Search

Background Computed tomography (CT) is the gold standard for analyzing muscle parameters. Purpose To clarify sex-specific paraspinal muscle area (PMA), paraspinal muscle index (PMI), and muscle fat infiltration (MFI) percentiles. Material and Methods This was a cross-sectional study of 760 individuals (45% men; age range = 20–92 years; mean age = 53.4 ± 21.1 years) with a body mass index (BMI) in the range of 16.4–38.1 kg/m2. CT scans were retrospectively used to establish PMA, PMI, and MFI at L3 level using a deep-learning (DL) tool. Sex-specific distributions for these parameters were assessed based on associations between age/BMI and individual muscle parameters, after which age- and BMI-specific percentile estimates were determined. The 5th percentile was regarded as the cutoff for PMA/PMI, and the 95th percentile was regarded as the cutoff for MFI. Results Sex-specific PMA, PMI, and MFI cutoffs in the paraspinal muscles group were 52.9 cm2, 15.0 cm2/m2, and 33.3%, respectively, in men, and 33.2 cm2, 9.5 cm2/m2, and 41.2% in women. Age was moderately negatively correlated with PMA and was strongly negatively correlated with PMI, but age was strongly positively correlated with MFI. BMI was moderately positively correlated with PMA/PMI in men and strongly positively correlated in women; BMI was weakly positively correlated with MFI, thus enabling the establishment of age- and BMI-specific cutoff percentiles. Conclusion Sex-specific PMA, PMI, and MFI percentiles and age- and BMI-specific cutoff values for these parameters were successfully established for an outpatient population.

Automatic and accurate 3D pancreas segmentation based on deep learning, playing an important role in medical professional's diagnosis and treatment of diseases, has received a lot of attention from medical image processing community. Although sufficient works on 3D pancreas segmentation have been conducted in recent years, they embrace two shortcomings: one is that the server environment required for segmentation is too excellent and not friendly to the public, and the other is that the segmentation accuracy needs to be further improved. In response to the above problems, we propose a Selecting the Overlap Method (SOM) operation that effectively relieves the memory pressure and associates contextual information. To accurately segment 3D medical images, a 3D segmentation model called RC-3DUnet is designed to reduce the parameters during segmentation compared with the general network. This integrates our newly proposed coarse-to-fine segmentation method, which utilizes SOM and RC-3DUnet, to both reduce the running memory environment required for 3D segmentation of the pancreas and increase the accuracy rate. Extensive experiments were conducted on the Medical Segmentation Decathlon (MSD) pancreas segmentation and the National Institutes of Health (NIH) pancreas segmentation datasets, showing our results not only showed higher accuracy than other excellent methods but also demonstrated that our method is more lightweight.

Background Muscle quantification is an essential step in sarcopenia evaluation. Purpose To develop and evaluate an automated machine learning (ML) algorithm for segmenting the paraspinous muscles on either abdominal or lumbar (L) computed tomography (CT) scans. Material and Methods A novel deep neural network algorithm for automated segmentation of paraspinous muscle was developed, CT scans of 504 consecutive patients conducted between January 2019 and February 2020 were assembled. The muscle was manually segmented at L3 vertebra level by three radiologists as ground truth, divided into training and testing subgroups. Muscle cross-sectional area (CSA) was recorded. Dice similarity coefficients (DSCs) and CSA errors were calculated to evaluate system performance. The degree of muscle fat infiltration (MFI) recording by percentage value was the fat area within the region of interest divided by the muscle area. An analysis of the factors influencing the performance of the V-net-based segmentation system was also implemented. Results The mean DSCs for paraspinous muscles were high for both the training (0.963, 0.970, 0.941, and 0.968, respectively) and testing (0.950, 0.960, 0.929, and 0.961, respectively) datasets, while the CSA errors were low for both training (1.9%, 1.6%, 3.1%, and 1.3%, respectively) and testing (3.4%, 3.0%, 4.6%, and 1.9%, respectively) datasets. MFI and muscle area index (MI) were major factors affecting DSCs of the posterior paraspinous and paraspinous muscle groups. Conclusion The ML algorithm for the measurement of paraspinous muscles was compared favorably to manual ground truth measurements.

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.

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. 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. 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. 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. The 3-D VIBE sequence reveals useful details in focal fibrocartilaginous dysplasia.

Background Lumbar vertebral endplates lesions (LEPLs), as one of the etiology of low back pain (LBP) which is one of the most common causes of health care cost, have an unclear pathogenesis. Although it gradually regarded as the focus in recent years, almost all studies have focused on symptomatic people, not healthy people. Therefore, our study was designed to determine the prevalence and distribution patterns of LEPLs and their associations with lumbar disc herniation (LDH), lumbar disc degeneration (LDD), and lumbar vertebral volumetric bone mineral density (vBMD) in a health cohort. Methods Seven hundred and fifty healthy participants aged 20–60 years were enrolled in the study from a study on the degeneration of the spine and knee. In this observational study, a lumbar quantitative computed tomography (QCT) and MRI scan were performed among participants within 48 hours. 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.Results The prevalence was higher among the male subjects. 80% of endplates were recognition as no lesions with a significant difference 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. Lesions 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). Weighted kappas of 0.66 and 0.87 were, respectively, assessed for the inter-and intra-observer reliabilities of the classification system. Conclusions Endplate lesions are also the common findings on lumbar MRIs in general people, particularly in men, and the presence, and advance from slightly to severely could be mainly attributed to LDH and men’s higher hipline.

The high dropout rate of students studying Chinese is a concern for educators in teaching Chinese as a Foreign Language (CFL). However, very limited studies have been undertaken to investigate the impact of the important part of CFL learning ‘Hanzi’ in the successful teaching and learning of CFL. This paper therefore investigated the rationale and significance of Hanzi’ instruction and the need to integrate Hanzi instruction into teaching of CFL from the very beginning of teaching CFL. Readers will find this paper useful in understanding the importance of Hanzi instruction in teaching CFL, and how to construct a contemporary, international curriculum that can adequately address the fundamental concerns of the teaching and learning of CFL. This paper can be used to initiate a research agenda and inform an initiative thinking for curriculum development, to be used as a signpost to set up a conceptual framework on international curriculum development of CFL.

Studies using quantitative computed tomography (QCT) and data-driven image analysis techniques have shown that trabecular and cortical volumetric bone mineral density (vBMD) can improve the hip fracture prediction of dual-energy X-ray absorptiometry areal BMD (aBMD). Here, we hypothesize that (1) QCT imaging features of shape, density and structure derived from data-driven image analysis techniques can improve the hip fracture discrimination of classification models based on mean femoral neck aBMD (Neck.aBMD), and (2) that data-driven cortical bone thickness (Ct.Th) features can improve the hip fracture discrimination of vBMD models. We tested our hypotheses using statistical multi-parametric modeling (SMPM) in a QCT study of acute hip fracture of 50 controls and 93 fragility fracture cases. SMPM was used to extract features of shape, vBMD, Ct.Th, cortical vBMD, and vBMD in a layer adjacent to the endosteal surface to develop hip fracture classification models with machine learning logistic LASSO. The performance of these classification models was evaluated in two aspects: (1) their hip fracture classification capability without Neck.aBMD, and (2) their capability to improve the hip fracture classification of the Neck.aBMD model. Assessments were done with 10-fold cross-validation, areas under the receiver operating characteristic curve (AUCs), differences of AUCs, and the integrated discrimination improvement (IDI) index. All LASSO models including SMPM-vBMD features, and the majority of models including SMPM-Ct.Th features performed significantly better than the Neck.aBMD model; and all SMPM features significantly improved the hip fracture discrimination of the Neck.aBMD model (Hypothesis 1). An interesting finding was that SMPM-features of vBMD also captured Ct.Th patterns, potentially explaining the superior classification performance of models based on SMPM-vBMD features (Hypothesis 2). Age, height and weight had a small impact on model performances, and the model of shape, vBMD and Ct.Th consistently yielded better performances than the Neck.aBMD models. Results of this study clearly support the relevance of bone density and quality on the assessment of hip fracture, and demonstrate their potential on patient and healthcare cost benefits.

Background/Objective: This study is a case–control study to explore risk and protective factors, including clinical data and bone mineral density (BMD), affecting vertebral body fragility fracture in elderly men and postmenopausal women. In addition, we investigate the effectiveness of lumbar spine BMD by quantitative computed tomography (QCT) in discriminating vertebral fragility fracture. Methods: In this case–control study, 52 males and 198 females with vertebral fragility fracture were compared with sex- and age-matched healthy controls to analyse the risk factors that may affect vertebral fragility fracture. The L1–L3 vertebral BMDs were measured by QCT. The difference in risk factors between fracture cases and controls were analysed using student t test and Mann–Whitney U test. The correlation between BMD, age, height and weight were analysed using univariate analysis. Multiple logistic regression analysis was used to study statistically significant indexes. The receiver operating characteristic curve was used to calculate the cut-off values for positive and negative predictive values of BMD for vertebral fracture discrimination. Results: In males, body weight and BMD were significantly different between the fracture group and the control group, whereas BMD was only weakly correlated with age (r = −0.234). In females, only BMD was significantly different between the fracture and control groups. BMD was weakly correlated with height (r = 0.133) and weight (r = 0.120) and was moderately correlated with age (r = −0.387). There was no correlation between BMD and the remaining variables in this study. In both men and women, the BMD (p = 0.000) was the independent protective factor against vertebral fracture. The cut-off values of vertebral BMD for fractures were 64.16 mg/cm3 for males and 55.58 mg/cm3 for females. QCT-measured BMD has a high positive predictive value and negative predictive value for discriminating vertebral fragility fracture across a range of BMD values. Conclusion: This study suggests that BMD is closely related to vertebral fragility fracture and that QCT is an effective technique to accurately discriminate vertebral fragility fracture. The translational potential of this article: The spine BMD measured by QCT is closely related to fracture, which may allow clinicians to more accurately discriminate which individuals are likely to experience vertebral fragility fracture. Keywords: Bone mineral density, Quantitative computed tomography, Vertebral fragility fracture

In recent years, 3D segmentation of the pancreas has received a lot of attention from researchers because of its importance for clinical diagnosis and treatment. However, there are many problems with 3D pancreatic segmentation: 1) because the shape of the pancreas is not regular enough compared to other organs in the abdomen, it has a relatively small shape and there is also an excessive background of interference, resulting in inaccurate segmentation results for the pancreas; 2) one of the main drawbacks of 3D convolutional neural networks for segmentation is the excessive memory occupation, which requires censoring of the network structure to fit a given memory budget. To address the above issues, this paper proposes a new coarse-to-fine method based on convolutional neural networks (CNNs). In the first stage, the segmentation is trained to obtain candidate regions. In the second stage, the approximate location of the pancreas is obtained after the first stage, and then the pancreas is finely segmented in this approximate location. The convolutional neural network used in this paper is a modified 3DUnet network, which is improved to require less memory and higher segmentation accuracy compared to the traditional 3DUnet network. This segmentation method requires a less demanding experimental environment than other algorithms, and can also improve accuracy by eliminating a large amount of irrelevant background interference. The combination of our proposed network structure and the two-stage segmentation method achieves advanced performance.

The lack of training samples is one of the main factors affecting the development of deep learning methods. Deep learning models often fail to learn useful features and have serious over-fitting problems when lacking of training data. In this work, we exploit two popular unsupervised learning techniques: adversarial learning and self-supervised learning, which is aimed at mine more useful representations and relieve over-fitting problems. Our training scheme is mainly divided into three steps. Firstly, we train a self-supervision network with unsupervised learning to extract obvious features from our liver lesion samples and these features will be transferred to next step. Secondly, we use the final output feature map generated by self-supervision network to train a discriminator by adversarial learning. Finally, the backbone network is trained under the constraint of discriminator and classifier. Our main idea is to train a discriminator with adversarial learning and self-supervised learning. Then, we use the discriminator to constrain the backbone network, which is aimed to reduce the backbone network solution search space. In particular, Different from generating data with GAN, we use GAN to feature adversarial learning for feature augmentation. Our experiments on liver lesion classification in CT show an average accuracy as 92.51% compared with the baseline training scheme, which demonstrates our proposed method can mime useful features and relieve over-fitting problem. It can assist physicians in the early detection and treatment of liver lesions.

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.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.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.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.The 3-D VIBE sequence reveals useful details in focal fibrocartilaginous dysplasia.

The aggregation behavior of dyes especially in the dyeing and printing of different textile materials is an important phenomenon which affects the process of dye adsorption and diffusion. In order to avoid the aggregation of dyes, scientists are looking for materials which can inhibit the aggregation process by fabricating the dye solution. Organic solvents have found important influence in the aggregation of dye molecules. Therefore, herein, we report the fabrication of reactive orange 13 dye solutions with the aid of ethylene glycol and its derivative organic solvents to investigate the aggregation behavior of dye molecules by UV-vis absorption spectrum, fluorescence spectrum, surface tension, rheological and particle size measurements. IR spectra were performed to understand the effect of hydrogen bonding on the aggregation behavior of dye molecules. Moreover, transmission electron microscopy was also tested to confirm the effect of organic solvents on the surface morphology of dye molecules. The results show that the reactive Orange 13 dye molecules show aggregation in terms of dimeric and multimeric structures at high dye concentrations due to π–π interaction of naphthalene rings. Moreover, on introducing the ethylene glycol and its derivatives, the dye molecules disaggregate by hydrophobic interactions of dye molecules and organic solvents which destroyed the ice-like structure between the dye molecules and the water molecules. Among the three organic solvents, DME solvent caused more disaggregation of reactive Orange 13 dye molecules due to extra hydrophobic methyl groups in its structure. The results also show that the interaction between Orange 13 dyes and ethylene glycol and its derivatives could decrease the surface tension and particle size of the dye, and increase the quantum yield and viscosity. This research will help to understand the aggregation behavior of dyes and help the textile industries to choose the suitable formulations of dye solutions for coloration of different textile substrates via dyeing and printing methods.

Avian H7N9 influenza virus, which emerged in 2013 China, had caused the fifth wave of peaks in 2016-2017. Gansu Province locate in western China far away from the epicenter of the virus, also detected cases in this wave. During the monitoring, five human cases with H7N9 virus infection, three cases in Jiuquan and two cases in Zhangye, were reported and investigated. A total of 88 environmental samples collected from March to June, in poultry farms and live poultry markets were H7N9 positive by real time RT-PCR assay. The two human viruses were identified as LPAI viruses, and phylogenetic analysis showed that the viruses might be introduced into Gansu by two distinct trade routes. Avian influenza H7N9virus posed a pandemic potential to threaten human health, and monitoring among birds and the environment should be strengthened.

In elderly subjects and in particular in those with osteoporosis the evidence on age related volume changes of the hip is still very limited. Even less is known about bone changes of the femoral head. The aim of this study is to explore associations of bone size of the femoral head and neck with age in postmenopausal women with very high risk of hip fracture and to investigate associations of femoral head and neck bone mineral density. MIAF (medical image analysis framework)-Femur was used for the analysis of CT datasets from 319 females with acute hip fractures age 50 to 98. Integral BMD and volume of the head and neck were assessed. The femoral head was divided into four quadrants to address differential vBMD and volume responses of its superior, inferior, posterior and anterior parts. Areal BMD (aBMD) of femoral neck was also obtained. In this population of postmenopausal women we did not observe age-related changes in bone volume of the femoral head or neck between ages 50 and 98 years. Integral vBMD in the head in the 90–98 year group was 48.0 mg/cm3 lower than that in 50–59 year group, which accounts for nearly 30% decrease in vBMD with 40 years increase. Age-related vBMD changes in the head quadrants were similar to that in total. With age, the trend line correlation coefficients for vBMD in quadrants were relatively small, but significant (p

There is increasing evidence that muscle volume and mass are poor predictors of muscle strength and physical performance. Other assessments of muscle quality such as skeletal muscle density measured by computed tomography (CT) may be more important. The aim of this study was to explore associations of muscle size and density with handgrip strength (HGS) and the Timed Up and Go test (TUG). We also hypothesized that the strength of these associations would depend on the specific muscle of muscle group, namely trunk, hip, and mid-thigh muscles.Cross-sectional study.University hospital; 316 volunteers aged 59 to 85 years.HGS, TUG, and quantitative CT imaging of the lumber, hip, and mid-thigh were performed in volunteers. From the CT images, cross-sectional area and attenuation were determined for the gluteus muscle, trunk muscle at vertebrae L2 level, and mid-thigh muscle.In men and women, associations of muscle area with TUG were insignificant after adjustment for age, height, and weight. Associations with HGS were only significant in men for the gluteus maximus and the mid-thigh but slopes were rather low (β 0.20). Associations between muscle density and TUG/HGS were more pronounced, in particular for HGS. After adjustment, associations with TUG were significant in women for the gluteus maximus and trunk muscle even (β -0.06, P .001 and β -0.07, P .031, respectively).Muscle density is more strongly associated with muscle strength than muscle size andin women muscle density was also more strongly associated than muscle size with physical performance. Therefore, muscle density may represent a more clinically meaningful surrogate of muscle performance than muscle size. Muscle density measurements of trunk and gluteus muscles can be easily obtained from routine CT scan and, therefore, may become an important measurement to diagnose and screen for sarcopenia.

Background and Purpose: 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. Materials and Methods: 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. Results: Total hip (TH) aBMD was associated significantly with G.MaxM CSA (men: P = 0.042; women: P < 0.001) and density (men: P = 0.012; women: P = 0.043). In women, 0.035 cm2 of mid-thigh CSA (95% CI, 0.014–0.057; P = 0.002) increased per SD increase in TH aBMD, but this significance was not observed in men (P = 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; P = 0.040) and in women (β, 15.426; 95% CI, 0.893–29.958; P = 0.038). Handgrip strength was only associated with TR aBMD (β, 0.038; 95% CI, 0.006–0.070; P = 0.019) and intertrochanter aBMD (β, 0.049; 95% CI, 0.009–0.090; P = 0.016) in men. Conclusions: 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.

Objective To investigate the correlation between non-alcoholic fatty liver disease and visceral adipose tissue in non-obese Chinese adults using computed tomography (CT). Materials and Methods The study included 454 subjects undergoing abdominal CT scan. Degree of CT attenuation in liver and spleen, and the degree of fat infiltration in liver were evaluated according to three indices: the attenuation value of liver parenchyma (CTLP), the attenuation ratio of liver and spleen (LSratio) and the attenuation difference between liver and spleen (LSdif). Visceral fat area (VFA) and total fat area (TFA) at L2/3 and L4/5 levels were measured, and the abdominal subcutaneous fat area (SFA) was calculated. Bivariate correlation analysis was carried out to determine the correlation among these factors. Results In men, VFA, SFA and TFA at L2/3 and L4/5 levels showed significant differences in terms of the three indices to distinguish fatty liver from non-fatty liver (all, p < 0.001). In men, all the three indices showed negative correlation with TFA, SFA and VFA (all, p < 0.001). The negative correlation between the three indices and VFA at the L2/3 level was higher than at L4/5 level (r = -0.476 vs. r = -0.340 for CTLP, r = -0.502 vs. r = -0.413 for LSratio, r = -0.543 vs. r = -0.422 for LSdif, p < 0.001, respectively). The negative correlation between LSratio, LSdif and VFA at L2/3 and L4/5 levels was higher than SFA at the corresponding level. In women, all the three indices showed negative correlation with VFA and TFA at L2/3 and L4/5 levels, and the negative correlation between CTLP and VFA was higher at L2/3 level than at L4/5 level (r = -0.294 vs. r = -0.254, p < 0.001). Conclusion In non-obese Chinese adults, the degree of hepatic fatty infiltration showed a strong correlation with abdominal fat on CT. VFA at L2/3 level was more closely related to fatty liver compared with VFA at L4/5 level.

There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for trochanteric fractures in Chinese women. © 2017 American Society for Bone and Mineral Research.

summary Objectives: To investigate the change in cartilage T2 values and structural degeneration in knee joints over 72 months in women of African American (AA) vs Caucasian American (CA) ethnicity. Methods: Knee 3T magnetic resonance imaging (MRIs) from baseline, 24, 48 and 72 months visits of 100 AA and 100 CA women from the Osteoarthritis Initiative (OAI) were assessed for cartilage T2 values and whole-organ magnetic resonance imaging (WORMS) score. Subjects were pair-matched by age, body mass index (BMI), KellgreneLawrence (KL) score, clinical site and subcohort within the OAI. We compared the rate of change in whole knee cartilage T2 values and WORMS cartilage, bone marrow edema pattern (BMEP) and meniscus scores between the two ethnic groups using mixed random effects models. Results: At 24 and 48 months 60 subjects and at 72 months 45 subjects per group were available for analysis resulting in 38 complete pairs with data of all time points. Compared to CA, cartilage T2 values in AA increased at a significantly faster rate at baseline (AA: 0.45 ms/y, CA: 0.35 ms/y, P ¼ 0.029) and averaged over 6 years (AA: 0.36 ms/y, CA: 0.27 ms/y, P ¼ 0.039) with changes in both groups reaching a plateau by 48 months. Cartilage, meniscus and BMEP scores tended to increase in both groups during follow up, but rates of change did not differ by ethnicity. Conclusion: Cartilage T2 values increased faster over 72 months in AA than CA, however changes in WORMS cartilage, meniscus and BMEP scores did not differ. T2 values may be able to distinguish ethnicity-related differences of cartilage degeneration at an early stage before differences in structural joint degeneration appear.

Objective: The objective of this study was to evaluate the usefulness of T2 high signal intensity (T2-HSI) and decreased anteroposterior diameter (APD), diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) in evaluating postoperative cervical cord function. Methods: The study included 57 postoperative cervical spondylotic myelopathy patients. Clinical evaluation and functional recovery assessments were performed using the modified Japanese Orthopaedic Association (mJOA) score and recovery rate. The presence of T2-HSI and decreased APD was recorded for exploring the relevance. Spearman correlation was applied to investigate the relationships between DTI and NODDI metrics and mJOA score. Multiple comparisons of T2 signal intensity, APD and diffusion metrics were evaluated by using multiple linear regression. Results: Only the recovery rate was significantly different between T2-HSI and non-T2-HSI (nT2-HSI) patients (χ2 = 4.466, p = 0.045). Significant differences were not observed between cervical cords with and without decreased APD. Diffusion metrics, including fractional anisotropy (p = 0.0005), mean diffusivity (p = 0.0008), radial diffusivity (p = 0.0003) and intracellular volume fraction (p = 0.001), were significantly correlated with mJOA score. The ability of T2 signal intensity (p = 0.421) and APD (p = 0.420) to evaluate the postoperative function was inferior to that of fractional anisotropy (p = 0.002), mean diffusivity (p = 0.001), radial diffusivity (p = 0.001) and intracellular volume fraction (p = 0.004). Conclusion: Conventional magnetic resonance imaging signs could be considered as a reference to make an approximate assessment, whereas DTI and NODDI could be better quantitative tools for evaluating the postoperative function and may help in interpreting residual symptoms. The translational potential of this article: DTI and NODDI could provide reliable postoperative evaluation and analysis for cervical spondylotic myelopathy patients. Keywords: Anteroposterior diameter, Cervical spondylotic myelopathy, Diffusion tensor imaging, Neurite orientation dispersion and density imaging, T2 high signal intensity

There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for trochanteric fractures in Chinese women. © 2017 American Society for Bone and Mineral Research.

The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI.Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map.Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t=-3.396, P0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients.Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

© 2015 ISS Objective: To determine the characteristics of femoral condyle insufficiency fracture (FCIF) lesions and their relative associations with the risk of clinical progression. Materials and methods: This HIPAA-compliant retrospective study was approved by our Institutional Review Board. Seventy-three patients (age range, 19–95) were included after excluding patients with post-traumatic fractures, bone marrow infarct, osteochondritis dissecans, or underlying tumor. Two board-certified musculoskeletal radiologists classified morphologic findings including lesion diameter, associated bone marrow edema pattern, and associated cartilage/meniscus damage. Electronic medical charts were evaluated for symptoms, risk factors, and longitudinal outcomes, including total knee arthroplasty (TKA). Imaging characteristics were correlated with clinical findings, and comparison of outcome groups was performed using a regression model adjusted for age. Results: The majority of patients with FCIF were women (64.4 %, 47/73), on average 10 years older than men (66.28 ± 15.86 years vs. 56.54 ± 10.39 years, p = 0.005). The most common location for FCIF was the central weight-bearing surface of the medial femoral condyle; overlying full thickness cartilage loss (75.7 %, 53/70) and ipsilateral meniscal injury (94.1 %, 64/68) were frequently associated. Clinical outcomes were variable, with 23.9 % (11/46) requiring TKA. Cartilage WORMS score, adjacent cartilage loss, and contralateral meniscal injury, in addition to decreased knee range of motion at presentation, were significantly associated with progression to TKA (p < 0.05). Conclusions: FCIF are frequently associated with overlying cartilage loss and ipsilateral meniscal injury. The extent of cartilage loss and meniscal damage, in addition to loss of knee range of motion at the time of presentation, are significantly associated with clinical progression.

Background Diffusion tensor imaging (DTI) is a noninvasive imaging technique for the assessment of the integrity of cerebral tissues. This study was undertaken to assess the changes of diffusion indices of hippocampal formation (HF) in patients with medial temporal lobe epilepsy (MTLE). Methods Fourteen patients with MTLE and 14 healthy subjects were evaluated. Mean diffusivity (MD) and fractional anisotropy (FA) from the symmetrical-voxel sampling regions of the anterior HF were calculated infill subjects. The MD and FA values were compared across the groups. Results No significant differences of MD and FA values were noted between right and left HF in the controls. In the patient group, MD significantly increased in the HF ipsilateral to the lesioned side [(9.27±1.09)×10-4 mm2/s], compared with the values in the contralateral HF [(8.20±0.59)×10-4 mm2/s] (t = 4.479, P = 0.001) and healthy subjects [(7.58±0.51)×10-4 mm2/s] (P 0.001), but no significant differences were found in FA. When compared with the controls, patients had a significantly higher MD in the contralateral HF (P 0.05), but the difference in FA was not statistically significant. Conclusions DTI could detect hippocampal abnormality in patients with MTLE. This technique may be helpful for preoperative evaluation of such patients. Chin Med J 2006; 119(15):1237-1241

Epidermoid cysts are congenital tumors, whose typical imaging presentations are characterized by low density on CT, low signal intensity on T1-weighted images and high signal intensity on proton density- and T2-weighted images. Coexistence of two intracranial epidermoid cysts with different MR presentations is very rare. Here, we report a case of multiple epidermoid cysts with typical and atypical MR presentations.

© 2015 Osteoarthritis Research Society International. Objective: To determine whether knee cartilage composition differs between African-American and Caucasian-American women at risk for Osteoarthritis (OA) using invivo 3T MRI T2 relaxation time measurements. Methods: Right knee MRI studies of 200 subjects (100 African-American women, and 100 closely matched Caucasian-American women) were selected from the Osteoarthritis Initiative (OAI). Knee cartilage was segmented in the patellar (PAT), medial and lateral femoral (MF/LF), and medial and lateral tibial compartments (MT/LT)). Mean T2 relaxation time values per compartment and per whole joint cartilage were generated and analyzed spatially via laminar and grey-level co-occurrence matrix (GLCM) texture methods. Presence and severity of cartilage lesions per compartment were graded using a modified WORMS grading. Statistical analysis employed paired t- and McNemar testing. Results: While African-American women and Caucasian-Americans had similar WORMS cartilage lesion scores (P=0.970), African-Americans showed significantly lower mean T2 values (~1ms difference; ~0.5SD) than Caucasian-Americans in the whole knee cartilage (P

The purpose of this study was to investigate the features of the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in cortical tubers and white-matter lesions in patients with tuberous sclerosis (TS) using diffusion tensor imaging (DTI).Conventional magnetic resonance imaging (MRI) and DTI were performed in 14 patients with clinically established TS. Based on these DT images, ADC and FA maps were generated. The ADC values in 32 cortical tubers, and the ADC and FA values in 18 white-matter lesions were measured and compared with those of the corresponding contralateral regions.Compared with the corresponding contralateral regions, cortical tubers of TS patients had significantly higher ADC values (P0.001); white-matter lesions had significantly higher ADC values (P0.001) and significantly lower FA values (P0.001).DTI is a useful tool for demonstrating changes in cortical tubers and white-matter lesions resulting from TS.

A study is made of influences of fine particles' size, ultrasonic frequency and addition agent on percentage (W) of ZnO particles embedded into the porous textile materials with power ultrasonic. To investigate these influences, five groups of ultrasonic frequencies from 28 kH to 59kH and three types of ZnO particles with different sizes are used to conduct experiments. In addition, the effects of addition agents on ZnO particles of 40 nm are compared. The results show that at lower frequency (here at 28 kHz), the value of W rises with the increase of the sizes of ZnO and in contrast at frequency of 4OkH, the value drops at the same condition. Surface-active agent such as penetrating agent and softening agent will influence the value of W more apparently than dispersing agent, which reaches up to over 0.2 per cent.

Purpose The purpose of this study was to analyze whole-brain white matter changes in medial temporal lobe epilepsy (MTLE). Materials and methods We studied 23 patients with MTLE and 13 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The seizure focus was right sided in 11 patients and left sided in 12. The data were collected on a 1.5 T MR system and analyzed by SPM 99 to generate white matter density maps. Results Voxel-based morphometry revealed diffusively reduced white matter in MTLE prominently including bilateral frontal lobes, bilateral temporal lobes and corpus callosum. White matter reduction was also found in the bilateral cerebellar hemispheres in the left MTLE group. Conclusion VBM is a simple and automated approach that is able to identify diffuse whole-brain white matter reduction in MTLE.

Purpose The purpose of this study was to characterize gliomatosis cerebri on magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS), and to analyze the value of these two techniques in diagnosis and differential diagnosis of gliomatosis cerebri. Materials and methods MR images of 14 patients with gliomatosis cerebri were reviewed retrospectively; seven of the patients also underwent MRS (single-voxel point-resolved spectroscopy, and chemical-shift imaging point-resolved spectroscopy). Tumorous were confirmed by surgery and biopsy. The distribution, extension and signal features of lesions were assessed, and the MR spectroscopy results were analyzed. Results Tumors involved at least two lobes of the brain in all patients. Widespread invasion with isointensity or hypointensity on T1-weighted MR images and hyperintensity on T2-weighted images were found while no prominent necrosis, hemorrhage or contrast enhancement was found. All patients who underwent MRS showed elevated Cho/Cr and Cho/NAA levels as well as decreased NAA/Cr ratios in the abnormal areas on T2-weighted images, three of which showed a lactate doublet. Anaplastic lesions had higher Cho/NAA levels in three cases. Abnormality of metabolism was also seen in the margin of the lesion that was normal on T2-weighted images. Conclusion MRI and MRS are valuable techniques for diagnosis and differential diagnosis of gliomatosis cerebri. Combining clinical information and MRI findings, as well as MRS, is crucial for making a definitive diagnosis.