The presence of macroscopic vessels within the tumor region is a potential confounding factor in MR-based dynamic susceptibility contrast (DSC)-enhanced glioma grading. In order to distinguish between such vessels and the elevated cerebral blood volume (CBV) of brain tumors, we propose a vessel segmentation technique based on clustering of multiple parameters derived from the dynamic contrast-enhanced first-pass curve. A total of 77 adult patients with histologically-confirmed gliomas were imaged at 1.5T and glioma regions-of-interest (ROIs) were derived from the conventional MR images by a neuroradiologist. The diagnostic accuracy of applying vessel exclusion by segmentation of glioma ROIs with vessels included was assessed using a histogram analysis method and compared to glioma ROIs with vessels included. For all measures of diagnostic efficacy investigated, the highest values were observed when the glioma diagnosis was based on vessel segmentation in combination with an initial mean transit time (MTT) mask. Our results suggest that vessel segmentation based on DSC parameters may improve the diagnostic efficacy of glioma grading. The proposed vessel segmentation is attractive because it provides a mask that covers all pixels affected by the intravascular susceptibility effect.
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http://dx.doi.org/10.1002/mrm.21944 | DOI Listing |
Acta Neurochir (Wien)
January 2025
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, 226014, Uttar Pradesh, India.
Background: Reaching parenchymal segments of the lateral lenticulostriate artery (LSA) perforators, which represent the medial resection limit in insular gliomas (IG), remains a challenge. The currently described methods are indirect and sometimes, imprecise.
Methods: We report an antegrade direct skeletonization technique to identify these tiny arteries at the medial end of IGs with an illustrative case of grade 2 astrocytoma.
J Clin Med
January 2025
Department of Neurosurgery, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
The management of multiple intracranial aneurysms presents significant clinical challenges, particularly when complicated by underlying conditions such as cerebral atherosclerosis. This case report highlights the successful treatment of a 66-year-old female diagnosed with three intracranial aneurysms located in the right middle cerebral artery (MCA), pericallosal artery, and M2 segment. The patient also had a history of systemic atherosclerosis and right-sided breast cancer, factors that increased the complexity of surgical intervention.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Surgery, Kurume University School of Medicine, Fukuoka 830-0011, Japan.
Endovascular stent graft repair was developed to minimize the invasiveness of open surgery for thoracic and abdominal aortic diseases. This approach involves covering the diseased segment with a stented artificial graft. However, in thoracic endovascular aortic repair (TEVAR) for aortic arch diseases, special consideration is needed to preserve the aortic arch vessels.
View Article and Find Full Text PDFInt J Mol Sci
December 2024
Department of Vascular Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany.
Thoracoabdominal aortic aneurysms (TAAAs) are rare but serious conditions characterized by dilation of the aorta characterized by remodeling of the vessel wall, with changes in the elastin and collagen content. Individuals with Marfan syndrome have a genetic predisposition for elastic fiber fragmentation and elastin degradation and are prone to early aneurysm formation and progression. Our objective was to analyze the medial collagen characteristics through histological, polarized light microscopy, and electron microscopy methods across the thoracic and abdominal aorta in twenty-five patients undergoing open surgical repair, including nine with Marfan syndrome.
View Article and Find Full Text PDFMultimed Man Cardiothorac Surg
January 2025
Respiratory Disease Center, Kyoto Katsura Hospital, Kyoto, Japan.
The plane running between two adjacent pulmonary segments consists of a very thin layer of connective tissue through which the pulmonary vein also runs. To perform an anatomically correct segmentectomy, this segmental plane needs to be divided. Before the operation, the locations of vessels and bronchi are confirmed by three-dimensional computed tomography.
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