AIM:To sufficiently improve magnetic resonance cholangiopancreatography(MRCP) quality to enable reliable computer-aided diagnosis(CAD).METHODS:A set of image enhancement strategies that included filters(i.e.Gaussian,m...AIM:To sufficiently improve magnetic resonance cholangiopancreatography(MRCP) quality to enable reliable computer-aided diagnosis(CAD).METHODS:A set of image enhancement strategies that included filters(i.e.Gaussian,median,Wiener and Perona-Malik),wavelets(i.e.contourlet,ridgelet and a non-orthogonal noise compensation implementation),graph-cut approaches using lazy-snapping and Phase Unwrapping MAxflow,and binary thresholding using a fixed threshold and dynamic thresholding via histogram analysis were implemented to overcome the adverse characteristics of MRCP images such as acquisition noise,artifacts,partial volume effect and large inter-and intra-patient image intensity variations,all of which pose problems in application development.Subjective evaluation of several popular pre-processing techniques was undertaken to improve the quality of the 2D MRCP images and enhance the detection of the significant biliary structures within them,with the purpose of biliary disease detection.RESULTS:The results varied as expected since each algorithm capitalized on different characteristics of the images.For denoising,the Perona-Malik and contourlet approaches were found to be the most suitable.In terms of extraction of the significant biliary structures and removal of background,the thresholding approaches performed well.The interactive scheme performed the best,especially by using the strengths of the graphcut algorithm enhanced by user-friendly lazy-snapping for foreground and background marker selection.CONCLUSION:Tests show promising results for some techniques,but not others,as viable image enhancement modules for automatic CAD systems for biliary and liver diseases.展开更多
AIM:To investigate the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in cases of suspected spontaneous passage of stones into t...AIM:To investigate the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in cases of suspected spontaneous passage of stones into the common bile duct.METHODS:Thirty-six patients with gallbladder stones were clinically suspected of spontaneous passage of stones into the common bile duct because they presented with clinical symptoms such as abdominal pain and fever,and showed signs of inflammatory reaction and marked rise of hepatobiliary enzymes.These symptoms resolved and they showed normalized values of blood biochemical parameters after conservative treatment without evidence of stones in the common bile duct on MRCP.All these patients were subjected to ERCP within 3 d of MRCP to check for the presence of stones.RESULTS:No stones were detected by ERCP in any patient,confi rming the results of MRCP.CONCLUSION:When clinical symptoms improve,blood biochemical parameters have normalized,and MRCP shows there are no stones in the common bile duct,it can be considered the stone has spontaneously passed and thus ERCP is not necessary.展开更多
BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)rarely recurs in a multicentric manner.We encountered a patient with multiple recurrences of the gastric subtype of IPNB one year after spontaneous detac...BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)rarely recurs in a multicentric manner.We encountered a patient with multiple recurrences of the gastric subtype of IPNB one year after spontaneous detachment of the primary tumor during peroral cholangioscopy(POCS).CASE SUMMARY A 68-year-old woman on maintenance hemodialysis because of lupus nephritis had several cardiovascular diseases and a pancreatic intraductal papillary mucinous neoplasm(IPMN).She was referred to our department for dilation of the common bile duct(CBD)and a tumor in the lumen,detected using ultrasonography.She had no complaints,and blood tests of hepatobiliary enzymes were normal.Magnetic resonance cholangiopancreatography(MRCP)showed a papillary tumor in the CBD with a filling defect detected using endoscopic retrograde cholangiography(ERC).Intraductal ultrasonography revealed a papillary tumor and stalk at the CBD.During POCS,the tumor spontaneously detached with its stalk into the CBD.Pathology showed low-intermediate nuclear atypia of the gastric subtype of IPNB.After 1 year,follow-up MRCP showed multiple tumors distributed from the left hepatic duct to the CBD.ERC and POCS showed multicentric tumors.She was alive without hepatobiliary symptoms at least two years after initial diagnosis of IPNB.CONCLUSION The patient experienced gastric subtype of IPNB without curative resection.Observation may be reasonable for patients with this subtype.展开更多
胆胰管系统疾病的诊断以往主要依靠 B 超、CT 和内窥镜逆行胰胆管造影(ERCP)等检查.磁共振胆胰管成象(magneticresonance cholangiopancreatography,MRCP)是一种无创性显示胆胰管结构的新技术,自1991年德国学者 Wallner et al 首次报道...胆胰管系统疾病的诊断以往主要依靠 B 超、CT 和内窥镜逆行胰胆管造影(ERCP)等检查.磁共振胆胰管成象(magneticresonance cholangiopancreatography,MRCP)是一种无创性显示胆胰管结构的新技术,自1991年德国学者 Wallner et al 首次报道以来,已逐渐应用到临床,其前景十分广阔.目前国内外报道 MRCP 成象序列主要是快速自旋回波序列(fast展开更多
基金Supported by The Brain Gain Malaysia international fellowship and post-doctoral program grant under the Ministry of Science,Technology and Innovation,Malaysia
文摘AIM:To sufficiently improve magnetic resonance cholangiopancreatography(MRCP) quality to enable reliable computer-aided diagnosis(CAD).METHODS:A set of image enhancement strategies that included filters(i.e.Gaussian,median,Wiener and Perona-Malik),wavelets(i.e.contourlet,ridgelet and a non-orthogonal noise compensation implementation),graph-cut approaches using lazy-snapping and Phase Unwrapping MAxflow,and binary thresholding using a fixed threshold and dynamic thresholding via histogram analysis were implemented to overcome the adverse characteristics of MRCP images such as acquisition noise,artifacts,partial volume effect and large inter-and intra-patient image intensity variations,all of which pose problems in application development.Subjective evaluation of several popular pre-processing techniques was undertaken to improve the quality of the 2D MRCP images and enhance the detection of the significant biliary structures within them,with the purpose of biliary disease detection.RESULTS:The results varied as expected since each algorithm capitalized on different characteristics of the images.For denoising,the Perona-Malik and contourlet approaches were found to be the most suitable.In terms of extraction of the significant biliary structures and removal of background,the thresholding approaches performed well.The interactive scheme performed the best,especially by using the strengths of the graphcut algorithm enhanced by user-friendly lazy-snapping for foreground and background marker selection.CONCLUSION:Tests show promising results for some techniques,but not others,as viable image enhancement modules for automatic CAD systems for biliary and liver diseases.
文摘AIM:To investigate the usefulness of magnetic resonance cholangiopancreatography (MRCP) and the need for endoscopic retrograde cholangiopancreatography (ERCP) in cases of suspected spontaneous passage of stones into the common bile duct.METHODS:Thirty-six patients with gallbladder stones were clinically suspected of spontaneous passage of stones into the common bile duct because they presented with clinical symptoms such as abdominal pain and fever,and showed signs of inflammatory reaction and marked rise of hepatobiliary enzymes.These symptoms resolved and they showed normalized values of blood biochemical parameters after conservative treatment without evidence of stones in the common bile duct on MRCP.All these patients were subjected to ERCP within 3 d of MRCP to check for the presence of stones.RESULTS:No stones were detected by ERCP in any patient,confi rming the results of MRCP.CONCLUSION:When clinical symptoms improve,blood biochemical parameters have normalized,and MRCP shows there are no stones in the common bile duct,it can be considered the stone has spontaneously passed and thus ERCP is not necessary.
文摘BACKGROUND Intraductal papillary neoplasm of the bile duct(IPNB)rarely recurs in a multicentric manner.We encountered a patient with multiple recurrences of the gastric subtype of IPNB one year after spontaneous detachment of the primary tumor during peroral cholangioscopy(POCS).CASE SUMMARY A 68-year-old woman on maintenance hemodialysis because of lupus nephritis had several cardiovascular diseases and a pancreatic intraductal papillary mucinous neoplasm(IPMN).She was referred to our department for dilation of the common bile duct(CBD)and a tumor in the lumen,detected using ultrasonography.She had no complaints,and blood tests of hepatobiliary enzymes were normal.Magnetic resonance cholangiopancreatography(MRCP)showed a papillary tumor in the CBD with a filling defect detected using endoscopic retrograde cholangiography(ERC).Intraductal ultrasonography revealed a papillary tumor and stalk at the CBD.During POCS,the tumor spontaneously detached with its stalk into the CBD.Pathology showed low-intermediate nuclear atypia of the gastric subtype of IPNB.After 1 year,follow-up MRCP showed multiple tumors distributed from the left hepatic duct to the CBD.ERC and POCS showed multicentric tumors.She was alive without hepatobiliary symptoms at least two years after initial diagnosis of IPNB.CONCLUSION The patient experienced gastric subtype of IPNB without curative resection.Observation may be reasonable for patients with this subtype.
文摘胆胰管系统疾病的诊断以往主要依靠 B 超、CT 和内窥镜逆行胰胆管造影(ERCP)等检查.磁共振胆胰管成象(magneticresonance cholangiopancreatography,MRCP)是一种无创性显示胆胰管结构的新技术,自1991年德国学者 Wallner et al 首次报道以来,已逐渐应用到临床,其前景十分广阔.目前国内外报道 MRCP 成象序列主要是快速自旋回波序列(fast
