- [Show abstract] [Hide abstract] ABSTRACT: PURPOSE To compare DIC-CT and MRCP in imaging the biliary system, we carried out a prospective study. METHOD AND MATERIALS Patients with suspected biliary disease and no history of allergy to contrast media entered the study. Between May 2003 and March 2004, both DIC-CT and MRCP were performed consecutively in 54 patients (32 men and 22 women; mean age: 66 years). Among them, 36 patients proved to have cholelithiasis. After drip infusion of 100 ml meglumine iotroxate, DIC-CT was performed using a 16-section multi-detector row CT. One-mm interval images were reformatted from the raw data. Thereafter, multi-plannar reconstruction (MPR) and volume rendering (VR) images were obtained from the reformatted images. The reformatted, MPR and VR images were reviewed. MRCP was performed using a 1.5-T MR imaging unit after administration of ferric ammonium citrate dissolved in 50 ml of water. Images were obtained in a coronal respiratory-triggered 3D heavily T2-weighted (T2W) fast spin-echo (FSE) sequence with 1.3-mm slice thickness, a 2D breath-hold single-shot FSE (SSFSE) rapid acquisition with relaxation enhancement (RARE) sequence, and a coronal T2W SSFSE sequence. The 3D FSE images (source images), maximum intensity projection (MIP) images obtained from the source images, RARE images, and coronal T2W images were reviewed. Image quality was assessed with regard to depiction of the common bile duct, cystic duct and gallbladder, and was classified as clearly visible, visible but unclear, or undetectable. RESULTS The cystic duct and common bile duct were clearly visible in more than 90% of the 54 cases in all kinds of DIC-CT images, but in MRCP, the cystic duct was undetectable in 24 cases in the source images, in 29 cases in MIP images, and in 26 cases in T2W images. The gallbladder was clearly visible in 25 to 35 cases in MRCP, but in DIC-CT, it was clearly visible in only 11 to 14 cases. CONCLUSIONS DIC-CT was better than MRCP in the depiction of the cystic and common bile ducts, but MRCP appeared to better depict the gallbladder. Therefore, it was concluded that DIC-CT and MRCP should be used complementarily, depending on the disease suspected.
- [Show abstract] [Hide abstract] ABSTRACT: It is unclear whether 123I-labelled beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) myocardial scintigraphy adds further predictive value for future cardiac events compared with the variables obtained during cardiac catheterisation in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI). We therefore investigated whether 123I-BMIPP imaging in patients with AMI treated by primary PCI was useful in predicting future cardiac events. One hundred and fifty-nine patients with AMI who were treated with primary PCI and underwent left ventriculography (LVG) on admission underwent 201Tl and 123I-BMIPP myocardial scintigraphy. Scintigrams were visually classified, and the total defect score (TDS) was calculated. Major adverse cardiac events (MACE) were defined as cardiac death including sudden death, congestive heart failure and recurrence of acute coronary syndrome. Patients were followed up for a mean of 34.5 months (12-63 months). Twenty-six patients had MACE. Kaplan-Meier analysis indicated that patients with the top 50% of 123I-BMIPP TDSs had a significantly higher rate of MACE (P=0.007). Patients with mismatch between 201Tl and 123I-BMIPP images also had significantly more MACE (P=0.02). In the prediction of MACE, the global chi-square value was 5.2 (P=0.001) based on LVEF (<45%) and the number of diseased vessels (two or three). Adding 123I-BMIPP TDS and the mismatch improved the global chi-square value (chi2=7.2) Myocardial scintigraphy using 201Tl and 123I-BMIPP predicts future cardiac events in patients with AMI treated with primary PCI, and provides additional predictive value compared with the variables obtained with cardiac catheterisation alone.