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  • ACI  (1)
  • Basilaristhrombose  (1)
  • CENTRAL-NERVOUS-SYSTEM  (1)
  • Diabetes mellitus  (1)
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  • 1
    Keywords: brain ; tumor ; evaluation ; Germany ; imaging ; TUMORS ; TIME ; PATIENT ; primary ; BODY-WEIGHT ; CONTRAST ; INJECTION ; MR ; ACQUISITION ; EFFICACY ; metastases ; PARAMETERS ; STATISTICAL-ANALYSIS ; MORPHOLOGY ; SAFETY ; CENTRAL-NERVOUS-SYSTEM ; CONTRAST AGENTS ; DOUBLE-BLIND ; GADOBENATE-DIMEGLUMINE ; GADODIAMIDE INJECTION ; GADOPENTETATE DIMEGLUMINE ; INTRACRANIAL METASTASES ; gadobenate dimeglumine ; MR imaging ; VASCULARIZATION ; GLIOMAS ; ENHANCED MRI ; brain neoplasms,MR,gadolinium,magnetic resonance (MR),contrast media ; HIGH-DOSE GADOTERIDOL ; MAGNEVIST GD-DTPA
    Abstract: PURPOSE: To evaluate the safety of and compare the enhancement characteristics of gadobenate dimeglumine (MultiHance; Bracco Imaging, Milan, Italy) with those of a standard gadolinium chelate (gadopentetate dimeglumine, Magnevist; Schering, Berlin, Germany) in primary and secondary brain tumors on the basis of qualitative and quantitative parameters, on an intraindiviual basis.MATERIALS AND METHODS: Twenty-seven patients with either high-grade glioma or metastases were enrolled in a bicentric intraindividual crossover study to compare lesion enhancement with doses of 0.1 mmol per kilogram of body weight of 0.5 mol/L gadopentetate dimeglumine and 0.5 mol/L gadobenate dimeglumine. MR imaging was performed before injection (T1-weighted spin-echo [SE] and T2-weighted fast SE acquisitions) and at 1, 3, 5, 7, 9, and 16 minutes after injection (T1-weighted SE acquisitions). Qualitative assessment was performed by blinded off-site readers (for 22 patients) and on-site investigators (for 24 patients) in terms of global contrast enhancement, lesion-to-brain contrast, lesion delineation, internal lesion morphology and structure, tumor vascularization, and global image preference. Additional quantitative assessment with region-of-interest analysis was performed by off-site readers alone. Statistical analysis of qualitative data was performed with the Wilcoxon signed rank test, whereas a nonparametric approach was adopted for analysis of quantitative data.RESULTS: Significant (P 〈 .05) preference for gadobenate dimeglumine over gadopentetate dimeglumine was noted both off-site and on-site for the global assessment of contrast enhancement. For off-site readers I and 2 and the on-site investigators, respectively, gadobenate dimeglumine was preferred in 13, 17, and 16 patients; gadopentetate dimeglumine was preferred in four, four, and four patients; and equality was found in five, one, and four patients). Similar preference for gadobenate dimeglumine was noted by off-site readers and on-site investigators for lesion-to-brain contrast and all other qualitative parameters. Off-site quantitative evaluation revealed significantly (P 〈 .05) superior enhancement for gadobenate dimeglumine compared with that for gadopentetate dimeglumine at all time points from 3 minutes after injection.CONCLUSION: Significantly superior contrast enhancement of intraaxial enhancing brain tumors was achieved with 0.1 mmol/kg gadobenate dimeglumine compared with that with 0.1 mmol/kg gadopentetate dimeglumine. (C) RSNA, 2004
    Type of Publication: Journal article published
    PubMed ID: 14695387
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  • 2
    ISSN: 1432-2102
    Keywords: Schlüsselwörter CTA ; Basilarisverschluß ; Basilaristhrombose ; Key words Basilar artery ; Occlusion ; Thrombosis ; Diagnosis ; Spiral CT angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Background and purpose: Without recanalisation, acute basilar artery (BA) occlusion has a mortality of 90 %, which is reduced to 50 % if recanalisation is achieved. Fast diagnosis of BA occlusion is necessary in order to start thrombolytic therapy without delay. We wanted to assess the role of CT angiography (CTA) in the diagnostic evaluation of suspected acute BA occlusion. Materials and methods: Ten patients with clinically suspected BA occlusion were examined with conventional CT and spiral CT angiography. Spiral scanning extended from the foramen magnum to the tip of the basilar artery. For CTA, 130 ml of nonionic contrast media were injected into an antecubital vein. In four patients, transfemoral digital subtraction angiography (DSA) was additionally performed. All but one patient had a follow-up CT examination the next day. Results: CTA demonstrated BA occlusion in six patients and a partially thrombosed megadolichobasilar artery in one patient. In four of the six patients with CT angiographically diagnosed BA occlusion, an additional DSA was performed, which confirmed the CTA findings. In three patients the BA showed normal intravasal contrast, and follow-up CT did not show infarctions in the vertebrobasilar territory. Conclusion: Although the number of cases is still small, CTA seems to be a promising method for the rapid diagnosis of BA occlusion. It may become a valuable tool for therapy decisions in acute BA occlusions.
    Notes: Zusammenfassung Die Letalität nicht rekanalisierter akuter Basilarisverschlüsse liegt bei 90 %. Erfolgt eine Rekanalisation, sinkt die Mortalität auf etwa 50 %. Eine schnelle Diagnostik eines Basilarisverschlusses ist erforderlich, um gegebenenfalls eine thrombolytische Therapie zu beginnen. Wir berichten über erste Erfahrungen mit der CT-Angiographie (CTA) in der Diagnose akuter Basilarisverschlüsse. Bei 10 Patienten mit klinisch begründetem Verdacht auf einen Basilarisverschluß wurde eine CTA des hinteren Hirnkreislaufs durchgeführt, die bei 6 Patienten einen Verschluß der A. basilaris und bei einem Patienten eine teilthrombosierte Megadolicho-Basilaris zeigte. Bei 4 der 6 Patienten mit CT-angiographisch nachgewiesenem Basilarisverschluß wurde eine DSA durchgeführt, die die Diagnose bestätigte. Bei 3 Patienten, bei denen sich die gesamte A. basilaris in der CTA regelrecht kontrastierte, zeigte das Kontroll-CT keine Infarkte. Wenngleich unsere Fallzahlen noch gering sind, scheint die CTA ein vielversprechendes, schnelles Verfahren zur Diagnostik akuter Basilarisverschlüsse zu sein und könnte ein wichtiges Hilfsmittel bei Therapieentscheidungen werden.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2102
    Keywords: Schlüsselwörter CTA ; Spiral-CT ; Dissektion ; ACI ; Key words CT angiography ; Spiral CT ; Dissection ; ICA
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Purpose: To evaluate the role of CT angiography (CTA) in the diagnosis of dissection of the internal carotid artery (ICA). Methods: In 21 patients who were clinically or sonographically suspected of having a dissection of the ICA, we performed CTA covering the extracranial course of the ICA. Our technique included spiral scanning (Picker PQ 2000), slice thickness 3 mm, index 1.5 mm, pitch factor 1.25, tube voltage 130 kV, amperage 125 mA, i. v. bolus injection of 100 ml nonionic contrast medium, injection rate 4 ml/s and scan delay 15 s. Spiral data were processed using a workstation (Picker Voxel Q) to calculate 3D “angiographic” reconstructions, maximal intensity projections and multiplanar reconstructions. In 20 of the 21 patients transfemoral angiography was performed, and in all patients cw-Doppler ultrasonography of the carotid arteries was performed. Results: Sensitivity of CTA in acute extracranial dissection of the ICA was 100 % (14/14). One patient had a pseudoaneurysm of the ICA, two patients had excessive kinking and one patient showed an atheromatous carotid ulcer. DSA could confirm this in all cases. One intracranial ICA dissection, not covered by the scan field, was missed by CTA. CTA source images demonstrated mural thickening and eccentric luminal narrowing in cases of dissection. 3D reconstructions showed tapering of the ICA. Conclusion: CTA is a reliable tool in the diagnosis of ICA dissection. Further studies comparing CTA, MRI and duplex ultrasound are necessary.
    Notes: Zusammenfassung Ziel der vorliegenden Studie war es, den Stellenwert der CT-Angiographie (CTA) bei der Diagnose von Dissektionen der A. carotis interna (ACI) zu ermitteln. Die Befunde der CTA wurden mit Ergebnissen der digitalen Subtraktionsangiographie (DSA) und der cw-Dopplersonographie (cw-DS) verglichen. Wir untersuchten 21 Patienten mit klinischem oder dopplersonographischem Verdacht auf eine ACI-Dissektion. Bei akuter extrakranieller ACI-Dissektion war die Sensitivität der CTA 100 % (14/14). Eine intrakranielle ACI-Dissektion wurde durch die CTA nicht erfaßt, da sie außerhalb des Scanbereichs lag. Die in der cw-DS unspezifischen pathologischen Befunde konnten mit der CTA geklärt werden. Häufigster Befund in der CTA war eine exzentrische Lumeneinengung und Wandverdickung sowie eine spitzauslaufende Verschmächtigung (sog. tapering) in der dreidimensionalen (3D-) Rekonstruktion. Die CTA ist bei akuter extrakranieller Karotisdissektion eine verläßliche und wenig invasive Untersuchungsmethode. Vergleichende Studien mit CTA, Duplexsonographie und Magnetresonanztomographie (MRT) sollten noch durchgeführt werden.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1920
    Keywords: Key words Basal ganglia ; Haemorrhage ; Diabetes mellitus
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We report bilateral oedema and haemorrhagic transformation in the basal ganglia of a 59-year old woman with severe diabetic ketoacidosis. Lack of cerebral vascular autoregulation, followed by blood-brain barrier disruption due to the so-called breakthrough mechanism is presumed to be the cause.
    Type of Medium: Electronic Resource
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