Segmentation du rein fonctionnel à partir de CTdouble énergie injectés

Les néphropaties (maladie des tissus rénaux) postradiques constituent l'un des facteurs limitants pour l'élaboration des plans de traitement lors des radiothérapies abdominales. Le processus actuel, qui consiste à évaluer la fonctionnalité relative des reins grâce à une scintigraphie gamma deux dimensions, ne permet pas d'identifier les portions fonctionnelles qui pourraient être évitées lors de l' élaboration des plans de traitement. Une méthode permettant de cartographier la fonctionnalité rénale en trois dimensions et d'extraire un contour fonctionnel utilisable lors de la planification a été développée à partir de CT double énergie injectés à l'iode. La concentration en produit de contraste est considérée reliée à la fonctionnalité rénale. La technique utilisée repose sur la décomposition à trois matériaux permettant de reconstruire des images en concentration d'iode. Un algorithme de segmentation semi-automatisé basé sur la déformation hiérarchique et anamorphique de surfaces permet ensuite d'extraire le contour fonctionnel des reins. Les premiers résultats obtenus avec des images patient démontrent qu'une utilisation en clinique est envisageable et pourra être bénéfique.

Utilidad de la resonancia magnética en el diagnóstico de apendicitis aguda

Comparar el resultado de la resonancia magnética en el diagnóstico de apendicitis aguda con el patrón de oro (estudio histopatológico o seguimiento clínico del paciente) con el fin de establecer la utilidad de ésta como prueba diagnóstica y poder incluirla dentro del algoritmo de estudio de esta patología cuando hay sospecha clínica y un resultado negativo o dudoso de la ecografía abdominal

Factores asociados a complicaciones post quirúrgicas en pacientes adultos con obstrucción intestinal mecánica en Bogotá, Colombia, período 2008 - 2014

Introducción: La obstrucción intestinal es una patología de alta prevalencia e impacto en los servicios de cirugía general a nivel mundial. El manejo de esta entidad puede ser médico o quirúrgico. Cuando se requiere intervención quirúrgica, se busca evitar el desarrollo de isquemia intestinal y resecciones intestinales; durante el postoperatorio, pueden existir complicaciones. El objetivo de este estudio es identificar los factores asociados al desarrollo de complicaciones post operatorias en un grupo de pacientes con obstrucción intestinal mecánica llevados a manejo quirúrgico. Metodología: Estudio analítico tipo casos y controles en un grupo de pacientes con diagnóstico de obstrucción intestinal mecánica llevados a manejo quirúrgico de su patología. Los casos corresponden a los pacientes con complicaciones postoperatorias y los controles aquellos que no presentaron complicaciones. Se identificaron factores asociados a complicación post operatoria mediante modelos estadísticos bivariados y multivariados de regresión logística para factores como edad, sexo, antecedente quirúrgico, presentación clínica, paraclínica y diagnóstico postoperatorio de malignidad, entre otras. Resultados: Se identificaron un total de 138 pacientes (54 casos y 129 controles). Los rangos de edad entre 55-66 años y mayor de 66 años fueron asociados con complicaciones postoperatorias (OR 3,87 IC95% 1,58-9,50 y OR 3,62 IC95% 1,45-9,08 respectivamente). El déficit de base inferior a 5 mEq/litro se relaciona con complicaciones postoperatorias (OR 2,64 IC95% 1.33-5,25) Otras pruebas de laboratorio, características radiológicas, hallazgos de malignidad en el postoperatorio y la evolución de los pacientes no fueron asociados con complicaciones. Conclusiones: Las disminución de las complicaciones durante el manejo quirúrgico de obstrucción intestinal mecánica continúa siendo un reto para la cirugía general. Factores no modificables como edad avanzada y modificables como el equilibrio ácido base deben ser tenidos en cuenta dada su correlación en el desarrollo de complicaciones postoperatorias.

Cálculo de doses em exames de TC abdómen-pélvico em dois hospitais da região de Lisboa

Este trabalho tem como objectivo avaliar se os valores de dose recebida pelos doentes que realizam exames de Tomografia Computorizada (TC) Abdómen-pélvicos em dois hospitais da grande Lisboa estão de acordo com os Níveis de Referência de Diagnóstico Europeus (NRD). Foram comparadas também as unidades dosimétricas de exames realizados com corrente modelada e de exames realizados com corrente contínua em ambos os hospitais. O estudo consistiu na recolha de dados de 200 exames de TC Abdómen-pélvicos, 100 em cada hospital. No Hospital A, a média dos valores de DLPfoi 562,34 mGy.cm e a média dos valores de CTDIvol foi 12,06 mGy. No Hospital B, a média dos valores DLPe CTDIvol foi 767,14 mGy.cm e 15,02 mGy, respectivamente. No total da nossa amostra, concluiu-se que em nenhum exame os valores de unidades dosimétricas ultrapassam os valores dos NRD. Verificou-se também que os exames realizados no Hospital B implicam em média uma maior dose de radiação ionizante para o doente.

Verification of computed tomographic estimates of cochlear implant array position: A micro-CT and histological analysis

We examine the efficacy two volume spatial registration of pre and postoperative clinical computed tomography (CT) imaging to verify post-operative electrode array placement in cochlear implant (CI) patients. To measure the degree of accuracy with which the composite image predicts in-vivo placement of the array, we replicate the CI surgical process in cadaver heads. Pre-operative, post-operative, micro CT imaging and histology are utilized for verification.

Effect of polymorphisms in the PPARGC1A gene on body fat in Asian Indians

OBJECTIVE: To evaluate whether polymorphisms in the peroxisome proliferator-activated receptor-gamma coactivator-1 alpha (PPARGC1A) gene were related to body fat in Asian Indians. METHODS: Three polymorphisms of PPARGC1A gene, the Thr394Thr, Gly482Ser and +A2962G, were genotyped on 82 type 2 diabetic and 82 normal glucose tolerant (NGT) subjects randomly chosen from the Chennai Urban Rural Epidemiology Study using PCR-RFLP, and the nature of the variants were confirmed using direct sequencing. Linkage disequilibrium (LD) was estimated from the estimates of haplotypic frequencies using an expectation-maximization algorithm. Visceral, subcutaneous and total abdominal fat were measured using computed tomography, whereas dual X-ray absorptiometry was used to measure central abdominal and total body fat. RESULTS: None of the three polymorphisms studied were in LD. The genotype (0.59 vs 0.32, P=0.001) and allele (0.30 vs 0.17, P=0.007) frequencies of Thr394Thr polymorphism were significantly higher in type 2 diabetic subjects compared to those in NGT subjects. The odds ratio for diabetes (adjusted for age, sex and body mass index) for the susceptible genotype, XA (GA+AA) of Thr394Thr polymorphism, was 2.53 (95% confidence intervals: 1.30-5.04, P=0.009). Visceral and subcutaneous fat were significantly higher in NGT subjects with XA genotype of the Thr394Thr polymorphism compared to those with GG genotype (visceral fat: XA 148.2+/-46.9 vs GG 106.5+/-51.9 cm(2), P=0.001; subcutaneous fat: XA 271.8+/-167.1 vs GG 181.5+/-78.5 cm(2), P=0.001). Abdominal (XA 4521.9+/-1749.6 vs GG 3445.2+/-1443.4 g, P=0.004), central abdominal (XA 1689.0+/-524.0 vs GG 1228.5+/-438.7 g, P<0.0001) and non-abdominal fat (XA 18763.8+/-8789.4 vs GG 13160.4+/-4255.3 g, P<0.0001) were also significantly higher in the NGT subjects with XA genotype compared to those with GG genotype. The Gly482Ser and +A2962G polymorphisms were not associated with any of the body fat measures. CONCLUSION: Among Asian Indians, the Thr394Thr (G --> A) polymorphism is associated with increased total, visceral and subcutaneous body fat.

Three dimensional analysis of cardiovascular development in mouse embryos using X-ray microcomputed tomography

Micro-computed tomography (μCT) has been successfully used to study the cardiovascular system of mouse embryos in situ. With the use of barium as a suitable contrast agent, blood vessels have been imaged and analysed quantitatively such as blood volume and vessel sizes on embryos of ages 14.5 to 16.5 days old. The advantage of using this imaging modality is that it has provided three dimensional information whilst leaving samples intact for further study.

The Nutritional Status of Children and Adolescents with HIV/AIDS on Antiretroviral Therapy

The objective of this cross-sectional study was to assess the nutritional status of children and adolescents with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) receiving highly active antiretroviral therapy (HAART). One hundred and eighteen subjects aged 6-19 years attending an outpatient clinic in Sao Paulo city were involved in the study. The following anthropometric measurements were assessed: weight, height, waist circumference and triceps and subscapular skinfold thickness. One (0.9%) adolescent was diagnosed with abdominal obesity based on waist circumference measurement; three (2.5%) adolescents were obese based on subscapular skinfold thickness. According to the body mass index, the population studied was mainly eutrophic. The prevalence of fat redistribution, a characteristic of patients with HIV/AIDS under HAART, was low. We advise the development of further studies to assess the nutritional status of children and adolescents with HIV/AIDS using anthropometric measurements as well as computed tomography to detect fat redistribution.

Computed tomographic-dacryocystography (CT-DCG) of the normal canine nasolacrimal drainage system with three-dimensional reconstruction

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Synchrotron microComputed tomography of the mature bovine dentinoenamel junction

The mature dentinoenamel junction (DEJ) is viewed by some investigators and the current authors, not as a fossilized, sharp transition between enamel and dentin, but as a relatively broad structural transition zone including the mantle dentin and the inner aprismatic enamel. In this study, the DEJ structure in bovine incisors was studied with synchrotron microComputed Tomography (microCT) using small cubes cut parallel to the tooth surface. The reconstructions revealed a zone of highly variable punctate contrast between bulk dentin and enamel; the mean linear attenuation coefficients and their standard deviations demonstrated that this zone averaged less mineral than dentin or enamel but had more highly variable structure than either. The region with the punctuate contrast is, therefore, the mantle dentin. The thickness of the mantle dentin seen in a typical data set was about 30 mu m, and the mantle dentin-enamel interface deviated +/- 15 mu m from the average plane over a distance of 520 mu m. In the highest resolution data (similar to 1.5 mu m isotropic voxels, volume elements), tubules in the dentin could be discerned in the vicinity of the DEJ. Contrast sensitivity was high enough to detect differences in mineral content between near-surface and near-DEJ volumes of the enamel. Reconstructions before and after two cubes were compressed to failure revealed cracks formed only in the enamel and did not propagate across the mantle dentin, regardless of whether loading was parallel to or perpendicular to the DEJ. (C) 2007 Elsevier B.V. All rights reserved.

Development and applications of three-dimensional gamma ray tomography system using ray casting volume rendering techniques

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo comparativo dos métodos de ultra-sonografia, tomografia computadorizada e ressonância magnética no estadiamento e invasão das estruturas adjacentes por tumores renais.

BACKGROUND: Ultrasonography (US), Computed Tomography (CT), and Magnetic Resonance imaging (MR) were compared for the staging of renal tumors. The differences between these imaging techniques were also studied for their ability to detect adenopathies, vascular invasion, distant intra-abdominal metastases, and particularly adjacent organ invasion. METHODS: Thirty-one patients with solid or complex renal masses were prospectively studied using US, CT, and MR. Differences between the results obtained were studied using the COCHRAN G test and the McNEMAR test. The sensitivity and specificity of each diagnostic technique were compared against a gold standard of the surgical and histopathological findings. RESULTS: The following sensitivities were obtained: For the detection of adenopathy, US 63.6%, CT and MR 90.9%. For vascular invasion, US 42.8%, CT and MR 85.7%. For the adjacent organ invasion, US 28.5%, CT 85.7%, and MR 71.4%. Some of the criteria that suggest invasion of adjacent structures include: the envelopment of the adjacent structures by the tumor, tumor extension into the adjacent structures with an irregular appearance, and alterations in shape, size, and density of adjacent structures. Loss of fat planes between the tumor and adjacent structures is not a sign of tumor invasion. CONCLUSIONS: Significant differences were found in the detection capacity of US in relation to CT and MR, which were similar. All three techniques were highly sensitive and specific only in the detection of distant abdominal metastases. In addition to the accuracy of these diagnostic modalities for the detection and staging of tumors, invasiveness, risks and cost should be considered in relation to relative costs and benefits.

Effects of contrast material on computed tomographic measurements of lung volumes in patients with acute lung injury

Background. Intravenous injection of contrast material is routinely performed in order to differentiate nonaerated lung parenchyma from pleural effusion in critically ill patients undergoing thoracic computed tomography (CT). The aim of the present study was to evaluate the effects of contrast material on CT measurement of lung volumes in 14 patients with acute lung injury. Method. A spiral thoracic CT scan, consisting of contiguous axial sections of 10 mm thickness, was performed from the apex to the diaphragm at end-expiration both before and 30 s (group 1; n=7) or 15 min (group 2; n=7) after injection of 80 ml contrast material. Volumes of gas and tissue, and volumic distribution of CT attenuations were measured before and after injection using specially designed software (Lungview®; Institut National des Télécommunications, Evry, France). The maximal artifactual increase in lung tissue resulting from a hypothetical leakage within the lung of the 80 ml contrast material was calculated. Results. Injection of contrast material significantly increased the apparent volume of lung tissue by 83 ± 57 ml in group 1 and 102 ± 80 ml in group 2, whereas the corresponding maximal artifactual increases in lung tissue were 42 ± 52 ml and 31 ± 18 ml. Conclusion. Because systematic injection of contrast material increases the amount of extravascular lung water in patients with acute lung injury, it seems prudent to avoid this procedure in critically ill patients undergoing a thoracic CT scan and to reserve its use for specific indications.

Construction and test of low cost X-ray tomography scanner for physical-chemical analysis and nondestructive inspections

X-ray computed tomography (CT) refers to the cross-sectional imaging of an object measuring the transmitted radiation at different directions. In this work, we describe the development of a low cost micro-CT X-ray scanner that is being developed for nondestructive testing. This tomograph operates using a microfocus X-ray source and contains a silicon photodiode as detectors. The performance of the system, by its spatial resolution, has been estimated through its Modulation Transfer Function - MTF and the obtained value at 10% of MTF is 661 μm. It was built as a general purpose nondestructive testing device. © 2009 American Institute of Physics.

Non-conventional applications of computerized tomography: Analysis of solid dosage forms produced by pharmaceutical industry

X-ray computed tomography (CT) refers to the cross-sectional imaging of an object measuring the transmitted radiation at different directions. In this work, we describe a non-conventional application of computerized tomography: visualization and improvements in the understanding of some internal structural features of solid dosage forms. A micro-CT X-ray scanner, with a minimum resolution of 30 μm was used to characterize some pharmaceutical tablets, granules, controlled-release osmotic tablet and liquid-filled soft-gelatin capsules. The analysis presented in this work are essentially qualitative, but quantitative parameters, such as porosity, density distribution, tablets dimensions, etc. could also be obtained using the related CT techniques. © 2010 American Institute of Physics.