Image quality enhancement of CT hepatic portal venography using dual energy blending with computer determined parameters

BACKGROUND: Previous studies have shown that using some post-processing methods, such as nonlinear-blending and linear blending techniques, has potential to improve dual-energy computed (DECT) image quality. OBJECTIVE: To improve DECT image quality of hepatic portal venography (CTPV) using a new non-linear blending method with computer-determined parameters, and to compare the results to additional linear and non-linear blending techniques. METHODS: DECT images of 60 patients who were clinically diagnosed with liver cirrhosis were selected and studied. Dual-energy scanning (80 kVp and Sn140 kVp) of CTPV was utilized in the portal venous phase through a dual-source CT scanner. For image processing, four protocols were utilized including linear blending with a weighing factor of 0.3 (protocol A) and 1.0 (protocol B), non-linear blending with fixed blending width of 200 HU and set blending center of 150HU (protocol C), and computer-based blending (protocol D). Several image quality indicators, including signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and contrast of hepatic portal vein and hepatic parenchyma, were evaluated using the paired-sample t-test. A 5-grade scale scoring system was also utilized for subjective analysis. RESULTS: SNR of protocols A-D were 9.1±2.1, 12.1±3.0, 11.6±2.8 and 14.4±3.2, respectively. CNR of protocols A-D were 4.6±1.3, 8.0±2.3, 7.0±2.0 and 9.8±2.4, respectively. The contrast of protocols A-D were 37.7±11.6, 91.9±21.0, 66.2±19.0 and 107.7±21.3, respectively. The differences between protocol D and other three protocols were significant (P < 0.01). In subjective evaluation, the modes of protocols A, B, C, and D were rated poor, good, generally acceptable, and excellent, respectively. CONCLUSION: The non-linear blending technique of protocol D with computer-determined blending parameters can help improve imaging quality of CTPV and contribute to a diagnosis of liver disease.

Determination of Median Lethal Concentration (LC50) for Endosulfan, Heptachlor and Dieldrin Pesticides to African Catfish, Clarias gariepinus and Their Impact on Its Behavioral Patterns and Histopathological Responses

Pesticides such as endosulfan, heptachlor and dieldrin persist in aquatic environments as a result of their resistance to biodegradation. However, there is no adequate information about the toxicity of endosulfan, heptachlor and dieldrin to the aquatic organism, African catfish (Clarias gariepinus)—a high valued widely distributed commercially interesting species. The current experiment was performed with the aim to determine the median lethal concentration (LC50) of endosulfan, heptachlor and dieldrin to African catfish (Clarias gariepinus); their behavioral abnormalities and histopathological alterations in several vital organs. A total of 324 juvenile fish were exposed for 96 h to six concentrations of endosulfan and dieldrin at 0, 0.001, 0.002, 0.004, 0.008 and 0.016 ppm, and to heptachlor at concentrations of 0, 0.02, 0.04, 0.08, 0.16 and 0.32 ppm for dose-response tests. The study demonstrated that the species is highly susceptible to those contaminants showing a number of behavioral abnormalities and histopathological changes in gill, liver and muscle. The 96-h LC50 value of endosulfan, dieldrin and heptachlor for the African catfish was found as 0.004 (0.001−0.01) mg/L, 0.006 mg/L and 0.056 (0.006−0.144) mg/L, respectively. Abnormal behaviors such as erratic jerky swimming, frequent surfacing movement with gulping of air, secretion of mucus on the body and gills were observed in response to the increasing exposure concentrations. Histopathological alterations of liver, gill and muscle tissues were demonstrated as vacuolization in hepatocytes, congestion of red blood cells (RBCs) in hepatic portal vein; deformed secondary lamellae and disintegrated myotomes with disintegrated epidermis, respectively. These findings are important to monitor and responsibly manage pesticide use in and around C. gariepinus aquacultural areas.

Multi-Omics Comparison of the Spontaneous Diabetes Mellitus and Diet-Induced Prediabetic Macaque Models

The prevalence of diabetes mellitus has been increasing for decades worldwide. To develop safe and potent therapeutics, animal models contribute a lot to the studies of the mechanisms underlying its pathogenesis. Dietary induction using is a well-accepted protocol in generating insulin resistance and diabetes models. In the present study, we reported the multi-omics profiling of the liver and sera from both peripheral blood and hepatic portal vein blood from Macaca fascicularis that spontaneously developed Type-2 diabetes mellitus with a chow diet (sDM). The other two groups of the monkeys fed with chow diet and high-fat high-sugar (HFHS) diet, respectively, were included for comparison. Analyses of various omics datasets revealed the alterations of high consistency. Between the sDM and HFHS monkeys, both the similar and unique alterations in the lipid metabolism have been demonstrated from metabolomic, transcriptomic, and proteomic data repeatedly. The comparison of the proteome and transcriptome confirmed the involvement of fatty acid binding protein 4 (FABP4) in the diet-induced pathogenesis of diabetes in macaques. Furthermore, the commonly changed genes between spontaneous diabetes and HFHS diet-induced prediabetes suggested that the alterations in the intra- and extracellular structural proteins and cell migration in the liver might mediate the HFHS diet induction of diabetes mellitus.

A Case of Intratumoral and Hepatic Portal Venous Gas in Patient with Gastric Cancer Liver Metastases

Background: Hepatic portal venous gas [HPVG] is not a common finding in daily practice. It is usually associated with mesenteric ischemia and bowel necrosis in adults. Combination of intratumoral gas in metastatic liver lesions with HPVG is quite rare and thought to be associated with chemotherapy-induced necrosis and infection of the necrotized metastasis. Objective: Here we present a case of gastric adenocarcinoma with portal venous and intratumoral gas in metastatic liver lesions due to the infected necrosis. Case Presentation: The patient was presented to the emergency room with severe abdominal pain and septic condition after the second round of chemotherapy. Hepatic portal venous and intratumoral gas in metastatic liver lesions due to the infected necrosis of liver metastasis was detected in computed tomography images. There were no findings of mesenteric ischemia both clinically and radiologically. Massive intratumoral infected necrosis in metastatic liver lesions and fistulization to the right portal vein branches were detected on abdominopelvic CT. Secondary infection of the necrotic metastases and fistulization to portal vein branches was believed to cause the air in metastatic liver masses and portal venous gas. Conclusion: Infected necrosis of metastatic liver lesions and fistulizations to the portal venous structures is extremely rare. Clinicians and radiologists should be aware of such a rare complication because early detection is crucial for patient management.

Hepatic portal vein gas in gastric outlet obstruction

A 55-year-old man presented to an emergency department with a history of abdominal pain and vomiting for one week. He had a history of having peptic ulcer perforation surgery. He appeared weak and frustration from pain, abdominal distension at upper abdomen without peritonitis sign on physical examination. Initial abdominal radiograph revealed pneumoperitoneum under both hemidiaphragms with markedly distension of stomach containing food content. Further computed tomography demonstrated evidence of gastric outlet obstruction without intra or extraluminal mass. There is also massive amount of portal venous gas in both lobes of liver. After patient resuscitation with intravenous fluid and nasogastric intubation for gastric decompression, his condition returned to normal, with no sign of peritonitis nor sepsis. Therefore, the upper gastrointestinal endoscopy showed gastric outlet obstruction from chronic peptic ulcers. The endoscopic balloon dilatation of the obstruction part was successful, and he was discharged home with full recovery in one week.

Lactic Acid Bacteria Exert a Hepatoprotective Effect against Ethanol-Induced Liver Injury in HepG2 Cells

Alcoholic liver fatty disease (ALFD) is caused by excessive and chronic alcohol consumption. Alcohol consumption causes an imbalance in the intestinal microflora, leading to liver disease induced by the excessive release of endotoxins into the hepatic portal vein. Therefore, research on the intestinal microflora to identify treatments for ALFD is increasing. In this study, the protective effects of lactic acid bacteria (LAB) strains, including Levilactobacillus brevis, Limosilactobacillus reuteri, and Limosilactobacillus fermentum, were evaluated in ethanol-induced HepG2 cells. Among the evaluated LAB, nine strains increased aldehyde dehydrogenase (ALDH) levels and downregulated lipid peroxidation and liver transferase in the ethanol-induced HepG2 cells. Moreover, L. brevis MG5280 and MG5311, L. reuteri MG5458, and L. fermentum MG4237 and MG4294 protected against ethanol-induced HepG2 cell damage by regulating CYP2E1, antioxidant enzymes (SOD, CAT, and GPX), lipid synthesis factors (SREBP1C and FAS), and lipid oxidation factors (PPARα, ACO, and CPT-1). Moreover, five LAB were confirmed to be safe probiotics based on antibiotic susceptibility and hemolysis assays; their stability and adhesion ability in the gastrointestinal tract were also established. In conclusion, L. brevis MG5280 and MG5311, L. reuteri MG5458, and L. fermentum MG4237 and MG4294 may be useful as new probiotic candidates for ALFD prevention.

Treatment of Upper Gastrointestinal Bleeding by Percutaneous Transsplenic Varices Embolization in Chronic Hepatic Schistosomiasis Japonicum Patients

To evaluate percutaneous transsplenic varices embolization (PTSVE) in the treatment of upper gastrointestinal bleeding (UGIB) in patients with chronic hepatic schistosomiasis japonicum (CHS), 29 CHS patients (20 males and 9 females) complicated with UGIB were selected as the investigation subjects. The patients were treated by PTSVE under the guidance of X-ray fluoroscopy. The success rate of PTSVE and the rate of complications were observed. In addition, the degrees of varices before and after PTSVE were evaluated by abdominal computed tomography (CT). Results showed that 26 CHS patients (89.6%) were successfully treated with PTSVE. Three cases (10.3%) failed, and two experienced intraperitoneal bleeding within 1 week after PTSVE. The abdominal CT showed a significant decrease of the varices stage in coronary (P < 0.001), esophageal (P = 0.006), and paraesophageal (P = 0.013) varices, but slightly increased perisplenic varices within 1 month of the intervention (P = 0.014). PTSVE may be a safe and effective procedure for the treatment of UGIB in CHS patients, particularly suitable for those with a widened hepatic fissure and exposed hepatic portal vein trunk and an enlarged spleen.