Visibility Of Blood Vessels Research Articles

The influence of color vision deficiency on vessel visibility during colorectal endoscopic submucosal dissection and the potential advantage of red dichromatic imaging to achieve color vision barrier-free.

Although color information is important in gastrointestinal endoscopy, there are limited studies on how endoscopic images are viewed by people with color vision deficiency. We aimed to investigate the differences in the visibility of blood vessels during endoscopic submucosal dissection (ESD) among people with different color vision characteristics and to examine the effect of red dichromatic imaging (RDI) on blood vessel visibility. Seventy-seven pairs of endoscopic images of white light imaging (WLI) and RDI of the same site were obtained during colorectal ESD. The original images were set as type C (WLI-C and RDI-C), a common color vision. These images were computationally converted to simulate images perceived by people with color vision deficiency protanope (Type P) or deutanope (Type D) and denoted as WLI-P and RDI-P or WLI-D and RDI-D. Blood vessels and background submucosa that needed to be identified during ESD were selected in each image, and the color differences between these two objects were measured using the color difference (ΔE 00) to assess the visibility of blood vessels. ΔE 00 between a blood vessel and the submucosa was greater under RDI (RDI-C/P/D: 24.05 ± 0.64/22.85 ± 0.66/22.61 ± 0.64) than under WLI (WLI-C/P/D: 22.26 ± 0.60/5.19 ± 0.30/8.62 ± 0.42), regardless of color vision characteristics. This improvement was more pronounced in Type P and Type D and approached Type C in RDI. Color vision characteristics affect the visibility of blood vessels during ESD, and RDI improves blood vessel visibility regardless of color vision characteristics.

A deep network DeepOpacityNet for detection of cataracts from color fundus photographs

BackgroundCataract diagnosis typically requires in-person evaluation by an ophthalmologist. However, color fundus photography (CFP) is widely performed outside ophthalmology clinics, which could be exploited to increase the accessibility of cataract screening by automated detection.MethodsDeepOpacityNet was developed to detect cataracts from CFP and highlight the most relevant CFP features associated with cataracts. We used 17,514 CFPs from 2573 AREDS2 participants curated from the Age-Related Eye Diseases Study 2 (AREDS2) dataset, of which 8681 CFPs were labeled with cataracts. The ground truth labels were transferred from slit-lamp examination of nuclear cataracts and reading center grading of anterior segment photographs for cortical and posterior subcapsular cataracts. DeepOpacityNet was internally validated on an independent test set (20%), compared to three ophthalmologists on a subset of the test set (100 CFPs), externally validated on three datasets obtained from the Singapore Epidemiology of Eye Diseases study (SEED), and visualized to highlight important features.ResultsInternally, DeepOpacityNet achieved a superior accuracy of 0.66 (95% confidence interval (CI): 0.64–0.68) and an area under the curve (AUC) of 0.72 (95% CI: 0.70–0.74), compared to that of other state-of-the-art methods. DeepOpacityNet achieved an accuracy of 0.75, compared to an accuracy of 0.67 for the ophthalmologist with the highest performance. Externally, DeepOpacityNet achieved AUC scores of 0.86, 0.88, and 0.89 on SEED datasets, demonstrating the generalizability of our proposed method. Visualizations show that the visibility of blood vessels could be characteristic of cataract absence while blurred regions could be characteristic of cataract presence.ConclusionsDeepOpacityNet could detect cataracts from CFPs in AREDS2 with performance superior to that of ophthalmologists and generate interpretable results. The code and models are available at https://github.com/ncbi/DeepOpacityNet (https://doi.org/10.5281/zenodo.10127002).

Near-infrared luminescent properties and applications of Fe3+-doped YAG phosphors

This study employed the high-temperature solid-phase method to successfully synthesize a comprehensive range of Y3Al12O5: xFe3+ novel near-infrared (NIR) phosphors based on yttrium aluminum garnet material. The samples were subjected to characterization utilizing X-ray diffraction (XRD), scanning electron microscopy (SEM), absorption spectroscopy, first-principles calculations, excitation and emission spectroscopy, as well as temperature-dependent luminescence intensity analysis. Subsequently, the specimens were encapsulated within light-emitting diodes (LED) to facilitate their application in night vision and biometric sensing. The results revealed that all sintered samples were phase-pure, with particle sizes around 0.6 μm, exhibiting uniform and fully developed morphology. The absorption spectroscopy indicated a decrease in the bandgap with increasing Fe3+ doping concentration. The first-principles results revealed that the doping of Fe3+ introduces Fe-d orbitals, and their contribution to the conduction bands is nearly comparable to that of the d orbitals of the Y3+. The spectroscopic results indicated that the samples can be excited through charge transfer of O2− → Fe3+, leading to near-infrared emission at 784 nm with a full width at half maximum (FWHM) of 77 nm at 280 nm, and the FWHM is 73 nm under excitation at 411 nm. The thermal stability analysis revealed that as the temperature increased, there was no observed redshift or blueshift in the emission spectra. The encapsulated NIR LED allows clear visibility of blood vessels on the hand and cacti in a dark room environment. All the aforementioned results provide substantial evidence for the significant application potential of Y3Al12O5: xFe3+ NIR phosphors in biometric sensing and night vision.

Benchmarking Polyp Segmentation Methods in Narrow-Band Imaging Colonoscopy Images.

In recent years, there has been significant progress in polyp segmentation in white-light imaging (WLI) colonoscopy images, particularly with methods based on deep learning (DL). However, little attention has been paid to the reliability of these methods in narrow-band imaging (NBI) data. NBI improves visibility of blood vessels and helps physicians observe complex polyps more easily than WLI, but NBI images often include polyps with small/flat appearances, background interference, and camouflage properties, making polyp segmentation a challenging task. This paper proposes a new polyp segmentation dataset (PS-NBI2K) consisting of 2,000 NBI colonoscopy images with pixel-wise annotations, and presents benchmarking results and analyses for 24 recently reported DL-based polyp segmentation methods on PS-NBI2K. The results show that existing methods struggle to locate polyps with smaller sizes and stronger interference, and that extracting both local and global features improves performance. There is also a trade-off between effectiveness and efficiency, and most methods cannot achieve the best results in both areas simultaneously. This work highlights potential directions for designing DL-based polyp segmentation methods in NBI colonoscopy images, and the release of PS-NBI2K aims to drive further development in this field.

A Study of Management of Adverse Reaction to Iodinated Contrast Media used in Computed Tomography at UCMS-TH

INTRODUCTION: Iodinated contrast media is used in computed tomography imaging to enhance the visibility of blood vessels and tissues. They have distinct clinical effectiveness and toxicity profiles. Although low osmolar contrast media have made iodinated contrast media safer in recent years, adverse reactions can sometimes occur. The management of adverse reactions to iodinated contrast media is an important aspect of patient care during computed tomography examinations. The purpose of this study was to evaluate the management of adverse reactions to iodinated contrast media during contrast-enhanced computed tomography examinations at Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal. MATERIALS AND METHODS: A prospective, observational study was conducted on 323 patients at Department of Radiodiagnosis and Medical Imaging, Universal College of Medical Sciences and Teaching Hospital, Bhairahawa, Nepal, from December 15, 2022 to May 15, 2023. All data was obtained from the Department of Radiodiagnosis and Medical Imaging, as per the study inclusion criteria. The data were analyzed with statistical package for the social sciences version 20. RESULTS: The mean age of study participants was 48.49±19.78 years. There were 34.67% male and 65.33% female patients involved in this study. Universal College of Medical Sciences and Teaching Hospital favoured a more strict approach, to determine the normal renal function and withhold metformin before iodinated contrast media exposure. 36.84% of patients had a history of previous adverse reactions, before undergoing contrast-enhanced computed tomography scans. Following iodinated contrast media administration, 94.74% experienced nausea and vomiting which was followed by mild urticarial (88.54%) and dyspnea (19.81%). Premedication protocol was predominantly implemented with antihistamine, pheniramine (73.1%), and corticosteroid, hydrocortisone (26.9%). Mild urticaria was treated with pheniramine (87.1%), nausea and vomiting was treated with metoclopramide (83.01%), dyspnea was treated by epinephrine, hydrocortisone and oxygen (9.38%). CONCLUSIONS: Universal College of Medical Sciences and Teaching Hospital has established a standard protocol for the management of adverse reactions experienced by patients during iodinated contrast media administration. Premedication with antihistamines and corticosteroids was recommended for highrisk patients.

Imaging breast malignancies with the Twente Photoacoustic Mammoscope 2.

Clinical measurements on breast cancer patients were performed with a three-dimensional tomographic photoacoustic prototype imager (PAM 2). Patients with a suspicious lesion, visiting the center for breast care of a local hospital, were included in the study. The acquired photoacoustic images were compared to conventional clinical images. Of 30 scanned patients, 19 were diagnosed with one or more malignancies, of which a subset of four patients was selected for detailed analysis. Reconstructed images were processed to enhance image quality and the visibility of blood vessels. Processed photoacoustic images were compared to contrast-enhanced magnetic resonance images where available, which aided in localizing the expected tumoral region. In two cases, spotty high-intensity photoacoustic signals could be seen in the tumoral region, attributable to the tumor. One of these cases also displayed a relatively high image entropy at the tumor site, likely related to the chaotic vascular networks associated with malignancies. For the other two cases, it was not possible to identify features indicative of malignancy, because of limitations in the illumination scheme and difficulties in locating the region of interest in the photoacoustic image.

Reconstruction and Visualization of 5μm Sectional Coronal Views for Macula Vasculature in OptoVue OCTA

A Computerized Medical Image Processing (CMIP) method is proposed to address the current challenges of optical coherence tomography angiography (OCTA): (1) the need for observing the macula vasculature concerning natural curvature of the macula region; (2) the need for generating OCTA frames at successive small depths in all macula layers; and (3) the need for enhancing the visibility of blood vessels, particularly below the outer retina region. The proposed CMIP method involves image preprocessing, reconstruction, and enhancement stages. Twenty subjects were obtained from the OCTA500 dataset, which was obtained from the OptoVue OCTA machine. The 20 subjects comprise the two OCTA fields of view (FOV), right and left eyes (OD and OS), and five common macula disorders. The sequential enface OCTA images at 5μm macula depths were displayed. The presentation of the macula vasculature was enhanced at all depths. The resulting new ophthalmic views enable: (1) avoiding the superimposition of macula vasculature into a projection map; (2) enhancing the OCTA presentation of blood vessels; and (3) inspecting the macula’s 3D oval-shaped. The proposed CMIP method can generate sectional macula coronal views (MCV) for every 5μm depth, clarifying the macula’s curvature in a way that has not been presented in OCTA machines. Therefore, “tracking” the 3D propagation of the blood vessel network at all macula depths becomes possible. Furthermore, the blood vessels’ display at all macula depths, including the deep choroid layers, is enhanced. The method yields futuristic ophthalmic advantages that would allow the physician to precisely inspect the 3D localization and diffusion of the macula disorders. The method is invariant to the OCTA’s FOVs, macula disorder, and OD or OS eye.

Frequency of Acute and Late Reaction of Non-Ionic Iodinated Contrast Media in Contrast Enhanced Computed Tomography

Introduction: A contrast agent is a substance used to increase the contrast of structures or fluids within the body in medical imaging. Contrast agents absorb or alter external electromagnetism or ultrasound, and enhance the radio density in a target tissue or structure. Contrast agents are commonly used to improve the visibility of blood vessels and the gastrointestinal tract. Several types of contrast agent are in use in medical imaging and they can roughly be classified based on the imaging modalities where they are used and the purposes of this study to find out the frequency of adverse reactions of non-ionic iodinated contrast media in contrast enhanced Computed Tomography. Material Methods: It was cross-sectional observational study conducted on 133 patients who visited Al-Razi healthcare hospital, Lahore for a CT (computed Tomography) scan. 36 of them got adverse reactions to the non-ionic contrast media. The frequency of adverse reactions happening with the non-ionic contrast usage was determined Results: In this study, one hundred and thirty-three patients who fulfilled the criteria were included in the study. 36 of the patients had adverse reactions to the non-ionic contrast media which included shivering, fatigue, headache, nausea and rashes. All of the patients had no previous history of allergies or contrast reactions. The mean age of patients ranged from 51.49 ± 16.19years. Conclusion: In conclusion, the use of non-ionic contrast media as a CT contrast agent has a safety profile. It is concluded that a non-ionic iodinated contrast media reaction rarely results in long-term sequelae as it is less severe and easily treatable. Keywords: Non-Ionic Iodine Contrast Media, Computed Tomography, Adverse Reactions DOI: 10.7176/JHMN/88-05 Publication date: April 30 th 2021

Dual red imaging: a novel endoscopic imaging technology visualizing thick blood vessels in the gastrointestinal wall.

Background Dual red imaging (DRI), a novel image-enhanced endoscopy (IEE) technology, has the potential to improve the visibility of blood vessels in deeper tissue using 600 nm and 630 nm wavelength lights in the red band. Aim To confirm the feasibility of DRI in visualization of vessels in deeper tissue and identify pathologically the features of blood vessels visualized by DRI. Methods Study 1: visibility of blood vessels was assessed by five observers in 137 pairs of DRI and white light imaging (WLI) images. The scores for the visibility of thick blood vessels were measured for randomized images and compared with the scoring template as a reference. The difference in visibility score between DRI and WLI was compared in each pair of images. Study 2: blood vessels detected only by DRI were examined pathologically using two pig stomachs. Results Study 1: The mean visibility scores of DRI and WLI for each observer were 1.69 – 2.26 and 1.31 – 1.67, respectively. The mean difference in visibility score and 95 % confidence interval for the five observers was 0.59 [0.46 – 0.72], 0.54 [0.40 – 0.68], 0.34 [0.18 – 0.49], 0.51 [0.36 – 0.66], and 0.71 [0.54 – 0.88]. The visibility was statistically significantly better in DRI than in WLI for all observers ( P < 0.0001). Study 2: three blood vessels were observed only by DRI. All of these blood vessels were located at a depth of 1000 – 1500 µm from the mucosal surface. The diameter of these blood vessels exceeded 80 – 200 µm. Conclusions DRI can feasibly detect thick blood vessels in the deep mucosa or submucosa of the gastrointestinal tract.

Ultrasonic Pressure Ballistic System-Assisted Minimally Invasive Pancreatic Necrosectomy for Necrotizing Pancreatitis.

Background: Although minimally invasive pancreatic necrosectomy (MIPN) is a new invasive technique for necrotizing pancreatitis, it has some disadvantages. This study aimed to improve the debridement technique with an ultrasonic pressure ballistic system. We hypothesized that this system would facilitate debridement and improve the safety of the procedure. Materials and Methods: Between October 2016 and January 2019, 5 patients diagnosed with necrotizing pancreatitis were enrolled in the clinical cohort. All patients underwent debridement due to infective necrosis. Access for debridement was typically established with percutaneous puncture. Then MIPN was performed. During the procedure, ultrasonic pressure was applied to liquefy the necrotic material and make it absorbable. The effect of debridement was assessed by analyzing the average bleeding volume, operation time, and complications. Postoperative clinical parameters were evaluated. Results: Debridement was performed successfully for all patients. Semisolid necrotic tissue was dissolved with ultrasonic pressure. Viscous pus was rapidly aspirated with the suction applied with negative pressure, which greatly enhanced efficiency. This approach enhanced the visibility of blood vessels, which improved safety. No major complications were encountered. Two patients (40%) developed puncture site infections. The average blood loss during the operation was 13 ± 6 mL. The average operation time was 78 ± 31 minutes. Postoperative APACHE II scores were significantly lower than preoperative scores (P < .05). White blood cells, C-reactive protein, and procalcitonin levels declined postoperatively. Conclusions: The ultrasonic pressure ballistic system could potentially enhance MIPN and make it safer.

Clinical Usefulness of Dual Red Imaging in Gastric Endoscopic Submucosal Dissection: A Pilot Study.

Background/AimsDual red imaging (DRI) is a new, image-enhanced endoscopy technique. There are few reports about the usefulness of DRI during gastric endoscopic submucosal dissection (ESD). We aimed to examine the usefulness of DRI in endoscopic hemostasis during gastric ESD. MethodsWe enrolled a total of 20 consecutive patients who underwent gastric ESD. Five endoscopists compared DRI with white light imaging (WLI) for the visibility of blood vessels and bleeding points while performing endoscopic hemostasis. ResultsThe visibility of blood vessels was increased in 56% (19/34) of the cases, and the visibility of bleeding points was improved in 55% (11/20) of the cases with the use of DRI compared with the use of WLI. ConclusionsDRI improved the visibility of blood vessels and bleeding points in cases with oozing bleeding, blood pooling around the bleeding points, and multiple bleeding points.

SNR-Adaptive OCT Angiography Enabled by Statistical Characterization of Intensity and Decorrelation With Multi-Variate Time Series Model.

In OCT angiography (OCTA), decorrelation computation has been widely used as a local motion index to identify dynamic flow from static tissues, but its dependence on SNR severely degrades the vascular visibility, particularly in low-SNR regions. To mathematically characterize the decorrelation-SNR dependence of OCT signals, we developed a multi-variate time series (MVTS) model. Based on the model, we derived a universal asymptotic linear relation of decorrelation to inverse SNR (iSNR), with the variance in static and noise regions determined by the average kernel size. Accordingly, with the population distribution of static and noise voxels being explicitly calculated in the iSNR and decorrelation (ID) space, a linear classifier is developed by removing static and noise voxels at all SNR, to generate a SNR-adaptive OCTA, termed as ID-OCTA. Then, flow phantom and human skin experiments were performed to validate the proposed ID-OCTA. Both qualitative and quantitative assessments demonstrated that the ID-OCTA offers a superior visibility of blood vessels, particularly in the deep layer. Finally, the implications of this work on both system design and hemodynamic quantification are further discussed.

Parallel imaging in time-of-flight magnetic resonance angiography using deep multistream convolutional neural networks.

To develop and evaluate a method of parallel imaging time-of-flight (TOF) MRA using deep multistream convolutional neural networks (CNNs). A deep parallel imaging network ("DPI-net") was developed to reconstruct 3D multichannel MRA from undersampled data. It comprises 2 deep-learning networks: a network of multistream CNNs for extracting feature maps of multichannel images and a network of reconstruction CNNs for reconstructing images from the multistream network output feature maps. The images were evaluated using normalized root mean square error (NRMSE), peak signal-to-noise ratio (PSNR), and structural similarity (SSIM) values, and the visibility of blood vessels was assessed by measuring the vessel sharpness of middle and posterior cerebral arteries on axial maximum intensity projection (MIP) images. Vessel sharpness was compared using paired t tests, between DPI-net, 2 conventional parallel imaging methods (SAKE and ESPIRiT), and a deep-learning method (U-net). DPI-net showed superior performance in reconstructing vessel signals in both axial slices and MIP images for all reduction factors. This was supported by the quantitative metrics, with DPI-net showing the lowest NRMSE, the highest PSNR and SSIM (except R = 3.8 on sagittal MIP images, and R = 5.7 on axial slices and sagittal MIP images), and significantly higher vessel sharpness values than the other methods. DPI-net was effective in reconstructing 3D TOF MRA from highly undersampled multichannel MR data, achieving superior performance, both quantitatively and qualitatively, over conventional parallel imaging and other deep-learning methods.

Method for Separation of Blood Vessels on the Three-Color Images of Biological Tissues

A new technology was developed to improve the visibility of blood vessels on images of tissues of hollow human organs(the alimentary tract and respiratory system) based on the relation between the color components of the image, the scattering properties of the tissue, and its hemoglobin content. A statistical operator was presented to convert the three-color image of the tissue into a parametric map objectively characterizing the concentration of hemoglobin in the tissue regardless of the illumination and shooting conditions. An algorithm for obtaining conversion parameters for image systems with known spectral characteristics was presented. An image of a multilayer multiple-scattering medium modeling bronchial tissue was synthesized and was used to evaluate the efficiency of the proposed conversion system. It was shown that the conversion made it possible to increase the contrast of the blood vessels by almost two orders of magnitude, to significantly improve the clarity of the display of their borders, and to eliminate almost completely the influence of background and nonuniform illumination of the medium in comparison with the original image.

Automated Detection and Segmentation of Vascular Structures of Skin Lesions Seen in Dermoscopy, With an Application to Basal Cell Carcinoma Classification.

Blood vessels are important biomarkers in skin lesions both diagnostically and clinically. Detection and quantification of cutaneous blood vessels provide critical information toward lesion diagnosis and assessment. In this paper, a novel framework for detection and segmentation of cutaneous vasculature from dermoscopy images is presented and the further extracted vascular features are explored for skin cancer classification. Given a dermoscopy image, we segment vascular structures of the lesion by first decomposing the image using independent-component analysis into melanin and hemoglobin components. This eliminates the effect of pigmentation on the visibility of blood vessels. Using k-means clustering, the hemoglobin component is then clustered into normal, pigmented, and erythema regions. Shape filters are then applied to the erythema cluster at different scales. A vessel mask is generated as a result of global thresholding. The segmentation sensitivity and specificity of 90% and 86% were achieved on a set of 500000 manually segmented pixels provided by an expert. To further demonstrate the superiority of the proposed method, based on the segmentation results, we defined and extracted vascular features toward lesion diagnosis in basal cell carcinoma (BCC). Among a dataset of 659 lesions (299 BCC and 360 non-BCC), a set of 12 vascular features are extracted from the final vessel images of the lesions and fed into a random forest classifier. When compared with a few other state-of-art methods, the proposed method achieves the best performance of 96.5% in terms of area under the curve (AUC) in differentiating BCC from benign lesions using only the extracted vascular features.

Postmortem computed tomography with the use of air for blood vessel enhancement—Early experience

Postmortem computed tomography (PMCT) is gaining popularity in forensic medicine. Computed tomography routinely performed in clinical medicine involves intravenous contrast administration. Unfortunately, postmortem examinations are typically limited to uncontrasted CT scans, where blood vessels and their potential injury sites are invisible. One serious problem is the fact that due to the process of decomposition, contrast agents used for vessel visualization in the living cannot be used in cadavers. Therefore, a special contrast agent designed for cadavers has been developed. This contrast agent has a high density and is lipophilic. Its use ensures very good visualization of blood vessels it is, however, associated with high costs and may alter findings of a later histopathological examination. This study presents early experience with the air as negative contrast agent to enhance all blood vessels in the body. The carbon dioxide (CO2) gas has been used as a contrast agent in live individuals with contraindications against the use of iodinated contrast. In corpses with advanced postmortem changes, putrefaction gases also considerably enhance the visibility of blood vessels and organs they fill. There have also been some positive effects with the use of gas in postmortem angiography of coronary vessels. These findings encouraged us to attempt air administration via catheters introduced into the femoral artery or a central venous access site in the superior vena cava. The gas distributed easily throughout the body and surprisingly well contrasted both arteries and veins of various caliber. The presence of the air administered into vessels did not cause any apparent, significant alterations in autopsy findings. Although optimization of the gas administration technique requires further studies, we can already say that this is a promising direction in postmortem angiography.

Cover Caption

Journal of Food ScienceVolume 80, Issue 9 p. i-ii ContentFree Access Cover Caption First published: 15 September 2015 https://doi.org/10.1111/1750-3841.12606AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Abstract September Online Cover: Several image analysis techniques demonstrated: skeletonization of pores in an open-cell foam; removal of background from an egg image (courtesy Kathy Spencer) to enhance visibility of blood vessels; and noise reduction from a microscopic image of stained yeast, from “Image Analysis of Foods” by John Russ; p. E1974. Volume80, Issue9September 2015Pages i-ii RelatedInformation

Multi-echo susceptibility-weighted imaging and histology of open-field blast-induced traumatic brain injury in a rat model.

Blast-induced traumatic brain injury is on the rise, predominantly as a result of the use of improvised explosive devices, resulting in undesirable neuropsychological dysfunctions, as demonstrated in both animals and humans. This study investigated the effect of open-field blast injury on the rat brain using multi-echo, susceptibility-weighted imaging (SWI). Multi-echo SWI provided phase maps with better signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR), making it a sensitive technique for brain injury. Male Sprague-Dawley rats were subjected to a survivable blast of 180 kPa. The visibility of blood vessels of varying sizes improved with multi-echo SWI. Reduced signal intensity from major vessels post-blast indicates increased deoxyhaemoglobin. Relative cerebral blood flow was computed from filtered phase SWI images using inferred changes in oxygen saturation from major blood vessels. Cerebral blood flow decreased significantly at day 3 and day 5 post-blast compared with that pre-blast. This was substantiated by the upregulation of β-amyloid precursor protein (β-APP), a marker of ischaemia, in the neuronal perikaya of the cerebral cortex, as observed by immunofluorescence, and in the cortical tissue by western blot analysis. Our findings indicate the presence of brain ischaemia in post-blast acute phase of injury with possible recovery subsequently. Our results from cerebrovascular imaging, histology and staining provide an insight into the ischaemic state of the brain post-blast and may be useful for prognosis and outcome.

The Use of Narrow Band Imaging in Patients With Benign Disease

: Narrow band imaging (NBI) is a new type of imaging technology that enhances the visibility of blood vessels used in the detection of abnormal angiogenesis in preneoplastic and neoplastic lesions. This technique is used in the diagnosis and management of dysplastic and malignant endobronchial lesions. To our knowledge, this is the first description of the use of NBI to diagnose and manage benign lesions, hereditary hemorrhagic telangiectasia (HHT). The objective of this study was to implement NBI as a tool for use in the bronchoscopic visualization leading to the diagnosis and management of nonmalignant lesions in the tracheobronchial tree. This is including but not limited to HHT. NBI was used to detect the origin of significant hemoptysis in a patient with HHT. The patient had conventional white light (CWL) bronchoscopy, followed by NBI. NBI illuminated the abnormal blood vessels significantly better than CWL bronchoscopy. This led to a more effective diagnosis and management of the abnormal vessels causing the hemoptysis. NBI may provide a higher probability of locating abnormal endobronchial lesions in both benign and malignant diseases than CWL bronchoscopy. It can be used to treat these abnormal lesions as in our patient who presented with hemoptysis. A prospective study is needed to determine whether NMI and CWL are additive as in malignant disease. Furthermore, NBI can be used in lesions of the tracheobronchial tree and the gastrointestinal tract, and pleura, so that the appropriate management can be initiated.

Chromoendoscopy in small bowel capsule endoscopy: Blue mode or Fuji Intelligent Colour Enhancement?

Introduction Virtual chromoendoscopy is used to enhance surface patterns and colour differences. One type of virtual chromoendoscopy is the Fuji Intelligent Colour Enhancement (FICE). Although widely applied in conventional endoscopy, data on FICE application in capsule endoscopy are limited. Furthermore, the validity of Blue filter (feature of RAPID ® software) has not been examined. Aim/s We aimed to qualitatively evaluate the use of FICE and Blue filter enhancement, in images of lesions obtained during small bowel capsule endoscopy, comparing them with similar, conventional (white light) images. Methods A total of 167 images (6 different lesion categories) obtained from 200 capsule endoscopy examinations. Two gastroenterologists examined the images with white light, FICE and Blue filter in regards to the visibility of blood vessels, the contrast of the mucosal surface, and the demarcation of lesion borders. The agreed scores were: improved, similar, worse. Inter-observer agreement was calculated. Results For all lesion categories, Blue filter provided image improvement (compared to white light) in 83%, (inter-observer agreement: 0.786). With FICE 1, improvement was observed in 34%, worse image in 55.9%, (inter-observer agreement: 0.646). With FICE 2, improvement was observed in 8.6%, worse in 77.5%, (inter-observer agreement: 0.617). With FICE 3, improvement was seen in 7.7%, worse in 79.9% (inter-observer agreement: 0.669). Conclusion Comparing with FICE, Blue filter offers better image enhancement in capsule endoscopy.