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1.
Céline Goffinet Valérie Kersten Anne-Catherine Pouleur Jean-Benoit le Polain de Waroux David Vancraeynest Agnès Pasquet Jean-Louis Vanoverschelde Bernhard L. Gerber 《European radiology》2010,20(2):326-336
Recent studies have suggested that both cardiac magnetic resonance (MR) and multidetector computed tomography (MDCT) can quantify
aortic regurgitation (AR) by planimetry of the anatomical regurgitant orifice (ARO). However, this measurement was not compared
with quantitative assessment of AR such as the effective regurgitant orifice (ERO) by proximal isosurface area (PISA) transthoracic
echocardiography (TTE) or phase contrast MR. In 42 patients (34 men, age 54 ± 11 years) we compared planimetered ARO by MDCT
and MR with ERO and regurgitant volume by PISA TTE and phase contrast MR. ARO by MDCT (r = 0.87, p < 0.001) and MR (r = 0.81, p < 0.001) correlated highly with ERO by TTE. However, ARO by MDCT (27 ± 15 mm2, p < 0.001), but not by MR (23 ± 13 mm2, p = 0.58), were larger than PISA ERO (22 ± 11 mm2). ARO by MDCT (r = 0.78, p < 0.001; r = 0.85, p < 0.001) and MR (r = 0.85, p < 0.001; r = 0.87 p < 0.001) correlated well with regurgitant volume by PISA and phase contrast MR. Both MDCT (к = 0.80, p < 0.001) and MR (к = 0.84, p < 0.001) demonstrated excellent agreement in correctly assessing the mechanisms of AR, i.e. aortic root dilatation (type
I), cusp prolapse (type II) and restrictive cusp motion (type III), using surgical inspection as a reference. Measurement
of ARO by both MDCT and MR allows accurate quantitative assessment of AR. Both techniques can also accurately determine the
mechanism of AR. 相似文献
2.
Bernhard D. Klumpp Joern Sandstede Klaus P. Lodemann Achim Seeger Tobias Hoevelborn Michael Fenchel Ulrich Kramer Claus D. Claussen Stephan Miller 《European radiology》2009,19(5):1124-1131
For contrast-enhanced imaging techniques relying on strong T1 weighting, 3 T provides increased contrast compared with 1.5 T.
The aim of our study was the intraindividual comparison of delayed enhancement MR imaging at 1.5 T and at 3 T. Twenty patients
with myocardial infarction were examined at 1.5 T and 3 T. Fifteen minutes after injection of contrast agent (0.1 mmol gadobenate
dimeglumine per kg body weight), inversion recovery gradient recalled echo (IR-GRE) sequences were acquired (1.5 T/3 T: TR
11.0/9.9 ms, TE 4.4/4.9 ms, flip 30°/30°, slice thickness 6/6 mm) to assess myocardial viability. Two observers rated image
quality (Wilcoxon signed rank test). Quantification of hyperenhanced myocardium and standardized SNR/CNR measurements were
performed (Student’s t test). There was no significant difference with respect to image quality (1.5 T/3 T: 3.5/3.3, p = 0.34, reader 1; 2.4/2.7, p = 0.12, reader 2) and infarction size (760 ± 566/828 ± 677 mm2 at 1.5 T, 808 ± 639/826 ± 726 mm2 at 3 T, reader 1/reader 2, p > 0.05). Mean SNR in hyperenhanced/normal myocardium was 19.2/6.2 at 1.5 T and 29.5/8.8 at 3 T (p < 0.05). Mean CNR was 14.3 at 1.5 T and 26.0 at 3 T (p < 0.05). Delayed enhancement MR imaging at 3 T is a robust procedure yielding superior tissue contrast at 3 T compared with
1.5 T which is, however, not reflected by increased image quality. 相似文献
3.
Cyran CC Sennino B Chaopathomkul B Fu Y Rogut VS Shames DM Wendland MF McDonald DM Brasch RC 《European radiology》2009,19(1):121-131
Thalidomide, which inhibits angiogenesis in certain tumor types, reduced extravasation of a macromolecular contrast medium
(MMCM) in a human breast cancer model as assayed by MMCM-enhanced dynamic magnetic resonance imaging (MRI) and fluorescence
microscopy in the same tumors. After a 1-week, three-dose course of thalidomide, the mean MRI-assayed endothelial transfer
coefficient, KPS, decreased significantly (p < 0.05) from 19.4 ± 9.1 to 6.3 ± 9.1 μl/min·100 cm3. Correspondingly, microscopic measurements of extravasated MMCM, expressed as fractional area of streptavidin staining, were
significantly (p < 0.05) lower in thalidomide-treated tumors (18.6 ± 11.9%) than in control saline-treated tumors (50.2 ± 2.3%). On a tumor-by-tumor
basis, post-treatment KPS values correlated significantly (r
2 = 0.55, p < 0.05) with microscopic measures of MMCM extravasation. However, no significant differences were observed between saline-
and thalidomide-treated tumors with respect to rate of growth, vascular richness, or amount of VEGF-containing cells. Because
of its sensitivity to the detection of changes in vascular leakage in tumors, this MMCM-enhanced MRI assay could prove useful
for monitoring the effects of thalidomide on an individual patient basis. The significant correlation between MRI and fluorescence
microscopic measures of MMCM extravasation supports the utility of the non-invasive MRI approach for assessing the action
of thalidomide on tumor blood vessels. 相似文献
4.
Abdel Razek AA Gaballa G Elhawarey G Megahed AS Hafez M Nada N 《European radiology》2009,19(1):201-208
We aimed to assess the clinical usefulness of the ADCs calculated from diffusion-weighted echo-planar MR images in the characterization
of pediatric head and neck masses. This study included 78 pediatric patients (46 boys and 32 girls aged 3 months–15 years,
mean 6 years) with head and neck mass. Routine MR imaging and diffusion-weighted MR imaging were done on a 1.5-T MR unit using
a single-shot echo-planar imaging (EPI) with a b factor of 0.500 and 1,000 s mm−2. The ADC value was calculated. The mean ADC values of the malignant tumours, benign solid masses and cystic lesions were
(0.93 ± 0.18) × 10−3, (1.57 ± 0.26) × 10–3 and (2.01 ± 0.21 )× 10–3 mm2 s−1, respectively. The difference in ADC value between the malignant tumours and benign lesions was statistically significant
(p < 0.001). When an apparent diffusion coefficient value of 1.25 × 10–3 mm2 s−1 was used as a threshold value for differentiating malignant from benign head and neck mass, the best results were obtained
with an accuracy of 92.8%, sensitivity of 94.4%, specificity of 91.2%, positive predictive value of 91% and negative predictive
value of 94.2%. Diffusion-weighted MR imaging is a new promising imaging approach that can be used for characterization of
pediatric head and neck mass. 相似文献
5.
Florian M. Buck Alexander Hoffmann Bernhard Hofer Christian W. A. Pfirrmann Bernhard Allgayer 《Skeletal radiology》2009,38(4):339-347
Objective The objective of this study was to correlate chronic medial knee pain at rest and during exercise with bone scintigraphic
uptake, bone marrow edema pattern (BMEP), cartilage lesions, meniscal tears, and collateral ligament pathologies on magnetic
resonance MR imaging (MRI).
Materials and methods Fifty consecutive patients with chronic medial knee pain seen at our institute were included in our study. Pain level at rest
and during exercise was assessed using a visual analog scale (VAS). On MR images, BMEP volume was measured, and the integrity
of femoro-tibial cartilage, medial meniscus, and medial collateral ligament (MCL) were assessed. Semiquantitative scintigraphic
tracer uptake was measured. Multivariate linear regression analysis was performed.
Results At the day of examination, 40 patients reported medial knee pain at rest, 49 when climbing stairs (at rest mean VAS 33 mm,
range 0–80 mm; climbing stairs mean VAS, 60 mm, range 20–100 mm). Bone scintigraphy showed increased tracer uptake in 36 patients
(uptake factor, average 3.7, range 2.4–18.0). MRI showed BMEP in 31 studies (mean volume, 4,070 mm3; range, 1,200–39,200 mm3). All patients with BMEP had abnormal bone scintigraphy. Ten percent of patients with pain at rest and 8% of patients with
pain during exercise showed no BMEP but tracer uptake in scintigraphy. Tracer uptake and signal change around MCL predicted
pain at rest significantly (tracer uptake p = 0.004; MCL signal changes p = 0.002). Only MCL signal changes predicted pain during exercise significantly (p = 0.001).
Conclusion In chronic medial knee pain, increased tracer uptake in bone scintigraphy is more sensitive for medial knee pain than BMEP
on MRI. Pain levels at rest and during exercise correlate with signal changes in and around the MCL. 相似文献
6.
Kenichiro Hamada Yasuhiko Tomita Ying Qiu Miki Tomoeda Takafumi Ueda Noriyuki Tamai Nobuyuki Hashimoto Hideki Yoshikawa Katsuyuki Aozasa Jun Hatazawa 《Skeletal radiology》2009,38(3):261-266
Objective In order to clarify the increased 2-deoxy-2-fluoro-18F-d-glucopyranose (18F-FDG) accumulation in schwannoma by positron emission tomography (PET) analysis, immunohistochemical analysis for the factors
involved in glucose transportation and vascular formation was performed.
Materials and methods Twenty-six patients with schwannoma (13 men and 13 women) with ages ranging from 27 to 75 years, who received whole body 18F-FDG PET scan, were enrolled for the present study. The retention index (RI) was calculated by dividing the increase in the
standardized uptake value (SUVmax) at the delayed scan by the SUVmax in the early scan. SUVmax and RI were compared with the
histologic variables, including the expression of glucose transporters 1 and 3, hexokinase II, vascular endothelial growth
factor/vascular permeability factor (VEGF/VPF), and microvascular density shown by CD31 immunohistochemistry.
Results Mean SUVmax values in the early and delayed scans were 2.64 ± 1.47 and 2.71 ± 1.57 (mean ± SD), respectively. RI was −2.5 ± 21 (percentage). SUVmax showed a positive correlation with the tumor size (tumor size <5 cm, 2.06 ± 0.72; >5 cm, 3.95 ± 1.89;
p < 0.05) and the microvascular density (negative density, 2.16 ± 1.12; positive density, 3.56 ± 1.67; p < 0.05). RI correlated with VEGF/VPF expression in the tumors (negative expression, −11 ± 6.1; positive expression, 13 ± 8.1;
p < 0.05). Other factors showed no correlation with SUVmax or RI.
Conclusions Microvascular density and vascular permeability of the tumor are suggested to affect the enhanced 18F-FDG accumulation in schwannoma. 相似文献
7.
Introduction This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas
by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately.
Materials and methods Thirty-seven meningiomas with peritumoral edema (15 meningothelial, ten fibrous, four angiomatous, and eight anaplastic) underwent
perfusion MR imaging by using a gradient echo echo-planar sequence. The maximal rCBV (compared with contralateral normal white
matter) in both tumoral parenchyma and peritumoral edema of each tumor was measured. The mean rCBVs of each two histological
subtypes were compared using one-way analysis of variance and least significant difference tests. A p value less than 0.05 indicated a statistically significant difference.
Results The mean rCBV of meningothelial, fibrous, angiomatous, and anaplastic meningiomas in tumoral parenchyma were 6.93 ± 3.75,
5.61 ± 4.03, 11.86 ± 1.93, and 5.89 ± 3.85, respectively, and in the peritumoral edema 0.87 ± 0.62, 1.38 ± 1.44, 0.87 ± 0.30,
and 3.28 ± 1.39, respectively. The mean rCBV in tumoral parenchyma of angiomatous meningiomas and in the peritumoral edema
of anaplastic meningiomas were statistically different (p < 0.05) from the other types of meningiomas.
Conclusion Perfusion MR imaging can provide useful functional information on meningiomas and help in the preoperative diagnosis of some
subtypes of meningiomas. 相似文献
8.
Huwart L Salameh N ter Beek L Vicaut E Peeters F Sinkus R Van Beers BE 《European radiology》2008,18(11):2535-2541
The purpose of this study was to prospectively compare the performance of magnetic resonance (MR) elastography using echo-planar
and spin-echo imaging for staging of hepatic fibrosis. Twenty-four patients who had liver biopsy for suspicion of chronic
liver disease had MR elastography performed with both spin-echo and echo-planar sequences. At histology, the fibrosis stage
was assessed according to METAVIR. The data acquisition time was about 20 min using spin-echo, and only 2 min using echo-planar
imaging. The hepatic signal-to-noise ratios were similar on both images (22.51 ± 5.37 for spin-echo versus 21.02 ± 4.76 for
echo-planar, p = 0.33). The elasticity measurements and the fibrosis stages were strongly correlated. The Spearman correlation coefficients
were r = 0.91 (p < 0.01) with spin-echo and r = 0.84 (p < 0.01) with echo-planar sequences. These correlation coefficients did not differ significantly (p = 0.17). A strong correlation was also observed between spin-echo and echo-planar elasticity (r = 0.83, p < 0.001), without systematic bias. The results of our study showed that echo-planar imaging substantially decreased the data
acquisition time of MR elastography, while maintaining the image quality and diagnostic performance for staging of liver fibrosis.
This suggests that echo-planar MR elastography could replace spin-echo MR elastography in clinical practice.
This work was supported by grants FRSM 3.4578.00 and 3.4580.06 from the Fonds National de la Recherche Scientifique, Belgium. 相似文献
9.
Storto G Sorrentino AR Pellegrino T Liuzzi R Petretta M Cuocolo A 《European journal of nuclear medicine and molecular imaging》2007,34(8):1156-1161
Purpose We assessed coronary flow reserve (CFR) by sestamibi imaging in patients with typical chest pain, positive exercise stress
test and normal coronary vessels.
Methods Thirty-five patients with typical chest pain and normal angiogram and 12 control subjects with atypical chest pain underwent
dipyridamole/rest 99mTc-sestamibi imaging. Myocardial blood flow (MBF) was estimated by measuring first transit counts in the pulmonary artery
and myocardial counts from SPECT images. Estimated CFR was expressed as the ratio of stress to rest MBF. Rest MBF and CFR
were corrected for rate–pressure product (RPP) and expressed as normalised MBF (MBFn) and normalised CFR (CFRn). Coronary vascular resistances (CVR) were calculated as the ratio between mean arterial pressure and estimated MBF.
Results At rest, estimated MBF and MBFn were lower in controls than in patients (0.98 ± 0.4 vs 1.30 ± 0.3 counts/pixel/s and 1.14 ± 0.5 vs 1.64 ± 0.6 counts/pixel/s,
respectively, both p < 0.02). Stress MBF was not different between controls and patients (2.34 ± 0.8 vs 2.01 ± 0.7 counts/pixel/s, p=NS). Estimated CFR was 2.40 ± 0.3 in controls and 1.54 ± 0.3 in patients (p < 0.0001). After correction for the RPP, CFRn was still higher in controls than in patients (2.1 ± 0.5 vs 1.29 ± 0.5, p < 0.0001). At baseline, CVR values were lower (p < 0.01) in patients than in controls. Dipyridamole-induced changes in CVR were greater (p < 0.0001) in controls (−63%) than in patients (−35%). In the overall study population, a significant correlation between
dipyridamole-induced changes in CVR and CFR was observed (r = −0.88, p < 0.0001).
Conclusion SPECT might represent a useful non-invasive method for assessing coronary vascular function in patients with angina and a
normal coronary angiogram. 相似文献
10.
Knaapen P de Mulder M van der Zant FM Peels HO Twisk JW van Rossum AC Cornel JH Umans VA 《European journal of nuclear medicine and molecular imaging》2009,36(2):237-243
Background Primary percutaneous coronary intervention (PCI) performed in large community hospitals without cardiac surgery back-up facilities
(off-site) reduces door-to-balloon time compared with emergency transferal to tertiary interventional centers (on-site). The
present study was performed to explore whether off-site PCI for acute myocardial infarction results in reduced infarct size.
Methods and results One hundred twenty-eight patients with acute ST-segment elevation myocardial infarction were randomly assigned to undergo
primary PCI at the off-site center (n = 68) or to transferal to an on-site center (n = 60). Three days after PCI, 99mTc-sestamibi SPECT was performed to estimate infarct size. Off-site PCI significantly reduced door-to-balloon time compared
with on-site PCI (94 ± 54 versus 125 ± 59 min, respectively, p < 0.01), although symptoms-to-treatment time was only insignificantly reduced (257 ± 211 versus 286 ± 146 min, respectively,
p = 0.39). Infarct size was comparable between treatment centers (16 ± 15 versus 14 ± 12%, respectively p = 0.35). Multivariate analysis revealed that TIMI 0/1 flow grade at initial coronary angiography (OR 3.125, 95% CI 1.17–8.33,
p = 0.023), anterior wall localization of the myocardial infarction (OR 3.44, 95% CI 1.38–8.55, p < 0.01), and development of pathological Q-waves (OR 5.07, 95% CI 2.10–12.25, p < 0.01) were independent predictors of an infarct size > 12%.
Conclusions Off-site PCI reduces door-to-balloon time compared with transferal to a remote on-site interventional center but does not
reduce infarct size. Instead, pre-PCI TIMI 0/1 flow, anterior wall infarct localization, and development of Q-waves are more
important predictors of infarct size. 相似文献
11.
Till A. Heusner Steffen Hahn Monia E. Hamami Svenja Kögel Michael Forsting Andreas Bockisch Gerald Antoch Alexander R. Stahl 《European journal of nuclear medicine and molecular imaging》2009,36(9):1397-1406
Purpose To retrospectively determine whether increased/asymmetric FDG uptake on PET without a correlating morphological lesion on
fully diagnostic CT indicates the development of a head and neck malignancy.
Methods In 590 patients (mean age 55.4 ± 13.3 years) without a head and neck malignancy/inflammation FDG uptake was measured at (a)
Waldeyer’s ring, (b) the oral floor, (c) the larynx, and (d) the thyroid gland, and rated as absent (group A), present (group
B), symmetric (group B1) or asymmetric (group B2). Differences between groups A and B and between B1 and B2 were tested for
significance with the U-test (p < 0.05). An average follow-up of about 2.5 years (mean 29.5 ± 13.9 months) served as the reference period to determine whether
patients developed a head and neck malignancy.
Results Of the 590 patients, 235 (40%) showed no evidence of enhanced FDG uptake in any investigated site, and 355 (60%) showed qualitatively
elevated FDG uptake in at least one site. FDG uptake values (SUVmax, mean±SD) for Waldeyer’s ring were 3.0 ± 0.89 in group A (n = 326), 4.5 ± 2.18 in group B (n = 264; p < 0.01), 5.4 ± 3.35 in group B1 (n = 177), and 4.1 ± 1.7 in group B2 (n = 87; p < 0.01). Values for the oral floor were 2.8 ± 0.74 in group A (n = 362), 4.7 ± 2.55 in group B (n = 228; p < 0.01), 4.4 ± 3.39 in group B1 (n = 130), and 5.1 ± 2.69 in group B2 (n = 98, p = 0.01). Values for the larynx were 2.8 ± 0.76 in group A (n = 353), 4.2 ± 2.05 in group B (n = 237; p < 0.01), 4.0 ± 2.02 in group B1 (n = 165), and 4.6 ± 2.8 in group B2 (n = 72; p = 0.027). Values for the thyroid were 2.4 ± 0.63 in group A (n = 404), 3.0 ± 1.01 in group B (n = 186; p < 0.01), 2.6 ± 0.39 in group B1 (n = 130), and 4.0 ± 1.24 in group B2 (n = 56; p < 0.01). One patient developed a palatine tonsil carcinoma (group B1, SUVmax 3.2), and one patient developed an oral floor carcinoma (group B1, SUVmax 3.7).
Conclusion Elevated/asymmetric head and neck FDG accumulation without a correlating morphological lesion can frequently be found and
does not predict cancer development. In populations in which goitre is endemic, FDG uptake by the thyroid is common and not
associated with thyroid cancer. 相似文献
12.
Masala S Mastrangeli R Petrella MC Massari F Ursone A Simonetti G 《European radiology》2009,19(1):165-171
Several authors claim that vertebroplasty (PVT) is a successful technique, but long-term effectiveness is still debated. Our
goal was to evaluate the effectiveness of PVT in patients with symptomatic vertebral fractures that had not responded to conservative
treatment. In our centre, 624 patients with 1,253 compression fractures were treated by PVT. Imaging studies, clinical visits
and short- and long-term follow-up were assessed by visual analogue scale (VAS) testing of pain. Statistical analysis was
performed to evaluate pain response after PVT (paired two-tailed t-test) and to assess any differences in pain due to different lesions (ANOVA test). We found a statistically significant improvement
in the patients’ quality of life, particularly in pain (P < 0.001). The average VAS value pre-PVT was 8.0 ± 2.5, which significantly dropped to 1.5 ± 0.4 by 12 months. There were
no significant differences in pain response between the groups of patients with different underlying disease. There was a
low complication rate in our study. PVT should be considered the treatment of choice in vertebral fractures with refractory
pain. With strict evaluation of the clinical indications and subspecialised operators, long-term effectiveness is probable. 相似文献
13.
This study was performed to prospectively compare multidetector computed tomography (MDCT) with 16 simultaneous sections and
magnetic resonance imaging (MRI) for the assessment of global right ventricular function in 50 patients. MDCT using a semiautomatic
analysis tool showed good correlation with MRI for end-diastolic volume (EDV, r = 0.83, p < 0.001), end-systolic volume (ESV, r = 0.86, p < 0.001) and stroke volume (SV, r = 0.74, p < 0.001), but only a moderate correlation for the ejection fraction (EF, r = 0.67, p < 0.001). Bland Altman analysis revealed a slight, but insignificant overestimation of EDV (4.0 ml, p = 0.08) and ESV (2.4 ml, p = 0.07), and underestimation of EF (0.1%, p = 0.92) with MDCT compared with MRI. All limits of agreement between both modalities (EF: ±15.7%, EDV: ±31.0 ml, ESV: ±18.0 ml)
were in a moderate but acceptable range. Interobserver variability of MDCT was not significantly different from that of MRI.
For MDCT software, the post-processing time was significantly longer (19.6 ± 5.8 min) than for MRI (11.8 ± 2.6 min, p < 0.001). Accurate assessment of right ventricular volumes by 16-detector CT is feasible but still rather time-consuming. 相似文献
14.
Allgayer C Zellweger MJ Sticherling C Haller S Weber O Buser PT Bremerich J 《European radiology》2008,18(12):2879-2884
Isolation of the pulmonary veins has emerged as a new therapy for atrial fibrillation. Pre-procedural magnetic resonance (MR)
imaging enhances safety and efficacy; moreover, it reduces radiation exposure of the patients and interventional team. The
purpose of this study was to optimize the MR protocol with respect to image quality and acquisition time. In 31 patients (23–73 years),
the anatomy of the pulmonary veins, left atrium and oesophagus was assessed on a 1.5-Tesla scanner with four different sequences:
(1) ungated two-dimensional true fast imaging with steady precession (2D-TrueFISP), (2) ECG/breath-gated 3D-TrueFISP, (3)
ungated breath-held contrast-enhanced three-dimensional turbo fast low-angle shot (CE-3D-tFLASH), and (4) ECG/breath-gated
CE-3D-TrueFISP. Image quality was scored from 1 (structure not visible) to 5 (excellent visibility), and the acquisition time
was monitored. The pulmonary veins and left atrium were best visualized with CE-3D-tFLASH (scores 4.50 ± 0.52 and 4.59 ± 0.43)
and ECG/breath-gated CE-3D-TrueFISP (4.47 ± 0.49 and 4.63 ± 0.39). Conspicuity of the oesophagus was optimal with CE-3D-TrueFISP
and 2D-TrueFISP (4.59 ± 0.35 and 4.19 ± 0.46) but poor with CE-3D-tFLASH (1.03 ± 0.13) (p < 0.05). Acquisition times were shorter for 2D-TrueFISP (44 ± 1 s) and CE-3D-tFLASH (345 ± 113 s) compared with ECG/breath-gated
3D-TrueFISP (634 ± 197 s) and ECG/breath-gated CE-3D-TrueFISP (636 ± 230 s) (p < 0.05). In conclusion, an MR imaging protocol comprising CE-3D-tFLASH and 2D-TrueFISP allows assessment of the pulmonary
veins, left atrium and oesophagus in less than 7 min and can be recommended for pre-procedural imaging before electric isolation
of pulmonary veins. 相似文献
15.
Till A. Heusner Steffen Hahn Monia E. Hamami Un-Hi Kim Rilana Baumeister Michael Forsting Alexander Stahl Andreas Bockisch Gerald Antoch 《European radiology》2009,19(9):2171-2179
Focal gastrointestinal 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) uptake can frequently be found on FDG-PET/CT even in patients without known gastrointestinal malignancy. The
aim of this study was to evaluate whether increased gastrointestinal FDG uptake without CT correlate is an early indicator
of patients developing gastrointestinal malignancies. A total of 1,006 patients without esophagogastric or anorectal malignancies
underwent FDG-PET/CT. The esophagogastric junction, the stomach and the anorectum were evaluated for increased FDG uptake.
Patients without elevated uptake were assigned to group A, patients with elevated uptake were allocated to group B. The SUVmax
values of both groups were tested for significant differences using the U test. A follow-up of longer than 1 year (mean 853 ± 414 days) served as gold standard. A total of 460 patients had to be
excluded based on insufficient follow-up data. For the remaining 546 patients the mean SUVmax was as follows: (a) esophagogastric
junction, group A 3.1 ± 0.66, group B 4.0 ± 1.11, p < 0.01; (b) stomach, group A 2.8 ± 0.77, group B 4.1 ± 1.33, p < 0.01; (c) rectal ampulla, group A 2.8 ± 0.83, group B 3.9 ± 1.49, p < 0.01; (d) anal canal, group A 2.7 ± 0.55, group B 3.9 ± 1.59, p < 0.01. Only one patient developed gastric cancer. In the case of an unremarkable CT, elevated esophagogastric or anorectal
FDG uptake does not predict cancer development and does not have to be investigated further. 相似文献
16.
Oto A Schmid-Tannwald C Agrawal G Kayhan A Lakadamyali H Orrin S Sethi I Sammet S Fan X 《Emergency radiology》2011,18(6):515-524
This study was conducted to determine the incremental value of diffusion-weighted MR imaging (DW-MRI) over T2-weighted imaging
diagnosing abdominopelvic abscesses and compare apparent diffusion coefficient (ADC) values of abscesses and non-infected
ascites. In this IRB-approved, HIPAA-compliant study, two radiologists retrospectively compared T2-weighted, T2-weighted + DW-MRI
and T2-weighted + contrast enhanced MR images of 58 patients (29 with abscess, 29 with ascites) who underwent abdominal MRI
for abscess detection. Confidence and sensitivity was compared using McNemar’s test. ADC of abscesses and ascites was compared
by t test, and a receiver operating characteristic (ROC) curve was constructed. Detection of abscesses and confidence improved
significantly when T2-weighted images were combined with DW-MRI (sensitivity: observer 1—100%, observer 2—96.6%) or contrast
enhanced images (sensitivity: both observers—100%) compared to T2-weighted images alone (sensitivity: observer 1—65.5%, observer
2—72.4%). All abscesses showed restricted diffusion. Mean ADC of abscesses (observer 1—1.17 ± 0.42 × 10−3 mm2/s, observer 2—1.43 ± 0.48 × 10−3 mm2/s) was lower than ascites (observer 1—3.57 ± 0.68 × 10−3 mm2/s, observer 2—3.42 ± 0.67 × 10−3 mm2/s) (p < 0.01). ROC analysis showed perfect discrimination of abscess from ascites with threshold ADC of 2.0 × 10−3 mm2/s (Az value 1.0). DW-MRI is a valuable adjunct to T2-weighted images diagnosing abdominopelvic abscesses. ADC measurements
may have the potential to differentiate abdominal abscesses from ascites. 相似文献
17.
Objectives Knowledge of bone age in achondroplasia is required for the prediction of adult height, timings of limb lengthening, and epiphysiodesis
procedures. The purpose of this investigation was to determine the differences in skeletal age in achondroplasia and a control
population with the Tanner–Whitehouse 3 method using the RUS score and to determine the right age for the interventional procedure
for limb lengthening procedure or deformity correction in these patients.
Materials and methods Left hand radiographs of 34 patients (age range, 5–18 years) with achondroplasia were evaluated for skeletal age using the
RUS scoring system, which were compared with the left hand radiographs of 41 patients (age range, 5–18 years) without achondroplasia
measuring skeletal age. The difference in chronological age and RUS bone age were evaluated statistically according to gender
and age group.
Results In the achondroplasia group, chronological age were 10.5 ± 4.3 years for males and 10.1 ± 3.6 years for females and RUS bone
age were 9.2 ± 4.0 years for males and 8.9 ± 3.4 years for females, which showed statistically significantly difference (males
p = 0.0003 and females p < 0.0001), while in the control group, chronological age were 11.1 ± 2.9 years for males and 10.7 ± 3.4 years for females
and RUS bone age were 11.2 ± 3.4 years for males and 10.7 ± 3.3 years for females, which did not show statistically significantly
difference (males p = 0.54 and females p = 0.76). Our finding suggested a delay of 1.4 years for males and 1.2 years for females in the maturation of bone in achondroplasia
patients. Difference between chronological age and RUS bone age was 0.9 ± 1.1 for <10 years and 1.6 ± 0.9 for >10 years in
the study group, while 0.1 ± 1.1 for <10 years and −0.2 ± 0.6 for >10 years in the control group, which also showed >statistically
significant difference (<10 years p = 0.04 and >10 years p < 0.0001). These differences indicate that there was a delay in the maturation of bones by 1 year in the group <10 years
and 1.8 years in the group >10 years in achondroplasia patients compared to nonachondroplasia patients.
Conclusion We recommend the use of the Tanner–Whitehouse 3 method especially the radius, ulna, short bone score to measure the skeletal
age and to wait for a longer time before interventional procedures in achondroplasia patients.
Each author certifies that he has no commercial associations (e.g., consultancies, stock ownership, equity interests, patent/licensing
arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. 相似文献
18.
Nakajima K Tamaki N Kuwabara Y Kawano M Matsunari I Taki J Nishimura S Yamashina A Ishida Y Tomoike H 《European journal of nuclear medicine and molecular imaging》2008,35(11):2038-2048
Backgrounds Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion
and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly
defined in multi-center studies.
Methods A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99mTc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up
period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments.
Results Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly
differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p < 0.0001 for non-gated; 64 ± 16% and 51 ± 17% for ES percent uptake, p < 0.0001). The area under the curve of receiver operating characteristics curve for non-gated percent uptake, ES percent
uptake, end-diastolic percent uptake and visual perfusion defect score was 0.70, 0.71, 0.61, and 0.56, respectively. Sensitivity
and specificity of percent uptake were 68% and 64% for non-gated map and 80% and 52% for ES percent uptake map. An optimal
threshold for predicting segmental improvement was 63% for non-gated and 52% for ES percent uptake values.
Conclusion Segmental 99mTc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated
and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study. 相似文献
19.
Yukihiro Umeda Yoshiki Demura Takeshi Ishizaki Shingo Ameshima Isamu Miyamori Yuji Saito Tatsuro Tsuchida Yasuhisa Fujibayashi Hidehiko Okazawa 《European journal of nuclear medicine and molecular imaging》2009,36(7):1121-1130
Purpose Individual clinical courses of idiopathic interstitial pneumonia (IIP) are variable and difficult to predict because the pathology
and disease activity are contingent, and chest computed tomography (CT) provides little information about disease activity.
In this study, we applied dual-time-point [18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET), commonly used for diagnosis of malignant tumours, to the differential diagnosis
and prediction of disease progression in IIP patients.
Methods Fifty patients with IIP, including idiopathic pulmonary fibrosis (IPF, n = 21), non-specific interstitial pneumonia (NSIP, n = 18) and cryptogenic organizing pneumonia (COP, n = 11), underwent 18F-FDG PET examinations at two time points: scan 1 at 60 min (early imaging) and scan 2 at 180 min (delayed imaging) after
18F-FDG injection. The standardized uptake values (SUV) at the two points and the retention index (RI-SUV) calculated from them
were evaluated and compared with chest CT findings, disease progression and disease types. To evaluate short-term disease
progression, all patients were examined by pulmonary function test every 3 months for 1 year after 18F-FDG PET scanning.
Results The early SUV for COP (2.47 ± 0.74) was significantly higher than that for IPF (0.99 ± 0.29, p = 0.0002) or NSIP (1.22 ± 0.44, p= 0.0025). When an early SUV cut-off value of 1.5 and greater was used to distinguish COP from IPF and NSIP, the sensitivity,
specificity and accuracy were 90.9, 94.3 and 93.5%, respectively. The RI-SUV for IPF and NSIP lesions was significantly greater
in patients with deteriorated pulmonary function after 1 year of follow-up (progressive group, 13.0 ± 8.9%) than in cases
without deterioration during the 1-year observation period (stable group, −16.8 ± 5.9%, p < 0.0001). However, the early SUV for all IIP types provided no additional information of disease progression. When an RI-SUV
cut-off value of 0% and greater was used to distinguish progressive IIPs from stable IIPs, the sensitivity, specificity and
accuracy were 95.5, 100 and 97.8%, respectively.
Conclusion Early SUV and RI-SUV obtained from dual-time-point 18F-FDG PET are useful parameters for the differential diagnosis and prediction of disease progression in patients with IIP. 相似文献
20.
Liu Z Okada DR Johnson G Hocherman SD Beju D Okada RD 《European journal of nuclear medicine and molecular imaging》2008,35(3):570-578
Introduction
99mTc-sestamibi has been proposed as a viability imaging agent. The purposes of this study were: (1) to determine the relationship
between myocardial viability and 99mTc-sestamibi kinetics using perfused rat heart models across a full spectrum of viability, (2) to do so under conditions where
myocardial flow was controlled and held constant, and (3) to do so using multiple quantitative methods to assess myocardial
viability.
Methods Twenty-three isolated rat hearts were perfused retrogradely with a modified Krebs-Henseleit (KH) solution. Four groups were
studied: controls (C, n = 6), stunned (S, n = 6), ischemic-reperfused (IR, n = 6), and calcium injured (CAL, n = 5). Following a 20-min baseline and subsequent treatment phase, 99mTc-sestamibi was infused over 60 min (uptake) followed by 60 min clearance. Treatment phases consisted of 20 min no flow for
S, 60 min no flow followed by 60 min reflow for IR, and 10 min infusion of KH solution without calcium followed by 20 min
infusion of KH solution with 2 times normal calcium for CAL hearts. Creatine kinase (CK) assay, triphenyltetrazolium chloride
(TTC) staining, and transmission electron microscopic (TEM) analysis were used to determine tissue viability.
Results Myocardial peak 99mTc-sestamibi uptake (%id) was significantly decreased in IR (4.11 ± 0.22 SEM; p < 0.05) and CAL (1.07 ± 0.13; p < 0.05), but not in S (4.88 ± 0.17) as compared with C (5.99 ± 0.50). One hour fractional retention was 79.3 ± 1.9% for C,
80.3 ± 1.3% for S (p = n.s.), 79.1 ± 1.8% for IR (p = n.s.), and 14.9 ± 4.3% for CAL (p < 0.05 compared to all other groups). 99mTc-sestamibi absolute retention (%id) 1 h after the end of tracer administration was significantly decreased in IR (3.26 ± 0.23)
and CAL (0.15 ± 0.02) as compared with both S (3.92 ± 0.16) and C (4.52 ± 0.32) (p < 0.05). CK increased significantly from baseline in the IR and CAL hearts. TTC determined percent viability was 100 ± 0%
for C, 98.3 ± 1.1% for S, 82.8 ± 2.6% for IR, and 0.0 ± 0% for CAL. TEM analysis supported these findings. End tracer activity
was significantly correlated with TTC determined percentage viable myocardium (r = 0.93, p < 0.05) and CK leak (r = −0.90, p < 0.05).
Conclusion
99mTc-sestamibi myocardial activity is significantly reduced in areas of nonviability after 1 h of tracer uptake and 1 h of tracer
clearance. There is a linear correlation between myocardial viability, as determined by three independent methods, and tracer
activity.
This work was supported by the American Heart Association, the Anne and Henry Zarrow Foundation, and the William K. Warren
Medical Research Foundation. 相似文献