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31.
Whole-heart cine MRI using real-time respiratory self-gating. 总被引:1,自引:0,他引:1
Sergio Uribe Vivek Muthurangu Redha Boubertakh Tobias Schaeffter Reza Razavi Derek L G Hill Michael S Hansen 《Magnetic resonance in medicine》2007,57(3):606-613
Two-dimensional (2D) breath-hold cine MRI is used to assess cardiac anatomy and function. However, this technique requires cooperation from the patient, and in some cases the scan planning is complicated. Isotropic nonangulated three-dimensional (3D) cardiac MR can overcome some of these problems because it requires minimal planning and can be reformatted in any plane. However, current methods, even those that use undersampling techniques, involve breath-holding for periods that are too long for many patients. Free-breathing respiratory gating sequences represent a possible solution for realizing 3D cine imaging. A real-time respiratory self-gating technique for whole-heart cine MRI is presented. The technique enables assessment of cardiac anatomy and function with minimum planning or patient cooperation. Nonangulated isotropic 3D data were acquired from five healthy volunteers and then reformatted into 2D clinical views. The respiratory self-gating technique is shown to improve image quality in free-breathing scanning. In addition, ventricular volumetric data obtained using the 3D approach were comparable to those acquired with the conventional multislice 2D approach. 相似文献
32.
Richard Werner Karsten Alfke Tobias Schaeffter Arya Nabavi H Maximilian Mehdorn Olav Jansen 《Magnetic resonance in medicine》2004,52(6):1443-1447
A new method for the selective spin labeling of left- or right-sided supplying arteries of the brain without the need for additional RF coils is demonstrated. A clinical 1.5 T scanner was used. The spatial selectivity of the labeling process is based on the limited coverage of the excitation field of a standard send/receive head coil together with an oblique positioning of the labeling plane. A computer simulation was used to optimize key labeling parameters under the condition of laminar flow. The validity of the computer model results was confirmed by MRI measurements with a flow model. For human studies, a double-inversion continuous arterial spin labeling (CASL) sequence was modified to allow for arbitrary positioning of the labeling plane. The obtained perfusion-weighted images showed a clear delineation of the perfusion territories of the selected arteries in the anterior circulation of the brain and good gray/white matter contrast. 相似文献
33.
Wolfgang H Oertel Tobias W?chter Niall P Quinn Gudrun Ulm Dirk Brandst?dter 《Movement disorders》2003,18(4):430-432
According to the consensus statement on the diagnosis of multiple system atrophy (MSA), erectile dysfunction is required for male patients to fulfil the urinary incontinence criterion. However, there is no equivalent item for female patients. We questioned 19 female patients with MSA of the parkinsonian type (MSA-P), 28 female patients with Parkinson's disease (PD), and 27 healthy controls on their genital sensitivity. A total of 47% of the MSA patients but only 4% of the PD patients and 4% of the control group admitted to reduced genital sensitivity, a highly significant difference (P < 0.001). Moreover, the appearance of reduced genital sensitivity in female MSA patients showed a close temporal relation to the onset of the disease. If these preliminary results can be confirmed and further specified in a larger sample, a historical item of reduced genital sensitivity in female patients might become a diagnostic feature for MSA, comparable to erectile dysfunction in male patients. 相似文献
34.
Three-dimensional reconstruction of magnetic resonance images of the temporomandibular joint by I-DEAS. 总被引:1,自引:0,他引:1
Evaluation of the temporomandibular joint has been limited by the inability of current technology to image complex morphology and motion in three dimensions. An engineering design program, I-DEAS, has been used to construct solid models from magnetic resonance images. A dried skull with an acrylic resin temporomandibular disc replica, immersed in water, provided sagittal and coronal MR images. Linear dimensions and disc volumes obtained from the models were compared with the original and found to be consistent, within the limits imposed by the slice thickness. We have applied the method to the living joint in an asymptomatic volunteer, and report our initial experience in demonstrating the spatial relationships and motion of the joint components. 相似文献
35.
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37.
Jan Stulik Tobias Rainer Pitzen Jan Chrobok Sabine Ruffing Jörg Drumm Laurentius Sova Ravel Kucera Tomas Vyskocil Wolf Ingo Steudel 《European spine journal》2007,16(10):1689-1694
Anterior cervical plate fixation is an approved surgical technique for cervical spine stabilization in the presence of anterior
cervical instability. Rigid plate design with screws rigidly locked to the plate is widely used and is thought to provide
a better fixation for the treated spinal segment than a dynamic design in which the screws may slide when the graft is settling.
Recent biomechanical studies showed that dynamic anterior plates provide a better graft loading possibly leading to accelerated
spinal fusion with a lower incidence of implant complications. This, however, was investigated in vitro and does not necessarily
mean to be the case in vivo, as well. Thus, the two major aspects of this study were to compare the speed of bone fusion and
the rate of implant complications using either rigid- or dynamic plates. The study design is prospective, randomized, controlled,
and multi-centric, having been approved by respective ethic committees of all participating sites. One hundred and thirty-two
patients were included in this study and randomly assigned to one of the two groups, both undergoing routine level-1- or level-2
anterior cervical discectomy with autograft fusion receiving either a dynamic plate with screws being locked in ap - position
(ABC, Aesculap, Germany), or a rigid plate (CSLP, Synthes, Switzerland). Segmental mobility and implant complications were
compared after 3- and 6 months, respectively. All measurements were performed by an independent radiologist. Mobility results
after 6 months were available for 77 patients (43 ABC/34 CSLP). Mean segmental mobility for the ABC group was 1.7 mm at the
time of discharge, 1.4 mm after 3 months, and 0.8 mm after 6 months. For the CSLP- group the measurements were 1.0, 1.8, and
1.7 mm, respectively. The differences of mean segmental mobility were statistically significant between both groups after
6 months (P = 0.02). Four patients of the CSLP-group demonstrated surgical hardware complications, whereas no implant complications were
observed within the ABC-group (P = 0.0375). Dynamic plate designs provided a faster fusion of the cervical spine compared with rigid plate designs after prior
spinal surgery. Moreover, the rate of implant complications was lower within the group of patients receiving a dynamic plate.
These interim results refer to a follow-up period of 6 months after prior spinal surgery. Further investigations will be performed
2 years postoperatively. 相似文献
38.
39.
Cheryl A. Cameron PhD JD C. Scott Litch JD MA Martha Liggett JD MS Steven Heimberg MD JD 《Special care in dentistry》1995,15(5):192-200
This paper examines medical malpractice law as it applies to medically necessary oral health care. The basic legal concepts and reported cases involving medically necessary oral health care are reviewed. It is concluded that dental professionals and consumer advocates must advance their educational and legislative advocacy efforts so that health professional colleagues and the public will become aware of the importance of these services and insurers will routinely include coverage of medically necessary oral health care in their medical and dental policies. While failure to provide medically necessary oral health care can be violative of patient rights and legally actionable, medical malpractice litigation should always be the behavior modifier of last resort. 相似文献
40.
Physicians may have the opportunity to prevent suicide. An awareness of suicide risk factors, such as depression, alcoholism, drug abuse, schizophrenia, and chronic pain or disease, may facilitate suicide prevention. Recognition of acute and chronic suicidal vulnerability occurs through direct questioning. Psychiatric consultation is indicated for patients exhibiting clear self-injury risk, as exemplified by expressed suicide intent, an overt plan for death, or a "gesture." Hospitalization is usually recommended for socially isolated patients presenting with overt suicidal ideation, complicated by injurious self-harm, encephalopathy, or substance abuse. Family involvement and a "no-suicide" contract with the patient, coupled with close outpatient follow-up appointments, should suffice for those exhibiting milder or transient thoughts of suicide without manifest intent to die. 相似文献