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  • ANGIOGRAPHY  (7)
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  • 1
    Keywords: Diagnostic Imaging ; radiology ; MULTISLICE CT ; imaging ; CT ; CT ANGIOGRAPHY ; ANGIOGRAPHY ; arteries
    Type of Publication: Book chapter
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  • 2
    Keywords: CANCER ; INVASION ; tumor ; carcinoma ; evaluation ; Germany ; CT ; DIAGNOSIS ; FOLLOW-UP ; SPIRAL CT ; TOOL ; DISEASE ; TUMORS ; computed tomography ; RESOLUTION ; PATIENT ; primary ; NO ; METASTASIS ; adenocarcinoma ; COMPUTED-TOMOGRAPHY ; sensitivity ; specificity ; VESSELS ; QUESTIONNAIRE ; pancreatic carcinoma ; HELICAL CT ; HYDRO-CT ; methods ; ROW CT ; CURVED PLANAR REFORMATIONS ; invasion score ; MULTISLICE SPIRAL CT ; resectability ; VASCULAR INVASION
    Abstract: Objective: It was the aim of this study to evaluate a new infiltration score to determine the resectability of pancreatic carcinomas in preoperative planning. Materials and Methods: Eighty patients with suspected pancreatic tumor were examined prospectively using 16-row spiral CT. The scans were evaluated for the presence of pancreatic carcinoma, peripancreatic tumor extension and vascular invasion using a standardized questionnaire. Invasion of the surgically relevant vessels was evaluated using a new invasion score. The operative and histological findings and the clinical follow-up served as the gold standard. Results: Forty patients had a pancreatic carcinoma, 5 had metastasis of a different primary tumor, and in 35 patients, there was no malignant pancreatic disease. The sensitivity for tumor detection was 100%, with a specificity of 88% for differentiating between malignant and benign pancreatic tumors. Invasion of the surrounding vessels was evaluated correctly using the invasion score, with a sensitivity of 89% and a specificity of 99%. In evaluation of resectability, a sensitivity of 94% and a specificity of 89% were achieved. Conclusion: Using 16-row spiral CT, the invasion score is a valid tool for correctly assessing invasion in relevant vessels in cases of pancreatic carcinoma and for determining resectability. Copyright (C) 2008 S. Karger AG, Basel and IAP
    Type of Publication: Journal article published
    PubMed ID: 18434758
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  • 3
    Keywords: computed tomography ; ANGIOGRAPHY ; ABDOMINAL-AORTA ; Aorta ; Aortic pathologies ; COMPUTED-TOMOGRAPHY AN
    Abstract: Current imaging of the aorta saw an improvement in terms of diversity and quality in recent years. In addition to verifying and documenting a clinical suspicion, it provides the basis for establishing an indication, choosing a therapy (conservative, surgical, interventional), as well as therapy planning and follow-up. Besides B-mode and duplex sonography, as well as transesophageal echocardiography (TEE), contrast-enhanced cross-sectional imaging, computer tomography (CT), with the option for CT angiography (CTA), and magnetic resonance tomography (MRT), with the option for MR angiography (MRA), play a significant role. The present article describes the possibilities offered by CTA and MRA for the diagnosis of aortic pathologies from the point of view of the radiologist in a maximum care hospital
    Type of Publication: Journal article published
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  • 4
    Keywords: Germany ; chest ; CT ; SYSTEM ; TOOL ; DEATH ; DISEASE ; MORTALITY ; RISK ; SURGERY ; PATIENT ; INJURIES ; MECHANISM ; IMPACT ; CONTRAST ; mechanisms ; treatment ; EXPERIENCE ; DISRUPTION ; REPAIR ; REGION ; ANGIOGRAPHY ; MANAGEMENT ; THORACIC AORTA ; HEIGHT ; wound ; STABILIZATION ; endovascular ; Cause of Death ; BLUNT ; DELAYED TREATMENT ; intracranial ; RUPTURE
    Abstract: Acute traumatic aortic tear (ATAT) is the second most common cause of deaths in trauma patients (about 8,000 deaths/year in the USA). Due to circumferential aortic disruption, up to 90% die at the scene. Responsible trauma mechanisms are: penetrating (gunshot/stab wounds), iatrogenic (interventional catheterization) and, most frequently, blunt chest trauma (high-speed motor vehicles, falls from heights, crushes, explosions) resulting in injury at the aortic isthmus region (loco typico, about 90%). Severe multiple system injuries (polytrauma), especially to intracranial and intraabdominal organs, are characteristic and prognostically predicitive. Immediate transthoracic open repair of ATAT has a mortality risk of 8% to 33% and paraplegia risk of 2% to 26%. Contrast enhanced CT scan has replaced the classical angiography as the diagnostic tool of choice. Patients with life-threatening multisystem injuries are scheduled for delayed repair after initial stabilization. Currently, the use of endovascular stent-grafts (EVAR) is being investigated. Our personal series confirms that EVAR for ATAT is a viable alternative to open repair while minimizing the morbidity and mortality of the open procedure and having a limited impact on trauma destabilization. The assessment of long-term durability of EVAR is one of the key issues to consider EVAR as the first choice of treatment
    Type of Publication: Journal article published
    PubMed ID: 16533692
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  • 5
    Keywords: ANGIOGENESIS ; CANCER ; SURVIVAL ; tumor ; Germany ; THERAPY ; DENSITY ; DIAGNOSIS ; imaging ; liver ; NEW-YORK ; SAMPLE ; SAMPLES ; TISSUE ; TUMORS ; NUCLEAR-MEDICINE ; PATIENT ; BIOMARKERS ; TISSUES ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; BREAST ; immunohistochemistry ; REGION ; REGIONS ; MUSCLE ; PARAMETERS ; NORMAL TISSUE ; SERIES ; CONTRAST-ENHANCED MRI ; nuclear medicine ; ASBESTOS ; mesothelioma ; MALIGNANT MESOTHELIOMA ; LUNG-CARCINOMA ; HETEROGENEITY ; radiology ; RE ; THERAPIES ; monitoring ; dynamic contrast enhanced MRI ; biomarker ; analysis ; methods ; SUBTYPES ; NUCLEAR ; USA ; correlation ; spleen ; Aorta ; microvascular density ; MEDICINE ; quantitative ; PHARMACOKINETIC ANALYSIS ; DCE-MRI ; neoplasm ; CD-34 ; IMAGING BIOMARKER
    Abstract: Rationale and Objectives. Malignant mesothelioma (MM) of the pleura is an aggressive and often fatal neoplasm. Because MM frequently demonstrates marked angiogenesis, it may be responsive to antiangiogenic therapy, but effective methods for selecting and monitoring of patients are further needed. We employed dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and quantitative immunohistochemistry (IHC) to characterize the microvascularity of MM using both a physiologic and ultrastructural method. Materials and Methods. Nineteen patients diagnosed with MM were enrolled and DCE-MRI was performed before antiangiogenic treatment. For each patient, tumor regions were characterized by their DCE-MRI-derived pharmacokinetic parameters (Amp, k(ep), k(el)), which were also compared to those of normal tissue (aorta, liver, spleen, and muscle). In addition, quantitative ITIC of representative samples was performed with CD-34 staining to compare the calculated microvessel density (MVD) results with DCE-MRI results. Results. MM demonstrated markedly abnormal pharmacokinetic properties compared with normal tissues. Among the parameters tested, Amp was significantly different in MM (P :5.001) compared to normal organs. Despite the observation that the MVD of mesotheliomas in this series was high compared to other tumors, DCE-MRI pharmacokinetic parameters had a moderately positive correlation with MVD (r = 0.5). Conclusions. DCE-MRI and IHC can be used in patients with MM to visualize tumor microvascularity and to characterize tumor heterogeneity. DCE-MRI and IHC results positively correlated, though moderately, but these two methods present as essential tumor biomarkers. This multimodal characterization may be useful in selecting possible tumor subtypes that would benefit from antiangiogenic therapy
    Type of Publication: Journal article published
    PubMed ID: 18423312
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  • 6
    Keywords: MODEL ; VISUALIZATION ; DISEASE ; BLOOD-FLOW ; MAGNETIC-RESONANCE ; magnetic resonance imaging ; SURVEILLANCE ; ANGIOGRAPHY ; endovascular repair ; endovascular ; ANEURYSM REPAIR ; Aorta ; stent graft ; phase-contrast flow ; blood flow velocity
    Abstract: PURPOSE: To validate flow measurements within an aortic nickel-titanium (nitinol) stent graft using velocity-encoded cine magnetic resonance imaging (VEC MRI) and to assess intraobserver agreement of repeated flow measurements. MATERIALS AND METHODS: An elastic tube phantom mimicking the descending aorta was developed with the possibility to insert an aortic nitinol stent graft. Different flow patterns (constant, sinusoidal and pulsatile aortic flow) were applied by a gear pump. A two-dimensional phase-contrast sequence was used to acquire VEC perpendicular cross-sections at six equidistant levels along the phantom. Each acquisition was performed twice with and without stent graft, and each dataset was analysed twice by the same reader. The percental difference of the measured flow volume to the gold standard (pump setting) was defined as the parameter for accuracy. Furthermore, the intraobserver agreement was assessed. RESULTS: Mean accuracy of flow volume measurements was -0.45+/- 1.63% without stent graft and -0.18+/- 1.45% with stent graft. Slightly lower accuracy was obtained for aortic flow both without (-2.31%) and with (-1.29%) stent graft. Accuracy was neither influenced by the measurement position nor by repeated acquisitions. There was significant intraobserver agreement with an intraclass correlation coefficient of 0.87 (without stent graft, p〈0.001) and 0.80 (with stent graft, p〈0.001). The coefficient of variance was 0.25% without stent graft and 0.28% with stent graft. CONCLUSION: This study demonstrated high accuracy and excellent intraobserver agreement of flow measurements within an aortic nitinol stent graft using VEC MRI. VEC MRI may give new insights into the haemodynamic consequences of endovascular aortic repair.
    Type of Publication: Journal article published
    PubMed ID: 20888719
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  • 7
    Keywords: POPULATION ; magnetic resonance imaging ; AGE ; NECK ; COMPUTED-TOMOGRAPHY ; ANGIOGRAPHY ; physiology ; CONFORMATIONAL-CHANGES ; THORACIC AORTA ; endovascular repair ; endovascular ; ANEURYSMS ; stent graft ; ARTERIAL STIFFNESS ; WAVE REFLECTION
    Abstract: PURPOSE: To test our hypothesis that distension and displacement in various segments of the healthy thoracic aorta are significant and can be predicted based on clinical characteristics. MATERIALS AND METHODS: Sixty-one Caucasian volunteers without cardiovascular disease (49 +/- 16 years, range 19-82; 28 men, 33 women) divided into two age groups (A: 〈50, B: 〉/= 50 years) underwent 1.5-T MRI. ECG-gated dynamic data sets were acquired at five locations perpendicular to the thoracic aorta. Aortic distension and Centre of Mass (CoM) displacement were determined as percentages of diastolic aortic diameter. A multiple linear regression model including age group, gender, location, mean arterial blood pressure, heart rate and body mass index was tested. RESULTS: Mean aortic distension averaged over all locations was 11.2 +/- 4.1% (age group A) and 6.7 +/- 3.3% (age group B), mean displacement 15.1 +/- 8.3% (A) and 11.0 +/- 6.2% (B). Systolic and diastolic aortic diameter and CoM position significantly differed at all locations (p〈0.001). Distension and displacement could be predicted based on the regression model (p〈0.001). Age group A and women exhibited significantly greater distension and displacement compared to age group B (p〈0.001) and men (p〈0.01), respectively. Distension increased, displacement decreased from proximal to distal. CONCLUSION: Distension and translational displacement are significant at all levels of the thoracic aorta and can be predicted based on clinical characteristics.
    Type of Publication: Journal article published
    PubMed ID: 20850234
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  • 8
    Keywords: Germany ; COMMON ; CT ; DIAGNOSIS ; FOLLOW-UP ; imaging ; DISEASE ; MORTALITY ; NEW-YORK ; ACCURACY ; computed tomography ; NUCLEAR-MEDICINE ; PATIENT ; REPAIR ; EFFICIENT ; tomography ; COMPUTED-TOMOGRAPHY ; sensitivity ; specificity ; CT ANGIOGRAPHY ; ANGIOGRAPHY ; ARTERY ; nuclear medicine ; DISSECTION ; radiology ; HIGH-RESOLUTION ; THORACIC AORTA ; MORBIDITY ; PRINCIPLES ; NUCLEAR ; USA ; aneurysm ; Aorta ; MEDICINE ; NOV ; medical imaging ; ANEURYSMS ; German ; aortic dissection ; aortic disease ; INTRAMURAL HEMATOMA ; MULTIDETECTOR-ROW CT ; multisclice computed tomography (MSCT)
    Abstract: Aortic disease is associated with high morbidity and mortality and thus require an efficient and accurate diagnostic approach, especially in the acute setting. Multislice computed tomography (MSCT) with the option of high-resolution CT angiography (CTA) has emerged as the standard of reference in diagnosis and follow-up of patients with acquired aortic disease. Aortic dissection is the most common aortic emergency, but it remains undiscovered in up to 38% of cases. Sensitivity and specificity of MSCT in the assessment of aortic dissection are greater than 99%. The sensitivity of CT in the detection of inflammatory changes is 83%; its specificity is almost 100%; and its diagnostic accuracy is ca. 94%. This article outlines state-of-the-art principles in diagnostic CT imaging of acquired aortic disease
    Type of Publication: Journal article published
    PubMed ID: 17938873
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  • 9
    Keywords: ANGIOGRAPHY ; ORIGIN ; RENAL-ARTERIES ; DISSECTIONS ; REPLACEMENT ; ATRIAL-FIBRILLATION ; BRANCHED STENT-GRAFT ; ANEURYSMS ; CTA
    Abstract: PURPOSE: To evaluate whether quantitative characterization of aortic arch geometry including its branches is feasible based on in vivo computed tomography (CT) angiography and magnetic resonance (MR) angiography data in healthy and diseased aortic arches. MATERIALS AND METHODS: Ten healthy volunteers, 10 patients with abdominal aortic disease, and 10 patients with aortic arch disease underwent MR angiography (10 volunteers) or CT angiography (20 patients). Commercial software was used for individual segmentation of supraaortic arteries. In-house software was developed for segmentation of aortic arch landmarks based on standardized multiplanar reformations (MPRs) and for subsequent aortic arch mapping. RESULTS: Supraaortic arteries and aortic arch landmarks were successfully segmented in all 30 subjects for CT angiography and MR angiography data. Significant tapering within the first centimeter was observed in all supraaortic arteries (P 〈 .001). The three supraaortic arteries showed significantly different vessel diameters and areas (P 〈 .001). The software developed in-house allowed detailed aortic arch mapping with quantitative definitions of the positional relationships between each supraaortic artery and the aorta. Distances between supraaortic arteries were less than 5 mm in 77.6% (mean 4.1 mm +/- 3.8). The brachiocephalic trunk tended to be positioned on the right side of the aortic arch, and the left subclavian and left common carotid arteries tended to be positioned on the left side of the aortic arch. CONCLUSIONS: The feasibility and application of a postprocessing method allowing quantification of geometry of supraaortic arteries and aortic arch mapping were successfully demonstrated. Validation and evaluation of clinical implications are warranted
    Type of Publication: Journal article published
    PubMed ID: 21459612
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  • 10
    Keywords: ANGIOGENESIS ; SURVIVAL ; tumor ; CELL LUNG-CANCER ; ENDOTHELIAL GROWTH-FACTOR ; IN-VIVO ; MODEL ; THERAPY ; VIVO ; DIAGNOSIS ; FOLLOW-UP ; TISSUE ; TUMORS ; PATIENT ; MRI ; BIOLOGY ; CYCLE ; treatment ; BREAST ; MALIGNANCIES ; METASTASIS ; chemotherapy ; REGION ; REGIONS ; PARAMETERS ; POSITRON-EMISSION-TOMOGRAPHY ; BENIGN ; Jun ; COMPUTED-TOMOGRAPHY ; CONTRAST-ENHANCED MRI ; TUMOR ANGIOGENESIS ; PLEURAL MESOTHELIOMA ; FEASIBILITY ; ELIMINATION ; MANAGEMENT ; MALIGNANCY ; GEMCITABINE ; malignant pleural mesothelioma ; SOLID TUMORS ; dynamic contrast enhanced MRI ; FACTOR EXPRESSION ; MAP ; in vivo ; PREDICTOR ; VARIETIES ; kinetic parameters ; dCE MRI ; PHARMACOKINETIC PARAMETERS ; therapy monitoring ; two-compartment model
    Abstract: Study objective: Dynamic contrast-enhanced MRI (DCE-MRI) followed by pharmacokinetic analysis has been successfully used in a variety of solid tumors. The aims of this study were to evaluate the feasibility of DCE-MRI in malignant pleural mesothelioma (MPM), to differentiate benign from pathologic tissue and compare pharmacokinetic with clinical parameters and survival in order to map out its microcirculation; and to compare pharmacokinetic with clinical parameter and survival in order to improve our understanding of the in vivo biology of this malignancy. Methods: Nineteen patients with a diagnosis of MPM who were scheduled to receive chemotherapy with gemcitabine were enrolled in the study. DCE-MRI was performed before treatment (n = 19) and after the third cycle (n = 12) and sixth cycle (n = 7) of chemotherapy. An established pharmacokinetic two-compartment model was used to analyze DCE-MRI. Tumor regions were characterized by the pharmacokinetic parameters amplitude (Amp), redistribution rate constant (kep), and elimination rate constant (kel). Kinetic parameters of tumor tissue and normal tissue were compared using the Student t test. Patients were classified as clinical responders or nonresponders according to clinical outcome, and these groups were compared with the pharmacokinetic parameters derived from DCE-MRI. Results: Normal and tumor tissue could be distinguished by the pharmacokinetic parameters Amp and kel (p 〈= 0.001). Clinical responders had a median kep value within the tumor of 2.6 min, while nonresponders showed a higher value (3.6 min), which coincided with longer survival (780 days vs 460 days). Conclusions: DCE-MRI can be used in patients with MPM to assess tumor microvascular properties and to demonstrate tumor heterogeneity for therapy monitoring. High pretherapeutic values of kep within the tumor correlated with a poor overall response to therapy
    Type of Publication: Journal article published
    PubMed ID: 16778277
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