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Performance of a new natural oral contrast agent (LumiVision®) in dynamic MR swallowing. Eur Radiol 2021; 31:8578-8585. [PMID: 33893856 PMCID: PMC8523424 DOI: 10.1007/s00330-021-07927-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 02/17/2021] [Accepted: 03/23/2021] [Indexed: 11/24/2022]
Abstract
Objectives To evaluate image quality by first use of LumiVision® in dynamic MR swallowing, a contrast medium consisting of biological substances versus a gadolinium-buttermilk mixture in patients who underwent Nissen fundoplication due to gastroesophageal reflux disease (GERD). Methods The protocol of this retrospective study was approved by the local Institutional Review Board. A hundred twenty-nine patients (146 examinations) underwent a dynamic MR swallowing study (at 1.5 T or 3.0 T) and received an oral contrast agent. Two readers evaluated the distention of the esophagus, contrast, and traceability of the bolus in a 3-point scale. A steady-state coherent sequence (B-FFE, TrueFISP) was used. The patients were divided into 3 different groups: 53 patients received gadolinium chelate (Dotarem®)–buttermilk mixture (GBM) in a dilution of 1:40 as an oral contrast agent; 44 patients received LumiVision® water mixture (LWM) in a dilution of 1:1 and 49 patients received LumiVision® (L) undiluted. Results GBM showed significantly better results in overall evaluation for both readers in contrast to LWM (p = .003, p = .002). L also reached significantly better results in overall evaluation than LWM in both readers (p = .004, p = .042). There was no significant difference in the overall evaluation between L and GBM (p = .914, p = .376).According to Landis and Koch, interobserver agreement was “substantial” (Cohen’s kappa = 0.738) between both readers. Conclusion LumiVision® undiluted showed equal image quality compared to gadolinium-buttermilk mixture. The constellation of LumiVision® water mixture led to a clearly negative result in relation to the image quality compared to LumiVision® undiluted. Therefore, oral ingestion of LumiVision® undiluted is recommended for MR swallowing examinations. Key Points • LumiVision® undiluted shows significantly better image quality in comparison to LumiVision® diluted in oral application in swallowing MRI. • LumiVision® undiluted shows equal image quality in comparison to gadolinium-buttermilk mixture in oral application. • Oral ingestion of LumiVision® undiluted can replace gadolinium-buttermilk mixture in oral MR examinations.
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Mohabir S, Pitcher RD, Perumal R, Goodier MDM. The efficacy of pineapple juice as a negative oral contrast agent in magnetic resonance cholangiopancreatography. SA J Radiol 2020; 24:1875. [PMID: 32832119 PMCID: PMC7433279 DOI: 10.4102/sajr.v24i1.1875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/13/2020] [Indexed: 11/03/2022] Open
Abstract
Background During magnetic resonance cholangiopancreatography (MRCP), the pancreatobiliary ducts can be obscured by the high-intensity signal from the stomach and duodenum. Pineapple juice may be an alternative to commercially available negative contrast agents, but has not been evaluated locally. Objectives To evaluate the efficacy of a local, off-the-shelf pineapple juice preparation as a negative oral contrast agent for MRCP. Method An observational, analytical study was conducted during January–December 2017. A 1.5 Tesla MRCP sequence was performed immediately before and after ingestion of 250 mL of a local, commercially-available pineapple juice preparation. Image evaluation was performed by two radiologists with independent, blind assessment of gastric/duodenal signal intensity and biliary /pancreatic duct visibility, before and after pineapple juice. Results Fifty adult patients (F = 44, 88%) with median age 44 years (IQR: 34.75, 57) were included. After pineapple juice administration, there was significant measured (1661.51 vs. 1409.94, p < 0.01) and perceived (2.16 vs. 2.72, p < 0.01) duodenal signal reduction but no significant change in measured (1081.17 vs. 1044.38, p = 0.34) or perceived (2.73 vs. 2.84, p = 0.14) gastric signal intensity. Visibility of the common bile duct was significantly improved (3.67 vs. 3.86, p < 0.01), whilst that of the main pancreatic duct showed no significant change (2.92 vs. 2.86, p = 0.44). Conclusion The local pineapple juice preparation used in this study is an effective, affordable and natural negative oral contrast agent for enhancement of MRCP images, and specifically improves visualisation of the common bile duct.
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Affiliation(s)
- Sheryl Mohabir
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Richard D Pitcher
- Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Rubeshan Perumal
- Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Durban, South Africa
| | - Matthew D M Goodier
- Department of Radiology, Grey's Hospital Pietermaritzburg, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
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Abstract
Imaging of the biliary system has improved and has allowed MR to become a key noninvasive tool for evaluation of the biliary system. A variety of magnetic resonance cholangiopancreatography techniques have been developed, with improved visualization of the biliary system and biliary pathology. Key avenues of advancement include increasing the speed of acquisition, improving spatial resolution, and reducing artifacts. T1-weighted imaging using gadolinium-based hepatobiliary contrast agents allows for evaluation in additional indications, such as liver donor evaluation, biliary leak identification, and choledochal cyst confirmation. There is potential for further increased utility of MR in the evaluation of the biliary system.
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Affiliation(s)
| | - Frank H Miller
- Body Imaging Section and Fellowship, Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, 676 North Saint Clair, Suite 800, Chicago, IL 60611, USA
| | - Benjamin M Yeh
- University of California - San Francisco, 505 Parnassus Avenue, M391 Box 0628, San Francisco, CA 94143-0628, USA
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Signal suppressions of grape syrup and grape syrup/lemon aqueous solutions in magnetic resonance cholangiopancreatography using heavily T2-weighted pulse sequence. POLISH JOURNAL OF MEDICAL PHYSICS AND ENGINEERING 2019. [DOI: 10.2478/pjmpe-2019-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Signal suppression of the gastrointestinal tract fluids in magnetic resonance cholangiopancreatography (MRCP) has been performed using various natural and chemical substances with the different MRCP pulse sequences. This study aimed to investigate the signal suppressions of the grape syrup and the grape syrup/lemon aqueous solutions in MRCP using the heavily T2-weighted sequences. For this purpose, the potassium, iron and manganese contents of grape syrup were measured by atomic absorption spectroscopy. The grape syrup and the grape syrup/lemon solutions with the various grape syrup percentages were imaged using the heavily T2-weighted sequences of MRCP such as T2 HASTE thick slab and T2 SPACE. MRCP in the volunteers was performed before and 10 minutes after oral administration of the grape syrup solution. The concentrations of potassium, iron, and manganese in grape syrup were 34.8, 2.4 and 1 mg/l, respectively. The in vitro study showed significantly lower signal to noise ratio using the grape syrup samples comparing to the grape syrup/lemon. The effective signal suppression for the in vitro study and considerable enhancement of negative contrast in the post-contrast MRCP was obtained using a T2 HASTE thick slab sequence. As a conclusion, the grape syrup solution can be used for signal suppression of the gastrointestinal tract fluid in MRCP as an oral negative contrast material. A T2 HASTE thick slab sequence produces suitable contrast in MRCP images using the grape syrup solution.
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Faletti R, Gatti M, Di Chio A, Fronda M, Anselmino M, Ferraris F, Gaita F, Fonio P. Concentrated pineapple juice for visualisation of the oesophagus during magnetic resonance angiography before atrial fibrillation radiofrequency catheter ablation. Eur Radiol Exp 2018; 2:39. [PMID: 30460417 PMCID: PMC6246758 DOI: 10.1186/s41747-018-0067-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 10/09/2018] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to compare in vitro pineapple juice and a solution of concentrated pineapple juice with a paramagnetic contrast agent in order to determine the feasibility of using the solution of concentrated pineapple juice in vivo for oesophagus visualisation at magnetic resonance angiography (MRA) before the radiofrequency catheter ablation procedure for atrial fibrillation. The pineapple juice was concentrated by a microwave heating evaporation process performed in a domestic microwave oven. Five grams of modified potato starch for every 40 mL of concentrated pineapple juice were added to the concentrated pineapple juice in order to thicken the solution. The solution resulted visually and quantitatively as hyperintense as the contrast agent in vitro (ratio = 1.02). in vivo, no technical difficulties were encountered during the MRA acquisition and a complete enhanced oesophagus was obtained in 37/38 patients (97.4%). The volumetric analysis and the three-dimensional reconstruction were feasible; the quality was rated as diagnostic in every patient. The intensified oesophagus was successfully merged into the electro-anatomical maps in all the patients. In summary, we demonstrated that this technique allows a feasible and safe oesophagus visualisation during MRA.
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Affiliation(s)
- Riccardo Faletti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Marco Gatti
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy.
| | - Andrea Di Chio
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Marco Fronda
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
| | - Matteo Anselmino
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Turin, Italy
| | - Federico Ferraris
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Turin, Italy
| | - Fiorenzo Gaita
- Division of Cardiology, Department of Medical Sciences, "Città della Salute e della Scienza" Hospital, University of Turin, Turin, Italy
| | - Paolo Fonio
- Radiology Unit, Department of Surgical Sciences, University of Turin, Via Genova 3, 10126, Turin, Italy
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Frisch A, Walter TC, Grieser C, Geisel D, Hamm B, Denecke T. Performance survey on a new standardized formula for oral signal suppression in MRCP. Eur J Radiol Open 2017; 5:1-5. [PMID: 29719852 PMCID: PMC5926272 DOI: 10.1016/j.ejro.2017.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Revised: 11/02/2017] [Accepted: 12/09/2017] [Indexed: 11/16/2022] Open
Abstract
Recently, a new biological standardized product for MRCP became available. The product is considered effective as oral signal suppressor in T2-w images. Obtained MRCP imagery show a good image quality. Patients’ feedback on taste and palatability is very high.
Background Orally administered substances, which reduce image contamination by overlying gastrointestinal fluid signals, can be used to enhance the quality of MRCP images. Recently, a new standardized formula consisting of biological substances has become available. The objective of this study is to provide a first assessment of achievable MRCP image quality, taste and palatability of this new dedicated agent. Methods In January 2015 to May 2015 practicing radiologists in Germany, Austria and Switzerland were asked to evaluate image quality as well as taste and palatability when using the new agent (LumiVision®; b.e. imaging; Baden-Baden; Germany) in MRCP questionnaire. Both criteria were rated with a 6-point Likert scale ranging from “1” (best) to “6” (worst). Results A total 185 of 475 radiologic institutions (39%) submitted feedback on image quality, 187 (39%) on the taste/palatability. Assessments of image quality regarding presence of disturbing gastrointestinal fluid signal resulted in a median of 2. The majority of patients rated the subjective taste as very good (median of 1). No side effects of relevance were recorded. Conclusion This large survey shows that the tested product is considered effective by radiologists regarding MRCP image quality. Patients’ feedback on taste and palatability was very positive.
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Affiliation(s)
- Anne Frisch
- Institute of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany
| | - Thula C Walter
- Institute of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany
| | - Christian Grieser
- Institute of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany
| | - Dominik Geisel
- Institute of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany
| | - Bernd Hamm
- Institute of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany
| | - Timm Denecke
- Institute of Radiology, Campus Virchow-Klinikum, Charité Universitätsmedizin Berlin, Germany
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Frisch A, Walter TC, Hamm B, Denecke T. Efficacy of oral contrast agents for upper gastrointestinal signal suppression in MRCP: A systematic review of the literature. Acta Radiol Open 2017; 6:2058460117727315. [PMID: 28894591 PMCID: PMC5582660 DOI: 10.1177/2058460117727315] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 07/29/2017] [Indexed: 12/26/2022] Open
Abstract
Background Orally administered substances which suppress signals from gastrointestinal fluid can be used to enhance image quality in magnetic resonance cholangiopancreatography (MRCP). In daily practice, the available substances range from commercial products to regular viands such as fruit juices. Purpose To provide an overview on the significance of and the substances used as gastrointestinal fluid signal suppressors in MRCP. Material and Methods A systematic review of the existing literature was performed to evaluate the efficacy and efficiency of oral T2-signal suppressors in MRCP. Results Twenty-five publications on 16 different oral contrast media were identified. The most commonly used substances were ferumoxsil, ferric ammonium citrate, and pineapple juice. Twenty-three out of 25 publications supported the use of oral signal suppressors in MRCP. Advantages of oral signal suppressors include improved visualization of the pancreatobiliary ductal system, increased help with differential diagnoses, and higher detection rates of relevant diagnoses due to a reduction of overlaying signals. Conclusion The application of oral substances for gastrointestinal signal suppression in MRCP is recommendable. A variety of substances are used in daily routine with good but varying effectivity and patient tolerance.
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Affiliation(s)
- Anne Frisch
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Germany
| | - Thula C Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Germany
| | - Bernd Hamm
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Germany
| | - Timm Denecke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Radiology, Germany
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Ferrer CJ, Bartels LW, van Stralen M, Denis de Senneville B, Moonen CTW, Bos C. Fluid filling of the digestive tract for improved proton resonance frequency shift-based MR thermometry in the pancreas. J Magn Reson Imaging 2017. [PMID: 28646608 DOI: 10.1002/jmri.25800] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To demonstrate that fluid filling of the digestive tract improves the performance of respiratory motion-compensated proton resonance frequency shift (PRFS)-based magnetic resonance (MR) thermometry in the pancreas. MATERIALS AND METHODS In seven volunteers (without heating), we evaluated PRFS thermometry in the pancreas with and without filling of the surrounding digestive tract. All data acquisition was performed at 1.5T, then all datasets were analyzed and compared with three different PRFS respiratory motion-compensated thermometry methods: gating, multibaseline, and referenceless. The temperature precision of the different methods was evaluated by assessing temperature standard deviation over time, while a simulation experiment was used to study the accuracy of the methods. RESULTS Without fluid intake, errors in temperature precision in the pancreas up to 10°C were observed for all evaluated methods. After liquid intake, temperature precision improved to median values between 1.8 and 2.9°C. The simulations showed that gating had the lowest accuracy, with errors up to 7°C. Multibaseline and referenceless thermometry performed better, with a median error in the pancreas between -3 and +3°C after fluid intake, for all volunteers. CONCLUSION Preparation of the digestive tract near the pancreas by filling it with fluid improved MR thermometry precision and accuracy for all common respiratory motion-compensated methods evaluated. These improvements are attributed to reducing field inhomogeneity in the pancreas. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2018;47:692-701.
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Affiliation(s)
- Cyril J Ferrer
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lambertus W Bartels
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marijn van Stralen
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Chrit T W Moonen
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Clemens Bos
- Imaging Division, University Medical Center Utrecht, Utrecht, the Netherlands
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Secretin-Stimulated Magnetic Resonance Imaging Assessment of the Benign Pancreatic Disorders: Systematic Review and Proposal for a Standardized Protocol. Pancreas 2016; 45:1092-103. [PMID: 27171509 DOI: 10.1097/mpa.0000000000000606] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
This systemic review summarizes the current literature and general consensus on secretin-stimulated magnetic resonance imaging (s-MRI) of the benign pancreatic disorders and discusses important aspects on how s-MRI is optimally performed. The aim is to provide an overview, for clinicians and radiologist, of the s-MRI protocols and the range of clinical applications. Furthermore, the review will summarize the criteria for evaluation of pancreatic morphology and function based on s-MRI.The literature search indentified 69 original articles and 15 reviews. Chronic pancreatitis was the disease that was most frequently assessed by s-MRI (33%), followed by acute pancreatitis (9%). Dynamic thick-slab 2-dimensional magnetic resonance cholangiopancreatography was the most used imaging sequence (86%). The diameter of the main pancreatic duct (75%) and pancreatic exocrine function based on visual grading of duodenal filling (67%) were the most evaluated pancreatic features. Sufficient similarities between studies were identified to propose the most agreeable standardized s-MRI protocol for morphological and functional assessment of the pancreas. In the future, more research and increased collaboration between centers is necessary to achieve more consensus and optimization of s-MRI protocols.
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Value of Magnetic Resonance Cholangiopancreatography in Assessment of Nonanastomotic Biliary Strictures After Liver Transplantation. Transplant Direct 2015; 1:e42. [PMID: 27500210 PMCID: PMC4946454 DOI: 10.1097/txd.0000000000000556] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 10/19/2015] [Indexed: 12/13/2022] Open
Abstract
Nonanastomotic biliary strictures (NAS) remain a frequent complication after orthotopic liver transplantation (OLT). The aim of this study was to evaluate whether magnetic resonance cholangiopancreatography (MRCP) could be used to detect NAS and to grade the severity of biliary strictures.
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Bittman ME, Callahan MJ. The effective use of acai juice, blueberry juice and pineapple juice as negative contrast agents for magnetic resonance cholangiopancreatography in children. Pediatr Radiol 2014; 44:883-7. [PMID: 24573534 DOI: 10.1007/s00247-014-2884-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/16/2013] [Accepted: 01/16/2014] [Indexed: 11/26/2022]
Abstract
Magnetic resonance cholangiopancreatography (MRCP) is commonly performed in the evaluation of known or suspected pancreaticobiliary disease in children. The administration of a negative oral contrast agent can improve the quality of the examination without significant additional cost. We describe our experience with certain brands of acai juice, blueberry juice and pineapple juice as negative oral contrast agents in children. We believe these fruit juices are safe, palatable and may improve MRCP image quality.
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Affiliation(s)
- Mark E Bittman
- Department of Radiology, Cohen Children's Medical Center of New York, North Shore Long Island Jewish Health System, 270-05 76th Ave., New Hyde Park, NY, 11040, USA,
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van der Molen AJ. Diagnostic Efficacy of Gadolinium-Based Contrast Media. MEDICAL RADIOLOGY 2014. [DOI: 10.1007/174_2013_896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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