MR exponential image in ischemic stroke: A preliminary evaluation

AbstractBackground and purposeMagnetic resonance (MR) diffusion images, including both the diffusion-weighted image (DWI) and the apparent diffusion coefficient (ADC), allow detection of cerebral ischemic lesions within minutes of onset, and the contrast within the image is based on microscopic motion of the water. A third type of diffusion image can be created, “the exponential image”. Our goals were to evaluate the ability of exponential image in reflecting the changes in both DWI and ADC and whether it can replace these two sets of images in cerebral infarction patients.Patients and methodsA total of 51 patients were enrolled in the study, 47 were included in the analysis, and four were excluded from the study. Conventional and DW MRI were performed in 47 patients. For each patient DWI, ADC maps, and exponential images were reviewed and the change in signal intensity of the lesion compared with the contralateral normal side was measured (rSI) as well as the changes in (rADC).ResultsThere was a significant change in the rSIDW and rSIExp in late subacute and chronic stages (p<.001), however, rADC showed a significant decrease (p<.001) in hyperacute and acute stages, followed by a significant increase (p<.001) in the late subacute and chronic stages. rSIExp was highly correlated with the change in the rADC values in different stages of infarction (r=.72, p<.001). However, the changes in the rSIDW correlated less closely with the change in the rADC values (r=.35, (p<.05)).ConclusionExponential image offers a simple, more accurate replacement for both sets (DWI and ADC), by combining the advantages of both sets

Anatomic variations of intrahepatic bile ducts in the general adult Egyptian population: 3.0-T MR cholangiography and clinical importance

AbstractObjectiveTo describe the anatomical variations occurring in intrahepatic bile ducts (IHDs) and their frequencies in general adult Egyptian population using 3.0-T MR cholangiography (MRC) as well as its clinical importance to reduce the biliary complications of hepatobiliary surgery.Materials and methodsMRC was applied to a study group of 106 subjects (26 potential liver donors and 80 volunteers). Anatomical variations in IHDs were classified based on the variable insertion of right posterior hepatic bile duct (RPHD) using Huang classification.ResultsAccording to this classification, the frequencies of each type were as follows: Huang A1 (typical pattern): 63.2% (n=67), Huang A2: 10.4% (n=11), Huang A3: 17% (n=18), Huang A4, 7.5% (n=8), and Huang A5: 1.9% (n=2). Total frequency for atypical types (i.e. A2, A3, A4 and A5) was 36.8%. No significant difference was detected in the distance between RPHD insertion to the junction of right and left hepatic duct in-between these Huang types. This distance was short (<1cm) in 21 of subjects under Huang A classification. Twenty-one donors underwent intraoperative cholangiograms, of which twenty (95.2%) had similar classification in both intraoperative and MRC findings.ConclusionThe incidence of variant biliary anatomy in general Egyptian population (36.8%) as well as the presence of Huang type A with short distance (<1cm) between RPHD insertion and junction of right and left hepatic duct (19.8%) enhance the importance of MRC as a pre-operative tool before hepato-biliary surgical procedures to reduce post-operative biliary complications

Diffusion-weighted MRI in liver fibrosis staging: Added value of normalized ADC using spleen and renal cortex as reference organs

AbstractAimTo evaluate the potential value of the spleen and renal cortex as a reference organ to improve the performance of DWI in the assessment of liver fibrosis.Material and methods44 subjects were included: 30 patients with chronic viral hepatitis and 14 age matched volunteers. They were subjected to diffusion weighted MRI (DWI). Liver ADC, normalized ADC (ratio between ADC of liver to spleen (S-ADC) and renal cortex (R-ADC)) was calculated. Data was analyzed and ROC was used to evaluate the performance of ADC, S-ADC and R-ADC.ResultsNo significant difference between spleen ADC and renal ADC values between patient group and control group or in-betweens different fibrosis stages. The mean liver ADC was significantly lower in cirrhotic patients than control group (1.59±0.024 versus 1.55±0.036×10−3mm2/s, P=0.009) with some overlap in different fibrosis grades.With exception to stage 1 fibrosis, the mean S-ADC value was significantly lower in patients with different hepatic fibrosis stages in comparison to control group (P 0.02–<0.001). Significant negative correlation was noted between S-ADC value and fibrosis stage (r=−0.75, p<0.001). It had significant difference between stage 0 compared to stage 2, 3, and 4 as well as between stage 4 in comparison to stage 1, 2 and 3. S-ADC had a significant ability to differentiate between stages 0–1 Vs stage 2–4, stage 0–2 Vs stage 3–4 as well as stage 0–3 Vs stage 4.Significant negative correlation was noted between R-ADC value and fibrosis stage (r=−0.68, p<0.001). The mean R-ADC value was lower in patients with liver fibrosis compared to volunteers with significant difference between stage 0 and 3 and between stage 0 and 4 (P<0.001). It had significant difference between stage 0 compared to stage 3, and 4 as well as in stage 4 in comparison to stage 1 and 2. R-ADC has a significant ability to differentiate between stages 0–1 Vs stage 2–4, stage 0–2 Vs stage 3–4 as well as stage 0–3 Vs stage 4.ROC analysis showed higher performance using S-ADC in comparison to liver ADC and R-ADC while R-ADC had higher performance in comparison to liver ADC. The AUC, sensitivity, specificity, PPV, NPV and k-value for detection of fibrotic stages ⩾2 (0.85, 95.8%, 60%, 74%, 92% and 0.85 for S-ADC Vs 0.68, 66.7%, 60%, 66%, 60% and 0.28 for ADC and 0.85, 95.8%, 50%, 69%, 91% and 0.47 for R-ADC). and in detection of fibrotic stages ⩾3 was (0.86, 100%, 52%, 61%, 100% and 0.48 for S-ADC Vs 0.63, 63%, 52%, 50%, 65% and 0.14 for ADC and 0.88, 100%, 44%, 57%, 100% and 0.40 for R-ADC) while for fibrosis stage 4, the corresponding values was (1, 100%, 100%, 100%, 100% and 1 for S-ADC Vs 0.7, 81%, 54%, 37%, 90% and 0.26 for ADC and 0.65, 100%, 65%, 45%, 100% and 0.43 for R-ADC) respectively.ConclusionNormalized liver ADC using the spleen and kidney increases the performance of ADC in the evaluation of liver fibrosis which is highest in spleen normalized ADC

Search for new particles in events with energetic jets and large missing transverse momentum in proton-proton collisions at root s=13 TeV

A search is presented for new particles produced at the LHC in proton-proton collisions at root s = 13 TeV, using events with energetic jets and large missing transverse momentum. The analysis is based on a data sample corresponding to an integrated luminosity of 101 fb(-1), collected in 2017-2018 with the CMS detector. Machine learning techniques are used to define separate categories for events with narrow jets from initial-state radiation and events with large-radius jets consistent with a hadronic decay of a W or Z boson. A statistical combination is made with an earlier search based on a data sample of 36 fb(-1), collected in 2016. No significant excess of events is observed with respect to the standard model background expectation determined from control samples in data. The results are interpreted in terms of limits on the branching fraction of an invisible decay of the Higgs boson, as well as constraints on simplified models of dark matter, on first-generation scalar leptoquarks decaying to quarks and neutrinos, and on models with large extra dimensions. Several of the new limits, specifically for spin-1 dark matter mediators, pseudoscalar mediators, colored mediators, and leptoquarks, are the most restrictive to date.Peer reviewe

Combined searches for the production of supersymmetric top quark partners in proton-proton collisions at root s=13 TeV

A combination of searches for top squark pair production using proton-proton collision data at a center-of-mass energy of 13 TeV at the CERN LHC, corresponding to an integrated luminosity of 137 fb(-1) collected by the CMS experiment, is presented. Signatures with at least 2 jets and large missing transverse momentum are categorized into events with 0, 1, or 2 leptons. New results for regions of parameter space where the kinematical properties of top squark pair production and top quark pair production are very similar are presented. Depending on themodel, the combined result excludes a top squarkmass up to 1325 GeV for amassless neutralino, and a neutralinomass up to 700 GeV for a top squarkmass of 1150 GeV. Top squarks with masses from 145 to 295 GeV, for neutralino masses from 0 to 100 GeV, with a mass difference between the top squark and the neutralino in a window of 30 GeV around the mass of the top quark, are excluded for the first time with CMS data. The results of theses searches are also interpreted in an alternative signal model of dark matter production via a spin-0 mediator in association with a top quark pair. Upper limits are set on the cross section for mediator particle masses of up to 420 GeV

Probing effective field theory operators in the associated production of top quarks with a Z boson in multilepton final states at root s=13 TeV

Peer reviewe

Measurement of the top quark mass using events with a single reconstructed top quark in pp collisions at root s=13 TeV

Abstract:A measurement of the top quark mass is performed using a data sample en-riched with single top quark events produced in thetchannel. The study is based on proton-proton collision data, corresponding to an integrated luminosity of 35.9 fb−1, recorded at√s= 13TeV by the CMS experiment at the LHC in 2016. Candidate events are selectedby requiring an isolated high-momentum lepton (muon or electron) and exactly two jets,of which one is identified as originating from a bottom quark. Multivariate discriminantsare designed to separate the signal from the background. Optimized thresholds are placedon the discriminant outputs to obtain an event sample with high signal purity. The topquark mass is found to be172.13+0.76−0.77GeV, where the uncertainty includes both the sta-tistical and systematic components, reaching sub-GeV precision for the first time in thisevent topology. The masses of the top quark and antiquark are also determined separatelyusing the lepton charge in the final state, from which the mass ratio and difference aredetermined to be0.9952+0.0079−0.0104and0.83+1.79−1.35GeV, respectively. The results are consistentwithCPTinvariance

Search for a heavy Higgs boson decaying into two lighter Higgs bosons in the tau tau bb final state at 13 TeV

A search for a heavy Higgs boson H decaying into the observed Higgs boson h with a mass of 125 GeV and another Higgs boson h(S) is presented. The h and h(S) bosons are required to decay into a pair of tau leptons and a pair of b quarks, respectively. The search uses a sample of proton-proton collisions collected with the CMS detector at a center-of-mass energy of 13TeV, corresponding to an integrated luminosity of 137 fb(-1). Mass ranges of 240-3000 GeV for m(H) and 60-2800 GeV for m(hS) are explored in the search. No signal has been observed. Model independent 95% confidence level upper limits on the product of the production cross section and the branching fractions of the signal process are set with a sensitivity ranging from 125 fb (for m(H) = 240 GeV) to 2.7 fb (for m(H) = 1000 GeV). These limits are compared to maximally allowed products of the production cross section and the branching fractions of the signal process in the next-to-minimal supersymmetric extension of the standard model.Peer reviewe

Observation of tW production in the single-lepton channel in pp collisions at root s=13 TeV

A measurement of the cross section of the associated production of a single top quark and a W boson in final states with a muon or electron and jets in proton-proton collisions at root s = 13 TeV is presented. The data correspond to an integrated luminosity of 36 fb(-1) collected with the CMS detector at the CERN LHC in 2016. A boosted decision tree is used to separate the tW signal from the dominant t (t) over bar background, whilst the subleading W+jets and multijet backgrounds are constrained using data-based estimates. This result is the first observation of the tW process in final states containing a muon or electron and jets, with a significance exceeding 5 standard deviations. The cross section is determined to be 89 +/- 4 (stat) +/- 12 (syst) pb, consistent with the standard model.Peer reviewe

Measurement of the W gamma Production Cross Section in Proton-Proton Collisions at root s=13 TeV and Constraints on Effective Field Theory Coefficients

A fiducial cross section for W gamma production in proton-proton collisions is measured at a center-of-mass energy of 13 TeV in 137 fb(-1) of data collected using the CMS detector at the LHC. The W -> e nu and mu nu decay modes are used in a maximum-likelihood fit to the lepton-photon invariant mass distribution to extract the combined cross section. The measured cross section is compared with theoretical expectations at next-to-leading order in quantum chromodynamics. In addition, 95% confidence level intervals are reported for anomalous triple-gauge couplings within the framework of effective field theory.Peer reviewe