Clinical application of improved 2D computer-assisted fluoroscopic navigation through simulating a 3D vertebrae image to guide pedicle screw internal fixation

Objective To study the effect of using improved 2D computer-assisted fluoroscopic navigation through simulating 3D vertebrae image to guide pedicle screw internal fixation.Methods Posterior pedicle screw internal fixation,distraction

A comparative study of the morphometry of sperm head components in cattle, sheep, and pigs with a computer-assisted fluorescence method

The aim of this study was to compare the sperm nuclear and acrosomal morphometry of three species of domestic artiodactyls; cattle （Bos taurus）, sheep （Ovis aries）, and pigs （Sus scrofa）. Semen smears of twenty ejaculates from each species were fixed and labeled with a propidium iodide-Pisum sativum agglutinin （PI/PSA） combination. Digital images of the sperm nucleus, acrosome, and whole sperm head were captured and analyzed. The use of the PI/PSA combination and CASA-Morph fluorescence-based method allowed the capture, morphometric analysis, and differentiation of most sperm nuclei, acrosomes and whole heads, and the assessment of acrosomal integrity with a high precision in the three species studied. For the size of the head and nuclear area, the relationship between the three species may be summarized as bull 〉 ram 〉 boar. However, for the other morphometric parameters （length, width, and perimeter）, there were differences in the relationships between species for sperm nuclei and whole sperm heads. Bull sperm acrosomes were clearly smaller than those in the other species studied and covered a smaller proportion of the sperm head. The acrosomal morphology, small in the bull, large and broad in the sheep, and large, long, and with a pronounced equatorial segment curve in the boar, was species-characteristic. It was concluded that there are clear variations in the size and shape of the sperm head components between the three species studied, the acrosome being the structure showing the most variability, allowing a clear distinction of the spermatozoa of each species.

Extravasated contrast volumetric assessment on computed tomography angiography in gastrointestinal bleeding:A useful predictor of positive angiographic findings

BACKGROUND Gastrointestinal bleeding(GIB)is a severe and potentially life-threatening condition,especially in cases of delayed treatment.Computed tomography angiography(CTA)plays a pivotal role in the early identification of upper and lower GIB and in the prompt treatment of the haemorrhage.AIM To determine whether a volumetric estimation of the extravasated contrast at CTA in GIB may be a predictor of subsequent positive angiographic findings.METHODS In this retrospective single-centre study,35 patients(22 men;median age 69 years;range 16-92 years)admitted to our institution for active GIB detected at CTA and further submitted to catheter angiography between January 2018 and February 2022 were enrolled.Twenty-three(65.7%)patients underwent endoscopy before CTA.Bleeding volumetry was evaluated in both arterial and venous phases via a semi-automated dedicated software.Bleeding rate was obtained from volume change between the two phases and standardised for unit time.Patients were divided into two groups,according to the angiographic signs and their concordance with CTA.RESULTS Upper bleeding accounted for 42.9%and lower GIB for 57.1%.Mean haemoglobin value at the admission was 7.7 g/dL.A concordance between positive CTA and direct angiographic bleeding signs was found in 19(54.3%)cases.Despite no significant differences in terms of bleeding volume in the arterial phase(0.55 mL vs 0.33 mL,P=0.35),a statistically significant volume increase in the venous phase was identified in the group of patients with positive angiography(2.06 mL vs 0.9 mL,P=0.02).In the latter patient group,a significant increase in bleeding rate was also detected(2.18 mL/min vs 0.19 mL/min,P=0.02).CONCLUSION In GIB of any origin,extravasated contrast volumetric analysis at CTA could be a predictor of positive angiography and may help in avoiding further unnecessary procedures.

鼻内镜下数码照相机豚鼠中耳成像技术

耳鼻咽喉解剖结构复杂且部位隐蔽，较难直接视及，随着鼻内镜及数字图像采集装置广泛应用，极大促进了本专业的发展。在临床科研工作中常会遇到一些认为有必要保存下来的病例影像资料，由于各种原因导致缺乏数字图像采集装置，使许多病例资料无法保留，且数字图像采集装置受采集芯片的限制，采集的图像像素相对较低。本研究旨在探索鼻内镜下利用普通数码相机拍摄清晰图像的方法，应用数码相机镜头直接接触内镜目镜，将所观察的图像拍摄下来，取得了良好的效果。

Three-dimensional reconstruction of light microscopy image sections： present and future

Three-dimensional （3D） image reconstruction technologies can reveal previously hidden microstruc-tures in human tissue. However, the lack of ideal, non-destructive cross-sectional imaging techniques is still a problem. Despite some drawbacks, histological sectioning remains one of the most powerful methods for accurate high-resolution representation of tissue structures. Computer technologies can produce 3D representations of interesting human tissue and organs that have been serial-sectioned, dyed or stained, imaged, and segmented for 3D visualization. 3D reconstruction also has great potential in the fields of tissue engineering and 3D printing. This article outlines the most common methods for 3D tissue section reconstruction. We describe the most important academic concepts in this field, and provide critical explanations and comparisons. We also note key steps in the reconstruction procedures, and highlight recent progress in the development of new reconstruction methods.

Advances in deep learning for computed tomography denoising

Computed tomography(CT)has seen a rapid increase in use in recent years.Radiation from CT accounts for a significant proportion of total medical radiation.However,given the known harmful impact of radiation exposure to the human body,the excessive use of CT in medical environments raises concerns.Concerns over increasing CT use and its associated radiation burden have prompted efforts to reduce radiation dose during the procedure.Therefore,low-dose CT has attracted major attention in the radiology,since CT-associated x-ray radiation carries health risks for patients.The reduction of the CT radiation dose,however,compromises the signal-to-noise ratio,which affects image quality and diagnostic performance.Therefore,several denoising methods have been developed and applied to image processing technologies with the goal of reducing image noise.Recently,deep learning applications that improve image quality by reducing the noise and artifacts have become commercially available for diagnostic imaging.Deep learning image reconstruction shows great potential as an advanced reconstruction method to improve the quality of clinical CT images.These improvements can provide significant benefit to patients regardless of their disease,and further advances are expected in the near future.

Anatomical references for tibial sagittal alignment in total knee arthroplasty： A comparison of three anatomical axes based on 3D reconstructed CT images

Background This study was designed to analyze three tibial axis reference lines including the anterior tibial cortex （ATC） line, the fibular line （FL）, and the anatomical axis of tibia （AAT） line, to determine which line most closely parallels the mechanical axis （MA） of the tibia in the sagittal plane. The clinical relevance of the study is that through finding a reliable landmark on the leg, a surgeon may minimize posterior tibial slope measurement errors thereby and improving the technique for assuring proper alignment of total knee arthroplasty.

Reproducibility of thrombus volume quantification in multicenter computed tomography pulmonary angiography studies

AIM To evaluate reproducibility of pulmonary embolism(PE) clot volume quantification using computed tomography pulmonary angiogram(CTPA) in a multicenter setting.METHODS This study was performed using anonymized data in conformance with HIPAA and IRB Regulations(March 2015-November 2016). Anonymized CTPA data was acquired from 23 scanners from 18 imaging centers using each site's standard PE protocol. Two independent analysts measured PE volumes using a semi-automated region-growing algorithm on an FDA-approved image analysis platform. Total thrombus volume(TTV) was calculated per patient as the primary endpoint. Secondary endpoints were individual thrombus volume(ITV), Qanadli score and modified Qanadli score per patient. Inter-and intra-observer reproducibility were assessed using intra-class correlation coefficient(ICC) and BlandAltman analysis. RESULTS Analyst 1 found 72 emboli in the 23 patients with a mean number of emboli of 3.13 per patient with a range of 0-11 emboli per patient. The clot volumes ranged from 0.0041-47.34 cm3(mean +/-SD, 5.93 +/-10.15 cm3). On the second read, analyst 1 found the same number and distribution of emboli with a range of volumes for read 2 from 0.0041 – 45.52 cm3(mean +/-SD, 5.42 +/-9.53 cm3). Analyst 2 found 73 emboli in the 23 patients with a mean number of emboli of 3.17 per patient with a range of 0-11 emboli per patient. The clot volumes ranged from 0.00459-46.29 cm3(mean +/-SD, 5.91 +/-10.06 cm3). Inter-and intraobserver variability measurements indicated excellent reproducibility of the semi-automated method for quantifying PE volume burden. ICC for all endpoints was greater than 0.95 for inter-and intra-observer analysis. Bland-Altman analysis indicated no significant biases.CONCLUSION Semi-automated region growing algorithm for quantifying PE is reproducible using data from multiple scanners and is a suitable method for image analysis in multicenter clinical trials.

Effect of varying computed tomography acquisition and reconstruction parameters on semi-automated clot volume quantification

AIM To examine effects of computed tomography(CT)image acquisition/reconstruction parameters on clot volume quantification in vitro for research method validation purposes.METHODS This study was performed in conformance with HIPAA and IRB Regulations(March 2015-November 2016).A ten blood clot phantom was designed and scanned on a dual-energy CT scanner(SOMATOM Force,Siemens Healthcare Gm BH,Erlangen,Germany)with varying pitch,iterative reconstruction,energy level and slicethickness.A range of clot and tube sizes were used in an attempt to replicate in vivo emboli found within central and segmental branches of the pulmonary arteries in patients with pulmonary emboli.Clot volume was the measured parameter and was analyzed by a single image analyst using a semi-automated region growing algorithm implemented in the FDA-approved Siemens syngo.via image analysis platform.Mixed model analysis was performed on the data.RESULTS On the acquisition side,the continuous factor of energy showed no statistically significant effect on absolute clot volume quantification(P=0.9898).On the other hand,when considering the fixed factor of pitch,there were statistically significant differences in clot volume quantification(P<0.0001).On the reconstruction side,with the continuous factor of reconstruction slice thickness no statistically significant effect on absolute clot volume quantification was demonstrated(P=0.4500).Also on the reconstruction side,with the fixed factor of using iterative reconstructions there was also no statistically significant effect on absolute clot volume quantification(P=0.3011).In addition,there was excellent R^2 correlation between the scale-measured mass of the clots both with respect to the CT measured volumes and with respect to volumes measure by the water displacement method.CONCLUSION Aside from varying pitch,changing CT acquisition parameters and using iterative reconstructions had no significant impact on clot volume quantification with a semi-automated region growing algorithm.

Retinal vessels caliber changes after strabismus surgery：results of 6mo follow-up

AIM：To evaluate the effect of strabismus surgery on retinal vessels calibers with digital color fundus photographs.METHODS：Two hundred consecutive strabismus patients underwent surgery,and 118 patients（female/male,55/63） who finished 6-month follow-up were finally included in this study.Optic disc-centered digital color fundus photographs of both eyes of all patients were taken prior to surgery and 6mo post surgery.The retinal vascular caliber of 116 operated eyes were measured using the computer program IVAN.The operated eyes were divided into 3 groups according to the surgical methods,recession of one muscle,one muscle recession and one muscle folding,one muscle resection and one muscle recession.The effect of number of altered muscles on retinal vessels was analyzed using statistic software SPSS 16.0.RESULTS：The mean age was 12.4±8.6y.Averaged central retinal artery equivalent（CRAE） of all patients was 120.31 ±23.02 μm preoperatively,and 122.87 ±15.93 μm six months after surgery.Averaged central retinal vein equivalent（CRVE） was 171.11 ±31.73 μm preoperatively and175.02±21.00 μm postoperatively.There was no significant difference of averaged CRAE（P=0.22） or CRVE（P=0.19）before and after operation.Averaged arteriole to venule ratio（AVR） was 0.71 ±0.07 before surgery and 0.70±0.07 after surgery.Comparison of preoperative and postoperative retinal vessels calibers among different surgical groups did not show significant differences.Also,there was no advantage of rectus muscle folding to muscle resection.CONCLUSION：Up to 6mo after strabismus surgery,the retinal vascular calibers were not altered.No more than two muscles in one surgery are safe for retinal perfusion.

内耳体素模型三维可视化

内耳结构精细而复杂,位于颞骨岩部骨质内,又称为迷路,由半规管、前庭、耳蜗三部分组成。迷路内充满淋巴液,临床MRI检查可以获取清晰影像,但不能或仅能部分显示膜迷路结构-（[1]）。内耳三维可视化和空间方向测量对于临床和研究都非常重要,其三维显示方式主要为表面绘制技术和体绘制技术。

Morphometric study on Leydig cells in capsulotomized testis of rats

AIM: To further clarify the changes occurred in the testicular capsulotomized rats. METHODS: In testicular capsulotomized and sham-operated rats, the cross sectional area, the nucleus diameter and the number of Leydig cells were morphologically analyzed by the Vidas Image Processing System connected to a microscope. RESULTS: In the capsulotomized animals, the cross sectional area of Leydig cells was gradually increased from 30 days onwards. There was no obvious change in the nucleus diameter of Leydig cells. However, The Leydig cell number was significantly increased from day 30 onwards. CONCLUSION: In rats, testicular capsulotomy may induce hyperplasia/hypertrophy of Leydig cells in the testis.

EFFECTSOFVASOACTIVEINTESTINALPEPTIDEONACTIVITIESOFSUCCINICDEHYDROGENASEANDALKALINEPHOSPHATASEINRATHEPATOMACELLS

Using cytochemical method,microspectrophotometry and image analysis,effects of va-soactive intestinal peptide(VIP)on activities of succinic dehydrogenase(SDH)and alkalinephosphatase(ALP)in rat hepatoma cells were studied in vitro.The results showed that thehepatoma cell expressed potent positive reactions of SDH and ALP,the positive positionswere located at the cell membranes and/or cytoplasm.Having been treated with VIP,ALPdecreased obviously in activity(P【0. 01,compared with hepatoma cells untreated by VIP).The sites of ALP activty were chiefly located at the cell membranes,particularly at the cell-cell contacts.Cultured rat hepatoma cells had intensive SDH activity in their cytoplasm.Compared with untreated eclls,there was no marked difference in the intensity of SDH activ-ity in VIP-treated hepatoma cells(P】0.05).

Short Report: A Sponge Phantom Provides a Homogeneous k-Space Pattern at MRI

Background: The spectral coverage of magnetic resonance (MR) sequences can be well assessed in k-space. However, many objects do not provide high signal intensities in the peripheral k-space. Purpose: To experimentally find a phantom that provides a homogeneous spectral pattern also at the high spatial frequencies of the k-space periphery. Material and Methods: Different phantoms were imaged on a 1.5 Tesla magnet, and the resulting MR images were viewed in k-space after fast Fourier transform. Results: Firstly, phantoms with a homogeneous physical structure were studied with a T2-weighted MR sequence, but they provided an inhomogeneous k-space pattern with dominant central low-frequency components. Secondly, phantoms with an inhomogeneous physical structure were studied. In this group, a water-soaked sponge showed a relatively homogeneous k-space pattern also at high spatial frequencies, owing to the fine porous structure. This sponge phantom can also be soaked with Gadolinium chelates for T1-weighted MR imaging. Conclusion: A simple sponge phantom provides a homogeneous k-space pattern, owing to its fine porous structure. This could be utilized in MR sequence development and for viewing the spectral coverage of MR sequences in k-space.

Diagnostic value of MSCT plain scan and dual-phase enhanced scan in thymic adenocarcinoma

Objective: To evaluate the value of MSCT plain scan and enhanced CT in the diagnosis of thymic adenocarcinoma. Methods: From May 2013 to June 2018, 37 cases of MSCT plain scan and dual-phase enhanced scan of thymic adenocarcinoma were retrospectively analyzed. The location, shape, size, density (CT value), enhanced features, peripheral invasion and mediastinal lymph node metastasis of the lesions were observed. Results: All 37 cases of thymic adenocarcinoma were diagnosed by CT before operation, and all cases were diagnosed by pathology after operation as malignant tumors,including 28 cases of thoracic adenocarcinoma and 9 cases of invasive thymoma. All 28 cases of thymic adenocarcinoma were single lesion of anterior superior mediastinum. The maximum cross-section was located in the midline in 7 cases and on the mediastinal side in 21 cases with significant difference (P<0.05). All lesions were irregular lobulated. The minimum diameter of lesions was 2.1 cm and the maximum diameter was 8.6 cm. Soft tissue density was dominant in the solid part. All cases of thymic adenocarcinoma showed inhomogeneous, moderate and severe enhancement in the arterial and venous phase after enhancement. The degree of enhancement in the venous phase was higher than that in the arterial phase, and there was no enhancement in the irregular liquefied necrosis area. 26 cases had necrotic lesions, 21 cases had mediastinal lymph node metastasis, and 8 cases had invasion of adjacent pleura. 19 cases had mediastinal vessels and 0 cases had distant pleural metastases. Conclusion: MSCT plain scan combined with dual-phase enhanced CT is helpful to display the details and metastasis of thymic adenocarcinoma, improve the coincidence rate of CT diagnosis and pathological diagnosis, and reduce the misdiagnosis rate. To provide help for clinical diagnosis and treatment of thymic adenocarcinoma.

动态喉镜图像主观评估

1878年Oertel发明了动态喉镜，至今100多年来，动态喉镜得到了长足的发展。目前动态喉镜被广泛应用于临床，已经成为喉发音功能检测的常规检查之一。

Three-dimensional CT angiography study on the relations between the vertebral artery and atlantoaxial joint

Background The vertebral artery （VA） and atlantoaxial joint （AAJ）, with complicated structures, are located in the depths of the head-neck boundary area, the regional anatomy of which cannot be shown globally and directly. This study aims to evaluate three-dimensional CT angiography （3DCTA） in displaying the AAJ, atlantoaxial segment of the vertebral artery （ASVA） and the identification of their interrelations. Methods Sixty-eight subjects without pathology of the ASVA and AAJ were selected from head-neck CTA examination. All the 3D images were formed with volume rendering （VR） together with techniques of separating, fusing, opacifying and false-coloring （SFOF）. On the 3D images, the ASVA and AAJ were observed, and their interrelations were measured. Results All the 3DCTA images were of high quality and up to our requirements. They could clearly and directly show the ASVA, ascending along the AAJ. There were 5 curves in the course of the ASVA, of which 2 curves were away from the atlantoaxial joint, one in the 2rid curve of 0.0 mm-5.4 mm, the other in the 4th of 2.6 mm-9.2 mm. There was no significant difference in the measurements between left and right （P 〉0.05）. The curved parts of the ASVA slightly expanded, with the biggest diameter of 5.6 mm in the 4th curve. Statistical comparison shows that the left ASVA is larger than the right （P 〈0.05）. Variations of the ASVA were found in 8 cases and of the AAJ in 12. Conclusions 3DCTA can globally and directly demonstrate the structures of the AAJ, ASVA and their interrelations. The 3D imaging data make up and enrich the research contents of regional anatomy and lay the foundation for related study and applications.

Stereological measurement of rat＇s seminiferous tubule

Background The morphological measurements of seminiferous tubules are important in the studies of testis tissues. The purpose of this study was to evaluate the feasibility of using a stereological method to measure the geometric parameters of seminiferous tubule and to optimize the method. Methods A stereological image processing program was developed with Delphi for the stereological measurement. Fields of view were obtained from 15 healthy Wistar rats＇ testis tissues （n=247）. The diameter, area and volume of seminiferous tubule were estimated with the image processing program by two individual observers. The area results were compared with those obtained by the standard morphometric method of planimetry, Results Diameter measurements showed the diameters of different seminiferous tubules were almost the same and the mean value of about 50 tubules could be a good representation of the whole structure. Area measurements indicated there was no significant difference between stereology and planimetry （P 〉0.05）. But the stereological method required about 45% less time. Volume measurement showed the inter-observer variability was small （P 〉0.05） and the reproducibility of the stereological method was good. Conclusion The stereological technique was practical and efficient in the quantitative measurement of the rat＇s seminiferous tubule.

Differentiating gastric cancer and gastric lymphoma using texture analysis(TA)of positron emission tomography(PET)

Background:Texture analysis(TA)can quantify intra-tumor heterogeneity using standard medical images.The present study aimed to assess the application of positron emission tomography(PET)TA in the differential diagnosis of gastric cancer and gastric lymphoma.Methods:The pre-treatment PET images of 79 patients(45 gastric cancer,34 gastric lymphoma)between January 2013 and February 2018 were retrospectively reviewed.Standard uptake values(SUVs),first-order texture features,and second-order texture features of the grey-level co-occurrence matrix(GLCM)were analyzed.The differences in features among different groups were analyzed by the two-way Mann-Whitney test,and receiver operating characteristic(ROC)analysis was used to estimate the diagnostic efficacy.Results:InertiaGLCM was significantly lower in gastric cancer than that in gastric lymphoma(4975.61 vs.11,425.30,z=-3.238,P=0.001),and it was found to be the most discriminating texture feature in differentiating gastric lymphoma and gastric cancer.The area under the curve(AUC)of inertiaGLCM was higher than the AUCs of SUVmax and SUVmean(0.714 vs.0.649 and 0.666,respectively).SUVmax and SUVmean were significantly lower in low-grade gastric lymphoma than those in high grade gastric lymphoma(3.30 vs.11.80,2.40 vs.7.50,z=-2.792 and-3.007,P=0.005 and 0.003,respectively).SUVs and first-order greylevel intensity features were not significantly different between low-grade gastric lymphoma and gastric cancer.EntropyGLCM12 was significantly lower in low-grade gastric lymphoma than that in gastric cancer(6.95 vs.9.14,z=-2.542,P=0.011)and had an AUC of 0.770 in the ROC analysis of differentiating low-grade gastric lymphoma and gastric cancer.Conclusions:InertiaGLCM and entropyGLCM were the most discriminating features in differentiating gastric lymphoma from gastric cancer and low-grade gastric lymphoma from gastric cancer,respectively.PET TA can improve the differential diagnosis of gastric neoplasms,especially in tumors with similar degrees of fluorodeoxyglucose uptake.

内耳三维重建与数值模拟

内耳是听觉和平衡觉的感受器，其精细的解剖结构及复杂的空间关系是其功能的重要基础，近年来，运用内耳组织连续切片及医学影像学资料获取二维结构信息，并进一步重建三维结构形态的技术正在不断发展。此外，基于三维成像模型进行数值模拟研究，亦获得了对内耳功能的进一步理解，本文拟对内耳三维重建及前庭生物力学数值模拟的研究进展做一综述。