (HCC) constitutes the majority of primary liver cancer cases. The Liver Imaging Reporting and Data System (LI-RADS) was introduced to standardize the lexicon, acquisition, interpretation, reporting, and data collection of imaging results in patients at increased risk for HCC. LI-RADS allows effective categorization of focal liver lesions, and has been applied in the full clinical spectrum of HCC from diagnosis, biological behavior characterization, prognosis prediction, to treatment response assessment. This review aimed to summarize the recent applications of CT/MRI LI-RADS in the diagnosis, biological behavior characterization and prognosis prediction of HCC, discuss current challenges and shed light on potential future directions.
Objective To analyze the correlation and difference of axial length (AL) measurements by comparing magnetic resonance imaging (MRI) of different pulse sequence with IOL Master of normal eyes. Methods The 67 emmetropic volunteers were selected by the slit lamp microscope, direct ophthalmoscope and refractive examination in this study. The patients included 30 males and 37 females. The patientsprime; ages ranged from eight to 21 years, with a mean age of 14.9 years. Fast spin echo (FSE) T1WI, FSE T2WI, fluid attenuated inversion recovery (FLAIR) T2WI, FSPGR T1WI were performed. The axial (AX) and oblique sagittal (OS) sections were taken and the AL from MRI section with different sequences were measured. The AL taken by IOL-Master was used as standard. The difference and correlation between measurements of two methods were analyzed. Results The AL of AX FSE T1WI, AX FSE T2WI, AX FLAIR T2WI, AX FSPGR T1WI, OS FSE T1WI, OS FSE T2WI, OS FLAIRT2WI and OS FSPGR T1WI were (24.14plusmn;0.81), (24.26plusmn;0.81), (23.87plusmn;0.79), (24.11plusmn;0.82), (24.08plusmn;0.86), (24.22plusmn;0.81), (23.84plusmn;0.79) and (24.03plusmn;0.81) mm, respectively. The AL of IOLMaster was (23.91plusmn;0.80) mm. The differences of AL between IOL-Master and various MRI sequences were statistically significant (t=－13.54,－23.20, 4.08, －15.55, －8.00, －23.22, 5.25, －10.62;P＜0.01). There were excellent correlations between IOL-Master and various MRI sequences (r=0.97, 0.96, 0.98, 0.97, 0.96, 0.80, 0.98, 0.97;P＜0.01). Conclusion There are differences and significant correlations between MRI sequences and IOL-Master.
With the rapid development of ophthalmic imaging methods, there are many ways of examination in the diagnosis and treatment of fundus diseases, such as FFA, ICGA, FAF, OCT and emerging blood vessels by OCT angiography in recent years. Multi-model image can understand the changes of anatomical structure and function of different levels and parts of the fundus from different aspects. A variety of imaging examinations are combined and complemented each other, which makes us have a further understanding of the location and pathological changes of many fundus diseases. But at the same time, the emergence of multi-modal images also brings a series of problems. How to standardize the use of multi-modal imaging platform to better serve the clinic is a problem that ophthalmologists need to understand.
Objective To investigate the value of magnetic resonance (MR) imaging for diagnosing typeⅠ congenital choledochocele and its complications. Methods The MR imaging data of 13 cases with proved typeⅠ congenital choledochocele associated with complications were retrospectively reviewed and compared with operative findings. MR imaging sequences included axial T2W and T1W plain scan, true-FISP coronal images, 2D-MRCP, and Gd-enhanced T1W images. Results All patients had cystic dilatation of the common bile ducts to various degrees. In 6 patients complicated with stone and infection, the bile duct showed uniform wall thickening with marked enhancement, and calculus were depicted within the duct lumen with dilatation of the proximal biliary duct. In 7 cases complicated with carcinoma of biliary duct, a polypoid soft tissue mass or nodule was seen inside the ductal lumen in 3 cases, or the duct wall was irregularly thickened in 4 patients. Six cases received curative operation, but one patient with extensive local infiltration, vascular encasement and lymphadenopathy had only palliative treatment. MR imaging observations were verified by surgery findings in all 13 patients.Conclusion MR imaging is very valuable not only in diagnosing typeⅠ congenital choledochocele, but also in revealing its complications.
The task of automatic generation of medical image reports faces various challenges, such as diverse types of diseases and a lack of professionalism and fluency in report descriptions. To address these issues, this paper proposes a multimodal medical imaging report based on memory drive method (mMIRmd). Firstly, a hierarchical vision transformer using shifted windows (Swin-Transformer) is utilized to extract multi-perspective visual features of patient medical images, and semantic features of textual medical history information are extracted using bidirectional encoder representations from transformers (BERT). Subsequently, the visual and semantic features are integrated to enhance the model's ability to recognize different disease types. Furthermore, a medical text pre-trained word vector dictionary is employed to encode labels of visual features, thereby enhancing the professionalism of the generated reports. Finally, a memory driven module is introduced in the decoder, addressing long-distance dependencies in medical image data. This study is validated on the chest X-ray dataset collected at Indiana University (IU X-Ray) and the medical information mart for intensive care chest x-ray (MIMIC-CXR) released by the Massachusetts Institute of Technology and Massachusetts General Hospital. Experimental results indicate that the proposed method can better focus on the affected areas, improve the accuracy and fluency of report generation, and assist radiologists in quickly completing medical image report writing.
ObjectiveTo summarize the research progress of near infra-red fluorescence imaging (NIRFI) in biliary tract surgery, and to provide protection for improvements of therapeutic effect and safety of biliary tract surgery.MethodThe relevant literatures about studies on NIRFI in the biliary tract surgery in recent years were reviewed.ResultsThe NIRFI had been preliminarily used in the surgical treatment of benign and malignant biliary diseases, and had shown its unique value in cholangiography. It provided a new method for effectively avoiding surgical complications, shortening operation time, reducing the rate of conversion to open surgery, evaluating blood supply of bile duct and improving the safety of operation.ConclusionsNIRFI has achieved notable successes in treatment of biliary tract diseases. With future application of fluorescence imaging in near infra-red Ⅱ window and new specific fluorescence targeting molecules, this technique will highlight its more important values in biliary surgery.