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Huhndorf M, Peters S, Cordt J, Margraf NG, Salehi Ravesh M, Jansen O, Synowitz M, Cohrs G. Venous 3D Phase Contrast Magnetic Resonance Angiography Increases Diagnostic Certainty in Children with Ventriculoperitoneal Shunt and Suspected Shunt Failure. Clin Neuroradiol 2023; 33:1067-1074. [PMID: 37395788 PMCID: PMC10654158 DOI: 10.1007/s00062-023-01310-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/16/2023] [Indexed: 07/04/2023]
Abstract
BACKGROUND Clinical symptoms in children with suspected malfunction of ventriculoperitoneal shunt may not be specific and difficult to interpret. The presence or absence of ventricular enlargement on magnetic resonance imaging (MRI) does not reliably predict raised intracranial pressure (ICP) in these patients. Therefore, the aim was to investigate the diagnostic utility of 3D venous phase-contrast MR angiography (vPCA) in these patients. MATERIALS The MR studies of two groups of patients at two different examination dates were retrospectively analyzed; one group without clinical symptoms on both examinations and one with symptoms of shunt dysfunction on one examination receiving surgery. Both MRI examinations had to have been performed including axial T2 weighted (T2-w) images and 3D vPCA. Two (neuro)radiologists evaluated T2-w images alone and in combination with 3D vPCA in terms of suspected elevated ICP. Interrater reliability, sensitivity and specificity were assessed. RESULTS Compression of venous sinuses was seen significantly more often in patients with shunt failure (p = 0.00003). Consequently, evaluation of 3D vPCA and T2-w images increases sensitivity to 0.92/1.0 compared to T2-w images alone with 0.69/0.77, the interrater agreement for the diagnosis of shunt failure rises from κ = 0.71 to κ = 0.837. Concerning imaging markers, three groups could be identified in children with shunt failure. CONCLUSION In accordance with the literature, the results show that ventricular morphology alone is an unreliable marker for elevated ICP in children with shunt malfunction. The findings confirmed 3D vPCA as a valuable supplemental diagnostic tool improving diagnostic certainty for children with unchanged ventricular size in cases of shunt failure.
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Affiliation(s)
- M Huhndorf
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany.
| | - S Peters
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - J Cordt
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - N G Margraf
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M Salehi Ravesh
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - O Jansen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M Synowitz
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - G Cohrs
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
- Pediatric Neurosurgery, Campus Virchow Klinikum, Charité Universitätsmedizin Berlin, Berlin, Germany
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Ravesh MS, Langguth P, Moritz JD, Rinne K, Harneit PL, Schulze-Nagel J, Graessner J, Uebing A, Jansen O, Both M, Hansen JH. Fontan-Associated Liver Disease: Quantification and Visualization of Abdominal Hemodynamics by 4D Flow MRI. Thorac Cardiovasc Surg 2023. [DOI: 10.1055/s-0043-1761859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- M. Salehi Ravesh
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - P. Langguth
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - J. D. Moritz
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - K. Rinne
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - P. L. Harneit
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - J. Schulze-Nagel
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | | | - A. Uebing
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - O. Jansen
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - M. Both
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
| | - J. H. Hansen
- University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Deutschland
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Langguth P, Aludin S, Horr A, Campbell GM, Lebenatus A, Salehi Ravesh M, Schunk D, Austein F, Larsen N, Syrek H, Both M, Jansen O, Sedaghat S. Iodine uptake of adrenal glands: A novel and reliable spectral dual-layer computed tomographic-derived biomarker for acute septic shock. Eur J Radiol 2022; 156:110492. [PMID: 36108480 DOI: 10.1016/j.ejrad.2022.110492] [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: 06/03/2022] [Revised: 08/09/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Septic shock is a potentially fatal condition. This study aims to assess whether iodine uptake and iodine density of abdominal organs on dual-layer spectral detector computed tomography (SDCT) could serve as a new imaging biomarker for patients in septic shock. METHODS Here, 95 patients who received contrast-enhanced abdominal CT examinations were included and separated into two groups: group A - septic shock; group B - no shock condition. Preselected abdominal (right and left adrenal gland, right and left kidney, infrarenal inferior vena cava (IVC), pancreas, spleen, and liver) localizations were independently evaluated by two radiologists, who measured iodine concentrations (mg/ml) and Hounsfield units (HU). RESULTS In all, 1520 measurements of iodine concentrations in mg/ml and HU were performed, with 27 patients in group A and 68 in group B. Iodine concentrations in mg/ml and HU correlated significantly in all organs measured. The corresponding correlation coefficient (r) ranged from 0.809 (pancreas) to 0.963 (right kidney). Inter-rater reliability (IRR) was very good for mg/ml (κ = 0.8; p < 0.01) and good for HU (κ = 0.773; p < 0.01) measurements. The mean iodine concentration and HU of the adrenal glands in septic and nonseptic patients was 4.88 ± 1.16 mg/ml/153 ± 36 HU and 2.67 ± 1.07 mg/ml/112 ± 41 HU, respectively. Iodine concentrations in the adrenal glands were significantly higher in group A than in group B patients (p < 0.01). The other organs remained unaffected and no significant difference was observed between patients in group A and B. Patients in group A presented significantly more often with an iodine uptake of >3.5 mg/ml of one adrenal gland (sensitivity = 0.926, specificity = 0.849, AUC = 0.951) or/and a combined concentration of >7 mg/ml of both adrenal glands (sensitivity = 0.889, specificity = 0.836, AUC = 0.928). CONCLUSION SDCT-derived iodine concentration of the adrenal glands could serve as a novel imaging biomarker for patients in acute septic shock. Our data suggest that an iodine uptake of >3.5 mg/ml of at least one adrenal gland or a combined iodine uptake of >7 mg/ml in both adrenal glands identifies patients in this condition.
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Affiliation(s)
- P Langguth
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
| | - S Aludin
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - A Horr
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | | | - A Lebenatus
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - M Salehi Ravesh
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - D Schunk
- Department for Interdisciplinary Emergency, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - F Austein
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Larsen
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - H Syrek
- Mediri GmbH, Heidelberg, Germany
| | - M Both
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - O Jansen
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - S Sedaghat
- Department for Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany; Department of Radiology, University of California San Diego, San Diego, CA, United States
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Jensen-Kondering U, Larsen N, Huhndorf M, Jansen O, Lüddecke R, Stürner K, Ravesh MS. Central vein sign in patients with inflammatory lesion of the upper cervical spinal cord on susceptibility weighted imaging at 3 tesla. Preliminary results. Magn Reson Imaging 2022; 93:11-14. [PMID: 35914655 DOI: 10.1016/j.mri.2022.07.013] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/23/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND A central vein sign (CVS) has been described in vivo in patients with MS but also in other inflammatory lesion of the brain such as neuromyelits optica spectrum disease and others. Recently, it has been used to differentiate patients with MS from other inflammatory lesions of the brain. OBJECTIVE It was the goal of this study to demonstrate the feasibility of the depiction of the CVS in patients with inflammatory lesion of the upper cervical spinal cord using susceptibility weighted imaging (SWI). METHODS Consecutive patients with inflammatory lesions of the upper cervical spinal cord were included. Patients were scanned using a 3 T Philips Ingenia CX. The presence of the CVS was assessed by two raters. Demographic and clinical parameters were compared between patients with and those without a CVS. RESULTS 20 patients could be included. 15 patients had a diagnosis of MS. A CVS was present in 8 patients (40%). Agreement between the two raters was substantial (κ = 0.79). Time from first manifestation was significantly different (14 vs. 2 years, p = 0.021) between patients with CVS and without CVS. CONCLUSION The depiction of the CVS in the upper cervical spine is feasible. More research is necessary to evaluate these preliminary results and the value of the CVS in the spinal cord.
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Affiliation(s)
- U Jensen-Kondering
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Department of Neuroradiology, University Hospital Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
| | - N Larsen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M Huhndorf
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - O Jansen
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - R Lüddecke
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - K Stürner
- Department of Neurology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - M Salehi Ravesh
- Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
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Peters S, Huhndorf M, Jensen-Kondering U, Larsen N, Koktzoglou I, Edelman RR, Graessner J, Both M, Jansen O, Salehi Ravesh M. Non-Contrast-Enhanced Carotid MRA: Clinical Evaluation of a Novel Ungated Radial Quiescent-Interval Slice-Selective MRA at 1.5T. AJNR Am J Neuroradiol 2019; 40:1529-1537. [PMID: 31395666 DOI: 10.3174/ajnr.a6171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 07/04/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Non-contrast-enhanced MRA techniques have experienced a renaissance due to the known correlation between the use of gadolinium-based contrast agents and the development of nephrogenic systemic fibrosis and the deposition of gadolinium in some brain regions. The purpose of this study was to assess the diagnostic performance of ungated non-contrast-enhanced radial quiescent-interval slice-selective MRA of the extracranial supra-aortic arteries in comparison with conventional contrast-enhanced MRA in patients with clinical suspicion of carotid stenosis. MATERIALS AND METHODS In this prospective study, both MRA pulse sequences were performed in 31 consecutive patients (median age, 68.8 years; 19 men). For the evaluation, the cervical arterial system was divided into 35 segments (right and left side). Three blinded reviewers separately evaluated these segments. An ordinal scoring system was used to assess the image quality of arterial segments and the stenosis grading of carotid arteries. RESULTS Overall venous contamination in quiescent-interval slice-selective MRA was rated as "none" by all readers in 84.9% of cases and in 8.1% of cases in contrast-enhanced MRA (P < .0001). The visualization quality of arterial segments was considered good to excellent in 40.2% for the quiescent-interval slice-selective MRA and in 52.2% for the contrast-enhanced MRA (P < .0001). The diagnostic accuracy of ungated quiescent-interval slice-selective MRA concerning the stenosis grading showed a total sensitivity and specificity of 85.7% and 90.0%, respectively. CONCLUSIONS Ungated quiescent-interval slice-selective MRA can be used clinically as an alternative to contrast-enhanced MRA without a significantly different image quality or diagnostic accuracy for the detection of carotid stenosis at 1.5T.
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Affiliation(s)
- S Peters
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - M Huhndorf
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - U Jensen-Kondering
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - N Larsen
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - I Koktzoglou
- Department of Radiology (I.K., R.R.E.), NorthShore University Health System, Evanston, Illinois.,University of Chicago Pritzker School of Medicine (I.K.), Chicago, Illinois
| | - R R Edelman
- Department of Radiology (I.K., R.R.E.), NorthShore University Health System, Evanston, Illinois.,Northwestern University Feinberg School of Medicine (R.R.E.), Chicago, Illinois
| | | | - M Both
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - O Jansen
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - M Salehi Ravesh
- From the Department of Radiology and Neuroradiology (S.P., M.H., U.J.-K., N.L., M.B., O.J., M.S.R.), University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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Bönner F, Merx M, Klingel K, Begovatz P, Flögel U, Sager M, Temme S, Jacoby C, Salehi Ravesh M, Grapentin C, Schubert R, Bunke J, Roden M, Kelm M, Schrader J. Monocyte imaging after myocardial infarction with 19F MRI at 3 T: a pilot study in explanted porcine hearts. ACTA ACUST UNITED AC 2015; 16:612-20. [DOI: 10.1093/ehjci/jev008] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Accepted: 01/12/2015] [Indexed: 12/23/2022]
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Salehi Ravesh M, Brix G, Laun FB, Kuder TA, Puderbach M, Ley-Zaporozhan J, Ley S, Fieselmann A, Herrmann MF, Schranz W, Semmler W, Risse F. Quantification of pulmonary microcirculation by dynamic contrast-enhanced magnetic resonance imaging: Comparison of four regularization methods. Magn Reson Med 2012; 69:188-99. [DOI: 10.1002/mrm.24220] [Citation(s) in RCA: 8] [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: 10/05/2011] [Revised: 12/23/2011] [Accepted: 01/27/2012] [Indexed: 11/11/2022]
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