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Objective The authors sought to verify the use of a preoperative simulation software for the treatment of intracranial aneurysms using flow diverters (FDs) based on three-dimensional rotational angiography (3DRA) data. Methods Based on 3DRA data, the preoperative simulation software (UKNOW) was used to simulate the deployment of virtual FDs. The length and dimensions of virtual and real devices were compared. The deployment plan recommended by the UKNOW software was preliminarily used to complete implantations in the real world. During the experiment, experienced neurointerventional experts were responsible for supervising and judging information such as the length, dimension, and deployment location of the FDs. Results This study retrospectively analyzed the data of 29 patients who received FD treatment. There was no statistical difference between the length of the real device and the virtual device ( p = 0.6). The dimensions of FDs recommended by the software were consistent with the dimensions used in 24 out of the 29 real cases. In four of the remaining five cases, neurointerventional experts found that the FD dimensions recommended by the software were superior to those were actually used. Thus, the accuracy rate for FD dimension recommendations by the UKNOW software was 96.6% (28/29). Procedures performed in five cases using deployment plans recommended by the UKNOW software all achieved good postoperative results; the deployment positions of the device were reasonable, and all devices showed good wall adherence. Conclusions UKNOW software could accurately simulate the length and deployment position of the real FDs and provide suitable device dimensions.

Normal aging has been linked with the decline of cognitive functions, such as memory and executive skills. One of the prominent approaches to investigate the age-related alterations in the brain is by examining the cortical brain connectome. IBASPM is a toolkit to realize individual atlas-based volume measurement. Hence, this study seeks to determine what further alterations can be revealed by cortical brain networks formed by IBASPM-extracted regional gray matter volumes. We found the reduced strength of connections between the superior temporal pole and middle temporal pole in the right hemisphere, global hubs as the left fusiform gyrus and right Rolandic operculum in the young and aging groups, respectively, and significantly reduced inter-module connection of one module in the aging group. These new findings are consistent with the phenomenon of normal aging mentioned in previous studies and suggest that brain network built with the IBASPM could provide supplementary information to some extent. The individualization of morphometric features extraction deserved to be given more attention in future cortical brain network research.

Thalamic segmentation serves an important function in localizing targets for deep brain stimulation (DBS). However, thalamic nuclei are still difficult to identify clearly from structural MRI. In this study, an improved algorithm based on the fuzzy connectedness framework was developed. Three-dimensional T1-weighted images in axial orientation were acquired through a 3D SPGR sequence by using a 1.5T GE magnetic resonance scanner. Twenty-five normal images were analyzed using the proposed method, which involved adaptive fuzzy connectedness combined with confidence connectedness (AFCCC). After non-brain tissue removal and contrast enhancement, the seed point was selected manually, and confidence connectedness was used to perform an ROI update automatically. Both image intensity and local gradient were taken as image features in calculating the fuzzy affinity. Moreover, the weight of the features could be automatically adjusted. Thalamus, ventrointermedius (Vim), and subthalamic nucleus were successfully segmented. The results were evaluated with rules, such as similarity degree (SD), union overlap, and false positive. SD of thalamus segmentation reached values higher than 85%. The segmentation results were also compared with those achieved by the region growing and level set methods, respectively. Higher SD of the proposed method, especially in Vim, was achieved. The time cost using AFCCC was low, although it could achieve high accuracy. The proposed method is superior to the traditional fuzzy connectedness framework and involves reduced manual intervention in time saving. An improved fuzzy connectedness based thalamic segmentation method was proposed.Image local gradient was incorporated in calculation of fuzzy affinity.The weight of intensity and local gradient can be automatic adjusted.Confidence connectedness was used in automatic ROI update.Only one seed point was needed.

BACKGROUND AND PURPOSE This study aims to investigate the regional changes in the early onset of blindness using the deformation-based morphometry (DBM) method. METHODS A total of 15 early blindness and 30 gender- and age-matched sighted control subjects were recruited for the study. Statistically significant changes in regional volume were analyzed using DBM through HAMMER registration. Using this technique, changes in regional tissue volume can be detected on the basis of the deformation field derived from the warping subject to the template image. A voxelwise estimation of the morphological differences between the two groups can be acquired after applying a threshold (P < .001, uncorrected) to the statistic maps. RESULTS Regions with enlarged volume in the brains of blind subjects are mainly localized in the left associated visual cortex, posterior cingulated cortex, and cerebellum, whereas volume reductions are primarily localized in the left early visual cortex. CONCLUSIONS DBM is an effective method for detecting entire brain structural changes in blindness. Visual deprivation actually alters the local structural organization during the early critical periods of neurodevelopment. Volume increases outside the occipital lobe detected with DBM may suggest compensatory adaptations.

Background: Recently, robotic systems have been introduced as a useful method for surgical procedures. But in the field of vascular interventional therapy, the development of robotic system is slower. Objective: The purpose of the study is to verify the reliability and safety of vascular interventional robotic system used in angiography, by the way of in vitro preliminary experiments and animal experiments. Method: The approach is to employ a proprietary vascular interventional robot system to complete glass vessel models and animal angiogram experiments. This robot system consists of a console port (remote steering system), an assistant port (propelled and rotation system) and a hydraulic fixing device, upon which surgeons control remotely to make go forward and rotate in the glass vessel models and animal vessels, on the 3D operation interface. Consequently, the operation time and success rate are counted and evaluated. Result: In the glass vessel model experiments, the Catheter can enter various kinds of vessel models with inside diameter length greater than 3mm and angle less than 90o. In the animal (adult dogs) experiments, surgeons can accomplish smoothly the angiogram of the renal artery, the vertebral renal and the arteria carotis communis, without any complications of surgery. Conclusion: The angiogram by using vascular interventional robot system is safe and reliable. Surgeons can finish the angiogram in part by remote operation, and the result of angiogram can meet a number of simple expectations. However without wire control and force feedback systems, the applicability of this kind of robot system is not flexible enough and need to be improved in the future.

TIMPs and PTEN are known to be inhibitors of the invasive activities of malignant glioma. But there has been no literature reported concerning the effect of combined gene transfer of these two genes on invasiveness of glioma. This study was designed to evaluate the effect of adenovirus-mediated in vitro gene transfer of tissue inhibitor of metalloproteinases-2 (TIMP-2) and phosphatase and tensin homology deleted on chromosome ten (PTEN) on invasion of human U87 glioma cells. The mRNA and protein expressions of TIMP-2 and PTEN in U87 cells infected with AdTIMP-2 and AdPTEN were determined by RT-PCR and Western blot, respectively. The relative activity of MMP-2 and MMP-9 were measured by Gelatin zymogram and invasion of U87 in vitro were detected using Boyden chamber. The number of invasion cell of U87, U87 infected with Ad-gal, AdPTEN, AdTIMP-2 and AdPTEN/TIMP-2 was 55.63±13.27, 48.27±14.75, 35.27±10.94, 27.37±12.81, and 19.17±5.45, respectively. In vitro invasiveness of glioma cells was significantly inhibited by infection with AdTIMP-2 and/or AdPTEN, which was not consistent with the change of MMPs activity. And in the combinated group, the inhibition effect was more remarkable than in single group. Our studies suggest that adenovirus-mediated combined TIMP-2 and PTEN gene therapy is possibly useful for anti-invasion therapy of malignant glioma.

To verify the feasibility and safety of the vascular interventional vascular interventional surgical robot system applied to vascular interventional operation.From March to September 2013, 10 patients had undergone robot-assisted cerebral angiography. There were 6 male and 4 female patients; aged from 19 to 58 years, with an average age of 38.4 years. The operation were carried out by neurosurgeons and vascular interventional robot. After successfully implanted of femoral artery sheath by hand, the catheter was fixed on the robot, under the guidance of navigation image the surgeon manipulate the master part and control the slave part of robot by sending command through network transmission, finally finished the whole cerebral angiography. The operation time was recorded from placing the sheath into femoral artery to finishing cerebrovascular selective angiography, simultaneously the time of staff under exposure of X ray was recorded, and the position difference between the setted targets and the actual position(positioning accuracy).It took 25-41 minutes to finish the cerebral angiography, the average time was (31 ± 5) minutes, and the robot-assisted angiography went quickly and smoothly without surgical complications. The remote positioning accuracy was (1.03 ± 0.23) mm. The time of staff under exposure of X ray was 0 minute, the entire experimental process was basically implemented mechanization and automation.This system basically achieves initial medical purposes, such as reducing the radiation, facilitating interventional procedures on the basis of enhancing the image navigation, shorting the operation time, and improve the quality of operation.

With the development of various imaging techniques, the deformation-based morphometry (DBM) method provides an objective automatic examination of the whole brain.This study aims to assess the abnormalities in the brains of first-episode schizophrenia (FES) patients treated with quetiapine using another advanced nonrigid registration method, hierarchical attribute matching mechanism for elastic registration, through the application of DBM in the entire brain.Thirty FES patients and 30 normal controls were grouped by age and handedness and subjected to magnetic resonance imaging examination. The patients had relatively short durations of untreated psychosis (DUP; 6.4 ± 5.2 months), and only a single antipsychotic drug, quetiapine (dosage, 200 ± 75 mg), was used for treatment. Statistically significant changes in regional volume were analyzed via DBM. In addition, a voxel-wise analysis of correlations between the duration of treatment or dosage and volume was also performed.Compared with control subjects, FES patients showed contracted regions located in Brodmann area (BA) 42 and BA 19. By contrast, expanded regions were observed in BA 38, BA 21, BA 6 and 8, and left cerebellum. A negative correlation was observed between dosage and volume in the hippocampus, while a positive correlation was found in the caudate. Meanwhile, a negative correlation was observed between duration of treatment and volume in BA 38.Both regional volume reductions and increases were detected in the brains of FES patients treated with quetiapine compared with healthy control subjects. Such differences may be partially relevant to dosage and treatment duration in clinic.

This study aims to investigate the regional changes in the early onset of blindness using the deformation-based morphometry (DBM) method.A total of 15 early blindness and 30 gender- and age-matched sighted control subjects were recruited for the study. Statistically significant changes in regional volume were analyzed using DBM through HAMMER registration. Using this technique, changes in regional tissue volume can be detected on the basis of the deformation field derived from the warping subject to the template image. A voxelwise estimation of the morphological differences between the two groups can be acquired after applying a threshold (P.001, uncorrected) to the statistic maps.Regions with enlarged volume in the brains of blind subjects are mainly localized in the left associated visual cortex, posterior cingulated cortex, and cerebellum, whereas volume reductions are primarily localized in the left early visual cortex.DBM is an effective method for detecting entire brain structural changes in blindness. Visual deprivation actually alters the local structural organization during the early critical periods of neurodevelopment. Volume increases outside the occipital lobe detected with DBM may suggest compensatory adaptations.

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Along with the development of medical assistant techniques, brain network is becoming an important tool for analysing brain nervous system diseases and researching the pathogenesis of diseases. Epilepsy is one of the common brain nervous system diseases, and it has been popular in researches. Idiopathic generalized epilepsy (IGE) is a set of epilepsy syndrome with no other obvious causes besides genetic factors, accounting for about 30% of all kinds of epilepsies. This article summarizes recent progresses in IGE foci detection based on brain network analysis, mainly focusing on the applications in IGE, including functional and structural brain network. Moreover, trends in future development of brain network applications in IGE have been