Magnetic resonance study on fractional anisotropy and neuronal metabolite ratios in peritumoral area of cerebral gliomas

Background and Objective. Cerebral gliomas have a tendency to infiltrate the surrounding brain tissue for several centimeters from the core of tumor. The usefulness of structural magnetic resonance (MR) sequences is limited because of their insensitivity for the detection of tumor cells outside the visible tumor border. The aim of this study wasto investigate the validity and the repeatability of 2 functional MR methods: fractional anisotropy (FA) and spectroscopy in the assessment of the peritumoral area of cerebralgliomas. Material and Methods. Forty-five patients with histologically verified brain gliomas underwent diffusion tensor imaging (DTI) and MR spectroscopy (MRS). Metabolic ratios were calculated from choline (Cho), creatine (Cr), N-acetylaspartate (NAA), lactate/lipids (LL), myo-inositol (MI) spectroscopic values obtained within the tumor center, perifocal edema, and distant and contralateral normal-appearing white matter. DTI maps of FAwere calculated at the same locations. Results. A significant gradual increase of FA anda decrease of LL/Cr ratios from the tumor center to the normal-appearing white matter were observed. The Cho/Cr ratio was significantly lower in the distant normal-appearing white matter than in the perifocal edema and the tumor center. The NAA/Cr ratio was significantly reduced in the tumor center, perifocal edema, and distant normal-appearing whitematter compared with the contralateral hemisphere. MRS and DTI measurements of glioma and peritumoral area had a high degree of repeatability. Conclusions. Our study shows thatMRS and DTI measurements are reproducible. The combined use of Cho/Cr, LL/Cr, and FA measurements is a promising MR technique that provides valuable additional information about the location of glioma potential border.Peer reviewe

Three-dimensional evaluation of TMJ parameters in Class II and Class III patients

The aim of our study was to assess condylar parameters and condyle position within glenoid fossa of TMJ in volumetric 3D imaging in patients with Class II and Class III malocclusions. MATERIALS AND METHODS. The study group included 15 patients with severe skeletal Class II (mean age 18.0 yrs) and 14 patients with severe skeletal Class III ( mean age 19,2 yrs) with an indication for combined orthodontic and orthognathic treatment. CT examination was performed, pictures were reconstructed in three - dimensional (3D) rendering and measured in two dimension projection (2D) pictures using IAC review and Transparent bone programs to quantify following condylar and glenoid fossa parameters - glenoid fossa width and height; tuberculum articulare angle; anterior, superior and posterior joint space; height and width of condyle, height of procesus condylaris. Mean values were calculated separately for left and right side. Differences of the mean values were tested using paired t-test. RESULTS. There were statistically significant differences (p<0,05) between two study groups for all spatial measurements on both sides with larger spatial measurements in patients with Class II malocclusions. Also the height of procesus condylaris varied between groups with statistical difference. Unilateral differences were detected for width of fossa glenoidale and height of condyle. CONCLUSION. Results show that there are a tendency for smaller condyle and wider spaces between condyle and walls of glenoid fossa comparing TMJ of Class II with Class III patients.publishersversionPeer reviewe

The relationship between mandibular rotation and osseous structure of the TMJ in pre-surgery orthognathic patients : A cone beam CT study

The aim of the study was to assess the relationship between vertical skeletal pattern in terms of mandibular rotation and osseous structural changes of the TMJ in pre- surgical orthognatic patients. TMJ skeletal morphology was evaluated in cone beam computer tomography images of 117 consecutive patients with Class II and Class III dentofacial deformities according to the research diagnostic criteria of the osseous components of the TMJ related to the maxillary-mandibular plane (MM) angle. The distribution of the number and percentage of joints with structural changes in Class II was markedly different in groups divided according to the MM angle. Statistically significant increase was found in the percentage of TMJ's with osseous changes separately for each side, i.e., right (p=0.001), left (p=0.04) and both together (p=0.0001), in the Class II patient group, an increased MM angle indicated backward rotation of the mandible. In Class III patients, there were no statistically significant differences in the number of joints with TMJ structural changes. The presence of mentioned changes was asymmetrical between the left and right joints in both the Class II and Class III patient groups. In conclusion, structural changes in the osseous parts of the TMJ are more common in patients with Class II skeletal dentofacial deformities with backward rotation of the mandible than in Class III pre-surgery orthognathic patients.publishersversionPeer reviewe

The Influence of Bowel Preparation on ADC Measurements: Comparison between Conventional DWI and DWIBS Sequences

Background and objectives: The aim of the study was to assess whether there were di ff erences between apparent di ff usion coe ffi cient (ADC) values of di ff usion-weighted imaging (DWI) and di ff usion-weighted imaging with background body signal suppression (DWIBS) sequences in non-prepared and prepared bowels before and after preparation with an enteric hyperosmolar agent, to assess whether ADC measurements have the potential to avoid bowel preparation and whether ADC-DWIBS has advantages over ADC-DWI. Materials and Methods: 106 adult patients without evidence of inflammatory bowel disease (IBD) underwent magnetic resonance (MR) enterography before and after bowel preparation. ADC-DWI and ADC-DWIBS values were measured in the intestinal and colonic walls demonstrating high signal intensity (SI) at DWI tracking images of b = 800 s /mm2 before and after preparation. Results: There were significant di ff erence (p < 0.0001) in both ADC-DWI and ADC-DWIBS results between non-prepared and prepared jejunum for DWI being 1.09 x 10 3 mm2 /s and 1.76 x 10 3 mm2 /s, respectively, and for DWIBS being 0.91 x 10 3 mm2 /s and 1.75 x 10 3 mm2 /s, respectively. Both ADC-DWI and DWIBS also showed significant di ff erence between non-prepared and prepared colon (p < 0.0001), with DWI values 1.41 x 10 3 mm2 /s and 2.13 x 10 3 mm2 /s, and DWIBS-1.01 x 10 3mm2 /s and 2.04 x 10 3mm2 /s, respectively. Nosignificant di ff erence between ADC-DWI and ADC-DWIBS was found in prepared jejunum (p = 0.84) and prepared colon (p = 0.58), whereas a significant di ff erence was found in non-prepared jejunum and non-prepared colon (p = 0.0001 in both samples). Conclusions: ADC between DWI and DWIBS does not di ff er in prepared bowel walls but demonstrates a di ff erence in non-prepared bowel. ADC in non-prepared bowel is lower than in prepared bowel and possible overlap with the ADC range of IBD is possible in non-prepared bowel. ADC-DWIBS has no advantage over ADC-DWI in regard to IBD assessment.publishersversionPeer reviewe

Leukocytosis and C-Reactive Protein May Predict Development of Secondary Cerebral Vasospasm in Patients with Aneurysmal Subarachnoid Hemorrhage

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.Background and Objectives: Secondary cerebral vasospasm (CV) with subsequent delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) remains an unpredictable pathology. The aim of this retrospective study was to investigate the association between inflammatory parameters, white blood cell (WBC) count, and C-reactive protein plasma levels (CRP) and the occurrence of secondary CV in patients with aSAH. Materials and Methods: The medical records of 201 Intensive Care Unit patients in Riga East University Hospital with aSAH were retrospectively reviewed in a 24-month period. WBC count and CRP values were observed at admission to the hospital and on the third day. According to the inclusion criteria, 117 (48 males) participants were enrolled for further analysis, with average age of 56 ± 15 years (mean ± SD). In total, secondary CV was diagnosed in 21.4% of cases, and DCI in 22.4% of cases. The patients were classified into three groups: SAH-CV group (n = 25), SAH-DCI group (n = 12), and SAH or control group (n = 80), for comparative analysis. Results: We found that SAH-CV patients demonstrated notably higher inflammatory parameters compared to controls: WBC 13.2 ± 3.3 × 109 /L vs. 11.2 ± 3.7 × 109 /L; p = 0.01 and CRP median 9.3 mg/L vs. 1.9 mg/L; p <0.001, respectively. We found that the odds of developing CV increased by 5% for each CRP increase of 1 mg/L at admission (OR, 1.05; CI, 1.014–1.087; p = 0.006). Concomitantly, the odds increased by 16% for every rise in WBC count of 1 × 109 /L (OR, 1.16; CI, 1.02–1.32; p = 0.02). WBC count was associated with the occurrence of CV with 96% sensitivity and 40% specificity, with a cut off level of 10.015 × 109 /L and AUC 0.683; p = 0.006. CRP displayed 54% sensitivity and 90% specificity with a cut off value of 8.9 mg/L and AUC 0.751; p < 0.001. Moreover, higher values of inflammatory parameters at admission correlated with a longer stay in ICU (r = 0.3, p = 0.002 for WBC count and r = 0.305, p = 0.002 for CRP values), and poor outcome (death) was significantly associated with higher CRP values at admission and on the third day (16.1. vs. 2.2. and 57.4. vs. 11.1, p < 0.001, respectively). Higher mortality was detected in SAH-CV patients (32%) compared to controls (6.3%; p < 0.001). Conclusions: Inflammatory parameters such as WBC count and CRP values at admission might be helpful to predict the development of secondary CV.publishersversionPeer reviewe

Three-dimensional evaluation of musculoskeletal in Class II and Class III patients

To evaluate and compare dimensional morphology of masseter and medial pterygoid muscles and mandibular skeletal parameters between subjects with skeletal Class II and Class III. The sample consisted of 13 patients with skeletal Class II and 10 patients with skeletal Class III prior to the start of combined orthodontic treatment and orthognathic surgery with correspondence to definite inclusion and exclusion criteria. Magnetic resonance imaging was performed for mandibular muscles and following 2D and 3D measurements were done: cross-sectional area (CSA), thickness, width, longitudinal dimension and volume. 3D multi-slice computed tomography investigation was performed for the assessment of skeletal mandibular parametres and following measurements were done: height of mandibular ramus, length af mandibular corpus, overall mandibular length, intergonial width. All the measurements were done bilaterally. Data were analyzed using descriptive statistics, t-test, and correlation coefficients. It was found that values of all mandibular and medial pterygoid measurements were higher in Class III subjects with statistical significance (p<0.05). There was a tendency of all masseter variables to be higher in Class III patients. Positive correlations were found between muscles' volume and CSA in both groups, muscles' volume and all mandibular parameters in Class II group, CSAs and all mandibular variables except intergonial width in Class II group. Overall symmetry was observed between left and right sides in all muscular and mandibular measurements in both groups. The data were acquired using two different imaging techniques - MRI and MSCT that can be mentioned as a novelty in this field of research. Remarkable differences were observed between study groups for both skeletal and muscular measurements.publishersversionPeer reviewe