Evaluation of Ischemic and Hemorrhagic Stroke on Computed Tomography

The stroke is the 3rd leading cause of death in Pakistan, wherein back in 2009, stroke used to be the 4th leading cause of death in Pakistan, a 19.2% increase is alarming (IHME, 2019). Ischemic stroke occurs 75-80 percent of the time, while hemorrhagic stroke occurs 8-20 percent of the time. The objective of our study is to evaluate the frequency and ratio of ischemic and hemorrhagic stroke on computed tomography. A Descriptive study was performed using non-probability convenient sampling technique. The study was conducted in Lahore General Hospital, Lahore, Pakistan. The data was collected from November 15, 2020 to February 15, 2021. Informed consent was taken from all the participants. In our study patients with provisional diagnose of clot or thrombosis, History of Ischemic Stroke, History of Hemorrhagic Stroke, patients who came with clinical manifestation of stroke, traumatic or Road Traffic Accidents (RTA) patients, patients with cerebral Transient Ischemic Stroke. Arterial Puncture in Last 7 days, patients with Active bleeding, peroneal nerve injuryand patients who have been injected Botulinum Toxic Injection in last 3 months were included in our study. Patients who had a previous history of Parkinson disease, patients not having any apparent cause or chronic or acute symptoms of stroke, no history of internal bleeding, patients with chronic cerebral disease and patients with other neurological defects were excluded.A total of 85 patients with Stroke were included in our study. Most of the patients were 40 to 65 years of age. The average age of the patients was 59.5 ± 11.1 years. Out of 85 there were 38.8% (P=33) positive with H/O Infarction females (P=11) and males (P=22 ) 55 (62.5%) were males and 33 (37.5%) were females with 1.62: 1 male to female ratio as shown in Fig 5.2. Ischemic stroke was observed in 33 (36.2%) patients and 40 (47.3%) were suffered hemorrhagic stroke and 12 (14.4%) patients were affected with TIA.The conclusion to this study is that to assess early stroke with extreme clarity, computed tomography is the safest modality for evaluating stroke patients and allows radiologists to more accurately assess these patients on CT in terms of prognosis, frequency, morbidity, and legitimacy. Keywords: Stroke, Hemorrhagic Stroke, Ischemic Stroke, Cerebral Infarction, Computed Tomography DOI: 10.7176/JHMN/90-06 Publication date:June 30th 202

RS-Net: Regression-Segmentation 3D CNN for Synthesis of Full Resolution Missing Brain MRI in the Presence of Tumours

Accurate synthesis of a full 3D MR image containing tumours from available MRI (e.g. to replace an image that is currently unavailable or corrupted) would provide a clinician as well as downstream inference methods with important complementary information for disease analysis. In this paper, we present an end-to-end 3D convolution neural network that takes a set of acquired MR image sequences (e.g. T1, T2, T1ce) as input and concurrently performs (1) regression of the missing full resolution 3D MRI (e.g. FLAIR) and (2) segmentation of the tumour into subtypes (e.g. enhancement, core). The hypothesis is that this would focus the network to perform accurate synthesis in the area of the tumour. Experiments on the BraTS 2015 and 2017 datasets [1] show that: (1) the proposed method gives better performance than state-of-the-art methods in terms of established global evaluation metrics (e.g. PSNR), (2) replacing real MR volumes with the synthesized MRI does not lead to significant degradation in tumour and sub-structure segmentation accuracy. The system further provides uncertainty estimates based on Monte Carlo (MC) dropout [11] for the synthesized volume at each voxel, permitting quantification of the system's confidence in the output at each location.Comment: Accepted at Workshop on Simulation and Synthesis in Medical Imaging - SASHIMI2018 held in conjunction with the 21st International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI 2018