Visualization and postprocessing of medical images – MPR, MIP, VRT, segmentation. Essence and application

The workload in radiology departments has been increasing substantially over the last few decades. This is due to the greater need of tomographic examinations, as well as the increasing number of slices in each examination, determined by the advancements in tomographic technology. In order to ameliorate this, it is necessary to implement means of optimising the workflow of the diagnostic radiologist. Among them the most widely spread and easily accessible are special methods for visualization and image postprocessing – multiplanar reformats, maximum intensity projections, volume rendering techniques, and segmentation. They enable easier differentiation of unclear findings, faster and more reliable discovery of fine small calibre lesions and thrombi, improved spatial orientation and pre-operative planning, as well as acquisition of reproducible and reliable medical scientific measurements. These methods are available as builtin modules in most medical imaging software packages (including ones with an open source) and are an integral part of radiological interpretation, saving time and effort. In the future they can be reinforced with highly specialized artificial intelligence, which could make automatic measurements and locate a specific type of finding

Epicardial fat as an imaging biomarker in the assessment of cardiometabolic risk in patients with type 1 diabetes with a duration of over 15 years

Diabetes mellitus is one of the most frequent metabolic diseases and is characterized by increased coronary risk. Data from epicardial fat quantification in long-term type 1 diabetes patients with poor control and healthy volunteers, performed with computed tomography and magnetic resonance tomography, is analyzed in relation to biochemical and anthropometric indicators. Statistically significant correlations are established between epicardial fat volume and body mass index in diabetic men, as well as between epicardial fat volume and dyslipidemic markers

Quantitative measurement of epicardial adipose tissue and correlation with other markers for increased cardiovascular and metabolic risk in patients with long-term diabetes mellitus type 1 // Количествено измерване на епикардната мастна тъкан и корелация с други маркери за повишен сърдечно-съдов и метаболитен риск при пациенти с дългогодишен тип ЗД 1

Diabetes mellitus (DM) is one of the most common metabolic diseases and is characterized by impaired carbohydrates, protein and lipid metabolism. In recent years, diabetes incidence has been gradually increasing, becoming a serious threat to public health. Increased accumulation of visceral adipose tissue (VAT) is a risk factor for insulin resistance, which may reduce insulin sensitivity, increase the expression and secretion of anti-inflammatory cytokines in adipose tissue and trigger the development of DM and cardiovascular disease (CVD). In the present study, we aim to examine EAT imaging methods, EAT role as a biomarker and its clinical significance as a factor in increased cardiovascular risk in correlation with other known risk factors. To achieve the aim of the dissertation, we set ourselves the following tasks: To determine whether there is a statistically significant correlation between epicardial adipose tissue (EAT) measured by CT and MRI, patient lipid profile, WC, VAT and BMI measured by DEXA; To correlate EAT with inflammatory cytokines (IL1, IL6 and TNF-α) in order to assess cardiovascular risk in both groups of patients; To compare tomographic quantification accuracy of EAT by CT and MRI; To determine whether there is a correlation between EAT measured by CT and MRI and diabetes duration; To develop an algorithm for estimating EAT volume by semi-automatic and manual segmentation.Захарният диабет (ЗД) е едно от най-често срещаните метаболитни заболявания и се характеризира с нарушение на метаболизма на въглехидратите, протеините и липидите. Повишеното натрупване на висцерална мастна тъкан е рисков фактор за инсулинова резистентност, която може да намали инсулиновата чувствителност, да увеличи експресията и секрецията на противовъзпалителни цитокини в мастната тъкан и отключи развитието на ЗД и сърдечно-съдови заболявания. Епикардната мастна тъкан (ЕМТ) е вид висцерална мастна тъкан и в последните години ѝ се отдава значение на потенциален рисков фактор за ССЗ. В настоящото изследване сме си поставили за цел да проучим начина на образна оценка на ЕМТ, ролята на ЕМТ като биомаркер и клиничната й значимост като фактор за повишен сърдечно-съдов риск в корелация с други известни биомаркери. За постигане на дисертационната цел, си поставихме следните задачи: Да се определи дали корелация между ЕМТ измерена с КТ и ЯМР, липидния профил на пациентите , обиколката на талията, индекса на телесна маса (ИТМ) и висцералната мастна тъкан измерени с DEXA; Да се направи корелация на ЕМТ с възпалителните цитокини ( IL-6, IL-1 и TNF-α) за да се оцени сърдечно-съдовия риск; Да се сравни точността на томографската квантификация на ЕМТ с КТ и ЯМР; Да се определи дали има корелация между ЕМТ измерена с КТ и ЯМР и давността на диабета; Да се изработи алгоритъм за оценка на обема на епикардната мастна тъкан чрез полуавтоматично и ръчно сегментиране

The role of education and its link to metabolic control in patients with type 1 diabetes mellitus with long duration

Type 1 diabetes mellitus (T1DM) is a disease with constantly increasing incidence. Acquiring knowledge and diabetes skills is an invariable and important part of the disease treatment during all life cycles. The association between socioeconomic status and, in particular, the level of educational qualification and the metabolic control in patients with long-duration of T1DM is not enough studied. The results received in the current study show that there is, although weak, association between the level of education and the glycaemic control, the presence of dyslipidaemia, and obesity in patients with T1DM with long duration

Correlation between coronary calcium score and epicardial fat in patients with long-term type 1 diabetes and healthy controls – preliminary results

In recent years еpicardial adipose tissue has been reported to be an independent predictor of coronary risk, along with the already well established coronary calcium score. In our study we look for a corellation between these two markers in patients with long-term diabetes mellitus type 1 and healthy controls. Epicardial fat volume is quantified by semiautomatically and manually segmenting images acquired with computed tomography and magnetic resonance tomography. The two types of images demonstrate excellent correlation between them. A mild to moderate correlation between epicardial fat volume and coronary calcium score is found, regardless of which type of image the fat is calculated from