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Urbanik A, Guz W, Gołębiowski M, Szurowska E, Majos A, Sąsiadek M, Stajgis M, Ostrogórska M. Assessment of the corpus callosum size in male individuals with high intelligence quotient (members of Mensa International). Radiologie (Heidelb) 2023; 63:49-54. [PMID: 37160478 PMCID: PMC10689507 DOI: 10.1007/s00117-023-01146-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVES The aim of this study was to assess the size of the corpus callosum in members of Mensa International, which is the world's largest and oldest high-intelligence quotient (IQ) society. METHODS We performed T2-weighted magnetic resonance imaging (Repetition Time, TR = 3200 ms, Time of Echo, TE = 409 ms) to examine the brain of members of Mensa International (Polish national group) in order to assess the size of the corpus callosum. Results from 113 male MENSA members and 96 controls in the age range of 21-40 years were analyzed. RESULTS The comparative analysis showed that the mean length of the corpus callosum and the thickness of the isthmus were significantly greater in the Mensa members compared to the control groups. A statistically significant difference was also identified in the largest linear dimension of the brain from the frontal lobe to the occipital lobe. The mean corpus callosum cross-sectional area and its ratio to the brain area were significantly greater in the Mensa members. CONCLUSIONS The results show that the dimensions (linear measures and midsagittal cross-sectional surface area) of the corpus callosum were significantly greater in the group of Mensa members than in the controls.
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Affiliation(s)
- Andrzej Urbanik
- Department of Radiology, Collegium Medicum, Jagiellonian University, Kopernika 19, 31-501, Krakow, Poland
| | - Wiesław Guz
- Department of Electroradiology, University of Rzeszów, Rzeszów, Poland
| | - Marek Gołębiowski
- I-st Department of Clinical Radiology, Medical University of Warsaw, Warszawa, Poland
| | - Edyta Szurowska
- 2nd Department of Radiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Agata Majos
- Chair of Radiology and Imaging Diagnostics, Medical University of Łódź, Łódź, Poland
| | - Marek Sąsiadek
- Department of Radiology, Wroclaw Medical University, Wrocław, Poland
| | - Marek Stajgis
- Department of General Radiology and Neuroradiology, Poznan University of Medical Sciences, Poznań, Poland
| | - Monika Ostrogórska
- Department of Radiology, Collegium Medicum, Jagiellonian University, Kopernika 19, 31-501, Krakow, Poland.
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Chrostowski J, Majos M, Walczak A, Majos A. Excessive brain atrophy in patients with severe aortic stenosis. Pol J Radiol 2023; 88:e311-e318. [PMID: 37404551 PMCID: PMC10317006 DOI: 10.5114/pjr.2023.129088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/17/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose To assess the prevalence of the neuroradiological indices of brain atrophy in patients with severe aortic valve stenosis (AS) in magnetic resonance imaging (MRI) with particular emphasis on the assessment of atrophy areas typical of cerebral small vessel disease (CSVD). Material and methods The group of 34 patients (age 60-90 years, 17 women and 17 men) with severe AS and 50 healthy controls (age 61-85 years, 29 women and 21 men) underwent MRI brain examinations, which were analysed for the neuroradiological indices of brain atrophy. Results A slight but statistically significant age difference was found between the study and control groups - about 3 years on average (p = 0.040). Differences between total brain volumes in both the groups did not show statistical significance. In a comparative analysis of the main brain compartments, a statistically significant difference was found only in the volumetry of cerebral hemispheres for both the groups: mean volume of cerebral hemispheres in patients with severe AS was 884.46 cm3, while it was 17 cm3 bigger in the volunteer group, reaching 901.80 cm3 on average (p = 0.043). Comparison of the volumetry of the other major and minor regions and structures according to the clinical and anatomical division revealed statistically non-significant differences. No statistically significant relationships were observed concerning structures correlated with CSVD. Conclusions Neuroradiological indices of the brain atrophy do not provide an unequivocal distinction in patients with severe AS. Most observations imply that brain atrophy in patients with severe AS is primarily a consequence of physiological ageing of the brain.
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Affiliation(s)
- Jakub Chrostowski
- II Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
| | - Marcin Majos
- II Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
| | - Andrzej Walczak
- Department of Cardiac Surgery, Medical University of Lodz, Poland
| | - Agata Majos
- II Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
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Mostowy M, Paul J, Majos A, Mefleh C, Piwnik M, Kowalski P, Kobielski S, Choate S, Buzas D, Kwapisz A. Proximal ulna morphology in various pediatric population age groups: proximal ulna dorsal angulation (PUDA) and olecranon tip-to-apex (TTA) distance. Surg Radiol Anat 2023:10.1007/s00276-023-03158-z. [PMID: 37178217 PMCID: PMC10317866 DOI: 10.1007/s00276-023-03158-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/24/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE To measure proximal ulna dorsal angulation (PUDA) and olecranon tip-to-apex distance (TTA) in pediatric population to aid surgeons with data for proximal ulna fractures fixation. METHODS Retrospective review of the hospital radiographic database. All elbow radiographs were identified and after implementing exclusion criteria, included were 95 patients aged 0-10; 53 patients aged 11-14; and 53 patients aged 15-18. PUDA was defined as the angle between lines placed on the "flat spot" of the olecranon and the dorsal edge of the ulnar shaft and TTA as the distance between the tip of the olecranon to the apex of angulation. Two evaluators performed measurements independently. RESULTS In age group 0-10, mean PUDA was 7.53°, range 3.8-13.7, 95% CI 7.16-7.91, while mean TTA was 22.04 mm, range 8.8-50.5, 95% CI 19.92-24.17. In age group 11-14, mean PUDA was 4.99°, range 2.5-9.3, 95% CI (4.61-5.37), while mean TTA was 37.41 mm, range 16.5-66.6, 95% CI (34.91-39.90). In age group 15-18, mean PUDA was 5.18°, range 2.9-8.1, 95% CI (4.75-5.61), while mean TTA was 43.79 mm, range 24.5-79.4, 95% CI (41.38-46.19). PUDA was negatively correlated with age (r = - 0.56, p < 0.001), while TTA was positively correlated with age (r = 0.77, p < 0.001). Reliability levels of 0.81-1 or 0.61-0.80 were achieved for most of intra- and inter-rater reliabilities besides two levels of 0.41-60 and one of 0.21-0.40. CONCLUSION The main study finding is that in most cases mean age-group values may serve as a template for proximal ulna fixation. There are some cases in which X-ray of contralateral elbow may provide surgeon with a better template. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Marcin Mostowy
- Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, str. Pomorska 251, 92-213, Lodz, Poland
| | - Joanna Paul
- Department of Radiology, Medical University of Lodz, Lodz, Poland
| | - Agata Majos
- Department of Radiology, Medical University of Lodz, Lodz, Poland
| | - Charbel Mefleh
- Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, str. Pomorska 251, 92-213, Lodz, Poland
| | - Marcin Piwnik
- Radiology Department, Veteran's Memorial Teaching Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Piotr Kowalski
- Department of Radiology, Medical University of Lodz, Lodz, Poland
| | - Szymon Kobielski
- Department of Radiology, Medical University of Lodz, Lodz, Poland
| | - Stephen Choate
- Ochsner Health, Ochsner Sports Medicine Institute, 1201 S Clearview Parkway, Building B, Suite 104, Jefferson, New Orleans, LA, 70121, USA
| | - David Buzas
- Ochsner Health, Ochsner Sports Medicine Institute, 1201 S Clearview Parkway, Building B, Suite 104, Jefferson, New Orleans, LA, 70121, USA
| | - Adam Kwapisz
- Clinic of Orthopedics and Pediatric Orthopedics, Medical University of Lodz, str. Pomorska 251, 92-213, Lodz, Poland.
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Derlatka-Kochel M, Kumoniewski P, Majos M, Ludwisiak K, Pomorski L, Majos A. Pre- and Postoperative Ultrasound and MRI Examinations in Assessing Vocal Folds in Patients with Goiter. Diagnostics (Basel) 2022; 12:diagnostics12061362. [PMID: 35741172 PMCID: PMC9221659 DOI: 10.3390/diagnostics12061362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 02/01/2023] Open
Abstract
Aim of the study: To determine the value of dynamic examinations ultrasound (US) and MRI in the 1.5T field in the assessment of the mobility of vocal folds (VF) in comparison to laryngoscopy in patients with thyroid gland resection. Materials and methods: A total of 44 patients with goiter, before and after thyroidectomy, were subjected to videolaryngoscopy and dynamic examinations of the vocal folds using ultrasound and the following MRI sequences: generic gradient echo (GRE) and true fast imaging with steady-state precession (TRUFI). The qualitative and quantitative data were analyzed, i.e., the angles of deviation from the midline of the vocal folds and the area of the right and left rima glottidis compartments. Results: The analysis of qualitative data showed that the results obtained by laryngoscopy, US and MRI are independent of the diagnostic method used in the group of patients pre and post thyroidectomy. Between the pre- and postoperative examinations in the group of paralyzed vocal folds, statistically significant differences were found in the minimum and maximum values of the angles for the MRI-GRE and MRI-TRUFI sequences and the maximum value of the angles in the US examination, but also in the maximum value of the area of the glottis compartments in both MRI-GRE and MRI-TRUFI dynamic sequences and the minimum value of the area in the sequence MRI-GRE. Statistically significant differences were found in both MRI sequences during phonation, both for the value of the angles and the area of the affected vocal folds. However, no statistically significant differences were found in the values of the angles or the areas in both vocal fold imaging methods without identified mobility abnormalities. Conclusions: Ultrasound and MRI examinations using dynamic sequences have a similar diagnostic value to laryngoscopy in the assessment of vocal fold paralysis in patients with goiter. The GRE sequence seems to be the most reliable one in determining vocal fold paralysis, and the most reliable parameter is the maximum area of the rima glottidis compartment. The inclusion of dynamic short sequences widely available in 1.5T scanners in standard neck examination protocols represents a novelty of the method and a promising diagnostic perspective in the diagnosis of vocal fold paralysis.
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Affiliation(s)
- Magdalena Derlatka-Kochel
- Department of Radiologic and Isotopic Diagnositcs and Therapy, Medical University of Lodz, 90-419 Lodz, Poland; (M.D.-K.); (K.L.); (A.M.)
| | - Paweł Kumoniewski
- Department of General and Oncological Surgery, Medical University of Lodz, 90-419 Lodz, Poland; (P.K.); (L.P.)
| | - Marcin Majos
- Department of Radiologic and Isotopic Diagnositcs and Therapy, Medical University of Lodz, 90-419 Lodz, Poland; (M.D.-K.); (K.L.); (A.M.)
- Correspondence:
| | - Kamil Ludwisiak
- Department of Radiologic and Isotopic Diagnositcs and Therapy, Medical University of Lodz, 90-419 Lodz, Poland; (M.D.-K.); (K.L.); (A.M.)
| | - Lech Pomorski
- Department of General and Oncological Surgery, Medical University of Lodz, 90-419 Lodz, Poland; (P.K.); (L.P.)
| | - Agata Majos
- Department of Radiologic and Isotopic Diagnositcs and Therapy, Medical University of Lodz, 90-419 Lodz, Poland; (M.D.-K.); (K.L.); (A.M.)
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Włodarczyk L, Cichon N, Saluk-Bijak J, Bijak M, Majos A, Miller E. Neuroimaging Techniques as Potential Tools for Assessment of Angiogenesis and Neuroplasticity Processes after Stroke and Their Clinical Implications for Rehabilitation and Stroke Recovery Prognosis. J Clin Med 2022; 11:jcm11092473. [PMID: 35566599 PMCID: PMC9103133 DOI: 10.3390/jcm11092473] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/05/2023] Open
Abstract
Stroke as the most frequent cause of disability is a challenge for the healthcare system as well as an important socio-economic issue. Therefore, there are currently a lot of studies dedicated to stroke recovery. Stroke recovery processes include angiogenesis and neuroplasticity and advances in neuroimaging techniques may provide indirect description of this action and become quantifiable indicators of these processes as well as responses to the therapeutical interventions. This means that neuroimaging and neurophysiological methods can be used as biomarkers—to make a prognosis of the course of stroke recovery and define patients with great potential of improvement after treatment. This approach is most likely to lead to novel rehabilitation strategies based on categorizing individuals for personalized treatment. In this review article, we introduce neuroimaging techniques dedicated to stroke recovery analysis with reference to angiogenesis and neuroplasticity processes. The most beneficial for personalized rehabilitation are multimodal panels of stroke recovery biomarkers, including neuroimaging and neurophysiological, genetic-molecular and clinical scales.
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Affiliation(s)
- Lidia Włodarczyk
- Department of Neurological Rehabilitation, Medical University of Lodz, Poland Milionowa 14, 93-113 Lodz, Poland
- Correspondence: (L.W.); (E.M.); Tel.: +48-(0)4-2666-77461 (E.M.); Fax: +48-(0)4-2676-1785 (E.M.)
| | - Natalia Cichon
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland; (N.C.); (M.B.)
| | - Joanna Saluk-Bijak
- Department of General Biochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland;
| | - Michal Bijak
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska, 141/143, 90-236 Lodz, Poland; (N.C.); (M.B.)
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, 92-213 Lodz, Poland;
| | - Elzbieta Miller
- Department of Neurological Rehabilitation, Medical University of Lodz, Poland Milionowa 14, 93-113 Lodz, Poland
- Correspondence: (L.W.); (E.M.); Tel.: +48-(0)4-2666-77461 (E.M.); Fax: +48-(0)4-2676-1785 (E.M.)
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Majos M, Polguj M, Stefańczyk L, Majos A. Venous supply of horseshoe kidneys and normal kidneys: an angio-MSCT-based study. Folia Morphol (Warsz) 2022; 82:368-374. [PMID: 35411544 DOI: 10.5603/fm.a2022.0039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Horseshoe kidney is a common developmental anomaly which can be associated with many atypical anatomical variants of blood supply. The aim of this study was to identify the anatomical variants of renal veins supplying horseshoe kidney, with particular emphasis on their relationship with the arterial system. MATERIALS AND METHODS The analysis included 94 patients with horseshoe kidney (HSK) and 248 persons with normal kidneys (NK). Based on CT-angiography, the number of renal arteries and veins was determined, along with the levels the arteries branched off the aorta and the veins communicated to their parental vessels. RESULTS 423 renal arteries (4.5 per person) and 364 renal veins (3.78 per persons) were found in HSK group (p=0.004), as compared with 598 arteries (2.41 per person) and 567 veins (2.29 per person) in the NK group (p=0.025). Mean number of renal veins in women with HSK was higher than in men (4.11 vs. 3.72 per patient, p=0.03). In the HSK group, the number of renal arteries correlated significantly with the number of renal veins only among men (ks=0.35, p=0.009). In patients with Nk, significant correlations between the number of renal arteries and renal veins were found both in the whole group and among men and women. CONCLUSIONS HSK are drained by a higher number of renal veins than NK, especially in women; this also refers to accessory renal veins. The number of renal veins for HSK is less dependent on the number of corresponding arteries than these for NK.
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Affiliation(s)
- M Majos
- Department of Radiology, Barlicki University Hospital, Medical University of Lodz, Poland
| | - M Polguj
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Poland.
| | - L Stefańczyk
- Department of Radiology, Barlicki University Hospital, Medical University of Lodz, Poland
| | - A Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
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Zytkowski ˙ A, Skrzat J, Mazurek A, Majos A, Radek M, Gładysz T, Clarke E, Wysiadecki G. Corrigendum to <’ Clinical relevance of the caroticoclinoid foramen – A case report and concise literature review’ >. Translational Research in Anatomy 2022. [DOI: 10.1016/j.tria.2022.100186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Zmysłowska A, Jakiel P, Gadzalska K, Majos A, Płoszaj T, Ben-Skowronek I, Deja G, Glowinska-Olszewska B, Jarosz-Chobot P, Klonowska B, Kowalska I, Mlynarski W, Mysliwiec M, Nazim J, Noczynska A, Robak-Kontna K, Skala-Zamorowska E, Skowronska B, Szadkowska A, Szypowska A, Walczak M, Borowiec M. Next- generation sequencing is an effective method for diagnosing patients with different forms of monogenic diabetes. Diabetes Res Clin Pract 2022; 183:109154. [PMID: 34826540 DOI: 10.1016/j.diabres.2021.109154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 11/13/2021] [Accepted: 11/20/2021] [Indexed: 11/03/2022]
Abstract
AIM Monogenic diabetes (MD) represents 5-7% of antibody-negative diabetes cases and is a heterogeneous group of disorders. METHODS We used targeted next-generation sequencing (NGS) on Illumina NextSeq 550 platform involving the SureSelect assay to perform genetic and clinical characteristics of a study group of 684 individuals, including 542 patients referred from 12 Polish Diabetes Centers with suspected MD diagnosed between December 2016 and December 2019 and their 142 family members (FM). RESULTS In 198 probands (36.5%) and 66 FM (46.5%) heterozygous causative variants were confirmed in 11 different MD-related genes, including 31 novel mutations, with the highest number in the GCK gene (206/264), 22/264 in the HNF1A gene and 8/264 in the KCNJ11 gene. Of the 183 probands with MODY1-5 diabetes, 48.6% of them were diagnosed at the pre-diabetes stage and most of them (68.7%) were on diet only at the time of genetic diagnosis, while 31.3% were additionally treated with oral hypoglycaemic drugs and/or insulin. CONCLUSIONS In summary, the results obtained confirm the efficacy of targeted NGS method in the molecular diagnosis of patients with suspected MD and broaden the spectrum of new causal variants, while updating our knowledge of the clinical features of patients defined as having MD.
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Affiliation(s)
- A Zmysłowska
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland.
| | - P Jakiel
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - K Gadzalska
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - A Majos
- Department of General and Transplant Surgery, Medical University of Lodz, Lodz, Poland
| | - T Płoszaj
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
| | - I Ben-Skowronek
- Department of Pediatric Endocrinology and Diabetology, Medical University of Lublin, Lublin, Poland
| | - G Deja
- Department of Children's Diabetology, Medical University of Silesia in Katowice, Poland
| | - B Glowinska-Olszewska
- Department of Pediatrics, Endocrinology, Diabetology with Cardiology Division, Medical University of Bialystok, Bialystok, Poland
| | - P Jarosz-Chobot
- Department of Children's Diabetology, Medical University of Silesia in Katowice, Poland
| | - B Klonowska
- Department of Clinical Pediatrics, University of Warmia and Mazury in Olsztyn, Provincial Specialist Children's Hospital, Olsztyn, Poland
| | - I Kowalska
- Department of Internal Medicine and Metabolic Diseases, Medical University of Bialystok, Bialystok, Poland
| | - W Mlynarski
- Department of Pediatrics, Oncology and Hematology, Medical University of Lodz, Lodz, Poland
| | - M Mysliwiec
- Department of Pediatrics, Diabetology and Endocrinology, Medical University of Gdansk, Gdansk, Poland
| | - J Nazim
- Department of Pediatric Endocrinology, Jagiellonian University Medical College, Cracow, Poland
| | - A Noczynska
- Department of Pediatric Endocrinology and Diabetology, Wroclaw Medical University, Wroclaw, Poland
| | - K Robak-Kontna
- Outpatient Clinic for Pediatric Diabetology, Regional Children's Hospital in Bydgoszcz, Bydgoszcz, Poland
| | - E Skala-Zamorowska
- Department of Children's Diabetology, Medical University of Silesia in Katowice, Poland
| | - B Skowronska
- Department of Pediatric Diabetes and Obesity, Poznan University of Medical Sciences, Poznan, Poland
| | - A Szadkowska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, Lodz, Poland
| | - A Szypowska
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - M Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology of the Developmental Age, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - M Borowiec
- Department of Clinical Genetics, Medical University of Lodz, Lodz, Poland
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Żytkowski A, Skrzat J, Mazurek A, Majos A, Radek M, Gładysz T, Clarke E, Wysiadecki G. Clinical relevance of the caroticoclinoid foramen – A case report and concise literature review. Translational Research in Anatomy 2021. [DOI: 10.1016/j.tria.2021.100153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Derlatka-Kochel M, Majos M, Ludwisiak K, Majos A. The value of 1.5T MRI in the evaluation of vocal fold mobility in patients with goiter. Eur J Radiol Open 2021; 8:100368. [PMID: 34307788 PMCID: PMC8283317 DOI: 10.1016/j.ejro.2021.100368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/29/2022] Open
Abstract
The laryngoscopic examination remains the gold standard in the perioperative evaluation of the mobility of the vocal folds in patients with goiter. During the COVID-19 pandemic, many medical procedures, including laryngoscopy are optimized in terms of epidemiological safety. Therefore, it seems deeply justified to implement methods like i.e. ultrasound or MRI which can provide the diagnostic information usually obtained via laryngoscopic examination. Aim of the study To determine the value of dynamic MRI examination in the 1.5 T field in the assessment of the mobility of vocal folds in patients with goiter compared to healthy people and in relation to ultrasound examinations and routine laryngoscopy. Materials and methods 35 healthy volunteers and 44 patients with goiter were subjected to videolaryngoscopy, dynamic examinations of the vocal folds during respiration and phonation using ultrasound and the MRI sequences: generic gradient echo (GRE) and true fast imaging with steady-state precession (TRUFI). The qualitative and quantitative data were analyzed, i.e. the angles of deviation from the midline of the vocal folds and the area of the right and left rima glottidis compartments. Results No statistically significant differences were found between the groups of healthy volunteers and patients with goiter in the values of the angles of deviation of the vocal folds with the use of ultrasound and two MRI dynamic sequences - GRE and TRUFI. There were also no statistically significant differences in the areas of the rima glottidis compartments between these two groups with the use of two MRI dynamic sequences - GRE and TRUFI. Among the analyzed parameters, the maximum size of each rima glottidis compartment was the only one to show features of sexual dimorphism and was significantly higher in men (GRE p < 0.001 and TRUFI p = 0.001). There was no correlation between the size of the minimum and maximum rima glottidis compartment and the total volume of the thyroid lobes in patients with goiter for the GRE and TRUFI sequences. Conclusions MRI is a promising tool for the objective assessment of the mobility of the vocal folds in patients with goiter, as well as for the qualification for treatment and monitoring its effects. It is particularly important during an epidemiological emergency due to its safety compared to laryngoscopy. The presence of the goiter and its volume do not limit the possibility of performing dynamic imaging studies of the vocal folds and do not affect the surface area of the glottis.
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Affiliation(s)
| | - Marcin Majos
- Zakład Diagnostyki i Terapii Radiologicznej i Izotopowej, Uniwersytet Medyczny w Łodzi, Poland
| | - Kamil Ludwisiak
- Zakład Diagnostyki i Terapii Radiologicznej i Izotopowej, Uniwersytet Medyczny w Łodzi, Poland
| | - Agata Majos
- Zakład Diagnostyki i Terapii Radiologicznej i Izotopowej, Uniwersytet Medyczny w Łodzi, Poland
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Sąsiadek M, Hartel M, Siger M, Katulska K, Majos A, Kluczewska E, Bartosik-Psujek H, Kułakowska A, Słowik A, Steinborn B, Adamczyk-Sowa M, Kalinowska A, Krzystanek E, Bonek R, Serafin Z, Sławek J, Nowacki P, Stępień A, Jóżwiak S, Rejdak K, Selmaj K, Walecki J. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for a protocol concerning routinely used magnetic resonance imaging in patients with multiple sclerosis. Neurol Neurochir Pol 2020; 54:410-415. [PMID: 33085075 DOI: 10.5603/pjnns.a2020.0084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 09/03/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022]
Abstract
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis that is essential for the detection and follow-up of the disease. OBJECTIVE: The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of their recommendations for investigations routinely conducted in magnetic resonance imaging departments in patients with multiple sclerosis. This version includes new data and practical comments for electroradiology technologists and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics necessary for establishing a diagnosis, as well as for MS patient monitoring, which directly translates into significant clinical decisions. INTRODUCTION: Multiple sclerosis (MS) is a chronic immune mediated inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in a CNS destruction process disseminated in time (DIT) and space (DIS). MRI detects focal lesions in the white and grey matter with high sensitivity (although with significantly lower specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume (GMV) and white matter volume (WMV) as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, and hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in MR techniques, as well as advances in postprocessing the obtained data, has driven the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MR imaging is unquestionably the best diagnostic tool available to follow up the course of the disease and support clinicians in choosing the most appropriate treatment strategy for their MS patient. However, to diagnose and follow up MS patients on the basis of MRI in accordance with the latest standards, the MRI study must adhere to certain quality criteria. Such criteria are the subject of this paper.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland
| | | | | | - Katarzyna Katulska
- Department of Neuroradiology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
| | - Ewa Kluczewska
- Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Poland
| | - Agnieszka Słowik
- Jagiellonian University Medical College, Department of Neurology, Krakow, Poland; University Hospital in Krakow, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Robert Bonek
- Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | | | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Sergiusz Jóżwiak
- Department of Pediatric Neurology, Warsaw Medical University, Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology; Medical University of Lublin, Poland
| | - Krzysztof Selmaj
- Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Sąsiadek M, Hartel M, Siger M, Katulska K, Majos A, Kluczewska E, Bartosik-Psujek H, Kułakowska A, Słowik A, Steinborn B, Adamczyk-Sowa M, Kalinowska A, Krzystanek E, Bonek R, Serafin Z, Sławek J, Nowacki P, Stępień A, Jóżwiak S, Rejdak K, Selmaj K, Walecki J. Recommendations of the Polish Medical Society of Radiology and the Polish Society of Neurology for the routinely used magnetic resonance imaging protocol in patients with multiple sclerosis. Pol J Radiol 2020; 85:e272-e276. [PMID: 32612727 PMCID: PMC7315047 DOI: 10.5114/pjr.2020.96010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022] Open
Abstract
Magnetic resonance imaging (MRI) is a widely used method for the diagnosis of multiple sclerosis (MS) that is essential for the detection and follow-up of the disease. The Polish Medical Society of Radiology (PLTR) and the Polish Society of Neurology (PTN) present the second version of the recommendations for examinations routinely conducted in magnetic resonance imaging departments in patients with MS, which include new data and practical comments for electroradiology technicians and radiologists. The recommended protocol aims to improve the MRI procedure and, most importantly, to standardise the method of conducting scans in all MRI departments. This is crucial for the initial diagnostics that are necessary to establish a diagnosis as well as monitor patients with MS, which directly translates into significant clinical decisions. MS is a chronic idiopathic inflammatory demyelinating disease of the central nervous system (CNS), the aetiology of which is still unknown. The nature of the disease lies in the CNS destruction process disseminated in time and space. MRI detects focal lesions in the white and grey matter with high sensitivity (with significantly less specificity in the latter). It is also the best tool to assess brain atrophy in patients with MS in terms of grey matter volume and white matter volume as well as local atrophy (by measuring the volume of thalamus, corpus callosum, subcortical nuclei, hippocampus) as parameters that correlate with disability progression and cognitive dysfunctions. Progress in magnetic resonance techniques, as well as the abilities of postprocessing the obtained data, has become the basis for the dynamic development of computer programs that allow for a more repeatable assessment of brain atrophy in both cross-sectional and longitudinal studies. MRI is unquestionably the best diagnostic tool used to follow up the course of the disease and to treat patients with MS. However, to diagnose and follow up the patients with MS on the basis of MRI in accordance with the latest standards, an MRI study must meet certain quality criteria, which are the subject of this paper.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wroclaw, Poland
| | | | - Małgorzata Siger
- Department of Neurology, Medical University of Lodz, Lodz, Poland
| | - Katarzyna Katulska
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Lodz, Poland
| | - Ewa Kluczewska
- Department and Institute of Medical Radiology and Radiodiagnostics in Zabrze, Medical University of Silesia in Katowice, Poland
| | | | - Alina Kułakowska
- Department of Neurology, Medical University of Bialystok, Bialystok, Poland
| | - Agnieszka Słowik
- Department of Neurology, Jagiellonian University Medical College, University Hospital in Krakow, Krakow, Poland
| | - Barbara Steinborn
- Department of Developmental Neurology, Poznan University of Medical Sciences, Poznan, Poland
| | - Monika Adamczyk-Sowa
- Department of Neurology in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewa Krzystanek
- Department of Neurology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
| | - Robert Bonek
- Department of Neurology and Clinical Neuroimmunology, Regional Specialist Hospital, Grudziądz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Jarosław Sławek
- Department of Neurology, St. Adalbert Hospital, “Copernicus” Ltd., Gdańsk, Poland
| | - Przemysław Nowacki
- Department of Neurology, Pomeranian Medical University, Szczecin, Poland
| | - Adam Stępień
- Department of Neurology, Military Institute of Medicine, Warsaw, Poland
| | - Sergiusz Jóżwiak
- Department of Paediatric Neurology, Warsaw Medical University, Warsaw, Poland
| | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin, Lublin, Poland
| | - Krzysztof Selmaj
- Department of Neurology, Laboratory of Neuroimmunology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Derlatka-Kochel M, Kumoniewski P, Majos M, Ludwisiak K, Pomorski L, Majos A. Assessment of vocal fold mobility using dynamic magnetic resonance imaging and ultrasound in healthy volunteers. Pol J Radiol 2019; 84:e368-e374. [PMID: 31969952 PMCID: PMC6964356 DOI: 10.5114/pjr.2019.89122] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 08/27/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To verify the value of dynamic magnetic resonance imaging (MRI) sequences, fast field echo (FFE), and balanced gradient echo (true fast imaging with steady-state free precession - TRUFI) in the evaluation of vocal fold mobility in healthy volunteers, against ultrasound examination (US) as the reference test. MATERIAL AND METHODS Vocal fold mobility in 35 healthy volunteers (age 20-59 years, 20 women and 15 men) with no history of laryngeal disorders and neck surgeries was determined by means of US and MRI during normal breathing and phonation of the "hiiii" sound. US images were used to determine the glottic angles. During MRI two dynamic sequences, fast field echo and balanced gradient echo, were applied to determine the minimum and maximum values of the glottic angles, along with the rima glottidis area, separately for the right and left compartments. Due to differences in larynx anatomy, the abovementioned parameters were analysed separately for women and men. RESULTS No significant differences were observed between the glottic angle values obtained during US and dynamic MRI (FFE and TRUFI sequences). Regardless of the dynamic MRI sequence used, a positive correlation was found between the maximum values of glottic angle and the rima glottidis area. This correlation was strong and statistically significant among men, but not in women. CONCLUSIONS Dynamic MRI of vocal folds using FFE and TRUFI sequence is an accurate method for the objective evaluation of rima glottidis width.
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Affiliation(s)
| | - Pawel Kumoniewski
- Department of General and Oncological Surgery, Chair of Surgical Clinical Sciences, Medical University of Lodz, Poland
| | - Marcin Majos
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
| | - Kamil Ludwisiak
- Department of Radiological, Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
| | - Lech Pomorski
- Department of General and Oncological Surgery, Chair of Surgical Clinical Sciences, Medical University of Lodz, Poland
| | - Agata Majos
- Department of Radiological, Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
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Majos M, Polguj M, Stefańczyk L, Derlatka-Kochel M, Wachowski M, Majos A. Renal-aortic ratio as an objective measure of renal artery diameter a computed tomography angiography study. BMC Cardiovasc Disord 2019; 19:181. [PMID: 31362712 PMCID: PMC6668124 DOI: 10.1186/s12872-019-1163-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/17/2019] [Indexed: 11/24/2022] Open
Abstract
Background Considering vital role of renal arteries in many surgical procedures, diameter of renal arteries seems to be an important measure of kidney perfusion. In this study, we analyzed a new parameter, renal-aortic ratio (R-Ar) as an objective measure of the renal artery diameter. Method The study included CT angiographic images from 254 patients (129 women and 125 men). R-Ar was calculated by dividing the diameter of the main renal artery for each kidney by the aortic diameter. Results R-Ar values for the whole study group ranged between 0.0863 and 0.5083; the ranges of R-Ar values for women and men patients were 0.1150–0.5083 and 0.0863–0.4449, respectively. In 412 cases (81.10%), the kidney was supplied by a single renal artery (RA variant) and in 96 (18.90%) by more than one artery (sRA variant). A significant difference was found in R-Ar values for RA and sRA variants (p = 0.0008). When the anatomical variant of renal perfusion was not considered on statistical analysis, a significant difference was found between the R-Ar values for women and men (p = 0.0259). No statistically significant difference was observed in R-Ar values for the right and left kidneys (p = 0.3123). Spearman’s coefficient of rank correlation between patient age and renal-aortic ratio values for the whole study group equaled − 0.36. Conclusion The analysis of the renal-aortic ratio values demonstrated that the diameter of renal arteries depended primarily on their number, and the relative diameter of renal arteries in women was larger than in men.
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Affiliation(s)
- Marcin Majos
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Kopcińskiego 22, 90-153, Łódź, Poland
| | - Michał Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland, Żeligowskiego 7/9, 90-752, Łódź, Poland.
| | - Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Kopcińskiego 22, 90-153, Łódź, Poland
| | - Magdalena Derlatka-Kochel
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Łódź, ul. Pomorska 251, 92-213, Lodz, Poland
| | - Mariusz Wachowski
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Łódź, ul. Pomorska 251, 92-213, Lodz, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Łódź, ul. Pomorska 251, 92-213, Lodz, Poland
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Kumoniewski P, Pomorski L, Derlatka-Kochel M, Majos A. The use of direct laryngoscopy and ultrasound in the perioperative
assessment of mobility of vocal folds in patients treated surgically
due to goiter. Pol Przegl Chir 2019. [DOI: 10.5604/01.3001.0013.2094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Poland has about 25000–30000 thyroid glands operations per year. These kind of operations are in fourth place as to the
frequency of scheduled operations. Most patients have total thyroidectomy. In addition to the classic method of accessing
the collar cut at the neck, there are also alternative access, e.g. through the vestibule of the mouth or armpit. Surgery carries
the risk of serious and even life-threatening consequences. One of the most serious complications of this surgery is failure of
one or both laryngeal recurrents nerves. Laryngeal recurrents nerves are responsible for the proper functioning of vocal folds.
Depending on the failure degree, results in disruption of phonation, difficulties in taking solid and liquid food, limitation of
physical performance, impaired breathing to respiratory failure.
The aim of this study is to assess the prevalence of early injury of the laryngeal nerves by evaluating the operation of vocal
folds in direct laryngoscopy and ultrasonography. The study was carried out from 15/05/2018 to 17/01/2019 at the Department
of General and Oncological Surgery. The patients were qualified for random examination from among the total number of
patients qualified for goiter surgery in the Clinic. Direct laryngoscopy was performed in the Endoscopic Laboratory of the
General and Oncological Surgery Clinic of the Medical University of Lodz. The ultrasound of the vocal folds was performed in
the Department of Diagnostic Imaging. In the study period, 42 patients were qualified to participate in the study.
In the study group, bilateral, early paresis of vocal folds was diagnosed in two patients (4.76%) and unilateral early paresis of
vocal fold in seven patients (16.67%). Both operations, complicated by bilateral paresis of vocal folds, were performed without
the use of intraoperative neuromonitoring (IONM - intraoperative neuromonitoring). One-sided paresis of vocal folds occurred
in 3 patients (7.14%) operated without neuromonitoring, and 4 patients (9.52%) with intraoperative neuromonitoring.
The study found that a severe complication in the form of early bilateral paresis of vocal folds occurred in operations without
the use of neuromonitoring. A similar occurrence of one-sided damage to the vocal fold indicates a lack of connection with the
additional support used in the form of intraoperative neuromonitoring.
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Affiliation(s)
- Paweł Kumoniewski
- Klinika Chirurgii Ogólnej i Onkologicznej Uniwersytetu Medycznego w Łodzi, SPZOZ CSK UM w Łodzi
| | - Lech Pomorski
- Klinika Chirurgii Ogólnej i Onkologicznej Uniwersytetu Medycznego w Łodzi, SPZOZ CSK UM w Łodzi
| | | | - Agata Majos
- Zakład Diagnostyki Obrazowej, SPZOZ CSK UM w Łodzi
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Stefańczyk L, Elgalal M, Ustyniak S, Polguj M, Majos A. Arterio-bronchial fistula as a complication of post-traumatic subclavian artery pseudoaneurysm - radiological findings and outcome. Adv Respir Med 2019; 87:110-113. [PMID: 31038722 DOI: 10.5603/arm.2019.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/20/2018] [Accepted: 01/21/2019] [Indexed: 11/25/2022]
Abstract
Post-traumatic arterio-bronchial fistula is a rare cause of life-threatening hemorrhage. We present a case of a ten-year-old patient with a post-traumatic subclavian artery pseudoaneurysm complicated by an arterio-bronchial fistula and occlusion of the subclavian artery. The patient was treated with a stent-graft. We present radiological images of the fistula and the evolution of the changes in subsequent follow-up examinations.
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Affiliation(s)
- Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, USK nr 1, 22 Kopcińskiego Str., 90-153 Lodz, Poland.
| | - Marcin Elgalal
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, USK nr 1, 22 Kopcińskiego Str., 90-153 Lodz, Poland
| | - Sergiusz Ustyniak
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, USK nr 1, 22 Kopcińskiego Str., 90-153 Lodz, Poland
| | - Michał Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, ul. Narutowicza 60, 90-136 Lodz, Poland
| | - Agata Majos
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, USK nr 1, 22 Kopcińskiego Str., 90-153 Lodz, Poland
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Majos M, Majos A, Polguj M, Szymczyk K, Chrostowski J, Stefańczyk L. Diameters of Arteries Supplying Horseshoe Kidneys and the Level They Branch off Their Parental Vessels: A CT-Angiographic Study. J Clin Med 2019; 8:jcm8040464. [PMID: 30959826 PMCID: PMC6518850 DOI: 10.3390/jcm8040464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/21/2019] [Accepted: 03/29/2019] [Indexed: 02/07/2023] Open
Abstract
Background: The most common renal fusion anomaly is horseshoe kidney (HSK), a condition associated with variable arterial blood supply. The aim of this study was to determine whether the height of origin of the renal artery determines its diameter and whether it differs from the mean diameter of the renal arteries of normal kidneys (NK). Methods: Computer tomography angiography (CTA) studies of 336 patients (88 HSK and 248 NK) were obtained in a search of renal arteries; these were than classified into four groups according to height of its origin: Group I, branching from the aorta superior to the inferior mesenteric artery (IMA); Group II, branching from the aorta below the IMA; Group III, branching from the iliac artery; and Group IV, originating from the internal and external iliac artery. Results: The HSK group included 398 arteries (mean diameter 4.30 mm) and the NK group 598 (5.52 mm) (p < 0.0001). In the HSK group, the mean diameters according to groups were: Group I, 4.54 mm; Group II, 4.28 mm; Group III, 3.41 mm; and Group IV, 3.43 mm. Statistically significant differences were found between arteries originating from the aorta and arteries branching from the iliac arteries (p < 0.0001). In the NK group, the corresponding values were: Group I, 5.53 mm; and Group II, 4.45 mm. The number of arteries supplying the HSK wider than 3.0 mm were: Group I, 83.0%; Group II, 82.4%; Group III, 68.4%; and Group IV, 66.6%. Conclusions: The renal arteries of the HSK branch from their parental vessels at lower levels and have smaller diameters than those of NK.
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Affiliation(s)
- Marcin Majos
- Department of Radiology, Barlicki University Hospital, Medical University of Łódź, Kopcińskiego Str. 22, 90-153 Łódź, Poland.
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Łódź, ul. Pomorska 251, 92-213 Łódź, Poland.
| | - Michał Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Łódź, Żeligowskiego 7/9, 90-752 Łódź, Poland.
| | - Konrad Szymczyk
- Department of Radiology, Barlicki University Hospital, Medical University of Łódź, Kopcińskiego Str. 22, 90-153 Łódź, Poland.
| | - Jakub Chrostowski
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Łódź, ul. Pomorska 251, 92-213 Łódź, Poland.
| | - Ludomir Stefańczyk
- Department of Radiology, Barlicki University Hospital, Medical University of Łódź, Kopcińskiego Str. 22, 90-153 Łódź, Poland.
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Szemraj-Rogucka ZM, Szemraj J, Masiarek K, Majos A. Circulating microRNAs as biomarkers for myocardial fibrosis in patients with left ventricular non-compaction cardiomyopathy. Arch Med Sci 2019; 15:376-384. [PMID: 30899290 PMCID: PMC6425222 DOI: 10.5114/aoms.2019.82919] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 03/22/2017] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Despite the fact that cardiovascular magnetic resonance (CMR) with late gadolinium enhancement (LGE) is a proven method for detecting myocardial fibrosis, there is a need for new and reliable serological biomarkers. Circulating miRNAs could be a practical and attractive alternative. The purpose of the study was to assess the miRNAs well established in myocardial fibrosis - miR-21, miR-29a, miR-30d and miR-133a - in the plasma of patients with left ventricular non-compaction (LVNC) that have areas of LGE assessed by CMR. MATERIAL AND METHODS We prospectively enrolled 13 adult patients (9 males and 4 females; mean age: 39 ±11.7 years) considered to meet standard CMR criteria for LVNC and 10 healthy age- and sex-matched subjects. All LVNC patients and control subjects underwent CMR examination and the measurement of peripheral plasma levels of 4 miRNAs: miR-21, miR-29a, miR-30d and miR-133a. RESULTS The LGE was present in 9 of the 13 (69.2%) LVNC patients, and most often located in the ventricular septum. Compared with LGE-negative patients, LGE-positive patients had significantly lower LVEF (28.3 ±13.3% vs. 53.5 ±14.9%, p = 0.0113) and greater LV end-diastolic diameter (67.8 ±9.5 mm vs. 57 ±2.2 mm, p = 0.01). Significant up-regulation of all 4 miRNAs was observed among LGE-positive patients vs. LGE-negative patients: miR-21 (p = 0.007), miR-29a (p = 0.0001), miR-30d (p = 0.001) and miR-133a (p = 0.0003). CONCLUSIONS The up-regulation of miR-21, miR-29a, miR-30d and miR-133a indicates the presence of LGE in LVNC patients, and therefore they may serve as potential biomarkers for myocardial fibrosis.
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Affiliation(s)
- Zofia M. Szemraj-Rogucka
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Central Clinical Hospital, Lodz, Poland
| | - Janusz Szemraj
- Department of Medical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Konrad Masiarek
- Department of Interventional Cardiology and Cardiac Arrhythmias, Medical University of Lodz, Medical University Teaching Hospital, Lodz, Poland
| | - Agata Majos
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Central Clinical Hospital, Lodz, Poland
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Sąsiadek M, Katulska K, Majos A, Siger M, Hartel M, Kalinowska A, Walecki J. Guidelines of the Polish Medical Society of radiology for the routinely used MRI protocol in patients with multiple sclerosis. Neurol Neurochir Pol 2018; 52:638-642. [PMID: 30447859 DOI: 10.1016/j.pjnns.2018.09.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/17/2018] [Accepted: 09/25/2018] [Indexed: 11/28/2022]
Abstract
Magnetic resonance imaging is widely used in diagnosing multiple sclerosis as a basic method for detecting and monitoring the disease. INTRODUCTION: Polish Medical Society of Radiology presents the second version of the recommendations for the routinely conducted MRI in multiple sclerosis, which include new data and practical remarks for radiographers and radiologists. The recommended protocol aims to improve the imaging procedure and, most importantly, to standardize conducting MRI scans in all MRI departments. This is crucial for monitoring the patients with MS, which directly contributes to essential clinical decisions. AIM OF THE GUIDELINES: Multiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease of the central nervous system (CNS) with its etiology still unknown. The fundamental requirement of the disease is the CNS destruction process disseminated in time (DIT) and space (DIS). MR imaging detects focal lesions in white and gray matter with high sensitivity and is the best way to assess brain atrophy in MS patients. It is unquestionably the best diagnostic tool to follow-up the clinical course of the disease and treatment of MS patients. However, to achieve a diagnosis based on MRI scans, and follow-up MS patients according to the latest standards, an MRI scan has to meet certain quality criteria that are the subject of this work.
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Affiliation(s)
- Marek Sąsiadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Poland.
| | - Katarzyna Katulska
- Department of Neuroradiology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Poland
| | | | | | - Alicja Kalinowska
- Department of Neurology, Division of Neurochemistry and Neuropathology, Poznan University of Medical Sciences, Poland
| | - Jerzy Walecki
- Department of Radiology, Medical Centre for Postgraduate Education, Warsaw, Poland
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Gulas E, Wysiadecki G, Szymański J, Majos A, Stefańczyk L, Topol M, Polguj M. Morphological and clinical aspects of the occurrence of accessory (multiple) renal arteries. Arch Med Sci 2018; 14:442-453. [PMID: 29593819 PMCID: PMC5868651 DOI: 10.5114/aoms.2015.55203] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 08/16/2015] [Indexed: 11/17/2022] Open
Abstract
Renal vascularization variants vastly differ between individuals due to the very complex embryogenesis of the kidneys. Moreover, each variant may have implications for clinical and surgical interventions. The number of operating procedures continues to grow, and includes renal transplants, aneurysmorrhaphy and other vascular reconstructions. In any surgical technique, unawareness of the presence of multiple renal arteries may result in a fatal outcome, especially if laparoscopic methods are used. The aim of this review is to comprehensively identify the variation within multiple renal arteries and to highlight the connections between the presence of accessory renal arteries and the coexistence of other variants of vascularization. Another aim is to determine the potential clinical implications of the presence of accessory renal arteries. This study is of particular importance for surgeons, intervention radiologists, nephrologists and vascular surgeons.
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Affiliation(s)
- Ewelina Gulas
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Jacek Szymański
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Lodz, Poland
| | | | - Mirosław Topol
- Department of Normal and Clinical Anatomy, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
| | - Michał Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland
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Gębska-Kośla K, Bryszewski B, Jaskólski DJ, Fortuniak J, Niewodniczy M, Stefańczyk L, Majos A. Reorganization of language centers in patients with brain tumors located in eloquent speech areas - A pre- and postoperative preliminary fMRI study. Neurol Neurochir Pol 2017; 51:403-410. [PMID: 28780063 DOI: 10.1016/j.pjnns.2017.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/06/2017] [Accepted: 07/06/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this study was to determine in pre- and postsurgical fMRI studies the rearrangement of the Broca's and Wernicke's areas and the lateralization index for these areas in patients with brain tumors located near speech centers. Impact of the surgical treatment on the brain plasticity was evaluated. MATERIALS AND METHODS Pre- and postoperative fMRI examinations were performed in 10 patients with low grade glial, left-sided brain tumors located close to the Broca's (5 patients) or Wernicke's area (5 patients). BOLD signal was recorded in regions of interest: Broca's and Wernicke's areas, and their anatomic right-sided homologues. RESULTS In the preoperative fMRI study the left Broca's area was activated in all cases. The right Broca's area was activated in all the patients with no speech disorders. In the postoperative fMRI the activation of both Broca's areas increased in two cases. In other two cases activation of one of the Broca's area increased along with the decrease in the contralateral hemisphere. In all patients with temporal lobe tumors, the right Wernicke's area was activated in the pre- and postsurgical fMRI. After the operation, in two patients with speech disorder, the activation of both Broca's areas decreased and the activation of one of the Wernicke's areas increased. CONCLUSIONS In the cases of tumors localized near the left Broca's area, a transfer of the function to the healthy hemisphere seems to take place. Resection of tumors located near Broca's or Wernicke's areas may lead to relocation of the brain language centers.
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Affiliation(s)
- Katarzyna Gębska-Kośla
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Central Clinical Hospital, Czechoslowacka 8/10, 92-216 Lodz, Poland.
| | - Bartosz Bryszewski
- Department of Neurosurgery, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Dariusz J Jaskólski
- Department of Neurosurgery, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Jan Fortuniak
- Department of Neurosurgery, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Maciej Niewodniczy
- Institute of Health Sciences, University of Social Sciences, Gdańska 121, 90-508 Łódź, Poland.
| | - Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Central Clinical Hospital, Czechoslowacka 8/10, 92-216 Lodz, Poland.
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Woźniak T, Strzelecki M, Majos A, Stefańczyk L. 3D vascular tree segmentation using a multiscale vesselness function and a level set approach. Biocybern Biomed Eng 2017. [DOI: 10.1016/j.bbe.2016.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chrzanowska M, Moczulska H, Janiak K, Kacprzak M, Majos A, Sieroszewski P. Prenatal diagnosis of Goldenhar syndrome – case report. Eur J Obstet Gynecol Reprod Biol 2016. [DOI: 10.1016/j.ejogrb.2016.07.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kaczmarek J, Kozera-Kępniak A, Majos A, Kaczorowska B. [The difficulties with the diagnosis of cerebral sinus thrombosis of a young woman - a case report]. Pol Merkur Lekarski 2016; 40:314-317. [PMID: 27234863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
UNLABELLED Cerebral venous stroke is disfunction of brain cause by thrombosis of cerebral veins or thrombosis of sinus of the dura mater. This disease represents about 0,5-1% of all strokes. Women are ill more often. There are over 100 factors which cause this disease. The most often symptoms are headache, epileptic fit, oedema of optic nerve, loss of visual acuity, speech defects. Magnetic resonance proves the diagnosis. MRI with contrast is recommended. A CASE REPORT We show the case of a young woman taking the oral contraceptive pill whose only symptom of venous thrombosis for a few days was a strong headache. When the woman was admitted to hospital, she didn't have any other symptoms ( in neurology examine, tomography and blood tests). The severity of headache after lumbar puncture (because of suspected subarachnoid bleeding) suggested presented of post-dural-puncture headache, which delayed the correct diagnosis. It was not until after the symptoms of the focal brain damage appeared on the fifth day that we finally made the correct diagnosis confirmed by some additional tests/examinations. Thus we started causal and symptomatic treatment. The difficulties we had with making the correct diagnosis indicate that the recognition of cerebral thrombosis should be taken into account when treating every young woman taking contraceptive pills and suffering from strong headaches. Headaches can be the only symptom of venous stroke in 90% of cases.
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Affiliation(s)
- Justyna Kaczmarek
- Medical University of Lodz, Poland: Department of Neurology and Brain Stroke University Clinical Hospital Military Memorial Medical Academy - Central Veteran`s Hospital
| | | | - Agata Majos
- Medical University of Lodz, Poland: Department of Radiological and Isotopic Diagnosis and Therapy
| | - Beata Kaczorowska
- Medical University of Lodz, Poland: Department of Neurology and Brain Stroke
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Ledakowicz-Polak A, Bartodziej J, Majos A, Zielińska M. Inverted stress- induced cardiomyopathy as a unusual variant of acute heart failure after cesarean delivery- a case report. BMC Cardiovasc Disord 2016; 16:76. [PMID: 27130218 PMCID: PMC4850726 DOI: 10.1186/s12872-016-0253-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/22/2016] [Indexed: 11/20/2022] Open
Abstract
Background Stress- induced cardiomyopathy is acute, reversible left ventricle mainly apical dysfunction in patients with normal coronary angiography. Rarely it regards basal segments, therefore defined as “inverted stress- induced cardiomyopathy”. While classic form mostly affects postmenopausal women, inverted variant occurs essentially in younger females, always triggered by stress. It can also develop after medical procedures and surgery. Herein we report such unique case of 36- year old woman after cesarean delivery. Case presentation A 36- year- old white woman at 40 week of gestation was admitted to hospital for elective repeated cesarean delivery. During caesarean delivery under spinal anaesthesia a previously healthy woman became hypotensive, requiring ephedrine to maintain her blood pressure. Three hours after delivery the patient presented acute heart failure and pulmonary oedema. Due to low blood pressure she demanded the administration of inotropic agents. Owing to respiratory failure and gradual deterioration of consciousness, mechanical ventilation was applied. Results of additional tests finally excluded pulmonary thromboembolism and acute coronary syndrome. The transthoracic echocardiography revealed severe left ventricular systolic dysfunction, ejection fraction 30 % with hypokinesis of the mid and basal segments of posterior, anterior and lateral wall with preserved contractility of the apical segments. The diagnosis of inverted stress- induced cardiomyopathy was set upon the overall clinical data. Both echocardiography and magnetic resonance imaging performed on the fifth day showed complete recovery of myocardial function. The patient was discharged after 15 days in good overall condition. At 12- month follow- up she remained asymptomatic with no echocardiographic abnormalities. Conclusions Inverted stress- induced cardiomyopathy may occur in postpartum period, especially in combination with spinal anesthesia and adrenergic stimulants administration. The clinical awareness and multimodality imaging of possible diagnosis and further management of this unexpected variant of acute heart failure after caesarean delivery is required.
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Affiliation(s)
- Anna Ledakowicz-Polak
- Intensive Cardiac Therapy Clinic, Department of Cardiology and Cardiosurgery, Medical University, Pomorska 251, 92-213, Lodz, Poland.
| | - Jarosław Bartodziej
- Department of Anaesthesiology and Intensive Care, Jonscher Municipal Hospital, Lodz, Poland
| | - Agata Majos
- Department of Radiology, Medical University, Lodz, Poland
| | - Marzenna Zielińska
- Intensive Cardiac Therapy Clinic, Department of Cardiology and Cardiosurgery, Medical University, Pomorska 251, 92-213, Lodz, Poland
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Gulas E, Wysiadecki G, Cecot T, Majos A, Stefańczyk L, Topol M, Polguj M. Accessory (multiple) renal arteries - Differences in frequency according to population, visualizing techniques and stage of morphological development. Vascular 2016; 24:531-7. [PMID: 26945775 DOI: 10.1177/1708538116631223] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this paper is to comprehensively analyze the literature focused on frequency of the presence of the accessory renal arteries in the human body. A systematic analysis of papers has been made. With regard to ethnicity, the incidence of accessory renal arteries fluctuates from 4% in a Malaysian population to 61.5% in a Brazilian population. The frequency is lowest in eastern and southern Asia (from 4% to 18.4%). In some, not ethnically homogenous populations, wide span of occurrence of accessory renal arteries is described (e.g. American - averaging from 18% to 28.8%). A higher frequency of accessory renal arteries was observed in fetuses compared to adults. Moreover, differences in the presence and number of accessory renal arteries reported in different papers are a consequence of type of visualizing technique used in research - especially when computed tomography and anatomical dissection were compared. The increasing number of surgical interventions, especially where laparoscopic methods are concerned, underlines the importance of such knowledge especially to surgeons, interventional radiologists, nephrologists, and vascular surgeons.
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Affiliation(s)
- Ewelina Gulas
- Department of Angiology, Medical University of Łódź, Narutowicza, Poland
| | - Grzegorz Wysiadecki
- Department of Normal and Clinical Anatomy, Medical University of Łódź, Narutowicza, Poland
| | - Tomasz Cecot
- Centre for Learning Anatomical Sciences, University of Southampton, Great Britain
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Łódź, Żeromskiego, Poland
| | - Ludomir Stefańczyk
- Department of Radiology, Medical University of Łódź, Kopcińskiego, Poland
| | - Mirosław Topol
- Department of Normal and Clinical Anatomy, Medical University of Łódź, Narutowicza, Poland
| | - Michał Polguj
- Department of Angiology, Medical University of Łódź, Narutowicza, Poland
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Polguj M, Majos A, Waszczykowski M, Fabiś J, Stefańczyk L, Podgórski M, Topol M. A computed tomography study on the correlation between the morphometry of the suprascapular notch and anthropometric measurements of the scapula. Folia Morphol (Warsz) 2015; 75:87-92. [PMID: 26365856 DOI: 10.5603/fm.a2015.0072] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 11/25/2022]
Abstract
BACKGROUND The suprascapular notch is a clinically important site because it is the main site of injury and compression of the suprascapular nerve. Its shape and size are the most important factors in the aetiopathology of suprascapular nerve neuropathy. This article reports the first computed topography (CT) study on the correlation between the diameters of the suprascapular notch and anthropometric measurements of the human scapula. MATERIALS AND METHODS A total of 130 scans of shoulders by a helical 32-row multidetector CT scanner were retrospectively analysed. The following scapular measurements were performed: morphological length, morphological width, projection length of the scapular spine, maximal width of the scapular spine, length of the acromion, maximal length of the coracoid process, length of the superior border of the scapula, morphological height of the supraspinous fossa, length of the lateral border of the scapula, and morphological height of infraspinous fossa. The following suprascapular notch dimensions were measured: maximal depth, superior transverse diameter, middle transverse diameter. RESULTS The maximum depth of the suprascapular notch correlates with the morphological length of the scapula, the length of the lateral border of the scapula and the morphological width of the scapula. The superior transverse diameter of the suprascapular notch correlates with the length of the superior border of the scapula and negatively with the length of the lateral border of the scapula. In addition it has been shown that the length of the superior border of the scapula correlates more closely with the superior transverse diameter of the suprascapular notch than the middle transverse diameter of the suprascapular notch. CONCLUSIONS It could be supposed that humans with longer scapulae have deeper notches. It may be also concluded that scapulae with a wider superior border have a shallower suprascapular notch.
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Affiliation(s)
- M Polguj
- Department of Angiology, Interfaculty Chair of Anatomy and Histology, Medical University of Lodz, Poland.
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Kośla K, Bryszewski B, Jaskólski D, Błasiak-Kołacińska N, Stefańczyk L, Majos A. Reorganization of Language Areas in Patient with a Frontal Lobe Low Grade Glioma - fMRI Case Study. Pol J Radiol 2015; 80:290-5. [PMID: 26097525 PMCID: PMC4461046 DOI: 10.12659/pjr.893897] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 03/05/2015] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Functional magnetic resonance (fMRI) studies results in case of an adult patient with low grade glioma (LGG) in dominant hemisphere suggest brain plasticity process with acquisition of language functions by the non-dominant hemisphere speech regions. CASE REPORT A 36-years old right-handed woman was admitted to the Department of Neurosurgery for surgical treatment of brain tumor. An MRI examination revealed a pathological mass in the left frontal lobe, in close topographical relationship to the Broca's area. A left fronto-parietal craniotomy was performed, with an intraoperative awake language mapping procedure. A total resection of the pathological mass was achieved. The tumor was examined histologically as LGG. In the follow-up MRI exam 32 months after the operation a tumor recurrence was suggested. The fMRI exams performed preoperative and 3, 32 and 41 months after the operation showed changes in language regions activation patterns, with a progressive right-sided activation of Broca's and Wernicke's areas. Pre- and postoperative cognitive evaluation by a neuropsychologist did not detect any language impairment. We present a running process of reorganization of language areas in a patient after brain tumor resection, from strong left-sided to symmetrical lateralization. CONCLUSIONS 1. FMRI results in comparison with the psychological status of the patient proved contribution of functional reorganization to the preservation of language performance. 2. A slow growing LGG as well as the recurrence of the tumor near the left Broca's area might be the factors leading to reorganization of language-related areas by recruiting the right hemisphe.
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Affiliation(s)
- Katarzyna Kośla
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland
| | | | - Dariusz Jaskólski
- Department of Neurosurgery, Medical University of Łódź, Łódź, Poland
| | | | - Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland
| | - Agata Majos
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland
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Polguj M, Rożniecki J, Sibiński M, Grzegorzewski A, Majos A, Topol M. The variable morphology of suprascapular nerve and vessels at suprascapular notch: a proposal for classification and its potential clinical implications. Knee Surg Sports Traumatol Arthrosc 2015; 23:1542-1548. [PMID: 24633009 PMCID: PMC4555201 DOI: 10.1007/s00167-014-2937-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 03/04/2014] [Indexed: 12/05/2022]
Abstract
PURPOSE The most common place for suprascapular nerve entrapment is the suprascapular notch. The aim of the study was to determine the morphological variation of the location of the suprascapular nerve, artery and vein, and measure the reduction in size of the suprascapular opening in each type of the passage. METHODS A total of 106 human formalin-fixed cadaveric shoulders were included in the study. After dissection of the suprascapular region, the topography of the suprascapular nerve, artery and vein was evaluated. Additionally, the area of the suprascapular opening was measured using professional image analysis software. RESULTS Four arrangements of the suprascapular vein, artery and nerve were distinguished with regard to the superior transverse scapular ligament: type I (61.3 %) (suprascapular artery was running above ligament, while suprascapular vein and nerve below it), type II (17 %) (both vessels pass above ligament, while nerve passes under it), type III (12.3 %) (suprascapular vessels and nerve lie under ligament) and type IV (9.4 %), which comprises the other variants of these structures. Statistically significant differences regarding the suprascapular opening were observed between the specimens with types II and III. Anterior coracoscapular ligaments were present in 55 from 106 shoulders. CONCLUSION The morphological variations described in this study are necessary to better understand the possible anatomical conditions which may promote suprascapular nerve entrapment (especially type III). They may be useful during open and endoscopic procedures at the suprascapular notch to prevent such complications as unexpected bleeding.
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Affiliation(s)
- Michał Polguj
- Department of Angiology, Medical University of Łódź, Narutowicza 60, 90-136, Łódź, Poland.
| | - Jacek Rożniecki
- Department of Neurology, Medical University of Łódź, Łódź, Poland
| | - Marcin Sibiński
- Clinic of Orthopedic and Pediatric Orthopedics, Medical University of Łódź, Łódź, Poland
| | - Andrzej Grzegorzewski
- Clinic of Orthopedic and Pediatric Orthopedics, Medical University of Łódź, Łódź, Poland
| | - Agata Majos
- Department of Radiology, Medical University of Łódź, Łódź, Poland
| | - Mirosław Topol
- Department of Normal and Clinical Anatomy, Medical University of Łódź, Łódź, Poland
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Olszycki M, Kozakiewicz M, Elgalal M, Majos A, Stefanczyk L. In vitro and in vivo imaging of ultra-high-molecular-weight polyethylene orbital implants. Int J Oral Maxillofac Implants 2015; 30:e24-9. [PMID: 25830408 DOI: 10.11607/jomi.3790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The aim of this study is to compare magnetic resonance imaging (MRI) with computed tomography (CT) for visualization of an orbital alloplastic prosthesis made of ultra-high-molecular-weight polyethylene (UHMW-PE) both in vitro and in vivo. A study of 15 test implants from UHMW-PE visualized in vitro in CT and MRI and an in vivo visualization in a patient who suffered from orbital injury and underwent reconstructive surgery is presented. The postsurgery MRI showed the UHMW-PE material clearly, with no significant artifacts. The surrounding tissues could be satisfactorily evaluated. The CT scans did not present the graft material. Both techniques were sufficient tools for in vitro evaluation of the shape and measurement of the prosthesis.
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Polguj M, Majos M, Topol M, Majos A, Stefańczyk L. The influence of atherosclerotic abdominal aorta on the shape of duplicated inferior vena cava: its potential clinical implications and vascular complications. Folia Morphol (Warsz) 2014; 73:521-6. [PMID: 25448915 DOI: 10.5603/fm.2014.0080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/21/2014] [Accepted: 03/22/2014] [Indexed: 11/25/2022]
Abstract
Duplication of the inferior vena cava (IVC) is a congenital condition where there are 2 large vessels: right IVC (RIVC) and left IVC (LIVC) on both sides of the abdominal aorta. Here, we present 2 cases of duplicated inferior cava coexisting with rare morphology of left gonadal (ovarian/testicular) vein. Both were observed during multidetector 64-row computer tomography. In first case atherosclerotic, tortuous abdominal aorta models both inferior venae cavae. The shape of veins were more- (RIVC) and less-arcuate (LIVC). Two years ago, the patient had been diagnosed with pulmonary thromboembolism. In second case abdominal aortic aneurysm models both large veins. The RIVC has a highly right-arcuate shape, while the LIVC has a less left-arcade shape. Our observation would seem to be especially important, because the tortuous abdominal aorta changes the shape of both IVC, and may predispose them for thrombosis formation. The presented report precisely describes the topography and measurements of the vessels in the retroperitoneal area. The literature concerning this anomaly, potential clinical implications and vascular complications are reviewed and the possible practical aspects are discussed. A familiarity with the anatomy of the most common types of venous anomalies is crucial for all surgeons, urologists and oncologists to reduce the risk of severe haemorrhage during all abdominal procedures.
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Affiliation(s)
- M Polguj
- Department of Angiology, Medical University of Lodz, Poland.
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Błasiak-Kołacińska N, Pietruszewska W, Grzelak P, Raźniewski M, Stefańczyk L, Majos A. Rare infraglottic lesions in magnetic resonance imaging. Pol J Radiol 2014; 79:305-10. [PMID: 25228940 PMCID: PMC4162451 DOI: 10.12659/pjr.890521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 02/24/2014] [Indexed: 11/24/2022] Open
Abstract
Background Primary pathological laryngeal lesions occur rarely in infraglottic space. Modern possibilities of diagnostic imaging of infraglottic space include computed tomography (CT) and magnetic resonance (MR). Diagnostic imaging was performed in potential lesions in this area: inflammatory process – cicatrical pemphigoid, benign neoplastic process – chondroma, malignant neoplastic – squamous cell carcinoma. The aim of the paper is to present clinical and radiographical characteristics of selected lesions located in infraglottic space in MRI examination. Material/Methods Three patients examined at the Department of Radiology and Diagnostic Imaging of University Hospital No. 1 in Lodz (SPZOZ USK nr 1) from 2010–2011 with a pathological mass in infraglottic space. Standard imaging protocol for MRI of the neck was used in all patients: field of 1.5 T, slice thickness 3 mm, the distance between the scans 10–20%, FOV – 3 mm, sequences: T1 (TR/TE 455/9, 7 ms, T2 (TR/TE 5300/67 ms), T1 + Gd-DTPA (contrast agent Gd-DTPA at 0.2 mmol/kg). Conclusions 1. It is possible to determine characteristic signal pattern for rare lesions of the infraglottic space in MRI. 2. MRI is a valuable complementary modality for the diagnostics and differentiation of lesions in infraglottic space, the evaluation of their advancement and treatment planning.
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Affiliation(s)
- Nina Błasiak-Kołacińska
- Department of Radiology - Diagnostic Imaging, Medical University of Łódź, N. Barlicki University Hospital No. 1, Łódź, Poland
| | - Wioletta Pietruszewska
- Department of Otolaryngology and Oncological Laryngology, Medical University of Łódź, N. Barlicki University Hospital No. 1, Łódź, Poland
| | - Piotr Grzelak
- Department of Radiology - Diagnostic Imaging, Medical University of Łódź, N. Barlicki University Hospital No. 1, Łódź, Poland
| | - Marek Raźniewski
- Department of Radiology - Diagnostic Imaging, Medical University of Łódź, N. Barlicki University Hospital No. 1, Łódź, Poland
| | - Ludomir Stefańczyk
- Department of Radiology - Diagnostic Imaging, Medical University of Łódź, N. Barlicki University Hospital No. 1, Łódź, Poland
| | - Agata Majos
- Department of Radiology - Diagnostic Imaging, Medical University of Łódź, N. Barlicki University Hospital No. 1, Łódź, Poland
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Podgórski M, Sibiński M, Majos A, Stefańczyk L, Topol M, Polguj M. The suprascapular vein: a possible etiology for suprascapular nerve entrapment and risk of complication during procedures around the suprascapular foramen region. Orthop Traumatol Surg Res 2014; 100:515-9. [PMID: 25082777 DOI: 10.1016/j.otsr.2014.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Revised: 03/20/2014] [Accepted: 05/13/2014] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Nerve can be compressed when traveling through any osteo-fibrous tunnel. Any eventual anatomic structure limiting this passage increases the risk of neuropathy. During dissection of the shoulder region we recognized a vein travelling on the inferior border of the suprascapular notch together with the suprascapular nerve. The aim of this work was to evaluate the morphological characteristics of this vein in cadaveric material. MATERIALS AND METHODS The suprascapular notch (SSN) region was dissected in 60 cadaveric shoulders. The course, number and diameter of nerve and vessels in the suprascapluar notch region were evaluated. Length, proximal and distal width of the superior transverse scapular ligament were measured. Photographic documentation was taken to evaluate the suprascapular nerve passage area. RESULTS The vein identified was named as the suprascapular notch vein. It was present in 58.3% of shoulders. In 11 specimens, it was double. Its mean diameter was 1.7 mm (SD 0.7 mm) and did not correlate with the suprascapular nerve passage area. A suprascapular notch vein co-occurred more often with the anterior coracoscapular ligament (ACSL). In comparison with the SSN without the ACSL, it has a significantly greater diameter (2 mm; SD 0.7 mm vs 1.5 mm; SD 0.6 mm, respectively; P=0.021). CONCLUSIONS The suprascapular notch vein was a common structure that did not replace the suprascapular vein. Its presence correlated with the occurrence of the ACSL and was independent of body side, STSL type and SSN type. TYPE OF STUDY Observational anatomic study.
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Affiliation(s)
- M Podgórski
- Department of Angiology, Chair of Anatomy, Medical University of Łódź, Narutowicza 60, 90-136 Lodz, Poland
| | - M Sibiński
- Clinic of Orthopaedic and Pediatric Orthopaedics, Medical University of Łódź, Łódź, Poland
| | - A Majos
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland
| | - L Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland
| | - M Topol
- Department of Normal and Clinical Anatomy, Chair of Anatomy, Medical University of Łódź, Łódź, Poland
| | - M Polguj
- Department of Angiology, Chair of Anatomy, Medical University of Łódź, Narutowicza 60, 90-136 Lodz, Poland.
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Kośla KN, Majos M, Podgórski M, Polguj M, Topol M, Stefańczyk L, Majos A. Anomalous course and diameter of left-sided vertebral arteries – Significance and predisposing factors in clinical practice. Ann Anat 2014; 196:360-4. [DOI: 10.1016/j.aanat.2014.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 04/16/2014] [Accepted: 04/17/2014] [Indexed: 12/01/2022]
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Polguj M, Majos M, Topol M, Majos A. An asymmetrical fenestration of the basilar artery coexisting with two aneurysms in a patient with subarachnoid haemorrhage: case report and review of the literature. Folia Morphol (Warsz) 2014; 73:229-33. [PMID: 24902104 DOI: 10.5603/fm.2014.0034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 10/24/2013] [Accepted: 10/25/2013] [Indexed: 11/25/2022]
Abstract
The vertebrobasilar system is a part of the cerebral arterial circle (circle of Willis), which forms the collateral circulation of the brain. A 75-year-old Caucasian female was admitted to hospital because of a strong headache radiating to the neck. On the basis of a neurological examination, the patient was classified into group III of the Hunt and Hess scale. Subarachnoid haemorrhage and 2 aneurysms of the cerebral arteries were diagnosed during multidetector 64-row computed tomography and angiography. An asymmetrical fenestration of the proximal part of the basilar artery was also observed. The bleeding aneurysm locating at anterior communicating artery was diagnosed and clipped surgically by right fronto-parietal craniotomy. The second aneurysm was located just after the junction of the vertebral arteries on the wall of the basilar artery. The presented case firstly illustrates the asymmetric fenestration of the proximal part of the basilar artery coexisting with subarachnoid haemorrhage and 2 aneurysms of brain arteries. Such observation should increase diagnostic attention in the detection of possible associated aneurysms and can help in preventing complications during all endovascular treatment procedures.
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Grzelak P, Domzalski M, Majos A, Podgórski M, Stefanczyk L, Krochmalski M, Polguj M. Thickening of the knee joint cartilage in elite weightlifters as a potential adaptation mechanism. Clin Anat 2014; 27:920-8. [PMID: 24648385 DOI: 10.1002/ca.22393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2013] [Revised: 02/03/2014] [Accepted: 02/20/2014] [Indexed: 01/17/2023]
Abstract
Thickening and increase of area of cartilage have been proposed as two alternative mechanisms of cartilage functional adaptation. The latter has been reported in endurance sportsmen. In weightlifters, extreme strain applied to the articular surfaces can result in other forms of adaptation. The aim of this research is to determine whether cartilage thickness is greater in elite weightlifters than in physically inactive men. Weightlifters (13) and 20 controls [age and body mass index (BMI) matched] underwent knee Magnetic Resonance Imaging (MRI). A single sagittal slice of the knee was taken and cartilage thickness was measured in five and six regions of the medial and lateral femoral condyles, respectively. The analyzed segments represented weight-bearing and nonweight-bearing regions. The tibia cartilage in the weight-bearing area was also measured. The time of training onset and its duration in the weightlifter group were recorded. The cartilage was found to be significantly thicker in weightlifters in most of the analyzed regions. The distribution of cartilage thickness on the medial and lateral femoral condyles was similar in both groups. The duration of training was not associated with cartilage thickness, but the time of training onset correlated inversely with cartilage thickness. It is possible that in high-strain sports, joint cartilage can undergo functional adaptation by thickening. Thus, mechanical loading history could exert a postnatal influence on cartilage morphology.
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Affiliation(s)
- Piotr Grzelak
- Department of Radiology and Diagnostic Imaging, Medical University of Lodz, Poland
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Stefańczyk L, Majos M, Majos A, Polguj M. Duplication of the inferior vena cava and retroaortic left renal vein in a patient with large abdominal aortic aneurysm. Vasc Med 2014; 19:144-145. [PMID: 24503488 DOI: 10.1177/1358863x14521891] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Marcin Majos
- Department of Angiology, Medical University of Łódź, Łódź, Poland
| | - Agata Majos
- Department of Radiology, Medical University of Łódź, Łódź, Poland
| | - Michał Polguj
- Department of Angiology, Medical University of Łódź, Łódź, Poland
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Bryszewski B, Tybor K, Ormezowska EA, Jaskólski DJ, Majos A. Rearrangement of motor centers and its relationship to the neurological status of low-grade glioma examined on pre- and postoperative fMRI. Clin Neurol Neurosurg 2013; 115:2464-70. [DOI: 10.1016/j.clineuro.2013.09.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 08/06/2013] [Accepted: 09/28/2013] [Indexed: 10/26/2022]
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Kośla K, Majos M, Polguj M, Antosik-Biernacka A, Stefańczyk L, Majos A. Prenatal diagnosis of a vein of Galen aneurysmal malformation with MR imaging - report of two cases. Pol J Radiol 2013; 78:88-92. [PMID: 24505230 PMCID: PMC3908515 DOI: 10.12659/pjr.889613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 08/19/2013] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Vein of Galen malformations (VGMs) are rare congenital defects of cerebral vessels. They are formed between the 6(th) and 11(th) week of gestation. The background of this defect involves presence of one or more arterovenous fistulas directing bloodflow toward a persistent, dilated, proximal part of median prosencephalic vein (MProsV). Ultrasound examination is a basic test for diagnosis of VGMs. It has now become possible to acquire images of diagnostic value using magnetic resonance (MR) techniques. CASE REPORT This work presents two cases of vein of Galen aneurysms diagnosed prenatally with magnetic resonance imaging. In both patients fetal CNS malformations were diagnosed in ultrasound examinations. MR imaging of the fetal head was performed for further diagnostics. CONCLUSIONS Because of the ability to precisely determine the size of the ventricular system, presence of raised intraventricular pressure and topographic relationships between pathologically changed vessels and particular cerebral structures as well as the presence of ischemic areas MR examination is currently not only complementary to ultrasonography, but is becoming an independent examination method in the diagnostics of vein of Galen malformations.
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Affiliation(s)
- Katarzyna Kośla
- Department of Radiology and Diagnostic Imaging, Medical University of ŁódŸ, Barlicki University Hospital No. 1, ŁódŸ, Poland
| | - Marcin Majos
- Department of Radiology and Diagnostic Imaging, Medical University of ŁódŸ, Barlicki University Hospital No. 1, ŁódŸ, Poland
| | - Michał Polguj
- Department of Angiology, Chair of Anatomy, Medical University of ŁódŸ, ŁódŸ, Poland
| | - Aneta Antosik-Biernacka
- Department of Radiology and Diagnostic Imaging, Medical University of ŁódŸ, Barlicki University Hospital No. 1, ŁódŸ, Poland
| | - Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of ŁódŸ, Barlicki University Hospital No. 1, ŁódŸ, Poland
| | - Agata Majos
- Department of Radiology and Diagnostic Imaging, Medical University of ŁódŸ, Barlicki University Hospital No. 1, ŁódŸ, Poland
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Abstract
Vascular type of Ehlers-Danlos syndrome involves many severe complications leading not only to organ-specific symptoms but often ends in a sudden death. The aim of this paper was to present a diagnostic possibilities and its efficiency rate in patients with vascular complications of Ehlers-Danlos syndrome who suffered from artery dissection resulting in acute brain or limb ischemia. We analysed three patients with diagnosed Ehlers-Danlos syndrome who were referred to radiology department for diagnostic imaging of affected vascular beds, each experienced brain ischemia. The paper also aims at offering some general recommendations for patients suffering from possible complications of type IV Ehlers-Danlos syndrome basing on our own experience and available literature data.
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Affiliation(s)
- Michal Pajak
- Department of Radiology and Imaging Diagnostic, Medical University of Lodz, Poland
| | - Marcin A Majos
- Department of Radiology and Imaging Diagnostic, Medical University of Lodz, Poland
| | - Wojciech Szubert
- Department of Radiology and Imaging Diagnostic, Medical University of Lodz, Poland
| | - Ludomir Stefanczyk
- Department of Radiology and Imaging Diagnostic, Medical University of Lodz, Poland
| | - Agata Majos
- Department of Radiology and Imaging Diagnostic, Medical University of Lodz, Poland
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Szymczyk K, Polguj M, Szymczyk E, Majos A, Grzelak P, Stefańczyk L. Persistent left superior vena cava with an absent right superior vena cava in a 72-year-old male with multivessel coronary artery disease. Folia Morphol (Warsz) 2013; 72:271-3. [PMID: 24068691 DOI: 10.5603/fm.2013.0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 03/18/2013] [Indexed: 11/25/2022]
Abstract
Congenital anomalies of systemic veins are usually asymptomatic and found incidentally during ultrasonography, computed tomography (CT) or magnetic resonance examinations performed for other clinical indications. Persistent left superior vena cava (PLSVC) with absent right superior vena cava (RSVC) is the congenital aberration in the thoracic venous system which occurs in only 0.09%to 0.13% of patients who have congenital heart defects. In this paper, we present the extremely rare case of a 72-year-old male with PLSVC associated with an absence of RSVC, referred for coronary CT angiography. Multidetector CT angiography is a powerful tool for the detection of venous anomalies, which is essential before invasive procedures such as the implantation of pacemakers.
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Affiliation(s)
- K Szymczyk
- Department of Radiology, Barlicki Memorial Teaching Hospital No. 1, Medical University of Lodz, Poland.
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Polguj M, Jędrzejewski K, Podgórski M, Majos A, Topol M. A proposal for classification of the superior transverse scapular ligament: variable morphology and its potential influence on suprascapular nerve entrapment. J Shoulder Elbow Surg 2013; 22:1265-73. [PMID: 23375880 DOI: 10.1016/j.jse.2012.11.017] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/12/2012] [Accepted: 11/21/2012] [Indexed: 02/01/2023]
Abstract
BACKGROUND The suprascapular region is the most common site of suprascapular nerve entrapment. The aim of the present study was to determine the morphologic variation of the superior transverse scapular ligament (STSL) and measure the reduction in size of the suprascapular opening. Other structures that might be potentially significant during open and arthroscopic procedures in this region are also described. MATERIALS AND METHODS The study used 86 randomized formalin-fixed human cadaveric shoulders. After dissection of the suprascapular region, the following measurements were defined and collected for every STSL: length, proximal width, distal width, and thickness at the proximal and distal ends. Measurements were also taken of the area of the suprascapular opening (aSSO) and the middle width of the suprascapular opening (mwSSO). RESULTS Three types of STSL may be distinguished: a fan-shaped type (54.6%), a band-shaped type (41.9%), and a bifid type (3.5%). Statistically significant differences between the specimens with fan-shaped and band-shaped types of STSL were observed in aSSO and mwSSO of the suprascapular opening. Anterior coracoscapular ligaments (ACSL) were present in 44 of 86 shoulders. The aSSO and mwSSO were smaller in specimens with an ACSL than in those without; however, this difference was only significant in the band-shaped type of STSL. CONCLUSION Knowledge of the morphologic variations of STSL presented in this study is important for better understanding the possible anatomic conditions that can promote suprascapular nerve entrapment and should be taken into particular consideration during surgical and arthroscopic procedures around the suprascapular notch.
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Affiliation(s)
- Michał Polguj
- Department of Angiology, Medical University of Łódź, Narutowicza 60, Łódź, Poland.
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Polguj M, Bliźniewska K, Jędrzejewski K, Majos A, Topol M. Morphological study of linea aspera variations - proposal of classification and sexual dimorphism. Folia Morphol (Warsz) 2013; 72:72-7. [PMID: 23749715 DOI: 10.5603/fm.2013.0012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Revised: 11/12/2012] [Accepted: 11/12/2012] [Indexed: 11/25/2022]
Abstract
The linea aspera is a roughened, longitudinally-oriented irregular crest composed of two lips located on the posterior surface of the femoral shaft. The purpose of this research was to investigate the morphological variations of the linea aspera in humans. The study was carried out on 90 femurs. Osteometric measurements of the bones were taken using two complementary methods: classical osteometry and a new one based on the analysis of digital photographic documentation of the femur using MultiScanBase v.18.03 software. The analysis allowed four types of the linea aspera to be determined: parallel (type I - 27.2%), concave (type II - 25.7%), convex (type III - 5.7%) and variform (type IV - 41.4%). The frequency of the each type in female and male was also described. Better knowledge of the anatomical variations of the linea aspera may be helpful in Orthopaedy and Radiology to distinguish pathological from normal anatomical variations.
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Affiliation(s)
- Michał Polguj
- Department of Angiology, Medical University of Łódź, Poland.
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Grzelak P, Augsburg Ł, Majos A, Stefańczyk L, Górski P, Piotrowski W, Antczak A. Diagnostic Potential of Contrast-Enhanced Ultrasound (CEUS) In the Assessment of Spleen and Liver Granulomas in the Course of Sarcoidosis. Adv Respir Med 2013. [DOI: 10.5603/arm.35517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Introduction: The aim of this study was to analyze the diagnostic potential of contrast enhanced ultrasound (CEUS) for the recognition of focal lesions of the spleen and liver in patients suffering from sarcoidosis. Material and methods: We analyzed the outcome of diagnostic imaging in a group of 21 patients treated for pulmonary sarcoidosis, searching for the systemic infiltration of the liver and/or spleen. All the participants are patients with inactive disease, who are monitored every 6 months at the Pulmonology Clinic. Apart from the check-up high-resolution computed tomography (HR-CT)—every 2 years, patients underwent an initial ultrasound examination (US) and if there was a suspicion of systemic infiltration, abdominal CT and/or magnetic resonance imaging (MRI) and CEUS were performed. Results: In 18 patients suffering from pulmonary sarcoidosis diagnostic imaging revealed no systemic infiltration. In three patients, the use of CEUS exposed the presence of lesions in the parenchymal organs. In all cases, the images from CEUS were consistent with those from CT/MRI. Conclusions: CEUS has the potential to become a reliable and safe screening tool for systemic infiltration in patients with sarcoidosis. It may also be an important method of monitoring the effects of therapy.
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Polguj M, Sibiński M, Grzegorzewski A, Grzelak P, Majos A, Topol M. Variation in morphology of suprascapular notch as a factor of suprascapular nerve entrapment. Int Orthop 2013; 37:2185-92. [PMID: 23892466 PMCID: PMC3824898 DOI: 10.1007/s00264-013-2005-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Accepted: 06/23/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE The shape and size of the suprascapular notch (SSN) is one of the most important risk factors in suprascapular nerve entrapment. The aim of the study was to perform a morphological study of SSN variations. METHODS A total of 616 computer tomography scans of scapulae were retrospectively analysed in 308 patients. The examination focused on the suprascapular region. The type of suprascapular notch was determined by using a classification based on three geometrical measurements: maximal depth (MD), superior (STD) and middle (MTD) transverse diameters. RESULTS In the scans, five types of SSN were noted. In type I (24.18%) maximal depth was greater than superior transverse diameter. Type II (1.95%) has equal MD, STD and MTD. In type III (56.16%) the superior transverse diameter was greater than the maximal depth. Scapulae with bony foramen were classified as type IV (4.72%). In type V a discrete notch (12.99 %) was found. Additionally, types I and III were divided into three subtypes: A, B and C. The frequency of type I and IV was lower in females than in males, but type III was more common in females than males. Distribution of other types of SSN in both groups was similar. CONCLUSION Knowledge of the anatomical variations of the suprascapular notch described in this study should be helpful in endoscopic and open procedures of the suprascapular region and also may increase the safety of operative decompression of the suprascapular nerve.
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Affiliation(s)
- Michał Polguj
- Department of Angiology, Medical University of Łódź, Narutowicza 60, 90-136, Łódź, Poland,
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Wilmanska D, Antosik-Biernacka A, Przewratil P, Szubert W, Stefanczyk L, Majos A. The role of MRI in diagnostic algorithm of cervicofacial vascular anomalies in children. Pol J Radiol 2013; 78:7-14. [PMID: 23807878 PMCID: PMC3693840 DOI: 10.12659/pjr.883941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 01/28/2013] [Indexed: 11/30/2022] Open
Abstract
Background: Vascular anomalies are usually diagnosed through their clinical picture and history. The purpose of this study was to assess the role of MR imaging in initial assessment of cervicofacial vascular anomalies in children. Material/Methods: Twenty pediatric patients with vascular anomalies located in the cervicofacial region underwent MRI examination in our department. Images were evaluated for lesion detectability and its signal characteristics (on T1w, T2w images with fat suppression and contrast enhanced T1w sequences); the extent of the lesions and surrounding tissue involvement were also assessed. Results: In the studied group MR images revealed all anomalies and provided information of their anatomic extent and invasion of surrounding anatomic structures. Nine hemangiomas and six venous malformations were found among studied patients. Two children had multiloculated lesions corresponding to lymphatic malformations. One examination visualized a lesion consisting mainly of dilated vascular channels with an apparent feeding artery, which was consistent with arteriovenous malformation. Two remaining lesions were mixed malformations. Nine patients had lesions limited to subcutaneous tissue. Two masses infiltrated bone structures. There was muscle involvement found in nine cases. Conclusions: MR imaging is a well-established method for detection and monitoring of vascular anomalies in children. With ultrasound used mostly for initial diagnosis and additional flow assessment, angiography viewed as an invasive therapeutic method and computed tomography used only in specific situations due to its high irradiation dose, magnetic resonance is the best imaging method used in differential diagnosis and topographical characterization of vascular malformations and tumors of cervicofacial area in pediatric patients. Noninvasively and without irradiation, it enables evaluation of the extent and characteristics of lesions and planning proper therapeutic strategy.
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Affiliation(s)
- Dagmara Wilmanska
- Department of Radiology and Imaging Diagnostics, Medical University of Łódź, Łódź, Poland
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Lipiec P, Płońska-Gościniak E, Kuśmierek J, Płachcińska A, Stefańczyk L, Majos A, Peruga JZ, Szymański P, Kępka C, Kasprzak JD. [Safety of non-invasive cardiovascular imaging techniques. Expert consensus statement of the Polish Clinical Forum for Cardiovascular Imaging]. Kardiol Pol 2013; 71:301-7. [PMID: 23575791 DOI: 10.5603/kp.2013.0048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Indexed: 11/25/2022]
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Polguj M, Podgórski M, Jędrzejewski K, Topol M, Majos A. Fenestration and duplication of the vertebral artery: the anatomical and clinical points of view. Clin Anat 2013; 26:933-43. [PMID: 23553773 DOI: 10.1002/ca.22231] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 12/20/2012] [Accepted: 01/17/2013] [Indexed: 11/07/2022]
Abstract
The vertebral artery (VA) acts as a foundation for the posterior circulation of the head and neck. It presents a number of anomalies that can be easily visualized thanks to modern imaging techniques, such as MR and CT angiography or color Doppler ulrasonography. Determining the appropriate terminology for those anomalies can be sometimes more challenging than their recognition. One particular challenge concerns the differentiation between VA fenestration and duplication. Because of the different clinical prognoses associated with those anomalies, confusion should be avoided. Knowledge of the morphological anomalies associated with the VA is important for both radiologists and head and neck surgeons, because any injury to the VA can result in a threat to the vascular supply of the brain stem, the cerebral or cerebellar hemispheres, the thalamus, cervical nerve roots and particularly the lateral medulla (Wallenberg's syndrome). This article analyses world literature concerning the issue of VA fenestration and duplication to facilitate a differential diagnosis.
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Affiliation(s)
- Michał Polguj
- Department of Angiology, Chair of Anatomy, Medical University of Łódź, 90-136, Łódź, Narutowicza 60, Poland
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Wieczorek-Pastusiak J, Kociński M, Raźniewski M, Strzelecki M, Stefańczyk L, Majos A. An attempt toward objective assessment of brain tumor vascularization using susceptibility weighted imaging and dedicated computer program - a preliminary study. Pol J Radiol 2013; 78:50-6. [PMID: 23493465 PMCID: PMC3596145 DOI: 10.12659/pjr.883767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 01/02/2013] [Indexed: 01/14/2023] Open
Abstract
Background: Susceptibility weighted imaging (SWI) is a novel MRI sequence which demonstrates the susceptibility differences between adjacent tissues and it is promising to be a sequence useful in the assessment of brain tumors vascularity. The aim of our study was to demonstrate usefulness of SWI in evaluation of intratumoral vessels in comparison to CET1 sequence in a standardized, objective manner. Material/Methods: 10 patients with supratentorial brain tumors were included in the study. All of them underwent conventional MRI examination with a 1,5 T scanner. SWI sequence was additionally performed using the following parameters: TR 49 ms,TE 40 ms. We used authors’ personal computer software – Vessels View, to assess the vessels number. Results: Comparison of SWI and CET1 sequences was performed using our program. Analysis of all 26 ROIs demonstrated predominance of SWI in the amount of white pixels (vessel cross-sectional) and a similar number of elongated structures (blood vessels). Conclusions: To conclude, the results of this study are encouraging; they confirm the added value of SWI as an appropriate and useful sequence in the process of evaluation of intratumoral vascularity. Using our program significantly improved visualization of blood vessels in cerebral tumors. The Vessel View application assists radiologists in demonstrating the vessels and facilitates distinguishing them from adjacent tissues in the image.
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Affiliation(s)
- Julia Wieczorek-Pastusiak
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Barlicki University Hospital No. 1, Łódź, Poland
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