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Moher Alsady T, Voskrebenzev A, Behrendt L, Olsson K, Heußel CP, Gruenig E, Gall H, Ghofrani A, Roller F, Harth S, Marshall H, Hughes PJC, Wild J, Swift AJ, Kiely DG, Behr J, Dinkel J, Beitzke D, Lang IM, Schmidt KH, Kreitner KF, Frauenfelder T, Ulrich S, Hamer OW, Vogel-Claussen J. Multicenter Standardization of Phase-Resolved Functional Lung MRI in Patients With Suspected Chronic Thromboembolic Pulmonary Hypertension. J Magn Reson Imaging 2024; 59:1953-1964. [PMID: 37732541 DOI: 10.1002/jmri.28995] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/19/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Detection of pulmonary perfusion defects is the recommended approach for diagnosing chronic thromboembolic pulmonary hypertension (CTEPH). This is currently achieved in a clinical setting using scintigraphy. Phase-resolved functional lung (PREFUL) magnetic resonance imaging (MRI) is an alternative technique for evaluating regional ventilation and perfusion without the use of ionizing radiation or contrast media. PURPOSE To assess the feasibility and image quality of PREFUL-MRI in a multicenter setting in suspected CTEPH. STUDY TYPE This is a prospective cohort sub-study. POPULATION Forty-five patients (64 ± 16 years old) with suspected CTEPH from nine study centers. FIELD STRENGTH/SEQUENCE 1.5 T and 3 T/2D spoiled gradient echo/bSSFP/T2 HASTE/3D MR angiography (TWIST). ASSESSMENT Lung signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were compared between study centers with different MRI machines. The contrast between normally and poorly perfused lung areas was examined on PREFUL images. The perfusion defect percentage calculated using PREFUL-MRI (QDPPREFUL) was compared to QDP from the established dynamic contrast-enhanced MRI technique (QDPDCE). Furthermore, QDPPREFUL was compared between a patient subgroup with confirmed CTEPH or chronic thromboembolic disease (CTED) to other clinical subgroups. STATISTICAL TESTS t-Test, one-way analysis of variance (ANOVA), Pearson's correlation. Significance level was 5%. RESULTS Significant differences in lung SNR and CNR were present between study centers. However, PREFUL perfusion images showed a significant contrast between normally and poorly perfused lung areas (mean delta of normalized perfusion -4.2% SD 3.3) with no differences between study sites (ANOVA: P = 0.065). QDPPREFUL was significantly correlated with QDPDCE (r = 0.66), and was significantly higher in 18 patients with confirmed CTEPH or CTED (57.9 ± 12.2%) compared to subgroups with other causes of PH or with excluded PH (in total 27 patients with mean ± SD QDPPREFUL = 33.9 ± 17.2%). DATA CONCLUSION PREFUL-MRI could be considered as a non-invasive method for imaging regional lung perfusion in multicenter studies. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 1.
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Affiliation(s)
- Tawfik Moher Alsady
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hannover, Germany
| | - Andreas Voskrebenzev
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hannover, Germany
| | - Lea Behrendt
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hannover, Germany
| | - Karen Olsson
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hannover, Germany
- Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany
| | | | - Ekkehard Gruenig
- Thoraxklinik, University Hospital of Heidelberg, Heidelberg, Germany
| | - Henning Gall
- Department of Internal Medicine, University Hospital Giessen, Giessen, Germany
| | - Ardeschir Ghofrani
- Department of Internal Medicine, University Hospital Giessen, Giessen, Germany
| | - Fritz Roller
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Giessen, Germany
| | - Sebastian Harth
- Department of Diagnostic and Interventional Radiology, University Hospital Giessen, Giessen, Germany
| | - Helen Marshall
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Paul J C Hughes
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Jim Wild
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - Andrew J Swift
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| | - David G Kiely
- Sheffield Pulmonary Vascular Disease Unit, NIHR Biomedical Research Centre Sheffield, Sheffield, UK
| | - Jürgen Behr
- Department of Medicine V, University Hospital of Munich, Munich, Germany
| | - Julien Dinkel
- Department of Radiology, University Hospital of Munich, Munich, Germany
| | - Dietrich Beitzke
- Department of Biomedical Engineering and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Irene M Lang
- Internal Medicine II, AKH-Vienna, Medical University of Vienna, Vienna, Austria
| | - Kai Helge Schmidt
- Cardiology I, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Karl Friedrich Kreitner
- Department of Diagnostic and Interventional Radiology, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Thomas Frauenfelder
- Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Silvia Ulrich
- Department of Pulmonology, University Hospital Zurich, Zurich, Switzerland
| | - Okka W Hamer
- Institute for Radiology, University Hospital Regensburg, Regensburg, Germany
| | - Jens Vogel-Claussen
- Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany
- Biomedical Research in End-Stage and Obstructive Lung Disease (BREATH), German Center for Lung Research, Hannover, Germany
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Mavromanoli AC, Valerio L, Bunck AC, Kreitner KF, Ley S, Gertz RJ, Rosenkranz S, Konstantinides SV, Barco S. Signs of chronic thromboembolic pulmonary hypertension in acute pulmonary embolism: results from the FOCUS study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1901] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Chronic thromboembolic pulmonary hypertension (CTEPH) is considered to be a late complication of acute pulmonary embolism (PE). However, up to one third of CTEPH patients do not report prior symptomatic venous thromboembolism (VTE). Furthermore, a substantial proportion of patients presenting with an acute PE event may exhibit radiological signs of chronicity at baseline computed tomography pulmonary angiography (CTPA).
Purpose
To determine the prevalence of baseline radiological parameters indicating chronic thrombosis or pulmonary hypertension, and ultimately pre-existing CTEPH, among patients with acute PE enrolled in the prospective multicentre Follow-Up after Acute Pulmonary Embolism (FOCUS) cohort study.
Methods
Patients with acute symptomatic PE and absence of a known history of CTEPH, enrolled at two large FOCUS centres, were included. The assessment of index CTPA scans was conducted by two independent expert radiologists who were unaware of the clinical characteristics and the follow-up data of the patients. CTPA parameters indicating chronicity were prespecified on the basis of recently proposed criteria in the literature. A third independent expert radiologist provided an assessment in case of disagreement between the first two. Baseline radiological data were prospectively validated with the aid of two-year prospective clinical follow-up data focusing on CTEPH and the post-PE syndrome (co-primary outcomes of the FOCUS study).
Results
A total of 303 patients (median age: 63 years, 44.6% women) were included. In >95% of the patients, the expert radiologists could confirm signs of acute PE at baseline CTPA. Radiological signs of chronic thrombi or pulmonary hypertension at baseline were detected in 46 (15.2%) patients. In 8 patients, the expert radiologists agreed on the presence of pre-existing CTEPH based on their interpretation of the overall radiological pattern. During follow-up, five (1.7%; 95% CI 0.7–3.8%) of 303 patients were diagnosed with CTEPH, over a median time of 95 days after baseline. Four of them were among the 8 patients in whom the radiological experts suspected pre-existing CTEPH at baseline, and among the 46 patients in whom CTPA findings suggesting chronic thrombi or chronic pulmonary hypertension were present at baseline. The use of the predefined individual parameters of chronicity from the literature also helped identifying patients with chronic disease, and could be used as a tool for screening acute PE patients for pre-existing CTEPH.
Conclusion
A substantial proportion of patients who are diagnosed with CTEPH during follow-up after acute PE may already have pre-existing CTEPH at the time of the index event. An intensified follow-up programme and focussed screening for CTEPH should be considered in patients with signs of chronicity at baseline CTPA.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): Bayer Health Care
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Affiliation(s)
- A C Mavromanoli
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University , Mainz , Germany
| | - L Valerio
- Center for Thrombosis and Hemostasis & Department of Cardiology, University Medical Center of the Johannes Gutenberg University , Mainz , Germany
| | - A C Bunck
- Department of Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - K F Kreitner
- Department of Radiology, University Medical Center of the Johannes Gutenberg University , Mainz , Germany
| | - S Ley
- Diagnostic and Interventional Radiology, Artemed Klinikum München Süd , Munich , Germany
| | - R J Gertz
- Department of Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - S Rosenkranz
- Department of Cardiology, Heart Center at the University Hospital Cologne, and Cologne Cardiovascular Research Center , Cologne , Germany
| | - S V Konstantinides
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg University , Mainz , Germany
| | - S Barco
- Department of Angiology, University Hospital Zurich , Zurich , Switzerland
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Kreitner KF, Kuhn S. Muss das CT immer im Schockraum integriert sein? Das Mainzer Modell. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581753] [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: 10/22/2022]
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Wirth G, Schmidt KH, Düber C, Kreitner KF. Erfassung der pulmonalen Hämodynamik mittels hochaufgelöster Phasenkontrast-MRT (PC-MRT): ermöglicht die Methode die Erkennung Lungengesunder? ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372884] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Wirth G, Brüggemann K, Bostel T, Mayer E, Düber C, Kreitner KF. Chronic thromboembolic pulmonary hypertension (CTEPH) - potential role of multidetector-row CT (MD-CT) and MR imaging in the diagnosis and differential diagnosis of the disease. ROFO-FORTSCHR RONTG 2014; 186:751-61. [PMID: 24756429 DOI: 10.1055/s-0034-1366425] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) can be defined as pulmonary hypertension (resting mean pulmonary arterial pressure of 25 mm Hg or more determined at right heart catheterization) with persistent pulmonary perfusion defects. It is a rare, but underdiagnosed disease with estimated incidences ranging from 0.5% to 3.8% of patients after an acute pulmonary embolism (PE), and in up to 10% of those with a history of recurrent PE. CTEPH is the only form of pulmonary hypertension that can be surgically treated leading to normalization of pulmonary hemodynamics and exercise capacity in the vast majority of patients. The challenges for imaging in patients with suspected CTEPH are fourfold: the imaging modality should have a high diagnostic accuracy with regard to the presence of CTEPH and allow for differential diagnosis. It should enable detection of patients suitable for PEA with great certainty, and allow for quantification of PH by measuring pulmonary hemodynamics (mPAP and PVR), and finally, it can be used for therapy monitoring. This overview tries to elucidate the potential role of ECG-gated multidetector CT pulmonary angiography (MD-CTPA) and MR imaging, and summarizes the most important results that have been achieved so far. Generally speaking, ECG-gated MD-CTPA is superior to MR in the assessment of parenchymal and vascular pathologies of the lung, and allows for the assessment of cardiac structures. The implementation of iodine maps as a surrogate for lung perfusion enables functional assessment of lung perfusion by CT. MR imaging is the reference standard for the assessment of right heart function and lung perfusion, the latter delineating typical wedge-shaped perfusion defects in patients with CTEPH. New developments show that with MR techniques, an estimation of hemodynamic parameters like mean pulmonary arterial pressure and pulmonary vascular resistance will be possible. CT and MR imaging should be considered as complementary investigations providing comprehensive information in patients with CTEPH.
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Affiliation(s)
- G Wirth
- Department of Radiology, Universitätsmedizin Mainz
| | - K Brüggemann
- Department of Radiology, Universitätsmedizin Mainz
| | - T Bostel
- Department of Radiology, Universitätsmedizin Mainz
| | - E Mayer
- Department of Thoracic Surgery, Kerckhoff Hospital, Bad Nauheim
| | - C Düber
- Department of Radiology, Universitätsmedizin Mainz
| | - K F Kreitner
- Department of Radiology, Universitätsmedizin Mainz
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Kreitner KF. Update MR- und CT-Arthrografie der Schulter. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373283] [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: 10/25/2022]
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Emrich T, Emrich K, Abegunewardene N, Oberholzer K, Münzel T, Düber C, Kreitner KF. Diagnostischer Wert der kardialen Magnetresonanztomografie bei Patienten mit akuten Brustschmerzen, erhöhten kardialen Enzymen und negativer Koronarangiografie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372882] [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: 10/25/2022]
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Maehringer-Kunz A, Kloeckner R, Mueller-Haberstock S, Dueber C, Kreitner KF. Benefit ergänzender ABER-Serien bei der direkten 3T MR-Schulterarthrografie. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373291] [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: 10/25/2022]
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Jungmann F, Czerniak J, Emrich T, Lena Poetini A, Mildenberger P, Düber C, Kreitner KF. Strahlenexposition und Bildqualität bei der aortokoronaren Bypassdiagnostik in der Mehrschicht-Computertomografie: Vergleich zwischen iterativer Rekonstruktionstechnik und gefilterter Rückprojektion. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372927] [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: 10/25/2022]
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Kreitner KF. Vorhöfe, Kammern und Klappen. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346134] [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: 10/26/2022]
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Kreitner KF. Sportverletzungen an der Schulter. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346142] [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: 10/26/2022]
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Kreitner KF. Thoraxtrauma. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345919] [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: 10/26/2022]
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Kneist W, Drescher DG, Hansen T, Kreitner KF, Lang H. [Surgical therapy of segmental jejunal, primary intestinal lymphangiectasia]. Z Gastroenterol 2012; 51:576-9. [PMID: 23229460 DOI: 10.1055/s-0031-1273473] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Primary intestinal lymphangiectasia (PIL) is a protein-losing, exsudative gastroenteropathy causing lymphatic obstruction. Diagnosis depends on clinical examination and histological findings. Conservative treatment modalities include a low-fat diet and enteral nutritional therapy in order to reduce enteric protein loss and to improve fat metabolism. Other treatment options consist of administration of antiplasmin or octreotide to lower lymph flow and secretion. We report on a 58-year-old patient who underwent exploratory laparotomy due to a worsening physical status, recurrent chylaskos and leg oedema under conservative dietary therapy. Intraoperative findings showed a typical PIL of the jejunum about 20 cm distal to the Treitz's ligament. Histological examinations confirmed this diagnosis. One year after segmental small bowel resection (105 cm) with end-to-end anastomosis the patient is healthy, free of symptoms, has gained weight and his serum protein level has increased. Intraabdominal ascites and leg oedema have not reoccurred since.
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Affiliation(s)
- W Kneist
- Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsmedizin der Johannes-Gutenberg-Universität, Mainz
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Weber S, Kreitner KF, Düber C, Schreiber LM. Quantitative Bestimmung der Myokardialen Perfusion mittels dynamischer, kontrastmittelverstärkter MRT bei 3,0T. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1329786] [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: 10/27/2022]
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Wolf U, Bojadzic N, Hoffmann C, Terekhov MV, Korn S, Ley S, Schreiber LM, Kreitner KF, Buhl R, Düber C. Charakterisierung der Atemdynamik bei Asthma und COPD mittels H1-MRT und Lungenfunktionsdiagnostik: erste Ergebnisse. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311255] [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: 10/28/2022]
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Davulcu I, Weber S, Kreitner KF, Düber C, Schreiber LM. Quantitative MR-Perfusionsbildgebung am Herzen: Vergleich von SR-TurboFLASH und SR-TrueFISP bei 1,5T und 3,0T. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1311066] [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: 10/28/2022]
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Kreitner KF. Falldiskussion - TED. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1278940] [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: 10/18/2022]
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Kreitner KF. Wann MRT? Wann CT. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1278868] [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: 10/18/2022]
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Wirth GM, Weber S, Schneider J, Pitton MB, Mayer E, Düber C, Kreitner KF. Erfassung der pulmonalen Hämodynamik bei Patienten mit chronisch thromboembolischer pulmonaler Hypertonie (CTEPH) mittels hochaufgelöster Phasenkontrastmessungen. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279138] [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: 10/18/2022]
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Bell A, Pinto dos Santos D, Emrich T, Kreitner KF, Dueber C, Mildenberger P. Einfluss der Herzfrequenz auf die Beurteilbarkeit der Aorta bei CT-Angiographien mit prospektiv getriggerter Datenakquisition. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279401] [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: 10/18/2022]
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Hartert M, Senbaklavaci Ö, Kreitner KF, Vahl CF. From partial anomalous pulmonary venous drainage to chronic thromboembolic pulmonary hypertension: successful surgical correction of a 14 year misinterpreted clinical feature. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1269277] [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: 10/18/2022]
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Schotten S, Conzelmann L, Kreitner KF, Düber C, Vahl CF, Oberholzer K. Assessment of subtle dissection of the ascending aorta by ECG-gated MD-CT - correlation with intraoperative findings and histopathology. Thorac Cardiovasc Surg 2011. [DOI: 10.1055/s-0030-1268929] [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: 10/18/2022]
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Weber S, Röhrl B, Espinola-Klein C, Kreitner KF, Schreiber LM. Quantitative Magnetresonanz-Perfusionsbildgebung zur Erfassung der Mikrozirkulation der Fußmuskulatur in Patienten mit Diabetischen Fußsyndrom (DFS). ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1268312] [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: 10/18/2022]
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Pedrosa DJ, Cleppien D, Karpi A, Borgulya M, Hadzijusufoviç E, Jansen H, Abegunewardene N, Vosseler M, Kreitner KF, Kempski O, Schreiber LM, Horstick G. Lokale Autologe Transplantation Endothelialer-Progenitor-Zellen (EPC-Tx) in Chronisch-Ischämisches Myokard steigert Kontraktilität in Nicht-ischämischen Arealen: Verhinderung des Negativen Remodeling. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253025] [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: 10/19/2022]
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Kreitner KF. Myokarditis. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252342] [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: 10/19/2022]
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Deubel J, Sittner C, Oberholzer K, Abegunewardene N, Düber C, Kreitner KF. Langzeit-Verlauf von Patienten mit Verdacht auf akute Myokarditis: Ergebnisse einer Kardio-MRT-Studie. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252903] [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: 10/19/2022]
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Bostel T, Stork K, Schneider J, Pitton MB, Mayer E, Düber C, Kreitner KF. Die EKG-getriggerte 128-Schicht-CT bei der Abklärung von Patienten mit chronisch-thrombembolischer pulmonaler Hypertonie (CTEPH): Erste Erfahrungen. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252635] [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: 10/19/2022]
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Pedrosa DJ, Cleppien D, Karpi A, Borgulya M, Hadzijusufoviç W, Jansen H, Abegunewardene N, Vosseler M, Kreitner KF, Kempski O, Schreiber LM, Horstick G. Autologe intramyokardiale Transplantation Endothelialer Progenitorzellen (EPC-Tx) in chronisch-ischämische, insuffiziente Herzen verhindert die Abnahme der Herzleistung und hemmt die Fibroseentstehung. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253024] [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: 10/19/2022]
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Kreitner KF. Impingement-Syndrom am Schultergelenk. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252504] [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: 10/19/2022]
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Peivandi AA, Kreitner KF, Kayhan N, Abugameh A, Karliova I, Denk K, Düber C, Vahl CF. Evaluation of beating-heart minimally invasive coronary procedure with intraoperative flow measurement and postoperative multislice computed tomography. Thorac Cardiovasc Surg 2010. [DOI: 10.1055/s-0029-1246761] [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: 10/19/2022]
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Weber S, Röhrl B, Espinola-Klein C, Schreiber LM, Kreitner KF. Perfusion Imaging in the Soft Tissues in Patients with Diabetic Foot Syndrome (DFS) – Preliminary Results. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0029-1246603] [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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Abstract
AIM: To compare the diagnostic capability of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC) tumour nodules and their effect on patient management.
METHODS: A total of 28 patients (25 male, 3 female, mean age 67 ± 10.8 years) with biopsy-proven HCC were investigated with 64-row MDCT (slice 3 mm native, arterial and portal-venous phase, 120 mL Iomeprol, 4 mL/s, delay by bolus trigger) and MRI (T1fs fl2d TE/TR 2.72/129 ms, T2tse TE/TR 102/4000 ms, 5-phase dynamic contrast-enhanced T1fs fl3d TE/TR 1.56/4.6, Gadolinium-DTPA, slice 4 mm). Consensus reading of both modalities was used as reference. Tumour nodules were analyzed with respect to number, size, and location.
RESULTS: In total, 162 tumour nodules were detected by consensus reading. MRI detected significantly more tumour nodules (159 vs 123, P < 0.001) compared to MDCT, with the best sensitivity for early arterial phase MRI. False-negative CT findings included nodules ≤ 5 mm ( n = 5), ≤ 10 mm ( n = 17), ≤ 15 mm ( n = 12 ), ≤ 20 mm ( n = 4 ), and 1 nodule > 20 mm. MRI missed 2 nodules ≤ 10 mm and 1 nodule ≤ 15 mm. On MRI, nodule diameters were greater than on CT (29.2 ± 25.1 mm, range 5-140 mm vs 24.1 ± 22.7 mm, range 4-129 mm, P < 0.005). In 2 patients, MDCT showed only unilobar tumour spread, whereas MRI revealed additional nodules in the contralateral lobe. Detection of these nodules could have changed the therapeutic strategy.
CONCLUSION: Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC nodules. Patients should be allocated to interventional or operative treatment according to a dedicated MRI-protocol.
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Kreitner KF. MRT des Herzens. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221671] [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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Kreitner KF. Myokarditis. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221091] [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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Kreitner KF, Abegunewardene N, Vosseler M, Oberholzer K, Horstick G, Düber C. Mikrovaskuläre Obstruktion nach akutem Herzinfarkt: wann ist der optimale Zeitpunkt zum Nachweis mit der kontrast-verstärkten MRT? ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221515] [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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Wirth GM, Weber S, Kunz RP, Pitton MB, Mayer E, Düber C, Kreitner KF. Hochaufgelöste Phasenkontrastmessungen zur Ermittlung der Druckverhältnisse im kleinen Kreislauf bei Patienten mit CTEPH – Korrelation mit simultan ermittelten, invasiven Druckwerten. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221563] [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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Wirth G, Weber S, Kunz P, Pitton M, Meyer E, Düber C, Kreitner KF. Bestimmung des mittleren pulmonalarteriellen Drucks (mPAP) bei Patienten mit chronisch thromboembolischer pulmonaler Hypertonie (CTEPH) mittels hochaufgelöster Phasenkontrast-MRT. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1208340] [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: 10/21/2022]
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Peivandi AA, Kreitner KF, Kayhan N, Ister D, Mehlhorn U, Düber C, Vahl CF. Is cardio-CT a suitable tool to evaluate bypass patency and to indicate surgical revision after MIDCAB-procedure? Thorac Cardiovasc Surg 2009. [DOI: 10.1055/s-0029-1191515] [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: 10/21/2022]
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Neugebauer E, Kunad N, Wittlich N, Todt M, Kunz RP, Röhrl B, Dueber C, Kreitner KF. Wertigkeit der kardialen MRT in einem ambulanten Patientenkollektiv. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073601] [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: 10/21/2022]
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Kloeckner R, Otto G, Herber S, Kreitner KF, Dueber C, Pitton MB. MRT versus 64-Zeilen MDCT zur Diagnose des hepatozellulären Karzinoms. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073436] [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: 10/21/2022]
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Neeb D, Kunz RP, Ley S, Szábo G, Strauß LG, Kauczor HU, Kreitner KF, Schreiber WG. Vergleich von regionalem pulmonalem Blutfluss in Schweinen bestimmt mittels PET und kontrastmittelverstärkter MRT. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1074022] [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: 10/21/2022]
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Kreitner KF. Direkte MR-Arthrographie. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073412] [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: 10/21/2022]
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Weber S, Kronfeld A, Kunz RP, Horstick G, Kreitner KF, Schreiber WG. Quantitative MR-Perfusionsbildgebung des Herzens unter Verwendung verschiedener paralleler Akquisitionstechniken. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073964] [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: 10/21/2022]
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Kreitner KF. Entzündliche Herzerkrankungen. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073296] [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: 10/21/2022]
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Kreitner KF. Polytrauma. ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073883] [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: 10/21/2022]
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Weber S, Kronfeld A, Kunz RP, Horstick G, Kreitner KF, Schreiber WG. Parallele Akquisitionstechniken und Pulssequenzen in der semiquantitativen und quantitativen myokardialen MR Perfusionsbildgebung. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956220] [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: 10/19/2022]
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Kreitner KF, Vosseler M, Abegunewardene N, Schmidt KH, Hoffmann N, Schreiber WG, Münzel T, Düber C, Horstick G. Differenzierte Analyse der KM-verstärkten MRT in der Frühphase nach experimentell indizierter Ischämie und Reperfusion: erlaubt sie eine Bestimmung des Risikoareals? ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956221] [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: 10/19/2022]
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Kunz RP, Herber S, Achenbach T, Oberholzer K, Horstick G, Mayer E, Düber C, Kreitner KF. Nicht-invasive Abschätzung des pulmonalarteriellen Mitteldrucks bei CTEPH-Patienten mittels Phasenkontrast-Flussmessungen. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956222] [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: 10/19/2022]
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Neeb D, Kunz P, Kreitner KF, Düber C, Schreiber WG. Auswirkungen von Einfaltungen innerhalb eines 3D-Anregungsvolumens bei einer FLASH-Sequenz am Beispiel der absoluten Quantifizierung der Lungenperfusion. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2006-956200] [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: 10/19/2022]
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Kronfeld A, Weber S, Münnemann K, Kreitner KF, Schreiber WG. Simulationsstudie zur Entwicklung einer Kontaminationskorrektur im Rahmen der Bestimmung der myokardialen Perfusion mittels MRT. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977311] [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: 10/21/2022]
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