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The anatomy education literature suggests blended-learning approaches as more effective. We performed a literature review to answer the question if virtual dissection tables can play a significant role as supplements to traditional cadaver-based anatomy education methods.PubMed, SCOPUS, ERIC and Cochrane databases were searched for articles with purpose to explore the outcomes of the use of virtual dissection tables in conjunction with cadaver-based anatomy education.Six articles were included. Three articles were comparative and comprised evaluation of participants' anatomy examinations results. Three articles were non-comparative and comprised only evaluation of participants' opinions about the educational intervention. In all studies, the participants expressed satisfaction about the educational value of this intervention, while the data about anatomy examinations' results suggest that virtual dissection tables may also enhance students' academic performance, when they are used in conjunction with cadavers.Virtual dissection tables seem to do have a role in modern blended-learning anatomy curricula and could essentially supplement the educational power of cadaver-based methods. Our findings may stimulate further implementation of virtual dissection tables as supplementary tools to cadaver-based anatomy education.

A reverse micelle method was used for the synthesis of water-soluble silica hybrid, spin-crossover (SCO) nanoparticles (NPs). MRI experiments provided temperature dependent T2 values, indicating their potential use as smart MRI agents, while lyophilization of NP dispersions in water yielded powders with a preserved but modified thermal hysteretic magnetic profile.

To present the anatomical variations of vidian canal (VC) and sphenoid sinus (SS), relative to other anatomical landmarks of skull base area, which may be helpful for safer surgical approach to this area. MDCT scans (128-row MDCT system) of 90 patients (mean age 62 years) and six cadaveric heads were studied, and the following parameters were evaluated: mean length and types of VC, distance between VC and foramen rotundum (FR) and optic canal (OC), position of the VC regarding the lateral pterygoid plate (MPTG) and petrous ICA, pneumatization of SS, position of intrasinus septum regarding ICA and OC, bone dehiscence and protrusion of ICA and OC into SS. Six cadaveric heads underwent MDCT and endoscopic dissection, and the type and length of VC were evaluated. The statistical significance was assessed using Chi-square (χ2) test. Significance level was set at p

Introduction: This study aims to assess the utility of Boosting ensemble classification methods for increasing the diagnostic performance of multiparametric Magnetic Resonance Imaging (mpMRI) radiomic models, in differentiating benign and malignant breast lesions. Methods: The dataset includes mpMR images of 140 female patients with mass-like breast lesions (70 benign and 70 malignant), consisting of Dynamic Contrast Enhanced (DCE) and T2-weighted sequences, and the Apparent Diffusion Coefficient (ADC) calculated from the Diffusion Weighted Imaging (DWI) sequence. Tumor masks were manually defined in all consecutive slices of the respective MRI volumes and 3D radiomic features were extracted with the Pyradiomics package. Feature dimensionality reduction was based on statistical tests and the Boruta wrapper. Hierarchical Clustering on Spearman's rank correlation coefficients between features and Random Forest classification for obtaining feature importance, were implemented for selecting the final feature subset. Adaptive Boosting (AdaBoost), Gradient Boosting (GB), Extreme Gradient Boosting (XGBoost) and Light Gradient Boosting Machine (LightGBM) classifiers, were trained and tested with bootstrap validation in differentiating breast lesions. A Support Vector Machine (SVM) classifier was also exploited for comparison. The Receiver Operator Characteristic (ROC) curves and DeLong's test were utilized to evaluate the classification performances. Results: The final feature subset consisted of 5 features derived from the lesion shape and the first order histogram of DCE and ADC images volumes. XGboost and LGBM achieved statistically significantly higher average classification performances [AUC = 0.95 and 0.94 respectively], followed by Adaboost [AUC = 0.90], GB [AUC = 0.89] and SVM [AUC = 0.88]. Conclusion: Overall, the integration of Ensemble Learning methods within mpMRI radiomic analysis can improve the performance of computer-assisted diagnosis of breast cancer lesions.

Background and Objective Prostate cancer (PCa) is a severe public health issue and the most common cancer worldwide in men. Early diagnosis can lead to early treatment and long-term survival. The addition of the multiparametric magnetic resonance imaging in combination with ultrasound (mpMRI-U/S fusion) biopsy to the existing diagnostic tools improved prostate cancer detection. Use of both tools gradually increases in every day urological practice. Furthermore, advances in the area of information technology and artificial intelligence have led to the development of software platforms able to support clinical diagnosis and decision-making using patient data from personalized medicine. Methods We investigated the current aspects of implementation, architecture, and design of a health care information system able to handle and store a large number of clinical examination data along with medical images, and produce a risk calculator in a seamless and secure manner complying with data security/accuracy and personal data protection directives and standards simultaneously. Furthermore, we took into account interoperability support and connectivity to legacy and other information management systems. The platform was implemented using open source, modern frameworks, and development tools. Results The application showed that software platforms supporting patient follow-up monitoring can be effective, productive, and of extreme value, while at the same time, aiding toward the betterment medicine clinical workflows. Furthermore, it removes access barriers and restrictions to specialized care, especially for rural areas, providing the exchange of medical images and patient data, among hospitals and physicians. Conclusion This platform handles data to estimate the risk of prostate cancer detection using current state-of-the-art in eHealth systems and services while fusing emerging multidisciplinary and intersectoral approaches. This work offers the research community an open architecture framework that encourages the broader adoption of more robust and comprehensive systems in standard clinical practice.

Purpose: The anatomy education literature suggests blended-learning approaches as more effective. We performed a literature review to answer the question if virtual dissection tables can play a significant role as supplements to traditional cadaver-based anatomy education methods. Methods: PubMed, SCOPUS, ERIC and Cochrane databases were searched for articles with purpose to explore the outcomes of the use of virtual dissection tables in conjunction with cadaver-based anatomy education. Results: Six articles were included. Three articles were comparative and comprised evaluation of participants’ anatomy examinations results. Three articles were non-comparative and comprised only evaluation of participants’ opinions about the educational intervention. In all studies, the participants expressed satisfaction about the educational value of this intervention, while the data about anatomy examinations’ results suggest that virtual dissection tables may also enhance students’ academic performance, when they are used in conjunction with cadavers. Conclusion: Virtual dissection tables seem to do have a role in modern blended-learning anatomy curricula and could essentially supplement the educational power of cadaver-based methods. Our findings may stimulate further implementation of virtual dissection tables as supplementary tools to cadaver-based anatomy education. © 2022 Elsevier Masson SAS

Background Apparent diffusion coefficient (ADC) measurements are not incorporated in BI-RADS classification. Purpose To assess the probability of malignancy of breast lesions at magnetic resonance mammography (MRM) at 3 T, by combining ADC measurements with the BI-RADS score, in order to improve the specificity of MRM. Material and Methods A total of 296 biopsy-proven breast lesions were included in this prospective study. MRM was performed at 3 T, using a standard protocol with dynamic sequence (DCE-MRI) and an extra echo-planar diffusion-weighted sequence. A freehand region of interest was drawn inside the lesion, and ADC values were calculated. Each lesion was categorized according to the BI-RADS classification. Logistic regression analysis was employed to predict the probability of malignancy of a lesion. The model combined the BI-RADS classification and the ADC value. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. Results In total, 153 malignant and 143 benign lesions were analyzed; 257 lesions were masses and 39 lesions were non-mass-like enhancements. The sensitivity and specificity of the combined method were 96% and 86%, respectively, in contrast to 95% and 81% with BI-RADS classification alone. Conclusion We propose a method of assessing the probability of malignancy in breast lesions by combining BI-RADS score and ADC values into a single formula, increasing sensitivity and specificity compared to BI-RADS classification alone.

Η διατριβή εξέτασε παράγοντες που επηρεάζουν τη σχέση των κινήτρων μαθητών με το συναίσθημα και την επίδοσή τους. Στην έρευνα συμμετείχαν μαθητές και εκπαιδευτικοί Δευτεροβάθμιας Εκπαίδευσης. Συγκεκριμένα, συμμετείχαν 949 μαθητές, που προέρχονταν από 49 τμήματα και 98 εκπαιδευτικοί, που δίδασκαν στα ίδια τμήματα.Όσον αφορά στους μαθητές, διερευνήθηκε η σχέση μεταξύ του προσανατολισμού των στόχων επίτευξης, της αντίληψης της ακαδημαϊκής αυτοαποτελεσματικότητας και της αντικειμενικής ικανότητας αναγνώρισης των συναισθημάτων των άλλων με τα ακαδημαϊκά αποτελέσματα των μαθητών, δηλαδή το θετικό και αρνητικό συναίσθημα, το άγχος εξέτασης και τη σχολική τους επίδοση. Επιπλέον, διερευνήθηκαν οι συσχετίσεις των στόχων επίτευξης των μαθητών με τα ακαδημαϊκά τους αποτελέσματα, σε αλληλεπίδραση με την αντικειμενική ικανότητα των μαθητών αναγνώρισης των συναισθημάτων των άλλων. Παρόμοια, όσον αφορά στους εκπαιδευτικούς, διερευνήθηκε η σχέση μεταξύ των στόχων επίτευξης στη διδασκαλία, της αντίληψης της αυτοαποτελεσματικότητας στην εργασία και των αντιληπτών ικανοτήτων συναισθηματικής νοημοσύνης με το θετικό και αρνητικό τους συναίσθημα στην εργασία τους. Επιπλέον, διερευνήθηκε η σχέση των εξεταζόμενων εννοιών μεταξύ των δύο ομάδων για να ελεγχθεί αν οι μεταβλητές των εκπαιδευτικών επιδρούν στις μεταβλητές των μαθητών σε επίπεδο σχολικής τάξης. Συγκεκριμένα, διερευνήθηκαν οι σχέσεις των κινήτρων στην εργασία και των αντιληπτών ικανοτήτων της συναισθηματικής νοημοσύνης των εκπαιδευτικών με τα κίνητρα και τα ακαδημαϊκά αποτελέσματα των μαθητών. Επιπλέον, διερευνήθηκαν οι συσχετίσεις των κινήτρων των μαθητών με τα ακαδημαϊκά τους αποτελέσματα, σε αλληλεπίδραση με την αντικειμενική ικανότητα των μαθητών αναγνώρισης των συναισθημάτων των άλλων και την αντιληπτή ικανότητα των εκπαιδευτικών χρήσης των συναισθημάτων. Τα αποτελέσματα έδειξαν ότι οι αναφορές των μαθητών για τον προσανατολισμό στην προσέγγιση της επίδοσης συσχετίζονται με το θετικό τους συναίσθημα. Τα αποτελέσματα των αλληλεπιδράσεων σε ατομικό επίπεδο έδειξαν ότι όσο υψηλότερη αντικειμενική ικανότητα αναγνώρισης των συναισθημάτων των άλλων έχουν οι μαθητές, τόσο υψηλότερη θετική συσχέτιση υπάρχει μεταξύ του προσανατολισμού των στόχων στη μάθηση και του θετικού συναισθήματος. Επιπλέον, οι αναφορές των εκπαιδευτικών για τον προσανατολισμό στο έργο συσχετίζονται αρνητικά με το αρνητικό τους συναίσθημα, ενώ οι αντιλήψεις της αυτοαποτελεσματικότητάς τους συσχετίζονται θετικά με το θετικό τους συναίσθημα. Σε επίπεδο σχολικής τάξης, τα αποτελέσματα έδειξαν ότι ο προσανατολισμός των εκπαιδευτικών στην προσέγγιση της επίδοσης συσχετίζεται θετικά με το θετικό συναίσθημα των μαθητών. Επίσης, η ικανότητα των εκπαιδευτικών κατανόησης των συναισθημάτων του εαυτού συσχετίζεται θετικά με την επίδοση των μαθητών και τον προσανατολισμό τους στη μάθηση. Τα αποτελέσματα των αλληλεπιδράσεων σε επίπεδο σχολικής τάξης έδειξαν ότι η θετική σχέση μεταξύ του προσανατολισμού των στόχων στη μάθηση και του θετικού συναισθήματος ήταν ισχυρότερη μεταξύ των μαθητών που είχαν υψηλά επίπεδα αντικειμενικής ικανότητας αναγνώρισης των συναισθημάτων των άλλων και που ανήκαν σε τάξεις όπου οι εκπαιδευτικοί ανέφεραν υψηλά επίπεδα χρήσης των συναισθημάτων.Η διατριβή συμβάλλει στην κατανόηση του ρόλου των συναισθηματικών ικανοτήτων στην κινητοποίηση των μαθητών μέσα στη σχολική τάξη.

Hepatic arterial variations are relatively common, but usually overlooked by radiologists, leading to iatrogenic complications or prolonging interventional or surgical procedures. Michels in 1966 classified hepatic arterial variations in 10 categories, based on a cadaveric study. Establishment of multidetector computed tomography (MDCT) provides useful anatomical information. The purpose of our study is to highlight these variations and to propose of a user-friendly algorithm when studying a CT examination. We studied 1,520 contrast-enhanced CTs (16-row MDCT system) during arterial phase and searched for hepatic arteries and celiac trunk (CTr) variations. CT images were postproccessed using multiplanar reconstruction, maximum intensity projection and volume rendering techniques in axial, sagittal, and coronal planes. Our results were organized according to Michels' classification. Normal anatomy was found in 72.89% of the cases and variations classified in Types II-X in 22.24%. However, 4.87% of the cases could not be classified in Michels' types. A single arterial variation was found in 22.89% of the cases and multiple arterial variations were found in 4.21% of the cases. We examined first the aorta for supernumerary branches and then checked the fissure between right and left liver lobe, following porta hepatis, and finally the CTr and superior mesenteric artery. Hepatic arteries and CTr variations are relatively common (27.11%) and should be identified by the radiologists when studying CTs as their recognition provides better surgical planning, preventing iatrogenic complications. Imaging in coronal plane was helpful for end branches, while sagittal plane was better for aortic branches. Clin. Anat., 33:1091-1101, 2020. © 2019 Wiley Periodicals, Inc.

Aims and objectives To investigate the value of advanced multiparametric MR imaging biomarker analysis based on radiomic features and machine learning classification, in the non-invasive evaluation of tumor heterogeneity towards the differentiation of Low Grade vs. High Grade Gliomas. Methods and materials Forty histologically confirmed glioma patients (20 LGG and 20 HGG) who underwent a standard 3T-MRI tumor protocol with conventional (T1 pre/post-contrast, T2-FSE, T2-FLAIR) and advanced techniques (Diffusion Tensor and Perfusion Imaging, 1H-MR Spectroscopy), were included. A semi-automated segmentation technique, based on T1W-C and DTI, was used for tumor core delineation in all available parametric maps. 3D Texture analysis considered 12 Histogram, 11 Co-Occurrence Matrix (GLCM) and 5 Run Length Matrix (GLRLM) features, derived from p, q, MD, FA, T1W-C, T2W-FSE, T2W-FLAIR and raw DSCE data. Along with 1H-MRS metabolic ratios and mean rCBV values, a total of 581 attributes for each subject were obtained. A Support Vector Machine – Recursive Feature Elimination (SVM-RFE) algorithm and SVM classifier were utilized for feature selection and classification, respectively. Results Three different SVM classifiers were evaluated with consecutively SVM-RFE feature subsets. Linear SMO classifier demonstrated the highest performance for determining the optimal feature subset. Finally, 21 SVM-RFE top-ranked features were adopted, for training and testing the SMO classifier with leave-one-out cross-validation, achieving 95.5% Accuracy, 95% Sensitivity, 96% Specificity and 95.5% Area Under ROC Curve. Conclusion Results demonstrate that quantitative analysis of phenotypic characteristics, based on advanced multiparametric MR neuroimaging data and texture features, utilizing state-of-the-art radiomic analysis methods, can significantly contribute to the pre-treatment glioma grade differentiation.

Purpose The aim of this retrospective study was to present the frequency and MDCT appearances of sternal variations and anomalies, as well as to highlight their clinical significance. Methods This retrospective study was carried out on 1150 patients, who underwent chest MDCT. Axial planes, multiplanar and curved-planar reconstructed images were studied. Age and sex distribution of the variations was evaluated. Results Anatomical variations of the sternum were found in 74.1%. The most frequent variation was the double-ended xiphoid process (36.9%), followed by the single xiphoidal foramen (25.8%) and the sternal sclerotic band (12.8%). Other variations observed were: sternal notch (10.1%), xiphoidal ligament calcification (8.3%), sternal foramen (4.9%), complete manubriosternal fusion (4.1%) and sternoxiphoidal fusion (4.1%), triple-ended xiphoid process (3.7%), sternal cleft (1.5%), whereas the rest of the variations including sternoxiphoidal junction pseudoforamen, suprasternal bone, pseudocleft, suprasternal tubercle and absence of xiphoid process were in less than 1%. In our subjects, sternal and xiphoidal foramina were adjacent to: the pericardium (37.14%), the diaphragm (22.9%), the mediastinal fat (17.1%), the liver (11.4%), the lung (8.5%) and to the stomach (2.9%). Conclusions Sternal variations are frequent, asymptomatic, detected incidentally at cross-sectional imaging and may be confused with pathologic conditions. Radiologists should be familiar with these variations in order to discriminate them from pathologies and avoid complications during interventional procedures. Advances in knowledge This study presents thoroughly the sternal variations’ MDCT appearance, detected in a Greek population, correlates them with age and gender and discuss their clinical significance in detail.

Facial nerve iatrogenic injuries are serious and can negatively affect the quality of life of the patients. Due to the properties of the nerve, the complications are devastating involving the aesthetic appearance and the function of the face. Moreover, the multiple branches of the nerve increase the risk of an iatrogenic injury making the detailed knowledge of the anatomical correlations around them critical. In this review, a meticulous analysis was performed including the surgical procedures posing the greater risk of an iatrogenic injury as well as the full description of all the reported anatomical landmarks involving the extracranial course of the facial nerve.

The main purpose of the study is to investigate the possible effect of school teachers’ collaborative networks on their individual innovativeness and the innovative school climate. In addition, 174 Greek primary school teachers’ views were explored about their collaboration networks (three collaboration types), their perceived individual innovativeness, the possible existence of innovative school climate, and the support they received in order to promote and/or produce new ideas and practices. Results showed that most of the participant school teachers belong to two categories of the five in the individual innovativeness scale, the early adopters and the early majority, although 20% belongs to innovators. Teachers’ collaboration network types affect innovative school climate and their individual innovativeness, but there were not found correlation between innovative school climate and perceived teachers’ innovativeness. However, collaborative networks within school have a higher effect on teachers’ innovativeness, and innovative school climate can be predicted by the network within school and among schools, as well as by the support that school teachers receive. Article visualizations

Epitope H contains an O-linked N-acetylglucosamine (O-GlcNAcH) residue in a specific conformation and/or environment recognized by the mouse monoclonal antibody H. O-GlcNAcH is present in several types of cells and in several polypeptides, including cytokeratin 8 and vimentin, on the latter in cells under stress. In the present work, we examined the expression of the O-GlcNAcH in 60 cases of endometrial curettings from missed miscarriage cases containing normal and simple hydropic degenerated chorionic villi in each case, using monoclonal antibody H and indirect immunoperoxidase and Western blot immunoblot. In all cases examined the expression of the O-GlcNAcH was cytoplasmic as follows: (1) syncytiotrophoblastic cells showed very low expression in chorionic villi (CV) with nonhydropic degeneration (NHD) and high expression in hydropic degenerated (HD) CV; (2) cytotrophoblastic cells showed low expression in CV with NHD and high expression in HD CV; (3) fibroblastic cells showed high expression in CV with NHD and very low expression in HD CV; (4) histiocytes showed very low expression in both types of CV; (5) endothelial cells showed high expression in both types of CV. An immunoblot of CV from one case of a legal abortion from a normal first-trimester pregnancy showed 5 polypeptides with 118.5, 106.3, 85, 53, and 36.7 kD bearing the epitope H and the 53 kD corresponded to cytokeratin 8. The expression of the O-GlcNAcH is upregulated in the trophoblastic cells and downregulated in the fibroblastic cells in the HD CV in comparison to the NHD CV.

Purpose To identify intra-lesion imaging heterogeneity biomarkers in multi-parametric Magnetic Resonance Imaging (mpMRI) for breast lesion diagnosis. Methods Dynamic Contrast Enhanced (DCE) and Diffusion Weighted Imaging (DWI) of 73 female patients, with 85 histologically verified breast lesions were acquired. Non-rigid multi-resolution registration was utilized to spatially align sequences. Four (4) DCE (2nd post-contrast frame, Initial-Enhancement, Post-Initial-Enhancement and Signal-Enhancement-Ratio) and one (1) DWI (Apparent-Diffusion-Coefficient) representations were analyzed, considering a representative lesion slice. 11 1st-order-statistics and 16 texture features (Gray-Level-Co-occurrence-Matrix (GLCM) and Gray-Level-Run-Length-Matrix (GLRLM) based) were derived from lesion segments, provided by Fuzzy C-Means segmentation, across the 5 representations, resulting in 135 features. Least-Absolute-Shrinkage and Selection-Operator (LASSO) regression was utilized to select optimal feature subsets, subsequently fed into 3 classification schemes: Logistic-Regression (LR), Random-Forest (RF), Support-Vector-Machine-Sequential-Minimal-Optimization (SVM-SMO), assessed with Receiver-Operating-Characteristic (ROC) analysis. Results LASSO regression resulted in 7, 6 and 7 features subsets from DCE, DWI and mpMRI, respectively. Best classification performance was obtained by the RF multi-parametric scheme (Area-Under-ROC-Curve, (AUC) ± Standard-Error (SE), AUC ± SE = 0.984 ± 0.025), as compared to DCE (AUC ± SE = 0.961 ± 0.030) and DWI (AUC ± SE = 0.938 ± 0.032) and statistically significantly higher as compared to DWI. The selected mpMRI feature subset highlights the significance of entropy (1st-order-statistics and 2nd-order-statistics (GLCM)) and percentile features extracted from 2nd post-contrast frame, PIE, SER maps and ADC map. Conclusion Capturing breast intra-lesion heterogeneity, across mpMRI lesion segments with 1st-order-statistics and texture features (GLCM and GLRLM based), offers a valuable diagnostic tool for breast cancer.

Breast cancer is a highly heterogeneous disease, exhibiting substantial spatiotemporal variations in gene expression, biochemistry, histopathology, and macroscopic structure. The complexities in the evaluation of malignant tumor heterogeneity, are pushing current clinical examinations to their limits and accounting for most of the failures of targeted therapies, and uncertainties in the clinical outcome among breast cancer patients. The incorporation of state-of-the-art image analysis methods, and emerging machine learning techniques, is providing the application of detailed data-driven quantitative studies of imaging phenotypes, termed Radiomics. Specifically, an immense number of quantifiable imaging features, are extracted with high-throughput computing from medical images, and correlated with other clinical data, for unraveling the complex underlying pathophysiological mechanisms which are potentially reflected in tissue macroscopic phenotype. Therefore, radiomic analysis is holding a key role in the future of clinical decision support, as it provides powerful tools for assessing the spatiotemporal heterogeneity of breast cancer, aiming at increasing the diagnostic accuracy and predicting patient's outcome toward individualized therapy planning.

Infertile couples with low oocyte yield in combination with abnormal semen parameters may experience intra-cytoplasmic sperm injection (ICSI) failure. An established factor associated with ICSI failure is oocyte activation deficiency (AOD). The latter originates from seminal contributors, such as phospholipase C-zeta (PLCζ) that is not adequate to produce calcium (Ca2+) oscillations for oocyte activation. Apart from this natural activator, other stimulants, such as A23187, ionomycin, strontium chloride or even electric pulses, have been used in embryological laboratories to overcome AOD and ICSI failure. The aim of the present narrative review is to discuss the role of Ca+2 oscillations in oocyte activation and summarize the evidence concerning the use of oocyte activators as agents for artificial oocyte activation (AOA). Studies in humans and animals have emerged many physiological, pathophysiological and ethical aspects of AOA. In conclusion, in mammalian eggs, the cytosolic Ca+2 oscillations derive from a periodic release of Ca+2 from intracellular pools. PLCζ, as well as artificial stimulants, have been used to produce Ca+2 oscillations for AOA. As the latter may increase the risk of epigenetic induced malformations, further studies are required to clarify whether AOA constitutes an effective and safe method to overcome ICSI failure. Abbreviations: AOA: artificial oocyte activation; AOD: oocyte activation deficiency; Ca+2: Calcium; CAMKII: Ca+2/calmodulin-dependent protein kinase II; CICR: calcium-induced calcium-release; DAG: diacylglycerol; GM-CSF: granulocyte-macrophage colony-stimulating factor; ICSI: intra-cytoplasmic sperm injection; InsP3R: inositol-trisphosphate receptor; IP3: inositol 1,4,5-trisphosphate; IVF: in vitro fertilization; MAP: mitogen-activated protein; MII: metaphase II; NADP: nicotinic acid adenine dinucleotide phosphate; NO: nitric oxide; PAWP: post-acrosomal WW-binding domain protein; PIP2: phosphatidylinositol 4,5-bisphosphate; PLC: phospholipase C; PLCζ: phospholipase C-zeta; SOAFs: spermatozoon-released oocyte-activating factors; Sr+2: strontium; TFF: total fertilization failure.

Aim To evaluate apparent diffusion coefficient (ADC) measurements of breast lesions on different computer platforms to address post-processing influences on ADC measurement reproducibility. Materials and methods One hundred biopsy-proven breast lesions were included in this prospective study. MRI examination was performed at 3 T using standard sequences and an echo planar diffusion-weighted imaging sequence with b-values of 0 and 850 s/mm2. The images were reviewed by two radiologists in consensus. Regions of interest were placed manually within the lesion, following its contour. Care was taken to exclude adjacent normal tissue or necrotic tissue and cystic components within the lesion. The mean ADC value was measured for each lesion on two different platforms: On the MRI workstation that came with the scanner and on a commercially available DICOM (digital imaging and communication in medicine) viewer. Agreement between workstation measurements was evaluated using intraclass correlation coefficient and Bland–Altman plots. Results Fifty-nine malignant and 41 benign lesions were analysed. Of the benign lesions, 28 were mass lesions and 13 were non-mass-like enhancements. In addition, 46 of the malignant lesions were masses and 13 were non-mass-like enhancements. Agreement between the two workstation measurements was high (intraclass correlation coefficients=0.981). Using Bland–Altman plots, no systematic differences were identified between workstations. Limits of agreement ranged between a minimum of –0.071×10−3 mm2/s and a maximum of 0.102×10−3 mm2/s. Conclusion ADC measurements are reproducible among the workstations considered in this study.

Research on students’ motivation has mainly focused on interpersonal differences rather than on the ongoing, intrapersonal dynamics that forge students’ everyday life. In this five-month longitudinal (diary) study, we recruited a sample of 179 high school students from Greece (35.8% males; Mage = 16.27; SD = 1.02) to investigate through multilevel analyses the ongoing dynamics of students’ motivation. We did so by examining the relation between autonomous functioning and aspects of study regulation (namely, study efforts and procrastination) and well-being (namely, subjective vitality and depressive feelings). After controlling for perceived competence, we found week-to-week autonomous functioning to relate positively to study efforts and subjective vitality and negatively to procrastination and depressive feelings. Interestingly, implicit theories of ability - the degree to which one believes that ability is fixed or amenable - were found to moderate the week-to-week relations of autonomous functioning to study efforts and homework procrastination. In particular, autonomous functioning co-varied positively to study efforts and negatively to homework procrastination only among students who believed that ability is malleable. Also, beliefs that ability is fixed predicted poorer grades, lower mean levels of study efforts, and higher homework procrastination. The results underscore the necessity of taking a more dynamic view when studying motivational phenomena and the importance of jointly considering the implicit theory framework and self-determination theory.

Objective. To assess body composition in adult male and female patients with thalassemia major by dual-energy X-ray absorptiometry (DXA) and to compare the findings with a group of healthy age-matched controls. Methods. Our study group included sixty-two patients (27 males, mean age 36 years, and 35 females, mean age 36.4 years) and fifteen age-matched healthy controls. All patients had an established diagnosis of thalassemia major and followed a regular blood transfusion scheme since childhood and chelation treatment. Fat, lean, and bone mineral density (BMD) were assessed with dual-energy X-ray absorptiometry. Ferritin levels and body mass index of all patients and controls were also recorded. Student t-test and Wilcoxon test were performed and statistical significance was set at p<0.05. Results. BMD and whole body lean mass are lower in both male and female adult patients compared with controls (p<0.01 in both groups), whereas whole body fat mass was found to have no statistically significant difference compared to controls. Regional trunk fat around the abdomen was found to be lower in male patients compared to controls (p=0.02). Conclusion. Severe bone loss and diminished lean mass are expected in adult male and female patients with thalassemia major. Fat changes seem to affect mainly male patients.

Background Conventional breast magnetic resonance imaging (MRI), including dynamic contrast-enhanced MR mammography, may lead to ambiguous diagnosis and unnecessary biopsies. Purpose To investigate the contribution of quantitative diffusion tensor imaging (DTI) in the discrimination between benign and malignant breast lesions at 3 T MRI. Material and methods The study included a total of 86 lesions (44 benign and 42 malignant) in 58 women (34 with malignant lesions, 23 with benign lesions and 1 with both types of lesions). All patients were examined on a 3 T MRI scanner. Fractional Anisotropy (FA), Mean Diffusivity (MD), Apparent Diffusion Coefficient (ADC), as well as eigenvalues (λ1, λ2, λ3) were calculated and compared between benign and malignant lesions using two different software packages (GE Functool and ExploreDTI). Results Malignant lesions exhibited significantly lower ADC values compared to benign ones (ADCmal = 1.06 × 10−3 mm2/s, ADCben = 1.54 × 10−3 mm2/s, p-value Conclusion The addition of eigenvalue analysis improves DTI's ability to differentiate between benign and malignant breast lesions.

Aim To evaluate the effect of intravenous gadolinium contrast agent on diffusion-weighted sequences and apparent diffusion coefficient (ADC) measurements at 3 T. Materials and methods Sixty-two biopsy-proven breast lesions were included in this prospective study. Magnetic resonance imaging (MRI) was performed at 3 T, using four echo-planar diffusion-weighted sequences (7,100 ms repetition time, 84 ms echo time) with b-values of 0 and 850, and 0 and 1,000 s/mm2. The first pair of DWI sequences was taken before intravenous contrast medium injection. The second pair of sequences was taken 6.5 minutes after intravenous contrast medium administration (right after the dynamic T1 sequence). A freeform region of interest (ROI) was drawn inside the lesion excluding adjacent normal tissue, necrotic, or cystic components and ADC values were calculated. The paired samples t-test was used to assess differences between ADC measurements before and after intravenous contrast medium administration. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve were calculated for each diffusion sequence. Results Twenty-seven malignant and 35 benign lesions were analysed. Fifty-eight lesions were masses, and four lesions were non-mass-like enhancements (NMLEs). Two of the NMLEs were malignant, and two were benign lesions. The contrast-enhanced ADC measurements were lower than the unenhanced measurements on b=850 and 1,000 s/mm2 (p Conclusion The injection of intravenous contrast medium reduces ADC values; however, the effect of contrast medium is modest. Sensitivity and specificity are not significantly affected.

Over the years, MR systems have evolved from imaging modalities to advanced computational systems producing a variety of numerical parameters that can be used for the noninvasive preoperative assessment of breast pathology. Furthermore, the combination with state-of-the-art image analysis methods provides a plethora of quantifiable imaging features, termed radiomics that increases diagnostic accuracy towards individualized therapy planning. More importantly, radiomics can now be complemented by the emerging deep learning techniques for further process automation and correlation with other clinical data which facilitate the monitoring of treatment response, as well as the prediction of patient’s outcome, by means of unravelling of the complex underlying pathophysiological mechanisms which are reflected in tissue phenotype. The scope of this review is to provide applications and limitations of radiomics towards the development of clinical decision support systems for breast cancer diagnosis and prognosis.

Purpose: Segmentation of microcalcification (MC) clusters in x-ray mammography is a difficult task for radiologists. Accurate segmentation is prerequisite for quantitative image analysis of MC clusters and subsequent feature extraction and classification in computer-aided diagnosis schemes. Methods: In this study, a two-stage semiautomated segmentation method of MC clusters is investigated. The first stage is targeted to accurate and time efficient segmentation of the majority of the particles of a MC cluster, by means of a level set method. The second stage is targeted to shape refinement of selected individual MCs, by means of an active contour model. Both methods are applied in the framework of a rich scale-space representation, provided by the wavelet transform at integer scales. Segmentation reliability of the proposed method in terms of inter and intraobserver agreements was evaluated in a case sample of 80 MC clusters originating from the digital database for screening mammography, corresponding to 4 morphology types (punctate: 22, fine linear branching: 16, pleomorphic: 18, and amorphous: 24) of MC clusters, assessing radiologists’ segmentations quantitatively by two distance metrics (Hausdorff distance—HDIST{sub cluster}, average of minimum distance—AMINDIST{sub cluster}) and the area overlap measure (AOM{sub cluster}). The effect of the proposed segmentation method on MC clustermore » characterization accuracy was evaluated in a case sample of 162 pleomorphic MC clusters (72 malignant and 90 benign). Ten MC cluster features, targeted to capture morphologic properties of individual MCs in a cluster (area, major length, perimeter, compactness, and spread), were extracted and a correlation-based feature selection method yielded a feature subset to feed in a support vector machine classifier. Classification performance of the MC cluster features was estimated by means of the area under receiver operating characteristic curve (Az ± Standard Error) utilizing tenfold cross-validation methodology. A previously developed B-spline active rays segmentation method was also considered for comparison purposes. Results: Interobserver and intraobserver segmentation agreements (median and [25%, 75%] quartile range) were substantial with respect to the distance metrics HDIST{sub cluster} (2.3 [1.8, 2.9] and 2.5 [2.1, 3.2] pixels) and AMINDIST{sub cluster} (0.8 [0.6, 1.0] and 1.0 [0.8, 1.2] pixels), while moderate with respect to AOM{sub cluster} (0.64 [0.55, 0.71] and 0.59 [0.52, 0.66]). The proposed segmentation method outperformed (0.80 ± 0.04) statistically significantly (Mann-Whitney U-test, p < 0.05) the B-spline active rays segmentation method (0.69 ± 0.04), suggesting the significance of the proposed semiautomated method. Conclusions: Results indicate a reliable semiautomated segmentation method for MC clusters offered by deformable models, which could be utilized in MC cluster quantitative image analysis.« less

To evaluate the ability of proton-density with fat-suppression BLADE (proprietary name for periodically rotated overlapping parallel lines with enhanced reconstruction in MR systems from Siemens Healthcare, PDFS BLADE) and turbo inversion recovery magnitude-BLADE (TIRM BLADE) sequences to reduce motion and pulsation artifacts in shoulder magnetic resonance examinations. Forty-one consecutive patients who had been routinely scanned for shoulder examination participated in the study. The following pairs of sequences with and without BLADE were compared: (a) Oblique coronal proton-density sequence with fat saturation of 25 patients and (b) oblique sagittal T2 TIRM-weighed sequence of 20 patients. Qualitative analysis was performed by two experienced radiologists. Image motion and pulsation artifacts were also evaluated. In oblique coronal PDFS BLADE sequences, motion artifacts have been significantly eliminated, even in five cases of non-diagnostic value with conventional imaging. Similarly, in oblique sagittal T2 TIRM BLADE sequences, image quality has been improved, even in six cases of non-diagnostic value with conventional imaging. Furthermore, flow artifacts have been improved in more than 80% of all the cases. The use of BLADE sequences is recommended in shoulder imaging, especially in uncooperative patients because it effectively eliminates motion and pulsation artifacts.

Incisional hernia is one of the most frequent complications of abdominal surgery [1–3] with a reported prevalence from 0.5% to 13.9% for abdominal operations but may be as high as 41% after aortic ...

The role of magnetic resonance angiography (MRA) in the evaluation of patients with blunt vertebral artery has not been fully established. Our aim is to define the diagnostic accuracy of MRA in comparison to digital subtraction angiography (DSA) for the detection of blunt vertebral artery injury in trauma patients. A computer-assisted literature search of the PubMed, Scopus, Highwire, Web of Science, and LILACS was conducted, in order to identify studies reporting on the sensitivity and specificity of MRA in comparison to DSA for the detection of blunt vertebral artery injury in trauma patients. The Database search retrieved 91 studies. Five studies fulfilled our eligibility criteria. Two authors assessed the risk of bias and applicability concerns using QUADAS-2. Two-by-two contingency tables were constructed on a per-vessel level. Heterogeneity was tested by the statistical significance of Cochran's Q, and was quantified by the Higgins's I2 metric. The pooled estimates of sensitivity and specificity for blunt vertebral artery injury detection with MRA in comparison to DSA were calculated based on the bivariate model. The meta-analysis was supplemented by subgroup and sensitivity analysis, as well as analysis for publication bias. There was significant clinical heterogeneity in the targeted population, inclusion criteria, and MRA related parameters. The reporting bias and applicability concerns were moderate and low, respectively. In the overall analysis, the sensitivity ranged from 25% to 85%, while the specificity varied from 65% to 99%, across studies. According to the bivariate model, the pooled sensitivity and specificity of MRA in the evaluation of patients with blunt vertebral artery was as high as 55% (95% CI 32.1%-76.7%), and 91% (95% CI 66.3%-98.2%), respectively. Subgroup analysis in terms of MRA sequence sensitivity of phase, the contrasted MRA (75% [95% CI 43%-92%]) seemed to be superior to the TOF MRA (46% [95%CI 20%-74%]). The addition of contrast enhancement did not seem to improve the diagnostic yield of MRA. The Egger's test did not identify any significant publication bias (p=0.2). An important limitation of the current meta-analysis is the small number of eligible studies, as well as the lack of studies on newer, high-field MR scanners. We concluded that MRA has a moderate diagnostic accuracy in the diagnosis of blunt vertebral artery injuries. Further studies on high-field magnetic resonance scanners are recommended.

Brain tumors represent a vast group of lesions, originating from different neuronal cells with different degrees of aggressiveness. Despite some technological advances either pre or post-treatment, these tumors may share similar imaging findings and properties, rendering diagnosis/prognosis, an ambiguous process. Gadolinium-enhanced magnetic resonance imaging remains the gold standard for providing detailed morphologic information, but presents several limitations due to the overlap of findings, in cases such as progressive tumor and post-radiation related effects. Tumor cellularity, vascularity, proliferative activity, metabolic and functional profiles are a few of many characteristics that may further support tumor classification, but cannot be assessed by conventional imaging alone. We review the aforementioned factors and indicate how they improve tumor characterization and grading in order to design the optimal treatment strategy and better evaluate post treatment efficacy.

Synovial plicae are normal anatomical structures of the knee that may become symptomatic. MRI is an established technique for evaluating the anatomy of the knee, and it is a valuable tool for detecting plicae because of its high resolution resulting in increased tissue characterisation. At MRI, knee plicae appear as low-signal-intensity structures of variable size and thickness, and they are better visualised at fluid-sensitive sequences with or without fat suppression. The combined use of clinical examination and MRI may also facilitate the diagnosis of fibrotic or inflamed plicae that may be symptomatic. Arthroscopy remains the gold standard for recognition and repair of knee plicae in cases of knee dysfunction.

Performance at school is affected not only by students’ achievement goals but also by emotional exchanges among classmates and their teacher. In this study, we investigated relationships between students’ achievement goals and emotion perception ability and class affect and performance. Participants were 949 Greek adolescent students in 49 classes and their Greek language and mathematics teachers. Results from multilevel analyses indicated that students’ mastery-approach and performance-approach goals were positively related to positive affect whereas performance-avoidance goals were negatively related to positive affect. At class-level, relationships between achievement goals and affect were moderated by students’ emotion perception ability. These findings highlight the importance of emotion abilities and their role in motivational processes for class-level outcomes.

Background Conventional breast magnetic resonance imaging (MRI), including dynamic contrast-enhanced MR mammography (DCE-MRM), may lead to ambiguous diagnosis and unnecessary biopsies. Purpose To investigate the contribution of proton MR spectroscopy (1H-MRS) combined with diffusion tensor imaging (DTI) metrics in the discrimination between benign and malignant breast lesions. Material and Methods Fifty-one women with known breast abnormalities from conventional imaging were examined on a 3T MR scanner. DTI was performed during breast MRI, and fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in the breast lesions and the contralateral normal breast. FA and ADC were compared between malignant lesions, benign lesions, and normal tissue. 1H-MRS was performed after gadolinium administration and choline peak was qualitatively evaluated. Results In our study 1H-MRS showed a sensitivity of 93.5%, specificity 80%, and accuracy 88.2%. FA was significantly higher in breast carcinomas compared to benign lesions. However, no significant difference was observed in ADC between benign and malignant lesions. The combination of Cho presence and FA achieved higher levels of accuracy and specificity in discriminating malignant from benign lesions over Cho presence or FA alone. Conclusion In conclusion, applying DTI and 1H-MRS together, adds incremental diagnostic value in the characterization of breast lesions and may sufficiently improve the low specificity of conventional breast MRI.

The purpose of the present study was to evaluate the visibility and the image quality of the biliary and pancreatic duct system on magnetic resonance cholangiopancreatography (MRCP) images based on two breath-hold (BH) methods using array spatial sensitivity technique: a single-shot fast spin-echo (SS-FSE) sequence and a three-dimensional single slab fast spin-echo (3D-FSE) sequence.In the present prospective comparative study, 47 patients (22 male and 25 female, mean age=50 years, age range=22-82 years) that were referred for MRCP during a 12-month period are included. All of them were referred with suspected pancreaticobiliary disease. All patients underwent MRCP with both a SS-FSE BH sequence and a 3D-FSE BH sequence. Qualitative evaluation regarding the depiction of three segments of the pancreaticobiliary tree and the frequency of artifacts was performed. Two radiologists graded each sequence of the obtained studies in a blinded fashion. Quantitative evaluation including calculation of relative signal intensity (rSI) and relative contrast (RC) ratios at seven segments of the pancreaticobiliary tree between fluid-filled ductal structures and organ parenchyma at the same ductal segments was performed. In order to evaluate the parameters' differences of the two sequences, either in qualitative or in quantitative analysis, the Wilcoxon paired signed-rank test was performed.On quantitative evaluation, both rSI and RC ratios of all segments of the pancreaticobiliary tree at SS-FSE BH sequence were higher than those at 3D-FSE BH sequences. This finding was statistically significant (P.01). On qualitative evaluation, the two radiologists found intrahepatic ducts and pancreatic ducts to be better visualized with SS-FSE BH than with 3D-FSE BH sequence. This finding was statistically significant (P.02). One of them found extrahepatic ducts to be significantly better visualized with SS-FSE BH sequence. Moreover, the frequency of artifacts was lower in the SS-FSE sequence, a finding that was of statistical significance. Interobserver agreement analysis found at least substantial agreement (κ0.60) between the two radiologists.The SS-FSE sequence is performed faster and significantly improves image quality; thus, it should be included into the routine MRCP sequence protocol at 3.0 T. Furthermore, we recommended SS-FSE BH MRCP examination to be applied to uncooperative patients or patients in emergency because of its short acquisition time (1 s).

The purpose of this study is to evaluate the ability of T2 turbo spin echo (TSE) axial and sagittal BLADE sequences in reducing or even eliminating motion, pulsatile flow and cross-talk artifacts in lumbar spine MRI examinations. Forty four patients, who had routinely undergone a lumbar spine examination, participated in the study. The following pairs of sequences with and without BLADE were compared: a) T2 TSE Sagittal (SAG) in thirty two cases, and b) T2 TSE Axial (AX) also in thirty two cases. Both quantitative and qualitative analyses were performed based on measurements in different normal anatomical structures and examination of seven characteristics, respectively. The qualitative analysis was performed by experienced radiologists. Also, the presence of image motion, pulsatile flow and cross-talk artifacts was evaluated. Based on the results of the qualitative analysis for the different sequences and anatomical structures, the BLADE sequences were found to be significantly superior to the conventional ones in all the cases. The BLADE sequences eliminated the motion artifacts in all the cases. In our results, it was found that in the examined sequences (sagittal and axial) the differences between the BLADE and conventional sequences regarding the elimination of motion, pulsatile flow and cross-talk artifacts were statistically significant. In all the comparisons, the T2 TSE BLADE sequences were significantly superior to the corresponding conventional sequences regarding the classification of their image quality. In conclusion, this technique appears to be capable of potentially eliminating motion, pulsatile flow and cross-talk artifacts in lumbar spine MR images and producing high quality images in collaborative and non-collaborative patients.

We present two cases of patients with celiomesenteric trunk in whom the celiac trunk and the superior mesenteric artery arise off a common vessel from the ventral part of the aorta, which was demonstrated by multi-detector (16 slices) computed tomography angiography (MDCTA) and confirmed by digital subtraction angiography (DSA). This is a very rare congenital vascular anomaly and its imaging demonstration is of great importance in several interventional procedures. These cases demonstrate the capability of MDCTA in the evaluation of abdominal aorta and its branches and shows that this method might replace diagnostic DSA.

Background Assessment of breast lesions with magnetic resonance imaging (MRI) provides a means for lesion detection and diagnosis. Proton (hydrogen-1) magnetic resonance spectroscopy (1H-MRS) has been proposed as a useful diagnostic technique in providing metabolic information of suspicious breast lesions. Purpose To determine the clinical significance of in-vivo single voxel 1H-MRS at 3T in the assessment of benign and malignant breast lesions in combination with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). Material and Methods Twenty-four women with known breast abnormalities from conventional imaging (mammography, ultrasonography) underwent DCE-MRI at a 3T MR scanner and 26 breast lesions were detected. Breast lesions were assessed according BI-RADS classification. Single voxel 1H-MRS was performed after gadolinium administration and choline peak was qualitatively evaluated. All lesions were confirmed histologically from the surgically excised specimens. Sensitivity, specificity, and accuracy of the 1H-MRS, of the BI-RADS classification and of their combination (DCE-MRI + 1H-MRS) were calculated. Results Fifteen out of 26 lesions proved to be malignant and 11 proved to be benign. In our study 1H-MRS showed sensitivity 80%, specificity 81.8%, and accuracy 80.7%. DCE-MRI showed sensitivity 100%, specificity 63.6%, and accuracy 84.6%. The combination of DCE-MRI and 1H-MRS provided higher accuracy (96.4%), as well as higher specificity 81.8% compared to BI-RADS classification. Conclusion The combined use of 1H-MRS and DCE-MRI found to have improved diagnostic performance in the assessment of equivocal breast lesions. 1H-MRS can be used as a useful adjunct during lesion characterization in clinical routine in cases classified as BI-RADS 3 and 4.

Adequately designed multiresponsive water-soluble graft copolymers were used to serve as a multifunctional polymeric platform for the encapsulation and transfer in aqueous media of hydrophobic magnetic nanoparticles (MNPs). The backbone of the graft copolymers was composed of hydrophilic sodium methacrylate units, hydrophobic dodecyl methacrylate units, and luminescent quinoline-based units, while either the homopolymer poly(N-isopropylacrylamide) or a poly(N,N-dimethylacrylamide-co-N-isopropylacrylamide) copolymer was used as thermosensitive pendent side chains. The polymeric platform forms micellar-type assemblies in aqueous solution, and exhibits pH-responsive luminescent properties and a lower critical solution temperature behavior in water. Depending on the design of the side chains, the cloud point temperatures were determined at 38 and 42 °C, close or slightly above body temperature (37 °C). Above the critical micelle concentration (CMC), both graft copolymers can effectively stabilize in aqueous media as magnetic colloidal superparticles (MSPs), oleylamine-coated MnFe

Parapneumonic effusions in children are usually associated with pneumococcal infections. In Greece, the 7-valent pneumococcal conjugate vaccine was replaced by higher-valent pneumococcal conjugate vaccines (PCVs); 10-valent was introduced in May 2009 and 13-valent (PCV13) in June 2010. Since July 2010, PCV13 has been the most commonly used PCV. In a study conducted at the University General Hospital of Larissa, Central Greece, from January 2012 to January 2016, 85.7% of children born after the implementation of PCV13 and aged 24-59 months had received the complete series (3 + 1 immunization schedule) of PCV13.We studied all paediatric community-acquired pneumonia cases with empyema hospitalized at the University General Hospital of Larissa from January 2008 to January 2016.There were 30 cases of parapneumonic empyema. Among 27 empyema cases of known aetiology, 19 (70.4%) were due to Streptococcus pneumoniae (identifiable serotypes 3, 19A, 7F, and 9N/L). After September 2011, no more cases caused by serotypes 7F and 19A were observed, whereas serotype 3 emerged as the predominant pathogen of pneumococcal empyema (9 of 11 cases). Serotype 3 continued to cause empyema despite vaccination with PCV13 either fully with a 3 + 1 schedule (n = 3) or with one booster dose at the age of 21 months (n = 1).In Central Greece during the first five years of high coverage with PCV13, serotype 3 was the only PCV13 serotype that clearly persisted in children with empyema.

Dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) with gadolinium constitutes one of the most promising protocols for boosting up the sensitivity in breast cancer detection. The aim of this study was twofold: first to design an image processing methodology to estimate the vascularity of the breast region in DCE-MRI images and second to investigate whether the differences in the composition/texture and vascularity of normal, benign and malignant breasts may serve as potential indicators regarding the presence of the disease. Clinical material comprised thirty nine cases examined on a 3.0-T MRI system (SIGNA HDx; GE Healthcare). Vessel segmentation was performed using a custom made modification of the Seeded Region Growing algorithm that was designed in order to identify pixels belonging to the breast vascular network. Two families of features were extracted: first, morphological and textural features from segmented images in order to quantify the extent and the properties of the vascular network; second, textural features from the whole breast region in order to investigate whether the nature of the disease causes statistically important changes in the texture of affected breasts. Results have indicated that: (a) the texture of vessels presents statistically significant differences (p

Purpose: The assessment of the morphology and dimensions of the craniocervical ligaments using a 3 Tesla (T) Magnetic Resonance (MR) scanner, the correlatation of our results with those from cadaveric and other MR studies and the detection of the most appropriate sequence for the best imaging of the craniovertebral junction ligaments. Methods: 58 healthy volunteers (mean age 45 years) underwent a Magnetic Resonance Imaging (MRI) of the cervical spine at 3T MR unit. The MRI protocol included axial, coronal and sagittal Proton-Density (PD) sequences and sagittal T1 Fluid Attenuated Inversion Recovery (FLAIR) and T2 sequences. The images were evaluated by two radiologists and the posterior atlantoocipital ligament, the anterior atlantoocipital ligament, the transverse ligament and the apical ligament were anatomically detected, described and measured. Results: The transverse ligament was identified at 93.1%, the apical ligament was identified at 60.34%, the posterior at- lantooccipital membrane was identified at 94.8% and the anterior atlantooccipital membrane was identified at 96.5% of the cases. All ligaments appeared with low signal intensity, except the anterior atlantooc-cipital ligament which appeared with intermediate signal intensity. Their length, width and thickness were measured and, in general, correlated well with other anatomic and MR studies. Conclusion: Reliable assessment of the morphology and signal intensity of the craniocervical ligaments can be achieved with PD sequence at 3T MR imaging. The sagittal plane provides better delineation of the craniocervical (CC) ligaments but the axial and coronal planes are of paramount importance in the assessment of the transverse and apical ligaments.

Dysembryoplastic neuroepithelial tumours (DNTs) are benign lesions affecting young people and are associated with epilepsy. There have been described more than 300 cases in the literature and the clinical, pathological and radiological findings are well known. Recent advances in neuroimaging allow the acquisition of cerebral microcirculation parameters by perfusion weighted imaging, giving additional diagnostic information improving the diagnostic accuracy. The aim of this study is to show the perfusion sensitive contrast-enhanced magnetic resonance imaging findings of a case of DNT as an additional neuroradiological finding. Further investigation of microcirculation parameters may be helpful to establish the correct diagnosis of such tumours. 46 2 184 188

Epitope H contains an O-linked N-acetylglucosamine (O-GlcNAc) residue in a specific conformation and/or environment recognized by mouse IgM monoclonal antibody H (mabH). Epitope H is present in several types of cells and in several polypeptides outside the CNS. Previous results have shown that in the adult human brains, epitope H is confined mostly to a minority of fibrous astrocytes, and it is greatly upregulated in the reactive astrocytes. Post-translational modification with O-GlcNAc occurs on many proteins involved in several cell processes, such as cell cycle progression, apoptosis, proteasome degradation pathways, and modulation of cellular function in response to nutrition and stress. Hypoxia is one of the major causes of cellular stress. Therefore, in this study, we used the mAbH and the indirect immunoperoxidase method to investigate the expression of epitope H in ependymal cells in brains of persons who died with signs of hypoxic encephalopathy. The results of the present study showed that practically all ependymal cells showed cytoplasmic staining for epitope H in supranuclear cytoplasm in the brain of two premature neonates and in ten infants who died with signs of hypoxic encephalopathy. However, the overwhelming majority of ependymal cells of the nine human embryos taken from legal abortions, ranging from 26 days until 13 weeks of gestational age, and of the ten infants' brains without any sign of hypoxic encephalopathy remained negative. Only occasionally did the ependymal cells show weak cytoplasmic staining in some foci. In addition, the reactive astrocytes in the hypoxic brains showed strong cytoplasmic staining, confirming previous results.