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MRI versus 64-row MDCT for diagnosis of hepatocellular carcinoma

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World Journal of Gastroenterology 2009年第48期15卷 6044-6051页

作者： michael Bernhard Pitton Roman Kloeckner Sascha Herber Gerd Otto Karl Friedrich Kreitner Christoph Dueber Department of Diagnostic and Interventional Radiology Johannes Gutenberg-University Department of Transplantation and Hepatobili-opancreatic Surgery University of Mainz

AIM： To compare the diagnostic capability of multidetector computed tomography （MDCT） and magnetic resonance imaging （MRI） for the detection of hepatocellular carcinoma （HCC） tumour nodules and their effect on patient management. METHODS： A total of 28 patients （25 male, 3 female, mean age 67 ± 10.8 years） with biopsy-proven HCC were investigated with 64-row MDCT （slice 3 mm native, arterial and portal-venous phase, 120 mL Iomeprol, 4 mL/s, delay by bolus trigger） and MRI （Tlfs fl2d TE/ TR 2.72/129 ms, T2tse TE/TR 102/4000 ms, 5-phase dynamic contrast-enhanced Tlfs fl3d TE/TR 1.56/4.6, Gadolinium-DTPA, slice 4 mm）. Consensus reading of both modalities was used as reference. Tumour nodules were analyzed with respect to number, size, and location. RESULTS： In total, 162 tumour nodules were detected by consensus reading. MRI detected significantly more tumour nodules （159 vs 123, P 〈 0.001） compared to MDCT, with the best sensitivity for early arterial phase MRI. False-negative CT findings included nodules ≤ 5 mm （n = 5）, ≤ 10 mm （n = 17）, ≤ 15 mm （n= 12）,≤20mm（n=4）,andlnodule〉*** missed 2 nodules ≤ 10 mm and 1 nodule ≤ 15 mm. On MRI, nodule diameters were greater than on CT （29.2 ≤25.1 mm, range 5-140 mm vs 24.1 ± 22.7 mm, range 4-129 mm, P 〈 0.005）. In 2 patients, MDCT showed only unilobar tumour spread, whereas MRI revealed additional nodules in the contralateral lobe. Detection of these nodules could have changed the therapeutic strategy. CONCLUSION： Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC nodules. Patients should be allocated to interventional or operative treatment according to a dedicated MRI-protocol.

关键词： American Association for the Study of Liver Diseases European Association for the Study of the Liver Hepatocellular carcinoma Multidetector computed tomography Magnetic resonance imaging

MR-arterioportography: A new technical approach for detection of liver lesions

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World Journal of Gastroenterology 2011年第13期17卷 1739-1745页

作者： Janine Rennert Ernst-michael Jung Andreas G Schreyer Patrick Hoffstetter Peter Heiss Stefan Feuerbach Niels Zorger Department of Radiology Regensburg University School of Medicine D-93053 Regensburg Germany

AIM: To evaluate the benefit and effectiveness of MRarterioportography (MR-AP) to achieve the highest sensitivity for detection and evaluation of hepatocellular carcinoma (HCC). METHODS: Twenty liver cirrhosis patients with suspected HCC were included before transarterial chemoembolization. In all patients double-enhanced Magnetic resonance imaging (MRI) was performed. A bolus of 10 mL Magnevist was injected through a selectively placed catheter in the superior mesenteric artery and MRI of the liver was performed in arterioportographic phase. Two independent readers evaluated number, size and localization of detected lesions. Diagnostic quality was determined using a 4-point scale. Differences were analyzed for significance using a t -test. Interobserver variability was calculated. RESULTS: In all 20 patients (100%), MR-AP was feasible. Diagnostic quality was, in all cases, between 1 and2 for both modalities and readers. MR-AP detected significantly more lesions than double-enhanced MRI (102.5 vs 61, respectively, P < 0.0024). The inter-observer variability was 0.881 for MRI and 0.903 for MR-AP. CONCLUSION: Our study confirmed that the MR-AP as an additional modality for detection of HCC is beneficial, as significantly more lesions were detected compared to MRI with liver-specific contrast.

关键词： MR-arterioportography Magnetic resonance imaging Hepatocellular carcinoma Liver lesions

Efficacy and safety of single-bolus tenecteplase compared with front-loaded alteplase in Chinese patients with acute myocardial infarction

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Journal of Geriatric Cardiology 2007年第3期4卷 142-143页

作者： Yuri B. Pride C. michael Gibson Department of Medicine Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA Division of Cardiology Department of MedicineBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA

　　Following ST-segment elevation myocardial infarction(STEMI), early and complete epicardial reperfusion is associated with improved survival.……

关键词： STEMI Efficacy and safety of single-bolus tenecteplase compared with front-loaded alteplase in Chinese patients with acute myocardial infarction

Peripheral leukocyte and endometrium molecular biomarkers of inflammation and oxidative stress are altered in peripartal dairy cows supplemented with Zn,Mn,and Cu from amino acid complexes and Co from Co glucoheptonate

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Journal of Animal Science and Biotechnology 2017年第4期8卷 885-896页

作者： Fernanda Batistel Johan S.Osorio Muhammad Rizwan Tariq Cong Li Jessica Caputo michael T.Socha Juan J.Loor Department of Animal Sciences and Division of Nutritional Sciences University of Illinois1207 West Gregory DriveUrbanaIL 61801USA Department of Dairy Science South Dakota State UniversityBrookingsSDUSA. Department of Food Science and Technology University College of Agriculture&Environmental SciencesThe Islamia University of BahawalpurBahawalpurPunjabPakistan College of Animal Science and Technology Key Laboratory of Animal Genetics and Breeding of Ministry of AgricultureNational Engineering Laboratory for Animal BreedingChina Agricultural UniversityBeijing 100193China Zinpro Corporation Eden PrairieMNUSA

Background: Immune dysfunction and a higher risk of uterine infections are characteristics of the transition into lactation in dairy cows. The supply of complexed trace minerals, which are more bioavailable, could help overcome the greater needs of these nutrients in tissues around parturition and early ***: Twenty Holstein cows received an oral bolus with a mix of inorganic trace minerals(INO) or complexed trace minerals(AAC) to achieve 75, 65, 11, and 1 ppm supplemental Zn, Mn, Cu, and Co, respectively, in the total diet dry matter from -30 d through +30 d relative to parturition. Blood for polymorphonuclear leukocyte(PMNL) isolation was collected at-30,-15, +10, and + 30 d relative to parturition, whereas endometrium biopsies were performed at +14 and +30 d. Feeding AAC led to greater PMNL expression of genes related with inflammation response(DDX58), oxidative stress response(MPO), eicosanoid metabolism(PLA2G4A and ALOX5AP), transcription regulation(PPARG), and cellular adhesion(TLN1). The upregulation by AAC in endometrium of genes related with inflammation response( TLR2, TLR4, NFKB1, TNF, IL6, IL1 B, IL10, IL8), prostaglandin synthesis(PTGS2, PTGES), and antioxidant responses(NFE2 L2, SOD1) indicated a faster remodeling of uterine tissue and potentially greater capacity to control a local bacterial ***: Data indicate that trace mineral supplementation from amino acid complexes improves PMNL activity and allows the prompt recovery of uterine tissue during early lactation. As such, the benefits of complexed trace minerals extend beyond an improvement of liver function and productive performance.

关键词： Inflammation Oxidative stress Trace minerals Transition period

Current hurdles in the management of eosinophilic oesophagitis:The next steps

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World Journal of Gastroenterology 2013年第6期19卷 790-796页

作者： Stephen EA Attwood michael SJ Wilson Department of General Surgery North Tyneside HospitalRake LaneNorth ShieldsTyne and Wear NE29 8NHUnited Kingdom

Eosinophilic oesophagitis (EoE) is a chronic,antigen mediated disease of the disease of the oesophagus that may present in both adults and *** is characterised by intermittent dysphagia,food bolus obstruction and weight *** pathogenesis is incompletely understood but is thought to culminate in poor compliance,or reduced *** condition is being reported and studied in the literature with increasing incidence,although equally it is highly likely that the diagnosis is being missed altogether with alarming *** of the condition requires at least one oesophageal biopsy with an eosinophil count greater than 15 per high power *** features include trachealisation,furrows,white exudate,narrowing and in the most severe cases stricture formation although none are pathognomonic of the *** is often not required,but in the acute setting may take the form of dietary therapy or topical *** term maintenance therapy is usually only required in the most severe cases and the most effective treatment is the subject of ongoing *** are a number of hurdles to be overcome in the management of patients with *** include;improving our understanding of the aetiologyof the condition,investigating the individual causes,assessing the true disease severity and planning the best long term maintenance *** EoE from EoE gastro-oesophageal reflux disease is also a hurdle because the two conditions,both being common,can *** order to overcome these hurdles,a multifaceted approach is *** management of food bolus obstruction requires a management algorithm that is accepted and endorsed by a number of *** and international disease registers should be established in order to facilitate future research but more importantly to address areas where further education or increased diagnostic capabilities may be *** of disease severity should become a ke

关键词： Eosinophil oesophagitis Dysphagia Food bolus obstruction Therapy Gastroscopy

Renal functional MRI in mice evaluated with a dual bolus of intravascular and diffusible contrast agents

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Journal of Biomedical Science and Engineering 2011年第4期4卷 315-319页

作者： michael Pedersen Sukru Oguz Topcu Steven Sourbron Rikke Norregaard MR Research Center University of AarhusSkejbyDenmark Institute of Clinical Medicine University of AarhusSkejbyDenmark Division of Medical Physics Leeds University HospitalLeedsGreat Britain

Background: The aim of this study was to evaluate the feasibility of a dualbolus protocol, where a first bolus of an intravascular tracer is used to measure perfusion, followed by a second bolus of a freely filtered gadolinium-containing agent to measure filtration capacity. Methods: The study was conducted in mice subjected to complete unilateral ureteral obstruction (UUO), and sham operated mice were used as controls. Dynamic contrast- en-hanced MRI was performed 2 days after surgery. Results and discussions: Mean signal-time curves of the renal cortex, renal medulla and abdominal aorta were used to calculate the relative renal blood flow (rRBF), relative renal blood volume (rRBV), mean transit time (MTT) and the glomerular transfer rate Ktrans. We demonstrated that kidneys suffering from two days of UUO showed a decrease in cortical as well as medullary rRBF compared to kidneys from sham-operated mice. Further, we found no changes in rRBV and MTT among groups, neither in the cortex nor in the medulla. The renal functional parameter Ktrans showed a tendency (but statistically insignificant) to be reduced in the ob-structed kidney compared to the sham-operated mice. Conclusions: We showed our first experiences with the consecutive use of intra- and extra-vascularly distributed agents in a renal-diseased mouse model, allowing analysis of both functional haemo- dyamics and filtration capacity in kidneys.

关键词： Renal Function Dynamic Contrast-Enhanced Magnetic Resonance Imaging Intravascular Agents Extravascular Agents

Identification of syndrome X using intravascular ultrasound imaging and Doppler flow mapping

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Chinese Medical Journal 2004年第4期117卷 521-527页

作者：钱菊英葛均波樊冰王齐兵陈灏珠 Dietrich Baumgart michael Haude Raimund Erbel Department of Cardiology Zhongshan Hospital Department of Cardiology

Background The purpose of this study was to assess the morphological changes and physiological function of coronary arteries in patients presenting with chest pain but having normal coronary angiograms, using intravascular ultrasound imaging (IVUS) and intracoronary Doppler (ICD) flow measurements, in order to elucidate the mechanism of syndrome X. Methods A total of 126 patients [67 males, 59 females, mean age (53.1±13.0) years] who experienced chest pain but had normal coronary angiograms were included in this study. ICD flow measurements of the left anterior descending coronary artery (LAD) were performed using a Cardiometrics FloMap Ⅱ system. Coronary flow velocity reserve (CFVR) was defined as the ratio of the average peak velocity during hyperemia to that at baseline, induced by an intracoronary bolus injection of 18 μg adenosine. A 3.2F or 2.9F 30 MHz mechanical rotating ultrasound catheter (CVIS, Boston Scientific) or a 3.0F 20MHz electronic ultrasound catheter (Endosonics) was used for IVUS. Results The mean CFVR value of the LAD was 2.71±0.74. Reduction of CFVR (<3.0) was found in 82 of 126 (65.1%) patients. IVUS images of the LAD were available for 109 patients. Plaque formation was detected in 76/109 (69.7%) patients. Based on the presence or absence of plaque formation as well as the reduction or non-reduction of CFVR, patients were divided into four groups: Group Ⅰ (n=10), normal IVUS findings and normal CFVR; Group Ⅱ (n=23), normal IVUS findings with reduction in CFVR; Group Ⅲ (n=29), IVUS evidence of plaque formation but normal CFVR; and Group Ⅳ (n=47), IVUS evidence of plaque formation with reduction in CFVR. Conclusion This study shows the important clinical value of a combination of IVUS and ICD in diagnosing patients with angiographically normal coronary arteries. Only 10% of patients studied (Group Ⅰ) were found to be truly free of coronary disease, while 20% of patients (Group Ⅱ) would be diagnosed as suffering from syndrome X.

关键词： coronary angiography Doppler ultrasound syndrome X

抗血栓药蕲蛇酶对高血糖大鼠脑中动脉缺血/再灌注后脑损伤的改善作用

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海峡药学 2009年第12期21卷 8-15页

作者：魏京娜王晴川刘广芬 Edward L.Ezeli michael J Quast Texas大学医学分校海洋生物医学研究所神经科学和细胞生物学系福建医科大学蛇毒研究所福州350004 Texas大学医学分校人类生化和基因西利结构生物学研究中心

目的应用核磁共振成像(MRI)技术,观察蕲蛇酶(Acutobin)对高血糖大鼠脑损伤体积和灌注不足的影响。方法在高血糖大鼠右脑中动脉阻塞/再灌注(MCAO/R)的动物模型上,在MCAO60min和再灌注后24h各静注***-1体重蕲蛇酶1次,在MCAO/R前和后,连续... 详细信息

目的应用核磁共振成像(MRI)技术,观察蕲蛇酶(Acutobin)对高血糖大鼠脑损伤体积和灌注不足的影响。方法在高血糖大鼠右脑中动脉阻塞/再灌注(MCAO/R)的动物模型上,在MCAO60min和再灌注后24h各静注***-1体重蕲蛇酶1次,在MCAO/R前和后,连续检测记录多断层扩散加权成像(multslice diffusion weighted imaging,DWI)和单一断层动态快速注射轨迹梯度回波成像(single slice dynamic bolus tracking gradien echo imaging,GE)。结果蕲蛇酶治疗组DWI所检测的损伤体积,在再灌注后明显减少(P<0.05),右脑半球脑血流残留量(residual CBF)明显增多,动物死亡率明显降低。结论蕲蛇酶能改善高血糖大鼠MCAO/R模型脑组织的灌流,减少梗塞面积,降低死亡率。

关键词：脑缺血蕲蛇酶溶栓性去纤剂核磁共振成像高血糖

开放式肩袖修复术后0．2％与0．3％的罗哌卡因行连续肌间沟镇痛对手术后镇痛和运动功能影响的比较

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麻醉与镇痛 2012年第3期8卷 18-22页

作者： Alain Borgeat, MD Jose Aguirre, MD michael Marquardt, MD Jelena Mrdjen, MD Stephan Blumenthal, MD 马宵雯(译) 杭燕南(校) Department of Anesthesiology Orthopedic University Clinic Zurich Balgrist Switzerland 不详

背景肌间沟镇痛是一种公认的肩部大手术的术后镇痛方法，但最有效的局麻药浓度仍有争议。本研究比较术后48小时肌间沟导管连续输注0．2％和0．3％的罗哌卡因的镇痛效果及不良反应。方法80例择期开放肩袖修复术患者随机分入两组中，通过... 详细信息

背景肌间沟镇痛是一种公认的肩部大手术的术后镇痛方法，但最有效的局麻药浓度仍有争议。本研究比较术后48小时肌间沟导管连续输注0．2％和0．3％的罗哌卡因的镇痛效果及不良反应。方法80例择期开放肩袖修复术患者随机分入两组中，通过肌间沟导管以14ml／h速率连续输注0．2％或0．3％罗哌卡因，所有患者术前给予0．5％的罗哌卡因40ml作为负荷量。由对分组盲态的麻醉医师进行疼痛评分（视觉模拟评分0-100）、运动阻滞强度、术后首夜睡眠质量、吗啡用量和患者满意度等方面的评估。结果0．3％罗哌卡因组中吗啡用量明显减少（12mg和30mg）、睡眠质量更佳（术后首夜觉醒率4％和27％），握力、视觉模拟评分以及不良反应两组间相似。结论开放式肩袖手术术后48小时，通过肌间沟导管输注0．3％罗哌卡因不增加运动阻滞强度和不良反应，且吗啡用量明显减少，术后首夜睡眠质量改善。

关键词：手术后镇痛罗哌卡因修复术后肌间沟开放式运动功能肩袖视觉模拟评分