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  • 1
    Keywords: tumor ; carcinoma ; CELL ; Germany ; CT ; imaging ; TUMORS ; computed tomography ; SURGERY ; renal ; INJECTION ; MRI ; SEQUENCE ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; DIFFERENCE ; tomography ; CARCINOMAS ; COMPUTED-TOMOGRAPHY ; ANGIOGRAPHY ; MASSES ; CELL CARCINOMA ; EXTENSION ; SURGICAL-TREATMENT ; CAVA TUMOR THROMBUS ; PREOPERATIVE EVALUATION ; renal cell carcinoma,staging,multidetector computed tomography,magnetic resonance imaging ; VENA-CAVA
    Abstract: Objective: The aim of this prospective study is to compare the diagnostic accuracy of multidetector-row computed tomography (CT) and magnetic resonance imaging (MRI) in tumor staging of renal cell carcinomas.Methods: in a prospective study, 82 renal cell carcinomas were assessed for tumor staging before surgery using multidetector-row CT and MRI, the results of which were then correlated to histopathologic staging. Triphasic CT (noncontrast, arterial phase, and parenchymal phase) imaging was performed using multi detector-row CT with a reconstructed slice thickness of 2 mm. In MRI, a transverse T1-weighted gradient echo sequence with and without administration of Gd-DTPA, a transverse T2-weighted respiratory-gated turbo spin echo (TSE) sequence, and a coronal T1-weighted gradient echo sequence with Gd-DTPA were used. In addition, multiphasic 3-dimensional angiography after Gd-DTPA injection and a transverse T1-weighted fat-suppression sequence were performed.Results: With MRI, readers 1 and 2 correctly staged 71 and 64 tumors (overall accuracy of 0.87 and 0.78, respectively) and achieved Mantel-Haenszel X-2 values of 66 and 63 (P 〈 0.0001). Computed tomography allowed correct staging of 68 and 66 tumors (readers 1 and 2, overall accuracy of 0.83 and 0.80, respectively) with Mantel-Haenszel X-2 values of 54 and 54 for CT staging (P 〈 0.0001). No statistically significant difference between overall accuracy was found in the X-2 test (P 〉 0. 15).Conclusion: Magnetic resonance imaging and multidetector-row CT with its multiplanar reconstruction capabilities achieve similar accuracy in tumor staging of renal cell carcinomas
    Type of Publication: Journal article published
    PubMed ID: 15100536
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    ISSN: 1432-1238
    Keywords: Key words Thermodilution cardiac output ; Continuous monitoring ; Postoperative intensive care ; Extubation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Commercially available semi-continuous cardiac output (SCCO) monitoring systems are based on the pulsed warm thermodilution technique. There is evidence that SCCO fails to correlate with standard intermittent bolus cardiac output (ICO) in clinical situations with thermal instability in the pulmonary artery. Furthermore, ventilation may potentially influence thermodilution measurements by enhanced respiratory variations in pulmonary artery blood temperature and by cyclic changes in venous return. Therefore, we evaluated the correlation, accuracy and precision of SCCO versus ICO measurements before and after extubation. Design: Prospective cohort study. Setting: Intensive care unit (ICU) of a university hospital. Patients and participants: 22 cardiac surgical ICU patients. Interventions: None. Measurements and results: SCCO and ICO data were obtained at nine postoperative time points while the patients were on controlled mechanical ventilation. Further sets of measurements were taken during the weaning phase 20 min before extubation, and 5 min, 20 min and 1 h after extubation. SCCO and ICO measurements yielded 286 data pairs with a range of 1.8–9.9 l/min for SCCO and 1.9–9.8 l/min for ICO. The correlation between SCCO and ICO was highly significant (r=0.92; p〈0.01), accompanied by a bias of –0.052 l/min and a precision of 0.56 l/min. Correlation, accuracy and precision were not influenced by the mode of respiration. Conclusions: Our results demonstrate excellent correlation, accuracy and precision between SCCO and ICO measurements in postoperative cardiac surgical ICU patients. We conclude that SCCO monitoring offers a reliable clinical method of cardiac output monitoring in ICU patients following cardiac surgery.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1238
    Keywords: Thermodilution cardiac output ; Continuous monitoring ; Postoperative intensive care ; Extubation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective Commercially available semi-continuous cardiac output (SCCO) monitoring systems are based on the pulsed warm thermodilution technique. There is evidence that SCCO fails to correlate with standard intermittent bolus cardiac output (ICO) in clinical situations with thermal instability in the pulmonary artery. Furthermore, ventilation may potentially influence thermodilution measurements by enhanced respiratory variations in pulmonary artery blood temperature and by cyclic changes in venous return. Therefore, we evaluated the correlation, accuracy and precision of SCCO versus ICO measurements before and after extubation. Design Prospective cohort study. Setting Intensive care unit (ICU) of a university hospital. Patients and participants 22 cardiac surgical ICU patients. Interventions None. Measurements and results SCCO and ICO data were obtained at nine postoperative time points while the patients were on controlled mechanical ventilation. Further sets of measurements were taken during the weaning phase 20 min before extubation, and 5 min, 20 min and 1 h after extubation. SCCO and ICO measurements yielded 286 data pairs with a range of 1.8–9.9 l/min for SCCO and 1.9–9.8 l/min for ICO. The correlation between SCCO and ICO was highly significant (r=0.92;p〈0.01), accompanied by a bias of −0.052 l/min and a precision of 0.56 l/min. Correlation, accuracy and precision were not influenced by the mode of respiration. Conclusions Our results demonstrate excellent correlation, accuracy and precision between SCCO and ICO measurements in postoperative cardiac surgical ICU patients. We conclude that SCCO monitoring offers a reliable clinical method of cardiac ouput monitoring in ICU patients following cardiac surgery.
    Type of Medium: Electronic Resource
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