Perfusion in ENT imaging

AbstractPerfusion MRI is an essential part of characterizing salivary gland tumors. The shape of the curves can provide a guide as to the type of lesion: benign (ascending plateau) or malignant (descending plateau), and can also occasionally strongly suggest a histological type such as a Warthin tumor (intense, rapid contrast enhancement with washout>30%). Perfusion imaging (CT or MRI) for other head and neck tumors is currently being developed and is being assessed. It should be a tool to assist in choosing the most appropriate initial treatment (chemotherapy, radiotherapy or surgery) and should also allow poor responders to conservative treatment to be identified and recurrences to be detected in post-treatment damaged tissues. Aims: (a) to determine when to perform perfusion MRI; (b) to determine the type of perfusion to carry out: CT, T1-weighted MRI; (c) to determine how to position the region of interest to plot the perfusion curve; (d) to know how to interpret MRI curves for salivary gland tumors; (e) to know how to interpret the information obtained from perfusion CT or MRI for the upper aerodigestive tract

Medial Axis Approximation with Constrained Centroidal Voronoi Diagrams On Discrete Data

International audienceIn this paper, we present a novel method for me-dial axis approximation based on Constrained Centroidal Voronoi Diagram of discrete data (image, volume). The proposed approach is based on the shape boundary subsampling by a clustering approach which generates a Voronoi Diagram well suited for Medial Axis extraction. The resulting Voronoi Diagram is further filtered so as to capture the correct topology of the medial axis. The resulting medial axis appears largely invariant with respect to typical noise conditions in the discrete data. The method is tested on various synthetic as well as real images. We also show an application of the approximate medial axis to the sizing field for triangular and tetrahedral meshing

Static and dynamic responses to hyperoxia of normal placenta across gestation with T2*-weighted sequences

OBJECTIVES: T2*-weighted sequences have been identified as non-invasive tools to study the placental oxygenation in-vivo. This study aims to investigate both static and dynamic responses to hyperoxia of the normal placenta across gestation.METHODS: We conducted a single-center prospective study including 52 uncomplicated pregnancies. Two T2*-weighted sequences were performed: T2*-relaxometry was performed before and after maternal hyperoxia. The histogram distribution of T2* values was assessed by fitting a gamma distribution as T2*~Γ(αβ). A dynamic acquisition (BOLD protocol) was also performed before and during oxygen supply, until placental oxygen saturation. The signal change over time was modeled using a sigmoid function, used to determine the intensity of enhancement (∆BOLD,%), a temporal variation coefficient (λ,min -1 , controlling the slope of the curve), and the maximal steepness (Vmax, ∆BOLD.min -1 ) of placental enhancement. RESULTS: The histogram analysis of the T2* values in normoxia showed a whole-placenta variation, with a decreasing linear trend in the mean T2* value (R= -0.83, 95% CI [-0.9, -0.71], p&lt;0.001) along with a more peaked and narrower distribution of T2* values across gestation. After maternal hyperoxia, the mean T2* ratios (mean T2* hyperoxia / mean T2* baseline ) were positively correlated with gestational age, while the other histogram parameters remained stable, suggesting a translation of the histogram towards higher values with a similar aspect. The ∆BOLD showed a non-linear increase across gestation. Conversely, the λ(min -1 ) parameter, showed an inverted trend across gestation, with a significantly weaker correlation (R = -0.33, 95% CI [-0.58, -0.02], p=0.04, R 2 = 0.1). As a combination of ∆BOLD and λ, the changes in Vmax throughout gestation were mainly influenced by the changes in ∆BOLD and resulted in a positive non-linear correlation with gestational age. CONCLUSION: Our results suggest that the decrease in the T2* placental signal over gestation does not reflect a dysfunction. The BOLD effect, representative of a free-diffusion model of oxygenation, highlights the growing differences in oxygen saturation between mother and fetus across gestation (∆BOLD), and placental permeability to oxygen (λ). This article is protected by copyright. All rights reserved.</p

Fetal Liver Volume Assessment Using Magnetic Resonance Imaging in Fetuses With Cytomegalovirus Infection

Objective: To assess fetal liver volume (FLV) by magnetic resonance imaging (MRI) in cytomegalovirus (CMV)-infected fetuses compared to a group of healthy fetuses. Method: Most infected cases were diagnosed by the evidence of ultrasound abnormalities during routine scans and in some after maternal CMV screening. CMV-infected fetuses were considered severely or mildly affected according to prenatal brain lesions identified by ultrasound (US)/MRI. We assessed FLV, the FLV to abdominal circumference (AC) ratio (FLV/AC-ratio), and the FLV to fetal body volume (FBV) ratio (FLV/FBV-ratio). As controls, we included 33 healthy fetuses. Hepatomegaly was evaluated post-mortem in 11 cases of congenital CMV infection. Parametric trend and intraclass correlation analyses were performed. Results: There were no significant differences in FLV between infected (n = 32) and healthy fetuses. On correcting the FLV for AC and FBV, we observed a significantly higher FLV in CMV-infected fetuses. There were no significant differences in the FLV, or the FLV/AC or FLV/FBV-ratios according to the severity of brain abnormalities. There was excellent concordance between the fetal liver weight estimated by MRI and liver weight obtained post-mortem. Hepatomegaly was not detected in any CMV-infected fetus. Conclusion: In CMV-infected fetuses, FLV corrected for AC and FBV was higher compared to healthy controls, indicating relative hepatomegaly. These parameters could potentially be used as surrogate markers of liver enlargement. Keywords: fetal brain abnormalities; fetal cytomegalovirus infection; fetal liver; magnetic resonance imaging; pregnancy

O2-Filled Swimbladder Employs Monocarboxylate Transporters for the Generation of O2 by Lactate-Induced Root Effect Hemoglobin

The swimbladder volume is regulated by O2 transfer between the luminal space and the blood In the swimbladder, lactic acid generation by anaerobic glycolysis in the gas gland epithelial cells and its recycling through the rete mirabile bundles of countercurrent capillaries are essential for local blood acidification and oxygen liberation from hemoglobin by the “Root effect.” While O2 generation is critical for fish flotation, the molecular mechanism of the secretion and recycling of lactic acid in this critical process is not clear. To clarify molecules that are involved in the blood acidification and visualize the route of lactic acid movement, we analyzed the expression of 17 members of the H+/monocarboxylate transporter (MCT) family in the fugu genome and found that only MCT1b and MCT4b are highly expressed in the fugu swimbladder. Electrophysiological analyses demonstrated that MCT1b is a high-affinity lactate transporter whereas MCT4b is a low-affinity/high-conductance lactate transporter. Immunohistochemistry demonstrated that (i) MCT4b expresses in gas gland cells together with the glycolytic enzyme GAPDH at high level and mediate lactic acid secretion by gas gland cells, and (ii) MCT1b expresses in arterial, but not venous, capillary endothelial cells in rete mirabile and mediates recycling of lactic acid in the rete mirabile by solute-specific transcellular transport. These results clarified the mechanism of the blood acidification in the swimbladder by spatially organized two lactic acid transporters MCT4b and MCT1b

Le sujet-temoin

Les œuvres de Madhva, comme celles de ses disciples font fréquemment appel à l’expérience comme à la règle même de la vérité. L’honneur en lequel elle est tenue ne saurait faire de doute, lorsqu’on la voit mise en parallèle constant avec la connaissance transmise par le livre du Savoir, le Veda, Tradition, Āgama, Audition, Śruti, entendue par les premiers ṛṣi. Madhva nomme de même l’expérience et la tradition upajīvya pramāṇa, c’est-à-dire sources de vérités donnant leur subsistance à toutes ..

Existence et relations

Le monde, tel qu’il est donné à l’expérience, est constitué d’objets multiples, distincts du sujet pensant, et séparés les uns des autres. Ces objets appartiennent ensemble à un même monde, étant insérés en un unique contexte spatio-temporel, condition nécessaire de nos jugements de réalité. Mais à l’intérieur de ce cadre règne, semble-t-il, un absolu pluralisme : chaque réalité est, par essence propre, svarūpa, différente des autres ; la juxtaposition de deux réalités fait aussitôt apparaîtr..

Conclusion

La tension entre le non-dualisme et le dualisme domine incontestablement toute l’histoire de la pensée du Vedānta. En face de l'advaita de Śaṅkara, le système de Madhva représente l’extrême dualisme, dvaita, et entre ces deux pôles se situent les diverses et nombreuses écoles qui se refusent à accepter les conséquences ultimes du non-dualisme. Mais il est certain que l’équilibre de toutes ces pensées se place de lui-même autour du non-dualisme et que la position de Madhva représente seule le ..