Morphological analysis of the vestibular aqueduct by computerized tomography images

OBJECTIVE: In the last two decades, advances in the computerized tomography (CT) field revise the internal and medium ear evaluation. Therefore, the aim of this study is to analyze the morphology and morphometric aspects of the vestibular aqueduct on the basis of computerized tomography images (CTI). MATERIAL AND METHOD: Computerized tomography images of vestibular aqueducts were acquired from patients (n=110) with an age range of 1-92 years. Thereafter, from the vestibular aqueducts images a morphometric analysis was performed. Through a computerized image processing system, the vestibular aqueduct measurements comprised of its area, external opening, length and the distance from the vestibular aqueduct to the internal acoustic meatus. RESULTS: The morphology of the vestibular aqueduct may be funnel-shaped, filiform or tubular and the respective proportions were found to be at 44%, 33% and 22% in children and 21.7%, 53.3% and 25% in adults. The morphometric data showed to be of 4.86 mm(2) of area, 2.24 mm of the external opening, 4.73 mm of length and 11.88 mm of the distance from the vestibular aqueduct to the internal acoustic meatus, in children, and in adults it was of 4.93 mm(2), 2.09 mm, 4.44 mm, and 11.35 mm, respectively. CONCLUSIONS: Computerized tomography showed that the vestibular aqueduct presents high morphological variability. The morphometric analysis showed that the differences found between groups of children and adults or between groups of both genders were not statistically significant.     

MR imaging of the normal shoulder

Magnetic resonance (MR) images of the shoulders of a healthy volunteer were obtained in axial, sagittal, and coronal orientations using a 0.5-T imaging system. Multiple high-resolution spin-echo images were generated using an off-center zoom technique and a specially designed surface coil. Several anatomic structures, including the rotator cuff, long biceps tendon, articular capsule, muscles, and bones, were visualized. The coronal and sagittal views were the most useful for demonstrating the rotator cuff. MR imaging has potential as a new non-invasive tool for the evaluation of the shoulder region.     

Parametric oesophageal multiple swallow scintigraphy for validation of dysphageal symptoms during external beam irradiation of mediastinal tumours

The aim of the study was to evaluate dysphageal symptoms and to measure the effect of local analgesic treatment using parametric oesophageal multiple swallow scintigraphy (PES) during external beam irradiation of the mediastinal region. Fifteen patients (most with lung cancer) with dysphagia grade II underwent PES during external beam radiotherapy of the mediastinum before and after application of local analgesics. Dynamic parametric condensed images were recorded. The intensity of clinical symptoms was correlated with the emptying rate at 10 s (ER-10 s) and the mean transit time (MTT). Visual analysis of the images was performed and the results were correlated with the fields of irradiation portals. Of the 15 patients, 12 showed a correlation between irradiation portals and the region of oesophageal motility disorder. Concordant results of clinical symptoms and PES data were found. In nine patients with a decrease in dysphagia following local analgesia, an increase in mean ER-10 s and a decrease in MTT were observed. In three patients with deterioration in clinical symptoms after analgesic treatment, a similar decrease in mean ER-10 s was found, though MTT remained constant. In three patients with normal values, motility disorders were detected in the dynamic study. In conclusion, PES was found to be a sensitive tool for the validation of dysphageal symptoms in patients during external beam irradiation of mediastinal tumours and for the evaluation and quantification of the efficacy of local analgesic treatment. Additional visual analysis of the dynamic study is helpful in diagnosing minimal disorders.     

Parametric oesophageal multiple swallow scintigraphy for validation of dysphageal symptoms during external beam irradiation of mediastinal tumours

The aim of the study was to evaluate dysphageal symptoms and to measure the effect of local analgesic treatment using parametric oesophageal multiple swallow scintigraphy (PES) during external beam irradiation of the mediastinal region. Fifteen patients (most with lung cancer) with dysphagia grade II underwent PES during external beam radiotherapy of the mediastinum before and after application of local analgesics. Dynamic parametric condensed images were recorded. The intensity of clinical symptoms was correlated with the emptying rate at 10 s (ER-10 s) and the mean transit time (MTT). Visual analysis of the images was performed and the results were correlated with the fields of irradiation portals. Of the 15 patients, 12 showed a correlation between irradiation portals and the region of oesophageal motility disorder. Concordant results of clinical symptoms and PES data were found. In nine patients with a decrease in dysphagia following local analgesia, an increase in mean ER-10 s and a decrease in MTT were observed. In three patients with deterioration in clinical symptoms after analgesic treatment, a similar decrease in mean ER-10 s was found, though MTT remained constant. In three patients with normal values, motility disorders were detected in the dynamic study. In conclusion, PES was found to be a sensitive tool for the validation of dysphageal symptoms in patients during external beam irradiation of mediastinal tumours and for the evaluation and quantification of the efficacy of local analgesic treatment. Additional visual analysis of the dynamic study is helpful in diagnosing minimal disorders.     

Infusion MR arteriography during hepatic arterial infusion chemotherapy: evaluation of clinical usefulness

PURPOSE: We developed a new method of infusion MR arteriography (IMRA) via an implantable port system using an infusion pump for the evaluation of drug distribution during hepatic arterial infusion chemotherapy. The purposes of this study were to optimize the method and evaluate its clinical usefulness. MATERIALS AND METHODS: We used 3D-T1 TFE as the most suitable sequence for IMRA according to the results of a phantom model experiment. We examined 33 cases of liver cancer that had been treated by arterial infusion chemotherapy via the port system. The following investigations were performed: degree of tumor enhancement, intra- and extrahepatic perfusion abnormality, and related toxicity. The evaluation of images was performed separately by two radiologists. RESULTS: IMRA provided good images of contrast enhancement, to reveal the perfusion patterns. The treatment response rate in the tumor group with well enhancement was higher than that of the group with poor enhancement (p < 0.0001). Extrahepatic perfusion was well visualized and was correlated with toxicity (p < 0.0001). CONCLUSION: IMRA is a useful method to evaluate drug perfusion for the optimization of arterial infusion chemotherapy.     

Imaging findings in the dominant shoulder of throwing athletes: comparison of radiography, arthrography, CT arthrography, and MR arthrography with arthroscopic correlation

OBJECTIVE: Conventional radiography, arthrography, CT arthrography, and MR arthrography--including use of the abduction and external rotation position--were compared, with arthroscopic correlation, to determine the spectrum of abnormalities encountered and the relative benefits of each imaging method in the evaluation of shoulder lesions occurring in 17 throwing athletes. SUBJECTS AND METHODS: Each of 36 athletes with shoulder pain aggravated by abduction and external rotation was examined in a single visit during which conventional radiography, arthrography, CT arthrography, and MR arthrography were performed. In 17 of these athletes, imaging findings were compared with those at arthroscopy. All images were independently evaluated by two groups of musculoskeletal radiologists. RESULTS: Structures found to be affected were, in decreasing order of frequency, the following: the posterosuperior labrum, supraspinatus tendon, infraspinatus tendon, humeral head, glenoid cavity and rim, acromioclavicular joint, anteroinferior capsulolabral complex, biceps tendon, and subscapularis tendon. MR arthrography without and with abduction and external rotation yielded the highest sensitivity and specificity for all lesions with the exceptions of bone sclerosis and enthesophytes (which were best seen with CT arthrography). MR arthrography with abduction and external rotation was most accurate for diagnosis of rotator cuff and anteroinferior capsulolabral complex tears. CONCLUSION: On the basis of these preliminary results, we believe that MR arthrography with abduction and external rotation should be part of the imaging evaluation of shoulder pain in throwing athletes, owing to the high sensitivity of this imaging technique.     

The value of computer-assisted sonographic tissue characterization in focal lesions of the thyroid

Thyroid lesions are a common observation in ultrasound examination. In most cases the differentiation of malignant and benign tissue is difficult. In this study 133 thyroid lesions were examined by an ultrasonographic tissue characterization system prior to surgery. The pathologic findings (29 cancers, 31 adenomas, 46 nodular goiters, 27 cysts) were examined with reference to the quantitative evaluation of the ultrasonic images (ROI method). The selected regions of interest (ROI) were analyzed with regard to the three most discriminating parameters. The overall accuracy of differentiation between malignant and benign thyroid nodules was 83.9%.     

Evaluation of time resolution of the primary motor cortex by a single paradigm using a stimulation system

Many researchers are investigating brain function by using a block paradigm in fMRI measurement. However, time resolution has been limited because the block paradigm employed data collection by consecutive image acquisition after stimulation began. Because of this problem, the evaluation of early brain activity was not adequate. Therefore, a system that was able to take imaging from a high time dependence to stimulation in real time was necessary to evaluate early brain activity. It is necessary to obtain controlled image taking by an MRI device with an external trigger by creating a sequence design in the system controlling stimulation and a sequence designed to achieve the above. The execution of a single paradigm by the originally designed sequence thus becomes possible, and arbitrarily setting all processes from stimulation to image taking is possible. It is thought that the practical use of the single paradigm designed by the control system of stimulation enables real-time imaging for stimulation and provides time-dependent data. From this, evaluation of brain activity of the primary motor cortex is possible in the early stage by event-related data collection. In addition, "sank," a relative decrement in PO(2) was also an initial stage of BOLD, that is, an initial dip occurs as a transitory signal change by using a single paradigm that synchronizes with the control system of stimulation for the evaluation of early brain activity. Moreover, it is thought that taking images by a single paradigm that is synchronized with the control system of stimulation is indispensable for time and spatial elucidation of detailed brain activity, to evaluate hyper brain function. Therefore, the brain activity in the primary visual cortex at the early stage was clarified in this study by using a single paradigm designed to synchronize with the control system of stimulation by single-shot EPI.     

A new in vivo technique for three-dimensional shoulder kinematics analysis

Objective. The field of shoulder kinematics research has long relied upon the use of cadaveric models or invasive techniques in human volunteers. In this paper, a novel method is presented that utilizes magnetic resonance imaging (MRI) and a software system called 3DVEWNIX. This method permits non-invasive, repetitive evaluation of living patients for glenohumeral kinematics analysis. The objectives of this study were twofold: to validate the quantitative accuracy of this technique; and to demonstrate glenohumeral relationships in asymptomatic volunteers during internal and external rotation of the arm. Design. The translational accuracy was first assessed by comparing known cadaveric glenohumeral translations with calculations from MR images of the cadaver. Nine asymptomatic volunteers were subsequently placed in an external shoulder positioning device in the scanner and imaged in 10° increments of actively achieved internal and external rotation. Three-dimensional reconstructions of the glenoid and humerus were used to evaluate the glenohumeral relationships in the tested positions of rotation. Results. The quantitative analysis revealed an error of 0.61 mm (SEM 0.11 mm). Examination of the volunteers demonstrated normal relationships about the glenohumeral joint in internal and external rotation. In addition, this method provided detailed images of the bony surface architecture from any perspective. These images can be transformed into a cinematic three-dimensional depiction of active shoulder rotation. Conclusion. This new technique offers an accurate, non-invasive method for assessing the normal glenohumeral relationships in shoulder kinematics. We now possess the capability to investigate the kinematics of normal and abnormal shoulder conditions non-invasively in a large patient population.     

MRI-SPET and SPET-SPET brain co-registration: evaluation of the performance of eight different algorithms.

The aim of this study was to assess the accuracy and computing time needed for MRI-SPET and SPET-SPET brain co-registration using eight different algorithms (Hermes software from Nuclear Diagnostics Ltd run on a SUN Ultra Sparc 2) to determine the clinically most suitable algorithm. MRI-SPET co-registration was evaluated using phantom studies. To approximate clinical dual-headed SPET studies, a Hoffman brain phantom was filled with 99Tcm. For MRI imaging (1.5 Tesla), the phantom was filled with water and doped with Gd-DTPA for contrast enhancement. For both modalities, phantom images were acquired and reconstructed using a routine clinical protocol. MRI and SPET images were matched by Downhill Simplex minimization of the sum of absolute Count Differences (CD), the sum of the Square Root of absolute count differences (SR), the Difference in Shape between the binary masks (SD), the number of Sign Changes in the subtracted image (SC), the Variance of intensities between corresponding pixels (VAR), the sum of absolute count differences between the 2D- and 3D-Gradient images (2DG-3DG) and, finally, the standard deviation of the Uniformity Index (UI), that is the intensity ratio between spatially corresponding voxels. Six degrees of freedom were allowed (three translation and three rotation parameters, three scaling parameters were constrained). The accuracy of the matching process with these different similarity measures was evaluated via the residual mismatch between external markers. We found that CD, SR, VAR nad UI give the most accurate registration compared with the other similarity measures. For the evaluation of SPET-SPET co-registration, five 99Tcm-ECD brain perfusion SPET scans were performed with a dual-headed gamma camera. These studies were then manually misaligned, and subsequently re-aligned using the methods outlined above. For this application, CD, SR and VAR were also found to give the most accurate registration. For all of these algorithms, the computing time required was clinically acceptable (i.e. less than 10 min).     

Multichannel biomagnetic system for study of electrical activity in the brain and heart

The authors designed a multichannel system for noninvasive measurement of the extremely weak magnetic fields generated by the brain and the heart. It uses a flat array of 37 superconducting magnetic field-sensing coils connected to sophisticated superconducting quantum interference devices. To prevent interference from external electromagnetic fields, the system is operated inside a shielded room. Complete sets of coherent data, even from spontaneous events, can be recorded. System performance was evaluated with phantom measurements and evoked-response studies. A spatial resolution of a few millimeters and a temporal resolution of a millisecond were obtained. First results in patients with partial epilepsy and investigations of the cardiac conductive pathway indicate that biomagnetism is now ready for a systematic clinical evaluation. Interpretation of measurements was facilitated by highlighting biomagnetically localized electrical activity in three-dimensional digital magnetic resonance images.     

Grouping of observer's visual characteristics on the basis of difference in the criteria of visual detection and selection of the fittest clustering method:verification of observer's group with radiologist-like visual characteristics

Various clustering methods are used in cluster analyses, with each clustering method demonstrating unique advantages. Therefore, it is important to make the best use of the advantages each method provides. We have recognized that it is necessary in the evaluation of X-ray images to classify observers quantitatively according to visual characteristics (grouping of observers) and have clustered observers using the UPGMA method, which is one of the clustering methods. We found that the observers were clustered into two different groups, one with radiologist-like characteristics and the other with medical physicist-like characteristics. Furthermore, we suggested that the group with radiologist-like characteristics was suitable for QC of X-ray images. However, it is doubtful whether the UPGMA method is most suitable for the grouping of observers. In this work we clustered observers using various clustering methods and examined the most suitable method for the evaluation of X-ray images. The results showed that the ward method was least suitable for the grouping of observers, and they were distinctly grouped into two different categories by using a further method.     

Selective intra-arterial 3-dimensional computed tomography angiography for preoperative evaluation of nephron-sparing surgery

OBJECTIVE: To evaluate selective intra-arterial 3-dimensional computed tomography (3D-CT) angiography as a tool for the preoperative evaluation of nephron-sparing surgery (NSS). METHODS: Twenty-three patients with renal cell carcinoma indicating NSS underwent selective intrarenal 3D-CT angiography. The time-lapse dual-phase technique was used for simultaneous vascular and urographic visualization. The 3D images were created by the shaded volume-rendering method. The CT attenuation of target structures was measured for quantitative evaluation. The 3D images were visually evaluated for the renal artery, vein, and collecting system using a grading system. Results were statistically analyzed. RESULTS: The 3D-CT angiography depicted the intrarenal branches of the renal artery and vein and the whole collecting system in most patients. Visualization of the renal artery was significantly correlated to its CT attenuation. Visualization of the renal vein was correlated to its CT attenuation adjusted by the surrounding renal parenchyma. CONCLUSION: Selective intra-arterial 3D-CT angiography allows the detailed visualization of intrarenal structures.     

Evaluation of SPET quantification of simultaneous emission and transmission imaging of the brain using a multidetector SPET system with the TEW scatter compensation method and fan-beam collimation

A gamma camera system which is able to acquire simultaneous single-photon emission tomographic (SPET) data and gamma ray transmission computed tomography (TCT) data for brain study using external rod sources and fan-beam collimators was developed and evaluated. Since the three external rod sources were located at the focal points of fan-beam collimators, which also happened to be the apexes of the equilateral triangle defined by the three detectors, simultaneous SPET and TCT scan could be performed using a 120° shared scan. Therefore, the proposed system required less than one third of the scanning time of a single-head system. Since the combination of rod sources and fan-beam collimators decreased the scatter component in transmission data without a slit collimator for each rod source, the radioactivity of the rod source was less than one-tenth of the previous investigations. For evaluation, we used two isotopes, thallium-201 for TCT and technetium-99m for SPET. The cross-contamination of transmission and emission was well compensated using the triple energy window (TEW) method. In a separate TCT scan, the measured attenuation coefficient of²⁰¹Tl for water was 0.19±0.01 cm^–1, while in a simultaneous scan, it was 0.20±0.01 cm^–1. The measured attenuation coefficient for water agreed well with the narrow-beam (theoretical) value of 0.187 cm^–1. In SPET images, scatter compensation was also performed using the TEW method and attenuation compensation was done using the measured attenuation map. The results showed the feasibility of simultaneous SPET and TCT scanning using the TEW method to obtain quantitative SPET images.     

Gastrointestinal examinations with digital radiography.

Basic imaging properties and clinical usefulness of an upgraded digital radiography system were evaluated. The system, which has 1,024 x 1,024 and 2,048 x 2,048 matrices, was upgraded with smaller focal spots (0.3 and 0.8 mm) and reduced thickness of the photoconductive layer of the video camera. Screen-film and digital images (with and without postprocessing) of the upper and lower gastrointestinal (GI) tract were used in the clinical evaluation. Overall modulation transfer functions of the upgraded digital system were comparable to those of the screen-film system, especially at the lower spatial frequency. Threshold contrasts of the two systems were similar despite a 50% reduction in incident exposure for the digital system. For the upper GI tract, digital images processed with unsharp masking techniques were comparable in quality to screen-film images before and after upgrade of the system. For the lower GI tract, screen-film images were better than digital images, except for those produced with a 2,048 x 2,048 matrix with unsharp masking. Further evaluation of the system for examination of other parts of the body seems warranted.     

Table-moving contrast-enhanced MR angiography of abdominal aortic aneurysm

Table-moving contrast-enhanced MR angiography (MRA) was performed in 14 cases of abdominal aortic aneurysm to evaluate its clinical usefulness. In all cases, aneurysms were clearly demonstrated and image quality was clinically acceptable. Findings of reconstructed MRA were highly consistent with those of DSA, and thrombosed areas were confirmed on source images. Main aortic branches including renal arteries, common iliac arteries, and internal and external iliac arteries were readily identified on reconstructed MRA and/or source images. Additional findings such as thoracic aortic aneurysm (n = 1), common iliac aneurysm (n = 6), external iliac aneurysm (n = 1), internal iliac aneurysm (n = 1), femoral arterial obstruction (n = 2), and femoral arterial stenosis (n = 4) were also detected. Although table-moving MRA may have disadvantages like reduced blood signal and limited spatial resolution compared with the conventional contrast-enhanced technique, the images that were obtained provided sufficient contrast and resolution for preoperative evaluation. Because abdominal aortic aneurysm is accompanied by various arterial abnormalities in many of the large arteries, table-moving MRA was considered a suitable technique for comprehensive assessment.     

Evaluating medical students on radiology clerkships in a filmless environment: use of an electronic test prepared from PACS and digital teaching collection images

RATIONALE AND OBJECTIVES: The competency of medical students in radiology clerkships is traditionally evaluated with film images, projected slides of photographed films, or printed reproductions of films. As radiology departments switch to filmless imaging, it seemed appropriate to determine the feasibility of an electronic evaluation prepared directly from digital images. MATERIALS AND METHODS: The image-based portion of a multiple-choice final examination was prepared as a PowerPoint presentation that included images downloaded from the departmental picture archiving and communication system (PACS) or digital teaching collections. The images were downloaded as bitmap files, imported to Adobe Photoshop for image editing, converted to tagged image file format, and finally imported to PowerPoint, where they were combined with text to create 50 questions. A liquid crystal diode projector displayed the questions, with a timer set to advance them automatically. RESULTS: The examination was easy and inexpensive to prepare (no photography costs). In an initial survey of 25 students, 17 (71%) of 24 students rated the resolution of images as excellent and five (21%) as good. No student gave an image a poor rating. Students preferred that images cover at least 40%-50% of the slides, and most approved of a blue background. An original allowance of 30 seconds per slide was reported to be too fast; the interval was increased to 45 seconds. CONCLUSION: An electronic final examination for medical students, prepared with images downloaded from PACS or digital teaching collections, is feasible, easy to prepare, and cost-effective, and it provides an excellent display of test images.     

Three-dimensional gadolinium-enhanced MR imaging of the breast: pulse sequence with fat suppression and magnetization transfer contrast. Work in progress

A pulse sequence with magnetization transfer contrast and fat suppression was used in three-dimensional magnetic resonance imaging of the breast. Two healthy volunteers, one person with silicone implants, and 12 patients with clinical and/or mammographic findings suspicious for malignancy were evaluated prior to and following infusion of gadopentetate dimeglumine. Imaging time was approximately 7 minutes for each set of data (128 sections). Final voxel dimensions ranged from 1.4 x 0.8 x 0.8 mm to 1.6 x 0.9 x 0.9 mm. All carcinomas, including ductal and lobular types, were enhanced before and after infusion of contrast medium. Multifocal carcinoma and inflammatory carcinoma could be clearly visualized. Enhancement was not evident in patients with fat necrosis (n = 1) or scar (n = 1). Fibrocystic changes in one patient were visible as areas of increased signal intensity on preinfusion images. Resolution and contrast of MR images obtained with this pulse sequence appeared to be improved over that achieved with conventional breast MR imaging techniques. This method has the potential to supplement conventional diagnostic methods in the evaluation of breast disease.     

城市核与辐射恐怖事件的辐射影响预测软件

目的 为更加直观了解核与辐射恐怖事件在城市地区的辐射影响范围,开发可将预测结果直接显示在城市电子地图上的系统软件.方法 针对放射性物质散布、脏弹袭击、辐射设施爆炸或纵火袭击3种场景,采用高斯扩散模型,预测污染物在大气中的扩散与沉降.结合相应的剂量转换因子,估算"代表人"的内、外照射剂量.集成计算系统与Mapinfo(R)地理信息系统,将相应的预测结果直观显示于城市电子地图.结果 该软件可实现预测结果在城市电子地图上的直接显示.其预测结果与国外类似软件Hotspot(R)的计算结果比较,对于主要污染区域的预测范围基本一致,事故下风向区域等剂量曲线位置偏差小于0.2 km.结论 研制出的软件系统能对城市核与辐射恐怖事件的辐射影响进行早期预测,为城市的应急响应提供参考,具有一定的实用价值.

Abstract：

Objective To develop a new software system that cau directly display the predicted results on an electronic map,in order to get a directly perceived understanding of the affected areas of nuclear and radiological terrorism events in city areas.Methods Three scenarios of events including spreading radioactive materials, dirty bomb attack,and explosion or arson attacks on the radiation facilities were assumed.Gaussian diffusion model was employed to predict the spread and deposition of radioactive pollutants,and both the internal and external doses were estimated for the representative person by using the corresponding dose conversion factors.Through integration of the computing system and Mapinfo geographic information system(GIS),the predicted results were visually displayed on the electronic maps of a city.Results The new software system could visually display the predicted results on the electronic map of a city, and the predicted results were consistent with those calculated by the similar software Hotspot(R)The deviation between this system and Hotspot was less than 0.2 km for predicted isoplethic curves of dose rate downwind.Conclusions The newly developed software system is of the practical value in predicting the effects of nuclear and radiological terrorism events in city areas.     

城市核与辐射恐怖事件的辐射影响预测软件

目的 为更加直观了解核与辐射恐怖事件在城市地区的辐射影响范围,开发可将预测结果直接显示在城市电子地图上的系统软件.方法 针对放射性物质散布、脏弹袭击、辐射设施爆炸或纵火袭击3种场景,采用高斯扩散模型,预测污染物在大气中的扩散与沉降.结合相应的剂量转换因子,估算"代表人"的内、外照射剂量.集成计算系统与Mapinfo(R)地理信息系统,将相应的预测结果直观显示于城市电子地图.结果 该软件可实现预测结果在城市电子地图上的直接显示.其预测结果与国外类似软件Hotspot(R)的计算结果比较,对于主要污染区域的预测范围基本一致,事故下风向区域等剂量曲线位置偏差小于0.2 km.结论 研制出的软件系统能对城市核与辐射恐怖事件的辐射影响进行早期预测,为城市的应急响应提供参考,具有一定的实用价值.