Recent advances in medical image processing for the evaluation of chronic kidney disease.

Tuberculosis of the liver

Aktuelle epidemiologische Daten zeigen in den letzten Jahren einen Anstieg der Tuberkulose im Kindes- und Jugendalter. Es findet sich zudem auch in Deutschland ein Anstieg von Infektionen mit gegenuber Tuberkulosemedikamenten resistenten Erregern. In diesem Zusammenhang stellt die Diagnose, Pravention und Therapie der Tuberkulose vor allem im Kindesalter eine Herausforderung dar. Leitlinien fur die Diagnostik und Therapie der Tuberkulose im Erwachsenenalter konnen nicht generell auf das Kindesalter ubertragen werden, da hier relevante altersabhangige Unterschiede bzgl. der Krankheitsprogression, Krankheitsmanifestation, Unterschiede in der Anwendung von diagnostischen Masnahmen und der Therapie bestehen. Unter Federfuhrung der Deutschen Gesellschaft fur Padiatrische Infektiologie (DGPI) e. V. wurde die S2k-Leitlinie fur die Diagnostik, Pravention und Therapie der Tuberkulose im Kindes- und Jugendalter verfasst, um die adaquate Versorgung von Kindern und Jugendlichen mit Tuberkulose-Exposition, Infektion oder Erkrankung nach neuesten wissenschaftlichen Erkenntnissen zu sichern. Aktualisierte Dosierungsempfehlungen berucksichtigen die altersabhangige Pharmakokinetik in der Therapie der medikamentensensiblen, aber auch resistenten Tuberkulose. Daruber hinaus werden die Themen perinatale Exposition und Erkrankung sowie die im Kindesalter haufigeren extrapulmonalen Manifestationsformen gesondert behandelt.

https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0043-116545.pdf

S2k-Leitlinie zur Diagnostik, Prävention und Therapie der Tuberkulose im Kindes- und Jugendalter : Eine Leitlinie unter Federführung der Deutschen Gesellschaft für Pädiatrische Infektiologie (DGPI) e. V.

Background There is increasing evidence that breast arterial calcification (BAC), an incidental finding on 3-29% of mammograms, could be used to screen for coronary artery disease (CAD). We conducted a systematic review to assess the associations between BAC and CAD and its risk factors (hypertension, hypercholesterolemia, diabetes mellitus and smoking). Methods and findings MEDLINE and EMBASE databases and references of relevant papers were searched up to 18 February 2020 for English language studies that evaluated the associations of BAC and CAD and its risk factors. A single reviewer extracted all data and assessed study quality with verification by another independent reviewer, if required. Across 31 studies (n = 35,583; 3 longitudinal and 28 cross-sectional studies) that examined the association of BAC and CAD, the OR was 2.61 (95% CI 2.12-3.21; I2 = 71%). Sub-analysis of studies that graded BAC severity using the 4- (4 studies) or 12-point scale systems (3 studies) revealed an association with CAD and moderate-severe BAC (OR 4.83 (95%CI 1.50-15.54) and OR 2.95 (95%CI 1.49-5.84), respectively) but not mild BAC (OR 2.04 (95%CI 0.82-5.05) and OR 1.08 (95%CI 0.42-2.75), respectively). BAC was associated with hypertension (42 studies; n = 32,646; OR 1.80; 95% CI 1.47-2.21; I2 = 85%) and diabetes mellitus (51 studies; n = 53,464; OR 2.17; 95% CI 1.82-2.59; I2 = 75%) but not with hypercholesterolemia (OR 1.31; 95%CI 0.97-1.77; I2 = 67%). Smoking was inversely associated with BAC (35 studies; n = 40,002; OR 0.54; 95% CI 0.42-0.70; I2 = 83%). Studies mostly included symptomatic women. Marked heterogeneity existed and publication bias may be present. Conclusions BAC is associated with CAD, diabetes mellitus and hypertension and inversely associated with smoking. Whether BAC could screen for CAD cannot be determined from current published data due to the lack of larger prospective studies. A consensus approach to quantifying BAC may also facilitate further translation into clinical care. PROSPERO: CRD42020141644.

/pdf/is-breast-arterial-calcification-associated-with-coronary-1zs6g7lk19.pdf

Is breast arterial calcification associated with coronary artery disease?-A systematic review and meta-analysis.

OBJECTIVE. Tuberculosis (TB) may present with highly variable imaging findings. The findings may vary from nonspecific hepatomegaly to abscesses or solid focal lesions, mimicking liver tumors. Biliary tract involvement may also be detected, which may manifest with ductal dilatations from underlying strictures. CONCLUSION. All cross-sectional imaging modalities, including sonography, CT, and MRI, may be used in the evaluation of patients with TB. Imaging findings may be perplexing to radiologists, particularly ones who practice in areas where TB is not endemic; thus, histopathologic diagnosis may be required.

Hepatobiliary Tuberculosis: Imaging Findings

We aim to illustrate the multimodal imaging spectrum of hepatic involvement in tuberculosis (TB). Whilst disseminated tuberculosis on imaging typically manifests as multiple small nodular lesions scattered in the liver parenchyma, isolated hepatic tuberculosis remains a rare and intriguing entity. Indubitably, imaging is the mainstay for detection of tubercular hepatic lesions which display a broad spectrum of imaging manifestations on different modalities. While sonography and computed tomography (CT) findings have been described in some detail, there is a paucity of literature on magnetic resonance imaging (MRI) features. Due to a significant overlap with other commoner and similar appearing hepatic lesions, hepatic tuberculosis is often either misdiagnosed or labelled as indeterminate lesions. This article is a compendium of cases highlighting the spectrum of imaging patterns that can be encountered in patients with isolated primary hepatic tuberculosis as well as disseminated (secondary) disease. Rare patterns of primary disease such as tubercular cholangitis, hypervascular liver masses, and those with vascular complications are also illustrated and discussed. Imaging plays a valuable role in the detection of tubercular hepatic lesions. Also, imaging can be helpful in their characterisation and for assessing associated complications. • Hepatic TB has myriad imaging manifestations and is often confounded with neoplastic lesions.
 • Imaging patterns include miliary TB, macronodular TB, serohepatic TB and tubercular cholangitis.
 • Concurrent splenic, nodal or pulmonary involvements are helpful pointers towards the diagnosis.
 • Miliary calcifications along the bile ducts are characteristic of tubercular cholangitis.
 • Histological/microbiological confirmation is often necessary to confirm the diagnosis.

/pdf/hepatic-tuberculosis-a-multimodality-imaging-review-950l78d72o.pdf

Hepatic tuberculosis: a multimodality imaging review

Peripheral nerve sheath tumors are categorized into benign and malignant forms, comprising of neurofibroma and schwannoma in the benign category and malignant peripheral nerve sheath tumors in the malignant category. Magnetic resonance imaging plays an important role in the diagnosis of these lesions. The various imaging features and signs that help to identify and characterize a nerve sheath tumor are, distribution of the tumor along a major nerve, an entering or exiting nerve sign, target sign, a fascicular sign and a split-fat sign.

Telltale signs of peripheral neurogenic tumors on magnetic resonance imaging

Context: Diffusion Tensor Imaging (DTI) is a reliable noninvasive tool to assess renal function with medullary Fractional Anisotropy (FA) values showing the most consistent results. Aims: Evaluation of FA, Apparent Diffusion Coefficient (ADC) for detecting diabetic nephropathy (DN) using 1.5-Tesla magnetic resonance imaging (MRI). To determine FA and ADC values in chronic kidney disease (CKD) patients and controls, and comparing these with estimated glomerular filtiration rate (eGFR) and categorizing the stage of CKD. Patients and Methods: Thirty nondiabetic volunteers underwent DTI.The study included 83 diabetics, 30 frank urine proteinuric, 30 micro-albuminuric, 23 normo-albuminuric with only raised blood sugar patients.Patients were stratified by eGFR into groups: eGFR 60ml/min. ADC and FA values in cortex and medulla were compared between controls and study groups. Statistical Analysis Used: Analysis of variance and Pearson correlation using SPSS 16 were performed. Results: There was significant difference of FA medulla in controls versus albuminuric and micro-albuminuric versus frank proteinuric patients (P 60 and eGFR

/pdf/role-of-diffusion-tensor-imaging-in-renal-parenchymal-1l6dfqfk6t.pdf

Role of Diffusion Tensor Imaging in renal parenchymal changes.

Purpose To assess the relationship between breast arterial calcification (BAC) on mammography and carotid intima medial thickness (C-IMT) by comparing these patients with healthy control subjects. Material and methods The study included 100 women divided into two groups based on presence of BAC on mammography using the WIPRO GE - DMR PLUS mammography unit. The groups included 50 BAC(+) (case group) and 50 BAC(-) (control group). BAC is defined as two linear calcific deposits forming the rail-road track pattern, with ring-like appearance in cross section. Relevant previous clinical and surgical history was taken and C-IMT was measured using B-mode ultrasonography Aplio XG (Toshiba medical systems corp., Japan) using an 8-13 MHz linear transducer within 1 cm from the proximal and distal portion of the common carotid artery and the mean value was taken. Results All the participants included in this study were within the age group of 40-70 years. Mean age with BAC(+) was 59.18 ± 8.59 years and BAC(-) was 50.70 ± 7.93 years. Mean C-IMT in the BAC(+) group was 0.86 ± 0.21 mm vs. 0.71 ± 0.12 mm in the BAC(-) group. Chi-square test, independent t test and Spearman's rho correlation to assess the association of the breast arterial calcification were performed. The study showed significant difference in mean C-IMT between two groups (p value < 0.001) when correlated with age, diabetes, hypertension, presence of BAC and history of surgery and drug intake. Conclusions BAC in mammography is independently associated with C-IMT. Furthermore, apart from age and menopausal status a statistically significant positive correlation with C-IMT was observed.

/pdf/association-of-vascular-calcification-of-breast-with-carotid-4ts09a61h4.pdf

Association of vascular calcification of breast with carotid intima media thickness.

Many studies on various meditation types have reported regional gray matter volume changes using voxel-based morphometric analysis of structural MRI, but there are no studies done on structural MRI of Rajyoga meditators. The objective of the present study is to analyze and compare gray matter volume changes of brain regions in meditators and non-meditators and further study the effects of meditation experience on alterations in various brain regions. These regions were then correlated and compared to positive thought scores of participants. Forty participants in each group (closely matched for age, gender, and handedness) were selected after obtaining their informed consent, and voxel-based morphometric analysis was carried out using their structural MRI scans. On voxel-wise comparison of the brain scans, meditators were observed to have significantly higher global gray matter volume and significant regional gray matter volume increases in the right superior frontal gyrus, left inferior orbitofrontal cortex, left inferior parietal gyrus, left posterior cerebellum, left middle temporal gyrus, bilateral precuneus, and cuneus. Additionally, long-term meditators particularly had significantly higher positive thinking scores compared to non-meditators. On multiple regression analysis, gray matter volume of the left superior parietal gyrus and left inferior parietal gyrus had a positive association, whereas the left posterior cerebellum had a negative association with hours of meditation experience. With the positive thoughts score, a significant relationship was found in the right superior temporal gyrus in meditators. These findings indicate that Rajyoga meditation experience/practice enhances gray matter volume of specific brain regions and positive thoughts.

/pdf/rajyoga-meditation-experience-induces-enhanced-positive-43x534cijy.pdf

Prakashini Koteshwara

Papers

Hepatic tuberculosis: a multimodality imaging review

Telltale signs of peripheral neurogenic tumors on magnetic resonance imaging

Role of Diffusion Tensor Imaging in renal parenchymal changes.

Association of vascular calcification of breast with carotid intima media thickness.

Rajyoga Meditation Experience Induces Enhanced Positive Thoughts and Alters Gray Matter Volume of Brain Regions: A Cross-sectional Study