Androgen deprivation in men leads to increased adiposity, but the mechanisms underlying androgen regulation of fat mass have not been fully defined. Androgen receptor (AR) is expressed in monocytes/macrophages, which are resident in key metabolic tissues and influence energy metabolism in surrounding cells. Male mice bearing a cell-specific knockout of the AR in monocytes/macrophages (M-ARKO) were generated to determine whether selective loss of androgen signaling in these cells would lead to altered body composition. Wild-type (WT) and M-ARKO mice (12-22 weeks of age, n = 12 per group) were maintained on a regular chow diet for 8 weeks and then switched to a high-fat diet for 8 additional weeks. At baseline and on both the regular chow and high-fat diets, no differences in lean mass or fat mass were observed between groups. Consistent with the absence of differential body weight or adiposity, no differences in food intake (3.0 ± 0.5 g per day for WT mice vs 2.8 ± 0.4 g per day for M-ARKO mice) or total energy expenditure (0.6 ± 0.1 Kcal h^-1 for WT mice vs 0.5 ± 0.1 Kcal h^-1 for M-ARKO mice) were evident between groups during high-fat feeding. Liver weight was greater in M-ARKO than that in WT mice (1.5 ± 0.1 g vs 1.3 ± 0.0 g, respectively, P = 0.02). Finally, M-ARKO mice did not exhibit impairments in glucose tolerance or insulin sensitivity relative to WT mice at any study time point. In aggregate, these findings suggest that AR signaling specifically in monocytes/macrophages does not contribute to the regulation of systemic energy balance, adiposity, or insulin sensitivity in male mice.
Adiposity/genetics* ; Animals ; Blood Glucose/metabolism* ; Energy Metabolism/genetics* ; Glucose Tolerance Test ; Homeostasis/genetics* ; Liver/anatomy & histology* ; Macrophages/metabolism* ; Male ; Mice ; Mice, Knockout ; Monocytes/metabolism* ; Organ Size ; Receptors, Androgen/metabolism* ; Signal Transduction

OBJECTIVETo investigate the anatomy of right portal vein based on three-dimensional (3D) visualization technology and provide a morphological basis for computer-assisted individualized liver segmentation and anatomical hepatectomy.

METHODSLiver CT data of 83 cases were segmented and reconstructed using the medical image three-dimensional visualization system (MI-3DVS), and 3D classifications of the right portal vein were established according to its branch number, direction and distribution. Individualized liver segmentation was performed based on the 3D typing results.

RESULTSThe reconstructed portal vein models were capable of visualizing the fourth-order portal branches. Generally, the third-order right portal branches were classified into P5, P6, P7 and P8 branches. According to the 3D distribution of the branches, P5 branches were classified into types A, B, C, D, and E [in 16 (19.3%), 5 (6%), 30 (36.1%), 7(8.5%), and 25 (30.1%) cases, respectively], P8 branches into types A, B, C, and D [in 29 (34.9%), 29 (34.9%), 10 (12.1%), and 15 (18.1%) cases, respectively], P6 branches into types A, B, C, and D [in 35 (42.2%), 12 (14.5%), 33 (39.7%), and 3 (3.6%) cases, respectively], and P7 branches into types A, B, C, D, E, and F [in 27 (32.5%), 11(33.3%), 27 (32.5%), 4(4.8%), 12 (14.5%), and 2 (2.4%) cases, respectively]. Individualized liver segmentation was achieved based on liver segments supplied by the third-order portal branches.

CONCLUSION3D classifications of the complex and highly variant anatomy of third-order right portal vein and individualized liver segmentation based on this classification before the operation facilitates successful performance of anatomical hepatectomy.

Hepatectomy ; methods ; Humans ; Imaging, Three-Dimensional ; Liver ; anatomy & histology ; surgery ; Portal Vein ; anatomy & histology ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Gadoxetate disodium is a widely used magnetic resonance (MR) contrast agent for liver MR imaging, and it provides both dynamic and hepatobiliary phase images. However, acquiring optimal arterial phase images at liver MR using gadoxetate disodium is more challenging than using conventional extracellular MR contrast agent because of the small volume administered, the gadolinium content of the agent, and the common occurrence of transient severe motion. In this article, we identify the challenges in obtaining high-quality arterial-phase images of gadoxetate disodium-enhanced liver MR imaging and present strategies for optimizing arterial-phase imaging based on the thorough review of recent research in this field.
Angiography ; Arteries/anatomy & histology ; Contrast Media/*chemistry ; Gadolinium DTPA/*chemistry ; Humans ; Liver/*radiography ; *Magnetic Resonance Imaging

OBJECTIVETo construct a three-dimensional (3D) liver model of Wuzhishan mini-pig for virtual liver surgeries.

METHODSThe biliary tree and hepatic arteries of Wuzhishan mini-pig were perfused with perchloroethylene and ethyl acetate along mixed with lead oxide, and the hepatic vein and portal vein were perfused with a mixture of dental base acrylic resin and lead oxide. The sectional images were acquired using a 64-slice spiral CT, and the 3D models of the portal vein, hepatic vein, biliary tree, hepatic arteries, and liver parenchyma were reconstructed using Mimics software; the resection image of the liver was also designed. The intrahepatic vascular cast was prepared by corroding the soft tissue with hydrochloric acid.

RESULTS AND CONCLUSIONThe intrahepatic vascular cast obtained fully retained the vascular architecture and displayed the fifth- and sixth-level branches of the hepatic vein and portal vein and the third- and fourth-level branches of the artery and bile duct. The 3D model of liver allowed stereoscopic and accurate display of the third- and fourth-level branches of the hepatic vein and portal vein and the second- and third-level branches of the artery and bile duct. The 3D model showed fewer branches but represented the structural distribution identical to the cast. The 3D model could clearly display the spatial relationship between the vasculature and the soft tissue in virtual resection of the liver tissues, and thus provides a useful model for training of laparoscopic liver resection.

Animals ; Bile Ducts ; Hepatic Artery ; Hepatic Veins ; Imaging, Three-Dimensional ; Liver ; anatomy & histology ; Models, Anatomic ; Portal Vein ; Swine ; Swine, Miniature ; Tomography, Spiral Computed

OBJECTIVETo study the value of three-dimensional (3D) visualization, 3D printing and 3D laparoscopy (3-3D techniques) in the diagnosis and surgical treatment of hepatic tumors.

METHODSFrom November 2013 to January 2015, 22 patients with hepatic tumors admitted in our department underwent abdominal thin-slice CT scanning. The CT images were imported into Medical Image three Dimensional Visualization System (MI-3DVS) for 3D reconstruction. Standard Template Library (STL) files were exported for 3D printing. The hepatic vascular classification and predicted liver resection were performed with the aid of MI-3DVS system. The 3D models were then printed and virtual liver resections were executed accordingly. Based on these preoperative surgical planning data, we performed anatomical hepatectomy using 3D laparoscopy, and the intraoperative blood loss, volume of virtual and actual liver resection and postoperative hospital stay were recorded.

RESULTSAccording to Michels's classifications, 19 patients had type I, 2 had type II, and 1 had type VIII hepatic arteries; based on Cheng classifications, the portal vein was classified into type I in 17 cases, type II in 2 cases, and type III in 2 cases, and type IV in 1 case; according to Nakamura classifications, the right hemiliver hepatic vein was classified into type I in 10 cases, type II in 7 cases, and type III in 5 cases. In the virtual operations, the mean volume of liver resected was 490 ± 228 ml and the mean remnant liver volume was 885 ± 139 ml, with a remnant to functional liver volume ratio of (71 ± 11)%. The 3D printed models stereoscopically displayed the location of the liver tumors and adjacent liver vascular structure clearly. Laparoscopic hepatectomy was performed successfully in 20 patients guided by the 3-3D techniques, and the other 2 patients required convertion to open hepatectomy. The mean operation time was 186 ± 92 min, the intraoperative blood loss was 284 ± 286 ml, the mean actual liver resection volume was 491 ± 192 ml, and the mean postoperative hospital stay of the patients was 8.6 ± 3.7 days.

CONCLUSIONSThe 3-3D technique can facilitate the evaluation of preoperative risk and critical anatomical structures and navigate the surgical procedure in real time in anatomical hepatectomy for hepatic tumors.

Blood Loss, Surgical ; Hepatectomy ; Hepatic Artery ; anatomy & histology ; Hepatic Veins ; anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Laparoscopy ; Liver Neoplasms ; diagnosis ; surgery ; Portal Vein ; Printing, Three-Dimensional ; Tomography, X-Ray Computed

In view of the problems of more artificial interventions and segmentation defects in existing two-dimensional segmentation methods and abnormal liver segmentation errors in three-dimensional segmentation methods, this paper presents a semi-automatic liver organ segmentation method based on the image sequence context. The method takes advantage of the existing similarity between the image sequence contexts of the prior knowledge of liver organs, and combines region growing and level set method to carry out semi-automatic segmentation of livers, along with the aid of a small amount of manual intervention to deal with liver mutation situations. The experiment results showed that the liver segmentation algorithm presented in this paper had a high precision, and a good segmentation effect on livers which have greater variability, and can meet clinical application demands quite well.
Algorithms ; Humans ; Image Interpretation, Computer-Assisted ; Imaging, Three-Dimensional ; Liver ; anatomy & histology

OBJECTIVETo investigate the risk factors associated with persistent thrombocytopenia after liver transplantation (LT), and to explore effective measures for prevention.

METHODSOne hundred and twenty-eight adult patients, who received liver transplantation in our hospital between January 2009 and June 2012 and met the inclusive criteria, were enrolled in the study. The clinical data were retrospectively analyzed, including pre-LT spleen volume, main portal vein size, coronary vein size, platelet and white blood cell levels, total bilirubin level and model of end stage liver disease score. The risk factors associated with persistent thrombocytopenia after LT were evaluated by logistic regression analysis. The effect of simultaneous splenic artery coarctation for high risk patients was evaluated with χ2 test.

RESULTSLogistic regression analysis showed that per-LT spleen volume larger than 500 ml (P = 0.012, OR=2.789, 95%CI: 1.249-6.227) and portal vein size beyond 15 mm (P = 0.017, OR = 3.124, 95%CI: 1.230-7.933) were independent risk factors for persistent thrombocytopenia after LT. The incidence rate of persistent thrombocytopenia after LT in patients with or without simultaneous splenic artery coarctation were 16.7% (1/6) and 66.7% (32/48), respectively(P < 0.05).

CONCLUSIONSpleen volume larger than 500 ml and portal vein size beyond 15 mm are risk factors for persistent thrombocytopenia after LT. Simultaneous splenic artery coarctation may reduce the occurrence of persistent thrombocytopenia after LT.

Adult ; Humans ; Liver Transplantation ; adverse effects ; Organ Size ; Portal Vein ; anatomy & histology ; Retrospective Studies ; Risk Factors ; Spleen ; anatomy & histology ; Thrombocytopenia ; epidemiology

OBJECTIVETo construct a three-dimensional (3D) model of arteries supplying the extrahepatic bile duct with a new segmentation algorithm based on submillimeter CT data.

METHODSThe new image segmentation algorithm based on interactive volume rendering was integrated into Medical Image Three-Dimensional Visualization System (MI-3DVS) as an intersected plug-in. The abdominal submillimeter CTA data of 10 patients were imported into MI-3DVS and the 3D model of the extrahepatic bile duct and its supplying arteries were constructed. The 3D model was zoomed in, zoomed out and spinned for observation and analysis of the arteries supplying the extrahepatic bile duct.

RESULTSThe 3D models of the blood supply to extrahepatic bile duct allowed stereoscopic, and accurate display of the fourth- and fifth-level branches of the hepatic artery, the second-level branches of the cystic artery, the pancreatic duodenal artery arch and the retroportal artery. The 3D models also provided a clear vision of the biliary structures including the hepatobiliary tract, the left and right hepatic ducts, gallbladder, the liver duct, and the common bile duct.

CONCLUSIONBased on the segmentation method of interactive volume rendering, the CT data of the arterioles supplying the extrahepatic bile duct can be extracted and segmented for 3D reconstruction to display the three-dimensional anatomical structures of the extrahepatic bile duct and its supplying arteries.

Bile Ducts, Extrahepatic ; anatomy & histology ; Hepatic Artery ; anatomy & histology ; Humans ; Imaging, Three-Dimensional ; Liver ; blood supply ; Models, Anatomic

BACKGROUND/AIMS: We compared the cirrhosis-prediction accuracy of an ultrasonographic scoring system (USSS) combining six representative sonographic indices with that of liver stiffness measurement (LSM) by transient elastography, and prospectively investigated the correlation between the USSS score and LSM in predicting cirrhosis. METHODS: Two hundred and thirty patients with chronic liver diseases (187 men, 43 women; age, 50.4+/-9.5 y, mean+/-SD) were enrolled in this prospective study. The USSS produces a combined score for nodularity of the liver surface and edge, parenchyma echogenicity, presence of right-lobe atrophy, spleen size, splenic vein diameter, and abnormality of the hepatic vein waveform. The correlations of the USSS score and LSM with that of a pathological liver biopsy (METAVIR scoring system: F0-F4) were evaluated. RESULTS: The mean USSS score and LSM were 7.2 and 38.0 kPa, respectively, in patients with histologically overt cirrhosis (F4, P=0.017) and 4.3 and 22.1 kPa in patients with fibrotic change without overt cirrhosis (F0-F3) (P=0.025). The areas under the receiver operating characteristic (ROC) curves of the USSS score and LSM for F4 patients were 0.849 and 0.729, respectively. On the basis of ROC curves, criteria of USSS > or =6: LSM > or =17.4 had a sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 89.2%:77.6%, 69.4%:61.4%, 86.5%:83.7%, 74.6%:51.9% and 0.83:0.73, respectively, in predicting F4. CONCLUSIONS: The results indicate that this USSS has comparable efficacy to LSM in the diagnosis of cirrhosis.
Adult ; Area Under Curve ; *Elasticity Imaging Techniques ; Female ; Hepatic Veins/physiopathology ; Humans ; Liver Cirrhosis/pathology/*ultrasonography ; Male ; Middle Aged ; Odds Ratio ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Severity of Illness Index ; Spleen/anatomy & histology ; Splenic Vein/physiology

No abstract available.
Fatty Liver/*complications ; Female ; Humans ; Intra-Abdominal Fat/*anatomy & histology ; Male ; Metabolic Syndrome X/*etiology