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Schenker N, van der Schalk H, Bohné M, Hahn J, Waddell D, Moschner A, Alexy H, Willems S, Kivelitz D, Bahlmann E. Hirninfarkt als Erstsymptom – seltene kardiogene Ursache. Med Klin Intensivmed Notfmed 2020; 115:343-347. [DOI: 10.1007/s00063-020-00666-3] [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] [Received: 10/01/2019] [Revised: 01/22/2020] [Accepted: 01/23/2020] [Indexed: 11/24/2022]
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Chmelevsky M, Budanova M, Zubarev S, Potyagaylo D, Sohns C, Lemes C, Kivelitz D, Metzner A, Kuck KH. P6566Noninvasive Panoramic Mapping of Phase Singularities with Signal Complexity Analysis in Patients with Persistent Atrial Fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1156] [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: 11/13/2022] Open
Abstract
Abstract
Background
An assessment of positive outcome probability of ablation therapy based on the comprehensive signal complexity analysis is a promising working hypothesis while electrocardiographic imaging (ECGI) can detect and visualize zones of phase singularities (PS) associated with stable sources of atrial fibrillation (AF).
Methods
Ten consecutive patients with persistent AF (three female, median (min–max) – 63.5 (45–75) years) underwent ECGI using “Amycard 01C EP lab” system with cardiac MRI (1.5-T Magnetom Avanto) followed by pulmonary vein isolation. Each T-Q segment with a length >800 ms during AF was processed to find PS. Sites with rotations around stable pivot points were considered as PS and then marked and visualized on the reconstructed anatomical 3D atrial model. Finally, a signal complexity cluster analysis was performed to define and depict phase-aggregation zones.
Results
ECGI analysis identified a total number of 410 PS, with 196 (47.8%) occurring in the LA and 214 (52.2%) in the RA. The median (25–75% IQR) number of revealed PS per patient was n=20 (14–30) for RA and n=20 (11–22) for the LA. The majority of the PS in the LA was located on the inferior wall n=66 (min-max 1–17). In eight patients, comprehensive signal complexity analysis revealed stability of phase-clustered zones over time. The mean number (min-max) of PS in a clustered area was 10 (6–15). In two patients, PS were distributed disordered on the entire LA and RA surface.
Distribution of phase singularities
Conclusions
This is the first clinical study demonstrating signal complexity analysis capability of clustering noninvasively mapped PS and relating them to specific atrial anatomical regions. Thereby obtained clusters may be a potential zones of conduction block, and could contribute to a better understanding of the temporal AF complexity.
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Affiliation(s)
- M Chmelevsky
- Almazov National Medical Research Center, Saint-Petersburg, Russian Federation
| | - M Budanova
- Almazov National Medical Research Center, Saint-Petersburg, Russian Federation
| | - S Zubarev
- Almazov National Medical Research Center, Saint-Petersburg, Russian Federation
| | - D Potyagaylo
- Karlsruhe Institut of Technology (IBT), Karlsruhe, Germany
| | - C Sohns
- Heart and Diabetes Center NRW, Department of Electrophysiology, Bad Oeynhausen, Germany
| | - C Lemes
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - D Kivelitz
- Asklepios Clinic St. Georg, Department of Radiology, Hamburg, Germany
| | - A Metzner
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
| | - K H Kuck
- Asklepios Clinic St. Georg, Department of Cardiology, Hamburg, Germany
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Bahlmann E, van der Schalk H, Ghanem A, Kuck KH, Kivelitz D, Laßner D, Terborg C. [Brain infarction as initial manifestation of eosinophilic myocarditis]. Nervenarzt 2019; 89:200-203. [PMID: 28246755 DOI: 10.1007/s00115-017-0302-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- E Bahlmann
- Abteilung für Kardiologie, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland.
| | - H van der Schalk
- Abteilung für Kardiologie, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland
| | - A Ghanem
- Abteilung für Kardiologie, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland
| | - K H Kuck
- Abteilung für Kardiologie, Asklepios Klinik St. Georg, Lohmühlenstraße 5, 20099, Hamburg, Deutschland
| | - D Kivelitz
- Abteilung für Radiologie, Asklepios Klinik St. Georg, Lohmühlenstrasse 5, 20099, Hamburg, Deutschland
| | - D Laßner
- Institut Kardiale Diagnostik und Therapie, Moltkestrasse 31, 12203, Berlin, Deutschland
| | - C Terborg
- Abteilung für Neurologie, Asklepios Klinik St. Georg, Lohmühlenstrasse 5, 20099, Hamburg, Deutschland
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Bahlmann E, van der Schalk H, Dreher A, Schmidt-Salzmann M, Kivelitz D, Starekova J, Ghanem A, Kuck KH. Plötzlicher Herztod einer Fitnesstrainerin mit hypertropher Kardiomyopathie vom apikalen Typ assoziiert mit Cor triatriatum sinister. Med Klin Intensivmed Notfmed 2018; 113:426-429. [DOI: 10.1007/s00063-017-0335-4] [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] [Received: 06/24/2017] [Revised: 07/24/2017] [Accepted: 08/25/2017] [Indexed: 11/30/2022]
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Klingebiel R, Zimmer C, Rogalla P, Kivelitz D, Bohner G, Götze R, Lehmann R. Assessment of the arteriovenous cerebrovascular system by multi-slice CT: A single-bolus, monophasic protocol. Acta Radiol 2016; 42:560-2. [PMID: 11736701 DOI: 10.1080/028418501127347377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: We present a protocol for the non-invasive angiographic assessment of the arterial and venous cerebrovascular (CV) system by multi-slice CT. Material and Methods: Data acquisition was performed in a multi-slice CT scanner with a scan range from the carotid bifurcation to the vertex and manual scan start following i.v. administration of 120 ml iodinated contrast medium with a flow rate of 4 ml/s. This protocol was applied in 12 patients with symptoms of acute CV insuffiency. Results: In all patients, comprehensive imaging of the arteriovenous CV system was achieved including the common carotid bifurcation, the third segment of the major cerebral arteries, the dural sinus and the internal cerebral veins. Various CV pathologies, such as a territorial artery occlusion, a thrombotic obstruction of the internal carotid artery, an intracranial arteriovenous malformation and a sinus vein thrombosis, were successfully evaluated. Conclusion: Comprehensive assessment of the arteriovenous CV system is possible by the use of a single-bolus, monophasic multi-slice scan technique.
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Affiliation(s)
- R Klingebiel
- Neuroradiology Section, Department of Radiology, Department of Radiology, Charité CM, Humboldt University, Berlin, Germany
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Kivelitz D. KHK: Infarkt und Vitalität. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581430] [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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Kivelitz D. Leitlinien und aktuelle Studien. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581439] [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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Kivelitz D. Untersuchungsstrategien nicht-ischämischer Herzerkrankungen. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581354] [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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9
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Kivelitz D. Klassifikation und Untersuchungsstrategien bei Kardiomyopathien. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550942] [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: 10/23/2022]
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10
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Kivelitz D. CT rund um die Klappen: Vor und nach der Therapie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550989] [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: 10/23/2022]
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11
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Kivelitz D. Klassifikation und Untersuchungsstrategien bei Kardiomyopathien. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372865] [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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Kivelitz D. Grundlagen der MRT des Herzens und der Gefäße. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1372755] [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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Kivelitz D. Akutes Koronarsyndrom. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1345816] [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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Natho O, Thomsen L, Feigen U, Kivelitz D, Wösle M. Ist die Thoraxaufnahme in Exspiration für die Diagnostik des Pneumothorax noch „Gold Standard“? ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346336] [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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Kösser A, Kuck KH, Kivelitz D, Schneider C, Cuneo A. Die CT-Coronarangiografie (CCTA) zur Sicherung einer KHK für Patienten mit Katheterangst. ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0031-1300899] [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: 10/14/2022]
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Renz DM, Röttgen R, Habedank D, Wagner M, Böttcher J, Pfeil A, Dietz R, Kivelitz D, Elgeti T. New insights into peripartum cardiomyopathy using cardiac magnetic resonance imaging. ROFO-FORTSCHR RONTG 2011; 183:834-41. [PMID: 21830182 DOI: 10.1055/s-0031-1281600] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE The aim of this study was to evaluate a comprehensive cardiac magnetic resonance (MR) imaging approach in patients with peripartum cardiomyopathy (PPCM). The focus was on inflammatory myocardial changes. MATERIALS AND METHODS Retrospective analysis of 12 cardiac MR examinations was performed in 6 patients with PPCM. The protocol comprised cine sequences for the determination of chamber sizes and function. T 2-weighted sequences for determination of edema (T 2 ratio), T 1-weighted images for measurement of early gadolinium enhancement ratio (EGER), and late gadolinium enhancement (LGE) sequences were used for tissue characterization. 5 examinations were performed during the acute stage, and 7 examinations were performed during the course of the disease. RESULTS Initially, 3 of 5 patients presented with an elevated left ventricular end-diastolic volume (LVEDV); in one patient, the LVEDV was in the upper range. In 4 of 5 subjects, the left ventricular ejection fraction (LVEF) was decreased. The T 2 ratio and EGER values were initially elevated in all women. No LGE was detected in initial scans. In follow-up examinations, the LVEDV decreased and the LVEF increased in all patients. Tissue-characterizing parameters decreased to normal in all but 1 patient. 2 patients showing LGE did not present a favorable clinical course. CONCLUSION Myocardial inflammation was detected in the acute stage of PPCM, which was mostly transient. In our small group, patients showing LGE had a non-favorable clinical course. Future studies should include tissue-characterizing parameters, such as T 2 ratio and EGER. Thus, further insights into pathophysiology can be gained and therapeutic effects can be measured in a more extensive manner.
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Affiliation(s)
- D M Renz
- Institut für Radiologie, Charité Universitätsmedizin Berlin, Germany
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Henrich W, Onügören O, Kivelitz D, Dudenhausen JW. Transvaginal color Doppler for the visualization of pelvic vein thrombosis during pregnancy. Ultraschall Med 2009; 30:596-597. [PMID: 19085748 DOI: 10.1055/s-2008-1027691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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Affiliation(s)
- Andreas Metzner
- From the Department of Cardiology (A.M., J.C., K.-H.K.) and the Department of Radiology (D.K.), Asklepios Klinik St Georg, Hamburg, Germany
| | - K.R. Julian Chun
- From the Department of Cardiology (A.M., J.C., K.-H.K.) and the Department of Radiology (D.K.), Asklepios Klinik St Georg, Hamburg, Germany
| | - D. Kivelitz
- From the Department of Cardiology (A.M., J.C., K.-H.K.) and the Department of Radiology (D.K.), Asklepios Klinik St Georg, Hamburg, Germany
| | - Karl-Heinz Kuck
- From the Department of Cardiology (A.M., J.C., K.-H.K.) and the Department of Radiology (D.K.), Asklepios Klinik St Georg, Hamburg, Germany
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Lotz J, Kivelitz D, Fischbach R, Beer M, Miller S. [Recommendations for utilizing computerized tomography and magnetic resonance tomography in heart diagnosis. 2--Magnetic resonance tomography ]. ROFO-FORTSCHR RONTG 2009; 181:800-14. [PMID: 19621277 DOI: 10.1055/s-0028-1109542] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
MRI and CT have become important tools in the diagnosis of cardiac diseases. The permanent technical development and the continuously growing clinical and scientific experience required an update of the previous recommendations regarding the spectrum of clinical applications and the technical aspects of MRI and CT of the heart. The Working group Herzdiagnostik of the German Roentgen Society has revised its recommendations based on the current literature and has updated technical requirements and clinical indications. Part I of the recommendations deals with cardiac computed tomography while part II focuses on MRI in cardiac applications. These recommendations shall serve as a guideline when deciding on appropriate technique for non-invasive cardiac imaging and shall help to perform high quality imaging based on a standardised approach.
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Affiliation(s)
- J Lotz
- Institut für Radiologie, Medizinische Hochschule Hannover.
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Fischbach R, Miller S, Beer M, Lotz J, Kivelitz D. Empfehlungen der Arbeitsgemeinschaft Herzdiagnostik der Deutschen Röntgengesellschaft für den Einsatz der Computertomografie und Magnetresonanztomografie in der Herzdiagnostik. Teil 1 – Computertomografie. ROFO-FORTSCHR RONTG 2009; 181:700-6. [DOI: 10.1055/s-0028-1109533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Lücke C, Schindler K, Krenauer A, Schuler G, Thiele H, Kivelitz D, Gutberlet M. Evaluation der funktionellen Relevanz der lipomatösen Metaplasie nach Myokardinfarkt mittels MRT. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221518] [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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Kivelitz D. Erprobte Sequenzprotokolle für die MRT. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221216] [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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Eitel I, Behrendt F, Schindler K, Kivelitz D, Gutberlet M, Schuler G, Thiele H. Differential diagnosis of suspected apical ballooning syndrome using contrast-enhanced magnetic resonance imaging. Eur Heart J 2008; 29:2651-9. [DOI: 10.1093/eurheartj/ehn433] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Lücke C, Schindler K, Nitzsche S, Lembcke A, Schuler G, Thiele H, Kivelitz D. Prävalenz der lipomatösen Metaplasie nach Myokardinfarkt. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977011] [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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Schindler K, Lücke C, Nitzsche S, Lembcke A, Schuler G, Thiele H, Kivelitz D. Nachweis linksventrikulärer Thromben mittels Magnetresonanztomographie (MRT) des Herzens bei Patienten mit akutem ST-Strecken-Hebungs-Infarkt (STEMI) im Vergleich zur transthorakalen Echokardiographie. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977013] [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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Kivelitz D. MRT-Diagnostik des akuten und chronischen Myokardinfarktes. ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-976670] [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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Asbach P, Breitwieser C, Diederichs G, Eisele S, Kivelitz D, Taupitz M, Zeitz M, Hamm B, Klessen C. Cine magnetic resonance imaging of the small bowel: comparison of different oral contrast media. Acta Radiol 2006; 47:899-906. [PMID: 17077038 DOI: 10.1080/02841850600965054] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate several substances regarding small bowel distension and contrast on balanced steady-state free precession (bSSFP) cine magnetic resonance (MR) images. MATERIAL AND METHODS Luminal contrast was evaluated in 24 volunteers after oral application of two different contrast agent groups leading to either bright lumen (pineapple, blueberry juice) or dark lumen (tap water, orange juice) on T1-weighted images. Bowel distension was evaluated in 30 patients ingesting either methylcellulose or mannitol solution for limiting intestinal absorption. Fifteen patients with duodeno-jejunal intubation served as the control. Quantitative evaluation included measurement of luminal signal intensities and diameters of four bowel segments, qualitative evaluation assessed luminal contrast and distension on a five-point scale. RESULTS Quantitative and qualitative evaluation of the four contrast agents revealed no significant differences regarding luminal contrast on bSSFP images. Quantitative evaluation revealed significantly lower (P<0.05) small bowel distension for three out of four segments (qualitative evaluation: two out of four segments) for methylcellulose in comparison to the control. Mannitol was found to be equal to the control. CONCLUSION Oral ingestion of tap water or orange juice in combination with mannitol is recommended for cine MR imaging of the small bowel regarding luminal contrast and small bowel distension on bSSFP sequences.
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Affiliation(s)
- P Asbach
- Department of Radiology, Charité - Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany.
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Kivelitz D. Grundlagen der MRT des Herzens und der Gefäße. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940298] [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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Kivelitz D. Kardiomyopathien und Myokarditis. ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-940333] [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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Althoff C, Thies U, Hermann KG, Kivelitz D, Enzweiler C, Klüner C, Bollow M, Hamm B. CT-gestützte Kortikoid-Instillation der Sakroiliakalgelenke: Qualitätssicherung und standardisierte, prospektive Evaluation der Wirksamkeit. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867744] [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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Kivelitz D. MR + CT: Spätes Enhancement. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867247] [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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Kivelitz D, Schnorr J, Klemmt J, Wagner S, Wetzler R, Hamm B, Busch M, Taupitz M. Langzeitmessungen mit aktiven MRI-Stents - bleibt die Signalverstärkung erhalten? ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-867820] [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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Taupitz M, Wagner S, Schnorr J, Krug L, Dewey M, Kivelitz D, Pilgrimm H, Hamm B. MR-Angiographie der Koronararaterien mit dem neuen Blutpool Kontrastmittel VSOP-C184: Erste Ergebnisse an gesunden Probanden. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-864003] [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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Rake A, Mühler M, Schwabe M, Hauptmann K, Kivelitz D, Bollmann R, Chaoui R. Möglichkeiten der Magnetresonanztomographie (MRT) in der postmortalen Diagnostik von Feten mit sonografisch gesicherten Herzfehlbildungen. Z Geburtshilfe Neonatol 2004. [DOI: 10.1055/s-2003-818320] [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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Taupitz M, Wagner S, Schnorr J, Kivelitz D, Krug L, Dewey M, Pilgrimm H, Hamm B. MR-Angiographie der Koronararterien: Erste Wirksamkeitsprüfung des neuen Eisenoxid-basierten Blutpool-Kontrastmittel VSOP-C184 am Menschen im Rahmen einer klinischen Phase IB Studie. ROFO-FORTSCHR RONTG 2003. [DOI: 10.1055/s-2003-819920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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Kivelitz D, Schnorr J, Klemmt J, Wagner S, Taupitz M, Wetzler R, Busch M, Melzer A, Hamm B. Der aktive MRI-Stent – Tierexperimentelle Langzeitergebnisse. ROFO-FORTSCHR RONTG 2003. [DOI: 10.1055/s-2003-819929] [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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37
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Dübel HP, Gliech V, Borges AC, Kivelitz D, Rutsch W. [Left ventricular pseudoaneurysm after mitral valve replacement]. Z Kardiol 2003; 92:953-6. [PMID: 14634765 DOI: 10.1007/s00392-003-0977-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2003] [Accepted: 06/11/2003] [Indexed: 04/27/2023]
Abstract
We report about a woman with a rare complication after mitral valve replacement 24 years ago. The patient had a massive hemorrhage some hours after operation. We performed invasive diagnostics because of an increasing pressure gradient across the prosthesis and revealed a left ventricular pseudoaneurysm. Before the planned reoperation the patient died suddenly. As the cause of death, we assumed a rupture of the pseudoaneurysm.
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Affiliation(s)
- H-P Dübel
- Universitätsklinikum Charité, Medizinische Klinik und Poliklinik, Berlin, Germany
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38
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Abstract
This is the first description of a case of isolated non-compaction of the left ventricular myocardium, involving a 52 year old woman presenting with progressive heart failure, with analysis of myocardial perfusion by contrast echocardiography in comparison with magnetic resonance imaging.
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Affiliation(s)
- A C Borges
- Cardiology, Pneumology, and Angiology, Medical Department, Charité, Humboldt University, Berlin, Germany.
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39
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Schnorr J, Wagner S, Ebert W, Heyer C, Laub G, Kivelitz D, Abramjuk C, Hamm B, Taupitz M. [MR angiography of the coronary arteries: comparison of the blood pool contrast medium Gadomer and Gd-DTPA in pigs]. ROFO-FORTSCHR RONTG 2003; 175:822-9. [PMID: 12811696 DOI: 10.1055/s-2003-39931] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM To investigate the signal-enhancing effects of the macromolecular contrast medium Gadomer in MR angiography of the coronary arteries compared to Gd-DTPA. MATERIAL AND METHODS A total of 15 MRI examinations of the heart were performed in pigs at 1.5 T using a pulse-triggered, segmented 3D FLASH sequence with data acquisition during breathhold before and up to 30 min after contrast medium injection. Gadomer was investigated at two doses (0.05 and 0.1 mmol Gd/kg), Gd-DTPA at one (0.3 mmol Gd/kg) (n = 5 examinations per dose). Standard sequences without magnetization preparation were supplemented by sequences with magnetization saturation applied before data acquisition before and immediately after contrast medium injection. Analysis comprised quantitative determination of blood and myocardium signal to noise (S/N) and contrast to noise (C/N) and qualitative assessment of several parameters of image quality and coronary artery visualization. RESULTS Gadomer leads to a significant C/N increase between blood and myocardium compared to the unenhanced examination and the increase is longer-lasting than that produced by Gd-DTPA (Gd-DTPA: only directly after injection; Gadomer: up to 5 min post injection at 0.05 mmol Gd/kg, up to 10 min at 0.1 mmol Gd/kg). The qualitative evaluation shows that visualization of the coronary arteries and branch vessels is significantly better with Gadomer at both doses than with Gd-DTPA. Magnetization saturation increases the C/N in combination with Gd-DTPA and at the higher dose of Gadomer with the latter producing a higher increase in C/N values. CONCLUSION Gadomer is a suitable contrast medium for MR angiography of the coronary arteries with the dose of 0.1 mmol Gd/kg being superior to 0.05 mmol Gd/kg due to a longer imaging window.
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Affiliation(s)
- J Schnorr
- Institut für Radiologie, Charité, Medizinische Fakultät der Humboldt Universität zu Berlin.
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40
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Affiliation(s)
- K Angstwurm
- Department of Neurology, Charité, Humboldt-University, 10098 Berlin, Germany.
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41
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Mahfouz AE, Sherif H, Saad A, Taupitz M, Filimonow S, Kivelitz D, Hamm B. Gadolinium-enhanced MR angiography of the breast: is breast cancer associated with ipsilateral higher vascularity? Eur Radiol 2002; 11:965-9. [PMID: 11419172 DOI: 10.1007/s003300000668] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to assess a possible association between breast malignancy and ipsilateral higher vascularity on gadolinium-enhanced MR angiography. One hundred six patients were examined by dynamic gadolinium-enhanced 3D MR imaging. Magnetic resonance angiographic views were generated by image subtraction and maximum intensity projection. The study included 85 patients with unilateral malignant breast neoplasms and 21 with unilateral benign lesions. Three blinded readers independently reviewed the MR angiograms after masking the lesions and the corresponding contralateral sites. The readers were asked to determine whether vascularity was higher on the right side, higher on the left side, or equal on both sides. The results were analyzed by the Kappa statistic and Pearson's chi-square test. The blood vessels of the breasts were clearly seen in all cases. There was good agreement among the observers (kappa > 0.54) in assessing vascularity on both sides. Breasts harboring malignant neoplasms were found to have a higher vascularity than the contralateral breasts (p < 0.005). This sign of malignancy had a sensitivity of 76.5%, a specificity of 57%, and an accuracy of 72.6%. Blood vessels of the breast can be depicted by MR angiography. Unilateral malignant neoplasms are associated with a higher ipsilateral vascularity. In conjunction with other indications of malignancy on gadolinium-enhanced MR images, a higher ipsilateral vascularity may serve as an additional sign of malignancy.
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Affiliation(s)
- A E Mahfouz
- Department of Radiology, Charité Medical Center, Humboldt-Universität zu Berlin, Schumannstrasse 20/21, 10098 Berlin, Germany
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42
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Konertz W, Hotz H, Kivelitz D, Zytowski M. 5 year results after partial left ventriculectomy in an european heart failure population. J Heart Lung Transplant 2002. [DOI: 10.1016/s1053-2498(01)00628-3] [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: 11/25/2022] Open
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43
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Taupitz M, Schnorr J, Wagner S, Kivelitz D, Rogalla P, Claassen G, Dewey M, Robert P, Corot C, Hamm B. Coronary magnetic resonance angiography: experimental evaluation of the new rapid clearance blood pool contrast medium P792. Magn Reson Med 2001; 46:932-8. [PMID: 11675645 DOI: 10.1002/mrm.1279] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The signal-enhancing characteristics of a new monodisperse monogadolinated macromolecular MR contrast medium (P792) were evaluated for magnetic resonance angiography (MRA) of the coronary arteries. A total of 15 cardiac examinations were performed in pigs at 1.5 T using a 3D gradient-echo sequence. Images were acquired during breath-hold before and up to 35 min after IV injection of Gd-DTPA (0.3 mmol Gd/kg), Gd-BOPTA (0.2 mmol Gd/kg), and P792 (13 micromol Gd/kg). An increase in the signal-to-noise ratio (SNR) of 97% +/- 17%, 108% +/- 37%, and 109% +/- 31% in coronary arteries and of 82% +/- 19%, 82% +/- 24%, and 28% +/- 18% in myocardium, respectively, was measured during the first postcontrast acquisition. The blood-to-myocardium signal-difference-to-noise ratio (SDNR) was significantly higher for P792 than for the other Gd compounds (P <.05) for up to 15 min after injection. Qualitative assessment showed that visualization of the coronary arteries and their branches was significantly better for P792 compared to the low-molecular Gd compounds (P <.05). The blood pool contrast medium P792 is well suited for MRA of the coronary arteries.
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Affiliation(s)
- M Taupitz
- Department of Radiology, Charité, Medizinische Fakultät, Humboldt-Universität zu Berlin, Berlin, Germany.
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44
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Klingebiel R, Zimmer C, Rogalla P, Kivelitz D, Bohner G, Gotze R, Lehmann R. Assessment of the arteriovenous cerebrovascular system by multi-slice CT . A single-bolus, monophasic protocol. Acta Radiol 2001. [DOI: 10.1034/j.1600-0455.2001.420605.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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45
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Kivelitz D, Wagner S, Hansel J, Schnorr J, Wetzler R, Busch M, Melzer A, Taupitz M, Hamm B. The active magnetic resonance imaging stent (AMRIS): initial experimental in vivo results with locally amplified MR angiography and flow measurements. Invest Radiol 2001; 36:625-31. [PMID: 11606839 DOI: 10.1097/00004424-200111000-00001] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
RATIONALE AND OBJECTIVES Magnetic resonance (MR) is limited by artifacts in vessels after stenting. An active MR imaging stent (AMRIS) allows for artifact-free imaging with local improvement in signal-to-noise ratio (SNR). In a rabbit model, we evaluated the imaging properties by MR angiography (MRA) and flow measurements. METHODS The AMRIS was placed in the abdominal aorta of five rabbits. At 1.5 T, MRA (three-dimensional fast low-angle shot) was performed before and after intravenous injection of an iron oxide-based, blood-pool contrast medium (dose, 50 micromol Fe/kg), and flow measurements were performed (electrocardiographically triggered phase-contrast cine gradient-echo sequence). Mean SNRs were calculated and flow volume curves were generated. RESULTS The SNR was 6.0 +/- 0.6 (outside the stent) versus 12.3 +/- 1.1 (inside the stent, P < 0.05) for plain MRA, 21.2 +/- 0.6 versus 40.6 +/- 5.2 (P < 0.05) for contrast-enhanced MRA, and 5.4 +/- 0.4 versus 13.7 +/- 2.1 (P < 0.05) for the magnitude images of flow measurements. Flow volume curves within and distal to the stent were comparable. CONCLUSIONS By using the AMRIS as a vascular stent, the stented vessel segment can be examined with enhanced signal intensity on MRI.
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Affiliation(s)
- D Kivelitz
- Institut für Radiologie, Charité, Medizinische Fakultät, Humboldt-Universität zu Berlin, Schumannstrasse 20/21, 10098 Berlin, Germnay.
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46
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Strohm O, Kivelitz D, Gross W, Schulz-Menger J, Liu X, Hamm B, Dietz R, Friedrich MG. Safety of implantable coronary stents during 1H-magnetic resonance imaging at 1.0 and 1.5 T. J Cardiovasc Magn Reson 2001; 1:239-45. [PMID: 11554385 DOI: 10.3109/10976649909088336] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The safety of most available implantable intracoronary stents during magnetic resonance imaging (MRI) has not been sufficiently tested. Minor, but possibly clinically significant, increases in temperature have not been excluded. We measured temperature changes of 14 different stents clinically in use or currently tested for release on the world market. Stents were examined in 1.0- and 1.5-T MR scanners with multiple sequences used in routine cardiac and thoracic MRI examinations ("clinical worst case") and after implantation of the stents into the coronary arteries of excised pig hearts (1.5-T scanner only). We used a highly sensitive infrared camera with a thermal resolution of 10 mK and did not see significant heating of any stent during the examinations. We conclude that MRI is safe in patients with the currently available intracoronary stents.
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Affiliation(s)
- O Strohm
- Universitätsklinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin, Medizinische Klinik mit Schwerpunkt Molekulare und Klinische Kardiologie (Buch), Berlin, Germany
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47
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Dohmen PM, Hotz H, Lembcke A, Kivelitz D, Hamm B, Konertz W. Magnetic resonance imaging of stentless xenografts for reconstruction of right ventricular outflow tract. Semin Thorac Cardiovasc Surg 2001; 13:24-7. [PMID: 11805945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
The objective was to overcome allograft shortage during the Ross operation; stentless xenografts were carefully evaluated for hemodynamic behavior and valve deterioration during medium term follow-up. Between January 10, 1994 and January 4, 1996 nine adult patients (age 31-51 years) underwent aortic valve replacement with an autologous pulmonary valve and right ventricular outflow tract reconstruction with the Edwards Prima or Medtronic Freestyle xenograft. One patient was dead early and one late, both from noncardiac reasons. Forty-eight to 66 months follow-up was available for 7 patients and was performed with physical examination in the outpatient clinic, transthoracic echocardiography (TTE), and magnetic resonance imaging (MRI). Two patients received 29-mm valves and the remaining 27-mm valves. No reoperation became necessary during follow-up. Preoperative left ventricular ejection fraction ranged from 20% to 84%, median 61%, mean 59% +/- 18%. At latest follow-up left ventricular ejection fraction was 49% to 70%, median 57%, mean 58% +/- 8%. TTE showed no calcification of the xenograft wall or cusps. MRI revealed good autograft function with no evidence of stenosis in any patient. Four patients showed no and three trivial regurgitation. Right ventricular outflow tract-stenosis could not be seen in any patient. Calculated gradients of the xenograft valves ranged from 2 to 6 mm Hg, median 3 mm Hg (mean 3.1 +/- 2.4 mm Hg) and calculated EOA ranged from 2.0 to 4.0 cm(2), median 2.8 cm(2). MRI supported these findings and showed pliable xenograft cusps in all patients. Right ventricular function was well preserved in all patients. In adult patients right ventricular outflow tract reconstruction with stentless xenografts can be performed safely and intermediate-term results are encouraging. During medium-term (5-7 years) follow-up no calcification or deterioration of valve function occurred with excellent hemodynamic behavior.
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Affiliation(s)
- P M Dohmen
- Department of Cardiovascular Surgery, Charité, Humboldt University Berlin, Berlin, Germany
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48
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Abstract
We report a 15-year-old boy with patent ductus venosus in whom the diagnosis was made by MR angiography. A patent ductus venosus Arantii is a rare form of portosystemic shunt. Only a few cases have been reported in adults and children. The diagnosis is usually made by US and digital subtraction angiography. In our patient, the diagnosis was first made by MR angiography. This demonstrates the excellent diagnostic potential of the method in paediatric patients.
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Affiliation(s)
- I Scheer
- Humboldt-Universität zu Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
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49
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Klingebiel R, Thieme N, Werner JF, Werbs M, Rogalla P, Kivelitz D, Kaschke O, Lehmann R. A post-processing protocol for three-dimensional visualization of the inner ear using the volume-rendering technique based on a standard magnetic resonance imaging protocol. Acta Otolaryngol 2001; 121:384-6. [PMID: 11425205 DOI: 10.1080/000164801300102851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
A superior diagnostic quality compared to other post-processing (PP) techniques for three-dimensional (3D) inner ear imaging has been attributed to volume rendering (VR). We defined and assessed a VR protocol for 3D visualization of the inner ear in a routine imaging setting. Following definition of a VR protocol by using lower threshold values, surface shading, perspective views and related parameters, standardized 3D views of the inner ear were generated and evaluated in 32 patients suffering from sensorineural or combined hearing loss. Comprehensive inner ear visualization was achieved in 28 patients by means of two 3D shaded-surface views. Incomplete data acquisition (1/32), motion and pulsation artefacts (2/32) and interposed fluid-retaining mastoid cells (1/32) were responsible for non-diagnostic image quality in 4/32 patients. In 5/32 patients modifications of the PP protocol involving the threshold value and depth-cueing parameters helped to establish diagnostic image quality. Mean post-processing time amounted to 5.8 min per site. 3D imaging with the VR technique is suitable for routine inner ear assessment if direct VR, predefined PP protocols and standardized labyrinthine views are used.
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Affiliation(s)
- R Klingebiel
- Department of Radiology, Charité CM, Humboldt University, Berlin, Germany.
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50
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Kröncke TJ, Taupitz M, Kivelitz D, Scheer I, Daberkow U, Rudolph B, Hamm B. Multifocal nodular fatty infiltration of the liver mimicking metastatic disease on CT: imaging findings and diagnosis using MR imaging. Eur Radiol 2001; 10:1095-100. [PMID: 11003404 DOI: 10.1007/s003300000360] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The aim of this study was to describe the MR appearance of multifocal nodular fatty infiltration of the liver (MNFIL) using T1-weighted in-phase (IP) and opposed-phase (OP) gradient-echo as well as T2-weighted turbo-spin-echo sequences with fat suppression (FSTSE) and without (HASTE). Magnetic resonance imaging examinations at 1.5 T using T1-weighted IP and OP-GRE with fast low angle shot (FLASH) technique, and T2-weighted FSTSE, T2-weighted HASTE of 137 patients undergoing evaluation for focal liver lesions were reviewed. Five patients were identified in whom CT indicated metastatic disease; however, no liver malignancy was finally proven. Diagnosis was confirmed by biopsy (n = 3), additional wedge resection (n = 1) or follow-up MRI 6-12 months later (n = 5). Regarding the identified five patients, the number of focal liver lesions was 2 (n = 2) and more than 20 (n = 3). The MR imaging characteristics were as follows: OP-image: markedly hypointense (n = 5); IP image: isointense (n = 2) or slightly hyperintense (n = 3); T2-weighted FSTSE-image: isointense (n = 5); T2-weighted HASTE image isointense (n = 1); slightly hyperintense (n = 4). On OP images all lesions were sharply demarcated and of almost spherical configuration (n = 5). Further evaluation by histology or follow-up MR imaging did not give evidence of malignancy in any case. Histology revealed fatty infiltration of the liver parenchyma in three patients. Magnetic resonance follow-up showed complete resolution in two patients and no change in three patients. Multifocal nodular fatty infiltration can simulate metastatic disease on both CT and MR imaging. The combination of in-phase (IP) and opposed-phase (OP) gradient-echo imaging can reliably differentiate MNFIL from metastatic disease.
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Affiliation(s)
- T J Kröncke
- Institut für Radiologie, Universitätsklinikum Charité, Humboldt-Universität zu Berlin, Germany
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