Link to journal
Wrigge, Hermann; Zinserling, Jorg ; Muders, Thomas ; Varelmann, Dirk ; Gunther, Ulf et al
Electrical impedance tomography compared with thoracic computed tomography during a slow inflation maneuver in experimental models of lung injury
Critical Care Medicine. 36(3):903-909, March 2008.
Abstract
Objective: To determine the validity of functional electric impedance tomography to monitor regional ventilation distribution in experimental acute lung injury, and to develop a simple electric impedance tomography index detecting alveolar recruitment.Design: Randomized prospective experimental study.Setting: Academic research laboratory.Subjects: Sixteen anesthetized, tracheotomized, and mechanically ventilated pigs.Interventions: Acute lung injury was induced either by acid aspiration (direct acute lung injury) or by abdominal hypertension plus oleic acid injection (indirect acute lung injury) in ten pigs. Six pigs with normal lungs were studied as a control group and with endotracheal suction-related atelectasis. After 4 hrs of mechanical ventilation, a slow inflation was performed.Measurements and Main Results: During slow inflation, simultaneous measurements of regional ventilation by electric impedance tomography and dynamic computed tomography were highly correlated in quadrants of a transversal thoracic plane (r2 = .63-.88, p < .0001, bias <5%) r2 =" .63)." r2 =" .71" r2 =" .48" r2 =" .79">
Thursday 31 July 2008
Plain Radiography Versus CT Scans
Link to journal
Dai, Li-Yang; Wang, Xiang-Yang; Jiang, Lei-Sheng et al
Plain Radiography Versus Computed Tomography Scans in the Diagnosis and Management of Thoracolumbar Burst Fractures
Spine. 33(16):E548-E552, July 15, 2008.
Abstract
Study Design. The role of plain radiography in the diagnosis and management of thoracolumbar burst fractures was evaluated when compared with computed tomography (CT) scans.Objective. To determine the accuracy of plain radiography in detecting thoracolumbar burst fractures when CT scans were used as the gold standard, and to assess the impact of disagreement of the results between plain radiographs and CT scans on treatment plan.Summary of Background Data. There have been few studies comparing the value of plain radiography with that of CT scans in the diagnosis and management of thoracolumbar burst fractures.Methods. Radiographs of 73 patients with a compression or burst fracture were reviewed independently by 3 residents and 3 spine surgeons. The results of CT scans were used as the gold standard to determine the accuracy of plain radiography for the diagnosis. More quantitative results of 57 patients with a burst fracture based on plain radiographs alone were compared with those after addition of CT scans. The disagreement between the results was analyzed, and the impact of disagreement on treatment plan was defined as the changes of load sharing score between <=6 and >=7.Results. The accuracy of plain radiography improved with the experience of observers. The results on the load sharing score agreed between plain radiographs alone and radiographs with CT scans only for 56%, indicating moderate agreement. The impact of disagreement on treatment plan was significant (P <>
Dai, Li-Yang; Wang, Xiang-Yang; Jiang, Lei-Sheng et al
Plain Radiography Versus Computed Tomography Scans in the Diagnosis and Management of Thoracolumbar Burst Fractures
Spine. 33(16):E548-E552, July 15, 2008.
Abstract
Study Design. The role of plain radiography in the diagnosis and management of thoracolumbar burst fractures was evaluated when compared with computed tomography (CT) scans.Objective. To determine the accuracy of plain radiography in detecting thoracolumbar burst fractures when CT scans were used as the gold standard, and to assess the impact of disagreement of the results between plain radiographs and CT scans on treatment plan.Summary of Background Data. There have been few studies comparing the value of plain radiography with that of CT scans in the diagnosis and management of thoracolumbar burst fractures.Methods. Radiographs of 73 patients with a compression or burst fracture were reviewed independently by 3 residents and 3 spine surgeons. The results of CT scans were used as the gold standard to determine the accuracy of plain radiography for the diagnosis. More quantitative results of 57 patients with a burst fracture based on plain radiographs alone were compared with those after addition of CT scans. The disagreement between the results was analyzed, and the impact of disagreement on treatment plan was defined as the changes of load sharing score between <=6 and >=7.Results. The accuracy of plain radiography improved with the experience of observers. The results on the load sharing score agreed between plain radiographs alone and radiographs with CT scans only for 56%, indicating moderate agreement. The impact of disagreement on treatment plan was significant (P <>
Articles from Circulation
Link to journal
Bluemke, David A. ; Achenbach, Stephan ; Budoff, Matthew et al
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young.
Circulation. Status Publish Ahead of Print, published online before print, 27 June 2008
Gavazzi, Emanuele; Ravanelli, Marco; Farina, Davide; Chiari, Maria Elena; Maroldi, Roberto
Scimitar Syndrome: Comprehensive, Noninvasive Assessment With Cardiovascular Magnetic Resonance Imaging
Source
Circulation. 118(3):e63-e64, July 15, 2008.
von zur Muhlen, C ; von Elverfeldt, D ; Moeller, J A. ; Choudhury, R P. et al
Magnetic Resonance Imaging Contrast Agent Targeted Toward Activated Platelets Allows In Vivo Detection of Thrombosis and Monitoring of Thrombolysis
Circulation. 118(3):258-267, July 15, 2008.
Abstract
Background-: Platelets are the key to thrombus formation and play a role in the development of atherosclerosis. Noninvasive imaging of activated platelets would be of great clinical interest. Here, we evaluate the ability of a magnetic resonance imaging (MRI) contrast agent consisting of microparticles of iron oxide (MPIOs) and a single-chain antibody targeting ligand-induced binding sites (LIBS) on activated glycoprotein IIb/IIIa to image carotid artery thrombi and atherosclerotic plaques.Methods and Results-: Anti-LIBS antibody or control antibody was conjugated to 1-[mu]m MPIOs (LIBS MPIO/control MPIO). Nonocclusive mural thrombi were induced in mice with 6% ferric chloride. MRI (at 9.4 T) was performed once before and repeatedly in 12-minute-long sequences after LIBS MPIO/control MPIO injection. After 36 minutes, a significant signal void, corresponding to MPIO accumulation, was observed with LIBS MPIOs but not control MPIOs (P<0.05).>
Nazarian, Saman ; Kolandaivelu, Aravindan ; Zviman, Menekhem M. et al
Feasibility of Real-Time Magnetic Resonance Imaging for Catheter Guidance in Electrophysiology Studies
Circulation. 118(3):223-229, July 15, 2008.
Abstract
Background-: Compared with fluoroscopy, the current imaging standard of care for guidance of electrophysiology procedures, magnetic resonance imaging (MRI) provides improved soft-tissue resolution and eliminates radiation exposure. However, because of inherent magnetic forces and electromagnetic interference, the MRI environment poses challenges for electrophysiology procedures. In this study, we sought to test the feasibility of performing electrophysiology studies with real-time MRI guidance.Methods and Results-: An MRI-compatible electrophysiology system was developed. Catheters were targeted to the right atrium, His bundle, and right ventricle of 10 mongrel dogs (23 to 32 kg) via a 1.5-T MRI system using rapidly acquired fast gradient-echo images ([almost equal to]5 frames per second). Catheters were successfully positioned at the right atrial, His bundle, and right ventricular target sites of all animals. Comprehensive electrophysiology studies with recording of intracardiac electrograms and atrial and ventricular pacing were performed. Postprocedural pathological evaluation revealed no evidence of thermal injury to the myocardium. After proof of safety in animal studies, limited real-time MRI-guided catheter mapping studies were performed in 2 patients. Adequate target catheter localization was confirmed via recording of intracardiac electrograms in both patients.Conclusions-: To the best of our knowledge, this is the first study to report the feasibility of real-time MRI-guided electrophysiology procedures. This technique may eliminate patient and staff radiation exposure and improve real-time soft tissue resolution for procedural guidance.
Flogel, Ulrich PhD; Ding, Zhaoping MD; Hardung, Hendrik et al
In Vivo Monitoring of Inflammation After Cardiac and Cerebral Ischemia by Fluorine Magnetic Resonance Imaging.
Circulation. 118(2):140-148, July 8, 2008.
Abstract Background-: In this study, we developed and validated a new approach for in vivo visualization of inflammatory processes by magnetic resonance imaging using biochemically inert nanoemulsions of perfluorocarbons (PFCs).Methods and Results-: Local inflammation was provoked in 2 separate murine models of acute cardiac and cerebral ischemia, followed by intravenous injection of PFCs. Simultaneous acquisition of morphologically matching proton (1H) and fluorine (19F) images enabled an exact anatomic localization of PFCs after application. Repetitive 1H/19F magnetic resonance imaging at 9.4 T revealed a time-dependent infiltration of injected PFCs into the border zone of infarcted areas in both injury models, and histology demonstrated a colocalization of PFCs with cells of the monocyte/macrophage system. We regularly found the accumulation of PFCs in lymph nodes. Using rhodamine-labeled PFCs, we identified circulating monocytes/macrophages as the main cell fraction taking up injected nanoparticles.Conclusions-: PFCs can serve as a "positive" contrast agent for the detection of inflammation by magnetic resonance imaging, permitting a spatial resolution close to the anatomic 1H image and an excellent degree of specificity resulting from the lack of any 19F background. Because PFCs are nontoxic, this approach may have a broad application in the imaging and diagnosis of numerous inflammatory disease states. Schwitter, Juerg Extending the Frontiers of Cardiac Magnetic Resonance. [editorial] Circulation. 118(2):109-112, July 8, 2008.Flogel, Ulrich PhD; Ding, Zhaoping MD; Hardung, Hendrik et al In Vivo Monitoring of Inflammation After Cardiac and Cerebral Ischemia by Fluorine Magnetic Resonance Imaging. Circulation. 118(2):140-148, July 8, 2008. Abstract Background-: In this study, we developed and validated a new approach for in vivo visualization of inflammatory processes by magnetic resonance imaging using biochemically inert nanoemulsions of perfluorocarbons (PFCs).Methods and Results-: Local inflammation was provoked in 2 separate murine models of acute cardiac and cerebral ischemia, followed by intravenous injection of PFCs. Simultaneous acquisition of morphologically matching proton (1H) and fluorine (19F) images enabled an exact anatomic localization of PFCs after application. Repetitive 1H/19F magnetic resonance imaging at 9.4 T revealed a time-dependent infiltration of injected PFCs into the border zone of infarcted areas in both injury models, and histology demonstrated a colocalization of PFCs with cells of the monocyte/macrophage system. We regularly found the accumulation of PFCs in lymph nodes. Using rhodamine-labeled PFCs, we identified circulating monocytes/macrophages as the main cell fraction taking up injected nanoparticles.Conclusions-: PFCs can serve as a "positive" contrast agent for the detection of inflammation by magnetic resonance imaging, permitting a spatial resolution close to the anatomic 1H image and an excellent degree of specificity resulting from the lack of any 19F background. Because PFCs are nontoxic, this approach may have a broad application in the imaging and diagnosis of numerous inflammatory disease states.
Schwitter, Juerg Extending the Frontiers of Cardiac Magnetic Resonance. [editorial]
Circulation. 118(2):109-112, July 8, 2008.
Bluemke, David A. ; Achenbach, Stephan ; Budoff, Matthew et al
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young.
Circulation. Status Publish Ahead of Print, published online before print, 27 June 2008
Gavazzi, Emanuele; Ravanelli, Marco; Farina, Davide; Chiari, Maria Elena; Maroldi, Roberto
Scimitar Syndrome: Comprehensive, Noninvasive Assessment With Cardiovascular Magnetic Resonance Imaging
Source
Circulation. 118(3):e63-e64, July 15, 2008.
von zur Muhlen, C ; von Elverfeldt, D ; Moeller, J A. ; Choudhury, R P. et al
Magnetic Resonance Imaging Contrast Agent Targeted Toward Activated Platelets Allows In Vivo Detection of Thrombosis and Monitoring of Thrombolysis
Circulation. 118(3):258-267, July 15, 2008.
Abstract
Background-: Platelets are the key to thrombus formation and play a role in the development of atherosclerosis. Noninvasive imaging of activated platelets would be of great clinical interest. Here, we evaluate the ability of a magnetic resonance imaging (MRI) contrast agent consisting of microparticles of iron oxide (MPIOs) and a single-chain antibody targeting ligand-induced binding sites (LIBS) on activated glycoprotein IIb/IIIa to image carotid artery thrombi and atherosclerotic plaques.Methods and Results-: Anti-LIBS antibody or control antibody was conjugated to 1-[mu]m MPIOs (LIBS MPIO/control MPIO). Nonocclusive mural thrombi were induced in mice with 6% ferric chloride. MRI (at 9.4 T) was performed once before and repeatedly in 12-minute-long sequences after LIBS MPIO/control MPIO injection. After 36 minutes, a significant signal void, corresponding to MPIO accumulation, was observed with LIBS MPIOs but not control MPIOs (P<0.05).>
Nazarian, Saman ; Kolandaivelu, Aravindan ; Zviman, Menekhem M. et al
Feasibility of Real-Time Magnetic Resonance Imaging for Catheter Guidance in Electrophysiology Studies
Circulation. 118(3):223-229, July 15, 2008.
Abstract
Background-: Compared with fluoroscopy, the current imaging standard of care for guidance of electrophysiology procedures, magnetic resonance imaging (MRI) provides improved soft-tissue resolution and eliminates radiation exposure. However, because of inherent magnetic forces and electromagnetic interference, the MRI environment poses challenges for electrophysiology procedures. In this study, we sought to test the feasibility of performing electrophysiology studies with real-time MRI guidance.Methods and Results-: An MRI-compatible electrophysiology system was developed. Catheters were targeted to the right atrium, His bundle, and right ventricle of 10 mongrel dogs (23 to 32 kg) via a 1.5-T MRI system using rapidly acquired fast gradient-echo images ([almost equal to]5 frames per second). Catheters were successfully positioned at the right atrial, His bundle, and right ventricular target sites of all animals. Comprehensive electrophysiology studies with recording of intracardiac electrograms and atrial and ventricular pacing were performed. Postprocedural pathological evaluation revealed no evidence of thermal injury to the myocardium. After proof of safety in animal studies, limited real-time MRI-guided catheter mapping studies were performed in 2 patients. Adequate target catheter localization was confirmed via recording of intracardiac electrograms in both patients.Conclusions-: To the best of our knowledge, this is the first study to report the feasibility of real-time MRI-guided electrophysiology procedures. This technique may eliminate patient and staff radiation exposure and improve real-time soft tissue resolution for procedural guidance.
Flogel, Ulrich PhD; Ding, Zhaoping MD; Hardung, Hendrik et al
In Vivo Monitoring of Inflammation After Cardiac and Cerebral Ischemia by Fluorine Magnetic Resonance Imaging.
Circulation. 118(2):140-148, July 8, 2008.
Abstract Background-: In this study, we developed and validated a new approach for in vivo visualization of inflammatory processes by magnetic resonance imaging using biochemically inert nanoemulsions of perfluorocarbons (PFCs).Methods and Results-: Local inflammation was provoked in 2 separate murine models of acute cardiac and cerebral ischemia, followed by intravenous injection of PFCs. Simultaneous acquisition of morphologically matching proton (1H) and fluorine (19F) images enabled an exact anatomic localization of PFCs after application. Repetitive 1H/19F magnetic resonance imaging at 9.4 T revealed a time-dependent infiltration of injected PFCs into the border zone of infarcted areas in both injury models, and histology demonstrated a colocalization of PFCs with cells of the monocyte/macrophage system. We regularly found the accumulation of PFCs in lymph nodes. Using rhodamine-labeled PFCs, we identified circulating monocytes/macrophages as the main cell fraction taking up injected nanoparticles.Conclusions-: PFCs can serve as a "positive" contrast agent for the detection of inflammation by magnetic resonance imaging, permitting a spatial resolution close to the anatomic 1H image and an excellent degree of specificity resulting from the lack of any 19F background. Because PFCs are nontoxic, this approach may have a broad application in the imaging and diagnosis of numerous inflammatory disease states. Schwitter, Juerg Extending the Frontiers of Cardiac Magnetic Resonance. [editorial] Circulation. 118(2):109-112, July 8, 2008.Flogel, Ulrich PhD; Ding, Zhaoping MD; Hardung, Hendrik et al In Vivo Monitoring of Inflammation After Cardiac and Cerebral Ischemia by Fluorine Magnetic Resonance Imaging. Circulation. 118(2):140-148, July 8, 2008. Abstract Background-: In this study, we developed and validated a new approach for in vivo visualization of inflammatory processes by magnetic resonance imaging using biochemically inert nanoemulsions of perfluorocarbons (PFCs).Methods and Results-: Local inflammation was provoked in 2 separate murine models of acute cardiac and cerebral ischemia, followed by intravenous injection of PFCs. Simultaneous acquisition of morphologically matching proton (1H) and fluorine (19F) images enabled an exact anatomic localization of PFCs after application. Repetitive 1H/19F magnetic resonance imaging at 9.4 T revealed a time-dependent infiltration of injected PFCs into the border zone of infarcted areas in both injury models, and histology demonstrated a colocalization of PFCs with cells of the monocyte/macrophage system. We regularly found the accumulation of PFCs in lymph nodes. Using rhodamine-labeled PFCs, we identified circulating monocytes/macrophages as the main cell fraction taking up injected nanoparticles.Conclusions-: PFCs can serve as a "positive" contrast agent for the detection of inflammation by magnetic resonance imaging, permitting a spatial resolution close to the anatomic 1H image and an excellent degree of specificity resulting from the lack of any 19F background. Because PFCs are nontoxic, this approach may have a broad application in the imaging and diagnosis of numerous inflammatory disease states.
Schwitter, Juerg Extending the Frontiers of Cardiac Magnetic Resonance. [editorial]
Circulation. 118(2):109-112, July 8, 2008.
Articles from Plastic & Reconstructive Surgery
Link to journal
Masia, Jaume , Ph.D.; Clavero, Juan Angel; Larranaga, Jose ; Vives, Lorena M.D.; Pons, Gemma Preoperative Planning of the Abdominal Perforator Flap with Multidetector Row Computed Tomography: 3 Years of Experience.[Editorial]
122(2):80e-81e, August 2008
Rozen, Warren M.; Ashton, Mark W.; Stella, Damien
The Accuracy of Computed Tomographic Angiography for Mapping the Perforators of the DIEA: A Cadaveric Study.
122(2):80e-81e, August 2008
Abstract
Background: The deep inferior epigastric artery (DIEA) perforator flap is increasingly used for breast reconstruction, with preoperative imaging sought as a means of improving operative outcome. Computed tomographic angiography has been recently described as the preferred imaging modality; however, formal evaluation of computed tomographic angiography has not been described. A cadaveric study was undertaken to evaluate the accuracy of computed tomographic angiography for perforator mapping.Methods: Ten cadaveric hemiabdominal walls from five fresh cadavers underwent contrast injection of each DIEA and subsequent computed tomographic scanning, with each DIEA and all perforating branches documented. Dissection was then performed, with the recording of the course of the DIEA and the course of all perforators in each specimen. The concordance of computed tomographic angiography with dissection findings was evaluated.Results: Cadaveric computed tomographic angiography identified 154 perforators in 10 hemiabdominal walls. Computed tomographic angiography was highly accurate, with eight false-positives and six false-negatives on cadaveric computed tomographic angiography, establishing an overall sensitivity of 96 percent and a positive predictive value of 95 percent for mapping perforators. For perforators greater than 1 mm in diameter, the sensitivity was 100 percent and the positive predictive value was 100 percent.Conclusions: Computed tomographic angiography is a highly accurate tool for identifying the perforators of the DIEA before DIEA perforator flaps for breast reconstruction. Preoperative identification of these vessels can aid planning for the preferred hemiabdomen for dissection, and may save operative time, angst, and potentially complications.
Saint-Cyr, Michel; Schaverien, Mark ; Arbique, Gary ; Hatef, Dan
Three- and Four-Dimensional Computed Tomographic Angiography and Venography for the Investigation of the Vascular Anatomy and Perfusion of Perforator FlapsPlastic & Reconstructive Surgery.
121(3):772-780, March 2008.
Abstract Background: Two-dimensional contrast radiography is the current standard for investigating the vascular anatomy of surgical flaps. The microvascular anatomy of the perforator flap, however, is limited conceptually by representation in two dimensions. Static three-dimensional computed tomographic angiography enables vascular anatomy to be evaluated in the coronal, axial, and sagittal planes, and dynamic four-dimensional computed tomographic angiography allows the vascular filling of a perforator flap to be visualized over short time intervals in three dimensions.Methods: An anatomical study was performed using 11 fresh adult cadavers acquired through the Willed Body Program at the University of Texas Southwestern Medical Center, in Dallas, Texas. Four male and seven female cadavers were included in the study. Perforator flaps harvested included the following: anterolateral thigh, deep inferior epigastric perforator, superior gluteal artery perforator, inferior gluteal artery perforator, thoracodorsal artery perforator, anteromedial thigh, and dorsal intercostal artery perforator.Conclusions: Novel techniques for acquiring both static and dynamic three-dimensional images of macrovascular and microvascular perforator flap anatomy using computed tomographic angiography have been described. This methodology has also allowed the sequential investigation of adjacent vascular territories. This can provide a better understanding of how perforator flaps and the skin are perfused and may aid in the future design of new flaps.
Masia, Jaume , Ph.D.; Clavero, Juan Angel; Larranaga, Jose ; Vives, Lorena M.D.; Pons, Gemma Preoperative Planning of the Abdominal Perforator Flap with Multidetector Row Computed Tomography: 3 Years of Experience.[Editorial]
122(2):80e-81e, August 2008
Rozen, Warren M.; Ashton, Mark W.; Stella, Damien
The Accuracy of Computed Tomographic Angiography for Mapping the Perforators of the DIEA: A Cadaveric Study.
122(2):80e-81e, August 2008
Abstract
Background: The deep inferior epigastric artery (DIEA) perforator flap is increasingly used for breast reconstruction, with preoperative imaging sought as a means of improving operative outcome. Computed tomographic angiography has been recently described as the preferred imaging modality; however, formal evaluation of computed tomographic angiography has not been described. A cadaveric study was undertaken to evaluate the accuracy of computed tomographic angiography for perforator mapping.Methods: Ten cadaveric hemiabdominal walls from five fresh cadavers underwent contrast injection of each DIEA and subsequent computed tomographic scanning, with each DIEA and all perforating branches documented. Dissection was then performed, with the recording of the course of the DIEA and the course of all perforators in each specimen. The concordance of computed tomographic angiography with dissection findings was evaluated.Results: Cadaveric computed tomographic angiography identified 154 perforators in 10 hemiabdominal walls. Computed tomographic angiography was highly accurate, with eight false-positives and six false-negatives on cadaveric computed tomographic angiography, establishing an overall sensitivity of 96 percent and a positive predictive value of 95 percent for mapping perforators. For perforators greater than 1 mm in diameter, the sensitivity was 100 percent and the positive predictive value was 100 percent.Conclusions: Computed tomographic angiography is a highly accurate tool for identifying the perforators of the DIEA before DIEA perforator flaps for breast reconstruction. Preoperative identification of these vessels can aid planning for the preferred hemiabdomen for dissection, and may save operative time, angst, and potentially complications.
Saint-Cyr, Michel; Schaverien, Mark ; Arbique, Gary ; Hatef, Dan
Three- and Four-Dimensional Computed Tomographic Angiography and Venography for the Investigation of the Vascular Anatomy and Perfusion of Perforator FlapsPlastic & Reconstructive Surgery.
121(3):772-780, March 2008.
Abstract Background: Two-dimensional contrast radiography is the current standard for investigating the vascular anatomy of surgical flaps. The microvascular anatomy of the perforator flap, however, is limited conceptually by representation in two dimensions. Static three-dimensional computed tomographic angiography enables vascular anatomy to be evaluated in the coronal, axial, and sagittal planes, and dynamic four-dimensional computed tomographic angiography allows the vascular filling of a perforator flap to be visualized over short time intervals in three dimensions.Methods: An anatomical study was performed using 11 fresh adult cadavers acquired through the Willed Body Program at the University of Texas Southwestern Medical Center, in Dallas, Texas. Four male and seven female cadavers were included in the study. Perforator flaps harvested included the following: anterolateral thigh, deep inferior epigastric perforator, superior gluteal artery perforator, inferior gluteal artery perforator, thoracodorsal artery perforator, anteromedial thigh, and dorsal intercostal artery perforator.Conclusions: Novel techniques for acquiring both static and dynamic three-dimensional images of macrovascular and microvascular perforator flap anatomy using computed tomographic angiography have been described. This methodology has also allowed the sequential investigation of adjacent vascular territories. This can provide a better understanding of how perforator flaps and the skin are perfused and may aid in the future design of new flaps.
CT for Localization of Parathyroid Adenomas
Link to journal
Zald, Philip B. MD; Hamilton, Bronwyn E. MD; Larsen, Michael L. MD; Cohen, James I.
The Role of Computed Tomography for Localization of Parathyroid Adenomas
Laryngoscope.
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 2 June 2008
Abstract
Objective/Hypothesis: The purpose of this study was to evaluate the use of computed tomography (CT) for localization of parathyroid adenomas (PA) when first-line imaging is indeterminate.Study Design: Retrospective case series.Methods: A search of operating room and radiology records identified 223 surgical explorations for primary hyperparathyroidism. Adenoma locations on CT, ultrasound, and nuclear scintigraphy were correlated with an independent review of operative records.Results: The presence of adenoma in the correct side and quadrant of the neck was predicted by CT in 89% and 77% of studies, respectively. When first-line studies were indeterminate, the positive predictive value of CT for localization of PA to the correct side and quadrant of the neck was 87% and 69%, respectively.Conclusions: When first-line localization studies are indeterminate in patients with primary hyperparathyroidism, CT is a valuable, rapid, and widely available imaging modality that can be used to localize PA.
Zald, Philip B. MD; Hamilton, Bronwyn E. MD; Larsen, Michael L. MD; Cohen, James I.
The Role of Computed Tomography for Localization of Parathyroid Adenomas
Laryngoscope.
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 2 June 2008
Abstract
Objective/Hypothesis: The purpose of this study was to evaluate the use of computed tomography (CT) for localization of parathyroid adenomas (PA) when first-line imaging is indeterminate.Study Design: Retrospective case series.Methods: A search of operating room and radiology records identified 223 surgical explorations for primary hyperparathyroidism. Adenoma locations on CT, ultrasound, and nuclear scintigraphy were correlated with an independent review of operative records.Results: The presence of adenoma in the correct side and quadrant of the neck was predicted by CT in 89% and 77% of studies, respectively. When first-line studies were indeterminate, the positive predictive value of CT for localization of PA to the correct side and quadrant of the neck was 87% and 69%, respectively.Conclusions: When first-line localization studies are indeterminate in patients with primary hyperparathyroidism, CT is a valuable, rapid, and widely available imaging modality that can be used to localize PA.
Radiologic Clinics of North America Vol 46, No 2
Overview of Lymphoma Diagnosis and Management
Matthew J. Matasar, Andrew D. Zelenetz
pages 175-198
------------------------------------------------------------------------
The Impact of Fluorodeoxyglucose–Positron Emission Tomography in Primary Staging and Patient Management in Lymphoma Patients
Martin Allen-Auerbach, Sven de Vos, Johannes Czernin
pages 199-211
------------------------------------------------------------------------
New Staging and Response Criteria for Non-Hodgkin Lymphoma and Hodgkin Lymphoma
Bruce D. Cheson
pages 213-223
------------------------------------------------------------------------
PET Imaging for Response Assessment in Lymphoma: Potential and Limitations
Heiko Schöder, Craig Moskowitz
pages 225-241
------------------------------------------------------------------------
Perspectives of Molecular Imaging and Radioimmunotherapy in Lymphoma
Andrei Iagaru, Michael L. Goris, Sanjiv Sam Gambhir
pages 243-252
------------------------------------------------------------------------
Cross-Sectional Evaluation of Thoracic Lymphoma
Young A Bae, Kyung Soo Lee
pages 253-264
------------------------------------------------------------------------
Imaging of Abdominal Lymphoma
Munazza Anis, Abid Irshad
pages 265-285
------------------------------------------------------------------------
Imaging of Gastrointestinal Lymphoma
Marc J. Gollub
pages 287-312
------------------------------------------------------------------------
Imaging of Pediatric Lymphomas
Sara J. Abramson, Anita P. Price
pages 313-338
------------------------------------------------------------------------
Imaging of Lymphoma of the Central Nervous System, Spine, and Orbit
Sofia Haque, Meng Law, Lauren E. Abrey, Robert J. Young
pages 339-361
------------------------------------------------------------------------
Imaging Hodgkin and Non-Hodgkin Lymphoma in the Head and Neck
Ashley H. Aiken, Christine Glastonbury
pages 363-378
------------------------------------------------------------------------
Imaging of Lymphoma of the Musculoskeletal System
Sinchun Hwang
pages 379-396
------------------------------------------------------------------------
Imaging of Complications of Hematopoietic Stem Cell Transplantation
Jyothi P. Jagannathan, Nikhil Ramaiya, Ritu R. Gill, Edwin Pascal Alyea, Pablo Ros
pages 397-417
------------------------------------------------------------------------
Imaging of Late Complications from Mantle Field Radiation in Lymphoma Patients
Sandra Brennan, Lucy E. Hann, Joachim Yahalom, Kevin C. Oeffinger, Jürgen Rademaker
pages 419-430
Matthew J. Matasar, Andrew D. Zelenetz
pages 175-198
------------------------------------------------------------------------
The Impact of Fluorodeoxyglucose–Positron Emission Tomography in Primary Staging and Patient Management in Lymphoma Patients
Martin Allen-Auerbach, Sven de Vos, Johannes Czernin
pages 199-211
------------------------------------------------------------------------
New Staging and Response Criteria for Non-Hodgkin Lymphoma and Hodgkin Lymphoma
Bruce D. Cheson
pages 213-223
------------------------------------------------------------------------
PET Imaging for Response Assessment in Lymphoma: Potential and Limitations
Heiko Schöder, Craig Moskowitz
pages 225-241
------------------------------------------------------------------------
Perspectives of Molecular Imaging and Radioimmunotherapy in Lymphoma
Andrei Iagaru, Michael L. Goris, Sanjiv Sam Gambhir
pages 243-252
------------------------------------------------------------------------
Cross-Sectional Evaluation of Thoracic Lymphoma
Young A Bae, Kyung Soo Lee
pages 253-264
------------------------------------------------------------------------
Imaging of Abdominal Lymphoma
Munazza Anis, Abid Irshad
pages 265-285
------------------------------------------------------------------------
Imaging of Gastrointestinal Lymphoma
Marc J. Gollub
pages 287-312
------------------------------------------------------------------------
Imaging of Pediatric Lymphomas
Sara J. Abramson, Anita P. Price
pages 313-338
------------------------------------------------------------------------
Imaging of Lymphoma of the Central Nervous System, Spine, and Orbit
Sofia Haque, Meng Law, Lauren E. Abrey, Robert J. Young
pages 339-361
------------------------------------------------------------------------
Imaging Hodgkin and Non-Hodgkin Lymphoma in the Head and Neck
Ashley H. Aiken, Christine Glastonbury
pages 363-378
------------------------------------------------------------------------
Imaging of Lymphoma of the Musculoskeletal System
Sinchun Hwang
pages 379-396
------------------------------------------------------------------------
Imaging of Complications of Hematopoietic Stem Cell Transplantation
Jyothi P. Jagannathan, Nikhil Ramaiya, Ritu R. Gill, Edwin Pascal Alyea, Pablo Ros
pages 397-417
------------------------------------------------------------------------
Imaging of Late Complications from Mantle Field Radiation in Lymphoma Patients
Sandra Brennan, Lucy E. Hann, Joachim Yahalom, Kevin C. Oeffinger, Jürgen Rademaker
pages 419-430
Friday 11 July 2008
New books in the Library
The following books have been added to the stock of the Health Sciences Library:
Graham: Principles of radiological physics. 5th ed. 2007
Shelved at 616.0757
Chapman : A guide to radiological procedures. 4th ed. 2001
Shelved at 616.0757
Graham: Principles of radiological physics. 5th ed. 2007
Shelved at 616.0757
Chapman : A guide to radiological procedures. 4th ed. 2001
Shelved at 616.0757
Wednesday 9 July 2008
Radiology Management 2008 Vol 30 Part 3
N.B. We do not have access to the full text of this journal
Keeping Things Fresh
Murphy , D . L
Page: 6-7
Search the Web:
[article] [author(s)]
The Need to Supersize : A look at how the obesity epidemic in America is creating a big problem for healthcare , in general , and imaging , in particular
Lipcamon , J . D
Page: 8-10
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[article] [author(s)]
Dealing with Stress . . Build Resilience with Mind - Body Interventions
McHenry , S
Page: 11-15
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Play Your Cards Right and You Could Be a Winner : Marshall uses Three Card Monte as an analogy for Medicare's new reimbursement packaging mechanism
Marshall , J
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Breast and Prostate MRI : New Frontiers in Women and Men's Imaging
Curry , S . ; Belmont , V . ; Osiason , A . ; Boonstra , J .
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CR Cassettes and IP Plates : Implementing an Inspection and Repair Program
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Leading Radiology Services in the Age of Teleradiology , Wikinomics , and Online Medical Information
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Old Friends : How a professional network of colleagues and friends contributed to a successful career journey
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Medical Imaging as a Contributor to Today's Healthcare Crisis
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Taking Stock : Completing a Routine Due Diligence Check
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The Use of Simulation in Radiology
Lindskold , L . ; Aspelin , P . ; Jacobsson , B . ; Lundberg , N .
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No Email , No Worries Living off the grid ( at least every once in a while ) may not be the worst strategy for obtaining a healthy work / life balance
Tye , G . A
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Keeping Things Fresh
Murphy , D . L
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The Need to Supersize : A look at how the obesity epidemic in America is creating a big problem for healthcare , in general , and imaging , in particular
Lipcamon , J . D
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Dealing with Stress . . Build Resilience with Mind - Body Interventions
McHenry , S
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Play Your Cards Right and You Could Be a Winner : Marshall uses Three Card Monte as an analogy for Medicare's new reimbursement packaging mechanism
Marshall , J
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Breast and Prostate MRI : New Frontiers in Women and Men's Imaging
Curry , S . ; Belmont , V . ; Osiason , A . ; Boonstra , J .
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CR Cassettes and IP Plates : Implementing an Inspection and Repair Program
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Leading Radiology Services in the Age of Teleradiology , Wikinomics , and Online Medical Information
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Old Friends : How a professional network of colleagues and friends contributed to a successful career journey
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Medical Imaging as a Contributor to Today's Healthcare Crisis
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Taking Stock : Completing a Routine Due Diligence Check
Kroken , P
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The Use of Simulation in Radiology
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No Email , No Worries Living off the grid ( at least every once in a while ) may not be the worst strategy for obtaining a healthy work / life balance
Tye , G . A
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British Journal of Radiology 2008 Vol 81 Part 966
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Are we doing more harm than good ?
Pilling , D . W
Page: 441
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Tailored CT : primum non nocere
Lautin , E . M . ; Novick , M . K . ; Jean - Baptiste , R .
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Response assessment in solid tumours : a comparison of WHO , SWOG and RECIST guidelines
Julka , P . K . ; Doval , D . C . ; Gupta , S . ; Rath , G . K .
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Left ventricular ejection fraction using 64 - slice CT coronary angiography and new evaluation software : initial experience
Krishnam , M . S . ; Tomasian , A . ; Iv , M . ; Ruehm , S . G . et al
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Correlation of diffusion - weighted MRI with whole mount radical prostatectomy specimens:
van As , N . ; Charles - Edwards , E . ; Jackson , A . ; Jhavar , S . ; Reinsberg , S . et al
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Comparison between coronal reformatted images and direct coronal CT images of the swine lung specimen : assessment of image quality with 64 - detector row CT
Choi , E . J . ; Oh , Y . - W . ; Ham , S . Y . ; Lee , K . Y . ; Kang , E . - Y
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Pre - operative MR assessment of recurrent rectal cancer
Messiou , C . ; Chalmers , A . G . ; Boyle , K . ; Wilson , D . ; Sagar , P
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Reduction in patient skin dose during interventional radiology with the use of an air gap substitute
Kawabe , A . ; Takeda , Y . ; Nakagiri , Y .
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Renal cell carcinoma radiofrequency ablation : evaluation of efficacy based on histological correlation
Mylona , S . ; Ntai , S . ; Stroumpouli , E . ; Glentzes , V . ; Martins , S . ; Thanos , L
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A novel method for CT - scan - based localization of the internal mammary chain by internal mammary catheterization : an aid in breast cancer radiation therapy planning
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Munshi , A . ; Mallick , I . ; Budrukkar , A . ; Jalali , R . ; Badwe , R . ; Dinshaw , K . A . ; Sarin , R .
Page: 485-489
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Definitive chemoirradiation for resectable head and neck cancer : treatment outcome and prognostic significance of MRI findings
Chen , Y . - H . ; Jian , J . J . - M . ; Chan , K . - Y . ; Tsai , S . Y . et al
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Modelling the effect of lead and other materials for shielding of the fetus in CT pulmonary angiography
Iball , G . R . ; Kennedy , E . V . ; Brettle , D . S .
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Imaging appearances of unusual conditions of the middle and inner ear
Offiah , C . E . ; Ramsden , R . T . ; Gillespie , J . E .
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A pulsatile tracheal compression
Saxena , S . ; Gothi , D . ; Joshi , J . M .
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Patient exposure and risk assessment
Moores , B . M
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Are we doing more harm than good ?
Pilling , D . W
Page: 441
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Tailored CT : primum non nocere
Lautin , E . M . ; Novick , M . K . ; Jean - Baptiste , R .
Page: 442-443
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Response assessment in solid tumours : a comparison of WHO , SWOG and RECIST guidelines
Julka , P . K . ; Doval , D . C . ; Gupta , S . ; Rath , G . K .
Page: 444-449
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Left ventricular ejection fraction using 64 - slice CT coronary angiography and new evaluation software : initial experience
Krishnam , M . S . ; Tomasian , A . ; Iv , M . ; Ruehm , S . G . et al
Page: 450-455
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Correlation of diffusion - weighted MRI with whole mount radical prostatectomy specimens:
van As , N . ; Charles - Edwards , E . ; Jackson , A . ; Jhavar , S . ; Reinsberg , S . et al
Page: 456-462
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Comparison between coronal reformatted images and direct coronal CT images of the swine lung specimen : assessment of image quality with 64 - detector row CT
Choi , E . J . ; Oh , Y . - W . ; Ham , S . Y . ; Lee , K . Y . ; Kang , E . - Y
Page: 463-467
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Pre - operative MR assessment of recurrent rectal cancer
Messiou , C . ; Chalmers , A . G . ; Boyle , K . ; Wilson , D . ; Sagar , P
Page: 468-473
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Reduction in patient skin dose during interventional radiology with the use of an air gap substitute
Kawabe , A . ; Takeda , Y . ; Nakagiri , Y .
Page: 474-478
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Renal cell carcinoma radiofrequency ablation : evaluation of efficacy based on histological correlation
Mylona , S . ; Ntai , S . ; Stroumpouli , E . ; Glentzes , V . ; Martins , S . ; Thanos , L
Page: 479-484
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A novel method for CT - scan - based localization of the internal mammary chain by internal mammary catheterization : an aid in breast cancer radiation therapy planning
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Munshi , A . ; Mallick , I . ; Budrukkar , A . ; Jalali , R . ; Badwe , R . ; Dinshaw , K . A . ; Sarin , R .
Page: 485-489
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Definitive chemoirradiation for resectable head and neck cancer : treatment outcome and prognostic significance of MRI findings
Chen , Y . - H . ; Jian , J . J . - M . ; Chan , K . - Y . ; Tsai , S . Y . et al
Page: 490-498
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Modelling the effect of lead and other materials for shielding of the fetus in CT pulmonary angiography
Iball , G . R . ; Kennedy , E . V . ; Brettle , D . S .
Page: 499-503
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Imaging appearances of unusual conditions of the middle and inner ear
Offiah , C . E . ; Ramsden , R . T . ; Gillespie , J . E .
Page: 504-514
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A pulsatile tracheal compression
Saxena , S . ; Gothi , D . ; Joshi , J . M .
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Patient exposure and risk assessment
Moores , B . M
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Circulation - online articles
Link to journal
Bluemke, David A. ; Achenbach, Stephan; Budoff, Matthew et al
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young.
Publish Ahead of Print, published online before print, 27 June 2008
Sverdlov, Aaron L. ; Taylor, Karen ; Elkington, Andrew G. ; Zeitz, Christopher J. et al
Cardiac Magnetic Resonance Imaging Identifies the Elusive Perivalvular Abscess
Circulation. 118(1):e1-e3, July 1, 2008.
Politi, Luigi ; Monopoli, Daniel Enrique; Sgura, Fabio Alfredo ; Rossi, Rosario et al
Spontaneous Echocardiographic Wall Motion Abnormalities in Variant Angina
Source Circulation. 118(1):e4-e6, July 1, 2008
Bluemke, David A. ; Achenbach, Stephan; Budoff, Matthew et al
Noninvasive Coronary Artery Imaging: Magnetic Resonance Angiography and Multidetector Computed Tomography Angiography: A Scientific Statement From the American Heart Association Committee on Cardiovascular Imaging and Intervention of the Council on Cardiovascular Radiology and Intervention, and the Councils on Clinical Cardiology and Cardiovascular Disease in the Young.
Publish Ahead of Print, published online before print, 27 June 2008
Sverdlov, Aaron L. ; Taylor, Karen ; Elkington, Andrew G. ; Zeitz, Christopher J. et al
Cardiac Magnetic Resonance Imaging Identifies the Elusive Perivalvular Abscess
Circulation. 118(1):e1-e3, July 1, 2008.
Politi, Luigi ; Monopoli, Daniel Enrique; Sgura, Fabio Alfredo ; Rossi, Rosario et al
Spontaneous Echocardiographic Wall Motion Abnormalities in Variant Angina
Source Circulation. 118(1):e4-e6, July 1, 2008
Stroke. 39(7):1999-2005, July 2008
Link to journal
Nitkunan, Arani ; Barrick, Tom R. ; Charlton, Rebecca A. ; Clark, Chris A. ; Markus, Hugh S.
Multimodal MRI in Cerebral Small Vessel Disease: Its Relationship With Cognition and Sensitivity to Change Over Time.
Abstract
Background and Purpose-: Cerebral small vessel disease is the most common cause of vascular dementia. Interest in using MRI parameters as surrogate markers of disease to assess therapies is increasing. In patients with symptomatic sporadic small vessel disease, we determined which MRI parameters best correlated with cognitive function on cross-sectional analysis and which changed over a period of 1 year.Methods-: Thirty-five patients with lacunar stroke and leukoaraiosis were recruited. They underwent multimodal MRI (brain volume, fluid-attenuated inversion recovery lesion load, lacunar infarct number, fractional anisotropy, and mean diffusivity from diffusion tensor imaging) and neuropsychological testing. Twenty-seven agreed to reattend for repeat MRI and neuropsychology at 1 year.Results-: An executive function score correlated most strongly with diffusion tensor imaging (fractional anisotropy histogram, r=-0.640, P=0.004) and brain volume (r=0.501, P=0.034). Associations with diffusion tensor imaging were stronger than with all other MRI parameters. On multiple regression of all imaging parameters, a model that contained brain volume and fractional anisotropy, together with age, gender, and premorbid IQ, explained 74% of the variance of the executive function score (P=0.0001). Changes in mean diffusivity and fractional anisotropy were detectable over the 1-year follow-up; in contrast, no change in other MRI parameters was detectable over this time period.Conclusion-: A multimodal MRI model explains a large proportion of the variation in executive function in cerebral small vessel disease. In particular, diffusion tensor imaging correlates best with executive function and is the most sensitive to change. This supports the use of MRI, in particular diffusion tensor imaging, as a surrogate marker in treatment trials.
Nitkunan, Arani ; Barrick, Tom R. ; Charlton, Rebecca A. ; Clark, Chris A. ; Markus, Hugh S.
Multimodal MRI in Cerebral Small Vessel Disease: Its Relationship With Cognition and Sensitivity to Change Over Time.
Abstract
Background and Purpose-: Cerebral small vessel disease is the most common cause of vascular dementia. Interest in using MRI parameters as surrogate markers of disease to assess therapies is increasing. In patients with symptomatic sporadic small vessel disease, we determined which MRI parameters best correlated with cognitive function on cross-sectional analysis and which changed over a period of 1 year.Methods-: Thirty-five patients with lacunar stroke and leukoaraiosis were recruited. They underwent multimodal MRI (brain volume, fluid-attenuated inversion recovery lesion load, lacunar infarct number, fractional anisotropy, and mean diffusivity from diffusion tensor imaging) and neuropsychological testing. Twenty-seven agreed to reattend for repeat MRI and neuropsychology at 1 year.Results-: An executive function score correlated most strongly with diffusion tensor imaging (fractional anisotropy histogram, r=-0.640, P=0.004) and brain volume (r=0.501, P=0.034). Associations with diffusion tensor imaging were stronger than with all other MRI parameters. On multiple regression of all imaging parameters, a model that contained brain volume and fractional anisotropy, together with age, gender, and premorbid IQ, explained 74% of the variance of the executive function score (P=0.0001). Changes in mean diffusivity and fractional anisotropy were detectable over the 1-year follow-up; in contrast, no change in other MRI parameters was detectable over this time period.Conclusion-: A multimodal MRI model explains a large proportion of the variation in executive function in cerebral small vessel disease. In particular, diffusion tensor imaging correlates best with executive function and is the most sensitive to change. This supports the use of MRI, in particular diffusion tensor imaging, as a surrogate marker in treatment trials.
Spine - online articles
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Park, Chun-Kun ; Ryu, Kyeong-Sik ; Jee, Won-Hee
Degenerative Changes of Discs and Facet Joints in Lumbar Total Disc Replacement Using ProDisc II: Minimum Two-Year Follow-up
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 23 June 2008
Abstract
Study Design. A retrospective clinical and radiologic data analysis. Objective. To determine the radiologic changes in the discs at the adjacent levels and facets at the index and adjacent levels after total disc replacement (TDR) using ProDisc II in a minimum 2-year follow-up.Summary of the Background Data. The main purposes of TDR are to preserve the physiologic segmental motion at index level, and to prevent accelerated degeneration at the index and adjacent segments. However, there are few reports dealing with the effects of TDR on the degenerative changes in a long-term follow-up.Methods. After TDR using ProDisc II, the degree of disc and facets degeneration at the index and adjacent levels was assessed by observing lumbar magnetic resonance imaging (MRI) and computed tomography (CT) images before surgery and at minimum 26 months after operations. The degenerative changes of the discs and facets were determined in relation to the clinical outcome, various perioperative factors, and prosthesis factors.Results. Thirty-two patients with 41 TDR included in this investigation. The progression of facets degeneration (PFA) was observed in 12 of 41 TDR levels. Among 47 adjacent segments, the progression of disc degeneration and PFA were observed in 2 levels (4.3%), and 3 levels (6.4%), respectively. All cases of PFA occurred only in those with preoperative degeneration of grade 1. PFA at the index segments was positively related with female in gender (P = 0.008), the malposition of prosthesis on frontal plane (P = 0.025), and 2-level TDR in the number of TDR level (P = 0.008).Conclusion. After TDR using ProDisc II, the degenerative changes in the discs and facets at the adjacent segments appeared to be minimal. However, in 29.3% of the TDR segments, the facet joints presented PFA, which was more common in female, malposition of prosthesis on frontal plane, and 2-level TDR in a minimum 2-year follow-up.
Park, Chun-Kun ; Ryu, Kyeong-Sik ; Jee, Won-Hee
Degenerative Changes of Discs and Facet Joints in Lumbar Total Disc Replacement Using ProDisc II: Minimum Two-Year Follow-up
Publish Ahead of Print, POST AUTHOR CORRECTIONS, 23 June 2008
Abstract
Study Design. A retrospective clinical and radiologic data analysis. Objective. To determine the radiologic changes in the discs at the adjacent levels and facets at the index and adjacent levels after total disc replacement (TDR) using ProDisc II in a minimum 2-year follow-up.Summary of the Background Data. The main purposes of TDR are to preserve the physiologic segmental motion at index level, and to prevent accelerated degeneration at the index and adjacent segments. However, there are few reports dealing with the effects of TDR on the degenerative changes in a long-term follow-up.Methods. After TDR using ProDisc II, the degree of disc and facets degeneration at the index and adjacent levels was assessed by observing lumbar magnetic resonance imaging (MRI) and computed tomography (CT) images before surgery and at minimum 26 months after operations. The degenerative changes of the discs and facets were determined in relation to the clinical outcome, various perioperative factors, and prosthesis factors.Results. Thirty-two patients with 41 TDR included in this investigation. The progression of facets degeneration (PFA) was observed in 12 of 41 TDR levels. Among 47 adjacent segments, the progression of disc degeneration and PFA were observed in 2 levels (4.3%), and 3 levels (6.4%), respectively. All cases of PFA occurred only in those with preoperative degeneration of grade 1. PFA at the index segments was positively related with female in gender (P = 0.008), the malposition of prosthesis on frontal plane (P = 0.025), and 2-level TDR in the number of TDR level (P = 0.008).Conclusion. After TDR using ProDisc II, the degenerative changes in the discs and facets at the adjacent segments appeared to be minimal. However, in 29.3% of the TDR segments, the facet joints presented PFA, which was more common in female, malposition of prosthesis on frontal plane, and 2-level TDR in a minimum 2-year follow-up.
Stroke - online articles
Link to journal
Burgess, Richard E.; Warach, Steven; Schaewe, Timothy J. et al
Development and Validation of a Simple Conversion Model for Comparison of Intracerebral Hemorrhage Volumes Measured on CT and Gradient Recalled Echo MRI.
Publish Ahead of Print, published online before print, 15 May 2008
Abstract
Background and Purpose-: Gradient recalled echo MRI (GRE) has been shown to be as accurate as CT for the detection of acute intracerebral hemorrhage (ICH). However, because of the differences in the signal parameter being detected, apparent hemorrhage size is expected to vary by imaging modality, with GRE providing larger volumes attributable to susceptibility effects.Methods-: Image data from patients participating in 3 ICH studies were retrospectively reviewed. Patients with acute ICH were included if (1) concurrent MRI and CT were performed within 72 hours of symptom onset, and (2) each modality was performed within 240 minutes of each other. ICH volumes were calculated using a semiautomated image analysis program. The least squares method was used to develop a conversion equation based on a linear regression of GRE volume on CT volume.Results-: Thirty-six patients met inclusion criteria. MRI was performed first in 18, CT first in 18. Mean hemorrhage volume was 25.2cc (range 0.1 to 83.9cc) on CT and 32.7cc (range 0.1 to 98.7cc) measured on GRE. A linear relationship defined by CT Volume=GRE Volume*0.8 (Spearman's correlation coefficient=0.992, P<0.001) volume="0.8*GRE">
Mandell, Daniel M. ; Han, Jay S. ; Poublanc, Julien et al
Mapping Cerebrovascular Reactivity Using Blood Oxygen Level-Dependent MRI in Patients With Arterial Steno-occlusive Disease: Comparison With Arterial Spin Labeling MRI.
Publish Ahead of Print, published online before print, 1 May 2008
Abstract Background and Purpose-: Blood oxygen level-dependent MRI (BOLD MRI) of hypercapnia-induced changes in cerebral blood flow is an emerging technique for mapping cerebrovascular reactivity (CVR). BOLD MRI signal reflects cerebral blood flow, but also depends on cerebral blood volume, cerebral metabolic rate, arterial oxygenation, and hematocrit. The purpose of this study was to determine whether, in patients with stenoocclusive disease, the BOLD MRI signal response to hypercapnia is directly related to changes in cerebral blood flow.Methods-: Thirty-eight patients with steno-occlusive disease underwent mapping of CVR by both BOLD MRI and arterial spin labeling MRI. The latter technique was used as a reference standard for measurement of cerebral blood flow changes.Results-: Hemispheric CVR measured by BOLD MRI was significantly correlated with that measured by arterial spin labeling MRI for both gray matter (R=0.83, P<0.0001) and white matter (R=0.80, P<0.0001). Diagnostic accuracy (area under receiver operating characteristic curve) for BOLD MRI discrimination between normal and abnormal hemispheric CVR was 0.90 (95% CI=0.81 to 0.98; P<0.001) for gray matter and 0.82 (95% CI=0.70 to 0.94; P<0.001) for white matter. Regions of paradoxical CVR on BOLD MRI had a moderate predictive value (14 of 19 hemispheres) for spatially corresponding paradoxical CVR on arterial spin labeling MRI. Complete absence of paradoxical CVR on BOLD MRI had a high predictive value (31 of 31 hemispheres) for corresponding nonparadoxical CVR on arterial spin labeling MRI.Conclusions-: Arterial spin labeling MRI confirms that, even in patients with stenoocclusive disease, the BOLD MRI signal response to hypercapnia predominantly reflects changes in cerebral blood flow.
Freund, Wolfgang MD; Kassubek, Jan MD; Aschoff, Andrik J. MD; Huber, Roman MRI-Based Separation of Congenital and Acquired Vertebrobasilar Artery Anomalies in Ischemic Stroke of the Posterior Circulation.[Letter]
Publish Ahead of Print, published online before print, 5 June 2008
Abstract Background and Purpose-: Stroke MRI protocols provide useful information about underlying vessel pathologies in the anterior circulation by means of intracranial time-of-flight angiography. However, these protocols mostly fail in the posterior circulation to differentiate between congenital variants and secondary thrombosis. Therefore, a high-resolution anatomic True Fast Imaging in Steady State Precession sequence, added to a commonly used stroke imaging protocol, was evaluated.Methods-: MRIs of all emergency admissions to the stroke unit over 2 months were analyzed. Variations in the posterior circulation as displayed by time-of-flight and by the True Fast Imaging in Steady State Precession sequence, respectively, were graded by 2 readers blinded to the diagnosis.Results-: In the time-of-flight angiography, 50% of patients presented with distinctive vertebrobasilar alterations. Half of these were judged as high-grade anomalies, of which the True Fast Imaging in Steady State Precession sequence identified 25% as hypoplasia. In 40% of all patients with posterior ischemia, the True Fast Imaging in Steady State Precession sequence confirmed an acquired occlusion of the vertebrobasilar arteries.Conclusions-: The addition of an anatomic (True Fast Imaging in Steady State Precession) to a functional sequence (time-of-flight) in stroke MRI protocols enables the differentiation between artery occlusions and hypoplastic variants of the vertebral arteries.
Kastrup, Andreas ; Groschel, Klaus ; Ringer, Thomas M. ; Redecker, Christoph et al
Early Disruption of the Blood-Brain Barrier After Thrombolytic Therapy Predicts Hemorrhage in Patients With Acute Stroke.[Letter]
Publish Ahead of Print, published online before print, 12 June 2008
Abstract Background and Purpose-: Leaks of the blood-brain barrier can be detected on postcontrast-enhanced T1-weighted MRIs. Although early disruptions of the blood-brain barrier appear to be an important risk factor for tissue plasminogen activator-related hemorrhages in rodents, little is known about their incidence and consequences in human stroke.Methods-: This is a retrospective analysis of a prospectively collected stroke database over the past 6 years. In 52 patients, multimodal MRI (including diffusion-weighted, perfusion-weighted, and postcontrast-enhanced T1-weighted MRI to detect blood-brain barrier changes) had been performed immediately before systemic thrombolysis and in 48 patients within a median of 30 minutes (interquartile range: 30 to 60 minutes) after recombinant tissue plasminogen activator treatment. The incidence of symptomatic hemorrhage (SICH), defined as any parenchymal hemorrhage leading to deterioration in the patient's clinical condition, was related to several clinical and imaging variables, including early blood-brain barrier changes.Results-: Overall, SICH was detected in 9 (9%) patients and among these, 2 died. Although no blood-brain barrier changes were detectable before thrombolysis, 3 of 48 patients (6.25%) had a parenchymal gadolinium enhancement in the areas of initial infarction after tissue plasminogen activator treatment. All 3 patients developed SICHs at sites corresponding to the areas of enhancement. The presence of a parenchymal enhancement was significantly associated with SICH (P<0.01),>
Burgess, Richard E.; Warach, Steven; Schaewe, Timothy J. et al
Development and Validation of a Simple Conversion Model for Comparison of Intracerebral Hemorrhage Volumes Measured on CT and Gradient Recalled Echo MRI.
Publish Ahead of Print, published online before print, 15 May 2008
Abstract
Background and Purpose-: Gradient recalled echo MRI (GRE) has been shown to be as accurate as CT for the detection of acute intracerebral hemorrhage (ICH). However, because of the differences in the signal parameter being detected, apparent hemorrhage size is expected to vary by imaging modality, with GRE providing larger volumes attributable to susceptibility effects.Methods-: Image data from patients participating in 3 ICH studies were retrospectively reviewed. Patients with acute ICH were included if (1) concurrent MRI and CT were performed within 72 hours of symptom onset, and (2) each modality was performed within 240 minutes of each other. ICH volumes were calculated using a semiautomated image analysis program. The least squares method was used to develop a conversion equation based on a linear regression of GRE volume on CT volume.Results-: Thirty-six patients met inclusion criteria. MRI was performed first in 18, CT first in 18. Mean hemorrhage volume was 25.2cc (range 0.1 to 83.9cc) on CT and 32.7cc (range 0.1 to 98.7cc) measured on GRE. A linear relationship defined by CT Volume=GRE Volume*0.8 (Spearman's correlation coefficient=0.992, P<0.001) volume="0.8*GRE">
Mandell, Daniel M. ; Han, Jay S. ; Poublanc, Julien et al
Mapping Cerebrovascular Reactivity Using Blood Oxygen Level-Dependent MRI in Patients With Arterial Steno-occlusive Disease: Comparison With Arterial Spin Labeling MRI.
Publish Ahead of Print, published online before print, 1 May 2008
Abstract Background and Purpose-: Blood oxygen level-dependent MRI (BOLD MRI) of hypercapnia-induced changes in cerebral blood flow is an emerging technique for mapping cerebrovascular reactivity (CVR). BOLD MRI signal reflects cerebral blood flow, but also depends on cerebral blood volume, cerebral metabolic rate, arterial oxygenation, and hematocrit. The purpose of this study was to determine whether, in patients with stenoocclusive disease, the BOLD MRI signal response to hypercapnia is directly related to changes in cerebral blood flow.Methods-: Thirty-eight patients with steno-occlusive disease underwent mapping of CVR by both BOLD MRI and arterial spin labeling MRI. The latter technique was used as a reference standard for measurement of cerebral blood flow changes.Results-: Hemispheric CVR measured by BOLD MRI was significantly correlated with that measured by arterial spin labeling MRI for both gray matter (R=0.83, P<0.0001) and white matter (R=0.80, P<0.0001). Diagnostic accuracy (area under receiver operating characteristic curve) for BOLD MRI discrimination between normal and abnormal hemispheric CVR was 0.90 (95% CI=0.81 to 0.98; P<0.001) for gray matter and 0.82 (95% CI=0.70 to 0.94; P<0.001) for white matter. Regions of paradoxical CVR on BOLD MRI had a moderate predictive value (14 of 19 hemispheres) for spatially corresponding paradoxical CVR on arterial spin labeling MRI. Complete absence of paradoxical CVR on BOLD MRI had a high predictive value (31 of 31 hemispheres) for corresponding nonparadoxical CVR on arterial spin labeling MRI.Conclusions-: Arterial spin labeling MRI confirms that, even in patients with stenoocclusive disease, the BOLD MRI signal response to hypercapnia predominantly reflects changes in cerebral blood flow.
Freund, Wolfgang MD; Kassubek, Jan MD; Aschoff, Andrik J. MD; Huber, Roman MRI-Based Separation of Congenital and Acquired Vertebrobasilar Artery Anomalies in Ischemic Stroke of the Posterior Circulation.[Letter]
Publish Ahead of Print, published online before print, 5 June 2008
Abstract Background and Purpose-: Stroke MRI protocols provide useful information about underlying vessel pathologies in the anterior circulation by means of intracranial time-of-flight angiography. However, these protocols mostly fail in the posterior circulation to differentiate between congenital variants and secondary thrombosis. Therefore, a high-resolution anatomic True Fast Imaging in Steady State Precession sequence, added to a commonly used stroke imaging protocol, was evaluated.Methods-: MRIs of all emergency admissions to the stroke unit over 2 months were analyzed. Variations in the posterior circulation as displayed by time-of-flight and by the True Fast Imaging in Steady State Precession sequence, respectively, were graded by 2 readers blinded to the diagnosis.Results-: In the time-of-flight angiography, 50% of patients presented with distinctive vertebrobasilar alterations. Half of these were judged as high-grade anomalies, of which the True Fast Imaging in Steady State Precession sequence identified 25% as hypoplasia. In 40% of all patients with posterior ischemia, the True Fast Imaging in Steady State Precession sequence confirmed an acquired occlusion of the vertebrobasilar arteries.Conclusions-: The addition of an anatomic (True Fast Imaging in Steady State Precession) to a functional sequence (time-of-flight) in stroke MRI protocols enables the differentiation between artery occlusions and hypoplastic variants of the vertebral arteries.
Kastrup, Andreas ; Groschel, Klaus ; Ringer, Thomas M. ; Redecker, Christoph et al
Early Disruption of the Blood-Brain Barrier After Thrombolytic Therapy Predicts Hemorrhage in Patients With Acute Stroke.[Letter]
Publish Ahead of Print, published online before print, 12 June 2008
Abstract Background and Purpose-: Leaks of the blood-brain barrier can be detected on postcontrast-enhanced T1-weighted MRIs. Although early disruptions of the blood-brain barrier appear to be an important risk factor for tissue plasminogen activator-related hemorrhages in rodents, little is known about their incidence and consequences in human stroke.Methods-: This is a retrospective analysis of a prospectively collected stroke database over the past 6 years. In 52 patients, multimodal MRI (including diffusion-weighted, perfusion-weighted, and postcontrast-enhanced T1-weighted MRI to detect blood-brain barrier changes) had been performed immediately before systemic thrombolysis and in 48 patients within a median of 30 minutes (interquartile range: 30 to 60 minutes) after recombinant tissue plasminogen activator treatment. The incidence of symptomatic hemorrhage (SICH), defined as any parenchymal hemorrhage leading to deterioration in the patient's clinical condition, was related to several clinical and imaging variables, including early blood-brain barrier changes.Results-: Overall, SICH was detected in 9 (9%) patients and among these, 2 died. Although no blood-brain barrier changes were detectable before thrombolysis, 3 of 48 patients (6.25%) had a parenchymal gadolinium enhancement in the areas of initial infarction after tissue plasminogen activator treatment. All 3 patients developed SICHs at sites corresponding to the areas of enhancement. The presence of a parenchymal enhancement was significantly associated with SICH (P<0.01),>
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