V Jevtic

University of Ljubljana, Lubliano, Ljubljana, Slovenia

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Publications (30)60.63 Total impact

  • Mitja Rupreht · Vladimir Jevtič · Igor Serša · Matjaž Vogrin · Marko Jevšek
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    ABSTRACT: Purpose: To evaluate effect of platelet-rich plasma gel (PRPG), locally administered during the anterior cruciate ligament (ACL) reconstruction, with two MRI methods. The proximal tibial tunnel was assessed with diffusion weighted imaging (DWI) and with dynamic contrast-enhanced imaging (DCE-MRI). Materials and methods: In 50 patients, standard arthroscopic ACL reconstructions were performed. The patients in the PRPG group (n = 25) received a local application of PRPG. The proximal tibial tunnel was examined by DWI and DCE-MRI, which were used to calculate apparent diffusion coefficient (ADC) values, as well as the contrast enhancement gradient (G(enh)) and enhancement factor (F(enh)) values. Results: At 1 month, the calculated average ADC value in the PRPG group was significantly lower than in the control group. At 2.5 and at 6 months, G(enh) was significantly higher in the PRPG group. There were no significant differences in F(enh) between the groups at any control examination. Conclusion: DWI and DCE-MRI measurements indicate a reduced extent of edema during the first postoperative month as well as an increased vascular density and microvessel permeability in the proximal tibial tunnel at 1 and 2.5 postoperative months as the effect of the application of PRPG.
    No preview · Article · Apr 2013 · Journal of Magnetic Resonance Imaging
  • V Jevtic · G Lingg
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    ABSTRACT: The 2 major and clinically most important primary inflammatory rheumatic diseases which affect small hand and feet joints are rheumatoid arthritis (RA) and psoriatic arthritis (PsA). The most important initial histopathological feature of RA is synovitis followed by chronic proliferative granulomatous pannus-tissue, which is associated with cartilage and bone destruction. Early inflammatory changes in RA also develop synchronously within the subchondral bone marrow. Enthesitis is the hallmark of SNSA, and is often seen as one of the first radiological manifestations of the diseases. As a rule inflammation within the synovial joints, histologically similar to RA, is not so pronounced. Consequently destructive changes within the synovial joints are much less with the exception of PsA in which pronounced bone destruction may develop (arthritis mutilans). Considerable overlapping in clinical and morphological manifestation of RA and PsA may be present. For evaluation of hand and feet joints and surrounding soft tissue structures in RA and PsA different imaging modalities are used, which include projection radiography, ultrasonography (US), radionuclide techniques and magnetic resonance imaging (MRI). MRI has become the imaging modality of choice for evaluation of arthritis, when conventional radiography is not conclusive.
    No preview · Article · Jun 2012 · Handchirurgie · Mikrochirurgie · Plastische Chirurgie
  • M Jeromel · V Jevtič · I Serša · A Ambrožič · M Tomšič
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    ABSTRACT: To test the feasibility of dynamic contrast enhanced (DCEI) and diffusion weighted (DWI) magnetic resonance imaging (MRI) for quantifying synovitis of the cranio-cervical (C-C) region in patients with early rheumatoid arthritis (RA) and neck pain at the beginning and at a six month follow up. 27 patients with duration of RA of less than 24 months and neck pain were studied with standard qualitative MRI evaluation and two quantitative MRI methods (DCEI and DWI) at the level of atlantoaxial joints. Rate of early enhancement (REE), enhancement gradient (Genh) and apparent diffusion coefficient (ADC) were extracted from DCEI and DWI data. MRI was coupled with clinical assessment and radiographic imaging. Using standard qualitative MRI evaluation, unequivocal active synovitis (grade 2 or 3 contrast enhancement) was proved in 16 (59%) patients at baseline and 14 (54%) at follow up. DCEI and DWI measurements confirmed active synovitis in 25 (93%) patients at baseline and 24 (92%) at follow up. Average REE, Genh and ADC values decreased during follow up, however the difference was not statistically significant (p>0.05). Both qualitative and quantitative MRI methods confirmed active inflammatory disease in the C-C region following therapy although all clinical criteria showed signs of improvement of the peripheral disease. The study proved the feasibility of DCEI and DWI MRI for quantifying synovitis of the C-C region in patients with early RA and neck pain. Both techniques can be used as additional method for evaluation of synovitis of the C-C region in RA.
    No preview · Article · May 2012 · European journal of radiology
  • G. Lingg · V. Jevtic

    No preview · Article · Apr 2012 · Aktuelle Rheumatologie
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    ABSTRACT: The aim of the study was to evaluate the feasibility of two quantitative MRI methods: diffusion weighted imaging (DWI) and dynamic contrast enhanced imaging (DCEI), for follow-up assessment of the tibial tunnel after reconstruction of the anterior cruciate ligament (ACL). MATHERIALS AND METHODS: Twenty-three patients were examined by MRI at 1 and 6 months following ACL reconstruction. DWI and DCEI were utilized for evaluating the region of interest (ROI) within the proximal part of the tibial tunnel. From the resulting apparent diffusion coefficient (ADC) maps, ADC values were calculated. DCEI data were used to extract the enhancement factor (f(enh)) and the enhancement gradient (g(enh)) for the same ROI. Calculated ADC as well as the f(enh) and g(enh) had diminished to a statistically significant extent by 6 months after ACL reconstruction. The average ADC value diminished from 1.48 (10(-3) mm(2)/s) at 1 month to 1.30 (10(-3) mm(2)/s) at 6 months after reconstruction. The average f(enh) value decreased from 1.21 at 1 month to 0.50 at 6 months and the average g(enh) value decreased from 2.01%/s to 1.15%/s at 6 months, respectively. The study proved feasibility of DWI and DCEI for quantitative assessment of the tibial tunnel at 1 and 6 months after ACL reconstruction. Both methods have the potential for use as an additional tool in the evaluation of new methods of ACL reconstruction. To our knowledge, this is the first time quantitative MRI has been used in the follow-up to the ACL graft healing process.
    No preview · Article · Aug 2011 · Skeletal Radiology
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    ABSTRACT: Since the 1990s, stent graft implantation for aortic pathology has become an alternative to extensive surgical procedures in some patients. Indeed, many patients with such pathology are now treated endovascularly. Only limited data concerning the risk of a deterministic effect during aortic stent graft implantation are available Accordingly, 179 consecutive patients treated in our institute between October 2002 and July 2008 with endovascular aortic stent grafts were included in this study. Dosimetric data (kerma area product (KAP) and cumulative dose at the interventional reference point (CD(irp))) from radiograph reports were analysed for 172 patients. On a group of 19 patients, GAFCHROMIC XR type dosimetric films were also used to verify the automatic measurements. Readings from the integrated KAP meter were found to be too high and were therefore corrected - KAP to dose area product (DAP) and CD(irp) to entrance skin dose (ESD). Median DAP was 153 Gy cm² (35-700 Gy cm²) and median ESD was 0.44 Gy (0.12-2.73 Gy). Recorded dosimetric quantities were found to be good predictors of the skin dose and highlighted 4 patients (2.3%) who received skin doses that might cause possible deterministic effects. Endovascular stent graft implantation is less invasive than a surgical procedure and is widely used; mid-term results are encouraging. In a small number of patients, deterministic effects can occur even in departments with well-trained staff. Operators should inform the patients of possible skin injury after receiving high doses of ionising radiation and proper support must be available should that occur.
    Full-text · Article · Nov 2010 · The British journal of radiology
  • N Gaspersic · I Sersa · V Jevtic · M Tomsic · S Praprotnik

    No preview · Article · Oct 2008 · Annals of the rheumatic diseases
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    ABSTRACT: The effects of different therapies on enthesitis/osteitis in active ankylosing spondylitis (AS) were evaluated by magnetic resonance imaging (MRI). The aim was to assess the role of quantitative MRI in the evaluation of AS treatment efficacy. Thirty patients with active spondylitis or bilateral sacroiliitis were selected and followed up for 1 year. Ten of the patients were treated only with non-steroidal anti-inflammatory drugs, 10 patients additionally received at baseline an intravenous pulse of glucocorticoids and 10 patients were treated with regular infusions of infliximab. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, one selected inflamed lesion was followed from baseline through control visits quantitatively by diffusion-weighted imaging (DWI) measuring the apparent diffusion coefficient (ADC) and by dynamic contrast-enhanced imaging (DCEI) with evaluation of the enhancement factor (f(enh)) and enhancement gradient (g(enh)). Clinical and quantitative MRI parameters diminished significantly with regression of the inflammatory activity. The improvement in AS was most pronounced in patients treated with infliximab; after 12 months the ADC diminished from an average of 1.31 to 0.88 x 10(-3) mm(2)/s, f(enh) from 1.85 to 0.60, and g(enh) from 3.09 to 1.40 %/s. Diffusion-weighted imaging and DCEI were shown to be effective in quantifying changes in inflammation in skeletal lesions during the treatment of AS, and could therefore be convenient for assessing treatment efficacy. To the best of our knowledge this is the first time DWI was used to evaluate the activity of skeletal inflammation in rheumatic diseases such as AS.
    No preview · Article · Mar 2008 · Skeletal Radiology
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    ABSTRACT: The aim of the study was a comparison of 2 novel macromolecular contrast agents, Gadomer-17 and Polylysine-Gd-DTPA, with commercially available Gd-DTPA in determining the quality of tumor microvasculature by dynamic contrast enhanced MRI. Three groups of 5 mice with SA-1 tumors were studied. To each group of animals one contrast agent was administered; i.e. the first group got Gd-DTPA, the second group Gadomer-17 and the third group Polylysine-Gd-DTPA. To perform dynamic contrast enhanced MRI a standard keyhole approach was used by which consecutive signal intensity change due to contrast agent accumulation in the tumor was measured. From the obtained data, tissue permeability surface area product PS and fractional blood volume BV were calculated on a pixel-by-pixel basis. PS and BV values were calculated for each contrast agent. Based on the values, contrast agents were classified according to their performance in characterizing tumor microvasculature. Results of our study suggest that Gadomer-17 and Polylysine-Gd-DTPA are significantly superior to Gd-DTPA in characterizing tumor microvasculature.
    Full-text · Article · Jan 2008 · Physica Medica
  • Irena Sedonja · Vladimir Jevtic · Metka Milcinski
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    ABSTRACT: Destructive and reconstructive processes at the reactive interface in femoral head osteonecrosis (FHO) are not well defined or predictable. The objectives of our study were to analyze scintigraphic characteristics of the reactive interface in the early stages of FHO and to assess the prognostic value of the reactive interface on scintigraphy (SC). Thirty-six hips in 27 patients (21 men, 6 women; mean age 41 years, range 20 64 years) with a final diagnosis of radiographic stage 1 (4 hips) or stage 2 FHO (32 hips) were evaluated by planar and pinhole SC. Tracer uptake at the reactive interface on pinhole SC was assessed visually. Three categories were formed: normal, moderately increased, and highly increased activities. The time to head collapse was observed. Tracer uptake at the reactive interface was more frequently increased in hips with stage 2 of the disease than in those with stage 1. In hips with the same stage of the disease, different activities were detected [stage 1 FHO: moderately increased in 1 of 4 (25%) and highly increased in 1 of 4 (25%0) hips; stage 2 FHO: moderately increased in 8 of 32 hips (25%) and highly increased in 20 of 32 (631%/) hips]. Femoral heads with highly increased activity at the reactive interface collapsed more frequently and earlier: 13/15 conservatively treated hips in stage 2 collapsed in 1-6 months, whereas no hips with normal uptake at the reactive interface collapsed in 12 months follow-up and only one of six hips with moderately increased activity collapsed after 11.5 months (P < 0.05). Our results indicate that the tracer uptake at the reactive interface can be different in the same stage of FHO. High tracer uptake at the reactive interface in the early phases of FHO seems to be a bad prognostic sign for femoral head collapse.
    No preview · Article · Jun 2007 · Annals of Nuclear Medicine
  • Vladimir Jevtic
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    ABSTRACT: Vertebral infection represents 2-4% of all cases of osteomyelitis. An increase in the incidence of pyogenic as well as granulomatous spondylitis has been noticed. Early radiological diagnosis is of great importance for prompt treatment and prevention of clinically significant consequences which include neural compromise and late spinal deformities. The most frequent causative pyogenic micro-organisms are gram-negative bacteria especially Staphylococcus aureus. An important form of nonpyogenic granulomatous infection is tuberculous spondylitis which represents the most common form of extrapulmonary tuberculosis. The routes of spinal infection include hematogenous spread, postoperative infections, direct implantation during spinal punctures and spread from a contiguous focus. The role of imaging is an early diagnosis, evaluation of extent of infection with special regard to potential neural compromise, differential diagnosis, guidance of diagnostic biopsy, planning of eventual operative procedures and assessment of therapeutic response. Imaging modalities include bone scintigraphy, radiography, CT and MRI. In practice, usually a combination of a sensitive and a specific method is utilised. The only imaging modality which combines high sensitivity with satisfactory specificity is MRI. This is the reason that MRI frequently has become the first imaging modality in clinically suspect spinal infection. The MRI is the method of choice for direct demonstration of extension of infection, especially of eventual epidural abscess or phlegmon and consecutive neural compression. Using MRI monitoring of therapeutic efficiency is possible.
    No preview · Article · Apr 2004 · European Radiology
  • V Jevtic
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    ABSTRACT: Chronic renal insufficiency, hemodialysis, peritoneal dialysis, renal transplantation and administration of different medications provoke complex biochemical disturbances of the calcium-phosphate metabolism with wide spectrum of bone and soft tissue abnormalities termed renal osteodystrophy. Clinically most important manifestation of renal bone disease includes secondary hyperparathyroidism, osteomalacia/rickets, osteoporosis, adynamic bone disease and soft tissue calcification. As a complication of long-term hemodialysis and renal transplantation amyloid deposition, destructive spondyloarthropathy, osteonecrosis, and musculoskeletal infections may occur. Due to more sophisticated diagnostic methods and more efficient treatment classical radiographic features of secondary hyperparathyroidism and osteomalacia/rickets are now less frequently seen. Radiological investigations play an important role in early diagnosis and follow-up of the renal bone disease. Although numerous new imaging modalities have been introduced in clinical practice (scintigraphy, CT, MRI, quantitative imaging), plain film radiography, especially fine quality hand radiograph, still represents most widely used examination.
    No preview · Article · Jun 2003 · European Journal of Radiology
  • V. Jevtic

    No preview · Article · May 2003 · European Journal of Radiology
  • V. Jevtic
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    ABSTRACT: Magnetic resonance imaging (MRI) is not only an excellent imaging modality for the demonstration of morphological changes but is also capable of providing pathophysiological and pathoanatomic information about various spinal diseases. Different techniques offer opportunities to demonstrate the degree of water content, the vascularity of tissue components, the accumulation of fat, and new bone production. Thus MRI closely reflects the initial phase as well as the progression of pathoanatomic changes during the evolution of a disease. Due to the high sensitivity of MRI, abnormalities are often established at an early stage of discovertebral disease, when etiological diagnosis may be difficult. The specificity of MRI findings lags behind its sensitivity; similar changes can be demonstrated in etiologically different disease entities, which reflects the limited reactive possibilities of the osteoarticular system. In fact, the MRI morphological and signal intensity features of different discovertebral lesions are commonly determined more by their location and by the reactive capabilities of disc and bone than by their etiology. Early and exact MRI differentiation of various discovertebral lesions is of the utmost clinical importance for prompt institution of appropriate therapy.
    No preview · Article · Jun 2001 · European Radiology
  • V Jevtic
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    ABSTRACT: Magnetic resonance imaging (MRI) is not only an excellent imaging modality for the demonstration of morphological changes but is also capable of providing pathophysiological and pathoanatomic information about various spinal diseases. Different techniques offer opportunities to demonstrate the degree of water content, the vascularity of tissue components, the accumulation of fat, and new bone production. Thus MRI closely reflects the initial phase as well as the progression of pathoanatomic changes during the evolution of a disease. Due to the high sensitivity of MRI, abnormalities are often established at an early stage of discovertebral disease, when etiological diagnosis may be difficult. The specificity of MRI findings lags behind its sensitivity; similar changes can be demonstrated in etiologically different disease entities, which reflects the limited reactive possibilities of the osteoarticular system. In fact, the MRI morphological and signal intensity features of different discovertebral lesions are commonly determined more by their location and by the reactive capabilities of disc and bone than by their etiology. Early and exact MRI differentiation of various discovertebral lesions is of the utmost clinical importance for prompt institution of appropriate therapy.
    No preview · Article · Feb 2001 · European Radiology
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    ABSTRACT: Background. A rapid mapping technique derived from dynamic contrast enhanced MRI data was used to identify and characterize reduction of blood flow in fibrosarcoma SA-1 tumors treated either by application of electric pulses or vinblastine. Materials and methods. Tissue permeability surface area product (PS) and fractional blood volume (BV) were calculated on a pixel-by-pixel basis using dynamic MRI intensity data after administration of gadomer-17 or polylysine-Gd-DTPA; prototypic macromolecular contrast agents designed for blood pool enhance-ment. PS and BV values of untreated tumors were compared to those of tumors treated by local application of 8 electric pulses (amplitude/distance ratio, 1300 V/cm; duration, 100 ms, frequency, 1 Hz) percutaneo-usly to the tumor or by systemic administration of vinblastine (2.5 mg/kg). Results. Both treatments transiently, but significantly reduced tumor blood flow, application of electric pul-ses to the tumors being by 40% more effective in reducing tumor blood flow than systemic administration of vinblastine. PS and BV values derived with polylysine-Gd-DTPA-enhanced MRI were lower compared to those with gadomer-17, due to larger molecular size. Interestingly, Gd-DTPA-enhanced MRI did not show any significant changes of PS and BV between untreated and treated tumors. Conclusion. This study demonstrates that dynamic contrast enhanced MRI can be effectively used to qua-litatively monitor tumor blood flow, and quantitatively by means of BV and PS.
    Full-text · Article · Jan 2001
  • G. Lingg · V. Jevtic · M. Schacherl

    No preview · Article · Aug 2000 · Aktuelle Rheumatologie
  • V Jevtic · M Kos-Golja · B Rozman · I McCall
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    ABSTRACT: To assess the value of Gd-DTPA magnetic resonance (MR) imaging in the demonstration of marginal destructive discovertebral Romanus lesions in ankylosing spondylitis. A prospective study of Gd-DTPA MR imaging was performed in 39 patients with a clinical diagnosis of ankylosing spondylitis and typical Romanus lesions seen on radiographs of the thoracolumbar spine. MR morphological appearances and signal intensity changes at the discovertebral junctions were analysed and compared with the radiographic findings. Ninety-nine discovertebral junctions with Romanus lesions showed low signal intensity on T1-weighted and high signal on T2-weighted and T1-weighted postcontrast images at the vertebral corners consistent with oedematous hyperaemic inflammatory tissue. There were nine discovertebral junctions with similar MR findings but normal radiographs. Fifty-three discovertebral junctions showed syndesmophyte formation with increased signal intensity on both T1- and T2-weighted images with no contrast enhancement. Sixty-five discovertebral junctions showed a mixture of radiographic features and varied high and low signal changes at the vertebral rim on MR imaging with rims of enhancement in the vertebral body following contrast administration. Gd-DTPA MR imaging demonstrates a variable signal pattern and degree of contrast enhancement which may reflect the evolutionary stages of discovertebral enthesitis in ankylosing spondylitis. MR imaging may identify early erosive changes in radiographically normal vertebra. The role of MR imaging needs further investigation.
    No preview · Article · Feb 2000 · Skeletal Radiology
  • G. Lingg · V. Jevtic · M. Schacherl
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    ABSTRACT: In Psoriatic Arthritis and Spondarthritis plain film radiography will remain the leading imaging procedure in the next years on the one hand as a basic investigation, and on the other hand as a procedure for evaluation of the progressing of the disease. Especially for the joints plain Xray film provides many advantages because of its low cost and its allover availability. Only for very special questions, the much more expensive MRI will be used. Concerning the S1-joints in young patients with relatively new disease, MRI is the method of choice. High-resolution-computed-Tomography is very capable of showing discrete changes in cortical structures - complementary to MR. So in not so young patients with a history of the disease for some years HR-CT can show the inflammatory destructions and early signs of ancylosis better than MRI. In the lumbar spine and thoracic spine MRI and HR-CT provide important information, which surpass those of plain film radiography.
    No preview · Article · Jan 2000 · Aktuelle Rheumatologie
  • J Lamovec · M Spiler · V Jevtic
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    ABSTRACT: We present a case of osteosarcoma arising in an osteochondroma of the right fibula in a 30-year-old woman. The available radiographic studies of the lesion were not suggestive of malignant transformation. The lesion and underlying bone were excised. Histologic examination showed a conventional high-grade osteoblastic osteosarcoma that focally eroded the fibrocartilaginous cap. The patient received postoperative chemotherapy and shows no evidence of disease 27 months following operation. The occurrence of osteosarcoma in an osteochondroma is an extremely rare event, and only a few cases are on record in the literature.
    No preview · Article · Oct 1999 · Archives of pathology & laboratory medicine

Publication Stats

533 Citations
60.63 Total Impact Points

Institutions

  • 1999-2013
    • University of Ljubljana
      • • Faculty of Medicine
      • • Department of Radiology
      Lubliano, Ljubljana, Slovenia
  • 2001-2008
    • Slovenia Medical
      Maribor, Maribor, Slovenia
  • 1995-2007
    • Ljubljana University Medical Centre
      • • Clinical Institute of Radiology
      • • Department of Rheumatology
      Lubliano, Ljubljana, Slovenia