Evaluation of Airway Obstruction at Soft Palate Level in Male Patients with Obstructive Sleep Apnea/Hypopnea Syndrome:Dynamic 3-Dimensional CT Imaging of Upper Airway

This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome（OSAHS） by using dynamic 3-Dimensional（3-D） CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller＇s maneuver.The soft palate length（SPL）,the minimal cross-sectional area of the retropalatal region（mXSA-RP）,and the vertical distance from the hard palate to the upper posterior part of the hyoid（hhL） were compared between the two breathing states.These parameters,together with hard palate length（HPL）,were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index（AHI） and the lowest saturation of blood oxygen（LSaO2）] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller＇s maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters（except the position of the hyoid bone） between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index（BMI）≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller＇s maneuver than those in group with BMI26（P0.05 for all）.It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI26.

Three-dimensional imaging identified the accessory bile duct in a patient with cholangiocarcinoma

The development of diagnostic imaging technology, such as multidetector computed tomography(MDCT) and magnetic resonance cholangiopancreatography(MRCP), has made it possible to obtain detailed images of the bile duct. Recent reports have indicated that a 3-dimensional(3D) reconstructed imaging system would be useful for understanding the liver anatomy before surgery. We have investigated a novel method that fuses MDCT and MRCP images. This novel system easily made it possible to detect the anatomical relationship between the vessels and bile duct in the portal hepatis. In this report, we describe a very rare case of extrahepatic cholangiocarcinoma associated with an accessory bile duct from the caudate lobe connecting with the intrapancreatic bile duct. We were unable to preoperatively detect this accessory bile duct using MDCT and MRCP. However, prior to the second operation, we were able to clearly visualise the injured accessory bile duct using our novel 3D imaging modality. In thisreport, we suggest that this imaging technique can be considered a novel and useful modality for understanding the anatomy of the portal hepatis, including the hilar bile duct.

Research on model testing of a new ultrasonic multi-wav detecting method

The traditional crack exploring method with echo （reflected wave） in metals is called the ＂single-wave detecting method＂ that uses a probe of single weight. This method is not able to detect directly the size and shape of the crack and the result can only be obtained by relative comparison, that is to compare the echo amplitudes of the unknown quantity （crack） with the known quantity （regular artificial crack） to determine the equivalent size and shape of a certain crack.

3-D RECONSTRUCTION OF SHAPE AND STRUCTURE FOR THE SPACE OBJECT FROM SERIAL CROSS-SECTIONS

A new method for reconstructing a 3-dimensional object from serial cross-sectionsis presented in this paper.The method is based on the principle of sampling and considersevery point in cross-sections as a sampling point and performs the interpolating of nonlinearfunction with these sampling points.Compared with other methods,this method has manyadvantages such as higher precision and fewer requested known sampling points.The result ofreconstruction with this method is an“entity”which involves the exterior shape and interiorconstruction information of the object simultaneously.

Technique of Embedding Depth Maps into 2D Images

This paper proposes a new technique that is used to embed depth maps into corresponding 2-dimensional （2D） images. Since a 2D image and its depth map are integrated into one type of image format, they can be treated as if they were one 2D image. Thereby, it can reduce the amount of data in 3D images by half and simplify the processes for sending them through networks because the synchronization between images for the left and right eyes becomes unnecessary. We embed depth maps in the quantized discrete cosine transform （DCT） data of 2D images. The key to this technique is whether the depth maps could be embedded into 2D images without perceivably deteriorating their quality. We try to reduce their deterioration by compressing the depth map data by using the differences from the next pixel to the left. We assume that there is only one non-zero pixel at most on one horizontal line in the DCT block because the depth map values change abruptly. We conduct an experiment to evaluate the quality of the 2D images embedded with depth maps and find that satisfactory quality could be achieved.

Preoperative liver functional volumetry performed by 3D-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT: a preliminary study

Aim:The present study was designed to evaluate the feasibility of preoperative liver functional volumetry performed by 3D-technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin(99mTc-GSA)scintigraphy/vascular fusion imaging using SYNAPSE VINCENT and to examine the discrepancy between conventional and functional volumetry.Methods:The study group comprised 15 patients who underwent preoperative 3-dimensional(3D)-99mTc-GSA scintigraphy/vascular fusion imaging using SYNAPSE VINCENT software before hepatectomy between July 2014 and August 2015.The diagnosis was hepatocellular carcinoma(n=4),metastatic liver tumor(n=10),or intrahepatic cholangiocarcinoma(n=1).Right hepatectomy was performed in 2 patients,left hepatectomy in 3 patients,right posterior sectionectomy in 3 patients,segmentectomy in 2 patients,and partial hepatectomy in 4 patients.99mTc-GSA scintigraphy and computed tomography(CT)were performed to construct 3D-99mTc-GSA scintigraphy/vascular fused images.The conventional volume ratio of the planned resection region without tumor(%CT),and the functional volume ratio of the planned resection region without tumor(%GSA)were calculated.The discrepancy ratio was calculated as follows:discrepancy ratio=100-%GSA/%CT×100(%).Results:The%GSA(17.9±16.7%)was significantly lower than the%CT(21.5±17.6%)(P<0.036).In all except 2 patients,the%GSA was lower than the%CT.The discrepancy ratio ranged from-4%to 75%(median,20.7%).Conclusion:3D-99mTc-GSA scintigraphy/vascular fused images constructed using SYNAPSE VINCENT were useful for noninvasively performing functional liver volumetry in patients scheduled to undergo various patterns of hepatectomy.In planned resection regions without tumor,the functional volume ratio was about 20%lower than the conventional volume ratio.