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ABSTRACT: Computed tomography pulmonary angiography (CTPA) has evolved as the gold standard for diagnosing pulmonary embolism. However, subsegmental arteries are often not assessed to do insufficient attenuation.
To evaluate the influence of simultaneous bilateral versus unilateral injection of a fixed amount of contrast media on pulmonary artery opacification and image quality in CTPA.
In this institutional review board-approved prospective study, 180 patients (91 women, mean age 61.9 ± 16.5 years) referred for CTPA (100 kV) due to suspected pulmonary embolism were randomized in groups of 45 patients each, with either unilateral (A:4 mL/s; B:6 mL/s) or bilateral (C: 6 mL/s; D: 8 mL/s) (Y-shaped line) injection of 50 mL contrast media. Attenuation was assessed including the subsegmental arteries (4th order). Image quality was evaluated by two readers in consensus using a three-point grading scale (3 = excellent image quality, no artifacts, 1 = non-diagnostic).
Mean pulmonary artery attenuation was significantly higher with bilateral injection (1st to 3rd order: A: 303.6 ± 8.8HU; B: 371.1 ± 11.0HU vs. C: 443.2 ± 24.1HU; D: 562.3 ± 15.3HU, P < 0.001). Evaluation of subsegmental arteries was feasible for all patients in groups B-D, but only in 36/45 (80%) patients in group A. Subsegmental attenuation was significantly higher with bilateral injection (A: 284.7 ± 12.1HU; B: 367.4 ± 12.1HU vs. C: 494.2 ± 21.5HU; D: 562.3 ± 26.7HU, P < 0.001). Image quality was diagnostic for all patients but best for group C (A: 2.15 ± 0.4; B: 2.14 ± 0.5; C: 2.92 ± 0.3, and D: 2.51 ± 0.5).
Using the same amount of contrast media, bilateral injection yields higher pulmonary artery attenuation and better image quality than unilateral injection. This technique may improve subsegmental pulmonary artery assessment.
Acta Radiologica 12/2011; 53(1):69-75. · 1.37 Impact Factor
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ABSTRACT: To evaluate the diagnostic value of T2-weighted radial MR imaging for the detection of superficial cranial arteries' inflammatory involvement in patients with giant cell arteritis (GCA).
Forty-three patients with suspected giant cell arteritis underwent 3 Tesla (T) high-field MRI. T2-weighted inversion recovery (IR) fast spin echo images with radial sampling (BLADE-technique) were acquired and compared with postcontrast T1-weighted spin echo images.
T2-weighted images revealed mural edema in the superficial cranial arteries in 11 patients in concordance with severe inflammatory contrast enhancement in T1-weighted images (grade 4 in a 4-point ranking scale). Excellent correlation (r = 0.82; P < 0.001) of measured wall thickness in T1- and T2-weighted images was achieved.
The results of this study indicate the potential of radial T2 weighted imaging for a first detection of inflammatory changes in the small superficial cranial arteries without the need for contrast medium. Future studies are needed to evaluate the influence of spatial resolution of the T2 images and to improve the detection of moderate GCA related changes in vessel inflammation.
Journal of Magnetic Resonance Imaging 02/2010; 31(2):470-4. · 2.70 Impact Factor
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ABSTRACT: Quantitative analysis of left-ventricular (LV) aneurysms after myocardial infarction is prognostically relevant and assists in planning surgery. Three-dimensional (3D) echocardiography facilitates clear visualization of cardiac anatomy and accurate assessment of functional parameters. The aim of the present study was to determine the ability of 3D echocardiography to quantify LV aneurysms.
Ten patients with a known LV-aneurysm after myocardial infarction underwent 3D echocardiography and cardiac magnetic resonance (CMR) imaging at 1.5 Tesla within 3 days. For 3D echocardiography, a multiplanar transesophageal examination was performed with full LV coverage and the 3D dataset was analyzed offline. The LV-aneurysm was defined by a wall thickness <5 mm. The following quantitative parameters were determined: left ventricular end-diastolic and end-systolic volumes, LV myocardial mass (LV-mass) and mass of the LV-aneurysm. LV ejection fraction and percentage of aneurysm mass (%-aneurysm) were calculated.
LV volumes and ejection fraction showed a strong correlation between 3D echocardiography and CMR (r = 0.94-0.97; P < 0.01). Importantly, the mass and percentage of mass of the LV-aneurysm demonstrated a high correlation as well (r = 0.94 and r = 0.86, respectively; P < 0.01). For all parameters, the calculated bias between both methods was found to be minimal (0.8-7.6%).
Three-dimensional echocardiography proved to be a reliable tool for quantitative analysis of LV volumes, ejection fraction and aneurysm size in patients with prior myocardial infarction. In addition, 3D visualization of the complex cardiac anatomy in patients with LV-aneurysm may assist surgical procedure planning.
Echocardiography 09/2009; 27(1):64-8. · 1.24 Impact Factor
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ABSTRACT: To assess a novel magnetic resonance imaging (MRI) protocol for quantifying the optic nerve diameter (OND) as a measure of axonal loss in the optic nerve.
Included in the study was one eye each from 47 subjects, of whom 9 had no eye disease, 16 had preperimetric glaucoma, 11 had a glaucomatous mean visual field defect of <10 dB and 11 of >10 dB. Each subject underwent automated perimetry, scanning laser polarimetry, optic coherence tomography, scanning laser tomography, and ultrafast high-resolution MRI at 3 T. OND was determined 5, 10, and 15 mm behind the eye with a half Fourier-acquired single-shot turbo spin-echo (HASTE)-sequence requiring 1.5 seconds of data acquisition time per slice and providing a spatial resolution of 0.11 mm. A multiple linear regression model was applied to determine correlations (r) among the different techniques.
The correlation (r) was <0.37 for OND measurements taken 5 mm behind the eye. At 10 mm behind the eye, r increased to 0.57 and was statistically significant in four out six instances. In the orbital apex 15 mm behind the eye, r reached a maximum of 0.80 and was statistically significant in all instances. OND correlated best with the retinal nerve fiber layer thickness measured by optic coherence tomography.
Retina- or optic nerve head-related surrogate markers for axonal content correlated closely with the OND, although only when it was measured in the orbital apex. High-resolution MRI using an ultrafast HASTE-sequence at 3 T proved useful for OND quantification and may be a valuable asset in future neuroprotection trials.
Investigative ophthalmology & visual science 04/2009; 50(9):4223-8. · 3.43 Impact Factor
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ABSTRACT: There is much experience with intoxication by aspiration of volatile hydrocarbon products, whereas intravenous injection of these distillates is rare. There are only few reports that describe a wide variety of associated pathological changes, predominantly in the pulmonary system.
We report the case of an intravenous self-injection of gasoline by a young man in a suicide attempt.
Immediately after injecting gasoline, the 22-year-old man developed bradycardia, hypotension, and increasing dyspnea. Computed tomography scan of the chest showed signs consistent with diffuse alveolar-toxic damage to the lung. These symptoms and radiological findings are similar to those commonly observed after inhalation of this type of substance. This may have been due to diffusion of gasoline into the alveoli, where its presence leads to this characteristic damage. In this patient, gasoline entered the intramuscular tissue, and the patient developed a soft-tissue phlegmon at the forearm. At operation, gas emanation and superficial necrosis were noted. Nevertheless, the patient's outcome was good, with full recovery within 3 weeks.
The major changes in this patient after intravenous injection of gasoline were in the pulmonary system, including hypoxemia and radiological findings that could be related to an exhalation of the volatile substance. In addition, gas in the musculature of the injection area caused a soft-tissue phlegmon.
Journal of Emergency Medicine 03/2009; 39(5):618-22. · 1.31 Impact Factor
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ABSTRACT: The number of multislice CT (MSCT) scans performed in polytraumatized children has increased rapidly. There is growing concern regarding the radiation dose in MSCT and its long-term consequences, especially in children.
To determine the effective dose to polytraumatized children who undergo whole-body MSCT.
A total of 51 traumatized children aged 0-16 years underwent a polytrauma protocol CT scan between November 2004 and August 2006 at our institution. The effective dose was calculated retrospectively by a computer program (CT-Expo 1.5, Hannover, Germany).
The mean effective dose was 20.8 mSv (range 8.6-48.9 mSv, SD +/- 7.9 mSv). There was no statistically significant difference in the effective dose between male and female patients.
Whole-body MSCT is a superior diagnostic tool in polytraumatized children with 20.8 mSv per patient being a justified mean effective dose. In a potentially life-threatening situation whole-body MSCT provides the clinicians with relevant information to initiate life-saving therapy. Radiologists should use special paediatric protocols that include dose-saving mechanisms to keep the effective dose as low as possible. Further studies are needed to examine and advance dose-saving strategies in MSCT, especially in children.
Pediatric Radiology 02/2009; 39(3):245-52. · 1.67 Impact Factor
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ABSTRACT: Ultrasonography, MRI, and PET are increasingly studied in large-vessel vasculitis. They have broadened our knowledge on these disorders and have a place in the diagnostic approach of these patients.
Temporal artery ultrasonography can be used to guide the surgeon to that artery segment with the clearest 'halo' sign to perform a biopsy, or in experienced hands can even replace biopsy. The distal subclavian, axillary, and brachial arteries can also be examined. High-resolution MRI depicts superficial cranial and extracranial involvement patterns in giant cell arteritis (GCA). Contrast enhancement is prominent in active inflammation and decreases under successful steroid therapy. Presence of aortic complications such as aneurysm or dissection can be ruled out within the same investigation. Large thoracic vessel FDG-uptake is seen in the majority of patients with GCA, especially at the subclavian arteries and the aorta. FDG-PET cannot predict which patients are bound to relapse, and once steroids are started, interpretation is hazardous, which makes its role in follow-up uncertain. Increased thoracic aortic FDG-uptake at diagnosis of GCA may be a bad prognostic factor for later aortic dilatation. In patients with isolated polymyalgia rheumatica - who have less intense vascular FDG uptake - symptoms are caused by inflammation around the shoulders, hips, and spine.
Ultrasonography, MRI, and PET remain promising techniques in the scientific and clinical approach of large-vessel vasculitis.
Current opinion in rheumatology 02/2009; 21(1):19-28. · 4.60 Impact Factor
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ABSTRACT: In this study, minimally invasive CurvTek refixation is introduced as a novel approach for repair of distal biceps tendon ruptures. Exploration at the radial tuberosity is minimized using CurvTek, thereby reducing operative trauma. Treatment outcomes were compared for this technique against the conventional technique. In addition, we introduce position-dependent isometric myometry to allow quantitative measures of post-operative strength at specific elbow joint positions, for improved comparative analyses.
Eighteen patients were included in this study and the mean follow-up was 17.6 months (range 6-35, SD +/- 6.9). Nine patients underwent conventional anatomical refixation, while the remaining nine patients underwent anatomical refixation using CurvTek-sutures. Clinical results and position-dependent strength were compared.
Mean age was 49.8 years (range 38-61; SD +/- 5.8). The average EFA-score was 82.2 (range 61-97; SD +/- 9.8). The CurvTek group scored a mean 87.0 (range 77-97; SD +/- 7.0) and the conventional anatomical refixation group a mean 77.4 (range 61-93; SD +/- 10.2) (P = 0.091). Position-dependent dynamic myometry revealed a loss of strength at end stage flexion and supination in the injured arm. Comparison of the two groups, revealed a statistically significant improvement in relative supination strength in the maximally supinated position for patients of the CurvTek group over those undergoing conventional refixation (P = 0.009).
Our results show that the CurvTek system leads to good post-operative strength and ROM without increasing the complication rate.
Archives of Orthopaedic and Trauma Surgery 07/2008; 128(6):573-81. · 1.37 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the diagnostic value of MRI and (18)FDG-PET in bone marrow infiltration of the spine due to metastases of solid tumours and lymphoma in cancer patients. In 35 cancer patients (solid tumours n = 26, lymphoma n = 9) MRI of the spine and (18)FDG-PET were reviewed and the detectability of metastases, infiltration of the spine, extent of disease, and therapeutic implications were compared. In 8/35 cases (23%) imaging technique showed concordantly no bone marrow infiltration. In 19/35 patients (54%), both MRI and (18)FDG-PET revealed bone marrow infiltration of the axial skeleton. In 12/19 patients (63%), MRI showed more extensive disease which lead to subsequent therapy. The imaging findings of MRI and (18)FDG-PET were discordant in 8/35 cases (23%). (18)FDG-PET was false positive in two patients. In six patients, (18)FDG-PET failed to detect bone metastases and bone marrow infiltration of the spine, which was detected by MRI and proven by clinical follow-up with subsequent therapy in two cases. MRI is more sensitive and specific than (18)FDG-PET detecting bone marrow metastases and infiltration of the spine and has a great impact in staging cancer patients.
European Spine Journal 11/2007; 16(11):1907-12. · 1.97 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the diagnostic value of MRI and 18FDG-PET in bone marrow infiltration of the spine due to metastases of solid tumours and lymphoma in cancer patients. In 35
cancer patients (solid tumours n=26, lymphoma n=9) MRI of the spine and 18FDG-PET were reviewed and the detectability of metastases, infiltration of the spine, extent of disease, and therapeutic implications
were compared. In 8/35 cases (23%) imaging technique showed concordantly no bone marrow infiltration. In 19/35 patients (54%),
both MRI and 18FDG-PET revealed bone marrow infiltration of the axial skeleton. In 12/19 patients (63%), MRI showed more extensive disease
which lead to subsequent therapy. The imaging findings of MRI and 18FDG-PET were discordant in 8/35 cases (23%). 18FDG-PET was false positive in two patients. In six patients, 18FDG-PET failed to detect bone metastases and bone marrow infiltration of the spine, which was detected by MRI and proven by
clinical follow-up with subsequent therapy in two cases. MRI is more sensitive and specific than 18FDG-PET detecting bone marrow metastases and infiltration of the spine and has a great impact in staging cancer patients.
European Spine Journal 10/2007; 16(11):1907-1912. · 1.97 Impact Factor
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ABSTRACT: BACKGROUND: Due to the complex embryologic development, pancreatic anatomy can be very variable. DISCUSSION: The authors present the second ever reported case in the literature of a complete pancreatic encasement of the portal vein which forced us to alter the standard operative procedure of pancreatic head resection, thus enabling possible dangerous complications.
Langenbeck s Archives of Surgery 08/2007; 392(4):489-91. · 1.81 Impact Factor
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ABSTRACT: Evaluation of MRI-findings in patients with involvement of psoriatic arthritis (PsA) in small joints in hands and feet. Twenty-five patients with symptomatic joint involvement were studied by MRI. All patients were found to be positive for one or more imaging criteria. Soft tissue oedema was identified in 22/25 (88%) patients. Joint effusion was observed in 23/25 (92%) patients, whereas bone erosion was seen in 20/25 (80%) patients. Bone marrow oedema was evident in 21/25 (84%) cases. In 12/25 (48%) cases, bone proliferation was noted. Tendon sheath effusion was present in 17/25 (68%) patients. Contrast enhancement of the synovia was detected in all patients (n = 25) (100%), whereas adjacent periost was enhanced in 22/25 (88%) and epiphysial bone marrow in 18/25 (72%) patients. MRI allows the assessment of PsA-alterations of soft tissue, cartilage, bone, bone marrow, and adjacent tendon sheath in patients with hand and foot involvement.
Rheumatology International 03/2007; 27(4):387-93. · 1.88 Impact Factor
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ABSTRACT: During successful chemotherapy of osteosarcomas tumour size does not diminish significantly because the therapy has limited impact on the mineralized matrix of the tumour. Treatment response is considered successful if, histologically, more than 90% of tumour cells show necrosis.
To determine if osteosarcomas change their water diffusion during preoperative chemotherapy in relation to the amount of tumour necrosis.
Eight patients (age 11-19 years) with histologically proven limb osteosarcoma underwent T1-weighted, fat-suppressed T2-weighted and contrast-enhanced T1-weighted spin-echo imaging together with diffusion-weighted EPI sequences (b = 700) at 1.5 T before and after five cycles of standard chemotherapy. Tumour volume and apparent diffusion coefficient (ADC) maps were calculated before and after chemotherapy. The degree of tumour necrosis after chemotherapy was assessed using the histological Salzer-Kuntschik classification (grades 1-6).
During chemotherapy, the ADC values of osteosarcomas changed significantly. The ADC of untreated tumour was 2.1 +/- 0.4 x 10(-3) mm(2)/s (mean +/- SD) (95% CI 1.6-2.0). The ADC of chemotherapy-treated sarcomas was 2.5 +/- 0.4 x 10(-3) mm(2)/s (95% CI 1.8-2.2). Necrotic areas, which were confirmed by macroscopic examination, showed ADC values up to 2.7 x 10(-3) mm(2)/s. Four patients with little viable tumour tissue within the neoplasm (Salzer-Kuntschik grades 1-2) had an increase in ADC of 0.4 up to 0.7 x 10(-3) mm(2)/s. Four patients with larger areas of viable tumour (Salzer-Kuntschik grade 4) showed a lesser increase in ADC of 0.0 up to 0.3 x 10(-3) mm(2)/s. The differences in ADC values in tumour tissue before and after chemotherapy were highly significant (P = 0.01).
During chemotherapy of osteosarcomas, tumour ADC changes are related to the degree of tumour necrosis.
Pediatric Radiology 01/2007; 36(12):1306-11. · 1.67 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the diagnostic accuracy in the assessment of coronary artery bypass grafts using 64-slice computed tomography (CT) technology.
CT coronary angiography was performed for 96 bypasses in 31 patients with suspected coronary artery disease using a Siemens Sensation 64-slice CT-scanner and compared with invasive coronary angiography (ICA). Patients with an irregular or fast heart rate despite beta-blocker administration were not excluded from the study. All bypass grafts and 94% of the distal bypass anastomoses could be visualized by CT, non-evaluable distal arterial anastomoses were either due to clip material or calcification artefacts. Forty-two bypass graft occlusions and three significant stenoses were detected by CT and confirmed by ICA. Two venous grafts were missed and one arterial graft was not evaluable with ICA, but both were clearly depicted by multi-slice CT. One false negative and two false positive CT-findings resulted in a sensitivity of 97.8%, a specificity of 89.3%, a positive predictive value of 90%, and a negative predictive value of 97.7%.
State-of-the-art 64-slice CT coronary angiography demonstrates high diagnostic accuracy in the assessment of arterial and venous bypass graft stenoses.
European Heart Journal 05/2006; 27(8):976-80. · 10.48 Impact Factor
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ABSTRACT: Postpneumonectomy esophago-pleural fistula (EPF) is rare and potentially life-threatening. It is mainly caused by surgical injury, local cancer recurrence, and chronic inflammation or infection. Patients with postpneumonectomy EPF usually present with empyema. We report a case of a clinically asymptomatic esophago-pleural fistula, diagnosed accidentally in a 64-year-old woman more than 30 years after right lobe pneumonectomy due to tuberculosis. Contrast-enhanced CT, chest radiography, and esophagogramm were the imaging modalities used together with esophagoscopy in diagnosing the EPF; however, contrast-enhanced CT in combination with oral given contrast-media is the first imaging technique of choice to evaluate esophago-pleural fistula.
Journal of Thoracic Imaging 09/2005; 20(3):223-5. · 0.98 Impact Factor
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ABSTRACT: Sclerosing mesenteritis is a rare, usually benign disorder of the mesentery. Depending on the predominant tissue component (inflammation, fat, or fibrosis), it is known as mesenteric panniculitis or retractile mesenteritis. We present a rare case of retractile mesenteritis of the mesocolon as a cause of severe abdominal pain. US, CT, and MRI were the imaging modalities used. We emphasize the MR finding of a fibrous capsula in retractile mesenteritis, as this is to our knowledge the first study to describe this entity. This finding may be valuable for establishing a diagnosis of sclerosing mesenteritis, as well as for differentiating this disease from other mesenteric diseases.
Journal of Magnetic Resonance Imaging 06/2005; 21(5):632-6. · 2.70 Impact Factor
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ABSTRACT: Adrenal gland tumors are often incidental findings during imaging of the upper abdomen. In the majority of cases, benign adrenal gland tumors, especially nonfunctioning adenomas, are diagnosed, although the evaluation of dignity is essential in order to avoid unnecessary biopsy and tumor extirpation. Lipid-containing adrenocortical adenomas and nonadenomas can be differentiated with high diagnostic accuracy and specificity by computed tomography (CT) and magnetic resonance imaging (MRI). The fat content of these lesions can be correlated with CT attenuation values or with signal decrease in chemical shift imaging in MRI. Furthermore, low-fat adenomas can be distinguished from nonadenomas with delayed contrast enhancement and washout characterization. For the differentiation of non-fat-containing nonadenomas (metastases, lymphoma, pheochromocytoma, and inflammatory processes), morphological imaging criteria in CT and MRI (signal alterations, contrast media enhancement), clinical signs and laboratory test are essential in order to establish the diagnosis. The localization of functioning adenomas can be easily performed with CT and MRI. Both imaging techniques reveal typical findings of lesions-like cysts and myelolipomas.
Medizinische Klinik 09/2004; 99(8):447-52. · 0.34 Impact Factor
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ABSTRACT: Raumforderungen der Nebennieren sind hufige Zufallsbefunde (Inzidentalome)
im Rahmen der Oberbauchdiagnostik. Da es sich berwiegend um benigne
Tumoren, vor allem um nicht endokrin aktive Adenome handelt, ist eine
Dignittsbeurteilung erforderlich, um eine groe Anzahl unntiger Biopsien
oder Exstirpationen zu vermeidenDie Differenzierung fetthaltiger adrenokortikaler Adenome von anderen
Raumforderungen (Nichtadenome) ist mit groer Genauigkeit und Spezifitt
mit der Computertomographie (CT) und der Magnetresonanztomographie
(MRT) mglich, da der Fettgehalt dieser Lsionen mit der im CT gemessenen
Dichte (CT-Densitometrie) und dem Signalabfall in der chemischen Verschiebungs-
MRT (chemical shift imaging [CSI]) korreliert.Neuere Ergebnisse weisen darauf hin, dass auch fettarme Adenome mit Sptkontrast–CT und Berechnung von Kontrastmittelauswaschraten von Nichtadenomen
unterschieden werden knnen. Die weitere Differenzierung der
kein Fett enthaltenden Nichtadenome (Metastasen, Lymphom, Phochromozytom,
Entzndungen) erfordert erweiterte bildmorphologische (Signalintensitten,
Kontrastmittelkinetiken) und klinisch–laborchemische Kriterien.Die Lokalisation klinisch und laborchemisch vermuteter endokrin aktiver
Nebennierenlsionen gelingt mit CT und MRT. Wegweisend sind beide Verfahren
bei Zysten und Myelolipomen.
Adrenal gland tumors are often incidental findings during imaging of
the upper abdomen. In the majority of cases, benign adrenal gland tumors,
especially nonfunctioning adenomas, are diagnosed, although the evaluation
of dignity is essential in order to avoid unnecessary biopsy and tumor extirpation.Lipid–containing adrenocortical adenomas and nonadenomas can be differentiated
with high diagnostic accuracy and specificity by computed tomography
(CT) and magnetic resonance imaging (MRI). The fat content of these lesions
can be correlated with CT attenuation values or with signal decrease in
chemical shift imaging in MRI.Furthermore, low-fat adenomas can be distinguished from nonadenomas
with delayed contrast enhancement and washout characterization. For the differentiation
of non–fat–containing nonadenomas (metastases, lymphoma,
pheochromocytoma, and inflammatory processes), morphological imaging criteria
in CT and MRI (signal alterations, contrast media enhancement), clinical
signs and laboratory test are essential in order to establish the diagnosis.The localization of functioning adenomas can be easily performed with CT
and MRI. Both imaging techniques reveal typical findings of lesions–like cysts
and myelolipomas.
07/2004; 99(8):447-452.
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ABSTRACT: A rare case of an ectopic thyroid gland in the porta hepatis and in the tongue in an asymptomatic euthyroid 24-year-old woman is reported. A solitary inhomogeneous, hypoechogenic and hyperechogenic mass in the porta hepatis was accidentally discovered by ultrasonography. Subsequent computed tomography demonstrated a heterogeneous, well-defined tumor with small calcifications without signs of environmental invasion. A hemangioma and focal nodular hyperplasia were excluded by blood pool and hepatobiliary scintigraphy. Surprisingly, fine-needle aspiration cytology revealed normal thyroid tissue. (123)I-scintigraphy confirmed the presence of ectopic dual thyroid tissue in the hepatic porta and lingua. At clinical inspection the lingual thyroid gland was palpable and visible, and appeared solid and spheroidal. The subhepatic, ectopic thyroid mass was resected. Postoperatively, thyroid hormone replacement was started to prevent an enlargement of the lingual thyroid. Today, 4 years after surgery, the patient remains euthyroid.
Thyroid 06/2003; 13(5):503-7. · 4.79 Impact Factor
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ABSTRACT: The purpose of our study was to investigate whether cardiovascular magnetic resonance imaging can detect early myocardial tissue edema as a first step in the development of myocarditis.
We examined 36 consecutive patients who were presented with symptoms of fatigue, weakness, and/or palpitations after respiratory tract infection but normal left ventricular function and compared these patients with 21 consecutive controls without acute symptoms. Electrocardiogram-triggered, T2-weighted, fast spin echo triple-inversion recovery sequences were performed in all patients.
We found a significant difference between patients with suspected myocarditis and controls in global myocardial signal intensity. The ratio of global myocardial signal intensity/muscle signal intensity was 2.4 +/- 0.3 in patients and 1.9 +/- 0.3 in controls, which was highly significant (P < 0.001).
Patients with symptoms of fatigue, weakness, and/or palpitations after respiratory tract infection showed an elevated signal intensity of the myocardium, indicating edematous tissue, which may be the first step in the development of myocarditis.
Journal of computer assisted tomography 33(1):15-9. · 1.38 Impact Factor
