Deep learning-based automatic and accurate 3D pancreas segmentation plays a significant role in medical diagnosis and disease treatment, which has received a lot of attention from the medical image ...processing community. 3D pancreas segmentation embraces two challenges: one is that the pancreas occupies a relatively small proportion in CT images, and there is a serious class imbalance problem between foreground and background, which makes it difficult to achieve accurate segmentation. Another issue is that existing models are overly reliant on computer memory. In response to the above issues, we propose a two-stage training framework to alleviate the influence of background on segmentation results while reducing memory consumption. Among which, different from previous methods that used the entire pancreas region as input, we design a Selective Overlap Method (SOM) that can learn contextual information while reducing computing costs by selecting the most appropriate number of overlapping slices. In addition, a novel 3D segmentation model named ResConv-3DUnet (RC-3DUNet) is integrated into this framework, which not only maintains the receptive field while drastically reducing parameter number but also uses the residual information between layers to strengthen edge attention and regularizes the output by designing the supervision weights of each decoder layer. Extensive experiments were conducted on the Medical Segmentation Decathlon (MSD) pancreas segmentation and the National Institutes of Health (NIH) pancreas segmentation datasets, demonstrating that our method has a superior trade-off between accuracy and lightweight than existing approaches.
Additionally, 3/18 patients had elevated alkaline phosphatase levels, and 4/5 patients had low serum 25(OH)VitD3 levels (10.78 ± 4.59 ng/dL, range: 6.66–16.33 ng/mL, normal value: 20.00–40.00 ng/mL). ......2/6 patients had elevated full-length parathyroid hormone levels (90.15 pg/mL, range: 71.00–109.30 pg/mL, normal value: 15.00–65.00 pg/mL). ...6/8 lesions were heterogeneous on T1-weighted imaging (T1W1), while 1/8 was slightly hypointense and 1/8 was iso-intense Figure 1B. The results showed that 9/12 lesions revealed an increased bone uptake by bone scintigraphy Figure 1D, 1/1 lesion showed hypermetabolic characteristics by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT), and 1/1 lesion with octreotide scanning showed a positive uptake in the tumor location. Aihong Yu, Department of Radiology, Beijing Anding Hospital, Capital Medical University, The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing 100088, China E-Mail: imaging2008@sina.com How to cite this article:
Background
Focal fibrocartilaginous dysplasia is a rare benign bone lesion of young children that causes deformities in the extremities. However, the pathogenesis and treatments have not been defined ...and the MR manifestations have been less well described.
Objective
To describe the MR manifestations of focal fibrocartilaginous dysplasia, especially on the T1-W three-dimensional (3-D) volumetric interpolated breath-hold examination (VIBE) sequence.
Materials and methods
In this retrospective study, the authors reviewed the MR and radiographic images, pathology and medical records of 21 cases of focal fibrocartilaginous dysplasia. All cases were evaluated by spin-echo MRI sequence. Among them, 17 cases were evaluated by T1-W 3-D VIBE sequence.
Results
The cohort consisted of 13 boys and 8 girls ages 4–75 months. In 14 cases, focal fibrocartilaginous dysplasia was located in the tibia, 3 in the femur and 4 in the ulna. MRI 3-D VIBE sequence findings showed all cases had hypointense fiber band structures in the bone defect areas. The fibrous bands in the lower extremities ended in the epiphysis or epiphyseal plate, and in the upper extremities the epiphysis or carpal bone. Ten cases had hyperintensities that might represent cartilage composition. Four cases had cartilage signals that were continuous with the epiphyseal cartilage. MR spin-echo sequence findings showed that bone marrow edema of the adjacent joint was observed in eight cases, enlargement of the epiphyseal plate in three cases and medial meniscus injury in five cases.
Conclusion
The 3-D VIBE sequence reveals useful details in focal fibrocartilaginous dysplasia.
Lumbar vertebral endplates lesions (LEPLs), one of the etiologies of low back pain (LBP), are one of the most prevalent causes of health-care costs. Despite progressively becoming the focus in recent ...years, almost all studies have concentrated on symptomatic patients rather than general populations. As a result, our study was designed to determine the prevalence and distribution patterns of LEPLs in a middle-young general population, as well as their associations with lumbar disc herniation (LDH), lumbar disc degeneration (LDD), and lumbar vertebral volumetric bone mineral density (vBMD).
Seven hundred fifty-four participants aged 20-60 years were recruited from the subjects enrolled in a 10-year longitudinal study of degeneration of the spine and knee being conducted at the Beijing Jishuitan Hospital and 4 of them were excluded due to the missing of MRIs. In this observational study, a lumbar quantitative computed tomography (QCT) and MRI scan were performed among participants within 48 h. T2-weighted sagittal lumbar MRI images for all included subjects were identified for LEPLs by two independent observers based on morphological and local characteristics. Lumbar vertebral vBMD was measured with QCT. The age, BMI, waistline, hipline, lumbar vBMD, LDD, and LDH were measured to investigate their associations with LEPLs.
The prevalence of LEPLs was higher among the male subjects. 80% of endplates were recognition as no lesions with a substantial disparity between female (75.6%) and male subjects (83.4%) (p < 0.001). The most common lesions were "wavy/irregular" and "notched", and "fracture" is most involved in L3-4 inferior endplate both in two genders. LEPLs were found to be associated with LDH (≥ 2 levels: OR = 6.859, P < 0.001; 1 level: OR = 2.328, P = 0.002 in men. OR = 5.004, P < 0.001; OR = 1.805, P = 0.014 in women) reference for non-LDH, and hipline in men (OR = 1.123, P < 0.001).
LEPLs are the common findings on lumbar MRIs in general population, particularly in men. The presence of these lesions and advance from slightly to severely could be mainly attributed to LDH and men's higher hipline.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
ObjectivesThe measurement of visceral fat (VF) is clinically important for the identification of individuals at high risk of visceral obesity-related health conditions. Bioelectrical impedance ...analysis (BIA) is a widely available and frequently used body composition assessment method, but there have been few validation studies for the measurement of VF. This validation study investigated agreement between BIA and CT for the assessment of VF in adults.DesignCross-sectional study.SettingBetween 2015 and 2016 in China.ParticipantsA total of 414 adults (119 men and 295 women) aged 40–82 years.Primary and secondary outcome measuresCT-visceral fat area (VFA) was derived at the L2-3 and umbilicus level and VFA cut-offs for visceral obesity applied. BIA measurements of visceral fat level were compared with CT VFA findings using scatter plots and receiver operator characteristic (ROC) curves.ResultsScatter plots showed poor agreement between BIA and CT-derived visceral fat measurements in both sexes (R=0.387–0.636). ROC curves gave optimum figures for sensitivity and specificity of 65% and 69% in women and 76% and 70% in men, respectively, for BIA to discriminate between adults with normal levels of VF and those with visceral obesity determined by CT.ConclusionBIA has limited accuracy for the assessment of VF in adults in practice when compared with the criterion method.
Abstract Differences in clinical manifestations and biological underpinnings between Major Depressive Disorder (MDD) onset during adolescence and adulthood have been posited in previous studies, ...implying an influential role of age of onset (AOO) in the clinical subtyping and therapeutic approaches to MDD. However, direct comparisons between the two cohorts and their age-matched controls have been lacking in extant investigations. In this investigation, 156 volunteers participated, comprising 46 adolescents with MDD (adolescent-onset group), 35 adults with MDD (adult-onset group), 19 healthy adolescents, and 56 healthy adults. Resting-state functional MRI scans were undergone by all participants. Large-scale network analyses were applied. Subsequently, a 2 × 2 ANOVA was employed to analyze the main effects of diagnosis, age, and their interaction effect on functional connectivity (FC). Furthermore, regression analysis was employed to scrutinize the association between anomalous FC and HAMD sub-scores. Increased FC in visual network (VN), limbic network (LN), VN-dorsal attention network (DAN), VN-LN, and LN-Default Mode (DMN) was found in both adolescent-onset and adult-onset MDD; however, the increased FC in DAN and LN were only found in adult-onset MDD and the decreased FC in DAN was only found in adolescent-onset MDD. Additionally, the relationship between HAMD factor 1 anxiety somatization and altered FC of DAN, VN, and VN-DAN was moderated by AOO. In conclusion, shared and distinctive large-scale network alterations in adolescent-onset and adult-onset MDD patients were suggested by our findings, providing valuable contributions towards refining clinical subtyping and treatment approaches for MDD.
Purpose
This study evaluated the prevalence of vertebral fractures (VF) in middle-aged and elderly Chinese men and women and explored the differences in lumbar spine volumetric bone mineral density ...(vBMD) derived from quantitative CT (QCT) between those with a grade 1 vertebral fracture and non-fractured individuals.
Materials and methods
3,457 participants were enrolled in the China Action on Spine and Hip Status (CASH) study and had upper abdominal CT examinations. Vertebral fractures were identified by Genant’s semi-quantitative method from lateral CT scout views or CT sagittal views. L1-3 vBMD was measured by Mindways QCT Pro v5.0 software. The characteristics of different fracture severity groups were compared using one-way ANOVA, independent-samples t-tests, and Kruskal-Wallis H-tests.
Results
1267 males (aged 62.77 ± 9.20 years) and 2170 females (aged 61.41 ± 9.01 years) were included in the analysis. In men, the prevalence of VF increased from 14.7% at age<50 years to 23.2% at age ≥70 years, and in women from 5.1% at age<50 years to 33.0% at age ≥70 years. Differences in mean age and vBMD were found between the different fracture grade groups. After age stratification, vBMD differences in men aged < 50 years old disappeared (p = 0.162) but remained in the older age bands. There was no significant difference in mean vBMD between those with multiple mild fractures and those with a single mild fracture.
Conclusion
In women, the prevalence of VF increased rapidly after age 50, while it grew more slowly in men. In general, with the exception of men <50 years old, participants with a grade 1 VF had lower vBMD than non-fractured individuals. The majority of women younger than 50 with a grade 1 VF had normal bone mass. We recommend that a vertebral height reduction ratio of <25% be diagnosed as a deformity rather than a fracture in people under the age of 50. The presence of multiple mild fractured vertebrae does not imply lower BMD.
Calcium supplementation can prevent gestational hypertension and pre-eclampsia. However, besides the non-consensus of existing studies, there is a lack of evidence regarding the optimal dosing of ...calcium.
Eight electronic databases, namely, the Cochrane Library, PUBMED, Web of Science, EMBASE, WANGFANG, VIP, CBM, and CNKI, were searched. The studies were retrieved from inception to July 13, 2021. Two researchers independently screened the literature, extracted data, and evaluated the methodological quality based on the inclusion criteria. In particular, the calcium supplementation doses were divided into three groups, namely, the high-dose (≥1.5 g), medium-dose (1.0-1.49 g), and the low-dose group (<1.0 g). The participants were also divided into high-risk and low-risk groups, according to the risk of developing gestational hypertension and pre-eclampsia.
A total of 48 studies were incorporated into the final analyses. All doses of calcium supplementation reduced the incidence of gestational hypertension in the low-risk population (low dose - three studies; medium dose- 11 studies; high dose- 28 studies), whereas the medium-dose (three studies) reduced the incidence of gestational hypertension in high-risk groups. Moreover, a medium dose of calcium supplementation had the maximum effect in reducing gestational hypertension in low-risk and high-risk populations. The medium (three studies) and high doses (13 studies) of calcium supplementation reduced the incidence of pre-eclampsia in the low-risk groups. However, a medium-dose calcium supplementation maximally prevented pre-eclampsia in the low-risk population. The authenticity and reliability of the results were reduced due to the limitations of contemporary studies in terms of experimental design, result measurement, statistics, and evidence quality. Therefore, high-quality studies with larger sample size are required to evaluate further the effect of calcium supplementation in preventing gestational hypertension and pre-eclampsia.
Panic disorder (PD) is an anxiety disorder that impairs life quality and social function and is associated with distributed brain regions. However, the alteration of the structural network remains ...unclear in PD patients. This study explored the specific characteristics of the structural brain network in patients with PD by graph theory analysis of diffusion tensor images (DTI). A total of 81 PD patients and 48 matched healthy controls were recruited for this study. The structural networks were constructed, and the network topological properties for individuals were estimated. At the global level, the network efficiency was higher, while the shortest path length and clustering coefficient were lower in the PD group compared to the healthy control (HC) group. At the nodal level, the PD group showed a widespread higher nodal efficiency and lower average shortest path length in the prefrontal, sensorimotor, limbic, insula, and cerebellum regions. Overall, the current results showed that the alteration of information processing in the fear network might play a role in the pathophysiology of PD.
Muscle weakness and bone fragility are both associated with hip fracture. In general, muscle contractions create forces to the bone, and bone strength adapts to mechanical loading through changes in ...bone architecture and mass. However, the relationship between impairment of muscle and bone function remain unclear. In particular, the associations of muscle with properties of proximal femur cortical and trabecular bone are still not well understood. The aim of this study was to explore the associations of hip/thigh muscle density (CT attenuation value in Hounsfield units) and size with cortical and trabecular bone mineral density (BMD) of the proximal femur.
Three-dimensional quantitative computed tomography (QCT) imaging of the lumber, hip and mid-thigh was performed in a total of 301 participants (mean age 68.4 ± 6.1 years, 194 women and 107 men) to derive areal BMD (aBMD) and volumetric BMD (vBMD). Handgrip strength (HGS) and the Timed Up and Go (TUG) test were also performed. From the CT images, cross-sectional area (CSA), and density were determined for the gluteus maximus muscle (G.MaxM), trunk muscle at the vertebrae L2 level, and mid-thigh muscle. Multivariate generalized linear models were applied to assess associations.
Total hip (TH) aBMD was associated significantly with G.MaxM CSA (men:
= 0.042; women:
< 0.001) and density (men:
= 0.012; women:
= 0.043). In women, 0.035 cm
of mid-thigh CSA (95% CI, 0.014-0.057;
= 0.002) increased per SD increase in TH aBMD, but this significance was not observed in men (
= 0.095). Trunk muscle density and CSA were not associated with proximal femur BMD. The associations of hip/thigh muscle parameters with femoral neck BMD were weaker than those with trochanter and intertrochanter BMD. Furthermore, compared to muscle density, muscle CSA showed better associations with vBMD. G.MaxM CSA was associated with trochanter (TR) Cort. vBMD in men (β, 19.898; 95% CI, 0.924-38.871;
= 0.040) and in women (β, 15.426; 95% CI, 0.893-29.958;
= 0.038). Handgrip strength was only associated with TR aBMD (β, 0.038; 95% CI, 0.006-0.070;
= 0.019) and intertrochanter aBMD (β, 0.049; 95% CI, 0.009-0.090;
= 0.016) in men.
We observed positive associations of the gluteus and thigh muscle size with proximal femur volumetric BMD. Specifically, the gluteus maximus muscle CSA was associated with trochanter cortical vBMD in both men and women.
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